Any undissolved particles should respond to careful rotation of the bottle. Avoid foaming. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Filtering of Carimune ® NF is acceptable but not required. Pore sizes of 15 microns or larger will be less likely to slow infusion, especially with higher Carimune ® NF concentrations. Antibacterial filters ( microns) may be used. When reconstitution of Carimune ® NF occurs outside of sterile laminar air flow conditions, administration must begin promptly with partially used vials discarded. When reconstitution is carried out in a sterile laminar flow hood using aseptic technique, administration may begin within 24 hours provided the solution has been refrigerated during that time. Do not freeze Carimune ® NF solution.
Cauda equina is formed by nerve roots caudal to the level of spinal cord termination. Cauda equina syndrome has been defined as low back pain, unilateral or usually bilateral symptoms in the distribution of sciatic nerve, saddle sensory disturbances, bladder and bowel dysfunction, and variable lower extremity motor and sensory loss. This may occur with neurotoxicity from local anesthesia. In the past, continuous spinal catheters with local anesthetics were associated with this syndrome. Those types of catheters and infusions are no longer in use.
What’s the best way to treat an MS relapse ? My neurologist has long said it makes little difference in treating an MS relapse if we are given a course of IV Solumedrol (IVSM) over several days or if we take an oral form of prednisone or decadron, a compounded formula. Research presented at the recent ECTRIMS/ACTRIMS Congress – that’s the European and American Committees for Treatment in Multiple Sclerosis – supports that thought. In a presentation titled Efficacy and safety of oral versus intravenous high-dose methylprednisolone in multiple sclerosis relapses , a randomized double blind trial (COPOUSEP) , a group of researchers from France looked at the this question and came to the conclusion that there is no statistical advantage of doing one form of treatment over the other. The benefits and the side effects were virtually identical.