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Additionally, there are other medications that may exacerbate OSA and theoretically worsen daytime sleepiness, such as: Benzodiazepine receptor agonists Barbiturates Antiepileptic medications Sedating antidepressants such as mirtazapine (antidepressants can cause weight gain, which worsens sleep apnea due to obesity) Antihistamines Opiates Various medications have been studied for treating obstructive sleep apnea, including drugs that stimulate the respiratory system (directly like theophylline, or indirectly like acetazolamide), drugs that reduce risk of upper airway collapse (desipramine), antimuscarinic drugs (oxybutynin), and noradrenergic drugs (atomoxetine), but none of them have yet shown a significant ability to reduce OSA
Oat cell carcinoma of the larynx
NEJM article: Diabetes and Obesity CARE Council:
Methylmalonyl-CoA mutase is one of only two vitamin B12 requiring enzymes in humans (the other is methionine synthase)
This reduced binding results in an extended half-life of 20-30 hours compared to native IGF-1's 12-15 hour half-life, and enhances biological potency approximately three times that of the endogenous hormone