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Neurotransmitter Physiology

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161. British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: An update

balance between arousing and sleep-inducing physiological systems. Current research suggests that arousal and wakefulness are promoted by parallel neurotransmitter systems whose cell bodies are located in brainstem or midbrain centres, with projections to the thalamus and forebrain. These activating neurotransmittersarenoradrenaline,serotonin,acetylcholine, dopamine and histamine. In addition the newly discovered orexin system with cell bodies in the hypothalamus promotes wakefulness through (...) (Raskind et al., 2007). Trazodone is commonly used to promote sleep and has blocking actions at noradrenaline, 5HT and histamine receptors; this multiple action probably explains why it is widely used, although there are few controlled clinical trials. Other drugs such as sedating antidepressants and antipsy- chotics probably promote sleep in a similar fashion. The promotion of sleep is regulated by a number of other neurotransmitters (see Table 2); primary amongst these is gamma-aminobutyric acid

2019 British Association for Psychopharmacology

164. CRACKCast E111 – Mood Disorders

was an increase from 5% in 2000. This increase is nearly double what would have been expected by population growth alone. Up to 50% of Americans will meet the criteria for a DSM-5 disorder sometime in their life, with an estimated 21% having a mood disorder.” [1] List the 3 neurotransmitters implicated in depression. Low levels of these in the synapse: Serotonin Norepinephrine Dopamine Other neurotransmitter systems implicated: Low levels of Glutamate γ-aminobutyric acid [2] List the DSM V criteria for Major (...) of worthlessness, or excessive or inappropriate guilt Diminished ability to think or concentrate, or indecisiveness Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation, or a suicide plan or attempt. B. Symptoms cause clinically significant distress or impairment in social, occupational, or other functioning. C. Symptoms are not caused by direct physiologic effects of a substance (eg, drug of abuse, medication) or a general medical condition (eg, hypothyroidism). D. Symptoms

2017 CandiEM

166. National Research Agenda on the Health Impacts of Non-Medical Cannabis Use

by the endocannabinoid system (ECS).7 In the past 10 to 15 years a large amount of research has been conducted on the ECS and there is now extensive knowledge about its constituent parts; their location in different regions of the brain and in other organs and tissues elsewhere in the body; their role in retrograde signaling in synapses using glutamate, serotonin, GABA, endogenous opioids and a variety of other neurotransmitters and neuromodulators; and their roles in neurogenesis, angiogenesis, synaptic plasticity (...) , nervous system maturation, inflammation and numerous other physiological and pathological processes. Much of this research has been motivated by the search for potential therapeutic agents, but increasing interest has been shown in the effects of altered ECS function in the production of the adverse effects of cannabis and other agents on health. Gene variants of different elements of the ECS, including the CB1 receptor and the enzymes that synthesize and degrade the endocannabinoids themselves, have

2017 Canadian Centre on Substance Abuse

167. Briviact - brivaracetam

Polypeptide 1B1 OATP1B3 Organic Anion Transporting Polypeptide 1B3 OCT1 Organic Cation Transporter 1 OCT2 Organic cation transporter 2 OECD Organisation for Economic Co-operation and Development PBO placebo PBPK Physiologically Based Pharmacokinetics PCTFE Polychlorotrifluoroethylene PD Pharmacodynamic PE Polyethylene PEC predicted environmental concentration P-GES Patient Global Evaluation Scale P-gp P-glycoprotein PGS primary generalized seizures Ph. Eur. European Pharmacopoeia pIC 50 log (...) to a relative molecular mass of 212.29 g/mol and has the following structure: The structure of brivaracetam was inferred from the route of synthesis and confirmed by 1 H and 13 C NMR spectroscopy, IR spectroscopy, UV spectroscopy, mass spectrometry, elemental analysis and XRPD. The active substance is a white to off-white non-hygroscopic crystalline solid, very soluble in aqueous media across the physiological pH range and also in polar organic solvents. The physicochemical properties of brivaracetam render

2016 European Medicines Agency - EPARs

168. Ixazomib (Ninlaro) - multiple myeloma

cation transporter ORR PAR overall response rate Proven acceptable range PBPK physiologically based pharmacokinetic PD progressive disease PFS progression-free survival P-gp Ph. Eur. P-glycoprotein European Pharmacopoeia PI proteasome inhibitor PK pharmacokinetic(s) PO oral administration PR partial response PT PVC preferred term Poly(vinyl chloride) QW once weekly RBC red blood cell RP2D recommended phase 2 dose RRMM relapsed and/or refractory multiple myeloma RVD bortezomib in combination (...) with dexamethasone) and panobinostat (in combination with bortezomib and dexamethasone) are approved agents in the EU. The proteasome inhibitor carfilzomib and the monoclonal antibody elotuzumab both in combination with lenalidomide and dexamethasone were approved in the EU for the treatment of adult patients with multiple myeloma who have received at least one prior therapy. Ixazomib citrate, a prodrug, is the drug substance that rapidly hydrolyses under physiological conditions to its biologically active form

2016 European Medicines Agency - EPARs

169. Pregabalin Mylan Pharma

, which has been authorised in the EU since 6 July 2004. The active substance of Pregabalin Mylan Pharma is pregabalin, an analogue of the neurotransmitter gamma-aminobutyric acid (GABA). Pregabalin decreases central neuronal excitability by binding to an auxiliary subunit (a2-d protein) of a voltage-gated calcium channel on neurons in the central nervous system. Pregabalin reduces the release of several neurotransmitters, including glutamate, noradrenaline, and substance P. The safety and efficacy (...) , with comparable dissolution profiles and acceptable stability. Since Lyrica is a hard capsule formulation, the same presentation was chosen for Pregabalin Mylan Pharma. Pregabalin is highly soluble over the physiological pH range and highly permeable (BCS I) and has reasonable flow properties. Therefore, a dry blending process was investigated, followed by filling into the hard capsules. Excipients were chosen based on the functionality of those in the reference product, literature information, and experience

2015 European Medicines Agency - EPARs

170. Pregabalin Mylan

Mylan is a generic medicinal product of Lyrica, which has been authorised in the EU since 6 July 2004. The active substance of Pregabalin Mylan is pregabalin, an analogue of the neurotransmitter gamma-aminobutyric acid (GABA). Pregabalin decreases central neuronal excitability by binding to an auxiliary subunit (a2-d protein) of a voltage-gated calcium channel on neurons in the central nervous system. Pregabalin reduces the release of several neurotransmitters, including glutamate, noradrenaline (...) was to produce immediate release capsules of pregabalin, pharmaceutically equivalent to Lyrica, with comparable dissolution profiles and acceptable stability. Since Lyrica is a hard capsule formulation, the same presentation was chosen for Pregabalin Mylan. Pregabalin is highly soluble over the physiological pH range and highly permeable (BCS I) and has reasonable flow properties. Therefore, a dry blending process was investigated, followed by filling into the hard capsules. Excipients were chosen based

2015 European Medicines Agency - EPARs

171. Sivextro - tedizolid phosphate

and AUC0-24 TR-700 values at the human therapeutic oral dose of 200 mg/day are 2.2 µg/mL and 24.6 µg.hr/mL, respectively. The TR-701/FA nonclinical pharmacodynamics and safety pharmacology program included in vitro and in vivo evaluations of the TR-700 efficacy profile against pathogens relevant to cSSTIs/ABSSSI and hospital-acquired lung infections, an investigation of its potential off-target pharmacological activities, and its actions on physiological responses both in vivo and in isolated tissues

2015 European Medicines Agency - EPARs

174. Food Supplementation for Improving the Physical and Psychosocial Health of Socio?economically Disadvantaged Children Aged Three Months to Five Years: A Systematic Review (Full text)

and severity of diarrhoea and pneumonia ( ). In turn, severe illness may lead to appetite loss, metabolic changes, and behavioural changes ( ), thus worsening nutritional status and may increase the risk of more prolonged or severe illness episodes ( ). Early and persistent undernutrition may cause permanent changes in physiology, metabolism, and endocrine function ( ; ); it has been increasingly linked to chronic diseases, including obesity, stroke, and coronary heart disease ( ; ; Caballero 2001 (...) of infection ( ; ; ). The energy, nutrients, and micronutrients given may also improve motivation and psychosocial health, including cognitive functions such as intelligence, attention, psychomotor skills, language,and visuospatial skills. Nutrition can influence the development and function of a young child's brain through several mechanisms: development of brain structure, including increased brain volume ( ), myelination, and neurotransmitter operation ( ; ). Feeding may also improve social behaviour

2015 Campbell Collaboration PubMed abstract

175. Eating disorders

with an eating disorder are female. Neurobiological factors: Eating disorders have been associated with abnormal neurotransmitter activity (including serotonin and dopamine) and satiety-related hormones (including adiponectin and ghrelin). It is not known if these are involved in the development of an eating disorder or are the result of physiological alterations due to malnutrition. Psychosocial factors such as: Anxiety, depression, perfectionism, low self-esteem, body dissatisfaction and overestimation (...) such as bradycardia, tachycardia, orthostatic hypotension, syncope or pre-syncope are associated with increased risk of sudden unexpected cardiovascular death in this group [ ]. The presence of oedema is usually multifactorial and reflects hypoalbuminaemia, nutritional deficiency, congestive cardiac failure or refeeding syndrome [ ]. Be aware that normal and cut-off physiological parameters such as blood pressure vary with age, and danger thresholds differ significantly for children and adults [ ]. Collateral

2019 NICE Clinical Knowledge Summaries

176. Premenstrual syndrome

include reduced cognitive ability and aggression. A diagnosis of PMS is supported by the timing (rather than the types) of symptoms and the degree of impact on daily activity. To differentiate PMS from physiological premenstrual symptoms (experienced by 80–90% of women), it must be demonstrated that symptoms cause significant impairment to the woman during the luteal phase of the menstrual cycle. Premenstrual dysphoric disorder (PMDD) is a severe form of PMS defined in the Diagnostic and Statistical (...) by the timing (rather than the types) of symptoms and the degree of impact on daily activity. To differentiate PMS from physiological premenstrual symptoms (experienced by 80–90% of women) [ ; ; ], it must be demonstrated that symptoms cause significant personal, interpersonal, and/or functional impairment to the woman during the luteal phase of the menstrual cycle. Women who experience minor, transient premenstrual symptoms (such as abdominal bloating [most common], breast tenderness, headache, acne

2019 NICE Clinical Knowledge Summaries

177. Harm of HPV vaccine: Latest information and examination of epidemiological studies

unaffected by haemodialysis or peritoneal dialysis. Liver damage: Because the prolongation of the elimination half-life is reported in patients with severe liver damage, methadone use should be avoided in them. The use of methadone is restricted even in patients with mild to moderate liver disease. Elderly people: Because renal, hepatic, cardio-pulmonary, and other physiological conditions including neurological functions, are all reduced, careful management is essential, especially to prevent (...) compartments, the coupled transport of small molecules such as neurotransmitters and ATP as well as the entry of pathogenic agents, including envelope viruses and bacterial toxins. V-ATPases are present in the plasma membrane of renal cells, osteoclasts, macrophages, epididymal cells and certain tumour cells where they are important for urinary acidification, bone resorption, pH homeostasis, sperm maturation and tumour cell invasion, respectively. PPI inhibits not only the proton pump of gastric parietal

2015 Med Check - The Informed Prescriber

178. Measuring fractional exhaled nitric oxide concentration in asthma: NIOX MINO, NIOX VERO and Nobreath

need and practice actice The problem addressed 3.1 Nitric oxide, which is produced in the lungs and is present in exhaled breath, has been implicated in the pathophysiology of lung diseases, including asthma. It has been shown to act as a vasodilator, bronchodilator, neurotransmitter and inflammatory mediator in the lungs and airways. Over the years, fractional exhaled nitric oxide (FeNO) has been proposed as a non-invasive marker of airway inflammation in asthma. FeNO levels are raised in people

2014 National Institute for Health and Clinical Excellence - Diagnostics Guidance

179. Acute pain management: scientific evidence (3rd Edition)

INTRODUCTION v SUMMARY OF KEY MESSAGES xix 1. PHYSIOLOGY AND PSYCHOLOGY OF ACUTE PAIN 1 1.1 Applied physiology of pain 1 1.1.1 Definition of acute pain 1 1.1.2 Pain perception and nociceptive pathways 1 1.1.3 Neuropathic pain 6 1.2 Psychological aspects of acute pain 6 1.2.1 Psychological factors 7 1.2.2 Acute pain settings 8 1.3 Progression of acute to chronic pain 9 1.3.1 Predictive factors for chronic postsurgical pain 11 1.3.2 Mechanisms for the progression from acute to chronic pain 12 1.4 Pre-emptive (...) and preventive analgesia 12 1.5 Adverse physiological and psychological effects of acute pain 15 1.5.1 Acute pain and the injury response 15 1.5.2 Adverse physiological effects 16 1.5.3 Pain and analgesia: effects on injury-induced organ dysfunction 19 1.5.4 Acute rehabilitation and ‘fast-track’ surgery 20 1.5.5 Adverse psychological effects 21 1.6 Pharmacogenomics and acute pain 21 1.6.1 Loss of pain sensation 22 1.6.2 Reduced sensitivity to pain 22 1.6.3 Drug metabolism 23 References 25 2. ASSESSMENT

2015 National Health and Medical Research Council

180. UnderNutrition and the Older Person

UnderNutrition and the Older Person Position Statement No 6 Undernutrition and the Older Person Key Points 1. Undernutrition in older people is common and the prevalence increases with increasing frailty. 2. Undernutrition in older people is associated with poor health outcomes and increased health care costs. 3. There are physiological reasons (reduced smell and taste) for decreased appetite and weight loss in older people and this includes the Anorexia of Ageing and Sarcopenia. 4. Sarcopenia (...) is the loss of muscle mass and muscle function and is also independently associated with poor health outcomes. 5. Non-physiological factors such as poverty, social isolation and depression play a part in the development of undernutrition. These must be identified and managed. 6. Screening and assessment tools exist for use in clinical practice. It is important that older people are screened and assessed for undernutrition and sarcopenia. 7. There is no gold standard for the diagnosis of undernutrition

2015 Australian and New Zealand Society for Geriatric Medicine

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