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. 1987 Mar;62(3):241–246. doi: 10.1136/adc.62.3.241

Cardiovascular effects of tolazoline and ranitidine.

A Bush, C M Busst, W B Knight, E A Shinebourne
PMCID: PMC1778285  PMID: 3566316

Abstract

The cardiovascular effects of ranitidine were studied in 12 children with congenital heart disease who had been given tolazoline as a pulmonary vasodilator. Ranitidine was given as prophylaxis against gastrointestinal haemorrhage induced by tolazoline. Tolazoline 1-2 mg/kg caused significant falls in pulmonary and systemic vascular resistances and a rise in heart rate. After intravenous administration of ranitidine 3 mg/kg both resistances rose again and neither resistance then differed significantly from baseline levels. Heart rate also fell and the final heart rate was significantly below baseline levels. We conclude that there may be H2 receptors within the pulmonary and systemic circulations and that tolazoline may mediate some of its effects through these H2 receptors rather than by alpha adrenergic receptor blockade. The safety of H2 blockade in children, particularly those with pulmonary hypertension, needs further investigation.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Barer G. R., Emery C. J., Mohammed F. H., Mungall I. P. H1 and H2 histamine actions on lung vessels; their relevance to hypoxic vasoconstriction. Q J Exp Physiol Cogn Med Sci. 1978 Apr;63(2):157–169. doi: 10.1113/expphysiol.1978.sp002428. [DOI] [PubMed] [Google Scholar]
  2. Bush A., Busst C., Booth K., Knight W. B., Shinebourne E. A. Does prostacyclin enhance the selective pulmonary vasodilator effect of oxygen in children with congenital heart disease? Circulation. 1986 Jul;74(1):135–144. doi: 10.1161/01.cir.74.1.135. [DOI] [PubMed] [Google Scholar]
  3. Chow J. S., Wang R. Y., Wong P. H., Chen W. W., Lai C. L. Intravenous ranitidine has no hemodynamic effects in subjects with normal lung function and patients with chronic obstructive airway disease. Aust N Z J Med. 1983 Jun;13(3):261–263. doi: 10.1111/j.1445-5994.1983.tb04654.x. [DOI] [PubMed] [Google Scholar]
  4. Davies N. J., Denison D. M. The measurement of metabolic gas exchange and minute volume by mass spectrometry alone. Respir Physiol. 1979 Feb;36(2):261–267. doi: 10.1016/0034-5687(79)90029-x. [DOI] [PubMed] [Google Scholar]
  5. Davies N. J., Shinebourne E. A., Scallan M. J., Sopwith T. A., Denison D. M. Pulmonary vascular resistance in children with congenital heart disease. Thorax. 1984 Dec;39(12):895–900. doi: 10.1136/thx.39.12.895. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Goetzman B. W., Milstein J. M. Pulmonary vascular histamine receptors in newborn and young lambs. J Appl Physiol Respir Environ Exerc Physiol. 1980 Sep;49(3):380–385. doi: 10.1152/jappl.1980.49.3.380. [DOI] [PubMed] [Google Scholar]
  7. Goetzman B. W., Milstein J. M. Pulmonary vasodilator action of tolazoline. Pediatr Res. 1979 Aug;13(8):942–944. doi: 10.1203/00006450-197908000-00014. [DOI] [PubMed] [Google Scholar]
  8. Goetzman B. W., Sunshine P., Johnson J. D., Wennberg R. P., Hackel A., Merten D. F., Bartoletti A. L., Silverman N. H. Neonatal hypoxia and pulmonary vasospasm: response to tolazoline. J Pediatr. 1976 Oct;89(4):617–621. doi: 10.1016/s0022-3476(76)80403-9. [DOI] [PubMed] [Google Scholar]
  9. Herz R., Rössle M., Bonzel T., Keller E., Gerok W. Effect of cimetidine on the hepatic extraction of indocyanine green, the portal pressure and the systemic circulation in patients with cirrhosis of the liver. Klin Wochenschr. 1984 Aug 16;62(16):759–764. doi: 10.1007/BF01721773. [DOI] [PubMed] [Google Scholar]
  10. Kelman G. R. Digital computer subroutine for the conversion of oxygen tension into saturation. J Appl Physiol. 1966 Jul;21(4):1375–1376. doi: 10.1152/jappl.1966.21.4.1375. [DOI] [PubMed] [Google Scholar]
  11. Levin D. L., Rudolph A. M., Heymann M. A., Phibbs R. H. Morphological development of the pulmonary vascular bed in fetal lambs. Circulation. 1976 Jan;53(1):144–151. doi: 10.1161/01.cir.53.1.144. [DOI] [PubMed] [Google Scholar]
  12. McAuley D. M., Moore J., McCaughey W., Donnelly B. D., Dundee J. W. Ranitidine as an antacid before elective Caesarean section. Anaesthesia. 1983 Feb;38(2):108–114. doi: 10.1111/j.1365-2044.1983.tb13927.x. [DOI] [PubMed] [Google Scholar]
  13. Mikkelsen E. O., Sakr A. M., Jespersen L. T. Effects of nifedipine on contractile responses to potassium, histamine, and 5-hydroxytryptamine in isolated human pulmonary vessels. J Cardiovasc Pharmacol. 1983 Mar-Apr;5(2):317–320. doi: 10.1097/00005344-198303000-00025. [DOI] [PubMed] [Google Scholar]
  14. Okpako D. T. A vasodepressor action of histamine mediated by H2-receptor activation. Eur J Pharmacol. 1974 Nov;29(1):10–14. doi: 10.1016/0014-2999(74)90163-0. [DOI] [PubMed] [Google Scholar]
  15. Van Thiel D. H., Gavaler J. S., Smith W. I., Jr, Paul G. Hypothalamic-pituitary-gonadal dysfunction in men using cimetidine. N Engl J Med. 1979 May 3;300(18):1012–1015. doi: 10.1056/NEJM197905033001803. [DOI] [PubMed] [Google Scholar]

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