A Pharmacological Appraisal of Neuroprotective and Neurorestorative Flavonoids Against Neurodegenerative Diseases

2019 ◽  
Vol 18 (2) ◽  
pp. 103-114 ◽  
Author(s):  
Jia Zhao ◽  
Mengxia Zhu ◽  
Mukesh Kumar ◽  
Fung Yin Ngo ◽  
Yinghui Li ◽  
...  
Keyword(s):  
Natural Products ◽  
Side Effects ◽  
Neurodegenerative Diseases ◽  
Elderly Population ◽  
The Elderly ◽  
Novel Therapeutics ◽  
The Core ◽  
Naturally Occurring ◽  
Underlying Mechanisms ◽  
Core Symptoms

Background & Objective: Alzheimer’s disease (AD) and Parkinson’s disease (PD) affect an increasing number of the elderly population worldwide. The existing treatments mainly improve the core symptoms of AD and PD in a temporary manner and cause alarming side effects. Naturally occurring flavonoids are well-documented for neuroprotective and neurorestorative effects against various neurodegenerative diseases. Thus, we analyzed the pharmacokinetics of eight potent natural products flavonoids for the druggability and discussed the neuroprotective and neurorestorative effects and the underlying mechanisms. Conclusion: This review provides valuable clues for the development of novel therapeutics against neurodegenerative diseases.

scholarly journals Amlodipine and the Successful Management of Post-Electroconvulsive Therapy Agitation

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
Ali Shahriari ◽  
Maryam Khooshideh ◽  
Mahdi Sheikh
Keyword(s):  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Elderly Population ◽  
The Elderly ◽  
Medical Intervention ◽  
Successful Management ◽  
Nonpharmacologic Treatment ◽  
Underlying Mechanisms ◽  
Motor Restlessness ◽  
Sedative Agents

Electroconvulsive therapy (ECT) is a highly effective nonpharmacologic treatment for the management of depression and some other psychiatric disorders. Post-ECT agitation occurs in up to 12% of ECT treatments and is characterized by motor restlessness, irritability, disorientation, and panic-like behaviors. The severity of post-ECT agitation ranges from mild and self-limited to serious and severe forms requiring prompt medical intervention to protect the patient and the medical staff. In severe agitation medical management may be necessary which consists of using sedative agents, either benzodiazepines or propofol. The side-effects of these sedative agents, especially in the elderly population, necessitate finding ways that could help the prevention of the occurrence of agitation after ECT treatments. We report a 68-year-old female with major depression who was referred for ECT. She experienced severe post-ECT agitation requiring medical intervention after all ECT treatments. Administering of oral amlodipine (5 mg) one hour before ECT treatment successfully prevented the occurrence of post-ECT agitation in this patient. We briefly discuss the possible underlying mechanisms and pathophysiology of amlodipine in the prevention of post-ECT agitation.

scholarly journals Aromatherapy Versus Pharmaceutical Interventions for Dementia Related Behaviors Translating & Integrating Scholarship Practicum

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Side Effects ◽  
Psychotropic Drugs ◽  
Elderly Population ◽  
The Elderly ◽  
Safe Alternative ◽  
Pharmaceutical Management ◽  
Diagnosis Of Dementia ◽  
Number Of Individuals ◽  
Relaxing Effect ◽  
Pharmaceutical Interventions

The elderly population is expected to double in the next thirty years increasing the number of individuals with the diagnosis of dementia. By proxy, dementia related behaviors such as agitation, anxiety and restless will also increase. Currently, pharmaceutical management of these behaviors include Ativan, Haldol and other psychotropic drugs which have side effects that place individuals at risk for falls and at times even aggravate the behaviors. Although, not widely researched, aromatherapy is a safe alternative to treating Dementia related behaviors. Research shows aromatherapy has a calming and relaxing effect which can be measured physiologically.

Guidelines for treating depressive illness with antidepressants: A statement from the British Association for Psychopharmacology

1993 ◽  
Vol 7 (1_suppl) ◽  
pp. 19-23 ◽  
Author(s):  
Stuart A. Montgomery ◽  
P. Bebbington ◽  
P. Cowen ◽  
W. Deakin ◽  
P. Freeling ◽  
...  
Keyword(s):  
Side Effects ◽  
Depressed Mood ◽  
Antidepressant Treatment ◽  
Depressive Illness ◽  
Social Impairment ◽  
Self Blame ◽  
The Core ◽  
The Right ◽  
Therapeutic Doses ◽  
Core Symptoms

Depression is a common illness which affects some 3% of the population per year. At least 25% of those with marked depression do not consult their general practitioner and in half of those who do the illness is not detected. Depression is easy to recognize when four or five of the core symptoms have been present for 2 weeks which often coincides with some occupational and social impairment. The core symptoms are depressed mood, loss of interest or pleasure, loss of energy or fatigue, concentration difficulties, appetite disturbance, sleep disturbance, agitation or retardation, worthlessness or self blame and suicidal thoughts. A diagnosis of depression is made when five of these core symptoms, one of which should be depressed mood or loss of interest or pleasure, have been present for 2 weeks. Four core symptoms are probably sufficient. Response to antidepressants is good in those with more than mild symptoms. When there are only few or very mild depressive symptoms evidence of response to antidepressants is more uncertain. Antidepressants are effective, they are not addictive and do not lose efficacy with prolonged use. The newer antidepressants have fewer side effects than the older tricyclics, they are better tolerated and lead to less withdrawals from treatment. They are less cardiotoxic and are safer in overdose. Antidepressants should be used at full therapeutic doses. Treatment failure is often due to too low a dose being used in general practice. It may be difficult to reach the right dose with the older tricyclics because of side effects. To consolidate response, treatment should be continued for at least 4 months after the patient is apparently well. Stopping the treatment before this is ill-advised as the partially treated depression frequently returns. Most depression is recurrent. Long-term antidepressant treatment is effective in reducing the risk of new episodes of depression and should be continued to keep the patient well.

scholarly journals Natural Products in Neurodegenerative Diseases: A Great Promise but an Ethical Challenge

2019 ◽  
Vol 20 (20) ◽  
pp. 5170 ◽  
Author(s):  
Marco Di Paolo ◽  
Luigi Papi ◽  
Federica Gori ◽  
Emanuela Turillazzi
Keyword(s):  
Natural Products ◽  
Patient Safety ◽  
Neurodegenerative Diseases ◽  
The Elderly ◽  
Biomedical Ethics ◽  
Point Of View ◽  
Ethical Framework ◽  
Ethical Challenge ◽  
Great Promise ◽  
Mortality And Morbidity

Neurodegenerative diseases (NDs) represent one of the most important public health problems and concerns, as they are a growing cause of mortality and morbidity worldwide, particularly in the elderly. Despite remarkable breakthroughs in our understanding of NDs, there has been little success in developing effective therapies. The use of natural products may offer great potential opportunities in the prevention and therapy of NDs; however, many clinical concerns have arisen regarding their use, mainly focusing on the lack of scientific support or evidence for their efficacy and patient safety. These clinical uncertainties raise critical questions from a bioethical and legal point of view, as considerations relating to patient decisional autonomy, patient safety, and beneficial or non-beneficial care may need to be addressed. This paper does not intend to advocate for or against the use of natural products, but to analyze the ethical framework of their use, with particular attention paid to the principles of biomedical ethics. In conclusion, the notable message that emerges is that natural products may represent a great promise for the treatment of many NDs, even if many unknown issues regarding the efficacy and safety of many natural products still remain.

Psychopharmacological Agents, Side Effects, and Black Box Warnings

2017 ◽  
Author(s):  
Manish A. Fozdar ◽  
Jacob C. Holzer
Keyword(s):  
Side Effects ◽  
Elderly Population ◽  
Treatment Options ◽  
Management Strategies ◽  
The Elderly ◽  
Mood Stabilizers ◽  
Pharmacological Management ◽  
Risk Management Strategies ◽  
Black Box Warnings ◽  
Sedative Hypnotics

From a medical-legal viewpoint, psychopharmacological management in the elderly population requires a multifaceted, comprehensive approach, involving a detailed clinical diagnostic assessment, an awareness of a patient’s current medical status, risk factors, and an understanding of the risks and benefits of various treatment options. Several risk management strategies can be employed as part of the treatment process, which are reviewed in this chapter. Special attention is needed in the pharmacological management of the elderly population with respect to efficacy and risk as well as polypharmacy. It is important that clinicians have a broad understanding of the different medication classes, including antidepressants, antipsychotics, mood stabilizers, cognitive-enhancing medications, benzodiazepines, sedative-hypnotics, and stimulants; specific agents; indications; kinetics; and side effects in both the clinical management of elderly patients and in medical-legal consultation.

Clozapine: Serious Adverse Side Effects, Drug Interactions, and Other Complications of Therapy

1996 ◽  
Vol 9 (2) ◽  
pp. 118-129 ◽  
Author(s):  
Deanna M. Guith
Keyword(s):  
Side Effects ◽  
Health Care Professionals ◽  
Elderly Population ◽  
Adverse Reactions ◽  
Psychotic Disorders ◽  
Antipsychotic Agent ◽  
The Elderly ◽  
Pharmacological Properties ◽  
Treatment Resistant ◽  
Clozapine Therapy

Clozapine (Clozaril®, Sandoz, East Hanover, NJ), an atypical antipsychotic agent with pharmacological properties considerably different from standard neuroleptics, has been found to be of great benefit especially to patients with treatment-resistant psychotic disorders. However, it is these unique pharmacological properties that have also been associated with mul tiple side effects ranging from the relatively benign (ie, sialorrhea during sleep, dizziness) to the potentially fatal (ie, agranulocytosis, seizures, and respiratory depression) which have limited its use. These untoward side effects are particularly problematic in the elderly population who often have concomitant medi cal illnesses requiring multiple medication regimens, including psychotropics that may interact with cloza pine (ie, benzodiazepines, cimetidine, fluoxetine). Because even the most benign of side effects has the potential of becoming fatal in certain circumstances if left unaddressed, it is imperative for patients, clinicians, pharmacists, and all health care professionals to be aware of adverse reactions and possible complica tions of clozapine therapy to prevent significant morbidity and mortality. Copyright © 1996 by W.B. Saunders Company

140 Midodrine Hydrochloride in the Management of Elderly Patients with Neurocardiogenic Syncope: A Prospective Observational Study

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv34-iv39
Author(s):  
Angelene Teo ◽  
Arturo Vilches-Moraga ◽  
John Staniland
Keyword(s):  
Side Effects ◽  
Observational Study ◽  
Orthostatic Hypotension ◽  
Elderly Population ◽  
Prospective Observational Study ◽  
Adverse Reactions ◽  
Vasovagal Syncope ◽  
The Elderly ◽  
Hair Follicles ◽  
Neurocardiogenic Syncope

Abstract Background Midodrine hydrochloride is an alpha-1 agonist that has been used in the management of syncope in patients with orthostatic hypotension, vasovagal syncope and vasodepressor carotid sinus syndrome when non-pharmacological means have failed. However, there are very limited information about its use, tolerability and side effects among the elderly population. Objectives We aim to document effectiveness of Midodrine in patients who have been diagnosed with neurocardiogenic syncope assessed and managed at a specialist falls and syncope outpatient unit. We monitored for changes in patients' symptoms, adverse reactions reported and optimum drug dosages that have shown benefit in this cohort of patients. Methods A prospective observational study of 33 subjects aged between 68 and 94 (mean age 79) who have been started on Midodrine therapy following positive tilt table test or confirmed diagnosis of symptomatic orthostatic hypotension despite conservative managements. They have been followed up for a mean of 2.9 years. Results 81% of patients( n=27) reported significant improvement in their symptoms. Although 7 patients reported adverse reactions to Midodrine, the majority of the patients tolerated the therapy well and continued on the treatment except for one patient who experienced gastrointestinal discomfort and withdrew completely. Commonest side effects are pruritus and piloerection, but they are not amenable to treatment due to underlying mechanism of action of Midodrine on hair follicles. The dosage varies from 2.5mg to 10mg, taken at 8am, 12pm and 5pm due to risk of nocturnal supine hypertension. Higher dose did not correlate with higher possibility of experiencing side effects. Conclusion Midodrine appears to be effective, safe and well tolerated among the elderly population. It should be considered in the management of patients with neurocardiogenic syncope when non-pharmacological means have failed, irrespective of age. This observational study requires further confirmation by randomised control studies with larger sample size.

Prevalence of opioid dispensings and concurrent gastrointestinal medications in an elderly population from Ontario, Canada

2018 ◽  
Vol 4 (4) ◽  
pp. 193 ◽  
Author(s):  
Rachel Williams, PhD, MS ◽  
Nevzeta Bosnic, BA ◽  
Ashlee W. Duncan, PhD, MS ◽  
Michael Brogan, BA ◽  
Suzanne F. Cook, PhD
Keyword(s):  
Side Effects ◽  
Elderly Population ◽  
Prophylactic Treatment ◽  
Opioid Analgesics ◽  
The Elderly ◽  
Therapeutic Agents ◽  
Drug Benefit ◽  
Cohort Design ◽  
Age Related ◽  
Prophylactic Use

Background: Although opioid analgesics are effective therapeutic agents, gastrointestinal (GI) side effects represent a challenging consequence of treatment. In an elderly population, age-related physiological changes, such as decreased GI functioning and dehydration, may compound the adverse effects of opioids; therefore, appropriate prophylactic treatment, utilizing laxatives and/or acid suppressants, is particularly important in an elderly population.Aim: This study describes the prevalence of outpatient opioid dispensings and the concomitant dispensing of opioids and GI medications in a population 65 years or older enrolled in the Ontario Drug Benefit Program in 2005.Methods: Using a retrospective cohort design, dispensings of opioids, laxatives, and acid suppressants were identified using claims reimbursement data. Concurrent dispensings were defined as having at least one “GI medication-dispensed day” overlapping an “opioid-dispensed day.”Results: More than 18 percent of the elderly, drug plan population was dispensed an opioid in 2005. Women had more opioid dispensings and were dispensed opioids for extended periods of time as compared with men. Approximately half of patients with an opioid dispensing were concomitantly dispensed a GI medication; these medications were dispensed nearly twice as frequently among people with chronic opioid dispensings when compared with people with nonchronic opioid dispensings.Conclusions: Although laxatives are commonly recommended in patients taking opioids, only half of the older adults in Ontario who were dispensed an opioid also received a concomitant GI medication dispensing. As the elderly are more likely to develop opioid-induced constipation, the prophylactic use of laxatives and/or acid suppressant medications is often necessary to mitigate the side effects associated with their pain management.

Growth Hormone: Myths and Misconceptions

1996 ◽  
Vol 5 (3) ◽  
pp. 244-250
Author(s):  
Valerie J. Wirth ◽  
Joe Gieck
Keyword(s):  
Growth Hormone ◽  
Adipose Tissue ◽  
Side Effects ◽  
Elderly Population ◽  
The Elderly ◽  
Fat Free Mass ◽  
Hormone Deficiency ◽  
Adipose Tissue Volume ◽  
The Many ◽  
Positive Results

Growth hormone is one of the many dangerous and illegal ergogenic aids currently used by athletes. In those who suffer from a growth hormone deficiency, supplementation does produce positive results: Muscle volume increases while adipose tissue volume is significantly reduced. Growth hormone supplementation can also lead to strength increases in the deficient population (2, 6, 13) as well as in the elderly population (16, 18, 25). In healthy young men, growth hormone supplementation has been shown to increase fat-free mass and to decrease fat mass. However, these changes are not accompanied by strength gains (5, 7, 23, 24). This finding, coupled with the numerous side effects associated with the drug, presents a strong case for athletes to abandon its use as an ergogenic aid.

scholarly journals Synthesis of the tetracyclic core of Illicium sesquiterpenes using an organocatalyzed asymmetric Robinson annulation

2013 ◽  
Vol 9 ◽  
pp. 1135-1140 ◽  
Author(s):  
Lynnie Trzoss ◽  
Jing Xu ◽  
Michelle H Lacoske ◽  
Emmanuel A Theodorakis
Keyword(s):  
Natural Products ◽  
Neurodegenerative Diseases ◽  
Therapeutic Potential ◽  
Enantioselective Synthesis ◽  
Diversity Oriented Synthesis ◽  
Efficient Approach ◽  
The Core ◽  
Tetracyclic Core ◽  
Robinson Annulation ◽  
Core Framework

An enantioselective synthesis of the core framework of neurotrophic Illicium majucin-type sesquiterpenes is described here. This strategy is based on an organocatalyzed asymmetric Robinson annulation and provides an efficient approach for a diversity-oriented synthesis of Illicium natural products that holds remarkable therapeutic potential for neurodegenerative diseases.

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