Associations between venous thromboembolism and antipsychotics. A study of the WHO database of adverse drug reactions.

Background: Concern has been raised about the occurrence of venous thromboembolism (VTE) during treatment with antipsychotics. However, to date, clozapine is the only antipsychotic agent for which recurring evidence supports an association with VTE. Therefore, the aim of this study was to investigate the association between antipsychotic drugs, including clozapine and VTE.

[Anaesthetics and breast feeding].

Many women undergo anaesthetic procedures related to childbirth or during the period of lactation. Most anaesthetic drugs are lipophilic and are thus excreted into breast milk. This article summarises available knowledge regarding anaesthetics, their excretion into breast milk and possible effects on the suckling infant.

[Benzodiazepine-like hypnotics--attitudes and prescription practice among general practitioners].

Background: The large increase in sales of the benzodiazepine-like hypnotics (z-hypnotics) zopiclone and zolpidem over the last decade prompted an investigation into Norwegian general practitioners' prescription habits, knowledge of and attitudes to these drugs.

Material And Methods: A questionnaire was distributed to all 928 registered GPs in six Norwegian counties. The physicians were asked to assess statements, patient vignettes and drug preferences with regard to z-hypnotic and benzodiazepine prescription practice.

[Toxicological screening of medicines and drugs of abuse in emergency cases].

Background: In some situations, and particularly when intoxications are suspected, it would be advantageous if medicines and drugs of abuse could be swiftly detected in serum or urine.

Material And Methods: The Department of Clinical Pharmacology at St. Olav University Hospital has since 2004 been developing a comprehensive toxicology service (at all hours 7-days/week) for immediate quantitative analysis of between 80 and 90 substances.

[Fruit and berries--interactions with drugs].

Diet is one of many factors that could alter the pharmacokinetics of drugs. Several fruits and berries have recently been shown to contain agents that affect drug-metabolizing enzymes. Grapefruit is the most well-known example, but also Sevillian orange, pomelo and star fruit contain agents that inhibit cytochrome P450 3A4 (CYP3A4), which is the most important enzyme in drug metabolism.

Incidence of fatal adverse drug reactions: a population based study.

What Is Already Known About This Subject: * Although drugs generally are safe and effective therapies for numerous diseases, adverse drug reactions do occur and may even be fatal. * The incidence of fatal adverse drug reactions in hospitalized patients has been estimated to be approximately 5%. * In previous studies the incidence of fatal adverse drug reactions in hospitalized patients has been reported, but the incidence of fatal adverse drug reactions in the general population is largely unknown.

The dark side of ecstasy: neuropsychiatric symptoms after exposure to 3,4-methylenedioxymethamphetamine.

3,4-Methylenedioxymethamphetamine (MDMA, ecstasy) is a known neurotoxin in animals. This review discusses the history, pattern of use, pharmacology, acute and long-term effects of MDMA. Emphasis is given to the concern that MDMA may induce long-term cognitive and psychiatric effects.

Pharmacokinetics of intraperitoneally instilled aminophylline, terbutaline and tobramycin in pigs.

Introduction: Venous catheters are sometimes difficult or even impossible to insert and may also be associated with serious complications. This study was carried out to investigate whether intraperitoneal administration of drugs may be an alternative to the intravenous route in patients with limited vascular access.

Materials And Methods: Three drugs commonly in use in clinical practise, aminophylline, terbutaline and tobramycin, were administered to pigs intravenously and intraperitoneally in small volumes.

Quetiapine and drug interactions: evidence from a routine therapeutic drug monitoring service.

Objective: The objective of the present study was to investigate the effect of age, gender, and various comedications on the pharmacokinetics of quetiapine in a naturalistic setting.

Method: In total, 2111 serum samples analyzed for quetiapine during the period from June 2001 to December 2004 were included in the study. The samples had been collected for routine therapeutic drug monitoring purposes from 1179 patients treated with quetiapine.

Gut luminal lactate measured by microdialysis mirrors permeability of the intestinal mucosa after ischemia.

The aim of the present study was to investigate the influence of a prolonged initial intestinal ischemic insult on transmucosal permeability after a subsequent ischemic event and whether microdialysis of biomarkers released to the gut lumen is able to reflect changes in intestinal permeability. The superior mesenteric artery was cross-clamped for 60 min followed by 4 h of reperfusion in 16 pigs. Nine pigs had a second cross-clamp of 60 min and 3 h of reperfusion, whereas seven pigs were observed for a further 4 h of reperfusion.

Effects of comedication on the serum levels of aripiprazole: evidence from a routine therapeutic drug monitoring service.

Introduction: The objective of the study was to compare the serum concentrations of the atypical antipsychotic aripiprazole in monotherapy with the concentrations found during concomitant therapy with other drugs.

Methods: Samples analyzed for aripiprazole by a liquid chromatography-mass spectrometry method in a routine therapeutic drug monitoring setting were collected consecutively.

Results: Samples from 81 patients were included in the study.

Lamotrigine in children and adolescents: the impact of age on its serum concentrations and on the extent of drug interactions.

Objective: To investigate the impact of age and co-treatment with other drugs on the serum concentrations of lamotrigine in children and adolescents.

Methods: A review of routine serum concentration measurements of lamotrigine performed in our laboratory yielded a total of 744 serum samples from 296 subjects (110 males, 186 females, age: 2-19 years) suitable for statistical analysis. The primary outcome variable was the dose-corrected lamotrigine serum concentration, expressed as the lamotrigine concentration/dose (C/D) ratio.

Drug insight: Anti-tumor necrosis factor therapy for inflammatory arthropathies during reproduction, pregnancy and lactation.

Tumor necrosis factor (TNF) antagonists are widely used to reduce disease activity and joint damage, and to improve health-related quality of life in patients suffering from rheumatoid arthritis, ankylosing spondylitis, or psoriatic arthritis. To date, no increased risk of embryotoxicity or teratogenicity, or adverse pregnancy outcome (such as birth defects, premature birth, and low birth weight) has been reported in patients with inflammatory arthropathies treated with anti-TNF therapy, compared with the general population. However, the available data are limited, and methotrexate, which is commonly used in combination with anti-TNF drugs, is teratogenic.

Antipsychotic-induced extrapyramidal symptoms in patients with schizophrenia: associations with dopamine and serotonin receptor and transporter polymorphisms.

Background: Little is known about the influence of polymorphisms of the dopamine and serotonin system on the risk for extrapyramidal symptoms (EPS) during treatment with antipsychotic drugs.

Methods: Of 119 subjects with schizophrenia treated with antipsychotics, 63 had current or previous EPS (acute dystonia, parkinsonism, tardive dyskinesia), and 56 had no such symptoms. All subjects were genotyped for a total of eight dopamine and serotonin receptor and transporter polymorphisms: the Taq1A polymorphism of the dopamine D(2) receptor (DRD2) gene, the Msc1 polymorphism of the dopamine D(3) receptor (DRD3) gene, the variable number of tandem repeat (VNTR) polymorphism of the dopamine transporter (DAT1) gene, four polymorphisms (102T/C, His452Tyr, 516 C/T, and Thr25Asn) of the serotonin 5-HT(2A) receptor (5HTR2A) gene, and the 5HTTLPR polymorphism of the serotonin transporter (5HTT) gene.

[Customized drug therapy--how near is the goal?].

Background: During the last years we have gained considerable knowledge , about genetic factors behind the huge inter-individual variation in drug response and the risk of adverse drug reactions.

Material And Methods: The article is based upon a recent search in PubMed and the author's own studies and experience with genotyping related to drug therapy.

Results And Interpretation: A considerable genetic variability has been revealed both in the function of drug-metabolising enzymes, transport proteins participating in drug distribution and excretion, and drug targets.

[On-site testing for drug abuse in urine].

Background: There is an increasing interest in on-site testing for drugs of abuse.

Methods: Based upon our own experience and published literature, we have reviewed advantages and disadvantages of such tests. On-site testing is also evaluated in relation to the recommendations for urinary testing of drugs of abuse from the Norwegian Health Authorities.

Cerebral haemorrhage induced by warfarin - the influence of drug-drug interactions.

Purpose: To evaluate the frequency, severity and preventability of warfarin-induced cerebral haemorrhages due to warfarin and warfarin-drug interactions in patients living in the county of Ostergötland, Sweden.

Methods: All patients with a diagnosed cerebral haemorrhage at three hospitals during the period 2000-2002 were identified. Medical records were studied retrospectively to evaluate whether warfarin and warfarin-drug interactions could have caused the cerebral haemorrhage.

Heart failure induced by non-cardiac drugs.

Although heart failure is predominantly caused by cardiovascular conditions such as hypertension, coronary heart disease and valvular heart disease, it can also be an adverse reaction induced by drug therapy. In addition, some drugs have the propensity to adversely affect haemodynamic mechanisms in patients with an already existing heart condition. In this article, non-cardiac drugs known to be associated with the development or worsening of heart failure are reviewed.

Toxicological analysis in rats subjected to heroin and morphine overdose.

In heroin overdose deaths the blood morphine concentration varies substantially. To explore possible pharmacokinetic explanations for variable sensitivity to opiate toxicity we studied mortality and drug concentrations in male Sprague-Dawley rats. Groups of rats were injected intravenously (i.