Our library of drug research abstracts drawn from the medical literature is updated on a regular schedule, and you can be assured that new catapresan research articles will be listed here shortly after becoming available to us.
Medical research on catapresan
Anaesthesist. 2010 Mar 13;
Zalunardo MP, Ivleva-Sauerborn A, Seifert B, Spahn DR
BACKGROUND: Premedication aims at alleviating preoperative anxiety and nervousness and also at minimizing adverse effects. To our knowledge there is no study comparing efficacy and patient satisfaction of different premedications in age-adjusted dosage. METHODS: In 139 patients anxiety, sedation and adverse effects were measured at 6 consecutive perioperative time points after administration of midazolam, clonidine or a placebo. RESULTS: Midazolam showed the strongest sedative and anxiolytic effects, clonidine less and placebo none. Clonidine and midazolam reduced the risk of postoperative nausea and vomiting (PONV). Midazolam showed minimal adverse effects and the best patient satisfaction. CONCLUSION: Midazolam was the most anxiolytic, sedative and favored premedication with the least adverse effects. Most patients would choose midazolam next time.
Int J Obstet Anesth. 2010 Mar 2;
Dewandre PY, Decurninge V, Bonhomme V, Hans P, Brichant JF
BACKGROUND: Sufentanil 5 mug and clonidine 75 mug produce a similar reduction in minimum local anaesthetic concentration of ropivacaine. The aim of the present study was to compare the side effects of two equianalgesic solutions by combining 0.2% ropivacaine with either sufentanil 5 mug or clonidine 75 mug for labour epidural analgesia. METHODS: In a prospective double-blind study, 60 women at 5 cm cervical dilatation were randomly allocated to receive 0.2% ropivacaine with either sufentanil 5 mug or clonidine 75 mug to initiate labour analgesia. The analgesic efficacy and side effects of the two mixtures were compared. RESULTS: Onset, duration and quality of analgesia and subsequent ropivacaine consumption were similar in the two groups. Hypotension was significantly more frequent and severe with clonidine than with sufentanil (systolic blood pressure
J Med Assoc Thai. 2010 Jan; 93(1): 38-47
Lusawat A, Dhiravibulya K, Thammongkol S, Vanavanan S, Mahachoklertwattana P
OBJECTIVE: To assess hypothalamic-pituitary dysfunction in childhood brain tumor survivors in Prasat Neurological Institute. MATERIAL AND METHOD: Between October 2007 and September 2008, 19 brain tumor survivor children in Prasat Neurological Institute without recurrence at least 2 years after complete treatment were included in the present study. The patients were categorized according to brain tumor location into directly (DHPA) (9 cases) and indirectly (IDHPA) (10 cases) involving hypothalamic-pituitary axis. All patients were treated by surgery. Furthermore, six cases were combined with radiation and chemotherapy and 10 cases were combined with radiation therapy only. Growth Hormone (GH) stimulation test by clonidine and/or L-Dopa, ACTH stimulation test and thyroid function test (TFT) were done. RESULTS: The mean age at diagnosis was 9.9 +/- 4.6 years old and the interval from diagnosis to study was 5.8 +/- 2.2 years. Seven DHPA (77%) and seven IDHPA patients (70%) had low peak GH with significant lower level in the former group (p < 0.05). Six of seven DHPA (85%) and one IDHPA patients (10%) had low response to ACTH stimulation test. All DHPA (100%) and 10% IDHPA patients had central hypothyroidism. By ACTH stimulation test in DHPA patients, hypocortisolism was detected in five and excluded in one who later stopped prednisolone after prolonged continuation. The central hypothyroidism was newly detected in two DHPA patients and replacement therapy was initiated GH deficiency (GHD) was detected by GH stimulation test in 73% of overall brain tumors. Growth hormone therapy would be considered in the appropriate GHD patients. CONCLUSION: With effective therapy and improving survival rates of brain tumor children, hypothalamic-pituitary dysfunction in either DHPA or IDHPA group should be regularly monitored to prevent further morbidity and improve quality of life.
Pharmazie. 2010 Jan; 65(1): 47-50
Liu H, Gong H, Liu Z, Yang X, Liu G, Li Z
Peripheral alpha-adrenoceptors are involved in mediating neurogenic inflammation. To characterize the effects of acute administration of selective alpha adrenoreceptor agonists or antagonists on capsaicin-evoked substance P (SP) release from dorsal root ganglion (DRG) neurons, dissociated cultured DRG neurons were preincubated with selective alpha 1-adrenoreceptor agonist phenylephrine (10(-5) mol/L), alpha 1-adrenoreceptor antagonist prazosin (10(-6) mol/L), alpha 2-adrenoreceptor agonist clonidine (10(-5) mol/L), alpha 2-adrenoreceptor antagonist yohimbine (10(-5) mol/L) for 10 min, followed by the addition of capsaicin (10(-7) nmol/L) for additional 10 min. Radioimmunoassay (RIA) was employed to determine if the capsaicin-evoked enhancement of neuropeptide release was subject to adrenergic modulation. Expression of SP mRNA was determined by RT-PCR. Acute exposure of selective alpha 1-adrenoreceptor agonist phenylephrine could increase capsaicin-evoked SP release from primary cultured DRG neurons. Expression of SP mRNA was not affected by acute stimulation with these adrenoreceptor agonists or antagonists. The data provided in the present study suggest that the excitatory effect of alpha 1-adrenoreceptor agonist on capsaicin-evoked release of neuropeptide from primary cultured DRG neurons is likely to be mediated by activation of VR1 to influence capsaicin sensitivity but not by promotion of SP synthesis under acute stimulative states.
Indian J Pharmacol. 2009 Oct; 41(5): 218-20
Manjunath S, Kugali SN, Deodurg PM
OBJECTIVES: Clonidine, a known antihypertensive, is currently used for many purposes including diabetic gastroparesis, postmenopausal hot flushes, opioid/nicotine/alcohol withdrawal. Its effects on carbohydrate metabolism appear to be variable. Hence, the present study was undertaken to evaluate the influence of clonidine on euglycemic and alloxan -induced diabetic rats and its interaction with glibenclamide. MATERIALS AND METHODS: Alloxan - induced (150 mg/kg, i.p) diabetic rats were divided into six groups of six animals each. Group I - Normal Control; Group II - Nondiabetic + Clonidine (25 mug/kg); Group III - Diabetic Control; Group IV - Diabetic + Glibenclamide (5 mg/kg); Group V - Diabetic + Glibenclamide + Clonidine. All drugs were given orally once daily. Blood glucose was estimated from rat tail vein using glucometer before start of the experiment and at the end of 30 days. RESULTS: After 30 days of treatment, clonidine (25 mug/kg) produced significant hyperglycemia in both euglycemic and diabetic rats. It also reduced the hypoglycemic effect of glibenclamide in diabetic rats. CONCLUSION: The results of present study indicate that clonidine has hyperglycemic effect and it also interacts with glibenclamide to reduce its hypoglycemic activity. If these findings are true to human beings then clonidine should not be used in diabetic patients on sulfonylureas.
J Pharmacol Toxicol Methods. 2010 Feb 19;
Champeroux P, Ouillé A, Martel E, Fowler JS, Maurin A, Jude S, Lala P, Le Guennec JY, Richard S
INTRODUCTION: QT interval assessment by telemetry has become one of the most useful models in testing strategies adopted for detection of drug induced QT prolongation in non-clinical safety pharmacology studies. This study reports experimental data showing that the autonomic nervous system might influence drug induced QT prolongation. METHODS: Animals were instrumented with telemetric transmitters and epicardial ECG leads. Effects on QT interval of reference drugs such as thioridazine and terfenadine were analysed with different approaches, the Holzgrefe's probabilistic method, the QT shift method and an individual analysis of beat-to-beat QT/RR pair distribution visualised as points-cloud. RESULTS: Two cases of unexpected absence of QT interval prolongation are reported with thioridazine and terfenadine in conscious beagle dogs under conditions of concomitant tachycardia. The pro-arrhythmic properties of these two molecules were unmasked by co-treatment with sympatholytic agents, atenolol and clonidine respectively suggesting that sympathetic activation and/or parasympathetic withdrawal might impair a drug induced QT prolongation. DISCUSSION: The apparent absence of changes in the QT interval due to novel drug candidates should be interpreted cautiously under conditions of concomitant tachycardia or elevated heart rate levels in non-clinical safety studies.
The pharmacological treatment of opioid addiction-a clinical perspective.
Eur J Clin Pharmacol. 2010 Feb 19;
Lobmaier P, Gossop M, Waal H, Bramness J
This article reviews the main pharmacotherapies that are currently being used to treat opioid addiction. Treatments include detoxification using tapered methadone, buprenorphine, adrenergic agonists such as clonidine and lofexidine, and forms of rapid detoxification. In opioid maintenance treatment (OMT), methadone is most widely used. OMT with buprenorphine, buprenorphine-naloxone combination, or other opioid agonists is also discussed. The use of the opioid antagonists naloxone (for the treatment of intoxication and overdose) and oral and sustained-release formulations of naltrexone (for relapse prevention) is also considered. Although recent advances in the neurobiology of addictions may lead to the development of new pharmacotherapies for the treatment of addictive disorders, a major challenge lies in delivering existing treatments more effectively. Pharmacotherapy of opioid addiction alone is usually insufficient, and a complete treatment should also include effective psychosocial support or other interventions. Combining pharmacotherapies with psychosocial support strategies that are tailored to meet the patients' needs represents the best way to treat opioid addiction effectively.
J Child Adolesc Psychopharmacol. 2010 Feb; 20(1): 55-61
van den Ban E, Souverein P, Swaab H, van Engeland H, Heerdink R, Egberts T
BACKGROUND: Previous Dutch studies showed increasing psychostimulant use, especially methylphenidate immediate-release (MPH-IR), between 1995 and 2003. In 2003 the extended-release (ER) formulation of MPH and in 2005 atomoxetine (ATX) were introduced in The Netherlands, which increased treatment options. OBJECTIVE: The aim of this study was to describe the change in incidence of attention-deficit/hyperactivity disorder (ADHD) drugs and the prescription profiles of patients younger than 45 years starting treatment with these medicines between 2001 and 2006. METHODS: Data were obtained from Dutch community pharmacies as collected by the Foundation for Pharmaceutical Statistics, covering 97% of all dispenses for prescription medicines to outpatients in The Netherlands. RESULTS: The overall incidence of ADHD drugs use increased 6.5-fold from 2001 to 2006 in men as well as in women. The absolute incidence was highest among 6- to 11-year-old boys. The percentage of first-time MPH-IR users decreased from 98.3% in 2001 to 75.9% in 2006. Likewise, MPH-ER use increased from 0% in 2001 to 18.9% in 2006, and ATX use increased from 0% in 2001 to 3.9% in 2006. The new nonstimulant drug ATX was prescribed more often to adults if they had been previously treated with selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, or antipsychotics. Youngsters
Eur J Drug Metab Pharmacokinet. 2009 Jul-Sep; 34(3-4): 229-32
Tigka E, Kotsiou A, Saranteas T, Mourouzis J, Kostopanagiotou G, Tesseromatis C
Lidocaine is a local anaesthetic widely used in regional and epidural anaesthesia. Clonidine a alpha2-adrenergic agonist is an antihypertensive agent, regulating the production of catecholamines (epinephrine and norepinephrine) and added to local anesthetic infusions in order to improve postoperative analgesia. The aim of the study was to investigate the influence of clonidine co-administration on the binding of 14C lidocaine to rat serum and heart tissue protein as well as its pharmacodynamic effects in the heart. Four groups of Wistar rats (n=7) were used; Groups I and II received 4 mg/kg lidocaine i.m. Groups III and IV received lidocaine and 1 microg/kg clonidine i.m. In group I and III fifteen minutes and in groups II and IV thirty minutes after the initial treatment, ultrasound examination of heart function (heart rate, diameter of left ventricle in systole and diastole, ejection fraction) was performed. The animals were then sacrificed in all groups. Lidocaine free fraction in serum and heart was evaluated via ultrafiltration. The kinetics of lidocaine was altered by clonidine co-administration probably by mechanisms related to protein binding alterations. However, the pharmacokinetic interactions were not accompanied by changes of pharmacodynamic parameters including those of heart function as measured by echocardiography.
Paediatr Anaesth. 2010 Feb 11;
Akin A, Ocalan S, Esmaoglu A, Boyaci A
Summary Background: Clonidine is used increasingly in pediatric anesthesia practice to prolong the duration of action of caudal block with a local anesthetic agent. Which route of administration of clonidine is the most beneficial remains unknown. We compared the effects of caudal and intravenous clonidine on postoperative analgesia produced by caudal levobupivacaine. Methods: Sixty ASA I and II children, aged 2-8 undergoing inguinal hernia repair or orchidopexy surgery received standardized premedication with midazolam and general anesthesia. The children were randomized in a double-blind fashion to three groups. Group L (n = 20) patients received 0.75 ml.kg(-1) of caudal 0.25% levobupivacaine and i.v. 5 ml saline, Group L-Ccau (n = 20) patients received 0.75 ml.kg(-1) of caudal 0.25% levobupivacaine + 2 mug.kg(-1) clonidine and i.v. 5 ml saline, Group L-Civ (n = 20) patients received 0.75 ml.kg(-1) of caudal 0.25% levobupivacaine and i.v. 2 mug.kg(-1) clonidine in 5 ml of saline. Mean arterial blood pressure, heart rate, peripheral oxygen saturation, and end-tidal carbon dioxide values were recorded. Postoperative pain [Children and Infants Postoperative Pain Scale (CHIPPS) score], sedation (Ramsay Sedation Scale) and motor blockade (Modified Bromage Scale) were assessed at predetermined time points during the first 24 h after surgery. Results: Caudal clonidine significantly delayed the time to first rescue analgesic and fewer patients required rescue analgesia in the 24 h after surgery. No motor block was observed in any of the three groups on awakening or during the study period. In Group L-Ccau, the CHIPPS score was lower than in Group L at all times through 240 min (P < 0.05), while the pain scores were lower in Group L-Civ only at extubation and at 240 min (P < 0.05). Conclusions: Caudal clonidine prolongs the duration of analgesia produced by caudal levobupivacaine without causing significant side effects and this is because of a spinal mode of action.