Hematologic Agents
Nomifensine
Encyclopedias as Topic
Antidepressive Agents
Doxepin
Cholinergic Antagonists
Cocaine
Randomised, double blind placebo controlled trial of pentoxifylline in the treatment of venous leg ulcers. (1/44)
OBJECTIVE: To determine whether pentoxifylline 400 mg (Trental 400) taken orally three times daily, in addition to ambulatory compression bandages and dressings, improves the healing rate of pure venous ulcers. DESIGN: Randomised, double blind placebo controlled trial, parallel group study of factorial design, permitting the simultaneous evaluation of alternative pharmaceutical, bandaging, and dressings materials. SETTING: Leg ulcer clinics of a teaching and a district general hospital in southern Scotland. PARTICIPANTS: 200 patients with confirmed venous ulcers and in whom other major causal factors were excluded. INTERVENTIONS: Pentoxifylline 400 mg three times daily or placebo. MAIN OUTCOME MEASURE: Complete healing (full epithelialisation) of all ulcers on the trial leg. RESULTS: Complete healing occurred in 65 of the 101 (64%) patients receiving pentoxifylline and 52 of the 99 (53%) patients receiving placebo. CONCLUSIONS: The difference in the healing rates between patients taking pentoxifylline and those taking placebo did not reach statistical significance. (+info)Drug-induced alterations in tumour perfusion yield increases in tumour cell radiosensitivity. (2/44)
The perfusion of human tumour xenografts was manipulated by administration of diltiazem and pentoxifylline, and the extent that observed changes in tumour perfusion altered tumour radiosensitivity was determined. 2 tumour systems having intrinsically different types of hypoxia were studied. The responses of SiHa tumours, which have essentially no transient hypoxia, were compared to the responses of WiDr tumours, which contain chronically and transiently hypoxic cells. We found that relatively modest increases in net tumour perfusion increased tumour cell radiosensitivity in WiDr tumours to a greater extent than in SiHa tumours. Moreover, redistribution of blood flow within WiDr tumours was observed on a micro-regional level that was largely independent of changes in net tumour perfusion. Through fluorescence-activated cell sorting coupled with an in vivo-in vitro cloning assay, increases in the radiosensitivity of WiDr tumour cells at intermediate levels of oxygenation were observed, consistent with the expectation that a redistribution of tumour blood flow had increased oxygen delivery to transiently hypoxic tumour cells. Our data therefore suggest that drug-induced changes in tumour micro-perfusion can alter the radiosensitivity of transiently hypoxic tumour cells, and that increasing the radiosensitivity of tumour cells at intermediate levels of oxygenation is therapeutically relevant. (+info)The underutilization of cardiac medications of proven benefit, 1990 to 2002. (3/44)
OBJECTIVES: To evaluate recent trends, we examined longitudinal national data on the outpatient use of warfarin in atrial fibrillation (AF), beta-blockers and aspirin in coronary artery disease (CAD), and angiotensin-converting enzyme inhibitors (ACEIs) in congestive heart failure (CHF). BACKGROUND: Previous studies indicate that specific cardiac medications are underutilized. METHODS: We used the National Disease and Therapeutic Index (NDTI) (produced by IMS HEALTH, Plymouth Meeting, Pennsylvania) for 1990 to 2002, and the National Ambulatory Medical Care Surveys (NAMCS) for 1990 to 2000 to follow nationally representative samples of outpatient visits. For visits by patients with AF (total n = 14,634 visits), CAD (n = 35,295), and CHF (n = 33,008), we examined trends in the proportion of visits with the selected medications reported. RESULTS: Warfarin use in AF increased from 12% in 1990, to 41% in 1995, to 58% in 2001 in NDTI; a similar moderation of recent increase was seen in NAMCS. For CAD in NDTI, beta-blocker use increased slowly from 19% in 1990, to 20% in 1995, then to 40% in 2001; NAMCS showed this same pattern. Aspirin use in CAD in NDTI increased from 18% in 1990, to 19% in 1995, to 38% in 2001; NAMCS, however, showed lower use rates. For NDTI, ACEI use in CHF increased from 24% in 1990 to 36% in 1996, but increased to only 39% by 2001, a general pattern also seen in NAMCS. CONCLUSIONS: Both national datasets demonstrate continuing underutilization of these cardiac medications of proven benefit. Although use is increasing, it remains lower than expected, and some increases noted in earlier years have slowed. Substantial public health benefits would result from further adoption of these effective therapies. (+info)Treatment of homozygous sickle cell disease with pentoxifylline. (4/44)
This case report describes the sustained symptomatic and hematologic improvement in a 21-year-old woman with homozygous sickle cell (ss) disease during treatment with pentoxifylline, 400 mg three times daily after meals. Pain crises decreased from six to zero per year, hemoglobin level rose from 8.4 g/dL to 11.4 g/dL, hematocrit rose from 24.8% to 34.8%, lactate dehydrogenase level decreased from 375 IU/L to 322 IU/L, and total bilirubin level decreased from 1.8 mg/dL to 1.6 mg/dL. Mean corpuscular hemoglobin increased from 21.6 pg to 30 pg and mean corpuscular hemoglobin concentration increased from 24.1 g/dL to 34.5 g/dL. These changes were sustained for seven years except for a brief self-imposed hiatus in therapy during which period a pain crisis occurred. Further increase in pentoxifylline dosage to 400 mg four times daily did not result in any further improvement in these hematologic parameters. These results suggest that pentoxifylline reduces hemolysis in SS patients with a resulting improvement in anemia and a reduction in or elimination of pain crises. (+info)Treatment of the leg ulcers by skin grafting. (5/44)
The ulcers, located below the knees and remaining for 6 weeks and more, are called trophic leg ulcers. The leg ulcers of different etiology disable 0.8-1% of total Earth population. It was found that blood vessel problems in legs account for more than 80% of ulcers; even 65% from these are caused by venous diseases. In Lithuania about 8000 patients suffer from venous trophic ulcers. Regardless of modern methods the treatment of leg ulcers remains an extremely expensive process. The treatment cost of trophic ulcers is the highest of all surgical wounds and also requires a lot of personal investments. In order to assess the efficiency of autodermoplastics in the treatment of large venous ulcers in legs a prospective study was carried out of 111 patients who were treated in the Department of Plastic Surgery and Burns of Kaunas University of Medicine Hospital from January 2001 to January 2004. The data was analyzed exceptionally of the operated 54 patients with venous origin ulcers open for more 6 months or exceeding 50 cm2. The above-mentioned patients were prepared for surgery by dressing the wounds with hydrocolloid Granuflex bandages and were operated by transplanting a 0.2-0.3 mm thick skin graft. The results were estimated by the surgeon during the dressings after the operation. The graft was taken in 35 (64.81%) cases; in 19 (35.19%) cases the graft was partially not taken and there were no cases when it was not taken at all. We came to the conclusions that skin graft transplantation is efficient in treatment of trophic venous leg ulcers larger than 50 cm2 and cures the trophic leg ulcers of vein origin completely in 2-3 weeks for 64.81% patients. (+info)Contraindications and safety of transbronchial lung biopsy via flexible bronchoscopy. A survey of pulmonologists and review of the literature. (6/44)
BACKGROUND: Transbronchial lung biopsy (TBLB) via flexible bronchoscopy is a common procedure performed by pulmonologists. Limited scientific data exist concerning the risk of this procedure in patients with conditions that may adversely affect the rate of procedural complications. OBJECTIVES: To evaluate the current practice pattern and attitude of pulmonologists toward the performance of TBLB in the presence of high-risk conditions. METHODS: A survey was constructed and distributed at the American College of Chest Physicians annual meeting, held in Philadelphia, USA, in November of 2001. RESULTS: A total of 227 surveys were distributed with a return of 158 (69.6%). Anticoagulation medications are temporarily held prior to TBLB by the majority of our survey respondents (98.7% for intravenous heparin, 90.5% for warfarin, and 87.3% for low-molecular-weight heparin). Medications with effect on platelet function are held by fewer pulmonologists. There is a wide variation in the pulmonologists' perception of the risk of performing TBLB when certain medical conditions coexist: pulmonary hypertension [absolute contraindication (AC), 28.7%; relative contraindication (RC) 58.6%], superior vena cava syndrome (AC 19.6%, RC 51%), mechanical ventilation (AC 17.8%, RC 58.6%) and lung cavity/abscess (AC 7%, RC 44.9%). A significant percentage of pulmonologists (55%) do not regard an elevated serum creatinine at any level as AC to TBLB. Thirty-eight percent of the survey participants administer desmopressin prior to TBLB in uremic patients to prevent excessive bleeding. CONCLUSIONS: Prior to performing bronchoscopic TBLB, the majority of pulmonologists temporarily holds anticoagulation medications. However, there is a lack of agreement in relation to perceived contraindications and safety of TBLB. (+info)Variability and growth in spending for outpatient specialty pharmaceuticals. (7/44)
Specialty pharmaceuticals are a unique group of drug agents used to treat complex clinical conditions. Many specialty pharmaceuticals are biological in nature and administered through injection or infusion. Tracking spending on these pharmaceuticals is complex, because these products may be processed as either medical or pharmacy claims. This benchmarking study of ten Blue Cross Blue Shield plans, representing almost eighteen million covered lives, documents large expenditures on select specialty pharmaceutical categories and much variation in spending across plans, age groups, and time. Our results underscore the need for insurers to scrutinize trends in specialty pharmaceutical spending and identify appropriate management strategies. (+info)Peri-procedural myocardial injury: 2005 update. (8/44)
During the past three decades, percutaneous coronary intervention has become one of the cardinal treatment strategies for stenotic coronary artery disease. Technical advances, including the introduction of new devices such as stents, have expanded the interventional capabilities of balloon angioplasty. At the same time, there has been a decline in the rate of major adverse cardiac events, including Q-wave acute myocardial infarction, emergency coronary artery bypass grafting, and cardiac death. Despite these advances, the incidence of post-procedural cardiac marker elevation has not substantially decreased since the first serial assessment 20 years ago. As of now, these post-procedural cardiac marker elevations are considered to represent peri-procedural myocardial injury (PMI) with worse long-term outcome potential. Recent progress has been made for the identification of two main PMI patterns, one near the intervention site (proximal type, PMI type I) and one in the distal perfusion territory of the treated coronary artery (distal type, PMI type II) as well as for preventive strategies. Integrating these new developments into the wealth of clinical information on this topic, this review aims at giving a current perspective on the entity of PMI. (+info)Hematologic agents are a class of drugs that affect the formation, function, or destruction of blood cells and related proteins. They include:
1. Hematopoietic growth factors: These are substances that stimulate the production of blood cells in the bone marrow. Examples include erythropoiesis-stimulating agents (ESAs) like epoetin alfa and darbepoetin alfa, which stimulate red blood cell production, and granulocyte colony-stimulating factors (G-CSFs) like filgrastim and pegfilgrastim, which stimulate white blood cell production.
2. Anticoagulants: These are drugs that prevent blood clots from forming or growing larger. Examples include heparin, warfarin, direct oral anticoagulants (DOACs) like apixaban and rivaroxaban, and antiplatelet agents like aspirin and clopidogrel.
3. Hemostatic agents: These are drugs that promote blood clotting to stop bleeding. Examples include fibrin glue, thrombin, and factor VIIa.
4. Hematological malignancy therapies: These are drugs used to treat cancers of the blood and bone marrow, such as leukemia, lymphoma, and multiple myeloma. They include chemotherapeutic agents, targeted therapies like monoclonal antibodies, immunomodulatory drugs, and proteasome inhibitors.
5. Iron chelators: These are drugs used to remove excess iron from the body in patients with conditions that cause iron overload, such as thalassemia and sickle cell disease. Examples include deferoxamine, deferasirox, and deferiprone.
6. Hemophilia therapies: These are drugs used to treat hemophilia, a genetic disorder that affects blood clotting. They include factor VIII replacement therapy for hemophilia A and factor IX replacement therapy for hemophilia B.
Nomifensine is a medication that was previously used in the treatment of depression, but it is no longer available in many countries due to safety concerns. It is a non-tricyclic antidepressant that works by inhibiting the reuptake of dopamine and noradrenaline, which helps to increase the levels of these neurotransmitters in the brain and improve mood.
The medical definition of Nomifensine is:
"Nomifensine is a non-tricyclic antidepressant that is a potent inhibitor of dopamine and noradrenaline reuptake, with minimal effects on serotonin reuptake. It was used in the treatment of depression but has been withdrawn from the market due to safety concerns."
It's important to note that Nomifensine should only be taken under the supervision of a medical professional, and it is not available in many countries due to its potential for causing serious side effects such as liver toxicity and the risk of developing a rare but potentially fatal condition called hemolytic anemia.
An encyclopedia is a comprehensive reference work containing articles on various topics, usually arranged in alphabetical order. In the context of medicine, a medical encyclopedia is a collection of articles that provide information about a wide range of medical topics, including diseases and conditions, treatments, tests, procedures, and anatomy and physiology. Medical encyclopedias may be published in print or electronic formats and are often used as a starting point for researching medical topics. They can provide reliable and accurate information on medical subjects, making them useful resources for healthcare professionals, students, and patients alike. Some well-known examples of medical encyclopedias include the Merck Manual and the Stedman's Medical Dictionary.
Antidepressive agents are a class of medications used to treat various forms of depression and anxiety disorders. They act on neurotransmitters, the chemical messengers in the brain, to restore the balance that has been disrupted by mental illness. The most commonly prescribed types of antidepressants include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), and monoamine oxidase inhibitors (MAOIs). These medications can help alleviate symptoms such as low mood, loss of interest in activities, changes in appetite and sleep patterns, fatigue, difficulty concentrating, and thoughts of death or suicide. It is important to note that antidepressants may take several weeks to reach their full effectiveness and may cause side effects, so it is essential to work closely with a healthcare provider to find the right medication and dosage.
Doxepin is a tricyclic antidepressant (TCA) medication that is primarily used to treat depression and anxiety disorders. It works by increasing the levels of certain neurotransmitters, such as serotonin and norepinephrine, in the brain. Doxepin is also used in the treatment of insomnia, as it can help to improve sleep quality and reduce nighttime awakenings.
In addition to its antidepressant and sedative effects, doxepin has anti-inflammatory properties and is sometimes used off-label to treat chronic itching associated with various skin conditions, such as eczema and psoriasis.
Like other TCAs, doxepin can cause a range of side effects, including dry mouth, blurred vision, constipation, dizziness, and drowsiness. It may also cause weight gain, sexual dysfunction, and orthostatic hypotension (a drop in blood pressure upon standing). In rare cases, doxepin can cause more serious side effects, such as seizures, irregular heart rhythms, and serotonin syndrome (a potentially life-threatening condition caused by excessive levels of serotonin in the body).
Doxepin is available in immediate-release and extended-release forms, and is typically taken orally once or twice a day. The dosage may vary depending on the individual's age, weight, and medical history, as well as the specific condition being treated. It is important to follow the prescribing physician's instructions carefully when taking doxepin, and to report any unusual symptoms or side effects promptly.
Cholinergic antagonists, also known as anticholinergics or parasympatholytics, are a class of drugs that block the action of the neurotransmitter acetylcholine in the nervous system. They achieve this by binding to and blocking the activation of muscarinic acetylcholine receptors, which are found in various organs throughout the body, including the eyes, lungs, heart, gastrointestinal tract, and urinary bladder.
The blockade of these receptors results in a range of effects depending on the specific organ system involved. For example, cholinergic antagonists can cause mydriasis (dilation of the pupils), cycloplegia (paralysis of the ciliary muscle of the eye), tachycardia (rapid heart rate), reduced gastrointestinal motility and secretion, urinary retention, and respiratory tract smooth muscle relaxation.
Cholinergic antagonists are used in a variety of clinical settings, including the treatment of conditions such as Parkinson's disease, chronic obstructive pulmonary disease (COPD), asthma, gastrointestinal disorders, and urinary incontinence. Some common examples of cholinergic antagonists include atropine, scopolamine, ipratropium, and oxybutynin.
It's important to note that cholinergic antagonists can have significant side effects, particularly when used in high doses or in combination with other medications that affect the nervous system. These side effects can include confusion, memory impairment, hallucinations, delirium, and blurred vision. Therefore, it's essential to use these drugs under the close supervision of a healthcare provider and to follow their instructions carefully.
Cocaine is a highly addictive stimulant drug derived from the leaves of the coca plant (Erythroxylon coca). It is a powerful central nervous system stimulant that affects the brain and body in many ways. When used recreationally, cocaine can produce feelings of euphoria, increased energy, and mental alertness; however, it can also cause serious negative consequences, including addiction, cardiovascular problems, seizures, and death.
Cocaine works by increasing the levels of dopamine in the brain, a neurotransmitter associated with pleasure and reward. This leads to the pleasurable effects that users seek when they take the drug. However, cocaine also interferes with the normal functioning of the brain's reward system, making it difficult for users to experience pleasure from natural rewards like food or social interactions.
Cocaine can be taken in several forms, including powdered form (which is usually snorted), freebase (a purer form that is often smoked), and crack cocaine (a solid form that is typically heated and smoked). Each form of cocaine has different risks and potential harms associated with its use.
Long-term use of cocaine can lead to a number of negative health consequences, including addiction, heart problems, malnutrition, respiratory issues, and mental health disorders like depression or anxiety. It is important to seek help if you or someone you know is struggling with cocaine use or addiction.
Stereoisomerism is a type of isomerism (structural arrangement of atoms) in which molecules have the same molecular formula and sequence of bonded atoms, but differ in the three-dimensional orientation of their atoms in space. This occurs when the molecule contains asymmetric carbon atoms or other rigid structures that prevent free rotation, leading to distinct spatial arrangements of groups of atoms around a central point. Stereoisomers can have different chemical and physical properties, such as optical activity, boiling points, and reactivities, due to differences in their shape and the way they interact with other molecules.
There are two main types of stereoisomerism: enantiomers (mirror-image isomers) and diastereomers (non-mirror-image isomers). Enantiomers are pairs of stereoisomers that are mirror images of each other, but cannot be superimposed on one another. Diastereomers, on the other hand, are non-mirror-image stereoisomers that have different physical and chemical properties.
Stereoisomerism is an important concept in chemistry and biology, as it can affect the biological activity of molecules, such as drugs and natural products. For example, some enantiomers of a drug may be active, while others are inactive or even toxic. Therefore, understanding stereoisomerism is crucial for designing and synthesizing effective and safe drugs.