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Transient ischemic attack associated with Metabolife 356 use

2005; Elsevier BV; Volume: 23; Issue: 2 Linguagem: Inglês

10.1016/j.ajem.2003.12.028

1532-8171

Frank LoVecchio, Belinda Sawyers, Patricia A. Eckholdt,

Poisoning and overdose treatments

This chapter describes drugs that affect autonomic functions or the extrapyramidal system. The chapter includes a special review of a very intriguing adverse effect of the use of dopamine receptor agonists, the apparent link with pathological gambling. Dobutamine is very commonly used in stress echocardiography. One well-recognized complication is nonsustained ventricular tachycardia. The prognostic implications have been considered in 1,266 consecutive patients, of whom 65 (5.1%) had this dysrhythmia. After 3 years of follow-up, there was no significant difference in all-cause mortality between patients who had ventricular tachycardia and those who did not (22 versus 17%). Further analysis showed that patients who had (i) nonsustained ventricular tachycardia, (ii) no evidence of inducible ischemia, and (iii) a moderately reduced ejection fraction (0.35–0.45) had significantly reduced chances of survival. In this chapter, an overview of drugs that stimulate both alpha- and beta-adrenoceptors is given. Noradrenaline (norepinephrine), ephedra, ephedrine, and pseudoephedrine are discussed. Drugs that predominantly stimulate alpha1-adrenoceptors are described. Studies on phenylephrine and phenylpropanolamine are also discussed in the chapter.