RESUMO
BACKGROUND: Prolactin (PRL) is a protein hormone secreted by the anterior pituitary gland that regulates pituitary hormones. Hyperprolactinemia (HPRL), a pathological phenomenon of excessive PRL, can cause infertility in severe cases and is currently treated mainly with Western drugs, such as bromocriptine, a dopamine agonist (DA). Unfortunately, DAs produce psychological side effects which limit their long-term use. Traditional Chinese medicine (TCM) has minimal side effects and good results spanning many years of research. The combined treatment of TCM and Western medicine may enhance treatment efficacy and improve the long-term prognosis in HPRL. To analyze the effects of Bu-shen-zhu-yun decoction (BSZY-D) combined with bromocriptine on serum hormones, anxiety, and pregnancy in hyperprolactinemic infertile patients. METHODS: One hundred patients diagnosed with HPRL infertility from June 2020 to June 2021 in the gynecology clinic of Jiangsu Provincial Hospital of Traditional Chinese Medicine were selected and grouped by envelope method. After excluding patients who withdrew or missed visits, 37 cases assigned to the control group were treated with bromocriptine, and 40 cases assigned to the observation group were treated with bromocriptine combined with BSZY-D. The patients' PRL and kisspeptin (KP) serum indexes, improvements in infertility, Anxiety Self-Assessment Scale (SAS) scores, and improvements in the Insomnia Severity Index Scale (ISI) scores were compared between the two groups. RESULTS: At 3 and 6 months of treatment, serum PRL, SAS, and ISI scores were significantly lower, and serum KP was significantly higher in the observation group than in the control group (P<0.05). During the study period, the pregnancy rates were 62.50% (25/40) and 37.84% (14/37) in the observation and control groups, respectively. The observation group also had significantly fewer early miscarriages [10.00% (4/40) vs. 32.43% (12/37)] and less adverse reactions [7.50% (3/40) vs. 24.32% (9/37)] than the control group (all P<0.05). CONCLUSIONS: The combination of bromocriptine with BSZY-D was superior to bromocriptine alone in treating HPRL and HPRL-related infertility, which also demonstrated a positive effect on patients' sleep and low mood.
Assuntos
Bromocriptina , Medicamentos de Ervas Chinesas/uso terapêutico , Hiperprolactinemia , Infertilidade Feminina , Taxa de Gravidez , Ansiedade , Bromocriptina/uso terapêutico , Feminino , Humanos , Hiperprolactinemia/tratamento farmacológico , Kisspeptinas/sangue , Gravidez , Prolactina/sangue , SonoAssuntos
Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hemoglobinas Glicadas/metabolismo , Hipoglicemiantes/uso terapêutico , Acarbose/uso terapêutico , Bromocriptina/uso terapêutico , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/prevenção & controle , Cloridrato de Colesevelam/uso terapêutico , Inibidores da Dipeptidil Peptidase IV/uso terapêutico , Humanos , Hipoglicemiantes/classificação , Metformina/uso terapêutico , Compostos de Sulfonilureia/uso terapêutico , Tiazolidinedionas/uso terapêutico , Resultado do TratamentoRESUMO
Background: In recent years, nanotechnology with modern advances in the macromolecular design of nano-carriers has proved to be helpful in the development of drugs delivery systems. This research represents a novel co-administration of nano-vehicles, known as liposomes. Liposomes efficiently encapsulate curcumin and bromocriptine (BR) in a polymer structure, which results in enhanced aqueous solubility of the mentioned hydrophobic agents and higher bioavailability of the drugs. Methods: Preparation of curcumin and BR liposomes were carried out by the thin film method, and the amounts of purified drug and its release were analyzed. After dose determination, the human lung cancer cells (QU-DB) were exposed to BR and curcumin liposomes for 12, 24, and 48 h. Then the viability and apoptosis assays were carried out by using tetrazolium dye and flow cytometry technique, respectively. Results: In this research, in vitro anti-cancer effects of former nano-formulations on lung cancer cells was confirmed, and no cytotoxicity effects of these nano-preparations were observed in the normal cells (HFLF-PI5). Discussion: Our findings suggest the nano-liposomal drugs as effective anti-cancer agents; however, additional clinical examinations are required.
Assuntos
Apoptose , Bromocriptina/administração & dosagem , Bromocriptina/uso terapêutico , Curcumina/administração & dosagem , Curcumina/uso terapêutico , Sistemas de Liberação de Medicamentos , Neoplasias Pulmonares/tratamento farmacológico , Nanopartículas/química , Apoptose/efeitos dos fármacos , Bromocriptina/farmacologia , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Curcumina/farmacologia , Liberação Controlada de Fármacos , Humanos , Lipossomos , Neoplasias Pulmonares/patologia , Tamanho da PartículaRESUMO
Catatonia is associated with psychomotor symptoms and severe disturbances of executive functioning. While the prognosis is good in most cases, malignant catatonia still continues to occur. The first-line choice for drug therapy is lorazepam, which usually results in a good response. In catatonic stupor, i.e. immobility and stupor, the first-line therapy is electrotherapy, preferably at an earliest possible stage. In mania, catatonia may become manifest also as psychomotor excitement. Electrotherapy can be used primarily in malignant catatonia, with dantrolene and bromocriptin also finding use in a critical situation.
Assuntos
Catatonia/terapia , Anticonvulsivantes/uso terapêutico , Antiparkinsonianos/uso terapêutico , Bromocriptina/uso terapêutico , Dantroleno/uso terapêutico , Eletroconvulsoterapia , Humanos , Lorazepam/uso terapêutico , Relaxantes Musculares Centrais/uso terapêutico , PrognósticoRESUMO
OBJECTIVE: To observe the therapeutic effect of Qilin Pills combined with bromocriptine on idiopathic hyperprolactinemic (HPRL) oligoasthenospermia. METHODS: We conducted a randomized controlled study on 40 cases of idiopathic HPRL oligoasthenospermia, who were equally assigned to a trial group and a control group to be treated with Qilin Pills (6 g tid) combined with bromocriptine and bromocriptine alone, respectively, both for a course of 12 weeks. Then we observed the changes in the semen volume, sperm concentration, sperm motility and the levels of serum prolactin and testosterone, and compared the therapeutic results between the two groups before and after medication. RESULTS: Compared with the parameters before medication, both the trial and the control group showed significant improvement after treatment in sperm concentration ([11.60 +/- 3.90] x 10(6)/ml vs [28.10 +/- 13.50] x 10(6)/ml and [12.03 +/- 4.10] x 10(6)/ml vs [18.85 +/- 8.50] x 10(6)/ml), the percentage of grade a sperm ([8.75 +/- 6.65]% vs [24.35 +/- 13.25 ]% and [8.70 +/- 6.70] % vs [19.65 +/- 10.05]%), the percentage of grade a + b sperm ( [28.45 +/- 11.35]% vs [45.80 +/- 16.55]% and [27.65 +/- 10.65]% vs [35.66 +/-13.25]%), and sperm motility ([38.22 +/- 16.35]% vs [60.05 +/- 20.65]% and [37.25 +/- 15.75 ]% vs [52.65 +/- 18.25 ]%) (all P<0.01). No significant differences were found in semen volume (P>0.05). The serum prolactin levels were significantly decreased in the trial and control groups ([152.00 +/- 22.32] and [160.45 +/- 26.65] mIU/L), as compared with premedication ([482.25 +/- 65.32] and [477.32 +/- 60.25] mIU/L) (P<0.01), while the serum testosterone levels were remarkably higher ([16.35 +/- 5.52] and [11.15 +/- 4.65] nmol/L) than before treatment ([3.75 +/- 1.10] and [4.05 +/- 1.30] nmol/L) (P<0.01). There were no statistically significant differences in the serum prolactin and testosterone levels between the two groups after treatment (P>0.05). CONCLUSION: Qilin Pills combined with bromocriptine have a significantly better efficacy than bromocriptine alone in the treatment of idiopathic HPRL oligoasthenospermia.
Assuntos
Astenozoospermia/tratamento farmacológico , Bromocriptina/uso terapêutico , Medicamentos de Ervas Chinesas/uso terapêutico , Hiperprolactinemia/tratamento farmacológico , Oligospermia/tratamento farmacológico , Adulto , Astenozoospermia/sangue , Bromocriptina/administração & dosagem , Quimioterapia Combinada , Medicamentos de Ervas Chinesas/administração & dosagem , Humanos , Hiperprolactinemia/sangue , Masculino , Oligospermia/sangue , Fitoterapia , Prolactina/sangue , Adulto JovemRESUMO
OBJECTIVE: To investigate the effect of Compound Xuanju Capsule (CXC) combined with bromocriptine on hyperprolactinemia-induced erectile dysfunction (ED). METHODS: We randomly assigned 46 patients with hyperprolactinemia-induced ED to receive bromocriptine (trial group, n = 23) and bromocriptine plus CXC (control group, n = 23), respectively, both for 12 weeks. Then we compared the two groups of patients in erectile function and the levels of serum prolactin and testosterone. RESULTS: After 12 weeks of treatment, the IIEF-5 scores were significantly improved in both the trial and the control groups as compared with the baseline (19.5 +/- 4.1 vs 13.0 +/- 3.8 and 16.4 +/- 3.7 vs 13.7 +/- 3.5, P<0.05), the level of serum prolactin was remarkably decreased ([156.07 +/- 26.31] vs [478.35 +/- 62.28] mIU/L and [164.73 +/- 28.58] vs [445.26 +/- 57.83] mIU/L, P<0.05), while the level of serum testosterone was markedly increased ([15.34 +/- 5.27] vs [3.80 +/- 1.09] nmol/L and [12.02 +/- 2.36] vs [4.07 +/- 1.25] nmol/L, P<0.05). Post-treatment erectile function was significantly better in the trial than in the control group (P<0.05), and the post-treatment serum testosterone level remarkably higher in the former than in the latter (P<0.05), but there was no significant difference in the serum prolactin level after treatment between the two groups (P>0.05). CONCLUSION: The combination of Compound Xuanju Capsule and bromocriptine is highly effective in the treatment of hyperprolactinemia-induced ED, and its effect is even better than that of bromocriptine alone.
Assuntos
Bromocriptina/uso terapêutico , Medicamentos de Ervas Chinesas/uso terapêutico , Disfunção Erétil/tratamento farmacológico , Hiperprolactinemia/tratamento farmacológico , Adulto , Quimioterapia Combinada , Disfunção Erétil/etiologia , Humanos , Hiperprolactinemia/complicações , Masculino , FitoterapiaRESUMO
Introducción. La fatiga es el síntoma más frecuente y el más discapacitante en los pacientes con síndrome pospoliomielitis. Objetivo. Analizar la efectividad de los diversos tratamientos utilizados para mejorar la fatiga en los pacientes con síndrome pospoliomielitis. Materiales y métodos. Revisión sistemática. Se definió una estrategia de búsqueda bibliográfica en Medline (desde 1961), EMBASE (desde 1980), ISI Web of Knowlegde y Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL), AMED (desde enero 1985), IME y Physiotherapy Evidence Database (PEDro) hasta febrero de 2008, definiendo la población (pacientes con síndrome pospoliomielitis) y la intervención (cualquier tratamiento para la fatiga en estos pacientes). Como variables resultado se seleccionaron las diferentes escalas de fatiga y la dimensión fatiga o vitalidad de las escalas de calidad de vida. Se seleccionaron ensayos clínicos. Resultados. Se recuperaron 396 artículos, de los que 23 se analizaron en detalle. Finalmente, se incluyeron 19 en el análisis, con un total de 705 pacientes. Conclusiones. Lamotrigina, bromocriptina, ejercicios aeróbicos y de flexibilidad, hidrocinesiterapia y utilización de ayudas técnicas son los tratamientos que más reducen la fatiga en estos pacientes (AU)
Introduction. Fatigue is the most common symptom and the most disabling in patients with post-polio syndrome. Aim. To analyze the effectiveness of various treatments used to improve fatigue syndrome patients post-polio. Materials and methods. Systematic review. Is defined a bibliographic search strategy in Medline (from 1961), EMBASE (from 1980), ISI Web of Knowlegde and Cochrane Library, Cochrane Central Register of Controlled Trials (CENTRAL), AMED (January 1985), EMI and Physiotherapy Evidence Database (PEDro) until February 2008, the population defined (post-polio syndrome patients) and intervention (any treatment for fatigue in these patients). Outcome were selected as different scales of fatigue and fatigue or vitality dimension scales quality of life. Clinical trials were selected. Results. We retrieved 396 articles, of which 23 were analyzed in detail. Finally, 19 were included in the analysis, a total of 705 patients. Conclusions. Lamotrigine, bromocriptine, aerobics and flexibility exercises, hydrokinesitherapy and technical aids are treatment techniques that reduce more fatigue in these patients (AU)
Assuntos
Humanos , Fadiga/etiologia , Síndrome Pós-Poliomielite/complicações , Fadiga/terapia , Bromocriptina/uso terapêutico , Terapia por Exercício , HidroterapiaRESUMO
PRIMARY OBJECTIVE: To review the literature regarding techniques used to promote arousal from coma following an acquired brain injury. MAIN OUTCOMES: A literature search of multiple databases (CINAHL, EMBASE, MEDLINE and PsycINFO) and hand searched articles covering the years 1980-2008 was performed. Peer reviewed articles were assessed for methodological quality using the PEDro scoring system for randomized controlled trials and the Downs and Black tool for RCTs and non-randomized trials. Levels of evidence were assigned and recommendations were made. RESULTS: Research into coma arousal has generally focused on the stimulation of neural pathways responsible for arousal. These pathways have been targeted using pharmacological and non-pharmacological techniques. This review reports the evidence surrounding agents targeting dopamine pathways (amantadine, bromocriptine and levodopa), sensory stimulation, music therapy and median nerve electrical stimulation. Each of these interventions has shown some degree of benefit in improving consciousness, but further research is necessary. CONCLUSIONS: Despite numerous studies, strong evidence was only found for one intervention (Amantadine use in children) and this was based on a single study. However, each of the interventions showed promise in some aspect of arousal and warrant further study. More methodologically rigorous study is needed before any definitive conclusions can be drawn.
Assuntos
Nível de Alerta/fisiologia , Lesões Encefálicas/terapia , Coma Pós-Traumatismo da Cabeça/terapia , Recuperação de Função Fisiológica , Amantadina/uso terapêutico , Nível de Alerta/efeitos dos fármacos , Lesões Encefálicas/fisiopatologia , Bromocriptina/uso terapêutico , Coma Pós-Traumatismo da Cabeça/fisiopatologia , Agonistas de Dopamina/uso terapêutico , Medicina Baseada em Evidências , Humanos , Levodopa/uso terapêutico , Musicoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Recuperação de Função Fisiológica/efeitos dos fármacos , Recuperação de Função Fisiológica/fisiologiaRESUMO
Mastalgia é um dos sintomas mais comuns em mulheres, tendo uma prevalência de 41 a 69% e pode se apresentar como um leve desconforto até dor severa, que interfere na qualidade de vida. A principal preocupação das pacientes que consultam por este sintoma é o medo do câncer. Essa é classificada em mastalgia cíclica, acíclica ou extramamária. Cíclica quando se apresenta no período pré-menstrual; na acíclica não há relação com o ciclo e, geralmente, acomete pacientes na pós-menopausa. A extramamária é a dor referida na mama, porém usualmente é de origem musculoesquelética. Na presença de achados clínicos e radiológicos normais, aproximadamente 85% das pacientes melhoram apenas com orientação e tranquilização, não necessitando de medicação. Foi realizada uma revisão sistemática para avaliar as possibilidades terapêuticas e seus níveis de evidência. Os anti-inflamatórios não esteróides tópico, para mastalgia cíclica ou acíclica, e o fitoterâpico Agnus castus, para mastalgia cíclica, demonstraram boa eficácia e tolerabilidade e podem ser usados como medida inicial. O tamoxifeno e o danazol são medicamentos eficazes, porém apresentam mais efeitos colaterais. Para casos especiais, ainda há a alternativa de usar bromocriptina e goserelina. O manejo da dor mamária pode ser sintetizado em três itens: excluir câncer, orientar e tranquilizar ao máximo e medicar ao mínimo.(AU)
Breast pain or mastalgia is one of the most common symptoms in women, with a prevalence ranging from 41 to 69%. It presents as a mild discomfort to severe pain, that interferes with the quality of life. The main concern of patients consulting for this symptom is the fear of cancer. It is classified as cyclical, acyclical or extra-mammary. When presented during the premenstrual period, it is cyclical; acyclical, when not cycle-related and usually affects patients in post-menopausal. Extra-mammary is the breast referred pain, but it is usually of muscle-skeptical origin. In the presence of normal clinical and radiological findings, approximately 85% of patients improve only with reassurance, not requiring medication. A systematic review was performed to assess the therapeutic possibilities and their evidence levels. Topical non-steroidal anti-inflammatory drugs, for cyclic or acyclic mastalgia, and the phytotherapic Agnus castus, for cyclic mastalgia, showed good efficacy and tolerability and can be used as an initial measure. Tamoxifen and danazol are effective drugs, but they present more side effects. For special cases, there is the alternative of using bromocriptin and goserelin. Breast pain management can be summarized in three items: exclude cancer, maximum reassurance and minimum medication.(AU)
Assuntos
Humanos , Feminino , Mastodinia/classificação , Mastodinia/diagnóstico , Mastodinia/etiologia , Mastodinia/tratamento farmacológico , Literatura de Revisão como Assunto , Anti-Inflamatórios não Esteroides/uso terapêutico , Bases de Dados Bibliográficas , Gosserrelina/efeitos adversos , Gosserrelina/uso terapêutico , Primula , Agnus castus/uso terapêutico , Bromocriptina/efeitos adversos , Bromocriptina/uso terapêutico , Danazol/efeitos adversos , Danazol/uso terapêutico , Medição da Dor , Tamoxifeno/efeitos adversos , Tamoxifeno/uso terapêuticoRESUMO
Hyperprolactinemia is a common adverse effect that occurs as a result of antipsychotic therapies, which often results in discontinuation. Empirical evidence has shown that some herbal medicines have suppressive effects on prolactin (PRL) hyperactivities. This study was designed to compare the herbal preparation called Peony-Glycyrrhiza Decoction (PGD) with bromocriptine (BMT), a dopamine agonist widely used for PRL-secreting disorders, in the treatment of risperidone-induced hyperprolactinemia. Twenty schizophrenic women who were under risperidone maintenance treatment, diagnosed with hyperprolactinemia (serum PRL levels >50 mug/L), and currently experiencing oligomenorrhea or amenorrhea were selected for the study. Subjects were randomized to additional treatment with PGD (45 g/d) followed by BMT (5 mg/d) or BMT followed by PGD at the same doses for 4 weeks each, with an interval of 4-week washout period between 2 treatment sessions. The severity of psychotic symptoms, adverse events, serum PRL, estradiol, testosterone, and progesterone levels were examined at baseline and end point. Peony-Glycyrrhiza Decoction treatment produced a significant baseline-end point decrease in serum PRL levels, without exacerbating psychosis and changing other hormones, and the decreased amplitudes were similar to those of BMT (24% vs 21%-38%). Moreover, there was a significantly greater proportion of patients during PGD treatment than BMT treatment showing improvements on adverse effects associated with hyperprolactinemia (56% vs 17%, P = 0.037). These results suggest that the herbal therapy can yield additional benefits while having comparable efficacy in treating antipsychotic-induced hyperprolactinemia in individuals with schizophrenia.
Assuntos
Antipsicóticos/toxicidade , Bromocriptina/uso terapêutico , Medicamentos de Ervas Chinesas/uso terapêutico , Glycyrrhiza , Hiperprolactinemia/induzido quimicamente , Hiperprolactinemia/tratamento farmacológico , Paeonia , Fitoterapia , Extratos Vegetais/uso terapêutico , Risperidona/toxicidade , Esquizofrenia/tratamento farmacológico , Adulto , Amenorreia/sangue , Amenorreia/induzido quimicamente , Amenorreia/tratamento farmacológico , Antipsicóticos/uso terapêutico , Quimioterapia Combinada , Estradiol/sangue , Feminino , Humanos , Hiperprolactinemia/sangue , Oligomenorreia/sangue , Oligomenorreia/induzido quimicamente , Oligomenorreia/tratamento farmacológico , Progesterona/sangue , Prolactina/sangue , Risperidona/uso terapêutico , Esquizofrenia/sangue , Testosterona/sangueRESUMO
One of the successful treatments for cyclical mastalgia is bromocriptine evening primrose combination. A double blind study was applied on 80 patients with cyclical mastalgia. They were randomly divided into two groups (A and B). In group A, patients were treated by bromocriptine/evening primrose. To group B, LILT with specified dosimetry was applied, using a device that delivers He-Ne laser combined with 4 infra-red diode laser. Evaluation of treatment was both subjective (using VAS) and objective (studying the degree of drop in plasma cortisol level). The drop of plasma cortisol with treatment was studied using the student -t distribution. A good response was observed in the laser group in 82.5%, compared to 63.9% in the bromocriptine/evening primrose group. There was a significant deference before and after treatment in both groups (P<0.05). This difference was more for the drug treated group than for the laser treated group, but in the latter, it acted on a wider sector of patients. In conclusion, LILT is recommended as a new treatment modality for cyclical mastalgia.
Assuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Doenças Mamárias/tratamento farmacológico , Doenças Mamárias/radioterapia , Bromocriptina/uso terapêutico , Ácidos Linoleicos/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Óleos de Plantas/uso terapêutico , Ácido gama-Linolênico/uso terapêutico , Adulto , Anti-Inflamatórios não Esteroides/administração & dosagem , Bromocriptina/administração & dosagem , Bromocriptina/efeitos adversos , Método Duplo-Cego , Quimioterapia Combinada , Egito , Feminino , Humanos , Hidrocortisona/sangue , Ácidos Linoleicos/administração & dosagem , Oenothera biennis , Medição da Dor , Óleos de Plantas/administração & dosagem , Ácido gama-Linolênico/administração & dosagemRESUMO
Several agents have been utilised for therapy of mastalgia based on data from small trials. No meta-analysis of trials on mastalgia exists. We have conducted a meta-analysis on trials on mastalgia published in the English language. Study was restricted to randomised controlled trials comparing Bromocriptine, Danazol, Evening primrose oil (EPO) and Tamoxifen with placebo. The analysis was carried out on the REVMAN statistical package. Weighted mean difference in the pain score in favour of Bromocriptine was -16.31(95% CI -26.35 to -6.27). Danazol produced a significant benefit with a mean pain score difference -20.23(95% CI -28.12 to -12.34). EPO did not offer any advantage over placebo in pain relief, mean pain score difference being -2.78 (95% CI -7.97 to 2.40). Tamoxifen achieved a relative risk (RR) of pain relief of 1.92 (95% CI 1.42-2.58). Tamoxifen is associated with least side effects and should be the drug of first choice.
Assuntos
Doenças Mamárias/tratamento farmacológico , Antagonistas de Estrogênios/uso terapêutico , Dor/tratamento farmacológico , Moduladores Seletivos de Receptor Estrogênico/uso terapêutico , Bromocriptina/uso terapêutico , Danazol/uso terapêutico , Feminino , Humanos , Medição da Dor , Fitoterapia , Óleos de Plantas/uso terapêutico , Primula , Ensaios Clínicos Controlados Aleatórios como Assunto , Tamoxifeno/uso terapêuticoRESUMO
The present study has been designed to evaluate the combined effect of bromocriptine (BRC) and Hypericum perforatum extract (HPE) on 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced Parkinson's disease in male Swiss Albino mice, which were randomly divided into seven groups of six animals each. Group I served as control. Groups II and III were given 300 mg/kg HPE (po) and 10 mg/kg BRC (i.p.) respectively, once daily for 7 days. The four doses of MPTP (20 mg/kg) were administered intraperitoneally with an interval of 2 h to the groups IV, V, VI and VII. The drug treatment was given to fifth group (10 mg/kg BRC; i.p), sixth group (300 mg/kg HPE; po) and seventh group (300 mg/kg HPE; po and 10 mg/kg BRC; i.p.) once in a day for 7 days and the dose on the first day was given 30 min prior to first MPTP injection. The rotarod test, hang test and forepaw stride length revealed significant improvement by the combined treatment. Dopamine and DOPAC levels were significantly improved (p<0.05). There was a significant reduction in lipid peroxidation after the combined treatment (p<0.05) and the antioxidant status was improved. These findings suggest that the combined effect of BRC and HPE was more pronounced than BRC or HPE alone. So it is concluded that the combined treatment might be preferable to either BRC (or) HPE alone in the effective clinical management of Parkinson's disease.
Assuntos
Antiparkinsonianos/uso terapêutico , Bromocriptina/uso terapêutico , Agonistas de Dopamina/uso terapêutico , Hypericum , Intoxicação por MPTP/prevenção & controle , Fármacos Neuroprotetores/uso terapêutico , Transtornos Parkinsonianos/prevenção & controle , Fitoterapia , Extratos Vegetais/uso terapêutico , Ácido 3,4-Di-Hidroxifenilacético/análise , Animais , Antiparkinsonianos/administração & dosagem , Ataxia/etiologia , Ataxia/prevenção & controle , Bromocriptina/administração & dosagem , Catalase/análise , Corpo Estriado/química , Dopamina/análise , Agonistas de Dopamina/administração & dosagem , Avaliação Pré-Clínica de Medicamentos , Sinergismo Farmacológico , Quimioterapia Combinada , Glutationa/análise , Glutationa Peroxidase/análise , Força da Mão , Peroxidação de Lipídeos , Locomoção/efeitos dos fármacos , Masculino , Camundongos , Debilidade Muscular/etiologia , Debilidade Muscular/prevenção & controle , Fármacos Neuroprotetores/administração & dosagem , Extratos Vegetais/administração & dosagem , Superóxido Dismutase/análiseRESUMO
INTRODUCTION: Ropinirole is a non-ergot dopaminergic agonist with a high affinity for D2 dopaminergic receptors which improves the symptoms of Parkinson's disease (PD) and delays the appearance of motor complications. It is different to the first generation of dopaminergic agonists in that, because it lacks an ergolinic structure, it does not have the side effects that usually appear with the use of this pharmacological group. DEVELOPMENT: Recent functional neuroimaging studies suggest a possible neuroprotector effect of the drug, although this aspect is still under discussion. The question as to when and how early treatment of PD must be started has been a controversial issue for many years now. Dopaminergic agonists have been used in monotherapy in patients with de novo disease with the intention of deferring treatment with levodopa and, in consequence, postponing the onset of the complications stemming from its use. Ropinirole has been evaluated in different studies both in monotherapy and as adjunctive therapy with levodopa. CONCLUSIONS: In the numerous clinical trials that were carried out, it would seem clear that ropinirole can be administered for years as sole early treatment for PD and that it offers a notable reduction in the appearance of dyskinesias. Given the linear dose-response relation it presents, the drug has a wide "therapeutic window" that allows the dosage to be increased as the disease progresses.
Assuntos
Antiparkinsonianos/uso terapêutico , Indóis/uso terapêutico , Doença de Parkinson/tratamento farmacológico , Antiparkinsonianos/efeitos adversos , Antiparkinsonianos/metabolismo , Bromocriptina/metabolismo , Bromocriptina/uso terapêutico , Ensaios Clínicos como Assunto , Avaliação Pré-Clínica de Medicamentos , Humanos , Indóis/efeitos adversos , Indóis/metabolismo , Fármacos Neuroprotetores/metabolismo , Fármacos Neuroprotetores/uso terapêutico , Doença de Parkinson/fisiopatologia , PlacebosRESUMO
Parkinson's disease (PD) is a chronic and progressive neurological disorder characterized by selective degeneration of dopaminergic neurons (DAergic) in the substantia nigra pars compacta (SNpc) and subsequent decrease in dopamine (DA) levels in the striatum. Although levodopa replacement therapy is initially effective in symptomatic treatment of parkinsonian patients, its effectiveness often declines and various levodopa-related side effects appear after long-term treatment. The disabling side effects of levodopa therapy include motor fluctuations such as the wearing-off or on-off phenomena, dyskinesias and psychiatric symptoms. Nowadays, DA receptor agonists are often regarded as first choice in de novo and young parkinsonian patients to delay the onset of levodopa therapy. In advanced stages of the disease, they are also used as adjunct therapy together with levodopa to retard the development of motor complications. DA receptor agonists mimic the endogenous neurotransmitter, dopamine, and act by direct stimulation of presynaptic (autoreceptors) and postsynaptic DA receptors. Next to their clinical role in treating parkinsonian patients, laboratory studies reported antioxidative and neuron-rescuing effects of DA receptor agonists either in vivo or in vitro. This may involve reduced DA turnover following autoreceptor stimulation and direct free radical scavenging activity. In this review, we focus on and summarize the recently reported effects of the most commonly used DA agonists either in clinical or in research studies relevant to PD treatment.
Assuntos
Antioxidantes/uso terapêutico , Antiparkinsonianos/uso terapêutico , Agonistas de Dopamina/uso terapêutico , Fármacos Neuroprotetores/uso terapêutico , Doença de Parkinson/tratamento farmacológico , Animais , Antioxidantes/farmacologia , Antiparkinsonianos/efeitos adversos , Antiparkinsonianos/farmacologia , Benzotiazóis , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Bromocriptina/farmacologia , Bromocriptina/uso terapêutico , Ensaios Clínicos como Assunto , Dopamina/metabolismo , Agonistas de Dopamina/efeitos adversos , Avaliação Pré-Clínica de Medicamentos , Radicais Livres/metabolismo , Humanos , Indóis/farmacologia , Indóis/uso terapêutico , Levodopa/efeitos adversos , Neurônios/efeitos dos fármacos , Neurônios/metabolismo , Fármacos Neuroprotetores/farmacologia , Doença de Parkinson/metabolismo , Pergolida/farmacologia , Pergolida/uso terapêutico , Pramipexol , Receptores Dopaminérgicos/efeitos dos fármacos , Receptores Dopaminérgicos/metabolismo , Tiazóis/farmacologia , Tiazóis/uso terapêuticoRESUMO
A case with common variable immunodeficiency associated to hyperprolactinaemia and severe damage of mucosal defenses is reported, in which humoral and cellular response was widely explored. The impact of the cytokines therapy was analyzed as complementary schedule to the conventional therapy with gammaglobuline. Immune response to the treatment was long-time evaluated in relation with therapeutic interventions. Combination of alpha 2 b-IFN, thymic factors, gammaglobuline and GM-CSF was a good alternative to treat complicated common variable immunodeficiency.
Assuntos
Adjuvantes Imunológicos/uso terapêutico , Imunodeficiência de Variável Comum/tratamento farmacológico , Fator Estimulador de Colônias de Granulócitos e Macrófagos/uso terapêutico , Hiperprolactinemia/complicações , Interferon-alfa/uso terapêutico , Ácido Pirrolidonocarboxílico/análogos & derivados , Ácido Pirrolidonocarboxílico/uso terapêutico , Tiazóis/uso terapêutico , Fator de Transferência/uso terapêutico , gama-Globulinas/uso terapêutico , 2-Piridinilmetilsulfinilbenzimidazóis , Adulto , Antibacterianos/uso terapêutico , Benzimidazóis/uso terapêutico , Bromocriptina/uso terapêutico , Imunodeficiência de Variável Comum/complicações , Quimioterapia Combinada , Feminino , Humanos , Hiperprolactinemia/tratamento farmacológico , Interferon alfa-2 , Mesalamina/uso terapêutico , Omeprazol/análogos & derivados , Rabeprazol , Ranitidina/uso terapêutico , Proteínas Recombinantes , Tiazolidinas , Vitaminas/uso terapêuticoRESUMO
Previous studies have been shown that the adrenergic system involves in gastric secretion and pathogenesis of peptic lesion and activation of alpha(2)-adrenoceptors located on the vagus nerve inhibits gastric acid secretion. Bromocriptine, a dopamine receptor agonist, also has alpha(2) agonistic effect and prevents indomethacin-induced gastric ulcer. alpha(2)-Adrenoceptors involve in the release of nitric oxide which has cytoprotective activity in gastric mucosa. Cyclosporin A (CsA) has also been suppressed stress-induced gastric mucosal lesions, dose dependently. The object of this study was to clarify the interaction between the anti-ulcer effect of bromocriptine (2, 4, 8 mg kg(-1)) or cyclosporin A (5, 10, 20 mg kg(-1)) and nitric oxide. Intraperitoneal injections of bromocriptine and cyclosporin A prevented water immersion stress-induced gastric ulcer in rats. L-Nitro-arginine methyl ester (L-NAME), a nitric oxide synthase inhibitor, increased stress-induced lesions while L-arginine, a precursor of nitric oxide, decreased these lesions. In conclusion, increasing level of nitric oxide by bromocriptine and cyclosporin A may be one of the contributory factors in their protective effects on gastric mucosa.
Assuntos
Bromocriptina/uso terapêutico , Ciclosporina/uso terapêutico , Óxido Nítrico/metabolismo , Úlcera Gástrica/prevenção & controle , Estresse Fisiológico/tratamento farmacológico , Animais , Bromocriptina/farmacologia , Ciclosporina/farmacologia , Citoproteção/efeitos dos fármacos , Citoproteção/fisiologia , Mucosa Gástrica/efeitos dos fármacos , Mucosa Gástrica/metabolismo , Mucosa Gástrica/patologia , Óxido Nítrico/antagonistas & inibidores , Ratos , Úlcera Gástrica/metabolismo , Úlcera Gástrica/patologia , Estresse Fisiológico/metabolismoRESUMO
OBJECTIVE: The purpose of this study was to survey the clinical characteristics, complications, and therapeutic outcome in patients with acromegaly. PATIENTS AND METHODS: The clinical features of 65 patients with acromegaly (31 males, 34 females; mean age: 50+/-2 yr.) who were admitted to Tokyo Women's Medical University between 1990 and 1999 were analyzed retrospectively from medical records. RESULTS: The retrospective analysis revealed that the diagnosis of acromegaly was preceded by approximately 8.1+/-1.1 years of signs and symptoms of the disease. Forty-six of the 65 patients (71%) had macroadenomas, 16 (25%) had microadenomas, and the remaining three had empty sella. The rate of biochemical cure or remission was 81% for microadenoma (13/16), 64% for macroadenoma without extrasellar extension (9/14), and 13% for macroadenoma with cavernous sinus extension (2/15). Eighteen (28%) patients had impaired glucose tolerance (IGT) and 32 (49%) had diabetes mellitus (DM). After treatment for acromegaly, glucose metabolism was analyzed again in 38 patients, and it improved in 26 patients with IGT or DM. Twenty-five of 65 patients (38%) had hypertension. Of 26 patients who underwent barium enema or colonoscopy, 10 had colonic polyps and 4 had colon cancer. CONCLUSION: This study suggests that long-term excessive growth hormone (GH) secretion causes many complications. Therefore, awareness of the early symptoms and signs of acromegaly and long-term careful management of complications, along with therapy to reduce serum GH/insulin-like growth factor (IGF)-I levels, are important for patients with acromegaly.
Assuntos
Acromegalia/diagnóstico , Acromegalia/terapia , Bromocriptina/uso terapêutico , Antagonistas de Hormônios/uso terapêutico , Hormônio do Crescimento Humano/sangue , Fator de Crescimento Insulin-Like I/metabolismo , Acromegalia/epidemiologia , Acromegalia/metabolismo , Adulto , Distribuição por Idade , Idoso , Terapia Combinada , Procedimentos Cirúrgicos Endócrinos , Feminino , Humanos , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Radioterapia Adjuvante , Estudos Retrospectivos , Distribuição por Sexo , Tóquio/epidemiologia , Resultado do TratamentoRESUMO
The aim of the study was to demonstrate the effects of dopaminergic drugs on 2,4-dinitrofluorbenzene (DNFB) induced experimental inflammatory bowel disease (IBD) in previously sensitized BALB/c mice. The number and extent of ulcerations and erosions, the intensity of haemorrhages, oedema, and accumulation of neutrophils and eosinophils within colonic lamina propria and submucosa were scored and statistically evaluated. The 180 BALB/c mice, were allocated into three equal groups. The mice in the first experimental group were treated with domperidone (DP), a peripheral dopamine (DA) antagonist. The mice from the second experimental group were treated with bromocriptine (BC), a dopamine agonist. The mice from the control group were treated with an equivalent volume of normal saline in the same manner. Ten animals from each group were killed on days 1, 2, 3, 5 and 10, subsequent to the challenge enema of DNFB solution. Gross and microscopic examination of the colon was performed. Treatment with BC resulted in clinical improvement and decreased mortality rate by 2 of 60 (3%), while domperidone treatment increased mortality rate to 12 of 60 (20%) compared with the controls [4 of 60 (6%)]. The analysis of the microscopic lesions indicated that the beneficial effects of BC were the result of maintenance of vascular integrity.