Since chlorpromazine appeared in the clinical field as the chief drug of the artificial hibernation therapy, many physicians were interested in its specific phamacologic and clinical actions, and now it has been used not only in the field of surgery and psychiatry but also in the every clinical field.Especially its action for the central nurvous system is remarkable i.e., the action of hypnotism, calmness, antispasm, control of vomit, alleviation of fever and etc.(1) And then it is said that it has the action of the pharmacologic lobotomy and the inhibitory action of thalamus. Therefor it is interesting to measure the effects of this drug on the cerebral circulation and metabolism, in a sense to observe its working mechanism. The hypotensive state and the lowered systemic metabolism caused by this drug is also the important chances to examine the changes in the brain. Already it was reported that in vitro chlorpromazine supressed the tissue respiration of slice of cerebral cortex(2).But these reports have not always showed the consistent results. For instance Grenell et al.(3), in measuring of the 02 content in the cerebral cortex of rat, showed that there was no significant difference between the medication group of chlorpromazine and the control group. Though a few yet, cerebral hemodynamics and metabolism were measured using the modified nitrous oxide method of Kety & Schmidt before and after administration of chlorpromazine. Table 1 205
Basic pharmacologic evidences have suggested the effects of dihydroergotoxine mesylate (DEM) on neurotransmitters. In its clinical use, however, various therapeutic effects and side effects are observed when the dose is changed, because of the complexity of this compound and the delicate mechanism of neurotransmitters in the brain, especially when modified by aging and vascular lesions. In order to investigate the optimal dose, a double-blind study in 550 patients with cerebrovascular disorders was carried out at 68 centers under observation by experienced specialists. Dihydroergotoxine mesylate in sublingual tablets, 3 mg daily, and in oral tablets, 6 mg daily, respectively, was given for 12 weeks, and therapeutic effects at those doses were compared by a double-blind method. In utility ratings for subjective and psychiatric symptoms, the effects in the oral tablet group at a daily dose of 6 mg were significantly superior to those in sublingual tablet group at a daily dose of 3 mg. There was no significant difference between those two groups in the comparison of side effects. These results show that the daily oral administration of 6 mg of DEM is more suitable for the improvement of subjective and psychiatric symptoms due to cerebrovascular disorders than is the daily sublingual administration of 3 mg. These results suggest that, despite much complexity in the neurohumoral transmitter mechanism in the brain, relatively simple dose-dependent efficacy of the drug in the range of the therapeutic doses was confirmed for many subjective and psychiatric symptoms of patients with cerebrovascular disorders.
The studies on plasmin system in the field of internal medicine have been made exclusively in hemorrhagic hematologic diseases up to date. Recently, we are investigating on this enzyme system on the patient ailing cerebral vascular lesions, and will present some of our results in this paper. Materials: The number of cases studied up to date is 45, involving both sexes aged from 45 to 71 years old.
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