The effect of amitriptyline, gabapentin, and carbamazepine on morphine-induced hypercarbia in rabbits.

Background: Severe exacerbation of chronic neuropathic pain often requires morphine in patients already treated with drugs such as tricyclic antidepressants, carbamazepine and gabapentin. However, it is unclear if a combination of these drugs intensifies the effects of morphine on the respiratory system and, if so, whether these effects are due to pharmacokinetic or pharmacodynamic interaction.

Methods: We gave rabbits (n=6 per group) the following drugs daily for 4 days: subcutaneous normal saline 1 mL (control); amitriptyline subcutaneously 7 mg/kg; carbamazepine orally 100 mg/kg; gabapentin subcutaneously 25 mg/kg; and all three drugs concurrently (combination).

Pregnancy outcome following rubella vaccination: a prospective controlled study.

The rubella virus is a potent human teratogen. Because the rubella vaccine is prepared with live virus, a high level of anxiety surrounds exposure in pregnancy. There is relatively scarce data on fetal risk following vaccination in pregnancy, and all of the available data were collected retrospectively.

Toxic ingestion of 6-mercaptopurine by young siblings of pediatric oncology patients.

We report two cases of accidental ingestion of large quantities of 6-mercaptopurine (6-MP) in siblings of patients with acute lymphoblastic leukemia (ALL). These cases reinforce the need for thorough anticipatory guidance to families in order to prevent the incidence of potentially life-threatening accidental ingestions.

Medications that can be fatal for a toddler with one tablet or teaspoonful: a 2004 update.

Objective: To provide an updated list of the highly toxic medications in North America that can kill a 10 kg toddler upon ingestion of 1-2 dose units.

Methods: All drugs available in North America were reviewed and their reported lethal doses in children or adults (where no pediatric data existed) were identified. The dose units of drugs available in North America were subsequently identified, followed by those dose units that could kill a toddler upon ingestion of 1-2 dose units or teaspoonfuls.

Bioavailability of a pediatric amlodipine suspension.

Currently, a suspension of crushed tablets of amlodidpine is widely used in children with hypertension without knowledge of its bioavailability. A comparative bioavailability study of a tablet and suspension formulation of amlodipine was completed in 20 healthy adult volunteers. Bioequivalence of the suspension was not different from the tablets.

The teratogenicity of drugs for nausea and vomiting of pregnancy: perceived versus true risk.

Women and health care providers commonly overestimate the teratogenic risk of medications in pregnancy. With regard to nausea and vomiting of pregnancy, this leads to an underutilization of pharmacologic therapy. Pregnancy termination has even been elected in some circumstances when safe and effective alternatives for nausea have not been attempted.

Nausea and vomiting of pregnancy. Evidence-based treatment algorithm.

Question: One of my patients suffers from a moderate-to-severe form of morning sickness. She responded only partially to doxylamine and pyridoxine (Dicletin), and I wish to try adding another medication. What should my priority be?

Answer: An algorithm used by Motherisk to manage thousands of patients takes a hierarchical approach to this condition.