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)

The mechanism of action of theophylline in the treatment of asthma is not yet fully understood. Theophylline appears to be beneficial in some patients with steroid-dependent or nocturnal asthma. It is recommended as an alternative or additional treatment for patients with chronic mild, moderate or severe disease that does not respond to first- or second-line therapy with beta 2 agonists and anti-inflammatory medications such as cromolyn sodium, nedocromil (in children 12 years of age or older) or inhaled corticosteroids. However, theophylline therapy may cause bothersome side effects, including gastrointestinal distress, anxiety, insomnia and headache. These side effects can be minimized by beginning therapy with a low dosage and increasing the dosage slowly, until a therapeutic blood level is reached. Toxicity is more likely if the blood level exceeds 20 micrograms per mL. Prolonged fever puts patients at especially high risk for toxicity. Appropriate patient selection, careful dosing and regular monitoring are crucial elements of safe theophylline therapy.
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PMID:The changing role of theophylline in pediatric asthma. 811 18

The distributions of sodium and potassium in the serum on admission, and the types of medicine used were studied retrospectively in hospitalized geriatric patients (n = 1418). Sodium concentrations below 130 mmol/l were found in 7.4% and potassium concentrations below 3.0 mmol/l in 5.0% of patients. Risk factors for low sodium concentrations were treatment with the combination of thiazide+amiloride, potassium-sparing diuretics, thiazides, emergency hospitalization and low body weight. Risk factors for low potassium concentrations were treatment with the combination of thiazide+amiloride, thiazides and female gender. On an average, patients were given two different drugs from specified groups both on admission and on discharge, but changes in medical treatment were often performed during the hospital stay. Prehospital treatment with thiazide diuretics and the combination of thiazide+amiloride was frequently withdrawn. 38% were given benzodiazepines on discharge. In 40.4% of these, treatment had been started during the hospital stay, most often on account of insomnia.
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PMID:[Serum electrolytes and drug therapy of patients admitted to a geriatric department]. 827 99

Headache, nausea, vomiting, insomnia and peripheral edema are the most important symptoms of acute mountain sickness (AMS), which occur within 6 to 12 h. after exposure to altitudes of more than 2500 m a. s. l. Usually, these symptoms resolve spontaneously; however, they may progress to life-threatening cerebral edema in some cases. High-altitude pulmonary edema (HAPE) is a noncardiogenic edema, which is often preceded by acute mountain sickness. Frequency and severity of these illnesses depend on the altitude, the rate of ascent and the degree of individual susceptibility. A low hypoxic ventilatory drive, sodium and water retention as well as increased capillary permeability are the most important pathophysiological factors which contribute to hypoxemia and edema formation in AMS. They are also important in the pathophysiology of HAPE. In addition, excessive hypoxic pulmonary artery hypertension is most likely crucial in the pathogenesis of HAPE. Constitutional factors which regulate ventilation and pulmonary artery pressure under hypoxia are considered the most important determinants of susceptibility to AMS and HAPE.
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PMID:[Clinical aspects and pathophysiology of altitude sickness]. 837 71

A patient with a history of cerebrovascular disease, hypertension, and previous gastrectomy developed metabolic alkalosis and myoclonus. His medications included the anti-hypertensive agents nicardipine hydrochloride, delapril, prazosin; dihydroergotoxin and ticlopidine for cerebral infarction; estazolam for insomnia; azuren-L-glutamine compound and S-M powder. In addition, he had taken 12 grams per day of Ohta's Isan antacid, which contained 625 mg sodium bicarbonate per 1.3 g of antacid powder over a 6-month period. This antacid is commonly used in Japan. This is the first report of a case of metabolic alkalosis and myoclonus secondary to ingestion of a commercially available antacid in Japan.
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PMID:Metabolic alkalosis and myoclonus from antacid ingestion. 883 8

An investigator-blind, parallel-group, multicentre study was undertaken to compare the efficacy and tolerability of once-daily, sustained-release (s-r) ibuprofen and diclofenac sodium in patients (mean age 59.8 years) suffering from painful osteoarthritis affecting chiefly the knee and/or hip. Patients attending eight Swiss centres received either two s-r tablets of ibuprofen (daily dose 1600 mg; n = 30) or a single s-r diclofenac 100 mg tablet (n = 31) each evening for 21 days. Clinical assessments were performed prior to initiating therapy and after 7 and 21 days of treatment. Both treatments were efficacious, but statistically significant differences in favour of s-r ibuprofen were observed for the principal measure of efficacy, the investigator's assessment of the overall change in clinical condition; by Day 21, 37% of ibuprofen-treated patients vs 10% of diclofenac-treated patients were 'much improved' (p = 0.04). Patients' assessments of the efficacy of their treatment also favoured s-r ibuprofen at Day 7 for the relief of night pain (p = 0.048), at Day 21 for alleviation of day pain (p = 0.006) and for the ability to carry out normal activities (p = 0.01), and at both Days 7 and 21 for quality of sleep (p = 0.04 and 0.03, respectively). The patients' overall opinion of treatment was also significantly in favour of s-r ibuprofen, which was rated 'good or excellent' by 80% (24/30), compared with only 38% of patients (11/29) receiving s-r diclofenac sodium (p = 0.002). Two patients (6%) receiving s-r diclofenac sodium ceased treatment owing to dizziness and severe diarrhoea, respectively; there were no withdrawals in the ibuprofen-treated group. Ten (32%) patients in the s-r diclofenac group reported a total of 12 adverse events (mostly gastrointestinal in nature), compared with three (10%) patients in the s-r ibuprofen group who reported only three events (abdominal pain, insomnia and constipation). In conclusion, although both NSAID treatments improved the clinical condition of patients with painful osteoarthritis, statistically significant differences in favour of once-daily s-r ibuprofen (1600 mg) were demonstrated in terms of efficacy, indicating a potential therapeutic advantage for this formulation. Ibuprofen was also better tolerated than diclofenac sodium (100 mg/day), the latter being associated with gastrointestinal side effects in a significant proportion of patients. Sustained-release ibuprofen (Brufen Retard) thus represents an important addition to the available therapeutic armamentarium of once-daily NSAID formulations.
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PMID:Ibuprofen and diclofenac sodium in the treatment of osteoarthritis: a comparative trial of two once-daily sustained-release NSAID formulations. 901 Jun 10

We report the cases of two patients with psychiatric stupor who developed venous thrombosis. A 29-year-old schizophrenic woman had been hospitalized in psychiatric institutions three times because of stupor associated with auditory hallucinations and thought blocking. These symptoms recurred and she was admitted to our hospital with deep venous thrombosis of her left leg. The other patient was a 67-year-old woman with depression. She had also suffered from insomnia. Following admission to our hospital, she developed a depressive stupor complicated by deep venous thrombosis of her left leg. Both cases were treated with sodium heparin and urokinase, and completely resolved. It is well known that dehydration, infection and decubitus ulcers are important physical complications of psychiatric stupor, but there have been few reports of deep venous thrombosis as a physical complication of stupor.
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PMID:Deep venous thrombosis of the leg due to psychiatric stupor. 941 81

In the present study, we attempted to characterize the circadian rhythm of locomotor activity of El mice and to examine the duration of sodium pentobarbital-induced sleep during the light and dark periods. The effect of Saiko-ka-ryukotsu-borei-to, a representative Kampo medicine used for treating insomnia, was studied on the locomotor activity and on the duration of sodium pentobarbital-induced sleep in El mice. The spontaneous locomotor activity of El mice during the dark period was not so different from that of ddY mice, whereas the activity during the light period was significantly higher in the El mice, and the duration of sodium pentobarbital-induced sleep of El mice was very short during the light period, nearly equal to that during the dark period. The administration of Saiko-ka-ryukotsu-borei-to caused marked reduction in the locomotor activity during the light period, and dose-dependent prolongation in the duration of sodium pentobarbital-induced sleep time during the light period, but that during the dark period was unaffected. These findings suggest that the El mouse is a model with a tendency to be easily excitable during the light period compared to ddY mice. Furthermore, it was confirmed that Saiko-ka-ryukotsu-borei-to reduced the excitation in El mice and might be useful against sleep disorder due to excitation.
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PMID:Effects of Saiko-ka-ryukotsu-borei-to on irritable characteristics in El mice. 957 78

The role of basolateral amygdaloid nuclei (BLN) in sleep and wakeful state (W) was investigated with polysomnography. Electrical lesion of bilateral BLN increased slow wave sleep (SWS) and paradoxical sleep (PS), but decreased W. Bilateral injection of kainic acid (KA), which selectively destroyed the soma of neurons, resulted in biphasic effects. At d 1 after KA, insomnia occurred. At d 4, SWS increased while W decreased, but PS did not change. Unilateral injection of NO donor sodium nitroferricyanide (SNP) caused an enhancement of W and a decrease of SWS. Injection of nitric oxide synthase inhibitor N-nitro-L-arginine (L-NNA) led to opposite effects. L-arginine, a precursor of NO, had no direct effect on sleep and W, but blocked the effects of L-NNA. The results suggest that BLN plays an important role in regulating sleep and wakeful state. Destruction of BLN increases SWS, and NO in BLN has W-promoting and SWS-inhibiting effects, which may be mediated by activation of neurons in BLN.
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PMID:[Role of basolateral amygdaloid nuclei in sleep and wakeful state regulation]. 1136 83

Carbamoyl phosphate synthetase I deficiency (CPSID) is a rare metabolic disorder affecting the first enzymatic step of urea cycle. We report clinical manifestations of a female case of late-onset CPSID in Japan. An 18-year-old girl was admitted to emergency room due to acute comatose state. Her parents had no apparent consanguineous history. She had suffered from intermittent psychotic episodes (excitation, aggressive behavior and insomnia) with nausea and vomiting from the age of 13, mostly coinciding with menstrual period. She had minor learning disability without major neurological deficits and convulsions. Her mental status was estimated as normal in her intermenstrual period. She had been diagnosed as having hysteria and premenstrual syndrome. Her neurological findings on admission showed deep coma and hypotonic tetraparesis. Plasma ammonia level was markedly elevated (684 micrograms/dl) without significant liver dysfunction. Blood urea nitrogen decreased to 6 mg/dl. Continuous venovenous filtration with subsequential administration of sodium benzoate and l-arginine was started to eliminate blood ammonia. Although the plasma ammonia level decreased to 300 mu/dl in next 10 hours, severe cerebral edema was observed in head computed tomography subsequently, followed by marked cerebral atrophy. Finally, her consciousness status became almost alert a month after the onset, but her mental status was severely retarded. CPSI activity of her biopsied liver markedly decreased and she was diagnosed as having CPS ID. CPSI cDNA analysis of her biopsied liver demonstrated a V1149G mutation. Genomic DNA analysis showed that she was heterozygous in V1149G mutation. The mutation allele was derived from her father. The causative factor for absence or very low level of maternal CPSI mRNA will require further analysis.
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PMID:[A case of late-onset carbamoyl phosphate synthetase I deficiency, presenting periodic psychotic episodes coinciding with menstrual periods]. 1208 Jun 9

Citrus aurantium L. is commonly used as an alternative treatment for insomnia, anxiety and epilepsy. Essential oil from peel (EOP) and hydroethanolic (70% w/v) extract (HE) from leaves were obtained. Hexanic (HF), dichloromethanic (DF) and final aqueous (AF) fractions were obtained from HE by successive partitions. Swiss male mice (35-45 g) were treated orally with 0.5 or 1.0 g/kg of these preparations 30 min before the experiments for the evaluation of the sedative/hypnotic activity (sleeping time induced by sodium pentobarbital - SPB: 40 mg/kg, i.p.), anxiolytic activity (elevated plus maze--EPM) and anticonvulsant activity (induced by pentylenetetrazole--PTZ: 85 mg/kg, sc or by maximal electroshock--MES: 50 mA, 0.11 s, corneal). The results showed that EOP (0.5 g/kg) increased the latency period of tonic seizures in both convulsing experimental models. This effect was not dose-dependent. Treatment with 1.0 g/kg increased the sleeping time induced by barbiturates and the time spent in the open arms of the EPM. Specific tests indicated that the preparation, in both doses used, did not promote deficits in general activity or motor coordination. HF and DF fractions (1.0 g/kg) did not interfere in the epileptic seizures, but were able to enhance the sleeping time induced by barbiturates. The results obtained with EOP in the anxiety model, and with EOP, HF and DF in the sedation model, are in accord with the ethnopharmacological use of Citrus aurantium L., which could be useful in primary medical care, after toxicological investigation.
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PMID:Anxiolytic and sedative effects of extracts and essential oil from Citrus aurantium L. 1249 53


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