Volume 2 Issue 1
Pharmacodynamics Parameters Determine Analgesic and Sedative Drug Dosing during Neonatal and Pediatric Extracorporeal Membrane Oxygenation
Pavla Pokorná*, Lenka Posch, Martina Bašková, Václav Vobruba, Dick Tibboel
Extracorporeal membrane oxygenation (ECMO) is a complex highly specialised treatment modality used in neonates and children with therapy resistent circulatory and/or respiratory failure. Analgesia and sedation during ECMO is used to provide decreased anxiety, pain, induce amnesia or facilitation of synchronous breathing with the ventilator, the prevention of removing lines as well as for cannulation and decannulation etc. Rapid changes in drug disposition on ECMO are due to decreased plasma concentrations and may result in changed pharmacodynamics (PD) due to altered pharmacokinetics (PK). Analgosedation in ECMO patients should be guided by validated pain and/or COMFORT scales.
Can Drug Combinations Ease Approval of New Promising CNS Products?
Pierre A. Guertin*
The worldwide crisis in 2008 and the patent cliff problems have had a devastating impact on the industry. Pharmaceutical companies have announced 156,000 jobs lost in the United States in recent years. Global sales of prescription drugs have drastically decreased whereas so-called Big Pharma such as GSK, AstraZeneca and Novartis have decided to significant decrease or even cease research activities in neurosciences. Indeed, in these conditions, developing new psychotherapeutic drugs has become more than ever high-risk projects with low approval rates. Unfortunately, many CNS diseases remain associated with significant unmet medical needs. In Europe, 38% of the population is diagnosed with a CNS disorder whereas the global market for CNS therapeutics is expected to reach $129B US dollars by 2020, driven largely by the rapidly increasing market that is aging.
Fluoxetine Outcome for the Treatment of Chronic Low Back Pain: What More We Need to Know
Leonidas Grigorakos*, Anastasia Alexopoulou, Daria Lazarescu, Zoi Gambopoulou, Anna Kandyli, Katerina Tzortzopoulou, Panagiotis Kormas, Christos Kelesis, Nikolaos Sakellaridis
Antidepressants, tricyclic and selective serotonin reuptake inhibitors (SSRIs), have been used to treat various chronic pain syndromes. Several meta-analyses evaluating the effect of antidepressants versus placebo for short-term therapy (eight weeks or less) in patients with non-specific back pain had conflicting results. Longer-term trials of antidepressants for chronic low back pain are not available.
The Top 25 Middle Eastern Drugs and Comparable U.S. Products to Acquaint Middle Eastern Immigrants with U.S. Medicine
Ara DerMarderosian*, Aren Dabaghian
Within the years 2010-2013, the revolutionary movement, known as the ArabSprings has caused many Middle Easterners to immigrate to the U.S. Due to the increasein Middle Eastern immigrants within the U.S. this research project aims to find the top25 utilized Middle Eastern Drugs, and to find their comparable products within U.S. pharmacies. These 25 Middle Eastern medications were discovered using articles, Middle Eastern drug indices, and via interviews. The medications were compared to one another based on their basic mechanism of action. These findings indicated that more than 80% of the top 25 Middle Eastern drugs are comparable to the medications found in the U.S. As a result the project will aid incoming Middle Easterners who are in dire need of guidance for finding medications in the U.S, and also it will direct U.S. medical practitioners to the plight of Middle Eastern patients.
Profound Coagulopathy and Lactic Acidosis in a Diabetic Patient with Acute Renal Failure Taking Dabigatran and Metformin
Vincent J. Colucci*, Valerie L. Nauditt, Margaret T. Eddy
A 71-year-old female was admitted for treatment of a left hemispheric stroke secondary to uncontrolled hypertension and carotid artery stenosis. Despite worsening renal function, she was initiated on dabigatran 150 mg twice daily. Upon discharge her home medications, including aspirin and metformin, were restarted. Two weeks after discharge she presented to the Emergency Department lethargic and in moderate respiratory distress. An extensive workup revealed lactic acidosis, acute kidney failure, and profound coagulopathy.