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)

The management of common medical problems in pregnancy often requires adjustments in drug therapy to assure a healthy fetus. The management of steroid-dependent bronchial asthma in pregnancy requires oxygen supplementation as well as vigorous treatment of airway obstruction to protect the fetus from maternal hypoxemia. The hypertensive pregnant patient should discontinue dietary sodium restriction and diuretic therapy and should be managed with alphmethyldopa or beta-blocker therapy. Hydralazine may be added if hypertension is severe. Mitral valve prolapse appears to produce no difficulties during pregnancy and the use of prophylactic antibiotics is probably not necessary for routine vaginal delivery, unless complications occur. Digoxin and quinidine are safe to use in pregnancy, provided careful monitoring is maintained. Oral anticoagulants are contraindicated in pregnancy and should be replaced with heparin if pregnancy is desired.
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PMID:Cardiovascular and respiratory agents during pregnancy: implications for fetal development. 286 59

Recent research has demonstrated the presence of endogenous compounds in blood and urine that crossreact with antibodies raised against digoxin. Given the widespread therapeutic use of digoxin and its being monitored clinically by immunoassay, such digoxin-like immunoreactive compounds pose significant diagnostic and interpretive problems. Serum levels of this factor(s) approaching therapeutic digoxin levels have been found in digoxin-free patients in renal failure, pregnant women, and newborns. The compound is incompletely characterized; however, existing data suggest that it is a small, neutral, nonpeptidic compound. In serum it is highly protein bound, and alterations in this binding appear to give rise to the false-positive assay results. The urinary form is probably conjugated. Digoxin-like immunoreactive substances may play a role in volume homeostasis and appear associated with essential and pregnancy-induced hypertension. If such roles are primary, measurement of digoxin-like immunoreactive substances may prove to be of value in and of itself.
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PMID:Endogenous digitalis-like factors. 301 91

Digoxin was measured by radioimmunoassay in the plasma of 25 patients with aneurysmal subarachnoid haemorrhage who had not received digoxin treatment. After heating the plasma an endogenous substance cross reacting with antibodies to digoxin was identified in 18 cases. The presence of this substance was significantly related to the total amount of blood and to the presence of blood in the frontal interhemispheric fissure and could not be explained by hypertension or intake of water and sodium. A negative sodium balance and volume depletion occurred more often in patients who were positive for digoxin, but this relation did not reach statistical significance. It is concluded that a digoxin-like natriuretic factor is released in response to a subarachnoid haemorrhage, probably as a result of hypothalamic damage.
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PMID:Digoxin-like immunoreactive substance in patients with aneurysmal subarachnoid haemorrhage. 310 13

We have re-examined digoxin-like immunoreactivity, commonly detected in plasma with antibodies, in order to determine whether it could represent the putative natriuretic factor originally proposed by de Wardener and Clarkson. Experiments were conducted in adult rabbits with two-kidney, two wrapped hypertension and in sham-operated controls. Six weeks after the bilateral renal cellophane wrapping or sham operation, the mean arterial pressure (MAP) was approximately 40 mmHg higher in the wrapped group. At this time the rabbits started a low-, normal- or high-salt diet (1.6, 25.6 and 40.8 mmol Na+/100 g) which continued for 2 weeks. During the final 3 days urinary volume and total sodium content measured in 24-h collections was significantly lowered in the rabbits on the low-salt diet and increased by the high-salt diet (P less than 0.01 for both). This pattern was identical for the normotensive and renal hypertensive rabbits. Digoxin-like immunoreactivity was measured at the beginning and at the end of the 2-week period of the salt study. Immediately before commencing the various salt diets the digoxin-like immunoreactivity, measured as ng digoxin equivalents/ml, was only marginally elevated in the renal hypertensive compared to the normotensive animals (it averaged 94.7 +/- 7.7 and 80.9 +/- 5.9 ng digoxin equivalents/ml, respectively). Neither the low- nor the high-sodium diet affected plasma digoxin-like immunoreactivity in either the normotensive or the renal hypertensive animals (P greater than 0.10). These results indicate that digoxin-like immunoreactivity is present in the plasma of normotensive and renal hypertensive rabbits.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Circulating digoxin-like immunoreactivity in renal hypertensive rabbits: lack of modulation by alterations in dietary sodium intake. 336 Nov 19

The care of the elderly covers a wide spectrum: 1, The prophylaxis of the relatively healthy olds. 2, The somatic, psychic and social care of the handicapped aged. 3, The treatment of special illnesses in old age. The gerotherapy must consider the characteristics of the biological age and the degree of the multimorbidity. I. General principles of therapy. The guide-lines of gerohygiene (diet, physical and mental activity, limitation of alcohol and sexuality, regular medical check-ups for registration of risk factors) have to be taken into consideration. The existing multimorbidities in high age should not be treated simultaneously in a polypragmatic way, but according to the prevailing illness with the least possible medicine. II. Special principles of therapy. In the early stage of heart insufficiency in long-lived persons low doses of Digoxin should be used. For aged with kidney insufficiency Digitoxin is preferable. Even in over 90 year old heart patients with the life threatening AV-block the implantation of the intracardial pacemaker is indicated. The myocardial infarction in very old patients developes mostly atypical and should not be treated with coumarin. The more severe hypertension in old age can be treated with low doses of beta-blocking substances in combination with a potassium saving diuretic and low doses of cardiac glycosides. Finally, the frequent sleep disturbances and their therapy in old age are mentioned. The brain function of elderly people depends on the quality of cardiac output and circulation.
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PMID:[Problems of therapy in very old age (author's transl)]. 612 34

Blood pressure and digitalis-like substance were measured in the plasma of control, salt-treated, and DOCA-salt treated rats. Blood pressure in DOCA-salt treated rats was significantly higher than that of either control or salt-treated animals. Digitalis-like activity was measured by two methods, radioimmunoassay for digoxin, and a receptor binding assay employing a rat brain synaptosomal membrane fraction. Digoxin-like immunoreactivity in plasma was not detected in either control or salt-treated rats, but was detected in DOCA-salt treated rats. Receptor binding activity in salt-treated rats was slightly but significantly higher than that of control rats. In DOCA-salt treated rats, receptor binding activity was significantly higher than that of salt-treated rats. Partial purification of the digitalis-like substance in plasma was performed by gel filtration using Sephadex G-25. Two peaks containing digoxin-like immunoreactivity were observed. Receptor binding activity, as well as Na+-K+ ATPase inhibitory activity, was detected only in the second peak, in which approximately 70% of the digoxin-like immunoreactivity was eluted. These results indicate that a circulating digitalis-like substance is increased in DOCA-salt hypertension.
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PMID:Circulating digitalis-like substance is increased in DOCA-salt hypertension. 633 39

The chronotropic effects of digoxin and deslanoside were studied in canine atria cross-perfused with heparinized arterial blood from donor dogs. Intravenous injections of either drug (100 micrograms/Kg) into the donor dog produced bradycardia followed by ventricular tachyarrhythmia, with or without hypertension, in the donor dog. A significant increase in the developed tension was observed in the isolated atria, with or without slight sinus acceleration. These effects continued over 150 min after the injection. Digoxin (200 micrograms/Kg, i.v.) caused an immediate bradycardia followed by ventricular tachycardia. In addition, ventricular fibrillation occurred in 3 out of 5 donor dogs within 20 min of the drug administration. In isolated atria, there was a marked increase in the developed tension, usually with a little sinus tachycardia. Deslanoside (200 micrograms/Kg, i.v.) caused almost the same response patterns as digoxin. However, this dose of deslanoside caused ventricular fibrillation in all 6 experiments. Drug concentrations in the donor's arterial blood decreased rapidly for 15-20 min and then decreased slowly in all experiments. It is concluded that digoxin and deslanoside have no significant direct accelerating action on the SA node in doses which produced marked increases in the developed tension; only extremely high doses cause a direct, slight sinus acceleration.
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PMID:Cardiovascular effects of digitalis on intact dogs and isolated cross-perfused atria. 667 65

Digoxin levels have been reported in neonatal blood when neither the mother nor the baby had received digoxin. An endogenous digoxin-like substance (DLS) that may be causally related to hypertension has been described. Using a commercially available radioimmunoassay kit, we investigated the presence of an immunoreactive DLS in 21 pre-eclamptic mothers, 36 mothers with normal blood pressure (the control group) and their infants. We found mean DLS levels to be higher in cord blood from infants born to the pre-eclamptic mothers than in cord blood from those born to mothers in the control group. Levels were also higher in cord blood than in maternal blood in both the pre-eclamptic and the control groups. DLS seems to be associated with pre-eclampsia. Although further work is needed for verification, a hypothesis on the possible role of DLS in the causation of pre-eclampsia is presented.
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PMID:The possible role of endogenous digitalis-like substance in the causation of pre-eclampsia. 672 27

Cardiac insufficiency in the elderly is not a typically age-induced phenomenon, but is rather due to pathological changes of the heart. Renal function, on the other hand, does show age-related deterioration without any apparent pathological changes occurring. For the treatment of cardiac insufficiency in the elderly three groups of drugs are used: diuretics, cardiac glycosides, and vasodilators. When sinusrhythm is still present diuretics should be primarily employed, and in uneffective glycosides, and finally vasodilators. If hypertension is the main cause of heart failure diuretics and vasodilators should be preferred, and glycosides only used in the last instance. Heart failure complicated by tachyarrhythmia should be treated primarily with glycosides, then diuretics and vasodilators. Powerfully as well as long acting diuretics may cause hypovolaemia, hyponatremia, and in particular hypokalaemia in the elderly. Digoxin accumulates with impaired renal function, Digitoxin is not affected by renal function but its half-life is extremely long. In the case of atherosclerotic changes of the vascular system, vasodilators should be employed with caution to prevent extreme drops in blood pressure.
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PMID:[Cardiac insufficiency in the elderly with particular reference to kidney function]. 702 38

Digoxin remains a very useful agent for chronic atrial fibrillation or for the ectopic beats associated with heart failure. But when rapid control of the ventricular rate is required to arrhythmias such as atrial fibrillation, atrial flutter, or paroxysmal atrial tachycardia, a slow infusion of verapamil is the agent of choice. In general, verapamil may be added to digoxin or given intravenously while a digoxin effect is awaited, unless there is digitalis toxicity. In digitalis toxicity, lignocaine remains the agent of choice for ventricular arrhythmias, and is given in the same doses as for acute myocardial infarction; phenytoin is used for digitalis-arrhythmias with A-V block. Verapamil may be infused very cautiously for digitalis-induced supraventricular tachyarrhythmias. The use of oral agents such as quinidine, disopyramide and mexilitene for chronic prophylaxis of ventricular ectopic beats is of doubtful effectiveness, unless the ectopic activity is symptomatic. Serious ventricular arrhythmias may be induced by quinidine and disopyramide. Beta-blockade is especially useful for ectopic beats associated with anxiety, or when arrhythmias are associated with angina of effort or hypertension. As always, major contraindications to the use of beta-blockade include cardiomegaly, heart failure or asthma.
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PMID:Anti-arrhythmic agents in ischemic heart disease: supraventricular arrhythmias, digitalis toxicity and chronic stable ventricular ectopic beats. 708 6


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