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Anticholinergic Toxicity

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Adverse drug reactions associated with amitriptyline - protocol for a systematic multiple-indication review and meta-analysis.

Maria-Sophie Brueckle, Elizabeth T Thomas, Svenja E Seide, Maximilian Pilz, Ana Isabel Gonzalez-Gonzalez, Truc Sophia Nguyen, Sebastian Harder, Paul P Glasziou, Ferdinand M Gerlach, Christiane Muth,

BACKGROUND:Unwanted anticholinergic effects are both underestimated and frequently overlooked. Failure to identify adverse drug reactions (ADRs) can lead to prescribing cascades and the unnecessary use of over-the-counter products. The objective of this systematic review and meta-analysis is to explore and quantify the frequency and severity of ADRs associated with amitriptyline ... Read more >>

Syst Rev (Systematic reviews)
[2020, 9(1):59]

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Unknowing ingestion of Brugmansia suaveolens leaves presenting with signs of anticholinergic toxicity: a case report.

K P Jayawickreme, K V C Janaka, S A S P Subasinghe,

BACKGROUND:Brugmansia suaveolens is the commonest species under the Solanacea ("Angels Trumpet" in English; "Attana" in Sinhalese) plant family in Sri Lanka. It contains alkaloids like scopolamine, atropine and hyoscyamine which can cause an anticholinergic toxindrome. There have been a few reported cases of accidental ingestion of Brugmansia seeds among children, ... Read more >>

J Med Case Rep (Journal of medical case reports)
[2019, 13(1):322]

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Scopolamine Toxicity in an Elderly Patient.

Kayla M Knuf, Francis M Spaulding, Gregory J Stevens,

We present a case of a 66-year-old female who was to undergo a scheduled operation and placed on our institution's ERAS (Enhanced Recovery After Surgery) protocol. The intraoperative course was unremarkable. The patient developed delayed emergence in the Post-Anesthesia Care Unit. On physical exam, the patient was noted to have ... Read more >>

Mil Med (Military medicine)
[2019, 184(11-12):937-938]

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Oleander and Datura Poisoning: An Update.

Vijay V Pillay, Anu Sasidharan,

India has a very high incidence of poisoning. While most cases are due to chemicals or drugs or envenomation by venomous creatures, a significant proportion also results from consumption or exposure to toxic plants or plant parts or products. The exact nature of plant poisoning varies from region to region, ... Read more >>

Indian J Crit Care Med (Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine)
[2019, 23(Suppl 4):S250-S255]

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Carbamazepine Toxicity Masquerading as Complex Febrile Seizures in a Pediatric Patient.

Richard J Chen, Muhammad Ershad, Maricel Dela Cruz, Ahmed Mamdouh Taha Mostafa,

Carbamazepine is an antiepileptic drug that can cause seizures in overdose. In certain patient populations, this may be misdiagnosed as a seizure disorder. We describe a case of a 20-month-old female who presented with fever and seizure-like activity who was initially thought to have complex febrile seizures. Further historical information ... Read more >>

Case Rep Emerg Med (Case Reports in Emergency Medicine)
[2020, 2020:]

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Arrhythmias in Severe Trazodone Overdose.

Kyaw Khaing Soe, Mark Young Lee,

BACKGROUND Trazodone is widely used in the treatment of depression, anxiety, and insomnia. It is thought to have a safe cardiac profile due to the relative lack of anticholinergic effects. Publications about cardiac toxicities of trazodone are scant. CASE REPORT A 55-year-old woman presented with acute disorder of consciousness secondary ... Read more >>

Am J Case Rep (The American journal of case reports)
[2019, 20:1949-1955]

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Drug interactions with cannabinoids.

Tony Antoniou, Jack Bodkin, Joanne M-W Ho,

CMAJ (CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne)
[2020, 192(9):E206]

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Association between anticholinergic (atropinic) drug exposure and cognitive function in longitudinal studies among individuals over 50 years old: a systematic review.

Laurine Andre, Adeline Gallini, François Montastruc, Jean-Louis Montastruc, Antoine Piau, Maryse Lapeyre-Mestre, Virginie Gardette,

PURPOSE:With increasing age, adults are often exposed to anticholinergic drugs and are prone to potential adverse drug reaction, among which cognitive impairment. If the short-term cognitive effects of anticholinergic drugs are well established, their long-term cognitive effects have less been studied. OBJECTIVE:To provide a systematic review of longitudinal studies which ... Read more >>

Eur. J. Clin. Pharmacol. (European journal of clinical pharmacology)
[2019, 75(12):1631-1644]

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Systemic infection and microglia activation: a prospective postmortem study in sepsis patients.

D Westhoff, J Y Engelen-Lee, I C M Hoogland, E M A Aronica, D J van Westerloo, D van de Beek, W A van Gool,

Background:Systemic infection is associated with long-term cognitive deficits and functional decline. In this study we hypothesized that severe systemic inflammation leads to a neuroinflammatory response that is characterized by microglial activation, and that these effects might be more pronounced in patients using medication with anticholinergic side-effects. Methods:Based on the results ... Read more >>

Immun Ageing (Immunity & ageing : I & A)
[2019, 16:18]

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Topical Glycopyrronium Tosylate in Primary Axillary Hyperhidrosis: A Profile of Its Use.

Yvette N Lamb,

Glycopyrronium tosylate (Qbrexza™) is available as single-use, pre-moistened cloths and has been approved in the USA for the topical treatment of primary axillary hyperhidrosis in adults and children ≥ 9 years of age. Glycopyrronium tosylate is effective in reducing patient-reported severity of disease and gravimetrically measured sweat production in this patient population; improvements ... Read more >>

Clin Drug Investig (Clinical drug investigation)
[2019, 39(11):1141-1147]

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Antiepileptic Overdose.

Shakuntala Murty,

Antiepileptics include various groups of drugs that have different mechanisms of actions and adverse effects. They are often also used to treat other disorders such as psychosis, chronic pain, and migraine. The most common drugs implicated in overdose include phenytoin, sodium valproate, carbamazepine, and phenobarbital. Common signs of toxicity of ... Read more >>

Indian J Crit Care Med (Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine)
[2019, 23(Suppl 4):S290-S295]

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Brazilian consensus in enuresis-recomendations for clinical practice.

José Murillo Bastos, Atila Victal Rondon, George Rafael Martins de Lima, Miguel Zerati, Edison Daniel Schneider-Monteiro, Carlos Augusto F Molina, Adriano de Almeida Calado, Ubirajara Barroso,

INTRODUCTION:Enuresis, defined as an intermittent urinary incontinence that occurs during sleep, is a frequent condition, occurring in about 10% of children at 7 years of age. However, it is frequently neglected by the family and by the primary care provider, leaving many of those children without treatment. Despite of many ... Read more >>

Int Braz J Urol (International braz j urol : official journal of the Brazilian Society of Urology)
[2019, 45(5):889-900]

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Medication burden and inappropriate prescription risk among elderly with advanced chronic kidney disease.

Clarisse Roux-Marson, Jean Baptiste Baranski, Coraline Fafin, Guillaume Exterman, Cecile Vigneau, Cecile Couchoud, Olivier Moranne, P S P A Investigators,

BACKGROUND:Elderly patients with chronic kidney disease (CKD) frequently present comorbidities that put them at risk of polypharmacy and medication-related problems. This study aims to describe the overall medication profile of patients aged ≥75 years with advanced CKD from a multicenter French study and specifically the renally (RIMs) and potentially inappropriate-for-the-elderly medications ... Read more >>

BMC Geriatr (BMC geriatrics)
[2020, 20(1):87]

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Barriers and facilitators to reducing anticholinergic burden from the perspectives of patients, their carers, and healthcare professionals: A protocol for qualitative evidence synthesis.

Carrie Stewart, Katie Gallacher, Athagran Nakham, Moira Cruickshank, Rumana Newlands, Christine Bond, Phyo Kyaw Myint, Debi Bhattacharya, Frances S Mair,

Anticholinergic drugs are prescribed for a range of conditions including gastrointestinal disorders, overactive bladder, allergies, and depression. While in some circumstances anticholinergic effects are therapeutic, they also pose many undesired or adverse effects. The overall impact from concomitant use of multiple medications with anticholinergic properties is termed anticholinergic burden (ACB). ... Read more >>

J Evid Based Med (Journal of evidence-based medicine)
[2019, 12(3):227-231]

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What urologists need to know about ketamine-induced uropathy: A systematic review.

Daniele Castellani, Giacomo M Pirola, Marilena Gubbiotti, Emanuele Rubilotta, Kalyan Gudaru, Andrea Gregori, Marco Dellabella,

AIMS:Ketamine is a general anesthetic. Dissociative effects and low cost led ketamine becoming an illegal recreational drug in young adults. Ketamine-induced uropathy (KIU) is one of the complications observed in abusers. This study aimed to provide a systematic literature review on KIU clinical presentation, pathophysiology, and treatments. METHODS:We performed the ... Read more >>

Neurourol. Urodyn. (Neurourology and urodynamics)
[2020, :]

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High-Throughput Small Molecule Screen Identifies Modulators of Mitochondrial Function in Neurons.

Boglarka H Varkuti, Ze Liu, Miklos Kepiro, Rodrigo Pacifico, Yunchao Gai, Ted Kameneka, Ronald L Davis,

We developed a high-throughput assay for modulators of mitochondrial function in neurons measuring inner mitochondrial membrane potential (ΔΨm) and ATP production. The assay was used to screen a library of small molecules, which led to the identification of structural/functional classes of mitochondrial modulators such as local anesthetics, isoflavones, COXII inhibitors, ... Read more >>

iScience (iScience)
[2020, 23(3):100931]

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Pinnatoxins' Deleterious Effects on Cholinergic Networks: From Experimental Models to Human Health.

Nicolas Delcourt, Emmeline Lagrange, Eric Abadie, Valérie Fessard, Jean-Marc Frémy, Jean-Paul Vernoux, Marie-Bénédicte Peyrat, Thomas Maignien, Nathalie Arnich, Jordi Molgó, César Mattei,

Pinnatoxins (PnTXs) are emerging neurotoxins that were discovered about 30 years ago. They are solely produced by the marine dinoflagellate Vulcanodinium rugosum, and may be transferred into the food chain, as they have been found in various marine invertebrates, including bivalves. No human intoxication has been reported to date although ... Read more >>

Mar Drugs (Marine drugs)
[2019, 17(7):]

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Refining the Definition of Polypharmacy and Its Link to Disability in Older Adults: Conceptualizing Necessary Polypharmacy, Unnecessary Polypharmacy, and Polypharmacy of Unclear Benefit.

Eric A Lee, Jeffrey W Brettler, Michael H Kanter, Steven G Steinberg, Peter Khang, Christopher C Distasio, John Martin, Mark Dreskin, Nolan H Thompson, Timothy M Cotter, Kim Thai, Lyn Yasumura, Nancy E Gibbs,

The term polypharmacy in older adults is generally used in a pejorative context in the medical literature. Because of its link to geriatric syndromes and disability, the avoidance of polypharmacy is usually recommended in older adults as a strategy to optimize functional status. However, there are many polypharmacy regimens based ... Read more >>

Perm J (The Permanente journal)
[2020, 24:]

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A retrospective evaluation of the association between potentially inappropriate prescribing and adverse drug reactions among hospitalized elderly Nigerians

Ajibola Sule Saka, Frasia Oosthuizen, Manimbulu Nlooto,

<title>Abstract</title> <p> Background Potentially inappropriate prescribing is associated with adverse clinical outcomes in the elderly. The Beers Criteria were developed to improve the quality of medication prescribing and safety to the elderly. However, the nexus between the Criteria’s potentially inappropriate medicines (PIMs) and adverse drug reactions (ADRs) remains ... Read more >>

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Serotonin syndrome triggered by postoperative administration of serotonin noradrenaline reuptake inhibitor (SNRI).

Junko Takata, Tomoko Arashi, Ayako Abe, Shoko Arai, Naoko Haruyama,

BACKGROUND:Serotonin syndrome is a rare but potentially severe disease, which is caused by hyperstimulation of serotonin receptors in the central nervous system. Several antidepressants exert their effect by modulating intrasynaptic serotonin concentration and anesthetics may affect the metabolism of serotonin, implicating to induce serotonin syndrome in patients taking those antidepressants. ... Read more >>

JA Clin Rep (JA clinical reports)
[2019, 5(1):55]

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Adaptation of potentially preventable medication-related hospitalisation indicators for Indigenous populations in Australia using a modified Delphi technique.

Jean Marie Spinks, Lisa M Kalisch Ellett, Geoffrey Spurling, Theo Theodoros, Daniel Williamson, Amanda J Wheeler,

OBJECTIVES:One of the outcomes of a medication review service is to identify and manage medication-related problems (MRPs). The most serious MRPs may result in hospitalisation, which could be preventable if appropriate processes of care were adopted. The aim of this study was to update and adapt a previously published set ... Read more >>

BMJ Open (BMJ open)
[2019, 9(11):e031369]

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Urine tropenol ester levels in workers handling tiotropium bromide synthesis: implications for exposure prevention and biomonitoring.

Axel Muttray, Michael Schneider, Bernd Roßbach,

Tropenol ester is a highly toxic anticholinergic substance and an intermediate used in industrial production of the bronchodilator tiotropium bromide. The aim of this study was to systematically test workers involved in its production for tropenol ester in urine to identify any exposure pathways and define additional preventive measures. Twelve ... Read more >>

Arh Hig Rada Toksikol (Arhiv za higijenu rada i toksikologiju)
[2019, 70(2):118-122]

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Local and generalized sensitization of thermally evoked defensive behavior in caterpillars.

Ritwika Mukherjee, Barry A Trimmer,

In addition to camouflage and chemical toxicity, many caterpillars defend themselves against predators with sudden sharp movements. For smaller species, these movements propel the body away from the threat, but in larger caterpillars, such as the tobacco hornworm, Manduca sexta, the movement is a defensive strike targeted to a noxious ... Read more >>

J. Comp. Neurol. (The Journal of comparative neurology)
[2020, 528(5):805-815]

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Prescribing issues in older adults living with HIV: thinking beyond drug-drug interactions with antiretroviral drugs.

Françoise Livio, Catia Marzolini,

Ther Adv Drug Saf (Therapeutic advances in drug safety)
[2019, 10:2042098619880122]

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Efficacy and Safety of Tolterodine and Pilocarpine in Patients with Overactive Bladder.

Kwang Jin Ko, Khae Hawn Kim, Sae Woong Kim, Sun-Ouck Kim, Ju Tae Seo, Myung-Soo Choo, Jeong Zoo Lee, Seung-June Oh, Hyeong Gon Kim, Kweon Sik Min, Jeong Hoon Kim, Kyu-Sung Lee,

PURPOSE:We evaluated the efficacy and safety of a combination of 2 mg tolterodine and 9 mg pilocarpine, vs tolterodine monotherapy in patients with overactive bladder. MATERIALS AND METHODS:We enrolled patients with overactive bladder symptoms in a multicenter, randomized, double-blind, parallel, active control study. Patients were randomized to the combination or ... Read more >>

J. Urol. (The Journal of urology)
[2019, 202(3):564-573]

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