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Results for “METHOTRIMEPRAZINE”

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At least 361 records · Page 20Linked to original sources

Silent ischemia and severity of pain in acute myocardial infarction.

An overall low tendency to complain of pain, due to a low perception of pain, has been suggested in the pathogenesis of silent ischemia, independent of the extent of the diseased coronaries and a history of previous acute myocardial infarction. This hypothesis has been tested indirectly in this retrospective study by comparison of the use of analgesics during admission for a first acute myocardial infarction with the occurrence of silent ischemia at exertion tests four weeks after discharge from hospital. The study did not show a lower use of analgesics in patients with silent ischemia, but this may be due to methodologic problems. Suggestions are given for another study design to overcome these problems.

Analgesics, Opioid↗

Effect of levomepromazine on EEG and on clinical side effects after lumbar myelography with metrizamide.

In patients with lumbago-sciatica levomepromazine is a potent supplement to analgetics in pain treatment. The hypothesis that neuroleptics increase the risk of epileptic seizures after metrizamide myelography was not confirmed in a series of 77 patients, 26 with and 51 without levomepromazine medication, before and after lumbar metrizamide myelography. No differences existed between the groups with regard to the appearance of EEG abnormalities such as slow waves or spikes. Mild side effects were more frequent in the levomepromazine group, except nausea and vomiting. Lumbar metrizamide epidurography in 30 patients did not cause any abnormal EEG.

Drug Interactions↗

[Methadone and sleep apnea syndrome].

BACKGROUND: Sleep apnea syndrome occurs when, during sleep, breathing stops for 10 seconds or longer, with an index of 5 times or more an hour. It is clinically characterized by loud snoring at night, continuous or interrupted by pauses followed by loud breathing. Sleep is fitful, broken by arousals, and yields little rest. There is daytime excessive sleepiness with repeated involuntary falling asleep, often unknown by the subject. CLINICAL DESCRIPTION: In this article, we describe an observation of central sleep apnea syndrome in a female patient receiving an opiate replacement therapy. METHOD: An analysis of the before and after methadone withdrawal polysomnograhic tracing was done for this patient. RESULTS: This diagnosis etiology and physiopathology are critically approached. Clinicians should be careful in treating induced sleep disorders in such patients. CONCLUSION: Prescribing benzodiazepines during an opiate withdrawal of the methadone type is not recommended when central apnea occurs.

Adult↗

Use of neuroleptics after an episode of neuroleptic malignant syndrome.

The authors report a case of unequivocal Neuroleptic Malignant Syndrome, in which the patient was successfully rechallenged with a different potent neuroleptic in substantial dosage during the recovery phase. The Neuroleptic Malignant Syndrome did not recur and the patient's psychosis cleared. Reference is made to the relevant world literature.

Adolescent↗

Resin haemoperfusion in levomepromazine poisoning: evaluation of effect on plasma drug and metabolite levels.

Plasma levels of levomepromazine and two of its major metabolites N-desmethyl-levomepromazine and levomepromazine sulphoxide were studied in two poisoned patients treated with resin haemoperfusion at a constant blood flow of 200 ml/min. The mean haemoperfusion clearance of levomepromazine, N-desmethyl-levomepromazine and levomepromazine sulphoxide was 114, 123 and 151 ml/min, respectively, in patient no. 1, and 153, 148 and 184 ml/min, respectively, in patient no. 2. Patient no. 2 had also ingested amitriptyline, and the mean haemoperfusion clearance of amitriptyline and its metabolite nortriptyline was 183 and 183 ml/min respectively. Haemoperfusion did not seem to alter the elimination profile of levomepromazine or the two metabolites in either patient. We conclude that haemoperfusion is of little value in removing levomepromazine, N-desmethyl-levomepromazine or levomepromazine sulphoxide from the body. This is probably due to the large apparent volume of distribution and the high intrinsic hepatic metabolic clearance of these compounds.

Adult↗

Focus on levomepromazine.

This is a review of the uses of levomepromazine in psychiatry, based upon MEDLINE, PSYCLIT and EMBASE literature searches. The main indications for this drug in psychiatry are schizophrenia and schizoaffective disorder. Levomepromazine's sedative properties particularly fit it to use in psychiatric intensive care. There is also some evidence to suggest it has efficacy in drug-resistant psychosis, although this property of the drug does require further research. In other areas of medicine levomepromazine has been used in: alleviating bronchoconstriction; as a preoperative sedative; in terminal pain control and postoperative analgesia; and in the control of nausea. Some antimycobacterial properties have been recorded. The drug should not be prescribed to patients at high risk of accidental or suicidal overdose.

Antipsychotic Agents↗

Zuclopenthixol, melperone and haloperidol/levomepromazine in the elderly. Meta-analysis of two double-blind trials at 15 nursing homes in Norway.

A meta-analysis was carried out of the data from two double-blind, multi-centre studies with identical methodology which compared the effectiveness of treatment of elderly patients with zuclopenthixol and with other antipsychotic drugs. In one study, patients were treated for 4 weeks with either zuclopenthixol or melperone; in the other, with either zuclopenthixol or a combination of haloperidol and levomepromazine. The meta-analysis evaluated the results of 96 patients, 49 in the zuclopenthixol group and 47 in the comparison group. Doses, which were adjusted to individual patient's needs, were low as shown by the percentages of defined daily doses for each of the study drugs. The results indicated that all three treatment alternatives were effective in the treatment of elderly patients with symptoms of agitation and hostility/aggressiveness. There was a trend, however, for zuclopenthixol to have a more rapid onset of effect. Zuclopenthixol also has the advantage for both patients and nursing staff that dosage is once daily. Only few and mild side-effects were reported with the three drug regimens.

Aged↗

Drugs and syringe drivers: a survey of adult specialist palliative care practice in the United Kingdom and Eire.

Subcutaneous delivery of drugs using a syringe driver is common practice within specialist palliative care units. There is, however, little documented information regarding clinical practice. A survey performed in 1992 reported that at least 28 drugs were used in combination with others in a single syringe driver. The aim of the present study was to reassess practice in this field and to enquire more specifically about newer drugs. Postal questionnaires were sent to all adult specialist palliative care in-patient units in the UK and Eire (n = 208). One hundred and sixty-five units (79%) responded. The most common syringe driver in use was the Graseby 26 (61% of responding units). Most units delivered the contents of the syringe over 24 h, and water was usually used as the diluent in 90% of cases. The maximum number of drugs that respondents were prepared to mix in a single syringe was usually three (51%) or four (35%). In the UK, all units used diamorphine in doses from 2.5 mg/24 h upwards. All respondents also used haloperidol, in doses from 0.5 to 60 mg/24 h. A total of 28 different drugs were used in syringe drivers. The most common combinations were diamorphine and midazolam (37%), diamorphine and levomepromazine (35%), diamorphine and haloperidol (33%), and diamorphine and cyclizine (31%). In conclusion, there is much in common with regard to the way in which drugs are delivered in syringe drivers. However, a wide variety of drugs and drug combinations are still in use.

Adult↗

Low-dose levomepromazine in refractory emesis in advanced cancer patients: an open-label study.

Seventy patients with advanced cancer and refractory emesis were treated with subcutaneous boluses of levomepromazine (median daily dose: 6.25 mg; range: 3.12-25) in an open-label prospective study. Treatment was associated with a decrease in nausea from a median of 8/10 at baseline (IQR 7-8) to a median of 1 (IQR 0-2) after two days of treatment (P<0.0001); vomiting ceased in 92% of cases. It was possible to remove the nasogastric tube from all 11 patients who had one. The most frequently reported side effect was sedation, with a median of 2/10 (25-75% percentile 1-3), which was not correlated with the dose of levomepromazine. This study suggests that treatment with low-dose levomepromazine is an effective and safe option for advanced cancer patients who fail to respond to first-line antiemetic treatment.

Adult↗