Journal of population therapeutics and clinical pharmacology = Journal de la thérapeutique des populations et de la pharamcologie clinique
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J Popul Ther Clin Pharmacol · Jan 2013
Clinical practice guideline: CYP2D6 genotyping for safe and efficacious codeine therapy.
This guideline is intended to provide a basis for informed decision-making regarding genetic testing to identify those individuals who will not benefit from codeine therapy, as well as those who are at an increased risk for codeine-induced toxicity. This guideline addresses the following key questions: 1) Should genetic testing for CYP2D6 be performed in patients prior to the initiation of codeine therapy? 2) How should patients with an indication for codeine therapy be managed based on their genotyping results for CYP2D6?
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J Popul Ther Clin Pharmacol · Jan 2013
The return to the USA of doxylamine-pyridoxine delayed release combination (Diclegis®) for morning sickness--a new morning for American women.
The US FDA approval in April 2013 of Diclegis®, the doxylamine-pyridoxine combination for morning sickness, is a major milestone, particularly since it is indicated for use in pregnancy and the FDA has labeled it a pregnancy category A drug the strongest evidence of fetal safety. After thirty years of being orphaned from an FDA-labeled drug for the most common medical condition in pregnancy, American women and their health care providers have a therapeutic solution that is likely to positively impact millions of women each year. This review highlights the milestones of this antiemetic agent over the last 40 years.
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J Popul Ther Clin Pharmacol · Jan 2013
Is mild-moderate drinking in pregnancy harmless? New experimental evidence to the opposite.
During the last decade a growing number of studies have failed to detect adverse neurodevelopmental effects of mild--to moderate maternal drinking in the exposed child, supporting a climate that "some drinking in pregnancy is OK". A recent experimental study in sheep, mimicking conditions of moderate drinking in the third trimester of pregnancy, provides powerful evidence that there are serious lifelong risks to fetal exposure to alcohol. These should serve as an alarm call to those who legitimize mild-moderate maternal drinking based on incomplete data.
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J Popul Ther Clin Pharmacol · Jan 2012
Case ReportsIntravenous lipid emulsion therapy for sustained release diltiazem poisoning: a case report.
We present a case of refractory cardiogenic shock secondary to sustained release diltiazem poisoning. Intravenous lipid emulsion therapy was initiated approximately 13 hours after ingestion. Vasopressors were weaned off hours after initiation of intravenous lipid emulsion therapy and the patient went on to make a full recovery. This report adds to the paucity of data on intravenous lipid emulsion rescue therapy in sustained release diltiazem poisoning. We hypothesize that the intravenous lipid emulsion may have mediated its favorable hemodynamic effects via increases in myocardial calcium concentration with resultant increased inotropy.
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This is a descriptive retrospective case series of 14 pregnant women treated with ondansetron for hyperemesis gravidarum (HG) at CHU Sainte-Justine, from January 2002 to October 2011. Two of the patients received ondansetron during two separate pregnancies. Both pregnancies were analyzed separately for the purposes of this study. ⋯ Teratogenicity associated with the use of ondansetron has so far not been shown in humans. This case series adds information on ondansetron use during pregnancy. However, until we have more published data, ondansetron should be used as a second-line agent for the management of HG.