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Jennifer L Schroeck, James Ford, Erin L Conway, Kari E Kurtzhalts, Megan E Gee, Krista A Vollmer, Kari A Mergenhagen
PURPOSE: Insomnia is problematic for older adults. After behavioral modifications fail to show adequate response, pharmacologic options are used. The pharmacokinetics of agents used to treat insomnia may be altered. This review focuses on the safety and efficacy of medications used to treat insomnia. METHODS: A literature search of Medline, PubMed, and Embase was conducted (January 1966-June 2016). It included systematic reviews, randomized controlled trials, observational studies, and case series that had an emphasis on insomnia in an older population...
October 14, 2016: Clinical Therapeutics
Tanja Mayer, Jürgen Kopitz, Konstanze Plaschke, Johanna Weiss, Hanna M Seidling, Walter E Haefeli
OBJECTIVE: The anticholinergic activity (AA) assay is a common method to determine a patient's anticholinergic load. Several limitations, however, are expected when applying the AA assay to patients or using drug scales to estimate anticholinergic burden based on AA levels. This study aims to demonstrate common pitfalls in an experimental setting and outline their clinical consequences. METHODS: The AA was analyzed for five drugs with reported interaction with muscarinic receptors...
August 4, 2016: American Journal of Geriatric Psychiatry
Gildasio S De Oliveira, Jane Bialek, R-J Marcus, Robert McCarthy
STUDY OBJECTIVE: Diphenhydramine is an antihistamine with previously demonstrated analgesic and antiemetic properties. However, it is unknown if the beneficial perioperative properties of diphenhydramine can translate to a better quality of postsurgical recovery. The main objective of the current investigation was to investigate dose-ranging effects of diphenhydramine on quality of recovery after surgery. SETTING: Tertiary hospital in the United States. DESIGN: A prospective, randomized, double-blind trial...
November 2016: Journal of Clinical Anesthesia
Manojkumar Bupathi, Joud Hajjar, Stacie Bean, Siqing Fu, David Hong, Daniel Karp, Bettzy Stephen, Kenneth Hess, Funda Meric-Bernstam, Aung Naing
Infusion reactions (IRs) to anti-neoplastic agents require prompt recognition and immediate treatment to avert significant complications. We conducted a retrospective review of the medical records of consecutive patients who received anti-neoplastic therapy in the outpatient treatment center of the Department of Investigational Cancer Therapeutics from January 1, 2013 to November 30, 2013. Of the 597 patients who received treatment, 9 (1.5 %) had IRs (all ≤ grade 2). The most common IRs observed on first occurrence were chills (n = 5), itching, rash, and facial flushing (n = 3 each)...
September 29, 2016: Investigational New Drugs
Ikunobu Muramatsu, Hatsumi Yoshiki, Junsuke Uwada, Takayoshi Masuoka, Kiyonao Sada, Takanobu Taniguchi, Matomo Nishio
Functional acetylcholine receptors (AChRs) were recently demonstrated to exist not only in the plasma membrane but also intracellularly in brain tissues. In order to activate intracellular AChRs, endogenous hydrophilic ACh must cross the plasma membrane. Here, we examined the pharmacological characteristics of this process, including whether it is mediated by active ACh uptake. When ACh esterase (AChE) was suppressed by diisopropylfluorophosphate, [(3) H]ACh was effectively taken up into segments of rat cerebral cortex and other brain regions, in contrast to peripheral tissues such as liver and kidney...
September 14, 2016: Journal of Neurochemistry
Aileen Chen, Erwin J Loquias, Ramesh Roshan, Richard Levene, Raymond Zelhof, Terry Hickey, Gail Austin Cooney, Faustino Gonzalez
BACKGROUND: Diphenhydramine (DPH) is most commonly used via oral, topical, intramuscular (IM) and intravenous (IV) routes for the palliation of pruritus, treatment of extrapyramidal symptoms, management of parkinsonism and for allergic reactions. However, many hospice patients are unable to take oral medications and/or do not have IV access. Moreover, topical administration has a relatively slow rate of absorption. For this reason, in the hospice setting it is not uncommon for diphenhydramine to be administered via the subcutaneous (SC) route secondary to its ease of access, low infection rates and its low levels of discomfort...
September 13, 2016: American Journal of Hospice & Palliative Care
Koichiro Nandate, Bryan B Voelzke
Indigo carmine (also known as 5,5'-indigodisulfonic acid sodium salt or indigotine) is a blue dye that is administered intravenously to examine the urinary tract and usually is biologically safe and inert. Indigo carmine rarely may cause adverse reactions. We treated a 66-year-old man who had general anesthesia and radical retropubic prostatectomy for prostate cancer. He had a previous history of allergy to bee sting with nausea, vomiting, and dizziness. Within 1 minute after injection of indigo carmine for evaluation of the ureters, the patient developed hypotension to 40 mmHg, severe hypoxia (the value of SpO2 (peripheral capillary oxygen saturation) was 75% on 40% inspired oxygen concentration), poor air movement and bilateral diffuse wheezing on auscultation, and marked subcutaneous erythema at the upper extremities...
2016: Case Reports in Urology
Sophie Gosselin, Lotte C G Hoegberg, Robert S Hoffman, Andis Graudins, Christine M Stork, Simon H L Thomas, Samuel J Stellpflug, Bryan D Hayes, Michael Levine, Martin Morris, Andrea Nesbitt-Miller, Alexis F Turgeon, Benoit Bailey, Diane P Calello, Ryan Chuang, Theodore C Bania, Bruno Mégarbane, Ashish Bhalla, Valéry Lavergne
BACKGROUND: Although intravenous lipid emulsion (ILE) was first used to treat life-threatening local anesthetic (LA) toxicity, its use has expanded to include both non-local anesthetic (non-LA) poisoning and less severe manifestations of toxicity. A collaborative workgroup appraised the literature and provides evidence-based recommendations for the use of ILE in poisoning. METHODS: Following a systematic review of the literature, data were summarized in four publications: LA and non-LA poisoning efficacy, adverse effects, and analytical interferences...
September 8, 2016: Clinical Toxicology
Jimmy Donkor, Patil Armenian, Isaac N Hartman, Rais Vohra
BACKGROUND: As decontamination trends have evolved, gastric lavage (GL) has become a rare procedure. The current information regarding use, outcomes, and complications of GL could help refine indications for this invasive procedure. OBJECTIVES: We sought to determine case type, location, and complications of GL cases reported to a statewide poison control system. METHODS: This is a retrospective review of the California Poison Control System (CPCS) records from 2009 to 2012...
October 2016: Journal of Emergency Medicine
Minh Duc Le, Hong Anh Duong, Manh Huy Nguyen, Jorge Sáiz, Hung Viet Pham, Thanh Duc Mai
In this study, the employment of purpose-made dual-channel compact capillary electrophoresis (CE) instrument with capacitively coupled contactless conductivity detection (C(4)D) as a simple and inexpensive solution for screening determination of various pharmaceutical pollutants frequently occurring in surface water and hospital wastewater in Hanoi, Vietnam is reported. Five negatively charged pharmaceutically active compounds, namely ibuprofen, diclofenac, bezafibrate, ketoprofen and mefenamic acid were determined using the first channel whereas three positively charged ones, namely diphenhydramine, metoprolol and atenolol were determined with the second channel of the CE-C(4)D instrument...
November 1, 2016: Talanta
Ming Zhao, Dingya Sun, Yangtai Guan, Zhihong Wang, Daoqian Sang, Mingdong Liu, Yingyan Pu, Xue Fang, Dan Wang, Aijun Huang, Xiaoying Bi, Li Cao, Cheng He
UNLABELLED: T-helper 17 (Th17) cells play an important role in the pathogenesis of multiple sclerosis (MS), an autoimmune demyelinating disease that affects the CNS. In the present study, MicroRNA sequencing (miRNA-seq) was performed in mouse Th0 and Th17 cells to determine the critical miRNAs that are related to Th17 differentiation. We found that miR-30a was significantly downregulated during mouse Th17 differentiation. In addition, the level of miR-30a in CD4(+) T cells from peripheral blood of MS patients and experimental autoimmune encephalomyelitis (EAE) animal models was also decreased and inversely correlated with the expression of interleukin 17a, the canonical cytokine of Th17 cells...
August 31, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Jacek C Szepietowski, Radomir Reszke
Pruritus is a bothersome and prevalent symptom reported by patients suffering from both cutaneous and extracutaneous diseases. Psychogenic pruritus, also referred to as functional itch disorder, is a distinct clinical entity. According to the definition proposed by the French Psychodermatology Group (FPDG) in 2007, the disorder is characterized by pruritus which is the chief complaint and psychologic factors that contribute to eliciting, worsening, and sustaining the symptoms. Specific diagnostic criteria were proposed, including 3 compulsory and 7 optional, of which 3 have to be met in order to establish the diagnosis...
2016: Current Problems in Dermatology
Melody J Bernot, Jesse C Becker, Jason Doll, Thomas E Lauer
We collaborated with 26 groups from universities across the United States to sample 42 sites for 33 trace organic compounds (TOCs) in water and sediments of lotic ecosystems. Our goals were 1) to further develop a national database of TOC abundance in United States lotic ecosystems that can be a foundation for future research and management, and 2) to identify factors related to compound abundance. Trace organic compounds were found in 93% of water samples and 56% of sediment samples. Dissolved concentrations were 10-1000× higher relative to sediment concentrations...
August 17, 2016: Science of the Total Environment
Hiroshi Ueda, Kazunori Kadota, Masaaki Imono, Takuya Ito, Ayaka Kunita, Yuichi Tozuka
In this study, we investigated the formation of a co-amorphous system of tranilast (TRL) and diphenhydramine hydrochloride (DPH), which are drugs used for treating allergies and inflammation. The crystallization from undercooled melts of the drugs and drug mixtures was evaluated by thermal analysis. Both drugs in the amorphous state underwent crystallization on heating, although the mixture remained in the amorphous state, indicating the formation of a co-amorphous system. The physicochemical properties of co-amorphous TRL-DPH prepared by the melting-cooling process were studied...
August 15, 2016: Journal of Pharmaceutical Sciences
Sylvain Auvity, Hélène Chapy, Sébastien Goutal, Fabien Caillé, Benoit Hosten, Maria Smirnova, Xavier Declèves, Nicolas Tournier, Salvatore Cisternino
Diphenhydramine, a sedative histamine H1-receptor (H1R) antagonist, was evaluated as a probe to measure drug/H(+)-antiporter function at the blood-brain barrier. In situ brain perfusion experiments in mice and rats showed that diphenhydramine transport at the blood-brain barrier was saturable, following Michaelis-Menten kinetics with a Km = 2.99 mM and Vmax = 179.5 nmol s(-1) g(-1) In the pharmacological plasma concentration range the carrier-mediated component accounted for 77% of diphenhydramine influx while passive diffusion accounted for only 23%...
August 3, 2016: Journal of Cerebral Blood Flow and Metabolism
Edson Baltazar Estrada-Arriaga, Juana Enriqueta Cortés-Muñoz, Arturo González-Herrera, César Guillermo Calderón-Mólgora, Ma de Lourdes Rivera-Huerta, Esperanza Ramírez-Camperos, Leticia Montellano-Palacios, Silvia Lucila Gelover-Santiago, Sara Pérez-Castrejón, Lina Cardoso-Vigueros, Alejandra Martín-Domínguez, Liliana García-Sánchez
Two full-scale biological nutrient removal systems upgraded with three physico-chemical processes (coagulation, chemical precipitation, and neutral Fenton) were evaluated in order to determine the removal of emerging pollutants (EPs) present in municipal wastewater from Mexico. Between 41 and 55 EPs were detected in the influents of two wastewater treatment plants (WWTPs), including personal care products (PPCPs), antibiotics, analgesics, antiepileptics, antilipidemics, antihypertensives, antiseptics, stimulants, and hormones...
November 15, 2016: Science of the Total Environment
Mark H Myer, W Matthew Henderson, Marsha C Black
Multiwalled carbon nanotubes (MWCNTs) and pharmaceutical compounds are classified by the US Environmental Protection Agency as contaminants of emerging concern, with significant research devoted to determining their potential environmental and toxicological effects. Multiwalled carbon nanotubes are known to have a high adsorptive capacity for organic contaminants, leading to potential uses in water remediation; however, there is concern that co-exposure with MWCNTs may alter the bioavailability of organic compounds...
July 21, 2016: Environmental Toxicology and Chemistry
Florian Berger, Andrea E Steuer, Katharina Rentsch, Dominic Gascho, Stamatios Stamou, Sarah Schärli, Michael J Thali, Thomas Krämer, Patricia M Flach
A case of fatal poisoning by ingesting formic acid, diphenhydramine, and ethanol by a 25-year-old woman who committed suicide is presented. Prior to autopsy, postmortem computed tomography and postmortem magnetic resonance tomography were performed and revealed severe damage to the stomach, the left thoracic wall, and parts of the liver. Imaging detected acid-induced fluid-fluid level within the thoracic cavity (fat-equivalent fluid and necrotic pleural effusion). This case report illustrates that postmortem cross-sectional imaging may facilitate dissection of severely damaged or complex regions, and may provide additional information compared to autopsy and toxicological examinations alone...
September 2016: Forensic Science, Medicine, and Pathology
Jiun-Hao Yu, Dong-Yi Chen, Hsien-Yi Chen, Kuo-Hua Lee
No abstract text is available yet for this article.
July 12, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Michele B Kaufman, Tammy Pham, Lalitha Parameswaran, Mary Choy
PURPOSE: An adverse drug reaction associated with the use of prasugrel for dual antiplatelet therapy after percutaneous coronary intervention (PCI) with stent placement is reported. SUMMARY: About one week after starting prasugrel use following angioplasty and a stent revision procedure, a 61-year-old woman arrived in the emergency department with wheezing, shortness of breath, a feeling of throat closure, and a widespread erythematous, maculopapular, pruritic rash...
July 15, 2016: American Journal of Health-system Pharmacy: AJHP
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