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Cognitive impact of anticholinergic medication in MS: Adding insult to injury?

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BACKGROUND Cognitive impairment in Multiple Sclerosis (MS) is well recognized, being documented even in the earliest stages of the disease. Anticholinergic drugs (ACD) are frequently used to address bladdder symptoms in this population. ACD are known for their deleterious cognitive effects in older

Anticholinergic Drug Burden in Noncancer Versus Cancer Patients Near the End of Life.

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Anticholinergic drugs can cause several side effects, impairing cognition and quality of life (QOL). Cancer patients are often exposed to increasing cumulative anticholinergic load (ACL) as they approach death, but this burden has not been examined in patients with nonmalignant diseases. To

The importance of rhinitis on sleep, daytime somnolence, productivity and fatigue.

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OBJECTIVE The goal of treatment of allergic rhinitis should include improvement of daytime and nighttime symptoms, sleep, and quality of life. Congestion from allergic rhinitis is associated with decreased learning and productivity at work and school and a reduced quality of life. The release of

Anticholinergic agents for the treatment of "death rattle" in patients with myasthenia gravis.

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Difficulty clearing upper airway secretions (death rattle) is a frequent problem at the end of life. Treatment often includes the use of anticholinergic drugs. Myasthenia gravis is a disease characterized by muscle weakness and fatigue caused by an immune-mediated deficiency of acetylcholine

Mechanisms by which pharmacologic agents may contribute to fatigue.

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Fatigue is a common side effect of medications. This review summarizes some of the mechanisms by which drugs may cause fatigue. One major mechanism by which medications can cause fatigue is by central nervous system (CNS) depression. CNS depression can result from decreased excitatory activity, as

Influences of allergic rhinitis on sleep.

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BACKGROUND Allergic rhinitis is classically characterized by sneezing, pruritus, rhinorrhea, and nasal congestion. These symptoms can lead to impaired nocturnal sleep, and this impairment results in daytime fatigue and somnolence, reducing both learning and work efficiency and decreasing quality of

Depression in Parkinson's Disease.

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Depression is very common in Parkinson's disease (PD), but its severity and particular symptoms vary. It can often be difficult to diagnose because many of the symptoms typically associated with depression (eg, sleep difficulties, fatigue) can be seen in nondepressed patients with PD, and signs

Comparative study of the safety of regadenoson between patients with mild/moderate chronic obstructive pulmonary disease and asthma.

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OBJECTIVE To compare the safety of regadenoson, a selective agonist of A2A adenosine receptors, combined with low-level exercise, between subjects with mild/moderate chronic obstructive pulmonary disease (COPD) and asthma referred for myocardial perfusion imaging (MPI). METHODS We studied 116

Evaluation of contraindicated drug-drug interaction alerts in a hospital setting.

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BACKGROUND Risks associated with contraindicated drug-drug interaction alerts (CDDIAs) should always outweigh benefits. Misclassified CDDIAs should be eliminated. OBJECTIVE To review CDDIAs and determine if they are contraindicated according to Food and Drug Administration-approved product labeling

LiverTox: Clinical and Research Information on Drug-Induced Liver Injury

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Antiemetics are used for the symptomatic management of nausea and vomiting that can be caused by a variety of medical conditions and situations, including acute gastroenteritis, pregnancy, surgery, anesthesia, opioids and chemotherapy. Antiemetics are rare causes of liver injury, partially because

Depression: impact and management by the patient and family.

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Prodromal personality features possibly presaging PD include excessive introversion, punctuality, and inflexibility. Neurobehavioral symptoms of PD that might complicate recognition and treatment of depression include loss of initiative, social withdrawal, excessive dependency indecisiveness,

Desmopressin in the management of nocturia in patients with multiple sclerosis. A double-blind, crossover trial.

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BACKGROUND Neurogenic bladder affects up to 80% of patients with multiple sclerosis (MS) and, in 50% of these patients, it is a significant cause of disability. The current management of neurogenic bladder, based on fluid restriction, anticholinergic agents, intermittent self-catheterization, and,

The Use of Dexmedetomidine in Pediatric Palliative Care: A Preliminary Study.

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OBJECTIVE To evaluate the effect of dexmedetomidine infusions in patients with advanced malignancies, advanced heart disease, or after stem cell transplantation (SCT), who during end-of-life care had pain and/or agitation unresponsive to conventional therapies. BACKGROUND Pediatric patients with

Prehospital asthma management.

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The treatment of acute asthma exacerbation consumes a significant portion of emergency medical services (EMS) system resources. Because few studies have addressed EMS treatment of asthma, most EMS providers model their approach to treatment on strategies thought to be effective in the emergency

Drugs, alcohol and driving.

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Driving a car is a complex psychomotor and perceptual task which is subject to impairment by many factors. Several workers have studied the potential effects of drugs and alchol in crash production by epidemiological and laboratory studies. Both types of studies have yielded useful data but their

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