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Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
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Did we abandon probucol too soon?

Shizuya Yamashita1, Daisaku Masuda, Yuji Matsuzawa

  • 1aDepartment of Community Medicine bDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine cSumitomo Hospital, Osaka, Japan.

Current Opinion in Lipidology
|July 1, 2015
PubMed
Summary

Probucol, an antioxidant drug, shows beneficial effects on the cardiovascular system and may be an option for secondary prevention of cardiovascular events when statins are ineffective.

Area of Science:

  • Cardiovascular Pharmacology
  • Lipid Metabolism
  • Oxidative Stress

Background:

  • Probucol is an antioxidant drug historically used for atherosclerotic cardiovascular diseases and xanthoma.
  • Its use declined in Western countries due to decreased high-density lipoprotein-cholesterol (HDL-C), despite its lipid-lowering properties.
  • Recent research elucidates probucol's molecular mechanisms and pleiotropic effects.

Purpose of the Study:

  • To review basic and clinical studies on probucol's pleiotropic effects.
  • To highlight new insights into its cardiovascular benefits.
  • To evaluate its role in secondary cardiovascular event prevention.

Main Methods:

  • Review of recent basic and clinical studies.
  • Analysis of molecular mechanisms of probucol's action.

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  • Retrospective analysis of patient data.

    • Main Results:

    • Probucol enhances HDL antioxidative function by increasing paraoxonase 1 activity.
    • It decreases HDL-C by enhancing cholesteryl ester transfer protein activity and hepatic scavenger receptor class B type I.
    • Retrospective analyses show probucol's benefit in secondary prevention of cardiovascular events and mortality.

    Conclusions:

    • Probucol exhibits pleiotropic and beneficial cardiovascular effects.
    • It can be considered as an alternative treatment when statins are insufficient for managing cardiovascular risk.