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Anticholinergic Syndrome

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https://www.readbyqxmd.com/read/28190432/acute-neurotoxicology-of-drugs-of-abuse
#1
S J Traub, M D Levine
Many substances can affect the central nervous system, and may cause patients to become critically ill. Acute central neurotoxicologic syndromes associated with drugs of abuse are usually caused by an overdose of sedative-hypnotic agents (including alcohol) or opioids, withdrawal from sedative-hypnotic agents, or an overdose of anticholinergic or sympathomimetic agents. Clinical findings are often syndromic, making physical examination the most important diagnostic tool in the approach to the patient with an unknown ingestion...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28081025/transdermal-scopolamine-withdrawal-syndrome-case-report-in-the-pediatric-cerebral-palsy-population
#2
Nasim A Chowdhury, Mary Laura Sewatsky, Heakyung Kim
Sialorrhea in children with cerebral palsy (CP) results in aspiration, decreased social integration, and poor quality of life. Management options include transdermal anticholinergics such as the scopolamine patch. A controlled clinical trial has proven botulinum toxin (BTX) injections into the salivary glands are an effective alternative to transdermal anticholinergics with a safer side effect profile. Multiple studies of the injections in diverse populations demonstrate reduction in saliva production with improvement in quality of life and decrease in hospitalization-associated costs...
January 9, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28073038/persistence-in-the-treatment-of-overactive-bladder-syndrome-oab-with-mirabegron-in-a-multicenter-clinical-study
#3
Alois Martan, Jaromir Masata, Jan Krhut, Roman Zachoval, Tomas Hanus, Kamil Svabik
OBJECTIVE: The objective of this project was to evaluate treatment persistence in patients being treated for overactive bladder syndrome (OAB) with mirabegron, employing clinical follow-up in a prospective, multicenter study. STUDY DESIGN: This is an analysis of patients who started treatment with mirabegron between May and September 2014 and were evaluated 1year after treatment commenced. During this evaluation we determined how many patients stopped treatment and established their reasons for discontinuation...
December 23, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28040533/tacrine-in-vivo-veritas
#4
Bevyn Jarrott
Tacrine was initially synthesised in 1945 as part of a project seeking antibacterial drugs to treat infected wounds in soldiers. However, it was inactive in vitro against common strains of bacteria. Serendipitously, it was injected in vivo into dogs anaesthetised with chloroform and morphine and noted to immediately counter the respiratory rate depression caused by morphine but not block analgesia. Subsequent studies showed that tacrine was an acetylcholinesterase inhibitor. When combined with morphine in ampoules it was possible to inject larger doses of morphine without causing respiratory depression and it was marketed for 10 years in Australia...
February 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27663539/postoperative-delirium-following-orthognathic-surgery-in-a-young-patient
#5
Fernanda Herrera da Costa, Paulo Adilson Herrera, Cecília Luiz Pereira-Stabile, Glaykon Alex Vitti Stabile
Delirium is an organic mental syndrome with acute onset characterized by diffuse brain dysfunction and neural activity disorganization. It is usually related to cognition and perception changes, decreased level of consciousness, and disorganization of thoughts that are unrelated to previous dementia. Occurrence is more frequent in patients with previous degenerative disease and elderly patients, especially those older than 85 years. Although the pathophysiology is not totally known, studies have shown that, among the main factors that lead to delirium, the drugs used for general anesthesia induction are the most relevant (hypnotics, anticholinergic drugs, and H2 receptor blockers), especially those used in long surgical procedures...
February 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27637870/-quetiapine-and-anticholinergic-drugs-induced-ischaemic-colitis-a-case-study
#6
P Cuny, M Houot, S Ginisty, S Horowicz, F Plassart, H Mentec, P Eftekhari
INTRODUCTION: The aim of this paper is to underline the need for systematic monitoring of patients treated with anticholinergic antipsychotic drugs. We present the clinical history of a 34-year-old adult, treated with quetiapine in combination with other drugs with anticholinergic effects. CASE REPORT: A 34-year-old male adult had been suffering from bipolar disorder since 2001. He was treated with risperidone, but he was not compliant due to adverse effects, including decreased libido and erectile dysfunction...
September 13, 2016: L'Encéphale
https://www.readbyqxmd.com/read/27606070/diagnosis-and-implications-in-the-therapeutic-management-of-patient-with-afebrile-neurolepctic-malignant-syndrome
#7
Rafael Quintes Ducasble Gomes, Amilton Dos Santos-Júnior, Gabriel Augusto de Araujo Silva Dias, Carlos Filinto da Silva Cais
This report aims at raising clinical awareness for the diagnosis of atypical presentations of neuroleptic malignant syndrome (NMS). We describe the case of a female patient with NMS symptoms, except fever, after starting the use of chlorpromazine. The afebrile condition delayed the consideration of NMS by the emergency clinicians who provided her initial assessment. Before this consideration, an anticholinergic agent, not recommended at this condition, was inadvertently prescribed. This might have contributed to the worsening of symptoms...
September 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27590078/olanzapine-as-a-possible-replacement-choice-for-paliperidone-induced-pisa-syndrome-a-case-report
#8
Chang-Chih Tsou, San-Yuan Huang
OBJECTIVE: The aim of this paper is to present a case of paliperidone-induced Pisa syndrome and provide treatment experience. METHOD: The case report is combined with a review of the literature. RESULTS: A 37-year-old man had been diagnosed with paranoid-type schizophrenia for about 10 years. He received three-month treatment of paliperidone extended release (ER) at 6 mg per day, but showed a progressively Pisa-like physical position. We initially added an anticholinergic drug, but saw no improvement...
December 2016: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/27548592/behavioral-disorders-in-dementia-appropriate-nondrug-interventions-and-antipsychotic-use
#9
Tyler R Reese, Derrick J Thiel, Katherine E Cocker
Behavioral and psychological symptoms of dementia pose management challenges for caregivers and clinicians. Firstline nonpharmacologic treatments include eliminating physical and emotional stressors, modifying the patient's environment, and establishing daily routines. Family members and caregivers benefit from education about dementia symptoms and reminders that the behaviors are normal and unintentional. Cognitive and emotion-oriented interventions, sensory stimulation interventions, behavior management techniques, and other psychosocial interventions are modestly effective...
August 15, 2016: American Family Physician
https://www.readbyqxmd.com/read/27530266/overactive-bladder-in-children
#10
REVIEW
Israel Franco
Overactive bladder (OAB) is a ubiquitous syndrome that is defined by urinary urgency with, or without urinary incontinence. OAB is observed in all parts of the world, with a prevalence of 5-12% in children (5-10 years of age) and a prevalence of 0.5% in older adolescents (16-18 years of age). Published data indicate that around a third of children with OAB are likely to become adults with similar complaints. Studies in children and in adults with OAB indicate that these individuals are more likely to also have anxiety, depression and attention deficit problems, and that appropriate treatment of these comorbidities can often improve the patient's OAB symptoms...
September 2016: Nature Reviews. Urology
https://www.readbyqxmd.com/read/27434314/benefit-risk-assessment-of-paliperidone-oral-extended-release-tablet-versus-monthly-injectable-for-maintenance-treatment-of-schizophrenia
#11
Bennett Levitan, Michael Markowitz, Ibrahim Turkoz, Dong-Jing Fu, Srihari Gopal, Larry Alphs
The purpose of this study was to conduct a post-hoc benefit-risk assessment of paliperidone palmitate once-monthly (PP1M) injectable versus oral paliperidone extended-release (ER) in schizophrenia maintenance treatment. The Benefit-Risk Action Team framework was used to structure the analysis based on patient-level data from two similar, double-blind, placebo-controlled relapse studies. Efficacy outcomes were relapse, psychiatric hospitalization, Clinical Global Impression-Severity scale, Personal and Social Performance (PSP) scale, and Positive and Negative Syndrome Scale (PANSS)...
November 2016: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27424016/secondary-sjogren-s-syndrome-in-83-patients-with-rheumatoid-arthritis
#12
Asghar Hajiabbasi, Irandokht Shenavar Masooleh, Yousef Alizadeh, Amir Sadredin Banikarimi, Pooneh Ghavidel Parsa
UNLABELLED: Sjogren syndrome (SS) can occur alone, primary Sjogren syndrome, or in association with other rheumatic diseases, secondary Sjogren syndrome (sSS), such as Rheumatoid arthritis (RA). The occurrence of Sjogren syndrome with RA makes it course worse and increases high morbidity and mortality of RA. In this exploratory study we aim to determine the prevalence of sSS (diagnosed based on the revised version of American-European consensus Group Classification Criteria: AUCG-criteria), sicca symptoms (dry eye, dry mouth), positive autoantibody tests (Anti RO or Anti-LA antibodies), UWSFR (Unstimulated Whole Salivary Flow Rate), Schirmer and Lissamine test...
July 2016: Acta Medica Iranica
https://www.readbyqxmd.com/read/27421224/primary-sj%C3%A3-gren-s-syndrome
#13
REVIEW
Maureen Rischmueller, Joanna Tieu, Susan Lester
Primary Sjögren's syndrome (pSS) is a relatively common autoimmune systemic rheumatic disease. In addition to sicca syndrome and swollen salivary glands, systemic features manifest in the majority of patients, and are severe in 15%, particularly affecting the joints, skin, lungs, and peripheral nervous system. A recent meta-analysis estimated a pooled relative risk of 13.76 for the development of non-Hodgkin lymphoma, particularly in pSS patients who have parotid enlargement, vasculitis, cryoglobulinemia, and antibodies to Ro and La...
February 2016: Best Practice & Research. Clinical Rheumatology
https://www.readbyqxmd.com/read/27293342/sporadic-and-familial-myoclonic-dystonia-report-of-three-cases-and-review-of-literature
#14
Kalyan B Bhattacharyya, Arijit Roy, Atanu Biswas, Ashutosh Pal
Myoclonic dystonia refers to a clinical syndrome characterized by rapid jerky movements along with dystonic posturing of the limbs. Clinically, it is characterized by sudden, brief, electric shock-like movements, mostly involving the upper extremities, shoulders, neck and trunk. Characteristically, the movements wane with consumption of small dose of alcohol in about 50% of cases. Additionally, dystonic contractions are observed in most of the patients in the affected body parts and some patients may exhibit cervical dystonia or graphospasm as well...
April 2016: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/27275433/an-overlooked-effect-of-systemic-anticholinergics-alteration-on-accommodation-amplitude
#15
Mehmet Ali Sekeroglu, Emre Hekimoglu, Mustafa Alpaslan Anayol, Yasemin Tasci, Ismail Dolen
AIM: To investigate the effect of oral solifenacin succinate, tolterodine-L-tartarate and oxybutinin hydrochloride (HCl) on accommodation amplitude. METHODS: Female overactive bladder syndrome (OAB) patients who were planned to use oral anticholinergics, patients that uses solifenacin succinate 5 mg (Group I, n=25), tolterodine-L-tartarate 4 mg (Group II, n=25), and oxybutinin HCl 5 mg b.i.d (Group III, n=25) and age matched healthy female subjects (Group IV, n=25) were recruited and complete ophthalmological examination and accommodation amplitude assessment were done at baseline and 4wk after initiation of treatment...
2016: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/27272514/-malignant-hyperthermia-syndrome-in-the-intensive-care-unit-differential-diagnosis-and-acute-measures
#16
W Grander
Malignant hyperthermia is a life-threatening disease caused by derangement of the autonomic nerve system and hypermetabolism of the peripheral musculature. Commonly body core temperatures of more than 40 °C will be found in this disease which is caused mostly by psychopharmacological drugs like antidepressants, neuroleptics but also antibiotics, pain killers, anti-Parkinson drugs, and volatile anesthetics. The inducers of malignant hyperthermia interact with postsynaptic receptors (serotonin, anticholinergics) or muscular intracellular structures responsible for calcium utilization (volatile anesthetics, succinylcholine)...
June 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27212741/delayed-recovery-from-anesthesia-a-postgraduate-educational-review
#17
REVIEW
Ullhas Sudhakarrao Misal, Suchita Annasaheb Joshi, Mudassir Mohd Shaikh
Delayed awakening from anesthesia remains one of the biggest challenges that involve an anesthesiologist. With the general use of fast-acting anesthetic agents, patients usually awaken quickly in the postoperative period. The time to emerge from anesthesia is affected by patient factors, anesthetic factors, duration of surgery, and painful stimulation. The principal factors responsible for delayed awakening following anesthesia are anesthetic agents and medications used in the perioperative period. Nonpharmacological causes may have a serious sequel, hence recognizing these organic conditions is important...
May 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27176185/overactive-bladder-18-years-part-ii
#18
Jose Carlos Truzzi, Cristiano Mendes Gomes, Carlos A Bezerra, Ivan Mauricio Plata, Jose Campos, Gustavo Luis Garrido, Fernando G Almeida, Marcio Augusto Averbeck, Alexandre Fornari, Anibal Salazar, Arturo Dell'Oro, Caio Cintra, Carlos Alberto Ricetto Sacomani, Juan Pablo Tapia, Eduardo Brambila, Emilio Miguel Longo, Flavio Trigo Rocha, Francisco Coutinho, Gabriel Favre, Jose Antonio Garcia, Juan Castano, Miguel Reyes, Rodrigo Eugenio Leyton, Ruiter Silva Ferreira, Sergio Duran, Vanda Lopez, Ricardo Reges
Traditionally, the treatment of overactive bladder syndrome has been based on the use of oral medications with the purpose of reestablishing the detrusor stability. The recent better understanding of the urothelial physiology fostered conceptual changes, and the oral anticholinergics - pillars of the overactive bladder pharmacotherapy - started to be not only recognized for their properties of inhibiting the detrusor contractile activity, but also their action on the bladder afference, and therefore, on the reduction of the symptoms that constitute the syndrome...
March 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/27175954/primary-care-of-the-prostate-cancer-survivor
#19
Erika M Noonan, Timothy W Farrell
This summary of the American Cancer Society Prostate Cancer Survivorship Care Guidelines targets primary care physicians who coordinate care of prostate cancer survivors with subspecialists. Prostate cancer survivors should undergo prostate-specific antigen screening every six to 12 months and digital rectal examination annually. Surveillance of patients who choose watchful waiting for their prostate cancer should be conducted by a subspecialist. Any hematuria or rectal bleeding must be thoroughly evaluated...
May 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27144622/age-gender-and-women-s-health-and-the-patient
#20
Lesley A Houghton, Margaret Heitkemper, Michael Crowell, Anton Emmanuel, Albena Halpert, James A McRoberts, Brenda Toner
Patients with functional gastrointestinal disorders (FGIDs) often experience distress, reduced quality of life, a perceived lack of validation, and an unsatisfactory experience with health care providers. A health care provider can provide the patient with a framework in which to understand and legitimize their symptoms, remove self-doubt or blame, and identify factors that contribute to symptoms that the patient can influence or control. This framework is implemented with the consideration of important factors that impact FGIDs, such as gender, age, society, and the patient's perspective...
February 15, 2016: Gastroenterology
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