scholarly journals Methadone, Buprenorphine, and Clonidine Attenuate Mitragynine Withdrawal in Rats

2021 ◽  
Vol 12 ◽  
Author(s):  
Rahimah Hassan ◽  
Sasidharan Sreenivasan ◽  
Christian P. Müller ◽  
Zurina Hassan
Keyword(s):  
Prescription Drugs ◽  
Treatment Options ◽  
Prescription Medications ◽  
Mitragyna Speciosa ◽  
Withdrawal Sign ◽  
Treatment Paradigm ◽  
Treatment Safety ◽  
Natural Settings ◽  
Withdrawal Effects ◽  
Withdrawal Signs

Background: Kratom or Mitragyna speciosa Korth has been widely used to relieve the severity of opioid withdrawal in natural settings. However, several studies have reported that kratom may by itself cause dependence following chronic consumption. Yet, there is currently no formal treatment for kratom dependence. Mitragynine, is the major psychoactive alkaloid in kratom. Chronic mitragynine treatment can cause addiction-like symptoms in rodent models including withdrawal behaviour. In this study we assessed whether the prescription drugs, methadone, buprenorphine and clonidine, could mitigate mitragynine withdrawal effects. In order to assess treatment safety, we also evaluated hematological, biochemical and histopathological treatment effects.Methods: We induced mitragynine withdrawal behaviour in a chronic treatment paradigm in rats. Methadone (1.0 mg/kg), buprenorphine (0.8 mg/kg) and clonidine (0.1 mg/kg) were i.p. administered over four days during mitragynine withdrawal. These treatments were stopped and withdrawal sign assessment continued. Thereafter, toxicological profiles of the treatments were evaluated in the blood and in organs.Results: Chronic mitragynine treatment caused significant withdrawal behaviour lasting at least 5 days. Methadone, buprenorphine, as well as clonidine treatments significantly attenuated these withdrawal signs. No major effects on blood or organ toxicity were observed.Conclusion: These data suggest that the already available prescription medications methadone, buprenorphine, and clonidine are capable to alleviate mitragynine withdrawal signs rats. This may suggest them as treatment options also for problematic mitragynine/kratom use in humans.

scholarly journals Systematic review of transdermal treatment options in attention-deficit/hyperactivity disorder: implications for use in adult patients

CNS Spectrums ◽  
2021 ◽  
pp. 1-13
Author(s):  
Christoph U. Correll ◽  
Brittney R. Starling ◽  
Michael Huss
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
English Language ◽  
Treatment Options ◽  
Adult Patients ◽  
Publication Date ◽  
Potential Cost ◽  
Hyperactivity Disorder ◽  
Related Quality ◽  
Treatment Safety

Abstract Background Adults with attention-deficit/hyperactivity disorder (ADHD) often face delays in diagnosis and remain untreated, despite significant negative impacts. To evaluate the safety and efficacy of transdermal treatment options in children, adolescents, and adults, a systematic literature review was conducted, with a focus on the implications of transdermal therapies for ADHD in adults. Methods A MEDLINE/Embase/BIOSIS/SCOPUS database search was conducted December 4, 2019, for English-language articles of interventional clinical trials using transdermal formulations for the treatment of ADHD without publication date limit. Assessed outcomes included efficacy, safety, adherence, abuse potential, cost efficacy, and health-related quality of life. Results Of 23 eligible publications, 18 were in children or adolescents (n = 1699; range 23-305), and 5 in adults (n = 274; range 14-90); all included methylphenidate transdermal system (MTS). All seven pediatric publications reporting change in ADHD symptomology from baseline reported a significant improvement with MTS treatment. Similarly, in three adult publications, ADHD symptoms improved significantly with MTS treatment. Safety findings in pediatric and adult studies were comparable; the most frequently reported treatment-emergent adverse events (TEAEs), namely, headache, decreased appetite, and insomnia, were reported in 13/16 (81%) of publications reporting specific TEAEs. MTS-related dermal reactions were mostly mild and transient. Discontinuation due to dermal reactions was reported in 10 studies (range 0%-7.1% [1 of 14 patients]). MTS compliance was high when assessed (97%-99%). Conclusions Transdermal therapies provide a useful treatment formulation for ADHD. Studies of MTS and other transdermal formulations, such as amphetamine, in adult patients are needed in this underserved population.

scholarly journals Optimizing the Diagnosis and Biomarker Testing for Patients with Intrahepatic Cholangiocarcinoma: A Multidisciplinary Approach

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 392
Author(s):  
May T. Cho ◽  
Sepideh Gholami ◽  
Dorina Gui ◽  
Sooraj L. Tejaswi ◽  
Ghaneh Fananapazir ◽  
...  
Keyword(s):  
Treatment Options ◽  
Biliary Tree ◽  
Physician Education ◽  
Community Healthcare ◽  
Heterogenous Group ◽  
Treatment Paradigm ◽  
Tissue Acquisition ◽  
Biomarker Testing ◽  
Standard Practices ◽  
The University

Cholangiocarcinoma (CCA) is a heterogenous group of malignancies originating in the biliary tree, and associated with poor prognosis. Until recently, treatment options have been limited to surgical resection, liver-directed therapies, and chemotherapy. Identification of actionable genomic alterations with biomarker testing has revolutionized the treatment paradigm for these patients. However, several challenges exist to the seamless adoption of precision medicine in patients with CCA, relating to a lack of awareness of the importance of biomarker testing, hurdles in tissue acquisition, and ineffective collaboration among the multidisciplinary team (MDT). To identify gaps in standard practices and define best practices, multidisciplinary hepatobiliary teams from the University of California (UC) Davis and UC Irvine were convened; discussions of the meeting, including optimal approaches to tissue acquisition for diagnosis and biomarker testing, communication among academic and community healthcare teams, and physician education regarding biomarker testing, are summarized in this review.

scholarly journals Non-Medical Use of Cognitive Enhancing Prescription Medications Among Occupational Therapy and Speech Language Pathology Health Care Students: A Pilot Study

2016 ◽  
Author(s):  
Randy McCombie ◽  
Hannah Slanina
Keyword(s):  
Pilot Study ◽  
Occupational Therapy ◽  
Prescription Drugs ◽  
Self Report ◽  
Future Research ◽  
Prescription Medications ◽  
Speech Language Pathology ◽  
Academic Cheating ◽  
Language Pathology ◽  
Return Envelope

Purpose: This research was designed to serve as a pilot study to generate baseline data on non-medical use of prescription drugs (NMUPD) for cognitive/academic enhancement purposes among students representing two healthcare professions, Occupational Therapy (OT) and Speech Language Pathology (SLP) and to assess students’ opinions regarding whether use of these medications constitutes academic “cheating.” Introduction: NMUPD, such as Adderall ® or Ritalin ®, to reduce fatigue, improve memory, and increase concentration to ultimately improve grades has increased among college students in recent years, with estimated use put as high as 35% on some campuses. These drugs appear to be readily available to those not prescribed them, with primary sources including family, friends, and classmates. Aside from health concerns stemming from ingesting non-prescribed medications is the ethical concern whether use of such cognitive enhancers is “cheating.” Methods: Following IRB approval, 150 OT and 150 SLP students, randomly selected from membership in their respective national associations, were mailed survey packets containing a cover letter, questionnaire, and return envelope. Results: A total of 51 completed surveys, including 25 OT and 26 SLP students, were returned and included in analyses. Of these, five (9.8%) reported using cognitive enhancing prescription medications. Four of these reported having a legal prescription, including one who admitted faking symptoms of ADHD to access the prescription. The fifth student had no prescription. Motives included recreational enjoyment, to improve attention/concentration, reduce hyperactivity/impulsivity, and to obtain higher grades. Four out of ten students indicated abuse of prescription medications was a problem at their institutions, with three out of ten believing it was easy to obtain such drugs. Students were visibly divided as to whether use of these medications was academic cheating. Conclusions: The percent of these healthcare profession students reporting to have used non-prescribed medications for academic enhancement purposes mirrors that of studies on the general college student population and reflects the division as to whether use constitutes cheating. As the survey is a self-report, the numbers using the prescription medications may be higher. Results indicate future research on NMUPD among healthcare students is warranted, along with a need to educate students on the risks of use of these medications for non-prescribed purposes.

Treating Erectile Dysfunction with Prescription Medications & Natural Products: A Pharmacist’s Guide

2021 ◽  
Vol 36 (12) ◽  
pp. 632-644
Author(s):  
Justyna Sudyka ◽  
Jeannette Y. Wick
Keyword(s):  
Natural Products ◽  
Erectile Dysfunction ◽  
Treatment Options ◽  
Prescription Medications ◽  
Patient Needs ◽  
Management Knowledge

Stigma surrounding erectile dysfunction creates a difficult environment for appropriate management. Knowledge of the condition and treatment options presents a unique opportunity for pharmacists to optimize a safe and affordable plan that meets patient needs.

Fade to Black: Importation and Counterfeit Drugs

2006 ◽  
Vol 32 (2-3) ◽  
pp. 279-323 ◽  
Author(s):  
Bryan A. Liang
Keyword(s):  
Quality Of Life ◽  
Prescription Drugs ◽  
Prescription Medications ◽  
Health Statistics ◽  
Counterfeit Drugs ◽  
Hospital Outpatient ◽  
The Us ◽  
Outpatient Departments ◽  
Outpatient Settings

Americans rely extensively upon prescription medications to maintain health and quality of life. According to the National Center for Health Statistics, in 2002, at least 1.5 billion drugs were prescribed to patients in physician offices, 196 million in US emergency departments, and 140 million in outpatient settings. Almost two-thirds of visits to physician offices and hospital outpatient departments had at least one drug associated with the visit, and 7% of visits had five or more drugs. In 2004, US pharmacies dispensed over 3.5 billion prescriptions to patients. Estimates indicate that annual expenditures for prescription drugs in the US top $230 billion dollars each year—and there is every indication that these numbers will only increase.

Low-Grade Lymphoma

Hematology ◽  
2004 ◽  
Vol 2004 (1) ◽  
pp. 203-220 ◽  
Author(s):  
Jane N. Winter ◽  
Randy D. Gascoyne ◽  
Koen Van Besien
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Treatment Options ◽  
B Cell Lymphoma ◽  
Allogeneic Transplantation ◽  
Low Grade ◽  
Non Hodgkin Lymphoma ◽  
Treatment Paradigm ◽  
Optimal Approach

Abstract Folicular lymphoma (FL), the second most common subtype of non-Hodgkin lymphoma, shows considerable heterogeneity in its clinical behavior, representative of a biology that appears increasingly complex and diverse. As our knowledge of the molecular basis of FL increases, we strive for an integration between the bench and clinic that yields treatments based on our scientific understanding and biomarkers that allow us to prescribe treatment rationally. In Section I, Dr. Randy Gascoyne describes the histologic, cytogenetic and biologic features of FL that underlie its clinical variability. Key aspects of the pathologic diagnosis of FL that have particular relevance to the clinician are highlighted. A proposed model for follicular lymphomagenesis and diffuse large B cell lymphoma transformation has emerged and continues to evolve as the molecular story unfolds. A biologic basis for clinical outcome in FL also appears to be forthcoming. In Section II, Dr. Jane Winter addresses the complex process of selecting among the many treatment options for patients with FL. Previously a simple matter of deciding between oral or intravenous alkylators, clinicians and patients must now struggle to choose among vastly different approaches ranging from “watch and wait” to stem cell transplantation. The introduction of rituximab and radioimmunoconjugates is changing the treatment paradigm, but the optimal approach to integrating these and other new agents remains to be determined. At every decision point, the best approach is always a clinical trial. In Section III, Dr. Koen Van Besien provides a well-documented update on outcomes associated with autologous and allogeneic stem cell transplantation for FL. The results of trials of autologous stem cell transplantation in first remission and recent data supporting a role for graft purging are discussed. Based on the premise that a graft-versus-lymphoma effect is operative in FL, reduced-intensity allogeneic transplantation is the preferred approach in many cases, and recently reported results are summarized. Criteria for patient selection and the optimal role of transplantation in the overall therapeutic plan for the patient with FL are presented.

A phase II trial of MEK inhibitor BAY 86-9766 in combination with sorafenib as first-line systemic treatment for patients with unresectable hepatocellular carcinoma (HCC).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4103-4103 ◽  
Author(s):  
Ho Yeong Lim ◽  
Chia-Jui Yen ◽  
Won-Young Tak ◽  
Jeong Heo ◽  
Hye Jin Choi ◽  
...  
Keyword(s):  
Survival Data ◽  
Systemic Treatment ◽  
Performance Status ◽  
Treatment Options ◽  
Tumor Lysis Syndrome ◽  
Mek Inhibitor ◽  
Open Label ◽  
Treatment Safety ◽  
Almost All ◽  
Dose Modifications

4103 Background: Sorafenib (S) is the only approved systemic treatment for unresectable HCC. Nevertheless, there remains an unmet medical need for more effective treatment options for this disease. BAY 86-9766 (B) is an oral, allosteric inhibitor of MEK, a key component of the MAP kinase pathway. This study evaluated the efficacy and safety of a combination therapy with B plus S in patients (pts) with HCC. Methods: This is a single arm, open-label, phase 2 study. Eligible were pts with unresectable HCC, Child-Pugh Class A, performance status (PS) 0-1, and no prior systemic anticancer therapy for HCC. Pts started Cycle 1 (21 days) with B 50 mg bid orally plus S 600 mg daily (200 mg AM, 400 mg PM) orally. If there was no hand-foot skin reaction, fatigue, or gastrointestinal toxicity ≥ grade 2, S was escalated to 400 mg bid from Cycle 2 on. Treatment continued until progression or withdrawal criteria were met. Tumor assessment was performed every 6 weeks during treatment. Safety was evaluated every week for the first 6 weeks and every 3 weeks thereafter. Results: Seventy pts from Asia started study treatment. Pts were predominantly male (86%); median age was 56 years; 54% had PS of 0 and 46% PS of 1. The vast majority had liver cirrhosis (83%) and infection with HBV (76%) or HCV (17%). Sixty-five were evaluable for efficacy per protocol. Three pts (5%) had confirmed partial response and 25 pts (38%) had prolonged stable disease (≥10 weeks), with a disease control rate of 43%. Median time-to-progression was 4.1 months. Survival data are not mature, yet. The most frequent drug-related adverse events (AEs) were rash (60%), diarrhea (59%), AST elevation (43%), vomiting (30%), nausea (29%), ALT elevation (26%), and anorexia (26%). There were 4 Grade 5 related AEs (hepatic failure, sepsis/hepatic encephalopathy, tumor lysis syndrome, and unknown cause, respectively). Dose modifications due to AEs were necessary in almost all pts. The median daily dose was 64.2 mg for B and 443.3 mg for S, respectively. Conclusions: B in combination with S showed antitumor activity in pts with HCC. However, frequent dose modifications due to AEs might have limited the treatment effect of this combination.

scholarly journals The Evolving Role of the Multiple Sclerosis Nurse

2011 ◽  
Vol 13 (3) ◽  
pp. 105-112 ◽  
Author(s):  
Therese Burke ◽  
Sara Dishon ◽  
Lynn McEwan ◽  
Jennifer Smrtka
Keyword(s):  
Multiple Sclerosis ◽  
Professional Training ◽  
Treatment Options ◽  
Health Care Team ◽  
Training And Development ◽  
Collaborative Partnerships ◽  
Treatment Paradigm ◽  
Complex Monitoring ◽  
New Treatments

A greater understanding of the pathogenesis of multiple sclerosis (MS) and the need for treatments with increased efficacy, safety, and tolerability have led to the ongoing development of new treatments. The evolution of treatments for MS is expected to have a dramatic impact on the entire health-care team, especially MS nurses, who build strong collaborative partnerships with their patients. MS nurses help patients better understand their disease and treatment options, facilitate the initiation and management of treatment, and encourage adherence. With new oral therapies entering the market, the potential for increased efficacy, tolerability, adherence, and convenience for patients is evident. However, the resulting change in the treatment paradigm means that the skill set required of an MS nurse will inevitably expand. There will be a growing need for professional training and development to ensure that nurses are familiar with the wider range of treatments and their specific modes of action, dosing schedules, and benefit/risk profiles. In addition, the MS nurse's role will expand to include management of the complex monitoring needs specific to each therapy. This article explores how the role of the MS nurse is evolving with the development of new MS therapies, including novel oral therapies.

scholarly journals Treatment with Herbal Mouthwash Mediates Improvement of Symptoms in Xerostomia and Oral Mucositis patients

2018 ◽  
Vol 4 (2) ◽  
pp. 202-206
Author(s):  
Jonathan Berrout ◽  
Scott Dahlbeck ◽  
Gianluca Rotino ◽  
Diane Nguyen ◽  
Jose Figueroa
Keyword(s):  
Side Effects ◽  
Oral Mucositis ◽  
Prescription Drugs ◽  
Prescription Medications ◽  
Peppermint Oil ◽  
Cinnamon Oil ◽  
Oral Pain ◽  
Oral Dryness ◽  
Peppermint Extract ◽  
Oral Conditions

Oral discomfort and pain are frequent side-effects of many popular prescription medications. Over 500 prescription drugs are known to result in the development of adverse oral conditions. In fact, approximately 40% of patients suffer from xerostomia and oral mucositis, as a result of cancer medications. The number of affected individuals is expected to continue to rise, given that the incidence of major cancers is predicted to grow over the next decade. Regrettably, there are currently lacks of treatments available to effectively improve xerostomia and oral mucositis symptoms. Interestingly, the use of several herbal ingredients (such as chamomile, cinnamon, and peppermint oil) has been reported to effectively improve pain and oral dryness. For this reason, we examined the effectiveness of an herbal mouthwash, Nature’s Herbal (a blend of cinnamon oil, chamomile, cranberry, and peppermint extract), to alleviate symptoms of oral pain and dry mouth exhibited by patients diagnosed with oral mucositis and xerostomia. Daily treatment with the mouthwash induced a 53% ± 6% and 33.2% ± 3.8% improvement in the severity of symptom, for the oral mucositis and xerostomia patients groups, respectively. Overall, the herbal mouthwash induced an improvement in 91% of oral mucositis and 83% of xerostomia patients.

scholarly journals Could Television Commercials Marketing Prescription Drugs Cause Psychological Harm to the Public?

2019 ◽  
pp. 01-02
Author(s):  
I Kenneth Royal
Keyword(s):  
Prescription Drugs ◽  
Heart Attack ◽  
Television Advertising ◽  
Pharmaceutical Companies ◽  
Prescription Medications ◽  
Television Commercials ◽  
The Public ◽  
Psychological Harm ◽  
Prescription Medicines ◽  
Keywords Anxiety

Keywords: Anxiety; Media; Prescription drugs; Pharmacy; Television; Advertising; Commercials Numerous studies have found media such as televised images and commercials may influence viewers’ perceptions of self and their subsequent behaviors [1-4]. Historically, television has long presented advertisements for medicine, but these typically were over-thecounter medicines, such as medication to treat a headache, a common cold, the flu, etc. These medicines might include Tylenol, Alka-Seltzer, Pepto Bismol, etc. In recent years, however, the marketing landscape has changed dramatically with pharmaceutical companies now advertising for prescription medications. Examples of prescription medicines commonly appearing on television at this time of this writing include Cialis and Viagra for treating erectile dysfunction, Lyrica for diabetic foot pain, Otezla for plaque psoriasis, Crestor and Xarelto to prevent the risk of heart attack, Eliquis to prevent stroke, and Humira and Xeljanz to treat rheumatoid arthritis.

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