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dc.contributor.authorMubaslat, Omar Mufleh Mohammad
dc.date.accessioned2023-03-06T05:26:35Z
dc.date.available2023-03-06T05:26:35Z
dc.date.issued2022en_AU
dc.identifier.urihttps://hdl.handle.net/2123/30154
dc.description.abstractHypersalivation and drooling are common adverse effects reported in patients treated with clozapine. The aim of the research in this thesis is to explore the management of Clozapine-Induced Hypersalivation (CIH) and Clozapine-Induced Drooling (CID) among psychiatrists in Australia, measure the effect of the most prescribed medication (sublingual atropine) on saliva secretion, measure the atropine plasma concentration after sublingual administration, and investigate the safety profile of sublingual atropine. Atropine sulfate 1% solution was prescribed in 9 of the 11 patients prescribed a medication to treat the condition as reported by a surveyed sample of psychiatry registrars. Two drops of the 1% eye drops solution (delivering approximately 600 µg of atropine sulfate) administered sublingually were recorded to decrease unstimulated nocturnal saliva secretion rate (mean difference from the placebo=-57.2%, 95% CI: -104.3, -10.1, P=0.02, n=21). An LC-MS/MS assay was developed and validated in this thesis to measure the atropine plasma concentrations over 9 hours after dosing. The dose adjusted relative bioavailability (mean ± SD) of the 1.2 mg SL atropine solution and 0.6 mg tablet relative to the 0.6 mg SL solution was 0.98 ± 0.01 and 1.54 ± 0.30, respectively. Most participants (6 out of 7) had a significant decrease (mean percentage change -40.5%, CI: -59.3, -21.7%) in saliva secretion after the 0.6 mg sublingual atropine solution administration. A reduction in sitting and standing systolic and diastolic BP as well as pulse rate was recorded. A crimped metered dose sublingual spray is recommended for the administration of sublingual atropine. In conclusion, small atropine doses (0.6 or 1.2 mg) were found to significantly reduce daytime and nighttime saliva secretion. The use of the small doses tested of sublingual or oral atropine are found to be well tolerated.en_AU
dc.subjectAtropineen_AU
dc.subjectClozapineen_AU
dc.subjectSialorrhoeaen_AU
dc.subjectSalivaen_AU
dc.subjectHypersalivationen_AU
dc.subjectSublingualen_AU
dc.titleSublingual Atropine for the Treatment of Clozapine-Induced Hypersalivation and Droolingen_AU
dc.typeThesis
dc.type.thesisDoctor of Philosophyen_AU
dc.rights.otherThe author retains copyright of this thesis. It may only be used for the purposes of research and study. It must not be used for any other purposes and may not be transmitted or shared with others without prior permission.en_AU
usyd.facultySeS faculties schools::Faculty of Medicine and Healthen_AU
usyd.departmentConcord Clinical Schoolen_AU
usyd.degreeDoctor of Philosophy Ph.D.en_AU
usyd.awardinginstThe University of Sydneyen_AU
usyd.advisorMubaslat, Omar


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