Adrenaline history

History. Up to 1948 it was known that the peripheral motor (vasoconstriction) effects of adrenaline were preventable and that the peripheral inhibitory (vasodilatation) and the cardiac stimulant actions were not preventable by the then available antagonists (ergot alkaloids, phenoxybenzamine). That... 

A 71-year-old man received intrathecal anesthesia using 0.3% cinchocaine 2 ml for a transurethral prostatectomy (8). He had a history of allergic rhinitis, and 2 months before had had an uneventful prostate biopsy and cystoscopy, also under spinal anesthesia with iso-baric bupivacaine. Within 45 minutes of the spinal injection he complained of periorbital itching, started to shake, and developed muscle rigidity. He rapidly became unconscious, with a systolic blood pressure of 40 mmHg and widespread erythema. He was treated with hydrocortisone and antihistamines and required an infusion of adrenaline. Intradermal testing after full recovery was positive with cinchocaine. 

A 17-year-old boy, with an 11-year history of asthma, had anaphylaxis with respiratory distress shortly after he received intravenous methylprednisolone for an exacerbation of asthma while taking a tapering course of oral prednisone 15 mg/day (259). He had been glucocorticoid-dependent for at least 1 year. He reported having received intravenous glucocorticoids previously. He was treated with inhaled salbutamol and then intravenous methylprednisolone 125 mg over 15-30 seconds, and 3-4 minutes later became flushed and dyspneic, and developed diffuse urticarial lesions on his trunk and face and an undetectable blood pressure. He was treated with adrenaline, but required intubation. Sinus bradycardia developed and then asystole. He was successfully resuscitated and a 10-15 seconds period of generalized tonic-clonic activity was treated with diazepam. He remained unresponsive to stimulation for... 

A 38-year-old white man with a history of coronary artery disease, myocardial infarction, coronary artery by-pass, alcoholism, and depression took a combined massive overdose of diltiazem and atenolol (24). He underwent cardiopulmonary resuscitation because of cardiac arrest bradycardia, hypotension, and oliguria followed and were resistant to intravenous pacing and multiple pharmacological interventions, including intravenous fluids, calcium, dopamine, dobutamine, adrenaline, prenalterol, and glucagon. Adequate mean arterial pressure and urine output were restored only after the addition of phenylephrine and transvenous pacing. He survived despite myocardial infarction and pneumonia. 

A 45-year-old white man, who had taken losartan, hydrochlorothiazide, allopurinol, and colchicine for 9 months, developed facial urticaria, eyelid swelling, shortness of breath, and upper chest tightness, which resolved quickly with famotidine, methylprednisolone, and adrenaline. He had a recurrence 7 hours later, not having taken another dose of losartan. The patient had no history of allergy and was well after losartan withdrawal. 

A 47-year-old man presented with a 4-day history of priapism and moderate pain. Several brief but otherwise similar episodes had occurred during the previous month. He had a history of depression and had been taking sertrahne 200 mg/day and dexamfetamine 10 mg/ day. He received intracorporeal methoxamine, but when this proved ineffective he was treated with intracorporeal adrenaline and a shunt procedure. However, detumescence was incomplete. At fohow-up after several weeks the priapism had resolved and he had not become impotent (a significant risk in cases of... 

Hypersensitivity reactions to potassium metabisulfite and other sulfites, mainly used as preservatives in food products, have been reported. Reactions include bronchospasm and anaphylaxis some deaths have also been reported, especially in those with a history of asthma or atopic allergy. " These reactions have led to restrictions by the FDA on the use of sulfites in food applications. However, this restriction has not been extended to their use in pharmaceutical applications. Indeed, epinephrine (adrenaline) injections used to treat severe allergic reactions may contain sulfites. ... 

A 38-year-old man with a history of hypertension and post-traumatic stress disorder who presented to the hospital with a chief complaint of chest pain and ECG changes. Earlier in the day the patient developed anaphylaxis and he was given 0.3 mg of adrenaline (i.m.) to his right thigh, with resolution of his symptoms. Shortly thereafter, he developed significant severe substerna 1 chest pain. An ECG demonstrated ST elevation of both inferior and anterolateral leads. A repeated ECG on arrival showed persistent 1-3 mm ST elevations of inferior and anterolateral leads [4 ]. 

The search for potent beta-adrenoceptor agonists (P2-agonists) for the treatment of asthma or chronic bronchitis has a long history and presumably started with the first reports on dyspnea in Chinese textbooks from 2600 The isolation and characterization of adrenaline in... 

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