Drug and Alcohol Rehabilitation: Effects of Intracuff Dexamethasone on Post-Extubation Reactions.
Effects of intracuff dexamethasone on post-extubation reactions.
Filed under: Drug and Alcohol Rehabilitation
J Res Med Sci. 2012 Apr; 17(4): 338-43
Rafiei MR, Arianpour N, Rezvani M, Ebrahimi A
The most common complications after tracheal intubation during general anesthesia are sore throat, hoarseness, and laryngospasm which can cause severe discomfort to patients. Several methods have been suggested to prevent these complications. In this study, the effects of intracuff dexamethasone, lidocaine, and normal saline in reducing post-extubation reactions were compared.This double-blind clinical trial was performed on 180 men of ASA (American Society of Anesthesiologists) class I or II who underwent general anesthesia for elective inguinal herniation surgery in Imam Reza Hospital, Tehran, Iran during 2008-2010. Depending on the kind of drug used to fill the endotracheal tube (ETT) cuff, patients were randomly allocated into normal saline, lidocaine, and dexamethasone groups. Post-extubation reactions were then evaluated in all groups.The groups were demographically comparable. There were no significant differences between the three groups regarding post-extubation sore throat, hoarseness, or laryngospasm (p > 0.05). However, a significant difference in cough existed between the three groups (p = 0.02). Moreover, the groups were not significantly different in terms of patient satisfaction after 24 hours (p = 0.062). Prolongation of spontaneous ventilation time and time to extubation were observed in the three groups. No significant differences were detected between the three groups regarding hemodynamic variables.The three drugs were not significantly different in attenuating post-extubation reactions such as hoarseness, sore throat, and laryngospasm. However, lidocaine was more effective on cough incidence while dexamethasone had better efficacy in reducing cough severity. In addition, all three drugs could satisfy patients after 24 hours. ETT tolerance was more in the lidocaine group than the other two groups.
HubMed – drug
Emergence of potential superbug mycobacterium tuberculosis, lessons from new delhi mutant-1 bacterial strains.
Filed under: Drug and Alcohol Rehabilitation
Int J Health Sci (Qassim). 2012 Jan; 6(1): 87-94
Nazir T, Abraham S, Islam A
Recent reports have shown that certain bacterial strains attain the New Delhi Metallo-beta-lactamase-1 (NDM-1) enzyme and become resistant to a broad range of antibiotics. Similarly, more dangerous “superbugs” of multi-drug resistant (MDR) and extensive drug resistant (XDR) Mycobacterium tuberculosis strains are gradually emerging through rapid genetic mutation caused by prescription non-compliance or unsupervised indiscriminate use of anti-tubercular drugs or other antibiotics. Mycobacterium tuberculosis cases have been reported in highly susceptible population groups including the aboriginal communities of US and Canada. In Canada alone, the total number of reported tuberculosis cases has decreased over the past decade. However, there is a steady increase in HIV cases in certain communities including the aboriginal communities. Reintroduction of MDR/XDR strains of tuberculosis is possible in these susceptible communities, which in turn may pose serious public health situation. MDR/XDR strains of tuberculosis are virtually untreatable using current anti-tubercular medication protocols. Thus, MDR/XDR tuberculosis presents a grave global public health threat. The unpredictable genetic mechanism involved in generating MDR/XDR resistant strains of Mycobacterium tuberculosis may pose greater challenges in developing appropriate treatment strategies. In this article, we briefly review potential genetic mechanism of emerging NDM-1 bacterial strains and draw a rationale parallel to the underlying genetic mechanism of MDR/XDR Mycobacterium tuberculosis strain development.
HubMed – drug
Antibody-Drug Conjugates: Where the Action Is: ADCs – The New Frontier.
Filed under: Drug and Alcohol Rehabilitation
Biotechnol Healthc. 2012; 9(4): 28-31
Carlson B
Next generation antibody-drug conjugates, like T-DM1, are meant to kill the cancer – not the patient.
HubMed – drug
MS Treatment Is on the Cusp of Something Big: On the Cusp of Something Big?
Filed under: Drug and Alcohol Rehabilitation
Biotechnol Healthc. 2012; 9(4): 24-7
Worley S
For so long, multiple sclerosis has frustrated physicians and patients. With bold new treatments on the way, payers are thinking about tighter management. Formal treatment guidelines would help. Bio-markers could also sort out the ‘right-drug, right-patient’ conundrum.
HubMed – drug
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