The Good, the Bad, and the Ugly
The urine drug screen commonly utilized in the emergency department is an immunoassay that uses antibodies to detect specific drugs or their metabolites. This allows for rapid screening for drugs of abuse, but it has many limitations.
Gas chromatography-mass spectrometry (GC-MS) is the confirmatory test, but it is more costly, time-consuming, and generally can only be performed by outside laboratories. This confirmatory test is generally not useful in the emergency department, but has a role in cases of pediatric exposures, research, or occupational drug testing.
One of the limitations of a urine drug s...
Source: The Tox Cave - June 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
The Good, the Bad, and the Ugly
The urine drug screen commonly utilized in the emergency department is an immunoassay that uses antibodies to detect specific drugs or their metabolites. This allows for rapid screening for drugs of abuse, but it has many limitations.
Gas chromatography-mass spectrometry (GC-MS) is the confirmatory test, but it is more costly, time-consuming, and generally can only be performed by outside laboratories. This confirmatory test is generally not useful in the emergency department, but has a role in cases of pediatric exposures, research, or occupational drug testing.
One of the limitations of a urine drug screen a...
Source: The Tox Cave - June 1, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Smoking cessation therapy – Cardiology MCQ
Which of the following is not used in smoking cessation therapy
a) Varenicline
b) Bupropion
c) Nicotine gum
d) None of the above
Correct answer: d) None of the above
Bupropion is well tolerated and has been shown to be safe even in the immediate post myocardial infarction period for smoking cessation therapy [1]. Even though some cardiovascular side effects for Varenicline has been suspected, the benefit of smoking cessation has been considered to be higher than any risk induced by it. Nicotine gum and other nicotine replacement therapies have been widely used as an aid to smoking cessation.
Eisenberg MJ et al. Bupropi...
Source: Cardiophile MD - May 24, 2015 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Diet Drug Study Crashes And Burns In The Wake Of Leaked Results
The ill-fated Light trial, which was supposed to examine the cardiovascular outcomes of the weight loss drug Contrave, a combination of naltrexone and bupropion marketed by Orexigen and Takeda, came to a spectacular halt today. The action was probably inevitable given the extreme controversy generated earlier this year when it became known that Orexigen had widely disseminated results from an early interim analysis of the study. The news about the trial was announced in a press release from the companies and a press release from the Cleveland Clinic, the home institution of Steve Nissen, the trial’s chairman....
Source: CardioBrief - May 12, 2015 Category: Cardiology Authors: Larry Husten Tags: People, Places & Events Policy & Ethics Prevention, Epidemiology & Outcomes Contrave diet drugs FDA Orexigen outcomes studies steve nissen Takeda Source Type: blogs
LITFL Review 175
Welcome to the 175th LITFL Review. Your regular and reliable source for the highest highlights, sneakiest sneak peeks and loudest shout-outs from the webbed world of emergency medicine and critical care. Each week the LITFL team casts the spotlight on the blogosphere’s best and brightest and deliver a bite-sized chuck of FOAM.The Most Fair Dinkum Ripper Beauts of the Week If you are trained in transcutaneously pacing then you absolutely must read part 1 and part 2 of Transcutaneous Pacing Success, over at the EMS 12-Lead Blog. [MG] The Best of #FOAMed Emergency MedicineEM Didactic offers a great primer to the c...
Source: Life in the Fast Lane - March 29, 2015 Category: Emergency Medicine Authors: Marjorie Lazoff, MD Tags: Education LITFL review Source Type: blogs
Orexigen Released Interim Data Without Approval Of Trial Leaders
Earlier today Orexigen Therapeutics disclosed positive results from a clinical trial of Contrave, its weight loss pill (a combination of naltrexone and bupropion) that it markets with Takeda. (You can read a good summary of the findings by Adam Feuerstein on TheStreet.) The surprising thing about the Orexigen disclosure, which was contained in a Form 8-K filed with the SEC, is that it consisted of data derived from an interim analysis of the company’s ongoing Light trial. Normally, interim results are performed by an independent data monitoring committee and the results are known only to More… (Source: CardioBrief)
Source: CardioBrief - March 3, 2015 Category: Cardiology Authors: Larry Husten Tags: People, Places & Events Policy & Ethics Prevention, Epidemiology & Outcomes Contrave FDA Nissen Orexigen trials Source Type: blogs
FDA Approves New Weight Loss Drug From Orexigen And Takeda
The FDA announced today that it had approved Contrave, the long-awaited and much-disputed weight loss drug. The drug is a combination of two drugs already approved for other indications: naltrexone hydrochloride, which is used to combat alcohol and opioid dependence, and bupropion, which is used to treat depression and seasonal affective disorder and as an aid to smoking cessation treatment. Contrave is manufactured by Orexigen and will be distributed by Takeda. … Click here to read the full post on Forbes. (Source: CardioBrief)
Source: CardioBrief - September 11, 2014 Category: Cardiology Authors: Larry Husten Tags: People, Places & Events Policy & Ethics Prevention, Epidemiology & Outcomes Contrave FDA obesity Orexigen weight loss Source Type: blogs
Many Anti-Smoking Advocates Actually Do Not Want Smokers to Quit Smoking Using E-Cigarettes
One lesson that has become apparent in the past few months is that for many anti-smoking advocates and groups, it doesn't matter whether you quit, the only thing that is important is how you quit. According to the thinking of these groups, there is a right way to quit and a wrong way to quit. Forget about the fact that you've just quit smoking and possibly saved your life. If you quit the wrong way, you are to be scorned.And what are the right and wrong ways to quit? The wrong way to quit is using electronic cigarettes, which have been so effective in reducing cigarette consumption that some tobacco analysts have predicted...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - July 31, 2014 Category: Addiction Source Type: blogs
Suboxforum QA Video: Dopamine Reuptake and Addiction
(Source: Suboxone Talk Zone)
Source: Suboxone Talk Zone - March 6, 2014 Category: Addiction Authors: J T Junig Tags: Buprenorphine receptor actions Research treatment bupropion dopamine reuptake and addiction dopamine reuptake inhibitor monoamine oxidase inhibitors Source Type: blogs
Smoking cessation therapy
Which of the following can be used for aiding smoking cessation:
a) Bupropion
b) Nicotine
c) Varenicline
d) All of the above
Correct answer: d) All of the above
Nicotine replacement therapy can be used in various ways like nicotine gum, patches, lozenges, inhaler, and nasal spray. In fact nicotine replacement therapies have been given ‘over-the-counter’ access. But bupropion and varenicline are prescription drugs used in smoking cessation programs. (Source: Cardiophile MD)
Source: Cardiophile MD - January 10, 2014 Category: Cardiology Authors: Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Videos: Antidepressants — Not a Quick Fix
In a series of heartfelt videos compiled online by healthtalkonline.org alongside research conducted by the University of Nottingham and Oxford University, 30 individuals share that antidepressant medications are not a ‘quick fix.’
Contrary to popular opinion, neither are they ‘happy pills.’
The individuals discuss the impact of depression and antidepressant medications on their lives. They also talk about the emotional difficulties they faced with side effects and finding a prescription that finally helped them manage their depression.
They’re worth checking out to hear of people’s real-li...
Source: World of Psychology - December 9, 2013 Category: Psychiatrists and Psychologists Authors: Emily Waters Tags: Antidepressant Depression Disorders General Medications Mental Health and Wellness Personal Psychotherapy Video Antidepressants Bupropion Headache Jenny media reports Personal Experiences professor Prozac Researcher Sel Source Type: blogs
Are You Struggling with Seasonal Affective Disorder?
Seasonal affective disorder (SAD) — sometimes known as the “winter blues” — is an “equal-opportunity oppressor,” according to Norman Rosenthal, M.D., in his comprehensive book Winter Blues Survival Guide: A Workbook for Overcoming SAD. This form of clinical depression affects people of all ages — even kids — races and ethnic groups.
Fortunately, SAD is highly treatable. One of the keys to managing the disorder is knowing your personal pattern of symptoms. This plays a big role in how you’ll treat your disorder.
For instance, if your symptoms last during several months of winter, t...
Source: World of Psychology - October 29, 2013 Category: Psychiatrists and Psychologists Authors: Margarita Tartakovsky, M.S. Tags: Antidepressant Books Depression Disorders General Medications Mental Health and Wellness Self-Help Treatment Bupropion Major Depressive Disorder Sad Seasonal Affective Disorder Solstice Sunlight Winter Blues Winter Depressi Source Type: blogs
Medical Mispronunciations and Misspelled Words: The Definitive List.
Hearing medical mispronunciations and seeing misspelled words are an under appreciated joy of working in healthcare. Physicians often forget just how alien the language of medicine is to people who don't live it everyday. The best part about being a physician is not helping people recover from critical illness. The best part is not about listening and understanding with compassion and empathy. Nope, the best part about being a physician is hearing patients and other healthcare providers butcher the language of medicine and experiencing great entertainment in the process. Doctors c...
Source: The Happy Hospitalist - October 2, 2013 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
Popular Synthetics: The Class of 2013
Navigating the new alphabet of intoxication.
You don’t have to be a molecular chemist to know which of today’s recreational drugs are safe. Wait, I take that back. You DO have to be a molecular chemist to navigate today’s synthetic drug market with anything like a modest degree of safety.
It’s hard not to get nostalgic: Back in the day, you had your pot, you had your acid, your coke, your speed, and your heroin. And that, with the exception of a few freak outriders like PCP, was about that. Baby boomers of today, already losing touch with leading-edge music—Macklemore? Tame Impala?—can now consider themsel...
Source: Addiction Inbox - July 6, 2013 Category: Addiction Authors: Dirk Hanson Source Type: blogs
New Cochrane Review of Smoking Cessation Drugs Hides the Truth from Readers
A new, comprehensive, 51-page review of multiple meta-analyses summarizing the effectiveness of nicotine replacement therapy (NRT) and other drugs for smoking cessation concludes that these drugs are highly effective in helping smokers quit.(See: Cahill K, Stevens S, Perera R, Lancaster T. Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.:CD009329.DOI: 10.1002/14651858.CD009329.pub2.)The review was extensive, covering hundreds of studies and tens of thousands of subjects: "The authors combined the findings of existin...
Source: The Rest of the Story: Tobacco News Analysis and Commentary - June 3, 2013 Category: Health Medicine and Bioethics Commentators Source Type: blogs
