Management of Acute Baclofen Withdrawal After Intrathecal Medication Delivery Failure

2015 ◽  
Vol 37 (8) ◽  
pp. 1-3
Author(s):  
Daniel Judkins ◽  
Sushma Thapa ◽  
Purushottam B. Thapa ◽  
Mohamed Ismaeil
US Neurology ◽  
2011 ◽  
Vol 07 (02) ◽  
pp. 154 ◽  
Author(s):  
David E Jamison ◽  
Indy M Wilkinson ◽  
Steven P Cohen ◽  
◽  
◽  
...  

Neuropathic pain represents a substantial burden on society. The treatment of neuropathic pain is challenging and typically involves multiple medication classes such as anticonvulsants, antidepressants, and opioids. The advent of intrathecal medication delivery in the late 1970s provided an additional option for the treatment of refractory neuropathic pain. This article presents a review of the evidence regarding intrathecal medications for neuropathic pain. There is strong evidence to support the use of intrathecal opioids in malignant pain of mixed characteristics, and moderate evidence for their use in non-malignant, neuropathic pain. The use of baclofen is strongly supported for spasticity, but there is only intermediate-level evidence for its use in neuropathic pain. With respect to clonidine and ziconotide, there is moderate evidence to support their use for neuropathic pain, although the effectiveness of the latter agent is limited by the high incidence of adverse effects. For steroids, there is weak evidence in favor of its use in neuropathic pain, predominantly in combination with opioids. The evidence is moderate to strong for the use of steroids in post-herpetic neuralgia, which must be weighed against the possibility of neurotoxicity if depot steroids are injected.


2020 ◽  
Vol 20 (4) ◽  
pp. 271-287 ◽  
Author(s):  
Kuldeep Rajpoot

Though modern available cancer therapies are effective, they possess major adverse effects, causing non-compliance to patients. Furthermore, the majority of the polymeric-based medication platforms are certainly not universally acceptable, due to their several restrictions. With this juxtaposition, lipid-based medication delivery systems have appeared as promising drug nanocarriers to replace the majority of the polymer-based products because they are in a position to reverse polymer as well as, drug-associated restrictions. Furthermore, the amalgamation of the basic principle of nanotechnology in designing lipid nanocarriers, which are the latest form of lipid carriers, has tremendous chemotherapeutic possibilities as tumor-targeted drug-delivery pertaining to tumor therapy. Apart from this, it is reported that nearly 40% of the modern medication entities are lipophilic. Moreover, research continues to be efficient in attaining a significant understanding of the absorption and bioavailability of the developed lipids systems.


Author(s):  
Joshua Biro ◽  
David M. Neyens ◽  
Candace Jaruzel ◽  
Catherine D. Tobin ◽  
Myrtede Alfred ◽  
...  

Medication errors and error-related scenarios in anesthesia remain an important area of research. Interventions and best practice recommendations in anesthesia are often based in the work-as-imagined healthcare system, remaining under-used due to a range of unforeseen complexities in healthcare work-as- done. In order to design adaptable anesthesia medication delivery systems, a better understanding of clinical cognition within the context of anesthesia work is needed. Fourteen interviews probing anesthesia providers’ decision making were performed. The results revealed three overarching themes: (1) anesthesia providers find cases challenging when they have incomplete information, (2) decision-making begins with information seeking, and (3) attributes such as expertise, experience, and work environment influence anesthesia providers’ information seeking and synthesis of tasks. These themes and the context within this data help create a more realistic view of work-as-done and generate insights into what potential medication error reducing interventions should look to avoid and what they could help facilitate.


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