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Theophylline Level
Lab Dept: Chemistry Test Name: THEOPHYLLINE LEVEL General Information Lab Order Codes: THEM Synonyms: Aminophylline, Theo-Dur, Slo-Bid CPT Codes: 80198 - Theophylline Test Includes: Theophylline concentration reported in mcg/mL. Logistics Test indications: Assessing and adjusting theophylline dosage for optimal therapeutic level. Assessing theophylline toxicity Theophylline is used to relax smooth muscles of the bronchial airways and pulmonary blood vessels to relieve and prevent symptoms of asthma and bronchospasm. Caffeine is a minor metabolite and is often seen in neonates taking theophylline. Peak levels are achieved in 30–90 minutes depending on the compound and type of preparation. Theophylline has a half-life of approximately 4 hours in children and adult smokers, and 8.7 hours in nonsmoking adults. Lab Testing Sections: Chemistry Referred to: Mayo Clinic Laboratories (MML Test: THEO) Phone Numbers: MIN Lab: 612-813-6280 STP Lab: 651-220-6550 Test Availability: Monday - Saturday Turnaround Time: 1 day Special Instructions: N/A Specimen Specimen Type: Blood Container: Preferred: Serum Gel (SST) Alternate: Red Top Draw Volume: 1.5 mL blood Processed Volume: 0.5 mL (Minimum: 0.25 mL) serum Collection: Routine blood collection Special Processing: Lab Staff: Centrifuge specimen within 2 hours of collection. Store and ship at refrigerated temperature. Patient Preparation: None Sample Rejection: Mislabeled or unlabeled specimen; gross hemolysis Interpretive Reference Range: Therapeutic: Bronchodilation: 8.0-20.0 mcg/mL Neonatal apnea (< or =4 weeks old): 6.0-13.0 mcg/mL Interpretation: Response to theophylline is directly proportional to the serum level. Patients usually receive the best response when the serum level is above 8.0 mcg/mL, with minimal toxicity experienced as long as the level is less than or equal to 20.0 mcg/mL Critical Values: >20.0 mcg/mL Limitations: Coadministration of cimetidine and erythromycin will significantly inhibit theophylline clearance, requiring dosagereduction. -
Synthetic Cathinones ("Bath Salts")
Synthetic Cathinones ("Bath Salts") What are synthetic cathinones? Synthetic cathinones, more commonly known as "bath salts," are synthetic (human- made) drugs chemically related to cathinone, a stimulant found in the khat plant. Khat is a shrub grown in East Africa and southern Arabia, and people sometimes chew its leaves for their mild stimulant effects. Synthetic variants of cathinone can be much stronger than the natural product and, in some cases, very dangerous (Baumann, 2014). In Name Only Synthetic cathinone products Synthetic cathinones are marketed as cheap marketed as "bath salts" should substitutes for other stimulants such as not be confused with products methamphetamine and cocaine, and products such as Epsom salts that people sold as Molly (MDMA) often contain synthetic use during bathing. These cathinones instead (s ee "Synthetic Cathinones bathing products have no mind- and Molly" on page 3). altering ingredients. Synthetic cathinones usually take the form of a white or brown crystal-like powder and are sold in small plastic or foil packages labeled "not for human consumption." Also sometimes labeled as "plant food," "jewelry cleaner," or "phone screen cleaner," people can buy them online and in drug paraphernalia stores under a variety of brand names, which include: Flakka Bloom Cloud Nine Lunar Wave Vanilla Sky White Lightning Scarface Image courtesy of www.dea.gov/pr/multimedia- library/image-gallery/bath-salts/bath-salts04.jpg Synthetic Cathinones • January 2016 • Page 1 How do people use synthetic cathinones? People typically swallow, snort, smoke, or inject synthetic cathinones. How do synthetic cathinones affect the brain? Much is still unknown about how synthetic cathinones affect the human brain. -
Study of Adulterants and Diluents in Some Seized Captagon-Type Stimulants
MedDocs Publishers ISSN: 2638-1370 Annals of Clinical Nutrition Open Access | Mini Review Study of Adulterants and Diluents in Some Seized Captagon-Type Stimulants Ali Zaid A Alshehri1,2*; Mohammed saeed Al Qahtani1,3; Mohammed Aedh Al Qahtani1,4; Abdulhadi M Faeq1,5; Jawad Aljohani1,6; Ammar AL-Farga7 1Department of Medical Laboratory Technology, College of Applied Medical Sciences, University of Jeddah, Saudi Arabia 2Poison Control and Medical Forensic Chemistry Center, Ministry of Health, Riyadh, Saudi Arabia 3Khammis Mushayte Maternity & Children Hospital, Ministry of Health, Saudi Arabia 4Ahad Rufidah General, Hospital, Aseer, Ministry of Health, Saudi Arabia 5Comprehensive Specialized Clinics of Security Forces in Jeddah, Ministry of Interior, Saudi Arabia 6Compliance Department, Yanbu Health Sector, Ministry of Health, Saudi Arabia 7Department of Biochemistry, Faculty of Science, University of Jeddah, Saudi Arabia *Corresponding Author(s): Ali Zaid A Alshehri Department of Medical Laboratory Technology, College of Applied Medical Sciences, University of Jeddah, Saudi Arabia Email: [email protected] Received: Apr 27, 2020 Accepted: Jun 05, 2020 Published Online: Jun 10, 2020 Journal: Annals of Clinical Nutrition Publisher: MedDocs Publishers LLC Online edition: http://meddocsonline.org/ Copyright: © Alshehri AZA (2020). This Article is distributed under the terms of Creative Commons Attribution 4.0 International License Introduction ATS are synthetic compounds belonging to the class of stimu- and heroin users combined [3,4]. Fenethylline, 7-(2-amethyl lants that excite the Central Nervous System (CNS) to produce phenyl-amino ethyl)-theophylline, is a theophylline derivative of adrenaline-like effects such as amphetamine, methamphet- amphetamine. It is a psychoactive drug which is similar to am- amine, fenethylline, methylphenidate and dextroamphetamine phetamine in many ways [5]. -
Reviews Insights Into Pathophysiology from Medication-Induced Tremor
Freely available online Reviews Insights into Pathophysiology from Medication-induced Tremor 1* 1 1 1 John C. Morgan , Julie A. Kurek , Jennie L. Davis & Kapil D. Sethi 1 Movement Disorders Program Parkinson’s Foundation Center of Excellence, Department of Neurology, Medical College of Georgia, Augusta, GA, USA Abstract Background: Medication-induced tremor (MIT) is common in clinical practice and there are many medications/drugs that can cause or exacerbate tremors. MIT typically occurs by enhancement of physiological tremor (EPT), but not all drugs cause tremor in this way. In this manuscript, we review how some common examples of MIT have informed us about the pathophysiology of tremor. Methods: We performed a PubMed literature search for published articles dealing with MIT and attempted to identify articles that especially dealt with the medication’s mechanism of inducing tremor. Results: There is a paucity of literature that deals with the mechanisms of MIT, with most manuscripts only describing the frequency and clinical settings where MIT is observed. That being said, MIT emanates from multiple mechanisms depending on the drug and it often takes an individualized approach to manage MIT in a given patient. Discussion: MIT has provided some insight into the mechanisms of tremors we see in clinical practice. The exact mechanism of MIT is unknown for most medications that cause tremor, but it is assumed that in most cases physiological tremor is influenced by these medications. Some medications (epinephrine) that cause EPT likely lead to tremor by peripheral mechanisms in the muscle (b-adrenergic agonists), but others may influence the central component (amitriptyline). -
Adenosine Strongly Potentiates Pressor Responses to Nicotine in Rats (Caffeine/Blood Pressure/Sympathetic Nervous System) REID W
Proc. Nadl. Acad. Sci. USA Vol. 81, pp. 5599-5603, September 1984 Neurobiology Adenosine strongly potentiates pressor responses to nicotine in rats (caffeine/blood pressure/sympathetic nervous system) REID W. VON BORSTEL, ANDREW A. RENSHAW, AND RICHARD J. WURTMAN Laboratory of Neuroendocrine Regulation, Department of Nutrition and Food Science, Massachusetts Institute of Technology, Cambridge, MA 02139 Communicated by Walle J. H. Nauta, May 14, 1984 ABSTRACT Intravenous infusion of subhypotensive doses epinephrine output during nerve stimulation is decreased (6). of adenosine strongly potentiates the pressor response of anes- Adenosine can be produced ubiquitously and is present in thetized rats to nicotine. A dose of nicotine (40 jpg/kg, i.v.), plasma and cerebrospinal fluid (7, 8); the nucleoside can which, given alone, elicits a peak increase in diastolic pressure therefore potentially act at a number of different loci, both of -15 mm Hg, increases pressure by -70 mm Hg when arte- central and peripheral, within the complex neural circuitry rial plasma adenosine levels have been increased to 2 puM from involved in the regulation of a single physiological function, a basal concentration of =1 puM. The pressor response to ciga- such as maintenance of blood pressure or heart rate. Neither rette smoke applied to the lungs is also strongly potentiated normal plasma adenosine levels nor the relative and absolute during infusion of adenosine. Slightly higher adenosine con- sensitivities of neural and cellular processes to adenosine centrations (-4 jaM) attenuate pressor responses to electrical have been well characterized in intact animals. The studies stimulation of preganglionic sympathetic nerves, or to injec- described below explore the effects of controlled measured tions of the a-adrenergic agonist phenylephrine, but continue alterations in arterial plasma adenosine concentrations on to potentiate pressor responses to nicotine. -
Narco-Terrorism Today: the Role of Fenethylline and Tramadol
Narco-terrorism today: the role of fenethylline and tramadol Introduction The relationship between psychoactive substances and violent crimes such as war acts and terrorism dates long back in history. Viking warriors famously fought in a trance-like state, probably as a result of taking agaric "magic" mushrooms and bog myrtle (McCarthy, 2016). More recently, under the German Nazis’ Third Reich, methamphetamine gained an extreme popularity, despite an official “drug-free” propaganda. Under the trademark Pervitin, it could be sold without prescription until 1939, and it was not regulated by the Reich Opium Law of 1941. Pervitin was commonly used in recreational and working settings, and, of course, the stimulant was shipped to German soldiers when the troops invaded France, allowing them to march sleepless for 36 to 50 hours (Ohler, 2016). On the other side, Benzedrine, a racemic mixture of amphetamine initially developed as a bronchodilator, was the stimulant of choice of the Allied forces during World War II (McCarthy, 2016). Vietnam War (1955-1975) is considered to be the first “pharmacological war” of modern history, so called due to an unprecedented high level of consumption of psychoactive substances by military personnel (Kamienski, 2016). In 1971, a report by the House Select Committee on Crime revealed that from 1966 to 1969, the US armed forces had used 225 million tablets of stimulants, mostly Dexedrine (dextroamphetamine), an amphetamine derivative that is nearly twice as strong as the Benzedrine used in the Second World War (Kamienski, 2016). The use of illicit drugs such as stimulants or painkillers by terrorists or insurgents while undertaking their terrorist activities has been hypothesized but still needs further documentation. -
Neuronal Adenosine A2A Receptors Signal Ergogenic Effects of Caffeine
www.nature.com/scientificreports OPEN Neuronal adenosine A2A receptors signal ergogenic efects of cafeine Aderbal S. Aguiar Jr1,2*, Ana Elisa Speck1,2, Paula M. Canas1 & Rodrigo A. Cunha1,3 Cafeine is one of the most used ergogenic aid for physical exercise and sports. However, its mechanism of action is still controversial. The adenosinergic hypothesis is promising due to the pharmacology of cafeine, a nonselective antagonist of adenosine A1 and A2A receptors. We now investigated A2AR as a possible ergogenic mechanism through pharmacological and genetic inactivation. Forty-two adult females (20.0 ± 0.2 g) and 40 male mice (23.9 ± 0.4 g) from a global and forebrain A2AR knockout (KO) colony ran an incremental exercise test with indirect calorimetry (V̇O2 and RER). We administered cafeine (15 mg/kg, i.p., nonselective) and SCH 58261 (1 mg/kg, i.p., selective A2AR antagonist) 15 min before the open feld and exercise tests. We also evaluated the estrous cycle and infrared temperature immediately at the end of the exercise test. Cafeine and SCH 58621 were psychostimulant. Moreover, Cafeine and SCH 58621 were ergogenic, that is, they increased V̇O2max, running power, and critical power, showing that A2AR antagonism is ergogenic. Furthermore, the ergogenic efects of cafeine were abrogated in global and forebrain A2AR KO mice, showing that the antagonism of A2AR in forebrain neurons is responsible for the ergogenic action of cafeine. Furthermore, cafeine modifed the exercising metabolism in an A2AR-dependent manner, and A2AR was paramount for exercise thermoregulation. Te natural plant alkaloid cafeine (1,3,7-trimethylxantine) is one of the most common ergogenic substances for physical activity practitioners and athletes 1–10. -
Do You Know... Caffeine
Do You Know... What is it? Caffeine is a stimulant that speeds up your central nervous system. It is the world’s most Caffeine popular drug. Caffeine occurs naturally in products such as coffee, tea, chocolate and cola soft drinks, and is added to a variety of prescription and over-the-counter medications, including cough, cold and pain remedies. Energy drinks may contain both naturally occurring and added caffeine. The following are typical amounts of caffeine in products you may use regularly. (A cup refers to a small take-out cup size of 237 mL [8 oz]. Keep in mind that coffee and tea are often served in much larger cups.) · cup of brewed coffee: 135 mg · cup of instant coffee: 76–106 mg · cup of decaffeinated coffee: about 3 mg · cup of tea: 43 mg · can of regular cola soft drink containing caffeine (355 ml): 36–50 mg · can of energy drink (250 ml): 80 mg · dark chocolate (28 g): 19 mg · milk chocolate (28 g): 7 mg · packet of hot chocolate mix: 7 mg · stay-awake pills: 100 mg 1/4 © 2003, 2011 CAMH | www.camh.ca To find out the amount of caffeine in headache and cold Who uses caffeine? medicines, check the label of over-the-counter medication, Caffeine is the most widely used psychoactive substance or ask your pharmacist about caffeine in prescription drugs. in the world. In North America, more than 80 per cent of adults regularly consume caffeine. The average amount In Canada, manufacturers of products that contain of caffeine consumed per person in Canada (from all naturally occurring caffeine are not required by law to sources) is estimated to be 210 to 238 mg per day. -
Pharmaceuticals and Medical Devices Safety Information No
Pharmaceuticals and Medical Devices Safety Information No. 296 November 2012 Executive Summary Published by Translated by Pharmaceutical and Food Safety Bureau, Pharmaceuticals and Medical Devices Agency Ministry of Health, Labour and Welfare Office of Safety I For full text version of Pharmaceuticals and Medical Devices Safety Information (PMDSI) No. 296, interested readers are advised to consult the PMDA website for upcoming information. The contents of this month's PMDSI are outlined below. 1. Summary of Payment/Non-payment of Adverse Drug Reaction Relief Benefits and Drugs with Many Cases of Improper Use Under the Relief System for Sufferers from Adverse Drug Reactions, relief benefits have not been approved in some cases due to improper use of drugs. MHLW/PMDA presents here drugs with many cases of improper use and encourages proper use of drugs. 2. Important Safety Information Regarding the revision of the Precautions section of package inserts of drugs in accordance with the Notification dated October 30, 2012, the contents of important revisions and case summaries that served as the basis for these revisions will be provided in section 2 of the full text. 1. Imatinib Mesilate 2. Ceftriaxone Sodium Hydrate 3. Mexiletine Hydrochloride 3. Revision of Precautions (No. 241) Revisions of Precautions etc. for the following pharmaceuticals: Inactivated Poliomyelitis Vaccine, Acetaminophen, Isopropylantipyrine/Acetaminophen/Allylisopropylacetylurea/Anhydrous Caffeine, Tramadol Hydrochloride/Acetaminophen, Salicylamide/Acetaminophen/Anhydrous Caffeine/Chlorpheniramine Maleate, Diprophylline/Dihydrocodeine Phosphate/dl-Methylephedrine Hydrochloride/Diphenhydramine Salicylate/Acetaminophen/Bromovalerylurea, Spironolactone, Dabigatran Etexilate Methanesulfonate, Rotavirus Vaccine, Live, Oral, Pentavalent 4. List of Products Subject to Early Post- marketing Phase Vigilance (as of November 2012) A list of products subject to Early Post-marketing Phase Vigilance as of November 1, 2012 will be provided in section 4 of the full text. -
Convergent Evolution of Caffeine in Plants by Co-Option of Exapted Ancestral Enzymes
Convergent evolution of caffeine in plants by co-option of exapted ancestral enzymes Ruiqi Huanga, Andrew J. O’Donnella,1, Jessica J. Barbolinea, and Todd J. Barkmana,2 aDepartment of Biological Sciences, Western Michigan University, Kalamazoo, MI 49008 Edited by Ian T. Baldwin, Max Planck Institute for Chemical Ecology, Jena, Germany, and approved July 18, 2016 (received for review March 25, 2016) Convergent evolution is a process that has occurred throughout the the evolutionary gain of traits such as caffeine that are formed via tree of life, but the historical genetic and biochemical context a multistep pathway. First, although convergently co-opted genes, promoting the repeated independent origins of a trait is rarely such as XMT or CS, may evolve to encode enzymes for the same understood. The well-known stimulant caffeine, and its xanthine biosynthetic pathway, it is unknown what ancestral functions they alkaloid precursors, has evolved multiple times in flowering plant historically provided that allowed for their maintenance over mil- history for various roles in plant defense and pollination. We have lions of years of divergence. Second, it is unknown how multiple shown that convergent caffeine production, surprisingly, has protein components are evolutionarily assembled into an ordered, evolved by two previously unknown biochemical pathways in functional pathway like that for caffeine biosynthesis. Under the chocolate, citrus, and guaraná plants using either caffeine synthase- cumulative hypothesis (26), it is predicted that enzymes catalyzing or xanthine methyltransferase-like enzymes. However, the pathway earlier reactions of a pathway must evolve first; otherwise, enzymes and enzyme lineage used by any given plant species is not predict- that perform later reactions would have no substrates with which to able from phylogenetic relatedness alone. -
A 1 Adenosine Receptor Agonists and Antiagonists
Europaisches Patentamt (19) European Patent Office Office europeenpeen des brevets EP 0 725 782 B1 (12) EUROPEAN PATENT SPECIFICATION (45) Date of publication and mention (51) intci.6: C07D 473/08, C07H 19/167, of the grant of the patent: C07D 519/00, A61K 31/52 15.12.1999 Bulletin 1999/50 // (C07D51 9/00, 493:00, 473:00) (21) Application number: 95901070.3 (86) International application number: PCT/US94/12388 (22) Date of filing: 28.10.1994 (87) International publication number: WO 95/11904 (04.05.1995 Gazette 1995/19) (54) A 1 ADENOSINE RECEPTOR AGONISTS AND ANTAGONISTS A1 ADENOSIN REZEPTOR AGONISTEN UND ANTAGONISTEN AGONISTES ET ANTAGONISTES DE RECEPTEURS DE L'ADENOSINE A 1 (84) Designated Contracting States: • SCAMMELLS, Peter, J. AT BE CH DE DK ES FR GB GR IE IT LI LU MC NL Highton, VIC 3216 (AU) PT SE • MILNER, Peter, Gerard Los Altos, CA 94022 (US) (30) Priority: 28.10.1993 US 144459 • PFISTER, Jurg, Roland Los Altos, CA 94024 (US) (43) Date of publication of application: • SCHREINER, George, Frederic 14.08.1996 Bulletin 1996/33 Los Altos, CA 94022 (US) (73) Proprietor: UNIVERSITY OF FLORIDA (74) Representative: Perry, Robert Edward RESEARCH FOUNDATION, INC. GILL JENNINGS & EVERY Gainesville, FL 32611 (US) Broadgate House 7 Eldon Street (72) Inventors: London EC2M 7LH (GB) • BELARDINELLI, Luiz Gainesville, FL 32605 (US) (56) References cited: • OLSSON, Ray EP-A- 0 374 808 EP-A- 0 415 456 Tampa, FL 33609-3504 (US) WO-A-92/00297 WO-A-94/16702 • BAKER, Stephen DE-A- 4 205 306 US-A- 5 288 721 Gainesville, FL 32607 (US) DO CM 00 Is- lO CM Is- Note: Within nine months from the publication of the mention of the grant of the European patent, any person may give notice the Patent Office of the Notice of shall be filed in o to European opposition to European patent granted. -
Methylxanthines and Neurodegenerative Diseases: an Update
nutrients Review Methylxanthines and Neurodegenerative Diseases: An Update Daniel Janitschke 1,† , Anna A. Lauer 1,†, Cornel M. Bachmann 1, Heike S. Grimm 1, Tobias Hartmann 1,2 and Marcus O. W. Grimm 1,2,* 1 Experimental Neurology, Saarland University, 66421 Homburg/Saar, Germany; [email protected] (D.J.); [email protected] (A.A.L.); [email protected] (C.M.B.); [email protected] (H.S.G.); [email protected] (T.H.) 2 Deutsches Institut für DemenzPrävention (DIDP), Saarland University, 66421 Homburg/Saar, Germany * Correspondence: [email protected] † These authors contributed equally to this work. Abstract: Methylxanthines (MTX) are purine derived xanthine derivatives. Whereas naturally occurring methylxanthines like caffeine, theophylline or theobromine are widely consumed in food, several synthetic but also non-synthetic methylxanthines are used as pharmaceuticals, in particular in treating airway constrictions. Besides the well-established bronchoprotective effects, methylxanthines are also known to have anti-inflammatory and anti-oxidative properties, mediate changes in lipid homeostasis and have neuroprotective effects. Known molecular mechanisms include adenosine receptor antagonism, phosphodiesterase inhibition, effects on the cholinergic system, wnt signaling, histone deacetylase activation and gene regulation. By affecting several pathways associated with neurodegenerative diseases via different pleiotropic mechanisms and due to its moderate side effects, intake of methylxanthines have been suggested to be an interesting approach in dealing with neurodegeneration. Especially in the past years, the impact of methylxanthines in neurodegenerative diseases has been extensively studied and several new aspects have been elucidated. In this review Citation: Janitschke, D.; Lauer, A.A.; Bachmann, C.M.; Grimm, H.S.; we summarize the findings of methylxanthines linked to Alzheimer´s disease, Parkinson’s disease Hartmann, T.; Grimm, M.O.W.