Calcium Channel Blockers
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Migraine Prophylaxis: Which Drugs Work and Which Ones Don't
Migraine Prophylaxis: Which Drugs Work and Which Ones Don’t Hans-Christoph Diener, MD Department of Neurology, University Hospital Essen, Essen, Germany. J Gen Intern Med 28(9):1125–6 investigated in two properly powered and conducted studies DOI: 10.1007/s11606-013-2469-2 and found not to be effective compared to placebo.3, 4 Adding © Society of General Internal Medicine 2013 data from poorly controlled and underpowered studies in a meta-analysis, as in this paper, gives the wrong impression that he paper by Shamliyan et al.1 in this issue of JGIM is a very nimodipine is as effective in migraine prevention as propran- T important contribution to headache research. The authors olol. Another example illustrated in this meta-analysis involves conducted a systematic literature review of drug treatment for the gabapentin. Most of the published trials are poorly conducted, underpowered, or have manipulated statistical analyses, such as prevention of episodic migraine. They analysed randomised 5 controlled trials (RCTs) and performed meta-analyses where modified intention-to-treat analyses. The meta-analysis in this appropriate. The two important outcomes examined in the paper indicated possible efficacy. Yet, in the time between the analysis are a ≥ 50 % reduction in migraine frequency and submission and publication of this paper, a recent well-powered adverse events leading to treatment discontinuation. dose finding trial was published investigating four doses of gabapentin as compared with placebo for migraine prevention. 6 What are the strengths of this paper? This trial showed no benefit for gabapentin. Another problem inherent in meta-analyses that this paper The authors are experts in this kind of analysis. -
Investigating the Influence of Polymers on Supersaturated
Page 1 of 45 Molecular Pharmaceutics 1 2 3 4 5 6 7 Investigating the Influence of Polymers on 8 9 10 11 12 Supersaturated Flufenamic Acid Cocrystal Solutions 13 14 15 16 1 1 2 2 1 17 Minshan Guo , Ke Wang , Noel Hamill , Keith Lorimer and Mingzhong Li * 18 19 20 1School of pharmacy, De Montfort University, Leicester, UK 21 22 23 2Almac Science, Seagoe Industrial Estate, Craigavon, UK 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 ACS Paragon Plus Environment 1 Molecular Pharmaceutics Page 2 of 45 1 2 3 4 5 6 7 Table of contents graphic 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 ACS Paragon Plus Environment 2 Page 3 of 45 Molecular Pharmaceutics 1 2 3 Abstract 4 5 6 7 The development of enabling formulations is a key stage when demonstrating the effectiveness 8 9 10 of pharmaceutical cocrystals to maximize the oral bioavailability for poorly water soluble drugs. 11 12 Inhibition of drug crystallization from a supersaturated cocrystal solution through a fundamental 13 14 understanding of the nucleation and crystal growth is important. In this study, the influence of 15 16 17 the three polymers of polyethylene glycol (PEG), polyvinylpyrrolidone (PVP) and a copolymer 18 19 of N-vinly-2-pyrrodidone (60%) and vinyl acetate (40%) (PVP-VA) on the flufenamic acid 20 21 22 (FFA) crystallization from three different supersaturated solutions of the pure FFA and two 23 24 cocrystals of FFA-NIC CO and FFA-TP CO has been investigated by measuring nucleation 25 26 induction times and desupersaturation rates in the presence and absence of seed crystals. -
Optum Essential Health Benefits Enhanced Formulary PDL January
PENICILLINS ketorolac tromethamineQL GENERIC mefenamic acid amoxicillin/clavulanate potassium nabumetone amoxicillin/clavulanate potassium ER naproxen January 2016 ampicillin naproxen sodium ampicillin sodium naproxen sodium CR ESSENTIAL HEALTH BENEFITS ampicillin-sulbactam naproxen sodium ER ENHANCED PREFERRED DRUG LIST nafcillin sodium naproxen DR The Optum Preferred Drug List is a guide identifying oxacillin sodium oxaprozin preferred brand-name medicines within select penicillin G potassium piroxicam therapeutic categories. The Preferred Drug List may piperacillin sodium/ tazobactam sulindac not include all drugs covered by your prescription sodium tolmetin sodium drug benefit. Generic medicines are available within many of the therapeutic categories listed, in addition piperacillin sodium/tazobactam Fenoprofen Calcium sodium to categories not listed, and should be considered Meclofenamate Sodium piperacillin/tazobactam as the first line of prescribing. Tolmetin Sodium Amoxicillin/Clavulanate Potassium LOW COST GENERIC PREFERRED For benefit coverage or restrictions please check indomethacin your benefit plan document(s). This listing is revised Augmentin meloxicam periodically as new drugs and new prescribing LOW COST GENERIC naproxen kit information becomes available. It is recommended amoxicillin that you bring this list of medications when you or a dicloxacillin sodium CARDIOVASCULAR covered family member sees a physician or other penicillin v potassium ACE-INHIBITORS healthcare provider. GENERIC QUINOLONES captopril ANTI-INFECTIVES -
Neurontin (Gabapentin)
Texas Prior Authorization Program Clinical Criteria Drug/Drug Class Gabapentin Clinical Criteria Information Included in this Document Neurontin (gabapentin) • Drugs requiring prior authorization: the list of drugs requiring prior authorization for this clinical criteria • Prior authorization criteria logic: a description of how the prior authorization request will be evaluated against the clinical criteria rules • Logic diagram: a visual depiction of the clinical criteria logic • Supporting tables: a collection of information associated with the steps within the criteria (diagnosis codes, procedure codes, and therapy codes); provided when applicable • References: clinical publications and sources relevant to this clinical criteria Note: Click the hyperlink to navigate directly to that section. Gralise (gabapentin Extended Release) • Drugs requiring prior authorization: the list of drugs requiring prior authorization for this clinical criteria • Prior authorization criteria logic: a description of how the prior authorization request will be evaluated against the clinical criteria rules • Logic diagram: a visual depiction of the clinical criteria logic • Supporting tables: a collection of information associated with the steps within the criteria (diagnosis codes, procedure codes, and therapy codes); provided when applicable • References: clinical publications and sources relevant to this clinical criteria Note: Click the hyperlink to navigate directly to that section. March 29, 2019 Copyright © 2019 Health Information Designs, LLC 1 Horizant -
Selective Mtorc2 Inhibitor Therapeutically Blocks Breast Cancer Cell Growth and Survival
Author Manuscript Published OnlineFirst on January 22, 2018; DOI: 10.1158/0008-5472.CAN-17-2388 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. Selective mTORC2 inhibitor therapeutically blocks breast cancer cell growth and survival Thomas A. Werfel1, 3, Shan Wang2, Meredith A. Jackson1, Taylor E. Kavanaugh1, Meghan Morrison Joly3, Linus H. Lee1, Donna J. Hicks3, Violeta Sanchez4, Paula Gonzalez Ericsson4, Kameron V. Kilchrist1, Somtochukwu C. Dimobi1, Samantha M. Sarett1, Dana Brantley-Sieders2, Rebecca S. Cook1,3,4* and Craig L. Duvall1* 1Department of Biomedical Engineering, Vanderbilt University, Nashville, TN 37232 USA 2Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232.USA 3Department of Cell and Developmental Biology, Vanderbilt University School of Medicine, Nashville, TN 37232 USA 4Breast Cancer Research Program, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN 37232 USA Running Title: A selective mTORC2 inhibitor blocks breast cancer growth Key Words: Breast Cancer, mTOR, Rictor, RNA interference, Nanomedicine *To whom correspondence should be addressed: Craig L. Duvall, PhD Vanderbilt University School of Engineering Department of Biomedical Engineering Nashville, TN 37232 Phone: (615) 322-3598 Fax: (615) 343-7919 Email: [email protected] Rebecca S. Cook, PhD Vanderbilt University Medical Center Department of Cancer Biology Nashville, TN 37232 Phone: (615) 936-3813 Fax: (615) 936-3811 Email: [email protected] Funding. This work was supported by Specialized Program of Research Excellence (SPORE) grant NIH P50 CA098131 (VICC), Cancer Center Support grant NIH P30 CA68485 (VICC), NIH F31 CA195989-01 (MMW), NIH R01 EB019409, DOD CDMRP OR130302, NSF GFRP 1445197, and CTSA UL1TR000445 from the National Center for Advancing Translational Sciences. -
Angiotensin-Converting Enzyme (ACE) Inhibitors Single Entity Agents
Therapeutic Class Overview Angiotensin-Converting Enzyme (ACE) Inhibitors Single Entity Agents Therapeutic Class Overview/Summary: The renin-angiotensin-aldosterone system (RAAS) is the most important component in the homeostatic regulation of blood pressure.1,2 Excessive activity of the RAAS may lead to hypertension and disorders of fluid and electrolyte imbalance.3 Renin catalyzes the conversion of angiotensinogen to angiotensin I. Angiotensin I is then cleaved to angiotensin II by angiotensin- converting enzyme (ACE). Angiotensin II may also be generated through other pathways (angiotensin I convertase).1 Angiotensin II can increase blood pressure by direct vasoconstriction and through actions on the brain and autonomic nervous system.1,3 In addition, angiotensin II stimulates aldosterone synthesis from the adrenal cortex, leading to sodium and water reabsorption. Angiotensin II exerts other detrimental cardiovascular effects including ventricular hypertrophy, remodeling and myocyte apoptosis.1,2 The ACE inhibitors block the conversion of angiotensin I to angiotensin II, and also inhibit the breakdown of bradykinin, a potent vasodilator.4 Evidence-based guidelines recognize the important role that ACE inhibitors play in the treatment of hypertension and other cardiovascular and renal diseases. With the exception of Epaned® (enalapril solution) and Qbrelis® (lisinopril solution), all of the ACE inhibitors are available generically. Table 1. Current Medications Available in Therapeutic Class5-19 Generic Food and Drug Administration -
Association of Hypertensive Status and Its Drug Treatment with Lipid and Haemostatic Factors in Middle-Aged Men: the PRIME Study
Journal of Human Hypertension (2000) 14, 511–518 2000 Macmillan Publishers Ltd All rights reserved 0950-9240/00 $15.00 www.nature.com/jhh ORIGINAL ARTICLE Association of hypertensive status and its drug treatment with lipid and haemostatic factors in middle-aged men: the PRIME Study P Marques-Vidal1, M Montaye2, B Haas3, A Bingham4, A Evans5, I Juhan-Vague6, J Ferrie`res1, G Luc2, P Amouyel2, D Arveiler3, D McMaster5, JB Ruidavets1, J-M Bard2, PY Scarabin4 and P Ducimetie`re4 1INSERM U518, Faculte´ de Me´decine Purpan, Toulouse, France; 2MONICA-Lille, Institut Pasteur de Lille, Lille, France; 3MONICA-Strasbourg, Laboratoire d’Epide´miologie et de Sante´ Publique, Strasbourg, France; 4INSERM U258, Hoˆ pital Broussais, Paris, France; 5Belfast-MONICA, Department of Epidemiology, The Queen’s University of Belfast, UK; 6Laboratory of Haematology, La Timone Hospital, Marseille, France Aims: To assess the association of hypertensive status this effect remained after multivariate adjustment. Cal- and antihypertensive drug treatment with lipid and hae- cium channel blockers decreased total cholesterol and mostatic levels in middle-aged men. apoproteins A-I and B; those differences remained sig- Methods and results: Hypertensive status, antihyperten- nificant after multivariate adjustment. ACE inhibitors sive drug treatment, total and high-density lipoprotein decreased total cholesterol, triglycerides, apoprotein B (HDL) cholesterol, triglyceride, apoproteins A-I and B, and LpE:B; and this effect remained after multivariate lipoparticles LpA-I, -
Potentially Harmful Drugs in the Elderly: Beers List
−This Clinical Resource gives subscribers additional insight related to the Recommendations published in− March 2019 ~ Resource #350301 Potentially Harmful Drugs in the Elderly: Beers List In 1991, Dr. Mark Beers and colleagues published a methods paper describing the development of a consensus list of medicines considered to be inappropriate for long-term care facility residents.12 The “Beers list” is now in its sixth permutation.1 It is intended for use by clinicians in outpatient as well as inpatient settings (but not hospice or palliative care) to improve the care of patients 65 years of age and older.1 It includes medications that should generally be avoided in all elderly, used with caution, or used with caution or avoided in certain elderly.1 There is also a list of potentially harmful drug-drug interactions in seniors, as well as a list of medications that may need to be avoided or have their dosage reduced based on renal function.1 This information is not comprehensive; medications and interactions were chosen for inclusion based on potential harm in relation to benefit in the elderly, and availability of alternatives with a more favorable risk/benefit ratio.1 The criteria no longer address drugs to avoid in patients with seizures or insomnia because these concerns are not unique to the elderly.1 Another notable deletion is H2 blockers as a concern in dementia; evidence of cognitive impairment is weak, and long-term PPIs pose risks.1 Glimepiride has been added as a drug to avoid. Some drugs have been added with cautions (dextromethorphan/quinidine, trimethoprim/sulfamethoxazole), and some have had cautions added (rivaroxaban, tramadol, SNRIs). -
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role of CALCIUM CHANNEL BLOCKERS in HYPERTENSION KEY POINTS ThIAZIDES ARE APPROPRIATE INITIAL THERAPY FOR MOST PEOPLE WITH HYPERTENSION Thiazides are appropriate initial therapy for most ▪ There is limited evidence of superiority of one antihypertensive people with hypertension. over another but evidence suggests that for most patients, ▪ Choice of other antihypertensives is decided by diuretics can be considered first, based on their effectiveness, individual patient factors. safety and low cost. ▪ Factors which potentially favour use of calcium channel blockers include arrhythmia (verapamil CHOICE OF ADDITIONAL ANTIHYPERTENSIVES only), angina, older age and high risk of stroke. IS DECIDED BY INDIVIDUAL PATIENT FACTORS ▪ Factors which may weigh against the use of Other agents may be chosen for individual patients based calcium channel blockers include potential drug on concurrent medical conditions, patient tolerability and interactions, and diltiazem and verapamil are drug interactions. Indications for treatment with different contraindicated in heart block and heart failure. antihypertensive agents are discussed in BPJ 6 (June 2007). ▪ Choice between the different calcium channel blockers depends on patient tolerability, co- morbidity and drug interactions. FACTORS FOR AND AGAINST THE USE OF CALCIUM chANNEL BLOCKERS Factors that potentially favour the use of calcium channel Factors favouring use of calcium channel blockers include arrhythmia (verapamil only), angina, or high blockers: risk of stroke. Verapamil can also be used post myocardial infarction if beta blockers are contraindicated or not tolerated. ▪ Hypertension with co-morbid angina In addition, calcium channel blockers may be more suitable than other agents for elderly people and those of African ▪ Hypertension with co-morbid arrhythmia 1 (verapamil only) descent. -
Supplementary Materials
Supplementary Materials Table S1. The significant drug pairs in potential DDIs examined by the two databases. Micromedex Drugs.com List of drugs paired PK-PD Mechanism details 1. Amiodarone— PD Additive QT-interval prolongation Dronedarone 2. Amiodarone— PK CYP3A inhibition by Ketoconazole Ketoconazole 3. Ciprofloxacin— PD Additive QT-interval prolongation Dronedarone 4. Cyclosporine— PK CYP3A inhibition by Cyclosporine Dronedarone 5. Dronedarone— PK CYP3A inhibition by Erythromycin Erythromycin 6. Dronedarone— PD Additive QT-interval prolongation Flecainide 7. Dronedarone— PK CYP3A4 inhibition by Itraconazole Itraconazole 8. Dronedarone— PK Contraindication Major CYP3A inhibition by Ketoconazole Ketoconazole 9. Dronedarone— PD Additive QT-interval prolongation Procainamide PD 10. Dronedarone—Sotalol Additive QT-interval prolongation 11. Felodipine— PK CYP3A inhibition by Itraconazole Itraconazole 12. Felodipine— PK CYP3A inhibition by Ketoconazole Ketoconazole 13. Itraconazole— PK CYP3A inhibition by Itraconazole Nisoldipine 14. Ketoconazole— PK CYP3A inhibition by Ketoconazole Nisoldipine 15. Praziquantel— PK CYP induction by Rifampin Rifampin PD 1. Amikacin—Furosemide Additive or synergistic toxicity 2. Aminophylline— Decreased clearance of PK Ciprofloxacin Theophylline by Ciprofloxacin 3. Aminophylline— PK Decreased hepatic metabolism Mexiletine 4. Amiodarone— PD Additive effects on QT interval Ciprofloxacin 5. Amiodarone—Digoxin PK P-glycoprotein inhibition by Amiodarone 6. Amiodarone— PD, PK Major Major Additive effects on QT Erythromycin prolongation, CYP3A inhibition by Erythromycin 7. Amiodarone— PD, PK Flecainide Antiarrhythmic inhibition by Amiodarone, CYP2D inhibition by Amiodarone 8. Amiodarone— PK CYP3A inhibition by Itraconazole Itraconazole 9. Amiodarone— PD Antiarrhythmic inhibition by Procainamide Amiodarone 10. Amiodarone— PK CYP induction by Rifampin Rifampin PD Additive effects on refractory 11. Amiodarone—Sotalol potential 12. Amiodarone— PK CYP3A inhibition by Verapamil Verapamil 13. -
Effect of Amlodipine and Indomethacin in Electrical and Picrotoxin Induced Convulsions in Mice
DOI: 10.5958/2319-5886.2014.00402.0 International Journal of Medical Research & Health Sciences www.ijmrhs.com Volume 3 Issue 3 Coden: IJMRHS Copyright @2014 ISSN: 2319-5886 Received: 9th Apr 2014 Revised: 3rd Jun 2014 Accepted: 14th Jun 2014 Research Article EFFECT OF AMLODIPINE AND INDOMETHACIN IN ELECTRICAL AND PICROTOXIN INDUCED CONVULSIONS IN MICE *Jagathi Devi N1, Prasanna V2 1Assistant Professor, 2Professor and Head, Department of Pharmacology, Osmania Medical College, Hyderabad *Corresponding author email: [email protected] ABSTRACT Background and Objectives: Antiepileptic drugs (AEDs) are the drugs used in the treatment of epilepsy. Many AEDs have been developed, but the ideal AED which can not only prevent but also abolish seizures by correcting the underlying pathophysiology is still not in sight. Calcium channel blockers (CCBs) may form such a group, as the initiation of epileptogenic activity in the neuron is connected with a phenomenon known as “intrinsic burst firing” which is activated by inward calcium current. In this study, Amlodipine, a CCB of the dihydropyridine class was evaluated for its anticonvulsant activity in mice. It was compared with Phenytoin sodium, one of the oldest anti epileptic drugs. Amlodipine was also combined with Indomethacin, a conventional NSAID, to look for any potentiating effect of this prostaglandin-synthesis inhibitor. Materials and Methods: A total of 48 adult Swiss albino mice of either sex weighing 20-30 G were used for this study; 48 were divided into 8 groups, each group containing 6 mice. Group 1-4 MES (50 m Amp for 0.1 secs) induced convulsion method, Group 5-8 evaluated by using the chemo-convulsant, picrotoxin (0.7 mg / kg). -
Sharon R. Roseman, MD, FACP Practice Limited to Gastroenterology
Sharon R. Roseman, MD, FACP Practice Limited to Gastroenterology 701 Broad Street, Suite 411 Sewickley, PA 15143 (412) 749-7160 Fax: (412) 749-7388 http://www.heritagevalley.org/sharonrosemanmd Patient Drug Education for Diltiazem / Nifedipine Ointment Diltiazem/Nifedipine ointment is used to help heal anal fissures. The ointment relaxes the smooth muscle around the anus and promotes blood flow which helps heal the fissure (tear). The ointment reduces anal canal pressure, which diminishes pain and spasm. We use a diluted concentration of Diltiazem/Nifedipine compared to what is typically used for heart patients, and this is why you need to obtain the medication from a pharmacy which will compound your prescription. It is also prescribed to treat anal sphincter spasm, painful hemorrhoids and pelvic floor spasm. The Diltiazem/Nifedipine ointment should be applied 3 times per day, or as directed. A pea-sized drop should be placed on the tip of your finger and then gently placed inside the anus. The finger should be inserted 1/3 – 1/2 its length and may be covered with a plastic glove or finger cot. You may use Vaseline ® to help coat the finger or dilute the ointment. (If you are unable or hesitant to use your finger to administer the ointment TELL U S and we will order you a suppository to use as an “applicator”.) If you are advised to mix the Diltiazem/Nifedipine with steroid ointment, limit the steroids to one to two weeks. The first few applications should be taken lying down, as mild light- headedness or a brief headache may occur.