Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The sympathomimetic agent ephedrine has potent thermogenic and anti-obesity properties in rodents. The effect is markedly enhanced by caffeine, while caffeine given alone has no effect. This study was undertaken to find out if a similar weight reducing synergism between ephedrine and caffeine is present in obese patients. In a randomized, placebo-controlled, double blind study, 180 obese patients were treated by diet (4.2 MJ/day) and either an ephedrine/caffeine combination (20mg/200mg), ephedrine (20 mg), caffeine (200 mg) or placebo three times a day for 24 weeks. Withdrawals were distributed equally in the four groups, and 141 patients completed the trial. Mean weight losses was significantly greater with the combination than with placebo from week 8 to week 24 (ephedrine/caffeine, 16.6 +/- 6.8 kg vs. placebo, 13.2 +/- 6.6 kg (mean +/- s.d.), P = 0.0015). Weight loss in both the ephedrine and the caffeine groups was similar to that of the placebo group. Side effects (tremor, insomnia and dizziness) were transient and after eight weeks of treatment they had reached placebo levels. Systolic and diastolic blood pressure fell similarly in all four groups. We conclude, that in analogy with animal studies, the ephedrine/caffeine combination is effective, while caffeine and ephedrine separately are ineffective for the treatment of human obesity.
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PMID:The effect and safety of an ephedrine/caffeine compound compared to ephedrine, caffeine and placebo in obese subjects on an energy restricted diet. A double blind trial. 131 81

Drug use among athletes has become a recognised problem in sports. Athletes may use drugs for therapeutic indications, for recreational or social reasons, as ergogenic aids or to mask the presence of other drugs during drug testing. Stimulants were some of the first drugs used and studied as ergogenic aids. Amphetamines may increase time to exhaustion by masking the physiological response to fatigue. Caffeine may improve utilisation of fatty acids as a fuel source thereby sparing muscle glycogen. Cocaine and other sympathomimetic drugs have little or no effect on athletic performance. Anabolic steroids appear to have the potential to increase lean muscle mass and strength under certain conditions. Human growth hormone may also be used for an anabolic effect, but data on this effect are lacking. Erythropoietin may represent a pharmacological alternative to blood doping by increasing red blood cell mass. The use of narcotic analgesics is not necessarily ergogenic but can be harmful if used to allow participation of an athlete with a severe injury. According to the American College of Sports Medicine alcohol does not possess an ergogenic effect. However, it may be used to reduce anxiety or tremor prior to competition. Marijuana does not increase strength. Tobacco products may produce psychomotor effects or control appetite which may be beneficial to some athletes. Other drugs used by athletes include beta-blocking agents, diuretics, and a variety of nutritional supplements. In addition, diuretics and probenecid may be taken to mask drug contents in the urine. Whether the ergogenic effects are real or perceived, the potential for adverse effects exists for all of these drugs. Potential health complications represent a serious risk to an otherwise healthy population. Further research on the long term health risks in athletes taking ergogenic drugs is needed.
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PMID:Enhancement of athletic performance with drugs. An overview. 168 20

Reports on the clinical effectiveness of oral treatment with beta-sympathomimetic fenoterol are quite divergent in their conclusions. The aim of this study was to determine the plasma levels of fenoterol in steady state during tocolytic treatment with high oral doses. Nine pregnant women with clinically indicated tocolysis were given a 5 mg dose of fenoterol in tablet form eight times per day at prescribed hours. During the first four days, in the late afternoon just before and again one hour after the intake, a blood sample was taken to determine the fenoterol concentration by radioimmunoassay. In addition, uterine activity, blood pressure, heart rate, and tremor were periodically checked while the patient was under observation. The fenoterol levels in the plasma ranged from 130 to 200 pg/ml; the steady state concentration remained relatively constant throughout the observation period. It is not certain, that by taking the blood sample one hour after the tablet was swallowed, the maximal concentration was found. However, with the given doses, nearly the same fenoterol levels were measured in the blood as with low doses of intravenously administered fenoterol.
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PMID:[Maternal plasma concentrations in multiple oral fenoterol treatment]. 272 83

Beta 2-adrenergic agents are useful in the management of acute and chronic asthma. Chronic bronchitis and emphysema are less responsive to bronchodilator therapy; however, a trial of beta 2-agonists is warranted in search of a reversible component. The newer beta 2-sympathomimetic agents have no important differences in the quality of bronchodilation, but individual patients may respond more favorably to one drug than to another. Most of the common adverse effects (eg, tremor and tachycardia) are an extension of the pharmacologic effects, so there are no important differences at equipotent doses. When chronic symptoms necessitate maintenance treatment, the frequency of dosing may become a deciding factor in the selection of a bronchodilator. Since tulobuterol is recommended for twice-a-day dosing, it may be more convenient for the patient than beta 2-sympathomimetics that require more frequent administration. The prolonged duration of action of tulobuterol minimizes the need for nocturnal drug administration, allowing the patient to sleep through the night. Thus tulobuterol offers the benefits of extended symptomatic protection and improved patient compliance.
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PMID:Tulobuterol in the management of obstructive airways disease in adults. 286 99

To establish the criteria for the selection of a beta-adrenergic blocking agent (beta-blockers) suitable for the long-term treatment of tremor, 20 patients with essential tremor were treated with five different types of beta-blockers. All beta-blockers were effective for essential tremor, but their efficacy differed. The weaker the intrinsic sympathomimetic activity (ISA) and the more marked the membrane stabilizing activity (MSA), the more marked was the anti-tremor effect. Propranolol, which showed the strongest anti-tremor effect, had no ISA, but its long-term administration induced symptoms of heart failure, such as pretibial oedema, in most cases. In most of these cases, when propranolol was replaced by indenolol, which showed a very slight ISA, the pretibial oedema subsided and well-controlled tremor was maintained over a long period. With regard to efficacy and usefulness, it was thought that the beta-blockers with a very slight ISA and a marked MSA, such as indenolol, was most suitable for the long-term treatment of essential tremor.
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PMID:Comparative studies on the effects of beta-adrenergic blockers in essential tremor. 289 95

Two single-blind placebo-controlled crossover studies on healthy volunteers were performed to compare typical adverse effects of the beta 2-adrenoceptor agonists salbutamol, terbutaline und tulobuterol in a daily period of eight h after acute oral administration of different doses. Assessments were repeated after six days of regular drug intake, to look for habituation phenomena. Finger tremor, integrated surface-EMG in relation to voluntary force, blood pressure and heart rate were measured. Tremor was recorded with a 3-dimensional accelerometer during three different states of hand extensor muscle activity: relaxed, lightly and maximally contracted. The tremor signal was submitted to power spectrum analysis (FFT). All drug effects depended on the dose and the type of drug used, 2 mg tulobuterol being about equivalent to 4 mg salbutamol and to 2.5 mg terbutaline. Cardiovascular adverse effects were weak and transient. The induction of resting tremor showed some habituation across subchronic medication, whereas cumulative and ceiling effects of the beta 2-agonists occurred in respect to tremor during both states of active muscle contraction. However, the beta 2-adrenergic effect during strong contraction consisted in a prominent reduction of tremor. This striking result did not seem to be related to a transient increase of force, relative to myoelectric activity, which was no longer seen after subchronic medication. In case of ceiling effects, the relative changes in tremor intensity decreased with continuous beta 2-sympathomimetic treatment. Therefore, tremor might become a tolerable though inevitable concomitant of bronchodilatory therapy. Its quantitative measurement seems to provide adequate means to assess dose- and time-efficacy as well as to estimate clinical benefit.
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PMID:Induction and reduction of muscle tremor upon acute and repeated administration of the beta 2-agonists terbutaline, salbutamol and tulobuterol. 289 78

In a total of 36 volunteers with cardiac hyperreaction, investigations were carried out on the effect of bisoprolol (designated tradename: Concor), pindolol and placebo on central nervous functions with the aid of a reaction test, spiral aftereffect, tremor test and mood and sleep questionnaires. In the randomized double-blind study performed with 3 independent groups the volunteers received placebo, 2 X daily 10 mg of pindolol or 1 X daily 10 mg of bisoprolol for a period of 14 days. Bisoprolol is a new highly beta 1-selective adrenoceptor blocker with moderate lipophilia and without intrinsic sympathomimetic activity (ISA). When compared to placebo neither of the beta-adrenoceptor blockers induced any significant changes in mood, vigilance, tremor and reaction times. Moreover, under bisoprolol no negative effect on sleep quality or feeling refreshed after sleep was determined. Under pindolol, on the other hand, a significant impairment of sleep quality was observed after acute dosage and a decrease in feeling refreshed after sleep, continuing up to day 14 of treatment. It is presumed that, as bisoprolol and pindolol have comparable lipophilia, the different intensity with which the two preparations act on the central nervous system is connected with the ISA of pindolol. In the selected doses bisoprolol had a stronger effect on diastolic blood pressure and heart rate than pindolol and placebo.
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PMID:[Comparative study of the central nervous system effect of the beta receptor blockaders pindolol and bisoprolol]. 293 54

The efficacy of procaterol, a new beta 2-selective sympathomimetic drug, was compared with that of salbutamol and placebo in a double-dummy crossover study in 20 asthmatic patients. Procaterol (0.1 mg orally) was given twice daily and salbutamol (4 mg orally) 3-times a day. The study was made up of four consecutive 4-day treatment periods including two periods of plain placebo. A significant direct bronchodilating effect of both procaterol and salbutamol could be seen in PEF values, measured 4-times a day, compared with the effect of placebo (p less than 0.01 for both). Procaterol was slightly superior to salbutamol. The afternoon and evening PEF values during the procaterol period did not differ from the values during the placebo period. In symptom scores, there was significantly more tremor during the procaterol period than during the placebo period (p less than 0.01). Both procaterol and salbutamol produced more palpitation than placebo (p less than 0.05). The study shows that oral procaterol is a potent bronchodilator. The doses of procaterol and salbutamol were not equivalent. Procaterol with the dose used in the study was more potent. Despite this, the duration of the bronchodilator effect of procaterol on a twice daily dosage did not seem to be long enough in all patients.
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PMID:Comparison between oral procaterol and salbutamol in patients with bronchial asthma. 297 4

1. (-)-Isoprenaline, salbutamol, orciprenaline and quinterenol injected intravenously decreased the tension and degree of fusion of incomplete tetanic contractions of the soleus muscle of the anaesthetized cat.2. Under the most sensitive conditions, the smallest effective dose of (-)-isoprenaline was of the order of 0.01 mug/kg intravenously. Salbutamol was usually 6-10 times, orciprenaline 20-30 times and quinterenol about 35 times less potent than isoprenaline. The effects of salbutamol were about 1.6 times, of orciprenaline about 1.8 times and of quinterenol more than 20 times as long lasting as those of (-)-isoprenaline.3. The effects of the sympathomimetic amines were blocked by propranolol, H56/28, H35/25 and butoxamine but not by ICI 50172. The combined results with agonists and antagonists indicate that the receptors involved can be classified as of the beta(2) type.4. The effect of the amines on the cat soleus muscle appears to be analogous to that causing enhancement of physiological tremor in man, which suggests that skeletal muscle tremor may be an occasional unwanted side effect of the use of these bronchodilators.
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PMID:Actions of some sympathomimetic bronchodilator and beta-adrenoceptor blocking drugs on contractions of the cat soleus muscle. 439 35

The ability of beta-adrenoceptor agonists to reduce the fusion of incomplete tetanic contractions of the soleus muscle of the cat has been used previously as a model to assess the potential tremor producing effect of sympathomimetic bronchodilators. The ability of (-)-isoprenaline, (-)-adrenaline, (+/-)-soterenol and (+/-)-quinterenol to depress incomplete tetanic contractions of the soleus has now been assessed using cumulative administration of the amines. The method quickly produced accurate and reproducible dose-response curves. It is particularly useful for evaluating the potency of long-acting compounds.
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PMID:Use of cumulative dose-response curves in potency comparisons of sympathomimetic amines on the cat soleus muscle. 504 Jun 70


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