Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 1981 and 1982, two US citizens died from Japanese encephalitis (JE) acquired in China. In 1983, the Centers for Disease Control initiated an evaluation of a purified, inactivated, mouse-brain-derived JE vaccine produced and used in Japan since 1966. Two doses of this vaccine given 1-2 weeks apart evoked neutralizing antibody titers greater than or equal to 8 in only 77% of recipients. After three JE vaccine doses administered 1-2 weeks apart, 99% developed titers greater than or equal to 8. When a third dose was given to 29 participants 6-12 months after the primary series, all developed titers greater than or equal to 16. Reported adverse reactions included injection site tenderness (18%), erythema (6%), or swelling (3%); headache (9%); and dizziness, fatigue, sleepiness, nausea, chills, fever, or lower back pain (less than or equal to 5%). On the basis of this study, three doses of BIKEN JE vaccine are recommended for US citizens who may be at risk of exposure to JE virus.
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PMID:Evaluation of the potency and safety of inactivated Japanese encephalitis vaccine in US inhabitants. 232 39

The author examined a series of 23 depressed and 15 obsessive compulsive disorder outpatients who were treated with 40-80 mg/day of tranylcypromine to determine the frequency and clinical features of fatigue and somnolence. Four (all depressed) of the 38 patients experienced hypersomnolence and fatigue in the late afternoon. The somnolence was severe enough to impair their ability to work and drive. Afternoon fatigue and somnolence appear to be important and not uncommon side effects of tranylcypromine treatment.
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PMID:Afternoon fatigue and somnolence associated with tranylcypromine treatment. 233 94

A dopamine receptor antagonist, metoclopramide has unique properties of increasing lower esophageal sphincter pressure and increasing the rate of gastric emptying. These gastrointestinal motility actions are useful in the treatment of diabetic gastroparesis and severe gastroesophageal reflux and in postoperative situations involving visceral atony. Metoclopramide is a useful adjunctive drug for intestinal intubation and radiologic examination. It has also been used intravenously to control the nausea and vomiting of intensive cancer chemotherapy, such as with cisplatin. Metoclopramide is a powerful antiemetic because of its combined actions on the chemoreceptor trigger zone and intestinal motility. This agent is generally not intended for long-term use. The oral preparations are recommended for four to 12 weeks of therapy. Use of parenteral metoclopramide should be limited to one or two days. The most common adverse reactions are restlessness, drowsiness, fatigue and lassitude. Extrapyramidal symptoms occur rarely and only with high dosage or prolonged use.
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PMID:Metoclopramide: a dopamine receptor antagonist. 240 79

The clinical experience of 763 medical practitioners who treated 3,708 hypertensive patients (51% men) with indoramin, administered alone or in combination with diuretics and/or beta-adrenergic antagonists, is reported. All patients had baseline diastolic blood pressure (DBP) of 95 mm Hg or greater, even though most of the patients (62%) already were receiving optimum doses of diuretics (20%), beta-adrenergic antagonists (15%), or diuretics and beta-adrenergic antagonists (27%). After 6 to 10 weeks of indoramin therapy, the DBP of 70% of the patients was 90 mm Hg or lower; another 17% had treated DBP between 91 and 95 mm Hg. Response rates were similar among patients treated with indoramin alone and those who received concomitant antihypertensive treatment. Indoramin doses of 50 mg/day or less (dose range, 12.5 to 125 mg/day) were required in approximately 70% of the patients. Weight gain and reflex tachycardia were not observed. The most frequently reported side effects were drowsiness/tiredness, dizziness, and dry mouth. Only 6% of the patients discontinued indoramin treatment because of side effects. The results of this study indicate that indoramin, administered alone or in combination with diuretics and/or beta-adrenergic antagonists, is a safe and effective antihypertensive agent when used in relatively low doses in clinical practice.
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PMID:Antihypertensive therapy in the Federal Republic of Germany: clinical practice experience with indoramin (Wydora). 242 96

The safety and efficacy of indoramin and prazosin added to hydrochlorothiazide (HCTZ) were compared in a double-blind trial involving 209 patients with mild to moderately severe essential hypertension. Patients whose supine diastolic blood pressure (SDBP) did not decrease to less than or equal to 90 mm Hg after 6 weeks of HCTZ therapy had indoramin or prazosin added to their regimen. Mean SDBP during 6 months of combination therapy with either regimen decreased by approximately 10 mm Hg from that at the final evaluation during HCTZ therapy (p less than 0.001); differences between the groups were not statistically significant. Mean heart rate was unchanged, whereas mean weight increased (p less than 0.001) above final HCTZ values by approximately 2 kg in both groups. Mean weight increased significantly (p less than 0.01) from baseline values, however, only in the prazosin/HCTZ group. Approximately 95% of the patients in each group had clinically significant decreases in SDBP. Fatigue or tiredness and dizziness were the most commonly reported adverse effects, and their frequencies were not significantly different in the two groups. Cardiac arrhythmias occurred only in patients in the prazosin/HCTZ group and were significantly (p less than 0.05) more frequent than among patients in the indoramin/HCTZ group; less severe adverse experiences, i.e., dry mouth, ejaculatory problems, drowsiness, and sedation, were significantly (p less than 0.05) more frequent in the indoramin/HCTZ group. When added to HCTZ, indoramin and prazosin are equally safe and effective in the treatment of hypertension.
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PMID:Antihypertensive effects of indoramin and prazosin in combination with hydrochlorothiazide. 242 99

The antihypertensive efficacy and safety of indoramin, an alpha 1-adrenergic antagonist, were evaluated in 215 elderly patients. Data were collected from patients aged 60 years and older who were treated under similar protocols with indoramin administered alone (n = 58) or in combination with a thiazide diuretic (n = 157). After at least 6 months of treatment, the mean daily dosage of indoramin was higher among patients who received indoramin alone (122 mg/day) than among those who received indoramin plus a diuretic (92 mg/day). Mean supine blood pressure decreased (p less than 0.001) from 174/105 to 152/191 mm Hg in indoramin-treated patients and from 179/101 to 150/91 mm Hg in patients who were treated with indoramin plus a diuretic. Clinically satisfactory blood pressure decreases occurred in the majority of the patients who received indoramin, either alone (69%) or with a diuretic (75%). Both treatments were well tolerated by elderly patients; only 15 patients (7%) discontinued therapy because of adverse effects. Drowsiness, fatigue, and dizziness were the most frequently reported side effects. The results of this analysis indicate that indoramin, administered alone or in combination with a thiazide diuretic, is a safe and effective therapeutic regimen for elderly hypertensive patients.
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PMID:Antihypertensive therapy with indoramin in the elderly. 242 7

A double-blind controlled, randomized, parallel, multicenter 12-week study was conducted to compare the antihypertensive efficacy of lisinopril with that of metoprolol in treatment of moderate to severe hypertension. Initially, 118 patients were recruited on lisinopril and 61 on metoprolol; and for the purpose of efficacy analysis at week 8, 115 patients on lisinopril and 60 on metoprolol were included. The doses of lisinopril or metoprolol were 40-80 mg/day and 100-200 mg/day, respectively. At week 4, the pretreatment diastolic blood pressure of 111 mm Hg was decreased to 97 mm Hg (p less than 0.01) with lisinopril: metoprolol decreased the diastolic blood pressure from 110 to 99 mm Hg (p less than 0.01). Similar decreases were noted at week 8; however, the drop in blood pressure with lisinopril was not significantly different from that with metoprolol. Systolic blood pressure also demonstrated a decrease of about 18 mm Hg with lisinopril and 12 mm Hg with metoprolol (p less than 0.01). This larger decrease in systolic blood pressure with lisinopril was statistically significant at week 4 (p less than 0.05). These decreases in systolic blood pressures were maintained at week 8, again with statistical significance (p less than 0.01). Of the 118 lisinopril-treated patients, four were discontinued from lisinopril therapy because of headache, dizziness, rash, flushing, or lymphadenopathy. Four patients out of 61 (9.8%) were discontinued from metoprolol therapy because of fatigue, somnolence, asthenia, weight gain, flatulence, tremor, or bronchospasm. In conclusion, lisinopril 40-80 mg once daily is as effective as metoprolol 100-200 mg once daily in reducing diastolic blood pressure in patients with moderate to severe hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of antihypertensive efficacy of lisinopril compared to metoprolol in moderate to severe hypertension. 244 53

The antiepileptic effect of lamotrigine (LTG) was assessed in a double-blind, placebo-controlled crossover trial in 24 adult patients with refractory partial seizures. LTG or placebo was added to existing antiepileptic drugs (AEDs). The dose of LTG varied from 75 to 400 mg daily. Three patients did not complete the trial. One was withdrawn from the trial with ataxia, tiredness, dyspnea, and diplopia while receiving LTG and died 18 days later of invasive carcinoma involving the liver. A second patient was withdrawn during baseline for contravening admission criteria, and a third received LTG in error during both treatment periods. Twenty-one patients (12 men and 9 women) completed the trial. An analysis of seizure counts in the 12-week treatment period with LTG showed a statistically significant reduction in seizures as compared with placebo for total seizures (p less than 0.002), partial seizures (p less than 0.002), and secondarily generalized seizures (p less than 0.05). The analysis of total seizure days showed a significant reduction during LTG treatment (p less than 0.002). There were no statistically significant changes in plasma concentrations of phenytoin (PHT), carbamazepine (CBZ), primidone (PRM), or phenobarbital (PB) between the two treatment periods. The most common adverse events reported during the trial were diplopia, drowsiness, tiredness, ataxia, and headache, but although these were more frequent during LTG treatment, the differences from placebo were not statistically significant. No hematological or biochemical changes were noted.
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PMID:Controlled trial of lamotrigine (Lamictal) for refractory partial seizures. 249 73

The metabolic effects of the anti-fungal drug fluconazole were investigated in 18 women, 10 of whom were taking oral contraceptives, to examine whether this steroid antagonist has any effects primarily on hormone systems. The women, aged 29-40, took 50 mg fluconazole orally from Day 1 of their menstrual cycle for 21-28 days. Subjects kept a symptom diary, were tested weekly for hematological and liver function, and were checked for compliance by analyzing blood for drug by GLC. 5 women reported side effects: somnolence, dizziness, fatigue, increased appetite, headache (1) and nausea (1). No effects on liver function or menses were noted. The only significant findings were increases in serum thyroxine and testosterone in fluconazole-only subjects, and increases in insulin and apo-lipoprotein B in fluconazole-oral contraceptive subjects. Pills containing levonorgestrel were used by 9 women, desogestrel by 1. No significant differences were seen in estradiol, progesterone, sex-hormone-binding globulin, thyroid function, cortisol, glucose, C-peptide, cholesterol, triglycerides, lipoproteins. Thus it is unlikely that the short-term use of fluconazole for treatment of superficial mycoses, such as vulvovaginal candidiasis, will adversely affect steroid metabolism in women.
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PMID:Metabolic effects of low-dose fluconazole in healthy female users and non-users of oral contraceptives. 254 10

Despite the fact that yawning is a reality of everyday life, its study is not included in the curriculum of medical schools, and most medical textbooks barely mention its existence. Two factors may help to explain this puzzling situation: (a) yawning's borderline position between psychology and neurology, and (b) researchers' lack of understanding as to why people yawn. After review of the literature and personal observation, it is concluded that yawning is a complex arousal defense reflex located in the reticular brainstem with a peripheral and central arche, whose aim is to reverse brain hypoxia. Yawning occurs with loss of interest (boredom) and may or may not be associated with fatigue. By reversing drowsiness, yawning avoids a decreased concentration capacity resulting from borderline hypoxia. It is hoped that this article will stimulate further research on the phenomenon.
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PMID:Is yawning an arousal defense reflex? 255 82


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