Propranolol vs flunarizine vs flunarizine plus propranolol in migraine without aura prophylaxis

Fourty-five migraine without aura patients underwent a parallel double-blind trial aiming the comparison of the effects of propranolol 60 mg/day to flunarizine 10 mg/day and to propranolol 60 mg/day plus flunarizine 10 mg/day simultaneously. There were 3 groups, each one with 15 patients. After a 20-day-baseline period, each group received one kind of treatment during 120 days. Migraine index on propranolol was 23.4*, on flunarizine 18,7* and on both drugs 14.4*, mean frequency of attacks on propranolol was 1.26**, on flunarizine 1.2** and on both drugs, 1.13** (*p<0.05, **p<0.01 compared to baseline) and global evaluation was reduced with all forms of treatment. It was not found statistical differences between groups, nevertheless there was a trend in the group using two drugs reaching lower values in migraine index, frequency of attacks and global evaluation. In individuals using flunarizine (alone or associated with propranolol) the therapeutic effect was largely maintained up to 45 days after drug withdrawal.

Propanolol reduces myocardial hypertrophy in the right cardiac chambers after infarction in rats

The effects of chronic propanolol (Prop) therapy on the post infarction myocardial hypertrophy of infarction rats were studied by histological techniques. male albino rats were submitted to left coronary artery ligation to produce infarction or to sham surgery (Con, N=6)., Infarction rats (Inf) were divided into 2 groups receiving Prop (2.5 mg/kg, twice a day, N+6) or saline (N=6) for one month, respectively. Myocyte diameters were measured in longitudinally oriented sections in the four heart chambers (60 cells/chamber). inf produced a significant increase in mean diameter of myocytes from the right atrium and ventricle and from the left atrium. In the right ventricle, myocyte diameter increased from 8.9 ñ 0.5 um in the Con group to 12.5 ñ 0.6 um in the the Inf group (P<0.05). Under Prop, myocyte diameter was reduced (P<0.05) to 9.8 ñ 0.9 um. Similar values were observed in the right atrium. In the left atrium, Prop produced only a partial reversion of the postinfarction hypertrophy. In the left ventricle, myocyte diameter was not significantly changed after Inf or Prop therapy. These data show that beta blockers reduce the myocardial hypertrophy in the right heart chambers after experimental infarcts in rats. This effect can be secondary to reduction of pulmonary hypertension or to blockade of direct effects of catecholamines on myocardial fibers or both

Empleo del propanolol en la prevención del sangramiento digestivo en pacientes cirróticos / Propanolol for prevention of gastrointestinal bleeding in patients with cirrhosis

Se administró Propranolol a 15 pacientes cirróticos a dosis requerida para reducir el gasto cardíaco en un 25% Fueron seguidos por un periodo de 1 a 2 años comparándose las tasas de sangramiento y el tamaño de las várices esofágicas con otros 15 pacientes tratados con placebo tomados como grupo control y seguidos por el mismo periodo de tiempo. En el grupo tratado sólo un paciente presentó sangramiento detectado por hemocult mientras que en el grupo control el 46.6% de los pacientes presentó sangramiento el cual fue la causa de muerte en dos de ellos. El tamaño de las várices, por endoscopía disminuyó en el 73.3% de los pacientes del grupo tratado lo cual no se apreció en el grupo control. El Propranolol es un medicamento útil para la reducción del tamaño de las várices esofágicas y para la prevención del sangramiento digestivo en pacientes cirróticos