Ceftaroline fosamil demonstrated high clinical cure and microbiological response rates in hospitalized patients with CAP of PORT risk class III or IV. Ceftaroline fosamil was well tolerated, with a safety profile similar to that of ceftriaxone and consistent with the cephalosporin class. In this study, ceftaroline fosamil was an effective and well-tolerated treatment option for CAP.

Aims To test the hypothesis that inhibition of cytochrome P450 2D6 (CYP2D6) by quinidine increases the antitussive effect of dextromethorphan (DEX) in an induced cough model. Methods Twenty-two healthy extensive metaboliser phenotypes for CYP2D6 were studied according to a double-blind, randomised cross-over design after administration of : (1) Placebo antitussive preceded at 1 h by placebo inhibitor; (2) 30 mg oral DEX preceded at 1 h by placebo inhibitor (DEX30); (3) 60 mg oral DEX preceded at 1 h by placebo inhibitor (DEX60); (4) 30 mg oral DEX preceded at 1 h by 50 mg oral quinidine sulphate (QDEX30). Cough frequency following inhalation of 10% citric acid was measured at baseline and at intervals up to 12 h. Plasma concentrations of DEX and its metabolites were measured up to 96 h by h.p.l.c. Results Inhibition of CYP2D6 by quinidine caused a significant increase in the mean ratio of DEX to dextrorphan (DEX5DOR) plasma AUC(96) (0.04 vs 1.81, P<0.001). The mean (±s.d.) decrements in cough frequency below baseline over 12 h (AUEC) were: 8% (11), 17% (14.5), 25% (16.2) and 25% (16.9) for placebo, DEX30, DEX60 and QDEX30 treatments, respectively. Statistically significant differences in antitussive effect were detected for the contrasts between DEX60/placebo ( P<0.001; 95% CI of difference +80, +327) and QDEX30/placebo ( P<0.001, +88, +336), but not for DEX30/placebo, DEX30/DEX60 or DEX30/QDEX30 ( P=0.071, −7, +241; P=0.254, −37, +211; P=0.187, −29, +219, respectively). Conclusions A significant antitussive effect was demonstrated after 60 mg dextromethorphan and 30 mg dextromethorphan preceded by 50 mg quinidine using an induced cough model. However, although the study was powered to detect a 10% difference in cough response, the observed differences for other contrasts were less than 10%, such that it was possible only to imply a dose effect (30 vs 60 mg ) in the antitussive activity of DEX and enhancement of this effect by CYP2D6 inhibition.Keywords: antitussive effect, CYP2D6, dextromethorphan, genetic polymorphism tion [8]. N-demethylation to 3-methoxymorphinan also Introduction occurs, largely by CYP3A4 but with contributions from CYPs 2C9 and 2C19 [9][10][11][12]. Both dextrorphan Dextromethorphan, a codeine analogue devoid of opiate side-effects, is widely available over-the-counter as a and 3-methoxymorphinan are further metabolized to 3-hydroxymorphinan, by CYPs 3A4 and 2D6, respectcough suppressant. Its efficacy has been confirmed in both clinical cough [1][2][3][4][5] and in experimental cough ively [13]. It is well established that the overall disposition of dextromethorphan is highly dependent upon CYP2D6 challenge studies [6, 7]. Metabolism of dextromethorphan is largely by CYP2D6-mediated O-demethylation to activity, which varies widely due to genetic polymorphism, and which can be inhibited selectively and dextrorphan, which then undergoes glucuronide formasignificantly by a small dose of quinidine [14][15][16].

Orthostatic hypotension is a common presentation in the primary care setting. Concise management is important as it can lead to falls, particularly in the elderly and can lead to significant morbidity and mortality. Its management presents as a challenge as there are differing guidelines on managing these patients. This case report illustrates two cases of drug-related orthostatic hypotension with similar presentation, however both were managed differently.International Journal of Human and Health Sciences Vol. 03 No. 04 October’19 Page : 241-244

Anak dengan HIV/AIDS membutuhkan perawatan orang tua yang lebih komprehensif dibandingkan anak lain pada umumnya karena mengalami masalah pada kesehatan fisik, psikologis, sosial dan spiritual. Orang tua memiliki banyak masalah ketika melakukan perawatan kepada ADHA. Penelitian ini bertujuan mengeksplorasi secara mendalam mengenai hambatan dan tantangan yang dialami orang tua (ibu) dalam merawat anak dengan HIV/AIDS (ADHA) yang mengakses layanan HIV. Metode penelitian menggunakan teknik kualitatif dengan pendekatan fenomenologi. Pemilihan informan penelitian menggunakan purposive sampling pada 6 informan dengan strategi in-depth interview menggunakan voice recorder dan field notes dengan prosedur analisa data 9 tahap Colaizzi. Hasil penelitian mengungkap tiga tema yaitu hambatan dari dalam, hambatan dari luar dan tantangan dalam perawatan. Saran, perlu adanya peningkatan upaya promosi kesehatan kepada masyarakat mengenai cara penularan HIV agar mengurangi stigma dan diskrimnasi pada ODHA.