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Anesthetic formulation of tumescent solutions

DERMATOLOGIC CLINICS 1999年第4期17卷 751-+页

作者： Klein, JA San Juan Capistrano CA 92675 30280 Rancho Viejo Road United States

There is no standard or official recipe for the tumescent anesthetic solutions. The actual concentrations of lidocaine and epinephrine should depend on the areas to be treated and clinical situation. This article discusses the safe usage of tumescent solutions and the proper procedures and precautions to take when mixing these solutions.

关键词：麻醉药局部/投药和剂量麻醉药局部/副作用麻醉药局部/化学化学药物药物相互作用肾上腺素/投药和剂量肾上腺素/副作用肾上腺素/化学等渗溶液/投药和剂量利多卡因/投药和剂量利多卡因/副作用利多卡因/化学脂肪切除术/方法安全钠/代谢氯化钠/投药和剂量时间因素血管收缩药/投药和剂量血管收缩药/副作用血管收缩药/化学水电解质平衡人类

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Coronary vascular responses to short-term cocaine administration in conscious baboons compared with dogs

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JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY 2000年第5期35卷 1347-1354页

作者： Shannon, RP Mathier, MA Shen, YT Allegheny Gen Hosp Dept Med Pittsburgh PA 15212 USA Med Coll Penn & Hahnemann Univ Sch Med Cardiovasc & Pulm Res Inst Pittsburgh PA USA Harvard Univ Sch Med New England Reg Primate Res Ctr Southborough MA 01772 USA Merck Res Labs W Point PA USA

OBJECTIVES Cardiovascular complications of cocaine use represent an important clinical problem, yet the mechanisms by which cocaine predisposes to myocardial ischemia are poorly understood. BACKGROUND The effects of cocaine on the coronary circulation have been studied extensively in experimental animal models, but have failed to recapitulate the clinical findings reported in humans who use cocaine. METHODS We studied 12 conscious, chronically instrumented dogs and 5 conscious, chronically instrumented baboons to determine whether there were important species differences in the response to cocaine. RESULTS Comparable doses of intravenous cocaine caused similar increases in left ventricular systolic, diastolic and mean arterial pressure in the two species. However, the peak coronary blood flow response in baboons (+/-8 +/- 3 from 47 +/- 6 ml/min) was less compared with dogs (+15 +/- 4 from 41 +/- 4 ml/min), while the coronary vascular resistance response was greater in baboons (+0.60 +/- 0.09 from 1.94 +/- 0.09 mm Hg/ml/mm) compared with dogs (+0.35 +/- 0.09 from 2.24 +/- 0.10 mm Hg/ml/min). Although myocardial oxygen consumption responses were similar between species, there was a significant difference (p < 0.05) in oxygen delivery between baboons (+164 +/- 47 from 705 +/- 59 mi of oxygen per minute) and dogs )+397 +/- 51 from 656 +/- 33 mi of oxygen per minute) that was attributable to a significant (p < 0.05) increase in hemoglobin concentration in dogs (+2.1 +/- 0.5 g/dl) that was not observed in baboons. Consequently, cocaine caused a significant increase in myocardial oxygen extraction and decreased coronary sinus pH in baboons, but not dogs. CONCLUSIONS Cocaine caused greater coronary vasoconstriction and greater requirements for oxygen extraction in baboons compared with dogs. (J Am Coil Cardiol 2000;35:1347-54) (C) 2000 by the American College of Cardiology.

关键词：可卡因/副作用意识冠状动脉循环/药物作用冠状血管/药物作用疾病模型动物狗药物评价临床前血流动力学/药物作用注射静脉内心肌缺血/化学诱导心肌缺血/代谢心肌缺血/病理生理学心肌/代谢麻醉品/副作用氧耗量/药物作用狒狒属脾切除术血管收缩药/副作用动物女(雌)性男(雄)性

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Determination of lidocaine in hair of drug fatalities by headspace solid-phase microextraction

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JOURNAL OF ANALYTICAL TOXICOLOGY 2000年第5期24卷 316-322页

作者： Sporkert, F Pragst, F Humboldt Univ Inst Legal Med D-10115 Berlin Germany

The local anesthetic lidocaine was determined in hair by hydrolysis of the samples with 4% NaOH in the presence of excessive Na2SO4 and subsequent headspace solid-phase microextraction with a 65-μm Carbowax/divinylbenzene fiber, and gas chromatography–mass spectrometry measurement with etidocaine as the internal standard. The calibration curve was linear between 0.1 and 1000 ng/mg. The detection and quantitation limits were 0.1 and 0.4 ng/mg, respectively. The method was applied to hair samples of 49 drug fatalities, and positive results were obtained in 32 cases with lidocaine concentrations between 0.4 and 400 ng/mg and 675 ng/mg in one extreme case. For comparison, morphine, 6-acetylmorphine, codeine, dihydrocodeine, methadone, cocaine, and benzoylecgonine were also determined by usual methods. From segmental investigations in four of the cases and from comparison with the hair concentrations of the other drugs, it follows that lidocaine was consumed for a longer period of time as an adulterant of cocaine and heroin preparations.

关键词：麻醉药局部/分析麻醉药局部/药代动力学校准可卡因/副作用药物污染法医学毛发/化学海洛因/副作用利多卡因/分析利多卡因/药代动力学麻醉品/副作用敏感性与特异性血管收缩药/副作用青少年成年人女(雌)性人类男(雄)性

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Vasoactive agents in intrahepatic portal hypertension and fibrogenesis: Implications for therapy

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GASTROENTEROLOGY 2000年第6期118卷 1261-1265页

作者： Rockey, DC Duke Univ Med Ctr Dept Med Durham NC 27710 USA Duke Univ Med Ctr Dept Cell Biol Durham NC 27710 USA

GASTROENTEROLOGY 2000;118:1261-1265

关键词：血管紧张素Ⅱ/副作用高血压门静脉/药物疗法高血压门静脉/病理学肝循环/药物作用肝硬化/药物疗法肝硬化/病理学血管收缩药/副作用人类

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Adverse drug interactions in dental practice: Interactions associated with vasoconstrictors Part V of a series

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JOURNAL OF THE AMERICAN DENTAL ASSOCIATION 1999年第5期130卷 701-709页

作者： Yagiela, JA Univ Calif Los Angeles Sch Dent Ctr Hlth Sci Div Diagnost & Surg Sci Los Angeles CA 90095 USA

Background. Adrenergic vasoconstrictors are commonly used by dentists to enhance the pain-relieving action of local anesthetics and to control local bleeding. Although normally considered safe for these applications, vasoconstrictors can participate in drug interactions that potentially are harmful to patients. Methods. The faculty of a March 1998 symposium entitled "Adverse Drug Interactions in Dentistry: Separating the Myths From the Facts" extensively reviewed the literature on drug interactions. They then established a significance rating of alleged adverse drug interactions pertaining to dentistry, based on the quality of documentation and severity of effect. The author of this article focused on the adrenergic vasoconstrictors epinephrine and levonordefrin. Results. Vasoconstrictor drug interactions involving tricyclic antidepressants, nonselective beta-adrenergic blocking drugs, certain general anesthetics and cocaine are well-documented in both humans and animals as having the potential for causing serious morbidity or death. Evidence for adverse interactions involving adrenergic neuronal blocking drugs, drugs with alpha-adrenergic blocking activity, local anesthetics and thyroid hormones is much less compelling, suggesting for the most part that clinically significant reactions may occur only when both the vasoconstrictor and the interacting drug are used in excessive doses. In the case of monoamine oxidase inhibitors, there is no credible evidence of a significant interaction with epinephrine or levonordefrin. Conclusions. Potentially serious adverse drug interactions involving adrenergic vasoconstrictors can occur in dental practice. In most circumstances, careful administration of small doses of vasoconstrictors and avoidance of gingival retraction cord containing epinephrine, coupled with monitoring of vital signs, will permit these drugs to be used with no risk or only minimally increased risk. Only in the case of cocaine intoxication must adrenergic v

关键词：肾上腺素能药/副作用肾上腺素能药/药理学牙科医疗药物相互作用血管收缩药/副作用血管收缩药/药理学人类

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