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Journal of Ayub Medical College,... 2019Green coloured urine is atypical as it usually signifies the presence of an exogenous substance. Several substances in literature have been associated with green urine...
Green coloured urine is atypical as it usually signifies the presence of an exogenous substance. Several substances in literature have been associated with green urine including propofol, biliverdin, metoclopramide, methylene blue, indigo blue, amitriptyline, methocarbamol, indomethacin, promethazine, cimetidine and food colourings. We present here a case of middleaged man who presented to our ER with altered mental status and green coloured urine with positive urine toxicology reports for benzodiazepine.
Topics: Aged; Benzodiazepines; Humans; Male; Mental Disorders; Urinalysis; Urine
PubMed: 31094132
DOI: No ID Found -
Biomedicines Aug 2023With the incidence of central and peripheral nervous system disorders on the rise, neurosurgical procedures paired with the careful administration of select medications...
With the incidence of central and peripheral nervous system disorders on the rise, neurosurgical procedures paired with the careful administration of select medications have become necessary to optimize patient outcomes. Despite efforts to decrease the over-prescription of common addictive drugs, such as opioids, prescription costs continue to rise. This study analyzed temporal trends in medication use and cost for spinal fusion and brain tumor resection procedures. The Medicare Part B Database was queried from 2016 to 2020 for data regarding spinal fusion and brain tumor resection procedures, while the Part D Database was used to extract data for two commonly prescribed medications for each procedure. Pearson's correlation coefficient and linear regression were completed for the analyzed variables. The results showed a significant negative correlation between the number of spinal procedure beneficiaries and the cost of methocarbamol, as well as between the annual percent change in spinal beneficiaries and the annual percent change in oxycodone cost. Linear regression revealed that oxycodone cost was the only parameter with a statistically significant model. Moving forward, it is imperative to combat rising drug costs, regardless of trends seen in their usage. Further studies should focus on the utilization of primary data in a multi-center study.
PubMed: 37626682
DOI: 10.3390/biomedicines11082185 -
Canadian Medical Association Journal Dec 1958
PubMed: 20325834
DOI: No ID Found -
Journal of Pharmaceutical Analysis Feb 2013A simple and selective micellar electrokinetic chromatographic (MEKC) method has been developed for the analysis of five pharmaceutical binary mixtures containing three...
Selective micellar electrokinetic chromatographic method for simultaneous determination of some pharmaceutical binary mixtures containing non-steroidal anti-inflammatory drugs.
A simple and selective micellar electrokinetic chromatographic (MEKC) method has been developed for the analysis of five pharmaceutical binary mixtures containing three non-steroidal anti-inflammatory drugs (NSAIDs). The investigated mixtures were Ibuprofen (IP)-Paracetamol (PC), Ibuprofen (IP)-Chlorzoxazone (CZ), Ibuprofen (IP)-Methocarbamol (MC), Ketoprofen (KP)-Chlorzoxazone (CZ) and Diclofenac sodium (DS)-Lidocaine hydrochloride (LC). The separation was run for all mixtures using borate buffer (20 mM, pH 9) containing 15% (v/v) methanol and 100 mM sodium dodecyl sulphate (SDS) at 15 kV and the components were detected at 214 nm. Different factors affecting the electrophoretic mobility of the seven investigated drugs were studied and optimized. The method was validated according to international conference of harmonization (ICH) guidelines and United States pharmacopoeia (USP). The method was applied to the analysis of five pharmaceutical binary mixtures in their dosage forms. The results were compared with other reported high performance liquid chromatographic methods and no significant differences were observed.
PubMed: 29403796
DOI: 10.1016/j.jpha.2012.07.005 -
Acta Medica Iranica 2011Descriptive case report of a 42-year old woman with coetaneous vasculitis, and severe abdominal pain, which was led to diagnostic laparotomy. These presentations are...
Descriptive case report of a 42-year old woman with coetaneous vasculitis, and severe abdominal pain, which was led to diagnostic laparotomy. These presentations are probably as a side effect of Methocarbamol injection. This is the first report according to our literature search (PubMed, google scholar, ISI web of knowledge, ProQuest, MD consult, Science Direct, SCOPUS) about Methocarbamol related vasculitis from 1966 since now. Vasculitis is not a known side effect of Methocarbamol. This case indicates, likely the potential for development of vasculitis with this medication.
Topics: Abdomen, Acute; Adult; Female; Humans; Methocarbamol; Muscle Relaxants, Central; Skin; Vasculitis, Leukocytoclastic, Cutaneous
PubMed: 21681710
DOI: No ID Found -
Pediatric Quality & Safety 2020Posterior spinal fusion for idiopathic scoliosis is extremely painful, with no superior single analgesic modality. We introduced a methadone-based multimodal analgesia...
Methadone-based Multimodal Analgesia Provides the Best-in-class Acute Surgical Pain Control and Functional Outcomes With Lower Opioid Use Following Major Posterior Fusion Surgery in Adolescents With Idiopathic Scoliosis.
INTRODUCTION
Posterior spinal fusion for idiopathic scoliosis is extremely painful, with no superior single analgesic modality. We introduced a methadone-based multimodal analgesia protocol, aiming to decrease the length of hospital stay (LOS), improve pain control, and decrease the need for additional opioids.
METHODS
We analyzed 122 idiopathic scoliosis patients with posterior instrumented spinal fusion. They were matched by age, sex, surgeon, and the number of levels fused before and after the implementation of the new protocol. This analysis included 61 controls (intrathecal morphine, gabapentin, intravenous opioids, and adjuncts) and 61 patients on the new protocol (scheduled methadone, methocarbamol, ketorolac/ibuprofen, acetaminophen, and oxycodone with intravenous opioids as needed). The primary outcome was LOS. Secondary outcomes included pain scores, total opioid use (morphine milligram equivalents), time to a first bowel movement, and postdischarge phone calls.
RESULTS
New protocol patients were discharged earlier (median LOS, 2 days) compared with control patients (3 days; < 0.001). Total inpatient morphine consumption was lower in the protocol group ( < 0.001). Pain scores were higher in the protocol group on the day of surgery, similar on postoperative day (POD) 1, and lower by POD 2 ( = 0.01). The new protocol also reduced the median time to first bowel movement ( < 0.001), and the number of postdischarge pain-related phone calls ( < 0.006).
CONCLUSION
Methadone-based multimodal analgesia resulted in significantly lower LOS compared with the conventional regimen. It also provided improved pain control, reduced total opioid consumption, and early bowel movement compared with the control group.
PubMed: 32766507
DOI: 10.1097/pq9.0000000000000336 -
The Journal of Biological Chemistry Dec 1992We previously showed that the zinc metalloenzyme carbonic anhydrases (CA I and II isozymes) bind "neutral" amides and related compounds as anions through coordination of... (Comparative Study)
Comparative Study
We previously showed that the zinc metalloenzyme carbonic anhydrases (CA I and II isozymes) bind "neutral" amides and related compounds as anions through coordination of their deprotonated amide nitrogen to the active site zinc (Rogers, J. I., Mukherjee, J., and Khalifah, R. G. (1987) Biochemistry 26, 5672-5679). Urethan, the ethyl carbamate ester, was among such compounds. The present study was designed to test whether other N-unsubstituted carbamate esters of pharmacological interest (as sedatives, hypnotics, anxiolytics, and skeletal muscle relaxants) were capable of binding to CA in the same manner. We studied the interaction of human CA I and II with urethan, phenyl carbamate, ethinamate, meprobamate, and methocarbamol. Phenyl carbamate studies were greatly complicated by its uncatalyzed hydrolysis via an elimination mechanism to form cyanate, a powerful CA inhibitor. In general, the compounds display: 1) slow on-off inhibition binding kinetics in the seconds range, 2) maximal inhibitor affinity at alkaline pH, and 3) characteristic three-band visible spectra of their complexes with cobalt-substituted CA I. These properties are shared with the previously studied amide inhibitors and are taken as evidence that the deprotonated carbamate nitrogen coordinates to the active site metal ion. CA I appeared to bind carbamate esters more tightly than CA II, an unusual 1000-fold selectivity being seen in the case of methocarbamol. The inhibition by these drugs is not sufficiently strong to implicate CA I and II in their mechanism of action. However, it does suggest the possible existence of previously unsuspected similarities between binding to CA and to their physiological receptors or targets, particularly the involvement of zinc.
Topics: Binding Sites; Carbamates; Carbonic Anhydrase Inhibitors; Carbonic Anhydrases; Erythrocytes; Esters; Humans; Isoenzymes; Kinetics; Mathematics; Models, Molecular; Molecular Structure; Protein Conformation; Spectrophotometry; Structure-Activity Relationship
PubMed: 1460006
DOI: No ID Found -
Journal of the American Veterinary... Nov 2002Mycotoxins are fungal metabolites that induce undesirable effects. The effects of these mycotoxins vary depending on the chemical structure of the toxin and degree of...
Mycotoxins are fungal metabolites that induce undesirable effects. The effects of these mycotoxins vary depending on the chemical structure of the toxin and degree of toxicity. Mycotoxins that induce muscle tremors, ataxia, and convulsions are termed tremorgenic mycotoxins. Our report documents the clinical course of 4 dogs from a single household that were simultaneously affected by tremorgenic mycotoxins. Diagnosis of tremorgenic mycotoxicosis was confirmed by stomach content analysis from 1 of the dogs. The mycotoxins identified were penitrem A and roquefortine, which are both produced by Penicillium spp. Treatment goals following tremorgenic mycotoxin ingestion include minimizing absorption, controlling tremors and seizures with methocarbamol and pentobarbital sodium administration, and providing supportive care. Two of the affected dogs required ventilatory support. With early aggressive treatment, prognosis is good and recovery is complete without sequelae. It is helpful for the clinician to be familiar with the typical clinical signs at the time of admission, treatment, and clinical course of dogs with tremorgenic mycotoxicosis.
Topics: Animals; Ataxia; Dog Diseases; Dogs; Ergolines; Gastrointestinal Contents; Heterocyclic Compounds, 4 or More Rings; Indoles; Male; Mycotoxicosis; Mycotoxins; Piperazines; Seizures; Tremor
PubMed: 12458614
DOI: 10.2460/javma.2002.221.1441 -
The Canadian Veterinary Journal = La... Jan 2014A 2-year-old cat was presented with acute onset seizures, tremors, and hypersalivation. Permethrin toxicity was diagnosed based on a history of recent flea treatment....
A 2-year-old cat was presented with acute onset seizures, tremors, and hypersalivation. Permethrin toxicity was diagnosed based on a history of recent flea treatment. Measures were taken to minimize further absorption of permethrin, and methocarbamol and intravenous lipid emulsion were used to control tremors. The cat recovered and was discharged within 42 h.
Topics: Animals; Cat Diseases; Cats; Drug Overdose; Fat Emulsions, Intravenous; Female; Insecticides; Permethrin
PubMed: 24381347
DOI: No ID Found -
The International Journal of... Jun 2014There is a lack of data regarding the abuse liability of centrally acting non-opioid analgesics (NOA) and muscle relaxants (MR). A comparison of data retrieved from a... (Comparative Study)
Comparative Study
Abuse liability of centrally acting non-opioid analgesics and muscle relaxants--a brief update based on a comparison of pharmacovigilance data and evidence from the literature.
There is a lack of data regarding the abuse liability of centrally acting non-opioid analgesics (NOA) and muscle relaxants (MR). A comparison of data retrieved from a German pharmacovigilance database (BfArM; accessed May 2013) and data from the literature concerning the abuse liability of NOA and MR approved in Germany was performed. The BfArM-database demonstrated cases of abuse only for clonidine and paracetamol, whereas the literature suggests evidence for an abuse potential of baclofen, clonidine, ketamine, metamizole, methocarbamol, orphenadrine, paracetamol, propyphenazone, and tizanidine. The low number of detected cases in the BfArM-database could be a result of under-reporting.
Topics: Adolescent; Adult; Aged; Analgesics, Non-Narcotic; Central Nervous System Agents; Databases, Pharmaceutical; Female; Germany; Humans; Male; Middle Aged; Muscle Relaxants, Central; Pharmacovigilance; Substance-Related Disorders; Young Adult
PubMed: 24552880
DOI: 10.1017/S1461145713001600