scholarly journals Modified drug regimen for ophthalmic anesthesia during COVID-19 pandemic: Revisiting pharmacological concepts

2021 ◽  
Vol 53 (2) ◽  
pp. 178
Author(s):  
Bharat Gurnani ◽  
Kirandeep Kaur
Keyword(s):  
Drug Regimen

New Hope for Resistant Hypertention

2012 ◽  
Vol 5 (1) ◽  
pp. 81-91
Author(s):  
Z Rahman ◽  
KK Karmaker ◽  
M Ahmed ◽  
M Aziz ◽  
S Chowdhury ◽  
...  
Keyword(s):  
Resistant Hypertension ◽  
Patient Adherence ◽  
Public Health Problem ◽  
Drug Regimen ◽  
Renal Sympathetic Denervation ◽  
Major Public Health Problem ◽  
Antihypertensive Medications ◽  
Baroreflex Activation Therapy ◽  
Activation Therapy ◽  
Increasing Trends

Hypertension is a major public health problem. Despite the increasing awareness of hypertension and its implications among patients and treating physicians, the prevalence of resistant hypertension    remains high.Resistant hypertension define as blood pressure that remains elevated above treatment goals despite administration of an optimal three drug regimen that include a diuretic1 The prevalence of resistant    hypertension is projected to increase, owing to the aging population and increasing trends in obesity, sleep apnea, and chronic kidney disease. It is estimated that at least 10% of all patients with hypertension are resistant to existing drugs. Management of resistant hypertension must begin with  a careful evaluation of the patient to confirm the diagnosis and exclude factors associated with “pseudo-resistance,” such as improper BP measurement technique, the white-coat effect, and poor patient adherence to life-style and/or antihypertensive medications. Despite the use of the appropriate dose and type of diuretic to overcome the management of resistant hypertension, we can’t achieve our goal. But there is at least two devices namely Baroreflex Activation Therapy and Catheter-based  renal sympathetic denervation make the new hope for the patient with resistant hypertension DOI: http://dx.doi.org/10.3329/cardio.v5i1.12278 Cardiovasc. j. 2012; 5(1): 81-91

Management of Glioblastoma Multiforme by Phytochemicals: Applications of Nanoparticle Based Targeted Drug Delivery System

2020 ◽  
Vol 21 ◽  
Author(s):  
Sayed Md Mumtaz ◽  
Gautam Bhardwaj ◽  
Shikha Goswami ◽  
Rajiv Kumar Tonk ◽  
Ramesh K. Goyal ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Glioblastoma Multiforme ◽  
Drug Delivery System ◽  
Delivery System ◽  
Genetic Disorder ◽  
Drug Regimen ◽  
Brain Regions ◽  
Radio Therapy ◽  
Novel Drug ◽  
The Brain

: The Glioblastoma Multiforme (GBM; grade IV astrocytoma) exhort tumor of star-shaped glial cell in the brain. It is a fast-growing tumor that spreads to nearby brain regions specifically to cerebral hemispheres in frontal and temporal lobes. The etiology of GBM is unknown, but major risk factors are genetic disorder like neurofibromatosis and schwanomatosis which develop the tumor in the nervous system. The management of GBM with chemo-radio therapy leads to resistance and current drug regimen like Temozolomide (TMZ) is less efficacious. The reasons behind failure of drugs are due to DNA alkylation in cell cycle by enzyme DNA guanidase and mitochondrial dysfunction. Naturally occurring bio-active compounds from plants known as phytochemicals, serve as vital sources for anti-cancer drugs. Some typical examples include taxol analogs, vinca alkaloids such as vincristine, vinblastine, podophyllotoxin analogs, camptothecin, curcumin, aloe emodin, quercetin, berberine e.t.c. These phytochemicals often act via regulating molecular pathways which are implicated in growth and progression of cancers. However the challenges posed by the presence of BBB/BBTB to restrict passage of these phytochemicals, culminates in their low bioavailability and relative toxicity. In this review we integrated nanotech as novel drug delivery system to deliver phytochemicals from traditional medicine to the specific site within the brain for the management of GBM.

Inflammatory Myositis Secondary to Anti-Retroviral Therapy in a Child; Case Report and Review of the Literature

2021 ◽  
pp. 1-7
Author(s):  
Marie Monaghan ◽  
Charlotte Loh ◽  
Stephen Jones ◽  
Agyepong Oware ◽  
Kathryn Urankar ◽  
...  
Keyword(s):  
Drug Regimen ◽  
Dramatic Improvement ◽  
Strand Transfer ◽  
Inflammatory Myositis ◽  
Once Daily ◽  
Immune Mediated ◽  
Show Evidence ◽  
Transfer Inhibitor ◽  
Integrase Strand Transfer Inhibitor

Here, we describe a five year old girl with congenital HIV who had a six-week onset of rapidly deteriorating mobility and progressive proximal muscle weakness, associated with a raised Creatine Kinase (CK) level of 4330 U/L [25–200 U/L], subsequently diagnosed with an inflammatory myositis. Potential causes were investigated by paediatric neurology and immunology teams. Her viral load had been undetectable over the preceding two years, excluding a primary HIV myositis. While MRI scanning did not show evidence of definite myositis, a muscle biopsy showed evidence of an inflammatory process, comprising a moderate endomysial, perimysial and perivascular mononuclear (CD8 + T cell) infiltrate with increased MHC expression. No particular features of dermatomyositis or immune-mediated necrotising myopathy were identified and there were no features of an inclusion body myositis. Given the absence of active HIV infection, the role of anti-retroviral medications was considered. She had had a recent switch in medication, from twice daily Raltegravir (an Integrase Strand Transfer Inhibitor, INSTI) to once daily Dolutegravir (an INSTI) while continuing on an established daily protocol of Abacavir and Lamivudine (Nucleoside Reverse Transcriptase Inhibitors). Changing the Dolutegravir back to Raltegravir, in combination with continuing Lamivudine and Abacavir for two months made no difference to her weakness or CK levels. Moreover, this drug regimen had been well-tolerated over the preceding 19 month period. Changing the anti-retroviral regime completely to a single drug class (Protease Inhibitors) of Ritonavir and Darunavir, resulted in a dramatic improvement in her symptomatology. Within ten days she regained the ability to stand and walk, with a reduction in her CK from 1700 U/L at time of switch to 403 U/L [25–200]. This case highlights the potential risk of developing inflammatory myositis from anti-retrovirals even 19 months into treatment.

scholarly journals 1096. Linezolid versus Tedizolid for the Treatment of Nontuberculous Mycobacteria in Solid Organ Transplant Recipients: An Assessment of Safety

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S577-S578
Author(s):  
Yi Kee Poon ◽  
Ricardo M La Hoz ◽  
James Sanders ◽  
Linda S Hynan ◽  
Marguerite Monogue
Keyword(s):  
Nontuberculous Mycobacteria ◽  
Organ Transplant ◽  
Drug Regimen ◽  
Solid Organ Transplant ◽  
Mixed Effects ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Duration Of Therapy ◽  
Anova Model ◽  
Solid Organ Transplant Recipients

Abstract Background Treatment options for nontuberculous mycobacteria (NTM) infections are limited by the long-term tolerability of antimicrobials. The oxazolidinones, linezolid and tedizolid, display in vitro activity against many NTM species and demonstrate excellent oral bioavailability. This study compares the hematologic safety profile of linezolid versus tedizolid for the treatment of NTM in solid organ transplant (SOT) recipients. Methods This retrospective cohort study included adult SOT recipients who received linezolid or tedizolid as part of a multi-drug regimen to treat NTM between January 1, 2010 to August 31, 2019. The primary endpoint was the hematologic effects of linezolid versus tedizolid from therapy initiation to week seven. This time frame was chosen based on the median duration of therapy. A mixed-effects ANOVA model was used to assess the effects of linezolid and tedizolid on platelet counts (PLT), absolute neutrophil counts (ANC), and hemoglobin (Hgb) across time. Subjects were treated as a random effect. The secondary analysis described the proportion of adverse effects and discontinuation. Results Twenty-four patients were included in the analysis (9 linezolid, 15 tedizolid). Mycobacterium abscessus abscessus was the most common isolate, and pulmonary was the most common site of infection (Table 1). The median duration of therapy was 24 days (range 3 to 164 days) and 48 days (range 11 to 571 days) for linezolid and tedizolid, respectively. All patients in the linezolid group received 600 mg daily or less for the majority of treatment duration. In the mixed-effects ANOVA, the ANC decreased in both groups after seven weeks of therapy (p=0.04). Otherwise, no significant effects for week, treatment group, or interaction between week and treatment group were found (Figure 1). Thrombocytopenia and neutropenia were common in both groups, and around one-fifth of patients in each group discontinued the medication due to adverse effects (Table 2). Table 1. Baseline characteristics of solid organ transplant recipients who received linezolid or tedizolid as part of a multi-drug regimen to treat nontuberculous mycobacteria infections between January 1, 2010 to August 31, 2019 at UT Southwestern Medical Center. Table 2. Adverse drug events and discontinuation of therapy over seven weeks of therapy. Figure 1. Effects of linezolid versus tedizolid during the initial seven weeks of therapy using a mixed-effects ANOVA model, (a) platelet counts, (b) absolute neutrophil counts, and (c) hemoglobin. Conclusion Non-significant statistical differences were found comparing the effects of linezolid versus tedizolid for PLT, ANC, and Hgb using mixed-effects ANOVA models. Larger cohort studies are required to compare the hematologic adverse effect profile of the oxazolidinones for the treatment of NTM infections in SOT recipients. Disclosures All Authors: No reported disclosures

scholarly journals The Road to Better Management in Resistant Hypertension–Diagnostic and Therapeutic Insights

Pharmaceutics ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 714
Author(s):  
Elisabeta Bădilă ◽  
Cristina Japie ◽  
Emma Weiss ◽  
Ana-Maria Balahura ◽  
Daniela Bartoș ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Resistant Hypertension ◽  
Renin Angiotensin System ◽  
Drug Regimen ◽  
Secondary Hypertension ◽  
Adverse Outcomes ◽  
Uncontrolled Hypertension ◽  
White Coat Hypertension ◽  
Mineralocorticoid Receptor Antagonist ◽  
Mortality And Morbidity

Resistant hypertension (R-HTN) implies a higher mortality and morbidity compared to non-R-HTN due to increased cardiovascular risk and associated adverse outcomes—greater risk of developing chronic kidney disease, heart failure, stroke and myocardial infarction. R-HTN is considered when failing to lower blood pressure below 140/90 mmHg despite adequate lifestyle measures and optimal treatment with at least three medications, including a diuretic, and usually a blocker of the renin-angiotensin system and a calcium channel blocker, at maximally tolerated doses. Hereby, we discuss the diagnostic and therapeutic approach to a better management of R-HTN. Excluding pseudoresistance, secondary hypertension, white-coat hypertension and medication non-adherence is an important step when diagnosing R-HTN. Most recently different phenotypes associated to R-HTN have been described, specifically refractory and controlled R-HTN and masked uncontrolled hypertension. Optimizing the three-drug regimen, including the diuretic treatment, adding a mineralocorticoid receptor antagonist as the fourth drug, a β-blocker as the fifth drug and an α1-blocker or a peripheral vasodilator as a final option when failing to achieve target blood pressure values are current recommendations regarding the correct management of R-HTN.

scholarly journals Risk of 30-day hospital readmission associated with medical conditions and drug regimens of polymedicated, older inpatients discharged home: a registry-based cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e052755
Author(s):  
Filipa Pereira ◽  
Henk Verloo ◽  
Taushanov Zhivko ◽  
Saviana Di Giovanni ◽  
Carla Meyer-Massetti ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hospital Readmission ◽  
Hospital Readmissions ◽  
Drug Regimen ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Day Hospital ◽  
Medical Conditions ◽  
Older Inpatients ◽  
Drug Regimens

ObjectivesThe present study analysed 4 years of a hospital register (2015–2018) to determine the risk of 30-day hospital readmission associated with the medical conditions and drug regimens of polymedicated, older inpatients discharged home.DesignRegistry-based cohort study.SettingValais Hospital—a public general hospital centre in the French-speaking part of Switzerland.ParticipantsWe explored the electronic records of 20 422 inpatient stays by polymedicated, home-dwelling older adults held in the hospital’s patient register. We identified 13 802 hospital readmissions involving 8878 separate patients over 64 years old.Outcome measuresSociodemographic characteristics, medical conditions and drug regimen data associated with risk of readmission within 30 days of discharge.ResultsThe overall 30-day hospital readmission rate was 7.8%. Adjusted multivariate analyses revealed increased risk of hospital readmission for patients with longer hospital length of stay (OR=1.014 per additional day; 95% CI 1.006 to 1.021), impaired mobility (OR=1.218; 95% CI 1.039 to 1.427), multimorbidity (OR=1.419 per additional International Classification of Diseases, 10th Revision condition; 95% CI 1.282 to 1.572), tumorous disease (OR=2.538; 95% CI 2.089 to 3.082), polypharmacy (OR=1.043 per additional drug prescribed; 95% CI 1.028 to 1.058), and certain specific drugs, including antiemetics and antinauseants (OR=3.216 per additional drug unit taken; 95% CI 1.842 to 5.617), antihypertensives (OR=1.771; 95% CI 1.287 to 2.438), drugs for functional gastrointestinal disorders (OR=1.424; 95% CI 1.166 to 1.739), systemic hormonal preparations (OR=1.207; 95% CI 1.052 to 1.385) and vitamins (OR=1.201; 95% CI 1.049 to 1.374), as well as concurrent use of beta-blocking agents and drugs for acid-related disorders (OR=1.367; 95% CI 1.046 to 1.788).ConclusionsThirty-day hospital readmission risk was associated with longer hospital length of stay, health disorders, polypharmacy and drug regimens. The drug regimen patterns increasing the risk of hospital readmission were very heterogeneous. Further research is needed to explore hospital readmissions caused solely by specific drugs and drug–drug interactions.

scholarly journals Epidemiology, clinical characteristics, and treatment outcomes of patients with COVID-19 at Thailand’s university-based referral hospital

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rujipas Sirijatuphat ◽  
Yupin Suputtamongkol ◽  
Nasikarn Angkasekwinai ◽  
Navin Horthongkham ◽  
Methee Chayakulkeeree ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Clinical Characteristics ◽  
Drug Regimen ◽  
Rt Pcr ◽  
Antiviral Therapies ◽  
Outbreak Period ◽  
Siriraj Hospital ◽  
Antiviral Medications

Abstract Background The epidemiology and outcomes of COVID-19 patients in Thailand are scarce. Methods This retrospective cohort study included adult hospitalized patients who were diagnosed with COVID-19 at Siriraj Hospital during February 2020 to April 2020. Results The prevalence of COVID-19 was 7.5% (107 COVID-19 patients) among 1409 patients who underwent RT-PCR for SARS-CoV-2 detection at our hospital during the outbreak period. Patients with COVID-19 presented with symptoms in 94.4%. Among the 104 patients who were treated with antiviral medications, 78 (75%) received 2-drug regimen (lopinavir/ritonavir or darunavir/ritonavir plus chloroquine or hydroxychloroquine), and 26 (25%) received a 3-drug regimen with favipiravir added to the 2-drug regimen. Disease progression was observed in 18 patients (16.8%). All patients with COVID-19 were discharged alive. Conclusions The prevalence of COVID-19 was 7.5% among patients who underwent RT-PCR testing, and 10% among those having risk factors for COVID-19 acquisition. Combination antiviral therapies for COVID-19 patients were well-tolerated and produced a favorable outcome.

STUDIES OF THYROID HORMONE AND METHIMAZOLE LEVELS IN PATIENTS WITH GRAVES' DISEASE ON A STANDARDIZED ANTI-THYROID DRUG REGIMEN

1981 ◽  
Vol 14 (6) ◽  
pp. 555-562 ◽  
Author(s):  
P. A. DAHLBERG ◽  
F. A. KARLSSON ◽  
B. LINDSTROM ◽  
L. WIDE
Keyword(s):  
Thyroid Hormone ◽  
Drug Regimen ◽  
Graves Disease
Sign in / Sign up

Export Citation Format

Share Document