Thrombosis adrenaline

Local injection treatment methods for non-varicose bleeding have proved uncomplicated, quick to carry out, independent of location, extremely reasonable in terms of cost and also very successful. Absolute alcohol, adrenaline, pohdocanol and hypertonic sodium solution are among the active substances used. (26) A combination of suprarenin and pohdocanol has meanwhile been established as first choice adrenaline (0.005—0.01%) is injected into the mucous membrane surrounding the lesion in order to induce vasoconstriction. Directly afterwards, pohdocanol (1%) or a hypertonic NaCl solution may be injected at the edges of the lesion, resulting in local oedema with vascular compression and thrombosis. The reported effectiveness of this method for primary haemostasis is 83—100%, and definitive haemostasis is attained in 91 —94% of cases. The complication rate is < 1%. 

Central retinal vein thrombosis occurred in a 75-year-old man 20 minutes after the ipsilateral insertion of a 1 % adrenaline-soaked cotton wool stick (15). Unfortunately, his visual acuity did not improve. 

Ginsenoside Rgi had no effect on arachidonate metabolism, but it did reduce the elevation of cytosolic free calcium concentration [Ca2+]i shown in the second phase (Ca2+ influx) induced by adrenaline and thrombin "Fig. (37)". The results suggest that ginsenoside Rgl in red ginseng roots may be effective as a drug for the treatment of arteriosclerosis and thrombosis. 

The difficulty in obtaining satisfactory evidence may be due to the fact that thrombosis is a local circulatory problem which will require release of heparin locally for control. Such amounts will not be apparent in gross biochemical tests either as an increase in plasma concentration or a decrease in concentration in tissue. It is probable that heparin will be like other auto-pharmacological agents (e.g. adrenalin, steroids, insulin) in that the amount of heparin in the general circulation at any one time is only a secondary reflection of secretion levels. More important is the determination of rate of urinary excretion of metabolites and still more important the determination of rate of secretion by the glandular tissue (mast cells) itself. 

Concurrently, emotional stress stimulates the sympathetic nervous system that enhances the secretion of catecholamines (adrenaline and norepinephrine), which can cause increased platelet aggregation, predisposing to blood clot and thrombosis formation. This may lead to blood vessel constriction, occlusion and spasm. The latter may result in unstable angina, myocardial infarction, and sudden cardiac death. 

Often one of the earliest therapeutic principles a medical student learns is that adrenaline is key in the treatment of anaphylaxis. A very unusual case from Glasgow suggests that this life-saving use of the drug can produce late thrombosis in a drug-eluting coronary stent [61" ]. 

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