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Drug Overdoses during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Overdose of ergotamine during pregnancy was published in a case report of a woman at 35 weeks’ gestation who took 10 tablets of ergotamine tartrate in a suicide gesture. Two hours later uterine contractions began with no relaxation between contractions. Fetal death occurred approximately eight hours after the overdose. Two weeks after the overdose, a macerated stillbirth with no gross abnormality was delivered. Impaired placental perfusion and fetal anoxia associated with ergotamine was speculated to have caused the fetal death (Au et al., 1985). Ergot compound exposure during pregnancy was reviewed for non-overdose use, and reported eight pregnancies exposed during organogenesis. Birth defects reported in these case reports are consistent with increased vascular resistance, spasm, and ischemia (Raymond, 1995). Ergot contaminated animal food results in peripheral gangrene, a result of vascular disruption. A similar etiologic mechanism is suggested for the congenital anomalies observed in cases of non-overdose ergot therapy (Raymond, 1995).
Adrenergic Antagonists
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
It is an adrenergic β1 selective receptor antagonist without having ISA and MSA (Brunton et al., 2011; Florey, 2008). It is employed in the treatment of essential hypertension, tachycardia, heart failure, angina pectoris, vasovagal syncope, secondarily in the prevention of myocardial infarction, migraine treatment, and hyperthyroidism. It can be administered orally and used intravenously as metoprolol tartrate. It is helpful in chronic heart failure. After an oral dose, the drug has 40% bioavail-ability because of first-pass effect. Extensive metabolism occurs in the liver by the enzyme CYP2D6. The drug excretion takes place via the urine after biotransformation and 85% drug excreted are metabolites. The drug has a half-life of about 4 h (Brunton et al., 2011; Florey, 2008).
Pharmacokinetic-Pharmacodynamic Modelling
Published in John G. Wagner, Pharmacokinetics for the Pharmaceutical Scientist, 2018
Figure 14.6 shows another application of the effect compartment where the pharmacokinetic model is the simple one-compartment open model with first-order elimination and first-order input (shown inset in the figure). The drug in this case was ergotamine tartrate and the effect endpoint was the systolic blood pressure gradient between toe and arm. The drug was administered by intramuscular injection. The dotted line gives the time course of plasma concentrations of ergotamine. The solid circles give the effect and the solid line is the model-predicted effect.
First report on the presence of aflatoxins in fig seed oil and the efficacy of adsorbents in reducing aflatoxin levels in aqueous and oily media
Published in Toxin Reviews, 2022
According to our results, aflatoxins in fig extracts could also be effectively reduced by marl treatment (Figure 1). Reductions of 76.23–93.79% and 66.94–89.60% in the levels of aflatoxin B1 and total aflatoxins, respectively, were recorded after treating the extracts with this agent. Reduction rates increased with increasing the concentration of the agent (p < 0.05). At the treatment concentration of 5.0%, the aflatoxin reduction rates obtained with marl were not significantly different than those obtained with activated carbon and bentonite (p < 0.05). Marl, a calcareous clay containing a high amount of calcium carbonate, is conventionally used for deacidification of grape must (Karababa and Develi Isikli 2005). It lowers the acidity by precipitating tartaric acid and malic acid as calcium tartrate and calcium malate, respectively. This causes an increase in the pH of the must from around 3.5 to 5.0–6.0 (Rezaei et al.2020). In the past, reductions in aflatoxin levels were observed during processing of the must, especially after treating with marl (Bahar and Altug 2009, Heshmati et al. 2019). However, it was not clarified that if the reduction was caused as a result of an adsorption effect or due to structural change of the toxin caused by alkalization of the medium.
Therapeutic efficacy of super-high-dose steroid therapy in patients with profound sudden sensorineural hearing loss: a comparison with conventional steroid therapy
Published in Acta Oto-Laryngologica, 2021
Mee Hyun Song, Su Young Jung, Ja Won Gu, Dae Bo Shim
In this study, five patients in Group 1 and four patients in Group 2 complained of insomnia during the hospitalization period. Zolpidem tartrate (6.25 mg/day) was used for treating insomnia during hospitalization, and the symptoms disappeared during the follow-up period. The proportion of patients who showed insomnia in each group was not significantly different (p = .787). When hepatic toxicity, a common complication after the use of high-dose steroids, was evaluated via a hepatic enzyme test (alkaline phosphatase/alanine transaminase) at the time of discharge, none of the patients in Group 2 showed increased values, but two patients in Group 1 had a transient elevation of values. After a week of ursodeoxycholic acid administration, the increased hepatic enzyme levels normalized. In patients with diabetes, no side effects, such as uncontrolled hyperglycemia or other related diabetic complications, were observed. No complications associated with intratympanic steroid injections administered as salvage therapy were encountered in any of the patients.
Effects of garden cress, fenugreek and black seed on the pharmacodynamics of metoprolol: an herb-drug interaction study in rats with hypertension
Published in Pharmaceutical Biology, 2021
Yousef A. Bin Jardan, Abdul Ahad, Mohammad Raish, Mohd Aftab Alam, Abdullah M. Al-Mohizea, Fahad I. Al-Jenoobi
In this study, we used L-NAME-induced hypertension models to investigate the antihypertensive effects of three commonly used herbs, namely, garden cress (GC), fenugreek (FG), and black seed (BS); for this purpose, L-NAME was orally administered in rats, which induced a substantial increase in blood pressure. The outcomes of this study showed that metoprolol tartrate (MT) alone, herbs alone, and their combination showed a decrease in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in hypertensive rats. Heart rate (HR), which was depleted following treatment with L-NAME alone, improved following treatment with MT alone, herbs alone, and herbs + MT. A more potent blood pressure-lowering effect of MT was observed when administered in combination with herbs. Furthermore, the concurrent administration of drugs, particularly those predominantly cleared through CYP2D-catalyzed metabolism, with the three herbs under study should be considered with caution.