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Biomedical subjects

J Sternon

Publications and source records attributed to J Sternon.

At least 55 records · Page 3Linked to original sources
PubMed1999

[Nevirapine (Viramune): a new HIV inhibitor].

Nevirapine is the first member of a new therapeutic class (NNRTI: non nucleoside inhibitors of the reverse transcriptase) in the treatment against human immunodeficiency virus (HIV). In association with two other antiretroviral products, it reduces significantly the viral load and increases the CD4-cells-count, especially in naive patients. Results at six months show that a tritherapy including nevirapine and 2 nucleoside inhibitors of the reverse transcriptase (NRTIs) has a similar efficacy than an association including 1 anti-protease and two NRTIs. Nevirapine is easy to take (1 tablet 2x/day, irrespective of the meals). Its tolerance profile is favourable. The principal side effect is a rash, which can be severe in rare cases.

Anti-HIV Agents↗
PubMed1999

[Orlistat (Xenical)].

Orlistat, a potent inhibitor of the pancreatic and intestinal lipases, is the first member of a new therapeutic class approved for the treatment of obesity. Its administration with fat-containing foods results in a partial inhibition of triglyceride hydrolysis in the digestive lumen and subsequent reduction of the free fatty acids and monoglycerides absorption. At the usual dosage of 120 mg tid, about 30% of ingested fat are excreted non digested in feces. When administered with a mildly hypocaloric diet, orlistat contributes to loss of weight by a additional caloric deficit and promotes further compliance of the obese patient to the dietary recommendations. Several double-blinded, placebo-controlled studies have shown a statistically significant loss of weight of about 10% when orlistat was prescribed with a well balanced, mildly hypocaloric diet to obese patients during one year. Moreover, small but significant beneficial changes in the serum lipid levels occurred in these patients. Because the orlistat molecule is not reabsorbed, its side effects are mostly due to the gastrointestinal effects and consist in steatorhea after fatty meals. However, the treatment is generally well tolerated. Since the recent withdrawal from the worldwide market of the anorectic agents, phentermine and fenfluramine, orlistat is at this time the only drug approved by the European Community for the treatment of obesity. However, its long-term value are not currently known.

Anti-Obesity Agents↗
PubMed1999

[Rejuvenating hormones].

The clinical and biological syndromes of menopause, andropause, somatopause and adrenopause are presented successively. Various substitutive hormonotherapies (including melatonin) are considered according to their efficacy, risks and cost.

Antioxidants↗
PubMed1999

[Atorvastatin (Lipitor)].

Atorvastatin is a second generation synthetic statin, introduced in Belgium in May 1998. Its mechanism of action is similar to that of the other statins, i.e. the inhibition of HMG Co-A reductase, the key enzyme in cholesterol synthesis, which leads to the increase of LDL receptors. The prolonged half-life (20-30 H) of atorvastatin and its active metabolites, induces a prolonged inhibition of HMG Co-A reductase and a reduction of hepatitic apo B production. The biological efficacy of atorvastatin is high: 41 to 61% lowering of LDL depending of the dose. Atorvastatin is indicated in primary hypercholesterolemia, mixed hyperlipidemia and homozygous familial hypercholesterolemia. If necessary, a resin or even a fibrate may be added. The safety profile is good. The most common adverse effects are gastro-intestinal and transient. Liver tests or muscle enzymes are rarely modified. If clinical proof of reduction of CV morbidity and mortality in primary and secondary prevention is obtained, atorvastatin shall represent a major step forward in the treatment of hypercholesterolemia.

Anticholesteremic Agents↗
PubMed1999

[Reboxetine (Edronax)].

Reboxetine is a new antidepressant acting by selective inhibition of noradrenaline reuptake (NARI) at the synaptic cleft. The efficacy of reboxetine is similar to other antidepressants such as tricyclic and Selective Serotonin reuptake inhibitors once (SSRI). A faster onset of action (in a mean of 10 days) is suggested by preliminary studies. Reboxetine seems also to improve social adjustment of the treated depressed patients. Due to its selectivity, reboxetine presents a favourable safety profile. Treatment of depression will certainly benefit from this new compound. However, some issues need to be clarified such as the use of reboxetine in combination with other antidepressants.

Adrenergic Uptake Inhibitors↗
PubMed1998

[Meloxicam].

NSAID's are currently medications widely prescribed. Meloxicam is a new oxicam which has a low COX-2/COX-1 ratio, i.e. it has an inhibitory effect focused on the inflammatory proteins (COX-2) with relative saving of the homeostatic proteins (COX-1). This molecule has been studied in three rheumatic diseases, the acute flare-up of osteoarthritis, rheumatoïd arthritis, and ankylosing spondylitis. The results show that meloxicam is as effective as comparative NSAID's. A global analysis of the data from more than 5000 patients included in clinical trials showed that gastro-intestinal tolerance of meloxicam was better than that of comparative NSAID'S. Nevertheless, the clinical translation of the anti-COX-2 selectivity concept is currently debated.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1998

[Transdermal fentanyl].

Fentanyl is a synthetic pure opioid agonist with a selective activity on mu receptors. Its high liposolubility allows a transdermal administration, using a Transdermal Therapeutic System (TTS). The clinical efficacy is widely demonstrated in the field of cancer pain control. The side effects are those observed with morphine but with less frequent constipation. The adjonction of a short acting morphine in case of acute pain is recommended.

Administration, Cutaneous↗
PubMed1998

[Mycophenolate mofetil].

Mycophenolate Mofetil (MMF) is a new immunosuppressive agent that selectively inhibits the proliferation of T and B lymphocytes. The use of MMF in renal transplantation significantly reduced the incidence of acute rejection episodes in the first year after transplantation. The main toxicities of MMF are the occurrence of diarrhea and leucopenia. This potent immunosuppressive agent is devoid of the nephrotoxicity of cyclosporin and of the multiple adverse effects of corticosteroids. Clinical trials are currently in progress to assess whether the use of MMF will allow the discontinuation of cyclosporine or corticosteroid therapy without leading to an increased risk of rejection. If results were positive, MMF would represent a significant advance in the field of renal transplantation.

Acute Disease↗
PubMed1998

[Routine screening of asymptomatic patients at risk, without warning signs: a necessity].

The biological checkup of asymptomatic patients but presenting various risk factors is justified in the hope of detecting and correcting premorbid pathological abnormalities early and treating various silent but threatening diseases effectively. The author considers type 2 diabetes mellitus, hypercholesterolemia, thyroid diseases, renal insufficiency, prostate and colorectal cancer, sexually transmitted diseases, and prenatal work up.

Adult↗
PubMed1998

[Sildenafil].

Sildenafil is an innovative molecule, effective in most cases of erectile dysfunction, acting by inhibition of type 5 phosphodiesterase in the corpus cavernosum. Its impressive success attests its efficacy and the frequency of erectile dysfunction in man. The authors review the clinical data and call for caution in its prescription requiring a thorough check-up of the cardiovascular system taking into account its potentially letal interactions with nitrates.

3',5'-Cyclic-GMP Phosphodiesterases↗
PubMed1998

[Zolmitriptan].

One of the outstanding therapeutic revolutions of this last decade has been the introduction of selective serotonin agonists in the acute treatment of migraine. After sumatriptan, introduced in Belgium in 1992, other "triptans" are emerging. The efficacy and the pharmacoeconomic profile of zolmitriptan, the second "triptan" now available in Belgium, are reviewed and the arrival of a third triptan, naratriptan is announced.

Chemistry, Pharmaceutical↗
PubMed1997

[Digestive and extra-digestive complications of nonsteroidal anti-inflammatory drugs. Preventive and curative strategies].

The authors review the digestive ulceration risk factors and the criteria for selecting a non steroidal antiinflammatory (NSAI), included the most recent drugs, such as selective anti-cyclo-oxygenases 2. They actualize the preventive strategies and insist on the values of misoprostol and of slow acting anti-rheumatic drugs. In the case of digestive ulcerations, they plead for the immediate stop of the NSAI and its replacement if necessary by corticosteroids, for the prescription of a proton pump inhibitor (PPI) or mesalazine according to the localisation of the lesion, finally for the eradication within 8 days of Helicobacter pylori.

Anti-Inflammatory Agents↗
PubMed1997

[Post myocardial infarction management].

Post myocardial infarction preventive strategies are effective in reducing morbidity and mortality. Life threatening risk factors can be controlled by medication in addition to dietary measures. The following update will be proposed on: new lipidic and non lipidic risk factors; necessity to control risk factors, nicotine dependence and lipid metabolism disorders in particular; patient follow-up; drug treatment efficacy (beta-blockers, aspirin, ACEI, statins); compliance to a varied drug treatment regimen. Three newly developed treatments will be presented: the first sartan, clopidogrel and troglitazone.

Aftercare↗
PubMed1997

[Current therapy: losartan].

The authors present losartan, an angiotensin II receptor inhibitor with respect to its clinical interest and its practical and economical aspects.

Angiotensin II↗
PubMed1997

[Therapeutic results: tacrine].

Tacrine is the first drug having been demonstrated as effective for the treatment of mild and moderate forms of Alzheimer's disease. It works as a potent centrally active inhibitor of acetylcholinesterase and therefore has cholinomimetic properties. The authors evaluate the costs/benefits ratio of this drug taking into account clinical and economical data.

Alzheimer Disease↗