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Nahata, Milap C. « Antiviral Drugs : Pharmacokinetics, Adverse Effects, and Therapeutic Use ». Journal of Pharmacy Technology 3, no 3 (mai 1987) : 100–108. http://dx.doi.org/10.1177/875512258700300305.
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Attardo, Silvia, Olimpia Musumeci, Daniele Velardo et Antonio Toscano. « Statins Neuromuscular Adverse Effects ». International Journal of Molecular Sciences 23, no 15 (28 juillet 2022) : 8364. http://dx.doi.org/10.3390/ijms23158364.
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Statins are drugs widely prescribed in high-risk patients for cerebrovascular or cardiovascular diseases and are, usually, safe and well tolerated. However, these drugs sometimes may cause neuromuscular side effects that represent about two-third of all adverse events. Muscle-related adverse events include cramps, myalgia, weakness, immune-mediated necrotizing myopathy and, more rarely, rhabdomyolysis. Moreover, they may lead to peripheral neuropathy and induce or unmask a preexisting neuromuscular junction dysfunction. A clinical follow up of patients assuming statins could reveal early side effects that may cause neuromuscular damage and suggest how to better modulate their use. In fact, statin dechallenge or cessation, or the alternative use of other lipid-lowering agents, can avoid adverse events. This review summarizes the current knowledge on statin-associated neuromuscular adverse effects, diagnosis, and management. It is conceivable that the incidence of neuromuscular complications will increase because, nowadays, use of statins is even more diffused than in the past. On this purpose, it is expected that pharmacogenomic and environmental studies will help to timely predict neuromuscular complications due to statin exposure, leading to a more personalized therapeutic approach.
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Spahn, Joseph D., et Alan K. Kamada. « Special Considerations in the Use of Glucocorticoids in Children ». Pediatrics In Review 16, no 7 (1 juillet 1995) : 266–72. http://dx.doi.org/10.1542/pir.16.7.266.
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GCs are used commonly for the treatment of various inflammatory and autoimmune diseases. Although potent and generally effective, they are not without risks for producing serious adverse effects, especially when used in high doses for prolonged periods of time. Thus, the clinician must balance the therapeutic effects of GCs with their risks for adverse effects; using the lowest possible effective GC doses as well as maximizing other therapeutic modalities are means by which this goal can be achieved. Early recognition and appropriate management are other methods to minimize GC-induced adverse effects. Maximization of therapy, early recognition, and appropriate management of adverse effects can minimize the potential severe complications of GC therapy.
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Grbovic, Leposava, et Miroslav Radenkovic. « Therapeutic use of glucocorticoids and immunosuppressive agents ». Srpski arhiv za celokupno lekarstvo 133, Suppl. 1 (2005) : 67–73. http://dx.doi.org/10.2298/sarh05s1067g.
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Pharmacotherapy of autoimmune thyroid disease (AITD) is complex. Apart from the replacement hormone therapy, antithyroid agents, beta adrenoceptor blockers and other drugs, in regard to the present symptoms, it also includes the administration of glucocorticoids and immunosuppressive agents. Physiological actions of glucocorticoids are significant in number, well known and described in details. The most prominent pharmacological properties of glucocorticoids, that are important for their clinical use, are antiinflammatory and immunosuppressive actions. In this article, the most notable clinical pharmacology aspects of glucocorticoids have been presented, including the basic principles of their therapeutic use, as well as the most important indications with the examples of dosing regiments (rheumatic disorders, renal diseases, allergic reactions, bronchial asthma, gastrointestinal inflammatory diseases, thrombocytopenia, organ transplantation, and Graves? ophthalmopathy). In addition, adverse and toxic effects of glucocorticoids as well as their interactions with other drugs have been described. Immunosuppressive agents have important role in treatment of immune disorders, including the reduction of immune response in autoimmune diseases and organ transplantation. Apart from glucocorticoids, immunosuppressive agents consist of calcineurin inhibitors (cyclosporine, tacrolimus), antiproliferative and antimetabolic agents (sirolimus, azathioprine, mycophenolate mofetil, methotrexate, cyclophosphamide), monoclonal antibodies: anti-CD3 antibody (muromonab-CD3), anti- CD25 antibody (daclizumab), anti-TNF-alpha antibody (infliximab). In this part, the most updated facts about mechanism of action, rational therapeutic use, as well as adverse and toxic effects of immunosuppressive agents have been reviewed.
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Jabbour, Serge A. « The Importance of Reducing Hyperglycemia While Preserving Insulin Secretion—The Rationale for Sodium-coupled Glucose Co-transporter 2 Inhibition in Diabetes ». US Endocrinology 05, no 01 (2009) : 75. http://dx.doi.org/10.17925/use.2009.05.1.75.
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The prevalence of type 2 diabetes continues to rise in a number of countries, presenting a need for additional effective therapeutic options to be developed. This condition has often been treated with medications that can lead to hypoglycemia (sulfonylureas), weight gain (thiazolidinediones), or other side effects, including the gastrointestinal side effects sometimes experienced with metformin. Sodium-coupled glucose co-transporter 2 (SGLT2) inhibitors are a novel class of drugs under investigation that target the kidney’s ability to reabsorb glucose into the bloodstream, improving glycemic control and aiding weight loss without inducing hypoglycemia. These compounds have shown encouraging results in several studies without any serious adverse events. They could therefore potentially become an important addition to the currently available diabetes treatments.
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Salman, Saad, Sayyed Muhammad Ashhad Halimi et Inzemam Khan. « Olanzapine Use in Schizophrenia and the Modulation of Its Response by Genetic Variations ». Molecular Medicine Communications 2, no 01 (30 juin 2022) : 43–76. http://dx.doi.org/10.55627/mmc.002.001.0038.
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Schizophrenia is a chronic disease with diverse psychopathology and multiple phases of illness. Consequently, numerous factors must be considered when assessing the benefits of a given treatment over short- and long-term periods. Olanzapine is an atypical antipsychotic reported to be effective without producing many of the disabling extrapyramidal adverse effects associated with older, typical antipsychotic drugs. Despite the fact that olanzapine is still associated with a known risk of metabolic side effects, including weight gain, many clinicians continue to prescribe olanzapine for the treatment of schizophrenia with the expectation of additional therapeutic antipsychotic efficacy relative to other first-line atypical antipsychotics. This review focuses on the epidemiology, pathogenesis, and treatment of schizophrenia with special emphasis on the role of olanzapine in the treatment of schizophrenia. Genetic variants associated with the therapeutic efficacy and adverse effects of olanzapine are reviewed and those with the potential to act as a clinical predictor of therapeutic response and/or adverse effects are discussed. Recommendations are made for the use of some of these genetic variants in clinical medicine.
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Sirasanagandla, Srinivasa Rao, Isehaq Al-Huseini, Hussein Sakr, Marzie Moqadass, Srijit Das, Norsham Juliana et Izuddin Fahmy Abu. « Natural Products in Mitigation of Bisphenol A Toxicity : Future Therapeutic Use ». Molecules 27, no 17 (24 août 2022) : 5384. http://dx.doi.org/10.3390/molecules27175384.
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Bisphenol A (BPA) is a ubiquitous environmental toxin with deleterious endocrine-disrupting effects. It is widely used in producing epoxy resins, polycarbonate plastics, and polyvinyl chloride plastics. Human beings are regularly exposed to BPA through inhalation, ingestion, and topical absorption routes. The prevalence of BPA exposure has considerably increased over the past decades. Previous research studies have found a plethora of evidence of BPA’s harmful effects. Interestingly, even at a lower concentration, this industrial product was found to be harmful at cellular and tissue levels, affecting various body functions. A noble and possible treatment could be made plausible by using natural products (NPs). In this review, we highlight existing experimental evidence of NPs against BPA exposure-induced adverse effects, which involve the body’s reproductive, neurological, hepatic, renal, cardiovascular, and endocrine systems. The review also focuses on the targeted signaling pathways of NPs involved in BPA-induced toxicity. Although potential molecular mechanisms underlying BPA-induced toxicity have been investigated, there is currently no specific targeted treatment for BPA-induced toxicity. Hence, natural products could be considered for future therapeutic use against adverse and harmful effects of BPA exposure.
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Huestis, Marilyn A., Renata Solimini, Simona Pichini, Roberta Pacifici, Jeremy Carlier et Francesco Paolo Busardò. « Cannabidiol Adverse Effects and Toxicity ». Current Neuropharmacology 17, no 10 (13 septembre 2019) : 974–89. http://dx.doi.org/10.2174/1570159x17666190603171901.
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Background: Currently, there is a great interest in the potential medical use of cannabidiol (CBD), a non-intoxicating cannabinoid. Productive pharmacological research on CBD occurred in the 1970s and intensified recently with many discoveries about the endocannabinoid system. Multiple preclinical and clinical studies led to FDA-approval of Epidiolex®, a purified CBD medicine formulated for oral administration for the treatment of infantile refractory epileptic syndromes, by the US Food and Drug Administration in 2018. The World Health Organization considers rescheduling cannabis and cannabinoids. CBD use around the world is expanding for diseases that lack scientific evidence of the drug’s efficacy. Preclinical and clinical studies also report adverse effects (AEs) and toxicity following CBD intake. Methods: Relevant studies reporting CBD’s AEs or toxicity were identified from PubMed, Cochrane Central, and EMBASE through January 2019. Studies defining CBD’s beneficial effects were included to provide balance in estimating risk/benefit. Results: CBD is not risk-free. In animals, CBD AEs included developmental toxicity, embryo-fetal mortality, central nervous system inhibition and neurotoxicity, hepatocellular injuries, spermatogenesis reduction, organ weight alterations, male reproductive system alterations, and hypotension, although at doses higher than recommended for human pharmacotherapies. Human CBD studies for epilepsy and psychiatric disorders reported CBD-induced drug-drug interactions, hepatic abnormalities, diarrhea, fatigue, vomiting, and somnolence. Conclusion: CBD has proven therapeutic efficacy for serious conditions such as Dravet and Lennox-Gastaut syndromes and is likely to be recommended off label by physicians for other conditions. However, AEs and potential drug-drug interactions must be taken into consideration by clinicians prior to recommending off-label CBD.
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Siroka, Z., et Z. Svobodova. « The toxicity and adverse effects of selected drugs in animals – overview ». Polish Journal of Veterinary Sciences 16, no 1 (1 mars 2013) : 181–91. http://dx.doi.org/10.2478/pjvs-2013-0027.
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Abstract Therapeutic products quite often are causes of poisoning in both small and large animals. Drug poisonings in animals occur commonly due to off-label use of medicines, wrong dosage, negligence, accidental ingestion and deliberate poisonings. Toxicity of veterinary drugs may become evident also in therapeutic doses when adverse effects may occur. The aim of this review is to inform veterinary specialists about both veterinary and human drugs, specifically antiparasitics, non-steroidal anti-inflammatory drugs and other medicinal substances, which are most often reported to cause acute poisonings or adverse reactions in animals and to contribute to their broader knowledge and more accurate use of medicines, improving instructions to the animal owners and, hopefully, decrease the incidence of drug poisonings in animals.
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Walczewska, Sylwia, et Agata Wawrzyniak. « N-acetylcysteine in clinical practice – properties, use and adverse effects ». Pediatria i Medycyna Rodzinna 16, no 3 (30 octobre 2020) : 243–46. http://dx.doi.org/10.15557/pimr.2020.0044.
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N-acetylcysteine is a simple chemical compound with antioxidant and mucolytic properties. Currently, it is the primary treatment for acetaminophen poisoning. Prior to the introduction of acetylcysteine, acetaminophen overdose was associated with high mortality due to acute liver failure. Owing to its antioxidant properties, acetylcysteine maintains appropriate levels of glutathione, thereby protecting the liver from damage by toxic metabolites of paracetamol. Acetylcysteine is also used for infections with excess respiratory secretions. The mechanism of action of cysteine derivatives involves cleavage of disulfide bonds between the macromolecules present in the mucus and, consequently, reduction of mucus viscosity. Clinical trials have shown that N-acetylcysteine also plays an important role in relieving cough by eliminating mucus from the airways. Owing to its antioxidant properties, it can also prevent contrast-induced nephropathy. It was shown that prophylactic doses of acetylcysteine administered the day before and at the day of contrast administration are effective in preventing contrastinduced nephropathy in patients with chronic kidney disease. The compound can also modulate pathophysiological processes involved in many mental and neurological disorders. There is also evidence supporting the efficacy of acetylcysteine in mental disorders such as autism, schizophrenia, Alzheimer’s disease, psychoactive substance dependence or bipolar disorder. However, in addition to its therapeutic activity, the drug may also induce adverse effects. Adverse effects of varying severity have been reported since the introduction of acetylcysteine into clinical use.
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Okaiyeto, Kunle, et Oluwafemi O. Oguntibeju. « African Herbal Medicines : Adverse Effects and Cytotoxic Potentials with Different Therapeutic Applications ». International Journal of Environmental Research and Public Health 18, no 11 (2 juin 2021) : 5988. http://dx.doi.org/10.3390/ijerph18115988.
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The African continent is naturally endowed with various plant species with nutritional and medicinal benefits. About 80% of the people in developing countries rely on folk medicines to treat different diseases because of indigenous knowledge, availability, and cost-effectiveness. Extensive research studies have been conducted on the medicinal uses of African plants, however, the therapeutic potentials of some of these plants has remained unexploited. Over the years, several studies have revealed that some of these African floras are promising candidates for the development of novel drugs. Despite the plethora of studies on medicinal plant research in Africa, there is still little scientific data supporting the folkloric claims of these plants. Besides, safety in the use of folk medicines has been a major public health concern over the year. Therefore, it has become mandatory that relevant authority should take measures in safeguarding the populace on the use of herbal mixtures. Thus, the present review extracted relevant information from different scientific databases and highlighted some problems associated with folk medicines, adverse effects on reproductive systems, issue about safety due to the toxicity of some plants and their toxicity effects with potential therapeutic benefits are discussed.
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Gupta, Jeetendra Kumar. « Emergence of Synthetic Cannabinoids : Pharmacological insights and adverse effects ». Research Journal of Chemistry and Environment 27, no 1 (15 décembre 2022) : 120–28. http://dx.doi.org/10.25303/2701rjce1200128.
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Despite the risks involved in the use of synthetic cannabinoids, their applications in researches gained huge popularity. Researches into synthetic cannabinoids have increased recently as a result of relaxed global legal developments. Synthetic cannabinoids such as Dronabinol and Nabilone may help with symptoms of chronic pain, muscle stiffness, nausea and vomiting brought on by chemotherapy and unmanageable adolescent epilepsy. The coarse use of cannabinoids is typically associated with psychotropic effects like relaxation, euphoria and a vague gratifying feeling, but their aberrant uses are also associated with serious adverse-effects. Despite this cognizance, affinity between the molecular structure of synthetic cannabinoids and their receptors mediated pharmacological activities is yet not well understood. Around the world, numerous experiments are being conducted in order to explore their therapeutic values as well as toxicities. The experimental models beneficial for the evaluation of emerging cannabinoids of synthetic origin include the cannabis tetrad test, drug discrimination, dependence, withdrawal and assays of tolerance. Real risks and perceived hazards can have significant disparity. Certain empirical approaches and scientific methods could be used to compare and appraise the therapeutic indications and adverse effects of the synthetic cannabinoids. The present review provides a scientific discussion of these substances and their pharmacological insights as well as adverse effects referring latest references.
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Madruga, GM, LZ Crivellenti, S. Borin-Crivellenti, CA Cintra, LG Gomes et PR Spiller. « Comparative use of dimethyl sulphoxide (DMSO) in different animal species ». Veterinární Medicína 62, No. 4 (10 avril 2017) : 179–85. http://dx.doi.org/10.17221/176/2015-vetmed.
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Dimethyl sulphoxide has a variety of biological effects that have made it the subject of numerous pharmacological studies. The first dimethyl sulphoxide therapeutic indication approved by the United States Food and Drug Administration (FDA) in 1978 was for intravesical instillation in cases of interstitial cystitis. Since then, due to its distinctive properties, it has been the subject of studies in several areas. This review describes indications, adverse effects and contraindications, as takes a critical approach to the main articles addressing the clinical use of dimethyl sulphoxide.
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Tromp, Angelino T., Yuxi Zhao, Ilse Jongerius, Erik C. J. M. Heezius, Pauline Abrial, Maartje Ruyken, Jos A. G. van Strijp et al. « Pre-existing antibody-mediated adverse effects prevent the clinical development of a bacterial anti-inflammatory protein ». Disease Models & ; Mechanisms 13, no 9 (29 mai 2020) : dmm045534. http://dx.doi.org/10.1242/dmm.045534.
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ABSTRACTBacterial pathogens have evolved to secrete strong anti-inflammatory proteins that target the immune system. It was long speculated whether these virulence factors could serve as therapeutics in diseases in which abnormal immune activation plays a role. We adopted the secreted chemotaxis inhibitory protein of Staphylococcus aureus (CHIPS) as a model virulence factor-based therapeutic agent for diseases in which C5AR1 stimulation plays an important role. We show that the administration of CHIPS in human C5AR1 knock-in mice successfully dampens C5a-mediated neutrophil migration during immune complex-initiated inflammation. Subsequent CHIPS toxicology studies in animal models were promising. However, during a small phase I trial, healthy human volunteers showed adverse effects directly after CHIPS administration. Subjects showed clinical signs of anaphylaxis with mild leukocytopenia and increased C-reactive protein concentrations, which are possibly related to the presence of relatively high circulating anti-CHIPS antibodies and suggest an inflammatory response. Even though our data in mice show CHIPS as a potential anti-inflammatory agent, safety issues in human subjects temper the use of CHIPS in its current form as a therapeutic candidate. The use of staphylococcal proteins, or other bacterial proteins, as therapeutics or immune-modulators in humans is severely hampered by pre-existing circulating antibodies.
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Paul, Alok K., Craig M. Smith, Mohammed Rahmatullah, Veeranoot Nissapatorn, Polrat Wilairatana, Mariana Spetea, Nuri Gueven et Nikolas Dietis. « Opioid Analgesia and Opioid-Induced Adverse Effects : A Review ». Pharmaceuticals 14, no 11 (27 octobre 2021) : 1091. http://dx.doi.org/10.3390/ph14111091.
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Opioids are widely used as therapeutic agents against moderate to severe acute and chronic pain. Still, these classes of analgesic drugs have many potential limitations as they induce analgesic tolerance, addiction and numerous behavioural adverse effects that often result in patient non-compliance. As opium and opioids have been traditionally used as painkillers, the exact mechanisms of their adverse reactions over repeated use are multifactorial and not fully understood. Older adults suffer from cancer and non-cancer chronic pain more than younger adults, due to the physiological changes related to ageing and their reduced metabolic capabilities and thus show an increased number of adverse reactions to opioid drugs. All clinically used opioids are μ-opioid receptor agonists, and the major adverse effects are directly or potentially connected to this receptor. Multifunctional opioid ligands or peripherally restricted opioids may elicit fewer adverse effects, as shown in preclinical studies, but these results need reproducibility from further extensive clinical trials. The current review aims to overview various mechanisms involved in the adverse effects induced by opioids, to provide a better understanding of the underlying pathophysiology and, ultimately, to help develop an effective therapeutic strategy to better manage pain.
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Natalia González-Quero et Pilar Martínez. « Bioactive compounds in some principal mushrooms : An association to adverse effects ». GSC Advanced Research and Reviews 5, no 2 (30 novembre 2020) : 031–47. http://dx.doi.org/10.30574/gscarr.2020.5.2.0103.
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Mushrooms are widely used in Asian medicine, both as dietary supplements and as nutraceutical foods. Some principal fungi have recently become popular in Europe for their nutritional and health benefits, and a large number of bioactive compounds have been isolated in several taxa showing antioxidant, anti-inflammatory, antiviral, antitumor activities and other biological properties with great therapeutic application. Separate research has been done separately for the different species. The aim of the present review was to give an overview of the present knowledge regarding bioactive compounds in ten of the most common species, their options in therapeutic use and, for the first time, their possible toxicity or adverse effects. Boletus edulis, Ganoderma lucidum, Grifola frondosa, Hericium erinaceus, Hypsizygus marmoreus, Lentinula edodes, Morchella esculenta, Pleurotus ostreatus, Poria cocos and Trametes versicol have great potential as functional foods and as a source of drugs for pharmaceutical science and medicine. Some adverse effects, however, were found to occur in individual daily consumption and during clinical trials. More research is needed to make a good rational use of these medicinal compounds.
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Stoner, Steven C. « Management of serious cardiac adverse effects of antipsychotic medications ». Mental Health Clinician 7, no 6 (1 novembre 2017) : 246–54. http://dx.doi.org/10.9740/mhc.2017.11.246.
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Abstract The use of antipsychotic medications has now expanded to multiple mental health conditions beyond schizophrenia. This has increased the overall population exposure to these medications, which have been associated with both metabolic changes and adverse cardiovascular effects. QTc prolongation, torsades de pointes, sudden cardiac death, myocarditis, and cardiomyopathy are all very real concerns that clinicians face on a regular basis. One must take these risks into consideration when selecting antipsychotic therapy and also when determining whether therapeutic changes and adjustments are necessary. This review examines a number of cardiac-associated concerns, the role that antipsychotics may play in contributing to these adverse events, and suggested management interventions.
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Parolaro, Daniela. « Therapeutic and toxicological aspects of the use of cannabis and cannabinoids in medicine ». Rendiconti Lincei. Scienze Fisiche e Naturali 32, no 1 (21 janvier 2021) : 17–23. http://dx.doi.org/10.1007/s12210-020-00968-w.
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AbstractThe legalization of cannabis products for recreational and/or medical use means that our society is now clearly more open to its diffusion. Thus, it is particularly important for people to understand what is known about both the adverse health effects and the potential therapeutic benefits linked to cannabis. The evaluation of the benefit vs adverse effect of cannabis use is generally referred to its recreational use; however, medicinal cannabis is now authorized in several countries, and therefore, it has become a public safety issue. In this article, the acute and long-lasting consequences of recreational cannabis use as well as the therapeutic vs toxicological effect of medicinal cannabis will be summarized.Graphic abstract
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Soler-Cedeno, Omar, et Zheng-Xiong Xi. « Neutral CB1 Receptor Antagonists as Pharmacotherapies for Substance Use Disorders : Rationale, Evidence, and Challenge ». Cells 11, no 20 (17 octobre 2022) : 3262. http://dx.doi.org/10.3390/cells11203262.
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Cannabinoid receptor 1 (CB1R) has been one of the major targets in medication development for treating substance use disorders (SUDs). Early studies indicated that rimonabant, a selective CB1R antagonist with an inverse agonist profile, was highly promising as a therapeutic for SUDs. However, its adverse side effects, such as depression and suicidality, led to its withdrawal from clinical trials worldwide in 2008. Consequently, much research interest shifted to developing neutral CB1R antagonists based on the recognition that rimonabant’s side effects may be related to its inverse agonist profile. In this article, we first review rimonabant’s research background as a potential pharmacotherapy for SUDs. Then, we discuss the possible mechanisms underlying its therapeutic anti-addictive effects versus its adverse effects. Lastly, we discuss the rationale for developing neutral CB1R antagonists as potential treatments for SUDs, the supporting evidence in recent research, and the challenges of this strategy. We conclude that developing neutral CB1R antagonists without inverse agonist profile may represent attractive strategies for the treatment of SUDs.
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Holt, Curtis D., Gordon Ingle et Theodore M. Sievers. « Inhibitors of Calcineurin ». Journal of Pharmacy Practice 16, no 6 (décembre 2003) : 414–33. http://dx.doi.org/10.1177/0897190003260317.
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Before the early 1980s, patient and allograft survival for solid organ transplant recipients was dismal. By 1983, the first calcineurin blocker, cyclosporine (Sandimmun), had been introduced, and outcomes were dramatically improved. However, cyclosporine macroemulsion had suboptimal pharmacokinetics, significant drug interactions, and several adverse effects, including nephrotoxicity, neurotoxicity, hyperlipidemia, and hypertension. Recent advances with cyclosporine include the introduction of modified dosage formulations: Neoral, a microemulsion, and several generic microemulsion products. The potent second-generation calcineurin blocker tacrolimus (Prograf) was introduced in 1994 and has become the drug of choice for several types of transplant recipients. Although tacrolimus has improved pharmacokinetics and therapeutic drugmonitoring parameters, it has adverse effects such as nephrotoxicity, neurotoxicity, and diabetes. Thus, current immunosuppressive regimens implementing calcineurin blockers often involve additional immunosuppressive agents to “spare” the use of these agents, minimizing their adverse effects. This article reviews the mechanisms of action, pharmacokinetics, clinical use, therapeutic drug monitoring, drug interactions, adverse effects, and dosing of cyclosporine and tacrolimus in solid organ transplant recipients.
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Bubnova, Marina G. « Adverse effects of statin therapy : real evidence ». CardioSomatics 10, no 1 (15 mars 2019) : 51–61. http://dx.doi.org/10.26442/22217185.2019.1.190264.
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Aim. To provide a current view on the tolerability and safety of statin therapy. Materials and methods. The data of 73 scientific sources from Russian and foreign literature published within 1996-2018 are considered. Results. It is generally accepted that statins are first-line therapeutic agents for hypercholesterolemia and combined hyperlipidemia. Today there in growing evidence that lowering of low-density lipoprotein cholesterol levels prevents atherosclerotic diseases and reduces a risk of cardiovascular and overall mortality. Main issues of current statin therapy include a use of inadequate dosage for atherosclerotic diseases prevention, low treatment compliance and drug intolerance. In recent years the issue of statin intolerance has become of great importance. Criteria were proposed for determining an inability to tolerate statins, some experts suggest replacing definition of “statin intolerance” with the term “statin-associated side-effects”. Most discussed adverse effects due to statins include muscle-related symptoms (myalgia/myopathy), hepatotoxicity (hepatic hyperenzymemia) new-onset diabetes, dementia and cognitive impairment. Mechanisms of development of these adverse effects are still unclear. Certain factors and conditions capable of triggering some adverse effects as well as absolute contraindications to statin therapy were established. Some factors and conditions capable of triggering some adverse effects as well as absolute contraindications to statin therapy were identified. Occurrence of statin-associated side-effects depends on statin dose, a patient's age, gender, comorbidity and concomitant therapy. Many adverse effects of statins are drug class effect. At the same time each of statins has specific features of its structure, metabolism, drug interactions and pharmacokinetics. Pitavastatin belongs to the last generation of statins and it has distinct pharmacological features and neutral diabetogenic effects, etc. Risk of adverse effects due to statins is often exaggerated while benefit from the use of statins for preventing atherosclerotic diseases outweighs potential risks. Real occurrence of some adverse effects due to statin therapy requires additional evidence. Conclusion. Overall, statins have a good tolerability profile and are approved for use in the vast majority of patients who required lipid-lowering therapy.
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Pichini, Simona, Alfredo Fabrizio Lo Faro, Francesco Paolo Busardò et Raffaele Giorgetti. « Medicinal Cannabis and Synthetic Cannabinoid Use ». Medicina 56, no 9 (7 septembre 2020) : 453. http://dx.doi.org/10.3390/medicina56090453.
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Cannabis products have been used for centuries by humans for recreational and medical purposes. Resent research, proposed the promising therapeutic potential of cannabis and related cannabinoids for a wide range of medical conditions, including psychiatric and neurological diseases. This Special Issue presents the latest updates on medicinal cannabis and synthetic cannabinoids pharmacology, toxicology and new analytical methods to identify and quantify these compounds in conventional and non-conventional biological matrices. Moreover, it provides current data regarding their adverse effects, safety, application for medical purposes and their harmful effects.
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Del Rosso, James. « Clinically Important Considerations with the Use of Oral Doxycycline ». SKIN The Journal of Cutaneous Medicine 1, no 3 (13 novembre 2017) : 143–47. http://dx.doi.org/10.25251/skin.1.3.4.
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Tetracyclines are the most commonly prescribed oral antibiotics in dermatology. They are used to treat both cutaneous infections and non-infectious inflammatory disorders, the latter often with chronic therapy. Doxycycline may be favored by some dermatologists over minocycline due to a lower risk of certain adverse reactions, especially some with systemic manifestations. The major adverse events that are more common with doxycycline are gastrointestinal side effects, including pill esophagitis, and phototoxicity. This article reviews practical tips when prescribing oral doxycycline, emphasizing suggestions to optimize therapeutic success and reduce untoward reactions.
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Maksimov, M. L., N. M. Kiseleva, D. G. Semenikhin et B. K. Romanov. « Adverse reactions with the use of non-steroidal anti-inflammatory drugs ». Vrač skoroj pomoŝi (Emergency Doctor), no 8 (1 août 2020) : 35–50. http://dx.doi.org/10.33920/med-02-2008-02.
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Non-steroidal anti-inflammatory drugs (NSAIDs) are included in a pharmacological group of drugs with different chemical structures providing anti-inflammatory, analgesic and antipyretic actions, as well as antiplatelet action to a certain degree. Unfortunately, NSAIDs can cause a wide range of adverse reactions (AR) posing a serious risk to the health and life of patients. Therefore, the rational use of NSAIDs should include methods for effective prevention of drug complications. Many NSAIDs have a pronounced therapeutic effect, simultaneously causing many undesirable effects, so the drug shall be chosen considering the development of predicted side effects and modern algorithms. According to clinical recommendations, risk factors and administration of safer NSAIDs shall be considered as the main prevention method. Besides, it is possible to protect the patient from the upper gastrointestinal tract complications using proton pump inhibitors. It should be noted that there are no effective medication methods for kidney and liver protection to reduce the risk of NSAID-associated complications.
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Monteiro-Oliveira, Bruno B., Ana Carolina Coelho-Oliveira, Tatiane S. A. David, Adriana T. Brito, Ana Carla A. Cruz, Genice G. Souza et Laisa L. Paineiras-Domingos. « The therapeutic use of essential oils in the care of cancer patients in chemotherapy : A systematic review ». Brazilian Journal of Health and Biomedical Sciences 20, no 1 (13 mai 2021) : 36–45. http://dx.doi.org/10.12957/bjhbs.2021.59744.
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Introducton: Chemotherapy is an important therapy in the treatment of cancer. Nausea, vomiting and worsening quality are some adverse effects of chemotherapy. Aromatherapy is an ancient technique that uses essential oils for physical and psychological/emotional improvement and is able to reduce the symptoms of chemotherapy and can be an excellent complementary technique.Objective: The aim of this systematic review was to determine the effects of aromatherapy on the adverse effects of chemotherapy in patients diagnosed with cancer. Methods: A search in three database PubMed, EMBASE and SCOPUS. Five studies that analyzed the use of aromatherapy to evaluate the reduction of the adverse effects of chemotherapy in a cancer patient, published only in English were included. Two reviewers, which independently examined titles and abstracts, identified records through database search and reference screening and irrelevant studies were excluded based in eligibility criteria. Relevant full texts were analyzed for eligibility, and all selected studies were included in this systematic review. Results: Five studies were included in this systematic review. This review suggests that aromatherapy reduces nausea, frequency of vomiting and improves quality of sleep. Conclusion: Aromatherapy is an effective technique to reduce nausea, the frequency of vomiting and improves the quality of sleep of patients diagnosed with cancer and undergoing chemotherapy. However, more randomized clinical trials with a good methodological quality are necessary to confirm the preliminary findings of this systematic review.
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Breijyeh, Zeinab, Buthaina Jubeh, Sabino A. Bufo, Rafik Karaman et Laura Scrano. « Cannabis : A Toxin-Producing Plant with Potential Therapeutic Uses ». Toxins 13, no 2 (5 février 2021) : 117. http://dx.doi.org/10.3390/toxins13020117.
Texte intégralRésumé :
For thousands of years, Cannabis sativa has been utilized as a medicine and for recreational and spiritual purposes. Phytocannabinoids are a family of compounds that are found in the cannabis plant, which is known for its psychotogenic and euphoric effects; the main psychotropic constituent of cannabis is Δ9-tetrahydrocannabinol (Δ9-THC). The pharmacological effects of cannabinoids are a result of interactions between those compounds and cannabinoid receptors, CB1 and CB2, located in many parts of the human body. Cannabis is used as a therapeutic agent for treating pain and emesis. Some cannabinoids are clinically applied for treating chronic pain, particularly cancer and multiple sclerosis-associated pain, for appetite stimulation and anti-emesis in HIV/AIDS and cancer patients, and for spasticity treatment in multiple sclerosis and epilepsy patients. Medical cannabis varies from recreational cannabis in the chemical content of THC and cannabidiol (CBD), modes of administration, and safety. Despite the therapeutic effects of cannabis, exposure to high concentrations of THC, the main compound that is responsible for most of the intoxicating effects experienced by users, could lead to psychological events and adverse effects that affect almost all body systems, such as neurological (dizziness, drowsiness, seizures, coma, and others), ophthalmological (mydriasis and conjunctival hyperemia), cardiovascular (tachycardia and arterial hypertension), and gastrointestinal (nausea, vomiting, and thirst), mainly associated with recreational use. Cannabis toxicity in children is more concerning and can cause serious adverse effects such as acute neurological symptoms (stupor), lethargy, seizures, and even coma. More countries are legalizing the commercial production and sale of cannabis for medicinal use, and some for recreational use as well. Liberalization of cannabis laws has led to increased incidence of toxicity, hyperemesis syndrome, lung disease cardiovascular disease, reduced fertility, tolerance, and dependence with chronic prolonged use. This review focuses on the potential therapeutic effects of cannabis and cannabinoids, as well as the acute and chronic toxic effects of cannabis use on various body systems.
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de Leve, Simone, Florian Wirsdörfer et Verena Jendrossek. « The CD73/Ado System—A New Player in RT Induced Adverse Late Effects ». Cancers 11, no 10 (16 octobre 2019) : 1578. http://dx.doi.org/10.3390/cancers11101578.
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Radiotherapy (RT) is a central component of standard treatment for many cancer patients. RT alone or in multimodal treatment strategies has a documented contribution to enhanced local control and overall survival of cancer patients, and cancer cure. Clinical RT aims at maximizing tumor control, while minimizing the risk for RT-induced adverse late effects. However, acute and late toxicities of IR in normal tissues are still important biological barriers to successful RT: While curative RT may not be tolerable, sub-optimal tolerable RT doses will lead to fatal outcomes by local recurrence or metastatic disease, even when accepting adverse normal tissue effects that decrease the quality of life of irradiated cancer patients. Technical improvements in treatment planning and the increasing use of particle therapy have allowed for a more accurate delivery of IR to the tumor volume and have thereby helped to improve the safety profile of RT for many solid tumors. With these technical and physical strategies reaching their natural limits, current research for improving the therapeutic gain of RT focuses on innovative biological concepts that either selectively limit the adverse effects of RT in normal tissues without protecting the tumor or specifically increase the radiosensitivity of the tumor tissue without enhancing the risk of normal tissue complications. The biology-based optimization of RT requires the identification of biological factors that are linked to differential radiosensitivity of normal or tumor tissues, and are amenable to therapeutic targeting. Extracellular adenosine is an endogenous mediator critical to the maintenance of homeostasis in various tissues. Adenosine is either released from stressed or injured cells or generated from extracellular adenine nucleotides by the concerted action of the ectoenzymes ectoapyrase (CD39) and 5′ ectonucleotidase (NT5E, CD73) that catabolize ATP to adenosine. Recent work revealed a role of the immunoregulatory CD73/adenosine system in radiation-induced fibrotic disease in normal tissues suggesting a potential use as novel therapeutic target for normal tissue protection. The present review summarizes relevant findings on the pathologic roles of CD73 and adenosine in radiation-induced fibrosis in different organs (lung, skin, gut, and kidney) that have been obtained in preclinical models and proposes a refined model of radiation-induced normal tissue toxicity including the disease-promoting effects of radiation-induced activation of CD73/adenosine signaling in the irradiated tissue environment. However, expression and activity of the CD73/adenosine system in the tumor environment has also been linked to increased tumor growth and tumor immune escape, at least in preclinical models. Therefore, we will discuss the use of pharmacologic inhibition of CD73/adenosine-signaling as a promising strategy for improving the therapeutic gain of RT by targeting both, malignant tumor growth and adverse late effects of RT with a focus on fibrotic disease. The consideration of the therapeutic window is particularly important in view of the increasing use of RT in combination with various molecularly targeted agents and immunotherapy to enhance the tumor radiation response, as such combinations may result in increased or novel toxicities, as well as the increasing number of cancer survivors.
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McCormack, Ann. « Temozolomide in the Treatment of Aggressive Pituitary Tumors—An Overview of Existing Knowledge and Future Perspectives ». US Endocrinology 08, no 02 (2012) : 112. http://dx.doi.org/10.17925/use.2012.08.02.112.
Texte intégralRésumé :
The management of aggressive pituitary tumors remains a challenge, however, the recent identification of temozolomide as a chemotherapeutic agent with significant efficacy against these tumors has heralded a new therapeutic era. There has been an exponential growth in the international experience with temozolomide over the past five years, now totaling 50 published cases. Overall, 67 % of cases demonstrated a response to temozolomide. Prolactin- and adrenocorticotrophic hormone (ACTH)-secreting tumors respond more frequently than non-functioning tumors. Response is typically evident in the first three months of treatment. Adverse effects occur in almost half of patients, although the majority are mild. The expression of a DNA repair enzyme, 06-methylguanine-DNA methyltransferase (MGMT), as determined by immunohistochemistry, appears to be the primary determinant of response to temozolomide in pituitary tumors. There is suggestion that MGMT may also play a role in pituitary tumorigenesis. Over the next few years we will see temozolomide used earlier in the treatment algorithm of aggressive pituitary tumors, making it imperative to collect global long-term data on its use.
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Kichloo, Asim, Michael Albosta, Michael Aljadah, Zain El-Amir, Ghazaleh Goldar, Muhammed Zatmar Khan, Dushyant Singh Dahiya, Srilakshmi Vallabhaneni, Farah Wani et Jagmeet Singh. « Marijuana : A systems-based primer of adverse effects associated with use and an overview of its therapeutic utility ». SAGE Open Medicine 9 (janvier 2021) : 205031212110009. http://dx.doi.org/10.1177/20503121211000909.
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Marijuana use is on the rise in the United States. By the end of 2019, 33 states have legalized marijuana use and marijuana byproduct use for medical purposes. However, marijuana use does not come without side effects. This manuscript reviews the increasing usage of marijuana and the different forms (natural and synthetic) that patients may use when presenting to clinicians. It also addresses the biochemical and behavioral changes observed with marijuana use, including the location and changes associated with cannabinoid receptors (abbreviated CB1 and CB2). These two topics lead into an extensive review of the side effects of marijuana use. This manuscript discusses gastrointestinal side-effects, such as Cannabinoid Hyperemesis Syndrome, pancreatitis, and hepatotoxicity. It also briefly reviews cardiovascular, neurologic, and pulmonary side effects. This article provides an overview of therapeutic effects of marijuana including the antiemetic effect, its medical utility as an appetite stimulant, and usefulness in cancer patients post-chemotherapy. A thorough social history pertaining to marijuana use is an important consideration for clinicians in patients presenting with a variety of symptoms, including those effecting the gastrointestinal, cardiovascular, pulmonary, or neurologic systems.
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Santos, Ana Cláudia, Miguel Pereira-Silva, Catarina Guerra, Diana Costa, Diana Peixoto, Irina Pereira, Inês Pita, António J. Ribeiro et Francisco Veiga. « Topical Minoxidil-Loaded Nanotechnology Strategies for Alopecia ». Cosmetics 7, no 2 (27 mars 2020) : 21. http://dx.doi.org/10.3390/cosmetics7020021.
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Androgenetic alopecia (AGA) is a multifactorial and age-related condition characterized by substantial hair loss affecting both men and women. Conventional treatments include the use of topical minoxidil (MNX) formulations to stimulate hair growth and restore hair condition. However, those treatments are associated with limited performance and a lack of tolerability and compliance due to the emergence of adverse effects. Considering that the development of nanotechnology-based formulations as hair loss therapeutic strategies has been clearly growing, topical MNX delivery by means of these innovative formulations is known to enhance MNX skin permeation and depot formation into hair follicles, allowing for MNX-controlled release, increased MNX skin bioavailability and enhanced therapeutic efficacy with minimal adverse effects. This review highlights the potential of nanotechnology-based MNX delivery formulations for improved hair loss therapeutics, including a thorough assessment of their in vitro and in vivo performances, as well as regulatory and nanosafety considerations.
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Gong, Guifang, Bailing Fu, Caixin Ying, Zhiqin Zhu, Xiaoqian He, Yingying Li, Zhuanxing shen et al. « Targeted delivery of paclitaxel by functionalized selenium nanoparticles for anticancer therapy through ROS-mediated signaling pathways ». RSC Advances 8, no 70 (2018) : 39957–66. http://dx.doi.org/10.1039/c8ra07539e.
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Merzlyak, E. M., D. S. Syrko, E. A. Musatkina et M. A. Israelson. « The use of monoclonal antibodies in autoimmunity treatment ». NANOMEDICINE, no 6 (31 décembre 2018) : 150–54. http://dx.doi.org/10.24075/brsmu.2018.094.
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Recently, monoclonal antibodies (MA) have gained popularity as therapeutic agents for the treatment of autoimmune disorders. These antibodies target proinflammatory cytokines, as well as T and B cells potentially involved in the pathogenesis of such conditions. In the present work we attempt to give a systematic description of available therapeutic MA, highlight their key mechanisms of action and pinpoint their adverse effects. We believe that MA that are capable of recognizing and eliminating pathogenic T- and B-cell clones hold the most promise for medical application as biologics. Detection and identification of autoreactive lymphocyte clones is one of the most serious challenges of contemporary medicine.
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Acosta, Leslie Del Carmen Luza, et Carla Aparecida Arena Ventura. « Scientific evidence on therapeutic marihuana use in individuals treated in Health Care Services ». SMAD Revista Eletrônica Saúde Mental Álcool e Drogas (Edição em Português) 13, no 3 (27 août 2018) : 167–74. http://dx.doi.org/10.11606/issn.1806-6976.v13i3p167-174.
Texte intégralRésumé :
The aim of this integrative review was to “identify, synthesize and evaluate the scientific evidence available on therapeutic marihuana use in those treated in health care services”. The articles analyzed were selected from the following databases LILACS, CINAHL and MEDLINE and using tools such as WOS (Web of Science) and SCOPUS. After a broad search in Spanish, Portuguese and English, a total of ninety article were identified. The final selection consisted of six articles, four of which were primary articles and the other two were case studies. The analysis found that there are gaps in the evidence on the therapeutic effects of cannabis. Some positive effects are suggested, potentially useful in some cases, but probable adverse effects were also reported, it being therefore recommended that use of marihuana and marihuana-based products be weighed up depending on the pathologies present in the individual.
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Lee, Gihyun, et Hyunsu Bae. « Therapeutic Effects of Phytochemicals and Medicinal Herbs on Depression ». BioMed Research International 2017 (2017) : 1–11. http://dx.doi.org/10.1155/2017/6596241.
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Background. Depression is a recurrent, common, and potentially life-threatening psychiatric disease related to multiple assignable causes. Although conventional antidepressant therapy can help relieve symptoms of depression and prevent relapse of the illness, complementary therapies are required due to disadvantage of the current therapy such as adverse effects. Moreover, a number of studies have researched adjunctive therapeutic approaches to improve outcomes for depression patients. Purpose. One potential complementary method with conventional antidepressants involves the use of medicinal herbs and phytochemicals that provide therapeutic benefits. Studies have revealed beneficial effects of medical herbs and phytochemicals on depression and their central nervous system mechanism. Here, we summarize the current knowledge of the therapeutic benefits of phytochemicals and medicinal herbs against depression and describe their detailed mechanisms. Sections. There are two sections, phytochemicals against depression and medical herbs against depression, in this review. Conclusion. Use of phytomedicine may be an alternative option for the treatment of depression in case conventional drugs are not applicable due to their side effects, low effectiveness, or inaccessibility. However, the efficacy and safety of these phytomedicine treatments for depression have to be supported by clinical studies.
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Ito, Matthew K. « Statin Drug Interactions in Patients with Comorbidities and on Multiple Medications ». US Endocrinology 08, no 02 (2012) : 104. http://dx.doi.org/10.17925/use.2012.08.02.104.
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Extensive clinical evidence has demonstrated the efficacy of statin treatment in the prevention of cardiovascular disease (CVD). However, nearly half of patients taking statins discontinue their use, largely as a result of side effects. Many patients receiving statins are elderly, and/or have comorbid conditions, increasing the potential for drug-drug interactions (DDIs). Statin DDIs are largely the result of altered drug metabolism via cytochrome P450s (CYPs), glucuronidation or altered drug transport via organic anion-transporting polypeptides (OATPs) and P-glycoprotein (P-gp). There is a need for discussion and education about DDIs within the clinical consultation. Statins that are not significantly metabolized via the CYP system have a reduced risk of DDIs. To date, pitavastatin has shown a low rate of DDIs compared to other available statins metabolized by CYP3A4 isozymes. Its potential for CYP-mediated DDIs has been studied in combination with a wide range of drug classes known to be CYP inhibitors and has been clinically evaluated in patients populations where multiple medications are used, including the elderly, those high risk of CVD, and those taking protease inhibitors. It may also have beneficial effects on parameters of glucose metabolism, and has shown improved outcomes in patients with chronic kidney disease. Knowledge of statin pharmacokinetics, their dose limitations and contraindications, and their mechanisms of DDI allows improved therapeutic choices, avoiding adverse interactions without compromising patient care.
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Simões, G., S. Jesus et R. Silva. « Therapeutic use of ayahuasca : a review of the evidence of its use in approaching depressive disorders ». European Psychiatry 65, S1 (juin 2022) : S715. http://dx.doi.org/10.1192/j.eurpsy.2022.1843.
Texte intégralRésumé :
Introduction Ayahuasca (AYA) is a psychotropic plant from South America used for religious purposes by indigenous people of the Amazon. Increasing evidence indicates that AYA may have therapeutic potential in the treatment of mental health disorders like depression – a common life-disrupting, highly recurrent disorder – that is among the leading causes of disability worldwide. Objectives The aim of this exploratory study is to gather and assess scientific evidence about clinical effects of AYA in the treatment and symptomatological expression of patients with depression. Methods A literature research was conducted on PubMed, starting from the MeSH terms: “Banisteriopsis” and “Depression”. Results corresponding to investigations using AYA, and based on an adult population with depressive disorders, were selected for our analysis. Results The research provided 8 results, of which 6 met the defined criteria. Different types of studies with variable samples were considered, including retrospective and prospective observational studies, meta-analysis and a narrative review. Overall, evidence about the use of AYA in depressive disorders is associated to reductions in depression scales, to significant antidepressant effects and in mediating improvement of grief symptoms. AYA administration increased introspection and positive mood, self-acceptance, empathy, openness and potentiated improvements in emotional processing. The underlying potential mechanisms, adverse effects and the current limitations related to its study and use are analysed and discussed. Conclusions The use of AYA in depression shows promising results that should be further explored in controlled trials with larger sample sizes, in order to better evaluate its clinical effects, safety profile and related short and long-term effects. Disclosure No significant relationships.
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Kalant, Harold. « Medicinal Use of Cannabis : History and Current Status ». Pain Research and Management 6, no 2 (2001) : 80–91. http://dx.doi.org/10.1155/2001/469629.
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OBJECTIVE: To provide an overview of the history and pharmacology of cannabis in relation to current scientific knowledge concerning actual and potential therapeutic uses of cannabis preparations and pure cannabinoids.METHODS: The literature on therapeutic uses of cannabis and cannabinoids was assessed with respect to type of study design, quality and variability of data, independent replications by the same or other investigators, magnitude of effects, comparison with other available treatments and reported adverse effects. The results of this review were also compared with those of major international reviews of this topic in the past five years.CONCLUSIONS: Pure tetrahydrocannabinol and several analogues have shown significant therapeutic benefits in the relief of nausea and vomiting, and stimulation of appetite in patients with wasting syndrome. Recent evidence clearly demonstrates analgesic and antispasticity effects that will probably prove to be clinically useful. Reduction of intraocular pressure in glaucoma and bronchodilation in asthma are not sufficiently strong, long lasting or reliable to provide a valid basis for therapeutic use. The anticonvulsant effect of cannabidiol is sufficiently promising to warrant further properly designed clinical trials. There is still a major lack of long term pharmacokinetic data and information on drug interactions. For all the present and probable future uses, pure cannabinoids, administered orally, rectally or parenterally, have been shown to be effective, and they are free of the risks of chronic inflammatory disease of the airways and upper repiratory cancer that are associated with the smoking of crude cannabis. Smoking might be justified on compassionate grounds in terminally ill patients who are already accustomed to using cannabis in this manner. Future research will probably yield new synthetic analogues with better separation of therapeutic effects from undesired psychoactivity and other side effects, and with solubility properties that may permit topical administration in the eye, or aerosol inhalation for rapid systemic effect without the risks associated with smoke inhalation.
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Shapiro, Evelyn. « Hospital Use by Elderly Manitobans Resulting From An Injury ». Canadian Journal on Aging / La Revue canadienne du vieillissement 7, no 2 (1988) : 125–33. http://dx.doi.org/10.1017/s0714980800007364.
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ABSTRACTThe results of examining all hospitalizations of the elderly consequent to injury in one Canadian province indicate that 66.3% were for accidental falls and 21.3% were for “other accidents” and for adverse effects of therapeutic regimens. Nursing home residents were significantly more likely to be hospitalized for falls than community dwellers but very elderly institutionalized females, who comprise 40% of the nursing home population, used significantly fewer days than their community peers.
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Gliszczyńska, Anna, et Marta Nowaczyk. « Lipid Formulations and Bioconjugation Strategies for Indomethacin Therapeutic Advances ». Molecules 26, no 6 (12 mars 2021) : 1576. http://dx.doi.org/10.3390/molecules26061576.
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Indomethacin (IND) is a drug which after successful clinical trials became available for general prescription in 1965 and from that time is one of the most widely used anti-inflammatory drug with the highest potencies in the in vitro and in vivo models. However, despite its high therapeutic efficacy in relieving the symptoms of certain arthritis and in treating gout or collagen diseases, administration of IND causes a number of adverse effects, such as gastrointestinal ulceration, frequent central nervous system disorders and renal toxicity. These obstacles significantly limit the practical applications of IND and make that 10–20% of patients discontinue its use. Therefore, during the last three decades many attempts have been made to design novel formulations of IND aimed to increase its therapeutic benefits minimizing its adverse effects. In this review we summarize pharmacological information about IND and analyze its new lipid formulations and lipid bioconjugates as well as discuss their efficacy and potential application.
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Weinberg, Mea A., et Michael Bral. « Tetracycline and Its Analogues : a Therapeutic Paradigm in Periodontal Diseases ». Critical Reviews in Oral Biology & ; Medicine 9, no 3 (juillet 1998) : 322–32. http://dx.doi.org/10.1177/10454411980090030501.
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This article discusses the use of tetracyclines in the clinical management of periodontal infections. A review of the drugs' pharmacology, pharmacokinetics, and potential adverse effects shows that they are relatively safe if used in appropriate dosages and under controlled conditions. Current data suggest that the routine use of tetracyclines in conjunction with the treatment of periodontitis is unnecessary. However, their distinctive characteristics can be utilized in different delivery systems as an adjunctive aid to conventional treatment of juvenile and refractory forms of periodontitis.
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Zothantluanga, James H., Hannah S. Lalnunpuii, Hans Raj Bhat et Anshul Shakya. « Awareness on the possible adverse effects of Garcinia cambogia : A scientific approach ». Science Vision 19, no 4 (31 décembre 2020) : 120–33. http://dx.doi.org/10.33493/scivis.19.04.02.
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The modern popular ideology is that plant-based products do not have adverse effects. Hence, people are fond of using herbal products of their choice to treat their own ailments or anyone else. As majority of the population are not aware of herbal toxicity concept, the use of formulated single or combined medicinal and/or nutritional plant extracts or isolated compounds to treat chronic diseases are increasingly popular due to the widespread concerns regarding the adverse effects of pharmaceutical drugs. Awareness from the scientific community to bring society to its senses regarding the safety issue of a herbal product is rare. Garcinia gummi-gutta (more popularly known by the synonym Garcinia cambogia in commercial preparations), belonging to the family of Clusiaceae (alt. Guttiferae) is a popularly consumed weight-loss nutraceutical. This review aims to highlight the possible adverse effects of G. cambogia. For the said purpose, 147 articles were collected from PubMed, Web of Science and Google scholar. Literature review revealed a plethora of beneficial actions. Investigational outcomes and clinical evidences hint the possible adverse effects likely to be linked with the use of G. cambogia. However, the use of G. cambogia as an anti-obesity agent is advisable as long as the therapeutic value outweighs the adverse effect.
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Tsapakis, E. M., Z. Gamie, G. T. Tran, S. Adshead, A. Lampard, A. Mantalaris et E. Tsiridis. « The adverse skeletal effects of selective serotonin reuptake inhibitors ». European Psychiatry 27, no 3 (avril 2012) : 156–69. http://dx.doi.org/10.1016/j.eurpsy.2010.10.006.
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AbstractSelective serotonin reuptake inhibitors (SSRIs) are a widely used group of antidepressants (ADs) with reported potential detrimental effects on bone mineral density (BMD) and increased fracture risk. Here, a comprehensive review of the in vitro, in vivo and clinical studies to date was carried out using the medical search engines MEDLINE (1950 to September 2010) and EMBASE (1980 to September 2010). Serotonin (5-HT) receptors have been identified on osteoclast, osteoblast and osteocyte cell lines. The effect of SSRIs on bone formation and resorption appears to be governed by the activation of a number of 5-HT receptors on osteoblasts and osteoclasts via endocrine, autocrine/paracrine and neuronal pathways. In vitro, in vivo and clinical collective data appears to indicate that SSRIs have a negative effect on bone at the therapeutic dose levels widely used for the treatment of depression in current clinical practice. Caution may therefore have to be employed with the use of SSRIs in patients at an increased risk of falls and osteoporosis. Further studies are needed in order to fully elicit the role of SSRIs in bone formation and their effects in the low oestrogen state.
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Fassakhov, R. S., et D. I. Marapov. « Mometasone furoate in the treatment of allergic rhinitis : a complex therapeutic effect ». Meditsinskiy sovet = Medical Council, no 12 (19 septembre 2021) : 130–37. http://dx.doi.org/10.21518/2079-701x-2021-12-130-137.
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The review examines the role of mometasone furoate (NSMF) intranasal spray (Nasonex) in the treatment of allergic rhinitis (AR). There is a wide prevalence of AR both among children and adults, its adverse effect on the quality of life of patients. It is emphasized that the main means of therapy for moderate and severe course in accordance with international and Russian recommendations for the diagnosis and treatment of AR are intranasal glucocorticosteroids (INGKS). The pharmacological features of the MF molecule that underlie its efficacy and safety, including the affinity, lipophilicity and viscosity of the drug, as well as low systemic bioavailability, are discussed in detail. The therapeutic effects of NSMF in the treatment of seasonal and perennial AR, its effect on nasal symptoms are discussed in detail. The beneficial effect of NSMF therapy on nasal congestion is emphasized separately. The beneficial effect of NSMF treatment on other clinical manifestations of AR, including ocular symptoms, effects on sleep, and olfactory function, has been noted. The safety issues of NSMF use are discussed in detail, including systemic effects, such as effects on adrenal function, eye, and growth retardation in children, and local adverse effects on the nasal mucosa; there is a high profile of local and systemic safety of long-term use of NSMF in the treatment of AR in both adults and children.
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Gotti, Manuel, Valeria Fiaccadori, Elisa Bono, Benedetta Landini, Marzia Varettoni, Luca Arcaini et Maurizio Bonfichi. « Therapy-Related Late Adverse Events in Hodgkin’s Lymphoma ». Lymphoma 2013 (11 avril 2013) : 1–7. http://dx.doi.org/10.1155/2013/952698.
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Hodgkin's lymphoma (HL) is one of the most curable hematologic diseases with an overall response rate over 80%. However, despite this therapeutic efficacy, HL survivors show a higher morbidity and mortality than other people of the same age because of long-term therapy-related events. In the last decades, many efforts have been made to reduce these effects through the reduction of chemotherapy dose, the use of less toxic chemotherapeutic agents, and the introduction of new radiation techniques. In this paper, we will describe the main long-term effects related to chemotherapy and radiotherapy for HL, the efforts to reduce toxicity made in the last years, and the clinical aspects which have to be taken into consideration in the followup of these patients.
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D'Agostino, Giovanni Marco, Giulio Rizzetto, Andrea Marani, Samuele Marasca, Matteo Candelora, Daisy Gambini, Helena Gioacchini et al. « Bullous Pemphygoid and Novel Therapeutic Approaches ». Biomedicines 10, no 11 (8 novembre 2022) : 2844. http://dx.doi.org/10.3390/biomedicines10112844.
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Bullous pemphigoid is a subepidermal blistering disease associated with autoantibodies (auto-ab) to BP180 and BP230 which affects elderly patients, predominately. Although it is a rare disease, bullous pemphigoid is the most common among the autoimmune bullous skin diseases. Systemic corticosteroids and immunosuppressants represent milestones in the treatment of patients suffering from bullous pemphigoid; however, therapeutic management of patients still represents a clinical challenge, owing to the chronic nature of the disease and to potential adverse effects related to the long-term use of systemic treatments. Recent discoveries on the pathogenesis of bullous pemphigoid have allowed investigation of new target therapies against selective pro-inflammatory mediators. These therapies appear to yield satisfactory results with fewer side effects in cases of refractory disease. The review discusses current evidence on these new therapeutic targets and specific drugs under investigation.
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Vassal, Mariana, Sandra Rebelo et Maria de Lourdes Pereira. « Metal Oxide Nanoparticles : Evidence of Adverse Effects on the Male Reproductive System ». International Journal of Molecular Sciences 22, no 15 (28 juillet 2021) : 8061. http://dx.doi.org/10.3390/ijms22158061.
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Metal oxide nanoparticles (MONPs) are inorganic materials that have become a valuable tool for many industrial sectors, especially in healthcare, due to their versatility, unique intrinsic properties, and relatively inexpensive production cost. As a consequence of their wide applications, human exposure to MONPs has increased dramatically. More recently, their use has become somehow controversial. On one hand, MONPs can interact with cellular macromolecules, which makes them useful platforms for diagnostic and therapeutic interventions. On the other hand, research suggests that these MONPs can cross the blood–testis barrier and accumulate in the testis. Although it has been demonstrated that some MONPs have protective effects on male germ cells, contradictory reports suggest that these nanoparticles compromise male fertility by interfering with spermatogenesis. In fact, in vitro and in vivo studies indicate that exposure to MONPs could induce the overproduction of reactive oxygen species, resulting in oxidative stress, which is the main suggested molecular mechanism that leads to germ cells’ toxicity. The latter results in subsequent damage to proteins, cell membranes, and DNA, which ultimately may lead to the impairment of the male reproductive system. The present manuscript overviews the therapeutic potential of MONPs and their biomedical applications, followed by a critical view of their potential risks in mammalian male fertility, as suggested by recent scientific literature.
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Mantle, David, et Marcel G. Smits. « Melatonin for the treatment of gastrointestinal disorders : an overview ». Gastrointestinal Nursing 19, no 3 (2 avril 2021) : 18–22. http://dx.doi.org/10.12968/gasn.2021.19.3.18.
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Conventional pharmacological agents for the treatment of common (10–25% prevalence) gastrointestinal disorders may be associated with significant adverse effects in some patients. Therefore, there is a rationale to develop alternative therapeutic strategies for such individuals. This article reviews the evidence for the use of supplemental melatonin—a substance with an excellent safety record, free of significant adverse effects—in the management of gastro-oesophageal reflux disease, gastritis, irritable bowel syndrome and ulcerative colitis.
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Ravindran, A. V., R. J. Bialik et Y. D. Lapierre. « Therapeutic Efficacy of Specific Serotonin Reuptake Inhibitors (SSRIs) in Dysthymia ». Canadian Journal of Psychiatry 39, no 1 (février 1994) : 21–26. http://dx.doi.org/10.1177/070674379403900106.
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Pharmacological treatment of dysthymia is a contentious issue mainly because of the traditional view that this disorder has characterological origins and responds to psychotherapy. However, Akiskal's subtyping of primary dysthymia, which was based in part on its response to older antidepressants, can assist in the prediction of responses to antidepressants. Specific serotonin reuptake inhibitors (SSRIs) have equal efficacy but fewer adverse effects and greater tolerability than older antidepressants. Therefore, SSRIs appear to be a viable treatment option for these patients although there are few documented systematic studies of the use of these agents in primary dysthymia. An open study was conducted to determine the efficacy of fluoxetine in primary dysthymia (DSM-IH-R and Akiskal's criteria). A good response was observed in the subaffective subtype but not in the character spectrum group. Overall, the antidepressant was tolerated well, with significant adverse effects reported and responders showing reductions in both depressive and anxious symptoms. These initial findings indicate a potential role for SSRIs in the pharmacotherapy of dysthymia.
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Wan Mohd Tajuddin, Wan Nur Baitty, Nordin H. Lajis, Faridah Abas, Iekhsan Othman et Rakesh Naidu. « Mechanistic Understanding of Curcumin’s Therapeutic Effects in Lung Cancer ». Nutrients 11, no 12 (6 décembre 2019) : 2989. http://dx.doi.org/10.3390/nu11122989.
Texte intégralRésumé :
Lung cancer is among the most common cancers with a high mortality rate worldwide. Despite the significant advances in diagnostic and therapeutic approaches, lung cancer prognoses and survival rates remain poor due to late diagnosis, drug resistance, and adverse effects. Therefore, new intervention therapies, such as the use of natural compounds with decreased toxicities, have been considered in lung cancer therapy. Curcumin, a natural occurring polyphenol derived from turmeric (Curcuma longa) has been studied extensively in recent years for its therapeutic effects. It has been shown that curcumin demonstrates anti-cancer effects in lung cancer through various mechanisms, including inhibition of cell proliferation, invasion, and metastasis, induction of apoptosis, epigenetic alterations, and regulation of microRNA expression. Several in vitro and in vivo studies have shown that these mechanisms are modulated by multiple molecular targets such as STAT3, EGFR, FOXO3a, TGF-β, eIF2α, COX-2, Bcl-2, PI3KAkt/mTOR, ROS, Fas/FasL, Cdc42, E-cadherin, MMPs, and adiponectin. In addition, limitations, strategies to overcome curcumin bioavailability, and potential side effects as well as clinical trials were also reviewed.
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Al-Roubaie, Zanab, Elena Guadagno, Agnihotram V. Ramanakumar, Afsheen Q. Khan et Kenneth A. Myers. « Clinical utility of therapeutic drug monitoring of antiepileptic drugs ». Neurology : Clinical Practice 10, no 4 (6 septembre 2019) : 344–55. http://dx.doi.org/10.1212/cpj.0000000000000722.
Texte intégralRésumé :
ObjectiveTo systematically review and evaluate the available evidence supporting or refuting clinical use of therapeutic drug monitoring (TDM) of antiepileptic drugs (AEDs) in patients with epilepsy.MethodsWe searched MEDLINE, Embase, BIOSIS, Cochrane, PubMed, Africa-Wide Information, Web of Science, and grey literature. Randomized controlled studies and observational studies that compared the clinical outcomes of TDM vs non-TDM were included. Two reviewers independently extracted the data. The primary outcome was seizure control; adverse effects were considered as secondary outcomes. The PROSPERO ID of this systematic review's protocol is CRD42018089925.ResultsSixteen studies were identified meeting eligibility requirements. Four randomized controlled trials (RCTs), 1 meta-analysis, and 11 quasiexperimental (QE) studies were included in the systematic review. Results from the analysis of RCTs showed no significant positive effect of TDM on seizure outcome (only 25% positive effect of phenytoin). However, some of the QE studies found that TDM was associated with better seizure control or lower rates of adverse effects. The existing evidence from various designs has shown various methodological implications, which warrants inconclusive results and highlights the requirement of more number of studies in this line.ConclusionsIf optimally implemented, TDM may enhance clinical care, particularly for phenytoin and other AEDs with complex pharmacokinetics. However, the ideal method for implementation is unclear, and serum drug levels should be considered in context with patient-reported clinical data regarding seizure control and adverse events.