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Eur J Pharmacol ; 898: 173988, 2021 May 05.
Artículo en Inglés | MEDLINE | ID: covidwho-1116626


There is a need for therapeutic approaches to prevent and mitigate the effects of Coronavirus Disease (2019) (COVID-19). The histone deacetylase (HDAC) inhibitor valproic acid, which has been available for the therapy of epilepsy for many years, is a drug that could be repurposed for patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. This article will review the reasons to consider valproic acid as a potential therapeutic to prevent severe COVID-19. Valproic acid could reduce angiotensin-converting enzyme 2 and transmembrane serine protease 2 expression, required for SARS-CoV-2 viral entry, and modulate the immune cellular and cytokine response to infection, thereby reducing end-organ damage. The combined anti-thrombotic, anti-platelet, and anti-inflammatory effects of valproic acid suggest it could be a promising therapeutic target for COVID-19.

Antiinflamatorios/uso terapéutico , Fibrinolíticos/uso terapéutico , Inhibidores de Histona Desacetilasas/uso terapéutico , Inhibidores de Agregación Plaquetaria/uso terapéutico , Ácido Valproico/uso terapéutico , Animales , Reposicionamiento de Medicamentos , Humanos
Tremor Other Hyperkinet Mov (N Y) ; 11: 7, 2021 02 10.
Artículo en Inglés | MEDLINE | ID: covidwho-1094310


The novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) is the cause of the COVID-19 pandemic [5]. SARS-Cov-2 demonstrates partial resemblance to SARS-CoV and MERS-CoV in phylogenetic analysis, clinical manifestations, and pathological findings [6, 7]. Reports emerging from China have described ataxia as a neurological symptom of the SARS-CoV-2 infection [5]. Opsoclonus consists of back-to-back multidirectional conjugate saccades without an inter-saccadic interval [8]. Myoclonus is defined as a sudden, brief, "shock-like", nonepileptic involuntary movement [9], which has been described as a symptom of SARS-CoV-2 infection [10]. Opsoclonus-Myoclonus-Ataxia syndrome (OMAS) associated COVID-19 infection has been reported recently [1112].

/fisiopatología , Síndrome de Opsoclonía-Mioclonía/fisiopatología , Adulto , Clonazepam/uso terapéutico , GABAérgicos/uso terapéutico , Humanos , Masculino , Metilprednisolona/uso terapéutico , Fármacos Neuroprotectores/uso terapéutico , Síndrome de Opsoclonía-Mioclonía/tratamiento farmacológico , Síndrome de Opsoclonía-Mioclonía/etiología , Pronóstico , Recuperación de la Función , Resultado del Tratamiento , Ácido Valproico/uso terapéutico
J Neurovirol ; 27(1): 26-34, 2021 02.
Artículo en Inglés | MEDLINE | ID: covidwho-1046668


Opsoclonus-myoclonus-ataxia syndrome is a heterogeneous constellation of symptoms ranging from full combination of these three neurological findings to varying degrees of isolated individual sign. Since the emergence of coronavirus disease 2019 (COVID-19), neurological symptoms, syndromes, and complications associated with this multi-organ viral infection have been reported and the various aspects of neurological involvement are increasingly uncovered. As a neuro-inflammatory disorder, one would expect to observe opsoclonus-myoclonus syndrome after a prevalent viral infection in a pandemic scale, as it has been the case for many other neuro-inflammatory syndromes. We report seven cases of opsoclonus-myoclonus syndrome presumably parainfectious in nature and discuss their phenomenology, their possible pathophysiological relationship to COVID-19, and diagnostic and treatment strategy in each case. Finally, we review the relevant data in the literature regarding the opsoclonus-myoclonus syndrome and possible similar cases associated with COVID-19 and its diagnostic importance for clinicians in various fields of medicine encountering COVID-19 patients and its complications.

Ataxia/fisiopatología , Tos/fisiopatología , Fiebre/fisiopatología , Mialgia/fisiopatología , Síndrome de Opsoclonía-Mioclonía/fisiopatología , /patogenicidad , Adulto , Anticonvulsivantes/uso terapéutico , Ataxia/diagnóstico por imagen , Ataxia/tratamiento farmacológico , Ataxia/etiología , Azitromicina/uso terapéutico , /diagnóstico por imagen , Clonazepam/uso terapéutico , Tos/diagnóstico por imagen , Tos/tratamiento farmacológico , Tos/etiología , Disnea/diagnóstico por imagen , Disnea/tratamiento farmacológico , Disnea/etiología , Disnea/fisiopatología , Femenino , Fiebre/diagnóstico por imagen , Fiebre/tratamiento farmacológico , Fiebre/etiología , Humanos , Hidroxicloroquina/uso terapéutico , Levetiracetam/uso terapéutico , Masculino , Persona de Mediana Edad , Mialgia/diagnóstico por imagen , Mialgia/tratamiento farmacológico , Mialgia/etiología , Síndrome de Opsoclonía-Mioclonía/diagnóstico por imagen , Síndrome de Opsoclonía-Mioclonía/tratamiento farmacológico , Síndrome de Opsoclonía-Mioclonía/etiología , Oseltamivir/uso terapéutico , Ácido Valproico/uso terapéutico
Epilepsy Behav ; 115: 107404, 2021 02.
Artículo en Inglés | MEDLINE | ID: covidwho-972215


The diagnosis of childhood absence epilepsy (CAE) is typically based on history and description of spells, supported by an office-based positive hyperventilation test and confirmed by routine electroencephalography (EEG). In the current coronavirus disease 2019 (COVID-19) pandemic, many pediatric neurologists have switched to telemedicine visits for nonemergent outpatient evaluations. We present a series of children diagnosed as having CAE on the basis of a positive hyperventilation test performed during remote televisits. Several of these children were begun on treatment for CAE prior to obtaining an EEG, with significant seizure reduction. Our series documents the feasibility of CAE diagnosis and management by telemedicine.

Anticonvulsivantes/uso terapéutico , Manejo de la Enfermedad , Epilepsia Tipo Ausencia/diagnóstico , Epilepsia Tipo Ausencia/tratamiento farmacológico , Telemedicina/métodos , /epidemiología , Niño , Preescolar , Electroencefalografía/métodos , Electroencefalografía/tendencias , Epilepsia Tipo Ausencia/epidemiología , Femenino , Humanos , Hiperventilación/diagnóstico , Hiperventilación/epidemiología , Masculino , Neurólogos/tendencias , Pediatras/tendencias , Telemedicina/tendencias , Ácido Valproico/uso terapéutico
Acta Med Port ; 33(10): 693-702, 2020 Oct 01.
Artículo en Portugués | MEDLINE | ID: covidwho-691633


INTRODUCTION: The COVID-19 pandemic is a particularly relevant threat to mentally ill patients, and it constitutes a new challenge for health care providers. To the best of our knowledge, there is not any embracing published review about the use of psychotropic drugs during the COVID-19 pandemic. MATERIALS AND METHODS: Non-systematic literature review. A search in the PubMed database was performed, with the terms 'psychotropic drugs', 'COVID-19', 'psychiatry' and 'pandemic'. Consensus and clinical guidelines about psychotropic drugs and COVID-19 approach, published by scientific societies, governmental entities and drug regulatory agencies were included. RESULTS AND DISCUSSION: We present the recommendations about the use of psychotropic drugs during the COVID-19 pandemic, in the outpatient and inpatient settings. The treatment of affective bipolar disorder and schizophrenia have now added increased difficulties. Some psychotropic drugs interfere with the pathophysiology of the novel coronavirus infection and they could interact with the drugs used in the treatment of COVID-19. Some patients will need pharmacological interventions due to the presence of delirium. Smoking cessation changes the serum levels of some psychotropic drugs and may influence their use. CONCLUSION: The COVID-19 pandemic has created new challenges in clinical practice. Psychiatric patients are a vulnerable population and often a careful clinical, laboratorial and electrocardiographic evaluation may be needed, particularly in those diagnosed with COVID-19. The regular treatment of mentally ill patients with COVID-19 presents increased complexity.

Betacoronavirus , Infecciones por Coronavirus/epidemiología , Trastornos Mentales/tratamiento farmacológico , Neumonía Viral/epidemiología , Psicotrópicos/uso terapéutico , Antivirales/uso terapéutico , Benzodiazepinas/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Regulación de la Temperatura Corporal/efectos de los fármacos , Regulación de la Temperatura Corporal/fisiología , Buprenorfina/efectos adversos , Buprenorfina/uso terapéutico , Clozapina/uso terapéutico , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/tratamiento farmacológico , Preparaciones de Acción Retardada/uso terapéutico , Interacciones Farmacológicas , Hospitalización , Humanos , Compuestos de Litio/uso terapéutico , Trastornos Mentales/complicaciones , Metadona/efectos adversos , Metadona/uso terapéutico , Antagonistas de Narcóticos/efectos adversos , Antagonistas de Narcóticos/uso terapéutico , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/tratamiento farmacológico , Esquizofrenia/tratamiento farmacológico , Agentes para el Cese del Hábito de Fumar/uso terapéutico , Ácido Valproico/uso terapéutico
Psychosomatics ; 61(5): 544-550, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-616923

Agonistas de Receptores Adrenérgicos alfa 2/uso terapéutico , Antipsicóticos/uso terapéutico , Infecciones por Coronavirus/terapia , Delirio/tratamiento farmacológico , Hipnóticos y Sedantes/efectos adversos , Neumonía Viral/terapia , Agitación Psicomotora/tratamiento farmacológico , Fármacos Inductores del Sueño/uso terapéutico , Anciano , Analgésicos Opioides/efectos adversos , Azepinas/uso terapéutico , Betacoronavirus , Depresores del Sistema Nervioso Central/uso terapéutico , Clordiazepóxido/efectos adversos , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/fisiopatología , Infecciones por Coronavirus/psicología , Delirio/etiología , Delirio/fisiopatología , Delirio/psicología , Dexmedetomidina/efectos adversos , Femenino , Guanfacina/uso terapéutico , Haloperidol/uso terapéutico , Humanos , Hidromorfona/efectos adversos , Unidades de Cuidados Intensivos , Ketamina/efectos adversos , Melatonina/uso terapéutico , Midazolam/efectos adversos , Oxicodona/efectos adversos , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/fisiopatología , Neumonía Viral/psicología , Propofol/efectos adversos , Agitación Psicomotora/etiología , Agitación Psicomotora/fisiopatología , Agitación Psicomotora/psicología , Respiración Artificial , Trastornos del Sueño del Ritmo Circadiano/tratamiento farmacológico , Trastornos del Sueño del Ritmo Circadiano/etiología , Trastornos del Sueño del Ritmo Circadiano/fisiopatología , Traqueostomía , Triazoles/uso terapéutico , Ácido Valproico/uso terapéutico