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Medical and open surgical management of chylous disorders
Published in Peter Gloviczki, Michael C. Dalsing, Bo Eklöf, Fedor Lurie, Thomas W. Wakefield, Monika L. Gloviczki, Handbook of Venous and Lymphatic Disorders, 2017
Ying Huang, Audra A. Duncan, Gustavo S. Oderich, Peter Gloviczki
Diuretics are frequently needed to decrease chyle production, and furosemide and aldactone are used in high doses in severe cases. Etilefrine, a sympathomimetic drug that causes smooth muscle contraction of the TD, has helped in the management of post-operative chylous disorders, but has not been used for primary chylous effusions.
Preparation and evaluation of fast-dissolving films of etilefrine hydrochloride for practical buccal dosing
Published in Pharmaceutical Development and Technology, 2021
Pharmacotherapy plays an important role in the treatment of hypotension, in which an appropriate drug is selected from several types of hypertensive drugs (Adigun and Fentem 1984). Etilefrine hydrochloride (ET) is the first choice in pharmacotherapy for hypotension (Haustein and Hüller 1985; Bouaggad et al. 2000). It is an agonist of α- and β-adrenergic receptors (Coleman et al. 1975), exerts constrictive effects on vascular smooth muscle, and increases cardiac output, thereby elevating blood pressure (Karasawa et al. 1992). Parenteral injections and oral tablets are currently available as pharmacotherapy for hypotension in Japan. However, since the dosages used may induce undesirable biological features or side effects, sufficient care is required when they are used in clinical settings. For example, orally administered ET undergoes first-pass metabolism in the gut wall, which reduces its bioavailability (B.A.) (55% in humans) (Hengstmann et al. 1975; Haustein and Hüller 1985). Excessively high plasma levels need to be avoided when ET is administered parenterally because they may induce abnormal cardiovascular states, such as cardiac palpitations, arrhythmia, and lung edema (Karasawa et al. 1992: Boehringer-Ingelheim 2014). Furthermore, ET injections may cause pain, irritation, and necrosis around administration sites.
Preparation of orally fast-dissolving tablets of etilefrine hydrochloride to achieve efficient absorption
Published in Pharmaceutical Development and Technology, 2020
Etilefrine hydrochloride (ET) (Figure 1), is often used in pharmacotherapy for hypotension (Haustein and Hüller 1985; Bouaggad et al. 2000). It functions as an agonist of α- and β-adrenergic receptors, resulting in constrictive effects on vascular smooth muscle and increased cardiac output, respectively, which collectively increase blood pressure (Karasawa et al. 1992). Orally administered tablets and parenteral injections of ET are clinically available in Japan. However, orally administered ET undergoes first-pass metabolism in the gut wall, which reduces bioavailability (BA) (55% in humans) and decreases systemic drug concentrations (Haustein and Hüller 1985; Hengstmann et al. 1975). ET is also administered intravenously (i.v.), intramuscularly, or subcutaneously to treat acute and orthostatic hypotension. The excessively high plasma levels associated with parenteral injections need to be avoided in order to prevent abnormal cardiovascular states, such as cardiac palpitations, arrhythmia, and lung edema (Karasawa et al. 1992). Furthermore, pain, irritation, and necrosis occasionally occur around injection sites. Therefore, these dosage forms have several disadvantages that need to be overcome.
An overview of emergency pharmacotherapy for priapism
Published in Expert Opinion on Pharmacotherapy, 2022
Graham A. Bobo, Wael Almajed, Jack Conlon, Rohan A. Morenas, Wayne J.G Hellstrom
Etilefrine is a sympathomimetic that activates α and β receptors and is used in the treatment of priapism in patients with SCD. Although not fully understood as to how an α adrenergic, which would assumedly induce vasoconstriction, can prevent vaso-occlusive episodes in SCD, etilefrine has proven to be effective in such patients [35–38].