Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This is the first report in Israel of the successful treatment of acute promyelocytic leukemia (APL; M3) with an active metabolite of vitamin A. In a 42-year-old woman with APL all-trans-retinoic acid (ATRA; tretinoin), 45 mg/m2/day was given per os for 90 days. APL is associated with a distinct cytogenetic abnormality: translocation of a portion of the long arm chromosome 17 onto the long arm chromosome 15t (15; 17) with a breakpoint on chromosome 17 in the region of the retinoic acid receptor-alpha (RAR-alpha), playing a crucial role in the leukemogenesis of APL. In man, the drug induces myeloid and mainly promyelocytic leukemic cells to differentiate, without the development of bone marrow hypoplasia. In our patient it caused complete remission and the disappearance of intravascular disseminated coagulation. The only side-effects were a transient macular rash, gastrointestinal symptoms and mild hypertriglyceridemia. Other principal adverse effects reported in the literature are relatively not very serious and consist of dryness of the skin, occasional headaches and intracranial hypertension, nasal congestion, lymphadenopathy, respiratory distress with infiltrates in the lung, bone pain and increased hepatic aminotransferase. A hyperleukocytosis syndrome seems to be more problematic. ATRA appears to be superior to conventional chemotherapeutic regimens. It is safe and highly effective in inducing clinical, morphologic and karyotypic remission with a marked decrease in the expression of the abnormal RAR-message in APL. There is a possible molecular link between the pathogenesis and treatment of this severe and often fatal coagulopathic disease. This therapy of course does not eradicate the leukemic clone, and consolidation chemotherapy or bone marrow transplantation is necessary.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Remission of acute promyelocytic leukemia after all-trans-retinoic acid]. 148 98

Retrospective experience with drug therapy in 747 patients with essential hypertension registered from 1972-1983 is reported. Five hundred patients were seen between 1972 to 1978 and 247 between 1979-1983; the latter group was characterised by the use of beta blockers as first line drugs. Hypertension was graded according to level of diastolic blood pressure as mild, moderate and moderately severe or severe in 423, 211, and 113 patients, respectively. The overall response to treatment at 6 months was satisfactory in 66.2% of mild, 50.2% of moderate and 58.4% of severe grades of hypertension. A large number of patients in both the groups having varying grades of severity needed at least 2 to 3 drugs for the control of hypertension. The side effects of drugs were generally mild which included general weakness with diuretics; skin rash, nasal congestion and pruritus with methyldopa; cold extremities with beta blockers and palpitations with prazosin.
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PMID:Experience with anti-hypertensive drug therapy in a hypertension clinic--1972-1983. A retrospective analysis. 198 Oct 83

A double-blind, placebo-controlled trial was carried out in 40 patients affected by multi-infarct dementia to see if a daily intravenous infusion of 3 mg co-dergocrine mesylate ('Hydergine') over 14 days would improve severely deteriorated elderly patients and shorten the latent period (3 months) which is observed when the drug is given orally. All the patients had severe mental impairment, psychological deficit or altered consciousness. A Hachinski score of 7 or more, and a cumulative score of at least 12 points on SCAG scale Items 1, 2 and 4 (anxiety/depression) and/or Items 5, 6 and 8 (alertness/confusion) were required for admission. After 1 week of intravenous infusion of placebo, patients were randomly allocated to treatment with co-dergocrine mesylate or placebo, from Day 1 to Day 14. The solutions were infused over a period of 2 hours. During the follow-up period from Day 15 to Day 21, the patients did not receive any treatment. Thirty-six patients (17 on co-dergocrine mesylate, 19 on placebo) completed the study. The results, as rated on the SCAG scale, indicated significant improvements, in favour of co-dergocrine mesylate, in cognitive dysfunction, mood depression, withdrawal and overall impression. Furthermore, the factor fatigue on the Nowlis scale and clinical global assessments by physicians also showed significant advantages of the co-dergocrine mesylate group over placebo. Nine out of 17 co-dergocrine mesylate patients complained of side-effects, usually experienced during infusion; they consisted mainly of nausea (6 patients), gastric discomfort (2 patients), and tremor, nasal congestion, flushing, hypotension and hypertension (1 patient each). Despite the appearance of side-effects, general tolerability was rated as 'good' by both physicians and patients. It is concluded, therefore, that intravenous high dose co-dergocrine mesylate treatment has a fast and clinically relevant effect on the key clinical symptoms of multi-infarct dementia.
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PMID:Effects of intravenous high dose co-dergocrine mesylate ('Hydergine') in elderly patients with severe multi-infarct dementia: a double-blind, placebo-controlled trial. 268 Feb 86

The efficacy and safety of terazosin were compared with those of other antihypertensive drugs in three parallel-group, randomized, double-blind studies in which 133 patients with mild to moderate hypertension participated. In two studies, terazosin monotherapy was compared with placebo and prazosin (study M79-073), or with hydrochlorothiazide (study M80-012). In a third study (M80-013), the combination of terazosin plus hydrochlorothiazide was compared with the combination of prazosin plus hydrochlorothiazide. Doses of study medications were administered twice daily and were increased at weekly intervals until the average supine diastolic blood pressure was 90 mm Hg or less, with a decrease from baseline of at least 10 mm Hg, or until the maximum specified dosage of a given study drug was reached. In general, all active treatments resulted in significant decreases from baseline in supine and standing blood pressures. There was no significant difference between terazosin- and prazosin-treated patients for changes from baseline to the final visit in supine or standing blood pressure measurements (study M79-073). Hydrochlorothiazide had a significantly greater effect on supine diastolic blood pressure when compared with terazosin (study M80-012). Otherwise, there were no significant differences between active treatment groups. Overall, no regimen caused clinically important changes in pulse rates, body weights, laboratory test results, physical examinations, or electrocardiograms. The incidence of side effects was approximately the same for all drugs; the most common side effects were headache, dizziness, malaise, asthenia, and nasal congestion. The results of these studies suggest that terazosin exhibits antihypertensive activity that is quantitatively similar to that of prazosin in patients with mild to moderate hypertension, and that a dose of 1 to 10 mg twice daily is well tolerated.
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PMID:Comparative trials of terazosin with other antihypertensive agents. 287 6

A randomized double-blind crossover trial was conducted in 20 patients with moderate to severe hypertension to compare the efficacy of labetalol, which combines alpha- and beta-adrenoceptor blocking properties, with that of metoprolol alone or in combination with prazosin. After placebo for 1 wk, active medication was given in two 6-wk phases. During one phase, metoprolol (100 to 400 mg/day) was given with prazosin (2 to 4 mg/day) as an option in the last 3 wk, whereas during the other phase, labetalol (200 to 1000 mg/day) was given alone. Satisfactory control of supine blood pressure was obtained in 10 patients with metoprolol and in another four patients after the addition of prazosin. During the labetalol phase, blood pressure control was achieved in 11 of 19 patients tested. Gastrointestinal disturbances, nasal congestion, impotence, failure to ejaculate, scalp tingling, and headache were more prevalent in the labetalol phase than in the other. In four cases these occurred in patients who did not require prazosin. Supine, erect, and exercise pulse rates were reduced by both metoprolol with or without prazosin and by labetalol; the effects were less in the labetalol phase. These differences could arise from an action of labetalol on cardiac presynaptic alpha-adrenoceptors. Adjunctive use of prazosin in nonresponders to metoprolol increases the response rate and avoids unnecessary deployment of alpha-adrenoceptor blockade in patients whose blood pressure can be controlled by beta-blockade alone.
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PMID:On the combination of alpha- and beta-adrenoceptor blockade in hypertension. 662 19

More than 1200 patients who received pindolol for the treatment of hypertension, angina pectoris, and various arrhythmias in studies conducted in the United States were included in the New Drug Application submitted to the FDA. Nearly 1000 of these patients received pindolol as monotherapy. The side effects reported were generally transient and of mild or moderate severity. The most frequently reported side effects seen after pindolol administration, compared to those seen after placebo, were in decreasing order of incidence: headache, dizziness, insomnia, muscle pain, fatigue, weakness, nervousness, joint pain, edema, nausea, and muscle cramps. Other side effects that occurred more frequently with pindolol than with placebo but at a rather low incidence induced weight gain, bizarre dreams, visual disturbances, lethargy, and diarrhea. Nasal congestion, throat discomfort, nocturia, impotence, pruritus, anxiety, hypotension, bradycardia, and heart failure occurred only rarely. Of the 323 patients who received pindolol alone for the treatment of mild to moderate hypertension, only 20 (6.2%) were withdrawn from the study because of side effects. Overall, 3.4% of the patients treated with pindolol were withdrawn because of side effects, most of which involved the central nervous system, that is, insomnia, anxiety, dizziness, and headache. However, a few patients manifested some edema and weight gain while receiving pindolol alone. Review of the side effects data did not reveal a tendency for the incidence of side effects to be dose related. One placebo-controlled, double-blind study designed to evaluate the fixed dosages of 15, 30, and 60 mg in the treatment of mild to moderate hypertension suggested that only the incidences of insomnia and nervousness increased with increasing doses. However, these side effects were generally transient and of mild or moderate severity. The evidence indicates that pindolol has an acceptable safety profile and that any side effects that appear are generally well tolerated and disappear with continued treatment.
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PMID:Adverse reactions to pindolol administration. 704 82

The possibility that intranasally administered phenylephrine might cause systemic vasoconstriction and an important increase in blood pressure if administered to susceptible individuals in higher doses was investigated in two groups potentially at high risk: 12 patients with chronic nasal congestion whose blood pressure was normal and 14 patients with hypertension receiving the beta-blocker metoprolol. On two separate days increasing doses (0.5 to 4 mg) of phenylephrine or a placebo of identical appearance were instilled into the nostrils at hourly intervals. The blood pressure and the heart rate were recorded every 10 minutes. The total amount of phenylephrine administered (7.5 to 15 mg) was 4 to 30 times the manufacturer's recommended dose. No significant changes in blood pressure or heart rate occurred in either group after the instillation of phenylephrine.
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PMID:Intranasally administered phenylephrine and blood pressure. 710 13

In a double-blind clinical trial with 20 patients suffering from endogenous depression statistically significant changes (improvement) were present in the scores of all assessment instruments. Although no statistically significant differences occurred between the groups, significant improvement on the HAM-D occurred earlier for amitriptyline and significant improvement occurred earlier on HAM-A for viloxazine. 2 patients were discontinued due to adverse reactions; one for nausea and vomiting while receiving viloxazine and one for paroxysmal atrial tachycardia while receiving amitriptyline. The same number of TES occurred for each group with seven unique to viloxazine (numbness, tingling, palpitation, ejaculation difficulty, nausea/vomiting, diarrhea, epigastric pain and gustatory disturbances) and seven unique to amitriptyline (insomnia, irritability, syncope, tremor, nasal congestion, orthostatic hypertension and paroxysmal atrial tachycardia). Other than for 1 patient who developed syncope and orthostatic hypotension and the patient who developed paroxysmal atrial tachycardia, there were no clinically significant changes in pulse rate, blood pressure and weight. There were no clinical laboratory findings with either drug that were judged to be pathological.
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PMID:Viloxazine in the treatment of endogenous depression. A standard (amitriptyline) controlled clinical study. 718 72

Autonomic dysreflexia (AD) is a syndrome that consists of facial flushing, excessive sweating, nasal congestion, throbbing headache and paroxysmal hypertension which may occur in response to bladder distension in patients with spinal cord lesions above the T6 level. We report the case of a C2 quadriplegic patient who developed clinical features of AD along with cortical blindness and seizures after administration of meglumine (Hypaque) for diagnostic cystogram.
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PMID:Seizures and cortical blindness after meglumine (hypaque) administration: a variant of autonomic dysreflexia. 812 Mar 39

Nasal congestion is among the most bothersome of the symptoms of intermittent allergic rhinitis (IAR). Decongestants such as pseudoephedrine are often accompanied by adverse effects and should be avoided by patients with hypertension, arrhythmia, and other medical conditions. Most of the currently available antihistamines are ineffective for nasal congestion. Oral desloratadine, a new, potent H1-receptor antagonist, was examined for its ability to relieve nasal congestion/stuffiness in 346 patients (172 in the desloratadine group and 174 in the placebo group) with IAR. Desloratadine, administered once daily at a dose of 5 mg, demonstrated significant improvement in nasal congestion/stuffiness at all time points assessed in the study. This benefit was observed as early as the first patient evaluation on day 2 and continued throughout the 2 weeks of the study. Desloratadine is a new treatment option for patients with IAR and nasal congestion.
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PMID:Desloratadine reduces nasal congestion in patients with intermittent allergic rhinitis. 1170 22


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