Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01275 (glucagon)
 26,492 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-five patients with acute severe asthma were treated with oxygen, corticosteroids and either salbutamol or aminophylline by intravenous infusion. Blood glucose, plasma insulin and glucagon were measured during the first 24 hours of treatment. Salbutamol and aminophylline rapidly caused hyperglycaemia, accompanied by a rise in insulin and a fall in plasma glucagon. At first the increase in plasma insulin was insufficient to restore normoglycaemia, but by 24 hours homeostasis was restored. The early submaximal insulin response was attributed to the fasting caused by breathlessness. There was no evidence of an increase in hormone secretion caused by direct beta 2-adrenergic stimulation of the pancreatic islets. The effect of corticosteroids on blood glucose over the period of study was considerably less than the contribution of either salbutamol, or aminophylline.
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PMID:Mechanisms of abnormal glucose metabolism during the treatment of acute severe asthma. 143 70

A 3-year-old male nanday conure (Nandayus nenday) was presented with acute lethargy, polyuria, and polydipsia. Marked persistent hyperglycemia, glycosuria, and ketonuria were also noted. The serum insulin concentration (< 3 microU/ml) was lower than reference ranges described for other psittacine birds. Initial treatment included insulin, antibiotics, and supportive care. Insulin therapy was adjusted based on results of serial blood glucose curves. Histopathologic examination of pancreatic biopsy samples revealed normal exocrine pancreatic tissue with rare lymphoplasmocytic infiltrates and absence of pancreatic islets, suggesting atrophy of endocrine pancreatic tissue. Resolution of clinical signs and a normalized blood glucose curve were obtained after administration of long-acting insulin (0.3 IU/kg IM AM and 0.25 IU/kg IM PM). One month after initial presentation, the conure was admitted for severe dyspnea and lethargy and died despite supportive care. Histopathologic examination of the pancreas revealed nearly total depletion of the endocrine pancreas with moderate lymphoplasmocytic pancreatitis. Immunohistochemical evaluation of the remaining pancreatic islets was negative for the presence of insulin and positive for glucagon. Results of polymerase chain reaction tests for Chlamydophila psittaci performed on tissues from the liver, spleen, and lung were negative. Transmission electron microscopy did not demonstrate viruses. Clinical and pathological findings observed in this case are consistent with insulin-dependant type 1 diabetes.
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PMID:Diabetes mellitus in a nanday conure (Nandayus nenday). 1901 99

An 11-mo-old infant received 12.5 times the maximum therapeutic dose of amlodipine as a result of a medication error in lieu of amoxicillin. He presented with vomiting, lethargy, breathlessness, muffled heart sounds and progressed to hypotensive shock within three hours of admission. He received mechanical ventilation, fluid therapy with normal saline and inotropes. But his parameters improved rapidly only after initiating him on insulin and dextrose infusion therapy (for 15 h) along with glucagon and calcium gluconate infusion (for 72 h). Calcium channel blockers (CCB) cause impaired insulin secretion causing hyperglycemia. High levels of blood sugar are of prognostic value rather than hemodynamic variables in CCB poisoning. A continuous infusion of 0.5 to 1 unit per kg body weight per hour of insulin along with supportive therapy including peritoneal dialysis (for deranged renal function) was used with success in managing amlodipine poisoning.
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PMID:Near fatal case of amlodipine poisoning in an infant. 2282 50

Anaphylaxis is a life-threatening systemic reaction, normally occurring within one to two hours of exposure to an allergen. The incidence of anaphylaxis in the United States is 2.1 per 1,000 person-years. Most anaphylactic reactions occur outside the hospital setting. Urticaria, difficulty breathing, and mucosal swelling are the most common symptoms of anaphylaxis. The most common triggers are medications, stinging insect venoms, and foods; however, unidentified triggers occur in up to one-fifth of cases. Coexisting asthma, mast cell disorders, older age, underlying cardiovascular disease, peanut and tree nut allergy, and drug-induced reactions are associated with severe or fatal anaphylactic reactions. Clinicians can obtain serum tryptase levels, reflecting mast cell degranulation, when the clinical diagnosis of anaphylaxis is not clear. Acute management of anaphylaxis involves removal of the trigger; early administration of intramuscular epinephrine; supportive care for the patient's airway, breathing, and circulation; and a period of observation for potential biphasic reactions. Only after epinephrine administration should adjunct medications be considered; these include histamine H1 and H2 antagonists, corticosteroids, beta2 agonists, and glucagon. Patients should be monitored for a biphasic reaction (i.e., recurrence of anaphylaxis without reexposure to the allergen) for four to 12 hours, depending on risk factors for severe anaphylaxis. Following an anaphylactic reaction, management should focus on developing an emergency action plan, referral to an allergist, and patient education on avoidance of triggers and appropriate use of an epinephrine auto-injector.
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PMID:Anaphylaxis: Recognition and Management. 3293 Dec 10