Catecholamine Excess
Catecholamine Excess
clinical causes
clinical manifestations
anesthetic management
ex. Pheochromocytoma (catecholamine secreting tumor)
-headache paroxysmal
-hypertension
-sweating
-palpitations
Preoperative management:
-alpha adrenergic blockade
-volume replacement
-evaluate blood pressure (resting blood pressure and orthostatic responsiveness)
-evaluate heart rate
-evaluate for ventricular ectopy
-evaluate for ecg changes
Intraoperative management:
Induction/intubation:
-should provide deep level of anesthesia prior to intubation
Intraoperative hypertension generally treated with:
-phentolamine
-nitroprusside
-nicardipine
After ligation of the adrenal tumor:
-may experience hypotension
-treat with fluids
-may try treating with phenylephrine and norepinephrine
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Highly variable
Highly variable symptomatology in patients with pheochromocytoma, may reflect variations in nature and types of catecholamines secreted, as well as co-secretion of neuropeptides: vasoactive intestinal peptide, corticotrophin, neuropeptide Y, atrial natriuretic factor, marirea penisului; somatostatin, parathyroid hormone-related peptide, calcitonin, and adrenomedulin.
They have been found in 44
They have been found in 44 plant families, but no essential metabolic function has been established for them. They are precursors of benzo[c]phenanthridine alkaloids, which are the active principal ingredients of many medicinal plant extracts. CAs have been implicated to have a possible protective role against insect predators, injuries, and nitrogen detoxification. They have been shown to promote plant tissue growth, somatic embryogenesis from in vitro cultures, and flowering.I am preparing for 000-330,642-504 and 642-373.CAs inhibit indole-3-acetic acid oxidation and enhance ethylene biosynthesis. They have also been shown to enhance synergistically various effects of gibberellins.