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[PMID]:28742291
[Au] Autor:Sultan RS; Olfson M; Correll CU; Duncan EJ
[Ad] Endereço:New York State Psychiatric Institute/Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Dr, New York, NY 10032. rs3511@cumc.columbia.edu.
[Ti] Título:Evaluating the Effect of the Changes in FDA Guidelines for Clozapine Monitoring.
[So] Source:J Clin Psychiatry;78(8):e933-e939, 2017 Sep/Oct.
[Is] ISSN:1555-2101
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Concerns exist that clozapine is underutilized in the management of treatment-resistant schizophrenia. Although a 2015 change in the US Food and Drug Administration (FDA) monitoring recommendations lowered the threshold of the absolute neutrophil count for treatment interruption from 1,500/µL to 1,000/µL and removed white blood cell count thresholds from the monitoring algorithm, the implications of this policy change on clozapine interruptions remain unknown. METHODS: We analyzed outpatient prescribing records for antipsychotic medications in the Veterans Integrated Service Network 7 (VISN 7) database between 1999 and 2012 to assess the potential impact of the recent changes in FDA neutropenia monitoring recommendations on clozapine treatment discontinuation. We evaluated results of complete blood count monitoring to compare percentages of patients who developed or would have developed ≥ 1 hematologic event under the previous and current FDA guidelines in the first year following initiation of clozapine. RESULTS: From a cohort of 14,620 patients with schizophrenia (ICD-9-295.x), 246 patients received clozapine treatment (1.7%). No agranulocytosis was observed during the study period. Under the former recommendations, 5 patients in the clozapine initiation cohort (n = 160, 3.1%; 95% CI, 0.43-5.83) qualified for treatment interruption during the first year of clozapine treatment, while only 1 patient (0.6%) qualified under the current recommendations. Under the former recommendations, hematologic events occurred at a similar rate for individuals taking and not taking clozapine. CONCLUSIONS: While clozapine remains an underused medication, the new FDA monitoring guidelines are likely to substantially reduce the percentage of patients who meet criteria for clozapine-associated hematologic events requiring treatment interruption. This decrease may reduce the clinical burden of managing patients on clozapine and therefore increase the number of individuals treated with this uniquely effective medication. However, prospective studies of individuals treated under the new guidelines are needed to fully assess safety of the FDA's change.
[Mh] Termos MeSH primário: Clozapina
Monitoramento de Medicamentos
Neutropenia
Esquizofrenia/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Sistemas de Notificação de Reações Adversas a Medicamentos/estatística & dados numéricos
Antipsicóticos/administração & dosagem
Antipsicóticos/efeitos adversos
Clozapina/administração & dosagem
Clozapina/efeitos adversos
Monitoramento de Medicamentos/métodos
Monitoramento de Medicamentos/estatística & dados numéricos
Prescrições de Medicamentos/estatística & dados numéricos
Feminino
Seres Humanos
Contagem de Leucócitos
Masculino
Conduta do Tratamento Medicamentoso/organização & administração
Conduta do Tratamento Medicamentoso/normas
Meia-Idade
Neutropenia/induzido quimicamente
Neutropenia/diagnóstico
Neutropenia/epidemiologia
Neutropenia/prevenção & controle
Farmacovigilância
Guias de Prática Clínica como Assunto
Escalas de Graduação Psiquiátrica
Melhoria de Qualidade
Esquizofrenia/diagnóstico
Esquizofrenia/epidemiologia
Estados Unidos/epidemiologia
United States Food and Drug Administration
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antipsychotic Agents); J60AR2IKIC (Clozapine)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE


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[PMID]:28452902
[Au] Autor:Fan KY; Liu HC
[Ad] Endereço:*Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital; and †Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.
[Ti] Título:Delirium Associated With Fluoxetine Discontinuation: A Case Report.
[So] Source:Clin Neuropharmacol;40(3):152-153, 2017 May/Jun.
[Is] ISSN:1537-162X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Withdrawal symptoms on selective serotonin reuptake inhibitor (SSRI) discontinuation have raised clinical attention increasingly. However, delirium is rarely reported in the SSRI discontinuation syndrome. CASE: We report a case of delirium developing after fluoxetine discontinuation in a 65-year-old female patient with major depressive disorder. She experienced psychotic depression with limited response to treatment of fluoxetine 40 mg/d and quetiapine 100 mg/d for 3 months. After admission, we tapered fluoxetine gradually in 5 days because of its limited effect. However, delirious pictures developed 2 days after we stopped fluoxetine. Three days later, we added back fluoxetine 10 mg/d. Her delirious features gradually improved, and the clinical presentation turned into previous psychotic depression state. We gradually increased the medication to fluoxetine 60 mg/d and olanzapine 20 mg/d in the following 3 weeks. Her psychotic symptoms decreased, and there has been no delirious picture noted thereafter. CONCLUSIONS: Delirium associated with fluoxetine discontinuation is a much rarer complication in SSRI discontinuation syndrome. The symptoms of SSRI discontinuation syndrome may be attributable to a rapid decrease in serotonin availability. In general, the shorter the half-life of any medication, the greater the likelihood patients will experience discontinuation symptoms. Genetic vulnerability might be a potential factor to explain that SSRI discontinuation syndrome also occurred rapidly in people taking long-half-life fluoxetine. The genetic polymorphisms of both pharmacokinetic and pharmacodynamic pathways might be potentially associated with SSRI discontinuation syndrome.
[Mh] Termos MeSH primário: Antidepressivos de Segunda Geração/efeitos adversos
Delírio/etiologia
Fluoxetina/efeitos adversos
Inibidores da Captação de Serotonina/efeitos adversos
Síndrome de Abstinência a Substâncias/etiologia
[Mh] Termos MeSH secundário: Idoso
Antipsicóticos/uso terapêutico
Benzodiazepinas/uso terapêutico
Delírio/prevenção & controle
Transtorno Depressivo Maior/tratamento farmacológico
Monitoramento de Medicamentos
Resistência a Múltiplos Medicamentos
Quimioterapia Combinada
Feminino
Fluoxetina/uso terapêutico
Seres Humanos
Inibidores da Captação de Serotonina/uso terapêutico
Síndrome de Abstinência a Substâncias/fisiopatologia
Síndrome de Abstinência a Substâncias/prevenção & controle
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antidepressive Agents, Second-Generation); 0 (Antipsychotic Agents); 0 (Serotonin Uptake Inhibitors); 01K63SUP8D (Fluoxetine); 12794-10-4 (Benzodiazepines); N7U69T4SZR (olanzapine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1097/WNF.0000000000000214


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Roesler, Rafael
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[PMID]:28452904
[Au] Autor:Marchezan J; Becker M; Schwartsmann G; Ohlweiler L; Roesler R; Renck LB; Gonçalves MMM; Ranzan J; Riesgo RDS
[Ad] Endereço:*Postgraduate Program in Child and Adolescent Health, School of Medicine, Federal University of Rio Grande do Sul; †Department of Pediatrics, Child Neurology Unit, Hospital de Clínicas de Porto Alegre; ‡Department of Internal Medicine, School of Medicine, Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), §Department of Pharmacology, Institute for Basic Health Sciences, Cancer and Neurobiology Laboratory, Experimental Research Center, Clinical Hospital (CPE-HCPA), and ∥Department of Pediatrics, Child Neurology Unit, Postgraduate Program in Child and Adolescent Health, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
[Ti] Título:A Placebo-Controlled Crossover Trial of Gastrin-Releasing Peptide in Childhood Autism.
[So] Source:Clin Neuropharmacol;40(3):108-112, 2017 May/Jun.
[Is] ISSN:1537-162X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The aim of this study was to evaluate the efficacy, safety, and tolerability of gastrin-releasing peptide (GRP) compared with placebo in autism spectrum disorder symptoms. METHODOLOGY: This is a randomized, double-blind, placebo-controlled crossover trial using GRP 160 pmol/kg for 4 consecutive days in 10 children with autism. Outcomes were measured by the Aberrant Behavior Checklist (ABC) scale. RESULTS: All participants were boys, aged between 4 and 9 years. There was a reduction in the scores of the ABC range and its subscales after use GRP and placebo. The reduction was more prominent with GRP, particularly in the subscale "hyperactivity and noncompliance," but there was no statistical difference between the results (P = 0.334). After a week of infusion, 5 children showed improvement of 25% or greater in the total score of the ABC scale with GRP use and 2 with placebo use; however, there was no statistical difference (P = 0.375). There were no adverse effects, changes in vital signs, or laboratory abnormalities associated with the use of GRP. CONCLUSIONS: The results of this study, despite the small sample size, reinforce previous data on the safety of the GRP in short-term use. There is a need for further research with other designs and a larger sample size to evaluate the efficacy and safety of GRP in children with autism.
[Mh] Termos MeSH primário: Transtorno do Espectro Autista/tratamento farmacológico
Comportamento Infantil/efeitos dos fármacos
Peptídeo Liberador de Gastrina/uso terapêutico
Psicotrópicos/uso terapêutico
[Mh] Termos MeSH secundário: Antiulcerosos/uso terapêutico
Anticonvulsivantes/efeitos adversos
Anticonvulsivantes/uso terapêutico
Antipsicóticos/efeitos adversos
Antipsicóticos/uso terapêutico
Transtorno do Espectro Autista/fisiopatologia
Transtorno do Espectro Autista/psicologia
Criança
Pré-Escolar
Terapia Combinada/efeitos adversos
Estudos Cross-Over
Manual Diagnóstico e Estatístico de Transtornos Mentais
Método Duplo-Cego
Quimioterapia Combinada/efeitos adversos
Seguimentos
Peptídeo Liberador de Gastrina/administração & dosagem
Peptídeo Liberador de Gastrina/efeitos adversos
Seres Humanos
Infusões Intravenosas
Masculino
Omeprazol/uso terapêutico
Escalas de Graduação Psiquiátrica
Psicotrópicos/administração & dosagem
Psicotrópicos/efeitos adversos
Reprodutibilidade dos Testes
Índice de Gravidade de Doença
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Ulcer Agents); 0 (Anticonvulsants); 0 (Antipsychotic Agents); 0 (Psychotropic Drugs); 80043-53-4 (Gastrin-Releasing Peptide); KG60484QX9 (Omeprazole)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1097/WNF.0000000000000213


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[PMID]:29179831
[Au] Autor:Chee GL; Wynaden D; Heslop K
[Ad] Endereço:School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, Western Australia, Australia. Electronic address: Johnathan.Chee@health.wa.gov.au.
[Ti] Título:Improving metabolic monitoring rate for young people aged 35 and younger taking antipsychotic medications to treat a psychosis: A literature review.
[So] Source:Arch Psychiatr Nurs;31(6):624-633, 2017 12.
[Is] ISSN:1532-8228
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Young people aged 35 and younger who are taking antipsychotic medications to treat a psychosis are a high risk for developing metabolic syndrome due to the adverse effects of the medications. This paper reports the finding of a review of literature to identify interventions to improve metabolic monitoring rates in this group. A review of 478 studies identified 15 articles which met the inclusion criteria. Five articles reported single-intervention studies and the remaining integrated two or more interventions to improve uptake level of metabolic monitoring. As metabolic syndrome can be detected early through metabolic monitoring in young people taking antipsychotics, early intervention is important to improve their physical health trajectory.
[Mh] Termos MeSH primário: Antipsicóticos/efeitos adversos
Síndrome Metabólica/etiologia
Transtornos Psicóticos/complicações
[Mh] Termos MeSH secundário: Antipsicóticos/uso terapêutico
Seres Humanos
Transtornos Psicóticos/tratamento farmacológico
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antipsychotic Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:29179826
[Au] Autor:Oh E; Song E; Shin J
[Ad] Endereço:Department of Nursing, Jeonbuk Science College, Republic of Korea.
[Ti] Título:Individual Factors Affecting Self-esteem, and Relationships Among Self-esteem, Body Mass Index, and Body Image in Patients With Schizophrenia.
[So] Source:Arch Psychiatr Nurs;31(6):588-595, 2017 12.
[Is] ISSN:1532-8228
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The purposes of this study were to identify correlations between body mass index, body image, and self-esteem in patients with schizophrenia and to analyse the specific factors affecting self-esteem. This study had a descriptive design, utilising a cross-sectional survey. Participants were patients with schizophrenia who were admitted to a mental health facility in South Korea. A total of 180 questionnaires were distributed, and an appropriate total sample size of 167 valid questionnaires was analysed. Self-esteem was significantly correlated with body image, the subscale of appearance orientation, and body areas satisfaction. However, body mass index exhibited no significant correlation with any variable. The variables found to have a significant explanatory power of 21.4% were appearance orientation and body areas satisfaction. The explanatory power of all factors was 33.6%. The self-esteem of patients with schizophrenia was influenced by body mass index and body image. The positive symptoms of schizophrenia can be controlled by medication, whereas negative symptoms can be improved through education and nursing care with medication. Thus, psychiatric nurses should develop education and care programs that contribute to the positive body image and self-esteem of patients with schizophrenia.
[Mh] Termos MeSH primário: Imagem Corporal
Índice de Massa Corporal
Esquizofrenia
Autoimagem
[Mh] Termos MeSH secundário: Adulto
Antipsicóticos/uso terapêutico
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Enfermagem Psiquiátrica/métodos
República da Coreia
Esquizofrenia/tratamento farmacológico
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antipsychotic Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM; N
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE


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[PMID]:28461252
[Au] Autor:Nedic Erjavec G; Uzun S; Nikolac Perkovic M; Kozumplik O; Svob Strac D; Mimica N; Hirasawa-Fujita M; Domino EF; Pivac N
[Ad] Endereço:Rudjer Boskovic Institute, Division of Molecular Medicine, Zagreb, Croatia.
[Ti] Título:Cortisol in schizophrenia: No association with tobacco smoking, clinical symptoms or antipsychotic medication.
[So] Source:Prog Neuropsychopharmacol Biol Psychiatry;77:228-235, 2017 Jul 03.
[Is] ISSN:1878-4216
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Cigarette smoking is associated with higher cortisol levels in healthy subjects. In schizophrenia this relationship is not clear. There are divergent results on the association between cortisol with smoking, clinical symptoms and medication in schizophrenia. This study evaluated this association in 196 Caucasian inpatients with schizophrenia (51.30±26.68years old), subdivided into 123 smokers and 73 non-smokers. Basal salivary cortisol levels were measured twice, at 08.00 and 09.00AM, 90-120min after awakening. The effect of smoking on cortisol was evaluated according to current smoking status, the number of cigarettes/day and the nicotine addiction intensity. The influence of clinical symptoms and/or antipsychotic medication on cortisol was determined using the Positive and Negative Syndrome Scale (PANSS), and chlorpromazine equivalent doses. Non-smokers were older, received lower doses of antipsychotics, had higher PANSS scores, and had longer duration of illness than smokers. Salivary cortisol was similar in schizophrenic patients subdivided according to the smoking status, the number of cigarettes/day and nicotine addiction intensity. No significant correlation was found between salivary cortisol and PANSS scores, chlorpromazine equivalent doses, age of onset or the duration of illness. The findings revealed no association between salivary cortisol and smoking, nicotine addiction intensity, or clinical symptoms. Our preliminary data showed no correlation between salivary cortisol and chlorpromazine equivalent doses and/or antipsychotic medication. Our findings suggest that smoking does not affect the cortisol response in schizophrenic patients as it has been shown in healthy individuals. Future studies should investigate a possible desensitization of the stress system to smoking.
[Mh] Termos MeSH primário: Antipsicóticos/uso terapêutico
Hidrocortisona/metabolismo
Esquizofrenia/metabolismo
Fumar/metabolismo
[Mh] Termos MeSH secundário: Adulto
Estudos de Casos e Controles
Feminino
Seres Humanos
Masculino
Meia-Idade
Saliva/metabolismo
Esquizofrenia/diagnóstico
Esquizofrenia/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antipsychotic Agents); WI4X0X7BPJ (Hydrocortisone)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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Registro de Ensaios Clínicos
Registro de Ensaios Clínicos
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[PMID]:29466591
[Au] Autor:van den Boogaard M; Slooter AJC; Brüggemann RJM; Schoonhoven L; Beishuizen A; Vermeijden JW; Pretorius D; de Koning J; Simons KS; Dennesen PJW; Van der Voort PHJ; Houterman S; van der Hoeven JG; Pickkers P; REDUCE Study Investigators
[Ad] Endereço:Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
[Ti] Título:Effect of Haloperidol on Survival Among Critically Ill Adults With a High Risk of Delirium: The REDUCE Randomized Clinical Trial.
[So] Source:JAMA;319(7):680-690, 2018 02 20.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Results of studies on use of prophylactic haloperidol in critically ill adults are inconclusive, especially in patients at high risk of delirium. Objective: To determine whether prophylactic use of haloperidol improves survival among critically ill adults at high risk of delirium, which was defined as an anticipated intensive care unit (ICU) stay of at least 2 days. Design, Setting, and Participants: Randomized, double-blind, placebo-controlled investigator-driven study involving 1789 critically ill adults treated at 21 ICUs, at which nonpharmacological interventions for delirium prevention are routinely used in the Netherlands. Patients without delirium whose expected ICU stay was at least a day were included. Recruitment was from July 2013 to December 2016 and follow-up was conducted at 90 days with the final follow-up on March 1, 2017. Interventions: Patients received prophylactic treatment 3 times daily intravenously either 1 mg (n = 350) or 2 mg (n = 732) of haloperidol or placebo (n = 707), consisting of 0.9% sodium chloride. Main Outcome and Measures: The primary outcome was the number of days that patients survived in 28 days. There were 15 secondary outcomes, including delirium incidence, 28-day delirium-free and coma-free days, duration of mechanical ventilation, and ICU and hospital length of stay. Results: All 1789 randomized patients (mean, age 66.6 years [SD, 12.6]; 1099 men [61.4%]) completed the study. The 1-mg haloperidol group was prematurely stopped because of futility. There was no difference in the median days patients survived in 28 days, 28 days in the 2-mg haloperidol group vs 28 days in the placebo group, for a difference of 0 days (95% CI, 0-0; P = .93) and a hazard ratio of 1.003 (95% CI, 0.78-1.30, P=.82). All of the 15 secondary outcomes were not statistically different. These included delirium incidence (mean difference, 1.5%, 95% CI, -3.6% to 6.7%), delirium-free and coma-free days (mean difference, 0 days, 95% CI, 0-0 days), and duration of mechanical ventilation, ICU, and hospital length of stay (mean difference, 0 days, 95% CI, 0-0 days for all 3 measures). The number of reported adverse effects did not differ between groups (2 [0.3%] for the 2-mg haloperidol group vs 1 [0.1%] for the placebo group). Conclusions and Relevance: Among critically ill adults at high risk of delirium, the use of prophylactic haloperidol compared with placebo did not improve survival at 28 days. These findings do not support the use of prophylactic haloperidol for reducing mortality in critically ill adults. Trial Registration: clinicaltrials.gov Identifier: NCT01785290.
[Mh] Termos MeSH primário: Antipsicóticos/administração & dosagem
Estado Terminal/mortalidade
Delírio/prevenção & controle
Haloperidol/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Antipsicóticos/efeitos adversos
Relação Dose-Resposta a Droga
Método Duplo-Cego
Feminino
Haloperidol/efeitos adversos
Seres Humanos
Unidades de Terapia Intensiva
Masculino
Meia-Idade
Modelos de Riscos Proporcionais
Fatores de Risco
Análise de Sobrevida
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antipsychotic Agents); J6292F8L3D (Haloperidol)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2018.0160


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[PMID]:29465603
[Au] Autor:Yu H; Shen X
[Ad] Endereço:Department of Otorhinolaryngology.
[Ti] Título:Postoperative delirium after partial laryngectomy in a middle-aged patient: A case report.
[So] Source:Medicine (Baltimore);97(8):e9988, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONAL: Postoperative delirium is a common occurrence in older patients. However, reports of postoperative delirium in middle-aged patients are limited, and the underlying mechanism of delirium in this patient population is not clear. PATIENT CONCERNS: A 45-year-old man who developed postoperative delirium on the second day after partial laryngectomy. Interviews of the surgical team, patient, and patient's spouse revealed that the patient was psychologically stressed, but had not been diagnosed or treated. The patient also suffered impairment in physiological functioning and sleep disturbance after surgery. DIAGNOSIS: Postoperative delirium. INTERVENTIONS: The postoperative delirium was treated with an antipsychotic drug. OUTCOMES: The patient recovered well. LESSONS: Preoperative psychological stress, which is often undiagnosed and untreated, can increase the risk of postoperative delirium in middle-aged patients undergoing laryngectomy. Therefore, screening for psychological stress and implementing strategies to prevent delirium should be considered for patients who undergo laryngectomy, even if they are not in high-risk older age groups.
[Mh] Termos MeSH primário: Delírio/etiologia
Laringectomia/efeitos adversos
Complicações Pós-Operatórias
[Mh] Termos MeSH secundário: Antipsicóticos/uso terapêutico
Delírio/tratamento farmacológico
Seres Humanos
Laringectomia/métodos
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antipsychotic Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009988


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[PMID]:29465560
[Au] Autor:Xue X; Song Y; Yu X; Fan Q; Tang J; Chen X
[Ad] Endereço:Department of Substance Abuse, Qingdao Mental Health Center, Qingdao.
[Ti] Título:Olanzapine and haloperidol for the treatment of acute symptoms of mental disorders induced by amphetamine-type stimulants: A randomized controlled trial.
[So] Source:Medicine (Baltimore);97(8):e9786, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: This study aimed to compare olanzapine and haloperidol efficacies in the treatment of acute psychiatric symptoms due to amphetamine-type stimulants (ATSs). METHODS: The Zelen II design method was used; 124 patients with acute mental disorders due to amphetamine were randomly divided into olanzapine group (n = 63) and haloperidol group (n = 61). Then, a 4-week open-label medical therapy was performed. Clinical Global Impression Scale Item 2 was employed to evaluate the onset time; meanwhile, Brief Psychiatric Rating Scale (BPRS) was used at baseline and at posttreatment weeks 1, 2, and 4. Moreover, adverse reactions during the treatment were recorded. RESULTS: Onset time in the olanzapine group was significantly earlier than in the haloperidol group; BPRS scores in the olanzapine group were significantly lower than haloperidol group values at 1 and 2 weeks of treatment. The overall effective rates had no statistically significant difference. CONCLUSION: Short-term olanzapine and haloperidol treatments had equivalent efficacies in the treatment of acute symptoms of mental disorders due to ATSs; however, olanzapine administration resulted in relatively earlier disease onset, with less adverse reactions.
[Mh] Termos MeSH primário: Transtornos Relacionados ao Uso de Anfetaminas/tratamento farmacológico
Antipsicóticos/administração & dosagem
Benzodiazepinas/administração & dosagem
Haloperidol/administração & dosagem
Transtornos Mentais/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Anfetamina/efeitos adversos
Transtornos Relacionados ao Uso de Anfetaminas/psicologia
Escalas de Graduação Psiquiátrica Breve
Estimulantes do Sistema Nervoso Central/efeitos adversos
Feminino
Seres Humanos
Masculino
Transtornos Mentais/induzido quimicamente
Projetos de Pesquisa
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antipsychotic Agents); 0 (Central Nervous System Stimulants); 12794-10-4 (Benzodiazepines); CK833KGX7E (Amphetamine); J6292F8L3D (Haloperidol); N7U69T4SZR (olanzapine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180222
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009786


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[PMID]:29407591
[Au] Autor:Zajdel P; Kos T; Marciniec K; Satala G; Canale V; Kaminski K; Holuj M; Lenda T; Koralewski R; Bednarski M; Nowinski L; Wójcikowski J; Daniel WA; Nikiforuk A; Nalepa I; Chmielarz P; Kusmierczyk J; Bojarski AJ; Popik P
[Ad] Endereço:Department of Medicinal Chemistry, Jagiellonian University Medical College, 9 Medyczna Street, 30-688 Kraków, Poland. Electronic address: pawel.zajdel@uj.edu.pl.
[Ti] Título:Novel multi-target azinesulfonamides of cyclic amine derivatives as potential antipsychotics with pro-social and pro-cognitive effects.
[So] Source:Eur J Med Chem;145:790-804, 2018 Feb 10.
[Is] ISSN:1768-3254
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:Currently used antipsychotics are characterized by multireceptor mode of action. While antagonism of dopamine D receptors is responsible for the alleviation of "positive" symptoms of schizophrenia and the effects at other, particularly serotonergic receptors are necessary for their additional therapeutic effects, there is no consensus regarding an "ideal" target engagement. Here, a detailed SAR analysis in a series of 45 novel azinesulfonamides of cyclic amine derivatives, involving the aryl-piperazine/piperidine pharmacophore, central alicyclic amine and azinesulfonamide groups has led to the selection of (S)-4-((2-(2-(4-(benzo[b]thiophen-4-yl)piperazin-1-yl)ethyl)pyrrolidin-1-yl)sulfonyl)isoquinoline (62). The polypharmacology profile of 62, characterized by partial 5-HT R agonism, 5-HT /5-HT /D /D R antagonism, and blockade of SERT, reduced the "positive"-like, and "negative"-like symptoms of psychoses. Compound 62 produced no catalepsy, demonstrated a low hyperprolactinemia liability and displayed pro-cognitive effects in the novel object recognition task and attentional set-shifting test. While association of in vitro features with the promising in vivo profile of 62 is still not fully established, its clinical efficacy should be verified in further stages of development.
[Mh] Termos MeSH primário: Aminas/farmacologia
Antipsicóticos/farmacologia
Cognição/efeitos dos fármacos
Receptores de Dopamina D2/metabolismo
Sulfonamidas/farmacologia
[Mh] Termos MeSH secundário: Aminas/síntese química
Aminas/química
Animais
Antipsicóticos/síntese química
Antipsicóticos/química
Relação Dose-Resposta a Droga
Cobaias
Células HEK293
Seres Humanos
Masculino
Estrutura Molecular
Ratos
Ratos Wistar
Relação Estrutura-Atividade
Sulfonamidas/síntese química
Sulfonamidas/química
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Amines); 0 (Antipsychotic Agents); 0 (Receptors, Dopamine D2); 0 (Sulfonamides)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180207
[St] Status:MEDLINE



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