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Clinical Infectious Diseases : An... Sep 2005Tigecycline, a first-in-class expanded-spectrum antimicrobial agent, has demonstrated efficacy in the treatment of complicated intra-abdominal and skin and... (Review)
Review
Tigecycline, a first-in-class expanded-spectrum antimicrobial agent, has demonstrated efficacy in the treatment of complicated intra-abdominal and skin and skin-structure infections. This new antibiotic is available as an intravenous formulation and exhibits linear pharmacokinetics. It is rapidly distributed and has a large volume of distribution, indicating extensive tissue penetration. After a 100-milligram loading dose, followed by 50 milligrams every 12 h, the steady-state maximum concentration in serum after a 1-h infusion is approximately 0.6 microg/mL, the 24-h steady-state area under the concentration-time curve is approximately 5-6 microg.h/mL, and the terminal elimination half-life is approximately 40 h. The major route of elimination of tigecycline is through the feces, primarily as unchanged drug. The pharmacokinetic profile is not affected by severe or end-stage renal disease, nor is it significantly altered by hemodialysis. The pharmacokinetics of tigecycline are also not affected by food, although tolerability is increased if the drug is administered following a meal.
Topics: Animals; Anti-Bacterial Agents; Area Under Curve; Half-Life; Humans; Minocycline; Tigecycline
PubMed: 16080071
DOI: 10.1086/431674 -
Journal of Perinatology : Official... Oct 2015The objective of our study was to determine the feasibility and safety of enoxaparin whole milligram dosing in premature and term neonates, and to assess response to...
OBJECTIVE
The objective of our study was to determine the feasibility and safety of enoxaparin whole milligram dosing in premature and term neonates, and to assess response to treatment.
STUDY DESIGN
Retrospective study of neonates with thrombosis treated between January 2008 and December 2014.
RESULT
Nineteen premature and 21 term neonates were treated with whole milligram doses of enoxaparin. The mean starting and therapeutic enoxaparin doses were 1.72±0.17 and 1.86±0.17 mg kg(-1), respectively. Twenty-five (64%) reached therapeutic antifactor Xa (anti-Xa) levels with the starting dose, whereas 14 (36%) required dose adjustments. One neonate reached a supratherapeutic anti-Xa level (>1.0 IU ml(-1)) in the loading phase. No bleeding episodes occurred. The mean treatment duration was 12 weeks. Among 34 (85%) evaluable patients, 23 (68%) had a complete response, 9 (26%) partial and 2 (6%) had a stable thrombotic state.
CONCLUSION
Whole milligram dosing of enoxaparin for thrombosis is feasible, safe and effective in premature and term neonates.
Topics: Anticoagulants; Dose-Response Relationship, Drug; Enoxaparin; Female; Humans; Infant, Newborn; Male; Premature Birth; Retrospective Studies; Term Birth; Thrombosis; Treatment Outcome
PubMed: 26181722
DOI: 10.1038/jp.2015.84 -
Radiology Nov 1982The relationships between the Fletcher and Manchester methods in dosimetry of cancer of the uterine cervix were explored in order to compare dose prescriptions between...
The relationships between the Fletcher and Manchester methods in dosimetry of cancer of the uterine cervix were explored in order to compare dose prescriptions between the systems, to optimize the best features of both systems, and to establish the necessity for computerized dosimetry. A total of 91 Fletcher-Suit radium applications was analyzed by a linear least-square regression analysis to compare Point A and Point B doses of the Manchester system will milligram-hours of the fletcher system. Although moderately high correlations were found between milligram-hours of radium and doses at Point A and Point B, it was concluded that direct comparisons, particularly between individual patients, are fraught with dose uncertainties of clinical significance. In addition, the correlation between milligram-hours of radium and Point A dose was markedly affected by the position of the colpostats and tandem, thus making it difficult to formulate a simple conversion factor between the two systems.
Topics: Brachytherapy; Carcinoma; Female; Humans; Radiotherapy Dosage; Radium; Time Factors; Uterine Cervical Neoplasms
PubMed: 7134455
DOI: 10.1148/radiology.145.2.7134455 -
Hormone and Metabolic Research =... Dec 1996Leptin, the product of the obese (ob) gene, is a 16 kilodalton protein secreted from adipose tissue. Restoration of leptin to obese ob/ob mice leads to normalization of...
Leptin, the product of the obese (ob) gene, is a 16 kilodalton protein secreted from adipose tissue. Restoration of leptin to obese ob/ob mice leads to normalization of body weight. The effect of leptin in larger animals has not been explored, in part because of limited supplies of leptin. To date, the potency and yield of recombinant leptin purified from a variety of eukaryotic sources or from E. coli has been highly variable. While purification of leptin from E. coli inclusion bodies has afforded the greatest yield of protein, its potency is at least an order of magnitude lower than that of leptin secreted from E. coli or eukaryotic cells. The mechanistic basis of this difference in potency is not clear at present. The ability to purify significant quantities of highly active leptin will be crucial for the evaluation of leptin structure, as well as its function in additional animal models of obesity. We now report a facile protocol for the preparation of recombinant leptin using an E. coli expression system. 75-85 milligrams of leptin with a purity of greater than 97 % was prepared from a liter of recombinant E. coil. The procedure can be performed in less than 48 h and requires no chromatography. Intraperitoneal injection of 0.1 mg/kg renatured leptin into ob/ob mice results in a significant reduction in food consumption. The potency of this material is similar to the most potent recombinant leptin described to date. The ability to rapidly prepare large quantities of high specific activity material will hasten the definition of leptin's role in non-rodent models of obesity.
Topics: Animals; Eating; Escherichia coli; Gene Expression; Humans; Injections, Intraperitoneal; Leptin; Macromolecular Substances; Mass Spectrometry; Mice; Mice, Obese; Proteins; Recombinant Proteins
PubMed: 9013744
DOI: 10.1055/s-2007-979880 -
The Cochrane Database of Systematic... 2000Schistosomiasis is a parasite that is carried by freshwater snails. There are two common forms, urinary schistosomiasis (which is considered in this review) and... (Review)
Review
BACKGROUND
Schistosomiasis is a parasite that is carried by freshwater snails. There are two common forms, urinary schistosomiasis (which is considered in this review) and intestinal schistosomiasis.
OBJECTIVES
The objective of this review was to assess the effects of drugs for treatment of Schistosomiasis haematobium.
SEARCH STRATEGY
The Cochrane Infectious Diseases Group trials register, Medline and reference lists of articles were searched. The WHO Division of Control of Tropical Diseases was contacted.
SELECTION CRITERIA
Randomised trials of metrifonate or praziquantel or other drugs for treating Schistosomiasis haematobium.
DATA COLLECTION AND ANALYSIS
One reviewer assessed trial quality and extracted data, and this was checked by a review editor.
MAIN RESULTS
Five trials, all from Africa, were included. The quality of the trials was variable. There were no good randomised controlled trials of praziquantel single dose treatment versus current standard treatment with metrifonate of three doses of 10 milligrams per kilogram at two weekly intervals. Praziquantel at doses of 40 milligram per kilogram was more effective than single dose metrifonate 10 milligrams per kilogram (odds ratio 6.94, 95% confidence interval 4.85 to 9.92). In one trial of metrifonate compared with praziquantel, there was no difference demonstrated in a range of clinical outcomes including cessation of haematuria and proteinuria. Both drugs improved nutritional status and physical fitness.
REVIEWER'S CONCLUSIONS
Praziquantel (single dose) appears to be more effective than metrifonate (split dose) in terms of parasitological cure of Schistosomiasis haematobium, but the reinfection rate is high with both drugs.
Topics: Anthelmintics; Humans; Praziquantel; Schistosomiasis haematobia; Trichlorfon
PubMed: 10796476
DOI: 10.1002/14651858.CD000053 -
Science (New York, N.Y.) Oct 1992An article in last week's issue ("Agencies Split on Nutrition Advice," 25 September, p. 1857) incorrectly reported the recommended daily allowance of folic acid as 400...
An article in last week's issue ("Agencies Split on Nutrition Advice," 25 September, p. 1857) incorrectly reported the recommended daily allowance of folic acid as 400 milligrams. The correct unit throughout the article should have been micrograms.
PubMed: 17835885
DOI: 10.1126/science.258.5079.26-a -
Talanta Mar 1966An accurate and selective milligram procedure for the determination of primary amides is described. About 3-4 mg of sample are hydrolysed with a concentrated solution of...
An accurate and selective milligram procedure for the determination of primary amides is described. About 3-4 mg of sample are hydrolysed with a concentrated solution of sodium hydroxide and the resulting ammonia is distilled into dilute sulphuric acid. The ammonium sulphate thus obtained is converted into ammonium iodide by passing it through hydroxide- and iodide-form resins. This iodide is oxidised to iodate with bromine, then titrated iodometrically. Determinations carried out on a number of primary amides, ureas and thioureas show a deviation of about 0.3% from full recovery of the compounds.
PubMed: 18959903
DOI: 10.1016/0039-9140(66)80068-1 -
Journal of the American Pharmacists... 2023We aimed to increase pharmacists' and regulatory agencies' awareness of emerging issues regarding current practices of semaglutide use in the community that has led to...
BACKGROUND
We aimed to increase pharmacists' and regulatory agencies' awareness of emerging issues regarding current practices of semaglutide use in the community that has led to increased reports of administration errors and adverse drug events to our regional poison control center.
CASE SUMMARY
We report 3 cases of adverse drug events after incorrect administration of semaglutide for weight loss obtained from compounding pharmacies and an aesthetic spa. Two patients self-administered 10-fold dosing errors. All patients experienced notable symptoms of nausea, vomiting, and abdominal pain with most symptoms lasting for days. Other symptoms of headache, anorexia, weakness, and fatigue were reported in one patient. One patient sought evaluation at a health care facility and responded well to an antiemetic and intravenous fluids. One patient who received their medication from a compounding pharmacy reported receiving a vial with syringes for self-administration; no pharmacist counseling was provided on proper drug administration. One patient reported dosing in milliliters and units rather than in milligrams.
PRACTICE IMPLICATIONS
These 3 semaglutide cases highlight the potential for patient harm given current practices. Vials of compounded semaglutide do not use safety features provided by prefilled manufactured pens and allow for large overdoses (e.g., 10-fold dosing errors). Use of syringes not intended for semaglutide contributes to the variability of dosing units (milliliters, units, milligrams), contributing to patient confusion. To address such issues, we encourage increased vigilance in labeling, dispensing, and counseling practices to ensure patients are confident in administering their medication regardless of the formulation. We additionally encourage boards of pharmacy and other regulatory agencies to promote proper use and dispensing of compounded semaglutide. Such vigilance and promotion could decrease the risk of more severe adverse drug events and avoidable hospital utilization that may arise from dosing errors.
Topics: Humans; Poison Control Centers; Medication Errors; Pharmaceutical Preparations; Drug-Related Side Effects and Adverse Reactions; Pharmacists
PubMed: 37392810
DOI: 10.1016/j.japh.2023.06.017 -
A&A Practice Nov 2020
Topics: Child; Humans; Neuromuscular Blockade; Rocuronium; Sugammadex
PubMed: 33185410
DOI: 10.1213/XAA.0000000000001343 -
Thrombosis Research Apr 2009Enoxaparin is a low molecular weight heparin (LMWH) commonly used for thromboprophylaxis children. Enoxaparin dosing is based on patients' weight and results in decimal...
UNLABELLED
Enoxaparin is a low molecular weight heparin (LMWH) commonly used for thromboprophylaxis children. Enoxaparin dosing is based on patients' weight and results in decimal dosing. Due to the high concentration of enoxaparin the resultant decimal dose makes precise measurement difficult. Dilution is necessary and often results in ten-fold medication administration errors [Ghaleb MA, Barber N, Franklin BD, Yeung VWS, Khaki ZF, Wong ICK. Systematic review of medication errors in pediatric patients. Ann Pharmacother Oct 2006;40(10):1766-76, Raju TN, Kecskes S, Thornton JP, Perry M, Feldman S. Medication errors in neonatal and paediatric intensive-care units. Lancet Aug 12 1989;2(8659):374-6]. Enoxaparin may be administered in whole milligram doses via insulin syringe, where one milligram of enoxaparin equals one unit on the 100 unit graduated insulin syringe.
STUDY DESIGN
A retrospective chart review of 514 children. Data was collected on underlying diagnosis, reason for anticoagulation, anti-Xa levels, hemorrhagic events, and medication errors identified.
OUTCOME
to determine the occurrence rate of supra-therapeutic anticoagulation as indicated by anti-Xa levels >1.0 u/ml, when enoxaparin doses are rounded up to the whole milligram, and are administered using insulin syringes. The secondary objectives were to determine if the supra-therapeutic anti-Xa levels were associated with hemorrhagic events. To determine if children achieved and maintained therapeutic anti-Xa range using whole milligram dosing and to evaluate the impact of utilizing insulin syringes for administration on reducing dose measurement errors.
RESULTS
All 514 patients were prescribed whole milligram enoxaparin dosing, and achieved therapeutic anti-Xa within a mean time of 2 days. No infant or child required decimal doses to achieve therapeutic levels. Five children achieved an initial supra-therapeutic anti-Xa level (1.04 -1.36 U/ml), requiring a single whole milligram dose decrease. There were no associated hemorrhagic events.
CONCLUSION
Whole milligram enoxaparin dosing administered via an insulin syringe safely and effectively, achieved therapeutic levels in infants and children. The reduced incidence of enoxaparin dosing errors suggests that whole milligram enoxaparin dosing via an insulin syringe is a method that should be considered for standard of care.
Topics: Adolescent; Anticoagulants; Child; Child, Preschool; Clinical Protocols; Cohort Studies; Enoxaparin; Factor Xa Inhibitors; Female; Humans; Infant; Infant, Newborn; Insulin; Male; Medication Errors; Retrospective Studies; Syringes
PubMed: 19038418
DOI: 10.1016/j.thromres.2008.09.001