Proceedings of the Western Pharmacology Society
-
Proc. West. Pharmacol. Soc. · Jan 2008
Review Case ReportsTakotsubo cardiomyopathy: case report and review of the literature.
Takotsubo cardiomyopathy, also known as stress induced cardiomyopathy and transient left ventricular apical ballooning syndrome, is a rare syndrome that is characterized by a transient decrease in ejection fraction. This is accompanied by hypokinesis of the left ventricle and ballooning of the apex, with hypercontractile base and non-obstructive coronary artery disease. Takotsubo was first described in Japan in the early 1990's. ⋯ Clinical symptoms are accompanied by transient left ventricular dysfunction. Despite clinical symptoms consistent with acute myocardial infarction, normal coronary arteries are usually detected upon cardiac catheterization. The case presented here is of an Asian woman who developed symptoms of acute myocardial infarction during a stressful hospital stay.
-
Proc. West. Pharmacol. Soc. · Jan 2007
ReviewDrug administration is an essential clinical competence.
Quotidian clinical practice implies at least four essential activities: i) integration of diagnosis; ii) design of the therapeutic regimen; iii) following up therapeutic outcomes; and, iv) keeping updated on medical knowledge. The therapeutic regimen may include the use of drugs among other forms of treatment. A competent clinician is expected to be knowledgeable, skillful, dutiful and altruistic when deciding to use drugs. ⋯ However, an integrated view on how BMPK relates to their clinical application is not clearly stated. By the same token, legal and ethical aspects of drug administration are narrowed to prescription writing skills, either for the patient or for the clinical file; thus, attenuating the appraisal of the impact on therapeutic adherence of physicians' communication skills, as well as availability and/or accessibility of recommended drugs. These issues are obviously related to therapeutic outcome but their integrated articulation occurs only if drug administration is considered as an essential clinical competence.
-
Proc. West. Pharmacol. Soc. · Jan 2002
Review Historical ArticleAn introduction to migraine: from ancient treatment to functional pharmacology and antimigraine therapy.
Migraine treatment has evolved from the realms of the supernatural into the scientific arena, but it seems still controversial whether migraine is primarily a vascular or a neurological dysfunction. Irrespective of this controversy, the levels of serotonin (5-hydroxytryptamine; 5-HT), a vasoconstrictor and a central neurotransmitter, seem to decrease during migraine (with associated carotid vasodilatation) whereas an i.v. infusion of 5-HT can abort migraine. In fact, 5-HT as well as ergotamine, dihydroergotamine and other antimigraine agents invariably produce vasoconstriction in the external carotid circulation. ⋯ Nevertheless, PNU-142633 proved to be ineffective in the acute treatment of migraine, whilst LY344864 did show some efficacy when used in doses which interact with 5-HT1B receptors. Finally, although the triptans are effective antimigraine agents producing selective cranial vasoconstriction, efforts are being made to develop other effective antimigraine alternatives acting via the direct blockade of vasodilator mechanisms (e.g. antagonists at CGRP receptors, antagonists at 5-HT7 receptors, inhibitors of nitric oxide biosynthesis, etc). These alternatives will hopefully lead to fewer side-effects.