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do Vale Ramos RC, Alegrete N. The role of pharmacotherapy in modifying the neurological status of patients with spinal and spinal cord injuries. Rev Bras Ortop. 2015;50(6):617-24doi: 10.1016/j.rboe.2015.09.001.
do Vale Ramos, R. C., & Alegrete, N. (2015). The role of pharmacotherapy in modifying the neurological status of patients with spinal and spinal cord injuries. Revista brasileira de ortopedia, 50(6), 617-24. https://doi.org/10.1016/j.rboe.2015.09.001
do Vale Ramos, Renato Carlos, and Alegrete, Nuno. "The role of pharmacotherapy in modifying the neurological status of patients with spinal and spinal cord injuries." Revista brasileira de ortopedia vol. 50,6 (2015): 617-24. doi: https://doi.org/10.1016/j.rboe.2015.09.001
do Vale Ramos RC, Alegrete N. The role of pharmacotherapy in modifying the neurological status of patients with spinal and spinal cord injuries. Rev Bras Ortop. 2015 Oct 01;50(6):617-24. doi: 10.1016/j.rboe.2015.09.001. eCollection 2015. PMID: 27218071; PMCID: PMC4866940.
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Rev Bras Ortop. 2015 Oct 01;50(6):617-24. doi: 10.1016/j.rboe.2015.09.001. eCollection 2015.

The role of pharmacotherapy in modifying the neurological status of patients with spinal and spinal cord injuries.

Revista brasileira de ortopedia

Renato Carlos do Vale Ramos, Nuno Alegrete

Affiliations

  1. School of Medicine, Universidade do Porto, Porto, Portugal.

PMID: 27218071 PMCID: PMC4866940 DOI: 10.1016/j.rboe.2015.09.001

Abstract

The aim here was to conduct a review of the literature on pharmacological therapies for modifying the neurological status of patients with spinal cord injuries. The PubMed database was searched for articles with the terms "spinal cord injury AND methylprednisolone/GM1/apoptosis inhibitor/calpain inhibitor/naloxone/tempol/tirilazad", in Portuguese or in English, published over the last five years. Older studies were included because of their historical importance. The pharmacological groups were divided according to their capacity to interfere with the physiopathological mechanisms of secondary injuries. Use of methylprednisolone needs to be carefully weighed up: other anti-inflammatory agents have shown benefits in humans or in animals. GM1 does not seem to have greater efficacy than methylprednisolone, but longer-term studies are needed. Many inhibitors of apoptosis have shown benefits in in vitro studies or in animals. Naloxone has not shown benefits. Tempol inhibits the main consequences of oxidation at the level of the spinal cord and other antioxidant drugs seem to have an effect superior to that of methylprednisolone. There is an urgent need to find new treatments that improve the neurological status of patients with spinal cord injuries. The benefits from treatment with methylprednisolone have been questioned, with concerns regarding its safety. Other drugs have been studied, and some of these may provide promising alternatives. Additional studies are needed in order to reach conclusions regarding the benefits of these agents in clinical practice.

Keywords: Apoptosis; Calpain; G(M1) ganglioside; Methylprednisolone; Naloxone; Spinal cord injuries

References

  1. Neurochem Int. 2013 Jun;62(7):903-12 - PubMed
  2. J Huazhong Univ Sci Technolog Med Sci. 2011 Oct;31(5):652-6 - PubMed
  3. PLoS One. 2012;7(7):e42129 - PubMed
  4. Exp Neurol. 2009 Nov;220(1):71-81 - PubMed
  5. J Neurosurg Spine. 2009 Apr;10(4):308-14 - PubMed
  6. Neuroscience. 2010 Dec 1;171(2):599-612 - PubMed
  7. J Endocrinol. 2011 Feb;208(2):171-82 - PubMed
  8. Int J Surg. 2013;11(5):414-8 - PubMed
  9. J Pharmacol Exp Ther. 2012 Oct;343 (1):21-33 - PubMed
  10. Surg Neurol. 2007;68 Suppl 1:S37-41; discussion S41-2 - PubMed
  11. JAMA. 1997 May 28;277(20):1597-604 - PubMed
  12. Neuropharmacology. 2013 Apr;67:126-35 - PubMed
  13. J Korean Med Sci. 2005 Feb;20(1):132-8 - PubMed
  14. PLoS One. 2009 Aug 20;4(8):e6705 - PubMed
  15. J Neurosci. 2009 Feb 18;29(7):2022-6 - PubMed
  16. Clinics (Sao Paulo). 2008 Jun;63(3):375-80 - PubMed
  17. Surg Neurol. 2008 Dec;70 Suppl 1:S1:19-24; discussion S1:24 - PubMed
  18. Injury. 2008 Jul;39(7):748-52 - PubMed
  19. Neurosci Lett. 2013 Jun 17;545:117-22 - PubMed
  20. Neurotherapeutics. 2011 Apr;8(2):152-67 - PubMed
  21. Neurol Sci. 2013 Sep;34(9):1621-8 - PubMed
  22. Endocrinology. 2012 Aug;153(8):3815-27 - PubMed
  23. Ulus Travma Acil Cerrahi Derg. 2013 Jul;19(4):313-9 - PubMed
  24. Neurosci Lett. 2010 Apr 12;473(3):196-201 - PubMed
  25. Indian J Orthop. 2007 Oct;41(4):300-4 - PubMed
  26. J Neurosci Res. 2009 Jan;87(1):130-40 - PubMed
  27. Int J Neurosci. 2012 Jul;122(7):381-7 - PubMed
  28. Pediatr Surg Int. 2012 Mar;28(3):287-94 - PubMed
  29. Neurochem Res. 2013 Mar;38(3):610-9 - PubMed
  30. Dev Biol. 2011 Jul 15;355(2):205-14 - PubMed
  31. Mol Neurobiol. 2014 Feb;49(1):276-87 - PubMed
  32. Neuroscience. 2009 Jul 7;161(3):753-63 - PubMed
  33. Acta Anaesthesiol Scand. 2009 Sep;53(8):1068-72 - PubMed
  34. Neurosci Lett. 2013 May 10;542:87-91 - PubMed
  35. Neuroscience. 2008 Jul 31;155(1):90-103 - PubMed
  36. Surg Neurol. 2005 Sep;64(3):213-20; discussion 220 - PubMed
  37. J Neurochem. 2010 Jul;114(1):237-46 - PubMed
  38. Cochrane Database Syst Rev. 2005 Apr 18;(2):CD004444 - PubMed
  39. Emerg Med J. 2014 Mar;31(3):201-6 - PubMed
  40. Eur Rev Med Pharmacol Sci. 2013 Oct;17(20):2766-72 - PubMed
  41. Exp Ther Med. 2012 Jul;4(1):49-54 - PubMed
  42. J Neurosci. 2010 Jul 14;30(28):9621-30 - PubMed
  43. Altern Lab Anim. 2009 Feb;37(1):43-62 - PubMed
  44. N Engl J Med. 1990 May 17;322(20):1405-11 - PubMed
  45. Exp Neurol. 2009 Mar;216(1):105-14 - PubMed
  46. BMC Neurosci. 2013 Mar 01;14 :23 - PubMed
  47. Neurochem Res. 2007 Dec;32(12):2046-53 - PubMed
  48. J Int Med Res. 2010 Mar-Apr;38(2):570-82 - PubMed
  49. J Neurotrauma. 2010 Sep;27(9):1685-95 - PubMed
  50. J Neurosci Res. 2005 May 1;80(3):369-80 - PubMed
  51. Acta Med Port. 2007 Sep-Oct;20(5):401-6 - PubMed
  52. Neurosci Lett. 2012 Mar 5;511(1):28-32 - PubMed
  53. Free Radic Res. 2011 Feb;45(2):221-36 - PubMed
  54. J Clin Neurosci. 2008 Oct;15(10):1130-6 - PubMed
  55. Free Radic Res. 2009 Jun;43(6):604-12 - PubMed
  56. World Neurosurg. 2014 Nov;82(5):848-54 - PubMed
  57. Neurosci Lett. 2012 Sep 27;526(2):154-9 - PubMed
  58. Cochrane Database Syst Rev. 2012 Jan 18;1:CD001046 - PubMed
  59. Spine J. 2013 Apr;13(4):439-42 - PubMed

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