Side Effects Of Long-Term Treatment With Danazol And Stanozolol In Hereditary Angioedema

2007 ◽  
Vol 119 (1) ◽  
pp. S275 ◽  
Author(s):  
K. Bork ◽  
L. Zingale ◽  
H. Farkas ◽  
A. Bygum ◽  
L. Bouillet ◽  
...  
Keyword(s):  
Side Effects ◽  
Hereditary Angioedema ◽  
Term Treatment ◽  
Long Term Treatment

Advances in the Management of Parkinsons Disease

1976 ◽  
Vol 21 (3) ◽  
pp. 139-148 ◽  
Author(s):  
C. D. Marsden
Keyword(s):  
Side Effects ◽  
Replacement Therapy ◽  
Term Treatment ◽  
Parkinsons Disease ◽  
Complex Time ◽  
Optimum Dosage ◽  
New Approaches ◽  
Long Term Treatment ◽  
Near Future

The treatment of Parkinson's disease today is complex, time-consuming, but rewarding. The introduction of levodopa has not cured the disease, but has provided the most powerful therapy available yet. Its use is limited by side effects and careful titration to optimum dosage, often in combination with other drugs, is required. Despite best therapy, some patients never respond, and others begin to lose benefit after some years of therapy. New problems, such as the ‘on-off’ effect have appeared with long-term treatment, and require careful adjustment of dosage. As with any replacement therapy, a balance between sub-optimal benefit and side effects has to be discovered and maintained by careful and frequent review. New approaches to treatment may offer further improvement in the near future.

The Common Side Effects of Long Term Treatment with Clozapine and Their Impact: a Sri Lankan Experience

2015 ◽  
Vol 30 ◽  
pp. 1586
Author(s):  
S.W. Kotalawala ◽  
K.P.M. Dalpatadu ◽  
C.U. Suraweera ◽  
K.G.C.L. Kapugama ◽  
H.G.V.W. Wijesiri ◽  
...  
Keyword(s):  
Side Effects ◽  
Term Treatment ◽  
Sri Lankan ◽  
Long Term Treatment ◽  
The Common

Lithium and related mood stabilizers

2012 ◽  
pp. 1198-1208
Author(s):  
Robert M. Post
Keyword(s):  
Bipolar Disorder ◽  
Side Effects ◽  
Mood Stabilizer ◽  
Term Treatment ◽  
Careful Consideration ◽  
Mood Stabilizers ◽  
Illness Onset ◽  
Predictors Of Response ◽  
Long Term Treatment

Lithium is the paradigmatic mood stabilizer. It is effective in the acute and prophylactic treatment of both mania and, to a lesser magnitude, depression. These characteristics are generally paralleled by the widely accepted anticonvulsant mood stabilizers valproate, carbamazepine (Table 6.2.4.1), and potentially by the less well studied putative mood stabilizers oxcarbazepine, zonisamide, and the dihydropyridine L-type calcium channel blocker nimodipine. In contrast, lamotrigine has a profile of better antidepressant effects acutely and prophylactically than antimanic effects. Having grouped lithium, valproate, and carbamazepine together, it is important to note they have subtle differences in their therapeutic profiles and differential clinical predictors of response (Table 6.2.4.1). Response to one of these agents is not predictive of either a positive or negative response to the others. Thus, clinicians are left with only rough estimates and guesses about which drug may be preferentially effective in which patients. Only sequential clinical trials of agents either alone or in combination can verify responsivity in an individual patient. Individual response trumps FDA-approval. Given this clinical conundrum, it is advisable that patients, family members, clinicians, or others carefully rate patients on a longitudinal scale in order to most carefully assess responses and side effects. These are available from the Depression Bipolar Support Alliance (DBSA), the STEP-BD NIMH Network, or www.bipolarnetworknews.org and are highly recommended. The importance of careful longitudinal documentation of symptoms and side effects is highlighted by the increasing use of multiple drugs in combination. This is often required because patients may delay treatment-seeking until after many episodes, and very different patterns and frequencies of depressions, manias, mixed states, as well as multiple comorbidities may be present. Treating patients to the new accepted goal of remission of their mood and other anxillary symptoms usually requires use of several medications. If each component of the regimen is kept below an individual's side-effects threshold, judicious use of multiple agents can reduce rather than increase the overall side-effect burden. There is increasing evidence of reliable abnormalities of biochemistry, function, and anatomy in the brains of patients with bipolar disorder, and some of these are directly related to either duration of illness or number of episodes. Therefore, as treatment resistance to most therapeutic agents is related to number of prior episodes, and brain abnormalities may also increase as well, it behooves the patient to begin and sustain acute and long-term treatment as early as possible. Despite the above academic, personal, and public health recommendations, bipolar disorder often takes ten years or more to diagnose and, hence, treat properly. In fact, a younger age of onset is highly related to presence of a longer delay from illness onset to first treatment, and as well, to a poorer outcome assessed both retrospectively and prospectively. New data indicate that the brain growth factor BDNF (brain-derived neurotrophic factor) which is initially important to synaptogenesis and neural development, and later neuroplasticity and long-term memory in the adult is involved in all phases of bipolar disorder and its treatment. It appears to be: 1) both a genetic (the val-66-val allele of BDNF) and environmental (low BDNF from childhood adversity) risk factor; 2) episode-related (serum BDNF decreasing with each episode of depression or mania in proportion to symptom severity; 3) related to some substance abuse comorbidity (BDNF increases in the VTA with defeat stress and cocaine self-administration); and 4) related to treatment. Lithium, valproate, and carbamazepine increase BDNF and quetiapine and ziprasidone block the decreases in hippocampal BDNF that occur with stress (as do antidepressants). A greater number of prior episodes is related to increased likelihood of: 1) a rapid cycling course; 2) more severe depressive symptoms; 3) more disability; 4) more cognitive dysfunction; and 5) even the incidence of late life dementia. Taken together, the new data suggest a new view not only of bipolar disorder, but its treatment. Adequate effective treatment may not only (a) prevent affective episodes (with their accompanying risk of morbidity, dysfunction, and even death by suicide or the increased medical mortality associated with depression), but may also (b) reverse or prevent some of the biological abnormalities associated with the illness from progressing. Thus, patients should be given timely information pertinent to their stage of illness and recovery that emphasizes not only the risk of treatments, but also their potential, figuratively and literally, life-saving benefits. Long-term treatment and education and targeted psychotherapies are critical to a good outcome. We next highlight several attributes of each mood stabilizer, but recognize that the choice of each agent itself is based on inadequate information from the literature, and sequencing of treatments and their combinations is currently more an art than an evidence-based science. We look forward to these informational and clinical trial deficits being reduced in the near future and the development of single nucleotide polymorphism (SNP) and other neurobiological predictors of individual clinical response to individual drugs. In the meantime, patients and clinicians must struggle with treatment choice based on: 1) the most appropriate targetting of the predominant symptom picture with the most likely effective agent (Table 6.2.4.1 and 6.2.4.2) the best side-effects profile for that patient (Table 6.2.4.2 and 6.2.4.3) using combinations of drugs with different therapeutic targets and mechanisms of action (Table 6.2.4.3 and 6.2.4.4) careful consideration of potential advantageous pharmacodynamic interactions and disadvantageous pharmacokinetic drug-drug interactions that need to be avoided or anticipated.

Successful long-term treatment with the bradykinin B2 receptor antagonist icatibant in a patient with hereditary angioedema

2011 ◽  
Vol 50 (10) ◽  
pp. 1294-1295 ◽  
Author(s):  
Jens Greve ◽  
Thomas K. Hoffmann ◽  
Patrick Schuler ◽  
Stephan Lang ◽  
Adam Chaker ◽  
...  
Keyword(s):  
Receptor Antagonist ◽  
Hereditary Angioedema ◽  
Term Treatment ◽  
Bradykinin B2 Receptor ◽  
Long Term Treatment

scholarly journals P709 Is azathioprine safe as long-term treatment in paediatric patients with inflammatory bowel disease?

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S573-S573
Author(s):  
M A Martínez Ibeas ◽  
I Bacelo Ruano ◽  
S Rodríguez Manchón ◽  
M Velasco Rodríguez-Belvís ◽  
J F Viada Bris ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Side Effects ◽  
Adverse Effects ◽  
Term Treatment ◽  
Tpmt Activity ◽  
Duration Of Treatment ◽  
Median Dosage ◽  
Long Term Treatment ◽  
Inflammatory Bowel

Abstract Background The toxicity of azathioprine (AZA) includes myelosuppression, infections, pancreatitis, photosensitivity, and hepatotoxicity. The aim of this study was to describe the adverse effects profile of azathioprine as long-term treatment in paediatric inflammatory bowel disease (IBD). Methods An observational, descriptive and retrospective study was performed in the paediatric IBD Unit of a tertiary care hospital from September 2008 to December 2018. It was included patients under 18 diagnosed with IBD who were treated with AZA during their follow-up. We recorded epidemiological data, thiopurine methyltransferase (TPMT) enzyme activity, AZA side effects, and the dosage the patients were receiving when these effects took place. Bone marrow suppression (BMS) was defined as leukopenia, thrombocytopenia and/or anaemia. Acute pancreatitis (AP) induced by azathioprine was considered when two of these criteria (Atlanta 2012) were met: lipase increase (> 3 times normal value), congruent signs and symptoms and/or echographic findings, without other possible aetiology and with complete recovery after AZA withdrawal. Results We included 52 patients, being 31 men (59.6%). They were diagnosed with Crohn′s disease (CD) (73%), ulcerative colitis (UC) (21%) and IBD-unclassified (6%). The median TPMT activity was 17 U/ml (14.2–19.2). Up to 63.5% developed adverse effects by AZA with a median time from the beginning of treatment of 11.4 months (2.6–26.4) and a median dosage of 2 mg/kg/day (1.7–2.3). The most frequent side effect was BMS (52%). These patients had a median TPMT activity of 16.9 U/ml (14.2–18.9), the median duration of treatment was 14 months (3.9–27.7), and the median dosage was 2 mg/kg/d (1.8–2.5). BMS was more frequent in patients with UC (p 0.04) and longer treatment (p 0.08). No differences were found according to age, sex or TPMT activity. Up to 11.5% developed AP, the median duration of treatment until its appearance was 1.5 months (0.7–43.3) and the median dosage was 2 mg/kg/d (1.5–2.5). No differences were found related to age, sex, diagnosis or dosage. Other side effects were: 3 flu-like symptoms, 3 opportunistic infections, 2 hypertransaminasemia, and 1 patient with elevated pancreatic enzymes and hyperbilirubinemia. AZA was discontinued in 14 patients (43.8%): in 6 due to AP, in 4 due to severe lymphopenia, in 2 because of Epstein-Barr virus infection, in 1 due to flu-like symptoms and in 1 with several adverse effects. Conclusion More than half of the patients treated with AZA presented side effects, mainly BMS, although most of them were mild and temporary, and the withdrawal of the drug was not necessary. It seems that TPMT activity is not useful to predict BMS, but this adverse effect could be related to a longer treatment.

No Metabolic Side Effects of Long-Term Treatment with Verapamil in Hypertension

Angiology ◽  
1988 ◽  
Vol 39 (12) ◽  
pp. 1025-1029 ◽  
Author(s):  
Kjell Midtbø ◽  
Oddveig Lauve ◽  
Ottar Hals
Keyword(s):  
Side Effects ◽  
Term Treatment ◽  
Metabolic Side Effects ◽  
Long Term Treatment

Aspects of Long-Term Treatment with Neuroleptics Historical and Literature Review—Personal Experience with Fluspirilene and Penfluridol

1975 ◽  
Vol 3 (2) ◽  
pp. 114-124 ◽  
Author(s):  
Lucian Floru
Keyword(s):  
Side Effects ◽  
Literature Review ◽  
Personal Experience ◽  
Term Treatment ◽  
Term Therapy ◽  
Tabular Form ◽  
Long Term Effects ◽  
Long Term Treatment ◽  
Long Term Therapy

The literature on neuroleptics with substance-specific long-term effects (fluspirilene, penfluridol) is reviewed in tabular form. This is followed by a report of personal investigations on 76 schizophrenics who were treated with fluspirilene initially within the hospital and later on an out-patient basis, on 86 patients who were treated with it exclusively at the out-patients' department, as well as on 123 schizophrenic psychoses treated with penfluridol in the out-patients' department. The side-effects caused by the two substances are compared. Pre-requisites for effective long-term therapy with a few complications are discussed.

scholarly journals Short-term and long-term treatment with propafenone: determinants of arrhythmia suppression, persistence of efficacy, arrhythmogenesis, and side effects in patients with symptoms.

Heart ◽  
1992 ◽  
Vol 67 (6) ◽  
pp. 491-497 ◽  
Author(s):  
M Zehender ◽  
S Hohnloser ◽  
A Geibel ◽  
A Furtwangler ◽  
M Olschewski ◽  
...  
Keyword(s):  
Side Effects ◽  
Term Treatment ◽  
Short Term ◽  
Long Term Treatment
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