Iran J Pharm Res
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Amitraz is a triazapentadiene, an α2 adrenergic agonist and a member of the amidine chemical family. A limited number of human intoxication cases have been published in the literature. Lack of a clear and specific protocol for the therapy of amitraz intoxication may make its successfully managed case reports useful and valuable for other clinical practitioners in poisoning departments. ⋯ Several studies reported that using atropine for those amitraz poisoned patients with both miosis and bradycardia resolved the problem and recommend it as the first line of drug therapy when bradycardia occurs from vagal stimulation and atrioventricular block. Management of amitraz poisoning is still considered to be supportive and symptomatic. Although the effects of activated charcoal and cathartics have not been studied, they may still be considered for treatment.
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Vitamin E is a potent reactive oxygen metabolites (ROM) scavenger. It is a lipid-soluble vitamin and its main function is to protect polyunsaturated fatty acids against oxidative stress. Twenty-five mechanically ventilated Intensive Care Unit (ICU) adult patients participated in a prospective randomized clinical trial receiving either placebo (10 patients) or 3 IM doses (1000 IU each) of vitamin E (15 patients). ⋯ Among these 25 patients, there were 14 men and 11 women, aged 63.16 ±15.48 years (mean ± SD; range = 33 to 87 years). Vitamin E supplementation resulted in significant differences in plasma and BAL vitamin E concentrations between the two groups (p-value = 0.01, 0.01), decrease in SOD activities (not differ significantly in plasma (p-value = 0.23)), but with significant differences in BAL (p-value = 0.016) and progressive reduction in Acute Physiology and Chronic Health Evaluation II (APACHE II) (p-value = 0.52) and Sequential Organ Failure Assessment (SOFA) (p-value = 0.008) score in vitamin E group. From the results of this study, it seems that supplementation of vitamin E as a potent antioxidant, along with other supportive measures, can be beneficial in decreasing SOD total activity, ROM production and risk of organ failure in critically ill patients.
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At times, despite an unripe cervix, induction of labor may be needed. In these cases, a safe and suitable method should be considered for cervical ripening and pregnancy termination. The aim of this study is the comparison of vaginal misoprostol with Foley catheter for cervical ripening and induction of labor. ⋯ Vaginal delivery was significantly higher in misoprostol group (89.9 vs. 62.7, p < 0.01). The mean of delivery time was significantly shorter in misoprostol group (11.08 ± 5.6 vs. 13.6 ± 16.0 h, p < 0.05). In the cases of pregnancy termination and unripe cervix, two methods of misoprostol and Foley catheter were considered suitable, but it seemed that misoprostol decreases the delivery time and was needed for the cesarean section.
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Insufficient control of post-thoracotomy pain can produce breathing dysfunction and long term staying in neonatal intensive care unit (NICU). It can increase the incidence of pulmonary complications such as atelectasis, pneumonia and respiratory failure. The aim of this study was to determine the analgesic effect of continuous extrapleural nerve block, using ropivacaine, in neonates younger than 7 days old with esophageal atersia (EA) and the incidence of atelectasis and duration of hospitalization in NICU. ⋯ Five percent of cases (n = 1) and 100% of the control group (n=20) had pain scores equal or greater than 3 (p < 0.001). The incidence of atelectasis among cases was less than the control group (35% vs. 65% respectively; p = 0.58). Duration of hospitalization in the case group (12 ± 5.6 days) had no significant difference from the control group (13.6 ± 4.8 days) (p = 0.3) In conclusion, the results showed that continuous extrapleural infusion of ropivacaine reduces the pain noticeably and atelectasis relatively, after thoracotomy in neonates younger than 7 days suffering from EA, compared to the acetaminophen group.