St. Louis Post-Dispatch du lieu suivant : St. Louis, Missouri • Page 34

ST. LOUIS POST- DISPATCH SUNDAY, FEBRUARY 4, 1996 Sister Jane Marie Dempsey; Retired Teacher Sister Jane Marie Dempsey, for- to 1971 and again from 1977 to mer teacher and mother superior of 1983. the Sisters of the Visitation, died Sat- She later was director of the Visiurday (Feb. 3, 1996) at the Visitation tation Alumnae Association and diMonastery in Town and Country of rector of the Sodality of the Children complications from Sjogren's syn- of Mary. She retired in 1990.

drome, a disease of the mucous mem- A funeral Mass will be celebrated branes. She was 79. at 9 a.m. Tuesday in the chapel at Sister Dempsey was born and Visitation Louis. She entered the Academy, 3020 North Balgrew up in St.

las Road, Town and Country. Visitaorder of the Sisters of the Visitation in 1935 and took her final in tion will be from 4 to 8 p.m. Monday vows in the chapel at the academy. Burial 1940. She graduated from the Visitation Academy in Town and Country will be in Calvary Cemetery.

and earned a bachelor's degree in Among survivors are a sister, SisEnglish and a master's degree in Lat- ter Margaret Jane Dempsey, a Sister in, both from St. Louis University. of Mercy, of Creve Coeur; and three For 40 years, she taught elemen- brothers, John J. Dempsey of St. tary school and Latin and English in Charles, Richard B.

Dempsey of high school at Visitation Academy. Chesterfield and David G. Dempsey She was mother superior from 1965 of St. Louis. OBITUARIES Fabian L.

Sickles, 72; Longtime Owner Of Firm That Provided Legal Photography Fabian L. Sickles, a legal photogra- tles at Roi-Namui, Saipan, Tinian and pher in St. Louis for many years, died Iwo Jima. Wednesday (Jan. 31, 1996) of cancer After the war, he returned here at his home in north St.

Louis County. and started his business. He was 72. A graveside service will be 11 a.m. Since the late Monday at Jefferson Barracks Na1940s, Mr.

Sickles tional Cemetery, 101 Memorial was the owner of Drive, Lemay. Fabian L. Sickles Among the survivors are his wife, Legal Photogra- Ruth Sickles; two daughters, Mary phy, now F.L. Ann Warner of Ballwin and Martha Sickles and Sons Sickles of Maryland Heights; two which special- sons, David Sickles of St. Louis and izes in photograph- Fabian L.

Sickles II of Affton; and two ing and document- grandchildren. ing evidence for Memorial contributions may be legal proceedings. made to the American Cancer SociWhile serving in Sickles ety or to a charity of the donor's the Marines during World War II, he choice. trained as a combat photographer. He photographed the terrain and bat- The following incidents were among those that were reported to police departments in the St.

Louis metropolitan area or that involved action in one of the area's courts: VIOLENT DEATH St. Louis: Dwight Collins, 23, was fatally shot about 9 p.m. Friday at his home in the 6300 block of Labadie Avenue. A suspect was taken into custody. A second victim suffered minor wounds.

FATAL ACCIDENTS Jefferson County: Stephan Candrl, 44, of High Ridge, was killed about 1 Saturday when his 1982 pickup ran off an exit ramp in northern Jefferson County. The Missouri Highway Patrol said Candrl was getting off old Missouri 21 onto new Missouri 21 when he lost control of the pickup and it overturned. Ste. Genevieve County: James Arrington, 28, of Cheboygan, was killed about 10:15 p.m. Friday when his 1978 Ford Mustang ran off U.S.

Highway 61, about two miles south of Route O. Police said Arrington's car veered off the left side of the highway, struck an embankment and overturned. Arrington was thrown from the car. Deadline For Media Scholarship Is Nearing College students studying print or broadcast journalism, advertising or public relations have until March 29 to submit completed application forms for scholarships administered by the Journalism Foundation of Metropolitan St. Louis.

Applicants must be full-time students in the fall and have completed their freshman year by then. They may attend college anywhere but must have home addresses in St. Louis city or county, the Missouri counties of Franklin, Jefferson, Lincoln, St. Charles or Warren, or the Illinois counties of Bond, Clinton, Jersey, Madison, Monroe or St. Clair.

Last year's program awarded more than $18,000 to 17 students. Applications are available from Joe Kenny, the foundation's scholarship coordinator, in care of the St. Louis Review, 462 North Taylor Avenue, St. Louis 63108, phone (314) 531- 9700. Forum To Discuss Regional Relations The Press Club of Metropolitan St.

Louis is holding a luncheon forum to look at how St. Louis and the Metro East area can build stronger working relationships. The forum will be at noon Feb. 14 at the Collinsville Holiday Inn, 1000 Eastport Plaza Drive. James R.

Pennekamp, executive director of the Leadership Council of Southwestern Illinois, will be the guest speaker. The council aims to encourage business and job development, enhance the area's image and improve the quality of life for Madison and St. Clair county residents. Tom Dehner, associate director of community development and affordable housing for Alton, will moderate the program. Tickets are $12 for Press Club members and $15 for non-members.

To make reservations, call (314) 241-NEWS. William Alfred Stern; Volunteer, Benefactor William Alfred Stern, a former volunteer and benefactor in St. Louis, died Saturday (Feb. 3, 1996) of infirmities at Gatesworth at One McKnight Place. He was 101 and had lived in Clayton.

For many years, Mr. Stern did volunteer work and supported Jewish Hospital. He was also a patron of the Missouri Athletic Club and Temple Israel congregation. He was an avid golfer and played at the Triple A Golf Club in Forest Park until he was 90. At 89, he won a golf tournament for octogenarians at the club.

Mr. Stern was born March 22, 1894, in Pittsburgh and raised in Chicago. From 1912 to 1916, he was a runner and set records for short distance running in the Amateur Athletic Union. He served in the Army Air Forces in World War and he played baseball and ran track for military teams. He also played amateur baseball in Chicago.

He moved to St. Louis in 1954, after retiring as a buyer at a department store in Little Rock, Ark. The funeral service and burial will be private. Mr. Stern's first wife, Lois Gottlieb, died in 1946.

Among the survivors are his wife, May Popper Stern; two daughters, Joan Abrams of Frontenac and Patsy Rubin of Peoria, seven grandchildren; and 11 great-grandchildren. PEOPLE WHO HAVE HIGH BLOOD PRESSURE OR ANGINA 1 possible drug interactions which could serious side effects. See important 07 1 Cardizem CD and May Help You Live Well Cardizem CD plus CardiSense may give you Talk to your doctor or health care professional about an opportunity to lead a healthier life. Cardizem CD. Only a health care professional authorized to prescribe Cardizem CD can evaluate the potential risks Cardizem CD gives: and benefits of Cardizem CD for you.

Effective control of high blood pressure or angina for many people Call for a free brochure on high blood pressure or angina, plus one free copy of CardiSense. Once-daily dosing A free quarterly newsletter, CardiSense, with timely information on nutrition, exercise, and maintaining a healthy lifestyle. 1 8 1-800-621-5775 In clinical studies with Cardizem CD, the most common side effects, seen in less than 5.5% of patients, have been headache, of the dizziness, slow heart Cardizem rate, is irregularities, and swelling ONCE -A -DAY heartbeat ankles. CD not appropriate for all people, Make sure your health care professional knows about your especially those with certain serious heart 1 rhythm conditions. CARDIZEM CD Tell health care professional about other medications (diltiazem HCI), 190- 180-, 240-, 300-mg Capsules medical history, including heart, liver, and kidney problems.

your you are taking because of result in other potentially Brief Summary of Prescribing Information as of April 1993 CD (diltiazem HCI) Capsules CONTRAINDICATIONS CARDIZEM is contraindicated in (1) patients with sick sinus syndrome except in the presence of a functioning ventricular pacemaker, (2) patients with second- or third-degree AV block except in the presence of a functioning ventricular pacemaker, (3) patients with hypotension (less than 90 mm Hg systolic), (4) patients who have demonstrated hypersensitivity to the drug, and (5) patients with acute myocardial infarction and pulmonary congestion documented by x-ray on admission. WARNINGS 1. Cardiac Conduction. CARDIZEM prolongs AV node refractory periods without significantly prolonging sinus node recovery time, except in patients with sick sinus syndrome. This effect may rarely result in abnormally slow heart rates (particularly in patients with sick sinus syndrome) or secondor third-degree AV block (13 of 3290 patients or 0.40%).

Concomitant use of diltiazem with beta-blockers or digitalis may result in additive effects on cardiac conduction. A patient with Prinzmetal's angina developed periods of asystole (2 to 5 seconds) after a single dose of 60 mg of diltiazem. 2. Congestive Heart Failure. Although diltiazem has a negative inotropic effect in isolated animal tissue preparations, hemodynamic studies in humans with normal ventricular function have not shown a reduction in cardiac index nor consistent negative effects on contractility An acute study of oral diltiazem in patients with impaired ventricular function (ejection fraction showed improvement in indices of ventricular function without significant decrease in contractile function Worsening of congestive heart failure has been reported in patients with preexisting impairment of ventricular function.

Experience with the use of CARDIZEM (diltiazem hydrochloride) in combination with beta-blockers in patients with impaired ventricular function is limited. Caution should be exercised when using this combination. 3. Hypotension. Decreases in blood pressure associated with CARDIZEM therapy may occasionally result in symptomatic hypotension.

4. Acute Hepatic Injury. Mild elevations of transaminases with and without concomitant elevation in alkaline phosphatase and bilirubin have been observed in clinical studies. Such elevations were usually transient and frequently resolved even with continued diltiazem treatment. In rare instances, 95370701 See important additional information below.

predict the effects of concomitant treatment in patients with left ventricular dysfunction or cardiac conduction abnormalities. Administration of CARDIZEM (diltiazem hydrochloride) concomitantly with propranolol in five normal volunteers resulted in increased propranolol levels in all subjects and bioavailability of propranolol was increased approximately In vitro, propranolol appears to be displaced from its binding sites by diltiazem. If combination therapy is initiated or withdrawn in conjunction with propranolol, an adjustment in the propranolol dose may be warranted. (See WARNINGS.) Cimetidine. A study in six healthy volunteers has shown a significant increase in peak diltiazem plasma levels and area-under-the-curve after a 1-week course of cimetidine at 1200 mg per day and a single dose of diltiazem 60 mg.

Ranitidine produced smaller, nonsignificant increases. The effect may be mediated by cimetidine's known inhibition of hepatic cytochrome P-450, the enzyme system responsible for the first-pass metabolism of diltiazem. Patients currently receiving diltiazem therapy should be carefully monitored for a change in pharmacological effect when initiating and discontinuing therapy with cimetidine. An adjustment in the diltiazem dose may be warranted. Digitalis.

Administration of CARDIZEM with digoxin in 24 healthy male subjects increased plasma digoxin concentrations approximately Another investigator found no increase in digoxin levels in 12 patients with coronary artery disease. Since there have been conflicting results regarding the effect of digoxin levels, it is recommended that digoxin levels be monitored when initiating, adjusting, and discontinuing CARDIZEM therapy to avoid possible over- or under (See WARNINGS.) Aesthetics. The depression of cardiac contractility, conductivity, and automaticity as well as the vascular dilation associated with aesthetics may be potentiated by calcium channel blockers. When used concomitantly, aesthetics and calcium blockers should be titrated carefully. Cyclosporine.

A pharmacokinetic interaction between diltiazem and cyclosporine has been observed during studies involving renal and cardiac transplant patients. In renal and cardiac transplant recipients, a reduction of cyclosporine dose ranging from to was necessary to maintain cyclosporine trough concentrations similar to those seen prior to the addition of diltiazem. If these agents are to be administered concurrently, cyclosporine concentrations should be monitored, especially when diltiazem therapy is initiated, adjusted, or discontinued. The effect of cyclosporine on diltiazem plasma concentrations has not been evaluated. Carbamazepine.

Concomitant administration of diltiazem with carbamazepine has been reported to result in elevated serum levels of carbamazepine to increase), resulting in toxicity in some cases. Patients receiving these drugs concurrently should be monitored for a potential drug interaction. below. significant elevations in enzymes such as alkaline phosphatase, LDH, SGOT, SGPT, and other phenomena consistent with acute hepatic injury have been noted. These reactions tended to occur early after therapy initiation (1 to 8 weeks) and have been reversible upon discontinuation of drug therapy.

The relationship to CARDIZEM is uncertain in some cases, but probable in some. (See PRECAUTIONS.) PRECAUTIONS General CARDIZEM (diltiazem hydrochloride) is extensively metabolized by the liver and excreted by the kidneys and in bile. As with any drug given over prolonged periods, laboratory parameters of renal and hepatic function should be monitored at regular intervals. The drug should be used with caution in patients with impaired renal or hepatic function. In subacute and chronic dog and rat studies designed to produce toxicity, high doses of diltiazem were associated with hepatic damage.

In special subacute hepatic studies, oral doses of 125 and higher in rats were associated with histological changes in the liver which were reversible when the drug was discontinued. In dogs, doses of 20 were also associated with hepatic changes; however, these changes were reversible with continued dosing. Dermatological events (see ADVERSE REACTIONS section) may be transient and may disappear despite continued use of CARDIZEM. However, skin eruptions progressing to erythema multiforme exfoliative dermatitis have also been infrequently reported. Should a dermatologic reaction persist, the drug should be discontinued.

Drug Interactions Due to the potential for additive effects, caution and careful titration are warranted in patients receiving CARDIZEM concomitantly with other agents known to affect cardiac contractility conduction. (See WARNINGS.) Pharmacologic studies indicate that there may be additive effects in prolonging AV conduction when using beta-blockers or digitalis concomitantly with CARDIZEM. (See WARNINGS.) As with all drugs, care should be exercised when treating patients with multiple medications. CARDIZEM undergoes biotransformation by cytochrome P-450 mixed function oxidase. Coadministration of CARDIZEM with other agents which follow the same route of biotransformation may result in the competitive inhibition of metabolism.

Especially in patients with renal hepatic impairment, dosages of similarly metabolized drugs, particularly those of low therapeutic ratio, may require adjustment when starting or stopping concomitantly administered diltiazem to maintain optimum therapeutic blood levels. Beta-blockers. Controlled and uncontrolled domestic studies suggest that concomitant use of CARDIZEM and beta-blockers is usually well tolerated, but available data are not sufficient to Mutagenesis, Impairment of Fertility A 24-month study in rats at oral dosage levels of up to 100 and a 21-month study in mice at oral dosage levels of up to 30 showed no evidence of carcinogenicity. There was also no mutagenic response in vitro or in vivo in mammalian cell assays or in vitro in bacteria. No evidence of impaired fertility was observed in a study performed in male and female rats at oral dosages of up to 100 Pregnancy Category C.

Reproduction studies have been conducted in mice, rats, and rabbits. Administration of doses ranging from five to ten times greater (on a basis) than the daily recommended therapeutic dose has resulted in embryo and fetal lethality. These doses, in some studies, have been reported to cause skeletal abnormalities. In the studies, there was an increased incidence of stillbirths at doses of 20 times the human dose or greater. There are no well-controlled studies in pregnant women; therefore, use CARDIZEM in pregnant women only if the potential benefit justifies the potential risk to the fetus.

Nursing Mothers Diltiazem is excreted in human milk. One report suggests that concentrations in breast milk may approximate serum levels. If use of CARDIZEM is deemed essential, an alternative method of infant feeding should be instituted. Pediatric Use Safety and effectiveness in children have not been established. ADVERSE REACTIONS Serious adverse reactions have been rare in studies carried out to date, but it should be recognized that patients with impaired ventricular function and cardiac conduction abnormalities have usually been excluded from these studies.

The following table presents the most common adverse reactions reported in placebo-controlled angina and hypertension trials in patients receiving CARDIZEM CD up to 360 mg with rates in placebo patients shown for comparison. CARDIZEM CD Capsule Angina and Hypertension Trials Adverse Reactions Headache Dizziness Bradycardia AV Block First Degree Edema ECG Abnormality Asthenia In clinical trials of CARDIZEM CD capsules, CARDIZEM tablets, and CARDIZEM SR capsules involving over 3200 patients, the most common events (ie, greater than were edema (4.6%), headache (4.6%), dizziness (3.5%), asthenia (2.6%), first-degree AV block (2.4%), bradycardia (1.7%), flushing (1.4%), nausea (1.4%), and rash (1.2%). In addition, the following events were reported infrequently (less than in angina or hypertension trials: Cardiovascular: Angina, arrhythmia, AV block (second- or third-degree), bundle branch block, congestive heart failure, ECG abnormalities, hypotension, palpitations, syncope, tachycardia, ventricular extrasystoles Nervous System: Abnormal dreams, amnesia, depression, gait abnormality, hallucinations, insomnia, nervousness, paresthesia, personality change, somnolence, tinnitus, tremor Gastrointestinal: Anorexia, constipation, diarrhea, dry mouth, dysgeusia, dyspepsia, mild elevations of SGOT, SGPT, LDH, and alkaline phosphatase (see hepatic warnings), thirst, vomiting, weight increase Dermatological: Petechia, photosensitivity, pruritus, urticaria Other: Amblyopia, CPK increase, dyspnea, epistaxis, eye irritation, hyperglycemia, hyperuricemia, impotence, muscle cramps, nasal congestion, nocturia, osteoarticular pain, polyuria, sexual difficulties The following postmarketing events have been reported infrequently in patients receiving CARDIZEM: alopecia, erythema multiforme, exfoliative dermatitis, extrapyramidal symptoms, gingival hyperplasia, hemolytic anemia, increased bleeding time, leukopenia, purpura, retinopathy, and thrombocytopenia. In addition, events such as myocardial infarction have been observed which are not readily distinguishable from the natural history of the disease in these patients. A number of welldocumented cases of generalized rash, characterized as leukocytoclastic vasculitis, have been reported.

However, a definitive cause and effect relationship between these events and CARDIZEM therapy is yet to be established. Prescribing Information as of April 1993 Marion Merrell Dow Inc. Kansas City, MO 64114 ccdb0493d Placebo-Controlled Combined Cardizem CD Placebo 5.4% 5.0% 3.0% 3.0% 3.3% 1.3% 3.3% 0.0% 2.6% 1.3% 1.6% 2.3% 1.8% 1.7% 0954E5 A.