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 each of the 16 patients included in our first study [6 idiopathic Raynaud's phenomenon (I), 4 associated with systemic lupus erythematosus (SLE) and 6 with progressive systemic sclerosis (PSS)] digital vasospasm could be reproduced by immersion of both hands in cold water (4 degree C). Each patient received in a double-blind manner and random order on two consecutive days, the calcium-channel blocking agent nifedipine (20 mg) and placebo. Nifedipine protection against vasospasm provoked by cold water (4 degrees C) was considered good or excellent in 14 of the 16 patients (p less than 0.001 versus placebo). In the second study, 30 patients [12 I, 10 PSS, 5 SLE and 3 rheumatoid arthritis (RA)] received in a double blind manner and random order, on two consecutive weeks, nifedipine (20 mg 3 time daily) and placebo. The improvement with nifedipine (in percentage of the decrease of the number of vasospastic attacks) was 90.95 in the 1 group, 78.63 SLE and RA and 64.02 in PSS (p less than 0.01). An open study during 3 months has confirmed the effectiveness of nifedipine (10 mg 3 times daily). The improvement was 88.92 in the 1 group, 76.33 in SLE and RA and 59.16 in PSS, 7 out of 30 patients stopped the treatment because of side effects (headache, flush, nausea, oedema of the ankles). Thus nifedipine appears to be extremely useful in the treatment of Raynaud's phenomenon.
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PMID:[Controlled study of nifedipine in the treatment of Raynaud's phenomenon]. 628 45

The pharmacokinetics, clinical efficacy, and adverse effects of three calcium-channel blocking agents--verapamil, nifedipine, and diltiazem--are reviewed. Verapamil, nifedipine, and diltiazem are absorbed well after oral dosing, but absolute bioavailability of each is reduced substantially by a first-pass effect. Each drug is metabolized extensively (verapamil and diltiazem to moderately active metabolites) by the liver. A substantial percentage of each drug is bound to plasma proteins, but the binding is of clinical importance only for nifedipine (92--98% protein bound). Intravenous verapamil has become the agent of first choice for treatment of acute paroxysmal supraventricular tachycardia (PSVT); use of chronic oral verapamil therapy for prophylaxis remains controversial. Verapamil and diltiazem have been evaluated with mixed results for atrial flutter and fibrillation. For treatment of myocardial ischemia, calcium-channel blockers may be of some value (possibly in combination with nitrates of B blockers). All three agents have been studied in patients with exertional angina with good results. Calcium-channel blockers appear to be equal with nitrates for treatment of variant angina. Patients with hypertropic cardiomyopathy have been treated with verapamil and nifedipine with promising results. Nifedipine has been effective for treatment of essential hypertension. Adverse effects of calcium-channel blockers have been relatively minor or infrequent. Diltiazem overall has the best side-effect profile, with adverse effects causing discontinuation of therapy in about 2--10% of patients; verapamil in intermediate (8--10%) and nifedipine the worst (17%) in this respect. The most common side effects generally are fatigue, headache, dizziness, skin rash, and peripheral edema. While they generally should be reserved for patients in whom more conventional therapy has failed (except those with PSVT), calcium-channel blockers appear to have a valid role as reserve agents for exertional and variant angina, cardiomyopathy, and hypertension.
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PMID:Update on calcium-channel blocking agents. 635 66

The antihypertensive activity of nifedipine in medium-term treatment has been studied in 30 patients affected by II and III WHO grade essential hypertension. After a 6-day period of placebo, patients were randomly allotted to group A (treated with single 10-mg doses of nifedipine) and group B (treated with single 20-mg doses). Treatment with nifedipine continued for 18 days. Patients in both groups were given one daily dose during the first 6 days, two daily doses in the following 6 days and three daily doses in the last 6 days. 1. Antihypertensive effect: In both groups, only three daily doses gave a satisfactory 24-hour antihypertensive activity. Nifedipine as monotherapy administered in single doses of both 10 mg (group A) and 20 mg (group B) normalized blood pressure (BP) and the measured antihypertensive effect was not statistically different in the two groups. The antihypertensive effect lasted between 7 and 8 hours after drug administration (both doses) and did not diminish with increasing duration of treatment or number of daily doses. 2. Change in heart rate: Nifedipine induced an increase in HR which diminished with shortening of the time interval between daily administrations. The effect on HR was unaltered throughout the whole experimental period. 3. Side-effects: Nifedipine did not induce orthostatic hypotension in any patient. Eleven of the 30 patients complained of side-effects, the most common being headache and palpitations. Incidence and severity of side-effects were not correlated with dose, whereas duration was longer with 20 mg. Side-effects never necessitated withdrawal of the drug.
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PMID:A study of the antihypertensive effect and some pharmacodynamic aspects of nifedipine in medium-term treatment. 646 34

Nifedipine, a "calcium channel blocker", is increasingly employed in the treatment of angina pectoris. Large interindividual differences have been observed in the effective dosage of the drug. Many of the reported alleged adverse reactions to nifedipine are linked to its primary pharmacologic action - vasodilatation. Therefore in 15 patients with angina pectoris we studied the relation between nifedipine concentration in the plasma and its clinical effects. Although in individual patients an increase in daily dose from 30 to 50 mg was followed by increased plasma levels and cessation of anginal attacks, no "therapeutic plasma range" could be delineated. Similarly, although some patients developed a headache when relatively high levels were measured, these levels still overlapped with those found in asymptomatic patients.
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PMID:Nifedipine plasma concentration in patients treated for angina pectoris. 671 89

Nifedipine (10 mg orally six times daily) was given to patients with unstable angina persisting despite adequate beta-blockade (group I, 35 patients) or despite the association of adequate beta-blockade and sublingual isosorbide dinitrate (group II, 47 patients). Stabilization of anginal symptoms was achieved in 31/35 patients of group I and in 39/47 patients of group II. Aorto-coronary bypass grafting was carried out in 19 patients because of persisting unstable angina (five patients) or because of the severity of residual angina (14 patients). Tolerance to these drug combinations was excellent, with side-effects consisting mainly of transient headache (eight patients) and noncardiac ankle edema (eight patients). Nifedipine was found to be valuable in stabilizing unstable angina persisting despite beta-blockade and nitrates.
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PMID:Benefits from adding nifedipine to the treatment of unstable angina when beta-blockade and isosorbide dinitrate have proved inadequate. 680 63

The calcium antagonist nifedipine (Adalat) was administered to 60 patients with essential hypertension and investigations were performed on acute and chronic hypotensive effects. The following results were obtained: 1. Acute hypotensive effects: Nifedipine (20 mg) was either orally or sublingually administered. Following oral administration, significant hypotensive effect was attained 20 min after administration and the maximum hypotensive response was obtained 2-4 h after administration. In cases of sublingual administration, significant hypotensive effect was notable 5 min after administration and blood pressure reached the lowest level 2-3 h after administration. The hypotensive effects lasted for a relatively longer period and significantly lower blood pressure than the control level was observed even 3 h after administration. 2. Chronic hypotensive effects: Nifedipine (30-60 mg/d) was orally administered consecutively. Significant hypotensive effect was attained in and after the 4th week of administration. The yearly changes in the long-term administration cases over 3 years demonstrated significant hypotensive effects. The cases who did not respond to single administration of thiazides or beta-blockers exhibited significant hypotensive response by the combined use of nifedipine. 3. Change in heart rate: In the acute study, heart rate increased after nifedipine administration and lasted for several hours. In the long-term administration cases, the changes in heart rate were not significant. 4. Side effects attributable to nifedipine such as headache in 2 cases, facial flushing, palpitation, warm sensation and nausea in 1 case each were observed early after the administration but there were no cases in whom administration was discontinued due to these side effects.
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PMID:Antihypertensive effects of the calcium antagonistic agent nifedipine. 720 Jul 85

Nifedipine gastrointestinal therapeutic system (GITS), a controlled-release delivery system given once a day, was evaluated in a multisite study of mild-to-moderate hypertensive subjects, seated diastolic pressure between 95 and 110 mm Hg, on placebo. Of 1,666 subjects enrolled, 69% were eligible to begin treatment. Therapy with nifedipine GITS was started at 30 mg daily and increased by 30 mg/day each week until there was a response (seated diastolic pressure < 90 mm Hg and a reduction of > or = 10 mm Hg) or until a maximum dose of 180 mg/day was reached. After titration, responders were kept on active treatment for 12 more weeks. Seventy-six percent of those treated responded, and 88% of the responders completed the 12-week phase. Comparisons were made among relevant subgroups. Elderly patients (age > or = 65 years) had a significantly higher response rate at a lower average daily dose, compared with younger subjects. Response rates were > 70% and relatively similar in (a) white and black patients, (b) diabetic and nondiabetic patients, (c) men and women, and (d) normal-weight, over-weight, and obese patients. Nifedipine GITS had no significant effect on fasting serum glucose or cholesterol fractions. Edema and headache were the most often observed adverse effects during treatment. Incidence of the former was related to dose but occurred without evidence of fluid retention (average body weight fell significantly by 1% during treatment). As antihypertensive monotherapy given once a day, nifedipine GITS is effective and well tolerated for a wide spectrum of hypertensive patients.
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PMID:Effectiveness of nifedipine gastrointestinal therapeutic system for treatment of hypertension: results of the MATH Trial. 769 45

This controlled, double-blind, completely randomized study assessed the efficacy and safety of nicardipine and nifedipine, both in slow-release formulations, in patients with unstable angina. Thirty patients (28 M, 2F) were included in the final analysis, mean age 56.5 +/- 9.1 years (SD), mean weight 73.5 +/- 9.2 kg, mean height 171.5 +/- 6.5 cm, all with unstable angina. Nicardipine was given at a daily dosage of 80-120 mg, and nifedipine 40-60 mg, for up to one month. At the end of treatment with nicardipine supine systolic and diastolic blood pressure (SBP and DBP) dropped respectively 7.7% and 5.5% at 8 am and 8.6% and 7.1% at 8 pm. Nifedipine reduced SBP and DBP by respectively 6.5% and 13.1% at 8 am and 5.3% and 9.4% at 8 pm. There was no clinical or statistical difference between the treatments. Heart rate did not change appreciably during either treatment. On completion of nicardipine treatment, 87.5% of patients had suffered no angina attacks, compared with 66.7% for nifedipine. The remaining 12.5% of patients treated with nicardipine presented only one mild angina attack per day, while the other 33.3% of the nifedipine patients had one moderate angina attack per day. No untoward effects were reported with nicardipine; one patient receiving nifedipine presented cardiopalmus and another complained of headache. These results indicate that nicardipine is at least as safe and effective as nifedipine in the treatment of unstable angina.
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PMID:[The efficacy and safety of slow-release nicardipine vs nifedipine in angina]. 775 27

The effect of the oral slow-release formulation of Nifedipine in rapidly lowering blood pressure was studied in 20 severely hypertensive Nigerians (8 males, 12 females). A significant fall (p < 0.05) in mean systolic, diatolic, and mean arterial pressure was obtained 30 minutes after administration of Nifedipine. The fall in all three parameters of blood pressure remained sustained and significant (p < 0.05) 6 hours after a single dose administration. Side effects were minimal and limited to headaches in 20% of patients and palpitations in 10%. All patients showed a sustained control of blood pressure over a three month follow up period on slow release Nifedipine. Addition of methyldopa resulted in improved blood pressure control in one patient with chronic renal failure. It was concluded that oral slow release Nifedipine is a drug of choice in the rapid and sustained control of blood pressure in severely hypertensive patients especially in a setting where critical intensive monitoring facilities are limited.
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PMID:Oral slow-release nifedipine in the rapid treatment of severe hypertension in Nigerians. 780 25

The efficacy and safety of once-daily nifedipine coat-core when added to a regimen of atenolol (ATN; 50 mg/day) were compared with ATN and placebo in 251 patients with essential hypertension in this 12-week, multicenter, randomized, double-blind, placebo-controlled, parallel-group study. Mean net reductions (ATN effect subtracted) in supine diastolic blood pressure at endpoint were 7.9 mmHg, 9.4 mmHg, and 9.9 mmHg at 30, 60, and 90 mg/day of nifedipine coat-core, respectively, and 4.1 mmHg on ATN+placebo. Beyond the first week of double-blind therapy, all reductions produced by nifedipine coat-core combined with ATN were statistically significant (P < 0.05) compared with ATN+placebo. On ambulatory blood pressure monitoring, trough-to-peak ratios of the change in diastolic blood pressure for the 30, 60, and 90 mg/day doses were 41%, 68%, and 78%, respectively. Adverse events were generally mild or moderate and most reflected the vasodilatory properties of nifedipine (eg, edema, headache). Nifedipine coat-core, when combined with ATN in patients not controlled by ATN alone, had significant antihypertensive activity for the entire 24-hour dosing interval and was well tolerated by the majority of patients in the study.
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PMID:The safety and efficacy of once-daily nifedipine coat-core in combination with atenolol in hypertensive patients. Adalat CC Cooperative Study Group. 811 17


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