Baclofen :: Multiple pharmacies comparison.

Product Management Today - Muscle relaxant approved

admin — Fri, 09 Jan 2009 04:51:16 +0000

The FDA announced final approval of Detroit-based Caraco Pharmaceutical Laboratories’ ANDA for baclofen tablets, 10 and 20 mg. The drug is a muscle relaxant and antispastic, and the manufacturer claims it can alleviate signs and symptoms of spasticity (including flexor spasms and concomitant pain, clonus, and muscular rigidity) resulting from multiple sclerosis.

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Patient management of cerebral origin spasticity with intrathecal baclofenOral baclofenIntrathecal Baclofen: A New Treatment Approach for Severe Spasticity in…The Baclofen PumpIntrathecal baclofen therapy

Caraco plans to launch the product immediately.
COPYRIGHT 2006 Medicom International, Inc.
COPYRIGHT 2008 Gale, Cengage Learning

Exceptional Parent, The - Oral baclofen

admin — Tue, 06 Jan 2009 08:57:14 +0000

CATEGORY: CEREBRAL PALSY
Anonymous has a 14-year-old son with spastic quadriplegia cerebral palsy and wants to hear from families who have tried oral baclofen.

Related Results

Patient management of cerebral origin spasticity with intrathecal baclofenIntrathecal Baclofen: A New Treatment Approach for Severe Spasticity in…The Baclofen PumpIntrathecal baclofen therapyIntrathecal baclofen for severe spasticity

My son (age six) was on oral baclofen for nearly three years until he received his intrathecal baclofen pump. Oral baclofen was, in our experience, a very effective medication, meaning our son has medium to high spasticity and got full-body relaxation results on a very low dose. However, it caused a lot of side effects, like problems with drowsiness, droopiness, and relaxation of areas we would rather not have seen, like eyelids and the few muscles with normal tone. After he went on the intrathecal baclofen pump, all the side effects went away since the intrathecal baclofen targets only the nerves of the spastic muscles.
COPYRIGHT 2007 EP Global Communications, Inc.
COPYRIGHT 2008 Gale, Cengage Learning

Exceptional Parent, The - Sleep issues

admin — Tue, 30 Dec 2008 15:09:24 +0000

CATEGORY: CEREBRAL PALSY

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We have a 19-month-old son with cerebral palsy. He has difficulty staying asleep more than a few hours at a time. He takes oral baclofen and his doctor recommended slow-release melatonin to help him stay sleeping for longer periods of time. He does fall asleep quickly and does not wake when we move him to his crib, he just doesn’t sleep more than a few hours before crying. He is easily comforted and usually falls back to sleep quickly. We realize that he has “trained” us to respond when he cries but we have a difficult time letting him cry and worry that he may wake his sister. Any advice is appreciated.
COPYRIGHT 2007 EP Global Communications, Inc.
COPYRIGHT 2008 Gale, Cengage Learning

Exceptional Parent, The - Information on Baclofen pumps

admin — Thu, 25 Dec 2008 03:46:12 +0000

CATEGORY: CEREBRAL PALSY

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Our neurologist suggested my daughter with cerebral palsy get a Baclofen pump inserted into her skin to hook up into her spinal column. Is there anyone out there who has done this before? Advantages, disadvantages, complications or otherwise would be helpful.
COPYRIGHT 2007 EP Global Communications, Inc.
COPYRIGHT 2008 Gale, Cengage Learning

British Medical Journal - Withdrawal of baclofen may cause acute confusion in elderly patients

admin — Sun, 21 Dec 2008 15:52:21 +0000

EDITOR–Ratnayaka et al have reported neonatal convulsions after withdrawal of baclofen.[1] To their piece we add our own experience of the difficulties of withdrawing baclofen at the opposite extreme of life.
An 82 year old man with left ventricular dysfunction and gout was admitted for deteriorating renal function. On admission he was taking lisinopril and frusemide, which were reduced; naproxen, which was stopped; allopurinol; and baclofen 20 mg three times daily. As no reason could be found for his baclofen treatment the dose was halved, and then stopped 10 days later.
Next day the patient had visual hallucinations with confusion and agitation requiring sedation with diazepam. He was afebrile with normal inflammatory markers. Computed tomography showed only cerebral atrophy. Before a lumbar puncture could be performed to exclude encephalitis, baclofen was reintroduced, with complete resolution of neuropsychiatric symptoms within 48 hours.
Baclofen is a derivative of [Gamma]-aminobutyric acid, exerting an inhibitory effect on spinal reflexes and reducing excessive tone. Oral baclofen is commonly used to treat spasticity of spinal origin, but 25-35% of cases are refractory to treatment or have considerable depression of the central nervous system, so that intrathecal administration is necessary. Baclofen is also commonly used to treat spasticity occurring as a result of stroke.
Baclofen has a half life of 3-4 hours, with 85% being renally excreted within 24 hours. Thus symptoms of withdrawal tend to occur rapidly. Withdrawal of oral baclofen results in neuropsychiatric symptoms as described above (anxiety, delusions, auditory and visual hallucinations) and new onset seizure activity.[2] Withdrawal of intrathecal baclofen, however, causes more serious systemic side effects (increased spasticity, hyperthermia, rhabdomyolysis, renal failure, and disseminated intravascular coagulopathy).[3 4] This resulted in death in one report?.[4] Treatment is supportive, with reintroduction of baclofen often leading to the resolution of symptoms within 24-48 hours. Dantrolene has been used successfully to treat one resistant case.[5]
Caution should be exercised when reducing or stopping long term baclofen treatment. The Committee on Safety of Medicines recommends tapering the dose over 1-2 weeks, or more slowly if symptoms occur.
F O’Rourke specialist registrar
fintyo@yahoo.co.uk

R Steinberg senior house officer
P Ghosh consultant
S Khan consultant
Department of Elderly Care Medicine, Lister
Hospital, Stevenage, Hertfordshire SG1 4AB

[1] Ramayaka BDM, Dhaliwal H, Watkin S. Neonatal convulsions after withdrawal of baclofen. BMJ 2001;323: 85. (14 July.)
[2] Terrence CF, Fromm GH. Complications of baclofen withdrawal. Arch Neurol 1981;38:588-9.
[3] Sampathkumar P, Scanlon PD, Plevak DJ. Baclofen withdrawal presenting as multiorgan system failure. Anesth Analg 1998;87:562-3.
[4] Green LB, Nelson VS. Death after acute withdrawal of intrathecal baclofen: case report and literature review. Arch Phys Med Rehabil 1999;80:1600-4.
[5] Khorasani A, Peruzzi WT. Dantrolene treatment for abrupt intrathecal baclofen withdrawal. Anesth Analg 1995;80:1054-6.
COPYRIGHT 2001 British Medical Association
COPYRIGHT 2008 Gale, Cengage Learning

Associating Back Pain And Multiple Sclerosis

admin — Fri, 19 Dec 2008 11:58:07 +0000

Multiple Sclerosis is a progressive disease such as demyelinating and affects the motor and sensory neurons. The disease will cause cycles of remission, which causes the condition to worsen. When exacerbation starts etiology is reviewed, which includes the cause? The cause at this time is not clear, yet some experts believe that viral infections and autoimmune disease plays a part in Multiple Sclerosis cause.
The disease is complication, yet it cause back pain. According to Pathophysiology views, the scatters of demyelinization will start affecting the brain, as well as the spinal cord. Once it affects these areas degeneration starts targeting the myelin sheath (Nerves that insulates the layers of cells) and causes a string of patches of sclerotic tissues. The patches impair the conduction, which reaches the motor nerve impulses.
How do I know if I have Multiple Sclerosis?
You consider the symptoms. The symptoms include ataxia, blurred vision, weakness, heat intolerance, nystagmus, sensation impairment, speech scan, diplopic, optic neuritis, paresthesia, tremor intentions, euphoria sensations, paralysis, incontinence urine, and powerlessness to feel or measure the pose of the body.
What is ataxia?
Ataxia is the lack or inability to control the muscles coordination or movement.
What is nystagmus? Nystagmus is involuntary movements of the eyes, which rhythmically move from side to side and is caused from the disease since the nerves and muscles behind the eyeball is affected. What is diplopic?
Diplopic and/or diplopia are double vision. Double vision is caused from lack of coordination of the eye movement. The optic neuritis also affects the eyes.
If multiple sclerosis is present doctors use MRI tests, EMG, CSF, CT, Oligoclonal banding, and so on. Once the tests are completed and if increases of G (IgG), i.e. immunoglobulin are present and protein intake is increasing as well, thus WBC is present, he considers medical management.
Atrophy when spotted under MRI tests will start medical management as well. The medical management varies from patient to patient. Back pain is common.
According to statistics, the mass of people in the universe will suffer some degree of back pain. Some people go through the pain, yet have never sustained injuries. Other people may experience pain from injuries, and feel how horrible the pain can become.
When considering back pain one must ask what its cause is. How can one control the pain? What self-care prevention strategies can one use to ease back pain? What treatments are available to me?
The fact is back pain can occur from feet conditions, such as swelling, heel pain, burning soles, battered ligaments, and so on. Sport injuries, car accidents, inappropriate bending, and lifting are all related to back pain. In fact, various medical conditions cause back pain, including multiple sclerosis, edema, and so on. With the many variants related to back pain, one must educate you on how the spine is structured and what happens if that structure is interrupted. Lets get started and learn what we can about back pain, and how we can eliminate such stress in our lives.
When multiple sclerosis is present, medical treatment often includes diet, controlled exercise, speech therapy, physical therapy; fluids increased, meds, and so on. Muscle relaxants, such as Baclofen or Lioresal are giving to the patient etc. The doctor will often recommend that the patient take Maalox. Maalox is laced with magnesium and aluminum hydroxide, which is in the muscles and apparently lacking its natural remedy, thus the Maalox acts as a substitute.
Alterna-GEL is also prescribed, which has the chemicals the muscles produce as well known as aluminum hydroxide gel. Once medical management is set up doctors will consider nurses intervention.

Hiccups – Causes and Treatment

admin — Mon, 15 Dec 2008 15:54:19 +0000

Hiccups are also called hiccoughs. They are repeated spasms of the diaphragm. The diaphragm is a big flat muscle that divides your chest from your abdomen (belly). Most hiccups last less than an hour and are not serious. Sometimes hiccups can last hours to days and keep coming back. These hiccups may be caused by a medical problem. If your hiccups do not go away in 48 hours or they come back often, call your caregiver.

It is thought that a number of specific nerves in the spinal cord at the back of the neck control hiccups. When something triggers these nerves - eating too quickly, for example - a signal is sent to the phrenic nerve, which controls the diaphragm. The diaphragm signals back to the hiccup center and hiccups begin. Within a split second, a structure called the glottis closes off the windpipe, producing the characteristic sound of a hiccup.

Causes

Many conditions are associated with hiccups, but none has been shown to be the cause of hiccups. If you eat too fast, you can swallow air along with your food and end up with a case of the hiccups.Any other practices that might irritate the diaphragm such as eating too much (especially fatty foods) or drinking too much (drunk people hiccup) can make you prone to having hiccups.

Some of the causes of hiccups are as follows. Overstretching the neck, Laryngitis, Heartburn, Irritation of the eardrum, General anesthesia, Surgery, Bloating, Tumor, Infection, Diabetes, Drinking excessive alcohol, Hot and spicy food, Smoking, Eating fast.

Herbal Remedies

Ask the affected person to sit quietly and hold his/her breath or give him/her something to drink.If this is unsuccessful, place a paper bag (not a plastic bag) over the patient’s mouth and nose, and ask the person to breathe in and out.If hiccups persist for more than a few hours, seek medical aid or psychotherapy. Kulatha in the form of a soup or dal is very useful for hiccups.

Everyone has a pet remedy for hiccups. A few tactics do make sense and may be based on physiology as well as folklore. One technique is to increase carbon dioxide levels in the blood, which may decrease the sensitivity of the vagus nerve in the brain. That nerve, one of the longest in the body, sends branches to many muscle groups, including those in the diaphragm.

Numerous home remedies for hiccups exist. The reason that these remedies are thought to work is that carbon dioxide build-up in the blood will stop hiccups, which is what happens when you hold your breath. If the vagus nerve that runs from the brain to the stomach is stimulated, hiccups can also be alleviated (this is what is happening when you drink water or pull on your tongue).

Chlorpromazine (Thorazine) is usually the first prescription medication tried for hiccups, although drugs such as baclofen (Lioresal) and medications for convulsions such as phenytoin (Dilantin) have also been successful. Surgery to disable the phrenic nerve (the nerve that controls the diaphragm) is often the treatment of last resort.

Central Vertigo Information

admin — Sat, 13 Dec 2008 08:00:06 +0000

Vertigo, or dizziness, is a symptom, not a disease. Vertigo is one of the most common health problems in adults. It is a major symptom of a balance disorder. It is the sensation of spinning or swaying while the body is stationary with respect to the earth or surroundings. There are two types of vertigo: subjective and objective. Subjective vertigo is when a person feels a false sensation of movement. Objective vertigo is when the surroundings will appear to move past a person’s field of vision. About 40% of people in the United States experience feeling dizzy at least once during their lifetime. Vertigo is usually associated with a problem in the inner ear balance mechanisms (vestibular system), in the brain, or with the nerve connections between these two organs.

The most common cause of vertigo is benign paroxysmal positional vertigo, or BPPV. Head trauma and neck injury may also result in vertigo, which usually goes away on its own. Vertigo Acoustic neuroma is a type of tumor causing vertigo. Symptoms involve vertigo with one-sided ringing in the ear and hearing loss. Migraine, a severe form of headache, may also cause vertigo. Vertigo can be a symptom of an underlying harmless cause, such as in BPPV or it can suggest more serious problems. These include drug toxicities, strokes or tumors. Vertigo-like symptoms may also appear as paraneoplastic syndrome (PNS) in the form of opsoclonus myoclonus syndrome, a multi-faceted neurological disorder associated with many forms of incipient cancer lesions or virus.

Vertigo, or dizziness, refers to the sensation of spinning (subjective vertigo) or the perception that surrounding objects are moving or spinning. Common symptoms of vertigo nausea, vomiting, and involuntary eye movements. Treatment for vertigo, or dizziness, depends on identifying and eliminating the underlying cause. Vertigo can be treated with medicine. Vestibular rehabilitation therapy (VRT) is a type of physical therapy used to treat vertigo. Benign paroxysmal positional vertigo may be treated with meclizine (Antivert ), an oral antiemetic that can be taken up to 3 times a day, or only as needed. Risk factors for stroke should control their high blood pressure and high cholesterol and stop smoking. Someone with Meniere disease should limit added salt to their diet.

Central Vertigo Treatment and Prevention Tips

1. Stop smoking also remember.

2. Stroke should control their high blood pressure and high cholesterol.

3. Benign paroxysmal positional vertigo may be treated with meclizine.

4. GABA modulators, specifically gabapentin and baclofen is also recommended.

5. Vestibular rehabilitation therapy (VRT) is a type of physical therapy used to treat vertigo.

6. Neurotransmitter reuptake inhibitors such as SSRI’s, SNRI’s and Tricyclics also recommended.

Hallervorden-spatz Disease

admin — Wed, 10 Dec 2008 17:15:58 +0000

Hallervorden-Spatz disease is an inherited, degenerative disease that usually begins in childhood and involves progressive muscle rigidity, weakness, and movement disorder. The disease can be familial or sporadic. When familial, it is inherited recessively and has been linked to chromosome 20. In these patients, chronic repeated dystonic movements, especially of the head and neck, can lead to excessive stress on the cervical spine, resulting in early degenerative changes and myelopathy. Hallervorden-Spatz is a disease that slowly gets worse (is degenerative). It usually begins in childhood. The condition involves muscle rigidity, weakness, and movement problems.
Most cases of Hallervorden-Spatz are due to a defect in a gene that makes a protein called pantothenate kinase 2. Symptoms, which vary greatly among patients and usually develop during childhood, may include slow writhing, distorting muscle contractions of the limbs, face, or trunk, choreoathetosis (involuntary, purposeless jerky muscle movements), muscle rigidity (uncontrolled tightness of the muscles), spasticity , ataxia (inability to coordinate movements), confusion, disorientation, seizures, stupor, and dementia. Mental deterioration, emaciation, severe feeding difficulties, and visual impairment occur commonly in the late stages of the disease.
Other less common symptoms may include painful muscle spasms, dysphasia (difficulty speaking), mental retardation, facial grimacing, dysarthria (poorly articulated speech), and visual impairment. Hallervorden’s enthusiastically encouraged the killings and the other aspects that led to the dehumanization of both the victims and the participants. Some believe that Hallervorden’s name should be removed from this disorder. It has been suggested that the disease might be called “Martha-Alma disease” for the 2 unfortunate sisters whose brains were first dissected in the original description of the disease by Hallervorden and Spatz.
The disease is equally common in both sexes. The goal of treatment is to control the symptoms. Although there is no specific treatment for Hallervorden-Spatz disease, many believe taking certain vitamins may be beneficial, including pantothenate, Coenzyme Q, and other anti-oxidants. Botulinum toxin can be injected into severely affected muscles to relieve dystonia. Continuous intrathecal baclofen infusion has been tried for refractory generalized dystonia without much success. Stereotactic pallidotomy and bilateral thalamotomy occasionally have been tried for patients with severe dystonia, resulting in partial relief of symptoms.

Glossopharyngeal Neuralgia

admin — Fri, 05 Dec 2008 21:29:10 +0000

Glossopharyngeal neuralgia (GPN) is also called vagoglossopharyngeal neuralgia. Glossopharyngeal neuralgia is characterized by shock like pains in the territory of the glossopharyngeal nerve. It is in every way similar to tic douloureux except for the distribution of the pain and the customary site of the triggering stimulus. It is generally located near the tonsil although the pain may extend deep into the ear. It is usually triggered by swallowing or chewing.Glossopharyngeal neuralgia sometimes results from nerve compression by an aberrant, pulsating artery similar to that in trigeminal neuralgia and hemifacial spasm.
Glossopharyngeal neuralgia usually begins after age 40 and occurs more often in men. Symptoms usually begin in people over 40 years of age. In most cases, the source of irritation is never discovered. Nevertheless, tumors or infections of the throat and mouth, compression of the glossopharyngeal nerve by neighboring blood vessels, and other lesions at the base of the skull can sometimes cause this type of neuralgia (nerve pain). Symptoms include severe pain in the areas connected to the ninth cranial nerves. This includes the throat, tonsillar region, posterior third of the tongue, nasopharynx (back of nose and throat), larynx, and ear.
The pain is episodic and may be severe. It can sometimes be triggered by swallowing, chewing, speaking, laughing, or coughing. The goal of treatment is to control pain. If oral drugs are ineffective, topical cocaine applied to the pharynx may provide temporary relief. Carbamazepine, phenytoin, gabapentin, baclofen, and tricyclic antidepressants may be used to ameliorate the pain of glossopharyngeal neuralgia. Some anti-depressants like amitriptyline are sometimes tried with variable degrees of success. If these drugs are ineffective, applying a local anesthetic (such as cocaine) to the back of the throat may provide temporary relief.
When a blood vessel is identified as compressing the glossopharyngeal nerve, surgery may be performed to move the vessel or to position a teflon felt pad between the blood vessel and the nerve, in order to attempt to mitigate any pressure that is exerted on the nerve. Surgical options, including nerve resection, tractotomy, or microvascular decompression, should be considered when individuals either dont respond to, or stop responding to, drug therapy. This surgery is generally considered effective. If a cause of the neuralgia is found, treatment should control the underlying problem.