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[PMID]:29345028
[Au] Autor:Goldberg JF
[Ad] Endereço:Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
[Ti] Título:Should we reserve big gun antimanic drugs for only big gun manias?
[So] Source:Bipolar Disord;20(1):7-8, 2018 02.
[Is] ISSN:1399-5618
[Cp] País de publicação:Denmark
[La] Idioma:eng
[Mh] Termos MeSH primário: Antimaníacos
Transtorno Bipolar
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; COMMENT
[Nm] Nome de substância:
0 (Antimanic Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180119
[St] Status:MEDLINE
[do] DOI:10.1111/bdi.12597


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[PMID]:27770296
[Au] Autor:Girardi P; Brugnoli R; Manfredi G; Sani G
[Ad] Endereço:Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), School of Medicine and Psychology, Sapienza University of Rome, Rome, Italy. paolo.girardi@uniroma1.it.
[Ti] Título:Lithium in Bipolar Disorder: Optimizing Therapy Using Prolonged-Release Formulations.
[So] Source:Drugs R D;16(4):293-302, 2016 Dec.
[Is] ISSN:1179-6901
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:Lithium has been a gold standard in the treatment of bipolar disorder (BD) for several decades. Despite a general reduction in the use of lithium over the past several years, it is effective in the management of both manic and depressive episodes in BD and continues to be recommended as a first-line mood stabilizer. This review provides an overview of the pharmacology of lithium and highlights its clinical profile in the management of BD, focusing on the potential advantages of prolonged-release (PR) versus immediate-release (IR) formulations of lithium. A literature search using PubMed was performed to identify articles describing IR and PR lithium in BD using specific search terms like 'lithium', 'prolonged-release', 'sustained-release', 'extended-release', 'bipolar disorder', 'adherence' and 'compliance'. Relevant pharmacodynamic and pharmacokinetic data were also included. Several clinical trials suggested that lithium is effective in the treatment of acute mania and prophylaxis of BD and reduces the risk of suicide in patients with BD; it may also be used in combination with other drugs in the treatment of bipolar depression. Treatment with lithium must be monitored to avoid lithium-associated toxicity. The prolonged PR formulation of lithium has several advantages including consistent serum lithium concentrations, fewer adverse events and improved adherence to therapy. Although direct comparative studies between PR and IR formulations of lithium are primarily limited to pharmacokinetic studies, PR formulation of lithium provides potential advantages over IR formulation and can be effectively used in the management of BD with lesser adverse events.
[Mh] Termos MeSH primário: Antimaníacos/uso terapêutico
Transtorno Bipolar/tratamento farmacológico
Composição de Medicamentos
Compostos de Lítio/uso terapêutico
[Mh] Termos MeSH secundário: Antimaníacos/administração & dosagem
Preparações de Ação Retardada
Seres Humanos
Compostos de Lítio/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antimanic Agents); 0 (Delayed-Action Preparations); 0 (Lithium Compounds)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE


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[PMID]:29215383
[Au] Autor:Patel N; Viguera AC; Baldessarini RJ
[Ti] Título:Mood-Stabilizing Anticonvulsants, Spina Bifida, and Folate Supplementation: Commentary.
[So] Source:J Clin Psychopharmacol;38(1):7-10, 2018 Feb.
[Is] ISSN:1533-712X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE/BACKGROUND: High risks of neural tube defects and other teratogenic effects are associated with exposure in early pregnancy to some anticonvulsants, including in women with bipolar disorder. METHODS/PROCEDURES: Based on a semistructured review of recent literature, we summarized findings pertaining to this topic. FINDINGS/RESULTS: Valproate and carbamazepine are commonly used empirically (off-label) for putative long-term mood-stabilizing effects. Both anticonvulsants have high risks of teratogenic effects during pregnancy. Risks of neural tube defects (especially spina bifida) and other major malformations are especially great with valproate and can arise even before pregnancy is diagnosed. Standard supplementation of folic acid during pregnancy can reduce risk of spontaneous spina bifida, but not that associated with valproate or carbamazepine. In contrast, lamotrigine has regulatory approval for long-term use in bipolar disorder and appears not to have teratogenic effects in humans. IMPLICATIONS/CONCLUSIONS: Lack of protective effects against anticonvulsant-associated neural tube defects by folic acid supplements in anticipation of and during pregnancy is not widely recognized. This limitation and high risks of neural tube and other major teratogenic effects, especially of valproate, indicate the need for great caution in the use of valproate and carbamazepine to treat bipolar disorder in women of child-bearing age.
[Mh] Termos MeSH primário: Antimaníacos/efeitos adversos
Ácido Fólico/administração & dosagem
Defeitos do Tubo Neural/prevenção & controle
Disrafismo Espinal/prevenção & controle
[Mh] Termos MeSH secundário: Anticonvulsivantes/administração & dosagem
Anticonvulsivantes/efeitos adversos
Antimaníacos/administração & dosagem
Transtorno Bipolar/tratamento farmacológico
Carbamazepina/administração & dosagem
Carbamazepina/efeitos adversos
Suplementos Nutricionais
Feminino
Seres Humanos
Defeitos do Tubo Neural/induzido quimicamente
Gravidez
Complicações na Gravidez/tratamento farmacológico
Disrafismo Espinal/induzido quimicamente
Triazinas/administração & dosagem
Triazinas/efeitos adversos
Ácido Valproico/administração & dosagem
Ácido Valproico/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anticonvulsants); 0 (Antimanic Agents); 0 (Triazines); 33CM23913M (Carbamazepine); 614OI1Z5WI (Valproic Acid); 935E97BOY8 (Folic Acid); U3H27498KS (lamotrigine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180201
[Lr] Data última revisão:
180201
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1097/JCP.0000000000000813


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[PMID]:29228982
[Au] Autor:Rask O; Suneson K; Holmström E; Bäckström B; Johansson BA
[Ad] Endereço:Department of Clinical Sciences, Division of Pediatrics, Lund University, Lund, Sweden. olof.rask@med.lu.se.
[Ti] Título:Electroconvulsive therapy for manic state with mixed and psychotic features in a teenager with bipolar disorder and comorbid episodic obsessive-compulsive disorder: a case report.
[So] Source:J Med Case Rep;11(1):345, 2017 Dec 12.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Comorbidity of bipolar disorder and obsessive-compulsive disorder is common in adolescence. Obsessive-compulsive disorder symptoms may be episodic and secondary to alterations in mood, and display specific features. Management of pediatric bipolar disorder-obsessive-compulsive disorder is challenging, as pharmacotherapy of obsessive-compulsive disorder may induce or exacerbate manic episodes and there is limited evidence of treatment efficacy. Electroconvulsive therapy is sparsely used in children and adolescents, but is documented to be a safe and efficacious intervention in adults with bipolar disorder. In view of the severity of symptoms in juvenile mania, studies on treatment strategies are warranted. We report a case of an adolescent with bipolar disorder-obsessive-compulsive disorder who was successfully treated with electroconvulsive therapy during an episode of severe mania. CASE PRESENTATION: A 16-year-old girl of Middle East origin first presented to us with depressed mood, irritability, and increased obsessive-compulsive disorder symptoms, which were initially interpreted in the context of acute stress secondary to migration. She had been diagnosed with bipolar disorder and obsessive-compulsive disorder in her previous home country, but had difficulties in accounting for earlier psychiatric history. During hospitalization her mood switched to a manic state with mixed and psychotic features, at times showing aggression toward others. Interruption in her lithium treatment for a short period and possibly the introduction of an atypical antipsychotic could in part have been triggering factors. After 8 weeks of in-patient care and psychotropic drug trials, electroconvulsive therapy was initiated and administered every second or third day for 4 weeks, with marked positive response. No apparent side effects were reported. CONCLUSIONS: This case demonstrates the need for a detailed medical history, taking special note of periodicity and character of obsessive-compulsive disorder symptoms, in adolescents with mood disorders. When treating culturally diverse patients, extra consideration should be taken. Special concerns in the pharmacological treatment to avoid the patient's condition from worsening must be addressed, including giving priority to mood stabilization before obsessive-compulsive disorder symptoms. There are potential benefits in considering electroconvulsive therapy in young patients with severe mania where first-line treatment options have failed.
[Mh] Termos MeSH primário: Transtorno Bipolar/terapia
Eletroconvulsoterapia/métodos
Transtorno Obsessivo-Compulsivo/terapia
Refugiados
[Mh] Termos MeSH secundário: Adolescente
Antimaníacos/uso terapêutico
Antipsicóticos/uso terapêutico
Transtorno Bipolar/epidemiologia
Transtorno Bipolar/psicologia
Comorbidade
Feminino
Haloperidol/uso terapêutico
Seres Humanos
Compostos de Lítio/uso terapêutico
Oriente Médio/etnologia
Transtorno Obsessivo-Compulsivo/epidemiologia
Transtorno Obsessivo-Compulsivo/psicologia
Suécia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antimanic Agents); 0 (Antipsychotic Agents); 0 (Lithium Compounds); J6292F8L3D (Haloperidol)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180130
[Lr] Data última revisão:
180130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-017-1508-8


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[PMID]:28458438
[Au] Autor:Maddala RNM; Ashwal AJ; Rao MS; Padmakumar R
[Ad] Endereço:Department of Medicine, Manipal University, Manipal, Udupi, Karnataka, India.
[Ti] Título:Chronic lithium intoxication: Varying electrocardiogram manifestations.
[So] Source:Indian J Pharmacol;49(1):127-129, 2017 Jan-Feb.
[Is] ISSN:1998-3751
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:Lithium is a commonly used drug in psychiatric practice. It is used in the treatment of depression and bipolar disorder. It has a narrow therapeutic index with documented adverse effects even near therapeutic levels. It has myriad of manifestations at toxic levels. The cardiovascular effects range from relatively benign ST-T wave changes to fatal arrhythmias. We describe a case of lithium toxicity which presented as a junctional rhythm and later showed a variety of manifestations such as complete heart block, atrial fibrillation, sinus bradycardia, and finally reverted to sinus rhythm at par with serum lithium levels.
[Mh] Termos MeSH primário: Antimaníacos/efeitos adversos
Arritmias Cardíacas/induzido quimicamente
Compostos de Lítio/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Antimaníacos/administração & dosagem
Antimaníacos/sangue
Arritmias Cardíacas/fisiopatologia
Fibrilação Atrial/induzido quimicamente
Transtorno Bipolar/tratamento farmacológico
Bradicardia/induzido quimicamente
Eletrocardiografia
Feminino
Bloqueio Cardíaco/induzido quimicamente
Seres Humanos
Compostos de Lítio/administração & dosagem
Compostos de Lítio/sangue
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antimanic Agents); 0 (Lithium Compounds)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171229
[Lr] Data última revisão:
171229
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.4103/ijp.IJP_204_16


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[PMID]:29088928
[Au] Autor:Young RC; Mulsant BH; Sajatovic M; Gildengers AG; Gyulai L; Al Jurdi RK; Beyer J; Evans J; Banerjee S; Greenberg R; Marino P; Kunik ME; Chen P; Barrett M; Schulberg HC; Bruce ML; Reynolds CF; Alexopoulos GS; GERI-BD Study Group
[Ad] Endereço:From the Department of Psychiatry and the Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, and New York Presbyterian Hospital, New York; the Department of Psychiatry, University of Toronto, and the Centre for Addiction and Mental Health, Toronto; the Department of Psyc
[Ti] Título:GERI-BD: A Randomized Double-Blind Controlled Trial of Lithium and Divalproex in the Treatment of Mania in Older Patients With Bipolar Disorder.
[So] Source:Am J Psychiatry;174(11):1086-1093, 2017 Nov 01.
[Is] ISSN:1535-7228
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Clinicians treating older patients with bipolar disorder with mood stabilizers need evidence from age-specific randomized controlled trials. The authors describe findings from a first such study of late-life mania. METHOD: The authors compared the tolerability and efficacy of lithium carbonate and divalproex in 224 inpatients and outpatients age 60 or older with bipolar I disorder who presented with a manic, hypomanic, or mixed episode. Participants were randomly assigned, under double-blind conditions, to treatment with lithium (target serum concentration, 0.80-0.99 mEq/L) or divalproex (target serum valproate concentration, 80-99 µg/mL) for 9 weeks. Participants with an inadequate response after 3 weeks received open adjunctive risperidone. The authors hypothesized that divalproex would be better tolerated and more efficacious than lithium. Tolerability was assessed based on a measure of sedation and on the proportions of participants achieving target concentrations. Efficacy was assessed with the Young Mania Rating Scale (YMRS). RESULTS: Attrition rates were similar for lithium and divalproex (14% and 18% at week 3 and 51% and 44% at week 9, respectively). The groups did not differ significantly in sedation. Participants in the lithium group tended to experience more tremor. Similar proportions of participants in the lithium and divalproex groups achieved target concentrations (57% and 56%, respectively). A longitudinal mixed model of improvement (change from baseline in YMRS score) favored lithium (change in score, 3.90; 97.5% CI=1.71, 6.09). Nine-week response rates did not differ significantly between the lithium and divalproex groups (79% and 73%, respectively). The need for adjunctive risperidone was low and similar between groups (17% and 14%, respectively). CONCLUSIONS: Both lithium and divalproex were adequately tolerated and efficacious; lithium was associated with a greater reduction in mania scores over 9 weeks.
[Mh] Termos MeSH primário: Antimaníacos/uso terapêutico
Transtorno Bipolar/tratamento farmacológico
Carbonato de Lítio/uso terapêutico
Ácido Valproico/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Antipsicóticos/uso terapêutico
Método Duplo-Cego
Quimioterapia Combinada
Feminino
Seres Humanos
Masculino
Meia-Idade
Risperidona/uso terapêutico
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antimanic Agents); 0 (Antipsychotic Agents); 2BMD2GNA4V (Lithium Carbonate); 614OI1Z5WI (Valproic Acid); L6UH7ZF8HC (Risperidone)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171102
[St] Status:MEDLINE
[do] DOI:10.1176/appi.ajp.2017.15050657


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[PMID]:28965429
[Au] Autor:Richardson T; Macaluso M
[Ad] Endereço:a Department of Psychiatry and Behavioral Sciences , Kansas University School of Medicine-Wichita , Wichita , KS , USA.
[Ti] Título:Clinically relevant treatment considerations regarding lithium use in bipolar disorder.
[So] Source:Expert Opin Drug Metab Toxicol;13(11):1105-1113, 2017 Nov.
[Is] ISSN:1744-7607
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The goal of this paper is to provide a practical, clinically oriented review of lithium, a salt widely used to treat mania since the 1870s and formally approved as a mood stabilizer in 1970. Although lithium is still considered a first-line treatment for bipolar mania in most practice guidelines, its use may be overshadowed by newer psychotropic medications. Areas covered: This paper addresses the historical use of lithium, modern indications for its use, guidelines for prescribing and monitoring continued lithium use, drug-drug interactions, and pharmacodynamics/pharmacokinetic properties. The paper also reviews the unique properties of lithium and their potential clinical importance. Expert opinion: While the use of lithium does involve some unique risks to the patient, it may also has some unique advantages in certain patient populations. Two major findings that make lithium unique are its potential neuroprotective benefits and decreased risk of suicide in patients with mood disorders.
[Mh] Termos MeSH primário: Antimaníacos/uso terapêutico
Transtorno Bipolar/tratamento farmacológico
Compostos de Lítio/uso terapêutico
[Mh] Termos MeSH secundário: Antimaníacos/administração & dosagem
Antimaníacos/efeitos adversos
Transtorno Bipolar/fisiopatologia
Interações Medicamentosas
Monitoramento de Medicamentos/métodos
Seres Humanos
Compostos de Lítio/administração & dosagem
Compostos de Lítio/efeitos adversos
Guias de Prática Clínica como Assunto
Suicídio/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antimanic Agents); 0 (Lithium Compounds)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171108
[Lr] Data última revisão:
171108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.1080/17425255.2017.1386653


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[PMID]:28953637
[Au] Autor:Cattaneo CI; Ressico F; Valsesia R; D'Innella P; Ballabio M; Fornaro M
[Ad] Endereço:aAsl Novara, Department of Mental Health - Outpatient Unit bAsl Novara, Department of Mental Health - Inpatient Unit- Borgomanero, Novara cDepartment of Neuroscience, University School of Naples "Federico II", Naples, Italy.
[Ti] Título:Sudden valproate-induced hyperammonemia managed with L-carnitine in a medically healthy bipolar patient: Essential review of the literature and case report.
[So] Source:Medicine (Baltimore);96(39):e8117, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Valproic Acid is a commonly used psychiatric drug primarily used as a mood stabilizer. Mild hyperammonemia is a Valproic Acid common adverse effect. This report presents an example of treated hyperammonemia on Valproic acid therapy managed with L-carnitine administration in BD patients characterized by sudden vulnerability. PATIENT CONCERNS: We report the case of a 29-year-old man suffering from bipolar disorder (BD) and substance use disorder who exhibited sudden altered mental status upon admittance to the inpatient unit. The patient was started on Valproic acid with no improvement. DIAGNOSES: The patient had remarkably high ammonia levels (594 µg/dL) without hepatic insufficiency, likely due to his valproate treatment. INTERVENTIONS: The patient was administered lactulose, intravenous hydration, and i.v. levocarnitine supplementation 4.5 g/day. OUTCOMES: The administration leads to reduction of ammonia levels to 99 µg/dL within 12 hours upon initiation of carnitine therapy and progressive restore of his mental status within 24 hours. LESSONS: Resolution of hyperammonemia caused by Valproic acid therapy may be enhanced with the administration of L-carnitine. An interesting aspect of this case was how rapidly the patient responded to the carnitine therapy.
[Mh] Termos MeSH primário: Antimaníacos/efeitos adversos
Transtorno Bipolar/tratamento farmacológico
Carnitina/administração & dosagem
Hiperamonemia/tratamento farmacológico
Transtornos Relacionados ao Uso de Substâncias/tratamento farmacológico
Ácido Valproico/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Hiperamonemia/induzido quimicamente
Masculino
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antimanic Agents); 614OI1Z5WI (Valproic Acid); S7UI8SM58A (Carnitine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008117


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[PMID]:28817575
[Au] Autor:Yu W; Daniel J; Mehta D; Maddipati KR; Greenberg ML
[Ad] Endereço:Department of Biological Sciences, Wayne State University, Detroit, Michigan, United States of America.
[Ti] Título:MCK1 is a novel regulator of myo-inositol phosphate synthase (MIPS) that is required for inhibition of inositol synthesis by the mood stabilizer valproate.
[So] Source:PLoS One;12(8):e0182534, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Myo-inositol, the precursor of all inositol compounds, is essential for the viability of eukaryotes. Identifying the factors that regulate inositol homeostasis is of obvious importance to understanding cell function and the pathologies underlying neurological and metabolic resulting from perturbation of inositol metabolism. The current study identifies Mck1, a GSK3 homolog, as a novel positive regulator of inositol de novo synthesis in yeast. Mck1 was required for normal activity of myo-inositol phosphate synthase (MIPS), which catalyzes the rate-limiting step of inositol synthesis. mck1Δ cells exhibited a 50% decrease in MIPS activity and a decreased rate of incorporation of [13C6]glucose into [13C6]-inositol-3-phosphate and [13C6]-inositol compared to WT cells. mck1Δ cells also exhibited decreased growth in the presence of the inositol depleting drug valproate (VPA), which was rescued by supplementation of inositol. However, in contrast to wild type cells, which exhibited more than a 40% decrease in MIPS activity in the presence of VPA, the drug did not significantly decrease MIPS activity in mck1Δ cells. These findings indicate that VPA-induced MIPS inhibition is Mck1-dependent, and suggest a model that unifies two current hypotheses of the mechanism of action of VPA-inositol depletion and GSK3 inhibition.
[Mh] Termos MeSH primário: Antimaníacos/farmacologia
Inibidores Enzimáticos/farmacologia
Quinase 3 da Glicogênio Sintase/metabolismo
Inositol/metabolismo
Mio-Inositol-1-Fosfato Sintase/metabolismo
Proteínas de Saccharomyces cerevisiae/metabolismo
Ácido Valproico/farmacologia
[Mh] Termos MeSH secundário: Quinase 3 da Glicogênio Sintase/genética
Mio-Inositol-1-Fosfato Sintase/antagonistas & inibidores
Saccharomyces cerevisiae/efeitos dos fármacos
Saccharomyces cerevisiae/genética
Saccharomyces cerevisiae/metabolismo
Proteínas de Saccharomyces cerevisiae/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antimanic Agents); 0 (Enzyme Inhibitors); 0 (Saccharomyces cerevisiae Proteins); 4L6452S749 (Inositol); 614OI1Z5WI (Valproic Acid); EC 2.7.11.26 (Glycogen Synthase Kinase 3); EC 2.7.12.1 (MCK1 protein, S cerevisiae); EC 5.5.1.4 (Myo-Inositol-1-Phosphate Synthase)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182534


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[PMID]:28806048
[Au] Autor:Barstow C
[Ad] Endereço:Womack Army Medical Center, 2817 Reilly Road, Fort Bragg, NC 28310.
[Ti] Título:Electrolytes: Calcium Disorders.
[So] Source:FP Essent;459:29-34, 2017 Aug.
[Is] ISSN:2159-3000
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:A normal serum calcium level is 8 to 10 mg/dL. The diagnosis of hypercalcemia (ie, levels 10.5 mg/dL or greater) should be confirmed with an albumin-adjusted or ionized calcium level. The two most common causes of hypercalcemia are hyperparathyroidism and malignancy. Drugs, notably lithium and thiazide diuretics, also can cause hypercalcemia. Patients with severe or symptomatic hypercalcemia should be treated initially with hydration to decrease calcium levels. The evaluation should include a parathyroid hormone (PTH) level. If the PTH level is low, cancer is a likely cause, particularly multiple myeloma, breast cancer, or lymphoma. If the PTH level is normal or elevated, hyperparathyroidism is the likely cause. Symptomatic patients with hyperparathyroidism and patients with certain clinical markers should be considered for surgery. For patients with mild disease, monitoring is an option. Hypocalcemia often is caused by vitamin D deficiency. Symptomatic patients and patients with calcium levels less than 7.6 mg/dL should be treated with intravenous calcium gluconate; concomitant magnesium deficiency should be addressed. There is no evidence that routine calcium and vitamin D supplementation reduces the risk of fractures, but studies have shown that vitamin D supplementation does decrease the number of falls in older adults at risk.
[Mh] Termos MeSH primário: Cálcio/metabolismo
Hipercalcemia/metabolismo
Hipocalcemia/metabolismo
Hormônio Paratireóideo/metabolismo
Vitamina D/metabolismo
[Mh] Termos MeSH secundário: Acidentes por Quedas/prevenção & controle
Antimaníacos/efeitos adversos
Cálcio/uso terapêutico
Gluconato de Cálcio/uso terapêutico
Suplementos Nutricionais
Hidratação
Fraturas Ósseas/prevenção & controle
Seres Humanos
Hipercalcemia/diagnóstico
Hipercalcemia/etiologia
Hipercalcemia/terapia
Hiperparatireoidismo/complicações
Hiperparatireoidismo/cirurgia
Hipocalcemia/diagnóstico
Hipocalcemia/etiologia
Hipocalcemia/terapia
Lítio/efeitos adversos
Neoplasias/complicações
Paratireoidectomia
Inibidores de Simportadores de Cloreto de Sódio/efeitos adversos
Vitamina D/uso terapêutico
Deficiência de Vitamina D/complicações
Deficiência de Vitamina D/tratamento farmacológico
Vitaminas/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antimanic Agents); 0 (Parathyroid Hormone); 0 (Sodium Chloride Symporter Inhibitors); 0 (Vitamins); 1406-16-2 (Vitamin D); 9FN79X2M3F (Lithium); SQE6VB453K (Calcium Gluconate); SY7Q814VUP (Calcium)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170815
[St] Status:MEDLINE



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