Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1323099 (sympathomimetic)
 2,957 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The position of pharmacotherapy of obesity is still controversial. Different groups of drugs are currently available in Switzerland--none is covered by the health insurances. Apparently the authorities are not convinced of their efficacy. Various groups of drugs have been tried, such as amphetamine derivatives, adrenergic drugs, serotonin agonists or hormones with thermogenic effects, intestinal enzyme inhibitors and dietary fibres. The results of sympathomimetic drugs demonstrate a relatively high incidence of side-effects, and with some preparations there is also the risk of addiction. The serotoninergic drug fenfluramine has been demonstrated in several controlled studies to be an effective weight-reducing agent; however, its effect was relatively modest: It lasted only as long as the drug was taken. Fenfluramine is relatively free of side-effects and is reported to diminish 'carbohydrate craving'.
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PMID:[Drugs against obesity]. 217 Nov 53

Amphetamine (beta-phenylisopropylamine) is a potent sympathomimetic amine of a simple structure with a multiplicity of biological effects that include hyperthermic, anorectic, cardiovascular and central nervous system stimulant actions. Since the 1930s a large number of drugs have been developed from systematic, chemical modifications of the basic amphetamine molecule to emphasize some of the properties of amphetamines and to eliminate or diminish others. These chemical manipulations have resulted in the synthesis of a variety of more selectively acting sympathomimetics. These altered molecules include CNS stimulants, potent psychomimetics (hallucinogens), anorectic agents, and vasoconstrictors that all have the basic beta-phenylisopropylamine skeleton. Reports of the consequences of abuse and addiction followed rather closely the development of these agents: manufacture, distribution and use continue to the present day. Both legitimate and illicit production account for a significant level of use of CNS stimulants. CNS stimulants are perhaps the most reinforcing drugs known to man. For this reason alone they will persist as drugs of choice among a variety of personalities.
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PMID:Amphetamines: pharmacology, abuse and addiction. 254 76

The subjective, behavioral, and physiological effects of bupropion, a nontricyclic antidepressant, were compared with those of dextroamphetamine and placebo in a randomized double-blind crossover study. The volunteers who participated were multiple-drug abusers. Six acute drug treatments, three doses of bupropion (100, 200, 400 mg), two doses of dextroamphetamine (15, 30 mg), and placebo were administered orally at intervals of not less than 72 h. Results indicated that the subjective effects of amphetamine as measured by the Addiction Research Center Inventory (ARCI) differed markedly from bupropion and placebo. Bupropion, in contrast to amphetamine, had no peripheral sympathomimetic effects and did not reduce appetite or caloric intake.
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PMID:A comparison of bupropion, dextroamphetamine, and placebo in mixed-substance abusers. 641 63

A patient addicted to khat was successfully treated as an outpatient. He was detoxified with bromocriptine mesylate 1.25 mg. q 6 h which was titrated downward over 4 weeks. Khat is a bush historically indigenous to the Mideast. It has high addictive potential due to its constituent, "cathinone." Cathinone, (1(5) + (minus sign) aminopropiophenon), is a sympathomimetic, similar but not identical to cocaine and amphetamine in activity and addiction potential. Bromocriptine has been extensively reported to successfully detoxify cocaine addiction and could be useful in khat addiction.
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PMID:Treatment of Khat Addiction with Bromocriptine Mesylate: A Case Report and Review of Cocaine- and Amphetamine-Like Effects. 1185 Jun 96

Alcohol abuse has been linked to intracranial hemorrhage, both intracerebral and subarachnoid. Some studies have found a dose-response relationship, so that increasing levels of abuse are associated with greater risk of hemorrhage. However, alcohol abuse has not been clearly linked to cerebral infarction, and some studies find that mild-to-moderate drinking appears to be associated with a decreased risk of cerebral infarction. Intravenous administration of drugs of abuse predisposes to endocarditis, which may lead to embolic stroke. Associations have been reported between various sympathomimetic drugs and cerebral infarction. A possible mechanism for cerebral infarction is focal arterial vasoconstriction and occasionally cerebral vasculitis. Associations have also been reported between various sympathomimetic drugs and intracranial hemorrhage. A likely mechanism for intracranial hemorrhage is acute arterial hypertension. With the exception of endocarditis, management of stroke related to drug abuse is largely supportive, with emphasis on supportive care to prevent stroke complications, physical and occupational therapy, and aggressive addiction rehabilitation.
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PMID:Cerebrovascular complications of alcohol and sympathomimetic drug abuse. 1250 9

Exposure to the once highly prevalent over-the-counter (OTC) sympathomimetic phenylpropanolamine (PPA; +/--norephedrine) during pre-adolescence alters the developmental trajectory of catecholamine and amino acid neurotransmitter systems in the nucleus accumbens (NAC) that culminate in a 'pro-addictive' phenotype in adulthood. Thus, the present study sought to extend these earlier data by examining the long-term consequences of repeated PPA treatment during adolescence upon the behavioral and neurochemical responses to cocaine. For this, C57BL/6J mice were pre-treated with PPA (0-40 mg/kg) during postnatal days 35-44, and the capacity of cocaine (4 x 15 mg/kg) to elicit a conditioned place-preference, as well as behavioral and neurochemical sensitization within the NAC, were then assessed in adulthood. While adolescent PPA exposure did not influence spontaneous locomotor activity or the motor responses to either acute or repeated cocaine (4 x 15 mg/kg), PPA pre-exposure dose-dependently reduced the expression of a conditioned place-preference. As observed previously for juvenile PPA treatment, adolescent PPA administration blunted the dopamine and norepinephrine response to acute cocaine, prevented the development of catecholamine sensitization but did not influence cocaine-induced elevations in serotonin. However, unlike juvenile PPA treatment, adolescent PPA also prevented the development of glutamate sensitization within the NAC. These data provide evidence that adolescent exposure to a formerly prevalent OTC sympathomimetic produces protracted effects upon cocaine-induced changes in NAC glutamate transmission that may reduce vulnerability to cocaine addiction in later life and further the hypothesis that early exposure to sympathomimetic drugs may be an environmental factor contributing to the etiology of addiction.
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PMID:Protracted 'anti-addictive' effects of adolescent phenylpropanolamine exposure in C57BL/6J mice. 1833 69

Ephedra is an amphetamine-like compound with a potent sympathomimetic effect. Ephedrine, its active component, is widely used for weight loss, to enhance athletic performance or as component of some drugs. Its cardiovascular effects include tachycardia, increased inotropy, arterial vasoconstriction and hypertension, and these are the effects for which it is used therapeutically. However, it can also cause adverse effects, such as neuropathy, myopathy, psychosis, addiction, stroke, insomnia, myocarditis, arrhythmias, myocardial infarction or sudden death. We present the case of a patient, with pre-existing psychiatric conditions, who developed congestive heart failure and pulmonary oedema in the context of severe biventricular dysfunction and myocardial necrosis secondary to longstanding ephedrine abuse. Secondary causes of dilated myocardiopathy such as alcohol abuse, autoimmunity, hemochromatosis, thyroid alterations, viral or bacterial myocarditis and coronary heart disease, were ruled out. Five years after total cessation of use of the drug containing ephedrine, the patient is symptom-free, with partial recovery of left ventricular ejection fraction.
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PMID:[Myocardial necrosis and severe biventricular dysfunction in the context of chronic ephedrine abuse]. 2030 Jul 11

A wider array of treatments are needed for people with substance abuse disorders. Some psychedelic compounds have been assessed as potential substance abuse treatments with promising results. MDMA may also help treat substance abuse based on shared features with psychedelic compounds and recent reports indicating that MDMAassisted psychotherapy can reduce symptoms of PTSD. Narrative reports and data from early investigations found that some people reduced or eliminated their substance use after receiving MDMA, especially in a therapeutic setting. MDMA is a potent monoamine releaser with sympathomimetic effects that may indirectly activate 5-HT2A receptors. It increases interpersonal closeness and prosocial feelings, potentially through oxytocin release. Findings suggest that ecstasy, material represented as containing MDMA, is associated with deleterious long-term effects after heavy lifetime use, including fewer serotonin transporter sites and impaired verbal memory. Animal and human studies demonstrate moderate abuse liability for MDMA, and this effect may be of most concern to those treating substance abuse disorders. However, subjects who received MDMA-assisted psychotherapy in two recent clinical studies were not motivated to seek out ecstasy, and tested negative in random drug tests during follow-up in one study. MDMA could either directly treat neuropharmacological abnormalities associated with addiction, or it could indirectly assist with the therapeutic process or reduce symptoms of comorbid psychiatric conditions, providing a greater opportunity to address problematic substance use. Studies directly testing MDMA-assisted psychotherapy in people with active substance abuse disorder may be warranted.
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PMID:Can MDMA play a role in the treatment of substance abuse? 2362 86

Medications for the treatment of obesity began to appear in the late 19th and early 20th century. Amphetamine-addiction led to the search for similar drugs without addictive properties. Four sympathomimetic drugs currently approved in the US arose from this search, but may not be approved elsewhere. When noradrenergic drugs were combined with serotonergic drugs, additional weight loss was induced. At present there are three drugs (orlistat, phentermine/topiramate and lorcaserin) approved for long-term use and four sympathomimetic drugs approved by the US FDA for short-term treatment of obesity. Leptin produced in fat cells and glucagon-like peptide-1, a gastrointestinal hormone, provide a new molecular basis for treatment of obesity. New classes of agents acting on the melanocortin system in the brain or mimicking GLP-1 have been tried with variable success. Combination therapy can substantially increase weight loss; a promising approach for the future.
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PMID:Medical treatment of obesity: the past, the present and the future. 2519 83

Drug abuse is a common problem and growing concern in the United States, and over the past decade, novel or atypical drugs have emerged and have become increasingly popular. Recognition and treatment of new drugs of abuse pose many challenges for health care providers due to lack of quantitative reporting and routine surveillance, and the difficulty of detection in routine blood and urine analyses. Furthermore, street manufacturers are able to rapidly adapt and develop new synthetic isolates of older drugs as soon as law enforcement agencies render them illegal. In this article, we describe the clinical and adverse effects and purported pharmacology of several new classes of drugs of abuse including synthetic cannabinoids, synthetic cathinones, salvia, desomorphine, and kratom. Because many of these substances can have severe or life-threatening adverse effects, knowledge of general toxicology is key in recognizing acute intoxication and overdose; however, typical toxidromes (e.g., cholinergic, sympathomimetic, opioid, etc.) are not precipitated by many of these agents. Medical management of patients who abuse or overdose on these drugs largely consists of supportive care, although naloxone may be used as an antidote for desomorphine overdose. Symptoms of aggression and psychosis may be treated with sedation (benzodiazepines, propofol) and antipsychotics (haloperidol or atypical agents such as quetiapine or ziprasidone). Other facets of management to consider include treatment for withdrawal or addiction, nutrition support, and potential for transmission of infectious diseases.
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PMID:New drugs of abuse. 2547 Oct 45


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