Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Clonidine hydrochloride (CH) is an antihypertensive drug with complex pharmacologic activity including central and peripheral alpha-adrenergic stimulation and CNS depression. We reviewed the records of 5 children admitted to our Pediatric Intensive Care Unit following accidental ingestion of CH. All patients presented with lethargy or stupor, beginning 20-60 minutes after ingestion. Respiratory depression or apnea occurred in 4, requiring endotracheal intubation in 2 and mechanical ventilation in 1. All 5 developed mild to moderate hypertension, and 3 developed asymptomatic bradycardia. The dose of CH ingested was estimated to be 0.2-0.4 mg in 4 out of 5 patients. Treatment consisted of efforts to prevent absorption of CH from the GI tract and supportive care. All signs of CH toxicity resolved within 6-14 hours. Four patients were transferred from ICU within 24 hours and discharged home the following day. One patient developed post-extubation stridor and atelectasis. Significant toxicity occurred even though the amount of CH ingested was relatively small in at least 4 or 5 patients. Transient hypertension occurred early in the hospital course of all patients and resolved without treatment. Hypotension and symptomatic bradycardia were not observed. Apnea was the most serious abnormality observed. All patients recovered without significant morbidity.
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PMID:Hypertension associated with clonidine ingestion. 652 27

The first collaborative statewide psychiatric quality improvement project, initiated by Louisiana Health Care Review, Inc, focused on the practice of inpatient electro-convulsive therapy (ECT) among Medicare patients. Data from the project indicated that the majority of Medicare patients receiving ECT were white females living at home, in good physical health, in their seventies, and with a diagnosis of major depression or major depression with psychotic features. The quality indicators for the project included: (documentation of) monitoring of cognitive side effects, monitoring of depressive target symptoms, ECT appropriateness, electrode placement, anesthesia evaluation, and dental examination. An additional indicator (administration of possibly detrimental medication during ECT) was developed based on the recommendation by the study group. At project conclusion, significant improvement occurred in all project indicators. ECT as practiced in the participating hospitals was effective and appropriate. Appropriateness was determined as depression refractory to two medication trails or an emergency due to severe suicidal ideation or physical deterioration secondary to malnutrition. Transient hypertension (13%) and cardiac dysrhythmia (3.5%) which resolved in the recovery period were the most frequent complications.
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PMID:The Louisiana Medicare Electro-Convulsive Therapy Quality Improvement Project. 1054 34

Dexmedetomidine is widely used for procedural sedation because of its unique combination of sedation, analgesia, and anxiolysis with minimal respiratory depression. Transient hypertension has been reported during the use of dexmedetomidine which is usually benign and is taken over by the hypotensive response on continuing the infusion. We report a case of hypertensive crisis following dexmedetomidine infusion used for procedural sedation, necessitating discontinuation of the infusion and treatment of hypertension. The dilemmas involved in treating hypertension caused by dexmedetomidine are discussed.
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PMID:Intravenous labetolol in treating hypertensive crisis following dexmedetomidine infusion for procedural sedation. 2689 44