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)

Beta adrenergic agonists are the most widely used agents in the management of bronchospasm as a result of their rapid onset of action and predictable efficacy. Administration of these agents by inhalation provides several advantages, including rapid effect, decreased adverse effects, and fewer drug interactions. The newer agents have greater beta-2 selectivity, which contributes to improved tolerance of these agents. Tremor is usually the dose-limiting side effect for the beta-2 selective agents. Other adverse effects include tachycardia, increased blood pressure, headache, anxiety, abnormal glucose metabolism, and hypokalemia. Controversy surrounding the use of beta adrenergic agonists includes reports of an increased mortality rate with increased use of these agents. Current information is inconclusive and should not limit the use of these agents in the management of acute bronchospasm. The significance of tolerance with prolonged administration is also an unresolved issue.
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PMID:Beta adrenergic agonists. 774 29

Physiological dependence on benzodiazepines is accompanied by a withdrawal syndrome which is typically characterized by sleep disturbance, irritability, increased tension and anxiety, panic attacks, hand tremor, sweating, difficulty in concentration, dry wretching and nausea, some weight loss, palpitations, headache, muscular pain and stiffness and a host of perceptual changes. Instances are also reported within the high-dosage category of more serious developments such as seizures and psychotic reactions. Withdrawal from normal dosage benzodiazepine treatment can result in a number of symptomatic patterns. The most common is a short-lived "rebound" anxiety and insomnia, coming on within 1-4 days of discontinuation, depending on the half-life of the particular drug. The second pattern is the full-blown withdrawal syndrome, usually lasting 10-14 days; finally, a third pattern may represent the return of anxiety symptoms which then persist until some form of treatment is instituted. Physiological dependence on benzodiazepines can occur following prolonged treatment with therapeutic doses, but it is not clear what proportion of patients are likely to experience a withdrawal syndrome. It is also unknown to what extent the risk of physiological dependence is dependent upon a minimum duration of exposure or dosage of these drugs. Withdrawal phenomena appear to be more severe following withdrawal from high doses or short-acting benzodiazepines. Dependence on alcohol or other sedatives may increase the risk of benzodiazepine dependence, but it has proved difficult to demonstrate unequivocally differences in the relative abuse potential of individual benzodiazepines.
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PMID:The benzodiazepine withdrawal syndrome. 784 56

Because of a depressive syndrome, a 39-year-old patient received 20 mg fluoxetine per day. Approximately 4 weeks later, treatment with this drug was stopped after the patient had complained of worsening tremor, particularly of the upper extremities. In addition, accommodation difficulties and problems with word-finding had appeared shortly before. The symptoms became worse after fluoxetine had been discontinued. Treatment of the side effects with piperiden and bromazepam brought about no real improvement in the patient's condition. The passive tremor with a frequency of approximately eight per second mainly suggests an extrapyramidal-parkinsonian cause. Five weeks after treatment with fluoxetine had been discontinued, owing to the persistence of the depressive syndrome the patient received maprotiline and clomipramine by infusion in a private hospital. After 2-3 days the patient complained of headaches and had a slightly raised temperature. After 7 days maprotiline and clomipramine were discontinued completely. During the fever there was no leucocytosis, so that a drug fever was diagnosed. These rare side effects are discussed.
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PMID:[A case of rare side effects of certain antidepressive drugs]. 788 18

In this report, we present the symptoms, biochemical investigations, 24 hour ambulatory blood pressure and heart rate recordings in a patient before and following removal of a predominantly adrenaline-secreting phaeochromocytoma. The symptoms were of episodic shaking, faintness, nausea, palpitations, sweating and panic, chest and neck pain with headache, and are consistent with previous reports. Ambulatory blood pressure recording demonstrated that mean daily blood pressure was normal, with normal diurnal variation, and two episodes of severe hypertension and bradycardia coincident with symptoms (MAP 150 mmHg and HR 49 beats/minute, MAP 178 mmHg and HR 29 beats/minute, respectively), not reported in predominantly adrenaline-secreting phaeochromocytoma.
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PMID:Twenty-four hour ambulatory blood pressure and heart rate in a patient with a predominantly adrenaline secreting phaeochromocytoma. 793 55

High-pressure neurological syndrome (HPNS) is a condition encountered in diving beyond a depth of 100 m. Manifestations include headache, tremor, myoclonus, neuropsychiatric disturbances and EEG changes. Convulsions are seen only in experimental animals. Most of the changes are reversible on surfacing but some such as memory disturbances may linger on for long periods. Excessive atmospheric pressure is the most important factor in the pathogenesis of HPNS. Neurotransmitter changes occur of which serotonin appears to be a more likely mediator because of the resemblance of HPNS to serotonin syndrome. Anesthetics and anticonvulsants have been used in experimental animals but are unsuitable for use in human divers. Breathing gas mixtures such as heliox have enabled the extension of depth of diving without HPNS. Use of 5-HT1A receptor antagonists may provide an interesting approach to prevention of HPNS.
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PMID:High-pressure neurological syndrome (HPNS). 794 56

Suspected postprandial (reactive or idiopathic) hypoglycemia is characterized by predominantly adrenergic symptoms appearing after meals rich in carbohydrates and by their rare association with low blood glucose level (< 2.77 mmol/L). We studied heart rate, blood pressure, plasma insulin, C-peptide, and catecholamine responses during a 5-h oral glucose tolerance test in eight patients with suspected postprandial hypoglycemia and eight age-, sex-, and body mass index-matched healthy controls. We also evaluated beta-adrenergic sensitivity by using the isoproterenol sensitivity test. Psychological profile was assessed by the Symptom Checklist (SCL-90R) self-report symptom inventory. Patients with suspected postprandial hypoglycemia had higher beta-adrenergic sensitivity (defined as the dose of isoproterenol required to increase the resting heart rate by 25 beats/min) than controls (mean +/- SEM, 0.8 +/- 0.13 vs. 1.86 +/- 0.25 microgram isoproterenol; P = 0.002). After administration of glucose (75 g) blood glucose, plasma C-peptide, plasma epinephrine, and plasma norepinephrine responses were identical in the two groups, but plasma insulin was higher in the patients (group effect, P = 0.02; group by time interaction, P = 0.0001). Both heart rate and systolic blood pressure were significantly higher (but remained in the normal range) after glucose administration in patients with suspected postprandial hypoglycemia than in controls (group by time interactions, P = 0.004 and 0.0007, respectively). After glucose intake, seven patients had symptoms (palpitations, headache, tremor, generalized sweating, hunger, dizziness, sweating of the palms, flush, nausea, and fatigue), whereas in the control group, one subject reported flush and another palpitations, tremor, and hunger. Analysis of the SCL-90R questionnaire revealed that patients had emotional distress and significantly higher anxiety, somatization, depression, and obsessive-compulsive scores than controls. We may conclude that patients with suspected postprandial hypoglycemia have normal glucose tolerance, increased beta-adrenergic sensitivity, and emotional distress.
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PMID:Suspected postprandial hypoglycemia is associated with beta-adrenergic hypersensitivity and emotional distress. 796 39

Neurological complications are important contributors to morbidity and mortality after liver transplantation. We reviewed 391 patients who underwent 427 consecutive orthotopic liver transplantations to analyze the clinical features of patients who experienced one or more neurological complication (74 patients [19%]) and to compare postoperative neurological problems in adults versus children. Neurological complications were more frequent in adults (64 of 273 patients [23%]) than children (10 of 118 patients [8%]) (P < 0.01). The most common neurological complication was encephalopathy (59%), which ranged widely in severity and occurred with similar frequency in adults and children. Other common neurological complications were seizures (12 patients), brachial plexus and peripheral nerve injuries (16 patients, 15 of whom were adults), stroke (5 patients), and central nervous system infections (5 patients). In 27 patients, drug toxicity was the primary cause of neurological complications, all of which reversed with dosage reduction or discontinuation of drug. Cyclosporine and FK506, primarily during intravenous administration for induction of immunosuppression, accounted for 25 of 27 drug-induced neurological complications, which included encephalopathy, seizures, severe tremor, and severe headache. Despite a higher rate of neurological complications in adults, those in children were more severe and associated with a higher mortality rate. When compared with liver transplant recipients without neurological complications, patients with neurological complications had a higher posttransplant mortality rate (14% vs. 5% for adults, and 50% vs. 7% for children). In conclusion, neurological complications after liver transplantation are more common in adults, more severe and associated with a higher mortality rate in children, and associated with a higher mortality rate in both children and adults when compared with transplant recipients without neurological complications.
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PMID:Neurological complications of liver transplantation in adult versus pediatric patients. 807 14

This randomised, open, parallel group study compared the antiemetic efficacy and tolerability of tropisetron with metoclopramide plus lorazepam in 102 patients receiving a first course of non-cisplatin-containing chemotherapy. Control of acute vomiting by tropisetron was significantly superior to that of the metoclopramide regimen, with total control (no vomiting) in 45% of 51 patients in the tropisetron group compared with 22% of 51 patients in the metoclopramide group (P = 0.013); total and partial control (< 5 vomits) occurred in 67 and 47% of patients, respectively (P = 0.044). The incidences of acute nausea and of delayed nausea and emesis were similar in the two treatment groups. Both tropisetron and metoclopramide were well tolerated; no adverse effects were attributed to tropisetron administration with the exception of headache. One patient in the metoclopramide group reported confusion and tremor thought to be related to the antiemetic therapy. Tropisetron is an effective and well-tolerated agent in the prevention of chemotherapy-induced vomiting. The control of acute nausea was similar in the two treatment groups, but tropisetron was superior to a metoclopramide-based regimen in the control of acute vomiting.
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PMID:Tropisetron compared with a metoclopramide-based regimen in the prevention of chemotherapy-induced nausea and vomiting. 808 Jun 74

Six healthy males, the EMSInauts, were isolated in hyperbaric chambers for a period of 28 days at 5-msw overpressure. During that period they had to carry out meaningful operational and research tasks in addition to monitoring their psychological and physiological reactions. The actual workload was evaluated and compared with the planned workload, and its effects on symptomatology and psychobiology. The perceived workload and its effects on psychosomatic symptomatology and on some biological indices were monitored. Thus it was possible to evaluate how the workload carried during 4 weeks of isolation affected the psychological and biological well-being of the six EMSInauts. The following three types of assessments were performed: 1. Workload assessment: The objective workload was calculated based on the schedule which was revised daily, and the actual load calculated by the commander. A workload questionnaire was administered daily after each working session. 2. Psychosomatic assessment: Morning and evening questionnaires were administered daily. The state of health and of anxiety were also evaluated. 3. Biological indices: Cortisol, testosterone, adrenalin, and noradrenaline were determined once a week. In addition, cardiac activity was monitored every day. The workload assessment showed that on the average the planned workload was accomplished in slightly less than the scheduled time. The workload was not perceived as severe in terms of cognitive, emotional, and physical load. The group rated the support received from each other and from the mission control personnel as average, with minor changes during the isolation period. They gave a high rating to the amount of control they had over their activities. Fatigue and tension were scored in the middle range. The psychosomatic assessment showed that there were few symptoms, and these were mostly of low severity. The most common symptom was general fatigue. Furthermore, minor dizziness, headache and light tremor was in some cases reported. The sleep quality was good, but complaints about poor sleep increased somewhat with the passing of time. Few and mostly minor health problems were experienced during isolation. Only one EMSInaut had to miss one day of work due to a bout of flu. The state of anxiety was below that of the general population throughout the isolation period. The biological indices used showed no evidence of stress from the workload handled during the isolation period. The level of the "stress hormone" cortisol actually decreased during isolation. The adrenalin excretion, which tends to go up during acute stress, remained unchanged during this period. Neither was there any evidence of changes in cardiac activity throughout the isolation period.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:European isolation and confinement study. Workload and stress: effects on psychosomatic and psychobiological reaction patterns. 816 54

Psychogenic seizures are unusual after age 60 years. A 73-year-old woman had onset of psychogenic seizures at age 69 years. Five to six attacks occurred each month, usually at night, characterized by an initial subjective sensation and headache followed by generalized stiffening and shaking. Continuous EEG-closed circuit television (EEG-CCTV) monitoring clearly showed these episodes to be nonepileptic. Discontinuation of antiepileptic drugs (AEDs) did not increase the frequency or severity of attacks. Epileptiform discharges were not recorded during the awake, drowsy, or sleeping states. Psychiatric evaluation identified significant turmoil in the patient's life and a history of childhood sexual and physical abuse. Psychogenic seizures may begin in old age and should be considered in the differential diagnosis of intractable seizures in the elderly. Predominantly nocturnal occurrence should not exclude the diagnosis.
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PMID:Psychogenic seizures in old age: a case report. 824 56


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