Added care is needed in monitoring the use and effects of herbal and alternative therapies in the hypertensive population. Braz J Med Biol Res, 41 7 : 600-9. The hazardous interactions are relatively infrequent but must be shown so they can be avoided. Plasma volume did not change. The hydrophobic indoline moiety of indapamide confers a lipid solubility to the molecule that is 5 to 80 times greater than that of the thiazide diuretics. Linear proportionality of blood concentration with increasing doses is evident following both single and multiple doses.
Denervated rats showed markedly reduced renal nerve tyrosine hydroxylase levels. In general, the treatment of hypertension is very rewarding: headache and symptoms of heart failure are relieved, retinopathy regresses, hypertensive encephalopathy is prevented, the likelihood of cerebrovascular accidents is much less, and renal deterioration is halted or slowed. Preparation of homogenates An accurately weighed piece of each of liver, spleen and kidney tissues was homogenized in ice-cold 0. In five patients who had responded poorly to combined adrenergic blocker and diuretic treatment, plasma volume was either expanded or normal. There were no differences in blood pressure between denervated and sham rats in the losartan and indapamide series. The resulting supernatant was used for biochemical analysis.
All antihypertensive agents have potential disadvantages in patients with diabetes. An index of possible interactions either adverse or salutary of guanidinium compounds and other drugs is given. Antagonism of the antihypertensive action of guanethidine by the tricyclic antidepressants, desipramine and protriptyline, has been demonstrated in controlled studies. Indapamide also slightly reduced the effect of the calcium agonist Bay K 8644, which increases intracellular calcium through voltage operated calcium channels. In addition, it has discrete effects on a number of interrelated systems that may protect the cardiovascular system. In vivo studies in man also show a reduction in sensitivity to pressor doses of noradrenaline and angiotensin without an increase in adrenergic sensitivity.
Thus factors influencing the rate of gastric emptying may alter the rate of absorption of most if not all orally administered drugs. In the latter two countries, beta-blockers are the most widely prescribed antihypertensives, and also in Germany they rank quite high in sales, but less so in the number of prescriptions. In chronic studies, a 4-week treatment with metoprolol caused a decrease in blood pressure. The hypoglycemic action of mebanazine was further investigated in five patients from a diabetic clinic who were poorly controlled on sulfonylurea treatment and who were not depressives. There may be a positive association between multi antihypertensive drug use and symptoms of depression, whereas this was not found in persons with symptoms of anxiety or mixed anxiety and depression.
Both the active drug and the placebo were well tolerated. Recumbent serum norepinephrine levels after indapamide alone or with nadolol for 4 to 8 weeks remained comparable with placebo levels. A review of its pharmacological properties and therapeutic efficacy Chaffman, M. They are not absorbed to any extent from the stomach but may be absorbed very rapidly from the small intestine. The absence of distinct lipoprotein alterations after short-term indapamide treatment may be of clinical and epidemiological interest. More recently, concern has been expressed about their long-term safety as larger populations are being exposed to diuretic agents for a significant proportion of their life-span.
In three subjects 50 mg. Introduction of the tricyclic antidepressant led to loss of blood pressure control in four of the patients. Disappearance of indapamide from the blood is biphasic, with a terminal half-life of approximately 16 hours. Introduction Cardiovascular diseases are one of the leading causes of death for people in developed countries world-wide. Therapeutic trials have shown prazosin to be effective in lowering blood pressure in all grades of hypertension: in mild and some cases of moderate hypertension when used alone and in moderate and severe hypertension when used in combination with other agents. Indapamide has been successfully combined with beta-adrenergic blocking agents, methyldopa, and other anti-hypertensive agents. Drugs are usually given orally.
In the 12 men both systolic and diastolic pressure correlated directly with plasma volume p less than 0. At present there is no reliable method of identifying patients at risk for this potentially serious side effect. The E-mail message field is required. Indapamide shows an alteration in vascular reactivity to calcium and other agonists, suggesting the possibility of a direct vascular effect. A number of adverse metabolic effects are associated with indapamide administration, including an increase in serum uric acid levels. Thirty-one patients with uncomplicated essential hypertension were included.
The present study may be indicative of the ability to withdraw some medications in many patients being treated with multiple antihypertensive agents. However, there are no data on the effect of combination therapy of indapamide with micronised fenofibrate on uric acid metabolism. The mice were housed in steel mech cage and provided with commercial standard diet and tap water ad libitum. Some of the problem with compliance is due to side effects of the drugs being used. The mean glucose tolerance of four patients showed deterioration after discontinuation of mebanazine. Glucose tolerance did not improve in five patients treated with placebo.
The use of alternative therapies, herbs, and supplements occurs at a very high rate among patients attending a variety of health care settings. Specific questioning regarding herbals and alternative therapies in the hypertension clinic is therefore needed. Overall, syncope has occurred in fewer than 0. Exp Clin Cardiol, 11 3 :206-216. Most important, repeat administration of indapamide to dogs with both kidneys removed produces no accumulation of intact indapamide or its metabolites. Data were analyzed using unpaired Student,s t-test.
In this double blind crossover study each drug was added in graded increments until a predetermined therapeutic response was obtained, blood pressure measurements and side effect scores were evaluated biweekly. Die Hoffnung, je nach Ätiologie des Hochdrucks beim einzelnen Patienten gezielt bestimmte Wirkstoffe einsetzen zu können, hat sich bisher nicht erfüllt. Kidney Int, 74: 655- 663. These finding are in accordance with those re-ported by Nishiya and Sugimoto, 2001 , Gradosova et al. Botany Department, Faculty of Science, Mansoura University, Mansoura, Egypt. To my knowledge, this has not been reported in the American literature with the exception of a precaution concerning the drug,1 although it has been discussed by the British. Ann Clin Biochem, 43, 207 — 13.