Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The literature describing nondyskinetic antipsychotic withdrawal symptoms is reviewed. The withdrawal of antipsychotic agents can result in nausea, emesis, anorexia, diarrhea, rhinorrhea, diaphoresis, myalgias, paresthesias, anxiety, agitation, restlessness, and insomnia. Psychotic relapse is often presaged by increased anxiety, agitation, restlessness, and insomnia. However, the temporal relationship of these prodromal symptoms to reduction in the dosage or discontinuation of neuroleptics distinguishes them from the effects of abrupt withdrawal.
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PMID:Antipsychotic withdrawal phenomena in the medical-surgical setting. 290 18

Terguride is an ergoline derivative with mixed agonistic/antagonistic dopaminergic activity. This led to a paradoxical suggestion that it is effective in the treatment of both schizophrenia and parkinsonism. A total of 65 in- or outpatients with parkinsonism mostly of vascular or idiopathic etiology were included in a 4-week, open, multicenter trial. Terguride was administered under an increasing dose schedule which was leveled off according to the clinical response. Mostly because of nausea, vomiting, and lack of improvement 25% of inpatients and 61% of outpatients were removed from the study. The average daily dose at the end of the trial was 4.2 mg, ranging from 1.0 to 5.5 mg. The average Simpson and Angus scale total score and performance in the Spiral Drawing Task improved significantly during the trial by 20% and 38% respectively. The following adverse effects were noted most frequently throughout the study (including those who withdrew): constipation (occurred in 42% of all ratings performed during the trial) drowsiness and nausea (16% each). Adverse circulatory effects were negligible. Psychotic symptoms, including depression, confusion, hallucinations, and paranoid syndrome, each occurred in 1 patient, i.e., at a lower rate than with other dopaminergic drugs. Scotopic electroretinograms in a subsample of 7 patients showed a significant transitory decrease in the B-wave amplitude at the end of the 1st week and a subsequent return to pretreatment values.
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PMID:Terguride in parkinsonism. A multicenter trial. 304 1

The toxicities of antimalarial drugs vary because of the differences in the chemical structures of these compounds. Quinine, the oldest antimalarial, has been used for 300 years. Of the 200 to 300 compounds synthesised since the first synthetic antimalarial, primaquine in 1926, 15 to 20 are currently used for malaria treatment, most of which are quinoline derivatives. Quinoline derivatives, particularly quinine and chloroquine, are highly toxic in overdose. The toxic effects are related to their quinidine-like actions on the heart and include circulatory arrest, cardiogenic shock, conduction disturbances and ventricular arrhythmias. Additional clinical features are obnubilation, coma, convulsions, respiratory depression. Blindness is a frequent complication in quinine overdose. Hypokalaemia is consistently present, although apparently self-correcting, in severe chloroquine poisoning and is a good index of severity. Recent toxicokinetic studies of quinine and chloroquine showed good correlations between dose ingested, serum concentrations and clinical features, and confirmed the inefficacy of haemodialysis, haemoperfusion and peritoneal dialysis for enhancing drug removal. The other quinoline derivatives appear to be less toxic. Amodiaquine may induce side effects such as gastrointestinal symptoms, agranulocytosis and hepatitis. The main feature of primaquine overdose is methaemoglobinaemia. No cases of mefloquine and piperaquine overdose have been reported. Overdose with quinacrine, an acridine derivative, may result in nausea, vomiting, confusion, convulsion and acute psychosis. The dehydrofolate reductase inhibitors used in malaria treatment are sulfadoxine, dapsone, proguanil (chloroguanide), trimethoprim and pyrimethamine. Most of these drugs are given in combination. Proguanil is one of the safest antimalarials. Convulsion, coma and blindness have been reported in pyrimethamine overdose. Sulfadoxine can induce Lyell and Stevens-Johnson syndromes. The main feature of dapsone poisoning is severe methaemoglobinaemia which is related to dapsone and to its metabolites. Recent toxicokinetic studies confirmed the efficacy of oral activated charcoal, haemodialysis and haemoperfusion in enhancing removal of dapsone and its metabolites. No overdose has been reported with artemesinine, a new antimalarial tested in the People's Republic of China. The general management of antimalarial overdose include gastric lavage and symptomatic treatment.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Clinical features and management of poisoning due to antimalarial drugs. 330 66

Palinacousis (auditory perseveration) is a rarely reported symptom of temporal lobe dysfunction. We describe a new case. A 50-year-old woman presented with nausea, vomiting, and global dysphasia, followed by two generalized seizures. Examination was otherwise normal, and computed tomography showed a small area of enhancement near the left sylvian fissure; there was a left temporal focus on the electroencephalogram. Treatment with phenytoin was instituted, and speech improved, with residual fluent dysphasia. Three days postictally, the patient complained of "echoing voices" in her right ear. Words or fragments of sentences recently uttered by the patient or others were perceived to recur unaltered for minutes to hours. Sounds other than speech were also affected. One week later the voices had disappeared, but a ticking sound was present; this also faded subsequently. The palinacousis never recurred; the patient was later found to have a Grade IV astrocytoma of the left temporal lobe, which caused her demise 8 months later. The features of this case are similar to those previously reported and favor an epileptic etiology. Palinacousis should be recognized as a sign of organic temporal lobe disease and not confused with manifestations of psychotic illness.
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PMID:Palinacousis: a case report. 341 74

Monoamine oxidase inhibitors (MAOIs) are being used more frequently in the treatment of various psychiatric and neurological disorders. Although adverse effects of MAOI treatment are widely known, withdrawal symptoms are less well known. They include nausea, sweating, palpitations, nightmares, and psychosis. Withdrawal reactions from combination therapy with an MAOI and another agent are seldom described. Reported here is the occurrence of myoclonic seizures after the abrupt discontinuation of phenelzine and alprazolam. Alterations in the GABA and serotonin neurotransmitter systems as a result of withdrawal of the MAOI and the benzodiazepine may account for the seizures.
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PMID:Myoclonic seizures after abrupt withdrawal from phenelzine and alprazolam. 380 75

A survey was made of drug prescriptions written for all medical/surgical patients in a general hospital on a single weekday in 1978. Of these 348 patients, 195 were over the age of 60. In this elderly group, 62 (32 percent) were receiving psychoactive drugs. Flurazepam was the drug most commonly prescribed (in 63 percent of the patients). Diazepam was the most frequently prescribed nonhypnotic psychoactive drug (in 29 percent). Neuroleptic drugs and phenothiazine anti-emetics (in 52 percent) were not prescribed for psychosis but for augmenting analgesia and sedation and for reducing nausea. The average daily doses were about 20 percent of those used to treat psychotic young adults. All antidepressants (in 9.7 percent) had been prescribed before admission. No monoamine oxidase inhibitors were used, and doses of tricyclic antidepressants were half to one-third lower than those used to treat younger depressed adults. Antidepressants, which pose a risk to the elderly patient, were overprescribed and underdosed.
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PMID:Psychotropic drug prescriptions for elderly patients in a general hospital. 610 Dec 83

This paper presents the usage of psychotropic drugs by all general inpatients of a Boston teaching and referral hospital on a randomly chosen weekday. Of all surveyed inpatients, 42.8% were receiving at least one psychotropic medication. Sleep medications were the most frequently prescribed class of psychotropic drugs and flurazepam was the most commonly prescribed of all drugs. Phenothiazine and neuroleptics were given to control agitation, pain, or nausea, rather than psychosis. Antidepressants were prescribed without notated justification in the medical record, and if given for depression, were underdosed. Diazepam was the most frequently prescribed antianxiety drug and was the most frequently prescribed psychotropic drug after flurazepam. Psychotropic drug polypharmacy was common, with the average patient receiving seven different drugs. Remedial approaches to this widespread problem are recommended.
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PMID:Psychotropic drug use and polypharmacy in a general hospital. 611 14

A case of rhabdomyolysis is described, with onset following three intramuscular injections of loxapine and one injection of benztropine over a 7-hour period. The possible additive effects of intramuscular drug administration and psychotic episode-associated increased muscle membrane permeability are discussed. Because of the risk of acute renal failure following rhabdomyolysis, monitoring of creatine phosphokinase levels and urine tests for myoglobin are recommended for patients who develop muscular discomfort, nausea, or confusion while receiving frequent intramuscular injections of neuroleptics.
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PMID:Rhabdomyolysis complicating rapid intramuscular neuroleptization. 614 Nov 90

A recently proposed diagnostic class, psychotic trigger reaction, is deduced from careful clinical studies of eight white men, who upon a very specific trigger stimulus committed murder or attempted to (and in one case also rape). The new class is defined as a sudden ego-alien, motiveless (at least with respect to aggression), motor-wise well organized, violent complex action without emotional concomitants. The action is evoked (not provoked) by an individually unique stimulus within a specific context reviving repeated past traumatic experience. Typically there is no (significant) loss of consciousness and practically full recall. Observed are first-time hallucinations (visual, auditory, tactile, somesthetic, but not olfactory as in temporal lobe epilepsy) and signs of imbalance in the autonomic nervous system (loss of bladder control, ejaculation, profuse sweating, nausea). Only four of these men had previous psychiatric diagnoses (and then various ones) or abnormal EEGs at some time in their lives. Variety in prior diagnoses would be consistent with a seizure-like disorder, here specifically implicating an imbalance in functioning between limbic and frontal lobe systems. Clinical tests for the latter were prevailingly indicative of dysfunctioning. A detailed clinical analysis of the violent acts within their context suggests behaviors are analogous to certain limbic system mechanisms, especially the kindling phenomenon.
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PMID:Specific stimulus-evoked violent action in psychotic trigger reaction: a seizure-like imbalance between frontal lobe and limbic systems? 649 48

Forty patients with severe Parkinson's disease (23 men, 17 women) who had been treated for six years with L-dopa-decarboxylase inhibitor, were part of a placebo-controlled double-blind trial to test the effectiveness of bromocriptin. In all patients the effectiveness of L-dopa had been decreasing, 34 patients had L-dopa-induced dyskinesias, 35 "on-off" symptoms. Bromocriptin dosage was gradually increased to a total dose of 30 - 40 mg daily. This led to a 25% reduction in L-dopa requirements. The symptoms of Parkinson's disease were favourably influenced, with rigor, tremor and also walking disturbances responding better than bradykinesia of the hands. At the same time, there was a marked prolongation of the periods of good mobility ("on" time) from 7 to 10.8 hours without influence on other "on-off" symptoms such as paradoxical akinesia. Two patients had to be excluded from the trial because the treatment caused side effects (orthostatic hypotension, exogenous psychotic symptoms). Other side effects, such as nausea and mild forms of collapse, could be controlled by drugs.
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PMID:[Bromocriptin in the treatment of progressive stages of Parkinson's disease (author's transl)]. 679 66


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