The relationship between clozapine dose and plasma level and side effects

SummaryThe plasma level of interleukin-1β (IL-1β) was determined in normal individuals, patients with disseminated intravascular coagulation (DIC), patients in the pre-DIC period (within 7 days before the onset of DIC), and non-DIC patients to examine the relationship between DIC and the plasma ILlp level. The plasma IL-1β level was 0-0.085 ng/ml in normal individuals, with little difference being seen according to related age. It was significantly higher in the DIC group (0.19 ± 0.19 ng/ml) than in the pre-DIC group (0.05 ± 0.08 ng/ml) or the non-DIC group (0.09 ± 0.01 ng/ml). The plasma IL-1β level was not markedly elevated in leukemia patients, even in the DIC group, but it was significantly increased in the DIC group of solid cancer patients and was generally elevated in patients with sepsis. It was markedly elevated to 0.39 ± 0.26 ng/ml in patients with organ failure. When mononuclear cells were incubated with lipopolysaccharide, it was found that IL-1β, tumor necrosis factor, and tissue factor (TF) were released into the medium, and there was an increase of TF release from endothelial cells incubated with this medium. These results suggest that the increase in IL-Iβ reflected the activation of monocytes and may be an important factor in DIC and its associated organ failure.

Download Full-text

Rational use of Metoprolol: The Relationship of Its Blood Concentration to Patient Compliance, Poor Quality Medicines and Side Effects

10.32792/utq/utjmed/16/2/11 ◽

2019 ◽

Keyword(s):

Side Effects ◽

Patient Compliance ◽

Blood Concentration ◽

Poor Quality ◽

Rational Use ◽

Relationship Of ◽

The Relationship

Download Full-text

Side Effects of Clozapine and Their Relationship with Clinical Variables in Patients with Schizophrenia

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2139 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S197-S197

Author(s):

G. Gürcan ◽

Ş. Hun Şenol ◽

A.E. Anıl Yağcıoğlu ◽

A. Ertuğrul

Keyword(s):

Metabolic Syndrome ◽

Side Effects ◽

Plasma Levels ◽

Rating Scale ◽

Clinical Status ◽

Clinical Variables ◽

Clozapine Treatment ◽

Clozapine Dose ◽

Severity Of Disability ◽

Competing Interest

IntroductionThe side effects of clozapine may affect the treatment process negatively, and increase the disability.AimsWe aimed to assess the side effects of clozapine, and their relationship with the clinical variables in schizophrenia patients, and study the predictors of disability.MethodsConsecutive 122 outpatients who met DSM-IV criteria for schizophrenia, and were on clozapine treatment were included in the study. Information about sociodemographic characteristics, past and current clinical status were gathered through a clinical interview and review of the medical records, and physical measures and laboratory tests, including clozapine plasma levels, were recorded. The patients were assessed with SCID-I, Positive and Negative Syndrome Scale, UKU-Side Effect Rating Scale, WHO-Disability Assessment Schedule-II.ResultsHypersalivation, weight gain, sedation and constipation were the most common side effects of clozapine. Although the mean plasma clozapine levels were high (828.11 ± 445.5 ng/mL), no significant effect of clozapine dose and plasma levels were detected on the severity of side effects, except for constipation. Metabolic syndrome prevalence was found to be 50% according to ATP IIIA criteria. Duration of clozapine treatment, clozapine dose and plasma levels were not significantly different between patients with and without metabolic syndrome. Regression analysis showed that the severity of schizophrenia psychopathology and the number of side effects predicted the severity of disability.ConclusionsSide effects of clozapine increase the disability of patients with schizophrenia and should be monitored regularly. On the other hand, clozapine dose and plasma levels do not determine the severity of most of the common side effects.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text

Neurological Complications of Biological Treatment of Psoriasis

Life ◽

10.3390/life12010118 ◽

2022 ◽

Vol 12 (1) ◽

pp. 118

Author(s):

Mateusz Kamil Ożóg ◽

Beniamin Oskar Grabarek ◽

Magdalena Wierzbik-Strońska ◽

Magdalena Świder

Keyword(s):

Nervous System ◽

Side Effects ◽

Biological Treatment ◽

Biological Therapy ◽

Neurological Complications ◽

Tnf Alpha ◽

Biological Drugs ◽

Discontinuation Of Treatment ◽

The Relationship ◽

Alpha Therapy

In the available literature, little attention has been paid to the assessment of psoriasis and the biological therapy used for it and the nervous system. The purpose of this article is to discuss the relationship between psoriasis and the nervous system as well as to analyze the mechanisms that lead to neurological complications during anticytokine therapies in psoriasis. However, this connection requires further analysis. The use of biological drugs in psoriasis, although it yields positive therapeutic results, is not without numerous side effects. Serious neurological side effects of the therapy are most often visible with the use of anti-TNF-alpha, which is why patients should be monitored for their potential occurrence. Early detection of complications and rapid discontinuation of treatment with the drug may potentially increase the patient’s chances of a full recovery or improvement of his/her neurological condition. It also seems reasonable that, in the case of complications occurring during anti-TNF-alpha therapy, some of the drugs from other groups should be included in the therapy.

Download Full-text

The relationship between obesity and plasma level of factor V and fibrinogen

Journal of the Faculty of Medicine Baghdad ◽

10.32007/med.1936/jfacmedbagdad.v59i1.11 ◽

2017 ◽

Vol 59 (1) ◽

pp. 53-59

Author(s):

Halla A. Jabber ◽

◽

Jaffar N. Alsaidissa ◽

Haithem A. Al-Rubaie ◽

◽

...

Keyword(s):

Plasma Level ◽

Factor V ◽

The Relationship

Download Full-text

Toxic Effects of Anticonvulsants: General Principles

PEDIATRICS ◽

10.1542/peds.53.4.551 ◽

1974 ◽

Vol 53 (4) ◽

pp. 551-557

Author(s):

H. Hooshmand

Keyword(s):

Drug Interaction ◽

Side Effects ◽

Toxic Effects ◽

Multiple Drug ◽

Severe Ataxia ◽

Multiple Drug Therapy ◽

Toxic Potential ◽

Therapeutic Doses ◽

Relationship Of ◽

The Relationship

Any drug, regardless of how benign and well tolerated, is potentially toxic. The toxicity may be due to (1) dosage; (2) the size of the patient; (3) drug interaction; (4) drug specificity for the disease; (5) the nature of the disease for which the drug is used; and (6) the mode and frequency of medication. DOSE OF ANTICONVULSANT Dose of anficonvulsant is very important (Table I). Any anticonvulsant in higher than therapeutic doses has toxic potential. It is well known that anticonvulsants in large enough doses can act as convulsants. This is especially true for diphenylhydantoin, benzodiazepines, and lidocaine. THE SIZE OF THE PATIENT The size of the patient should be considered in dosage. It is safer and more accurate to adjust dosage to body surface than to weight (Table I). As the child grows, there may be a need to gradually increase the dose of anticonvulsants if seizure control is poor, or if the serum level of the anticonvulsant starts to decline. DRUG INTERACTION The relationship. of multiple drug therapy and its toxic effects on the brain is quite complicated, and many forms of toxicity can result. Toxicity may be the result of a combination of pharmacologically similar drugs. Such a combination may enhance the side effects of drowsiness and ataxia. The patient may suffer from these side effects without attaining therapeutic levels of individual anticonvulsants in the blood. In other words, a combination of drugs such as phenobarbital and primidone may result in severe ataxia and drowsiness.

Download Full-text

Redefining Beauty

Taking Flight ◽

10.14325/mississippi/9781496828637.003.0005 ◽

2020 ◽

pp. 84-106

Author(s):

Jennifer Donahue

Keyword(s):

Breast Cancer ◽

Body Image ◽

Anorexia Nervosa ◽

Side Effects ◽

Temporary Migration ◽

Elizabeth Nunez ◽

Body Image Ideals ◽

The Relationship

The fourth chapter turns to works by Pauline Melville and Elizabeth Nunez to explore how breast cancer and anorexia nervosa offer physical and emotional renewal for the protagonists. In The Migration of Ghosts, Boundaries, and Anna-In-Between, Melville and Nunez use their characters to question body-image ideals. The works attest to the life-altering impact of disease. The protagonists’ illnesses, rooted in their dis-ease with their bodies, their relationships, and their privilege, highlight the emotional side effects that can accompany physical maladies. In Melville and Nunez’s works, illness functions as the force of inertia that propels temporary migration and the protagonists’ intensely introspective experiences. Together, the texts afford a closer look at the relationship between disease, migration, and familial reconnection.

Download Full-text

Conclusion

Why Delegate? ◽

10.1093/oso/9780190904197.003.0007 ◽

2021 ◽

pp. 162-166

Author(s):

Neil J. Mitchell

Keyword(s):

Side Effects ◽

Professional Responsibility ◽

Principal Agent ◽

Control Problems ◽

Standard Account ◽

Complicated Process ◽

The Relationship ◽

The Church ◽

Police Forces

This chapter explains how the modified logic of delegation differs from the standard account in the treatment of the main parties to the relationship. The principal is a more untrustworthy and at times unresponsive figure in her relationship with the agents. The agent, likely a professional agent, is more complicated than portrayed. Professional responsibility is a mechanism to overcome the trust gap in a delegation relationship, according to principal-agent theorists. But overlooked are the side effects of professionalism, where the loyalties it fosters create tenacious control problems. It has a pronounced form in the church and the army, but other security and police forces may find punishing and controlling rogue agents a complicated process. While the boundaries to delegation are uncertain and some may choose not to delegate as much as they should, blame is one task that will be delegated.

Download Full-text