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Baclofinding solutions: Baclofen-induced encephalopathy in a peritoneal dialysis patient.
Perit Dial Int
January 2025
Department of Medicine, Johns Hopkins Aramco Healthcare Center, Dhahran, Saudi Arabia.
Baclofen is a gamma-aminobutyric acid agonist that is commonly and widely used for the treatment of muscle spasticity. Given its predominant kidney excretion, patients with reduced kidney function are at particular risk of drug accumulation and toxicity, with neurotoxicity in the form of drowsiness, encephalopathy, seizures, and coma being the most reported clinical features. In addition to the importance of early identification of baclofen toxicity and drug discontinuation, dialysis can effectively accelerate baclofen elimination given its small molecule weight, and the relatively low volume of distribution and weak protein binding.
View Article and Find Full Text PDFBaclofen-induced neurotoxicity in a dialysis patient managed with continuous venovenous hemodialysis: A case report and literature review.
Turk J Emerg Med
July 2024
Department of Emergency Medicine, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman.
Despite documented cases of baclofen toxicity in individuals with kidney disease, the drug is widely prescribed for various medical conditions, primarily spasticity, hiccups, and multiple sclerosis. Baclofen, a gamma-aminobutyric acid derivative, relies on renal excretion, rendering those with impaired kidney function susceptible to toxicity - a concern often underestimated by health-care providers. Adverse reactions, including single or double doses, are well documented in addition to multi-dose toxicity.
View Article and Find Full Text PDFIntrathecal baclofen pump in pregnancy: case report, literature review, and management considerations.
Reg Anesth Pain Med
December 2024
USC Keck School of Medicine, Los Angeles, California, USA.
Background: Baclofen, a gamma-aminobutyric acid receptor type B agonist in the central nervous system, is the first-line medication among central nervous system modulating agents for the treatment of neurogenic muscle spasticity. While baclofen is most often administered enterally, patients with severe spasticity may be candidates for baclofen delivered by intrathecal pump. Currently, there are only nine studies reporting on the use of intrathecal baclofen (ITB) during pregnancy and childbirth.
View Article and Find Full Text PDFProlonged administration of intrathecal baclofen in a patient with generalized grade 4 tetanus.
Reg Anesth Pain Med
July 2024
Anesthesiology, University of Florida College of Medicine, Jacksonville, Florida, USA.
Introduction: This case report presents the management of a 62-year-old woman with generalized grade 4 tetanus, focusing on the innovative use of intrathecal baclofen (ITB) therapy. The patient initially presented with a laceration and subsequently developed severe tetanic spasms, necessitating interventions beyond standard tetanus immunoglobulin and antibiotics due to the condition's progressive and life-threatening nature. The preference for ITB over oral baclofen is highlighted, considering ITB's enhanced bioavailability in the central nervous system and its efficacy in reducing spinal cord reflexes, which is critical for managing severe spasticity.
View Article and Find Full Text PDFWhen the fever will not stop, stop the pills! A case report.
Sao Paulo Med J
December 2023
MD. Physician, Internal Medicine, Tondela-Viseu Hospital Center, Viseu, Portugal.
Background: Neuroleptic malignant syndrome (NMS) is a neurologic emergency potentially fatal. This rare side effect is most commonly associated with first-generation antipsychotics and less frequently with atypical or second-generation antipsychotics. The diagnosis relies on both clinical and laboratory criteria, with other organic and psychiatric conditions being ruled out.
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