Management of Chronic Brain Syndrome Secondary to Cerebral Arteriosclerosis, With Special Reference to Papaverine Hydrochloride

Stern, Francis H.

doi:10.1111/j.1532-5415.1970.tb01337.x

Cited by 21 publications

(5 citation statements)

References 10 publications

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“…These data suggest that compounds which are primarily vasodilators would be useful in only a minority of patients. If impeded blood flow is contributing to senile dementia in only 17 percent of randomly drawn patients, it is difficult to envision how papaverine could have produced the statistically significant improvement found in a small number of published studies (12–14). Therefore, in order to explain the positive results of the present study and others, we suggest that papaverine may be producing its effects by a mechanism other than vasodilation.…”

Section: Discussionmentioning

confidence: 99%

Effects of Chronic Papaverine Administration on Mild Senile Organic Brain Syndrome

Branconnier¹,

Cole²

1977

J American Geriatrics Society

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Two groups of geriatric patients were treated with either 300 mg/day of papaverine hydrochloride (Pavabid) or placebo in a double‐blind study of two months’ duration. All patients (25 in each group initially) had mild to moderate senile organic brain syndrome but were ambulatory and treated on an outpatient basis. Neuropsychologic evaluations were made by means of the following six tests: Electroencephalographic Analysis (EEG), Profile of Mood States (POMS), Subject Paced Digit Symbol Substitution Test (SPDT), Continuous Performance Test (CPT), Peterson and Peterson Test (P & P) for Short‐Term Memory, and Clinical Global Impression (CGI). The tests were comparative with a baseline period and between treatment groups. There were positive responses from baseline to active‐drug treatment in four of the six evaluations—EEG, POMS, SPDT and CPT. Some side effects were noted in both drug and placebo groups, but these were not disabling and did not interrupt therapy. Positive responses were also observed between treatment groups. By the EEG criterion, the papaverine patients responded positively. By the P & P test for short‐term memory, the placebo group responded better than did the papaverine group. It is suggested that the pharmacodynamic action of papaverine in ameliorating the symptoms of senile organic brain syndrome may not be due to vasodilation but to dopamine receptor blockade.

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Section: Discussionmentioning

confidence: 99%

Effects of Chronic Papaverine Administration on Mild Senile Organic Brain Syndrome

Branconnier¹,

Cole²

1977

J American Geriatrics Society

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“…Papaverine is a further opium alkaloid that is clinically used as an anti‐spasmolytic agent because of its smooth muscle relaxing effect and is also available for the treatment of erectile dysfunction . Papaverine has a plasma half‐life of about 2–3 hours (Table ) and after intravenous or oral administration of 80 mg papaverine, this opium alkaloid can be determined in plasma up to 24 hours .…”

Section: Methodsmentioning

confidence: 99%

Confirmation of recent heroin abuse: Accepting the challenge

Maas

Madea

Heß

2017

Drug Testing and Analysis

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Confirmation or exclusion of recent heroin consumption is still one of the major challenges for forensic and clinical toxicologists. A great variety of biomarkers is available for heroin abuse confirmation, including various opium alkaloids (eg, morphine, codeine), street heroin impurities (eg, 6-acetylcodeine [6-AC], noscapine, papaverine) as well as associated metabolites (eg, 6-monoacetylmorphine [6-MAM], morphine glucuronides). However, the presence of most of these biomarkers cannot solely be attributed to a previous heroin administration but can, among other things, also be due to consumption of poppy seed products ('poppy seed defense'), opium preparations or specific medications, respectively. A reliable allocation is of great importance in different contexts, for instance in the case of DUID (driving under the influence of drugs) investigations, in driving licence re-granting processes, in workplace drug testing (WDT), as well as in post-mortem identification of illicit opiate use. Additionally, differentiation between illicit street heroin abuse and pharmaceutical heroin administration is also important, especially within the frame of heroin-assisted treatments. Therefore, analysis of multiple biomarkers is recommended when illicit opiate consumption is assumed to obtain the most reliable results possible. Beyond that, interpretation of positive opiate test results requires a profound insight into the great variety of biomarkers available and their validity regarding the alleged consumption. This paper aims to provide an overview of the wide variety of heroin abuse biomarkers described in the literature and to review them regarding their utility and reliability in daily routine analysis.

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“…It decreases cerebrovascular resistance and papaverine hydrochloride has been much used in the U.S.A. in recent years in patients with cerebral arterial disease and peripheral arterial disease (Jayne, Scheinberg and Belle, 1952;Whittier, 1964;Stern, 1970). Side effects following oral administration were considered insignificant and largely limited to nausea, vomiting or throbbing headache.…”

Section: Introductionmentioning

confidence: 99%