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Biomedical subjects

A Breckenridge

Publications and source records attributed to A Breckenridge.

At least 55 records · Page 3Linked to original sources
PubMed1985

Angiotensin converting enzyme inhibition in clinical practice. Re-examination of step care: choice of first drug.

In any therapeutic situation, the choice of drug therapy depends on an estimation of relative risk and benefit. With respect to moderate hypertension, and with less certainty, mild hypertension, the use of drug therapy has resulted in a decrease in overall mortality, a decrease in the incidence of stroke and renal impairment, but little or no change in the incidence of ischemic heart disease. For several years, the choice of first drug in these situations has rested between thiazide diuretics and beta-adrenoceptor blocking agents. There is probably little to choose between these two groups in terms of efficacy, and equally there is little evidence that patient response to one or other agents can be predicted either on demographic or biochemical evidence. There are, however, several studies both in Africa and America suggesting that black patients have a relatively greater hypotensive response to thiazides than to beta-blockers. The adverse reaction profile of these two groups is quite different. There is currently much debate whether the administration of large doses of thiazide diuretics (for example, 10 mg bendrofluazide per day) may cause a constellation of metabolic side effects (hyperlipemia, hypokalemia, abnormal glucose tolerance, and hyperuricemia) which may result in an increase of the risk of developing coronary artery disease in spite of lowering blood pressure. Further, there is no good evidence that the hypotensive effect of diuretics is dose dependent. On the other hand, the evidence that beta-blockers when used as antihypertensive agents have a primary preventive effect for ischemic heart disease is currently very small.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists↗
PubMed1985

Decision-making in the development of new drugs.

The main decisions concerning the development of new drugs are taken by the drug producer, the prescriber, the drug regulator and the patient. The decisions taken by each party are different, although their aims are similar--to obtain safer and more effective therapy. These proposals are discussed in relation to antihypertensive drug therapy, but the underlying principles are similar for any therapeutic area. The producer must decide whether to be innovative, to cross-license another manufacturer's preparation, or to manufacture a 'me-too' drug. The prescriber must decide whether to treat the hypertensive patient and, if so, whether to use an established or a new drug. The regulator's decisions are constrained by the laws of the country in which he works and are concerned with safety, quality and efficacy of the product. The final arbiter is the patient, whose decisions are determined more by adverse effects than efficacy.

Antihypertensive Agents↗
PubMed1983

Which beta blocker?

Explore the source record for details and available documents.

Adrenergic beta-Agonists↗
PubMed1982

Jogger's blockade.

Explore the source record for details and available documents.

Adrenergic beta-Antagonists↗
PubMed1982

Labetalol in essential hypertension.

1 Labetalol is an effective agent in essential hypertension as documented in open studies and controlled studies in which its efficacy has been compared with both placebo and a variety of other anti-hypertensive drugs. 2 Labetalol given by mouth lowers blood pressure rapidly. There is no evidence of tolerance to its anti-hypertensive action. 3 Adverse effects include excessive hypotension, but only when the drug is given in large doses. Epigastric discomfort and scalp tingling have been documented especially after intravenous administration. 4 From a pharmacokinetic and pharmacodynamic point of view, labetalol can be given once daily, but postural hypotension after large (greater than 1 g) single doses may limit the usefulness of once daily regimes. Twice daily administration appears an acceptable compromise.

Adrenergic beta-Antagonists↗
PubMed1980

Propranolol in the control of blood pressure: a dose-response study.

In a double-blind crossover study, it has been shown that the hypotensive response to propranolol in 24 patients with essential hypertension was no greater at doses of 80, 160, or 240 mg twice daily than at 40 mg twice daily. A relationship was observed between dose and response as defined by the ability to achieve a standing diastolic blood pressure of 95 mm Hg. Four patients with low plasma renin activity (PRA) had no fall in blood pressure even at highest dose levels. Plasma propranolol levels in the groups were related to dose, and up to a concentration of 300 ng/ml, with degree of beta-adrenoceptor blockade; there was, however, no correlation with hypotensive response.

Adrenergic beta-Antagonists↗
PubMed1980

An Indochinese refugee psychiatric clinic: culturally accepted treatment approaches.

In 1978 the authors established a weekly psychiatric clinic for Indochinese refugees. During the first 20 months, 50 patients were evaluated and treated at the clinic; a Vietnamese psychiatric resident and several native Indochinese mental health counselors bridged the language and cultural barriers between patients and clinic personnel. Most of the patients seen at the beginning of the program were psychotic and severely impaired. However, patients seen later suffered from a wider variety of problems. A flexible approach to treatment was adopted that would be compatible with the cultural expectations of the refugees. This resulted in the use of different forms of therapy and special emphasis on the medical approach of the physician, a role familiar to Indochinese patients. Gradually the clinic gained acceptance by members of the local refugee community.

Adolescent↗
PubMed1978

Postgraduate education in therapeutics: experience in Merseyside.

A teaching programme in therapeutics for general practitioners in Merseyside, which was led by a group of clinical pharmacologists, had as its principal aim to emphasise the importance of rational drug prescribing. The course comprised 15 sessions restricted to 25 GPs, and the topics were suggested by both the organisers and the GPs. Though each session was introduced by a clinical pharmacologist, the emphasis was an open discussion and exchange of views. This programme may serve as a pattern for other centres.

Drug Prescriptions↗