ABSTRACT
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.
Subject(s)
Social Media , Humans , Female , Pregnancy , Valproic Acid/therapeutic use , Information Sources , Video Recording , EmotionsSubject(s)
Anticonvulsants/therapeutic use , Epilepsies, Myoclonic/drug therapy , Fenfluramine/therapeutic use , Adolescent , Anticonvulsants/administration & dosage , Anticonvulsants/adverse effects , Child , Child, Preschool , Dose-Response Relationship, Drug , Double-Blind Method , Drug Approval , Drug Interactions , Fenfluramine/administration & dosage , Fenfluramine/adverse effects , Humans , Randomized Controlled Trials as Topic , United States , United States Food and Drug AdministrationSubject(s)
Calcitonin Gene-Related Peptide Receptor Antagonists/administration & dosage , Migraine Disorders/drug therapy , Piperidines/administration & dosage , Pyridines/administration & dosage , Pyrroles/administration & dosage , Receptors, Calcitonin Gene-Related Peptide/drug effects , Spiro Compounds/administration & dosage , Administration, Oral , Calcitonin Gene-Related Peptide Receptor Antagonists/adverse effects , Drug Interactions , Humans , Migraine Disorders/diagnosis , Migraine Disorders/metabolism , Piperidines/adverse effects , Pyridines/adverse effects , Pyrroles/adverse effects , Receptors, Calcitonin Gene-Related Peptide/metabolism , Signal Transduction , Spiro Compounds/adverse effects , Treatment OutcomeABSTRACT
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.
Subject(s)
Extracorporeal Membrane Oxygenation , Heart Arrest , Drug Monitoring , Humans , Valproic Acid/therapeutic useSubject(s)
Antibodies, Monoclonal, Humanized/administration & dosage , Calcitonin Gene-Related Peptide Receptor Antagonists/administration & dosage , Migraine Disorders/prevention & control , Antibodies, Monoclonal, Humanized/adverse effects , Antibodies, Monoclonal, Humanized/pharmacology , Calcitonin Gene-Related Peptide Receptor Antagonists/adverse effects , Calcitonin Gene-Related Peptide Receptor Antagonists/pharmacology , Humans , Migraine Disorders/physiopathologySubject(s)
Analgesics/therapeutic use , Calcitonin Gene-Related Peptide Receptor Antagonists/therapeutic use , Migraine Disorders/drug therapy , Tryptamines/therapeutic use , Acupuncture Therapy , Adult , Analgesics/administration & dosage , Analgesics/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Antiemetics/adverse effects , Antiemetics/therapeutic use , Drug Interactions , Ergot Alkaloids/adverse effects , Ergot Alkaloids/therapeutic use , Female , Humans , Migraine Disorders/prevention & control , Pregnancy , Serotonin 5-HT1 Receptor Antagonists/therapeutic use , Tryptamines/administration & dosage , Tryptamines/adverse effectsSubject(s)
Antibodies, Monoclonal/administration & dosage , Migraine Disorders/prevention & control , Antibodies, Monoclonal/pharmacology , Antibodies, Monoclonal, Humanized , Calcitonin Gene-Related Peptide/antagonists & inhibitors , Drug Approval , Humans , Injections, Subcutaneous , Randomized Controlled Trials as Topic , United States , United States Food and Drug AdministrationSubject(s)
Analgesics/administration & dosage , Antibodies, Monoclonal/administration & dosage , Calcitonin Gene-Related Peptide/antagonists & inhibitors , Migraine Disorders/prevention & control , Analgesics/adverse effects , Antibodies, Monoclonal/adverse effects , Antibodies, Monoclonal, Humanized , Calcitonin Gene-Related Peptide/immunology , Calcitonin Gene-Related Peptide/metabolism , Humans , Injections, Subcutaneous , Migraine Disorders/diagnosis , Migraine Disorders/immunology , Migraine Disorders/metabolism , Signal Transduction/drug effects , Treatment OutcomeABSTRACT
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.