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)

Frontotemporal dementia is more frequently diagnosed because of revised diagnostic procedures. Due to the lack of pharmacological trials it is a disease that is difficult to manage in the way of evidence based medicine. Deficits in serotonergic and dopaminergic signal-transmission are well known. The cholinergic system does not seem to be affected. Case reports and clinical trials show a benefit by using antidepressants, neuroleptics and mood stabilizers. Nevertheless only paroxetine, trazodone and rivastigmine are tested by double-blind, placebo-controlled studies. While paroxetine shows inconsistent data, trazodone improves behavioural symptoms. Patients report a treatment-emergent adverse effect including fatigue, dizziness and hypotension. Rivastigmine leads to a significant decrease in the Neuropsychiatric Inventory Score. Finally, we present a two-cases-report that shows improve of disease symptoms under treatment with repetitive transcranial magnet stimulation.
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PMID:[Frontotemporal dementia: neurotransmitter and clinical symptoms with focus on therapeutic targets]. 1941 87

Rivastigmine is a non-competitive reversible inhibitor of acetylcholinesterase which is approved as one of the fi rst-line treatment options for Alzheimer's disease. We present the case of a 33-year-old woman with acute cholinergic syndrome secondary to deliberate rivastigmine poisoning. The patient presented at the emergency department (ED) with drowsy consciousness, dizziness, vomiting, diarrhea, sweating, and hypertension (171/103 mmHg). At the scene, an empty bottle of Rivast 120 mL/Bot, containing rivastigmine 2 mg/mL, was found beside the patient. Two hours later, we noted bronchorrhea and persistent salivation along with drowsiness, agitation, fatigue, incontinence, and limbs paralysis. A notably low serum cholinesterase level (651 U/l) was identified. Acute cholinergic syndrome secondary to rivastigmine intoxication was diagnosed. Endotracheal intubation with ventilator support was required due to respiratory failure. Atropine (0.5 mg intravenous injection) was administered. She was subsequently admitted to the intensive care unit for further care. Extubation was performed on the third day. The patient insisted on being discharged on the second day after extubation, and after administration of a total of 11 mg of atropine, no signs of either intermediate syndrome or delayed polyneuropathywere noted. rivastigmine, an acetylcholinesterase inhibitor, can precipitate an acute cholinergic crisis in cases of intoxication. Typical clinical features of cholinergic excess include increased secretions in the airway and oral cavity, miosis, diarrhea, anxiety, twitching, bronchoconstriction, convulsions, confusion, and gastrointestinal and muscular cramps. The treatment for acute cholinergic crisis is administration of atropine alone or in combination with an antidote to the cholinesterase inhibitor (such as pralidoxime). Patients often recover well with atropine supplements and optimal supportive care.
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PMID:Successful Resuscitation of a Young Girl Who Drank Rivastigmine With Respiratory Failure. 3299 49