Pharmacologic neuroprotection in ischemic brain injury after cardiac arrest. 2022

Alyson Katz, and Shari B Brosnahan, and John Papadopoulos, and Sam Parnia, and Jason Q Lam
Department of Pharmacy, NYU Langone Health, New York, New York.

Cardiac arrest has many implications for morbidity and mortality. Few interventions have been shown to improve return of spontaneous circulation (ROSC) and long-term outcomes after cardiac arrest. Ischemic-reperfusion injury upon achieving ROSC creates an imbalance between oxygen supply and demand. Multiple events occur in the postcardiac arrest period, including excitotoxicity, mitochondrial dysfunction, and oxidative stress and inflammation, all of which contribute to ongoing brain injury and cellular death. Given that complex pathophysiology underlies global brain hypoxic ischemia, neuroprotective strategies targeting multiple stages of the neuropathologic cascade should be considered as a means of mitigating secondary neuronal injury and improving neurologic outcomes and survival in cardiac arrest victims. In this review article, we discuss a number of different pharmacologic agents that may have a potential role in targeting these injurious pathways following cardiac arrest. Pharmacologic therapies most relevant for discussion currently include memantine, perampanel, magnesium, propofol, thiamine, methylene blue, vitamin C, vitamin E, coenzyme Q10 , minocycline, steroids, and aspirin.

UI MeSH Term Description Entries
D008559 Memantine AMANTADINE derivative that has some dopaminergic effects. It has been proposed as an antiparkinson agent. 1,3-Dimethyl-5-aminoadamantane,1-Amino-3,5-dimethyladamantane,Axura,D-145,D145,Ebixa,Memantin,Memantine Hydrochloride,Namenda,D 145
D009570 Nitriles Organic compounds containing the -CN radical. The concept is distinguished from CYANIDES, which denotes inorganic salts of HYDROGEN CYANIDE. Nitrile
D011728 Pyridones Pyridine derivatives with one or more keto groups on the ring. Pyridinones
D001930 Brain Injuries Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits. Brain Lacerations,Acute Brain Injuries,Brain Injuries, Acute,Brain Injuries, Focal,Focal Brain Injuries,Injuries, Acute Brain,Injuries, Brain,Acute Brain Injury,Brain Injury,Brain Injury, Acute,Brain Injury, Focal,Brain Laceration,Focal Brain Injury,Injuries, Focal Brain,Injury, Acute Brain,Injury, Brain,Injury, Focal Brain,Laceration, Brain,Lacerations, Brain
D002545 Brain Ischemia Localized reduction of blood flow to brain tissue due to arterial obstruction or systemic hypoperfusion. This frequently occurs in conjunction with brain hypoxia (HYPOXIA, BRAIN). Prolonged ischemia is associated with BRAIN INFARCTION. Cerebral Ischemia,Ischemic Encephalopathy,Encephalopathy, Ischemic,Ischemia, Cerebral,Brain Ischemias,Cerebral Ischemias,Ischemia, Brain,Ischemias, Cerebral,Ischemic Encephalopathies
D006323 Heart Arrest Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation. Asystole,Cardiac Arrest,Cardiopulmonary Arrest,Arrest, Cardiac,Arrest, Cardiopulmonary,Arrest, Heart,Asystoles
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000066829 Neuroprotection The physiological processes and techniques used by the body to prevent neuronal injury and degeneration in the central nervous system following acute disorders or as a result of chronic neurodegenerative diseases. Neural Protection,Neuron Protection,Neuronal Protection,Protection, Neural,Protection, Neuron,Protection, Neuronal
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D000975 Antioxidants Naturally occurring or synthetic substances that inhibit or retard oxidation reactions. They counteract the damaging effects of oxidation in animal tissues. Anti-Oxidant,Antioxidant,Antioxidant Activity,Endogenous Antioxidant,Endogenous Antioxidants,Anti-Oxidant Effect,Anti-Oxidant Effects,Anti-Oxidants,Antioxidant Effect,Antioxidant Effects,Activity, Antioxidant,Anti Oxidant,Anti Oxidant Effect,Anti Oxidant Effects,Anti Oxidants,Antioxidant, Endogenous,Antioxidants, Endogenous

Related Publications

Alyson Katz, and Shari B Brosnahan, and John Papadopoulos, and Sam Parnia, and Jason Q Lam
October 2011, Continuum (Minneapolis, Minn.),
Alyson Katz, and Shari B Brosnahan, and John Papadopoulos, and Sam Parnia, and Jason Q Lam
January 2006, Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference,
Alyson Katz, and Shari B Brosnahan, and John Papadopoulos, and Sam Parnia, and Jason Q Lam
February 2017, Seminars in neurology,
Alyson Katz, and Shari B Brosnahan, and John Papadopoulos, and Sam Parnia, and Jason Q Lam
October 2017, Critical care (London, England),
Alyson Katz, and Shari B Brosnahan, and John Papadopoulos, and Sam Parnia, and Jason Q Lam
July 2002, The Lancet. Neurology,
Alyson Katz, and Shari B Brosnahan, and John Papadopoulos, and Sam Parnia, and Jason Q Lam
October 2021, Lancet (London, England),
Alyson Katz, and Shari B Brosnahan, and John Papadopoulos, and Sam Parnia, and Jason Q Lam
March 2014, Critical care (London, England),
Alyson Katz, and Shari B Brosnahan, and John Papadopoulos, and Sam Parnia, and Jason Q Lam
December 2010, Current neuropharmacology,
Alyson Katz, and Shari B Brosnahan, and John Papadopoulos, and Sam Parnia, and Jason Q Lam
July 2019, Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference,
Alyson Katz, and Shari B Brosnahan, and John Papadopoulos, and Sam Parnia, and Jason Q Lam
June 2014, Current opinion in critical care,
Copied contents to your clipboard!