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The long-term safety and effectiveness of modafinil have not been conclusively established. [99] The FDA does not endorse modafinil for children's medical conditions due to an increased risk of rare but serious dermatological toxicity, manifested as Stevens–Johnson syndrome which is a type of severe skin reaction.
A Cephalon-founded study in which patients were administered modafinil, methylphenidate, and a placebo found that modafinil produces "psychoactive and euphoric effects and feelings consistent with [methylphenidate]." [12] Like modafinil, armodafinil is an inhibitor and/or inducer of certain cytochrome P450 enzymes.
Modafinil and armodafinil are thought to act as selective, weak, atypical dopamine reuptake inhibitors (DRIs). [13] [3] [4] However, additional actions are also possible and have not been ruled out. [13] Adrafinil acts as a prodrug of modafinil and hence shares its mechanism of action. [13]
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Unlike armodafinil ((R)-(–)-modafinil), esmodafinil has never been marketed on its own. [ 3 ] Esmodafinil is suspected to be less clinically useful for treating conditions that modafinil and armodafinil are marketed for, such as narcolepsy , shift work sleep disorder , and obstructive sleep apnea .
Modafinil sulfone has been described as inactive, [1] and similarly to modafinil acid, does not appear to contribute to the wakefulness-promoting effects of modafinil. [2] [3] [4] However, like modafinil, modafinil sulfone was found to show anticonvulsant properties in animals, indicating that it does possess some biological activity. [5] [6] [7]
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Pulmonary laceration usually heals quickly after a chest tube is inserted and is usually not associated with major long-term problems. [8] Pulmonary lacerations usually heal within three to five weeks, [ 12 ] and lacerations filled with air will commonly heal within one to three weeks but on occasion take longer. [ 1 ]