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)

Fourteen patients, 2 to 20 years old were investigated. Two had primary pulmonary hypertension, 11 had congenital heart disease and post-tricuspid shunts, and 1, a 20-year-old patient, was investigated after he had undergone surgical correction of truncus arteriosus I. Pulmonary arterial pressure, pulmonary flow index, peripheral systolic blood pressure and heart rate were measured before, and several times after intrapulmonary injection into the pulmonary artery of 0.5 microgram nifedipine/kg. Six patients were given an additional dose of 1 microgram nifedipine per kilogram into the pulmonary artery and hemodynamic measurements were repeated. In eight children, receiving 100% oxygen via a breathing mask, nifedipine effects were compared with oxygen effects. After 10 minutes under oxygen, the same hemodynamics were determined as after nifedipine. In addition, in four of these children aortic pressure and arterial oxygen saturation were also measured. Maximal effects occurred within 4 minutes. 0.5 micrograms nifedipine per kilogram caused a slight reduction in mean pulmonary arterial pressure (p less than 0.05), as well as increase in pulmonary flow index (p less than 0.005). However, no significant change in heart rate or in systolic blood pressure was observed. 1 microgram nifedipine per kilogram IP had almost the same effects. No adverse side effects occurred, besides mild headaches in one child. A comparison of nifedipine injected into the pulmonary artery with oxygen breathing in congenital heart disease combined with pulmonary hypertension, is reported for the first time. Nifedipine had a more pronounced and beneficial effect with a selective action on the pulmonary vascular bed.
Cardiovasc Drugs Ther 1988 Dec
PMID:Hemodynamic effects of nifedipine and oxygen in children with pulmonary hypertension. 315 41

In a prospective single-blind study we examined the effects of additional molsidomine in 20 patients (63 +/- 10 years; 15 males, 5 females) with unstable resting angina (greater than or equal to 3 attacks/24 hours) refractory to triple therapy (nitrates, calcium antagonists, and beta blockers) combined with heparin or aspirin. All but one patient had coronary artery disease documented by coronarography (n = 17) or by recent myocardial infarction (n = 3). Two patients had angiographically documented severe coronary spasms. Patients entered the study if coronary bypass surgery or PTCA could not be performed within 3 days after angiography (n = 9) or was not feasible due to anatomical or technical reasons (n = 6), concomitant malignant disease (n = 2), or age greater than 75 years (n = 3). All patients received molsidomine orally 12 to 24 mg/day. In 15 of the 20 patients molsidomine was given i.v. initially, starting with 20 mg i.v., followed by infusion of 1 to 4 mg/hour. Heart rate and blood pressure did not change significantly, and eight patients had a slight decrease of systolic and diastolic blood pressure. Severe adverse effects did not occur, and moderate headaches were reported by five patients. In 13 patients, unstable angina could be stabilized, and they remained free of resting angina; five had a marked reduction of the frequency of anginal attacks. In two patients, molsidomine was without demonstrable beneficial effects.(ABSTRACT TRUNCATED AT 250 WORDS)
Cardiovasc Drugs Ther 1988 May
PMID:Additional molsidomine in refractory unstable angina pectoris. 315 86

In a multicenter, randomized and double-blind study, the efficiency of molsidomine on infarct size has been examined in 303 patients suffering from a first myocardial infarction and compared with a placebo. According to previous enzyme studies, and in order to detect a 20% reduction infarct size with conventional levels of risk, alpha = 0.05 and beta = 0.20, the recommended sample size was 264 patients. Thirty-three patients initially selected were excluded for protocol violation and, among the 270 patients definitively included, 133 were allocated to molsidomine and 137 to placebo, without any difference concerning age, delay of treatment, infarct location, and initial blood pressure. Test drugs were both initiated within the 6 first hours and administered orally at decreasing doses for 10 days: 16 mg on the first day, 12 mg on the second day, and 6 mg daily from the third to the tenth days. There was not a significant difference between the molsidomine and placebo groups regarding the enzyme evaluation of infarct size, neither for CK dosage (101.72 +/- 74.76 gram equivalents vs. 92.71 +/- 65.91 gram equivalents, NS) nor for its MB fraction (67.34 +/- 50.07 gram equivalents vs. 63.50 +/- 43.01 gram equivalents, NS). Moreover, changes in the Q- or R-wave sum during the 10 days of follow-up were strictly identical. However, in-hospital mortality was lower in the molsidomine group than in the placebo group (4.5% vs. 8.0%), but this reduction was not statistically significant. During the study, there were few side effects, mainly headaches, without withdrawal of the treatment.
Cardiovasc Drugs Ther 1988 May
PMID:The influence of molsidomine on infarct size: an acute post-infarction pilot study with 303 patients. 315 88

With the correct selection of drug and patient, the calcium antagonists as a group can be remarkably effective at relatively low cost of serious side effects. Almost all side effects are dose related. Minor side effects include those caused by vasodilation (flushing and headaches), constipation (verapamil), and ankle edema. Serious side effects are rare and result from improper use of these agents, as when intravenous verapamil (or diltiazem) is given to patients with sinus or atrioventricular nodal depression from drugs or disease, or nifedipine to patients with aortic stenosis. The potential of a marked negative inotropic effect is usually offset by afterload reduction, especially in the case of nifedipine which actually has the most marked negative inotropic effect. Yet caution is required when even calcium antagonists, especially verapamil, are given to patients with myocardial failure unless caused by hypertensive heart disease. Drug interactions of calcium antagonists occur with other cardiovascular agents such as alpha-adrenergic blockers, beta-adrenergic blockers, digoxin, quinidine, and disopyramide. The most marked interaction with digoxin is that with verapamil, which may raise digoxin levels by over 50%. Combination therapy of calcium antagonists with beta-blockers is increasingly common, and is probably safest in the case of dihydropyridines. Other combinations being explored are those with angiotensin-converting enzyme inhibitors and diuretics.
Cardiovasc Drugs Ther 1988 Jul
PMID:Calcium channel antagonists. Part IV: Side effects and contraindications drug interactions and combinations. 315 4

The antianginal effects of sustained-released oral nitroglycerin were evaluated in patients with chronic stable angina using a double-blind randomized protocol. Nineteen patients were inducted into the trial and 17 of these completed the study. Two doses of oral nitroglycerin were used; 2.6 mg and 6.5 mg given three times daily for a period of 2 weeks, the patients crossing over to the alternative dose at the end of each period. Evaluation of effect was carried out 2 hours after the morning dose using graded treadmill exercise testing with on-line computer analysis of the electrocardiogram (EKG) (CASE, Marquette Electronics, Inc.). Various exercise parameters were measured and the results compared to placebo values and between the two dosages. The aim was to demonstrate an antianginal effect and to look for a dose-response relationship and for attenuation of effect if any on continued administration. The mean +/- SEM exercise time on placebo was 6.7 +/- 0.6 min, increasing to 8.6 +/- 8 min (p less than 0.02) with 2.6 mg tds dosage and 8.4 +/- 0.7 min (p less than 0.01) with 6.5 mg tds of oral nitroglycerin. None of the other exercise-derived indices were altered significantly by oral nitroglycerin. Two patients were withdrawn because of severe headaches and both were receiving the higher dose. The data did not demonstrate any dose-response relationship but confirmed the anti-anginal efficacy of sustained action oral nitroglycerin. This efficacy did not show any significant attenuation of effect on continued administration, indicating a possible lack of development of tolerance.
Cardiovasc Drugs Ther 1988 Nov
PMID:Oral nitroglycerin in angina pectoris--evaluation of effect by computerized exercise testing using two different doses. 315 16

Forty-five consecutive patients (32 women and 13 men) underwent biopsy of the temporal artery because of suspected giant cell arteritis. Their ages ranged from 38 to 84 years, mean 68.1 years. Five patients (11.1%) four of them women, were found to be affected by the disease. Their ages ranged from 54 to 80 years, mean 69 years. Clinical and laboratory findings included elevated erythrocyte sedimentation rate, prolonged fever, continuous headache, sudden onset of unilateral blindness, intermittent mandibular claudication, severe anemia and myalgia. None of these, whether present in isolation or in various combinations, were of significant diagnostic value. All biopsies were examined both by light microscopy and by scanning electron microscopy. The former examination took about 5-7 days to complete, and the latter about 3 hours. Light microscopy studies showed that 46.6% of the arterial biopsies were normal, 42.3% were arteriosclerotic and 11.1% (5 specimens) were characteristic of giant cell arteritis. Scanning electron microscopy revealed that the biopsies obtained from all five patients found to have temporal arteritis displayed the "occlusive" pattern: the three-laminar appearance of the artery was markedly distorted or lost, the internal elastic lamina was barely detectable, and the densely hypertrophied media and intima filled the arterial lumen, virtually obliterating it. We conclude that scanning electron microscopy is a quick and accurate procedure for diagnosis of temporal arteritis and that positive findings may be taken as an indication for immediate steroid treatment.
J Cardiovasc Surg (Torino)
PMID:Scanning electron microscopy as a diagnostic procedure in giant cell arteritis. 366 83

Fifty-five patients suffering from essential or renal hypertension who had been insufficiently treated previously with combination therapy using diuretics and beta-blockers as well as reserpine, clonidine, prazosin, captopril, or minoxidil have been included in this open study. In addition to receiving diuretics and beta-blockers alone or in combination with reserpine, clonidine, or methyldopa, the patients were given nitrendipine in a dose of 2 X 20 to 2 X 40 mg/day. A normalisation of blood pressure values was attained in 46 of the 55 patients; 18 of these patients have been treated for more than 1 year. Few side-effects were observed. Dizziness and ankle oedema each occurred once. A rash occurred in one patient, causing the withdrawal of nitrendipine. No complaints of headache and palpitations were made. It may be concluded that nitrendipine is well suited as a partner in the combination treatment of patients with essential or renal hypertension that is difficult to stabilise.
J Cardiovasc Pharmacol 1984
PMID:Nitrendipine in hypertension that is difficult to control. 608 67

More than 1,700 patients with essential or renal hypertension were treated with nitrendipine; data from 967 of these were included in a data pool, and safety data were evaluated. Treatment duration was between 7 days and 2 years. The most frequent side-effects were headache, flush, oedema, dizziness, and palpitations due to the pharmacodynamic effect of the drug. All other side-effects had an incidence below 2%. Eighty-two of the 967 patients stopped therapy before the end of the trial. In 33 of these patients, this was probably due to the side-effects of nitrendipine. Hematological and clinical chemistry data did not indicate any systemic or organ damage. When nitrendipine was combined with thiazides, a lowering of plasma potassium levels could be found, which, however, did not necessitate any therapy.
J Cardiovasc Pharmacol 1984
PMID:Safety aspects of long-term nitrendipine therapy. 608 68

The antihypertensive efficacy of the calcium entry blocker nitrendipine administered as monotherapy (20-80 mg; mean, 36/day) on the average for 144 days to 46 patients with essential hypertension (WHO I and II) was investigated in relation to age, pretreatment blood pressure, and plasma renin activity. In addition, we compared the blood pressure responses to verapamil (n = 11) and nifedipine (n = 15) with those to nitrendipine. Nitrendipine monotherapy reduced blood pressure from 168 +/- 16/107 +/- 7 mm Hg to 145 +/- 13/91 +/- 6 (both p less than 0.001); in 33 of 46 patients a diastolic pressure less than or equal to 95 mm Hg was achieved. During long-term treatment, heart rate and body weight remained unchanged. Thirteen of 16 patients in whom blood pressure was measured 24 h after a single oral dose (20 to 40 mg) reached a diastolic pressure less than or equal to 95 mm Hg. Treatment with nitrendipine had to be discontinued because of severe headache in two and ankle oedema in one patient. The fall in mean blood pressure after nitrendipine was directly related to age (r = 0.553; p less than 0.001) and pretreatment mean blood pressure (r = 0.470; p less than 0.01) and inversely related to plasma renin activity (r = 0.558; p less than 0.001). These correlations were also significant for systolic and diastolic blood pressure. There was comparable antihypertensive efficacy, as expressed by changes in mean blood pressure, between nitrendipine and verapamil (r = 0.869; p less than 0.01), and nitrendipine and nifedipine (r = 0.953; p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
J Cardiovasc Pharmacol 1984
PMID:Antihypertensive therapy with the long-acting calcium antagonist nitrendipine. 608 70

Fifty-one patients with essential hypertension, 22 males and 29 females with a mean age of 51 (range, 28 to 65 years), were studied for more than 12 months in a controlled clinical trial with nitrendipine, a new calcium antagonist agent. No differences in age, severity of hypertension, and other risk factors between the two sexes were detected. Forty-four of 51 patients completed the study, and 38 (86.4%) achieved a normalization of blood pressure. Mean systolic blood pressure decreased from 196.0 +/- 12.9 mm Hg (means +/- SD) during placebo to 171.2 +/- 9.5 mm Hg (12.6%, p less than 0.001) after 12 months. Mean diastolic blood pressure at the same time decreased from 109.0 +/- 5.2 mm Hg to 88.5 +/- 3.6 mm Hg (18.8%, p less than 0.001). Heart rate also decreased slightly but significantly (p less than 0.01) after the fifth week. A significant change in weight was not observed throughout the trial. Plasma potassium remained unchanged during the year, and plasma sodium after a transient increase (p less than 0.001) in the fifth week returned very close to basal levels in the sixth month. Side-effects were observed in 17 patients, 5 of whom had to leave the trial, but in the rest they were usually mild and transient. These were mainly frontal and occipital headache, facial flushing, ankle and pretibial oedema, and dizziness. No relationship was detected between side-effects and body weight or plasma sodium disturbances. Preliminary data on a separate group of 27 elderly patients (66-83 years) showed a better and faster effect of nitrendipine given in low doses.(ABSTRACT TRUNCATED AT 250 WORDS)
J Cardiovasc Pharmacol 1984
PMID:Clinical experience with long-term nitrendipine treatment in essential hypertension. 608 73


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