Clozapine-Induced Hypersalivation

2000 ◽  
Vol 34 (5) ◽  
pp. 662-665 ◽  
Author(s):  
Liya Davydov ◽  
Sheila R Botts
Keyword(s):  
Case Reports ◽  
Treatment Options ◽  
Receptor Activation ◽  
Data Synthesis ◽  
Search Terms ◽  
Primary Literature ◽  
Adrenoceptor Agonists ◽  
Swallowing Reflex ◽  
Pharmacologic Agents ◽  
Underlying Pathophysiology

OBJECTIVE: To review underlying pathophysiology and possible treatments for clozapine-induced hypersalivation. DATA SOURCES: Primary literature was accessed through MEDLINE (1966–May 1999). Key search terms included clozapine, hypersalivation, sialorrhea, and treatment. DATA SYNTHESIS: Hypersalivation occurs in up to 54% of patients receiving clozapine. An evaluation of studies and case reports focusing on management of clozapine-induced hypersalivation was conducted. CONCLUSIONS: It is unclear whether clozapine increases salivation through its muscarinic M4 receptor activation and/or blockade of α2-adrenoceptors, or by causing a distortion in swallowing reflex. Treatment options include chewing gum, reducing the dosage of clozapine, or prescribing pharmacologic agents such as anticholinergics or α2-adrenoceptor agonists.

Drug-Induced Yawning—A Review

2011 ◽  
Vol 45 (10) ◽  
pp. 1297-1301 ◽  
Author(s):  
Edna Patatanian ◽  
Nancy Toedter Williams
Keyword(s):  
Case Reports ◽  
Data Extraction ◽  
Background Information ◽  
Drug Induced ◽  
Data Synthesis ◽  
Search Terms ◽  
Dopaminergic Agents ◽  
Study Selection ◽  
Physiologic Function ◽  
Induction Agents

Objective: To review the current literature on drug-induced yawning. Data Sources: Literature was accessed through MEDLINE/PubMed (1996-July 2011), International Pharmaceutical Abstracts (1997-July 2011), and EMBASE, using the search terms yawning, drug-induced yawning, and adverse drug reactions. Study Selection and Data Extraction: Relevant clinical trials and case reports were selected and included to present background information. Bibliographies of all relevant articles were reviewed for additional citations. Data Synthesis: Yawning is a common stereotype behavior with unknown physiologic function that occurs in most vertebrates and humans as early as 15 weeks of intrauterine life. Yawning Is under the control of several neurotransmitters and neuropeptides, Including dopamine, serotonin, oxytocin, and acetylcholine. Among drugs, antidepressants, opioids, dopaminergic agents, benzodiazepines, and induction agents are the main pharmacologic classes associated with yawning. Conclusions: Yawning is rarely a serious adverse reaction and is not frequently listed in the drug summary. Most available data are based on case reports, small studies, and older literature. Clinicians should be aware of the agents commonly triggering this behavior.

Isotretinoin and Psychiatric Illness in Adolescents and Young Adults

2003 ◽  
Vol 37 (7-8) ◽  
pp. 1124-1127 ◽  
Author(s):  
Shelly J Enders ◽  
Jason M Enders
Keyword(s):  
Young Adults ◽  
Causal Relationship ◽  
Psychiatric Illness ◽  
Case Reports ◽  
Data Sources ◽  
Adolescents And Young Adults ◽  
Data Synthesis ◽  
Primary Literature ◽  
Key Terms ◽  
The Relationship

OBJECTIVE: To evaluate the relationship between isotretinoin and psychiatric illness in adolescents and young adults. DATA SOURCES: Primary literature located via MEDLINE (1966–December 2002). Key terms were isotretinoin, depression, psychosis, suicide, and adolescents. DATA SYNTHESIS: Information regarding depression was added to isotretinoin labeling in 1998 following a series of case reports and submitted to the MedWatch system. CONCLUSIONS: Although a causal relationship may exist between isotretinoin and psychiatric illness in adolescents and young adults, this has not been demonstrated in the literature. Until evidence establishes a presence or lack of causality, prescribers should exercise caution when treating adolescents and young adults with isotretinoin.

Nebulized Morphine for Relief of Dyspnea Due to Chronic Lung Disease

2005 ◽  
Vol 39 (6) ◽  
pp. 1088-1092 ◽  
Author(s):  
Sherrill J Brown ◽  
Samantha F Eichner ◽  
Jennifer R Jones
Keyword(s):  
Lung Disease ◽  
Chronic Lung Disease ◽  
Case Reports ◽  
Data Sources ◽  
Pulmonary Diseases ◽  
Efficacy And Safety ◽  
Data Synthesis ◽  
Disease States ◽  
Search Terms ◽  
Chronic Pulmonary Diseases

OBJECTIVE: To evaluate the efficacy and safety of nebulized morphine for the management of dyspnea in chronic pulmonary diseases. DATA SOURCES: MEDLINE (1966–May 2004), EMBASE (1980–May 2004), and International Pharmaceutical Abstracts (1970–May 2004) searches were performed. Key search terms included morphine, dyspnea, and inhalation. DATA SYNTHESIS: Nine studies have evaluated the efficacy of nebulized morphine in relieving dyspnea. Three trials had positive resuts, but the rest failed to show improvement after treatment with doses ranging from 1 to 40 mg nebulized morphine. The small number of subjects, variety of disease states, and different outcome measures limit interpretation of the studies. CONCLUSIONS: Results from several small studies do not support the use of nebulized morphine for treatment of dyspnea; however, several positive case reports have been published.

Review of Serum Voriconazole Concentrations and Correlations with Adverse Events and Efficacy

2009 ◽  
Vol 25 (3) ◽  
pp. 183-189
Author(s):  
Michael J Latran
Keyword(s):  
Adverse Events ◽  
Fungal Infections ◽  
Case Reports ◽  
Elevated Serum ◽  
Therapeutic Drug ◽  
Serum Concentrations ◽  
Efficacy And Safety ◽  
Data Synthesis ◽  
Additional Information ◽  
Search Terms

Objective: To review the available evidence regarding the monitoring of serum voriconazole concentrations in terms of efficacy and safety. Data Sources: A literature search of MEDLINE was conducted (1950–February 2009), with combinations of the following search terms: voriconazole, therapeutic drug monitoring, voriconazole serum concentrations, voriconazole levels, trough, and adverse events. Data Collection: All studies and case reports that evaluated serum voriconazole concentrations in adults were reviewed and considered for inclusion. Citations in identified articles were searched for additional information. Data Synthesis: Ten studies and case reports that evaluated serum voriconazole concentrations in terms of efficacy and safety in adults were identified and included in this review. Results from efficacy studies show an association between low serum voriconazole concentrations and disease progression. One study found that a lack of response occurred more often in patients with a serum voriconazole trough of 1 μg/mL or less (p = 0.02). Another study found that patients were more likely to fail voriconazole therapy for invasive fungal infections when serum concentrations were less than or equal to 2 μg/mL. In terms of safety, 6 studies showed an association between elevated serum voriconazole concentrations and adverse events. Conclusions: Available data suggest that serum voriconazole concentrations of 1 μg/mL or less are associated with therapeutic failures, whereas serum voriconazole concentrations of 6 μg/mL or more are associated with adverse events. Studies show that monitoring serum voriconazole concentrations may decrease the incidence of adverse events while increasing efficacy.

Levodopa Therapy and the Risk of Malignant Melanoma

2000 ◽  
Vol 34 (3) ◽  
pp. 382-385 ◽  
Author(s):  
Jolene F Siple ◽  
Diana C Schneider ◽  
Wendy A Wanlass ◽  
Burton K Rosenblatt
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Malignant Melanoma ◽  
English Language ◽  
Case Reports ◽  
Levodopa Therapy ◽  
Data Sources ◽  
Data Synthesis ◽  
Medline Search ◽  
Search Terms

OBJECTIVE: To evaluate the use of levodopa therapy in patients with Parkinson's disease and malignant melanoma. DATA SOURCES: A MEDLINE search (January 1966–September 1999) of English-language articles was conducted. Key search terms included levodopa, melanoma, and Parkinson's disease; 34 case reports were identified. DATA SYNTHESIS: Carbidopa/levodopa continues to be a mainstay in the treatment of Parkinson's disease. Since the late 1970s, a warning has appeared in the prescribing literature for levodopa regarding the risk of activating malignant melanoma. An evaluation was conducted of the case reports in which a causal relationship between levodopa and melanoma was suggested. CONCLUSIONS: There is an unlikely association between levodopa and induction or exacerbation of malignant melanoma.

Treatment of Listeriosis

2000 ◽  
Vol 34 (5) ◽  
pp. 656-661 ◽  
Author(s):  
Mary E Temple ◽  
Milap C Nahata
Keyword(s):  
Treatment Options ◽  
Alternative Therapies ◽  
Second Line ◽  
Data Synthesis ◽  
Disease States ◽  
Drug Of Choice ◽  
Search Terms ◽  
Food Borne ◽  
Clinical Literature ◽  
Food Borne Illness

OBJECTIVE: To review the most currently accepted treatment options for the treatment of listeriosis. DATA SOURCES: Clinical literature was accessed through MEDLINE (1966–October 1999). Key search terms included Li steria monocytogenes, food-borne illness, penicillins, fluoroquinolones, cephalosporins, and vancomycin. DATA SYNTHESIS: Listeriosis is mainly a food-borne illness caused by L. monocytogenes;people most prone to the disease are pregnant women, newborns, elderly, and those with HIV or other diseases compromising immunity. Listeria infections are associated with a high mortality rate, and thus effective antibiotic treatment is essential. Although a variety of antibiotics have activity against the organism, ampicillin alone or in combination with gentamicin remains the treatment of choice. Some patients may require alternative therapies due to allergies or certain disease states. Second-line agents for these cases include trimethoprim/ sulfamethoxazole, erythromycin, vancomycin, and the fluoroquinolones. Cephalosporins are not active against Listeria. CONCLUSIONS: Ampicillin is currently the drug of choice for treating L. monocytogenes infections. Many antibiotics have been shown to be effective and are used as second-line agents. However, further study is required for some of the most recently introduced antibiotics, such as the fluoroquinolones, to determine their place in the treatment of Listeriainfections.

Drug-Associated Guillain-Barré Syndrome: A Literature Review

1996 ◽  
Vol 30 (2) ◽  
pp. 173-180 ◽  
Author(s):  
Ingrid E Awong ◽  
Kenneth R Dandurand ◽  
Christopher A Keeys ◽  
Felix A Khin Maung-Gyi
Keyword(s):  
English Language ◽  
Human Subjects ◽  
Case Reports ◽  
Guillain Barre Syndrome ◽  
Current Management ◽  
Data Synthesis ◽  
Search Terms ◽  
Chemically Induced ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

OBJECTIVE: To present an overview of reported drug-associated Guillain-Barré syndrome (GBS) and current management of the disease. DATA SOURCES: Case reports and reviews of drug-associated GBS published in the English-language literature from 1982 through 1994 were retrieved from MEDLINE. An additional search was done through the Iowa Drug Information System for the same period. This search yielded incidents that occurred as early as 1976. The key search terms were GBS, polyneuropathy, chemically induced polyradiculoneuropathy, and etiology of GBS. The searches were limited to human subjects. DATA SYNTHESIS: Drugs that have been associated with GBS are presented, and although no definite relationships have been established, selected reports attempt to show an increased incidence of GBS after drug therapy. Outcome of medical management of GBS has been variable; however, death occurs in less than 10% of those affected. CONCLUSIONS: GBS and clinically similar states have been reported to occur with a variety of drugs and biologics; however, because of the paucity of available data a well-defined cause and effect relationship has not been established between GBS and any drug. There appears to be no treatment of choice for this disorder. Further comparative studies should be done to determine the therapy with the most consistent outcome.

Fomepizole as an Antidote for Ethylene Glycol Poisoning

2002 ◽  
Vol 36 (6) ◽  
pp. 1085-1089 ◽  
Author(s):  
Marisa Battistella
Keyword(s):  
Ethylene Glycol ◽  
English Language ◽  
Case Reports ◽  
Controlled Trial ◽  
Prospective Trial ◽  
Data Synthesis ◽  
Medline Search ◽  
Randomized Controlled ◽  
Search Terms ◽  
Ethylene Glycol Poisoning

OBJECTIVE: To assess the use of fomepizole in the treatment of ethylene glycol poisoning in the absence of hemodialysis. DATA SOURCES: A MEDLINE search (1966–May 2001) of English-language literature pertaining to the use of fomepizole in ethylene glycol poisoning was performed. Key search terms included fomepizole, ethylene glycol poisoning, and hemodialysis. References cited in those articles were also evaluated. DATA SYNTHESIS: Results from a number of case reports and a prospective trial suggest that fomepizole is a safe and effective antidote in the treatment of ethylene glycol poisoning. CONCLUSIONS: Case reports and 1 prospective trial have shown that, in the absence of both renal dysfunction and significant metabolic acidosis, the use of fomepizole should obviate the need for hemodialysis. However, the decision to add hemodialysis in the treatment of ethylene glycol poisoning based on plasma ethylene glycol concentrations is still debatable. A randomized, controlled trial is needed to determine the exact criteria for adding hemodialysis.

scholarly journals 185 Second Generation Antipsychotics and Catatonia: A Literature Review

CNS Spectrums ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 105-106
Author(s):  
Ryan Slauer ◽  
Mina Boazak ◽  
Michael Lowley ◽  
Jeffrey Lawrence ◽  
Zachary Hudson ◽  
...  
Keyword(s):  
Second Generation ◽  
Case Reports ◽  
Controlled Trial ◽  
Treatment Options ◽  
Antipsychotic Treatment ◽  
Patient Demographics ◽  
Second Generation Antipsychotics ◽  
Psychiatric Units ◽  
Pubmed Search ◽  
Pharmacologic Agents

AbstractIntroductionCatatonia is an underrecognized neuropsychiatric syndrome affecting approximately 10% of individuals hospitalized on inpatient psychiatric units. First-line treatments for this condition include benzodiazepines (BZD) and/or electroconvulsive therapy (ECT). However, 20-40% of individuals do not respond to BZD alone and ECT is not always accessible. Second generation antipsychotics (SGA) have been used to treat catatonia in these circumstances. Here, we review the literature pertaining to the efficacy and safety of SGA in the treatment of catatonia.MethodsWe conducted a PubMed search for articles linking catatonia to antipsychotics, under the search heading “catatonia” or “kahlbaum” and “risperidone”, “amisulpride”, “iloperidone”, “olanzapine”, “aripiprazole”, “paliperidone”, “clozapine”, “brexpiprazole”, or “cariprazine”. Reports commenting on SGA treatment efficacy and/or their role in the development of catatonia were included in the analysis. Selected articles were reviewed for patient demographics, psychiatric/medical history, symptoms, cause of catatonia and treatment, and co-administered agents. For each SGA, we calculated the number of cases in which catatonia was likely improved with antipsychotic treatment, and the number of cases in which catatonia was precipitated or worsened with antipsychotic treatment (improved/worsened ratio). Case data was assessed using the Naranjo Adverse Drug Reaction Probability Scale. Descriptive statistics were used to analyze the data.ResultsAt the time this abstract was written, we reviewed 480 of the original 507 articles. One hundred and seventeen of the 480 met inclusion criteria. There was one randomized controlled trial (RCT), five prospective studies, four retrospective studies and 107 case reports. Of all reviewed literature quetiapine (34:3, 92%), aripiprazole (16:2, 89%), amisulpride (18:1, 95%), andclozapine (19:1, 95%) had the highest improved/worsened ratio, conversely paliperidone (0:5, 0%) had the lowest improved/worsened ratio.ConclusionOf the available literature quetiapine, amisulpride, aripiprazole, and clozapine were found to be relatively safe andeffective as treatment options in catatonia, while palipderidone was found to have reports pointing to its role in the development/worsening, but none on the improvement, of catatonia. These results need to be interpreted with caution. In the majority of cases where SGA’s were effective, patients were co- treated with other pharmacologic agents (most frequently benzodiazepines), making it difficult to assess the role of the antipsychotic alone. Also, given that the preponderance of studies were case reports, publication bias may be an important limitation. Further studies are needed to examine the safety and efficacy of SGA in treating catatonia.Funding AcknowledgementsNo funding.

Possible Association of Benzalkonium Chloride in Nebulizer Solutions with Respiratory Arrest

1992 ◽  
Vol 26 (6) ◽  
pp. 772-774 ◽  
Author(s):  
Michel Boucher ◽  
Myrella T. Roy ◽  
John Henderson
Keyword(s):  
Benzalkonium Chloride ◽  
Active Drug ◽  
Medical Literature ◽  
Case Reports ◽  
Respiratory Arrest ◽  
Data Sources ◽  
Severe Reaction ◽  
Data Synthesis ◽  
Pharmacologic Agents

OBJECTIVE: To report a case of possible association of benzalkonium chloride in nebulizer solutions with respiratory arrest and to review the involvement of various preservative agents in paradoxical bronchoconstrictive reactions. DATA SOURCES: Reference articles, case reports, and editorials are identified in the text. DATA SYNTHESIS: Many pharmacologic agents are available for nebulization. In addition to the active drug, these nebulizer solutions may contain preservatives. We describe a case of respiratory arrest in a 64-year-old man following nebulization therapy with albuterol and ipratropium solutions. These solutions contain benzalkonium chloride as a preservative. We are aware of only one report describing two deaths associated with such a severe reaction attributable to nebulization therapy. However, many reports of milder paradoxical bronchoconstriction are available in the medical literature. CONCLUSIONS: Clinicians should be aware of the possibility of paradoxical bronchoconstrictive reactions when patients are treated with nebulized bronchodilators.

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