Please help with this drug: Cedephin?

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Long story short. Had a patient last night say he took 30 "Cedephin". Best spelling I could do guys. He locked his keys in his apartment and was just casually waiting by the door with security. Guys vitals are great. AO X 3 etc.

Asked if he still had the bottle and he said no and he doesn't know where its at. Guy is acting fine just said he took it because he is "depressed". Asked what the pills were for he said "Um probably depression". Asked where he got it, and he said the typical response "Ma Street doc!"

I asked if it was Excederin he said nope. Asked if it was Sudafed, he said no.

Went to the ER and nobody ever heard of it. Not sure why this guy would lie about taking pills (not like he is going to get pain meds for it) because I doubt (I hope) he would like what they were going to do to him

Guy was in his early 30's Just curious if anyone ever heard of this?



On the brighter side, I had a call to the jail earlier and the guy said his doc prescribed him PCP. Made me laugh a tiny bit inside
 
Google shows a result for "Sedaphin": some kind of herbal remedy featuring lots of valerian root in tablet form. Probably not it; if it is, somebody got screwed. More likely, a combination of drug-addled memory and mishearing. If you're really curious, ask somebody at the ED about the tox screen that they probably did.
 
Poison control is also very good at Rx name rhymes, or IDing drugs based on how the tablets look. You may have considered calling them.
 
Could be

Sildenafil - aka Viagra
 
There is a brand name of Fluoxetine called Sarafem, my guess is that is what he took.
 
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AJ Hidell said:
Wouldn't that have been pretty obvious though? :lol:
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You may start to see Viagra (Sildenafil or marketed as Revatio) listed as a patient's med but not for the reason you are thinking. It is now in clinical trials throughout the country for Pulmonary Hypertension. You may also hear about it if you do IFTs for neonates with pulmonary hypertension. They may transport with Nitric Oxide but there might be discussion of the baby being a candidate for Sildenafil.

We also have people who want to make some extra money participating in various drug trials for research. So, don't always assume the obvious.
 
That's pretty nuts. Read into it, and for those interested:

informative: http://www.globalrph.com/sildenafil.htm

Or for a shorter read:
http://www.medscape.com/viewarticle/471168
Sildenafil is a selective inhibitor of phosphodiesterase type 5 (PDE5). Present throughout the body, PDE5 is found in high concentrations in the lungs. Inhibition of PDE5 enhances the vasodilatory effects of nitric oxide in pulmonary hypertension by preventing the degradation of cyclic guanosine monophosphate (cGMP), which promotes relaxation of vascular smooth muscle and increases blood flow. In animal models and human trials, sildenafil has been found to produce a relatively selective reduction in pulmonary artery pressure without adverse systemic hemodynamic effects. Inhibition of PDE5 by sildenafil may also enhance the platelet antiaggregatory activity of nitric oxide and inhibit thrombus formation.
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Can't immediately find anything regarding long term studies...
 
vquintessence said:
Can't immediately find anything regarding long term studies...
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We've been using Nitro Oxide for pulmonary hypertension (acute) since the 1980s and the "Viagra" products for about 8 years in NICU and PICU. Hopefully after the pulmonary hypertenson resolves from the rescue phase, whatever meds or gases used to alleviate it can be discontinued.

For those with chronic or long term conditions pertaining to Primary Pulmonary Hypertension, they may be on a variety of meds available by nebulizers, implantable pumps, pills and tanks similiar to home care O2. So don't always assume that is albuterol they are taking every hour or it is O2 in the tank.

neonates

http://scholar.google.com/scholar?q=Sildenafil+neonates&hl=en&lr=

peds long term

http://scholar.google.com/scholar?q=Sildenafil+pediatrics+long+term&hl=en&lr=
 
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VentMedic said:
We've been using Nitro Oxide for pulmonary hypertension (acute) since the 1980s and the "Viagra" products for about 8 years in NICU and PICU. Hopefully after the pulmonary hypertenson resolves from the rescue phase, whatever meds or gases used to alleviate it can be discontinued.

For those with chronic or long term conditions pertaining to Primary Pulmonary Hypertension, they may be on a variety of meds available by nebulizers, implantable pumps, pills and tanks similiar to home care O2. So don't always assume that is albuterol they are taking every hour or it is O2 in the tank.
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Oh, ok. Thanks. My knowledge of neonate's is quite lacking aside from basic A&P, NALS and the random FYI's picked up from NICU transfers. That being said, I assume from what you said sildenafil is a last line resort? If so, is that because of lack of trial studies, or is there some larger danger at play?

Found this:
Nearly 20-30% of cases do not respond to nitric oxide, especially those with severe parenchymal lung disease (as in meconium aspiration and pneumonia) or pulmonary hypoplasia (as in congenital diaphragmatic hernia)
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But for the chronic cases, what is the typical slew of meds to keep the plm htn at bay? Or is it a congenital issue where modern society is trying sustain life against the consideration of quality of life?
 
vquintessence said:
Oh, ok. Thanks. My knowledge of neonate's is quite lacking aside from basic A&P, NALS and the random FYI's picked up from NICU transfers. That being said, I assume from what you said sildenafil is a last line resort? If so, is that because of lack of trial studies, or is there some larger danger at play?

Found this:


But for the chronic cases, what is the typical slew of meds to keep the plm htn at bay? Or is it a congenital issue where modern society is trying sustain life against the consideration of quality of life?
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Sildenafil: depends on the etiology. Long term use may be considered. I didn't say it was only used in rescue. What I said was hopefully most of the meds (and ventilator) will be discontinued once the Pulmonary HTN resolves. Usually we can get them through the Pulmonary HTN if it was caused by some form of hypoxia near or at birth if the rest of the anatomy is normal.

There are a few aerosolized Prostacyclins on the market including Iloprost and Flolan. Nitric Oxide is also used in the home care setting. As I already mentioned, pill forms of Viagra and implantable pumps are available.

Nearly 20-30% of cases do not respond to nitric oxide, especially those with severe parenchymal lung disease (as in meconium aspiration and pneumonia) or pulmonary hypoplasia (as in congenital diaphragmatic hernia)
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Nitric Oxide is not the only thing we have available. The aerosolized Prostacyclins and Sildenafil are available to the neonate. HFOV and HFJV can control further lung damage and the diaphragmatic hernia can be surgically repaired. Once the inflammation and infections are also treated the pulmonary HTN may resolve.

Or is it a congenital issue where modern society is trying sustain life against the consideration of quality of life?
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Then why bother saving the 23 week preemie? HPLV or any of the severe CHDs? Down Syndrome children? Cystic fibrosis? Muscular dystrophy? We diagnosis most of these in utero so maybe we should just abort before they become society's burden and "frequent flyers" for EMS.

Many have posed these questions but aborting a life just because it is not perfect is still controversial.
 
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Thanks again for the brain picking, it seriously makes personal research easier when knowing where to start.

Wasn't trying to incite an abortion conversation. Just saying that modern medicine and technology is so powerful & amazing that sometimes it allows us to hurt who we're helping. Personally remember all the transfers from Salem hospital to B&W in Boston of preterm complications/abnormalities at 17/19/?? weeks. The return rides with the accompanying RN talking about slim to nill odds of survivability and the awful struggles the children, mother and family will face. Sobering stuff.
 
vquintessence said:
Wasn't trying to incite an abortion conversation. Just saying that modern medicine and technology is so powerful & amazing that sometimes it allows us to hurt who we're helping.
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Which is why I toss out things that some don't understand but might decide they want to research it to learn more. Medicine is vast and we don't always have recipe books or even a total plan for things we do. In the ICUs, it takes a village or the entire team of every discipline to save someone's life. That is why I try to stress those in EMS venture out of their comfort zone and meet people that work in the hospitals or take more classes to see just how much medicine there is to see. It is a shame that those working CCTs as CCEMT-Ps have not had the opportunity to do rotations through some of the intense ICUs. Even those on some Flight programs get their trial by fire. The better programs have extensive training internships.

I'll be happy to give you the directions for more information to questions you might have.
 
Cetafen is a branded form of Acetamenophen. Acetamenophen or Tylenol is a very dangerous OD as it affects the liver. I think this is what your guy took.
 
Could he have meant "Cephalexin"?
 
BossyCow said:
Cetafen is a branded form of Acetamenophen. Acetamenophen or Tylenol is a very dangerous OD as it affects the liver. I think this is what your guy took.
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That sounds like the most likley explanation so far. (To me at least!) That's just my (not so) humble opinion.
 
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