A recent report has described the ability of baclofen to suppress cough due to angiotensin-converting enzyme inhibition. In that study, initial symptomatic relief was noted after 3 to 6 days of baclofen therapy, and maximal antitussive effect was achieved by 5 to 14 days. The 14-day course of baclofen used in the present study was based on these data.
The proposed mechanism of cough involves the stimulation of two types of receptors within the respiratory tract: rapidly adapting pulmonary stretch receptors (RARs) with thin, myelinated fibers in the vagus nerves, and C-fiber receptors with unmyelinated afferent fibers. RARs are believed to cause cough directly by sending impulses to the brainstem, whereas C-fiber receptors may mediate cough by releasing sensory neuropeptides within the airway, which subsequently activate RARs to cause cough. The antitussive effect of baclofen observed in this study can be explained by central inhibition, as shown in animal studies, but may also involve peripheral inhibitory mechanisms. For example, baclofen has been shown to suppress the release of the protussive neuropeptide, substance P, from primary afferent neurons in rat trachea.
The results of the present study document the antitussive activity of a GABA-agonist in healthy human subjects. The demonstrated efficacy of low-dose oral baclofen supports further investigation of a potential therapeutic use for this Viagra Canada drugs, or other GABA-agonists, in the treatment of pathologic cough.
Invasive thymoma recently has been shown to be sensitive to combination chemotherapy and in some cases to be relatively indolent. Two cases of extensive thymoma which responded to primary treatment with a combination of a platinum compound (carboplatin or cisplatin), doxorubicin (Adriamycin), and cyclophosphamide (or РАС) are described. Tumor progression occurred 14 (case 1) and 60 months (case 2) after completion of initial РАС therapy and was treated with the same regimen resulting in a second remission, which lasted 6 months in case 1 and is continuing at 8 months in case 2. Similar reports of secondary responses using the same chemotherapy have been described in breast, lung, and ovarian cancers, as well as in Hodgkin’s lymphomas. Our observations suggest that retreatment with the same platinum-based regimen should be considered in patients who have progressive thymomas following a previous chemotherapeutic response and a disease-free interval of greater than 12 months.