Medizinische Monatsschrift für Pharmazeuten
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Med Monatsschr Pharm · Nov 2007
Review[Pregabalin--a neuromodulator for the treatment of neuropathic pain, generalized anxiety disorders and fibromyalgia syndrome].
Synthesized in 1990 as an anticonvulsant agent, pregabalin was designed as a lipophilic gamma-aminobutyric acid (GABA) analog substituted at the 3'-position in order to facilitate diffusion across the blood-brain barrier. It is an alpha2delta1 ligand that binds to, and modulates, voltage-gated calcium channels. ⋯ Pregabalin has analgetic, anticonvulsant, and anxiolytic activity and has demonstrated efficacy in the management of neuropathic pain associated with diabetic peripheral neuropathy, postherpetic neuralgia, and as adjuvant therapy for adult patients with partial onset seizures. Pregabalin was significantly more effective than placebo for the treatment of generalized anxiety disorder as well as of fibromyalgia and was well tolerated by most of the patients.
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Med Monatsschr Pharm · Nov 2007
Review[Are AT1 receptor antagonists an alternative to ACE inhibitors in angioedema?].
History of angioedema is a contraindication for ACE-inhibitors. Angioedema is caused by: 1. a decreased degradation of bradykinin, 2. a defect in C 1-esterase-inhibitor with the increased generation of bradykinin or 3. other trigger mechanisms as food, pollen and stress. ⋯ Thus angioedema is no contraindication for AT1 receptor antagonists. In patients with an anamnestic angioedema or ACE-induced angioedema AT1 receptor antagonists can be given under close monitoring provided that there is strong indication for inhibition of the renin-angiotensin system.