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1.
BMJ Case Rep ; 13(12)2020 Dec 09.
Article in English | MEDLINE | ID: mdl-33298492

ABSTRACT

Vasoactive agents should be administered through a controlled well-marked infusor pump, ideally via a central venous catheter if given over longer periods of time. During transfer of haemodynamically unstable patients with limited staffing and resources on site, a peripheral vasopressor infusion is sometimes resorted to as a temporary measure of optimising haemodynamic parameters. We report a case of accidental norepinephrine overdose after such practice, resulting in cardiac arrest. It illustrates the importance of careful use and labelling of vasoactive agents during the transport and handover of critically ill patients. Finally, we explore human factor issues associated with transfer from the pre-hospital to the in-hospital environment when such preparations are used.


Subject(s)
Drug Overdose/physiopathology , Heart Arrest/chemically induced , Norepinephrine/poisoning , Vasoconstrictor Agents/poisoning , Critical Illness , Crystalloid Solutions/administration & dosage , Hemodynamics , Humans , Male , Medication Errors , Middle Aged
2.
Int Heart J ; 61(6): 1298-1302, 2020 Nov 28.
Article in English | MEDLINE | ID: mdl-33116021

ABSTRACT

Takotsubo cardiomyopathy (TTC) is characterized by reversible ventricular dysfunction induced by endogenous and, occasionally, exogenous catecholamine. We present a report on a patient who developed TTC and cardiogenic shock during percutaneous coronary intervention (PCI) secondary to inadvertent norepinephrine administration. His hemodynamic status and cardiac function were totally restored within 1 week after hemodynamic support using intra-aortic balloon pump without sequela. Thus, TTC should be considered once a patient presents with symptoms mimicking acute coronary syndrome (ACS) after catecholamine administration.


Subject(s)
Coronary Restenosis/surgery , Hypotension/drug therapy , Intraoperative Complications/drug therapy , Medication Errors , Norepinephrine/poisoning , Percutaneous Coronary Intervention , Shock, Cardiogenic/chemically induced , Takotsubo Cardiomyopathy/chemically induced , Vasoconstrictor Agents/poisoning , Adrenergic beta-1 Receptor Antagonists/therapeutic use , Angiotensin II Type 1 Receptor Blockers/therapeutic use , Bisoprolol/therapeutic use , Creatine Kinase/blood , Creatine Kinase, MB Form/blood , Drug Overdose , Drug-Eluting Stents , Echocardiography , Humans , Iatrogenic Disease , Intra-Aortic Balloon Pumping , Male , Middle Aged , Recovery of Function , Shock, Cardiogenic/blood , Shock, Cardiogenic/diagnosis , Shock, Cardiogenic/therapy , Stents , Stroke Volume , Takotsubo Cardiomyopathy/blood , Takotsubo Cardiomyopathy/diagnostic imaging , Takotsubo Cardiomyopathy/therapy , Troponin I/blood , Valsartan/therapeutic use
4.
Am J Physiol Heart Circ Physiol ; 287(1): H29-39, 2004 Jul.
Article in English | MEDLINE | ID: mdl-14962827

ABSTRACT

Cardiac norepinephrine (NE) uptake activity is reduced in congestive heart failure. Our studies in intact animals suggest that this effect on the cardiac sympathetic nerve endings is caused by oxidative stress and/or NE toxic metabolites derived from NE. In this study, we investigated the direct effects of NE on neuronal NE uptake activity and NE transporter (NET), using undifferentiated PC12 cells. Cells were incubated with NE (1-500 microM) either alone or in combination of Cu(2+) sulfate (1 microM), which promotes free radical formation by Fenton reaction for 24 h. NE uptake activity was measured using [(3)H]NE. Cell viability was determined with the use of Trypan blue exclusion and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide assay, and cellular oxidative stress by dichlorodihydrofluorescein fluorescence and the GSH/GSSG ratio. Cell viability was reduced by NE >100 microM. At lower doses, NE produced oxidative stress and a dose-dependent reduction of NE uptake activity without affecting cell viability significantly. Cu(2+), which has no direct effect on NE uptake activity, potentiated oxidative stress and reduction of NE uptake activity produced by NE. This decrease of NE uptake activity was associated with reductions of NE uptake binding sites and NET protein expression by using the radioligand assay and Western blot analysis, but no changes in NET gene expression. In addition, the free-radical scavenger mannitol, and antioxidant enzymes superoxide dismutase and catalase, reduced oxidative stress and attenuated the reductions of NE uptake activity and NET protein produced by NE/Cu. Thus our results support a functional role of oxidative stress in mediating the neuronal NE uptake reducing effect of NE and that this effect of NE on NET is a posttranscriptional event.


Subject(s)
Extracellular Space/metabolism , Neurons/metabolism , Norepinephrine/metabolism , Oxidative Stress/physiology , Animals , Antioxidants/pharmacology , Binding Sites/drug effects , Cell Membrane/metabolism , Cell Survival/drug effects , Copper Sulfate/pharmacology , Dose-Response Relationship, Drug , Drug Combinations , Neurons/physiology , Norepinephrine/administration & dosage , Norepinephrine/pharmacokinetics , Norepinephrine/poisoning , Norepinephrine Plasma Membrane Transport Proteins , Oxidative Stress/drug effects , PC12 Cells , RNA, Messenger/metabolism , Rats , Symporters/genetics , Symporters/metabolism
5.
Bull Exp Biol Med ; 132(4): 966-8, 2001 Oct.
Article in English | MEDLINE | ID: mdl-11782794

ABSTRACT

Experiments on Wistar rats showed that acute poisoning with organophosphorus compound dimethyldichlorovinylphosphate (0.2 and 0.8 LD50) was accompanied by suppression of the major immune reactions. Increasing the concentration of epinephrine and norepinephrine in the plasma produced less pronounced opposite effects, except for the influence on natural killer activity.


Subject(s)
Adrenal Glands/drug effects , Dichlorvos/poisoning , Immune System/drug effects , Insecticides/poisoning , Organophosphate Poisoning , Animals , Dose-Response Relationship, Drug , Epinephrine/poisoning , Lethal Dose 50 , Male , Norepinephrine/poisoning , Rats , Rats, Wistar
6.
Ukr Biokhim Zh (1978) ; 66(3): 85-9, 1994.
Article in Ukrainian | MEDLINE | ID: mdl-7754564

ABSTRACT

Patients suffering from stress-induced angina pectoris subjected to exertion show a decreased level of non-protein SH-groups in blood plasma and erythrocytes which depends on the level of myocardial hypoxia and may indicate metabolic exhaustion of the organism. Lowered concentrations of non-protein SH-groups are not a result of lipid peroxidation. Adrenalin is known to antagonize the depletion of non-protein SH-groups under exertion, while noradrenaline promotes the process of their oxidation. When the level of non-protein SH-groups decreases under exertion, the content of atherogenic lipids in blood does not increase, which implies that SH-groups are involved into the mechanism of appearance of atherogenic lipids in blood under exertion.


Subject(s)
Angina Pectoris/etiology , Norepinephrine/poisoning , Physical Exertion/physiology , Stress, Physiological/complications , Sulfhydryl Compounds/blood , Angina Pectoris/blood , Animals , Cell Hypoxia/physiology , Disease Models, Animal , Erythrocyte Count , Male , Oxidation-Reduction , Rabbits
7.
Biull Eksp Biol Med ; 89(7): 52-5, 1980 Jul.
Article in Russian | MEDLINE | ID: mdl-7407372

ABSTRACT

A study was made of the adrenaline and noradrenaline content in the blood, myocardium and adrenals of 74 male Wistar rats. Four series of experiments were conducted with administration of noradrenaline alone and noradrenaline after premedication with arfonad (ganglion-blocking agent) or rausedil (reserpine drug). Distilled water was used in control experiments. The content of adrenaline and noradrenaline in blood and tissues was shown to change 45 seconds after noradrenaline administration and to return to normal by the 7th minute. Correlation of the catecholamine content in rat blood and tissues with morphological changes in the myocardium recorded in the analogous series of experiments has shown that the increased content of catecholamines in bloods is one of the most important factors in the pathogenesis of myocardial injury since the diminution of their content during ganglionic blockade is associated with a reduced heart injury. The noradrenaline content in the myocardium does not correlate with the severity of myocardial injury.


Subject(s)
Adrenal Glands/analysis , Cardiomyopathies/metabolism , Catecholamines/analysis , Myocardium/analysis , Norepinephrine/poisoning , Animals , Cardiomyopathies/chemically induced , Catecholamines/blood , Rats , Reserpine , Trimethaphan
8.
Vopr Med Khim ; (3): 358-60, 1977.
Article in Russian | MEDLINE | ID: mdl-888400

ABSTRACT

Administration of toxic doses of noradrenaline into rats led to exhaustion of noradrenaline reserves in liver and heart tissues with the simultaneous increase in the activity of glucose-6-phosphate dehydrogenase in the tissues. Actinomycin D, administered together with noradrenaline, completely prevented the elevation of the G6PD activity in the tissues studied. The data obtained suggest that sympathetic nervous system and its mediator are responsible for regulation of the rate of enzymatic protein synthesis in tissues.


Subject(s)
Chemical and Drug Induced Liver Injury/enzymology , Glucosephosphate Dehydrogenase/metabolism , Liver/enzymology , Myocardium/enzymology , Norepinephrine/poisoning , Animals , Heart/drug effects , Liver/drug effects , Male , Rats
9.
Rev. cuba. cir ; 6(3): 379-82, jun.-30-1967.
Article in Spanish | CUMED | ID: cum-10891

ABSTRACT

Se presenta un caso de shock provocado por administración intravenosa de Nor-Adrenalina. Se emplea la Dihidroergotamina droga bloqueadora de los receptores Alfa Adrenérgicos, con éxito en su tratamiento (AU)


Subject(s)
Anaphylaxis/etiology , Norepinephrine/poisoning , Ergotamines/administration & dosage
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