flunarizine and Raynaud-Disease

Raynaud's phenomenon (Raynaud's disease), an accessual vascular acrosyndrome characterised by an important constriction of distal arterioles, has still no specific pharmacological therapy. In the last years, the use of calcium-entry-blockers (nifedipine, diltiazem, verapamil, nicardipine), drugs able to control the contractility of the vessels, showed some positive results. Considering this data, we appraised the efficacy of flunarizine, another calcium-entry-blocker, in a preliminary study of 28 patients (23 females, 5 males, aged between 15 and 48 years) suffering from Raynaud's disease. Apart from a statistically insignificant improvement of subjective symptoms (i.e. acroparesthesias, cold extremities) flunarizine (10 mg/day for 1 month) did not have positive results. Finally, this drug caused some side-effects: drowsiness, increase of weight and appetite, but without a real necessity for withdrawal of therapy.

Topics: Adolescent; Adult; Female; Flunarizine; Humans; Male; Middle Aged; Raynaud Disease; Time Factors

The purpose of the present study was to investigate the effect of atenolol, a beta 1-selective blocker, along with flunarizine, a calcium antagonist, in the management of Raynaud's disease. Forty patients with Raynaud's disease were randomized into a trial in which atenolol (50 mg daily) was given with flunarizine (10 mg daily). During the trial all patients were subjected to finger photoplethysmography and were given a diary to note daily the number and duration of the crises and presence or absence of pain and paresthesia. The association of atenolol with flunarizine caused an 80% reduction in the number of vasospastic crises, a significant increase (p less than 0.001) in the photoplethysmographic wave amplitude, and complete disappearance of pain and paresthesia. These results were not observed in patients treated with a placebo. Flunarizine reinforces the action of atenolol in causing a decrease in vasoconstriction in patients with Raynaud's disease, as observed previously by us, in that it acts directly on the beta-presynaptic receptors or on the calcium slow channels connected to the beta-receptors. The present study confirms that the principal role in the physiopathologic progression of Raynaud's disease seems to be played by a modification of the beta-presynaptic receptors in the nerve endings of the peripheral vessels.

Topics: Adolescent; Adult; Atenolol; Clinical Trials as Topic; Drug Therapy, Combination; Female; Flunarizine; Humans; Male; Middle Aged; Plethysmography; Random Allocation; Raynaud Disease; Receptors, Adrenergic, beta

A bloodless study with a Photoplethysmographic test of the limb's blood circulation among haemodialyzed patients with arteriovenous fistula and the influence of Flunarizine treatment was performed. All patients showed a blood reduction flux on the hand with fistulas in front of the controlateral limb. Three patients affected by Raynaud Syndrome were identified. The Flunarizine treatment did not show significative blood flux variations among among those patients with low Photopletysmographic index (P.I.) in the limb with arteriovenous fistula, while a significative increase of P.I. was registered in the limb of the patients affected by Raynaud Syndrome. Concluding, the Photopletysmographic test is useful to follow the limb's blood circulation of haemodialyzed with arterio-venous fistula, being it bloodless, sure and repeteable test to follow the influence of vasoactive therapy.

Topics: Adult; Arm; Arteriovenous Shunt, Surgical; Female; Flunarizine; Humans; Male; Middle Aged; Plethysmography; Raynaud Disease; Renal Dialysis

Topics: Adult; Blood Circulation; Cinnarizine; Female; Flunarizine; Humans; Male; Piperazines; Raynaud Disease

Topics: Adult; Aged; Arterial Occlusive Diseases; Cerebrovascular Disorders; Cinnarizine; Female; Flunarizine; Humans; Male; Middle Aged; Piperazines; Raynaud Disease; Vasodilator Agents