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At least 127 records · Page 7Linked to original sources
PubMed1984

Patients compliance in hypertension--the importance of number of tablets.

The importance of number of tablets for patient compliance was investigated in 160 patients with mild-moderate essential hypertension treated with a beta-adrenoceptor blocker and a thiazide diuretic. Mean BP at entry 146 +/- 16/92 +/- 8 mm Hg. All patients were given pindolol 10 mg and clopamide 5 mg in one combination tablet or in separate tablets for 4 months respectively. Approximately 90% of the patients took greater than 90% of the prescribed dose throughout the study. Mean BP decreased progressively and heart rate increased slightly. Side effects were more frequently reported during the first month of the study than previously, and 30 patients discontinued the treatment. No differences in this respect were seen between 1 and 2 tablets daily. Approximately 75% of the patients preferred 1 tablet daily, but combining two drugs in one tablet had no effect upon compliance.

Adult↗
PubMed1984

Lowering blood pressure in the aged: a 40-month experience.

In the author's experience once a day treatment of the hypertensive aged is feasible. A group of 71 cases with an average BP of 170/95 mm Hg or greater and an average age of 72 years were treated with DH ergocristine-clopamide-reserpine compound or methyldopa. The asymptomatic nature of hypertension and a realization of long-term medication accounted for the withdrawal of 18 cases (25.3%) in the first year. At the end of a 40-month period, 47 cases were still under treatment. The BP had been reduced to normal in 27 cases (57.4%) and significantly lowered in 8 cases (17%). With the exception of 1 case, all tolerated the therapy well and experienced no side effects.

Aged↗
PubMed1979

A multi-centre general practice trial of a pindolol/clopamide combination ('Viskaldix') in essential hypertension.

A large, open, multi-centre study was carried out in general practice to evaluate the effectiveness and tolerance of a combination of 10 mg pindolol plus 5 mg clopamide, in single tablet form, in the treatment of patients with essential hypertension. Computer analysis of the records of 8989 patients who completed the 8-weeks' study period showed that treatment with the combination product, in a dosage of 1 tablet daily in 83% of the patients, resulted in excellent blood pressure control in the majority (75%) of cases, irrespective of age or previous antihypertensive treatment, and was particularly effective in those with mild to moderate hypertension who had previously not received any therapy. Side-effects were generally not troublesome and only 8.3% of patients stopped treatment for this reason. The most commonly reported side-effects were dizziness, nausea, tiredness and headache.

Adolescent↗
PubMed1990

Combination of a thiazide, a vasodilator and reserpine compared with methyldopa plus hydrochlorothiazide in the treatment of hypertension in Zimbabwe.

Brinerdin (Sandoz), a combination of a diuretic (clopamide 5 mg), a vasodilator (dihydro-ergocristine 0.5 mg) and reserpine (0.1 mg) (CDR) was compared with methyldopa (MD) plus hydrochlorothiazide (HCT) for antihypertensive effect, adverse reactions, compliance and patient preference in an open cross-over trial. Eighteen patients completed both arms of the trial and 5 patients who completed the CDR arm were withdrawn while on the MD arm because of adverse effects in 4 and poor control in 1. On HCT 50 mg daily the mean baseline systolic blood pressure was 163.9 +/- 16.3 mmHg and the diastolic blood pressure was 105.9 +/- 6.7 mmHg. On CDR these were reduced to systolic blood pressure 140.3 +/- 15.1 mmHg and diastolic blood pressure 87.8 +/- 9.3 mmHg. On MD + HCT the systolic blood pressure was reduced to 138.5 +/- 16.9 mmHg and the diastolic blood pressure to 88.9 +/- 10.3 mmHg. The differences between the two treatment periods in systolic blood pressure (1.8 mmHg; 95% confidence interval (CI) - 4.1 + 7.7 mmHg) and diastolic blood pressure (1.1 mmHg; 95% CI - 4.6 + 2.4 mmHg) were not significant with P values of 0.6 and 0.7 respectively. Compliance was 98.2% for CDR and 94.7% for MD + HCT (P = 0.02). Unusual sleepiness occurred more frequently in the MD arm (P less than 0.01). Thirteen patients chose to continue on CDR, 2 on MD + HCT and 3 had no preference (P = 0.005). CDR is similar in antihypertensive effect to MD + HCT but is better tolerated with fewer withdrawals, fewer adverse effects, better compliance and has more patients electing to continue taking it.

Adult↗
PubMed1989

Effects of pindolol, or a pindolol/clopamide combination preparation, on plasma lipid levels in essential hypertension. Hunter Hypertension Research Group.

In an open study that was conducted in general practice, 22 patients with previously-untreated mild hypertension received an average daily dose of 11.7 mg of pindolol over a 50-week study period. The total cholesterol, high-density lipoprotein fraction and plasma triglyceride levels showed no significant change from baseline values at the conclusion of this period. A separate group of 18 patients were treated with 10 mg of pindolol a day for 12 weeks, to which regimen was added 5 mg of clopamide for the succeeding 38 weeks. A small rise in total plasma cholesterol levels in this group of patients at both 12 and 50 weeks did not achieve statistical significance, and no change was observed in either the high-density lipoprotein fraction or the plasma triglyceride levels. These results which were obtained in general practice and over a prolonged period of time accord with the general view that the treatment of hypertension with pindolol, a beta-receptor blocking drug with partial agonist activity, is not associated with either the increases in total plasma cholesterol levels or the falls in the high-density lipoprotein fraction that have been reported with other beta-blocking compounds.

Adult↗
PubMed1989

Diuretic agents related to indapamide. III--Synthesis and pharmacological activity of N-(4-chloro-3-sulfamoylbenzamido)-1,2,3,4-tetrahydroquinolines and 1,2,3,4-tetrahydroisoquinolines.

A series of N-(4-chloro-3-sulfamoylbenzamido)-1,2,3,4-tetrahydroquinoline++ + (IV-1) and isoquinoline (IV-2) have been synthesized and their diuretic and antihypertensive activities evaluated. While none of the test compounds was found to be provided with antihypertensive properties, most of them displayed a diuretic activity comparable to (IV-2 a) or higher (IV-1 a,b) (IV-2 c) than those of indapamide and clopamide, taken as reference drugs.

Animals↗
PubMed1986

Effects of single doses of two antihypertensive rauwolfia-diuretic combinations on urinary excretion.

In a double-blind placebo-controlled investigation, 14 healthy adult male volunteers were studied to assess and compare the urinary effects of acute single doses of two antihypertensive formulations containing: hydroflumethiazide 50 mg, Rauwolfia serpentina 50 mg and potassium chloride 625 mg (HFRK) (Rautrax-50; Squibb Laboratories); and clopamide 5 mg, reserpine 0.1 mg and dihydroergocristine 0.5 mg (CRE) (Brinerdin; Sandoz Products). Both significantly increased mean 24-hour urinary outputs of fluid, Cl-, Na+, K+ and Mg2+. CRE increased creatinine and decreased Ca2+ output. After dosing, times to maximal urinary flow of fluid, Cl-, Na+, Ca2+ and creatinine were shortened by HFRK and CRE and those corresponding to K+, Mg2+, phosphate and urate were unaffected. Both formulations thus acted mainly through their diuretic constituents.

Adolescent↗
PubMed1981

[Hypertension therapy with Briserin: what role do dihydroergocristine components play?].

40 patients with essential hypertension were subjected to an analysis of efficacy and safety of the three-component-combination Briserin (Reserpine, Clopamide, Dihydroergocristine). After double-blind and randomized allocation, one group received the two constituents Reserpine/Clopamide, another the full combination Briserin and a third first Reserpine/Clopamide and Briserin afterwards. Both types of treatment proved equi-effective in terms of blood pressure reduction with the blood pressure values falling below 150/90 mm Hg within one week. The most important finding resided in the improved orthostatic tolerance due to Briserin. Maximal systolic pressure drop during standing and the tachycardia associated were significantly reduced by Briserin, i.e. by the influence of Dihydroergocristine. In addition, there was a corresponding difference in terms of subjective complaints due to orthostasis. The same held true for general symptoms related to hypertension such as headache, dizziness, undue tiredness and sleeplessness. Patients preferred treatment with Briserin as compared to the other regimen. The discussion deals with the clinical-pharmacological impact of the orthostatic regulation quality within the framework of antihypertensive treatment.

Antihypertensive Agents↗
PubMed1982

[Viskaldix in the treatment of arterial hypertension].

Viskaldix, a combination of Pindolol (Visken)--10 mg with Clopamide--5 mg, was administered to 15 patients with arterial hypertension. The follow up of the patients was according to a previous plan, the preparation administered according, to a schedule. In the determination of the stage of the disease, consideration was mainly given to the values of the diastolic pressure, measured in a lying position. The patients examined were of the following age: to 40--I patient; to 50-7 patients; to 60--7 patients. Seven patients were at the stage I, 4 patients--stage OII and 4 patients--stage III. Reduction of systolic and diastolic pressure with more than 1.33 kPa (10 mm Hg column) both in a lying and standing position were recorded in 2/3 of the patients with the treatment carried out. The effect on the blood pressure, was noticed to develop in 1/3 of the patients with the administration of 2 tablets daily. The blood pressure of only one patient failed to respond to the treatment.

Adult↗
PubMed1975

[The effect of an antihypertensive drug during psychological stress. A double-blind study].

A sample of 20 patients suffering hypertension (with a moderate rise in blood pressure) was randomly divided into two treatment groups of equal size. The patients of one group received antihypertension treatment with the combination drug Briserin¿ (containing 0.1 mg reserpine, 5 mg clopamide, 0.5 mg dihydroergocristin/per tablet); the other patients who served as control group, received a matched placebo. After a fortnight's treatment, the responsiveness of both groups to five different psychologically stressing situations (those with cognitive and/or emotional overload) was tested. Analysis of covariance revealed clinically significant differences in the mean systolic and diastolic pressure scores of the two groups. The scores of the treatment group were lower not only under stress but also at rest. There was in interaction between rise of blood pressure under stress and kind of stress in the two groups, i.e., in situations with heavy emotional and/or cognitive load the differences in the pressure scores of the two groups were less substantial than in situations with a low or medium load. The treatment had no systematic effect on heart rate in this sample. In the treatment group reaction time, perceptual speed, and short-term memory were impaired as compared with the control group; but these differences did not reach a level of significance.

Adolescent↗
PubMed1997

[Erythrocyte-induced "torsade de pointes" ventricular tachycardia].

A case of erythromycin-induced acquired long QT syndrome and "torsades de pointes" ventricular tachycardia is reported. The peculiar ventricular tachyarrhythmia was evoked by orally administered erythromycin (1.5 g/die) in the presence of diuretic (clopamide)-induced hypokalaemia. The pause-dependent "torsades de pointes" was preceded by prolonged QTU interval (560 ms), "particular bigeminy" and "short-long-short" RR interval sequence. The recurrent ventricular tachycardia causing syncopal attacks was abolished by the discontinuation of erythromycin treatment, K+/Mg(2+)-supplementation and oral mexiletine therapy. It is emphasized that the macrolide antibiotic/prokinetic erythromycin, applied in therapeutic dosages, blocks the rapidly activating delayed rectifier potassium current (IKr), and as such, prolongs ventricular repolarization and may be "torsadogenic".

Clopamide↗
PubMed1991

Treatment of Paget's disease of bone with a combination of intranasal salmon calcitonin and oral calcium and thiazide.

The purpose of this study was to establish the smallest dose of nasally administered salmon calcitonin (SCT) which, if given in conjunction with a previously published calcium/thiazide treatment, would be as effective as parenteral SCT in the treatment of Paget's disease of bone. Forty patients suffering from symptomatic Paget's disease were treated with 0.5 g calcium three times daily, 10 mg/day clopamide, and 400 IU nasally administered salmon calcitonin given once or twice weekly. This regimen was given for 5 months, after which all treatment was ceased for 4 months. Parenteral SCT (100 IU) was then given three times weekly for 5 months to 25 of the patients. With the oral/nasal treatment, the plasma alkaline phosphatase level (AP) decreased by 30 +/- 15 (SD)% when the SCT was given once weekly and by 39 +/- 11% (P less than 0.05) when the SCT was given twice weekly. There were similar decreases in the fasting urinary hydroxyproline:creatinine ratios. The parenteral SCT reduced the AP by 33 +/- 23%. Though reduction in bone pain was similar with both treatments, most patients preferred the oral/nasal treatment. It is concluded that the oral/nasal treatment, when the SCT is given twice weekly, has similar efficacy to parenteral SCT, and is a well tolerated, effective initial treatment for Paget's disease of bone.

Administration, Intranasal↗
PubMed2006

Fast gas chromatographic/mass spectrometric determination of diuretics and masking agents in human urine: Development and validation of a productive screening protocol for antidoping analysis.

An analytical procedure was developed for the fast screening of 16 diuretics (acetazolamide, althiazide, amiloride, bendroflumethiazide, bumetanide, canrenoic acid, chlorthalidone, chlorthiazide, clopamide, ethacrynic acid, furosemide, hydrochlorthiazide, hydroflumethiazide, indapamide, triamterene, trichlormethiazide) and a masking agent (probenecid) in human urine. The whole method involves three analytical steps, including (1) liquid/liquid extraction of the analytes from the matrix, (2) their reaction with methyl iodide at 70 degrees C for 2 h to form methyl derivatives, (3) analysis of the resulting mixture by fast gas chromatography/electron impact mass spectrometry (fast GC/EI-MS). The analytical method was validated by determining selectivity, linearity, accuracy, intra and inter assay precision, extraction efficiencies and signal to noise ratio (S/N) at the lowest calibration level (LCL) for all candidate analytes. The analytical performances of three extraction procedures and five combination of derivatization parameters were compared in order to probe the conditions for speeding up the sample preparation step. Limits of detection (LOD) were evaluated in both EI-MS and ECNI-MS (electron capture negative ionization mass spectrometry) modes, indicating better sensitivity for most of the analytes using the latter ionization technique. The use of short columns and high carrier gas velocity in fast GC/MS produced efficient separation of the analytes in less than 4 min, resulting in a drastic reduction of the analysis time, while a resolution comparable to that obtained from classic GC conditions is maintained. Fast quadrupole MS electronics allows high scan rates and effective data acquisition both in scan and selected ion monitoring modes.

Diuretics↗
PubMed1987

Liquid chromatographic screening of diuretics in urine.

We describe a liquid chromatographic screening procedure for the detection, in urine, of twelve of the fifteen potassium-depleting diuretics available in Australia. A 2-ml urine sample was acidified with NaH2PO4 (pH 4.1) and extracted with 4 ml ethyl acetate. The sample was cleaned up further by washing with 5 ml Na2HPO4 (pH 7.5). The ethyl acetate was then evaporated to dryness, the residue reconstituted in 100 microliters mobile phase and 5 microliter were injected onto a Merck LiChrosorb RP-18 (5 microns) column. The ultraviolet absorbance of the eluent was monitored at 271 nm for 10 min. The screen was evaluated by giving each of thirty volunteers the lowest recommended dose of one of the diuretics in the study and obtaining urine samples 4, 8 and 24 h after having taken the dose. Twelve diuretics, chlorothiazide, hydrochlorothiazide, quinethazone, chlorthalidone, methyclothiazide, clopamide, frusemide, metolazone, mefruside, bendrofluazide, cyclopenthiazide and bumetanide, were all detectable up to 24 h after a dose. We therefore conclude that the screen would be reliable for the detection of these diuretics in urine.

Chromatography, High Pressure Liquid↗
PubMed1977

Comparison of the effect of two groups of diuretics on renin secretion in the anaesthetized dog.

1. The effects of two groups of diuretics on renin secretion have been compared in dogs anaesthetized with pentobarbital. 2. Frusemide, ethacrynic acid and bumetanide cause an immediate rise in renin secretion which is not inhibited either by DL-propranolol or by a bilateral ureterovenous anastomosis which prevents salt and water loss. 3. Clopamide, metolazone and indapamide do not cause an immediate rise in renin secretion. Renin hypersecretion is induced only 1 h after intravenous injection of these diuretics. 4. Renin secretion was studied for 6 h after frusemide injection: the immediate rise was followed by a later increase in renin secretion. This later rise was inhibited by propranolol and by ureterovenous anastomosis. 5. These results allow us to distinguish between a direct renal mechanism responsible for early renin hypersecretion, which appears to be connected with the action of the diuretic on the ascending limb of Henle's loop, and an indirect mechanism responsible for late renin hypersecretion, which appears to be connected with salt and water loss.

Animals↗
PubMed1981

Beta-receptor-blocking agents may reverse or prevent diuretic-induced increases in serum low-density lipoprotein cholesterol.

1. The effect of treatment with a thiazide-like diuretic alone or combined with a beta-adrenoceptor blocker on serum lipoproteins was investigated in 35 patients with essential hypertension. 2. In group I (18 patients), serum low-density lipoprotein cholesterol was increased (P less than 0.001) during monotherapy with chlorthalidone (100 mg/day) but not during combined chlorthalidone--beta-blocker therapy. 3. This tendency was similar in subgroups studied with an inverse sequence of drug administration. In subgroup IA (11 men), a 22% increase (P less than 0.01) in low-density lipoprotein cholesterol after 6 weeks of chlorthalidone was reversed after use of a beta-blocker as well as chlorthalidone; in subgroup IB (five men, two post-menopausal women), low-density lipoprotein cholesterol was increased by 41% (P less than 0.05) above placebo values 6 weeks after withdrawal of the beta-blocker from combination therapy. 4. In group II (18 men), low-density lipoprotein cholesterol was increased by 13% (P less than 0.025) after 4 weeks of monotherapy with clopamide (5 mg/day) but restored to control levels 4 weeks after addition of pindolol (10 mg/day). 5. No significant changes occurred during any treatment phase in high-density lipoprotein cholesterol. 6. Certain beta-receptor blocking agents may prevent or reverse diuretic-induced increases in serum low-density lipoprotein cholesterol.

Adolescent↗
PubMed1981

Antihypertensive effect of guanfacine: long-term 'once-a-day' treatment and sudden withdrawal.

1. Twenty patients with essential hypertension were treated with guanfacine given in single daily doses of 1--5 mg over a period of 24 weeks. Compared with the initial values at the end of the first wash-out period, there was a significant decrease of blood pressure and heart rate. The most common side effect, dryness of the mouth, usually disappeared after 8--10 weeks of treatment. No changes in laboratory values were seen. In the post-treatment placebo period there were significant increases in blood pressure and heart rate compared with the last readings during the treatment period. However, these never exceeded the pretreatment values. 2. In a second trial guanfacine (1--5 mg daily) was abruptly discontinued in 11 patients after 6--20 weeks' treatment. Blood pressure was measured twice a day, in lying and standing positions, during the 4 days before abrupt withdrawal of guanfacine and for 7 days after discontinuation. Clopamide was given concurrently to two patients, and this was continued after withdrawal of guanfacine. Only in two patients did the blood pressure rise to values above the initial levels (30 mmHg systolic and 10 mmHg diastolic), but no clinical symptoms were observed during the withdrawal. A transitory increase of heart rate of between 10 and 30 beats/min was observed in five patients after abrupt discontinuation of the drug.

Adult↗
PubMed2005

Screening procedure for detection of diuretics and uricosurics and/or their metabolites in human urine using gas chromatography-mass spectrometry after extractive methylation.

A gas chromatography-mass spectrometry (GC-MS)-based screening procedure was developed for the detection of diuretics, uricosurics, and/or their metabolites in human urine after extractive methylation. Phase-transfer catalyst remaining in the organic phase was removed by solid-phase extraction on a diol phase. The compounds were separated by GC and identified by MS in the full-scan mode. The possible presence of the following drugs and/or their metabolites could be indicated using mass chromatography with the given ions: m/z 267, 352, 353, 355, 386, and 392 for thiazide diuretics bemetizide, bendroflumethiazide, butizide, chlorothiazide, cyclopenthiazide, cyclothiazide, hydrochlorothiazide, metolazone, polythiazide, and for canrenoic acid and spironolactone; m/z 77, 81, 181, 261, 270, 295, 406, and 438 for loop diuretics bumetanide, ethacrynic acid, furosemide, piretanide, torasemide, as well as the uricosurics benzbromarone, probenecid, and sulfinpyrazone; m/z 84, 85, 111, 112, 135, 161, 249, 253, 289, and 363 for the other diuretics acetazolamide, carzenide, chlorthalidone, clopamide, diclofenamide, etozoline, indapamide, mefruside, tienilic acid, and xipamide. The identity of positive signals in such mass chromatograms was confirmed by comparison of the peaks underlying full mass spectra with reference spectra. This method allowed the detection of the abovementioned drugs and/or their metabolites in human urine samples, except torasemide. The limits of detection ranged from 0.001 to 5 mg/L in the full-scan mode. Recoveries of selected diuretics and uricosurics, representing the different chemical classes, ranged from 46% to 99% with coefficients of variation of less than 21%. After ingestion of the lowest therapeutic doses, furosemide was detectable in urine samples for 67 hours, hydrochlorothiazide for 48 hours, and spironolactone for 52 hours (via its target analyte canrenone). The procedure described here is part of a systematic toxicological analysis procedure for acidic drugs and poisons.

Diuretics↗