The Experts below are selected from a list of 72 Experts worldwide ranked by ideXlab platform
Sergio D Bergese - One of the best experts on this subject based on the ideXlab platform.
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the effect of transdermal scopolamine for the prevention of postoperative nausea and vomiting
Frontiers in Pharmacology, 2014Co-Authors: Mara A A Antor, Joseph V Pergolizzi, Alberto A Uribe, Natali Erminyfalcon, Joseph G Werner, Keith A Candiotti, Sergio D BergeseAbstract:Postoperative nausea and vomiting is one of the most common and undesirable complaints recorded in as many as 70%-80% of high-risk surgical patients. The current prophylactic therapy recommendations for PONV management stated in the Society of Ambulatory Anesthesia guidelines should start with monotherapy and patients at moderate to high risk, a combination of antiemetic medication should be considered. Consequently, if rescue medication is required, the antiemetic drug chosen should be from a different therapeutic class and administration mode than the drug used for prophylaxis. The guidelines restrict the use of dexamethasone, transdermal scopolamine, aprepitant, and palonosetron as rescue medication 6 hours after surgery. In an effort to find a safer and reliable therapy for postoperative nausea and vomiting, new drugs with antiemetic properties and minimal side effects are needed, and scopolamine may be considered an effective alternative. Scopolamine is a Belladonna Alkaloid, α-(hydroxymethyl) benzene acetic acid 9-methyl-3-oxa-9-azatricyclo non-7-yl ester, acting as a nonselective muscarinic antagonist and producing both peripheral antimuscarinic and central sedative, antiemetic, and amnestic effects. The empirical formula is C17H21NO4 and its structural formula is a tertiary amine L-(2)-scopolamine (tropic acid ester with scopine; MW = 303.4). Scopolamine became the first drug commercially available as a transdermal therapeutic system used for extended continuous drug delivery during 72 hours. Clinical trials with transdermal scopolamine have consistently demonstrated its safety and efficacy in postoperative nausea and vomiting. Thus, scopolamine is a promising candidate for the management of postoperative nausea and vomiting in adults as a first line monotherapy or in combination with other drugs. In addition, transdermal scopolamine might be helpful in preventing postoperative discharge nausea and vomiting owing to its long-lasting clinical effects.
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Studying the Effectiveness of Triple Therapy with Scopolamine,Ondansetron and Dexamethasone for Prevention of Post OperativeNausea and Vomiting in High Risk Patients Undergoing NeurologicalSurgery and General Anesthesia
Journal of Clinical Trials, 2012Co-Authors: Mara A A Antor, Alberto A Uribe, Erika G. Puente, Juan Portillo, Sergio D BergeseAbstract:Post operative nausea and vomiting (PONV) are common complications and occurs in as many as 70%- 80% of high risk surgical patients. The latest prophylactic treatment recommended in the Society of Ambulatory Anesthesia Guidelines (SAMBA) for the management of Post operative Nausea and Vomiting for high risk patients is a combination of 2 or more interventions (multimodal therapy). A combination of a 5-HT3 receptor antagonist with Dexamethasone and/or Droperidol, or a 5-HT3 receptor antagonist with Droperidol alone, or Dexamethasone with Droperidol, have been the pharmacologic combination therapies suggested in these guidelines. Scopolamine “Transdermal Scop” is a Belladonna Alkaloid with anticholinergic properties. It acts as a nonselective muscarinic antagonist, approved by the FDA for PONV prophylaxis. The use of this novel drug in a triple therapy combination with Dexamethasone and/or Droperidol could be an effective treatment for the prevention of PONV. However, since the FDA issued a warning stating that Droperidol may cause life – threatening arrhythmias as well as a prolongation of the QTc interval, the need to discover new combination therapies for PONV prevention in high risk patients is still in demand. Therefore, we hypothesize that the use of a triple prophylactic therapy consisting of Scopolamine, Dexamethasone, and Ondansetron will be an effective treatment for the prevention of PONV in patients at a high risk for developing PONV during the first 120 hours after neurosurgery.
Mara A A Antor - One of the best experts on this subject based on the ideXlab platform.
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the effect of transdermal scopolamine for the prevention of postoperative nausea and vomiting
Frontiers in Pharmacology, 2014Co-Authors: Mara A A Antor, Joseph V Pergolizzi, Alberto A Uribe, Natali Erminyfalcon, Joseph G Werner, Keith A Candiotti, Sergio D BergeseAbstract:Postoperative nausea and vomiting is one of the most common and undesirable complaints recorded in as many as 70%-80% of high-risk surgical patients. The current prophylactic therapy recommendations for PONV management stated in the Society of Ambulatory Anesthesia guidelines should start with monotherapy and patients at moderate to high risk, a combination of antiemetic medication should be considered. Consequently, if rescue medication is required, the antiemetic drug chosen should be from a different therapeutic class and administration mode than the drug used for prophylaxis. The guidelines restrict the use of dexamethasone, transdermal scopolamine, aprepitant, and palonosetron as rescue medication 6 hours after surgery. In an effort to find a safer and reliable therapy for postoperative nausea and vomiting, new drugs with antiemetic properties and minimal side effects are needed, and scopolamine may be considered an effective alternative. Scopolamine is a Belladonna Alkaloid, α-(hydroxymethyl) benzene acetic acid 9-methyl-3-oxa-9-azatricyclo non-7-yl ester, acting as a nonselective muscarinic antagonist and producing both peripheral antimuscarinic and central sedative, antiemetic, and amnestic effects. The empirical formula is C17H21NO4 and its structural formula is a tertiary amine L-(2)-scopolamine (tropic acid ester with scopine; MW = 303.4). Scopolamine became the first drug commercially available as a transdermal therapeutic system used for extended continuous drug delivery during 72 hours. Clinical trials with transdermal scopolamine have consistently demonstrated its safety and efficacy in postoperative nausea and vomiting. Thus, scopolamine is a promising candidate for the management of postoperative nausea and vomiting in adults as a first line monotherapy or in combination with other drugs. In addition, transdermal scopolamine might be helpful in preventing postoperative discharge nausea and vomiting owing to its long-lasting clinical effects.
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Studying the Effectiveness of Triple Therapy with Scopolamine,Ondansetron and Dexamethasone for Prevention of Post OperativeNausea and Vomiting in High Risk Patients Undergoing NeurologicalSurgery and General Anesthesia
Journal of Clinical Trials, 2012Co-Authors: Mara A A Antor, Alberto A Uribe, Erika G. Puente, Juan Portillo, Sergio D BergeseAbstract:Post operative nausea and vomiting (PONV) are common complications and occurs in as many as 70%- 80% of high risk surgical patients. The latest prophylactic treatment recommended in the Society of Ambulatory Anesthesia Guidelines (SAMBA) for the management of Post operative Nausea and Vomiting for high risk patients is a combination of 2 or more interventions (multimodal therapy). A combination of a 5-HT3 receptor antagonist with Dexamethasone and/or Droperidol, or a 5-HT3 receptor antagonist with Droperidol alone, or Dexamethasone with Droperidol, have been the pharmacologic combination therapies suggested in these guidelines. Scopolamine “Transdermal Scop” is a Belladonna Alkaloid with anticholinergic properties. It acts as a nonselective muscarinic antagonist, approved by the FDA for PONV prophylaxis. The use of this novel drug in a triple therapy combination with Dexamethasone and/or Droperidol could be an effective treatment for the prevention of PONV. However, since the FDA issued a warning stating that Droperidol may cause life – threatening arrhythmias as well as a prolongation of the QTc interval, the need to discover new combination therapies for PONV prevention in high risk patients is still in demand. Therefore, we hypothesize that the use of a triple prophylactic therapy consisting of Scopolamine, Dexamethasone, and Ondansetron will be an effective treatment for the prevention of PONV in patients at a high risk for developing PONV during the first 120 hours after neurosurgery.
Arrico L - One of the best experts on this subject based on the ideXlab platform.
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Temporary diplopia upon hyoscine-N-butyl bromide administration: case report
Clinical ophthalmology (Auckland N.Z.), 2013Co-Authors: R Migliorini, Malagola R, M Mafrici, R Spena, Arrico LAbstract:Hyoscine-N-butyl bromide is a widely used antispasmodic belonging to the Belladonna Alkaloid class of semisynthetic quaternary ammonium compounds. These compounds exert a spasmolytic action on the smooth muscles of the bile-gastrointestinal tract, genitourinary tract, salivary glands (xerostomia), and also on the visual apparatus - in particular, the irido-ciliary complex. As a consequence, they provoke collateral effects such as mydriasis and accommodation disturbances. We report the case of a 23-year-old woman who complained of not only “dry mouth” but also “cloudy vision” and a “diplopia”, both of temporary type, 2 hours after oral administration of hyoscine-N-butyl bromide.
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Temporary diplopia upon hyoscine-N-butyl bromide administration: case report
Dove Medical Press, 2013Co-Authors: Migliorini R, Malagola R, Mafrici M, Spena R, Arrico LAbstract:R Migliorini, R Malagola, M Mafrici, R Spena, L ArricoDepartment of Sense Organs, University of Rome "La Sapienza", Rome, ItalyAbstract: Hyoscine-N-butyl bromide is a widely used antispasmodic belonging to the Belladonna Alkaloid class of semisynthetic quaternary ammonium compounds. These compounds exert a spasmolytic action on the smooth muscles of the bile-gastrointestinal tract, genitourinary tract, salivary glands (xerostomia), and also on the visual apparatus – in particular, the irido-ciliary complex. As a consequence, they provoke collateral effects such as mydriasis and accommodation disturbances. We report the case of a 23-year-old woman who complained of not only "dry mouth" but also "cloudy vision" and a "diplopia", both of temporary type, 2 hours after oral administration of hyoscine-N-butyl bromide.Keywords: hyoscine-N-butyl bromide, accommodation disorders, temporary diplopia, fusion alteration, vertical strabismu
Ozlem Guneysel - One of the best experts on this subject based on the ideXlab platform.
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Anticholinergic Syndrome Due to Suicidal Intake of Datura Stramonium: A Case Report
Journal of Academic Emergency Medicine Case Reports, 2014Co-Authors: Ali Kandemir, Alparslan Mutlu, Mehmet Tatli, Ozlem GuneyselAbstract:Introduction: Datura stramonium is a member of the Belladonna Alkaloid family. It contains atropine and can cause anticholinergic symptoms. Datura stramonium intoxications in the literature often occur as side effects of an alternative medicine method. In our case, the patient researched and used it with the aim of suicide.Case Report: A 38-year-old patient was brought to the emergency department with confusion, muscle contractions, and hallucinations. The patient’s relatives informed us he had eaten seeds of a plant 8 hours before he arrived to the hospital, and his complaints had started 5 to 6 hours after he had eaten the seeds. He was an old boxer and he looked like he was fighting against an imaginary opponent with the face off with both arms. His pupils were mydriatic, the mucosal membranes and his tongue were dry, his bowel sounds were decreased, and his eyes were red. We had learned that the seeds were datura stramonium seeds. We administered physostigmine. Patient consciousness recovered after physostigmine. Patient was discharged after follow-up.Conclusion: Patients who are admitted to emergency services with anticholinergic toxidrome should be kept in mind about plants like datura stramonium which is commonly used for alternative medicine and emergent appropriate therapy should started early
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Anticholinergic Syndrome Due to Suicidal Intake of Datura Stramonium: A Case Report Özkiyim Amaçli Datura Stramonium Alimina Bağli Antikolinerjik Sendrom:
2014Co-Authors: Olgu Sunumu, Ali Kandemir, Alparslan Mutlu, Mehmet Tatli, Ozlem GuneyselAbstract:Introduction: Datura stramonium is a member of the Belladonna Alkaloid family. It contains atropine and can cause anticholinergic symptoms. Datura stramonium intoxications in the literature often occur as side effects of an alternative medicine method. In our case, the patient researched and used it with the aim of suicide. Case Report: A 38-year-old patient was brought to the emergency department with confusion, muscle contractions, and hallucinations. The patient’s relatives informed us he had eaten seeds of a plant 8 hours before he arrived to the hospital, and his complaints had started 5 to 6 hours after he had eaten the seeds. He was an old boxer and he looked like he was fighting against an imaginary opponent with the face off with both arms. His pupils were mydriatic, the mucosal membranes and his tongue were dry, his bowel sounds were decreased, and his eyes were red. We had learned that the seeds were datura stramonium seeds. We administered physostigmine. Patient consciousness recovered after physostigmine. Patient was discharged after follow-up. Conclusion: Patients who are admitted to emergency services with anticholinergic toxidrome should be kept in mind about plants like datura stramonium which is commonly used for alternative medicine and emergent appropriate therapy should started early.
Alberto A Uribe - One of the best experts on this subject based on the ideXlab platform.
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the effect of transdermal scopolamine for the prevention of postoperative nausea and vomiting
Frontiers in Pharmacology, 2014Co-Authors: Mara A A Antor, Joseph V Pergolizzi, Alberto A Uribe, Natali Erminyfalcon, Joseph G Werner, Keith A Candiotti, Sergio D BergeseAbstract:Postoperative nausea and vomiting is one of the most common and undesirable complaints recorded in as many as 70%-80% of high-risk surgical patients. The current prophylactic therapy recommendations for PONV management stated in the Society of Ambulatory Anesthesia guidelines should start with monotherapy and patients at moderate to high risk, a combination of antiemetic medication should be considered. Consequently, if rescue medication is required, the antiemetic drug chosen should be from a different therapeutic class and administration mode than the drug used for prophylaxis. The guidelines restrict the use of dexamethasone, transdermal scopolamine, aprepitant, and palonosetron as rescue medication 6 hours after surgery. In an effort to find a safer and reliable therapy for postoperative nausea and vomiting, new drugs with antiemetic properties and minimal side effects are needed, and scopolamine may be considered an effective alternative. Scopolamine is a Belladonna Alkaloid, α-(hydroxymethyl) benzene acetic acid 9-methyl-3-oxa-9-azatricyclo non-7-yl ester, acting as a nonselective muscarinic antagonist and producing both peripheral antimuscarinic and central sedative, antiemetic, and amnestic effects. The empirical formula is C17H21NO4 and its structural formula is a tertiary amine L-(2)-scopolamine (tropic acid ester with scopine; MW = 303.4). Scopolamine became the first drug commercially available as a transdermal therapeutic system used for extended continuous drug delivery during 72 hours. Clinical trials with transdermal scopolamine have consistently demonstrated its safety and efficacy in postoperative nausea and vomiting. Thus, scopolamine is a promising candidate for the management of postoperative nausea and vomiting in adults as a first line monotherapy or in combination with other drugs. In addition, transdermal scopolamine might be helpful in preventing postoperative discharge nausea and vomiting owing to its long-lasting clinical effects.
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Studying the Effectiveness of Triple Therapy with Scopolamine,Ondansetron and Dexamethasone for Prevention of Post OperativeNausea and Vomiting in High Risk Patients Undergoing NeurologicalSurgery and General Anesthesia
Journal of Clinical Trials, 2012Co-Authors: Mara A A Antor, Alberto A Uribe, Erika G. Puente, Juan Portillo, Sergio D BergeseAbstract:Post operative nausea and vomiting (PONV) are common complications and occurs in as many as 70%- 80% of high risk surgical patients. The latest prophylactic treatment recommended in the Society of Ambulatory Anesthesia Guidelines (SAMBA) for the management of Post operative Nausea and Vomiting for high risk patients is a combination of 2 or more interventions (multimodal therapy). A combination of a 5-HT3 receptor antagonist with Dexamethasone and/or Droperidol, or a 5-HT3 receptor antagonist with Droperidol alone, or Dexamethasone with Droperidol, have been the pharmacologic combination therapies suggested in these guidelines. Scopolamine “Transdermal Scop” is a Belladonna Alkaloid with anticholinergic properties. It acts as a nonselective muscarinic antagonist, approved by the FDA for PONV prophylaxis. The use of this novel drug in a triple therapy combination with Dexamethasone and/or Droperidol could be an effective treatment for the prevention of PONV. However, since the FDA issued a warning stating that Droperidol may cause life – threatening arrhythmias as well as a prolongation of the QTc interval, the need to discover new combination therapies for PONV prevention in high risk patients is still in demand. Therefore, we hypothesize that the use of a triple prophylactic therapy consisting of Scopolamine, Dexamethasone, and Ondansetron will be an effective treatment for the prevention of PONV in patients at a high risk for developing PONV during the first 120 hours after neurosurgery.