santaclara
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what happened to a pt if he has asthma and get epinephrine injection?
what happened to a pt if he has anaphylaxis shock and get epinephrine injection?
pls reply.
thanx.
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| mdwannabe
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Epi binds to B2 in lung and A receptors in vessels, so since Histamine and Bradykinin, that are responsible for Asthma and Anaphilaxis, it reverses the effects of both, bringing pressure back upwards, and relaxing bronchioles to ensure gas exchange.
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| mdwannabe
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Here is the question though....
You have reversed asthma ina patient with in 15 min of arrival, should you let him go now, whatch him for a bit, or give something else in addition to Epi?
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| santaclara
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ok
let me know one thing what is the effect on heart in both situation.
iunderstand in one condition vasodilation and in one brochodilation.
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| mdwannabe
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Tachicardia..is an uncomfortible side-effect of such treatment. Though vasonstriction will oppose some of the techicardia, as you know affinity of Epi to B1 is greater than Alfa receptors, so theres going to be more effect on heart and lungs than vessels, and this will offset the ballance, and tachicardia will persist, with bronchodilation.
So here is the gist of it...
There is going to be MARKED BRONCHODILATION, MARKED TACHICARDIA, LESS MARKED VASOCONSTRICTION.
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| mdwannabe
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THERE is no vasodilation... EPI sti,ulates Alfa receptors ..not block it..so there is vasoconstriction.
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| santaclara
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may be u r right but i will again confirm it.
thanx.
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| mdwannabe
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My pleasure :-)
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| santaclara
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ok listen one thing can uread this page 405 of kapalan micro/immuno.i will also read that page today
i can't understand u.
as u know in allergic rection like in asthma the clinical finding r bronchial and tracheal constriction,edema,mucus production,and massive inflammtion.(so in this case i think bronchodilation but we rarely use epinephrine for asthma.i don't understand what effect on heart but i think may be increase heart rate and raise BP.I M NOT SURE JUST THINKING).
CASE 2----SYSTEMIC ANAPHYLAXIS(IN THIS CLINICAL FINDING R BRONCHIAL AND TRACHEAL CONTICTION AND COMPLETE VASODILATION AND DEATH)SO IN THIS CASE IF WE IMMIEDIATELY GIVE EPINEPHRINE THEN WHAT HAPPEND I DON'T UNDERSTAND BUT TELL ME.AND WHAT EFFECT ON HEART RATE AND BP?I THINK ON BP IT GOES DOWN BUT I M NOT SURE.
SO PLS READ ALL THIS.
AND MAKE ME SURE WHERE I M WRONG.
THNAX. 
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| mdwannabe
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First of all..trahea DOES NOT constrict...cartilage rings won't let it happen.
Action of Epi is to Dialate Bronchioles, Constrict vessels, and incresae Heart rate.
Just make inferences from this, coz the rest I have described above.
In severe asthma, especially if suspected cause is allergic, we use Epi sub q all the time. In any case tachycardia will insue, wheather allergy(anaphylaxis) or asthma is the cause of disturbance.
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"Life not lived for others, is not worth living" Uncle Einstein
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| mdwannabe
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So anytime you give Epi the heart reate will go up, BP will go up, bronchioles will dillate,.... no mater the indication for Epi use. Review also the effect on insulin secretion, glucagon, Hormone sensitive Lypase... etc. Good stuff!
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| santaclara
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ok thnax alot for reply.
which book u r studying and when is your exam?
thanx.
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| mdwannabe
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I already took the exam. Got 220. Studied many different books. But also took Kaplan Video.
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