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Variability of Prehospital Pain Management Protocols: A Review of Prehospital Care Protocols in the United States.
Open Access Emerg Med
December 2024
Department of Emergency Medicine, Northwell, New Hyde Park, NY, USA.
Purpose: We describe emergency medical services (EMS) protocols for pain management in the United States to elucidate systemic variability in protocols. We describe types of pain medications included in protocols, routes of administration, indications for use, standing orders for dosing, and use in pediatric patients.
Methods: We performed a review of all publicly accessible EMS protocols from the website http://www.
A Rare Case of Weil's Disease Presenting With Severe Hyperbilirubinemia and Acute Kidney Injury: A Diagnostic Challenge in Urban England.
Cureus
November 2024
Internal Medicine, Northumbria Healthcare NHS Trust, Newcastle-Upon-Tyne, GBR.
We present a rare and challenging case of Weil's disease in a patient who was admitted to the Critical Care Unit with a clinical suspicion of the condition. The patient showed a prompt response to treatment before laboratory confirmation was obtained. Leptospirosis, a zoonotic disease, is most commonly found in tropical and temperate regions.
View Article and Find Full Text PDFHepatoprotective Effects of Resveratrol on Acetaminophen-Induced Acute Liver Injury and Its Implications for Tofacitinib Disposition in Rats.
Biomol Ther (Seoul)
December 2024
College of Pharmacy and Research Institute of Pharmaceutical Science and Technology, Ajou University, Suwon 16499, Republic of Korea.
Tofacitinib, which is used to treat rheumatoid arthritis (RA), is primarily metabolized by the hepatic cytochrome P450 (CYP) enzymes, CYP3A1/2 and CYP2C11. Acetaminophen (APAP), which is frequently used for pain relief in patients with RA, can induce acute liver injury (ALI) when taken in excess, profoundly affecting drug metabolism. Resveratrol (RVT) is a polyphenolic compound with hepatoprotective properties.
View Article and Find Full Text PDFParacetamol metabolism by endothelial cells - Potential mechanism underlying intravenous paracetamol-induced hypotension.
Pharmacol Res
December 2024
Department of Biomedical Sciences, University of Copenhagen, Blegdamsvej 3, Copenhagen N 2200, Denmark. Electronic address:
It was shown previously that a metabolite of acetaminophen (APAP), N-acetyl-p-benzoquinone imine (NAPQI), is a potent vasodilator, which could underlie the hypotension observed when APAP is administered intravenously. However, it is unknown whether APAP metabolism to NAPQI is possible in the vasculature. In this study, we examine the hypothesis that APAP is metabolized by cytochrome P450 enzymes within the endothelium, which may be accelerated in critically ill patients by the presence of elevated myeloperoxidase (MPO).
View Article and Find Full Text PDFPneumocephalus After Lumbar Epidural Steroid Injection: A Rare Complication With Spontaneous Resolution.
Cureus
November 2024
Internal Medicine, Icahn School of Medicine at Mount Sinai, Queens Hospital Center, New York, USA.
Pneumocephalus is a rare but potentially serious complication of spinal procedures, characterized by the presence of intracranial air. This report presents the case of a 40-year-old female who developed pneumocephalus following a lumbar epidural steroid injection. She presented to the emergency department with a persistent headache, blurred vision, and eye pain, which began shortly after the procedure.
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