Modern approaches to drug treatment for vestibular vertigo

In recent years, some progress has been achieved in elaborating the algorithms and standards for the treatment of many conditions accompanied by vertigo. The current possibilities of treating vestibular vertigo consist of a gradually expanding arsenal of symptomatic and pathogenetic drugs. Among the drugs used for the symptomatic treatment of vestibular vertigo, there are vestibular suppressants (antihistamines, benzodiazepines, and calcium antagonists) and antiemetics (dopamine antagonists and serotonin 5-HT3 receptor antagonists). The paper discusses the possibilities of using betahistine and vitamin D as pathogenetic agents for recurrent benign paroxysmal positional vertigo; diuretics, betahistine (including the new prolonged release formulation Betaserc® Long), glucocorticoids, and gentamicin for Meniere's disease; triptans, beta-blockers, tricyclic antidepressants, and anticonvulsants for vestibular migraine; glucocorticoids, antiviral agents, and drugs that accelerate vestibular compensation for acute unilateral peripheral vestibulopathy (vestibular neuritis and Ramsey Hunt syndrome).The emergence of new drugs, as well as the design of new dosage forms that enhance patient adherence to the prescribed treatment, can improve quality of life in patients suffering from diseases that have recently led to long-term disability or even incapacitation.

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SARS-CoV-2: a view on its origin, transmission, genetic characteristics and pathogenicity

Revista Eletrônica Acervo Saúde ◽

10.25248/reas.e7567.2021 ◽

2021 ◽

Vol 13 (6) ◽

pp. e7567

Author(s):

Kassyo Lenno Sousa Dantas ◽

Wilian Reis Rosário ◽

Alice Gabrielly Landim Lima ◽

Antonio Ycaro Rodrigues Lucena ◽

Thallyson Jose Dourado de Sousa ◽

...

Keyword(s):

Clinical Efficacy ◽

Life Support ◽

Genomic Sequence ◽

Antiviral Agents ◽

Unknown Origin ◽

Symptomatic Treatment ◽

Etiologic Agent ◽

New Drugs ◽

Therapeutic Interventions ◽

Genetic Characteristics

Objective: To describe the origin, transmission, morphological and genetic characteristics of SARS-CoV-2 and its pathogenicity mechanisms. Bibliographic review: At the end of December 2019, health centers in Wuhan, Hubei-China province, observed several cases of pneumonia of unknown origin, associated with a new etiologic agent, a virus, with a similar, but distinct, genomic sequence of SARS-CoV and MERS-CoV, named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The most common symptoms at the beginning of the infection are fever, cough, fatigue, olfactory and taste disorders; on the other hand, severe cases include pulmonary impairment and hypoxia. Currently, there are no antiviral agents with proven clinical efficacy and vaccination occurs in slow steps in most countries, with symptomatic treatment and life support still being the main therapeutic interventions available. Final considerations: SARS-CoV-2 presents itself as one of the biggest public health problems in the world nowadays. The search for new drugs to treat COVID-19 is constant, however, so far no new drug is available for use with 100% proven clinical efficacy.

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New Opioids

Journal of Clinical Oncology ◽

10.1200/jco.2013.51.8662 ◽

2014 ◽

Vol 32 (16) ◽

pp. 1671-1676 ◽

Cited By ~ 15

Author(s):

Sebastiano Mercadante ◽

Giampiero Porzio ◽

Vittorio Gebbia

Keyword(s):

Treatment Options ◽

Opioid Analgesics ◽

Receptor Activation ◽

New Drugs ◽

Prolonged Release ◽

Antagonist Activity ◽

Release Formulation ◽

Opioid Medication ◽

Μ Opioid Receptor ◽

The Individual

Despite the skilled use of opioid analgesics, which is crucial to the relief of cancer pain, there is a lack of evidence to support many aspects of current clinical practice. Therefore, there is a significant need for more effective treatment options. New opioids have been marketed in the past years, including hydrocodone and oxymorphone. Moreover, mixed opioids with combined mechanisms of action have been developed; one such agent, tapentadol, is a centrally acting oral analgesic that possesses a combined mechanism of action: μ-opioid receptor activation with norepinephrine reuptake inhibition. Drug development strategies involving naloxone have been initiated to reduce peripheral opioid-related adverse effects. The rationale is based on the local antagonist activity of naloxone in intestinal opioid receptors and the negligible oral bioavailability of naloxone, particularly in a prolonged-release formulation. New delivery systems have been developed to provide rapid analgesia with potent opioid drugs such as fentanyl. Despite the upcoming availability of these new drugs and technologies that will add to existing types of opioid medication, their benefits and liabilities will ultimately need to be determined by the individual physician and individual patient experiencing pain.

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Neuroprotective Properties of 4-Aminopyridine

Neurology Neuroimmunology & Neuroinflammation ◽

10.1212/nxi.0000000000000976 ◽

2021 ◽

Vol 8 (3) ◽

pp. e976

Author(s):

Michael Dietrich ◽

Hans-Peter Hartung ◽

Philipp Albrecht

Keyword(s):

Motor Skills ◽

Visual Function ◽

Symptomatic Treatment ◽

Prolonged Release ◽

Symptomatic Therapy ◽

Release Formulation ◽

Voltage Gated ◽

Beneficial Effects ◽

Kv Channels ◽

Neurologic Disorders

As an antagonist of voltage-gated potassium (Kv) channels, 4-aminopyridine (4-AP) is used as symptomatic therapy in several neurologic disorders. The improvement of visual function and motor skills and relieve of fatigue in patients with MS have been attributed to 4-AP. Its prolonged release formulation (fampridine) has been approved for the symptomatic treatment of walking disability in MS. The beneficial effects were explained by the blockade of axonal Kv channels, thereby enhancing conduction along demyelinated axons. However, an increasing body of evidence suggests that 4-AP may have additional properties beyond the symptomatic mode of action. In this review, we summarize preclinical and clinical data on possible neuroprotective features of 4-AP.

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Practical Applications for Single Pill Combinations in the Cardiovascular Continuum

Cardiac Failure Review ◽

10.15420/cfr.2017:5:1 ◽

2017 ◽

Vol 03 (01) ◽

pp. 40 ◽

Cited By ~ 2

Author(s):

Ferdinando Iellamo ◽

Karl Werdan ◽

Krzysztof Narkiewicz ◽

Giuseppe Rosano ◽

Maurizio Volterrani ◽

...

Keyword(s):

Combination Therapy ◽

Patient Adherence ◽

Beta Blockers ◽

New Drugs ◽

Practical Applications ◽

Proven Efficacy ◽

Single Pill ◽

Improve Patient Adherence ◽

Improve Patient ◽

Lower Medical Cost

Despite the availability of new drugs and devices, the treatment of cardiovascular disease remains suboptimal. Single-pill combination therapy offers a number of potential advantages. It can combine different classes of drugs to increase efficacy while mitigating the risks of treatment-related adverse events, reduce pill burden, lower medical cost, and improve patient adherence. Furthermore, in hypertension, single pill combinations include lower doses of each drug than would be necessary to achieve goals with monotherapy, which may explain their better tolerability compared with higher dose monotherapy. Combination therapy is now established in the treatment of hypertension. In ischaemic heart disease, the concept of a preventative polypill has been studied, but its benefits have not been established conclusively. However, the combination of ivabradine and beta-blockers has proven efficacy in patients with stable angina pectoris. This combination has also demonstrated benefits in patients with chronic heart failure.

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