- |||||||||| clomipramine / Generic mfg., ziprasidone / Generic mfg.
Journal: Tricyclic Antidepressant and Antipsychotic Toxicity: Clomipramine and Ziprasidone Overdose. (Pubmed Central) - Aug 2, 2024
In conjunction with the local poison control center, progression of the clinical toxidrome was anticipated, aggressively managed, and successfully treated. This case highlights the dangers of significant TCA toxicity, peak onset of toxicity within six hours, and the amplification of clinical toxidromes with co-ingestions.
- |||||||||| Botox (onabotulinumtoxin A) / GSK, AbbVie, Healis Therap
Journal: Ear Dyskinesia in the Absence of Neuroleptics: A Case Report. (Pubmed Central) - Aug 2, 2024
This case adds to the limited literature on the rare phenomenon of ear dyskinesia, highlighting the clinical presentation and the challenges in the management of this unusual movement disorder. Further research is needed to better understand the underlying mechanisms and optimal treatment approaches for this condition.
- |||||||||| memantine / Generic mfg., bumetanide / Generic mfg.
Review, Journal: Emerging Treatments and Therapies for Autism Spectrum Disorder: A Narrative Review. (Pubmed Central) - Aug 2, 2024
It also discusses additional therapies such as diet intervention, acupuncture, music therapy, melatonin, and the use of technology to aid education. Notably, several of these therapies require more long-term research to determine efficacy in specific ASD groups within this patient population.
- |||||||||| clozapine / Generic mfg.
Journal: Impacts of exposure to and subsequent discontinuation of clozapine on tripartite synaptic transmission. (Pubmed Central) - Aug 2, 2024
Clozapine discontinuation restored PP2A signalling due to decreased L-BAIBA, increased 5-HT receptor expression via probably enhanced 5-HT receptor recycling, but increased astroglial D-serine release persisted by transiently activated IP3 receptors via transiently increased IP3 level. Decreased L-BAIBA caused by clozapine discontinuation is, at least partially, involved in the transiently increased 5-HT receptor and astroglial D-serine release.
- |||||||||| haloperidol / Generic mfg.
Journal: Diabetic striatopathy: Hyperglycemic chorea/ballism successfully treated with L-dopa. (Pubmed Central) - Aug 2, 2024
Diabetic striatopathy, a rare hyperglycemia complication, is characterized by chorea/ballism and striatal anomalies on neuroimaging, usually managed with glycemic control and haloperidol...This finding prompted the initiation of L-dopa, which significantly improved her symptoms. This case underlines the need to consider presynaptic dopaminergic dysfunction in diabetic striatopathy patients unresponsive to standard treatments, highlighting the effectiveness of L-dopa in such scenarios.
- |||||||||| amitriptyline / Generic mfg.
Preclinical, Journal: Cajaninstilbene acid ameliorates depression-like behaviors in mice by suppressing TLR4/NF-?B mediated neuroinflammation and promoting autophagy. (Pubmed Central) - Aug 1, 2024
Notably, CSA (15?mg/kg) reversed despair behavior in mice more persistently than amitriptyline, indicating that optimal doses of CSA may effectively decelerate the procession of mood despair and yield a good compliance...Collectively, these findings suggest that CSA mitigates depression-like behaviors in mice by inhibiting TLR4/NF-?B-mediated neuroinflammation and enhancing autophagy. This research provides further insights into CSA's mechanisms of action in ameliorating depressive behaviors, offering a scientific foundation for developing CSA-based antidepressants.
- |||||||||| clozapine / Generic mfg.
Retrospective data, Journal: Use of Clozapine in persons with a history of seizures: A retrospective study. (Pubmed Central) - Aug 1, 2024
About one-fourth of the patients with history of an episode of seizure have recurrence of seizure while receiving clozapine. The demographic and clinical variables do not differ between those who develop and who do not develop seizures after starting clozapine, including concomitant use of antiepileptics.
- |||||||||| haloperidol / Generic mfg., ziprasidone / Generic mfg.
P3 data, Journal: Long-term outcomes after treatment of delirium during critical illness with antipsychotics (MIND-USA): a randomised, placebo-controlled, phase 3 trial. (Pubmed Central) - Aug 1, 2024
P3
In delirious, critically ill patients, neither haloperidol nor ziprasidone had a significant effect on cognitive, functional, psychological, or quality-of-life outcomes among survivors. Our findings, along with insufficient evidence of short-term benefit and frequent inappropriate continuation of antipsychotics at hospital discharge, indicate that antipsychotics should not be used routinely to treat delirium in critically ill adults.
- |||||||||| asenapine / Generic mfg., iloperidone / Generic mfg., lurasidone / Generic mfg.
Preclinical, Journal: The effect of new atypical antipsychotic drugs on the expression of transcription factors regulating cytochrome P450 enzymes in rat liver. (Pubmed Central) - Aug 1, 2024
The changes in the expression of AhR, CAR, and PXR mostly correlate with alterations in the expression and activity of respective CYP enzymes found in our previous studies. Since these transcription factors are also engaged in the expression of phase II drug metabolism and drug transporters, changes in their expression may affect the metabolism of endogenous substrates and pharmacokinetics of concomitantly used drugs.
- |||||||||| Trintellix (vortioxetine) / Lundbeck, Takeda
Journal: Serotoninergic antidepressants combination in psilocybin-assisted psychotherapy: a case report. (Pubmed Central) - Aug 1, 2024
This case report suggests that serotoninergic antidepressants combination with psilocybin appears to be safe and that antidepressant discontinuation prior to PAP may not be necessary. Since the continuation of antidepressants during PAP has the potential to improve treatment acceptability and accessibility, future research should assess whether psilocybin can be administered concurrently with antidepressants.
- |||||||||| aripiprazole / Generic mfg.
Trial completion date, Trial primary completion date: Aripiprazole in Body Focused Repetitive Behaviors (clinicaltrials.gov) - Aug 1, 2024
P2, N=100, Not yet recruiting,
Intravenous clonidine has been used in terminally ill patients with poorly controlled symptoms, in particular pain and agitation. Trial completion date: Oct 2024 --> Oct 2025 | Trial primary completion date: Oct 2024 --> Oct 2025
- |||||||||| Botox (onabotulinumtoxin A) / GSK, AbbVie, Healis Therap
USE OF BRONCHOALVEOLAR PEPSIN ASSAY AS A SURROGATE FOR DECISION OF POSTTRANSPLANT FUNDOPLICATION (Convention Center Exhibit Hall: Poster Area 5) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5662;
Acid suppression medication can influence the pH of the aspirate but does not prevent tracheal aspiration. On the other hand, surgical management of GER with fundoplication has been associated with improved long-term allograft function [2].
- |||||||||| aripiprazole / Generic mfg.
ANTIPSYCHOTIC-INDUCED CENTRAL ASLEEP APNEA (Convention Center Exhibit Hall: Poster Area 5) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5655;
Aripiprazole has been associated with central sleep apnea (CSA), with one previously published case... Sleep disordered breathing can be associated with antipsychotic medications and clinicians should have low threshold to evaluate for sleep disorders.
- |||||||||| famotidine / Generic mfg., ceftriaxone / Generic mfg., quetiapine / Generic mfg.
A UNIQUE CASE OF SALMONELLA EMPYEMA (Convention Center Exhibit Hall: Rapid Fire Area 1C) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5433;
Salmonella should be considered as a differential diagnosis when managing exudative pleural effusions in patients with risk factors for invasive disease, particularly in those taking medications known to alter gastrointestinal tract or cause immunosuppression. Elevated LDH in the thousands could also increase index of suspicion
- |||||||||| A COMMONLY AVAILABLE ATYPICAL TRICYLIC ACID LEADING TO MULTIORGAN DYSFUNCTION (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5291;
In conclusion, this case underscores the severe risks associated with such products. It highlights the importance of medical management and increased awareness of the hazards of substances like Neptune Elixir, which are easily available at gas stations and can have profound effects on multiple organ systems including the renal systems.
- |||||||||| risperidone / Generic mfg.
TARDIVE DYSKINESIA OF THE VOCAL CORDS: AN UNCOMMON CAUSE OF TACHYPNEA (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5277;
CASE PRESENTATION: A 65-year-old female with a history of chronic obstructive pulmonary disease, major depressive disorder with psychotic features on risperidone, tardive dyskinesia (TD) secondary to medication, and dysphagia presented to her local emergency department (ED) for worsening shortness of breath...If patients with TD present with stridor, dyspnea on exertion, interrupted speech, or other concerning respiratory symptoms, vocal cord dysfunction from TD should be considered, although it is a diagnosis of exclusion. The treatment for vocal cord dysfunction due to TD is botulinum toxin injections every 3-6 months.
- |||||||||| A RARE CASE OF NEUROLEPTIC MALIGNANT SYNDROME (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5196;
This case highlights the importance of identifying the signs of NMS in patients who are on antipsychotics. Although it is an uncommon phenomenon, heightened awareness is important to prevent delays or worsening conditions.
- |||||||||| COMPLEXITY OF DIAGNOSIS AND MANAGEMENT OF SILENT SYNDROME (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_5190;
His home medications included Seroquel 300 mg qAM and 800 mg qHS, Lithium 900 mg qHS, Depakote 1500 mg BID, Keppra 1000 mg BID, Benztropine 0.5 mg BID, and Pramipexole 1.5 mg BID...A trial of lorazepam was initiated for suspected catatonia, though no improvement was observed... As clinicians, we must remain vigilant and bring awareness regarding the recognition and management of SILENT and other medication-induced neurological complications.
- |||||||||| TCA TOXICITY TACHYCARDIA, A RARE BUT SERIOUS SIDE EFFECT (Convention Center Exhibit Hall: Rapid Fire Area 1A) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4996;
As TCAs are less commonly prescribed, overdose may be more difficult to recognize. In a patient on TCA therapy presenting with arrhythmias, anticholinergic symptoms, or seizure activity, sodium bicarbonate therapy as an antidote to potential TCA toxicity should be considered.
- |||||||||| hydroxocobalamin (vit B12) / Generic mfg., fluoxetine / Generic mfg.
AMLODIPINE TOXICITY WITH NON CARDIOGENIC PULMONARY EDEMA REQUIRING VV ECMO (Convention Center 256) - Jul 31, 2024 - Abstract #CHEST2024CHEST_4030;
Amlodipine overdose can result in life-threatening complications with multiorgan organ failure despite aggressive management. Further research is warranted to explore novel therapeutic approaches, with the ultimate goal of improving outcomes in this challenging patient population.
- |||||||||| haloperidol / Generic mfg., quetiapine / Generic mfg.
DELIRIUM INCIDENCE AND FUNCTIONAL RECOVERY IN A POST-ECMO COHORT (Convention Center Exhibit Hall: Rapid Fire Area 1D) - Jul 31, 2024 - Abstract #CHEST2024CHEST_3455;
Delirious patients had slower functional recovery and were more likely to be discharged to AR. Delirious patients also received over twice as many antipsychotics, which, though sometimes used in delirium treatment, increase the risk of over-sedation and can delay patient recovery.
- |||||||||| TNKASE (tenecteplase) / Roche, Boehringer Ingelheim
PROMPT RECOGNITION OF NEUROLEPTIC MALIGNANT SYNDROME: A CASE REPORT (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2648;
Tenecteplase 25 mg was administered at 8:29pm...The patient was back to baseline 2 midnights after dantrolene administration, transferred to telemetry, and ultimately discharged home... Given that haloperidol is one of the most used antipsychotics for acute onset delirium and agitation in intensive care units and emergency departments, even after a small dose of haloperidol, NMS should be in the differential as prompt recognition and treatment can improve mortality.
- |||||||||| A CHALLENGING CASE OF A 4-WEEK-LONG DELIRIUM TREMENS: A THERAPEUTIC DILEMMA! (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2642;
Clinical mimickers of prolonged DTs (Wernicke's encephalopathy, electrolytes disturbances, other substances withdrawal, particularly benzodiazepines, subdural hematoma, and sepsis) should be investigated in detail and ruled out in cases of refractory DTs. Various classes of sedatives may be necessary to stabilize critically ill patients with unusually prolonged DTs Further studies are needed to define the standard of care management of persistent DTs.
- |||||||||| aripiprazole / Generic mfg.
A CASE PRESENTATION OF HYGROMA (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_2608;
Subdural Hygroma is a pathology which clinical signs can vary from asymptomatic to alterations of the consciousness. If patient's consciousness is affected and if no improvement with conservative management, surgical options should be considered.
- |||||||||| modafinil / Generic mfg., venlafaxine / Generic mfg.
A CASE OF NARCOLEPSY TYPE 1 POSSIBLY INDUCED FROM COVID-19 MRNA VACCINATION (Convention Center Exhibit Hall: Rapid Fire Area 4D) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1920;
Modafinil 100mg and venlafaxine 37.5mg daily were started for hypersomnolence, with modafinil dosage gradually increased based on persistent symptoms. Exploring autoimmune pathways is imperative for comprehending the potential for development of Narcolepsy Type 1 post-vaccination.
- |||||||||| trimethoprim/sulfamethoxazole / Generic mfg., sumatriptan succinate / Generic mfg., nitrofurantoin / Generic mfg.
A CASE OF SULFHEMOGLOBINEMIA: A PERFECT STORM OF BUGS AND DRUGS? (Convention Center 256) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1886;
To our knowledge, this is the first case reported of isolated SHba related to AS, nitrofurantoin, and OTC supplements without concomitant methemoglobinemia. Treatment is recommended with supplemental oxygen and consideration of transfusion strategies if cyanosis persists.
- |||||||||| Botox (onabotulinumtoxin A) / GSK, AbbVie, Healis Therap
RESPIRATORY COMPLICATIONS OF MUCOPOLYSACCHARIDOSES (Convention Center Exhibit Hall: Poster Area 4) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1718;
MPS patients have respiratory symptoms as a byproduct of the disease affecting other primary structures. MPS patients require a multimodal care approach to limit the respiratory complications that contribute significantly to their mortality.
- |||||||||| ANTERIOR MEDIASTINAL MASS MASQUERADING AS PERSISTENT HICCUPS: A CASE REPORT (Convention Center Exhibit Hall: Poster Area 3) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1518;
Clinicians should uphold a vigilant approach and promptly order relevant imaging studies when faced with unyielding hiccups. Swift diagnosis and intervention play a pivotal role in mitigating patient discomfort and distress.
- |||||||||| fentanyl citrate / Generic mfg., olanzapine / Generic mfg., escitalopram / Generic mfg.
A COMPLICATED CASE OF SEROTONIN SYNDROME IN AN ELDERLY PATIENT WITH PREEXISTING POLYPHARMACY AND DRUG-DRUG INTERACTION (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1439;
Serotonin syndrome is an uncommonly recognized condition that is associated with increased morbidity and mortality if not identified and treated promptly. Early identification of clinical findings suggestive of serotonin syndrome will allow for decrease in unnecessary interventions like in our patient that presented to the emergency department and was intubated before having received guided treatment indicated for serotonin syndrome.
- |||||||||| clomipramine / Generic mfg., clonidine / Generic mfg.
AN UNCOMMON CONDITION THAT AFFECTS SALT, SUGAR, AND BODY TEMPERATURE: SHAPIRO SYNDROME (Convention Center Exhibit Hall: Poster Area 2) - Jul 31, 2024 - Abstract #CHEST2024CHEST_1377;
Unfortunately, the rarity of this condition and the lack of familiarity among clinicians often lead to misdiagnosis. Thus, raising awareness about this disease and its symptoms is crucial to ensure patients receive the correct diagnosis and management.
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