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Importance of Medication Reconciliation: Tizanidine-Induced Hepatitis
No abstract available (Source: American Journal of Therapeutics)
Source: American Journal of Therapeutics - September 1, 2017 Category: Drugs & Pharmacology Tags: Letters to the Editors Source Type: research

Non ‐medical use of psychoactive prescription drugs is associated with fatal poisoning
ConclusionsNon‐prescribed psychoactive drugs are commonly found at post‐mortem in drug poisoning deaths in Finland with history of drug abuse being a major contributing factor. (Source: Addiction)
Source: Addiction - August 26, 2017 Category: Addiction Authors: Jari Haukka, Pirkko Kriikku, Claudia Mariottini, Timo Partonen, Ilkka Ojanper ä Tags: Research Report Source Type: research

A novel non-opioid protocol for medically supervised opioid withdrawal and transition to antagonist treatment.
CONCLUSION: This retrospective chart review suggests the feasibility of a novel protocol for medically supervised opioid withdrawal and transition to relapse prevention strategies, including injectable ER naltrexone. This withdrawal protocol does not utilize opioid agonists or other controlled substances.‬‬‬‬. PMID: 28795846 [PubMed - as supplied by publisher] (Source: The American Journal of Drug and Alcohol Abuse)
Source: The American Journal of Drug and Alcohol Abuse - August 10, 2017 Category: Addiction Authors: Rudolf G, Walsh J, Plawman A, Gianutsos P, Alto W, Mancl L, Rudolf V Tags: Am J Drug Alcohol Abuse Source Type: research

Melanin binding study of clinical drugs with cassette dosing and rapid equilibrium dialysis inserts.
In this study, we introduce a powerful tool for screening of melanin binding. The binding of a set of 34 compounds to isolated porcine RPE melanin was determined by cassette (n-in-one) dosing in rapid equilibrium dialysis inserts and the binding was quantitated with LC-MS/MS analytics. The compounds represented large variety in melanin binding (from 8.6%, ganciclovir) to over 95% bound (ampicillin and ciprofloxacin). The data provides information on melanin binding of small molecular weight compounds that are used for ocular (e.g. brinzolamide, ganciclovir) and systemic (e.g. tizanidine, indomethacin) therapy. Interestingl...
Source: European Journal of Pharmaceutical Sciences - July 26, 2017 Category: Drugs & Pharmacology Authors: Pelkonen L, Tengvall-Unadike U, Ruponen M, Kidron H, Del Amo EM, Reinisalo M, Urtti A Tags: Eur J Pharm Sci Source Type: research

Hemopericardium under dabigatran for stroke prevention in atrial fibrillation
We report a polymorbid 75-year old male under a therapy with dabigatran, valsartan, amlodipine, nicorandil, furosemide, atorvastatin, bisoprolol, metformin, tizanidine, pantoprazole, and tramadol. He suffered from chest pain for 4 months. Coronary angiography showed only ectatic coronary arteries. He started taking nonsteroidal anti-inflammatory drugs. He was hospitalized because of dyspnea starting 10 days before admission, melena, and renal failure. Hemopericardium was diagnosed and pericardiocentesis yielded 2000 ml hemorrhagic fluid. Review of previous echocardiograms showed a 4 mm echo-free space, epicardial fat o...
Source: Blood Coagulation and Fibrinolysis - February 11, 2017 Category: Hematology Tags: Case Reports Source Type: research

Nanotransfersomes-loaded thermosensitive in situ gel as a rectal delivery system of tizanidine HCl: preparation, in vitro and in vivo performance.
Authors: Moawad FA, Ali AA, Salem HF Abstract The purpose of the current study was to develop tizanidine HCl (TIZ; a myotonolytic agent used for treatment of spasticity) loaded nanotransfersomes intended for rectal administration, aiming to bypass the hepatic first-pass metabolism. TIZ-loaded nanotransfersomes were prepared by thin-film hydration method followed by characterization for various parameters including entrapment efficiency, vesicle diameter, in vitro release and ex vivo permeation studies. Transfersomal formulation composed of phosphatidylcholine and Tween 80 at a weight ratio of (85:15) gave a satisfa...
Source: Drug Delivery - February 6, 2017 Category: Drugs & Pharmacology Tags: Drug Deliv Source Type: research

Potential drug-drug interactions in the pediatric intensive care unit of a pulmonary teaching hospital
Conclusions: Life-threatening drug interactions may develop in pediatric patients hospitalized in the PICU. Clinical managements such as avoiding combination, close monitoring, and considering related risk factors could prevent the consequences of these interactions. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 7, 2016 Category: Respiratory Medicine Authors: Baniasadi, S., Hassanzad, M., Alehashem, M. Tags: 7.5 Neonatology and Paediatric Intensive Care Source Type: research

Pharmacological management of spasticity in multiple sclerosis: Systematic review and consensus paper
Conclusion: The available studies on spasticity treatment offer some insight to guide clinical practice but are of variable methodological quality. Large, well-designed trials are needed to confirm the effectiveness of antispasticity agents and to produce evidence-based treatment algorithms. (Source: Multiple Sclerosis)
Source: Multiple Sclerosis - October 2, 2016 Category: Neurology Authors: Otero-Romero, S., Sastre-Garriga, J., Comi, G., Hartung, H.-P., Soelberg Sorensen, P., Thompson, A. J., Vermersch, P., Gold, R., Montalban, X. Tags: Review Source Type: research

Poster 257 Tizanidine Reduces Night Sweats due to Dysautonomia in Syringomyelia: A Case Report
Ryan Menard: I Have No Relevant Financial Relationships To Disclose (Source: PM and R)
Source: PM and R - August 31, 2016 Category: Rehabilitation Authors: Ryan A. Menard, Daniel Moon, Paul Hurd Source Type: research

Clinical efficacy and safety of eperisone for low back pain: A systematic literature review.
Abstract Eperisone, an analgesic and centrally acting muscle relaxant has been in use for the treatment of low back pain (LBP). The present systematic review evaluates the efficacy and safety of eperisone in patients with LBP. Cochrane Back and Neck (CBN) Group and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were adopted to perform this systematic review. For risk of bias assessment CBN Group and Moga tools were used. Seven (5 randomized controlled trials [RCTs] and 2 uncontrolled studies) studies involving 801 participants were included. Eperisone intervention may be eff...
Source: Pharmacological Reports - June 28, 2016 Category: Drugs & Pharmacology Authors: Bavage S, Durg S, Ali Kareem S, Dhadde SB Tags: Pharmacol Rep Source Type: research

Prediction of inter-individual variability on the pharmacokinetics of CYP1A2 substrates in non-smoking healthy volunteers.
Authors: Haraya K, Kato M, Chiba K, Sugiyama Y Abstract The activity of CYP1A2, a major drug-metabolizing enzyme, is known to be affected by various environmental factors. Our study aimed to predict inter-individual variability of AUC/Dose of CYP1A2 substrates in non-smoking healthy volunteers using the Monte Carlo simulation. Inter-individual variability in hepatic intrinsic clearance of CYP1A2 substrates (CLint,h,1A2) was estimated using dispersion model based on the inter-individual variability (N = 96) of the AUC of caffeine, a major CYP1A2 substrate. The estimated coefficient of variation (CV) of CLi...
Source: Drug Metabolism and Pharmacokinetics - June 20, 2016 Category: Drugs & Pharmacology Tags: Drug Metab Pharmacokinet Source Type: research

Influence of Previous Failed Antispasticity Therapy on the Efficacy and Tolerability of THC:CBD Oromucosal Spray for Multiple Sclerosis Spasticity
Conclusions: THC:CBD oromucosal spray provided consistent relief with good tolerability in MS spasticity patients irrespective of their antispasticity pre-treatment history.Eur Neurol 2016;75:236-243 (Source: European Neurology)
Source: European Neurology - May 9, 2016 Category: Neurology Source Type: research

Alpha2-adrenergic agonists for the management of opioid withdrawal.
CONCLUSIONS: Clonidine and lofexidine are more effective than placebo for the management of withdrawal from heroin or methadone. We detected no significant difference in efficacy between treatment regimens based on clonidine or lofexidine and those based on reducing doses of methadone over a period of around 10 days, but methadone was associated with fewer adverse effects than clonidine, and lofexidine has a better safety profile than clonidine. PMID: 27140827 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - May 2, 2016 Category: Journals (General) Authors: Gowing L, Farrell M, Ali R, White JM Tags: Cochrane Database Syst Rev Source Type: research

Haloperidol as an Abortive and Preventative Agent in Status Dystonicus (P2.352)
We present two cases with histories of severe spasms, necessitating intrathecal baclofen pump placement, who both required intubation for status dystonicus. It was not until use of haloperidol as a preventative and abortive agent, that there was significantly decreased spasm frequency and severity in these patients. Cases: Patient 1 is a 40-year-old man with cerebral palsy and spasms controlled with a baclofen pump who was admitted for increasing spasms. Treatment with trihexyphenidyl, increasing amounts of baclofen (oral and intrathecal) and onabotulinumtoxinA injections lessened spasm frequency but did not eliminate them...
Source: Neurology - April 3, 2016 Category: Neurology Authors: George, I., Machado, D. Tags: Movement Disorders: Therapeutics Source Type: research

Drug safety of macrolide and quinolone antibiotics in a tertiary care hospital: administration of interacting co-medication and QT prolongation
Conclusion In the studied real-life setting, we found a considerable number of MQAB users with additional risk factors for TdP but no ECG monitoring. However, adverse drug reactions were rarely found, and costs vs. benefits of ECG monitoring have to be weighted. In contrast, avoidable risk factors and selected contraindicated pharmacokinetic interactions are clear targets for implementation as automated alerts in electronic prescribing systems. (Source: European Journal of Clinical Pharmacology)
Source: European Journal of Clinical Pharmacology - March 28, 2016 Category: Drugs & Pharmacology Source Type: research

Tizanidine for the management of acute postoperative pain after inguinal hernia repair: A placebo-controlled double-blind trial
BACKGROUND: α2-Agonists are used postoperatively as a component of multimodal analgesia. Tizanidine is a centrally acting α2-agonist with muscle relaxant properties. OBJECTIVE: The aim of this study was to compare the efficacy of tizanidine with placebo in terms of postoperative pain scores, analgesic consumption, return to daily activity and health-related quality of life. DESIGN: A randomised double-blind study. SETTING: Diskapi Yildirim Beyazit Training and Research Hospital. INTERVENTIONS: After obtaining ethical approval and informed patient consent, 60 patients undergoing inguinal hernia repair under ...
Source: European Journal of Anaesthesiology - February 3, 2016 Category: Anesthesiology Tags: Postoperative pain Source Type: research

Long-term myocardial toxicity in a patient with tizanidine and etizolam overdose
Publication date: Available online 28 November 2015 Source:Journal of Cardiology Cases Author(s): Mari Amino, Koichiro Yoshioka, Yuji Ikari, Sadaki Inokuchi Tizanidine hydrochloride, α2-receptor stimulant, is a central muscle relaxant. Etizolam is a benzodiazepine-based anti-anxiety agent. Both drugs are widely used for the treatment of a variety of muscle pain and frequently used together in Japan. We experienced a case of complicating prolonged myocardial dysfunction in a 56-year-old woman. Six hours after overdose of 48mg tizanidine and 24mg etizolam, she showed sinus bradycardia and peripheral vascular resi...
Source: Journal of Cardiology Cases - January 12, 2016 Category: Cardiology Source Type: research

Comparison of Efficacy and Side Effects of Oral Baclofen Versus Tizanidine Therapy with Adjuvant Botulinum Toxin Type A in Children With Cerebral Palsy and Spastic Equinus Foot Deformity
This retrospective study aimed to compare the therapeutic response, including side effects, for oral baclofen versus oral tizanidine therapy with adjuvant botulinum toxin type A in a group of 64 pediatric patients diagnosed with static encephalopathy and spastic equinus foot deformity. Following botulinum toxin A treatment, clinical improvement led to the gradual reduction of baclofen or tizanidine dosing to one-third of the former dose. Gross Motor Functional Measure and Caregiver Health Questionnaire scores were markedly elevated post–botulinum toxin A treatment, with scores for the tizanidine (Gross Motor Function...
Source: Journal of Child Neurology - January 12, 2016 Category: Neurology Authors: Dai, A. I., Aksoy, S. N., Demiryürek, A. T. Tags: Original Articles Source Type: research

Tizanidine-induced acute severe cystitis in a female taking famotidine.
We report a case of a 26-year-old Asian female on famotidine who presented with acute severe urinary burning after taking tizanidine. PMID: 26251632 [PubMed] (Source: Clinical Pharmacology: Advances and Applications)
Source: Clinical Pharmacology: Advances and Applications - November 29, 2015 Category: Allergy & Immunology Tags: Clin Pharmacol Source Type: research

Analgesic efficacy of oral gabapentin added to standard epidural corticosteroids in patients with failed back surgery.
CONCLUSION: It was concluded that addition of oral gabapentin to epidural corticosteroid application in patients with failed back surgery syndromes was effective in ameliorating pain at an early stage without significant side effects. PMID: 22291506 [PubMed] (Source: Clinical Pharmacology: Advances and Applications)
Source: Clinical Pharmacology: Advances and Applications - November 29, 2015 Category: Allergy & Immunology Tags: Clin Pharmacol Source Type: research

Tizanidine and Speech Therapy for Spastic Dysarthria: A Case Study
To evaluate tizanidine with speech therapy for dysarthria associated with spastic tetraplegia. (Source: Archives of Physical Medicine and Rehabilitation)
Source: Archives of Physical Medicine and Rehabilitation - November 23, 2015 Category: Rehabilitation Authors: Jon A. Mukand, Patricia Swift Fulton, Minh Tran, Nita H. Mukand Tags: Research Poster Source Type: research

Spinal antinociceptive action of amiloride and its interaction with tizanidine in the rat formalin test.
PMID: 26357686 [PubMed - as supplied by publisher] (Source: Pain Research and Management)
Source: Pain Research and Management - September 10, 2015 Category: Anesthesiology Authors: Ouyang H, Wang P, Huang W, Li Q, Nie B, Zeng W Tags: Pain Res Manag Source Type: research

Evaluation of tizanidine as a marker of canine CYP1A2 activity
The dog CYP1A2 enzyme is likely an important contributor to the metabolism of veterinary drugs. Dog CYP1A2 is expressed in liver, plus it is inducible and polymorphic, creating the potential for intersubject differences in pharmacokinetics. Hence, the ability to probe dog CYP1A2 activity and inhibition is relevant toward veterinary drug development and drug–drug interaction assessment. Previous studies have relied on human probes with questionable specificity for CYP1A2, so it was hypothesized that recombinant CYP1A2 could be used to find a specific CYP1A2 substrate. Intrinsic clearance experiments demonstrated that ...
Source: Journal of Veterinary Pharmacology and Therapeutics - July 30, 2015 Category: Veterinary Research Authors: C. W. Locuson, P. Williams, J. M. Adcock, J. S. Daniels Tags: Scientific Paper Source Type: research

Tizanidine-induced acute severe cystitis in a female taking famotidine
We report a case of a 26-year-old Asian female on famotidine who presented with acute severe urinary burning after taking tizanidine. Keywords: adverse drug reaction, cystitis, famotidine, tizanidine (Source: International Journal of COPD)
Source: International Journal of COPD - July 29, 2015 Category: Respiratory Medicine Tags: Clinical Pharmacology: Advances and Applications Source Type: research

Tizanidine-induced cystitis
Poudel RR, Kafle NK (Source: International Journal of COPD)
Source: International Journal of COPD - July 28, 2015 Category: Respiratory Medicine Source Type: research

A severe interaction between Tizanidine and Ciprofloxacin
Tizanidine is a commonly prescribed medication for muscle spasms [1]. The pharmacokinetics of Tizanidine are altered by the use of CYP1A2 inhibitors as Ciprofloxacin in healthy subjects; elevation of Tizanidine levels leads to a decrease in psychomotor activity and hemodynamic changes which are manifested as a decrease in blood pressure and heart rate [2,3]. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - June 29, 2015 Category: Anesthesiology Authors: Alaa Abd-Elsayed, Hesham Elsharkawy, Wael Sakr Tags: Correspondence Source Type: research

Interventions to Reduce Spasticity and Improve Function in People With Chronic Incomplete Spinal Cord Injury: Distinctions Revealed by Different Analytical Methods
Conclusions. Improvements in function were achieved in a limited number of people with SCI. Using the MID and GMM techniques, differences in responses to interventions between high-and low-functioning participants could be identified. These techniques may, therefore, have potential to be used for characterizing therapeutic effects resulting from different interventions. (Source: Neurorehabilitation and Neural Repair)
Source: Neurorehabilitation and Neural Repair - June 25, 2015 Category: Neurology Authors: Duffell, L. D., Brown, G. L., Mirbagheri, M. M. Tags: Clinical Research Articles Source Type: research

A Case of Stiff Person Syndrome: Immunomodulatory Effect of Benzodiazepines: Successful Rituximab and Tizanidine Therapy
This report demonstrates ineffective benzodiazepine therapy of SPS that prompts tachyphylaxis, loss of responsiveness, and finally benzodiazepine withdrawal syndrome. Convulsion and anxiety correlate with high level of creatine phosphokinase (CK). Although tonus and spasm attacks were successfully controlled by tizanidine, glutamate release inhibitor, the immune response, and autoimmune diabetes development require the plasmapheresis, mycophenolat mofetil, and rituximab therapy that results in a significant decrease of GADAb, impaired glucose tolerance (IGT), lactate dehydrogenase (LDH), and CK normalization. Unfortunately...
Source: Medicine - June 1, 2015 Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research

Scoliosis in Childhood-Onset Stiff Person Syndrome (P2.073)
CONCLUSIONS: In children and young adults with spinal column deformities including hyperlordosis or new scoliosis, the diagnosis of SPS should be considered since early treatment may help reduce long term complications, disability and improve the quality of life. Study Supported by: noneDisclosure: Dr. Rasameesoraj has nothing to disclose. Dr. Katirji has nothing to disclose. Dr. Devereaux has received personal compensation for activities with Digitrace. (Source: Neurology)
Source: Neurology - April 8, 2015 Category: Neurology Authors: Rasameesoraj, T., Katirji, B., Devereaux, M. Tags: Neurological Consequences of Autoimmune Disease Source Type: research

"Spinal" Movement Disorders in NMO Patients: An Under-Recognized Phenomenon (S46.001)
CONCLUSIONS: Movement disorders are common in NMO patients and can be a major source of disability. Randomized clinical trials are needed to identify effective treatments. Study Supported by:Disclosure: Dr. Abboud has nothing to disclose. Acorda Therapeutics; Sanofi; Viropharma, Inc.; NeuralStem, Inc.; Shire/Abvie; TerumoBCT (Source: Neurology)
Source: Neurology - April 8, 2015 Category: Neurology Authors: Abboud, H., Levy, M. Tags: Neuromyelitis Optica Source Type: research

Facilitatory effects of anti-spastic medication on robotic locomotor training in people with chronic incomplete spinal cord injury
The objective of this study was to investigate whether an anti-spasticity medication can facilitate the effects of robotic locomotor treadmill training (LTT) to improve gait function in people with incomplete spinal cord injury (SCI). Methods: Individuals with chronic incomplete SCI were recruited and carried out a 4 week intervention of either locomotor treadmill training (LTT) alone (n = 26) or LTT combined with Tizanidine (TizLTT), an anti-spasticity medication (n = 22). Gait function was evaluated using clinical outcome measures of gait, speed and endurance. To better understand the und...
Source: Journal of NeuroEngineering and Rehabilitation - March 20, 2015 Category: Rehabilitation Authors: Lynsey DuffellGeoffrey BrownMehdi Mirbagheri Source Type: research

Drugs used to treat joint and muscle disease
Publication date: Available online 19 February 2015 Source:Anaesthesia & Intensive Care Medicine Author(s): David G. Lambert Joint disease: Arthritis can be simply broken into osteoarthritis and rheumatoid arthritis (RA). Osteoarthritis is treated with symptomatic pain relief and surgery. RA is a chronic autoimmune disease that causes inflammation of joints (leading to their destruction), tissues around joints and other organ systems. Treatment (for pain) of RA in the first instance is with non-steroidal anti-inflammatory drugs, with second-line treatment using disease-modifying antirheumatic drugs (DMARDs). DMAR...
Source: Anaesthesia and intensive care medicine - February 24, 2015 Category: Anesthesiology Source Type: research

Impact of Intravenous Acetaminophen on Reducing Opioid Use After Hysterectomy
ConclusionThe multimodal approach to perioperative analgesic management, which includes concurrent administration of intravenous acetaminophen and opioids, is effective in reducing the total average amount of opioids administered on postoperative days 1–2 and perioperatively. Limitations of this study include its short duration, retrospective design, and single‐site setting. These results may not be generalized to patients undergoing other types of obstetric‐gynecologic surgeries. (Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy)
Source: Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy - December 17, 2014 Category: Drugs & Pharmacology Authors: Brittany O. Herring, Sheila Ader, Angel Maldonado, Carla Hawkins, Margaretta Kearson, Madeline Camejo Tags: Original Research Article Source Type: research

Cranberry juice ingestion and clinical drug-drug interaction potentials; review of case studies and perspectives.
Authors: Srinivas NR Abstract Cranberry juice is a popular beverage with many health benefits. It has anthocyanins to supplement dietary needs. Based on in vitro evidence cranberry juice is an inhibitor of CYP enzymes and at higher amounts as potent as ketoconazole (CYP3A) and fluconazole (CYP2C9). There is, however, a discrepancy between in vitro and in vivo observations with respect to a number of substrates (cyclosporine, warfarin, flurbiprofen, tizanidine, diclofenac, amoxicillin, ceflacor); with the exception of a single report on midazolam, where there was a moderate increase in the AUC of midazolam in subjec...
Source: Journal of Pharmacy and Pharmaceutical Sciences - December 2, 2014 Category: Drugs & Pharmacology Tags: J Pharm Pharm Sci Source Type: research

Patient education and self-care for the management of jaw pain upon awakening: a randomized controlled clinical trial comparing the effectiveness of adding pharmacologic treatment with cyclobenzaprine or tizanidine.
CONCLUSION: The use of tizanidine or cyclobenzaprine in addition to self-care management and patient education was not more effective than placebo for the management of patients with myofascial jaw pain upon awakening. PMID: 24822235 [PubMed - indexed for MEDLINE] (Source: Journal of Orofacial Pain)
Source: Journal of Orofacial Pain - November 25, 2014 Category: ENT & OMF Tags: J Oral Facial Pain Headache Source Type: research

Profound Symptomatic Bradycardia Requiring Transvenous Pacing After a Single Dose of Tizanidine
We report a case of profound symptomatic bradycardia after a single dose of tizanidine. (Source: The Journal of Emergency Medicine)
Source: The Journal of Emergency Medicine - November 18, 2014 Category: Emergency Medicine Authors: Jennifer Cortes, Brad Hall, Danyelle Redden Tags: Pharmacology in Emergency Medicine Source Type: research

Prescriber perceptions of a near real-time fax alert program for potential drug-drug interactions.
CONCLUSIONS: The positive response to fax alerts by physicians varies by the component drugs of the PDDI alerts. PMID: 24761821 [PubMed - in process] (Source: Journal of Managed Care Pharmacy)
Source: Journal of Managed Care Pharmacy - November 14, 2014 Category: Drugs & Pharmacology Tags: J Manag Care Pharm Source Type: research

Central noradrenergic mechanisms and the acute stress response during painful stimulation
Events that threaten tissue integrity including noxious stimulation activate central noradrenergic circuits, particularly locus coeruleus and its projections. Recent advances in theory hold that an adaptive, defensive shift in brain activity takes place in response to threat. In principle, this shift may accentuate the autonomic and central biomarkers of the perception of painful events and the experience of pain itself. We have examined the effects of an alpha-2 agonist on pupil dilation responses, skin conductance responses, near field somatosensory evoked potentials and pain reports in normal volunteers undergoing repea...
Source: Journal of Psychopharmacology - November 12, 2014 Category: Psychiatry Authors: Chapman, C. R., Bradshaw, D. H., Donaldson, G. W., Jacobson, R. C., Nakamura, Y. Tags: Original Papers Source Type: research

Hot-melts in Buccoadhesive Patches: An Approach for Bioavailability Enhancement of Highly-Metabolized Drugs with Short Elimination Half-Life.
Abstract The present study deals with the inclusion or incorporation of hot-melts into buccoadhesive patches. Our aim is to develop a patient-friendly dosage form that is capable of extending release of short elimination half-life drugs so to decrease dosing frequency and to increase the bioavailability of highly-metabolized drugs with the ultimate aim of dose reduction. Tizanidine hydrochloride (TIZ) was used as a model drug. TIZ was incorporated into Compritol-based hot-melts, and then further formulated into buccal patches prepared using HPMC, PVA and Polyox. A Central Composite Face-centered Design was employe...
Source: European Journal of Pharmaceutics and Biopharmaceutics - October 25, 2014 Category: Drugs & Pharmacology Authors: El Mahrouk GM, El Gazayerly ON, Aboelwafa AA, Taha MS Tags: Eur J Pharm Biopharm Source Type: research

Coadministration of Tramadol and Tizanidine in an Experimental Acute Pain Model in Rat
Abstract The use of drug combinations to achieve a desired effect is a common practice in pharmacological reaserch and in clinical practice. The present study was designed to evaluate the potential synergistic antinociceptive interactions between tizanidine, an α‐2‐adrenoceptor agonist and tramadol on formalin‐induced nociception in rat using isobolographic analyses. Tramadol (0.1–100 μg/paw) and tizanidine (0.01–10 μg/paw) were injected into the paw prior to formalin injection (1%). Both drugs produced a dose‐dependent antinociceptive effect. The EC50 values were estima...
Source: Drug Development Research - September 1, 2014 Category: Drugs & Pharmacology Authors: Karla Lizet Beltrán‐Villalobos, Pamela Monserrat Ramírez‐Marín, Carlos Alberto Zúñiga Cruz, Myrna Déciga‐Campos Tags: Research Article Source Type: research

Chronic Daily Headache: Diagnosis and Management.
Abstract Chronic daily headache is defined as the presence of a headache on 15 days or more per month for at least three months. The most common types of chronic daily headache are chronic migraines and chronic tension-type headaches. If a red flag for a secondary cause of headache is present, magnetic resonance imaging of the head should be performed. All patients should be asked about medication overuse, which can increase the frequency of headaches. Patients who overuse medications for abortive therapy for headache should be encouraged to stop the medications entirely and consider prophylactic treatment. Severa...
Source: American Family Physician - April 15, 2014 Category: Primary Care Authors: Yancey JR, Sheridan R, Koren KG Tags: Am Fam Physician Source Type: research

Alpha2-adrenergic agonists for the management of opioid withdrawal.
CONCLUSIONS: Clonidine and lofexidine are more effective than placebo for the management of withdrawal from heroin or methadone. No significant difference in efficacy was detected for treatment regimens based on clonidine or lofexidine, and those based on reducing doses of methadone over a period of around 10 days but methadone is associated with fewer adverse effects than clonidine, and lofexidine has a better safety profile than clonidine. PMID: 24683051 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - March 31, 2014 Category: Journals (General) Authors: Gowing L, Farrell MF, Ali R, White JM Tags: Cochrane Database Syst Rev Source Type: research

Non-antiepileptic drugs for trigeminal neuralgia.
CONCLUSIONS: There is low-quality evidence that the effect of tizanidine is not significantly different than that of carbamazepine in treating trigeminal neuralgia. Pimozide is more effective than carbamazepine, although the evidence is of low quality and the data did not allow comparison of adverse event rates. There is also low-quality evidence that 0.5% proparacaine hydrochloride eye drops have no benefit over placebo. Limitations in the data for tocainide prevent any conclusions being drawn. There is insufficient evidence from randomised controlled trials to show significant benefit from non-antiepileptic drugs in trig...
Source: Cochrane Database of Systematic Reviews - December 3, 2013 Category: Journals (General) Authors: Zhang J, Yang M, Zhou M, He L, Chen N, Zakrzewska JM Tags: Cochrane Database Syst Rev Source Type: research

Effect of Antispastic Drugs on Motor Reflexes and Voluntary Muscle Contraction in Incomplete Spinal Cord Injury
Conclusions: These results suggest that antispastic drugs are effective in reducing stretch reflexes without substantially reducing volitional torque. Differential effects of tizanidine and baclofen on reflexes of flexors and extensors warrant further investigation into patient-specific management of antispastic drugs. (Source: Archives of Physical Medicine and Rehabilitation)
Source: Archives of Physical Medicine and Rehabilitation - November 25, 2013 Category: Rehabilitation Authors: Virginia Way Tong Chu, Thomas George Hornby, Brian David Schmit Tags: Featured Articles Source Type: research

The effect of antispastic drugs on motor reflexes and voluntary muscle contraction in incomplete spinal cord injury.
CONCLUSIONS: These results suggest that antispastic agents are effective in reducing stretch reflexes without substantially reducing volitional torque. Differential effects of tizanidine and baclofen on reflexes of flexors and extensors warrant further investigation into patient-specific management of antispastic medications. PMID: 24269485 [PubMed - as supplied by publisher] (Source: Physica Medica)
Source: Physica Medica - November 21, 2013 Category: Physics Authors: Tong Chu VW, Hornby TG, Schmit BD Tags: Arch Phys Med Rehabil Source Type: research

Amitriptyline versus tizanidine in the management of tension‐type headache in Nepal
(Source: Emergency Medicine Australasia)
Source: Emergency Medicine Australasia - November 13, 2013 Category: Emergency Medicine Authors: Ajay Singh Thapa Tags: Case Letter Source Type: research

Use of Intrathecal Baclofen for Treatment of Severe Spasticity in Selected Patients With Motor Neuron Disease
Objective. To assess the safety and efficacy of intrathecal baclofen (ITB) therapy for severe spasticity in patients with upper–motor neuron predominant motor neuron disease (U-MND). Methods. A total of 44 patients with U-MND were referred for discussion of ITB therapy. Baseline and outcomes data were extracted on 35 patients from a clinical spasticity registry at a tertiary referral center. Patients choosing to initiate ITB (n = 20) were compared with those choosing conservative therapy (n = 15). Results. At baseline, lower average pain score in the non-ITB group was the only significant difference between the 2 gro...
Source: Neurorehabilitation and Neural Repair - October 7, 2013 Category: Neurology Authors: Bethoux, F., Boulis, N., McClelland, S., Willis, M. A., Hussain, M., Machado, A., Mychkovsky, L., Stough, D., Sutliff, M., Pioro, E. P. Tags: Clinical Research Articles Source Type: research

Unintentional Pediatric Exposures to Central Alpha-2 Agonists Reported to the National Poison Data System
Conclusions: The number of unintentional pediatric exposures to alpha-2 agonists increased from 2000-2011. Clonidine exposures were the most commonly reported, more symptomatic, and associated with 3 deaths. Despite central nervous system depression, bradycardia, and hypotension being common, the need for intubation and vasopressors was rare. (Source: The Journal of Pediatrics)
Source: The Journal of Pediatrics - October 3, 2013 Category: Pediatrics Authors: George Sam Wang, Marie-Claire Le Lait, Kennon Heard Tags: Original Articles Source Type: research

Adherence Associated With Oral Medications in the Treatment of Spasticity
Objective: To examine adherence to baclofen, tizanidine, and dantrolene (U.S. Food and Drug Administration–approved oral spasticity medications), and identified determinants of adherence.Design: A retrospective administrative claims data analysis that used medical and pharmacy claims data and enrollment information from a large, national U.S. health plan.Subjects and Methods: The subjects were commercial health plan members who initiated treatment on baclofen, tizanidine, or dantrolene from January 1, 2004, through September 30, 2009, and who had stroke, spinal cord injury, traumatic brain injury, cerebral palsy, or ...
Source: PM and R - May 6, 2013 Category: Rehabilitation Authors: Rachel Halpern, Patrick Gillard, Glenn D. Graham, Sepideh F. Varon, Richard D. Zorowitz Tags: Original Research Source Type: research