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https://www.readbyqxmd.com/read/28344076/inhibition-of-human-cyp3a4-and-cyp3a5-enzymes-by-gomisin-c-and-gomisin-g-two-lignan-analogs-derived-from-schisandra-chinensis
#1
Jin Zhao, Tao Sun, Yun-Feng Cao, Zhong-Ze Fang, Hong-Zhi Sun, Zhi-Tu Zhu, Kun Yang, Yong-Zhe Liu, Frank J Gonzalez, Jing-Jing Wu, Jun Yin
Gomisin C (GC) and gomisin G (GG) are two lignan analogs isolated from the Traditional Chinese Medicine Schisandra chinensis which possesses multiple pharmacological activities. However, the potential herb-drug interactions (HDI) between these lignans and other drugs through inhibiting human cytochrome P450 3A4 (CYP3A4) and CYP3A5 remains unclear. In the present study, the inhibitory action of GC and GG on CYP3A4 and CYP3A5 were investigated. The results demonstrated that both GC and GG strongly inhibited CYP3A-mediated midazolam 1'-hydroxylation, nifedipine oxidation and testosterone 6β-hydroxylation...
March 23, 2017: Fitoterapia
https://www.readbyqxmd.com/read/28340572/does-sevoflurane-add-to-outpatient-procedural-sedation-in-children-a-randomised-clinical-trial
#2
Hugo Sérgio de Oliveira Gomes, Heloisa de Sousa Gomes, Joji Sado-Filho, Luciane Rezende Costa, Paulo Sucasas Costa
BACKGROUND: There is little evidence concerning the effect of sevoflurane in outpatient procedural sedation, especially in children. We hypothesised that the addition of sevoflurane to a sedation regimen improves children's behaviour with minimal adverse events. METHODS: This is a randomised, triple-blind clinical trial conducted on an outpatient basis. Participants were 27 healthy children aged 4 to 6 years, who previously refused dental treatment with non-pharmacologic methods...
March 24, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28338566/midazolam-as-an-active-placebo-in-three-fentanyl-validated-nociceptive-pain-models
#3
Julian Prosenz, Burkhard Gustorff
The use of inactive placebos in early translational trials of potentially analgesic compounds is discouraged due to the side-effect profiles of centrally acting analgesics. Therefore, benzodiazepines are used, although their use has not been validated in this context. Whether benzodiazepines confound the results of acute pain tests is unknown. Midazolam (0.06 mg/kg) as an active placebo was investigated in three nociceptive models that included contact heat, electrical pain, and pressure pain thresholds in 24 healthy volunteers...
March 23, 2017: Pain
https://www.readbyqxmd.com/read/28337407/fentanyl-induced-chest-wall-rigidity-syndrome-in-a-routine-bronchoscopy
#4
Chee Kiang Phua, Audrey Wee, Albert Lim, John Abisheganaden, Akash Verma
Combination of sedatives such as fentanyl and midazolam during bronchoscopy is recommended by American College of Chest Physician due to its favourable drug profile. It improves patient comfort and tolerance, and is commonly given unless contraindicated. We describe a rare case of fentanyl-induced chest wall rigidity syndrome during a routine bronchoscopy with endobronchial ultrasound guided-transbronchial needle aspiration (EBUS-TBNA) in a 55 year old male presenting with a lung mass and mediastinal lymphadenopathy...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28333707/the-effect-of-sedation-on-cortical-activation-a-randomized-study-comparing-the-effects-of-sedation-with-midazolam-propofol-and-dexmedetomidine-on-auditory-processing
#5
Michael A Frölich, Catiffaney Banks, Timothy J Ness
BACKGROUND: Every day, millions of people undergo surgical procedures facilitated by anesthesia. Yet, there is no clinically accepted measure to predict the effects of sedation or anesthesia on the central nervous system. Auditory brain activation may provide an objective and quantifiable method to measure of the effects of sedation on neuronal processing. METHODS: This is a randomized clinical trial. Forty-eight healthy volunteers were randomly assigned to receive 1 of 3 sedative drugs (midazolam [n = 11], propofol [n = 12], or dexmedetomidine [n = 12]) at a concentration adjusted to achieve mild sedation by self-rating, or to a no-drug control group (n = 13)...
March 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28328950/repeated-anaesthesia-with-isoflurane-and-medetomidine-midazolam-fentanyl-in-guinea-pigs-and-its-influence-on-physiological-parameters
#6
Sabrina Schmitz, Sabine Tacke, Brian Guth, Julia Henke
Repeated anaesthesia may be required in experimental protocols and in daily veterinary practice, but anaesthesia is known to alter physiological parameters in GPs (Cavia porcellus, GPs). This study investigated the effects of repeated anaesthesia with either medetomidine-midazolam-fentanyl (MMF) or isoflurane (Iso) on physiological parameters in the GP. Twelve GPs were repeatedly administered with MMF or Iso in two anaesthesia sets. One set consisted of six 40-min anaesthesias, performed over 3 weeks (2 per week); the anaesthetic used first was randomized...
2017: PloS One
https://www.readbyqxmd.com/read/28328698/reduced-sufentanil-doses-are-effective-for-postoperative-analgesia-after-ductal-closure-in-extremely-premature-infants-a-10-years-retrospective-cohort-study
#7
Yohan Soreze, Etienne Audureau, Fabrice Decobert, Olivier Jaby, Sabine Blary, Claude Danan, Xavier Durrmeyer
OBJECTIVES: The objective of the study was to assess the efficacy of reduced sufentanil doses for postoperative analgesia following surgical ductal closure in extremely premature infants. METHODS: This was a retrospective, single-center, cohort study comparing 2 sufentanil dosing regimens used between 2001 and 2010 and included all infants born at <28 weeks of gestation with surgical ductal closure. Sufentanil doses were reduced in 2007 as a standard of care...
March 21, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28322414/effect-of-dexmedetomidine-on-mortality-and-ventilator-free-days-in-patients-requiring-mechanical-ventilation-with-sepsis-a-randomized-clinical-trial
#8
Yu Kawazoe, Kyohei Miyamoto, Takeshi Morimoto, Tomonori Yamamoto, Akihiro Fuke, Atsunori Hashimoto, Hiroyuki Koami, Satoru Beppu, Yoichi Katayama, Makoto Itoh, Yoshinori Ohta, Hitoshi Yamamura
Importance: Dexmedetomidine provides sedation for patients undergoing ventilation; however, its effects on mortality and ventilator-free days have not been well studied among patients with sepsis. Objectives: To examine whether a sedation strategy with dexmedetomidine can improve clinical outcomes in patients with sepsis undergoing ventilation. Design, Setting, and Participants: Open-label, multicenter randomized clinical trial conducted at 8 intensive care units in Japan from February 2013 until January 2016 among 201 consecutive adult patients with sepsis requiring mechanical ventilation for at least 24 hours...
March 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28319511/the-first-us-clinical-experience-with-computer-assisted-propofol-sedation-a-retrospective-observational-comparative-study-on-efficacy-safety-efficiency-and-endoscopist-and-patient-satisfaction
#9
Otto S Lin, Richard A Kozarek, Deborah Tombs, Danielle La Selva, Wade Weigel, Ryan Beecher, Ana Jensen, Michael Gluck, Andrew Ross
BACKGROUND: Computer-assisted propofol sedation (CAPS) is now approved for moderate sedation of American Society of Anesthesiologists (ASA) class I and II patients undergoing routine endoscopy. As the first US medical center to adopt CAPS for routine clinical use, we compared patient and endoscopist satisfaction with CAPS versus midazolam and fentanyl (MF) sedation. METHODS: Patients who underwent elective outpatient upper endoscopy and colonoscopy with CAPS were compared with concurrent patients sedated with MF...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28306741/pre-hospital-midazolam-for-benzodiazepine-treated-seizures-before-and-after-the-rapid-anticonvulsant-medication-prior-to-arrival-trial-a-national-observational-cohort-study
#10
Eytan Shtull-Leber, Robert Silbergleit, William J Meurer
BACKGROUND: Implementation of evidence-based treatment for pre-hospital status epilepticus can improve outcomes. We hypothesized that publication of a pivotal pre-hospital clinical trial (RAMPART), demonstrating superiority of intramuscular midazolam over intravenous lorazepam, altered the national utilization rates of midazolam for pre-hospital benzodiazepine-treated seizures, while upholding its safety and efficacy outside the trial setting. METHODS AND FINDINGS: This is a retrospective, observational cohort study of pre-hospital patient encounters throughout the United States in the National Emergency Medicine Services Information System database, from January 2010 through December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28301096/effects-of-tenapanor-on-cytochrome-p450-mediated-drug-drug-interactions
#11
Susanne Johansson, David P Rosenbaum, Marie Ahlqvist, Helen Rollison, Mikael Knutsson, Bergur Stefansson, Marie Elebring
Tenapanor (RDX5791, AZD1722) is an inhibitor of sodium/hydrogen exchanger isoform 3 in development for the treatment of constipation-predominant irritable bowel syndrome and the treatment of hyperphosphatemia in patients with chronic kidney disease on dialysis. We aimed to investigate whether tenapanor inhibits or induces cytochrome P450s (CYPs). In vitro experiments assessing the potential of tenapanor to affect various CYPs indicated that it could inhibit CYP3A4/5 (IC50 0.4-0.7 μM). An open-label, phase 1 clinical study (NCT02140268) evaluated the pharmacokinetics of the CYP3A4 substrate midazolam when administered with and without tenapanor...
March 16, 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28298782/comparison-of-oral-clonidine-oral-dexmedetomidine-and-oral-midazolam-for-premedication-in-pediatric-patients-undergoing-elective-surgery
#12
Sarika Kumari, Nidhi Agrawal, G Usha, Vandana Talwar, Poonam Gupta
BACKGROUND: Midazolam has been commonly used orally for premedication in children. A search for a better alternative continues to overcome its side effects. Recently alpha-2 agonists, clonidine, and dexmedetomidine have been used for premedication in children. AIM: To study and compare the efficacy of oral clonidine, oral dexmedetomidine, and oral midazolam for premedication in pediatric surgical patients. SETTINGS AND DESIGN: This prospective, randomized, double blind study was conducted in a tertiary care hospital...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298758/comparison-of-analgesic-efficacy-of-dexmedetomidine-and-midazolam-as-adjuncts-to-lignocaine-for-intravenous-regional-anesthesia
#13
Bharti Gupta, Ravinder Kumar Verma, Sudershan Kumar, Geeta Chaudhary
BACKGROUND: Intravenous regional anesthesia (IVRA) is safe, technically simple, and cost-effective technique compared to general anesthesia with success rates of 94-98% for upper and lower limb surgeries. The main disadvantage of this procedure is its limited duration for surgery, lack of postoperative analgesia, and tourniquet pain. To overcome this disadvantage, various adjuvants to lignocaine have been studied from time to time. AIM: To compare the analgesic efficacy of dexmedetomidine and midazolam as adjuncts to lignocaine for IVRA for forearm and hand surgeries...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298753/a-prospective-randomized-trial-comparing-dexmedetomidine-and-midazolam-for-conscious-sedation-during-oocyte-retrieval-in-an-in-vitro-fertilization-program
#14
Ali Mohamed Ali Elnabtity, Mohamed Fouad Selim
BACKGROUND: Various sedative and analgesic techniques have been used for pain relief during oocyte retrieval which is the most painful part of in vitro fertilization (IVF) procedures. AIM: This study aimed at comparing dexmedetomidine and midazolam for conscious sedation in women undergoing transvaginal oocyte retrieval during an IVF program. SETTINGS AND DESIGN: Prospective randomized double-blinded comparative study. PATIENTS AND METHODS: Fifty-two patients undergoing oocyte retrieval in their first IVF cycle were randomly allocated into two equal groups...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28296782/the-safety-and-efficacy-of-dexmedetomidine-remifentanil-in-children-undergoing-flexible-bronchoscopy-a-retrospective-dose-finding-trial
#15
Xia Li, Xue Wang, Shuguang Jin, Dongsheng Zhang, Yanuo Li
Flexible bronchoscopy is more and more used for diagnosis and management of various pulmonary diseases in pediatrics. As poor coordination of children, the procedure is usually performed under general anesthesia with spontaneous or controlled ventilation to increase children and bronchoscopists' safety and comfort. Previous studies have reported that dexmedetomidine (DEX) could be safely and effectively used for flexible bronchoscopy in both adulate and children. However, there is no trial to evaluate the dose-finding of safety and efficacy of dexmedetomidine-remifentanil (DEX-RF) in children undergoing flexible bronchoscopy...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28293921/effects-of-intramuscular-midazolam-and-lorazepam-on-acute-agitation-in-non-elderly-subjects-a-systematic-review
#16
Sabrina Just Kousgaard, Rasmus W Licht, René Ernst Nielsen
Benzodiazepines are commonly used for the treatment of acute agitation in a psychiatric setting.We searched MEDLINE, EMBASE, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL) for relevant publications. Randomized trials evaluating intramuscular (IM) midazolam or lorazepam given as monotherapy or as add-on treatment, with more than 10 patients aged 18-65 years, conducted in a psychiatric setting, and published between January 1, 1980, and February 3, 2016, were included. 16 studies from a search result of 5 516 studies were included...
March 14, 2017: Pharmacopsychiatry
https://www.readbyqxmd.com/read/28287454/am-2201-inhibits-multiple-cytochrome-p450-and-uridine-5-diphospho-glucuronosyltransferase-enzyme-activities-in-human-liver-microsomes
#17
Ju-Hyun Kim, Soon-Sang Kwon, Tae Yeon Kong, Jae Chul Cheong, Hee Seung Kim, Moon Kyo In, Hye Suk Lee
AM-2201 is a synthetic cannabinoid that acts as a potent agonist at cannabinoid receptors and its abuse has increased. However, there are no reports of the inhibitory effect of AM-2201 on human cytochrome P450 (CYP) or uridine 5'-diphospho-glucuronosyltransferase (UGT) enzymes. We evaluated the inhibitory effect of AM-2201 on the activities of eight major human CYPs (1A2, 2A6, 2B6, 2C8, 2C9, 2C19, 2D6, and 3A4) and six major human UGTs (1A1, 1A3, 1A4, 1A6, 1A9, and 2B7) enzymes in pooled human liver microsomes using liquid chromatography-tandem mass spectrometry to investigate drug interaction potentials of AM-2201...
March 10, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28282553/challenges-in-the-treatment-of-convulsive-status-epilepticus
#18
REVIEW
Gaetano Zaccara, Gianfranco Giannasi, Roberto Oggioni, Eleonora Rosati, Luciana Tramacere, Pasquale Palumbo
Convulsive status epilepticus (CSE) is a medical emergency associated with high mortality and morbidity. The most recent definition of CSE is a convulsive seizure lasting more than 5min or consecutive seizures without recovery of consciousness. In adults, for the treatment of the early stages of CSE, diazepam, lorazepam or midazolam are the most common treatments, although the choice of agent seems less important than rapid treatment. Midazolam, when administered intramuscularly (best evidence), buccally, or nasally, is effective and safe in the pre-hospital setting...
February 28, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28271228/comparison-of-ease-of-administration-of-intranasal-midazolam-spray-and-oral-midazolam-syrup-by-parents-as-premedication-to-children-undergoing-elective-surgery
#19
Milthi Manoj, M V S Satya Prakash, Srinivasan Swaminathan, Rithu Krishna Kamaladevi
BACKGROUND: The efficacy of midazolam as premedication in children for providing pre-operative sedation and reducing parental separation anxiety has been well established. Many studies have compared the effectiveness and medication acceptance of midazolam via oral and intranasal routes. In this study, we have compared the ease of administration of oral midazolam syrup and intranasal midazolam spray as premedication, administered by parents to children. METHODS: Ninety children were randomly allocated into one of the two groups: group N received nasal midazolam spray 0...
March 7, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28271084/analgesia-following-arthroscopy-a-comparison-of-intra-articular-bupivacaine-and-or-midazolam-and-or-fentanyl
#20
Mahmoud Nahravani, Seyed Mostafa Moosavi Tekye, Mohammad Alipour, Hadi Makhmalbaf, Monnavar Afzal Aghaee
BACKGROUND: Arthroscopic intervention is very common for conducting orthopedic surgeries. After a knee arthroscopic surgery, different drugs are used through intra-articular administration to induce analgesia. The aim of this study was to evaluate analgesic effects of Bupivacaine (marcaine), Bupivacaine plus midazolam, and Bupivacaine plus fentanyl in reducing pain after knee arthroscopic surgery. METHODS: Frothy five patients who were candidate for knee arthroscopy were divided into three groups...
January 2017: Archives of Bone and Joint Surgery
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