Pharmacology & therapeutics
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Adrenaline (epinephrine) has been used for cardiopulmonary resuscitation (CPR) since 1896. The rationale behind its use is thought to be its alpha-adrenoceptor-mediated peripheral vasoconstriction, causing residual blood flow to be diverted to coronary and cerebral circulations. This protects these tissues from ischaemic damage and increases the likelihood of restoration of spontaneous circulation. ⋯ Adrenaline has deleterious effects in the setting of resuscitation, predictable from its promiscuous pharmacological profile. This article discusses the relevant pharmacology of adrenaline in the context of CPR. Experimental and clinical evidences for the use of adrenaline and alternative vasopressor agents in resuscitation are given, and the properties of an ideal vasopressor are discussed.
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Depression and anxiety represent a major problem. However, the current treatment of both groups of diseases is not satisfactory. As the glutamatergic system may play an important role in pathophysiology of both depression and anxiety, we decided to discuss the recent data on possible anxiolytic and/or antidepressant effects of metabotropic glutamate (mGlu) receptor ligands. ⋯ On the other hand, data has been accumulated, indicating that antagonists of group II mGlu receptors have an antidepressant potential. Group III mGlu receptor ligands represent the least investigated group of mGlu receptors. However, preclinical data also indicates that ligands of these receptors, both agonists and antagonists, may have an anxiolytic-like and antidepressant-like potential.