9 results on '"Serum drug concentration"'
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2. Rekomendacje Polskiego Towarzystwa Psychiatrycznego dotyczące leczenia zaburzeń afektywnych u kobiet w wieku rozrodczym. Część II: Choroba afektywna dwubiegunowa.
- Author
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Rybakowski, Janusz, Cubała, Wiesław Jerzy, Gałecki, Piotr, Rymaszewska, Anna, Samochowiec, Jerzy, Szulc, Agata, and Dudek, Dominika
- Abstract
In the article, the recommendations of the Polish Psychiatric Association regarding pharmacological treatment of women with bipolar disorder during pregnancy and postpartum period were presented. The issue pertains to every twentieth woman wanting to get pregnant. Before planned pregnancy, it is advisable to obtain a several-month stabilization of psychiatric state, to establish treatment with one mood-stabilizing drug (except for valproate and carbamazepine) or gradual discontinuation of drugs in case of mild course of illness and lack of recurrences in recent two years. In the first trimester of pregnancy, the dose of the mood-stabilizing drug should be reduced (lithium carbonate to 500 mg/day). Depression during pregnancy can be treated with quetiapine or lamotrigine or with antidepressant drug added to a mood-stabilizing drug. Atypical antipsychotics drugs with mood-stabilizing properties can be used in case of (hypo) manic or mixed states. Following the delivery, it is advisable to introduce a moodstabilizing drug as soon as possible to prevent postpartum psychiatric disturbances. In the treatment of postpartum depression, quetiapine can be used or an antidepressant drug added to a mood-stabilizer. Considering breastfeeding, it should be remembered that the infant/maternal ratio of serum drug concentration is low for valproate, olanzapine, quetiapine, sertraline and paroxetine, and high for lithium and lamotrigine. In the case of postpartum psychosis, a hospitalization and antipsychotic treatment are needed. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
3. Recommendations of the Polish Psychiatric Association regarding the treatment of affective disorders in women of childbearing age : part II: Bipolar disorder
- Subjects
bipolar disorder ,okres okołoporodowy ,choroba afektywna dwubiegunowa ,pregnancy ,ciąża ,perinatal period - Abstract
In the article, the recommendations of the Polish Psychiatric Association regarding pharmacological treatment of women with bipolar disorder during pregnancy and postpartum period were presented. The issue pertains to every twentieth woman wanting to get pregnant. Before planned pregnancy, it is advisable to obtain a several-month stabilization of psychiatric state, to establish treatment with one mood-stabilizing drug (except for valproate and carbamazepine) or gradual discontinuation of drugs in case of mild course of illness and lack of recurrences in recent two years. In the first trimester of pregnancy, the dose of the mood-stabilizing drug should be reduced (lithium carbonate to 500 mg/day). Depression during pregnancy can be treated with quetiapine or lamotrigine or with antidepressant drug added to a mood-stabilizing drug. Atypical antipsychotics drugs with mood-stabilizing properties can be used in case of (hypo) manic or mixed states. Following the delivery, it is advisable to introduce a moodstabilizing drug as soon as possible to prevent postpartum psychiatric disturbances. In the treatment of postpartum depression, quetiapine can be used or an antidepressant drug added to a mood-stabilizer. Considering breastfeeding, it should be remembered that the infant/maternal ratio of serum drug concentration is low for valproate, olanzapine, quetiapine, sertraline and paroxetine, and high for lithium and lamotrigine. In the case of postpartum psychosis, a hospitalization and antipsychotic treatment are needed.
- Published
- 2019
4. Recommendations of the Polish Psychiatric Association regarding the treatment of affective disorders in women of childbearing age. Part II: Bipolar disorder.
- Author
-
Rybakowski J, Cubała WJ, Gałecki P, Rymaszewska J, Samochowiec J, Szulc A, and Dudek D
- Subjects
- Female, Humans, Pregnancy, Poland, Societies, Medical, Antipsychotic Agents therapeutic use, Bipolar Disorder drug therapy, Bipolar Disorder prevention & control, Pregnancy Complications drug therapy, Pregnancy Complications prevention & control
- Abstract
In the article, the recommendations of the Polish Psychiatric Association regarding pharmacological treatment of women with bipolar disorder during pregnancy and postpartum period were presented. The issue pertains to every twentieth woman wanting to get pregnant. Before planned pregnancy, it is advisable to obtain a several-month stabilization of psychiatric state, to establish treatment with one mood-stabilizing drug (except for valproate and carbamazepine) or gradual discontinuation of drugs in case of mild course of illness and lack of recurrences in recent two years. In the first trimester of pregnancy, the dose of the mood-stabilizing drug should be reduced (lithium carbonate to 500 mg/day). Depression during pregnancy can be treated with quetiapine or lamotrigine or with antidepressant drug added to a mood-stabilizing drug. Atypical antipsychotics drugs with mood-stabilizing properties can be used in case of (hypo) manic or mixed states. Following the delivery, it is advisable to introduce a moodstabilizing drug as soon as possible to prevent postpartum psychiatric disturbances. In the treatment of postpartum depression, quetiapine can be used or an antidepressant drug added to a mood-stabilizer. Considering breastfeeding, it should be remembered that the infant/maternal ratio of serum drug concentration is low for valproate, olanzapine, quetiapine, sertraline and paroxetine, and high for lithium and lamotrigine. In the case of postpartum psychosis, a hospitalization and antipsychotic treatment are needed.
- Published
- 2019
- Full Text
- View/download PDF
5. [Intoxication with tricyclic antidepressants in 2000: regional toxicological poison data from the center in Lublin].
- Author
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Gołacka E
- Subjects
- Adolescent, Adult, Aged, Catchment Area, Health, Drug Overdose, Female, Humans, Male, Middle Aged, Poland epidemiology, Antidepressive Agents, Tricyclic poisoning, Cardiovascular Diseases chemically induced, Cardiovascular Diseases epidemiology
- Abstract
The thirty eight tricyclic antidepressants (TCA) intoxicated patients were hospitalised during 2002 year in the Regional Toxicological Center in Lublin. The attempted suicides were the reason of administrating TCA drugs. All hospitalised patients did not suffer from cardio-vascular diseases. Analyzing the cases of patients intoxicated with TCA we took into account: heart rate, blood pressure, ECG record--QRS, QT, PQ, ST abnormalities, blood gases ((pH, pCO2, pO2, saturation), and serum drug concentration. The 50% of our TCA intoxicated patients demonstrated cardio-vascular symptoms confirming our expectations.
- Published
- 2003
6. [Effect of therapeutic drug monitoring of amitriptyline and genotyping on efficacy and safety of depression therapy].
- Author
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Ostapowicz A, Zejmo M, Wrześniewska J, Białecka M, Górnik W, and Gawrońska-Szklarz B
- Subjects
- Adult, Female, Humans, Male, Middle Aged, Polymorphism, Genetic genetics, Treatment Outcome, Amitriptyline blood, Amitriptyline therapeutic use, Antidepressive Agents, Tricyclic blood, Antidepressive Agents, Tricyclic therapeutic use, Cytochrome P-450 CYP2D6 genetics, Depressive Disorder drug therapy, Drug Monitoring methods, Genotype
- Abstract
Modern pharmacotherapy is based on precise adjustment of a dosage schedule to individual requirements of patient. Therapeutic drug monitoring is a method that allows for a more effective treatment approach, especially in the case of a narrow therapeutic index of a drug. Tricyclic antidepressant drugs are characterised by narrow therapeutic index as well as relationship between serum drug concentration and side effects. It was demonstrated that interindividual variability of blood concentrations of tricyclic antidepressant drugs is related to genetic polymorphism of oxidating enzymes participating in metabolism of these drugs. The aim of the study was to estimate the impact of therapeutic drug monitoring of tricyclic antidepressant drugs as well as genotyping on efficacy and safety of endogenous depression therapy. The study included 9 patients with established diagnosis of endogenous depression. Blood serum concentrations of amitryptyline was measured by fluorescence polarisation immune assay (FPIA, Abbott system). Genotype of cytochrome P450 isoenzyme CYP2D6 was determined using PCR-RFLP method. It was demonstrated that monitoring therapy of tricyclic antidepressant drugs in combination with determination of the genotype seems to be more safe and effective. Monitoring therapy and genotyping may be less expensive than the costs of prolonged hospitalisation and risk of side effects.
- Published
- 2000
7. [Cardura XL--a unique drug formulation--doxazosine administered in a slow-release form (doxazosine GITS)].
- Author
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Grzeszczak W
- Subjects
- Adrenergic alpha-Antagonists adverse effects, Adrenergic alpha-Antagonists pharmacokinetics, Adult, Aged, Area Under Curve, Delayed-Action Preparations, Doxazosin adverse effects, Doxazosin pharmacokinetics, Female, Humans, Hypertension complications, Intestinal Absorption, Male, Adrenergic alpha-Antagonists administration & dosage, Doxazosin administration & dosage, Hypertension drug therapy
- Abstract
An active component in the tablet Cardura XL is doxazosine. Doxazosine belongs to the third generation of alpha 1-adrenolytics. It is a blocker of post-synaptic alpha 1-receptors both in humans and in animals. It is a long acting preparation. A tablet cover of Cardura XL is built of two layers (GITS system). It has enabled administration of doxazosine once a day. A great advance of the GITS system is a verly slow and systematic release of the drug from the tablet. This release is independent of pH of gastro-intestinal content or peristalsis. After administration of the tablet of Cardura XL, over 85% of the drug is released after 12 hours and the release ends after 12-16 hours. Maximal serum drug level after administration of doxazosine GITS is observed after 14-16 hours. Higher maximal serum drug level is achieved when the drug is administered together with a meal. Using doxazosine in the GITS form, minimal and maximal serum drug levels during the whole 24 hours differ non significantly. GITS technology enabled achieving stable daily serum drug concentration. Introducing doxazosine GITS caused: 1. decrease of Cmax; 2. elongation of Tmax; and 3. decrease of Cmin compared to doxazosine. It became possible due to gradual absorption of the preparation from gastrointestinal tract and improved coefficient of the drug fluctuation. It should be stated that the described pharmacological differences of doxazosine GITS in younger and elderly, in female and male patients do not influence significantly initial dosing of the drug. Stenosis of the gastrointestinal tract or chronic diarrhea affecting bowel passage of the drug, change its therapeutic effect. An effect of doxazosine GITS, doxazosine and placebo on blood pressure was studied in 392 patients with mild and moderate hypertension (< or = 220/95-115 mm Hg). Doxazosine GITS similarly to doxazosine effectively decreases blood pressure. The value of diastolic blood pressure decrease increases together with the therapy duration. Use of the unique GITS technology assures stable daily serum drug concentration. It results in: mild but permanent decrease of the blood pressure, decreased risk of side-effects, including orthostatic hypotony. Based on the performed post-registration studies it should be stated that doxazosine GITS is not only a very effective but also a safe preparation, which may be administered once daily. The treatment should be initialized with a dose of 4 mg daily. In as much as 60% of the patients with mild or moderate arterial hypertension, an initial dose (4 mg of Cardura XL) effectively lowers blood pressure. Taking into consideration unique features of the described preparation, it is worth thinking of Cardura XL while initializing or switching therapy in hypertensive patients. Cardura XL, due to favourable metabolic effects as well as the unique GITS technology seems to be the drug particularly suitable in hypertensive patients with accompanying dyslipidaemia, diabetes mellitus type 2 and/or benign prostata hypertrophy.
- Published
- 2000
8. [The effect of monotherapy on concentration of selected blood serum hormones and upon cognitive function of children with epilepsy].
- Author
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Kaciński M
- Subjects
- Adolescent, Child, Epilepsy physiopathology, Female, Follow-Up Studies, Humans, Male, Psychomotor Performance drug effects, Regression Analysis, Carbamazepine therapeutic use, Cognition drug effects, Epilepsy drug therapy, Phenobarbital therapeutic use, Primidone therapeutic use, Thyroid Hormones blood
- Abstract
The studies included 64 children with newly diagnosed epilepsy, aged from 6 to 15 years of life. In 25 children with partial and secondary generalized seizures monotherapy with carbamazepine was introduced; in 19 children with primary generalized seizures--with phenobarbital, and in patients with both types of seizures--with primidone. Monotherapy was controlled by means of blood serum drug concentration level monitoring; the therapy was successful in all the children. The group did not include patients with mental retardation, and epilepsy was idiopathic. Prior to the institution of treatment, a single determination of blood serum triiodothyronine, thyroxine, TSH, prolactin, cortisol, LH and testosterone was made. Psychological test were carried out employing Wechsler's scale, Bender-Santucci test, rhythmic structures developed by Mira Stambak and test of manual dexterity (card display). In order to evaluate short-term effects of the employed drugs upon the blood serum concentration values of the studied hormones, a repeated determination was made one month after the initiation of therapy. The third determination was made one year after the onset of treatment in order to assess the long-term effects. The effect of drugs upon their cognitive functions was assessed in a follow-up psychological testing performed after one year of therapy. The studies combined with statistical analysis led to a conclusion that after one month of monotherapy there occurred a significant drop in thyroxine concentration levels, still augmented after one year. Patients treated with carbamazepine showed a significant decrease of T3 levels after one month and one year, whereas treatment with phenobarbital and primidone did not result in significant changes of T3 concentration. Yet, T3 and T4 concentration values did not exceed normal limits. No type of monotherapy resulted in significant long-term changes of TSH concentration levels. No clinical signs of hypothyroidism nor goiter were observed in the studied children. After one month of monotherapy with carbamazepine and phenobarbital there was observed a significant increase of prolactin and cortisol levels, which was absent after one year. The values observed did lie within normal limits. No significant changes were observed with respect to the effect of the studied drugs upon blood serum LH and testosterone levels. After a one-year monotherapy with primidone the children revealed a significant improvement of results measured on performance scale and by means of a full Wechsler scale. Carbamazepine and phenobarbital did not affect the intelligence quotient of the studied children.(ABSTRACT TRUNCATED AT 400 WORDS)
- Published
- 1992
9. [The HDL cholesterol level in patients treated with antiepileptic drugs].
- Author
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Niedzielska K, Rosnowska M, and Wehr H
- Subjects
- Adolescent, Adult, Alcoholism complications, Epilepsy complications, Epilepsy drug therapy, Female, Humans, Male, Middle Aged, Sex Factors, Alcoholism blood, Anticonvulsants therapeutic use, Cholesterol, HDL blood, Epilepsy blood, Hyperlipoproteinemias chemically induced
- Abstract
Total cholesterol, HDL cholesterol, and HDL2 and HDL3 cholesterol were estimated in individuals undergoing anticonvulsant therapy. Significantly higher, than in the corresponding control groups HDL concentration, concerning mainly HDL2 subfraction was found in female epileptic and in male alcoholic epileptic patients. It was observed that higher drug levels were accompanied by higher HDL cholesterol values. In alcohol addicted subjects undergoing anticonvulsant therapy low-nontherapeutic serum drug concentration was often observed. In spite of this, HDL levels were high. This could result from an additional induction of cytochrome P-450 caused by alcohol and an accelerated oxidation of the drugs. This observation indicates that frequent control of drug concentration in these patients is desirable.
- Published
- 1989
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