piperidines and Hyperthyroidism

Topics: Adrenal Gland Neoplasms; Bradykinin; Carotid Stenosis; Clinical Trials as Topic; Contrast Media; Endarterectomy, Carotid; Esophageal and Gastric Varices; Female; Heart Failure; Humans; Hyperglycemia; Hypertension; Hyperthyroidism; Internal Medicine; Male; Middle Aged; Osteitis Deformans; Piperidines; Pulmonary Disease, Chronic Obstructive; Pyrazoles; Renal Insufficiency; Rimonabant; Risk Factors; Stents; Stethoscopes; Weight Loss

Topics: Animals; Chlorpromazine; Clinical Trials as Topic; Diphenhydramine; Drug Synergism; Hyperthyroidism; Piperidines; Procaine; Rabbits

A 21-year-old man was scheduled to undergo posterior cruciate ligament reconstruction under arthroscopic control. The patient did not have a previous history of thyroid disease. Low blood cholesterol was revealed in the laboratory data. On arriving at the operating room, he showed sinus tachycardia of 130 beats x min(-1). Anesthesia was induced with remifentanil and propofol intravenously followed by sevoflurane inhalation, and maintained with remifentanil at a rate of 0.3 microg x kg(-1) x min(-1) and 2% sevoflurane. Heart rate was stable around 70-90 beats x min(-1) during the operation. After remifentanil and sevoflurane were discontinued following surgery, his heart rate increased and paroxysmal atrial fibrillation occurred. Although verapamil was administered intravenously, atrial fibrillation and tachycardia persisted. Further investigations revealed an elevated serum free thyroxin level and suppressed thyroid-stimulating hormone (TSH). Serum TSH receptor antibody concentration was elevated. Upon postoperative examination, goiter and the protuberance of the eyes were noticed. We conclude that he was suffering from Basedow disease. Although he had no subjective symptoms in the preoperative period, the possibility of hyperthyroidism should have been predicted from the laboratory data such as hypolipidemia and by conducting a careful medical examination. It seems that remifentanil suppresses sympathetic activity, and is useful for patients with hyperthyroidism.

Topics: Anesthesia Recovery Period; Anesthesia, General; Atrial Fibrillation; Humans; Hyperthyroidism; Male; Piperidines; Plastic Surgery Procedures; Posterior Cruciate Ligament; Postoperative Complications; Remifentanil; Young Adult

We examined the acute effects of endocannabinoid, anandamide, and of synthetic cannabinoid receptor antagonist, AM251[N-(piperidin-1-yl)-1-(2,4-dichlorophenyl)-5-(4-chlorophenyl)-4-methyl-1H-pyrazole-3-carboxamide], on TSH, thyroxine (T(4)), and triiodothyronine (T(3)) secretions. Euthyroid male rats showed a 42% decrease in serum TSH, 2 h after a single i.p. injection of 0.02, but not 0.2 mg/kg body weight (BW), anandamide, accompanied by a 39% reduction in serum T(4), without alteration in serum T(3). At 0.5 and 1 h, these serum hormones showed no significant change. Hypothyroid rats showed a 35% reduction in serum TSH (P<0.01), 2 h after anandamide injection, which had no effect on hyperthyroid rats. In both thyroid states, no modification of serum thyroid hormones was observed. Intraperitoneal injection of 0.17 or 1.7 mg/kg BW AM251 in euthyroid rats caused, 1.5 h later, 1.7-fold or 4.3-fold increase in serum TSH respectively, without changing thyroid hormones. Stimulatory effect of 0.17 mg/kg BW AM251 and inhibitory effect of anandamide was abolished in the group injected with AM251 followed by an anandamide injection, 30 min later. Intracerebroventricular injection of 20 ng (but not 200 ng) anandamide induced a decrease in serum TSH at 60 min after injection, which tended to disappear at 120 min. Anterior pituitary explants presented significant reduction in TSH release in the presence of 10(-7) M anandamide in incubation medium, which was blocked by 10(-7) M AM251. In conclusion, anandamide has the ability to acutely inhibit TSH release in eu- and hypothyroid rats, acting at the hypothalamus-pituitary axis. Since, in addition, the cannabinoid receptor antagonist AM251 increased TSH release, we suggest that endocannabinoid system has a role as negative regulator of TSH secretion.

Topics: Animals; Arachidonic Acids; Cannabinoid Receptor Modulators; Endocannabinoids; Hyperthyroidism; Hypothyroidism; In Vitro Techniques; Male; Piperidines; Pituitary Gland; Polyunsaturated Alkamides; Pyrazoles; Radioimmunoassay; Rats; Rats, Wistar; Receptor, Cannabinoid, CB1; Thyrotropin; Thyroxine; Triiodothyronine

Topics: Adolescent; Adult; Aged; Amides; Antihypertensive Agents; Blood; Blood Glucose; Blood Pressure; Blood Urea Nitrogen; Child; Child, Preschool; Clopamide; Depression, Chemical; Diabetes Complications; Diuretics; Ergoloid Mesylates; Female; Humans; Hypertension; Hypertension, Renal; Hyperthyroidism; Infant; Liver Function Tests; Male; Middle Aged; Piperidines; Potassium; Reserpine; Urine

Topics: Anti-Allergic Agents; Autonomic Agents; Chlorpromazine; Hexamethonium; Hibernation; Histamine H1 Antagonists; Hyperthyroidism; Hypothermia, Induced; Piperidines; Thyrotoxicosis