scholarly journals Severe secondary hyperkalemia and arrhythmia from drug interactions between calcium‐channel blocker and voriconazole: a case presentation

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xinju Zhao ◽  
Chunyan Zhang ◽  
Li Zhu ◽  
Bei Wu ◽  
Yun Han ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Drug Interactions ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Antihypertensive Drugs ◽  
Kidney Injury ◽  
Channel Blockers ◽  
Case Presentation ◽  
Escape Rhythm ◽  
Cyp3a4 Inhibitors

Abstract Background Patients with kidney disease may have concurrent hypertension and infection. Dihydropyridine calcium-channel blockers (CCB) are the most popular class of antihypertensive drugs used in clinical settings and can be metabolized by cytochrome P450 isoenzyme 3A4 (CYP3A4). Voriconazole is a commonly used antifungal treatment and a CYP3A4-inhibitor. Insufficient attention to drug interactions from the concomitant use of CCB and voriconazole may result in serious adverse reactions. Case presentation Here, we report a patient with acute kidney injury on stable anti-neutrophil cytoplasm antibody associated vasculitis who developed hyperkalemia resulting in sinus arrest with junctional escape rhythm attributed to drug interactions of CCB with voriconazole. This is a very rarely reported case and may be an under-recognized complication. After continuous renal replacement therapy and changing the anti-hypertensive drugs, symptoms, and laboratory abnormalities of the patient fully recovered. Conclusions This case warns us of severe consequences of drug interactions. Co-prescription of CYP3A4-inhibitors with calcium-channel blockers increases the risk of hypotension and acute kidney injury, which may further induce hyperkalemia and arrhythmia.

Cardiotoxicity with antihypertensive drugs (literature review) Part 1. Calcium channel blockers and beta-blockers

2021 ◽  
pp. 12-19
Author(s):  
A. N. Esaulenko ◽  
A. Yu. Moiseeva ◽  
A. A. Ivannikov ◽  
I. V. Bratischev ◽  
Kh. G. Alidzhanova
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Antihypertensive Drugs ◽  
Beta Blockers ◽  
Research Literature ◽  
Channel Blockers ◽  
Distinctive Features ◽  
Experimental Pharmacology ◽  
Myocardial Insufficiency ◽  
Β Blockers

The effect of hypotensive drugs overdose on cardiovascular system is poorly studied; it should undergo clinical, experimental pharmacology and toxicology together with cardiology. There is too little information about cardiotoxicity of beta-blockers (β-blockers) and calcium channel blockers (CCB) in existing research literature. Intoxication from these groups of drugs causes similar severe hemodynamic abnormalities and myocardial insufficiency, however pathophysiological mechanisms of these abnormalities are not thoroughly studied. The review highlights how difficult it is to identify toxic level and distinctive features of clinical evidence of intoxication. Methods of diagnosis as well as β-blockers and CCB overdose treatment are discussed.

scholarly journals DRUG UTILIZATION BASED ADRS MONITORING OF ANTIHYPERTENSIVE AGENTS PRESCRIBED IN AL-QUWAYIYAH GENERAL HOSPITAL, SAUDI ARABIA

2018 ◽  
Vol 10 (3) ◽  
pp. 22
Author(s):  
Md Salahuddin Ansari ◽  
Faisal Al-otaibi
Keyword(s):  
Saudi Arabia ◽  
Calcium Channel ◽  
General Hospital ◽  
Drug Utilization ◽  
Calcium Channel Blockers ◽  
Antihypertensive Drugs ◽  
Antihypertensive Agents ◽  
Channel Blockers ◽  
Hypertensive Patients ◽  
Patient Interviews

Objective: To monitor drug utilization based adverse drug reactions (ADRs) of antihypertensive agents prescribed in Al-Quwayiyah general hospital, Saudi Arabia.Methods: An open, non-comparative, observational study was conducted on hypertensive patients attending the medicine outpatient department of Al-Quwayyah general hospital, Al-Quwayyah, Saudi arabia. Data were collected by conducting patient interviews. Data were captured for adverse drug reaction monitoring based on Narinjo scale and WHO format.Results: 25 ADRs were observed out of 212 hypertensive patients. Incidence was found to be higher in patients more than 40 y age, and females experienced more ADRs (n = 16, 7.54%) than males, 9 (4.62%). Combination therapy was associated with more number of ADRs (64.0%) as against monotherapy (36.0%). Calcium channel blockers were found to be the most frequently associated drugs with ADRs (n = 8), followed by diuretics (n = 6), and β-blockers (n = 5). Among individual drugs, amlodipine was found to be the commonest drug associated with ADRs (n = 8), followed by torasemide (n = 4). ADRs associated with the central nervous system was found to be the most frequent (48.0%) followed by musculoskeletal complaints (20.0%) and respiratory system disorders (16.0%).Conclusion: ADRs were experienced by taking the antihypertensive drugs prescribed in Al-Quwayyah general hospital, Saudi arabia. The findings would be useful for physicians in rational prescribing. Calcium channel blockers were found to be the most frequently associated drugs with ADRs.

scholarly journals The safety of antihypertensive drugs. Retrospective analysis of adverse reactions based on a regional database

2021 ◽  
Vol 27 (2) ◽  
pp. 216-228
Author(s):  
A. V. Matveev ◽  
A. E. Krasheninnikov ◽  
A. V. Ushakov ◽  
E. A. Egorova ◽  
A. G. Dormidor
Keyword(s):  
Calcium Channel ◽  
Retrospective Analysis ◽  
Calcium Channel Blockers ◽  
Adverse Reactions ◽  
Antihypertensive Drugs ◽  
Channel Blockers ◽  
Drug Reactions ◽  
Life Threatening ◽  
Β Blockers ◽  
Design And Methods

Objective. To analyze adverse drug reactions (ADR) occuring in patients taking antihypertensive drugs (AHD).Design and methods. We have analyzed 459 cases of ADR caused by AHD and recorded in the regional database (register) called ARCADe (Adverse Reactions in Crimea, Autonomic Database) during 2011–2018 years.Results. Out of all ADR, 304 cases (3,9 4,4 4,9 % of the total number of cases) were associated with AHD affecting renin-angiotensin-aldosterone system,101 (1,2 1,5 1,8 %) — with calcium channel blockers, and 54 cases (0,6 0,8 1,0 %) — with β-blockers. In the majority of cases, the ADRs were attributed to Enalapril (85 cases) and Amlodipine (76 cases). The analysis of the outcomes showed that serious reactions (life-threatening conditions, hospitalization, and disability) occurred in 72 cases. The remaining 387 ADRs were not considered serious. The majority of reported ADRs were unavoidable reactions of mild severity.

scholarly journals Densitas tulang mandibula pengguna obat anti hipertensi calcium channel blocker (CCB) melalui radiograf panoramik

2020 ◽  
Vol 4 (2) ◽  
pp. 1
Author(s):  
Gunawan Gunawan ◽  
Suhardjo Sitam ◽  
Lusi Epsilawati
Keyword(s):  
Bone Density ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Calcium Channel Blockers ◽  
Drug Users ◽  
Channel Blocker ◽  
Antihypertensive Drugs ◽  
Panoramic Radiograph ◽  
Channel Blockers ◽  
Hypertensive Drug

Objectives: The purpose of this research was to describe radiographic density of mandibular bone in calcium channel blocker anti-hypertensive drug users. Bone density in the mandible is assessed from the trabecular. Panoramic radiograph is a routine examination that is often done in dentistry that can be used to assess changes in quality in the form of changes in bone density in users of anti-hypertensive calcium channel blockers Material and Methods: This research is a descriptive study of 21 panoramic radiographs of calcium channel blocker anti-hypertensive drug users aged 40-75 years. Panoramic radiograph archive density checks in the distal region of the foramen mentale and the mandibular angular region using software image j, with the final result was the percentage between bone and marrow. Results: This research showed the average radiographic density in male using calcium channel blocker antihypertensive drugs was 18.81% and the average radiographic density in female was 20.92%. Conclusion: Based on the results of the study found that the average radiographic density of female patients taking antihypertensive drugs calcium channel blockers was higher than male.

scholarly journals An Observational Study on Drug Utilization Pattern in Chronic Kidney Disease Patients using Anti-Hypertensive Drugs in a Tertiary Care Teaching Hospital

2021 ◽  
pp. 9-18
Author(s):  
Rajesh Hadia ◽  
Hemraj Singh Rajput ◽  
Vidhi Mehta ◽  
Pushti Shah ◽  
Arti Muley ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Calcium Channel ◽  
Drug Utilization ◽  
Calcium Channel Blockers ◽  
Antihypertensive Drugs ◽  
Tertiary Care ◽  
Antihypertensive Agents ◽  
Channel Blockers ◽  
Utilization Pattern

Background: There is a strong relationship between Hypertension and chronic kidney disease. HTN is highly prevalent in CKD patients, contributing to high cardiovascular risk. Objectives: This study aims drug utilization pattern of Antihypertensive drugs in CKD. The objective of the study to determine the occurrence of co-morbidities, the prevalence of CKD stages in chronic kidney patients and to prepare a protocol of anti-hypertensive in CKD. Methodology: This was an observational/cross-sectional study that was carried out for six months at Dhiraj General Hospital, Vadodara. CKD patients who were prescribed antihypertensive agents were included as per study criteria. Data was collected by filling the patient medical record sheet. Results: A total of 60 CKD patients with HTN were included in the study according to inclusion and exclusion criteria. Out of 60 patients, we noticed that number of inpatients was 67% while the number of OPD patients was just 33%. Comparing gender proportionality, male represents 63% and female represents 37% were found between the age group of 18-65 years. The recorded systolic BP in mild case in the overall study population was found to be 140-159 mmHg and diastolic BP was found to be 90-99 mmHg. In moderate case systolic BP was 160-179 mmHg and diastolic BP was found to be 100-109 mmHg. In severe cases systolic BP was ≥180 mmHg and diastolic BP was found to be ≥110 mmHg. Among antihypertensive Calcium channel blockers was prescribed in 34.18% of patients and mostly recommended drug for hypertensive chronic kidney patients was furosemide which was 19.34%. Most participants were treated with multi-drug therapy. Conclusion: In Hypertensive CKD patients, calcium channel blockers and furosemide were highly recommended which do not diverge from National Kidney Foundation Kidney Disease, Outcome Quality Initiative guidelines.

scholarly journals Cost effectiveness analysis of anti-hypertensive drugs used for chronic kidney disease patients

2019 ◽  
Vol 10 (4) ◽  
pp. 2820-2825
Author(s):  
Mohamed Saleem TS ◽  
Sreeja N ◽  
Kiran Karthik J ◽  
Bhanu Sree K
Keyword(s):  
Chronic Kidney Disease ◽  
Cost Effectiveness ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Antihypertensive Drugs ◽  
Incremental Cost Effectiveness Ratio ◽  
Channel Blockers ◽  
Cost Effectiveness Ratio ◽  
Effectiveness Analysis ◽  
Β Blockers

Cost effectiveness analysis branch of pharmacoeconomics is a technique used to aid in decision making between alternatives. A prospective observational study would be conducted in the nephrology department at O.P, Patients with CKD with hypertension, with or deprived of diabetes are included in the study. Patients with drug-induced renal disease or unknown cause. Pregnant women with chronic kidney disease are excluded from the study. The research was conducted in150 patients in which common are men. The mean age of the research people was found to be 51.2 ±7. 02. .It was observed that calcium channel blockers 127 (84.6%), diuretics 51 (34%), α agonists 33 (22%), β blockers 21 (14%), α blockers 17 (11.3%), α+β blockers 10 (6.6%), Angiotensin receptor blockers 3 (2%) and angiotensin-converting enzyme inhibitors 1 (0.6%) were the numerous antihypertensive drugs given to the study people. Incremental Cost-Effectiveness Ratio was assessed, and it was observed that Rs.31.80 was extra required while using diuretics than Calcium Channel Blockers for achieving respective maintenance value. The major classes of antihypertensive drugs prescribed in all of them are CCB+α agonist was found most effective CCB+ Diuretics were the second most effective. Incremental Cost-Effectiveness Ratio was calculated, and it was found that  Rs.4.40 was Extra needed to attaining essential upkeep of blood pressure. Pharmacoeconomic study shows that Calcium channel blockers were the utmost cost-effective antihypertensive in CKD patients when linked to other antihypertensive drugs. In two-drug combination therapy, CCB+α agonist was found most effective.

scholarly journals Patterns of use of drugs in hypertension in geriatric patients in the department of medicine at tertiary care hospital of Nepal.

2020 ◽  
Vol 5 (3) ◽  
pp. 1155-1160
Author(s):  
Binod Raut ◽  
Anjan Khadka
Keyword(s):  
Combination Therapy ◽  
Calcium Channel ◽  
Antihypertensive Drug ◽  
Calcium Channel Blockers ◽  
Geriatric Patients ◽  
Antihypertensive Drugs ◽  
Tertiary Care ◽  
Channel Blockers ◽  
Care Hospital ◽  
Cross Sectional

Introduction: In Nepal, the prevalence of hypertensive in elderly population is 41.7% aged 65 years or more.  Hypertension increases with age leading to arterial stiffness and endothelial dysfunction. The prevalence of hypertension is 20% of urban populations. Blood pressure control with the use of antihypertensive drugs reduces cardiovascular complications in geriatric patients. Objectives: The objective of our study is to know  the various patterns of drugs used in geriatrics hypertensive patient along with their co-morbidities and to know  the most commonly used antihypertensive drug in geriatric patient. Methodology: It was a hospital based cross sectional study involving 130 patients based on non-probability sampling. The study involved the hypertensive elderly patients of age > 65 years prescribed with antihypertensive drugs. Data were collected from patients attending outpatient  department of medicine .    Medical and nursing records were analyzed for patient’s characteristics (e.g. age, gender), systolic and diastolic BP readings, number of drugs, monotherapy, combination therapy, co morbidities. Data were analysed by using SPSS version 20. Results: The total 130 geriatric patients under treatment with antihypertensive drugs were included, in which 55.38% were male and 44.62% were female. The total numbers of antihypertensive drugs prescribed were 212 either as monotherapy or as a component of a combination therapy. The average number of drugs prescribed per patient was found to be 1.66. Among these drugs 56.92% were prescribed as monotherapy,26.92% were prescribed as two drugs combination therapy,12.30% were prescribed as three drugs combination and 3.84% were prescribed as four drugs combination therapy. calcium channel blockers (amlodipine )was the most commonly prescribed antihypertensive. Conclusion: The study showed male patient were more predominant hypertensive compare to female. calcium channel blockers group of drugs in which amlodipine was the most commonly prescribed antihypertensive drug and more than half of the patients were in monotherapy.

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