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[Assessment of the influence of pharmacologic substances on pressor vasomotor reflexes in anesthetized animals].

Causes accounting for differing results of experiments during studies on the effects of morphine and chlordiazepoxide upon the intensity of pressor vasomotor reflexes provoked by an electric stimulation of afferent fibers in the tibial nerve were investigated in tests set up on urethan and chloralose anesthetized animals. With this purpose in view the relationship between the amplitude of the vasomotor reflexes and the intensity of electric stimulation, as well as the nature of the drugs action upon the vasomotor reflexes, depending on the stimulation parameters adopted during their registration, were studied. The intensity and the nature of changes of the pressor vasomotor reflexes are shown to depend not only on the properties of the test drugs, but also upon the intensity of electric stimulation employed in the experiment during registration of the reflexes. The most adequate procedure for investigating the effect of pharmaceutics on the intensity of vasomotor reflexes, e. g. a study into the influence exerted by drugs on the threshold of the reflexes origination, is proposed.

Anesthesia, General↗
PubMed1999

Effect of lipid-lowering therapy on vasomotion and endothelial function.

The recent clinical trials of lipid lowering have established the benefit of this therapy in men and women with, or at high risk for, cardiovascular disease. It is now thought that most of the reduction in the risk of clinical events is due to functional rather than anatomic changes in atherosclerotic arteries. Cholesterol-lowering drugs improve endothelial vasomotor function and vascular nitric oxide in patients with coronary artery disease over several months. These changes in vasomotor function may reflect other beneficial changes that are regulated by nitric oxide such as the reduced recruitment and activation of inflammatory cells and a shift in the coagulation balance to favor thrombolysis. These mechanisms may contribute to the reduction in myocardial ischemia and clinical events observed with lipid lowering in patients with vascular disease. Lipid-lowering therapy decreases cardiovascular events and is an important adjunct to coronary revascularization most likely because an improvement in endothelial function prevents the development and destabilization of new atherosclerotic lesions and subsequent ischemic events.

Anticholesteremic Agents↗
PubMed1994

Effects of bepridil on silent myocardial ischemia and eicosanoid metabolism in chronic stable angina pectoris after healing of myocardial infarction.

To investigate the effects of bepridil on silent myocardial ischemia and on eicosanoid metabolism, 10 patients with chronic stable angina underwent exercise treadmill testing and 48-hour ambulatory electrocardiographic monitoring both before and after 4 weeks of bepridil administration (150 mg/day). Fasting venous levels of thromboxane B2, 6-keto-prostaglandin F1 alpha, and leukotriene C4 were measured by radioimmunoassay. Bepridil decreased heart rate responses to daily activities during ambulatory monitoring, and significantly (p < 0.05) reduced the median frequency and duration of silent myocardial ischemic episodes (from 5.5 to 0 events/48 hours and from 86 to 0 minutes/48 hours respectively). Bepridil significantly decreased the blood pressure heart rate product at peak exercise and significantly prolonged the mean exercise tolerance time (from 456.6 to 527.0 second). Bepridil also significantly decreased the plasma levels of thromboxane B2 and leukotriene C4 at rest. These results suggest that bepridil may reduce silent myocardial ischemic episodes either by the reduction of cardiac oxygen demand during daily activities and exercise stress, or by controlling coronary and systemic vasomotor tone. The drug also has a salutary effect on eicosanoid metabolism, to which its efficacy on silent myocardial ischemic episodes may be related.

6-Ketoprostaglandin F1 alpha↗
PubMed2000

[Intravascular Doppler for the evaluation of renal blood flow: validation and demonstration of vessel reactivity].

AIM: To assess the feasibility and to demonstrate the potential clinical application of intravascular doppler in the evaluation of renal blood flow in patients with hypertension and normal renal arteries. MATERIALS AND METHODS: Intravascular doppler was used to measure renal blood flow in 19 patients (34 kidneys) during arteriography to rule out renovascular hypertension. Arteriography showed no evidence of renal artery stenosis in any patient. Hemodynamic parameters, renal artery diameter, and doppler measurements were undertaken at baseline, after injection of a bolus (10 ml) of normal (0.9%) saline, and after injection of isosorbide dinitrate (1 mg diluted in 10 ml normal saline). RESULTS: Repeated measurements of renal blood flow confirmed the reproducibility of the technique. Basal blood flow was similar in both right and left kidneys; injection of vehicle solution (10 ml normal saline) had no effect on doppler parameters. Injection of isosorbide dinitrate resulted in a significant increase in renal blood flow velocity reflecting an increase in renal blood flow; this demonstrates the existence of a renal flow reserve. The degree of increase in renal blood flow varied significantly between kidneys. CONCLUSIONS: Intravascular doppler is a safe, effective, and reproducible technique for measurement of renal blood flow. It allows evaluation of variations in renal blood flow in response to diverse vasoactive drugs or other vasomotor stimuli. The present study demonstrated the heterogenous response of renal blood flow in response to vasodilator stimuli.

Angiography↗
PubMed2000

[Hypertension: microvascular complications].

The arterioles, vessels situated before the capillary bed, are responsible for the increased systemic resistances characteristic of hypertension. In short, three abnormalities are observed in the arterioles of hypertensives: abnormally high vasoconstrictor tone, essentially due to sympathetic hyperactivity, hypertrophic remodelling or increased wall thickness/radius ratio of the arteriole promoting both the increase in vasoconstriction tone and reduction of the vascular lumen, rarefaction of the microvascular bed which contributes to the increase in the haemodynamic resistances. These three factors are observed to different degrees in all forms of hypertension; their influence varies with the organ involved and the stage of the disease. A change in therapeutic strategy has occurred over the last 20 years in the field of hypertension. Before the 1980's, anti-hypertensive therapy was essentially aimed at a vasomotor target: the drugs used had a vasodilatory effect on the resistive arterioles or decreased their response to vasoconstrictor agents. From the mid-1980's, a lot of research was made into the therapeutic possibilities of limiting or correcting the hypertrophic remodelling of the arteries and arterioles of hypertensive patients. In the last few years, the vascular rarefaction in hypertension has been considered to be a significant factor and the possibility of correcting the structural abnormality has become a new therapeutic option.

Antihypertensive Agents↗
PubMed2006

Diagnosing rhinitis: allergic vs. nonallergic.

Allergic rhinitis, the most common type of rhinitis, generally can be differentiated from the numerous types of nonallergic rhinitis through a thorough history and physical examination. Allergic rhinitis may be seasonal, perennial, or occupational. The most common cause of nonallergic rhinitis is acute viral infection. Other types of nonallergic rhinitis include vasomotor, hormonal, drug-induced, structural, and occupational (irritant) rhinitis, as well as rhinitis medicamentosa and nonallergic rhinitis with eosinophilia syndrome. Since 1998, three large expert panels have made recommendations for the diagnosis of allergic and nonallergic rhinitis. Allergy testing (e.g., percutaneous skin testing, radioallergosorbent testing) is not necessary in all patients but may be useful in ambiguous or complicated cases.

Diagnosis, Differential↗
PubMed1980

[Effect of nonachlazine and oxyfedrine on central processes regulating vasomotor tone].

Effect of the antianginal drugs nonachlazin and oxyfedrin on tonic and evoked activity in sympathetic renal nerves and on vasomotor reflexes induced by stimulation of the tibial nerve was studied and compared in anesthetized cats with intact brain. Low doses of nonachlizin facilitated somatosympathetic reflexes. High doses of the drug induced a selective inhibition of somatosympathetic reflexes evoked by stimulation of high-threshold afferent A-fibers. The inhibition of somatosympathetic reflexes induced by oxyfedrin had no such a selectivity and was less prolonged. The effects of nonachlazin and oxyfedrin attained after the administration of reserpine and propranolol allow a conclusion that the central effects of nonachlazin and oxyfedrin are related to the fact that they modulate the adrenergic brain structures.

Animals↗
PubMed1995

Effects of antihypertensive therapy with angiotensin converting enzyme inhibitors or calcium antagonists on spontaneous cyclic vasomotor activity in small resistance arteries of spontaneously hypertensive rats.

OBJECTIVE: Spontaneous cyclic vasomotor activity can occur in small resistance arteries in vitro after precontraction with a vasoconstrictor. Calcium and potassium channels and nitric oxide synthesis or release seem to be involved in the genesis of this vasomotor activity. We therefore investigated the effects of chronic antihypertensive therapy with calcium antagonists and angiotensin converting enzyme (ACE) inhibitors on the amplitude and frequency of cyclic vasomotor activity in vitro in spontaneously hypertensive rats (SHR). MATERIALS AND METHODS: SHR were treated with fosinopril at 25 mg/kg per day or lacidipine at 10 mg/kg per day or nitrendipine at 30 mg/kg per day, from the age of 4 to 12 weeks. Data were compared with those obtained in untreated SHR and Wistar-Kyoto (WKY) rats. Half the rats were killed at 13 weeks of age, and the remaining half were killed at 38 weeks of age. The mesenteric small resistance arteries were dissected, mounted on a micromyograph and then contracted submaximally with noradrenaline. Acetylcholine was then added to the organ bath. RESULTS: More than 50% of the vessels showed cyclic vasomotor activity. The frequency and amplitude of this activity were greater in SHR than WKY rats after noradrenaline and after acetylcholine. At 13 weeks of age (but not at 38 weeks of age), treatment with a calcium antagonist (either lacidipine or nitrendipine) significantly reduced the frequency and amplitude of the vasomotor activity, probably by interfering with calcium entry. No change was observed after fosinopril. CONCLUSIONS: Antihypertensive treatment with different drugs may affect cyclic vasomotor activity differently, probably by interfering with cellular mechanisms involved in its genesis. The effects of calcium antagonists on cyclic vasomotor activity are still present after short-term but not after long-term treatment withdrawal.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1996

Gender differences in drug therapy.

Patient response to drug therapy is affected by multiple factors, including age, renal function, diet, smoking, congestive heart failure and gender. However, the data on gender differences in pharmacotherapy are limited, predominantly because women are excluded from clinical research due to the potential risks involved during pregnancy and co-existing illnesses in elderly women. Currently some information is available on gender differences in drug therapy. Differences in drug distribution and response due to different body composition as well as the effects of hormonal differences are the few that have been documented. Differences in drug metabolism due to differences in blood concentration of enzymes such as alcohol dehydrogenase has been recently described. Pharmacotherapy may also have to be altered due to differences in disease expression, like increased vasomotor tone in women. Drug efficacy has been found to be affected by gender---an example is antiplatelet therapy for stroke prevention. Finally, the side effects of drugs may differ depending on gender. Those involved in pharmacotherapy should be aware of these differences when prescribing drugs to female patients, since the majority of clinical data regarding pharmaceuticals has been derived primarily from a population of young males.

Journal Article↗
PubMed2003

Rhinitis in pregnancy.

About 30% of women suffer from nasal symptoms during pregnancy. The hormonal changes occurring during pregnancy favour per se mucosal oedema and relaxation of smooth muscles, thus contributing to nasal congestion. The most common forms of rhinitis are allergic, drug-induced, infectious and vasomotor rhinitis. In addition to the detrimental effects that rhinitis can have on quality of life, it is important to correctly treat rhinitis itself since it can influence concomitant asthma, as underlined in ARIA document. In pregnancy, the safety profile of drugs is the primary item to be considered. The American FDA pointed out that foetal damage could not be totally excluded with the majority of antirhinitis drugs. It is recommended to use "older drugs" because more data about their safety are available. Cromones are the safest drugs but, although they need multiple daily administrations. Antihistamines should be considered as second choice drugs, and their use is not recommended during the first three months of pregnancy. Topical steroids are useful in moderate-severe rhinitis, being beclometasone the most documented molecule. Topical vasoconstrictors should not be used continuously because they can induce pharmacological rhinitis. It is not recommended to start specific immunotherapy in pregnancy but it can be continued in patients who benefit from its use. Infective rhinitis should be treated with beta-lactams, cephalosporins or macrolides. Finally it is important to evaluate the cost/usefulness ratio before any drug prescription.

Abnormalities, Drug-Induced↗