Synthetic Heroin-Like Drugs

Abstract

A 32-year-old woman who ingested thallium sulfate was treated with combined hemoperfusion-hemodialysis. Classical therapy, including Prussian Blue, was also administered. The clearance rate of the hemoperfusion and hemodialysis were 139 and 47 mL/ min, respectively. The efficiencies of these different methods were compared with each other and with the classical methods. It was concluded that hemoperfusion was the most efficient technique in extracting thallium sulfate. The combined hemoperfusionhemodialysis procedure is proposed for the treatment of severe intoxications with thallium sulfate.

Thallium intoxication occurs rather frequently. The beneficial effects of gastric lavage in the early hours and the use of Prussian Blue [1] are well known. In recent years more attention has been paid to the use of the aritifical kidney, mostly in combination with the earlier described methods. We present a case of thallium intoxication treated with a combination of hemoperfusion (HP) and hemodialysis (HD).     

New Drugs

Information published in this department has been supplied by the manufacturers of the products described     

New Drugs

Paroxysmal hypertension is a fairly common clinical entity and is frequently overlooked. It is caused by either disturbances in the adrenal medullary function or a hypersensitive sympathetic nervous system. It is seen in several clinical types of different degrees of seriousness.     

New Drugs

Information published in this department has been supplied by the manufacturers of the products described     

New Drugs

Information published in this department has been supplied by the manufacturers of the products described     

New Drugs

Mitral stenosis forms the chief subject of this diagnostic clinic. The history of surgery for mitral stenosis is briefly reviewed, together with a discussion of the indirect and direct surgical approaches to the problem. Two patients are presented to illustrate the indications, contraindications and results of direct attack (commissurotomy) on the stenotic mitral valve.     

Signal Identification in Addictovigilance: the Functioning of the French System

The French addictovigilance network (addictovigilance: surveillance of addiction), composed of 13 Addictovigilance Centres, was set up in 1990 in order to achieve reliable surveillance and evaluation of abuse and dependence cases due to psychoactive substances (alcohol and tobacco excepted). The detection of safety signals is one of the roles of the addictovigilance centres. Signals from spontaneous reports need to be analyzed before further communication. In addictovigilance, signals may be linked to adverse effects (deaths, pathological signs), to products (new psychoactive substances with potentially dangerous effects) or to practices (new administration routes, new contexts of use). These signals are provided by numerous partners among whom the addictovigilance network has to raise awareness about information that may possibly be an alert signal. The watchful attitude of all partners will make it possible that signals will be, after analyze, considered as true alerts. The addictovigilance network collects data, assess the potential for addiction of psychoactive drugs to provide information on the risk of addiction and give opinions for public health decisions (harm reduction or prevention programs, psychoactive substances control, health alerts).     

New Drugs and Instruments

Information published in this department has been supplied by the manufacturers of the products described.     

New Drugs and Instruments

Information published in this department has been supplied by the manufacturers of the products described.     

New Drugs and Instruments

Information published in this department has been supplied by the manufacturers of the products described.     

New Drugs and Instruments

Information published in this department has been supplied by the manufacturers of the products described.     

New Drugs and Instruments

Information published in this department has been supplied by the manufacturers of the products described.     

New Drugs and Instruments

Information published in this department has been supplied by the manufacturers of the products described.     

New Drugs and Instrument

Information published in this department has been supplied by the manufacturers of the products described.     

Otorhinolaryngological Toxicities of New Drugs in Oncology

Many new or relatively new cancer drugs—personalized anticancer agents—have been approved for use in various clinical settings in oncology or are still under evaluation in clinical trials. Targeted therapies as well as new immune checkpoint blockers have toxicity profiles that differ from conventional cytotoxic chemotherapy, and many can cause adverse effects that affect the mouth and pharynx, the nasal cavities, and the larynx. This review aims to provide an overview of current knowledge concerning these side effects and contemporary management. Adverse effects of the mouth/pharynx, nasal cavities, larynx, and cochlear-vestibular system are generally low grade (according to the Common Terminology Criteria for Adverse Events) and generally present non-life-threatening symptoms. However, the impact on patients’ quality of life could be important. The incidence and severity vary according to the drug, its target(s), and dose, but there are currently no known predictive factors, and each patient has an individual toxicity profile. Management guidelines are based on expert opinion. These ear, nose, and throat adverse effects are not frequently mentioned in the literature because of the often non-specific nature of the symptoms and their mildness, but also the absence of specific treatment. These symptoms can contribute to decreased quality of life and lead to drug compliance issues if not diagnosed and managed appropriately.     

New Drugs for Old Hearts

The newer antiarrhythmic agents propranolol, diphenylhydantoin and lidocaine have significant potential for depressing cardiac function and must be used with caution, especially in elderly patients. The new diuretic agents ethacrynic acid and furosemide are extremely potent and offer great advantages in refractory edema, but their indiscriminate use in the aged patient may lead to overdiuresis and to deterioration in cerebral, cardiac and renal function.     

New Role for FDA-Approved Drugs in Combating Antibiotic-Resistant Bacteria

Antibiotic resistance in medically relevant bacterial pathogens, coupled with a paucity of novel antimicrobial discoveries, represents a pressing global crisis. Traditional drug discovery is an inefficient and costly process; however, systematic screening of Food and Drug Administration (FDA)-approved therapeutics for other indications in humans offers a rapid alternative approach. In this study, we screened a library of 780 FDA-approved drugs to identify molecules that rendered RAW 264.7 murine macrophages resistant to cytotoxicity induced by the highly virulent Yersinia pestis CO92 strain. Of these compounds, we identified 94 not classified as antibiotics as being effective at preventing Y. pestis-induced cytotoxicity. A total of 17 prioritized drugs, based on efficacy in in vitro screens, were chosen for further evaluation in a murine model of pneumonic plague to delineate if in vitro efficacy could be translated in vivo. Three drugs, doxapram (DXP), amoxapine (AXPN), and trifluoperazine (TFP), increased animal survivability despite not exhibiting any direct bacteriostatic or bactericidal effect on Y. pestis and having no modulating effect on crucial Y. pestis virulence factors. These findings suggested that DXP, AXPN, and TFP may modulate host cell pathways necessary for disease pathogenesis. Finally, to further assess the broad applicability of drugs identified from in vitro screens, the therapeutic potential of TFP, the most efficacious drug in vivo, was evaluated in murine models of Salmonella enterica serovar Typhimurium and Clostridium difficile infections. In both models, TFP treatment resulted in increased survivability of infected animals. Taken together, these results demonstrate the broad applicability and potential use of nonantibiotic FDA-approved drugs to combat respiratory and gastrointestinal bacterial pathogens.