The effects of direct adrenergic stimulation, achieved by 60-min adrenaline infusion (0.1-0.2 microgram kg-1 min-1), on thromboxane B2 (TxB2) production by platelets in whole blood ex vivo and on ADP-induced platelet aggregation were studied in seven healthy male volunteers. The effects of two beta-adrenergic blocking agents, pindolol and practolol, on the adrenaline-induced changes were furthermore analyzed. Adrenaline administration resulted in an about ten-fold elevation in plasma adrenaline, and an about three-fold increase in TxB2 production by platelets at 30 min of infusion. The increased TxB2 production persisted throughout the entire adrenaline infusion, and up to 30 min of postinfusion period (recovery). Pindolol blunted markedly the effects of adrenaline on platelet TxB2 production, whereas practolol seemed to have only a weak effect. The sensitivity of platelets to ADP-induced aggregation did not change during the 60 min of adrenaline infusion. However, at 60 min of recovery the platelets showed a significantly increased sensitivity to ADP. Correspondingly, pindolol treatment did not affect platelet sensitivity during the infusion period, but at 60 min of recovery it had caused a significantly decreased sensitivity of platelets to ADP-stimulation. Plasma-free fatty acids increased markedly during the adrenaline infusion. This increase was totally blocked by pindolol, but only partly by practolol. The present results demonstrate that adrenaline, at plasma levels seen for example, in complicated myocardial infarction, stimulates platelet TxB2 production and increases the sensitivity of platelets to ADP after the infusion. Pindolol, but not practolol, inhibits these adrenaline-induced changes in platelet behaviour.
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Arch Orthop Trauma Surg
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Department of Anaesthesia, Main-Kinzig-Kliniken, Herzbachweg 14, 63571, Gelnhausen, Germany.
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This report describes the development of oesophagitis and oesophageal stricture in a dog secondary to anaphylaxis. A 9-month-old male entire Brussels Griffon presented in anaphylactic shock after exposure to Hymenoptera species (Sp). The dog had a history of an anaphylactic reaction after exposure to Hymenoptera, successfully managed with antihistamines and dexamethasone.
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From the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona.
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bioRxiv
February 2024
Critical Care Medicine Department, Clinical Center, National Institutes of Health, (NIH, CC) Bethesda, Maryland 20892 USA.
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Department of Emergency Medicine, University of California San Francisco, San Francisco, California, USA.
Coingestion of cardiovascular drugs with angiotensin-converting enzyme inhibitors (ACEIs) can be associated with refractory shock derangements complicated by vasopressor resistance, prompting the use of novel, unconventional, or uncommonly used agents. A young adult male presented to the emergency department (ED) 10 h after ingesting lisinopril and amlodipine. On arrival, he was hypotensive with a blood pressure of 72/39 mmHg.
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