Descriptive and functional neuroanatomy of locus coeruleus-noradrenaline-containing neurons involvement in bradykinin-induced antinociception on principal sensory trigeminal nucleus.

The present study was carried out in Wistar rats, using the jaw-opening reflex and dental pulp stimulation, to investigate noradrenaline- and serotonin-mediated antinociceptive circuits. The effects of microinjections of bradykinin into the principal sensory trigeminal nucleus (PSTN) before and after neurochemical lesions of the locus coeruleus noradrenergic neurons were studied. Neuroanatomical experiments showed evidence for reciprocal neuronal pathways connecting the locus coeruleus (LC) to trigeminal sensory nuclei and linking monoaminergic nuclei of the pain inhibitory system to spinal trigeminal nucleus (STN). Fast blue (FB) injections in the locus coeruleus/subcoeruleus region retrogradely labeled neurons in the contralateral PSTN and LC. Microinjections of FB into the STN showed neurons labeled in both ipsilateral and contralateral LC, as well as in the ipsilateral Barrington's nucleus and subcoeruleus area. Retrograde tract-tracing with FB also showed that the mesencephalic trigeminal nucleus sends neural pathways towards the ipsilateral PSTN, with outputs from cranial and caudal aspects of the brainstem. In addition, neurons from the lateral and dorsolateral columns of periaqueductal gray matter also send outputs to the ipsilateral PSTN. Microinjections of FB in the interpolar and caudal divisions of the STN labeled neurons in the caudal subdivision of STN. Microinjections in the STN interpolar and caudal divisions also retrogradely labeled serotonin- and noradrenaline-containing nucleus of the brainstem pain inhibitory system. Finally, the gigantocellularis complex (nucleus reticularis gigantocellularis/paragigantocellularis), nucleus raphe magnus and nucleus raphe pallidus also projected to the caudal divisions of the STN. Microinjections of bradykinin in the PSTN caused a statistically significant long-lasting antinociception, antagonized by the damage of locus coeruleus-noradrenergic neuronal fibres with (N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine) (DSP4), a neurotoxin that specifically depleted noradrenaline from locus coeruleus terminal fields. These data suggest that serotonin- and noradrenaline-containing nuclei of the endogenous pain inhibitory system exert a key-role in the antinociceptive mechanisms of bradykinin and the locus coeruleus is crucially involved in this effect.

[Pharmacotherapy in the elderly: a review about the multidisciplinary team approach in systemic arterial hypertension control]. / A farmacoterapia no idoso: revisão sobre a abordagem multiprofissional no controle da hipertensão arterial sistêmica.

The greater prevalence of chronic diseases like systemic arterial hypertension among elderly people results in an increase of drugs use. Therefore, the incidence of a lot of drug-related problems (DRP) rises, and this leads to many health problems in the population. Based on literature, authors emphasize the multidisciplinary team approach (physicians, nurses and pharmacists) to activities directly related with pharmacotherapy for hypertension, granting elderly persons a better comprehension about taking care of their own health, to reduce DRP and achieve satisfactory adherence.

Fever induced by platelet-derived growth factor, in contrast to fever induced by lipopolysaccharide, depends only on nitric oxide, but not on carbon monoxide pathway.

Platelet-derived growth factor (PDGF) is a multifunctional protein which is known to induce a febrile response when injected intracerebroventricularly. The gaseous neurotransmitters, nitric oxide (NO) and carbon monoxide (CO), are both known to exert thermoregulatory effects and to participate in lipopolysaccharide-induced fever. In this study, we investigated the role of NO and CO in the febrile response to PDGF-BB in rats. Intracerebroventricular (i.c.v.) injection of PDGF-BB produced a dose-dependent increase in body temperature. This increase in body temperature induced by PDGF-BB was exacerbated by N(G)-nitro-L-arginine methyl ester (L-NAME-a nonselective NO synthase inhibitor) and S-methyl-L-thiocitrulline treatment [SMTC-a neuronal NOS (nNOS) selective inhibitor], but not by aminoguanidine treatment [an inducible NOS (iNOS) selective inhibitor]. Zinc deuteroporphyrin 2,4-bis glycol treatment (ZnDPBG-a nonselective heme oxygenase (HO) blocker) did not affect PDGF-BB fever. Our data indicate that the NO but not the CO pathway participates in PDGF-BB fever. Furthermore, our data show that nNOS is the NOS isoform responsible for NO synthesis in this response.

Impact of Pharmaceutical Care interventions in the identification and resolution of drug-related problems and on quality of life in a group of elderly outpatients in Ribeirão Preto (SP), Brazil.

OBJECTIVE: To evaluate the impact of a Pharmaceutical Care service in the identification and resolution of drug-related problems (DRPs) and in quality of life (QoL) of a group of elderly outpatients with chronic health conditions. METHODS: 30 outpatients (aged 60-75-years old) were followed between August 2003 and July 2004 at a primary health care unit in Ribeirão Preto (SP), Brazil. Patients were scheduled monthly to meet with the researcher, who provided Pharmaceutical Care service (the intervention). Through Pharmaceutical Care, the pharmacist worked with the patient and other care providers to improve outcomes of drug therapy through focused education, care planning, and monitoring. Intervention outcomes were the number of DRPs prevented or resolved, and the impact on QoL. The Short Form-36 health survey was used to measure changes in QoL. RESULTS: The mean age of patients was 66 ± 5 years, 21 of whom had low literacy. During the study, 92 DRP were identified, 3.0 ± 1.5 problems per patient. By the end of the study, the interventions solved 69% of actual DRP and prevented 78.5% potential DRP. In addition, QoL showed improvement in 22 patients after DRP resolution or prevention. CONCLUSION: Despite the limitations in this study that may affect generalizability of the results, this study demonstrates that humanistic and behavioral interventions based on the Pharmaceutical Care model were capable in reducing DRPs, and improve QoL in patients.

A farmacoterapia no idoso: revisão sobre a abordagem multiprofissional no controle da hipertensão arterial sistêmica / Pharmacotherapy in the elderly: a review about the multidisciplinary team approach in systemic arterial hypertension control

A maior prevalência de doenças crônicas entre os idosos, como a hipertensão arterial sistêmica, implica no crescimento do consumo de medicamentos. Em conseqüência, ocorre o aumento na incidência dos problemas relacionados aos medicamentos (PRM), deixando essa população vulnerável aos vários problemas de saúde. Fundamentados na literatura, destaca-se a abordagem multiprofissional (médico, enfermeiro e farmacêutico) nas atividades ligadas diretamente à farmacoterapia da hipertensão arterial sistêmica, para proporcionar ao idoso a conscientização quanto aos seus cuidados com a saúde, reduzir os PRM e obter a adesão satisfatória.

Inibiçäo induzida por drogas antipsicóticas na febre devida ao lipopolissacarídeo de E. Coli / Antipsychotics drugs induced inhibition in the fever elicited by LPS from E. coli

Os resultados mostraram que, considerando-se as doses molares utilizadas das drogas antipsicóticas, a flufenazina (Flu) foi a mais potente, em termos da inibiçäo da resposta febril

Possível envolvimento dopaminérgico na resposta febril induzida pelo lipopolissacarídeo de E. coli, no coelho / Dopaminergic involvement in the fever response induced in rabbits by lipopolysaccharide from E. coli

Drogas neurolépticas como a clorpromazina (CLOR), flufenazina (Flu), haloperidol (HAL) e pinozide (Pim), conhecidas por atuarem como antipsicóticas e bloqueadoras de receptores dopaminérgicos centrais, inibiram parcialmente a resposta febril induzida pelo lipopolissacarídeo de E. coli (LPS), um pirogênio bacteriano, em coelhos. Os presentes resultados sugerem que os receptores dopaminérgicos centrais podem estar envolvidos nessa resposta febril, muito embora essa mobilizaçäo näo represente o principal mecanismo

Participaçäo colinérgica nos efeitos das drogas antipsicóticas na febre devida a um pirogênio bacteriano / Cholinergic participation in effects of antipsichotics drugs in the fever elicited by one bacterial pyrogen

Os resultados mostraram que a associaçäo de atropina às drogas antipsicóticas produziu reduçäo da resposta febril, quando clorpromazina e flufenazina foram os antipsicóticos utilizados. A associaçäo de atropina ao haloperidol e ao pimozide potencializou a resposta febril

Efeitos do propranolol e da fenoxibenzimina sobre a resposta febril induzida pelo lipopolissacarídeo de E. coli, em coelhos / Effects of propranolol and phenoxibenzamine on the febrile response induced in rabbits by lipopolysaccharide from E. coli

Drogas bloqueadoras de receptores Alfa e Beta adrenérgicos, como a fenoxibenzamina e o propranolol, produziram reduçäo estatisticamente significante da resposta febril induzida pelo lipopolissacarídeo de E. coli (LPS) em coelhos. Os presentes resultados sugerem que receptores Alfa e Beta adrenérgicos poderäo estar envolvidos nessa resposta febril