Knowledge Center

Category: Drug Reviews

Off-Label Drug Use Versus FDA-Approved Medications

In November 2012, Medtronic issued a warning letter regarding the use of off-label medications within its Synchromed II pain pump. This letter emphasized an increase of motor stalls within implantable infusion devices with unapproved drugs. This letter specifically stated, “The use of unapproved drugs can lead to intermittent or permanent pump motor stalls which may […]

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Pharmacology, A Review: Clonidine

Synthesized in 1962 as a derivative of the known alpha sympathomimetic drug Naphazoline, clonidine hydrochloride acts centrally to inhibit sympathetic tone on systemic blood vessels, thereby reducing mild to severe hypertension. Marketed under the brand name of Catapres, it is classified as an “alpha 2 adrenergic agonist for the treatment of high blood pressure.” Clonidine […]

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Napa Pain Conference, Dr. Carol Warfield: History of Pain Management

The 19th Annual Napa Pain Conference, hosted by Dr. Eric Grigsby, was held September 14-16, 2012, at the Meritage Conference Center in Napa, California. I had the pleasure of participating this year as a registered attendee and was able to sit in on a number of lectures. Many industry leaders were at this meeting, and […]

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Polyanalgesic Consensus Conference (PACC) 2012 Recommendations

Did You Know? that the Polyanalgesic Consensus Conference (PACC) 2012 has published its updated recommendations for the management of pain by intrathecal drug delivery? Neuromodulation: Technology at the Neural Interface, the official journal of the International Neuromodulation Society, has recently provided online, early view access to published recommendations by the PACC for the management of […]

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Dexmedetomidine: A Clinical Review

Dexmedetomidine is an alpha-2 agonist structurally related to clonidine—a drug primarily used for hypertension, but also used intraspinally for pain management. It differs from clonidine because it has an eight times greater affinity for the alpha-2 receptor and, being a dextrorotatory isomer of medetomidine, it has fewer cardiovascular side effects than clonidine. Dexmedetomidine (Dex) was […]

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Intrathecal Baclofen: A Review (2012)

History: The use of baclofen can be traced back to the 1920s when it was used as a potential antiepileptic drug, and was also found to be safe and effective for reducing spasticity. However, in the 1980s it was determined to be more effective when delivered directly to the central nervous system.  Dr. Tony Yaksh […]

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Resiniferatoxin: Using Extreme “Heat” to Treat Pain

At the 2nd Annual Future of Intrathecal Drug Delivery Conference (2012), I had the pleasure of hearing a lecture by Dr. Tony Yaksh regarding the intraspinal administration of resiniferatoxin (RTX) – a very potent analogue of capsaicin. I was introduced to the topic about seven years ago, and I wanted to learn more – so […]

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Don’t Worry! It’s Just Us!

In light of the recent drug shortage events, doctors are receiving products from unfamiliar names. Certain commercially available products are now unavailable, and drugs are being compounded from powder forms. This means that physicians are receiving products from names they are unaccustomed to. I recently received a call from a buyer where the doctor was […]

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Intrathecal Fentanyl: A Review (2012)

For some readers, much of what is stated here is review – while to others, it is enlightening. This article describes the properties of fentanyl citrate and the appropriate dosing for converting patients from morphine to fentanyl for intrathecal treatment of chronic pain. Patented by Janssen Pharmaceuticals in 1963, fentanyl is a potent narcotic analgesic […]

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Large Volume Parenterals: Pain Pump Trials

Life is the most important gift, and everyone deserves to live pain and illness free. This is why clinical trials are important. Clinical trials offer patients with specific health conditions a chance to benefit from otherwise unavailable treatments. In the case of chronic pain, drug pump trials are common. The trials for an implantable pain […]

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