Proceedings of the Western Pharmacology Society
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Proc. West. Pharmacol. Soc. · Jan 2008
Review Case ReportsTakotsubo cardiomyopathy: case report and review of the literature.
Takotsubo cardiomyopathy, also known as stress induced cardiomyopathy and transient left ventricular apical ballooning syndrome, is a rare syndrome that is characterized by a transient decrease in ejection fraction. This is accompanied by hypokinesis of the left ventricle and ballooning of the apex, with hypercontractile base and non-obstructive coronary artery disease. Takotsubo was first described in Japan in the early 1990's. ⋯ Clinical symptoms are accompanied by transient left ventricular dysfunction. Despite clinical symptoms consistent with acute myocardial infarction, normal coronary arteries are usually detected upon cardiac catheterization. The case presented here is of an Asian woman who developed symptoms of acute myocardial infarction during a stressful hospital stay.
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Proc. West. Pharmacol. Soc. · Jan 2008
Randomized Controlled TrialA pilot study of the effect of diclofenac with B vitamins for the treatment of acute pain following lower-limb fracture and surgery.
The aim of this pilot study was to compare the efficacy and tolerability of the non-steroidal anti-inflammatory drug (NSAID), diclofenac (2-(2,6-dichloranilino) phenylacetic acid), for treatment of acute pain originated by lower-limb fracture and surgery, with that of diclofenac plus B vitamins. This clinical trial was single-center, prospective randomized and double-blinded. After giving informed consent, patients with lower-limb closed fractures rated their pain on a 10-cm visual analog scale (VAS). ⋯ The subjects' assessments of limb pain on the visual analog scale showed a significant reduction from baseline values regardless of the treatment group when surveyed at 12, 24, 36 and 48 hr post operation. All treatments showed a similar profile in pain reduction. There were reports of pain in the administration site, but in general, all the regimens were well tolerated.
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Proc. West. Pharmacol. Soc. · Jan 2007
ReviewDrug administration is an essential clinical competence.
Quotidian clinical practice implies at least four essential activities: i) integration of diagnosis; ii) design of the therapeutic regimen; iii) following up therapeutic outcomes; and, iv) keeping updated on medical knowledge. The therapeutic regimen may include the use of drugs among other forms of treatment. A competent clinician is expected to be knowledgeable, skillful, dutiful and altruistic when deciding to use drugs. ⋯ However, an integrated view on how BMPK relates to their clinical application is not clearly stated. By the same token, legal and ethical aspects of drug administration are narrowed to prescription writing skills, either for the patient or for the clinical file; thus, attenuating the appraisal of the impact on therapeutic adherence of physicians' communication skills, as well as availability and/or accessibility of recommended drugs. These issues are obviously related to therapeutic outcome but their integrated articulation occurs only if drug administration is considered as an essential clinical competence.
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Myasthenia gravis (MG) is a chronic neuromuscular disease which leads to varying degrees of weakness in the skeletal muscles. Some of the symptoms of the disorder include weakness of the eye muscles, difficulty in swallowing and slurred speech. When only the muscles of the eyes are affected, the illness is termed ocular myasthenia, which is often characterized by abrupt onset of diplopia and ptosis of the eyelid. ⋯ His symptoms improved dramatically after treatment with Acetyl cholinesterase (AchE) inhibitors and steroids, regaining much of his ocular mobility and ability to walk without gait imbalance. At follow-up visits, the patient remained healthy with no evidence development of other myasthenic signs. This case is atypical since ocular MG does not normally occur in the absence of other myasthenic forms.
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Proc. West. Pharmacol. Soc. · Jan 2005
Randomized Controlled TrialAnalgesic efficacy of tramadol by route of administration in a clinical model of pain.
The objective of this study was to evaluate the analgesic efficacy produced by tramadol given by two different routes of administration in patients experiencing pain after removal of an impacted mandibular third molar under local anesthesia. A double-blind, randomized, placebo-controlled clinical trial was conducted. Patients were assigned into four groups of treatment, twelve subjects per group: Group A, tramadol 50 mg IM one hr before surgery; group B, tramadol 50 mg into the surgical site; group C, tramadol by both routes of administration, 50 mg IM one hr before surgery plus 50 mg into the surgical site; and group D, control. ⋯ However, only in the route combination group was a significant reduction in the requirement of acetaminophen observed. Nine patients requiring additional medication were treated with ketorolac 30 mg injected intramuscularly; 2 in the systemic group, 2 in the local group, 4 in the control group and only 1 in the combination group. Adverse events were minimal and similar in all groups.