Drugs of today
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Intramuscular paliperidone palmitate is a long-acting atypical antipsychotic, which is currently marketed in the U. S. for the acute and maintenance treatment of schizophrenia in adults. Paliperidone is the active 9-hydroxy metabolite of risperidone. ⋯ As maintenance therapy, paliperidone palmitate (25-100 mg eq.) was significantly more effective than placebo in delaying the time to first relapse in stable schizophrenia patients. Overall, paliperidone palmitate was shown to be well tolerated. It is available as prefilled syringes embracing a wide dose range (25, 50, 75, 100 and 150 mg eq.), and requires no refrigeration, reconstitution or oral antipsychotic supplementation.
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No single analgesic drug provides the perfect therapeutic/adverse effect profile for every pain condition. In addition to convenience and possibly improved compliance, a combination of analgesic drugs offers the potential, requiring verification, of providing greater pain relief and/or reduced adverse effects than the constituent drugs when used individually. ⋯ Clinical experience and studies suggest that the combinations are safe and effective and may offer certain advantages. As with all combinations, the profile of adverse effects must also be determined in order to provide the clinician with the overall benefit/risk assessment.
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Extended-release guanfacine (Intuniv) is a novel long-acting, once-daily formulation of guanfacine indicated for attention deficit hyperactivity disorder (ADHD) in 6 to 17 year old children and adolescents. In doses 1 to 4 mg/day, guanfacine extended release (GXR) significantly improves the symptoms of inattention and hyperactivity-impulsivity in ADHD youngsters compared with placebo. ⋯ Children with a clinically significant cardiovascular history are not eligible for GXR therapy. Future research is exploring GXR effectiveness in ADHD complicated by oppositional defiant symptoms, ADHD complicated by tic disorders, posttraumatic stress disorders, and impulsive aggression in ADHD youngsters.
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Fungal infections are an increasingly frequent problem in oncohematological patients with febrile neutropenia and hematopoietic precursors transplant recipients. According to the definitions of the EORTC/MSG Consensus Group, the term invasive fungal infection (IFI) is preferred nowadays to name this group of infections. This aims at highlighting the complex disease resulting from a fungal infection involving higher morbidity, longer hospital stays, increased health care costs and higher mortality risk. Candidiasis and aspergillosis account for about 80% of IFIs in oncohematological patients, while Fusarium diseases, mucormycosis, among others, are emerging infections.
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Restless legs syndrome (RLS) is a sleep-related movement disorder with a high prevalence in the general population. Patients affected by a severe form of the disorder may develop comorbidities, such as psychological distress, cognitive dysfunction and cardiovascular diseases; these patients require pharmacotherapy. Dopamine agonists represent the first line treatment for RLS patients but, if adverse events such as compulsive behaviors and augmentation occur, the pharmacological approach should be modified. ⋯ Doses from 1200 to 1800 mg/day of gabapentin enacarbil appear effective in treating RLS after only a few days of treatment. The most frequently reported adverse events associated with gabapentin enacarbil are dizziness and somnolence, which are transient and of mild intensity. Further studies are required to confirm the long term efficacy and safety of gabapentin enacarbil on the symptoms of RLS.