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)

Renal insufficiency was not shown to affect the pharmacokinetics of terazosin in fifteen patients receiving oral terazosin (1 mg once daily) for two weeks. Five patients had normal renal function (creatinine clearance 80 ml per minute or more), five had moderate renal insufficiency (creatinine clearance 30 to 79 ml per minute), and five had severe renal insufficiency (creatinine clearance 10 to 29 ml per minute). Urine and blood samples were collected, and blood pressure and pulse rate were determined on days one and 15 of the study. Renal insufficiency had no significant effect on the absorption lag time, rate of absorption, rate of elimination in the urine, volume of distribution, or plasma clearance of terazosin. The plasma half-life of terazosin in patients with normal renal function was 10.0 hours, compared with 8.4 hours in patients with moderate renal insufficiency and 9.8 hours in the group with severe renal insufficiency. There was also no apparent relationship between renal insufficiency and the maximum change in blood pressure or pulse rate. Renal excretion was found to play a minor role in the elimination of terazosin, and this explains the lack of a relationship between renal insufficiency and the pharmacodynamics of terazosin. After the administration of terazosin on day 1 of the study, 1.6 +/- 0.3 percent and 5.1 +/- 1.4 percent of the total dose was excreted in the urine of patients with severe renal insufficiency and normal renal function, respectively. Adverse experiences were reported by four patients and caused one patient to withdraw from the study. Symptoms reported included gastralgia, headache, dizziness, malaise, weakness, and palpitations. The results of this study indicate that terazosin may be safely administered to patients with renal insufficiency without altering the usual dosing regimen.
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PMID:Influence of renal insufficiency on the pharmacokinetics and pharmacodynamics of terazosin. 287 15

Blood pressure, which ist the product of cardiac output and peripheral vascular resistance is regulated by a complex feedback mechanism involving the sympathetic and parasympathetic systems and hormones. An acute disturbance of regulation may lead to a life-threatening increase in blood pressure. Diagnosis is based upon a careful measurement of blood pressure, which must be performed under internationally standardized conditions. Hypertensive crisis refers to a rapid blood pressure increase greater than 30 mmHg above the age-related 95th percentile. The main causes of hypertension in childhood are renal diseases, which may be aggravated by additional conditions either by the clinician himself (e.g. cyclosporin, steroids) or by the patient (lack of compliance). Crisis affects the brain (hypertensive encephalopathy), the heart (left ventricular insufficiency), the retina (visual disturbances) and the mucous membranes (epistaxis). Hypertensive encephalopathy is induced by a break-through of the autoregulation of brain flow, leading to hyperperfusion and, thus to cerebral oedema. The clinical manifestations are characterized by restlessness, severe and diffuse headache, vomiting, nystagmus, impaired vision, dizziness, paraesthesia, seizures and palsies, which may lead - if untreated - to coma and death. The course is usually prolonged and reversible by adequate treatment. The morphological consequences are purpura cerebri, fresh retinal haemorrhages and papillary oedema, apart from left ventricular dilatation and hypertrophy. The diagnostic procedure rests on the quick realization of essential anamnestic (blood pressure, renal disease, drugs), clinical (oedema, cardiac action, central nervous system, fundus) and laboratory parameters (serum creatinine, electrolytes, glucose, blood count, urine). Treatment should start before the manifestation of clinical signs (hypertensive emergency) with rapidly acting antihypertensive drugs.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The hypertensive crisis in childhood]. 305 87

Benzoate and phenylacetate improve prognosis in inherited urea cycle enzyme deficiencies by increasing waste nitrogen excretion as amino acid acylation products. We studied metabolic changes caused by these substances and their pharmacokinetics in a biochemically different urea cycle disorder, lysinuric protein intolerance (LPI), under strictly standardized induction of hyperammonemia. Five patients with LPI received an intravenous infusion of 6.6 mmol/kg L-alanine alone and separately with 2.0 mmol/kg of benzoate or phenylacetate in 90 min. Blood for ammonia, serum urea and creatinine, plasma benzoate, hippurate, phenylacetate, phenylacetylglutamine, and amino acids was obtained at 0, 120, 180, and 270 min. Urine was collected in four consecutive 6-h periods. Alanine caused hyperammonemia: maximum increase 107, 28-411 microM (geometric mean, 95% confidence interval); ammonia increments were nearly identical after alanine + benzoate (60, 17-213 microM) and alanine + phenylacetate (79, 13-467 microM) (NS). Mean plasma benzoate was 6.0 mM when extrapolated to the end of alanine + benzoate infusions; phenylacetate was 4.9 mM at the end of alanine + phenylacetate. Transient toxicity (dizziness, nausea, vomiting) occurred in four patients at the end of combined infusions, and we suggest upper therapeutic plasma concentrations of 4.5 mM for benzoate and 3.5 mM for phenylacetate. Benzoate and phenylacetate then decreased following first-order kinetics with t1/2S of 273 and 254 min, respectively. Maximal plasma hippurate (0.24, 0.14-0.40 mM) was lower than maximal phenylacetylglutamine (0.48, 0.22-1.06 mM, p = 0.008).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Waste nitrogen excretion via amino acid acylation: benzoate and phenylacetate in lysinuric protein intolerance. 309 49

Carotid body tumors (CBTs) are rare, usually benign, neoplasms of the extra-adrenal paraganglion system. They are almost always nonfunctional. The diagnosis is generally confirmed by an angiogram that shows a vascular tumor enlarging the space between the internal and external carotid arteries. A 55-year-old man with hypertension and episodes of flushing, palpitations, and dizziness was treated for a firm, nonmobile mass measuring 3 x 2 cm at the left carotid bifurcation. Plasma and urine catecholamines, and the vanilylmandelic acid/creatinine ratios were elevated. Carotid arteriograms showed a vascular mass displacing the vessels, but the space between the arteries was narrowed rather than enlarged, and an atherosclerotic plaque was present. At operation the CBT was removed by resection of the bifurcation and with a temporary shunt a saphenous vein graft was inserted between the common and internal carotid arteries. Pathologic examination revealed a typical paraganglionoma. Although most CBTs produce catecholamines, only 11 patients have been reported to have elevated plasma and urine levels, and most were symptomatic. Since these tumors slowly increase in size, early surgical removal is recommended, even in asymptomatic patients.
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PMID:Carotid body tumor: atypical angiogram of a functional tumor. 333 80

In patients with portal hypertension and tense ascites, large-volume paracentesis improves patient comfort and may improve systemic hemodynamics. However, it has been avoided in nonedematous patients because of concern for complications, including intravascular volume depletion. In this study, 12 nonedematous patients with chronic liver disease, portal hypertension and tense ascites underwent 14 large-volume (5-liter) paracenteses for the relief of discomfort and/or respiratory distress. Plasma volume was measured directly by a dilution method with 125I-labeled human serum albumin prior to and at 24 or 48 hr after 13 of the paracenteses. All patients felt better postparacentesis. No dizziness, hypotension, tachycardia, encephalopathy or change in mean serum sodium, creatinine or blood urea nitrogen occurred. Two patients experienced a decrease in hematocrit, which was not explained by blood loss or increase in plasma volume. Mean plasma volume was 3,713 +/- 129 ml (55.1 +/- 1.5 ml per kg ideal body weight) preparacentesis and 3,684 +/- 136 ml postparacentesis, the difference being -0.78% (p = 0.48, NS). Our results suggest that 5-liter paracentesis in nonedematous patients with tense portal hypertension-related ascites improves patient comfort and is not associated with a decrease in measured plasma volume.
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PMID:Large-volume paracentesis in nonedematous patients with tense ascites: its effect on intravascular volume. 335

The impact of industrial toluene exposure was assessed in 262 male employees of two Danish photographic printing plants. The study involved assessment of acute and chronic exposure based on a scoring system, standardised questions, measurement of blood pressure, pulmonary functions, and the plasma concentrations of urate, creatinine, creatine kinase, alanine-aminotransferase, FSH, LH, testosterone, sexual hormone binding globulin, thyroxine, triiodothyronine, and cortisole (following synacthen). The potentially confounding factors: age, weight, height, alcohol consumption and tobacco smoking were included in statistical analysis which showed that systolic blood pressure (p less than 0.01), P-P-FSH (p less than 0.001), dizziness (p less than 0.0001), decreased ability to concentrate (p less than 0.001), and dizziness during the past year (p less than 0.01) were correlated with the exposure score. Following six weeks without exposure, systolic blood pressure and P-ALAT decreased, the latter being correlated with the exposure score.
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PMID:Health effects of toluene exposure. 335 18

Ciprofloxacin is a new quinolone antimicrobial agent with activity against a broad spectrum of gram-negative and gram-positive organisms, including Pseudomonas aeruginosa and methicillin-resistant strains of staphylococci. The efficacy and safety results of 80 clinical studies of the oral form of ciprofloxacin are reported. Drug safety was assessed in 2236 courses in 2203 adult patients treated primarily in the United States. Data from 1676 courses were suitable for analysis of drug efficacy. The unit dose for most patients ranged from 250 mg to 750 mg (median, 500 mg), usually given every 12 hours. The duration of treatment ranged from 3 to 231 days (median, 10 days). Predominant among 1722 infections were those of the urinary tract (43%), skin structures (29%), and respiratory tract (19%); the remainder were bone and joint infections (5%), bacteremias (2%), and intra-abdominal (1%), gastrointestinal (1%), and pelvic infections (less than 1%). Signs and symptoms of infection resolved in 79% of all cases; a further 15% improved, and 5% failed to improve. Pathogens were eradicated in 89% of urinary tract infections and persisted in 5%; 80% of patients still had sterile urine at the 3-to 6-week follow-up. In 81% of nonurinary tract infections, pathogens were eradicated; they persisted in 11%, and superinfection occurred in less than 5%. After treatment, 89% of the 2253 causative organisms were eradicated and 2% were reduced to clinically insignificant counts; 8% persisted. Of 411 isolates of P. aeruginosa, 77% were eradicated, as were 97% of 421 Escherichia coli and 80% of 248 Staphylococcus aureus isolates. Also eradicated were 95% of 166 Klebsiella, 96% of 139 Proteus mirabilis, 100% of 20 other Proteus, 94% of 123 Enterobacter, 100% of 68 Haemophilus influenzae, 96% of 49 Citrobacter, 89% of 45 Serratia, 95% of 41 Streptococcus pneumoniae, 91% of 43 Salmonella, 100% of 38 Morganella morganii, and 100% of 35 Providencia isolates. Adverse reactions were judged probably or possibly drug-related in 14.8% of courses; drug treatment had to be stopped prematurely in 3.5%. The most frequent reactions were gastrointestinal complaints (chiefly nausea, diarrhea, and vomiting), metabolic disorders (elevated SGOT, SGPT, serum creatinine, or blood urea nitrogen), and nervous system effects (dizziness, light-headedness, restlessness, tremor, and headache). Crystalluria, judged to be related to ciprofloxacin, occurred in two patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:A survey of clinical experience with ciprofloxacin, a new quinolone antimicrobial. 336 Sep 68

The antihypertensive effect and safety of long-term therapy with nifedipine were evaluated in 132 hypertensive patients, including 100 aged patients who received nifedipine alone or with other antihypertensive agents for a mean duration of 28.6 months. A prompt hypotensive effect was observed 1 month after the initiation of nifedipine therapy. The hypotensive effect persisted for the entire follow-up period and was related to the pretreatment mean blood pressure level. Late drug tolerance was not observed. Dizziness, facial flushing and other unpleasant sensations were observed in 7.5% and ankle edema in 9.8% of the patients. The therapy did not significantly influence serum creatinine levels. Hypotension and side effects were the cause of discontinuation in 10.6% and 4.5% of patients, respectively. We conclude that long-term antihypertensive therapy with nifedipine is both effective and safe, not only in adult patients but also in the high-risk aged patient.
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PMID:The efficacy and safety of long-term antihypertensive therapy with nifedipine. 372 91

The effect of the converting enzyme inhibitor captopril as long term treatment was investigated in 14 patients with severe congestive heart failure in a double blind trial. Captopril reduced plasma concentrations of angiotensin II and noradrenaline, with a converse increase in active renin concentration. Effective renal plasma flow increased and renal vascular resistance fell; glomerular filtration rate did not change. Serum urea and creatinine concentrations rose. Both serum and total body potassium contents increased; there were no long term changes in serum concentration or total body content of sodium. Exercise tolerance was appreciably improved, and dyspnoea and fatigue lessened. Left ventricular end systolic and end diastolic dimensions were reduced. There was an appreciable reduction in complex ventricular ectopic rhythms. Adverse effects were few: weight gain and fluid retention were evident in five patients when captopril was introduced and two patients initially experienced mild postural dizziness; rashes in two patients did not recur when the drug was reintroduced at a lower dose; there was a significant reduction in white cell count overall, but the lowest individual white cell count was 4000 X 10(6)/l. Captopril thus seemed to be of considerable value in the long term treatment of severe cardiac failure.
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PMID:Captopril in heart failure. A double blind controlled trial. 638 12

In a special hypertension clinic, 35 hypertensive elderly men (mean age, 72 years) and 29 hypertensive younger men (mean age, 45 years) were studied. In the clinic, nurse-clinicians evaluated and treated the patients under physician supervision, and compared the findings in the two groups. The same success in blood pressure control was achieved in both groups. Syncope or serious dizziness was uncommon in either group. A slight rise in the serum creatinine level over time was observed in both the older and the younger patients, but was greater in the elderly (mean increment 0.27 mg/dl, elderly; 0.096 mg/dl, younger). Compliances with medication schedules (diuretics, or a diuretic and methyldopa) were equally good in the two groups. The rates of required clinic visits were the same, but the elderly had a better attendance record. It is concluded that the treatment of elderly hypertensive patients is feasible and may be carried out in a focused "hypertension clinic." Including older persons in such programs can be expected to result in their protection from cardiovascular complications, as well as other indirect health benefits.
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PMID:Care of elderly patients in a special hypertension clinic. 705 77


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