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Neuropharmacology Poster Session






Abstract

Introduction

Materials & Methods

Results

Discussion & Conclusion

References




Discussion
Board

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The role of psyhometric scale in humans to emphasize the anxolytic activity of calcium channel blockers.


Contact Person: Luput Georgeta (hospital@occmed.ro)


Introduction

CALCIUM CHANNEL BLOCKERS (CCB) decrease calcium influx. The effects appear on the skeletal, tracheal, bronchial, intestinal smooth muscles, heart, neuronal and vascular system.

CCB action through the neuronal cells by:

Reflex sympathetic5)

Vascular system1, 5)

Cell protection -cerebral vascular1, 5),

- cellular: free radicals, AGL, proteolyses

- neuromediators

CCB in ANXIETY3,4) MEDICAL disorders that can mimic panic

  • decrease calcium inward,
  • decrease norepinephrine release
  • improve cardiovascular activity by: vasodilatation, reduction of afterload, reduce heart rate, negative inotropism, coronary dilatation.

GENERALISED ANXIETY means6):

A)-Motor tension-tension,muscle symptoms

B)-Autonomic disturbance-cardiovascular

-respiratory

-gastro-intestinal

-genito-urinar

-autonomic nervous system

-sensorial symptoms

C)-Anger, fear

D)-Sleep disturbances,trouble in memory,depressive disposition

PANIC ATTACK means6):

Delimitate periode of fear and anger with-anxiety + -tension

-autonomic nervous symptoms

-sensorial symptoms

-cardiovascular symptoms

-respiratory symptoms

 

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Materials and Methods

We studied a group of 104 subjects devised in 3 groups: cardiovascular group (CV), 20 subjects, hypertensive group (HTA), 31 subjects, control group 53 subjects.

Below there is showed the psihometric paradigm scale and the scales used.

Psychometric scales tests:

  • behavioral findings
  • neurological findings2)

Scales:

STAI(State trait anxiety inventory)

-X 1-Like momentarily state

-X 2-like feature

Roumanian people standard STAI

HAM(Hamilton Anxiety Scale) applied at HTA and Control group

-0-5= -

-6-14=minor anxiety

>15=major anxiety

HAD(Anxiety and depression scale) applied at HTA and control group

A>4-8

The results were statistical analyzed with

-T test-two paired of means (For STAI X1-X2)

-T test-Unequal pair of means (for the rests of tests)

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Results

All the tests demonstrate a high level of anxiety. STAI test make us the differences between all anxiety state wich is different like feature and momentarily state (figure 1)

 Figure 1.: STAI differences at studied groups.

 

It is trough, the anxiety level is highest from the roumanian people standard make in 1987 (figure 2).

  Figure 2: STAI X2

 

CCB can influence the autonomic symptoms from anxiety and the catecholamines discharges .The different changes from CV group and HTA group can be given because the HTA group make an continuous treatment with CCB, in a chronic way and they have a sure state in hospital. The CV group have a stress state pre and postsurgical. In the same time the control group is made by students before examens session (in stress condition).

HAM study didn't give us statistical differences between studied groups. (Figure 3).  HAD tests give us significantly differences at studied groups, for anxiety.(Figure 4) The differences between HAM and HAD are given because in HAM are a lot of questions about the autonomic system which are equal in both groups.

  Figure 3: HAM study.

 

 

 

 

 

 

 

 

Figure 4. HAD study.

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Discussion and Conclusion

Mostly calcium channel blockers(CCB) used clinically are the tree distinct chemical classes:the phenylalkylamines(verapamil),the dihydropyridines(nifedipine) and the benzothiazepines(diltiazem).

Since the maintenance of intracellular and extracellular concentration of calcium is crucial for the proper function of tissue and organ systems, CCB have been used selectively to manage a variety of cardiovascular (CV) and cerebrovascular disorders.

The final therapeutic effect in humans dependson the mechanism of actionat the molecular level,the tissue selectivity,and and the hemodynamic changes of each agent.

Neuronal tissue are relatively insensitive to calcium antagonists5)

Outside of cerebrovascularaction the CCB have an cerebral cell protective action.The cell protection is realise by the action of cerebrovascular flow ,and to the neuronal cell and trought the neuromediators.

In anxiety definition and althought in panic disorders,caused by psychiatric or medical disorders,it is involve many organic symptoms like cardiovascular ,respiratory disturbances. This disturbances can be induced by a reflex stimulation of sympathetic system5) or another theory say that is an noradrenergic discharge from locus coeruleus2),or an elevation of hypotalamic-pituitary-adrenal axis.In all this cases the mechanism of action of CCB influence the catecholamines release and synthesis.Ferrari and col.said that catecholamines can completely overcome the effects of nifedipine.The lipophilic dihydropiridines(DHP),sublingual or oral DHP caused a very modest sympathetic reflex. But intravascular administration of CCB determines a sympatethic stimulation.

 Conclusions:

1)CCB influence neurovegetative symptoms.

2)CCB influence anxiety momentarily through feature anxiety state.

3)It was a difference between CV and HTA group ,even they made CCB treatment.

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References

    1. Ben-Ari,J.K.Canaux ioniques dans l'anoxie cerebrale,Medecin Science,vol.7,1:43-51
    2. Boer den.J.A,WesterbergH.G.M.-Effect of a serotonin land NA uptake inhibitors in panic Disorders,Cl.Psychopharma,3,1988,59-74. 3. Gibbs,D.M.-Hyperventilation-induced cerebral ischemia in panic disorders and effect of nimodipine, Am.J.Psychiatry,149:11:1589-1591,1992.
    4. Klein,E,Uhde,Th.W.-Controlled study of verapamil for treatment of panic disorders,Am.J.Psychiatry,145:4,1988
    5. Ferrari R.,Cucchini F,etc-How do Calcium antagonists Differ in Clinical Practice?,CV dgugs and teraphie,1994, 8 565-575
    6. Erris.C.J.,Bech F.The Hamilton Anxiety Disorders,1983,13,243-255
    7. Hannien H.,Antero A.,etc-Occupational exposure to lead and neuropsychological dysfunction,Occup.Environ.Med.,1998,55,202-209.
    8. Stephans R.,Penny Barker-Rol of human neurobehavioral tests in regulatory activity on chemicals,Occup.Environ.Med.,1998,55,210-214

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Luput, G.; Paduraru, A.; (1998). The role of psyhometric scale in humans to emphasize the anxolytic activity of calcium channel blockers.. Presented at INABIS '98 - 5th Internet World Congress on Biomedical Sciences at McMaster University, Canada, Dec 7-16th. Available at URL http://www.mcmaster.ca/inabis98/neuropharm/luput0370/index.html
© 1998 Author(s) Hold Copyright