Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085631 (agitation)
 12,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Theophylline, with its narrow therapeutic margin, is a common cause of iatrogenic and deliberate overdose. Most cases of self-poisoning are with sustained release preparations, with peak concentrations occurring up to 12 or more hours after overdose. Toxic symptoms are often seen at concentrations above 15 mg/L. Theophylline is metabolised within the cytochrome P-450 system, with an average total body clearance of 50 to 60 ml/min. Clearance is, however, affected by many factors such as other drugs or disease, and in overdose zero order kinetics may result in prolonged half-lives. Toxicity is characterised by agitation, tremor, nausea, vomiting, abdominal pains, seizures, and tachyarrhythmias. Hypokalaemia and metabolic acidosis are more profound in acute toxicity, and hypercalcaemia is usually present. Seizures occur at lower concentrations after chronic over-medication than after acute overdose. Gastric lavage should be performed in all patients presenting early, and an oral multiple dose charcoal regimen started with 50 to 100g charcoal, repeating with 50g doses and checking theophylline concentrations at 2- to 4-hour intervals. Multiple dose charcoal can be expected to double the clearance of theophylline, being as effective as a haemodialysis. Of the invasive techniques available, charcoal haemoperfusion is the most effective, increasing clearance 4- to 6-fold. Supportive care is particularly important. The aggressive supplementation of potassium, treatment of emesis with droperidol and ranitidine, and treatment of tachyarrhythmias and hypotension (possibly with propranolol), together with oral multiple dose charcoal may obviate the need for haemoperfusion. Seizures suggest increased morbidity and mortality. Charcoal haemoperfusion should be considered if plasma concentrations are greater than 100 mg/L in an acute intoxication or greater than 60 mg/L in a chronic intoxication. The decision to haemoperfuse should not be based on plasma concentrations alone, but an overall evaluation of the patient's laboratory and clinical status.
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PMID:Role of extracorporeal drug removal in acute theophylline poisoning. A review. 330 69

The content of cytochrome P-450 as a function of oxygen supply was studied during growth of Acinetobacter on n-hexadecane in batch cultures at constant pH and agitation. The rate of growth and the content of cytochrome P-450 were not affected as long as the dissolved oxygen tension ranged above 3 to 5% of saturation. The amount of cytochrome P-450 increased when the oxygen tension declined to zero. Cytochrome P-450 levels of about 0.3 to 0.4 nmol/mg protein, i.e. a more than a threefold increase, were observed under conditions where oxygen supply was strictly limited and allowed to maintain only a minimum of metabolism or growth. Limited oxygen supply exerted a special effect on the induction of the cytochrome P-450 as concluded from an increasing ratio between cytochrome P-450 and cytochrome o, and from the absence of cytochrome d in cells with elevated content of cytochrome P-450. The increased formation of cytochrome P-450 was a reversible process.
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PMID:Effect of oxygen limitation on the content of n-hexadecane-inducible cytochrome P-450 in Acinetobacter calcoaceticus strain EB 104. 358 13

We report a case of serotonin syndrome that occurred in a patient with chronic heart failure associated with a panic disorder. The 39-year-old Japanese man had been treated with paroxetine at 20 mg/d for 1 1/2 years. He presented with rhabdomyolysis, renal failure, fulminant liver failure, cardiac conduction disturbance, and disseminated intravascular coagulation, as well as conventional symptoms of serotonin syndrome including alterations in cognition (disorientation, confusion) and behavior (restlessness), autonomic nervous system dysfunction (fever, shivering), and abnormal neuromuscular activity (ataxia, hyperreflexia, myoclonus). All medications prescribed before hospital admission were discontinued. After 24 hours of continuous venovenous hemofiltration, diuresis resumed and renal and liver function improved rapidly. Disorientation, restlessness, hyperreflexia, and myoclonus abated slowly over the next 72 hours. The patient's anxiety subsided more slowly, and he recovered completely 1 week later. The plasma concentration of paroxetine was elevated far above the upper limit of the therapeutic range. The patient had cytochrome P-450 (CYP) 2D6*1/*5, a heterozygosity of an inactivated allele of CYP2D6, which metabolizes paroxetine. The patient was determined to be an intermediate metabolizer who was potentially vulnerable to paroxetine, a major inhibitor of CYP2D6. Heart failure is often accompanied by psychiatric disorders. A wide range of drugs commonly prescribed for these conditions, including beta-blockers, antiarrhythmics, and antidepressants, are metabolized by CYP2D6. Genetic screening for CYP2D6 in patients with these conditions may prevent life-threatening drug intoxication.
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PMID:Life-threatening serotonin syndrome in a patient with chronic heart failure and CYP2D6*1/*5. 1554 25

The filamentous fungus Myrothecium roridum isolated from a dye-contaminated area was investigated in terms of its use for the treatment of Malachite green (MG). The mechanisms involved in this process were established. Peroxidases and cytochrome P-450 do not mediate MG elimination. The laccase of M. roridum IM 6482 was found to be responsible for the decolorization of 8-11% of MG. Thermostable low-molecular-weight factors (LMWF) resistant to sodium azide were found to be largely involved in dye decomposition. In addition, MG decolorization by M. roridum IM 6482 occurred in a non-toxic manner. Data from antimicrobial tests showed that MG toxicity decreased after decolorization. To optimize the MG decolorization process, the effects of operational parameters (such as the medium pH and composition, process temperature and culture agitation) were examined. The results demonstrate that M. roridum IM 6482 may be used effectively as an alternative to traditional decolorization agents.
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PMID:Malachite green decolorization by the filamentous fungus Myrothecium roridum--Mechanistic study and process optimization. 2618 24