RESUMEN
BACKGROUND: YouTube™ ( http://www.youtube.com ), as a very popular video site worldwide, is increasingly being used as a platform to disseminate health information. The purposes of this review were to assess the overall usefulness of the information on the prevention of valproic acid use in women during pregnancy on YouTube™ for patients. METHODS: The YouTube™ website was systematically using 8 keywords. One hundred and fifty four videos meet the selection criteria. The researcher evaluated the video duration, days since upload, views and the likes. These videos are categorized as Education, News & Politics and People & Blogs. We designed a usefulness scoring scheme to assess videos quality and classified them as "slightly useful", "useful" and "very useful". The Kruskal-Wallis test was used to determine whether differences existed between total usefulness scores and categories and Pearson chi-square test for categorical variables. RESULTS: The majority of videos were educational (62.8%). The "People & Blogs" and "News & Politics" videos scored significantly higher, but had no significant difference in days since upload, views, views/day or likes. More than half of the videos (91/154) were categorized as "useful". The mean posted days (p = 0.045) was significantly different in the useful group compared with the slightly useful group. There were no correlation between usefulness and the number of days since upload, duration, views, views/day, or likes. CONCLUSION: YouTube™ is a promising source of information regarding the use of valproic acid during pregnancy. "News & Politics" videos are the most usefulness. Considering the presence of more slightly useful information, publishers need to improve more comprehensive video content that includes replacement medications, diagnoses and treatments. In the healthcare information space, consumers need to be directed to reliable video.
Asunto(s)
Medios de Comunicación Sociales , Humanos , Femenino , Embarazo , Ácido Valproico/uso terapéutico , Fuentes de Información , Grabación en Video , EmocionesAsunto(s)
Anticonvulsivantes/uso terapéutico , Epilepsias Mioclónicas/tratamiento farmacológico , Fenfluramina/uso terapéutico , Adolescente , Anticonvulsivantes/administración & dosificación , Anticonvulsivantes/efectos adversos , Niño , Preescolar , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Aprobación de Drogas , Interacciones Farmacológicas , Fenfluramina/administración & dosificación , Fenfluramina/efectos adversos , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Estados Unidos , United States Food and Drug AdministrationAsunto(s)
Antagonistas del Receptor Peptídico Relacionado con el Gen de la Calcitonina/administración & dosificación , Trastornos Migrañosos/tratamiento farmacológico , Piperidinas/administración & dosificación , Piridinas/administración & dosificación , Pirroles/administración & dosificación , Receptores de Péptido Relacionado con el Gen de Calcitonina/efectos de los fármacos , Compuestos de Espiro/administración & dosificación , Administración Oral , Antagonistas del Receptor Peptídico Relacionado con el Gen de la Calcitonina/efectos adversos , Interacciones Farmacológicas , Humanos , Trastornos Migrañosos/diagnóstico , Trastornos Migrañosos/metabolismo , Piperidinas/efectos adversos , Piridinas/efectos adversos , Pirroles/efectos adversos , Receptores de Péptido Relacionado con el Gen de Calcitonina/metabolismo , Transducción de Señal , Compuestos de Espiro/efectos adversos , Resultado del TratamientoRESUMEN
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) is a life-saving therapy for those in cardiopulmonary failure, including post-cardiac arrest. Despite a high volume of ECMO patients using anti-seizure medication, there is a paucity of data concerning the dosing, levels, and clinical scenarios for their use. CASE REPORT: We present three cases of ECMO patients post-PEA arrest who were on valproic acid (VPA) for treatment of seizure and/or myoclonus. The total and free levels of VPA are reported. DISCUSSION: The trough levels are consistent throughout therapy, suggesting VPA is not significantly removed by the ECMO circuitry. Although the total serum levels remained below the toxic range, the free level was elevated in two patients. These patients did not develop signs of toxicity. CONCLUSION: VPA may be an effective anti-seizure medication in ECMO patients. Free VPA levels should be more readily available to better quantify efficacy or toxicity, especially in ECMO patients.
Asunto(s)
Oxigenación por Membrana Extracorpórea , Paro Cardíaco , Monitoreo de Drogas , Humanos , Ácido Valproico/uso terapéuticoAsunto(s)
Anticuerpos Monoclonales Humanizados/administración & dosificación , Antagonistas del Receptor Peptídico Relacionado con el Gen de la Calcitonina/administración & dosificación , Trastornos Migrañosos/prevención & control , Anticuerpos Monoclonales Humanizados/efectos adversos , Anticuerpos Monoclonales Humanizados/farmacología , Antagonistas del Receptor Peptídico Relacionado con el Gen de la Calcitonina/efectos adversos , Antagonistas del Receptor Peptídico Relacionado con el Gen de la Calcitonina/farmacología , Humanos , Trastornos Migrañosos/fisiopatologíaAsunto(s)
Analgésicos/uso terapéutico , Antagonistas del Receptor Peptídico Relacionado con el Gen de la Calcitonina/uso terapéutico , Trastornos Migrañosos/tratamiento farmacológico , Triptaminas/uso terapéutico , Terapia por Acupuntura , Adulto , Analgésicos/administración & dosificación , Analgésicos/efectos adversos , Antiinflamatorios no Esteroideos/uso terapéutico , Antieméticos/efectos adversos , Antieméticos/uso terapéutico , Interacciones Farmacológicas , Alcaloides de Claviceps/efectos adversos , Alcaloides de Claviceps/uso terapéutico , Femenino , Humanos , Trastornos Migrañosos/prevención & control , Embarazo , Antagonistas del Receptor de Serotonina 5-HT1/uso terapéutico , Triptaminas/administración & dosificación , Triptaminas/efectos adversosAsunto(s)
Anticuerpos Monoclonales/administración & dosificación , Trastornos Migrañosos/prevención & control , Anticuerpos Monoclonales/farmacología , Anticuerpos Monoclonales Humanizados , Péptido Relacionado con Gen de Calcitonina/antagonistas & inhibidores , Aprobación de Drogas , Humanos , Inyecciones Subcutáneas , Ensayos Clínicos Controlados Aleatorios como Asunto , Estados Unidos , United States Food and Drug AdministrationAsunto(s)
Analgésicos/administración & dosificación , Anticuerpos Monoclonales/administración & dosificación , Péptido Relacionado con Gen de Calcitonina/antagonistas & inhibidores , Trastornos Migrañosos/prevención & control , Analgésicos/efectos adversos , Anticuerpos Monoclonales/efectos adversos , Anticuerpos Monoclonales Humanizados , Péptido Relacionado con Gen de Calcitonina/inmunología , Péptido Relacionado con Gen de Calcitonina/metabolismo , Humanos , Inyecciones Subcutáneas , Trastornos Migrañosos/diagnóstico , Trastornos Migrañosos/inmunología , Trastornos Migrañosos/metabolismo , Transducción de Señal/efectos de los fármacos , Resultado del TratamientoRESUMEN
Antiepileptic medications are the frontline treatment for seizure conditions. However, these medications are not without cognitive side effects. Previously, our laboratory reported learning deficits in phenytoin and carbamazepine-treated rats. In the experiment reported here, the effects of valproic acid (VPA) have been studied using the same instrumental training tasks. VPA-treated rats displayed a severe deficit in acquiring a tone-signaled avoidance response. This deficit was attenuated in animals that had prior training in an appetitive context. Thus, this deficit is specific to learning in an aversive context, and does not result from difficulties in transferring associations from an appetitive to aversive context. Learning transfer deficits were previously observed in rats treated with phenytoin, and to a lesser extent, carbamazepine. On the other hand, rats treated with VPA fail to suppress inappropriate responsiveness across aversive training whether they had undergone prior appetitive training or not.