Effects of avitriptan, a new 5 HT(1B/1D) receptor agonist, in experimental models predictive of antimigraine activity and coronary side-effect potential

Abstract Several acutely acting antimigraine drugs, including ergotamine and sumatriptan, have the ability to constrict porcine arteriovenous anastomoses as well as the human isolated coronary artery. These two experimental models seem to serve as indicators, respectively, f

Coronary side-effect potential of current and prospective antimigraine drugs

BACKGROUND: The antimigraine drugs ergotamine and sumatriptan may cause angina-like symptoms, possibly resulting from coronary artery constriction. We compared the coronary vasoconstrictor potential of a number of current and prospective antimigraine drugs (ergotamine, dihydroergotamine, methysergide and its metabolite methylergometrine, sumatriptan, naratriptan, zolmitriptan, rizatriptan, avitriptan). METHODS AND RESULTS: Concentration-response curves to the antimigraine drugs were constructed in human isolated coronary artery segments to obtain the maximum contractile response (Emax) and the concentration eliciting 50% of Emax (EC50). The EC50 values were related to maximum plasma concentrations (Cmax) reported in patients, obtaining Cmax/EC50 ratios as an index of coronary vasoconstriction occurring in the clinical setting. Furthermore, we studied the duration of contractile responses after washout of the acutely acting antimigraine drugs to assess their disappearance from the recept

The pathophysiology of migraine: year 2005

Migraine is a complex patholophysiology in which both central and peripheral components of the trigeminal pain pathway probably play a significant role, both in the symptoms and signs of the attack and in the mechanisms of action of antimigraine compounds, such as triptans, which constitute the most important therapy for aborting migraine pain and posses several mechanisms on 5–HT receptor–mediated actions. The experimental neurogenic inflammation model represents a simple procedure to obtain preliminary information on well characterized receptortargeted drugs. The apparent paradox observed with certain drugs that are shown to be effective in this model but not in clinical trials offers the opportunity to better manipulate structure–activity to obtain the best pharmacological profile using an array of experimental models. The observation that nitric oxide donors induce migraine–like pain in migraineours and that nitric oxide plays a pivotal role in the control of several functions in the central nervous system, has prompted the use of such molecules for better understanding the pathophysiology of migraine attacks. A link between central and peripheral components of the trigeminal pain pathway is provided by the observation that cortical spreading depression in the rat activates trigeminovascular afferents and induces a series of cortical meningeal and brainstem events consistent with the development of headache. Studies in humans support the hypothesis that cortical spreading depression underlies migraine.aura. Therefore, tt is possible that visual, motor or sensory aura might be responsible for the generation of the pain through the above mechanism

Automatic summarization of MEDLINE citations for evidence-based medical treatment: A topic-oriented evaluation

AbstractAs the number of electronic biomedical textual resources increases, it becomes harder for physicians to find useful answers at the point of care. Information retrieval applications provide access to databases; however, little research has been done on using automatic summarization to help navigate the documents returned by these systems. After presenting a semantic abstraction automatic summarization system for MEDLINE citations, we concentrate on evaluating its ability to identify useful drug interventions for 53 diseases. The evaluation methodology uses existing sources of evidence-based medicine as surrogates for a physician-annotated reference standard. Mean average precision (MAP) and a clinical usefulness score developed for this study were computed as performance metrics. The automatic summarization system significantly outperformed the baseline in both metrics. The MAP gain was 0.17 (p<0.01) and the increase in the overall score of clinical usefulness was 0.39 (p<0.05)

5-Hydroxytryptamine Receptors Mediating Carotid and Systemic Haemodynamic Effects: The Relation to Acute Antimigraine Therapy

The presence of a vasoconstrictor substance in blood was suspected for 130 years (Ludwig & Schmidt, 1868) and, 50 years ago, Page and associates at the Cleveland Clinic (Cleveland, Ohio, USA) succeeded in isolating 'serotonin' from the blood (Rapport et al., 1948). Within the next 3 years, the chemical structure of serotonin was deduced (Rapport, 1949) and 5-HT (5-hydroxytryptamine; for other abbreviations see Section 16.4) synthesised (Hamlin & Fischer, 1951; Speeter et al., 1951). Independently, during the 1930s and 40s, Erspamer and colleagues (Rome, Italy), who were interested in characterising the substance imparting characteristic histochemical properties to the enterochromaffin cells of the gastrointestinal mucosa, extracted a basic gut-stimulating factor and named it "enteramine" (Erspamer, 1954). The chemical identity of enteramine with the natural and synthetic serotonin (Erspamer & Asero, 1952) was soon backed by the similarity of pharmacological profile (contraction of sheep carotid artery, guinea-pig, mouse and rabbit jejunum, rat and cat uterus and cat nictitating membrane, triphasic blood pressure response and antagonism by yohimbine and potentiation by cocaine of the sheep carotid artery contraction) (Erspamer, 1954; Page, 1954). Thus, the scene was set for the characterisation of 5-HT receptors

Characterization of binding, functional activity, and contractile responses of the selective 5-HT1F receptor agonist lasmiditan

Background and Purpose: Triptans are 5-HT1B/1D receptor agonists (that also display 5-HT1F receptor affinity) with antimigraine action, contraindicated in patients with coronary artery disease due to their vasoconstrictor properties. Conversely, lasmiditan was developed as an antimigraine 5-HT1F receptor agonist. To assess the selectivity and cardiovascular effects of lasmiditan, we investigated the binding, functional activity, and in vitro/in vivo vascular effects of lasmiditan and compared it to sumatriptan. Experimental Approach: Binding and second messenger activity assays of lasmiditan and other serotoninergic agonists were performed for human 5-HT1A, 5-HT1B, 5-HT1D, 5-ht1E, 5-HT1F, 5-HT2A, 5-HT2B, and 5-HT7 receptors, and the results were correlated with their potency to constrict isolated human coronary arteries (HCAs). Furthermore, concentration–response curves to lasmiditan and sumatriptan were performed in proximal and distal HCA, internal mammary, and middle meningeal arteries. Finally, anaesthetized female beagle dogs received i.v. infusions of lasmiditan or sumatriptan in escalating cumulative doses, and carotid and coronary artery diameters were measured. Key Results: Lasmiditan showed high selectivity for 5-HT1F receptors. Moreover, the functional potency of the analysed compounds to inhibit cAMP increase through 5-HT1B receptor activation positively correlated with their potency to contract HCA. In isolated human arteries, sumatriptan, but not lasmiditan, induced contractions. Likewise, in vivo, sumatriptan decreased coronary and carotid artery diameters at clinically relevant doses, while lasmiditan was devoid of vasoconstrictor activity at all doses tested. Conclusions and Implications: Lasmiditan is a selective 5-HT1F receptor agonist devoid of vasoconstrictor activity. This may represent a cardiovascular safety advantage when compared to the triptans

ANALYTICAL APPLICATION OF E.B.T IN SPECTRPHOTOMETRIC DETERMINATION OF ELETRIPTAN HYDROBROMIDE

A simple and sensitive spectrophotometric method has been developed for the estimation of Eletriptan Hydrobomide (EHB).The method is based on the formation of  ion-association complex with EHB with  acid dye, E.B.T. The cationic form of the dye E.B.T involves in the formation of neutral coloured ion-association complex  with negative charge (acid groups in the drug) which is extractable into chloroform and behaves as a single unit being held together by electrostatic attraction. The absorption maxima were found to be at lMax 510nm. The method obeys Beer's law within the limits 40-240µg/ml and gives reproducible results. Molar absorptivity value is obtained as 1.2116 x 105 L mol-1 cm-1 and recovery was found to be 99.806 to 99.742. Interferences of the other ingredients and excipients were not observed. The proposed method can be used for the determination of EHB both in pure and pharmaceutical formulations