OBJECTIVE: To compare the efficacy of @entity935 (DA) with that of @entity1063 (NE) in the treatment of refractory @entity551 caused by tricyclic antidepressants (TCAs). METHODS: A retrospective analysis was used to compare blood pressure responses in concurrent case series of @entity1 treated with vasopressors for @entity2974 -associated @entity551 . The @entity1 were adults (aged > or = 16 years) treated at 2 urban teaching hospitals from 1983 to 1994. All @entity1 were diagnosed as having @entity2974 ingestion (positive serum toxicologic assay), were @entity551 [systolic blood pressures (SBPs) < or = 90 mm Hg], and required vasopressor therapy. The @entity1 were grouped by initial vasopressor treatment (i.e., NE vs DA). RESULTS: There were 26 @entity551 adult @entity1 who met study criteria. All 26 @entity1 remained @entity551 after initial treatment of their @entity2974 -associated @entity551 with crystalloid infusion and alkalinization. The NE and DA groups were similar in age, sex, and proportion of @entity1 with single and co-drug ingestion. The NE group, however, had a significantly lower average @entity13519 at study entry (56 vs 74 mm Hg, p = 0.04). Nine of 15 (60%) @entity1 responded to DA (5-10 micrograms/kg/min) and 11/11 (100%) @entity1 responded to NE (5-53 micrograms/min). The difference in response rates was statistically significant (p = 0.02). Six @entity1 in whom DA (max rate 10-50 micrograms/min/kg) failed to raise the @entity13519 subsequently responded to NE (max rate 5-74 micrograms/ min) when this drug was later used. One @entity1 receiving NE (12 micrograms/min) developed @entity1540 , successfully treated with @entity3303 . There were no ischemic complications from either NE or DA. @entity1 who failed DA therapy tended to be older (39 vs 30 years, p = 0.08), to be more @entity551 at study entry (64 vs 81 mm Hg, p = 0.008), and to remain @entity551 even at higher doses of DA (24 vs 7 micrograms/min/kg, p = 0.002). CONCLUSION: While this was not a prospective randomized study, NE appears advantageous over DA as the first-line vasopressor agent for those @entity1 who require vasopressor support in the setting of @entity2974 -induced @entity551 that is refractory to IV fluid and serum alkalinization.

Response to @entity935 vs @entity1063 in tricyclic antidepressant-induced XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'Patients', 'patient'] @entity935 :: ('MESH:D004298', 'Chemical') :: ['dopamine'] @entity2974 :: ('CHEBI:30956', 'Chemical') :: ['TCA'] @entity13519 :: ('8991', 'Gene') :: ['SBP'] @entity3303 :: ('MESH:D008012', 'Chemical') :: ['lidocaine'] @entity1540 :: ('MESH:D018879', 'Disease') :: ['ventricular ectopy'] @entity1063 :: ('MESH:D009638', 'Chemical') :: ['norepinephrine'] @entity551 :: ('MESH:D007022', 'Disease') :: ['hypotensive', 'hypotension']
@entity551 :: (MESH:D007022,Disease) :: ['hypotension']
