RESUMEN
Epilepsy is characterized by the manifestation of spontaneous and recurrent seizures. The high prevalence of comorbidities associated with epilepsy, such as cognitive dysfunction, affects the patients quality of life. Adenosine signaling modulation might be an effective alternative to control seizures and epilepsy-associated comorbidities. This study aimed to verify the role of adenosine modulation on the seizure development and cognitive impairment induced by pentylenetetrazole (PTZ) in zebrafish. At first, animals were submitted to a training session in the inhibitory avoidance test and, after 10 min, they received an intraperitoneal injection of valproate, adenosine A1 receptor agonist cyclopentyladenosine (CPA), adenosine A1 receptor antagonist 8-cyclopentyl-1,3-dipropylxanthine (DPCPX), adenosine A2A receptor antagonist ZM 241385, adenosine deaminase inhibitor erythro-9-(2-hydroxy-3-nony1)-adenine hydrochloride (EHNA) or the nucleoside transporter inhibitor dipyridamole. Thirty min after the intraperitoneal injection, the animals were exposed to 7.5 mM PTZ for 10 min, where they were evaluated for latency to reach the seizure stages (I, II, and III). Finally, 24 h after the training session, the animals were submitted to the inhibitory avoidance test to verify their cognitive performance during the test session. Valproate, CPA, and EHNA showed antiseizure effects and prevented the memory impairment induced by PTZ exposure. DPCPX, ZM 241385, and dipyridamole pretreatments caused no changes in seizure development; however, these drugs prevented memory impairment without altering locomotion. Our results reinforce the antiseizure effects of adenosine signaling and support the idea that the involvement of adenosine in memory processes may be a target for preventive strategies against cognitive impairment associated with epilepsy.
Asunto(s)
Epilepsia , Pentilenotetrazol , Animales , Pentilenotetrazol/toxicidad , Adenosina/farmacología , Pez Cebra , Ácido Valproico/efectos adversos , Calidad de Vida , Convulsiones/inducido químicamente , Convulsiones/tratamiento farmacológico , Convulsiones/prevención & control , Dipiridamol/efectos adversosAsunto(s)
Humanos , Masculino , Femenino , Reperfusión Miocárdica/métodos , Isquemia Miocárdica/diagnóstico por imagen , Radiofármacos/uso terapéutico , Síndrome Coronario Agudo/diagnóstico por imagen , Cintigrafía/métodos , Ecocardiografía de Estrés/métodos , Dipiridamol/efectos adversos , Dobutamina/efectos adversos , Prueba de Esfuerzo/efectos de los fármacosAsunto(s)
Humanos , Femenino , Persona de Mediana Edad , Vasodilatadores/efectos adversos , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Dipiridamol/efectos adversos , Infarto del Miocardio con Elevación del ST/inducido químicamente , Cintigrafía/efectos adversos , Electrocardiografía , Infarto del Miocardio con Elevación del ST/diagnóstico por imagenAsunto(s)
Humanos , Isquemia Miocárdica , Dipiridamol/efectos adversos , Uruguay , Informes de CasosRESUMEN
Pacientes com resposta da frequência cardíaca (FC) diminuída apresentam mortalidade cardíaca aumentada embora o mecanismo para isso seja desconhecido...
Asunto(s)
Humanos , Masculino , Adolescente , Dipiridamol/administración & dosificación , Dipiridamol/efectos adversos , Frecuencia Cardíaca , Tomografía Computarizada de Emisión de Fotón Único/efectos adversosRESUMEN
OBJECTIVE: The therapeutics for bipolar disorders are still far from adequate, and new options with improved effectiveness, safety, and tolerability in a wide range of patients are necessary. Preliminary data have suggested a role for dysfunctions targeting the purinergic system in mood disorders. This study aimed to evaluate the efficacy and tolerability of the purinergic agents allopurinol and dipyridamole combined with lithium in bipolar mania. METHOD: A randomized, placebo-controlled, double-blind study was performed in adult inpatients (N = 180) with a DSM-IV-TR diagnosis of bipolar I disorder, current episode manic with or without psychotic features (rapid cyclers and mixed episodes were not included). No antipsychotic agent was used during the study. Subjects were given fixed oral doses of either allopurinol 600 mg/day (N = 60), dipyridamole 200 mg/day (N = 60), or placebo (N = 60) added to lithium for 4 weeks. Subjects were rated at baseline and days 7, 14, 21, and 28 using the Young Mania Rating Scale (YMRS) as the primary efficacy measure. The study was conducted between September 2003 and September 2006. RESULTS: Allopurinol resulted in greater mean reductions in YMRS scores from baseline to day 21 (p < .001) and day 28 (p = .003) compared with placebo using a linear model analysis (d = 0.32, 95% CI = 0.07 to 0.57). Remission rates were significantly higher for allopurinol compared with dipyridamole and placebo (p = .008). Lithium showed a significant antimanic efficacy even in the placebo group. Decrease in plasma uric acid levels showed a significant positive association with antimanic effects in the allopurinol group (p < .001). CONCLUSION: Allopurinol is clinically effective and well-tolerated adjunctively with lithium in manic episodes and may represent an alternative approach in the treatment of acute mania, especially for those presenting tolerability and safety issues with antipsychotics. The present results strongly support the involvement of the purinergic system in the pathophysiology and therapeutics of bipolar disorder. Further placebo-controlled studies with allo-purinol compared with standard mood stabilizers in mania and maintenance are warranted. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00560079.
Asunto(s)
Alopurinol/efectos adversos , Antipsicóticos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Dipiridamol/efectos adversos , Inhibidores Enzimáticos/efectos adversos , Carbonato de Litio/uso terapéutico , Inhibidores de Fosfodiesterasa/efectos adversos , Enfermedad Aguda , Adolescente , Adulto , Anciano , Alopurinol/uso terapéutico , Trastorno Bipolar/diagnóstico , Trastorno Bipolar/rehabilitación , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Dipiridamol/uso terapéutico , Método Doble Ciego , Esquema de Medicación , Quimioterapia Combinada , Inhibidores Enzimáticos/uso terapéutico , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Inhibidores de Fosfodiesterasa/uso terapéutico , Índice de Severidad de la Enfermedad , Encuestas y CuestionariosRESUMEN
Fundamentos: Com o envelhecimento da população, no Brasil e no mundo, cresce o número de doenças crônicas, dentre elas a doença arterial coronariana. Faz-se, portanto, necessária a adoção de estratégias racionais na avaliação dessa população. Objetivos: Avaliar segurança, exequibilidade e resposta hemodinâmica do ecocardiograma de estresse com dipiridamol e atropina (Eco-Dip-Atro) num grupo de idoso (maior ou menor que 65 anos - Grupo I), comparando os achados com um grupo jovem (menor que 65 anos - Grupo II). Métodos: Um total de 203 pacientes consecutivos com suspeita ou com coronariopatia conhecida (Grupo I - n igual 69; Grupo II - n igual 134) realizaram o Eco-Dip-Atro seguindo o protocolo do estudo EPIC 2, ou seja, dipiridamol (até 0,84mg/kg em 10min) e atropina (até 1mg em 4 min).Resultados: O índice de exames conclusivos ou em que o protocolo pôde ser completado foi de 78,9 por cento no Grupo I e 92,5 por cento no Grupo II (p menor que 0,0001)...
Asunto(s)
Humanos , Anciano , Enfermedad Coronaria , Estrés Fisiológico , Atropina , Dipiridamol/efectos adversos , EcocardiografíaRESUMEN
Objetivo: Avaliar a segurança do uso do dipiridamol (dipi) em dose máxima com a técnica combinada para a pesquisa de isquemia miocárdica(TCPI). Métodos: Foram avaliados, prospectivamente, 110 pacientes, encaminhados no período de junho 2006 a abril 2007, com indicação de pesquisa de isquemia miocárdica, associada ou não à pesquisa de viabilidade miocárdica, que não apresentassem alguma contra-indicação ao exame. Resultados: Todos os pacientes conseguiram realizar o exame completo, sem interrupção por sintomas. O tempo médio de aquisição das imagens durante os exames foi de 39,6min, com o tempo de estresse de 11,8min. Conclusão: É possível realizar o exame completo de TCPI pela RMC, com dose máxima do dipi, com boa tolerabilidade e segurança, e com tempo de aquisição de imagem em média inferior a 40 minutos.
Objective: To assess the safety of using a maximum dose of dipyridamole through the combined technique forinvestigating myocardial ischemia.Methods: A prospective assessment of 110 patients from June 2006 to April 2007, recommended for myocardialischemia investigation and associated or not with myocardial feasibility studies, presenting no counterindicationsfor this examination. Results: All the patients managed to complete the fullexamination with no interruptions caused by symptoms. The average time of image acquisition was 39.6 minutes,with a stress time of 11.8 minutes.Conclusion: It is possible to use the combined technique for investigating myocardial ischemia through magneticresonance imaging (MRI) with a maximum dose of dipyridamole, without causing hemodynamic effects orsymptoms that interrupt the examination. This procedure may be performed in less than forty minutes, providing important clinical information.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Dipiridamol/administración & dosificación , Dipiridamol/efectos adversos , Isquemia Miocárdica/complicaciones , Isquemia Miocárdica/diagnóstico , Isquemia/complicaciones , Isquemia/diagnósticoRESUMEN
En el siguiente artículo se describen los diferentes tipos de anticoagulantes orales y antiagregantes plaquetarios. Se especifican sus modos de acción, sus efectos adversos y precauciones y advertencias de cada uno de ellos (AU)
Asunto(s)
Humanos , Acenocumarol/efectos adversos , Warfarina/efectos adversos , Aspirina/efectos adversos , Dipiridamol/efectos adversos , Ticlopidina/efectos adversos , Anticoagulantes , Inhibidores de Agregación Plaquetaria , Acenocumarol/farmacología , Acenocumarol , Warfarina/farmacología , Warfarina , Aspirina/farmacología , Aspirina , Dipiridamol/farmacología , Dipiridamol , Ticlopidina/farmacología , Ticlopidina , Interacciones Farmacológicas , Guías de Práctica Clínica como AsuntoRESUMEN
Objetivos: este estudio describe la incidencia de efectos adversos y síntomas causados por el dipiridamol, usado como apremio farmacológico para estudio de perfusión miocárdica Talio 201. Métodos: se seleccionaron 175 pacientes consecutivos durante un período de tiempo de 18 meses, a los cuales se les realizó estudio de perfusión miocárdica con Talio 201 SPECT con apremio farmacológico con dipiridamol a dosis de 0,56 mg/kg. Población: de los 175 pacientes en los que se usó apremio con dipiridamol 100 (57,1 por ciento) eran de sexo masculino, el promedio de edad fue de 61 años (26-82), 34 (19,4 por ciento) tenían antecedentes de IAM previo, en 110 (62,8) se realizó el estudio para diagnóstico de enfermedad coronaria, I (0,57 por ciento) prequirúrgico y en los 30 (17,14 por ciento) pacientes restantes, el mativo fue detección de viabilidad y cuantificación de izquemia. Sobre la totalidad de los pacientes 43 (24,5 por ciento) presentaban previamente al estudio bloqueo completo de rama izquierda, 26 (14,8 por ciento) arteriopatía periférica, 57 (32,5 por ciento) efecto medicamentoso, 12 (6,8 por ciento) IAM de menos de 5 días de evolución y 47 (26,8 por ciento) imposiblidad de pedalear... (AU)
Asunto(s)
Humanos , Persona de Mediana Edad , Talio , Dipiridamol/efectos adversos , Perfusión , Cardiomiopatías/diagnósticoRESUMEN
For preventing thromboembolic events, the concurrent use of oral anticoagulant and antiplatelet drugs has been proposed. In prosthetic heart valves the use of moderate intensity anticoagulants [International Normalized Ratio (INR) 2-3] plus aspirin (100 mg/day) decreases the amount and severity of embolic episodes. The possibility that the same regimen could provide benefit in the prevention of thrombotic events in other arterial diseases is also indicated by the ATACS trial in unstable angina. The ongoing studies in ischemic heart diseases will also give the answer to this possibility.
Asunto(s)
Anticoagulantes/uso terapéutico , Aspirina/uso terapéutico , Inhibidores de Agregación Plaquetaria/uso terapéutico , Tromboflebitis/tratamiento farmacológico , Administración Oral , Angina Inestable/tratamiento farmacológico , Anticoagulantes/administración & dosificación , Anticoagulantes/efectos adversos , Aspirina/administración & dosificación , Aspirina/efectos adversos , Ensayos Clínicos como Asunto , Dipiridamol/administración & dosificación , Dipiridamol/efectos adversos , Dipiridamol/uso terapéutico , Embolia/tratamiento farmacológico , Embolia/epidemiología , Embolia/etiología , Embolia/prevención & control , Estudios de Seguimiento , Prótesis Valvulares Cardíacas/efectos adversos , Hemorragia/inducido químicamente , Humanos , Incidencia , Metaanálisis como Asunto , Infarto del Miocardio/tratamiento farmacológico , Inhibidores de Agregación Plaquetaria/administración & dosificación , Inhibidores de Agregación Plaquetaria/efectos adversos , Recurrencia , Tromboembolia/tratamiento farmacológico , Tromboembolia/etiología , Tromboembolia/prevención & control , Tromboflebitis/etiología , Tromboflebitis/prevención & controlRESUMEN
From March 1991 to October 1992, 41 patients with advanced non-small cell lung cancer (NSCLC) (20 stage IIIB and 21 stage IV) received a regimen consisting of cisplatin (CP) 100 mg/m2 i.v. days 1 and 8, and dipyridamole (DPD) 100 mg p.o. 75 minutes before CP, and then at hours 6, 12, and 18 as first-line chemotherapy. Cycles were repeated every 28 days for a total of 3. Median age was 56 years (range: 40-70). All patients had a performance status 0 to 1 and a weight loss < or = 10%. Squamous-cell carcinoma was diagnosed in 19 patients; adenocarcinoma in 16, and large-cell carcinoma in 6. A total of 37 patients were fully evaluable for response, whereas 39 were assessable for toxicity. No complete responses were observed: 5 patients (14%) achieved partial response; 23 patients (62%) showed no change, and progressive disease was observed in 9 (24%). The median time to treatment failure was 4 months, whereas median survival was 8 months. The average dose intensity received at the end of the third course of therapy was 46 mg/m2/week. There were no drug-related deaths. Toxicity was mild to moderate, with a high incidence of ototoxicity (54%) and emesis (67%). In conclusion, these results failed to demonstrate any significant advantage from a high-dose CP regimen modulated by DPD in patients with advanced NSCLC.
Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Cisplatino/uso terapéutico , Dipiridamol/uso terapéutico , Neoplasias Pulmonares/tratamiento farmacológico , Adulto , Carcinoma de Pulmón de Células no Pequeñas/secundario , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Dipiridamol/administración & dosificación , Dipiridamol/efectos adversos , Sinergismo Farmacológico , Quimioterapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
PURPOSE: To analyze adverse reactions (AR), hemodynamic and electrocardiographic changes and thallium scintigraphy (TS) results, during pharmacological stress with dipyridamole (SD), correlating these data to the presence and extension of coronary artery disease (CAD). METHODS: We studied 126 patients, 66 had no evidence of cardiovascular disease (G1) and 60 had critical occlusive CAD > or = 70% stenosis (G2). Most of them were male, mean age 56.5 +/- 10.9 years old. All patients were submitted to TS after receiving 0.56 mg/kg of dipyridamole intravenously (0.14 mg/min during 4 min) followed by 111MBq of thallium-chloride-201. Conventional ECG was recorded before and after SD; heart rate (HR) and arterial pressure (AP) were monitored during dipyridamole infusion. All signals and/or symptoms were observed. RESULTS: Cine-coronarography showed 22 patients (37%) with one vessel disease (VD) (G2a), 26 (46%) with two VD (G2b) and 12 (20%) with three VD (G2c). Of the 126 patients 63% did not present symptoms. Flushing (25%) and sick-headache (12%) were most frequent AR. Typical angina was reported by one G1 patient (1.5%) and six G2 patients (10%) (p < 0.05). HR increased 18.09 +/- 12.27% and 12.40 +/- 4.90%, systolic blood pressure varied -5.2 +/- 7.5% and -4.3 +/- 6.5% in G1 and G2, respectively. These parameters are not correlated to CAD presence and extension. ST depression and ectopic beats occurred in 5% and 11% of G1 patients, in 15% and 30% of G2 patients, respectively (p < 0.05). Typical angina was more common in G2a and G2b; ST changes in G2b and G2c; and arrhythmia in G2c (not significant). Sensitivity of TS associated to SD was 84%, comparable to stress exercise thallium test. CONCLUSION: TS associated to SD, a noninvasive, safe with low morbidity and few collateral effects method is an option to patients with limitations to physical exercise tests.
Asunto(s)
Enfermedad Coronaria/diagnóstico por imagen , Corazón/diagnóstico por imagen , Adulto , Anciano , Presión Sanguínea/efectos de los fármacos , Enfermedad Coronaria/fisiopatología , Dipiridamol/efectos adversos , Electrocardiografía , Femenino , Corazón/efectos de los fármacos , Corazón/fisiopatología , Frecuencia Cardíaca/efectos de los fármacos , Hemodinámica/efectos de los fármacos , Humanos , Inyecciones Intravenosas , Masculino , Persona de Mediana Edad , CintigrafíaRESUMEN
PURPOSE--To analyze adverse reactions (AR), hemodynamic and electrocardiographic changes and thallium scintigraphy (TS) results, during pharmacological stress with dipyridamole (SD), correlating these data to the presence and extension of coronary artery disease (CAD). METHODS--We studied 126 patients, 66 had no evidence of cardiovascular disease (G1) and 60 had critical occlusive CAD > or = 70 per cent stenosis (G2). Most of them were male, mean age 56.5 +/- 10.9 years old. All patients were submitted to TS after receiving 0.56 mg/kg of dipyridamole intravenously (0.14 mg/min during 4 min) followed by 111MBq of thallium-chloride-201. Conventional ECG was recorded before and after SD; heart rate (HR) and arterial pressure (AP) were monitored during dipyridamole infusion. All signals and/or symptoms were observed. RESULTS--Cine-coronarography showed 22 patients (37 per cent ) with one vessel disease (VD) (G2a), 26 (46 per cent ) with two VD (G2b) and 12 (20 per cent ) with three VD (G2c). Of the 126 patients 63 per cent did not present symptoms. Flushing (25 per cent ) and sick-headache (12 per cent ) were most frequent AR. Typical angina was reported by one G1 patient (1.5 per cent ) and six G2 patients (10 per cent ) (p < 0.05). HR increased 18.09 +/- 12.27 per cent and 12.40 +/- 4.90 per cent , systolic blood pressure varied -5.2 +/- 7.5 per cent and -4.3 +/- 6.5 per cent in G1 and G2, respectively. These parameters are not correlated to CAD presence and extension. ST depression and ectopic beats occurred in 5 per cent and 11 per cent of G1 patients, in 15 per cent and 30 per cent of G2 patients, respectively (p < 0.05). Typical angina was more common in G2a and G2b; ST changes in G2b and G2c; and arrhythmia in G2c (not significant). Sensitivity of TS associated to SD was 84 per cent , comparable to stress exercise thallium test. CONCLUSION--TS associated to SD, a noninvasive, safe with low morbidity and few collateral effects method is an option to patients with limitations to physical exercise tests
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Enfermedad Coronaria , Corazón , Enfermedad Coronaria/fisiopatología , Dipiridamol/efectos adversos , Dipiridamol , Electrocardiografía , Corazón , Corazón/fisiopatología , Frecuencia Cardíaca , Hemodinámica , Inyecciones Intravenosas , Presión ArterialRESUMEN
La prueba de Talio con Dipiridamol constituye en la actualidad un método no invasivo de gran utilidad para evaluar a pacientes en quienes se sospecha o se ha confirmado una enfermedad coronaria. El Dipiridamol se puede administrar por vía endovenosa u oral, produce vasodilatación coronaria y puede poner en evidencia defectos de reperfusión miocárdica. Su administración puede asociarse a una incidencia variable de efectos colaterales. Comunicamos nuestra experiencia con la administración de Dipiridamol en 286 pacientes, 223 de ellos por vía endovenosa y 63 por vía oral. El 87% de los pacientes tenía evidencia previa de enfermedad coronaria. La administración de Dipiridamol se asoció a un aumento significativo de la frecuencia cardiaca y descenso también significativo de la presión arterial. Encontramos efectos colaterales en el 29,7% de los pacientes que recibieron Dipiridamol endovenoso y en el 32,3% de los que recibieron Dipiridamol oral. El síntoma colateral más frecuente, 15,4%, fue el dolor torácico, que se presentó de preferencia, 81,3%, en pacientes con enfermedad coronaria y cedió con la administración de Trinitina y/o Aminofilina. Otros síntomas colaterales fueron cefalea, náuseas y/o vómitos, pero con una incidencia menor. Concluimos en que los síntomas colaterales durante la prueba de Talio con Dipiridamol son frecuentes, la mayoría de ellos leves y no son diferentes según el tipo de administración oral o endovenosa de la droga. El síntoma colateral más severo, dolor torácico, revierte facilmente con la administración de Trinitina o Aminofilina
Asunto(s)
Humanos , Enfermedad Coronaria/diagnóstico , Dipiridamol/efectos adversos , TalioRESUMEN
Fifty three patients were studied with dipyridamole thallium myocardial scintigraphy, 4 to 6 days after a first episode of myocardial infarction. Localization of infarction was anterior in 25 and inferior in 28. Infarction was confirmed by myocardial scintigraphy in 87% of cases. A non q wave myocardial infarction was present in 5 of the 7 patients with negative scintigraphy. Residual myocardial ischemia was suggested by myocardial scintigraphy in 68% of patients. Correlated to coronary arteriography, sensitivity for myocardial ischemia was 80%, specificity 82%. After a mean follow up of 11.2 months, 22 of 36 patients with positive myocardial scintigraphy had new coronary events, 15 of them requiring myocardial revascularization. In contrast, only 2 of 17 patients with negative scintigraphy had new events (p < 0.05). Thus dipyridamole thallium myocardial scintigraphy early after myocardial infarction is a valuable prognostic test.
Asunto(s)
Dipiridamol , Infarto del Miocardio/diagnóstico por imagen , Talio , Adulto , Anciano , Angiografía Coronaria , Dipiridamol/efectos adversos , Electrocardiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Isquemia Miocárdica/diagnóstico , Pronóstico , Cintigrafía , Factores de Riesgo , Sensibilidad y EspecificidadAsunto(s)
Adulto , Persona de Mediana Edad , Humanos , Masculino , Femenino , Talio , Angiografía Coronaria , Dipiridamol , Infarto del Miocardio , Pronóstico , Factores de Riesgo , Sensibilidad y Especificidad , Isquemia Miocárdica/cirugía , Isquemia Miocárdica/diagnóstico , Dipiridamol/efectos adversos , Electrocardiografía , Revascularización MiocárdicaRESUMEN
From 1976 to 1985, a total of 58 infants and children with the hemolytic-uremic syndrome were randomly assigned to treatment either with heparin and dipyridamole or with supportive management only. In the treatment group, two patients died in the early weeks of the disease. Analysis of clinical and laboratory data showed no significant difference between either group of patients as to the evolution of their illness except for a significantly higher incidence of anuria and a significantly faster recovery from hypertension in the treated group. Renal biopsy studies showed no differences between the two groups in terms of incidence and severity of the histologic lesions. The long-term data on blood pressure and creatinine clearance values in the survivors were similar in both groups. This study indicates that treatment with heparin and dipyridamole has no benefit over symptomatic therapy alone in the typical form of childhood hemolytic-uremic syndrome.