scholarly journals Glukokortikoidi v nefrologiji I: farmakologija in stranski učinki

2015 ◽  
Vol 84 (3) ◽  
Author(s):  
Jernej Pajek ◽  
Mojca Jensterle Sever
Keyword(s):  
Side Effects ◽  
Mode Of Action ◽  
Withdrawal Syndrome ◽  
Clinical Medicine ◽  
Ongoing Research ◽  
Organ Systems ◽  
Genomic Effects ◽  
Higher Doses

Glucocorticoids have been used in clinical medicine since 1940s. Despite the time-long use they are still a subject of active ongoing research. We describe the mode of action, pharmacology and side effects to enable proper prescription of these drugs. Glucocorticoids exert genomic and non-genomic effects, the latter become important at higher doses. The nomenclature of dosage ranges and the principles of dosage adjustments are given. Glucocortioid use is associated with frequent and important side effects in numerous organ systems. Prophylactic treatments for osteoporosis and infections are described. The suppression of hypothalamic-hypophyseal hormonal axis determines the need for gradual glucocorticoid withdrawal and supplementation after discontinuation. Finally, glucocorticoid withdrawal syndrome is described.

Oral Sildenafil in the Treatment of Erectile Dysfunction

2021 ◽  
pp. 245-250
Author(s):  
Joshua Bodie
Keyword(s):  
Erectile Dysfunction ◽  
Side Effects ◽  
Sexual Activity ◽  
Once Daily ◽  
Higher Doses ◽  
Different Doses ◽  
Visual Disturbances ◽  
Better Than

This chapter summarizes the results of a landmark trial comparing different doses of oral sildenafil versus placebo to treat erectile dysfunction. Patients received either an identical placebo or 25- mg, 50-mg, or 100-mg tablets of sildenafil to be taken approximately one hour before planned sexual activity (but not more than once daily) for 24 weeks. Higher doses of sildenafil resulted in higher mean score for frequency of penetration and maintenance of erection, which were also consistently better than placebo. The most common side effects were headaches, flushing, dyspepsia, rhinitis, and visual disturbances. This study established sildenafil as an effective, reasonably well-tolerated treatment for men with erectile dysfunction of varying etiologies.

Monoamine Agonists (“Antidepressants”), Including Dopamine Agonists (“Stimulants”)

2018 ◽  
pp. 85-100
Author(s):  
S. Nassir Ghaemi
Keyword(s):  
Clinical Pharmacology ◽  
Side Effects ◽  
Sexual Dysfunction ◽  
Drug Interactions ◽  
Psychotropic Drugs ◽  
Withdrawal Syndrome ◽  
Serotonin Reuptake ◽  
Dopamine Agonists ◽  
Serotonin Reuptake Inhibitors ◽  
Norepinephrine Reuptake

The drug class of monoamine agonists includes agents called antidepressants and stimulants. Monoamine agonists are the most widely used class of psychotropic drugs. There are three major monoamines, and thus three main types of monoamine agonists. We consider each in turn: the serotonin reuptake inhibitors (SRIs), norepinephrine reuptake inhibitors (NRIs), and dopaminergic agents. We also discuss the dopamine agonists—bupropion (Wellbutrin) and amphetamines (“stimulants”), as well as other new monoamine agonists. The clinical pharmacology of specific agents within each class, including their efficacy and side effects, is explored. Specific phenomena surveyed include SRI tolerance, sexual dysfunction, drug interactions, serotonin withdrawal syndrome, and suicide and akathisia.

scholarly journals Emetine Is Not Ipecac: Considerations for Its Use as Treatment for SARS-CoV2

2020 ◽  
Vol 13 (12) ◽  
pp. 428
Author(s):  
Martin D. Bleasel ◽  
Gregory M. Peterson
Keyword(s):  
Side Effects ◽  
Viral Inhibition ◽  
Response Data ◽  
Spanish Influenza ◽  
The Past ◽  
Inhibition Data ◽  
Potential Mode ◽  
Pure Drug ◽  
Anti Inflammatory ◽  
Higher Doses

Emetine is a potent antiviral that acts on many viruses in the low-nM range, with several studies in animals and humans demonstrating antiviral activity. Historically, emetine was used to treat patients with Spanish influenza, in the last stages of the pandemic in the early 1900s. Some of these patients were “black” with cyanosis. Emetine rapidly reversed the cyanosis and other symptoms of this disease in 12–24 h. However, emetine also has been shown to have anti-inflammatory properties and it appears it is these anti-inflammatory properties that were responsible for the effects seen in patients with Spanish influenza. Emetine, in the past, has also been used in 10s to 100s of millions of people at a dose of ~60 mg daily to treat amoebiasis. Based on viral inhibition data we can calculate a likely SARS-CoV2 antiviral dose of ~1/10th the amoebiasis dose, which should dramatically reduce the risk of any side effects. While there are no anti-inflammatory dose response data available, based on the potential mode of action, the anti-inflammatory actions may also occur at low doses. This paper also examines the toxicity of emetine seen in clinical practice and that seen in the laboratory, and discusses the methods of administration aimed at reducing side effects if higher doses were found to be necessary. While emetine is a “pure drug” as it is extracted from ipecac, some of the differences between emetine and ipecac are also discussed.

Recommendations for Monitoring Lithium Therapy

1983 ◽  
Vol 17 (5) ◽  
pp. 346-350 ◽  
Author(s):  
Ronald B. Salem
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Serum Levels ◽  
Normal Serum ◽  
Lithium Therapy ◽  
Organ Systems

The literature concerning side effects of normal serum levels of lithium on various organ systems is reviewed. Suggestions for monitoring and managing these adverse effects are discussed. A table is presented that provides recommendations for evaluation prior to initiation and during follow-up of therapy.

Autoimmunity associated with immunotherapy of cancer

Blood ◽  
2011 ◽  
Vol 118 (3) ◽  
pp. 499-509 ◽  
Author(s):  
Sally M. Amos ◽  
Connie P. M. Duong ◽  
Jennifer A. Westwood ◽  
David S. Ritchie ◽  
Richard P. Junghans ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Monoclonal Antibodies ◽  
Side Effects ◽  
Cell Transfer ◽  
Serious Adverse Events ◽  
Normal Tissues ◽  
Immune Mediated ◽  
Organ Systems ◽  
Immunotherapy Of Cancer ◽  
Future Potential

Abstract In this age of promise of new therapies for cancer, immunotherapy is emerging as an exciting treatment option for patients. Vaccines and cytokines are being tested extensively in clinical trials, and strategies using monoclonal antibodies and cell transfer are mediating dramatic regression of tumors in patients with certain malignancies. However, although initially advocated as being more specific for cancer and having fewer side effects than conventional therapies, it is becoming increasingly clear that many immunotherapies can lead to immune reactions against normal tissues. Immunotoxicities resulting from treatment can range from relatively minor conditions, such as skin depigmentation, to severe toxicities against crucial organ systems, such as liver, bowel, and lung. Treatment-related toxicity has correlated with better responses in some cases, and it is probable that serious adverse events from immune-mediated reactions will increase in frequency and severity as immunotherapeutic approaches become more effective. This review introduces immunotherapeutic approaches to cancer treatment, provides details of toxicities arising from therapy, and discusses future potential ways to avoid or circumvent these side effects.

scholarly journals Comparative endocrine disrupting effects of abamectin and indoxacarb insecticides

2016 ◽  
Vol 4 (1) ◽  
pp. 89
Author(s):  
Atef Nassar
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Mode Of Action ◽  
Management Program ◽  
Plant Pests ◽  
Wide Range ◽  
Endocrine Disrupting ◽  
Chemical Groups ◽  
Pronounced Reduction ◽  
Follicular Stimulating Hormone

Abamectin and indoxacarb are relatively new insecticides with different mode of action and are applied to control a wide range of plant pests. However, their side effects to mammals are not fully studied. Accordingly, current study aimed to compare the adverse effects of both insecticides against the endocrine biomarkers: triiodothyronine (T3), tetraiodothyronine (T4), follicular-stimulating hormone (FSH), progesterone, and testosterone. These parameters were measured after orally-injecting rats with 1/20 LD50 doses of each of abamectin and indoxacarb for 60 days. Results showed that indoxacarb had pronounced reduction in the contents of T3 and FSH hormones compared to control and abamectin. Also, indoxacarb increased testosterone level compared to abamectin. T4 level was reduced by abamectin treatment compared to indoxacarb. Progesterone content was significantly increased after the abamectin treatment, while it was decreased after the indoxacarb treatment. However, the tested insecticides belong to avermectins and oxadiazine chemical groups that have different mode of action. They showed some similarity in their effect on T3, T4, and FSH, except for the progesterone hormone that showed a contradicting response. These two insecticides were marked as safe but current study highlight the need for caution during their application in the integrated pest management program.

Management of polyuria in autosomal dominant polycystic kidney disease after treatment with tolvaptan: an educational approach

2020 ◽  
Vol 5 (1) ◽  
pp. 26-29
Author(s):  
Elena Brioni ◽  
Cristiano Magnaghi ◽  
Marco Silingardi
Keyword(s):  
Chronic Kidney Disease ◽  
Side Effects ◽  
Kidney Disease ◽  
Mode Of Action ◽  
Autosomal Dominant ◽  
Educational Programme ◽  
Polycystic Kidney ◽  
Educational Approach ◽  
Autosomal Dominant Polycystic Kidney ◽  
Stage 1

Tolvaptan is the first drug to be approved for delaying the progression of autosomal dominant polysystic disease in adults with stage 1–3 chronic kidney disease. Its mode of action, however, results in polyuria. An adequate educational programme is required to help individuals maintain adherence to the medication and deal with the side-effects.

scholarly journals Ranking Self-reported Gastrointestinal Side Effects of Pharmacotherapy in Sarcoidosis

Lung ◽  
2020 ◽  
Vol 198 (2) ◽  
pp. 395-403 ◽  
Author(s):  
M. Drent ◽  
V. L. J. Proesmans ◽  
M. D. P. Elfferich ◽  
N. T. Jessurun ◽  
S. M. G. de Jong ◽  
...  
Keyword(s):  
Weight Gain ◽  
Side Effects ◽  
Side Effect ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Future Research ◽  
Dietary Interventions ◽  
Cross Sectional ◽  
Organ Systems ◽  
Gastrointestinal Side Effects

Abstract Background Clinical manifestations of sarcoidosis vary widely, depending on the intensity of the inflammation and the organ systems affected. So far, no curative treatment exists; the disease can only be suppressed. All treatment options cause side effects affecting quality of life. The aim of this study was to establish and rank the prevalence of self-reported gastrointestinal side effects of drugs used in the treatment of sarcoidosis. Methods A cross-sectional web-based anonymous survey about complaints and side effects was conducted among sarcoidosis patients in the Netherlands, United Kingdom, and United States of America. Results Of the participants, 70% were being treated with one or more drugs. The most important reported side effect was weight gain, associated with increased appetite among prednisone users (as monotherapy as well as in combination with other drugs). Methotrexate (MTX) users especially experienced nausea, with monotherapy as well as combination therapy. Vomiting and weight loss were most prominent among azathioprine and mycophenolate mofetil (MMF) users, whereas diarrhoea was frequently mentioned by MMF and MTX users. The reported side effects of hydroxychloroquine were generally rather mild. Conclusion The current study ranked the gastrointestinal side effects associated with pharmacotherapy in sarcoidosis patients. Pharmacotherapy does have multiple gastrointestinal side effects. The strongest association between a reported side effect and drug use was that of weight gain associated with increased appetite among prednisone users. It would therefore be useful for future research to look further into dietary interventions to counter these side effects and reduce their burden.

Withdrawal Reactions Associated with Venlafaxine

1998 ◽  
Vol 32 (2) ◽  
pp. 291-294 ◽  
Author(s):  
Gordon Parker ◽  
Jenny Blennerhassett
Keyword(s):  
Single Dose ◽  
Side Effects ◽  
Clinical Picture ◽  
Withdrawal Syndrome ◽  
Withdrawal Symptoms ◽  
Selective Serotonin ◽  
Short Acting ◽  
Severe Withdrawal ◽  
Uptake Inhibitors

Objective: The aim of this paper is to describe discontinuation syndromes associated with abrupt and tapered withdrawal of venlafaxine, and to document that withdrawal symptoms may occur after missing a single dose. Clinical picture: We report on two patients prescribed venlafaxine. One developed a broad range of serious side effects after reaching a dose of 300 mg a day, and a severe withdrawal syndrome (including hallucinations) during a slow taper regime. The second had severe discontinuation symptoms during and aborting a slow taper regime, and described withdrawal responses after missing a single dose of venlafaxine. Conclusions: As for the short-acting selective serotonin re-uptake inhibitors, severe discontinuation reactions may occur with venlafaxine, seemingly marked most distinctly by headache, nausea, fatigue, dizziness and dysphoria, and may make cessation of the drug extremely difficult. Two strategies for addressing the concern are considered.

Acute Painful Radiculopathy After Intrathecal Rituximab

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4920-4920
Author(s):  
Jacoline Bromberg ◽  
Jeanette Doorduyn ◽  
Johanna W. Baars ◽  
Gustaaf Van Imhoff ◽  
Roelien Enting ◽  
...  
Keyword(s):  
Side Effects ◽  
Research Funding ◽  
Phase Ii Study ◽  
Intrathecal Administration ◽  
Intrathecal Methotrexate ◽  
Intraventricular Administration ◽  
Off Label Use ◽  
Off Label ◽  
Prospective Phase ◽  
Higher Doses

Abstract Abstract 4920 Within a prospective phase II study (HOVON 80) of patients with recurrent diffuse large B-cel lymphoma in the CNS, three of 13 patients treated with intrathecal rituximab developed an acute, transient, extremely painful lumbosacral radiculopathy. All were treated with systemic R-DHAP every 4 weeks with i.v. HD-MTX on day 15 for three cycles. In addition intrathecal Rituximab was administered twice weekly via lumbar puncture starting on day -1. According to protocol the first administration consisted of 10 mg of rituximab after premedication with acetaminophen, thereafter the dose was increased to 25 mg. No patient experienced side effects of the first intrathecal administration of rituximab. However, after the first administration of 25 mg rituximab three of 13 treated patients reported extremely painful tingling sensations in the buttocks, legs and feet immediately after administration and lasting 30–60 minutes. Concomitantly a temporarily increased bloodpressure was documented. Premedication with an antihistaminic in the third patient was ineffective. No neurologic deficits occurred and the pain resolved completely. The patients refused further treatment with intrathecal rituximab, and therapy was changed to intrathecal methotrexate, without any side effects. After these events the rituximab was diluted in saline to 5 mg/ml, the dose reduced to 10 mg per administration, and 4 mg dexamethasone was administered concomitantly in all subsequent patients. Twelve additional patients were thus treated and no further incidents of painful radiculopathy were observed. This serious, though completely transient, adverse effect of intrathecal rituximab precludes intrathecal administration of higher doses of rituximab via lumbar route. It has never been described after intraventricular administration. Disclosures: Bromberg: Roche: Research Funding. Off Label Use: rituximab administration intrathecally. Doorduyn: Roche: Research Funding. van den Bent: Roche: Consultancy, Research Funding.

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