Hemodynamic Effects of Edrophonium Chloride (Tensilon) Infusion

Cooper, Jerome A.; Baratta, Frank; Frieden, Julian; Grossman, James I.

doi:10.1378/chest.67.2.147

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…Edrophonium (Tensilon™) is a rapidly acting inhibitor of acetylcholinesterase. Systemic injection of edrophonium increases delivery of acetylcholine to its receptors in the heart and thereby decreases heart rate, without importantly affecting other aspects of cardiac function 24. Cardiac parasympathetic denervation would be expected to be associated with the absence of a bradycardia response to edrophonium.…”

Section: Methodsmentioning

confidence: 99%

Generalized and neurotransmitter‐selective noradrenergic denervation in Parkinson's disease with orthostatic hypotension

et al. 2008

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Background Patients with Parkinson disease (PD) often have manifestations of autonomic failure. About 40% have neurogenic orthostatic hypotension (NOH), and among PD+NOH patients virtually all have evidence of cardiac sympathetic denervation; however, whether PD+NOH entails extra-cardiac noradrenergic denervation has been less clear. Methods Microdialysate concentrations of the main neuronal metabolite of norepinephrine (NE), dihydroxyphenylglycol (DHPG), were measured in skeletal muscle, and plasma concentrations of norepinephrine and DHPG were measured in response to i.v. tyramine, yohimbine, and isoproterenol, in patients with PD+NOH, patients with pure autonomic failure (PAF), which is characterized by generalized catecholaminergic denervation, and control subjects. Results Microdialysate DHPG concentrations were similarly low in PD+NOH and PAF, compared to control subjects (163±25, 153±27, and 304±27 pg/ml, p<0.01 each vs. control). The two groups also had similarly small plasma DHPG responses to tyramine (71±58 and 82±105 vs. 313±94 pg/ml; p<0.01 each vs. control) and NE responses to yohimbine (223±37 and 61±15 vs. 672±130 pg/ml, p<0.01 each vs. control) and virtually absent NE responses to isoproterenol (20±34 and 14±15 vs. 336±78 pg/ml, p<0.01 each vs. control). PD+NOH patients had normal bradycardia responses to edrophonium and normal epinephrine responses to glucagon Conclusions The results support the concept of generalized noradrenergic denervation in PD+NOH, with similar severity to that seen in PAF. In contrast, the parasympathetic cholinergic and adrenomedullary hormonal components of the autonomic nervous system seem intact in PD+NOH.

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Section: Methodsmentioning

confidence: 99%

Generalized and neurotransmitter‐selective noradrenergic denervation in Parkinson's disease with orthostatic hypotension

et al. 2008

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“…Edrophonium, a rapidly acting inhibitor of acetylcholinesterase, was used to assess cholinergic function. Systemic injection of edrophonium increases delivery of acetylcholine to its receptors in the heart and may thereby decrease the heart rate . Therefore, subjects with baseline bradycardia were excluded from the testing.…”

Section: Methodsmentioning

confidence: 99%

Predominant Glandular Cholinergic Dysautonomia in Patients With Primary Sjögren's Syndrome

Imrich

Alevizos

Bebris

et al. 2015

Arthritis & Rheumatology

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Objectives The autonomic nervous system (ANS) modulates exocrine gland function. Available data show poor correlation between the degree of exocrine gland function and destruction in primary Sjögren’s syndrome (pSS) suggesting other mechanisms, such as autonomic dysfunction may be important in these patients. We performed a comprehensive analysis of sympathoneural and sympathetic cholinergic function in well-characterized patients with pSS. Methods 21 pSS patients (mean±SE age 44±3 years) and in 13 healthy controls (51±2 years) were assessed during orthostasis and intravenous injection of edrophonium (10 mg). The postganglionic sympathetic cholinergic system was evaluated by assessing sweat production by the quantitative sudomotor axon reflex test (QSART). Gastric empting testing assessed the gastro-intestinal ANS in pSS patients. Results Velocity index and acceleration index were significantly higher (p<0.05) in pSS compared to controls before and during the orthostatic and edrophonium tests. Other hemodynamic and neurochemical parameters did not differ between pSS patients and controls during the orthostasis and edrophonium test, however, edrophonium-induced saliva increment was lower in pSS (p=0.002). Abnormally low sweat production was found in four (N=4) pSS patients but in none of the controls in the QSART. Gastric empting was delayed in 53 % of pSS patients. Conclusion We observed subtle differences in several ANS domains, including gastrointestinal and sympathocholinergic system suggesting a complex ANS dysfunction in pSS. The impact was the largest on the exocrine glands with subtle differences in the cardiac parasympathetic function independent of glandular inflammation and atrophy, suggesting an alternative pathogenesis mechanism of the disease in pSS.

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Intraoperative hemodynamic management for minimally invasive direct coronary artery bypass: two case reports

et al. 1998

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Hemodynamic Effects of Edrophonium Chloride (Tensilon) Infusion

Cited by 5 publications

References 15 publications

Generalized and neurotransmitter‐selective noradrenergic denervation in Parkinson's disease with orthostatic hypotension

Generalized and neurotransmitter‐selective noradrenergic denervation in Parkinson's disease with orthostatic hypotension

Predominant Glandular Cholinergic Dysautonomia in Patients With Primary Sjögren's Syndrome

Intraoperative hemodynamic management for minimally invasive direct coronary artery bypass: two case reports

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