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)

Ranitidine was first marketed in 1981; since then many patients have been treated such that much experience has been accumulated on the safety of this histamine H2-receptor antagonist in the treatment of gastroduodenal disease. A wide array of ranitidine-associated side effects has been described, but infrequently. As so much information is now available, the aim of this review is to assess the weight of evidence for a causal link between ranitidine and the reported side effects. Overall, ranitidine is well tolerated. The incidence of general side effects at less than 2% is very similar to placebo. Headaches, tiredness, dizziness and mild gastrointestinal disturbance (e.g. diarrhoea, constipation and nausea) are among the most frequent complaints, but have very seldom resulted in stopping treatment. Cardiovascular side effects are extremely rare and unpredictable with the usual doses of oral ranitidine (at most 1 in 1 million patients). They mostly comprise sinusal bradycardia and atrioventricular blockade, especially after rapid intravenous administration, receding after cessation of the drug. Clinical studies, however, have not shown a significant pharmacological effect of ranitidine on the cardiovascular system via H2-receptors, even though individual sensitivities cannot be ruled out in a few isolated reports. Ranitidine is unlikely to be directly hepatotoxic: a transient change in liver function tests has been noted in only 1 in 100 to 1 in 1000 patients. Several cases of mixed hepatitis have been reported, but very few were fully documented. The incidence of ranitidine-associated acute hepatitis has been estimated to be less than 1 in 100,000 patients. Neuropsychiatric complications may be less common and clinically quite similar to those reported with cimetidine, i.e. confusion, disorientation, hallucinations, delirium. These side effects have occurred especially in critically ill and multiple-therapy patients, or patients with chronic renal or hepatic failure, so that the direct causal link with ranitidine treatment was often difficult to ascertain. Even though an H2-receptor-mediated effect is an attractive hypothesis (since similar complications were noted with other H2-receptor antagonists), other mechanisms have been suggested to play a role, e.g. cholinergic or histaminic effects. The overall incidence of neuropsychiatric complications is probably markedly less than 1%. White cell injury (i.e. agranulocytosis) appears to be the most frequent haematological complication, even though case reports are very few and poorly documented.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Side effects of ranitidine. 204 87

Primary malignant tumours of the heart are very rare, with an incidence of only 0.0017%-0.03% in consecutive autopsy series. Fibrosarcoma of the heart is also rare, representing only about 0.3% of all cardiac tumours. We observed a case of epicardial fibrosarcoma which developed 12 years after the first resection of an epicardial tumour. A 31-year-old woman was referred to our hospital because of fatigue, nausea and right back pain. She had had surgery to resect an epicardial tumour when she was 19 years old. On admission, there was a huge, heterogeneous tumour on the right inferior side of the heart. At surgery, the tumour was totally resected and a pathological diagnosis of fibrosarcoma was made. The patient was free of symptoms for 6 months, but died of a recurrence 11 months after the operation. It is postulated that the epicardial tumour had only been partially resected and had been latent for a rather long period but began to grow rapidly 12 years after the initial resection.
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PMID:Recurrent epicardial fibrosarcoma which arose 12 years after the first resection. 204 63

The plasma concentration of lisuride and prolactin have been measured in twelve healthy male volunteers after IV, IM or SC injection of 25 micrograms lisuride hydrogen maleate as an aqueous solution. After IV administration the plasma lisuride fell in two phases with half-lives of 14 min and 1.5 h. Total clearance was 13 ml.min-1.kg-1. After IM and SC injection the plasma concentrations peaked at 12 to 15 min and the profiles were similar to that found after IV administration. The systemic availabilities were 90% and 94%, respectively. Prolactin concentrations were reduced by a maximum of 60% relative to the normal circadian rhythm after all three routes of administration. The treatments were well tolerated, the only adverse reactions reported by some of the volunteers being mild, transient dizziness, tiredness, and nausea.
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PMID:The pharmacokinetics and pharmacodynamics of lisuride in healthy volunteers after intravenous, intramuscular, and subcutaneous injection. 205 Jan 75

The new fluorinated adenine analog, fludarabine, has been tested for efficacy in many tumor types over the past ten years. Two other similar nucleoside analogs are currently available for commercial use. Cytarabine is used principally as an antileukemic agent, and vidarabine as an antiviral. Unlike vidarabine, fludarabine is resistant to deactivation by adenosine deaminase. Data from Phase I and II trials suggest that fludarabine is potentially effective in a number of leukemias, including acute lymphocytic leukemia, acute nonlymphocytic leukemia, and chronic lymphocytic leukemia (CLL). Unfortunately, the doses required to achieve adequate response in the acute leukemias (greater than 75 mg/m2) were above the maximum tolerated dose, resulting in intolerable granulocytopenia, thrombocytopenia, and a life-threatening neurotoxic syndrome. In CLL: however, the dose required to achieve a satisfactory response is well within tolerated limits. Long-term survival statistics are not yet available, but historical perspective strongly correlates response to other agents with increased survival times. Toxicities seen at dose regimens of 15-40 mg/m2/d for five consecutive days include somnolence, metabolic acidosis, confusion, fatigue, nausea, vomiting, increase in serum creatinine and aminotransferase concentrations, and pulmonary and hepatic abnormalities. Mild to severe hematologic toxicity has been observed at all dose levels.
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PMID:Fludarabine: a review. 206 37

Okinawa prefecture is well known as an endemic area of Strongyloides stercoralis infection, and its recent infection rate was reported 6.2%, which was investigated by a new technique to detect S. stercoralis, agar plate method. Traditional treatment with thiabendazole was temporarily effective for S. stercoralis, but the recurrence rate was extremely high. We tried the new treatment for the purpose of complete eradication of the parasite. The patients were divided into two groups, who were given 500 mg of thiabendazole three times daily for 5 days and not medicated for the following 9 days. The medication was repeated 3 times in group 1 which consisted of 92 patients and 4 times in group 2 which consisted of 70 patients. Obtained results were as follows: 1) Six months after treatment, the cure rate was 89.5% in the only one course treatment, and 100% in more than 2 course treatments. 2) Side effects such as nausea, vomiting, anorexia or general fatigue were noted in 67.5% of all the patients after initial treatment, and 45.1% of the patients were dropped out of this trial. The dose of the drug was reduced in 32.1% of the patients, and only 22.8% were treated with full course of the regimen. 3) The elevation of S-GPT was observed in 33.8% of all patients. After initial treatment the rate was only 8.1%, but after 3 or 4 repeated course of treatments the rate was elevated to 39.0% and 45.4%, respectively. The liver injury was closely related to the total dose of thiabendazole and the period of the medication.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[New trial with thiabendazole for treatment of human strongyloidiasis]. 207 49

In a randomized, double-blind, parallel group study, diltiazem was compared with metoprolol as add-on therapy to diuretic treatment in 115 patients with hypertension. Following a placebo and diuretic period of four weeks, patients were randomized to either slow release diltiazem 90 mg twice daily or metoprolol 100 mg once daily using a double dummy technique. If after four weeks a target supine diastolic blood pressure (DBP) less than or equal to 90 mmHg pressure was not reached, the doses of diltiazem and metoprolol were doubled. Supine inclusion systolic/diastolic blood pressures (SBP/DBP) at randomization were 158 +/- 13 (mean +/- SD)/102 +/- 5 mmHg in the diltiazem group and 158 +/- 17/101 +/- 6 mmHg in the metoprolol group. Active therapy significantly lowered SBP and DBP in both groups by 7-10%. Heart rate was significantly lowered in both groups, although the effect of metoprolol was more pronounced. Response rates (supine DBP less than or equal to 90 mmHg and/or decreased by greater than or equal to 10%) were 43% on diltiazem 90 mg twice daily and 52% on metoprolol 100 mg once daily, increasing to 82% and 62%, respectively, after dose escalations. No serious side effects were seen, but three patients, two on diltiazem and one on metoprolol, were withdrawn from the study due to severe headache, nausea and bradycardia respectively. of mild to moderate adverse reactions, tiredness was most frequent, occurring in 14.5% and 15.8% on active diltiazem and metoprolol therapy, respectively. We conclude that both diltiazem and metoprolol lower BP when added to diuretics in hypertensive patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diltiazem compared with metoprolol as add-on-therapies to diuretics in hypertension. Swedish Diltiazem-Metoprolol Multicentre Study Group. 207 68

The aim of the study was to examine the frequency, severity, persistence and etiology of relapses occurring during the hepatitis A viral infection. Therefore, a prospective study of 910 patients suffering from hepatitis A (HA) was carried out. The clinical examination and determination of glutamyl pyruvic transaminase (GPT) in the serum every 7-14 days till recovery (usually during 6--8 months) were performed. HAV infection was confirmed by detecting anti-HAV IgM in the blood of all the examined by radioimmunoassay. In 876 (93.3%) patients HA had typical clinical features and a monophasic course. All cases made a rapid clinical recovery and liver function tests improved strikingly between 1 and 4 months after the onset of illness. However, in 34 (3.7%) of 910 patients, after an asymptomatic interval of 4--8 weeks, relapsing hepatitis occurred. Mild clinical symptoms: fatigue, myalgia, nausea, epigastric discomfort accompanied by the elevated levels of GPT in the serum were noticed in 11 patients, while 3 of them redeveloped jaundice. In 23 remaining patients relapses of hepatitis were asymptomatic, except for the reappearance of icterus in six cases. The only way to establish the exacerbation of the disease was through the pathological findings of GPT in the serum, which increased 10--60 times above the upper limit of the normal value. While 25 patients had one relapse, in 9 there were two or more relapses, so that hepatitis had a biphasic or polyphasic course. The second relapse was registered 3--6 weeks after the first one disappeared. Through biochemical tests the average values of the GPT were established: 1566 U/L in the acute stage, 107 U/L during the early stage of convalescence and 1016 U/L during the first relapse of hepatitis. After the first relapse and during remission, in 9 patients the average values of GPT in the serum were 84 U/L, while during the second relapse 518 U/L. Clinical signs of relapsing hepatitis disappeared approximately in 4 days, but liver function tests decreased slowly and persisted elevated between 5 and 12 months. A possibility of establishing the etiology of relapsing hepatitis, which has yet remained unknown, is discussed. Anti-HAV IgM were present in all 34 patients during the initial and relapsing phase of hepatitis and in 26 cases in the latter phase of convalescence between 9 and 11 months after the beginning of the disease. Serological tests excluded infection with hepatitis B, cytomegalovirus and Epstein-Barr virus. With a great probability other infections and toxic agents damaging the liver could have been excluded.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Recurrences of viral hepatitis A]. 207 29

Within the framework of an open, multicenter study of 16 physicians treated 206 hypertensive patients with a daily dose of 2 x 30 mg to 2 x 90 mg of urapidil over a period of 3 years. Data are available on 182 patients for the entire study period. 24 patients discontinued the study due to adverse effects (n = 2), an inadequate effect (n = 2), or for reasons unrelated to therapy (n = 20); 58 (28.2%) patients had complaints. The most frequently reported symptoms were nausea, dizziness, drowsiness and fatigue. No relevant changes in laboratory values were observed. Average body weight remained constant and there were no signs of sodium or water retention. In the first year systolic blood pressure was reduced by 25 mm Hg from 174 +/- 13 mm Hg to 149 +/- 10 mm Hg (mean value +/- SD), and diastolic pressure by 17 mm Hg from 103 +/- 6 mm Hg to 86 +/- 6 mm Hg. At the same average dose this drop in BP persisted in the second year (150 +/- 12/86 +/- 7 mm Hg) and the third year (146 +/- 10/85 +/- 7 mm Hg), indicating that there was no decrease in urapidil effect. The pulse rate fell from 77 +/- 8 beats/minute to 74 +/- 6 beats/minute and remained virtually constant over the next 2 years.
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PMID:[Long-term antihypertensive therapy with urapidil. A 3-year open, multicenter trial of tolerance, safety and effectiveness]. 211 78

The efficacy, tolerability and safety of dilevalol in essential hypertension has been documented in an international clinical trials programme which was conducted with doses up to 1600mg daily. Initial double-blind trials confirmed the superiority of dilevalol over placebo in essential hypertensive patients and documented the suitability of a once-daily dosage. Almost all of the subsequent trials have been randomised, double-blind comparative trials of dilevalol versus established anti-hypertensive agents with the duration of treatment ranging from four weeks up to one year. The recommended dosage range of dilevalol, of 200-400 mg once-daily, has generally been shown to be at least as effective at lowering raised blood pressure as established antihypertensive agents given according to their recommended doses. In one study in elderly hypertensives, dilevalol was significantly more effective than atenolol in lowering systolic blood pressure. Safety data is available from a consolidated database of 2011 dilevalol-treated patients representing over 500 patient-years exposure. Overall, dilevalol was well tolerated and evidence of dose-related adverse effects became apparent only for nausea and dizziness above the recommended dose range. The most common adverse effects considered probably or definitely related to treatment were fatigue (2.5%), nausea (1.9%), headache (1.8%) and dizziness (1.7%). 'Typical' beta-blocker adverse effects were observed, though many of these effects were less frequent than seen with comparator beta-blockers. Evidence of excessive vasodilation was rarely found, consistent with the counter-balancing effect of beta-blockade.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Overview of clinical trials of dilevalol in essential hypertension. 214 8

72 patients with hormone resistant, progressing prostatic cancer completed a self-administered questionnaire to assess subjective morbidity and quality of life before they were entered into a phase III trial of estramustine (34) vs. mitomycin (38). At least one post-treatment assessment was available in 43 patients. This considerable degree of non-compliance is explained by practical problems related to completion and collection of the questionnaires in these rapidly deteriorating patients. Doctors underestimated subjective morbidity (pain, decreased performance status, nausea) in 30-50% of the cases. Decreased functional status, fatigue and pain were identified as the most frequent major morbidities before study entry. In most patients, treatment did not reduce this morbidity. The routine application of self-administered quality of life questionnaires has considerable practical problems but yields clinically worthwhile information about subjective morbidity. Simple but relevant monitoring of subjective morbidity by the patient should be mandatory in cancer trials where palliation is a major endpoint.
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PMID:Quality of life and treatment of hormone resistant metastatic prostatic cancer. The EORTC Genito-Urinary Group. 214 95


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