ABSTRACT
The antihypertensive treatment with a single agent is not useful for the arterial pressure control in a significant number of patients. In such cases, combined treatment or drug substitution are recommended (sequential or substitutive monotherapy). In the last years, the fixed dose combinations in one single pharmaceutical preparation have proliferated. These associations must fulfill a number of conditions in order to be considered rational, as for instance the compatibility of its pharmacokinetic features, properly dosing, the absence of new secondary effects and the high efficiency showed in most of patients. The advantages of these combinations are the comfort and easiness of the therapeutic schema, antihypertensive action strengthening, less secondary effects when dose is reduced, and perhaps a synergism in the protection of target organs. The most popular combinations are: potassium sparing diuretic plus thiazide, diuretic plus beta block, diuretic plus ACEI, or calcium antagonist plus ACEI.
Subject(s)
Antihypertensive Agents/administration & dosage , Hypertension/drug therapy , Adrenergic beta-Antagonists/administration & dosage , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Antihypertensive Agents/adverse effects , Calcium Channel Blockers/administration & dosage , Diuretics/administration & dosage , Drug Synergism , Drug Therapy, Combination , HumansABSTRACT
El tratamiento antihipertensivo con un solo agente no controla la presión arterial en una proporción apreciable de pacientes. En estos casos suele recurrirse a tratamientos combinados o a la sustitución por otro fármaco (monoterapia secuencial o sustitutiva). En los últimos años han proliferado las combinaciones a dosis fijas en un solo preparado. Estas asociaciones deben cumplir una serie de condiciones para poder ser consideradas racionales, como la compatibilidad en sus características farmacocinéticas, dosificación adecuada, no ocasionar nuevos efectos secundarios y alta eficacia en la mayoría de los pacientes. Sus ventajas serían la comodidad y simplificación del esquema terapéutico, potenciación de la acción antihipertensiva, menos efectos secundarios al reducir dosis y quizás un sinergismo en la protección de órganos diana. Las combinaciones disponibles más populares son: diurético ahorrador de potasio y tiazida, diurético y betabloqueante, diurético e IECA y calcioantagonista e IECA (AU)
Subject(s)
Humans , Adrenergic beta-Antagonists/administration & dosage , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Antihypertensive Agents , Calcium Channel Blockers/administration & dosage , Diuretics/administration & dosage , Drug Therapy, Combination , Hypertension , Drug Synergism , Antihypertensive Agents/administration & dosage , Antihypertensive Agents/adverse effects , Hypertension/drug therapyABSTRACT
The development of rhabdomyolysis is a complications of acute intoxications, although its actual incidences is unknown. We had studied the frequency and differential characteristics of the patients with such complications. A prospective study was conducted with 200 patients admitted to a General Hospital from an urban area due to acute intoxication, recording the etiology of the intoxication, motivation and analytical characteristics of the patients with rhabdomyolysis compared to their patients without rhabdomyolysis. The incidence of rhabdomyolysis was 7.7%. Among the patients with rhabdomyolysis, ludic motivation (59%) and etiology associated to drug abuse (heroin 30%, cocaine 24%) were more frequent compared to the patients without rhabdomyolysis. Twenty per cent of the patients consuming cocaine and 17% of the patients consuming heroin developed rhabdomyolysis. Acute rhabdomyolysis was, thus, a significant complication of acute intoxications, associated to the consumption of illegal drugs and, at least in our cases, with a good evolution regarding the renal function.