cardiovascular-agents and Substance-Related-Disorders

The NIH Pharmacogenetics Research Network (PGRN) is a collaborative group of investigators with a wide range of research interests, but all attempting to correlate drug response with genetic variation. Several research groups concentrate on drugs used to treat specific medical disorders (asthma, depression, cardiovascular disease, addiction of nicotine, and cancer), whereas others are focused on specific groups of proteins that interact with drugs (membrane transporters and phase II drug-metabolizing enzymes). The diverse scientific information is stored and annotated in a publicly accessible knowledge base, the Pharmacogenetics and Pharmacogenomics Knowledge base (PharmGKB). This report highlights selected achievements and scientific approaches as well as hypotheses about future directions of each of the groups within the PGRN. Seven major topics are included: informatics (PharmGKB), cardiovascular, pulmonary, addiction, cancer, transport, and metabolism.

Topics: Animals; Cardiovascular Agents; Cardiovascular Diseases; Carrier Proteins; Drug Therapy; Humans; Informatics; Lung Diseases; Neoplasms; Pharmaceutical Preparations; Pharmacogenetics; Platelet Aggregation Inhibitors; Polymorphism, Single Nucleotide; Substance-Related Disorders

Topics: Cardiovascular Agents; Drug-Related Side Effects and Adverse Reactions; Erectile Dysfunction; Humans; Male; Phosphodiesterase Inhibitors; Psychotropic Drugs; Substance-Related Disorders; Vasodilator Agents

Drug-induced seizures are a commonly encountered problem for physicians. In this article, drugs that cause seizures are discussed with regards to the incidence of seizures, associated clinical factors, risk factors, and special treatment considerations. This information should help physicians determine appropriate evaluation and treatment strategies when their patients experience a seizure while using drugs.

Topics: Analgesics; Anti-Bacterial Agents; Anticonvulsants; Antidepressive Agents; Antipsychotic Agents; Cardiovascular Agents; Epilepsy; Humans; Immunosuppressive Agents; Psychotropic Drugs; Substance-Related Disorders

Topics: Caffeine; Cardiovascular Agents; Humans; Narcotics; Pharmacology; Psychopharmacology; Publishing; Receptors, Drug; Substance-Related Disorders

Topics: Animals; Anti-Anxiety Agents; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antidepressive Agents; Antipsychotic Agents; Cardiovascular Agents; Diuretics; Drug Interactions; Hormones; Humans; Lithium; Neuroeffector Junction; Psychotropic Drugs; Substance-Related Disorders; Synapses

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 limitations must be borne in mind when applying the results in pratice. Alcohol is obviously the most common single cause of traffic accidents. A progessively increased risk with increasing blood alcohol levels is well documented; fatigue and/or drugs increase this risk. Drugs are related much more infrequently to traffic accidents although on the basis of statistics, there is a potential risk with drug use. However, drugs alone are not as important as alcohol. The most significant drugs as regards driving risk are obviously certain antianxiety agents, hypnotics, stimulants, hallucinogens, marihuana, lithium and narcotic analgesics, as well as ganglionic blocking agents, insulin and sulphonylurea derivates. Patients should not drive after taking these drug until they are objectively fully alert and capable. Anticholinergics, antihistamines, antidepressants, antipsychotics, phenybutazone, indomethacin, alpha-methyldopa, and beta-blockers may in some cases cause central side effects (e.g. drowsiness) strong enough to affect driving performance. After starting therapy with these drugs, or after a significant change in dose, driving should be avoided until it is known that unwanted effects do not occur. Psychotropic drugs may enhance the deleterious effect of alcohol, and with most hypnotics there is still an effect the next morning. Some drugs (e.g. anticonvulsants or antiparkinsonian drugs) may make driving safer, but the disease (epilepsy, Parkinsonism, cardiovascular diseases, psychic disorders, etc.) ofter precludes driving. Clinicians should warn their patients about an impairment of driving skills if this is likely to occur due to the drug or the illness concerned.

Topics: Alcohol Drinking; Analgesics; Anti-Anxiety Agents; Anti-Inflammatory Agents; Anticonvulsants; Antidepressive Agents; Antiparkinson Agents; Antipsychotic Agents; Automobile Driving; Cannabis; Cardiovascular Agents; Central Nervous System Stimulants; Drug Interactions; Epidemiologic Methods; Hallucinogens; Histamine H1 Antagonists; Humans; Hypnotics and Sedatives; Hypoglycemic Agents; Lithium; Motor Skills; Muscle Relaxants, Central; Parasympatholytics; Substance-Related Disorders

Medication non-adherence is common and a primary reason for poor medical outcomes among individuals with heart failure (HF). This study's aims were to determine whether depression, hostility, and the personality-based Millon Behavioral Medicine Diagnostic (MBMD) Medication Abuse scale were associated with medication adherence (e.g., beta-blockers, ACE inhibitors, diuretics, statins) beyond contributions of demographic, medical, and psychosocial variables in an ethnically-diverse sample of 105 men and women diagnosed with HF. In hierarchical regression, greater MBMD Medication Abuse scale scores were associated with poorer adherence above and beyond both depression (β = .236, t[102] = 2.113, p = .037) and hostility (β = .244, t[102] = 2.506, p = .014). The Medication Abuse scale also completely mediated the relationship between adherence and depression. These findings suggest that personality measures such as the MBMD and hostility scales might be utilized in future studies investigating predictors of adherence and also used clinically to predict medication adherence among HF patients.

Topics: Aged; Cardiovascular Agents; Comorbidity; Cross-Sectional Studies; Depressive Disorder; Female; Heart Failure; Hostility; Humans; Male; Medication Adherence; Middle Aged; Personality Inventory; Psychometrics; Regression Analysis; Reproducibility of Results; Statistics as Topic; Substance-Related Disorders; Treatment Outcome

To compare the use of co-medication, the potential drug-drug interactions (PDDIs) and the effect on antiretroviral therapy (ART) tolerability and efficacy in HIV-infected individuals according to age, ≥ 50 years or <50 years.. All ART-treated participants were prospectively included once during a follow-up visit of the Swiss HIV Cohort Study. Information on any current medication was obtained by participant self-report and medical prescription history. The complete treatment was subsequently screened for PDDIs using a customized version of the Liverpool drug interaction database.. Drug prescriptions were analysed for 1497 HIV-infected individuals: 477 age ≥ 50 and 1020 age <50. Older patients were more likely to receive one or more co-medications compared with younger patients (82% versus 61%; P < 0.001) and thus had more frequent PDDIs (51% versus 35%; P < 0.001). Furthermore, older patients tended to use a higher number of co-medications and certain therapeutic drug classes more often, such as cardiovascular drugs (53% versus 19%; P < 0.001), gastrointestinal medications (10% versus 6%; P = 0.004) and hormonal agents (6% versus 3%; P = 0.04). PDDIs with ART occurred mainly with cardiovascular drugs (27%), CNS agents (22%) and methadone (6%) in older patients and with CNS agents (27%), methadone (15%) and cardiovascular drugs (11%) in younger patients. The response to ART did not differ between the two groups.. The risk for PDDIs with ART increased in older patients who take more drugs than their younger HIV-infected counterparts. However, medication use in older and younger patients did not differ in terms of effect on antiretroviral tolerability and response.

Topics: Adult; Aged; Aging; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; Cardiovascular Agents; Central Nervous System Agents; Cohort Studies; Drug Interactions; Drug Prescriptions; Female; Follow-Up Studies; Gastrointestinal Agents; HIV Infections; Hormones; Humans; Male; Methadone; Middle Aged; Narcotics; Socioeconomic Factors; Substance Abuse, Intravenous; Substance-Related Disorders; Switzerland

Coronary heart disease affects 7.6% of the population in the United States, where > 900,000 myocardial infarctions (MIs) occur annually. Approximately half of all MIs have an identifiable clinical trigger. Myocardial ischemia, MI, sudden cardiac death, and thrombotic stroke each occur with circadian variation and peak after waking in the morning. In addition, physical exertion and mental stress are common precipitants of MI. Waking in the morning, physical exertion, and mental stress influence a number of physiologic parameters, including blood pressure, heart rate, plasma epinephrine levels, coronary blood flow, platelet aggregability, and endothelial function. Upregulation of sympathetic output and catecholamines increase myocardial oxygen demand and can decrease myocardial oxygen supply and promote thrombosis. Ischemia ensues when myocardial oxygen demand exceeds supply. Increases in blood pressure and ventricular contractility increase intravascular shear stress and may cause vulnerable atherosclerotic plaques to rupture, forming a nidus for thrombosis that can precipitate MI. Numerous clinical triggers of MI have been identified, including blizzards, the Christmas and New Year's holidays, experiencing an earthquake, the threat of violence, job strain, Mondays for the working population, sexual activity, overeating, smoking cigarettes, smoking marijuana, using cocaine, and particulate air pollution. Avoiding clinical triggers or participating in therapies that prevent clinical triggers from precipitating cardiac events could potentially postpone clinical events by several years and improve cardiovascular morbidity and mortality. Direct or indirect evidence suggests that the risk of triggered MIs is reduced with β-blockers, aspirin, statins, stress management, and transcendental meditation.

Topics: Air Pollution; Blood Pressure; Cardiovascular Agents; Cardiovascular Diseases; Catecholamines; Circadian Clocks; Heart; Hemodynamics; Holidays; Humans; Myocardial Infarction; Physical Exertion; Stress, Psychological; Substance-Related Disorders

The geriatric patient has a high incidence of cardiovascular and psychiatric illness; treatment of either may lead to emergence or aggravation of the other. Toxic side effects can frequently be managed by a reduction in dose or a change in medication. In general, the psychiatric problems of elderly patients, including patients with cardiovascular disease, can be managed despite the cardiovascular toxicity of most psychotropic drugs. Psychiatrists who treat geriatric patients need an understanding of psychopharmacology and clinical manifestations of the cardiovascular system in order to provide well-rounded care.

Topics: Aged; Antidepressive Agents, Tricyclic; Antihypertensive Agents; Antipsychotic Agents; Cardiovascular Agents; Cardiovascular Diseases; Cardiovascular System; Coronary Care Units; Drug Interactions; Female; Hemodynamics; Humans; Lithium; Psychotropic Drugs; Substance-Related Disorders

Topics: Cardiovascular Agents; Ergonovine; Ergot Alkaloids; Mental Disorders; Oxytocics; Substance-Related Disorders

Topics: Autonomic Agents; Behavior, Addictive; Cardiovascular Agents; Ergot Alkaloids; Ergotamine; Humans; Oxytocics; Substance-Related Disorders

Topics: Analgesics; Analgesics, Non-Narcotic; Antipyretics; Behavior, Addictive; Cardiovascular Agents; Ergot Alkaloids; Substance-Related Disorders

Topics: Cardiovascular Agents; Humans; Mental Disorders; Muscle Relaxants, Central; Substance-Related Disorders

Topics: Alkaloids; Behavior, Addictive; Cardiovascular Agents; Ergot Alkaloids; Humans; Lysergic Acid; Mescaline; Substance-Related Disorders