ABSTRACT
Despite the well-known adverse health effects of tobacco smoking, numerous studies have shown that nicotine, the principal pharmacologically active alkaloid in tobacco smoke, exerts neuroprotective properties in several animal models of neurodegeneration. Furthermore, cigarette smoking appears to significantly reduce the risk of developing Parkinson's disease in human subjects. We review the animal and human studies that investigated possible neuroprotective actions of nicotine and other nicotinic receptor agonists and antagonists. We demonstrate that nicotine is not neuroprotective in all animal models of neurodegenerative disease. In fact, C57Bl/6 mice pretreated with nicotine have an increased sensitivity to 3-nitropropionic acid, a neurotoxin used in mice to mimic some aspects of Huntington's disease. The actions of nicotine on dopamine release may explain the variable effects of nicotine in animal models of Parkinson's and Huntington's diseases. Finally, we focus on some future directions for studies that evaluate neuroprotective properties of nicotinic agonists and antagonists.
Subject(s)
Brain Diseases/drug therapy , Neuroprotective Agents/therapeutic use , Nicotine/therapeutic use , Receptors, Nicotinic/physiology , Recovery of Function/drug effects , Animals , Brain Diseases/etiology , Disease Models, Animal , Drug Administration Schedule , Humans , Mice , Neuroprotective Agents/pharmacologyABSTRACT
BACKGROUND: Tensilon (edrophonium chloride) is a reversible acetylcholinesterase inhibitor used in the diagnosis of myasthenia gravis, diagnosis and treatment of arrhythmias, detection of early digitalis toxicity, reversal of neuromuscular blockade, and other medical conditions. Toxicity associated with Tensilon use has appeared in the literature for decades. REVIEW SUMMARY: This review discusses the risks of Tensilon and the information practitioners should know before administering the drug. We review the literature regarding serious toxicity of this drug and offer recommendations for its safe use. CONCLUSIONS: A careful medication history should be taken before the administration of Tensilon. Additionally, physicians should be aware of appropriate alternative methods of diagnosis before choosing to administer Tensilon. Physicians should be aware of the clinical situations where the Tensilon test no longer is indicated.
