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Authors: Roy U, Chakravarty G, Honer Zu Bentrup K, Mondal D The ATP binding cassette (ABC)-transporters are energy dependent efflux pumps which regulate the pharmacokinetics of both anti-cancer chemotherapeutic agents, e.g. taxol, and of human immunodeficiency virus-1 (HIV-1) protease inhibitors (HPIs), e.g. saquinavir. Increased expression of several ABC-transporters, especially P-glycoprotein (P-gp) and multidrug resistance protein 2 (MRP2), are observed in multidrug resistant (MDR) tumor cells and on HIV-1 infected lymphocytes. In addition, due to their apical expression on vascular endothelial barriers, both P-gp and MRP2 are of crucial importance towards dictating drug access into sequestered tissues. However, although a number of P-gp inhibitors are currently in clinical trials, …

In this report, we present the case of a 52-year-old Jehovah’s Witness with sickle cell disease in whom he and his family refused blood products for the treatment of severe anemia associated with profound and progressive acidosis, acute oliguric renal failure, and hemodynamic instability. Attempts carried out during the first 3 hospital days to stabilize the patient using standard therapies to support oxygen delivery as well as the use of sedation, pain control, temperature control, neuromuscular blockade, and mechanical ventilation to reduce oxygen demand were not successful. Thus, because oxygen consumption by the brain represents approximately 20 per cent of the body’s oxygen needs, and pentobarbital’s primary action is as a central nervous system depressant, the induction of pentobarbi…

Breast cancer patients getting the chemo drug may suffer long-term neuropathic discomfort, study finds Source: HealthDay Related MedlinePlus Topics: Breast Cancer, Cancer Chemotherapy, Pain (Source: MedlinePlus Health News)

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Treximet (Sumatriptan and Naproxen Sodium Tablets) drug description – FDA approved labeling for prescription drugs and medications at RxList (Source: RxList – New and Updated Drug Monographs)

Updated Date: Nov 30, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

A 52-year-old man is referred to your gastroenterology practice for a history of gastroesophageal reflux disease (GERD). The patient reports a long history of heartburn symptoms, dating back at least 5 years. His symptoms were responsive to over-the-counter remedies including antacid tablets and liquids, but eventually became such a regular occurrence that he sought medical care from his primary care physician. He was initially prescribed an H2 blocker, which was incompletely effective, so he was started on proton pump inhibitor therapy. He currently takes 20 mg of omeprazole daily which is effective, but notes that if he misses a dose, he sometimes experiences heartburn. He denies dysphagia, nausea or vomiting, blood in his stool, or unintentional weight loss. He has no other chronic medi…

Summary: Sixty percent of cases of clinical depression are considered to be treatment-resistant depression (TRD). Magnesium-deficiency causes N-methyl-d-aspartate (NMDA) coupled calcium channels to be biased towards opening, causing neuronal injury and neurological dysfunction, which may appear to humans as major depression. Oral administration of magnesium to animals led to anti-depressant-like effects that were comparable to those of strong anti-depressant drugs. Cerebral spinal fluid (CSF) magnesium has been found low in treatment-resistant suicidal depression and in patients that have attempted suicide. Brain magnesium has been found low in TRD using phosphorous nuclear magnetic resonance spectroscopy, an accurate means for measuring brain magnesium. Blood and CSF magnesium do not appe…

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Abstract
TREATMENT OF PREGABALIN TOXICITY BY HEMODIALYSIS IN A PATIENT WITH KIDNEY FAILURE Yoo L et al.   Am J Kidney Dis Dec 2009;54:1127-30.
Pregabalin (Lyrica) is an anticonvulsant also used to treat diabetic neuropathy, post-herpetic neurolagia, and fibromyalgia.  This case report describe a dialysis patient who developed signs of mild pregabalin toxicity — myoclonus and muscular contractions — after having her dosage of the drug tripled.  Because pregabalin has a low molecular weight, a small volume of distribution, and is not bound to plasma proteins, the patient was treated with hemodialysis and had immediate improvement of symptoms.  Pharmacokinetic data cited in the article demonstrates that clearance of the drug by dialysis was successful.
The com…

This article considers four broad classes of psychological techniques and their effects on fibromyalgia (FM) pain. A literature search identified 14 randomized controlled trials (RCTs) of cognitive-behavioral therapy (CBT) and operant-behavioral therapy (OBT), five relaxation RCTs, five biofeedback RCTs, five hypnotherapy RCTs, and two writing intervention RCTs. For psychoanalytic therapy in FM, no RCTs have been published. The highest effect sizes (r = 0.53–2.14) for pain reduction are found after CBT and OBT group treatments. Relaxation as a single treatment has not been proven useful. Hypnotherapy and writing intervention have demonstrated mild treatment effects, whereas psychological treatment is effective in FM pain. Considering the heterogeneity of FM, the promising effects of…