Drug Treatment of Lower Urinary Tract Dysfunction in Women
Linda Cardozo, Staskin David in Textbook of Female Urology and Urogynecology - Two-Volume Set, 2017
Fesoterodine 8 mg performed better thAn the 4 mg dose in improving urgency And uuI As recorded by 3-dAy blAdder diAry, offering the possibility of dose titrAtion. A study on the effect of fesoterodine on HrQL in pAtients with oAb confirmed improvement for both the 4 And 8 mg dose of the drug [32]. A heAd-to-heAd plAcebocontrolled triAl compAring fesoterodine 8 mg to toLt er 4 mg (n = 1590) showed greAter improvements in urgency incontinence episodes, completely dry rAtes, voided volume, And pAtient perception of improvement with fesoterodine [315]. no difference wAs noted in frequency of micturition And urgency episodes. significAntly, greAter side effects (dry mouth, heAdAche, constipAtion, And discontinuAtion) were reported with fesoterodine. This study suggests thAt fesoterodine 8 mg cAn provide improved symptom control over toLt er. In A lArge double-blind, double-dummy, phAse III study (n = 2417), fesoterodine 8 mg showed greAter improvement in urgency incontinence episodes, frequency of micturition, urgency episodes, And pAtient perception of improvement thAn toLt er 4 mg or plAcebo [323]. no difference in voided volume or nocturiA wAs noted. Dry mouth, constipAtion, And discontinuAtion rAtes were greAter with fesoterodine 8 mg. Fesoterodine hAs not been found to prolong Qt/Qtc or produce other cArdiAc AbnormAlities [321]. HyoscyAmine HyoscyAmine is A phArmAcologicAlly Active AntimuscArinic component of Atropine thAt is reported to hAve similAr Actions And side effects [12]. Few clinicAl studies Are AvAilAble to evAluAte efficAcy in the treAtment of Do [33]. A sublinguAl formulAtion of hyoscyAmine sulfAte is AvAilAble. ImidAfenAcin ImidAfenAcin is A muscArinic AntAgonist with greAter Affinity for the M3 And M1 receptors thAn the M2 receptor [326]. The orAl AdministrAtion of imidAfenAcin in rAts showed longerlAsting And more selective binding to muscArinic receptors in the blAdder thAn other tissues, with little binding in the brAin [352]. Whether this trAnslAtes to its phArmAcologicAl effects on humAns remAins unknown. The drug is primArily metAbolized in the liver by cytochrome P450 enzyme CYP3A4 [322]. The drug is Also excreted in the urine; however, the phArmAcologicAl importAnce of this hAs not yet been elucidAted. ClinicAl studies hAve primArily been performed in JApAn And the drug is not AvAilAble in Western countries. 519CONSERVATIVE AND MINIMALLY INVASIVE THERAPIES
The Psychopharmacological Revolution
Petteri Pietikainen in Madness, 2015
Still, he did not believe that hashish was an efficient drug (Dowbiggin 1991, 55–8; Goldstein 1987, 266). Compared to cannabis, opium, obtained from the opium poppy, had been known and used in Europe since antiquity. Opium produces a pleasant lassitude and drowsiness, and it was the most potent form of pain relief. In antiquity, all known antidotes included opium. In the sixteenth century, the innovative physician Paracelsus described an opium-based tincture that he called ‘laudanum’, and he recommended that it be used – sparingly, though – as a potent painkiller. The seventeenth-century British doctor Thomas Sydenham praised opium as the most universal and efficacious drug for the relief of suffering, and he compounded a proprietary opium tincture that he also named laudanum (Jones 1983, 39). When the East India Company became involved in the opium trade through India in the late eighteenth century, laudanum became popular among doctors and their patients in Britain. In 1804, the alkaloid morphine was extracted from the opium poppy plant in Germany. Morphine began to be used as a sedative in German psychiatry (Hodgson 2001). Named after the Greek god Morpheus, morphine was an efficient pain-killer, but it was soon noticed that it was more addictive than opium or alcohol. In the 1830s, hyoscyamine was isolated from Hyoscamus in Germany, and pharmacological investigations indicated that the drug had hypnotic (sleep-inducing) and sedative properties. Hyoscamine was taken into use in mental asylums, and some alienists even reported patients with chronic forms of mania and alcoholism being cured. Then, in 1874, heroin (diacetylmorphine) was synthesized from morphine. Heroin was the most potent opium-based drug, and also the most addictive. But the latter information was still lacking when the drug company Bayer brought it to market in 1898 as a non-addictive morphine substitute and cough suppressant (Fernandez & Libby 2011). In the 1880s, hyoscine was isolated from hyoscamine, and the new drug, later named scopolamine, began to be used in asylums to calm agitated patients. The drug also produced confusion, disorientation and incoordination. The German drug company Merck became the leading manufacturer of hyoscine, and the drug was still used in the 1950s, for example in Dutch mental hospitals (Pieters & Snelders 2006, 383–5). As it was thought that individuals under the influence of scopolamine (hyoscine) could not tell lies, scopolamine was also used for a while as a ‘truth serum’ in the United States. In 1922, the US obstetrician Robert House suggested that the drug be used in the interrogation of suspected criminals, and he himself did one successful experiment with two prisoners from Dallas county jail. For a while, scopolamine was indeed used for police interrogation, but due to its undesirable side effects, it was disqualified as a truth serum in the United States (Bimmerle 1993).
Abies Spectabilis (D. Don) G. Don (Syn. A. Webbiana Lindl.) Family: Coniferae
L.D. Kapoor in Handbook of Ayurvedic Medicinal Plants, 2017
Calcium oxalate crystals are present in the spongy mesophyll. The calyx exhibits the presence of trichomes and stomata, but the corolla shows trichomes on the outer side only. Ayurvedic description — Rasa — tikta, kata, kasaya; Guna — guru, raksha; Veerya — ushna; Vipak — katu. Action and uses—Kapha vat samak, pittawardhak, sotha har, badana nasak, pachan, krimi nasak, hirdya awsadak swashar, madak, kam awsadak grahi, nidrajank. Chemical constituents—Leaves of H.niger contain hyoscyamine, hyoscine, scopolamine, hyosciprin, cholin, fatty oil, mucilage, albumen, and potassium nitrate. Seeds contain hyoscyamine, a fixed or fatty oil (25%); an empyreumatic oil and ash (4 to 5%). The roots contain atropamine, tetramethyldiamenobutane, and tropine. The leaves and roots also contain an unnamed alkaloid. Pharmacological action — Seeds are intoxicating, narcotic, anodyne, digestive, astringent, and anthelmintic. Leaves are sedative, anodyne, antispasmodic, stimulant, and mydriatic in effect. Medicinal properties and uses—Hyoscyamus is largely prescribed in mental and maniacal excitement, epileptic mania, chronic dementia with insomnia, paralysis agitans, convulsions, neuralgia, hypochondriasis, functional palpitations, spasmodic cough, asthma, hiccup, in urinary affections as irritation of the kidneys, uterus, and bladder, and hysteria. It has a sedative effect particulary beneficial in irritable affections of the lungs, bowels, and genitourinary organs such as cystitis. Doses — Leaf powder — 5 to 10 gr; fresh juice — 2 to 4 ml; tincture — 2 to 4 ml; extract of the fresh plant — 1 to 3 ml.
Influence of Food on the Effect of Propantheline and L-hyoscyamine on Salivation
Published in Scandinavian Journal of Gastroenterology, 1977
G. Ekenved, A. Magnusson, G. Bodemar, A. Walan
The absorption of a quartenary (propantheline, 30 mg) and a tertiary (1-hyoscyamine, 0.8 mg) anticholinergic compound was studied in 8 healthy volunteers by measuring the effects on salivation. Both compounds were administered as rapidly disintegrating tablets, 1-hyoscyamine also in a slow-release formulation (Egazil®Durules®). The three preparations and placebo were administered under fasting conditions and with a standardized light meal using a randomized cross-over design. Salivation measurements were performed with a citric acid stimulation method every hour for 10 hours. In the fasting patient, all three anticholinergic test preparations decreased the salivation significantly. When taken with food, the effect of propantheline was almost abolished, while the effects of the 1-hyoscyamine preparations were uninfluenced. It was concluded that the clinical effects of propantheline might be extremely varying depending how the drug is taken in relation to meals. In contrast the clinical effects of 1-hyoscyamine seem to be independent of food intake.
Plant Nutritional Elements and Tropane Alkaloid Production in the Roots of Henbane (Hyoscyamus niger)
Published in Pharmaceutical Biology, 2003
K. Pudersell, R. Vardja, T. Vardja, A. Raal, E. Arak
The effect of calcium on the morphology, growth, tropane alkaloid production (hyoscyamine and scopolamine) and plant nutritional element (calcium, magnesium and potassium) content of roots and root cultures of Hyoscyamus niger L. was examined in this study. It was observed that the tropane alkaloid productivity of root cultures was significantly higher than that of the corresponding field cultures. Murashige-Skoog (MS) medium was found to be optimal for the production of tropane alkaloids of the root cultures of H. niger. Variation in the calcium content of the medium had no substantial effect on the morphology, growth or content of magnesium, potassium and sodium of the root cultures of H. niger. However, increased calcium content in MS medium increased the production of the scopolamine and decreased the production of alkaloid hyoscyamine in the root cultures of H. niger. Collectively, our results are helpful in the optimization of medium composition for the production of highly valuable tropane alkaloid scopolamine using root cultures of H. niger.
The Effect of 1-Hyoscyamine on Gastric Secretion of Acid and Pepsin in Man
Published in Scandinavian Journal of Gastroenterology, 1969
After collecting basal secretion for 30 minutes a histamine infusion was started. The infusion speed was increased every 15 minutes. The histamine infusion lasted 1 1/2 hours. During histamine stimulation there was a continuous increase in volume, acid concentration, acid output, and pepsin output for every period. Treatment with 1-hyoscyamine, which prior to the second investigation had been given for at least 2 1/2 weeks, resulted in a lowered volume, acid concentration, and acid output, during all periods of histamine stimulation. The pepsin concentration was also slightly lower for every period during treatment, resulting in a marked decrease in pepsin output.
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