2820 Nitrates and other socalled vasodilators

Organic nitrates are available in many forms, but all relax vascular smooth muscle by releasing nitric oxide (also known as endothe-lium-derived relaxing factor) which acts via cyclic GMP. Glyceryl trinitrate (GTN), isosorbide mononitrate, and isosorbide dinitrate are used as coronary dilators, therapeutically after a heart attack and to prevent cardiac spasms in pregnancy. In addition, they have been used successfully for gall bladder colic, and attempts have been made to use them to lower...

2231 Solvent exposure in general

Organic solvents are chemicals that dissolve other chemicals. Common organic solvents include alcohols see Chapter 2.21 , eth-ylether, hexane, tetrachloroethane, toluene, and xylene. Other degreascrs, such as paint thinners, varnish removers, lacquers, silk-screening inks, and paints also contain these chemicals. Exposure is frequently to mixed solvents by the inhalatory or dermal route. Exposure to one single solvent is rare. Hence, much of the epidemiology has been conducted on mixed or...

244 Acupuncture and acupressure

Acupuncture is a popular form of Chinese medicine, based on the notion that vital life energy qi Hows through dozens of paths meridians throughout the human body. Illness is thought to be the result of obstructed or misdirected energy flow, and stimulating of acupoints within the meridian system is believed to restore health by correcting this flow. By inserting very thin needles 5 mm deep under the skin, different organs can be influenced via the meridians. Many acupoints influence the upper...

2413 Other agents with antiemetic properties

With respect to the antiemetics such as alizapride and aprepitant, used primarily in oncology, there is insufficient experience to estimate prenatal risk. Betahistine, a histamine analog, and the antihistamines cinnarizine and flimarizin have long been in use, and no increase in birth defects after clinical use has been shown. However, the absence of controlled studies on the use of these agents during pregnancy argues against their routine use. Betahistine and cinnarizine are both effective...

259 Atropine and other anticholinergic spasmolytics

Atropine, a belladonna-alkaloid, is a classic parasympatholytic, which inhibits the action of acetylcholine by competitively blocking muscarine rcccptors. With local application in the eye , systemic availability is negligible when applied properly. I-Atropinc is the biologically active enantiomer, and is sometimes encountered under the name hyoscyarnine. Atropine reaches concentrations in the fetus equivalent to those in the mother within a few minutes. Although atropine may alter fetal heart...