419 results match your criteria Toxicity Clonidine


Clonidine Compounding Error: Bradycardia and Sedation in a Pediatric Patient.

J Emerg Med 2020 May 7. Epub 2020 May 7.

Harvard Medical Toxicology Fellowship, Boston Children's Hospital, Boston, Massachusetts; Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts.

Background: Clonidine is a centrally-acting α-2 agonist used in the treatment of hypertension and attention-deficit/hyperactivity disorder, among other off-label uses. In overdose, it can cause sedation, bradycardia, and hypotension. Clonidine can be compounded as a liquid formula for patients who are unable to take pills, however, this can add to the risk of dosing errors. Read More

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http://dx.doi.org/10.1016/j.jemermed.2020.04.027DOI Listing

A review of neuropsychiatric adverse events from topical ophthalmic brimonidine.

Authors:
N Cimolai

Hum Exp Toxicol 2020 Apr 29:960327120918307. Epub 2020 Apr 29.

Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada.

Brimonidine is a first-line topical medication for increased intraocular pressure and glaucoma which may be used alone or in conjunction with other topical therapies. Its structural and pharmacological comparabilities to clonidine give way to the hypothesis that it may cause neuropsychiatric side effects. The majority of case reports citing brimonidine toxicity, either for topical or peripheral exposure, include pediatric age groups but especially infants. Read More

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http://dx.doi.org/10.1177/0960327120918307DOI Listing

Studies on retinal mechanisms possibly related to myopia inhibition by atropine in the chicken.

Graefes Arch Clin Exp Ophthalmol 2020 Feb 26;258(2):319-333. Epub 2019 Dec 26.

Section of Neurobiology of the Eye, Ophthalmic Research Institute, University of Tuebingen, Tuebingen, Germany.

Purpose: While low-dose atropine eye drops are currently widely used to inhibit myopia development in children, the underlying mechanisms are poorly understood. Therefore, we studied possible retinal mechanisms and receptors that are potentially involved in myopia inhibition by atropine.

Methods: A total of 250 μg atropine were intravitreally injected into one eye of 19 chickens, while the fellow eyes received saline and served as controls. Read More

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http://dx.doi.org/10.1007/s00417-019-04573-yDOI Listing
February 2020

Safety and Efficacy of an On-Site Intensive Treatment Protocol for Mild and Moderate Sympathomimetic Toxicity at Australian Music Festivals.

Prehosp Disaster Med 2020 Feb 6;35(1):41-45. Epub 2019 Dec 6.

Edith Cowan University, School of Medical and Health Sciences, Joondalup, Western Australia, Australia.

Introduction: Serotonin and sympathomimetic toxicity (SST) after ingestion of amphetamine-based drugs can lead to severe morbidity and death. There have been evaluations of the safety and efficacy of on-site treatment protocols for SST at music festivals.

Problem: The study aimed to examine the safety and efficacy of treating patients with SST on-site at a music festival using a protocol adapted from hospital-based treatment of SST. Read More

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http://dx.doi.org/10.1017/S1049023X19005089DOI Listing
February 2020
5 Reads

Effects of 24 CYP2D6 variants found in Chinese population on the metabolism of clonidine in vitro.

Chem Biol Interact 2019 Nov 1;313:108840. Epub 2019 Oct 1.

Department of Pharmacology, School of Pharmacy of Wenzhou Medical University, Wenzhou, Zhejiang, China. Electronic address:

Background And Objectives: Clonidine has been clinically used to treat Tourette's syndrome for decades. There was research finding that clonidine possessed the best risk-benefit ratio, especially for patients associated with attention deficit hyperactivity disorder. CYP2D6 is a significant member of Cytochrome P450 enzymes. Read More

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http://dx.doi.org/10.1016/j.cbi.2019.108840DOI Listing
November 2019
6 Reads

Clinically Relevant Drug-Drug Interactions in Primary Care.

Am Fam Physician 2019 05;99(9):558-564

Medical College of Georgia at Augusta University, Augusta, GA, USA.

Drug interactions are common in the primary care setting and are usually predictable. Identifying the most important and clinically relevant drug interactions in primary care is essential to patient safety. Strategies for reducing the risk of drug-drug interactions include minimizing the number of drugs prescribed, re-evaluating therapy on a regular basis, considering nonpharmacologic options, monitoring for signs and symptoms of toxicity or effectiveness, adjusting dosages of medications when indicated, and adjusting administration times. Read More

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May 2019
15 Reads

Amphetamine and Clonidine Toxicity Resulting in Posterior Reversible Encephalopathy Syndrome.

Pediatr Emerg Care 2019 Apr 9. Epub 2019 Apr 9.

Emergency Medicine, and.

Amphetamine toxicity typically presents with hypertension and tachycardia. Conversely, clonidine acts as an agonist at central α2 and imidazoline receptors, which may cause brief initial hypertension followed by hypotension and bradycardia in overdose. We report a case of mixed ingestion resulting in posterior reversible encephalopathy syndrome (PRES) successfully treated with phentolamine. Read More

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http://dx.doi.org/10.1097/PEC.0000000000001819DOI Listing
April 2019
30 Reads

Caudal epidural blocks in paediatric patients: a review and practical considerations.

Br J Anaesth 2019 Apr 1;122(4):509-517. Epub 2019 Feb 1.

Department of Paediatric Anesthesia and Intensive Care, Section of Anaesthesiology and Intensive Care, Karolinska University Hospital, Stockholm, Sweden; Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.

Caudal epidural blockade in children is one of the most widely administered techniques of regional anaesthesia. Recent clinical studies have answered major pharmacodynamic and pharmacokinetic questions, thus providing the scientific background for safe and effective blocks in daily clinical practice and demonstrating that patient selection can be expanded to range from extreme preterm births up to 50 kg of body weight. This narrative review discusses the main findings in the current literature with regard to patient selection (sub-umbilical vs mid-abdominal indications, contraindications, low-risk patients with spinal anomalies); anatomical considerations (access problems, age and body positioning, palpation for needle insertion); technical considerations (verification of needle position by ultrasound vs landmarks vs 'whoosh' or 'swoosh' testing); training and equipment requirements (learning curve, needle types, risk of tissue spreading); complications and safety (paediatric regional anaesthesia, caudal blocks); local anaesthetics (bupivacaine vs ropivacaine, risk of toxicity in children, management of toxic events); adjuvant drugs (clonidine, dexmedetomidine, opioids, ketamine); volume dosing (dermatomal reach, cranial rebound); caudally accessed lumbar or thoracic anaesthesia (contamination risk, verifying catheter placement); and postoperative pain. Read More

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http://dx.doi.org/10.1016/j.bja.2018.11.030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435837PMC
April 2019
24 Reads

Evaluation of Antidepressant Effects on Recovery of Electrical Field Stimulation-Induced Contractions that have been Suppressed by Clonidine in Isolated Rat Vas Deferens.

Pharmacology 2019 29;103(3-4):189-201. Epub 2019 Jan 29.

Department of Chemical Pharmacology, Faculty of Pharmaceutical Sciences, Toho University, Funabashi, Japan,

Background: A report examining whether clinically available antidepressants increase urethral smooth muscle contraction via antagonistic effects on the α2-adrenoceptor (α2-AR) is lacking.

Objectives: The present study was performed to evaluate the potential of clinically available antidepressants to reverse α2-AR-mediated contractile inhibition in rat vas deferens, in order to predict whether they can induce voiding impairment.

Method: The effects of 18 antidepressants of different classes on electrical field stimulation (EFS)-induced contractions suppressed by 10-8 mol/L clonidine (a selective α2-AR agonist) in isolated rat vas deferens were investigated and related to their respective clinical blood concentrations. Read More

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http://dx.doi.org/10.1159/000495616DOI Listing
March 2019
10 Reads

High-Throughput Video Processing of Heart Rate Responses in Multiple Wild-type Embryonic Zebrafish per Imaging Field.

Sci Rep 2019 01 15;9(1):145. Epub 2019 Jan 15.

National Health and Environmental Effects Research Laboratory, US Environmental Protection Agency, Research Triangle Park, NC, USA.

Heart rate assays in wild-type zebrafish embryos have been limited to analysis of one embryo per video/imaging field. Here we present for the first time a platform for high-throughput derivation of heart rate from multiple zebrafish (Danio rerio) embryos per imaging field, which is capable of quickly processing thousands of videos and ideal for multi-well platforms with multiple fish/well. This approach relies on use of 2-day post fertilization wild-type embryos, and uses only bright-field imaging, circumventing requirement for anesthesia or restraint, costly software/hardware, or fluorescently-labeled animals. Read More

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http://www.nature.com/articles/s41598-018-35949-5
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http://dx.doi.org/10.1038/s41598-018-35949-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6333808PMC
January 2019
25 Reads

Cross-sectional survey of off-label and unlicensed prescribing for inpatients at a paediatric teaching hospital in Western Australia.

PLoS One 2019 8;14(1):e0210237. Epub 2019 Jan 8.

School of Pharmacy and Biomedical Sciences, Curtin University, Perth, Western Australia, Australia.

Objectives: To evaluate the prevalence of off-label and unlicensed prescribing in inpatients at a major paediatric teaching hospital in Western Australia and to identify which drugs are commonly prescribed off-label or unlicensed, including factors influencing such prescribing.

Methods: A retrospective cross-sectional study was conducted in June, 2013. Patient and prescribing data were collected from 190 inpatient medication chart records which had been randomly selected from all admissions during the second week of February 2013. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0210237PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6324807PMC
October 2019
11 Reads

Antiasthmatic potential of Zizyphus jujuba Mill and Jujuboside B. - Possible role in the treatment of asthma.

Respir Physiol Neurobiol 2019 02 3;260:28-36. Epub 2018 Dec 3.

R.C. Patel Institute of Pharmaceutical Education & Research, Shirpur, Dhule, 425405, India.

Zizyphus jujuba Mill, a famous oriental traditional medicine, has been reported to exhibit diverse activities in biological systems including the respiratory system. However, a little information is available on its antiasthmatic activity. Jujuboside B (JB) is a natural saponin and one of the active constituent of fruits of Zizyphus jujuba. Read More

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http://dx.doi.org/10.1016/j.resp.2018.12.001DOI Listing
February 2019
16 Reads

Clonidine exposures in children under 6 (2004-2017): a retrospective study.

Arch Dis Child 2019 03 13;104(3):287-291. Epub 2018 Nov 13.

New South Wales Poisons Information Centre, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.

Objective: To describe trends in clonidine exposures in children under 6. Clonidine has become increasingly popular for management of paediatric behavioural disorders. Clonidine has a narrow therapeutic index, and toxicity can occur with inadvertent double dosing. Read More

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http://adc.bmj.com/lookup/doi/10.1136/archdischild-2018-3160
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http://dx.doi.org/10.1136/archdischild-2018-316026DOI Listing
March 2019
32 Reads

Pharmacologic Treatment of Opioid Use Disorder: a Review of Pharmacotherapy, Adjuncts, and Toxicity.

J Med Toxicol 2018 12 30;14(4):306-322. Epub 2018 Oct 30.

Harvard Medical Toxicology Program, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.

Opioid use disorder continues to be a significant source of morbidity and mortality in the USA and the world. Pharmacologic treatment with methadone and buprenorphine has been shown to be effective at retaining people in treatment programs, decreasing illicit opioid use, decreasing rates of hepatitis B, and reducing all cause and overdose mortality. Unfortunately, barriers exist in accessing these lifesaving medications: users wishing to start buprenorphine therapy require a waivered provider to prescribe the medication, while some states have no methadone clinics. Read More

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http://link.springer.com/10.1007/s13181-018-0685-1
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http://dx.doi.org/10.1007/s13181-018-0685-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6242798PMC
December 2018
22 Reads

Clonidine Protects Against Neurotoxicity Induced by Sevoflurane Through NF-κB Signaling Inhibition and Proinflammatory Cytokine Release in Rats.

J Mol Neurosci 2018 Aug 2;65(4):507-513. Epub 2018 Aug 2.

Department of Anesthesia, the Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

Exposure of neonatal animals to anesthetics may cause developmental functional changes and acute structural anomalies in the brain. Clonidine, an α2-adrenoceptor agonist, functions as an analgesic and sedative and protects against brain injury. Nevertheless, whether clonidine protects the developing brain from damage caused by sevoflurane (SEVO) anesthesia remains unclear. Read More

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http://dx.doi.org/10.1007/s12031-018-1117-zDOI Listing
August 2018
12 Reads

Pharmacopuncture With Scolopendra subspinipes Suppresses Mechanical Allodynia in Oxaliplatin-Induced Neuropathic Mice and Potentiates Clonidine-induced Anti-allodynia Without Hypotension or Motor Impairment.

J Pain 2018 10 4;19(10):1157-1168. Epub 2018 Jun 4.

Dental Research Institute and Department of Neurobiology and Physiology School of Dentistry; Department of Brain and Cognitive Sciences College of Natural Sciences, Seoul National University, Seoul, Republic of Korea. Electronic address:

Chemotherapy-induced neuropathic pain is a common dose-limiting side effect of anticancerdrugs but lacks an effective treatment strategy. Scolopendra subspinipes has been used in traditional medicine to treat chronic neuronal diseases. Moreover, pharmacopuncture with S subspinipes (SSP) produces potent analgesia in humans and experimental animals. Read More

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http://dx.doi.org/10.1016/j.jpain.2018.04.015DOI Listing
October 2018
5 Reads

Naloxone reversal of clonidine toxicity: dose, dose, dose.

Clin Toxicol (Phila) 2018 10 16;56(10):873-879. Epub 2018 Mar 16.

b Tennessee Poison Center , Nashville , TN , USA.

Context: Following clonidine ingestion, naloxone is seldom administered as it is considered ineffective in reversing somnolence, bradycardia, or hypotension. However, this conclusion has been based on administration of small doses (2 mg or less) of naloxone. The somnolence is frequently treated with endotracheal intubation (ETI), a procedure with significant morbidity. Read More

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https://www.tandfonline.com/doi/full/10.1080/15563650.2018.1
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http://dx.doi.org/10.1080/15563650.2018.1450986DOI Listing
October 2018
48 Reads

Carrier-mediated uptake of clonidine in cultured human lung cells.

Naunyn Schmiedebergs Arch Pharmacol 2018 04 19;391(4):361-369. Epub 2018 Jan 19.

Institut de Recherches en Santé, Environnement et Travail (IRSET), UMR INSERM U1085, Université de Rennes 1, 2 Avenue du Pr Léon Bernard, 35043, Rennes, France.

The lung is a preferential organ site for accumulation of lipophilic basic amine drugs, so-called pneumophilic drugs and belonging to various pharmacological classes, which can result in lung toxicity. In order to investigate the mechanism involved in such pulmonary accumulation of drugs, uptake of clonidine, used here as a prototypical basic amine drug, was characterized in cultured human lung cells. Clonidine accumulation in lung alveolar A549 cells was found to be temperature- and pH-dependent; it was saturable, with a Michaelis-Menten affinity constant (Km) value of 569. Read More

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http://dx.doi.org/10.1007/s00210-018-1467-7DOI Listing
April 2018
17 Reads

Effect of Locally Administered Dexmedetomidine as Adjuvant to Levobupivacaine in Supraclavicular Brachial Plexus Block: Double-blind Controlled Study.

Anesth Essays Res 2017 Oct-Dec;11(4):981-986

Department of Anaesthesiology and Critical Care, BS Medical College, Bankura, West Bengal, India.

Context: Brachial plexus block is effective with good postoperative analgesia in upper limb surgery has gained importance as it safe, low cost, and maintains stable hemodynamics intraoperatively. To decrease the onset time and prolong the duration of nerve block bicarbonate, opioids (morphine, fentanyl, etc.), sympathomimetic agents (epinephrine, phenylephrine, etc. Read More

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http://dx.doi.org/10.4103/aer.AER_55_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735499PMC
December 2017
36 Reads

Antiallergic and antihistaminic actions of Ceasalpinia bonducella seeds: Possible role in treatment of asthma.

J Ethnopharmacol 2018 Apr 14;216:251-258. Epub 2017 Dec 14.

Department of Pharmacognosy, Pravara Rural College of Pharmacy, Loni 413736, Maharashtra, India.

Ethnopharmacological Relevance: Seed kernel of the plant Ceasalpinia bonducella Linn (Caesalpiniacaeae) are used for the treatment of asthma in folk medicine and ancient books.

Aim Of Study: To assess the pharmacological efficacy of the plant in asthma and to confine and describe the synthetic constituents from the seeds that are in charge of the action.

Material And Methods: The viability of petroleum ether, ethanol extract and ethyl acetate fraction from ethanol extract of C. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S03788741173043
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http://dx.doi.org/10.1016/j.jep.2017.12.007DOI Listing
April 2018
25 Reads

Pharmacological Approach for Managing Pain in Irritable Bowel Syndrome: A Review Article.

Anesth Pain Med 2017 Apr 25;7(2):e42747. Epub 2017 Jan 25.

Department of Biomedical Engineering, University of Connecticut, Storrs, CT 06269, USA.

Context: Visceral pain is a leading symptom for patients with irritable bowel syndrome (IBS) that affects 10% - 20 % of the world population. Conventional pharmacological treatments to manage IBS-related visceral pain is unsatisfactory. Recently, medications have emerged to treat IBS patients by targeting the gastrointestinal (GI) tract and peripheral nerves to alleviate visceral pain while avoiding adverse effects on the central nervous system (CNS). Read More

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http://dx.doi.org/10.5812/aapm.42747DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556397PMC
April 2017
26 Reads

Antidepressant-Like Effect of the Endogenous Neuroprotective Amine, 1MeTIQ in Clonidine-Induced Depression: Behavioral and Neurochemical Studies in Rats.

Neurotox Res 2017 Jul 3;32(1):94-106. Epub 2017 Apr 3.

Department of Neurochemistry, Institute of Pharmacology Polish Academy of Sciences, 12 Smętna Street, 31-343, Kraków, Poland.

Biogenic amines such as norepinephrine, dopamine, and serotonin play a well-described role in the treatment of mood disorders especially depression. Animal models are widely used to study antidepressant-like effect in rodents; however, it should be taken into account that pharmacological models do not always answer to the complexity of the disease processes. This study verified the behavioral (forced swim test (FST), locomotor activity test) and neurochemical effects (monoamines metabolism) of a low dose of clonidine (0. Read More

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http://dx.doi.org/10.1007/s12640-017-9715-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5487857PMC
July 2017
32 Reads

Continuous-Infusion Etomidate in a Patient Receiving Extracorporeal Membrane Oxygenation.

J Pediatr Pharmacol Ther 2017 Jan-Feb;22(1):65-68

We describe a 16-year-old, 65-kg male deployed on extracorporeal membrane oxygenation (ECMO) for refractory respiratory failure secondary to ingestion of multiple substances. During his ECMO course, standard sedative and analgesic strategies failed and alternative medications were used. The patient received various dosages of fentanyl, morphine, hydromorphone, clonidine patches, dexmedetomidine, lorazepam, methadone, pentobarbital, olanzapine, and propofol. Read More

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http://dx.doi.org/10.5863/1551-6776-22.1.65DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5341534PMC
March 2017
56 Reads

Preventing Corneal Calcification Associated With Xylazine for Longitudinal Optical Coherence Tomography in Young Rodents.

Invest Ophthalmol Vis Sci 2017 01;58(1):461-469

Department of Pharmacology and Therapeutics, McGill University, Montréal, Québec, Canada 2Hôpital Maisonneuve-Rosemont Research Center, Montréal, Québec, Canada 4Department of Ophthalmology, Université de Montréal, Montréal, Québec, Canada 5Department of Pharmacology, Centre Hospitalier Universitaire Sainte-Justine Hospital, University of Montréal, Montréal, Québec, Canada 6Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine Research Center, Université de Montréal, Montréal, Québec, Canada.

Purpose: Spectral-domain optical coherence tomography (SD-OCT) is widely used in clinical ophthalmology and recently gained popularity in laboratory research involving small rodents. Its noninvasive nature allows repeated measurements, thereby decreasing the number of animals required. However, when used at a conventional dosage, xylazine (an α2-adrenoceptor) can cause irreversible corneal calcification, especially among young rodents. Read More

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http://dx.doi.org/10.1167/iovs.16-20526DOI Listing
January 2017
73 Reads

Adult clonidine overdose: prolonged bradycardia and central nervous system depression, but not severe toxicity.

Clin Toxicol (Phila) 2017 Mar 20;55(3):187-192. Epub 2017 Jan 20.

a Clinical Toxicology Research Group , University of Newcastle , Newcastle , Australia.

Context: There are limited reports of adult clonidine overdose. We aimed to describe the clinical effects and treatment of clonidine overdose in adults.

Methods: This was a retrospective review of a prospective cohort of poisoned patients who took clonidine overdoses (>200 μg). Read More

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https://www.tandfonline.com/doi/full/10.1080/15563650.2016.1
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http://dx.doi.org/10.1080/15563650.2016.1277234DOI Listing
March 2017
34 Reads

Organophosphate-Hydrolyzing Enzymes as First-Line of Defence Against Nerve Agent-Poisoning: Perspectives and the Road Ahead.

Protein J 2016 Dec;35(6):424-439

Department of Biotechnology, National Institute of Pharmaceutical Education and Research (NIPER), Sector 67, S.A.S. Nagar (Mohali), 160062, Punjab, India.

Nerve agents (NAs) are extremely neurotoxic synthetic organophosphate (OP) compounds exploited as weapons of mass destruction in terrorist attacks and chemical warfare. Considering the current world scenario, there is a persistent threat of NA-exposure to military personals and civilians. Various prophylactic and post-exposure treatments (such as atropine and oximes) available currently for NA-poisoning are inadequate and unsatisfactory and suffer from severe limitations. Read More

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http://dx.doi.org/10.1007/s10930-016-9686-6DOI Listing
December 2016
52 Reads

Clonidine to treat Irukandji syndrome.

Emerg Med Australas 2016 Dec 22;28(6):756-757. Epub 2016 Sep 22.

Department of Emergency Medicine, Cairns Hospital, Cairns, Queensland, Australia.

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http://dx.doi.org/10.1111/1742-6723.12675DOI Listing
December 2016
13 Reads

Genotoxic and Mutagenic Activity of PT-31.

Curr Pharm Biotechnol 2016;17(12):1043-1048

Northeast Biotechnology Network (RENORBIO), Postgraduate Program in Biotechnology, Federal University of Piauí, Teresina (Piauí)-64.049-550, Brazil.

Toxicity assessment is an important tool in drug discovery and development. PT-31 (3-(2-chloro-6-fluorobenzyl)-imidazolidine-2,4-dione) is an imidazolidine- 2,4-dione analogue of clonidine that displays a dose-dependent analgesic profile and synergism with morphine. This study investigated genotoxic and mutagenic effects of PT-31 in Swiss mice. Read More

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http://dx.doi.org/10.2174/1389201017666160811122811DOI Listing
January 2017
20 Reads

Clonidine Overdose in a Toddler Due to Accidental Ingestion of a Compounding Cream.

Pediatr Emerg Care 2018 Apr;34(4):e79-e81

A 22-month-old girl without any significant medical history accidentally consumed a small amount of a therapeutic compounding cream that contained camphor, gabapentin, clonidine, ketoprofen, and lidocaine. Upon presentation to the emergency department, the child exhibited immediate onset of altered mental status with wide fluctuation in her vital signs, which included intermittent apnea requiring bag-valve mask assistance and endotracheal intubation. Serum laboratory analysis measured a clonidine level of 2. Read More

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http://dx.doi.org/10.1097/PEC.0000000000000790DOI Listing
April 2018
40 Reads

Effects of topical combinations of clonidine and pentoxifylline on capsaicin-induced allodynia and postcapsaicin tourniquet-induced pain in healthy volunteers: a double-blind, randomized, controlled study.

Pain 2016 10;157(10):2366-74

aDepartment of Anesthesia, McGill University, Montreal, QC, Canada bAlan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada cFaculty of Dentistry, McGill University, Montreal, QC, Canada dMcGill University Hospital Centre Research Institute, Montreal, QC, Canada eAlan Edwards Pain Management Unit, McGill University Health Centre, Montreal, QC, Canada fAntiva Biosciences, Inc, South San Francisco, CA, USA Departments of gNeurology & Neurosurgery and hPsychology, McGill University, Montreal, QC, Canada.

This double-blind randomized controlled study was designed to evaluate the analgesic effects of topical treatments with clonidine (CLON) and pentoxifylline (PTX) tested alone or as low- and high-dose combinations in a human experimental model of pain. Of 69 healthy subjects aged 18 to 60 years, 23 each were randomly allocated to low-dose (0.04% + 2%) and high-dose (0. Read More

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http://dx.doi.org/10.1097/j.pain.0000000000000659DOI Listing
October 2016
40 Reads

Psychiatric and Behavioural Disorders in Children with Epilepsy (ILAE Task Force Report): When should pharmacotherapy for psychiatric/behavioural disorders in children with epilepsy be prescribed?

Epileptic Disord 2016 May 16. Epub 2016 May 16.

MD PhD, Professor Dr. emer., Senior Research Scientist, Depts. Public Health and Child Neurology, University of Turku, Turku, Finland.

The most important factor in deciding whether psychotropic medication should be prescribed is a meticulous assessment of the possible causes of the behavioural/psychiatric disturbance. This assessment should include a consideration of the possible roles of the epilepsy itself, treatment of the epilepsy, associated brain damage or dysfunction, reactions to the epilepsy and causes that are unrelated to the epilepsy or its treatment. If the epilepsy itself or antiepileptic drug treatment are responsible for the disorder then a review of antiepileptic medication is required. Read More

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http://www.jle.com/download/epd-307201-psychiatric_and_behav
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http://dx.doi.org/10.1684/epd.2016.0819DOI Listing
May 2016
97 Reads

A Case Report of Kratom Addiction and Withdrawal.

WMJ 2016 Feb;115(1):49-52; quiz 53

Kratom, a relatively unknown herb among physicians in the western world, is advertised on the Internet as an alternative to opioid analgesics, as a potential treatment for oploid withdrawal and as a "legal high" with minimal addiction potential. This report describes a case of kratom addiction in a 37-year-old woman with a severe oploid-like withdrawal syndrome that was managed successfully with symptom-triggered clonidine therapy and scheduled hydroxyzine. A review of other case reports of kratom toxicity, the herb's addiction potential, and the kratom withdrawal syndrome is discussed. Read More

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February 2016
12 Reads

Randomized controlled studies on the efficacy of antiarthritic agents in inhibiting cartilage degeneration and pain associated with progression of osteoarthritis in the rat.

Arthritis Res Ther 2016 Jan 21;18:24. Epub 2016 Jan 21.

Bolder BioPATH, Inc., 5541 Central Avenue, Suite 160, Boulder, CO, 80301, USA.

Background: As an initial step in the development of a local therapeutic to treat osteoarthritis (OA), a number of agents were tested for their ability to block activation of inflammation through nuclear factor κ-light-chain-enhancer of activated B cells (NF-κB), subchondral bone changes through receptor activator of nuclear factor κB ligand (RANKL)-mediated osteoclastogenesis, and proteolytic degradation through matrix metalloproteinase (MMP)-13 activity. Candidates with low toxicity and predicted efficacy were further examined using either of two widely accepted models of OA joint degeneration in the rat: the monoiodoacetic acid (MIA) model or the medial meniscal tear/medial collateral ligament tear (MMT/MCLT) model.

Methods: Potential therapeutics were assessed for their effects on the activation of nuclear factor (NF)-κB, RANKL-mediated osteoclastogenesis, and MMP-13 activity in vitro using previously established assays. Read More

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http://dx.doi.org/10.1186/s13075-016-0921-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721142PMC
January 2016
74 Reads
5 Citations
3.753 Impact Factor

Clonidine complexation with hydroxypropyl-beta-cyclodextrin: From physico-chemical characterization to in vivo adjuvant effect in local anesthesia.

J Pharm Biomed Anal 2016 Feb 18;119:27-36. Epub 2015 Nov 18.

Biochemistry and Tissue Biology Department, Biology Institute, State University of Campinas, Campinas, SP, Brazil. Electronic address:

Clonidine (CND), an alpha-2-adrenergic agonist, is used as an adjuvant with local anesthetics. In this work, we describe the preparation and characterization of an inclusion complex of clonidine in hydroxypropyl-beta-cyclodextrin (HP-β-CD), as revealed by experimental (UV-vis absorption, SEM, X-ray diffraction, DOSY- and ROESY-NMR) and theoretical (molecular dynamics) approaches. CND was found to bind to HP-β-CD (Ka=20M(-1)) in 1:1 stoichiometry. Read More

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http://dx.doi.org/10.1016/j.jpba.2015.11.015DOI Listing
February 2016
21 Reads

Effectiveness of ondansetron as an adjunct to lidocaine intravenous regional anesthesia on tourniquet pain and postoperative pain in patients undergoing elective hand surgery: a systematic review protocol.

JBI Database System Rev Implement Rep 2015 01;13(1):27-38

1 The Louisiana Center for Evidence-Based Nursing at LSUHSC School of Nursing: an Affiliate Center of the Joanna Briggs Institute.

Review Question/objective: The objective of this quantitative systematic review is to determine the effects of ondansetron as an adjunct to lidocaine on the tourniquet pain and postoperative pain of American Society of Anesthesiologists (ASA) class 1 or 2 adult patients undergoing elective hand surgery with intravenous regional anesthesia.

Background: Both injury and deformity of the upper extremity can result in dysfunction to nerves, tendons and bones which can lead to disability and pain. Hand injuries and deformities encompass an area of upper extremity surgery, wherein isolation and accessibility to peripheral nerves allows for a wide range of anesthesia techniques. Read More

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https://insights.ovid.com/crossref?an=01938924-201513010-000
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http://dx.doi.org/10.11124/jbisrir-2015-1768DOI Listing
January 2015
60 Reads

Activation of serotonin 5-HT(2C) receptor suppresses behavioral sensitization and naloxone-precipitated withdrawal symptoms in morphine-dependent mice.

Neuropharmacology 2016 Feb 3;101:246-54. Epub 2015 Dec 3.

Life Science Initiative, Charles E. Schmidt College of Science, Florida Atlantic University, 5353 Parkside Drive, Jupiter, FL 33458, USA. Electronic address:

Opioid abuse and dependence have evolved into an international epidemic as a significant clinical and societal problem with devastating consequences. Repeated exposure to the opioid, for example morphine, can induce profound, long-lasting behavioral sensitization and physical dependence, which are thought to reflect neuroplasticity in neural circuitry. Central serotonin (5-HT) neurotransmission participates in the development of dependence on and the expression of withdrawal from morphine. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00283908153012
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http://dx.doi.org/10.1016/j.neuropharm.2015.09.031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4996259PMC
February 2016
45 Reads

Pharmacological treatment of organophosphorus insecticide poisoning: the old and the (possible) new.

Br J Clin Pharmacol 2016 Mar 30;81(3):462-70. Epub 2015 Oct 30.

Department of Medicine, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh.

Despite being a major clinical and public health problem across the developing world, responsible for at least 5 million deaths over the last three decades, the clinical care of patients with organophosphorus (OP) insecticide poisoning has little improved over the last six decades. We are still using the same two antidotes - atropine and oximes - that first came into clinical use in the late 1950s. Clinical research in South Asia has shown how improved regimens of atropine can prevent deaths. Read More

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http://dx.doi.org/10.1111/bcp.12784DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767211PMC
March 2016
18 Reads

Local Anesthetic Peripheral Nerve Block Adjuvants for Prolongation of Analgesia: A Systematic Qualitative Review.

PLoS One 2015 10;10(9):e0137312. Epub 2015 Sep 10.

Department of Anesthesiology, Hospital for Special Surgery, New York, New York, United States of America; Department of Anesthesiology, Weill College of Medicine at Cornell University, New York, New York, United States of America.

Background: The use of peripheral nerve blocks for anesthesia and postoperative analgesia has increased significantly in recent years. Adjuvants are frequently added to local anesthetics to prolong analgesia following peripheral nerve blockade. Numerous randomized controlled trials and meta-analyses have examined the pros and cons of the use of various individual adjuvants. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0137312PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4565585PMC
May 2016
17 Reads

Topical treatment in pain medicine: from ancient remedies to modern usage.

Pain Manag 2015 Sep 21;5(5):359-71. Epub 2015 Jul 21.

Centre for Research on Chronic Pain & Inflammatory Diseases, Murdoch University, Perth, Western Australia, Australia.

Over several millennia, substances have been applied to the skin for treatment of pain. Some ingredients are in current use; others have been discontinued. Mechanisms of action include interactions with nociceptive neural networks and inflammatory processes. Read More

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http://dx.doi.org/10.2217/pmt.15.23DOI Listing
September 2015
10 Reads

The effect of clonidine pretreatment on epidural resiniferatoxin in a neuropathic pain rat model.

Acta Med Okayama 2015 ;69(2):95-103

Department of Anesthesiology and Pain Medicine, Gachon University Gil Hospital, Incheon 405-760, Korea.

Resiniferatoxin (RTX) is an ultrapotent synthetic TRPV1 (transient receptor potential vanilloid subtype 1) agonist with significant initial transient hyperalgesia followed by a prolonged analgesic effect in response to thermal stimulus. Using a rat model of neuropathic pain, we evaluated the effect of pretreatment with clonidine-which has been shown to relieve intradermal capsaicin-induced hyperalgesia-on the initial hyperalgesic response and the thermal analgesic property of RTX. Thirty-six male rats were divided into 6 treatment groups (n=6 each):RTX 500 ng, RTX 1 μg, clonidine 20 μg (Cl), Cl+RTX 500 ng, Cl+RTX 1 μg, or normal saline 20 μL (control). Read More

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http://dx.doi.org/10.18926/AMO/53338DOI Listing
February 2016
19 Reads

Modulation of L-DOPA's antiparkinsonian and dyskinetic effects by α2-noradrenergic receptors within the locus coeruleus.

Neuropharmacology 2015 Aug 25;95:215-25. Epub 2015 Mar 25.

Behavioral Neuroscience Program, Department of Psychology, Binghamton University, Binghamton, NY, USA. Electronic address:

Long-term l-DOPA use for Parkinson's disease (PD) is frequently complicated by the emergence of a debilitating motor side effect known as l-DOPA-induced dyskinesia (LID). Accumulating evidence has implicated the norepinephrine (NE) system in the pathogenesis of LID. Here we used the unilateral 6-hydroxydopamine rat model of PD to determine the role of the α2-adrenoceptors (α2R) in l-DOPA's therapeutic and detrimental motor-inducing effects. Read More

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http://dx.doi.org/10.1016/j.neuropharm.2015.03.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4466080PMC
August 2015
22 Reads

Constipation enhances the propensity to seizure in pentylenetetrazole-induced seizure models of mice.

Epilepsy Behav 2015 Mar 6;44:200-6. Epub 2015 Mar 6.

Neonatal Research Centre, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:

Epilepsy is characterized by spontaneous recurrent seizures and represents one of the most frequent neurological diseases, affecting about 60 million people worldwide. The cellular and neurocircuit bases of epilepsy are poorly understood. Constipation is a common gastrointestinal disorder characterized by symptoms such as straining, hard stool, and infrequent defecation. Read More

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http://dx.doi.org/10.1016/j.yebeh.2015.01.013DOI Listing
March 2015
25 Reads

Delayed-onset movement disorder and encephalopathy after oxycodone ingestion.

Semin Pediatr Neurol 2014 Jun 18;21(2):160-5. Epub 2014 Jun 18.

Department of Neurology, University of Washington, Seattle, WA; Division of Neurology, Seattle Children's Hospital, Seattle, WA; Department of Pediatrics, University of Washington, Seattle, WA.

We present the case of a 14-year-old girl with a biphasic course after oxycodone ingestion. Clinically, she had a rapid return to baseline after initial ingestion and presented a week later with new-onset ballism, akathisia, and encephalopathy. Neuroimaging demonstrated bilateral globi pallidi and cerebellar lesions with a relative decrease of metabolite peaks on magnetic resonance spectroscopy. Read More

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http://dx.doi.org/10.1016/j.spen.2014.06.009DOI Listing
June 2014
58 Reads

Breathing and temperature control disrupted by morphine and stabilized by clonidine in neonatal rats.

Respir Physiol Neurobiol 2014 Sep 5;201:93-100. Epub 2014 Jul 5.

Pediatrics, Johns Hopkins Medical Institutions, Baltimore, MD, United States. Electronic address:

Background: Sedative-analgesics are often given to newborn infants and are known to affect many components of the autonomic nervous system. While morphine is most frequently used, α-2 adrenergic receptor agonists are being increasingly used in this population. Alpha-2 adrenergic receptors agonists also have anti-shivering properties which may make it a desirable drug to give to infants undergoing therapeutic hypothermia. Read More

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http://dx.doi.org/10.1016/j.resp.2014.06.015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425248PMC
September 2014
23 Reads

Effects of indole-3-carbinol on clonidine-induced neurotoxicity in rats: Impact on oxidative stress, inflammation, apoptosis and monoamine levels.

Neurotoxicology 2014 Sep 27;44:48-57. Epub 2014 May 27.

Department of Pharmacology and Toxicology, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt.

The relationship between inflammation, oxidative stress and the incidence of depression had been well studied. Indole-3-carbinol (I3C), a natural active compound found in cruciferous vegetables, was shown to have anti-oxidant and anti-inflammatory activities. Therefore, the aim of this study was to investigate the potential protective effects of I3C against clonidine-induced depression-like behaviors in rats. Read More

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http://dx.doi.org/10.1016/j.neuro.2014.05.004DOI Listing
September 2014
20 Reads

Toxicity of antihypertensives in unintentional poisoning of young children.

J Emerg Med 2014 Aug 18;47(2):155-62. Epub 2014 Apr 18.

Mainz Poison Center, Mainz, Germany; 2(nd) Medical Clinic, University Medical Center Mainz, Germany; Krankenhaus der Barmherzigen Brüder Trier, Trier, Germany.

Background: Knowledge is limited about the toxicity of unintentional exposure to antihypertensives in young children (0-6 years of age).

Objective: Our aim was to research symptoms and poisoning severity in unintentional poisonings in this group of age and determine adequate poisoning management.

Methods: We performed a 10-year retrospective, explorative analysis of the Mainz Poison Center/Germany database with regard to circumstances of poison exposure, dosage, symptoms, and treatment. Read More

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http://dx.doi.org/10.1016/j.jemermed.2014.02.006DOI Listing
August 2014
34 Reads

Significance of the imidazoline receptors in toxicology.

Authors:
J A Lowry J T Brown

Clin Toxicol (Phila) 2014 Jun 25;52(5):454-69. Epub 2014 Mar 25.

Division of Clinical Pharmacology, Toxicology and Therapeutic Innovations, Department of Pediatrics, Children's Mercy Hospitals and Clinics, University of Missouri School of Medicine , Kansas City, MO , USA.

Introduction: The alpha-2 adrenergic (AA-2) receptor agonists and imidazolines are common exposures in the American Association of Poison Control Centers (AAPCC) National Poison Data System (NPDS). Although the interaction between the AA-2 receptor and imidazoline receptors has been extensively studied, it largely remains unknown to health-care professionals. This review describes these interactions and mechanisms by which agonists affect physiologic responses binding to these receptors. Read More

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http://dx.doi.org/10.3109/15563650.2014.898770DOI Listing
June 2014
50 Reads

Safety and efficacy of flumazenil for reversal of iatrogenic benzodiazepine-associated delirium toxicity during treatment of alcohol withdrawal, a retrospective review at one center.

J Med Toxicol 2014 Jun;10(2):126-32

Department of Internal Medicine, Harrisburg Hospital, PinnacleHealth, Harrisburg, PA, 17101, USA,

Both alcohol withdrawal syndrome (AWS) and benzodiazepines can cause delirium. Benzodiazepine-associated delirium can complicate AWS and prolong hospitalization. Benzodiazepine delirium can be diagnosed with flumazenil, a GABA-A receptor antagonist. Read More

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http://dx.doi.org/10.1007/s13181-014-0391-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057541PMC
June 2014
44 Reads
5 Citations