All posts; Tags Include "Pharmacology"
- February 19, 2012
- 06:30 AM
- 677 views
Intramuscular Midazolam for Seizures – Part II
by Rogue Medic in Rogue Medic
While there have been studies comparing IM (IntraMuscular) midazolam (Versed) with IV (IntraVenous) anti-epileptic medications, this is a large study that compares IM midazolam with the best IV anti-epileptic medication in a double-blind, randomized, noninferiority trial.
For the study, there were two different doses for the auto-injector (the same as an EpiPen). The doses were not small.
Midazolam for seizures is an off-label use both when given IM and when given IV.[2]
The lorazepa........ Read more »
Silbergleit, R., Durkalski, V., Lowenstein, D., Conwit, R., Pancioli, A., Palesch, Y., & Barsan, W. (2012) Intramuscular versus Intravenous Therapy for Prehospital Status Epilepticus. New England Journal of Medicine, 366(7), 591-600. DOI: 10.1056/NEJMoa1107494
Chamberlain JM, Altieri MA, Futterman C, Young GM, Ochsenschlager DW, & Waisman Y. (1997) A prospective, randomized study comparing intramuscular midazolam with intravenous diazepam for the treatment of seizures in children. Pediatric emergency care, 13(2), 92-4. PMID: 9127414
- February 13, 2012
- 11:18 PM
- 611 views
PROMETA™ Postmortem
by Dirk Hanson in Addiction Inbox
How the latest miracle cure for addiction failed to deliver.
PROMETA™: Last seen going down fast, smoke pouring from all engines.
As reported here at Addiction Inbox, a double-blind placebo-controlled evaluation of PROMETA™ by W. Ling and associates, published online last month in the journal Addiction, found that the much-publicized treatment protocol for meth addiction “appears to be no more effective than placebo in reducing methamphetamine use, retaining patients in treatment or red........ Read more »
HUMPHREYS, K. (2012) What can we learn from the failure of yet another ‘miracle cure’ for addiction?. Addiction, 107(2), 237-239. DOI: 10.1111/j.1360-0443.2011.03652.x
- February 9, 2012
- 05:36 AM
- 1,042 views
Why parkin has scientists backing the future of Parkinson's research
by Andrew Watt in A Hippo on Campus
Back in the '80s the name Michael J. Fox was more or less interchangeable with that of Marty McFly, the effortlessly cool protagonist from the Back to the Future trilogy who introduced an entire generation of kids to hoverboards, self-lacing shoes and flux capacitors. Not to mention 'Johnny B Goode'. These days however Fox's name is more likely to have us thinking of his fight with Parkinson's disease, which he was diagnosed with back in 1991, or the advocacy work he does for his ........ Read more »
Obeso JA, Rodríguez-Oroz MC, Benitez-Temino B, Blesa FJ, Guridi J, Marin C, & Rodriguez M. (2008) Functional organization of the basal ganglia: therapeutic implications for Parkinson's disease. Movement disorders : official journal of the Movement Disorder Society. PMID: 18781672
- February 7, 2012
- 04:00 AM
- 971 views
Thoughts on World Cancer Day: Part I–Unraveling Yuvraj Singh’s Cancer
by Pranab Chatterjee in Scepticemia
Sorry for missing the train on this one. February 4th is the World Cancer Day and is one of the public health days that could do with some more propaganda in the public eye. I was so caught up with work and studies it just passed me by and I could not even get the [...]... Read more »
Bokemeyer C, Droz JP, Horwich A, Gerl A, Fossa SD, Beyer J, Pont J, Schmoll HJ, Kanz L, Einhorn L.... (2001) Extragonadal seminoma: an international multicenter analysis of prognostic factors and long term treatment outcome. Cancer, 91(7), 1394-401. PMID: 11283942
- February 2, 2012
- 06:30 AM
- 691 views
This is the Way to Bad Medicine - II
by Rogue Medic in Rogue Medic
Their categorization of only 3 (out of 32) serious adverse events as "Probably related to treatment" and none as "Definitely related to treatment" suggests that they are not being objective. How do they explain this in the discussion? They don’t. Maybe they aren’t referring to the serious adverse events, but are referring to deaths. I don’t know and since they do not explain, I can only speculate.... Read more »
Barreto, A., Alexandrov, A., Lyden, P., Lee, J., Martin-Schild, S., Shen, L., Wu, T., Sisson, A., Pandurengan, R., Chen, Z.... (2012) The Argatroban and Tissue-Type Plasminogen Activator Stroke Study: Final Results of a Pilot Safety Study. Stroke. DOI: 10.1161/STROKEAHA.111.625574
- January 31, 2012
- 06:15 PM
- 828 views
How antipsychotics cause side effects such as obesity and diabetes
by Sanford- Burnham in Beaker
Sanford-Burnham study suggests that many antipsychotics affect metabolism because they activate the TGFbeta pathway—a finding that could lead to safer therapeutics for bipolar disorder and schizophrenia patients.... Read more »
Cohen, T., Sundaresh, S., & Levine, F. (2012) Antipsychotics activate the TGFβ pathway effector SMAD3. Molecular Psychiatry. DOI: 10.1038/mp.2011.186
- January 31, 2012
- 11:20 AM
- 767 views
Reward and Punish: Say Hello to Dopamine’s Leetle Friend
by Dirk Hanson in Addiction Inbox
Dopamine recruits a helper to track drug rewards.
Ah, dopamine. Whenever it seems like researchers have finally gotten a bead on how that tricky molecule modulates pleasure and reward, and the role in plays in the process of drug and alcohol addiction, along come new findings that rearrange its role, deepening and complicating our understanding of brain function.
We know that the ultimate site of dopamine activity caused by drugs is the ventral tegmental area, or VTA, and an associated ........ Read more »
Cohen, J., Haesler, S., Vong, L., Lowell, B., & Uchida, N. (2012) Neuron-type-specific signals for reward and punishment in the ventral tegmental area. Nature. DOI: 10.1038/nature10754
- January 29, 2012
- 03:28 AM
- 696 views
2011 Orwellian Prize for Journalistic Misrepresentation
by Dorothy Bishop in bishopblog
The Orwellian Prize was set up to identify bad science journalism. The winner for 2011 contains a spectacular number of errors in reporting on a paper about cannabinoid receptors in rats.... Read more »
Kucewicz, M., Tricklebank, M., Bogacz, R., & Jones, M. (2011) Dysfunctional Prefrontal Cortical Network Activity and Interactions following Cannabinoid Receptor Activation. Journal of Neuroscience, 31(43), 15560-15568. DOI: 10.1523/JNEUROSCI.2970-11.2011
- January 16, 2012
- 10:06 AM
- 614 views
The Neuropsychology of Opioid Abuse
by William Yates, M.D. in Brain Posts
This is the last post in a series on prescription opioid abuse and dependence. Prescription opioid overdose fatalities is a growing public health problem in the United States. This problem varies by state of residence. There are effective pharmacological strategies for the treatment of opioid dependence, but relapse rates are high.With this growing problem, an important clinical question is "What are the cognitive effects of chronic opioid use/abuse/dependence?". One of ........ Read more »
Fernández-Serrano MJ, Pérez-García M, & Verdejo-García A. (2011) What are the specific vs. generalized effects of drugs of abuse on neuropsychological performance?. Neuroscience and biobehavioral reviews, 35(3), 377-406. PMID: 20451551
- January 15, 2012
- 08:09 PM
- 1,012 views
Avoiding Lasting Pain With Administration of High Dosage Spurts of Morphine
by DJ Busby in Astronasty
This discovery, in a nutshell, can be found in the last sentence of the abstract:
"Opioids thus not only temporarily dampen pain but may also erase a spinal memory trace of pain."... Read more »
Drdla-Schutting, R., Benrath, J., Wunderbaldinger, G., & Sandkuhler, J. (2012) Erasure of a Spinal Memory Trace of Pain by a Brief, High-Dose Opioid Administration. Science, 335(6065), 235-238. DOI: 10.1126/science.1211726
- January 13, 2012
- 09:56 AM
- 838 views
Suboxone Treatment for Prescription Opioid Abuse
by William Yates, M.D. in Brain Posts
Chemical Structures for Buprenorphine and NaloxoneIn three previous posts I have reviewed several aspects of prescription opioid abuse including posts on epidemiology, toxicology and clinical pathways to abuse.Given the growing numbers of individuals with prescription opioid abuse, safe and effective treatment options become increasingly important.Opioid withdrawal can be quite painful and often leads to resumption of opioid use. Treatment of opioid withdrawal can include non-opioid drugs ........ Read more »
Weiss RD, Potter JS, Fiellin DA, Byrne M, Connery HS, Dickinson W, Gardin J, Griffin ML, Gourevitch MN, Haller DL.... (2011) Adjunctive counseling during brief and extended buprenorphine-naloxone treatment for prescription opioid dependence: a 2-phase randomized controlled trial. Archives of general psychiatry, 68(12), 1238-46. PMID: 22065255
- January 5, 2012
- 01:29 PM
- 573 views
Pathways to Prescription Opioid Overdose
by William Yates, M.D. in Brain Posts
The majority of initial prescriptions for opioid analgesics in acute pain management occur without development of a pattern of misuse or abuse.However, in some individuals, opioid prescriptions produce a pathway for misuse, abuse and risk of opioid overdose death. In two previous posts, I have outlined the epidemiology of opioid overdose death and the toxicology of these compounds.Risk factors for the development of prescription opioid drugs have not been extensively studied. However........ Read more »
Paulozzi, L., Kilbourne, E., Shah, N., Nolte, K., Desai, H., Landen, M., Harvey, W., & Loring, L. (2011) A History of Being Prescribed Controlled Substances and Risk of Drug Overdose Death. Pain Medicine. DOI: 10.1111/j.1526-4637.2011.01260.x
- January 4, 2012
- 02:20 PM
- 757 views
Nifekalant versus lidocaine for in-hospital shock-resistant ventricular fibrillation or tachycardia
by Rogue Medic in Rogue Medic
Why compare nikefelant with lidocaine? Why not compare nikefelant with amiodarone? Why not compare nikefelant with an antiarrhythmic that is more effective than amiodarone – procainamide, sotalol, or ajmaline?
Lidocaine is probably used because the IRB (Institutional Review Board) would consider it unethical to have a placebo group. Lidocaine is the placebo, but with less safety than the placebo.... Read more »
Shiga, T., Tanaka, K., Kato, R., Amino, M., Matsudo, Y., Honda, T., Sagara, K., Takahashi, A., Katoh, T., Urashima, M.... (2010) Nifekalant versus lidocaine for in-hospital shock-resistant ventricular fibrillation or tachycardia. Resuscitation, 81(1), 47-52. DOI: 10.1016/j.resuscitation.2009.09.027
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
- December 29, 2011
- 10:02 AM
- 1,030 views
Beta blockers and genetic variation
It's happening again.I'm sitting in a meeting, and suddenly I feel my hands prickling. My heart thumps faster. I can't concentrate on what people around me are saying. My head is buzzing, and cold sweat trickles down my neck. I feel the tingling of panic biting at the tip of my fingers. My muscles tense, adrenaline spikes. Every cell of my body screams, "Danger!"Now, part of me wants to take out my notebook and jot everything down for my next high-adrenaline, action-packed story.The other (more ........ Read more »
Nagele P, & Liggett SB. (2011) Genetic Variation, β-blockers, and Perioperative Myocardial Infarction. Anesthesiology, 115(6), 1316-27. PMID: 21918425
- December 20, 2011
- 12:45 PM
- 808 views
Antidepressant Effects in Healthy Brains
by William Yates, M.D. in Brain Posts
In a previous post I summarized some of what is known about the effect of antidepressants in healthy brains. This issue is important because antidepressant drugs have indications outside of mood and anxiety disorders including peripheral neuropathy and migraine prophylaxis. Additionally, understanding the effects of antidepressants in healthy brains may also provide insight into the brain mechanisms related to depression.A recent fMRI imaging study provides some additional insight in........ Read more »
McCabe C, & Mishor Z. (2011) Antidepressant medications reduce subcortical-cortical resting-state functional connectivity in healthy volunteers. NeuroImage, 57(4), 1317-23. PMID: 21640839
- December 15, 2011
- 06:30 AM
- 1,592 views
Intraosseous Versus Intravenous Vascular Access During Out-of- Hospital Cardiac Arrest – A Randomized Controlled Trial
by Rogue Medic in Rogue Medic
For treatment of medical cardiac arrest patients, which is better – IO (IntraOsseous) or IV (IntraVenous) access for medication administration?
Since no medications have ever been demonstrated to improve survival from cardiac arrest (only chest compressions and defibrillation have), the most important consideration will be what method results in the least interruption of compressions and the least interference with defibrillation.... Read more »
Reades R, Studnek JR, Vandeventer S, & Garrett J. (2011) Intraosseous Versus Intravenous Vascular Access During Out-of-Hospital Cardiac Arrest: A Randomized Controlled Trial. Annals of emergency medicine, 58(6), 509-16. PMID: 21856044
- December 12, 2011
- 12:00 PM
- 4,672 views
Does Epinephrine Improve Survival from Cardiac Arrest
by Rogue Medic in Rogue Medic
Even though epinephrine (adrenaline) is used automatically in cardiac arrest, and there is evidence that epinephrine helps to produce a pulse (ROSC – Return Of Spontaneous Circulation), there is no evidence that epinephrine improves the only survival statistic that matters – discharge from the hospital with a brain that still works. There were so many deviations from assignment protocol in their 2009 study,[1] that the authors decided to examine the results based on what treatment pa........ Read more »
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
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
- December 1, 2011
- 10:30 AM
- 749 views
Droperidol, QT prolongation, and sudden death - what is the evidence - Part I
by Rogue Medic in Rogue Medic
The FDA relies on surrogate endpoints. Surrogate endpoints are great for making it seem that we know more than we actually do know. When there is not enough information, surrogate end points are a way of saying, "If this belief is true, and this other belief is also true, then Treatment Z is safe (or dangerous), or saves X number of lives per year (or kills X number of patients who otherwise would have been expected to live)."... Read more »
Kao LW, Kirk MA, Evers SJ, & Rosenfeld SH. (2003) Droperidol, QT prolongation, and sudden death: what is the evidence?. Annals of emergency medicine, 41(4), 546-58. PMID: 12658255
- November 30, 2011
- 11:30 AM
- 624 views
Pills, thrills and polymorphs
by sciencebase in Sciencebase Science Blog
Almost any skilled organic chemist could create novel variations on the solid form, polymorphs, of small molecules currently used as pharmaceuticals. This represents a problem for manufacturers of generic drugs because big pharma attempts to extend the patent lifespan of its well-known products by adding such polymorphs to the patent. Prasad Vure of Indian generics [...]Pills, thrills and polymorphs is a post from: Sciencebase Science Blog
... Read more »
Prasad Vure. (2011) Polymorph patents; how strong they are really?. Int. J. Intellectual Property Management, 4(4), 297-306. info:/
- November 30, 2011
- 06:30 AM
- 883 views
How Dangerous is a Long QT Segment on the ECG
by Rogue Medic in Rogue Medic
There are many things that will lengthen the QT segment, but how much should we worry when the patient has a long QT segment, or when giving the patient a treatment that lengthens the QT segment? Are there some things that, even though they may lengthen the QT segment, may protect the heart from arrhythmia at the same time?... Read more »
Storm C, Hasper D, Nee J, Joerres A, Schefold JC, Kaufmann J, & Roser M. (2011) Severe QTc prolongation under mild hypothermia treatment and incidence of arrhythmias after cardiac arrest--a prospective study in 34 survivors with continuous Holter ECG. Resuscitation, 82(7), 859-62. PMID: 21482009
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