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1.
Article Dans Anglais | IMSEAR | ID: sea-138756

Résumé

A 75-year-old female was commenced on sildenafil for the treatment of pulmonary arterial hypertension (PAH) secondary to chronic obstructive pulmonary disease (COPD). She reported blurring of vision within 72 hours after starting treatment and was found to have a central retinal vein occlusion (CRVO). Such an occurrence is the second case reported to date, and we review the possible mechanisms and literature on the subject.


Sujets)
3',5'-Cyclic-GMP Phosphodiesterases/antagonistes et inhibiteurs , Sujet âgé , Diagnostic différentiel , Femelle , Humains , Hypertension pulmonaire/traitement médicamenteux , Inhibiteurs de la phosphodiestérase/effets indésirables , Inhibiteurs de la phosphodiestérase/usage thérapeutique , Pipérazines/effets indésirables , Pipérazines/usage thérapeutique , Purines/effets indésirables , Purines/usage thérapeutique , Occlusion veineuse rétinienne/induit chimiquement , Occlusion veineuse rétinienne/diagnostic , Sulfones/effets indésirables , Sulfones/usage thérapeutique
2.
Journal of Korean Medical Science ; : 586-590, 2004.
Article Dans Anglais | WPRIM | ID: wpr-109222

Résumé

DA-8159, a selective inhibitor of phosphodiesterase type 5, was developed as a new drug for erectile dysfunction. The effect of DA-8159 on the electroretinogram (ERG) and the retinal histopathology were evaluated in rabbits. The ERG was performed prior to, and 1 and 5 hr after DA-8159 (5 to 30 mg/kg) administration. The plasma concentration of DA-8159 was determined at each time point, and retinal microscopic examination was also performed. There was no statistically significant ERG change at any dose or at any time. Though the 30 Hz flicker showed a prolongation of the implicit time at 5 hr after the administration of either DA-8159 15 mg or 30 mg/kg (p<0.05), but concurrent amplitude decreases were not statistically significant. At a dose of 5 mg/kg, no test drug was detected in the blood after either 1 or 5 hr. At either 15 mg/kg or 30 mg/kg, there was a dose-dependent increase in the blood concentration after 1 hr of drug administration, which decreased with time. In light and electron microscopic examinations of the retina, there was no remarkable change at any dose. These results suggest DA-8159 has a low risk potential to the retina, but further evaluation on the visual functions in human is needed.


Sujets)
Animaux , Humains , Mâle , Lapins , 3',5'-Cyclic-GMP Phosphodiesterases/antagonistes et inhibiteurs , Relation dose-effet des médicaments , Électrorétinographie/effets des médicaments et des substances chimiques , Inhibiteurs de la phosphodiestérase/sang , Pyrimidines/sang , Rétine/cytologie
4.
Indian Heart J ; 2003 Jan-Feb; 55(1): 55-9
Article Dans Anglais | IMSEAR | ID: sea-4214

Résumé

BACKGROUND: Pulmonary arterial hypertension is a life-threatening disease for which continuous intravenous infusion of prostacyclin has proved effective. However, it carries the risk of serious complications arising from the complex delivery system. Prostacyclin analogs, endothelin antagonists, and the phosphodiesterase-5 inhibitor sildenafil are emerging promising therapies. This study was aimed at evaluating the utility of oral sildenafil in patients with pulmonary hypertension of varied etiology, poorly controlled on conventional treatment. METHODS AND RESULTS: Ten consecutive patients with pulmonary hypertension, either primary or related to previous left-to-right shunts, thromboembolism, or interstitial lung disease, poorly controlled on conventional therapy such as warfarin, calcium antagonists, digitalis, and diuretics, were included. A thorough clinical, laboratory, and comprehensive echo Doppler evaluation was performed before enrollment in the trial to establish the diagnosis and obtain baseline data. Subjects received sildenafil 25 mg 8 hourly, or a matching placebo for two weeks each, in a randomized, double-blind, crossover design. A run-in period of two weeks was permitted between the two therapies during which patients continued to receive the conventional therapy without any vasodilator. At the end of each therapy period, the patients were evaluated for symptoms, New York Heart Association class, distance covered during the 6 min walk test, rating of modified Borg dyspnea score, and systolic pulmonary artery pressure using echo Doppler. The differences in the above variables at the end of sildenafil and placebo therapies were compared. Nine patients completed the study protocol. Sildenafil, compared to placebo, was associated with improved exercise tolerance as determined by the 6 min walk test (266.67+/-131.45 m v. 170+/-105 m; p<0.005), decrease in modified Borg dyspnea score (3.56+/-1.01 v. 5.11+/-1.45; p<0.01), decrease in Doppler-estimated pulmonary artery systolic pressures (55.33+/-16.52 mmHg v. 75.33+/-19.75 mmHg; p<0.005), improvement in New York Heart Association class (2 patients), and improvement in symptoms. Sildenafil was well tolerated with no untoward effects; further, no significant changes in heart rate or blood pressure occurred during the study period. CONCLUSIONS: Sildenafil improves exercise capacity and symptoms, and decreases pulmonary artery pressures in patients with primary or secondary pulmonary hypertension of varied etiology.


Sujets)
3',5'-Cyclic-GMP Phosphodiesterases/antagonistes et inhibiteurs , Adulte , Études croisées , Méthode en double aveugle , Femelle , Humains , Hypertension pulmonaire/traitement médicamenteux , Mâle , Adulte d'âge moyen , Inhibiteurs de la phosphodiestérase/usage thérapeutique , Pipérazines/usage thérapeutique , Études prospectives , Purines , Sulfones
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