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Biomedical subjects

Z Fejfar

Publications and source records attributed to Z Fejfar.

At least 37 records · Page 2Linked to original sources
PubMed1989

The antifibrillatory effect of fentanyl, sufentanil and carfentanil in the acute phase of local myocardial ischaemia in the dog.

To determine the effect of strong analgesics on electrical instability (vulnerability to ventricular fibrillation), we examined the action of fentanyl (60 micrograms/kg), sufentanil (10 micrograms/kg) and carfentanil (3 micrograms/kg) on the ventricular fibrillation threshold (VFT) in a dog model of coronary artery occlusion. The effect of strong analgesics was compared with that of the first-generation beta-blocker propranolol (1.2 mg/kg) and the third-generation beta-blocker celiprolol (3 mg/kg). In the 5th minute of ischaemia, VFT declines in all groups of dogs. VFT values rise significantly from the 23rd to the 60th minute of ischaemia after opiate analgesic administration. The mean increase in VFT after opiate analgesics is less pronounced than after beta-blockers. Administration of opioid analgesics is followed by strong prevalence of vagal drive to the heart. Sympathetic drive to the heart after propranolol administration disappears and is depressed after the administration of celiprolol only. Blockers of the beta-receptors apparently intervene directly in the ischaemic focus and affect the "substrate" of electrical instability. The opioid analgesics probably exert their effect through a change in "substrate" modulation. There is an ongoing search for drugs that would stabilize the heart electrically in acute myocardial infarction, thus preventing sudden death. Our experimental results favour a combination of strong analgesics with other electrostabilizing drugs.

Adrenergic beta-Antagonists↗
PubMed1989

The electrostabilizing effect of a combination of midazolam and fentanyl: an experimental study in the dog.

Using a model of local myocardial ischaemia in the dog, the authors studied the electrostabilizing effect of a combination of the benzodiazepine midazolam (Dormicum Hoffman--La Roche) and the strong narcotic analgesic drug Fentanyl (Richter). The electrostabilizing effect was assessed using the method of ventricular fibrillation threshold (VFT) measurement. The same increase in the fibrillation threshold as that induced by the administration of midazolam or fentanyl alone was achieved by a combination of both drugs given, however, in reduced doses. The electrostabilizing effect of benzodiazepines and potent analgesics is enhanced by their simultaneous administration. At the same time, the adverse side effects observed on the administration of fentanyl alone (bradycardias, hypotension, cardiac blockade) due to the prevalence of parasympathetic drive, are reduced. Simultaneous administration of a benzodiazepine and an analgesic has become a modern technique, in anaesthesiology, so-called analgosedation. Experiments have shown the technique, in addition to the generally recognized analgesia, sedation and anxiolysis, exerts electrostabilizing effects on the myocardium damaged by ischaemia. The authors therefore recommend analgosedation in the drug treatment of acute myocardial infarction.

Animals↗
PubMed1987

A comparison of the antifibrillatory effect of midazolam and flunitrazepam in acute myocardial ischaemia in the dog.

A study was carried out using a model of myocardial ischaemia in the dog after ligation of the left coronary artery to determine the effects of the benzodiazepines, flunitrazepam and midazolam, on the ventricular fibrillation threshold. The fibrillation threshold was measured twice within 15 min and 8 min after ligation. Fifteen minutes after the onset of ischaemic heart attack, 1.2 mg midazolam/kg or 0.25 mg of ischaemia. Their effects on haemodynamics were negligible. It is suggested that both benzodiazepines can be used for increasing electrical stability of the heart in patients with acute myocardial infarction and to inhibit the psychic stress response. Because of its short biological half-life and water solubility, allowing painless intravenous administration, midazolam offers a more flexible approach to pharmacotherapy immediately after acute heart attack according to the patient's current clinical status.

Animals↗
PubMed1987

An experimental contribution to the treatment of acute myocardial infarction.

1. Benzodiazepines and strong analgesics raise considerably the ventricular fibrillation threshold and thus electrically stabilize the heart in the early stage of myocardial ischaemia. 2. Benzodiazepines markedly potentiate the electrostabilizing effect of the beta-blocker metipranolol. 3. Trimecaine per se does not electrically stabilize the heart in the first hour of ischaemia. When combined with a benzodiazepine, trimecaine stabilizes the heart also in this early stage of myocardial ischaemia. 4. Infusion of a benzodiazepine (midazolam) combined with fractionated administration of a potent analgesic (fentanyl) does not produce pronounced changes in the haemodynamics and ventilation of healthy subjects. 5. Benzodiazepines and strong analgesics exert a favourable effect on the neurovegetative stress response in the early stage of acute myocardial ischaemia. They can be therefore recommended as a component in the treatment of patients with acute myocardial infarction.

Adult↗
PubMed1986

Electrical instability of the heart in acute local myocardial ischaemia: pathogenesis and experimental prevention.

The pathogenesis of electrical instability of tissue in the earliest phase of ischaemia is well known. Convincing results in the prevention of ventricular fibrillation at this stage have been obtained only by agents inhibiting sympathetic activation of the heart, or by agents significantly prolonging the refractory period of heart cells. On the other hand, it was documented that sodium channel inhibitors are not suitable for prevention of electrical instability in the early phase of ischaemia and can, on the contrary, aggravate it. A question which is still unresolved and deserves further research is the effect of calcium channel inhibitors and of agents acting directly on the metabolism of ischaemic tissue.

Animals↗
PubMed1983

[Atherosclerosis].

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Arteriosclerosis↗
PubMed1982

Some effects of a health educational film on cardiac patients.

A health educational film on the psychosocial problems of their illness and recovery was viewed by 51 male patients with myocardial infarction. The attractiveness of the topic was tested and found to be high. Reactions elicited by separate messages of the film during the performance were recorded: their rate rose significantly after statements concerning mostly psychosocial aspects of recovery. On behalf of 13 criteria the film was evaluated by the patients medium positively with differences depending on their education. Viewing of the film changed the kind and structure of expressed demands for more health information and made them more concrete.

Attitude to Health↗