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Biomedical subjects

L E Tune

Publications and source records attributed to L E Tune.

53 records · Page 3Linked to original sources
PubMed1981

Association of postoperative delirium with raised serum levels of anticholinergic drugs.

Drugs with anticholinegic effects are often used in surgical procedures and may impair higher cognitive functions and produce delirious states. This prospective study examined the relation between serum levels of anticholinergic drugs, measured by a radioreceptor assay, and the development of delirium in patients undergoing cardiac surgery. Most patients who had postoperative delirium had high serum levels of anticholinergic drugs, whereas those who remained cognitively intact had low levels; and impairment in cortical function correlated with serum levels of anticholinergic drugs (p less than 0.001). Raised serum levels of drugs with anticholinergic effects may contribute to the development of delirium, and to the increase in risk of morbidity following cardiac surgery.

Adult↗
PubMed1981

Neuroleptic serum levels measured by radioreceptor assay and clinical response in schizophrenic patients.

Serum neuroleptic levels and clinical response have been compared serially in 10 schizophrenic patients treated with a variety of neuroleptics using a novel radioreceptor assay for neuroleptics. In this assay the drug in serum completes with [3H]spiroperidol for binding to dopamine receptors on membranes of the caudate nucleus. Serum neuroleptic levels, expressed in terms of dopamine receptor occupancy, were similar for most neuroleptics at therapeutic doses. Thioridazine levels were substantially higher than those of other neuroleptics.

Adult↗
PubMed1981

Tardive dyskinesia.

Explore the source record for details and available documents.

Antipsychotic Agents↗
PubMed1980

Low neuroleptic serum levels in patients receiving fluphenazine decanoate.

The authors monitored serum levels of fluphenazine in nine patients following injections of fluphenazine decanoate ranging from 10 to 75 mg. Levels were detected by a radioreceptor assay based on the ability of the drug to complete with 3H-spiroperidol for binding to dopamine receptors in rat caudate membranes. Serum levels of fluphenazine were quite stable over a 2- to 3-week period following single intramuscular injections of the decanoate and correlated with injected dose. Following decanoate treatment serum levels of fluphenazine are substantially lower than levels observed for most other neuroleptics administered orally. This raises questions as to how fluphenazine decanoate can exert therapeutic actions.

Administration, Oral↗
PubMed1980

Clinical state and serum neuroleptic levels measured by radioreceptor assay in schizophrenia.

The authors measured serum neuroleptic levels by radioreceptor assay in 30 schizophrenic patients receiving haloperidol, fluphenazine, chlorpromazine, molindone, thiothixene, or trifluoperazine. Neuroleptic levels were significantly correlated with clinical state, monitored by an abbreviated version of the Present State Examination (the mini-PSE). Poor therapeutic responses were associated with serum levels under 50 ng/ml chlorpromazine equivalents. There was no correlation between neuroleptic dosage and mini-PSE score or between neuroleptic dose and serum neuroleptic levels.

Adolescent↗
PubMedDate not supplied

Effects of anticholinergic medication on memory in schizophrenia.

Verbal memory and reaction time of ten schizophrenic patients were compared at two different serum anticholinergic levels. Verbal recall was worse at higher drug levels, while reaction time tended to be improved by anticholinergic treatment. Implications for studies of memory in schizophrenia are considered.

Adult↗
PubMedDate not supplied

Major depression in Alzheimer's disease. An interaction between gender and family history.

Major depression afflicts from 15% to 31% of patients with Alzheimer's disease (AD). The charts of 137 patients with AD were reviewed to assess the association between several variables and the risk of developing major depression. Thirty-eight patients (28%) had major depression. A family history of mood disorder was associated with a significantly increased risk for major depression, but this was only true in women (relative of odds = 2.82,95 confidence interval from 1.19 to 6.69). There was no relationship between major depression and a personal history of depression, younger age at onset of AD, history of substance use disorder, institutionalization, and marital status. These results suggest that the relationship between family history and depression in AD is more complex than previously thought.

Alzheimer Disease↗
PubMedDate not supplied

Acetylcholine and delirium.

The neurotransmitter acetylcholine has been implicated in animal and human studies of delirium. This chapter will briefly review the clinical studies focussing on measurement of serum levels of anticholinergic activity in delirious states. Three approaches have been taken. First, to identify medications currently prescribed that have subtle anticholinergic effects. The current 'list' includes 48 commonly prescribed medications. Second, to associate serum anticholinergic activity with delirium in various clinical states including postcardiotomy delirium, postelectroconvulsive delirium, delirious elderly medical inpatients, and nursing home patients. Third, to intervene in patients with elevated anticholinergic activity by reducing known anticholinergics and correlating this reduction with clinical measures of cognition and delirium. Our most recent data investigates the impact of anticholinergics on demented patients. Rates of delirium were significantly higher in patients receiving larger numbers of anticholinergics.

Acetylcholine↗
PubMedDate not supplied

Diagnosis and treatment of Alzheimer disease and related disorders. Consensus statement of the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society.

OBJECTIVE: A consensus conference on the diagnosis and treatment of Alzheimer disease (AD) and related disorders was organized by the American Association for Geriatric Psychiatry, the Alzheimer's Association, and the American Geriatrics Society on January 4 and 5, 1997. The target audience was primary care physicians, and the following questions were addressed: (1) How prevalent is AD and what are its risk factors? What is its impact on society? (2) What are the different forms of dementia and how can they be recognized? (3) What constitutes safe and effective treatment for AD? What are the indications and contraindications for specific treatments? (4) What management strategies are available to the primary care practitioner? (5) What are the available medical specialty and community resources? (6) What are the important policy issues and how can policymakers improve access to care for dementia patients? (7) What are the most promising questions for future research? PARTICIPANTS: Consensus panel members and expert presenters were drawn from psychiatry, neurology, geriatrics, primary care, psychology, nursing, social work, occupational therapy, epidemiology, and public health and policy. EVIDENCE: The expert presenters summarized data from the world scientific literature on the questions posed to the panel. CONSENSUS PROCESS: The panelists listened to the experts' presentations, reviewed their background papers, and then provided responses to the questions based on these materials. The panel chairs prepared the initial drafts of the consensus statement, and these drafts were read by all panelists and edited until consensus was reached. CONCLUSIONS: Alzheimer disease is the most common disorder causing cognitive decline in old age and exacts a substantial cost on society. Although the diagnosis of AD is often missed or delayed, it is primarily one of inclusion, not exclusion, and usually can be made using standardized clinical criteria. Most cases can be diagnosed and managed in primary care settings, yet some patients with atypical presentations, severe impairment, or complex comorbidity benefit from specialist referral. Alzheimer disease is progressive and irreversible, but pharmacologic therapies for cognitive impairment and nonpharmacologic and pharmacologic treatments for the behavioral problems associated with dementia can enhance quality of life. Psychotherapeutic intervention with family members is often indicated, as nearly half of all caregivers become depressed. Health care delivery to these patients is fragmented and inadequate, and changes in disease management models are adding stresses to the system. New approaches are needed to ensure patients' access to essential resources, and future research should aim to improve diagnostic and therapeutic effectiveness.

Alzheimer Disease↗