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drug-induced hypotension

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https://www.readbyqxmd.com/read/28501080/intravenous-contrast-induced-nephropathy-the-rise-and-fall-of-a-threatening-idea
#1
REVIEW
Lyndon Luk, Jonathan Steinman, Jeffrey H Newhouse
Contrast-induced nephropathy (CIN) has been considered to be a cause of renal failure for over 50 years, but careful review of past and recent studies reveals the risks of CIN to be overestimated. Older studies frequently cited the use of high-osmolality contrast media, which have since been replaced by low-osmolality contrast media, which have lower risks for nephropathy. In addition, literature regarding CIN typically describes the incidence following cardiac angiography, whereas the risk of CIN from intravenous injection is much lower...
May 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28489728/novel-adjunct-drugs-reverse-endothelial-glycocalyx-damage-after-hemorrhagic-shock-in-rats
#2
Ivo P Torres Filho, Luciana N Torres, Christi Salgado, Michael A Dubick
INTRODUCTION: There is interest in the small-volume therapeutic use of adjunct drugs for treating hemorrhagic shock (HS). However, critical information is only partially available on mechanisms of action of promising compounds such as adenosine-lidocaine-Magnesium (ALM), beta-hydroxybutyrate plus melatonin (BHB/M), and poloxamer 188 (P-188). Therefore, we tested the hypothesis that these adjuncts would reverse HS-induced damage to microvascular endothelial glycocalyx and hemodynamics...
May 9, 2017: Shock
https://www.readbyqxmd.com/read/28449192/anti-inflammatory-effects-of-pegylated-human-adrenomedullin-in-a-mouse-dss-induced-colitis-model
#3
Sayaka Nagata, Motoo Yamasaki, Kazuo Kitamura
Preclinical Research Human adrenomedullin (hAM), a hypotensive peptide, also has anti-inflammatory effects. hAM can reduce the severity of the dextran sulphate sodium (DSS)- and 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis in animal models. Furthermore, in a clinical study, hAM treatment reduced the Disease Activity Index in ulcerative colitis. However, these therapeutic effects required continuous administration of hAM as the half-life of native hAM is quite short in blood. To resolve this problem, hAM N-terminal was conjugated with two kinds of polyethylene glycol (PEG); 5 kDa PEG or 60 kDa PEG (5 kDa PEG-hAM and 60 kDa PEG-hAM respectively)...
April 27, 2017: Drug Development Research
https://www.readbyqxmd.com/read/28447886/drug-induced-hyperlactatemia
#4
Eike Blohm, Jeffrey Lai, Mark Neavyn
BACKGROUND: Hyperlactatemia is common in critically ill patients and has a variety of etiologies. Medication toxicity remains an uncommon cause that providers often fail to recognize. In this article, we review several medications that cause hyperlactatemia in either therapeutic or supratherapeutic dosing. When known, the incidence, mortality, pathophysiology, and treatment options are discussed. METHODS: We performed a literature search using PUBMED and Google Scholar for English language articles published after 1980 regarding medication induced hyperlactatemia and its management...
April 27, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28439951/incidence-and-risk-factors-of-hypotension-after-intravenous-fosphenytoin-administration
#5
H K Kim, I G Hwang, I-S Koh, D W Kim
WHAT IS KNOWN AND OBJECTIVE: Fosphenytoin (FOS) administered intravenously offers several benefits over intravenously administered phenytoin, including a faster infusion rate, decreased pain and irritation at the infusion site, and fewer cardiovascular complications. However, some studies suggest that the intravenous administration of FOS in some patients may also induce adverse cardiovascular events. Here, we investigated the clinical characteristics of patients who experienced hypotension following an intravenous infusion of a FOS loading dose...
April 24, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28413279/comparing-slow-and-rapid-bolus-of-ephedrine-in-pregnant-patients-undergoing-planned-cesarean-section-under-spinal-anesthesia
#6
Prabu Gunasekaran, Lenin Babu Elakkumanan, Hemavathi Balachander, M V S Satyaprakash
BACKGROUND AND AIMS: While ephedrine was the preferred drug for treating spinal-induced hypotension in pregnancy, its use has declined because of resultant fetal acidosis. The objective of this randomized control trial was to compare the effects of a slow and rapid bolus of ephedrine on fetal acidosis, maternal blood pressure, and heart rate (HR) during cesarean section performed under spinal anesthesia. MATERIAL AND METHODS: Eighty full-term parturients scheduled for cesarean section under spinal anesthesia were randomly allocated into two groups...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28407743/new-drugs-new-toxicities-severe-side-effects-of-modern-targeted-and-immunotherapy-of-cancer-and-their-management
#7
REVIEW
Frank Kroschinsky, Friedrich Stölzel, Simone von Bonin, Gernot Beutel, Matthias Kochanek, Michael Kiehl, Peter Schellongowski
Pharmacological and cellular treatment of cancer is changing dramatically with benefits for patient outcome and comfort, but also with new toxicity profiles. The majority of adverse events can be classified as mild or moderate, but severe and life-threatening complications requiring ICU admission also occur. This review will focus on pathophysiology, symptoms, and management of these events based on the available literature.While standard antineoplastic therapy is associated with immunosuppression and infections, some of the recent approaches induce overwhelming inflammation and autoimmunity...
April 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28358593/a-case-of-amoxicillin-induced-acute-generalized-exanthematous-pustulosis-presenting-as-septic-shock
#8
Katherine A McDonald, Tadeusz A Pierscianowski
This case report demonstrates the challenges of diagnosing and managing acute generalized exanthematous pustulosis (AGEP) presenting as septic shock. The disseminated, erythematous, pustular rash is a common feature. However, extensive organ involvement and life-threatening hypotension are unusual. The constellation of signs has not previously been documented following amoxicillin therapy. Toxic epidermal necrolysis (TEN) and toxic shock syndrome (TSS) were considered in addition to AGEP because of the systemic presentation...
March 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28243591/transcranial-motor-evoked-potentials-during-spinal-deformity-corrections-safety-efficacy-limitations-and-the-role-of-a-checklist
#9
Shankar Acharya, Nagendra Palukuri, Pravin Gupta, Manish Kohli
INTRODUCTION: Intraoperative neuromonitoring (IONM) has become a standard of care in spinal deformity surgeries to minimize the incidence of new onset neurological deficit. Stagnara wake up test and ankle clonus test are the oldest techniques described for spinal cord monitoring, but they cannot be solely relied upon as a neuromonitoring modality. Somatosensory evoked potentials monitor only dorsal tracts and give high false positive and negative alerts. Transcranial motor evoked potentials (TcMEPs) monitor the more useful motor pathways...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28155226/propofol-versus-thiopental-sodium-for-the-treatment-of-refractory-status-epilepticus
#10
REVIEW
Hemanshu Prabhakar, Mani Kalaivani
BACKGROUND: This review is an update of a previously published review in the Cochrane Database of Systematic Reviews (Issue 6, 2015).Failure to respond to antiepileptic drugs in patients with uncontrolled seizure activity such as refractory status epilepticus (RSE) has led to the use of anaesthetic drugs. Coma is induced with anaesthetic drugs to achieve complete control of seizure activity. Thiopental sodium and propofol are popularly used for this purpose. Both agents have been found to be effective...
February 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28138563/ganglionic-gfap-glial-gq-gpcr-signaling-enhances-heart-functions-in-vivo
#11
Alison Xiaoqiao Xie, Jakovin J Lee, Ken D McCarthy
The sympathetic nervous system (SNS) accelerates heart rate, increases cardiac contractility, and constricts resistance vessels. The activity of SNS efferent nerves is generated by a complex neural network containing neurons and glia. Gq G protein-coupled receptor (Gq-GPCR) signaling in glial fibrillary acidic protein-expressing (GFAP(+)) glia in the central nervous system supports neuronal function and regulates neuronal activity. It is unclear how Gq-GPCR signaling in GFAP(+) glia affects the activity of sympathetic neurons or contributes to SNS-regulated cardiovascular functions...
January 26, 2017: JCI Insight
https://www.readbyqxmd.com/read/28091926/effect-of-hypotensive-drugs-on-dynamics-of-nitroxide-producing-renal-function-in-rats-with-nephrogenic-hypertension
#12
E V Eliseeva, E F Romanchenko, I V Dyuizen, A V Tyrtyshnikova, Yu I Pigolkin
An original model of nephrogenic hypertension in rats was used for histochemical mapping of NADPH diaphorase (NO synthase) in various renal segments to examine the effect of hypotensive drugs furosemide, bendazol, and clonidine on the time course of nitroxide production in the kidneys. In various nephron segments, these drugs modulated NO synthesis in different ways. Clonidine induced a stable up-regulation of NO synthesis, which can maintain active vasodilation and gradually diminish the rennin production...
January 2017: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28070113/pharmacological-characterization-of-microminipig-as-a-model-to-assess-the-drug-induced-cardiovascular-responses-for-non-clinical-toxicity-and-or-safety-pharmacology-studies
#13
Hirofumi Yokoyama, Yuji Nakamura, Hiroyuki Saito, Yukitoshi Nagayama, Kiyotaka Hoshiai, Takeshi Wada, Hiroko Izumi-Nakaseko, Kentaro Ando, Yasuki Akie, Atsushi Sugiyama
We tried to establish the halothane-anesthetized microminipigs as an alternative animal model for non-clinical toxicity and/or safety pharmacology studies. In order to characterize the halothane-anesthetized microminipigs, we firstly clarified the effects of halothane anesthesia on their cardiovascular system (n = 5). Then, we examined the cardiovascular effects of dl-sotalol in doses of 0.1, 0.3 and 1 mg/kg, i.v. on the halothane-anesthetized microminipigs (n = 6). Induction of the halothane anesthesia by itself prolonged the QT interval as well as QTcF, suggesting that the halothane anesthesia can reduce the cardiac repolarization reserve in microminipigs like in dogs...
2017: Journal of Toxicological Sciences
https://www.readbyqxmd.com/read/28069789/hypotension-induced-by-the-concomitant-use-of-a-calcium-channel-blocker-and-clarithromycin
#14
Sayako Takeuchi, Yuki Kotani, Toshihide Tsujimoto
In the elderly, calcium-channel blockers are the first-line treatment for hypertension, and macrolides are commonly prescribed antibiotics. Here we report a 78-year-old man taking nifedipine, diltiazem and carvedilol who presented with persistent hypotension and bradycardia after clarithromycin was prescribed. He was diagnosed with drug-induced hypotension and treated with fluid resuscitation and vasoactive agents. His symptoms gradually improved. He was transferred out of the intensive care unit 3 days after hospitalisation...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28008301/iloperidone-in-the-treatment-of-schizophrenia-an-evidence-based-review-of-its-place-in-therapy
#15
REVIEW
Fernanda S Tonin, Astrid Wiens, Fernando Fernandez-Llimos, Roberto Pontarolo
INTRODUCTION: Schizophrenia is a chronic and debilitating mental disorder that affects the patient's and their family's quality of life, as well as financial costs and health care settings. Despite the variety of available antipsychotics, optimal treatment outcomes are not always achieved. Novel drugs, such as iloperidone, can provide more effective, tolerable and safer strategies. AIM: To review the evidence for the clinical impact of iloperidone on the treatment of patients with schizophrenia...
2016: Core Evidence
https://www.readbyqxmd.com/read/27986618/recurrent-episodes-of-life-threatening-vasodilatory-shock-following-unintentional-intoxication-with-amlodipine
#16
Chris J Kapelios, George Karamanakos, Stavros Liatis, Magda Sarafadi, Marios Polizois, Ioannis Papoutsis, Alexander D Kokkinos
Calcium channel blockers (CCBs) have a narrow therapeutic index, and their intake in excess is associated with a critical clinical presentation of sustained hypotension and non-cardiogenic pulmonary edema, which are difficult to treat. Unfortunately, available means of treatment fail to resuscitate a significant number of patients poisoned by CCBs, rendering them the main cardiovascular drugs involved in deaths due to overdose. Importantly, in all cases reported until now in the literature, CCB intoxication was known at the time of the patients' presentation and the medical challenge regarded solely the therapeutic approach...
December 13, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/27977314/diabetes-and-kidney-disease-the-role-of-sodium-glucose-cotransporter-2-sglt-2-and-sglt-2-inhibitors-in-modifying-disease-outcomes
#17
Christian W Mende
Patients with type 2 diabetes (T2D) often have coexisting chronic kidney disease (CKD). However, healthy renal function is crucial in maintaining glucose homeostasis, assuring that almost all of the filtered glucose is reabsorbed by the sodium glucose cotransporters (SGLTs) SGLT-1 and SGLT-2. In diabetes, an increased amount of glucose is filtered by the kidneys and SGLT-2 is upregulated, leading to increased glucose absorption and worsening hyperglycemia. Prolonged hyperglycemia contributes to the development of CKD by inducing metabolic and hemodynamic changes in the kidneys...
March 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27976370/droperidol-for-psychosis-induced-aggression-or-agitation
#18
REVIEW
Mariam A Khokhar, John Rathbone
BACKGROUND: People experiencing acute psychotic illnesses, especially those associated with agitated or violent behaviour, may require urgent pharmacological tranquillisation or sedation. Droperidol, a butyrophenone antipsychotic, has been used for this purpose in several countries. OBJECTIVES: To estimate the effects of droperidol, including its cost-effectiveness, when compared to placebo, other 'standard' or 'non-standard' treatments, or other forms of management of psychotic illness, in controlling acutely disturbed behaviour and reducing psychotic symptoms in people with schizophrenia-like illnesses...
December 15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27918857/new-approach-to-molsidomine-active-metabolites-coming-from-the-results-of-2-models-of-experimental-cardiology
#19
Michał Żorniak, Katarzyna A Mitręga, Maurycy Porc, Tadeusz F Krzemiński
Molsidomine is a well-known vasodilatating, antianginal drug. Despite earlier studies with its metabolites (3-morpholino-syndnonimine (SIN-1) and N-nitroso-N-morpholino-amino-acetonitrile (SIN-1A)), which indicated a potential favorable cardioprotective activity, a lot of controversy remains. The aim of our research was to compare molsidomine, SIN-1, SIN-1A, and lidocaine influence on arrhythmias and hemodynamic parameters in 2 experimental models in rats. In the Langendorff heart study, SIN-1A markedly elevated left ventricular systolic pressure, maximum rise and fall of the first pressure derivative, coronary flow, and myocardial oxygen consumption...
February 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/27898164/dexmedetomidine-reduces-catheter-related-bladder-discomfort-a-prospective-randomized-placebo-controlled-double-blind-study
#20
Yang Zhao Yun, Xu Jun Mei, Zhu Rong, Dai Ru Ping, Liu Lei
OBJECTIVE: To evaluate the efficacy of dexmedetomidine in preventing catheterrelated bladder discomfort (CRBD) in a postanesthesia care unit (PACU). METHODS: A total of 138 consecutive adult male patients, classified by the American Society of Anesthesiologists (ASA) as ASA class I and ASA class II, were scheduled for elective open upper-middle abdominal surgery. They were randomized into 2 groups, C and D, comprising 69 patients each. Group C was given a saline solution as placebo, and group D received dexmedetomidine...
December 2016: Puerto Rico Health Sciences Journal
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