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)

Because of the close anatomic and physiologic relationship between the heart and lungs, patients with chronic obstructive lung disease are at special risk of arrhythmias. Effective therapy hinges on identifying the mechanisms of the arrhythmias--hemodynamic, metabolic, or drug-induced. Impulsive use of antiarrhythmic agents may result only in a more complex and dangerous rhythm disorder. Extremes of pH are a major cause of arrhythmias in these patients. Respiratory alkalemia usually originates with inappropriate ventilation, often during mechanical respiration, while metabolic alkalemia generally can be traced to diuretic or bicarbonate therapy. Lidocaine or diphenylhydantoin are of little use, since the alkaline pH inside and outside heart muscle cells hampers drug distribution and activity. At the other extreme, the arrhythmias of acidemia strike patients who have severe respiratory failure with carbon dioxide retention or severe cardiac failure with shock and lactic acidemia. Arrhythmias may develop if vagal restraint is lost, which is especially likely in patients with potassium depletion. Irritant receptors along the bronchopulmonary tree can trigger arrhythmias if stimulated by cough, microembolism, or mechanical irritation, which is a hazard with endotracheal or tracheostomy tubes.
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PMID:Mechanisms of arrhythmias in chronic obstructive lung disease. 1 Feb 30

Pseudoephedrine hydrochloride (I), brompheniramine maleate (II), and dextromethorphan hydrobromide (III) in a cough-cold sytup were separated and determined by ion-pair reversed-phase high-pressure liquid chromatography. The separation was carried out using a muBondapak C18 column (30 cm x 3.9 mm i.d.) and a mobile phase of acetonitrile-water-acetic acid (40:60:1) with 0.01 N 1-octanesulfonic acid sodium salt and 0.05 N potassium nitrate. Detection was accomplished using a UV detector at 265 nm for I and II; III was monitored at 280 nm. Concentration versus peak height plots in the ranges of 0.37-1.9 mg/ml for I, 0.025-0.126 mg/ml for II, and 0.125-0.625 mg/ml for III were linear. Ten consecutive injections of a mixture gave a percent relative standard deviation of less than 1% for all three components. Average recoveries from laboratory-prepared samples were 100.5% for I, 100.9% for II, and 100.1% for III. No precolumn cleanup was necessary, and the chromatogram was complete in 16 min.
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PMID:Ion-pair reversed-phase high-pressure liquid chromatography of cough-cold syrups I: pseudoephedrine hydrochloride, brompheniramine maleate, and dextromethorphan hydrobromide. 51 4

Colorimetric methods for the quantitative determinations of chlorpheniramine maleate, ephedrine hydrochloride, and guaiacolsulfonate potassium in a cough syrup containing color (amaranth) are reported. Chlorpheniramine maleate can be assayed using the cyanogen bromide method as reported in the literature. Ephedrine hydrochloride can be assayed using a dye method in which interference from chlorpheniramine maleate is taken into consideration. Guaiacolsulfonate potassium can be assayed by coupling it with 4-aminoantipyrine (the method is similar to the one for phenylephrine hydrochloride). All of the methods are simple, accurate, and precise. The application of the guaiacolsulfonate potassium assay method to commercial dosage forms is reported.
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PMID:Colorimetric determinations of chlorpheniramine maleate, ephedrine hydrochloride, and guaiacolsulfonate potassium in a cough syrup. 120 96

The angiotensin converting enzyme (ACE) inhibitors are a group of effective drugs with a unique mechanism of action. These drugs have proven to be useful for hypertension and congestive heart failure. Early clinical trials of captopril used doses that are now known to be inappropriately high, and dose-related adverse effects were observed frequently. The recognition that lower doses are effective has reduced the incidence of adverse reactions and resulted in improved patient tolerance. When patients are properly selected and correctable risk factors are removed, serious side effects are uncommon. Unfortunately, the early reputation of nephrotoxicity persists, as does the belief that significant blood dyscrasias, endocrine effects and rash are serious risks for the average patient. After wide use of captopril, enalapril and lisinopril, and investigational trials of nearly a dozen newer agents, a sufficiency of clinical observation, experimental evidence and accurate postmarketing recording of events is accumulating to allow insight into the major toxicities with regard to more intelligent patient selection, more rational dosing and proper identification of risk factors. The most common adverse reactions are cough and skin rash. It appears that the agents are generally not cross-reactive with regard to skin rash, although it is not clear whether this effect is drug-specific or class-specific with regard to cough. Statistically but not clinically significant lowering of haemoglobin and hematocrit is common; these effects are inconsequential in most patients. Neutropenia, once thought to be prevalent, now appears to be so only in patients with autoimmune or collagen-vascular disease; the majority of patients outside these groups are at low risk. Hyperkalaemia is a frequent occurrence. This should not be surprising in view of the effect of the ACE inhibitors on plasma aldosterone. When dietary potassium intake is regulated and sources of altered potassium excretion are identified, hyperkalaemia is seldom a serious problem. Identification of sodium and water deficits allows correction before the drugs are started, and the frequency of hypotension and hyperkalaemia caused by the drugs is quite low if these factors are properly managed. An unexpected finding emerging in recent years is the dry cough associated with ACE inhibitor therapy. Its mechanism is not definitely known. Nonsteroidal anti-inflammatory drugs may control this symptom in some patients. The frequent observation of proteinuria in patients taking ACE inhibitors has gained notice and sometimes caused undue alarm. It is difficult to separate disease effects in diabetes and hypertension from true drug effects.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Adverse effects of angiotensin converting enzyme (ACE) inhibitors. An update. 153 95

A total of 930 patients have been evaluated for safety in a programme of clinical trials for lisinopril-hydrochlorothiazide combination treatment. Combination therapy with these two agents is generally well tolerated. In clinical trials, adverse experiences in patients treated with a lisinopril-hydrochlorothiazide combination were dizziness (7.5%), headache (5.2%), cough (3.9%), fatigue (3.7%), orthostatic effects (3.2%), diarrhoea (2.5%), nausea (2.2%) and upper respiratory tract infection (2.2%). Withdrawals from treatment have been relatively infrequent comprising dizziness (0.8%), headache (0.3%), cough (0.6%), fatigue (0.4%), diarrhoea (0.2%), orthostatic effects and nausea (0.1% each). The most common laboratory adverse experiences in patients on therapy with the lisinopril-hydrochlorothiazide combination are: increases in serum glucose, triglycerides, uric acid, serum creatinine, blood urea nitrogen and blood urea; and decreases in serum potassium. However, in individual controlled studies, the addition of lisinopril to treatment with hydrochlorothiazide results in attenuation of some of the potentially adverse metabolic affects of the diuretic. Adverse experiences in the patients treated for periods of 50 weeks or more, the elderly and the renally impaired are similar to those seen in the total population. Overall the available data indicate that a fixed dose combination of lisinopril-hydrochlorothiazide is a well-tolerated therapeutic option in patients with mild-to-moderate hypertension.
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PMID:Review of international safety data for lisinopril-hydrochlorothiazide combination treatment. 166 80

Bacterial endocarditis of the tricuspid valve was diagnosed in a cow with weight loss, reduced milk production, and intermittent fever. Clinical signs of disease included jugular and mammary vein pulses, tachycardia, large cardiac silhouette, and grade-III/V holosystolic murmur. The diagnosis was also supported by echocardiographic findings and isolation of Streptococcus viridans from blood samples. The cow was treated with penicillin, furosemide, acetylsalicylic acid, heparin, and potassium chloride and survived 14 months after the diagnosis, producing 1 live calf and 4 viable embryos. The cow's heart rate exceeded an upper normal limit of 80 beats/min during most of the initial 4 months of treatment. Additional clinical signs of disease that were observed during treatment included diarrhea, ventral edema, and coughing. General medicine and cardiology textbooks have previously minimized the potential benefits of anticoagulant use in cases of septic endocarditis. The advent of routinely performed embryo transfer procedures may make treatment of endocarditis feasible in cattle with exceptional genetic merit.
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PMID:Endocarditis in a cow. 191 33

During a 2-year period from January 1988 to December 1989, 125 patients (68 boys, 57 girls), aged 30 days to 9 years, were diagnosed as rotavirus gastroenteritis at this hospital. Diagnosis was made by identification of the rotavirus antigen in stool samples by latex agglutination assay. Ninety-nine (79.2%) of them were under 2 years of age. The seasonal peak in incidence was from January to March. The most common clinical characteristics were watery diarrhea (100%), followed by vomiting (68.8%), fever (68.0%), cough (42.4%), rhinorrhea (17.6%), convulsions (6.4%) and moderate to severe dehydration (1.6%). Fecal occult blood was positive in 4 patients and fecal leukocytes were positive in one patient. Stool cultures revealed concomitant infections with enteropathogenic Escherichia coli in 4 patients. Of the 106 patients who underwent serum electrolyte examinations, serum sodium concentrations ranged from 135-145 meq/L in 81.9% (86/106) and serum potassium concentrations ranged from 3.5-5.0 meq/L in 86.8% (92/106). Leukocyte counts greater than 15,000/mm3 were found in 10.8% (13/120) of the patients. All 125 patients recovered from the diarrheal illness on follow-up. Our results showed a different seasonal distribution of this disease from that of a previous observation between 1983-1984 in Taipei City and provides original clinical information on rotavirus gastroenteritis in children living in an area of Taipei County. Using the simple and rapid latex agglutination assay, we can make early diagnosis of rotavirus gastroenteritis. Thus, early treatment and early isolation of patients to prevent nosocomial infection among hospitalized patients is possible.
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PMID:Rotavirus gastroenteritis in children: a clinical study of 125 patients in Hsin-Tien area. 206 88

Angiotensin converting enzyme (ACE) inhibitors are becoming increasingly used in the treatment of hypertension. Although they are generally well tolerated, they have been implicated in the occurrence of certain side effects such as cough, hypotension and deterioration of renal function. These have been investigated prospectively during the development of perindopril. In a long term study in 632 hypertensive patients 6% of subjects stopped treatment prematurely because of adverse events and cough was the side effect most frequently responsible for treatment withdrawal (1.3%). A typical ACE inhibitor-induced cough was seen in a further 1.6% of patients. Symptomatic hypotension was rarely reported (0.2%), even in the elderly and patients with congestive heart failure. No clinically significant changes in plasma creatinine or potassium levels were seen during the long-term administration of perindopril in uncomplicated hypertensive patients. The overall safety profile of perindopril in clinical studies was favourable even in groups of more vulnerable patients. However the effect of long-term treatment with ACe inhibitors on cardiovascular morbidity and mortality is unknown.
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PMID:The safety and acceptability of perindopril. 228 54

Cystic fibrosis (CF) is the most common inherited fatal disorder among Caucasians. Bronchial mucus in CF contains more potassium and less sodium, which may be due to increased sodium absorption, resulting in a reduced airway water content. We studied 23 patients with CF after inhalation of normal saline or amiloride (10(-3) M), a sodium transport blocker. Mucociliary clearance (MC) and cough clearance (CC) were determined with a gamma camera that traced the movement of 99mTc-labeled, hardened erythrocytes over a 1-h period after the patients inhaled these particles as an aerosol. Before and after each investigation pulmonary function tests (PFT) and blood pressure (BP) were measured. Sputum thread formation was measured by means of a filancemeter. Six of the patients also completed a 3-wk trial of amiloride inhalation therapy. MC increased significantly (p less than 0.001) after acute amiloride inhalation (bronchial deposition, 0.07 mg amiloride) compared with that in the saline control. CC also increased, but not as much as MC. After 3 wk of amiloride inhalation (2 times a day) clearance values (both MC and CC) were markedly enhanced (p less than 0.01); after a similar period of saline inhalation, clearance values were not different from baseline. Sputum filance values also decreased significantly after amiloride inhalation. There were no adverse effects of the amiloride inhalation compared with saline. We conclude that amiloride inhalation administered as a single dose or as long-term therapy is able to increase MC and CC in CF airways and that the effect of 10(-3) M amiloride inhalation on MC lasts at least 40 min. (ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Acute and long-term amiloride inhalation in cystic fibrosis lung disease. A rational approach to cystic fibrosis therapy. 231 93

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


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