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1.
Indian J Exp Biol ; 53(2): 93-7, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25757239

RESUMO

Though there are literature indicating the bone loss due to alcohol consumption, studies on the association between ethanol consumption and periodontal breakdown in animals are either scarce or have provided conflicting results. Here, we investigated the effects of chronic alcohol exposure from adolescence to adulthood on the alveolar bone in rats. Wistar rats were exposed to ethanol (6.5 g/kg/day) in a solution of 22.5% (w/v) or distilled water (control) by gavage from 35 days of age (adolescent) until 90 days (adulthood). Evaluation of the bone loss was performed using scanning electronic microscopy, in which the distances between the cement-enamel junction and the alveolar bone crest from the palatal side of the first molar mandibular were measured. The measurements obtained were tabulated and analyzed using Student's t-test. Alcohol-treated group revealed greater bone loss in comparison to the control group. These findings indicate that heavy chronic alcohol exposure from adolescent to adulthood can induce alveolar bone loss in rats associated to absence of periodontitis.


Assuntos
Perda do Osso Alveolar/induzido quimicamente , Processo Alveolar/efeitos dos fármacos , Etanol/toxicidade , Doenças Mandibulares/induzido quimicamente , Fatores Etários , Perda do Osso Alveolar/diagnóstico , Processo Alveolar/patologia , Processo Alveolar/ultraestrutura , Análise de Variância , Animais , Peso Corporal/efeitos dos fármacos , Depressores do Sistema Nervoso Central/administração & dosagem , Depressores do Sistema Nervoso Central/toxicidade , Etanol/administração & dosagem , Feminino , Doenças Mandibulares/diagnóstico , Microscopia Eletrônica de Varredura , Ratos , Ratos Wistar , Fatores de Tempo
2.
Nicotine Tob Res ; 12(7): 763-7, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20511349

RESUMO

INTRODUCTION: Menthol is a flavored tobacco additive claimed to mask the bitter taste and reduce the harshness of cigarette smoke. (Azzi, C., Zhang, J., Purdon, C. H., Chapman, J. M., Nitcheva, D., Hebert, J. R., et al., 2006, Permeation and reservoir function of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and benzo[a]pyrene (B[a]P) across porcine esophageal tissue in the presence of ethanol and menthol. Carcinogenesis, 27, 137-145). have shown that menthol increased the flux of tobacco carcinogens (TC) across porcine esophagus. As oral mucosa is exposed to both smoke and smokeless tobacco in tobacco users, the objective of this study was to determine whether menthol influenced the penetration of the TC nitrosonornicotine (NNN) across porcine buccal (BM) and floor of mouth (FM) mucosa. METHODS: Porcine BM and FM were collected at slaughter, mounted in perfusion chambers (n = 7/group), and exposed to tritiated NNN ((3)H-NNN; Amersham, activity 1 muCi/ml) and tritiated nicotine ((3)H-nicotine; Sigma) in 3% nicotine/phosphate-buffered saline (0.01 M, pH 7.4) containing 0.01% unlabeled NNN (National Cancer Institute Chemical Carcinogen Repository) +/- 0.08% menthol for 0.5, 1, 2, or 12 hr. K(p) values (cm/min) were determined and statistically analyzed (analysis of variance, Tukey's, p < .05). RESULTS: FM and BM permeability to both (3)H-NNN and (3)H-nicotine was significantly increased (p < .05) with addition of menthol over that of nicotine alone regardless of exposure times. Even short 30-min menthol exposure significantly increased the flux of both compounds, and this was maintained throughout the experiment. DISCUSSION: Menthol enhances penetration of NNN and nicotine through FM and BM in vitro, even after short exposure. This may reflect loading of a superficial epithelial reservoir (Squier, C. A., Kremer, M. J., Bruskin, A., Rose, A., & Haley, J. D., 1999. Oral mucosal permeability and stability of transforming growth factor beta-3 in vitro. Pharmaceutical Research, 16, 1557-1563.), thus delivering menthol and enhancing flux for several hours. Practical implications are for a potentially increased oral exposure to carcinogens among users of menthol-flavored cigarettes and chewing tobacco.


Assuntos
Carcinógenos/farmacologia , Depressores do Sistema Nervoso Central/farmacologia , Mentol/farmacologia , Mucosa Bucal/metabolismo , Nicotiana/química , Nitrosaminas/farmacologia , Animais , Carcinógenos/administração & dosagem , Permeabilidade da Membrana Celular/efeitos dos fármacos , Depressores do Sistema Nervoso Central/administração & dosagem , Relação Dose-Resposta a Droga , Sinergismo Farmacológico , Mentol/administração & dosagem , Mucosa Bucal/efeitos dos fármacos , Nitrosaminas/administração & dosagem , Suínos
3.
Alcohol Alcohol ; 44(5): 443-8, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19589828

RESUMO

AIM: The aim of the present study was to determine whether the endocannabinoid system could be involved in the ethanol-induced inhibition of salivation in adult male Wistar rats. METHODS: Salivary secretion induced by different concentrations of methacholine, a cholinergic agonist, and the endocannabinoid arachidonoyl ethanolamide (anandamide, AEA) production in the submandibular gland (SMG) were determined in rats after ethanol (3 g/kg) administration by gastric gavage. To study the participation of cannabinod receptors in ethanol action, we evaluated methacholine-induced salivary secretion after ethanol administration when CB1 or CB2 receptors were blocked by intra-SMG injections of their selective antagonists AM251 and AM630, respectively. Additionally, we evaluated the in vitro effect of ethanol (0.1 M) on SMG production of cAMP, alone or combined with AM251 or AM630. RESULTS: Acute ethanol administration increased AEA production in SMG and also inhibited the methacholine-induced saliva secretion that was partially restored by intraglandular injection of AM251 or AM630. In addition, ethanol significantly reduced the forskolin-induced increase in cAMP content in SMG in vitro while treatment with AM251 blocked this response. CONCLUSION: We conclude that the inhibitory effect produced by ethanol on submandibular gland salivary secretion is mediated, at least in part, by the endocannabinoid system.


Assuntos
Ácidos Araquidônicos/farmacologia , Moduladores de Receptores de Canabinoides/farmacologia , Depressores do Sistema Nervoso Central/farmacologia , Endocanabinoides , Etanol/farmacologia , Cloreto de Metacolina/farmacologia , Agonistas Muscarínicos/farmacologia , Alcamidas Poli-Insaturadas/farmacologia , Saliva/efeitos dos fármacos , Saliva/metabolismo , Salivação/efeitos dos fármacos , Glândula Submandibular/efeitos dos fármacos , Animais , Ácidos Araquidônicos/administração & dosagem , Moduladores de Receptores de Canabinoides/administração & dosagem , Depressores do Sistema Nervoso Central/administração & dosagem , Colforsina/antagonistas & inibidores , AMP Cíclico/genética , Etanol/administração & dosagem , Indóis/administração & dosagem , Indóis/farmacologia , Masculino , Cloreto de Metacolina/administração & dosagem , Agonistas Muscarínicos/administração & dosagem , Piperidinas/administração & dosagem , Piperidinas/farmacologia , Alcamidas Poli-Insaturadas/administração & dosagem , Pirazóis/administração & dosagem , Pirazóis/farmacologia , Ratos , Ratos Wistar , Receptor CB2 de Canabinoide/antagonistas & inibidores
4.
J Pharm Sci ; 108(2): 970-976, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30312723

RESUMO

Modified release tablet formulations with melatonin (MLT) are clinically more useful in initiating and maintaining sleep in elderly insomniacs, compared with those designed for immediate release. Aiming at the modified release of MLT, monolayered and 3-layered tablets, incorporating nanofibrous mats composed of cellulose acetate and polyvinylpyrrolidone loaded with MLT, were prepared and studied. In vitro dissolution profiles of MLT in gastrointestinal-like fluids revealed tableting pressure/pH-dependence. The release of the hormone from physical mixture tablets was generally slower from the nanofibers-based tablets, thus exhibiting in the latter case properties that are necessary for the control of both the sleep-onset and the maintenance dysfunctions. The nature of the excipients (hydroxypropylmethylcellulose or lactose monohydrate) used in this study to produce 3-layered tablets was also found to affect the release of MLT, adjusting it to the endogenous hormone's chronobiotic profile. The release of MLT from formulation F(nf)2 (nanofiber mats incorporated into 3-layered tablets containing lactose monohydrate both in the upper and lower layers) was found to be in closer alignment with these effects than the other delivery systems.


Assuntos
Celulose/análogos & derivados , Depressores do Sistema Nervoso Central/administração & dosagem , Preparações de Ação Retardada/química , Melatonina/administração & dosagem , Nanofibras/química , Povidona/química , Celulose/química , Depressores do Sistema Nervoso Central/química , Liberação Controlada de Fármacos , Melatonina/química , Nanofibras/ultraestrutura , Solubilidade , Comprimidos
5.
Psychopharmacology (Berl) ; 201(1): 137-45, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18641974

RESUMO

RATIONALE: Alcohol may be self-administered for its anxiolytic effects to alleviate symptoms of stress, but different types of stressors have varying effects on alcohol intake. Social stress is particularly relevant to alcohol drinking, and a primate model of stress-induced alcohol self-administration would be useful. OBJECTIVE: The objective of the study is to determine if social stresses of different lengths and intensities affect voluntary alcohol intake in monkeys. MATERIALS AND METHODS: Subjects were adult male and female squirrel monkeys (Saimiri sciureus) housed in social colonies. Subjects were trained to drink a solution of ethanol and sucrose, alternated daily with a control solution of quinine and an equal concentration of sucrose in 15-min sessions. Drinking was tested during 20-min acute, social separations and 1-week, extended, social separations. Dominance status was quantified using observational records of social interactions within the colonies. Salivary cortisol was sampled in the home colony and during extended social separation. RESULTS: Dominance rank was inversely correlated with alcohol intake during social housing but was not correlated with control fluid intake. Acute social separation abolished drinking of both fluids, accompanied by increased anxiety-like behavior. Extended social separation increased salivary cortisol and alcohol drinking but not control fluid intake in males. In females, drinking was unchanged by extended separation. CONCLUSIONS: The chronic stress of social subordination is correlated with increased alcohol drinking. Acute social separation stress suppresses drinking behavior, while extended separation preferentially increases alcohol intake in a subset of individuals. These findings suggest that social stressors of different time-courses and intensities have opposing effects on alcohol self-administration.


Assuntos
Consumo de Bebidas Alcoólicas , Depressores do Sistema Nervoso Central/toxicidade , Etanol/toxicidade , Hierarquia Social , Isolamento Social , Fatores Etários , Animais , Comportamento Animal , Depressores do Sistema Nervoso Central/administração & dosagem , Comportamento de Ingestão de Líquido , Etanol/administração & dosagem , Feminino , Hidrocortisona/análise , Hidrocortisona/química , Locomoção/efeitos dos fármacos , Locomoção/fisiologia , Masculino , Saimiri , Saliva/química , Autoadministração , Fatores Sexuais , Estresse Psicológico , Sacarose/administração & dosagem , Vocalização Animal/efeitos dos fármacos
6.
J Pineal Res ; 44(4): 373-8, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-18410585

RESUMO

Infection with Herpes simplex virus type 1 (HSV-1) typically causes lesions of the mouth, face, skin, esophagus, or brain. Herpes simplex virus type 2 (HSV-2) usually causes infections of the genitals, rectum, skin, hands, or meninges. The herpes viruses are a major cause of blindness from keratitis. The usual drugs used for herpes are Vidarabine, Acyclovir, Penciclovir and Ganciclovir; they are associated with several complications. The aim of this study was to investigate if a formulation containing 2.5 mg melatonin and 100 mg SB-73 would help patients with herpes, and to compare the preparation with 200 mg Acyclovir. SB-73 is a mixture of magnesium, phosphate, fatty acids extracted from Aspergillus sp. which has anti-herpes virus properties. A single blind randomized study was performed in which 70 patients underwent treatment using the supplement cited above (group A) and 75 received treatment of 200 mg Acyclovir (group B). Sixty-seven patients of the group A (95.7%) reported a complete regression of symptoms after 7 days of treatment. By comparison, 64 subjects (85.3%) of the Acyclovir reported regression of symptoms in the same period. There was statiscally significant difference between the groups (P < 0.05).


Assuntos
Aciclovir/administração & dosagem , Antivirais/administração & dosagem , Depressores do Sistema Nervoso Central/administração & dosagem , Herpes Genital/tratamento farmacológico , Herpesvirus Humano 1 , Herpesvirus Humano 2 , Ácidos Linoleicos/administração & dosagem , Melatonina/administração & dosagem , Compostos Organofosforados/administração & dosagem , Adulto , Cegueira/tratamento farmacológico , Cegueira/etiologia , Cegueira/patologia , Cegueira/virologia , Feminino , Herpes Genital/complicações , Herpes Genital/patologia , Humanos , Ceratite/tratamento farmacológico , Ceratite/etiologia , Ceratite/patologia , Ceratite/virologia , Masculino , Método Simples-Cego
7.
Compend Contin Educ Dent ; 39(3): 159-163; quiz 164, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29493245

RESUMO

Current demographic data demonstrate an aging North American population, and projections suggest that the percentage of the elderly will increase. Substance abuse among seniors is a common problem, though it is often unidentified and frequently undiagnosed. The most predominant drugs abused by the geriatric individual are alcohol; analgesics, including opioids; central nervous system depressants; and illicit drugs. This article will discuss reasons for drug abuse among the elderly, warning signs associated with substance abuse, and the implications of this problem to the oral cavity and the dental practice.


Assuntos
Padrões de Prática Odontológica/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Fatores Etários , Idoso , Intoxicação Alcoólica/epidemiologia , Alcoolismo/epidemiologia , Analgésicos Opioides/efeitos adversos , Depressores do Sistema Nervoso Central/administração & dosagem , Humanos , América do Norte/epidemiologia
9.
Alcohol ; 49(7): 675-89, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26496796

RESUMO

Identification of facial dysmorphology is essential for the diagnosis of fetal alcohol syndrome (FAS); however, most children with fetal alcohol spectrum disorders (FASD) do not meet the dysmorphology criterion. Additional objective indicators are needed to help identify the broader spectrum of children affected by prenatal alcohol exposure. Computed tomography (CT) was used in a sheep model of prenatal binge alcohol exposure to test the hypothesis that quantitative measures of craniofacial bone volumes and linear distances could identify alcohol-exposed lambs. Pregnant sheep were randomly assigned to four groups: heavy binge alcohol, 2.5 g/kg/day (HBA); binge alcohol, 1.75 g/kg/day (BA); saline control (SC); and normal control (NC). Intravenous alcohol (BA; HBA) or saline (SC) infusions were given three consecutive days per week from gestation day 4-41, and a CT scan was performed on postnatal day 182. The volumes of eight skull bones, cranial circumference, and 19 linear measures of the face and skull were compared among treatment groups. Lambs from both alcohol groups showed significant reduction in seven of the eight skull bones and total skull bone volume, as well as cranial circumference. Alcohol exposure also decreased four of the 19 craniofacial measures. Discriminant analysis showed that alcohol-exposed and control lambs could be classified with high accuracy based on total skull bone volume, frontal, parietal, or mandibular bone volumes, cranial circumference, or interorbital distance. Total skull volume was significantly more sensitive than cranial circumference in identifying the alcohol-exposed lambs when alcohol-exposed lambs were classified using the typical FAS diagnostic cutoff of ≤10th percentile. This first demonstration of the usefulness of CT-derived craniofacial measures in a sheep model of FASD following binge-like alcohol exposure during the first trimester suggests that volumetric measurement of cranial bones may be a novel biomarker for binge alcohol exposure during the first trimester to help identify non-dysmorphic children with FASD.


Assuntos
Consumo Excessivo de Bebidas Alcoólicas/patologia , Anormalidades Craniofaciais/induzido quimicamente , Transtornos do Espectro Alcoólico Fetal/patologia , Ovinos , Animais , Peso Corporal/efeitos dos fármacos , Depressores do Sistema Nervoso Central/administração & dosagem , Depressores do Sistema Nervoso Central/sangue , Depressores do Sistema Nervoso Central/toxicidade , Anormalidades Craniofaciais/patologia , Etanol/administração & dosagem , Etanol/sangue , Etanol/toxicidade , Feminino , Infusões Intravenosas , Gravidez , Carneiro Doméstico , Crânio/anormalidades , Crânio/anatomia & histologia , Tomografia Computadorizada por Raios X
10.
Eur J Pharmacol ; 462(1-3): 61-6, 2003 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-12591096

RESUMO

Using the microdialysis method, we investigated whether the levels of serotonin (5-hydroxytryptamine, 5-HT) and its metabolites, 5-hydroxyindoleacetic acid (5-HIAA) and 5-hydroxytryptophol (5-HTPL), in the locus coeruleus are influenced by tryptophan alone or simultaneous administration of tryptophan and ethanol. Tryptophan (50 mg/kg, i.p.) led to a significant increase in the levels of 5-HIAA, but not 5-HT in the locus coeruleus. However, ethanol (1.25 g/kg) had no effect on the levels of 5-HT and its metabolites. Combined administration of tryptophan and ethanol caused very marked increases in 5-HIAA and 5-HTPL levels in the locus coeruleus. A time lag in the increased 5-HIAA levels between tryptophan alone and tryptophan plus ethanol was observed. Moreover, 5-HIAA levels in the locus coeruleus induced by tryptophan were abolished by microinjection of 5,7-dihydroxytryptamine (150 microg/4 microl) into the dorsal raphe nucleus. Judging from the present results, the serotonergic afferents to the locus coeruleus may originate for about 20-30% from cell bodies located in the dorsal raphe nucleus. Teeth-chattering was significantly detected in the tryptophan plus ethanol-treated rats when compared with the tryptophan-treated rats, but not in the saline-treated controls. These results may suggest that the increased levels of 5-HIAA and 5-HTPL in the locus coeruleus induced by tryptophan are potentiated by ethanol, and that these levels are partly responsible for behavioral activation.


Assuntos
Antidepressivos de Segunda Geração/farmacologia , Depressores do Sistema Nervoso Central/farmacologia , Etanol/farmacologia , Locus Cerúleo/efeitos dos fármacos , Serotonina/metabolismo , Triptofano/farmacologia , 5,7-Di-Hidroxitriptamina/administração & dosagem , Animais , Antidepressivos de Segunda Geração/administração & dosagem , Comportamento Animal/efeitos dos fármacos , Depressores do Sistema Nervoso Central/administração & dosagem , Sinergismo Farmacológico , Etanol/administração & dosagem , Ácido Hidroxi-Indolacético/metabolismo , Hidroxitriptofol/metabolismo , Locus Cerúleo/metabolismo , Masculino , Núcleos da Rafe/efeitos dos fármacos , Núcleos da Rafe/fisiologia , Ratos , Ratos Sprague-Dawley , Triptofano/administração & dosagem
11.
Int J Oral Maxillofac Surg ; 31(5): 499-505, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12418565

RESUMO

Oromandibular dystonia (OMD) is a focal dystonia manifested by involuntary masticatory and/or lingual muscle contractions. Muscle afferent block (MAB) by injecting anaesthetic and alcohol intramuscularly is recently used for the treatment of OMD. To study the factors affecting the efficacy of MAB, 44 patients with OMD were treated by local injection of lidocaine and ethanol. They were divided into four groups (spastic, rhythmic, dyskinetic, and task-specific) according to the pattern of incisal movement and involuntary contraction. We used a clinical scaling protocol in terms of four parameters (mastication, speech, pain, and discomfort) to evaluate the change of symptoms objectively. The relationship of improvement in clinical scores with various parameters was assessed statistically. The overall objective improvement was 60.2 +/- 29.5%. The scores decreased significantly (P<0.0001, paired t-test) after MAB. The maximal incisal velocity significantly correlated inversely with the clinical improvement, and MAB was particularly effective for spastic contraction. Dyskinetic and rhythmic groups showed variable and significantly less improvements than the spastic group. MAB is highly effective for OMD, but not for the patients with dyskinetic symptoms. The jaw movement pattern is an important factor for predicting the outcome. The difference in the response to MAB in OMD and oral and/or orofacial dyskinesia suggests the distinct pathophysiology between the two.


Assuntos
Distúrbios Distônicos/terapia , Músculos da Mastigação/fisiopatologia , Bloqueio Neuromuscular/métodos , Doenças da Língua/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Anestésicos Locais/administração & dosagem , Anestésicos Locais/uso terapêutico , Depressores do Sistema Nervoso Central/administração & dosagem , Depressores do Sistema Nervoso Central/uso terapêutico , Discinesias/fisiopatologia , Discinesias/terapia , Distúrbios Distônicos/classificação , Distúrbios Distônicos/fisiopatologia , Etanol/administração & dosagem , Etanol/uso terapêutico , Feminino , Humanos , Injeções Intramusculares , Lidocaína/administração & dosagem , Lidocaína/uso terapêutico , Modelos Lineares , Masculino , Mandíbula/fisiopatologia , Mastigação/fisiologia , Músculos da Mastigação/efeitos dos fármacos , Análise por Pareamento , Pessoa de Meia-Idade , Contração Muscular/efeitos dos fármacos , Medição da Dor , Espasmo/fisiopatologia , Espasmo/terapia , Fala/fisiologia , Estatística como Assunto , Doenças da Língua/fisiopatologia
12.
Dent Clin North Am ; 46(4): 781-802, 2002 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-12436832

RESUMO

There are clearly many safe and effective sedatives available to the dental practitioner for reducing patient fear and improving their level of comfort. Careful consideration needs to be given to the objectives of the sedation when deciding which pharmacologic agents to use because they all possess slightly different clinical characteristics and various degrees of risk. Patient selection also is critical when making decisions about sedation because the patient's expectations and general health status factor into keeping the procedure safe. N2O/O2 sedation is an excellent choice for managing the mildly fearful dental patient or when minimal sedation is desirable. Among the sedatives administered enterally, the benzodiazepines are the most commonly used, and for good reason. These drugs are safe, effective, and offer a host of different personalities from which the dentist can choose. If used wisely and thoughtfully, the dentist can tailor the effects and duration of onset and recovery to the needs of the patient and the expected parameters of the appointment. When N2O/O2 sedation is combined with a single enteral sedative, a more profound level of CNS depression is achieved that can be modestly altered by changing the concentration of inhaled nitrous oxide. With these many pharmacologic alternatives, many different dental patient populations can be sedated in a safe, effective manner, thus allowing the delivery of most dental treatments in a setting of reduced psychologic and physiologic stress. These pharmacologic sedatives have truly opened up a wonderful world of possibilities for the comfortable delivery of dental care, and should be integrated into every office's repertoire for delivery of care.


Assuntos
Anestesia Dentária/métodos , Sedação Consciente/métodos , Hipnóticos e Sedativos/administração & dosagem , Administração por Inalação , Administração Oral , Adulto , Período de Recuperação da Anestesia , Anestésicos Inalatórios/administração & dosagem , Ansiolíticos/administração & dosagem , Benzodiazepinas , Depressores do Sistema Nervoso Central/administração & dosagem , Tomada de Decisões , Ansiedade ao Tratamento Odontológico/prevenção & controle , Nível de Saúde , Humanos , Óxido Nitroso/administração & dosagem , Oxigênio/administração & dosagem , Seleção de Pacientes , Fatores de Risco , Segurança , Estresse Fisiológico/prevenção & controle , Estresse Psicológico/prevenção & controle , Fatores de Tempo
13.
CNS Drugs ; 27(7): 531-43, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23757186

RESUMO

The prevalence of attention-deficit hyperactivity disorder (ADHD) in the USA is estimated at approximately 4-9% in children and 4% in adults. It is estimated that prescriptions for ADHD medications are written for more than 2.7 million children per year. In 2010, US poison centers reported 17,000 human exposures to ADHD medications, with 80% occurring in children <19 years old and 20% in adults. The drugs used for the treatment of ADHD are diverse but can be roughly separated into two groups: the stimulants such as amphetamine, methylphenidate, and modafinil; and the non-stimulants such as atomoxetine, guanfacine, and clonidine. This review focuses on mechanisms of toxicity after overdose with ADHD medications, clinical effects from overdose, and management. Amphetamine, dextroamphetamine, and methylphenidate act as substrates for the cellular monoamine transporter, especially the dopamine transporter (DAT) and less so the norepinephrine (NET) and serotonin transporter. The mechanism of toxicity is primarily related to excessive extracellular dopamine, norepinephrine, and serotonin. The primary clinical syndrome involves prominent neurological and cardiovascular effects, but secondary complications can involve renal, muscle, pulmonary, and gastrointestinal (GI) effects. In overdose, the patient may present with mydriasis, tremor, agitation, hyperreflexia, combative behavior, confusion, hallucinations, delirium, anxiety, paranoia, movement disorders, and seizures. The management of amphetamine, dextroamphetamine, and methylphenidate overdose is largely supportive, with a focus on interruption of the sympathomimetic syndrome with judicious use of benzodiazepines. In cases where agitation, delirium, and movement disorders are unresponsive to benzodiazepines, second-line therapies include antipsychotics such as ziprasidone or haloperidol, central alpha-adrenoreceptor agonists such as dexmedetomidine, or propofol. Modafinil is not US FDA approved for treatment of ADHD; however, it has been shown to improve ADHD signs and symptoms and has been used as an off-label pharmaceutical for this diagnosis in both adults and children. The mechanism of action of modafinil is complex and not fully understood. It is known to cause an increase in extracellular concentrations of dopamine, norepinephrine, and serotonin in the neocortex. Overdose with modafinil is generally of moderate severity, with reported ingestions of doses up to 8 g. The most common neurological effects include increased anxiety, agitation, headache, dizziness, insomnia, tremors, and dystonia. The management of modafinil overdose is largely supportive, with a focus on sedation, and control of dyskinesias and blood pressure. Atomoxetine is a selective presynaptic norepinephrine transporter inhibitor. The clinical presentation after overdose with atomoxetine has generally been mild. The primary effects have been drowsiness, agitation, hyperactivity, GI upset, tremor, hyperreflexia, tachycardia hypertension, and seizure. The management of atomoxetine overdose is largely supportive, with a focus on sedation, and control of dyskinesias and seizures. Clonidine is a synthetic imidazole derivative with both central and peripheral alpha-adrenergic agonist actions. The primary clinical syndrome involves prominent neurological and cardiovascular effects, with the most commonly reported features of depressed sensorium, bradycardia, and hypotension. While clonidine is an anti-hypertensive medication, a paradoxical hypertension may occur early with overdose. The clinical syndrome after overdose of guanfacine may be mixed depending on central or peripheral alpha-adrenoreceptor effects. Initial clinical effects may be drowsiness, lethargy, dry mouth, and diaphoresis. Cardiovascular effects may depend on time post-ingestion and may present as hypotension or hypertension. The management of guanfacine overdose is largely supportive, with a focus on support of blood pressure. Overdose with ADHD medications can produce major morbidity, with many cases requiring intensive care medicine and prolonged hospital stays. However, fatalities are rare with appropriate care.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Depressores do Sistema Nervoso Central/toxicidade , Estimulantes do Sistema Nervoso Central/toxicidade , Overdose de Drogas , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Depressores do Sistema Nervoso Central/administração & dosagem , Depressores do Sistema Nervoso Central/farmacocinética , Depressores do Sistema Nervoso Central/uso terapêutico , Estimulantes do Sistema Nervoso Central/administração & dosagem , Estimulantes do Sistema Nervoso Central/farmacocinética , Estimulantes do Sistema Nervoso Central/uso terapêutico , Overdose de Drogas/diagnóstico , Overdose de Drogas/etiologia , Overdose de Drogas/terapia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/diagnóstico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/etiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/terapia , Humanos
14.
Sleep ; 34(2): 195-205, 2011 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-21286495

RESUMO

STUDY OBJECTIVES: To explore the time of day effects of alcohol on sleep, we examined sleep following alcohol administered at four times of day and three homeostatic loads during a 20-hr forced desynchrony (FD) protocol. PARTICIPANTS: Twenty-six healthy young adults (21-25 yrs) were studied. DESIGN: Participants were dosed at 4 clock times: 0400 (n = 6; 2 females), 1600 (n = 7; 4 females), 1000 (n = 6; 1 female) or 2200 (n = 7; 2 females). Participants slept 2300 to 0800 for at least 12 nights before the in-lab FD study. Double blind placebo and alcohol (vodka tonic targeting 0.05g% concentration) beverages were each administered three times during FD at different homeostatic loads: low (4.25 or 2.24 hrs awake), medium (8.25 or 6.25 hrs awake), high (12.25 or 10.25 hrs awake) in the 0400 and 1600 or 1000 and 2200 groups, respectively. Sleep was staged and subjected to spectral analysis. MEASUREMENTS AND RESULTS: Breath Alcohol Concentration (BrAC) confirmed targeted maximal levels. At bedtime, BrAC was 0 in the low and medium homeostatic load conditions; however, at high homeostatic load, BrAC was still measurable. Spectral characteristics of sleep were unaffected with alcohol at any time of day. Few alcohol related changes were seen for sleep stages; however, with alcohol given at 0400 at a high homeostatic load there was an increase in wake. CONCLUSIONS: These data lend support to the idea that alcohol may be disruptive to sleep; however, our findings are inconsistent with the idea that a low dose of alcohol is a useful sleep aid when attempting to sleep at an adverse circadian phase.


Assuntos
Depressores do Sistema Nervoso Central/farmacologia , Etanol/farmacologia , Fases do Sono/efeitos dos fármacos , Adulto , Testes Respiratórios , Depressores do Sistema Nervoso Central/administração & dosagem , Ritmo Circadiano/efeitos dos fármacos , Relação Dose-Resposta a Droga , Método Duplo-Cego , Eletroencefalografia/efeitos dos fármacos , Etanol/administração & dosagem , Feminino , Humanos , Masculino , Polissonografia/efeitos dos fármacos , Valores de Referência , Saliva/efeitos dos fármacos , Saliva/metabolismo , Fatores de Tempo , Vigília/efeitos dos fármacos , Adulto Jovem
15.
Pol J Pharmacol ; 55(4): 639-44, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14581724

RESUMO

The aim of this study was to compare the pharmacokinetics of ethanol in saliva and blood according to gender and to evaluate the determination of ethanol in saliva for evidential sobriety testing. Twenty-four persons, 12 men and 12 women, took part in the experiments. The subjects received ethanol, as neat 40% v/v vodka, in the amount which should lead according to Widmark formula to the blood alcohol concentration equal to 1.0 g/l. Duplicate samples of an unstimulated mixed saliva secretion and venous blood were taken at 15 min intervals timing from the end of consumption, and ethanol concentrations in both specimens were determined by means of gas chromatography. The pharmacokinetic calculations were done using first-order absorption and Michaelis-Menten or zero order elimination models. In most cases ethanol reached higher maximal concentration in saliva than in venous blood, and was faster eliminated from saliva. The significant gender differences in the time-concentration profiles were observed. The maximal ethanol concentrations, both in blood and saliva, were lower in women compared to men. In females, ethanol was faster excreted from the body. Both experimental (Cmax) and extrapolated to zero time (C0) maximum ethanol concentrations were lower in females. The apparent volumes of distribution after oral dose for saliva and blood were very close and did not differ statistically. The study shows that the same factor equivalent to volume of distribution should be used in back calculation of alcohol concentration, and saliva alcohol analysis can be treated as independent method to test sobriety.


Assuntos
Depressores do Sistema Nervoso Central/farmacocinética , Etanol/farmacocinética , Saliva/metabolismo , Administração Oral , Adulto , Área Sob a Curva , Depressores do Sistema Nervoso Central/administração & dosagem , Etanol/administração & dosagem , Etanol/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Fatores Sexuais , Fatores de Tempo
16.
Int J Cancer ; 111(4): 480-3, 2004 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-15239123

RESUMO

Alcohol drinking and smoking are independent risk factors for upper digestive tract cancers. Furthermore, their combined use interacts in a multiplicative way on cancer risk. There is convincing evidence that acetaldehyde, the first metabolite of ethanol and a constituent of tobacco smoke, is a local carcinogen in humans. Therefore, we examined the combined effect of alcohol drinking and tobacco smoking on in vivo acetaldehyde concentration in saliva. Seven smokers and 6 nonsmokers participated in the study. First, to measure the effect of alcohol on salivary acetaldehyde, all volunteers ingested 0.8 g/kg body weight of ethanol and saliva samples were collected every 20 min for 160 min thereafter. After a 3-day washout period, smokers ingested again the same amount of ethanol and smoked one cigarette every 20 min and saliva samples were collected at 10 min intervals for 160 min. Acetaldehyde and ethanol concentrations were analyzed by headspace gas chromatograph. Firstly, smokers without concomitant smoking during ethanol challenge had 2 times higher in vivo salivary acetaldehyde concentrations than nonsmokers after ethanol ingestion (AUC 114.8 +/- 11.5 vs. 54.2 +/- 8.7 microM x hr, respectively; p = 0.002). Secondly, smokers with active smoking during ethanol challenge had 7 times higher in vivo salivary acetaldehyde levels than nonsmokers (AUC 369.5 +/- 12.2 vs. 54.2 +/- 8.7 microM x hr, respectively; p < 0.001). We conclude that this markedly increased exposure of upper digestive tract mucosa to carcinogenic salivary acetaldehyde of smoking and drinking subjects may explain the synergistic and multiplicative risk effect of alcohol drinking and tobacco smoking on upper gastrointestinal tract carcinogenesis.


Assuntos
Acetaldeído/análise , Consumo de Bebidas Alcoólicas/efeitos adversos , Depressores do Sistema Nervoso Central/metabolismo , Etanol/metabolismo , Saliva/química , Fumar/efeitos adversos , Adulto , Depressores do Sistema Nervoso Central/administração & dosagem , Etanol/administração & dosagem , Feminino , Neoplasias Gastrointestinais/etiologia , Humanos , Masculino , Fatores de Risco
17.
Doc Ophthalmol ; 109(2): 123-30, 2004 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-15881257

RESUMO

Light onset or drinking alcohol causes the standing potential of the eye to rise and then fall to a trough (the EOG). After allowing for the time for the alcohol to be absorbed into the blood stream, the changes of current with time are identical for the two agents but each acts through a separate pathway, on the same effector mechanism. We have shown that +ve and -ve processes of the alcohol-EOG may be differentially affected in disease. We have now determined the separate dose-response relationship of the two voltage changes. Alcohol diluted with water was given by mouth to fasting dark-adapted subjects. Recordings continued until both the positive peak and the later negative trough were well-characterised. Doses of alcohol ranged from 3.54 to 450 mg Kg(-1) of body weight. Experiments were carried out on three normal subjects, 4-8th decade. The results are consistent with the hypothesis that each voltage change is determined by the relation: [EtOH] x [R] <--> [EtOH.R], where <--> represents a reversible reaction. For the +ve peak, semi-saturation occurs at approximately 35 mg Kg(-l). For the -ve trough it is smaller, 11 mg Kg(-l). Therefore the result is consistent with there being 2 distinct processes, and the human EOG cannot be a single 'damped oscillation'. During the short period when change of blood alcohol concentration is effective in causing the EOG sequence (using doses which provoke large voltage changes), the computed blood concentration varies from 0.01 to 0.1 mM, i.e. is > 2 orders of magnitude less than the levels required for intoxication.


Assuntos
Depressores do Sistema Nervoso Central/administração & dosagem , Eletroculografia/efeitos dos fármacos , Etanol/administração & dosagem , Epitélio Pigmentado Ocular/fisiologia , Administração Oral , Adulto , Idoso , Idoso de 80 Anos ou mais , Adaptação à Escuridão , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Potenciais da Membrana/efeitos dos fármacos , Pessoa de Meia-Idade , Epitélio Pigmentado Ocular/efeitos dos fármacos , Valores de Referência
18.
Alcohol Clin Exp Res ; 26(3): 352-7, 2002 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11923588

RESUMO

BACKGROUND: Chronic ethanol has been shown to increase oxidative stress leading to neurodegenerative changes in the brain. Oxidative stress may up-regulate extracellular signal regulated kinases (ERK1/2) and, subsequently, the arachidonic acid cascade mediated by phospholipase A2 (PLA2) and cyclooxygenase (COX-2). Our earlier study showed that grape polyphenols (GP) could ameliorate oxidative damage to synaptic membrane proteins due to chronic ethanol treatment. This study was aimed at examining the effects of GP on mRNA expression of ERK1/2, cytosolic PLA2 (cPLA2), and COX-2 in different brain regions after chronic ethanol treatment. METHODS: Male Sprague-Dawley rats were fed a Lieber-DeCarli liquid diet with ethanol or isocaloric amount of maltose, with or without GP for 2 months. In situ hybridization was carried out using coronal brain sections through the hippocampus. RESULTS: Quantitative in situ hybridization showed no changes in ERK1 and cPLA2 mRNA levels in cortical areas and hippocampus after ethanol and/or GP administration. However, a decrease in ERK2 and an increase in COX-2 mRNA level was found in the hippocampus of ethanol-treated animals. GP completely inhibited the increase in COX-2 due to ethanol treatment. CONCLUSION: Increase in COX-2 expression may be an underlying mechanism for the increase in oxidative stress induced by chronic ethanol administration. Dietary supplementation of GP may have a beneficial role in inhibiting certain alcohol effects.


Assuntos
Encéfalo/efeitos dos fármacos , Encéfalo/enzimologia , Inibidores de Ciclo-Oxigenase/farmacologia , Etanol/administração & dosagem , Flavonoides , Isoenzimas/biossíntese , Fenóis/farmacologia , Polímeros/farmacologia , Prostaglandina-Endoperóxido Sintases/biossíntese , RNA Mensageiro/antagonistas & inibidores , Vitis , Animais , Depressores do Sistema Nervoso Central/administração & dosagem , Ciclo-Oxigenase 2 , Inibidores de Ciclo-Oxigenase 2 , Regulação da Expressão Gênica/efeitos dos fármacos , Isoenzimas/antagonistas & inibidores , Isoenzimas/genética , Masculino , Polifenóis , Prostaglandina-Endoperóxido Sintases/genética , RNA Mensageiro/biossíntese , Ratos , Ratos Sprague-Dawley
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