Patch Down the Hatch
A 42-year-old man presented with somnolence. His initial vital signs were heart rate 54 bpm, blood pressure 92/68 mm Hg, temperature 37°C, respiratory rate 6, and pulse oximetry 90% on room air. His physical examination was remarkable for depressed level of consciousness, miosis, and bradypnea. His mental status and respiratory rate temporarily improved with the administration of 0.04 mg naloxone. He reports swallowing several “patches” in a suicide attempt.
Popular transdermal patches are listed in the table. Others include diclofenac, buprenorphine, hormone patches (estrogen, contraceptive, testosterone), methy...
Source: The Tox Cave - March 31, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Patch Down the Hatch
A 42-year-old man presented with somnolence. Initial vital signs include: heart rate 54 bpm, blood pressure 92/68 mm/Hg, temperature 37°C, respiratory rate 6, pulse oximetry 90% on room air. Physical examination is remarkable for depressed level of consciousness, miosis, and bradypnea. His mental status and respiratory rate temporarily improved with the administration of 0.04 mg naloxone. He reports swallowing several “patches” in a suicide attempt.
What are examples of medications available as a transdermal patch? Compare the dose of drug delivered and the patch content.
Popular transdermal patches are listed bel...
Source: The Tox Cave - March 31, 2015 Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
Common Pain Drugs Linked To More Problems After A Heart Attack
The cardiovascular safety of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and diclofenac has been the subject of considerable uncertainty and controversy. Now a new study published in JAMA raises specific concerns about the safety of these drugs in the highly vulnerable population of people who have had a recent heart attack. … Click here to read the full post on Forbes, including comments from Peter Berger and Sanjay Kaul. (Source: CardioBrief)
Source: CardioBrief - February 24, 2015 Category: Cardiology Authors: Larry Husten Tags: Prevention, Epidemiology & Outcomes aspirin bleeding clopdiogrel ibuprofen NSAIDs Source Type: blogs
DIffuse ST Elevation with Apical Ballooning: is it Takotsubo Stress Cardiomyopathy?
A 33 year old male had 2 days of chest pain, intermittently relieved with acetaminophen (paracetamol) and diclofenac. He came to the ED after 5 hours of constant chest pain. He had a possible history of fever.He had this initial ECG:The leads on the right are, from top to bottom: I, II, III, aVR, aVL aVF.There is ST elevation in anterior leads. as well as lateral and also inferior. There are also QS-waves in anterior leads, suggesting that this is a well developed infarct. The diffuse ST elevation led the emergency physician to believe that this might be Takotsubo Stress Cardiomyopathy. He also...
Source: Dr. Smith's ECG Blog - January 30, 2015 Category: Cardiology Authors: Steve Smith Source Type: blogs
Knee Arthritis Treatments Ranked By Relative Effectiveness
In conclusion, the elephant in the room is that weight loss and exercise are still the very best treatments for knee osteoarthritis. Check out the American Academy of Orthopedic Surgery’s recent list of evidence-based recommendations for the treatment of knee arthritis for more information about the full spectrum of treatment options. (Source: Better Health)
Source: Better Health - January 5, 2015 Category: American Health Authors: Dr. Val Jones Tags: Health Tips Research Acetaminophen Annals Of Internal Medicine Celecoxib Comparative Effectiveness Corticosteroids Diclofenac hyaluronic acid Ibuprofen Knee OA Osteoarthritis What Works For Knee Pain? Source Type: blogs
Top stories in health and medicine, November 7, 2014
From MedPage Today:
Old COX-2 Inhibitors Tied to Stroke Mortality. New use of nonsteroidal anti-inflammatory drugs of the first generation that selectively inhibits the cyclooxygenase-2 (COX-2) enzyme, such as diclofenac and etodolac, was associated with increased 30-day mortality following ischemic stroke in a Danish database analysis.
Edoxaban Reversal Agent in the Works. A small molecule agent appeared promising as a reversal agent for the novel anticoagulant edoxaban (Savaysa), based on early-stage results.
Speed Is Ebola Vaccine Trial Goal. Results from trials of Ebola vaccines and therapeutics will be analyzed cons...
Source: Kevin, M.D. - Medical Weblog - November 7, 2014 Category: Journals (General) Authors: MedPage Today Tags: News Heart Infectious disease Neurology Source Type: blogs
Research and Reviews in the Fastlane 045
Welcome to the 45th edition of Research and Reviews in the Fastlane. R&R in the Fastlane is a free resource that harnesses the power of social media to allow some of the best and brightest emergency medicine and critical care clinicians from all over the world tell us what they think is worth reading from the published literature.
This edition contains 10 recommended reads. The R&R Editorial Team includes Jeremy Fried, Nudrat Rashid, Soren Rudolph, Anand Swaminathan and, of course, Chris Nickson. Find more R&R in the Fastlane reviews in the R&R Archive, read more about the R&R project or check out the f...
Source: Life in the Fast Lane - August 25, 2014 Category: Emergency Medicine Authors: Anand Swaminathan Tags: Clinical Research Emergency Medicine Intensive Care R&R in the FASTLANE critical care Education literature recommendations Research and Review Source Type: blogs
The Role Of Black Box Warnings In Safe Prescribing Practices
TweetNote: In addition to Lara Maggs, Aaron Kesselheim also coauthored this post.
In the Health Affairs article, “Era of Faster Drug Approval Has Also Seen Increased Black-Box Warnings and Market Withdrawals,” published in the August issue, Cassie Frank and coauthors compare the number of approved prescription drugs that received black-box warnings or were withdrawn from the market for safety-related reasons prior to the 1992 Prescription Drug User Fee Act (PDUFA) with black-box warnings and safety-related withdrawals in the post-PDUFA era.
PDUFA for the first time authorized FDA to collect user fees from brand-name...
Source: Health Affairs Blog - August 20, 2014 Category: Health Management Authors: Lara Maggs and Aaron Kesselheim Tags: All Categories Bioethics Patient Safety Pharma Policy Public Health Source Type: blogs
Did chemotherapy change your body?
A week or so ago, I had asked a doctor about change in your body due to chemotherapy. A friend and I had the same discussion yesterday. Does chemotherapy change a person's body in more ways than we think?I am talking about food and medications to be specific.Before chemotherapy, I enjoyed all kinds of seafood - preferably cold ocean water seafood to be precise. Shrimp, lobster, clams, oysters, scallops, cod, haddock, hake, salmon, calamari (octopus), and more. I never turned it down. Now I hate shrimp. I won't eat them. I can't stand them.More importantly are medical allergies. Before chemo, I was told I was allergic to am...
Source: Caroline's Breast Cancer Blog - July 26, 2014 Category: Cancer Tags: allergens changes chemotherapy reactions Source Type: blogs
NSAIDs — Yet another dubious “health” product at CVS
Now that the ‘healthiness’ of products sold at CVS stores is a matter of public discourse, it seems a perfect time to mention the common pain relievers known as Non-Steroidal Anti-inflammatory Drugs (NSAIDs).
It just so happens that two FDA advisory committees are meeting today and tomorrow to discuss the cardiovascular risks of NSAIDs. The Arthritis Advisory Committee and Drug Safety and Risk Management Advisory Committee will hash out details on labeling, and will likely offer comment on whether naproxen (Aleve) may be the least risky NSAID from a cardiovascular standpoint.
I’ve written a lot about the ...
Source: Dr John M - February 10, 2014 Category: Cardiology Authors: Dr John Source Type: blogs
What are some of the challenges of small pharma marketing?
Recently, Next Generation Pharma interviewed Ayse Kocak, VP of Marketing at Cerimon Pharmaceuticals, Inc to get her standpoint on marketing in a small biotech - and how some things aren't all that different from marketing at a large Pharma company. She points out that the most common items in common when marketing at a Pharma and a Biotech are the missions of the companies, the product development and the regulatory challenges in addition to the changing landscape of the American healthcare system and current troubles facing the drug development pipelines.
However, when it comes to marketing, she sees a more open system ...
Source: ePharma Summit - July 29, 2013 Category: Medical Marketing and PR Tags: pharma marketing Challenges of Small Pharma Marketing ePharma Summit Ayse Kocak ePharma Summit West Cermion Pharma Biotech Marketing Source Type: blogs
Europe Creates A Water Pollution Watch List For Pharmaceuticals
In response to concern over the presence of prescription drugs in water supplies, the European Parliament has added three pharmaceutical compounds to a watch list of emerging pollutants, and these could one day be placed on a priority list of known pollutants, PM Live reports.
The three compounds placed on the watch list are diclofenac, a commonly-used generic painkiller which is suspected of killing fish, and two hormones - 17 alpha-ethinylestradiol (EE2) and 17 beta-estradiol (E2) - which the EC claims can disrupt the endocrine system in humans and harm fish reproduction.
The move comes as 12 other chemicals were placed ...
Source: Pharmalot - July 9, 2013 Category: Pharma Commentators Authors: esilverman Source Type: blogs
#179: NJ cardiologist received more than $100 000 in referral kickbacks; deaths doubled with high calcium intake plus supplements; widely used diclofenac associated with increased risk of CV events; functional evaluation of CAD using angiographic images
NJ cardiologist received more than $100 000 in referral kickbacks; deaths doubled with high calcium intake plus supplements; widely used diclofenac associated with increased risk of CV events; functional evaluation of CAD using angiographic images alone (Source: Blogs@theHeart.org)
Source: Blogs@theHeart.org - February 22, 2013 Category: Cardiology Authors: theheart.org Tags: This week in cardiology from heartwire Source Type: blogs
MKSAP: 20-year-old man with a 6-month history of low back pain
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.A 20-year-old man is evaluated for a 6-month history of low back pain accompanied by prolonged morning stiffness. His symptoms improve over the course of the day, but he is now unable to play recreational soccer. Rest, physical therapy, and acupuncture have not improved his symptoms. Use of ibuprofen or diclofenac provides only partial relief. He has no other pertinent medical history and takes no additional medications.On physical examination, vital signs are normal. There is loss of normal lumbar lordosis, and f...
Source: Kevin, M.D. - Medical Weblog - February 16, 2013 Category: Family Physicians Tags: Conditions orthopedics Source Type: blogs
