Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Vincristine, referred to as a vinka alkaloid, has been used as a component of the various chemotherapeutic regimens. The major side effects of the usual dosage of vincristine are bone marrow suppression, gastrointestinal disorder, and neurotoxicity. A 53-year-old cervical cancer patient received 14 mg (4 mg/m2/day for 2 days) of vincristine instead of vinblastine because of the similarity between the two names. Then life threatening toxicities including paresthesias, bone marrow depression, severe oral mucositis, paralytic ileus, bladder atony, myalgia, muscle weakness, high fever, derangements of various organs (liver, heart), hypertension, and insomnia were encountered. But hypotension and syndrome of inappropriate secretion of antidiuretic hormone (SIADH) were not observed. Other than paresthesias in the extremities, the patient recovered completely from toxic impairments with intensive symptomatic and supportive care. In order to prevent the administration of the overdosed drug, it would be advisable for chemotherapy to be administered only by an experienced physician who is able to check the dose and concentration.
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PMID:Overdose of vincristine: experience with a patient. 968 18

The purpose of this study was to determine whether psychological support associated with hormone replacement therapy (HRT) was more beneficial than replacement therapy alone. Our findings showed that HRT alone was more effective against vasomotor symptoms than HRT with psychological treatment (PT). While the combination of both treatment modalities (HRT + PT) was more effective against insomnia, nervousness, melancholy, fatigue, palpitations, and vertigo. Hormonal treatment alone and HRT with psychological treatment had little effect against paresthesia or tingling. Neither HRT alone nor HRT with psychological treatment was effective against joint and muscle pain or headache.
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PMID:Hormonal and psychological treatment: therapeutic alternative for menopausal women? 969 91

Fibromyalgia syndrome is a musculoskeletal pain and fatigue disorder manifested by diffuse myalgia, localized areas of tenderness, fatigue, lowered pain thresholds, and nonrestorative sleep. Evidence from multiple sources support the concept of decreased flux through the serotonin pathway in fibromyalgia patients. Serotonin substrate supplementation, via L-tryptophan or 5-hydroxytryptophan (5-HTP), has been shown to improve symptoms of depression, anxiety, insomnia and somatic pains in a variety of patient cohorts. Identification of low serum tryptophan and serotonin levels may be a simple way to identify persons who will respond well to this approach.
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PMID:Fibromyalgia and the serotonin pathway. 980 12

Recently, 5-hydroxy-L-tryptophan (5-OHTrp) has been promoted as an alternative to banned L-tryptophan as a dietary supplement. It has been claimed to help alleviate obesity, insomnia, depression, and headaches. However, eosinophilia-myalgia syndrome (EMS)-like symptoms have also been associated with ingestion or exposure to 5-OHTrp. HPLC-UV analysis of EMS-implicated 5-OHTrp revealed the presence of peak X, described as case-implicated. We show that peak X is actually a family of contaminants with the same molecular weight (234 Da) and similar HPLC retention times. We also demonstrate that all eight samples of commercially available 5-OHTrp analyzed by HPLC-MS contained three or more contaminants of the peak X family. The significance of these findings is discussed.
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PMID:Eosinophilia-myalgia syndrome case-associated contaminants in commercially available 5-hydroxytryptophan. 1072 Oct 89

One of the treatment alternative of withdrawal symptoms of patients suffering from opiate dependence is to apply the clonidine in combination or itself. This remedy is not in commercial trade in our country. It is expectable according to the recent data analysing the effects of the alfa2 adreneregic agonist tizanidine that tizanidine has the similar protective effect as clonidine with the resembling target point. Based on this theory a research was done, in the course of which the i.v. heroin users who presented themselves at the Drug Outpatient Department of Buda between 1.10.1998-8.01.1999. were divided into two groups. The groups had got the usual detoxification treatment, but in the experimental group tizanidine were given in 3 x 8 mg/day dose too. Sixteen patients were in the tizanidine group, 10 patients were in the control group. The patients estimated the intensity of 7 symptoms of withdrawal (sweating, nervousness, insomnia, tremor, diarrhoea, muscle pain, drug craving) on a subjective scale day by day. The analysis showed that the tizanidine treatment decreased the intensity of the withdrawal symptoms in every symptom type examined. The ten days long acute withdrawal period were accomplished by all of the patients, but in the short course of the following (mean 9 and 11 weeks in the treated and the control groups respectively) there were three relapses in each group (3/16 in the treated and 3/10 in the control).
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PMID:[Tizanidine in the treatment of acute withdrawal symptoms in heroin dependent patients]. 1080 29

Acupuncture, a Chinese medical therapy which uses fine needles to alleviate symptoms, is being used as a complement to drug therapy in some patients. It provides relief for some problems that are caused by disease pathogens or are side effects of drug treatments. Symptoms relieved by acupuncture include night sweats, diarrhea, vomiting, digestive difficulty, insomnia, anxiety, muscle pain, and other symptoms. A related treatment called moxibustion is sometimes used, which applies heat through the acupuncture needles. Herbal formulas are also used to complement acupuncture.
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PMID:Acupuncture and traditional Oriental medicine in the treatment of HIV and AIDS. 1136 90

Safety and tolerability of sildenafil citrate was assessed in a population subset of 60 Singaporean men with erectile dysfunction taken from the Asian Sildenafil Efficacy and Safety Study (ASSESS-I), a double-blind, placebo-controlled, flexible-dose study. The men, from two centres, with > or = 6 months' history of erectile dysfunction, were randomized to two treatment arms for 12 weeks. One group (30 patients) received sildenafil (initial dose 50 mg taken 1 h before sexual activity for the first 2 weeks, increased to 100 mg or decreased to 25 mg, according to efficacy and/or tolerability). The remaining 30 patients received a matching placebo. Incidence and type of adverse effects were evaluated at 2, 4, 8 and 12 weeks. Nine patients (30.0%) on sildenafil (33.1% in the full ASSESS-I study) and one patient (3.3%) on placebo (22.8% in the full ASSESS-I study) experienced treatment-related adverse events, the most frequent being headache in the sildenafil group (reported by five patients [16.7%]; 11.0% in the full ASSESS-I study). Flushing, visual disturbance, dizziness, insomnia, myalgia and back pain each occurred in one patient in the sildenafil group (3.3%); in the placebo group, one patient (3.3%) had headache. Importantly, the incidence of cardiovascular and respiratory system adverse events were relatively less than in the full ASSESS-I population (cardiovascular 3.3% in the present study versus 10.2% in the full ASSESS-I population; respiratory 3.3% versus 5.5%). All adverse events were transient and mild, and did not lead to treatment withdrawal. There was no effect on sitting blood pressure, heart rate or standard laboratory parameters; more importantly, there was no incidence of myocardial infarction, stroke or priapism. These results should reassure Singaporean patients and their physicians of the safety of sildenafil for erectile dysfunction.
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PMID:Clinical safety profile of sildenafil in Singaporean men with erectile dysfunction: pre-marketing experience (ASSESS-I evaluation). 1202 21

In the course of treatment of psychiatric patients, it is often necessary to switch antipsychotic medications. In recent years, atypical antipsychotic agents have become the first-line therapeutic interventions for treating psychotic symptoms. Reasons for switching patients from the typical antipsychotics to the atypical agents can include enhanced efficacy against negative symptoms, improvement in cognitive capacity, and reduction of risk of extrapyramidal side effects. The presumed long-term benefits of switching to the new antipsychotic drug should be assessed. Pharmacokinetic and pharmacodynamic properties of antipsychotic agents and drug-drug interactions should be considered during the switch process. Two methods are employed for the switch process: crossover ("crosstitration") and an abrupt switch. With the crossover method, the patient's current medication is tapered over a period of several days to several months to prevent potential withdrawal symptoms, such as nausea, vomiting, insomnia, muscle aches, and diaphoresis. Due to withdrawal symptoms, clozapine is the only atypical agent recommended to proceed with a slow dose taper when switching to another atypical drug. Sudden cessation could also precipitate the emergence of motor symptoms, which can include pseudoparkinsonism, dystonia, akathisia, and dyskinesia. The initiation of the new antipychotic occurs concurrently with the tapering of the previous drug. In an abrupt switch, the previous antipsychotic is discontinued suddenly, independent of its dose, and the new antipsychotic is started on the next day. Both methods have been used in clinical practice and double-blind studies. To date, only two medications have been studied in large multicenter clinical trials. These are olanzapine and ziprasidone. The olanzapine study revealed optimal benefits when the previous agents were gradually withdrawn and olanzapine was initiated at 10 mg/day. The ziprasidone switch study demonstrated both reduced adverse side effects from the previous agents and improvements in clinical efficacy. Additional studies are needed to examine the optimal methods for switching patients from one atypical agent to another atypical antipsychotic.
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PMID:Clinical significance of drug binding, protein binding, and binding displacement drug interactions. 1247 62

Symptoms serve as intervention foci for patients and health care providers. Research has established a relationship between symptoms and quality of life for persons living with HIV/AIDS. This article reports symptom prevalence and intensity data that include gynecological and cognitive symptoms self-reported by HIV-infected women (N = 118). Using a cross-sectional, descriptive design, data were obtained using the Center for Epidemiological Studies-Depression Scale (CES-D), Medical Outcomes Study Short Form-36 (MOS SF-36), and the revised Sign and Symptom Check-List for Persons Living with HIV/AIDS (SSC-HIV). Prevalent symptoms were depression (83%), muscle aches (84%), weakness (80%), and painful joints (71%). Symptoms with the highest mean intensity, however, were headaches, rash, insomnia, vaginal itching, and shortness of breath at rest. Symptoms also significantly predicted role functioning. This study contributes to our understanding the nature of symptoms and the influence of symptoms on role and physical functioning among HIV-infected women.
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PMID:The influence of symptoms on quality of life among HIV-infected women. 1498 39

Availability of a drug regimen that eradicates the hepatitis C virus (HCV) in more than half of treated patients provides the medical community with a powerful new weapon to diminish the anticipated future wave of HCV-related liver disease and cancer. Clinicians must understand the benefits, risks, and costs associated with the combination of peginterferon alfa and ribavirin. Major clinical trials with this new standard of HCV therapy have demonstrated sustained virologic responses of 54% and 56% with 48 weeks of combination therapy. Response is highest in those with genotype 2/3, with early virologic response by week 12, in patients with high adherence, and in patients receiving weight-appropriate ribavirin dosages. The most common side effects are manageable and include fatigue, headache, myalgia, rigors, fever, nausea, insomnia, and depression. Neutropenia associated with interferon and anemia associated with ribavirin are more serious side effects that can cause discontinuation or dose reduction. Clinicians can maximize results and reduce costs with a regimen of peginterferon alfa plus ribavirin by choosing patients carefully, educating patients thoroughly, stopping therapy early in those patients who do not respond by week 12 of therapy, and enhancing adherence by managing side effects with appropriate dose reductions and/or selective use of antidepressants or hematopoietic colony stimulators.
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PMID:Managing hepatitis C. 1508 65


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