1/7. Painful ejaculation and urinary hesitancy in association with antidepressant therapy: relief with tamsulosin.Painful ejaculation has been reported in association with a variety of antidepressants such as the tricyclic antidepressants (TCAs, e.g. clomipramine, imipramine, desipramine, protriptyline, amoxapine), the selective serotonin reuptake inhibitors (SSRIs, e.g. fluoxetine), venlafaxine and the MAOIs. Apart from lowering the dose and changing the antidepressant, no strategies are available to treat this side effect. In this paper, painful ejaculation following the administration of reboxetine is described in two patients. Both patients were treated concomitantly with the selective alpha(1A)-adrenoceptor antagonist, tamsulosin. A re-challenge was performed in one patient. The Hamilton depression Rating Scale (HAM-D), the American Urological association symptom index, a (dis)satisfaction item score and the Udvalg for Kliniske Undersoegelser (UKU-side effect rating scale) were used to assess the treatment. Tamsulosin rapidly and completely resolved the painful ejaculation and urinary hesitancy in both patients. A re-challenge in one patient resulted in a prompt reappearance of both side effects. Tamsulosin resolved the problem of painful ejaculation in these patients; however, larger studies are needed to confirm these results.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
2/7. Topical application of the tricyclic antidepressant doxepin can reduce dysuria and frequency.The aim of this article is to highlight a novel treatment for the symptoms of chronic urethral and trigonal irritation. A patient with severe urethral hyperaesthesia who derived almost complete alleviation of symptoms with topical application of a tricyclic antidepressant cream is described. The possible modes of action of tricyclics when used via the topical route of administration are described. Topical application of a tricyclic antidepressant cream may alleviate the symptoms of urethral hyperaesthesia.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
3/7. Functional recovery of chronic complete idiopathic transverse myelitis after administration of neurotrophic factors.STUDY DESIGN: Case report. OBJECTIVE: To evaluate the functional recovery of chronic complete idiopathic transverse myelitis (ITM) after administration of acidic fibroblast growth factor (aFGF). methods: A 28-year-old woman presented with a 4-year history of spastic paralysis, sensory level at T10, urinary retention and constipation due to ITM. In all, 20 microg aFGF bolus injection was applied via intradural lumbar puncture, which was repeated every 5 months for 15 months. RESULTS: At 3 weeks after first injection, the patient experienced vague sensation at approximately T12-L1 dermatomes. At 2 months after the second injection, muscle activities and gait pattern were recorded in bilateral gluteus and hip abductors as she ambulated with long leg brace and axillary crutches. Increased walking speeds, reduced pelvic tilting and reduced compensatory trunk rotation during the swing phase were also demonstrated as compared to the initial gait analysis. At 18 months after injection, motor evoked potentials were obtained in hip abductors of both legs. CONCLUSIONS: aFGF may increase the efficacy of spinal reactivation/regeneration and is a potential remedy for chronic transverse myelitis.- - - - - - - - - - ranking = 5keywords = administration (Clic here for more details about this article) |
4/7. clomipramine-induced urinary dysfunction in an obsessive-compulsive adolescent.Two episodes of urinary retention occurred in a 15-year-old male following administration of clomipramine given for obsessive-compulsive disorder. Improvement of behavioral symptoms along with side effects was clearly correlated with clomipramine dosage. Severity of side effects, and their resistance to bethanechol and to phenoxybenzamine, necessitated a complete withdrawal of clomipramine. This case demonstrates that clomipramine-induced urinary retention is not limited to older individuals. Possible involvement of noncholinergic and nonadrenergic mechanisms in this adverse drug reaction is suggested.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
5/7. Transient ischemic attacks and amaurosis fugax from timolol.A variety of neurological disturbances may occur in patients receiving ocular administration of timolol. Possible mechanisms include direct effects on neurons of the central nervous system, effects on peripheral vasculature, and cardiac arrhythmias. Interestingly, transient ischemic attacks have not been documented to occur synchronously with timolol-related arrhythmias. We report a case of recurrent dizziness and staggering gait occurring synchronously with timolol related arrhythmias. An attack of amaurosis fugax also occurred. Discontinuing timolol abolished all the symptoms. Pre-existing autonomic dysfunction in our patient may have been an important contributing factor in his symptomatology.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
6/7. Aggravated CNS depression with urinary retention secondary to baclofen administration.A 74-year-old woman with a history of cerebrovascular disease developed profound central nervous system (CNS) and respiratory depression, generalized hypotonia, sinus bradycardia, and urinary retention following an increase in dose of baclofen, an antispasticity agent. Before receiving baclofen therapy the patient had had minor urinary dysfunction associated with a remote cerebrovascular accident but no urinary retention. Cessation of baclofen therapy and the relief of the urinary obstruction improved mental status and normalized motor function within 24 hours. A withdrawal syndrome of agitation, hallucinosis, and convulsive activity persisted for eight days following discontinuation of the baclofen. Our experience suggests that patients with various forms of CNS disease states may be at risk of serious CNS depression with even small therapeutic doses of baclofen.- - - - - - - - - - ranking = 4keywords = administration (Clic here for more details about this article) |
7/7. Phase I study of a new antitumor drug, 1-hexylcarbamoyl-5-fluorouracil (HCFU), administered orally: an HCFU clinical study group report.A phase I study of a new fluorinated pyrimidine, 1-hexylcarbamoyl-5-fluorouracil (HCFU), was performed by a multi-institutional clinical study group using a total of 111 patients with histologically proven malignancies. The characteristic toxic effects were a transient hot sensation and pollakiuria, which occurred 15-120 minutes after oral administration of the drug, continued for 30 minutes to 4 hours, and subsided spontaneously. Gastrointestinal disturbances such as nausea, vomiting, diarrhea, and anorexia, which are common with 5-FU administration, also occurred with HCFU but did so less frequently. The maximum tolerated dose for a single oral administration was estimated to be between 12 and 15 mg/kg and the optimal daily dose for continuous administration was considered to be between 9 and 18 mg/kg, with divided daily administration. Fifty-seven patients received 5-19 mg/kg/day of HCFU for > 4 weeks, including 31 patients with > 60 days' treatment. Cumulative doses were from 9.5 to 166.2 g, with a mean of 26.3 g. Hematopoietic toxicity was slight and hepatic toxicity was questionable. No renal or other cumulative toxicity was observed. In ten of the 57 patients, favorable clinical effects were seen: an active decrease in the size of the solid tumor (three patients), the disappearance of ascites (six), and the improvement of intestinal obstruction due to peritoneal carcinomatosis (one).- - - - - - - - - - ranking = 5keywords = administration (Clic here for more details about this article) |