Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In 15 patients with coronary heart disease and typical ST-segment depression during and/or after increasing physical effort in supine cycloergometry the normalizing effect of different dosages of Molsidomine on the electrocardiogram under effort was investigated in 74 exercise tolerance tests. Already after application of 0,5 mg Molsidomine there was observed a significant positive effect in comparison to an identical workload without drug. The normalizing effect was further increased by raising the dosage ot 1 mg or 2 mg respectively. To the administration of 3 mg only 1 out of 10 patients in the trial responded with an additional normalizing effect on the ECG since the rest of the patients showed already normal ECGs on 2 mg. This dose relationship also was observed in the pressure-rate-product. There was a dose-dependent decrease from which we can conclude a relief of the working myocardium. Under effort without drug 13 of 15 patients complained about stenocardia. Under the same effort and under Molsidomine however there were no more of these complaints. Because of these results it is recommended to use 2 mg of Molsidomine as a dosage in daily routine. It is needed 2 or 3 times dialy since in previous investigations there was shown a long-lasting effect over more than 5 hours. 3 out of 15 patients showed side effects which were only weak headache or weak congestion in the head.
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PMID:[The normalizing effect of ECG in exercise tolerance tests under molsidomine in different dosages (author's transl]. 67 55

A new agent, Molsidomine, with anti-anginal effect was investigated in 43 patients with coronary heart disease by means of 121 exercise tolerance studies. A good effect was observed 1 hour after sublingual or enteral absorption of 2 mg, which was comparable to 20 mg of Isosorbiddinitrate administered sublingually. Recorded and evaluated were the depression of ST-segment in the ECG, heart rate, systolic and diastolic blood pressure as well as subjective parameters. In comparison to the controls there was a highly significant reduction of anginal pain and ST-depression equivalent to that obtained 1 hour after Isosorbiddinitrate. The effect of Molsidomine could be established already 10 min after sublingual administration and sustained 5 to 6 hours afterwards with a highly statistic significance after sublingual as well as after enteral absorption. Side effects were noticed in 3 out of 43 patients, 2 of them with headache. The remarkable advantages of the drug are to be seen in its simple dosage and administration, its good tolerability, and its intrinsic retard-effect. A combination with beta-blocking agents seems to be possible in the same way as with Isosorbiddinitrate.
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PMID:[Studies on the influence of Molsidomin on coronary heart disease (author's transl)]. 100 55

The methods used presently for abortion of the attacks of migraine and cluster headache are not fully satisfactory which causes that the search for new therapies is continuing. Although the mechanism of migraine attacks remains unexplained, it is thought that an important role in it is played by serotonin receptors, vasodilation in certain regions and opening of arteriovenous communications in the head. Sumatriptan is an agonist of 5-HT1 -like receptors and exerts a selective vasoconstricting effect on the arteries of the head, particularly in the rami of the carotid artery. In 1988 the first reports appeared on the effectiveness of the drug in migraine attacks. In the following years extensive, multicentre and international studies of the drug were carried out on over 600 healthy volunteers and nearly 6000 patients with migraine. The studies demonstrated that Sumatriptan was effective in abortion of migraine attacks. After oral administration of 100 mg or subcutaneous injection of 6 mg in nearly 70% of cases the attack regressed or was greatly alleviated, similarly as other symptoms accompanying the headache such as photophobia, nausea, vomiting. Studies were undertaken also on the effectiveness of Sumatriptan in emergency treatment of cluster headache, and good results were again achieved. The tolerance of the drug is good, although in some cases side effects develop, usually transient and mild, among them tingling, feeling of pressure, heat or heaviness of the head or chest, taste change and burning sensation at the site of injection. Sumatriptan, similarly as all novel drugs, requires caution in its use, particularly in patients with coronary heart disease and hypertension, and also in old patients. As yet, the use of the drug in paediatric migraine or in pregnancy is not recommended.
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PMID:[Sumatriptan and its use in treatment of migraine and cluster headaches]. 133 66

The antianginal effect and tolerability of isosorbide mononitrate (ISMN), 20 mg 2-3 times daily, orally were investigated in an open study in 28 patients, suffering from coronary heart disease and stable angina pectoris. Ergometric exercise tests were carried out before treatment and 2 h after drug intake, every 3 months during the first year and at 6-month intervals during the following 2 years. At the conclusion of the 3-year study the reduction of ST-segment depression, which had amounted to 58% after 1 year, could be improved to 78% (p less than 0.01). The frequency of angina was markedly reduced during the treatment with ISMN. While 14 of the patients had more than 3 episodes per day prior to the study, 16 patients were symptom-free at the end of the three years' therapy, and none of the patients had more than 1 or 2 attacks per day. The consumption of sublingual nitroglycerin diminished by 94% after one year and by 98% after 3 years of therapy (p less than 0.01). Headache was the only adverse effect observed in some of the patients (at the initiation of the treatment only). In conclusion this study demonstrated (1) the good tolerability of ISMN, at the doses used, and (2) the fact that the antianginal efficacy may be enhanced during the course of the therapy.
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PMID:Evaluation of effectiveness and tolerability of isosorbide mononitrate during a three-year period in patients with angina pectoris. 176 Aug 29

This Latin American study assessed in the general practice setting the efficacy and tolerance of once-daily doxazosin in the treatment of mild or moderate essential hypertension (sitting diastolic blood pressure, 95 to 115 mm Hg). Patients (n = 220) were treated with doxazosin for 12 weeks as monotherapy or in combination with other antihypertensive agents. At the final visit, doxazosin produced a mean change in sitting systolic/diastolic blood pressure of -18.4/-14.4 mm Hg, at a mean daily dose of 4.3 mg. One hundred sixty-three (77.6%) of the 210 evaluable patients were considered a therapeutic success. Lipid analyses identified a statistically significant (p = 0.02) reduction in total serum cholesterol (4.85%) and an overall decrease in triglyceride levels (5.12%). According to the Framingham Heart Study equation, doxazosin produced a highly significant (p less than 0.001) 20% reduction in the calculated probability of developing coronary heart disease in 10 years. Of the 220 patients evaluated, 54 (24.5%) reported side effects that were considered related to treatment. Ten (4.5%) patients reported side effects unrelated to treatment and 37 (16.8%) reported events of unknown relationship. Most side effects were mild or moderate and were tolerated or disappeared with continued treatment. Nine patients (4.1%) were discontinued from therapy and in 13 (5.9%) the dose was reduced. The most prevalent side effects were headache and dizziness. The investigator's overall assessment of antihypertensive efficacy was excellent or good for 176 patients (80.4%); tolerance was considered excellent or good in 193 patients (88.5%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Doxazosin in the treatment of essential hypertension in general medical practice in Latin America. 182 56

This study was designed to assess the efficacy and tolerance of doxazosin in patients with mild, moderate, or severe essential hypertension in a general practice setting. Ninety-six adults of a mean age of 55 1/2 years took part in the 14-week study, consisting of a placebo phase (2 weeks), a dose-adjustment phase with doxazosin (8 weeks), and a maintenance phase (4 weeks). Doxazosin, at a final mean daily dose of 3.4 mg, produced a significant (p less than 0.05) reduction in blood pressure at all points of measurement during the study. The mean change in sitting blood pressure at the end of treatment was -15.4/-15.8 mm Hg. Of the 85 patients who could be categorized as a success or failure, 78 (92%) were considered a therapeutic success; 78 (89%) of the 88 efficacy-evaluable patients demonstrated an improvement in the severity category of their hypertension. Treatment with doxazosin produced a reduction in serum cholesterol (-3.1%) and triglyceride (-3.8%) levels, although these changes did not attain statistical significance. The calculated probability of developing coronary heart disease in 10 years (according to the Framingham equation) was significantly (p less than 0.001) reduced by 22%, from 16.7 chances per 100 (baseline) to 14.3 chances per 100 (final visit). Twenty-six patients (27.1%) reported side effects that were possibly related to treatment, the most prevalent of which were vertigo (7.3%) and headache (6.3%). In four (4.2%) patients the dose of doxazosin was reduced and two (2.1%) were withdrawn prematurely. The investigator's assessments of tolerance was reduced and two (2.1%) were considered to be excellent or good in 85 (88%) patients.
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PMID:A multicenter study of doxazosin in the treatment of essential hypertension in France. 182 57

The antihypertensive efficacy, lipid effects, and safety of doxazosin, a selective alpha 1-inhibitor for the reduction of coronary heart disease (CHD) risk in hypertensive patients, was assessed in a general medical practice setting. Seven hundred seventy-one patients were entered into the study, which involved three phases: (1) a 2-week baseline period, (2) an 8-week period in which patients received doxazosin, 1 to 8 mg once daily, and (3) a 4-week maintenance period. From baseline to final visit there was a highly significant 27% reduction (p less than 0.001) in calculated CHD risk based on the Framingham equation as a consequence of doxazosin's favorable effects on both blood pressure and serum lipid levels. Efficacy and toleration of doxazosin therapy were good to excellent in most patients. The investigators' global assessment of efficacy of once-daily doxazosin therapy was excellent or good for 82% of patients and fair or poor for only 18% of patients. After 12 weeks, 83% of the patients were considered therapy successes (sitting diastolic blood pressure either less than or equal to 90 mm Hg or greater than or equal to 10 mm Hg reduction not reaching less than or equal to 90 mm Hg) at a mean daily dose of 3.5 mg. Seventy-one percent achieved "normalized" blood pressure control (sitting diastolic less than or equal to 90 mm Hg with a decrease of greater than or equal to 5 mm Hg) at a mean dose of 3.1 mg once daily. By the final treatment visit, systolic/diastolic blood pressures of efficacy evaluable patients were reduced by 20.6/15.3 and 21.0/15.4 mm Hg from a mean baseline of 166/104 and 165/104 mm Hg in the sitting and standing positions, respectively (p less than 0.05). Total cholesterol was significantly decreased (p less than 0.01). Most side effects were mild or moderate and disappeared with or were tolerated on continued therapy. The investigators' global assessment of patient toleration of doxazosin treatment was excellent or good for 89% of the 763 patients evaluated and fair or poor for only 11% of patients. The most commonly reported side effects were headache (8%) and dizziness (7%). No clinically significant laboratory changes were apparent, and no trends were observed with regard to organ systems or correlations with dose or duration of treatment.
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PMID:Clinical experience with doxazosin in general medical practice. 290 45

A previous study verified the antianginal efficacy of 0.025 mg nitroglycerin without it having any effect on heart rate and blood pressure. In a randomized double-blind study, 40 patients with coronary heart disease received intravenously either 0.025 mg nitroglycerin or placebo. Before and 1-2 min after injection, the aortic and left ventricular (n = 20) pressures were recorded and coronary angiography performed. Mean heart rate, systolic and diastolic aortic pressure, left ventricular filling pressure and the pre- and poststenotic diameter of the coronary arteries, as well as the diameter of a distal coronary artery segment, showed no significant changes (p greater than 0.05). The stenotic segment diameter of the coronary artery remained unchanged after placebo administration (1.01 +/- 0.5 to 1.13 +/- 0.49 mm; p greater than 0.05) but increased significantly after the injection of nitroglycerin (from 1.15 +/- 0.68 to 1.32 +/- 0.73 mm; p less than 0.01). These results support the hypothesis that dilatation of coronary stenoses is an important aspect of the antianginal action of nitroglycerin. This may have practical consequences in the treatment of patients with angina and low blood pressure or severe headaches after the administration of conventional doses of nitroglycerin.
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PMID:[Coronary-dilating effect of minimal doses of nitroglycerin]. 312 Apr 36

The chemistry, pharmacology, pharmacokinetics, clinical efficacy, dosage and administration, and adverse effects of lovastatin are reviewed. Lovastatin is the first agent marketed in a new class of pharmacologic compounds called the 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitors. By competitively inhibiting HMG CoA reductase, the drug disrupts the biosynthesis of cholesterol in hepatic and peripheral cells. This increases the synthesis of low-density-lipoprotein (LDL) receptors and thereby increases the uptake of LDL cholesterol from the plasma. In doses of 20 to 80 mg daily, lovastatin decreases total and LDL cholesterol concentrations 25 to 45%. It also substantially reduces concentrations of triglycerides, very-low-density-lipoprotein (VLDL) cholesterol, and apolipoprotein B and slightly increases high-density-lipoprotein (HDL) cholesterol concentrations. Lovastatin is effective in patients with heterozygous familial and nonfamilial (polygenic) hypercholesterolemia but is ineffective in patients with homozygous familial hypercholesterolemia. It is also effective in combination with bile acid sequestrants, nicotinic acid, and gemfibrozil. Administration of lovastatin once daily in the evening (to enhance compliance) or twice daily is recommended to maximize the drug's cholesterol-lowering effects. Headache and gastrointestinal complaints are the most common adverse effects. Treatment has been withdrawn from 1.9% of patients receiving the drug because of elevated aminotransferase concentrations. The relationship of lovastatin to the development of lens opacities requires further evaluation. Lovastatin is highly effective in the treatment of primary hypercholesterolemia and represents an important therapeutic advance. Safety with long-term use and effect on coronary heart disease remain to be established.
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PMID:Lovastatin: a new cholesterol-lowering agent. 327 32

Continuous Holter monitoring of patients with coronary heart disease can show transient ischemic episodes occurring spontaneously with or without angina throughout the day. A controlled double-blind trial was conducted comparing the effects of isosorbide-5-mononitrate (IS-5-MN) and nifedipine in patients with documented transient ischemic episodes. Seventy-five percent of the ischemic episodes were not accompanied by pain. Twenty patients with documented coronary heart disease were included; 15 finished the 4-week study (1 patient had headaches, 1 thyrotoxicosis, 1 hypertensive crisis and 2 unstable angina). On a dual-channel FM-recorded electrocardiogram, ischemic episodes were counted when ST deviation was greater than 1 mm for greater than 1 minute. Patients received IS-5-MN (20 mg 3 times a day or 50 mg in a sustained-release tablet) or nifedipine (20 mg in a sustained-release tablet 3 times a day) in random order over four 1-week periods. At the end of each week, Holter monitoring was repeated and showed reductions of episodes by 67% and 67% after weeks of IS-5-MN therapy and 56% and 58% after weeks of nifedipine therapy (all p less than 0.05). Painful and painless episodes were reduced to a similar extent. Individual responses showed great variability, and in all treatment periods not more than half of the patients were completely free of ischemic episodes. One of the 12 patients did not respond to either way of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Nitrates and calcium antagonists for silent myocardial ischemia. 327 43


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