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In the mid-1950s, a large series of pharmacologic agents, originally referred to as tranquilizers (later, as psychotropic or neuroleptic drugs), came into prominent use mainly for the control of schizophrenia, psychotic states associated with organic brain syndromes, and affective disorders (depression and manic-depressive disease) The mechanisms by which these drugs ameliorate disturbances of thought and affect in psychotic states are not fully understood, but presumably they act by blocking the postsynaptic mesolimbic dopamine receptors of which there are four subtypes, termed D1 through D4 on neuronal membranes (see Table 4-2 and discussion of dopamine receptor subtypes on page 60) The D2 receptors are located mainly in the frontal cortex, hippocampus, and limbic cortex, and the D1 receptors, in the striatum as discussed in Chap 4 The blockade of dopamine receptors in the striatum is probably responsible for the parkinsonian side effects of this entire class of drugs, and the blockade of another dopaminergic (tuberoinfundibular) system, for the increased prolactin secretion by the pituitary These drugs also produce some adrenergic blocking effect The newer atypical antipsychotic drugs, typi ed by clozapine (Clozaril), apparently achieve the same degree of D2 and D3 blockade in the temporal and limbic lobes while exhibiting substantially less antagonistic activity in the striatum accounting also for their lesser parkinsonian side effects These drugs also block subsets of serotonin receptors Since the introduction in the 1950s of the phenothiazine chlorpromazine as an anesthetic agent and the serendipitous discovery of its antipsychotic effect on schizophrenia, a large number of antipsychotic drugs have been marketed for clinical use No attempt is made here to describe or even list all of them Some have had only an evanescent popularity, and others have yet to prove their asp.net mvc pdf editor pdf viewer in aps.net mvc - CodeProject
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Data Export to PDF,Excel and CSV files in WPF from DataGrid. upload multiple file in mvc and export to excel by webgrid in mvc. Export data to excel and pdf ASP.NET. Export data in Gridview to Excel sheet and pdf. to export data present in griview to pdf,word, excel. PDF table data to Excel using Vb.net. movement These symptoms may appear after several days of drug therapy but more often after several weeks Suppression of dopamine in the striatum (similar to the effect of loss of dopaminergic nigral cells that project to the striatum) is presumably the basis of the parkinsonian signs Acute dyskinesic and dystonic reactions, taking the form of involuntary movements of lower facial muscles (mainly around the mouth) and protrusion of the tongue (buccolingual or oral-masticatory syndrome), dysphagia, torticollis and retrocollis, oculogyric crises, and tonic spasms of a limb These complications usually occur early in the course of administration of the drug, sometimes after the initial dose, in which case they recede dramatically upon immediate discontinuation of the drug and the intravenous administration of diphenhydramine hydrochloride (Benadryl) or benztropine (Cognetin) Akathisia an inner restlessness re ected by a persistent shifting of the body and feet and an inability to sit still, such that the patient paces the oor or jiggles the legs constantly (see page 97) Of all the phenothiazines, molindone has a special tendency to cause akathisia This disorder often responds to oral propranolol Tardive dyskinesias A group of late and persistent complications of neuroleptic therapy, which may continue after removal of the offending drug, comprises lingual-facialbuccal-cervical dyskinesias, choreoathetotic and dystonic movements of the trunk and limbs, diffuse myoclonus (rare), perioral tremor ( rabbit syndrome), and dysarthria or anarthria Snyder has postulated that the movements are due to hypersensitivity of dopamine receptors in the basal ganglia, secondary to prolonged blockade of the receptors by antipsychotic medication Baldessarini estimates that as many as 40 percent of patients receiving long-term antipsychotic medication develop tardive dyskinesia of some degree A pathology has never been ascertained and the effect is likely due to subcellular pathophysiologic alterations in the basal ganglia Treatment is discussed later The neuroleptic malignant syndrome is discussed separately later because of its gravity and requirement for speci c treatment. mvc return pdf ASP . NET MVC PDF Viewer | Reliable & Responsive UI | Syncfusion
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Generate Popup PDF Forms with ASP.NET MVC and Open Office[^]. 5: well, but the tardive dyskinesias stand apart because they may persist for months or years and may be permanent Oral, lingual, and laryngeal dyskinesias of the tardive type are affected relatively little by any antiparkinsonian drugs Amantadine (Symmetrel) in doses of 50 to 100 mg tid has been useful in a few of the cases of postphenothiazine dyskinesia Other drugs such as benztropine have been tried in the treatment of regional and more generalized tardive dyskinesia, with uncertain results Nevertheless, there is a tendency for most of the obstinate forms to subside slowly even after several years of unsuccessful therapy Once a tardive syndrome has been identi ed, several authoritative clinicians recommend a gradual reduction in the dose of the antipsychosis medication to the minimum necessary for the control of psychotic symptoms Some reports favor the substitution of one of the newer atypical antipsychotic medications but no systematic study of their effectivenes has been undertaken For severe and recalcitrant cases, particularly those involving axial dystonias and similar disabling features, Fahn recommends administration of the dopamine depleting drug tetrabenazine (similar but faster in action and less toxic than reserpine) This medication is given in doses of 75 to 300 mg per day Jankovic and Beach report an 83 percent success rate using this approach for tardive dyskinesias The medication is not easily available in the United States but can be obtained from Canada at this time The use of low doses of antipsychotic drugs and frequent drug holidays, especially in the more susceptible older patients, may help to prevent the development of tardive dyskinesia mvc display pdf from byte array issue when converting html string to pdf using evo pdf library ...
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