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Male rats allowed copulating without restriction with a single oestrous female ejaculate repeatedly until reaching sexual exhaustion. Twenty-four hours after this process, sexually exhausted males exhibit a series of physiological alterations when compared to non-exhausted males. Among them, the most conspicuous are a long-lasting sexual behaviour inhibition and a generalised hypersensitivity to drug actions. The objective of the present work was to establish if there was a correlation between these two features of sexual satiation in relation to the duration of its expression. To that aim, we characterised the spontaneous sexual behaviour recovery process from sexual satiation, as well as the duration of the drug hypersensitivity phenomenon. The latter was assessed through the appearance of a sign of the serotonergic syndrome: the flat body posture. Results showed that the drug hypersensitivity phenomenon and the sexual inhibition that results from copulation to satiation follow a similar time course of recovery, with a drastic decrease in their expression 96 h after the sexual satiation process. This finding indicates that these phenomena might represent two expressions of a same brain plasticity process, as suggested by the long lasting character of both events, which interestingly appears to be reversible.

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Prokinetic agents are a very large family of drugs with different mechanisms of action. Only QT prolongation by cisapride has made notable impact and deserved its partial restriction and/or withdrawal from the market. Postmarketing surveillance initially showed that cisapride was generally safe and well tolerated, but in the past decade, more recent data have shown some risk in the patient populations. QT prolongation by prokinetic agents can raised from different mechanisms: some involve increased plasma concentrations of cisapride due to increased bioavailability by inhibiting P glycoprotein, and inhibition of metabolism or deficit in the elimination. On the other hand, pharmacodynamic interactions can also enhance the arrhythmogenic effect of cisapride. The present article presents the mechanisms and reviews the main interactions studied so far, and the role of pharmacovigilance in the detection of rare clinical events. We emphasize the need for physicians to look for conditions (either clinical or not) prone to increase the risk of QT interval prolongation.

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OBJECTIVE: Chronic migraine (CM) is a common disorder, affecting 2% to 3% of the general population. Glutamate is implicated in cortical spreading depression, trigeminovascular activation, central sensitization, and may be linked to migraine chronification. Triptans brought a novel option for the acute migraine treatment. As the development of central sensitization impacts upon the effectiveness of triptan therapy, we hypothesized that glutamate might be related to triptan response mechanisms. METHODS: We studied 19 patients diagnosed with CM according to the International Headache Society (2004) criteria. Patients were divided in those overusing analgesics (NSAIDs); those without overuse, and those overusing triptans. RESULTS: Cerebrospinal fluid (CSF) glutamate levels were similar in patients overusing acute medications (0.335 +/- 0.225 micromol) compared to those without overuse (0.354 +/- 0.141 micromol), P= NS). In contrast, patients overusing triptans had CSF glutamate levels significantly lower than that observed in nonoverusers (0.175 +/- 0.057 vs 0.354 +/- 0.141 micromol, P= 0.015), and significantly higher than controls (0.175 +/- 0.057 vs 0.109 +/- 0.066 micromol, P= 0.039). In triptan overusers, CSF glutamate levels, although lower, were not significantly different from patients overusing other types of analgesics. CONCLUSIONS: Our study showed lower glutamate levels in CSF of CM patients overusing triptans. Glutamate may be implicated in triptan response mechanisms, triptans may work in part by reducing extracellular glutamate levels in the brain.

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Transient vagal bradycardia occurring during coronary arteriography (CA) immediately following intracoronary injection of ionic contrast medium is believed to be a component of the von Bezold-Jarisch reflex (BJ). Data obtained from experimental animals using buspirone (BSP) and other 5-HT1A receptor ligands suggest that these serotonergic receptors modulate the excitability of cardiac vagal motoneurones (CVM). This is a preliminary investigation of the possible effects of BSP in altering the bradycardia of patients submitted to CA for diagnostic purposes. Patients were divided into two age- and race-matched groups: control (C:N = 45, age 58.6 +/- 1.6 years, mean arterial blood pressure (MAP) 109 +/- 2.4 mmHg, heart rate (HR) 79 +/- 2.9 bpm) and BSP-treated (B:N = 14, age 58.9 +/- 2.1 years, MAP 111 +/- 4.5 mmHg, HR 76 +/- 3.4 bpm). The prevalent underlying pathology was coronary artery disease. Patients with acute angina, congestive heart failure, symptomatic arrhythmia and patients requiring atropine were excluded. CA was performed by a standard procedure using diatrizoate (MD-76) as contrast agent. The left and then the right coronary ostia were selectively catheterized and 8 ml of contrast medium was injected (over a period of 3 sec). HR was measured from ECG tracings before and after contrast injection into the left (LC) and right (RC) coronary arteries. Peak bradycardia was measured as the longest R-R interval during the first 15 sec after the injection minus the pre-injection R-R value, and reported as delta R-R. Group B patients received BSP tablets 48 and 24 h before the examination (30 mg/day po). There was no statistically significant difference (P > 0.05) in bradycardia between groups (C:LC = -147 +/- 23, RC = -155 +/- 25; B: LC = -143 +/- 44, RC = -234 +/- 56 msec). These results suggest that, in contrast to experimental animals, the central 5-HT1A receptors of humans are not relevant for modulating the excitability of CVM in the BJ reflex. However, since drugs and diseases can affect the responses, further studies are necessary to clarify this issue.

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