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Conclusions Authors concluded that one size fits all strategy will not be effective, and CE must be stage specific to be effective. Recommend that need to understand strategies for each stage in order to design programmes to assist pharmacists in taking the next step Suggested support required to overcome barriers: improving public relations, professional training, support from Government and professional bodies, remuneration, money to employ additional staff, utilisation of CE courses, working with other healthcare professionals Study found that 22% of pharmacists' time was devoted to non professional activities which could have been performed by non professional members of the team. Authors recommended time management and use of staff would increase scope for pharmacists to integrate PC into routine practice.
Fluvoxamine faverin ; , fluoxetine prozac ; , paroxetine seroxat ; and sertraline lustral ; second best.
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Pretreatment with Antidepressants Enhanced BDNF-evoked Release of Glutamate and Increase in Intracellular Ca2 Concentration in Cultured Cortical Neurons--Immunocytochemical analysis, using anti-microtubule-associated protein 2 MAP2, a neuronal marker ; and antiglial fibrillary acidic protein an astroglial marker ; , revealed that the proportion of MAP2 positive cells in our cortical cultures 7 days in vitro, DIV 7 ; was 80% n 4, the number of selected fields ; , suggesting that the majority of cultured cells were neurons Fig. 1A ; . After cultured neurons were pretreated with 0.0110 M imipramine or fluvoxamine for 48 h, BDNF-induced glutamate release was measured. As shown in Fig. 1B, both antidepressants enhanced the BDNF-induced glutamate release. Both drugs were effective at 0.110 M, although these antidepressants had no effect at the concentration of 0.01 M a and b in Fig. 1B ; . The basal release of glutamate was not influenced by either drug. In our previous study 1, 29 ; , we showed that the BDNF-induced glutamate release depends on increases in [Ca2 ]i through IP3-sensitive Ca2 channels. Therefore, we monitored changes in the intracellular concentration of Ca2 stimulated by BDNF. Pretreatment with imipramine or fluvoxamine potentiated the BDNF-elicited [Ca2 ]i Fig. 1C ; . The time dependence of the [Ca2 ]i increase in cell bodies before and after BDNF application is shown a in Fig. 1C ; . The changes in [Ca2 ]i were quantified by normalizing the Fluo-3 fluorescence intensity to the basal line F F0 ; . The [Ca2 ]i increase by BDNF was observed in both neurites and soma b in Fig. 1C ; . Quantitative data of [Ca2 ]i were obtained by analyzing the concentration at the cell body c in Fig. 1C ; as a higher intensity of dye emission was seen in cell bodies than in neurites. Pretreatment with Imipramine Increased Activation of PLC- by BDNF--We previously reported that the PLC- IP3 Ca2 an increase in [Ca2 ]i from the IP3-sensitive Ca2 channel receptors ; pathway, downstream of TrkB, is essential for the BDNF-induced glutamate release 1, 29 ; . Therefore, the effect of pretreatment with imipramine on BDNF-stimulated PLC- activation phosphorylation ; was examined. To determine PLC- activity, the blotting with anti-phospho-Tyr antibody following immunoprecipitation with anti-PLC- antibody was performed. As shown in Fig. 2A, PLC- was activated within 0.5 min after the application of BDNF with or without imipramine pretreatment. However, the magnification of PLC- activation was significantly greater in imipramine-treated cultures, compared with non-treated cultures. The enhancement of the PLC- activation was confirmed at 0.5, 1.0, or 3.0 min after the BDNF stimulation as compared with that obtained from non-treated cultures a in Fig. 2A ; . Quantification of the levels of activated PLC- is shown b in Fig. 2A ; . The enzymatic activity of PLC- stimulated by BDNF were also examined supplementary Fig. S1 ; . The enhancement of PLC- enzymatic activity was confirmed supplementary Fig. S1 ; . Activation of TrkB was also examined Fig. 2B ; . TrkB was equally activated by BDNF with or without imipramine pre.
Modified Cyclics Maprotiline Trazodone HCl Selective Serotonin Reuptake Inhibitors SSRIs ; Citalopram Hydrobromide Paroxetine Hydrochloride Fluoxetine Sertraline Fluvoxamine Tricyclic Agents Amitriptyline HCl Desipramine HCl Doxepin HCl Imipramine HCl Nortriptyline HCl Misc. Antidepressants Bupropion HCl Venlafaxine HCl Mirtazapine Nefazodone HCl LUDIOMIL DESYRYL and folic.
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Pay. Federal Drug Administration FDA ; approval for a new use or "indication" takes less than 18 months, as opposed to eight years to bring a drug from lab to pharmacy. The selective serotonin reuptake inhibitors SSRIs ; are a case in point. This family of pharmaceuticals, which includes Paxil, Prozac, Zoloft, Celexa, and Luvox, were originally approved simply and solely for use as antidepressants. Brendan Koerner 2002 ; explains how SmithKline Beecham was able to increase Paxil's market share, when in 1993 Paxil lagged behind its competitors -- Prozac an Eli Lilly product ; and Zoloft owned by Pfizer ; . SmithKline subsequently found two disorders in the Diagnostic Statistical Manual of Mental Disorders DSM ; for which Paxil might be prescribed, namely, "social anxiety disorder" and "generalized anxiety disorder." It would not be long before Pfizer, in turn, would seek a new use for Zoloft, specifically as a medication for "posttraumatic stress disorder." Although DSM entries are shaped by social and cultural norms, and the politics surrounding them e.g., homosexuality was diagnosed as a mental disorder up until 1973 ; , the DSM notation is considered sufficient proof by the FDA that a disease actually exists, and in-house corporate studies are basically unquestioned, even when companies fail to make their data or methodologies available to other members of the scientific community, as would be essential for professional academic acceptance. In August 2002, escitalopram became the sixth member of the SSRI family. Its birth came about as a result of another kind of pharmaceutical marketing and development strategy. The strategy is not to find new uses for an old drug but to push an old drug as if it were new. Drug companies do this by manipulating a chemical molecule known as an isomer and then selling what amounts to a chemical mirror image of the original drug an isomer.is, chemically speaking, a molecule containing identical atoms to another molecule, but differently arranged: a mirror image, to be precise. Consider two isomers of a certain molecule to be like a pair of gloves same number of fingers, just arranged differently. parating these mirror images and selling only a single mirror image as a "new " drug is a successful business scheme, not a strategy to improve public health. This may be likened to selling one glove and claiming that it is as good as or better than two. Public Citizen Health Research Group, March 2003: 2 and geodon.
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Diabetes insipidus results from either a deficiency in anti diuretic hormone central or cranial diabetes insipidus, see Table 11.14 ; or from renal resistance to ADH nephrogenic diabetes insipidus, see Table 11.15!
And obesity in non-insulin-dependent diabetics Daubresse et al., 1996 ; . However, the actions of putative SSRIs in invertebrates are poorly understood, even though 5-HT is a widely occurring biogenic monoamine that has been identified in a large number of invertebrates including cnidarians, platyhelminthes, nemerteans, annelids, arthropods, and especially molluscs Welsh and Moorhead, 1960; Fujii and Takeda, 1988; Sandeman et al., 1988; Linn and Roelofs, 1993 ; . Although some authors report enhanced fertilizability of bivalve oocytes in 5-HT Juneja et al., 1993 ; , others report that high concentrations of 5-HT have toxic effects on zebra mussel gametes J. Lynn, pers. comm.; pers. obs. ; . In the present experiments, toxic effects on mussels were noticed at high concentrations of fluoxetine and paroxetine. However, these effects were observed after most, if not all, animals in each group had already spawned. Thus the toxicity is not believed to have stimulated the spawning. The reduction in sperm motility observed in fluoxetine and paroxetine may be due to the direct action of the drugs on the sperm, since sperm transferred to fresh lake water usually recovered their motility. The mucus release seen in mussels exposed to paroxetine has also been observed in fingernail clams exposed to the same drug pers. obs. ; . Other than algal and gamete extracts Ram et al., 1996 ; fluvoxamine, fluoxetine, and paroxetine are the only compounds that stimulate spawning in zebra mussels which are not well-known 5-HT receptor ligands. Moreover, the lowest concentrations of any compound previously and ziprasidone.
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Table 1. Drugs by Class Metabolized Entirely or Partially by CYP2D6 [3, 1416]. Class 5-HT3 receptor antagonists Antiarrhythmics Beta-blockers Antipsychotics Antidepressants Antihistamines Analgesics Miscellaneous Drugs Dolasetron, ondansetron, palonosetron, tropisetron Amiodarone, aprindine, flecainide, mexiletine, procainamide, propafenone, quinidine, sparteine Carvedilol, metoprolol, propranolol, timolol Clozapine, fluphenazine, haloperidol, perphenazine, risperidone, thioridazine, zuclopenthixol Amitriptyline, citalopram, clomipramine, desipramine, fluoxetine, fluvoxamine, imipramine, maprotiline, mianserin, maprotiline, mirtazapine, nortriptyline, paroxetine, sertraline, venlafaxine Mequitazine, promethazine Codeine conversion to morphine ; , dextromethorphan, dihydrocodeine, hydrocodone, oxycodone, tramadol Atomoxetine, captopril, cinnarizine, diltiazem, flunarizine, galanthamine, lignocaine, loratadine, methylenedioxy methamphetamine "ecstasy" ; , nicergoline, ritonavir, tamoxifen, theophylline, vinblastine and grisactin.
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Spawning at low concentrations, and fluvoxamine is the most powerful spawning inducer in any bivalve. These may be useful agents for stimulating invertebrate serotonergic mechanisms without applying exogenous 5-HT, and they are potentially important in bivalve aquaculture. Moreover, these results suggest, for the first time, the presence of 5-HT reuptake transporters in bivalve mollusts. Introduction Serotonergic mechanisms regulate a wide variety of physiological functions in molluscs. Amongst bivalve molluscs, reproductive processes including oocyte maturation Hirai et al., 1988; Krantic et al., 1991; Fong et al., 1994a; Gobet et al., 1994 ; , spawning Hirai et al., 1988; Ram et al., 1993 ; , and parturition Fong and Warner, 1995; Fong et al., 1996a ; are regulated by serotonin 5-hydroxytryptamine, 5-HT ; or a 5-HT-like compound. Exogenous application of 5-HT and 5-HT receptor ligands such as 8-OH-DPAT and alpha-methyl-5-HT induce spawning in a number of marine and freshwater bivalves Gibbons and Castagna, 1984; Ram et al., 1993; Fong et al., 1993, 1996b ; . The serotonin pharmacology of spawning has been recently elucidated in the exotic zebra mussel, Dreissena polymorpha Fong et al., 1993, 1994b ; . Both male and female zebra mussels spawn when exposed to 10e4 M and 10e3 M 5-HT. Fluvoxamine 5 -methoxy -4' - trifluoromethyl ; valerophenone E ; -0- 2-amimoethyl ; oxime maleate ; , fluoxetine ; , and paroxetine - ; -trans-4R- 4'-fluorophenyl ; 3S - [93', 4' - methylenedioxyphenoxy ; methyl] piperidine hydrochloride hemihydrate ; are commonly prescribed antidepressants "Luvox, " "Prozac, " and "Paxil, " respec143.
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Table QRS width Tv-SD Tsr-SD Tstrain-SD 0.39 * 0.38 * 0.24# EF -0.26# -0.70 * -0.72 * EDVI 0.44 * 0.68 * 0.61 * ESVI 0.42 * 0.76 * 0.70.
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Some antidepressants can be helpful to people with Parkinson's who have depression. However, it is important to note that there are three main types of antidepressants and some will be more suitable for people with Parkinson's than others. There are also one or two that are contraindicated for people with Parkinson's. The main groups of antidepressants available are tricyclics, SSRIs and MAOIs, but antidepressants with other mechanisms also exist. Tricyclic and related antidepressants have been available for the longest time and work at least partly by blocking the re-uptake in the brain of the neurotransmitters serotonin and noradrenaline, thereby increasing levels of these neurotransmitters at their receptors. Selective Serotonin Re-Uptake Inhibitors SSRIs ; , such as fluoxetine Prozac ; , fluvoxamine Faverin ; , citalopram Cipramil ; , escitalopram Cipralex ; , paroxetine Seroxat ; and sertraline Lustral ; , are newer drugs that specifically target the neurotransmitter serotonin. Antidepressants with other mechanisms such as venlafaxine Efexor ; , reboxetine Endronax ; , duloxetine Cymbalta, Yentreve ; or mirtazapine Zispin ; work on the receptors of more than one neurotransmitter system. Monoamine oxidase inhibitors MAOIs ; fall into two types - MAOI A ; and MAOI B and micronase.
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Pharmacotherapy: There are three classes of antidepressants which are most commonly prescribed. Historically, tricyclic antidepressants TCAs ; 1 were used as the first line antidepressant. They act by blocking reuptake of neurotransmitters serotonin and norepinephrine ; presynaptically so that more of them are available for the transmission of electrical impulses. TCAs now available are amitriptyline, amoxapine, imipramine, clomipramine, desipramine, doxepin, dothiepin2 , maprotiline, nortriptyline, oxaprotiline3, proptriptyline and trimipramine. As is the case with all antidepressants, TCAs may cause anticholinergic side effects, including dry mouth, urinary retention, postural hypotension, blurred vision and constipation. Cardiac arrhythmias may also occur in some cases. Monoamine oxidase inhibitors MAOIs ; , another class of antidepressants, act by inhibiting monoamine oxidase, an enzyme, from transforming neurotransmitters into metabolites, thereby increasing the number of these for transmission. The side effects of MAOIs are not unlike those of TCAs, but patients on MAOIs have to adhere to a diet for tyramine control to prevent hypertensive crises. At present, a reversible and selective inhibitor of the MAO-A isoenzyme RIMA ; , moclobemide, lacks the side effects of the older MAOIs, tends to cause less gastrointestinal effects than the SSRIs and has not been reported to interfere with sexual function. However, in Canada, MAOIs or RIMAs are not as widely used as TCAs. SSRIs are the newest class of drugs for treating depression, and include fluoxetine, fluvoxamine, paroxetine and sertraline, and have been reported to have fewer adverse effects than TCAs or MAOIs; these include nausea, nervousness, diarrhea, agitation, dry mouth, insomnia and anxiety. Overall, SSRIs are considerably more expensive than the other drugs, but generic products of fluoxetine, which have been approved for the Canadian market, have reduced the cost differences with TCAs. Other new cyclic antidepressants such bupropion3, nefazodone, trazodone and venlafaxine have little or no anticholinergic effects but some have also been reported to interfere with sexual function. They have been available in Canada but are not yet widely used. More than half of all outpatients who begin treatment with antidepressants experience marked improvement or remission of symptoms. In the absence of contraindications, antidepressants are first-line treatment when there are: moderate to severe symptoms, chronic symptoms, recurrent episodes, hallucinations, melancholic symptoms, family history of depression, or when response to psychotherapy alone is incomplete or on the basis of patient preference Depression Guideline Panel, 1993b.
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Paroxetine, WAY-100635 and L-368899 Introduction The Selective Serotonin Reuptake Inhibitors SSRIs ; fluoxetine, citalopram, paroxetine, fluvoxamine, and sertraline are widely used antidepressants that act by blocking 5-HT transporters in the central nervous system, thereby elevating extracellular serotonin levels Nutt et al., 1999; Vaswani et al., 2003 ; . Although chronic SSRI-treatment induces relatively few side-effects, sexual dysfunctions such as delayed ejaculation or anorgasmia are reported regularly Gregorian et al., 2002; Rosen et al., 1999 ; . The neurobiological background of SSRI-induced delayed ejaculation is not yet unravelled. Increased 5-HT neurotransmission probably plays a role, since elevated serotonin levels in brain and spinal cord inhibit ejaculation Ahlenius and Larsson, 1998; Foreman et al., 1992; Hillegaart et al., 1991; Marson and McKenna, 1992; Verma et al., 1989 ; , most likely via activation of 5-HT1B and or 5-HT2C receptors Fernandez-Guasti et al., 1989; Foreman et al., 1989; Hillegaart and Ahlenius, 1998; Klint et al., 1992; Pomerantz et al., 1993a; Watson and Gorzalka, 1991 ; . Although SSRIs acutely elevate 5-HT levels Bymaster et al., 2002 ; , the inhibition of ejaculation seems to require chronic SSRI-treatment Cantor et al., 1999; Mos et al., 1999; Taylor et al., 1996; Vega et al., 1998 ; . Moreover, the degree of delayed ejaculation differs markedly between paroxetine and fluoxetine, which cause a severe delay, and citalopram and fluvoxamine, which hardly impair ejaculation in humans and rats Waldinger et al., 1998b; Waldinger et al., 2002; Waldinger et al., 2001; Waldinger et al., 2004a ; , despite their comparable effect on 5-HT levels Bymaster et al., 2002 ; . Growing evidence suggests that 5-HT1A receptor functioning plays a crucial role in the occurrence and degree of SSRI-induced delayed ejaculation. It is well known that 5-HT1A receptor activation strongly facilitates ejaculation Ahlenius et al., 1981; Coolen et al., 1997a; Haensel and Slob, 1997 ; , and it is possible that after acute injection with an SSRI the inhibiting effects of elevated 5-HT levels on ejaculation are compensated by 5-HT1A receptor activation. Consistently, acute treatment with the SSRI citalopram strongly inhibits ejaculation when co-administered with the selective 5-HT1A receptor antagonist WAY-100635 Ahlenius and Larsson, 1999; de Jong et al., 2005a ; . Chronic treatment with paroxetine impairs those 5-HT1A receptors that facilitate ejaculation de Jong et al., 2005c ; , probably by desensitization Le Poul et al., 1995; Li et al., 1997b ; , and together with the elevated serotonin levels this might underlie delayed ejaculation. It is not yet known whether and how 5-HT1A receptor activation can prevent the inhibition of ejaculation following acute SSRI treatment. The neuropeptide oxytocin might play a role, since both 5-HT1A receptor activation and acute treatment with the SSRI.
6 Recent Patents on Anti-Infective Drug Discovery, 2006, Vol. 1, No. 1.
It is anticipated that recent approval to market these drugs without a prescription will result in increased market activity and improvements in many of the these areas.
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