Antipanic-like effect of esketamine and buprenorphine in rats exposed to acute hypoxia.

The antidepressant effect of ketamine has been widely acknowledged and the use of one of its enantiomers, S-ketamine (esketamine), has recently been approved for the clinical management of treatment-resistant depression. As with ketamine, the non-selective opioid receptor-interacting drug buprenorphine is reported to have antidepressant and anxiolytic properties in humans and rodents. Given the fact that antidepressant drugs are also first line treatment for panic disorder, it is surprising that the potential panicolytic effect of these compounds has been scarcely (ketamine), or not yet (buprenorphine) investigated. We here evaluated the effects of ketamine (the racemic mixture), esketamine, and buprenorphine in male Wistar rats submitted to a panicogenic challenge: acute exposure to hypoxia (7% O2). We observed that esketamine (20 mg/kg), but not ketamine, decreased the number of escape attempts made during hypoxia, and this effect could be observed even 7 days after the drug administration. A panicolytic-like effect was also observed with MK801, which like esketamine, antagonizes NMDA glutamate receptors. Buprenorphine (0.3 mg/kg) also impaired hypoxia-induced escape, an effect blocked by the non-selective opioid receptor antagonist naloxone, indicating an interaction with classical ligand sites, such as µ and kappa receptors, but not with nociception/orphanin FQ receptors. Altogether, the results suggest that esketamine and buprenorphine cause rapid-onset panicolytic-like effects, and may be alternatives for treating panic disorder, particularly in patients who are refractory to standard pharmacological treatment.

Effects of the adjunctive treatment of antidepressants with opiorphin on a panic-like defensive response in rats.

BACKGROUND: Antidepressants are the first-choice for pharmacological treatment of panic disorder. However, they present disadvantages, such as delayed therapeutic effect, many side effects and a considerable rate of non-responders. These shortcomings prompt the development of new therapeutic strategies. Among these are the adjunctive use of enkephalinase inhibitors, such as opiorphin, which supposedly acts by increasing the availability of brain enkephalins and other endogenous opioids. AIMS: We here evaluated whether opiorphin in the dorsal periaqueductal grey matter (dPAG), a key panic-related area, accelerates and/or facilitates the antipanic-like effect of fluoxetine or imipramine. We also verified whether the panicolytic effect of imipramine depends on activation of µ-opioid receptors (MORs). METHODS: Male Wistar rats were submitted to the escape task of the elevated T-maze, an index of panic attack, after treatment with imipramine (3, 7 or 21 days) or fluoxetine (3, 7, 14 or 21 days), combined with an intra-dPAG injection of opiorphin. RESULTS: Opiorphin facilitated and accelerated the panicolytic-like effect caused by imipramine, but not with fluoxetine. The antipanic-like effect caused by chronic imipramine did not depend on MOR activation in the dPAG. CONCLUSION: Combined treatment of antidepressant drugs with opiorphin for hastening or potentiating the effects of the former compounds may not be generally effective, with the results varying depending on the type/class of these panicolytic drugs.

B2-kinin receptors in the dorsal periaqueductal gray are implicated in the panicolytic-like effect of opiorphin.

Reported results have shown that the pentapeptide opiorphin inhibits oligopeptidases that degrade brain neuropeptides, and has analgesic and antidepressant effects in experimental animals, without either tolerance or dependency after chronic administration. In a previous study we showed that opiorphin has a panicolytic-like effect in the dorsal periaqueductal gray (dPAG) electrical stimulation test (EST), mediated by the µ-opioid receptor (MOR). This study further analyzes the mechanism of opiorphin panicolytic action, using the EST and drug injection inside the dPAG. The obtained results showed that blockade of the 5-HT1A receptors with WAY-100635 did not change the escape-impairing effect of opiorphin, and combined injection of sub-effective doses of opiorphin and the 5-HT1A-agonist 8-OH-DPAT did not have a significant anti-escape effect. In contrast, the anti-escape effect of opiorphin was antagonized by pretreatment with the kinin B2 receptor blocker HOE-140, and association of sub-effective doses of opiorphin and bradykinin caused a significant anti-escape effect. The anti-escape effect of bradykinin was not affected by previous administration of WAY-100635. Therefore, the anti-escape effect of opiorphin in the dPAG seems to be mediated by endogenous bradykinin, acting on kinin B2 receptors, which previous results have shown to interact synergistically with MOR in the dPAG to restrain escape in two animal models of panic. Chemical compounds: Opiorphin (PubChem CID: 25195667); WAY100635 maleate salt (PubChem CID: 11957721); 8-OH-DPAT hydrobromide (PubChem CID: 6917794); Bradykinin (PubChem CID: 439201); HOE-140 (Icatibant) (PubChem CID: 6918173).

µ-Opioid and 5-HT1A receptors in the dorsomedial hypothalamus interact for the regulation of panic-related defensive responses.

The dorsomedial hypothalamus (DMH) and the dorsal periaqueductal gray (DPAG) have been implicated in the genesis and regulation of panic-related defensive behaviors, such as escape. Previous results point to an interaction between serotonergic and opioidergic systems within the DPAG to inhibit escape, involving µ-opioid and 5-HT1A receptors (5-HT1AR). In the present study we explore this interaction in the DMH, using escape elicited by electrical stimulation of this area as a panic attack index. The obtained results show that intra-DMH administration of the non-selective opioid receptor antagonist naloxone (0.5 nmol) prevented the panicolytic-like effect of a local injection of serotonin (20 nmol). Pretreatment with the selective µ-opioid receptor (MOR) antagonist CTOP (1 nmol) blocked the panicolytic-like effect of the 5-HT1AR agonist 8-OHDPAT (8 nmol). Intra-DMH injection of the selective MOR agonist DAMGO (0.3 nmol) also inhibited escape behavior, and a previous injection of the 5-HT1AR antagonist WAY-100635 (0.37 nmol) counteracted this panicolytic-like effect. These results offer the first evidence that serotonergic and opioidergic systems work together within the DMH to inhibit panic-like behavior through an interaction between µ-opioid and 5-HT1A receptors, as previously described in the DPAG.

Panicolytic-like action of bradykinin in the dorsal periaqueductal gray through µ-opioid and B2-kinin receptors.

A wealth of evidence has shown that opioid and kinin systems may control proximal defense in the dorsal periaqueductal gray matter (dPAG), a critical panic-associated area. Studies with drugs that interfere with serotonin-mediated neurotransmission suggest that the µ-opioid receptor (MOR) synergistically interacts with the 5-HT1A receptor in the dPAG to inhibit escape, a panic-related behavior. A similar inhibitory effect has also been reported after local administration of bradykinin (BK), which is blocked by the non-selective opioid receptor antagonist naloxone. The latter evidence, points to an interaction between BK and opioids in the dPAG. We further explored the existence of this interaction through the dPAG electrical stimulation model of panic. We also investigated whether intra-dPAG injection of captopril, an inhibitor of the angiotensin-converting enzyme (ACE) that also degrades BK, causes a panicolytic-like effect. Our results showed that intra-dPAG injection of BK inhibited escape performance in a dose-dependent way, and this panicolytic-like effect was blocked by the BK type 2 receptor (B2R) antagonist HOE-140, and by the selective MOR antagonist CTOP. Conversely, the panicolytic-like effect caused by local administration of the selective MOR agonist DAMGO was antagonized by pre-treatment with either CTOP or HOE-140, indicating cross-antagonism between MOR and B2R. Finally, intra-dPAG injection of captopril also impaired escape in a dose-dependent way, and this panicolytic-like effect was blocked by pretreatment with HOE-140, suggesting mediation by endogenous BK. The panicolytic-like effect of captopril indicates that the use of ACE inhibitors in the clinical management of panic disorder may be worth exploring.

Participation of dorsal periaqueductal gray 5-HT1A receptors in the panicolytic-like effect of the κ-opioid receptor antagonist Nor-BNI.

Panic patients may have abnormalities in serotonergic and opioidergic neurotransmission. The dorsal periaqueductal gray (dPAG) plays an important role in organizing proximal defense, related to panic attacks. The 5-HT1A receptor (5-HT1A-R) is involved in regulating escape behavior that is organized in the dPAG. Activation of κ-opioid receptor (KOR) in this region causes anxiogenic effects. In this study, we investigated the involvement of KOR in regulating escape behavior, using systemic and intra-dPAG injection of the KOR antagonist Nor-BNI. As panic models, we used the elevated T-maze (ETM) and the dPAG electrical stimulation test (EST). We also evaluated whether activation of the 5-HT1A-R or the µ-opioid receptor (MOR) in the dPAG contributes to the Nor-BNI effects. The results showed that systemic administration of Nor-BNI, either subcutaneously (2.0 and 4.0mg/kg) or intraperitoneally (2.0mg/kg), impaired escape in the EST, indicating a panicolytic-like effect. Intra-dPAG injection of this antagonist (6.8nmol) caused the same effect in the EST and in the ETM. Association of ineffective doses of Nor-BNI and the 5-HT1A-R agonist 8-OH-DPAT caused panicolytic-like effect in these two tests. Previous administration of the 5-HT1A-R antagonist WAY-100635, but not of the MOR antagonist CTOP, blocked the panicolytic-like effect of Nor-BNI. These results indicate that KOR enhances proximal defense in the dPAG through 5-HT1A-R modulation, independently of MOR. Because former results indicate that the 5-HT1A-R is involved in the antipanic action of antidepressants, KOR antagonists may be useful as adjunctive or alternative drug treatment of panic disorder.

Panicolytic-like effect of tramadol is mediated by opioid receptors in the dorsal periaqueductal grey.

Tramadol is a synthetic opioid prescribed for the treatment of moderate to severe pain, acting as agonist of µ-opioid receptors and serotonin (5-HT) and noradrenaline (NE) reuptake inhibitor. This study evaluated the effects of tramadol in rats submitted to the elevated T-maze (ETM), an animal model that evaluates behavioural parameters such as anxiety and panic. Male Wistar rats were intraperitoneally (i.p.) treated acutely with tramadol (16 and 32mg/kg) and were submitted to the ETM. Tramadol (32mg/kg) promoted a panicolytic-like effect. Considering that dorsal periaqueductal grey (dPAG) is the main brain structure related to the pathophysiology of panic disorder (PD), this study also evaluated the participation of 5-HT and opioid receptors located in the dPAG in the panicolytic-like effect of tramadol. Seven days after stereotaxic surgery for implantation of a cannula in the dPAG, the animals were submitted to the test. To assess the involvement of 5-HT1A receptors on the effect of tramadol, we combined the 5-HT1A receptor antagonist, WAY100635 (0.37nmol), microinjected intra-dPAG, 10min prior to the administration of tramadol (32mg/kg, i.p.). WAY100635 did not block the panicolytic-like effect of tramadol. We also associated the non-selective opioid receptor antagonist, naloxone, systemically (1mg/kg, i.p.) or intra-dPAG (0.5nmol) administered 10min prior to tramadol (32mg/kg, i.p.). Naloxone blocked the panicolytic-like effect of tramadol in both routes of administrations, showing that tramadol modulates acute panic defensive behaviours through its interaction with opioid receptors located in the dPAG.

Opiorphin causes a panicolytic-like effect in rat panic models mediated by µ-opioid receptors in the dorsal periaqueductal gray.

Reported evidence indicates that endogenous opioid peptides regulate the expression of escape behavior in rats, a panic-related defensive response, through µ-opioid receptors (MORs) in the dorsal periaqueductal gray (dPAG). These peptides are rapidly catabolized by degrading enzymes, including neutral endopeptidase (NEP) and aminopeptidase N (APN). Opiorphin is a peptide inhibitor of both NEP and APN and potentiates the action of endogenous enkephalins. This study evaluated the effects of intravenous and intra-dPAG administration of opiorphin on escape responses in the elevated T-maze and in a dPAG electrical stimulation test in rats. We also evaluated the involvement of MORs in the effects of opiorphin using the selective MOR antagonist CTOP. A dose of 2.0 mg/kg, i.v., of opiorphin impaired escape performance in both tests. Similar effects were observed with intra-dPAG administration of 5.0 nmol of opiorphin. Local pretreatment with 1.0 nmol CTOP antagonized the anti-escape effects of intra-dPAG opiorphin in both tests, as well as the effect of systemically administered opiorphin (2.0 mg/kg, i.v.) in the electrical stimulation test. These results indicate that opiorphin has an antipanic-like effect that is mediated by MORs in the dPAG. They may open new perspectives for the development of opiorphin analogues with greater bioavailability and physicochemical characteristics in the pursuit of new medications for the treatment of panic disorder.

Pharmacological evidence for the mediation of the panicolytic effect of fluoxetine by dorsal periaqueductal gray matter µ-opioid receptors.

Previously reported results have shown that the inhibitory effect of fluoxetine on escape behavior, interpreted as a panicolytic-like effect, is blocked by pretreatment with either the opioid receptor antagonist naloxone or the 5-HT1A receptor (5-HT1A-R) antagonist WAY100635 via injection into the dorsal periaqueductal gray matter (dPAG). Additionally, reported evidence indicates that the µ-opioid receptor (MOR) interacts with the 5-HT1A-R in the dPAG. In the present work, pretreatment of the dPAG with the selective MOR blocker CTOP antagonized the anti-escape effect of chronic fluoxetine (10 mg/kg, i.p., daily, for 21 days), as measured in the elevated T-maze (ETM) test, indicating mediation of this effect by the MOR. In addition, the combined administration of sub-effective doses of the selective MOR agonist DAMGO (intra-dPAG) and sub-effective doses of chronic as well as subchronic (7 days) fluoxetine increased avoidance and escape latencies, suggesting that the activation of MORs may facilitate and accelerate the effects of fluoxetine. The current observation that MORs located in the dPAG mediate the anti-escape effect of fluoxetine may open new perspectives for the development of more efficient and fast-acting panic-alleviating drugs.

Molecular docking and panicolytic effect of 8-prenylnaringenin in the elevated T-maze.

The purpose of this study was to investigate the effects of the chronic administration of a racemic mixture of 8-prenylnaringenin (8-PN) on rats submitted to the elevated T-maze (ETM) model of generalized anxiety and panic disorders. The selective serotonin (SERT) reuptake inhibitor fluoxetine was used as a positive control. Rat locomotion was assessed in a circular arena following each drug treatment. The administration of racemic 8-PN for 21 d in rats increased one-way escape latencies from the ETM open arm, indicating a panicolytic effect. To evaluate the interactions of 8-PN with monoamine transporters, a docking study was performed for both the R and S configurations of 8-PN towards SERT, norepinephrine (NET) and dopamine transporters (DAT). The application of the docking protocol showed that (R)-8-PN provides greater affinity to all transporters than does the S enantiomer. This result suggests that enantiomer (R)-8-PN is the active form in the in vivo test of the racemic mixture.

Acute and Chronic Toxicity of an Aqueous Fraction of the Stem Bark of Stryphnodendron adstringens (Barbatimão) in Rodents.

Stryphnodendron adstringens has a high tannin content and is used as an antiseptic and antimicrobial and in the treatment of leucorrhea, gonorrhea, wound healing, and gastritis. The present study evaluated the toxic effects of the heptamer prodelphinidin (F2) from the stem bark of S. adstringens in rodents. In the acute toxicity test, the mice that received oral doses exhibited reversible effects, with an LD50 of 3.015 mg · kg(-1). In the chronic toxicity test at 90 days, Wistar rats were treated with different doses of F2 (10, 100, and 200 mg · kg(-1)). In the biochemical, hematological, and histopathological examinations and open-field test, the different dose groups did not exhibit significant differences compared with controls. The present results indicate that F2 from the stem bark of S. adstringens caused no toxicity with acute and chronic oral treatment in rodents at the doses administered.

Serotonin-1A receptors in the dorsal periaqueductal gray matter mediate the panicolytic-like effect of pindolol and paroxetine combination in the elevated T-maze.

The ß-adrenergic blocker and 5-HT(1A) receptor antagonist pindolol has been combined with selective serotonin reuptake inhibitors (SSRIs) in patients with depressive and anxiety disorders to shorten the onset of the clinical action and/or increase the proportion of responders. The results of a previous study have shown that pindolol potentiates the panicolytic effect of paroxetine in rats submitted to the elevated T-maze (ETM). Since reported evidence has implicated the 5-HT(1A) receptors of the dorsal periaqueductal gray matter (DPAG) in the panicolytic effect of antidepressants, rats treated with pindolol (5.0mg/kg, i.p.) and paroxetine (1.5mg/kg, i.p.) received a previous intra-DPAG injection of the selective 5-HT(1A) antagonist, WAY-100635 (0.4 µg) and were submitted to the ETM. Pretreatment with WAY-100635 reversed the increase in escape latency, a panicolytic effect, determined by the pindolol-paroxetine combination. These results implicate the 5-HT(1A) receptors of the DPAG in the panicolytic effect of the pindolol-paroxetine combination administered systemically. They also give further preclinical support for the use of this drug combination in the treatment of panic disorder.

Anxiolytic effects of a semipurified constituent of guaraná seeds on rats in the elevated T-maze test.

The objective of this study was to investigate the effects of chronic administration of a semi-purified extract (Purified Extract A--PEA; 4, 8, or 16 mg/kg) of PAULLINIA CUPANA (guaraná) seeds on rats submitted to the elevated T-maze (ETM) model of generalized anxiety and panic disorders. The selective serotonin (5-HT) reuptake inhibitor (SSRI) paroxetine (PAR; 3 mg/kg), was used as a positive control. To evaluate possible serotonergic and dopaminergic neurotransmission involvement in the action of PEA during the ETM test, ineffective doses of metergoline (MET; 5-HT (2A/2C) antagonist receptor) or sulpiride (SUL; dopaminergic receptor antagonist) were acutely administered together with the PEA. The locomotion of the rats was assessed in a circular arena following each drug treatment. Both PEA (8 and 16 mg/kg) and PAR (3 mg/kg) increased one-way escape latencies from the open arm of the ETM, indicating a panicolytic effect compared to the control group. MET, in higher doses (1, 2 or 3 mg/kg), produced a panicolytic effect in the ETM test, whereas SUL did not (10, 20 or 40 mg/kg). The panicolytic effect produced by PEA (8 mg/kg) was blocked by both MET (2 mg/kg) and SUL (20 mg/kg), whereas the panicolytic effect produced by PAR (3 mg/kg) was blocked only by MET (2 mg/kg). These results show that chronic treatment with PEA produces a panicolytic effect during the ETM test, and that the dopaminergic and the serotonergic neurotransmission systems are involved in this effect.

Preliminary toxicity study of dichloromethane extract of Kielmeyera coriacea stems in mice and rats.

Kielmeyera coriacea Mart. (Clusiaceae), known as "Pau Santo" or "Saco de Boi" in the central Brazilian plateau region, is used to treat several tropical diseases. The present study evaluated the toxic effects of dichloromethane (DcM) extract of Kielmeyera coriacea stems, administered to rodents. In the acute toxicity tests, mice receiving doses of this extract by the oral and intraperitoneal routes, showed reversible effects, with LD50 values of 1503.0 and 538.8 mg/kg, respectively. In the repeated-dose oral (90 days) toxicity tests, male and female Wistar rats were treated by gavage with different doses of DcM extract (5, 25 or 125 mg/kg). In biochemical and haematological evaluations, the results varied widely in respect to dose and sex, with no linear profile, and did not show clinical correlations. In the histopathological examinations, the groups exhibited some changes, but there were no significant differences between the groups compared to the controls. In conclusion, these investigations appeared to indicate the safety of acute and repeated oral administration of the DcM extract of Kielmeyera coriacea stems, which can therefore be continuously used with safety.

Anxiolytic and sedative effects of a combined extract of Passiflora alata Dryander and Valeriana officinalis L. in rats / Efeito ansiolítico e sedativo do extrato combinado de Passiflora alata Dryander e Valeriana officinalis L. em ratos

Este trabalho investigou o efeito do extrato combinado de Passiflora alata Dryander e Valeriana officinalis L. (EPV) em ratos submetidos aos testes do labirinto em cruz elevado (LCE) e campo aberto (TCA). Nenhum efeito foi detectado após o tratamento agudo ou repetido por 3 ou 7 dias com EPV (5, 10 or 20 mg/kg, gavagem) no LCE e TCA. Entretanto, ratos tratados por 15 dias com EPV (20 mg/kg) mostraram aumento na porcentagem de entradas e tempo gasto nos braços abertos no LCE, sem alterar a atividade locomotora no TCA, comparado ao controle. Diazepan (droga de referência, i.p.), aumentou os mesmos parâmetros analisados no LCE e OFT após o tratamento agudo ou por 15 dias. O tratamento agudo com 300 ou 600 mg/kg do EPV diminuiu significativamente a atividade locomotora no TCA. Estes resultados mostram que EPV produz efeito ansiolítico e sedativo, com ampla margem de segurança para o efeito ansiolítico.

This work investigated the effects of a combined extract of Passiflora alata Dryander and Valeriana officinalis L. (EPV) in rats under going elevated plus maze (EPM) and open- test (OFT). No effects were detected after acute or repeated (3 or 7-days) treatment with EPV (5, 10 or 20 mg/kg, by gavage), on the EPM or the OFT. However, rats treated for 15 day (20 mg/kg) with EPV showed increased percentage of entries and time spent in the open arms on the EPM without alter locomotor activity in the OFT compared to control group. Acute or a 15 day administration of diazepam (2 mg/kg, i.p.), increased the same parameters on the EPM and OFT. Acute treatment with 300 or 600 mg/kg of EPV, decreased the locomotor activity in the OFT. Results suggest anxiolytic and sedative effects for the EPV and reveal a wide dose range for the anxiolytic effect.

Effect of crude extract and its semi purified constituents from guaraná seeds [Paullinia cupana var. sorbilis (Mart.) lucke] on cognitive performance in Morris water maze in rats

O efeito do tratamento crônico (gavagem) do extrato bruto liofilizado (EBPC) das sementes da Paullinia cupana, guaraná, e seus constituintes semi-purificados EPA e EPB, sobre o comportamento cognitivo foi estudado em ratos submetidos ao teste do labirinto aquático de Morris. EBPC (30.0 mg/kg) e EPA (2.0 mg/kg), mostraram menor latência para encontrar a plataforma submersa quando comparados ao grupo controle (salina+ tween 80 a 0.2%), em ratos normais ou tratados com escopolamina, o que sugere efeito benéfico sobre a cognição. Estes extratos não alteraram a atividade locomotora no teste do campo aberto. A cafeína, reduziu o tempo de latência para encontrar a plataforma submersa no teste do labirinto aquático de Morris em tratados com escopolamina. Além disso, aumentou o número de cruzamentos no teste do campo aberto, mostrando efeito estimulante. Ratos tratados com EPB não produziram alteração significativa nos testes utilizados. Os animais tratados cronicamente com EBPC, EPA ou EPB tiveram a mesma evolução ponderal e sobrevida o que sugere baixa toxicidade para os extratos.

Evaluation of gastric anti-ulcer activity in a hydro-ethanolic extract from Kielmeyera coriacea

A atividade antiulcerogênica do extrato hidroetanólico de caule de Kielmeyera coriacea Mart. (Guttiferae) foi avaliada em ratos por meio de três modelos experimentais: etanol-ácido, indometacina e estresse agudo. O índice ulcerativo observado após o tratamento com o extrato de Kielmeyera coriacea foi comparado com a droga de referência, cimetidina. O tratamento com o extrato mostrou significante atividade anti-ulcerogênica nos modelos de indução de lesões de mucosa gástrica produzidas por etanol-ácido e indometacina, mas não contra úlcera induzida pelo modelo de estresse agudo. Etanol-ácido e agentes antiinflamatórios, como a indometacina, são compostos que produzem úlcera de mucosa gástrica. Os resultados deste estudo sugerem uma atividade protetora de mucosa gástrica para o extrato de Kielmeyera coriacea.

Activity of hydroethanolic extract from Kielmeyera coriacea stems on central nervous system in rats

O objetivo deste estudo foi investigar as propriedades psicotrópicas do extrato hidroetanólico liofilizado obtido de caule de Kielmeyera coriacea após tratamento agudo ou crônico por via oral (gavagem) em ratos. As atividades ansiolítica, antidepressiva e estimulante de sistema nervoso central, foram avaliadas através da utilização dos testes do labirinto em cruz elevado (LCE), nado forçado (NF) e campo-aberto (TCA), respectivamente. A administração crônica de EH de caule de Kielmeyera coriacea (60.0 mg/kg) produziu redução no tempo de imobilidade no teste do NF, comparável a mipramina (20.0 mg/kg), sem aumentar a atividade locomotora no TCA. A dose de 120.0 mg/kg do mesmo extrato aumentou significativamente a percentagem de entradas nos braços abertos no teste do LCE após administração aguda. Estes resultados mostram que EH de caule de Kielmeyera coriacea apresenta perfil de composto ansiolítico e ntidepressivo

Análise do consumo de drogas antidepressivas na cidade de Umuarama - PR / Analysis of the consumption of antidepressant drugs in Umuarama - PR

O objetivo deste trabalho foi avaliar o padrão de utilização de drogas antidepressivas em farmácias de manipulação, de dispensação e em hospitais psiquiátricos na cidade de Umuarama, durante o período de 01/06/96 a 31/07/97, a partir de dados fornecidos pela 11a Secretaria Regional de Vigilância Sanitária. Verificamos que, em hospitais psiquiátricos e em farmácias de dispensação, imipramina e amitriptilina foram os compostos mais consumidos, enquanto a fluoxetina foi a mais usada em farmácias de manipulação. Entre os compostos encontrados, temos representantes das classes de antidepressivos tricíclicos, inibidores da monoaminooxidase, inibidores seletivos da recaptação de serotonina, antidepressivos atípicos e ainda, sais de lítio. Foram abordadas também questões referentes à duração e à suspensão do tratamento farmacológico, à resistência ao tratamento e ao uso indiscriminado de drogas antidepressivas

Isoenzimas do CYP450 e biotransformação de drogas / Biotransformation of drugs

A administração de uma droga em seres humanos, muitas vezes, gera uma resposta farmacológica inesperada, que pode ser determinada pela concentração plasmática anormal da mesma, podendo produzir, como consequencia, vários efeitos indesejáveis. A avaliação deste fato revela que tais efeitos podem estar diretamente relacionados ao processo de biotransformação. A biotransformação de drogas envolve reações bioquímicas específicas, em que cada etapa conta com a participação de sequências enzimáticas altamente ordenadas. A produção dessas enzimas, por sua vez, é determinada geneticamente através de processos de tradução e transcrição. Uma anormalidade nos genes codificadores da produção enzimática responsável pela biotransformação de drogas pode gerar alterações na resposta terapêutica. Além disso, inúmeras substâncias podem interferir no processo de biotransformação, através da inibição ou da indução de enzimas responsáveis pelo mesmo. 0 propósito deste trabalho é ressaltar a biotransformação como uma das principais etapas farmacocinéticas responsáveis pela atividade terapêutica das drogas e analisar os fatores genéticos que possam interferir neste processo