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Doxepin and diphenhydramine increased non-rapid eye movement sleep through blockade of histamine H1 receptors
Publication date: Available online 11 December 2014 Source:Pharmacology Biochemistry and Behavior Author(s): Yi-Qun Wang , Yohko Takata , Rui Li , Ze Zhang , Meng-qi Zhang , Yoshihiro Urade , Wei-Min Qu , Zhi-Li Huang Histaminergic neurons have been reported to play an important role in the regulation of sleep-wake behavior through the histamine H1 receptor (R, H1R). First generation H1R antagonists, such as doxepin and diphenhydramine, produce drowsiness in humans, and are occasionally used to treat insomnia. However, if H1R antagonists function via physically blocking the H1R remains unclear. In the current study, we u...
Source: Pharmacology Biochemistry and Behavior - December 11, 2014 Category: Biochemistry Source Type: research

Respiratory drugs prescribed off-label among children in the outpatient clinics of a hospital in Malaysia
Conclusion There was substantial prescribing of respiratory drugs for children in an off-label manner at the outpatient clinics at the Universiti Kebangsaan Malaysia Medical Centre. This highlights the need for more research to be carried out on respiratory drugs in the pediatric population. (Source: International Journal of Clinical Pharmacy)
Source: International Journal of Clinical Pharmacy - December 9, 2014 Category: Drugs & Pharmacology Source Type: research

In vitro detection of cardiotoxins or neurotoxins affecting ion channels or pumps using beating cardiomyocytes as alternative for animal testing.
Abstract The present study investigated if and to what extent murine stem cell-derived beating cardiomyocytes within embryoid bodies can be used as a broad screening in vitro assay for neurotoxicity testing, replacing for example in vivo tests for marine neurotoxins. Effect of nine model compounds, acting on either the Na(+), K(+), or Ca(2+) channels or the Na(+)/K(+) ATP-ase pump, on the beating was assessed. Diphenhydramine, veratridine, isradipine, verapamil and ouabain induced specific beating arrests that were reversible and none of the concentrations tested induced cytotoxicity. Three K(+) channel blockers, a...
Source: Toxicology in Vitro - December 2, 2014 Category: Toxicology Authors: Nicolas J, Hendriksen PJ, de Haan LH, Koning R, Rietjens IM, Bovee TF Tags: Toxicol In Vitro Source Type: research

An LC-MS/MS method for the simultaneous determination of lycorine and galanthamine in rat plasma and its application to pharmacokinetic study of Lycoris radiata extract in rats
Summary A rapid, sensitive, and selective liquid chromatography-tandem mass spectrometry was developed for the simultaneous determination of lycorine and galanthamine, two major constituents in Lycoris radiata extract, in rat plasma. Liquid-liquid extraction with ethyl ether was carried out using diphenhydramine as the internal standard. The two bioactive alkaloids were separated on a Zorbax SB-C18 reserved-phase column (150 mm × 4.6 mm, i.d., 5 μm) by gradient elution using a mobile phase consisting of methanol with 0.1% formic acid (A) and water with 0.1% formic acid (B) at a flow rate of 0.6 mL/min. All anal...
Source: Journal of Huazhong University of Science and Technology -- Medical Sciences -- - December 1, 2014 Category: Research Source Type: research

Acute vocal fold dystonic reaction to Propofol: A case report
Publication date: Available online 20 November 2014 Source:American Journal of Otolaryngology Author(s): Rachel C. Steckelberg , David Tsiang , Kelly Pettijohn , Abie Mendelsohn , Nir Hoftman A 67-year old male underwent uneventful robotic-assisted thorascopic resection of a solitary pulmonary fibrous tumor. Immediately following extubation at the completion of the surgical procedure, the patient developed respiratory distress that did not resolve with treatment. Benadryl provided only temporary relief. Midazolam and Hydromorphone were given for anxiolysis and analgesia respectively, which provided transient relief of sy...
Source: American Journal of Otolaryngology - November 28, 2014 Category: Endocrinology Source Type: research

The Case Files: The Effects of an Epidural Steroid Injection
This study showed that the duration of absorption of 50 ml of air decreased from 5.8 to 1.9 weeks by 40% FiO2 from 1.9 to 0.6 weeks on room air and 100% FiO2, respectively. (Anesthesiology 1996;84[2]:442.)     Several diagnoses should be added to the headache differential diagnosis in the case of a patient receiving recent epidural spinal injections. Post-procedural headache or low-pressure headache, as well as pneumocephalus, should be added to the differential. The patient can be easily placed on a face mask to expedite air resorption, and can be provided symptom control as needed. This patient was successfully manag...
Source: The Case Files - November 21, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Stability of i.v. admixture containing metoclopramide, diphenhydramine hydrochloride, and dexamethasone sodium phosphate in 0.9% sodium chloride injection.
CONCLUSION: An i.v. admixture containing metoclopramide 1.6 mg/mL, diphenhydramine hydrochloride 2 mg/mL, and dexamethasone sodium phosphate 0.16 mg/mL in 0.9% sodium chloride injection was chemically stable for 48 hours when stored at room temperature without light protection. PMID: 25404598 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)
Source: American Journal of Health-System Pharmacy : AJHP - November 20, 2014 Category: Drugs & Pharmacology Authors: Kintzel PE, Zhao T, Wen B, Sun D Tags: Am J Health Syst Pharm Source Type: research

Variability of bioavailability and intestinal absorption characteristics of bisoprolol.
Authors: Ishida K, Horie A, Nishimura M, Taguchi M, Fujii N, Nozawa T, Inoue H, Hashimoto Y Abstract We previously reported that renal function is partly responsible for the interindividual variability of the pharmacokinetics of bisoprolol. The aim of the present study was to examine the variability of bioavailability (F) of bisoprolol in routinely treated Japanese patients and intestinal absorption characteristics of the drug. We first analyzed the plasma concentration data of bisoprolol in 52 Japanese patients using a nonlinear mixed effects model. We also investigated the cellular uptake of bisoprolol using huma...
Source: Drug Metabolism and Pharmacokinetics - November 18, 2014 Category: Drugs & Pharmacology Tags: Drug Metab Pharmacokinet Source Type: research

Variability of bioavailability and intestinal absorption mechanisms of metoprolol.
Authors: Fukao M, Ishida K, Horie A, Taguchi M, Nozawa T, Inoue H, Hashimoto Y Abstract We previously reported that aging and/or cytochrome P450 2D6 polymorphism are responsible for the interindividual variability in the systemic clearance (CL) and bioavailability (F) of metoprolol. The aim of the present study was to evaluate the residual variability of F of metoprolol in routinely treated Japanese patients and to investigate the intestinal absorption mechanism of the drug using human intestinal epithelial LS180 cells. We first re-analyzed the blood concentration data for metoprolol in 34 Japanese patients using a...
Source: Drug Metabolism and Pharmacokinetics - November 18, 2014 Category: Drugs & Pharmacology Tags: Drug Metab Pharmacokinet Source Type: research

Modulatory effects of taurine on jejunal contractility.
Abstract Taurine (2-aminoethanesulfonic acid) is widely distributed in animal tissues and has diverse pharmacological effects. However, the role of taurine in modulating smooth muscle contractility is still controversial. We propose that taurine (5-80 mM) can exert bidirectional modulation on the contractility of isolated rat jejunal segments. Different low and high contractile states were induced in isolated jejunal segments of rats to observe the effects of taurine and the associated mechanisms. Taurine induced stimulatory effects on the contractility of isolated rat jejunal segments at 3 different low contractil...
Source: Braz J Med Biol Res - November 16, 2014 Category: Research Authors: Yao QY, Chen DP, Ye DM, Diao YP, Lin Y Tags: Braz J Med Biol Res Source Type: research

Efficacy and Tolerability of Benzodiazepines for the Treatment of Behavioral and Psychological Symptoms of Dementia: A Systematic Review of Randomized Controlled Trials
The objective of this review is to summarize the available data on the use of benzodiazepines for the treatment of behavioral and psychological symptoms of dementia (BPSD) from randomized controlled trials (RCTs). A systematic search of 5 major databases, PubMed, MEDLINE, PsychINFO, EMBASE, and Cochrane Collaboration, yielded a total of 5 RCTs. One study compared diazepam to thioridazine, 1 trial compared oxazepam to haloperidol and diphenhydramine, 1 trial compared alprazolam to lorazepam, 1 trial compared lorazepam to haloperidol, and 1 trial compared intramuscular (IM) lorazepam to IM olanzapine and placebo. The data in...
Source: American Journal of Alzheimer's Disease and Other Dementias - November 12, 2014 Category: Geriatrics Authors: Tampi, R. R., Tampi, D. J. Tags: Reviews Source Type: research

Effects of antihistamines on the function of Human α7-nicotinic acetylcholine receptors.
Abstract Effects of the histamine H1 receptor (H1R) antagonists (antihistamines), promethazine (PMZ), orphenadrine (ORP), chlorpheniramine (CLP), pyrilamine (PYR), diphenhydramine (DPH), citerizine (CTZ), and triprolidine (TRP) on the functional properties of the cloned α7 subunit of the human nicotinic acetylcholine receptor expressed in Xenopus oocytes were investigated. Antihistamines inhibited the α7- nicotinic acetylcholine receptor in the order PYR>CLP>TRP>PMZ>ORP≥DPH≥CTZ. Among the antihistamines, PYR showed the highest reversible inhibition of acetylcholine (100µM)-induced responses with ...
Source: European Journal of Pharmacology - November 8, 2014 Category: Drugs & Pharmacology Authors: Sadek B, Soha Khanian S, Ashoor A, Prytkova T, Ghattas MA, Atatreh N, Nurulain SM, Susan Yang KH, Christopher Howarth F, Oz M Tags: Eur J Pharmacol Source Type: research

Mouse anaphylactic shock is caused by reduced cardiac output, but not by systemic vasodilatation or pulmonary vasoconstriction, via PAF and histamine
Publication date: 29 October 2014 Source:Life Sciences, Volume 116, Issue 2 Author(s): Mofei Wang , Toshishige Shibamoto , Mamoru Tanida , Yuhichi Kuda , Yasutaka Kurata Aims Systemic anaphylaxis is life-threatening, and its pathophysiology is not fully clarified. Mice are frequently used for experimental study on anaphylaxis. However, the hemodynamic features and mechanisms of mouse anaphylactic hypotension remain unknown. Therefore, we determined mechanisms of systemic and pulmonary vascular response to anaphylactic hypotension in anesthetized BALB/c mice by using receptor antagonists of chemical mediators. Main metho...
Source: Life Sciences - November 4, 2014 Category: Biology Source Type: research

Life-Threatening Diphenhydramine Toxicity Presenting With Seizures and a Wide Complex Tachycardia Improved With Intravenous Fat Emulsion
We present the case of a 30-year-old woman presenting with seizures, a wide complex tachycardia, and cardiovascular collapse after an ingestion of diphenhydramine refractory to other therapies with rapid improvement after IFE administration. (Source: American Journal of Therapeutics)
Source: American Journal of Therapeutics - November 1, 2014 Category: Drugs & Pharmacology Tags: Case Report Source Type: research

Fatal diphenhydramine poisoning in a dog.
We report a fatal diphenhydramine poisoning of a 10-year-old, male poodle-cross dog with pre-existing conditions and suspected co-ingestion of ethanol. This case illustrates that diphenhydramine overdose can be fatal in certain circumstances and that analytical toxicology may play an important role in animal death investigations. PMID: 25392554 [PubMed - in process] (Source: The Canadian Veterinary Journal)
Source: The Canadian Veterinary Journal - November 1, 2014 Category: Veterinary Research Authors: Buchweitz JP, Raverty SA, Johnson MB, Lehner AF Tags: Can Vet J Source Type: research

Effect of ingested H antihistamines on methacholine challenge
Current guidelines recommend withholding H1 antihistamines before methacholine challenge.1 There does not appear to be much evidence to support this recommendation. We performed a double-blind random-order study comparing single-dose diphenhydramine, desloratadine, and cetirizine to placebo on the airway response to methacholine. (Source: Journal of Allergy and Clinical Immunology)
Source: Journal of Allergy and Clinical Immunology - October 24, 2014 Category: Allergy & Immunology Authors: Donald W. Cockcroft, Beth E. Davis, Yeonju Roh, Joe-Ann Lourens Tags: Letter to the Editor Source Type: research

Comparative Pharmacology and Toxicology of Pharmaceuticals in the Environment: Diphenhydramine Protection of Diazinon Toxicity in Danio rerio but Not Daphnia magna
Abstract Pharmaceuticals and other contaminants of emerging concern present unique challenges to environmental risk assessment and management. Fortunately, mammalian pharmacology and toxicology safety data are more readily available for pharmaceuticals than other environmental contaminants. Identifying approaches to read-across such pharmaceutical safety information to non-target species represents a major research need to assess environmental hazards. Here, we tested a biological read-across hypothesis from emergency medicine with common aquatic invertebrate and vertebrate models. In mammals, the antihistamine di...
Source: The AAPS Journal - October 18, 2014 Category: Drugs & Pharmacology Source Type: research

Flushing and pruritus secondary to prescription fish oil ingestion in a patient with allergy to fish
Conclusion Due to the patient’s allergic history, timing of onset/offset of the reaction, laboratory evidence, and the use of the Naranjo probability scale, prescription fish oil capsules were deemed the probable cause of this patient’s pruritus and flushing of the face and trunk. Practitioners and patients should always ensure they have an updated list of allergies within the patient’s medical record that includes medications as well as foods and food additives. (Source: International Journal of Clinical Pharmacy)
Source: International Journal of Clinical Pharmacy - October 16, 2014 Category: Drugs & Pharmacology Source Type: research

Septic Cavernous Sinus Thrombosis Caused by Sinusitis
By Ichwan, Brian MD; Barrie, Michael MD; Neltner, Kurt MD A 37-year-old man with no significant medical history presented to the emergency department with a headache. He described it as an insidious, constant severe pain that was initially localized occipital but progressed to a bitemporal distribution. His neurologic exam, extraocular movements, and visual acuity were all normal. The patient was given symptomatic treatment with compazine and Benadryl. He was responsive to therapy and discharged home after his headache symptoms resolved.   Seven days later, however, he presented to the emergency department with a worse...
Source: The Case Files - October 14, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Oil-in-water emulsion lotion providing controlled release using 2-methacryloyloxyethyl phosphorylcholine n-butyl methacrylate copolymer as emulsifier
Publication date: 2012 Source:Results in Pharma Sciences, Volume 2 Author(s): Akiko Ishikawa , Makiko Fujii , Kumi Morimoto , Tomomi Yamada , Naoya Koizumi , Masuo Kondoh , Yoshiteru Watanabe Lotion is a useful vehicle for active ingredients used to treat skin disease because it can be applied to the scalp, can cover large areas of skin, and it is easy to spread due to low viscosity. An emulsion lotion (EL) containing 2-methacryloyloxyethyl phosphorylcholine n-butyl methacrylate copolymer (PMB) as an emulsifier that provides controlled-release was developed. Diphenhydramine (DPH) was used as a model drug. Formulation wit...
Source: Results in Pharma Sciences - October 12, 2014 Category: Drugs & Pharmacology Source Type: research

Common ocular effects reported to a poison control center after systemic absorption of drugs in therapeutic and toxic doses
Purpose of reviewOcular effects resulting from medications assist toxicologists in determining substances involved when treating a poisoned patient. The intention of this review is to discuss the most common ocular effects, the medications that cause them, and the mechanisms by which they occur. Recent findingsAccording to National Poison Data System, the most common reported ocular effects following a drug ingestion/injection/inhalation are mydriasis, miosis, and nystagmus. The most common drug/drug classes reported to a regional poison control center causing these ocular effects include the following: first, mydriasis ...
Source: Current Opinion in Ophthalmology - October 6, 2014 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by Russell W. Read Source Type: research

Abstract 5041: The effect of YOCAS(C)(R) Yoga on prescription sleep medication and over-the-counter sleep medication usage in cancer survivors with impaired sleep quality
Background: Impaired sleep quality (ISQ) is highly prevalent among cancer survivors; 30-90% of cancer survivors report some form of ISQ following treatment. Cancer survivors with ISQ are often provided with sleep medications, which fall into two classes: prescription sleep medications (PSM) or over-the-counter sleep medications (OSM). The most common PSM are non-benzodiazepine hypnotics (NBH), benzodiazepines (BENZO), and tricyclic antidepressants (TCA). PSM have an uncertain efficacy, carry a risk of dependency, and may cause deleterious side effects. OSM (usually diphenhydramine and doxylamine) are believed to be safer, ...
Source: Cancer Research - September 30, 2014 Category: Cancer & Oncology Authors: Peppone, L. J., Janelsins, M., Friedberg, J., Tejani, M., Kamen, C., Flannery, M., Peoples, A., Atkins, J., Melnik, M., Mustian, K. Tags: Prevention Research Source Type: research

Hypnotic use and fatigue in multiple sclerosis
• Fatigue, insomnia, and hypnotic use are each common in patients with multiple sclerosis (MS).• Products that contain diphenhydramine account for a high proportion of hypnotic use in MS.• Over-the-counter hypnotic use is independently associated with MS-related fatigue. (Source: Sleep Medicine)
Source: Sleep Medicine - September 25, 2014 Category: Sleep Medicine Authors: Tiffany J. Braley, Benjamin M. Segal, Ronald D. Chervin Tags: Original Article Source Type: research

1532p * the evaluation of paclitaxel hypersensitivity reactions (hsrs) following the discontinuation of prophylactic pre-medications
Conclusions: In patients receiving paclitaxel+platinum regimens or paclitaxel +/- trastuzumab, the discontinuation of pre-medications is a safe and feasible option if a patient has not experienced an HSR during the first or second dose of paclitaxel.Disclosure: All authors have declared no conflicts of interest. (Source: Annals of Oncology)
Source: Annals of Oncology - September 24, 2014 Category: Cancer & Oncology Authors: Meyer, C., Raymond, C., Lee, R., Amir, E., Mackay, H., Oza, A. M., Warr, D., Ng, P. Tags: supportive care Source Type: research

893p * predictors of hypersensitivity reactions (hsrs) in patients receiving carboplatin-based chemotherapy for ovarian cancer
Conclusions: Ovarian cancer patients receiving 8 to 10 cycles of carboplatin-containing chemotherapy and those with a long interval (>12 months) since last receiving carboplatin are at an increased risk of carboplatin-induced HSRs. These patients may be targeted for future prevention therapies.Disclosure: All authors have declared no conflicts of interest. (Source: Annals of Oncology)
Source: Annals of Oncology - September 24, 2014 Category: Cancer & Oncology Authors: Jerzak, K. J., Manshadi, S. D., Ng, P., Maganti, M., McCuaig, J. M., Oza, A. M., Mackay, H. Tags: gynaecological cancers Source Type: research

Symptomatic treatment of the cough in whooping cough.
CONCLUSIONS: There is insufficient evidence to draw conclusions about the effectiveness of interventions for the cough in whooping cough. More high-quality trials are needed to assess the effectiveness of potential antitussive treatments in patients with whooping cough. PMID: 25243777 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 22, 2014 Category: Journals (General) Authors: Wang K, Bettiol S, Thompson MJ, Roberts NW, Perera R, Heneghan CJ, Harnden A Tags: Cochrane Database Syst Rev Source Type: research

A viscous lidocaine mouthwash is no better than placebo for improving oral intake in children with painful mouth ulcers
Commentary on: Hopper SM, McCarthy M, Tancharoen C, et al.. Topical lidocaine to improve oral intake in children with painful infectious mouth ulcers: a blinded, randomized, placebo-controlled trial. Ann Emerg Med 2014;63:292–9. Context Ulcerative oral conditions, infectious (herpetic gingivostomatitis, herpangina, hand, foot and mouth disease) and non-infectious (pharyngitis, gingivostomatitis and aphthous), are often observed in children.1 While most conditions are benign, they can be highly painful, impair food intake, and, more specifically, result in dehydration in young children. Aetiological therapies of viral...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Descroix, V., Coudert, A. E. Tags: Pain (neurology), Dentistry and oral medicine, Ear, nose and throat/otolaryngology Therapeutics Source Type: research

Pre-medications for cetuximab induced infusion reactions – Commentary
We read with great interest the recent work by Touma and colleagues evaluating the role of additional pre-medications to mitigate cetuximab-related hypersensitivity reactions (HSR) [1]. Their results suggest the addition of dexamethasone, albuterol and famotidine to diphenhydramine prior to cetuximab reduces the incidence of overall as well as high-grade HSR. This finding is in agreement with a retrospective analysis of the MABEL trial, which indicated that dexamethasone as a premedication reduced the rate of HSR [2]. (Source: Oral Oncology)
Source: Oral Oncology - September 14, 2014 Category: Cancer & Oncology Authors: Trevor McKibbin, R. Donald Harvey, Nabil F. Saba Tags: Letter to the editor Source Type: research

Electrocardiogram attenuation of QRS complexes in association with Takotsubo syndrome
The interesting case report by Rojas-Marte et al. [1], published ahead of print in the Journal on July 31, 2014, about a 31year-old woman who suffered Takotsubo syndrome (TTS), complicated by cardiac arrest and cardiogenic shock, following an overdose of ibuprofen and diphenhydramine, and was treated successfully with extracorporeal membrane oxygenation, provides me with the opportunity to bring to the attention of the authors a newly described association of TTS with early transient electrocardiogram (ECG) attenuation of the QRS complexes (ATTQRS) [2,3]. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - September 14, 2014 Category: Cardiology Authors: John E. Madias Source Type: research

The Case Files: Culling through Diagnoses to Get to Rat Bite Fever
By Dyer, Alexandra; Berg, Kenneth MD; King, Andrew MD Rat bite fever (RBF) is a fairly rare illness caused by Streptobacillus moniliformis or Spirillum minus. It can be a devastating and even fatal illness if left undiagnosed or untreated. Despite its name, RBF is not only transmitted by rat bites but also by contact with rat feces, ingestion of rat-contaminated food and water, or simply through direct contact with rats. (Clin Microbiol Rev 2007;20[1]:13; Vet Microbiol 2009;133[3]:211; BMJ Case Rep 2009; Epub Dec 17.) The first documented outbreak in Haverhill, MA, in 1926 was believed to be caused by a pathogen named Have...
Source: The Case Files - September 2, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Diphenhydramine’s Role in Death Investigations: An Examination of Diphenhydramine Prevalence in 2 US Geographical Areas
ConclusionsAs people seek legal alternative drugs to abuse and with the ease of obtaining information via online forums, there is a potential to see an increase in the number of cases involving excessive use of DPH. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - September 1, 2014 Category: Forensic Medicine Tags: Case Reports Source Type: research

Immediate hypersensitivity reaction following liposomal amphotericin-B (AmBisome) infusion.
We report two patients with kala-azar: one developed breathing difficulties and hypotension followed by shock and the other had facial angioedema with chest tightness during treatment. Both patients were managed with immediate action of injection: adrenaline, diphenhydramine and hydrocortisone. In our experience, AmBisome can cause severe hypersensitivity reactions that warrant proper support and close supervision. PMID: 25139411 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - August 19, 2014 Category: Tropical Medicine Authors: Nath P, Basher A, Harada M, Sarkar S, Selim S, Maude RJ, Noiri E, Faiz A Tags: Trop Doct Source Type: research

Inadvertent Iatrogenic Misuse of Intravenous Diphenhydramine in an Adolescent: Implications for Routine Medication Administration
Journal of Child and Adolescent Psychopharmacology , Vol. 0, No. 0. (Source: Journal of Child and Adolescent Psychopharmacology)
Source: Journal of Child and Adolescent Psychopharmacology - July 30, 2014 Category: Pediatrics Tags: article Source Type: research

The Case Files: CrossFit-Induced Carotid Artery Dissection
By Fox, Alex MD; King, Andrew MD   CrossFit has become a workout phenomenon with more than 5,500 gyms and millions of staunch followers. Developed by Greg Glassman, CrossFit defines itself as “that which optimizes fitness, constantly varied functional movements performed at relatively high intensity.” The craze has been embraced by fitness enthusiasts and weekend warriors alike.   These intense workouts can be dangerous for those with less experience who do not have trainers to help ease them into the routine. A 2005 New York Times article, “Getting Fit, Even If It Kills You,” criticized CrossFit for placing emph...
Source: The Case Files - July 8, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Scavenger hunt: A creative teaching strategy to introduce pharmacological concepts and ethical concerns
Abstract: The sheer volume and number of errors in medication administration obliges nursing educators to facilitate a higher level of student understanding in foundational pharmacological concepts. The focus of this manuscript was the use of a faculty created teaching strategy to introduce foundational pharmacological concepts and ethical concerns in an undergraduate nursing pharmacology course. The use of the Scavenger Hunt facilitated active learning and student engagement as students were responsible for and active in their own learning.The intent of the Scavenger Hunt was to introduce students to complex pharmacologic...
Source: Teaching and Learning in Nursing - July 1, 2014 Category: Nursing Authors: Elizabeth A. Tinnon Source Type: research

Olfactory stimulatory with grapefruit and lavender oils change autonomic nerve activity and physiological function.
Abstract This review summarizes the effects of olfactory stimulation with grapefruit and lavender oils on autonomic nerve activity and physiological function. Olfactory stimulation with the scent of grapefruit oil (GFO) increases the activity of sympathetic nerves that innervate white and brown adipose tissues, the adrenal glands, and the kidneys, decreases the activity of the gastric vagal nerve in rats and mice. This results in an increase in lipolysis, thermogenesis, and blood pressure, and a decrease in food intake. Olfactory stimulation with the scent of lavender oil (LVO) elicits the opposite changes in nerve...
Source: Autonomic Neuroscience - June 25, 2014 Category: Neuroscience Authors: Nagai K, Niijima A, Horii Y, Shen J, Tanida M Tags: Auton Neurosci Source Type: research

Novel Use of Dexmedetomidine for the Treatment of Anticholinergic Toxidrome.
We report the case of an adolescent with anticholinergic toxidrome from diphenhydramine overdose, whose symptoms were treated with a novel application of dexmedetomidine. CASE REPORT: A 13-year-old female developed an anticholinergic toxidrome after intentionally ingesting 9.5 mg/kg of diphenhydramine. Despite routine supportive therapies, to include appropriate doses of lorazepam, she continued to have significant agitation, psychosis, and hallucinations. A dexmedetomidine infusion was started to aid in the treatment of her agitation and psychosis with marked improvement of her symptoms. DISCUSSION: Using dexmede...
Source: Journal of Medical Toxicology - June 19, 2014 Category: Toxicology Authors: Walker A, Delle Donne A, Douglas E, Spicer K, Pluim T Tags: J Med Toxicol Source Type: research

Honey for acute cough in children
Abstract BackgroundCough causes concern for parents and is a major cause of outpatient visits. It can impact on quality of life, cause anxiety and affect sleep in parents and children. Several remedies, including honey, have been used to alleviate cough symptoms. ObjectivesTo evaluate the effectiveness of honey for acute cough in children in ambulatory settings. Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2011) which contains the Cochrane Acute Respiratory Infections Group's Specialised Register; MEDLINE (1950 to December week 4, 2011); EMBASE (1990 ...
Source: Evidence-Based Child Health: A Cochrane Review Journal - June 16, 2014 Category: Pediatrics Authors: Olabisi Oduwole, Martin M Meremikwu, Angela Oyo‐Ita, Ekong E Udoh Tags: Intervention Review Source Type: research

Effects of Leukoreduction and Premedication With Acetaminophen and Diphenhydramine in Minimizing Febrile Nonhemolytic Transfusion Reactions and Allergic Transfusion Reactions During and After Blood Product Administration: A Literature Review With Recommendations for Practice
Transfusion-related reactions cause unwanted interruptions in blood-product administration and potential complications for patients. The most common reactions are febrile nonhemolytic transfusion reactions (FNHTRs) and allergic transfusion reactions (ATRs). The presence of leukocytes in blood products has been associated with these reactions, and efficacy of leukoreduction in minimizing FNHTRs and ATRs has recently been investigated. In addition, premedication with acetaminophen and diphenhydramine is the most widely used practice in minimizing FNHTRs and ATRs, yet the benefit of this is not supported by research. The aim ...
Source: Journal of Pediatric Oncology Nursing - June 13, 2014 Category: Nursing Authors: Duran, J., Siddique, S., Cleary, M. Tags: Articles Source Type: research

The Case Files: Disease Traveling by Plane
By Hirashima, Eva Tovar MD, MPH; Crucio, Ted MD   A 34-year-old woman presented to the ED complaining of nausea, vomiting, and body tingling. She had just returned from a one-week stay in Haiti. Four days prior to presentation, she had eaten red snapper in a local restaurant. A few hours after the ingestion, she had colicky abdominal pain, watery non-bloody diarrhea, and circumoral tingling, which later progressed to generalized itching, tingling, and intense burning.   The patient reported on arrival at our ED improvement of the diarrhea, but the generalized itching and tingling had worsened, and she complained of fatig...
Source: The Case Files - June 4, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Use of a Physostigmine Continuous Infusion for the Treatment of Severe and Recurrent Antimuscarinic Toxicity in a Mixed Drug Overdose.
We present a case of physostigmine continuous infusion for the treatment of antimuscarinic symptoms in a polydrug overdose due to the ingestion of diphenhydramine along with bupropion, citalopram, acetaminophen, and naproxen. CASE PRESENTATION: A 13-year-old female presented with hyperthermia, myoclonus and rigidity, hallucinations, severe agitation, and antimuscarinic toxicity including inability to sweat after a polydrug overdose. Several doses of lorazepam were administered followed by physostigmine which produced resolution of hallucinations and attenuation of the antimuscarinic symptoms including perspiration, tem...
Source: Journal of Medical Toxicology - May 6, 2014 Category: Toxicology Authors: Phillips MA, Acquisto NM, Gorodetsky RM, Wiegand TJ Tags: J Med Toxicol Source Type: research

A Randomized Trial of the Effectiveness of Topical “ABH Gel” (Ativan, Benadryl, Haldol) vs. Placebo in Cancer Patients With Nausea
(Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - May 1, 2014 Category: Palliative Care Authors: Devon S. Fletcher, Patrick J. Coyne, Patricia W. Dodson, Gwendolyn G. Parker, Wen Wan, Thomas J. Smith Source Type: research

A Randomized Trial of the Effectiveness of Topical “ABH Gel” (Ativan, Benadryl, Haldol) vs. Placebo in Cancer Patients With Nausea
The topical gel known as “ABH gel,” comprising lorazepam (Ativan®), diphenhydramine (Benadryl®), and haloperidol (Haldol®), is frequently used to treat nausea because of its perceived efficacy, relatively low cost, and ease of use in the home setting. There are limited scientific data on this medication, however. Recent pilot studies showed no absorption of the active ingredients of the gel, prompting further prospective studies into the cause of the perceived efficacy in the clinical setting. (Source: Journal of Pain and Symptom Management)
Source: Journal of Pain and Symptom Management - May 1, 2014 Category: Palliative Care Authors: Devon S. Fletcher, Patrick J. Coyne, Patricia W. Dodson, Gwendolyn G. Parker, Wen Wan, Thomas J. Smith Tags: Original Article Source Type: research

Neurology, Volume 1, 1951 (P1.293)
CONCLUSIONS: Notable authors of papers in the first issue of Neurology included Drs. Adolph Sahs, Francis Forster, A.B. Baker, Elizabeth Crosby, W.G. Lennox, and Webb Haymaker, author of Bing's Local Diagnosis in Neurological Diseases. Percival Bailey authored a paper on the past, present and future of Neurology in the U.S. Bailey, one of the most prominent neurosurgeons of the era, had trained in neurosurgery with Harvey Cushing. Frederic and Erna Gibbs, authors of the first atlas of EEG wrote a paper on thalamic and hypothalamic epilepsy. There was also a paper on 14 and 6 spikes, which had been described by the Gibbses....
Source: Neurology - April 9, 2014 Category: Neurology Authors: Campbell, W. Tags: History of Neurology Source Type: research

Age-related pharmacokinetic changes of acetaminophen, antipyrine, diazepam, diphenhydramine, and ofloxacin in male cynomolgus monkeys and beagle dogs.
Abstract Abstract 1.  The pharmacokinetics of acetaminophen (marker of gastric emptying), antipyrine (marker of hepatic metabolic activity and total body water), diazepam (lipophilic and highly distributed), diphenhydramine (hepatic blood flow-limited and alpha-1 acid glycoprotein bound) and ofloxacin (renally eliminated) were evaluated in cynomolgus monkeys (3-18 years old) and beagle dogs (2-11 years old) as models in elderly persons. 2.  Gastric pH fluctuated with aging in monkeys and dogs. The concentration of alpha-1 acid glycoprotein appeared to be increased by aging. There were no age-related differences...
Source: Xenobiotica - March 21, 2014 Category: Research Authors: Koyanagi T, Yamaura Y, Yano K, Kim S, Yamazaki H Tags: Xenobiotica Source Type: research

Diphenhydramine dependence through deep intramuscular injection resulting in myonecrosis and prolonged QT interval
We describe a retired nurse with history of depression, who began to develop drug‐seeking behaviour after her first receiving of an intramuscular (IM) DPH injection due to urticaria. Case summaryThe 49‐year‐old patient had developed IM DPH dependence within 4 months. She needed to receive psychiatric inpatient treatment because of depressive mood, serious myonecrosis over injected sites, and prolongation of QT interval. What is new and conclusionThis is the first reported case of DPH dependence through the IM route. Second‐generation antihistamines might be better choices for patients with psychiatric illness by re...
Source: Journal of Clinical Pharmacy and Therapeutics - March 6, 2014 Category: Drugs & Pharmacology Authors: T.‐Y. Chen, Y.‐W. Yeh, S.‐C. Kuo, C.‐Y. Chen, T.‐P. Lin, C.‐C. Chang Tags: Case Report Source Type: research

Rituximab Use in Pediatric Central Demyelinating Disease
Conclusions: The use of rituximab in our pediatric neuromyelitis optica and multiple sclerosis cohort was overall safe and effective. Larger studies should confirm our observations. (Source: Pediatric Neurology)
Source: Pediatric Neurology - February 18, 2014 Category: Neurology Authors: Shannon J. Beres, Jennifer Graves, Emmanuelle Waubant Tags: Clinical Observations Source Type: research

Mechanism of the Histamine H3 Receptor-mediated Increase in Exploratory Locomotor Activity and Anxiety-like Behaviours in Mice.
This study aimed to determine the mechanism underlying H3R-mediated behavioural changes using a specific H3R antagonist, JNJ-10181457 (JNJ). First, we examined the effect of JNJ injection to mice on the concentrations of brain monoamines and their metabolites. JNJ exclusively increased N(τ)-methylhistamine, the metabolite of brain histamine used as an indicator of histamine release, suggesting that JNJ dominantly stimulates the release of histamine release but not of other monoamines. Next, we examined the mechanism underlying JNJ-induced behavioural changes using open-field tests and elevated zero maze tests. JNJ-induced...
Source: Neuropharmacology - February 13, 2014 Category: Drugs & Pharmacology Authors: Mohsen A, Yoshikawa T, Miura Y, Nakamura T, Naganuma F, Shibuya K, Iida T, Harada R, Okamura N, Watanabe T, Yanai K Tags: Neuropharmacology Source Type: research

Effects of Diphenhydramine on aqueous tear production in dogs
Antihistamines competitively inhibit histamine at H1-receptors and reduce inflammatory reactions that result from allergic reactions. Use of topical antihistamine medications to treat ocular allergy has been seldom reported in veterinary medicine. Breeds commonly diagnosed with or at increased risk for developing atopic dermatitis and/or food allergy include the boxer, West Highland white terrier, English springer spaniel, miniature schnauzer, American cocker spaniel, shih tzu, Labrador retriever, and golden retriever. Antihistamines serve as a viable symptomatic treatment option for dogs unresponsive to therapy directed a...
Source: Advances in Small Animal Medicine and Surgery - February 1, 2014 Category: Veterinary Research Source Type: research

Parenteral Treatment of Episodic Tension-Type Headache: A Systematic Review.
CONCLUSIONS: Various parenteral medications other than salicylates or nonsteroidals provide acute relief of tension-type headache. Comparative efficacy studies are needed. PMID: 24433525 [PubMed - as supplied by publisher] (Source: Headache)
Source: Headache - January 16, 2014 Category: Neurology Authors: Weinman D, Nicastro O, Akala O, Friedman BW Tags: Headache Source Type: research