[Therapeutic use of adrenergic alpha-1 and alpha-2 receptor agonists and antagonists].
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Biomedical subjects
Publications and source records attributed to A Scheen.
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Tolmesoxide, a potent vasodilating compound, was infused intravenously (0.5 to 3.5 mg/kg b.w., rate of infusion: 2.5 to 10.0 mg/min during 7--25 min, 2 or 3 successive infusions separated by a 30 min rest period) in 7 hypertensive patients. An abrupt fall in blood pressure and heart rate occurred in 4 patients whereas 2 patients exhibited almost no hemodynamic response. The remaining case suffering from renovascular hypertension responded with a progressive dose-dependent decrease in blood pressure. No obvious correlation could be demonstrated between the drug plasma levels (ranging between 1.0 and 11.1 microgram/ml) and the hemodynamic effects among the 7 patients studied.
The protein-supplemented fasting induces a progressive but moderate decrease in blood glucose (-26%) and a marked rise in plasma free fatty acids levels (+ 43%). Nevertheless the secretion of epinephrine by the adrenal medulla, as indirectly estimated by the ratio of the basal urinary elimination to the recovery percentage from the urine of an epinephrine infusion, shows a significant decrease (- 36%) during the protein diet. Thus the enhanced lipolysis does not result from an adrenergic overactivity but merely depends upon the marked reduction in the plasma insulin level (- 38%).
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The effects of a single oral dose of 40 mg propranolol on endurance time and on the maximum oxygen consumption were studied in eight healthy young men. They were running on a motor-driven treadmill (work rate from 80 to 150% VO2 max. The VO2 max and endurance time were decreased to an average of 10 and 30% of controls respectively. The relationship between the endurance time and the relative work load (VO2/VO2 max) remained unchanged after beta-adrenoceptor blockade. The reduction of the endurance time following beta-adrenoceptor blockade is a consequence of the reduction of the VO2 max.
During exercises at constant workload, the hyperlactatemia threshold (continuous lactate production during the whole exercise) (48% VO2 max) and the hyperventilation threshold (57% VO2 max) are not simultaneous. This finding demonstrates that the hyperventilation threshold could not be regarded as an "anaerobic threshold".
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Eleven normal subjects underwent epinephrine perfusions (1.9; 6.1; 11.8 ng/min) during a short (20 min) and mild (50% VO2 max) exercise. VO2 was not modified by epinephrine perfusion, while heart rate ventrilation and plasmatic lactate were increased proportionally to epinephrine doses.
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The slow increase in heart rate which is observed in normal man submitted to heavy muscular exercise is due for a part to an activation of orthosympathetic cardiac activity which is blocked by beta antagonists. It is also explained by direct action of hyperthermia on the heart.
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VO2 max, maximum oxygen uptake, has been measured in 4 normal young men, before and after beta-adrenergic blockade (0.5 to 5 mg Pindolol by mouth). Pindolol induces bradycardia and reduces VO2 max. A statistically significant positive correlation appears between posology of Pindolol and bradycardia, this posology and reduction of VO2 max, and finally between bradycardia and reduction of VO2 max. These correlations indicate that the reduction of VO2 max is best explained by a circulatory limitation of oxygen supply to active muscles.
In normal man, food ingested two hours before the beginning of physical exercise increases the lactacidemia (+ 27%).
In normal subjects, beta-adrenergic blockage by propranolol or pindolol reduces exercise hyperventilation (40 to 60% VO2 max).
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