I agree with Andrew Lyon that pyridostigmine and
neostigmine are both acetylcholineesterase inhibitors
and therefore will lead to increased cholinergic
activity at sympathetic and parasympathetic ganglionic
sites. The adrenal medulla is a large sympathetic
ganglia supplied by preganglionic sympathetic
cholinergic fibers and therefore any increase in
acetylcholine at this site will lead to increased
sympathoadrenal discharge. Hence the finding of raised
catecholamines levels observed in this patient which
had to be genuine and not false.
--- Andrew Lyon <[log in to unmask]> wrote:
>
>
> Piridostigmin and neostigmin are both
> acetylcholinesterase
> inhibitors however I am not aware of any clinical
> studies on urinary cat
> levels during treatment. Is it possible that the
> levels
> you are detecting are real (not false) and that the
> physiological effects
> of the cats are masked by the inhibitors? Andrew
>
>
============================================================================
>
>
> Andrew Lyon, Clinical Biochemist email:
> [log in to unmask]
> Saskatoon, SASK, CANADA. homepage:
> http://duke.usask.ca/~lyona
>
> On Wed, 26 Jan 2000, Milan Skitek wrote:
>
> > Dear List members,
> >
> > We found some unexpected results (false elevetad)
> for urinary
> > catecholamines, metanefrines and VMA (confirmed by
> TLC) by Bio-Rad
> > HPLC-ECD method and reagents. Patients is on drug
> treatment with
> > PROSTIGMIN (piridostigmin, neostigmin) and IMURAN
> (sporadically also
> > RANITAL, SPASMEX, DYBENZIRAN and PARACETAMOL). Any
> suggestiones about
> > specifity, drug interference or drug interactiones
> would be of great
> > value.
> > We would like also share some experiences about
> references values for
> > urinary matanephrines corrected to creatinine of
> non phaeo hospital
> > population.
> >
> > Yours sincerely
> > Dr. Milan Skitek, Senior Clinical Biochemist
> > MEDICAL CENTRE LJUBLJANA
> > CLINICAL INSTITUTE OF CLINICAL CHEMISTRY
> > AND BIOCHEMISTRY
> > 1525 LJUBLJANA, Njegoševa 4/I
> > SLOVENIA
> > UNIVERSITY MEDICAL CENTRE LJUBLJANA
> > CLINICAL INSTITUTE OF CLINICAL CHEMISTRY
> > AND BIOCHEMISTRY
> > 1525 LJUBLJANA, Njegoševa 4/I
> > SLOVENIA
> > Tel.: +386 61/131-31-13 int. 49-94
> > Fax.: +386 61/1325-131
> >
> >
> >
>
>
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