Opioid overdose: Questions – Answers

Opioid agonists bind to G-protein-coupled receptors to reduce adenylyl cyclase activity, to reduce prejunctional calcium conductance, which results in a decrease in neurotransmitter release, and to enhance postjunctional potassium conductance, which results in decreased responsiveness to excitatory neurotransmitters. Meperidine is metabolized to normeperidine that may result in seizures. Morphine is metabolized to morphine-6 glucuronide.

Ergot alkaloids

You are called to see a 24-year-old G3P3 woman who approximately 1 hour ago underwent a vaginal delivery of an 8 lb infant. The nurse is concerned that the patient is continuing to bleed more than would be expected, and that her uterine fundus does not feel firm.

New Drugs Target Women’s Needs

A total of almost 400 drugs are now in various stages of development to meet the special needs of women. The drugs, many of which offer innovative therapeutic approaches, are intended to treat diseases that either disproportionately affect women or are among the leading causes of death. The top causes of death in women are heart disease, cancer, cerebrovascular disease, chronic obstructive pulmonary disease, pneumonia, diabetes, adverse drug reactions, Alzheimer’s disease, nephritis and septicemia.

SSRIs Safe for Cardiac Patients

A study has found that paroxetine (Paxil/ SmithKline Beecham) effectively reduced depression in patients without affecting cardiac function. The patients in the study were administered either paroxetine, an SSRI, nortriptyline or placebo. Of the 41 patients taking nortriptyline, heart rates increased by 11% and 7 of the patients dropped out of the study because of potentially serious cardiovascular side effects, such as angina and sinus tachycardia.

Nonprescription NSAIDs: Safety and Efficacy

Aspirin and nonaspirin nonsteroidal antiinflammatory drugs (NSAIDs) are among the most commonly used medications. Prescription use of NSAIDs in the United States appears to be stabilizing, but nonprescription (over-the-counter, OTC) use is growing. Sales of ibuprofen – Advil, Motrin IB, Nuprin – have more than tripled since the analgesic was approved for OTC sales nearly a decade ago.

Psychotropic Drugs in Children: Introduction

Parents and child advocates have been simultaneously concerned, however, about accuracy of diagnosis, over-labelling of the child, long-term side-effects, and providing a quick “fix” while neglecting other therapies that require long-term commitment. Consumer complaints in Ontario resulted in unique legislation, the Child and Family Services Act (CFSA) of 1985, which defines psychotropic drugs; formally states the physician’s responsibility to obtain informed consent; defines informed consent to include drug dosage and risks; requires caretakers other than the parents to be informed about the medication; and sets limitations on the emergency use of psychotropic drugs with adolescents older than 16.

Injectable Risperdal Aids Compliance

Many patients with schizophrenia do not take their medication as prescribed. Researchers have been studying ways to improve compliance by providing long-acting relief. Data suggest that a long-acting, injectable formulation of risperidone (Risperdal/Janssen) provides consistently reliable symptom relief when administered as an intramuscular injection given every two weeks.

Non-steroidal Anti-inflammatory Drugs (NSAIDs): Hematologic problems

Blood dyscrasias related to non-steroidal anti-inflammatory drug (NSAID) therapy are clinically important, although rare. In the Danish study, one third of reported deaths associated with NSAIDs had hematologic causes. All blood cell lines can be affected, resulting in red cell aplasia, hemolytic anemia, agranulocytosis, thrombocytopenia, and aplastic anemia.

Eletriptan (Relpax) Most Effective Drug for Treating Migraine

New drug trials suggest that Pfizer’s drug Relpax (eletriptan) may be one of the most effective drugs for the treatment of migraine headaches. Researchers at Memorial University in St.

Psychotropic Drugs in Children: Side-Effects

The physician should inform the guardian of the most frequent expected side-effects and the likelihood of the most untoward effects (Tables 2-4). The discussion of benefits and risks should be noted in the patient record.

Proscar Reduces Need for Surgery

A four-year study confirms that finasteride (Proscar/Merck) reduces by half the need for surgery in men who are experiencing acute urinary retention. The study of 3,040 men showed that those taking the drug were 55% less likely to need prostate surgery; men who did not have acute urinary retention were 57% less likely to develop the condition than men who were not taking the drug. The drug “clearly alters the progression of BPH,” said Dr.

COX-2 Drugs Curb Ocular Herpes

The herpes simplex type 1 virus, which can reside in the body for decades, is responsible for more than 500,000 cases of ocular herpes each year. Ocular herpes is a common cause of corneal blindness.

Drugs Add Years of Life

Big gainer: persons with cardiovascular diseases. The good news for many Americans is that persons with diseases treatable by drugs, such as stomach ulcers and hypertension, are living longer. The death rate from these diseases has plunged thanks to the introduction of beta-blockers, proton pump inhibitors, and other drugs.

The Statins and the Heart

A new class of lipid-lowering agents is proving to be effective for preventing both first and second heart attacks in patients with hypercholesterolemia. These agents reduce cholesterol levels by inhibiting the activity of the hepatic enzyme 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase. Blocking this enzyme increases the hepatic production of cholesterol receptors, and these receptors, in turn, pull cholesterol out of the bloodstream.

Viadur: Drug for Prostate Cancer

This year, more than 180,000 new cases of prostate cancer will be diagnosed in the US. In patients with advanced prostate cancer, decreasing the production of the hormone testosterone often reduces prostate cancer growth and relieves symptoms, such as pain and problems urinating.

Nonsteroidal Anti-Inflammatory Drugs: Application to Clinical Practice

Results of this study provide strong evidence that topical nonsteroidal anti-inflammatory drugs work by mechanisms other than local massage, since this would have been provided by placebo as well. The consistency of the trials is striking, and the effect size of the pooled results is large.

Psychotropic Drugs in Children: Methylphenidate (Ritalin)

Prescribing Information for Methylphenidate (Ritalin).

Non-steroidal Anti-inflammatory Drugs (NSAIDs): Renal problems

Four types of renal problems can occur with non-steroidal anti-inflammatory drugs (NSAIDs). Acute renal dysfunction has been reported; it rarely progresses to tubular necrosis.

Arthrotec (Diclofenac and Misoprostol) for Inflammatory Rheumatic Diseases

Arthrotec is a new product that combines the NSAID diclofenac and the prostaglandin analog misoprostol. The diclofenac component of Arthrotec is responsible for the relief of the symptoms of arthritis.

Non-steroidal Anti-inflammatory Drugs (NSAIDs): Hepatotoxicity

Hepatotoxic effects range from asymptomatic elevations of serum transaminases and alkaline phosphatase to acute cytolytic, cholestatic, or mixed hepatitis. Reye’s syndrome may occur in children in association with acetylsalicylic acid (ASA) use and a viral illness.