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At least 1,603 records · Page 89Linked to original sources
PubMed1993

Is combined therapy of sympathomimetics and theophylline indicated?

Bronchodilator effect and toxicity of theophylline 300 mg twice a day (R1), salbutamol 4 mg tid (R2), their combination in higher (200/4mg, R3), and lower doses (100/2mg R4), and placebo (calcium lactate 300 mg) tid (R5) were compared in 25 patients with bronchial asthma in a randomized crossover trial. Statistically significant improvement in forced expiratory volume in one second (FEV1) was observed in all the active treatment groups (R1 to R4) compared with placebo (R5). The mean improvement in FEV1 was 29.0%, 22.0%, 28.0%, 30.0%, and 0.73% in regimen R1, R2, R3, R4, and R5, respectively day 1, and corresponding improvement was 30.0%, 24.0%, 29.0%, 34.0%, and 4.4% on completion of one week therapy. On intergroup statistical comparison, mean improvement in pulmonary function test values were statistically significant or highly significant in regimens R1 to R4, as compared with placebo. However, improvement between any two regimens was not statistically significant in any of the regimens (R1-R4). Almost all the regimens were tolerated well and no patient showed major adverse reactions or cardiotoxicity necessitating withdrawal of the drug. On the other hand, minor adverse reactions were common and the high dose combination (R3) was found to have more adverse reactions than the low dose combination and either drug used alone.

Adolescent↗
PubMedDate not supplied

A randomized comparison of the effect of two diuretics, a converting enzyme inhibitor, and a sympathomimetic amine on weight loss in diet-refractory patients.

We hypothesized that women refractory to dietary weight loss may have a type of idiopathic edema. In a study of 200 women, we compared four drugs, used previously for treating idiopathic edema, to determine their efficacy in causing weight reduction. After 6 months of treatment, the percentage of treated groups losing at least 10% of baseline weight was 6% for hydrochlorothiazide, 8% for spironolactone, 68% for dextroamphetamine sulfate, and 4% for captopril. The percentage losing >20% and >30% of baseline weight in the same treatment groups was 28% and 10% for dextroamphetamine therapy but 0% for the other three groups. Of the women who failed to lose weight with one of the nonamphetamine therapies during the first 6 months, 132 were then treated with dextroamphetamine; 68% lost =10% of their baseline weight, and 30% and 7% of patients lost =20% and =30%, respectively. With use of the classic definition of idiopathic orthostatic edema (urinary output of <55% of ingested water load in 4 hours), only 58 of the 200 study patients had this diagnosis; however, 144 patients excreted <75% of the load. Comparison of the efficacy of amphetamine therapy in patients with <75% versus =75% urinary excretion showed 120 of 131 (92%) lost =10% in the former category versus only 4 of 51 (8%) in the latter. Of the 58 patients who excreted <55% of the water load, 52 (90%) lost =10% of baseline weight with amphetamine therapy. The patients noted no effects of therapy on dietary consumption. The responsiveness of the patients to amphetamine therapy during the second 6-month period despite failing to lose weight with the three other therapies suggests that no inadvertent bias was present in the randomization process. Thus, the results suggest that some women who are recalcitrant to dietary weight loss may have a mild type of water retention that is refractory to diuretics but responsive to amphetamines.

Clinical Trial↗
PubMed1976

[Effect of sympathomimetic substances and DOPA on the ultrastructure of the nervous apparatus of the heart].

After a single administration of norepinephrine or DOPA to albino rats there occurred an incorporation of norepinephrine into the adrenergic axons of the heart and its deposition in the form of granules in small synaptic vesicles, about 300 A in diameter. The adrenergic and cholinergic axons can be thus differentiated. The amount of cholinergic axons in the auricles is greater than that of the adrenergic ones. The adrenergic terminals came into the most intimate contact with the cholinergic terminals and with the endothelial cells of the blood capillaries and the myocardial muscle cells. It is supposed that adrenergic fibers can act upon the heart muscle in three ways: by means of presynaptic inhibition through the cholinergic axons, by humoral route, and directly on the myocardial muscle cells.

Adrenergic Fibers↗
PubMed1976

[Acute myocardial infarct and pindolol. Effect of a beta sympatholytic with intrinsic sympathomimetic activity on hemodynamics and contractility].

After acute circumscribed myocardial infarction the effects of the beta-sympatholytic agent 1-(indol-4-yl-oxy)-3-isopropyl-amino-propan-2-ol (pindolol; Visken) on hemodynamics and contractility were examined. Hemodynamic changes after application of pindolol are of small extent only. Heart rate shows a rising tendency whereas systolic and diastolic aortic pressure decreases only after higher doses. Left ventricular end-diastolic pressure (LVEDP) does not change remarkably. Cardiac output is reduced by small doses of pindolol and reaches starting values again before the administration of higher doses. Changes of the contractility parameters (dp/dt)max, t-(dp/dtmax, and PEP in the sense of a beta-sympatholysis appear only in the lower range of the doses given. Thus maximum decrease of contractility is 20% measured at (dp/dt)max, which consequently reaches the starting value again. The other contractility parameters change accordingly. These typical dose-response relations between pindolol and contractility parameters are considered to be due to lacking cardiac depressive properties combined with significant so-called positive intrinsic activity. Our results show that no contraindication can be derived from the small influence of pindolol on contractility in acute myocardial infarction.

Animals↗
PubMed2003

Sedation with midazolam and ketamine for invasive procedures in children with malignancies and hematological disorders: a prospective study with reference to the sympathomimetic properties of ketamine.

Different pharmacological agents have been used for sedation in children undergoing invasive procedures. The authors prospectively evaluated the efficacy, the occurrence of adverse side effects, and cardiovascular parameters in midazolam and ketamine sedation for invasive procedures in children with malignancies and hematological disorders. A total of 183 invasive procedures were performed on 63 children (mean age 9.2 +/- 5.2 years). Intravenous sedation consisted of 0.1 mg midazolam/kg and 1.0 mg ketamine/kg. Incremental dosages of ketamine (0.33 mg/kg) were given if necessary to maintain deep sedation. Systolic and diastolic blood pressure, heart rate, and oxygen saturation were recorded. All 183 invasive procedures were successfully completed with satisfactory sedation levels in 170 procedures (92.9%; 95% CI:88.2-96.2%). In 33 procedures (18%; 95% CI: 12.8-24.4%) sedation was associated with side effects, the most common being oxygen desaturation. One patient experienced a transient episode of laryngospasm. There was a significant increase in both systolic and diastolic blood pressure and heart rate after ketamine medication (p <.01). Procedure and recovery time were correlated to ketamine dosage (p <.01). The combination of midazolam and ketamine is efficacious in achieving deep sedation for painful invasive procedures. Considering the possibility of potentially serious respiratory complications it should be performed only by physicians who are trained in advanced airway management and life support. As opposed to many other sedative drugs with cardio-depressant properties, ketamine causes a rise in both systolic and diastolic blood pressure, and heart rate.

Anesthetics, Combined↗