Hypertension arrhythmias and

The toxins from Bufo species of toads are venom complexes that have a distinct cardioactive digitalislike action. Toxic signs include profuse salivation with pulmonary edema, cardiac arrhythmia, hypertension, and prostration. Convulsions and death due to cardiac arrest may occur as early as 15 min after exposure to the toxin. Susceptible populations include children and pet dogs or cats playing with toads. 

Acebutolol. Acebutolol hydrochloride is a hydrophilic, cardioselective P-adrenoceptor blocker that has about 1/25 the potency of propranolol in this regard. The dmg has moderate ISA and weak membrane stabilizing activities. It is approved for the treatment of hypertension and ventricular arrhythmias, especially PVCs. Acebutolol should produce minimal depression of heart rate because of its ISA (32). 

These dragp are used with caution in patients with tachycardia, cardiac arrhythmias, hypertension, hypotension, those with a tendency toward urinary retention, those with decreased liver or kidney function, and those with obstructive disease of the urinary system or gastrointestinal tract. The anticholinergic drugp are given with caution to the older adult. 

Adverse reactions include transitory stinging on initial instillation, blurring of vision, mydriasis, increased redness, irritation, discomfort, and increased IOP. Systemic adverse reactions include headache, browache, palpitations, tachycardia, arrhythmias, hypertension, myocardial infarction, and stroke. 

The answer is b. (Hardmanr p 444.) This patient ate tyramine-rich foods while taking an MAOI and went into hypertensive crisis. Tyramine causes release of stored catecholamines from presynaptic terminals, which can cause hypertension, headache, tachycardia, cardiac arrhythmias, nausea, and stroke. In patients who do not take MAOls, tyramine is inactivated in the gut by MAO, and patients taking MAOls must be warned about the dangers of eating tyramine-rich foods. 

Episodes may be caused by obesity or fixed upper airway lesions, enlarged tonsils, amyloidosis, and hypothyroidism. Complications include arrhythmias, hypertension, cor pulmonale, and sudden death. 

Cardiovascular manifestations include hypertension and cardiac arrhythmias (e.g., heart block, atrial flutter, paroxysmal atrial tachycardia, ventricular fibrillation, and digitalis-induced arrhythmias). In severe hypokalemia (serum concentration <2.5 mEq/L), ECG effects include ST-segment depression or flattening, T-wave inversion, and U-wave elevation. 

Angiotensin-converting enzyme inhibitors are indicated for use in hypertension and heart failure. Angiotensin-converting enzyme inhibitors have no use in the management of arrhythmias. 

Respiratory and cardiovascular effects of maitotoxin have been studied in pentobarbital anaesthetized cats (21). Sublethal doses of maitotoxin induced an important hyperventilation phase, hypertension and a transitory tachycardia followed by slight bradycardia. Higher dosage caused respiratory depression, cardiac arrhythmias and tachycardia leading to cardiac failure. Artificial respiration did not modify the cardiac responses. 

Verapamil is used for preventing angina pectoris attacks, arterial hypertension, and treating and preventing supraventricular arrhythmia (paroxysmal supraventricular tachycardia, atrial fibrillation, atrial flutter, extrasystole). Synonyms of this drug are isoptin, calan, fmoptin, falicard, manidone, and many others. 

Verapamil is used to prevent attacks of stenocardia, arterial hypertension, and to treat and prevent supraventricular arrhythmia. 

Hypotension Hypotension (postural) occurs regularly in about 50% of patients while they are supine, manifested by dizziness, light-headedness, vertigo, or faintness. Tolerance occurs unpredictably but may be present after several days. Hypotension with supine systolic pressure above 75 mm Hg need not be treated unless symptomatic. If supine systolic pressure falls below 75 mm Hg, infuse dopamine or norepinephrine to increase blood pressure use dilute solution and monitor blood pressure closely because pressor effects are enhanced by bretylium. Perform volume expansion with blood or plasma and correct dehydration where appropriate. Transient hypertension and increased frequency of arrhythmias Transient hypertension and increased frequency of arrhythmias may occur due to initial release of norepinephrine from adrenergic postganglionic nerve terminals. 

Cardiovascular effects Use with caution in patients with cardiovascular disorders including coronary insufficiency, ischemic heart disease, history of stroke, coronary artery disease, cardiac arrhythmias, CHF, and hypertension. 

Adverse reactions may include transient stinging and burning eye pain/ache browache headache allergic lid reaction conjunctival hyperemia conjunctival or corneal pigmentation ocular irritation (hypersensitivity) localized adrenochrome deposits in conjunctiva and cornea (prolonged use) reversible cystoid macular edema (may result from use in aphakic patients) palpitations tachycardia extrasystoles cardiac arrhythmia hypertension faintness. 

Adverse reactions may include tachycardia arrhythmias hypertension burning and stinging conjunctival injection. 

Fluid overload occurs commonly in patients with renal failure, often in the absence of associated heart disease. If salt and water intake is not controlled in the patient who is oliguric or anaemic, plasma volume and symptoms of congestive heart failure ensue. Hypertension and coronary heart disease with increasing age contributes to the congestive heart failure. Diuretics like loop-diuretics or metolazone may be of value. Digitalis should be used with caution in patients on dialysis as cardiac arrhythmias may ensue in patients receiving dialysis in the presence of hypokalemia. 

The greatest hazards of accidental overdosage with epinephrine and norepinephrine are cardiac arrhythmias, excessive hypertension, and acute pulmonary edema. Large doses of isoproterenol can produce such excessive cardiac stimulation, combined with a decrease in diastolic blood pressure, that coronary insufficiency may result. It also may cause arrhythmias and ventricular fibrillation. Tissue sloughing and necrosis due to severe local ischemia may follow extravasation of norepinephrine at its injection site. 

Besides stimulating the CNS, these drugs activate the autonomic nervous system. Individuals have tachycardia, hypertension, and possibly arrhythmias. Autonomic hyperactivity is also expressed as hyperthermia and mydriasis. More serious effects include the possibility of myocardial infarction, cerebrovascular hemorrhage, seizure, and death. 

MDA, which is similar to MDMA, has been termed the love drug because it produces a feeling of closeness to others. Typically, a dose of 75 mg produces the primary psychotomimetic effects, while a dose of 150 mg produces LSD-like effects, and a dose of 300 mg produces amphetaminelike CNS stimulation. The amphetaminelike stimulation of the CNS and periphery is prominent with both MDA and MDMA. To a lesser degree this stimulation also occurs with LSD. The effects that can be produced by stimulatory doses of hallucinogens include tachycardia, hypertension, and arrhythmias. 

Patients treated with recommended dosages of epinephrine will complain of feeling nervous or anxious. Some will have tremor of the hand or upper extremity and many will complain of palpitations. Epinephrine is dangerous if recommended dosages are exceeded or if the drug is used in patients with coronary artery disease, arrhythmias, or hypertension. The inappropriate use of epinephrine has resulted in extreme hypertension and cerebrovascular accidents, pulmonary edema, angina, and ventricular arrhythmias, including ventricular fibrillation. 

The hypercalcemia resulting from hypervitaminosis D is responsible for toxic symptoms such as muscle weakness, bone pain, anorexia, ectopic calcification, hypertension, and cardiac arrhythmias. Toxicity in infants can result in mental and physical retardation, renal failure, and death. 

Overdosage results in severe respiratory depression, skeletal muscle flaccidity, bronchospasm, cardiovascular disturbances, such as CHF, hypotension or hypertension, arrhythmias, cold and clammy skin, cyanosis, and coma. 

Later signs of overdosage are evidenced by polyuria, polydipsia, anorexia, weight loss, nocturia, photophobia, rhinorrhea, pruritus, disorientation, hallucinations, hyperthermia, hypertension, and cardiac arrhythmias. 

Multivalvular heart disease, primary pulmonary hypertension and arrhythmias occur rarely... 

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