Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eprosartan is an angiotensin II receptor antagonist (angiotensin II receptor blocker [ARB]) used in the treatment of hypertension. In large, randomized trials, eprosartan (with or without hydrochlorothiazide [HCTZ]) demonstrated superior antihypertensive efficacy to that of placebo and, when administered at comparable dosage regimens, had similar blood pressure-lowering effects to enalapril. Eprosartan was generally well tolerated in clinical trials and had a lower incidence of persistent dry cough than enalapril. Eprosartan has a neutral effect on metabolic parameters, such as serum lipid levels and glucose homeostasis, and a low propensity for pharmacokinetic drug interactions. The use of eprosartan or other ARBs in combination with HCTZ tends to reverse the potassium loss associated with thiazide diuretics. Independent of its antihypertensive effects, eprosartan was associated with improved clinical outcomes (primary composite endpoint of all causes of mortality and all cardiovascular and cerebrovascular events, including all recurrent events) compared with nitrendipine in a randomized, secondary prevention trial in hypertensive patients with previous cerebrovascular events (MOSES trial). Eprosartan also reduced blood pressure and was associated with a modest improvement in cognitive function in a large observational study in patients > or =50 years of age with newly diagnosed hypertension (OSCAR study). In both of these trials, additional antihypertensive therapy, such as HCTZ, was permitted. Therefore, eprosartan is a useful treatment option in the management of a broad range of patients with hypertension, and its use with HCTZ provides a rational combination regimen.
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PMID:Eprosartan: a review of its use in hypertension. 1991 59

All antagonists (sartans) are considered to be a group of pharmaceuticals with comparable indications and comparable effects as ACE inhibitors, while almost lacking the side effect ofa dry cough. Large clinical trials showed that All antagonists had a comparable (statistically insignificantly smaller) effect on so called "hard targets", i.e. mortality and morbidity, in patients with ischemic heart diseases and/or heart failure. The study of their effect in the treatment of hypertension was first limited to diabetics and patients with microalbuminuria and showed that they had a significant renoprotective effect in said cases. Large clinical trials followed, focusing on hypertension in primary as well as secondary prevention of cardiovascular diseases. Five large clinical trials focusing on All antagonists addressed cerebrovascular accidents and cognitive functions: LIFE, SCOPE, OSCAR, MOSES and POWER. The LIFE study (Losartan Intervention For Endpoint) confirmed that in 9,193 patients with proven left ventricular hypertrophy, losartan led to a lower incidence of cerebrovascular accidents or new development of diabetes mellitus than atenolol, which in turn led to statistically significant lower primary endpoint (fatality, myocardial infarction and cerebrovascular accident) (p = 0.021), while blood pressure dropped at the same rate. The SCOPE study (Study on COgnition and Prognosis in Elderly hypertensives) compared candesartan with another antihypertensive treatment in 4,937 hypertonic patients older than 70. The primary endpoint was a decrease in massive cardiovascular accidents (fatality, MI, CVA). The decrease rate reached 10.9%, which was not considered statistically significant (p = 0.19). However, statistically significant was the decrease in cerebrovascular accidents (p = 0.04). The MOSES study (Morbidity and mortality after stroke) compared eprosartan and nitrendipine in secondary prevention of cerebrovascular diseases in 1,405 patients. Blood pressure was reduced to a comparable extent without showing significant differences between the two groups. During the study period, a total of 461 primary accidents occurred: 206 in patients with eprosartan and 255 in patients with nitrendipine (p = 0.014). Cardiovascular accidents were: 77 with eprosartan and 101 with nitrendipine (p = 0.06); cerebrovascular accidents were: 102 with eprosartan and 134 with nitrendipine (p = 0.03). OSCAR study was an open study with the objective to assess the impact of eprosartan treatment on cognitive functions. Use of eprosartan was associated with a significant reduction in blood pressure from 161.9/93.1 mm Hg to 136.1/80.8 mm Hg after 6 months (p < 0.0001). The total average score of the MMSE test after the completion of the follow-up period was 27.9 - 2.9 compared to 27.1 + 3.4 at the beginning (p < 0.0001). The results of the OSCAR study support the statement that antihypertensive treatment based on drugs that target the reninangiotensin system is associated with the preservation of cognitive functions. The POWER study proved in a large unselected population the suitability and practical aspect ofa reduction in the total cardiovascular risk by means of systematic treatment of high blood pressure.
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PMID:[AII antagonists in the treatment of hypertension and prevention of CVA]. 2356 27

Malignant pleural mesothelioma (MPM) is a rare neoplasm. It predominantly affects elderly individuals aged over 70 years presenting with a unilateral pleural tumor usually associated with previous asbestos exposure. The respiratory symptoms are associated with ipsilateral pleural involvement with concomitant pleural effusions. The diagnosis of MPM is established by the morphologic and immunohistochemical features of a cytologic specimen. MPM can present as three histologic subtypes: epithelioid, sarcomatoid, or biphasic. We present a case of an 85-year-old Caucasian female with a history of occupational asbestos exposure. She complained of 1-week history of progressive sharp right flank and scapular pain with mild shortness of breath, dry cough and pleuritic chest pain. CT of the chest showed a large loculated right pleural effusion with adjacent pleural thickening. CT abdomen and pelvis was negative for other neoplastic findings. CT-guided core biopsy of the right pleural-based mass was positive for a spindle to plasmacytoid small blue cell tumor. An extensive immunohistochemical panel was non-specific. A focal OSCAR keratin and WT-1 expression in the absence of carcinoma markers, a malignant mesothelioma, biphasic type was diagnosed. Further workup with PET-CT and cytotoxic chemotherapy combined with immunotherapy or tyrosine kinase inhibitors was recommended by oncology. The patient refused further imaging and treatment, and palliative care was consulted.
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PMID:Malignant Pleural Mesothelioma, Biphasic Type: An Unusual and Insidious Case of Rapidly Progressive Small Blue Cell Tumor. 3010 62