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P Kulling

Publications and source records attributed to P Kulling.

27 records · Page 2Linked to original sources
PubMed1983

Beta-adrenoceptor blocker intoxication: epidemiological data. Prenalterol as an alternative in the treatment of cardiac dysfunction.

1 During the three years 1978--1980 the Swedish Poison Information Centre received reports of 184 patients hospitalized due to beta-adrenoceptor blocker overdosage. Of the 35 patients who developed signs of severe cardiac dysfunction (HR less than 50 beats/min, systolic blood pressure less than 80 mm Hg), 23 had ingested propranolol, 10 metoprolol and 2 alprenolol. 2 The mean value of the defined daily doses (DDD) per 1000 inhabitants per day in Sweden during these years were 11.97 for propranolol, 8.02 for alprenolol and 7.74 for metoprolol. The incidence of severe poisoning due to alprenolol overdosage is lower than expected according to DDD. 3 During 1979 19 persons died from overdosage with beta-adrenoceptor blockers in Sweden: 15 due to propranolol (non-selective, lacks intrinsic sympathomimetic activity), 2 to metoprolol (cardioselective, lacks intrinsic sympathomimetic activity). These findings indicate that severe and even fatal poisoning may occur regardless of the type of beta-blocking agent. 4 The usefulness of prenalterol, a cardioselective beta-adrenoceptor partial agonist, in reversing unwanted cardiac effects of beta-adrenoceptor blocking agents is illustrated by two cases of massive propranolol intoxication (maximal plasma concentrations of propranolol 7.2 and 7.8 mumol/l respectively). Prenalterol in high doses (130 and 280 mg/24 h respectively) restored cardiac function.

Adrenergic beta-Antagonists↗
PubMed1983

Veratrum alkaloids in sneezing-powder a potential danger.

Sneezing-powders containing pulverized root of veratrum album (white hellebore) have recently been marketed in the Scandinavian countries. The powder, imported from the Federal Republic of Germany, has caused severe intoxications.

Child↗
PubMed1982

Clinical experiences with prenalterol as an antidote to Beta-adrenoceptor blockade.

The cases presented in this paper suggest that prenalterol is useful in the treatment of myocardial depression due to beta-blockade. According to its pharmacological properties, prenalterol might even be the drug of choice in these situations. It is wellknown that massive beta-blocker overdosage may be difficult to manage and as the therapeutic guidelines in these cases have not yet been definitely stated, it is obvious that prenalterol in this context will be of utmost importance. What remains to be solved is the dosage level. So far, experience has shown that high doses, widely exceeding the recommended initial dose of 50-100 micrograms/kg, are necessary to restore normal circulation in massive beta-blocker overdosage.

Adrenergic beta-Agonists↗
PubMed1981

Hemodynamic effects of hyperosmolal glucose infusion in the critically ill patient.

A 30% glucose solution was infused for 4 h at a rate of 1.53 ml . kg-1, corresponding to 10 g . kg-1 . 24 h-1 in 8 critically ill patients requiring parenteral nutrition. The osmotic load resulted in an expanded blood volume due to hemodilution. Stroke volume (SV) increased, while peripheral vascular resistance (PVR) and pulmonary capillary wedge pressure (WP) decreased. Otherwise, no major effects on the circulation were observed. Thus, during these experimental conditions, the heart seems to cope very well with the increased osmotic load.

Adolescent↗
PubMedDate not supplied

Role of the intensive care unit in the management of the poisoned patient.

By applying a sensible toxicological approach to the general principles of intensive care, an optimum setting for the treatment of poisoning is created. The intensive care unit (ICU) can perform the necessary close observation and monitoring, and thus facilitate rapid detection of symptoms, and the institution of early appropriate treatment. Diagnosis may be complex in poisoning and require continuous qualified interpretation of clinical and analytical data. Antidote therapy and treatment to enhance elimination of the poison must often be dealt with under careful supervision. The capacity of the ICU to counteract various toxic effects in a nonspecific way and to provide optimum symptomatic and supportive care is crucial. However, the ongoing toxic effects on the body must always be considered and allowed to guide symptomatic treatment. Thus, clinical toxicology appears to be a specialised branch of intensive care medicine.

Acute Disease↗