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[Atropine in the premedication of patients at risk. Its effect on hemodynamics and salivation during intubation anesthesia using succinylcholine].

Should atropine be administered for premedication? This question continues to be controversial; in particular, the combined administration of atropine and succinylcholine has been investigated with conflicting results by numerous researchers. The present study was carried out to assess the effect of premedication with atropine on hemodynamic variables and salivation in patients assigned to ASA class II and III. METHODS. Eighty ASA class II or III patients received pethidine 1.0 mg/kg and promethazine 0.5 mg/kg i.m. 30 min prior to induction of anesthesia and atropine, either 0.01 mg/kg i.v. 10 min or 0.01 mg/kg i.m. 30 min prior to a standardized anesthetic induction with alcuronium (precurarizing dose), thiopental, and succinylcholine. In the control groups (20 patients each), no atropine was given. Systolic, diastolic, and mean arterial pressures (MAP) were measured. The ECG was monitored for arrhythmias. Salivation was assessed semiquantitatively using swabs positioned within the pharyngeal space. RESULTS. Ten minutes after the administration of atropine i.v., a significant increase in heart rate (HR) was observed; this did not occur within 30 min after administration of atropine i.m. At the time of tracheal intubation, HR was significantly increased in both i.v. atropine risk groups. After atropine i.m., an increase in heart rate during intubation was observed in ASA class II patients only. No increase in heart rate occurred in the control groups during tracheal intubation. Neither i.m. nor i.v. atropine had any significant effect on blood pressure. Arrhythmias occurred in a few cases with both routes of administration; several instances of marked tachycardia were recorded.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

[Salivation in healthy volunteers and patients with complicated duodenal ulcer depending on Helicobacter pylori contamination of the stomach mucous coat].

Such salivation parameters as saliva volume, total protein saliva concentration and amylolytic enzyme activity as well as their discharge levels were compared to the level of H. pylori contamination of the stomach mucous coat in clinically healthy people (30 people) and patients with complicated duodenum ulcer (142 patients) within various terms after the duodenoplasty eradication and within long-term periods after the selective proximal vagotomy (50 patients). The amylolytic enzyme activity and ptyalin discharge was higher in clinically healthy but HP-contaminated subjects than HP-negative people. A direct relationship that was expressed by the salivation volume and ptyalin discharge best of all with the level of the stomach mucous coat contamination in healthy volunteers and patients with duodenal ulcer was established.

Adult↗

[Syndromes of combined damage to the greater and lesser superficial petrosal nerves (paradoxical phenomena of hyperemia of the face, salivation, lacrimation and mucus secretion)].

Combined damage to the large and small superficial petrosal nerves is associated with paradoxical phenomena: face hyperemia, profuse salivation from the parotid gland, lacrimation and mucus secretion from the nose. Face hyperemia and salivation develop following atropine administration (an atropine salivatory paradox) while lacrimation and mucus secretion at the impaired side usually develop during eating. The above is explained by the development of ephaptic ("false") relation between the damaged nerves.

Adult↗

Effect of CP-96,345, a nonpeptide substance P receptor antagonist, on salivation in rats.

CP-96,345 [(2S,3S)-cis-2-(diphenylmethyl)-N-[(2-methoxyphenyl) methyl]-1-azabicyclo[2.2.2]octan-3-amine) antagonism of substance P-stimulated salivation was investigated in pentobarbital-anesthetized rats. Administered either intraperitoneally or orally, CP-96,345 produced dose-dependent inhibition of the sialogogic response elicited by substance P, with a median effective dose of 12-24 mumol/kg (5-10 mg/kg) of body weight, but had no effect on acetylcholine-stimulated salivation. CP-96,345 produced concentration-dependent inhibition of [3H]substance P binding to rat submaxillary gland membranes, with a median effective concentration of 34 +/- 3.6 nM. These biological activities were confined to CP-96,345 in that the 2R,3R enantiomer (CP-96,344) was without effect.

Animals↗

Intracellular salivation is the aphid activity associated with inoculation of non-persistently transmitted viruses.

Approximately 75 % of aphid-vectored viruses are transmitted in a non-persistent (non-circulative) manner. Localization studies indicate that such viruses are acquired via ingestion and retained in the food canal of the maxillary stylets, but the inoculation mechanism has remained unresolved. Electrical recording of stylet penetration activities reveals that inoculation is associated with the first intracellular activity (subphase II-1) following maxillary puncture of an epidermal cell. Subphase II-1 may represent virus inoculation via egestion (regurgitation of virions with food-canal contents) or salivation (saliva-mediated release of virions from the common food-salivary duct at the tips of the maxillary stylets). Here, inoculation of the circulatively transmitted Pea enation mosaic virus was used as a marker for intracellular salivation during epidermal cell punctures. The results confirmed that inoculation of non-persistently transmitted viruses (subphase II-1) is associated with active injection of saliva directly into the cytoplasm.

Animals↗

Recording of swallowing events using electromyography as a non-invasive measurement of salivation.

The present study examined whether the measurement of swallowing activity by electromyography (EMG) provides a sensitive and valid method for the assessment of the amount of saliva secreted. Thirteen subjects tasted lemon juice and water, and smelled lasagna and hay, while the amount of saliva, measured with the aid of cotton dental rolls, was compared with the number of peaks in the EMG activity of the musculus digastricus. Swallowing indeed differentiated between the stimuli and the correlation between the number of swallows and the amount of saliva was significant. The present data suggest that monitoring the swallowing movement using EMG might be a sensitive, valid and reliable method for the measurement of salivary flow. The use is recommended for the measurement of salivation when a simple and non-invasive method is needed.

Adult↗

The effect of beta-sympathomimetic stimulation on parotid salivation in the red kangaroo (Macropus rufus).

Salivation was stimulated by intracarotid isoprenaline infusion given alone or combined with acetylcholine. By itself, isoprenaline (0.12-1.2 nmol kg-1 min-1) stimulated flow rates of 0.037-0.233 ml min-1 (2.77-10.5 microliters/g gland per min). Salivary Na, Cl, PO4 and total solute concentrations were positively correlated with flow; K, Mg and urea were negatively correlated with flow; and Ca, H+, HCO3, protein and amylase activity were not correlated with flow. Relative to cholinergic saliva, isoprenaline-evoked saliva had higher levels of amylase activity, urea, protein, K, Mg, H+, PO4 and Cl but lower osmolality, Na, Ca and HCO3. At a steady flow (1 ml min-1), isoprenaline infusion (0.3 nmol kg-1 min-1) superimposed on a pre-existing acetylcholine infusion increased salivary amylase activity, protein, urea, K, Mg, Cl and PO4, reduced HCO3 and did not alter Na, Ca, H+ and osmolality. Superimposition of isoprenaline infusion (0.5 nmol kg-1 min-1) on a low-level acetylcholine infusion increased flow rate by 400-900%. Excretion rates of K, Mg, Cl and PO4 were higher and Ca lower than predicted for saliva secreted at equivalent flows during acetylcholine stimulation. Na, H+ and HCO3 were as predicted for the same flow rate under cholinergic stimulation. The simplest coherent interpretation of these data is that isoprenaline affects transport of protein and ions at the end organs, but has little effect on the resting transport characteristics of the striated and excretory ducts of the kangaroo parotid, in accord with the known nerve distribution of this gland.

Acetylcholine↗

Characterization of muscarinic receptor binding and inhibition of salivation after oral administration of tolterodine in mice.

The current study was undertaken to characterize the effects of oral administration of tolterodine on muscarinic receptor binding in the bladder and submaxillary gland and on salivation in mice. In the in vitro experiment, tolterodine and its metabolite (5-hydroxymethyl metabolite: 5-HM) competed concentration-dependently with [N-methyl-(3)H]-scopolamine ([(3)H]NMS) in the mouse bladder, submaxillary gland and heart, and the potencies of both agents were greater than that of oxybutynin. After oral administration of tolterodine (6.31, 21.0 micromol/kg) and oxybutynin (76.1 micromol/kg), there was a dose and time-dependent increase in K(d) values for specific [(3)H]NMS binding in the bladder, prostate, submaxillary gland, heart, colon and lung, compared with control values, suggesting significant muscarinic receptor binding in each tissue. The K(d) increase in each tissue by oral oxybutynin reached a maximum value of 0.5 h after oral administration and then rapidly declined, while that by tolterodine was greatest 2 h after the administration and it was maintained for at least 6 or 12 h, depending on the dose and on the tissue. Thus, muscarinic receptor binding of oral tolterodine was slower in onset and of a longer duration than that of oxybutynin. Also, oral oxybutynin showed relatively greater receptor binding in the submaxillary gland as compared with other tissues, but such high selectivity to the exocrine gland muscarinic receptors was not observed by oral tolterodine. Oral administration of tolterodine and oxybutynin reduced significantly the pilocarpine-induced salivary secretion in mice, and the attenuation of oral tolterodine appeared more slowly and it was more persistent than that of oral oxybutynin. The antagonistic effect of oral tolterodine on the dose-response curves to pilocarpine was significantly weaker than that of oxybutynin. These data suggest that oral tolterodine, compared with the case of oral oxybutynin, binds more selectively to muscarinic receptors in the mouse bladder than in the submaxillary gland, which may be advantageous in treating patients with overactive bladder.

Administration, Oral↗

Nicotinic acetylcholine receptor alpha5 subunits modulate oxotremorine-induced salivation and tremor.

Neuronal nicotinic acetylcholine receptors (nAChRs) are composed of 12 subunits (alpha2-alpha10 and beta2-beta4). alpha5 Subunits, expressed throughout the central nervous system (CNS) and the autonomic nervous system (ANS), possess unique pharmacological properties. The effects of oxotremorine (OXO) on autonomic functions and tremor were examined in mice lacking alpha5 nAChR subunits (alpha5-/-) and compared with those in wild-type (WT) control mice. The alpha5-/- mice showed significantly increased salivation and tremor responses to OXO. The hypothermia, bradycardia and defecation induced by OXO were of similar magnitudes in the two mouse strains. The enhanced OXO effects in alpha5-/- mice indicate inhibitory effects of alpha5 subunits in autonomic ganglia, and support the participation of these subunits in cholinergic transmission in autonomic ganglia.

Acetylcholine↗

Lesions of periventricular tissue surrounding the anteroventral third ventricle (AV3V) attenuate salivation and thermal tolerance in response to a heat stress.

The purpose of this study was to determine if ablation of the periventricular tissue that surrounds the anteroventral third ventricle (AV3V) would reduce an animal's ability to withstand a thermal challenge. The results show that AV3V-lesion rats are less capable of withstanding a 37 degrees C heat stress and that this is, at least in part, due to a reduced salivation response.

Animals↗

Salivation and depression: a role for appetitive factors.

A decrease in salivary flow rate (SFR) is associated with depressive illness although the mechanisms underlying this association are unknown. Appetitive factors are known to influence SFR, but are not adequately considered in the studies of salivation and depression. Diminished SFR in depressive illness may be more closely related to the appetite disturbances commonly associated with depressive illness than to mood disorder or depressive illness per se. The implications for considering SFR as a physiological correlate of depressive illness are discussed in light of this possibility.

Appetite↗

The role of age and salivation in acid clearance in symptomatic patients with gastro-oesophageal reflux disease.

BACKGROUND: Cisapride has been shown to have not only prokinetic effects, but also salivary stimulating effects. Both of these mechanisms play an important role in the acid clearance of the oesophagus. AIM: To access the efficacy of cisapride in facilitating acid clearance in patients with symptomatic gastro-oesophageal reflux disease. METHODS: Fifteen older adults and 15 younger adults with symptomatic gastro-oesophageal reflux disease completed the study. The acid clearance test was accomplished by infusing 15 mL of 0.1 N HCl into the distal oesophagus, and the number of swallows was determined to achieve an oesophageal pH of 4.0. This was accomplished under baseline conditions and salivary stimulation with a peppermint lozenge. After 1 week of treatment with cisapride (10 mg, q.d.s.), the acid clearance test was repeated. RESULTS: The lozenge produced a significant decrease in the number of swallows compared to baseline in both groups (P < 0.01). There was a significant decrease in the number of swallows after the treatment with cisapride compared to baseline in both groups (P < 0.01). No significant difference was found in the number of swallows when comparing cisapride with lozenge. CONCLUSIONS: Cholinergic stimulation of salivation is an effective means of facilitating oesophageal acid clearance. Drugs, such as 5 hydroxytriptamine (5-HT)4-receptor agonists, should be considered as potentially important compounds in the treatment of gastro-oesophageal reflux disease.

Aged↗

Severe impairment of salivation in Na+/K+/2Cl- cotransporter (NKCC1)-deficient mice.

The salivary fluid secretory mechanism is thought to require Na(+)/K(+)/2Cl(-) cotransporter-mediated Cl(-) uptake. To directly test this possibility we studied the in vivo and in vitro functioning of acinar cells from the parotid glands of mice with targeted disruption of Na(+)/K(+)/2Cl(-) cotransporter isoform 1 (Nkcc1), the gene encoding the salivary Na(+)/K(+)/2Cl(-) cotransporter. In wild-type mice NKCC1 was localized to the basolateral membranes of parotid acinar cells, whereas expression was not detected in duct cells. The lack of functional NKCC1 resulted in a dramatic reduction (>60%) in the volume of saliva secreted in response to a muscarinic agonist, the primary in situ salivation signal. Consistent with defective Cl(-) uptake, a loss of bumetanide-sensitive Cl(-) influx was observed in parotid acinar cells from mice lacking NKCC1. Cl(-)/ HCO(3)(-) exchanger activity was increased in parotid acinar cells isolated from knockout mice suggesting that the residual saliva secreted by mice lacking NKCC1 is associated with anion exchanger-dependent Cl(-) uptake. Indeed, expression of the Cl(-)/ HCO(3)(-) exchanger AE2 was enhanced suggesting that this transporter compensates for the loss of functional Na(+)/K(+)/2Cl(-) cotransporter. Furthermore, the ability of the parotid gland to conserve NaCl was abolished in NKCC1-deficient mice. This deficit was not associated with changes in the morphology of the ducts, but transcript levels for the alpha-, beta-, and gamma-subunits of the epithelial Na(+) channel were reduced. These data directly demonstrate that NKCC1 is the major Cl(-) uptake mechanism across the basolateral membrane of acinar cells and is critical for driving saliva secretion in vivo.

Animals↗

Morphine pharmacokinetics and effects on salivation and continuous reaction times in healthy volunteers.

Ten healthy volunteers were given an i.v. infusion of 10 mg morphine HCl, an oral solution of 20 mg morphine HCl, or a new controlled release tablet of 30 mg morphine sulphate on three separate occasions in a complete crossover design. Venous blood samples were collected serially for 14-24 h and analyzed for morphine using high-performance liquid chromatography (HPLC). Continuous reaction times (CRTs) and salivation were measured repeatedly in all subjects. Oxygen saturation remained normal throughout the procedure. Five subjects experienced nausea on at least one occasion. Pharmacokinetic parameters, calculated using a two-compartment model, were in accordance with previous results for i.v. and oral administration of morphine solutions. The absolute bioavailability of morphine in the oral solution was 21.6% (15.4-27.7%; 95% CI) and in the controlled release tablet, 17.1% (12.6-21.6%; CI). Secondary peaks in the plasma concentration curves strongly indicated an enterohepatic circulation (EHC) of morphine. Alternative pharmacokinetic calculations, including EHC, were performed and used in a pharmacokinetic-pharmacodynamic model, in which the studied effects were well correlated to the concentrations of morphine.

Administration, Oral↗

Induction of salivation in biting midges and mosquitoes, and demonstration of virus in the saliva of infected insects.

Culicoides biting midges and Aedes aegypti (Linnaeus) mosquitoes were induced to salivate by the topical application of pilocarpine, neostigmine, malathion and dimethoate; of these, malathion was the most effective. Drops of saliva produced by virus-infected midges and mosquitoes were shown to contain virus. The method could be used to demonstrate transmission in insects infected with a variety of pathogens.

Aedes↗

Comparison of the effects of percutaneous and intraduodenal administration of oxybutynin on bladder contraction and salivation in rabbits.

AIM: As only a few basic animal experiments have assessed the usefulness of percutaneous application of oxybutynin, we compared the effects of percutaneous application and intraduodenal injection of oxybutynin on urinary bladder contraction accompanied by micturition in conscious rabbits and salivation in anesthetized rabbits. METHODS: Bladder contractions were induced by continuous infusion of saline (2 mL/min) into the bladder. Salivary secretion was induced by pilocarpine (0.1 mg/kg, i.v.). Oxybutynin was administered at 15 mg/animal, and the plasma concentrations of oxybutynin and N-desethyloxybutynin were measured by high-performance liquid chromatography to clarify the effective concentration. RESULTS: The intercontraction interval (ICI) was prolonged from 0.5 h after intraduodenal injection of oxybutynin, and this effect continued for 2 h. The ICI prolongation after percutaneous application of oxybutynin appeared at 2 h and continued throughout the 6-h experimental period. The saliva secretion induced by pilocarpine was inhibited to almost the same level by oxybutynin 3 h after intraduodenal injection and 6 h after percutaneous application. However, the sum of the plasma concentrations of oxybutynin and N-desethyloxybutynin rose steeply to a very high level within 20 min after oral administration instead of intraduodenal injection and decreased within 3 h to about half of the level evident 6 h after percutaneous application. CONCLUSION: We confirmed that percutaneous application of oxybutynin caused long-lasting ICI prolongation in our rabbit model, as compared with that after intraduodenal injection, and produced weaker inhibitory effects on saliva secretion because it did not cause steep elevation of the plasma concentration.

Administration, Cutaneous↗

The central and peripheral effectiveness of two oxotremorine-antagonists determined using oxotremorine-induced tremor and salivation.

Two oxotremorine antagonists have been examined using oxotremorine as the tremor salivation inducer and the ratios between the central and peripheral nervous systems determined. Under these conditions these compounds are still more effective antagonists centrally than peripherally. Differences in distribution to the various muscarinic receptors involved is believed to be the major factor in determining this separation of central and peripheral activities.

Alkynes↗