PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “VASOMOTOR DRUGS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources
PubMed1987

Control of the hypersecretion of vasomotor rhinitis by topical ipratropium bromide.

A randomized, double-blind, placebo-controlled trial of ipratropium bromide nasal spray was performed with 25 patients with vasomotor rhinitis. Criteria for selection of patients were (1) clear watery nasal discharge more than 1 hour each day, (2) absent or mild nasal obstruction, (3) no known allergic cause, and (4) no satisfactory response to previous alternative medications. Ipratropium bromide, two sprays (20 micrograms per spray) in each nasal cavity four times daily, for 3 weeks, produced a major reduction in nasal discharge severity and duration (p less than 0.00005 for daytime reduction in both). There was a decreased daily use of nasal tissues (p = 0.0017). At the end of the trial, 21 patients preferred the drug, two preferred placebo, one had no preference, and one patient dropped out for a reason unrelated to symptoms or treatment. This drug preference in favor of active medication was statistically significant at the 0.01 level. Local mild side effects were reported in 21/25 (84%) with ipratropium bromide and 8/25 (32%) with placebo (p = 0.0004). Pulse and blood pressure were not affected. In an ensuing 1-year open trial in which the frequency of use of ipratropium bromide nasal spray was selected by the subjects, the dosage chosen was considerably lower than that used in the controlled trial. There were seven dropouts caused by insufficient benefit or local side effects. Seventeen subjects continued the use of ipratropium bromide for 1 year and reported good results and no side effects. Topical nasal ipratropium bromide is highly effective in the control of the rhinorrhea of vasomotor rhinitis. Drug dosage is a major determinant of local nasal side effects.

Administration, Topical↗
PubMed1965

Physiological and pharmacological interactions of antihypertensive drugs.

The complex mechanisms that maintain the blood pressure can be interfered with at many points by drugs. A drug acting at one point may be potentiated by another which blocks a compensatory reflex minimizing the effect of the first. Many therapeutically useful drug combinations have a nonspecific mechanism of this kind although drugs that act upon different points in the sympathetic efferent vasomotor pathway have not been proved to have a useful additive effect.It is not easy to prove a synergistic action of two drugs unless it is large. The best supported examples are combinations of either a diuretic or a vasodilator with a sympathetic blocking drug. These combinations are the ones most widely used in treatment of hypertension. They allow the dose of each active substance to be reduced so that unwanted side-effects are decreased without losing the desired action on the blood pressure.Drug combinations have special risks besides their obvious advantages. Patients are more likely to become confused and take the wrong doses if their treatment regime is complicated. Two drugs which are individually nontoxic may have dangers when used together. Oliguria and a mounting blood urea may follow combined use of powerful modern diuretics. Toxic effects may be entirely unrelated to the main therapeutic action of the drug, as with the enhanced diabetogenic effect of diazoxide used with hydrochlorothiazide.Several potent cardiovascular drugs modify the response to drugs which might be given to raise the blood pressure in an emergency. No drug in common therapeutic use seriously reduces the response to injected noradrenaline but some, such as sympathetic blockers and monoamine oxidase inhibitors, greatly increase sensitivity. Pressor amines that act indirectly by noradrenaline release may be ineffective in the presence of drugs which deplete or insulate the stores of the transmitter in adrenergic nerve endings.The advantages and disadvantages of drug interactions deserve more thought and study than they usually receive.

Antihypertensive Agents↗
PubMedDate not supplied

On the mechanisms of hypotensive action of indoramin.

Effect of indoramin in small doses on the central vasomotor loci has been studied in chloralose anesthetized cats by localizing it to the central sites. An intracerebroventricular dose of 100 micrograms or intra-vertebral arterial injection of 50 micrograms significantly inhibited the excitability of hypothalamic and medullary vasomotor loci and produced hypotension. Similarly, topical application of indoramin (0.5%) to the floor of the IV ventricle inhibited the medullary and the hypothalamic vasomotor responses but a similar application to the ventral surface of the medulla had no effect. An intrathecal dose of 100 micrograms did not inhibit the spinal compression vasmotor response. Administration of higher amounts led to inhibition of the adrenaline pressor response also, indicating a peripheral leak of the drug. Indoramin has a definite inhibitory effect on the medullary vasomotor loci which contributes to the hypotension produced by this drug.

Administration, Topical↗
PubMed1986

Anaesthesia for congenital analgesia. A case report.

Bilateral amputations were performed without analgesia on a patient with congenital insensitivity to pain (congenital analgesia). Positioning, vasomotor control and possible sensitivity to anaesthetic drugs are discussed.

Adult↗
PubMed2005

Diabetes and the menopause.

As life expectancy increases, women are spending more time in the postmenopausal phase of life. Diabetes is one of the most common chronic diseases in the world and its prevalence is increasing. Type 2 diabetes mellitus is more common than type 1 (it accounts for 90% of all cases) and is most frequent in obese individuals over the age of 40 years. In this review, the main problems faced by postmenopausal diabetic women are examined, and hormone replacement therapy (HRT) in this group of women is discussed. HRT appears to decrease the incidence of type 2 diabetes mellitus and to improve glycaemic control; the results vary according to the type of HRT and the route of administration. HRT also improves lipid profiles and transdermal delivery seems to decrease triglyceride levels in particular. There are conflicting data on the effect of HRT on coronary heart disease (CHD); however, it may be beneficial in younger postmenopausal diabetic women. Cardioprotective treatment adjuncts (such as statins or low-dose aspirin) may be advised in diabetic women with CHD risk factors who require HRT. However, their prescription is currently not recommended solely for the possible prevention of cardiovascular disease. HRT may also protect women from osteoporosis in diabetes, especially in type 1 diabetes mellitus. It is recommended that the lowest possible effective dose is used. In postmenopausal diabetic women in whom HRT is not suitable, alternatives such as bisphosphonates may be employed. In these women, vasomotor symptoms can also be improved using drugs such as venlafaxine or gabapentin. Based on current data, we have proposed a regimen that could be used for women with diabetes.

Coronary Disease↗
PubMed1990

[Evaluation of the effects of verapamil, flunarizine, diltiazem, nimodipine and placebo in the prevention of hemicrania. A double-blind randomized cross-over study].

Notwithstanding progress in the prophylactic treatment of migraine, the available therapies are often inefficient and unsatisfactory. In this study, 50 patients suffering for at least one year from the classic or common type migraine and treated with calcium-antagonists: Verapamil, Flunarizine, Diltiazem, Nimodipine, as well as placebo, were studied. 34 patients completed the study. All of the calcium-antagonists studied resulted efficacious in the prophylaxis of migraine; however, more attention should be paid to Flunarizine since this substance, in addition to its therapeutic efficacy, also has the advantages of a single daily dose which makes it the drug of choice in the prophylaxis of vasomotor migraine.

Adolescent↗
PubMed1979

Central hypotensive action of alpha-methyldopa: an iontophoretic study in the cat.

The central site and mechanism of alpha-methyldopa-induced hypotension were examined with the microiontophoretic technique which permits the topical application of drugs to single neurons of the bulbar vasomotor center in decerebrate cats. Cardiovascular neurons were identified by their response to an increase in arterial blood pressure following a small intravenous pressor dose of norepinephrine. Microiontophoretic application of alpha-methyldopa was found to have an inhibitory effect on the spontaneous firing rate of cardiovascular neurons. Furthermore, alpha-methyldopa was found to completely block the excitatory response of cardiovascular neurons to iontophoretically applied norepinephrine. Non-cardiovascular neurons, recorded from the same brain area, were unaffected by iontophoretic application of alpha-methyldopa at the same or greater doses that produced responses in cardiovascular neurons. While peripheral factors cannot be entirely ruled out, the present findings are contrary to the postulate that alpha-methyldopa lowers arterial blood pressure by stimulating central alpha-adrenoceptors, causing a reduction of sympathetic outflow to the periphery. Rather, the data indicate that alpha-methyldopa or its metabolites act directly on central alpha-adrenoceptors in a manner which results in reduced activity.

Action Potentials↗
PubMed1997

Pretreatment with quinpirole inhibits the central antihypertensive effects of rilmenidine and alpha-methyldopa in conscious rats.

Treatment of conscious spontaneously hypertensive rats (SHR) with the dopamine D2 receptor agonist quinpirole causes a short-lasting pressor response and apparent desensitisation to the effects of subsequent injections of quinpirole or central antihypertensives such as clonidine. In the present study, a number of aspects of this apparent desensitisation were investigated. Thirty minutes after intravenous injection of quinpirole into spontaneously hypertensive rats, treatment with the dopamine D2 receptors antagonist raclopride caused a significant fall in blood pressure. At this time point, circulating levels of vasopressin were not significantly different compared to controls. In Brattleboro rats, the pressor response to quinpirole was reduced in the first 15 min after injection, but not difference in blood pressure was observed at later time points. In SHR which had been treated with quinpirole, the central antihypertensive effects of rilmenidine or alpha-methyldopa were significantly inhibited. By contrast, the bradycardia induced by these drugs was similar in quinpirole-treated rats and controls. Quinpirole pretreatment caused an enhancement of the hypotension but a reduction of the reflex tachycardia after intravenous treatment with hydralazine. In SHR treated with methylatropine and quinpirole, the upper plateau of the sympathetic baroreceptor-heart rate reflex curve was reduced. These results show that treatment with quinpirole has marked effects on central sympathetic vasomotor mechanisms which are the target of antihypertensive drugs such as rilmenidine and alpha-methyldopa. At least some of these effects may occur at the level of the sympathetic baroreflex. Moreover, while the effects of quinpirole on sympathetic regulation are prolonged, the initial pressor response is counteracted by an as yet unidentified compensatory mechanism which can be unmasked when quinpirole is displaced from its receptor by dopamine D2 receptor antagonist treatment.

Animals↗
PubMed1998

The effects of potassium channel openers on saphenous vein exposed to arterial flow.

OBJECTIVES: To assess the sensitivity of saphenous vein to potassium channel opening drugs (KCOs). METHODS: Saphenous vein, harvested at bypass surgery or high ligation for correction of varicose veins, was exposed to an in vitro flow circuit and vasomotor responses assessed by organ bath pharmacology. OUTCOME MEASURES: Effective drug concentrations for 50% reduction in vein ring tension (IC50). RESULTS: Vein rings pre-contracted with phenylephrine showed a concentration-dependent relaxation to all the KCOs tested with a potency ranking of HOE 234 > cromakalim > pinacidil > diazoxide. The relaxation to cromakalim was endothelium-independent and was inhibited by glibenclamide (an ATP-sensitive K+ channel blocker). The sensitivity of vein rings to cromakalim increased after exposure to arterial flow conditions for 90 minutes (IC50 before 1.7 +/- 0.25 microM and after 0.25 +/- 0.08 microM, p > 0.001). This effect was not evident after 90 min of venous flow conditions, 2.19 +/- 0.49 microM. When the workload on vein, exposed to arterial flow conditions, was reduced mechanically by external stenting with PTFE the increased sensitivity to cromakalim was abolished. CONCLUSIONS: Saphenous vein has ATP-sensitive K+ channels responsive to KCOs. The increased sensitivity to cromakalim, induced by arterial flow conditions, may represent an endogenous protective mechanism limiting ischaemic damage resulting from the higher workload imposed on grafted vein.

Arteries↗
PubMed1996

Efficacy and local tolerance of a low-dose, 7-day matrix estradiol transdermal system in the treatment of menopausal vasomotor symptoms.

OBJECTIVE: To determine the efficacy and local tolerance of a new matrix transdermal drug-delivery system that delivers 0.02 mg of 17 beta-estradiol (E2) daily for 7 days for the relief of vasomotor symptoms. METHODS: A total of 324 surgically or naturally menopausal women, all with prior hysterectomy and moderate to severe vasomotor symptoms (56-140 hot flushes per week, with episodes of sweating, during a baseline observation period), participated in two independent, 12-week, randomized, double-blind, placebo-controlled studies. After a 4-week, treatment-free period, each woman received a continuous regimen of either one E2 transdermal system, two E2 transdermal systems, or placebo transdermal system(s) applied every week for 12 weeks. Efficacy was measured as reduction in hot flush frequency, determined from subject diaries. To measure local tolerance, skin irritation (erythema and edema) was objectively and systematically evaluated under blue light after removal of the transdermal system(s). Serum E2 and estrone concentrations were determined in one of the studies during baseline and on days 1, 9, 30, 58, 79, and 84. RESULTS: Mean hot flush frequency decreased from 80 hot flushes per week at baseline to approximately 13 hot flushes per week (84% decrease) after 12 weeks of transdermal E2 treatment. Compared with placebo, the decrease in hot flush frequency was significant as early as weeks 2 and 3, and was maintained through the end of the study. Few clinically significant skin reactions occurred, and only nine (3%) of the subjects withdrew because of a skin effect. After initial increase, serum E2 concentrations remained stable throughout the study, achieving values of approximately 20 and 40 pg/mL above baseline for one and two E2 transdermal systems, respectively. CONCLUSION: The E2 transdermal system effectively reduced the frequency of moderate to severe vasomotor symptoms as early as the second week of therapy and was very well tolerated. The decrease in hot flush frequency was similar to that reported for oral and other transdermal estrogens, but at lower serum E2 concentrations. This result may be due to the stable E2 blood level achieved with this transdermal system.

Administration, Cutaneous↗
PubMed1999

Aspirin seems as effective as myelosuppressive agents in the prevention of rethrombosis in essential thrombocythemia.

The course of essential thrombocythemia (ET) is complicated by bleeding, major thrombosis, and microvascular complications. Because about one-half of ET patients remain asymptomatic long term, the decision to use aspirin acetylsalicylic acid, (ASA) or myelotoxic drugs has not yet been clearly established. While vasomotor symptoms are improved by small doses of ASA, higher doses (900 mg/day) induce an unacceptable rate of serious hemorrhagic complications in patients with polycythemia vera. This retrospective study evaluates the utility of therapy in preventing thrombosis in ET and the efficacy and a safety of 100 mg/day of ASA in these patients. One hundred ninety-five consecutive patients with ET diagnosed in agreement with the Polycythemia Vera Study Group (PVSG) criteria are evaluated. All vascular complication before, at, or after diagnosis were recorded and related to the treatment used: no therapy, ASA alone, myelosuppressive agents or both. All treated patients had a significant reduction of thrombotic complications without increased hemorrhagic complications, in spite of therapy adopted. In addition, a significant reduction of rethrombosis was obtained in 60 patients with a previous thrombosis. A low rate of thrombosis (5.1%) was observed during the follow-up of the 135 patients previously asymptomatic for major complications. No difference appears to exist between the use of ASA and cytotoxic drugs in preventing thrombosis and rethrombosis in ET patients. However, the possible increase of cancer and leukemia with myelosuppressive drugs is minimized in patients treated with ASA. A low dose of ASA would seem to be a safe and effective agent in ET.

Adolescent↗