A Fixed Combination of Metoprolol Slow-Release and Chlorthalidone, Given Once Daily, in the Long-Term Treatment of Arterial Hypertension

1982 ◽  
Vol 10 (2) ◽  
pp. 82-86 ◽  
Author(s):  
Bruno Floris ◽  
Gianni Franchetta ◽  
Nicola Palestini ◽  
Giulio Sonaglioni ◽  
Paolo Verdecchia ◽  
...  
Keyword(s):  
Arterial Hypertension ◽  
Slow Release ◽  
Fixed Combination ◽  
Term Treatment ◽  
Once Daily ◽  
Clear Cut ◽  
Long Term Treatment ◽  
Term Basis ◽  
Pre Treatment

A fixed combination of metoprolol slow-release 200 mg and chlorthalidone 25 mg was given once daily over a 3 months period in forty out-patients with mild-to-moderate arterial hypertension stage I or II WHO. The combination elicited a clear-cut antihypertensive effect lasting at least 24 hours after drug. As compared with pre-treatment values, systolic and diastolic blood pressures were gradually reduced within the first month of treatment, remaining nearly constant in the following 2 months. Treatment was well tolerated by all patients. Neither serum potassium nor any other laboratory test (creatinine, glucose, uric acid, etc.) showed significant changes. In conclusion, slow-release metoprolol in fixed association with chlorthalidone provides a safe and effective treatment of arterial hypertension even on a long-term basis. The once daily dosing schedule may considerably improve patient's compliance.

Chlorthalidone Alone or in Fixed Combination with Slow-Release Metoprolol in the Management of Arterial Hypertension: A Long-Term Study of 545 Patients

1989 ◽  
Vol 17 (4) ◽  
pp. 339-349 ◽  
Author(s):  
E. Bichisao ◽  
L. Merlini ◽  
O. Gambini ◽  
D. Alberti ◽  
G. Pollavini
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Diastolic Blood Pressure ◽  
Slow Release ◽  
Fixed Combination ◽  
Combined Therapy ◽  
Double Blind ◽  
Long Term Study ◽  
Long Term Treatment

In a double-blind trial, 545 out-patients with essential hypertension received 25 mg/day chlorthalidone alone (274 patients) or in fixed combination with 200 mg/day slow-release metoprolol (271 patients) for 8 weeks. Both treatments significantly (P<0.001) decreased systolic and diastolic blood pressure; 45.6% of patients receiving chlorthalidone and 82.5% receiving combined therapy had a diastolic blood pressure of less than 95 mmHg. Patients not controlled by chlorthalidone or chlorthalidone plus metoprolol subsequently received chlorthalidone plus metoprolol (137 patients) or chlorthalidone plus metoprolol plus a third drug (34 patients), respectively, for 8 weeks. A total of 79.5% of patients receiving chlorthalidone plus metoprolol and 61.8% receiving chlorthalidone plus metoprolol plus a third drug had a diastolic blood pressure of less than 95 mmHg. Only 5.9% of patients experienced mild to modérate side-effects. Plasma potassium leveis significantly ( P<0.01) decreased during the first 8 weeks only. It is concluded that a diuretic alone or in fixed combination with a β-blocker is effective in the long-term treatment of arterial hypertension.

Long-Term Treatment with Slow-Release Frusemide Compared with Thiazide Treatment in Arterial Hypertension

1989 ◽  
Vol 17 (6) ◽  
pp. 552-559 ◽  
Author(s):  
H. Jørgensen ◽  
N. Anderssen ◽  
T. Silsand ◽  
L.-E. Peterson
Keyword(s):  
Arterial Hypertension ◽  
Antihypertensive Effect ◽  
Slow Release ◽  
Serum Glucose ◽  
Term Treatment ◽  
Moderate Essential Hypertension ◽  
Fasting Serum ◽  
Long Term Treatment ◽  
Previously Treated

The effect of 30 mg/day slow-release frusemide given orally for 12 months was studied in 64 patients previously treated with thiazides for mild to moderate essential hypertension. Frusemide had a significant antihypertensive effect ( P<0.001), and compared to thiazides significantly reduced fasting serum glucose ( P<0.015), haemoglobin A1c ( P<0.025), albumin ( P<0.025) and serum calcium ( P<0.025), and significantly increased serum sodium and chloride concentrations ( P<0.0001). There was also a non-significant trend for frusemide to reduce serum total cholesterol, triglycerides and urate, and to increase serum potassium. Frusemide was well tolerated in all but three patients. It is concluded that slow-release frusemide has a comparable antihypertensive effect to that of thiazide diuretics, but has fewer metabolic side-effects, and should be used in preference to thiazides for the treatment of arterial hypertension when a diuretic is indicated.

Long-term treatment of acromegaly with the slow-release somatostatin analogue lanreotide

1994 ◽  
Vol 131 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Josef Marek ◽  
Václav Hána ◽  
Michal Kršek ◽  
Vlasta Justová ◽  
France Catus ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Slow Release ◽  
Serum Levels ◽  
Term Treatment ◽  
Somatostatin Analogue ◽  
Tumour Mass ◽  
Long Term Treatment ◽  
Active Acromegaly ◽  
One Year

Marek J, Hána V. Kršek M. Justová V, Catus F, Thomas F. Long-term treatment of acromegaly with the slow-release somatostatin analogue lanreotide. Eur J Endocrinol 1994;131:20–6. ISSN 0804–4643 Thirteen patients with active acromegaly despite previous surgery were treated with 30 mg lanreotide im twice a month for 9 months. In 10 subjects the treatment continued to 19 months. GH serum levels of all patients decreased significantly from an initial value of 32.0 (29.4) μg/l [median (standard error of median)] to 10.0 (3.6) and 19.1 (5.7) after 3 and 9 months of treatment, respectively. In the 10 patients with the treatment longer than one year the decrease in GH was from 46.8 (29.4) μg/l to 12.5 (5.0) and 16.1 (5.3) after 13 and 19 months, respectively. IGF-I serum levels decreased significantly from 1193 (73)μg/l to 782 (99) and 621 (103) after 3 and 9 months, respectively, and were normalized in 3 patients. In the 10 patients treated for longer than one year, levels decreased significantly from 1318 (74)μg/l to 653 (170) and 742 (180) after 13 and 19 months, respectively. IGF BP-3 levels were reduced to the normal range in 6 patients and decreased from 8.7 (1.5)mg/l to 6.4 (0.8) and to 5.4 (1.0) after 3 and 9 months, respectively. In the patients with the 19 months treatment the decrease was from 9.3 (1.6) mg/l to 3.9 (0.9) and 4.8 (0.9) after 13 and 19 months, respectively. The IGF BP-3 to IFG I ratio increased in 7 patients. This elevation significantly correlated with the decrease in bioassayable somatomedin. Prolactin serum levels fell in all patients with increased prolactin secretion. Testosterone plasma levels increased in 4 out of 5 men without replacement therapy. Clinical improvement was observed in all patients. A reduction of tumour mass was observed in five patients and complete disappearance of the tumour in one subject. All patients complained of mild abdominal pain and softened stools for several days following the injections. However, these side effects never required interruption of treatment. Asymptomatic microlithiasis was seen in only one patient after 13 months, which led to treatment being suspended for a period of 3 months after which it was resumed. Fasting serum insulin and insulin area under the curve (AUC) after oral glucose tolerance test (OGTT) fell in all patients. Fasting blood glucose, fructosamine and glucose AUC after OGTT slightly increased during the treatment, but all blood glucose levels (fasting and during OGTT) remained within normal ranges. Lanreotide appears to be a safe and effective treatment in patients with active acromegaly unresolved by surgery. The long-acting formulation avoids the drawbacks associated with either repeated daily injections or continuous infusions of somatostatin analogues. Josef Marek, Third Department of Medicine, Charles University, U nemocnice 1, 128 21 Praha 2, The Czech Republic

scholarly journals Successful Long-term Treatment with Once-daily Injection of Low-dose Octreotide in an Aged Patient with Insulinoma

2005 ◽  
Vol 52 (5) ◽  
pp. 629-634 ◽  
Author(s):  
Takuyuki KATABAMI ◽  
Hiroyuki KATO ◽  
Naoko SHIRAI ◽  
Satoru NAITO ◽  
Nobuhiko SAITO
Keyword(s):  
Low Dose ◽  
Term Treatment ◽  
Daily Injection ◽  
Aged Patient ◽  
Once Daily ◽  
Long Term Treatment

Will a once-weekly anticoagulant for the treatment and secondary prevention of thromboembolism improve adherence?

2009 ◽  
Vol 101 (03) ◽  
pp. 422-427 ◽  
Author(s):  
Louise Maillardet ◽  
Yshai Yavin ◽  
Alexander T. Cohen
Keyword(s):  
Secondary Prevention ◽  
Depressive Disorders ◽  
Term Treatment ◽  
Bisphosphonate Treatment ◽  
Weekly Administration ◽  
Once Daily ◽  
New Anticoagulants ◽  
Improved Outcomes ◽  
Long Term Treatment

SummaryOral anticoagulation, most commonly with warfarin once daily, has long been the main form of long-term treatment and secondary prevention of thromboembolism. The efficacy of warfarin has been established in clinical trials, but problems with unstable anticoagulation with international normalized ratios (INRs) outside the recommended range due to incorrect dosing, drug and food interactions, and with adherence and persistence have been reported in practice. Poor adherence and persistence are serious problems because they result in out-of-range INRs. Many new thromboembolic events, such as strokes, occur when INRs are out-of-range or after warfarin discontinuation. Among the new anticoagulants currently being investigated, some offer the possibility of more stable anticoagulation and weekly administration. Less frequent dosing schedules generally improve adherence. In many cases, such as bisphosphonate treatment for osteoporosis, and the long-term treatment of depressive disorders or multiple sclerosis, adherence to, and persistence with, weekly dosing is improved compared with daily dosing, and most patients prefer weekly dosing. The advent of novel anticoagulants such as idraparinux with its long half-life offers hope for improved adherence with anticoagulation, and ultimately improved outcomes.

INFLUENCE OF THIAZIDES ON THYROID PARAMETERS IN MAN

1978 ◽  
Vol 89 (4) ◽  
pp. 673-678 ◽  
Author(s):  
Karine Bech ◽  
Lis Skovsted ◽  
Kaj Siersbæk-Nielsen ◽  
Jens Mølholm Hansen
Keyword(s):  
Arterial Hypertension ◽  
Urinary Iodine ◽  
Iodine Intake ◽  
Term Treatment ◽  
Distribution Volume ◽  
Long Term Treatment ◽  
Thyroid Uptake ◽  
Iodine Metabolism ◽  
Normal Controls

ABSTRACT Iodine metabolism and thyroid hormones in blood were studied in 19 men and 11 women who had been treated with thiazides for arterial hypertension from 1 month to 15 years. The results were compared with the findings from age-matched normal controls. No differences were found regarding 24-h 131I-thyroid uptake, thyroid iodide clearance, renal iodide clearance, plasma inorganic iodide, absolute iodine uptake (AIU), serum thyroxine (T4 (D)), resin T3 test (T3U) and TSH after TRH. Twenty-four-hour urinary iodine was higher in the patients treated with diuretics which could be explained by increased iodine intake. The findings of increased serum triiodothyronine (T3 (RIA)) and reverse T3 (rT3) might be due to changes in distribution volume in the thiazide-treated patients. Long-term treatment with thiazides in man do not lead to iodine depletion.

Long-term treatment of idiopathic hyperaldosteronim using trilostane

1986 ◽  
Vol 113 (1) ◽  
pp. 104-110 ◽  
Author(s):  
Kaoru Nomura ◽  
Hiroshi Demura ◽  
Nobuo Horiba ◽  
Kazuo Shizume
Keyword(s):  
Antihypertensive Drugs ◽  
Competitive Inhibitor ◽  
Inhibitory Effect ◽  
Term Treatment ◽  
Continuous Treatment ◽  
Steroid Biosynthesis ◽  
Long Term Treatment ◽  
Idiopathic Hyperaldosteronism ◽  
Pre Treatment

Abstract. Three patients with idiopathic hyperaldosteronism were continuously treated with trilostane, a competitive inhibitor of adrenal 3β-hydroxysteroid dehydrogenase (3β-HSDH) (3 to 4⅔ years). Trilostane, in conjunction with antihypertensive drugs, effectively decreased plasma aldosterone levels and improved hyperaldosteronism symptoms without undesirable side effects. Trilostane continued to be effective even when treatment was continuous. Rapid ACTH testing (iv bolus of 0.25 mg α1–24 ACTH) was done on the day without trilostane after long-term treatment, and plasma levels of aldosterone and cortisol were compared to those obtained during a pre-treatment period. Results suggest that the inhibitory effect of trilostane on steroid biosynthesis rapidly disappears following discontinuance of trilostane administration even after long-term treatment, and that continuous treatment causes no significant or irreversible change in steroid biosynthesis. These results suggest that trilostane is a safe, feasible therapeutic agent for long-term treatment of idiopathic hyperaldosteronism.

scholarly journals Endothelin research and the discovery of macitentan for the treatment of pulmonary arterial hypertension

2016 ◽  
Vol 311 (4) ◽  
pp. R721-R726 ◽  
Author(s):  
Martine Clozel
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Structural Changes ◽  
Term Treatment ◽  
Vasopressin Release ◽  
Long Term Treatment ◽  
Pulmonary Arterial ◽  
Kinetics Of

Endothelin receptor antagonists (ERAs) are used for the treatment of pulmonary arterial hypertension (PAH). Macitentan, a dual (ETA+ETB) ERA approved for the long-term treatment of PAH, was discovered through a tailored research program aimed at improving efficacy and safety over the existing ERAs. The goal of improved efficacy was based on the understanding that not only the ETA receptor but also the ETB receptor contributed to the hemodynamic and structural changes induced by endothelin-1 (ET-1) in pathological conditions and on the predefined requirements for optimal tissue penetration and binding kinetics of the antagonist. The goal of improved safety was based on the discovery of the role of ETB receptors in vascular permeability and vasopressin release and on the elucidation of the mechanism by which bosentan (the first approved oral dual ETA/ETB ERA) caused liver enzyme changes. Our intention was to design a molecule that would block ETA and ETB receptors optimally and would not interfere with bile salt elimination. This review takes us through the drug discovery journey that led to the discovery, development, and registration of macitentan.

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