Complete atrioventricular block due to ingestion of Visine eye drops

Visine eye drops are a commonly used topical drug for irritation of the eye. The active component in Visine eye drops is tetrahydrozoline. Tetrahydrozoline is an imidazoline derivative found in several ophthalmic and nasal decongestants. Exposure is common in young children, who unintentionally ingest it, but cases have been rising in the adult population. The main systemic effects are bradycardia and hypotension due to activation of the central alpha-adrenergic receptors. In this case report, a 76-year-old man presents with bradycardia after 24 hours following ingestion of 120 mL of 0.05% tetrahydrozoline (eight bottles of Visine eye drops) in a suicide attempt. His initial ECG demonstrated complete heart block and QT prolongation. Subsequent ECGs showed unremitting first-degree atrioventricular block and QT prolongation. Here, we are presenting the first case of complete heart block following tetrahydrozoline consumption.

Effect of tamsulosin on testis histopathology and serum hormones in adult rats: Experimental study

Background: Tamsulosin is an inhibitory factor of alpha-adrenergic receptors that is used for relieving of the clinical symptoms and management of acute urinary retention. Objective: The aim of this study was to evaluate the effects of tamsulosin on the endocrine axis and testicular tissue in adult male rats. Materials and Methods: In this experimental study, 30 adult male Wistar rats (weighing 250-300 gr) were divided into three groups: 1) control (received distilled water), 2) experimental 1 (received 0.2 mg/kg/day tamsulosin) and 3) experimental 2 (received 0.4 mg/kg/day tamsulosin) through oral gavage for 28 days. Serum hormones level and testicular histopathology were evaluated at the end of the experiment. Results: In this study, the testicular weight decreased significantly in the experimental groups compared to the control group. A significant decrease was seen in testicular weight (p = 0.004) and the number of Leydig cells in tamsulosin-treated groups (p = 0.012). Tamsulosin improved the hormone profile in experimental groups. Also, higher dose of tamsulosin significantly changed the number of Leydig, spermatogonia cells, the thickness of germinal layer, and the diameter of the seminiferous tubules. Conclusion: Results showed that using tamsulosin, possibly reduces the testosterone concentration through adrenergic axis system and in turn has destructive effects on proliferative activity of germ cells. Key words: Tamsulosin, Seminiferous tubules, Histopathology, Rat, Testis.

Abstract 360: Effects of Different Doses of Pralidoxime Administered During Cardiopulmonary Resuscitation and the Role of Alpha-Adrenergic Receptors in its Pressor Action

Introduction: We previously reported that pralidoxime potentiated the pressor effect of epinephrine and improved restoration of spontaneous circulation (ROSC) rate and short-term survival in pigs undergoing cardiopulmonary resuscitation (CPR). We sought to explore the optimal dose of pralidoxime to be used during CPR and to evaluate the involvement of α-adrenoceptors in its pressor action. Methods: In the first substudy, 44 pigs randomly received one of three doses of pralidoxime (40, 80, or 120 mg/kg) or saline placebo during CPR. All animals were given epinephrine every 3 minutes. In the second substudy, 49 rats were divided into 7 groups. In the first 4 groups, the effects of 40 mg/kg pralidoxime on arterial pressure were determined after pretreatment with saline, guanethidine, phenoxybenzamine, or phentolamine. In the other 3 groups, the effects of 200 mg/kg pralidoxime were determined after pretreatment with saline, propranolol, or phentolamine. Results: In the first substudy, 40 mg/kg pralidoxime resulted in the highest coronary perfusion pressure (CPP) among the groups, while 120 mg/kg pralidoxime resulted in the lowest CPP (group effect P <0.001). Sustained ROSC was attained in 4 (36.4%), 11 (100%), 9 (81.8%), and 3 (27.3%) animals in the saline, 40 mg/kg, 80 mg/kg, and 120 mg/kg groups, respectively ( P <0.001). In the second substudy, 40 mg/kg pralidoxime elicited a pressor response. Phenoxybenzamine completely inhibited the pressor response, but guanethidine and phentolamine did not. The pressor response of pralidoxime was even greater after pretreatment with guanethidine or phentolamine. Two-hundred mg/kg pralidoxime produced an initial vasodepressor response followed by a delayed pressor response. Phentolamine eliminated the initial vasodepressor response and reversed it into a pressor response. Conclusions: Forty mg/kg of pralidoxime administered with epinephrine led to a significantly higher ROSC rate by improving CPP in a pig model of cardiac arrest, whereas 120 mg/kg did not improve CPP or the ROSC rate. Our findings suggest that the pressor effect of pralidoxime is unrelated to α-adrenoceptors and that its pressor effect is buffered by its vasodepressor action mediated by the inhibition of the sympathetic nervous system.

Dynamics of prostate protectors assortment in the state formulary of medicines of 1-9 issues

Prostatitis is one of the most frequent urology diseases of men of reproductive age. Recommendations for rational pharmacotherapy prostatitis are included into the State Formulary of Medicines, which is reviewed and updated annually. Thus, the aim of our work was to study the dynamics of the assortment of prostate protectors.The State Formulary of Medicines of 1–9 issues and the State Register of Medicines of Ukraine dated 01. 08. 2017 were the materials of the research. The methods of search, content analysis, statistics, comparison and generalization were applied. It was established that the first, second and third issues of State Formulary of Medicines include three therapeutic and chemical subgroups of prostate protectors: alpha-adrenergic receptors antagonists (G04CA), testosterone-5-alpha reductase inhibitors (G04CB), other drugs used in benign prostatic hypertrophy (G04CX). And since the fourth issue – only the first two subgroups of prostate protectors were icnluded. Assortment prostate protectors was stabilized in State Formulary of Medicines of 8, 9 issues. Depth of assortment of the State Formulary of Medicines of the ninth issue is 55,8% in comparison with the State Register of Medicines of Ukraine along with 100% index for prostate protectors trade names based on alfuzosin, terazosin (G04CA – Аntagonists of alpha adrenergic receptors), finasteride and dutasteride (G04CB – Inhibitors of testosterone-5-alpha reductase), as well as the absence of drugs based on silodosin, dutasteride-tamsulosin, solifenacin-tamsulosin (G04CA – Antagonists of alpha-adrenergic receptors) and prostate protectors with G04CX – Other drugs used in benign prostatic hypertrophy.