Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Our data in 74 patients demonstrate that procaine hydrochloride is a safe anesthetic adjuvant in doses of 1 mg/kg/min even when total doses are 5 to 7 g. Blood pressure, heart rate, electrocardiographic variables, and blood gases were not adversely affected. Patients had no nausea or untoward postanesthesia symptoms. Emergence from anesthesia was rapid, within less than 15 minutes in all patients, and most were fully awake before leaving the operating room. In two patients in whom blood levels were studied the drug disappeared within 40 minutes. Procaine is inexpensive, $1.16 for 10 g, and it is not a known liver or kidney toxin. Until studies on cardiovascular dynamics and analgesic effects as in whom a low plasma cholinesterase activity is present or suspected. The clinical appraisal in 56 patients indicates its usefulness in suppressing premature venticular contractions and cough reflexes during endoscopic procedures in the respiratory tract. Procaine can be used to advantage in supplementing general anesthesia in outpatient surgery because of its brief action. For these reasons, the drug merits further study.
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PMID:Reappraisal of intravenous procaine as a short-acting anesthetic adjuvant. 50 95

A 30-year-old man had an acute onset of orthostatic lightheadedness, sweating disturbance, paroxysmal cough and loss of potency. These symptoms reached the peak in two weeks, and then remitted very slowly. He was admitted to our hospital for further evaluation when he was 39 years old. Neurological examinations revealed right Horner's syndrome, dry skin and impotence, but neither motor nor sensory system was impaired. No abnormalities were found on routine examinations of the blood and cerebrospinal fluid, motor and sensory nerve velocities, computed tomography and electroencephalography. On sural nerve biopsy, the density of unmyelinated fibers was mildly decreased (13,857/mm2), whereas that of myelinated fibers was normal (7,220/mm2). Autonomic function tests disclosed orthostatic hypotension (-31 mmHg) on tilting, reduced levels of serum noradrenaline and vanillyl mandelic acid, supersensitive responses to noradrenaline infusion and adrenaline eye-dripping, severe sweating impairment and complete absence of sympathetic skin response. On the other hand, Aschner's test, Czermak's test and coefficient variation of R-R intervals were all normal. These results suggested that the chief lesion was located in the postganglionic fiber of sympathetic efferent pathway. We (Hayashi et al, 1990) quantified acetylcholinesterase (AchE)-positive fibers in the specimens of sural nerve biopsy, and reported that the density of AchE-positive fibers was correlated to the function of sympathetic postganglionic fibers. The density of AchE-positive fibers in the present case of acute idiopathic pandysautonomia (AIPD) was severely decreased to 225/mm2 by optical microscopy (control: 5,703 +/- 1,289/mm2), and to 2,996/mm2 by electron microscopy (control: 14,112 +/- 3,987/mm2).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of acute idiopathic pandysautonomia--a histochemical study of sural nerve by acetylcholinesterase staining]. 137 6

In recent years, studies of the regulation of the airways have focused to an increasing degree on the roles of neuropeptides. Several peptides have been shown to be present in airways and mediate such diverse responses as ion transport, mucus secretion, bronchospasm or relaxation, edema, cough, changes in vascular permeability, and neutrophil chemotaxis. More recently, studies have described the roles of peptidases, most notably neutral endopeptidase (NEP, also known as enkephalinase, or E.C. 3.4.24.11) and kininase II (also known as angiotensin-converting enzyme, or E.C. 3.4.15.1) in modulating peptide-induced responses. The enzymes cleave a wide variety of peptides, generating metabolites that are inactive in the systems studied to date. Thus inhibitors of NEP potentiate responses to peptides that are cleaved by it. Therefore, NEP plays roles in modulating peptide-induced effects analogous to the role of acetylcholinesterase in modulating cholinergic neurotransmission. In several experimental respiratory diseases, the activity of neutral endopeptidase is decreased, resulting in increased responses to peptides. The therapeutic application of recombinant NEP protects the airways from the adverse actions of stimuli that release inflammatory peptides, and induction of the NEP gene expression by glucocorticoids suggest a possible mechanism for the action of these steroids in treating airway diseases such as asthma, chronic bronchitis, or cystic fibrosis.
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PMID:Roles of neutral endopeptidase in airways. 201 45

The major categories of medications known to induce bronchospasm or cough, including beta-blockers, cholinesterase inhibitors, angiotensin-converting enzyme inhibitors, and inhalational agents are reviewed. The anatomy and physiology of the human airway relevant to this topic are discussed as well.
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PMID:Drug-induced bronchospasm. 218 76

Chronic obstructive pulmonary disease (COPD) is a disease involving either or both of chronic bronchitis and emphysema. In the elderly, bronchial asthma is usually called chronic asthma because of sustained asthma attacks and resistance to therapy. Although the absolute value of IgE is low in the asthma in the elderly, IgE values correlated to the symptoms of asthma in the elderly. Therefore, asthma in the elderly is supposed to be primarily caused by allergic reactions. Airway epithelium products histamine methyl-transferase (HMT) and cholinesterase. Allergic reactions and/or virus infection in the airway epithelium reduce productions of these enzymes, which exacerbate bronchoconstriction. Steroid hormones increase these enzymes and relieve bronchoconstriction. Silent aspiration may exacerbate asthma attack in the night and recurrent cough and sputum in COPD. Macrolide antibiotics relieve chronic infections in the elderly. Plural constriction against bullae using thoracoscopy reduce dyspnea dramatically in emphysema.
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PMID:[Clinical strategy of chronic obstructive pulmonary disease in the elderly]. 811 44

A 52-year-old woman had a 14-year history of stridor attacks. Pulmonary function tests revealed reversible airway obstruction, and bronchial asthma was diagnosed. She also has bilateral ptosis, diplopia, and moderate weakness of all four limbs; a positive edrophonium test confirmed the diagnosis of myasthenia gravis. Although the parasympathetic system plays an important role in the regulation of bronchial tone, in this patient the edrophonium test did not provoke an asthmatic attack or exacerbate pulmonary function, except for increases in sputum production and in frequency of cough. The general weakness was usually worse in the afternoon. The decrease in grip strength and the shortening of arm elevation time also occurred after asthma attacks, which means that general muscle fatigue was caused by the work of breathing. Furthermore, dyspnea increased and pulmonary function worsened when an anti-cholinesterase inhibitor was discontinued, probably because of respiratory muscle weakness. Accordingly, the clinical status of bronchial asthma seemed to change in parallel with that of the myasthenia gravis.
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PMID:[Bronchial asthma complicated by myasthenia gravis]. 869 67

1. Pentamidine is routinely used to reduce the incidence of Pneumocystis carinii pneumonia in patients infected with human immunodeficiency virus, but it has been described as inducing pulmonary adverse effects, such as cough and bronchospasm. 2. In this paper we have investigated the effects of pentamidine on guinea-pig isolated main bronchi and human isolated bronchi. Pentamidine induced a concentration-dependent contraction in both preparations with pD2 values of 9.64 +/- 0.07 (n = 8) and 9.73 +/- 0.06 (n = 8) and a maximal effect (Emax) of 40 +/- 4% and 34 +/- 5% of the response to acetylcholine (1 mM) in guinea-pig and human bronchi respectively. Atropine (0.01 to 0.1 microM) and the muscarinic M3 receptor antagonist, hexahydro-siladiphenidol (0.1 and 1 microM) inhibited pentamidine-induced concentration-responses in both preparations in a non-competitive manner, whereas only high concentrations of the M1 receptor antagonist pirenzipine (1 microM) inhibited pentamidine concentration-response curves. 3. The cholinesterase inhibitor, tacrine (1 microM), potentiated the effect of pentamidine; in contrast, morphine inhibited pentamidine-induced responses. 4. The bronchoconstrictor effect of pentamidine on guinea-pig and human isolated bronchi was not modified by the H1 histamine receptor antagonist, mepyramine, by indomethacin or by the neurokinin NK1 and NK2 receptor antagonists, CP-96,345 and SR 48969 respectively, suggesting that neither histamine receptor stimulation, arachidonic acid derivative formation, nor tachykinin release are involved in pentamidine-induced contraction of human and guinea-pig airways. 5. Our overall results suggest that pentamidine induces contraction of guinea-pig and human isolated bronchi through prejunctional cholinergic nerve stimulation.
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PMID:Indirect muscarinic receptor activation by pentamidine on airway smooth muscle. 893 15

On the day of the disaster, 641 victims were seen at St. Luke's International Hospital. Among those, five victims arrived with cardiopulmonary or respiratory arrest with marked miosis and extremely low serum cholinesterase values; two died and three recovered completely. In addition to these five critical patients, 106 patients, including four pregnant women, were hospitalized with symptoms of mild to moderate exposure. Other victims had only mild symptoms and were released after 6 hours of observation. Major signs and symptoms in victims were miosis, headache, dyspnea, nausea, ocular pain, blurred vision, vomiting, coughing, muscle weakness, and agitation. Almost all patients showed miosis and related symptoms such as headache, blurred vision, or visual darkness. Although these physical signs and symptoms disappeared within a few weeks, psychologic problems associated with posttraumatic stress disorder persisted longer. Also, secondary contamination of the house staff occurred, with some sort of physical abnormality in more than 20%.
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PMID:Sarin poisoning on Tokyo subway. 919 33

Acute health effects of organophosphorus (OP) pesticides on coffee farmworkers in 1991-1992 in Tanzania are reported to provide a basis for concern over farmworkers being overexposed during application. Workers exposed to OP pesticides (N=133) were drawn from a population of about 240,000 coffee farmers. They were interviewed on symptoms and personal protection, and their erythrocyte acetylcholinesterase (AChE) activity was determined during both spraying and nonspraying period. AChE activities during spraying and nonspraying period were comparable (mean 32.0, SD 7.8 vs. 33.0, SD 8.7 U/g HgB, P=0.26). The prevalence of cough, headache, abdominal pain, excessive sweating, nausea, excessive salivation, diarrhea, and vomiting did not differ significantly between spraying and nonspraying periods. There was no suggestion of decreased AChE in exposed subjects who complained of OP-related symptoms compared to symptomless exposed subjects. Use of gloves, long boots, head cover, face cover, and coverall was not significantly associated with AChE activity. No marked AChE depression was found during spraying season, which may explain the lack of association between symptoms and AChE. The fact that only moderately toxic OP pesticides were used may indicate that toxicity was not sufficiently high to cause depression. Experience, however, suggests that occupational poisoning remains a potential serious danger in coffee cultivation in Tanzania.
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PMID:Acute health effects of organophosphorus pesticides on Tanzanian small-scale coffee growers. 1157 13

We report on a 23-year-old female patient who underwent removal of the implants after maxillary surgery. At the end of surgery the administration of anaesthetic agents was discontinued. During the following 30 min several attempts were made to wake the patient, but she did not respond to verbal or pain stimuli. No changes in heart rate, blood pressure vegetative reactions such as sweating, lacrimation, or mydriasis were noted. Protective reflexes like coughing could not be elicited. After 30 min neuromuscular monitoring was applied and indicated residual muscle paralysis after the use of mivacurium. The patient was again sedated and transferred to the ICU, where she was mechanically ventilated for an additional 9 h. An atypical cholinesterase was determined as the underlying reason for the prolonged action of mivacurium. Retrospectively, the patient remembered the attempted wake-up period in detail. However, she reported no feelings of fear or helplessness because she had faith in the anaesthesiologist, a close friend of the patient's family for many years, who kept her calm and comfortable by talking to her during the entire period. Several months after the incident, the patient reported having neither increased fear of surgery nor any negative psychological effects on her life following this incident of awareness.
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PMID:["Relaxant" awake but still relaxed]. 1529 65


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