Hypotensive and sedative effects of insulin in autonomic failure
| Autor: | Christopher J. Mathias, P. Fosbraey, Niels Juel Christensen, D F da Costa, R. Bannister |
|---|---|
| Rok vydání: | 1987 |
| Předmět: |
Blood Glucose
Male Supine position medicine.medical_treatment Sedation Hemodynamics Blood Pressure Heart Rate Heart rate medicine Humans Insulin Pure autonomic failure Aged General Environmental Science business.industry General Engineering General Medicine Middle Aged medicine.disease Forearm Glucose medicine.anatomical_structure Blood pressure Autonomic Nervous System Diseases Anesthesia Vascular resistance General Earth and Planetary Sciences Female Vascular Resistance medicine.symptom Skin Temperature business Research Article |
| Zdroj: | BMJ. 295:161-163 |
| ISSN: | 1468-5833 0959-8138 |
| DOI: | 10.1136/bmj.295.6591.161 |
| Popis: | The haemodynamic responses to intravenous insulin (0.15 units/kg) were measured in five patients with chronic autonomic failure who were not receiving drug treatment. After the administration of insulin supine blood pressure fell steadily, with a substantial reduction even before the onset of hypoglycaemia. None of the patients showed the usual range of neuroglycopenic symptoms, but they all became drowsy, with increasing sedation as the blood glucose concentration fell. In four other patients with autonomic dysfunction intravenous injection of 25-50 ml of 50% glucose alone caused a striking, although transient, fall in blood pressure. Hypoglycaemia was reversed by a 10 minute intravenous infusion of 100 ml of 25% glucose; this did not lower blood pressure further and rapidly restored previous levels of alertness. Consideration must be given to the hypotensive potential of insulin in patients with autonomic failure during an insulin stress test. The inability of these patients to show the usual manifestations of hypoglycaemia, plus the short lived, though pronounced, reduction in blood pressure after intravenous administration of 50% glucose, may further increase the risks of this procedure. |
| Databáze: | OpenAIRE |
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