The use of hexamethonium injected i.v. in successive 2.5 mg doses resulted in .alpha.-adrenergic sympathetic nerve blocking and associated peripheral vasodilatation with dramatic improvement of the symptoms and signs ...
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The use of hexamethonium injected i.v. in successive 2.5 mg doses resulted in .alpha.-adrenergic sympathetic nerve blocking and associated peripheral vasodilatation with dramatic improvement of the symptoms and signs in patients with marked chronic intractable CHF [congestive heart failure]. The vasodilatating effect of the drug is simple to monitor at the bedside and serves as an effective, simple means to bleed the patient i.v. by decreasing systemic venous tone and reducing the wall stress in the vessels. This i.v. bleeding results in a shifting of excessive blood from the lungs and central systemic venous areas to the larger volume of the more peripheral systemic venous reservoirs. Rheoplethysmographic recordings of digital blood flow in the fingertips of the patients revealed marked constriction of all vessels of the fingers during CHF. Hexamethonium dilated all these vessels and increased digital blood flow even though arterial blood pressure was reduced by the drug. Theoretic discussions of aspects of the mechanism of congestive heart failure of the 2 pump system of the heart of man and the mechanical or hemodynamic advantages of the small veins over the larger centrally located veins tend to explain why the use of hexamethonium benefits the circulation by producing venodilatation. The therapeutic usefulness of hexamethonium is indicated in the management of acute and chronic intractable CHF and provides physiologic and theoretic data to explain why the drug is effective.
In choosing a pharmacologic approach to the treatment of angina, the clinician will consider primarily the nitrites, beta-adrenergic blocking agents, and in special circumstances, digitalis. Experience with each of th...
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In choosing a pharmacologic approach to the treatment of angina, the clinician will consider primarily the nitrites, beta-adrenergic blocking agents, and in special circumstances, digitalis. Experience with each of these is summarized.
In fifteen patients affected by essential nonvibratory tinnitus, local applications in the external auditive canal of 2 ml medicated DMSO spray were made. The spray solution contained DMSO integrated with anti-inflamm...
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In fifteen patients affected by essential nonvibratory tinnitus, local applications in the external auditive canal of 2 ml medicated DMSO spray were made. The spray solution contained DMSO integrated with anti-inflammatory and vasodilatory substances. This application was repeated every four days for a month. At the same time each patient was administered a daily intramuscular injection of a preparation that contained DMSO and a vasodilatory component. The therapeutic effect was evaluated through the subjective modification of the symptom and functional tests of the auditory system. Of the fifteen patients treated, the tinnitus symptom completely disappeared in nine, and did not return during a one-year observation period. The patient's symptoms diminished in two cases, and in four cases the permanent tinnitus became occasional, triggered principally by environmental cold. It is important to note that among the concomitant signs, the five patients with vertigo noted improvement. Hypacusis diminished in three of the six patients affected. Insomnia disappeared in eight and diminished in seven cases. The rise in the average tympanic membrane temperature from 36.8 degrees C before to 37.9 degrees C after treatment was noteworthy. This could indicate an improvement of the blood flow in the inner ear.
Some therapies used to treat cardiogenic shock may actually increase myocardial damage. An aggressive approach to monitoring and managment can help to identify correctable contributing events and evaluate therapies cu...
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Some therapies used to treat cardiogenic shock may actually increase myocardial damage. An aggressive approach to monitoring and managment can help to identify correctable contributing events and evaluate therapies currently in use.
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