OBJECT: The study was performed to examine the psychotrophic drugs used in psychiatric out-patients in which neutropenia developed and current state of consultation and to confirm the importance of complete blood count and differential count (CBC/DC). SUBJECTS AND METHODS: The subjects were 60 patients of our university hospital in which neutropenia developed in out-patient department (OPD) of psychiatry during recent three years. The absolute neutrophil counts of patient were below 2,000/mm3. RESULTS: The reasons why exam was performed were mainly to follow-up exam during medications. Mood stabilizers such as carbamazepine, phenytoin, sodium valproate were identified to cause neutropenia in the group using multiple drugs, and clozapine was highly related in the group using single drug. But many kinds of drugs were related with neutropenia. We have not checked well enough the CBC/DC and have not consulted well to hematologist in OPD of neuropsychiatry. CONCLUSIONS: It is important to find neutropenia in the psychiatric out-patients using psychotropic drugs. We had better check CBC/DC routinely and consult to hematologist.
Blood Cell Count ; Carbamazepine ; Clozapine ; Follow-Up Studies ; Humans ; Neuropsychiatry ; Neutropenia* ; Neutrophils ; Outpatients* ; Phenytoin ; Psychotropic Drugs ; Valproic Acid

Laryngoscopy and endotracheal intubation are often associated with hypertension, tachycardia and increase in catecholamines concentrations. The mechanism for these reflex cardiovas-cular changes is unknown, but may be a result of reflex sympathetic activation, involving baroreceptor system, provoked by stimulation of the epipharynx and laryngopharynx. The purpose of the present study was to determine the effect of increasing age on the changes of hemodynamic response to endotracheal intubation. We evaluated in 36 patients aged 20~79 years, ASA class I and II, given atropine sulfate 0.01 mg/kg and hydroxyzine sulfate 0.04 mg/kg I.M as premedication and thiopental sodium 5.0 mg/kg and succinylcholine chloride 1.0 mg/kg I.V. for induction of anesthesia. Patients were studied in three age group's as followings, Group I (n=12):20~39years Group II (n=12): 40~59 years Group III (n=12): 60~79 years Heart rate and blood pressure increased at endotracheal intubation in all age groups to compare with control value, there were no relationship with age in increment of blood pressure but increment of heart rate diminished with advancing age. The reason for above results is that the sensitivity to the vasoconstrictive effect of a-recep- tor stimulation is similar in all age groups, but the sensitivity to B-receptor stimulation altered cardiac chronotropic response is different with advancing age. Additionally, the diminution of sensitivity to a-receptor is not caused by decrease of density of B-receptor, but due to the impairment in the coupling of the B-receptor adenylate cyclase complex in the elderly.
Adenylyl Cyclases ; Aged ; Anesthesia ; Anesthesia, General ; Atropine ; Blood Pressure ; Catecholamines ; Geriatrics ; Heart Rate ; Hemodynamics* ; Humans ; Hydroxyzine ; Hypertension ; Hypopharynx ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy ; Premedication ; Pressoreceptors ; Reflex ; Succinylcholine ; Tachycardia ; Thiopental

Laryngoscopy and endotracheal intubation are often associated with hypertension, tachycardia and increase in catecholamines concentrations. The mechanism for these reflex cardiovas-cular changes is unknown, but may be a result of reflex sympathetic activation, involving baroreceptor system, provoked by stimulation of the epipharynx and laryngopharynx. The purpose of the present study was to determine the effect of increasing age on the changes of hemodynamic response to endotracheal intubation. We evaluated in 36 patients aged 20~79 years, ASA class I and II, given atropine sulfate 0.01 mg/kg and hydroxyzine sulfate 0.04 mg/kg I.M as premedication and thiopental sodium 5.0 mg/kg and succinylcholine chloride 1.0 mg/kg I.V. for induction of anesthesia. Patients were studied in three age group's as followings, Group I (n=12):20~39years Group II (n=12): 40~59 years Group III (n=12): 60~79 years Heart rate and blood pressure increased at endotracheal intubation in all age groups to compare with control value, there were no relationship with age in increment of blood pressure but increment of heart rate diminished with advancing age. The reason for above results is that the sensitivity to the vasoconstrictive effect of a-recep- tor stimulation is similar in all age groups, but the sensitivity to B-receptor stimulation altered cardiac chronotropic response is different with advancing age. Additionally, the diminution of sensitivity to a-receptor is not caused by decrease of density of B-receptor, but due to the impairment in the coupling of the B-receptor adenylate cyclase complex in the elderly.
Adenylyl Cyclases ; Aged ; Anesthesia ; Anesthesia, General ; Atropine ; Blood Pressure ; Catecholamines ; Geriatrics ; Heart Rate ; Hemodynamics* ; Humans ; Hydroxyzine ; Hypertension ; Hypopharynx ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy ; Premedication ; Pressoreceptors ; Reflex ; Succinylcholine ; Tachycardia ; Thiopental

To evaluate the efficacy of verapamil to prevent sympathetic stimulation during endotracheal intubation. Author studied the cardiovascular responses to laryngoscopy and endoracheal intubation in 60 patients who received verapamil 0.075 mg/kg, 0.15 mg/kg or no verapamil medication before the larngoscopy. The index of'cardiovascular response during laryngoscopy and tracheal intubation were mean arterial pressure(MAP), heart rate(HR), and rate pressure product(RPP). And author concluded as follows. l) The changes of MAP were more stable in verapamil groups than no verapamil group(P 0.05). But there were no difference between verapamil 0.075 mg/kg and 0.15 mg/kg groups. 2) The changes of HR were more stable in verapamil group until 5 minutes after tracheal intubation. In difference between verapamil 0.015 mg/kg and 0.15 mg/kg, verapamil 0.15 mg/kg(P 0.01) were more stable than 0.075 mg/kg group(P 0.005). 3) The canges of RPP were more stable in verapamil group until 10 min. after tracheal intubation. But there were no difference in verapamil 0.075 mg/kg and 0.15 mg/kg group.
Blood Pressure ; Heart ; Heart Rate ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy ; Verapamil*

To evaluate the efficacy of verapamil to prevent sympathetic stimulation during endotracheal intubation. Author studied the cardiovascular responses to laryngoscopy and endoracheal intubation in 60 patients who received verapamil 0.075 mg/kg, 0.15 mg/kg or no verapamil medication before the larngoscopy. The index of'cardiovascular response during laryngoscopy and tracheal intubation were mean arterial pressure(MAP), heart rate(HR), and rate pressure product(RPP). And author concluded as follows. l) The changes of MAP were more stable in verapamil groups than no verapamil group(P 0.05). But there were no difference between verapamil 0.075 mg/kg and 0.15 mg/kg groups. 2) The changes of HR were more stable in verapamil group until 5 minutes after tracheal intubation. In difference between verapamil 0.015 mg/kg and 0.15 mg/kg, verapamil 0.15 mg/kg(P 0.01) were more stable than 0.075 mg/kg group(P 0.005). 3) The canges of RPP were more stable in verapamil group until 10 min. after tracheal intubation. But there were no difference in verapamil 0.075 mg/kg and 0.15 mg/kg group.
Blood Pressure ; Heart ; Heart Rate ; Humans ; Intubation* ; Intubation, Intratracheal ; Laryngoscopy ; Verapamil*