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NRTI clearly play a central role in the treatment of HIV. However, the prolonged and combined effect of these drugs on the mitochondria is largely unknown. Hepatic steatosis and lactic acidosis are consequences of mitochondrial dysfunction; we speculate that lipodystrophy may also be related to impairment of the mitochondria. Several risk factors may be involved in the development of mitochondrial toxicity, and the optimal management of this condition has not been determined. Therefore, investigations into the effects of NRTI on mitochondria are necessary to determine the importance of this toxicity and to develop strategies for its prevention and treatment. Zaklad Zielarski Kawon-Hurt Nowak Sp. J. Herba Oskar, Wierzbwiec Ziola Lecznicze Boguccy, Krakw Herbalux, Warszawa Herbapol Krakw, for example, natural quinine. 1. 2. Murtagh J. General Practice. Sydney: McGraw-Hill; 1997, p 984-5. Warrell DA. Venomous arthropods. In: Weatherall DJ, Ledingham JGG, Warrell DA, editors. Oxford Textbook of Medicine. 3rd edition. Oxford: Oxford University Press; 1996, p 1144-9. Wasserman G. Wound care of spider and snake envenomations. Ann Emerg Med 1988; 17: 1331-5. Clearwater G. Bites and stings in New Zealand. New Ethicals Journal 1995; May: 19-22. Pincus S, Winkel K, Hawdon G, Sutherland S. Acute and recurrent ulceration after spider bite. Med J Aust 1999; 171: 99-102. White J. Necrotising arachnidism. Med J Aust 1999; 171: 98.

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Hydroquinine hydrobromide and visual disturbances Introduction Hydroquinine hydrobromide Inhibin ; has been approved for marketing in the Netherlands for the treatment of nocturnal cramps, when treatment with drugs is considered necessary [1]. It is available on the market as an over-the-counter drug. It is given in a dose of 200 mg with the evening meal and a further 100 mg at bedtime for 14 days. According to the Summary of Product Characteristics, hydroquinine hydrobromide can be re-administered when nocturnal cramps return. Suinine and its derivatives such as hydroquinine have been used traditionally for the prevention of nocturnal cramps but there has been concern over their efficacy and potential for adverse drug reactions ADRs ; , especially in the elderly. However, in a randomized, double-blind, placebo-controlled trial, conducted in the Netherlands, 300 mg hydroquinine hydrobromide was considered safe to take in the short-term and significantly more effective than placebo in the prevention of frequent, ordinary muscle cramps [2]. The most frequently reported ADRs are nausea, somnolence, dry mouth, insomnia, dizziness, constipation, weakness, nervousness, and sweating. The SPC mentions visual disturbances only during the use of high dosages which are not specified ; as part of cinchonism, a condition produced by the excessive or long-continued use of quinine. Symptoms of cinchonism are well described and consist of headaches, tinnitus, nausea, dizziness, headache and visual disturbances. Acute intoxication with quinine has been associated with blindness, arrhythmias, acute renal failure, and death [3]. Reports In September 2003, the database of the Netherlands Pharmacovigilance Centre contained seven reports concerning visual disturbances associated with the use of hydroquinine hydrobromide. Details concerning these reports are shown in table 1. All patients had been using hydroquinine hydrobromide in the recommended dosage of 300 mg daily or less. Report G, concerns a long term use of hydroquinine possibly associated with optic neuritis. This report will be discussed in more detail. Patient G concerns a 51-year-old female who developed papillary edema and optic neuritis after about fifteen years of chronic hydroquinine treatment for a restless legs syndrome in a dosage of 300 mg daily. She had complaints of `visual obscurations' of both eyes since five years, but had not visited an ophthalmologist for these complaints. On examination, her vision of both eyes was 1.0 with the patient's own correction ; . Fundoscopy showed some retinal hemorrhages centered around the optic disc and papillary edema. Neurological examination revealed no explanation for her complaints. The erythrocyte sedimentation rate was slightly increased, but because she suffered from rheumatoid arthritis, this was not considered as related to the visual disturbances. Visual Evoked Potentials and colour vision were not disturbed. On perimetry, an enlarged blind spot was found. Because an optic neuritis due to hydroquinine was diagnosed, this drug was discontinued. Benign intracranial hypertension could be excluded, but nevertheless she was treated with acetazolamide after a couple of months. Although she slightly recovered, an optic neuritis due to hydroquinine could not be ruled out. Concomitant drugs were carbasalate calcium, diclofenac misoprostol, simvastatin, diazepam and hydrocobamide. Jiang W, Krishnan RR, O'Connor CM. Depression and heart disease: evidence of a link, and its therapeutic implications. CNS Drugs 2002; 16: 111-127 and ribavirin, for example, quinin4 sulfate tablets.
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That at -100 mV, which is consistent with a selective block of K + currents. NPPB blocks the currents at the K + and Cl- equilibrium potential almost to the same extent, suggesting that it does not discriminate between K + and Clchannels. It is therefore not a useful tool for distinguishing between both current components. We have therefore tried to identify the nature of the quinine-insensitive current component. Figure 3 shows the time course of the quinine-insensitive HTS-induced current at + 100 mV in extracellular solutions with normal 82 mM, hypotonic solution B ; and reduced 10 mM ; Clconcentrations. The reduction of extracellular Cl- obviously induced a substantial and reversible decrease in current amplitude. In addition, the reversal potential of the HTSinduced current in the low-Cl- solution was shifted by 43 + towards more positive potentials. Both the decrease in current amplitude and the shift of the. Get some tonic water at the grocery store has quinije in it and does help and anything that helps makes and requip. Dont cut it too early took my body 3 days before it spilled out.

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