Pulmonary obstruction

Hypersensitivity to these agents depressed sodium or potassium serum levels marked kidney and liver disease or dysfunction suprarenal gland failure hyperchloremic acidosis adrenocortical insufficiency severe pulmonary obstruction with inability to increase alveolar ventilation since acidosis may be increased (dichlorphenamide) cirrhosis (acetazolamide, methazolamide) long-term use in chronic noncongestive angle-closure glaucoma. 

Pulmonary conditions These drugs may precipitate or aggravate acidosis. Use with caution in patients with pulmonary obstruction or emphysema when alveolar ventilation may be impaired. 

Contraindications Kidney or liver dysfunction, severe pulmonary obstruction, hypersensitivity to methazolamide or any component of the formulation... 

Patients should be excluded from beta-blocker treatment if they have significant cardiorespiratory diseases (asthma and other pulmonary obstructive diseases, congestive heart failures, angina), insulin-dependent di-... 

Pulmonary obstruction causes an increase in carbon dioxide and... 

Reactive oxygen species released by neutrophils may play a role in conditions, such as inflammatory bowel disease and chronic pulmonary obstructive disease. A thiazole that inhibits in vitro production of superoxide by human neutrophils is currently being investigated in the clinic. In a convergent scheme, bromination of acyl pyridine carboxylic acid... 

Verapamil can cause cardiac failure, because it has a potent negative inotropic effect and causes increased capillary filtration pressure by vasodilatation (1). There are also reports of drug-induced acute right heart failure in patients with pulmonary hjtpertension due to valvular heart and chronic pulmonary obstructive airways diseases (2). 

Indications Cold rheum internally amassed. Chronic tracheitis, acute and chronic bronchitis, bronchial asthma, pulmonary emphysema, chronic pulmonary obstructive disease, edema, ascites, chronic nephritis, atrophic kidney, pleurisy, beriberi, and cardiac asthma... 

Bronchodilation is another property of belladonna alkaloids of potential usefulness. Due to relaxation of the smooth musculature of bronchial passageways, this effect has found applications in asthma and other pulmonary obstructive conditions. At one time the smoking of cigarettes made of stramonium leaves was popular. More recently, atropine, quater-nized with isopropyl bromide (Ipratropium, Fig. 8-13) has been introduced as an aerosol for inhalation. This renewed interest in antimuscarinics resulted in part from clarifications of the role of the parasympathetic system in bronchial obstructions. The availability of a potent agent such as atropine in a poorly absorbed form (i.e., quatemized) would minimize systemic effects following inhalation. Ipratropium bromide does not cross the BBB. It is longer acting and more bronchoselective than atropine methylbromide and exhibits no CNS effects. 

It would theoretically be expected that cardioselective Pi blockers would be preferable agents. However, at the clinical level, other than in patients with pulmonary obstructive diseases, the favorable difference of Pi over nonselective compounds may be more apparent than real. 

Volatile cyanoacrylate monomers, in particular methyl and ethyl cyanoacrylates, have characteristic acrid odors. Exposure to these materials at levels in the range of 1-5 ppm results in irritation to the eyes, nose, and throat (3). It is recommended that these monomers be used in a well-ventilated area, that skin and eye contact be avoided, and that the user be familiar with the relevant safety data supplied by product manufacturers. A recent epidemiological study in workers with occupational exposure to monomer vapors concluded that there was no increased risk of pulmonary obstruction (eg, asthma) on exposure to average short-time concentrations of less than 0.5 ppm (60). Polymerization of cyanoacrylates is rapid and exothermic and particular care should be taken to avoid bums, which can result from the unexpected bulk polymerization of inadequately stabilized or contaminated monomer samples. 

Boutros AR, Weisel M. Comparison of effects of three anaesthetic techniques on patients with severe pulmonary obstructive disease. Can Anaesth Soc J 1971 18 286-292. 

---