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Space motion sickness (SMS) is often treated in space with promethazine (PMZ). Common side effects of PMZ administration (50 mg intramuscular) on the ground are drowsiness and impaired cognitive performance. Anecdotal reports indicate that these effects are absent or less pronounced in space. This suggests that the availability of PMZ to the body (bioavailability) and/or the response of the body to PMZ (pharmacodynamics) may change during space flight. Opportunities for clinical research in space are limited. The study described here is our response to a NASA Research Announcement for proposals for flight-based research needed to improve, or answer specific questions about, diagnosis and therapy during space flight, and post-flight rehabilitation. We propose here to evaluate noninvasive methods for determining the bioavailability and pharmacodynamics of PMZ. The specific objectives of the proposed research are to 1) compare pharmacokinetic and pharmacodynamic parameters of PMZ, estimated from saliva and plasma levels after administration of PMZ, 2) estimate the relative bioavailability of the three dosage forms of PMZ that are often administered to control motion sickness symptoms in space, and 3) establish the dose-response relationship of PMZ. We will estimate the bioavailability of an intramuscular injection (IM), oral tablet, and rectal suppository of PMZ in noma1 subjects during ambulatory and antiorthostatic bed rest (ABR) conditions using novel stable isotope techniques. We will compare and contrast the bioavailability of PMZ during normal and microgravity conditions to examine changes in drug absorption and bioavailability during microgravit. Results of this study will validate methods for an approved in-flight investigation with this medication awaiting an opportunity for manifestation..Putcha, Lakshmi and Boyd, Jason L. and Cintron, Nitza and Berens, Kurt L.Johnson Space CenterAEROSPACE MEDICINE; DOSAGE; DRUGS; MOTION SICKNESS; SPACE ADAPTATION SYNDROME; I
Safe Passage: Astronaut Care for Exploration Missions sets forth a vision for space medicine as it applies to deep space voyage. As space missions increase in duration from months to years and extend well beyond Earth's orbit, so will the attendant risks of working in these extreme and isolated environmental conditions. Hazards to astronaut health range from greater radiation exposure and loss of bone and muscle density to intensified psychological stress from living with others in a confined space. Going beyond the body of biomedical research, the report examines existing space medicine clinical and behavioral research and health care data and the policies attendant to them. It describes why not enough is known today about the dangers of prolonged travel to enable humans to venture into deep space in a safe and sane manner. The report makes a number of recommendations concerning NASA's structure for clinical and behavioral research, on the need for a comprehensive astronaut health care system and on an approach to communicating health and safety risks to astronauts, their families, and the public.
Over the years, a large body of knowledge has developed regarding the ways in which space flight affects the health of the personnel involved. Now, for the first time, this clinical knowledge on how to diagnose and treat conditions that either develop during a mission or because of a mission has been compiled by Drs. Michael Barratt and Sam L. Pool of the NASA/Johnson Space Center. Complete with detailed information on the physiological and psychological affects of space flight as well as how to diagnose and treat everything from dental concerns to decompression to dermatological problems encountered, this text is a must have for all those associated with aerospace medicine.
More than four decades have passed since a human first set foot on the Moon. Great strides have been made in our understanding of what is required to support an enduring human presence in space, as evidenced by progressively more advanced orbiting human outposts, culminating in the current International Space Station (ISS). However, of the more than 500 humans who have so far ventured into space, most have gone only as far as near-Earth orbit, and none have traveled beyond the orbit of the Moon. Achieving humans' further progress into the solar system had proved far more difficult than imagined in the heady days of the Apollo missions, but the potential rewards remain substantial. During its more than 50-year history, NASA's success in human space exploration has depended on the agency's ability to effectively address a wide range of biomedical, engineering, physical science, and related obstacles-an achievement made possible by NASA's strong and productive commitments to life and physical sciences research for human space exploration, and by its use of human space exploration infrastructures for scientific discovery. The Committee for the Decadal Survey of Biological and Physical Sciences acknowledges the many achievements of NASA, which are all the more remarkable given budgetary challenges and changing directions within the agency. In the past decade, however, a consequence of those challenges has been a life and physical sciences research program that was dramatically reduced in both scale and scope, with the result that the agency is poorly positioned to take full advantage of the scientific opportunities offered by the now fully equipped and staffed ISS laboratory, or to effectively pursue the scientific research needed to support the development of advanced human exploration capabilities. Although its review has left it deeply concerned about the current state of NASA's life and physical sciences research, the Committee for the Decadal Survey on Biological and Physical Sciences in Space is nevertheless convinced that a focused science and engineering program can achieve successes that will bring the space community, the U.S. public, and policymakers to an understanding that we are ready for the next significant phase of human space exploration. The goal of this report is to lay out steps and develop a forward-looking portfolio of research that will provide the basis for recapturing the excitement and value of human spaceflight-thereby enabling the U.S. space program to deliver on new exploration initiatives that serve the nation, excite the public, and place the United States again at the forefront of space exploration for the global good.
This two-volume handbook, directed at medical professionals and students who are involved in developing the space industry or are academicians doing research in this area, covers current pharmaceutical knowledge about the difference in medication efficacy in space versus on Earth and includes trial results and best practices for the space research and travel industry. The well-known contributors come from an interdisciplinary background and address all aspects of the subject, from the physiological impact of spaceflight to the effects of radiation. As the commercial space industry expands its operations in industry and tourism, the field of space pharmaceuticals is growing commensurately. Existing pharmacological research from space is thoroughly covered in this book, and Earth applications are also described. Potential pharmacological solutions are posed along with the known challenges and examples from existing studies, which are detailed at length. This major reference work is a comprehensive and important medical resource for all space industry players.
Construction of the international space station, scheduled to start in late 1998, ushers in a new era for laboratory sciences in space. This is especially true for space life sciences, which include not only the use of low gravity as an experimental parameter to study fundamental biological processes but also the study of the serious physiological changes that occur in astronauts as they remain in space for increasingly longer missions. This book addresses both of these aspects and provides a comprehensive review of ground-based and space research in eleven disciplines, ranging from bone physiology to plant biology. It also offers detailed, prioritized recommendations for research during the next decade, which are expected to have a considerable impact on the direction of NASA's research program. The volume is also a valuable reference tool for space and life scientists.
Review of NASA's Evidence Reports on Human Health Risks 2015 Letter Report is the third in a series of five reports from the Institute of Medicine that will independently review more than 30 evidence reports that the National Aeronautics and Space Administration has compiled on human health risks for long-duration and exploration space flights. This report builds on the 2008 IOM report Review of NASA's Human Research Program Evidence Books: A Letter Report, which provided an initial and brief review of the evidence reports. This letter report reviews seven evidence reports and examines the quality of the evidence, analysis, and overall construction of each report; identifies existing gaps in report content; and provides suggestions for additional sources of expert input. The report analyzes each evidence report's overall quality, which included readability; internal consistency; the source and breadth of cited evidence; identification of existing knowledge and research gaps; authorship expertise; and, if applicable, response to recommendations from the 2008 IOM letter report.
The herbai medicine industry is growing at an astounding rate. Trade group estimates suggest that total sales exceeded $4 billion dollars in 1999. Herbai remedies are for sale not just in health food stores, but in supermar kets, drug stores, and even discount warehouses. Along with the proliferation in sales has come a proliferation ofinformation sources. Not all ofthe sources are equally reliable, or even intelligible. Traditional herbalists c1assify thistle and mugwort as "cholagogues," substances used to make the gallbladder con tract and release bile. Medical school graduates are unlikely to have ever heard the term, or even accept the notion that most right-sided abdominal pain is a result of diminished bile flow. Heroin and cocaine may not be the only drugs to come from plants, but a practicing physician or toxicologist might be forgiven for thinking so. In 1998, 1264 papers were published about cocaine and only 17 about kava kava, an abused herb that is not without toxic side effects. Unfortunately, the majority of the papers about kava kava were published in journals not found in ordi nary hospitallibraries. In recognition ofthis fact, and ofthe obvious need for a reliable reference work on herbai toxicology, The Toxicology and Clinical Pharmacology 0/ Herbal Products was an early addition to our new series in Forensie Science and Medicine. It is very badly needed.
“Space Pharmacology” is a review of the current knowledge regarding the use of pharmaceuticals during spaceflights. It is a comprehensive review of the literature, addressing each area of pharmacokinetics and each major physiological system in turn. Every section begins with a topic overview, and is followed by a discussion of published data from spaceflight, and from ground experiments meant to model the spaceflight situation. Includes a discussion looking forward to the new medical challenges we are likely to face on longer duration exploration missions. This book is a snapshot of our current knowledge that also highlights areas of unknown.