Cardiovascular disorders shock

Cardiovascular Disorders. DA itself is a useful agonist where intravenous therapy is required for immediate effects limited to the periphery (i.e. outside the blood Drain barrier). It has therefore been employed as a pharmacolgical agent in shock - a condition in which there is no disease involving dopaminergic mechanisms, but where the inotropic actions on the heart and vasodilator effects on the kidney can reverse the potentially lethal consequences of profound arterial hypotension, whatever its cause. This subject is discussed in detail elsewhere in this symposium. 

Signs and symptoms the first signs and symptoms appear after 1-3 hours. Neuromuscular disturbances are the most prominent. Cardiovascular disorders are generally milder, and severe cardiac complications occur only when very high doses (>60 g) have been ingested. Other signs and symptoms include respi-304 ratory depression, tachycardia, hypotension or hypertension, shock, conduction disorders, coma. 

Anaphylaxis is the most dramatic and potentially catastrophic manifestation of allergic disorders. It can affect virtually any organ including the cardiovascular system. Cardiovascular collapse and hypotensive shock in anaphylaxis have been attributed to peripheral vasodilation, enhanced vascular permeability and plasma leakage, rather than any direct effect on the myocardium. However, there is increasing experimental and clinical evidence that the human heart is a site and target of anaphylaxis. 

Concentrated sodium chloride injection Inadvertent direct injection or absorption of concentrated sodium chloride injection may give rise to sudden hypernatremia and such complications as cardiovascular shock, CNS disorders, extensive hemolysis, cortical necrosis of the kidneys, and severe local tissue necrosis (if administered extravascularly). Do not use unless solution is clear. When administered peripherally, slowly infuse through a small bore needle placed well within the lumen... 

Nalepa I, Kreiner G, Kowalska M, Sanak M, Zelek-Molik A, Vetulani J (2002) Repeated imipramine electroconvulsive shock increase alpha(lA)-adrenoceptor mRNA level in rat prefrontal cortex. Eur J Clin Pharmacol 444 151-159 Nesse RM, Ciu-tis GC, Thyer BA, McCann DS, Huber-Smith MJ, Knopf RF (1985) Endocrine and cardiovascular responses during phobic anxiety. Psychosom Med 47 320-332 Nisenbaiun LK, Zigmund MJ, Sved AF, Abercrombie ED (1991) Prior exposure to chronic stress results in enhanced synthesis and release of hippocampal norepinephrine in response to a novel stressor. J Neurosci 11 1473-1484 Nutt DJ (1989) Altered alpha2-adrenoceptor sensitivity in panic disorder. Arch Gen Psychiatry 46 165-169... 

The neurotransmitter dopamine has currently found clinical application in the treatment of cardiovascular collapse and shock. Treatment with dopamine-related drugs has been limited to such brain disorders as Parkinson s disease, schizophrenia, and hyperprolactinemias. Accumulating data from animal experiments, however, indicate the possible involvement of dopamine in other diseases and the potential use of dopamine agonists or antagonists in these disorders. Gastrointestinal disturbances (especially duodenal ulcer disease) seem to represent such a group of dopamine-sensitive alterations. 

Clinical forms a) Foudroyant expressed by a quick lethal issue due to paralysis of respiration, shock and asystolia b) Cerebral paralytic (extremely severe) characterised by paralysis of bulbar centres, apnoea, paralysis of interbone and other nerves, conscience disorders, coma c) polyorgan respiratory coma (severe) acute respiratory and cardiovascular insufficiency are observed expressed by and combined with the symptoms described in the clinical picture. 

However, most pathological conditions, believed to involve derangements in the thromboxane biosynthesis - or in the thromboxane/prostacyclin balance - concern the cardiovascular system. A large number of diseases affecting this organ system have been studied in this respect, i.e. atherosclerosis, myocardial infarction, coronary artery disease with angina of various etiologies, thrombotic disorders, hemostatic defects, circulatory shock, ulcerative diseases, and so on. The possible roles of thromboxane and prostacyclin in the cardiovascular system have been discussed in several reviews, e.g. refs. 32, 33, 348-354. 

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