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Ramirez Fernandez MDM, Wille SMR, Samyn N. Incorporation of doxylamine and N-doxylamine-oxide in human hair and the impact of a permanent oxidative hair dye. Drug Test Anal 2023; 15:933-940. [PMID: 36354215 DOI: 10.1002/dta.3404] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 09/29/2023]
Abstract
Knowledge of the drug incorporation in hair and impact of cosmetic treatments remains essential to correctly interpret forensic cases. The study shows the analysis of doxylamine and doxylamine-N-oxide and the evaluation of the relationship between dose and hair concentration and the impact of hair treatment (oxidative dying). The study included (A) three subjects participated to the study: a regular user (Subject 1) and two single-dose users (Subject 2, 1 single dose; and Subject 3, 2 single doses spaced 5 months apart). Subject 3 applied a permanent oxidative hair dying monthly. (B) A permanent oxidative hair dying was applied twice to the hair collected from Subject 2. (A) The average concentrations in head hair for doxylamine and its N-doxylamine-oxide, respectively, were as follows: Subject 1, 1825 pg/mg and 16 pg/mg; Subject 2, 182 and
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Affiliation(s)
| | - Sarah M R Wille
- Department of Toxicology, National Institute of Criminalistics and Criminology, Brussels, Belgium
| | - Nele Samyn
- Department of Toxicology, National Institute of Criminalistics and Criminology, Brussels, Belgium
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2
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Cadet B, Bhutta S, Mahmoudzadeh S, Merisier M, Shah N. When Overdose of Doxylamine Leads to Severe Rhabdomyolysis and Renal Failure That Requires Hemodialysis: A Case Report and Literature Review. Cureus 2023; 15:e43395. [PMID: 37581198 PMCID: PMC10423311 DOI: 10.7759/cureus.43395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2023] [Indexed: 08/16/2023] Open
Abstract
A 52-year-old male with acute onset right-sided weakness, numbness, and buttock pain after consuming 30 tablets of doxylamine antihistamine the night prior. Laboratory tests showed elevated creatinine kinase, blood urea nitrogen, creatinine, troponins, liver transaminases, and phosphate. The patient was admitted to the medical intensive care unit for severe rhabdomyolysis, acute liver failure, and acute kidney injury secondary to doxylamine intoxication. Studies describe symptoms of severe doxylamine intoxication, such as impaired consciousness (coma), grand mal seizures, and cardiopulmonary arrest. Circulating myoglobin causes oxidative injury to the kidney through the formation of F2-isoprostanes leading to renal vasoconstriction. One study explained drug-induced rhabdomyolysis via two mechanisms: direct drug injury to the striated muscle and local muscle compression in seizure, coma, and metabolic abnormality. Treatment involves aggressive hydration with monitoring of serum electrolytes and renal function. Aggressive volume expansion via intravenous fluids remains critical in preventing rhabdomyolysis-associated nephrotoxicity and myoglobin-induced acute renal failure. Alkalinization of urine may prevent renal vasoconstriction resulting in enhanced excretion of the toxic metabolites of doxylamine and myoglobin via renal tubules, thereby reducing peak serum concentration time and preventing direct renal tissue damage.
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Affiliation(s)
- Bair Cadet
- Nephrology, Nassau University Medical Center, East Meadow, USA
| | - Salman Bhutta
- Nephrology, Long Island Jewish Medical Center, Queens, USA
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3
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Drugs for chronic insomnia. Med Lett Drugs Ther 2023; 65:1-6. [PMID: 36630579 DOI: 10.58347/tml.2023.1667a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Daridorexant (Quviviq) for insomnia. Med Lett Drugs Ther 2022; 64:107-10. [PMID: 35802843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
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Wesley BD, Sewell CA, Chang CY, Hatfield KP, Nguyen CP. Prescription medications for use in pregnancy-perspective from the US Food and Drug Administration. Am J Obstet Gynecol 2021; 225:21-32. [PMID: 34215352 DOI: 10.1016/j.ajog.2021.02.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/22/2021] [Accepted: 02/22/2021] [Indexed: 10/21/2022]
Abstract
Obstetrical healthcare providers frequently field questions about the safety of medications recommended or prescribed to their pregnant patients. Most women use as least 1 medication during pregnancy; however, there is little information about the safety or appropriate dosing of many medications during this phase of life. In addition, the development of drugs for use in pregnant women trails behind the development of drugs intended for other sectors of the population. Our goal is to inform the obstetrics community about the US Food and Drug Administration authority and their role in approving drugs for marketing. We begin with the statutes that led to the creation of the Food and Drug Administration and its current organization. We then cover drug development and the Food and Drug Administration review process, including the role of the advisory committee. The different types of drug approvals are discussed, with some specific examples. Finally, we enumerate the drugs specifically approved for use in obstetrics and contrast them with drugs commonly used by pregnant women and drugs used "off-label" during pregnancy. The Food and Drug Administration is committed to protecting and advancing the public health of pregnant women by guiding the development and ensuring the availability of effective and safe therapeutics for obstetrical indications and for medical conditions during pregnancy. We hope this review will inspire more research addressing drug use during pregnancy.
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Xiong JQ, Cui P, Ru S. Biodegradation of Doxylamine From Wastewater by a Green Microalga, Scenedesmus obliquus. Front Microbiol 2020; 11:584020. [PMID: 33224120 PMCID: PMC7669909 DOI: 10.3389/fmicb.2020.584020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/22/2020] [Indexed: 12/18/2022] Open
Abstract
Pharmaceutical contaminants (PCs) have been recognized as emerging contaminants causing unexpected consequences to environment and humans. There is an urgent need for development of efficient technologies to treat these PCs from water. The current study has investigated the removal capacity of a green microalgal species, Scenedesmus obliquus, for doxylamine, chemical oxygen demand (COD), and nutrients from real wastewater. Results have indicated that S. obliquus can grow well in the doxylamine-polluted wastewater with the achievement of 56, 78.5, 100, and 89% removal of doxylamine, COD, total nitrogen (TN), and total phosphorus (TP). Addition of 2 g L-1 bicarbonate enhanced the removal of doxylamine up to 63% and slightly inhibited the removal of COD. Decreased carbohydrate (28-26%) and increased protein content (30-33%) of the harvested biomass have been observed after cultivation in the wastewater. The current study has shown the feasibility of using microalgae-based biotechnologies for PC-contaminated wastewater.
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Affiliation(s)
- Jiu-Qiang Xiong
- College of Marine Life Sciences, Ocean University of China, Qingdao, China
| | - Pengfei Cui
- College of Marine Life Sciences, Ocean University of China, Qingdao, China
| | - Shaoguo Ru
- College of Marine Life Sciences, Ocean University of China, Qingdao, China
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7
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Abstract
The review describes general patterns of the development of acute (short-term) insomnia, its occurrence and course with the risk of transition to chronic insomnia. Main approaches for pharmacological and psychotherapeutic correction of acute insomnia needed to prevent chronification are indicated. The author suggests an algorithm for the treatment of acute insomnia taking into account its staging.
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Affiliation(s)
- A Yu Melnikov
- Research and Clinical Center of Otorhinolaryngology by Federal Biomedical Agency, Moscow, Russia
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Abstract
Insomnia is one of the most common symptoms of mental pathology (affective, anxious, hypochondriac, asthenic, psychotic) and reveals a number of characteristic features depending on the structure of the mental disorder. Psychopharmacotherapy for insomnia in mental disorders is an important aspect of patient supervision. Doxylamine (donormil) is one of the promising drugs for the correction of insomnia, both in combination with other psychotropic drugs and in monotherapy.
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Affiliation(s)
- B A Volel
- University Clinical Hospital #3 of Sechenov First Moscow State Medical University Ministry of Health, Moscow, Russia
| | - D S Petelin
- University Clinical Hospital #3 of Sechenov First Moscow State Medical University Ministry of Health, Moscow, Russia
| | - M G Poluektov
- Sechenov First Moscow State Medical University Ministry of Health, Moscow, Russia
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Drugs for chronic insomnia. Med Lett Drugs Ther 2018; 60:201-5. [PMID: 30625122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Tzeng JI, Chiu CC, Wang JJ, Hung CH, Chen YW. Spinal sensory and motor blockade by intrathecal doxylamine and triprolidine in rats. J Pharm Pharmacol 2018; 70:1654-1661. [PMID: 30251371 DOI: 10.1111/jphp.13017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 09/02/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The aim of this experiment was mainly to examine the effects of intrathecally injected doxylamine and triprolidine, two antihistamine drugs spinal motor and sensory functions. METHODS After intrathecally injecting the rats with five different doses, the dose-response curves of spinal sensory and motor block with doxylamine and triprolidine were constructed. In comparison with the local anaesthetic mepivacaine, the quality and duration of spinal anaesthesia with doxylamine or triprolidine were conducted. KEY FINDINGS Doxylamine, mepivacaine and triprolidine elicited spinal motor and sensory (nociception and proprioception) blockades in a dose-dependent fashion. On the ED50 (50% effective dose) basis, the rank order of drug potency was triprolidine > mepivacaine > doxylamine (P < 0.05) at provoking spinal motor, proprioceptive and nociceptive blockades. On the equianaesthetic doses (ED25 , ED50 and ED75 ), the duration of spinal anaesthesia with doxylamine was longer (P < 0.01) than that with mepivacaine or triprolidine. Moreover, doxylamine or triprolidine displayed greater potency (ED50 ) (P < 0.05) and duration (P < 0.05) of sensory block over motor block. CONCLUSIONS Doxylamine or triprolidine produces a dose-dependent effect of spinal motor and sensory block. Triprolidine with a better nociception-selective action over motor block has a better potency than mepivacaine or doxylamine. Doxylamine and triprolidine produce longer durations than mepivacaine.
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Affiliation(s)
- Jann-Inn Tzeng
- Department of Anesthesiology, Chi-Mei Medical Center, Yong Kang, Tainan, Taiwan
| | - Chong-Chi Chiu
- Department of General Surgery, Chi-Mei Medical Center, Tainan and Liouying, Taiwan
- Department of Electrical Engineering, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Ching-Hsia Hung
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Wen Chen
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
- Department of Physical Therapy, College of Health Care, China Medical University, Taichung, Taiwan
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Abstract
The article analyzes the anatomy, morphological and neurochemical connections and functions of the brain histaminergic system, one of the leading systems in the mechanism maintaining wakefulness. The possibilities of histaminergic system modulating for the treatment of various sleep/wake cycle disorders are discussed. The data of clinical trials on the influence of the histamine H1 receptor antagonist doxylamine on sleep in healthy volunteers and patients with insomnia are considered. The evidence-based efficacy of the drug in sleep disorders is discussed.
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Affiliation(s)
- K N Strygin
- Scehenov First Moscow Medical University, Moscow, Russia
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12
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Abstract
Derinöz-Güleryüz O. Doxylamine succinate overdose: Slurred speech and visual hallucination. Turk J Pediatr 2018; 60: 439-442. Doxylamine succinate is a commonly used antihistamine for respiratory allergies including allergic rhinitis as well as for the management of insomnia. As it is available over-the-counter like other nonprescription antihistamines and sleep aids, there is a risk of overdose. It is believed that doxylamine succinate has both peripheral and central activity with its anticholinergic properties. Delirium, seizures, and coma are among the central adverse effects that are rare. This case was presented since it is the first case in the literature who developed slurred speech and visual hallucination after high dose doxylamine succinate use and received antidotal therapy for anticholinergic side effects.
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Melnikov AY, Lavrik SY, Bikbulatova LF, Raginene IG, Ivanova YA, Zakharov AV. [Effectiveness of reslip ( doxylamine) in short-term insomnia: multicenter comparative randomized study]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:56-59. [PMID: 28777365 DOI: 10.17116/jnevro20171174256-59] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM Evaluate the efficiency of reslip (doxylamine) in short-term insomnia in comparison with donormyl in multicenter comparative randomized study. MATERIAL AND METHODS The study was conducted in 6 medical centers and included 60 patients aged from 30 to 59 years with short-term insomnia. Patients were divided into two groups: in first one patients took reslip and in the second one donormyl in same dosage and regimen. RESULTS The complete clinical remission of insomnia was achieved in majority of patients in both groups. Indicators of insomnia severity, sleep quality and daytime sleepiness in both groups improved with a high significance. Side effects were mild and in most cases did not result in treatment cessation. No significant differences between the groups in terms of clinical efficacy were found. CONCLUSION Short-term doxylamine intake causes significant positive clinical effect in short-term insomnia with satisfactory acceptability by patients. Russian doxylamine Reslip correlates well with donormil regarding the clinical efficacy and acceptability and can be used in clinical practice for the short-term insomnia treatment.
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Affiliation(s)
- A Yu Melnikov
- Research and Clinical Center of Otorhinolaryngology by Federal Biomedical Agency, Moscow, Russia
| | - S Yu Lavrik
- Irkutsk State Medical Academy of Continuing Education, Irkutsk, Russia
| | | | - I G Raginene
- Center for Aesthetic Medicine 'Renovacio', Krasnoyarsk, Russia
| | - Ya A Ivanova
- Federal State Budgetary Scientific Institution 'Scientific Research Institute of Physiology and Basic Medicine', Novosibirsk, Russia
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Nuangchamnong N, Niebyl J. Doxylamine succinate-pyridoxine hydrochloride (Diclegis) for the management of nausea and vomiting in pregnancy: an overview. Int J Womens Health 2014; 6:401-9. [PMID: 24748822 PMCID: PMC3990370 DOI: 10.2147/ijwh.s46653] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Nausea and vomiting in pregnancy (NVP) is common and often undertreated, in part due to fears of adverse effects of medications on the fetus during early pregnancy. In April 2013, the US Food and Drug Administration (FDA) approved doxylamine succinate 10 mg and pyridoxine hydrochloride (a vitamin B6 analog) 10 mg as a delayed-release combination pill called Diclegis for the treatment of NVP. Diclegis is currently the only medication that is FDA-approved for the indication of NVP. This review addresses the historical context, safety, efficacy, pharmacology, and practical role of doxylamine and pyridoxine for the management of NVP. The reintroduction of this doxylamine-pyridoxine combination pill into the American market fills a therapeutic gap in the management of NVP left by the removal of the same active drugs marketed over 30 years ago in the form of Bendectin. The substantial amount of safety data accumulated over the years makes it one of the few drugs that qualify for FDA Pregnancy Category A status. In the hierarchical approach to pharmacological treatment of NVP, the combination of doxylamine and pyridoxine should thus be first-tier.
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Affiliation(s)
- Nina Nuangchamnong
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa, IA, USA
| | - Jennifer Niebyl
- Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa, IA, USA
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