Adverse effects of modified release oxycodone/naloxone in patients with moderate to severe liver impairment

2018 ◽  
Vol 209 (6) ◽  
pp. 279-280
Author(s):  
Venessa Pattullo ◽  
Gavin G Pattullo ◽  
Simone I Strasser
2020 ◽  
Vol 21 (2) ◽  
pp. 79-88 ◽  
Author(s):  
Pankaj Mandpe ◽  
Bala Prabhakar ◽  
Pravin Shende

Background: Overactive bladder syndrome is a broadly occurring urological disorder with a distressing impact on the quality of life. The commonly used antimuscarinic drugs show poor patient compliance because of unsatisfactory potency, tolerability and high occurrence of adverse effects such as dry mouth, blurred vision, constipation, dizziness etc. Mirabegron is the first approved β3-adrenoreceptor agonist, used as mono or in combination therapies for overactive bladder syndrome. Objective: The present review provides an insight into the mechanism, pharmacokinetics, toxicokinetics, clinical trials and the development of various conventional and modified-release dosage forms of mirabegron for the treatment of overactive bladder syndrome. Results: The clinical trials of phase II and phase III of mirabegron demonstrated symptomatic relief from the overactive bladder without disturbing the micturition cycle. To date, mirabegron showed promising results for safety, tolerability and efficacy in patients with overactive bladder syndrome. The modified-release tablet dosage form of mirabegron appear to be a proficient and suitable replacement for antimuscarinics and revealed the tremendous potential to overcome the adverse effects of conventional antimuscarinic drugs like Oxybutyline chloride ER, Detrol LA, VESIcare, etc. Conclusion: Mirabegron shows a distinct mode of action, i.e., targeting β3-adrenoreceptors and improving bladder storage without altering void contractions. The limited side effects, high safety, efficacy and tolerability of mirabegron present an adequate substitute to antimuscarinics. However, long-term analysis and clinical studies are prerequisites for assessing the safety, tolerability and efficacy profile of mirabegron.


Author(s):  
Giuseppe Castaldo ◽  
Emilia Rippa ◽  
Donatello Salvatore ◽  
Raffaella Sibillo ◽  
Valeria Raia ◽  
...  

2006 ◽  
Vol 26 (10) ◽  
pp. 1225-1233 ◽  
Author(s):  
Aezam Katoonizadeh ◽  
Frederik Nevens ◽  
Chris Verslype ◽  
Jacques Pirenne ◽  
Tania Roskams

2019 ◽  
Vol 26 (2) ◽  
pp. 500-506
Author(s):  
Ola Mashni ◽  
Khlood Qasem ◽  
Aseel Abu Sara ◽  
Wedad Awad

Introduction Limited data are available on dosing etoposide in patients with liver impairment. Case report We report the dosing strategies for etoposide utilized in two patients with neuroendocrine tumors and severe liver impairment. Management and outcomes Treatment consisted of platinum-based chemotherapy regimens, with the decision of whether to administer etoposide and at what doses being based on the liver function before each chemotherapy cycle. By the end of treatment, total bilirubin was normal, and the performance status of both patients had improved, with stable computed tomography scan findings. Discussion The reported two cases suggest that the administration of etoposide at reduced doses with close monitoring in patients with neuroendocrine tumors and severe liver impairment may still be considered as an option and may improve outcomes.


1975 ◽  
Author(s):  
Hamid Al-Mondhiry

Disseminated intravascular coagulation (DIC) developed in 89 patients seen at Memorial Sloan-Kettering Cancer Center between 1971 and 1974. Criteria for the diagnosis of DIC wore: 1. Hypofibrinogenemia or > 50% reduction in plasma fibrinogen on serial determinations. 2. Prolonged thrombin time and/or elevated titer of fibrinogen-related material in the serum. 3. Thrombocytopenia not due to drugs or disease. Patients with severe liver disease or uremia were excluded. The patients included 19 with leukemia (17 acute), 3 with multiple myeloma, 15 with lymphoma, 46 with metastatic solid tumors (12 genitourinary, 10 lung, 9 breast, 8 gastrointestinal, 7 miscellaneous), 4 with vascular tumors, and 3 without tumor. Other conditions which might have precipitated or initiated DIC such as gramnegative sepsis (20 patients), mild liver impairment (31 patients), and mucin secreting tumors (4 patients), were also noted. Four patients with vascular tumors, two with leukemia, and one with vasculitis had markedly shortened fibrinogen survival. Bleeding occurred in 75% of the patients and was fatal in 36%. Thromboembolism occurred in 22.5%. Thirteen percent were asymptomatic. Treatment with heparin was helpful in only three of twenty patients. Eighty percent of the patients died within one to over 30 days of the onset of DIC. Post mortem evidence of DIC was present in 18 of 43 autopsies.Results of this study indicate that DIC is a frequent complication of a wide variety of tumors and that its occurrence causes morbidity and mortality in a significant number of patients. Treatment with heparin is of little help unless remission is induced and the precipitating factor(s) are reversed.


Sensors ◽  
2019 ◽  
Vol 19 (17) ◽  
pp. 3656
Author(s):  
Danila Germanese ◽  
Sara Colantonio ◽  
Mario D’Acunto ◽  
Veronica Romagnoli ◽  
Antonio Salvati ◽  
...  

Biologically inspired to mammalian olfactory system, electronic noses became popular during the last three decades. In literature, as well as in daily practice, a wide range of applications are reported. Nevertheless, the most pioneering one has been (and still is) the assessment of the human breath composition. In this study, we used a prototype of electronic nose, called Wize Sniffer (WS) and based it on an array of semiconductor gas sensor, to detect ammonia in the breath of patients suffering from severe liver impairment. In the setting of severely impaired liver, toxic substances, such as ammonia, accumulate in the systemic circulation and in the brain. This may result in Hepatic Encephalopathy (HE), a spectrum of neuro–psychiatric abnormalities which include changes in cognitive functions, consciousness, and behaviour. HE can be detected only by specific but time-consuming and burdensome examinations, such as blood ammonia levels assessment and neuro-psychological tests. In the presented proof-of-concept study, we aimed at investigating the possibility of discriminating the severity degree of liver impairment on the basis of the detected breath ammonia, in view of the detection of HE at its early stage.


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