Alpha Adrenergic Modulation of Impulse Initiation in Normal and Ischemic Cardiac Fibers
Samuel Sideman, Rafael Beyar in Analysis and Simulation of the Cardiac System — Ischemia, 2020
We then considered the response of fibers to alpha adrenergic stimulation during ischemia at high (10.8 mM) and normal (2.7 mM) [Ca2+]o.35 We found that at both [Ca2+]o, automatic rhythms ceased during ischemia (control rate of 17 ± 2 beats per minute). On reperfusion, the automatic rates remained significantly higher in the high Ca2+ than the low Ca2+ environment. Addition of an alpha adrenergic agonist in the presence of either low or high Ca2+ ischemia again reduced the rate of the dominant automatic rhythm to 0. On reperfusion, however, there was a more rapid return to normal maximum diastolic potential and control automatic rates in the Ca2+ = 2.7 than in the high Ca2+ setting. Hence, in the setting of reperfusion, alpha adrenergic stimulation was “protective”, returning membrane potential and rhythm more rapidly to control values than would otherwise have been the case.
Treatment Of Alzheimer’s Disease
Zaven S. Khachaturian, Teresa S. Radebaugh in Alzheimer’s Disease, 2019
There is ample evidence demonstrating that multiple neurotransmitter systems are involved in Alzheimer’s disease; thus a combined treatment strategy is likely to be more efficacious than cholinergic monotherapy. Animal research shows that noradrenergic brain lesions negate cholinomimetic enhancement of memory in hypocholinergic animals (Haroutunian et al., 1985). Administration of alpha adrenergic agonist clonidine in turn restores the efficacy of cholinomimetic treatment in animals with a large noradrenergic and modest cholinergic lesions (Haroutunian et al., 1990). The alpha adrenergic antagonist idazoxan, which enhances locus cereleus firing and norepinephrine turnover, has been shown to improve memory in rodents (Sara et al., 1989). Moreover, post-mortem studies showed major neurotransmitter losses of the noradrenergic systems in Alzheimer’s disease patients. All these findings support the use of a combination of cholinergic and noradrenergic agents to treat AD.
Complications of Adrenal Gland Surgery
Stephen M. Cohn, Matthew O. Dolich in Complications in Surgery and Trauma, 2014
Postoperatively, patients should be sent to a unit capable of frequent hemodynamic monitoring and effective management of any hemodynamic instability. Loss of adrenergic stimulation can cause hypotension lasting several days and can be further exacerbated by preoperative beta-blockade. This is effectively treated with volume expansion. In extreme cases, an alpha-adrenergic agonist may be necessary so that normal blood pressure can be maintained. Beta-antagonists are to be tapered off over the first postoperative week to avoid reflex tachycardia.
Management of Pregabalin Use Disorder: A Case Series
Published in Journal of Psychoactive Drugs, 2022
Lisa Langlumé, Céline Eiden, Sophie Roy, Floriane Taruffi, Julien Gambier, Hélène Donnadieu-Rigole, Hélène Peyrière
In this series of patients, management of withdrawal was based, for some anxious patients, on the short-term use of diazepam with a programmed dose reduction. Importantly, the diazepam dose should be adapted in patients with a history of benzodiazepine abuse and/or current use. At the time of the study, the long-term effectiveness of this adjuvant treatment was unknown. However, two patients who took diazepam relapsed and restarted pregabalin consumption. One of the limitations is the risk of the shift of dependence from pregabalin to diazepam or another substance (Gahr et al. 2015). Clonidine (used in patient no. 8) might be another possible option to manage pregabalin-related withdrawal symptoms. Clonidine is an alpha-adrenergic agonist used off-label for the management of opioid withdrawal (Toce et al. 2018). Clonidine helps to reduce the signs and symptoms of excessive autonomic activity (e.g. anxiety, chills, piloerection, tachycardia, and hypertension). Clonidine has been previously used for pregabalin withdrawal management outside the context of pregabalin use disorder and was effective on agitation (Barrett, Kittler, and Singarajah 2015).
Role of ferritin in pathogenesis of rosacea and its value in efficacy of 595 nm pulsed dye laser in treatment of different variants of rosacea: a clinical and immunohistochemical study
Published in Journal of Cosmetic and Laser Therapy, 2020
Nagwa Mohamed Elwan, Salwa Mohamed Salah, Shady F Abdelsalam, Nashwa Naeem Elfar
Medical treatments such as topical metronidazole and azaleic acid can treat inflammatory lesions as papules and pustules (23), and topical brimonidine gel, an alpha-adrenergic agonist, can be used to treat persistent facial erythema (24,25). However, vascular signs such as flushing, erythema, and telangiectasia often persist despite medical therapy (26), and induce social stigma due to their visibility (27).
Brimonidine tartrate for the treatment of glaucoma
Published in Expert Opinion on Pharmacotherapy, 2019
Daniel J. Oh, Judy L. Chen, Thasarat S. Vajaranant, Mark S. Dikopf
The third-generation alpha adrenergic agonist, brimonidine tartrate, has the addition of a quinoxaline bicyclic ring and bromine substitution at the chlorine site, increasing alpha-2 selectivity and further reducing lipophilicity[14]. In 1996, brimonidine was approved by the FDA for the treatment of OHTN and glaucoma.
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