Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Presentation of drugs most worthy of interest in autumn 1995. Among these, the ACE inhibitors, the HMGCOA inhibitors, the Proton Pump inhibitors, the serotoninergics used against depression and migraine, the endobronchial corticoids and finally the ASA. Review of their successes, failures and uncertainties.
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PMID:[Leading drugs in 1995: success, failures and uncertainties]. 748 Dec 49

The alpha-agonist drug phenylephrine has been generally considered to be contraindicated in patients with heart failure for the reason that increased afterload produced by the vasoconstriction should decrease ventricular function; the beta-adrenergic blocking drugs generally have been considered to be contraindicated in heart failure because of the dependence of the failing heart on beta-sympathetic agonism; the angiotensin converting enzyme inhibitors have been indicted recently as causing undesirable cardiovascular depression in patients for coronary artery bypass surgery. Yet recently, phenylephrine has been shown to have positive cardiac inotropic effects in a variety of experimental preparations including intact humans; the beta-adrenergic blocking drugs have been shown to be therapeutically effective in treating patients with chronic congestive heart failure (CHF); and the "gold standard" for treating chronic CHF at present are the ACEI. Consequently, the clinician caring for patients with cardiac disease needs to reevaluate the use of classic drugs whose original pharmacological properties may either have changed because of advances in technology or may be producing effects that were unanticipated previously.
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PMID:New directions in the treatment of heart failure: some paradoxical observations. 757 51

Chronic heart failure (CHF) impairs endothelium-dependent vasodilatation of large conductance arteries. We investigated whether a similar reduction also occurs in small arteries, and whether such a reduction can be prevented by the angiotensin converting enzyme inhibitor perindopril (P) in a rat model of CHF (left coronary artery ligation). After 1 month treatment with placebo or P (2 mg/kg/day), rats were anesthetized and arterial pressure, left ventricular end-diastolic pressure, and central venous pressure were measured with a micromanometer. Segments of aorta and mesenteric artery (mean diameter, 281 +/- 8 microns) were then isolated, cannulated, and perfused at constant pressure using an arteriograph. Responses to increasing concentrations of acetylcholine (Ach), nitroprusside, and to 10(-4) mol/L NG-nitro-L-arginine methyl ester (L-NAME) were studied after preconstriction by phenylephrine. Heart failure resulted in a decrease in systolic and diastolic pressures, an increase in left ventricular end-diastolic and central venous pressures, and a significant depression of Ach-induced dilatation of the mesenteric artery (maximal dilatation, from 90 +/- 4% to 63 +/- 4%, P < .05) but not of the aorta (from 56 +/- 8% to 45 +/- 5%, NS) without any modification in the endothelium-independent vasodilatation induced by nitroprusside. In the group treated by the angiotensin converting enzyme (ACE) inhibitor perindopril, systolic and diastolic pressures were slightly decreased, whereas left ventricular end diastolic, central venous pressures, and the endothelium-dependent vasodilating response to Ach were normalized. Responses to L-NAME were not affected by CHF or perindopril. Perindopril also decreased hypertrophy, as evidenced by a significantly lower heart weight in treated rats.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prevention of endothelial dysfunction in small and large arteries in a model of chronic heart failure. Effect of angiotensin converting enzyme inhibition. 764 44

We investigated the redistribution of myocardial isoenzymes of creatine kinase (CK) and lactate dehydrogenase (LD) in rats with right heart failure induced by monocrotaline and assessed the effect of enalapril, an angiotensin converting enzyme inhibitor. Wistar rats were divided into four groups: (1) control (n = 20), (2) control + enalapril (25 mg/kg/day) (n = 22), (3) monocrotaline (50 mg/kg) (n = 45), (4) monocrotaline (50 mg/kg) + enalapril (25 mg/kg/day) (n = 32). After 4 weeks, the monocrotaline group developed severe pulmonary hypertension and right ventricular hypertrophy with marked decrease in myocardial norepinephrine and increase in both plasma atrial natriuretic peptide and mortality rate (33.3%). The marked decrease in both MM and mitochondrial CK ('creatine shuttle') and the relatively constant BB and MB CK caused the net depression of total CK. The depression of LD1 (aerobic LD) was remarkable compared with the relatively constant total LD. In the monocrotaline+enalapril group, mortality rate (9.4%), cardiac hypertrophy and plasma atrial natriuretic peptide were all significantly reduced and myocardial norepinephrine recovered although pulmonary hypertension was not improved at all. However, myocardial total, MM and mitochondrial CK and LD1 activities were all recovered completely or partially in this group. Thus, enalapril reduced cardiac hypertrophy and failure and improved the prognosis in this model of pulmonary hypertension. This beneficial effect of enalapril was not associated with pulmonary vasodepression but with the inhibition of myocardial isoenzyme redistribution of CK and LD, i.e. the preservation of 'creatine shuttle' and aerobic LD.
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PMID:Enalapril improves heart failure induced by monocrotaline without reducing pulmonary hypertension in rats: roles of preserved myocardial creatine kinase and lactate dehydrogenase isoenzymes. 772 99

Since the first reports of depressions associated with the use of reserpine, reports of affective syndromes related to the use of medications have proliferated in the literature. We chose to review controlled and uncontrolled studies, comprehensive reviews with comparisons of controlled studies, and case reports where sheer numbers indicated a relationship existed between affective syndromes and nonpsychotropic medications. Our findings suggest a relationship between the use of reserpine or lipophilic beta-blockers and depressive symptoms, but no clear evidence to support such a relationship with alpha-methyldopa, clonidine, calcium-channel blockers, or ACE-inhibitors. Glucocorticoids are related to both depressive symptoms and mania. Patients on anabolic steroids should be monitored for evidence of mania, rage, depression, and suicidality. There is no clear evidence that oral contraceptives are related to depressive symptoms. Our review does not support a close relationship between the use of H2 blockers, anticonvulsants, levodopa or antiarrhythmics, or antibiotics to affective syndromes.
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PMID:Critical review of data supporting affective disorder caused by nonpsychotropic medication. 790 78

We have previously shown that transdermal nitroglycerin may induce an increase in the activity of the adrenergic and the renin-angiotensin-aldosterone systems (SRAA) in patients with chronic stable angina pectoris (SA); when the activation of these systems is more pronounced, the antianginal effect of this drug seems to be reduced. The aim of this study was to evaluate the antianginal efficacy of transdermal nitroglycerin administration (TTS-NG 10 mg.24 h-1) in combination with an ACE inhibitor without sulphydryl groups (BNZ, benazepril 10 mg b.i.d.) in respect to placebo, or to TTS-NG or BNZ administered as monotherapy. Twenty-four patients (21M, 3F) were admitted to this multicentre, randomized, double-blind, latin square, placebo-controlled study. Patients received all the treatments (placebo, TTS-NG, BNZ and BNZ + TTS-NG) each for one week; at the end of each week patients performed two exercise tests 2 and 22 h post-dosing. Two hours post-dosing, exercise duration at 1 mm ST depression was significantly increased in respect to placebo during TTS-NG (P < 0.05) and TTS-NG + BNZ (P < 0.05) treatments. Two hours post-dosing, exercise duration at peak exercise was also increased in respect to placebo during TTS-NG (P < 0.05) and TTS-NG + BNZ (P < 0.05); 22 h post-dosing the increase in exercise duration was significant only during TTS-NG + BNZ treatment (P < 0.05) in respect to placebo, but not during TTS-NG given alone. Rate-pressure product at 1 mm ST depression was significantly increased 2 h post-dosing during TTS-NG treatment (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of transdermal nitroglycerin in combination with an ACE inhibitor in patients with chronic stable angina pectoris. 813 70

The LOMIR-MCT-IL study was designed to investigate the effects of different antihypertensive drugs on the quality of life (QoL) of men with mild-to-moderate hypertension. This report focuses on the subgroup of patients treated with the combination of the angiotensin converting enzyme (ACE) inhibitor captopril and the calcium antagonist isradipine. The LOMIR-MCT-IL was a double-blind multicenter, placebo-controlled, one-year follow-up study in which 368 hypertensive men, aged 40-65 years, were randomly allocated to receive either isradipine, methyldopa or placebo at three titration levels. If diastolic blood pressure (DBP) remained > 90 mmHg, captopril was added openly. The QoL evaluation introduced a qualitative self-structured subjective measure in addition to prestructured quantitative measures. The quality of life was assessed at baseline, after 6 months and at the end of the study. Methyldopa normalized DBP in 50% of patients when given as monotherapy and an additional 34% with the addition of captopril (84% total). With placebo, 36% normalized DBP and another 39% on addition of captopril (75% total) and, with isradipine, 64% normalized DBP and an additional 26% with added captopril (90% total). Assessment of QoL showed that both the placebo and the isradipine+captopril groups showed significant improvement in semantic memory after antihypertensive treatment. The isradipine+captopril group showed a clear tendency towards lower depression scores, better quality of sleep, better subjective evaluation of QoL and a more positive evaluation of personal life events in comparison to the other groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Does the combination of ACE inhibitor and calcium antagonist control hypertension and improve quality of life? The LOMIR-MCT-IL study experience. 820 97

Reduction of hypertension, whether systolic and diastolic or isolated systolic, is associated with significant reductions in mortality and morbidity rates even in older asymptomatic patients, particularly those less than 80 years old. The increased availability of antihypertensive preparations makes it possible to individualize the choice of therapy to meet the particular needs of the older patient. Although most presently available antihypertensive agents are effective, each one possesses different properties and none is free of side effects. We review the indications for and the action and side effects of diuretics, angiotensin converting enzyme inhibitors, calcium channel blockers, and adrenergic blocking drugs, and we offer treatment suggestions for hypertension associated with other diseases such as diabetes mellitus, heart failure, peripheral vascular insufficiency, depression, dementia, and urinary incontinence. Orthostatic hypotension is particularly serious in older patients because it may precipitate falls. It is also possible that the relationship between blood pressure levels and mortality and morbidity risks is not linear but J-shaped, both low and high levels increasing risks. Caution in treating hypertensive elderly patients will minimize the incidence of side effects.
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PMID:Management of hypertension in older patients. 821 49

Changes of ischemic myocardium following coronary occlusion, including active and passive functions, and adaptive changes of non-ischemic surviving myocardium have been summarized under the term "left ventricular remodeling" post myocardial infarction. An increase in left ventricular volume may be a consequence, and associated with an adverse prognosis. Although left ventricular dilatation may increase stroke volume and, thus, be compensatory at first, in about one-fifth of patients it ultimately results in progressive dysfunction and heart failure. Major determinants of this process are time, infarct size, infarct location, global left ventricular function assessed 4 days after infarction by radionuclide ejection fraction and right heart catheter (stroke volume), and morphology of the infarct-associated coronary artery. The surviving myocardium hypertrophies and may also dilate structurally. Depression of left ventricular ejection fraction chronically after the infarct is due to deterioration of wall motion of chamber segments initially classified normal by radionuclide analysis. Biochemical changes may also occur, including reduction of phosphocreatine, prolongation of time to peak Cai2+, and changes in myosin isoforms. Systemic or local humoral factors may be involved in these changes, however, clear evidence is still lacking. Perfusion of surviving myocardium may be altered under various conditions due to morphologic and functional changes of coronary vasculature. Successful prevention of heart failure and death by angiotensin converting enzyme inhibitors in asymptomatic patients with left ventricular dysfunction post-myocardial infarction has supported the pathophysiologic concepts of remodeling.
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PMID:Ventricular remodeling after myocardial infarction. Experimental and clinical studies. 835 28

Diseases of the respiratory organs comprise almost 4% of the adverse drug reactions reported to the Spontaneous Adverse Drug Reactions Center, SANZ (169 of the 4415 reports collected between 1981 and 1990). The most frequent reports were coughing caused by ACE inhibitors, attack of bronchial asthma induced by nonsteroidal anti-inflammatory drugs and beta-blocking agents, interstitial pneumopathy caused by amiodarone and sulfonamides, and respiratory depression due to benzodiazepines. The spontaneous reporting system does not allow one to determine the incidence, the reports are only of a signal-generating function. Classical semiology and special diagnostic techniques in assessing adverse drug reactions are discussed. A precise analysis of the case, temporal correlation with reaction and exposure time as well as comparisons with similar cases, together with a critical study of the literature on adverse drug reactions, remain the most important diagnostic procedures.
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PMID:[Drug side effects on the bronchi and lung]. 837 63


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