To study the efficacy of losartan on urinary uric acid excretion in thiazide induced hyperuricemic and hypertensive patients

The precise relationship of Hyperuricemia found in hypertensive patients is still obscure; this study is a urinary uric acid lowering intervention with Losartan in hypertensive patients induced by Thiazide diuretics. A number of pharmacological agents like loop diuretics, similarly low doses of aspirin [<3g daily] aggravate Hyperuricemia. The effect of Losartan on urinary uric acid excretion In Hypertensive patients with Thiazide induced Hyperuricemia were investigated in the Department of pharmacology and therapeutics, Basic Medical Sciences Institute Jinnah Postgraduate Medical Centre Karachi. It was randomized, open label, prospective, comparative study. Total 60 hypertensive Hyperuricemic patients were enrolled one by one in this study, selected from medical OPD and wards of Jinnah Postgraduate Medical Centre, Karachi. Patients were divided in three groups. Group-1 patients were treated with Thiazide 50 mg/day, Group-2 with Losartan + Thiazide 50 mg/day, and Group-3 with Losartan 50 mg/day. The effect on urinary uric acid level was measured, after every fortnightly. Treatment with Thiazide + Losartan group and Losartan group showed significantly increase in urinary uric acid excretion. Whereas, Thiazide group decrease in urinary uric acid level. In contrast to Thiazide and Losartan alone Thiazide + Losartan led to a greater increased in urinary uric acid excretion. The average percentage increase in urinary uric acid excretion in Thiazide + Losartan group was -13.27% and the average percentage increased in urinary uric acid excretion was 6.7% in Losartan group. Thus it can be concluded from the present study that urinary uric acid excretion was more increased in combination therapies. Ultimately Losartan decrease serum uric acid level and uricosuric effect of Losartan might be particularly useful in Hyperuricemic patients those on Thiazide diuretic [for hypertension and heart failure]

Ibuprofen: Adverse Effects

Ibuprofen is the first member of the class propionic acid introduced in 1969. It is better-tolerated analgesic as compared to aspirin. All members belonging to propionic acid group inhibit prostaglandins, easily absorbed on oral administration, enter brain, synovial fluid and cross placenta, largely metabolized in liver by hydroxylation and glucuronic conjugation excreted in urine as well as in bile. It has analgesic, antipyretic and anti-inflammatory effects. It is commonly used in rheumatoid arthritis, osteoarthritis, and other musculoskeletal disorders. It is useful drug but cannot be considered free of adverse effects, the side effects comprise of milder gastric discomfort, nausea and vomiting, headache, dizziness, blurring of vision, tinnitus, depression, rashes, itching and other hypersensitive phenomena. Anaphylactic shock has also been reported, salt retention and hypertension has also been reported in elderly patients. In our study we noticed 10 male and 25 female patients developing gastric discomfort on prolonged use of ibuprofen. Two females patients have been noted developing analgesic headache. 5 male and 2 female observed nausea. 3 males and 2 females reported dizziness. 2 male patients were observed to have fixed drug eruptions