Manage perioperative pain in morbidly obese patients by taking an all-round multimodal approach
AbstractMorbidly obese individuals often require surgery, including bariatric (weight management) surgery. Acute pain management in the morbidly obese must consider the risk of chronic post-surgical pain, opioid dependence, and comorbidities (e.g. sleep-disordered breathing). A stepped, multimodal, opioid-sparing approach titrated to the type and severity of pain type should be taken, with co-administration of systemic and local anaesthetic agents when appropriate. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - January 20, 2020 Category: Drugs & Pharmacology Source Type: research

Reduce medication errors in tube feeding administration by establishing administration standards and standardizing operation procedures
ConclusionOur study shows that establishment and application of standards for tube feeding administration and SOPs can significantly reduce medical errors associated with tube feeding. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - January 7, 2020 Category: Drugs & Pharmacology Source Type: research

A closer look at the 2019 Beers criteria
AbstractIncreased use of potentially inappropriate medications (PIMs) is one of the major issues arising in older adults. The use of PIMs has been found to be associated with adverse drug events, drug-related problems and other major significant health consequences. However, PIMs continue to be prescribed as first-line drugs in older adults in many parts of the world. Beers criteria for PIM use were first established by Mark Beers in 1991 and the criteria have been updated multiple times by Mark Beers and the American Geriatric Society. The Beers criteria for PIM use are a specially designed tool to improve medication sele...
Source: Drugs and Therapy Perspectives - January 4, 2020 Category: Drugs & Pharmacology Source Type: research

A prospective observational pilot study of adverse drug reactions contributing to hospitalization in a cohort of middle-aged adults aged 45 –64 years
ConclusionsOne in five patients had an ADR and experienced short-term morbidity as a result. For 11 patients, the ADR was preventable. These findings illustrate that middle-aged patients are vulnerable to medicine-related harm. Additional research in larger studies is needed to more comprehensively describe the prevalence and risk factors for ADRs in middle-aged patients. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - January 3, 2020 Category: Drugs & Pharmacology Source Type: research

Why the USA should “drop the pounds” to improve patient safety in adults
(Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - January 2, 2020 Category: Drugs & Pharmacology Source Type: research

Capsaicin 8% dermal patch in peripheral neuropathic pain: a profile of its use
AbstractA dermal patch containing a high (8%) capsaicin concentration (hereafter referred to as the capsaicin 8% dermal patch) [Qutenza®] is a useful option for the treatment of peripheral neuropathic pain (PNP). The patch, referred to as Qutenza 179  mg cutaneous patch in the EU summary of product characteristics, is indicated in the EU for the treatment of PNP in adults, either alone or in combination with other medicinal products for pain. Prolonged exposure to capsaicin (the main pungent component in hot chilli peppers) appears to engender analgesia/pain relief by inducing cutaneous nociceptor ‘defunctio...
Source: Drugs and Therapy Perspectives - December 24, 2019 Category: Drugs & Pharmacology Source Type: research

Manage congenital hyperinsulinism with pharmacotherapy and nutritional therapy based on its form, severity and response
AbstractCongenital hyperinsulinism (CHI) is rare and causes a particularly damaging form of hypoglycaemia that deprives the brain of all critical fuels (i.e. glucose, ketones and lactate). Prompt recognition and treatment are required to avoid brain damage, with some patients needing pancreatectomy. Treatment of acute hypoglycaemia usually involves dextrose or glucagon, and chronic treatment usually involves nutritional therapy (food and supplemental enteral glucose), alongside a stepwise and combination approach with various pharmacological agents (diazoxide, somatostatin analogues and glucagon, rarely nifedipine and, as ...
Source: Drugs and Therapy Perspectives - December 19, 2019 Category: Drugs & Pharmacology Source Type: research

Long-term use of systemic azole antifungals can result in hepatotoxicity and other serious adverse effects
AbstractLong-term use of systemic azole antifungals (i.e. fluconazole, isavuconazole, itraconazole, ketoconazole, posaconazole and voriconazole) can result in serious adverse drug effects (ADEs), such as hepatotoxicity and cardiac effects. Cytochrome P450 inhibition by azoles contributes to many ADEs, such as adrenal insufficiency due to hormone disruption, while pharmacokinetic interactions can lead to myositis or peripheral neuropathy. Other notable ADEs include pancreatitis, bone pain, renal failure, skin cancer and Stevens-Johnsons syndrome. ADEs may be managed with monitoring, adjusting dosages and switching azoles. (...
Source: Drugs and Therapy Perspectives - December 16, 2019 Category: Drugs & Pharmacology Source Type: research

Prevalence and predictors of inappropriate apixaban dosing in patients with non-valvular atrial fibrillation at a large tertiary academic medical institution
ConclusionIn patients with NVAF receiving apixaban for stroke prevention in this real-world analysis,>  80% were prescribed an appropriate dosage of apixaban. Proactive procedures, such as integrating an electronic dosing algorithm, educating healthcare providers, and involving clinical pharmacists in medication review, may help ensure the use of appropriate apixaban dosages. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - December 5, 2019 Category: Drugs & Pharmacology Source Type: research

Optimize antihypertensive treatment in older individuals by using a decision framework
AbstractCurrent hypertension treatment guidelines differ somewhat with regard to their recommendations for treating older patients. Based on the characteristics of the individual, antihypertensive treatment can be optimized by using a decision framework that sets therapeutic goals, estimates absolute cardiovascular (CV) risk, accurately measures blood pressure (BP), determines threshold and target BP levels most likely to confer benefit, and considers situations that warrant deprescribing. In general, hypertension should be treated to a target systolic BP (SBP) of no lower than  130 mmHg in older patients who are...
Source: Drugs and Therapy Perspectives - November 27, 2019 Category: Drugs & Pharmacology Source Type: research

Correction to: Evaluation of levofloxacin utilization in intensive care units of tertiary care hospital: a retrospective observational study
The author has alerted us to the following error. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - November 27, 2019 Category: Drugs & Pharmacology Source Type: research

Be aware that the benefits of biological drugs in multiple sclerosis may be offset by their capacity to cause immunological complications
AbstractBiological immunotherapies for multiple sclerosis (MS) include recombinant proteins (preparations of interferon- β) and monoclonal antibodies (e.g. natalizumab, alemtuzumab, ocrelizumab and off-label rituximab). They have shown unprecedented efficacy in the treatment of MS; however, they are all immunogenic and have been associated with immunological complications, such as neutralizing immunogenicity, seconda ry immunodeficiency and secondary autoimmunity. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - November 25, 2019 Category: Drugs & Pharmacology Source Type: research

Pattern of antibiotic prophylaxis usage and timing of administration in common paediatric surgeries:  a retrospective cross-sectional study in teaching hospitals
This study was conducted to assess antimicrobial prophylaxis practices and compliance rates with international guidelines in common paediatric surgical procedures.MethodsA retrospective cross-sectional study was conducted in paediatric patients aged  
Source: Drugs and Therapy Perspectives - November 25, 2019 Category: Drugs & Pharmacology Source Type: research

Act quickly when treating atopic keratoconjunctivitis to avoid adverse outcomes
AbstractAtopic keratoconjunctivitis (AKC) is the most severe form of allergic conjunctivitis and, if inadequately treated, can cause vision loss. Treatment aims to minimize symptoms, recurrence and consequent eye rubbing, which cause long-term eye damage. First-line treatment generally involves the use of topical ophthalmic formulations of mast-cell stabilizers and/or antihistamines, corticosteroids, calcineurin inhibitors and immunomodulators (used in that order). Systemic formulations of these drugs can be used to treat refractory cases of AKC or when deemed appropriate for the individual. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - November 25, 2019 Category: Drugs & Pharmacology Source Type: research

Evaluation of levofloxacin utilization in intensive care units of tertiary care hospital: a retrospective observational study
ConclusionsOur study indicated that there is substantial scope for improvement in prescribing patterns at Damanhour Medical National Institute that could be achieved by adhering to standard guidelines of treatment and restriction policies to promote rationality of drug use. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - November 14, 2019 Category: Drugs & Pharmacology Source Type: research

Aprotinin in adults at high risk of major blood loss during isolated CABG with cardiopulmonary bypass: a profile of its use in the EU
AbstractProphylactic treatment with aprotinin, a haemostatic antifibrinolytic agent, is indicated to reduce blood loss and blood transfusion in adults with a high risk of major bleeding undergoing primary or repeat isolated coronary artery bypass graft (CABG) with cardiopulmonary bypass. Overall, aprotinin was consistently more effective than tranexamic acid, ε-aminocaproic acid, desmopressin and placebo in reducing massive blood loss, the need for transfusions of blood products, and the need for reoperation due to diffuse bleeding in trials in this patient population, and was generally well-tolerated. The app...
Source: Drugs and Therapy Perspectives - November 11, 2019 Category: Drugs & Pharmacology Source Type: research

Treatment of Mycobacterium avium –intracellulare complex lung disease in the real world: a retrospective big data analysis
ConclusionMany patients with MAC lung disease do not complete a full course of treatment over the standard treatment period. Therefore, it is important to develop methods to overcome adverse effects or to develop an alternative treatment regimen for MAC lung disease. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - November 11, 2019 Category: Drugs & Pharmacology Source Type: research

First reports of adverse drug reactions
(Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - November 8, 2019 Category: Drugs & Pharmacology Source Type: research

Acknowledgement to referees
(Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - November 7, 2019 Category: Drugs & Pharmacology Source Type: research

Fluticasone propionate/salmeterol (Wixela ® Inhub ® ) dry-powder inhaler in asthma and COPD: a profile of its use in the USA
AbstractWixela® Inhub® is the first therapeutically equivalent, substitutable generic version of Advair Diskus® (fluticasone propionate/salmeterol) approved for the treatment of asthma and chronic obstructive pulmonary disease (COPD) in the USA. Wixela Inhub combines the inhaled corticosteroid fluticasone propionate and the long-acting β2-adrenoceptor agonist salmeterol in a single dry-powder inhaler. Each drug has a different mechanism of action, targeting different and complementary aspects of the pathophysiology of asthma and COPD. The in vitro performance of Wixela Inhub is comparable to that of Advair...
Source: Drugs and Therapy Perspectives - November 6, 2019 Category: Drugs & Pharmacology Source Type: research

Fluticasone propionate/formoterol fumarate in children aged ≥ 5 years with asthma: a profile of its use
AbstractThe fluticasone propionate/formoterol fumarate (hereafter fluticasone/formoterol) 50/5  µg pressurized metered-dose inhaler (pMDI) [Flutiform®] is a fixed-dose combination of an inhaled corticosteroid (ICS) and a long-acting β2-adrenoceptor agonist (LABA) for the regular treatment of asthma where regular use of an ICS and a LABA combination product is appropriate. In the EU, the fluticasone/formoterol 50/5  µg pMDI is recommended for use in adults, adolescents and children aged ≥ 5 years, with the latter being a recent expansion of the indicated population and the focus...
Source: Drugs and Therapy Perspectives - November 4, 2019 Category: Drugs & Pharmacology Source Type: research

Identification of deprescribing opportunities for patients with diabetes and dementia discharged to a nursing home using a mortality prognostic index
ConclusionThe 30-day mortality rates were higher than the predicted mortality rate in this patient population, indicating significant opportunities for deprescribing. Use of a mortality prognostic index, such as the Mitchell Index, for elderly nursing home residents with dementia can be considered to guide deprescribing. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - November 1, 2019 Category: Drugs & Pharmacology Source Type: research

Probiotics could pay off in Helicobacter pylori eradication
AbstractHelicobacter pylori infection, a cause of gastric disease, is generally eradicated with standard antibiotic therapy. However, adding probiotics to standard therapy may improve rates of eradication and adverse effects. Despite the growing interest in probiotics in this area, data should be carefully interpreted before evidence-driven decision-making in clinical settings can be made. This commentary highlights current standard therapy, and the efficacy and underlying mechanisms of probiotics inH. pylori eradication. The commentary also speculates on some controversies around research results, and gives an opinion on ...
Source: Drugs and Therapy Perspectives - November 1, 2019 Category: Drugs & Pharmacology Source Type: research

Fremanezumab in the prevention of migraine: a profile of its use
AbstractFremanezumab (fremanezumab-vfrm; Ajovy®), a monoclonal antibody that targets calcitonin gene-related peptide (CGRP), is indicated for the prevention of migraine in adults in the EU and USA. Subcutaneous fremanezumab 225  mg once monthly or 675 mg once every 3 months was effective in reducing monthly migraine days or headache days in patients with episodic or chronic migraine in pivotal, 12-week clinical trials. Both regimens also reduce acute headache medication use and headache-related disability. Improvements were maintained through ≤ 52 weeks of additional treatment in a longer-...
Source: Drugs and Therapy Perspectives - October 22, 2019 Category: Drugs & Pharmacology Source Type: research

Association between variants of COQ2 and TNF- α genes and statin-induced toxicities in Bangladeshi hyperlipidemic patients
In conclusion, this preliminary pharmacogenetic study identifies thatCOQ2 gene polymorphism (rs4693075, G  >  C), notTNF- α gene polymorphism (rs1799724, C  >  T), is involved in causing statin-induced myopathy in Bangladeshi hyperlipidemic patients. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - October 19, 2019 Category: Drugs & Pharmacology Source Type: research

Adverse events and monitoring requirements associated with monoclonal antibody therapy in patients with multiple sclerosis
AbstractMultiple sclerosis (MS) is treated with a variety of immunomodulatory and immunosuppressive drugs. Among the most potent therapeutic options are monoclonal antibodies (MAbs). So far, the MAbs natalizumab, alemtuzumab, and ocrelizumab have been approved for MS treatment. While their efficacy is indisputable, these drugs have safety issues not seen with previous MS drugs. MAbs are the ideal class of treatment for many patients with MS, but neurologists prescribing these MAbs need to be aware of their potential risks and monitor patients closely. Although rare, adverse events associated with MAbs may be fatal; opportu...
Source: Drugs and Therapy Perspectives - October 19, 2019 Category: Drugs & Pharmacology Source Type: research

Current and investigational anti-obesity drugs help reduce weight and offer additional benefits, but more effective options are needed
AbstractA number of pharmacological options for the treatment of obesity are available, but their efficacy is limited to losses of 5 –10% of patient weight and their use should be secondary to lifestyle changes. The safety and efficacy of anti-obesity drugs, as well as the characteristics and co-morbidities of the patient, should be taken into consideration when treating obesity, as not all treatments are appropriate for all pa tients. A variety of new anti-obesity drugs are currently undergoing clinical investigation, but none appears to be the ideal agent to treat obesity. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - October 15, 2019 Category: Drugs & Pharmacology Source Type: research

Manage vulvodynia using a multimodal and individualized approach
AbstractVulvodynia (i.e. vulvar pain lasting  ≥ 3 months) is common, but is often not correctly diagnosed. Causative factors and pain profiles are varied and a multimodal approach to management, starting with non-pharmacological interventions, is recommended. Cognitive behaviour therapy and pelvic floor physical therapy are first-line t reatments for most cases. Pharmacological options, including anti-nociceptive, anti-inflammatory and neuromodulating agents, warrant further investigation. Surgical vestibulectomy is an effective option in women with localized provoked vulvodynia. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - October 15, 2019 Category: Drugs & Pharmacology Source Type: research

Correction to: Insulin glargine/lixisenatide in type 2 diabetes: a profile of its use
The article Insulin glargine/lixisenatide in type 2 diabetes: a profile of its use, written by Emma Deeks, was originally published Online First without Open Access. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - October 14, 2019 Category: Drugs & Pharmacology Source Type: research

Vitamin D with calcium supplements: a new hope for the treatment of dengue infection
(Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - October 3, 2019 Category: Drugs & Pharmacology Source Type: research

Patchy evidence in skin-picking disorder supports management with combined behavioural and drug treatments
AbstractSkin-picking disorder (SPD) is a common, repetitive, compulsive and distressing disorder with significant psychosocial effects. Data from relatively few clinical trials support behavioural therapies, especially habit-reversal therapy, as the first-line treatment. Depending on the individual ’s SPD style and comorbidities, augmenting habit-reversal therapy with other behavioural therapies or pharmacological options, particularly glutamatergic modulators or specific serotonin-reuptake inhibitors, may enhance treatment outcomes. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - October 1, 2019 Category: Drugs & Pharmacology Source Type: research

Intranasal esketamine in treatment-resistant depression: a profile of its use
AbstractIntranasal esketamine (Spravato ™), theS-enantiomer of ketamine, targets the glutamatergic system via non-competitive antagonism of theN-methyl-D-aspartate receptor, thereby providing a novel approach to traditional antidepressants that target modulation of the monoaminergic system. In conjunction with an oral antidepressant (OAD), intranasal esketamine is approved in the USA for use in adult patients with treatment-resistant depression (TRD). Given its novel mechanism and rapid onset of action, convenient weekly or once every 2 weeks maintenance regimen, and the current paucity of approved pharmacotherapy op...
Source: Drugs and Therapy Perspectives - September 28, 2019 Category: Drugs & Pharmacology Source Type: research

Manage cutaneous adverse effects induced by diabetes medications or devices by removing the offending agent and choosing appropriate treatment
AbstractNumerous cutaneous adverse effects (CAEs) have been reported with glucose-lowering medications (e.g. insulin, dipeptidyl peptidase  4 inhibitors and sulfonylureas) and medical devices (e.g. continuous subcutaneous insulin infusion and continuous glucose monitoring) used in the management of diabetes. Notable CAEs include angioedema, autoimmune blistering diseases, contact dermatitis, Stevens-Johnson syndrome and worsening bloo d glucose control. While some of CAEs are common and others rare, it is important for healthcare providers to be aware of the potential culprits and their associated CAEs, as well as eff...
Source: Drugs and Therapy Perspectives - September 23, 2019 Category: Drugs & Pharmacology Source Type: research

Fexinidazole in human African trypanosomiasis: a profile of its use
AbstractFexinidazole winthrop (hereafter fexinidazole) is the first all-oral therapy available for the treatment of human African trypanosomiasis (HAT; commonly known as ‘sleeping sickness’). Fexinidazole is a 5-nitroimidazole derivative developed by the Drugs for Neglected Diseases initiative in collaboration with Sanofi. It has received a positive opinion from the European Medicines Agency (under Article 58) for the treatment of both stage 1 and 2 HAT due toTrypanosoma brucei gambiense (g-HAT) in patients aged  ≥ 6 years and weighing ≥ 20 kg, supporting its registration...
Source: Drugs and Therapy Perspectives - September 18, 2019 Category: Drugs & Pharmacology Source Type: research

Insulin glargine/lixisenatide in type 2 diabetes: a profile of its use
AbstractSubcutaneous insulin glargine/lixisenatide [Suliqua® 100/33 and 100/50 (EU); Soliqua® 100/33 (USA)] is a titratable, fixed-ratio combination of a long-acting basal insulin analogue  + a glucagon-like peptide-1 receptor agonist (GLP-1 RA) approved to treat inadequately controlled type 2 diabetes (T2D) in adults. Once-daily insulin glargine/lixisenatide provided glycaemic control better than that of insulin glargine or lixisenatide in insulin-naive patients (when added to me tformin) and better than that of insulin glargine in insulin-experienced patients (when used ± metfor...
Source: Drugs and Therapy Perspectives - August 30, 2019 Category: Drugs & Pharmacology Source Type: research

Properly prescribed, proton pump inhibitors are largely safe, but precautions are needed to prevent potential problems, overuse and misuse
AbstractAdverse events have been widely reported in users of popular proton pump inhibitors (PPIs). Most data come from observational studies, with clear causation rarely demonstrated. Evidence linking PPIs to gastrointestinal infections is stronger and some drug interactions are important. The use of PPI is often prolonged, without a clear reason for continued therapy. PPIs should be prescribed after a careful assessment of risks and benefits and their use reviewed regularly. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - August 29, 2019 Category: Drugs & Pharmacology Source Type: research

Manage postpartum depression with psychosocial strategies, psychotherapy and/or pharmacotherapy based on its severity
AbstractPostpartum depression (PPD) is more intense than the ‘baby blues’, and may last for months to years without treatment. PPD may have significant, as well as devastating, consequences, but is often under-detected and under-treated. Screening questions and questionnaires can be used to identify patients with PPD, and psychosocial strategies (e.g. pee r support, professional counselling), psychotherapy (e.g. cognitive behavioural therapy, interpersonal therapy) and pharmacotherapy (e.g. brexanolone, sertraline) can be used to treat the disorder. Severe and refractory cases may benefit from electroconvulsive...
Source: Drugs and Therapy Perspectives - August 23, 2019 Category: Drugs & Pharmacology Source Type: research

Zinc l -carnosine in gastric ulcers: a profile of its use
AbstractOral zincl-carnosine (Gastrozin®) 75 mg twice daily is an effective gastric mucoprotective option for the treatment and prevention of gastric ulcers. The two components of the chelated compound (i.e. zinc andl-carnosine in a 1:1 ratio) provide beneficial anti-inflammatory, antioxidant and other effects that work together to support the natural mucoprotective mechanisms of the gastrointestinal tract. Zincl-carnosine 75 mg twice daily has well established efficacy in the treatment of gastric ulcers, and is at least as effective as other mucoprotectants in this indication. It consistently provides rapid healing of...
Source: Drugs and Therapy Perspectives - August 20, 2019 Category: Drugs & Pharmacology Source Type: research

First reports of adverse drug reactions
(Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - August 13, 2019 Category: Drugs & Pharmacology Source Type: research

Correction to: Metreleptin in lipodystrophy: a profile of its use
The article Metreleptin in lipodystrophy: a profile of its use, written by Emma Deeks. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - August 13, 2019 Category: Drugs & Pharmacology Source Type: research

Colorful dyes and other vibrant topical creams as treatments for dermatological conditions
AbstractThis review summarizes the mechanisms, applications, and adverse effects of colorful dyes, such as Castellani ’s paint, gentian violet, and potassium permanganate, as well as two other vibrant topical creams—vitamin B12 and indigo naturalis. Certain dyes such as Castellani ’s paint, gentian violet, and potassium permanganate were once commonplace topical therapies for cutaneous infections; these dyes are brightly colored on application and have been suggested to be efficacious and well tolerated through case studies as well as controlled studies. Moreover, topical v itamin B12 and topical indigo n...
Source: Drugs and Therapy Perspectives - August 9, 2019 Category: Drugs & Pharmacology Source Type: research

Recent and updated pharmacotherapy of migraine
AbstractMigraine is a complex and still debatable neurovascular disorder that is on the rise globally, affecting patients of all ages. Various drugs are available for acute and chronic management, but migraine appears to be a chronic and progressive condition, with 5.1% of patients ultimately becoming refractory to drugs. For the acute and preventative management of migraine, newer molecules targeting calcitonin gene-related peptide (CGRP) have been approved and others are in various phases of development. This narrative review aims to give an overview of migraine therapy with special emphasis on CGRP and the molecules tar...
Source: Drugs and Therapy Perspectives - August 8, 2019 Category: Drugs & Pharmacology Source Type: research

Revisiting clinical practice in therapeutic drug monitoring of first-generation antiepileptic drugs
AbstractDue to the complex and diverse nature of epilepsy and antiepileptic drugs (AEDs), the implementation of therapeutic drug monitoring (TDM) can contribute significantly to the overall improvement of clinical outcome in epilepsy. Establishing and interpreting an individual serum drug concentration range by TDM is beneficial to prevent recurrence of epilepsy, as well as to avoid adverse drug effects. It enables optimization of dosage regimen, especially in case of drugs that follow non-linear pharmacokinetics, and in special populations such as pregnancy, pediatrics, geriatrics, critically ill, and liver and renal impa...
Source: Drugs and Therapy Perspectives - August 6, 2019 Category: Drugs & Pharmacology Source Type: research

Managing nocardiosis: a review and case series of its treatment with trimethoprim –sulfamethoxazole
We report a case series of nocardiosis with diverse clinical presentations (primary pulmonary, primary cutaneous, and disseminated) and successful treatment with trimethoprim –sulfamethoxazole (TMP–SMX). We briefly review the cases to assess the efficacy of treatment with TMP–SMX. The optimal therapy for nocardiosis has yet to be established. Our clinical experience, together with the clinical evidence in the literature, suggests that TMP–SMX should be considered as the therapeutic drug of choice for treating nocardiosis. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - August 5, 2019 Category: Drugs & Pharmacology Source Type: research

Ravulizumab in paroxysmal nocturnal hemoglobinuria: a profile of its use
AbstractRavulizumab (Ultomiris ™) is a humanized monoclonal antibody that inhibits terminal complement C5, thereby reducing hemolysis, inflammation, and thrombosis in patients with paroxysmal nocturnal hemoglobinuria (PNH). Ravulizumab was developed by re-engineering eculizumab to create a longer-acting antibody, which allows a n 8-weekly administration schedule instead of the 2-weekly schedule required with eculizumab. A single intravenous infusion of ravulizumab provides immediate and complete inhibition of serum free C5. With continued ravulizumab treatment, breakthrough hemolysis rates decrease as a result of eli...
Source: Drugs and Therapy Perspectives - August 1, 2019 Category: Drugs & Pharmacology Source Type: research

Treat childhood vitiligo with topical corticosteroids, topical calcineurin inhibitors and/or targeted phototherapy
AbstractVitiligo, which manifests as varying sizes and shapes of well-circumscribed amelanotic macules or patches amid normally pigmented skin, has a quite common onset during childhood. The most common treatments of childhood vitiligo are topical corticosteroids, topical calcineurin inhibitors and targeted phototherapy. Adequate sun protection and cosmetic camouflage may also be of benefit. It is also important to identify individuals in need of psychological support, as childhood vitiligo can negatively impact psychosocial factors and health-related quality of life. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - July 26, 2019 Category: Drugs & Pharmacology Source Type: research

Correction to: K-haler ® breath-triggered inhaler: a profile of the properties of the device
The article K-haler ® breath-triggered inhaler: a profile of the properties of the device, written by Emma D. Deeks and Katherine A. Lyseng-Williamson, was originally published Online First without open access. After publication in volume 35, issue 7, pages 315–320, Mundipharma International Limited requested that t he article be Open Choice to make the article an open access publication. Post-publication open access was funded by Mundipharma International Limited. The article is forthwith distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommo...
Source: Drugs and Therapy Perspectives - July 24, 2019 Category: Drugs & Pharmacology Source Type: research

Individualize treatment when prescribing medical cannabis to older patients as efficacy data remains limited
AbstractThere is a growing interest in the use of cannabis for medical purposes, especially in older patients who experience pain, sleep difficulties, mood disturbances or neurological disorders that are poorly managed by current treatment options. However, efficacy data on the use of medical cannabis remains limited, yet the risk of known and potential adverse events are considerably high. Treatment should be individualized based on the characteristics of the patient and be closely monitored. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - July 23, 2019 Category: Drugs & Pharmacology Source Type: research

Examine the skin and thoroughly review medical/medication history when considering a diagnosis of drug-induced pigmentation
AbstractSeveral medications have been implicated in drug-induced pigmentation, with evidence for the association primarily derived from case reports. The incidence rates of drug-induced pigmentation are difficult to assess and diagnosis is often complicated by the delayed onset of pigmentation and co-existing polypharmacy. Therefore, a thorough medical history, a review of current and previous medications and a complete skin examination are necessary, with subsequent discontinuation of the suspected causative agent to resolve symptoms. (Source: Drugs and Therapy Perspectives)
Source: Drugs and Therapy Perspectives - July 22, 2019 Category: Drugs & Pharmacology Source Type: research

Some phytomedicines show promise for the management of migraine, but further clinical evidence is needed before they can be strongly recommended
AbstractPhytomedicines may provide new options for migraine prophylaxis and treatment based on their historical use and pharmacological properties. However, as clinical data are limited, no phytomedicine can currently be strongly recommended to manage migraine. Feverfew and butterbur may be effective in preventing migraine, but the efficacy of butterbur has been overshadowed by reports of severe petasites hepatotoxicity. Although further research is needed, chamomile, coriander, peppermint and ginkgo have shown encouraging results in explorative clinical studies, and the active components of cannabis and St John ’s w...
Source: Drugs and Therapy Perspectives - July 22, 2019 Category: Drugs & Pharmacology Source Type: research