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Critical care pharmacology

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https://www.readbyqxmd.com/read/29048945/cell-density-affects-the-detection-of-chk1-target-engagement-by-the-selective-inhibitor-v158411
#1
Clara C Geneste, Andrew J Massey
Understanding drug target engagement and the relationship to downstream pharmacology is critical for drug discovery. Here we have evaluated target engagement of Chk1 by the small-molecule inhibitor V158411 using two different target engagement methods (autophosphorylation and cellular thermal shift assay [CETSA]). Target engagement measured by these methods was subsequently related to Chk1 inhibitor-dependent pharmacology. Inhibition of autophosphorylation was a robust method for measuring V158411 Chk1 target engagement...
October 1, 2017: SLAS Discovery
https://www.readbyqxmd.com/read/29042299/non-pharmacological-interventions-for-spasticity-in-adults-an-overview-of-systematic-reviews
#2
REVIEW
Fary Khan, Bhasker Amatya, Djamel Bensmail, Alain Yelnik
OBJECTIVES: Spasticity causes significant long-term disability-burden, requiring comprehensive management. This review evaluates evidence from published systematic reviews of clinical trials for effectiveness of non-pharmacological interventions for improved spasticity outcomes. METHODS: Data sources: A literature search was conducted using medical and health science electronic (MEDLINE, EMBASE, CINAHL, PubMed, and the Cochrane Library) databases for published systematic reviews up to 15(th) June 2017...
October 14, 2017: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29032602/muscle-specific-differences-in-expression-and-phosphorylation-of-the-janus-kinase-2-signal-transducer-and-activator-of-transcription-3-following-long-term-mechanical-ventilation-and-immobilization-in-rats
#3
Heba Salah, Wen Fury, Jesper Gromada, Yu Bai, Tamar Tchkonia, James L Kirkland, Lars Larsson
AIM: Muscle wasting is one of the factors most strongly predicting mortality and morbidity in critically ill intensive care unit (ICU). This muscle wasting affects both limb and respiratory muscles but the understanding of underlying mechanisms and muscle-specific differences remains incomplete. This study aims at investigating the temporal expression and phosphorylation of the Janus kinase / signal transducer and activator of transcription (JAK/STAT) pathway in muscle wasting associated with the ICU condition in order to characterize the JAK/STAT proteins and the related changes leading or responding to their activation during exposure to the ICU condition...
October 15, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/29027654/pharmacokinetic-drug-drug-interactions-in-the-intensive-care-unit-single-centre-experience-and-literature-review
#4
Piotr Łój, Aleksanda Olender, Weronika Ślęzak, Łukasz J Krzych
BACKGROUND: Drug-drug interactions constitute a serious health hazard in everyday clinical practice in critically ill patients. Drug-drug interactions may be pharmacokinetic or pharmacodynamic in their nature. We aimed to investigate the quantity and quality of possible drug-drug interactions, and their possible side effects in intensive care unit patients in a 12-month period. METHODS: This retrospective study covered data on pharmacological treatment of 43 consecutive patients (11 females, 32 males) aged 62 ± 15 years, hospitalized between January 2015 and February 2016...
October 13, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29024974/functional-recovery-in-major-depressive-disorder-providing-early-optimal-treatment-for-the-individual-patient
#5
Oloruntoba J Oluboka, Martin A Katzman, Jeffrey Habert, Diane McIntosh, Glenda M MacQueen, Roumen V Milev, Roger S McIntyre, Pierre Blier
Major depressive disorder (MDD) is an often chronic and recurring illness. Left untreated, MDD may result in progressive alterations in brain morphometry and circuit function. Recent findings, however, suggest that pharmacotherapy may halt and possibly reverse those effects. These findings, together with evidence that a delay in treatment is associated with poorer clinical outcomes, underscore the urgency of rapidly treating depression to full recovery. Early optimized treatment, using measurement-based care and customizing treatment to the individual patient, may afford the best possible outcomes for each patient...
September 8, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28991714/the-pharmacological-and-non-pharmacological-interventions-for-the-management-of-fatigue-related-multiple-sclerosis
#6
REVIEW
Philippa Miller, Andrew Soundy
AIM: The clinical aim was to provide up-to-date evidence-based recommendations for the treatment of MS-related fatigue (MSRF). The scientific aim was to prioritise topics for future randomised clinical trials with sufficient power. METHODS: A systematic search of review based research that considered MSRF in adults (18years and over) was undertaken in May 2016. Data from reviews was extracted, critically appraised and synthesised using four specific techniques. RESULTS: A total of 24 reviews were identified (17 non-pharmacological, 5 pharmacological, 2 combining both), which contained 339 studies on interventions deigned to improve MSRF...
October 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28982305/advanced-modes-of-mechanical-ventilation-introduction-for-the-critical-care-pharmacist
#7
Michael J Cawley
Mechanical ventilation continues to be an evolving modality in the critical care environment. Technological advances in microprocessor-controlled ventilation integrated with the complexity of new ventilator modes has provided the multidisciplinary team opportunities to further improve the care of the critically ill ventilator patients. As members of the critical care multidisciplinary team, pharmacists require a basic understanding of both conventional and advanced modes of mechanical ventilation in order to assist in optimizing medication use and ultimately patient health-care outcomes...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28979558/the-significance-of-circadian-rhythms-and-dysrhythmias-in-critical-illness
#8
REVIEW
Helen T McKenna, Irwin Km Reiss, Daniel S Martin
Many physiological and cellular processes cycle with time, with the period between one peak and the next being roughly equal to 24 h. These circadian rhythms underlie 'permissive homeostasis', whereby anticipation of periods of increased energy demand or stress may enhance the function of individual cells, organ systems or whole organisms. Many physiological variables related to survival during critical illness have a circadian rhythm, including the sleep/wake cycle, haemodynamic and respiratory indices, immunity and coagulation, but their clinical significance remains underappreciated...
May 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28978209/treatment-and-managed-care-issues-of-atopic-dermatitis
#9
Danielle Ezzo
The specific cause of atopic dermatitis (AD) is not known. It is a multifactorial disease involving environmental agents, immune dysregulation, genetic predisposition, and defects in skin barrier function. Patients are typically classified as having mild, moderate, or severe disease. Most patients with AD can control their symptoms with various combinations of moisturizers, conventional prescription therapies, and lifestyle modifications, while patients with more severe disease may require adjunctive treatment with phototherapy, biologic treatments, or systemic immunosuppressants...
June 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28976571/ketamine-and-norketamine-stability-in-whole-blood-at-ambient-and-4%C3%A2-c-conditions
#10
Benjamin Duy Tran, Ganesh S Moorthy, Athena F Zuppa
A study was implemented to describe the pharmacokinetics (PK) of ketamine (K) and its metabolite norketamine (NK) in critically ill adults. Conducting studies in these subjects is hindered by the immediate need to process and freeze samples obtained in a busy intensive care setting. The ability to store unprocessed samples at room temperature for an extended time period would overcome this barrier. Stability and blood to plasma partitioning of K and NK were investigated in whole blood up to 120 h at room temperature and 4 °C...
October 4, 2017: Biomedical Chromatography: BMC
https://www.readbyqxmd.com/read/28973626/delirium-in-older-persons-advances-in-diagnosis-and-treatment
#11
REVIEW
Esther S Oh, Tamara G Fong, Tammy T Hshieh, Sharon K Inouye
Importance: Delirium is defined as an acute disorder of attention and cognition. It is a common, serious, and often fatal condition among older patients. Although often underrecognized, delirium has serious adverse effects on the individual's function and quality of life, as well as broad societal effects with substantial health care costs. Objective: To summarize the current state of the art in diagnosis and treatment of delirium and to highlight critical areas for future research to advance the field...
September 26, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28971346/combined-pet-mri-global-warming-summary-report-of-the-6th-international-workshop-on-pet-mri-march-27-29-2017-t%C3%A3-bingen-germany
#12
REVIEW
D L Bailey, B J Pichler, B Gückel, G Antoch, H Barthel, Z M Bhujwalla, S Biskup, S Biswal, M Bitzer, R Boellaard, R F Braren, C Brendle, K Brindle, A Chiti, C la Fougère, R Gillies, V Goh, M Goyen, M Hacker, L Heukamp, G M Knudsen, A M Krackhardt, I Law, J C Morris, K Nikolaou, J Nuyts, A A Ordonez, K Pantel, H H Quick, K Riklund, O Sabri, B Sattler, E G C Troost, M Zaiss, L Zender, Thomas Beyer
The 6th annual meeting to address key issues in positron emission tomography (PET)/magnetic resonance imaging (MRI) was held again in Tübingen, Germany, from March 27 to 29, 2017. Over three days of invited plenary lectures, round table discussions and dialogue board deliberations, participants critically assessed the current state of PET/MRI, both clinically and as a research tool, and attempted to chart future directions. The meeting addressed the use of PET/MRI and workflows in oncology, neurosciences, infection, inflammation and chronic pain syndromes, as well as deeper discussions about how best to characterise the tumour microenvironment, optimise the complementary information available from PET and MRI, and how advanced data mining and bioinformatics, as well as information from liquid biomarkers (circulating tumour cells and nucleic acids) and pathology, can be integrated to give a more complete characterisation of disease phenotype...
October 2, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/28965157/the-effect-of-listening-to-holy-quran-recitation-on-weaning-patients-receiving-mechanical-ventilation-in-the-intensive-care-unit-a-pilot-study
#13
Mohammad Yadak, Khalid Aziz Ansari, Hatem Qutub, Hajed Al-Otaibi, Omar Al-Omar, Nawal Al-Onizi, Faraz Ahmed Farooqi
Mechanical ventilation (MV) causes high level of stress in hospitalized patients. Weaning is the gradual process of decreasing ventilator support that in turn lead to termination of MV and increased respiratory effort, which may exacerbate symptoms and prolong MV. This study aimed to investigate the effect of listening to Holy Quran recitation (HQR) as a non-pharmacological intervention in patients during weaning from mechanical ventilation. This is a randomized controlled trial in which 55 patients admitted in the intensive care unit (ICU) and on mechanical ventilation were recruited...
September 30, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/28958185/targeting-the-endothelial-glycocalyx-in-acute-critical-illness-as-a-challenge-for-clinical-and-laboratory-medicine
#14
Vladimir Cerny, David Astapenko, Florian Brettner, Jan Benes, Radomir Hyspler, Christian Lehmann, Zdenek Zadak
The purpose of this manuscript is to review the role of endothelial glycocalyx (EG) in the field of critical and perioperative medicine and to discuss possible future directions for investigations in this area. Under physiological conditions, EG has several well-defined functions aimed to prevent the disruption of vessel wall integrity. Under pathological conditions, the EG represent one of the earliest sites of injury during inflammation. EG structure and function distortion contribute to organ dysfunction related to sepsis, trauma, or global ischemia of any origin...
August 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28944590/effect-of-the-use-of-earplugs-and-eye-mask-on-the-quality-of-sleep-in-intensive-care-patients-a-systematic-review
#15
Hana Locihová, Karel Axmann, Hana Padyšáková, Jakub Fejfar
Intensive care unit (ICU) environment has a very strong and unavoidable negative impact on patients' sleep. Sleep deprivation in ICU patients has been already studied and negative effects on their outcome (prolonged ICU stay, decreased recovery) and complication rates (incidence of delirium, neuropsychological sequels of critical illness) discussed. Several interventions potentially improving the sleep disturbance in ICU (sleep-promotion strategies) have been assumed and tested for clinical practice. We present a review of recent literature focused on chosen types of non-pharmacological interventions (earplugs and eye mask) analysing their effect on sleep quality/quantity...
September 25, 2017: Journal of Sleep Research
https://www.readbyqxmd.com/read/28939396/novel-therapies-for-angiotensin-converting-enzyme-inhibitor-induced-angioedema-a-systematic-review-of-current-evidence
#16
Heidi M Riha, Bryant B Summers, Jessica V Rivera, Megan A Van Berkel
BACKGROUND: Angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema can occur at any point during therapy and, when severe, can require mechanical ventilation. Standard agents for anaphylactic reactions have limited efficacy for bradykinin-mediated angioedema and, therefore, agents approved for hereditary angioedema are increasingly prescribed for these patients. OBJECTIVE OF THE REVIEW: This systematic review critically evaluates evidence describing the off-label use of fresh frozen plasma (FFP), prothrombin complex concentrate (PCC), complement 1 esterase inhibitor (C1-INH), icatibant, and ecallantide for treatment of ACEI-induced angioedema...
September 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28925861/perioperative-pulmonary-medication-management
#17
Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: Pulmonary conditions such as asthma and chronic obstructive pulmonary disease (COPD) are common conditions that warrant special consideration in the perioperative period. When these patients undergo surgical interventions, they have risk of complications such as bronchospasm, hypoxia, and even postoperative respiratory failure that warrants unplanned intensive care unit admission. Thus, clinicians must be familiar with pulmonary medication regimens that are critical for maintaining stable homeostasis of these chronic conditions...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28900890/high-level-of-venous-thromboembolism-in-critically-ill-trauma-patients-despite-early-and-well-driven-thromboprophylaxis-protocol
#18
S R Hamada, C Espina, T Guedj, R Buaron, A Harrois, S Figueiredo, J Duranteau
BACKGROUND: Venous thromboembolism (VTE) is one of the most common preventable causes of in-hospital death in trauma patients surviving their injuries. We assessed the prevalence, incidence and risk factors for deep venous thrombosis (DVT) and pulmonary embolism (PE) in critically ill trauma patients, in the setting of a mature and early mechanical and pharmacological thromboprophylaxis protocol. METHODS: This was a prospective observational study on a cohort of patients from a surgical intensive care unit of a university level 1 trauma centre...
September 12, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28895186/the-placebo-effect-on-bradykinesia-in-parkinson-s-disease-with-and-without-prior-drug-conditioning
#19
Elisa Frisaldi, Elisa Carlino, Maurizio Zibetti, Diletta Barbiani, Francesca Dematteis, Michele Lanotte, Leonardo Lopiano, Fabrizio Benedetti
BACKGROUND: Placebo effects represent a major drawback in clinical trials, and their magnitude hampers the development of new treatments. Previous research showed that prior exposure to active treatments increases the placebo response for muscle rigidity in Parkinson's disease. METHODS: We investigated the effects of prior exposure to apomorphine on the placebo response of another cardinal symptom of Parkinson's disease, bradykinesia, by a movement time analyzer...
September 12, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/28876970/responding-to-ten-common-delirium-misconceptions-with-best-evidence-an-educational-review-for-clinicians
#20
Mark A Oldham, Nina M Flanagan, Ariba Khan, Olga Boukrina, Edward R Marcantonio
Delirium (acute confusion) is a serious, common health condition, and it predicts poor outcomes, including greater rates of mortality, institutionalization, prolonged hospitalization, and cognitive impairment. Expedient diagnosis and management are critical to address modifiable delirium causes and improve both quality of care and outcomes. Moreover, more than a third of delirium is preventable. Despite the clear significance of delirium and our increasingly sophisticated understanding of the condition, the gap between evidence and practice persists...
September 6, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
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