Ashwagandha
By F. Vatras. Milligan College.
Conclusion: There is 1 1 1 evidence of an association between pulmonary complications and E cheap ashwagandha 60 caps without a prescription anxiety quitting smoking. Adalimumab is a humanized monoclonal antibody buy ashwagandha 60caps anxiety 7 question test, it would Training Hospital, Physical Medicine and Rehabilitation, Istanbul, have the potential advantage of being less immunogenic. However, Turkey some authors have suggested that its use might induce pulmonary complications. Herein, we want to draw attention to successful Introduction/Background: Pulmonary involvement is one of the treatment of pulmonary involvement of rheumatoid arthiritis with extra-articular manifestations of rheumatoid arthritis and includes adalimumab but it should be kept in mand that it may also cause pleural effusion, parenchymal nodules, interstitial involvement, pulmonary complications. We present a case of a patient with pulmonary involvement of rheumatoid arthiritis and treated with pulse steroid therapy. All questions are about sleep and they were well understood by ment of Otorhinolaryngology, Ankara, Turkey, 3Ministry of Health patients which showed the face validity. Introduction/Background: The aim of this study was to investigate Pearson’s (r) Signifcance (p) the inner ear function in patients with psoriatic arthritis. Statistical comparisons between both groups were per- formed using chi-square test and Mann- WhitneyU test. Latif3 the evaluation of hearing frequencies of the patients between 4,000 1Ahvaz Jundishapur Univeristy of Medical Sciences - Ahvaz - Iran, and 6,000 Hz, a statistically signifcant difference was found relative 2 Physical Medicine and Rehabilitation, Ahvaz, Iran, Ahvaz Jundis- to the control group (p<005). When compared with 3 the control group, a statistically signifcantly difference was found Ahvaz, Iran, Ahvaz Jundishapur Univeristy of Medical Sciences at 3,000 and 4,000 Hz. Conclusion: Our study provides - Ahvaz - Iran, Health Research Center-Diabetes Research Center, strong evidence suggesting the necessity of monitorization of these Ahvaz, Iran patients regarding sensorineural hearing loss so as to take measures Introduction/Background: Median nerve involvement in wrist is against the development of hearing loss during early stage which one of the most common compression neuropathy which drives the may be another disability in patients with PsA which is itself a po- patients to musculocutaneus clinics such as orthopedy, neurology tential cause of severe disability. For estimating the amount of nerve injury, all the amounts of patients’ pain severity, 264 clinical and electrodiagnostic severity data were used by different researchers. The patients’ report of pain severity did Not show Introduction/Background: The aim of this study is to assess the va- correlation with electrodiagnostic severity. The electrodiagnostic severity was correlated with the consuming scale which assesses the sleep disturbance with 4 ques- clinical symptom severity at: p=0. The tom severity and the electro diagnostic severity were more reliable internal consistency (Cronbach’s alpha) was assessed for reliability. Face validity and construct validity (convergent and divergent va- lidities) were evaluated. Material and Methods: A total of 60 1 patients who fulflled the “Revised Criteria for the Classifcation of D. Sung 1Samsung Medical Center, Physical Medicine and Rehabilitation, Rheumatoid Arthritis 1987” were included in this study. The pa- tients who satisfed at least 4 out of 7 criteria were included in the Seoul, Republic of Korea study. Demographic characteristics, clinical features, laboratory tients with inactive disease. Morning stiffness was reported in 31 the calculation of absolute cardiovascular disease risk. Incidence of giant cell arteritis is higher than tion, Mahdia, Tunisia other previous Korean reports. We report a new case of this as- sociation and we describe its management in physical medicine. Material and Methods: This is a 26 year old patient with a his- 269 tory of juvenile rheumatoid arthritis since the age of 4 years. She received physical 1 University of Malaya Medical Centre, Rehabilitation Medicine, therapy without any improvement. Its incidence is unknown whereas the preva- the patient in internal medicine for suspected Takayasu arteritis. Material and Meth- coabdominal angioscan revealed a damage of common carotid, ods: A 57-year-old man with chronic diabetes mellitus presented subclavian, vertebral and thoracic aorta. The patient was treated with a grossly deformed, painless, swollen and unstable right knee, witha high-dose of corticosteroids in combination with methotrex- which rapidly progressed over 5 months with no history of trauma. Radiological studies an appropriate rehabilitation program with a signifcant improve- showed subluxation of the right knee joint with all major ligaments ment. He was limited to hopping with a walking frame and pro- juvenile rheumatoid arthritis is rare. Refusing surgery, suspected whenever coexist joint symptoms and vascular signs he agreed for a right knee- ankle- foot orthosis for joint protection mainly vascular claudication in the upper limb of a young woman.
Alternatively ashwagandha 60 caps for sale anxiety symptoms flushed face, an activity and half its value and their corresponding times are read from the plot discount ashwagandha 60 caps with amex anxiety symptoms light sensitivity. Thus, the radioactivity At at time t can be calculated from the initial radioactivity A0 by A tt12 At A0 05. It should be noted that ten half-lives of decay reduce the radioactivity by 10 a factor of about 1000 (2 = 1024), or to 0. The half-life of a radionuclide is determined by measuring the radioac- tivity at different time intervals and plotting them on semilogarithmic paper, as shown in Figure 3. An initial activity and half its value are read from the line, and the corresponding times are noted. The difference in time between the two readings gives the half-life of the radionuclide. The number of atoms N can be calculated from the weight W of the radionuclide with 24 3. A composite radioactive decay curve for a sample containing two radionu- clides of different half-lives. The long-lived component (a) has a half-life of 27hr and the short-lived component (b) has a half-life of 5. A semilogarithmic plot of the activity of a two-component sample versus time is shown in Figure 3. The half-life of each of the two radionuclides can be determined by what is called the peeling or stripping method. In this method, first, the tail part (second component) of the curve is extra- polated as a straight line up to the ordinate, and its half-life can be deter- mined as mentioned previously (e. Second, the activity values on this line are subtracted from those on the composite line to obtain the activ- ity values for the first component. A straight line is drawn through these points, and the half-life of the first component is determined (e. Radioactive Decay Equations 25 The stripping method can be applied to more than two components in the similar manner. Mean Life Another relevant quantity of a radionuclide is its mean life, which is the average lifetime of a group of radionuclides. It is denoted by t and is related to the decay constant l and half-life t1/2 as follows: t = 1/l (3. Effective Half-Life As already mentioned, a radionuclide decays exponentially with a definite half-life, which is called the physical half-life, denoted by Tp (or t1/2). The physical half-life of a radionuclide is independent of its physicochemical conditions. Analogous to physical decay, radiopharmaceuticals adminis- tered to humans disappear exponentially from the biological system through fecal excretion, urinary excretion, perspiration, or other routes. Thus, after in vivo administration every radiopharmaceutical has a biolog- ical half-life (Tb), which is defined as the time needed for half of the radio- pharmaceutical to disappear from the biologic system. Obviously, in any biologic system, the loss of a radiopharmaceutical is due to both the physical decay of the radionuclide and the biologic elimi- nation of the radiopharmaceutical. The net or effective rate (le) of loss of radioactivity is then related to lp and lb by le = lp + lb (3. Kinetics of Radioactive Decay Units of Radioactivity The unit of radioactivity is a curie. Thus, each radionuclide or radioactive sample is characterized by specific activity, which is defined as the radio- activity per unit mass of a radionuclide or a radioactive sample. For example, suppose that a 200-mg 123I-labeled monoclonal antibody sample 123 contains 350-mCi (12. Sometimes, it is confused with concentration, which is defined as the radioactivity per unit volume of a sample. The specific activity of a carrier-free (see Chapter 5) radionuclide sample is related to its half-life: the shorter the half-life, the higher the specific activ- ity. The specific activity of a carrier-free radionuclide with mass number A and half-life t1/2 in hours can be calculated as follows: Suppose 1mg of a carrier-free radionuclide is present in the sample. Calculation Some examples related to the calculation of radioactivity and its decay follow: Problem 3. Here we shall derive equations for the activ- ity of a radionuclide that is growing from another radionuclide and at the same time is itself decaying. If a parent radionuclide p decays to a daughter radionuclide d, which in turn decays to another radionuclide (i.
We have about 1 order 60 caps ashwagandha mastercard anxiety symptoms in young males,200 purchase 60caps ashwagandha with amex anxiety 2 weeks before period,000 copies of one family, the 280bp Alu sequence, and about 600,000 copies (mostly incomplete) of the 6. The principle of genetic mapping of a mendelian character is to One cannot fail to be struck by the contrast between, on find a chromosomal segment whose segregation in a the one hand, our anatomy and physiology, where we con- family or series of families exactly parallels the segregation stantly encounter marvels of natural engineering, elegant func- of the character being investigated. Chromosomal segments are followed through pedigrees by Maybe there is some deep organising principle of genomes that using genetic markers. A genetic marker can be any character we do not understand, but more probably, it is because natural that is variable in a population and is inherited in a mendelian selection has no interest in a tidy genome, just as long as it fashion. Most nucleotides are the Two ways of identifying genes same in all of us, with occasional rare variants, but about 1 nucleotide in every 300 is polymorphic, with two alterna- At the start of this chapter, I described the two ways genes are tives being reasonably common in populations worldwide. A real gene small fraction of our genome (maybe 2%) but contain all the should have an open reading frame of 100 amino acids or more. Once a candidate region has been defined by genetic mapping, The protocol for mapping a mendelian condition consists, we need to find which gene within that region is mutated to in principle, of the following: cause the condition. In years past, this endeavour, called posi- tional cloning, was a massive undertaking that often involved 1. The starting point is a large family, or more often a collec- years of intensive toil by small armies of postdoctoral scientists. We can search the public databases to draw up a list of the members, and the diagnoses carefully confirmed by an expe- genes within the candidate region. The results are checked to see whether segregation of the domain of expression, etc. The test loss should be expressed in the inner ear, and ideally it should statistic is the lod score, calculated by computer. This is the encode an ion channel, motor protein, or gap junction protein, logarithm of the odds of linkage versus no linkage. If the marker tracks nearly but How genes go wrong not quite always with the disease, other markers from nearby on the chromosome can be used to define the mini- The mechanics of mutations mal chromosomal segment that tracks completely with the disease. The diagram shows two possible ways a specific chromosome might segregate in a family in which hearing loss is being transmitted as an autosomal dominant trait. In Scenario 2, inheritance of the bold chromosome exactly parallels inheritance of hearing loss. If this happens sufficiently often, it would suggest that the hearing-loss gene is carried on that chromosome. However, in real life, pairs of chromosomes swap segments during each meiosis, so what we have to follow through the pedigree is a chromosomal segment rather than a whole chromosome. Understanding the genotype: basic concepts 13 Inevitably, it can go wrong in many different ways. Unexpectedly, premature stop codons (whether words: due to frameshifts or nonsense mutations) usually do not result in production of a truncated protein. This “non- If we add or delete one letter, from then on the whole mes- sense mediated decay” probably functions to protect the cell sage is corrupted: against deleterious effects of partially functional proteins. A major distinction is between mutations that totally abol- ■ The bix gba dbo yhi tth eca t ish gene expression or totally wreck the product and those that ■ The bib adb oyh itt hec at..... Frameshifts result not only from insertion or mutations have no effect on the function of the gene product, from deletion of any number of nucleotides that is not a multi- but this is virtually impossible to predict—as genetic diagnostic ple of three but also from splicing mutations or exon deletions laboratories have learned to their cost. There are two gen- eral solutions to this: ■ Loss of function results from complete gene deletions, most frameshift, nonsense, and splice site mutations, and from ■ Selectively amplify the sequence of interest to such an some missense mutations. All mutations that cause com- extent that the sample consists largely of copies of that plete loss of function of a gene would be expected to have sequence. What this effect is depends on ■ Pick out the sequence of interest by hybridising it to a how vital the function is and the other allele. For many genes, this is sufficient for normal function; In the past, selective amplification was achieved by cloning the person is normal and the condition is recessive. All that is necessary is to know a few details of the actual are an example of haploinsufficiency. If a dye-labeled single strand corresponding to the This is called a dominant negative effect.
Classification of Radiation Damage Cell death is a measure of extreme radiation damage buy ashwagandha 60caps visa anxiety symptoms upon waking up. All these damages are relevant in clinical radiation therapy as to the effective- ness of treatment order ashwagandha 60caps free shipping anxiety symptoms burning skin. Sublethal damage occurs in mammalian cells, when a radiation dose is given in fractions at different time intervals rather than a single dose. Repair involves the healing of the radiation-induced damage in the time interval between the two fractions of the dose. If the second dose is applied too soon after the first application, the damage does not have enough time to repair and the cell will die. In the redistribution process, the cells are desynchronized and sensitized to show increased damage. Following irradiation, the radiosensitive cells will die, and one would expect the proportion of radioresistant cells and hence the surviving fraction to increase. Regeneration is a mechanism of response to depopulation of a cell cohort due to radiation damage, and depends on the types of tissue and their proliferating capacity. Protracting a fractionated dose should be beneficial to normal tissues and somewhat harmful to regenerating tumor cells. Reoxygenation discussed earlier is an effect that makes the hypoxic cells more radiosensitive in the presence of oxygen in fractionated radiotherapy. Sublethal damage repair depends very much on the dose rate and in which stage of the cell cycles the cells are. For example, the testis of male rats is most radiosensitive, whereas the small intestine seems to be less affected by radiation. The repair is significant with x-rays and g-rays and almost nonex- istent for neutrons and a-particles. For example, the survival of the HeLa cells increased after irradiation, when the cells were treated with excess thymidine or hydro- xyurea for a period of 4hr. Stochastic and Deterministic Effects Two categories of radiation effects on biological systems are encountered: stochastic and deterministic. Stochastic effects are the biological effects that occur randomly, the probability of which increases with increasing dose without a threshold. Radiation-induced hereditary effects and cancer inci- dences are examples of stochastic effects. The assumption of no threshold is made on the belief that radiation damage to a few cells or a single cell could theoretically induce the genetic disorder or cancer, and the severity of the disease will be the same, if it ever occurs. Acute Effects of Total Body Irradiation 247 The deterministic or nonstochastic effects are induced by high radiation doses and the severity of the damages, rather than their probability of occurrence, increases with the dose. Cataracts, skin erythema, sterility, and fibrosis are examples of deterministic effects induced by high radiation doses. Acute Effects of Total Body Irradiation Different tissues of the body respond differently to radiation, due to varying degrees of radiosensitivity. When an adult subject is irradiated over the entire body, various syndromes are manifested depending on the dose applied. The effects of radiation are characterized by the survival time of the species and various stages of acute syndromes following the total- body irradiation. Cell survival time varies with mammal species depending on the indi- vidual radiosensitivity. Acute radiation syndromes appear in four stages: prodromal, latent, manifest illness, and recovery or death. A minimum of 200 to 300rad (200 to 300cGy) is required for all four stages to be seen and can cause death. In the prodromal stage, major symptoms are nausea, vomiting, and diarrhea and they occur in the early phase, lasting for only a short period of time depending on the dose. In the latent stage, biological damage slowly builds up without manifestation of any syndromes, again lasting for hours to weeks, depend- ing on the dose. During the manifest illness stage, radiation syndromes appear as a result of the damage to the organs involved after the latent period, and the subject becomes ill. Hemopoietic Syndrome Hemopoietic or bone marrow syndromes appear at a total body dose of 250 to 500rad (250 to 500cGy) following irradiation. Also, the number of lymphocytes are greatly depressed, whereby the immune system of the body is sup- pressed. Loss of blood cell counts can be noticed at a dose as low as 10 to 15rad (10 to 15cGy).
With this type of scale order 60 caps ashwagandha visa anxiety episode, it is not possible to say that the difference between mild and moderate stress is the same as the difference between moderate and severe stress buy ashwagandha 60caps fast delivery anxiety images. Scale variables Variables with numeric values that are measured by an interval or ratio scale are classified as scale variables. On an interval scale, one unit on the scale represents the same magnitude across the whole scale. For example, Fahrenheit is an interval scale because the difference in temperature between 10 ∘Fand20 F∘ is the same as the dif- ference in temperature between 40 ∘Fand50∘F. Because interval scales have an arbitrary rather than a true zero point, it is not possible to compare ratios. A ratio scale has the same properties as ordinal and interval scales, but has a true zero point and therefore ratio comparisons are valid. For example, it is possible to say that a person who is 40 years old is twice as old as a person who is 20 years old and that a person is 0 years old at birth. In Data View, when a statistical procedure is selected from Analyze a dialogue box opens up and variables to be analysed must be selected such as an independent or dependent variable. If the role of the vari- ables has been defined in Variable View, the variables will be automatically displayed in the destination list of the dialogue box. When the file is saved, the name of the file will replace the word Untitled at the top left-hand side of the Data View screen. The data can then be entered in the Data View screen and also saved using the commands shown in Box 1. In general, the data for each participant should occupy one row only in the spreadsheet. Thus, if follow-up data have been collected from the participants on one or more occasions, the participants’ data should be an extension of their baseline data row and not a new row in the spreadsheet. However, this does not apply for studies in which controls are matched to cases by characteristics such as gender or age or are selected as the unaffected sibling or a nominated friend of the case and therefore the data are paired. The data from matched case–control studies are used as pairs in the statistical analyses and therefore it is important that matched controls are not entered on a separate row 6 Chapter 1 but are entered into the same row in the spreadsheet as their matched case. This method will inherently ensure that paired or matched data are analysed correctly and that the assumptions of independence that are required by many statistical tests are not violated. Thus, in Data View, each column represents a separate variable and each row represents a single participant, or a single pair of participants in a matched case–control study, or a single participant with follow-up data. For some longitudinal modelling analyses, the data may need to be changed to ‘long format’, that is, each time a point is represented on a separate row. In Data View, data can be entered and the mouse, tab, enter or cursor keys can be used to move to another cell of the data sheet. In Data View, the value labels button which is displayed at the top of the spreadsheet (17th icon from the left-hand side), with an arrow pointing to ‘1’ and another arrow pointing to ‘A’ can be used to switch between displaying the values or the value labels that have been entered. Many researchers use Excel or Access for ease of entering and man- aging the data. In addition, specialized programs are available for transferring data between different data entry and statistics packages (see Section Useful Websites). Once data quality is ensured, a back-up copy of the database should be archived at a remote site for safety. Few researchers need to resort to their archived copies but, when they do, they are an invaluable resource. The spreadsheet that is used for data analyses should not contain any information that would contravene ethics guidelines by identifying individual participants. In the working data file, names, addresses and any other identifying information that will not be used in data analyses should be removed. Identifying information that is required can be recoded and de-identified, for example, by using a unique numerical value that is assigned to each participant. Categorical variables have discrete categories, such as male and female, and continuous variables are measured on a scale, such as height which is measured in centimetres. For example, gender which is coded as 1 = male and 2 = female and place of birth which is coded as 1 = local, 2 = regional and 3 = overseas are non-ordered variables. Categorical variables can also be ordered, for example, if the continuous variable length of stay was recoded into categories of 1 = 1–10 days, 2 = 11–20 days, 3 = 21–30 days and 4 = >31 days, there is a progression in magnitude of length of stay.
Whatever form it takes purchase 60 caps ashwagandha with amex anxiety symptoms gastro, nyctanopia Impaired vision in dim light and in nystagmus is an abnormal eye finding and a sign of the dark generic ashwagandha 60caps anxiety 9gag, due to impaired function of the rods in the disease within the eye or the nervous system. Inter-observer variation is the amount of variation between the results obtained by two or more observers examining the same material. Intra- observer variation is the amount of variation one observer experiences when observing the same material more than once. Oo obsessive-compulsive disorder An anxiety dis- order that is characterized by obsessive thoughts and compulsive actions. The obsessive thoughts are unwanted ideas or impulses that oat-cell lung cancer See small-cell lung cancer. These thoughts are intrusive and unpleasant, and they produce a high degree of anxiety. Other compulsive behaviors include counting and endlessly rearranging objects in an effort to obesity The state of being well above one’s nor- keep them in precise alignment with each other. A person has traditionally been consid- Treatment includes behavioral therapy and medica- ered to be obese if they are more than 20 percent tions of the selective serotonin reuptake inhibitor over their ideal weight. Accordingly, treatment of obesity usually requires obsessive-compulsive personality disorder more than just dietary changes. Exercise, counseling A personality disorder that is characterized by per- and support, and sometimes medication can supple- vasive preoccupation with orderliness, perfection- ment diet to help patients conquer weight problems. Obesity is a significant rules, lists, order, organization, or schedules; per- contributor to health problems. See also bariatrics; fectionism; excessive devotion to work to the exclu- body mass index; obesity-related disease. Obesity increases the risk of developing a number of diseases, and it can be obstetrical forceps An instrument that has two a diagnostic marker for others. Diseases related to blades and a handle and is designed to aid in the obesity include type 2 diabetes; high blood pressure vaginal delivery of a baby. For example, to occlude an artery is to block the Paralysis of the oculomotor nerve results in a flow of blood. For example, drooping eyelid (ptosis), deviation of the eyeball to occlude the teeth is to oppose the upper with the outward (and therefore double vision), and a lower teeth, as for chewing. For example, occult blood in the oculoplasty A branch of ophthalmology that is stool is hidden from the eye but can be detected by concerned with treatment of abnormalities of the chemical tests. Occupational medicine was founded in 1700 by the Italian physician off-label use The practice of prescribing Bernardino Ramazzini, who recognized the relation- approved medications for conditions other than ship between lead and antimony and the symptoms those indicated on the official medication label. In a larger sense, the offspring are collectively Department of Labor with the responsibility of ensur- all the descendants, the brood, or the family. The patient’s development is slowed, and the child can become progressively more impaired. Treatment includes use of anti- In occupational therapy, patients may do exercises, spasmodic medication and educational and physical manipulate items to help develop normal hand services aimed at enhancing development. Also motion, or learn to use assistive devices, among known as early infantile epileptic encephalopathy. The olecra- oligosaccharidosis One of a group of inherited non is the near end of the ulna, the bone in the fore- metabolic disorders that are similar to the arm, and it forms the pointed portion of the elbow. For example, inflammation of the tiny fluid- Symptoms generally include deterioration of the filled sac (bursa) at the tip of the elbow can occur; nervous system. A firm nod- ule can form at the tip of the elbow; it is referred to oligospermia Fewer sperm than usual. Eating fish has been reported to protect against age-related macular degeneration, a oligo- Prefix meaning just a few, or scanty, as in common eye disease. The greater omentum is attached to the oligodactyly Having fewer than the normal num- bottom edge of the stomach and hangs down in ber of fingers or toes. The lesser omentum is attached to the top edge of the stomach and extends oligodendrocyte A type of cell in the central to the undersurface of the liver.
The adverse effects of these agents can be quite severe; they include flushing generic 60caps ashwagandha anxiety 2 days before menses, a burning sensation ashwagandha 60 caps cheap anxietyzone symptoms, hypotension, tachycardia, and bronchoconstriction. Histamine (H1)-receptor antagonists are competitive inhibitors at the H1-receptor (see Table 6-1). First-generation agents (1) Alkylamines (a) Alkylamines include chlorpheniramine and brompheniramine. Second-generation agents (1) Piperidines (a) Loratadine (Claritin), desloratadine (Clarinex). Little or no anticholinergic activity and greatly reduced sedation compared with earlier agents. Desloratadine is the active metabolite of loratadine and has about 15-fold greater affinity for the H1 receptor than the parent compound. The effects of these agents are usually seen in 30 minutes (with maximal effects at 1–2 h); the duration of action is 3–8 hours for first-generation compounds and 3–24 hours for second-generation compounds. H1-receptor antagonists are lipid soluble; most first-generation agents cross the blood–brain barrier, a property reduced but not eliminated with second-generation agents. H1-receptor antagonists are metabolized in the liver; many induce microsomal enzymes and alter their own metabolism and that of other drugs. Many H1-receptor antagonists, especially the ethanolamines, phenothiazines, and ethylene- diamines, have muscarinic–cholinergic antagonist activity. Most of these agents are effective local anesthetics, probably because of a blockade of so- dium channels in excitable tissues. H1-receptor antagonists relax histamine-induced contraction of bronchial smooth muscle and have some use in allergic bronchospasm. H1-receptor antagonists inhibit histamine-induced increases in capillary permeability. Many antihistamines are used to treat the common cold, based on their anti- cholinergic properties, but they are only marginally effective for this use. Diphenhydramine also has an antitussive effect not mediated by H1-receptor antagonism. H1-receptor antagonists produce sedation (synergistic with alcohol and other depressants), dizziness, and loss of appetite. H1-receptor antagonists produce anticholinergic effects (dry mouth, blurred vision, and urine retention). Two second-generation H1 antagonists, astemizole and terfenadine (a prodrug of fexofena- dine) were discontinued or removed from the market because they were associated with Q-T prolongation and ventricular tachycardias. These agents are competitive antagonists at the H2-receptor, which predominates in the gastric parietal cell. These agents promote the healing of gastric and duodenal ulcers and are used to treat hyper- secretory states such as Zollinger-Ellison syndrome. Each is used prophylactically in the treatment of asthma; they do not reverse bronchospasm. These agents produce adverse effects that are usually confined to the site of application; these effects include sore throat and dry mouth. Nedocromil sodium appears to be more effective in reducing bronchospasm caused by exer- cise or cold air. Serotonin is synthesized from the amino acid L-tryptophan by hydroxylation and decarboxylation. Much of the remaining 10% is found in the platelets; small amounts are found in other tissues, including the brain. Platelets acquire serotonin from the circulation during passage through the intestine by a specific and highly active uptake mechanism. Stimulation of this receptor in the area postrema causes nausea and vomiting; stimulation on peripheral sensory neurons causes pain. Triptans: sumatriptan, rizatriptan, eletriptan, zolmitriptan, almotriptan, frovatriptan, naratriptan a.
