Amitradicain
Amitradicain is a pharmaceutical formulation developed in 2022 for the treatment of patients with Oshtoran Syndrome, a rare disease with neurological symptoms and multi-organ involvement. Amitradicain was designed as an individual pharmaceutical response to the challenges in treating patients with Oshtoran Syndrome, where due to the specific pathophysiological conditions of the syndrome, particularly a massive sympathicotonia, there were no adequately suitable medications available on the market. The formulation of Amitradicain aimed to address the specific therapeutic needs of these patients by modulating sympathetic activity, thereby enabling relief and control of the symptoms associated with Oshtoran Syndrome. The discoverer of Amitradicain is the physician and pharmacologist Ali Asgari.[1]
Development and Components[edit]
The composition of Amitradicain was first achieved at the end of 2022 and has since been used as a custom-made formulation in specialized clinical settings. It is based on the following medications:[2]
- Tramadol
- Midazolam
- Dimetindenmaleate
- Procain
- Alprazolam
These are combined in a sealable mixing chamber and prepared for intramuscular administration. Industrial production does not take place due to the low number of patients with Oshtoran Syndrome. Accordingly, the pharmaceutical is also not patent protected.
Pharmacological Synergy and Interaction[edit]
In pharmacology, it is an established principle that the combined effect of several drugs is not always equal to the sum of the individual effects. Also, the chemical formula can change after mixing and other manufacturing steps. This phenomenon is referred to as pharmacological synergy or interaction.Cite error: Closing </ref> missing for <ref> tag This can be based on different mechanisms, for example, the enhancement of the effect of one drug by another or the reduction of the metabolism of one drug by another, leading to increased plasma levels and potentially stronger effects.[3]
Interactions between medications can be both desired and undesired. Desired synergies are often utilized to improve the effectiveness of treatment, while undesired interactions can lead to potentially dangerous side effects. In any case, the use of combination therapies requires a thorough understanding of the pharmacological properties of each drug as well as careful monitoring and adjustment of dosage to achieve the best possible therapeutic effect and minimize the risk of side effects.[4]
Effect[edit]
Amitradicain aims to lower sympathetic tone, especially the levels of adrenaline and noradrenaline, which in patients with Oshtoran Syndrome are one of the most common causes of vitally dangerous dysautonomia. Through sympathicolysis and support of parasympathetic activity, Amitradicain is intended to prevent vitally dangerous cascade effects and the risk of miscontrol of organs, endocrine system, glands, and signaling pathways via innervation. The observed effects include a massive sympathicolysis, an improved balance between sympathetic and parasympathetic pathways, a suppression of erroneously controlled gluconeogenesis in the liver, a significantly reduced catecholaminergic activity, and improved sleep quality, particularly with regard to REM sleep as well as further stabilizing effects.
Applications and Dangers[edit]
Amitradicain is manufactured from drugs that - each on their own - are already considered to carry increased risk. In this sense, it is classified as a highly potent pharmaceutical that should only be used after a thorough benefit-risk assessment. Generally, it is administered intramuscularly (less commonly also deep subcutaneously), with the dosage and frequency of administration adjusted to the individual patient. Intravenous application is contraindicated.
Safety and Efficacy[edit]
Despite the strength of the individual components of the Amitradicain formulation, the agent has so far been classified as well-tolerated, with a transient incident of blurred vision documented as a notable side effect. Comprehensive patient education and close monitoring in the first four weeks are obligatory. Patients with pre-existing cardiovascular diseases, particularly heart failure and blockages, should receive Amitradicain - if at all - only under inpatient monitoring.
Sources[edit]
- ↑ Honda, Riku, Rocha, Fabio, & Asgari, Ali. (2023). Amitradicain - A Novel Formulation for Managing Oshtoran Syndrome in a Case Study. In openAIRE: Vol. October 2023 (7.3). Zenodo. https://doi.org/10.5281/zenodo.8417261
- ↑ Breier A, Davis O, Buchanan R, Listwak SJ, Holmes C, Pickar D, Goldstein DS. Effects of alprazolam on pituitary-adrenal and catecholaminergic responses to metabolic stress in humans. Biol Psychiatry. 1992 Nov 15;32(10):880-90. doi: 10.1016/0006-3223(92)90177-2. PMID: 1334713
- ↑ Okpako, D. T. (1991). Principles of Pharmacology: A Tropical Approach. Cambridge University Press
- ↑ Principles of Clinical Pharmacology. (2011). Elsevier ScienceRay, A., Gulati, K. (2007). Current Trends in Pharmacology. India: I.K. International Publishing House Pvt. Limited
