Cerebral blood flow and indomethacin drug levels in subjects with and without central nervous side effects.

Seideman, P; Arbin, Magnus von

doi:10.1111/j.1365-2125.1991.tb05558.x

Cited by 32 publications

(22 citation statements)

References 15 publications

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“…Dexamethasone alters arachidonic acid metabolism by inhibition of phospholipase A2, and thus prevents the production of vasoactive agents such as prostaglandins and leukotrienes [18,19]. Indomethacin, a cyclo-oxygenase inhibitor, is known to inhibit prostaglandin synthesis [19] and decrease cerebral blood flow velocity (CBFV) in adults [8,22] and neonates [1,9,11,17,21,25]. Although dexamethasone and indomethacin act at different sites in the metabolism of arachidonic acid, dexamethasone may also alter the CBFV.…”

Section: Introductionmentioning

confidence: 99%

The effect of dexamethasone on time averaged mean velocity in the middle cerebral artery in very low birth weight infants

et al. 1994

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The effect of repeated doses of dexamethasone (0.25 mg/kg/dose every 12 h) on time averaged mean velocity in the middle cerebral artery was assessed in ten ventilated very low birth weight infants requiring treatment with dexamethasone for bronchopulmonary dysplasia or airway obstruction. The infants were studied by colour/duplex Doppler technique prior to the administration of the first and the third dose of dexamethasone, and 10, 30, and 120 min after these doses. Dexamethasone treatment was associated with an improvement in infant lung condition, an increase in mean arterial blood pressure and a decrease in heart rate. The time averaged mean velocity was statistically significantly reduced at 120 min after the first dose. This was not associated with a decrease in PCO2. The observed reduction of 18% from baseline in the time averaged mean velocity is unlikely to be of clinical importance.

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Section: Introductionmentioning

confidence: 99%

The effect of dexamethasone on time averaged mean velocity in the middle cerebral artery in very low birth weight infants

et al. 1994

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“…Neither Laudignon et al [10], nor Saliba et al [16] reported on the presence or absence of a PDA at the time of the third dose. In adults however, in the absence of a PDA a repeat dose of indomethacin after 7 days of treatment has resulted in an almost identical decrease in CBFV as after the first dose [4], We did not obtain blood gases at the time of each measurement of CBFV, but Laudig non et al [10] noted that blood gases re mained extremely stable during their study on the effect of indomethacin on CBFV, and it is therefore unlikely that our findings could be explained by changes in blood gases. In addi tion, we found no statistically significant changes in blood gases obtained prior to the first and the third dose of indomethacin.…”

Section: Discussionmentioning

confidence: 99%

“…A 30-60% reduction in CBF velocity (CBFV) has since been demonstrated in normal adult subjects [3,4], The effect of indomethacin on cerebral haemodynamics in preterm infants has been investigated by several means [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19], Regard less of technique, all studies have shown a sta tistically significant reduction in CBF/CBFY. The validity and/or the reliability of Doppler Meta-analyses of randomized controlled trials (RCTs) have shown that indomethacin administered every 8-12 h for a maximum of 3 doses improves the cardiorespiratory status and decreases mortality of preterm neonates with a symptomatic patent ductus arteriosus (PDA) [ 1 ].…”

Section: Pickard and Mckenziementioning

confidence: 99%

Effect of Indomethacin on Cerebral Blood Flow Velocities in Very Low Birth Weight Neonates with a Patent Ductus Arteriosus

Ohlsson¹,

Bottu²,

Govan³

et al. 1993

Dev Pharmacol Ther

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The effect of repeated doses of indomethacin on mean peak velocity (MPV) and time-averaged mean velocity in the middle cerebral artery was assessed in 10 ventilated neonates with a patent ductus arteriosus using colour/duplex Doppler technique prior to, and 10, 30, and 120 min after the first and the third dose. Velocities were significantly reduced up to 120 min after the first dose. The third dose resulted in a significant reduction in MPV at 10 and 30 min following treatment. This reduction was half of that observed after the first dose. Systemic blood pressure (BP) and heart rate did not change significantly after each separate dose. However, by the third dose, mean and diastolic BP were significantly increased from pretreatment levels. The attenuated response of cerebral blood flow (CBF) velocities to the third dose of indomethacin compared with the first dose is probably related to altered haemodynamics. Indomethacin should be used cautiously in infants with other conditions which are known to decrease CBF such as hypotension, hypocarbia and polycythaemia.

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“…However, it can be deduced that acute cognitive decline is not a predicted adverse effect in conjunction with the other aforementioned side effects in healthy individuals. In order to elucidate the pathophysiology of the central nervous system with regard to the side effects of indomethacin, Seideman and von Arbin [14] investigated cerebral blood flow in healthy subjects and showed that there were no differences in cerebral blood flow reductions in subjects either with or without these side effects. However, cognitive function was not affected in our study population.…”

Section: Discussionmentioning

confidence: 99%

“…As a potent nonselective COX inhibitor, it has been hypothesized that indomethacin causes vasoconstriction and a decline in cerebral blood flow. [13,14] Besides its effects on cerebral blood flow and vascular reactivity, indomethacin suppresses the mediators of central nervous system (CNS) inflammation. [12] However, this neuroprotective action [15] has not been verified in all studies.…”

Section: Discussionmentioning

confidence: 99%

A Single Dose of Indomethacin Does Not Prolong Premotor Reaction Time in Young, Healthy Adults: A Randomized, Placebo-Controlled, Double-Blind, Cross-Over Study

et al. 2012

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Amaç: Bu çalışmada sağlıklı bireylerde tek doz indometazinin bilgi işlem hızını etkileyebileceği hipotezi araştırıldı. Objectives: In this study, we aimed to investigate the hypothesis that a single dose of indomethacin may affect information processing speed in healthy subjects. Hastalar ve yöntemler: Patients and methods:In this cross-sectional, randomized, placebo controlled, double-blind, cross-over study, 30 healthy adults (8 males, 22 females; mean age 32.4±5.3 years; range 24 to 42 years) received a single dose of 25 mg indomethacin (Endol, oral capsule, DEVA Pharmaceutics, Kartepe, Turkey) and placebo. Premotor reaction and response times were measured electromyographically before and after the administration of preparations by a blinded researcher in the Electrophysiology Laboratory at Gazi University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Ankara.Results: Premotor reaction time measurements before and after a single dose of indomethacin were 169.1±36.3 and 160.2±29.5 msec, respectively (p=0.113). Premotor reaction time measurements before and after a single dose of placebo were 158.7±35.5 and 161.5±36.3 msec, respectively (p=0.516). There was also no statistically significant difference between premotor reaction time measurements of the indomethacin and placebo groups. Conclusion:A single dose of indomethacin did not change premotor reaction time and response time in healthy adults. This may suggest that indomethacin has no effect on the information processing speed in healthy adults.

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Cerebral blood flow and indomethacin drug levels in subjects with and without central nervous side effects.

Cited by 32 publications

References 15 publications

The effect of dexamethasone on time averaged mean velocity in the middle cerebral artery in very low birth weight infants

The effect of dexamethasone on time averaged mean velocity in the middle cerebral artery in very low birth weight infants

Effect of Indomethacin on Cerebral Blood Flow Velocities in Very Low Birth Weight Neonates with a Patent Ductus Arteriosus

A Single Dose of Indomethacin Does Not Prolong Premotor Reaction Time in Young, Healthy Adults: A Randomized, Placebo-Controlled, Double-Blind, Cross-Over Study

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