China
Africa
Explore chapters and articles related to this topic
Drugs and Therapeutics
Published in James Sherifi, General Practice Under the NHS, 2023
Adrenaline is primarily used by GPs in a self-administered, subcutaneous, injectable form for emergency use in severe anaphylaxis. Due to the relatively infrequent occurrence of such emergencies, vigilance is needed to ensure that the expiry date on the device has not been exceeded prior to plunging the needle into the patient’s thigh. However, where needs must, doctors have been known to ignore this advice, with no adverse consequences. Phenbenzamine, Chlorpheniramine—1948Allergy Antihistamines were first made available to patients around the same time as the NHS came into being. Phenbenzamine, the first compound in this group, was discovered by a Swiss-born Italian pharmacologist, Daniel Bovet, who won the Nobel Prize for Physiology and Medicine in 1957.
Cardiovascular disease
Published in Sally Robinson, Priorities for Health Promotion and Public Health, 2021
When we are stressed, the body’s instinct to survive kicks in, and we are primed to ‘fight’, ‘flight’ or ‘freeze’. The hormone cortisol triggers the release of glucose into the bloodstream. It also increases chronic low-grade inflammation throughout the body, which encourages the blood vessel walls to become scarred and constricted, so blood pressure rises. At the same time, adrenaline increases the heart rate, quickens the blood flow to the brain and muscles, and also increases blood pressure. We are in high alert. After the stress has passed, the parasympathetic nervous system returns the body to rest. However, for people experiencing high levels of chronic stress, their bodies remain in a state of readiness with the high blood glucose, rapid heart rate and high blood pressure damaging their heart and the artery walls. How we deal with stress, such as drinking alcohol, smoking tobacco, eating ‘comforting’ high fat/sugar foods or being sedentary, can also contribute to atherosclerosis.
The Development of Beta Receptor Agonist Drugs
Published in Richard Beasley, Neil E. Pearce, The Role of Beta Receptor Agonist Therapy in Asthma Mortality, 2020
When adrenaline was first synthesized in the early 1900s, one of the hypotheses used to explain asthma invoked vasodilatation. Because the vasoconstrictor effects of adrenaline were being studied at that time, it seemed logical that adrenaline should be effective in asthma. The marked effectiveness of adrenaline was used to support this “vascular” theory of asthma.9 An alternative hypothesis that asthma occurred because of bronchospasm subsequently received support when adrenaline was shown to relax isolated airway preparations. By the 1950s adrenaline was well recognized as one of the most powerful bronchodilators available to physicians for treating asthma, and it was used in many forms including an intramuscular injection in oil, an early attempt to increase the duration of a bronchodilator response. Although Hyde Salter is better known for his contributions to the history of the use of xanthines in asthma, it is interesting to note that in the 1860s he had described an “instantaneous cure of asthma” by “violent emotions”;9 he may have been observing a beneficial bronchodilator effect of endogenous adrenaline.
Beta-blocker carteolol and oxprenolol produce cutaneous analgesia in response to needle pinpricks in the rat
Published in Neurological Research, 2023
To prolong the duration of the nerve block, a mixture of local anesthetics and adrenaline was administrated [11]. Adrenaline helps to minimize blood loss, lowers the risk of toxicity, prevents systemic absorption, and thus extends the duration of action [32,33]. The addition of epinephrine (non-selective alpha- and beta-adrenergic agonist) prolonged the duration of action of oxprenolol or carteolol (non-selective beta-adrenergic blocking agent). Our data suggest that alpha-adrenergic receptors may be a critical role in prolonging the duration of local anesthetic action. The effect (AUC) of carteolol+epinephrine combination, oxprenolol+epinephrine combination, or bupivacaine+epinephrine combination was almost 1.7-, 1.9-, and 2.9-times larger than carteolol, oxprenolol, or bupivacaine alone, respectively. Our results are similar to the previous study that found that lidocaine 1% plus epinephrine (1:200,000) was comparable to the higher dose of lidocaine when performing ear surgery [34]. Despite their recognized action in stabilizing membranes [4], beta-blockers have other functions, we still cannot omit information about the greater selectivity of the compounds for beta-adrenergic receptors that make it difficult to explore target mechanisms. Accordingly, in the presence of a non-selective ß-blocker, the α effect is not opposed and may result in increased vasoconstriction with a prolongation of the local anesthetic effect.
Development of a Novel IgG1 Anaphylaxis Mouse Model with Uniquely Characteristic Skin Manifestations Induced Through the FcγRIII-Histamine Pathway
Published in Immunological Investigations, 2023
Masato Terashi, Kouya Yamaki, Yutaka Koyama
Anaphylaxis is a hypersensitivity reaction classified as a type I allergy (Warrington et al. 2011). Re-exposure to the same antigen in sensitized patients can cause various symptoms: pruritus, edema, hypotension, erythema, and dyspnea (Reber et al. 2017). Anaphylaxis, which can be life-threatening, may be caused by ingestion of food, insect sting, or administration of medicines (Singer et al. 2015). Drug-related anaphylaxis is mainly reported in cases involving antibiotics, antibody drugs, non-steroidal anti-inflammatory drugs, radiocontrast agents, and acetaminophen (Yu et al. 2020). The first line of treatment for anaphylaxis is intramuscular adrenaline. Other than adrenaline, antihistamines and steroids are administered, all of which are symptomatic treatments (LoVerde et al. 2018). Disease-modifying treatment includes oral immunotherapy for food allergies; however, it is not complete, and the risk of developing symptoms remains (Commins 2017). Patients at risk are, therefore, forced to reduce their exposure to causative agents such as drugs and foods.
IgE-mediated gastroallergic anisakiasis with eosinophilic oesophagitis: a case report
Published in Acta Clinica Belgica, 2022
Philippe Decruyenaere, Beatrice Van de Maele, Eva Hulstaert, Hans Van Vlierberghe, Johan Decruyenaere, Hilde Lapeere
We report a case of gastroallergic anisakiasis, in which the patient developed an acute food-induced IgE-mediated hypersensitivity reaction as well as concurrent gastro-intestinal manifestations after consumption of raw fish. Anisakis allergy has to be considered as causative agent in patients presenting with acute urticarial rash and anaphylaxis, especially when symptoms occur after consumption of seafood. The diagnosis can be made based on a positive history in combination with a positive skin prick test and/or positive serum-specific IgE level. In this specific case, the patient was also diagnosed with a histologically confirmed eosinophilic oesophagitis, a rare but important complication of Anisakisis infection. Endoscopic evaluation with esophageal biopsies should therefore be considered in patients with anisakiasis if suggestive symptoms are present. Patients with confirmed gastroallergic anisakiasis are advised to properly freeze or cook fish prior to consumption, although caution is advised, since heat-stable allergen proteins have been described. An adrenaline auto-injector should be prescribed.