Gastric Lavage ; methods ; Humans ; Mannitol ; administration & dosage ; Norepinephrine ; administration & dosage ; Organophosphate Poisoning ; Pesticides ; poisoning ; Poisoning ; therapy

Ketamine produces an increase in the heart rate and blood pressure, but the precise mechanism is controversial. In order to obtain inslight into the mechanism by observing the influence of nitroglycerin (NTG) on the ketamine effect, ketamine was administered intravenously following sublingual administration of nitroglycerin in conscious patients. The results were as follows: 1) In the ketamine(2mg/kg) group(n=15), the heart rate and blood pressure increased significantly by as much as 25%. 2) In the nitroglycerin(1.2mg) group(n=12), the heart rate increased, but blood pressure decreased from 5 minutes after administration. 3) In the group which received ketamine(2mg/kg) 5min. after NTG(1.2mg)(N=15), the heart rate did not change, but the blood pressure increased significantly without attenuation by nitroglycerin. From the above results, it is suggested that in the ketamine effect control mechanism may also be participated in addition ot the peripheral mechanism involving norepinephrine release.
Administration, Sublingual ; Blood Pressure* ; Heart Rate* ; Heart* ; Humans ; Ketamine* ; Nitroglycerin* ; Norepinephrine

OBJECTIVE: New antidepressant, nefazodone is classified as a serotonin -2 antagonist/reuptake inhibitor like old antidepressant, trazodone. Nefazodone, however, differs from trazodone in that it lacks anti-histaminergic properties and in that it has some norepinephrine reuptake inhibitory properties. These differences may account for the differences between the two drugs in the side effect profiles. This study was conducted to compare the acute effects of nefazodone on the psychomotor performance with those of trazodone. METHODS: The subjects were 12 healthy male volunteers aged between 20-40 years. A single, oral starting dose of nefazodone or trazodone was administered in a double-blind, randomized latin-square design with a 1-week interval between each drug switch. Psychomotor performances were assessed at 1 hour before and at 2 hours after administration of nefazodone 50 mg, nefazodone 100 mg or trazodone 50 mg. The measures of psychomotor performance included Vienna Determination Unit for complex choice reaction time, Critical Flicker Fusion Test, and Grooved Pegboard Test. RESULTS: In the Vienna Determination Unit, when 'within drug effect' (pre- vs. post-medication) was analyzed, nefazodone 100 mg decreased complex choice reaction time in both subtest 2 and subtest 3. Nefazodone 50 mg also decreased the reaction time in subtest 3 but not in subtest 2 which was more difficult and demanding task than subtest 3. On the other hand, no significant changes in the reaction time were observed with trazodone 50 mg in either subtest 2 or subtest 3. When 'between drug effect' was analyzed, however, the differences between drugs were not found to reach statistically significant level. No significant 'between drug effect' or 'within drug effect' was observed in Critical Flicker Fusion Test and Grooved Pegboard Test. CONCLUSION: Although the differences between nefazodone and trazodone did not reach statistically significant level, the results on the complex choice reaction time suggest that al least a single starting dose of nefazodone up to 100 mg does not impair psychomotor performances and it might have a less detrimental effect than trazodone on the psychomotor performance.
Administration, Oral* ; Flicker Fusion ; Hand ; Healthy Volunteers* ; Humans ; Male ; Norepinephrine ; Psychomotor Performance* ; Reaction Time ; Serotonin ; Trazodone* ; Volunteers

We report a case in which a 63-year-old male patient with pheochromocytoma developed persistent hypotension during surgery despite rapid volume replacement and administration of vasopressors. The patient was prepared for surgery with phenoxybenzamine for 13 days. Anesthesia was induced with thiopental sodium and maintained with N2O, O2, and enflurane. Sodium nitroprusside (SNP) was initiated and titrated based upon intraarterial blood pressure. Hypertensive episode during tumor manipulation was effectively managed by increased infusion of SNP. After surgical removal of tumor, this patient developed profound hypotension, which was aggressively managed by intravenous administration of crystalloid and blood as well as dopamine and epinephrine. However, this hypotension was persistent and aggravated. Accordingly, Infusion of norepinephrine (Levophed(R))was started and then the patient recoverd from his hemodynamic aberrations. We conclude that the cause of the persistent hypotension was cumulative and residual effect of preoperative phenoxybenzamine. Therefore, norepinephrine should be readily available for the treatment of hypotension resistant to other pharmacologic interventions.
Administration, Intravenous ; Anesthesia ; Blood Pressure ; Dopamine ; Enflurane ; Epinephrine ; Hemodynamics ; Humans ; Hypotension* ; Male ; Middle Aged ; Nitroprusside ; Norepinephrine* ; Phenoxybenzamine ; Pheochromocytoma* ; Thiopental

OBJECTIVETo investigate the effects of dopamine and norepinephrine on the renal function in the patients with septic shock.

METHODSEighty-seven patients with septic shock were divided into three groups (group A, B, C) according to the biggest infusing rate of norepinephrine, with the infusing rate of 0.5 - 0.9, 1.0 - 1.5, 1.6 - 2.0 microg x kg(-1) x min(-1), respectively. Mean arterial blood pressure (MAP), heart rate (HR), urine output, blood urea nitrogen (BUN), creatinine (CRE), urine albumin (U-ALB) and urine beta(2)-microglobulin (Ubeta(2)-MG) as well as APACHE III score in all the patients were detected.

RESULTSBefore anti-shock therapy was given, hypotension, tachycardia and oliguria occurred in all the 87 patients, and CRE, BUN, U-ALB, Ubeta(2)-MG and APACHE III score were abnormal in most cases. With the anti-shock therapy, MAP, HR, urine output and BUN, CRE in all patients returned to normal levels gradually, and U-ALB, Ubeta(2)-MG levels and APACHE III score also restored but still remained abnormal.

CONCLUSIONSThe first aim of treating septic shock should be restoring the organ blood supply, and based on volume resuscitation, dopamine, noradrenaline and other vasoactive drugs could be combined to maintain circulatory stability.

APACHE ; Adult ; Aged ; Blood Transfusion ; Cardiotonic Agents ; administration & dosage ; Combined Modality Therapy ; Dopamine ; administration & dosage ; Drug Therapy, Combination ; Female ; Humans ; Kidney ; drug effects ; physiopathology ; Male ; Middle Aged ; Norepinephrine ; administration & dosage ; Retrospective Studies ; Shock, Septic ; physiopathology ; therapy ; Vasoconstrictor Agents ; administration & dosage

OBJECTIVE: Duloxetine hydrochloride is a selective serotonin (5-hydroxytryptamine) and norepinephrine reuptake inhibitor. It is approved for effective treatment for major depressive disorder. The pharmacokinetics (PK) of duloxetine has been studied, but few pharmacokinetics properties in Chinese subjects are available. This study explored the dose proportionality and determined duloxetine levels in human plasma by comparing the PK properties after administration of single or multiple doses in healthy volunteers. METHODS: Thirty-six subjects were divided randomly into three groups and received a single dose of 15, 30, or 60 mg duloxetine. Those who received 30 mg continued on to the multiple-dose phase and received 30 mg daily for 7 days. Liquid chromatography/mass spectroscopy was applied to determine concentrations. The PK properties were calculated and included maximum plasma concentration (Cmax), time when maximum plasma concentration was reached (Tmax), time when half-maximum plasma concentration was reached (t1/2), area under the plasma concentration-time curve from time zero to the last measurable concentration (AUC0-t), mean concentration levels (AUC0-infinity), and apparent total clearance of the drug from plasma after oral administration (CL/F). RESULTS: The standard calibration curve was linear in the concentration range 0.11-112 ng/ml (r>0.992). Linear PK properties were found at doses of 15-60 mg. The Cmax and AUC were proportional to dose, but the Tmax and t1/2 did not increase with increasing dose. CONCLUSION: No significant differences in the PK parameters were found among the three groups during the single-dose phase. The AUC and Cmax were greater in the multiple-dose phase, indicating duloxetine accumulation following multiple-dose administration.
Administration, Oral ; Area Under Curve ; Asian Continental Ancestry Group ; Calibration ; Depressive Disorder, Major ; Humans ; Norepinephrine ; Plasma ; Serotonin ; Spectrum Analysis ; Tablets, Enteric-Coated ; Thiophenes ; Duloxetine Hydrochloride

The central dopaminergic receptor is believed to suppress the cardiovascular system So it may be involved in the blood pressure regulation But, it's action is still controversial. Furthermore, the mechanisms involved in the central dopaminergic receptor-induced blood pressure regulation is unclear. So, present study was performed in order to clarify the effects of central dopaminergic receptor and to investigate the mechamisms involved in it. Lisuride a D2-receptor agonist, and clonidine, a alpha2-receptor agonist, were administered into lateral ventricle in rat and the changes of blood pressure were compared The results were as follows; 1. Intracerebroventricular administration of lisuride amd clonidine from 0.3 ug to 10 ug elicited dose related decrease of blood pressure and heart rate. The potencies were similar in both drugs. 2. Centrally administered sulpiride, a D2-antagonist, blocked only the lisuride-induced hypotension while the clonidine induced hypotension was blocked only by centrally adrninistered tolazoline, a alpha2-antagonist. Intravenous administration of both antagonists elicited no or minimal attenuabon of agonists effects. 3. After desipramine pretreatment, which increases the norepinephrine concentration lisuride elicited somewhat further decrease of blood pressure than normal, while clonidine administration caused rather increase in blood pressure. 4. After chemical sympathectomy by 6-hydroxydopamine, lisuride administration still elicited strong suppression of blood pressure. From thses above results, it is concluded that central dopaminergic receptor activation decrease the blood pressure. Suppression of the norepinephrine release at the sympathetic nerve terminal is not related with central dopaminergic receptor induced hypotension.
Administration, Intravenous ; Animals ; Blood Pressure ; Cardiovascular System* ; Clonidine ; Desipramine ; Heart Rate ; Hypotension ; Lateral Ventricles ; Lisuride ; Norepinephrine ; Oxidopamine ; Rats ; Sulpiride ; Sympathectomy, Chemical ; Tolazoline

Antihypertensive effects of ethanol extracts of Aralia elata (Miq.) Seem. (AE) were investigated in spontaneously hypertensive rats (SHR). SHR aged 14 weeks were treated for 8 weeks with AE (10 or 50 mg/kg/day) or amlodipine besylate (Am; 10 mg/kg/day) orally. Hypertension results in injury to several organs and can produce a significant increase in malondialdehyde (MDA) content as a result of lipid peroxidation and endothelial dysfunction. In this study, oral administration of AE and Am significantly reduced systolic blood pressure, organ weight index, and MDA content in tissues but increased significantly the plasma nitrite and nitrate concentrations. The endothelium-dependent relaxant activities of acetylcholine (10⁻¹⁰–10⁻³ M) in norepinephrine (NE)-precontracted aorta were increased in AE- and Am-treated rats. Particularly strong endothelium-dependent relaxant activities were observed in AE-treated (50 mg/kg) rats. The endothelium-independent relaxant activities of sodium nitroprusside (10⁻¹⁰–10⁻³ M) in NE-precontracted aorta were not changed. The results of this study suggest that AE has both antihypertensive and end-organ protective effects in SHR.
Acetylcholine ; Administration, Oral ; Amlodipine ; Animals ; Aorta ; Aralia* ; Blood Pressure ; Ethanol* ; Hypertension ; Lipid Peroxidation ; Malondialdehyde ; Nitroprusside ; Norepinephrine ; Organ Size ; Plasma ; Rats ; Rats, Inbred SHR*

The purpose of this study is to investigate whether the combination of green tea extract (GTE) and L-theanine has an anxiolytic effect by oral administration through behavioral tests and neurtransmitters (or hormone) anaylses. Four week oral administration of GTE (24 mg/kg), L-theanine (4 mg/kg) or their combination showed anxiety-reducing effects determined by increasing numbers of head-dips in a hole board test and reducing retention time in a rota-rod test without changing spontaneous locomotor activity. Biochemical analyses indicated that the test materials decreased dopamine (DA), noradrenaline (NA), corticosterone (CS) and increased serotonin (5-HT) levels in brain cortex, hippocampus, and striatum, which suggests a possible mechanism of previous behavioral tests. Although the synergistic effects of GTE and L-theanine combination were not observed on the behavioral test, its effects on neurotransmitters (NA, CS) were synergistic and comparable to diazepam (2 mg/kg i.p.) with much less muscle relaxation side effect. Therefore, a combination of GTE and L-theanine may be useful as a functional food ingredient having an anxiolytic effect.
Administration, Oral ; Anti-Anxiety Agents ; Brain ; Corticosterone ; Diazepam ; Dopamine ; Functional Food ; Hippocampus ; Motor Activity ; Muscle Relaxation ; Neurotransmitter Agents ; Norepinephrine ; Retention (Psychology) ; Serotonin ; Tea

OBJECTIVETo explore the clinical effect of low dose pituitrin in children with septic shock.

METHODSA total of 48 pediatric cases with septic shock, in whom 6 hours, conventional treatment could not reverse shock from January 2008 to December 2010, were selected for this study. The patients were divided into two groups randomly (completely random design) (control group 24, remedial group 24). The conventional treatment included antibiotics/fluid resuscitation/correcting acid-base imbalance, glucocorticoid, organ (heart/lung) support, dopamine 1 - 15 µg/(kg·min) and norepinephrine 0.5 - 2 µg/(kg·min) pumped in continuously in the control group. In initial 6 hours the same treatment was given to the remedial group, while low dose pituitrin (0.01 - 0.03 U/min) was pumped additionally during the rest of time. The therapeutic effect on correcting shock was evaluated in both groups.

RESULTSThe total effective rate was 76.2% in the remedial group and 40.0% in the control group; the mortality was 33.3% and 60% respectively. The difference between both groups was significant (P = 0.025).

CONCLUSIONLow dose pituitrin could improve the clinical effect significantly in children with septic shock in whom 6 hours conventional treatment failed to correct shock, shorten the total periods of treatment, and decrease mortality.

Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Norepinephrine ; therapeutic use ; Pituitary Hormones, Posterior ; administration & dosage ; therapeutic use ; Shock, Septic ; drug therapy ; Treatment Outcome ; Vasoconstrictor Agents ; therapeutic use