ABSTRACT
The objective of this study was to determine the speed and efficiency of ketorolac in reducing the symptoms of migraine headache. Twenty-three patients who presented in the emergency department during the period between April and July 1992 with a previous diagnosis of migraine headache were considered for the study. Patients subjectively evaluated parameters of their migraine headaches (eg, pain and nausea) with a numerical scale and were asked to re-evaluate these same parameters at 30, 60, and 360 minutes after a single injection of Ketorolac. Seventeen (74%) patients reported a decrease in headache symptoms that was significant (P < .005) after 1 hour. Relief lasted at least 6 hours after injection.
Subject(s)
Analgesics/therapeutic use , Migraine Disorders/drug therapy , Tolmetin/analogs & derivatives , Acute Disease , Adult , Analgesics/pharmacology , Body Weight , Emergency Service, Hospital , Female , Humans , Injections, Intramuscular , Ketorolac , Male , Middle Aged , Migraine Disorders/diagnosis , Migraine Disorders/physiopathology , Migraine Disorders/psychology , Pain Measurement , Patient Satisfaction , Severity of Illness Index , Time Factors , Tolmetin/pharmacology , Tolmetin/therapeutic useABSTRACT
Advanced cardiac life support drugs undergo a wide range of temperature exposures in the prehospital setting. Although manufacturers place temperature restrictions for drug stability on their products, it has been shown that these limits are often exceeded in the prehospital environment. We exposed four different drugs to temperatures of -20 degrees C (-6 degrees F) and 70 degrees C (150 degrees F) and subsequently performed assays to determine their respective chemical stability compared with that of control samples. We determined that no significant difference in chemical structure occurred between the standard sample and the four drugs exposed to extreme temperatures (P > .05). This information has obvious implications in making further recommendations for drug storage. More work to determine bioactivity of temperature-exposed drugs may show results with implications for success in prehospital cardiac resuscitation.
Subject(s)
Atropine/chemistry , Cold Temperature/adverse effects , Emergency Medical Services/standards , Epinephrine/chemistry , Heart Diseases/drug therapy , Hot Temperature/adverse effects , Lidocaine/chemistry , Life Support Care/standards , Naloxone/chemistry , Analysis of Variance , Chromatography, High Pressure Liquid , Drug Stability , Drug Storage , Evaluation Studies as Topic , Fluorescence Polarization Immunoassay , Gas Chromatography-Mass Spectrometry , HumansABSTRACT
We report six cases of acute carbon monoxide poisoning during pregnancy. All of the women survived with good outcomes, but three cases were associated with fetal mortality. Two fetuses were delivered stillborn within 36 hours of exposure. One fetus remained alive in utero for 20 weeks and was delivered nonviable at 33 weeks gestation with multiple morphologic anomalies. Three pregnancies were carried to term and resulted in normal neonates. Maternal blood carboxyhemoglobin levels did not correlate with the concurrent severity of symptoms in the woman. Maternal symptoms at the site of exposure seemed to predict the risk of associated morbidity to the fetus. A single maternal carboxyhemoglobin level cannot be used to estimate fetal carboxyhemoglobin if the exposure pattern is not known.