Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The pharmacology, pharmacokinetics, clinical efficacy, adverse effects, dosage, and cost of the atypical antipsychotic drug clozapine are reviewed. Clozapine is a dibenzazepine compound chemically similar to loxapine but with a distinct pharmacologic profile. Unlike currently available medications, clozapine has a low potential for causing extrapyramidal symptoms and does not induce dopamine type 2 receptor hypersensitivity. It shows affinity in vitro not only for dopamine type 1 and 2 receptors but also for histamine type 1, alpha-adrenergic type 1 and 2, serotonin type 2, and muscarinic receptors. Clozapine given orally is nearly completely absorbed and readily metabolized. Urinary excretion is the major route of metabolite elimination. Clozapine has been used to treat schizophrenia, nonschizophrenic psychotic states, depression, neuroses, and behavioral disorders. Double-blind comparative studies have shown clozapine to be superior to haloperidol, chlorpromazine, and placebo in treating the symptoms of schizophrenia, as measured with validated psychiatric rating scales. Adverse effects include orthostatic hypotension, tachycardia, benign hyperthermia, hypertension, seizures, and sedation. Many of these effects are transient. Because of the risk of agranulocytosis, a comprehensive case-management system has been developed. In treating acute psychosis, the optimum dosage of clozapine is 300-450 mg/day given orally in divided doses. The high cost of clozapine may be offset by improved patient response and reduced hospital costs. Clozapine may be superior to other agents in the treatment of refractory schizophrenia and is associated with a negligible incidence of extrapyramidal symptoms.
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PMID:Clozapine: an atypical antipsychotic agent. 257 73

Combined clinical neurological study was performed in 111 schizophrenic patients with acute, subacute psychotic signs and at the end of psychosis. Techniques included echoencephalography, eye fundus study, spinal puncture. None of the patients had a history of craniocerebral trauma, neuroinfections, chronic alcoholism, severe somatic diseases. In 53.1% of the patients intracranial hypertension syndrome was detected with the highest rate in patients with acute psychotic signs. Besides, the hypertension syndrome was found to be related to the type of schizophrenia course: it was twice as frequent in attack forms as in permanent ones. The authors suggest that intracranial hypertension has a distinct role to play in the pathogenesis of acute schizophrenic attacks.
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PMID:[The hypertensive-hydrocephalic syndrome in the clinical picture of schizophrenia]. 271 73

An autopsy case of a 65-year-old female with dentatorubropallidoluysian atrophy (DRPLA) is reported. Her mother had gait disturbance and died at the age of 63. Her mother's brother developed psychotic symptoms. A daughter of her older sister was observed to have involuntary movement when she admitted to a mental hospital due to post-delivery psychotic state. Her younger brother has developed gait disturbance from about 56-year-old. Her older son has suffered from schizophrenia for long years. Since 58-year-old, she developed cerebellar ataxic gait and three years later, choreic involuntary movement developed in her extremities and face and progressively became prominent. Since 63-year-old, abnormal behavior brought about by the visual hallucination was occasionally observed. At the age of 63, she admitted to a mental hospital because of persistent persecutive delusion for her husband and was clinically diagnosed as Huntington's chorea for her remarkable choreic movement and psychotic state with dementia. Hypertension was also noticed. At the age of 65, she died of acute pneumonia. The duration of her illness was about 6 years. Histopathological findings of the CNS: the brain weighed 1,014 g. Brainstem and spinal cord were noticed to be relatively small in size. The cerebral cortex was well preserved. The cerebral white matter was diffusely demyelinated in the central semiovale where arteriosclerotic change of the small vessels was remarkable. Significant pathological changes consisted of marked symmetrical atrophy of the following two systems, i. e., dentatofugal pallidoluysian systems.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[An autopsy case of dentatorubropallidoluysian atrophy (DRPLA) clinically diagnosed as Huntington's chorea]. 293 81

Acute porphyria afflicts a large kindred in Chester that stems from a marriage in 1896 that has produced 200 descendants; this is the largest porphyric kindred to be identified in the United Kingdom. Six members aged 51 or under died from the condition over the past eight years. The diagnosis of porphyria was overlooked in some as the symptoms may mimic those of other acute illnesses, so that incomplete or incorrect death certificates have been issued. Psychosis, hypertension, and renal complications are particularly common. The porphyric members of the kindred show a previously undescribed hereditary disorder in which the characteristic enzymatic defects of acute intermittent porphyria and variegate porphyria coexist in the same subject. Acute porphyria is poorly understood by hospital and general practitioners, and this has caused anxiety in the kindred. A register of the kindred has been established, and families at risk should be offered biochemical screening, education, and genetic counselling.
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PMID:Chester porphyria: a clinical study of a new form of acute porphyria. 308 Nov 25

Patients (123) with traumatic cerebral arachnoiditis due to closed craniocerebral trauma, were investigated during complications or late sequelae of the trauma. All the patients were subjected to spinal puncture. Asthenic, psychosis-like and hallucinatory-paranoid disorders were detected as well as partial oligophrenia and dullness of consciousness. The degree of mental disorders run parallel with intracranial pressure elevation, suggesting the role of intracranial hypertension in pathogenesis of several psychic disorders.
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PMID:[Diagnosis and forensic psychiatric expertise in traumatic cerebral arachnoiditis]. 324 79

Eighty-five corticosteroid dependent patients with respiratory diseases requiring alternate day prednisone were studied for certain adverse effects that have been reported to be associated with corticosteroid therapy. The mean age of the patients was 52 years, the average years of prednisone therapy was 5.3, and the mean dose of alternate day prednisone was 26.2 mg. In this group of 85 patients the prevalence of hypertension, peptic ulcer disease, pathologic fractures and psychosis was not statistically increased over that of the general population. None of the patients was diagnosed as having steroid-induced psychosis, pancreatitis or tuberculosis. One patient developed aseptic necrosis of the hip; however, she received daily prednisone for approximately 3.2 years before being converted to an alternate day schedule. Our results demonstrate that alternate day corticosteroid therapy can be used without significant risk of adverse effects in patients in whom it is essential for control of respiratory disease.
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PMID:Prevalence of adverse effects in corticosteroid dependent asthmatics. 339 24

This study reports the prevalence of psychosomatic disorders in psychiatric patients in India. The psychosomatic disorders studied were hypertension, peptic ulcer, bronchial asthma, rheumatoid arthritis, ischaemic heart disease and chronic pain. 21.5% of psychiatric patients had psychosomatic illnesses. Fifty five cases had two psychosomatic illnesses. Chronic pain (14.4%) and hypertension (9.9%) were the commonest. Patients with psychosomatic disorders were significantly more often older in age, females, married and from an urban habitat. Neurotic illness was the commonest diagnosis in them. Psychosis was significantly and inversely associated with psychosomatic disorders. This report emphasises the need for as much attention on psychosomatic problems in developing countries as in affluent ones.
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PMID:Psychosomatic disorders in psychiatric patients in a developing country. 341 Jun 57

In Japan, the age-adjusted death rate from ischemic heart disease has decreased for both male and female since 1970, although the rate appears to be slightly affected by mortality from senility without mention of psychosis, "cardiac insufficiency", and sudden death in elderly persons. On the other hand, consultation rate has shown an increase, suggesting an increase in the number of recovered patients and a lengthening in the duration of ischemic heart disease from onset to termination by CCU treatment. A 7.5-year prospective study of ischemic heart disease (myocardial infarction + angina pectoris on effort + sudden death) among residents 40 years and older was conducted at a rural community, Akadani-Ijimino district in Niigata Prefecture. Statistically significant risk factors appeared to be age, hypertension, ECG abnormalities and fuduscopic changes. Even in 1977-1984 when Japanese dietary habits were westernized, neither hyperlipidemia nor obesity was related to the development of ischemic heart disease in this agricultural district. Statistically significant risk ratios were not observed for any nutrient or food, although the ratio for animal fat, calcium, salted vegetables and caloric percent of animal protein was more than one respectively.
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PMID:Trends in death and consultation rates of ischemic heart disease in Japan and the risk factors in a rural community. 359 72

A total of 104 schizophrenics have been examined using echoencephalography. Some patients presented manifestations of hydrocephalia and intracranial hypertension. The latter was predominantly observed in patients with acute psychotic states.
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PMID:[Neurologic changes in schizophrenic patients]. 377 99

Episodes of depression and acute psychosis in two patients receiving propranolol hydrochloride are described, and the literature on propranolol-induced depression and psychosis is reviewed. A 42-year-old woman developed severe depression, marked apathy, social withdrawal, and anorexia after taking propranolol hydrochloride (80 mg/day) for three months to control her hypertension. Five days after the dose was reduced to 40 mg/day, there was a major improvement in her depressive symptoms, with a complete resolution in eight days. Upon rechallenge with 80 mg/day of propranolol, she again experienced depressive symptoms. Atenolol 50 mg/day was substituted for the propranolol therapy, and she exhibited a complete remission of her depression. The second patient was a 63-year-old man who had been taking propranolol hydrochloride 160 mg/day for three months without incident. Because of an increased frequency of anginal attacks, the dosage was increased to 240 mg/day. Within two days, he demonstrated such agitation, excitement, and combativeness that he had to be controlled with a 25-mg dose of methotrimeprazine. When the propranolol dose was reduced to 160 mg/day, his psychotic symptoms rapidly cleared. However, when the dose was subsequently increased to 200 mg/day, he again showed increased agitation. After substituting atenolol 100 mg/day for propranolol, the patient's mental status returned to normal. Both of these patients experienced symptoms that were temporarily associated with propranolol. Both patients were subsequently controlled without symptoms with atenolol therapy. Propranolol is a highly lipophilic beta blocker that achieves high concentrations in the brain. When continued beta-blocking therapy is necessary or beta blockade is indicated, a weakly lipophilic agent such as atenolol is indicated.
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PMID:Propranolol-induced depression and psychosis. 398 22


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