Thursday, 9 June 2011

Subjective, Objective, Assessment, Plan and Transurethral Resection

Guanetidin cause significant orthostatic hypotension (associated with a reduction of venous analog when applying reserpine orthostatic hypotension little pronounced. In connection with the activation of CNS a2adrenoreceptors clonidine has a marked sedative effect, potentiates the action ethanol, exhibits analgesic properties. By centrally acting antihypertensive drugs include clonidine, analog guanfacine, methyldopa. For the systematic application of little use because of ganglion blocking in the tubular effects (expressed as an orthostatic hypotension, disturbance of accommodation, dry mouth, tachycardia, possible atoms of bowel and bladder, impaired sexual function). Methyldopa (dopegit, aldomet) in the chemical structure - ametilDOFA. Pre-Preparata appointed interior. In sharp discontinuation of the drug develops a pronounced withdrawal syndrome: after 18-25 h blood pressure rises, possible hypertensive crisis. From the center of the pulse transmitted to the spinal sympathetic centers brain and further along the sympathetic innervation to the Microscope or Endoscope and analog vessels. As a result, the inhibitory effect of vagus nerve on the heart and decreases the stimulating effect of sympathetic innervation on heart and blood vessels. Solutions of clonidine in the form of eye drops used in the treatment of glaucoma (decreases production of intraocular fluid). Weight acting 10-15 min is introduced into the solution intravenously for controlled hypotension during surgical operations. Hence, the excitation is transferred to the analog of the sympathetic nervous system, located in the region continue rostroventrolateralnoy govatogo brain (RVLM - rostroventrolateral medulla), traditionally called the vasomotor center. Guanetidin not penetrate through gematoentsefa-crystal barrier and does not alter the content catecholamines in the adrenal glands. ?Adpenoblo?atopy reinforce withdrawal clonidine, so together these drugs are not indicated. In accordance with this neurotropic antihypertensives share at analog expense of the central and peripheral action. Azametony administered as slow intravenous injection in 20 ml of isotonic sodium chloride solution in hypertensive crises, cerebral edema, light on the background of high blood pressure, spasms periph-crystal vessels, bowel, liver or kidney colic. In sharp schenii discontinue the drug withdrawal syndrome manifested after 48 hours Means that block peripheral sympathetic innervation. At the same time excited centers vagus (nucleus ambiguus) and inhibitory neurons which have a depressing effect on the RVLM (vasomotor center). Simultaneously ganglioplegic block parasimpati-cal ganglia, thus eliminating the braking the influence of the vagus nerves on the heart and usually cause tachycardia. At higher doses, clonidine stimulates extrasynaptic a2Badrenoreceptors smooth muscle of Renal Function Test vessels here with rapid intravenous injection may cause transient vasoconstriction and increased blood pressure (and therefore Clonidine administered intravenously slowly over 57 min). Activation of this center is to increase the frequency and force contractions of the heart (increased cardiac output) and increasing that of the here of blood vessels here increased blood pressure. In the body of methyldopa becomes analog and then metiladrenalin that amphetamine-liruyut a2adrenoreceptors center pressosensitive reflex. Both drugs differ in duration of action: after the cessation of the systematic antihypertensive effect may persist up to 2 weeks. Therefore, when application sympatholytic possible: bradycardia, povyschenie secretion of HC1 (contraindicated in peptic ulcer disease), diarrhea. In contrast, clonidine did not affect the Surgical History The duration of the hypotensive effect of about 24 hours Assign inside for a systematic treatment of arterial hypertension. Moxonidine (Cynthia) in the medulla stimulates imidazoline 11receptors and to a lesser extent a2adrenoreceptors. Side effects of methyldopa: dizziness, sedation, depression equilibrium position, nasal congestion, bradycardia, dry mouth, nausea, constipation, liver function abnormalities, analog trombotsitope-of. Reserpine lowers norepinephrine, dopamine and serotonin in the CNS, as well as adrenaline and noradrenaline in the adrenal glands. A weakening here the heart rate and increased arterial and venous vessels - arterial and venous pressure decreases. Guanetidin reserpine significantly more effective, but because of significant side effects is rare. Reserpine lowers Uro-Wen monoamines in the CNS, can cause sedation effect of depression.

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