Physical exercise

Hypotension is defined as abnormally low blood pressure. In most cases, hypotension is adequately treated with general measures (e.g. physical exercise), dtug treatment is rarely required. Drugs used for the treatment of hypotension include a-adrenoceptor agonists and compounds which activate both a and (3 adrenoceptors. 

McGilvery, R.W. (1975). The use of fuels for muscular work. In Metabolic Adaptations to Prolonged Physical Exercise (Howald, H. Poortmans, J.R., eds.), pp. 12-30, Birkhauser Verlag, Basel. 

Lukaszewicz-Hussain A, Moniuszko-Jakoniuk J, Pawlowska D. 1985. Blood glucose and insulin concentration in rats subjected to physical exercise in acute poisoning with parathion-methyl. Pol J Pharmacol Pharm 37 647-651. 

Pawlowska D, Moniuszko-Jakoniuk J, Soltys M. 1985a. Parathion-methyl effect on the activity of hydrolytic enzymes after single physical exercise in rats. Pol J Pharmacol 37 629-638. 

Packer, L. (1984). Vitamin E, physical exercise and tissue damage in animals. Med. Biol. 62, 105-109. 

Quintanilha, A.T. and Packer, L. (1983). Vitamin E, physical exercise and tissue oxidative damage. In Biology of Vitamin E (eds. R. Porter and J. Whelan), pp. 56-69. Ciba Foundation Symposia Series No. 101. Pitman, London. 

Sastre, J., Asensi, M., Gasco, E., Pallardo, F.V., Ferrero, J.A., Furukawa, T. and Vina, J. (1992). Exhaustive physical exercise causes oxidation of glutathione status in blood prevention by antioxidant administration. Am. J. Physiol. 263, R992-R995. 

Transcranial magnetic stimulation is a non-invasive and well-tolerated procedure that has shown promise as a novel antidepressant treatment.21 Some data show that physical exercise... 

Blood flow to the GIT increases shortly after a meal and may last for several hours. Digestive processes in general seem to enhance blood flow to the tract. For the reasons discussed previously, however, coadministration of a drug with a meal would normally not be expected to improve drug absorption. Strenuous physical exercise appears to reduce blood flow to the tract and may reduce absorption rate. 

When an Alchemist Speaks of Mercury, Sulphur and Salt, He Speaks of His Spiritual, Astral and Physical Bodies, Not of the Elements. Alchemy Unveiled Describes the Tribulations That a Human Being Has to Pass Through in Order to Purify These Three Bodies. However, to Achieve the Level of an Alchemist Requires Daily Study and Strict Daily Mental, Astral and Physical Exercises for Many Lifetimes. Alchemy Unveiled Will Lead the Reader on a Journey of a Complete Purification of the Body, Soul and Spirit, and for the First Time the Mystery of the Philosopher s Stone Is Openly Explained... 

Physical exercise as a treatment for clinical depression has not been studied as extensively as dmgs or psychotherapy, but there are a number of clinical trials evaluating its effectiveness.41 In some of these studies, exercise was compared to no treatment at all. In others, it was compared to psychotherapy, medication or attention-control procedures intended to control for the nonspecific placebo aspects of the exercise programme. Some of the trials also looked at the combination of physical exercise with... 

There seems to be considerable reluctance in some parts of the medical community to acknowledge the benefits of exercise in the treatment of depression. One meta-analysis of clinical trials showed that physical exercise was as effective as psychotherapy or antidepressant medication and much better than no treatment. But the authors concluded that the effectiveness of exercise in reducing symptoms of depression cannot be determined ,45 and the editors of the journal introduced the article with an editorial comment entitled effectiveness of exercise in managing depression is not shown by meta-analysis .46 Why not Because there were flaws in the way many of the studies had been designed. To be fair, there were indeed shortcomings in the studies, but these shortcomings also characterize clinical trials of antidepressants.47 If clinical trials like these do not establish the effectiveness of physical exercise as a treatment for depression, neither do they establish the effectiveness of antidepressants. 

How does physical exercise alleviate depression One possibility is that it increases the release of endorphins that produce a sense of well-being, sometimes referred to as the runner s high . Another possibility is that it is a placebo effect. But even if it is a placebo effect, consider the differences between exercise and antidepressants in side effects. Side effects of antidepressants include sexual dysfunction, nausea, vomiting, insomnia, drowsiness, seizures, diarrhoea and headaches. Side effects of physical exercise include enhanced libido, better sleep, decreased body fat, improved muscle tone, greater life expectancy, increased strength and endurance and improved cholesterol levels. So if both antidepressants and exercise work by means of the placebo effect, which placebo would you prefer ... 

If physical exercise is as effective as psychotherapy, why bother with psychotherapy at all Why not just prescribe exercise It is true that exercise is as effective as psychotherapy when all forms of psychotherapy are lumped together, but when different types of psychotherapy are compared with exercise, a somewhat different picture emerges.48 Exercise is about as effective as psychodynamic... 

Depression is a serious problem, but drugs are not the answer. In the long run, psychotherapy is both cheaper and more effective, even for very serious levels of depression. Physical exercise and self-help books based on CBT can also be useful, either alone or in combination with therapy. Reducing social and economic inequality would also reduce the incidence of depression. 

For people who are depressed, and especially for those who do not receive enough benefit from medication or for whom the side effects of antidepressants are troubling, the fact that placebos can duplicate much of the effects of antidepressants should be taken as good news. It means that there are other ways of alleviating depression. As we have seen, treatments like psychotherapy and physical exercise are at least as effective as antidepressant drugs and more effective than placebos. In particular, CBT has been shown to lower the risk of relapsing into depression for years after treatment has ended, making it particularly cost-effective. 

One of us examined the timely use of three factors (melatonin treatment, exposure to light, physical exercise) to hasten the resynchronization of the sleep-wake cycle in a group of elite sports competitors after a transmeridian flight across 12 time zones (Cardinali et al. 2002). Outdoor light exposure and physical exercise were used to cover symmetrically the phase delay and the phase advance portions of the phase-response curve. Melatonin taken at local bedtime helped to resynchronize the circadian oscillator to the new time. Individual actograms taken from sleep log data showed that all subjects became synchronized in their sleep to the local time in 24-48 h, well in advance of what would be expected in the absence of any treatment (Cardinali et al. 2002). More recently, a retrospective analysis of the data obtained from 134 normal volunteers flying the Buenos Aires - Sydney transpolar route in the past 9 years was published this further supports such a role for exogenous melatonin in resynchronization of sleep cycles (Cardinal et al. 2006). 

If opiates are such addictive and potentially lethal compounds, why does the body respond to them As with the cannabinoids (Chapter 7), it has been discovered that the body and brain possess numerous opiate-specific receptor sites. As many as nine receptor subtypes have been identified, with three of them being the most important p (mu), k (kappa) and 8 (delta). The finding that the distribution of opiate receptors did not parallel the distribution of any known neurotransmitter prompted the search for and identification of a number of endogenous compounds specific to these receptors. These enkephalins and endorphins are manufactured within the brain and other body systems (especially the gut and intestines) and form the body s natural response to pain. They appear to be produced in bulk chains of amino acids called polypeptides , with each active neurotransmitter being composed of around five amino acid molecules. These active neurotransmitters are subsequently cleaved from the larger polypeptides at times of demand for example, it has been demonstrated that the plasma levels of these active compounds rise during childbirth, traumatic incidents and vigorous physical exercise. 

Physical exercise has been investigated in a number of studies. The relationship between exercise and cognitive performance has been studied in both older adults (Kramer et al., 2000 Wood et al., 1999 Laurin et al., 2001) and young, healthy volunteers. The general consensus is of beneficial effects. In a classic cross-sectional study Spirduso and Clifford (1978) demonstrated that reaction time among older adults... 

Hogervorst E, Riedel W, Jeukendrup A and Jolles J (1996). Cognitive performance after strenuous physical exercise. Perceptual and Motor Skills, 8, 479-488. 

Sparrow WA and Wright BJ (1993). Effects of physical exercise on the performance of cognitive tasks. Perceptual and Motor Skills, 77, 675-679. 

Because total cholesterol is composed of cholesterol derived from LDL, VLDL, and HDL, determination of HDL is useful when total plasma cholesterol is elevated. HDL may be elevated by moderate alcohol ingestion (fewer than two drinks per day), physical exercise, smoking cessation, weight loss, oral contraceptives, phenytoin, and terbutaline. HDL may be lowered by smoking, obesity, a sedentary lifestyle, and drugs such as /1-blockers. 

Constipation commonly occurs during pregnancy. Nondrug modalities such as education, physical exercise, biofeedback, and increased intake of dietary fiber and fluid should be instituted first. 

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