DOCSLIB.ORG

Hindbrain Serotonin Neurons Activate 5-HT1A Receptors in the Nucleus

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Hindbrain Serotonin Neurons Activate 5-HT1A Receptors in the Nucleus Loyola University Chicago Loyola eCommons Dissertations Theses and Dissertations 2010 Hindbrain Serotonin Neurons Activate 5-HT1A Receptors in the Nucleus Tractus Solitarius (NTS) to Modulate Sympathetic and Ventilatory Recovery Following Hypotensive Hemorrhage Ling-Hsuan Kung Loyola University Chicago Follow this and additional works at: https://ecommons.luc.edu/luc_diss Part of the Neuroscience and Neurobiology Commons Recommended Citation Kung, Ling-Hsuan, "Hindbrain Serotonin Neurons Activate 5-HT1A Receptors in the Nucleus Tractus Solitarius (NTS) to Modulate Sympathetic and Ventilatory Recovery Following Hypotensive Hemorrhage" (2010). Dissertations. 189. https://ecommons.luc.edu/luc_diss/189 This Dissertation is brought to you for free and open access by the Theses and Dissertations at Loyola eCommons. It has been accepted for inclusion in Dissertations by an authorized administrator of Loyola eCommons. For more information, please contact [email protected]. This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. Copyright © 2010 Ling-Hsuan Kung LOYOLA UNIVERSITY CHICAGO HINDBRAIN SEROTONIN NEURONS ACTIVATE 5-HT1A RECEPTORS IN THE NUCLEUS TRACTUS SOLITARIUS (NTS) TO MODULATE SYMPATHETIC AND VENTILATORY RECOVERY FOLLOWING HYPOTENSIVE HEMORRHAGE A DISSERTATION SUBMITTED TO THE FACULTY OF THE GRADUATE SCHOOL IN CANDIDACY FOR THE DEGREE OF DOCTOR OF PHILOSOPHY PROGRAM IN NEUROSCIENCE BY LING-HSUAN KUNG (THERESA) CHICAGO, ILLNOIS DECEMBER 2010 Copyright by Ling-Hsuan Kung, 2010 All rights reserved. ACKNOWLEDGEMENT I give my deep thanks to my advisor, Dr. Karie E Scrogin, for her wonderful mentorship throughout my Ph.D. education. I am extremely grateful for her guidance all along my dissertation studies. She encouraged me to make great progress not only in scientific research, but also in every aspect of my life. I sincerely thank my committee members, Dr. Edward Neafsey, Dr. Lydia DonCarlos, Dr. Mary Druse-Manteuffel and Dr. Caron Dean-Bernhoft, for their constant support and thoughtful input. I also give thanks to the people in my laboratory. It was a great pleasure to work with Dr. Ruslan Tiniakov, Dr. Nichole Dudek, Dr. Marcus Henze, Jaimee Glasgow, Jaime Vantrease and Anna Ruszaj. They provided me with a wonderful scientific environment and inspired my research. I am also grateful to the faculty, staff, and students of the neuroscience program and the Graduate School of Loyola University Chicago for their constant support. Finally, I would like to thank my family and friends especially my uncle, Kao-Der Kung, my mother, Feng-I Kung, my husband, Fei Han, and my son, Nathan Han, for their unconditional love and encouragement. iii Dedicated to My Mother, Uncle and My Husband TABLE OF CONTENTS ACKNOWLEDGEMENTS .……..………………………………………..………… iii LIST OF TABLES…………..……………………………….………….................. viii LIST OF FIGURES ....…………..………………………………………............... ix LIST OF ABBREVIATIONS ………..………..…………………………………..…. xii CHAPTERS I. INTRODUCTION .................................................................................. 1 II. REVIEW OF RELATED LITERATURE............................................... 11 A. Current treatment for hemorrhagic shock .......................... 11 B. Autonomic response to hemorrhage .................................. 13 C. Overview of baro-, chemo- and cardiopulmonary reflexes during hypotensive hemorrhage ...................................… 16 Central pathways in control of the baroreflex .................… 18 Anatomy of the arterial baroreflex ...................................... 18 Peripheral chemoreflex ...................................................... 21 Central chemoreflex .......................................................…. 25 Cardiopulmonary reflex. ................................................... .. 31 D. Hormonal response to hemorrhage ....................................... 31 E. Overview of central serotonergic system .............................. 35 Anatomy ..……………………..……………………….…………… 35 Co-transmitters …..............................................................…. 39 v Serotonin receptors ...........................................................… 40 Major function of serotonin ...............................................….. 42 F. Serotonin and 5HT1A receptors in hemorrhage...................... 43 G. Serotonin in central chemoreflex function .......................... 45 H. Serotonin in peripheral chemoreflex function....................... 46 III. SEROTONIN NEURONS OF THE CAUDAL RAPHE NUCLEI CONTRIBUTE TO SYMPATHETIC RECOVERY FOLLOWING HYPOTENSIVE HEMORRHAGE.…….…….……..……………. 48 ABSTRACT .....................................................................…. 48 INTRODUCTION .............................................................…. 49 METHODS.......................................................................… 52 RESULTS ........................................................................…. 63 DISCUSSION...................................................................…. 94 IV. 5-HT1A-RECEPTOR AGONISTS ACT ON NON-SEROTONERGIC CELLS TO ACCELERATE SYMPATHETIC RECOVERY FOLLOWING HYPOTENSIVE HEMORRHAGE IN CONSCIOUS RATS…........................................................... 104 ABSTRACT ................................................................… 104 INTRODUCTION.........................................................… 105 METHODS ..................................................................… 108 RESULTS ...................................................................… 115 DISCUSSION..............................................................… 134 vi V. SEROTONERGIC NEURONS ACTIVATE 5-HT1A RECEPTORS IN THE NTS TO STIMULATE RECOVERY OF SYMPATHETIC ACTIVITY AFTER HYPOTENSIVE HEMORRHAGE IN CONSCIOUS RATS……..…………..……………………………….. 144 ABSTRACT...........................................................................… 144 INTRODUCTION..................................................................... 145 METHODS ............................................................................… 149 RESULTS .............................................................................… 164 DISCUSSION........................................................................… 195 VI. GENERAL DISCUSSION ................................................................ 205 REFERENCE LIST……………………………………………………………….... 215 VITA .............................................................................................................. 240 vii LIST OF TABLES TABLE Page 1. Body weight at start of experiment, hematocrit and plasma protein concentration before and after hemorrhage............................................ 71 2. Effects of hemorrhage on blood gases and acid-base status in hindbrain lesion and sham-lesioned rats. ...............................................................76 3. Arterial blood pH and arterial blood CO2 pressure at the end of hyperoxic hypercapnia . ..........................................................................................83 4. Indices of baroreflex gain, heart rate and blood pressure variability in caudal hindbrain lesioned and sham-lesioned rats ..................................84 5. Serotonin immunoreactive nerve terminal content in medullary terminal fields in caudal hindbrain lesion and sham-lesioned rats.........................93 6. Tryptophan hydroxylase immunoreactive cell number in each serotonin- rich nucleus ………..................................................................................125 7. Spontaneous baroreflex gain, heart rate and blood pressure variability in global lesion and sham-lesioned rats…………………………………….. 132 8. Spontaneous baroreflex gain, heart rate and blood pressure variability in nucleus tractus solitarius lesioned and sham-lesioned rats ..................177 9. Heart rate and renal sympathetic baroreflex parameters in nucleus tractus solitarius lesioned and sham-lesioned rats ................................181 viii LIST OF FIGURES Figure Page 1. The four different phases of hemodynamic responses to hemorrhage...........15 2. Central pathway of the arterial baroreflex ......................................................20 3. Central pathway of the peripheral chemoreflex in sympathetic activation……23 4. Central pathway of the peripheral chemoreflex in ventilation .........................24 5. Central pathway of the central chemoreflex in sympathetic activation............29 6. Central pathway of the central chemoreflex in ventilation.............................. 30 7. Illustration of catheter placement in rat.......................................................... 68 8. Illustration of the placement of dual recording electrode and external catheters.................................................................................................... 69 9. Hemodynamic data during hemorrhage and recovery of caudal raphe lesioned- and sham-lesioned rats..............................................................73 10. Representative segments of hemodynamic data during hyperoxic hypercapnia in caudal raphe lesioned- and sham-lesioned rats ...............79 11. Summary data of hyperoxic hypercapnia in caudal raphe lesioned- and sham-lesioned rats. ................................................................................. 80 12. Tryptophan hydroxylase immunoreactive neurons in caudal raphe... ………. 86 13. Tryptophan hydroxylase immunoreactive neurons in midbrain raphe ……... 90 14. Tyrosine hydroxylase immunoreactive
Load more

Recommended publications
  • Pediatric Guanfacine Exposures Reported to the National Poison Data System, 2000–2016
    Clinical Toxicology ISSN: 1556-3650 (Print) 1556-9519 (Online) Journal homepage: https://www.tandfonline.com/loi/ictx20 Pediatric guanfacine exposures reported to the National Poison Data System, 2000–2016 Emily Jaynes Winograd, Dawn Sollee, Jay L. Schauben, Thomas Kunisaki, Carmen Smotherman & Shiva Gautam To cite this article: Emily Jaynes Winograd, Dawn Sollee, Jay L. Schauben, Thomas Kunisaki, Carmen Smotherman & Shiva Gautam (2019): Pediatric guanfacine exposures reported to the National Poison Data System, 2000–2016, Clinical Toxicology, DOI: 10.1080/15563650.2019.1605076 To link to this article: https://doi.org/10.1080/15563650.2019.1605076 Published online: 22 Apr 2019. Submit your article to this journal Article views: 19 View Crossmark data Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=ictx20 CLINICAL TOXICOLOGY https://doi.org/10.1080/15563650.2019.1605076 POISON CENTRE RESEARCH Pediatric guanfacine exposures reported to the National Poison Data System, 2000–2016 Emily Jaynes Winograda, Dawn Solleea, Jay L. Schaubena, Thomas Kunisakia, Carmen Smothermanb and Shiva Gautamb aFlorida/USVI Poison Information Center – Jacksonville, UF Health – Jacksonville/University of Florida Health Science Center, Jacksonville, FL, USA; bCenter for Health Equity and Quality Research, UF Health – Jacksonville, Jacksonville, FL, USA ABSTRACT ARTICLE HISTORY Introduction: The purpose of this study was to characterize the frequency, reasons for exposure, clin- Received 10 December 2018 ical manifestations, treatments, duration of effects, and medical outcomes of pediatric guanfacine Revised 12 March 2019 exposures reported to the National Poison Data System (NPDS) from 2000 to 2016. Accepted 25 March 2019 Methods: Data extracted from poison control center call records for pediatric (0–5 years, 6–12 years, Published online 19 April 2019 – and 13 19 years), single-substance guanfacine ingestions reported to NPDS between 2000 and 2016 KEYWORDS was retrospectively analyzed.
    [Show full text]
  • Pharmacology of Ophthalmologically Important Drugs James L
    Henry Ford Hospital Medical Journal Volume 13 | Number 2 Article 8 6-1965 Pharmacology Of Ophthalmologically Important Drugs James L. Tucker Follow this and additional works at: https://scholarlycommons.henryford.com/hfhmedjournal Part of the Chemicals and Drugs Commons, Life Sciences Commons, Medical Specialties Commons, and the Public Health Commons Recommended Citation Tucker, James L. (1965) "Pharmacology Of Ophthalmologically Important Drugs," Henry Ford Hospital Medical Bulletin : Vol. 13 : No. 2 , 191-222. Available at: https://scholarlycommons.henryford.com/hfhmedjournal/vol13/iss2/8 This Article is brought to you for free and open access by Henry Ford Health System Scholarly Commons. It has been accepted for inclusion in Henry Ford Hospital Medical Journal by an authorized editor of Henry Ford Health System Scholarly Commons. For more information, please contact [email protected]. Henry Ford Hosp. Med. Bull. Vol. 13, June, 1965 PHARMACOLOGY OF OPHTHALMOLOGICALLY IMPORTANT DRUGS JAMES L. TUCKER, JR., M.D. DRUG THERAPY IN ophthalmology, like many specialties in medicine, encompasses the entire spectrum of pharmacology. This is true for any specialty that routinely involves the care of young and old patients, surgical and non-surgical problems, local eye disease (topical or subconjunctival drug administration), and systemic disease which must be treated in order to "cure" the "local" manifestations which frequently present in the eyes (uveitis, optic neurhis, etc.). Few authors (see bibliography) have attempted an introduction to drug therapy oriented specifically for the ophthalmologist. The new resident in ophthalmology often has a vague concept of the importance of this subject, and with that in mind this paper was prepared.
    [Show full text]
  • Sympatholytic Drugs
    SYMPATHOLYTIC DRUGS ADRENERGIC ADRENERGIC NEURON RECEPTOR BLOCKERS BLOCKERS ADRENALINE REVERSAL Sir Henry Dale, awarded the Nobel prize in 1936 §ILOS Outline the mechanisms of action of adrenergic neuron blockers Classify a-receptor blockers into selective & non- selective §Study in detail the pharmacokinetic aspects & pharmacodynamic effects of a adrenergic blockers MECHANISMS OF ADRENERGIC BLOCKERS §1-Formation of False Transmitters a-Methyl dopa MECHANISMS OF ADRENERGIC BLOCKERS §2-Depletion of Storage sites Reserpine MECHANISMS OF ADRENERGIC BLOCKERS §3-Inhibition of release Guanethidine MECHANISMS OF ADRENERGIC BLOCKERS §4-Stimulation of presynaptic a2 receptors Clonidine and a-Methyldopa a-Methyldopa §Forms false transmitter that is released instead of NE §Acts centrally as a2 receptor agonist to inhibit NE release Drug of choice in the treatment of hypertension in pregnancy (pre- eclampsia - gestational hypertension) Clonidine §Apraclonidine §Acts directly as a2 receptor is used in open agonist to inhibit NE release angle glaucoma as eye drops. Suppresses sympathetic acts by outflow activity from the brain decreasing aqueous humor Little Used as Antihypertensive agent due to formation rebound hypertension upon abrupt withdrawal Adrenergic SYNOPSIS neuron blockers Stimulation of False Depletion of Inhibition of neurotransmit stores release presynaptic α- ter formation receptors Clonidine α-Methyldopa Reserpine Guanethidine α-Methyldopa ADRENERGIC RECEPTOR BLOCKERS They block sympathetic actions by antagonizing:- §a-receptor §β-receptor
    [Show full text]
  • Ipratropium Bromide Nasal Spray 06.Pdf
    IPRATROPIUM BROMIDE Nasal Solution 0.06% NASAL SPRAY 42 mcg/spray ATTENTION PHARMACISTS: Detach “Patient’s Instructions for Use” from package insert and dispense with product. Prescribing Information DESCRIPTION The active ingredient in Ipratropium Bromide Nasal Spray is ipratropium bromide (as the monohydrate). It is an anticholinergic agent chemically described as 8-azoniabicyclo [3.2.1] octane, 3-(3-hydroxy-1-oxo- 2- phenylpropoxy)-8-methyl-8-(1-methylethyl)-, bromide monohydrate (3-endo, 8-syn)-: a synthetic quaternary ammonium compound, chemically related to atropine. The structural formula is: ipratropium bromide monohydrate C20H30BrNO3 • H2O Mol. Wt. 430.4 Ipratropium bromide is a white to off-white crystal- line substance, freely soluble in water and methanol, sparingly soluble in ethanol, and insoluble in non-polar media. In aqueous solution, it exists in an ionized state as a quaternary ammonium compound. Ipratropium Bromide Nasal Spray 0.06% is a metered-dose, manual pump spray unit which delivers 42 mcg (70 mcL) ipratropium bromide per spray on an anhydrous basis in an isotonic, aqueous solution with pH adjusted to 4.7. It also contains benzalkonium chloride, edetate disodium, sodium chloride, sodium hydroxide, hydrochloric acid, and purified water. Each bottle contains 165 sprays. CLINICAL PHARMACOLOGY Mechanism of Action Ipratropium bromide is an anticholinergic (para-sympatholytic) agent which, based on animal studies, appears to inhibit vagally-mediated reflexes by antagonizing the action of acetylcholine, the transmitter agent released at the neuromuscular junctions in the lung. In humans, ipratropium bromide has anti- secretory properties and, when applied locally, inhibits secretions from the serous and seromucous glands lining the nasal mucosa.
    [Show full text]
  • Intuniv (Guanfacine ER) Pediatric Safety Review
    Pediatric Focused Safety Review Intuniv® (guanfacine ER) Pediatric Advisory Committee Meeting September 20, 2018 Amy M. Taylor, MD, MHS Division of Pediatric and Maternal Health Office of New Drugs/ ODE IV Center for Drug Evaluation and Research Food and Drug Administration Outline • Background Information • Pediatric Studies • Labeling Changes • Drug Use Trends • Safety • Summary www.fda.gov 2 Background Drug Information Intuniv® (guanfacine ER) • Drug: Intuniv® (guanfacine ER) • Formulation: extended-release tablets • Sponsor: Shire • Original Market Approval: September 2, 2009 • Therapeutic Category: central alpha2A-adrenergic receptor agonist • An immediate-release guanfacine for management of hypertension was approved on October 27, 1986. www.fda.gov 3 Background Drug Information, continued Intuniv® (guanfacine ER) Indication For the treatment of Attention Deficit Hyperactivity Disorder (ADHD) as monotherapy and as adjunctive therapy to stimulant medications www.fda.gov 4 Background Drug Information, continued Intuniv® (guanfacine ER) Contraindications History of a hypersensitivity reaction to Intuniv® or its inactive ingredients, or other products containing guanfacine Warnings and Precautions • Hypotension, Bradycardia and Syncope: monitor heart rate and blood pressure prior to and during therapy. • Sedation and Somnolence • Cardiac Conduction Abnormalities: titrate Intuniv® slowly and monitor vital signs frequently in patients with cardiac conduction abnormalities or patients concomitantly treated with other sympatholytic drugs. • Rebound Hypertension: taper dose when withdrawing medication and monitor blood pressure and heart rate. www.fda.gov 5 Background Drug Information, continued Intuniv® (guanfacine ER) Previous PAC Presentations May 2011 – review of FAERS reports from September 2, 2009 to September 30, 2010. No new safety concerns identified. September 2013 – Review of FAERS reports from October 1, 2010 to June 30, 2012.
    [Show full text]
  • Sympatholytic Mechanisms for the Beneficial Cardiovascular Effects Of
    International Journal of Molecular Sciences Hypothesis Sympatholytic Mechanisms for the Beneficial Cardiovascular Effects of SGLT2 Inhibitors: A Research Hypothesis for Dapagliflozin’s Effects in the Adrenal Gland Anastasios Lymperopoulos * , Jordana I. Borges, Natalie Cora and Anastasiya Sizova Laboratory for the Study of Neurohormonal Control of the Circulation, Department of Pharmaceutical Sciences, Nova Southeastern University, Fort Lauderdale, FL 33328-2018, USA; [email protected] (J.I.B.); [email protected] (N.C.); [email protected] (A.S.) * Correspondence: [email protected]; Tel.: +1-954-262-1338; Fax: +1-954-262-2278 Abstract: Heart failure (HF) remains the leading cause of morbidity and death in the western world, and new therapeutic modalities are urgently needed to improve the lifespan and quality of life of HF patients. The sodium-glucose co-transporter-2 (SGLT2) inhibitors, originally developed and mainly indicated for diabetes mellitus treatment, have been increasingly shown to ameliorate heart disease, and specifically HF, in humans, regardless of diabetes co-existence. Indeed, dapagliflozin has been reported to reduce cardiovascular mortality and hospitalizations in patients with HF and reduced ejection fraction (HFrEF). This SGLT2 inhibitor demonstrates these benefits also in non- diabetic subjects, indicating that dapagliflozin’s efficacy in HF is independent of blood glucose control. Evidence for the effectiveness of various SGLT2 inhibitors in providing cardiovascular benefits irrespective of their effects on blood glucose regulation have spurred the use of these agents Citation: Lymperopoulos, A.; Borges, in HFrEF treatment and resulted in FDA approvals for cardiovascular indications. The obvious J.I.; Cora, N.; Sizova, A. question arising from all these studies is, of course, which molecular/pharmacological mechanisms Sympatholytic Mechanisms for the underlie these cardiovascular benefits of the drugs in diabetics and non-diabetics alike.
    [Show full text]
  • HST-151 1 Autonomic Pharmacology Reading: Chapters 6-10 in Katzung Are Quite Good; Those in Goodman and Gilman Are Based On
    Harvard-MIT Division of Health Sciences and Technology HST.151: Principles of Pharmocology Instructor: Dr. Carl Rosow HST-151 1 Autonomic Pharmacology Reading: Chapters 6-10 in Katzung are quite good; those in Goodman and Gilman are based on the same fundamental outline. Overview As you will see throughout the course, the autonomic nervous system (ANS) is a very important topic for two reasons: First, manipulation of ANS function is the basis for treating a great deal of cardiovascular, pulmonary, gastrointestinal and renal disease; second, there is hardly a drug worth mentioning without some major autonomic side effects (cf. antihistamines). You have already heard something about the ANS and its wiring diagram in the lecture by Dr. Strichartz on cholinergic receptors, and it is certainly not my intent to reproduce these pictures or the various diagrams in your text. I hope to give you a slightly different presentation which highlights the important points in this rather long textbook assignment. You have already heard about nicotinic cholinergic receptors and the somatic nervous system (SNS) control of voluntary striated muscle. The ANS, simply put, controls everything else: smooth muscle, cardiac muscle, glands, and other involuntary functions. We usually think about the ANS as a motor system -- although it does have sensory nerves, there is nothing particularly distinctive about them. Anatomy The sympathetic division of the ANS is called THORACOLUMBAR, but it has input from higher brain centers like hypothalamus, limbic cortex, etc. The preganglionic sympathetic nerves have cell bodies in the intermediolateral column of the spinal cord from about T1 to L3.
    [Show full text]
  • Efficacy of Stellate Ganglion Block with an Adjuvant Ketamine for Peripheral Vascular Disease of the Upper Limbs
    Clinical Investigation Efficacy of stellate ganglion block with an adjuvant ketamine for peripheral vascular disease of the upper limbs Kalpana R Kulkarni, Anita I Kadam, Ismile J Namazi Department of Anesthesia, D.Y. Patil Medical College, Kolhapur, Maharashta, India Address for correspondence: ABSTRACT Dr. Kalpana R Kulkarni, 1168, “Chaitanya” A-5, Stellate ganglion block (STGB) is commonly indicated in painful conditions like reflex sympathetic Takala Square, Kolhapur - 416 006, dystrophy, malignancies of head and neck, Reynaud’s disease and vascular insufficiency of the Maharashtra, India. upper limbs. The sympathetic blockade helps to relieve pain and ischaemia. Diagnostic STGB is E-mail: drrmk@rediffmail. usually performed with local anaesthetics followed by therapeutic blockade with steroids, neurolytic com agents or radiofrequency ablation of ganglion. There is increasing popularity and evidence for the use of adjuvants like opioid, clonidine and N Methyl d Aspartate (NMDA) receptor antagonist – ketamine – for the regional and neuroaxial blocks. The action of ketamine with sympatholytic block is through blockade of peripherally located NMDA receptors that are the target in the management of neuropathic pain, with the added benefit of counteracting the “wind-up” phenomena of chronic pain. We studied ketamine as an adjuvant to the local anaesthetic for STGB in 20 cases of peripheral vascular disease of upper limbs during the last 5 years at our institution. STGB was given for 2 days with 2 ml of 2% lignocaine + 8 ml of 0.25% bupivacaine, followed by block with the addition of 0.5 mg/kg of ketamine for three consecutive days. There was significant pain relief of longer duration with significant rise in hand temperature.
    [Show full text]
  • OBI 836 the Autonomic Nervous System -Sympatholytics M.T. Piascik August 30, 2012
    1 OBI 836 The Autonomic Nervous System -Sympatholytics M.T. Piascik August 30, 2012 Sympatholytics: Drugs that bind to beta or alpha receptors or act through other mechanisms to block the actions of endogenous neurotransmitters or other sympathomimetics. Learning Objectives Lecture III The student should be able to explain or describe 1. The pharmacologic properties and therapeutic uses of alpha and beta blockers. 2. How the presence of sympathomimetics alters the dental management of patients. Prototype Drugs Metoprolol-Toprol XL - Lopressor - Various formulations in the top 50 leading prescription drugs in the US in 2010 Clonidine - Catapres,- 109th leading prescription drug in the US in 2010 MAO Inhibitors Phentolamine – Ora Verse Propranolol - Inderal - various trade names Terazosin - Hytrin Tamsulosin-Flomax - 37th leading prescription drug in the US in 2010 * A more complete list of sympatholytics and their trade names can be found in the Yagiela text. 2 BETA ADRENERGIC RECEPTOR BLOCKERS 1. These drugs are competitive antagonists of the beta adrenergic receptor. 2. The beta blockers used are referred to as either selective, that is blocking the beta1 receptor, or nonselective, blocking both the beta1 and beta2 receptor. Propranolol is the prototype nonselective beta blocker while metoprolol is a prototype selective beta1 blocker. 3. There are over 15 beta blockers available for clinical use. In addition to selective and non selective antagonists, many of these drugs have novel effects unrelated to beta blockade. 3 Basic Properties of Beta Blockers Implications in Dental Practice Nonselective beta-blockers increase the risk of a hypertensive episode following systemic absorption of epinephrine. In addition, they could prolong the duration of local anesthetic action.
    [Show full text]
  • Clonidine Hydrochloride Tablet, Extended Release Golden State Medical Supply, Inc.
    CLONIDINE HYDROCHLORIDE EXTENDED-RELEASE- clonidine hydrochloride tablet, extended release Golden State Medical Supply, Inc. ---------- HIGHLIGHTS OF PRESCRIBING INFORMATION CLONIDINE HYDROCHLORIDE EXTENDED-RELEASE TABLETS These highlights do not include all the information needed to use CLONIDINE HYDROCHLORIDE EXTENDED- RELEASE TABLETS safely and effectively. See full prescribing information for CLONIDINE HYDROCHLORIDE EXTENDED-RELEASE TABLETS. CLONIDINE HYDROCHLORIDE extended-release tablets, for oral use Initial U.S. Approval: 1974 INDICATIONS AND USAGE Clonidine hydrochloride extended-release tablets are a centrally acting alpha 2-adrenergic agonist indicated for the treatment of attention deficit hyperactivity disorder (ADHD) as monotherapy or as adjunctive therapy to stimulant medications. ( 1) DOSAGE AND ADMINISTRATION Start with one 0.1 mg tablet at bedtime for one week. Increase daily dosage in increments of 0.1 mg/day at weekly intervals until the desired response is achieved. Take twice a day, with either an equal or higher split dosage being given at bedtime, as depicted below ( 2.2) Total Daily Dose Morning Dose Bedtime Dose 0.1 mg/day 0.1 mg 0.2 mg/day 0.1 mg 0.1 mg 0.3 mg/day 0.1 mg 0.2 mg 0.4 mg/day 0.2 mg 0.2 mg Do not crush, chew or break tablet before swallowing. ( 2.1) Do not substitute for other clonidine products on a mg-per-mg basis, because of differing pharmacokinetic profiles. ( 2.1) When discontinuing, taper the dose in decrements of no more than 0.1 mg every 3 to 7 days to avoid rebound hypertension. ( 2.3) DOSAGE FORMS AND STRENGTHS Extended-release tablets: 0.1 mg and 0.2 mg, not scored.
    [Show full text]
  • Alpha -2 Agonists
    McClain, B.C. NEWER MODALITIES FOR PAIN MANAGEMENT Brenda C. McClain, M.D., DABPM Associated Professor of Anesthesiology and Pediatrics Yale University School of Medicine Yale New Haven Children’s Hospital Alpha -2 Agonists The alpha -2 agonists used in pain management include clonidine, dexmedetomidine, and tizanidine. There are three adrenoceptor subtypes:alpha2A, alpha2B, and alpha2C. These receptor subtypes are distributed ubiquitously, and each may be uniquely responsible for some of the actions of alpha2 agonists. It is the alpha2A adrenoceptor that is responsible for the anesthetic and sympatholytic responses. All the subtypes produce cellular action by signaling through a G-protein [1]. G-proteins couple to effector mechanisms, which appear to differ depending on the receptor subtype. Alpha-2 receptors play a key part in the descending modulation of pain. Descending supraspinal pathways include the periaqueductal gray area of the midbrain, stimulation of which results in widespread analgesia. In particular, stimulation of alpha-2 receptors located in the locus ceruleus and parabrachial nucleus of the medulla affords analgesia through G-protein mediated potassium channel conductance [2]. Clonidine Clonidine, an alpha- 2 agonist has been administered by the enteric, neuraxial, and intravenous routes for pain management in various settings of acute and chronic pain. The benefits of clonidine as an adjuvant include 1) reduction in the amount of opioid required for analgesia and thus, a likely decrease in the side effects due to opioids 2) titrated sedation and anxiolysis without additive respiratory depression when given in combination with opioids and 3) vasodilatation and improved circulation of cerebral, coronary and visceral vascular beds.
    [Show full text]
  • Sympatholytic Agents)*
    BRrrmsh 598 3 June 1967 MEDICAL JOURNAL Br Med J: first published as 10.1136/bmj.2.5552.598 on 3 June 1967. Downloaded from Double-blind Trial of Four Hypotensive Drugs (Methyldopa and Three Sympatholytic Agents)* V. VEJLSGAARD, M.D.; M. CHRISTENSEN, M.D.; E. CLAUSEN, M.D. Brit. med. 7., 1967, 2, 598-600 In general, drug treatment of hypertension is started with a Guanoclor is 2-(2,6-dichlorphenoxy) ethylamino-guanidine. diuretic. If such therapy is not successful another hypotensive In animal experiments and in experiments in vitro reduction of drug is added, either a specific sympatholytic agent or methyl- the concentration of catecholamine was found both in the hypo- dopa. thalamus and the adrenal medulla, and peripherally. Further- In order to be as objective as possible regarding which of these more, on administration of guanoclor a peripheral sympathetic methods of treatment is the best a double-blind trial was carried blockade has been demonstrated. out; this included two of the known hypotensive drugs, guan- In-vitro experiments have shown that guanoclor inhibits the ethidine (Ismelin) and methyldopa (Aldomet), and two new enzyme dopamine-beta-oxidase. Correspondingly, it was pos- drugs, guanoxan (Envacar) and guanoclor (Vatensol). sible to show a considerable reduction in the excretion of adrenaline both in experimental animals and in patients during hypotensive treatment with guanoclor (Brit. med. 7., 1964; Chemistry and Pharmacology Lawrie et al., 1964b). A similar reduced excretion was not observed in patients who were treated with guanoxan or guan- Guanethidine is a sympatholytic agent (Maxwell et al., 1959), ethidine. With oral administration of guanoclor the influence and its effect is predominantly a lowering of the blood pressure on the blood pressure becomes measurable after 24 hours and in the erect position, whereas only a slight reduction is obtained maximal effect is obtained after 48 hours.
    [Show full text]