Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1323099 (sympathomimetic)
 2,957 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Salmeterol is an original molecule with a selective-beta-2-sympathomimetic effect which is intended to a prolonged treatment of asthma. This inhaled preparation has a long duration of action which points to its use on a BID regimen. Results of the phase III development has been assessed in 2,277 subjects. Salmeterol administered at a dose of 50 micrograms morning and evening results in a marked increase in FEV1, which remains superior to 15% by comparison with baseline 12 hours after the last dose in the majority of subjects. In the specific case of more severe asthma (FEV1 less than 50% of predicted), the use of 100 micrograms morning and evening allows for an extra-improvement in FEV1. In the majority of studies, salmeterol has resulted in an almost complete remission of the clinical symptomatology: disappearance or major diminution in the use of inhaled salbutamol administered as a rescue medication on a PRN basis (during the day and at night) and of nocturnal awakenings, global improvement of clinical scores. Daily peak expiratory flow rates (morning and night values) are considerably improved (greater than or equal to 50 l/min) with a significant reduction of daily swings. Lung function tests are also very significantly improved. Salmeterol has proved to be largely superior to the comparison medications, salbutamol taken at a dose of 200 micrograms four times a day, and optimal therapy with theophylline. Clinical acceptability of salmeterol is good and is not different from salbutamol.
Rev Mal Respir 1992
PMID:[Salmeterol and prolonged treatment of asthma: international clinical data]. 135 Mar 64

Nicotine has a small molecular weight and is absorbed via the mucosa (Guccal or nasal), the pulmonary alveoli and the skin. The phenomenon of autotitration explains how a dependent smoker can unconsciously change his method of smoking to maintain a steady nicotine level. Nicotine leads to a liberation of catecholamines by acting on the nervous system through the intermediary of nicotine receptors. There is increased vigilance and powers of intellectual concentration, an awakening reaction and some anxiolytic and euphoriant effects. From the cardiac stand point there is an increased heart rate and blood pressure, as a result of the sympathomimetic effects. Elimination is via the kidneys as unchanged nicotine, cotinine and 1'-N-oxide of nicotine. Nicotine has an addictive action and is capable of inducing pharmacological dependency, tolerance and withdrawal syndrome in cases of abrupt cessation. A knowledge of the pharmacology of nicotine is important in the process of stopping smoking.
Rev Mal Respir 1992
PMID:[Pharmacology of nicotine]. 150 83

Ten patients with cardiogenic shock after acute myocardial infarction were referred to the University Hospital Henri Mondor as candidates for cardiac transplantation. The period before transplantation was bridged by maximal pharmacological support including sympathomimetic and phosphodiesterase inhibitor inotropic agents and, in non-responders, by mechanical ventricular assist devices (1 case) or artificial hearts (2 cases). The 7 patients who improved with optimal pharmacological support alone had a good initial course. However, only two of these patients were finally transplanted, three died suddenly either in the intensive care unit or after withdrawal of intravenous drugs and hospital discharge. One patient remained well and after coronary bypass surgery, enjoys good quality life. One patient was found secondarily to be a poor candidate for transplantation and died shortly after. The outcome of 2 of the 3 patients who did not respond to pharmacological treatment and who required mechanical support was spectacularly good and enabled successful cardiac transplantation. Our experience underlines the numerous difficulties of different natures of cardiac transplantation in this indication, the value and risks of the new inotropic agents, and the real but limited role of heroic procedures such as the artificial heart.
Arch Mal Coeur Vaiss 1991 Jun
PMID:[Heart transplantation in acute myocardial infarction]. 183 53

Cardiac transplantation is theoretically the optimal final treatment of terminal cardiac failure but the indications, especially in the emergency situation, should be carefully considered. Sympathomimetic agents are of limited use in patients with severe cardiac failure partly because of the down regulation of the myocardial beta-receptors. The phosphodiesterase inhibitors, represented by enoximone, are valuable because of their action on the cardiac muscle (inotropic and lusitropic) and their direct systemic vasodilator effect. Enoximone can be administered by intravenous bolus resulting in a rapid onset of action (peak at 30 minutes) with a prolonged effect due to its hepatic metabolites. The authors' experience in this indication dates over 5 years and over 50 patients were included. A preliminary study in 34 patients with cardiac failure resistant to betamimetic drugs, referred to the intensive care unit for urgent cardiac transplantation, or, in the absence of a donor, circulatory assistance is reported. A Swan Ganz catheter and radial artery canula were inserted for haemodynamic monitoring and enoximone was administered in an intravenous bolus over 15 minutes every 8 hours in addition to sympathomimetic agents. A haemodynamic improvement was observed after the 30th minute in 30 patients. The cardiac index increased from 1.82 to 2.67 l/mn/m2 and the pulmonary capillary pressures decreased from 30.8 to 18.9 mmHg. Systemic arterial resistances fell from 2,170 to 1,520 dynes.s.cm-5. No haemodynamic improvement was observed in 4 patients who were treated by mechanical ventricular assistance. After investigations to detect contra-indications to cardiac transplantation, 12 of the 30 patients remained candidates for cardiac transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1990 Sep
PMID:[Medical strategy in patients awaiting emergency heart transplantation]. 214 25

37 subjects with stable asthma and a mean age of 50.3 undertook a protocol to study the cardiac tolerance to a spray B2SM. A Holter monitor was performed before and 48 hours after the institution of a Fenoterol spray in 4 daily doses of 600 micrograms at fixed times. Before starting treatment with a beta 2 sympathomimetic spray (B2SM) 11 subjects had abnormal traces with significant auricular extra-systoles in 4, ventricular extra-systoles in 5 and both in one subject: one patient had a run of ventricular tachycardia without symptoms. On Fenoterol, a worsening of pre-existing extra systoles was noted thrice, one was auricular the other two ventricular. Two patients had brief runs of ventricular tachycardia but the role of Fenoterol was uncertain; one of the patients was very elderly and hypoxaemic. In the second and elevated theophylline level of 20 micrograms/l was noted. The arrythmogenic power of a B2SM seems weak, but in certain situations such as hypoxaemia, metabolic acidosis and overdosage of theophylline, over consumption of B2SM in association with the above factors could contribute to serious arrhythmias. Also in this study in which there was a protocol limited in time, no premature conclusion should be made on the crucial problem of the cardiovascular risks of B2SM in the basic treatment of asthma but raises the problem of the arrythmogenic potential of the drug association of Theophylline + B2SM.
Rev Mal Respir 1985
PMID:[Cardiac tolerance of a beta-2-sympathomimetic spray: fenoterol. Apropos of 37 patients followed using a Holter monitor during a brief treatment protocol]. 241 75

Enoximone is a positive inotropic agent belonging to the group of phosphodiesterase F-III inhibitors. The drug was tested in 34 patients uncontrolled by sympathomimetic drugs and referred to our department for urgent heart transplantation or circulatory assistance. After insertion of a Swan-Ganzgatheter and a radial artery catheter for haemodynamic monitoring, enoximone was administered as a 15-minute intravenous bolus injection of 1 to 2.5 mg/kf every 8 hours, in addition to sympathomimetic agents. Clinical and haemodynamic improvement was observed after thirty minutes in 30 patients. The cardiac index rose from 1.82 to 2.67 l/min/m2 and the pulmonary wedge pressure fell from 30.8 to 18.9 mmHg. Systemic arterial resistance decreased from 2170 to 1520 dyn. s. cm-5, and pulmonary resistance from 5.5 to 4.6 Wood units (p less than 0.01 for all values). Four patients had no haemodynamic improvement and were put on circulatory assistance, using a Jarvik 7 total artificial heart in 3 of them and heterotopic circulatory assistance in one. After clinical investigation for contra-indication to heart transplantation, and as their improved haemodynamic status permitted, 12 of the 30 patients were considered suitable (group B) for heart transplantation. Transplantation was performed within a week of admission in 11 patients without any need for mechanical assistance. One of the group B patients who required implantation of a Jarvik 7 artificial heart died after 12 hours of assistance. Eighteen patients were considered unsuitable for transplantation (group A) and treated medically.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss
PMID:[Enoximone and the therapeutic strategy in patients awaiting emergency cardiac graft]. 252 34

In mild hypertension, a betablocker treatment could reduce cardiovascular events. But in smoking men the benefit disappears and this interaction is unexplained. In 6 healthy non smoking men, we studied the effects of acute oral administration of propranolol (80 mg) pindolol (15 mg) and placebo after cigarette smoking (CS) (two cigarettes within 10 minutes). In a double blind cross over randomized study, arterial pressure and heart rate (HR) were recorded within 20 minutes after CS. Brachial artery diameter (D), Local vascular Resistance (RL), Local arterial Compliance (CL) and pulse wave velocity (VOP) were determined non invasively (using a pulsed doppler system) before and 20 mn after CS. Under placebo, mean arterial pressure (PAM), HR and RL increased significantly after CS (+9.2 +/- 3 mmHg, +4.5 +/- 3 b/mn and +36 +/- 14 per cent, respectively). These modifications were not different after propranolol, pindolol or placebo (ANOVA). Arterial distensibility (CL) was decreased after CS and this alteration was not prevented by beta-blockers. Brachial artery diameter was not modified after CS. Our results demonstrate that acute treatment with non selective beta-blockers with or without sympathomimetic intrinsic activity does not prevent haemodynamic modifications induced by cigarette smoking.
Arch Mal Coeur Vaiss 1988 Jun
PMID:[Effects of beta-blockers on hemodynamics of the forearm after tobacco stimulation]. 290 27

The aim of this prospective, monocentric, opened study and with random order for antihypertensive sequence was to compare a betablocker with sympathomimetic activity (ACE) and an alphabetablocker (LAB) to the gold standard treatment (MD) in moderate HDP (BP greater than 90 mmHg). This study (January 1984 to December 1985) includes 63 women, mean age 28.2 years, divided into three comparable subgroups (age, parity, risk factors and initial level of SBP/DBP). Initial doses are 500 mg/bid (MD), and 400 mg/bid (ACE, LAB) and optimal dosages could not be respectively more than 1500 mg/bid (MD) or 1200 mg/bid (ACE, LAB). Usual criteria for maternal and foetal care are taken into account. The chi 2 test, the Student "t" test and the Kruskall Wallis test were used for statistical analysis. The results show: 1--A similar antihypertensive effect for MD and LAB, but significantly less for ACE (initial PAD-37th week PAD: MD +/- 18.8 +/- 2; LAB = -17.9 +/- 3; ACE = - 8.2 +/- 2.7 mmHg, p less than 0.02; 2--A more frequent adjustment of daily dosage with MD (n = 15) than with ACE (n = 10) or LAB (n = 7); 3--The absence of any significant difference for uricemia level, platelet counts, foetal cardiac rythm, and occurrence of pre-eclampsia (MD = 4; ACE = 3; LAB = 4; 4--An equivalent birth-weight (MD = 3110 +/- 628 g; ACE = 3115 +/- 645.(ABSTRACT TRUNCATED AT 250 WORDS)
Arch Mal Coeur Vaiss 1988 Jun
PMID:[Randomized, comparative study on the treatment of moderate arterial hypertension during pregnancy: methyldopa, acebutolol, labetalol]. 314 96

Beta-blocking agents may induce vascular syndromes related to environmental temperature, accentuation of arterial diseases, gangrene of the extremities. Incidence and severity are variable with beta-blocking agent's properties: cardioselectivity, intrinsic sympathomimetic activity, cardiac depression, and with the patient's disease. The risk of complication is greater with hypertension disease because of the reduction of arterial compliance and quantitative and qualitative alterations of adrenergic receptors.
J Mal Vasc 1984
PMID:[Peripheral vascular complications of beta-blocking agents]. 614 17

The complications of myocardial infarction after transfer from the Coronary Care Unit on the 6th day were analysed bu a retrospective study of 3,460 computerised case reports (1973-1980). The mortality rate was 6% (1/3 of hospital deaths) in the period from the 7th day to discharge from hospital (14th to 30th day). Cardiac arrest as not uncommon (20% of all cardiac arrests) but the prognosis was better thn during the initial phase (p less than 0.05) as the mechanism was more commonly ventricular fibrillation or tachycardia (p less than 0.05). This series was compared with a similar population from 1970-1973; an improvement was observed in global hospital mortality (27% previously compared to 17%, in the study series, p less than 0.001). As the population were comparable, this phenomenon seems to be related to better treatment of shock and cardiac failure and the advances in cardiac surgery during the initial phase of infarction. Thd commonest mechanical complication was ventricular aneurysm; its occurrence does not influence the vital prognosis during this period. The incidence of cardiac arrest and death due to cardiac failure is not negligible after the first week of myocardial infarction. Therefore, we do not believe that the hospital period should be reduced after myocardial infarction. Special training of the nursing staff is essential for the successful treatment of these complications. The global prognosis could be improved by the rehabilitation of digitalis therapy and the introduction of new sympathomimetic amines in the acute phase of myocardial infarction.
Arch Mal Coeur Vaiss 1982 Sep
PMID:[Complications of myocardial infarction between the 2d and 4th week]. 681 81


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