A rare case of spontaneous expulsive suprachoroidal haemorrhage in a glaucomatous eye treated with topical alpha-adrenergic agonist

Spontaneous expulsive suprachoroidal hemorrhage is a rare ocular condition, which usually occurs after sudden decompression of the eyewall. Most of the cases of expulsive hemorrhage reported had a predisposing glaucoma with the combination of corneal pathology. We are reporting a case of spontaneous expulsive suprachoroidal hemorrhage in a glaucoma patient probably due to perpetuated inflammatory reaction and frequent eye rubbing induced by allergic reaction to topical alpha adrenergic agonist in a compromised cornea.

Electrosensing of an alpha-adrenergic agonist psychoactive methyldopa using a sodium bentonite–graphene oxide nanocomposite

In the present report, we describe the preparation of a sodium bentonite–graphene oxide nanocomposite for the electrosensing of methyldopa (MD).

Abstract 3315: Therapeutic Implications of Sympathetic Stimulus in Orthostatic Patients: Measured by Spectral Domain Analysis

Upon assuming an upright, head up posture, a sympathetic surge is expected. Sympathetic Withdrawal (SW) is abnormal and can differentiate Orthostasis. SW, with blood pressure (BP) and heart rate (HR), can fully define the continuum that is Orthostasis, including pre-clinical forms: Orthostatic Hypotension (OH-), Orthostatic Intolerance (OI), Orthostatic Hypertension (OH+), and Postural Orthostatic Tachycardia Syndrome (POTS). Our objective was to test the therapeutic implications of SW in Orthostatic patients. Autonomic profiling of 210 consecutive Orthostatic patients recruited from ambulatory clinics was performed using the ANX-3.0 Autonomic Monitoring System (Ansar, Inc., Philadelphia, PA). The cohort (age=58.9±11.6; 30 Diabetics; 132 Females, 28 Controls) was followed over a two year period. Autonomic profiling was based on patient responses to a standard clinical study that includes a resting baseline and periods of deep (relaxed) breathing, short Valsalva maneuvers, and quick stand immediately followed by quiet standing. The control group were patients with known diagnoses. The experimental group were prescribed 2.5 mg Midodrine once a day around dinner. Control patients were administered Flourinef, or support hose, or when possible were requested to modify their diets to add salt and build fluid volume. Patients with dysautonomia, with symptoms of elevated BP when supine were omitted from the study. In 89% of the experimental cases, SW was reversed in approximately 6 months and weaned from the medication. The remaining cases were reversed and weaned before the end of the two year follow up. In the control group, 46% of the patients on Flourinef, 4% of the support hose patients and 12% of the diet modification patients corrected SW within the two year period. The application of an alpha-adrenergic agonist seems to have greater efficacy than a mineralo-corticoid, mechanical intervention, or dietary modification in correcting SW associated with Orthostasis.

Suppression of alpha adrenergic agonist-induced catalepsy in mice by potentized Agaricus muscarius

Agaricus muscarius 30c, a potentized homoeopathic drug prepared by successive dilution with 90% ethanol followed by sonication in 30 steps, suppressed catalepsy induced by alpha adrenergic agonists in Swiss albino mice. Agaricus produced anticataleptic effect when it was administered orally and no such effect when administered intraperitoneally. The alpha 1 agonist phenylephrine and alpha 2 agonist clonidine were administered intraperitoneally to mice at a dose of 2 mg/kg and 1 mg/kg, respectively. Mice were pretreated orally with Agaricus muscarius 30c. The action of Agaricus is thought to be mediated through ororeceptors.

Treatment of Hypotension after Hyperbaric Tetracaine Spinal Anesthesia

Background Despite many advantages, spinal anesthesia often is followed by undesirable decreases in blood pressure, for which the ideal treatment remains controversial. Because spinal anesthesia-induced sympathectomy and management with a pure alpha-adrenergic agonist can separately lead to bradycardia, the authors hypothesized that epinephrine, a mixed alpha- and beta-adrenergic agonist, would more effectively restore arterial blood pressure and cardiac output after spinal anesthesia than phenylephrine, a pure alpha-adrenergic agonist. Methods Using a prospective, double-blind, randomized, cross-over study design, 13 patients received sequential infusions of epinephrine and phenylephrine to manage hypotension after hyperbaric tetracaine (10 mg) spinal anesthesia. Blood pressure, heart rate, and stroke volume (measured by Doppler echocardiography using the transmitral time-velocity integral) were recorded at baseline, 5 min after injection of tetracaine, and before and after management of hypotension with epinephrine and phenylephrine. Cardiac output was calculated by multiplying stroke volume x heart rate. Results Five min after placement of a hyperbaric tetracaine spinal anesthesia, significant decrease in systolic (from 143 +/- 6 mmHg to 125 +/- 5 mmHg; P < 0.001), diastolic (from 81 +/- 3 to 71 +/- 3; P < 0.001), and mean (from 102 +/- 4 to 89 +/- 3; P < 0.001) arterial pressures occurred. Heart rate (75 +/- 4 beats/min to 76 +/- 4 beat/min; P = 0.9), stroke volume (115 +/- 17 to 113 +/- 13; P = 0.9), and cardiac output (8.0 +/- 1 l/m to 8.0 +/- 1l/m; P = 0.8) did not change significantly after spinal anesthesia. Phenylephrine was effective at restoring systolic blood pressure after spinal anesthesia (120 +/- 6 mmHg to 144 +/- 5 mmHg; P < 0.001) but was associated with a decrease in heart rate from 80 +/- 5 beats/min to 60 +/- 4 beats/min (P < 0.001) and in cardiac output from 8.6 +/- 0.7 l/m to 6.2 +/- 0.7 l/m (P < 0.003). Epinephrine was effective at restoring systolic blood pressure after spinal anesthesia (119 +/- 5 mmHg to 139 +/- 6 mmHg; P < 0.001) and was associated with an increase in stroke volume from 114 +/- 12 ml to 142 +/- 17 (P < 0.001) and cardiac output from 7.8 +/- 0.6 l/m to 10.8 +/- 1.1 l/m (P < 0.001). Conclusions Epinephrine management of tetracaine spinal-induced hypotension increases heart rate and cardiac output and restores systolic arterial pressure but does not restore mean and diastolic blood pressure. Phenylephrine management of tetracaine spinal-induced hypotension decreases heart rate and cardiac output while restoring systolic, mean, and diastolic blood pressure.