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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14595/823

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Prevention and treatment of cisplatin-induced ototoxicity in adults: A systematic review
(2023-09-23) Juan Esteban Correa-Morales; Sara Giraldo-Moreno; Nidia Mantilla-Manosalva; Laura Cuellar-Valencia; Oscar Felipe Borja-Montes; Lennis Jazmin Bedoya-Muñoz; María Fernanda Iriarte-Aristizábal; Elias Quintero-Muñoz; Andrea Marcela Zuluaga-Liberato
Objectives: Ototoxicity is a common disabling side effect of platinum-based chemotherapy. This study aimed to assess the evidence on the management of platinum-induced ototoxicity in adult cancer patients. Methods: Four databases were searched up to 1 November 2022. Original studies were included if they reported on a pharmacologic or non-pharmacologic intervention to prevent or treat platinum ototoxicity in adults. The articles' quality was assessed via two grading scales. Results: Nineteen randomised controlled trials and five quasi-experimental studies with 1673 patients were analysed. Eleven interventions were identified, nine pharmacological and two non-pharmacological. Six of the interventions (sodium thiosulphate, corticoids, sertraline, statins, multivitamins and D-methionine) showed mild benefits in preventing cisplatin-induced ototoxicity. Only one trial assessed corticoids as a potential treatment. Overall, only six trials were deemed with a low risk of bias. The majority of studies inadequately documented intervention-related adverse effects, thereby limiting safety conclusions. Conclusions: Current interventions have mild benefits in preventing cisplatin-induced ototoxicity in adult cancer patients. Sodium thiosulphate is the most promising intervention as a preventive strategy. Rigorous, high-quality research is warranted, encompassing an evaluation of all potential symptoms and innovative treatment modalities. Keywords: chemotherapy-related adverse events; cisplatin-induced ototoxicity; hearing loss; otoprotection; platinum chemotherapy.
Subcutaneous Levetiracetam Administration in Latino Patients on Home Care
(Sage Journals, American Journal of Hospice and Palliative Medicine, 2023-10-31) Cuellar-Valencia, Laura; Claros-Hulbert, Angelica; Ortegon, Adriana; Pino, Juliana; Velandia, Laura; Correa-Morales, Juan Esteban
Background: Levetiracetam has a favorable pharmacology profile to be used subcutaneously. However, its subcutaneous use is still considered off-label as this is beyond its license. The evidence base for its safety, tolerability, and efficacy is limited to observational studies. Objectives: To report the safety and efficacy of subcutaneous levetiracetam in Latino patients on home care. Design: Observational retrospective case series study. Subjects: Consecutive sample of Latino adults with life-limiting illnesses. Methods: A case series framework with 4 domains (selection, ascertainment, causality, and reporting) to ensure reporting quality was used. Additionally, 8 relevant outcomes established in a previous comprehensive review, were collected and reported. Adverse reactions were documented using the Common Terminology Criteria for Adverse Events. Results: Fifteen Latino patients with oncological and non-oncological diagnoses received subcutaneous levetiracetam for a mean of 21 days on home care. Levetiracetam was most frequently initiated subcutaneously due to loss of the oral route. The average dosage of subcutaneous levetiracetam was 1200 mg. Only 1 patient required a dose adjustment, and only 2 patients experienced a total of 5 seizures during the therapy trial. No adverse reactions were reported. Conclusions: Subcutaneous levetiracetam appears to be effective and safe. This case series of Latino patients in home care expands the evidence of its use in the home care setting. The preliminary data reported by now on multiple case series warrants robust trials.
Nefopam, ¿Útil para él dolor neuropático?
(Revista Chilena de Anestesia, 2024-06-04) Santiago Téllez Buitrago Ribero; Omar Fernando Gomezese; Andrea Gutiérrez
Nefopam is a drug with very interesting pharmacological characteristics for the treatment of acute postoperative pain, but even more, as an understudied analgesic strategy for neuropathic pain. The present review article was proposed to perform a search with the MeSH terms in (PubMed) with the formula terms (nefopam [MeSH Terms]) AND (neuropathic pain [MeSH Terms]). In this way, a great void of medical literature on a molecule with a great potential for research was evidenced since the sixties in European countries, doctors like Basset and collaborators in 1969 as a potential antidepressant which owes its action in relation to its interaction with the inhibition of monoamine reuptake, suppressive effect on sodium voltage channels and an inhibitory activity on voltage-dependent calcium channels; so, it is a drug with a high likelihood to the antineuropathic ones. At present there are no recommendations or guidelines that support the use of Nefopam for the treatment of neuropathic pain and so it is interesting to make a review article that can examine the little literature found and allow to awaken the interest of clinical researchers to add an intravenous analgesic strategy for neuropathic pain.

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