Effect of Cyclobenzaprine on Tricyclic Antidepressant Assays

2005 ◽  
Vol 39 (7-8) ◽  
pp. 1314-1317 ◽  
Author(s):  
Nicole M Van Hoey
Keyword(s):  
Tricyclic Antidepressants ◽  
Tricyclic Antidepressant ◽  
Ultraviolet Absorption ◽  
Data Sources ◽  
Charge Ratio ◽  
Data Synthesis ◽  
Medline Search ◽  
Search Terms ◽  
History Of ◽  
Unique Mass

OBJECTIVE To evaluate cyclobenzaprine interference on tricyclic antidepressant assays. DATA SOURCES Literature was identified through a MEDLINE search (1966–August 2004) using the search terms cyclobenzaprine, tricyclic antidepressant, toxicology, and assay. DATA SYNTHESIS Cyclobenzaprine is structurally similar to tricyclic antidepressants and is often identified as a tricyclic antidepressant on toxicology assays. Older chromatographic assays demonstrate retention time differences of only seconds and nearly identical color stains between cyclobenzaprine and individual tricyclic antidepressants. In comparison, ultraviolet absorption ratios of 4.18 for amitriptyline and 1.85 for cyclobenzaprine are easily distinguished. Spectroscopy also consistently identifies cyclobenzaprine's unique mass-to-charge ratio peaks of 275 and 215 compared with those of amitriptyline. Available bioanalytic techniques are reviewed for their ability to correctly identify cyclobenzaprine and differentiate the drug from tricyclic antidepressants. CONCLUSIONS When assays are positive for tricyclic antidepressants without a history of their use, an attempt should be made to identify confounders, such as cyclobenzaprine. Newer bioanalytic techniques, such as ultraviolet absorption and mass spectroscopy, accurately identify cyclobenzaprine in such instances.

Safety and Efficacy of Influenza Vaccine in Children

2003 ◽  
Vol 37 (11) ◽  
pp. 1712-1715 ◽  
Author(s):  
Leslie GB Goldstein
Keyword(s):  
Influenza Vaccine ◽  
Asthma Exacerbation ◽  
Data Sources ◽  
Influenza Vaccines ◽  
Data Synthesis ◽  
Safety And Efficacy ◽  
Medline Search ◽  
Asthmatic Children ◽  
Search Terms

OBJECTIVE: To describe the safety and efficacy of influenza vaccines in asthmatic children. DATA SOURCES: Literature was identified by a MEDLINE search (2002–March 2003). Key search terms included asthma, exacerbation, children, vaccine, and influenza. DATA SYNTHESIS: Concerns that the influenza vaccine may exacerbate asthma attacks have kept many asthmatic children from receiving this immunization. Researchers have conducted studies to determine the burden of influenza on asthmatic children, the safety of influenza vaccines, and their benefit in the presence of glucocorticoid burst therapy in the same population. CONCLUSIONS: Influenza vaccines tested are safe and efficacious in asthmatic children.

Levodopa Therapy and the Risk of Malignant Melanoma

2000 ◽  
Vol 34 (3) ◽  
pp. 382-385 ◽  
Author(s):  
Jolene F Siple ◽  
Diana C Schneider ◽  
Wendy A Wanlass ◽  
Burton K Rosenblatt
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Malignant Melanoma ◽  
English Language ◽  
Case Reports ◽  
Levodopa Therapy ◽  
Data Sources ◽  
Data Synthesis ◽  
Medline Search ◽  
Search Terms

OBJECTIVE: To evaluate the use of levodopa therapy in patients with Parkinson's disease and malignant melanoma. DATA SOURCES: A MEDLINE search (January 1966–September 1999) of English-language articles was conducted. Key search terms included levodopa, melanoma, and Parkinson's disease; 34 case reports were identified. DATA SYNTHESIS: Carbidopa/levodopa continues to be a mainstay in the treatment of Parkinson's disease. Since the late 1970s, a warning has appeared in the prescribing literature for levodopa regarding the risk of activating malignant melanoma. An evaluation was conducted of the case reports in which a causal relationship between levodopa and melanoma was suggested. CONCLUSIONS: There is an unlikely association between levodopa and induction or exacerbation of malignant melanoma.

Tricyclic Antidepressant Withdrawal Syndrome

1993 ◽  
Vol 27 (9) ◽  
pp. 1068-1072 ◽  
Author(s):  
E. Michelle Garner ◽  
Michael W. Kelly ◽  
Dennis F. Thompson
Keyword(s):  
Mental Illness ◽  
Withdrawal Syndrome ◽  
Tricyclic Antidepressants ◽  
Case Reports ◽  
Individual Case ◽  
Tricyclic Antidepressant ◽  
Data Sources ◽  
Data Synthesis ◽  
Somatic Distress ◽  
Study Selection

OBJECTIVE: To examine the evidence pointing to a withdrawal syndrome associated with the discontinuation of tricyclic antidepressants (TCAs). DATA SOURCES: MEDLINE searches were conducted. References used in relevant articles were screened for additional published information. STUDY SELECTION: Emphasis was placed on human trials and individual case reports. DATA SYNTHESIS: Symptoms of gastrointestinal and somatic distress, sleep disturbance, and movement disorders and mania have been temporally linked to withdrawal of TCAs. Cholinergic and adrenergic overdrive after TCA discontinuation have been suggested as the proposed mechanism for this syndrome. Reported symptoms may be psychosomatic or related to underlying mental illness. CONCLUSIONS: Clinicians should be aware that discontinuation of TCA therapy may produce a withdrawal syndrome in some patients.

Safety of Selegiline with Cold Medications

2003 ◽  
Vol 37 (3) ◽  
pp. 438-441 ◽  
Author(s):  
Jeena E Jacob ◽  
Mary L Wagner ◽  
Jacob I Sage
Keyword(s):  
Adverse Events ◽  
Drug Interactions ◽  
Interaction Potential ◽  
Data Sources ◽  
Data Synthesis ◽  
Search Terms ◽  
Clinical Literature

OBJECTIVE: To evaluate the safety of the coadministration of selegiline with cold medications. DATA SOURCES: Clinical literature accessed through MEDLINE(1965–September 2002), IPA database, and Drug-Reax System. The following search terms were used: selegiline, pseudoephedrine, dextromethorphan, MAOI, and drug interactions. Somerset Pharmaceuticals, the marketers of Eldepryl (selegiline HCI), were also contacted. DATA SYNTHESIS: Despite a warning against its concomitant use with pseudoephedrine and dextromethorphan, interactions with selegiline have not been reported. However, there have been reports of patients experiencing adverse events with related agents. CONCLUSIONS: Patients taking selegiline should try to avoid pseudoephedrine and dextromethorphan or use drugs without interaction potential. If selegiline is used with these medications, watch for adverse events or replace selegiline with another drug.

Isoniazid-Associated Psychosis: Case Report and Review of the Literature

1993 ◽  
Vol 27 (2) ◽  
pp. 167-170 ◽  
Author(s):  
Karen A. Pallone ◽  
Morton P. Goldman ◽  
Matthew A. Fuller
Keyword(s):  
Case Report ◽  
English Language ◽  
Case Reports ◽  
Data Extraction ◽  
Data Sources ◽  
Review Of The Literature ◽  
Data Synthesis ◽  
Medline Search ◽  
Study Selection ◽  
Language Literature

Objective To describe a case of isoniazid-associated psychosis and review the incidence of this adverse effect. Data Sources Information about the patient was obtained from the medical chart. A MEDLINE search of the English-language literature published from 1950 to 1992 was conducted and Index Medicus was manually searched for current information. Study Selection All case reports describing isoniazid-associated psychosis were reviewed. Data Extraction Studies were evaluated for the use of isoniazid, symptoms of psychosis, onset of symptoms, and dosage of isoniazid. Data Synthesis The case report is compared with others reported in the literature. The incidence of isoniazid-associated psychosis is rare. Conclusions The mechanism of isoniazid-associated psychosis is uncertain. It appears that isoniazid was associated with the psychosis evident in our patient and in the cases reviewed.

Dexrazoxane: A New Cardioprotective Agent

1998 ◽  
Vol 14 (5) ◽  
pp. 182-190 ◽  
Author(s):  
Beverly D Abbott ◽  
Cindy M Ippoliti
Keyword(s):  
Supportive Care ◽  
English Language ◽  
Bolus Dose ◽  
Cardiac Tissue ◽  
Data Extraction ◽  
Data Synthesis ◽  
Medline Search ◽  
Search Terms ◽  
Study Selection ◽  
Clinically Significant

Objective: To review the literature discussing the use of dexrazoxane (e.g., Zinecard, ICRF-187) to prevent doxorubicin-induced cardiotoxicity. Data Sources: Pertinent English-language reports of studies in humans were retrieved from a MEDLINE search (January 1980-January 1997); search terms included chelating agents, razoxane, dexrazoxane, Zinecard, ICRF-187, ADR-529, and ICRF-159. Study Selection: Representative articles discussing the chemistry, pharmacology, pharmacokinetics, dosing, and administration of dexrazoxane and those discussing clinical trials were selected. Data Extraction: Data were extracted and analyzed if the information was relevant and consistent. Studies were selected for review in the text on the basis of study design and clinical end points. Data Synthesis: Dexrazoxane is a chemoprotective agent developed to prevent cardiac tissue toxicity. Dexrazoxane exerts a cardioprotective effect with some clinically significant toxicities; it may also interfere with the antitumor activity of doxorubicin. Until there are sufficient data to support its use in first-line supportive care therapy, dexrazoxane should be reserved for use in patients responding to doxorubicin-based chemotherapy but who have risk factors for cardiac toxicity or have received a cumulative doxorubicin bolus dose of 300 mg/m2. Conclusions: The management of doxorubicin-induced cardiotoxicity has led to the development of supportive care drugs that specifically counteract the dose-limiting toxicities. Dexrazoxane may not completely eliminate the concern about doxorubicin-induced cardiotoxicity, but it may open new avenues for continuing doxorubicin-based chemotherapy.

Thalidomide Dosing in Patients with Relapsed or Refractory Multiple Myeloma

2003 ◽  
Vol 37 (4) ◽  
pp. 571-576 ◽  
Author(s):  
Jennifer L Thompson ◽  
Lea Ann Hansen
Keyword(s):  
Multiple Myeloma ◽  
Data Synthesis ◽  
Medline Search ◽  
Prognostic Features ◽  
Refractory Multiple Myeloma ◽  
Search Terms ◽  
Promising Agent ◽  
Pertinent Data ◽  
Reasonable Approach ◽  
Gradual Dose

OBJECTIVE: To evaluate the literature regarding the dosing of thalidomide in multiple myeloma. DATA SOURCES: A MEDLINE search (1990–February 2003) using the search terms thalidomide and multiple myeloma was performed to identify clinical trials and abstracts. Identified literature was then cross-referenced for further pertinent data. DATA SYNTHESIS: Patients with relapsed or refractory multiple myeloma have few therapeutic options. Thalidomide is a promising agent, although many dose-related issues are still in question. Starting doses studied ranged from 50 to 200 mg/d, usually given at bedtime. Gradual dose escalation up to 800 mg/d has been studied, with some evidence of improved outcome with doses of 400–600 mg/d, while thalidomide appears to be best tolerated at doses ≤400 mg/d. CONCLUSIONS: A reasonable approach for use of thalidomide in multiple myeloma is to initiate therapy at 50–100 mg nightly and escalate every 2 weeks in 50-to 100-mg increments as tolerated. Efforts should be made to titrate the dose to 400–600 mg/d, especially in patients with poor prognostic features. Efficacy should be assessed at approximately 8 weeks and the dose maintained if desired response is achieved.

Testosterone Replacement Therapy for Bone Loss Prevention in HIV-Infected Males

2003 ◽  
Vol 37 (4) ◽  
pp. 582-585 ◽  
Author(s):  
Patrick G Clay ◽  
Amy I Lam
Keyword(s):  
Bone Loss ◽  
Hiv Infection ◽  
Data Sources ◽  
Hormone Deficiency ◽  
Testosterone Replacement Therapy ◽  
Data Synthesis ◽  
Medline Search ◽  
Prevention Of Bone Loss ◽  
Endocrine Abnormality ◽  
Hiv Negative

OBJECTIVE: To review the use of testosterone for the prevention of bone loss in men with HIV infection. DATA SOURCES: A MEDLINE search (1966–May 2002) on the use of testosterone in osteoporosis/HIV infection was performed. A reference bibliography search was also completed. DATA SYNTHESIS: Osteopenia/osteoporosis is reported in HIV-infected men due to a myriad of factors. Sex hormone deficiency is a frequent endocrine abnormality in this population. CONCLUSIONS: In HIV-negative men, testosterone may be beneficial for preventing bone loss and hastening the resolution of fractures. Testosterone's role in preventing bone loss in HIV-infected men remains to be defined.

Topical Tacrolimus in the Treatment of Atopic Dermatitis

2001 ◽  
Vol 35 (7-8) ◽  
pp. 943-946 ◽  
Author(s):  
Laura M Gianni ◽  
Maria Marzella Sulli
Keyword(s):  
Atopic Dermatitis ◽  
Skin Penetration ◽  
Data Sources ◽  
Cell Mediated Immunity ◽  
Efficacy And Safety ◽  
Data Synthesis ◽  
Topical Tacrolimus ◽  
Duration Of Therapy ◽  
Search Terms ◽  
Optimal Duration

OBJECTIVE: To review the efficacy of topical tacrolimus in the treatment of atopic dermatitis (AD). DATA SOURCES: Searches of MEDLINE (1966–October 2000), International Pharmaceutical Abstracts (1970–October 2000), and ScienceDirect (1994–October 2000) were performed using the key search terms tacrolimus, FK506, and atopic dermatitis. DATA SYNTHESIS: Since patients with AD have defects in cell-mediated immunity, the immunosuppressant properties of the macrolides (cyclosporine and tacrolimus) may prove to be beneficial in the treatment of AD. Topical tacrolimus has been frequently studied in the treatment of AD because it was found to have better skin penetration and higher potentency than topically applied cyclosporine. Studies evaluating the use of topical tacrolimus are presented and provide evidence that topical tacrolimus is effective in the treatment of AD with no evidence thus far of systemic adverse effects. CONCLUSIONS: There is a fair amount of documentation of the efficacy and safety of topical tacrolimus. Further trials are needed to determine the optimal duration of therapy and its efficacy and safety in children less than seven years of age.

Bismuth Subgallate–Epinephrine Paste in Adenotonsillectomies

2000 ◽  
Vol 34 (4) ◽  
pp. 522-525 ◽  
Author(s):  
Randy C Hatton
Keyword(s):  
Active Ingredient ◽  
Science Citation Index ◽  
Citation Index ◽  
Postoperative Bleeding ◽  
Data Sources ◽  
Data Synthesis ◽  
Search Terms ◽  
Bismuth Subgallate ◽  
Minimal Evidence

OBJECTIVE: To evaluate the role of bismuth subgallate–epinephrine (BSE) paste as a hemostatic in adenotonsillectomies. DATA SOURCES: MEDLINE (January 1966–October 1999) and Current Contents (January 1997–October 1999) were searched, using bismuth subgallate, adenoidectomy, tonsillectomy, and adenotonsillectomy as search terms. A citation search was performed using Science Citation Index (January 1977–October 1999). DATA SYNTHESIS: Adenotonsillectomies are common procedures; although there are few complications, hemorrhage is a concern. Bismuth subgallate has historically been used as an astringent and hemostatic. An evaluation of studies of bismuth subgallate and BSE paste was conducted. CONCLUSIONS: There is minimal evidence to support this practice, but data suggest that epinephrine may be the active ingredient in BSE paste. BSE paste is inexpensive, poses little risk, and may decrease postoperative bleeding; therefore, it may be a reasonable hemostatic agent.

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