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Information about Papaverine

Papaverine is an opium alkaloid used primarily in the treatment of visceral spasm, vasospasm (especially those involving the heart and the brain), and occasionally in the treatment of erectile dysfunction.[3] While it is found in the opium poppy, papaverine differs in both structure and pharmacological action from the other opium alkaloids (opiates).

Uses

Papaverine is approved to treat spasms of the gastointestinal tract, bile ducts and ureter and for use as a cerebral and coronary vasodilator[3] in subarachnoid hemorrhage (combined with balloon angioplasty)[6] and coronary artery bypass surgery.[7] Papaverine may also be used as a smooth muscle relaxant in microsurgery where it is applied directly to blood vessels.

The in vivo mechanism of action is not entirely clear, but an inhibition of the enzyme phosphodiesterase causing elevation of cyclic AMP levels is significant. It may also alter mitochondrial respiration.

It is also commonly used in cryopreservation of blood vessels along with other glycosaminoglycans and protein suspensions.[1][2] Functions as a vasodilator during cryopreservation when used in conjunction with verapamil, phentolamine, nifedipine, tolazolines, or nitroprusside.[3][4]

Papaverine is also being investigated as a topical growth factor in tissue expansion with some success.[5]

Side effects

Frequent side effects of papaverine treatment include polymorphic ventricular tachycardia, constipation, interference with sulphobromophthalein[8] retention test (used to determine hepatic function), increased transaminase levels, increased alkaline phosphatase levels, somnolence, and vertigo.[3]

Rare side effects include flushing of the face, hyperhidrosis (excessive sweating), cutaneous eruption, arterial hypotension, tachycardia, lack of appetite, jaundice, eosinophilia, thrombopenia, mixed hepatitis, headache, allergic reaction, chronic active hepatitis,[3] and paradoxical aggravation of cerebral vasospasm.[9]

Formulations and trade names

Papaverine is available as a conjugate of hydrochloride, codecarboxylate, adenylate, and teprosylate.[10] It was also once available as a salt of hydrobromide, camsylate, cromesilate, nicotinate, and phenylglycolate. The hydrochloride salt is available for intramuscular, intravenous, rectal and oral administration.[5] The teprosylate is available in intravenous, intramuscular, and orally administered formulations.[11] The codecarboxylate is available in oral form, only,[12] as is the adenylate.[13]

The codecarboxylate is sold under the name Albatran®,[14] the adenylate as Dicertan®,[15] and the hydrochloride salt is sold variously as Artegodan® (Germany), Cardioverina® (countries outside Europe and the United States), Dispamil® (countries outside Europe and the United States), Opdensit® (Germany), Panergon® (Germany), Paverina Houde® (Italy, Belgium), Pavacap (United States), Pavadyl® (United States), Papaverin-Hamelin® (Germany), Paveron® (Germany), Spasmo-Nit® (Germany),[5] Cardiospan®, Papaversan®, Cepaverin®, Cerespan®, Drapavel®, Forpaven®, Papalease®, Pavatest®, Paverolan®, Therapav® (France[16]), Vasospan®, Cerebid®, Delapav®, Dilaves®, Durapav®, Dynovas®, Optenyl®, Pameion®, Papacon®, Pavabid®, Pavacen®, Pavakey®, Pavased®, Pavnell®, Alapav®, Myobid®, Vasal®, Pamelon®, Pavadel®, Pavagen®, Ro-Papav®, Vaso-Pav®, Papanerin-hcl®, Qua bid®, Papital T.R.®, Paptial T.R.®, Pap-Kaps-150®.[17]

References

1. ^ E. Müller-Schweinitzer and P. Ellis: "Sucrose promotes the functional activity of blood vessels after cryopreservation in DMSO-containing fetal calf serum". Naunyn-Schmiedeberg's Archives of Pharmacology, Volume 345, Number 5 / May, 1992
2. ^ Muller-Schweinitzer E, Hasse J, Swoboda L. : "Cryopreservation of human bronchi.". J Asthma. 1993;30(6):451-7. Links
3. ^ Brockbank KG.: "Effects of cryopreservation upon vein function in vivo". Cryobiology. 1994 Feb;31(1):71-81
4. ^ Joseph S. Giglia, Jeremy D. Ollerenshaw, Patti E. Dawson, Kirby S. Black, William M. Abbott : "Cryopreservation Prevents Arterial Allograft Dilation ". Annals of Vascular Surgery Volume 16, Number 6 / December, 2002
5. ^ Tang Y, Luan J, Zhang X (2004). "Accelerating tissue expansion by application of topical papaverine cream". Plast. Reconstr. Surg. 114 (5): 1166–9. PMID 15457029. 
  1. a  b  c  SID 544606 -- PubChem Substance Summary. Retrieved on 25 September, 2005. National Center for Biotechnology Information.
  2. a  Papaverine Material Safety Data Sheet. Retrieved on 25 September, 2005.
  3. a  b  c  d  e  f  g  h  Unknown (2000). PAPAVERINE. Molécule(s) de base : PAPAVERINE. Biam. Retrieved on 25 September, 2005. (French)
  4. a  Unknown (2004). Who should not take papaverine?. papaverine Consumer Drug Information. Cerner Multum, Inc. Retrieved on 26 September, 2005.
  5. a  b  c  Unknown (1999). PAPAVERINE CHLORHYDRATE. Molécule(s) de base : PAPAVERINE. Biam. Retrieved on 25 September, 2005. (French)
  6. a  Liu, James K.; Couldwell, William T (2005). "Intra-arterial papaverine infusions for the treatment of cerebral vasospasm induced by aneurysmal subarachnoid hemorrhage". Neurocritical Care 2 (2): 124-32. PMID 16159054.  Fulltext options List of Library Holdings
  7. a  Takeuchi K, Sakamoto S, Nagayoshi Y, Nishizawa H, Matsubara J (2004). "Reactivity of the human internal thoracic artery to vasodilators in coronary artery bypass grafting". European Journal of Cardio-Thoracic Surgery 26 (5): 956-9. PMID 15519189.  Fulltext options List of Library Holdings
  8. a  SID 149219 -- PubChem Substance Summary. Retrieved on 26 September, 2005. National Center for Biotechnology Information.
  9. a  Clyde BL, Firlik AD, Kaufmann AM, Spearman MP, Yonas H (1996). "Paradoxical aggravation of vasospasm with papaverine infusion following aneurysmal subarachnoid hemorrhage. Case report". Journal of Neurosurgery 84 (4): 690-5.  PubMed
  10. a  Molécule de base : PAPAVERINE. Retrieved on 26 September, 2005. Biam.
  11. a  Unknown (1999). PAPAVERINE TEPROSILATE. Molécule(s) de base : PAPAVERINE. Biam. Retrieved on 26 September, 2005. (French)
  12. a  Unknown (1998). PAPAVERINE CODECARBOXYLATE. Molécule(s) de base : PAPAVERINE. Biam. Retrieved on 26 September, 2005. (French)
  13. a  Unknown (1998). PAPAVERINE ADENYLATE. Molécule(s) de base : PAPAVERINE. Biam. Retrieved on 26 September, 2005. (French)
  14. a  SID 660773 PubChem Substance Summary. Retrieved on 25 September, 2005. National Center for Biotechnology Information.
  15. a  SID 660767 -- PubChem Substance Summary. Retrieved on 25 September, 2005. National Center for Biotechnology Information.
  16. a  THERAPAV (PRODUIT PUR) - Détail. Retrieved on 26 September, 2005. CSST - Service du répertoire toxicologique. (French)
  17. a  SID 660767 -- PubChem Substance Summary - Depositor-Supplied Synonyms: All. Retrieved on 26 September, 2005. National Center for Biotechnology Information.


 •  • [ e]
Drugs for functional gastrointestinal disorders (A03)
Drugs for functional bowel disordersanticholinergics/antimuscarinics (Mebeverine, Dicycloverine, Propantheline) - papaverine and derivatives (Papaverine, Drotaverine, Moxaverine) - acting on serotonin receptors (Alosetron, Tegaserod, Cilansetron) - other (Diisopromine, Isometheptene, Phloroglucinol)
Belladonna and derivatives
(antimuscarinics)		Atropine - Hyoscyamine - Butylscopolamine - Methylscopolamine
Propulsivesprimarily dopamine antagonists (Metoclopramide/Bromopride, Domperidone, Alizapride) - Cisapride - Clebopride
 •  • [ e]
Urologicals (G04)
AcidifiersAmmonium chloride, Calcium chloride
Urinary antispasmodics (primarily antimuscarinics)Darifenacin, Emepronium, Flavoxate, Meladrazine, Oxybutynin, Propiverine, Solifenacin, Terodiline, Tolterodine, Trospium
For erectile dysfunctionAlprostadil, Apomorphine, Moxisylyte, Papaverine, Phentolamine, Yohimbine, PDE5 inhibitors (Avanafil, Sildenafil, Tadalafil, Udenafil, Vardenafil)
Other urologicalsAcetohydroxamic acid, Collagen, Dimethyl sulfoxide, Magnesium hydroxide, Pentosan polysulfate, Phenazopyridine, Phenyl salicylate, Succinimide
For benign prostatic hypertrophy5α-reductase inhibitors: Dutasteride, Finasteride
Alpha blockers: Alfuzosin, Doxazosin, Tamsulosin, Terazosin
Herbals: Pygeum africanum, Serenoa repens
Opium is a narcotic formed from the latex released by lacerating (or "scoring") the immature seed pods of opium poppies (Papaver somniferum). It contains up to 16% morphine, an opiate alkaloid, which is most frequently processed chemically to produce heroin for the illegal
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alkaloid is, strictly speaking, a naturally occurring amine produced by a plant, but amines produced by animals and fungi are also called alkaloids[1]. Many alkaloids have pharmacological effects on humans and other animals.
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Muscle spasm
Classifications and external resources

ICD-10 R 25.2
ICD-9 728.85

A spasm is a sudden, involuntary contraction of a muscle, a group of muscles, or a hollow organ, or a similarly sudden contraction of an orifice.
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Vasospasm
Classification & external resources

ICD-9 443.9

Vasospasm refers to a condition in which blood vessels spasm, leading to vasoconstriction. This can lead to tissue ischemia and death (necrosis).
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heart is a muscular organ responsible for pumping blood through the blood vessels by repeated, rhythmic contractions, or a similar structure in the annelids, mollusks, and arthropods.
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In animals, the brain or encephalon (Greek for "in the skull"), is the control center of the central nervous system, responsible for behavior. The brain is located in the head, protected by the skull and close to the primary sensory apparatus of vision, hearing,
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MeSH D007172 Erectile dysfunction (ED or (male) impotence) is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis.
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P. somniferum

Binomial name
Papaver somniferum
L.

The opium poppy, Papaver somniferum
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opiate describes any of the narcotic alkaloids found in opium.

Overview

The main opiates derived from opium are morphine, codeine, thebaine, and Papaverine, Noscapine, narceine and approximately 25 other alkaloids are also present, but have essentially little to no effect
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A bile duct is any of a number of long tube-like structures that carry bile.

Bile, required for the digestion of food, is excreted by the liver into passages that carry bile toward the hepatic duct, which joins with the cystic duct (carrying bile to and from the
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In human anatomy, the ureters are the ducts that carry urine from the kidneys to the urinary bladder, passing anterior to the psoas major. The ureters are muscular tubes that can propel urine along by the motions of peristalsis. In the adult, the ureters are usually 25-30cm long.
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Cerebral may mean:
  • Cerebral (adjective), Describes an angle of thinking that utilizes the intellect rather than intuition or instinct.
  • Cerebral (musician), an American electronic musician
  • Cerebral consonants

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The coronary circulation is the circulation of blood in the blood vessels that supply blood to and from the heart muscle itself. Although blood fills the chambers of the heart, the muscle tissue of the heart, or myocardium, is so thick that it requires coronary blood vessels to
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A vasodilator is a drug or chemical that relaxes the smooth muscle in blood vessels, which causes them to dilate. Dilation of arterial blood vessels (mainly arterioles) lead to a decrease in blood pressure.
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Subarachnoid hemorrhage
Classification & external resources

CT scan of the brain showing subarachnoid hemorrhage as a white area in the center
ICD-10 I 60. , S 06.6
ICD-9 430 , 852.0 - 852.
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Intervention:


ICD-10 code:
ICD-9 code: 00.6

Other codes: Angioplasty is the mechanical widening of a narrowed or totally-obstructed blood vessel. These obstructions are often caused by atherosclerosis.
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Coronary artery bypass surgery, also coronary artery bypass graft surgery, and colloquially heart bypass or bypass surgery is a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease.
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Microsurgery is a general term for surgery requiring an operating microscope. The most obvious developments have been procedures developed to allow anastomosis of successively smaller blood vessels and nerves (typically 1 mm in diameter) which have allowed transfer of tissue from
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Enzymes are proteins that catalyze (i.e. accelerate) chemical reactions.[1] In enzymatic reactions, the molecules at the beginning of the process are called substrates, and the enzyme converts them into different molecules, the products.
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Editing of this page by unregistered or newly registered users is currently disabled due to vandalism.
If you are prevented from editing this page, and you wish to make a change, please discuss changes on the talk page, request unprotection, log in, or .
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Cellular respiration describes the metabolic reactions and processes that take place in a cell or across the cell membrane to obtain biochemical energy from fuel molecules and the release of the cells' waste products.
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Cryopreservation is a process where cells or whole tissues are preserved by cooling to low sub-zero temperatures, such as (typically) 77 K or −196 °C (the boiling point of liquid nitrogen).
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The blood vessels are part of the cardiovascular system and function to transport blood throughout the body. The most important types, arteries and veins, carry blood away from or towards the heart, respectively.
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A vasodilator is a drug or chemical that relaxes the smooth muscle in blood vessels, which causes them to dilate. Dilation of arterial blood vessels (mainly arterioles) lead to a decrease in blood pressure.
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Verapamil (brand names: Isoptin, Verelan, Calan, Bosoptin) is an L-type calcium channel blocker. It has been used in the treatment of hypertension, angina pectoris, cardiac arrhythmia, and most recently, headaches.
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Phentolamine (Regitine) is a reversible nonselective alpha-adrenergic antagonist. Its primary action is vasodilation. The primary application for phentolamine is for the control of hypertensive emergencies, most notably due to phaeochromocytoma (pheochromocytoma).
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Nifedipine (brand name Adalat, Nifedical, and Procardia) is a dihydropyridine calcium channel blocker. Its main uses are in angina pectoris (especially Prinzmetal's angina) and hypertension, although a large number of other uses have recently been found for
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Sodium nitroprusside is the chemical compound with the formula Na2[Fe(CN)5NO]·2H2O.[1] This salt serves as a source of nitric oxide, a potent peripheral vasodilator that affects both arterioles and venules (venules more than arterioles).
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MeSH D017180 Ventricular tachycardia (V-tach or VT) is a tachycardia, or fast heart rhythm that originates in one of the ventricles of the heart. This is a potentially life-threatening arrhythmia because it may lead to ventricular fibrillation and sudden death.
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transaminase or an aminotransferase is an enzyme that catalyzes a type of reaction between an amino acid and an α-keto acid. Specifically, this reaction (transamination) involves removing the amino group from the amino acid, leaving behind an α-keto acid, and
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