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

Calcium channel blocking drugs are a chemically heterogenous group, so it might be expected that their effects on vascular smooth muscle, cardiac contractility, and conduction tissue may differ. However, the majority of adverse reactions are predictable from their pharmacological actions and may be conveniently grouped in the following categories: 1) vasodilatation, 2) negative inotropic effects, 3) conduction disturbances, 4) gastrointestinal effects, 5) metabolic effects, and 6) drug interactions. Vasodilatory symptoms, namely, dizziness, headaches, flushing sensation, and palpitation, are more likely with nifedipine. Peripheral edema is also common with nifedipine, but the mechanism is uncertain. For a given degree of vasodilation, the greatest negative inotropic effect is seen with verapamil first, diltiazem second, and nifedipine last. Calcium channel blocking drugs are contraindicated in hypertensive patients with second and third degree heart block, sick sinus syndrome, and severe heart failure. Verapamil and diltiazem have a significant effect on cardiac conduction, whereas nifedipine, in therapeutic doses, does not. Local gastrointestinal symptoms, such as nausea and constipation, are common with verapamil. None of the calcium channel blocking drugs have been reported to adversely affect lipid or protein metabolism. However, nifedipine, verapamil, and diltiazem in high doses may inhibit liberation of insulin. The significance of this finding needs to be explored further in hypertensive diabetics. Serum digoxin levels have been shown to increase after administration of verapamil and nifedipine, but there is no evidence that this change has any clinical relevance.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Side effects of calcium channel blockers. 328 Apr 92

It is estimated that there are approximately six million patient-years of clinical experience with fenofibrate among physicians outside of the United States. A review of the European literature and unpublished studies supplied by the manufacturer (Laboratoires Fournier, Dijon, France) has been compiled with the data recently reported from a double-blind, placebo-controlled study completed in the United States. In general, fenofibrate has been found to reduce serum triglyceride levels by 30 to 60 percent in patients with type II B and IV hyperlipoproteinemia. Serum cholesterol levels were also reduced by 20 to 25 percent in this group of hypertriglyceridemic patients. A similar reduction in serum cholesterol levels was also found in type II A patients (normal triglyceride levels). Low-density lipoprotein levels were usually reduced in those patients with elevated levels and high-density lipoprotein levels increased when baseline levels were low. Fenofibrate also produced a 10 to 28 percent reduction in uric acid that was sustained for years. The incidence of unwanted effects ranged from 2 to 15 percent in the open trials lasting from a few months up to six years. Gastrointestinal problems (abdominal discomfort, diarrhea, and constipation) are most common, occurring in approximately 5 percent of patients. Reports including fatigue, headache, loss of libido, impotence, dizziness, and insomnia were grouped as neurologic and occurred with a total incidence of 3 to 4 percent. In about 1 percent of patients, muscle tenderness developed, often accompanied by elevated creatine phosphokinase levels. These and the gastrointestinal problems occurred with a similar frequency in the placebo-treated cohort in controlled studies. In approximately 2 percent of patients, a skin rash developed, an incidence that appears significantly higher than that of placebo control groups. Liver changes in rodents have included marked peroxisome proliferation and increased hepatic carcinomas with very high doses. In humans, only a small increase in incidence of elevated levels of serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase seems to be present and is not clearly different from that of the control groups. Alkaline phosphatase, gamma-glutamyl transferase, and bilirubin levels are often decreased with no known undesirable effects. Investigations into the lithogenicity of bile indicated a significant increase in five studies. However, there has been no evidence of a significant rise in the incidence of cholelithiasis in the clinical trials completed to date.
 ...
PMID:Comparative toxicity and safety profile of fenofibrate and other fibric acid derivatives. 331 50

To evaluate the effect of hypercholesterolemic treatment on coronary artery disease in patients known to be susceptible to disease progression, 44 patients with familial hypercholesterolemia and coronary artery disease were started on a lipid-lowering diet and either probucol (1 g/day) or colestipol (30 g/day). After 5 months of monotherapy, all patients went on a regimen of diet and 2-drug therapy. To date, combination therapy has continued for 3.4 to 4.1 years, and has resulted in the following changes from baseline in mean serum lipid levels: -48.5% in total cholesterol, -53.3% in low density lipoprotein cholesterol, -30.0% in high density lipoprotein cholesterol and +14.5% in triglycerides. The reduction in low density lipoprotein cholesterol apparently improved the clinical status of these patients despite the associated drop in high density lipoprotein cholesterol. In the 19 patients who underwent coronary arteriography before admission to the study, follow-up arteriograms showed that combined treatment stabilized the progression of established lesions and prevented the formation of new ones. Side effects occurred mainly with monotherapy and during the early phase of combination therapy. Reactions included diarrhea, constipation, other vague abdominal symptoms, headache and joint stiffness. In all instances, the side effects gradually subsided after the institution of combination therapy. The combination of probucol and colestipol plus diet appears to be effective in treating most patients with familial hypercholesterolemia.
 ...
PMID:Effects of combined probucol-colestipol treatment for familial hypercholesterolemia and coronary artery disease. 352 77

We compared verapamil and propranolol hydrochloride for monotherapy of hypertension. Verapamil lowered blood pressure (BP) more effectively than propranolol in black and white patients. Verapamil was equally effective in blacks and whites, whereas propranolol was more effective in whites. Heart rate was reduced by 6.0 beats per minute by verapamil, and by 13.6 beats per minute by propranolol. In blacks, verapamil lowered systolic BP 16.9 vs 8.1 mm Hg for propranolol; verapamil reduced diastolic BP 12.8 vs 8.6 mm Hg for propranolol. In whites, verapamil lowered systolic BP 19.0 vs 12.7 mm Hg for propranolol; verapamil reduced diastolic BP 16.7 vs 12.3 mm Hg for propranolol. Increases in systolic BP were observed in 22% and 3.4% of patients receiving propranolol and verapamil, respectively. The PR interval was increased from 163.5 to 174.9 ms for verapamil vs 160.3 to 164.4 ms for propranolol. Constipation (15%) and headaches (10%) were most frequent complaints for verapamil vs fatigue (18%) and dizziness (7%) for propranolol. Changes in blood biochemistry values were of small magnitude. We conclude that verapamil monotherapy is a safe and effective means of achieving BP control in patients with essential hypertension.
 ...
PMID:A comparison of verapamil and propranolol for the initial treatment of hypertension. Racial differences in response. 353 60

Forty-two outpatients with major depressive disorder were treated with oral fezolamine in a 6-week, three-center open-label study. Therapy was initiated at 100 mg/day; thereafter dosage was increased based on the response of the patient. Maintenance dosage usually ranged between 100 and 450 mg/day. Clinically significant improvement relative to the patient's prestudy state was observed after 2 weeks in both patient and physician-rating scales. Fifty-five percent of patients improved their Hamilton Psychiatric Rating Scale for Depression (HAM-D) scores by more than 50%. The median dose associated with a clinically significant response was 245 mg/day. Five of the 6 patients who dropped out did so because of gastrointestinal adverse effects. The most common adverse effects were nausea (36%), headache (29%), constipation (26%), and dry mouth (24%).
 ...
PMID:Efficacy and safety of fezolamine in depressed patients. 368 2

The antihypertensive effect of an oral slow release (retard) formulation of verapamil was evaluated in a negative (placebo) and positive (nifedipine) controlled study. After a run-in period of one week without antihypertensive therapy, 54 patients were classified as having mild to moderate hypertension (diastolic blood pressure 95-115 mm Hg) and assigned randomly to one of three groups (n = 18 each). These received one of the following treatments over 2 weeks: either placebo b.i.d., or a nifedipine retard preparation 20 mg b.i.d., or a verapamil retard preparation 240 mg b.i.d. Assessments of blood pressure were made at rest and during a standardized bicycle stress test. Data were recorded at baseline and at the end of each week. After one week of treatment, 1 patient receiving nifedipine and 14 patients receiving placebo dropped out of the study because their diastolic pressures were equal to or above the values before treatment. After two weeks of treatment, 13 of 18 patients on verapamil and 9 of 18 patients on nifedipine had resting diastolic pressures less than or equal to 90 mm Hg. Also systolic pressure and blood pressures during exercise were significantly lowered by both active drugs. Verapamil caused a fall in heart rate during rest and under maximal exercise. Undesired side effects from verapamil were constipation (6 of 18) and headache (1 of 18); those from nifedipine were flush or headache (5 each of 18); ankle edema, dizziness, or tachycardia were each reported by one patient. In comparison with placebo values, verapamil lengthened the atrioventricular conduction time (PQ-interval) significantly, however, PQ-interval did not exceed 0.24 s.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Controlled study on the treatment of hypertension with verapamil in retard form]. 390 62

Twenty out-patients with active, chronic duodenal ulcer were treated over a period of 6 weeks with either 0.6 g ranitidine per day or 2 g triletide per day, a new synthetic tripeptide shown to be effective in healing ulcers by increasing the mucosal defence mechanisms. Efficacy was assessed by scoring the intensity of day and night pain before, after 2 and after 6 weeks of treatment, and by endoscopy before and after. Tolerance was assessed by routine laboratory tests, physical examination and a survey of any accessory symptoms. Both drugs significantly relieved pain almost at the same rate and to the same extent, whereas endoscopy showed a not significantly greater improvement in the ranitidine group. It was found, however, that the patients in the triletide group had, on average, a significantly greater intensity of intractable factors on entry than those in the ranitidine group (+75%; p less than 0.02). After stratifying the intractability factor intensity, the 5 patients in the triletide sub-group comparable with those in the ranitidine group exhibited exactly the same behavior on pain relief and a very similar one on endoscopy findings (2 healed, 2 improved and 1 unchanged, compared with 7 healed and 3 improved, respectively). The sub-group with greater severity also showed improvements, both symptomatic and endoscopic, but to a lesser extent, indicating the need for prolonged treatment. Tolerance was good with both drugs. Two patients on triletide reported adverse effects; 1 of increased intensity of previous constipation and the other 1 of mild headache and dizziness, but these could not be related definitely to treatment.
 ...
PMID:Triletide and ranitidine for the management of chronic duodenal ulcer: a controlled clinical investigation. 390 87

Tumors of the posterior fossa presenting orthostatic hypotension are rare and only nine cases have been reported so far. The locations of almost all these tumors were near the fourth ventricle and three of them were hemangioblastoma. A case of a tumor of the fourth ventricle showing autonomic disturbances mainly composed of orthostatic hypotension is reported. A 42-year-old male was admitted to the Department of Neurology of Chiba University Hospital on June 25th, 1981 because of three years' history of autonomic disturbances including orthostatic syncope, impotence, urinary disturbance and bowel dysfunction such as vomiting, diarrhea and constipation. He also complained of weight loss and staggering of gait to the left side. On admission, the patient was emaciated being 50 kg in weight and 172 cm in height. Neurological examination revealed hippus of bilateral pupils in light reflex, saccadic eye movement, slightly hypoactive deep tendon reflexes, mild terminal oscillations in bilateral finger-to-nose test, oscillation in the left heel-to-knee test, staggering tendency of gait to the left, slightly impaired tactile and thermal sensations in distal parts of the legs. Autonomic disturbances were showed by orthostatic hypotension (BP 104-50 in supine and 70-40 in sitting position), impotence, weight loss, anorexia, decrease of sweating, spontaneous yawning and loss of sensation of bladder fullness. About 5 weeks after admission, he began to complain of temporal headache and showed impairment of memory, drowsiness, paroxysmal apnea and papilledema.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Progressive dysautonomia in hemangioblastoma in the region of the fourth ventricle]. 396 90

2 preparations of a sequential oral contraceptive containing 11 tablets of .1 mg mestranol and 10 tablets of .1 mg mestranol and 2 mg chlormadinone were compared: 127 women took the pills with 7 placebos (Eunomin) for 848 cycles and 47 women took them without placebos (GC 527) for 267 cycles. 1 pregnancy occurred due to patient error. No differences were recorded in weight changes, bone symptoms, breakthrough bleeding, breast symptoms, or increased libido. Mucorrhea and constipation were more common with the placebos. The side effects of nausea, nervousness, headache, fatigue, and decreased libido were frequent with placebos. 19.8% discontinued Eunomin, while 23.4% stopped taking CG 527. 76.9% of the women on Eunomin and 65.2% of those on CG 527 did not have the side effects that they had experienced with previou s pills.
 ...
PMID:[Effect of placebo instead of a pause in the taking of ovulation inhibitors]. 551 25

In the United States, the drugs most commonly used to treat peptic ulcer disease are antacids and the H2-receptor antagonists cimetidine and ranitidine. Other available agents include anticholinergics and the coating agent sucralfate. Investigational drugs such as colloidal bismuth, carbenoxolone, prostaglandins, the tricyclic compound pirenzepine, and substituted benzimidazoles are not available for use in the United States. Most of the commercially available and investigational compounds have similar efficacy; therefore the optimal drug may be the one associated with the fewest adverse effects and the most convenient dosing regimen. Cimetidine causes a small number of adverse effects, including neuropsychiatric disorders, gynecomastia, impotence, loss of libido, elevation of serum creatinine and serum transaminases concentrations, and drug interactions. Some of these reactions have been of clinical significance. Presently, there are rare reports of gynecomastia, bradycardia, inhibition of acetylcholinesterase, headache, lethargy, diarrhea, and rash in patients receiving ranitidine. Antacids can produce either diarrhea or constipation and have been associated with low serum phosphorus concentrations, and metabolic alkalosis. Anticholinergics, especially in elderly or debilitated patients, can cause central nervous system disorders, intestinal atony, or urinary retention. Sucralfate may cause constipation, diarrhea, nausea, and headache. The investigational agents have their own side effect profiles. The adverse effects of anticholinergics make them unattractive therapeutic choices, and antacids and sucralfate have inconvenient dosing requirements compared with some equally efficacious alternatives. In addition, clinical experience with sucralfate in the United States is limited. The safety record of cimetidine is admirable. As clinical experience with ranitidine increases, currently unrecognized adverse effects may be reported. However, based on current data, ranitidine is as effective as cimetidine and is associated with a lower incidence of side effects.
 ...
PMID:Problems associated with medical treatment of peptic ulcer disease. 609 62


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>