Monosymptomatická noční enuréza (MNE) je časté onemocnění v dětském věku. Má výrazný vliv na kvalitu života dítěte i celé rodiny. U některých pacientů se setkáváme se selháním nastavené terapie. Nejčastějšími příčinami jsou nedostatečná spolupráce pacienta, špatně nebo neúplně diagnostikované onemocnění a nesprávně prováděná léčba. Motivace pacienta i celé rodiny, detailní kontrola předchozích vyšetření s cílem vyloučit přidružená onemocnění a pečlivá kontrola prováděné léčby jsou klíčem k úspěchu. Vlastní léčba enurézy by měla respektovat doporučení Mezinárodní společnosti pro dětskou inkontinenci, kde 1. linii tvoří léčba enuretickým alarmem a/nebo desmopresinem, ve 2. linii přidáváme anticholinergika. Léčbu 3. linie představuje podání imipraminu.

Monosymptomatic nocturnal enuresis (MNE) is a common disease in childhood. Enuresis has a significant impact on the childand its family quality of life. In some cases treatment fails. The most common causes of a failure are: low patient's adherence totreatment, misdiagnosis of other underlying pathology and incorrect use of therapy. Repeated child and its parents' education,detailed reexamination aiming to rule out all possible missed pathologic conditions and detailed history of previous therapy arethe key points of success. The treatment should follow the International Children's Continence Society recommendations. The firstline treatment is represented by enuretic alarm and/or desmopressin, the second line includes administration of anticholinergics,imipramin should only be used as a third line treatment.

• MeSH
• Patient Compliance psychology   MeSH
• Medical History Taking MeSH
• Cholinergic Antagonists administration & dosage   pharmacology   contraindications   MeSH
• Deamino Arginine Vasopressin administration & dosage   pharmacology   MeSH
• Diagnosis, Differential MeSH
• Child MeSH
• Attention Deficit Disorder with Hyperactivity diagnosis   drug therapy   MeSH
• Imipramine administration & dosage   pharmacology   MeSH
• Humans MeSH
• Treatment Failure MeSH
• Nocturnal Enuresis * diagnosis   psychology   therapy   MeSH
• Constipation diagnosis   therapy   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Publication type
• Review MeSH

Herein, the direct electroanalytical determination of antidepressant imipramine using a boron-doped diamond electrode is presented. Cyclic and linear sweep voltammetric measurements revealed one distinct, irreversible and diffusion-controlled oxidation peak at +0.75 V (vs. Ag/AgCl) and oval-shaped peaks at +1.0 V and +1.5 V in the presence of Britton-Robinson buffer at pH 9. Using differential pulse voltammetry, the peak current of IMIP was found to be linear function of the concentration from 1.5 to 19.4 μM with the obtained detection limit of 0.5 μM and good repeatability (relative standard deviation of 5.4 % for n = 20 at 1.5 μM IMIP). The practical usefulness of the developed method was successfully manifested on the analysis of pharmaceutical tablets with significant recoveries (99.0–100.4 %). Finally, boron-doped diamond electrode could be considered as an alternative to widely used chemically modified electrodes in antidepressant sensing and may be applied as a sensitive electrochemical sensor in routine pharmaceutical analysis.

• MeSH
• Antidepressive Agents analysis   MeSH
• Chemistry Techniques, Analytical * methods   MeSH
• Electrochemical Techniques methods   MeSH
• Imipramine * analysis   MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

The aim of the study was to compare the adsorption ability of two adsorbent materials, namely diosmectite and activated charcoal towards selected model compounds that are most commonly involved in acute intoxication. Eleven model compounds were selected: acetylsalicylic acid, α-amanitin, amlodipine, digoxin, phenobarbital, ibuprofen, imipramine, carbamazepine, oxazepam, promethazine, and theophylline. Of the tested compounds, promethazine and imipramine were the most effectively adsorbed to diosmectite. Their adsorption to diosmectite (0.356±0.029mg promethazine/mg diosmectite and 0.354±0.019mg imipramine/mg diosmectite, respectively) was significantly higher than their adsorption to activated charcoal. The effect of temperature and pH on the adsorption efficiencies was also evaluated. In the case of experiments with mixture of both adsorbents, they mostly behaved in a solution independently or in a slightly antagonistic way. Using various methods such as N2 adsorption and thermogravimetric analysis, the structure and texture of diosmectite and activated charcoal were attained.

• MeSH
• Adsorption MeSH
• Alpha-Amanitin chemistry   MeSH
• Amlodipine chemistry   MeSH
• Antidotes chemistry   MeSH
• Aspirin chemistry   MeSH
• Digoxin chemistry   MeSH
• Charcoal chemistry   MeSH
• Phenobarbital chemistry   MeSH
• Ibuprofen chemistry   MeSH
• Imipramine chemistry   MeSH
• Carbamazepine chemistry   MeSH
• Poisoning prevention & control   MeSH
• Oxazepam chemistry   MeSH
• Promethazine chemistry   MeSH
• Silicates chemistry   MeSH
• Theophylline chemistry   MeSH
• Publication type
• Journal Article MeSH
• Comparative Study MeSH

• MeSH
• Patient Compliance psychology   MeSH
• Medical History Taking MeSH
• Cholinergic Antagonists administration & dosage   pharmacology   contraindications   MeSH
• Deamino Arginine Vasopressin administration & dosage   pharmacology   MeSH
• Diagnosis, Differential MeSH
• Child MeSH
• Attention Deficit Disorder with Hyperactivity diagnosis   drug therapy   MeSH
• Imipramine administration & dosage   pharmacology   MeSH
• Humans MeSH
• Treatment Failure MeSH
• Nocturnal Enuresis diagnosis   psychology   therapy   MeSH
• Constipation diagnosis   therapy   MeSH
• Check Tag
• Child MeSH
• Humans MeSH

Převládajícím urologickým problémem u geriatrických pacientů jsou symptomy dolních močových cest (LUTS). Nejčastěji zahrnují inkontinenci, nestabilitu detruzoru nebo benigní hyperplazii prostaty. Každodenní fungování staršího pacienta je těmito potížemi afektováno, a tím se snižuje kvalita jeho života. Pomoc je mnohdy svízelná. Řešením by mohla být farmakoterapie. Avšak vzhledem k užívání mnoha léčiv na jiné zdravotní potíže je zde vysoká pravděpodobnost vzniku nežádoucích účinků. Proto je potřeba každého takového pacienta posoudit individuálně a postupovat velice obezřetně.

The predominant urologic problems in geriatric patients are symptoms of the lower urinary tract. Most include incontinence, detrusor instability or benign prostatic hyperplasia. Daily functioning of older patients is affected by these problems, reducing the quality of his life. Help is often difficult. The solution could be pharmacotherapy. However, due to the use of many drugs to other health problems, there is a high probability of side effects. Therefore, the need of each patient individually assessed and proceeds very cautiously.

• MeSH
• Adrenergic alpha-1 Receptor Antagonists pharmacology   adverse effects   therapeutic use   MeSH
• Muscarinic Antagonists pharmacology   adverse effects   therapeutic use   MeSH
• Calcium Channel Blockers pharmacology   adverse effects   therapeutic use   MeSH
• Cholinergic Antagonists pharmacology   adverse effects   therapeutic use   MeSH
• Deamino Arginine Vasopressin pharmacology   adverse effects   therapeutic use   MeSH
• Estrogens pharmacology   adverse effects   therapeutic use   MeSH
• Phytotherapy methods   MeSH
• Prostatic Hyperplasia diagnosis   drug therapy   MeSH
• Imipramine pharmacology   adverse effects   therapeutic use   MeSH
• 5-alpha Reductase Inhibitors pharmacology   adverse effects   therapeutic use   MeSH
• Urinary Incontinence diagnosis   drug therapy   classification   rehabilitation   MeSH
• Drug Therapy, Combination methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Male Urogenital Diseases * diagnosis   epidemiology   etiology   therapy   MeSH
• Aged MeSH
• Lower Urinary Tract Symptoms * diagnosis   drug therapy   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH
• Review MeSH

OBJECTIVE: Neurochemical approaches to antidepressant effects and depressive disorder are also focusing on G-protein coupled receptors (GPCR) and subsequent signalling. Trimeric G-proteins play a crucial role in transmembrane signalling, its amplification and processing. It is evident that immune system participates in antidepressant mode of action by neurotransmitter GPCR. METHODS: We studied the effect of acute administration of fluoxetine or NECA agonist of adenosine receptor (GPCR) on C6 glioma cells and natural killer (NK) cell line, innate immunity. We used immunochemical estimation (ELISA) of the main types of G-protein alpha subunits from isolated membranes of tested cells. RESULTS: Significant reduction of G alpha q/11 subunits after acute administration of fluoxetine or NECA agonist was found. In contrast, no significant influence of G alpha s or G alpha i1,2 subunit levels of C6 glioma cells were observed. Lowered Gq/11 signalling was in accordance with decreased 2nd messenger 1,4,5 IP3 formation by PLC. Acute effect of fluoxetine or NECA agonist on NK cell line resulted in significantly reduced G alpha q/11 levels without changes in G alpha s and G alpha i1,2. Furthermore, we determined that NECA agonist was able to abolish fluoxetine-evoked G alpha q/11 levels of NK cell line. CONCLUSIONS: Results show involvement of fluoxetine in the C6 glioma signal transduction and were comparable with NK cells. Similar inhibiton of G alpha q/11 by NECA agonist in both C6 glioma cells and NK cell line was determined. Furthermore NECA induced attenuation of fluoxetine evoked Galpha q/11 signalling can indicate parallel interference between GPCR and final response. Finally, we determined similarity in both interleukin 2, IL2 immunostimulator and fluoxetine evoked G q/11 levels in NK cell line and thus fluoxetine action could be related to signalling aspects of neuroimmunomodulatory activity.

• MeSH
• Adenosine-5'-(N-ethylcarboxamide) pharmacology   MeSH
• Antidepressive Agents, Tricyclic pharmacology   MeSH
• Killer Cells, Natural drug effects   metabolism   MeSH
• Enzyme-Linked Immunosorbent Assay MeSH
• Fluoxetine pharmacology   MeSH
• Glioma metabolism   MeSH
• Imipramine pharmacology   MeSH
• Immunologic Factors pharmacology   MeSH
• Interleukin-2 metabolism   MeSH
• Rats MeSH
• Humans MeSH
• Cell Line, Tumor MeSH
• Brain Neoplasms metabolism   MeSH
• Rats, Inbred F344 MeSH
• GTP-Binding Proteins metabolism   MeSH
• Selective Serotonin Reuptake Inhibitors pharmacology   MeSH
• Signal Transduction drug effects   MeSH
• Animals MeSH
• Check Tag
• Rats MeSH
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

Volba léčby úzkostných poruch je daná pacientovými charakteristikami (jako předchozí odpověď na léčbu či kontraindikace), dostatečným množstvím dat podporujících její použití, pacientovými a lékařovými preferencemi, místní dostupností. Za nedostatečným zlepšením bývá větší závažnost poruchy, její delší trvání a současná sociální nepřízeň. Máme dostatek informací o účinnosti léků (hlavně antidepresiv) a kognitivně behaviorální terapie u úzkostných poruch. Tělesná aktivita a cvičení mají také pozitivní efekt v klinických i neklinických populacích. Generalizovaná úzkostná porucha patří mezi nejčastější duševní onemocnění v primární péči, úroveň zneschopnění je stejná jako U deprese. Ze systematických shrnutí a randomizovaných kontrolovaných studií vyplývá, že některé inhibitory zpětného vychytávání sero oninu (SSRI), inhibitor zpětného vychytávání serotoninu a noradrenalinu (SNRI) venlafaxin, některé benzodiazepiny (BZD), imipramin a buspiron jsou v akutní léčbě účinné; dalšími piprověřovanými látkami jsou například některá antipsychotika, hydroxyzin, pregabalin, agomelatin. Pokračovací léčba SSRI či SNRI vede k vyššímu počtu zlepšení a remisí v dlouhodobých studiích.

The need for treatment of anxiety disorders is determined by the severity and persistence of symptoms, the presence of comorbid men- tal disorder or physical illness, the level of disability and impact on social functioning, concomitant medication, and a histo ry of good response to, or poor tolerability of, previous treatment approaches. Choice of treatment is affected by the patients characteri stics (such a previous response or contraindications), the evidence base supporting its use, patients and physicians preference, and the lo cal availa- bility of the respective intervention. Severity, duration of illness and ongoing social adversity were associated with lack of improvement. There is good evidence for the efficacy of medication and cognitive behavioral therapy for anxiety disorders. The physical acti vity and exercise have also positive effects in both clinical and nonclinical populations. Generalized anxiety disorder is amongst the most common mental disorders in primary care, leading to the disability comparable to that associated with major depression. Systematic reviews and placebo-controlled RCTs indicate that some SSRIs, the SNRI venlaf axine, some benzodiazepines, imipramine, and buspirone are all efficacious in acute treatment; other compounds with proven efficacy in clude some antipsychotics, hydroxyzine, pregabalin, and agomelatin. Continuing with SSRI or SNRI treatment is associated with an incr ease in overall response rates in the long term studies.

• Keywords
• tricyklická antidepresiva, tělesná aktivita, SSRI, SNRI, generalizovaná úzkostná porucha, doporučení k léčbě,
• MeSH
• Acetamides therapeutic use   MeSH
• Medical History Taking MeSH
• Antidepressive Agents administration & dosage   adverse effects   MeSH
• Anticonvulsants MeSH
• Antipsychotic Agents MeSH
• Anti-Anxiety Agents MeSH
• Behavior Therapy methods   MeSH
• Benzodiazepines administration & dosage   adverse effects   MeSH
• Buspirone administration & dosage   adverse effects   MeSH
• Exercise physiology   psychology   MeSH
• Long-Term Care MeSH
• gamma-Aminobutyric Acid analogs & derivatives   therapeutic use   MeSH
• Imipramine therapeutic use   MeSH
• Cognitive Behavioral Therapy methods   MeSH
• Combined Modality Therapy methods   MeSH
• Humans MeSH
• Melatonin therapeutic use   MeSH
• Recurrence MeSH
• Secondary Prevention MeSH
• Selective Serotonin Reuptake Inhibitors therapeutic use   MeSH
• Severity of Illness Index MeSH
• Anxiety Disorders diagnosis   drug therapy   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH
• Guideline MeSH

OBJECTIVE: Monoamine oxidase (MAO), the enzyme responsible for metabolism of monoamine neurotransmitters, has an important role in the brain development and function, and MAO inhibitors have a range of potential therapeutic uses. We investigated systematically in vitro effects of pharmacologically different antidepressants and mood stabilizers on MAO activity. Methods: Effects of drugs on the activity of MAO were measured in crude mitochondrial fraction isolated from cortex of pig brain, when radiolabeled serotonin (for MAO-A) or phenylethylamine (for MAO-B) was used as substrate. The several antidepressants and mood stabilizers were compared with effects of well known MAO inhibitors such as moclobemide, iproniazid, pargyline, and clorgyline. Results: In general, the effect of tested drugs was found to be inhibitory. The half maximal inhibitory concentration, parameters of enzyme kinetic, and mechanism of inhibition were determined. MAO-A was inhibited by the following drugs: pargyline > clorgyline > iproniazid > fluoxetine > desipramine > amitriptyline > imipramine > citalopram > venlafaxine > reboxetine > olanzapine > mirtazapine > tianeptine > moclobemide, cocaine > lithium, valproate. MAO-B was inhibited by the following drugs: pargyline > clorgyline > iproniazid > fluoxetine > venlafaxine > amitriptyline > olanzapine > citalopram > desipramine > reboxetine > imipramine > tianeptine > mirtazapine, cocaine > moclobemide, lithium, valproate. The mechanism of inhibition of MAOs by several antidepressants was found various. Conclusions: It was concluded that MAO activity is acutely affected by pharmacologically different antidepressants at relatively high drug concentrations; this effect is inhibitory. There are differences both in inhibitory potency and in mechanism of inhibition between both several drugs and the two MAO isoforms. While MAO inhibition is not primary biochemical effect related to their therapeutic action, it can be supposed that decrease of MAO activity may be concerned in some effects of these drugs on serotonergic, noradrenergic, and dopaminergic neurotransmission.

• MeSH
• Affect drug effects   MeSH
• Amitriptyline pharmacology   MeSH
• Antidepressive Agents pharmacology   MeSH
• Antimanic Agents pharmacology   MeSH
• Benzodiazepines pharmacology   MeSH
• Citalopram pharmacology   MeSH
• Cyclohexanols pharmacology   MeSH
• Desipramine pharmacology   MeSH
• Fluoxetine pharmacology   MeSH
• Imipramine pharmacology   MeSH
• Monoamine Oxidase Inhibitors pharmacology   MeSH
• Iproniazid pharmacology   MeSH
• Clorgyline pharmacology   MeSH
• Cocaine pharmacology   MeSH
• Valproic Acid pharmacology   MeSH
• Lithium pharmacology   MeSH
• Mianserin analogs & derivatives   pharmacology   MeSH
• Mitochondria drug effects   enzymology   MeSH
• Moclobemide pharmacology   MeSH
• Monoamine Oxidase drug effects   metabolism   MeSH
• Morpholines pharmacology   MeSH
• Cerebral Cortex cytology   MeSH
• Pargyline pharmacology   MeSH
• Swine MeSH
• In Vitro Techniques MeSH
• Thiazepines pharmacology   MeSH
• Animals MeSH
• Check Tag
• Animals MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Diagnostic Techniques, Urological MeSH
• Imipramine therapeutic use   MeSH
• Urinary Incontinence diagnosis   drug therapy   rehabilitation   MeSH
• Humans MeSH
• Parasympatholytics therapeutic use   MeSH
• Aged MeSH
• Urinary Incontinence, Stress diagnosis   drug therapy   rehabilitation   MeSH
• Suburethral Slings utilization   MeSH
• Incontinence Pads MeSH
• Check Tag
• Humans MeSH
• Aged MeSH

Na kazuistice nočního pomočování chci upozornit na nutnost širšího pohledu na pacienta a jeho rodinu před nasazením antienuretické medikace. Tragický případ je také apelem na těsnější spolupráci a lepší informovanost mezi jednotlivými lékaři, především mezi specialisty a P LDD .

• MeSH
• Child MeSH
• Imipramine therapeutic use   toxicity   MeSH
• Interprofessional Relations MeSH
• Humans MeSH
• Adolescent MeSH
• Nocturnal Enuresis psychology   MeSH
• Family Relations MeSH
• Suicide MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Female MeSH
• Publication type
• Case Reports MeSH