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Taste and smell.

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Copper↗

The nurse's role in nutritional management of radiotherapy patients.

The education of the cancer patient is a nursing responsibility. The authors feel strongly that individualization in diet therapy is most important. The guidelines, therefore, stress assessments, development of individualized diets, education, and periodic reassessment. The educational content includes information regarding the side effects, with known preventive and therapeutic measures. Measures that are acceptable, practical, and effective for one individual may to another individual be ineffective, impractical, or unacceptable. Since this is true, multiple alternatives have been given for each problem.

Body Weight↗

Overall tolerance and safety of enalapril.

To date, more than 5000 patients have had experience with enalapril. Over 1000 subjects have been exposed to the drug for more than one year and approximately 600 for over two years. In controlled trials, 2249 subjects, who included normal volunteers and patients with hypertension and congestive heart failure, have received enalapril alone or concomitantly with hydrochlorothiazide or other antihypertensive agents. There have been no deaths attributed to enalapril. The incidence of serious adverse experiences in controlled trials was similar to placebo, and was not higher in the elderly. The incidence of adverse experiences was not dose-related. Drug discontinuation due to adverse experiences was 3.5%, similar to placebo, and approximately half that of control drugs. Serious laboratory adverse experiences were rare. Enalapril attenuated the adverse metabolic effects of hydrochlorothiazide, particularly hypokalaemia. Skin rash occurred in approximately 1.0% of patients. One case of transient taste loss occurred on enalapril, and one on enalapril in combination with hydrochlorothiazide. Neutropenia and agranulocytosis were not encountered. Mean white blood cell counts did not change overall. Most patients (approximately equal to 80%) show no change or an improvement in renal function on enalapril. Discontinuation of concomitant hydrochlorothiazide usually normalized renal function. Enalapril is well tolerated in renal insufficiency. Azotaemia may occur in bilateral renovascular hypertension. Proteinuria was rarely seen and often improved on enalapril. Compassionate use protocols have been available to patients either resistant or intolerant to captopril. Of 68 patients admitted for captopril-related skin rashes, only five recurred on enalapril.(ABSTRACT TRUNCATED AT 250 WORDS)

Captopril↗

[Side effects induced by captopril. Comparison of a series of hypertensive patients with renal failure and a series with cardiac failure].

The first oral converting enzyme inhibitor, Captopril, has been used to treat hypertension and cardiac failure since 1978. Based on this two year experience, we studied the side-effects of this drug in 64 patients, a privileged series as it included 32 hypertensive patients with chronic renal failure and 32 patients with cardiac failure and normal renal function. After 16 months of treatment, we observed 19 p. 100 of skin complaints, 17 p. 100 disturbance of taste, 6 p. 100 oral problems, and one case of orthostatic hypotension. From the biological point of view: 20 p. 100 eosinophilia, 10 p. 100 hyperkalemia, 5 p. 100 antinuclear antibodies, 2 p. 100 renal failure, and one case of agranulocytosis. The group with renal failure had many more side effects due to a relative dosage (corrected for weight and renal function) which was three times as great. It would therefore appear to be essential to adapt the dosage in each individual case, a task which we have attempted using a formula which considerably reduced the incidence of side effects in our series: (formula; see text)

Captopril↗