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ZOFRAN  Tablets, Oral Solution and Injection PRODUCT MONOGRAPH
ZOFRAN Tablets, Oral Solution and Injection PRODUCT MONOGRAPH

... Serotonin syndrome/Neuroleptic Malignant Syndrome-like events: Cases of lifethreatening serotonin syndrome or neuroleptic malignant syndrome-like events have been reported with 5-HT3 receptor antagonist antiemetics, including ZOFRAN® and ZOFRAN® ODT, when given in combination with other serotonergic ...
100 Essential Drugs - University of Toledo
100 Essential Drugs - University of Toledo

... MOA: for antidepressant effect: it may decrease supersensitivity of dopamine receptors, increase acetylcholine, enhance 5-HT activity for depression; for anti-mania effect: it may prevent recycling of phosphoinositides, thereby causing depletion of IP3 and DAG, which diminishes excess catecholamines ...
LSD (Lysergic acid diethylamide), death? and distraction
LSD (Lysergic acid diethylamide), death? and distraction

... – Cardiovascular – mild increases in heart rate or blood pressure – may be secondary to anxiety or restlessness; require only supportive care ...
ACMD Advisory Council on the Misuse of Drugs  ACMD consideration of tramadol
ACMD Advisory Council on the Misuse of Drugs ACMD consideration of tramadol

... resulting from inhibition of re-uptake of both noradrenaline and serotonin and from some agonist activity at α2_adrenergic receptors. The fact that, in contrast to other opioids, the analgesic action of tramadol is only partially inhibited by the opioid antagonist naloxone lends support to the view ...
Which neuroreceptors mediate the subjective effects of MDMA in
Which neuroreceptors mediate the subjective effects of MDMA in

... intravenously) in 16 subjects, the 5-HT2 antagonist ketanserin (50 mg orally) in 14 subjects, and the D2 antagonist haloperidol (1.4 mg intravenously) in 14 subjects. Each of these studies used a double-blind placebo-controlled within-subject design and all subjects were examined under placebo, pret ...
PRODUCT MONOGRAPH PrZOLOFT® (sertraline hydrochloride) 25
PRODUCT MONOGRAPH PrZOLOFT® (sertraline hydrochloride) 25

... monoamine oxidase - RIMA), moclobemide and linezolid,an antibiotic which is a reversible nonselective MAOI and methylthioninium chloride (methylene blue), which is a MAOI. Some cases presented with features resembling the serotonin syndrome. Similar cases have been reported with other antidepressant ...
The Background and Chemistry ofMDMA
The Background and Chemistry ofMDMA

... iodine. MDMA was obtained, but the dimethylated tertiary amine and the trimethylated quarternary products were also generated as contaminants, Two procedures exist for the synthesis of MDMA by the reductive amination ofpiperonyl acetone with methylamine. The reducing agents are either sodium cyanobo ...
Restless Legs Syndrome
Restless Legs Syndrome

... RLS can be unpleasant and uncomfortable. However, there are some simple self-care approaches and lifestyle changes that can help in mild cases. RLS symptoms often improve with medical treatment. Research is ongoing to better understand the causes of RLS and to develop better treatments. What Causes ...
Xtram
Xtram

... Use with other serotonergic agents - the presence of another drug that increases serotonin by any mechanism should alert the treating physician to the possibility of an interaction. In isolated cases, there have been reports of serotonin syndrome in a temporal connection with the therapeutic use of ...
Medical Emergencies and Adverse Events in Ecstasy Users
Medical Emergencies and Adverse Events in Ecstasy Users

... above estimate. The researchers found that 8 of 329 users had presented to an ED with an ecstasy-related problem in the previous 6 months. Given the data in this report, it can be calculated (see Table 6.1) that there were at most 7305 episodes of ecstasy use by these users in this period. Because t ...
Campus Location: Wilmington Effective Date: 2018
Campus Location: Wilmington Effective Date: 2018

... See Core Curriculum Competencies and Program Graduate Competencies at the end of the syllabus. CCPOs are linked to every competency they develop. Measurable Performance Objectives (MPOs): Upon completion of this course, the student will: 1. Identify the general principles of pharmacology. ...
Product Monograph  January 4, 2017
Product Monograph January 4, 2017

... of 185 mg/m2) for approximately two years, although the study was not done with the Maximum Tolerated Dose. This finding is not believed to suggest risk in humans. No such finding occurred in a rat carcinogenicity study (dosing orally up to 30 mg/kg, 180 mg/m2, or 1 times the maximum daily human tra ...
Public Assessment Report Mutual Recognition Procedure DALSAN
Public Assessment Report Mutual Recognition Procedure DALSAN

... years. Citalopram has been marketed in EU since 1989 (Denmark), it has a well establwashed medicinal use, with recognized efficacy and acceptable level of safety. The originator's (H. Lundbeck's) citalopram product has been authorised and marketed under different brand names in different member stat ...
the mechanism of acupuncture and clinical applications
the mechanism of acupuncture and clinical applications

... It has been determined that electroacupuncture (EA) application causes the secretion of endorphin, which plays a role in producing the analgesic effect of hypophysis (Takeshige et al., 1992). It also plays a role in the increase of the endorphin level in plasma and the central nervous system (Jin et ...
EVALUATION OF ANTIDEPRESSANT EFFECT OF CHRONIC ADMINISTRATION OF TRAMADOL
EVALUATION OF ANTIDEPRESSANT EFFECT OF CHRONIC ADMINISTRATION OF TRAMADOL

... antidepressants produce effect on brain monoaminergic system. The clinically used analgesic Tramadol apart from having effect on µ type opioid receptors, also have monoaminergic uptake blockade effect. Hence, the present study was carried out to evaluate the antidepressant activity of Tramadol in Ta ...
drugs used in migraine
drugs used in migraine

... Migraine with aura • This is the second most commonly seen form of migraine: patients who primarily suffer from migraine with aura may also have attacks of migraine without aura. According to the International Classification of Headache Disorders it is a recurrent disorder manifesting in attacks of ...
Quinidine Revisited
Quinidine Revisited

... reconsidered given the promising synergy with verapamil. (OR 2.29; 95% CI, 1.05-5.01, P ⫽ .04). In the Suppression of Paroxysmal Atrial TachyarrhythIn addition to the concerns regarding the use of quinidine mias Trial (SOPAT), a fixed combination of quinidine and for atrial fibrillation, there was g ...
Reynolds-Psych-Panels-11-20-12
Reynolds-Psych-Panels-11-20-12

... Rapid metabolism expected, especially in smokers. Consider dose increases for medications inactivated by CYP1A2 particularly in smokers, or alternative medications not metabolized by CYP1A2. Common CYP1A2 medications below. ...
In Vivo Criteria To Differentiate Monoamine Reuptake Inhibitors from
In Vivo Criteria To Differentiate Monoamine Reuptake Inhibitors from

... al., 1995). It is unlikely that this would be a property of releasing agents, assuming that they produce depolarizationindependent release of 5-HT. 4) Because both reuptake inhibitors and releasing agents such as fenfluramine bind to the 5-HT carrier, pretreatment with reuptake inhibitors can attenu ...
PAXIL CR™ PRODUCT MONOGRAPH
PAXIL CR™ PRODUCT MONOGRAPH

... Monoamine Oxidase Inhibitors: In patients receiving serotonin reuptake inhibitors (SSRIs) in combination with a MAO inhibitor, there have been reports of serious, sometimes fatal, reactions including hyperthermia, rigidity, myoclonus, autonomic instability with possible rapid fluctuations of vital s ...
Quinine toxicity identified after 40 years
Quinine toxicity identified after 40 years

... denervation hypersensitive pupil response to 0.125% pilocarpine.19 These pupil effects may be due to the direct toxic effect of quinine to the iris parasympathetic nerves, the neuromuscular junction of the iris, or the sphincter pupillae, or they may be due to the curare-like effects of quinine, inh ...
MDMA (Ecstasy) - cloudfront.net
MDMA (Ecstasy) - cloudfront.net

... MDMA is rapidly absorbed into the human bloodstream, but once in the body, MDMA metabolites interfere with the body's ability to metabolize, or break down, the drug.8 As a result, additional doses of MDMA can produce unexpectedly high blood levels, which could worsen the cardiovascular and other tox ...
Behavioural analysis of the acute and chronic effects of MDMA
Behavioural analysis of the acute and chronic effects of MDMA

... Both clinical depression and age-related cognitive impairments (Fischer et al. 1995) are associated with reductions in 5-HT markers and may be amenable to treatment with drugs acting through the 5-HT system. Therefore, an improved understanding of the long-term consequences of MDMA exposure is of si ...
Product Monograph
Product Monograph

... When discontinuing treatment, patients should be monitored for symptoms which may be associated with discontinuation. The risk of discontinuation symptoms may be dependent on several factors, including the duration and dose of therapy and the rate of dose reduction. Dizziness, sensory disturbances ( ...
Product Monograph Template - Standard
Product Monograph Template - Standard

... When discontinuing treatment, patients should be monitored for symptoms which may be associated with discontinuation. The risk of discontinuation symptoms may be dependent on several factors, including the duration and dose of therapy and the rate of dose reduction. Dizziness, sensory disturbances ( ...
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Serotonin syndrome



Serotonin syndrome is a potential symptom of any number of life-threatening drug interactions which may follow therapeutic drug use, combination, overdose of particular drugs, or the recreational use of certain drugs. Serotonin syndrome is not an idiopathic drug reaction; it is a predictable consequence of excess serotonin on the CNS and/or peripheral nervous system. For this reason, some experts strongly prefer the terms serotonin toxicity or serotonin toxidrome which more accurately reflect that it is a form of poisoning. Other names include serotonin sickness, serotonin storm, serotonin poisoning, hyperserotonemia, or serotonergic syndrome.Excessive levels of serotonin produce a spectrum of specific symptoms including cognitive, autonomic, and somatic effects. Symptoms may range from barely perceptible to fatal. Numerous drugs and drug combinations have been reported to produce serotonin syndrome, though the exact mechanism is not well understood in many instances.Diagnosis includes observing symptoms and investigating patient history for causal factors (interacting drugs). The syndrome has a characteristic picture but can be mistaken for other illnesses in some people, particularly those with neuroleptic malignant syndrome. No laboratory tests can currently confirm the diagnosis. Hence it is diagnosed based on symptoms, disease course (that is, the progression of the disease) and the exclusion of other possible causes of the presenting symptoms.Treatment consists of discontinuing medications which may contribute and in moderate to severe cases administering a serotonin antagonist. An important adjunct treatment includes controlling agitation with benzodiazepine sedation. The high-profile case of Libby Zion, who is generally accepted to have died from serotonin syndrome, resulted in changes to graduate medical education in New York State.
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