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)

A case of intravenous labetalol in the treatment of a resistant hypertensive emergency is reported. Although there have been several reports of the use of oral labetalol in resistant hypertension, no intravenous administration in hypertensive emergency resistant to other drugs has been reported to date. A 36-year-old black female with BP of 270/160 mm Hg with complaints greater than one month's duration of dizziness, severe headaches, blurred vision, shortness of breath, vomiting, palpitations, flushing, agitation, diarrhea, weakness, and weight loss, was treated successfully with intravenous labetalol after she failed to respond to other established parenteral antihypertensive drugs. The patient received labetalol 20 mg iv bolus, and then 20 mg every ten minutes until a cumulative dose of 200 mg was attained. Labetalol produced a prompt but smooth reduction in BP without any reflex tachycardia or other adverse effects. Intravenous labetalol may be safe and effective for the management of rapid BP control in hypertensive emergencies resistant to other parenteral antihypertensive agents.
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PMID:Intravenous labetalol in the management of resistant hypertensive emergency. 360 97

A phase I and pharmacokinetic study of recombinant tumor necrosis factor (rH-TNF Asahi) was carried out in 29 patients, who received a total of 72 courses with doses ranging from 1 to 48 X 10(4) units/m2. Drug was given as 1-h i.v. infusions. Acute toxicities, taking the form of fever, chills, tachycardia, hypertension, peripheral cyanosis, nausea and vomiting, headache, chest tightness, low back pain, diarrhea and shortness of breath were seen, but were not dose-limiting or dose-related. Some early rise in SGOT, without any change in serum bilirubin, was noted at the highest doses. Eosinophilia, monocytosis, mild hypocalcemia and an increase in fibrin degradation products were seen in a few patients. The dose-limiting toxicity was hypotension, which occurred after the end of the drug infusion and was seen in all 5 patients treated at the highest dose. There was no mortality or long-term morbidity. There were no responses. Pharmacokinetic studies indicated a rapid plasma clearance and a short plasma half-life, generally less than 0.5 h.
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PMID:Phase I clinical trial of recombinant human tumor necrosis factor. 366 33

The effect of vitamin E use on selected medical disorders and laboratory parameters was studied in a large ambulatory elderly population. Information obtained from a standardized questionnaire concerning reports of numerous clinical disorders, such as hypertension, fatigue, and vaginal bleeding, was used to determine whether the use of vitamin E predisposed to those conditions. During a 2-year period, information was available on 369 vitamin E users and 1,861 non-users. No differences were noted in the prevalence of reported clinical disorders between the two groups, except that men using vitamin E complained more often of shortness of breath (p less than .04) and angina (p less than .03). There were no significant differences between vitamin E users and controls in any hematologic parameters studied. After the groups had been adjusted for age and sex differences, only one biochemical parameter, serum glutamic-oxaloacetic transaminase (SGOT) in men, was found to be significantly different in vitamin E users as compared with controls. Use of vitamin E by the participants in this study appeared to have little influence on clinical disorders or hematologic or biochemical parameters.
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PMID:Vitamin E effect on symptoms and laboratory values in the elderly. 370 Sep 24

Calcium channel blockers are assuming increasingly important roles in the practice of emergency medicine. Two cases and a review of the literature relating to treatment of hypertensive emergencies with nifedipine are presented. Nifedipine has a rapid onset of action (buccal, 10-15 minutes; oral, 30-45 minutes) and peak effect (buccal, 30 minutes, oral, 60 minutes). The duration of effects is four to six hours regardless of the route of administration, with a mean arterial pressure reduction of 21.6% (248/134 mm Hg to 165/87 mm Hg). In patients with severe hypertension and left ventricular failure, a consistent reduction in systemic vascular resistance (2,088 dynes/sec/cm-5 to 1242 dynes/sec/cm-5) and cardiac index (2.76 l/min/m2 to 3.77 l/min/m2) has been reported. The patients in this study had severe hypertension (systolic blood pressure greater than 180 mm Hg, diastolic blood pressure greater than 120 mm Hg) and end organ involvement (including heart failure, left ventricular strain, headache, confusion, dizziness, and shortness of breath). Nifedipine (10 mg) was administered buccally with prompt reduction of blood pressure and resolution of the patients' symptoms. Nifedipine appears to be a safe, effective agent for the management of hypertensive emergencies. Its pharmacokinetic profile and routes of administration make it particularly valuable in the practice of emergency medicine.
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PMID:Nifedipine in the management of hypertensive emergencies: report of two cases and review of the literature. 406 18

A 48-year-old white woman who for 3 years had been taking hydralazine, 100 mg three times a day, propranolol, 160 mg twice a day, and chlorothiazide, 500 mg/day, for hypertension suddenly developed rapidly expanding ulcers that looked like pyoderma gangrenosum. Arthralgias, fevers, and occasional shortness of breath were also noted. A pericardial effusion was diagnosed by echocardiography. The antinuclear antibody (ANA) titer on routine mouse liver substrate was initially negative, but the ANA titer was positive (1:1,920) on human epithelioid cell substrate. Antibodies to histones and single-stranded DNA were also elevated. After discontinuing hydralazine, all signs and symptoms cleared over a 4-week period. At the time of discharge the ANA titer had decreased to 1:480.
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PMID:Hydralazine-induced systemic lupus erythematosus presenting as pyoderma gangrenosum-like ulcers. 623 17

Labetalol is a new adrenergic antagonist with both alpha- and beta-blocking effects. The effects of labetalol and hydrochlorothiazide on the hypertension and ventilatory function of patients with both hypertension and mild reversible chronic pulmonary disease were compared. In this double-blind study, 20 patients were randomly allocated to receive increasing doses of labetalol (100 to 400 mg three times a day) or hydrochlorothiazide (25 to 50 mg three times a day) over a four-week treatment period. Patients returned at weekly intervals for spirometry baseline, two hours after receiving the medication for the following week, and five minutes after an exercise test. Each treatment reduced the blood pressure significantly and to a comparable degree. There was no significant decrease in ventilatory function two hours after administration of the drug at any visit for either drug. Ventilatory function did not deteriorate significantly following exercise with either drug. With labetalol there was a progressive statistically significant decline in baseline forced expiratory volume in one second from 1,860 +/- 190 ml to 1,685 +/- 190 ml during the four-week study period, although no patient became symptomatic from shortness of breath. We conclude that labetalol is an effective antihypertensive agent that does not adversely effect ventilatory function immediately, but that may lead to a decline in ventilatory function when administered long-term.
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PMID:Comparison of the effects of labetalol and hydrochlorothiazide on the ventilatory function of hypertensive patients with mild chronic obstructive pulmonary disease. 635 97

A case is presented of a 32-year old gravida 3, para 1, ab 1, presented at 26 weeks with chief complaints of periorbital edema, headaches, and blurred vision for about 1 week. 2 weeks prior to admission she had experienced shortness of breath and decreased fetal movement. Admission was at 28 weeks with uncontrolled hypertension, blood pressure 190/120, pulse 100/min. Temperature was 98.8 degrees. Attempted induction of labor with oxytocin was unsuccessful. A hydralazine infusion decreased the blood pressure to 180/100 and a 20 mg prostaglandin (PG) E2 suppository was inserted. A few hours later the blood pressure had dropped to 100/60 and the hydrazaline infusion was discontinued. About 3 hours later a stillborn female infant was born; post delivery examination revealed a large gap in the wall of the uterus extending into the lateral vaginal fornix. A total abdominal hysterectomy and right salpingo-oophorectomy was then performed and recovery was uneventful. PGE2 reliably initiates labor even in the presence of an "uninducible cervix" and is prone to increase intrauterine pressure to a level beyond that of normal labor with a lag in cervical changes. The 2 most common traumata reported following PG administration for therapeutic abortion are either cervico-vaginal fistulas or lateral tears. In this case since there was no indication of any congenital weakness of the uterine wall, it is reasonable to assume that the mechanism leading to the rupture was intense and prolonged uterine contractions combined with a rigid cervix.
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PMID:Uterine rupture associated with the use of vaginal prostaglandin E2 suppositories. 658 51

614 patients with hypertension of either sex of 4 clinical institutions were questioned for complaints, own anamnesis and family anamnesis with the help of a questionnaire specially developed for this purpose. The result was an accumulation of certain complaints, such as shortness of breath, cardiac pains, and slight excitability. As preliminary diseases particularly heart diseases, diabetes and renal diseases were mentioned. Many of the patients were in their families concerned with hypertension, diabetes mellitus, overweight, heart diseases and cerebrovascular insults. The throughly made anamnesis particularly furthers the development of a stable doctor-patient-relationship, for epidemiologic purposes (early recognition of unknown patients with hypertension) it is less suitable.
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PMID:[Complaint profile and anamnesis in the hypertensive patient]. 744 14

We administered the Rose Questionnaire to 1442 black, white, and Latino patients (approximately equal numbers) who sought care for acute chest pain at two medical centers. Of these, 718 subjects were enrolled at a large public hospital serving a low-socioeconomic status population and 724 at a large health maintenance organization hospital serving a middle-class clientele. Using the standard definition of Rose angina, multivariate logistic regression analysis identified five factors that contributed to the relative risk of a positive response: family history of myocardial infarction (2.48), history of peripheral vascular disease (1.41), history of high blood pressure (1.29), history of high cholesterol (1.26), and low-socioeconomic status hospital (0.78). Inquiring about shortness of breath as a substitute for chest pain or an alternative complaint in set one of the Rose Questionnaire did not increase the number of positive responses or differentiate between the socioeconomic groups or race-ethnic subgroups. Having a prior history of self-reported risk factors clearly defined a group with greater likelihood of a positive response to the Rose Questionnaire. Receiving care at a large public hospital (ie, being in a low-socioeconomic status group) was associated with reduced likelihood of having "typical" angina in comparison to receiving care at a health maintenance organization (middle socioeconomic status) for white subjects but not for Latinos and blacks.
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PMID:Rose Questionnaire responses among black, Latino, and white subjects in two socioeconomic strata. 816 46

We describe a case of positional dyspnea due to compression of the tracheobronchial tree by an extensive thoracic aneurysm. In a 77-year-old woman with long-standing systemic hypertension, intermittent anterior chest pain gradually developed over several years. She had no history of asthma or thoracic trauma. She was admitted to our hospital because of sudden, severe shortness of breath. The breathlessness was markedly worse when she lay on her back or on her right side. On physical examination, she was in acute respiratory distress with cyanosis, severe hypertension (180/110 mmHg), tachycardia, and inspiratory stridor. A chest X-ray film showed loss of volume and nearly complete radiopacity of the left hemithorax. Arterial blood gas analysis revealed an arterial oxygen partial pressure of 54.8 mmHg, a carbon dioxide partial pressure of 39.8 mmHg, and an oxygen saturation of 84.5 percent on room air. Computed tomographic examination of the thorax showed dilation of the aortic arch and descending aorta, and marked compression of the trachea and the left main bronchus. Examination with a fiberoptic bronchoscope revealed extrinsic compression of the trachea just proximal to the carina. The patient's symptoms stabilized. However, she did not undergo surgery because of her age and because of the size of the aneurysm. She died due to rupture of the aneurysm.
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PMID:[Asthma-like symptoms due to thoracic aneurysm]. 862 77


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