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At least 865 records · Page 48Linked to original sources
PubMed1975

A benzodioxanhydroxyethylpiperidine derivative with an acute central hypotensive action, different from that of clonidine. A comparison with neuroleptic agents.

Ertyhro-1-(1-[2-(1,4-benzodioxan-2-yl)-2-OH-Et]-4-piperidyl)-2-benzimidazolinone (R28935), a new benzodioxanhydroxyethylpiperidyl derivative that is chemically but not pharmacologically related to pimozide, proved to possess potent central hypotensive activity when injected into the left vertebral artery of anaesthetized cats. Although almost as potent as clonidine, its hypotensive action is more prolonged. The central hypotensive effect is dose-dependent and stereospecific, the threo-isomer being much less effective than the erythro-form. In contrast to the effect of clonidine, the centrally induced hypotensive action of R 28935 is not diminished after pretreatment with piperoxane, yohimbine or desipramine. Accordingly, central alpha-adrenergic receptors are probably not involved in the central hypotensive action of R 28935. The following surgical interventions did not diminish the central hypotensive action of R 28935: bilateral vagotomy, bilateral cervical sympathectomy, bilateral extirpation of the stellate ganglia. Neuroleptic agents like pimozide, haloperidol, chlorpromazine and promazine were far less potent hypotensive agents. Promazine showed some central hypotensive action but the blood pressure-lowering effects of the other neuroleptic drugs are of peripheral origin and probably reflect the alpha-sympatholytic properties. From the results it si concluded that R 28935 depresses peripheral sympathetic tone via a centrally induced primary effect. Central alpha-adrenergic receptors do not play a role in this primary effect of R 28935, whereas they do play their part in that of clonidine or alpha-methyl-DOPA. As such, R 28935 is an example of a new class of centrally acting hypotensive compounds. Moreover, this compound provesthat it has been possible to separate the neuroleptic and hypotensive properties in benzimidazolinone derivatives.

Animals↗
PubMed2001

[Acute insufficiency of the gastrointestinal tract in patients with severe gunshot injury].

Acute insufficiency of the gastrointestinal tract (GIT) in patients with severe gunshot injuries is an important link of pathogenesis of the polyorganic insufficiency syndrome. The character of the wound, the numerical score objective assessment of the injury severity and severity of the patient's state are considered to be criteria of early diagnosis of a risk of the development of acute insufficiency of GIT. The specific feature of "general" intensive therapy of acute insufficiency of GIT in severe gunshot traumas is the necessary application of regional anesthesia, sympatholytics, anticholinesterase agents and H2-blockers. Intensive "enteral" therapy of acute insufficiency of GIT in severe gunshot wounds includes the measures resulting in improvement of microcirculation, tissue respiration in organs of GIT, decompression of the stomach, local defense of mucosa, detoxication and early enteral balanced nutrition. The described method of treatment of wounded to the stomach used at specialized medical institutions resulted in 6.2 less lethality among this category of patients.

Abdominal Injuries↗
PubMedDate not supplied

[Modes of intensive therapy for arterial hypertension in children with terminal chronic kidney failure].

In spite of considerable progress in development of pediatric science, intensive therapy of kidney diseases remains the pressing issue because of high lethality among patients with renal failure (RF). Cardiovascular diseases, especially malignant hypertension syndrome with development of left ventricular insufficiency, are leading among the causes of late deaths of postdialysis patients. We studied hemodynamics in 18 children with terminal chronic renal failure running with marked arterial hypertension and left ventricular hypertrophy. We have found that high blood pressure was initially caused by hyperhydration and hypernatriemia. After hemodialysis, children with KT/V > 1 developed hypertension due to hyperkinetic hemodynamics. Establishment of "dry weight" of the child on programmed dialysis was followed by renin-dependent arterial hypertension which was treated by inhibitors of angiotensin-converting enzyme and calcium antagonists, in one case by nephrectomy. In hemodialysis regimen KT/V < 1, dry weight was not achieved and hyperhydration-caused hypertension remained. Moderate arterial hypertension due to cukinetic hemodynamics was achieved only after 4 weeks of hemodialysis in administration of calcium antagonists, beta-blockers and central sympatholytics.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1975

Pharmacological properties of 2-(2-chloro-p-toluidino)-2-imidazoline-nitrate (tolonidine), a new antihypertensive agent. II. Action on cardiac contraction, circulatory parameters, autonomic receptors and diuresis.

Tolonidine, 2(2-chloro-p-toluidino)-2-imidazoline-nitrate, is a substance chemically related to clonidine. In the anesthetized dog, tolonidine administered i.v. decreased the amplitude of ventricular contractions, reduced aortic blood flow and increased peripheral vascular resistances. In the bivagotomized pithed rat, tolonidine induced a long-lasting increase in blood pressure with no secondary hypotension, thus suggesting peripheral sympathomimetic properties, however, contractions of seminal vesicles in vitro were not obtained. The product proved to have no peripheral sympatholytic or parasympatholytic properties. In the dog and the rat, diuresis was hardly changed. These properties are closely related to those of clonidine, which was studied comparatively. A general discussion is proposed at the end of a third article.

Animals↗
PubMed2002

Dexmedetomidine in intensive care unit: a study of hemodynamic changes.

BACKGROUND: Dexmedetomidine is a potent new alpha-2 adrenoceptor agonist with an alpha-2 to alpha- ratio more than 7 times that of clonidine. Its potent sedative, analgesic and sympatholytic effects blunt the cardiovascular responses (hypertension, tachycardia) without unexpected toxicity. Many reports confirmed its pharmacological properties if given by infusion. Recent report confirmed favorable non-depressant effect on respiration and blood gases. SETTING: ICU patients at King Khalid University Hospital. PATIENTS AND METHOD: Open label clinical evaluation on ten surgical patient ASA I class received dexmeditomidine infusion to the sedative effect level of Ramsy scale of 3 for ventilated patients and 2 for spontaneously breathing patient. The clinical observation and analgesic requirement as well as the hemodynamic parameters and hemoglobin oxygen saturation were observed for the period of ventilation and weaning till discharge from the ICU. These records were subjected to paired t test for values measured at preinfusion period compared to 10 minutes and 6 hours measurement after infusion. RESULTS: The study confirmed the previous findings of previous reports regarding the cardiovascular stability and non depressive effect on respiration. It also confirmed the sparing effect on the use of analgesics which indicates its analgesic effect. The sedation quality is unique in that the patient is easily arousable. This was reported favorably by the nursing staff. Bradycardia was observed in one patient who was treated effectively by stopping the infusion. CONCLUSION: We concluded that dexmedetomidine is useful sedative agent with analgesic properties which reduce the analgesic requirement of the patient. The patient were ventilated, weaned, then breathed spontaneously in a satisfactory manner.

Adrenergic alpha-Agonists↗
PubMed1992

Hypertensive heart disease--significance of left ventricular hypertrophy.

One of the earliest structural changes in the heart adapting to hypertension is left ventricular hypertrophy, which can now be exactly measured by echocardiography. Left ventricular hypertrophy increases the incidence of coronary artery disease, heart failure, and sudden death severalfold, independent of the blood pressure levels. Left ventricular hypertrophy requires specific antihypertensive therapy that controls both high blood pressure and increased left ventricular mass. Preliminary data from clinical studies indicate that regression of left ventricular hypertrophy leads to a better cardiovascular prognosis. Sympatholytic substances, angiotensin-converting enzyme (ACE) inhibitors, and calcium antagonists are antihypertensive agents that effected adequate reductions in blood pressure as well as regression of left ventricular hypertrophy.

Antihypertensive Agents↗
PubMedDate not supplied

[The effect of obzidan and isobarin on the lysosomal apparatus of the neutrophilic granulocytes and on hemostasis under stress factors].

Experiments on rabbits were carried out with the purpose of evaluating the participation of beta-adreno-blockader and sympatholytic agent in the reaction of liberation of lysosomal enzymes of peripheral blood neutrophilic granulocytes in response to the immobilization. It was established that the sympathetic nervous system (via alpha- and beta adrenoreceptors) produces an effect on reduction of the number of lysosomes and liberation of lysosomal enzymes that participate indirectly through factor XII in hemostasis regulation.

Animals↗
PubMedDate not supplied

[Correction of hemodynamic disorders during cesarean delivery under prolonged epidural anesthesia].

The article deals with the analysis of the hemodynamic characteristics, loss of blood and infusion-transfusion therapy of women in birth during the cesarean section under the conditions of CEA. As a result of the investigation, it was revealed that the use, in case of need, of microdoses of adrenomimetics for the prophylaxis of hemodynamic disturbances mollifies the development of the sympatholytic blockade under the conditions of CPA and ensures a more flexible control over the hemodynamic reactions without deteriorating the quality of the infusion-transfusion therapy. The authors expect that the above method will be a standard one in the cesarean section under the conditions of CPA.

Adrenergic Agonists↗
PubMed1992

[Approach to the optimal therapy of the psycho-autonomic syndrome].

To potentiate the psycho- and autonomic activity of phenazepam and to decrease its side effects, cranio-cervical electrophoresis of the drug is suggested. The method is realized with the aid of a special electrode helmet which permits localizing electrodes in the frontal and occipital areas and at different levels of the lateral surfaces of the neck. Phenazepam in the amount of 1 ml of 3% solution was administered from the cathode. 194 patients with the psychovegetative syndrome in the clinical structure of neurosis or neurosis-like condition were treated. The dynamics of the psycho-vegetative status was verified with the aid of psychometric and vegetative techniques. Cerebral hemodynamics was investigated by rheoencephalography. The data obtained demonstrate that the treatment suggested improves the patients' functional status, decreases reactive anxiety, raises the tempo of sensomotor reactions and attention activity, ameliorates short-term memory, exerts a sympatholytic action, and makes cerebral hemodynamics return to normal. The method produces fewer side effects as compared to the enteral intake of phenazepam.

Anti-Anxiety Agents↗
PubMed1992

Left ventricular hypertrophy and antihypertensive therapy.

Left ventricular hypertrophy is more common in hypertensive individuals than in normotensive persons. Its presence in hypertensive patients is associated with an increased incidence of ventricular arrhythmias, myocardial infarction, congestive heart failure, stroke and cardiovascular mortality. Echocardiography is more sensitive than electrocardiography in detecting left ventricular hypertrophy. Echocardiographic evidence of this condition in patients with borderline hypertension may identify those who need treatment. Weight reduction and drug therapy can prevent or reverse ventricular hypertrophy in hypertensive patients. Recent studies suggest that some antihypertensive drugs are more effective than others in reducing left ventricular hypertrophy. These agents include beta-adrenergic blockers, angiotensin converting enzyme inhibitors, calcium channel blockers and sympatholytic agents. Although little evidence exists to show that reduction of left ventricular mass decreases cardiovascular morbidity and mortality, avoidance of antihypertensive agents that may aggravate hypertrophy would seem prudent.

Antihypertensive Agents↗
PubMed1962

Treatment of endotoxic shock--the dilemma of vasopressor and vasodilator therapy.

Hemodynamic studies have demonstrated that the fall of blood pressure in shock caused by endotoxin in dogs does not result primarily from dilatation or "vasomotor collapse." Indeed, vasoconstriction is increased and may be excessive. Progression of shock has recently been blamed on such excessive vasoconstriction. For this reason the use of sympathomimetic drugs as vasopressor agents has been challenged and sympatholytic or adrenolytic agents have been recommended. In the present study, vasopressor and vasodilator drugs were used for the treatment of shock in dogs caused by endotoxin. Vasodilator drugs, when used after the onset of shock, hastened a fatal outcome but vasopressor agents were not detrimental when used in moderate doses. The effectiveness of the vasopressor agent is not necessarily due to a primary vasoconstrictor action on arteries and arterioles, as previously assumed.

Animals↗
PubMed1992

Acute herpes zoster and postherpetic neuralgia: effects of acyclovir and outcome of treatment with amitriptyline.

This retrospective study was designed to assess the effects of acyclovir treatment of acute herpes zoster on subsequent postherpetic neuralgia, and to examine the effects of amitriptyline in the treatment of postherpetic neuralgia. Eighty seven patients with postherpetic neuralgia of three or more months' duration were studied: 24 of them had had their herpes zoster treated with oral acyclovir. At first presentation, only 25% of the 24 patients who had had their herpes zoster treated with acyclovir selected the word group containing burning on the McGill pain questionnaire compared with 76% of the 63 patients who had not received acyclovir. A higher proportion of patients who had had acyclovir than had not selected the word group which contains the word aching (63% versus 49%). Acyclovir thus appears to change the nature of postherpetic neuralgia. Postherpetic neuralgia was treated with amitriptyline, alone or in combination with distigmine and/or sodium valproate. There was a strong correlation between pain relief and the interval between the occurrence of herpes zoster and the initiation of treatment with amitriptyline--early treatment is almost twice as likely to be successful as late. Since conventional analgesics and sympatholytic drugs are of no benefit in the treatment of established postherpetic neuralgia, the sequelae of herpes zoster must, therefore, be recognized and treated with amitriptyline as soon as possible.

Acute Disease↗
PubMedDate not supplied

[The role of humoral factors in the pathogenesis of the postoperative syndrome].

Blood plasma levels of "pain substances" (serotonin, histamine, prostaglandin F2 alpha, adrenaline /A/) and neuropeptides (beta-endorphin, somatostatin) have been evaluated in 39 patients during the early postoperative period after lung and mediastinum surgery. The studies have shown that the content of these biologically active substances increases considerably. Following stellate ganglion blockade A concentration decreased significantly, the uptake of narcotic analgesics used for postoperative analgesia reduced 1.7-fold, however the levels of "pain substances" and neuropeptides remained unchanged. It is believed that postoperative pain syndrome develops due to the elevation of the levels of the substances under study. Stellate ganglion blockade produces only sympatholytic effect, which shows the necessity of the elaboration of drug therapeutic techniques blocking "pain" receptors and using "pain substance" antagonists.

Adolescent↗
PubMed2004

The metabolic syndrome in women: implications for therapy.

It is becoming increasingly clear that hypertension and metabolic risk factors in women are inter-related and often share underlying causes. Menopause acts explicitly as a risk factor by reducing the direct beneficial effect of ovarian hormones upon cardiovascular functions and indirectly by negatively influencing other risk factors for coronary artery disease--i.e. hyperinsulinaemia, blood cholesterol, blood pressure, coagulation etc. Adverse changes in one factor may induce adverse changes in a variety of other risk factors and it is important to consider co-ordinated changes when evaluating these patients rather than attempt to isolate independent factors. Similarly with treatment, the prevalence of metabolic syndrome in postmenopausal hypertensive women has important implications and some antihypertensive drugs may worsen the already altered metabolic profile of these patients while others may be beneficial. Centrally-acting sympatholytic agents, e.g. moxonidine, are therefore important to consider in hypertensive postmenopausal women who experience other symptoms of metabolic syndrome.

Adipose Tissue↗
PubMed2004

[The effects of rilmenidine on cardiac autonomic function in healthy volunteers].

INTRODUCTION AND OBJECTIVES: Rilmenidine is an antihypertensive drug whose antihypertensive effect occurs via a sympatholytic action on the central nervous system. However, the effects of rilmenidine on autonomic cardiovascular function are not clear. The aim of this study was to evaluate the acute effect of rilmenidine on autonomic cardiac function by measuring heart rate variability. SUBJECTS AND METHOD: A total of 20 healthy men (mean age, 263 years) were included in the study; 1 mg of rilmenidine or placebo was given to participants on different days in a double-blind crossover randomized study protocol. After drug administration, time domain and frequency domain parameters of heart rate variability were determined before and after 2 h with the patient in supine decubitus and during the handgrip exercise with 5-min electrocardiographic recordings. RESULTS: Rilmenidine caused an increase in mean RR values after administration when compared to pre-drug administration recordings with the patient in supine decubitus (929 ms vs 860 ms, P<.05), but this effect was not found in the placebo group. However, there were no differences in other time domain parameters or in any of the frequency domain parameters (normalized low frequency unit, normalized high frequency unit and low frequency/high frequency ratio) with the participant in supine position in either group. In addition, neither rilmenidine nor placebo modified heart rate variability parameters during the handgrip exercise. CONCLUSION: Administration of a single dose of rilmenidine increased vagal tone without affecting vagal modulation in the supine position. The absence of vagal tone increase during the handgrip exercise suggests that this effect of rilmenidine is minimal.

Adult↗
PubMedDate not supplied

[Raynaud's phenomenon].

Raynaud's phenomenon (RP) is a vasospastic disorder characterized by episodic color changes of blanching, cyanosis, and hyperemia in response to cold and/or emotional stress. Although most typically noted in the fingers, the circulation of the toes, ears, nose and tongue is also frequently affected. Population studies have shown that RP in adults is more common in women than men, with prevalence estimates ranging from 4% to 30%. Geographic variations in the prevalence reflect differences in climate. RP may be a primary or a secondary process. LeRoy and Medsger suggested criteria for primary RP: symmetric attacks, the absence of tissue necrosis, ulceration or gangrene, the absence of a secondary cause, negative antinuclear antibodies, normal nailfold capillaroscopy and a normal erythrocyte sedimentation rate. Secondary RP is characterized by an age of onset of more than 30 years, painful and asymmetric attacks, ischemic skin lesions, positive autoantibodies, capillaroscopic abnormalities and/or clinical features suggestive of connective tissue diseases (CTDs). Among the CTDs, systemic sclerosis has the highest frequency of RP. Finding a cause for RP requires a knowledge of the patient's occupational, smoking, drug history, physical examination, nailfold capillaroscopy, routine laboratory tests and autoantibodies. Furthermore, RP should be distinguished from acrocyanosis, a condition characterized by continuous cyanosis of the hands or feet that is aggravated by cold temperature. The most important instruction to the patient is abstinence from any smoking, offending drugs should be discontinued, and abrupt changes in temperature. If these measures are inadequate, calcium-channel blockers are the most widely used (nifedipine 30 mg up to 90 mg daily). Alternatively, sympatholytic agent (prazosin), angiotensin II -receptor type I antagonist (losartan), selective sertonin-reuptake inhibitor (fluoxetine) may be useful. In the severe cases the role of prostaglandins is well established, but standard therapeutic protocols are not jet available.

Adolescent↗
PubMed2004

[Male contraception].

The only safe method of male contraception is vasectomy, with high reversibility secured by microsurgery. Italy, however, suffers from a lack of regulations on this subject. Hormonal treatment (testosterone plus progestational hormones) is far from providing reliability and safety, while some perspectives, theoretical only for the time being, are offered by studies on functional infertility induced by either speeding up (ganglioplegic, sympathomimetic, parasympatholytic, oxytocin, endothelin, angiotensin) or inhibiting (sympatholytic) the sperm transport through the epididymis, or altering the epididymal environment (alpha-chloridin, chlorodeoxyglucose).

Antispermatogenic Agents↗
PubMed2005

Ambulatory detoxification of patients with alcohol dependence.

Detoxification from alcohol can be undertaken in ambulatory settings with patients who are alcohol-dependent and show signs of mild to moderate withdrawal when they are not drinking. An appropriate candidate for outpatient detoxification should have arrangements to start an alcohol treatment program and a responsible support person who can monitor progress, and should not have significant, acute, comorbid conditions or risk factors for severe withdrawal. Long-acting benzodiazepines, the preferred medications for alcohol detoxification, can be given on a fixed schedule or through "front-loading" or "symptom-triggered" regimens. Adjuvant sympatholytics can be used to treat hyperadrenergic symptoms that persist despite adequate sedation. Progress can be monitored with the use of a standard withdrawal-assessment scale and daily physician contact. Detoxification is not a stand-alone treatment but should serve as a bridge to a formal treatment program for alcohol dependence.

Alcoholism↗