Stokes-Adams attack

Three cases of carbamazepine-induced Stokes-Adams attacks caused by intermittent total atrioventricular block, sinoatrial block with functional escape rhythm, and intermittent asystole have been described it was suggested that cardiac conduction should be assessed if syncope or changes in seizure tjrpe occur in patients taking carbamazepine (5). 

Physicians routinely used intravenous ephedrine for the prophylaxis and treatment of hypotension caused by spinal anesthesia particularly during caesarean section (9). In the past, ephedrine was used to treat Stokes-Adams attacks (complete heart block), and was also recommended as a treatment for narcolepsy. Over the years, ephedrine has been replaced by other, more effective agents (10), and the advent of highly selective [3-agonists has mostly eliminated the need to use ephedrine in treating asthma. 

In the past, ephedrine was used to treat Stokes-Adams attacks with complete heart block and as a CNS stimulant in narcolepsy and depressive states. It has been replaced by alternate treatments in each of these disorders. In addition, its use as a bronchodilator in patients with asthma has become much less extensive with the development of p2-selective agonists. Ephedrine has been used to promote urinary continence, although its efficacy is not clear. Indeed, the drug may cause urinary retention, particularly in men with benign prostatic hyperplasia. Ephedrine also has been used to treat the hypotension that may occur with spinal anesthesia. 

Possibly bradycardia-induced syncope (known as a Stokes-Adams attacks... 

Bradycardia-induced syncope may occur and is known as a Stokes-Adams attack. 

Ephedrine may be used with success in combating the fall of blood pressure in spinal anesthesia, in the treatment of bronchial asthma (bronchodilatation), hay fever, and other allergic conditions. It relieves whooping cough. Ephedrine has been used both for the prevention and the cure of attacks of heart block known as Stokes-Adam s syndrome. Use of ephedrine in the prevention of the pathological sleep of narcolepsy is now replaced by its more efficient chemical relative, deoxynorephedrine (Benzedrine). Ephedrine is of value in the treatment of myasthenia... 

Penicillamine has no direct effect on the cardiovascular system. However, penicillamine-associated polymyositis can involve cardiac muscle and cause dysrhythmias, Adams-Stokes attacks, and death. Necrotizing vasculitis can occur as an immunological reaction to penicillamine... 

Effects vary from only biochemical abnormalities, through moderate muscular weakness, to severe polymyositis with myolysis and sometimes myocarditis. There can be dysrhythmias, heart block, and Adams-Stokes attacks (362) and deaths have occurred (96). Muscle weakness can cause secondary respiratory failure (56,321). The clinical, pathological, and electromyographic features are similar to those of idiopathic polymyositis. 

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