Esmolol Clonidine

Unlike isoflurane, desflurane may stimulate the sympathetic nervous system at concentrations above 1 MAC. Sudden and unexpected increases in arterial blood pressure and heart rate have been reported in some patients, accompanied by increases in plasma catecholamine and vasopressin concentrations and increased plasma renin activity. These pressor effects may increase morbidity or mortality in susceptible patients. The mechanism of sympathetic activation is unclear but does not appear to be baroreceptor-mediated. Clonidine, esmolol, fentanyl and propofol partially block the response but lignocaine (lignocaine) is ineffective. 

Tetanus toxin often causes disturbances in autonomic control, resulting in sympathetic overactivity and high plasma catecholamine concentrations. The first-line treatment for autonomic dysfunction is by sedation with a benzodiazepine and opioid. Infusion of the short-acting i-blocker esmolol, or the o -adrenergic agonist clonidine, helps to control episodes of hypertension. Intravenous magnesium sulphate is also used to reduce autonomic disturbance. 

Also analyzed acebutolol, alprenolol, antazoline, atenolol, betaxolol, bisoprolol, bopindolol, bupranolol, carteolol, celiprolol, chlorop5Tamine, chlorpheniramine, cicloprolol, cinnari-zine, cirazoline, clonidine, dilevalol, dimethindene, diphenhydramine, doxazosin, esmolol, famotidine, isothipendyl, ketotifen, metiamide, metoprolol, moxonidine, nadolol, napha-zoline, nifenalol, nizatidine, oxprenolol, pheniramine, phentolamine, pindolol, pizotyline (pizotifen), practolol, prazosin, promethazine, propranolol, pyrilamine (mepyramine), ranitidine, roxatidine, sotalol, tiamenidine, timolol, tramazoline, tripelennamine, triproli-dine, tymazoline, UK-14,304... 

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