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[PMID]: 28904237 [Au] Autor: Starr JB; Tirschwell DL; Becker KJ [Ad] Endereço: From the Departments of Anesthesiology and Pain Medicine (J.B.S.) and Neurology (D.L.T., K.J.B.), University of Washington, Seattle. starrj@uw.edu. [Ti] Título: Labetalol Use Is Associated With Increased In-Hospital Infection Compared With Nicardipine Use in Intracerebral Hemorrhage. [So] Source: Stroke;48(10):2693-2698, 2017 Oct. [Is] ISSN: 1524-4628 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND AND PURPOSE: Increased sympathetic tone causes hypertension after intracerebral hemorrhage, and blood pressure reduction has been studied as a way to decrease hemorrhage growth and improve outcomes. It is unknown if the antihypertensive used to achieve blood pressure goals influences either. Because sympatholytic drugs reduce death and infection in animal models, we hypothesized that labetalol would improve outcomes compared with nicardipine. METHODS: Prospective data from a single center were retrospectively reviewed. Patients receiving labetalol, nicardipine, or both during their first 3 days of hospitalization were included. Outcomes included in-hospital death; discharge modified Rankin Score >2; and in-hospital urinary tract infection, pneumonia, or bacteremia. Patients were compared with propensity scoring and analyzed with linear models adjusted for significant confounders. RESULTS: Of 1066 admissions, 525 were treated with labetalol or nicardipine and are included; 229 (43.6%) received labetalol, 107 (20.4%) received nicardipine, and 189 (36.0%) received both. Mortality and infection rates were 40.2% and 15.8%, respectively, 77.2% had a modified Rankin Score >2. After adjustment, compared with nicardipine alone, labetalol alone was associated with infection (odds ratio, 3.12; confidence interval, 1.27-7.64; =0.013) but not when combined with nicardipine (odds ratio, 2.44; confidence interval, 0.98-6.07; =0.055). Labetalol, with or without nicardipine, was not associated with death or discharge modified Rankin Score >2. CONCLUSIONS: Compared with nicardipine, labetalol was associated with increased in-hospital infections, but not mortality or modified Rankin Score >2. These findings do not support our hypothesis that labetalol use improves outcomes relative to nicardipine in intracerebral hemorrhage. [Mh] Termos MeSH primário: Hemorragia Cerebral/tratamento farmacológico Hemorragia Cerebral/epidemiologia Infecção Hospitalar/induzido quimicamente Infecção Hospitalar/epidemiologia Labetalol/efeitos adversos Nicardipino/uso terapêutico [Mh] Termos MeSH secundário: Antagonistas Adrenérgicos beta/efeitos adversos Antagonistas Adrenérgicos beta/uso terapêutico Adulto Idoso Anti-Hipertensivos/efeitos adversos Anti-Hipertensivos/uso terapêutico Hemorragia Cerebral/diagnóstico Infecção Hospitalar/diagnóstico Feminino Seres Humanos Hipertensão/tratamento farmacológico Hipertensão/epidemiologia Masculino Meia-Idade Estudos Prospectivos Estudos Retrospectivos [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Adrenergic beta-Antagonists); 0 (Antihypertensive Agents); CZ5312222S (Nicardipine); R5H8897N95 (Labetalol) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171009 [Lr] Data última revisão: 171009 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170915 [St] Status: MEDLINE [do] DOI: 10.1161/STROKEAHA.117.017230

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[PMID]: 28178175 [Au] Autor: Won YJ; Lim BG; Yeo GE; Lee MK; Lee DK; Kim H; Lee IO; Kong MH [Ad] Endereço: Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea. [Ti] Título: The effect of nicardipine on the surgical pleth index during thyroidectomy under general anesthesia: A prospective double-blind randomized controlled trial. [So] Source: Medicine (Baltimore);96(6):e6154, 2017 Feb. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: The effectiveness of surgical pleth index (SPI) for managing nociception-antinociception balance during general anesthesia with vasodilators, including nicardipine has not been demonstrated. We aimed to compare the time course during surgery in SPI values in patients receiving nicardipine or remifentanil infusion during thyroidectomy. METHODS: Forty patients undergoing thyroidectomy were randomly assigned to receive nicardipine (group N; n = 19) or remifentanil (group R; n = 21) along with induction (propofol, fentanyl, and rocuronium) and maintenance (50% desflurane/nitrous oxide in oxygen) anesthesia (goal bispectral index [BIS] ∼50). The infusion of nicardipine or remifentanil was started before the 1st incision and adjusted to keep mean blood pressure (MBP) within ±20% of the preoperative value. SPI, BIS, end-tidal desflurane concentration (EtDes), MBP, and heart rate were recorded at 2.5 minute intervals from the 1st incision to the end of surgery. Extubation and recovery times, pain score/rescue ketorolac consumption, and adverse events in postanesthesia care unit (PACU) were recorded. RESULTS: The trend of SPI during surgery was comparable between the 2 groups (P = 0.804), although the heart rates in group N were significantly higher than those in group R (P = 0.040). The patient characteristics, trends of BIS, EtDes, and MBP during surgery, extubation and recovery times, and incidence of nausea/vomiting were comparable between the groups. Group N had significantly lower pain scores and rescue ketorolac consumption at PACU. CONCLUSION: SPI was comparable between patients receiving nicardipine or remifentanil infusion during thyroidectomy under general anesthesia, which suggests that the administration of nicardipine may confound the interpretation of SPI values during general anesthesia. CLINICAL TRIAL REGISTRATION: This trial was registered in the UMIN clinical trials registry (unique trial number: UMIN000019058; registration number: R000022028; principal investigator's name: Young Ju Won; date of registration: September 17, 2015). [Mh] Termos MeSH primário: Frequência Cardíaca/efeitos dos fármacos Nicardipino/farmacologia Dor Pós-Operatória/tratamento farmacológico Fotopletismografia/efeitos dos fármacos Tireoidectomia/métodos Vasodilatadores/farmacologia [Mh] Termos MeSH secundário: Analgésicos Opioides/uso terapêutico Anestesia Geral/métodos Método Duplo-Cego Feminino Seres Humanos Masculino Piperidinas/uso terapêutico Náusea e Vômito Pós-Operatório/tratamento farmacológico Estudos Prospectivos [Pt] Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Analgesics, Opioid); 0 (Piperidines); 0 (Vasodilator Agents); CZ5312222S (Nicardipine); P10582JYYK (remifentanil) [Em] Mês de entrada: 1702 [Cu] Atualização por classe: 170227 [Lr] Data última revisão: 170227 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170209 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000006154

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[PMID]: 27995512 [Au] Autor: Finger JR; Kurczewski LM; Brophy GM [Ad] Endereço: Banner-University Medical Center, Tucson, AZ, USA. jacqueline.finger@bannerhealth.com. [Ti] Título: Clevidipine Versus Nicardipine for Acute Blood Pressure Reduction in a Neuroscience Intensive Care Population. [So] Source: Neurocrit Care;26(2):167-173, 2017 Apr. [Is] ISSN: 1556-0961 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Currently, a lack of published literature exists regarding the use of clevidipine in the neuroscience population. This agent may be preferred in some patients because of its short half-life, potentially leading to more narrow blood pressure (BP) control in comparison with other agents. The purpose of this study was to compare the difference in time to achieve target systolic blood pressure (SBP) goals with clevidipine versus nicardipine infusions in patients admitted to the neuroscience intensive care unit (NSICU) at our institution. METHODS: A retrospective review was performed on patients receiving clevidipine or nicardipine infusions while in the NSICU between July 1, 2011 and June 30, 2014. Patients were matched based on indication for BP lowering and target SBP. Primary endpoints included time to target SBP and percentage of time within target BP range. RESULTS: Of the 57 patients included in the study, the median time to target SBP was 30 min in the clevidipine group and 46 min in the nicardipine group (p = 0.13). The percentage of time spent within target BP range was 79 versus 78% (p = 0.64). Clevidipine administration resulted in significantly less volume administered per patient versus nicardipine (530 vs. 1254 mL, p = 0.02). CONCLUSIONS: There were no statistically significant differences in acute BP management between the two agents; however, there was a trend toward shorter time to target and significantly less volume administered in the clevidipine group. Either agent should be considered a viable option in a NSICU population. [Mh] Termos MeSH primário: Bloqueadores dos Canais de Cálcio/farmacologia Cuidados Críticos/métodos Hipertensão/tratamento farmacológico Doenças do Sistema Nervoso/terapia Nicardipino/farmacologia Piridinas/farmacologia [Mh] Termos MeSH secundário: Idoso Bloqueadores dos Canais de Cálcio/administração & dosagem Feminino Seres Humanos Masculino Meia-Idade Nicardipino/administração & dosagem Piridinas/administração & dosagem Estudos Retrospectivos [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Calcium Channel Blockers); 0 (Pyridines); 19O2GP3B7Q (clevidipine); CZ5312222S (Nicardipine) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171108 [Lr] Data última revisão: 171108 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161221 [St] Status: MEDLINE [do] DOI: 10.1007/s12028-016-0349-4

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[PMID]: 27979421 [Au] Autor: Ishikawa K; Omori K; Takeuchi I; Jitsuiki K; Yoshizawa T; Ohsaka H; Nakao Y; Yamamoto T; Yanagawa Y [Ad] Endereço: Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Japan. [Ti] Título: A comparison between evacuation from the scene and interhospital transportation using a helicopter for subarachnoid hemorrhage. [So] Source: Am J Emerg Med;35(4):543-547, 2017 Apr. [Is] ISSN: 1532-8171 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: PURPOSE: We investigated the changes in the vital signs and the final outcomes subarachnoid hemorrhage (SAH) patients who were evacuated from the scene using the doctor-helicopter (Dr. Heli) service and those who only underwent interhospital transportation using the doctor-helicopter Dr. Heli service to investigate safety of this system. METHODS: We retrospectively investigated all of the patients with non-traumatic SAH who were transported by a Dr. Heli between January 2010 and March 2016. The subjects were divided into two groups: the Scene group included subjects who were evacuated from the scene by a Dr. Heli, while the Interhospital group included subjects who were transported by a ground ambulance to a nearby medical facility and then transported by a Dr. Heli to a single tertiary center. RESULTS: The systolic blood pressure, ratio of cardiac arrest, and Fisher classification values of the patients in the Scene group were significantly greater than those in the Interhospital group. The Glasgow Coma Scale in the Scene group was significantly lower than that in the Interhospital group. After excluding the patients with cardiac arrest, the Glasgow Coma Scale scores of the patients in the two groups did not differ to a statistically significant extent during, before or after transportation. There were no significant differences in Glasgow Outcome Scores or the survival ratio of the two groups, even when cardiac arrest patients were included. CONCLUSION: The present study indirectly suggests the safety of using a Dr. Heli to evacuate SAH patients from the scene. [Mh] Termos MeSH primário: Resgate Aéreo Anti-Hipertensivos/uso terapêutico Hipertensão/tratamento farmacológico Transferência de Pacientes Hemorragia Subaracnóidea/fisiopatologia Transporte de Pacientes [Mh] Termos MeSH secundário: Idoso Idoso de 80 Anos ou mais Ambulâncias Pressão Sanguínea Feminino Escala de Coma de Glasgow Parada Cardíaca/complicações Seres Humanos Hipertensão/complicações Japão Masculino Meia-Idade Nicardipino/uso terapêutico Estudos Retrospectivos Hemorragia Subaracnóidea/complicações Hemorragia Subaracnóidea/mortalidade [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antihypertensive Agents); CZ5312222S (Nicardipine) [Em] Mês de entrada: 1704 [Cu] Atualização por classe: 170417 [Lr] Data última revisão: 170417 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161217 [St] Status: MEDLINE

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[PMID]: 27824680 [Au] Autor: Inamasu J; Nakae S; Adachi K; Hirose Y [Ad] Endereço: Department of Neurosurgery, Fujita Health University Hospital, Toyoake, Japan. [Ti] Título: Angiotensin II receptor blockers following intravenous nicardipine administration to lower blood pressure in patients with hypertensive intracerebral hemorrhage: a prospective randomized study. [So] Source: Blood Press Monit;22(1):34-39, 2017 Feb. [Is] ISSN: 1473-5725 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND AND OBJECTIVE: In patients with hypertensive intracerebral hemorrhage (HICH), intravenous nicardipine is primarily used to lower blood pressure (BP). However, there are few studies investigating the role of oral antihypertensives administered after intravenous nicardipine to prevent BP from rising. Angiotensin II receptor blockers (ARBs) may be beneficial in HICH patients not only as antihypertensives but also by lowering plasma catecholamine levels. A prospective randomized study was conducted between January 2015 and March 2016 to comparatively evaluate the efficacy of two ARBs (azilsartan vs. candesartan) following intravenous nicardipine administration on BP reduction. PATIENTS AND METHODS: Thirty conscious HICH patients presenting within 6 h of symptom onset were enrolled (15 in each arm). After administering intravenous nicardipine for 24-48 h, the patients were randomized either to the azilsartan (20 mg) arm or to the candesartan (8 mg) arm. Frequency of hematoma expansion, 30-day modified Rankin scale, and temporal profiles of systolic blood pressure (SBP) and plasma norepinephrine/aldosterone were compared. RESULTS: Substantial hematoma expansion occurred in two (13%) azilsartan patients and in one (7%) candesartan patient (P=1.00). SBPs were maintained at lower than 140±20 mmHg in both arms. Neither SBPs nor plasma norepinephrine/aldosterone levels differed significantly. All 30 patients had 30-day modified Rankin scale scores of 1-2. CONCLUSION: Administration of ARBs following intravenous nicardipine effectively prevented BP from rising in HICH patients. However, whether BP should be strictly managed after 24 h of symptom onset should be addressed in future studies focusing not only on neurologic but also on cardiovascular and renal functions of HICH patients. [Mh] Termos MeSH primário: Antagonistas de Receptores de Angiotensina/administração & dosagem Pressão Sanguínea/efeitos dos fármacos Hemorragia Cerebral/tratamento farmacológico Hemorragia Cerebral/fisiopatologia Nicardipino/administração & dosagem [Mh] Termos MeSH secundário: Administração Intravenosa Idoso Feminino Seres Humanos Masculino Meia-Idade Estudos Prospectivos [Pt] Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Angiotensin Receptor Antagonists); CZ5312222S (Nicardipine) [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 170817 [Lr] Data última revisão: 170817 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161109 [St] Status: MEDLINE [do] DOI: 10.1097/MBP.0000000000000225

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[PMID]: 27729218 [Au] Autor: Mittra R; Pavy M; Subramanian N; George AM; O'Mara ML; Kerr ID; Callaghan R [Ad] Endereço: Division of Biomedical Science & Biochemistry, Research School of Biology and Medical School, The Australian National University, Canberra, Australia. [Ti] Título: Location of contact residues in pharmacologically distinct drug binding sites on P-glycoprotein. [So] Source: Biochem Pharmacol;123:19-28, 2017 Jan 01. [Is] ISSN: 1873-2968 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: The multidrug resistance P-glycoprotein (P-gp) is characterised by the ability to bind and/or transport an astonishing array of drugs. This poly-specificity is imparted by at least four pharmacologically distinct binding sites within the transmembrane domain. Whether or not these sites are spatially distinct has remained unclear. Biochemical and structural investigations have implicated a central cavity as the likely location for the binding sites. In the present investigation, a number of contact residues that are involved in drug binding were identified through biochemical assays using purified, reconstituted P-gp. Drugs were selected to represent each of the four pharmacologically distinct sites. Contact residues important in rhodamine123 binding were identified in the central cavity of P-gp. However, contact residues for the binding of vinblastine, paclitaxel and nicardipine were located at the lipid-protein interface rather than the central cavity. A key residue (F978) within the central cavity is believed to be involved in coupling drug binding to nucleotide hydrolysis. Data observed in this investigation suggest the presence of spatially distinct drug binding sites connecting through to a single translocation pore in the central cavity. [Mh] Termos MeSH primário: Membro 1 da Subfamília B de Cassetes de Ligação de ATP/metabolismo [Mh] Termos MeSH secundário: Membro 1 da Subfamília B de Cassetes de Ligação de ATP/genética Animais Sítios de Ligação Meios de Cultura Eletroforese em Gel de Poliacrilamida Seres Humanos Mariposas Mutagênese Sítio-Dirigida Nicardipino/metabolismo Paclitaxel/metabolismo Isoformas de Proteínas/genética Isoformas de Proteínas/metabolismo Rodamina 123/metabolismo Vimblastina/metabolismo [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (ATP-Binding Cassette, Sub-Family B, Member 1); 0 (Culture Media); 0 (Protein Isoforms); 1N3CZ14C5O (Rhodamine 123); 5V9KLZ54CY (Vinblastine); CZ5312222S (Nicardipine); P88XT4IS4D (Paclitaxel) [Em] Mês de entrada: 1705 [Cu] Atualização por classe: 171116 [Lr] Data última revisão: 171116 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161013 [St] Status: MEDLINE

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[PMID]: 28154698 [Au] Autor: Berdai MA; Labib S; Harandou M [Ad] Endereço: Obstetric and Pediatric Intensive Care Unit, University Hospital Hassan II, Fez, Morocco. [Ti] Título: Prolonged neuromuscular block in a preeclamptic patient induced by magnesium sulfate. [So] Source: Pan Afr Med J;25:5, 2016. [Is] ISSN: 1937-8688 [Cp] País de publicação: Uganda [La] Idioma: eng [Ab] Resumo: Recent large use of magnesium in the obstetric population should incite anesthesiologists to control its side effects and drugs interactions. We report a case of a 30-year-old woman, with severe preeclampsia and HELLP syndrome, receiving sulfate magnesium and nicardipine, who underwent a cesarean section under general anesthesia. She developed a prolonged and deep neuromuscular blockade, which was antagonized three hours later with neostigmine. In case of therapeutic hypermagnesaemia, non-depolarizing relaxants must be used in reduced doses, and at increased time intervals, with appropriate neuromuscular monitoring. [Mh] Termos MeSH primário: Sulfato de Magnésio/administração & dosagem Neostigmina/administração & dosagem Bloqueio Neuromuscular/métodos [Mh] Termos MeSH secundário: Adulto Anestesia Geral/métodos Cesárea/métodos Feminino Síndrome HELLP/fisiopatologia Seres Humanos Sulfato de Magnésio/efeitos adversos Nicardipino/uso terapêutico Pré-Eclâmpsia/fisiopatologia Gravidez [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Nm] Nome de substância: 3982TWQ96G (Neostigmine); 7487-88-9 (Magnesium Sulfate); CZ5312222S (Nicardipine) [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 170322 [Lr] Data última revisão: 170322 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170204 [St] Status: MEDLINE [do] DOI: 10.11604/pamj.2016.25.5.6616

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[PMID]: 27823932 [Au] Autor: Yamamoto S; Suzuki Y; Ono H; Kume K; Ohsawa M [Ad] Endereço: Department of Neuropharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University, 3-1 Tanabe-dori, Mizuho-ku, Nagoya 467-8603, Japan; Laboratory of CNS Pharmacology, Graduate School of Pharmaceutical Sciences, Nagoya City University, Japan. [Ti] Título: N- and L-type calcium channels blocker cilnidipine ameliorates neuropathic pain. [So] Source: Eur J Pharmacol;793:66-75, 2016 Dec 15. [Is] ISSN: 1879-0712 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: Cilnidipine is a dihydropyridine derivative that inhibits N-type and L-type voltage-gated Ca channels (VDCCs). We recently reported that a selective N-type VDCC blocker attenuated the spinal long-term potentiation (LTP) of C-fiber-evoked field potentials recorded in the spinal dorsal horn of rats, which served as a model for examining synaptic function during central pain sensitization. In this study, we investigated the effects of cilnidipine on the changes related to neuropathic pain induced by nerve injury. Mechanical allodynia and hyperalgesia were evaluated by von Frey test and pin prick test, respectively. Spinal LTP of C-fiber-evoked field potentials were evaluated by in vivo electrophysiology. Intrathecally administrated cilnidipine attenuated mechanical allodynia and hyperalgesia in the spared nerve injury mouse model. Using in vivo electrophysiology in rats, cilnidipine (10µm) administered spinally inhibited the induction and maintenance of high-frequency stimulation-induced LTP of C-fiber-evoked field potentials, while basal C-fiber-evoked field potentials in naïve rats were unaffected. The basal C-fiber-evoked field potentials in nerve-injured rats were strongly inhibited by cilnidipine. Treatment with a specific N-type VDCC blocker, ω-conotoxin GVIA, which reportedly attenuates C-fiber-evoked field potentials both before and after the induction of LTP, attenuated mechanical allodynia and hyperalgesia in nerve-injured mice. By contrast, an L-type VDCC blocker, nicardipine attenuated only mechanical hyperalgesia, but not mechanical allodynia in nerve-injured mice, and also attenuated the established LTP of C-fiber-evoked field potentials in rats. These results suggested that N-type and L-type VDCC blockers may effectively alleviate the hyperalgesia and allodynia associated with neuropathic pain without affecting normal pain perception. [Mh] Termos MeSH primário: Bloqueadores dos Canais de Cálcio/farmacologia Canais de Cálcio Tipo L/metabolismo Canais de Cálcio Tipo N/metabolismo Di-Hidropiridinas/farmacologia Neuralgia/tratamento farmacológico [Mh] Termos MeSH secundário: Animais Bloqueadores dos Canais de Cálcio/uso terapêutico Conotoxinas/toxicidade Di-Hidropiridinas/uso terapêutico Potenciais Evocados/efeitos dos fármacos Potenciação de Longa Duração/efeitos dos fármacos Masculino Camundongos Fibras Nervosas Amielínicas/efeitos dos fármacos Fibras Nervosas Amielínicas/patologia Neuralgia/metabolismo Neuralgia/patologia Nicardipino/farmacologia Ratos Corno Dorsal da Medula Espinal/patologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Calcium Channel Blockers); 0 (Calcium Channels, L-Type); 0 (Calcium Channels, N-Type); 0 (Conotoxins); 0 (Dihydropyridines); 93438-65-4 (conotoxin GV); 97T5AZ1JIP (cilnidipine); CZ5312222S (Nicardipine) [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 170327 [Lr] Data última revisão: 170327 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161109 [St] Status: MEDLINE

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[PMID]: 27754742 [Au] Autor: Villablanca PA; Briceno DF; Jagannath AD; Cohen M; Pyo R [Ad] Endereço: a Montefiore Medical Center, Albert Einstein College of Medicine , New York , USA. [Ti] Título: Coronary artery spasm: Is ST-elevation key for diagnosis? [So] Source: Acute Card Care;18(1):11-12, 2016 Mar. [Is] ISSN: 1748-295X [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Coronary vasospasm is uncommon during pregnancy and the postpartum period. We present a very rare case of an acute coronary vasospasm in a 36-year-old woman who was two weeks postpartum. The coronary arteriograms showed a coronary vasospasm in the distal left anterior descending and circumflex coronary arteries. Electrocardiogram (ECG) presentation was atypical, with T-wave inversions in leads I, aVL, and V2 to V6. To our knowledge, this is the first case with a well-documented coronary artery vasospasm in a postpartum woman without the classic ST elevation on ECG. Management should follow the usual principles of care for acute coronary vasospasm. [Mh] Termos MeSH primário: Vasoespasmo Coronário Eletrocardiografia/métodos Nicardipino/administração & dosagem Nitroglicerina/administração & dosagem Transtornos Puerperais [Mh] Termos MeSH secundário: Adulto Angiografia Coronária/métodos Vasoespasmo Coronário/diagnóstico Vasoespasmo Coronário/tratamento farmacológico Vasoespasmo Coronário/etiologia Vasoespasmo Coronário/fisiopatologia Diagnóstico Diferencial Monitoramento de Medicamentos Ecocardiografia/métodos Feminino Seres Humanos Transtornos Puerperais/diagnóstico Transtornos Puerperais/tratamento farmacológico Transtornos Puerperais/fisiopatologia Resultado do Tratamento Vasodilatadores/administração & dosagem [Pt] Tipo de publicação: CASE REPORTS; LETTER [Nm] Nome de substância: 0 (Vasodilator Agents); CZ5312222S (Nicardipine); G59M7S0WS3 (Nitroglycerin) [Em] Mês de entrada: 1702 [Cu] Atualização por classe: 170817 [Lr] Data última revisão: 170817 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161019 [St] Status: MEDLINE [do] DOI: 10.1080/17482941.2016.1234057

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[PMID]: 27725386 [Au] Autor: Yamamura A [Ad] Endereço: Department of Pharmacy, College of Pharmacy, Kinjo Gakuin University. [Ti] Título: Molecular Mechanism of Dihydropyridine Ca Channel Blockers in Pulmonary Hypertension. [So] Source: Yakugaku Zasshi;136(10):1373-1377, 2016. [Is] ISSN: 1347-5231 [Cp] País de publicação: Japan [La] Idioma: jpn [Ab] Resumo: Idiopathic pulmonary arterial hypertension (IPAH) is a progressive and fatal disease of unidentified pathogenesis. IPAH is pathologically characterized as sustained vasoconstriction and vascular remodeling of the pulmonary artery. In pulmonary arterial smooth muscle cells (PASMCs), an increase in cytosolic Ca concentration ([Ca ] ) triggers vasoconstriction and stimulates cell proliferation leading to vascular remodeling. However, dihydropyridine-type voltage-dependent Ca channel blockers are only effective in very few patients with IPAH (<10%). It is unclear why dihydropyridine Ca channel blockers are not therapeutically effective in a majority of IPAH patients. We have previously shown that extracellular Ca -sensing receptor (CaSR) is upregulated in PASMCs from IPAH patients, and it contributes to enhanced [Ca ] responses and augmented cell proliferation. In this study, the effects of dihydropyridine Ca channel blockers on [Ca ] responses mediated by CaSR were examined in IPAH-PASMCs. Nifedipine (dihydropyridines) enhanced the CaSR-mediated increase in [Ca ] in IPAH-PASMCs, but not in PASMCs from normal subjects. Nicardipine (dihydropyridines) and Bay K 8644 (a dihydropyridine Ca channel activator) also augmented the CaSR-mediated [Ca ] increase in IPAH-PASMCs. In contrast, non-dihydropyridine Ca channel blockers such as diltiazem (benzothiazepines) and verapamil (phenylalkylamines) had no effect on the [Ca ] response in IPAH-PASMCs. Finally, in monocrotaline-induced pulmonary hypertensive rats, nifedipine caused further increase in right ventricular systolic pressure and thus right ventricular hypertrophy. In conclusion, dihydropyridine Ca channel blockers could exacerbate symptoms of pulmonary hypertension in IPAH patients with upregulated CaSR in PASMCs. [Mh] Termos MeSH primário: Bloqueadores dos Canais de Cálcio/efeitos adversos Di-Hidropiridinas/efeitos adversos Hipertensão Pulmonar/tratamento farmacológico Hipertensão Pulmonar/etiologia Terapia de Alvo Molecular Nicardipino/efeitos adversos Receptores de Detecção de Cálcio/metabolismo [Mh] Termos MeSH secundário: Animais Cálcio/metabolismo Sinalização do Cálcio/efeitos dos fármacos Modelos Animais de Doenças Progressão da Doença Seres Humanos Hipertensão Pulmonar/genética Músculo Liso Vascular/citologia Músculo Liso Vascular/metabolismo Artéria Pulmonar/efeitos dos fármacos Artéria Pulmonar/fisiopatologia Ratos Regulação para Cima/efeitos dos fármacos Remodelação Vascular/efeitos dos fármacos Vasoconstrição/efeitos dos fármacos [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Calcium Channel Blockers); 0 (Dihydropyridines); 0 (Receptors, Calcium-Sensing); 7M8K3P6I89 (1,4-dihydropyridine); CZ5312222S (Nicardipine); SY7Q814VUP (Calcium) [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 171017 [Lr] Data última revisão: 171017 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161012 [St] Status: MEDLINE

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