Vasopressor effects of epinephrine, norepinephrine, ephedrine, phenylephrine, methoxamine and of mephentermine were compared in resrpinized dogs with or without nitrous oxide-oxygen-halothane anesthesia. The results are as follows: (1) Epinephrine and norepinephrine were shown to have the most potent pressor effect in reserpinized and nitrous oxide-oxygen-halothane-anesthetized dogs. Phenylephrine, methoxamine, mephen-termine and ephedrine were less potent in decreasing order. (2) Decrease in mean arterial pressure was less marked in dogs reserpinized and anesthetized with nitrous oxide-oxygen-halothane than in reserpinized but unanesthetized dogs. (3) It revealed that nitrous oxide-oxygen-halothane anesthesia potentiated the vasopressor effects of the sympathomimetic amines studied. Nitrous oxide-oxygen-halothane anesthesia is implicated to exert an sympathomimetic effect.
Anesthesia* ; Animals ; Arterial Pressure ; Dogs* ; Ephedrine ; Epinephrine ; Mephentermine ; Methoxamine ; Norepinephrine ; Phenylephrine ; Sympathomimetics*

Allyl alcohol is an intermediate widely used in industrial production activities, which has caused many occupational damage in China. In this paper, the data of a case of skin damage and clinical cure of inhalation pneumonia caused by occupational allyl alcohol exposure were analyzed and summarized. The patient accidentally inhaled large amounts of allyl alcohol at work and had skin exposure, which was mainly manifested as aspiration pneumonia, respiratory failure, eye damage and skin bullae. After short-term hormone shock therapy, mechanical ventilation, infection prevention, local treatment and other comprehensive treatment, the patient was clinically cured. This case suggests that chemical pneumonia and respiratory failure may be caused by inhalation of allyl alcohol, and skin bullae may be caused by skin contact. Early treatment and hormone use should be emphasized.
Blister ; Hormones ; Humans ; Pneumonia ; Propanols ; Respiratory Insufficiency

To 100 patients who underwent various operations under general anesthesia, Effortil and methoxamine were given in order to assess and to compare their effects on blood pressure and pulse rate. The drugs were administered intravenously in 6 to 10 mg doses when the systolic pressure fell to 80 mmHg. or lower during the operation. The results obtained are as follows: 1. Excellent pressor effect was obtained with Effortil in 84% of 50 patients while in 72% with methoxamine. 2. Both drugs were equally effectve in elevating both systolic and diastolic pressures. 3. The effect of Effortil on pulse rate was much less than that of methoxamine which moderately reduced the pulse rate, especially in the early phase. 4. No untoward effects of either Effortil or methoxamine were observed in this study.
Anesthesia, General ; Blood Pressure ; Etilefrine* ; Heart Rate ; Humans ; Methoxamine

Halothane, isoflurane and desflurane are metabolized to hepatotoxic trifluoroacetyl proteins. But sevoflurane is metabolized to hexafluoroisopropanol. Hexafluoroisopropanol has a low binding affinity for liver protein and is therefore rapidly converted to glucuronidate that are excreted in the urine. Thus sevoflurane has been considered to have a very low potential for hepatotoxicity. We report a case of a 67 years old woman who developed acute hepatic dysfunction after sevoflurane anesthesia.
Anesthesia ; Female ; Halothane ; Humans ; Isoflurane ; Liver ; Methyl Ethers ; Propanols ; Proteins

In propranolol (1. 0mg) pretreated men atropine (0.5mg), ephedrine (20mg) and aramine (2mg) were administered respectively by intravenous route under the ether anesthesia. The results were as follows. 1) Five minutes after intravenous administration of propranolol, the three groups showed decrease of pulse rates, 9, 6 and 8 per minutes respectively, but blood pressure changes were not observed. 2) After intravenous administration of atropine (0.5mg) the decreased pulse rates were increased and blood pressure was elevated. 3) After intravenous administration of ephedrine(20mg) the decreased pulse rates were decreased and lowered blood pressure was lowered further. 4) After intravenous administration of aramine(2.0mg) the lowered blood pressure was elevated, but pulse rate changes were not observed. 5) Circulatory depression due to ether anesthesia after propranolol pretreatment, was corrected by treatment with atropine and aramine, but was not corrected by ephedrine.
Administration, Intravenous ; Anesthesia* ; Atropine ; Blood Pressure* ; Depression ; Ephedrine ; Ether* ; Heart Rate* ; Humans ; Male ; Metaraminol ; Propranolol*

To combat the cardiovascular depression in blood pressure and palserate induced by halothane anesthesia in healthy persons after administration of propranolol(1.0mg) by the intravenous route, atropnie sulfate(0.5mg), ephedrine Hcl(20mg) and aramine(1.0mg) were administered respectively i.v. The results were as follows: 1) After i.v. administration of atropine sulfate, systolic blood pressure was elevated by 15 mmHg, diastolic blood pressure was elevated by 13mmHg, and pulse rate was increased by 24 per minute. 2) After i.v. administration of ephedrine, systolic blood pressure was elevated by 27 mmHg, diastolic blood pressure was elevated by 17mmHg, but significant pulse rate change was not observed. 3) After i.v. administration of aramine, systolic blood pressure was elevated by 29mmHg, diastolic blood pressure was elevated by 19mmHg, but pulse rate was decreased by 8 per minute. 4) As shown in the above results, in the cardiovascular depression due to halothane anesthesia after propranolol intravenous administration, blood pressure and pulse rated were corrected by treatment with atropine sulfate. Ephedrine and aramine effected elevation of the blood pressure, but not the pulse rate.
Administration, Intravenous ; Anesthesia* ; Atropine ; Blood Pressure* ; Depression ; Ephedrine ; Halothane* ; Heart Rate* ; Humans ; Metaraminol ; Propranolol*

PURPOSE: There are few reports concerning the first-line treatment of choice for an overactive bladder. The aim of this study was to compare the effects of bladder training, tolterodine, and bladder training with tolterodine, as first-line treatments in patients with an overactive bladder. MATERIALS AND METHODS: A prospective randomized study was conducted on 99 female patients with overactive bladders. The patients were treated with bladder training, tolterodine (2mg twice daily), and bladder training with tolterodine, as first-line treatments, for 12 weeks. Of the 99 patients, 74 (bladder training: 24, tolterodine: 24, combined: 26) were followed up for 12 weeks. The treatment efficacy was measured by a micturition diary, subjective urgency scores and subjective perception of bladder condition at the end of the treatment. The safety and tolerability were assessed from adverse events and treatment withdrawals. RESULTS: After 12 weeks of treatment, the mean frequency of micturition and nocturia decreased by 27.1 and 55.8% in the bladder training group, 30.3 and 61.9% in the tolterodine group and 32.6 and 63.2% in the combined therapy group. The subjective mean urgency score decreased by 48.4, 62.5 and 63.2% in the three respective groups. The subjective perception of bladder symptom scores at the end of the treatments were 1.5, 1.42 and 1.31, with significant improvement rates of 50.0, 58.3 and 69.3% in the bladder training, tolterodine and combined therapy groups, respectively. Adverse events, and withdrawals due to adverse events, were 23.1 and 7.7% in the tolterodine and 28.6 and 7.1% in the combined therapy groups, but there were none in the bladder training group. CONCLUSIONS: Bladder training, tolterodine and combined therapy are all effective first-line treatments in female patients with overactive bladders. There are some enhanced effects with the combined therapy than with the bladder training and tolterodine monotherapies. Because of its high success rate, relatively low cost and absence of adverse events, bladder training should be included as a first-line treatment.
Female* ; Humans ; Nocturia ; Prospective Studies* ; Treatment Outcome ; Urinary Bladder* ; Urinary Bladder, Overactive* ; Urination ; Tolterodine Tartrate

PURPOSE: Nocturia has been one of the most bothersome symptoms in benign prostatic hyperplasia (BPH) patients. Therefore, the authors evaluated the effect of tolterodine and oxybutyninin on nocturia in BPH patients. MATERIALS AND METHODS: From September 2006 to March 2007, 82 patients who presented over than 2 in nocturnal bladder capacity index (NCBI) in spite of having alpha blockers for 6 months were enrolled. Group I (n=38) took alpha blocker with tolterodine, group II (n=44) took alpha blocker with oxybutynin. The number of their nocturia episodes was separately evaluated by the time before and after the medication. The complications were assessed using a questionnaire. RESULTS: The number of nocturia episodes decreased by at least 1 in 68.4% (26/38), 84.1% (37/44) of patients in group I, II, respectively, and decreased by 2 or more, 1 and were unchanged or increased were 36.8, 31.6, 31.6% in group I patients and 45.5, 38.6, 15.9% in group II patients, respectively. In baseline nocturia > or =6 group, the nocturia decreased by 1 or more in 66.7%, 77.8% in group I, II, respectively. Adverse events, including dry mouth, dizziness, headache, etc, occurred in 21.1% (8/38) in group I and 27.3% (12/44) in group II patients. The complications between two groups showed no significant differences. CONCLUSIONS: Alpha blockers with tolterodine or oxybutynin can be effectively combined as a treatment option for patients with BPH complaining of unresolved nocturia.
Dizziness ; Headache ; Humans ; Mouth ; Nocturia* ; Prostatic Hyperplasia* ; Surveys and Questionnaires ; Urinary Bladder ; Tolterodine Tartrate

Overactive bladder is a chronic condition defined by bothersome urgency with or without urgency incontinence, usually associated with daytime frequency and nocturia. The treatment of this condition is to control bothersome urinary symptoms and is therefore to improve quality of life. The Korean Continence Society published the overactive bladder guideline in 2007, which suggested the mainstay of management is behavioral therapy and antimuscarinic pharmacotherapy. With growing awareness toward overactive bladder and quality of life, clinical information regarding antimuscarinic agents should be updated. There are several agents with good level of evidence and good grade of recommendation. Newer antimuscarinic agents are available or will be available in near future. The pharmacological properties, efficacy and tolerability of oxybutynin, trospium, propiverine, tolterodine, darifenacin, solifenacin, fesoterodine and imidafenacin are reviewed and discussed here. The results of major clinical studies are summarized.
Cholinergic Antagonists* ; Drug Therapy ; Muscarinic Antagonists ; Nocturia ; Quality of Life ; Urinary Bladder, Overactive* ; Solifenacin Succinate ; Tolterodine Tartrate

PURPOSE: The aim of this study was to investigate the efficacy and adverse effects of oral tolterodine compared to oxybutynin in children with a neurogenic bladder. MATERIALS AND METHODS: 16 patients, with persistent daytime or nighttime wetting after oxybutynin medication for the treatment of a neurogenic bladder, were enrolled. All 16 patients had been crossed-over from oxybutynin to tolterodine due to serious side effects or lack of improvement. The mean age was 6.4 years (range 3 to 11), and the mean body weight was 22kg (range 16 to 33). All patients were initially treated with oral tolterodine, 2mg, twice daily. The efficacy of tolterodine was assessed in comparison to oxybutynin, and considered as improved with a greater than 50% reduction in wetting episodes, as stationary with a less than 50% reduction or as increased or aggravated with a greater than 50% increase. The tolerability was also assessed using a questionnaire for adverse events. RESULTS: The mean duration of tolterodine treatment was 193 days (range 14 to 940). After treatment with an initial tolterodine dose of 2mg bid, 5 patients (31%) were improved, 8 (50%) were stationary and 3 (19%) were aggravated. Overall, the initial tolterodine dose showed equal efficacy to that of oxybutynin (p=0.483). Of the 16 patients, side effects developed in 12 (75%) during the oxybutynin treatment, whereas only 2 (13%) developed side effects during the tolterodine treatment (p=0.001). CONCLUSIONS: Compared to oxybutynin, tolterodine was well tolerated in children, allowing greater compliance and offering an equally effective treatment for neurogenic incontinence in children with a neurogenic bladder. Therefore, it seems that tolterodine can be safely and effectively used to replace oxybutynin in children with a neurogenic bladder.
Body Weight ; Child* ; Compliance ; Humans ; Muscarinic Antagonists ; Surveys and Questionnaires ; Urinary Bladder ; Urinary Bladder, Neurogenic* ; Tolterodine Tartrate