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1.
Clin Ter ; 146(12): 801-10, 1995 Dec.
Article in Italian | MEDLINE | ID: mdl-8681500

ABSTRACT

The above study was performed as a single blind trial in 70 elderly patients (average age 66 years) who were randomized into two groups of 36 and 34 subjects respectively. After clinical and laboratory evaluation without treatment for at least two weeks, the two groups were treated with enalapril 5-10 or 20 mg daily plus doxazosin at the dosage of 1-2-4- or 8 mg daily; they were observed for 24 weeks. During the trial, pressure values, both systolic and diastolic, were seen to diminish significantly in both groups. This effect was accompanied by minor, usually transient side effects. At echocardiography at the end of the treatment period, doxazosin was found to reduce some volumetric cardiac parameters, thus showing to be apt to counteract left ventricular hypertrophy. These findings go to counteract left ventricular hypertrophy. These findings go to show that alpha-1 inhibitors are a valid alternative in the "first step" of antihypertensive therapy, especially in patients at risk for cardiovascular complications.


Subject(s)
Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Antihypertensive Agents/therapeutic use , Doxazosin/therapeutic use , Enalapril/therapeutic use , Hypertension/drug therapy , Age Factors , Aged , Angiotensin-Converting Enzyme Inhibitors/adverse effects , Angiotensin-Converting Enzyme Inhibitors/pharmacology , Antihypertensive Agents/adverse effects , Antihypertensive Agents/pharmacology , Body Weight , Dose-Response Relationship, Drug , Doxazosin/adverse effects , Doxazosin/pharmacology , Echocardiography , Enalapril/adverse effects , Enalapril/pharmacology , Female , Humans , Male , Middle Aged , Sex Factors
2.
Minerva Med ; 83(1-2): 57-64, 1992.
Article in Italian | MEDLINE | ID: mdl-1312233

ABSTRACT

The aim of this study was to assess the efficacy and tolerability of the combinations of lisinopril (LIS) 20 mg + hydrochlorothiazide (HCTZ) 12.5 mg and captopril (CAP) 50 mg + HCTZ 25 mg in moderately hypertensive patients not adequately controlled by LIS or CAP alone. The study was multicentre (11 centres), open, random and carried out in parallel groups. After two weeks' placebo run in patients were randomly assigned to LIS 10-20 mg/o.d. or CAP 25-50 mg/b.i.d. treatment for 6 weeks. After this, patients with supine diastolic blood pressure (SDBP) greater than 90 mmHg were treated with the combinations LIS 20 mg + HCTZ 12.5 mg/o.d. or CAP 50 mg + HCTZ 25 mg/o.d. for 4 weeks; this dose was doubled if DBP was found to be greater than 90 mmHg after 2 weeks' combined therapy. A total of 175 patients were enrolled (92 females and 83 males) of which 153 completed the study. The LIS + HCTZ association caused a significant reduction of DBP in comparison to the other combined treatment (88.1 +/- 0.7 vs 90.3 +/- 0.7; p = 0.026). The statistical analysis of mean SBP values showed no significant difference between the two groups (144.0 +/- 1.3 vs 146.8 +/- 1.3; p = 0.15). At the end of the study 79.5% of patients treated with LIS + HCTZ presented normal results (DBP less than or equal to 90 mmHg), whereas the percentage of similar results in the comparison group was 72%. The percentage of "responder" patients to therapy (DBP reduced by 10 mmHg or more in relation to basal values) was 96.3% in the LIS + HCTZ group and 86.7% in the CAP + HCTZ group. In the CAP + HCTZ group 0.6% of patients reported adverse reactions, while only 0.3% were observed in the LIS + HCTZ group.


Subject(s)
Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Antihypertensive Agents/administration & dosage , Captopril/administration & dosage , Enalapril/analogs & derivatives , Hydrochlorothiazide/administration & dosage , Hypertension/drug therapy , Adolescent , Adult , Aged , Drug Therapy, Combination , Enalapril/administration & dosage , Female , Humans , Lisinopril , Male , Middle Aged , Time Factors
3.
Cardiologia ; 36(12 Suppl 1): 343-54, 1991 Dec.
Article in Italian | MEDLINE | ID: mdl-1841790

ABSTRACT

The authors relate the pathophysiologic, hemodynamic and pharmacologic aspects of peripheral vascular damage in arterial hypertension. Particular attention is paid to the role of structural and functional changes both large elastic and muscular arteries (macroangiopathy) and small resistance vessels (microangiopathy) in the determinism and maintenance of arterial hypertension. These changes include impaired arterial wall compliance, vascular hyperactivity to agonists due to both hypertrophy and hyperplasia of smooth muscle cells, and endothelial dysfunction seen as an increase in endothelial permeability as well as an impaired release of relaxing and contracting factors. In the second part, personal observations are related. The aim of the research was to individuate hemodynamic non invasive patterns of peripheral vascular damage in essential, mild or moderate, hypertensives and to evaluate the hemodynamic peripheral effect of hypotensive drugs. The hemodynamic evaluation has been carried out by means of epiaortic vessels and lower limbs echo-Doppler, strain gauge plethysmography of lower limbs, and echocardiography. The following parameters have been considered: Trevis index, rest flow, peak flow, total time, resistance index of Pourcelot, left ventricular mass and ejection fraction. The first study involved 100 subjects (60 males and 40 females) with mild or moderate hypertension and a control group of 60 healthy subjects (35 males and 25 females). The hypertensives, compared to normotensives, showed an increase of Trevis index, reduction of peak flow, increase of total time and increase of resistance index. The second study was performed on 60 hypertensive subjects, 28 (17 diabetics) treated with nicardipine slow-release (40 mg twice a day) and 32 treated with terazosine (2-4 mg once a day). The treatment with nicardipine slow-release showed an increase of Trevis index, increase of rest flow and reduction of resistance index; the left ventricular mass resulted reduced. The treatment with terazosine showed a significant increase of rest flow and peak flow, reduction of total time, increase of Trevis index, reduction of resistance index, reduction of left ventricular mass. These data, concordantly with what known in literature, showed in hypertension an hemodynamic situation characterized by high resistance circulations, expression of arteriolar involvement. Nicardipine and terazosine can be placed as first choice hypotensive drugs adding at the hypotensive efficacy and tolerability a positive effect on peripheral vascular damage.


Subject(s)
Hypertension/complications , Peripheral Vascular Diseases/etiology , Arteries/physiopathology , Compliance , Humans , Hypertension/drug therapy , Hypertension/physiopathology , Peripheral Vascular Diseases/drug therapy , Peripheral Vascular Diseases/physiopathology , Vascular Resistance
4.
Ann Ital Med Int ; 6(1 Pt 2): 178-82, 1991.
Article in English | MEDLINE | ID: mdl-1742154

ABSTRACT

Intensive saluresis, intended as an exceptional though real and practicable therapeutic approach, has made unimaginable progress possible in different sectors of Internal Medicine relating to hydrosaline balance alterations such as chronic and acute renal failure, nephrosic syndrome, refractory heart failure, acute pulmonary edema and ascites. We are proud to be the first who followed a path that assured patients compensation beyond "classic" therapeutic possibilities, and undoubtedly better quality of life, as well.


Subject(s)
Chlorides/urine , Diuresis , Diuretics/therapeutic use , Sodium/urine , Acute Kidney Injury/drug therapy , Ascites/drug therapy , Diuretics/administration & dosage , Edema/drug therapy , Furosemide/administration & dosage , Furosemide/therapeutic use , Heart Failure/drug therapy , Humans , Kidney Failure, Chronic/drug therapy , Nephrotic Syndrome/drug therapy , Time Factors
5.
Clin Ter ; 135(6): 465-8, 1990 Dec 31.
Article in Italian | MEDLINE | ID: mdl-2151432

ABSTRACT

We treated 38 consecutive outpatients with ureter colic with a new anticholinergic spasmolytic agent, cimetropium bromide, in order to evaluate its efficacy in this condition. After assessing pain intensity by means of a visual analogic scale, we administered 5 mg i.v. Already after 30 minutes, 4 patients (11%) reported complete subsidence of pain. In 21 patients (55%) pain subsided almost completely within one hour. Eighteen patients required a second 5 mg i.v. injection after one hour; of these, 13 (72%) had complete regression or marked reduction of pain. Apart from dryness of the mouth which appeared in two cases after the second injection and was of moderate intensity, no side effects were observed.


Subject(s)
Colic/drug therapy , Kidney Diseases/drug therapy , Parasympatholytics/therapeutic use , Scopolamine Derivatives/therapeutic use , Acute Disease , Adult , Aged , Drug Evaluation , Female , Humans , Male , Middle Aged , Remission Induction , Ureteral Diseases/drug therapy
6.
Clin Ter ; 135(1): 31-6, 1990 Oct 15.
Article in Italian | MEDLINE | ID: mdl-2149540

ABSTRACT

The authors have studied a group of 25 patients treated with an HMG-CoA reductase inhibitor associated with DEAE-dextran, a safe and useful drug for the treatment of dyslipidemia. The patients were selected from a group of subjects previously submitted to long-term treatment with an HMG-CoA reductase inhibitor only who had failed to achieve normal cholesterol blood levels. The combined treatment with DEAE-dextran (1.5 g 3 times daily) and simvastatin (20 mg once daily) for 90 days lead to a further significant decrease in cholesterol and triglyceride blood levels. These findings confirm the validity of the association of an ion exchange resin with an HMG-CoA reductase inhibitor in the treatment of refractory dyslipidemias.


Subject(s)
Hyperlipoproteinemias/drug therapy , Anticholesteremic Agents/therapeutic use , Cholesterol/blood , DEAE-Dextran/therapeutic use , Drug Evaluation , Drug Therapy, Combination , Female , Humans , Hyperlipoproteinemias/blood , Lovastatin/analogs & derivatives , Lovastatin/therapeutic use , Male , Middle Aged , Simvastatin , Triglycerides/blood
7.
Clin Ter ; 133(4): 239-43, 1990 May 31.
Article in Italian | MEDLINE | ID: mdl-1695872

ABSTRACT

The authors report the results of an open trial in 859 dyslipidemic patients, performed with the cooperation of general practitioners, treated with isocaloric diet and daily doses of 3 g deae-dextran for 3 months. Deae-dextran was effective in reducing cholesterol and triglyceride blood levels and in controlling body weight. The drug was very well tolerated and no significant side effects were registered during treatment with deae-dextran.


Subject(s)
DEAE-Dextran/therapeutic use , Dextrans/therapeutic use , Hypercholesterolemia/drug therapy , Hypertriglyceridemia/drug therapy , Adult , Aged , Drug Evaluation , Female , Humans , Male , Middle Aged
8.
Pharmatherapeutica ; 5(6): 416-22, 1989.
Article in English | MEDLINE | ID: mdl-2687897

ABSTRACT

A single-blind, placebo-controlled study was carried out in 30 patients with chronic obstructive bronchopneumopathy to assess the effectiveness and tolerability of the theophylline derivative, bamyphylline. On entry, patients were allocated to receive twice daily oral doses of either 600 mg bamyphylline or placebo for a period of 60 days. Spirometric measurements, blood pressure and respiratory rate recordings and blood gas analyses were made at baseline and after 10, 30 and 60 days of treatment, as were assessments of clinical and objective signs, such as sibili, rales and vesicular murmurs. Plasma concentrations of bamyphylline 1 hour after the first dose of the day were monitored at the same intervals. The results showed that there was a highly significant progressive improvement in pulmonary function which was already apparent after 10 days and this was accompanied by a marked improvement in cardiac dynamics and clinical signs. Plasma concentrations of bamyphylline remained stable throughout the study period and there were no reports of side-effects or significant variations in blood chemistry.


Subject(s)
Lung Diseases, Obstructive/drug therapy , Theophylline/analogs & derivatives , Adult , Aged , Aged, 80 and over , Auscultation , Blood Gas Analysis , Blood Pressure/drug effects , Double-Blind Method , Female , Heart Rate/drug effects , Humans , Lung Diseases, Obstructive/physiopathology , Male , Middle Aged , Randomized Controlled Trials as Topic , Respiratory Function Tests , Theophylline/adverse effects , Theophylline/pharmacokinetics , Theophylline/therapeutic use
11.
Pharmacol Res Commun ; 19(8): 547-53, 1987 Aug.
Article in English | MEDLINE | ID: mdl-2448833

ABSTRACT

The breakdown of the carbohydrates by the colonic bacterial flora can cause intestinal symptoms, such as meteorism, abdominal pain and diarrhoea. The ability of human bacterial flora to break down the DEAE-dextran, a new lipid lowering resin, similar to cholestyramine, was investigated in man. Colonic bacterial flora did not appear to break down DEAE-dextran, as assessed by hydrogen respiratory excretion measured in healthy volunteers. Furthermore, the blood levels of vitamin A, E and D (as 25-OH and 1,25-OH derivatives) were measured in patients treated with the DEAE-dextran in order to study the interference of DEAE-dextran on the absorption of liposoluble vitamins. With the exception of slightly depressed vitamin A levels in 3 patients out of 16, the blood values of the vitamins A, E and D were within the normal ranges, indicating that DEAE-dextran does not interfere with liposoluble vitamin absorption by the gut.


Subject(s)
DEAE-Dextran/adverse effects , Dextrans/adverse effects , Adult , Bile Acids and Salts/metabolism , Calcitriol/blood , Colon/metabolism , Colon/microbiology , Dietary Fats/metabolism , Humans , Hydrogen/metabolism , Hydroxycholecalciferols/blood , Methane/metabolism , Middle Aged , Vitamin A/blood , Vitamin E/blood
12.
Pharmacol Res Commun ; 19(6): 405-13, 1987 Jun.
Article in English | MEDLINE | ID: mdl-2443935

ABSTRACT

The breakdown of the carbohydrates by the colonic bacterial flora can cause intestinal symptoms, such as meteorism, abdominal pain and diarrhoea. The ability of digestive enzymes and colonic bacterial flora to break down the DEAE-dextran, a new lipid lowering resin, was investigated in rats. DEAE-dextran appeared to be unaffected by either enzyme activity in the small intestine or bacterial flora in the large intestine. This may be important when dealing with the pharmacological activity of DEAE-dextran and estimating its side effects. Small intestinal transit rate appeared to be accelerated by oral DEAE-dextran in rats.


Subject(s)
DEAE-Dextran/metabolism , Dextrans/metabolism , Administration, Oral , Animals , Creatinine/urine , DEAE-Dextran/administration & dosage , Feces/analysis , Fluoresceins/urine , Gastrointestinal Transit , Intestinal Absorption , Intestine, Large/metabolism , Male , Rats
14.
Int J Clin Pharmacol Res ; 7(1): 13-7, 1987.
Article in English | MEDLINE | ID: mdl-3294614

ABSTRACT

The authors studied the life quality in a group of 74 patients--31 males and 43 females--affected with essential hypertension of World Health Organization I or II degree. All patients began treatment with frusemide at a dose of 25 mg once a day. The 35 non-responsive patients to frusemide were then treated, by random selection, with captopril at a dose of 25 mg twice a day, or nadolol at a dose of 80 mg once a day, for three months. The results show no significant differences on the hypotensive effect with either drug; in view of the incidence of side-effects of the two drugs, treatment with captopril is clearly better tolerated by the patients.


Subject(s)
Antihypertensive Agents/adverse effects , Captopril/adverse effects , Hypertension/complications , Nadolol/adverse effects , Quality of Life , Antihypertensive Agents/therapeutic use , Blood Pressure/drug effects , Female , Furosemide/adverse effects , Furosemide/therapeutic use , Heart Rate/drug effects , Humans , Hypertension/drug therapy , Hypertension/physiopathology , Male , Patient Compliance
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