Pharmacology/Therapeutics II Block I Lectures – 2013‐14
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Mapping the Dissociated Body
Lesley University DigitalCommons@Lesley Graduate School of Arts and Social Sciences Expressive Therapies Capstone Theses (GSASS) Spring 5-16-2020 Mapping the Dissociated Body Elizabeth Hough [email protected] Follow this and additional works at: https://digitalcommons.lesley.edu/expressive_theses Part of the Social and Behavioral Sciences Commons Recommended Citation Hough, Elizabeth, "Mapping the Dissociated Body" (2020). Expressive Therapies Capstone Theses. 239. https://digitalcommons.lesley.edu/expressive_theses/239 This Thesis is brought to you for free and open access by the Graduate School of Arts and Social Sciences (GSASS) at DigitalCommons@Lesley. It has been accepted for inclusion in Expressive Therapies Capstone Theses by an authorized administrator of DigitalCommons@Lesley. For more information, please contact [email protected], [email protected]. Running Head: MAPPING THE DISSOCIATED BODY 1 Mapping the Dissociated Body Elizabeth Hough Lesley University Running Head: MAPPING THE DISSOCIATED BODY 2 Abstract This capstone thesis explored the use of body mapping and body scans as a tool for assessing and tracking somatic dissociation and embodiment. The researcher utilized a client- centered approach and mindfulness-based interventions and theory to ground the work with the clients. While there were a variety of questionnaire-based tools for assessing dissociation with clients, many of them were lacking in the somatic component of dissociation. The available assessments were also exclusively self-reported and written or verbal, which had the potential to result in biased reporting. Clients may have also struggled to identify their level of somatic dissociation due to an inherent disconnection or dismissal of their somatic experience. This research described two case studies in which body scans and body mapping were utilized as a method to assess and track the client’s level of body dissociation and embodiment. -
MASCC/ESMO ANTIEMETIC GUIDELINE 2016 with Updates in 2019
1 ANTIEMETIC GUIDELINES: MASCC/ESMO MASCC/ESMO ANTIEMETIC GUIDELINE 2016 With Updates in 2019 Organizing and Overall Meeting Chairs: Matti Aapro, MD Richard J. Gralla, MD Jørn Herrstedt, MD, DMSci Alex Molassiotis, RN, PhD Fausto Roila, MD © Multinational Association of Supportive Care in CancerTM All rights reserved worldwide. 2 ANTIEMETIC GUIDELINES: MASCC/ESMO These slides are provided to all by the Multinational Association of Supportive Care in Cancer and can be used freely, provided no changes are made and the MASCC and ESMO logos, as well as date of the information are retained. For questions please contact: Matti Aapro at [email protected] Chair, MASCC Antiemetic Study Group or Alex Molassiotis at [email protected] Past Chair, MASCC Antiemetic Study Group 3 ANTIEMETIC GUIDELINES: MASCC/ESMO Consensus A few comments on this guideline set: • This set of guideline slides represents the latest edition of the guideline process. • This set of slides has been endorsed by the MASCC Antiemetic Guideline Committee and ESMO Guideline Committee. • The guidelines are based on the votes of the panel at the Copenhagen Consensus Conference on Antiemetic Therapy, June 2015. • Latest version: March 2016, with updates in 2019. 4 ANTIEMETIC GUIDELINES: MASCC/ESMO Changes: The Steering Committee has clarified some points: 2016: • A footnote clarified that aprepitant 165 mg is approved by regulatory authorities in some parts of the world ( although no randomised clinical trial has investigated this dose ). Thus use of aprepitant 80 mg in the delayed phase is only for those cases where aprepitant 125 mg is used on day 1. • A probable modification in pediatric guidelines based on the recent Cochrane meta-analysis is indicated. -
Clinical Practice Guideline for Emergency Department Ketamine Dissociative Sedation: 2011 Update
PAIN MANAGEMENT/CONCEPTS Clinical Practice Guideline for Emergency Department Ketamine Dissociative Sedation: 2011 Update Steven M. Green, MD, Mark G. Roback, MD, Robert M. Kennedy, MD, Baruch Krauss, MD, EdM From the Department of Emergency Medicine, Loma Linda University Medical Center and Children’s Hospital, Loma Linda, CA (Green); the Department of Pediatrics, University of Minnesota, Minneapolis, MN (Roback); the Division of Emergency Medicine, St. Louis Children’s Hospital, Washington University, St. Louis, MO (Kennedy); and the Division of Emergency Medicine, Children’s Hospital Boston and Department of Pediatrics, Harvard Medical School, Boston, MA (Krauss). We update an evidence-based clinical practice guideline for the administration of the dissociative agent ketamine for emergency department procedural sedation and analgesia. Substantial new research warrants revision of the widely disseminated 2004 guideline, particularly with respect to contraindications, age recommendations, potential neurotoxicity, and the role of coadministered anticholinergics and benzodiazepines. We critically discuss indications, contraindications, personnel requirements, monitoring, dosing, coadministered medications, recovery issues, and future research questions for ketamine dissociative sedation. [Ann Emerg Med. 2011;xx:xxx.] 0196-0644/$-see front matter Copyright © 2011 by the American College of Emergency Physicians. doi:10.1016/j.annemergmed.2010.11.030 INTRODUCTION thalamocortical and limbic systems, effectively dissociating the The dissociative -
Cysteinyl Leukotriene Receptor 1/2 Antagonists Nonselectively Modulate Organic Anion Transport by Multidrug Resistance Proteins (MRP1-4) S
Supplemental material to this article can be found at: http://dmd.aspetjournals.org/content/suppl/2016/04/11/dmd.116.069468.DC1 1521-009X/44/6/857–866$25.00 http://dx.doi.org/10.1124/dmd.116.069468 DRUG METABOLISM AND DISPOSITION Drug Metab Dispos 44:857–866, June 2016 Copyright ª 2016 by The American Society for Pharmacology and Experimental Therapeutics Cysteinyl Leukotriene Receptor 1/2 Antagonists Nonselectively Modulate Organic Anion Transport by Multidrug Resistance Proteins (MRP1-4) s Mark A. Csandl, Gwenaëlle Conseil, and Susan P. C. Cole Departments of Biomedical and Molecular Sciences (M.A.C., S.P.C.C.), and Pathology and Molecular Medicine (G.C., S.P.C.C.), Division of Cancer Biology and Genetics, Queen’s University Cancer Research Institute, Kingston, ON, Canada Received January 13, 2016; accepted April 7, 2016 ABSTRACT Active efflux of both drugs and organic anion metabolites is class of antagonists showed any MRP selectivity. For E217bG Downloaded from mediated by the multidrug resistance proteins (MRPs). MRP1 uptake, LTM IC50s ranged from 1.2 to 26.9 mMandweremost (ABCC1), MRP2 (ABCC2), MRP3 (ABCC3), and MRP4 (ABCC4) have comparable for MRP1 and MRP4. The LTM rank order inhibitory partially overlapping substrate specificities and all transport 17b- potencies for E217bGversusLTC4 uptake by MRP1, and E217bG estradiol 17-(b-D-glucuronide) (E217bG). The cysteinyl leukotriene versus PGE2 uptake by MRP4, were also similar. Three of four receptor 1 (CysLT1R) antagonist MK-571 inhibits all four MRP CysLT1R-selective LTMs also stimulated MRP2 (but not MRP3) homologs, but little is known about the modulatory effects of newer transport and thus exerted a concentration-dependent biphasic leukotriene modifiers (LTMs). -
Antiemetics/Antivertigo Agents
Antiemetic Agents Therapeutic Class Review (TCR) May 1, 2019 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, digital scanning, or via any information storage or retrieval system without the express written consent of Magellan Rx Management. All requests for permission should be mailed to: Magellan Rx Management Attention: Legal Department 6950 Columbia Gateway Drive Columbia, Maryland 21046 The materials contained herein represent the opinions of the collective authors and editors and should not be construed to be the official representation of any professional organization or group, any state Pharmacy and Therapeutics committee, any state Medicaid Agency, or any other clinical committee. This material is not intended to be relied upon as medical advice for specific medical cases and nothing contained herein should be relied upon by any patient, medical professional or layperson seeking information about a specific course of treatment for a specific medical condition. All readers of this material are responsible for independently obtaining medical advice and guidance from their own physician and/or other medical professional in regard to the best course of treatment for their specific medical condition. This publication, inclusive of all forms contained herein, is intended to be educational in nature and is intended to be used for informational purposes only. Send comments and suggestions to [email protected]. May 2019 Proprietary Information. Restricted Access – Do not disseminate or copy without approval. © 2004-2019 Magellan Rx Management. All Rights Reserved. 3 FDA-APPROVED INDICATIONS Drug Manufacturer Indication(s) NK1 receptor antagonists aprepitant capsules generic, Merck In combination with other antiemetic agents for: (Emend®)1 . -
The 5-HT6 Receptor Antagonist SB-271046 Selectively Enhances Excitatory Neurotransmission in the Rat Frontal Cortex and Hippocampus Lee A
The 5-HT6 Receptor Antagonist SB-271046 Selectively Enhances Excitatory Neurotransmission in the Rat Frontal Cortex and Hippocampus Lee A. Dawson, Ph.D., Huy Q. Nguyen, B.S., and Ping Li, B.S. Preclinical evidence has suggested a possible role for the 5-HT6 increases in extracellular glutamate levels in both frontal receptor in the treatment of cognitive dysfunction. However, cortex and dorsal hippocampus, respectively. These effects were currently there is little neurochemical evidence suggesting the completely attenuated by infusion of tetrodotoxin but mechanism(s) which may be involved. Using the selective unaffected by the muscarinic antagonist, atropine. Here we 5-HT6 antagonist SB-271046 and in vivo microdialysis, we demonstrate for the first time the selective enhancement of have evaluated the effects of this compound on the modulation excitatory neurotransmission by SB-271046 in those brain of basal neurotransmitter release within multiple brain regions regions implicated in cognitive and memory function, and of the freely moving rat. SB-271046 produced no change in provide mechanistic evidence in support of a possible basal levels of dopamine (DA), norepinephrine (NE) or 5-HT therapeutic role for 5-HT6 receptor antagonists in the in the striatum, frontal cortex, dorsal hippocampus or nucleus treatment of cognitive and memory dysfunction. accumbens. Similarly, this compound had no effect on [Neuropsychopharmacology 25:662–668, 2001] excitatory neurotransmission in the striatum or nucleus © 2001 American College of Neuropsychopharmacology. accumbens. Conversely, SB-271046 produced 3- and 2-fold Published by Elsevier Science Inc. KEY WORDS: 5-HT6 receptor; SB-271046; Microdialysis; sma et al. 1993; Ruat et al. -
Revised Use-Function Classification (2007)
INTERNATIONAL PROGRAMME ON CHEMICAL SAFETY IPCS INTOX Data Management System (INTOX DMS) Revised Use-Function Classification (2007) The Use-Function Classification is used in two places in the INTOX Data Management System: the Communication Record and the Agent/Product Record. The two records are linked: if there is an agent record for a Centre Agent that is the subject of a call, the appropriate Intended Use-Function can be selected automatically in the Communication Record. The Use-Function Classification is used when generating reports, both standard and customized, and for searching the case and agent databases. In particular, INTOX standard reports use the top level headings of the Intended Use-Functions that were selected for Centre Agents in the Communication Record (e.g. if an agent was classified as an Analgesic for Human Use in the Communication Record, it would be logged as a Pharmaceutical for Human Use in the report). The Use-Function classification is very important for ensuring harmonized data collection. In version 4.4 of the software, 5 new additions were made to the top levels of the classification provided with the system for the classification of organisms (items XIV to XVIII). This is a 'convenience' classification to facilitate searching of the Communications database. A taxonomic classification for organisms is provided within the INTOX DMS Agent Explorer. In May/June 2006 INTOX users were surveyed to find out whether they had made any changes to the Use-Function Classification. These changes were then discussed at the 4th and 5th Meetings of INTOX Users. Version 4.5 of the INTOX DMS includes the revised pesticides classification (shown in full below). -
Drugs to Avoid in Patients with Dementia
Detail-Document #240510 -This Detail-Document accompanies the related article published in- PHARMACIST’S LETTER / PRESCRIBER’S LETTER May 2008 ~ Volume 24 ~ Number 240510 Drugs To Avoid in Patients with Dementia Elderly people with dementia often tolerate drugs less favorably than healthy older adults. Reasons include increased sensitivity to certain side effects, difficulty with adhering to drug regimens, and decreased ability to recognize and report adverse events. Elderly adults with dementia are also more prone than healthy older persons to develop drug-induced cognitive impairment.1 Medications with strong anticholinergic (AC) side effects, such as sedating antihistamines, are well- known for causing acute cognitive impairment in people with dementia.1-3 Anticholinergic-like effects, such as urinary retention and dry mouth, have also been identified in drugs not typically associated with major AC side effects (e.g., narcotics, benzodiazepines).3 These drugs are also important causes of acute confusional states. Factors that may determine whether a patient will develop cognitive impairment when exposed to ACs include: 1) total AC load (determined by number of AC drugs and dose of agents utilized), 2) baseline cognitive function, and 3) individual patient pharmacodynamic and pharmacokinetic features (e.g., renal/hepatic function).1 Evidence suggests that impairment of cholinergic transmission plays a key role in the development of Alzheimer’s dementia. Thus, the development of the cholinesterase inhibitors (CIs). When used appropriately, the CIs (donepezil [Aricept], rivastigmine [Exelon], and galantamine [Razadyne, Reminyl in Canada]) may slow the decline of cognitive and functional impairment in people with dementia. In order to achieve maximum therapeutic effect, they ideally should not be used in combination with ACs, agents known to have an opposing mechanism of action.1,2 Roe et al studied AC use in 836 elderly patients.1 Use of ACs was found to be greater in patients with probable dementia than healthy older adults (33% vs. -
Yorkshire Palliative Medicine Clinical Guidelines Group Guidelines on the Use of Antiemetics Author(S): Dr Annette Edwards (Chai
Yorkshire Palliative Medicine Clinical Guidelines Group Guidelines on the use of Antiemetics Author(s): Dr Annette Edwards (Chair) and Deborah Royle on behalf of the Yorkshire Palliative Medicine Clinical Guidelines Group Overall objective : To provide guidance on the evidence for the use of antiemetics in specialist palliative care. Search Strategy: Search strategy: Medline, Embase and Cinahl databases were searched using the words nausea, vomit$, emesis, antiemetic and drug name. Review Date: March 2008 Competing interests: None declared Disclaimer: These guidelines are the property of the Yorkshire Palliative Medicine Clinical Guidelines Group. They are intended to be used by qualified, specialist palliative care professionals as an information resource. They should be used in the clinical context of each individual patient’s needs. The clinical guidelines group takes no responsibility for any consequences of any actions taken as a result of using these guidelines. Contact Details: Dr Annette Edwards, Macmillan Consultant in Palliative Medicine, Department of Palliative Medicine, Pinderfields General Hospital, Aberford Road, Wakefield, WF1 4DG Tel: 01924 212290 E-mail: [email protected] 1 Introduction: Nausea and vomiting are common symptoms in patients with advanced cancer. A careful history, examination and appropriate investigations may help to infer the pathophysiological mechanism involved. Where possible and clinically appropriate aetiological factors should be corrected. Antiemetics are chosen based on the likely mechanism and the neurotransmitters involved in the emetic pathway. However, a recent systematic review has highlighted that evidence for the management of nausea and vomiting in advanced cancer is sparse. (Glare 2004) The following drug and non-drug treatments were reviewed to assess the strength of evidence for their use as antiemetics with particular emphasis on their use in the palliative care population. -
Receptor Antagonist (H RA) Shortages | May 25, 2020 2 2 2 GERD4,5 • Take This Opportunity to Determine If Continued Treatment Is Necessary
H2-receptor antagonist (H2RA) Shortages Background . 2 H2RA Alternatives . 2 Therapeutic Alternatives . 2 Adults . 2 GERD . 3 PUD . 3 Pediatrics . 3 GERD . 3 PUD . 4 Tables Table 1: Health Canada–Approved Indications of H2RAs . 2 Table 2: Oral Adult Doses of H2RAs and PPIs for GERD . 4 Table 3: Oral Adult Doses of H2RAs and PPIs for PUD . 5 Table 4: Oral Pediatric Doses of H2RAs and PPIs for GERD . 6 Table 5: Oral Pediatric Doses of H2RAs and PPIs for PUD . 7 References . 8 H2-receptor antagonist (H2RA) Shortages | May 25, 2020 1 H2-receptor antagonist (H2RA) Shortages BACKGROUND Health Canada recalls1 and manufacturer supply disruptions may be causing shortages of commonly used acid-reducing medications called histamine H2-receptor antagonists (H2RAs) . H2RAs include cimetidine, famotidine, nizatidine and ranitidine . 2 There are several Health Canada–approved indications of H2RAs (see Table 1); this document addresses the most common: gastroesophageal reflux disease (GERD) and peptic ulcer disease (PUD) . 2 TABLE 1: HEALTH CANADA–APPROVED INDICATIONS OF H2RAs H -Receptor Antagonists (H RAs) Health Canada–Approved Indications 2 2 Cimetidine Famotidine Nizatidine Ranitidine Duodenal ulcer, treatment ü ü ü ü Duodenal ulcer, prophylaxis — ü ü ü Benign gastric ulcer, treatment ü ü ü ü Gastric ulcer, prophylaxis — — — ü GERD, treatment ü ü ü ü GERD, maintenance of remission — ü — — Gastric hypersecretion,* treatment ü ü — ü Self-medication of acid indigestion, treatment and prophylaxis — ü† — ü† Acid aspiration syndrome, prophylaxis — — — ü Hemorrhage from stress ulceration or recurrent bleeding, — — — ü prophylaxis ü = Health Canada–approved indication; GERD = gastroesophageal reflux disease *For example, Zollinger-Ellison syndrome . -
Binding Mode Exploration of B1 Receptor Antagonists' by the Use of Molecular Dynamics and Docking Simulation—How Different T
International Journal of Molecular Sciences Article Binding Mode Exploration of B1 Receptor Antagonists’ by the Use of Molecular Dynamics and Docking Simulation—How Different Target Engagement Can Determine Different Biological Effects Marica Gemei 1,*, Carmine Talarico 1 , Laura Brandolini 1, Candida Manelfi 1, Lorena Za 2, Silvia Bovolenta 2, Chiara Liberati 2, Luigi Del Vecchio 3, Roberto Russo 4 , Carmen Cerchia 4, Marcello Allegretti 1 and Andrea Rosario Beccari 1 1 Dompé Farmaceutici SpA, via Campo di Pile, 67100 L’Aquila, Italy; [email protected] (C.T.); [email protected] (L.B.); candida.manelfi@dompe.com (C.M.); [email protected] (M.A.); [email protected] (A.R.B.) 2 Axxam, Via Meucci 3, Bresso, 20091 Milano, Italy; [email protected] (L.Z.); [email protected] (S.B.); [email protected] (C.L.) 3 Ceinge Biotecnologie Avanzate, via G. Salvatore 486, 80145 Napoli, Italy; [email protected] 4 Department of Pharmacy, University of Naples “Federico II”, via D. Montesano, 49, 80131 Napoli, Italy; [email protected] (R.R.); [email protected] (C.C.) * Correspondence: [email protected]; Tel.: +34-06-465916 Received: 26 August 2020; Accepted: 12 October 2020; Published: 16 October 2020 Abstract: The kinin B1 receptor plays a critical role in the chronic phase of pain and inflammation. The development of B1 antagonists peaked in recent years but almost all promising molecules failed in clinical trials. Little is known about these molecules’ mechanisms of action and additional information will be necessary to exploit the potential of the B1 receptor. -
XELJANZ (Tofacitinib)
HIGHLIGHTS OF PRESCRIBING INFORMATION Psoriatic Arthritis (in combination with nonbiologic DMARDs) These highlights do not include all the information needed to use XELJANZ 5 mg twice daily or XELJANZ XR 11 mg once daily. (2.2) XELJANZ/XELJANZ XR safely and effectively. See full prescribing Recommended dosage in patients with moderate and severe renal information for XELJANZ. impairment or moderate hepatic impairment is XELJANZ 5 mg once daily. (2, 8.7, 8.8) ® XELJANZ (tofacitinib) tablets, for oral use Ulcerative Colitis ® XELJANZ XR (tofacitinib) extended-release tablets, for oral use XELJANZ 10 mg twice daily for at least 8 weeks; then 5 or 10 mg Initial U.S. Approval: 2012 twice daily. Discontinue after 16 weeks of 10 mg twice daily, if adequate therapeutic benefit is not achieved. Use the lowest effective dose to WARNING: SERIOUS INFECTIONS AND MALIGNANCY maintain response. (2.3) See full prescribing information for complete boxed warning. Recommended dosage in patients with moderate and severe renal impairment or moderate hepatic impairment: half the total daily dosage Serious infections leading to hospitalization or death, including recommended for patients with normal renal and hepatic function. (2, 8.7, tuberculosis and bacterial, invasive fungal, viral, and other 8.8) opportunistic infections, have occurred in patients receiving Dosage Adjustment XELJANZ. (5.1) See the full prescribing information for dosage adjustments by indication If a serious infection develops, interrupt XELJANZ/XELJANZ XR for patients receiving CYP2C19 and/or CYP3A4 inhibitors; in patients until the infection is controlled. (5.1) with moderate or severe renal impairment or moderate hepatic Prior to starting XELJANZ/XELJANZ XR, perform a test for latent impairment; and patients with lymphopenia, neutropenia, or anemia.