Clinics for treatment

Poteryaeva A (2001) Use of Enterosgel in clinic for treatment of occupational diseases. Methodical Recommendations, Moscow, (In Russian)... 

There are many places that people who have a problem with drug addiction can go for help. Clinics for treatment of addiction exist in most, if not all, cities. While these clinics are helpful... 

The data about fields of application of Silics in clinics for treatment for infectious diseases are presented in Table 4. From Table 4 it is evident that the field of application of Silics is rather large and covers both intestinal infections and toxicoses which victimize infants, as well as viral hepatitis, and botulism. It is appropriate to mention here that inclusion of Silics into the complex treatment of patients suffering from salmonellosis, dysentery, and intestinal toxicoses accelerates normalization of clinic manifestations of these diseases by a factor of two and more. In the case of botulism the normalization of symptoms characteristic of lesions of the nervous system is shortened by almost 4 days. If intestinal infections are not severe, Silics can be recommended as a single therapeutic agent. In the case of a considerable diarrheal syndrome it is more expedient to use it together with rehydration substances. Inclusion of Silics into a complex of therapeutic agents for patients suffering from viral hepatitis substantially accelerates recovery rates of patients, so that their normal level of bilirubin and activity of alanine aminotranspherase are recovered within shorter periods of time. 

Buimer M, Bruisten S. Comparison between the LCx Probe system and the COBAS AMPLICOR system for detection of Chlamydia trachomatis and Neisseria gonorrhoeae infections in patients attending a clinic for treatment of sexually transmitted diseases in Amsterdam, The Netherlands. J Clin Microbiol 2001 39 829-35. 

Yet compelling it is - every year small but significant numbers of people (usually teenagers) are admitted to hospital emergency rooms and drug-abuse clinics for treatment of acute datura poisoning. Much of the contemporary interest in these plants is doubtless traceable to... 

QUINIDINE Quinidine is one of the quinoline alkaloids in Cinchona bark. (See POl, Antimalaria-drugs). Thus, quinidine is an antiarrythmic drug, whereas its stereoisomer, quinine, is an antimalarial. In antiarryth-mically effective doses quinidine reduces the contraction capacity of the heart. The minute volume of the heart diminishes through its negative inotropic effect. Quinidine is used clinically for treatment of relapse into auricle fibrillation, and at extrasystohcs and paroxysmal tachycardia and ventricular tachycardia. 

Bisphosphonate inhibitors of farnesyl disphosphate synthase have been used clinically for treatment of bone diseases. Many of their effects may be mediated by depletion of geranylgeranyl diphosphate, and Wiemer and coworkers have discovered a number of novel pivaloyloxymethyl-modified isoprenoid bisphosphonates (251) that selectively inhibited geranylgeranyl diphosphate synthase. They found that addition of pivaloyloxymethyl moieties to isoprenoid bisphosphonates increased their potency towards cellular geranylgeranylation even though this modification decreased their in vitro inhibition of geranylgeranyl diphosphate synthase. Moreover, pivaloyloxymethyl modifications more effectively increased the cellular activity of the more polar isoprenoid bisphosphonates. 

The flavonoid diosmin extracted from lemon is used clinically for treatment of venous insufficiency. Increased vascular tone has been observed after in vivo oral administration. Anti-inflammatory, antihistamine, and diuretic activities are also reported (wren). 

HPR was first introduced into the clinic for treatment of skin diseases. Three out of eight patients with severe chronic plaque psoriasis were graded as being better after a 600 mg daily dose [58]. Subsequently in a phase II trial in patients with advanced breast cancer and melanoma who had been heavily pretreated with other drugs, 4HPR at doses of 300 and 400 mg/day, showed no beneficial effect [59]. The same doses were not effective in patients with myelodys-platic syndromes on the contrary, disease acceleration was observed in some patients [68]. 

Hydrazine sulfate [10034-93-2] N2H4 H2SO4, originally advanced by the Syracuse Cancer Research Institute for treatment of cancerous cachexia and tumor inhibition (221), now has Investigational New Dmg (IND) status in the United States. Clinical evaluations are under way at various institutions such as Harbor-UCLA Medical Center (222) and the Mayo Clinic. After extensive trials, hydrazine sulfate has been approved as an anticancer dmg in Russia (223). Chemical stmctures for estabUshed dmgs in the United States may be found in Reference 224. 

The anainoacridines, tacrine (19) and its 1-hydroxy metaboUte, velnacrine (20), are reversible inhibitors of AChE. Tacrine was synthesi2ed in the 1940s and has been used clinically for the treatment of myasthenia gravis and tardive dyskinesia (115). Placebo-controUed studies have indicated modest efficacy of tacrine to treat AD dementia (122,123) and in 1993 the dmg was recommended for approval by the PDA under the trade name Cognex. Tacrine (19) has been shown to interact with sites other than AChE, such as potassium channels (124) and muscarinic receptors. However, these interactions are comparatively weak and are not thought to contribute to the biological activity of the dmg at therapeutic levels (115). 

Galanthamine (23) is an alkaloid extracted from the common snowdrop Galanthus nivalis. This compound is a long-acting, competitive AChE inhibitor which appears to be somewhat more specific for acetylcholinesterase than plasma butyrylcholinesterase (132). It is well tolerated during long-term treatment (133) and is being evaluated clinically for AD (134). 

Therapeutic opportunities for NO synthons include angina, for which nitroglycerin is effectively used, as well as penile erectile dysfunction. NOS inhibitors have demonstrated some protection in cerebral ischemia models and may be potentially beneficial in alleviating cell death associated with cerebral ischemia. l-NMA is under clinical study for treatment of sepsis. 

Monoamine—Oxidase Inhibitors. In the mid-1950s, tuberculosis patients with depression being treated with iproniazid (42) were occasionally reported to become euphoric. This observation led to the discovery of irreversible monoamine—oxidase (MAO) inhibiting properties. Hydrazine and nonhydrazine-related MAO inhibitors were subsequentiy shown to be antidepressants (122). Three other clinically effective irreversible MAO inhibitors have been approved for treatment of major depression phenelzine (43), isocarboxazid (44), and tranylcypromine (45). 

SSRIs are widely used for treatment of depression, as well as, for example, panic disorders and obsessive—compulsive disorder. These dmgs are well recognized as clinically effective antidepressants having an improved side-effect profile as compared to the TCAs and irreversible MAO inhibitors. Indeed, these dmgs lack the anticholinergic, cardiovascular, and sedative effects characteristic of TCAs. Their main adverse effects include nervousness /anxiety, nausea, diarrhea or constipation, insomnia, tremor, dizziness, headache, and sexual dysfunction. The most commonly prescribed SSRIs for depression are fluoxetine (31), fluvoxamine (32), sertraline (52), citalopram (53), and paroxetine (54). SSRIs together represent about one-fifth of total worldwide antidepressant unit sales. 

In the treatment of diseases where the metaboUtes are not being deUvered to the system, synthetic metaboUtes or active analogues have been successfully adrninistered. Vitamin metaboUtes have been successfully used for treatment of milk fever ia catde, turkey leg weakness, plaque psoriasis, and osteoporosis and renal osteodystrophy ia humans. Many of these clinical studies are outlined ia References 6, 16, 40, 51, and 141. The vitamin D receptor complex is a member of the gene superfamily of transcriptional activators, and 1,25 dihydroxy vitamin D is thus supportive of selective cell differentiation. In addition to mineral homeostasis mediated ia the iatestiae, kidney, and bone, the metaboUte acts on the immune system, P-ceUs of the pancreas (iasulin secretion), cerebellum, and hypothalamus. 

The use of selective P-antagonists for treatment of CHF has included the P -blocker metoprolol (Table 1) and results of clinical trials suggest long-term beneficial effects. Selective P -antagonists have also been tested, an example of which is xamoterol [81801 -12-9], C2 H25N20, which is (i)-A/-(2-hydroxy-3-(4-hydroxyphenoxy)propylamino)ethylmorphine-4-carboxamide. Xamoterol exhibits approximately 50% of the activity of isoproterenol, and serves to provide modest inotropic effects (128,129). 

The majority of promising drug candidates emerging from marine natural products research to date are potential cancer treatments. Six anti-cancer compounds that are either marine natural products or synthetic analogs of marine natural products have made it to clinical trials. The first of these compounds to enter clinical trials was didemnin B (43), one of a family of cyclic depsipetides isolated from the Caribbean tunicate Trididemnum solidum Didemnin B was advanced to Phase II clinical trials for treatment of small cell lung cancer, myeloma, prostate cancer, and melanoma. Unfortunately, no favorable responses were found so the compound has been withdrawn. Crude extracts of another Caribbean tunicate, Ecteinascidia turbinata, showed extremely... 

Given the routine use of mast cell stabilizers in the clinic, for example in the setting of asthma treatment, these preclinical results may stimulate clinical evaluation in humans. 

Synthetic steroid with strong glucocorticoid-agonistic activity. Dexamethasone is over 10 times more potent than cortisol due to a higher binding affinity for glucocorticoid receptor and a decreased clearance rate of the compound. Due to its potency, dexamethasone is widely used in the clinics for the treatment of inflammatory diseases. 

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