Hypotension blood substitutes

Secondary hypotension is a sign of an underlying disease that should be treated first. If stroke volume is too low, as in heart failure, a cardiac glycoside can be given to increase myocardial contractility and stroke volume. When stroke volume is decreased due to insufficient blood volume, plasma substitutes will be helpful in treating blood loss, whereas aldosterone deficiency requires administration of a mineralocor-ticoid (e.g., fludrocortisone). The latter is the drug of choice for orthostatic hypotension due to autonomic failure. A parasympatholytic (or electrical pacemaker) can restore cardiac rate in bradycardia. 

In severe anaphylaxis, hypotension is due to vasodilation and loss of circulating volume through leaky capillaries. Colloid is more effective at restoring blood volume than crystalloid and 1-21 of plasma substitute should be infused rapidly. Oxygen and artificial ventilation may be necessary. Advice on the management of anaphylactic shock may be altered from time to time check the UK Resuscitation Council website (www.resus.org.uk) for current information. 

A number of substituted l,it-diazabicyclo [ t. t.O]decanes have been synthesized and shown to lower the blood pressure of 5,5-dial3ylbarblturic acid - anesthetized cats upon intravenous administration. It appears that the hypotensive... 

The vasoconstrictor effect of adrenaline should cause hypertension. However, paradoxical hypotension has been reported in three patients with massive quetiapine overdose, in whom the blood pressure fell dramatically after infusion of adrenaline hemodynamic stability was restored when noradrenaline was substituted for adrenaline [67 ]. 

The highly substituted tetrahydroisoquinolines (XXXII, R = PhCH and CH-s) lower the blood pressure of anesthetized dogs by 30 mm Hg for 1 hour at 10 and k mg/kg (l.v.) respectively 82 a reduction of 0% more for at least k.S hours occurs after giving several 4-substituted aminoquinolines (XXXIII).83 The benzocycloheptenes (XXXIV, a and b) show hypotensive activity In rats at 10 and 20 mg/kg (i.v.)... 

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