Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042109 (urticaria)
 6,569 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The dose-response relationship and the time course of action of Org 7617, a short acting non-depolarizing neuromuscular blocking agent, were evaluated during thiopentone, fentanyl, halothane and N2O anaesthesia. Neuromuscular transmission was monitored mechanomyographically. The ED50 and ED90 were calculated after single bolus doses of the drug. Twelve, seven and three patients received 2.5, 3.75 or 5.0 mg.kg-1 Org 7617, respectively. Neuromuscular block was characterized by a short lag time (average 30 s) and rapid development of neuromuscular block (69-84 s). Maximum block approximated to 66%, 91% and 95%, and the duration until clinically adequate recovery (TOF ratio of 0.7) to 7.4, 12.1 and 12.2 min after 2.5, 3.75, 5 mg.kg-1 of Org 7617, respectively. The calculated ED50 and ED90 were 1.8 and 3.4 mg.kg-1. Adverse effects, including a moderate fall in systolic and diastolic arterial blood pressure and a concomitant increase in heart rate appeared to be dose-dependent. Some patients showed flushing. One patient given 5 mg/kg Org 7617 had serious adverse effects suggestive of histamine release, i.e. flushing, urticaria, tachycardia, hypotension and bronchospasm. Therefore further clinical investigations were terminated. Although its low potency and the adverse effects observed will prevent further clinical development of ORG 7617, the results do support the contention that it is feasible to develop short-acting non-depolarizing neuromuscular blocking agents from the steroidal series.
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PMID:Clinical pharmacology of ORG 7617, a short-acting non-depolarizing neuromuscular blocking agent. 791 36

The number of arthroscopic procedures performed annually for the management of intraarticular injuries has grown at an exponential rate. Whether done with the patient under general anesthesia or local anesthesia supplemented with intravenous sedation, it is common practice to postoperatively inject each portal as well as the joint with a local anesthetic to provide pain relief in the transition to the recovery room and discharge after outpatient surgery. To our knowledge, no previous reports of localized urticaria and delayed hypersensitivity reaction have been reported in the postarthroscopy setting. We are reporting a case of delayed hypersensitivity reaction and urticaria of the knee that presented after bupivacaine (Marcaine) injection of arthroscopic portals after routine meniscectomy.
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PMID:Delayed hypersensitivity reaction of the knee after injection of arthroscopy portals with bupivacaine (marcaine) 757 92

In a double-blind, randomised study of patients scheduled for minor hand surgery 0.5% 2-chloroprocaine (n = 30) and 0.5% prilocaine (n = 30) in a volume of 40 ml were compared for intravenous regional anaesthesia. The onset of sensory and motor block and recovery of sensory block were determined, and the occurrence of side-effects was noted. Twenty-four patients in the 2-chloroprocaine group and 17 in the prilocaine group developed complete sensory block by 15 min after injection (p < 0.05). Complete recovery of sensation was faster after prilocaine (7.1 min) than 2-chloroprocaine (9.8 min) (p < 0.01). Venous irritation and/or urticaria after tourniquet release was observed on 10 occasions in those receiving 2-chloroprocaine and twice in those receiving prilocaine. An increase in heart rate of > 20% above control values occurred in three patients, all of whom had been given 2-chloroprocaine. Clinically, local anaesthetic properties of 0.5% 2-chloroprocaine and prilocaine were similar, but there were more side-effects with the former drug.
Anaesthesia 1993 Dec
PMID:Comparison of 2-chloroprocaine and prilocaine for intravenous regional anaesthesia of the arm: a clinical study. 828 34

Occasionally, a dental patient presents his/her dentist with a history of hypersensitivity to local anesthetic agents. The symptoms may include immediate reactions to the injection procedure (dizziness, shortness of breath, tachycardia, etc), or delayed reactions to the anesthetic (swelling, urticaria, etc). Although the true incidence of local anesthetic allergy is low, such a history often involves the patient's anxiety regarding the use of the drug in question, and the dentist's apprehension to treat the "problematic" patient. In such cases, hypnosis can play a major role in controlling pain and the associated distress. In the present article, the method concerning the implementation of hypnosis to induce local anesthesia is described and illustrated through case demonstrations.
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PMID:When pharmacologic anesthesia is precluded: the value of hypnosis as a sole anesthetic agent in dentistry. 836 35

Latex (natural rubber), which is obtained from the Hevea brasiliensis tree, is known to cause contact urticaria and aggravate pre-existing atopic dermatitis. We present a 4.5 year-old boy with bladder exstrophy and epispadias who developed generalized urticaria and bronchospasm during general anesthesia prior to correction of the epispadias. He had undergone previous urologic operations uneventfully. Allergic evaluation revealed atopy with specific IgE antibodies against latex. Immediate skin tests performed with the medications given during the general anesthesia were negative, supporting the possibility that his anaphylactic reaction was caused by exposure to latex during intubation and ventilation. Similar cases have recently been described, especially in children with congenital urogenital abnormalities who are frequently exposed to latex (catheters, surgical gloves). Exposure to latex in these children should be minimized. In addition, they should be prepared with orally administered corticosteroids and antihistamine medication prior to operation.
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PMID:[Latex hypersensitivity in children]. 843 5

Immediate-type hypersensitivity due to natural rubber (latex) products is an increasing problem for the anaesthetist, because a major part of products used for anaesthesia contains natural rubber. If the patient has a positive history of allergic symptoms after contact to natural rubber like urticaria, bronchospasm or anaphylaxis, preoperative skin tests, in vitro tests, and if necessary even the latex-glove-wearing test should be performed. If preoperative diagnosis of natural latex allergy is established, latex free anaesthesia is strictly recommended; otherwise life-threatening complications may ensue. Accordingly, we report on a patient who developed intraoperative anaphylactic shock following exposure to natural latex. In addition to the treatment with drugs, latex-containing products should be immediately replaced by latex-free ones, in particular all persons should put on latex-free gloves. For prevention of anaphylactic episodes in sensitized patients the reader is provided with an exemplary list of latex-free products for anaesthesia. Because the incidence of immediate-type reactions to latex is still increasing, intraoperative occurrence of an anaphylactic reaction to an unknown agent is likely to be due to allergy to natural rubber.
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PMID:[Anesthesiologic pecularities in patients with latex allergy]. 876 57

We have used eltanolone and propofol to induce anaesthesia and by intermittent injection to supplement nitrous oxide during maintenance in 67 patients undergoing minor gynaecological surgery. This study was a controlled randomized phase III with two parallel groups and a blinded assessment of post-operative recovery. Complications during induction and maintenance were few. Urticaria occurred in two patients given eltanolone and in none of those given propofol. Time to orientation and time to eye opening were significantly shorter in the propofol group (P < 0.001). Systolic and diastolic blood pressure decreased in both groups but the decrease was significantly greater in the propofol group (P < 0.005 systolic blood pressure; P < 0.001 diastolic blood pressure). Heart rate decreased significantly in the propofol group (P < 0.002). We conclude that eltanolone anaesthesia is associated with a greater haemodynamic stability than propofol anaesthesia but that early recovery occurs more slowly.
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PMID:A comparison of eltanolone and propofol anaesthesia for minor gynaecological surgery. 930 87

Cis-atracurium is a stereoisomer of atracurium, about five times more potent than the racemate. Whereas cis-atracurium is routinely used in adults, its effects on children are still poorly defined. We compared equipotent doses of atracurium and cis-atracurium in children aged between 2 and 12 years regarding the quality of neuromuscular blockade, the intubation conditions and the occurrence of side-effects. After approval by the ethics committee and with informed parental consent, 84 children (ASA I or ASA II) were randomly allocated to receive either 0.5 mg/kg atracurium (group A, n = 42) or 0.1 mg/kg cis-atracurium (group C, n = 42). In both groups anaesthesia was induced with 15 micrograms/kg alfentanil and 5-7 mg/kg thiopentone. We assessed the intubation conditions according to the Krieg Scale. Anaesthesia was maintained with a nitrous oxide/oxygen mixture of 2:1 and isoflurane in an endexpiratory concentration of approximately 0.6 Vol.%. Neuromuscular blockade was controlled acceleromyographically in response to supramaximal stimulation of the ulnar nerve. We measured the onset time (T1 = 5%), duration of effect (T1 = 25%), recovery index (T1 = 25%-75%) and the recovery time at a train-of-four-ratio (T4/T1) of 0.7. These parameters did not show any significant differences between group A and group C: onset time: 3.1 +/- 1.5 min (group A) versus 3.4 +/- 1.1 min (group C), duration of effect: 34.1 +/- 5.5 min (group A) versus 34.1 +/- 6.5 min (group C), recovery index: 9.3 +/- 3.3 min (group A) versus 9.6 +/- 2.5 min (group C), recovery time at a TOF-ratio of 0.7:49.3 +/- 8.4 min (group A) versus 52.3 +/- 6.6 min (group C). In group A, the intubation conditions were "excellent" or "good" in 98% of the patients, whereas in group C the figure was only 69%. Regarding side-effects, we found significantly more frequent urticaria in group A (6 of the 42 patients) (p < or = 0.05) than in group C, in which no patient showed urticaria. Flush and tachycardia occurred much less frequently and there were no significant differences in the two groups: two patients in group A and only one in group C. The authors conclude that atracurium and cis-atracurium lead to comparable neuromuscular effects in children aged between 2 and 12 years. Only the intubation conditions were better after atracurium, but atracurium was followed by urticaria more often than cis-atracurium.
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PMID:[Cis-atracurium--an equivalent substitution for atracurium in pediatric anesthesia?]. 1223 66

A contributing role of neurogenic inflammation has provided a new dimension in understanding the pathogenesis of various cutaneous and systemic inflammatory diseases such as atopic dermatitis, urticaria, rheumatoid arthritis, ulcerative colitis and bronchial asthma. Several critical observations, such as (i) psoriasis resolves at sites of anaesthesia, (ii) neuropeptides are upregulated, and (iii) there is a marked proliferation of terminal cutaneous nerves in psoriatic plaques, encouraged us to search for a mechanism of neural influence in inflammation and inflammatory diseases. In immunohistochemical studies, we found that keratinocytes in lesional and nonlesional psoriatic tissue express high levels of nerve growth factor (NGF) and that there is a marked upregulation of NGF receptors, p75 neurotrophin receptor (p75NTR) and tyrosine kinase A (TrkA), in the terminal cutaneous nerves of psoriatic lesions. As keratinocytes of psoriatic plaques express increased levels of NGF, it is likely that murine nerves will promptly proliferate into the transplanted plaques on a severe combined immunodeficient mouse. Indeed, we have noted marked proliferation of nerve fibers in transplanted psoriatic plaques compared with the few nerves in transplanted normal human skin. By double label immunofluorescence staining, we have further demonstrated that in these terminal cutaneous nerves there is a marked upregulation of neuropeptides, such as substance P and calcitonin gene-related protein. These observations, as well as recent findings about NGF-induced chemokine expression in keratinocytes, further substantiate a role of the NGF-p75NTR-TrkA system in the inflammatory process of psoriasis. Currently, we are evaluating antagonists to selected neuropeptides and NGF/receptors, with the expectation of identifying pharmacological agents to counter neurogenic inflammation in psoriasis.
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PMID:Role of NGF and neurogenic inflammation in the pathogenesis of psoriasis. 1469 78

Chlorhexidine, an antiseptic belonging to family of biguanides, is used extensively in the medical and surgical environment. Late onset hypersensitivity and eczema occur regularly and are well documented events. Conversely, immediate hypersensitivity, sometimes taking the form of acute urticaria that can result in anaphylactic shock, is rarer. These manifestations can occur during contact of the skin or mucosa with chlorhexidine. Out of the fifty case reports of chlorhexidine-related anaphylaxis published worldwide over the past ten years, fifteen occurred during surgery. Signs generally appear from 15 to 45 minutes after the start of anesthesia. If there is any suspicion of immediate allergy to chlorhexidine, prick-tests or even intradermal reaction (IDR) techniques are highly recommended. In the event of confirmed allergy to chlorhexidine, strict eviction is required, bearing in mind that over a hundred medicinal products currently on the French market contain chlorhexidine.
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PMID:Immediate hypersensitivity to chlorhexidine: literature review. 1518 Mar 52


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