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Degenerative Diseases of the Nervous System
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
James A. Mastrianni, Elizabeth A. Harris
Anticholinergics primarily have a role in young patients with early PD and prominent or refractory resting (alternating) tremor, although benefit may be modest. Available drugs include benztropine and trihexyphenidyl. Adverse effects include dry mouth, mental confusion, hallucinations, blurred vision, and difficulty initiating micturition with urinary retention.
Biogenic amines
Published in William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop, Atlas of Inherited Metabolic Diseases, 2020
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop
First-choice medications appear to be dopamine agonists, such as bromocriptine or pramipexole, or ropinirole, followed by MAO inhibitors such as selegeline or tranylcypromine. An additional trial with the anticholinergic drug trihexyphenidyl can be helpful. Pergolide and cabergoline should not be used because of the high risk of fibrotic complications. Amantadine with 4 mg/kg/d can help against drug induced dyskinesias.
Pharmacological Management of Parkinson’s Disease
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Newman Osafo, Samuel Obeng, David D. Obiri, Oduro K. Yeboah, Leslie B. Essel
After oral administration in rats, benztropine is metabolized into eight phase I metabolites and four other glucuronide conjugates that undergo biliary and urinary excretion (He et al., 1995). The clearance of the ACPs is low relative to hepatic blood flow hence, there is decrease hepatic first-pass effect associated when given orally (Brocks, 1999). Plasma elimination of trihexyphenidyl following prolong treatment course follows a two-compartmental model (Deleu et al., 2002). The drug is mainly metabolized via hydroxylation of the alicyclic moeity and is excreted 76% renally (Nation et al., 1978).
Premarital sex and its contributing factors in high-risk Indonesian adolescents: an observational study
Published in Journal of Social Distress and Homelessness, 2023
Hartono Gunardi, Wresti Indriatmi, Soedjatmiko Soedjatmiko, Rini Sekartini, Bernie E. Medise, Achmad Rafli, Nia Kurniati
The risk of having premarital sex was increased by 3.4 times in adolescents with NMUPD. This finding is consistent with a previous study that found alcohol consumption and NMUPD were related to HRSB (Li et al., 2013). Any medicine that may induce psychoactive effects (relaxation, sedation, intoxication, euphoria, increased energy, and hallucinations) can be abused and such effects can be produced if taken in higher doses. For example, intoxicating, hallucinogenic, and dissociative effects are produced by dextromethorphan when consumed 5–10 times the recommended dose. Trihexyphenidyl is abused for its stimulant, euphoriant, and hallucinogenic effects, and chlorpromazine for its significant anticholinergic and sedating effects (Reeves et al., 2015). Adolescents who practiced NMUPD were more likely to have multiple sex partners, have sex after drinking or using drugs, and engage in unprotected sex (Benotsch et al., 2011).
The cognitive safety of antimuscarinics in the treatment of overactive bladder
Published in Expert Opinion on Drug Safety, 2020
George Araklitis, Dudley Robinson
The hypothesis that loss or blockade of cholinergic/muscarinic receptors may lead to Alzheimer’s disease was investigated in patients with Parkinson’s disease, with no evidence of dementia [38]. Patients taking long-term antimuscarinic medication were 2.5 times more likely to have amyloid plaques in brain samples, compared to those taking no antimuscarinics or antimuscarinics for less than two years. There were no differences in the control group (no antimuscarinic) and the group using them for less than two years. Neurofibrillary tangles were also two-fold higher in the long-term antimuscarinic group compared with the control or short-term treatment groups although there was no difference between the short-term group and control group. The most common antimuscarinic was trihexyphenidyl, a drug used to manage complications of Parkinson’s disease. The most commonly used bladder antimuscarinic used in this cohort of patients was oxybutynin.
Repurposing drugs for the treatment of galactosemia
Published in Expert Opinion on Orphan Drugs, 2019
Movement disorders occur in some patients with type I galactosemia [33]. Dystonia (sustained, uncontrolled muscle contractions) is the most commonly observed symptom and weaknesses which results in reduced dexterity and balance is also seen [33,90]. Treatment is not always given, although patients are often supported by physiotherapy and occupational therapy. One patient has been reported to have been treated with trihexyphenidyl (CAS: 144-11-6; Figure 4) and botulinum toxin in addition to a lycra suit [33]. Trihexyphenidyl is used in the treatment of Parkinson’s disease and other conditions which result in involuntary movements and botulinum toxin is used as a muscle relaxant in a variety of diseases. Wider consideration of the use of existing drugs to treat dystonia and ataxia may be worth considering for galactosemia patients.