Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

ADD 94057, a metabolite of fluzinamide, manufactured by the A. H. Robins Company, blocks chemically- and electrically-induced seizures in animals. The primary objective of this open add-on study was to evaluate patient tolerability of ADD 94057 at ascending target plasma concentrations. Nine subjects with medically refractory seizures were receiving phenytoin (PHT, 3), carbamazepine (CBZ, 3), or both (3). A pharmacokinetic profile after a single oral 400-mg dose of ADD 94057 was used to calculate ADD 94057 dosages. After a 4-week baseline period, patients were treated for 4 weeks with weekly ADD 94057 dosage escalations. Two patients completed the study at their assigned highest dosage level; the other patients finished the study at lower dosages. The patients receiving PHT (but not CBZ) tolerated higher plasma concentrations of ADD 94057 than did patients receiving CBZ, alone or in combination with PHT. Adverse experiences included headache, ataxia, blurred vision, diplopia, dizziness, lightheadedness, and mild confusion. Eight of nine patients had reductions in seizure frequency from baseline.
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PMID:Pharmacokinetic and dose tolerability study of ADD 94057 in comedicated patients with partial seizures. 173 43

Twenty adult male volunteers were studied in an unblinded, ascending-dose study to evaluate the safety, tolerance, and pharmacokinetics of intravenously administered nonionic gadodiamide injection. Dosages administered were 0.05, 0.1, 0.2, and 0.3 mmol/kg. Subjects were monitored from 36 hours before, through 72 hours after administration. There were no clinically relevant changes in vital signs or electrocardiograms. No clinically significant changes occurred in blood or urine laboratory parameters, although a tendency for minor, transient elevations in serum iron levels 8 to 48 hours after administration was noted. These changes were not dose-related. Nine of 20 subjects reported at least one adverse event; all events were transient and of mild intensity, the most common being dizziness/lightheadedness and perversion of taste or smell. One subject reported discomfort consisting of mild stinging at the injection site during administration. Gadodiamide was excreted unmetabolized in the urine with greater than 95% recovery at 72 hours after administration. The serum elimination half-life was approximately 70 minutes.
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PMID:A phase I clinical trial with gadodiamide injection, a nonionic magnetic resonance imaging enhancement agent. 174 22

Trospectomycin sulfate is a novel aminocyclitol antibiotic. This study evaluated the tolerance and the pharmacokinetics of multiple, intravenous doses of trospectomycin (TRO) in healthy male volunteers. Three groups of 10 volunteers were studied. Eight volunteers in each group were studied in a parallel design to receive trospectomycin (Group 1 = 250 mg, Group 2 = 500 mg, Group 3 = 750 mg) while 2 volunteers received placebo (normal saline). Drug doses were administered in 30 ml volumes over 30 min every 8 h for 7 days (i.e. 21 total doses). Evaluations of vital signs, side effects, and safety laboratory tests were made at regular intervals during the study. The most frequent medical events observed in the volunteers receiving trospectomycin were perioral/facial paresthesias (54%), pain at the i.v. infusion site (46%), dizziness/lightheadedness (58%), and GI symptoms (38%). A statistically significant dose response relationship was observed for the incidence of perioral/facial paresthesias and pain at the i.v. infusion site (i.e., increased incidence with increased dose). All the medical events were mild or moderate in severity and reversible following drug discontinuation. In the 500 and 750 mg trospectomycin groups, standing systolic blood pressure decreased significantly with the first dose of study drug. Elevated levels of SGPT were observed in 9 volunteers (1 in placebo, 3 in 250 mg, 1 in 500 mg, and 4 in 750 mg dose groups). This study demonstrates that multiple intravenous trospectomycin doses up to 750 mg are reasonably well tolerated in healthy male volunteers. The concentration of trospectomycin in serum, measured with a sensitive HPLC assay, was less than 3 mcg/ml at 8 h postinfusion for all dose levels.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Multiple-dose, double-blind, placebo controlled intravenous tolerance and pharmacokinetic study of trospectomycin sulfate (U-63, 366F) in healthy male volunteers. 214 31

One hundred eighteen patients, 77 men and 23 women ranging in age from 18 to 70 years of age, admitted to an inpatient facility in Central New York were administered buspirone HCl for treatment of the alcohol withdrawal syndrome. Although one patient had an unwitnessed seizure, none of the subjects required discontinuance of buspirone HCl because of symptoms of dizziness, nausea, headache, nervousness, or lightheadedness, typical side effects described by the manufacturer. All but one of the individuals given buspirone HCl for alcohol detoxification completed that phase of treatment within six days in a manner which effectively controlled their withdrawal symptoms. The findings were suggestive of an important role for buspirone HCl in the detoxification of the alcohol-dependent patient using a pharmacologic agent other than traditional medications such as benzodiazepines, phenobarbital, beta blockers, magnesium sulphate, or clonidine.
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PMID:The role of buspirone in the management of alcohol withdrawal: a preliminary investigation. 223 26

The majority of cases of acute, nonspecific diarrhea are of short duration, can be treated symptomatically with nonprescription medications and adequate hydration, and do not require a visit to the physician's office. If the family practitioner can determine via telephone that the patient, or the caller's child, is not experiencing certain signs and symptoms often associated with diarrheal illness that may indicate a more severe condition (e.g., high fever, vomiting, persistent diarrhea, or diarrhea accompanied by blood or severe abdominal or rectal pain), self-treatment may be allowed without an office visit. In addition, if the physician determines that the patient is not suffering from diarrheal dehydration, indicated by dry mouth, excessive thirst (or for children, inadequate fluid intake), wrinkled skin, little or no urination, dizziness, or lightheadedness, the physician may also allow the patient to be treated without an office visit. If, however, the patient is experiencing any of these symptoms, an office visit is required to facilitate further evaluation by the physician.
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PMID:Family practitioner's guide to patient self-treatment of acute diarrhea. 235 47

Between the years 1981-1984, 89 air-personnel, ages 18-45 years, underwent 24-hour ambulatory ECG monitoring at the Israel Air Force Aeromedical Center due to an incidental finding of one or more premature ventricular contractions (PVCs) on the resting supine 12-lead ECG. Complex ectopic arrhythmias (bigemini, trigemini, couplets, ventricular tachycardia, R on T phenomenon, or multifocal patterns) were observed during monitoring in 1.4% of 138 control subjects without PVCs, in 22% of those with 1 to 3 PVC X min-1 and in 68% of those with 4 or more PVC X min-1 on the resting ECG. Altogether 39(44%) of the 89 subjects with PVCs on the resting ECG had complex ectopic rhythms on monitoring. Of the 43 subjects with available follow-up data, 3 (7%) reported bouts of dizziness and light headedness which coincided with complex ectopic rhythms. In one of these three subjects, the bouts of dizziness coincided with runs of ventricular tachycardia during exercise testing.
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PMID:Predictive value of premature ventricular contractions on the resting electrocardiogram for ventricular arrhythmias on 24 hour monitoring in asymptomatic young adults. 243 71

In this study, we used Holter pacemakers in a group of 13 patients affected by severe carotid sinus syndrome in order to evaluate its evolution. All the patients had one to three syncopal episodes and frequent other symptoms such as fainting, dizziness, lightheadedness and pre-syncope interferring with their daily activity so that pacemaker therapy was considered necessary. Patient selection criteria were: presence of the isolated cardioinhibitory type, absence of associated sinus dysfunction and absence of symptomatic VVI pacemaker effect. All the patients received a Micropacer 1 device; among special functions, bradycardia events counter was activated and programmed so that each sequence of three consecutive beats at a cycle length 1.5 sec (i.e., 4.5 sec total interval) could be recognized and stored in its memory. The follow-up lasted 13 +/- 7 months. Brady events occurred in eight out of 13 patients (62%), during this period. Syncope and major symptoms disappeared in all the patients; mild dizziness recurred rarely in two patients and were not linked to brady-events recording. In conclusion, disappearance of severe symptoms observed after pacemaker implant in cardioinhibitory carotid sinus syndrome seems to depend from pacing therapy, in most cases, yet from the benign natural course of the disease in some other cases.
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PMID:Assessment of VVI diagnostic pacing mode in patients with cardioinhibitory carotid sinus syndrome. 246 26

Since most of the toxicity associated with class 1B antiarrhythmic drugs is dose-related, this review examines adverse effects seen in both therapeutic practice and accidental or premeditated overdose. Toxicity is very common with these agents and can be life-threatening. A high percentage of patients must discontinue therapy because of adverse effects. Mexiletine and tocainide are structural analogues of lignocaine (lidocaine) and toxicity is similar with all 3 drugs. With gradual intoxication (the most common form) central nervous system effects such as lightheadedness, dizziness, drowsiness and confusion are seen first. Seizures and respiratory arrest can occur. Cardiovascular toxicity is manifested by progressive heart block, reduced cardiac contraction, hypotension and asystole. Both mexiletine and tocainide may have proarrhythmic effects. Gastrointestinal toxicity is also common. Shock, hypotension, cardiac failure and beta-blocker therapy reduce lignocaine clearance and enhance the risk of intoxication during routine therapy. Both lignocaine and mexiletine elimination is impaired in severe liver disease while tocainide clearance is reduced in renal failure. Management of toxicity is largely supportive and symptomatic. Lignocaine infusion must be discontinued and decontamination of the gut in the case of oral preparations is recommended. Serious intoxication requires intensive care unit admission. Haemodialysis or haemoperfusion may be helpful in serious lignocaine and tocainide poisoning. In institutions where extracorporeal circulatory assistance is available, massive lignocaine poisoning has been successfully treated with this intervention. In the therapeutic setting serious toxicity can be prevented by close clinical surveillance and appropriate dose reduction in patients with reduced drug clearance. Because of the large interindividual variation in lignocaine pharmacokinetic parameters, therapeutic drug monitoring is recommended if results can be reported quickly. Mexiletine and tocainide have stereoselective metabolism and assays do not distinguish the more active isomers. Therapeutic drug monitoring is less useful in this situation.
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PMID:Poisoning due to class 1B antiarrhythmic drugs. Lignocaine, mexiletine and tocainide. 251 64

19 cases of pacemaker syndrome were observed in 121 patients implanted with VVI pacemakers. The main manifestations of pacemaker syndrome were dizziness, lightheadedness, fatigue, hypotension and congestive cardiac failure after permanent ventricular pacing. The incidence of pacemaker syndrome was 20% in patients with sick sinus syndrome and 13.2% with A-V block. Pacemaker ECG showed retrograde ventriculoatrial conduction in 25 of 121 cases. Among these patients, 14 (56%) had pacemaker syndrome, while only 5 of 96 cases without ventriculoatrial conduction had this syndrome, so the incidence of the two groups were quite different, P less than 0.0001. The frequency of ventriculoatrial conduction in patients with sick sinus syndrome was higher than in patients with A-V block (16/45 vs 9/76, P less than 0.05). The electrophysiologic study were performed in 17 cases before PM implantation. 3 cases had 170-190 ms ventriculoatrial 1:1 conduction. Retrograde ventriculoatrial conduction in pacemaker ECG were present during ventricular pacing in all of them.
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PMID:[Pacemaker syndrome and retrograde ventriculoatrial conduction]. 262 75

Postural hypotension (PH) was investigated in 100 ambulatory patients aged 65 years or older, who were seen in a university family practice clinic. Thirty-one percent had a decrease in systolic blood pressure of 20 mmHg or more, while 16 percent had a diastolic drop of 10 mmHg or more. Twelve percent had a significant drop in both systolic and diastolic blood pressure upon standing. Patients with both systolic and diastolic PH were more likely to have had a fall during the year prior to evaluation and decreased functional ability compared with those without PH. The group with systolic PH was more likely to have symptoms on standing and a history of weakness, but dizziness and lightheadedness were not correlated with PH. Postural hypotension occurred in only 13 percent of patients without risk factors for PH and in 35 percent of patients with risk factors. However, this difference was not statistically significant. Demographics and functional ability were similar between the risk factor groups. Thus, PH occurred frequently in our patients, could not be reliably predicted on the basis of risk factors or symptoms, and was correlated with a history of a recent fall and decreased functional ability.
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PMID:Postural hypotension in elderly family practice patients. 280 Nov 91


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