nerve X the vagus nerve , which is part of the autonomic nervous system . This causes bradycardia and peripheral ... diving reflex is not induced when limbs are introduced to cold water. Mild bradycardia is caused ... url ref However the greatest bradycardia effect is induced when the subject is holding breath with face ... more details
Proarrhythmia is a new or more frequent occurrence of pre existing arrhythmia s, paradoxically precipitated by antiarrhythmic therapy, which means it is a Adverse effect side effect associated with the administration of some existing Antiarrhythmic agent antiarrhythmic drugs , as well as drugs for other indications. In other words, it is a tendency of antiarrhythmic drugs to facilitate emergence of new arrhythmias. Types of proarrhythmia According to the Vaughan Williams classification VW of antiarrhythmic drugs, there are 3 main types of Proarrhythmia during treatment with various antiarrhythmic drugs for Atrial Fibrillation or Atrial flutter Ventricular proarrhythmia Torsade de pointes VW type IA and type III drugs Sustained monomorphic ventricular tachycardia usually VW type IC drugs Sustained polymorphic ventricular tachycardia ventricular fibrillation without long QT VW types IA, IC, and III drugs Atrial proarrhythmia Conversion of atrial fribrillation to flutter usually VW type IC drugs or amiodarone . May be a desired effect. Increase of defibrillation threshold a potential problem with VW type IC drugs Provocation of recurrence probably VW types IA, IC and III drugs . It is rare. Abnormalities of conduction or impulse formation Sinus node dysfunction, atrioventricular block almost all drugs Accelerate conduction over accessory pathway digoxin , intravenous verapamil , or diltiazem Acceleration of ventricular rate during atrial fibrillation VW type IA and type IC drugs . Increased risk Presence of structural heart disease , especially LV systolic dysfunction . Class IC agents. Increased age. Females. Clinical pointers Class IA drugs Dose independent, occurring at normal levels. Follow QT interval, keep ms. Class IC drugs May be provoked by increased heart rate. Exercise stress tests after loading. Class III drugs Dose dependent. Follow bradycardia, prolonged QT closely. External links cite journal doi 10.1016 S0002 9149 98 00472 X author Roden DM title Mechan ... more details
A parasympatholytic agent is a substance or activity that reduces the activity of the parasympathetic nervous system . ref name urlDorlands Medical Dictionary parasympatholytic cite web url http www.mercksource.com pp us cns cns hl dorlands split.jsp?pg ppdocs us common dorlands dorland six 000078651.htm title Dorlands Medical Dictionary parasympatholytic work accessdate ref The parasympathetic nervous system is often colloquially described as the Feed and Breed or Rest and Digest portion of the autonomic nervous system . The parasympathetic nervous system becomes strongly engaged during or after a meal and during times when the body is at rest. The term parasympatholytic typically refers to the effect of a drug , although some poison s act to block the parasympathetic nervous system as well. Most drugs with parasympatholytic properties are anticholinergic s. Parasympatholytic and sympathomimetic agents have similar but not identical effects. For example, both cause mydriasis , but parasympatholytics reduce Accommodation eye accommodation cycloplegia , whereas sympathomimetics do not. Clinical significance Parasympatholytic drugs are sometimes used to treat slow heart rhythms bradycardia s or bradydysrhythmias caused by myocardial infarction s or other pathologies, as well as to treat conditions that cause bronchiole s in the lung to constrict, such as asthma . By blocking the parasympathetic nervous system, parasympatholytic drugs can increase heart rate in patients with bradycardic heart rhythms, and open up airways and reduce mucous production in patients suffering from asthma. Main Article Anticholinergic References reflist External links http www.salisbury.edu healthsci RESP Classes RLJoyner Fall AHPH544 4parasym.htm Overview at salisbury.edu MeshName Parasympatholytics Receptor agonists and antagonists Category Anticholinergics med stub es Parasimpaticol tico ... more details
Micturition syncope or post micturition syncope is the name given to the human phenomenon of fainting shortly after or during urination . It is a type of Vasovagal response . People often become pale, nauseated, sweaty and weak before they lose consciousness. Sometimes even defecating , cough ing, or severe vomiting may cause fainting in a similar way. Epidemiology Responsible for 2.4 to 8.4 percent of all cases of fainting in adult s, it most commonly occurs in male s. The events often occur at night or after awaking this means that it occurs while standing immediately after being recumbent for some time . Causes When one strains to increase the flow of urine it stimulates the vagus nerve usually more pronounced in elderly men with benign prostatic hyperplasia large prostates . The vagus nerve stimulus causes slowing down of the heart bradycardia and severe hypotension drop in blood pressure . The heart cannot perform as a pump effectively because insufficient blood comes to it. It is classically associated with a tumor known as a pheochromocytoma within the urinary bladder. Treatment There is no specific treatment for micturition syncope. General advice to men who have a micturition syncope includes ref http www.mayoclinic.com health micturition syncope AN01608 ref to sit while urinating to sit on the edge of the bed for a while before getting up and going to the toilet to avoid micturition while sleepy to go for micturition before sleep References reflist External links http www.patient.co.uk showdoc 40000734 Micturition Syncope Patient Plus disease stub Category Urological conditions zh ... more details
Unreferenced date January 2008 SLUDGE is a mnemonic for the pathological effects indicative of massive discharge of the parasympathetic nervous system . Unlikely to occur naturally, SLUDGE is usually encountered only in cases of drug overdose, ingestion of certain mushroom poisoning poisonous mushroom s particularly the muscarine containing members of the genera Inocybe and Clitocybe , or exposure to nerve agent nerve gases . Nerve gases irreversibly inhibit the enzyme Cholinesterase acetylcholinesterase this results in a chronically high level of acetylcholine at cholinergic synapses throughout the body, thus chronically stimulating acetylcholine receptors throughout the body. The symptoms of SLUDGE are due to chronic stimulation of muscarinic acetylcholine receptors , in organs and muscles innervated by the parasympathetic nervous system. It is useful to remember some of the symptoms of increased cholinergic stimulation through the mnemonic SLUDGE Salivation stimulation of the salivary glands Lacrimation stimulation of the lacrimal glands Urination relaxation of the internal sphincter muscle of urethra , and contraction of the Detrusor urinae muscle detrusor muscles Defecation relaxation of the internal anal sphincter Nausea Gastrointestinal upset Smooth muscle tone changes causing gastrointestinal problems, including diarrhea Emesis Vomiting An extension is SLUDGEM , where the additional M indicates Miosis stimulation of the Iris sphincter muscle pupillary constrictor muscles or Muscle spasm stimulation of skeletal muscle Another mnemonic is DUMBBELSS which stands for diarrhea, urination, miosis muscle weakness, bronchorrhea, bradycardia, emesis, lacrimation, salivation sweating. One common cause of SLUDGE is exposure to organophosphates organophosphorus insecticides including parathion , malathion , and diazinon or nerve gas , such as sarin . These agents phosphorylate acetylcholinesterase, thereby irreversibly deactivating acetylcholinesterase and raising acety ... more details
Infobox Disease Name Accelerated idioventricular rhythm Image Caption DiseasesDB ICD10 ICD10 I 45 6 i 30 ICD9 ICDO OMIM MedlinePlus eMedicineSubj eMedicineTopic MeshID D016170 In accelerated idioventricular rhythm AIVR , the rate of cardiac contraction is determined by the intrinsic rate of depolarization of the cardiac cells. It can be present at birth. ref name pmid17687587 cite journal author Freire G, Dubrow I title Accelerated idioventricular rhythm in newborns a worrisome but benign entity with or without congenital heart disease journal Pediatr Cardiol volume 29 issue 2 pages 457 62 year 2008 month March pmid 17687587 doi 10.1007 s00246 007 9024 z ref Pathophysiology In normal hearts the sinoatrial node in the atria depolarizes at a rate of 60 100 beats per minute as an effect of the parasympathetic autonomic nervous system otherwise the SA node would depolarize at a rate of 120 beats per minute . This suppresses the intrinsic depolarization of the other parts of the heart. The accelerated idioventricular rhythm occurs when depolarization rate of a normally suppressed focus increases to above that of the higher order focuses the sinoatrial node and the atrioventricular node . This most commonly occurs in the setting of a sinus bradycardia . ref name urlAccelerated Idioventricular Rhythm Overview eMedicine cite web url http www.emedicine.com med topic12.htm title Accelerated Idioventricular Rhythm Overview eMedicine format work accessdate 2008 12 21 ref Accelerated idioventricular rhythm is also the most common reperfusion arrhythmia in humans. However, ventricular tachycardia and ventricular fibrillation remain the most important causes of sudden death following spontaneous restoration of antegrade flow. ref AL Moens, MJ Claeys, JP Timmermans, CJ Vrints. Myocardial ischemia reperfusion injury, a clinical view on a complex pathophysiological process. International Journal of Cardiology 2005 100 179 ref Appearance AIVR appears similar to ventricular tachycardia ... more details
Image Bezold.JPG right thumb Albert von Bezold 1836 1868 Albert von Bezold January 7, 1836 March 2, 1868 was a German physiologist born in Ansbach . He studied at Munich , W rzburg and Berlin , where he was an assistant to Emil Du Bois Reymond 1818 1896 . Later he was a professor of physiology at Jena 1859 and W rzburg 1865 . Bezold performed important research involving the physiology of the muscle s, nerve s and cardiovascular system . He is also remembered for studying the physiological effects of pharmacology pharmacological substances such as curare , atropine and veratrum on the bodys muscle s, heart , nerve s and circulatory system . The eponymous Bezold Jarisch reflex is a triad of responses apnea , bradycardia , and hypotension resulting from an intravenous injection of veratrum alkaloid s. This medical sign is named along with pharmacologist Adolf Jarisch Jr. 1891 1965 , who in 1937 re confirmed Bezold s earlier experiments. Bezold is well known for his physiological work. Associated eponym Bezold s ganglion an aggregation of ganglion cells in the interatrial septum . References http www.ncbi.nlm.nih.gov sites entrez?cmd Retrieve&db PubMed&list uids 11458703&dopt AbstractPlus NCBI article on the Bezold Jarisch Reflex http www.whonamedit.com doctor.cfm 2644.html Albert von Bezold Who Named It Further reading DSB first Johannes last Steudel title Bezold, Albert von volume 2 pages 110 111 Persondata Metadata see Wikipedia Persondata . NAME Bezold, Albert von ALTERNATIVE NAMES SHORT DESCRIPTION DATE OF BIRTH January 7, 1836 PLACE OF BIRTH DATE OF DEATH March 2, 1868 PLACE OF DEATH DEFAULTSORT Bezold, Albert von Category German physiologists Category 1836 births Category 1868 deaths Category People from Ansbach Category University of W rzburg faculty Category University of Jena faculty de Albert von Bezold pl Albert von Bezold fi Albert von Bezold sv Albert von Bezold ... more details
Orphan date February 2009 J receptors juxtacapillary are nerve s innervation innervating into the body of the lung . They are present in the alveolar interstitium and are innervated by fibers of the vagus nerve . ref cite book last Sircar first Sabyasachi title Principles of Medical Physiology isbn 1588905721 pages 350 51 ref J receptors respond to events such as pulmonary edema , pulmonary emboli , pneumonia , and barotrauma , which cause a decrease in oxygenation and thus lead to an increase in ventilation physiology ventilation respiration. They may be also stimulated by hyperinflation of the lung as well as intravenous or intracardiac administration of chemicals. Citation needed date April 2009 The stimulation of the J receptors causes a reflex increase in breathing rate, and is also thought to be involved in the sensation of dyspnea , the subjective sensation of difficulty breathing. ref A.A. Majid, A.N.Kingsworth, Fundamentals of Surgical Practice . Cambridge, MA Cambridge University Press, 2006. ISBN 0 521 67706 8. ref ref J.C. Bennett, F.Plum ed. Cecil Textbook of Medicine , 20th ed., W.B. Saunders, Philadelphia PA, 1996. ISBN 0 7216 3574 1 ref The reflex response that is produced is apnea followed by rapid breathing, bradycardia, and hypotension pulmonary chemoreflex . The physiologic role of this reflex is uncertain, but it probably occurs in pathologic states such as pulmonary congestion or embolization. ref Ganong WF. 2005. Chapter 36 regulation of respiration. Review of medical physiology. 22nd ed. McGraw Hill. ref .These receptors were discovered by Dr. A.S Paintal. ref http www.hindu.com seta 2006 01 19 stories 2006011900181500.htm ref References reflist Text book of medical physiology by guyton and hall 11th edi 2006. Category Nervous system sr they are also stimulated in congestive heart failure. ... more details
Image Lifepak.JPG thumb right 200px Lifepak 12 semi automatic defibrillator ECG monitor Lifepak is a series of external cardiac defibrillator s produced by medical technology company Medtronic, Inc. The Lifepak series was introduced in 1972 and was produced by Physio Control Inc. until the company merged with Medtronic in 1998. The units are dual branded as Medtronic Physio Control. Semi automatic units include the Lifepak 12 and Lifepak 15 for use by healthcare professionals such as emergency medical technicians and paramedics . automated external defibrillator Automatic units include the Lifepak 500 and Lifepak 1000 for use by members of the public who have been trained to operate them. ref cite web title Physio Control LIFEPAK publisher http www.physio control.com A Medtronic Company url http www.physio control.com about ref Lifepaks are more than just defibrillators. They constantly monitor heart rates, and alert the users to sudden changes. They allow for 12 Lead EKG acquisition and interpretation. The Lifepak 15 models include a CPR Metronome, which also verbally tells the rescuers when to ventilate the patient. All Lifepaks also include options for Cardioversion synchronized cardioversion for treating unstable fast rhythms like supraventricular tachycardia or A fib atrial fibrillation , external pacing for post cardiac arrest, bradycardia, and or Heart block heart block patients , and also monitor oxygen saturation, CO2 output for intubation, and blood pressure. Medical crews can transmit EKGs to receiving hospitals wireless via a device called a Rosetta Box. cn date January 2012 See also Ambulance Medical device health stub Reflist Category Health care brands Category Healthcare Category Medtronic ... more details
in the extremities and around the mouth, low blood pressure and sinus bradycardia . In higher doses symptoms can include loss of coordination, severe and progressive muscular weakness, bradycardia ... more details
doi 10.1046 j.1365 2044.2000.01158.x ref . However, this reflex may also occur with adults. Bradycardia ... antagonist , such as atropine or glycopyrrolate. If bradycardia does occur, removal of the inciting ... more details
contraindicated in patients with bradycardia slow heart rate because of its vasodilatory effects and tendency to cause bradycardia. Because of its beta 2 activity, nadolol causes pulmonary bronchoconstriction ..., a selective beta 1 blocker is preferred over non selective blockers. Side effects Bradycardia Fatigue ... more details
injection it causes initial bradycardia . This is because by i.m s.c it acts on presynaptic M1 receptor ... more acetylcholine into the Chemical synapse synapse which initially causes bradycardia. In the atrioventricular ... August year 1991 pmid 1886116 pmc 1293378 ref anticholinesterase poisoning ref name Rang147 bradycardia ... more details
D title Familial sinus bradycardia associated with a mutation in the cardiac pacemaker channel. journal ... synthesis, trafficking, and functional expression is associated with familial asymptomatic sinus bradycardia ... more details
can cause bradycardia and bronchospasm. Metabolism Propafenone is metabolized primarily in the liver ... propafenone in individuals with hepatic dysfunction, asthma, CHF, or bradycardia. Patent issues ... more details
Infobox disease Name Fetal distress Image Caption DiseasesDB 4882 ICD10 ICD10 O 68 o 60 ICD9 ICD9 768.2 ICD9 768.4 ICDO OMIM MedlinePlus eMedicineSubj eMedicineTopic MeshID D005316 In medicine obstetrics , the term fetal distress refers to the presence of signs in a pregnancy pregnant woman ref MeshName Fetal Distress ref &mdash before or during childbirth &mdash that suggest that the fetus may not be well. Because of its lack of precision, the term is eschewed in modern obstetrics. ref name acog cite journal author ACOG title Committee Opinion, Number 326, December 2005 Inappropriate Use of the Terms Fetal Distress and Birth Asphyxia. accessdate June 9, 2010 url http www.acog.org publications committee opinions co326.cfm ref Signs and symptoms Generally it is preferable to describe specific signs in lieu of declaring fetal distress that include Decreased movement felt by the mother Meconium in the amniotic fluid meconium stained liquor Non reassuring patterns seen on cardiotocography increased or decreased fetal heart rate tachycardia and bradycardia , especially during and after a contraction childbirth contraction decreased variability in the fetal heart rate late decelerations Biochemical signs, assessed by collecting a small sample of baby s blood from a scalp prick through the open cervix in labor fetal metabolic acidosis elevated fetal blood lactate levels indicating the baby has a lactic acidosis Some of these signs are more reliable predictors of fetal compromise than others. For example, cardiotocography can give high false positive rates, even when interpreted by highly experienced medical personnel. Metabolic acidosis is a more reliable predictor, but is not always available. Causes There are many causes of fetal distress including Breath ing problems Abnormal position and presentation of the fetus Multiple birth s Shoulder dystocia Umbilical cord prolapse Nuchal cord Placental abruption Premature closure of the fetal ductus arteriosus Uterine rupture Tr ... more details
Drugbox Verifiedfields changed verifiedrevid 477868834 IUPAC name N & x200b 2,6 & x200b dimethylphenyl & x200b 5,6 & x200b dihydro & x200b 4 H & x200b 1,3 & x200b thiazin & x200b 2 & x200b amine image Xylazin.svg Clinical data tradename Drugs.com drugs.com international xylazine pregnancy AU A B1 B2 B3 C D X pregnancy US A B C D X pregnancy category legal AU Unscheduled S2 S3 S4 S5 S6 S7 S8 S9 legal CA Schedule I, II, III, IV, V, VI, VII, VIII legal UK GSL P POM CD Class A, B, C legal US OTC Rx only Schedule I, II, III, IV, V legal status Veterinary Use routes of administration Pharmacokinetic data bioavailability protein bound metabolism elimination half life excretion Identifiers CASNo Ref cascite correct CAS CAS number Ref cascite correct ?? CAS number 7361 61 7 ATCvet yes ATC prefix N05 ATC suffix CM92 PubChem 5707 IUPHAR ligand 523 DrugBank Ref drugbankcite correct drugbank DrugBank DB04898 ChemSpiderID Ref chemspidercite changed chemspider ChemSpiderID 5505 UNII Ref fdacite correct FDA UNII 2KFG9TP5V8 KEGG Ref keggcite correct kegg KEGG D08683 ChEMBL Ref ebicite changed EBI ChEMBL 297362 Chemical data C 12 H 16 N 2 S 1 molecular weight 220.33 smiles N 1 C SCCC 1 Nc2c cccc2C C StdInChI Ref stdinchicite changed chemspider StdInChI 1S C12H16N2S c1 9 5 3 6 10 2 11 9 14 12 13 7 4 8 15 12 h3,5 6H,4,7 8H2,1 2H3, H,13,14 StdInChIKey Ref stdinchicite changed chemspider StdInChIKey BPICBUSOMSTKRF UHFFFAOYSA N Xylazine is a medication drug that is used for sedation , anesthesia , muscle relaxation, and analgesia in animals such as horses, cattle and other non human mammals. An analogue of clonidine , it is an agonist at the &alpha small sub 2 sub small class of adrenergic receptor . As with other &alpha small sub 2 sub small agonists, adverse effects include bradycardia , conduction disturbances, and myocardial depression. Yohimbine Yobine and atipamezole commercial name Antisedan can be used to reverse xylazine effects. In veterinary anesthesia , xylazine is often used ... more details
Multiple issues unreferenced November 2009 expert subject November 2008 cleanup November 2007 Drop attacks are sudden spontaneous falls while Standing position standing or walking , followed by a very swift recovery, within seconds or minutes. See also Atonic seizure Causes Drop attacks are typically seen in elderly patients, and the most common cause is carotid sinus hypersensitivity, resulting in either short periods of reversible asystole , or in marked drop in blood pressure in response to carotid sinus stimulation. Other causes include the following vascular transient ischemic attack , cerebrovascular accident , dissection, occlusion, hemorrhage intracranial hematoma posterior circulation infarction , emboli, vasospasm bilateral anterior circulation occlusion migraine accompagnee develop over 1hr with assoc paresthesia , HA basilar artery insuff older pt with no LOC, transient loss of LE tone epilepsy paroxysmal neurally mediated syncope 75 of all causes Atonic seizure Lennox Gastaut syndrome atonic, myoclonic, GTC typically in neuro abnormal pt Juvenile myoclonic epilepsy Juvenile Myoclonic Epilepsy fall with myoclonus cataplexy associated with narcolepsy periodic paralyses complex partial seizure breath holding spells associate pallor cyanosis , emotional aspect pure autonomic failure Riley Day , long standing DM episodic ataxia Panayiotopoulos syndrome degenerative postural instability with Parkinsons structural chronic odontoid instability spinal cord trauma with transient paraplegia brainstem mass metabolic hypoglycemia , hypocalcemia , Hypomagnesemia toxins , drugs cocaine , sedatives , antihistamine , TCA cardiac prolonged QT, tachycardia , bradycardia , sick sinus syndrome , Cardiac arrhythmia arrhythmia , IHSS. AS hypovolemia psychiatric malingering, conversion, panic , anxiety labyrinth hydrops an overflow of endolymph in ear labyrinth causes distortions and breaks see also M ni re s syndrome Diagnosis important if there was an inciting event NMS, bre ... more details
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