Steroidal Influences on Catecholamines

FEW treatments in medicine are based on more tenuous evidence than that used to justify paralysis of the adrenergic nervous system in the contemporary clinical management of "shock." To a large degree such efforts have resulted from preoccupation with one aspect of adrenergic activity, vasoconstriction, and other fundamental aspects of adrenergic responsiveness have been largely ignored. Although alpha-adrenergic receptor blockade with phenoxybenzamine, frequently coupled with high doses of hydrocortisone, has been used to combat vasoconstriction no convincing experimental data exist to justify it; whereas data do support the use of glucocorticoid hormones in shock, there is little information on how . . .