Succinate sumatriptan evaluation by Doppler echocardiography in patients with migraine.

Recent reports show that sumatriptan administration increases blood pressure and vascular resistance both in systemic and pulmonary circulation. This study was performed to evaluate by echo-Doppler technique the hemodynamic effects of subcutaneous sumatriptan administration. Forty-one migraine subjects (26 males, 15 females), mean age 36 +/- 2 years (range 36-39 years), and 20 healthy control subjects (14 males, six females), mean age 36 +/- 2 years (range 36-39 years) were randomized (double-blind) to receiving sumatriptan (group A) or placebo (group B). After a 2-week complete pharmacological washout, clinical examination, electrocardiogram, and Doppler echocardiography were performed at baseline, 15, 30, 45, and 60 min after sumatriptan or placebo administration. No significant differences were found between the two groups regarding Doppler echocardiographic parameters (aortic integral, pulmonary integral, end-systolic and end-diastolic diameters) and heart rate; only a slight but not significant increase in arterial blood pressure was observed in group A. Our data show that succinate sumatriptan can be used with safety in patients without hypertension and other cardiovascular disease.

[Raynaud's phenomenon: effects of terazosin]. / Il fenomeno di Raynaud: effetti della terazosina.

After considering the clinical and physiopathological aspects of Raynaud's phenomenon, the authors have evaluated the medium effects of therazosine in 2 groups of patients, respectively with idiopathic and secondary Raynaud's phenomenon. The results show that the therazosin determines a decrease of number, intensity and duration of vasospastic attacks to the hands as well as an improvement of telethermographic and ultrasonographic findings.

[Effect of sumatriptan on facial temperature variations, blood pressure and electrocardiogram in healthy subjects and patients with migraine without aura]. / Variazioni termografiche facciali, pressorie ed elettrocardiografiche indotte dal sumatriptan in soggetti normali ed in emicranici senza aura.

40 patients were evaluated for skin temperature changes from baseline measurements and after 6 mg subcutaneous sumatriptan administration. During examination, skin temperature were recorded on a color picture at 10', 20', 30', 60', 90' and 120 minutes after sumatriptan administration. At the some time, heart rate (HR), systolic (SBP), diastolic (BDP) blood pressure and ECG-monitoring were automatically recorded. The patients were subgrouped as follow: 20 non migrainous control subjects (6 males and 14 females) aged 19 to 55 years (mean age 39.5 +/- 15.4); 20 headache free migrainous patients (6 males and 14 females) aged 25 to 46 years (mean age 37.8 +/- 8.4). Our data demonstrate a significant reduction in skin temperature (face) in all patients studied. 10 minutes after sumatriptan administration a significant increase (p > 0.001) both in SBP and BDP was observed. This findings suggest that sumatriptan show a vasoconstrictor effect as demonstrate by reduction in face temperature both in nonmigrainous and in migrainous patients. The unchange in HR and ECG and the transient increase in blood pressure, not associated with clinical symptoms, suggest that this drug may be used in migrainous patients.

Effects of sumatriptan on isolated rabbit heart.

Sumatriptan provokes, in healthy subjects as well as in those who suffer from hemicrania, a slight increase in both systolic and diastolic arterial pressure. It has also been shown to increase the pressure of pulmonary circulation and to reduce the calibre of coronary arteries. The present investigation was undertaken to study the effects of sumatriptan (75 ng/l) on isolated rabbit hearts. Fifteen isolated rabbit hearts, perfused according to Langerdoff's procedure, were divided into two groups: Group I (5 hearts), perfused with Krebs-Henseleit solution, as a control, and Group II (10 hearts), perfused with Krebs-Henseleit mixed with sumatriptan succinate (75 ng/l). After 30 min of perfusion, the basal values of heart rate (HR) dp/dt, systolic ventricular pressure (SVP), diastolic ventricular pressure (DVP) and coronary flow (CF) were measured. The above values in either control or treated hearts were measured 5, 15, 30, 45, 60 min after recording the baseline values. HR, SVP, DVP, dp/dt and CF did not show significant differences in the two groups. The present data suggest that sumatriptan does not exert any action on isolated rabbit hearts.

[The effects of terazosin hydrochloride and buflomedil in patients with hemicrania without aura]. / Effetti della terazosina cloridrato e del buflomedil in pazienti affetti da emicrania senz'aura.

Considering the pharmacologic properties of terazosine and buflomedil, the authors postulated a prophylactic activity of these drugs for paroxysmal headache in migraine patients without aura. Therefore, in an open trial, 46 such patients were subdivided into three groups, the first of which (10 patients) was treated with terazosine, the second (29 patients) with buflomedil, and the third (7 patients) with both drugs according to a previously elaborated protocol with periodical assessment of the M.I.C. (Migraine Index Corrected). At the end of the treatment period, statistically evaluated M.I.C. variations appeared to indicate that buflomedil had better therapeutic activity than terazosine and the terazosine-buflomedicl combination. Finally, the authors discuss some hypotheses in the attempt to account for the mechanism of action since the lesser therapeutic effect of the combination compared to buflomedil alone cannot be reasonably explained.

Effects of dopamine on isolated failing rat heart.

Dopamine has been used for many years to treat patients with severe heart failure. It is not clear whether improvements of cardiac function may be due to a direct action on heart. This study was aimed to investigate the direct action of dopamine on failing heart. we chose male Wistar rats which had undergone uninephrectomy under ether anaesthesia to induce hypertension to result in heart failure. After 5 weeks the hearts were excised and perfused according to Langerdoff's technique. Heart rate, systolic and diastolic ventricular pressures, the derivative of the intraventricular pressure time ratio, and coronary flow were measured at baseline, at 2 and 5 min and then every 5 min during a 30-min period. Rat hearts were divided into 4 groups of 5 hearts: group 1, perfused without drug; group 2, perfused with dopamine at 4 micrograms/kg/min; group 3, perfused with dopamine at 8 micrograms/kg/min; group 4, perfused with dopamine at 8 micrograms/kg/min and with 100 nM I.C.I. 118.551 (beta 2-ant: beta-2 receptors antagonist) at the same time. Our results show that dopamine induced a negative inotropic effect and a reduction of coronary flow. Moreover, there was a significant chronotropic action even when dopamine was administered at high concentrations. So we found no positive dopamine effect on isolated failured hearts of rat. This might be explained by both alpha-1-induced vasoconstriction and the stimulation of alpha-1B receptors. We conclude that the favourable effects of dopamine in heart failure could be due to DA1 vasodilation rather than to a direct inotropic action on the heart.

[Captopril versus placebo in the prevention of hemicrania without aura. A randomized double-blind study]. / Captopril versus placebo nella profilassi dell'emicrania senz'aura. Studio in doppio cieco randomizzato.

Endogenous opioids are known to be involved in the pathophysiology of idiopathic headache. In fact, decreased levels of enkephalin (E) or endorphin (BE) during headache attacks might be a marker of an altered pain-inhibiting system of central neurotransmission or could be secondary to alterations of brain circulation that often occur during the headache crisis. Recently, captopril (C) has been shown to be apt to restore the availability of endogenous opioids, to improve cerebral blood flow via the inhibition of both the cerebral and systemic renin-angiotensin system or of catecholamine release. It has also been reported to be able to restore the nociceptive-antinociceptive balance through an increase of serum kinin (K) or prostaglandin (Pr) levels. In the present study, the efficacy of C in reducing the frequency (F), duration (D), or severity (S) of headache paroxysm were investigated in a double blind trial vs. placebo (P). Twenty-six subjects (5 males and 21 females; mean age 37 +/- 11 years) suffering from idiopathic headache at least for one year have been allocated to treatment with C (25 mg three times/day) or P according to a double-blind randomized protocol for 4 months. The effects of C or P have been evaluated with Migraine Index Correct, related to changes in F, D or S of headache attacks. Our results indicate that C is effective in reducing F, D or S in subjects with idiopathic headache.