Posts tagged with "Healthline"

Caution: You can overdose on this diarrhea med

May 2, 2019

If you’ve got the “runs,” be careful how often you run to the medicine cabinet. Overdoses of loperamide, commonly sold as the over-the-counter diarrhea treatment, Imodium, have been steadily increasing in number and severity nationwide over the past five years, researchers at Morristown Medical Center and Rutgers New Jersey Medical School report.

Many people don’t realize that the drug is an opioid—and those who are aware of its properties may be misusing it, says a recent report by Futurity.

Loperamide treats diarrhea by slowing down the rhythm of digestion, so that the small intestines have more time to absorb fluid and nutrients from the foods we eat. It works by affecting proteins called opioid receptors found in cells in the gastrointestinal tract. It signals these opioid receptors to keep working. Unlike other opiates, however, loperamide doesn’t cross the blood-brain barrier into your brain or spinal column. Therefore, it doesn’t cause a high or relieve pain like other opiates can. However, stopping the drug abruptly or taking it in extremely high dosages can be life-threatening, according to Healthline.

Indeed, the study, published by the journal, Clinical Toxicology, found increasing instances in which patients with opioid-use disorder misused loperamide to prevent or self-treat withdrawal symptoms. To a lesser extent, some took massive doses to get a high similar to heroin, fentanyl, or oxycodone.

Misuse of the drug is particularly alarming because non-prescription drugs like loperamide are inexpensive, readily available online and in retail stores, undetectable on routine drug tests, and buyable in bulk.

“When used appropriately, loperamide is a safe and effective treatment for diarrhea—but when misused in large doses, it is more toxic to the heart than other opioids which are classified under federal policy as controlled dangerous substances,” says senior author Diane Calello, executive and medical director of the New Jersey Poison Control Center at Rutgers New Jersey Medical School.

“Overdose deaths occur not because patients stop breathing, as with other opioids, but due to irregular heartbeat and cardiac arrest.”

The researchers reviewed cases of patients with loperamide exposure reported by medical toxicologists to a national registry, the Toxicology Investigators’ Consortium (ToxIC), from January 2010 to December 2016, reporting a growing number of cases over that time frame. The Poison Control Center database (National Poison Data System) also reported a 91% increase during that time period—which in 2015 included 916 exposures and two deaths.

The patients reporting misuse in the Rutgers study were predominantly young white men and women. The majority used extremely high doses of loperamide, the equivalent of 50 to 100 two-milligram pills per day.

“Possible ways of restricting loperamide misuse include limiting the daily or monthly amount an individual could purchase, requiring retailers to keep personal information about customers, requiring photo identification for purchase, and placing medication behind the counter,” Calello says.

“Most importantly, consumers need to understand the very real danger of taking this medication in excessive doses.”

Research contact: @Rutgers_NJMS

Alive and kicking: When fetuses feel like kicking up their heels, it may be a sign of brain development

January 9, 2019

Nothing attracts a crowd like a baby kicking in utero. When a pregnant woman’s ever-expanding bump suddenly starts perambulating, it’s hard to avoid an all-hands-on experience with anyone nearby. But why is that infant thrashing around in there?

A recent study  conducted by the Department of Neuroscience, Physiology, and Pharmacology at the UK’s University College London—and published in  Scientific Reports—has found that kicking can help the fetus to “map” his or her body and explore the surrounding womb.

Author Kimberley Whitehead, along with co-authors Judith Meek and Lorenzo Fabrizi, examined the sleep patterns of 19 newborns between the ages of 31 weeks and 42 weeks. Some of the infants studied had been born prematurely—the accurate age of a baby from conception, regardless of when he or she actually is born. For instance, an infant who was one week old but born at 35 weeks would be 36 weeks old. Infants are considered full term anywhere from 37 to 42 weeks.

According to a report by Healthline, the three researchers looked at the brainwaves that fetuses produce when they kick during rapid eye movement (REM) sleep. When the fetus moves its right hand, for example, it produces brainwaves immediately afterwards in the part of the left-brain hemisphere that processes touch for the right hand.

The brainwaves are extremely fast in premature babies. (In the case of premature babies, they would still be in the womb when these fast brainwaves occur.) By the time the babies are a few weeks old, the fast brainwaves naturally disappear.

Fetal kicks in the third trimester help the infant develop brain areas linked to sensory input. They also help the baby to form a sense of his or her own body, the scientists say.

“Spontaneous movement and consequent feedback from the environment during the early developmental period are known to be necessary for proper brain mapping in animals, such as rats. Here we showed that this may be true in humans too,” Lorenzo Fabrizi said in a statement.

“For example, it is already routine for infants to be ‘nested’ in their cots. This allows them to ‘feel’ a surface when their limbs kick, as if they were still inside the womb,” she said. The study supports the notion that sleep should be protected and interruptions minimized, as the findings show how important movement is during fetal and premature newborn sleep.

For her part, Whitehead believes that the findings could help hospitals to provide an optimal environment for infants born prematurely. “We were surprised that although the movement-evoked fast brainwaves disappear a few weeks after the average time of birth, movement continues to trigger slow brainwaves,” she said.

This draws on her team’s previous earlier research, which showed that different types of brainwaves can perform different functions in unborn children. That research showed that a big change happens at full-term age because different types of sleep start to be associated with particular brainwave patterns.

Whitehead said they plan to continue studying movement in babies, but they are also focused on how aspects of brain development are processed, such as touch and painful stimuli (as with a blood test, for example).

The medical community already knows a good deal about the quality, frequency, and perceptibility of fetal movements, Dr. Amber Samuel, medical director, Maternal-Fetal Medicine at the Obstetrix Medical Group of Houston, told Heathline. Sporadic movements at about nine or ten weeks become more organized in the second trimester. Mothers can feel a fetus kick as early as 15 weeks.

As the brain develops, the fetus kicks and responds to his or her own brain activity, as well as to changes in maternal movement, sound, temperature, and other stimuli.

“The perception of fetal movement changes in the third trimester to body rolling more often than distinctive kicks but all fetal movement is reassuring even if the quality evolves,” Samuel said.

Fetal kicking serves several purposes, added Sullivan. The first is that it gives muscles and limbs exercise. It also shows response to stimuli and, as the current study suggests, helps the brain make connections for spatial sense.

And for the pregnant mother the kicking is also a learning experience. She gets chance to see how big and active her baby has become—and maybe even to hold a hand or a foot.

Research contact: @uclnpp