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The Non-Prescription Products – Market-Profits and Public Health in Conflict
Published in Mickey C. Smith, E.M. (Mick) Kolassa, Walter Steven Pray, Government, Big Pharma, and the People, 2020
Some nonprescription products were granted “grandfather” status by the 1938 FDC Act, meaning that they did not have to comply with the law as long as the label remained the same. This was the reason that companies were allowed to continue to sell nonprescription phenazopyridine for urinary tract pain without a label precaution urging the patient to consult a physician. An FDA officer confirmed to the Author that the Agency would eventually pursue these old products despite their status.
Urinary Symptoms and Investigations
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Many drugs and foodstuffs have been reported to produce abnormal discolouration of the urine. Most colours have been reported but the most frequently encountered clinically are red/orange and brown. Clearly, haematuria is the commonest cause for red urine; however, the presence of haem in the urine also produces red discolouration and generates a positive dipstick test. Red urine discolouration due to haemoglo- binuria may present in haemolytic disorders such as ‘march haematuria’, classically seen in dehydrated soldiers after prolonged marching. Likewise, myoglobinuria due to myocyte destruction, e.g. caused by rhabdomyolysis after crush injury, can also result in red discolouration of the urine. Disordered haem production, seen in porphyria, can result in red discolouration that may change to brown or purple with exposure to sunlight. Several medications can cause red/orange discolouration of the urine, most commonly rifampicin, isoniazid or phenazopyridine with tears and other bodily fluids generally also discoloured. Others include chlorpromazine, thioridazine, senna and laxatives containing a phenolphthalein component. Consumption of large quantities of beetroot can result in red discolouration of the urine. This discolouration is due to the excretion of betalain (betacyanin) pigments such as betanin. There is no direct genetic influence and no single gene variant that differentiates excreters from non-excreters.
The pad-weighing test
Published in Jacques Corcos, David Ginsberg, Gilles Karsenty, Textbook of the Neurogenic Bladder, 2015
The pyridium pad test is a qualitative counterpart to the quantitative pad test. It is performed by asking a patient to take phenazopyridine hydrochloride (pyridium), a medication that turns the urine orange. The patient then wears a pad for the next 24 hours while performing normal daily activities. This test is considered positive if there is any orange staining seen on the pad(s). Wall et al. showed 100% sensitivity in symptomatic patients with stress urinary incontinence when using the pyridium pad test. However, the group found a 52% false-positive rate in healthy, asymptomatic continent women. They concluded that the addition of pyridium to a standard pad weighing test was not useful, and may in fact be misleading.16
Update on vesicovaginal fistula: A systematic review
Published in Arab Journal of Urology, 2019
Ahmed S. El-Azab, Hassan A. Abolella, Mahmoud Farouk
The physician should become suspicious of the presence of a VVF when the patient complains of a leakage of urine after a pelvic operation. Occasionally these postoperative VVFs may not develop until a few weeks or even few months after an operation or RT. On pelvic examination, the vagina should be carefully inspected using a speculum; under anaesthesia, if required. Ghoniem and Warda [14] in their review stated that acute VVFs are usually not palpated but by inspection with the speculum, the mucosa surrounding the VVF may appear erythematous and inflamed. However, in mature VVFs an opening is usually seen or palpated in the vagina. A phenazopyridine test can be performed by giving the patient oral phenazopyridine (pyridium). A vaginal pack or a tampon is inserted into the vagina before taking the phenazopyridine. After careful removal, if the pack reveals the presence of orange stain, there is a high likelihood that a VVF exists. The authors have been using a methylene blue test for many years, with very good sensitivity. The test is carried out by installing 100 mL methylene blue solution into the bladder through the urethra using a catheter. After removing the catheter, three cotton swabs are placed into the vagina. After 2 h the swabs are inspected and if stained blue this indicates a VVF; whilst an orange stain indicates a ureterovaginal fistula (UVF) [14].
Antimalarial drugs for treating and preventing malaria in pregnant and lactating women
Published in Expert Opinion on Drug Safety, 2018
Makoto Saito, Mary Ellen Gilder, Rose McGready, François Nosten
Studies of the risk of in-utero hemolysis with G6PD hemolytic agents yield mixed results. Some medications known to cause hemolysis are used routinely in pregnancy (for example nitrofurantoin and phenazopyridine), however primaquine is thought to be a more potent oxidizing agent than these other drugs. Case reports have been published of in-utero hemolysis, hydrops, or stillbirth associated with fetal G6PD deficiency and maternal ingestion of fava beans [152,153], sulfa-based antibiotics [154], and intravenous treatment with methylene blue [155]. However, a study prospectively measuring markers of subclinical hemolysis at birth in G6PD deficient neonates did not find a difference between those exposed to fava beans in-utero vs those not exposed [156]. The younger average age of erythrocytes in fetal and neonatal blood is theoretically protective against G6PD-mediated hemolysis, as evidenced by higher rates of false negative results on fluorescent spot tests for G6PD deficiency in the neonatal period, especially for preterm infants [157,158].
Dipstick analysis of urine chemistry: benefits and limitations of dry chemistry-based assays
Published in Postgraduate Medicine, 2020
Varun Kavuru, Tommy Vu, Lampros Karageorge, Devasmita Choudhury, Ryan Senger, John Robertson
Results of visual characterization and dipstick testing (in samples that have been properly collected [see below]) can be very helpful in triggering more rigorous patient evaluation. For example, gross turbidity invariably indicates a need for sample centrifugation and sediment evaluation. Intense, yellow-orange color and high urine specific gravity may be indicative of dehydration; the presence of chromogenic drug metabolites (rifampin [Rifadin®], phenazopyridine [Pyridium®], sulfasalazine [Azulfidine®], and isoniazid [Nydrazid®]), vitamin, and dietary plant metabolites; and a number of other normal and abnormal states of health and disease.