Central nervous system cardiovascular drugs

In Portugal, the most consumed/sold pharmaceutical groups belong to the central nervous system, cardiovascular, anti-infective classes and cytostatics, being these groups heavily represented within the top 100 drugs of the ranking as presented in Table 1 and in Fig. 1. Pharmaceuticals sales increased 10% in the period 2003/2007 [23], and an increase in cardiovascular system and central nervous system has been observed [22]. 

Patients with coexisting cardiovascular and pulmonary conditions (e.g., ARDS, pulmonary infection, pulmonary aspiration) may be more susceptible to the toxic effects or complications of tricyclic antidepressant poisoning. The influence of chronic exposure to tricyclic antidepressants on the risks of an acute overdose is unclear. Tricyclic antidepressants interact with other central nervous system depressant drugs, which together may lead to increased central nervous system and respiratory depression. 

For example, drugs acting on the central nervous system, cardiovascular system, respiratory system, diabetes, rheumatoid arthritis, etc. 

Strategic licensing of compounds discovered in India (several groups have advanced programs in the areas of antiinfective, antihistamine, central nervous system (CNS) drugs, cardiovascular, and natural products-based drug discovery)... 

The following sections provide examples of approaches to assess drug effects on the cardiovascular, respiratory, and central nervous systems in compliance with the current and emerging regulatory guidance documents.25,42 45 60... 

In Chapter 1, John Lowe details The Role of Medicinal Chemistry in Drug Discovery in the twenty first century. The overview should prove invaluable to novice medicinal chemists and process chemists who are interested in appreciating what medicinal chemists do. In Chapter 2, Neal Anderson summarizes his experience in process chemistry. The perspectives provide a great insight for medicinal chemists who are not familiar with what process chemistry entails. Their contributions afford a big picture of both medicinal chemistry and process chemistry, where most of the readers are employed. Following two introductory chapters, the remainder of the book is divided into three major therapeutic areas I. Cancer and Infectious Diseases (five chapters) II. Cardiovascular and Metabolic Diseases (six chapters) and III. Central Nervous System Diseases (four chapters). 

Finally the effect of the compound on several body functions is investigated in so-called safety pharmacology studies. The most relevant are the possible effects on the respiratory system, the cardiovascular system and on the central nervous system. Usually these studies are done in rodents, dogs or primates. Lately there has been increased interest in the effect of new drugs on ECG parameters. 

Pharmacokinetics Characterized by slow onset of action and sustained effects. Both cardiovascular and central nervous system effects may persist for a period of time following withdrawal of the drug. Mean maximum plasma levels were attained after a median of 3.5 hours. Bioavailability was approximately 50% of that of a corresponding intravenous dose. Protein binding 96%. Half life 33 hours. 

Dopamine is the immediate precursor in the synthesis of norepinephrine (see Figure 6-5). Its cardiovascular effects were described above. Endogenous dopamine may have more important effects in regulating sodium excretion and renal function. It is an important neurotransmitter in the central nervous system and is involved in the reward stimulus relevant to addiction. Its deficiency in the basal ganglia leads to Parkinson s disease, which is treated with its precursor levodopa. Dopamine receptors are also targets for antipsychotic drugs. 

More important than numerical data are the clinical implications of differences between the two countries. The largest differences have narrowed since the previous study, but important categories in which the U.S. still lagged behind Britain in December 1976 included cardiovascular drugs, peptic ulcer treatment, and central nervous system drugs—including therapies for depression, epilepsy, and migraine. 

---