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Prolonged-action ▼guanfacine (Intuniv-Shire Pharmaceuticals Ltd) is a non-stimulant drug that has recently been licensed in Europe for the management of attention deficit hyperactivity disorder (ADHD) in children and adolescents aged 6-17 years for whom stimulants are unsuitable.(1) The company suggests that it has a unique mechanism of action in ADHD, providing improvement in core symptoms within 3 weeks with once-daily flexible dosing.(2) Here we review the evidence on the efficacy and safety of guanfacine in ADHD and consider whether it offers any advantages over other therapeutic options...
May 2016: Drug and Therapeutics Bulletin
Amy F T Arnsten, Min Wang
Medications to treat cognitive disorders are increasingly needed, yet researchers have had few successes in this challenging arena. Cognitive abilities in primates arise from highly evolved N-methyl-d-aspartate (NMDA) receptor circuits in layer III of the dorsolateral prefrontal cortex. These circuits have unique modulatory needs that can differ from the layer V neurons that predominate in rodents, but they offer multiple therapeutic targets. Cognitive improvement often requires low doses that enhance the pattern of information held in working memory, whereas higher doses can produce nonspecific changes that obscure information...
2016: Annual Review of Pharmacology and Toxicology
Anthony A Fossa, Meijian Zhou, Antoine Robinson, Jaideep Purkayastha, Patrick Martin
BACKGROUND: Guanfacine (Intuniv) is a centrally active alpha-2A adrenergic agonist for the new indication of attention-deficit/hyperactivity disorder. QTc (QTcF and QTcNi) was prolonged at both therapeutic (4 mg) and supratherapeutic (8 mg) doses of a thorough QT study even though guanfacine has had a safe clinical history of over 3 million prescriptions for the treatment of hypertension. In an attempt to understand this disparity, retrospective evaluation of the continuous ECG data utilized dynamic beat-to-beat and ECG restitution analyses was performed...
November 2014: Annals of Noninvasive Electrocardiology
Benno Roesch, Mary Corcoran, Mary Haffey, Annette Stevenson, Phillip Wang, Jaideep Purkayastha, Patrick Martin, James Ermer
BACKGROUND: α2-Adrenoceptor agonists are used adjunctively to psychostimulants in treating attention-deficit/hyperactivity disorder (ADHD) when psychostimulants alone do not sufficiently reduce symptoms. However, data on the pharmacokinetic profiles and safety of combination treatments in ADHD are needed. OBJECTIVE: The primary objective of this study was to evaluate the pharmacokinetic profiles of guanfacine extended release (GXR) and methylphenidate hydrochloride (MPH) extended release, alone and in combination...
March 2013: Drugs in R&D
Sharon B Wigal, Stephanie Chae, Avni Patel, Robin Steinberg-Epstein
The purpose of this article is to assist pediatric neurologists in practice and in training to better understand and distinguish between several of the most commonly prescribed treatments for attention-deficit/hyperactivity disorder (ADHD) in school-aged children. Among the various pharmacotherapies available for ADHD, 4 specific medications will be reviewed: oral release osmotic system methylphenidate hydrochloride (CON; Concerta, McNeil Pharmaceuticals), lisdexamfetamine dimesylate (LDX; Vyvanse, Shire Pharmaceuticals), atomoxetine (ATX; Strattera, Eli Lilly), and guanfacine extended-release (GXR; Intuniv, Shire Pharmaceuticals)...
December 2010: Seminars in Pediatric Neurology
(no author information available yet)
No abstract text is available yet for this article.
October 18, 2010: Medical Letter on Drugs and Therapeutics
Martin P Cruz
No abstract text is available yet for this article.
August 2010: P & T: a Peer-reviewed Journal for Formulary Management
Daniel F Connor, Robert L Findling, Scott H Kollins, Floyd Sallee, Frank A López, Andrew Lyne, Gerald Tremblay
OBJECTIVE: To evaluate the efficacy and safety of guanfacine extended release (XR, Intuniv; Shire Development Inc., Wayne, PA, USA) in the treatment of oppositional symptoms in children aged 6-12 years with a diagnosis of attention-deficit hyperactivity disorder (ADHD) and the presence of oppositional symptoms. SUBJECTS AND METHODS: In this randomized, double-blind, placebo-controlled, multicentre, flexible-dose, dose-optimization study, children aged 6-12 years were randomized to receive guanfacine XR (1-4 mg/day) or placebo for 9 weeks...
September 2010: CNS Drugs
D F Connor, J Rubin
Extended-release guanfacine (Intuniv) is a novel long-acting, once-daily formulation of guanfacine indicated for attention deficit hyperactivity disorder (ADHD) in 6 to 17 year old children and adolescents. In doses 1 to 4 mg/day, guanfacine extended release (GXR) significantly improves the symptoms of inattention and hyperactivity-impulsivity in ADHD youngsters compared with placebo. Because of different pharmacokinetics, GXR is not substitutable on a mg-for-mg basis with immediate release guanfacine. Although extended release guanfacine does not demonstrate clinically significant ECG changes, mild slowing of the heart rate and some lowering of SBP and DBP does occur and requires vital sign monitoring during treatment...
May 2010: Drugs of Today
Carrie Haglock, Carl Wolf, Alphonse Poklis
Guanfacine (Tenex), an antihypertensive available since 1975, has recently been indicated for the treatment of attention deficit hyperactivity disorder in children (Intuniv). Because of this new usage, a gas chromatography-mass spectrometry method was developed and validated for the determination of guanfacine in urine. Guanfacine and 100 ng of protriptyline (internal standard) were extracted from 1.0 mL urine with 0.5 mL of saturated carbonate/bicarbonate buffer and 2 mL of ethyl acetate. The solvent extract was evaporated and derivatized with heptaflurobutyric anhydride in n-butyl chloride...
October 2008: Journal of Analytical Toxicology
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