RESUMO
Corticosteroids are widely used in the treatment of various diseases because of its potent antiinflammatory effect. According to recent knowledge, bronchial asthma is also chronic inflammatory disease. Therefore antiinflammtory agent such as cromoyln sodium and corticosteroid is highly recommended for treament of chronic bronchial asthma. Especially hydrocortisone succinate (Solu-Cortef) is commonly used for treament. to acute .asthmatic attack via intravenous injection due to have rapid therapeutic onset and short duration. Since Sunaga et al. reported acute asthma attack after hydrocortisone injection in 1973, several cases of bronchospam with or without angioedema and urticaria after intravenous injection of hydrocortisone have been reported. We experienced a case of severe bronchospasm and acute respiratory failure after intraveous injection of hydrocortisone succinate in 64 year-old (tamale asthmatic patient who visited to emergency room for acute asthmatic attack. About 5 minites after Solu-Cortef injection, a severe bronchospasm with arterial hypoxemia was developed. In order to confirm the suspected relationship between the offending drug(Solu-Cortex and acute bronchospasm, we exacted intravenous and inhalation provocation test by hydrocortisone succinate and methylprednisolone (control). After administration of hydrocortisone succinate via intravenous and inhalation route, severe asthmatic attack occurred. But administration of intravenous methylprednisolone and orall triamcinolone and saline were not provoke bronchospasm. Skin test using hydrocortisone sodium succinate was also positive. Administration of hydrocortisone is very serious to asthmatic patient with hydrocortisone hypersensitivity. Therefore, the clinician must be have history taking about previous adverse reaction of steroid before its clinical use. And methylprednisone may be useful and safe drug to the treatment of acute asthmatic patient with hydrocortisone hypersensitivity.
Assuntos
Humanos , Corticosteroides , Angioedema , Hipóxia , Asma , Testes de Provocação Brônquica , Espasmo Brônquico , Serviço Hospitalar de Emergência , Hidrocortisona , Hipersensibilidade , Inalação , Injeções Intravenosas , Metilprednisolona , Insuficiência Respiratória , Testes Cutâneos , Sódio , Ácido Succínico , Triancinolona , UrticáriaRESUMO
No abstract available.
Assuntos
Humanos , Interleucina-2 , Interleucinas , Falência Renal Crônica , PlasmaRESUMO
BACKGROUND: Hypertension is the major risk factor for cardiovascular disease. The increased left ventricular mass has been recognized as an independent predictor of morbidity and mortality in hypertensive patients. The assessment of the regression of left ventricular(LV) mass after antihypertensive therapy offers prognostic information. 2D echocardiography has proved a sensitive tool for the detection of the change of LV mass. METHOD: LV mass and LV mass index were measured by area-length method of 2D echocardiography in 26 hypertensive patients and 10 normal control to evaluate the effect of betablocker(group I, n=16) and angiotensin converting enzyme(ACE) inhibitor(group II, n=10) on the regression of LV mass. RESULT: There was a significant increase of LV mass and LV mass index in the hypertensive patients(199.0+/-37.7gm, 119.2+/-21.2gm/m2) compaired to the control(129.7+/-11.7gm, 87.4+/-8.8gm/m2)(p<0.01, p<0.01). After 13.1 week treatment, LV mass was significantly decreased in group I(200.9+/-35.3gm vs 164.7+/-25.4gm)(p<0.01) and group II(195.9+/-43.3gm vs 152.4+/-27.1gm)(p<0.01). The LV mass index was also significantly decreased in group I(120.3+/-20.7gm/m2 vs 98.8+/-15.5gm/m2)(p<0.01) and group II(117.5+/-22.9gm/m2 vs 91.5+/-13.6gm/m2)(p<0.01). CONCLUSION: This results showed that LV mass can be reduced in hypertensive patients who receive beta blocker and ACE inhibitor. The effect of antihypertensive therapy on LV mass should be considered in treatment of the hypertensive patients who had hypertrophied LV.