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  1. Article: Etiology of Drug-Induced Edema: A Review of Dihydropyridine, Thiazolidinedione, and Other Medications Causing Edema.

    Sinnathamby, Evan S / Urban, Bretton T / Clark, Robert A / Roberts, Logan T / De Witt, Audrey J / Wenger, Danielle M / Mouhaffel, Aya / Willett, Olga / Ahmadzadeh, Shahab / Shekoohi, Sahar / Kaye, Alan D / Varrassi, Giustino

    Cureus

    2024  Volume 16, Issue 2, Page(s) e53400

    Abstract: Edema is an accumulation of fluid in the body's tissues that affects millions of Americans yearly. It can affect multiple body parts, for example, the brain or eyes, but often occurs in the periphery, including the feet and legs. Medications, such as ... ...

    Abstract Edema is an accumulation of fluid in the body's tissues that affects millions of Americans yearly. It can affect multiple body parts, for example, the brain or eyes, but often occurs in the periphery, including the feet and legs. Medications, such as dihydropyridine and thiazolidinediones (TZDs), can be the etiology of edema. Edema can develop in association with problems in the vasculature or lymphatic flow. In recent years, a better understanding of these drug-induced mechanisms has been appreciated. Specifically, dihydropyridines can increase hydrostatic pressure and cause selective pre-capillary vessel vasodilation. TZDs can cause edema through increased vascular permeability and increased hydrostatic pressure. Specifically, peroxisome proliferator-activated receptor gamma (PPARγ) stimulation increases vascular endothelial permeability, vascular endothelial growth factor (VEGF) secretion, renal sodium, and fluid retention. Other drugs that can cause edema include neuropathic pain agents, dopamine agonists, antipsychotics, nitrates, nonsteroidal anti-inflammatory (NSAIDS), steroids, angiotensin-converting enzyme (ACE) inhibitors, and insulin. There are various clinical presentations of edema. Since multiple mechanisms can induce edema, it is important to understand the basic mechanisms and pathophysiology of drug-induced edema. Edema can even become fatal. For example, angioedema can occur from ACE inhibitor therapy. In this regard, it is considered a medical emergency when there is laryngeal involvement. This review aims to thoroughly appreciate the multiple causes of drug-induced edema and the ways it can be treated or prevented.
    Language English
    Publishing date 2024-02-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.53400
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Hyperkalemia: Pharmacotherapies and Clinical Considerations.

    Sinnathamby, Evan S / Banh, Kelly T / Barham, William T / Hernandez, Tyler D / De Witt, Audrey J / Wenger, Danielle M / Klapper, Vincent G / McGregor, David / Paladini, Antonella / Ahmadzadeh, Shahab / Shekoohi, Sahar / Kaye, Alan D / Varrassi, Giustino

    Cureus

    2024  Volume 16, Issue 1, Page(s) e52994

    Abstract: Hyperkalemia has been defined as a condition where a serum potassium level is >5.5 mmol/l. It is associated with fatal dysrhythmias and muscular dysfunction. Certain medical conditions, such as chronic kidney disease (CKD), diabetes mellitus, and others, ...

    Abstract Hyperkalemia has been defined as a condition where a serum potassium level is >5.5 mmol/l. It is associated with fatal dysrhythmias and muscular dysfunction. Certain medical conditions, such as chronic kidney disease (CKD), diabetes mellitus, and others, can lead to hyperkalemia. Many of the signs of hyperkalemia are nonspecific. A history and physical examination can be beneficial in the diagnosis of the condition. In this regard, certain characteristic electrocardiogram findings are associated with hyperkalemia along with laboratory potassium levels. In acute and potentially lethal conditions, hyperkalemia treatments include glucose and insulin, bicarbonate, calcium gluconate, beta-2 agonists, hyperventilation, and dialysis. There are several drugs, both old and new, that can additionally aid in the reduction of serum potassium levels. The present investigation evaluated some of these different drugs, including sodium polystyrene sulfonate (SPS), sodium zirconium cyclosilicate (SZC), and patiromer. These drugs each have increased selectivity for potassium and work primarily in the gastrointestinal (GI) tract. Each of these medications has unique benefits and contraindications. Clinicians must be aware of these medications when managing patients with hyperkalemia.
    Language English
    Publishing date 2024-01-26
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.52994
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: The Effects of Opioid Dependency Use on Postoperative Spinal Surgery Outcomes: A Review of the Available Literature.

    Fortier, Luc / Sinkler, Margaret A / De Witt, Audrey J / Wenger, Danielle M / Imani, Farnad / Morsali, Seyedeh Fatemeh / Urits, Ivan / Viswanath, Omar / Kaye, Alan D

    Anesthesiology and pain medicine

    2023  Volume 13, Issue 4, Page(s) e136563

    Abstract: There is a lack of evidence to support the effectiveness of long-term opioid therapy in patients with chronic, noncancer pain. Despite these findings, opioids continue to be the most commonly prescribed drug to treat chronic back pain and many patients ... ...

    Abstract There is a lack of evidence to support the effectiveness of long-term opioid therapy in patients with chronic, noncancer pain. Despite these findings, opioids continue to be the most commonly prescribed drug to treat chronic back pain and many patients undergoing spinal surgery have trialed opioids before surgery for conservative pain management. Unfortunately, preoperative opioid use has been shown repeatedly in the literature to negatively affect spinal surgery outcomes. In this review article, we identify and summarize the main postoperative associations with preoperative opioid use that have been found in previously published studies by searching on PubMed, Google Scholar, Medline, and ScienceDirect; using keywords: Opioid dependency, postoperative, spinal surgery, specifically (1) increased postoperative chronic opioid use (24 studies); (2) decreased return to work (RTW) rates (8 studies); (3) increased length of hospital stay (LOS) (9 studies); and (4) increased healthcare costs (8 studies). The conclusions from these studies highlight the importance of recognizing patients on opioids preoperatively to effectively risk stratify and identify those who will benefit most from multidisciplinary counseling and guidance.
    Language English
    Publishing date 2023-07-04
    Publishing country Netherlands
    Document type Journal Article ; Review
    ZDB-ID 3018888-X
    ISSN 2228-7531 ; 2228-7523
    ISSN (online) 2228-7531
    ISSN 2228-7523
    DOI 10.5812/aapm-136563
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Low-Dose Initiation of Buprenorphine: A Narrative Review.

    Edinoff, Amber N / Fahmy, Omar H / Spillers, Noah J / Zaheri, Alexa R / Jackson, Eric D / De Witt, Audrey J / Wenger, Danielle M / Cornett, Elyse M / Skidmore, Kimberly L / Kaye, Adam M / Kaye, Alan D

    Current pain and headache reports

    2023  Volume 27, Issue 7, Page(s) 175–181

    Abstract: Purpose of review: Opioid use disorder (OUD) is a chronic disorder in which a person loses control over the use of opioids, develops a compulsive behavior, and defends the use despite knowing the negative consequences. There are numerous treatments for ... ...

    Abstract Purpose of review: Opioid use disorder (OUD) is a chronic disorder in which a person loses control over the use of opioids, develops a compulsive behavior, and defends the use despite knowing the negative consequences. There are numerous treatments for OUD, including buprenorphine. Since it is displacing a full agonist opioid, precipitated withdrawal can occur with standard inductions involving buprenorphine.
    Recent findings: Case reports have noted success with a low-dose initiation of buprenorphine, which is different from typical protocols, relatively limited by adverse effects when patients were recently administered full agonists. A cohort investigation studied the use of a transdermal patch as part of the protocol, which was fairly well tolerated. While ongoing research is being conducted on this topic, recent case studies and smaller cohort studies have demonstrated the feasibility of a trial to treat OUD with low-dose initiation of buprenorphine.
    MeSH term(s) Humans ; Buprenorphine/therapeutic use ; Analgesics, Opioid/therapeutic use ; Opioid-Related Disorders/drug therapy ; Opiate Substitution Treatment/methods ; Chronic Disease
    Chemical Substances Buprenorphine (40D3SCR4GZ) ; Analgesics, Opioid
    Language English
    Publishing date 2023-04-21
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2055062-5
    ISSN 1534-3081 ; 1531-3433
    ISSN (online) 1534-3081
    ISSN 1531-3433
    DOI 10.1007/s11916-023-01116-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Cebranopadol for the Treatment of Chronic Pain.

    Edinoff, Amber N / Flanagan, Chelsi J / Roberts, Logan T / Dies, Ross M / Kataria, Saurabh / Jackson, Eric D / DeWitt, Audrey J / Wenger, Danielle M / Cornett, Elyse M / Kaye, Adam M / Kaye, Alan D

    Current pain and headache reports

    2023  Volume 27, Issue 10, Page(s) 615–622

    Abstract: Purpose of review: Regardless of the etiology, if pain persists chronically, it can detrimentally impact multiple aspects of a patient's well-being. Both physical and psychological effects are significant in many chronic pain patients. In this regard, ... ...

    Abstract Purpose of review: Regardless of the etiology, if pain persists chronically, it can detrimentally impact multiple aspects of a patient's well-being. Both physical and psychological effects are significant in many chronic pain patients. In this regard, psychological consequences can alter a patient's quality of life, functionality, and social functioning. Opioids have been the long-established gold standard for acute pain treatment in settings such as the postoperative period. An alternative to opioids in pain management has been highly sought after. Through a non-selective mechanism, cebranopadol is a first-in-class oral drug which combines agonism of the mu and nociceptin opioid peptide (NOP) receptors to provide improved analgesia, while reducing the occurrence of many typically opioid side effects. This manuscript is a narrative review of the possible use of cebranopadol in pain management.
    Recent findings: In pre-clinical studies, cebranopadol was similar to morphine in its pain control efficacy. In a phase IIa trial, cebranopadol was superior to placebo in reducing pain. In a randomized clinical trial, cebranopadol was superior to morphine. Another study concluded that cebranopadol had a lower misuse potential when compared to hydromorphone. In summary, cebranopadol offers new opportunities in treating chronic moderate to severe pain, while also countering risks of addiction. Additional studies are warranted to further evaluate the safety and efficacy of cebranopadol. In this regard, cebranopadol could prove to be a promising alternative to current pain treatment options.
    MeSH term(s) Humans ; Chronic Pain/drug therapy ; Quality of Life ; Morphine/therapeutic use ; Indoles/adverse effects ; Analgesics, Opioid/therapeutic use ; Nociceptin Receptor ; Randomized Controlled Trials as Topic ; Clinical Trials, Phase II as Topic
    Chemical Substances 6'-fluoro-4',9'-dihydro-N,N-dimethyl-4-phenylspiro(cyclohexane-1,1'(3'H)-pyrano(3,4-b)indol)-4-amine ; Morphine (76I7G6D29C) ; Indoles ; Analgesics, Opioid ; Nociceptin Receptor
    Language English
    Publishing date 2023-08-09
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2055062-5
    ISSN 1534-3081 ; 1531-3433
    ISSN (online) 1534-3081
    ISSN 1531-3433
    DOI 10.1007/s11916-023-01148-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Clostridioides difficile Infection: A Clinical Review of Pathogenesis, Clinical Considerations, and Treatment Strategies.

    Sinnathamby, Evan S / Mason, Joseph W / Flanagan, Chelsi J / Pearl, Nathan Z / Burroughs, Caroline R / De Witt, Audrey J / Wenger, Danielle M / Klapper, Vincent G / Ahmadzadeh, Shahab / Varrassi, Giustino / Shekoohi, Sahar / Kaye, Alan D

    Cureus

    2023  Volume 15, Issue 12, Page(s) e51167

    Abstract: Background: Clostridioides difficile: Conclusion: Prevention of CDI can be achieved by proper hygiene, vaccinations, and detecting the infection early. Proper hygiene is indeed noted to be one of the best ways to prevent CDI in the hospital setting. ... ...

    Abstract Background: Clostridioides difficile
    Conclusion: Prevention of CDI can be achieved by proper hygiene, vaccinations, and detecting the infection early. Proper hygiene is indeed noted to be one of the best ways to prevent CDI in the hospital setting. Overprescribing antibiotics is also another huge reason why CDI occurs. Proper prescription of antibiotics can also help reduce the chances of acquiring CDI.
    Language English
    Publishing date 2023-12-27
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.51167
    Database MEDical Literature Analysis and Retrieval System OnLINE

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