Presentation
We present the case of a 84-year-old man with a history of total atrioventricular block developing NOMI. [ncbi.nlm.nih.gov]
It is suggested that a relative adrenergic renal immaturity present in the newborn rabbit protects him from the deleterious effect of tolazoline. Article / Publication Details [karger.com]
Entire Body System
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Hypoxemia
Survival could not be related to the method of administration or initial relief of hypoxemia with tolazoline. [ncbi.nlm.nih.gov]
Respiratoric
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Respiratory Distress
Severe hypoxia unresponsive to maximum ventilatory support occurs both in idiopathic respiratory distress syndrome and meconium aspiration. [ncbi.nlm.nih.gov]
Thirteen infants had hyaline membrane disease and 14 had respiratory distress attributable to causes other than hyaline membrane disease. [journals.lww.com]
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Pulmonary Disorder
Thirty-six additional infants with a variety of pulmonary disorders had severe hypoxemia which was refractory to mechanical ventilation. [ncbi.nlm.nih.gov]
Gastrointestinal
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Intestinal Perforation
Two patients who were receiving Tolazoline by infusion developed duodenal ulceration and subsequent intestinal perforation. [ncbi.nlm.nih.gov]
Cardiovascular
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Tachycardia
Adverse Effect : Transient tachycardia; peripheral vasodilatation presenting as sweating, hyperalgesia of the lips, piloerection; clear lacrimal and nasal discharge; muscle fasciculation; apprehensiveness. [pediatriconcall.com]
However, the reported side effects of tolazoline in horses (species for which the drug was developed and is labeled) include abdominal discomfort, gastrointestinal hypermotility, diarrhea, tachycardia, ventricular dysrhythmia, hypertension and apprehensiveness [pubs.er.usgs.gov]
Article Journal of Pharmacology and Experimental Therapeutics February 1956, 116 (2) 156-163; Abstract The intravenous administration of tolazoline (Priscoline) induced cardiac arrhythmias, particularly ventricular premature contractions and ventricular tachycardia [jpet.aspetjournals.org]
{01} Note: Tachycardia is a reflex response to vasodilation and a result of direct cardiac stimulation. [drugs.com]
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Left Ventricular Dysfunction
Left ventricular dysfunction, assessed by left ventricular systolic time intervals (LVSTIs), ejection fraction (EF), shortening fraction (SF), and velocity of circumferential fiber shortening (VCF), was also evident prior to therapy and improved, though [ncbi.nlm.nih.gov]
Eyes
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Eye Irritation
irritation Serious eye damage/eye irritation Category 2A Warning P264, P280, P305 P351 P338,P337 P313P H335 May cause respiratory irritation Specific target organ toxicity, single exposure;Respiratory tract irritation Category 3 Warning Precautionary [chemicalbook.com]
Neurologic
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Intracranial Hemorrhage
A fatal toxic syndrome consisting of metabolic acidosis, central nervous system (CNS) depression, respiratory problems, renal failure, hypotension, and possibly seizures and intracranial hemorrhages has been associated with the use of benzyl alcohol. [drugs.com]
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Ataxia
Ataxia and immobilisation were rapidly induced, with stable respiratory rate, heart rate and body temperature recorded. [pesquisa.bvsalud.org]
Workup
Serum
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Decreased Oxygen Saturation
After treatment with cimetidine, there was a rapid deterioration with decreased oxygen saturation and arterial PO2 values. Tolazoline induces a dilatation of the pulmonary vascular system by stimulating H2 receptors. [ncbi.nlm.nih.gov]
Treatment
Fourteen infants (2 to 12 months old) in this group required postoperative treatment with tolazoline or prostacyclin. [ncbi.nlm.nih.gov]
JIVZKJJQOZQXQB-UHFFFAOYSA-N alpha-adrenergic antagonist An agent that binds to but does not activate alpha -adrenergic receptors thereby blocking the actions of endogenous or exogenous alpha -adrenergic agonists. alpha -Adrenergic antagonists are used in the treatment [ebi.ac.uk]
Etiology
Abstract Twenty-seven infants with respiratory distress and hypoxemia of noncardiac etiology were treated with tolazoline. [ncbi.nlm.nih.gov]
MD Original Article: PDF Only Abstract Twenty-seven infants with respiratory distress and hypoxemia of noncardiac etiology were treated with tolazoline. [journals.lww.com]
Pathophysiology
Feather, George Russell Department of Child Health, University of Aberdeen Royal Aberdeen Children's Hospital Abstract Comparisons have been made between the effects of autonomic dysfunction and the pathophysiological changes in the exocrine secretions [thorax.bmj.com]
Prevention
This undesirable side effect of Tolazoline may be prevented by the concomitant use of antacids to maintain gastric pH greater than 5. [ncbi.nlm.nih.gov]
The combined application of Tolazoline and Dopamine for the treatment of the persistent fetal circulation syndrome showed that Dopamine prevented the most common side effects of Tolazoline i.e. systemic hypotension and oliguria. [hungary.pure.elsevier.com]