Tolerability

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Martin C Michel - One of the best experts on this subject based on the ideXlab platform.

  • the forefront for novel therapeutic agents based on the pathophysiology of lower urinary tract dysfunction α blockers in the treatment of male voiding dysfunction how do they work and why do they differ in Tolerability
    Journal of Pharmacological Sciences, 2010
    Co-Authors: Martin C Michel
    Abstract:

    alpha(1)-Adrenoceptor antagonists are the mainstay of medical treatment of male voiding dysfunction which typically is attributed to benign prostatic hyperplasia While original concepts have assumed that they relieve voiding dysfunction by relaxing prostatic smooth muscle, newer data indicate that their therapeutic effects at least partly occur independent of prostatic relaxation, perhaps involving direct effects on blood vessels, urothelium. afferent nerves, and/or smooth muscle of the Urinary bladder The adverse event profiles differ among alpha(1)-adrenoceptor antagonists, With tamsulosin having a particularly good cardiovascular Tolerability While this was originally attributed to its selectivity for alpha(1A)-adrenoceptors, it appears that alfuzosin which lacks subtype-selectivity. has a very similar Tolerability In contrast, doxazosin and terazosin, which are chemically and pharmacologically more closely related to alfuzosin than to tamsulosin. appear to have more side effects attributable to the cardiovascular system. More recent data indicate that Tolerability differences between alpha(1)-adrenoceptor antagonists may at least partly relate to pharmacokinetic rather than to pharmacodynamic differences. Taken together, these data emphasize the idea that concepts about drug efficacy and Tolerability despite being highly plausible may not necessarily be true and always require thorough experimental testing

  • tamsulosin treatment of 19 365 patients with lower urinary tract symptoms does co morbidity alter Tolerability
    The Journal of Urology, 1998
    Co-Authors: Martin C Michel, Ludwig Mehlburger, Hansulrich Bressel, Helmut Schumacher, Rafael F Schafers, M Goepel
    Abstract:

    AbstractPurpose: We compare the Tolerability and blood pressure effects of 0.4 mg. tamsulosin once daily in patients with lower urinary symptoms suggestive of benign prostatic obstruction with or without concomitant disease and/or antihypertensive medication.Materials and Methods: Data from 2 open label, observational studies (study 1, 9,507 patients treated for 4 weeks and study 2, 9,858 patients treated for 12 weeks) were analyzed for global Tolerability and effects on blood pressure stratifying for co-morbidity (none, diabetes, hypertension, other cardiovascular disease) and co-medication (diuretics, beta-blockers, calcium channel blockers, angiotensin converting enzyme inhibitors).Results: Overall 90 and 95% of patients in studies 1 and 2, respectively, reported good or very good Tolerability. While global Tolerability was slightly reduced in patients with concomitant disease or some forms of medication (p <0.05), it was rated as good or very good by more than 90 and 95% of patients even in those grou...

Marc Kamin - One of the best experts on this subject based on the ideXlab platform.

  • Topiramate Titration and Tolerability
    Annals of Pharmacotherapy, 2001
    Co-Authors: Victor Biton, Keith Edwards, Georgia Montouris, J Chris Sackellares, Cynthia L. Harden, Marc Kamin
    Abstract:

    OBJECTIVE:To evaluate the Tolerability and efficacy of two titration rates for topiramate initiated as adjunctive therapy in adults with partial-onset seizures, with or without secondary generalization, in a multicenter, double-blind trial.METHODS:After a two-week baseline phase, 188 patients were randomized to either a 50/50 titration schedule (initial dosage 50 mg/d increased in 50-mg/d increments at weekly intervals; n = 95) or to a 100/200 titration schedule (initial dosage 100 mg/d increased by 100–200 mg/d at weekly intervals; n = 93). The maximum dosage of 400 mg/d was therefore achieved in eight weeks or three weeks, respectively.RESULTS:Compared with the 100/200 titration rate, the 50/50 titration rate significantly reduced the cumulative incidence of treatment-emergent adverse events (TEAEs) leading to changes in topiramate therapy (i.e., dosage reductions, interruptions or discontinuations of therapy) (p = 0.048) and significantly reduced treatment interruptions or withdrawals due to TEAEs (p =...

Grazia Sances - One of the best experts on this subject based on the ideXlab platform.

  • Tolerability of the Triptans
    Drug Safety, 2003
    Co-Authors: Giuseppe Nappi, Giorgio Sandrini, Grazia Sances
    Abstract:

    The triptans represent a relatively new class of compounds effective in the treatment of migraine. The safety and Tolerability of these drugs have been extensively investigated since the first triptan (sumatriptan) became commercially available. A report on a very large population of patients tested during clinical trials and in postmarketing studies, confirms that these drugs are safe and well tolerated when correctly used. Adverse events are frequently reported, but are usually mild and only a few patients discontinue therapy because of them. These adverse events include, in particular, the so-called ‘triptan symptoms’ (tingling, sensation of warmth, etc.). The exact mechanism of chest symptoms reported by 20% of patients with migraine treated with triptans remains unclear, but are exceptionally related to a cardiac mechanism. CNS adverse events (i.e. somnolence) are also reported, but it is a matter of debate whether they are related to the pharmacological properties (i.e. lipophilicity) of the drug or are symptoms of the disease itself. The potential risk for drug overuse must be taken into account when the triptans are given to patients with a high frequency of migraine attacks. Clinical interaction of triptans with other drugs metabolised in the liver may theoretically influence the incidence of adverse events, but there is little evidence to support this assumption. There is no evidence of a teratogenic risk of triptans in pregnant women taking these drugs.

Leo Verhagen Metman - One of the best experts on this subject based on the ideXlab platform.

  • the core assessment program for surgical interventional therapies in parkinson s disease capsit pd Tolerability of preoperative neuropsychological testing for deep brain stimulation in parkinson s disease p3 357
    Neurology, 2016
    Co-Authors: Gian Pal, Bryan Bernard, Christopher G. Goetz, Virginia Persinger, Bichun Ouyang, Leo Verhagen Metman
    Abstract:

    Objective: We examined Tolerability of preoperative neuropsychological testing (the Core Assessment Program for Surgical Interventional Therapies in Parkinson9s Disease [CAPSIT-PD] protocol) for DBS. We also examined factors that may influence Tolerability, including fatigue, global cognitive function, depression, and patient-based characteristics. Background:The CAPSIT-PD protocol was published in 1999 with the goal of providing the minimal requirements for a common patient evaluation protocol for surgical interventions, including DBS, in PD. Factors such as fatigability, baseline cognitive impairment, duration of testing, and disease duration, may influence neuropsychological performance, but have not fully been explored. Methods:We reviewed preoperative neuropsychological testing results from 35 patients who were scheduled for DBS. We examined the overall Tolerability of the full battery and the Tolerability of each test. We placed attention on a test9s placement in the fixed order of the battery to measure whether there was a clustering of poorly tolerated tests toward the end of the battery as an indication of fatigue. Spearman9s rank correlation was used to determine the relationship between Tolerability and (1) global cognitive function, (2) depression, and (3) patient-based characteristics. Results:Fourteen subjects (40[percnt]) were able to tolerate the full battery and completed all 10 tests. The domains that were least tolerated pertained to executive function and procedural memory. There was a consistent time-based Tolerability pattern that was observed. There was a significant correlation between Tolerability and global cognitive function (ρ = 0.344; P = 0.043), but not depression (P = 0.197). There was a significant correlation between Tolerability and age (ρ = −0.491; P = 0.003) and disease duration (ρ = −0.442; P = 0.008), but not UPDRS-III scores (P = 0.284). Conclusions:Given the limited Tolerability of the neuropsychological battery as outlined by the CAPSIT-PD protocol, we suggest the consideration of updating the neuropsychological assessment used for DBS implantation. Disclosure: Dr. Pal has received personal compensation for activities with Medtronic, US World Meds, Allergan, Ipsen, Merz & Solstice Neurosciences, Sermo, Deerfield Institute, and Huron Consulting Services. Dr. Persinger has nothing to disclose. Dr. Bernard has received research support from the Parkinson9s Disease Foundation. Dr. Ouyang has nothing to disclose. Dr. Goetz has received royalty payments from Oxford University Press, Elsevier Publishers, Wolters Kluwer Health-Lippincott, and Wilkins and Wilkins. Dr. Verhagen has received personal compensation for activities with Medtronic, Depomed, and Impax as a consultant. Dr. Verhagen has received research support from Medtronic, Boston Scientific, Adamas, Osmotica, Avanir, WorldMeds, NIH, and the Michael J Fo

  • the core assessment program for surgical interventional therapies in parkinson s disease capsit pd Tolerability of preoperative neuropsychological testing for deep brain stimulation in parkinson s disease
    Movement Disorders Clinical Practice, 2015
    Co-Authors: Gian Pal, Bryan Bernard, Christopher G. Goetz, Virginia Persinger, Bichun Ouyang, Leo Verhagen Metman
    Abstract:

    Objective We examined Tolerability of preoperative neuropsychological testing (the Core Assessment Program for Surgical Interventional Therapies in Parkinson's Disease [CAPSIT-PD] protocol) for DBS. We also examined factors that may influence Tolerability, including fatigue, global cognitive function, depression, and patient-based characteristics. Methods In this retrospective study, we reviewed preoperative neuropsychological testing results from 35 patients who were scheduled to undergo DBS. We examined the overall Tolerability of the full battery and the Tolerability of each test. We placed attention on a test's placement in the fixed order of the battery to measure whether there was a clustering of poorly tolerated tests toward the end of the battery as an indication of fatigue. Spearman's rank correlation was used to determine the relationship between Tolerability and (1) global cognitive function, (2) depression, and (3) patient-based characteristics. Results Fourteen subjects (40%) were able to tolerate the full battery and completed all 10 tests. The domains that were least tolerated pertained to executive function and procedural memory. There was a consistent time-based Tolerability pattern that was observed. There was a significant correlation between Tolerability and global cognitive function (ρ = 0.344; P = 0.043), but not depression (P = 0.197). There was a significant correlation between Tolerability and age (ρ = −0.491; P = 0.003) and disease duration (ρ = −0.442; P = 0.008), but not UPDRS-III scores (P = 0.284). Conclusion Our results have shown limited Tolerability of the full neuropsychological battery as outlined by the CAPSIT-PD protocol. We suggest the consideration of updating the neuropsychological assessment used in the CAPSIT-PD protocol.

Michele Tansella - One of the best experts on this subject based on the ideXlab platform.

  • Sex differences in the subjective Tolerability of antipsychotic drugs.
    Journal of clinical psychopharmacology, 2005
    Co-Authors: Corrado Barbui, Michela Nosè, Jonathan Bindman, Aart H. Schene, Thomas Becker, Maria Angela Mazzi, Martijn J. Kikkert, Jayne Camara, Anja Born, Michele Tansella
    Abstract:

    In recent years, research efforts have been directed to better characterize the subjective experience of taking psychotropic drugs. This study investigated the sex difference in the subjective Tolerability of antipsychotic drugs. Participants were recruited from patients under the care of psychiatric services serving geographical catchment areas in Croydon (UK), Verona (Italy), Amsterdam (Netherlands), and Leipzig (Germany). Clinically unstable patients with a clinical diagnosis of schizophrenia and a research diagnosis of schizophrenia, established using the Item Group Checklist of the Schedule for Clinical Assessment in Neuropsychiatry, were enrolled. Antipsychotic subjective Tolerability was rated by means of the Liverpool University Neuroleptic Side Effect Rating Scale. During the recruitment period, 245 men and 164 women with schizophrenia were recruited. In both sexes, the most frequently reported side effects were difficulty in concentrating, tiredness, and weight gain; these side effects occurred in approximately 50% of men and in up to 70% of women. Extrapyramidal and anticholinergic reactions were reported more often by women, whereas men reported sexual problems more often. After background group differences were controlled for, sex was the strongest determinant of the subjective Tolerability of antipsychotic drugs. We therefore conclude that sex differences in the subjective Tolerability of antipsychotic drugs should be taken into account in the pharmacological management of patients with schizophrenia. Studies should no longer consider men and women as a homogeneous group, given that the subjective Tolerability of antipsychotic drugs substantially differs between sexes.