Therapeutic drug monitoring
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Pregabalin has an abuse potential and is occasionally used as a recreational drug. To draw the right conclusions regarding new intake of pregabalin in situations of repeated urinary drug testing, the knowledge of its disappearance rate in urine is essential. ⋯ In subjects with normal renal function, it seems highly unlikely that a urine specimen should remain positive for pregabalin for more than 5-6 days after intake.
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Clinical Trial
The pharmacokinetic profile of intravenous paracetamol in adult patients undergoing major abdominal surgery.
Intravenous (IV) paracetamol is commonly used in the postoperative period for the treatment of mild to moderate pain. The main pathways for paracetamol metabolism are glucuronidation, sulfation, and oxidation, accounting for approximately 55%, 30%, and 10% of urinary metabolites, respectively. The aim of this study was to describe the pharmacokinetics of IV paracetamol and its metabolites in adult patients after major abdominal surgery. ⋯ After major abdominal surgery, there were apparent increases in the metabolic conversion to paracetamol glucuronide and its urinary clearance suggesting potential induction of paracetamol glucuronidation.
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The plasma concentrations of valproic acid (VPA) are known to decrease during the concomitant administration of carbapenem antibiotics, such as meropenem, imipenem, and ertapenem. This study summarizes 6 cases of drug-drug interactions between VPA and carbapenem antibiotics. ⋯ The interaction between VPA and carbapenem antibiotics caused decreases in the VPA serum concentrations; the extent of this decrease was greater in the meropenem-treated patients than in the imipenem-treated or ertapenem-treated cases. Because the therapeutic effect of VPA depends on its serum concentration, it should be recognized that there may be a loss of seizure control in patients using VPA with carbapenem antibiotics.
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Randomized Controlled Trial Multicenter Study
Determinants of adherence to delayed-release doxylamine and pyridoxine in patients with nausea and vomiting of pregnancy.
Women often hesitate to take medications in pregnancy due to fears of perceived potential fetal damage. The authors' objective is to identify the determinants of adherence to delayed-release doxylamine-pyridoxine (Diclectin) in patients with nausea and vomiting of pregnancy (NVP). ⋯ Adherence to antinauseants for NVP is affected by number of tablets prescribed per day, and treatment duration and effectiveness.
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This case report describes a false-positive amphetamine/ecstasy [3,4-methylenedioxymethamphetamine (MDMA)] and ecstasy (MDMA) screen after therapeutic use of antihyperlipidemic drug, fenofibrate. A 60-year-old male patient was admitted to inpatient psychiatry unit with the diagnosis of alcohol dependency. He was prescribed diazepam 30 mg/day, thiamine 300 mg/day, and naltrexone 50 mg/day. ⋯ After discontinuation of fenofibrate, amphetamine/MDMA, and MDMA immunoassay results turned out to be negative. Caution should be given to interpretation of amphetamine/MDMA (CEDIA) and MDMA (DRI) tests in patients taking fenofibrate. Specific confirmation with a suitable method should be used to prevent erroneous interpretations.