cardiovascular-agents and Respiration-Disorders

Topics: Cardiovascular Agents; Humans; Iatrogenic Disease; Respiration Disorders

Various drugs are associated with adverse respiratory disorders (ARDs) ranging in severity from mild, moderate to severe and even fatal. Cardioselective and nonselective beta-blockers, calcium antagonists and dipyridamole can induce asthma. ACE inhibitors are mainly associated with cough. Amiodarone is related to a form of interstitial pneumonitis (IP) which can be fatal, tocainidine and flecainidine to a form of IP, and hydrochlorothiazide to a form of IP and pulmonary oedema. Antiasthmatic drugs can be associated with a paradoxical bronchospasm, while leukotriene antagonists are linked to the development of Churg-Strauss syndrome. Nonsteroidal anti-inflammatory drugs including aspirin (acetylsalicylic acid) may induce asthma. Gold is mainly related to IP, penicillamine to IP, systemic lupus erythematosus, bronchiolitis obliterans, and Goodpasture's syndrome. Acute respiratory reactions to nitrofurantoin include dyspnoea, cough, IP, and pleural effusion while IP and fibrosis are common in chronic reactions. Other antibacterials mainly evoke pneumonitis, pulmonary infiltrates and eosinophilia, and bronchiolitis obliterans. ARDs are similar for most categories of cytotoxic agents, with chronic pneumonitis and fibrosis being the most common. Noncardiogenic pulmonary oedema occurs as the most common respiratory complication in opioid agonist addiction. Psychotropic drugs such as phenothiazides, butyrophenones and tricyclic antidepressants can also induce pulmonary oedema. Oral contraceptives may produce asthma exacerbation, while long term use and/or high doses of postmenopausal hormone replacement therapy increase the risk of asthma. Bromocriptine is mainly associated with pleural effusion, while methysergide is usually associated with pleural effusion and fibrosis. Some anorectic agents have been linked to the development of primary pulmonary hypertension. The possibility of the occurrence of ARDs should be taken into account in each individual patient. Although in most cases the adverse effects are unpredictable, they can be reduced to a minimum or prevented if some drugs are avoided or stopped in time.

Topics: Anti-Asthmatic Agents; Anti-Infective Agents; Anti-Inflammatory Agents; Antineoplastic Agents; Cardiovascular Agents; Humans; Incidence; Narcotics; Psychotropic Drugs; Respiration Disorders

Postoperative complications after cardiac surgery increase mortality. This study aimed to evaluate the efficacy of cardiopulmonary rehabilitation with adaptive servo-ventilation (ASV) in patients undergoing off-pump coronary artery bypass grafting (OPCAB).. A total of 66 patients undergoing OPCAB were enrolled and divided into 2 groups according to the use of ASV (ASV group, 30 patients; non-ASV group, 36 patients). During the perioperative period, all patients undertook cardiopulmonary rehabilitation. ASV was used from postoperative day (POD) 1 to POD5. Hemodynamics showed a different pattern in the 2 groups. Blood pressure (BP) on POD6 in the ASV group was significantly lower than that in the non-ASV group (systolic BP, 112.9±12.6 vs. 126.2±15.8 mmHg, P=0.0006; diastolic BP, 62.3±9.1 vs. 67.6±9.3 mmHg, P=0.0277). The incidence of postoperative atrial fibrillation (POAF) was lower in the ASV group than in the non-ASV group (10% vs. 33%, P=0.0377). The duration of oxygen inhalation in the ASV group was significantly shorter than that in the non-ASV group (5.1±2.2 vs. 7.6±6.0 days, P=0.0238). The duration of postoperative hospitalization was significantly shorter in the ASV group than in the non-ASV group (23.5±6.6 vs. 29.0±13.1 days, P=0.0392).. Cardiopulmonary rehabilitation with ASV after OPCAB reduces both POAF occurrence and the duration of hospitalization.

Topics: Adult; Aged; Aged, 80 and over; Atrial Fibrillation; Breathing Exercises; Cardiovascular Agents; Combined Modality Therapy; Comorbidity; Coronary Artery Bypass, Off-Pump; Coronary Disease; Exercise Test; Exercise Therapy; Female; Hemodynamics; Humans; Incidence; Male; Middle Aged; Oxygen Inhalation Therapy; Positive-Pressure Respiration; Postoperative Care; Postoperative Complications; Pulmonary Ventilation; Respiration Disorders; Ultrasonography

Rett syndrome is a neurodevelopmental disorder that manifests itself early in childhood, progresses with the evolution of characteristic clinical signs and symptoms and is confirmed by mutation in the methyl-CpG-binding protein 2 gene. Seizures are present in a majority of Rett patients. Respiratory dysrhythmia in the awake state is present in two-thirds of patients, leading in some cases to severe nonepileptic paroxysmal events. There are no optimal treatment recommendations thus far. The aim of this case study is to present the electro-clinical correlation of severe respiratory dysrhythmia mimicking seizures in 2 Rett patients and effective treatment with topiramate.

Topics: Adolescent; Brain; Cardiovascular Agents; Child; Electroencephalography; Female; Follow-Up Studies; Fructose; Humans; Respiration Disorders; Rett Syndrome; Topiramate

Research and practice indicate that a sizeable amount of prescribed drugs is never used.. To assess the habitual up-take of medicines in subjects with respiratory symptoms/diseases or impaired lung function in general population samples.. Data regard 4010 subjects (8-88 years) from the rural area of Po River Delta (North Italy) and the urban area of Pisa (North-Central Italy). Analyses concern the habitual use of any or specific medicines (broncho-pulmonary, anti-allergic, cardio-vascular, diuretic) in subjects with asthma, chronic bronchitis/emphysema (COPD), COPD or chronic cough/phlegm (COPDsx), and airways obstruction (AO, FEV(1)/FVC<70%).. Asthma, COPD, COPDsx, and AO were present in 6%, 5%, 21%, and 13% of cases, respectively. Only 37% and 21% of subjects with respiratory symptoms/diseases used any or specific medicines, respectively. The subjects with COPD exhibited the highest prevalence of assumption (59% for any drug, 38% for specific medicines), followed by asthmatics (42% and 30%), and subjects with AO (40% and 25%). After accounting for sex, age, residence area, smoking habit, education, and presence of comorbidity, the conditions significantly related to any medicine up-take were COPD (OR 1.65, 95% CI 1.08-2.53) and asthma (OR 1.47, 95% CI 1.01-2.12). Only asthma resulted significantly associated with the use of specific drugs (OR 3.11, 95% CI 1.94-4.97). Drug use was higher in the urban than in the rural area.. The results indicate that most people in the general population do not use drugs, in spite of reported respiratory disorders. The underuse of medicines seems lower in the urban area.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Allergic Agents; Asthma; Attitude to Health; Bronchodilator Agents; Cardiovascular Agents; Child; Child, Preschool; Diuretics; Humans; Italy; Middle Aged; Prevalence; Pulmonary Disease, Chronic Obstructive; Regression Analysis; Respiration Disorders; Rural Health; Treatment Refusal

Topics: Adolescent; Autonomic Nervous System Diseases; Cardiovascular Agents; Child; Child, Preschool; Diagnosis, Differential; Diet; Humans; Hypotension, Orthostatic; Infant; Physical Examination; Reflex; Respiration Disorders; Syncope, Vasovagal; Tachycardia