RESUMO
The aim of this study was to compare the efficacy and safety of oral administration of miltefosine (Milteforan) at 2 mg/kg/day for 28 days (Group M; n = 60) with a subcutaneous administration of meglumine antimoniate (Glucantime) at 50 mg/kg/12 h or at 100 mg/kg/day for 28 days (Group G; n = 59) in the treatment of canine leishmaniosis in dogs. Out of 119 dogs included in the study, 90 could be used for efficacy assessment and 112 for safety assessment. Treated dogs were followed up for 6 weeks, with re-checks every 14 days. The mean total clinical scores significantly decreased throughout the study in both treatment groups. The evolution of parasitological results after treatment (D42) shows a high percentage of dogs with negative bone marrow smears, 90% and 91.3% in groups M and G respectively, and did not significantly differ between groups (p = 0.8066). Out of the 112 dogs used for the safety assessment, only 26 dogs (23.2%) presented product-related adverse events concerning the gastrointestinal tract. These results showed that miltefosine at 2 mg/kg once daily can be safely used over a 28-day period in the treatment of canine leishmaniosis and provides both a steadily increasing improvement of the clinical signs and a good leishmanicidal efficacy.
Assuntos
Doenças do Cão/tratamento farmacológico , Leishmaniose/veterinária , Meglumina/efeitos adversos , Meglumina/uso terapêutico , Compostos Organometálicos/efeitos adversos , Compostos Organometálicos/uso terapêutico , Fosforilcolina/análogos & derivados , Administração Oral , Animais , Antiprotozoários/efeitos adversos , Antiprotozoários/uso terapêutico , Medula Óssea/parasitologia , Doenças do Cão/parasitologia , Cães/parasitologia , Feminino , Injeções Subcutâneas , Leishmaniose/tratamento farmacológico , Masculino , Meglumina/administração & dosagem , Antimoniato de Meglumina , Compostos Organometálicos/administração & dosagem , Fosforilcolina/administração & dosagem , Fosforilcolina/efeitos adversos , Fosforilcolina/uso terapêuticoRESUMO
The study was aimed to assess the efficacy and tolerance profiles of an oral administration miltefosine drug (Milteforan(R), Virbac) in dogs with natural leishmaniosis. In this multicentric open trial, 96 dogs were treated with the drug administered orally at a dose of 2 mg/kg body weight once a day for 28 days. During the 56-day trial, clinical signs of the dogs were monitored every 2 weeks. On the first and the last visits, blood and bone marrow samples were collected for laboratory analyses. According to clinical scores, the treatment demonstrated a significant time-dependent therapeutic effect resulting in a 61.2% mean reduction on day 56. Hematologic and biochemical analyses showed improvements in most of the parameters examined, supporting the observed clinical efficacy of the drug. Overall, veterinarians estimated that 82.7% of the dogs treated with the miltefosine drug showed an equal or higher treatment efficacy than other antileishmanial drugs. During the trial, the adverse reactions probably associated with the drug treatment were observed in 11.7% of the dogs. However, they were not serious. The most frequent one was vomiting, which was transient, self-limiting, and reversible. These data demonstrate that the drug, at the recommended dose and treatment regime, was safe and efficacious for the treatment of canine leishmaniosis.
Assuntos
Antiprotozoários/uso terapêutico , Doenças do Cão/tratamento farmacológico , Leishmaniose Visceral/veterinária , Fosforilcolina/análogos & derivados , Administração Oral , Animais , Antiprotozoários/administração & dosagem , Antiprotozoários/efeitos adversos , Cães , Feminino , Leishmaniose Visceral/tratamento farmacológico , Masculino , Fosforilcolina/administração & dosagem , Fosforilcolina/efeitos adversos , Fosforilcolina/uso terapêutico , Resultado do TratamentoRESUMO
In this blinded randomized and controlled study, the anthelmintic efficacy of a tablet formula of ivermectin-praziquantel was evaluated in horses experimentally infected with three species of Strongylus larvae. Eighteen previously dewormed horses were inoculated on study day 0 with third-stage larvae of Strongylus vulgaris, Strongylus equinus, and Strongylus edentatus. The horses were randomly allocated to three groups (n = 6): test-drug (tablet formula), positive-control (reference gel), and negative-control (placebo tablet). On day 56, the horses were treated once with the respective drugs. On day 95, the horses were sacrificed, and necropsy examinations were performed to assess the status of the parasite burden (L4 and immature L5) and pathological lesions on selected organs and tissues. By the criteria of worm counts, the test-drug and positive-control showed, respectively, 100% and 97.3% anthelmintic efficacies on S. vulgaris, 100% and 81.4% on S. equinus, and equally 100% on S. edentatus. However, the efficacies on S. equinus and S. edentatus should be taken only as face values considering their respective low worm counts in the placebo group. The S. vulgaris-induced arterial lesions were also reduced in the test-drug and positive-control groups with efficacies of 73.9% and 62.9%, respectively. No adverse reactions were observed with either of the drugs. Our data demonstrate that the Equimax tablet formula was as safe and efficacious as the gel formula anthelmintic on large strongyles in horses.
Assuntos
Anti-Helmínticos/uso terapêutico , Doenças dos Cavalos/tratamento farmacológico , Ivermectina/uso terapêutico , Praziquantel/uso terapêutico , Infecções por Strongylida/veterinária , Strongylus/efeitos dos fármacos , Comprimidos/administração & dosagem , Animais , Anti-Helmínticos/administração & dosagem , Anti-Helmínticos/efeitos adversos , Artérias/patologia , Peso Corporal , Método Duplo-Cego , Feminino , Doenças dos Cavalos/parasitologia , Cavalos , Ivermectina/administração & dosagem , Ivermectina/efeitos adversos , Masculino , Placebos/administração & dosagem , Praziquantel/administração & dosagem , Praziquantel/efeitos adversos , Índice de Gravidade de Doença , Infecções por Strongylida/tratamento farmacológico , Resultado do TratamentoRESUMO
The reinforcing effects of drugs of abuse result from the complex interaction between pharmacological effects and conditioned responses. Here we evaluate how expectation affects the response to the stimulant drug methylphenidate in 25 cocaine abusers. The effects of methylphenidate (0.5 mg/kg, i.v.) on brain glucose metabolism (measured by [18F]deoxyglucose-positron emission tomography) and on its reinforcing effects (self-reports of drug effects) were evaluated in four conditions: (1) expecting placebo and receiving placebo; (2) expecting placebo and receiving methylphenidate; (3) expecting methylphenidate and receiving methylphenidate; (4) expecting methylphenidate and receiving placebo. Methylphenidate increased brain glucose metabolism, and the largest changes were in cerebellum, occipital cortex, and thalamus. The increases in metabolism were approximately 50% larger when methylphenidate was expected than when it was not, and these differences were significant in cerebellum (vermis) and thalamus. In contrast, unexpected methylphenidate induced greater increases in left lateral orbitofrontal cortex than when it was expected. Methylphenidate-induced increases in self-reports of "high" were also approximately 50% greater when subjects expected to receive it than when they did not and were significantly correlated with the metabolic increases in thalamus but not in cerebellum. These findings provide evidence that expectation amplifies the effects of methylphenidate in brain and its reinforcing effects. They also suggest that the thalamus, a region involved with conditioned responses, may mediate the enhancement of the reinforcing effects of methylphenidate by expectation and that the orbitofrontal cortex mediates the response to unexpected reinforcement. The enhanced cerebellar activation with expectation may reflect conditioned responses that are not linked to conscious responses.
Assuntos
Encéfalo/metabolismo , Estimulantes do Sistema Nervoso Central/farmacologia , Transtornos Relacionados ao Uso de Cocaína/metabolismo , Transtornos Relacionados ao Uso de Cocaína/psicologia , Condicionamento Psicológico , Metilfenidato/farmacologia , Reforço Psicológico , Adulto , Encéfalo/diagnóstico por imagem , Encéfalo/efeitos dos fármacos , Feminino , Glucose/metabolismo , Humanos , Masculino , Tomografia Computadorizada de EmissãoRESUMO
OBJECTIVE: Methylphenidate is the most commonly prescribed drug for attention deficit hyperactivity disorder (ADHD), yet its therapeutic mechanisms are poorly understood. The objective of this study was to assess if methylphenidate, by increasing dopamine (neurotransmitter involved in motivation) in brain, would enhance the saliency of an academic task, making it more interesting. METHOD: Healthy subjects (N=16) underwent positron emission tomography with [(11)C]raclopride (dopamine D(2) receptor radioligand that competes with endogenous dopamine for binding) to assess the effects of oral methylphenidate (20 mg) on extracellular dopamine in the striatum. The authors compared the effects of methylphenidate during an academic task (solving mathematical problems with monetary reinforcement) and a neutral task (passively viewing cards with no remuneration). In parallel, the effects of methylphenidate on the interest that the academic task elicited were also evaluated. RESULTS: Methylphenidate, when coupled with the mathematical task, significantly increased extracellular dopamine, but this did not occur when coupled with the neutral task. The mathematical task did not increase dopamine when coupled with placebo. Subjective reports about interest and motivation in the mathematical task were greater with methylphenidate than with placebo and were associated with dopamine increases. CONCLUSIONS: The significant association between methylphenidate-induced dopamine increases and the interest and motivation for the task confirms the prediction that methylphenidate enhances the saliency of an event by increasing dopamine. The enhanced interest for the task could increase attention and improve performance and could be one of the mechanisms underlying methylphenidate's therapeutic effects. These findings support educational strategies that make schoolwork more interesting as nonpharmacological interventions to treat ADHD.
Assuntos
Encéfalo/metabolismo , Estimulantes do Sistema Nervoso Central/farmacologia , Dopamina/metabolismo , Matemática , Glicoproteínas de Membrana , Metilfenidato/farmacologia , Resolução de Problemas/efeitos dos fármacos , Adulto , Atenção/efeitos dos fármacos , Atenção/fisiologia , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Encéfalo/diagnóstico por imagem , Encéfalo/efeitos dos fármacos , Cerebelo/diagnóstico por imagem , Cerebelo/efeitos dos fármacos , Cerebelo/metabolismo , Corpo Estriado/diagnóstico por imagem , Corpo Estriado/efeitos dos fármacos , Corpo Estriado/metabolismo , Dopamina/fisiologia , Proteínas da Membrana Plasmática de Transporte de Dopamina , Feminino , Humanos , Masculino , Moduladores de Transporte de Membrana , Proteínas de Membrana Transportadoras/antagonistas & inibidores , Motivação , Proteínas do Tecido Nervoso/antagonistas & inibidores , Placebos , Resolução de Problemas/fisiologia , Racloprida , Recompensa , Análise e Desempenho de Tarefas , Tomografia Computadorizada de EmissãoRESUMO
The clinical efficacy of a recombinant feline interferon, rFeIFN-omega, was evaluated for the treatment of cats presented with clinical signs associated with feline leukemia virus (FeLV) infection and FeLV/feline immunodeficiency virus (FIV) coinfection in the field. In this multicentric, double-blind, placebo-controlled trial, 81 cats meeting the inclusion criteria were randomly placed into 2 groups and treated subcutaneously with rFelFN-omega (1 million [M]U/kg per day) or placebo once daily for 5 consecutive days in 3 series (day 0, 14, 60). The cats were monitored for up to 1 year for clinical signs and mortality. During the initial 4-month period, interferon (IFN)-treated cats (n = 39) had significantly reduced clinical scores compared with placebo (n = 42), with all cats having received concomitant supportive therapies. Compared with the control, the IFN-treated group showed significantly lower rates of mortality: 39% versus 59% (1.7-fold higher risk of death for controls) at the 9-month time point and 47% versus 59% (1.4-fold higher risk of death for controls) at the 12-month time point. The IFN treatment was associated with minor but consistent improvement in abnormal hematologic parameters (red blood cell count, packed cell volume, and white blood cell count), apparently underlying the positive effects of IFN on clinical parameters. These data demonstrate that rFeIFN-omega initially has statistically significant therapeutic effects on clinical signs and later on survival of cats with clinical signs associated with FeLV infection and FeLV/FIV coinfection.
Assuntos
Doenças do Gato/tratamento farmacológico , Síndrome de Imunodeficiência Adquirida Felina/tratamento farmacológico , Interferon Tipo I/uso terapêutico , Leucemia Felina/tratamento farmacológico , Animais , Doenças do Gato/mortalidade , Doenças do Gato/virologia , Gatos , Esquema de Medicação , Síndrome de Imunodeficiência Adquirida Felina/complicações , Feminino , Vírus da Imunodeficiência Felina/isolamento & purificação , Injeções Subcutâneas , Interferon Tipo I/administração & dosagem , Vírus da Leucemia Felina/isolamento & purificação , Leucemia Felina/complicações , Contagem de Leucócitos/veterinária , Masculino , Análise de Sobrevida , Resultado do TratamentoRESUMO
Moderate doses of alcohol decrease glucose metabolism in the human brain, which has been interpreted to reflect alcohol-induced decreases in brain activity. Here, we measure the effects of two relatively low doses of alcohol (0.25 g/kg and 0.5 g/kg, or 5 to 10 mM in total body H2O) on glucose metabolism in the human brain. Twenty healthy control subjects were tested using positron emission tomography (PET) and FDG after placebo and after acute oral administration of either 0.25 g/kg, or 0.5 g/kg of alcohol, administered over 40 min. Both doses of alcohol significantly decreased whole-brain glucose metabolism (10% and 23% respectively). The responses differed between doses; whereas the 0.25 g/kg dose predominantly reduced metabolism in cortical regions, the 0.5 g/kg dose reduced metabolism in cortical as well as subcortical regions (i.e. cerebellum, mesencephalon, basal ganglia and thalamus). These doses of alcohol did not significantly change the scores in cognitive performance, which contrasts with our previous results showing that a 13% reduction in brain metabolism by lorazepam was associated with significant impairment in performance on the same battery of cognitive tests. This seemingly paradoxical finding raises the possibility that the large brain metabolic decrements during alcohol intoxication could reflect a shift in the substrate for energy utilization, particularly in light of new evidence that blood-borne acetate, which is markedly increased during intoxication, is a substrate for energy production by the brain.
Assuntos
Química Encefálica/efeitos dos fármacos , Depressores do Sistema Nervoso Central/farmacologia , Etanol/farmacologia , Glucose/metabolismo , Adulto , Anestésicos/farmacologia , Comportamento/efeitos dos fármacos , Encéfalo/diagnóstico por imagem , Depressores do Sistema Nervoso Central/sangue , Cognição/efeitos dos fármacos , Relação Dose-Resposta a Droga , Metabolismo Energético/efeitos dos fármacos , Etanol/sangue , Feminino , Fluordesoxiglucose F18 , Humanos , Hipnóticos e Sedativos/farmacologia , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Tomografia por Emissão de Pósitrons , Compostos RadiofarmacêuticosRESUMO
Methylphenidate (Ritalin) is an effective drug in the treatment of attention deficit hyperactivity disorder. However, the doses required therapeutically vary significantly between subjects and it is not understood what determines these differences. Since methylphenidate's therapeutic effects are in part due to increases in extracellular DA secondary to blockade of dopamine transporters (DAT), the variability could reflect differences in levels of DAT blockade. Here we used PET to assess if for a given dose of methylphenidate the differences in DAT blockade account for the variability in methylphenidate-induced increases in extracellular DA. Ten healthy adult subjects were tested before and 60 min after oral methylphenidate (60 mg) with PET to estimate DAT occupancy (with [(11)C]cocaine as the radioligand) and levels of extracellular DA (with [(11)C]raclopride as the D2 receptor radioligand that competes with endogenous DA for binding to the receptor). Methylphenidate significantly blocked DAT (60 +/- 11%) and increased extracellular DA in brain (16 +/- 8% reduction in [(11)C]raclopride binding in striatum). However, the correlation between methylphenidate-induced DAT blockade and DA increases was not significant. These results indicate that for a given dose of methylphenidate, individual differences in DAT blockade are not the main source for the intersubject variability in MP-induced increases in DA. This finding suggests that individual differences in response to MP are due in part to individual differences in DA release, so that for an equivalent level of DAT blockade, MP would induce smaller DA changes in subjects with low than with high DA cell activity.
Assuntos
Encéfalo/efeitos dos fármacos , Inibidores da Captação de Dopamina/farmacologia , Dopamina/metabolismo , Espaço Extracelular/efeitos dos fármacos , Glicoproteínas de Membrana , Moduladores de Transporte de Membrana , Proteínas de Membrana Transportadoras/antagonistas & inibidores , Metilfenidato/farmacologia , Proteínas do Tecido Nervoso , Neurônios/efeitos dos fármacos , Racloprida/metabolismo , Regulação para Cima/efeitos dos fármacos , Administração Oral , Adulto , Fatores Etários , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/metabolismo , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Comportamento/efeitos dos fármacos , Comportamento/fisiologia , Encéfalo/diagnóstico por imagem , Radioisótopos de Carbono/metabolismo , Fenômenos Fisiológicos Cardiovasculares/efeitos dos fármacos , Cocaína/metabolismo , Antagonistas de Dopamina/metabolismo , Proteínas da Membrana Plasmática de Transporte de Dopamina , Espaço Extracelular/metabolismo , Humanos , Masculino , Proteínas de Membrana Transportadoras/metabolismo , Metilfenidato/sangue , Neostriado/diagnóstico por imagem , Neostriado/efeitos dos fármacos , Neurônios/metabolismo , Tomografia Computadorizada de Emissão , Regulação para Cima/fisiologiaRESUMO
OBJECTIVE: Eating behavior in humans is influenced by variables other than just hunger-satiety including cognitive restraint, emotional distress, and sensitivity to food stimuli. We investigate the role of dopamine (DA), a neurotransmitter involved with food motivation, in these variables. METHODS: We used the Dutch Eating Behavior Questionnaire (DEBQ) to measure Restraint, Emotionality, and Externality in 10 subjects. We correlated DEBQ scores with brain DA levels. Positron emission tomography and [(11)C]raclopride uptake were used to measure baseline D(2) receptors (neutral stimulation) and to assess changes in extracellular DA to food stimulation (display of food). RESULTS: Restraint was correlated with DA changes with food stimulation (higher restraint, greater responsivity), emotionality was negatively correlated with baseline D(2) receptors (higher emotionality, lower D(2) receptors), whereas externality was not. These correlations were significant in the dorsal but not in the ventral striatum. DISCUSSION: These results provide evidence that DA in the dorsal striatum is involved with the restraint and emotionality components regulating eating behavior and that these two dimensions reflect different neurobiologic processes.