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)

Angiotensin-converting enzyme inhibitors (ACEI) constitute an effective and well tolerated class of drugs for the treatment of arterial hypertension. Yet they have been blamed for the occurrence of side-effects the most frequently reported of which are renal function impairment, hypotension and cough. For this reason, the renal function of hypertensive patients has been evaluated after short - and long - term treatment with perindopril. In patients with normal renal function on short-term treatment (1 and 5 days) perindopril produced an increase of renal plasma flow without change in glomerular filtration. In long-term treatment (up to 18 months), no significant change in plasma creatinine level was observed. In old age hypertensive patients or in patients with chronic renal failure glomerular filtration was also preserved, apart from rare cases of creatinine clearance reduction, notably after addition of hydrochlorothiazide. A very slight and clinically not significant rise of kaliemia was noted when perindopril was used as single-drug treatment. Cases of symptomatic hypotension were rare (0.2 p. 100), even in situations of water and salt depletion. Among the other side-effects of ACEI, cough, which has more recently been described, has carefully been looked for. Its incidence has been determined in a double-blind trial comparing perindopril (1.2 p. 100) with captopril (2.4 p. 100). It has also been evaluated in a long-term study involving 632 hypertensive patients, 391 of whom were treated for 1 year; its incidence then was 2.9 p. 100, and drug withdrawal was required in 8 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Tolerance and safety of the use of perindopril]. 250 18

To determine the potential toxicity of prolonged aerosol tobramycin administration, 22 patients with cystic fibrosis were monitored while receiving inhaled tobramycin three times a day for 12 weeks. Prior to, four times during administration and approximately 6 weeks after discontinuation of treatment, we assessed pulmonary function, weight, height, body temperature, eighth cranial nerve function, serum creatinine, blood urea nitrogen, urinary creatinine clearance, plasma iothalamate clearance, urinary beta-2 microglobulin concentration, and Pseudomonas aeruginosa density in sputum. There was no detectable laboratory evidence of nephrotoxicity. Neither a decrease in auditory acuity (range 250-20,000 Hz) nor vestibular dysfunction was detected. Pulmonary function tests significantly improved during the first month in all subjects (P less than 0.05) but returned to enrollment values by the end of the 12th week of administration of tobramycin aerosol. Sputum P. aeruginosa density initially decreased from a mean of 10(7) cfu/gm to a mean of 10(4) cfu/gm after 2 weeks of aerosol tobramycin administration and remained significantly below the enrollment value throughout. Coincident with the reduced bacterial density, a reduction in cough frequency and sputum production, as well as a weight gain was observed. Seventy-three percent of the patients with sputum P. aeruginosa isolates susceptible to tobramycin on enrollment yielded resistant organisms during aerosol administration. However, 1 year later all sputum P. aeruginosa isolates obtained from patients were susceptible to tobramycin. We conclude that thrice daily aerosol tobramycin administration for 3 months is not associated with detectable eighth cranial nerve or renal toxicity. Transient emergence of tobramycin resistant P. aeruginosa may occur.
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PMID:Safety of aerosol tobramycin administration for 3 months to patients with cystic fibrosis. 251 23

This report reviews the tolerability profile of enalapril, an angiotensin-converting enzyme (ACE) inhibitor, in the treatment of patients with congestive heart failure. Data have been collected from 546 patients treated with enalapril for up to 9 months in clinical trials other than the Cooperative North Scandinavian Enalapril Survival Study. Results in patients treated with enalapril (n = 193) or placebo (n = 195) in double-blind, controlled clinical trials show that the incidences of death, serious adverse experiences, and adverse experiences requiring discontinuation of double-blind therapy, as well as the overall incidence of such experiences, were similar in the 2 groups. However, certain adverse experiences that are related to the mechanism of action of ACE inhibitors were seen more often after enalapril than after placebo treatment. Dizziness and hypotension were the most frequent adverse experiences reported in patients with heart failure treated with enalapril. The most frequent laboratory adverse experiences were increases in blood urea nitrogen and serum creatinine levels. hyperkalemia was also seen in patients receiving enalapril. It is possible to identify patients at risk of these experiences before initiating treatment with enalapril and to take certain measures (such as withholding or reducing the dose of diuretic drugs and discontinuing potassium supplements or potassium-sparing diuretic drugs) to reduce the likelihood that hypotension, increases in blood urea nitrogen and serum creatinine levels, or hyperkalemia will occur. Angioedema, a recognized adverse effect of ACE inhibitors, was not seen in the clinical trials reviewed here. Cough , another recognized adverse effect of these agents, was seen infrequently and rarely resulted in the discontinuation of enalapril.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Tolerability of enalapril in congestive heart failure. 253 64

A retrospective analysis of records from an outpatient medical practice was undertaken to determine the incidence and features of cough resulting from the use of enalapril maleate. Of 209 patients taking enalapril, 22 (10.5%) required discontinuation of therapy because of an intractable, dry cough. Cough was more than twice as common in women; 16 (14.6%) of 109 women and 6 (6%) of 100 men stopped taking enalapril because of cough. The cough resolved in 21 of 22 patients within 2 weeks of discontinuation of enalapril therapy. When the patients with cough were compared with the others, there was no significant difference in age, smoking status, creatinine levels, enalapril dosage, associated cardiopulmonary disease, or concomitant administration of medications. Among the 187 study patients who did not discontinue taking enalapril because of cough, many developed a persistent, dry cough that to date has not been severe enough to require discontinuation of therapy, after a mean follow-up period of 16 months. The enalapril-induced cough is insidious, dry, persistent, benign, and reversible on discontinuation of therapy. It is important to distinguish enalapril-induced cough from cough resulting from acute illness, reactive airway disease, and congestive heart failure. Optimal clinical application of enalapril in the treatment of hypertension and congestive heart failure will require increased awareness of this incessant cough, which requires discontinuation of the therapy in about 10% of patients.
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PMID:Enalapril-induced cough. 255 77

27 cases of uremia with abnormal appearances on the chest films were analysed. The results showed that the clinical features were cough, expectoration dyspnea and hemoptysis. However, the degree of these symptoms was relatively mild as judged from the amount of pulmonary edema found on the chest films. The chest X-ray finding in these group of patients were characterized by pulmonary blood stasis, interstitial edema of the lung and edematous alveoli. The pathogenesis of uremic lung was said to be related to blood urea nitrogen and creatinine retention and the concurrent presence of left side heart failure may also play a role. Hemodialysis and other comprehensive treatments could help the patients with uremic lung for relief the symptoms. But the fundamental managements to improve the prognosis for this disease are early treatment of the primary renal diseases, in order to prevent the occurrence of renal failure. Kidney transplantation should be advised.
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PMID:[The uremic lung]. 263 29

Inhibitors of the angiotensin conversion enzyme (ICE) represent an effective and well tolerated therapeutic class, for the treatment of arterial hypertension. The antihypertensive efficacy or perindopril, an ICE active in one single daily dose, is at least equal to that of reference antihypertensive drugs administered at usual doses. The possibility of occurrence of some side-effects while using ICE, has resulted in a particular attention in evaluating the safety of perindopril. First, the renal function was monitored. During essential hypertension, no significant variation of the creatininemia was observed with long-term administration of the drug (12 months). In elderly hypertensive patients or patients with chronic renal insufficiency, the glomerular filtration is also preserved, except during rare occurrences of decreased creatinine clearance, especially after adjunction of hydrochlorothiazide. A discrete elevation of the kaliemia without clinical significance is observed when perindopril is used as a single drug. Reports of symptomatic hypotension with perindopril are rare (0.2%), even in situations of water and sodium depletion. Among other side-effects of ICE, cough, more recent, was thoroughly investigated. Its frequency was determined during a double blind trial comparing perindopril (1.2%) with captopril (2.4%). It was also evaluated during a long-term study concerning 632 hypertensive patients (391 patients treated in 1 year); its incidence is the 2.9 p. cent and it resulted in discontinuation of the treatment in 8 cases. In this study, 36 patients interrupted the treatment prematurily because of an adverse reaction (5.7%). Finally no harmful drug interaction was reported. The favorable tolerance profile of perindopril is combined with a beneficial effect on the functional and structural modifications of the heart and large vessels related to hypertension.
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PMID:[First intention treatment of arterial hypertension. Effectiveness and safety of perindopril]. 268 25

Angiotensin converting enzyme inhibitors (ACEIs) constitute a safe and effective therapeutic class for the treatment of hypertension. However, they have been incriminated in the development of certain adverse effects, the most frequently reported being alteration in renal function, development of hypotension and cough. This justified the evaluation of renal function after short-term and long-term treatment with perindopril in hypertensive subjects. In patients with normal renal function, during short-term treatment (1 and 5 days), perindopril induced an increase in renal plasma flow without any modification of the glomerular filtration rate. During long-term administration (up to 18 months of treatment), no significant variation in plasma creatinine was observed. In elderly hypertensive patients or patients with chronic renal failure, the glomerular filtration rate was also preserved, apart from a few rare cases of decreased creatinine clearance, particularly after the addition of hydrochlorothiazide. A slight increase in plasma potassium, with no clinical significance, was observed when perindopril was used as single-agent therapy. Symptomatic hypotension was rarely reported with perindopril (0.2% of cases), even under conditions of salt and water depletion. Amongst the other adverse effects of ACEIs, cough, more recently identified, was investigated in detail. Its frequency was determined in a double-blind study comparing perindopril (1.2%) and captopril (2.4%). It was also evaluated in a long-term study in 632 hypertensive patients (391 treated for 1 year); its incidence was 2.9% and it was responsible for discontinuation of treatment in 8 cases. In this study, 36 patients stopped treatment prematurely because of an adverse effect (5.7%). No harmful drug interactions were reported. The combination of a thiazide diuretic potentiates the antihypertensive effect of perindopril and is perfectly tolerated. The favorable safety profile of perindopril should be related to the correct determination of effective doses.
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PMID:Tolerance and safety of perindopril. 269 Nov 32

The effectiveness of enalapril 10-40 mg/day as first choice treatment of mild (90-104 mmHg, n = 37), moderate (105-114 mmHg, n = 21), or severe (115-130 mmHg excluding accelerated hypertension, n = 16) essential hypertension was studied in an open multicentre trial. Enalapril alone controlled the hypertension (diastolic blood pressure 90 mmHg or less) in 25 patients (34%). Of these, 20 had mild and 5 had moderate hypertension. The remaining patients required either enalapril plus hydrochlorothiazide 12.5 or 25 mg/day (n = 30), or a third drug of the physician's choice (n = 9). A relationship was present between baseline blood pressure and the number of drugs required to achieve blood pressure control. Plasma creatinine increased beyond the limits of laboratory error in 3 patients, and from 100-108 mumol/l (p less than 0.05) on enalapril alone in a subgroup of patients who ultimately required a diuretic. Enalapril was well tolerated; 60 (73%) had no drug related side effects during active treatment. Tiredness (n = 5), headache (n = 4), dizziness (n = 4) and palpitations (n = 3) were the most frequent side effects. Cough was a feature in 3 patients and 1 patient had a rash. This study suggests that enalapril is an effective and well tolerated anti-hypertensive agent in mild, moderate or severe hypertension, but that caution may be required in patients with impaired renal function.
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PMID:Enalapril as first choice treatment of mild, moderate and severe essential hypertension: results of an open multicentre clinical trial. New Zealand Hypertension Study Group. 283 97

Lisinopril is a new, nonsulfhydryl angiotensin-converting enzyme inhibitor approved for the treatment of hypertension. After oral administration, 25-29 percent of the dose is absorbed intact; biotransformation is not required for pharmacological activity. Onset of action occurs one to two hours after administration, with effects still present 24 hours later. The major route of elimination is through renal excretion and an elimination half-life of 12.6 hours has been reported in normotensive individuals. In patients with impaired renal function (creatinine clearance less than or equal to 30 ml/min) a longer half-life and accumulation have been observed. Lisinopril 20-80 mg/d has been shown to be as effective as hydrochlorothiazide, nifedipine, and beta-blocking agents in the treatment of essential hypertension. Its efficacy in renovascular hypertension has also been demonstrated. In congestive heart failure (CHF) doses of 2.5-20 mg/d appear to provide hemodynamic effects comparable to those of captopril. Dizziness and cough have been the most frequently reported side effects; rash and proteinuria have also been reported in a small number of patients. Interactions with diuretics, potassium supplements, and possibly with nonsteroidal antiinflammatory agents may occur. Lisinopril appears to be similar in efficacy to other antihypertensive agents in the treatment of essential hypertension and to captopril in the treatment of CHF. Whether lisinopril is safer or more effective than captopril or enalapril in the treatment of hypertension or CHF requires further investigation. Prolonged duration of action of lisinopril allows once daily dosing, unlike captopril for which dosing is required every 8-12 hours or enalapril which may necessitate twice daily dosing.
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PMID:Lisinopril: a new angiotensin-converting enzyme inhibitor. 283 26

The chemistry, pharmacology, pharmacokinetics, clinical use, adverse effects, and dosage of lisinopril are reviewed. Lisinopril, a new nonsulfhydryl angiotensin-converting-enzyme (ACE) inhibitor, is absorbed in its active form. Like the other ACE inhibitors, it lowers peripheral vascular resistance, with a resultant decrease in blood pressure. Approximately 29% of lisinopril is absorbed after oral administration. No measurable metabolism occurs, and excretion is primarily renal. Accumulation of lisinopril occurs in patients with renal dysfunction; however, dosage adjustment is necessary only when the creatinine clearance is less than 30 mL/min. Lisinopril has been shown to be an effective antihypertensive agent at doses of 10 to 80 mg given once daily in patients with essential and secondary hypertension caused by renal artery stenosis. The effectiveness of lisinopril is comparable to that with diuretics, beta blockers, and calcium-channel antagonists. In patients who are unresponsive to maximal doses of lisinopril alone, addition of another antihypertensive agent may be beneficial. Limited information suggests that lisinopril may be comparable to captopril for the treatment of congestive heart failure. Adverse effects associated with lisinopril are relatively minor and are comparable to those associated with enalapril. Hematological abnormalities have not been reported with lisinopril. Class-related adverse effects include cough, azotemia, angioedema, hypotension, and hyperkalemia. Lisinopril appears to be comparable to other ACE inhibitors for the treatment of hypertension and may be as effective as its predecessors for the treatment of congestive heart failure. Further study is needed to better define a therapeutic niche for lisinopril.
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PMID:Lisinopril: a nonsulfhydryl angiotensin-converting enzyme inhibitor. 285 60


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