salicylates and Hypotension

Topics: Antidepressive Agents, Tricyclic; Arrhythmias, Cardiac; Brain Diseases; Brain Edema; Diazepam; Gastric Lavage; Humans; Hypotension; Myocardial Infarction; Pacemaker, Artificial; Physostigmine; Pyridostigmine Bromide; Respiration, Artificial; Salicylates

Topics: Acute Kidney Injury; Barbiturates; Blood Volume; Child; Child, Preschool; Costs and Cost Analysis; Heart Failure; Humans; Hyperkalemia; Hypocalcemia; Hypotension; Intestinal Obstruction; Intestinal Perforation; Kidney Failure, Chronic; Metabolic Diseases; Methods; Nutrition Disorders; Peritoneal Dialysis; Poisoning; Renal Dialysis; Salicylates; Time Factors

Reactive oxygen species contribute to the multiple organ failure endotoxic shock. Here we investigate the effects of a salen-manganese complex, which exhibits both superoxide dismutase and catalase activity (EUK-134), on the circulatory failure and the renal and liver injury and dysfunction caused by endotoxin in the anaesthetised (thiopentone, 120 mg/kg) rat.. Male Wistar rats were anaesthetised with thiopentone sodium (120 mg/kg i.p.) and instrumented for the measurements of systemic haemodynamics. Animals received lipopolysaccharide (LPS, E. coli, 6 mg/kg i.v.) or saline and were treated with either EUK-134 (0.3 or 1 mg/kg bolus injection followed by an infusion of 0.3 or 1 mg/kg/h) or its vehicle (saline). After 6 h of endotoxaemia, blood was taken to evaluate biochemical parameters of organ injury and dysfunction. All data are mean I s.e. mean of n observations. Statistical comparisons were made with a ANOVA followed by Dunnet's test for multiple comparisons.. Endotoxaemia for 6 h caused hypotension, renal dysfunction, liver injury, skeletal-muscle injury and pancreatic injury. Treatment of rats with EUK-134 attenuated the renal dysfunction as well as the liver and skeletal muscle injury (but not the pancreatic injury) caused by endotoxin.. Thus, an enhanced formation of reactive oxygen species importantly contribute to the organ injury and dysfunction associated with endotoxic shock. We propose that small molecules, which have the catalytic activity of both superoxide dismutase and catalase, may represent a novel therapeutic approach for the therapy of endotoxic shock.

Topics: Animals; Endotoxins; Hypotension; Kidney; Liver; Male; Manganese Compounds; Muscle, Skeletal; Organometallic Compounds; Pancreas; Rats; Rats, Wistar; Reactive Oxygen Species; Salicylates; Shock, Septic; Superoxide Dismutase; Time Factors

Systemic inflammatory response syndrome (SIRS) is characterized by body temperature abnormalities, tachypnea or hyperventilation, tachycardia, and leukocytosis or leukopenia. Although it is typically associated with a serious infection and referred to as sepsis, SIRS can stem from noninfectious causes, as well. We report the cases of four patients with toxic serum levels of salicylate (33.5 to 67.6 mg/dL) and SIRS, and we discuss mechanisms responsible for SIRS. Our patients showed temperature disturbances (35.5 degrees C to 39.8 degrees C), noncardiogenic pulmonary edema, and mixed acid base disturbances. Other abnormalities included coagulopathy (disseminated intravascular coagulation), encephalopathy, and hypotension. All four patients recovered from SIRS, probably due to early recognition and treatment; only one patient did not survive the hospitalization. Chronic salicylate toxicity should be considered as a cause of SIRS in the absence of a source of infection, since survival appears to be dependent on prompt diagnosis and management.

Topics: Acid-Base Imbalance; Adult; Anti-Arrhythmia Agents; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; Chronic Disease; Disseminated Intravascular Coagulation; Female; Fever; Humans; Hypotension; Male; Middle Aged; Pulmonary Edema; Salicylates; Salicylic Acid; Systemic Inflammatory Response Syndrome

In 1967-76 the annual number of admissions to a poisoning treatment centre rose from 964 to 2134. The proportion of admissions caused by taking barbiturate hypnotics and methaqualone fell considerably while that caused by taking benzodiazepines and tricyclic antidepressants increased. As a result the proportion of patients admitted unconscious fell from 23% to 15%. The declining contributions of barbiturates and methaqualone and increased importance of tricyclic antidepressants were significant in all grades of coma. The change in drugs taken, however, has not yet reduced the percentage of unconscious patients needing endotracheal intubation or assisted ventilation, and hypothermia remains as common. Only hypotension has become less frequent as antidepressants replace barbiturates as the main cause of drug-induced coma. The use of salicylates for self-poisoning is declining slowly, and paracetamol poisoning is now as common.

Topics: Acetaminophen; Antidepressive Agents, Tricyclic; Barbiturates; Benzodiazepines; Humans; Hypotension; Methaqualone; Patient Admission; Poisoning; Salicylates; Suicide; Suicide, Attempted; Unconsciousness; United Kingdom

Two and three Dow Cordis Hollow Fiber and Gambro Lundia artificial kidneys were used for high efficiency dialysis in large patients, intoxications, and for rapid ultrafiltration. BUN clearances of up to 240 ml/min were achieved. One episode of severe neuropathy occurred during high efficiency dialysis, and hypotensive episodes were more common. High efficiency dialysis has certain indications particularly in intoxication cases. However, because of possible side effects more experience is needed before its ultimate place in the treatment of uremia can be ascertained.

Topics: Barbiturates; Blood Urea Nitrogen; Body Weight; Calcium; Creatinine; Edema; Headache; Humans; Hypotension; Kidneys, Artificial; Nausea; Phenobarbital; Phenytoin; Poisoning; Primidone; Renal Dialysis; Salicylates; Substance-Related Disorders; Ultrafiltration; Uremia; Uric Acid

Topics: 1-Propanol; Acute Kidney Injury; Aged; Albumins; Antidepressive Agents; Antihypertensive Agents; Benzyl Compounds; Cephaloridine; Coumarins; Digitoxin; Diuretics; Drug Interactions; Ethacrynic Acid; Guanethidine; Guanidines; Heart; Heart Block; Heart Conduction System; Humans; Hypoglycemia; Hypotension; Kidney; Pancreas; Phenylbutazone; Salicylates; Sympathetic Nervous System; Tolbutamide; Warfarin

Topics: Abdominal Injuries; Adrenal Cortex Hormones; Anti-Bacterial Agents; Anuria; Blood Gas Analysis; Blood Volume; Electrocardiography; Humans; Hypotension; Hypothermia, Induced; Kinetics; Oxygen; Respiratory Insufficiency; Salicylates; Shock; Shock, Hemorrhagic; Shock, Traumatic; Thoracic Injuries; Urination; Vascular Resistance; Vasodilator Agents; Venous Pressure

Topics: Acute Disease; Adult; Antidepressive Agents; Arrhythmias, Cardiac; Barbiturates; Body Temperature; Carbon Monoxide Poisoning; Child, Preschool; Female; Hospitalization; Humans; Hypnotics and Sedatives; Hypotension; Intensive Care Units; Intubation, Intratracheal; Male; Middle Aged; Poisoning; Rectum; Respiration; Salicylates; Seasons; Tranquilizing Agents; Unconsciousness

Topics: Aminocaproates; Animals; Atropine; Dogs; Ethanolamines; Hypotension; Phenylbutazone; Procaine; Promethazine; Salicylates; Sparteine