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Michele A Glinn, Andrew J Lickteig, Luke Weber, Sherri Recer, Matthew Salske, Audrey Harvey, Brian Rappold, Julie Stensland, Patrick Bell
A common treatment for chronic pain is prescription of analgesics, but their long-term use entails risk of morbidity, addiction and misuse. One way to reduce the risk of abuse is prescribing of analgesics in a topical form. Physicians are urged to perform urine drug testing to ensure that patients are compliant with their medication regimens. However, there is little data on the efficiency of transdermal delivery for many analgesic drugs, and no data on expected urine drug levels. This study includes data from over 29,000 specimens tested for gabapentin, ketamine, cyclobenzaprine or amitriptyline used orally or topically...
March 1, 2017: Journal of Analytical Toxicology
John Trimble, Bob Light
Transdermal compositions for pain management are comprised of nonsteroidal anti-inflammatory drugs, opioid drugs, and adjuvant drugs acting on: voltage-gated channels, gamma-aminobutyric acid receptors, acute musculoskeletal pain, and as an antidepressant. In this work, baclofen, bupivacaine, cyclobenzaprine, diclofenac, gabapentin, ibuprofen, ketamine, and pentoxifylline were loaded in transdermal compositions, prepared using a mixture of lipids (isopropyl palmitate and mineral oil) and one of two selected penetration enhancer mixtures: alkyl dimethicone, phenyl trimethicone, and polyoxyethylene sorbitan monostearate; and cetostearyl polyoxyethylene ether and ethylene oxide/propylene oxide copolymer...
May 2016: International Journal of Pharmaceutical Compounding
Winfried Häuser, Jacob Ablin, Serge Perrot, Mary-Ann Fitzcharles
Fibromyalgia (FM) is a prevalent and costly condition worldwide, affecting approximately 2% of the general population. Recent evidence- and consensus‑based guidelines from Canada, Germany, Israel, and the European League Against Rheumatism aim to support physicians in achieving a comprehensive diagnostic workup of patients with chronic widespread (generalized) pain (CWP) and to assist patients and physicians in shared decision making on treatment options. Every patient with CWP requires, at the first medical evaluation, a complete history, medical examination, and some laboratory tests (complete blood count, measurement of C‑reactive protein, serum calcium, creatine phosphokinase, thyroid‑stimulating hormone, and 25‑hydroxyvitamin D levels) to screen for metabolic or inflammatory causes of CWP...
January 4, 2017: Polish Archives of Internal Medicine
Edézio Ferreira Cunha-Júnior, Valter Viana Andrade-Neto, Marta Lopes Lima, Thais Alves da Costa-Silva, Andres J Galisteo Junior, Maria A Abengózar, Coral Barbas, Luis Rivas, Elmo Eduardo Almeida-Amaral, Andre Gustavo Tempone, Eduardo Caio Torres-Santos
BACKGROUND: The leishmanicidal action of tricyclic antidepressants has been studied and evidences have pointed that their action is linked to inhibition of trypanothione reductase, a key enzyme in the redox metabolism of pathogenic trypanosomes. Cyclobenzaprine (CBP) is a tricyclic structurally related to the antidepressant amitriptyline, differing only by the presence of a double bond in the central ring. This paper describes the effect of CBP in experimental visceral leishmaniasis, its inhibitory effect in trypanothione reductase and the potential immunomodulatory activity...
January 2017: PLoS Neglected Tropical Diseases
Osama Siddique, Somwail Rasla, Seth Clark, Aravind Kokkirala
ST segment elevation is associated with non-cardiac pathologies but is not as well reported as myocardial infarction. We present a case of a 63-year-old man who was admitted for an overdose on cyclobenzaprine with signs of anti-cholinergic toxicity. He developed signs of ileus on imaging and became progressively obtunded. He was noted to have ST segment elevations on electrocardiogram (EKG) with no troponin elevation. Patient required urgent catheterization which showed normal coronary arteries. His bowel was decompressed subsequently resulting in resolution of the ST segment changes...
November 1, 2016: Rhode Island Medical Journal
Gayatri C Patel, Megha Kasarwala
BACKGROUND: The purpose of this study was to investigate the application of a controlled porosity osmotic tablet (CPOT) utilizing solid dispersion (SD) of poorly soluble drug. The patents on Cyclobenzaprine HCl (US4968507 A) and Venlafaxine salts (EP 2085078 A1) helped in selection of drug and polymers. METHOD: The SDs having different ratio of drug to carrier (PVP K 30) were prepared by kneading method and optimized. Effect of three independent variables, total amount of osmogen (mannitol& potassium chloride), total amount of polymer (polyethylene oxide WSR 301, hydroxy propyl methyl cellulose K100 M), and polymer1: polymer 2 ratio was investigated using Box Behnken design...
October 4, 2016: Recent Patents on Drug Delivery & Formulation
Michael Gottlieb, Abdoulie Njie
Clinical Question Does the addition of cyclobenzaprine or oxycodone with acetaminophen to naproxen result in improved functional outcomes at one week when compared to placebo in patients with acute low back pain? Article Chosen Friedman B, Dym A, Davitt, M, et al. Naproxen with cyclobenzaprine, oxycodone/acetaminophen, or placebo for treating acute low back pain: a randomized clinical trial. JAMA 2015:20;314(15):1572-80. Study Objective The primary objective of this study was to compare functional outcomes at one week and three months after emergency department (ED) presentation for acute low back pain among patients prescribed naproxen plus one of the following: (1) oxycodone/acetaminophen; (2) cyclobenzaprine; or (3) placebo...
November 2016: CJEM
Byron J Schneider, David J Kennedy, Dinesh Kumbhare
No abstract text is available yet for this article.
September 8, 2016: American Journal of Physical Medicine & Rehabilitation
Kevin Frazer, James J Stevermer
Adding cyclobenzaprine or oxycodone/acetaminophen to naproxen for the treatment of acute low back pain does nothing more than increase adverse effects.
June 2016: Journal of Family Practice
E Gómez Torrijos, M García Arpa, C García Rodríguez, Y Mendez Díaz, J Borja Segade, P A Galindo Bonilla, J F Feo Brito, R García Rodríguez
No abstract text is available yet for this article.
2016: Journal of Investigational Allergology & Clinical Immunology
Siji Lv, Peng Quan, Wei Wang, Liang Fang
The aim of this study was to improve the transdermal delivery of cyclobenzaprine (CBZ) from drug-in-adhesive patch which showed less side effects and better compliance. CBZ base was prepared and then characterized using differential scanning calorimetry (DSC). The interaction between CBZ and pressure-sensitive adhesive (PSA) was determined by Fourier Transform Infrared Spectroscopy (FT-IR). The influences of PSAs, penetration enhancers, patch thickness and drug content on the transdermal delivery of CBZ were studied thoroughly in vitro...
July 19, 2016: Drug Development and Industrial Pharmacy
Kaylee R Mastrianni, L Andrew Lee, William E Brewer, Nagaraju Dongari, Michael Barna, Stephen L Morgan
A collaborative study was conducted to investigate discrepancies in recoveries of two commonly prescribed compounds, amitriptyline and cyclobenzaprine, in patient urine samples when hydrolyzed with different enzymes from different sources. A 2- to 10-fold increase in analyte recoveries was seen for patient samples hydrolyzed using a recombinant β-glucuronidase (IMCSzyme™) over samples hydrolyzed with β-glucuronidase from Haliotis rufescens We report outcomes from four commercially available β-glucuronidase enzymes (IMCSzyme™, Patella vulgata, Helix pomatia and H...
November 2016: Journal of Analytical Toxicology
Pegah Safaeian, Ryan Mattie, Matthew Hahn, Christopher T Plastaras, Zachary L McCormick
INTRODUCTION: Pharmacologic treatment of radicular pain with oral medications is limited by adverse effects and concern for dependence. While topical formulations have been explored in pain research, there is no published literature evaluating the efficacy in radicular pain. We present the first three cases of radicular pain successfully treated with a topical formulation of diclofenac, ibuprofen, baclofen, cyclobenzaprine, bupivacaine, gabapentin, and pentoxifylline (T7). CASE PRESENTATION: Case series evaluating T7 for treatment of radicular pain in a single, outpatient pain center...
April 2016: Anesthesiology and Pain Medicine
Mark H Ebell, Roland Grad
In 2015, a group of primary care clinicians with expertise in evidence-based practice performed monthly surveillance of more than 110 English-language clinical research journals. They identified 251 studies that addressed a primary care question and had the potential to change practice if valid (patient-oriented evidence that matters, or POEMs). Each study was critically appraised and disseminated to subscribers via e-mail, including members of the Canadian Medical Association who had the option to use a validated tool to assess the clinical relevance of each POEM and the benefits they expect for their practice...
May 1, 2016: American Family Physician
Brandon T Suehs, Cralen Davis, Billy Franks, Thomas E Yuran, Daniel Ng, Jason Bradt, John Knispel, Maria Vassilakis, Todd Berner
OBJECTIVES: To examine potentially inappropriate medication (PIM) use in older adults initiating an antimuscarinic medication for the treatment of overactive bladder (OAB). DESIGN: Retrospective database analysis. SETTING: Medical and pharmacy claims data. PARTICIPANTS: Medicare Advantage Prescription Drug Plan members aged 65 and older newly initiated on an antimuscarinic OAB treatment were identified and assigned to PIM and non-PIM comparison groups based on 2012 American Geriatrics Society Beers Criteria and/or the presence of an anticholinergic medication interaction at the time of initiation of treatment (N = 66,275)...
April 2016: Journal of the American Geriatrics Society
Bogdan Ionel Cioroiu, Ioana Cezara Grigoriu, Mona Elisabeta Cioroiu, Marius Niculaua, Roxana Lupuleasa, Mihai Ioan Lazar
Association of cyclobenzaprine hydrochloride, piroxicam and lidocaine in a topical formulation is one of the newest innovations in the pharmaceutical formulary field. In this study, a reversed-phase liquid chromatographic method was developed for the establishment of the impurities of cyclobenzaprine hydrochloride, lidocaine and piroxicam in the semisolid topical formulation. In this study, we not only determined 2,6-dimethylaniline, 2-pyrydilamine but also specified impurities of cyclobenzaprine hydrochloride (dibenzosuberenone, amitriptyline, carbinole, cyclobenzaprine N-oxide and anthrachinone)...
July 2016: Journal of Chromatographic Science
Yifei Liu, Chunlin Qian, Mei Yang
BACKGROUND: Fibromyalgia (FM) affects up to 6% of U.S. adults, resulting in a significant burden on the health care system and poor quality of life for patients. Duloxetine, pregabalin, and milnacipran are approved for management of FM; however, consensus is lacking regarding optimal therapy. Patients with FM taking approved medications often do not experience meaningful symptom relief, and many experience intolerable adverse events. OBJECTIVE: To assess treatment patterns associated with available and commonly used medications for the management of FM using U...
March 2016: Journal of Managed Care & Specialty Pharmacy
Javi Hartenstine, Hope Jackson, Keith Mortman
A 38-year-old black woman with a medical history significant for hypertension and depression presented to the emergency department with a 2-week history of lower back pain. This visit was her second in 1 week with the same symptoms, after attaining minimal pain relief with cyclobenzaprine.
March 2016: Chest
Donald M Chaffee
No abstract text is available yet for this article.
February 1, 2016: American Family Physician
Akshanth R Polepally, Jennifer R King, Bifeng Ding, Diana L Shuster, Emily O Dumas, Amit Khatri, Yi-Lin Chiu, Thomas J Podsadecki, Rajeev M Menon
BACKGROUND AND AIMS: The three direct-acting antiviral regimen of ombitasvir/paritaprevir/ritonavir and dasabuvir (3D regimen) is approved for treatment of hepatitis C virus (HCV) genotype 1 infection. Drug-drug interaction (DDI) studies of the 3D regimen and commonly used medications were conducted in healthy volunteers to provide information on coadministering these medications with or without dose adjustments. METHODS: Three phase I studies evaluated DDIs between the 3D regimen (ombitasvir/paritaprevir/ritonavir 25/150/100 mg once daily + dasabuvir 250 mg twice daily) and hydrocodone bitartrate/acetaminophen (5/300 mg), metformin hydrochloride (500 mg), diazepam (2 mg), cyclobenzaprine hydrochloride (5 mg), carisoprodol (250 mg), or sulfamethoxazole/trimethoprim (SMZ/TMP) (800/160 mg twice daily), all administered orally...
August 2016: Clinical Pharmacokinetics
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