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https://www.readbyqxmd.com/read/28340102/impact-of-unrestricted-access-to-pregabalin-on-the-use-of-opioids-and-other-cns-active-medications-a-cross-sectional-time-series-analysis
#1
Herman Kwok, Wayne Khuu, Kimberly Fernandes, Diana Martins, Mina Tadrous, Samantha Singh, David N Juurlink, Tara Gomes
Objective. : Access to pregabalin via Ontario's public drug insurance program was expanded to an unrestricted model on April 1, 2013, from a prior authorization model. This study aims to identify the effect of expanded access on the rate of pregabalin use by publicly insured persons and to assess the characteristics of new patients initiating pregabalin following this expanded access. Methods. : We conducted a cross-sectional time series analysis using the linked health administrative records of residents of Ontario, Canada, with public drug coverage who were dispensed a prescription for pregabalin between April 1, 2006, and December 31, 2014...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28331860/quetiapine-misuse-and-abuse-is-it-an-atypical-paradigm-of-drug-seeking-behavior
#2
REVIEW
Sean Kim, Gayoung Lee, Eric Kim, Hyejin Jung, Jongwha Chang
Recent case reports in medical literatures suggest that more and more second-generation atypical antipsychotics (AAs) have been prescribed for off-label use; quetiapine (Brand name: Seroquel(®)) showed increase in its trend for off-label use. Little is known about the reasons behind this trend, although historical sedative and hypnotic prescription patterns suggest that despite relatively superior safety profiles of quetiapine (especially for movement disorders), it may be used for treating substance abuse disorder...
January 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/28328708/long-term-outcomes-of-melanoma-in-situ-treated-with-topical-5-imiquimod-cream-a-retrospective-review
#3
Andrew J Park, Joan Paul, M Shane Chapman, Faramarz H Samie
BACKGROUND: Melanoma in situ (MIS) is a noninvasive form of melanoma for which nonsurgical therapeutic options continue to be explored. The off-label use of topical 5% imiquimod cream in the management of MIS has shown potential but reported recurrence rates vary considerably between 0% and 40%. Furthermore, the long-term efficacy of imiquimod is not well established. OBJECTIVE: To determine the recurrence rate of MIS among patients treated with topical 5% imiquimod cream at Dartmouth-Hitchcock Medical Center with at least 1 year of follow-up...
March 21, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28322168/pediatric-off-label-and-unlicensed-drug-use-and-its-implications
#4
Rajeshwari Gore, Preeta Kaur Chugh, Chakra Dhar Tripathi, Yangshen Lhamo, Sandhya Gautam
BACKGROUND: Worldwide, in the absence of standard pediatric prescribing information, clinicians often use medicines in children in a dosage form or for an indication that has not been approved for use. Inadequate clinical trials increase exposure to drugs that lack safety-efficacy data in pediatric population. Hence, off-label and unlicensed drug use must be regarded as a patient safety-issue that is known to be associated with increased risks of adverse drug reactions apart from under- or over-dosing due to lack of pharmacokinetic data...
March 17, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28321136/procarbazine-lomustine-and-vincristine-pcv-regimen-for-central-nervous-system-tumors
#5
Dominic A Solimando, J Aubrey Waddell
The complexity of cancer chemotherapy requires pharmacists be familiar with the complicated regimens and highly toxic agents used. This column reviews various issues related to preparation, dispensing, and administration of antineoplastic therapy, and the agents, both commercially available and investigational, used to treat malignant diseases. Questions or suggestions for topics should be addressed to Dominic A. Solimando, Jr, President, Oncology Pharmacy Services, Inc., 4201 Wilson Blvd #110-545, Arlington, VA 22203, e-mail: OncRxSvc@comcast...
February 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28320139/10-year-outcomes-after-rituximab-for-myasthenia-gravis-efficacy-safety-costs-of-inhospital-care-and-impact-on-childbearing-potential
#6
Karl Stieglbauer, Robert Pichler, Raffi Topakian
Rituximab (RTX) has emerged as an attractive off-label treatment option for patients with myasthenia gravis (MG) refractory to other immune therapies. However, data on long-term outcome after RTX for MG are still scarce. Here we present the 10-year outcomes [median (range) 10.1 (6.7-11.2) years] with respect to efficacy, safety, costs of inhospital care, and impact on childbearing potential in all four MG patients treated by one of the authors with RTX. In all patients, RTX led to sustained clinical improvement and eventual tapering of other immune therapies...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28319507/recombinant-factor-viia-is-associated-with-increased-thrombotic-complications-in-pediatric-cardiac-surgery-patients
#7
Laura Downey, Morgan L Brown, David Faraoni, David Zurakowski, James A DiNardo
BACKGROUND: Recombinant factor VIIa (rFVIIa) is routinely used as an off-label hemostatic agent in children undergoing cardiac surgery. Despite evidence that rFVIIa use is associated with an increased incidence of thrombotic complications in adult cardiac surgery, the safety of rFVIIa as a rescue hemostatic agent in the pediatric cardiac surgical population is less definitively delineated. In this retrospective study, we used propensity score matching to compare the incidence of thrombotic complications between children treated with rFVIIa and their matched controls...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28318897/efficacy-of-off-label-augmentation-in-unipolar-depression-a-systematic-review-of-the-evidence
#8
REVIEW
Julia Kleeblatt, Felix Betzler, Laura L Kilarski, Tom Bschor, Stephan Köhler
Treatment of unipolar depression with currently available antidepressants is still unsatisfactory. Augmentation with lithium or second generation antipsychotics is an established practice in non-responders to antidepressant monotherapy, but is also associated with a substantial non-response rate and with non-tolerance. Based on a systematic review of the literature, including meta-analyses, randomized controlled trials (RCTs), non-randomized comparative studies and case studies, off-label augmentation agents (administered in addition to an antidepressant, without FDA approval for treatment of MDD) were identified and evaluated regarding their efficacy using levels of evidence...
March 16, 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28317153/pharmacokinetics-and-pulmonary-distribution-of-gamithromycin-after-intravenous-administration-in-foals
#9
S Berlin, T Randow, E Scheuch, M Grube, M Venner, W Siegmund
The long-acting azalide antibiotic gamithromycin is marketed for intramuscular treatment of bovine and swine infections. Off-label use in foals leads to severe local lesions likely caused by hyperosmolality of the injected solution. We provide evidence from a pharmacokinetic study in 10 warm-blooded healthy foals for intravenous bolus injection of gamithromycin diluted in distilled water to be a safe and well tolerated alternative. By intravenous dosing, markedly higher plasma exposure and better penetration into bronchoalveolar lavage cells but lower distribution into epithelial lining fluid are achieved as after intramuscular or subcutaneous administration...
March 19, 2017: Journal of Veterinary Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28315798/bone-morphogenetic-proteins-in-anterior-cervical-fusion-a-systematic-review-and-meta-analysis
#10
REVIEW
Shayan Abdollah Zadegan, Aidin Abedi, Seyed Behnam Jazayeri, Hirbod Nasiri Bonaki, Seyed Behzad Jazayeri, Alexander R Vaccaro, Vafa Rahimi-Movaghar
OBJECTIVE: Bone morphogenetic proteins (BMPs) have been commonly used as a graft substitute in spinal fusion. Although the Food and Drug Administration (FDA) issued warning on life-threatening complications of recombinant human BMPs (rhBMPs) in cervical spine fusion in 2008, their off-label use has been continued. This investigation aimed to review the evidence for the use of rhBMP-2 and rhBMP-7 in anterior cervical spine fusions. METHODS: A comprehensive search was performed through Ovid (MEDLINE), PubMed and Embase...
March 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28303630/comparison-of-5-year-outcomes-of-paclitaxel-eluting-and-endeavor-zotarolimus-eluting-stents-in-new-york
#11
Feng Qian, Ye Zhong, Edward L Hannan
OBJECTIVES: To evaluate long-term outcomes in patients undergoing either paclitaxel-eluting stents (PES) or endeavor zotarolimus-eluting stents (E-ZES) placement and to assess comparative effectiveness of PES vs. E-ZES in different "off-label" and "high-risk" patient subgroups. BACKGROUND: PES and E-ZES are frequently used in percutaneous coronary interventions (PCIs). However, the long-term comparative effectiveness of PES vs. E-ZES in real practice is unknown...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28302745/current-status-and-future-potential-of-transcatheter-interventions-in-congenital-heart-disease
#12
Damien P Kenny, Ziyad M Hijazi
Percutaneous therapies for congenital heart disease have evolved rapidly in the past 3 decades. This has occurred despite limited investment from industry and support from regulatory bodies resulting in a lack of specific device development. Indeed, many devices remain off-label with a best-fit approach often required, spurning an innovative culture within the subspecialty, which had arguably laid the foundation for many of the current and evolving structural heart interventions. Challenges remain, not least encouraging device design focused on smaller infants and the inevitable consequences of somatic growth...
March 17, 2017: Circulation Research
https://www.readbyqxmd.com/read/28301628/recurrent-herpes-labialis-in-adults-new-tricks-for-an-old-dog
#13
Ted Rosen
<p>Herpes labialis remains a common worldwide affliction. Recent advances in understanding the basic pathogenesis have led to new therapeutic intervention, both on-label and off-label. Aside from reducing the duration and symptomatology of acute outbreaks, another goal of treatment is to decrease the frequency of future episodes. Oral and topical acyclovir and its analogues are the mainstay of both chronic suppressive and episodic therapy. A new muco-adhesive formulation of acyclovir provides a decrease in outbreaks, probably due to a diminution of herpesvirus load in all reservoir sites...
March 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28301412/large-silicone-droplets-after-intravitreal-bevacizumab-avastin
#14
Robert L Avery, Alessandro A Castellarin, Dilsher S Dhoot, Dante J Pieramici, Maʼan A Nasir, Nathan C Steinle, Logan P Avery, Gabriel M Gordon
PURPOSE: Despite its off-label status, intravitreal bevacizumab is the most commonly used intraocular anti-vascular endothelial growth factor agent. Regulation of compounding pharmacies has recently increased to make compounded pharmaceuticals safer. Despite these changes, a marked increase in symptomatic, large silicone oil droplets following intravitreal bevacizumab injections was noticed. METHODS: Retrospective chart review was performed. Within a single private practice, patients who were noted to have large or symptomatic silicone oil bubbles after an intravitreal injection were reviewed...
March 15, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/28300462/an-update-on-the-advancements-in-the-treatment-of-agitation-in-alzheimer-s-disease
#15
Anton P Porsteinsson, Inga M Antonsdottir
Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) are associated with significant negative outcomes for patients and their caregivers. Agitation, one of the most distressing NPS, lacks well-established long term interventions that are both effective and safe. While nonpharmacological interventions are suggested as first-line treatment, they aren't effective in managing symptoms for every patient, resulting in pharmacological interventions for some patients. Traditionally these interventions consist of off-label use of antipsychotics, sedative/hypnotics, anxiolytics, acetylcholinesterase inhibitors, memantine, and antidepressants; where the efficacy doesn't necessarily outweigh the associated risks...
March 16, 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/28299676/bioresorbable-scaffolds-for-coronary-stenosis-when-and-how-based-upon-current-studies
#16
REVIEW
Alexandre Abizaid, J Ribamar Costa
PURPOSE OF REVIEW: First-generation bioresorbable scaffolds (BRS), largely represented by the poly-l-lactic acid (PLLA) ABSORB (Abbott Vascular, Temecula, Illinois, US), have demonstrated, in low to moderate lesion complexity, similar efficacy to current generation metallic drug-eluting stents. However, a trend toward more device thrombosis has been observed, especially when the scaffolds are used in off-label situations. In this review, we address the most relevant drawbacks of these devices and, based on the available scientific data, we visit the scenarios where there is more uncertainty about their indication, trying to identify the lesions/patients to whom this technology should be voided at its current stage of development...
March 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28295441/fosfomycin-for-the-treatment-of-cystitis-in-the-abdominal-solid-organ-transplant-population
#17
A A Loethen, L Kerstenetzky, J L Descourouez, G E Leverson, J A Smith, M R Jorgenson
STUDY OBJECTIVES: Evaluate the use of fosfomycin (FOS) at the FDA-approved single-dose regimen as well as off-label multidose regimens for the treatment of cystitis after abdominal solid organ transplant (aSOT). DESIGN: Retrospective study. SETTING: Tertiary academic medical center. PATIENTS: Adult inpatients with history of aSOT receiving FOS between 1/1/2009-4/30/2015 for the treatment of cystitis. MEASUREMENTS AND MAIN RESULTS: Seventy-six courses of FOS were identified in 64 patients...
March 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28295234/adverse-drug-reactions-in-children-the-double-edged-sword-of-therapeutics
#18
Abdelbaset A Elzagallaai, Michael J E Greff, Michael J Rieder
Adverse drug reactions (ADRs) represent a major health problem worldwide with high morbidity and mortality rates. ADRs are classified into type A (augmented) and type B (bizarre) ADRs with the former group being more common and the later less common but often severe and clinically more problematic due to their unpredictable nature and occurrence at any dose. Pediatric populations are especially vulnerable to ADRs due to the lack of data for this age group from the drug development process and because of the wide use of Off-label and unlicensed use of drugs...
March 13, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28293992/poor-evidence-for-use-of-most-off-label-antidepressants
#19
(no author information available yet)
There is a lack of scientific evidence to support the use of most off-label antidepressants, a study suggests.
March 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28289789/-medical-care-of-patients-with-spasticity-following-stroke-evaluation-of-the-treatment-situation-in-germany-with-focus-on-the-use-of-botulinum-toxin
#20
L Kerkemeyer, G Lux, A Walendzik, J Wasem, A Neumann
BACKGROUND: Upper limb spasticity is a common complication following stroke. Cohort studies found 19% of post-stroke patients had upper limb spasticity at 3 months and 38% of patients at 12 months. For focal spasticity, intramuscular injections of botulinum toxin are indicated. In Germany, it is assumed that patients with the described indication are undersupplied with botulinum toxin. OBJECTIVE: The aim of the present study is to evaluate the medical care of patients with upper limb spasticity post-stroke with the focus on the use of botulinum toxin as one treatment option...
March 13, 2017: Der Nervenarzt
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