Peripheral ischemia

Atherosclerosis is a condition of the organism characterized by elevated levels of atherogenic lipoproteins in blood plasma, lipid deposits (including cholesterol) in the form of esters inside walls of the arterial system, and it is expressed by a gradual difficulty of blood circulation. The most appropriate name for this disease is lipoproteinemia. Clinically, it is manifested in the form of ischemic heart disease, stroke, abnormal cerebral blood flow, and peripheral ischemia. 

Most adverse effects are mild and transient and rarely require withdrawal of therapy. Cardiovascuiar Bradycardia torsade de pointes and other serious new ventricular arrhythmias chest pain hypertension hypotension peripheral ischemia pallor flushing worsening of angina and arterial insufficiency shortness of breath ... 

Acebufolol adminisfration may precipitate CHF or MI in patients with heart disease thyroid storm in those with thyrotoxicosis or peripheral ischemia in those with existing peripheral vascular disease. 

Contraindications Concomitant use of ergot derivatives (causes peripheral ischemia of extremities and vasospasm), flecainide, midazolam, pimozide, propafenone (increases the risk of serious cardiac arrhythmias), or triazolam (increases sedation or respiratory depression) hypersensitivity to lopinavir or ritonavir... 

Unlabeled Uses Adie s syndrome diagnosis, familial dysautonomia diagnosis, peripheral ischemia, parotitis... 

Nifedipine may precipitate CHFand MI in patients with cardiac disease and peripheral ischemia,... 

Chekanov VS, Zargarian M, Baibekov IM, etal. Deferoxamine-fibrin accelerates angiogenesis in a rabbit model of peripheral ischemia. Vase Med 2003 8(3) 157-162. 

Contraindications include hypotension, second and third degree heart block, cardiogenic shock and overt cardiac failure, peripheral ischemia, and bronchospasm. 

Serious, life-threatening peripheral ischemia (ergotism) has resulted from the use of CYP3A4 inhibitors (e.g., macrolide antibiotics and HIV protease inhibitors) with Cafergot, and a black box warning has been added to the drug information literature about this drug (106,119). 

The hypertensive crisis that can follow the withdrawal of clonidine can be accentuated by beta-blockers. It has also been reported that when beta-blockers are used in conjunction with drugs that cause arterial vasoconstriction they can have an additional effect on peripheral perfusion, which can be hazardous. Thus, combining beta-blockers with ergot alkaloids, as has been recommended for migraine, can cause severe peripheral ischemia and even tissue necrosis (408). 

Severe peripheral ischemia (even leading to dermal necrosis) can occur, as with dopamine (20). 

Case Conclusion KO is experiencing peripheral vasospasm from an interaction between his ergotamine and the erythromycin. It is also recommended that KO not exceed 6 tablets of ergotamine per migraine attack or 10 tablets per week. Acute ergotism can be manifested when these agents are u d concurrently, manifesting as peripheral ischemia. Nitro-prusside IV may be required In more severe cases. 

Many patients with advanced peripheral arterial disease are more limited by the consequences of peripheral ischemia than by myocardial ischemia. In the cerebral circulation, arterial disease may be manifest as stroke or transient ischemic attacks. The painful symptoms of peripheral arterial disease in the lower extremities (claudication) typically are provoked by exertion, with increases in skeletal muscle O2 demand exceeding blood flow impaired by proximal stenoses. When flow to the extremities becomes critically limiting, peripheral ulcers and rest pain from tissue ischemia can become debilitating. 

The concurrent use of beta-adrenergic-receptor-blocking agents and methysergide may resnlt in peripheral ischemia manifested by cold extremities with possible peripheral gangrene. 

Papaverine, a benzyhsoquinohne derivative with peripheral vasodilating properties (300 mg p.o. t.i.d.), is indicated in the relief of cerebral and peripheral ischemia associated with arterial spasm and myocardial ischemia it is used in the treatment of coronary occlusion and certain cerebral angiospastic states. 

Baroreceptor reflex effects, such as tachycardia, palpitation, and arrhythmia effects due to decreased tension, such as edema, and postural hypotension and effects due to decreased oxygen delivery, such as peripheral ischemia, dizziness, syncope, vertigo, and lightheadedness. 

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