Prostacyclin Administration During Cardiopulmonary Bypass in Man

Longmore, D. B.; Hoyle, P.M.; Gregory, Alex; Bennett, J. G.; Smith, M.A.; Osivand, T.; Jones, W.A.

doi:10.1016/s0140-6736(81)92680-5

Cited by 90 publications

(19 citation statements)

References 17 publications

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“…All our subjects showed this effect and it is reported consistently in other studies (Bergman et al, 1981;Data et al, 1981;Eklund et al, 1981;FitzGerald et al, 1979;O'Grady et al, 1979;Olsson, 1980;Pardy et al, 1980;Szczeklik et al, 1978a,b;Warrington et al, 1980;Wilhelmsson et al, 1981). This effect has been looked for but not seen consistently in patients undergoing cardiopulmonary bypass Longmore et al, 1981;Walker et al, 1981) or charcoal haemoperfusion; this may be because the agent responsible is being destroyed or removed , or because in these circumstances flushing seems too minor an effect to warrant comment. Facial flushing can also occur during haemodialysis with PGI2 (Turney et al, 1980;Zusman et al, 1981b) and has also been seen following inhalation of PGI2 (Bianco et al, 1979;Szczeklik et al, 1978b).…”

Section: Discussion and Literature Review Flushingsupporting

confidence: 80%

Side effects occurring during administration of epoprostenol (prostacyclin, PGI2), in man.

Pickles¹,

O’Grady²

1982

Brit J Clinical Pharma

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1 Fifty infusions of epoprostenol (PGI2) were made, usually increasing the infusion rate until adverse effects were encountered. The volunteers were appraised that they might experience headache and facial flushing. 2 Facial flushing, headache, tachycardia and decrease in diastolic blood pressure were seen in almost all subjects. Erythema over the venous infusing site was also encountered in 13 infusions. Less common effects were sudden bradycardia, pallor and sweating-the vagal reflex-(seven times) and chest pain (twice). Other complaints included restlessness, abdominal discomfort, nausea and drowsiness.3 The literature on side effects reported during PGI2 infusion is reviewed and recommendations are made concerning administration of PGI2.

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Section: Discussion and Literature Review Flushingsupporting

confidence: 80%

Side effects occurring during administration of epoprostenol (prostacyclin, PGI2), in man.

Pickles¹,

O’Grady²

1982

Brit J Clinical Pharma

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“…Several double blind clinical trials of prostacyclin in cardiopulmonary bypass have been published (127)(128)(129)(130)(131)(132)(133). The treatment groups showed a preservation of platelet number and function, with a reduction in the blood loss in the first 18 h after operation.…”

Section: (D) Prostacyclin and Atherosclerosismentioning

confidence: 99%

Adventures and excursions in bioassay: the stepping stones to prostacyclin

Vane

1983

British J Pharmacology

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Physiology has spawned many biological sciences, amongst them my own field of pharmacology. No man has made a more important contribution to the fields of physiology and pharmacology than Sir Henry Dale (1875( -1968 (4)), biological techniques and bioassay have contributed very substantially to the development of the field. Bioassay has provided crucial information on the role of the lungs in the removal of circulating prostaglandins (5), the participation of prostaglandins in inflammatory reactions (6, 7), the contribution of prostaglandins to the autoregulation and maintenance of blood flow to the kidney (8-10), the inhibitory effect of aspirin-like drugs on the biosynthesis of prostaglandins (11-13), the mediation of pyrogen fever by prostaglandins (14), and the release of rabbit aorta-contracting substance (RCS; now identified as thromboxane A2, TXA2) from lungs during anaphylaxis (15, 16). Moreover in 1976, bioassay made possible the discovery of PGX, now renamed prostacyclin (PGI2), the latest member of the prostaglandin family (17)(18)(19)(20). Indeed, it is doubtful whether the biological significance of any of the unstable products of arachidonic acid metabolism would have been recognized without bioassay techniques. With extraordinary simplicity and convenience, by its very nature, bioassay distinguishes between the important biologically active compounds and their closely related but biologically unimportant metabolites.In this review I shall discuss the development of the cascade superfusion bioassay technique and some of the discoveries and concepts which arose from its application, leading up to the discovery and development of prostacyclin. The effects of prostacyclin in man and its clinical assessment (another application of bioassay) will also be discussed.Cascade superfusion bioassay (a) Development Most uses of bioassay involving smooth muscle demand high sensitivity and specificity. These aspects have been achieved first, by limiting the volume of fluid bathing the isolated tissue and second, by using an assay organ sensitive to, and relatively specific for, the test substances under study. Further specificity can be achieved by using a combination of several tissues which present a characteristic pattern of response to the test substance or substances. This takes advantage of the principle of parallel pharmacological assay, regarded by Gaddum (21) as strong evidence for the identity of a compound.Magnus (22) introduced the idea of suspending an isolated portion of smooth muscle in a chamber

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“…166 In dogs fed fish oil, thrombosis and subsequent infarct size (3% compared to 25% in control group) induced by electrical stimulation was reduced with less than 30% ectopic beats after 19 hours compared to 80% in the control group at the same time. 187 The prolonged bleeding time in Eskimos is reduced after aspirin ingestion, 153 suggesting a decreased thromboxane synthesizing capacity coupled with normal or possibly elevated prostacyclin production. Overall, then, the present evidence suggests that it is well worthwhile continuing to study the effects of EPA in man.…”

Section: Modification Of Fatty Acid Precursorsmentioning

confidence: 99%