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Abbott Laboratories has announced the approval of adalimumab (Humira) for reducing signs and symptoms of active ankylosing spondylitis (AS). An autoimmune disease, AS affects the spine and large peripheral joints and causes inflammatory back pain and stiff ness. It can also be associated with other inflammatory diseases of the skin, eyes and intestines. Over time, severe AS can result in complete spinal fusion.

The recommended dose is 40 mg every other week by subcutaneous injection, the usual dose recommended for patients with moderate-to-severe rheumatoid arthritis and psoriatic arthritis.
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Adalimumab is available in the U.S. in a pre-filled syringe.

The approval for this new indication was based on data from the Adalimumab Trial Evaluating Long-Term Efficacy and Safety in AS (ATLAS).

Although spinal anesthesia has been performed since the late 1800s, postdural puncture headache (PDPH) continues to be a problem for patients and a challenge for clinical staff members.

The cardinal feature of this type of headache is associated with posture; the pain worsens when patients are sitting or standing and improves when patients are supine. Pain occurs in the frontal, temporal, or occipital regions on both sides and can be accompanied by neck stiffness, backache, and nausea. In approximately 15% of cases, PDPH is so severe that patients cannot eat, drink, or carry out activities of daily living.

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Alpharma’s morphine sulfate extended-release capsule (Kadian) has been approved in a new dosage strength of 200 mg. Kadian is currently available in strengths of 20 mg, 30 mg, 50 mg, 60 mg, 80 mg and 100 mg.

The capsules are indicated for the management of moderate-to-severe chronic pain when a continuous, around-the-clock opioid analgesic is needed for an extended period of time. They can be taken once daily every 24 hours or twice daily every 12 hours to provide up to 24 hours of pain relief. buy antibiotics no prescription

The 100-mg and 200-mg doses are indicated for opioid-tolerant patients only.

The capsules contain an opioid agonist, which is a Schedule II controlled substance.

The FDA is concerned that nursing infants might be at increased risk of a morphine overdose if the mothers are taking codeine and if they are “ultra-rapid metabolizers” of this pain-relieving agent.

In one case, a 13-day old breast-fed infant died from a morphine overdose. The morphine levels in the mother’s milk were abnormally high after she took small doses of codeine to treat episiotomy pain. A genetic test showed that she was an ultra-rapid metabolizer of codeine.

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A patient’s sex seems to matter when it comes to the type of analgesia given, according to a study from Monash University, Victoria, British Columbia, and The University of Melbourne, Australia.

Of 3,357 patients transported to the hospital by ambulance, 1,766 reported pain; 50% of the patients were women. Their median initial pain score was 6 on a verbal scale of 0 to 10. The patients received analgesia in roughly the same proportions, with no significant difference between the sexes.

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A 75-year-old patient who was given gabapentin (Neurontin, Pfizer) for severe anxiety developed choreiform movements, according to doctors at Richmond University, New York, and the University of Connecticut.

The patient’s memory complaints, attributed to dementia and comorbid anxiety disorder, were present before the first evaluation. Neuropsychological evaluation confirmed global cognitive dysfunction, including memory loss. The cause was believed to be vascular.

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