International journal of clinical pharmacology, therapy, and toxicology
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Int J Clin Pharmacol Ther Toxicol · Nov 1985
ReviewCurrent status of labetalol, the first alpha- and beta-blocking agent.
Labetalol is a unique antihypertensive agent which is a competitive peripheral antagonist at both alpha- and beta-adrenoceptor sites. Clinically, it possesses about one fourth of the beta-adrenoceptor blocking activity of propranolol and one half of the alpha-adrenoceptor blocking activity of phentolamine with a beta- to alpha-blocking ratio of approximately 7:1. Nowadays, the clinical profile of labetalol is clearly defined. ⋯ In induced hypotension during anesthesia and surgery no invasive blood pressure measurements are needed. The most frequent adverse effects include fatigue, postural hypotension, headache and gastrointestinal complaints. On the whole, labetalol expands the armamentarium of the practising physician in the treatment of hypertension of different origin.
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Int J Clin Pharmacol Ther Toxicol · Jan 1985
Epidural morphine as postoperative analgesic following cesarean section under epidural analgesia.
Low dosage epidural morphine (4 mg) provided adequate postoperative pain relief in patients undergoing elective cesarean section under epidural analgesia. In the control group (n = 11), all but one patient needed opiates postoperatively, but 9 patients out of the 11 receiving epidural morphine needed only mild analgesics or no analgesics at all, postoperatively. Slight nausea and facial itching were the most common unwanted effects in the epidural morphine group. Low dosage epidural morphine is a useful tool in postoperative pain treatment following cesarean section.
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Int J Clin Pharmacol Ther Toxicol · Sep 1984
Comparative Study Clinical TrialDezocine for postoperative wound pain.
We assessed the analgesic effectiveness of a single intramuscular injection of dezocine, 10 mg or 15 mg; morphine, 10 mg; or a placebo in 160 patients with moderate to severe postoperative pain. Dezocine, 10 mg, was as effective as and had approximately the same duration of action as morphine, 10 mg. ⋯ A small percentage of patients suffered nausea and became sedated; the drugs and placebo, however, did not differ statistically with respect to the side effects. Blood pressure, heart rate, and respiratory rate generally were slightly decreased by both drugs.
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Int J Clin Pharmacol Ther Toxicol · Jun 1984
Review Comparative StudyEpidural and intrathecal opiates in obstetrics.
The use of epidural and intrathecal opiates in obstetrics is reviewed. Opiate receptors in the substantia gelatinosa of the spinal cord appear to be the main site of drug action after both epidural and intrathecal modes of drug administration. However, an additional systemic effect for this selective spinal analgesia cannot be excluded, especially after epidural drug administration. ⋯ After intrathecal injection of opiates, there was a strong analgesic action during delivery, but an unacceptable amount of side effects prevents their routine use. In post-cesarean patients, epidurally administered opiates are quite effective analgesics, but they still have one serious unwanted effect: respiratory depression of delayed onset. Thus, in routine obstetric practice, epidural or intrathecal opiates play only a limited role.
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Int J Clin Pharmacol Ther Toxicol · Apr 1984
Use of atropine in connection with oral midazolam premedication.
The clinical significance of intramuscular premedication with 0.01 mg/kg of atropine in a procedure involving oral benzodiazepine premedication (15 mg midazolam the evening before surgery and on the morning of surgery) was investigated in a double-blind study. As far as sedation, apprehension, excitement, dizziness, emesis, and headache were concerned, there were no significant differences between group 1 (atropine) and group 2 (placebo) patients; however, both during and after anesthesia patients in group 1 had less excessive salivary secretion (especially during extubation). As a result of sympathetic overactivity, patients in group 1 had an increased heart rate and an increased incidence of supraventricular tachycardia. ⋯ From the anesthetist's viewpoint, atropine has both beneficial effects (antisecretory) and unwanted effects (cardiovascular effects). For the patient atropine caused only subjective unwanted effects. Midazolam, a new short-acting, sedative benzodiazepine derivatives, can be used without atropine as an oral premedicant.