Coding Corner: A Critical Opportunity
A 17-year-old with a history of major depressive disorder who is new to the hospitalist service is being transferred out of the pediatric intensive care unit (PICU) after an intentional Benadryl overdose in a suicide attempt.
You review her labs from this morning showing that her electrolytes are normal. You review her pregnancy test and urine drug screen which are both negative. You review the nursing note from this morning which states she is alert, oriented, and calm and her parents are at the bedside. You interpret her electrocardiogram (EKG) tracing and calculate her QTc to be back to normal at 420.
She remains active...
Source: The Hospitalist - April 1, 2024 Category: Hospital Management Authors: Ronda Whitaker Tags: Business of Medicine Clinical Guidelines Coding Source Type: research
Transcriptome-based deep learning analysis identifies drug candidates targeting protein synthesis and autophagy for the treatment of muscle wasting disorder
This study analyzed the gene expression signatures associated with cancer formation and 5-FU chemotherapy-induced muscle wasting. Our findings suggest that dimenhydrinate, a combination of 8-chlorotheophylline and diphenhydramine, is a potential therapeutic for sarcopenia. In vitro experiments demonstrated that dimenhydrinate promotes muscle progenitor cell proliferation through the phosphorylation of Nrf2 by 8-chlorotheophylline and promotes myotube formation through diphenhydramine-induced autophagy. Furthermore, in various in vivo sarcopenia models, dimenhydrinate induced rapid muscle tissue regeneration. It improved mu...
Source: Molecular Medicine - March 31, 2024 Category: Molecular Biology Authors: Min Hak Lee Bada Lee Se Eun Park Ga Eul Yang Seungwoo Cheon Dae Hoon Lee Sukyeong Kang Ye Ji Sun Yongjin Kim Dong-Sub Jung Wonwoo Kim Jihoon Kang Yi Rang Kim Jin Woo Choi Source Type: research
A hybrid nanoparticle-protein hydrogel system for prolonged local anesthesia
Biomaterials. 2024 Feb 1;306:122494. doi: 10.1016/j.biomaterials.2024.122494. Online ahead of print.ABSTRACTLocal anesthetics are effective in relieving pain, but their duration of action is short. Therefore, the development of injectable sustained release systems to prolong the effect of local anesthetics has been of interest. In such systems delivering conventional local anesthetics, it has been challenging to achieve long durations of effect, particularly without incurring tissue toxicity. To overcome these challenges, we created a platform comprising a protein hydrogel incorporating hydrophobic local anesthetic (bupiva...
Source: Biomaterials - February 5, 2024 Category: Materials Science Authors: Wonmin Choi Gil Aizik Claire A Ostertag-Hill Daniel S Kohane Source Type: research
Letter in Response to Oral and Transdermal Rivastigmine for the Treatment of Anticholinergic Delirium: A Case Report
We read with interest the article “Oral and Transdermal Rivastigmine for the Treatment of Anticholinergic Delirium: A Case Report” by Fratta et al. (1). Using a rivastigmine dosing approach similar to that described in the article, we successfully managed a case of diphenhydramine-associated antimuscarinic toxicity with 13.8 mg of transdermal rivastigmine (0.15 mg/kg). Whereas the ultimate management of our patient with transdermal rivastigmine followed the dosing strategy within this case report, we describe here additional pertinent factors that we considered in the use of transdermal rivastigmine for antimuscarinic ...
Source: The Journal of Emergency Medicine - February 1, 2024 Category: Emergency Medicine Authors: Jordan E. Jenrette, Jacob A. Lebin Tags: Letter to the Editor Source Type: research
Tenecteplase-associated orolingual angioedema: A case report and literature review
CONCLUSION: Although rare, OA is a potentially life-threatening complication of tenecteplase therapy and requires prompt pharmacological intervention to optimize patient outcomes. Currently, no single agent or treatment algorithm exists that has shown significant efficacy or safety in the setting of thrombolytic-associated OA. Until data are available for C1 esterase inhibitors in this application, these inhibitors should only be considered if there is continued symptom progression after intravenous administration of corticosteroids and antihistamines.PMID:38270186 | DOI:10.1093/ajhp/zxad334 (Source: American Journal of He...
Source: American Journal of Health-System Pharmacy : AJHP - January 25, 2024 Category: Drugs & Pharmacology Authors: Jeffrey K Pitts Dylan M Burns Kevin R Patellos Source Type: research
Network pharmacology combined with Mendelian randomization analysis to identify the key targets of renin-angiotensin-aldosterone system inhibitors in the treatment of diabetic nephropathy
ConclusionCTSC and PDE5A were identified as key targets for RAAS inhibitors in the treatment of DN, which might provide some clinical significance in helping to diagnose and treat DN. Among the targets of RAAS inhibitors, PTGS2, ITGA4 and ANPEP have a causal relationship with acute kidney injury, which is worthy of further clinical research. (Source: Frontiers in Endocrinology)
Source: Frontiers in Endocrinology - January 25, 2024 Category: Endocrinology Source Type: research
Medicating the coast in a metropolitan city: Enantiomeric profiles and joint probabilistic risk assessment of antidepressants and antihistamines
Environ Int. 2024 Jan 9;184:108434. doi: 10.1016/j.envint.2024.108434. Online ahead of print.ABSTRACTPharmaceuticals are receiving increasing attention as emerging contaminants in the aquatic environment. Herein, we investigated the occurrence of 11 antidepressants, 6 antihistamines and 4 metabolites in treated wastewater effluents, rivers, stormwater, and seawater in Hong Kong, with special focus on chirality. The average levels of ∑pharmaceuticals ranged from 0.525 to 1070 ng/L in all samples and the total annual mass load of target pharmaceuticals in the marine environment of Hong Kong was 756 kg/y. Antihistamines acc...
Source: Environment International - January 18, 2024 Category: Environmental Health Authors: Rongben Wu Esther Yan-Yin Sin Kai Zhang Shaopeng Xu Yuefei Ruan Yim Ling Mak Ying-Kit Yung Sunny Wai-Choi Sun Rong Yang Paul K S Lam Source Type: research
Sustainable Electrochemical Benzylic C-H Oxidation Using MeOH as an Oxygen Source
ChemSusChem. 2024 Jan 15:e202400028. doi: 10.1002/cssc.202400028. Online ahead of print.ABSTRACTNew methods and strategies for the direct oxidation of benzylic C-H bonds are highly desirable, owing to the importance of ketone motifs in significant organic transformations and the synthesis of valuable molecules, including pharmaceuticals, pesticides, and fine chemicals. Herein, we describe an electrochemical benzylic C-H oxidation strategy for the synthesis of ketones using MeOH as an oxygen source. Inexpensive and safe KBr serves as both an electrolyte and a bromide radical precursor in the reaction. This transformation al...
Source: ChemSusChem - January 15, 2024 Category: Chemistry Authors: Meng Xue Tao Pan Zhichao Shao Wenxuan Wang Hu Li Lixing Zhao Xin Zhou Yuexia Zhang Source Type: research
Diphenhydramine-involved Fatal and Nonfatal Drug Overdoses in Tennessee, 2019-2022
CONCLUSION: Nonfatal overdoses remained consistent while fatal overdoses peaked in 2021 in Tennessee. Use of DPH among other illicit substances lends to evidence suggesting its use as an adulterant. Monitoring of DPH-involved fatal and nonfatal overdoses is critical to inform harm reduction initiatives.PMID:38189325 | DOI:10.1080/10826084.2023.2280542 (Source: Substance Use and Misuse)
Source: Substance Use and Misuse - January 8, 2024 Category: Addiction Authors: Sarah Riley Saint Edward Onyango Jessica Korona-Bailey Joshua Jayasundara Kristi Hall Sutapa Mukhopadhyay Source Type: research
Hereditary Alpha Tryptasemia Presenting as Recurrent Chemotherapy Hypersensitivity Reactions
A 56-year-old patient with history of high-grade serous ovarian cancer receiving her second cycle of carboplatin/paclitaxel in February of 2021 developed acute hypotension, hypoxia and altered mental status nine minutes into the paclitaxel infusion. The patient became unresponsive, a ‘Code Blue’ was called, and the patient was treated with 100 mg intravenous (IV) hydrocortisone, 50 mg IV diphenhydramine, and two doses of 0.3 mg intramuscular (IM) epinephrine with resolution of symptoms. An event tryptase drawn within 2.5 hours of symptom onset was elevated at 87.2ng/mL (nor mal (Source: Annals of Allergy, Asthma and Immunology)
Source: Annals of Allergy, Asthma and Immunology - December 25, 2023 Category: Allergy & Immunology Authors: Rose Monahan, Emely Alfaro, Hansen Ho, Iris M. Otani, Lulu R. Tsao Tags: Challenging Clinical Cases Source Type: research
Treatment Options for Posttraumatic Headache: A Current Review of the Literature
AbstractPurpose of ReviewWe evaluate evidence-based treatments for posttraumatic headache (PTH), a secondary headache disorder resulting from traumatic brain injury (TBI), comprising nearly 4% of all symptomatic headache disorders. Utilizing recent publications, we aim to inform clinicians of current treatment methods.Recent FindingsThere is limited research on PTH treatment. A randomized controlled trial (RCT) of metoclopramide with diphenhydramine for acute PTH found that the treatment group (N = 81) experienced more significant pain improvement than placebo by 1.4 points. For persistent PTH, an open-label study of ...
Source: Current Pain and Headache Reports - December 22, 2023 Category: Neurology Source Type: research
Hypersensitivity reaction to nedaplatin: A case report and literature review
Medicine (Baltimore). 2023 Dec 15;102(50):e36690. doi: 10.1097/MD.0000000000036690.ABSTRACTRATIONALE: Although rare, systemic hypersensitivity reactions to nedaplatin chemotherapy arise rapidly and can be life-threatening. The causes are unclear, and multiple potential mechanisms exist. Here, we report a case of systemic hypersensitivity reaction to nedaplatin and review the literature to establish a recommended protocol.PATIENT CONCERNS: A 62-year-old man was being treated for squamous lung cancer with multiple metastases. On the first day of chemotherapy, 5 minutes after nedaplatin infusion, he developed panic, shortness...
Source: Cancer Control - December 20, 2023 Category: Cancer & Oncology Authors: Kelun Gan Daiyuan Ma Source Type: research
Fallen Leaves
Benadryl gift to vein bone colding elbow of the creek deep clear flow of obinutuzumab killing the part of me killing me fledgling trout scurry winter deskinned pine limbs muscles chilled to stiffness synch the pattern of hall footfall scale to measure the nausea oxygen tubed and tasted chest tightness path training to get better faster running from the peak closed dark over glacial shale shards sierra swim for corpuscles cold beer froth poured with tremor giving in not giving up bread or more bread for gut rebellion pull altitude from the air until sleep pilled relief. (Source: JAMA)
Source: JAMA - December 19, 2023 Category: General Medicine Source Type: research
Synthesis and functionalization of mucoadhesive mesoporous silica particles containing diphenhydramine for treatment of aphthous ulcers
CONCLUSION: Eventually, the mucoadhesive study and DPH-loaded particles were investigated. Also, the MSN-SH exhibited a high mucoadhesive capacity for buccal mucosa compared with MSN-NH2 and MSN.PMID:38022378 | PMC:PMC10676526 | DOI:10.34172/bi.2023.27548 (Source: BioImpacts)
Source: BioImpacts - November 29, 2023 Category: Research Authors: Azadeh Vaezi Moghaddam Seyed Alireza Mortazavi Farzad Kobarfard Reza Bafkary Behzad Darbasizadeh Source Type: research
