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At least 163 records · Page 9Linked to original sources
PubMed1980

Diuretic treatment of resistant hypertension.

In patients with hypertension resistant to three or four drugs including a thiazide diuretic substitution of frusemide for the thiazide, or the addition of spironolactone, produced significant reductions in blood pressure and body weight. The response did not depend on the presence of overt fluid retention, renal impairment, or the use of antihypertensive drugs of high potency. Women had larger responses than men. Expansion of the plasma or extracellular fluid volume is an important cause of resistance to treatment even when a thiazide diuretic is used. An increase in diuretic treatment should be tried before using the postganglionic adrenergic blockers or minoxidil in resistant hypertension.

Adult↗
PubMed1985

Arrhythmogenic potential of diuretic induced hypokalaemia in patients with mild hypertension and ischaemic heart disease.

In view of evidence suggesting an association of mild hypokalaemia with cardiac arrhythmia, the arrhythmogenic potentials of potassium losing and potassium sparing diuretic treatments were compared in a controlled prospective crossover study of 10 patients with mild hypertension and ischaemic heart disease. Mean (SEM) plasma potassium was 4.3(0.06) mmol/l and 3.3(0.07) mmol/l after potassium sparing and potassium losing treatments respectively. Blood pressure and volume depletion as assessed by weight change, plasma renin activity, and noradrenaline concentrations did not differ significantly in the two treatment periods. The potassium losing treatment phase was associated with an increased frequency of ventricular extrasystoles, a higher Lown grading during ambulatory electrocardiographic monitoring, prolonged duration and decreased phase 0 velocity of the monophasic action potential, a prolonged ventricular effective refractory period, and increased myocardial electrical instability as assessed by programmed ventricular stimulation. It is concluded that minor changes in plasma potassium concentration are associated with increased ventricular electrical instability in patients with ischaemic heart disease. Mild hypokalaemia in such patients may predispose to life threatening arrhythmias and should be avoided.

Amiloride↗
PubMed1987

The breast pain clinic: a rational approach to classification and treatment of breast pain.

Three hundred and fifty women complaining of breast pain symptoms of sufficient severity to interfere with their normal lifestyle were reviewed in a special breast pain clinic over a 5 year period. Seventy-two patients (21%) had spontaneous resolution of breast pain and they required reassurance only before discharge. Of the remaining 278 patients, accurate classification of breast pain syndromes was achieved in 89%, the commonest syndrome being cyclical breast pain which accounted for 54% of the women followed up. The remaining womens' breast pain was classified as trigger zone (14%), continuous (8%), Tietze's disease (5%), spinal root (4%), duct ectasia (4%) and psychological depression (2%). In the remaining 25 patients (9%) the breast pain could not be classified. The experience from this clinic is that a majority of women complaining of severe breast pain symptoms can be accurately classified and appropriate therapy instituted.

Breast↗
PubMed1982

Do all diuretics have equal hypotensive efficacy?

An open parallel study was carried out in general practice on 70 patients with uncomplicated mild to moderate hypertension to compare the hypotensive efficacy of hydrochlorothiazide/amiloride with that of cyclopenthiazide/potassium. After a 2-week baseline period on placebo, patients were allocated at random to receive treatment with one or other of the diuretics starting with 1 tablet per day and increasing up to a maximum of 4 tablets per day or until their supine diastolic blood pressure was 90 mmHg or less. They were then continued at their optimum dose for a further 4 weeks. Analysis of the results from 62 patients showed that the hydrochlorothiazide/amiloride preparation produced both a greater decrease and better control of blood pressure in a greater percentage of patients that did the comparison diuretic. In addition, the beneficial effects were attained with fewer tablets, of importance for patient compliance.

Adult↗
PubMed1982

Comparison of timolol/hydrochlorothiazide/amiloride ('Moducren') with cyclopenthiazide/potassium in mild to moderate hypertension.

An open study was carried out in 641 patients with mild to moderate hypertension seen in general practice to assess the effectiveness of treatment with a timolol/hydrochlorothiazide/amiloride preparation compared with cyclopenthiazide/potassium. The timolol/hydrochlorothiazide/amiloride preparation produced better control of blood pressure in a larger percentage of patients after 2 and 6 weeks of treatment than did the diuretic/potassium preparation, and more patients were maintained on 1 tablet per day. Both treatments reduced the number of symptoms complained of by the patients at the initial visit.

Adult↗
PubMed1990

Age dependent differences in stimulation and compensation of renal and biliary transport processes. Correlation to the physicochemical properties of the exerted substances.

The relation between renal and biliary excretion of drugs was investigated in dependence on physicochemical factors, on age, and on repeated administration of hormones and xenobiotics for stimulation. Furthermore, the relation between molecular parameters of drugs and the degree of compensation of drug elimination after blockade of one excretion pathway (nephrectomy--NX, bile duct ligation--DL) was characterized. Experiments were performed on female 20-day and 55-day-old rats to demonstrate changes in the relationship between kidney and liver for drug elimination during ontogenesis. Finally it was tried to correlate the effect of a stimulation of elimination capacity of kidney and liver after repeated administration of hormones or xenobiotics and the physicochemical features of clearance substances tested. For estimation of physicochemical differences of the model substances a so called "rank coefficient" R (0-100) was used. It was calculated from molecular weight, lipophilicity, degree of ionization at pH 7.4, and protein binding rate. Compounds with low ranks (low values of molecular weight, lipophilicity, and protein binding, nearly completely ionic at pH 7.4) are eliminated first of all via urine. High ranks are typical of drugs preferentially eliminated into bile. Intermediate ranks (40-60) have been obtained for substances eliminated effectively both via kidney and liver. For these compounds only, a distinct compensation via the intact elimination route can be expected after blocking operations. Qualitative age differences could not be found. But there were differences concerning relation between acceleration of transport capacity of kidney and liver during postnatal maturation and physicochemical properties of the respective test substance.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗
PubMedDate not supplied

Postnatal development and inducibility of renal tubular transport processes in rats.

The reason for the immaturity and for the time course of postnatal development of renal tubular transport of organic anions was studied, measuring age differences in renal tubular transport of p-aminohippurate (PAH) under various experimental conditions. In principle, PAH transport can be stimulated by repeated administration of weak organic anions, which were eliminated by the carrier system for weak organic anions. However, there is nearly no effect in neonatal rats. Pretreatment with thyroid hormones can enhance the low tubular transport capacity of young rats, too. Pretreatment with dexamethasone is preferentially effective in 5- to 15-day-old rats. The data indicate the involvement of hormonal regulation in postnatal development of renal tubular transport of PAH.

Age Factors↗
PubMed1984

Influence of neomycin pretreatment on stimulated and maturative renal transport of p-aminohippurate (PAH).

Renal tubular transport of organic anions is immature at birth and can be stimulated in adult rats by repeated administration of xenobiotics. There is some evidence of an increased synthesis of carrier proteins in renal tubular cells following stimulation as well as during postnatal development of renal tubular transport processes. The effect of pretreatment with an inhibitor of protein biosynthesis (neomycin) on stimulated and maturative transport of p-aminohippurate (PAH) was measured. Neomycin has a dose dependent long acting and reversible effect on stimulated PAH transport and on postnatal maturation of PAH excretion, and increased protein biosynthesis is the likely common basic phenomenon of both processes.

Aminohippuric Acids↗