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To the Editor:—
In the article, "Arrhythmias and Cardiac Arrest Induced by Metaraminol (Aramine) Bitartrate," in The Journal, Nov. 19, 1960, page 1635, the authors stated that isoproterenol (Isuprel) is a vasodepressor drug which stimulates the myocardium and that methoxamine is a pressor amine with almost purely peripheral action. Both statements are pharmacologically inexact.Isoproterenol is a vasodepressor (Goodman and Gilman, Pharmacological Basis of Therapeutics, page 533, ed. 2, 1955); it decreases total peripheral vascular resistance as well as vascular resistance in renal, femoral, and mesenteric vascular beds (Kaufman; Iglauer; and Herwitz: Effect of Isuprel [Isopropylepinephrine] on Circulation of Normal Man, Amer J Med11:442-447 [Oct.] 1951). Even though isoproterenol is chronotropic and inotropic and usually increases cardiac output and stroke volume, systemic arterial pressure remains essentially unchanged (Dodge; Lord; and Sandler: Cardiovascular Effects of Isoproterenol in Normal Subjects and Subjects with Congestive Heart Failure, Amer Heart J60
Berkowitz S, Greene BA. Arrhythmias and Cardiac Arrest. JAMA. 1961;176(4):388. doi:10.1001/jama.1961.03040170134026
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