Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Carbamazepine, a drug effective in pain, seizure, and affective disorders, was screened for its ability to interact with a variety of neurotransmitter and neuromodulator binding sites on brain membranes. The most potent effect was observed on adenosine antagonist ( [3H]DPX) binding to the adenosine receptor (KI = 3.5 +/- 0.4 microM) followed by adenosine agonist ( [3H]CHA) binding (KI = 24.5 +/- 3.6 microM). Lower potency effects were observed on benzodiazepine receptors, and no inhibition was seen in a variety of other systems. The inhibition of adenosine receptor binding by carbamazepine was competitive. No correlation was observed between the potency of a series of carbamazepine analogs as inhibitors of either ( [3H]DPX, [3H]CHA or [3H]diazepam binding and their ability to inhibit electroshock-induced convulsions, suggesting that the anticonvulsant properties of these agents are not mediated by the adenosine receptor, but raising the possibility that other clinical effects of carbamazepine may relate to its ability to act at the adenosine receptor.
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PMID:Specific and potent interactions of carbamazepine with brain adenosine receptors. 631 50

The benzodiazepine--gamma-aminobutyric acid (GABA) receptor--ionophore system is an oligomeric complex, composed of at least three interacting components. These three components have been well characterized in vitro by radioreceptor binding assays. A variety of centrally acting anxiolytic, depressant, anticonvulsant and convulsant drugs, which affect GABAergic transmission, bind to one of the sites and modulate the binding of ligands at the other sites. Thus, depressant barbiturates, nonbarbiturate hypnotics (like etomidate) and pyrazolopyridines (like etazolate), while inhibiting the binding of alpha-dihydropicrotoxinin (DHP), enhance the binding of GABA and benzodiazepines. These enhancing effects are blocked by convulsant drugs that inhibit the binding of dihydropicrotoxinin and also by bicuculline. These interactions involving barbiturates and other modulatory drugs, exhibit stereoselectivity, anion dependence and brain regional selectivity. Several classes of drugs which facilitate GABAergic transmission appear to interact with the sites for GABA and benzodiazepines allosterically via the dihydropicrotoxinin site of the oligomeric complex. The GABA system has also been implicated in a variety of pathological conditions, including anxiety, seizure activity, movement disorders, cardiovascular control, pain and in drug dependence. Since most of the GABA agonists do not pass the blood-brain barrier, future trends in the pharmacology of GABA may be the development of drugs that will activate the GABA receptor system via picrotoxinin or benzodiazepine sites.
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PMID:Benzodiazepine-GABA receptor-ionophore complex. Current concepts. 632 40

Within 20 months 145 ascending thoracocervical myelographies and 155 lumbar myelographies with the nonionic water-soluble contrast medium iopamidol were performed. The iodine concentration given was 250 mg I/ml or 200 mg I/ml respectively. The total iodine never exceeded 2.5 g (8-10 ml). Image quality was assessed in terms of diagnostic value having experience of more than 1,000 myelographies using metrizamide. Picture quality was similar to metrizamide of equal iodine concentration. In 35 patients electroencephalography (EEG) was recorded before and after myelography with iopamidol 250. No changes that could be referred to the contrast medium were seen. There were no adverse reactions to lumbar myelography other than those following the lumbar puncture. In thoracocervical myelography mild and transient side effects occurred in 41 (28.3%). The most common were headache (41 cases), nausea (12), radicular pain (10), and dizziness (five). General seizures and psychopathologic symptoms were not observed.
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PMID:Clinical experience with iopamidol for myelography. 641 Jul 31

Fifty adult patients with partial motor status epilepticus were treated with a single intravenous (i.v.) injection of diphenylhydantoin (DPH), 20 mg/kg body weight at a rate of 1 mg/kg/min. Seizures were controlled in 32 patients (64%) during the injection or within the following hour; in 13 of them previous (i.v.) injections out of benzodiazepines had been ineffective. DPH was effective in 10 patients of 11 with a previous history of epileptic seizures and without problems of consciousness during their epileptic status. In contrast, 13 failures out of 18 concern occasional status in patients deeply comatose because of head trauma, neurosurgical operation or intracerebral hemorrhage. Total plasmatic levels of DPH, when measured 24 h after the injection, were found between 38 mumol/l in all patients, and were in the range of 40 mumol/l-100 mumol/l in 77% of cases. Adverse effects were: pain at the injection site (6 cases), horizontal nystagmus during injection (5 cases), transient cerebellar symptoms (3 cases). This study confirms that single loading doses of DPH can maintain DPH plasmatic levels within the therapeutic range during 24 h, with minor or transient side effects, provided that cardiovascular contra-indications are respected.
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PMID:[Treatment of partial motor status epilepticus in adults with intravenous diphenylhydantoin (DPH). Prospective study of 50 cases]. 644 81

Two patients presented with unilateral peri-orbital pain, proptosis, chemosis and external ophthalmoplegia. They were shown to have dural arteriovenous fistulae related to the cavernous sinus. Intracerebral haemorrhage occurred in both patients within 18 months of presentation; this gave rise to focal seizures and signs of unilateral hemisphere dysfunction. The haematomas were in the region drained by the superficial middle cerebral vein ipsilateral to the shunt and are presumed to have been the result of locally raised venous pressure.
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PMID:Intracerebral haemorrhage complicating dural arteriovenous fistula: a report of two cases. 648 84

Recent neuroanatomical and behavioral evidence has indicated that vasopressin (VP) increases pain thresholds. In the present study intracerebroventricular (ICV) administration of both arginine VP (AVP: 75-500 ng) and 1-deamino-8-D-arginine vasopressin (DDAVP: 150-500 ng) elevated tail flick latencies. Oxytocin (OXY, ICV), also elevated tail-flick latencies (150-1000 ng); however this increase was accompanied by "barrel-roll" seizure activity. VP analgesia was eliminated by pretreatment with 1-deamino-penicillamine-2(O-methyl)tyrosine-AVP (dPTyr(me)AVP: 500 ng, ICV), a VP antagonist, but not naloxone (1 or 10 micrograms, ICV), suggesting that VP modulates nonciceptive thresholds through its own binding sites. Conversely, pretreatment with naloxone (1 micrograms, ICV) but not dPTyr(me)AVP (1 microgram, ICV) attenuated the analgesic efficacy of systemic morphine (10 mg/kg), further dissociating VP and central opiate analgesic processes. Finally, systemic pretreatment with dexamethasone potentiated VP analgesia. These data support the notion that VP is a specific non-opioid pain inhibitor.
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PMID:Vasopressin analgesia: specificity of action and non-opioid effects. 649 25

A 21-year-old student had generalized tonic-clonic seizures induced by the mental image of human pain. One ictal event occurred while he was listening to a description of suffering, as read from Fox's Book of Martyrs. While again listening to the offending passage during EEG and ECG monitoring, he had 25 s of asystole terminating in electrocerebral silence and a generalized tonic, tonic-clonic seizure. A 24-hour ambulatory monitor recorded episodes of progressive sinus bradycardia concomitant with PR-interval prolongation and Wenckebach atrioventricular block. Sinoatrial conduction times and sinus node recovery times were normal on atrial pacing. Since implantation of a permanent pacemaker, he has been asymptomatic. This patient demonstrates the advantages of reproducing the circumstances associated with an unexplained loss of consciousness while monitoring the EEG and ECG.
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PMID:A case of being scared to death. 661 4

To learn more about postictal behaviors and their underlying mechanisms, five behaviors and EEG recordings were studied following fully generalized, kindled seizures in rats. The behaviors included bar pressing for food; tail withdrawal, squeak, and multiple squeak responses to painful tail shocks; consumption of freely available food; clinging to a vertical grid; and locomotion. Latencies from the end of a seizure afterdischarge until each behavior recovered were compared and were found to cluster in three distinct pairs. Locomotion and grid clinging recovered most quickly; consumption of freely available food and EEG postictal depression recovered next; and bar pressing for food and the multiple squeak response recovered most slowly. Naloxone pretreatment (10 mg/kg but not 1 mg/kg) shortened recovery to multiple squeak responses, grid clinging, and locomotion, without affecting recovery of bar pressing, food consumption, or EEG postictal depression. These results suggest that complex behaviors recover more slowly following a seizure than simple behaviors. It also appears that opioids are released by a kindled seizure and mediate certain postictal changes in motor- and pain-related behaviors.
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PMID:Changes in simple and complex behaviors following kindled seizures in rats: opioid and nonopioid medication. 661 85

Consecutive head-injured patients admitted to Cook County Hospital in Chicago, Illinois, over a 12-month period were examined upon admission and discharge. Information was collected about the nature of the injury, symptoms, signs, and sequelae for 702 patients. Detailed descriptions of the causes of these injuries, and their correlates, were also obtained.Approximately 80 percent of the patients had localized pain, loss of consciousness and/or posttraumatic amnesia, and associated injuries; 16 percent had a skull fracture, 7.0 percent had an intracranial hematoma, 4.1 percent had early seizures, and 2.4 percent died.Skull x-ray examinations were performed on 93.4 percent of the patients (16.9 percent were positive) and radiographic examination of the cervical spine was performed on 67.2 percent (1.7 percent were positive). Utilization of EEGs, computerized tomography scans, and arteriograms was also assessed.Falls were the leading cause of injury (45.8 percent) for patients under 16 years of age and interpersonal injuries accounted for the majority (55.7 percent) of the injuries to adults. About 15 percent of the adults sustained severe or fatal injuries, compared with only 7 percent of the children.It is concluded that although this set of data suggests new considerations for the prevention of head injuries, the lack of comparative data about the medical correlates of these injuries inhibits similar observations about medical care.
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PMID:Urban head injury: a clinical series. 663 94

Out of 858 epileptic patients, 24 had painful seizures. Three distinct groups emerged: (1) those with unilateral pain in the face, arm, leg or trunk (Unilateral Group)--10 cases; (2) a Cephalic Group with pain restricted to the head--11 cases; and (3) an Abdominal Group with central abdominal pain--3 cases. Unilateral pain consistently implicated ictal involvement of the contralateral rolandic region at the time of pain. In most cases it was probably due to involvement of the primary somatosensory cortex (SI). Cephalic pain did not localize the site of seizure origin. In most cases it probably arose by a vascular mechanism. Abdominal ictal pain reflected temporal lobe epileptic activity in our cases. The mechanism of its production is uncertain, but it is unlikely to be due to a peripheral (for example gastrointestinal) mechanism.
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PMID:Painful epileptic seizures. 664 Feb 68


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