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At least 1,045 records · Page 58Linked to original sources
PubMed1978

Familial hyperpotassemia and hypertension accompanied by normal plasma aldosterone levels: possible hereditary cell membrane defect.

Hypertension and hyperpotassemia that were accompanied by normal plasma aldosterone and low renin levels and were responsive to chlorothiazide administration were found in a 29-year-old patient and two decades later in his 21-year-old son. Their renal function is normal, including response to sodium sulfate, mannitol, and aldosterone infusions. Adrenal insufficiency was excluded. The renin-aldosterone system was proved intact by physiological and pharmacologic stress and angiotensin-II infusion. Also normal were values for blood counts, blood volumes, and erythrocyte and exchangeable body potassium. The postulation of a defective cell membrane impeding potassium influx is supported by the failure of glucose and insulin infusions to substantially reduce hyperpotassemia. In the context of a hereditary disorder (the pedigree, compatible with autosomal dominant inheritance, includes five affected in two generations), hypertension is a second phenotypic character of a single defective pleiotropic gene although its pathogenesis remains unclear.

Adult↗
PubMed1980

Liquid-chromatographic detection of thiazide diuretics in urine.

We describe a liquid-chromatographic procedure for detection in urine of all thiazide drugs currently used clinically. Urine is treated initially with NaBH4 to convert any chlorothiazide present to hydrochlorothiazide. The urine is acidified with NaH2PO4 (1.0 mol/L, pH 5), and thiazides are extracted with ethyl acetate. Interfering substances are then removed in two washes with 0.1 mol/L Na2HPO4 at pH 8. The ethyl acetate is evaporated and the residue redissolved in mobile phase. Thiazides are assayed by reversed-phase chromatography, with detection by ultraviolet absorption. Analytical recovery of thiazides ranged from 53 to 93%. Urines from 48 patients were so studied, and the results were compared with results by the currently used spectrophotometric method. The two methods agreed for 56% of samples. Evaluation of the discrepancies by review of patients' histories clearly showed liquid chromatography to have correctly identified seven of eight positive urines that the spectrophotometric method failed to detect. Ultraviolet scanning incorrectly identified as positive two samples, whereas liquid chromatography did not falsely identify any urines as positive. Our method was more sensitive and more specific than the spectrophotometric method.

Chromatography, High Pressure Liquid↗
PubMed1995

[Diuretics in the neonatal period].

Careful management of fluid and electrolytes may require the rational use of diuretic agents in some neonatal pathological conditions. High efficacy diuretics include "loop" diuretics--furosemide, bumetanide and ethacrynic acid. The elimination half-life and renal effects of furosemide are prolonged in newborn infants as compared with adults. In congestive heart failure, the mean net losses associated with a 1 mg i.v. dose of furosemide, are 28 ml/kg, 3.6 mmol/kg and 0.3 mmol/kg respectively for water, sodium and potassium. The furosemide--dopamine (2 micrograms/kg/min) combination may improve renal insufficiency in the course of respiratory distress syndrome (RDS). Furosemide also decreases the deleterious renal effects of indomethacin. Beneficial effect of furosemide has not been clearly demonstrated in RDS and bronchopulmonary dysplasia (BPD). Metabolic alkalosis, hypokalemia, renal calcifications, cholelithiasis and worsening in BPD outcome have been related to long-term administrations of furosemide. The risk of furosemide induced-ototoxicity has not been clearly assessed in newborn infants. Medium efficacy diuretics (thiazides) act primarily in the early distal tubule. Chlorothiazide may reduce calcium urinary excretion in neonates receiving long-term furosemide therapy. Weak diuretics (potassium-sparing diuretics and carbonic anhydrase inhibitors) cause excretion of less than 5% of the filtered sodium. Potassium-sparing diuretics are usually reserved for neonates with congestive heart failure and are always used in combination.

Benzothiadiazines↗
PubMed1995

[Familial hyperinsulinism].

The authors present the case history of a 2 year old child suffering from nesidioblastosis. Severe non-ketotic symptomatic hypoglycaemia developed within the first hour of birth. Diagnosis of nesidioblastosis was confirmed by high insulin concentration accompanying hypoglycaemia, the increase in blood glucose level after glucagon administration and the stabilization of blood glucose level by continuous high rate glucose infusion. Normal blood glucose concentration was achieved by combined medical treatment (diazoxide, chlorothiazide and prednisolone) and the administration of starch. The authors present by familial form of the disease with autosomal recessive inheritance pattern and stress the significance of the intrauterine diagnosis. They summarize the main diagnostic and therapeutical management of the disease with special emphasize of the early intervention in order to prevent severe brain damage.

Adult↗
PubMed1995

Effects and interactions of gentamicin, polyaspartic acid and diuretics on urine calcium concentration.

Gentamicin causes isolated, reversible calciuria in rats by an unknown mechanism. We hypothesized that gentamicin calciuria is related to nonantibacterial properties that may interfere with transtubular calcium transport (calcium channel blockade, Na,K-ATPase inhibition or competition with calcium for binding to the brush-border membrane). The calciuric effect of gentamicin was compared to the calcium channel blockers lanthanum and cobalt, the Na,K-ATPase inhibitor ouabain and the polycation aprotinin (which competes with gentamicin for brush-border membrane binding). Although gentamicin 0.02 mmol/kg caused a 6-8-fold increase in urine calcium concentration, none of the other agents was calciuric. We also found that the calciuric effects of gentamicin and furosemide were additive, whereas the noncalciuric diuretic chlorothiazide had no effect on gentamicin calciuria. We also determined the effect of poly-L-aspartic acid (PAA), which binds gentamicin and prevents nephrotoxicity. PAA caused isolated calciuria similar in magnitude and character to gentamicin. However, PAA pretreatment decreased the magnitude of gentamicin calciuria to insignificance. PAA pretreatment did not prevent furosemide calciuresis. These results indicate that: 1) gentamicin and furosemide calciuria are caused by different mechanisms; 2) gentamicin calciuria is probably not mediated by calcium channel blockade, Na,K-ATPase inhibition or displacement of brush-border membrane-bound calcium; 3) gentamicin and PAA calciuria may reflect interference with intracellular events related to transtubular calcium transport.

Animals↗
PubMed1976

The use of clonidine and practolol in the treatment of hypertension.

The antihypertensive effects of clonidine hydrochloride and practolol were compared in 42 men, aged 45 years, who had not received any antihypertensive therapy before, except one patient. The diastolic blood pressures were at least 110 mmHg on two successive visits to the health centre before their selection to the trial. One half of them were classified into the WHO group 1 and the other half into group 2. There was no statistical difference in the systolic and diastolic blood pressures between clonidine and practolol group at the end of placebo period. The study started with a three-week placebo period. Thereafter, 20 patients were given clonidine 0.225 mg and twenty-two practolol 200 mg daily. The next control was carried out after three weeks. The dosage was kept unchanged or increased according to the antihypertensive response. After three weeks, clonidine and practolol dosages were checked again, and 25 mg of chlorothiazide were added to the treatment in 15 clonidine cases and in 18 practolol cases. After the next three-week period, the same regimen was continued on most patients for 6-9 weeks. The daily dosage of clonidine varied from 0.225 to 0.900 (mean 0.394) mg and that of practolol from 200 to 600 (mean 382) mg. Both regimens resulted, when individually adjusted, in a mean systolic blood pressure level of less than 150 mmHg and diastolic pressures less than or equal to 100 mmHg. Hydrochlorothiazide potentiated the blood pressure effect almost equally in both regimens. The blood pressure reduction was statistically significant (p less than 0.05) both in the clonidine and practolol group. There was no significant difference of the mean blood pressures after the active drug therapy between these two groups. A moderate reduction of pulse rate was observed in both main groups, but it was not related to the antihypertensive efficacy. Side-effects were mild. Dryness of the mouth and sedation were more common in patients receiving clonidine. No oculocutaneous or other "immunological" manifestation were seen during the 15-18 weeks' practolol therapy.

Clinical Trials as Topic↗
PubMed1994

General pharmacology of pidotimod and testing for drug interactions.

Pidotimod ((R)-3-[(S)-(5-oxo-2-pyrrolidinyl) carbonyl]-thiazolidine-4-carboxylic acid, PGT/1A, CAS 121808-62-6) is a new biological response modifier. General pharmacology and interactions with some drugs were tested. The drug, at doses of 200 mg/kg i.p. and 400 mg/kg p.o., did not affect the normal behaviour, did not modify the responses to stimulation of autonomic nervous system or central nervous system. Pidotimod did not display any cardiovascular or respiratory effect up to 125 mg/kg i.v. in 3 animal species. The drug did not show antimicrobial or antifungal activities nor interact with some of the most common therapeutics (antibiotics, tolbutamide, pentobarbital, antihypertensives, chlorothiazide, warfarin, non-steroidal antiinflammatory agents). On the basis of these results pidotimod shows a safe profile; moreover it does not interact with many therapeutic agents.

Animals↗
PubMed1993

[Comparative analysis of several treatment methods for severe congestive heart failure].

UNLABELLED: Western medicines (WM) and the combining WM-TCM were used to treat congestive heart failure (CHF). The three groups of WM were: Digoxin with dihydro-chlorothiazide, captopril with nifedipium, and dobutamine. The three groups of combining WM-TCM were: the above-mentioned three groups of WM with Jisen Shenqi Pill (JSSQ) respectively. The result observed: Total effective rate was 82%, marked effective rate was 43%, the rates of the WM groups were 77% and 36% respectively, and the groups of combining WM-TCM were 88% and 53%. Total mortality was 8.66% (the WM groups was 11.76%, the groups of combining WM-TCM 5%). Cardio-function indexes observed in the groups of combining WM-TCM were obviously improved, including HR, SV, CI, EF, FS and A/E (P < 0.01). HR, CI and SV in the groups of WM were also significantly improved (P < 0.05) except for EF, FS and A/E (P > 0.05). CONCLUSIONS: (1) The treatment of CHF should depend on various conditions and different symptoms in selecting medicines, so that individual treatment could reach the optimal effects. (2) The treatment method of combining WM-TCM could significantly promote effective rate, reduce toxic and side-effects and lower the rate of mortality. (3) JSSQ could obviously improve the function of ventricular diastole and its mechanism might be that the reduced density of beta-receptor was increased.

Adult↗
PubMedDate not supplied

[Electroconvulsive therapy and aortic aneurysm: apropos of a case].

The adverse effects of electroconvulsive therapy (ECT) become rare due to the increased progress specially in avoiding cardiovascular side effects. In fact, several studies report ECT treatment performed with success and without side effects, in depressive patients presenting serious cardiovascular diseases (aortic anevrysm, cerebral venous angioma, cerebral infarct, aortic dissection...). Occurrence of cardiovascular complications can be prevented if an elevation of blood pressure or an arythmia occurring during the seizure are previously and correctly detected and managed. Hence an adequate anaesthetic premedication must be implemented. Usual protocols use atropine, hydralazine and hydro-chlorothiazide. However, ECT treatment should be avoided in patients requiring urgent surgical correction of their cardiovascular abnormalities. Also, patients and families must be informed on the benefit derived from ECT treatment and reassured on the therapeutic issue when ECT treatment is correctly managed. This case report concerns an 89 year old woman presenting a melancholic depressive state complicated with an aortic anevrysm, successfully treated with ECT.

Aged↗
PubMed1997

Effects of uricosuric and antiuricosuric agents on urate transport in human brush-border membrane vesicles.

Inhibition of [14C]-urate uptake by uricosuric and antiuricosuric agents was investigated in human brush-border membrane vesicles, urate being transported either by anion exchange mechanisms or by voltage sensitive pathway. The IC50 for drugs on [14C]-urate uptake in vesicles loaded with 1 mM cold urate or with 5 mM lactate was, respectively: 0.7 and 0.3 microM for benzbromarone; 6 and 4 microM for salicylate; 133 and 13 microM for losartan; 520 and 190 microM for sulfinpyrazone and 807 and 150 microM, for probenecid. The IC50 ratio for [14C]-urate uptake in exchange for cold urate or for lactate varied from about 1 for salicylate to 10 for losartan, supporting the hypothesis that two distinct anion exchangers are involved in urate transport. Application of Hill equation revealed that urate/anion exchangers have more than one binding site, possibly two binding sites with high cooperativity, for benzbromarone and sulfinpyrazone, but only one for probenecid, salicylate and losartan. The uricosuric diuretic, tienilic acid was 10 to 50 times more potent than hydrochlorothiazide, chlorothiazide and furosemide, for inhibiting [14C]-urate uptake in exchange for cold urate. This higher potency is the reason of its uricosuric properties. All uricosuric agents, as well as the antiuricosuric agents, pyrazinoate and ethambutol, had a much lower potency for inhibiting [14C]-urate uptake through the voltage sensitive pathway (apical secretory step) than through the urate/anion exchangers. This suggests that antiuricosuria, induced by pyrazinoate and ethambutol, as well as by low concentrations of uricosuric agents, does not result from an inhibition of the apical voltage sensitive pathway.

Aged↗
PubMed1977

[Hyperuricemia due to therapeutic measures].

Some therapeutic measures cause hyperuricemia, which may require treatment in certain cases. The following may induce hyperuricemia: cytostatic long-term treatment, weight reduction through fasting, antihypertensive treatment with different chlorothiazides but also furosemide and etacrynic acid, anti-tuberculostatic therapy and Parkinson long-term treatment.

Antihypertensive Agents↗
PubMed1997

A history of edema and its management.

The obvious disfigurement caused by clinically evident edema has been a matter of medical concern for ages. Most of the early writings on the subject (Sumerian, Babylonian, Egyptian, Greek) center on dropsy, its causes and management. While reference to the heart is made in the ancient texts, much of the focus is on the abdominal (ascitic) accumulation of fluid. The role of the heart and "dropsy of the chest" began to be differentiated and attract attention sometime by the end of the seventeenth century, and were well appreciated by the eighteenth century. By the beginning of the nineteenth century the reports of John Blackall and Richard Bright provided new insight by differentiating dropsy into that of cardiac and renal origins. The role of salt, initially measured and thought in terms of its anion chloride, began to be appreciated by the middle to late nineteenth century. Its mobilization, however, remained problematic. The "cure de dechloruration", which gained fame by the end of the nineteenth century, was not always a successful undertaking. The treatment of dropsy, which centered on augmenting secretions (diaphoretics, purgatives) or mechanical removal of body fluids (bleeding, leeching, lancing), remained a frustrating and chancy undertaking for much of the time that medicine has had to deal with it. Although mercury had been advocated as a diuretic in the sixteenth century, even the organic mercurials that were introduced after World War II were limited in their effectiveness. The discovery of sulfanilamide-induced sodium bicarbonate diuresis in the late 1940s was to provide the first step in the new age of clinically effective diuretics, which began in the 1950s with the introduction of chlorothiazide, the first orally effective agent to mobilize sodium chloride. The subsequent introduction of more potent diuretics was made possible by concurrent advances in renal physiology and the understanding of the sodium handling by the kidney.

Diuretics↗
PubMed1997

Evaluation of phototoxic properties of oral antidiabetics and diuretics. Photohemolysis model as a screening method for recognizing potential photosensitizing drugs.

The oral hypoglycemic drugs carbutamide, chlorpropamide, glibenclamide, glubornuride, gliclazide, glipizide, gliquidone, glisoxepide, glymidine, tolazamide and tolbutamide, and the diuretics acetazolamide, bemetizide, bendroflumethiazide, benzthiazide, benzylhydrochlorothiazide, bumetanide, butizide, chlorazanile, chlorothiazide, chlortalidone, clopamide, cyclopenthiazide, cyclothiazide, diazoxide, etozoline, furosemide, hydrochlorothiazide, hydroflumethiazide, indapamide, mefruside, metolazone, piretanide, polythiazide, trichlormethiazide, and xipamide were investigated for photohemolytic properties in vitro. Irradiation with a SOL 3 apparatus (solar simulating irradiation) revealed hemolysis in the presence of five oral hypoglycemic agents and in the presence of 19 out of the 25 tested diuretics. Photohemolysis was induced in the presence of three substances, respectively, after exposure to UVA or visible light. UVB alone did not induce phototoxic hemolysis in the presence of the tested drugs. Compared to clinical reports on photosensitivity reactions, the photohemolysis model seems a good predictive model in recognizing potential photosensitizing sulfonamides.

Dermatitis, Phototoxic↗
PubMed1998

[Persistent udder edema as a herd problem: a literature review].

The data presented in literature suggest that disturbances of volume regulation do not have a role in the pathogenesis of persistent udder oedema. Instead, they favour local mammary problems. The presence of both mast cells and oedema, especially in subcutaneous tissue, focuses attention on the role of mast cells in the pathogenesis of persistent udder oedema via increased endothelial permeability due to histamine release. The dissociation constants (Kd) for the high-affinity glucocorticoid receptor of normal and oedematous udders are not significantly different, and nor are there differences between the total quantity of dexamethasone bound (Bmax) and mast cell density in normal and oedematous udders. It has been shown that, in cattle, the concentration of histamine is higher in milk than in plasma. In addition, the urine histamine concentration is affected by the diet. Treatments to reduce udder oedema include combined salt and water restriction, supplementation with potassium or vitamin E (alpha-tocopheryl acetate), sodium restriction, and administration of hydrochlorothiazide intramuscularly, chlorothiazide orally, or sodium-acetazolamide orally and/or parenterally (i.v./i.m.). A low cation-anion balance in a diet containing 1.6% calcium also seems to reduce mammary oedema formation.

Animals↗
PubMedDate not supplied

Advances in human chronopharmacology.

Regular and thus predictable changes in biologic susceptibility and response to a large variety of physical as well as chemical agents can now be viewed as rather common phenomena. Chronopharmacology involves both the investigation of drug effects as a function of biologic timing and the investigation of drug effects upon rhythm characteristics (the period, tau, the acrophase, phi, the amplitude, A, and the mesor, M). Illustrative examples of circadian (tau congruent to 24 hrs) chronopharmacology in man are summarized in up-dated tables, keeping in mind that the objective demonstration of chronopharmacologic facts demands the use of an appropriate methodology. Circadian changes in the effects of various chemical agents have been documented: histamine, sodium salicylate, acetylcholine, halothane, prostaglandin F2alpha, reserpine, cyproheptadine, ethanol, insulin, chlorothiazide, oxymetholone, orcinprenaline and SCH 1000 (the latter being bronchodilators), Indomethacin, lignocaine, ACTH, cortisol and various synthetic corticosteroids. Despite that pharmacological facts are well documented in man for circadian rhythms, studies are not only restricted to the 24-h period but have been already extended to rhythms of periods of e.g. approximately 30 days as well as approximately 1 year. For a better understanding of chronopharmacologic findings, three new concepts must be considered: a) the chronokinetics of a drug, defined as both rhythmic (circadian) changes in the drug bioavailability (and/or pharmacokinetic effects) and its excretion (urinary, among others); b) the chronesthesy of a biosystem to a drug, or the circadian change in the susceptibility of any biosystem to a drug (including organ systems, tumors, parasites, etc.); and c) The chronergy of a drug, or the rhythmic change in the overall effects and the effectiveness of a drug. This term takes into consideration the chronokinetics and the chronesthesies of the organismic biosystems involved. Presently, one of the aims of chronopharmacology is to solve problems of drug optimization, i.e. to enhance the desired efficiency of a corticosteroid or other medications, while reducing undesired effects. In the human organism, among other animal species, the metabolic fate of a pharmacologic agent (as well as that of a nutrient) is not constant as a function of biological time. The metabolic pathways are neither open permanently, nor open with a constant patency along the 24-h scale, among other bioperiodic domains. Thus, the chronobiologic approach concerning pharmacologic phenomena involves a lesser risk of errors and/or false information than the conventional homeostatic approach.

Biological Clocks↗
PubMedDate not supplied

Detection of thiazide-based diuretics in equine urine by liquid chromatography/mass spectrometry.

Thiazide-based diuretics are included in the list of banned drugs in the horse-racing industry. One effect of their misuse is increased urine flow, contributing to dilution of other doping agents. Their determination is essential in ensuring compliance to horse-racing regulation. This study evaluates the feasibility of using liquid chromatography/mass spectrometry (LC/MS) with electrospray and atmospheric pressure chemical ionization interfaces to analyze thiazidic diuretics in equine urine samples. Existing LC and gas chromatography/MS methods are limited in their applicability to thiazide analysis. Sample preparation, analyte extraction, chromatographic separation, ion-source collision induced dissociation, solvent composition, ionization mode, and ion polarity are discussed. The practicality of LC/MS for this analysis is demonstrated with actual equine administration samples collected at specified time intervals. Detection limits were 270 ng/mL for chlorothiazide, 131 ng/mL for hydrochlorothiazide, and 384 ng/mL for trichlormethiazide.

Animals↗