Overdose, adverse drug effects

The adverse side-effects of the TCAs, coupled with their toxicity in overdose, provoked a search for compounds which retained their monoamine uptake blocking activity but which lacked the side-effects arising from interactions with Hj, aj-adreno-ceptors and muscarinic receptors. One of the first compounds to emerge from this effort was iprindole, which has an indole nucleus (Fig. 20.3). This turned out to be an interesting compound because it has no apparent effects on monoamine uptake and is not a MAO inhibitor. This, together with its relatively minor antimuscarinic effects, led to it commonly being described as an atypical antidepressant. Mechanisms that could underlie its therapeutic actions have still not been identified but, in any case, this drug has now been withdrawn in the UK. 

Adverse drug reaction is an undesired or unintended effect of the drug, occurs at dose normally used by human being. The adverse drug reaction requires treatment or decrease in dose if it is due to poisoning or overdose. 

Injecting Psilocybe mushroom juice intravenously is not common but it is reported. Most psilocybin users are seeking a natural experience and use of needles is not considered natural. Intravenous injection is the fastest means of getting psilocybin to the brain. In less than 16 seconds, the psilocybin is mixed with the blood, taken to the lungs, returned to the heart, and delivered to the brain. As the natural barriers and buffers of the stomach, small intestine, and liver are bypassed, the chances of overdose and adverse side effects such as coma, convulsions, and kidney failure, are greatly increased. It is even more rare for users to inject psilocybin powder, as this drug is difficult to obtain on the street. Supposed psilocybin powder bought on the street is almost always LSD, PCP, or both. 

Serotonin-Selective Reuptake Inhibitors. Since their introduction in the mid-1980s SSRIs have become the most widely used of all antidepressants. This is largely because of their improved safety and tolerability in clinical use. Although the SSRIs are no more efficacious or rapid in onset of action than the tricyclics, they lack most of the serious toxicity and adverse side effects associated with the first-generation drugs. The relative absence of cardiac toxicity makes the SSRIs relatively safe in overdose (36). Fatal overdose... 

Of these, the low level of SERTs in depressed patients has received the most attention in the development and synthesis of the SSRIs. The precise antidepressant mechanism of action for the SSRIs eludes neuroscientists, but the SSRIs have been shown to alleviate depression and are the most commonly used drugs in the therapy for depression. Claims of decreased adverse effects (adverse drug reactions) and less toxicity in overdose than both the MAOIs and the TCAs, together with increased safety, have led to their extensive use, and several are ranked in the Top 50 prescription drugs dispensed in the United States during the year 2005. 

Drug overdose Two cases of massive, acute ingestion of amantadine hydrochloride were associated with serious adverse cardiovascular effects [291 ]. 

MDMA overdose as well as the concomitant consumption of selective serotonin reuptake inhibitors (SSRI) with other dmgs that exert serotoninergic effects (such as inhibitors of monoamine oxidase) can rapidly lead to the serotonin syndrome. Its symptoms, which are reversible upon cessation, of the drug include confusion, muscle rigidity in the lower limbs, and hyperthermia suggesting an acute reaction to serotonin overflow in the CNS. Blocking the function of SERT outside the brain causes side effects (e.g., nausea), which may be due to elevated 5HT however , impairment of transporter function is not equivalent to direct activation of 5HT recqrtors in causing adverse effects such as fibrosis and pulmonary hypertension. 

Adverse reactions to drugs differ in both type and incidence in the pediatric population. Because of immature metabolic pathways, infants and children may have different metabolic patterns than adults. This at least partially explains why neonates require lower theophylline serum concentrations for the treatment of neonatal apnea and why the incidence of hepatotoxi-city following acetaminophen overdose is much lower in young children than in adults [44,45]. Antibiotic adverse effects unique to the pediatric population may... 

Adverse effects and drug interactions with codeine are similar to those reported for morphine, although they are less intense. Overdose in children results in the same effects as overdose of morphine, such as respiratory depression, miosis, and coma these symptoms are treated with naloxone administration. 

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