Side-effects of L-dopa on venous tone in Parkinson's disease: a leg-weighing assessment

2006 ◽  
Vol 110 (3) ◽  
pp. 369-377 ◽  
Author(s):  
Jean-Pierre Wolf ◽  
Malika Bouhaddi ◽  
Francis Louisy ◽  
Andrei Mikehiev ◽  
Laurent Mourot ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Heart Rate ◽  
Parkinson's Disease ◽  
Side Effects ◽  
Vascular Tone ◽  
Lower Limbs ◽  
Plasma Noradrenaline ◽  
Venous Tone ◽  
Arterial Blood

In the present study, the effects of L-dopa treatment on cardiovascular variables and peripheral venous tone were assessed in 13 patients with Parkinson's disease (PD) with Hoehn and Yahr stages 1–4. Patients were investigated once with their regular treatment and once after 12 h of interruption of L-dopa treatment. L-Dopa intake significantly reduced systolic and diastolic blood pressure, heart rate and plasma noradrenaline and adrenaline in both the supine and upright (60°) positions. A significant reduction in stroke volume and cardiac output was also seen with L-dopa. The vascular status of the legs was assessed through thigh compression during leg weighing, a new technique developed in our laboratory. Healthy subjects were used to demonstrate that this technique provided reproducible results, consistent with those provided by strain gauge plethysmography of the calf. When using this technique in patients with PD, L-dopa caused a significant lowering of vascular tone in the lower limbs as shown, in particular, by an increase in venous distensibility. Combined with the results of the orthostatic tilting, these findings support that the treatment-linked lowering of plasma noradrenaline in patients with PD was concomitant with a significant reduction in blood pressure, heart rate and vascular tone in the lower limbs. These pharmacological side-effects contributed to reduce venous return and arterial blood pressure which, together with a lowered heart rate, worsened the haemodynamic status.

Acute Cardiovascular Responses to Self-selected Intensity Exercise in Parkinson's Disease

2021 ◽  
Author(s):  
Hélcio Kanegusuku ◽  
Gabriel Grizzo Cucato ◽  
Paulo Longano ◽  
Erika Okamoto ◽  
Maria Elisa Pimentel Piemonte ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Heart Rate ◽  
Parkinson's Disease ◽  
Pulse Wave ◽  
Augmentation Index ◽  
Cardiovascular Responses ◽  
Cycle Ergometer ◽  
Control Session ◽  
Wave Analysis

AbstractParkinson’s disease patients frequently present cardiovascular dysfunction. Exercise with a self-selected intensity has emerged as a new strategy for exercise prescription aiming to increase exercise adherence. Thus, the current study evaluated the acute cardiovascular responses after a session of aerobic exercise at a traditional intensity and at a self-selected intensity in Parkinson’s disease patients. Twenty patients (≥ 50 years old, Hoehn & Yahr 1–3 stages) performed 3 experimental sessions in random order: Traditional session (cycle ergometer, 25 min, 50 rpm, 60–80% maximum heart rate); Self-selected intensity: (cycle ergometer, 25 min, 50 rpm with self-selected intensity); and Control session (resting for 25 min). Before and after 30 min of intervention, brachial and central blood pressure (auscultatory method and pulse wave analysis, respectively), cardiac autonomic modulation (heart rate variability), and arterial stiffness (pulse wave analysis) were evaluated. Brachial and central systolic and diastolic blood pressure, heart rate, and the augmentation index increased after the control session, whereas no changes were observed after the exercise sessions (P<0.01). Pulse wave velocity and cardiac autonomic modulation parameters did not change after the three interventions. In conclusion, a single session of traditional intensity or self-selected intensity exercises similarly blunted the increase in brachial and central blood pressure and the augmentation index compared to a non-exercise control session in Parkinson’s disease patients.

scholarly journals Fentanyl Pretreatment Modifies Anaesthetic Induction with Etomidate

1988 ◽  
Vol 16 (2) ◽  
pp. 171-176 ◽  
Author(s):  
R. J. Stockham ◽  
T. H. Stanley ◽  
N. L. Pace ◽  
S. Gillmor ◽  
F. Groen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Side Effects ◽  
Linear Regression ◽  
Anaesthetic Induction ◽  
Arterial Blood ◽  
Group I ◽  
Haemodynamic Changes ◽  
Induction Of Anaesthesia ◽  
Fentanyl Group

Haemodynamic changes and side-effects of induction of anaesthesia with etomidate were evaluated in 60 ASA Class I or II patients. The objective was to find an optimal pre-induction dose of fentanyl which eliminated haemodynamic changes and side-effects during induction and intubation without introducing other problems. Patients were randomly assigned to four groups according to the pretreatment dose of fentanyl (Group I= 2 ml normal saline; Group II= 100 μg of fentanyl; Group III= 250μg of fentanyl; Group IV = 500 μg of fentanyl) administered intravenously five minutes prior to induction of anaesthesia with etomidate, 0.3 mg/kg. There was an increasing incidence of apnoea (53, 87, 87 and 100% in Groups I-IV respectively) and a decreasing incidence of myoclonus (60, 33, 13 and 0% in Groups I-IV respectively) and injection pain (53, 13, 7 and 0% in Groups I-IV respectively), P< 0.002 chi-square test for linear trends, with increasing fentanyl dosage. The incidences of postoperative nausea and vomiting were similar in the four groups. There were also significant linear regression relationships (P< 0.01 ANOVA for linear regression) between increasing doses of fentanyl administered before etomidate and the prevention of increases in systolic blood pressure and heart rate during the induction-intubation sequence. The data demonstrate that increasing pre-induction doses of fentanyl are more effective at minimising side-effects and preventing increases in systolic arterial blood pressure and heart rate but also increase the incidence of apnoea during induction. The results suggest that 500 μg of fentanyl is an ideal pretreatment dose in fit patients prior to anaesthetic induction with etomidate.

scholarly journals Arterial blood pressure in patients with Parkinson's disease

1975 ◽  
Vol 38 (1) ◽  
pp. 73-77 ◽  
Author(s):  
M. J. Aminoff ◽  
M. Gross ◽  
B. Laatz ◽  
S. D. Vakil ◽  
A. Petrie ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Arterial Blood Pressure ◽  
Arterial Blood

Acute Cardiometabolic Responses to Three Modes of Treadmill Exercise in Older Adults With Parkinson’s Disease

2018 ◽  
Vol 35 (4) ◽  
pp. 424-436
Author(s):  
Brandon R. Rigby ◽  
Ronald W. Davis ◽  
Marco A. Avalos ◽  
Nicholas A. Levine ◽  
Kevin A. Becker ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Parkinson’S Disease ◽  
Heart Rate ◽  
Parkinson's Disease ◽  
Perceived Exertion ◽  
Treadmill Exercise ◽  
Rating Of Perceived Exertion ◽  
Elderly Adults ◽  
All Speeds ◽  
Physiologic Responses

The purpose of this study was to compare acute cardiometabolic responses to 3 modes of treadmill exercise in adults diagnosed with Parkinson’s disease (PD). Eight elderly adults with PD (67.9 ± 3.0 yr) completed 1 session each on a land, aquatic, and antigravity treadmill at 50% body weight. Participants walked from 1 to 3 mph in 0.5-mph increments at 0% grade for 5 min at each speed. Heart rate, energy expenditure, blood pressure, and rating of perceived exertion were measured at rest and during exercise. All variables except diastolic blood pressure increased with speed on all treadmills (p < .001). At all speeds except 1.5 mph, heart rate was higher on the land treadmill than the antigravity treadmill (p < .05). Exercising on an aquatic or antigravity treadmill elicits similar submaximal physiologic responses to exercise on a land treadmill in adults with PD.

Dose–response and Cardiopulmonary Side Effects of the Novel Neuromuscular-blocking Drug CW002 in Man

2016 ◽  
Vol 125 (6) ◽  
pp. 1136-1143 ◽  
Author(s):  
Paul M. Heerdt ◽  
Hiroshi Sunaga ◽  
Joel S. Owen ◽  
Matthew T. Murrell ◽  
Jaideep K. Malhotra ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Nitrous Oxide ◽  
Side Effects ◽  
Histamine Release ◽  
Healthy Subjects ◽  
Neuromuscular Blocking ◽  
Blocking Drug ◽  
Neuromuscular Blocking Drug ◽  
Arterial Blood

Abstract Background CW002 is a benzylisoquinolinium nondepolarizing neuromuscular-blocking drug found to be inactivated by cysteine in preclinical studies. The current study represents a dose escalation clinical trial designed to describe CW002 potency, duration, cardiopulmonary side effects, and histamine release. Methods Healthy subjects anesthetized with sevoflurane/nitrous oxide were divided into five groups (n = 6), each receiving a fixed CW002 dose (0.02, 0.04, 0.06, 0.08, or 0.10 mg/kg), and one group (n = 4) receiving 0.14 mg/kg. Blood pressure and heart rate were continuously recorded along with airway dynamic compliance. Neuromuscular blockade was assessed with mechanomyography at the adductor pollicis. Arterial blood was obtained before and after CW002 injection for analysis of plasma histamine concentration. Potency was estimated from a baseline sigmoid Emax model. Results ED50 was found to be 0.036 mg/kg (95% CI, 0.020 to 0.053 mg/kg) and ED95 0.077 mg/kg (95% CI, 0.044 to 0.114 mg/kg). At 0.14 mg/kg (1.8 × ED95), 80% twitch depression occurred in 94 ± 18 s with complete block in 200 ± 87 s. Clinical recovery (25% of maximum twitch) occurred in 34 ± 3.4 min, with a 5 to 95% recovery interval of 35.0 ± 2.7 min. The time to a train-of-four ratio greater than 0.9 ranged from 59 to 86 min. CW002 did not elicit histamine release or significant (greater than 10%) changes in blood pressure, heart rate, or dynamic airway compliance. Conclusions In healthy subjects receiving sevoflurane/nitrous oxide, CW002 at 1.8 × estimated ED95 produces a clinical duration less than 40 min, elicits no histamine release, and has minimal cardiopulmonary side effects.

Haemodynamic effects of physiological concentrations of circulating noradrenaline in man

1988 ◽  
Vol 75 (5) ◽  
pp. 469-475 ◽  
Author(s):  
Peter C. Chang ◽  
Eugene Kriek ◽  
Jacques A. Van Der Krogt ◽  
Gerard-Jan Blauw ◽  
Peter Van Brummelen
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Flow ◽  
Vascular Resistance ◽  
Forearm Blood Flow ◽  
Haemodynamic Effects ◽  
Plasma Noradrenaline ◽  
Arterial Blood ◽  
Forearm Vascular Resistance ◽  
Venous Plasma

1. To define the role of circulating noradrenaline in cardiovascular regulation, threshold concentrations for haemodynamic effects were determined in arterial and venous plasma of eight healthy volunteers. 2. Five doses of noradrenaline, 0–54 ng min−1 kg−1, were infused intravenously in random order and single-blind for 15 min per dose. Changes in intra-arterial blood pressure, heart rate, forearm blood flow and forearm vascular resistance were determined, and plasma noradrenaline was measured in arterial and venous blood samples. 3. Significant increases in systolic and diastolic blood pressure were found at arterial and venous plasma noradrenaline concentrations (means ±sem) of 3.00 ± 0.23 and 1.35 ±0.12 nmol/l, respectively. A significant decrease in heart rate was found at arterial and venous plasma noradrenaline concentrations of 8.99 ± 0.69 and 3.09 ± 0.60 nmol/l, respectively. The lower doses of noradrenaline tended to increase forearm blood flow and to decrease forearm vascular resistance, whereas the higher doses had no consistent effect on forearm haemodynamics. 4. During the noradrenaline infusions 73 ± 5% of the increase in arterial plasma noradrenaline concentration was extracted in the forearm. 5. The venous plasma noradrenaline threshold concentration was found to be much lower than previously reported. It is concluded that arterial and venous plasma noradrenaline concentrations which are readily encountered in physiological circumstances elicit haemodynamic effects.

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