Lack of Disulfiram-Like Reaction with Metronidazole and Ethanol

BACKGROUND: Metronidazole, an effective antianaerobic agent, has been reported to have aversive properties when ingested with ethanol. This is thought to be due to the blocking of hepatic aldehyde dehydrogenase (ALDH) enzyme followed by the accumulation of acetaldehyde in the blood. However, based on animal studies and on only 10 human case reports, the existence of metronidazole-related disulfiram-like reaction has recently been questioned. OBJECTIVE: To investigate the possible disulfiram-like properties of metronidazole and ethanol in human volunteers. METHODS: Of 12 healthy male volunteers in this double-blind study, one-half received metronidazole for 5 days and the other half received placebo. All volunteers received ethanol 0.4 g/kg at the beginning of the study. Repeated blood samples were taken every 20 minutes for 4 hours, and blood acetaldehyde and ethanol concentrations were determined. Blood pressure, heart rate, and skin temperature were also measured every 20 minutes for objective signs of a possible disulfiram-like reaction. Volunteers also completed a questionnaire focusing on the subjective signs of disulfiram-like reaction. RESULTS: Metronidazole did not raise blood acetaldehyde or have any objective or subjective adverse effects when used together with ethanol. CONCLUSIONS: This study shows that metronidazole does not have an effect on blood acetaldehyde concentrations when ingested with ethanol and does not have any objective or subjective disulfiram-like properties. However, it is possible that disulfiram-like reaction can occur in some subgroups and by other mechanisms than the inhibition of hepatic ALDH.

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Tacrolimus in Dermatology

Journal of Cutaneous Medicine and Surgery ◽

10.1177/120347540100500409 ◽

2001 ◽

Vol 5 (4) ◽

pp. 329-335 ◽

Cited By ~ 2

Author(s):

Quang Hieu Dé Tran ◽

Elizabeth Guay ◽

Suzanne Chartier ◽

Jacqueline Tousignant

Keyword(s):

Animal Studies ◽

Case Reports ◽

Growth Disorders ◽

Double Blind Study ◽

Double Blind ◽

Fk 506 ◽

Topical Tacrolimus ◽

Streptomyces Tsukubaensis ◽

Gm Csf ◽

Adults And Children

Background: Tacrolimus (FK 506), a metabolite of the fungus Streptomyces tsukubaensis, is an anti-T-cell drug. It acts by inhibiting the production of IL-2, IL-3, IL-4, TNFα, and GM-CSF. More potent and with slightly less secondary effects than cyclosporine, it has been the object of considerable interest, especially in conditions that could benefit from the latter. Objective: In psoriasis, a placebo-controlled double-blind study has shown oral tacrolimus at 0.1 mg/kg/day to be effective in controlling recalcitrant lesions. In human, small studies have reported tacrolimus ointment to be effective in controlling acute contact dermatitis. Short-term trials of topical tacrolimus in the treatment of atopic dermatitis have recently shown excellent results in both adults and children. In animal studies of hair growth disorders, topical tacrolimus induces anagen and protects from chemotherapy-induced alopecia. Animal studies with the ointment for the prevention of skin graft rejection, lupus dermatoses, and skin papilloma formation have also shown to be promising. Conclusions: There are case reports of pyoderma gangrenosum, Sezary's syndrome, and Behçet's disease successfully treated with oral tacrolimus but, because of their small number, they remain anecdotal at this point.

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Faculty Opinions recommendation of Clevidipine compared with nitroglycerin for blood pressure control in coronary artery bypass grafting: a randomized double-blind study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718338720.793493657 ◽

2014 ◽

Author(s):

Andreas Hoeft

Keyword(s):

Blood Pressure ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Coronary Artery Bypass ◽

Blood Pressure Control ◽

Artery Bypass ◽

Pressure Control ◽

Double Blind Study ◽

Bypass Grafting ◽

Double Blind

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Does Oral Calcium Supplementation Lower High Blood Pressure? A Double Blind Study

Journal of Hypertension ◽

10.1097/00004872-198702000-00010 ◽

1987 ◽

Vol 5 (1) ◽

pp. 67-71 ◽

Cited By ~ 38

Author(s):

Francesco P. Cappuccio ◽

Nirmala D. Markandu ◽

Donald R.J. Singer ◽

Stephen J. Smith ◽

Angela C. Shore ◽

...

Keyword(s):

Blood Pressure ◽

High Blood Pressure ◽

Calcium Supplementation ◽

Blind Study ◽

Double Blind Study ◽

Double Blind ◽

Oral Calcium

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SYSTEMIC HYPERTENSION FOLLOWING OCULAR ADMINISTRATION OF 10% PHENYLEPHRINE IN THE NEONATE

PEDIATRICS ◽

10.1542/peds.51.6.1032 ◽

1973 ◽

Vol 51 (6) ◽

pp. 1032-1036 ◽

Cited By ~ 1

Author(s):

Virginia Borromeo-McGrail ◽

Joseph Bordiuk ◽

Hans Keitel

Keyword(s):

Blood Pressure ◽

Birth Weight ◽

Low Birth Weight ◽

Systemic Blood Pressure ◽

Systemic Effect ◽

Systemic Hypertension ◽

Double Blind Study ◽

Eye Drops ◽

Low Birth Weight Infants ◽

Double Blind

The effect of ophthalmic instillation of 10% phenylephrine on systemic blood pressure in the neonate has not been previously evaluated, despite reports of adverse reactions. The effect of 10% and 2½% phenylephrine eye drops in healthy low birth weight neonates was compared in a double-blind study. Blood pressure showed a rise of 12 to 16 mm Hg in systole and 10 to 14 mm Hg in diastole following administration of 10% phenylephrine. Blood pressure remained stable in infants receiving 2½% phenylephrine. Consistent, although more variable, increases in blood pressure were noted in eight low birth weight infants given 10% phenylephrine eye drops in a nonblind study. Complete mydriasis was achieved with 2½% phenylephrine as well as with 10%. Neither concentration had an effect on pulse or respiratory rates. Cutaneous administration of either 10% or 2½% phenylephrine to abdominal skin produced local blanching but no systemic effect. To avoid potentially dangerous sequelae from iatrogenic hypertension, it is recommended that not more than one drop of 2½% phenylephrine in each eye be administered to neonates for mydriasis.

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The Use of Dexamethasone in Premature Infants at Risk for Bronchopulmonary Dysplasia or Who Already Have Developed Chronic Lung Disease: A Cautionary Note

PEDIATRICS ◽

10.1542/peds.88.2.413 ◽

1991 ◽

Vol 88 (2) ◽

pp. 413-414

Author(s):

LEE FRANK

Keyword(s):

Risk Factors ◽

Bronchopulmonary Dysplasia ◽

Animal Studies ◽

Very Low Birth Weight ◽

Double Blind Study ◽

Dexamethasone Treatment ◽

Double Blind ◽

High Incidence ◽

Potential Risk Factors ◽

Clinical Problems

To the Editor.— The distressingly high incidence of bronchopulmonary dysplasia (BPD) in today's very low birth weight premature infant population and the prolonged morbidity and tumultuous clinical problems associated with BPD in these tiny infants have led to a trial usage of dexamethasone treatment to try to assuage these problems in this patient population. The report of Kazzi et al1 is noteworthy because the authors not only indicate in clear fashion the failure of relatively prolonged dexamethasone treatment to ameliorate the hospital course of infants with BPD (in a randomized prospective double-blind study), but they also clearly identify potential risk factors associated with dexamethasone treatment that are of concern to them as clinical investigators, risk factors based both on clinical and experimental animal studies.

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Pharmacokinetic and pharmacodynamic comparison of two "pegylated" interferon alpha-2 formulations in healthy male volunteers: a randomized, crossover, double-blind study

BMC Pharmacology ◽

10.1186/1471-2210-10-15 ◽

2010 ◽

Vol 10 (1) ◽

Cited By ~ 20

Author(s):

Idrian García-García ◽

◽

Carlos A González-Delgado ◽

Carmen M Valenzuela-Silva ◽

Alina Díaz-Machado ◽

...

Keyword(s):

Interferon Alpha ◽

Pegylated Interferon ◽

Blind Study ◽

Double Blind Study ◽

Healthy Male ◽

Double Blind ◽

Pegylated Interferon Alpha ◽

Healthy Male Volunteers ◽

Male Volunteers

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ACE inhibition and ANG II receptor blockade improve glomerular size-selectivity in IgA nephropathy

AJP Renal Physiology ◽

10.1152/ajprenal.1999.276.3.f457 ◽

1999 ◽

Vol 276 (3) ◽

pp. F457-F466 ◽

Cited By ~ 10

Author(s):

Andrea Remuzzi ◽

Norberto Perico ◽

Fabio Sangalli ◽

Giovanni Vendramin ◽

Monica Moriggi ◽

...

Keyword(s):

Blood Pressure ◽

Iga Nephropathy ◽

Ace Inhibitors ◽

Ace Inhibition ◽

Maximum Effect ◽

Double Blind Study ◽

Ang Ii ◽

Size Selectivity ◽

Double Blind ◽

Glomerular Size

Protein trafficking across the glomerular capillary has a pathogenic role in subsequent renal damage. Despite evidence that angiotensin-converting enzyme (ACE) inhibitors improve glomerular size-selectivity, whether this effect is solely due to ANG II blocking or if other mediators also play a contributory role is not clear yet. We studied 20 proteinuric patients with IgA nephropathy, who received either enalapril (20 mg/day) or the ANG II receptor blocker irbesartan (100 mg/day) for 28 days in a randomized double-blind study. Measurements of blood pressure, renal hemodynamics, and fractional clearance of neutral dextran of graded sizes were performed before and after 28 days of treatment. Both enalapril and irbesartan significantly reduced blood pressure over baseline. This reduction reached the maximum effect 4–6 h after drug administration but did not last for the entire 24-h period. Despite transient antihypertensive effect, proteinuria was effectively reduced by both treatments to comparable extents. Neither enalapril nor irbesartan modified the sieving coefficients of small dextran molecules, but both effectively reduced transglomerular passage of large test macromolecules. Theoretical analysis of sieving coefficients showed that neither drug affected significantly the mean pore radius or the spread of the pore-size distribution, but both importantly and comparably reduced the importance of a nonselective shunt pathway. These data suggest that antagonism of ANG II is the key mechanism by which ACE inhibitors exert their beneficial effect on glomerular size-selective function and consequently on glomerular filtration and urinary output of plasma proteins.

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Comparison of Effect of Intrathecal Fentanyl-bupivacaine and Tramadol-bupivacaine Combination on Postoperative Analgesia in Lower Abdominal Surgeries

Research & Innovation in Anesthesia ◽

10.5005/jp-journals-10049-0010 ◽

2016 ◽

Vol 1 (2) ◽

pp. 35-40 ◽

Cited By ~ 2

Author(s):

Naina P Dalvi ◽

Narendra Patil

Keyword(s):

Blood Pressure ◽

Postoperative Analgesia ◽

Total Duration ◽

Double Blind Study ◽

Motor Blockade ◽

Hyperbaric Bupivacaine ◽

Double Blind ◽

Sensory Blockade ◽

Prolonged Duration ◽

American Society

ABSTRACT Introduction This single-center, prospective, randomized, double-blind study compares the effect of intrathecal fentanylbupivacaine and tramadol-bupivacaine on the onset and duration of sensory and motor blockade, as well as postoperative analgesia in lower abdominal surgeries. Materials and methods Patients of either sex, aged 18 to 60 years, American Society of Anesthesiologists (ASA) grade I/II undergoing lower abdominal surgeries like appendicectomy, inguinal hernia repair surgery, and hydrocele surgery were administered either 2.5 mL of 0.5% bupivacaine + 0.5 mL (25 μg) of fentanyl citrate (group F) or 2.5 mL of 0.5% bupivacaine + 0.5 mL (25 mg) of tramadol (group T) intrathecally. Monitoring of the vital parameters, onset and duration of sensory and motor block, duration of postoperative analgesia, visual analog scale (VAS) score, sedation score, and any adverse drug reactions was done at predetermined intervals. Results Sixty patients were randomized to the group F (n = 30) and group T (n = 30). The duration of sensory blockade was significantly prolonged in group F (314.66 ± 49.25 minutes) as compared to group T (261.66 ± 27.92 minutes). Similarly, duration of motor blockade was longer in group F (263.66 ± 40.97 minutes) compared to group T (214.66 ± 26.61 minutes). The total duration of analgesia was significantly prolonged (p < 0.001) in group F (412 ± 97.888 minutes) compared to group T (301 ± 38.75 minutes). Hemodynamic parameters, such as pulse, systolic blood pressure, diastolic blood pressure and oxygen saturation were comparable in both the groups. Visual analog scores were significantly lower in the group F patients as compared to the group T patients. The group F patients had got significantly higher sedation scores as compared to Group T patients. Discussion Fentanyl 25 μg, when added to 2.5 mL of 0.5% hyperbaric bupivacaine, confers prolonged duration of sensory and motor blockade than 25 mg tramadol added to 2.5 mL of 0.5% hyperbaric bupivacaine. The bupivacaine-fentanyl combination prolonged duration of sensory and motor blockade, improved analgesia, as manifested by lower pain scores, and prolonged duration of postoperative analgesia. How to cite this article Dalvi NP, Patil N. Comparison of Effect of Intrathecal Fentanyl-bupivacaine and Tramadol-bupivacaine Combination on Postoperative Analgesia in Lower Abdominal Surgeries. Res Inno in Anesth 2016;1(2):35-40.

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Effects of Preoperative Intravenous Clonidine in Patients Undergoing Cataract Surgery: A Double-Blind, Randomized Trial

Journal of Ophthalmology ◽

10.1155/2014/346549 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Ana Ellen Queiroz Santiago ◽

Adriana Machado Issy ◽

Rioko Kimiko Sakata

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Intraocular Pressure ◽

Myocardial Ischemia ◽

Cataract Surgery ◽

The Other ◽

Intraocular Lens Implantation ◽

Double Blind ◽

Lens Implantation ◽

Lidocaine Gel

Objectives. The aim of this study was to assess the effects of clonidine on intraoperative analgesia, sedation, intraocular and blood pressure, arrhythmia, and ischemia.Methods. Forty patients undergoing cataract surgery were allocated into two groups. They were monitored with Holter machine, the pupil was dilated, and 30 minutes later, 20 patients received clonidine (4 µg/kg), while the other 20 patients were given a 0.9% saline intravenously. Twenty minutes later, 2% lidocaine gel was applied. There were assessed intraoperative analgesia, intraocular pressure, blood pressure, heart rate, and the occurrence of arrhythmias and myocardial ischemia.Results. Pain intensity was lower in G1 during the phacoemulsification, irrigation, aspiration, and intraocular lens implantation. The HR and BP were lower with clonidine. The IOP was lower with clonidine after 15 minutes and at the end of the surgery. Sedation was higher with clonidine. The incidence of arrhythmia was lower at the end of surgery with clonidine. The incidence of myocardial ischemia did not differ between the groups.Conclusions. Clonidine (4 µg/kg) before a phacoemulsification reduced the intensity of pain during cataract surgery. It also induced sedation, reduction of BP, HR, and incidence of arrhythmia at the end of the surgery, and did not alter myocardial ischemia. This trial is registered with Clinicaltrials.govNCT01677351.

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