ABSTRACT
Torasemide is a loop diuretic and has been used for the treatment of both acute and chronic congestive heart failure (CHF) and arterial hypertension (AH). Torasemide is similar to other loop diuretics in terms of its mechanism of diuretic action. It has higher bioavailability (>80%) and a longer elimination half-life (3 to 4 hours) than furosemide. In the treatment of CHF torasemide (5 to 20 mg/day) has been shown to be an effective diuretic. Non-diuretic dosages (2.5 to 5 mg/day) of torasemide have been used to treat essential AH, both as monotherapy and in combination with other antihypertensive agents. When used in these dosages, torasemide lowers diastolic blood pressure to below 90mm Hg in 70 to 80% of patients. Antihypertensive efficacy of torasemide is similar to that of thiazides and related compounds. Thus low-dose torasemide constitutes an alternative to thiazides in the treatment of essential AH.
Subject(s)
Blood Pressure/drug effects , Heart Failure/drug therapy , Hypertension/drug therapy , Loop of Henle/drug effects , Renin-Angiotensin System/drug effects , Sulfonamides/pharmacology , Biological Availability , Chronic Disease , Dose-Response Relationship, Drug , Half-Life , Heart Failure/metabolism , Heart Failure/physiopathology , Humans , Hyperglycemia/chemically induced , Hypertension/metabolism , Hypertension/physiopathology , Hypokalemia/chemically induced , Loop of Henle/metabolism , Loop of Henle/physiopathology , Sodium Potassium Chloride Symporter Inhibitors/pharmacology , Torsemide , Treatment OutcomeABSTRACT
We consider in this review traditional and novel approaches to drug prevention of pulmonary embolism (PE) which in predominant number of cases is related to deep vein thrombosis of lower extremities. Risk of PE development is especially high in patients after orthopedic hip or knee surgery. Modern recommendations contemplate use of unfractionated and low molecular weight heparins, vitamin K antagonists (warfarin in the first place), fondaparinux. Oral direct anticoagulants related to selective inhibitors of blood coagulation factors IIa (thrombin) and Xa have appeared recently and proved their preventive efficacy and safety in randomized controlled studies. Preventive efficacy and safety of dabigatran among direct selective factor IIa (thrombin) inhibitors and of rivaroxaban, apixaban, and edoxaban among direct selective factor IIa inhibitors have been studied best.
Subject(s)
Anticoagulants/pharmacology , Orthopedic Procedures/adverse effects , Postoperative Complications , Pulmonary Embolism , Venous Thrombosis , Drug Administration Routes , Drug Substitution , Factor Xa Inhibitors , Heparin/pharmacology , Heparin, Low-Molecular-Weight/pharmacology , Humans , International Normalized Ratio/standards , Lower Extremity/surgery , Pulmonary Embolism/etiology , Pulmonary Embolism/prevention & control , Randomized Controlled Trials as Topic , Risk Factors , Secondary Prevention , Therapies, Investigational , Thrombin/antagonists & inhibitors , Venous Thrombosis/etiology , Venous Thrombosis/prevention & control , Warfarin/pharmacologyABSTRACT
The prevalence of right ventricular cardiac failure (CF) and its characteristics were analysed in 326 hospitalized elderly patients with chronic obstructive pulmonary disease (COPD) (average age 70+/-11 years). At admission right ventricular CF was diagnosed in 107 (33%) patients with COPD; its prevalence did not depend to sex but increased with age, especially among men. In patients with COPD right ventricular CF was associated with atrial fibrillation, anemia and obesity as well as a history of myocardial infarction. In patients with right ventricular CF dimensions of right ventricle and left atrium were significantly larger than those in patients without CF. Right ventricular CF was often associated with dilation of right atrium and pulmonary hypertension, especially with severe pulmonary hypertension. These data suggested that age (especially among men), pulmonary hypertension, atrial fibrillation, anemia, obesity and probably a history of myocardial infarction are risk factors for right ventricular CF in hospitalized elderly patients with COPD.
Subject(s)
Heart Failure/epidemiology , Inpatients , Pulmonary Disease, Chronic Obstructive/therapy , Ventricular Function, Right/physiology , Adult , Age Distribution , Aged , Aged, 80 and over , Echocardiography , Female , Heart Failure/etiology , Heart Failure/physiopathology , Humans , Male , Middle Aged , Prevalence , Prognosis , Pulmonary Disease, Chronic Obstructive/complications , Risk Factors , Russia/epidemiologySubject(s)
Anemia/epidemiology , Heart Failure/complications , Inpatients , Adult , Aged , Aged, 80 and over , Anemia/diagnosis , Anemia/etiology , Female , Follow-Up Studies , Heart Failure/therapy , Humans , Incidence , Male , Middle Aged , Prognosis , Russia/epidemiology , Sex FactorsSubject(s)
Diabetic Foot/drug therapy , Pancreatitis, Acute Necrotizing/drug therapy , Peritonitis/drug therapy , Protease Inhibitors/therapeutic use , Thienamycins/therapeutic use , Adolescent , Adult , Aged , Aged, 80 and over , Antibiotic Prophylaxis , Cilastatin/therapeutic use , Cilastatin, Imipenem Drug Combination , Diabetic Foot/surgery , Drug Combinations , Female , Humans , Imipenem/therapeutic use , Male , Middle Aged , Pancreatitis, Acute Necrotizing/surgery , Peritonitis/surgery , Postoperative Care , SuppurationABSTRACT
The analysis of the impact of various group antibiotics on the mechanisms of development and correction of pathogenetically heterogeneous immune deficiency in 235 patients at age of 17 to 85 years with local (80 patients) and general (155 patients) peritonitis is presented. Cephalosporins and fluoroquinolones promoted restoration of the immune and interleukin (IL-1 and IL-2 of donors, IL-1r and IL-2r of patients) status and lowered the immunodepressive effect of glucocorticoids (GC) at the organism (cortisol, ACTH and cortisol-binding globulin) and cellular (GC receptors III) levels. Aminoglycosides and penicillins had no significant action on the immune and interleukin status but lowered the EG effect at the organism (aminoglycosides) and cellular (penicillins) levels. It is recommended that the antibiotics be used with an account of their involvement in the systemic reactions of the host.
