Cns Drugs
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Review
Acetyl-L-carnitine for the treatment of chemotherapy-induced peripheral neuropathy: a short review.
Peripheral neurotoxicity is a major complication associated with the use of chemotherapeutic agents such as platinum compounds, taxanes and vinca alkaloids. The neurotoxicity of chemotherapy depends not only on the anticancer agent(s) used, the cumulative dose and the delivery method, but also on the capacity of the nerve to cope with the nerve-damaging process. The sensory and motor symptoms and signs of neurotoxicity are disabling, and have a significant impact on the quality of life of cancer patients. ⋯ These results, plus the favourable safety profile of ALC in neuropathies of other aetiologies, have led to the effects of ALC on CIPN being investigated in cancer patients. Preliminary results have confirmed the reasonably good tolerability profile and the efficacy of ALC on CIPN. The present studies support the use of ALC in cancer patients with persisting neurotoxicity induced by paclitaxel or cisplatin treatment.
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Randomized Controlled Trial Comparative Study
Spectral frequency index monitoring during propofol-remifentanil and propofol-alfentanil total intravenous anaesthesia.
The aim of this study was to evaluate the usefulness of spectral frequency index (SFx) monitoring to assess the depth of anaesthesia during propofol-opioid total intravenous anaesthesia (TIVA). ⋯ As SFx is linearly related to plasma propofol concentration, this index may be used to measure anaesthetic effect during propofol anaesthesia. The results of this clinical trial are consistent with a previous computer-simulated opioid-propofol model with regard to intraoperative and recovery variables, although the recovery occurred at different propofol concentration and SFx values.
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Pramipexole is an oral, non-ergoline dopamine agonist with selectivity for the dopamine D(3) receptor, which was recently approved in the EU and the US for the treatment of idiopathic restless legs syndrome (RLS) in adults. In a polysomnographic study, pramipexole 0.125, 0.25, 0.50 or 0.75 mg once daily for 3 weeks significantly reduced from baseline the periodic limb movement index compared with placebo (-27 to -53 vs -3). ⋯ Treatment with pramipexole 0.25, 0.50 or 0.75 mg once daily for 12 weeks significantly reduced IRLS scores from baseline values (-13 to -14 vs -9) and produced significantly higher proportions of CGI-I responders (68-75% vs 51%) compared with placebo. Pramipexole was generally well tolerated, with most adverse events being transient and of mild to moderate severity.