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A Castiglioni

Publications and source records attributed to A Castiglioni.

28 records · Page 2Linked to original sources
PubMed1986

Effect of age on the pharmacokinetics of indobufen.

Eighteen patients of both sexes, aging between 54 and 81 years entered a study on the effects of age on the disposition kinetics of indobufen, a potent inhibitor of platelet aggregation. Plasma levels and urinary excretion of the drug were assayed by HPLC after a single oral dose (200 mg) and after the last dose of a repeated oral schedule (200 mg b.i.d. for 5 days). At steady-state, indobufen plasma levels were about double those after the single dose; plasma level profiles were similar. No significant differences were detected between single dose and steady-state as regards pharmacokinetic parameters of the drug which, at steady-state, were (mean +/- SD, n = 16): Cmax = 32.6 +/- 9.3 micrograms/ml, t 1/2 beta = 12.8 +/- 4.4 h, Pl.Cl. = 14.9 +/- 6.1 ml/min, Vd beta = 223 +/- 63 ml/kg. Evidence of reduced efficiency and rate of indobufen elimination was found in elderly patients compared to young healthy subjects. This is probably because of the age-related decrease in renal function. In the patients of the present study, average Cr.Cl. was about 60 ml/min, corresponding to 50-60% of the normal values in young subjects. A statistically significant correlation was found in patients between drug plasma clearance and Cr.Cl. in agreement with the findings of a previous study on the effects of renal insufficiency on indobufen kinetics. The same dose reduction of indobufen as previously suggested for patients with mild to moderate renal insufficiency should, therefore, be adopted in elderly patients.

Administration, Oral↗
PubMedDate not supplied

[Diabetic nephropathy and arterial hypertension: the physiopathological aspects and antihypertensive treatment].

The purpose of our review is to delineate the pathogenic steps linking arterial hypertension in diabetes to diabetic nephropathy. The results of recent studies suggest that arterial hypertension in diabetes might lay a decisive pathogenetic role in the evolution of diabetic nephropathy: the existence of a higher ratio of erythrocytic Na/Li counter-transport in nephropathic diabetics as well as higher pressure values in the parents of diabetics who develop nephropathy indicates that hypertension may be casually related to renal complications. Diabetes-associated hypertension involves the modification of two important pressure- regulation factors: 1. an alteration in extracellular volume and increased renal absorption of sodium which leads to an expanded pool; 2. increased cardiovascular reactivity to norepinephrine and angiotensin II, an effect which might be related to increased intracellular calcium. Hyperfiltration seems to be present at the onset of diabetes, and arterial hypertension increases the transglomerular pressure gradient which is thought to play an important role in the pathogenesis of kidney damage. Antihypertensive drugs such as ACE-inhibitors and calcium channel blockers tend to protect the regulation of renal function. This could be explained by the fact that ACE-inhibitors suppress the trophic effects of angiotensin II on the nephron, while calcium channel blockers might interfere with intracellular processes involved in cell hypertrophy that require the interaction of calcium ions. In the management of diabetes prevention of diabetic nephropathy requires early and careful correction of diabetes-associated hypertension. We discuss the major groups of antihypertensive drugs, their metabolic side-effects and intrarenal induced hemodynamic changes.

Antihypertensive Agents↗
PubMedDate not supplied

[Uremic myopathy].

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Female↗
PubMedDate not supplied

[Treatment of arterial hypertension in diabetic nephropathy. Certainties and hypotheses].

Clinical observation has long emphasized the importance of arterial hypertension in the course of diabetic nephropathy and recent studies suggest that hypertension might play a decisive pathogenetic role in the course of the disease, hence the necessity of correcting the hypertension of diabetic patients has by now been universally accepted. There is, however, still some uncertainty concerning the usefulness of acting preventively on so-called microhypertension; in other words, whether early antihypertensive drug treatment can prevent diabetic nephropathy. This paper discusses the criteria to be followed in the choice of antihypertensive medication during diabetic nephropathy giving special attention to pathophysiological considerations. Moreover, it also discusses the effects of antihypertensive drugs currently regarded as first-choice agents, i.e. calcium antagonists and the angiotensin converting enzyme inhibitors, on intrarenal hemodynamics.

Antihypertensive Agents↗