Pregabalin in muscular cramps [charely hoarse] a new application

Pregabalin is a newly introduced medicine which is an analogue to Gaba pentin and similar to its structure, it was approved by the FDA in 2004 and marketed by Pfizer company under the name of LARYICA. It has been described in various medical disorders among which are: neuropathic pain as that of diabetes [1,2], post herpetic neuralgia [3], seizure disorders [4] and anxiety state [5]. Pregabalin the first medicine approved for treatment of fibromyalgia by the FDA [6,7] Pharmacologically Pregabalin bind to alpha 2 delta subunit of the voltage-dependent calcium channels in the central nervous system, it also decrease the releases neurotransmitters such as glutamate, noradrenalin and the substance P [8,9]. Though FDA label indications are; diabetic peripheral neuropathy, fibromyalgia, Post herpetic neuralgia and as an adjunct in seizure, yet Pregabalin have been Used in many other conditions on empirical bases as a treatment of a single case Or more as in post operative Pain [10] or hot flash [11] beside other diseases. Herewith I am reporting an unusual clinical observation never been described before, the Night Muscular cramps in the Legs collegially known as "Charley hoarse" known by Iraqis as "ABU SLSHERGATE"

lung and the gut

Abnormalities of the gastro-intestinal tract [GI] may affect the lungs adversely. Aspiration pneumonia may occur in patients with nasogastric or even direct gastric intubation, and in esophageal dysmotility from neurological disease or scleroderma. Importantly, asthma, chronic cough, or hoarseness is often associated with gastro esophageal reflux disease [GERD]. in such patients, treatment with high doses of proton pump inhibitors [PPI] for upwards of 6 months often causes a dramatic improvement of the asthma, chronic cough, or the hoarseness. in refractory cases, surgical approach may achieve good results or complete cure. The gut is the supplier of fuel to the lung, and the lung is the oxygen provider to the gut, yet certain pathological conditions of the gut may have adverse effects on the lung. The two systems have a common port of entry, the oropharynx. Poor oral hygiene and loose teeth or dentures are well known sources of aspiration, pulmonary infection, and abscess formation, especially during periods of impaired consciousness as in sleep; epileptic, diabetic or hypoglycemic coma, cerebro-vascular accident; and intoxication by alcohol or other drugs