Zanamivir in the Treatment and Prevention of Influenza

2000 ◽  
Vol 34 (6) ◽  
pp. 798-801 ◽  
Author(s):  
Kevin J Chapple ◽  
Anne E Hendrick ◽  
Michelle W McCarthy

OBJECTIVE: To evaluate the efficacy of zanamivir in the prevention and treatment of influenza. DATA SOURCES: Medical literature was accessed through MEDLINE (1966–June 1999). Key search terms included zanamivir, GG167, and influenza. Additional information was obtained from GlaxoWellcome, Inc. DATA SYNTHESIS: Zanamivir is the first in a new class of drugs to be developed for the treatment of influenza. An evaluation of clinical trials using inhaled zanamivir was conducted to determine its efficacy. CONCLUSIONS: Zanamivir appears to shorten the median duration of influenza symptoms by up to 2.5 days when compared with placebo. It was well tolerated in clinical trials, with mild adverse effects occurring in a small percentage of subjects.

2003 ◽  
Vol 37 (3) ◽  
pp. 438-441 ◽  
Author(s):  
Jeena E Jacob ◽  
Mary L Wagner ◽  
Jacob I Sage

OBJECTIVE: To evaluate the safety of the coadministration of selegiline with cold medications. DATA SOURCES: Clinical literature accessed through MEDLINE(1965–September 2002), IPA database, and Drug-Reax System. The following search terms were used: selegiline, pseudoephedrine, dextromethorphan, MAOI, and drug interactions. Somerset Pharmaceuticals, the marketers of Eldepryl (selegiline HCI), were also contacted. DATA SYNTHESIS: Despite a warning against its concomitant use with pseudoephedrine and dextromethorphan, interactions with selegiline have not been reported. However, there have been reports of patients experiencing adverse events with related agents. CONCLUSIONS: Patients taking selegiline should try to avoid pseudoephedrine and dextromethorphan or use drugs without interaction potential. If selegiline is used with these medications, watch for adverse events or replace selegiline with another drug.


2003 ◽  
Vol 37 (2) ◽  
pp. 268-273 ◽  
Author(s):  
Robert J Cersosimo

OBJECTIVE: To review data on the use of tamoxifen for primary prevention of breast cancer. DATA SOURCES: A literature search was performed through MEDLINE (1992–May 2002) using the key words tamoxifen, breast cancer, and prevention. DATA SYNTHESIS: Breast cancer is the most common malignancy detected in American women. Attempts to reduce morbidity and mortality include early detection programs and chemoprevention. Clinical trials of tamoxifen for reduction of breast cancer risk are reviewed. CONCLUSIONS: Tamoxifen may reduce the risk of primary breast cancer in women at increased risk. The benefit of tamoxifen in women who are not at risk is uncertain. The risks of developing thromboembolic disorders or endometrial cancer must be considered before tamoxifen is prescribed. Women should be given all of the information about the benefits and risks of tamoxifen use so that they can make an informed decision based on the best data available.


1992 ◽  
Vol 26 (10) ◽  
pp. 1277-1282 ◽  
Author(s):  
Theresa V. Kot ◽  
Ngaire A. Pettit-Young

OBJECTIVE: To review the current published clinical studies evaluating the clinical efficacy and safety of lactulose compared with other laxatives or placebo. Adverse effects associated with lactulose are also reported. DATA SOURCES: Information was retrieved by searching the MEDLINE and EMBASE databases for clinical trials, abstracts, conference proceedings, and review articles dealing with lactulose. STUDY SELECTION: Emphasis was placed on clinical trials where lactulose was compared with other laxatives or placebo in patient populations where the diagnosis of constipation was reasonably established. DATA EXTRACTION: The methodology and results from clinical studies were evaluated. Assessment of the studies was made based on diagnosis of constipation, prior management of patients, follow-up of patients, dosage, and adverse effects. DATA SYNTHESIS: Clinical trials in geriatric patients, terminally ill patients, children, and normal and constipated subjects were reviewed. In most instances, lactulose was compared with a placebo, without incorporating the current education on dietary techniques for improving defecation. CONCLUSIONS: Generally, clinical trials have demonstrated a beneficial response compared with placebo, although sometimes that response has been only marginally better, from a clinical point of view.


2001 ◽  
Vol 35 (7-8) ◽  
pp. 943-946 ◽  
Author(s):  
Laura M Gianni ◽  
Maria Marzella Sulli

OBJECTIVE: To review the efficacy of topical tacrolimus in the treatment of atopic dermatitis (AD). DATA SOURCES: Searches of MEDLINE (1966–October 2000), International Pharmaceutical Abstracts (1970–October 2000), and ScienceDirect (1994–October 2000) were performed using the key search terms tacrolimus, FK506, and atopic dermatitis. DATA SYNTHESIS: Since patients with AD have defects in cell-mediated immunity, the immunosuppressant properties of the macrolides (cyclosporine and tacrolimus) may prove to be beneficial in the treatment of AD. Topical tacrolimus has been frequently studied in the treatment of AD because it was found to have better skin penetration and higher potentency than topically applied cyclosporine. Studies evaluating the use of topical tacrolimus are presented and provide evidence that topical tacrolimus is effective in the treatment of AD with no evidence thus far of systemic adverse effects. CONCLUSIONS: There is a fair amount of documentation of the efficacy and safety of topical tacrolimus. Further trials are needed to determine the optimal duration of therapy and its efficacy and safety in children less than seven years of age.


2000 ◽  
Vol 34 (4) ◽  
pp. 522-525 ◽  
Author(s):  
Randy C Hatton

OBJECTIVE: To evaluate the role of bismuth subgallate–epinephrine (BSE) paste as a hemostatic in adenotonsillectomies. DATA SOURCES: MEDLINE (January 1966–October 1999) and Current Contents (January 1997–October 1999) were searched, using bismuth subgallate, adenoidectomy, tonsillectomy, and adenotonsillectomy as search terms. A citation search was performed using Science Citation Index (January 1977–October 1999). DATA SYNTHESIS: Adenotonsillectomies are common procedures; although there are few complications, hemorrhage is a concern. Bismuth subgallate has historically been used as an astringent and hemostatic. An evaluation of studies of bismuth subgallate and BSE paste was conducted. CONCLUSIONS: There is minimal evidence to support this practice, but data suggest that epinephrine may be the active ingredient in BSE paste. BSE paste is inexpensive, poses little risk, and may decrease postoperative bleeding; therefore, it may be a reasonable hemostatic agent.


2002 ◽  
Vol 36 (10) ◽  
pp. 1625-1628 ◽  
Author(s):  
Crystal E Pratt ◽  
Steven M Davis

OBJECTIVE: To review available literature regarding the use of divalproex sodium in the treatment of agitation in elderly patients with dementia. DATA SOURCES: Clinical trials and review articles were identified by MEDLINE search (1966 — March 2002). DATA SYNTHESIS: The literature provides information regarding the potential benefits and tolerability of divalproex sodium in the treatment of dementia-related agitation. This article analyzes 7 studies to better understand the role of divalproex sodium in the treatment of dementia. CONCLUSIONS: Divalproex sodium may offer a slight benefit to elderly patients suffering from dementia-related agitation. Until better-controlled trials demonstrate statistical significance and comparisons with established treatments are performed, practitioners should use divalproex sodium cautiously.


2003 ◽  
Vol 37 (11) ◽  
pp. 1712-1715 ◽  
Author(s):  
Leslie GB Goldstein

OBJECTIVE: To describe the safety and efficacy of influenza vaccines in asthmatic children. DATA SOURCES: Literature was identified by a MEDLINE search (2002–March 2003). Key search terms included asthma, exacerbation, children, vaccine, and influenza. DATA SYNTHESIS: Concerns that the influenza vaccine may exacerbate asthma attacks have kept many asthmatic children from receiving this immunization. Researchers have conducted studies to determine the burden of influenza on asthmatic children, the safety of influenza vaccines, and their benefit in the presence of glucocorticoid burst therapy in the same population. CONCLUSIONS: Influenza vaccines tested are safe and efficacious in asthmatic children.


2002 ◽  
Vol 36 (10) ◽  
pp. 1614-1619 ◽  
Author(s):  
Angela L McQueen ◽  
Steven A Baroletti

OBJECTIVE: To review the clinical literature evaluating the utilization of intravenous ketamine for the management of cancer-related pain, to summarize the data that suggest ketamine is an appropriate adjuvant method of providing analgesia and to report a case of successful pain management using ketamine in a patient with recurrent testicular cancer at our institution. DATA SOURCES: Primary literature was identified through a MEDLINE search (1966–March 2002), and additional information was obtained through secondary and tertiary sources. DATA SYNTHESIS: The available data suggest that supplementation of morphine with ketamine improves analgesia in patients with cancer, and also provides insight to the controversy regarding the efficacy and adverse effects of various ketamine doses. At subanesthetic doses, ketamine may be beneficial at reducing opioid requirements and related adverse effects. CASE SUMMARY: A 34-year-old white man with recurrent testicular cancer was admitted with radiating neuropathic pain of the legs and lower back. The patient was suspected to also be experiencing opioid adverse effects; therefore, alternative analgesic options were warranted. Ketamine was successful in reducing patient-reported pain and was also well tolerated. CONCLUSIONS: Ketamine is an adjuvant analgesic for the treatment of cancer-related pain when other agents either fail or are intolerable. Accordingly, there are several factors that may prevent adequate pain control with opioid use; therefore, alternative analgesic options should be considered. Promise exists for ketamine as a contemporary analgesic in the appropriate patient.


2021 ◽  
Vol 15 (5) ◽  
pp. 1589-1598
Author(s):  
Z. Poursaleh ◽  
M. Khodadoost ◽  
E. Vahedi ◽  
M. M. A. Attari ◽  
M. Jafari ◽  
...  

Background: Insomnia is a universal health problem that affects the health and quality of life of people worldwide. During the last decade treatment of insomnia with herbal has been introduced to be effective but unfortunately, the safety and efficacy of these medicines are currently uncertain. However, the administration of various herbal medicines for insomnia is increasing mainly due to the diversity of various adverse effects of western medication. Objective: The present study is aimed to investigate available herbal medicine options for the treatment of chronic insomnia. Method: All demanded data were retrieved from electronic databases, Natural Medicines, TCMID, Natural Medicines Comprehensive Database, MedlinePlus, PubMed, EMBASE, and Google Scholar. Among them, randomized clinical trials were chosen precisely to be investigated more for seeking any additional information related to the treatment of chronic insomnia. All related papers in English and Persian languages included in the study criteria. At first, 162 articles were chosen to be investigated, then after screening all articles based on the PRISMA method, 83 qualified articles remained to be investigated carefully. Results: Herbal plants with medical properties as sedative agents are obtaining more and more attention because they contain various types of natural bioactive metabolites with the lowest rate of adverse effects. Moreover, these novel medicines are highly economic, with high efficacy while could be available easily. Conclusion: The data from this study demonstrated that medical plants could yield sedative activity and some of them are effective for insomnia, but we must not forget that further clinical trials are demanded to approve this. Keywords: Sleep disorders, Chronic insomnia, Herbal medicine, Alternative medication, Treatment.


2005 ◽  
Vol 39 (6) ◽  
pp. 1088-1092 ◽  
Author(s):  
Sherrill J Brown ◽  
Samantha F Eichner ◽  
Jennifer R Jones

OBJECTIVE: To evaluate the efficacy and safety of nebulized morphine for the management of dyspnea in chronic pulmonary diseases. DATA SOURCES: MEDLINE (1966–May 2004), EMBASE (1980–May 2004), and International Pharmaceutical Abstracts (1970–May 2004) searches were performed. Key search terms included morphine, dyspnea, and inhalation. DATA SYNTHESIS: Nine studies have evaluated the efficacy of nebulized morphine in relieving dyspnea. Three trials had positive resuts, but the rest failed to show improvement after treatment with doses ranging from 1 to 40 mg nebulized morphine. The small number of subjects, variety of disease states, and different outcome measures limit interpretation of the studies. CONCLUSIONS: Results from several small studies do not support the use of nebulized morphine for treatment of dyspnea; however, several positive case reports have been published.


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