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Abstract The muscarinic receptors that modulate acetylcholine release from rat cortical synaptosomes were characterized with respect to sensitivity to drugs that act selectively at M, or Ma receptor subtypes, as well as to changes in ionic strength and membrane potential. The modulatory receptors appear to be of the M2 type, since they are activated by carbachol, acetylcholine, methacholine, oxotremorine, and bethanechol, but not by pilocarpine, and are blocked by atropine, scopolamine, and gallamine at high concentrations ; , but not by pirenzepine or dicyclomine. The ED s for carbachol, acetylcholine, and oxotremorine are less than 10 PM, suggesting that the high affinity state of the receptor is functional. High ionic strength induced by raising the NaCl concentration has no effect on agonist oxotremorine ; potency, but increases the efficacy of this compound, which disagrees with receptor-binding studies. On the other hand, depolarization with either KCI or with veratridine 20 MM ; reduces agonist potencies by approximately an order of magnitude, suggesting a potential mechanism for receptor regulation.
Background. A minority of patients having cardiac procedures 15% to 20% ; consume more than 80% of the blood products transfused at operation. Blood must be viewed as a scarce resource that carries risks and benefits. A careful review of available evidence can provide guidelines to allocate this valuable resource and improve patient outcomes. Methods. We reviewed all available published evidence related to blood conservation during cardiac operations, including randomized controlled trials, published observa * The Society of Thoracic Surgeons Clinical Practice Guidelines are intended to assist physicians and other health care providers in clinical decision-making by describing a range of generally acceptable approaches for the diagnosis, management, or prevention of specific diseases or conditions. These guidelines should not be considered inclusive of all proper methods of care or exclusive of other methods of care reasonably directed at obtaining the same results. Moreover, these guidelines are subject to change over time, without notice. The ultimate judgment regarding the care of a particular patient must be made by the physician in light of the individual circumstances presented by the patient. For the full text of this and other STS Practice Guidelines, visit : sts sections aboutthesociety practiceguidelines at the official STS Web site sts ; . Address correspondence to Dr Ferraris, Division of Cardiovascular and Thoracic Surgery, University of Kentucky Chandler Medical Center, CTW Bldg, Suite 320, 900 South Limestone, Lexington, KY 40536-0200; e-mail: ferraris earthlink, for instance, dicyclomine side effects.

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Cutaneous adverse reactions to drugs are common--occurring in up to 8% of the general population and in 2% to 3% of hospitalized patients--and are among the most readily recognizable adverse drug reactions.1 Indeed, clinicians should consider the possibility of a drug reaction in any patient who presents with an acute eruption. Diagnosis of these reactions often is complicated by their resemblance to other skin disorders. Cutaneous reactions to drugs vary in clinical presentation and severity, and although most reactions are mild, they may be the initial presentation of a more severe skin reaction, such as angioedema, acute generalized exanthematous pustulosis AGEP ; , drug rash with eosinophilia and systemic symptoms DRESS ; , StevensJohnson syndrome SJS ; , or toxic epidermal necrolysis TEN ; .2 These severe skin reactions, although rare, are life-threatening, and rapid recognition and discontinuation of the offending drug are essential toward minimizing adverse outcomes.2, for example, dicycclomine hydrochloride ip. Drug interactions and or related problems the following drug interactions and or related problems have been selected on the basis of their potential clinical significance possible mechanism in parentheses where appropriate ; — not necessarily inclusive » major clinical significance ; : note: combinations containing any of the following drug classes, depending on the amount present, may also interact with this medication and benazepril.
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