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Metamizol Suicide - Lethal Outcome Despite Maximum Therapy
Toxichem Krimtech 2012;79(2):71 Report from the Clinical Toxicology Committee of the Society of Toxicological and Forensic Chemistry (GTFCh) Metamizol Suicide - Lethal Outcome Despite Maximum Therapy Detlef Haase, Sabine Hübner, Silke Kunellis, Gerlinde Kotzerke, Harald König Helios Hospital Schwerin, Institute for Laboratory and Transfusion Medicine, Toxicology Department, Wismarsche Straße 393-397, D-19049 Schwerin, Germany Abstract A 70 year old female patient, suffering for years from rheumatoid arthritis and associated chronic pain was referred to the hospital by an emergency physician. Her blood pressure was no longer measurable; a hemiparesis has developed. A preliminary examination was carried out in the emergency department by a neurologist and a cerebral CT was requested. Immediately after examination, the patient suffered from hypodynamic cardiac arrest and had to be cardiopulmonary resuscitated. After stabilisation she was transferred to the Stroke Unit, where tonic-clonic convulsive seizures occurred. Toxicological general-unknown analysis of the patient's serum confirmed a suspected metamizol intoxication. Despite a maximum permissible dose of noradrenaline, she died four days after hospitalisation due to multiple organ failure. 1. Introduction 1.1. Metamizol Metamizol (novaminsulfone), closely related to phenazone and propyphenazone, is the most powerful analgesic and antipyretic of the pyrazolone derivatives and still on the market. 4-N- methyl-aminoantipyrine (MAA) is also effective, but formed through metamizol hydrolysis in the body. Patients with glucose-6-dehydrogenase deficiency should never use metamizol, be- cause a haemolytic crisis could be triggered. In addition, metamizol has a considerable poten- tial for side-effects, of which agranulocytosis is the most significant [1]. Therefore, metamizol is no more licensed in many countries. -
Universitätsspital Balgrist, Zürich Chiropraktische Medizin Kommissarischer Leiter: Prof
Universitätsspital Balgrist, Zürich Chiropraktische Medizin Kommissarischer Leiter: Prof. Dr. Armin Curt, MD, FRCPC Betreuung der Masterarbeit: Dr. Brigitte Wirth, PT, PhD Leitung der Masterarbeit: Prof. em. Dr. Barry Kim Humphreys, BSc, DC, PhD A SYSTEMATIC REVIEW ON QUANTIFIABLE PHYSICAL RISK FACTORS FOR NON-SPECIFIC ADOLESCENT LOW BACK PAIN MASTERARBEIT zur Erlangung des akademischen Grades Master in Chiropraktischer Medizin (M Chiro Med) der Medizinischen Fakultät der Universität Zürich vorgelegt von Tobias Potthoff (09-712-712) 2017 Table of Content 1. Scientific Accompanying Text .......................................................................................................... 3 2. Abstract ......................................................................................................................................... 13 3. Introduction ................................................................................................................................... 14 4. Methods ........................................................................................................................................ 15 a. Search strategy .......................................................................................................................... 15 b. Inclusion criteria ........................................................................................................................ 15 c. Study selection ......................................................................................................................... -
Injuries and Affections of the Spine ศ.นพ.พิบูลย์ อิทธิระวิวงศ์ ภาควิชาออร์โธปิดิกส์ I
Injuries and Affections of the Spine ศ.นพ.พิบูลย์ อิทธิระวิวงศ์ ภาควิชาออร์โธปิดิกส์ I. Injuries of the spine and thorax :- Classification 1. Major fractures and displacements of the cervical spine - Wedge compression fracture of vertebral body - Burst fracture of vertebral body - Extension subluxation - Flexion subluxation - Dislocation and fracture-dislocation - Fracture of the aieas - Fracture-dislocation of atlanto-axial joint - Intra-spinal displacements of soft tissue 2. Major fractures and displacements of the thoracic and lumbar vertebrae - Wedge compression fracture of vertebral body - Burst fracture of vertebral body - Dislocation and fracture-dislocation 3. Paraplegia from spinal injuries 4. Minor fractures of the spinal column - Fracture of transverse processes - Fracture of spinous processes - Fracture of the sacrum - Fracture of the coccyx 5. Fractures of the thoracic case - Fracture of the ribs - Fracture of the sternum II. Orthopaedic disorders of the spine Disorders Neck and cervical spine Trunk and spine (T,L,S) Congenital - Lumbar and sacral variations, abnormalities Hemivertebra. Spina bifida. Deformities Infantile torticollis Scoliosis. Congenital short neck Kyphosis. Congenital high spcapula Lordosis. Infections of bone Tuberculosis of C-spine Tuberculosis of T or L-spine Pyogenic infection of C- Pyogenic infection of T of L-spine. spine Arthritis of the spinal Ankylosing spondylitis Rheumatoid arthritis Osteoarthritis joints Cervical spondylosis Ankylosing spondylitis Osteochondritis - Scheuermann’s disease Calve’s -
Evicore Spine Imaging Guidelines
CLINICAL GUIDELINES Spine Imaging Policy Version 1.0 Effective February 14, 2020 eviCore healthcare Clinical Decision Support Tool Diagnostic Strategies: This tool addresses common symptoms and symptom complexes. Imaging requests for individuals with atypical symptoms or clinical presentations that are not specifically addressed will require physician review. Consultation with the referring physician, specialist and/or individual’s Primary Care Physician (PCP) may provide additional insight. CPT® (Current Procedural Terminology) is a registered trademark of the American Medical Association (AMA). CPT® five digit codes, nomenclature and other data are copyright 2017 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in the CPT® book. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for the data contained herein or not contained herein. © 2019 eviCore healthcare. All rights reserved. Spine Imaging Guidelines V1.0 Spine Imaging Guidelines Procedure Codes Associated with Spine Imaging 3 SP-1: General Guidelines 5 SP-2: Imaging Techniques 14 SP-3: Neck (Cervical Spine) Pain Without/With Neurological Features (Including Stenosis) and Trauma 22 SP-4: Upper Back (Thoracic Spine) Pain Without/With Neurological Features (Including Stenosis) and Trauma 26 SP-5: Low Back (Lumbar Spine) Pain/Coccydynia without Neurological Features 28 SP-6: Lower Extremity Pain with Neurological Features (Radiculopathy, Radiculitis, or Plexopathy and Neuropathy) With or Without Low Back (Lumbar Spine) Pain 32 SP-7: Myelopathy 36 SP-8: Lumbar Spine Spondylolysis/Spondylolisthesis 39 SP-9: Lumbar Spinal Stenosis 42 SP-10: Sacro-Iliac (SI) Joint Pain, Inflammatory Spondylitis/Sacroiliitis and Fibromyalgia 44 SP-11: Pathological Spinal Compression Fractures 47 SP-12: Spinal Pain in Cancer Patients 49 SP-13: Spinal Canal/Cord Disorders (e.g. -
(12) United States Patent (10) Patent No.: US 9,498,481 B2 Rao Et Al
USOO9498481 B2 (12) United States Patent (10) Patent No.: US 9,498,481 B2 Rao et al. (45) Date of Patent: *Nov. 22, 2016 (54) CYCLOPROPYL MODULATORS OF P2Y12 WO WO95/26325 10, 1995 RECEPTOR WO WO99/O5142 2, 1999 WO WOOO/34283 6, 2000 WO WO O1/92262 12/2001 (71) Applicant: Apharaceuticals. Inc., La WO WO O1/922.63 12/2001 olla, CA (US) WO WO 2011/O17108 2, 2011 (72) Inventors: Tadimeti Rao, San Diego, CA (US); Chengzhi Zhang, San Diego, CA (US) OTHER PUBLICATIONS Drugs of the Future 32(10), 845-853 (2007).* (73) Assignee: Auspex Pharmaceuticals, Inc., LaJolla, Tantry et al. in Expert Opin. Invest. Drugs (2007) 16(2):225-229.* CA (US) Wallentin et al. in the New England Journal of Medicine, 361 (11), 1045-1057 (2009).* (*) Notice: Subject to any disclaimer, the term of this Husted et al. in The European Heart Journal 27, 1038-1047 (2006).* patent is extended or adjusted under 35 Auspex in www.businesswire.com/news/home/20081023005201/ U.S.C. 154(b) by Od en/Auspex-Pharmaceuticals-Announces-Positive-Results-Clinical M YW- (b) by ayS. Study (published: Oct. 23, 2008).* This patent is Subject to a terminal dis- Concert In www.concertpharma. com/news/ claimer ConcertPresentsPreclinicalResultsNAMS.htm (published: Sep. 25. 2008).* Concert2 in Expert Rev. Anti Infect. Ther. 6(6), 782 (2008).* (21) Appl. No.: 14/977,056 Springthorpe et al. in Bioorganic & Medicinal Chemistry Letters 17. 6013-6018 (2007).* (22) Filed: Dec. 21, 2015 Leis et al. in Current Organic Chemistry 2, 131-144 (1998).* Angiolillo et al., Pharmacology of emerging novel platelet inhibi (65) Prior Publication Data tors, American Heart Journal, 2008, 156(2) Supp. -
Specifications of Approved Drug Compound Library
Annexure-I : Specifications of Approved drug compound library The compounds should be structurally diverse, medicinally active, and cell permeable Compounds should have rich documentation with structure, Target, Activity and IC50 should be known Compounds which are supplied should have been validated by NMR and HPLC to ensure high purity Each compound should be supplied as 10mM solution in DMSO and at least 100µl of each compound should be supplied. Compounds should be supplied in screw capped vial arranged as 96 well plate format. -
Use of Aspirin and Nsaids to Prevent Colorectal Cancer
Evidence Synthesis Number 45 Use of Aspirin and NSAIDs to Prevent Colorectal Cancer Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, MD 20850 www.ahrq.gov Contract No. 290-02-0021 Prepared by: University of Ottawa Evidence-based Practice Center at The University of Ottawa, Ottawa Canada David Moher, PhD Director Investigators Alaa Rostom, MD, MSc, FRCPC Catherine Dube, MD, MSc, FRCPC Gabriela Lewin, MD Alexander Tsertsvadze, MD Msc Nicholas Barrowman, PhD Catherine Code, MD, FRCPC Margaret Sampson, MILS David Moher, PhD AHRQ Publication No. 07-0596-EF-1 March 2007 This report is based on research conducted by the University of Ottawa Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-02-0021). Funding was provided by the Centers for Disease Control and Prevention. The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services. The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment. This document is in the public domain and may be used and reprinted without permission except those copyrighted materials noted for which further reproduction is prohibited without the specific permission of copyright holders. -
Lumiracoxib: Suspension of UK Licences with Immediate Effect (Non
Primary and Community Care Directorate Pharmacy Division T: 0131-244 2528 F: 0131-244 2375 E: [email protected] abcdefghijklmnopqrstu 19 November 2007 ___ 1. Medical Directors NHS Boards 2. Directors of Public Health 3. Specialists in Pharmaceutical Public Health/Directors of Pharmacy 4. NHS 24 LUMIRACOXIB – SUSPENSION OF UK LICENCES WITH IMMEDIATE EFFECT (NON URGENT ) CASCADE WITHIN 48 HOURS Please see attached for onward transmission a copy of a message from Professor Gordon Duff, Chairman, Commission on Human Medicines about the suspension of UK licences (marketing authorisations) due to the risk of severe liver reactions associated with lumiracoxib. Please could Medical Directors in NHS Boards forward on to :- ● All General Practitioners - please ensure this message is seen by all practice nurses and non principals working in your practice and retain a copy in your ‘locum information pack’. ● Deptutising services Please could all Directors of Public Health forward the message to: ● Chief Executives NHS Boards Specialists in Pharmaceutical Public Health/Directors of Pharmacy will also receive this information through the usual drug alert channels to forward on to community pharmacists. Yours sincerely PAMELA WARRINGTON Deputy Chief Pharmaceutical Officer St Andrew’s House, Regent Road, Edinburgh EH1 3DG www.scotland.gov.uk abcde abc a Ref: EL(07)A/21 LUMIRACOXIB - SUSPENSION OF UK LICENCES WITH IMMEDIATE EFFECT 19 November 2007 Dear Colleague, I am writing to inform you that the UK licences (marketing authorisations) for lumiracoxib have been suspended and stocks are being withdrawn from pharmacies, on the basis of advice from the Commission on Human Medicines (CHM). -
Nsaids: Dare to Compare 1997
NSAIDs TheRxFiles DARE TO COMPARE Produced by the Community Drug Utilization Program, a Saskatoon District Health/St. Paul's Hospital program July 1997 funded by Saskatchewan Health. For more information check v our website www.sdh.sk.ca/RxFiles or, contact Loren Regier C/O Pharmacy Department, Saskatoon City Hospital, 701 Queen St. Saskatoon, SK S7K 0M7, Ph (306)655-8506, Fax (306)655-8804; Email [email protected] We have come a long way from the days of willow Highlights bark. Today salicylates and non-steroidal anti- • All NSAIDs have similar efficacy and side inflammatory drugs (NSAIDs) comprise one of the effect profiles largest and most commonly prescribed groups of • In low risk patients, Ibuprofen and naproxen drugs worldwide.1 In Saskatchewan, over 20 may be first choice agents because they are different agents are available, accounting for more effective, well tolerated and inexpensive than 300,000 prescriptions and over $7 million in • Acetaminophen is the recommended first line sales each year (Saskatchewan Health-Drug Plan agent for osteoarthritis data 1996). Despite the wide selection, NSAIDs • are more alike than different. Although they do Misoprostol is the only approved agent for differ in chemical structure, pharmacokinetics, and prophylaxis of NSAID-induced ulcers and is to some degree pharmacodynamics, they share recommended in high risk patients if NSAIDS similar mechanisms of action, efficacy, and adverse cannot be avoided. effects. week or more to become established. For this EFFICACY reason, an adequate trial of 1-2 weeks should be NSAIDs work by inhibiting cyclooxygenase (COX) allowed before increasing the dose or changing to and subsequent prostaglandin synthesis as well as another NSAID. -
Efficacy of Etoricoxib, Celecoxib, Lumiracoxib, Non-Selective Nsaids, and Acetaminophen in Osteoarthritis: a Mixed Treatment Comparison W.B
6 The Open Rheumatology Journal, 2012, 6, 6-20 Open Access Efficacy of Etoricoxib, Celecoxib, Lumiracoxib, Non-Selective NSAIDs, and Acetaminophen in Osteoarthritis: A Mixed Treatment Comparison W.B. Stam1, J.P. Jansen2 and S.D. Taylor*,3 1Mapi Group, Houten, The Netherlands 2Mapi Group, Boston, MA, USA 3Merck & Co., Inc., Whitehouse Station, NJ, USA Abstract: Objective: To compare the efficacy of etoricoxib, lumiracoxib, celecoxib, non-selective (ns) NSAIDs and acetaminophen in the treatment of osteoarthritis (OA) Methods: Randomized placebo controlled trials investigating the effects of acetaminophen 4000mg, diclofenac 150mg, naproxen 1000mg, ibuprofen 2400mg, celecoxib 100-400mg, lumiracoxib 100-400mg, and etoricoxib 30-60mg with treatment duration of at least two weeks were identified with a systematic literature search. The endpoints of interest were pain, physical function and patient global assessment of disease status (PGADS). Pain and physical function reported on different scales (VAS or LIKERT) were translated into effect sizes (ES). An ES 0.2 - 0.5 was defined as a “small” treatment effect, whereas ES of 0.5 – 0.8 and > 0.8 were defined as “moderate” and “large”, respectively. A negative effect indicated superior effects of the treatment group compared to the control group. Results of all trials were analyzed simultaneously with a Bayesian mixed treatment comparison. Results: There is a >95% probability that etoricoxib (30 or 60mg) shows the greatest improvement in pain and physical function of all interventions compared. ESs of etoricoxib 30mg relative to placebo, celecoxib 200mg, ibuprofen 2400mg, and diclofenac 150mg were -0.66 (95% Credible Interval -0.83; -0.49), -0.32 (-0.50; -0.14), -0.25 (-0.53; 0.03), and -0.17 (-0.41; 0.08), respectively. -
Non-Steroidal Anti-Inflammatory Drugs for Chronic Low Back Pain (Review)
Cochrane Database of Systematic Reviews Non-steroidal anti-inflammatory drugs for chronic low back pain (Review) Enthoven WTM, Roelofs PDDM, Deyo RA, van Tulder MW, Koes BW Enthoven WTM, Roelofs PDDM, Deyo RA, van Tulder MW, Koes BW. Non-steroidal anti-inflammatory drugs for chronic low back pain. Cochrane Database of Systematic Reviews 2016, Issue 2. Art. No.: CD012087. DOI: 10.1002/14651858.CD012087. www.cochranelibrary.com Non-steroidal anti-inflammatory drugs for chronic low back pain (Review) Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. TABLE OF CONTENTS HEADER....................................... 1 ABSTRACT ...................................... 1 PLAINLANGUAGESUMMARY . 2 SUMMARY OF FINDINGS FOR THE MAIN COMPARISON . ..... 4 BACKGROUND .................................... 7 OBJECTIVES ..................................... 7 METHODS ...................................... 7 RESULTS....................................... 9 Figure1. ..................................... 10 Figure2. ..................................... 12 Figure3. ..................................... 13 Figure4. ..................................... 14 Figure5. ..................................... 15 Figure6. ..................................... 16 DISCUSSION ..................................... 17 AUTHORS’CONCLUSIONS . 19 ACKNOWLEDGEMENTS . 19 REFERENCES ..................................... 20 CHARACTERISTICSOFSTUDIES . 23 DATAANDANALYSES. 43 Analysis 1.1. Comparison 1 NSAIDs versus placebo, Outcome 1 Change in pain intensity -
Stems for Nonproprietary Drug Names
USAN STEM LIST STEM DEFINITION EXAMPLES -abine (see -arabine, -citabine) -ac anti-inflammatory agents (acetic acid derivatives) bromfenac dexpemedolac -acetam (see -racetam) -adol or analgesics (mixed opiate receptor agonists/ tazadolene -adol- antagonists) spiradolene levonantradol -adox antibacterials (quinoline dioxide derivatives) carbadox -afenone antiarrhythmics (propafenone derivatives) alprafenone diprafenonex -afil PDE5 inhibitors tadalafil -aj- antiarrhythmics (ajmaline derivatives) lorajmine -aldrate antacid aluminum salts magaldrate -algron alpha1 - and alpha2 - adrenoreceptor agonists dabuzalgron -alol combined alpha and beta blockers labetalol medroxalol -amidis antimyloidotics tafamidis -amivir (see -vir) -ampa ionotropic non-NMDA glutamate receptors (AMPA and/or KA receptors) subgroup: -ampanel antagonists becampanel -ampator modulators forampator -anib angiogenesis inhibitors pegaptanib cediranib 1 subgroup: -siranib siRNA bevasiranib -andr- androgens nandrolone -anserin serotonin 5-HT2 receptor antagonists altanserin tropanserin adatanserin -antel anthelmintics (undefined group) carbantel subgroup: -quantel 2-deoxoparaherquamide A derivatives derquantel -antrone antineoplastics; anthraquinone derivatives pixantrone -apsel P-selectin antagonists torapsel -arabine antineoplastics (arabinofuranosyl derivatives) fazarabine fludarabine aril-, -aril, -aril- antiviral (arildone derivatives) pleconaril arildone fosarilate -arit antirheumatics (lobenzarit type) lobenzarit clobuzarit -arol anticoagulants (dicumarol type) dicumarol