Evaluating the Side Effects of Treatment for Preterm Labor in a Center that Uses “High-Dose” Magnesium Sulfate

Background: Tuberculosis (TB) continues to be among the leading causes for high mortality among developing countries. Though a seemingly effective treatment regimen against TB is in place, there has been no significant improvement in the therapeutic rates. This is primarily owing to the high drug doses, their associated sideeffects, and prolonged treatment regimen. Discontinuation of therapy due to the severe side effects of the drugs results in the progression of the infection to the more severe drug-resistant TB. Objectives: Reformulation of the current existing anti TB drugs into more efficient dosage forms could be an ideal way out. Nanoformulations have been known to mitigate the side effects of toxic, high-dose drugs. Hence, the current research work involves the formulation of Isoniazid (INH; a first-line anti TB molecule) loaded chitosan nanoparticles for pulmonary administration. Methods: INH loaded chitosan nanoparticles were prepared by ionic gelation method using an anionic crosslinker. Drugexcipient compatibility was evaluated using DSC and FT-IR. The formulation was optimized on the principles of Qualityby-Design using a full factorial design. Results: The obtained nanoparticles were spherical in shape having an average size of 620±10.97 nm and zeta potential +16.87±0.79 mV. Solid state characterization revealed partial encapsulation and amorphization of INH into the nanoparticulate system. In vitro release study confirmed an extended release of INH from the system. In vitro cell line based safety and efficacy studies revealed satisfactory results. Conclusion: The developed nanosystem is thus an efficient approach for antitubercular therapy.

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TNF-Alpha Inhibitors for Chronic Urticaria: Experience in 20 Patients

Journal of Allergy ◽

10.1155/2013/130905 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 13

Author(s):

Freja Lærke Sand ◽

Simon Francis Thomsen

Keyword(s):

Side Effects ◽

Chronic Urticaria ◽

Treatment Options ◽

Significant Proportion ◽

Response Duration ◽

Immunosuppressive Drugs ◽

Tnf Alpha ◽

High Dose ◽

Duration Of Treatment ◽

Durable Response

Patients with severe chronic urticaria may not respond to antihistamines, and other systemic treatment options may either be ineffective or associated with unacceptable side effects. We present data on efficacy and safety of adalimumab and etanercept in 20 adult patients with chronic urticaria. Twelve (60%) patients obtained complete or almost complete resolution of urticaria after onset of therapy with either adalimumab or etanercept. Further three patients (15%) experienced partial response. Duration of treatment ranged between 2 and 39 months. Those responding completely or almost completely had a durable response with a mean of 11 months. Six patients (30%) experienced side effects and five patients had mild recurrent upper respiratory infections, whereas one patient experienced severe CNS toxicity that could be related to treatment with TNF-alpha inhibitor. Adalimumab and etanercept may be effective and relatively safe treatment options in a significant proportion of patients with chronic urticaria who do not respond sufficiently to high-dose antihistamines or in whom standard immunosuppressive drugs are ineffective or associated with unacceptable side effects.

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Bilateral dysthyroid compressive optic neuropathy responsive to teprotumumab

European Journal of Ophthalmology ◽

10.1177/1120672121991042 ◽

2021 ◽

pp. 112067212199104

Author(s):

Catherine J Hwang ◽

Erin E Nichols ◽

Brian H Chon ◽

Julian D Perry

Keyword(s):

Side Effects ◽

Optic Neuropathy ◽

Surgical Decompression ◽

Thyroid Eye Disease ◽

Eye Disease ◽

High Dose ◽

Compressive Optic Neuropathy ◽

Traditional Management ◽

Immune Mediated ◽

Orbital Radiation

Thyroid eye disease is an auto-immune mediated orbitopathy which can cause dysthyroid compressive optic neuropathy. Traditional management of active thyroid eye disease includes temporizing high-dose steroids, orbital radiation and surgical decompression, which each possess significant limitations and/or side effects. Teprotumumab is an IGF-IR inhibitor recently FDA-approved for active thyroid eye disease. The authors report reversal of bilateral dysthyroid compressive optic neuropathy managed medically utilizing teprotumumab.

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Current Nanocarrier Strategies Improve Vitamin B12 Pharmacokinetics, Ameliorate Patients’ Lives, and Reduce Costs

Nanomaterials ◽

10.3390/nano11030743 ◽

2021 ◽

Vol 11 (3) ◽

pp. 743

Author(s):

Marco Fidaleo ◽

Stefano Tacconi ◽

Carolina Sbarigia ◽

Daniele Passeri ◽

Marco Rossi ◽

...

Keyword(s):

Side Effects ◽

Vitamin B12 ◽

Memory Performance ◽

Oral Route ◽

High Dose ◽

Human Beings ◽

Inborn Errors ◽

Essential Nutrient

Vitamin B12 (VitB12) is a naturally occurring compound produced by microorganisms and an essential nutrient for humans. Several papers highlight the role of VitB12 deficiency in bone and heart health, depression, memory performance, fertility, embryo development, and cancer, while VitB12 treatment is crucial for survival in inborn errors of VitB12 metabolism. VitB12 is administrated through intramuscular injection, thus impacting the patients’ lifestyle, although it is known that oral administration may meet the specific requirement even in the case of malabsorption. Furthermore, the high-dose injection of VitB12 does not ensure a constant dosage, while the oral route allows only 1.2% of the vitamin to be absorbed in human beings. Nanocarriers are promising nanotechnology that can enable therapies to be improved, reducing side effects. Today, nanocarrier strategies applied at VitB12 delivery are at the initial phase and aim to simplify administration, reduce costs, improve pharmacokinetics, and ameliorate the quality of patients’ lives. The safety of nanotechnologies is still under investigation and few treatments involving nanocarriers have been approved, so far. Here, we highlight the role of VitB12 in human metabolism and diseases, and the issues linked to its molecule properties, and discuss how nanocarriers can improve the therapy and supplementation of the vitamin and reduce possible side effects and limits.

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High dose antipsychotic polypharmacy and dopamine partial agonists - time to rethink guidelines?

Journal of Psychopharmacology ◽

10.1177/02698811211026456 ◽

2021 ◽

pp. 026988112110264

Author(s):

Gavin P Reynolds

Keyword(s):

Side Effects ◽

Dopamine D2 Receptor ◽

D2 Receptor ◽

Receptor Site ◽

Receptor Occupancy ◽

Antipsychotic Agents ◽

High Dose ◽

Partial Agonists ◽

Favourable Side Effect Profile ◽

Different Characteristics

Guidelines for the treatment of schizophrenia limit the use of antipsychotic agents to clinically-established maximum doses. This acknowledges both the absence of additional efficacy of dopamine D2 receptor antagonists above a receptor occupancy threshold, and the increases in side effects that can occur at higher doses. These limits restrict the dosing of combinations of antipsychotics as they do single agents; drugs sharing the major antipsychotic mechanism of D2 receptor antagonism will act additively in blocking these receptors. Several newer antipsychotic drugs, including aripiprazole and cariprazine, act as partial agonists at the D2 receptor site and avoid action at several other receptors, effects at which are responsible for some non-dopaminergic adverse effects. This pharmacology imparts different characteristics to the drugs resulting often in a more favourable side effect profile. Their partial agonism, along with high affinities for the D2 receptor, also means that these drugs given adjunctively may in part replace, rather than enhance, the D2 antagonism of other antipsychotic agents. This can result in an improvement in certain side effects without loss of antipsychotic efficacy. This article makes the case for distinguishing the D2 partial agonists from antagonists in defining maximum doses of combined treatments, which would increase the options available to the prescriber, emphasising that pharmacological mechanisms need to be understood in identifying optimal treatments for psychotic illness.

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Adverse maternal and neonatal outcome of prolonged magnesium sulfate treatment for preterm labor

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2004.10.280 ◽

2004 ◽

Vol 191 (6) ◽

pp. S111

Author(s):

Anwar Nassar ◽

Khaled Sakhel ◽

Hoda Maarouf ◽

George Naasan ◽

Ihab Usta

Keyword(s):

Magnesium Sulfate ◽

Preterm Labor ◽

Neonatal Outcome

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Premature birth (Clinical lecture)

HEALTH OF WOMAN ◽

10.15574/hw.2018.130.9 ◽

2018 ◽

pp. 9-12

Author(s):

I.B. Ventskovskaya ◽

◽

V.V. Bila ◽

O.S. Countryside ◽

◽

...

Keyword(s):

Magnesium Sulfate ◽

Key Words ◽

Gestational Age ◽

Evidence Based Medicine ◽

Premature Birth ◽

Preterm Labor ◽

Evidence Based ◽

Advantages And Disadvantages ◽

Based Medicine ◽

Tocolytic Agents

The article presents modern views on the pathogenesis of preterm labor, their relevance and classification. From the perspective of evidence-based medicine methods of prevention are considered. A comparison of the main tocolytic agents, their advantages and disadvantages is presented. Key words: premature birth, perinatal and infantile mortality, tocolysis, magnesium sulfate, gestational age.

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Ampicillin-Associated Diarrhea: Effect of Dosage and Route of Administration

PEDIATRICS ◽

10.1542/peds.58.6.869 ◽

1976 ◽

Vol 58 (6) ◽

pp. 869-872

Author(s):

John A. Phillips ◽

Frederick H. Lovejoy ◽

Yoichi Matsumiya

Keyword(s):

Urinary Tract ◽

Side Effects ◽

High Dose ◽

Total Dosage ◽

Pediatric Practice ◽

Severe Diarrhea ◽

Bowel Movements ◽

Gastrointestinal Side Effects ◽

Tract Infections ◽

Mild Diarrhea

Ampicillin is one of the most frequently used antibiotics in pediatric practice.1 Its clinical efficacy has been widely studied, but its gastrointestinal side effects are poorly documented. In adults with urinary tract infections, 11% taking 1 gm/day of ampicillin orally had bowel movements which were at least twice as frequent as normal.2 Another series in adults receiving ampicillin reported an increase in stools with 16% having ≤5 and 5% having ≥5 stools per day. The change in stools increased with total dosage and was equal after oral or intravenous administration.3 In children, ampicillin ranging from 50 to the unusually high dose of 200 mg/kg/day resulted in mild diarrhea (≤5 stools per day) in 18% to 30%, moderate diarrhea (5 to 10 stools per day) in 2% to 11%, and severe diarrhea (≥10 stools per day) in 1% or less of cases.

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