Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Pivot Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Target Concepts:
Gene/Protein
Disease
Symptom
Drug
Enzyme
Compound
Query: UNIPROT:P01185 (
vasopressin
)
23,126
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
This article will review for bedside clinicians how to manage septic ALI.ARDS and shock to use the principles of
EBM
to evaluate the various therapeutic approaches for them. Low tidal volume ventilation (6 mg/dl/kg) is recommended for ALI.ARDS, but application of a minimum amount of PEEP, recruitment maneuvers with high PEEP and prone position are needed to confirm any benefit. NO inahalation, ECMO/ECCR, and glucocorticoid therapies don' t recommended for ALI.ARDS. Sivelestat Na, is available for ALI.ARDS in Japan, is needed further prospective randomized studies. Aggressive infusion of crystalloid and colloid is recommended for septic shock, but blood transfusion and bicarbonate administration are not recommended. Vasopressors are recommended for septic shock: preference for norepinephrine and cautious use of
vasopressin
. Stress-dose of steroid and activated protein C for severe sepsis are useful if shock don't recover by aggressive fluid infusion and vasopressors' administration.
...
PMID:[Respiratory and cadiovascular management of septic ALI-ARDS and shock]. 1559
Background:
Clozapine is the antipsychotic of choice for treatment-resistant schizophrenia and has minimal risk for extrapyramidal symptoms. Therapeutic benefits, however, are accompanied by a myriad of cardiometabolic side-effects. The specific reasons for clozapine's high propensity to cause adverse cardiometabolic events remain unknown, but it is believed that autonomic dysfunction may play a role in many of these.
Objective:
This systematic review summarizes the literature on autonomic dysfunction and related cardiovascular side effects associated with clozapine treatment.
Method:
A search of the EMBASE, MEDLINE, and
EBM
Cochrane databases was conducted using the search terms antipsychotic agents, antipsychotic drug
*
, antipsychotic
*
, schizophrenia, schizophren
*
, psychos
*
, psychotic
*
, mental ill
*
, mental disorder
*
, neuroleptic
*
, cardiovascular
*
, cardiovascular diseases, clozapine
*
, clozaril
*
, autonomic
*
, sympathetic
*
, catecholamine
*
, norepinephrine, noradrenaline, epinephrine, adrenaline.
Results:
The search yielded 37 studies that were reviewed, of which only 16 studies have used interventions to manage cardiovascular side effects. Side effects reported in the studies include myocarditis, orthostatic hypotension and tachycardia. These were attributed to sympathetic hyperactivity, decreased vagal contribution, blockade of cholinergic and adrenergic receptors, reduced heart rate variability and elevated catecholamines with clozapine use. Autonomic neuropathy was identified by monitoring blood pressure and heart rate changes in response to stimuli and by spectral analysis of heart rate variability. Metoprolol, lorazepam, atenolol, propranolol, amlodipine,
vasopressin
and norepinephrine infusion were used to treat tachycardia and fluctuations in blood pressure, yet results were limited to case reports.
Conclusion:
The results indicate there is a lack of clinical studies investigating autonomic dysfunction and a limited use of interventions to manage cardiovascular side effects associated with clozapine. As there is often no alternative treatment for refractory schizophrenia, the current review highlights the need for better designed studies, use of autonomic tests for prevention of cardiovascular disease and development of novel interventions for clozapine-induced side effects.
...
PMID:Clozapine-Induced Cardiovascular Side Effects and Autonomic Dysfunction: A Systematic Review. 2967 May 4
