Monthly Archives: July 2014

FDA Approves Ryanodex, New MH Drug



The FDA has approved Ryanodex (Eagle Pharmaceuticals) for the treatment of malignant hyperthermia, marking the first major development for the life-threatening complication of anesthesia in more than 30 years, according to the manufacturer.

The drug, an injectable suspension of dantrolene sodium, will be available in 250 mg single-use vials containing the active ingredient in a lyophilized powder. According to Eagle Pharmaceuticals, Ryanodex can be prepared and administered in less than one minute, compared with 15 to 20 minutes for conventional dantrolene.

“When a patient experiences malignant hyperthermia during surgery, it is a life‐threatening emergency requiring immediate treatment, including the administration of the antidote drug dantrolene sodium,” said Henry Rosenberg, MD, president of the Malignant Hyperthermia Association of the United States, in a statement. “The ability for health care professionals in hospitals and surgery centers to more quickly prepare and administer this new formulation of the antidote dantrolene sodium is expected to bring the crisis under control more rapidly, and prevent severe complications from MH.”

Ryanodex will be available to order from drug wholesalers in August, the company said.

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Opioid Deaths Highest in Younger Patients

Anesthesiology_Pain Management


Deaths involving opioids proved to be a particular problem among younger people in one Canadian province, researchers reported.

In 2010, one in nearly every eight deaths in Ontario among people ages 25 to 34 were opioid-related, Tara Gomes, MHSc, of St. Michael’s Hospital in Toronto, and colleagues reported online in Addiction.

The deaths were reflected in an “extraordinary number” of years of life lost due to premature death, they wrote.

“The proportion of deaths [in this age group] has risen dramatically,” David Juurlink, MD, PhD, of the University of Toronto, a co-author of the paper, told MedPage Today. “It’s a staggering number.”

The increase parallels rising opioid-related deaths rates in the U.S., which continued to climb,hitting 16,917 in 2011, the most recent year for which data were available. Given the lag in data reporting, some experts expect that the trend may have leveled off, if not started declining, during the last 2 years given a significant amount of public attention drawn to the issue.

Gomes, Juurlink, and colleagues looked at coroner records of 5,935 patients who died from opioid-related causes in Ontario between January 1991 and December 2010.

Overall rate of opioid-related mortality rose 242% during that time, jumping from 12.2 to 41.6 deaths per 1,000,000 population, with the most recent figure equating to one in every 170 deaths in the province potentially being related to opioid overdose.

Although opioid overdose-related death increased in every age group, it was particularly high among those ages 25 to 34, they reported, accounting for 12% of all deaths in this age group.

The annual years of life lost due to premature opioid-related death rose threefold over that period, from 7,006 to 21,927. The 2010 figure tops years of life lost due to alcohol use disorders (18,564) and pneumonia (18,987), they reported.

That “extraordinary number” reflects in part the disproportionate number of these deaths among younger people and “highlights the public health and societal burden of opioid overdose,” they wrote.

They said the findings “underline the urgent need for a change in perception regarding the safety of these medications.”

The study was supported by a grant from the Ontario Ministry of Health and Long-Term Care and the Institute for Clinical Evaluative Sciences.

Gomes and Juurlink reported no relevant financial disclosures.