felypressin and Hypertension

Hemodynamic changes were evaluated in patients with essential hypertension when felypressin of various concentrations was administered. The parameters studied were systolic pressure, diastolic pressure, heart rate, left ventricular systolic phase, and endocardial viability ratio. Results showed that blood pressure tended to increase, and the value of 1/pre-ejection period2 (PEP2) tended to decrease, upon administration of 3 ml of 2% propitocaine containing 0.06 international units/ml (IU/ml) of felypressin. Significant increase of blood pressure and decrease in 1/PEP2 was noted upon administration of 3 ml of anesthetic solution containing 0.13 IU/ml of felypressin. No ischemic change of the myocardium was detected even with the highest felypressin concentration (3 ml of 2% propitocaine containing 0.25 IU/ml of felypressin). These results suggest that the clinically safe dosage of felypressin for patients with essential hypertension is approximately 0.18 IU. This amount is equivalent to 6 ml of 3% propitocaine with 0.03 IU/ml of felypressin, which is a commercially available local anesthetic for dental use. It seems that the decrease in 1/PEP2 that occurred during blood pressure increase was due to the increase in afterload caused by contraction of the arterioles. Although in the present study no ischemic change was noted, special care should be taken to prevent myocardial ischemia in patients with severe hypertension.

Topics: Analysis of Variance; Anesthesia, Local; Chi-Square Distribution; Dental Care for Chronically Ill; Diastole; Dose-Response Relationship, Drug; Felypressin; Female; Hemodynamics; Humans; Hypertension; Male; Mandibular Nerve; Middle Aged; Nerve Block; Systole; Vasoconstrictor Agents

Cigarette smoking is usually associated with hypertension and may modify vasoconstrictor response.. The present study aimed to analyze and compare the interaction of passive cigarette smoking and hypertension on epinephrine and felypressin blood pressure effects after intravascular injection.. 45-day male Wistar rats had the main left renal artery partially constricted and the right kidney removed (1K1C model). Rats were placed in the chamber for exposition to passive cigarette smoking (10 cigarettes) during 10 min (6 days a week). Hypertensive rats received atenolol (90 mg/kg/day) by gavage for two weeks. Hypotensive and hypertensive response, response duration and heart rate were recorded from direct blood pressure values. The significance level was 5%.. Passive cigarette smoking increased maximal hypertensive response to epinephrine in normotensive and 1K1C-atenolol treated rats and to felypressin only in 1K1C-atenolol treated rats; it also reduced epinephrine hypotensive response. Epinephrine increased heart rate in normotensive and hypertensive passive smokers or non-smoker rats. Comparing the two vasoconstrictors, epinephrine showed greater hypertensive response in normotensive smokers, 1K1C-atenolol treated smokers and non-smokers. However, in normotensive-nonsmoker rats, felypressin showed a greater and longer hypertensive effect.. Our results suggest that passive cigarette smoking may reduce epinephrine vasodilation and increase hypertensive response when compared to felypressin. Therefore, felypressin may be safe for hypertensive patients to avoid tachycardia and atenolol interaction, but for normotensive and non-smoker patients, epinephrine may be safer than felypressin.

Topics: Animals; Antihypertensive Agents; Atenolol; Blood Pressure; Dose-Response Relationship, Drug; Drug Interactions; Epinephrine; Felypressin; Heart Rate; Hypertension; Hypotension; Male; Rats, Wistar; Time Factors; Tobacco Smoke Pollution; Vasoconstrictor Agents; Vasodilation

Topics: Animals; Atenolol; Blood Pressure; Cigarette Smoking; Epinephrine; Felypressin; Hypertension; Rats; Tobacco Smoke Pollution

Epinephrine is considered the gold standard vasoconstrictor for hypertensive patients, but few studies report felypressin's effects. The present study aimed to analyze and compare the effects of these two vasoconstrictors, injected by the intravenous route, on the arterial pressure of normotensive, hypertensive and atenolol-treated hypertensive rats.. The hypertension model was one-kidney-one-clip (1K1C): the main left renal artery was partially constricted and the right kidney was surgically removed in 45-day-old male Wistar rats. 1K1C hypertensive rats received atenolol (90 mg/kg/day) by gavage for 2 weeks. 28-35 days after hypertension induction, a catheter was inserted into the left carotid artery to record direct blood pressure values. The following parameters were recorded: minimal hypotensive response, maximal hypertensive response, response duration and heart rate.. Epinephrine, but not felypressin, exerted an important hypotensive action; non-treated hypertensive rats showed more pronounced vasodilation. Treated and non-treated rats showed hypertensive responses of the same magnitudes in all groups; 1K1C atenolol rats showed reduced hypertensive responses to both vasoconstrictors. Felypressin's response duration was longer than that of epinephrine in all groups. Epinephrine increased heart rate while felypressin reduced this parameter only in the normotensive group.. Our results suggest that felypressin has equipotent pressure responses when compared with epinephrine, showing a greater extent of action. Atenolol's reduction of hypertensive effects surprisingly suggests that atenolol β-blockade may also be important for felypressin's cardiovascular effect, as is widely known for epinephrine. Our data suggest that felypressin is safe for hypertensive subjects, in particular those receiving atenolol.

Topics: Animals; Atenolol; Blood Pressure; Epinephrine; Felypressin; Heart Rate; Hypertension; Hypotension; Male; Rats; Rats, Wistar; Vasoconstrictor Agents; Vasodilation

Felypressin has been added to local anesthetic to increase the length of the anesthetic effect and reduce toxicity during dental procedures. However, the effect on blood pressure remains uncertain, and this may be highly relevant in the dental treatment of hypertensive patients.. To investigate the effect of felypressin on blood pressure in hypertensive patients with controlled BP.. 71 subjects with these characteristics and in need of periodontal treatment were studied. After 10 minutes of rest, local anesthesia (prilocaine) was infiltrated with and without addition of felypressin. Then, a deep subgingival scaling was performed. Blood pressure was measured by an automated oscillometric device (DIXTAL DX2010). Ten minutes after the administration of the anesthetic, peak anesthetic action was recorded. The State-Trait Anxiety Inventory (STAI) was used to assess the patients' trait anxiety.. Systolic blood pressure increased after anesthesia, regardless of association with felypressin, throughout the dental procedure (p<0.05) and this response can be explained, at least in part, by the trait anxiety levels of the subjects. However, a further increase in diastolic blood pressure was observed when prilocaine was associated with felypressin (p<0.05), but this response did not change with trait anxiety levels.. Felypressin increased the diastolic blood pressure of hypertensive patients with controlled blood pressure. Patients with high trait anxiety presented increases in systolic blood pressure upon some procedures, suggesting that an increase in blood pressure might also be related to fear or anxiety.

Topics: Adult; Analysis of Variance; Anesthesia, Dental; Anxiety; Blood Pressure; Felypressin; Female; Humans; Hypertension; Male; Middle Aged; Periodontal Diseases; Statistics, Nonparametric; Time Factors; Vasoconstrictor Agents

A healthy 82-year-old woman presented for dacryocystorhinostomy under general anaesthesia. Following the application of intranasal cocaine and subcutaneous injection of felypressin she developed severe hypertension, multiple ventricular ectopic beats and depression of the ST segment on the electrocardiogram. A drug interaction is suspected.

Topics: Aged; Arrhythmias, Cardiac; Cocaine; Drug Hypersensitivity; Drug Interactions; Felypressin; Female; Humans; Hypertension; Intraoperative Complications; Lacrimal Apparatus; Lypressin; Nasal Cavity

Topics: Blood Circulation; Blood Pressure; Felypressin; Heart Function Tests; Hemodynamics; Hepatic Artery; Hepatic Veins; Humans; Hypertension; Hypertension, Portal; Liver Cirrhosis; Pharmacology; Vasopressins