Pseudohyperaldosteroism during itraconazole treatment: a hitherto neglected clinically significant side effect

We describe a married couple who both presented with hypertension and hypokalaemia. Both patients were diagnosed with pseudohyperaldosteronism triggered by the widely used antifungal drug itraconazole. This effect appears to be dose-dependent, where a daily intake of 100 mg itraconazole is enough to induce pseudohyperaldosteronism. Clinicians should be aware of pseudohyperaldosteronism as a possible adverse effect of itraconazole, and we recommend monitoring potassium levels and blood pressure in all patients receiving this drug over a longer period of time. Voriconazole is probably an alternative antifungal treatment to itraconazole but also with this drug potassium levels should be monitored.

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Refractive Changes Induced by Strabismus Corrective Surgery in Adults

Journal of Ophthalmology ◽

10.1155/2017/2680204 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8

Author(s):

Daphna Mezad-Koursh ◽

Ari Leshno ◽

Tomer Ziv-Baran ◽

Chaim Stolovitch

Keyword(s):

Postoperative Period ◽

Side Effect ◽

Chart Review ◽

Retrospective Chart Review ◽

Final Analysis ◽

Spherical Equivalent ◽

Corrective Surgery ◽

Significant Side Effect ◽

Refractive Change ◽

Clinically Significant

Purpose. To investigate refractive changes after strabismus correction procedures among adults.Methods. Retrospective chart review of adult patients who had horizontal recti muscles surgery with preoperative and postoperative cycloplegic refraction measurements. The preoperative refraction was mathematically subtracted from the postoperative refraction, and the induced refractive changes were statistically analyzed. Vector analysis was used to examine the magnitude of the toric change. The proportion of clinically significant refractive change was evaluated as well.Results. Thirty-one eyes from 22 subjects met the criteria and were included in the final analysis. A significant postoperative refractive change of the spherical equivalent towards myopia and a change of the astigmatism in the with-the-rule direction were observed. In a subset of 9 cases a third cycloplegic refraction measurement demonstrated stable refraction compared to the 1-month postoperative measurement. In 10 cases of single eye surgery, significant refractive changes were observed only in the operated side when compared to the sound eye. The induced surgical refractive change was of clinical significance (≥0.5 D) in 11 eyes of 9 patients (40.9% of patients).Conclusions. Refractive changes are a significant side effect of horizontal strabismus corrective surgery among adults. Therefore, patients should be informed about it prior to surgery and should be rerefracted in the postoperative period.

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A COMPARATIVE STUDY BETWEEN DEXMEDETOMIDINE AND MIDAZOLAM AS AN ADJUVANT TO INTRATHECAL BUPIVACAINE

10.36106/paripex/5409659 ◽

2020 ◽

pp. 1-4

Author(s):

K.K. Arora ◽

Neetu Gupta ◽

Nidhi Sharma

Keyword(s):

Side Effect ◽

Motor Block ◽

Local Anaesthetics ◽

Efficacy And Safety ◽

Significant Side Effect ◽

Significant Difference ◽

Haemodynamic Changes ◽

The Common ◽

Clinically Significant ◽

Group D

Background: Subarachnoid block(SAB) is the common mode of anaesthesia. To prolong its action various adjuvants are being added to local anaesthetics(LA). In this study we compared the efficacy and safety of midazolam and dexmedetomidine as an adjuvant to intrathecal 0.5% hyperbaric (H) bupivacaine. Material & Methods: 80 ASA grade I or II patients of either sex scheduled for lower limb or lower abdominal surgeries were randomly allocated into two groups, Group D & Group M. In group D, patients received 3ml of 0.5% (H) bupivacaine + dexmedetomidine 5mcg in 0.5ml normal saline(NS). While group M received 3ml of 0.5% (H) bupivacaine + 2mg midazolam ( 0.4ml of 5mg/ml) + 0.1ml of NS. Onset of sensory & motor block and duration of sensory & motor block were recorded. Patients were monitored for any haemodynamic changes and side effect. Result: Duration of both sensory & motor blockade was significantly prolonged in group D as compared to group M. There was no clinically significant difference observed among both the groups in respect to hemodynamic parameters, sedation and side effect. Conclusion: Dexmedetomidine as an adjuvant to intrathecal bupivacaine (H) was better as compared to midazolam. It significantly prolongs the duration of analgesia postoperatively without any significant side effect.

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Terbutaline and Ephedrine in Asthmatic Children

PEDIATRICS ◽

10.1542/peds.60.1.14 ◽

1977 ◽

Vol 60 (1) ◽

pp. 14-19

Author(s):

Michael Z. Blumberg ◽

David G. Tinkelman ◽

Elliot J. Ginchansky ◽

Barbara S. Blumberg ◽

John C. Taylor ◽

...

Keyword(s):

Blood Pressure ◽

Drug Treatment ◽

Pulse Rate ◽

Side Effect ◽

Significant Side Effect ◽

Onset Of Action ◽

Hand Tremor ◽

Bronchodilator Effect ◽

Asthmatic Children ◽

Pulmonary Functions

The effects of terbutaline, ephedrine, and placebo on the cardiovascular and pulmonary systems have been compared in 24 asthmatic children. Ephedrine and terbutaline were both found to be effective bronchodilators, with onset of action within 30 minutes. The bronchodilator effect of ephedrine was maintained for three hours, while terbutaline was active for five hours. Terbutaline caused significantly greater improvement in pulmonary functions than did ephedrine. Both terbutaline and ephedrine were associated with clinically insignificant changes in blood pressure and pulse rate. The only significant side effect observed was hand tremor in children receiving terbutaline and this appeared only early in the course of drug treatment. There was no evidence of tolerance to the bronchodilator effect of ephedrine or terbutaline after eight weeks of therapy.

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Vasorelaxant and Antihypertensive Effects of Mentha pulegium L. in Rats: An in vitro and in vivo Approach

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530320666200909093908 ◽

2020 ◽

Vol 20 ◽

Author(s):

Mohammed Ajebli ◽

Mohamed Eddouks

Keyword(s):

Blood Pressure ◽

Acute Experiment ◽

Antihypertensive Activity ◽

Mentha Pulegium ◽

In Vitro Experiment ◽

Arterial Blood ◽

Dose Dependent ◽

Ca2 Channels

Aims and objective: The aim of the study was to investigate the effect of aqueous aerial part extract of Mentha pulegium L. (Pennyrile) (MPAE) on arterial pressure parameters in rats. Background: Mentha pulegium is a medicinal plant used to treat hypertension in Morocco. Material and methods: In the current study, MPAE was prepared and its antihypertensive activity was pharmacologically investigated. L-NAME-hypertensive and normotensive rats have received orally MPAE (180 and 300 mg/kg) during six hours for the acute experiment and during seven days for the sub-chronic treatment. Thereafter, systolic, diastolic, mean arterial blood pressure and heart rate were evaluated. While, in the in vitro experiment, isolated denuded and intact thoracic aortic rings were suspended in a tissue bath system and the tension changes were recorded. Results: A fall in blood pressure was observed in L-NAME-induced hypertensive treated with MPAE. The extract also produced a dose-dependent relaxation of aorta pre-contracted with NE and KCl. The study showed that the vasorelaxant ability of MPAE seems to be exerted through the blockage of extracellular Ca2+ entry. Conclusion: The results demonstrate that the extract of pennyrile exhibits antihypertensive activity. In addition, the effect may be, at least in part, due to dilation of blood vessels via blockage of Ca2+ channels.

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Dehulled Adlay Consumption Modulates Blood Pressure in Spontaneously Hypertensive Rats and Overweight and Obese Young Adults

Nutrients ◽

10.3390/nu13072305 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2305

Author(s):

Wan-Ju Yeh ◽

Jung Ko ◽

Wei-Yi Cheng ◽

Hsin-Yi Yang

Keyword(s):

Blood Pressure ◽

Daily Intake ◽

Experimental Period ◽

Overweight And Obesity ◽

Hypertensive Rats ◽

Spontaneously Hypertensive ◽

Beneficial Effects ◽

Underlying Mechanisms ◽

Grain Foods

High blood pressure is a crucial risk factor for many cardiovascular diseases, and a diet rich in whole-grain foods may modulate blood pressure. This study investigated the effects of dehulled adlay consumption on blood pressure in vivo. We initially fed spontaneous hypertensive rats diets without (SHR group) or with 12 or 24% dehulled adlay (SHR + LA and SHR + HA groups), and discovered that it could limit blood pressure increases over a 12-week experimental period. Although we found no significant changes in plasma, heart, and kidney angiotensin-converting enzyme activities, both adlay-consuming groups had lower endothelin-1 and creatinine concentrations than the SHR group; the SHR + HA group also had lower aspartate aminotransferase and uric acid levels than the SHR group did. We later recruited 23 participants with overweight and obesity, and they consumed 60 g of dehulled adlay daily for a six-week experimental period. At the end of the study, we observed a significant decrease in the group’s systolic blood pressure (SBP), and the change in SBP was even more evident in participants with high baseline SBP. In conclusion, our results suggested that daily intake of dehulled adlay had beneficial effects in blood-pressure management. Future studies may further clarify the possible underlying mechanisms for the consuming of dehulled adlay as a beneficial dietary approach for people at risk of hypertension.

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Salt intake and blood pressure in Iranian children and adolescents: a population-based study

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-01876-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mohammad Hassan Emamian ◽

Hossein Ebrahimi ◽

Hassan Hashemi ◽

Akbar Fotouhi

Keyword(s):

Blood Pressure ◽

Rural Areas ◽

Urban Areas ◽

Salt Intake ◽

Daily Intake ◽

Population Based ◽

World Health ◽

Second Phase ◽

Salt Consumption ◽

The Mean

Abstract Background Previous studies have reported a high prevalence of hypertension in Iranian students, especially in rural areas. The aim of this study was to investigate the daily intake of salt in students and its association with high blood pressure. Methods A random sub-sample was selected from the participants of the second phase of Shahroud schoolchildren eye cohort study and then a random urine sample was tested for sodium, potassium and creatinine. Urine electrolyte esexcretion and daily salt intake were calculated by Tanaka et al.’s formula. Results Among 1455 participants (including 230 participants from rural area and 472 girls), the mean age was 12.9 ± 1.7 year and the mean daily salt intake was 9.7 ± 2.6 g (95% CI 9.5–9.8). The mean salt consumption in rural areas [10.8 (95% CI 10.4–11.2)] was higher than urban areas [9.4 (95% CI 9.3–9.6)], in people with hypertension [10.8 (95% CI 10.3–11.3)] was more than people with normal blood pressure [9.4 (95% CI 9.3–9.6)], and in boys [9.8 (95% CI 9.7–10.0)] was more than girls [9.3 (95% CI 9.1–9.6)]. Higher age, BMI z-score, male sex and rural life, were associated with increased daily salt intake. Increased salt intake was associated with increased systolic and diastolic blood pressure. Conclusion Daily salt intake in Iranian adolescents was about 2 times the recommended amount of the World Health Organization, was higher in rural areas and was associated with blood pressure. Reducing salt intake should be considered as an important intervention, especially in rural areas.

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Effects of NG-nitro-L-arginine methyl ester on renal function and blood pressure

AJP Renal Physiology ◽

10.1152/ajprenal.1991.261.6.f1033 ◽

1991 ◽

Vol 261 (6) ◽

pp. F1033-F1037 ◽

Cited By ~ 42

Author(s):

V. Lahera ◽

M. G. Salom ◽

F. Miranda-Guardiola ◽

S. Moncada ◽

J. C. Romero

Keyword(s):

Nitric Oxide ◽

Blood Pressure ◽

Renal Function ◽

Methyl Ester ◽

Renal Plasma Flow ◽

Urinary Sodium Excretion ◽

Systemic Blood Pressure ◽

Synthesis Inhibitor ◽

Renal Changes ◽

Dose Dependent

The dose-dependent effects of intravenous infusions of nitric oxide (NO) synthesis inhibitor, NG-nitro-L-arginine methyl ester (L-NAME; 0.1, 1, 10, and 50 micrograms.kg-1.min-1), were studied in anesthetized rats to determine whether the inhibitory actions of L-NAME are manifested primarily in alterations of renal function or whether they are the consequences of the increase in systemic blood pressure. Mean arterial pressure (MAP) was not altered by the intravenous L-NAME infusions of 0.1 and 1.0 microgram.kg-1.min-1. However, 0.1 microgram.kg-1.min-1 L-NAME induced a 30% decrease in urine flow rate (UV). The administration of 1.0 microgram.kg-1.min-1 L-NAME, in addition to decreasing UV, also decreased urinary sodium excretion (UNaV) and renal plasma flow (RPF). The intravenous L-NAME infusions of 10.0 and 50.0 microgram.kg-1.min-1 intravenous L-NAME infusions of 10.0 and 50.0 microgram.kg-1.min-1 produced significant increases in MAP that reversed the initial fall in UV and UNaV, despite decreasing RPF and glomerular filtration rate (GFR). The administration of L-arginine alone (10 micrograms.kg-1.min-1) did not modify any of the parameters measured, but it effectively prevented all the hemodynamic and renal changes induced by the infusion of 50 micrograms.kg-1.min-1 L-NAME. These results suggest that the decrease in nitric oxide production induced by the intravenous infusion of L-NAME affects renal excretion of sodium and water in the absence of any significant change in blood pressure. At larger doses, L-NAME also produces hypertension that overrides the initial antinatriuretic effect.

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Aliskiren, an Oral Renin Inhibitor, Provides Dose-Dependent Efficacy and Sustained 24-Hour Blood Pressure Control in Patients With Hypertension

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2006.11.032 ◽

2007 ◽

Vol 49 (11) ◽

pp. 1157-1163 ◽

Cited By ~ 210

Author(s):

Byung-Hee Oh ◽

Jerry Mitchell ◽

James R. Herron ◽

Jenny Chung ◽

Mahmudul Khan ◽

...

Keyword(s):

Blood Pressure ◽

Blood Pressure Control ◽

Pressure Control ◽

Renin Inhibitor ◽

Dose Dependent

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Central hypothyroidism under Bexarotene: a significant side effect.

Endocrine Abstracts ◽

10.1530/endoabs.73.aep698 ◽

2021 ◽

Author(s):

Hadadi Farah El ◽

Zineb Mhamdi ◽

Laila Benzekri ◽

Karima Senouci

Keyword(s):

Side Effect ◽

Significant Side Effect ◽

Central Hypothyroidism

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Treatment of Severe Apnea in Prematures With Orally Administered Theophylline

PEDIATRICS ◽

10.1542/peds.55.5.595 ◽

1975 ◽

Vol 55 (5) ◽

pp. 595-598

Author(s):

Ricardo Uauy ◽

Donald L. Shapiro ◽

Barbara Smith ◽

Joseph B. Warshaw

Keyword(s):

Heart Rate ◽

Mechanical Ventilation ◽

Premature Infants ◽

Side Effect ◽

Significant Side Effect ◽

Daily Number ◽

The Mean

Twelve premature infants with primary apnea were treated with theophylline as an alternative to mechanical ventilation. There was a significant (P< .005) reduction in the mean daily number and the severity of apneic episodes after treatment. The only significant side effect noted was a rise in heart rate.

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