RESUMO
We describe hereafter a case of idiopathic varicose veins in a patient with pulmonary embolism. To our knowledge, the condition has not been reported yet in the literature and enhances the usefulness of complementing the workup of pulmonary embolism by pelvic examination.
Assuntos
Pelve/irrigação sanguínea , Embolia Pulmonar/diagnóstico , Varizes/diagnóstico , Trombose Venosa/diagnóstico , Adulto , Humanos , Pelve/diagnóstico por imagem , Artéria Pulmonar/diagnóstico por imagem , Embolia Pulmonar/complicações , Radiografia , Varizes/etiologia , Trombose Venosa/etiologiaRESUMO
The bioavailability patterns of a 100 mg metoprolol controlled release tablet and a 10 mg bisoprolol normal release tablet were compared in a single dose crossover study in 12 healthy subjects. The plasma drug concentration levels were measured for 36 h post-dose, using HPLC with fluorimetric detection. The 2 formulations were equally well tolerated, headache being the most frequently reported adverse event. Episodes of bradycardia (heart rate < 50 bpm) occurred at a similar rate with both formulations. The plasma metoprolol profile differed significantly (p < 0.05) from the bisoprolol profile regarding time to maximum concentration, mean residence time, the ratio of peak concentration (Cmax) to the area under the curve (AUC) and the plateau time as estimated from the half-value duration. The average drug plasma concentration observed 24 h after administration still accounted for 54% of the Cmax value for the metoprolol controlled release tablet, but only 23% with the bisoprolol normal release tablet. A large inter-individual variability was seen in the bioavailability of metoprolol, with 3 subjects (characterised as CYP2D6 deficient) exhibiting AUC values 8 - 10 times larger than in the other subjects. The controlled release pattern of the formulation was similar in slow and fast metabolizers. No such variability pattern was apparent for bisoprolol. The findings allow to conclude that, after administration of the metoprolol controlled release tablet, the rate of absorption of the active principle is significantly slower, therefore yielding more constant plasma concentration levels over the 24 h post-dose period, than after administration of the bisoprolol normal release tablet.
Assuntos
Antagonistas Adrenérgicos beta/farmacocinética , Bisoprolol/farmacocinética , Metoprolol/farmacocinética , Absorção/fisiologia , Administração Oral , Adulto , Disponibilidade Biológica , Estudos Cross-Over , Citocromo P-450 CYP2D6/deficiência , Preparações de Ação Retardada , Feminino , Humanos , Masculino , Valores de Referência , ComprimidosAssuntos
Fator Natriurético Atrial/uso terapêutico , Isquemia/tratamento farmacológico , Rim/irrigação sanguínea , Injúria Renal Aguda/tratamento farmacológico , Injúria Renal Aguda/fisiopatologia , Animais , Taxa de Filtração Glomerular/efeitos dos fármacos , Isquemia/fisiopatologia , Rim/efeitos dos fármacos , Rim/fisiopatologia , Masculino , Ratos , Ratos Endogâmicos , Micção/efeitos dos fármacosRESUMO
In a rat experimental study we investigated whether the atrial natriuretic peptide by itself is able to improve early renal function after an ischemic injury. Two groups of Wistar male rats underwent a right nephrectomy and a left renal artery occlusion for 30 min and were infused for 2 hr after ischemia with isotonic saline or rat atrial natriuretic peptides (alpha ANF: 28 amino acids (AP 28) and atriopeptin III (AP 24): 24 amino acids). ANF infusion increased the urinary flow (P less than 0.001), the urinary sodium concentration (P less than 0.001), the sodium excretion rate (P less than 0.0001), and improved the glomerular filtration rate (GFR) recovery (P less than 0.02) determined at the end of the 2-hr infusion period. AP 24 exhibited higher natriuretics activities than AP 28. The effect of both peptides upon GFR recovery was equivalent. These effects of ANF observed after acute ischemia suggest that this peptide may be beneficial on the resumption of renal function in the early phases following transplantation.