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Anticholinergics

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https://www.readbyqxmd.com/read/28336159/the-anticholinergic-impregnation-scale-towards-the-elaboration-of-a-scale-adapted-to-prescriptions-in-french-psychiatric-settings
#1
Jeanne Briet, Hervé Javelot, Edwige Heitzmann, Luisa Weiner, Catherine Lameira, Philippe D'Athis, Marie Corneloup, Jean-Louis Vailleau
PURPOSE: Some drugs have anticholinergic activity and can cause peripheral or central side effects. Several scales exist to evaluate the potential anticholinergic effect of prescribed drugs but: (i) they are validated in the elderly and mainly assess the cognitive side effect of treatments; (ii) they do not concern some of the drugs frequently used in clinical psychiatry in France. The aim of our study is to develop a new scale, the anticholinergic impregnation scale (AIS), with drugs used in France and based on an assessment of the drugs used against peripheral anticholinergic adverse effects...
February 17, 2017: Thérapie
https://www.readbyqxmd.com/read/28335763/identification-of-drug-combinations-administered-by-continuous-subcutaneous-infusion-that-require-analysis-for-compatibility-and-stability
#2
Andrew Dickman, Matthew Bickerstaff, Richard Jackson, Jennifer Schneider, Stephen Mason, John Ellershaw
BACKGROUND: A continuous subcutaneous infusion (CSCI) delivered via syringe pump is a method of drug administration used to maintain symptom control when a patient is no longer able to tolerate oral medication. Several classes of drugs, such as opioids, antiemetics, anticholinergics, antipsychotics and benzodiazepines are routinely administered by CSCI alone or in combinations. Previous studies attempting to identify the most-common CSCI combinations are now several years old and no longer reflect current clinical practice...
March 23, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28329748/extensive-multilevel-split-laminotomy-for-debulking-a-cervicothoracolumbar-nondysraphic-intramedullary-spinal-cord-lipoma-in-a-2-month-old-infant
#3
Ha Son Nguyen, Sean Lew
INTRODUCTION: Laminectomy is the traditional approach for posterior exposure of the spinal canal for tumor resection. Another technique is split laminotomy, which entails the division and retraction of the spinous processes and laminae to access the thecal sac. This technique has been employed for small-segment exposures, but not extensively explored for long-segment exposures. CASE: A 2-month-old male presented with progressive right-leg plegia. MRI of the spine revealed a large, intramedullary spinal-cord lipoma extending from C6 to L5...
March 23, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28325523/total-management-of-chronic-obstructive-pulmonary-disease-copd-as-an-independent-risk-factor-for-cardiovascular-disease
#4
REVIEW
Katsuya Onishi
Patients with cardiovascular disease (CVD) often have multiple comorbid conditions that may interact with each other, confound the choice of treatments, and reduce mortality. Chronic obstructive pulmonary disease (COPD) is one of the most important comorbidities of CVD, which causes serious consequences in patients with ischemic heart disease, stroke, arrhythmia, and heart failure. COPD shares common risk factors such as tobacco smoking and aging with CVD, is associated with less physical activity, and produces systemic inflammation and oxidative stress...
March 18, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28320023/-update-opipramol
#5
Maximilian Gahr, Christoph Hiemke, Bernhard J Connemann
Opipramol was developed in the 1960s as an antidepressant and has chemical similarities with tricyclic antidepressants. Pharmacodynamic properties with absent reuptake inhibition of serotonin and noradrenaline and agonism at sigma receptors distinguish opipramol from tricyclics. Furthermore, antidepressive effects are smaller than the anxiolytic ones. The mechanism of action of opipramol is currently not sufficiently understood. Agonistic effects at sigma receptors have been linked with therapeutic effects...
March 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28318209/end-of-life-care-managing-common-symptoms
#6
REVIEW
Ross H Albert
Physicians should be proficient at managing symptoms as patients progress through the dying process. When possible, proactive regimens that prevent symptoms should be used, because it is generally easier to prevent than to treat an acute symptom. As swallowing function diminishes, medications are typically administered sublingually, transdermally, or via rectal suppository. Opiates are the medication of choice for the control of pain and dyspnea, which are common symptoms in the dying process. Delirium and agitation may be caused by reversible etiologies, which should be identified and treated when feasible...
March 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28316304/postoperative-central-anticholinergic-syndrome-is-it-really-that-rare
#7
Celia Y Quang, Scott G Blair, Robert Watson, Sidney B Brevard, Jon D Simmons, Marcus C B Tan
No abstract text is available yet for this article.
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28300854/randomized-placebo-and-active-controlled-crossover-study-of-the-safety-and-efficacy-of-thvd-102-a-fixed-dose-combination-of-oxybutynin-and-pilocarpine-in-subjects-with-primary-focal-hyperhidrosis
#8
David M Pariser, Janakan Krishnaraja, Thomas M Tremblay, R Michael Rubison, Ted W Love, Benjamin F McGraw
BACKGROUND: While muscarinic antagonists (anticholinergics) have shown efficacy in treating primary focal hyperhidrosis (PFH), side effects - most commonly dry mouth - are intolerable for most patients. THVD-102, a fixed-dose combination product has been developed combining oxybutynin, a muscarinic antagonist, and pilocarpine, a muscarinic agonist. The pilocarpine is at a dose level and release profile optimized to correct salivary flow impaired by oxybutynin yet not interfere with the therapeutic muscarinic antagonist effect of oxybutynin upon the sweat glands...
February 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28299770/does-systemic-disease-aggravate-the-severity-of-dry-mouth-by-anticholinergics-in-overactive-bladder-patients
#9
Keon-Cheol Lee, Bong-Mo Seong
PURPOSE: In overactive bladder (OAB) patients with systemic diseases, dry mouth tends to be more prominent owing to the effects of systemic diseases or related medications. We evaluated how systemic diseases affect dry mouth before and after anticholinergic treatment. MATERIALS AND METHODS: OAB patients were enrolled in this study. The patients were divided according to the presence or absence of systemic diseases. Patients with systemic diseases were sub-grouped by the number of systemic diseases (only one or more than one disease)...
March 16, 2017: Urology Journal
https://www.readbyqxmd.com/read/28296334/a-study-on-cyp2c19-and-cyp2d6-polymorphic-effects-on-pharmacokinetics-and-pharmacodynamics-of-amitriptyline-in-healthy-koreans
#10
S Ryu, S Park, J H Lee, Y R Kim, H S Na, H S Lim, H Y Choi, I Y Hwang, J G Lee, Z W Park, W Y Oh, J M Kim, S E Choi
We performed a double-blinded, genotype-based stratification study to explore the pharmacokinetics and pharmacodynamics of amitriptyline according to CYP2C19 and CYP2D6 genotype in Korean subjects. Twenty-four healthy adults were grouped by genotype of CYP2C19 and CYP2D6. After a single dose of 25 mg of amitriptyline, blood samples were collected and anticholinergic effects were measured. The extent of N-demethylation of amitriptyline significantly decreased in subjects carrying two nonfunctional alleles of CYP2C19...
March 2017: Clinical and Translational Science
https://www.readbyqxmd.com/read/28289795/-pharmacological-treatment-of-motor-symptoms-in-parkinson-s-diseases
#11
W H Jost
Since the 1960s many substance classes have been introduced for treatment of idiopathic Parkinson's disease. The most important and effective medication is levodopa (L-dopa) always in combination with a decarboxylase inhibitor. In addition, dopamine agonists, monoamine oxidase B (MAO-B) inhibitors, catechol-o-methyltransferase (COMT) inhibitors, N‑methyl-D-aspartate (NMDA) antagonists and very rarely anticholinergics are administered depending on the motor symptoms, age and a multitude of other factors. Fortunately, within the substance classes there are various preparations, which also have different effects...
March 13, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28288026/delirium-and-mortality-in-critically-ill-children-epidemiology-and-outcomes-of-pediatric-delirium
#12
Chani Traube, Gabrielle Silver, Linda M Gerber, Savneet Kaur, Elizabeth A Mauer, Abigail Kerson, Christine Joyce, Bruce M Greenwald
OBJECTIVES: Delirium occurs frequently in adults and is an independent predictor of mortality. However, the epidemiology and outcomes of pediatric delirium are not well-characterized. The primary objectives of this study were to describe the frequency of delirium in critically ill children, its duration, associated risk factors, and effect on in-hospital outcomes, including mortality. Secondary objectives included determination of delirium subtype, and effect of delirium on duration of mechanical ventilation, and length of hospital stay...
March 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28286993/clinical-and-economic-impact-of-mirabegron-compared-with-antimuscarinics-for-the-treatment-of-overactive-bladder-in-canada
#13
Zalmai Hakimi, Jameel Nazir, Charles McCrea, Malin Berling, Francis Fatoye, Barbara Ramos, Adrian Wagg
BACKGROUND: The β3-adrenoceptor agonist, mirabegron, and antimuscarinic agents provide similar efficacy for the treatment of overactive bladder (OAB), but mirabegron appears to be associated with better persistence, perhaps due to an absence of anticholinergic side-effects. This study estimated the expected costs associated with the management of OAB in Canada from a societal perspective by utilizing real-world evidence. METHODS: An economic model with monthly cycles and a 1-year time horizon was developed to depict a treatment pathway for a hypothetical cohort of 100 patients with OAB...
March 12, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28286067/future-directions-of-research-and-care-for-urinary-incontinence-in-women-findings-from-the-national-institute-of-diabetes-and-digestive-and-kidney-diseases-niddk-summit-on-urinary-incontinence-clinical-research-in-women
#14
REVIEW
Toby C Chai, Tirsit S Asfaw, Jan E Baker, Becky Clarkson, Pamela Coleman, Susan Hoffstetter, Kimberly Konkel, Missy Lavender, Shailaja Nair, Jenna Norton, Leslee Subak, Anthony Visco, Robert A Star, Tamara Bavendam
PURPOSE: Female urinary incontinence (UI) is prevalent, costly, and morbid. Participants in an NIDDK-sponsored summit reviewed findings from NIH-funded clinical research in UI and discussed the future of UI research. MATERIALS AND METHODS: On March 14 2014, the NIDDK convened a "Summit on Urinary Incontinence Clinical Research in Women." Participants representing a broad range of clinical expertise reviewed completed, NIH-sponsored UI-related studies, including results from community-based, epidemiologic studies such as the Boston Area Community Health (BACH) Survey and from randomized clinical trials such as the Program to Reduce Incontinence by Diet and Exercise (PRIDE) and studies conducted by the Pelvic Floor Disorders Network (PFDN) and the Urinary Incontinence Treatment Network (UITN)...
March 9, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28284822/-algorithms-and-urinary-incontinence-in-the-elderly-assessment-treatment-recommendations-and-levels-of-evidence-review
#15
P Meyer
OBJECTIVES: Search processing algorithms in a primary care setting, analyzing the specifics of care management for seniors suffering from urinary incontinence (UI), described the recommendations and levels of evidence of treatment. METHODS: A literature review carried out via PubMed(®) and websites of scientific societies with search keywords classified according to an algorithm. RESULTS: One hundred algorithms have been discovered in the field of evaluation and treatment of UI...
March 8, 2017: Progrès en Urologie
https://www.readbyqxmd.com/read/28280892/antidepressant-pharmacotherapy-in-old-age-depression-a-review-and-clinical-approach
#16
REVIEW
Nathalie Pruckner, Vjera Holthoff-Detto
PURPOSE: Depression in old age is a disabling disease associated with functional and cognitive decline severely affecting quality of life. Studies specifically investigating antidepressant treatment for this special cohort of patients remain scarce and results are often conflicting. A narrative literature review was undertaken, synthesizing findings from published studies, systematic reviews, and treatment guidelines specifically conducted in elderly depressed patients to summarize implications and current recommendations as well as gaps in evidence for old-age pharmacologic treatment...
March 10, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28277890/analysis-of-spatiotemporal-pattern-and-quantification-of-gastrointestinal-slow-waves-caused-by-anticholinergic-drugs
#17
Kelvin K L Wong, Lauren C Y Tang, Jerry Zhou, Vincent Ho
Anticholinergic drugs are well-known to cause adverse effects, such as constipation, but their effects on baseline contractile activity in the gut driven by slow waves is not well established. In a video-based gastrointestinal motility monitoring (GIMM) system, a mouse's small intestine was placed in Krebs solution and recorded using a high definition camera. Untreated controls were recorded for each specimen, then treated with a therapeutic concentration of the drug, and finally, treated with a supratherapeutic dose of the drug...
February 23, 2017: Organogenesis
https://www.readbyqxmd.com/read/28276076/managing-the-oral-side-effects-of-medications-used-to-treat-multiple-sclerosis
#18
N Cockburn, K Pateman, M W Taing, A Pradhan, P J Ford
BACKGROUND: Many medications used to manage multiple sclerosis (MS) affect oral health. This review aimed to identify the oral side effects of the current drugs recommended in Australia to treat MS and make dental practitioners aware of the range of symptoms. METHODS: The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat MS. For each medication, the generic name, class, route of administration, dosage and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (MIMs) database...
March 9, 2017: Australian Dental Journal
https://www.readbyqxmd.com/read/28274871/an-improved-high-efficiency-assay-for-assessing-serum-anticholinergic-activity-using-cultured-cells-stably-expressing-m1-receptors
#19
José N Nobrega, Roger J Raymond, Bruce G Pollock
Assessments of total anticholinergic activity (SAA) in serum are of considerable interest for its potential involvement in cognitive impairment associated with polydrug states in the elderly and other populations. Such estimations have been based on the displacement of radioligand binding in rat brain tissues. The validity of such measurements has been questioned, as a potentially distorting effect of large serum proteins was identified. We sought to develop a modified assay that would be more efficient and free of this potential confound...
March 6, 2017: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/28270954/the-attitudes-of-urologists-and-gynecologists-about-overactive-bladder-and-treatment-of-it-in-turkey-a-questionnaire-survey
#20
Burhan Coşkun, Ömer Bayrak, Murat Dinçer, Kadir Önem, Cenk Gürbüz, Rahmi Onur
OBJECTIVE: We aimed to review the approaches of urologist and gynecologist in the management of overactive bladder (OAB). MATERIAL AND METHODS: A questionnaire consisting of 12 items were answered by 375 urologist and 46 gynecologist. The differences between frequency of encountering OAB, their viewpoints concerning conservative treatment, and their experience related to anticholinergic drug use and the management of refractory OAB were compared. RESULTS: The majority of the urologists, and gynecologists responded to the question "How often do you encounter OAB patients in your daily practice?" as 'in 10-25, and 50% of our patients', respectively (<0...
March 2017: Turkish Journal of Urology
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