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Biomedical subjects

M J Cupp

Publications and source records attributed to M J Cupp.

9 recordsLinked to original sources
PubMed1999

Herbal remedies: adverse effects and drug interactions.

A growing number of Americans are using herbal products for preventive and therapeutic purposes. The manufacturers of these products are not required to submit proof of safety and efficacy to the U.S. Food and Drug Administration before marketing. For this reason, the adverse effects and drug interactions associated with herbal remedies are largely unknown. Ginkgo biloba extract, advertised as improving cognitive functioning, has been reported to cause spontaneous bleeding, and it may interact with anticoagulants and antiplatelet agents. St. John's wort, promoted as a treatment for depression, may have monoamine oxidase-inhibiting effects or may cause increased levels of serotonin, dopamine and norepinephrine. Although St. John's wort probably does not interact with foods that contain tyramine, it should not be used with prescription antidepressants. Ephedrine-containing herbal products have been associated with adverse cardiovascular events, seizures and even death. Ginseng, widely used for its purported physical and mental effects, is generally well tolerated, but it has been implicated as a cause of decreased response to warfarin. Physicians must be alert for adverse effects and drug interactions associated with herbal remedies, and they should ask all patients about the use of these products.

Drug Interactions↗
PubMed1998

Cytochrome P450: new nomenclature and clinical implications.

Many drug interactions are a result of inhibition or induction of cytochrome P450 enzymes (CYP450). The CYP3A subfamily is involved in many clinically significant drug interactions, including those involving nonsedating antihistamines and cisapride, that may result in cardiac dysrhythmias. CYP3A4 and CYP1A2 enzymes are involved in drug interactions involving theophylline. CYP2D6 is responsible for the metabolism of many psychotherapeutic agents. The protease inhibitors, which are used to treat patients infected with the human immunodeficiency virus, are metabolized by the CYP450 enzymes and consequently interact with a multitude of other medications. By understanding the unique functions and characteristics of these enzymes, physicians may better anticipate and manage drug interactions and may predict or explain an individual's response to a particular therapeutic regimen.

Aged↗
PubMed1998

Use and abuse of flunitrazepam.

Flunitrazepam is not available in the US, and it is presently illegal to import it. Flunitrazepam has no therapeutic advantage over benzodiazepines presently marketed in the US. Its quick onset of sedation, amnesic properties, and additive effects with alcohol have led to its reputation as a party drug, club drug, or date rape drug. Several measures have been undertaken to curb its illicit use. It is unclear whether flunitrazepam poses a greater public health risk than other benzodiazepines.

Anti-Anxiety Agents↗
PubMed1998

Doxorubicin dosage guidelines in a patient with hyperbilirubinemia of Gilbert's syndrome.

OBJECTIVE: To reconcile dosage modification guidelines for doxorubicin in a patient with hyperbilirubinemia of Gilbert's syndrome (GS). CASE SUMMARY: A 62-year-old white man with concurrent diagnoses of large-cell non-Hodgkin's lymphoma and GS was treated with standard doses of a doxorubicin-containing chemotherapy regimen. No increase of end-organ toxicity was observed during four treatment cycles. DISCUSSION: The relative prevalence of GS coupled with the rising incidence of non-Hodgkin's lymphoma increases the probability that both disorders will be present in the same individual. A MEDLINE search (1966 through July 1997) revealed little, and often conflicting, information pertaining to drug metabolism and disposition in GS. In addition, no information has been reported regarding the metabolic fate of doxorubicin in these patients. It is important to emphasize that the lack of enhanced extramedullary toxicity in this patient is not conclusive evidence that the hepatic abnormality of GS had no effect on doxorubicin metabolism. CONCLUSIONS: Based on information regarding mechanisms for hepatic clearance, dosage modification of doxorubicin may not be necessary in hyperbilirubinemia of GS.

Antineoplastic Agents↗
PubMed1997

Melatonin.

Melatonin, a hormone produced by the pineal gland, appears to help regulate the sleep-wake cycle. With further study and clinical experience, it may become an accepted therapy for insomnia. Although melatonin preparations are available without prescription in health food stores and pharmacies, their potency, purity, safety and effectiveness cannot be assured. Until large clinical trials provide further information about melatonin's efficacy, adverse effects, drug interactions and effects on various disease states, melatonin products should be used with the understanding that many questions about their safety remain unanswered.

Animals↗