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)

Using a double-blind, crossover design, the comparative efficacy and safety of nifedipine and isosorbide dinitrate in the treatment of stable angina were studied in 34 patients. The study included a 2-week placebo washout period and two 6-week periods during which patients were randomized to either nifedipine or isosorbide dinitrate. The doses were titrated for each patient, and mean doses of the 2 drugs were comparable. A time-limited thallium treadmill test was performed at the end of each phase. Ischemic zone count rates were normalized to those of the nonischemic zone, and the change in this ratio with redistribution was calculated as reversible thallium defect. Two patients were discontinued from the study within 1 week after initiation of isosorbide dinitrate because of severe, intolerable headache. Two patients were withdrawn while receiving nifedipine: one had new congestive heart failure and the other had increasing angina. Of the remaining 30 patients who tolerated both drugs for at least 1 week, 4 patients from the isosorbide dinitrate group were either prematurely crossed over or discontinued from the study because of headache. One patient suffered headache from both drugs and was discontinued from the study. In the 30 patients, only nifedipine significantly reduced resting arterial pressure compared with baseline. Further, only nifedipine therapy resulted in significant decreases in the rate-pressure product and systolic pressure at a given workload. However, significant decreases in angina frequency, nitroglycerin consumption and exercise-induced maximum ST-segment depression and reversible thallium perfusion defect were produced by both nifedipine and isosorbide dinitrate.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Comparison of antianginal efficacy of nifedipine and isosorbide dinitrate in chronic stable angina: a long-term, randomized, double-blind, crossover study. 400 86

Recent reports have shown that beta-adrenergic blockade may exacerbate variant angina. On theoretical grounds, alpha-adrenergic blockade may be beneficial in these patients. To test this hypothesis, we assessed the efficacy of prazosin, an alpha-adrenergic blocking agent, in six men, mean age 49 years, with variant angina. Prazosin, 14.0 +/- 2.4 mg/day (mean +/- SD) in three equal doses, was compared with placebo in a double-blind, randomized, double-crossover trial lasting 4 1/2 months: 2 weeks of open-label prazosin followed by four 1-month periods of blinded alternating therapy. No other vasoactive medications were administered during the study. Prazosin reduced sitting systolic arterial pressure from 145 +/- 18 to 127 +/- 16 mm Hg (p = 0.02), but exerted no effect on diastolic arterial pressure or heart rate. Prazosin did not change the weekly number of episodes of chest pain (2.5 +/- 2.3 with placebo vs 3.1 +/- 3.0 with prazosin, NS), nitroglycerin tablets used (3.9 +/- 3.7 with placebo vs 4.6 +/- 4.2 with prazosin, NS), or transient ST-segment deviations (by calibrated two-channel Holter monitoring for 24 hours/week throughout the study) (6.5 +/- 10.1 with placebo vs 11.8 +/- 17.4 with prazosin, NS). During prazosin therapy, three patients had orthostatic dizziness and one patient had headache. Thus, in a long-term, randomized, double-blind trial, prazosin exerted no obvious beneficial effect in patients with variant angina.
 ...
PMID:Alpha-adrenergic blockade for variant angina: a long-term, double-blind, randomized trial. 613 37

To assess the effects of nitroglycerin ointment (NTG) on hemodynamics and autonomic nervous activity, 17 normal subjects and 13 patients with severe congestive heart failure (CHF) were studied. In 12 normal subjects, NTG significantly increased the plasma norepinephrine concentration in association with a slight reduction in systolic blood pressure and a slight increase in heart rate, plasma cyclic adenosine monophosphate (cyclic AMP) concentration, and renin activity at 1 hr. All normal subjects complained of headache or felt heavy-headed after NTG administration. In the 13 patients with CHF, NTG significantly decreased plasma norepinephrine and cyclic AMP concentrations in association with a significant increase in the cardiac index and a significant reduction in pulmonary arterial diastolic pressure, systemic vascular resistance, systolic blood pressure, and heart rate. The effects occurred at 30 min after NTG administration and continued for 3 hr. Relief from dyspnea or orthopnea in patients with CHF was observed. NTG did not change the plasma cyclic GMP concentration in normal subjects and patients with CHF. We conclude that in patients with CHF, NTG decreases the enhanced sympathetic nervous activity, with concomitant beneficial effects on hemodynamics and improvement of clinical symptoms. In contrast, NTG increases sympathetic nervous activity in normal subjects.
 ...
PMID:Effects of nitroglycerin ointment on plasma norepinephrine and cyclic nucleotides in congestive heart failure. 616 16

A new topical dosage form of nitroglycerin has been developed in which nitroglycerin and its vehicle are incorporated in a polymer gel matrix of fixed dimension. Venous plasma nitroglycerin concentrations were measured for 24 h after application of nitroglycerin polymer gel systems measuring 10 cm and containing 2% nitroglycerin (wt/wt) to 10 normal male volunteers. Five of these subjects were subsequently tested with 20-cm2 gel systems of similar composition. With the 10-cm2 nitroglycerin polymer gel system, venous plasma nitroglycerin concentrations were 0.83 +/- 0.26 ng/ml ast 4 h and 0.89 +/- 0.23 ng/ml at 24 h. For the 20-cm2 system, venous plasma nitroglycerin concentrations were 1.83 +/- 0.55 ng/ml at 8 h and 1.81 +/- 0.13 ng/ml at 24 h. The only adverse effect noted was headache, which affected all the subjects tested with the 20-cm2 appliance. The plasma nitroglycerin concentrations obtained with the polymer gel system appear to be in a clinically useful range; thus this new form of topical nitroglycerin should be of benefit to patients in whom sustained plasma nitroglycerin concentrations are desirable, e.g., those patients with chronic congestive heart failure and angina on awakening.
 ...
PMID:The nitroglycerin polymer gel matrix system: a new method for administering nitroglycerin evaluated with plasma nitroglycerin levels. 617 52

The efficacy and tolerability of nitroglycerin (NTG) ointment were studied in 80 male patients with severe angina pectoris. Two symptom-limited exercise tests were performed on successive days after application of an ointment containing 15 mg NTG or a placebo (P) ointment. The patients were assigned to 4 groups. The study was conducted in a double-blind, cross-over manner. The total amount of work performed was higher in all groups on NTG (46-70%) compared to P ointment. The difference was statistically significant (p less than 0.001) at all points of time from 0.5 to 7 hours. The ST segment depression in ECG at the end of the exercise test was slightly greater on P than on NTG, but the difference was statistically significant only in the 3-hour group (p less than 0.01). The frequencies of headache and dizziness were 35% and 16%, respectively, on NTG. Eight patients (10%) reported that headache was severe enough to prevent regular use of NTG ointment. NTG ointment is effective, has a long duration of action and is relatively well tolerated by patients with severe angina pectoris.
 ...
PMID:Nitroglycerin ointment effective for seven hours in severe angina pectoris. 640 84

Nine patients with coronary heart disease, 8 of whom were taking adrenergic beta-blockers, were tested by dynamic (bicycle) and isometric (sitting handgrip) exercise before and 2 and 6 h after application of nitroglycerin 30 mg in an ointment, or a matching placebo ointment, over 225 cm2 surface on the chest, in a double-blind, cross-over, single dose study. Exercise time until stopping from chest pain was significantly increased (by about 20%) by active ointment, and electrocardiographic ST-depression and chest pain intensity were significantly less pronounced during exercise both 2 and 6 h after application. During seated rest, active ointment also produced a significantly lower systolic blood pressure and a significantly higher heart rate at both 2 and 6 h, whereas during handgrip, significant differences from placebo were seen only at 2 h. All patients experienced headache for at least the 6 h of the study. At a given heart rate, ST-depression was less pronounced with active ointment than with placebo.
 ...
PMID:Effect of nitroglycerin ointment (Nitrong) on exercise tolerance and several circulatory parameters in patients with angina pectoris. 641 79

The recently introduced preparation of intravenous glyceryl trinitrate (nitroglycerin) provides a rapid steady therapeutic blood concentration of nitrates during continuous infusion. Intravenous glyceryl trinitrate causes venodilation at low doses, but at higher doses dilates both arteries and veins. Its principal haemodynamic effects at therapeutic dosages include a decrease in blood pressure in preload (left ventricular filling pressure) and in determinants of afterload, and a decrease in myocardial oxygen demand. Human pharmacokinetic data are few and difficult to interpret due to wide interstudy and interindividual variation. There is no close correlation between infusion rate, blood concentration and haemodynamic effects. The nature of the patient population treated with intravenous glyceryl trinitrate has largely precluded the use of a placebo, but in open trials the drug has been used successfully in the treatment of unstable angina, left ventricular failure accompanying acute myocardial infarction and in the control of hypertension associated with cardiac surgery at dosages titrated to achieve a specific end-point. Favourable haemodynamic responses have been achieved in very short term studies in congestive heart failure, and preliminary studies suggest that institution of intravenous glyceryl trinitrate early after acute myocardial infarction may limit ischaemic damage. However, use of the drug in acute myocardial infarction remains controversial. Intravenous glyceryl trinitrate is generally well tolerated, although hypotension and headache occur occasionally, and sinus tachycardia and bradycardia less frequently. Careful titration of dosage is required (beginning at 5 micrograms/min), and if the infusion sets contain polyvinylchloride, the delivered dose is lower than that calculated, because of adsorption of glyceryl trinitrate onto the plastic tubing.
 ...
PMID:Intravenous glyceryl trinitrate (nitroglycerin). A review of its pharmacological properties and therapeutic efficacy. 642 Jan 39

Post-Marketing Surveillance (PMS) of Transiderm-Nitro, a new transdermal form of nitroglycerin, was undertaken during the 6 months following its introduction to general practitioners in the United Kingdom. Two thousand four hundred and seventy-five record forms were received. Excluding the fourteen patients who died during the surveillance, treatment in the remaining 2461 was judged as effective in 80.6% of patients and was well tolerated, with 70.5% having no unwanted effects. The incidences of withdrawal from Transiderm-Nitro in all patients analyzed were 5.7% due to headaches, 3.6% due to other unwanted effects and only 3.1% due to the treatment being judged as ineffective. This PMS confirms that Transiderm-Nitro is an effective, well tolerated addition to the therapy of angina pectoris.
 ...
PMID:Post-marketing surveillance of the Transiderm-Nitro patch in general practice. 642 Feb 13

Nitroglycerin ointment (Nitrong 2%, 5 cm) and an identical placebo ointment were tested in a double-blind crossover study in five healthy volunteers to determine its influence on heart rate, blood pressure, and venous distensibility during supine rest and at 45 degrees tilt. Two hours after administration, a significantly higher venous distensibility was observed with the active ointment than with placebo. There were insignificant changes in heart rate and blood pressure. Three of the five subjects experienced headache for 6 h or more after active ointment.
 ...
PMID:Circulatory effects of nitroglycerin ointment (Nitrong) with special reference to venous distensibility. 642 58

The two main problems in defining and classifying the syndrome of benign paroxysmal vertigo (BPV) in childhood are the vestibular function pattern and the relationship between BPV and migraine. 13 children suffering from this syndrome were submitted to complete otoneurological examination, including caloric and rotational labyrinthine stimulation with ENG recording, and to headache provocation tests with nitroglycerin, histamine and fenfluramine. Vestibular responses were normal in all except 2 cases which presented signs of central vestibular impairment at the level of the vestibulocerebellar pathways. Headache provocation tests were positive in 9 out of 10 children, and in 4 cases they induced a typical vertiginous attack instead of headache. In addition, several children had a positive family history for migraine, headache was frequently associated with the crisis and other signs of a 'periodic syndrome' (motion sickness, cyclic vomiting, abdominal pain) were present, unrelated to vertiginous attacks. During the follow-up period, some children responded positively to migraine treatment. BPV, like paroxysmal torticollis in infancy and the signs of the periodic syndrome, can be considered a migraine equivalent or a migraine precursor and could be due to the same vascular and/or biochemical mechanisms responsible for the migraine. In children, for anatomical or developmental reasons, these mechanisms could selectively affect parts of the brain stem, including the vestibular nuclei and vestibulocerebellar pathways.
 ...
PMID:Benign paroxysmal vertigo in childhood: a migraine equivalent. 642 77


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