Reversible pulmonary hypertension associated with anorexigen use
Article Abstract:
Pulmonary hypertension is the development of abnormally high blood pressures within the lungs. It may be caused by certain conditions, such as impaired function of the left heart ventricle, chronic thromboembolic disease (characterized by blockage of blood vessels by blood clots in the circulation), congenital heart disease, and anoretic agents (appetite suppressants). Pulmonary hypertension caused by anorexigens (appetite suppressants) can be reversed, and has been reported outside the United States. A case is described of a 41-year-old woman who used a suppressant called phendimetrazine tartrate and developed difficulty breathing six months thereafter. She was treated for pneumonia and asthma, but her symptoms did not resolve. She developed cardiogenic shock, or a condition characterized by inadequate blood flow due to ineffective heart contraction. Diagnostic tests revealed abnormalities of the right heart, including poor contraction of the right ventricle and enlargement of the right atrium. Surgery on the lung revealed blood vessel changes consistent with pulmonary hypertension, and inflammation of the pericardium, the membranous sac covering the heart. The patient was treated with digoxin, to improve heart contraction; the diuretic Dyazide, to decrease tissue fluid accumulation; and the anticoagulant warfarin, to prevent blood coagulation. The mechanism whereby anorexigens may cause pulmonary hypertension is not clear, but may be due to the ability of these agents to constrict blood vessels, and thereby decrease blood flow. Several studies have reported the development of pulmonary hypertension in relation to use of appetite suppressants. Discontinuing the suppressant is usually accompanied by relief of symptoms of pulmonary hypertension, such as difficulty breathing, fainting spells, and inability to tolerate exercise, and signs of impaired right ventricle function. Hence patients who use anorexigens should be monitored for the development of signs and symptoms of pulmonary hypertension. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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Current trends in bacterial respiratory pathogens
Article Abstract:
Many types of bacteria can cause infection of the respiratory system. Streptococcus pneumoniae is the cause of the most cases of bacterial pneumonia in the United States. Decreased susceptibility to antibiotics by S. pneumoniae has been observed, but the newly available group of antibiotics known as fluoroquinolones are effective in treating pneumococcal infections. Other types of bacteria can cause pneumonia, including: Hemophilus influenzae, Legionella pneumophila, Mycoplasma pneumoniae, Chlamydia pneumoniae, Moraxella catarrhalis, Corynebacterium diphtheriae (which causes diphtheria), Bordetella pertussis (which causes whooping cough), Enterobacteriaceae, Pseudomonas, and Staphylococcus aureus. The pneumonia caused by Mycoplasma pneumoniae usually occurs in children aged three to six years. Vaccines are available against diphtheria, whooping cough and Hemophilus influenzae. Other vaccines must be developed to prevent respiratory infections. Until then, effective antibiotics are needed to treat respiratory disease caused by these bacteria. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Medicine
Subject: Health care industry
ISSN: 0002-9343
Year: 1991
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