Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0012833 (dizziness)
 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nadolol (N) titrated from 80 to 240 mg or bendroflumethiazide (B) 5 to 10 mg, or the combination (B + N), were randomly assigned double-blind to 365 men with pretreatment diastolic blood pressures (BP) of 95 to 114 mm Hg. After 12 weeks of treatment, a diastolic BP of less than 90 mm Hg was achieved in 49% who received N, 46% who received B and 85% who received B + N. With N, the diastolic BP decreased more in whites than in blacks; with B, this racial trend was reversed. Side effects were infrequent; the most common were impotence, lethargy, weakness and postural dizziness, which occurred more often with B than with N. Addition of hydralazine, 25 to 100 mg twice daily, controlled diastolic BP at a level of less than 90 mm Hg in approximately 60% of those previously uncontrolled. N, and especially B + N, provided an efficacious once-daily treatment for systemic hypertension, and addition of hydralazine was effective in most nonresponders.
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PMID:Efficacy of nadolol alone and combined with bendroflumethiazide and hydralazine for systemic hypertension. 635 51

100 diabetic patients who were newly referred to our hospital and 50 normal controls received 1) physical and chemical examinations, 2) a self-rating depression score (SDS), and 3) an examination consisting of 18 questions to detect subjective neuropathic symptoms. Many more neuropathic symptoms were found in diabetics than in normal controls; these symptoms included pain and numbness of the extremities, cold sensation, dizziness, constipation, impotence and sweating disorders. Few patients with neuropathic symptoms, however, exhibited neurological findings (tendon reflex, sensory disturbance or dorsal pulsation) or blood glucose control measured by HbA1. The likelihood of symptoms in the feet or in the urogenital tract increased with the duration of diabetes mellitus. Diabetics were significantly more depressive than normal controls shown by the result of SDS.
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PMID:The prevalence of neuropathic symptoms in diabetic patients newly referred to our hospital. 668 May 20

More than 1200 patients who received pindolol for the treatment of hypertension, angina pectoris, and various arrhythmias in studies conducted in the United States were included in the New Drug Application submitted to the FDA. Nearly 1000 of these patients received pindolol as monotherapy. The side effects reported were generally transient and of mild or moderate severity. The most frequently reported side effects seen after pindolol administration, compared to those seen after placebo, were in decreasing order of incidence: headache, dizziness, insomnia, muscle pain, fatigue, weakness, nervousness, joint pain, edema, nausea, and muscle cramps. Other side effects that occurred more frequently with pindolol than with placebo but at a rather low incidence induced weight gain, bizarre dreams, visual disturbances, lethargy, and diarrhea. Nasal congestion, throat discomfort, nocturia, impotence, pruritus, anxiety, hypotension, bradycardia, and heart failure occurred only rarely. Of the 323 patients who received pindolol alone for the treatment of mild to moderate hypertension, only 20 (6.2%) were withdrawn from the study because of side effects. Overall, 3.4% of the patients treated with pindolol were withdrawn because of side effects, most of which involved the central nervous system, that is, insomnia, anxiety, dizziness, and headache. However, a few patients manifested some edema and weight gain while receiving pindolol alone. Review of the side effects data did not reveal a tendency for the incidence of side effects to be dose related. One placebo-controlled, double-blind study designed to evaluate the fixed dosages of 15, 30, and 60 mg in the treatment of mild to moderate hypertension suggested that only the incidences of insomnia and nervousness increased with increasing doses. However, these side effects were generally transient and of mild or moderate severity. The evidence indicates that pindolol has an acceptable safety profile and that any side effects that appear are generally well tolerated and disappear with continued treatment.
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PMID:Adverse reactions to pindolol administration. 704 82

Eighty-seven patients with intractable hypertension received minoxidil for a mean duration of 27 months (range three months to five years). A significant reduction in mean outpatient blood pressure from 206/129 to 158/98 mmHg (p less than 0.001 for both systolic and diastolic values) was recorded after one month's treatment. In 26 patients who received minoxidil for four or more years a further reduction in mean blood pressure to 147/89 mmHg was achieved. The mean daily dose of minoxidil was 23 mg (range 2.5 to 60 mg). In all patients a beta adrenergic neurone blocker and a diuretic were prescribed with minoxidil to counteract tachycardia and fluid retention. Thirteen patients required the addition of a fourth hypotensive agent. The use of minoxidil led to simpler drug regimens with the majority of patients well controlled on twice daily or once daily schedules. Most patients commented spontaneously on a feeling of improved wellbeing while taking minoxidil which also appeared to be relatively free from side effects commonly encountered with other hypotensive drugs, particularly drowsiness, dizziness and impotence. Fluid retention of 7 kg or more occurred in 18 patients, more commonly in those with renal impairment, but could be controlled by increasing the dose or potency of diuretics. Four patients with end stage renal failure and one patient with normal renal function developed pericardial effusions. Hirsutism was universal and limited the usefulness of the drug in women. We currently recommend minoxidil for hypertensive men who diastolic blood pressure remains greater than or equal to 110 mmHg despite an adequate trial of a beta adrenergic neurone blocker, diuretic and an additional drug, or for patients who find the side effects of such therapy intolerable.
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PMID:Minoxidil in the management of intractable hypertension. 730 17

Guanabenz, a centrally acting antihypertensive (alpha-agonist) that does not induce secondary sodium retention or other metabolic disturbances, was evaluated for up to two years at 19 investigational sites. In 329 patients completing six months of therapy, the mean supine diastolic blood pressure (SDBP) fell from 101 to 90 mmHg (P less than 0.01). Clinically significant individual SDBP decreases occurred in 74% of the patients by week 2, and these reductions were maintained in 72% at six months. Mean weight was reduced 1.4 lb (P less than 0.01), and mean supine pulse rate was decreased 5 beats/min (P less than 0.01). The most frequent effective doses were 8 and 16 mg BID (range, 2 to 32 mg BID). Principal side effects, usually mild, were sedation (31%), dry mouth (24%), dizziness (6%), and weakness (6%). Postural hypotension, impotence, and abrupt discontinuation symptoms were rare or absent. There were no clinically significant drug-related laboratory changes other than a 10 mg/100 ml mean serum cholesterol decrease. Two hundred twenty-two patients completed one year of therapy, and 80 completed two years, with little change in any parameters other than improvement in mean SDBP to 85 mmHg and in individual response rate to 84%. These results suggest that guanabenz is safe and effective for initial and sole therapy of hypertension.
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PMID:Long-term therapy of hypertension with guanabenz. 730 37

Timolol has become so populat with ophthalmologists that it is prescribed 44% of the time when an anti-glaucoma drop is needed. This popularity is due to its newness and the publicity it has received, its effectiveness in most types of glaucoma, and the apparent scarcity of side effects. This paper looks at the first 489 patients treated with timolol at Wills Eye Hospital and the side effects encountered. These include blurring of vision, burning and pain, bradycardia and heart failure, hallucinations, dilated pupils, headaches, dizziness, hypotony, allergy, asthma, impotence, drowsiness, anxiety, emotional lability, and nausea.
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PMID:The place of timolol in the practice of ophthalmology. 740 91

The purpose of this study was to evaluate the effects of the alpha 1-blocking agent terazosin on blood pressure (BP) and blood lipids in a large, variant population of patients with hypertension. A total of 16,917 patients with hypertension were evaluated at 2214 primary and community care facilities; 7808 of these patients had not been treated previously for hypertension; 3928 were switched to terazosin from another antihypertensive agent; and 5181 received terazosin in addition to an agent that had not controlled their hypertension. Terazosin produced highly significant reductions in systolic (-18.2 +/- 0.2 mm Hg) and diastolic (-13.2 +/- 0.1 mm Hg) BP when used as monotherapy (mean dose, 3.1 mg; range, 2 to 10 mg) without causing a significant increase in heart rate. Equal antihypertensive efficacy was demonstrated in men, women, blacks, and whites of all ages, with particular benefit to elderly patients (> or = 65 years of age) with systolic hypertension. Comparative studies indicated that terazosin had equal antihypertensive efficacy in combination with diuretics, beta-blockers, calcium channel blockers, and angiotensin-converting enzyme (ACE) inhibitors. Patients who had not responded to monotherapy with one of these classes of antihypertensive drugs showed significant reductions of BP after terazosin, in the following average doses, was added to diuretics, 3.1 mg; beta-blockers, 3.4 mg; calcium channel blockers, 3.3 mg; and ACE inhibitors, 3.4 mg. Terazosin produced highly significant reductions in blood levels of total cholesterol (-5.0%), triglycerides (-6.1%), and low-density lipoprotein cholesterol (-7.6%) without change in high-density lipoprotein cholesterol when used as monotherapy. Similar favorable effects on blood lipid levels were demonstrated when terazosin was used in combination with all other classes of antihypertensive drugs. The greatest reductions in blood cholesterol (-9.2%) were observed among patients with hyperlipidemia (total cholesterol > or = 240 mg/dL). Terazosin maintained its antihypertensive efficacy and was well tolerated by patients with a variety of concomitant diseases, including congestive heart failure, peripheral vascular disease, chronic obstructive pulmonary disease, benign prostatic hyperplasia, diabetes, and obesity. Adverse effects occurred in 17.9% of patients and caused 2.2% to drop out of the study. The most frequent adverse effects were dizziness (4.8%), headache (2.5%), and asthenia (2.4%). Only 0.4% suffered syncope and 0.2% impotence. These data demonstrate the usefulness of terazosin as monotherapy or add-on therapy for treatment of hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Alpha 1-blockade for the treatment of hypertension: a megastudy of terazosin in 2214 clinical practice settings. 792 16

A 67-year-old man with SIADH complicated by slowly progressing autonomic failure was described. The patient noticed constipation at the age of 57. In the following years, he suffered from urinary incontinence, depletion of sweating, impotence, sleeplessness with snore, and dizziness while walking. Physical examination revealed a masked oily face with slight cerebellar disturbance. Abnormality of autonomic function tests was recognized and he was diagnosed as Shy-Drager syndrome with gradually progressing, diffuse autonomic failure accompanied by slight cerebellar ataxia and Parkinsonism. Both serum sodium level and plasma osmotic pressure were reduced, whereas daily sodium excretion was more than 100mEq and urinary osmolality was about 500mOsm/kgH2O. His renal function was intact, and the adrenocortical and thyroid hormone levels were normal, then criteria of SIADH was fulfilled. SIADH was thought to have occurred on the basis of Shy-Drager syndrome. Water load test showed failure of adequate water diuresis, but intravenous phenytoin administration following the water load test ameliorated the diuresis to normal. The relationship between plasma osmolality and the ADH response indicates that ADH was adequately secreted in response to the increase in plasma osmolality but not suppressed in response to the decrease in plasma osmolality below 280mOsm/kgH2O. These results suggest that ADH synthesis in the hypothalamus and its secretion from the pituitary gland were both intact. The response of ADH secretion to the orthostatic hypotension induced by head-up tilt was quite blunted, being compatible with Shy-Drager Syndrome. Sleep disturbance was studied by polysomnography and laryngoscopy, and was revealed to be based upon severe sleep apnea due to incomplete paralysis of the bilateral vocal cords. Sleep apnea due to vocal cord paralysis is sometimes found to be complicated in patients with multiple system atrophy (MSA) including Shy-Drager syndrome, and is known as Gerhardt syndrome. This is the first report on a case of Shy-Drager syndrome complicated with SIADH and bilateral vocal cord paralysis. In this case, SIADH is caused by impaired afferent pathways from baroreceptors to the hypothalamus, which transfer inhibitory stimuli on ADH secretion. It is suggested that Shy-Drager syndrome should be considered one of the causes of SIADH.
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PMID:[A case of Shy-Drager syndrome complicated with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and incomplete paralysis of bilateral vocal cords]. 795 87

Autonomic nervous function was assessed in twenty two patients (16 males and 6 females) with chronic renal failure on conservative management. The presenting symptoms were postural dizziness in 10(45%), impotence in 4(18%) patients and 1 patient each with diplopia, urinary urgency and nocturnal diarrhoea. The following autonomic function tests were performed; valsalva manoeuvre, heart rate response to deep breathing, heart rate response to posture and postural change in blood pressure. Fifteen (68%) patients had abnormal autonomic function tests. Out of these patients, 14(93%) had abnormalities of the parasympathetic system and only one had abnormalities in the sympathetic system. There was a negative correlation between the creatinine levels and the following; valsalva ratio (r = -0.72 p < 0.001), heart rate response to standing (r = -0.56 p < 0.01) and heart rate response to deep breathing (r = -0.45 p < 0.05).
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PMID:Autonomic nervous function in patients with chronic renal failure at the Kenyatta National Hospital. 806 74

Sympathetic skin response (SSR) and R-R interval variation (RRIV) were studied in 36 chronic, nondiabetic uremics to compare with their nerve conduction studies (NCS) and clinical dysautonomia. Abnormal SSR was noted in 5 (13.9%) patients, abnormal RRIV in 14 (38.9%), and abnormal NCS in 26 (72.2%). The patients were classified into three groups: group (GP) 1: "normal," n = 21 (58.3%), normal RRIV and SSR; GP 2: "isolated parasympathetic dysfunction," n = 10 (27.8%), abnormal RRIV and normal SSR; and GP 3: "sympathetic sudomotor dysfunction," n = 5 (13.9%), abnormal SSR. A significant difference in age was found among the three groups (GP 3 > GP 2 > GP 1; P < 0.0001, ANOVA). After controlling the age factor, we still noted a tendency toward increasing NCS disturbances (distal latency and nerve conduction velocity of peroneal nerve; P < 0.05, multiple regression analysis) and frequencies of clinical autonomic symptoms (postural dizziness and impotence; P < 0.05, Mantel-Hanszel test) from GP 1 to GP 3. Patients with abnormal SSR (GP 3) displayed significantly higher frequencies of postural dizziness and impotence, indicating the relationship between an absence of SSR and clinical dysautonomia.
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PMID:Sympathetic skin response and R-R interval variation in chronic uremic patients. 817 Apr 87


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