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Antiasthma Agents during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Patients with an acute asthma attack should have a clinical assessment, including evaluation for symptoms suggestive of complications such as pneumonia or pneumothorax and for the presence of agitation, pulse paradoxus, severe wheezing, or cyanosis (Box 5.5). Beta-adrenergic agonists are a critical element of first-line pharmacological therapy (ACOG, 2008; Robin and Felder, 2021). The guidelines for management of asthma during pregnancy are given in Box 5.6. These actions include the medications listed in Table 5.2. During an acute asthma attack, 0.3–0.5 mL of epinephrine in a 1:1000 dilution is administered subcutaneously every 30 min. Alternatively; 0.25 mg of terbutaline in two to three doses can be given subcutaneously every 20–30 min. Some physicians advocate the use of inhaled beta agonists initially. Each dose should be followed by spirometry. Evaluation should include forced expiratory volume in 1 s (FEV) and peak expiratory flow rate (PEFR) (ACOG, 2008; Robin and Felder, 2021). Supplemental oxygen should be administered, as needed, to maintain a pO2 greater than 60 mmHg. Intravenous hydration is also important, along with respiratory care to remove the tenacious secretions.
Targeting the Nervous System
Published in Nathan Keighley, Miraculous Medicines and the Chemistry of Drug Design, 2020
The treatment of asthma demonstrates the usefulness of adrenergic agonists. Drugs specifically designed to target β2-receptors can be used to relax smooth muscle. In the treatment of asthma, this causes dilation of the airways, and because β2-adrenoreceptors predominate in the bronchioles, this allows for selectivity. Originally, adrenaline was used to treat asthma attacks, but because there was no selectivity for β2-receptors, it caused stimulation of adrenergic receptors around the body and particularly had cardiovascular side-effects. Elevated heart rate increased the bodies demand for oxygen which counteracts the effects of opening the airways. The use of adrenaline is restricted to emergencies now.
Surgical Facilities, Peri-Operative Care, Anesthesia, and Surgical Techniques
Published in Yuehuei H. An, Richard J. Friedman, Animal Models in Orthopaedic Research, 2020
Alison C. Smith, M. Michael Swindle
Alpha adrenergic agonists and antagonists include xylazine and medetomidine,21 which are the two most commonly used agents in this class. They are best utilized in combination with other agents to provide general anesthesia. Xylazine causes bradycardia, heart block, peripheral vasodilation and nausea in many species. These side effects can be counteracted with atropine. Medetomidine has less of the undesirable effects of xylazine. These agents have mild analgesic activity, which may be very transient in some species. They generally have activity for 20 min.11-16
Examination of the role of adrenergic receptor stimulation in the sensitization of neuroinflammatory-based depressive-like behavior in isolated Guinea pig pups
Published in Stress, 2023
Rachel R. Kessler, Patricia A. Schiml, Sean M. McGraw, Erin N. Tomlin, Mikayla J. Hoeferlin, Terrence Deak, Michael B. Hennessy
The mechanism by which early-life stress induces sensitization of neuroinflammatory signaling and depressive-like behavior in young guinea pigs remains unclear. While the nonspecific adrenergic agonist ephedrine was injected in Experiment 1, and Experiment 2 examined blockade of beta-adrenergic receptors, it remains possible that alpha-adrenergic receptors play a role. For example, alpha-adrenergic blockade has been found to inhibit neuroinflammatory signaling as a result of chronic sleep fragmentation (Wheeler et al., 2021), while alpha-1- adrenergic – but not beta-adrenergic – blockade inhibited neuroinflammatory signaling underlying demyelinating disease in rats (Brosnan et al., 1985). Similarly, we did not antagonize cortisol effects in Experiment 2, so it is possible that cortisol elevations are necessary for sensitization in our model.
History of asthma in Canada
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2022
Acute asthma treatment throughout the first half of the 20th century was dominated by the use of parenteral epinephrine.39–43 Epinephrine, a nonselective α and ß adrenergic agonist and an important autonomic neurotransmitter, was identified in 1901 and synthesized in 1904.44 Toward the end of this half-decade, mention is made of the acute use of nebulized epinephrine.43 Atropine received occasional mention39,41 but was regarded as less reliable.41 Aminophylline, administered either intravenously or rectally, was added to the treatment of acute asthma in the 1940s.42–43 The remainder of treatments were nonspecific and included morphine,41 ether,41 chloroform,41 potassium iodide,39,40 amyl nitrate1,3 and others.
Xylazine poisoning: a systematic review
Published in Clinical Toxicology, 2022
Noah S. Ball, Brittany M. Knable, Taylor A. Relich, Allyson N. Smathers, Michael R. Gionfriddo, Branden D. Nemecek, Courtney A. Montepara, Anthony J. Guarascio, Jordan R. Covvey, David E. Zimmerman
Xylazine (Rompun®, Anased®, Sedazine™, Chanazin®) is used in veterinary medicine, often in combination with ketamine, opioids, or barbiturates for anesthetic purposes. Xylazine was originally developed in the early 1960s by Bayer AG as an antihypertensive agent [1]. Further testing of the drug revealed central nervous system (CNS) effects which halted its further investigation in humans [1]. Xylazine is structurally similar to clonidine, phenothiazines, and imidazolines, and is highly lipophilic. It acts primarily as a presynaptic alpha-2 adrenergic agonist, inhibiting release of norepinephrine and dopamine in the CNS. These receptor interactions ultimately result in clinical effects, including sedation, muscle relaxation, and analgesia [2]. Xylazine is not currently approved by the US FDA for use in humans but is approved for use in a variety of animals (dogs, cats, horses, deer, and elk) [2].