‘taking’ Tagged Posts

Affected person Develops Glandular Tularemia After Taking Care of Sick Cat

Diana Ernst, RPh October 11, 2018 A recent case published in the New England Journal of Medicine reports on a patient diagnosed with glandular tul...


October 11, 2018

A recent case published in the New England Journal of Medicine reports on a patient diagnosed with glandular tularemia, an infection that was likely transmitted by his cat.

The 68-year-old patient reported having a fever for 1 week followed by progressive, painful swelling on the right side of his neck for 2 months. The symptoms had started 2 days after his outdoor cat had died from what was believed to be feline leukemia, however laboratory testing had not been conducted to confirm the diagnosis.

Image courtesy of The New England Journal of Medicine ©2018.

During the physical examination, it was noted that the patient had 3 erythematous, tender lymph nodes. Serologic testing was conducted and revealed the patient was positive for Francisella tularensis, a Gram-negative coccobacillus that is transmitted to humans by infected animals. “Domestic cats can become infected through the consumption of infected prey and can transmit the bacteria to humans,” explained the authors. The patient reported he had been administering medication to his cat at the time of its illness.

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Depending on how the bacteria enter the body, the signs and symptoms of tularemia can vary and illness can range from mild to life-threatening. The most common form of tularemia is ulceroglandular, in which case a skin ulcer appears at the site of bacterial entry. Glandular tularemia is similar to ulceroglandular tularemia but without the presence of an ulcer. Antibiotics used to treat tularemia include streptomycin, gentamicin, doxycycline, and ciprofloxacin.

Within 5 days of receiving doxycycline, the patient’s lesions improved; resolution of symptoms occurred within 3 weeks of treatment (the patient was treated for a total of 4 weeks).

For more information visit NEJM.org.

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Taking Benefit of a Drug-Drug Interplay: A Case of Valproic Acid Toxicity


June 14, 2018

A 45-year-old male was found unresponsive after ingesting 10 grams of extended-release divalproex sodium

A 45-year-old male was discovered unresponsive after ingesting 10 grams of extended-release divalproex sodium

In response to findings of a current case report, short-term administration of carbapenem antibiotics could also be useful within the remedy of valproic acid (VPA) overdose in sufferers with no historical past of seizure dysfunction.

The case report, printed in The Journal of Medical Pharmacy and Therapeutics, describes a 45-year-old male affected person who was discovered unresponsive after ingesting 10 grams of extended-release divalproex sodium. His previous medical historical past was vital for bipolar dysfunction. Laboratory evaluation confirmed elevated serum VPA concentrations (396.2mg/mL initially; 415mg/mL after 5.5 hours) in addition to a traditional serum ammonia degree (24mmol/L). The affected person was prescribed activated charcoal, 1 dose of intravenous levocarnitine, cefepime, and metronidazole.

The authors defined, “Given the priority for rising VPA concentrations and dangers of extra extreme toxicity, an interprofessional settlement was made to alter antibiotic remedy to short-term administration of meropenem as a remedy for aspiration pneumonia that may deliberately benefit from the interplay between VPA and carbapenem antibiotics.” 

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A major lower within the affected person’s serum VPA focus was noticed following the primary dose of meropenem in addition to over the subsequent 14 hours (to 36.5mg/mL). Moreover, the affected person was reported to develop into extra alert regardless of elevated serum ammonia ranges. After 5 days of hospitalization, the affected person acquired a complete of eight doses of meropenem (500mg each 6 hours administered intravenously) previous to being discharged to inpatient psychiatry.

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Administration of carbapenem antibiotics could also be useful for the remedy of poisonous ranges of VPA. The authors concluded, “The lower within the elimination half-life induced by this main drug-drug interplay could hasten enchancment in neurological restoration, decrease toxicity from VPA overdose and shorten size of hospital keep.” They added, “Nevertheless, this requires affirmation of security and efficacy in a well-designed examine previous to widespread implementation.”


Khobrani MA et al. Intentional use of carbapenem antibiotics for valproic acid toxicity: A case report. Journal of Medical Pharmacy and Therapeutics. 2018. 

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What Not To Eat While Taking Lisinopril?


Can You Drink Alcohol While Taking Lisinopril?


Drinking and taking prescription medications General and dangerous


drink and prescription drugs are taking common and dangerous
Nonsteroidal anti-inflammatory drugs (NSAIDs) – Motrin, Bextra, Naproxen, Celebrex aspirin, Voltaren, Lodine, Indocin, Orudis, Toradol, Relafen, Daypro, Clinoril, Aleve or Naprosyn and others, are the most commonly used drugs in the world. Most people & amp; nbsp; …
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