Pharmacokinetic drug–drug interaction study between clindamycin and cyclosporin in rabbits

Cyclosporine A (CSA) is an immunosuppressant drug, metabolized mainly by CYP3A4 that is one of the CytochromeP450 enzymes. Clindamycin (CLN) is a lincosamide antibiotic, inducing CYP3A4 activity in vitro, and thereby mayalter CSA pharmacokinetics (PK). The current research was performed to investigate the PK parameters changes ofCSA up on co-administrating with CLN in healthy male rabbits. Twelve healthy male rabbits randomly were selectedand divided into two groups: Control set (n = 6) in which the rabbits were received oral normal saline CSA solution(10 mg/kg/day), meanwhile rabbits in the test group (n = 6) were treated with oral normal saline CSA solution (10 mg/kg/day) concomitantly with normal saline solution of CLN (8 mg/kg/day) at the same time for 7 days. Blood samples(2 ml) were collected and CSA concentrations were measured in whole blood at the predetermined time points byusing Chemiluminescent Immunoassay (CLIA) detection kit. PK profiles of CSA for both groups in the control andtest groups including Cmax, tmax, AUC0-24, the area under the blood concentration–time curve from 0 hour to infinity(AUC0-∞), t½, and Ke were compared. The results showed a statistically insignificant differences in the PK parametersof CSA alone or combined with CLN with p > 0.05. In conclusion, it has been found that CLN does not affect the CSAPK. Further confirmation of our findings is requiered in humans before these results can be applied in patient care.

Carbon fibre cage vs. autograft for anterior cervical discectomy and interbody fusion: graft morbidity and clinical outcome

We performed a study to evaluate and compare the clinical outcome following anterior cervical discectomy and interbody fusion [ACDF] with either carbon fibre cage [CFC] implant or iliac crest autograft for cervical spondylotic patients. A retrospective review of 66 consecutive patients [30 in the autograft group and 36 in the CFC group] who underwent ACDF for cervical spondylotic radiculopathy, myelopathy, or both at one or two levels over a 4 year period from 1999-2002. We evaluated clinical outcome including symptomatic relief, operative morbidity and length of stay in each group. Postal questionnaires were sent to all patients to assess their clinical outcome [one year minimum follow-up] Neck Disability Index [NDI] was slightly better in the CFC group [man: 16.42, SD: 10.24] compared to autograft group [mean: 19.9, SD: 14], the difference was statistically insignificant [p>0.2]. Patient's self-rating of overall functions in the CFC group were better in 73% of patients, same in 21% and worse in 6% compared to better in 55%, same in 27%, and worse in 18% in the autograft group [p>0.2]. Arm pain rating were better in 70%, same in 24%, and worse in 6% [CFC group] compared to better in 59%,s ame in 26%, and worse in 14% [autograft group] [p>0.2]. There was a significant rate of long-term donor site pain in the autograft group [mild pain at the time of answering in 54.5% of patients]. There was one graft-related complication in each group. In the radiculopathic patients [19 autograft, 20 CFC] the difference in length of stay was significant [autograft; mean 4.1, median 4 vs. CFC; mean 3.75 median 3] [p=0.050]. Autograft and CFC implants for anterior cervical discectomy and interbody fusion are both safe and effective. No significant differences were found in the long-term clinical outcomes. The use of CFC implant however, can avoid donor site pain and achieve a shorter hospital stay

Nalbuphine combined with midazolam as supplement to nitrous oxide-oxygen anaesthesia for nasal surgery

The hemodynamic effects of submucous infiltration with adrenaline were investigated in 30 patients who had nasal surgery under general anesthesia. Fifteen patients received general anesthesia with halothane. A further 15 patients were given nitrous oxide-oxygen anesthesia supplemented with nalbuphine combined with midazolam. There were significant rises in heart rate and arterial blood pressure in both groups of patients. However, dysrhythmias and ST segment changes were present only in patients given halothane anesthesia. Nitrous oxide- oxygen anesthesia supplemented with nalbuphine combined with midazolam is safe for nasal surgery. This technique prevents the occurrence of dysrhythmias under normocapnic condition following infiltration with adrenaline and offers good analgesia, sedation, rapid recovery and no respiratory depression