The Use of Long-Acting Lipoglycopeptides for the Treatment of Serious, Off-label Infections: a Review of the Literature

It is now acknowledged that Attention-deficit Disorder with Hyperactivity (ADHD) is not limited to children or adolescents. Regardless of culture, up to 4% of the adults in the general population might be diagnosed with ADHD, a disorder often accompanied by comorbid psychiatric disorders. Among those is Substance Abuse including cigarette smoking. Indeed, ADHD patients tend to start with drugs earlier than normal controls. Pharmacological treatments of ADHD chiefly encompass amphetamine salts, methylphenidate and atomoxetine with a good tolerance and effectiveness. These treatments are even better tolerated now that long-acting, extended-release formulations and transdermal delivery systems become available. But it is likely that some patients will still not respond, especially when comorbid disorders are associated. Other agents are being tested as future pharmacotherapies of ADHD. Here we propose a review of the literature concerned with the relationships between cigarette smoking and ADHD in adolescent and adult patients, and an overview of the future pharmacotherapies of ADHD related with nicotine receptor agonists.

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Intravenous Infusion of Sterile Water for the Treatment of Hypernatraemia

Anaesthesia and Intensive Care ◽

10.1177/0310057x1404200215 ◽

2014 ◽

Vol 42 (2) ◽

pp. 258-262

Author(s):

H. Ramaswamykanive ◽

J. Greaves

Keyword(s):

Insulin Infusion ◽

Serum Sodium Level ◽

Central Line ◽

Sterile Water ◽

Review Of The Literature ◽

Lower Serum ◽

Off Label ◽

Contentious Issue ◽

Water Infusion ◽

Extensive Search

Little research has been carried out into the infusion of intravenous sterile water for the treatment of hypernatraemia, and it remains a contentious issue. We conducted a review of the literature and extract results following an extensive search of Medline 1946, Embase 1974, ProQuest, evidence-based practice resources, national and international guideline sites and the publications of various professional bodies. The review is presented on the infusion of sterile water (hypotonic fluid) to lower serum sodium level in those circumstances when enteral supplementation of water is not possible, such as in postoperative patients or when other isotonic fluids (such as 5% dextrose in water infusion) are less than ideal—for example, hyperglycaemic patients on an insulin infusion. Absence of guidelines has limited the use of sterile water, even as an off-label drug when it can be administered relatively safely via a central line.

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ACUTE AORTIC DISSECTION IN A POSTMENOPAUSAL FEMALE IN THE SETTING OF PARENTERAL TESTOSTERONE, ESTRADIOL, AND PROGESTERONE THERAPY

AACE Clinical Case Reports ◽

10.4158/accr-2019-0087 ◽

2019 ◽

Vol 5 (5) ◽

pp. e287-e289

Author(s):

Michael Zeihen ◽

Daniel Mattox ◽

Timothy Sanborn ◽

Michael Kreager ◽

Raaid Museitif ◽

...

Keyword(s):

Postmenopausal Women ◽

Thoracic Aorta ◽

Acute Aortic Dissection ◽

Aortic Disease ◽

Review Of The Literature ◽

Free Standing ◽

Testosterone Therapy ◽

Laboratory Findings ◽

Off Label ◽

Postmenopausal Female

Objective: The FDA has not approved the use of testosterone in women. However, parenteral testosterone is being used off-label in free standing clinics throughout America. The recent multi-ethnic study of atherosclerosis (MESA) population study showed that postmenopausal women with a higher testosterone/estradiol ratio had a higher incident of cardiovascular disease. This is a case of a postmenopausal woman who dissected her thoracic aorta after 8 months of parenteral testosterone. Methods: The clinical examination, radiographic, and laboratory findings of a patient are presented along with a review of the literature. Results: A heathy postmenopausal women, whose only risk factor was parenteral testosterone, developed a dissection of her entire thoracic aorta. Conclusion: The MESA study and other conflicting publications on cardiovascular events in transgender patients receiving exogenous androgens indicates the need for further investigation to determine the safety of testosterone therapy for women and its possible role in contributing to aortic disease.

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Can drug interaction be useful? Case report of a schizophrenic patient treated with paliperidone long-acting injection

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1648 ◽

2017 ◽

Vol 41 (S1) ◽

pp. s837-s837

Author(s):

M. Sarpe ◽

M. Bran ◽

L. Maria

Keyword(s):

Rating Scale ◽

Involuntary Movement ◽

Anti Psychotic ◽

Off Label ◽

Compliant Patient ◽

Syndrome Scale ◽

Competing Interest ◽

Clinically Significant ◽

The One ◽

Long Acting

IntroductionIntramuscular paliperidone palmitate (PLAI) is a long-acting atypical anti-psychotic approved in Romania for the maintenance treatment of adults with schizophrenia.ObjectivesTo determine the efficacy and tolerability of PLAI in a non-compliant patient with previously very low tolerability to oral anti-psychotics. The patient had been on risperidone long acting injection (RLAI) and had significant adverse events (i.e. tremor, akatisia) which persisted even when treated with the lowest dose of PLAI: 50 mg.AimsSince the efficacy of PLAI was good, and since a lower dose (than 50 mg of PLAI) is not available in Romania, we tried different ways to lower plasma concentration (PC) of the anti-psychotic because the patient presented clinically significant adverse effects (AE).MethodsInitially the time between the injections was extended at maximum recommended (35 days), with a slight effect, then an off label treatment was associated in order to lower the PC of PLAI. We used 300 mg of carbamazepine long acting, that may lower the PC of PLAI up to 30%. For the evaluation of the efficacy and tolerability, we applied: the clinical evaluation, the positive and negative syndrome scale, the Barnes Akathisia rating scale, the Simpson-Angus Scale and the abnormal involuntary movement scale.ResultsAfter using the above mentioned, strategies, the one that had indeed good results on reducing AE, with no alteration of the psychic status of the patient, was the association of carbamazepine.ConclusionsIn clinical practice, some off label medication associations may be salutary!Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Successful free flap revision with off-label use of Alteplase: A case report and review of the literature

10.1055/s-0038-1639970 ◽

2018 ◽

Author(s):

F Barhoum ◽

M Koch ◽

K Tschaikowsy ◽

M Sievert ◽

H Iro ◽

...

Keyword(s):

Case Report ◽

Free Flap ◽

Off Label Use ◽

Review Of The Literature ◽

Off Label ◽

Label Use

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Pulmonary embolism in a patient receiving risperidone and paliperidone: A case report and review of the literature

Mental Health Clinician ◽

10.9740/mhc.n166827 ◽

2013 ◽

Vol 3 (3) ◽

pp. 144-147

Author(s):

Ariane Casey ◽

Marianne Saitz ◽

Paul R. Swaim

Keyword(s):

Pulmonary Embolism ◽

Case Report ◽

Venous Thromboembolism ◽

Atypical Antipsychotic ◽

Antipsychotic Treatment ◽

Review Of The Literature ◽

Long Acting

Several cases of pulmonary embolism (PE) have been associated with antipsychotic treatment. We report a case of an otherwise healthy 27-year old male who developed a PE after receiving paliperidone long acting injection. The patient received risperidone long acting injection for over 3 months before initiating paliperidone, but was switched incorrectly. After 3 weeks on paliperidone long acting injection the patient developed a PE requiring hospitalization and a course of anticoagulation. A review of atypical antipsychotic-induced venous thromboembolism is discussed.

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