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What is the status of SNX-111?

: What is the status of SNX-111?

This site is dedicated to the latest updates on this drug. Here is an excerpt: Ziconotide is a novel non-opioid, non local anesthetic, developed for the treatment of
severe chronic pain. Ziconotide (also previously referred to as CI 1009, or SNX-111) is the synthetic form of the cone snail peptide w-cenotoxin M-VII-A, a neurone-specific N-type calcium channel blocker that is being developed as an analgesic agent by Neurex Corporation (a subsidiary of Elan Corporation). The New Drug Application (NDA) for ziconotide, which was submitted on December 28, 1999, had been accepted as filed by the FDA. The FDA has agreed to a six-month review of this NDA.

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Posted by JCB on June 29, 2001 at 23:44:28:

In Reply to: Re: SNX-111 posted by A Nasser on June 21, 2001 at 07:13:22:

The latest information I have is that Ziconotide is in Stage NDA Preparation Phase II. It is marketed by Elan Pharmaceutical. http://backandneck.about.com/health/backandneck/library/blziconotide.htm
http://www.elancorp.com/home/

What is-was Canthrone? What is its composition, strength, active ingredients? Where can it be purchased?

In Reply to: Canthrone posted by Charles E. Anderson on April 18, 2001 at 00:03:08:

This agent is actually known as Cantharidin and it is a topical keratolytic. Cantharidin was used for the treatment of warts (usually plantar). It appears that this drug never underwent any clinical drug trials necessary for FDA approval.

The following site had located a company in Canada that still sells this agent:

http://zip.mail-list.com/archives/footclinic/msg00041.html

Excerpt:
(NOTE: the original Canthrone or Canthrone Plus is no longer made by the Seres company. However, a Canadian company, Omniderm of Hudson, Quebec, is currently making a very similiar product, that in my experience, is just a little bit weaker than Canthrone Plus and works well. Here is their contact info:

Company: Omniderm 888 4580158
Product: Canthacur-PS 7.5 ml
Price: $40 + $5 shipping

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(Literature search)
Recommended reading:

Miller DM, Brodell RT.
Human papillomavirus infection: treatment options for warts. Am Fam Physician. 1996 Jan;53(1):135-43, 148-50.

the use of cefotaxime to patients with allergies to pcn.

In Reply to: cefotaxime posted by lucy on April 18, 2001 at 14:42:41:

Generally speaking, patients who have had a mild reaction to penicillin e.g. rash or urticaria, are usually able to tolerate a cephalosporin without exhibiting an allergic response. However, patients who have had potentially life-threatening anaphylaxis when exposed to pencillin, should not be prescribed a cephalosporin

I'm trying to find equivalences for dayli intake of corticosteroids. i.e a patient on solu-cortef iv 50 mg q 8hrs that I want to convert to predniso p.o ID.
What should be the dosage of prednisone and based on which convertion rule?? Same question for switching from solu-medrol to prednisone or solu-cortef...

Moreover, in every book they suggest giving solu-medrol q 6hrs but when you chexk out half-lives, it has the same one as prednison that we give ID.

I'M asking you: Where's the truth???

Thanks a lot

Cris

In Reply to: corticosteroids equivalences posted by Christian Gaouette, Md on April 20, 2001 at 09:19:15:

Here are the relative potencies of the available corticosteroids:

Cortisone--25 mg
Hydrocortisone--20 mg
Prednisolone--5 mg
Prednisone--5 mg
Methylprednisolone--4 mg
Triamcinolone--4 mg
Dexamethasone--0.75 mg
Betamethasone--0.6 mg

You could also use the program I wrote located here.

Using the table above or the program on this site, 50 mg of Solu-Cortef (hydrocortisone)q8h would be equivalent to 37.5 mg of prednisone given once daily.

The frequency of dosing of a particular corticosteroid depends on the underlying disease state. Some studies have found more frequent dosing may be slightly more efficacious in some instances. Dividing up the doses creates greater variations in the peak and trough concentrations and this may be perceived by the patient as providing more "consistent" relief. In general, intravenous corticosteroids are usually reserved for acute exacerbations (induction therapy) and oral therapy is generally used for maintenance. High dose oral therapy can be used, however, there is a greater incidence of gastrointestinal side effects. This can be minimized by giving divided doses with meals. Because of the high bioavailability of the commonly used corticosteroids, there is actually little difference in the efficacy of oral versus IV therapy. Peak concentrations will be achieved faster with intravenous therapy, but the clinical significance after 24 hours is most likely negligible.

Hope this helps....

Where can I find a good updated list of which drugs are dialyzable or not?

In Reply to: dialyzable drugs posted by Raquel Schwankhart on May 02, 2001 at 14:10:57:

: Where can I find a good updated list of which drugs are dialyzable or not?

A comprehensive reference is published each year by Amgen. You can download a copy of the current guidelines here.

Web link: http://www.nephrologypharmacy.com/pub_dialysis.html

What is the formula for adjusting dosages for patients with amputated limbs?

In Reply to: Gentamicin dosing posted by Doug Bland, Pharm.D. on May 08, 2001 at 07:00:45:

Many practitioners will use the patient’s pre-amputated height to calculate an estimated ideal body weight and then use this info to calculate an estimated creatinine clearance. It should be noted that the reliability of these empiric equations declines proportionately with the significance of the amputation(s). Your next step will depend on the severity of the underlying infection. If the patient is critical and you are dosing a patient on an aminoglycoside, you can obtain two levels off of the first dose and then calculate an elimination rate constant as well as the volume of distribution. If the condition is not critical, the impact of your estimation should not have a profound effect on the eventual steady state concentrations. As with most consults, the patients underlying clinical status (e.g. hydration status, cardiac and renal function, etc) plays a much greater role. In sum, because of the multiplicity of clinical tools available to you, the overall impact of an estimation can be notably reduced……

If someone out there takes a different approach, please post your protocol here...

On 3/23/01 FDA Medwatch released a statement regarding dosage adjustment for patients receiving famotidine with moderate renal insufficiency(creatinine clearance < 50 ml/min)It recommends reducing the dose by 1/2 or prolonging the dosing interval to Q36 - 48hrs as indicated by clinical response. I believe your renal dosing chart only recommends changes for creatinine clearance < 10.
Thanks again.

• Summary of Pepcid Labeling Changes- 3/23/01- medwatch

In Reply to: Famotidine dosage adjustment in renal impairment posted by Thomas Suchy R.Ph. on May 15, 2001 at 17:25:22:
Thank you for the update. The dosing chart has been changed...

What is the standard regarding administering TPN via an electronic pump as opposed to a gravity flow controller? Is it absolutely necessary to use an electronic pump everytime TPN is administered?

In Reply to: TPN-electronic pump vs. gravity flow controllers posted by Michele Malecki RN, BSN on May 17, 2001 at 11:31:37:

Most if not all hospitals have established policies that state all TPN's must be on a pump. With 15 years of critical care experience, I have never seen TPN on a gravity flow controller. Using a gravity flow controller would place the patient in unnecessary danger.

WHEN SOMEONE HAS AN ANAPHYLAXIS REACTION TO MORPHINE AND IS ON ORAL METHADONE AND THE DOCTOR WANTS TO CONVERT TO IV DILAUDID (HYDROMORPHONE), WHAT DO YOU DO? WHAT DO YOU DO FOR PT'S ALLERGIC TO MORPHINE? ISN'T DILAUDID RELATED TO MORPHINE WHERE YOU WOULD SEE THE SAME REACTION? PLEASE HELP QUICK, I JUST GOT THE FAX TO SEND IV DILAUDID.

In Reply to: MORPHINE ALLERGY posted by LISA on May 21, 2001 at 14:52:52:

Schedule II alternatives for true morphine allergy would be Methadone, Meperidine, or Fentanyl. However, the use of meperidine should be avoided for chronic use because of the potential for the accumulation of the toxic metabolite nor-meperidine.

The following drugs should be avoided because they all contain the same phenanthrine nucleus as morphine: hydromorphone, oxymorphone, codeine, hydrocodone, and oxycodone.

Here is a list of suitable alternatives (disregarding the schedule- eg II to V):
phenylheptylamines: Methadone or propoxyphene. phenylpiperidines: Meperidine, alfentanyl, fentanyl, or sufentanil.