BACKGROUND: Standard care in severe SARS-CoV-2 pneumonia complicated by severe dyspnea and respiratory failure, consists of symptom reduction, ultimately supported by mechanical ventilation. Patients with severe SARS-CoV-2, a prominent feature of COVID-19, show several similar symptoms to Critical Asthma Syndrome (CAS) patients, such as pulmonary edema, mucus plugging of distal airways, decreased tissue oxygenation, (emergent) exhaustion due to severe dyspnea and respiratory failure. Prior application of elective phosphodiesterase (PDE)3-inhibitors milrinone and enoximone in patients with CAS yielded rapid symptomatic relief and reverted the need for mechanical ventilation, due to their bronchodilator and anti-inflammatory properties. Based on these observations, we hypothesized that enoximone may be beneficial in the treatment of patients with severe SARS-CoV-2 pneumonia and prominent CAS-features. METHODS: In this case report enoximone was administered to four consecutive patients (1 M; 3 F; 46-70 y) with emergent respiratory failure due to SARS-CoV-2 pneumonia. Clinical outcome was compared with three controls who received standard care only. RESULTS: After an intravenous bolus of enoximone 20 mg followed by 10 mg/h via perfusor, a rapid symptomatic relief was observed: two out of four patients recovered within a few hours, the other two (with comorbid COPD GOLD II/III) responded within 24-36 h. Compared to the controls, in the enoximone-treated patients respiratory failure and further COVID-19-related deterioration was reverted and mechanical ventilation was prevented, leading to reduced hospital/ICU time. DISCUSSION: Our preliminary observations suggest that early intervention with the selective PDE3-inhibitor enoximone may help to revert respiratory failure as well as avert mechanical ventilation, and reduces ICU/hospital time in patients with severe SARS-CoV-2 pneumonia. Our findings warrant further research on the therapeutic potential of PDE3-inhibition, alone or in combination with other anti-COVID-19 strategies.
- MeSH
- COVID-19 MeSH
- Enoximone therapeutic use MeSH
- COVID-19 Drug Treatment MeSH
- Phosphodiesterase 3 Inhibitors therapeutic use MeSH
- Intensive Care Units MeSH
- Middle Aged MeSH
- Humans MeSH
- Respiratory Insufficiency therapy MeSH
- SARS-CoV-2 * MeSH
- Aged MeSH
- Respiration, Artificial * MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
[Cilostazol in treating lower limb ischaemia]
Cilostazol je vazodilatans s protidestičkovými, vazodilatačními a metabolickými účinky. Spolu s pohybovou aktivitou se uplatňuje v léčbě intermitentních klaudikací, klasických klinických projevů chronické končetinové ischemie. V doporučeních odborných společností je uváděný na prvním místě jako lék volby. Zatímco vliv cilostazolu na klaudikace hodnotí řada studií, jeho možnosti při ovlivnění individuálního kardiovaskulárního a cerebrovaskulárního rizika jsou stále ještě nedoceněné.
Cilostazol is a vasodilator with antiplatelet and metabolic properties. In addition to physical activity, it is used in the treatment of intermittent claudications, i.e. classic clinical signs of chronic limb ischaemia. Professional societies' guidelines list it as the first drug of choice. While the effect of cilostazol on claudications has been evaluated in a number of studies, its options for affecting the individual cardiovascular and cerebrovascular risks still remain unappreciated.
- MeSH
- Cilostazol MeSH
- Lower Extremity * blood supply MeSH
- Platelet Aggregation Inhibitors therapeutic use MeSH
- Phosphodiesterase 3 Inhibitors therapeutic use MeSH
- Intermittent Claudication * drug therapy prevention & control MeSH
- Clinical Trials as Topic MeSH
- Humans MeSH
- Peripheral Arterial Disease * drug therapy MeSH
- Tetrazoles therapeutic use MeSH
- Check Tag
- Humans MeSH
- Keywords
- inotropní látky, senzitizéry vápníku,
- MeSH
- Epinephrine agonists administration & dosage adverse effects MeSH
- Digoxin pharmacology adverse effects MeSH
- Dobutamine administration & dosage pharmacology adverse effects MeSH
- Dopamine administration & dosage pharmacology MeSH
- Phosphodiesterase 3 Inhibitors administration & dosage classification adverse effects therapeutic use MeSH
- Isoproterenol administration & dosage pharmacology adverse effects MeSH
- Cardiovascular Agents pharmacology classification adverse effects MeSH
- Cardiovascular Diseases * drug therapy MeSH
- Myocardial Contraction drug effects MeSH
- Contraindications, Drug MeSH
- Drug Interactions MeSH
- Humans MeSH
- Drug-Related Side Effects and Adverse Reactions MeSH
- Practice Guidelines as Topic MeSH
- Cardiac Glycosides pharmacology blood MeSH
- Sympathomimetics * administration & dosage pharmacology classification adverse effects MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
[Cilostazol in treating lower limb ischaemia]
Cilostazol je vazodilatans s protidestičkovými, vazodilatačními a metabolickými účinky. Spolu s pohybovou aktivitou se uplatňuje v léčbě intermitentních klaudikací, klasických klinických projevů chronické končetinové ischemie. V doporučeních odborných společností je uváděný na prvním místě jako lék volby. Zatímco vliv cilostazolu na klaudikace hodnotí řada studií, jeho možnosti při ovlivnění individuálního kardiovaskulárního a cerebrovaskulárního rizika jsou stále ještě nedoceněné.
Cilostazol is a vasodilator with antiplatelet and metabolic properties. In addition to physical activity, it is used in the treatment ofintermittent claudications, i. e. classic clinical signs of chronic limb ischaemia. Professional societies' guidelines list it as the firstdrug of choice. While the effect of cilostazol on claudications has been evaluated in a number of studies, its options for affectingthe individual cardiovascular and cerebrovascular risks still remain unappreciated.
- MeSH
- Cilostazol MeSH
- Lower Extremity * blood supply MeSH
- Platelet Aggregation Inhibitors therapeutic use MeSH
- Phosphodiesterase 3 Inhibitors therapeutic use MeSH
- Intermittent Claudication * drug therapy prevention & control MeSH
- Clinical Trials as Topic MeSH
- Humans MeSH
- Peripheral Arterial Disease * drug therapy MeSH
- Tetrazoles therapeutic use MeSH
- Check Tag
- Humans MeSH
Trombocyty hrají významnou úlohu při hemostáze, a to účastí na mechanismu adheze, agregace, konstrikce, tvorbě trombu a hojení. Antiagregační přípravky působí proti funkci trombocytů, respektive proti primární hemostáze. Léky, které máme v současné době k dispozici, umožňují blokovat účinek krevních destiček na úrovni aktivace - jednak ireverzibilní acetylací cyklooxygenázy (COX-1), blokací reabsorpce adenosinu, inhibicí fosfodiesterázy 3 a inhibicí vazby ADP na destičkový receptor P2Y12. Jeden ze zásadních problémů antiagregační léčby vedle jejich nežádoucích účinků je rezistence na léčbu. Ta je také důvodem vývoje nových antiagregačních přípravků.
Platelets are important for hemostasis. Adhesion, aggregation, constriction, thrombus formation and healing as a mechanism of action. Antiplatelet drugs are drugs that counteract the platelet function, or against primary hemostasis. Drugs which are currently available allow to block the action of platelet activation level - firstly irreversible acetylation of cyclooxygenase (COX1), blocking reabsorption adenosine, inhibition of phosphodiesterase 3 and inhibition of binding of ADP to the P2Y12 platelet receptor. Resistance to treatment is one of the main problems antiplatelet therapy in addition to their adverse effects. What is the reason for the development of new antiplatelet drugs.
- Keywords
- CLOPIDOGREL, prasugrel, elinogrel, cangrelor,
- MeSH
- Purinergic P2Y Receptor Antagonists pharmacology therapeutic use MeSH
- Purinergic P2 Receptor Antagonists pharmacology therapeutic use MeSH
- Aspirin administration & dosage pharmacology therapeutic use MeSH
- Stroke prevention & control MeSH
- Drug Resistance, Neoplasm MeSH
- Dipyridamole pharmacology therapeutic use MeSH
- Platelet Aggregation Inhibitors * pharmacology therapeutic use MeSH
- Cyclooxygenase Inhibitors administration & dosage pharmacology therapeutic use MeSH
- Phosphodiesterase 3 Inhibitors pharmacology therapeutic use MeSH
- Drug Therapy, Combination MeSH
- Humans MeSH
- Ticagrelor MeSH
- Ticlopidine pharmacology therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
- MeSH
- Antihypertensive Agents therapeutic use MeSH
- Drug Combinations MeSH
- Hypertension drug therapy MeSH
- Phosphodiesterase 3 Inhibitors administration & dosage pharmacology MeSH
- Cardiovascular Diseases * etiology drug therapy prevention & control MeSH
- Humans MeSH
- Peripheral Arterial Disease drug therapy MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
- Keywords
- ambrisentam, studie AMBITION, agonisté prostacyklinového receptoru, selexipag, studie GRIPHON, macitentan, studie SERAPHIN,
- MeSH
- Endothelin A Receptor Antagonists therapeutic use MeSH
- Endothelin B Receptor Antagonists therapeutic use MeSH
- Echocardiography MeSH
- Evaluation Studies as Topic MeSH
- Phosphodiesterase 3 Inhibitors MeSH
- Phosphodiesterase 5 Inhibitors therapeutic use MeSH
- Clinical Trials as Topic MeSH
- Drug Therapy, Combination MeSH
- Humans MeSH
- Morbidity MeSH
- Mortality MeSH
- Multicenter Studies as Topic MeSH
- Hypertension, Pulmonary * diagnosis drug therapy complications mortality physiopathology prevention & control MeSH
- Prognosis MeSH
- Randomized Controlled Trials as Topic MeSH
- Endpoint Determination * MeSH
- Severity of Illness Index MeSH
- Tadalafil MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Newspaper Article MeSH
Ischemická choroba dolních končetin je významným projevem systémové aterosklerózy. Základem její léčby je razantní úprava známých rizikových faktorů – kouření, dyslipoproteinemie, arteriální hypertenze a diabetu. Medikamentózně ovlivňujeme rizikové faktory i u asymptomatických nemocných. S cílem zlepšit celkovou kardiovaskulární prognózu jsou podávány protidestičková léčiva, statiny a inhibitory angiotensin konvertujícího enzymu (ACE) (eventuálně telmisartan). K ovlivnění symptomů onemocnění (prodloužení klaudikačního intervalu) se používají vazoaktivní léčiva, především cilostazol a naftidrofuryl. Z nefarmakologických postupů hraje v ovlivnění klaudikací zásadní roli svalový dávkovaný trénink, zejména pod dohledem rehabilitačních specialistů, význam však má i bez supervize.
- Keywords
- naftidrofuryl,
- MeSH
- Purinergic P2Y Receptor Antagonists administration & dosage pharmacokinetics adverse effects therapeutic use MeSH
- Serotonin Antagonists administration & dosage pharmacokinetics therapeutic use MeSH
- Anticoagulants therapeutic use MeSH
- Arterial Occlusive Diseases drug therapy MeSH
- Arteriosclerosis physiopathology MeSH
- Aspirin administration & dosage pharmacokinetics adverse effects therapeutic use MeSH
- Adrenergic beta-Antagonists administration & dosage pharmacokinetics therapeutic use MeSH
- Cilostazol MeSH
- Diabetes Mellitus MeSH
- Lower Extremity * MeSH
- Angiotensin-Converting Enzyme Inhibitors administration & dosage pharmacokinetics therapeutic use MeSH
- Platelet Aggregation Inhibitors administration & dosage pharmacokinetics adverse effects therapeutic use MeSH
- Phosphodiesterase 3 Inhibitors administration & dosage pharmacokinetics therapeutic use MeSH
- Intermittent Claudication MeSH
- Ischemia * drug therapy MeSH
- Humans MeSH
- Meta-Analysis as Topic MeSH
- Drug-Related Side Effects and Adverse Reactions MeSH
- Motor Activity MeSH
- Receptor, PAR-1 administration & dosage therapeutic use MeSH
- Receptors, Thrombin administration & dosage therapeutic use MeSH
- Risk Factors MeSH
- Ticlopidine administration & dosage pharmacokinetics adverse effects therapeutic use MeSH
- Thrombolytic Therapy MeSH
- Tobacco Use Cessation MeSH
- Age Factors MeSH
- Health Behavior MeSH
- Check Tag
- Humans MeSH
- Publication type
- Research Support, Non-U.S. Gov't MeSH
Causa subita, ISSN 1212-0197 Ročník 15, 2. kompendium, 2015
24 stran : ilustrace ; 30 cm
- MeSH
- Survival Analysis MeSH
- Endothelin Receptor Antagonists therapeutic use MeSH
- Early Diagnosis MeSH
- Phosphodiesterase 3 Inhibitors therapeutic use MeSH
- Disease Management MeSH
- Hypertension, Pulmonary diagnosis etiology therapy MeSH
- Prostaglandins therapeutic use MeSH
- Publication type
- Collected Work MeSH
- Conspectus
- Patologie. Klinická medicína
- NML Fields
- pneumologie a ftizeologie
- angiologie
- Keywords
- Noclaud,
- MeSH
- Cilostazol MeSH
- Phosphodiesterase 3 Inhibitors * adverse effects therapeutic use MeSH
- Intermittent Claudication * drug therapy MeSH
- Humans MeSH
- Peripheral Arterial Disease * drug therapy MeSH
- Risk Factors MeSH
- Tetrazoles adverse effects therapeutic use MeSH
- Vasodilator Agents adverse effects therapeutic use MeSH
- Check Tag
- Humans MeSH
