All posts; Tags Include "Pharmacology"

September 2, 2014
08:00 AM
1,068 views

The Anti-Vaccine Movement Is A Preventable Disease

Yet another study that attempts to make a link between vaccines and autism has been withdrawn by the publishers. Data from the CDC was re-analysed, and low and behold, a link between vaccine timing and autism was drawn, but only for African-American boys. The problems with this paper and the anti-vaccine movement in general are discussed.... Read more »

Hooker, B. (2014) Measles-mumps-rubella vaccination timing and autism among young african american boys: a reanalysis of CDC data. Translational Neurodegeneration, 3(1), 16. DOI: 10.1186/2047-9158-3-16

Tang G, Gudsnuk K, Kuo SH, Cotrina ML, Rosoklija G, Sosunov A, Sonders MS, Kanter E, Castagna C, Yamamoto A.... (2014) Loss of mTOR-Dependent Macroautophagy Causes Autistic-like Synaptic Pruning Deficits. Neuron. PMID: 25155956

August 19, 2014
10:15 PM
1,228 views

Dextrose 10% in the Treatment of Out-of-Hospital Hypoglycemia

by Rogue Medic in Rogue Medic

Is 50% dextrose as good as 10% dextrose for treating symptomatic hypoglycemia?

If the patient is disoriented, but becomes oriented before the full dose of dextrose is given, is it appropriate to continue to treat the patient as if the patient were still disoriented? If your protocols require you to keep giving dextrose, do the same protocols require you to keep giving opioids after the pain is relieved? Is there really any difference?

50% dextrose has problems.... Read more »

Kiefer MV, Gene Hern H, Alter HJ, & Barger JB. (2014) Dextrose 10% in the treatment of out-of-hospital hypoglycemia. Prehospital and disaster medicine, 29(2), 190-4. PMID: 24735872

Levy SB, & Rosh AJ. (2006) Images in emergency medicine. Dextrose extravasation causing skin necrosis. Annals of emergency medicine, 48(3). PMID: 16934641

August 18, 2014
10:16 AM
650 views

Guidelines for Treatment of Problem Gambling

by William Yates, M.D. in Brain Posts

Despite the prevalence and impact of problem gambling, few summaries or guidelines address treatment.Searching the guideline.gov website shows no recent additions to the guideline literature.A guideline was published by the Singapore Ministry of Health in 2011. This guideline is still relevant and highlights some of the key elements of a problem gambling treatment program.I will summarize some of these key elements from this source titled: "Management of gambling disorders". In their summa........ Read more »

Lee KM, Chan HN, Cheah B, Gentica GF, Guo S, Lim HK, Lim YC, Noorul F, Tan HS, Teo P.... (2011) Ministry of Health clinical practice guidelines: management of gambling disorders. Singapore medical journal, 52(6), 456. PMID: 21732000

August 14, 2014
11:17 AM
739 views

FDA Approves Novel Insomnia Drug Suvorexant (Belsomra)

by William Yates, M.D. in Brain Posts

Regular readers of this blog had a heads up last year on the development of orexin receptor antagonists for the treatment of insomnia.I posted a review of an Italian clinical drug trial in humans with insomnia paired with polysomnography. This study used three different doses of a orexin receptor antagonist (10 mg 30 mg and 60 mg).In a second post, I reviewed a sleep lab study of the effects of an orexin antagonist drug compared to zolpidem (Ambien) on sleep architecture.This second study found ........ Read more »

Michelson D, Snyder E, Paradis E, Chengan-Liu M, Snavely DB, Hutzelmann J, Walsh JK, Krystal AD, Benca RM, Cohn M.... (2014) Safety and efficacy of suvorexant during 1-year treatment of insomnia with subsequent abrupt treatment discontinuation: a phase 3 randomised, double-blind, placebo-controlled trial. Lancet neurology, 13(5), 461-71. PMID: 24680372

Bennett T, Bray D, & Neville MW. (2014) Suvorexant, a dual orexin receptor antagonist for the management of insomnia. P , 39(4), 264-6. PMID: 24757363

August 13, 2014
11:35 PM
868 views

The Controversy of Admitting 'We Do Not Know What Works'

by Rogue Medic in Rogue Medic

There are several news articles today criticizing a study because the patients might be deprived of a drug that has not been adequately studied in humans. This criticism is coming from journalists – the people who publicized the fraudulent vaccines research by Andrew Wakefield, who was trying to sell his competing vaccine and was being paid to produce negative research by lawyers suing the vaccine companies.[1]

The real controversy is that this untested drug became the standard of care ........ Read more »

Larabee TM, Liu KY, Campbell JA, & Little CM. (2012) Vasopressors in cardiac arrest: a systematic review. Resuscitation, 83(8), 932-9. PMID: 22425731

Woodhouse SP, Cox S, Boyd P, Case C, & Weber M. (1995) High dose and standard dose adrenaline do not alter survival, compared with placebo, in cardiac arrest. Resuscitation, 30(3), 243-9. PMID: 8867714

Herlitz J, Ekström L, Wennerblom B, Axelsson A, Bång A, & Holmberg S. (1995) Adrenaline in out-of-hospital ventricular fibrillation. Does it make any difference?. Resuscitation, 29(3), 195-201. PMID: 7667549

Ong ME, Tan EH, Ng FS, Panchalingham A, Lim SH, Manning PG, Ong VY, Lim SH, Yap S, Tham LP.... (2007) Survival outcomes with the introduction of intravenous epinephrine in the management of out-of-hospital cardiac arrest. Annals of emergency medicine, 50(6), 635-42. PMID: 17509730

Olasveengen, T., Sunde, K., Brunborg, C., Thowsen, J., Steen, P., & Wik, L. (2009) Intravenous Drug Administration During Out-of-Hospital Cardiac Arrest: A Randomized Trial. JAMA: The Journal of the American Medical Association, 302(20), 2222-2229. DOI: 10.1001/jama.2009.1729

Olasveengen TM, Wik L, Sunde K, & Steen PA. (2011) Outcome when adrenaline (epinephrine) was actually given vs. not given - post hoc analysis of a randomized clinical trial. Resuscitation. PMID: 22115931

Jacobs IG, Finn JC, Jelinek GA, Oxer HF, & Thompson PL. (2011) Effect of adrenaline on survival in out-of-hospital cardiac arrest: A randomised double-blind placebo-controlled trial. Resuscitation, 82(9), 1138-43. PMID: 21745533

Hagihara A, Hasegawa M, Abe T, Nagata T, Wakata Y, & Miyazaki S. (2012) Prehospital epinephrine use and survival among patients with out-of-hospital cardiac arrest. JAMA : the journal of the American Medical Association, 307(11), 1161-8. PMID: 22436956

Hayashi Y, Iwami T, Kitamura T, Nishiuchi T, Kajino K, Sakai T, Nishiyama C, Nitta M, Hiraide A, & Kai T. (2012) Impact of early intravenous epinephrine administration on outcomes following out-of-hospital cardiac arrest. Circulation journal : official journal of the Japanese Circulation Society, 76(7), 1639-45. PMID: 22481099

Glover BM, Brown SP, Morrison L, Davis D, Kudenchuk PJ, Van Ottingham L, Vaillancourt C, Cheskes S, Atkins DL, Dorian P.... (2012) Wide variability in drug use in out-of-hospital cardiac arrest: A report from the resuscitation outcomes consortium. Resuscitation. PMID: 22858552

Donnino, M., Salciccioli, J., Howell, M., Cocchi, M., Giberson, B., Berg, K., Gautam, S., Callaway, C., & , . (2014) Time to administration of epinephrine and outcome after in-hospital cardiac arrest with non-shockable rhythms: retrospective analysis of large in-hospital data registry. BMJ, 348(may20 2). DOI: 10.1136/bmj.g3028

Callaham M, Madsen CD, Barton CW, Saunders CE, & Pointer J. (1992) A randomized clinical trial of high-dose epinephrine and norepinephrine vs standard-dose epinephrine in prehospital cardiac arrest. JAMA : the journal of the American Medical Association, 268(19), 2667-72. PMID: 1433686

Brown CG, Martin DR, Pepe PE, Stueven H, Cummins RO, Gonzalez E, & Jastremski M. (1992) A comparison of standard-dose and high-dose epinephrine in cardiac arrest outside the hospital. The Multicenter High-Dose Epinephrine Study Group. The New England journal of medicine, 327(15), 1051-5. PMID: 1522841

Choux C, Gueugniaud PY, Barbieux A, Pham E, Lae C, Dubien PY, & Petit P. (1995) Standard doses versus repeated high doses of epinephrine in cardiac arrest outside the hospital. Resuscitation, 29(1), 3-9. PMID: 7784720

Gueugniaud PY, Mols P, Goldstein P, Pham E, Dubien PY, Deweerdt C, Vergnion M, Petit P, & Carli P. (1998) A comparison of repeated high doses and repeated standard doses of epinephrine for cardiac arrest outside the hospital. European Epinephrine Study Group. The New England journal of medicine, 339(22), 1595-601. PMID: 9828247

Vandycke C, & Martens P. (2000) High dose versus standard dose epinephrine in cardiac arrest - a meta-analysis. Resuscitation, 45(3), 161-6. PMID: 10959014

Stiell IG, Hebert PC, Weitzman BN, Wells GA, Raman S, Stark RM, Higginson LA, Ahuja J, & Dickinson GE. (1992) High-dose epinephrine in adult cardiac arrest. The New England journal of medicine, 327(15), 1045-50. PMID: 1522840

Callaway, C. (2012) Questioning the Use of Epinephrine to Treat Cardiac Arrest. JAMA: The Journal of the American Medical Association, 307(11), 1198. DOI: 10.1001/jama.2012.313

August 3, 2014
05:00 PM
1,184 views

Resuscitation characteristics and outcomes in suspected drug overdose-related out-of-hospital cardiac arrest

by Rogue Medic in Rogue Medic

This study is interesting for several reasons.

In a system that claims excellence, the most consistent way to identify the study group is by documentation of a protocol violation - but it is not intended as a study of protocol violations.

This may hint at some benefit from epinephrine (Adrenaline in Commonwealth countries), but that would require some study and we just don't study epinephrine. We only make excuses for not studying epinephrine.

The atropine results suggest that the ........ Read more »

Roberts, J. (2011) InFocus: Dissecting the ACLS Guidelines on Cardiac Arrest from Toxic Ingestions. Emergency Medicine News, 33(10), 16-18. DOI: 10.1097/01.EEM.0000406945.05619.ca

Koller, A., Salcido, D., Callaway, C., & Menegazzi, J. (2014) Resuscitation characteristics and outcomes in suspected drug overdose-related out-of-hospital cardiac arrest. Resuscitation. DOI: 10.1016/j.resuscitation.2014.05.036

July 29, 2014
07:01 PM
1,123 views

Gabapentin and pregabalin misuse

by DJMac in Recovery Review

Gabapentin and pregabalin misuse are problems that are not going to go away. My post on gabapentin is one of the most-read on this site. While these are useful medicines, workers in drug treatment and support see patients regularly on gabapentin or pregabalin who have misused the drugs or who are misusing them. Guidance is [...]
The post Gabapentin and pregabalin misuse appeared first on Recovery Review.
... Read more »

Schifano, F. (2014) Misuse and Abuse of Pregabalin and Gabapentin: Cause for Concern?. CNS Drugs, 28(6), 491-496. DOI: 10.1007/s40263-014-0164-4

July 23, 2014
12:14 PM
557 views

Vaccine halves dengue cases

by Yao-Hua Law in TORCH

[Another version of this article was first published on SciDev.Net. Click here for link.] A vaccine that can half the number of dengue cases will soon be available. A recent trial conducted in Southeast Asia shows that this dengue vaccine achieves a vaccine efficacy of 56.5%: the vaccine reduces an individual’s chance of getting […]... Read more »

Capeding, M., Tran, N., Hadinegoro, S., Ismail, H., Chotpitayasunondh, T., Chua, M., Luong, C., Rusmil, K., Wirawan, D., Nallusamy, R.... (2014) Clinical efficacy and safety of a novel tetravalent dengue vaccine in healthy children in Asia: a phase 3, randomised, observer-masked, placebo-controlled trial. The Lancet. DOI: 10.1016/S0140-6736(14)61060-6

July 20, 2014
11:21 AM
766 views

Slowing Heart Disease

by Viputheshwar Sitaraman in Draw Science

Stopping just one minor enzyme leads to an entire cascade of pathways that can slow heart disease. [Infographic]... Read more »

Blazevic T, Schwaiberger AV, Schreiner CE, Schachner D, Schaible AM, Grojer CS, Atanasov AG, Werz O, Dirsch VM, & Heiss EH. (2013) 12/15-lipoxygenase contributes to platelet-derived growth factor-induced activation of signal transducer and activator of transcription 3. The Journal of biological chemistry, 288(49), 35592-603. PMID: 24165129

July 16, 2014
08:05 AM
987 views

East To West And Back Again

by Mark Lasbury in As Many Exceptions As Rules

Sunflowers were named by Linnaeus for their round shape and bright color that reminded him of the sun, not because they follow the sun. But they do seem to turn to face the sun each day. A new review has looked at the molecular mechanisms that control the movement of the apex of the plant. But questions remain – how does the plant turn back to the east at night? Why is it that the flower turns but the leaves do not? Why does the movement stop when the flower matures?... Read more »

Vandenbrink JP, Brown EA, Harmer SL, & Blackman BK. (2014) Turning heads: The biology of solar tracking in sunflower. Plant science : an international journal of experimental plant biology, 20-26. PMID: 24908502

Chang WC, Jia H, Aw W, Saito K, Hasegawa S, & Kato H. (2014) Beneficial effects of soluble dietary Jerusalem artichoke (Helianthus tuberosus) in the prevention of the onset of type 2 diabetes and non-alcoholic fatty liver disease in high-fructose diet-fed rats. The British journal of nutrition, 1-9. PMID: 24968200

July 12, 2014
07:02 PM
777 views

Legal highs – not for human consumption

by DJMac in Recovery Review

Legal highs in Lothian The UK has the largest market for new psychoactive substances (NSP or “legal highs”) in Europe. Scotland is no stranger to them and, as a seminar in Edinburgh heard last week, the Lothian area is seeing a surge in demand, some worrying trends in injecting and significant new presentations due to problems [...]
The post Legal highs - not for human consumption appeared first on Recovery Review.
... Read more »

Baumann, M. (2014) Awash in a sea of ‘bath salts’: implications for biomedical research and public health. Addiction. DOI: 10.1111/add.12601

July 10, 2014
07:17 AM
716 views

Can a Failed Schizophrenia Drug Prevent PTSD?

by The Neurocritic in The Neurocritic

In the 2000s, enthusiasm was high that a novel class of drugs would reach the market as blockbuster treatments for psychiatric disorders. These drugs act on receptors for a group of neuropeptides known as tachykinins (or neurokinins). These peptides — substance P (SP), neurokinin A (NkA), and neurokinin B (NkB) — function as neurotransmitters or neuromodulators in the central nervous system, but are quite different from the usual monoamines targeted by current psychotropic medications prescr........ Read more »

Andero, R., Dias, B., & Ressler, K. (2014) A Role for Tac2, NkB, and Nk3 Receptor in Normal and Dysregulated Fear Memory Consolidation. Neuron. DOI: 10.1016/j.neuron.2014.05.028

Spooren, W., Riemer, C., & Meltzer, H. (2005) NK3 receptor antagonists: the next generation of antipsychotics?. Nature Reviews Drug Discovery, 4(12), 967-975. DOI: 10.1038/nrd1905

July 9, 2014
08:15 AM
799 views

What’s So Repelling About Repellents?

by Mark Lasbury in As Many Exceptions As Rules

It’s amazing that even though citronella and DEET reduce mosquito bites, we have very little idea of how they work. New research is showing that DEET interacts with olfactory receptors so that chemical attractants are still sensed, but their interpretations are confused. You are still there, but you pretty disappear as far as the mosquito is concerned. Other research shows that one of the co-receptors for olfactory receptors is responsible not only for DEET activity, but also for mosquito ........ Read more »

DeGennaro M, McBride CS, Seeholzer L, Nakagawa T, Dennis EJ, Goldman C, Jasinskiene N, James AA, & Vosshall LB. (2013) orco mutant mosquitoes lose strong preference for humans and are not repelled by volatile DEET. Nature, 498(7455), 487-91. PMID: 23719379

Stanczyk NM, Brookfield JF, Field LM, & Logan JG. (2013) Aedes aegypti mosquitoes exhibit decreased repellency by DEET following previous exposure. PloS one, 8(2). PMID: 23437043

Klun JA, Kramer M, & Debboun M. (2013) Four simple stimuli that induce host-seeking and blood-feeding behaviors in two mosquito species, with a clue to DEET's mode of action. Journal of vector ecology : journal of the Society for Vector Ecology, 38(1), 143-53. PMID: 23701619

July 2, 2014
03:54 PM
870 views

Plant = Pill?

by Viputheshwar Sitaraman in Draw Science

E. Longfolia: an aphrodisiac, anti-inflammatory, and anti-malarial miracle plant. [Infographic]... Read more »

Tran TV, Malainer C, Schwaiger S, Atanasov AG, Heiss EH, Dirsch VM, & Stuppner H. (2014) NF-κB inhibitors from Eurycoma longifolia. Journal of natural products, 77(3), 483-8. PMID: 24467387

July 2, 2014
08:25 AM
1,014 views

How Do Mosquitoes Find You?

by Mark Lasbury in As Many Exceptions As Rules

Spend much time outside in the summer and you will have to deal with mosquitoes. The mechanisms that females use to find a blood meal are becoming better understood. New research shows how the proboscis probes for a blood vessel, perhaps using the TRPA1 heat sensing ion channel as a signal for nearby blood.

Once they feed, females lay eggs. New research indicates that they actually prefer water that contains the dead larvae of similar mosquitoes, dead from predators. The presence of predator........ Read more »

Maekawa E, Aonuma H, Nelson B, Yoshimura A, Tokunaga F, Fukumoto S, & Kanuka H. (2011) The role of proboscis of the malaria vector mosquito Anopheles stephensi in host-seeking behavior. Parasites , 10. PMID: 21272298

Albeny-Simões D, Murrell EG, Elliot SL, Andrade MR, Lima E, Juliano SA, & Vilela EF. (2014) Attracted to the enemy: Aedes aegypti prefers oviposition sites with predator-killed conspecifics. Oecologia, 175(2), 481-92. PMID: 24590205

Olanga EA, Okal MN, Mbadi PA, Kokwaro ED, & Mukabana WR. (2010) Attraction of Anopheles gambiae to odour baits augmented with heat and moisture. Malaria journal, 6. PMID: 20051143

Liu C, & Zwiebel LJ. (2013) Molecular characterization of larval peripheral thermosensory responses of the malaria vector mosquito Anopheles gambiae. PloS one, 8(8). PMID: 23940815

June 29, 2014
11:55 PM
893 views

Safety of Intranasal Fentanyl in the Out-of-Hospital Setting - A Prospective Observational Study

by Rogue Medic in Rogue Medic

I have been very critical of plans to have first responders treat people they suspect of having a heroin (or other) opioid overdose with naloxone.

Would first responders be safer with fentanyl?

It is not really the same question, but it does highlight the differences and why I think fentanyl is safer. The patient will be seen by someone more likely to recognize when the treatment is inappropriate. This study looked at IN (IntraNasal) fentanyl given by basic EMTs prior to transport to the E........ Read more »

Krauss, W., Shah, S., Shah, S., & Thomas, S. (2011) Fentanyl in the Out-of-Hospital Setting: Variables Associated with Hypotension and Hypoxemia. The Journal of Emergency Medicine, 40(2), 182-187. DOI: 10.1016/j.jemermed.2009.02.009

Karlsen AP, Pedersen DM, Trautner S, Dahl JB, & Hansen MS. (2014) Safety of intranasal fentanyl in the out-of-hospital setting: a prospective observational study. Annals of emergency medicine, 63(6), 699-703. PMID: 24268523

June 25, 2014
08:15 AM
927 views

They Can See The Blood Running Through You

by Mark Lasbury in As Many Exceptions As Rules

Vampire bats sense heat via pit organs in their nose-leaves, but they find their victims by sight, smell and echolocation. New research shows that an alternatively spliced version of the capsaicin receptor TRPV1 is responsible for the heat sensing, but what do they use it for? Their teeth are so short that they must find blood vessels close to the surface – shallow vessels give off more heat than do deep vessels or skin where there is no large vessel.

Vampire bats occasionally feed on ........ Read more »

Vanderelst D, De Mey F, Peremans H, Geipel I, Kalko E, & Firzlaff U. (2010) What noseleaves do for FM bats depends on their degree of sensorial specialization. PloS one, 5(8). PMID: 20808438

Patel R, Ispoglou S, & Apostolakis S. (2014) Desmoteplase as a potential treatment for cerebral ischaemia. Expert opinion on investigational drugs, 23(6), 865-73. PMID: 24766516

Ma D, Mizurini DM, Assumpção TC, Li Y, Qi Y, Kotsyfakis M, Ribeiro JM, Monteiro RQ, & Francischetti IM. (2013) Desmolaris, a novel factor XIa anticoagulant from the salivary gland of the vampire bat (Desmodus rotundus) inhibits inflammation and thrombosis in vivo. Blood, 122(25), 4094-106. PMID: 24159172

Gröger U, & Wiegrebe L. (2006) Classification of human breathing sounds by the common vampire bat, Desmodus rotundus. BMC biology, 18. PMID: 16780579

Gracheva EO, Cordero-Morales JF, González-Carcacía JA, Ingolia NT, Manno C, Aranguren CI, Weissman JS, & Julius D. (2011) Ganglion-specific splicing of TRPV1 underlies infrared sensation in vampire bats. Nature, 476(7358), 88-91. PMID: 21814281

June 23, 2014
01:30 PM
1,344 views

The Iceman Cometh

by Dr. Jekyll in Lunatic Laboratories

Are you so fat you can’t see your toes? Have you forgotten what toes even look like? Have you been mistaken for the infamous “Kool-aid man”? Want to shed the […]... Read more »

Lee, P., Smith, S., Linderman, J., Courville, A., Brychta, R., Dieckmann, W., Werner, C., Chen, K., & Celi, F. (2014) Temperature-acclimated brown adipose tissue modulates insulin sensitivity in humans. Diabetes. DOI: 10.2337/db14-0513

Liu, M., Bai, J., He, S., Villarreal, R., Hu, D., Zhang, C., Yang, X., Liang, H., Slaga, T., Yu, Y.... (2014) Grb10 Promotes Lipolysis and Thermogenesis by Phosphorylation-Dependent Feedback Inhibition of mTORC1. Cell Metabolism, 19(6), 967-980. DOI: 10.1016/j.cmet.2014.03.018

June 23, 2014
10:52 AM
535 views

Varenicline for Smoking Cessation

by William Yates, M.D. in Brain Posts

Varenicline is a drug designed to assist smokers in cessation. It is marketed in the U.S. as Chantix.Varenicline is one of the first drugs to target the nicotine receptor. It is classified as a partial agonist, meaning it stimulates the nicotine receptor but to a weaker effect than nicotine itself.The mechanism of action of varenicline differs from that of another smoking cessation drug bupropion marked under trade name Zyban in the U.S.One concern with varenicline is the risk for psychiatric ad........ Read more »

Ebbert JO, Hatsukami DK, Croghan IT, Schroeder DR, Allen SS, Hays JT, & Hurt RD. (2014) Combination varenicline and bupropion SR for tobacco-dependence treatment in cigarette smokers: a randomized trial. JAMA : the journal of the American Medical Association, 311(2), 155-63. PMID: 24399554

Rose JE, & Behm FM. (2014) Combination Treatment With Varenicline and Bupropion in an Adaptive Smoking Cessation Paradigm. The American journal of psychiatry. PMID: 24934962

Anthenelli RM, Morris C, Ramey TS, Dubrava SJ, Tsilkos K, Russ C, & Yunis C. (2013) Effects of varenicline on smoking cessation in adults with stably treated current or past major depression: a randomized trial. Annals of internal medicine, 159(6), 390-400. PMID: 24042367

Boudrez H, Hoengenaert JP, Nackaerts K, Messig M, & Metcalfe M. (2013) Predictors of quit success in Belgian participants of a varenicline observational smoking cessation study. Acta clinica Belgica, 68(1), 37-42. PMID: 23627193

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