ABSTRACT
One hundred seventy-one patients, 60 years of age or older with isolated systolic hypertension, were randomly assigned to receive chlorthalidone 12.5, 25.0, or 50.0 mg or placebo once daily for 12 weeks. The majority of the patients receiving chlorthalidone 12.5 mg achieved therapeutic success with no clinically significant biochemical changes or side effects. The 50.0-mg dose level enhanced efficacy only minimally over the 25.0-mg dose level. Drug-related side effects were significantly more prevalent in the chlorthalidone 50.0-mg group than in the placebo group. The data suggest that most elderly patients with isolated systolic hypertension, regardless of the severity, could be treated effectively and safely with chlorthalidone 12.5 mg per day.
Subject(s)
Chlorthalidone/administration & dosage , Hypertension/drug therapy , Age Factors , Aged , Blood Glucose/analysis , Body Weight , Chlorthalidone/adverse effects , Cholesterol/blood , Clinical Trials as Topic , Dose-Response Relationship, Drug , Double-Blind Method , Electrocardiography , Female , Humans , Hypokalemia/chemically induced , Male , Middle Aged , Potassium/blood , Pulse , Systole/drug effects , Uric Acid/bloodABSTRACT
Hyperammonemic associated encephalopathy developed in an adult receiving essential amino acids. Evidence that her encephalopathy was related to her hyperammonemia included (1) elevated CSF glutamine and serum ammonia levels, (2) the absence of any other drug or metabolic cause of encephalopathy, and (3) resolution of her encephalopathy and abnormal ammonia levels with discontinuation of the hyperalimentation. The serum ammonia levels of patients receiving essential amino acid fluid should be monitored. If the levels remain elevated or if toxicity develops, consideration should be given to switching to an alternate fluid.
