piperidines and Lung-Diseases--Obstructive

The pulmonary endothelium modulates vascular tone by the release of endothelium-derived constricting (EDCF) and relaxing (EDRF) factors, among them endothelin-1, nitric oxide, prostacyclin, and putative endothelium-derived hyperpolarizing factors. Abnormalities in EDCF and EDRF generation have been demonstrated in a number of cardiopulmonary disease states, such as primary and secondary pulmonary hypertension, chronic obstructive lung disease, cardiopulmonary bypass, and congestive heart failure. An imbalance between EDCF and EDRF, termed "pulmonary endothelial dysfunction," may contribute to the alteration in vascular tone characteristic of pulmonary disease. The following review summarizes the present knowledge of the role of EDCF and EDRF in such processes with major focus on pulmonary endothelial dysfunction in hypoxia-induced pulmonary hypertension.

Topics: Animals; Antihypertensive Agents; Atrasentan; Bosentan; Controlled Clinical Trials as Topic; Disease Models, Animal; Endothelin Receptor Antagonists; Endothelin-1; Endothelins; Endothelium, Vascular; Epoprostenol; Heart Failure; Humans; Hypertension, Pulmonary; Hypoxia; Lung Diseases, Obstructive; Nitric Oxide; Oligopeptides; Peptides, Cyclic; Piperidines; Pulmonary Circulation; Pyrrolidines; Receptors, Endothelin; RNA, Messenger; Sulfonamides; Time Factors; Vasoconstriction; Vasodilation

In a double-blind long-term study, regular inhalations of a short-acting selective beta2-stimulator, rimiterol, was compared with a long-acting one, terbutaline. The trial comprised 60 patients with chronic obstructive lung disease, all patients were on a small dose of an oral beta2-stimulator. Both drugs were regularly given in aerosol form with a minimum dose of three inhalations three times daily. The main purpose was to study subjective and objective side effects. Haematological, hepatic and renal functions were screened for toxicity. Consumption of spray was recorded. No side effects occurred. There was no evidence of development of isoprenaline resistance. The consumption of spray was the same in both groups. In this study, regular inhalation treatment of rimiterol seemed to be as effective as terbutaline in long-term bronchodilator therapy.

Topics: Aerosols; Asthma; Bronchitis; Catechols; Chronic Disease; Drug Evaluation; Female; Humans; Isoproterenol; Lung Diseases, Obstructive; Male; Piperidines; Pulmonary Emphysema; Terbutaline

Topics: Animals; Asthma; Catechols; Clinical Trials as Topic; Drug Evaluation; Drug Evaluation, Preclinical; Humans; Lung Diseases, Obstructive; Piperidines

We described the anesthetic management of a 17-year-old male patient with Fukuyama congenital muscle dystrophy (FCMD) who underwent surgical repair for scoliosis under total intravenous anesthesia. The patient had severe constructive lung disease (%VC 18.6%). Left ventricular wall motion was reduced (left ventricular ejection fraction 40%). Propofol and remifentanil were continuously infused to maintain anesthesia, but we did not use any muscle relaxant throughout the course. We used arterial pressure-based cardiac output and stroke volume variation as a guide for circulatory management. We could not find any congestion on chest X-ray after the surgery. The emergence and recovery from the anesthesia was rapid and muscle strength was enough, and we could extubate the patient just after the end of the surgery. No respiratory and cardiac complications occurred during the postoperative period. Even though he was in the young age in FCMD, respiratory and cardiac complications were severely impaired. For successful anesthetic management in FCMD patient, we should take care of rapid emergence from anesthesia and also we should not impair muscle strength for good postoperative respiratory function. Appropriate hemodynamic monitoring to avoid postoperative cardiac congestion is also required.

Topics: Adolescent; Anesthesia, Intravenous; Humans; Lung Diseases, Obstructive; Male; Monitoring, Intraoperative; Perioperative Care; Piperidines; Propofol; Remifentanil; Scoliosis; Stroke Volume; Ventricular Dysfunction, Left; Walker-Warburg Syndrome

To determine and compare the reactive oxygen and nitrogen species (ROS and RNS) in pulmonary tissues of horses affected with recurrent airway obstruction (RAO) and clinically healthy horses, and to evaluate the effectiveness of potential therapeutic agents in reducing ROS and RNS in the tissues of these horses.. We hypothesised that RAO-affected horses would have high levels of reactive species and that the test agents would reduce them. The objectives were as follows: 1) to determine the level of ROS and RNS in pulmonary tissues (bronchial and arterial rings) of RAO-affected and clinically healthy horses; and 2) to determine the ability of pentoxifylline, pyrrolidine-dithiocarbamate and a combined use of endothelin A and B receptor antagonists (BQ123 and BQ788, respectively) in reducing reactive species.. Arterial and bronchial rings were collected from the diaphragmatic lung lobe of each horse immediately after euthanasia. The levels of ROS and RNS were measured in control tissues and those incubated with test agents, using an electron paramagnetic resonance instrument.. The levels of ROS and RNS were significantly greater in arterial and bronchial tissues of RAO-affected than of clinically healthy horses. Pentoxifylline and endothelin antagonists reduced both ROS and RNS in tissues from RAO-affected horses. Basal levels of reactive species in clinically healthy horses were not affected by these agents. No difference in the level of reactive species was observed between arterial and bronchial tissues.. Horses affected by RAO had higher ROS and RNS than clinically healthy horses. Pentoxifylline and endothelin antagonists effectively reduced ROS and RNS in pulmonary tissues of RAO-affected horses.. The study suggested a potential use for pentoxifylline and endothelin antagonists in treating RAO-affected horses. As endothelin is involved in physiological functions, therapeutic use of its antagonists is cautioned.

Topics: Animals; Bronchodilator Agents; Female; Horse Diseases; Horses; Lung; Lung Diseases, Obstructive; Male; Oligopeptides; Oxidative Stress; Pentoxifylline; Peptides, Cyclic; Piperidines; Pulmonary Artery; Pyrrolidines; Reactive Nitrogen Species; Reactive Oxygen Species; Thiocarbamates; Tissue Culture Techniques

Since there have been only a few studies on muscarinic receptor subtypes in airway smooth muscle, the effect was investigated of pirenzepine on airways of patients with chronic obstructive pulmonary disease (COPD) and the functional responses compared from these patients with those from healthy subjects. Our data demonstrated that the therapy with pirenzepine significantly improved ventilatory function in patients with COPD. The data also suggested that this drug exerts its action on small airways, but not larger airways in normal subjects. It is possible that in healthy human beings pirenzepine produces mild bronchodilation by means of a vagal efferent blockade, while in patients with COPD, it may be effective because it not only decreases the activity of the vagal efferent pathway, but also decreases the sensitivity of vagal sensory endings and causes a vagal afferent blockade.

Topics: Atropine; Forced Expiratory Volume; Humans; Lung Diseases, Obstructive; Muscle, Smooth; Piperidines; Pirenzepine; Receptors, Muscarinic; Respiratory Muscles

The authors measured changes in pulmonary and systemic haemodynamics in seven patients following oxygen inhalation, nifedipine and Ketanserin administration. A significant decrease in mean pulmonary artery pressure, cardiac index and heart rate could be observed following 30-min oxygen inhalation. No significant changes were found in pulmonary haemodynamics 1 hour after sublingual administration of 20 mg Corinfar (nifedipine). Long-term treatment (6 months) with Corinfar (30-60 mg per day) was not followed by a significant change in mean pulmonary artery pressure. However, in 3 patients a decrease in mean pulmonary artery pressure (6-11 mmHg) could be observed. Ketanserin (10 mg intravenously) did not significantly change the mean pulmonary artery pressure in patients with hypoxic pulmonary hypertension.

Topics: Adult; Carbon Dioxide; Cardiac Output; Female; Heart Rate; Humans; Hypertension, Pulmonary; Hypoxia; Ketanserin; Lung Diseases, Obstructive; Lung Volume Measurements; Male; Middle Aged; Nifedipine; Oxygen; Oxygen Inhalation Therapy; Piperidines; Pulmonary Wedge Pressure; Serotonin Antagonists

Topics: Bronchitis; Chronic Disease; Humans; Injections, Intravenous; Khellin; Lung Diseases; Lung Diseases, Obstructive; Phenothiazines; Piperidines; Posture; Quaternary Ammonium Compounds; Respiratory Tract Diseases; Theophylline