American journal of therapeutics
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Each year, more than 62 million cases of the common cold in the United States require medical attention and more than 80% affect school-aged children. The objective of this prospective, intent-to-treat, phase IV study was to determine the therapeutic and prophylactic effectiveness of zinc gluconate glycine lozenges (Cold-Eeze) for the common cold. Zinc lozenges were administered once daily during the cold season for prophylaxis. ⋯ There was no antibiotic use for any cold, and there were no adverse events reported. Results of this study are consistent with those from our previous retrospective study showing significantly shorter cold duration and fewer colds with the use of zinc gluconate glycine lozenges. The zinc gluconate glycine lozenges are well tolerated and are an easy-to-administer therapy that has the potential to substantially reduce cold-related school absences and antibiotic use and misuse as well as to provide a cost saving.
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Comparative Study
Retrospective comparison of nebulized levalbuterol and albuterol for adverse events in patients with acute airflow obstruction.
The objective of this study was to retrospectively compare the mean change in heart rate (HR) of patients with acute airflow obstruction treated with nebulized levalbuterol vs. albuterol. The study was conducted at the Akron General Medical Center, a 537-bed adult tertiary care teaching and research medical center. The participants were patients (> or = 18 years old) presenting to the emergency department with acute airflow obstruction. ⋯ An increase in HR of 2.7 bpm by albuterol compared with levalbuterol on day 3 of therapy was the only significant finding among the analyses. However, this finding did not demonstrate dangerous elevations in HR following treatment with albuterol. Even the upper end of the confidence interval range at 5.4 bpm does not support a clinically significant difference in tachycardia with the pure isomer compared with the racemic mixture during acute airway obstruction.
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Case Reports
Preliminary experience with dexmedetomidine in the treatment of cyclic vomiting syndrome.
Cyclic vomiting syndrome (CVS) is a chronic, recurrent disorder of unknown etiology characterized by episodes of nausea and vomiting lasting hours or days and separated by symptom-free intervals of weeks to months. Although several different therapeutic regimens have been suggested for CVS, there remains no standard, effective regimen. In many cases, management of vomiting episodes includes the use of potent sedatives that induce prolonged durations of sedation and sleep. ⋯ Several physiologic effects have been demonstrated with dexmedetomidine including sedation, anxiolysis, analgesia, and blunting of the sympathetic nervous system. We report, for the first time, successful use of dexmedetomidine to treat CVS in 3 pediatric-aged patients. Potential mechanisms for its efficacy and future potential as a therapeutic agent for CVS are discussed.
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Methemoglobinemia, an increased concentration of methemoglobin in the blood, is an altered state of hemoglobin whereby the ferrous form of iron is oxidized to the ferric state, rendering the heme moiety incapable of carrying oxygen. This can cause hypoxia, cyanosis, or even death. ⋯ We report a case of severe acquired methemoglobinemia resulting from topical benzocaine use before transesophageal echocardiography. This case serves to highlight the severity of methemoglobinemia that can result from an otherwise innocuous agent even in small doses and the fact that prompt recognition and treatment of this disorder can be lifesaving.