- Green Urine And Altered Mental Status: A Case Of Intoxication. [Case Reports]
- JAJ Ayub Med Coll Abbottabad 2019 Apr-Jun; 31(2):278-281
- Green coloured urine is atypical as it usually signifies the presence of an exogenous substance. Several substances in literature have been associated with green urine including propofol, biliverdin,…
Green coloured urine is atypical as it usually signifies the presence of an exogenous substance. Several substances in literature have been associated with green urine including propofol, biliverdin, metoclopramide, methylene blue, indigo blue, amitriptyline, methocarbamol, indomethacin, promethazine, cimetidine and food colourings. We present here a case of middleaged man who presented to our ER with altered mental status and green coloured urine with positive urine toxicology reports for benzodiazepine.
- Elastomeric Pain Pumps for Scoliosis Surgery. [Journal Article]
- CCureus 2019 Feb 11; 11(2):e4042
- Objective Postoperative pain management following scoliosis surgery has traditionally relied on intravenous opioids. The objective of this study was to evaluate the effect of elastomeric pain pumps. …
Objective Postoperative pain management following scoliosis surgery has traditionally relied on intravenous opioids. The objective of this study was to evaluate the effect of elastomeric pain pumps. Methods A retrospective chart review of 81 adolescent patients who underwent scoliosis surgery in a seven-year period was performed. Patients were divided into three groups as the practice changed: (1) patient-controlled analgesia group (12 patients) who used intravenous (IV) opioids with oral opioids; (2) elastomeric pain pump group (28 patients) with the added use of bupivacaine; and (3) multimodal pain pump group (41 patients) with the added use of gabapentin and methocarbamol. Endpoints were analyzed for length of stay in the hospital, infection rate, and gastrointestinal retention. Results The length of stay in the elastomeric pain pump group was 3.1 days shorter than in the patient-controlled analgesia group (P = 0.004). The length of stay in the multimodal group was 3.9 days shorter than in the patient-controlled analgesia group (P = 0.001). The incidence of prolonged postoperative bowel retention decreased significantly from 25% to 18% to 2% (P = 0.03). Conclusions To our knowledge, this is the first study on the use of elastomeric pain pumps in conjunction with multimodal pain medication following scoliosis surgery. The use of elastomeric pain pumps was associated with clinically and statistically significant improvements in the postoperative course. The addition of methocarbamol and gabapentin was associated with a trend toward further improvements.
- Pyrethroid toxicity in a Vietnamese pot-bellied pig. [Case Reports]
- CVCan Vet J 2019; 60(4):377-380
- A 7-month-old spayed female Vietnamese pot-bellied pig (VPBP) was presented for diffuse muscle fasciculations and seizure-like activity that had started 4 hours before presentation. The pig was stupo…
A 7-month-old spayed female Vietnamese pot-bellied pig (VPBP) was presented for diffuse muscle fasciculations and seizure-like activity that had started 4 hours before presentation. The pig was stuporous and displayed diffuse involuntary gross motor movement and muscle fasciculations, as well as hypertonicity of all 4 limbs. Hematologic analysis revealed hemoconcentration, severe hyperlactatemia, moderate metabolic acidosis, increased creatine kinase and gamma-glutamyltransferase. The pig failed to respond to diazepam, propofol, methocarbamol, and supportive care, followed by general anesthesia, and was euthanized. Bifenthrin, a pyrethroid insecticide, was identified by gas chromatography-mass spectrometry of stomach contents. Pyrethroid insecticide toxicity in VPBP may result in clinical signs similar to those seen in companion animals.
- Simultaneous determination of environmental contaminants using a graphite oxide - Polyurethane composite electrode modified with cyclodextrin. [Journal Article]
- MSMater Sci Eng C Mater Biol Appl 2019; 99:1415-1423
- A composite electrode based on graphite oxide (GrO)-polyurethane (PU) modified with β-cyclodextrin (CD) was proposed for the simultaneous determination of three drugs: terbutaline (TER), nimesulide (…
A composite electrode based on graphite oxide (GrO)-polyurethane (PU) modified with β-cyclodextrin (CD) was proposed for the simultaneous determination of three drugs: terbutaline (TER), nimesulide (NIM), and methocarbamol (MET), as possible contaminants in river water samples. To evaluate the performance of the proposed CD-GrOPUE, voltammetric techniques were used and two other electrodes were fabricated (GrOPUE and GrPUE) for comparison. The functionalization of the GrO was confirmed by scanning electron microscopy images, energy-dispersive X-ray spectroscopy analysis, and thermogravimetry. Cyclic voltammograms obtained for TER, NIM, and MET indicated an irreversible behaviour at 0.6 V, 0.9 V and 1.2 V (vs. Ag/AgCl (3 mol L-1 KCl)), respectively, on each working electrode, with the highest peak current values been obtained using the CD-GrOPUE. Under optimal conditions, using square-wave voltammetry, the linear ranges obtained (and limit of detection) for TER, NIM, and MET were 2.5-30 (0.55), 0.62-7.3 (0.083), and 0.62-7.3 (0.077) μmol L-1, respectively. The analytical method developed were applied in the simultaneous determination of TER, NIM, and MET in river water samples, with results like those obtained using a reference spectrophotometric method (at a confidence level of 95%). One can conclude, that the modification of GrO with CD arrays made possible the development of a robust and simple sensor platform for environmental analyses.
- Simultaneous voltammetric sensing of levodopa, piroxicam, ofloxacin and methocarbamol using a carbon paste electrode modified with graphite oxide and β-cyclodextrin. [Journal Article]
- MAMikrochim Acta 2019 02 15; 186(3):174
- A carbon paste electrode (CPE) was modified with graphite oxide (GrO) and β-cyclodextrin (CD) to obtain a sensor for simultaneous voltammetric determination of levodopa (LD), piroxicam (PRX), ofloxac…
A carbon paste electrode (CPE) was modified with graphite oxide (GrO) and β-cyclodextrin (CD) to obtain a sensor for simultaneous voltammetric determination of levodopa (LD), piroxicam (PRX), ofloxacin (OFX) and methocarbamol (MCB). The morphology, structure and electrochemical properties of the functionalized GrO were characterized by scanning electron microscopy, energy-dispersive X-ray spectroscopy, contact angle measurements and cyclic voltammetry. Under the optimal experimental conditions, the sensor is capable of detecting LD, PRX, OFX and MCB by square wave voltammetry (SWV) at working potentials of +0.40, +0.60, +1.03 and + 1.27 V (versus Ag/AgCl), respectively. Response is linear from 1.0 to 20 μM for LD, from 1.0 to 15 μM for PRX, from 1.0 to 20 μM for OFX, and from 1.0 to 50 μM for MCB. The respective limits of detection are 65, 105, 89 and 400 nM. The method was successfully applied to the simultaneous determination of LD, PRX, OFX and MCB in (spiked) real river water and synthetic urine samples, and the results were in agreement with those obtained using a spectrophotometric method, with recoveries close to 100%. Graphical abstract Schematic presentation of a novel electroanalytical method employing a carbon paste electrode modified with graphite oxide and β-cyclodextrin for the simultaneous determination of levodopa, piroxicam, ofloxacin and methocarbamol in urine and river water samples by square wave voltammetry.
- Corrigendum to "Methocarbamol use is associated with decreased hospital length of stay in trauma patients with closed rib fractures" [Am J Surg 214/4 (2018) 738-742]. [Published Erratum]
- AJAm J Surg 2019 Feb 12
- Comparison of skin traction, pressure, and rapid muscle release with conventional method on intramuscular injection pain: A randomized clinical trial. [Journal Article]
- JEJ Educ Health Promot 2018; 7:172
- CONCLUSIONS: The results of this study showed that innovative method can be used as a substitute for conventional method to reduce IM injection pain.
- Randomized-controlled trial of methocarbamol as a novel treatment for muscle cramps in cirrhotic patients. [Journal Article]
- EJEur J Gastroenterol Hepatol 2019; 31(4):499-502
- CONCLUSIONS: Methocarbamol seems to be a promising safe and well-tolerated medication, and plays a role in the treatment of muscle cramps in patients with liver cirrhosis.
- Simultaneous determination of methocarbamol and aspirin in presence of their pharmacopeial-related substances in combined tablets using novel HPLC-DAD method. [Journal Article]
- DDDrug Dev Ind Pharm 2019; 45(2):265-272
- CONCLUSIONS: The optimized method proved to be specific, robust and precise for the quality control of the studied drugs in pharmaceutical preparations to ascertain that their related substances are not exceeding the permitted pharmacopeial limits.
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- Inhibition of In Vitro Metabolism of Opioids by Skeletal Muscle Relaxants. [Journal Article]
- BCBasic Clin Pharmacol Toxicol 2018; 123(3):327-334
- The purpose of this study was to test the hypothesis that skeletal muscle relaxants could inhibit the in vitro metabolism of common comedications opioids buprenorphine, methadone and oxycodone. The c…
The purpose of this study was to test the hypothesis that skeletal muscle relaxants could inhibit the in vitro metabolism of common comedications opioids buprenorphine, methadone and oxycodone. The compounds [solubility-limited concentration (μM) studied] were as follows: baclofen (1000), carisoprodol (200), its metabolite meprobamate (1000), chlorzoxazone (200), cyclobenzaprine (1000), metaxalone (50), methocarbamol (1000), orphenadrine (1000) and tizanidine (1000). Compounds were first incubated with human liver microsomes ± pre-incubation, screened with pathway-specific cDNA-expressed cytochrome P450s (rCYP), and then IC50 values determined using either 8-concentration tests for those where the rCYP screen suggested an IC50 was achievable, or a 3-concentration test with downward extrapolation if screen suggested 50% inhibition was not achievable. These results were then extrapolated to determine an inhibitory potential. Six pathway inhibitor combinations were identified with a moderate inhibitory potential (≥2.0 < 5.0): five with chlorzoxazone, R-EDDP, S-EDDP and noroxycodone production by CYP3A4, and R- and S-EDDP production by CYP2B6; and one for the meprobamate effect on noroxycodone production by CYP3A4. An additional eleven combinations were found with a weak inhibitory potential (≥1.25 < 2.0): five with carisoprodol, two each with methocarbamol and meprobamate, and one each with metaxalone and orphenadrine. This represents the first comprehensive study of the inhibitory effect of this class of drugs and suggests that some of them may produce significant drug-drug interactions with opioids that are frequent comedications with skeletal muscle relaxants.