Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020440 (hypercapnia)
 7,939 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Recent investigations have shown that the calcium channel blocker verapamil attenuated the hypoxic ventilatory chemosensitivity of carotid body in animals. To determine whether this is also the case in humans, transient physiological chemodenervation by O2 breaths (withdrawal test) during sustained hypoxia (N = 7), and ventilatory and circulatory responses to progressive hypoxia and hypercapnia (N = 8) were examined after oral administration of verapamil. During sustained hypoxia after verpamil, there was a significant reduction of withdrawal response from 5th to 25th min value (p < 0.01), but not after placebo. On the other hand, no significant difference in ventilatory responses to progressive hypoxia and hypercapnia was observed after verapamil. Verapamil run reveals similar features with placebo run in circulatory parameters except blood pressure response, which tended to be suppressed by verapamil. We conclude that verapamil attenuates peripheral chemoreceptor activity with time during sustained mild hypoxia in normal adult humans and this may be explained by delayed depletion in intracellular Ca2+ for chemotransduction of the peripheral chemoreceptors.
 ...
PMID:Effect of verapamil on ventilatory and circulatory responses to hypoxia and hypercapnia in normal subjects. 149 1

Acute postoperative hypertension (APH) has been documented in the PACU. Over half of the patients who exhibit APH have pre-existing primary hypertension. Sustained blood pressure (BP) elevation increases the risk of myocardial ischemia, infarction, surgical site bleeding, or cerebral hemorrhage in these patients. Following surgery and anesthesia, increased sympathetic stimulation caused by a high level of circulating catecholamines can lead to APH. Some direct perioperative stimulants include pain, anxiety, hypoxia, hypercapnia, hypothermia, shivering, volume overload, and bladder distension. Nursing interventions are directed toward identifying and relieving the cause of APH. Antihypertensive drug therapy with vasodilators or adrenergic inhibitors is used if initial nursing interventions are not effective. Vasodilators frequently used are hydralazine, sodium nitroprusside, and nitroglycerin. Nicardipine has recently been introduced as an intravenous calcium channel blocker. Vasodilators are effective in BP reduction but may cause reflex tachycardia when used alone. Adrenergic inhibitors, such as esmolol and labetalol, block alpha and/or beta receptors to decrease heart rate and BP. Labetalol's effectiveness, relative freedom from side effects, and ease of administration have made it a useful drug in the treatment of APH.
 ...
PMID:Acute postoperative hypertension in the hypertensive patient. 173 70

Acute effects of calcium channel blocker nifedipine were investigated in patients with chronic obstructive pulmonary disease (COPD. In the present study 10 patients were included in the early phase of COPD and 20 patients in the late phase with chronic respiratory insufficiency characterized with resting hypoxemia, hypercapnia and respiratory acidosis. The patients were examined before and after sublingual application of nifedipine (10 mg) or placebo in single-blind study design. Nifedipine did not alter spirometric parameters (FVC, FEV1, FEV1/FVC), except in the late phase of COPD (FEV1). However, acute nifedipine treatment significantly improved resting arterial blood gases: PaO2 increased in both groups while PaCO2 decreased only in the patients in advanced phase of COPD. Additionally, nifedipine increased DLCOSB in the early phase of COPD. Acute nifedipine was found to have a beneficial effect in COPD patients.
 ...
PMID:[The acute effect of nifedipine in chronic obstructive lung disease]. 279 77

The individual and combined effects of subcutaneous morphine and diltiazem, a calcium channel inhibitor, on arterial blood gases and pH were assessed in conscious Fischer-344 rats. Morphine (4 mg kg-1) produced hypercapnia, hypoxia and slight acidosis, as compared with control values. Diltiazem (10 mg kg-1) alone did not affect these parameters; however, it significantly delayed the onset of the aforementioned effects of morphine.
 ...
PMID:Effects of diltiazem on morphine-induced respiratory decline. 287 84

Effects of s.c. doses of morphine and verapamil, alone and in combination, on arterial blood gases and pH, mean blood pressure and heart rate were assessed in partially restrained, awake Fischer-344 rats. As expected, morphine (4-16 mg/kg) produced a dose-dependent respiratory depression, as indicated by hypoxia, hypercapnia and acidosis. Verapamil, a calcium channel antagonist, alone (10 mg/kg) did not affect these parameters; however, it significantly attenuated and delayed the aforementioned effects of morphine. Morphine caused a slight increase in mean blood pressure, which was not dose dependent, whereas verapamil reduced blood pressure dramatically even in the presence of morphine. All groups showed some tachycardia, but rats treated with morphine alone showed the most pronounced increase in heart rate, which was antagonized by verapamil. The authors conclude that the interaction of verapamil with morphine's respiratory depressant effects differs from the previously reported potentiation of morphine's antinociceptive and hypothermic actions.
 ...
PMID:Interactions between verapamil and morphine on physiological parameters in rats. 372 97

We have recently reported that in an anesthetized rat model, generation of oxygen free radicals (OFR) via i.v. administration of Xanthine plus Xanthine Oxidase [X + XO] resulted in death of about 90% of the animals within a 120-min observation period. Pretreatment of the rats with endogenous scavengers Superoxide Dismutase and Catalase, or with felodipine, a dihydropyridine calcium channel blocker, and/or with dopexamine, an agonist of beta 2 adrenoceptors as well as dopamine (DA-1) receptors significantly enhanced the survival rate to over 70%. The present study was designed to investigate whether lipid peroxidation and ensuing respiratory depression contributed to the lethal toxicity of the free radicals. In the control group, the death of the rats administered [X + XO] was proceeded by significant increases in the plasma lipid peroxides (PLP) and by a severe hypertensive response characteristic of an intense ischemic state, which was confirmed by the presence of hypercapnia, hypoxemia, and acidosis. Placement of the animals on the positive pressure ventilation prior to the administration of [X + XO] did not prevent increases in PLP but, prevented any adverse alterations in the respiratory markers and significantly enhanced survival rate up to 70%. In contrast, both felodipine as well as dopexamine prevented any increases in PLP, normalized blood gas profile, and significantly increased survival rate to 80 to 90%. These observations suggest that the lethal toxicity produced by oxygen free radical was due to respiratory distress. The relationship between increases in the PLP and respiratory depression and the mechanisms via which two pharmacologically distinct agents, felodipine and dopexamine, facilitated the salutary effects cannot be conclusively stated at this time. It is further suggested that although the doses of these two drugs employed in the present studies are not adequate to function as antioxidants, such a possibility cannot be entirely ruled out.
 ...
PMID:Effect of pharmacological interventions in the prevention of lipid peroxidation and respiratory depression induced by oxygen free radicals in anesthetized rats. 890 25

The use of low tidal volumes with permissive hypercapnia in patients with acute respiratory distress syndrome may require heavy sedation to allow them to tolerate mechanical ventilation. Administration of methadone for sedation is an alternative to using other opioids, given its longer elimination half-life and incomplete cross-tolerance with other mu-receptor-active opioids. Methadone appears to have a molecular structure similar to that of verapamil, a calcium channel blocker, and may exhibit similar cardiac properties as well. A 43-year-old man with acute respiratory distress syndrome experienced bradycardia while receiving a continuous infusion of methadone for sedation and mechanical ventilation management. This case report demonstrates that caution is warranted when high dosages of methadone are administered because of its potential cardiac effects.
 ...
PMID:Bradycardia associated with intravenous methadone administered for sedation in a patient with acute respiratory distress syndrome. 1222 59

The trigeminocardiac reflex (TCR) is defined as the sudden onset of parasympathetic dysrhythmia, sympathetic hypotension, apnea, or gastric hyper-motility during stimulation of any of the sensory branches of the trigeminal nerve. The proposed mechanism for the development of TCR is--the sensory nerve endings of the trigeminal nerve send neuronal signals via the Gasserian ganglion to the sensory nucleus of the trigeminal nerve, forming the afferent pathway of the reflex arc. It has been demonstrated that the TCR may occur with mechanical stimulation of all the branches of the trigeminal nerve anywhere along its course (central or peripheral). The reaction subsides with cessation of the stimulus. But, some patients may develop severe bradycardia, asystole, and arterial hypotension which require intervention. The risk factors already known to increase the incidence of TCR include: Hypercapnia; hypoxemia; light general anesthesia; age (more pronounced in children); the nature of the provoking stimulus (stimulus strength and duration); and drugs: Potent narcotic agents (sufentanil and alfentanil); beta-blockers; and calcium channel blockers. Because of the lack of full understanding of the TCR physiology, the current treatment options for patients with TCR include: (i) risk factor identification and modification; (ii) prophylactic measures; and (iii) administration of vagolytic agents or sympathomimetics.
 ...
PMID:Management of the trigeminocardiac reflex: facts and own experience. 1977 May 35

Migraine is a neurovascular disorder characterized by autonomic nervous system dysfunction and severe headache attacks. Studies have shown that changes in the intracranial vessels during migraine have an important role in the pathophysiology. Many studies have been conducted on the increased risk of stroke in patients with migraine, but insufficient data are available on the mechanism underlying the increase. This study aimed to evaluate basal cerebral blood flow velocity and vasomotor reactivity in patients with chronic migraine. We evaluated 38 patients with chronic migraine. Three of them were excluded because they had auras and four of them were excluded because of their use of medication that can affect cerebral blood flow velocity and breath holding index (beta or calcium channel blockers). Our study population consisted of 31 patients with chronic migraine without aura and 29 age- and gender-matched healthy individuals who were not taking any medication. The mean blood flow velocity and breath holding index were measured on both sides from the middle cerebral artery and posterior cerebral artery, with temporal window insonation. The breath holding index for middle cerebral artery and posterior cerebral artery was significantly lower in the migraine group compared to that of the control group (p < 0.05).The vasomotor reactivity indicates the dilatation potential of a vessel, and it is closely related to autoregulation. According to our results, the vasodilator response of cerebral arterioles to hypercapnia was lower in patients with chronic migraine. These findings showed the existence of impairments in the harmonic cerebral hemodynamic mechanisms in patients with chronic migraine. This finding also supports the existing idea of an increased risk of stroke in patients with chronic migraine due to impaired vasomotor reactivity.
 ...
PMID:Reduced breath holding index in patients with chronic migraine. 2530 11