Articles: dextromethorphan-therapeutic-use.
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Interventional Study of Dextromethorphan Abuse Within the U.S. Military Community in Okinawa, Japan.
Dextromethorphan, a common over-the-counter cough suppressant, has potential for abuse. In the present commentary, we summarize findings to suggest extensive dextromethorphan overuse/abuse within the U. S. military community residing in Okinawa, Japan. ⋯ S. military community, a survey of medical records showed high rates of treatment provided for dextromethorphan intoxication. These findings motivated interventions established throughout the military community in Okinawa to combat dextromethorphan overuse. These stricter policy changes resulted in decreases in sales of dextromethorphan-containing medications as well as a substantial drop in hospital visits from dextromethorphan intoxication, suggesting that the interventions were largely effective and should be maintained.
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Randomized Controlled Trial
Dextromethorphan Analgesia in a Human Experimental Model of Hyperalgesia.
Central pain sensitization is often refractory to drug treatment. Dextromethorphan, an N-methyl-D-aspartate receptor antagonist, is antihyperalgesic in preclinical pain models. The hypothesis is that dextromethorphan is also antihyperalgesic in humans. ⋯ This study shows that low-dose (30-mg) dextromethorphan is antihyperalgesic in humans on the areas of primary and secondary hyperalgesia and reverses peripheral and central neuronal sensitization. Because dextromethorphan had no intrinsic antinociceptive effect in acute pain on healthy skin, N-methyl-D-aspartate receptor may need to be sensitized by pain for dextromethorphan to be effective.
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Randomized Controlled Trial Multicenter Study
Dextromethorphan and memantine after ketamine analgesia: a randomized control trial.
Intravenous ketamine is often prescribed in severe neuropathic pain. Oral N-methyl-D-aspartate receptor (NMDAR) antagonists might prolong pain relief, reducing the frequency of ketamine infusions and hospital admissions. This clinical trial aimed at assessing whether oral dextromethorphan or memantine might prolong pain relief after intravenous ketamine. ⋯ Oral dextromethorphan given after ketamine infusion extends pain relief during one month and could help patients to better cope with pain. Future studies should include larger populations stratified on pharmacogenetics screening. Optimization of an oral drug that could extend ketamine antihyperalgesia, with fewer hospital admissions, remains a prime challenge in refractory neuropathic pain.
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Cough causes concern for parents and is a major cause of outpatient visits. Cough can impact quality of life, cause anxiety, and affect sleep in children and their parents. Honey has been used to alleviate cough symptoms. This is an update of reviews previously published in 2014, 2012, and 2010. ⋯ Honey probably relieves cough symptoms to a greater extent than no treatment, diphenhydramine, and placebo, but may make little or no difference compared to dextromethorphan. Honey probably reduces cough duration better than placebo and salbutamol. There was no strong evidence for or against using honey. Most of the children received treatment for one night, which is a limitation to the results of this review. There was no difference in occurrence of adverse events between the honey and control arms.
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Case Reports
Use of Compounded Dextromethorphan-Quinidine Suspension for Pseudobulbar Affect in Hospice Patients.
Pseudobulbar affect (PBA) consists of unprovoked and uncontrollable episodes of laughing and/or crying. In end-of-life situations, PBA symptoms can be especially distressing to family and friends during an already heightened emotional time. Although a commercial product combining dextromethorphan and quinidine (DMQ) is FDA approved for use in PBA, many hospice patients are unable to swallow any solids or semisolids. An alternative formulation for these patients is needed. ⋯ DMQ suspension is an effective alternative for PBA symptoms in patients who cannot swallow oral solid medication.