Oral albuterol to treat symptomatic bradycardia in acute spinal cord injury

Rollstin, Amber; Carey, Michael Christopher; Doherty, Gloria; Tawil, Isaac; Marinaro, Jonathan

doi:10.1007/s11739-015-1324-3

Cited by 5 publications

(3 citation statements)

References 15 publications

(25 reference statements)

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“…We did not discover literature evidence supporting sepsis outcomes in combined use of atropine or paroxetine with albuterol. A retrospective chart review supported that albuterol and atropine were both therapeutic options for systematic bradycardia, 25 suggesting that patients may have overlapping exposures to these drugs. A clinical trial in infants suffering from chronic lung disease observed that salbutamol (a synonym of albuterol) had no observable effect on patient sepsis, 26 further supporting that albuterol is not associated with sepsis when used alone.…”

Section: Resultsmentioning

confidence: 99%

A network paradigm predicts drug synergistic effects using downstream protein–protein interactions

Wilson

Steinberg

Racz

et al. 2022

CPT Pharmacom & Syst Pharma

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In some cases, drug combinations affect adverse outcome phenotypes by binding the same protein; however, drug-binding proteins are associated through proteinprotein interaction (PPI) networks within the cell, suggesting that drug phenotypes may result from long-range network effects. We first used PPI network analysis to classify drugs based on proteins downstream of their targets and next predicted drug combination effects where drugs shared network proteins but had distinct binding proteins (e.g., targets, enzymes, or transporters). By classifying drugs using their downstream proteins, we had an 80.7% sensitivity for predicting rare drug combination effects documented in gold-standard datasets. We further measured the effect of predicted drug combinations on adverse outcome phenotypes using novel observational studies in the electronic health record. We tested predictions for 60 network-drug classes on seven adverse outcomes and measured changes in clinical outcomes for predicted combinations. These results demonstrate a novel paradigm for anticipating drug synergistic effects using proteins downstream of drug targets. Study Highlights WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?Current knowledge of drug-drug interactions (DDIs) emphasize the drug target level by identifying shared transporters, enzymes, or pharmacodynamic targets, and do not prioritize proteins downstream of targets. WHAT QUESTION DID THIS STUDY ADDRESS?Here, we sought to address if proteins downstream of drug targets were sufficient to predict DDIs; we used protein interaction network analysis and real-world evidence to predict and detect rare DDIs mediated by downstream proteins. WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE?These results provide evidence that downstream proteins are sufficient for anticipating drug-drug effects.

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Section: Resultsmentioning

confidence: 99%

A network paradigm predicts drug synergistic effects using downstream protein–protein interactions

Wilson

Steinberg

Racz

et al. 2022

CPT Pharmacom & Syst Pharma

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“…Such cardiovascular phenomena are usually observed in patients with upper thoracic or cervical SCIs 8 . Bradycardia is the most common form of dysrhythmia developing after SCI, especially in the acute phase of injury 9 .…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have shown that almost all patients with complete cervical SCIs will develop bradycardia, and 16% will suffer cardiac arrest 5, 9. Cardiac dysfunction usually commences within 3–5 days after injury, and it typically resolves in 6–8 weeks 8, 10. Although bradycardia developing after acute SCI is usually temporary, there is a real risk of cardiac arrest, and adequate management is required.…”

Section: Discussionmentioning

confidence: 99%

Cardiac arrest attributable to dysfunction of the autonomic nervous system after traumatic cervical spinal cord injury

Kim

Park

Kim

et al. 2017

Chinese Journal of Traumatology

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Bradycardia is the most common form of dysrhythmia developing after disruption of the sympathetic pathway by a spinal cord injury (SCI), and it can have fatal consequences, including cardiac arrest. Here, we report a case of cardiac arrest developing after cervical SCI attributable to sympathetic hypoactivity. A 26-year-old male pedestrian was admitted after a traffic accident. Radiologically, fractures were apparent at the C6–7 bilateral articular facets, and cord contusion with hemorrhage was evident at C4–7. During his stay in ICU, intermittent bradycardia was noted, but the symptoms were not specific. On the 22nd postoperative day, the patient was taken to the computed tomography suite for further evaluation and experienced cardiac arrest during a positional change. After immediate cardiac massage, the patient was resuscitated. We scheduled Holter monitoring, which detected 26 pauses, the longest of which was 17.9 s. The patient underwent cardiac pacemaker insertion. No further cardiac events were noted.

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Oral Albuterol Treatment in Three Pediatric Patients with Bradycardia: A Novel Therapy

Butensky,

Patten,

Silver

et al. 2023

Pediatr Cardiol

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Oral albuterol to treat symptomatic bradycardia in acute spinal cord injury

Cited by 5 publications

References 15 publications

A network paradigm predicts drug synergistic effects using downstream protein–protein interactions

A network paradigm predicts drug synergistic effects using downstream protein–protein interactions

Cardiac arrest attributable to dysfunction of the autonomic nervous system after traumatic cervical spinal cord injury

Oral Albuterol Treatment in Three Pediatric Patients with Bradycardia: A Novel Therapy

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