almitrine--raubasine-drug-combination and Cerebrovascular-Disorders

According to an epidemiological study of cerebrovascular disease carried out in China in 1986, the prevalence, incidence, and mortality rates were 159.93/100,000, 115.61/100,000, and 31.33/100,000, respectively. These figures were high compared to available epidemiological data for the rest of the world. This highlights the fact that, as in other countries, functional rehabilitation after stroke is an important medical and social need in China. Clinical experience shows that within a few hours to a few months after a stroke, a large proportion of patients spontaneously experience partial, or on occasion, complete recovery from neurologic symptoms. However, functional rehabilitation in medical care units is required because it assists in and accelerates the recovery of impaired function. Almitrine-raubasine has been used to improve functional rehabilitation after stroke for some time in China. By enriching the oxygen content of arterial blood, it brings more oxygen to the cerebral tissues and therefore promotes cerebral aerobic metabolism during ischemia. In the acute phase of stroke, positron emission tomography showed, in man, that almitrine-raubasine helps normalize the ischemic penumbra area, as shown by an improvement in the coupling between oxygenation and perfusion. Long after stroke, single photon emission computed tomography showed that almitrine-raubasine restores normal cerebral vasodilator response to acetazolamide. With a view to further documenting the clinical efficacy of almitrine-raubasine on the convalescent period of patients with cerebrovascular disease, a double-blind, placebo-controlled study is planned. One hundred patients with ischemic cerebrovascular disease in the territory of the carotid artery will be included 4-6 weeks after the acute onset. Two tablets daily of almitrine-raubasine or placebo will be prescribed for 3-6 months. Before treatment, there will be a 2-week washout period for all other drugs, except for antihypertensive and antidiabetic drugs. In addition to complete clinical monthly examinations, neurological functional deficit scores, Barthel index, Hasagawa Dementia scales, and CT scan are scheduled. The study results should confirm those reported in the scientific literature: although untreated patients may show spontaneous improvement, almitrine-raubasine should accelerate patients' functional rehabilitation.

Topics: Aged; Aged, 80 and over; Aging; Almitrine; Cerebrovascular Disorders; China; Drug Combinations; Female; Humans; Incidence; Male; Middle Aged; Neuroprotective Agents; Prevalence; Yohimbine

Duxil is a combination of almitrine and raubasine. Almitrine produces an increase of PaO2 in arterial blood, and this beneficial effect on hypoxemia is potentiated by that of raubasine on microcirculation. Pharmacological studies of Duxil in healthy animals and experimental models have demonstrated that the drug increases arterial oxygen supply, improves tissue oxygenation and is capable of correcting vascular and metabolic disorders due to hypoxia. After administration of Duxil to animals whose brain has been severely deprived of oxygen by experimental anoxia or ischaemia, the oxygen supply is sufficient for the brain cells to take up their preferential substrate (glucose) and to use it through the most energy-producing aerobic pathway. Thus, the energy stores (ATP or glycogen) of these cells are spared and above all, their structural integrity is preserved. Their functional activity may be maintained, and this would justify the use of Duxil in mental and behavioural disorders of cerebral senescence and cerebro-vascular diseases related to hypoxia.

Topics: Aging; Almitrine; Animals; Cerebrovascular Circulation; Cerebrovascular Disorders; Disease Models, Animal; Dogs; Drug Combinations; Glucose; Humans; Hypoxia, Brain; Neurons; Oxygen Consumption; Piperazines; Rabbits; Rats; Yohimbine