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J Cereb Blood Flow Metab ; 41(4): 693-706, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33210576

RESUMO

Adrenoceptor and calcium channel modulating medications are widely used in clinical practice for acute neurological and systemic conditions. It is generally assumed that the cerebrovascular effects of these drugs mirror that of their systemic effects - and this is reflected in how these medications are currently used in clinical practice. However, recent research suggests that there are distinct cerebrovascular-specific effects of these medications that are related to the unique characteristics of the cerebrovascular anatomy including the regional heterogeneity in density and distribution of adrenoceptor subtypes and calcium channels along the cerebrovasculature. In this review, we critically evaluate existing basic science and clinical research to discuss known and putative interactions between adrenoceptor and calcium channel modulating pharmacotherapies, the neurovascular unit, and cerebrovascular anatomy. In doing so, we provide a rationale for selecting vasoactive medications based on lesion location and lay a foundation for future investigations that will define neuroprotective paradigms of adrenoceptor and calcium channel modulating therapies to improve neurological outcomes in acute neurological and systemic disorders.


Assuntos
Adrenérgicos/uso terapêutico , Bloqueadores dos Canais de Cálcio/uso terapêutico , Canais de Cálcio/efeitos dos fármacos , Transtornos Cerebrovasculares/tratamento farmacológico , Doenças do Sistema Nervoso/tratamento farmacológico , Receptores Adrenérgicos/efeitos dos fármacos , Animais , Humanos , Vasoconstritores/farmacologia , Vasoconstritores/uso terapêutico
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