Some drugs can provide recovery after stroke

A high percentage of disability acquired by stroke survivors means that the problem of effective neurorehabilitation of patients, falling into this category, is highly topical. Stroke is an age-dependent disease, which develops due to the conditions of other systems and organs (hypertension, atherosclerosis, ischemic heart disease, chronic hepatocholecystitis, etc.). Therefore, rehabilitation of the patients who have suffered ischemic stroke applies a comprehensive approach, which involves the use of drugs with different effects (vasoactive, neuroprotective, nootropic, etc.). Particular attention is paid to the use of neuroprotective agents and nootropics.

Nootropics improves the transmission of information between the hemispheres, stimulating the transmission of excitation in the central neurons, improving cerebral blood flow, increasing the intensity of metabolic processes and have a pronounced antihypoxic activity. Piracetam is the most common and most studied nootropic drug. The mechanism of action of nootropics of this group is determined by the effect on bioenergetic, metabolic processes in the nerve cell, activation of protein synthesis and an increase in the turnover speed of information macromolecules.

Piracetam

Piracetam increases synthesis of protein and phospholipids, which are necessary for memory processes, enhances the utilization of glucose in the brain, activates adenylate cyclase, which catalyzes the conversion of ADP to ATP. Also, this drug has a positive effect on the metallogenic homeostasis, and inhibits the processes of lipid peroxidation. In addition, the medication in this group interact with the glutamate system.

One of the most significant features of the effect of pyrrolidines on the NMDA receptor complex is its ability to change the ion currents of potassium, calcium and sodium, which explains the fact that small doses of piracetam enhance the effect of prolonged potentiation (and, consequently, neural plasticity). The nootropic effect of piracetam is realized through cholinergic mechanisms by increasing the release and synthesis of acetylcholine. The drug increases the sensitivity and number of muscarinic receptors, enhances high-affinity capture of choline.

There are data that describe the interaction of the steroid system and piracetam. For example, with the exception of the steroid component, the cognitive effect of piracetam is completely eliminated, whereas the administration of corticosterone or aldosterone enhances this effect. Piracetam affects the morphofunctional state of erythrocytes: it prevents the attachment of red blood cells to the endothelium of the vascular walls and enhances the deformation of the erythrocyte membrane. Also, the drug reduces the levels of fibrinogen and platelet aggregation, which leads to decreased blood viscosity.

Piracetam can accelerate the recovery of movements by more active incorporation of the stroke patient in the tasks included in the course of rehabilitation therapy. This drug increases the degree of control over subcortical structures, has a slight psychoanalgic effect.

Piracetam has the properties of a psychostimulant focused on the intellectual sphere of patients and has antidepressant activity. The drug reduces extrapyramidal dysfunction increasing control over subcortical structures in patients with ischemic stroke. Piracetam increases the intensity of alpha rhythm in the hemisphere of lesion localization and reduces the intensity of theta rhythm in the healthy hemisphere. It also helps to improve perception (in particular, visual) and the ability to concentrate attention and stimulates speech function.

To summarize the above, one can conclude that piracetam has a multifactorial effect: anti-aggregative, vasoactive and metabolic. The rapid metabolic effect of the drug is due to the activation of oxidation restoring processes and energy metabolism. The prolonged effect is associated with an increase in the plasticity of the brain tissue due to the increased receptor sensitivity to neurotransmitters.

Tiotriazolin

The medicines with a wide range of action also include tiotriazolin, which has antioxidant, anti-ischemic and membrane stabilizing properties. Tiotriazolin is widely used in the comprehensive treatment of atherosclerosis, ischemic heart disease, liver cirrhosis and chronic hepatitis. The drug reduces the degree of fatty infiltration, reduces the spread of centrolobular liver necrosis, prevents the death of hepatocytes, improves the processes of their reparative regeneration and normalizes their lipid, protein, carbohydrate and pigment metabolism. The drug improves the compensatory activity of anaerobic glycolysis, activates antioxidant systems and slows down the oxidation of lipids in the ischemic zones of the myocardium. In addition, tiotriazolin reduces the sensitivity of the myocardium to catecholamines, improves the rheological properties of blood, reduces and stabilizes the zones of ischemia and necrosis of the myocardium.

Thiocetam

This group of drugs also includes thiocetam, the clinical use of which showed:

• After a two-week intravenous administration of thiocetam, the patients who have suffered ischemic stroke experienced alleviated dizziness, the intensity of the headache and improved sleep. Also, the feeling of heaviness in the head, fatigue and unsteady gait were decreased;
• According to the assessment of the psycho-emotional status, the course of thiocetam resulted in a significant improvement of speech and concentration, activation of memory function and increased efficiency factor in patients with ischemic stroke;
• After the course of thiocetam, the patients with ischemic stroke noted increased LBLV, decreased angiospasm in the intact internal carotid artery, improved cerebral hemodynamics, decreased peripheral resistance in the cerebral middle cerebral artery, which is the area of lesion localization;
• In patients who have suffered ischemic stroke, the course of treatment with thiocetam leads to an expansion of the range of existing relationships between cerebral hemodynamics and the level of psychometric activity. This is evidenced by a decreased rigidity of the correlation links between the LBLV in the vertebral and carotid arteries, the thickness of IMT, as well as a number of indicators that characterize performance, memory, speech and perception;

The course of treatment with thiocetam contributed to the fact that patients with ischemic stroke experienced an increase in the effectiveness of rehabilitation and the index of daily activity.

You can also read other articles on this topic:

• Potassium and magnesium
• Menopause and stroke
• Transient ischemic attack

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