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drug-induced hypotension

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https://www.readbyqxmd.com/read/29138017/angiotensin-converting-enzyme-inhibitors-enhance-the-hypotensive-effects-of-propofol-by-increasing-nitric-oxide-production
#1
Gustavo H Oliveira-Paula, Lucas C Pinheiro, Graziele C Ferreira, Waynice N P Garcia, Riccardo Lacchini, Luis V Garcia, Jose E Tanus-Santos
Propofol anesthesia is usually accompanied by hypotension. Studies have shown that the hypotensive effects of propofol increase in patients treated with angiotensin-converting enzyme inhibitors (ACEi). Given that both propofol and ACEi affect nitric oxide (NO) signaling, the present study tested the hypothesis that ACEi treatment induces pronounced hypotensive responses to propofol by increasing NO bioavailability. In this study we evaluated 65 patients, divided into three groups: hypertensive patients chronically treated with ACEi (HT-ACEi; n = 21), hypertensive patients treated with other antihypertensive drugs instead of ACEi, such as angiotensin II receptor blockers, β-blockers or diuretics (HT; n = 21) and healthy normotensive subjects (NT; n = 23)...
November 11, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/29132913/beta2-adrenergic-receptor-silencing-change-intraocular-pressure-in-new-zealand-rabbits
#2
Patricia Loma, Ana Guzman-Aranguez, Maria J Perez de Lara, Jesus Pintor
PURPOSE/AIM: Glaucoma consists of a group of progressive optic neuropathies that are characterized by degeneration of the optic nerve and irreversible visual filed loss. Elevated intraocular pressure is the only proven treatable risk factor and commercial products used for glaucoma treatment are focused in lowering intraocular pressure. These drugs can have various undesirable side effects and this invites to look for new strategies. The purpose of this work is to study the use of a siRNA (small interfering RNA) to selectively silence beta2 adrenergic receptors and to see whether it reduces IOP (intraocular pressure)...
November 10, 2017: Journal of Optometry
https://www.readbyqxmd.com/read/29123869/drug-induced-anaphylaxis-in-the-emergency-room
#3
REVIEW
Tomonori Takazawa, Kiyohiro Oshima, Shigeru Saito
Anaphylaxis is a life-threatening, systemic allergic reaction that presents unique challenges for emergency care practitioners. Anaphylaxis occurs more frequently than previously believed. Therefore, proper knowledge regarding the epidemiology, mechanisms, symptoms, diagnosis, and treatment of anaphylaxis is essential. In particular, the initial treatment strategy, followed by correct diagnosis, in the emergency room is critical for preventing fatal anaphylaxis, although making a diagnosis is not easy because of the broad and often atypical presentation of anaphylaxis...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29109881/hypothermia-with-extreme-bradycardia-following-spinal-cord-infarction-of-septic-origin
#4
Philippe Hantson, Thierry Duprez
Among other autonomic dysfunctions complicating acute spinal cord injury, deep hypothermia is rare but may induce serious cardiovascular complications. There are few pharmacological options to influence hypothermia. A 66-year-old woman was transferred to the intensive care unit (ICU) for serious cardiac arrhythmias (atrial fibrillation and asystole) in the context of a deep hypothermia (axillary temperature below 32°C). She had been admitted to the hospital two months before for an acute L4-L5 infectious spondylodiscitis without any initial neurological deficit...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/29109639/evaluation-of-the-efficacy-of-desflurane-with-or-without-labetalol-for-hypotensive-anesthesia-in-middle-ear-microsurgery
#5
Neha Gupta, Vandana Talwar, Smita Prakash, Achyut Deuri, Anoop Raj Gogia
Background and Aims: Hypotensive anesthesia technique is used to reduce intraoperative bleeding and to improve the visibility of the operative field. The aim was to evaluate the efficacy of desflurane with and without labetalol for producing hypotensive anesthesia. Material and Methods: Sixty adult patients undergoing elective middle ear surgery were administered general anesthesia and randomly divided into two groups - Group D and Group L. The target mean arterial pressure (MAP) was 55-65 mmHg during hypotensive period...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29097308/analysis-of-natural-product-regulation-of-opioid-receptors-in-the-treatment-of-human-disease
#6
REVIEW
S Badal, S Turfus, R Rajnarayanan, C Wilson-Clarke, S L Sandiford
Opioid receptors (ORs), μOR, δOR, κOR and ORL1 mediate numerous signaling cascades, most importantly, through the modulation of ion channels. Research demonstrates the role of OR mediated signal transduction in treating pain, cancer, neurodegenerative disorders and cardiac insults. Yet, the primary application of drugs that modulate ORs is analgesia. Current opioids like morphine that are mainly μOR orthosteric agonists attract many undesirable side-effects (constipation, urinary retention, respiratory depression and hypotension) and the existing modus operandi against these is the inclusion of a μOR antagonist (for example...
October 30, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29095263/ed50-of-intrathecal-ropivacaine-for-cesarean-section-under-prophylactic-infusion-of-phenylephrine-a-consort-study
#7
Wangping Zhang, Hanbin Wu
BACKGROUND: Studies have reported that prophylactic continuous infusion of phenylephrine during spinal anesthesia for cesarean section can decrease the spread of local anesthetics. We investigated the ED50 of intrathecal hyperbaric ropivacaine in parturient women undergoing cesarean section under prophylactic infusion of phenylephrine. METHODS: Sixty parturient women were allocated into 2 groups in this prospective study. Group P received 0.5 mL kg h of phenylephrine (5 mg/50 mL) at the start of intrathecal injection, and Group C (control group) received the same volume of saline...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29070499/identifying-and-characterizing-preventable-adverse-drug-events-for-prioritizing-pharmacist-intervention-in-hospitals
#8
Nakyung Jeon, Ben Staley, Thomas Johns, Glori Pflugfelder Lipori, Babette Brumback, Richard Segal, Almut G Winterstein
PURPOSE: The approach and results for identifying and characterizing preventable adverse drug events (pADEs) that are key targets for pharmacist medication therapy management (MTM) are summarized. METHODS: This study was part of a larger effort aimed at developing an electronic health record-based prediction model (the complexity score, or C-score) that ranks hospitalized patients according to their risk for pADEs. An environmental scan of published epidemiologic pADE studies and national patient safety priority areas was conducted...
November 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29034064/personalized-therapy-against-preeclampsia-by-replenishing-placental-protein-13-pp13-targeted-to-patients-with-impaired-pp13-molecule-or-function
#9
REVIEW
Hamutal Meiri, George Osol, Irene Cetin, Sveinbjörn Gizurarson, Berthold Huppertz
Hypertensive disorders affect about one third of all people aged 20 and above, and are treated with anti-hypertensive drugs. Preeclampsia (PE) is one form of such disorders that only develops during pregnancy. It affects ten million pregnant women globally and additionally causes fetal loss and major newborn disabilities. The syndrome's origin is multifactorial, and anti-hypertensive drugs are ineffective in treating it. Biomarkers are helpful for predict its development. Generic drugs, such as low dose aspirin, were proven effective in preventing preterm PE...
2017: Computational and Structural Biotechnology Journal
https://www.readbyqxmd.com/read/28991483/vasoactive-intestinal-peptide-nanomedicine-for-the-management-of-inflammatory-bowel-disease
#10
Dulari Jayawardena, Arivarasu N Anbazhagan, Grace Guzman, Pradeep K Dudeja, Hayat Onyuksel
Inflammatory bowel disease (IBD) is a chronic relapsing disorder of the intestine, with increasing incidence worldwide. At present, the management of IBD is an unmet medical need due to the ineffectiveness of currently available drugs in treating all patients, and there is strong demand for novel therapeutics. In this regard, vasoactive intestinal peptide, a potent anti-inflammatory endogenous hormone, has shown promise in managing multiple immune disorders in animal models. However, when administered in the free form, VIP undergoes rapid degradation in vivo, and with continuous infusion, it causes severe dose limiting side effects...
November 6, 2017: Molecular Pharmaceutics
https://www.readbyqxmd.com/read/28977090/use-of-sglt-2-inhibitors-in-the-treatment-of-type-2-diabetes-mellitus
#11
REVIEW
Leyna Leite Santos, Fernando José Camello de Lima, Célio Fernando de Sousa-Rodrigues, Fabiano Timbó Barbosa
INTRODUCTION: Diabetes mellitus is one of the most common chronic diseases in the world, with high morbidity and mortality rates, resulting in a greatly negative socioeconomic impact. Although there are several classes of oral antidiabetic agents, most of the patients are outside the therapeutic goal range. OBJECTIVE: To review the use of SGLT-2 inhibitors in the treatment of type 2 diabetes mellitus, focusing on their favorable and unfavorable effects, as well as on cardiovascular profile...
July 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28928581/a-comparative-study-of-intravenous-esmolol-labetalol-and-lignocaine-in-low-doses-for-attenuation-of-sympathomimetic-responses-to-laryngoscopy-and-endotracheal-intubation
#12
Ekta Ratnani, Om Prakash Sanjeev, Abhishek Singh, Manoj Tripathi, Hemant Kumar Chourasia
BACKGROUND: Direct layngoscopy and endotracheal intubation is a noxious stimuli and induces sympathomimetic responses. Although well tolerated in healthy subjects, it may impose life threatening arrhythmias, left ventricular failure or rupture of cerebral aneurysm in susceptible patients. Esmolol, Labetalol and Lignocaine attenuate these responses but are associated with side effects of bradycardia, hypotension etc. In lower doses, chances of these side effects are comparatively low. So we designed this prospective clinical trial to assess the efficacy of intravenous esmolol, labetalol and lignocaine in low doses for attenuation of sympathomimetic responses to endotracheal intubation...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28915221/metformin-exerts-beneficial-effects-in-hemorrhagic-shock-in-an-ampk%C3%AE-1-independent-manner
#13
Paul Kim, Giovanna Piraino, Michael O'Connor, Paul W Hake, Vivian Wolfe, Patrick Lahni, Basilia Zingarelli
Despite therapeutic advances in hemorrhagic shock, mortality from multiple organ failure remains high. AMP-activated protein kinase (AMPK) is involved in cellular energy homeostasis. Two catalytic subunits, α1 and α2, have been identified, with α1 subunit largely expressed in major organs. Here, we hypothesized that genetic deficiency of AMPKα1 worsens hemorrhage-induced multiple organ failure. We also investigated whether treatment with metformin, a clinically used drug for metabolic homeostasis, affords beneficial effects...
September 14, 2017: Shock
https://www.readbyqxmd.com/read/28899928/treatment-of-hypertension-by-increasing-impaired-endothelial-trpv4-kca2-3-interaction
#14
Dongxu He, Qiongxi Pan, Zhen Chen, Chunyuan Sun, Peng Zhang, Aiqin Mao, Yaodan Zhu, Hongjuan Li, Chunxiao Lu, Mingxu Xie, Yin Zhou, Daoming Shen, Chunlei Tang, Zhenyu Yang, Jian Jin, Xiaoqiang Yao, Bernd Nilius, Xin Ma
The currently available antihypertensive agents have undesirable adverse effects due to systemically altering target activity including receptors, channels, and enzymes. These effects, such as loss of potassium ions induced by diuretics, bronchospasm by beta-blockers, constipation by Ca(2+) channel blockers, and dry cough by ACEI, lead to non-compliance with therapies (Moser, 1990). Here, based on new hypertension mechanisms, we explored a new antihypertensive approach. We report that transient receptor potential vanilloid 4 (TRPV4) interacts with Ca(2+)-activated potassium channel 3 (KCa2...
November 2017: EMBO Molecular Medicine
https://www.readbyqxmd.com/read/28844424/analysis-of-proarrhythmic-potential-of-an-atypical-antipsychotic-drug-paliperidone-in-the-halothane-anesthetized-dogs
#15
Koki Chiba, Takeshi Wada, Yuji Nakamura, Xin Cao, Mihoko Hagiwara-Nagasawa, Hiroko Izumi-Nakaseko, Kentaro Ando, Koichiro Tanaka, Atsuhiko T Naito, Atsushi Sugiyama
Fatal cases with the use of atypical antipsychotic drug paliperidone have been reported; however, there was no clinical report describing paliperidone-induced torsade de pointes. In this study we assessed its electropharmacological effects together with its proarrhythmic potential in intravenous doses of 0.03, 0.3 and 3 mg/kg using the halothane-anesthetized dogs (n = 5), which could provide approximately 2, 20 and 200 times higher peak plasma drug concentrations than its therapeutic level, respectively...
August 2017: Journal of Pharmacological Sciences
https://www.readbyqxmd.com/read/28833562/randomized-placebo-controlled-trial-of-ads-5102-amantadine-extended-release-capsules-for-levodopa-induced-dyskinesia-in-parkinson-s-disease-ease-lid-3
#16
Wolfgang Oertel, Karla Eggert, Rajesh Pahwa, Caroline M Tanner, Robert A Hauser, Claudia Trenkwalder, Reinhard Ehret, Jean Philippe Azulay, Stuart Isaacson, Larissa Felt, Mary Jean Stempien
BACKGROUND: The treatment of levodopa-induced dyskinesia in Parkinson's disease (PD) is an unmet need with no approved drug therapy. OBJECTIVE: The purpose of this study was to investigate the efficacy and safety of 274 mg ADS-5102 (amantadine) extended-release capsules (equivalent to 340-mg amantadine HCl) for levodopa-induced dyskinesia in a randomized controlled trial. METHODS: PD patients with ≥1 hour of troublesome dyskinesia and at least mild functional impact were randomized to placebo or ADS-5102 once daily at bedtime for 13 weeks...
August 21, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/28805574/nonmotor-symptoms-in-vascular-and-other-secondary-parkinsonism
#17
Oleg S Levin, Achcha Sh Chimagomedova, Natalia A Skripkina, Elena A Lyashenko, Olga V Babkina
Vascular parkinsonism (VP) is a relatively frequent variant of secondary parkinsonism caused by ischemic or hemorrhagic lesions of basal ganglia, midbrain, or their links with frontal cortex. According to different investigations, various forms of cerebrovascular disease cause 1%-15% of parkinsonism cases. Nonmotor symptoms are frequently found in VP and may negatively influence on quality of life. However, nonmotor symptoms such as hallucinations, orthostatic hypotension, REM-sleep behavior disorder, and anosmia are rarely revealed in VP, which may be noted to another diagnosis or mixed pathology...
2017: International Review of Neurobiology
https://www.readbyqxmd.com/read/28740895/using-low-dose-radiation-to-potentiate-the-effect-of-induction-chemotherapy-in-head-and-neck-cancer-results-of-a-prospective-phase-2-trial
#18
Susanne M Arnold, Mahesh Kudrimoti, Emily V Dressler, John F Gleason, Natalie L Silver, William F Regine, Joseph Valentino
PURPOSE: Low-dose fractionated radiation therapy (LDFRT) induces effective cell killing through hyperradiation sensitivity and potentiates effects of chemotherapy. We report our second investigation of LDFRT as a potentiator of the chemotherapeutic effect of induction carboplatin and paclitaxel in locally advanced squamous cell cancer of the head and neck (SCCHN). EXPERIMENTAL DESIGN: Two cycles of induction therapy were given every 21 days: paclitaxel (75 mg/m(2)) on days 1, 8, and 15; carboplatin (area under the curve 6) day 1; and LDFRT 50 cGy fractions (2 each on days 1, 2, 8, and 15)...
October 2016: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/28702139/ramipril-associated-cholestasis-in-the-setting-of-recurrent-drug-induced-liver-injury
#19
David Forner, Tasha Kulai, Thomas Arnason, Steven E Gruchy, Magnus MacLeod
Aim: Angiotensin-converting enzyme inhibitors (ACEIs) are commonly used to treat hypertension. Although generally well tolerated, the adverse effects of ACEIs include hypotension, cough, acute kidney injury and hyperkalemia. Rare reports of ACEI-induced hepatotoxicity have been described, most notably a cholestatic pattern of injury related to captopril. A 67-year-old male presented to the emergency department with a three-week history of jaundice, pruritis and weakness. Eight weeks before, he began taking ramipril and clopidogrel...
2017: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28684143/what-s-new-in-clinical-obstetric-anesthesia-in-2015
#20
REVIEW
P E Hess
Each calendar year the Society for Obstetric Anesthesia and Perinatology invites an individual to conduct a review of the medical literature, identifying clinically relevant publications of interest to the obstetric anesthesia provider. This report of that effort covers the publications from 2015 and includes the categories of anesthesia and analgesia, complications of neuraxial procedures, and the effects of anesthesia on the fetus. Neuraxial procedures represent the foundation of obstetric anesthesia; advances in anesthesia and analgesia include novel modes of administration, and refinements in care of the medically complex patient...
November 2017: International Journal of Obstetric Anesthesia
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