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 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

All currently available antihypertensive drugs can cause adverse drug reactions. Potential adverse drug reactions should already be taken into account when a new antihypertensive regimen is started. It is furthermore important to ask at follow-up visits specifically about common adverse reactions. The aims of this article are therefore to shortly summarise common and typical adverse drug reactions of antihypertensives. All antihypertensives may cause dizziness, hypotension, allergies, rashes, gastrointestinal complaints and dry mouth. Thiazide diuretics furthermore may cause electrolyte disturbances, dehydration and hyperuricemia, betablockers may cause bronchospasm, bradycardia, cold extremities and sleep disturbances and calcium antagonists may cause flushing, ankle oedema and gingival hyperplasia. Concerning potential lethal adverse drug reactions, it is important to know that ACE inhibitors and angiotensin receptor antagonists are contraindicated in all patients with a history of angioedema. However, angiotensin receptor antagonists are well-suited alternatives for patients with ACE inhibitor-induced cough or hypogeusia. Rare adverse drug reactions are commonly recognised only after drug approval based on spontaneous reporting. This demonstrates the importance of considering medications as potential causes of new complaints and symptoms and to reports such suspected adverse drug reactions to the national pharmacovigilance centres. Only the local or international accumulation of comparable spontaneous reports allows the drug regulation agencies to recognise new and unexpected adverse drug reactions early and to initiate appropriate measures.
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PMID:[Antihypertensives--which adverse drug reactions are clinically relevant?]. 1519 39

Although people age at different rates, changes to the composition of the human body are a hallmark of aging. As a result of such changes, disease can present differently in a person over 65 years old than it would in a younger adult or child. This article identifies the critical indicators of underlying conditions, including changes in mental status, loss of function, decrease in appetite, dehydration, falls, pain, dizziness, and incontinence. It also describes the presentation of diseases common to older adults, including depression, infection, cardiac disease, gastrointestinal disorders, thyroid disease, and type 2 diabetes.
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PMID:Presentation of illness in older adults. 1549 36

ALTHOUGH PEOPLE AGE at different rates, changes to the composition of the human body are a hallmark of aging. As a result of such changes, disease can present differently in a person over 65 years old than it would in a younger adult or child. THIS ARTICLE IDENTIFIES the critical indicators of underlying conditions, including changes in mental status, loss of function, decrease in appetite, dehydration, falls, pain, dizziness, and incontinence. It also describes the presentation of diseases common to older adults, including depression, infection, cardiac disease, gastrointestinal disorders, thyroid disease, and type 2 diabetes.
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PMID:Presentation of illness in older adults. If you think you know what you're looking for, think again. 1654 57

Heat stroke in athletes is entirely preventable. Exertional heat illness is generally the result of increased heat production and impaired dissipation of heat. It should be treated aggressively to avoid life-threatening complications. The continuum of heat illness includes mild disease (heat edema, heat rash, heat cramps, heat syncope), heat exhaustion, and the most severe form, potentially life-threatening heat stroke. Heat exhaustion typically presents with dizziness, malaise, nausea, and vomiting, or excessive fatigue with accompanying mild temperature elevations. The condition can progress to heat stroke without treatment. Heat stroke is the most severe form of heat illness and is characterized by core temperature >104 degrees F with mental status changes. Recognition of an athlete with heat illness in its early stages and initiation of treatment will prevent morbidity and mortality from heat stroke. Risk factors for heat illness include dehydration, obesity, concurrent febrile illness, alcohol consumption, extremes of age, sickle cell trait, and supplement use. Proper education of coaches and athletes, identification of high-risk athletes, concentration on preventative hydration, acclimatization techniques, and appropriate monitoring of athletes for heat-related events are important ways to prevent heat stroke. Treatment of heat illness focuses on rapid cooling. Heat illness is commonly seen by sideline medical staff, especially during the late spring and summer months when temperature and humidity are high. This review presents a comprehensive list of heat illnesses with a focus on sideline treatments and prevention of heat illness for the team medical staff.
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PMID:Heat-related illness in athletes. 1760 28

Studies have shown that beverages containing glycerol can enhance and maintain hydration status and may improve endurance exercise performance by attenuating adverse physiological changes associated with dehydration. Improvements to performance include increased endurance time to exhaustion by up to 24%, or a 5% increase in power or work. However, some studies have found no performance benefits during either prolonged exercise or specific skill and agility tests. In studies that have shown benefits, the improvements have been associated with thermoregulatory and cardiovascular changes. These include increased plasma volume and sweat rates, as well as reduced core temperature and ratings of perceived exertion. In a very small number of subjects, glycerol consumption has been associated with side-effects including nausea, gastrointestinal discomfort, dizziness, and headaches. In summary, while glycerol and fluid ingestion results in hyperhydration, the documented benefits to exercise performance remain inconsistent.
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PMID:Physiological and performance effects of glycerol hyperhydration and rehydration. 1994 15

A new hazard for adolescents is the negative health effects of energy drink consumption. Adolescents are consuming these types of drinks at an alarming amount and rate. Specific effects that have been reported by adolescents include jitteriness, nervousness, dizziness, the inability to focus, difficulty concentrating, gastrointestinal upset, and insomnia. Health care providers report that they have seen the following effects from the consumption of energy drinks: dehydration, accelerated heart rates, anxiety, seizures, acute mania, and strokes. This article is a comprehensive literature review on the health effects of energy drinks. Findings from this article indicate the need for educational intervention to inform adolescents of the consequences of consuming these popular drinks. School nurses are in a unique position to teach adolescents about the side effects and possible health issues that can occur when energy drinks are consumed.
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PMID:Energy drinks: a new health hazard for adolescents. 2053 66

The pharmacodynamics and pharmacokinetics of medications, their therapeutic and toxic effects are age dependant. In the treatment of old people polypharmacy is widely used. The most common results of polypharmacy are increased adverse drug reactions, drug-drug interactions. In this study the use of different medications at the Departments of General Medicine and Cardiology (Tbilisi Republic Hospital) was analyzed. The case histories (1995, 2000 and 2005) of 1708 patients were studied. It was found that in 2005 the number of 60 years and older patients has doubled comparably with 1995, but the number of 24-44 years old patients remained almost the same. The complication rate was higher in elderly as compared with younger patients. It was found that in treatment of elderly population hypotensive drugs, diuretics and cardiac glycosides are used excessively. In the case of excess use of antihypertension medications there is a big risk of developing arterial hypotension. In old people it may lead to orthostatic hypotension, in youth - to dizziness. The frequent use of diuretics in old people may be accompanied with dehydration and risk of developing thromb formation. Hyponatraemia, hypokalaemia, hypomagnesemia lead to heart rhythm disturbances and risk of glycoside intoxication. In old people the therapeutical doses of diuretics depend not only on their biological activity, but also on the ability of their absorption from the gastrointestinal tract, on the organism's resistance and in the case of repeated intake on their cumulation quality and extraction.
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PMID:Treatment characteristics in elderly. 2109 93

Orthostatic hypotension is defined as a decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing when compared with blood pressure from the sitting or supine position. It results from an inadequate physiologic response to postural changes in blood pressure. Orthostatic hypotension may be acute or chronic, as well as symptomatic or asymptomatic. Common symptoms include dizziness, lightheadedness, blurred vision, weakness, fatigue, nausea, palpitations, and headache. Less common symptoms include syncope, dyspnea, chest pain, and neck and shoulder pain. Causes include dehydration or blood loss; disorders of the neurologic, cardiovascular, or endocrine systems; and several classes of medications. Evaluation of suspected orthostatic hypotension begins by identifying reversible causes and underlying associated medical conditions. Head-up tilt-table testing can aid in confirming a diagnosis of suspected orthostatic hypotension when standard orthostatic vital signs are nondiagnostic; it also can aid in assessing treatment response in patients with an autonomic disorder. Goals of treatment involve improving hypotension without excessive supine hypertension, relieving orthostatic symptoms, and improving standing time. Treatment includes correcting reversible causes and discontinuing responsible medications, when possible. Nonpharmacologic treatment should be offered to all patients. For patients who do not respond adequately to nonpharmacologic treatment, fludrocortisone, midodrine, and pyridostigmine are pharmacologic therapies proven to be beneficial.
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PMID:Evaluation and management of orthostatic hypotension. 2188 4

Exercise-associated collapse (EAC) commonly occurs after the completion of endurance running events. EAC is a collapse in conscious athletes who are unable to stand or walk unaided as a result of light headedness, faintness and dizziness or syncope causing a collapse that occurs after completion of an exertional event. Although EAC is perhaps the most common aetiology confronted by the medical provider attending to collapsed athletes in a finish-line tent, providers must first maintain vigilance for other potential life-threatening aetiologies that cause collapse, such as cardiac arrest, exertional heat stroke or exercise-associated hyponatraemia. Previously, it has been believed that dehydration and hyperthermia were primary causes of EAC. On review of the evidence, EAC is now believed to be principally the result of transient postural hypotension caused by lower extremity pooling of blood once the athlete stops running and the resultant impairment of cardiac baroreflexes. Once life-threatening aetiologies are ruled out, treatment of EAC is symptomatic and involves oral hydration and a Trendelenburg position - total body cooling, intravenous hydration or advanced therapies is generally not needed.
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PMID:Exercise-associated collapse: an evidence-based review and primer for clinicians. 2194 22

There is increasing evidence that intraoperative fluid therapy decisions may influence postoperative outcomes. In the past, patients undergoing major surgery were often administered large volumes of crystalloid, based on a presumption of preoperative dehydration and nebulous intraoperative 'third space' fluid loss. However, positive perioperative fluid balance, with postoperative fluid-based weight gain, is associated with increased major morbidity. The concept of 'third space' fluid loss has been emphatically refuted, and preoperative dehydration has been almost eliminated by reduced fasting times and use of oral fluids up to 2 h before operation. A 'restrictive' intraoperative fluid regimen, avoiding hypovolaemia but limiting infusion to the minimum necessary, initially reduced major complications after complex surgery, but inconsistencies in defining restrictive vs liberal fluid regimens, the type of fluid infused, and in definitions of adverse outcomes have produced conflicting results in clinical trials. The advent of individualized goal-directed fluid therapy, facilitated by minimally invasive, flow-based cardiovascular monitoring, for example, oesophageal Doppler monitoring, has improved outcomes in colorectal surgery in particular, and this monitor has been approved by clinical guidance authorities. In the contrasting clinical context of relatively low-risk patients undergoing ambulatory surgery, high-volume crystalloid infusion (20-30 ml kg(-1)) reduces postoperative nausea and vomiting, dizziness, and pain. This review revises relevant physiology of body water distribution and capillary-tissue flow dynamics, outlines the rationale behind the fluid regimens mentioned above, and summarizes the current clinical evidence base for them, particularly the increasing use of individualized goal-directed fluid therapy facilitated by oesophageal Doppler monitoring.
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PMID:Intraoperative fluids: how much is too much? 2266 47


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