Electrophysiological properties of phentolamine in man

OraVerse: Reverses Numbness After Dental Procedures

The lingering numbness that can last anywhere from 3 to 5 h after a routine dental procedure is often an unnecessary, inconvenient hassle. Patients may find that their ability to speak, smile, eat and drink is impaired, and may even have uncontrollable drooling. The effects of local dental anesthetics can now be reversed. That's because OraVerse, an anesthetic reversal agent, can return the patient to normal sensation and function in about half the time. OraVerse which is U.S. Food and Drug Administration approved is a safe and effective form of phentolamine mesylate, a vasodilator that has been used in several other medical applications since 1952. OraVerse injection - the first and only proven safe and effective product of its kind can quickly reverse the effects of local dental anesthetics, so patient can carry on without impairment of talk, smile and drink after dental procedures. Studies also have shown that there are no known drug interactions and no evident toxicity or contraindications for using OraVerse.

Antiarrhythmic efficacy of labetalol as assessed by programmed electrical stimulation

1. The purpose of the present study was to investigate the haemodynamic, electrophysiological and antiarrhythmic effects of labetalol in the late reperfusion phase after myocardial infarction in conscious dogs. 2. Labetalol was administered in cumulative doses (0.5, 1 and 3 mg kg-1 90 min-1, i.v.). Compared to control the systolic blood pressure was significantly decreased 20 min after 0.5, 1 and 3 mg kg-1 and up to 30 min after 3 mg kg-1 labetalol. The diastolic blood pressure was significantly decreased 20 and 30 min after 0.5 and 3 mg kg-1 but was not significantly altered after 1 mg kg-1 labetalol. 3. Labetalol significantly increased the PQ, QRS, QT and QTc intervals, the 2:1 AV-conduction point, the ventricular effective refractory periods and the intraventricular conduction time from the apex of the right ventricle to the infarcted LAD-area. With the exception of the alterations in the PQ interval and 2:1 AV-conduction point the effects described above were dose-dependent. 4. Labetalol was active against arrhythmias induced by programmed electrical stimulation. This effect was already present after the lowest dose (0.5 mg kg-1). 5. The good antiarrhythmic activity of labetalol in this study can be explained by the adrenoceptor blocking properties and both the class I and III activity of this drug. Labetalol may be of potential benefit in controlling arrhythmias arising following myocardial infarction.

Electrophysiologic properties of hydralazine in man

There is considerable interest in selecting the proper drug to preserve the ischemic myocardium, or twilight zone, in a patient with a recent myocardial infarction. Vasodilator therapy with an infusion of nitroprusside or phentolamine has been shown to improve left ventricular function by reducing both preload and afterload. Sublingual nitroglycerin as well as an infusion of nitroglycerin can also alleviate left ventricular failure in patients with an acute myocardial infarction. Similarly, chronic congestive heart failure patients, irrespective of the etiology, improve hemodynamically after an infusion of phentolamine, nitroprusside or hydralazine. Oral nitrates, phentolamine, and hydralazine have also been demonstrated to produce improvement in chronic heart failure patients. Recently data has become available on the effects of phentolamine, nitroglycerin and nitroprusside on cardiac conduction in man. However there is no information on the electrophysiological properties of hydralazine in man. The present study involving 12 human subjects was undertaken to determine what effect intravenously administered hydralazine has on the human conduction system.

Electrophysiologic properties of nitroprusside in man

The effects of nitroprusside on His bundle electrograms, when given intravenously for 10 minutes, were studied in 14 patients with heart disease. Recordings were made at varied heart rates using atrial and ventricular pacing. Nitroprusside significantly reduced the AH interval, but it had no effect on the HV interval. Functional and effective refractory periods were measured by the extrastimulus technique. The functional refractory period of the AV node as well as the effective refractory period of the ventriculoatrial conduction system significantly decreased after nitroprusside infusion. This improvement in conduction can probably be explained by the systemic hypotension produced by nitroprusside, which reflexly will increase sympathetic drive to the heart and decrease vagal tone.

His bundle electrogram in patients with acute myocardial infarction

Thirty-seven patients with acute myocardial infarction complicated by atrioventricular or bundle branch block, or a combination of both, has His bundle electrogram studies performed during their stay in the coronary care unit. The acute mortality of the 14 patients with a complicating bundle branch was 50%. Pump failure was the main cause of death. Three patients in this group had a prolonged H-V interval and one patient had a split blundle of His. The presence or absence of a prolonged H-V interval did not affect mortality in this group of patients. The acute mortality of the 16 patients with an inferior wall myocardial infarction was 6%. The H-V interval was normal in all but one of these patients. The atrioventricular block was caused by a proximal block in all cases. The acute mortality of the seven patients with an anterior wall myocardial infarction was 29%. The H-V interval was prolonged in two of seven patients. Pump failure was the acute cause of the deaths. The presence or absence of a prolonged H-V interval did not affect mortality in this group of patients.

The effect of phentolamine on intra-Hisian conduction

A His bundle electrogram was obtained in a 70 year old male with syncopal episodes. A split bundle of His deflection was recorded. After the intravenous administration of phentolamine, a marked shortening of the H-H' interval was observed. This signifies an improvement in conduction at the bundle of His level.