Galantamine 4Mg/Ml Oral Solution Package Leaflet
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Pyridostigmine in the Treatment of Postural
Pyridostigmine in the Treatment of Postural Orthostatic Tachycardia: A Single-Center Experience KHALIL KANJWAL, M.D.,* BEVERLY KARABIN, PH.D.,* MUJEEB SHEIKH, M.D.,* LAWRENCE ELMER, M.D., PH.D.,† YOUSUF KANJWAL, M.D.,* BILAL SAEED, M.D.,* and BLAIR P. GRUBB, M.D.* From the *Electrophysiology Section, Division of Cardiology, Department of Medicine, The University of Toledo, Toledo, Ohio; and †Department of Neurology, The University of Toledo College of Medicine, Health Science Campus, Toledo, Ohio Background: The long-term efficacy of pyridostigmine, a reversible acetyl cholinesterase inhibitor, in the treatment of postural orthostatic tachycardia syndrome (POTS) patients remains unclear. We report our retrospective, single-center, long-term experience regarding the efficacy and adverse effect profile of pyridostigmine in the treatment of POTS patients. Methods: This retrospective study included an extensive review of electronic charts and data collection in regards to patient demographics, orthostatic parameters, side-effect profile, subjective response to therapy, as well as laboratory studies recorded at each follow-up visit to our institution’s Syncope and Autonomic Disorders Center. The response to pyridostigmine therapy was considered successful if patient had both symptom relief in addition to an objective response in orthostatic hemodynamic parameters (heart rate [HR] and blood pressure). Three hundred patients with POTS were screened for evaluation in this study. Of these 300, 203 patients with POTS who received pyridostigmine therapy were reviewed. Of these 203 patients, 168 were able to tolerate the medication after careful dose titration. The mean follow- up duration in this group of patients was 12 ± 3 (9–15) months. Pyridostigmine improved symptoms of orthostatic intolerance in 88 of 203 (43%) of total patients or 88 of 172 (51%) who were able to tolerate the drug. -
Corticosterone and Pyridostigmine/DEET Exposure
HHS Public Access Author manuscript Author ManuscriptAuthor Manuscript Author Neurotoxicology Manuscript Author . Author Manuscript Author manuscript; available in PMC 2019 May 24. Published in final edited form as: Neurotoxicology. 2019 January ; 70: 26–32. doi:10.1016/j.neuro.2018.10.006. Corticosterone and pyridostigmine/DEET exposure attenuate peripheral cytokine expression: Supporting a dominant role for neuroinflammation in a mouse model of Gulf War Illness Lindsay T. Michalovicza, Alicia R. Lockera, Kimberly A. Kellya, Julie V. Millera, Zachary Barnesb,c, Mary Ann Fletcherb,c, Diane B. Millera, Nancy G. Klimasb,c, Mariana Morrisb, Stephen M. Lasleyd, and James P. O’Callaghana,* aHealth Effects Laboratory Division, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, WV, USA bInstitute for Neuro-Immune Medicine, Nova Southeastern University, Ft. Lauderdale, FL, USA cMiami Veterans Affairs Medical Center, Miami, FL, USA dDepartment of Cancer Biology & Pharmacology, University of Illinois College of Medicine at Peoria, Peoria, IL, USA Abstract Gulf War Illness (GWI) is a chronic multi-symptom disorder experienced by as many as a third of the veterans of the 1991 Gulf War; the constellation of “sickness behavior” symptoms observed in ill veterans is suggestive of a neuroimmune involvement. Various chemical exposures and conditions in theater have been implicated in the etiology of the illness. Previously, we found that GW-related organophosphates (OPs), such as the sarin surrogate, DFP, and chlorpyrifos, cause neuroinflammation. The combination of these exposures with exogenous corticosterone (CORT), mimicking high physiological stress, exacerbates the observed neuroinflammation. The potential relationship between the effects of OPs and CORT on the brain versus inflammation in the periphery has not been explored. -
Title 16. Crimes and Offenses Chapter 13. Controlled Substances Article 1
TITLE 16. CRIMES AND OFFENSES CHAPTER 13. CONTROLLED SUBSTANCES ARTICLE 1. GENERAL PROVISIONS § 16-13-1. Drug related objects (a) As used in this Code section, the term: (1) "Controlled substance" shall have the same meaning as defined in Article 2 of this chapter, relating to controlled substances. For the purposes of this Code section, the term "controlled substance" shall include marijuana as defined by paragraph (16) of Code Section 16-13-21. (2) "Dangerous drug" shall have the same meaning as defined in Article 3 of this chapter, relating to dangerous drugs. (3) "Drug related object" means any machine, instrument, tool, equipment, contrivance, or device which an average person would reasonably conclude is intended to be used for one or more of the following purposes: (A) To introduce into the human body any dangerous drug or controlled substance under circumstances in violation of the laws of this state; (B) To enhance the effect on the human body of any dangerous drug or controlled substance under circumstances in violation of the laws of this state; (C) To conceal any quantity of any dangerous drug or controlled substance under circumstances in violation of the laws of this state; or (D) To test the strength, effectiveness, or purity of any dangerous drug or controlled substance under circumstances in violation of the laws of this state. (4) "Knowingly" means having general knowledge that a machine, instrument, tool, item of equipment, contrivance, or device is a drug related object or having reasonable grounds to believe that any such object is or may, to an average person, appear to be a drug related object. -
Mechanism of Central Hypopnoea Induced by Organic Phosphorus
www.nature.com/scientificreports OPEN Mechanism of central hypopnoea induced by organic phosphorus poisoning Kazuhito Nomura*, Eichi Narimatsu, Hiroyuki Inoue, Ryoko Kyan, Keigo Sawamoto, Shuji Uemura, Ryuichiro Kakizaki & Keisuke Harada Whether central apnoea or hypopnoea can be induced by organophosphorus poisoning remains unknown to date. By using the acute brainstem slice method and multi-electrode array system, we established a paraoxon (a typical acetylcholinesterase inhibitor) poisoning model to investigate the time-dependent changes in respiratory burst amplitudes of the pre-Bötzinger complex (respiratory rhythm generator). We then determined whether pralidoxime or atropine, which are antidotes of paraoxon, could counteract the efects of paraoxon. Herein, we showed that paraoxon signifcantly decreased the respiratory burst amplitude of the pre-Bötzinger complex (p < 0.05). Moreover, pralidoxime and atropine could suppress the decrease in amplitude by paraoxon (p < 0.05). Paraoxon directly impaired the pre-Bötzinger complex, and the fndings implied that this impairment caused central apnoea or hypopnoea. Pralidoxime and atropine could therapeutically attenuate the impairment. This study is the frst to prove the usefulness of the multi-electrode array method for electrophysiological and toxicological studies in the mammalian brainstem. Te pre-Bötzinger complex (preBötC) in the ventrolateral lower brainstem is essential for the formation of the unconscious breathing rhythm in mammals1,2. Tis is because the cyclic burst excitation generated from preBötC synchronizes with the respiratory rhythm through phrenic nerve fring and the diaphragmatic contractions, and destruction of preBötC causes the disappearance of the rhythm. Periodic respiratory burst excitation has also been confrmed from an island specimen derived by isolating preBötC in an island shape to block input from other neurons2. -
Acetylcholinesterase Inhibitor Pyridostigmine Bromide Attenuates Gut Pathology and Bacterial Dysbiosis in a Murine Model of Ulcerative Colitis
Florida International University FIU Digital Commons HWCOM Faculty Publications Herbert Wertheim College of Medicine 10-23-2019 Acetylcholinesterase Inhibitor Pyridostigmine Bromide Attenuates Gut Pathology and Bacterial Dysbiosis in a Murine Model of Ulcerative Colitis SP Singh Hitendra S. Chand S. Banerjee H. Agarwal V. Raizada See next page for additional authors Follow this and additional works at: https://digitalcommons.fiu.edu/com_facpub Part of the Medicine and Health Sciences Commons This work is brought to you for free and open access by the Herbert Wertheim College of Medicine at FIU Digital Commons. It has been accepted for inclusion in HWCOM Faculty Publications by an authorized administrator of FIU Digital Commons. For more information, please contact [email protected]. Authors SP Singh, Hitendra S. Chand, S. Banerjee, H. Agarwal, V. Raizada, S. Roy, and M. Sopori Digestive Diseases and Sciences (2020) 65:141–149 https://doi.org/10.1007/s10620-019-05838-6 ORIGINAL ARTICLE Acetylcholinesterase Inhibitor Pyridostigmine Bromide Attenuates Gut Pathology and Bacterial Dysbiosis in a Murine Model of Ulcerative Colitis Shashi P. Singh1 · Hitendra S. Chand2 · Santanu Banerjee3 · Hemant Agarwal4 · Veena Raizada4 · Sabita Roy3 · Mohan Sopori1 Received: 30 March 2019 / Accepted: 10 September 2019 / Published online: 23 October 2019 © The Author(s) 2019 Abstract Background Ulcerative colitis (UC) is a Th2 infammatory bowel disease characterized by increased IL-5 and IL-13 expres- sion, eosinophilic/neutrophilic infltration, decreased mucus production, impaired epithelial barrier, and bacterial dysbiosis of the colon. Acetylcholine and nicotine stimulate mucus production and suppress Th2 infammation through nicotinic receptors in lungs but UC is rarely observed in smokers and the mechanism of the protection is unclear. -
Guideline for Preoperative Medication Management
Guideline: Preoperative Medication Management Guideline for Preoperative Medication Management Purpose of Guideline: To provide guidance to physicians, advanced practice providers (APPs), pharmacists, and nurses regarding medication management in the preoperative setting. Background: Appropriate perioperative medication management is essential to ensure positive surgical outcomes and prevent medication misadventures.1 Results from a prospective analysis of 1,025 patients admitted to a general surgical unit concluded that patients on at least one medication for a chronic disease are 2.7 times more likely to experience surgical complications compared with those not taking any medications. As the aging population requires more medication use and the availability of various nonprescription medications continues to increase, so does the risk of polypharmacy and the need for perioperative medication guidance.2 There are no well-designed trials to support evidence-based recommendations for perioperative medication management; however, general principles and best practice approaches are available. General considerations for perioperative medication management include a thorough medication history, understanding of the medication pharmacokinetics and potential for withdrawal symptoms, understanding the risks associated with the surgical procedure and the risks of medication discontinuation based on the intended indication. Clinical judgement must be exercised, especially if medication pharmacokinetics are not predictable or there are significant risks associated with inappropriate medication withdrawal (eg, tolerance) or continuation (eg, postsurgical infection).2 Clinical Assessment: Prior to instructing the patient on preoperative medication management, completion of a thorough medication history is recommended – including all information on prescription medications, over-the-counter medications, “as needed” medications, vitamins, supplements, and herbal medications. Allergies should also be verified and documented. -
Demecarium Bromide/Homatropine 1881
Demecarium Bromide/Homatropine 1881 Dyflos (BAN) junctival injection of pralidoxime has been used to reverse severe ocular adverse effects. Supportive treatment, including assisted DFP; Difluorophate; Di-isopropyl Fluorophosphate; Di-isopro- ventilation, should be given as necessary. CH3 pylfluorophosphonate; Fluostigmine; Isoflurofato; Isoflurophate. Di-isopropyl phosphorofluoridate. To prevent or reduce development of iris cysts in patients receiv- N ing ecothiopate eye drops, phenylephrine eye drops may be giv- C6H14FO3P = 184.1. en simultaneously. CAS — 55-91-4. ATC — S01EB07. Precautions ATC Vet — QS01EB07. As for Neostigmine, p.632. For precautions of miotics, see also OH under Pilocarpine, p.1885. In general, as with other long-acting anticholinesterases, ecothiopate should be used only where ther- O apy with other drugs has proved ineffective. Ecothiopate iodide CH3 should not be used in patients with iodine hypersensitivity. O O H3C O Interactions P CH3 As for Neostigmine, p.632. The possibility of an interaction re- O F mains for a considerable time after stopping long-acting anti- Homatropine Hydrobromide (BANM) CH3 cholinesterases such as ecothiopate. Homatr. Hydrobrom.; Homatropiinihydrobromidi; Homatropi- Pharmacopoeias. In US. Uses and Administration na, hidrobromuro de; Homatropine, bromhydrate d’; Homatro- USP 31 (Isoflurophate). A clear, colourless, or faintly yellow liq- Ecothiopate is an irreversible inhibitor of cholinesterase; its ac- pin-hidrobromid; Homatropinhydrobromid; Homatropin-hydro- uid. Specific gravity about 1.05. Sparingly soluble in water; sol- tions are similar to those of neostigmine (p.632) but much more bromid; Homatropini hydrobromidum; Homatropinium Bro- uble in alcohol and in vegetable oils. It is decomposed by mois- prolonged. Its miotic action begins within 1 hour of its applica- mide; Homatropino hidrobromidas; Homatropinum Bromatum; ture with the evolution of hydrogen fluoride. -
Pharmacology of Ophthalmologically Important Drugs James L
Henry Ford Hospital Medical Journal Volume 13 | Number 2 Article 8 6-1965 Pharmacology Of Ophthalmologically Important Drugs James L. Tucker Follow this and additional works at: https://scholarlycommons.henryford.com/hfhmedjournal Part of the Chemicals and Drugs Commons, Life Sciences Commons, Medical Specialties Commons, and the Public Health Commons Recommended Citation Tucker, James L. (1965) "Pharmacology Of Ophthalmologically Important Drugs," Henry Ford Hospital Medical Bulletin : Vol. 13 : No. 2 , 191-222. Available at: https://scholarlycommons.henryford.com/hfhmedjournal/vol13/iss2/8 This Article is brought to you for free and open access by Henry Ford Health System Scholarly Commons. It has been accepted for inclusion in Henry Ford Hospital Medical Journal by an authorized editor of Henry Ford Health System Scholarly Commons. For more information, please contact [email protected]. Henry Ford Hosp. Med. Bull. Vol. 13, June, 1965 PHARMACOLOGY OF OPHTHALMOLOGICALLY IMPORTANT DRUGS JAMES L. TUCKER, JR., M.D. DRUG THERAPY IN ophthalmology, like many specialties in medicine, encompasses the entire spectrum of pharmacology. This is true for any specialty that routinely involves the care of young and old patients, surgical and non-surgical problems, local eye disease (topical or subconjunctival drug administration), and systemic disease which must be treated in order to "cure" the "local" manifestations which frequently present in the eyes (uveitis, optic neurhis, etc.). Few authors (see bibliography) have attempted an introduction to drug therapy oriented specifically for the ophthalmologist. The new resident in ophthalmology often has a vague concept of the importance of this subject, and with that in mind this paper was prepared. -
Problems with Botulinum Toxin Treatment in Mitochondrial Cytopathy
1594 J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.2004.057661 on 14 October 2005. Downloaded from SHORT REPORT Problems with botulinum toxin treatment in mitochondrial cytopathy: case report and review of the literature T Gioltzoglou, C Cordivari, P J Lee, M G Hanna, A J Lees ............................................................................................................................... J Neurol Neurosurg Psychiatry 2005;76:1594–1596. doi: 10.1136/jnnp.2004.057661 We report two patients (a brother and sister) who had an Botulinum toxin type A (BTXA) is widely used in neurological unexpected reaction to botulinum toxin injections into their therapeutics for a variety of indications such as dystonia, parotid and submandibular glands for the treatment of spasticity, hyperhidrosis, and hypersalivation. It is relatively sialorrhoea. contraindicated in disorders of neuromuscular transmission, in individuals with known hypersensitivity or bleeding CASE REPORTS disorders, and during pregnancy. Two patients are presented Patient 1 with initially undetermined multisystem neurological disor- The first patient was a 30 year old man with an insidious ders and excessive sialorrhoea, later diagnosed as mito- onset of intellectual and movement disorders in infancy. He chondrial cytopathy, who had side effects after treatment had delayed motor and intellectual development. He was with ultrasound guided BTXA injections. Published reports on wheelchair bounded, while his language was limited to single the use of BTXA injections in hypersalivation of various words or simple phrases. He had good comprehension and causes are reviewed, along with the proposed mechanisms of memory, and normal sphincter function. He had no difficulty hypersensitivity to BTXA in patients with mitochondrial in swallowing. cytopathies. Clinicians should be cautious when using BTXA Neurologically, multiple systems were affected, resulting in injections in such patients because of the significant risk of spasticity, pigmentary changes in both eyes on fundoscopy, side effects. -
Rivastigmine
International Journal of Organic Chemistry, 2011, 1, 26-32 doi:10.4236/ijoc.2011.12005 Published Online June 2011 (http://www.SciRP.org/journal/ijoc) A Simple and Highly Efficient Enantioselective Synthesis of (S)-Rivastigmine Veera R. Arava1*, Laxminarasimhulu Gorentla1, Pramod K. Dubey2 1R&D Laboratory, Suven Life Sciences Ltd., Hyderabad, India 2Department of Chemistry, J. N. T. University, Hyderabad, India E-mail: [email protected] Received April 1, 2011; revised May 17, 2011; accepted May 28, 2011 Abstract A highly efficient and convenient procedure for the enantioselective synthesis of (S)-Rivastigmine, a cho- linergic agent for the treatment of mild to moderate dementia of the Alzheimer’s type and dementia due to Parkinson’s disease, is accomplished by the treatment of versatile, readily accessible (S)-(-)-2-methyl- 2-propanesulfinamide with 3-hydroxyacetophenone. This protocol provides high yield and excellent enan- tiomeric excess in short step synthesis. Keywords: Cholinergic Agent, Enantioselective, Highly Efficient, (S)-(-)-2-Methyl-2-Propane Sulfinamide, (S)-Rivastigmine 1. Introduction hibits the desired cholinesterase inhibition, which re- quires the drug in enantiomerically pure form. Alzheimer’s disease (AD) is the most common form of The insertion of chiral amine functionality through dementia, a severe human health threat with more than N-sulfinylimines is a major breakthrough endeavor due 30 million sufferers worldwide [1]. Rivastigmine, (S)-3- to the exceptional behavior of the chiral sulfinyl group in [1-(dimethylamino)ethyl] phenyl ethyl (methyl) car- N-sulfinylimines, as an activator, chiral controller and bamate 1, is the first USFDA approved drug in the form useful protective group and finally recyclability [8] of capsules and patches for the treatment of mild to makes the sulfinamides extremely versatile chiral re- moderate dementia of the Alzheimer’s type [2-5] and for agents (Figure 2) [9]. -
Mytelase (Ambenonium Chloride) Tablets Label
NDA 010155/S-022 NDA 010155/ S-023 FDA Approved Labeling Text dated 11/10/2011 Page 1 MYTELASE® AMBENONIUM CHLORIDE DESCRIPTION MYTELASE, brand of ambenonium chloride, is [Oxalylbis (iminoethylene)] bis[(o chlorobenzyl) diethylammonium] dichloride, a white crystalline powder, soluble in water to 20 percent (w/v). Inactive Ingredients: Acacia, Dibasic Calcium Phosphate, Gelatin, Lactose, Magnesium Stearate, Starch, Sucrose. CLINICAL PHARMACOLOGY The compound is a cholinesterase inhibitor with all the pharmacologic actions of acetylcholine, both the muscarinic and nicotinic types. Cholinesterase inactivates acetylcholine. Like neostigmine, MYTELASE suppresses cholinesterase but has the advantage of longer duration of action and fewer side effects on the gastrointestinal tract. The longer duration of action also results in more even strength, better endurance, and greater residual effect during the night and on awakening than is produced by shorter-acting anticholinesterase compounds. INDICATION AND USAGE This drug is indicated for the treatment of myasthenia gravis. CONTRAINDICATIONS Routine administration of atropine with MYTELASE is contraindicated since belladonna derivatives may suppress the parasympathomimetic (muscarinic) symptoms of excessive gastrointestinal stimulation, leaving only the more serious symptoms of fasciculation and paralysis of voluntary muscles as signs of overdosage. MYTELASE should not be administered to patients receiving mecamylamine, or any other ganglionic blocking agents. MYTELASE should also not be administered to patients with a known hypersensitivity to ambenonium chloride or any other ingredients of MYTELASE. WARNINGS Because this drug has a more prolonged action than other antimyasthenic drugs, simultaneous administration with other cholinergics is contraindicated except under strict medical supervision. The overlap in duration of action of several drugs complicates dosage schedules. -
12.2% 122,000 135M Top 1% 154 4,800
View metadata, citation and similar papers at core.ac.uk brought to you by CORE We are IntechOpen, provided by IntechOpen the world’s leading publisher of Open Access books Built by scientists, for scientists 4,800 122,000 135M Open access books available International authors and editors Downloads Our authors are among the 154 TOP 1% 12.2% Countries delivered to most cited scientists Contributors from top 500 universities Selection of our books indexed in the Book Citation Index in Web of Science™ Core Collection (BKCI) Interested in publishing with us? Contact [email protected] Numbers displayed above are based on latest data collected. For more information visit www.intechopen.com Chapter Anticholinesterases Zeynep Özdemir and Mehmet Abdullah Alagöz Abstract Acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) are known serine hydrolase enzymes responsible for the hydrolysis of acetylcholine (ACh). Although the role of AChE in cholinergic transmission is well known, the role of BChE has not been elucidated sufficiently. The hydrolysis of acetylcholine in the synaptic healthy brain cells is mainly carried out by AChE; it is accepted that the contribution to the hydrolysis of BChE is very low, but both AChE and BChE are known to play an active role in neuronal development and cholinergic transmission. Myasthenia gravis (MG) is a muscle disease characterized by weakness in skeletal muscles and rapid fatigue. Anticholinesterases, which are not only related to the immune origin of the disease but also have only symp- tomatic benefit, have an indispensable role in the treatment of MG. Pyridostigmine, distigmine, neostigmine, and ambenonium are the standard anticholinesterase drugs used in the symptomatic treatment of MG.