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https://www.readbyqxmd.com/read/28335023/qbd-driven-development-and-validation-of-liquid-chromatography-tandem-mass-spectrometric-method-for-the-quantitation-of-sildenafil-in-human-plasma
#1
M Saquib Hasnain, Shaukat Ali Ansari, Shireen Rao, Mohammad Tabish, Mukul Singh, Mohammad Syafiq Abdullah, Mohammed Tahir Ansari
The present work was employing the Quality by Design approach for the development and validation of a LC-MS-MS method to support the clinical advancement in determination of sildenafil in human plasma using lorazepam as an internal standard. Sample preparation involved solid phase extraction and calibration range observed between 3 and 1,700 ng/mL. The method was systematically optimized by employing Box-Behnken design and used mobile phase flow rate, pH and composition of mobile phase as the critical factors, and assessing the design for retention time and peak area as the responses...
February 27, 2017: Journal of Chromatographic Science
https://www.readbyqxmd.com/read/28331645/propylene-glycol-toxicity-in-adolescent-with-refractory-myoclonic-status-epilepticus
#2
Kara A Bjur, Bryan C Cannon, Anthony L Fine, Matthew J Ritter, Kerry E Schueler, Michael E Nemergut
Propylene glycol (PG) is a solvent commonly used in medications that, while benign at low doses, may cause toxicity in adults and children at high doses. We describe a case and the physiologic sequelae of propylene glycol toxicity manifested in a critically ill adolescent male with refractory myoclonic status epilepticus aggressively treated with multiple PG-containing medications (lorazepam, phenobarbital, and pentobarbital)-all within accepted dosing guidelines and a total daily PG exposure previously recognized to be safe...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/28322337/sedation-of-mechanically-ventilated-adults-in-intensive-care-unit-a-network-meta-analysis
#3
Zhongheng Zhang, Kun Chen, Hongying Ni, Xiaoling Zhang, Haozhe Fan
Sedatives are commonly used for mechanically ventilated patients in intensive care units (ICU). However, a variety of sedatives are available and their efficacy and safety have been compared in numerous trials with inconsistent results. To resolve uncertainties regarding usefulness of these sedatives, we performed a systematic review and network meta-analysis. Randomized controlled trials comparing sedatives in mechanically ventilated ICU patients were included. Graph-theoretical methods were employed for network meta-analysis...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28321081/metoclopramide-induced-serotonin-syndrome
#4
Taku Harada, Takanobu Hirosawa, Kouhei Morinaga, Taro Shimizu
A 40-year-old woman with bipolar disorder who was taking mirtazapine presented with mydriasis, abnormal diaphoresis, myoclonus and muscle rigidity after taking metocloplamide. Her medical history, which included the use of serotonergic agents, and the presence of symptoms including myoclonus and muscle rigidity were consistent with a diagnosis of serotonin syndrome (SS) according to the Hunter criteria. The symptoms diminished following three days of treatment with oral lorazepam and cyproheptadine and a reduced dose of mirtazapine...
2017: Internal Medicine
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
#5
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/28293921/effects-of-intramuscular-midazolam-and-lorazepam-on-acute-agitation-in-non-elderly-subjects-a-systematic-review
#6
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/28282553/challenges-in-the-treatment-of-convulsive-status-epilepticus
#7
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/28274337/catatonia-among-women-with-postpartum-psychosis-in-a-mother-baby-inpatient-psychiatry-unit
#8
Abhinav Nahar, Nithin Kondapuram, Geetha Desai, Prabha S Chandra
OBJECTIVE: The aims of the present study were to determine the prevalence of catatonia in women with postpartum psychosis, describe its socio demographic, clinical and obstetric correlates and identify predictors of treatment response. METHODS: Data was extracted from clinical charts of 200 women with postpartum psychosis admitted to an inpatient mother baby unit (MBU) in India over a 3year period. RESULTS: Of the 200 patients, 20% (n=40) had symptoms of catatonia...
March 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28259526/review-of-intranasally-administered-medications-for-use-in-the-emergency-department
#9
Abby M Bailey, Regan A Baum, Karolyn Horn, Tameka Lewis, Kate Morizio, Amy Schultz, Kyle Weant, Stephanie N Justice
BACKGROUND: Intranasal (IN) medication delivery is a viable alternative to other routes of administration, including intravenous (IV) and intramuscular (IM) administration. The IN route bypasses the risk of needle-stick injuries and alleviates the emotional trauma that may arise from the insertion of an IV catheter. OBJECTIVE: This review aims to evaluate published literature on medications administered via the IN route that are applicable to practice in emergency medicine...
March 1, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28249542/prophylaxis-of-radiation-induced-nausea-and-vomiting-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#10
Wing S Li, Joanne M van der Velden, Vithusha Ganesh, Sherlyn Vuong, Srinivas Raman, Marko Popovic, Henry Lam, Kam H Wong, Roger K Ngan, J P Maarten Burbach, Carlo DeAngelis, Rachel McDonald Xxxx, Edward Chow
BACKGROUND: The aim of this article was to systematically review the efficacy and safety of various antiemetics in prophylaxis of radiation-induced nausea and vomiting (RINV). METHODS: A literature search of Ovid MEDLINE, EMBASE and Cochrane CENTRAL was performed to identify randomized controlled trials (RCTs) that evaluated the efficacy of prophylaxis for RINV in patients receiving radiotherapy to abdomen/pelvis, including total body irradiation (TBI). Primary endpoints were complete control of nausea and complete control of vomiting during acute and delayed phases...
January 9, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28223850/unusual-etiology-of-gastrointestinal-symptoms-the-case-of-jojoba-butter
#11
Michael R Minckler, Joseph Fisher, Rachel Bowers, Richard Amini
BACKGROUND: Jojoba butter is cyanogenic and has gained attention among herbal supplement consumers due to claims that it may aid in weight loss. Jojoba butter is extracted from the seeds of jojoba shrubs found in the Sonoran Desert. The seeds have long been recognized as inedible, however clinical symptoms following ingestion are not well documented. CASE REPORT: This report describes a patient who developed restlessness and gastrointestinal complaints following ingestion of homemade jojoba seed butter...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/28213908/a-randomized-controlled-trial-of-lacosamide-versus-sodium-valproate-in-status-epilepticus
#12
Usha K Misra, Deepanshu Dubey, Jayantee Kalita
OBJECTIVE: To compare the efficacy and safety of lacosamide (LCM) and sodium valproate (SVA) in lorazepam (LOR)-resistant status epilepticus (SE). METHODS: Patients with LOR-resistant SE were randomized to intravenous LCM 400 mg at a rate of 60 mg/kg/min or SVA 30 mg/kg at a rate of 100 mg/min. The SE severity score (STESS), duration of SE and its etiology, and magnetic resonance imaging (MRI) findings were noted. Primary outcome was seizure cessation for 1 h, and secondary outcomes were 24 h seizure remission, in hospital death and severe adverse events (SAEs)...
February 18, 2017: Epilepsia
https://www.readbyqxmd.com/read/28209389/physical-stability-of-highly-concentrated-injectable-drugs-solutions-used-in-intensive-care-units
#13
M Closset, J D Hecq, L Soumoy, J Simar, E Gonzalez, L Charlet, C Declave, P Gillet, L Galanti
BACKGROUND: The intensive care department of the institution use drug solutions within higher concentration to avoid fluid overload. The purpose of the study is to prove the physical stability of different injectable drugs within high concentration (amiodarone 25mg/mL, isosorbide 0.60mg/mL, lorazepam 0.16mg/mL, noradrenalin 0.120 and 0.240mg/mL, salbutamol 0.06mg/mL and sodium valproate 12mg/mL) to ensure the patients safety. METHODS: Five of 30 or 50mL polypropylene syringes were prepared for each solution under aseptic conditions and stored at room temperature...
February 13, 2017: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/28181946/case-report-of-midazolam-withdrawal-induced-catatonia-in-a-9-year-old-patient
#14
Cassandra R Duncan-Azadi, Peter N Johnson, Andrew Gormley
Benzodiazepine withdrawal-induced catatonia is a rare phenomenon in the adult population and has never been reported in a pediatric patient. We present a 9-year-old boy who exhibited catatonia symptoms following discontinuation of a midazolam infusion in the pediatric intensive care unit. The pediatric anesthesia acute pain team was consulted. When the patient's altered mental status could not otherwise be explained, benzodiazepine withdrawal-induced catatonia was considered. A dose of 2 mg intravenous lorazepam was given and the patient's symptoms dramatically improved within 5 minutes of administration...
February 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28163499/long-term-benzodiazepine-treatment-in-patients-with-psychotic-disorders-attending-a-mental-health-service-in-rural-greece
#15
Vaios Peritogiannis, Thiresia Manthopoulou, Venetsanos Mavreas
INTRODUCTION: Long-term benzodiazepine (BZD) treatment in patients with mental disorders is widespread in clinical practice, and this is also the case of patients with schizophrenia, although the evidence is weak and BZD prescription is discouraged by guidelines and medical authorities. Data on BZD prescription are usually derived from national or regional databases whereas information on the use of BZD by patients with schizophrenia and related psychoses in general population-based samples is limited...
December 2016: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28160051/characterization-and-identification-of-eight-designer-benzodiazepine-metabolites-by-incubation-with-human-liver-microsomes-and-analysis-by-a-triple-quadrupole-mass-spectrometer
#16
Souleiman El Balkhi, Maxime Chaslot, Nicolas Picard, Sylvain Dulaurent, Martine Delage, Olivier Mathieu, Franck Saint-Marcoux
Designer benzodiazepines (DBZDs) have become of particular importance in the past few years. The metabolite monitoring of DBZD in biological fluids could be of great interest in clinical and forensic toxicology. However, DBZD metabolites are not known or not commercially available. The identification of some DBZD metabolites has been mostly explored by self-administration studies or by in vitro studies followed by high-resolution mass spectrometry. The question arose whether a unit resolution instrument could be efficient enough to allow the identification of DBZD metabolites...
February 4, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28157273/a-novel-animal-model-of-acquired-human-temporal-lobe-epilepsy-based-on-the-simultaneous-administration-of-kainic-acid-and-lorazepam
#17
Friederike Kienzler-Norwood, Lara Costard, Chinmaya Sadangi, Philipp Müller, Valentin Neubert, Sebastian Bauer, Felix Rosenow, Braxton A Norwood
OBJECTIVE: Kainic acid (KA) is a potent glutamate analog that is used to induce neurodegeneration and model temporal lobe epilepsy (TLE) in rodents. KA reliably induces severe, prolonged seizures, that is, convulsive status epilepticus (cSE), which is typically fatal without pharmacologic intervention. Although the use of KA to model human epilepsy has proven unquestionably valuable for >30 years, significant variability and mortality continue to confound results. These issues are probably the consequence of cSE, an all-or-nothing response that is inherently capricious and uncontrollable...
February 2017: Epilepsia
https://www.readbyqxmd.com/read/28153413/model-predicted-occurrence-of-multiple-pharmaceuticals-in-swedish-surface-waters-and-their-flushing-to-the-baltic-sea
#18
C Lindim, J van Gils, I T Cousins, R Kühne, D Georgieva, S Kutsarova, O Mekenyan
An exposure assessment for multiple pharmaceuticals in Swedish surface waters was made using the STREAM-EU model. Results indicate that Metformin (27 ton/y), Paracetamol (6.9 ton/y) and Ibuprofen (2.33 ton/y) were the drugs with higher amounts reaching the Baltic Sea in 2011. 35 of the studied substances had more than 1 kg/y of predicted flush to the sea. Exposure potential given by the ratio amount of the drug exported to the sea/amount emitted to the environment was higher than 50% for 7 drugs (Piperacillin, Lorazepam, Metformin, Hydroxycarbamide, Hydrochlorothiazide, Furosemide and Cetirizine), implying that a high proportion of them will reach the sea, and below 10% for 27 drugs, implying high catchment attenuation...
April 2017: Environmental Pollution
https://www.readbyqxmd.com/read/28151790/management-of-opioid-and-sedative-weaning-in-pediatric-congenital-heart-disease-patients-assessing-the-state-of-practice
#19
Caitlin O'Connell, Sonja Ziniel, Lauren Hartwell, Jean Connor
BACKGROUND: Opioid and sedative medications are commonly used to treat pediatric patients with congenital heart disease; however, their use is not without adverse effects. Symptoms of withdrawal can occur if the medications are discontinued abruptly or weaned too quickly. OBJECTIVE: The aim of this study was to understand and describe the current management of opioid and sedative weaning in pediatric congenital heart disease patients in freestanding children's hospitals across the United States...
March 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28149745/afatinib-induced-severe-esophagitis-in-a-lung-cancer-patient-with-an-activated-epidermal-growth-factor-receptor-mutation-a-case-report
#20
Takako Inoue, Madoka Kimura, Motohiro Tamiya, Kazumi Nishino, Toru Kumagai, Fumio Imamura
A 58-year-old woman with lung cancer complaint odynophagia by sour food. Endoscopic examination revealed severe erosion strictly limited to the esophagus. Drug-induced esophagitis was suspected. She was taking afatinib, loxoprofen, pregabalin, lorazepam, a formulation of butyric acid bacteria, and amino acid supplements for more than 1 month at the time of developing esophagitis. Her appetite was very poor for several days before developing the esophagitis. Although not definitive, the most probable cause of her esophagitis is an increased blood concentration of afatinib due to prolonged starved condition...
2017: Respiratory Medicine Case Reports
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