Tolerance, drug

Define drug tolerance, cumulative drug effect, and drug idiosyncrasy. 

Drug reactions are potentially serious. The nurse should observe all patients for adverse drug reactions, drug idiosyncrasy, and evidence of drug tolerance (when applicable). It is important to report all drug reactions or any unusual drug effect to the primary health care provider. 

Warns about possible addiction, drug tolerance, and psychological dependency. 

Avramov MN, Shingu K, Mori K Progressive changes in electroencephalographic responses to nitrous oxide in humans a possible acute drug tolerance. Anesth Analg... 

Hemodynamic parameters should be routinely monitored to assess drug tolerance. Assess blood pressure at baseline, after drug initiation and dose titration, then periodically thereafter in patients treated with fk-blockers, CCBs, nitrates, ACE inhibitors, and/or ARBs. 

Trujillo K., Akil H. Excitatory amino acids and drugs of abuse a role for A-methyl-D-aspartate receptors in drug tolerance, sensitization and physical dependence. Drug Alcohol Depend. 38 139, 1995. 

In neurochemical terms, amphetamine and cocaine boost monoamine activity. Amphetamine has a threefold mode of action first, it causes dopamine and noradrenaline to leak into the synaptic cleft second, it boosts the amount of transmitter released during an action potential and third, it inhibits the reuptake of neurotransmitter back into presynaptic vesicles. These three modes all result in more neurotransmitter being available at the synapse, thus generating an increase in postsynaptic stimulation. Cocaine exerts a similar overall effect, but mainly by reuptake inhibition. The main neurotransmitters affected are dopamine and noradrenaline, although serotonin is boosted to a lesser extent. These modes of action are outlined in Chapter 3, and the neurochemical rationale for drug tolerance is covered more fully in Chapter 10. The main differences between amphetamine and cocaine are their administration routes (summarised above) and the more rapid onset and shorter duration of action for cocaine. 

Goudie AJ and Emmett-Oglesby MW (eds) (1989). Psychoactive Drugs Tolerance and Sensitization. Humana Press, Clifton, NJ. 

Welch JC, Lilleyman JS. 6-Mercaptopur-ine dose escalation and its effect on drug tolerance in childhood lymphoblastic leukaemia. Cancer Chemother Pharmacol 1996 38 113-116. 

Fisher RS. Sucralfate a review of drug tolerance and safety. J Clin Gastroenterol 1981 3(Suppl 2) 181. 

Siegel, S. (1979). The role of conditioning in drug tolerance and addiction. InPsychopathol-ogy in Animals Research and Clinical Implications, ed. J. D. Keehn, pp. 143-168. New York Academic Press. 

With respect to veterinary medicines, the US-FDA establishes tolerances to include a safety factor to assure that the drug will have no harmful effects on consumers of the food product. The US-FDA first determines the level at which the dmg does not produce any measurable effect in laboratory animals. From this, the US-FDA determines an acceptable daily intake (ADI), and the drug tolerance and withdrawal times are then determined so that the concentrations of dmg residues in edible tissues are below the ADI. Depending on the dmg, safety factors of between 100-fold to 2000-fold are included in the calculations used to set the tolerances. 

Stroke Baclofen has not significantly benefited patients with stroke they also have poor drug tolerance. 

Huntington s disease Amyotrophic lateral sclerosis Anxiety Depression Pain Schizophrenia Drug tolerance Drug abuse... 

The chief use of reserpine is in the treatment of mild to moderate hypertension. As with other sympathetic depressant drugs, tolerance to the antihypertensive effects of reserpine can occur, owing to a compensatory increase in blood volume that frequently accompanies decreased peripheral vascular resistance. Reserpine, therefore, should be used in conjunction with a diuretic. 

Rectal bioavailability and pharmacokinetics. Serenoa repens extract, administered rectally to 12 healthy male volunteers at a dose of 640 mg/person, produced the mean maximum concentration in plasma of nearly 2.60 (Xg/mL approx 3 hours after administration, with mean value for the area under the curve AUC 10 (Xg/hour/mL. The bioavailability and pharmacokinetic profile were similar to those observed after oral administration. T j occurred approx 1 hour later, and plasma concentration 8 hours after drug administration was still quantified. The drug tolerability was good, and no adverse effect was observed ". Serenoa repens capsules, administered orally at a dose of 160 mg four times daily or rectally 640 mg daily for 30 days to 60 patients with BPH, produced no significant differences in diminu-... 

Buspirone does not appear to cause drug tolerance, psychological or physical dependence, or withdrawal syndrome. 

Repeated use may result in drug tolerance and physical dependence. 

Drug tolerance or dependence may occur with prolonged, high-dose therapy. 

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