scholarly journals Failure of intravenous lipid emulsion in treatment of cardiotoxicity caused by mixed overdose including dihydropyridine calcium channel blockers

2016 ◽  
Vol 73 (1) ◽  
pp. 88-91 ◽  
Author(s):  
Jasmina Jovic-Stosic ◽  
Vesna Putic ◽  
Dragan Zivanovic ◽  
Milica Mladenov ◽  
Gordana Brajkovic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Lipid Emulsion ◽  
Ventricular Rate ◽  
Channel Blockers ◽  
Av Block ◽  
Intravenous Lipid Emulsion

Introduction. Calcium channel blockers and beta-blockers are among the most frequently ingested cardiovascular drugs in self-poisoning causing significant mortality. Intravenous lipid emulsion (ILE) is reported as a potentially novel antidote for treatment of acute poisoning caused by some of these drugs. Case report. We presented two cases of poisoning with these drugs. The case 1, a 24-year-old woman ingested amplodipine, metformin and gliclazide for self-poisoning. She presented with tachycardia and hypotension. Laboratory analyses revealed hyperglycaemia and metabolic acidosis. Despite the treatment which included fluid resuscitation, vasopressors, intravenous calcium, glucagon and ILE, circulatory shock occurred. The patient died 10 hours after admission due to cardiac arrest refractory to cardiopulmonary resuscitation. The case 2, a 41-year old man, was found in a coma with empty packages of nifedipine, metoprolol and diazepam tablets. On admission vital signs included Glasgow Coma Scale (GCS) of 3, weak palpable pulses, undetectable blood pressure, and irregular breathing with oxygen saturation of 60%. An electrocardiography showed AV block (Mobitz II) with ventricular rate of 44/min with progression to third degree of AV block. In attempt to increase heart rate and blood pressure the following agents were administered: atropine boluses, normal saline with dopamine, glucagon, calcium chloride and ILE. Temporary transvenous pacemaker was placed, electrical capture was recorded, but without improvement in haemodynamics. Three hours after admission cardiac arrest happened and cardiopulmonary resuscitation was unsuccessful. Conclusion. Intravenous lipid emulsion may be ineffective in acute poisonings with amlodipine, nifedipine or metoprolol.

scholarly journals Calcium Channel Blockers Shorten the Periodicity of Ultradian Variation in Blood Pressure in Patients with Essential Hypertension.

1998 ◽  
Vol 21 (3) ◽  
pp. 179-186 ◽  
Author(s):  
Hiroshi Kawamura ◽  
Hiromi Mitsubayashi ◽  
Tomoaki Saito ◽  
Katsuo Kanmatsuse ◽  
Noboru Saito
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Channel Blockers

scholarly journals Comparing the Efficacy of Angiotensin Converting Enzyme In-hibitors with Calcium Channel Blockers on the Treatment of Di-abetic Nephropathy: A Meta-Analysis

2019 ◽  
Author(s):  
Zhaowei ZHANG ◽  
Chunlin CHEN ◽  
Shiwen LV ◽  
Yalan ZHU ◽  
Tianzi FANG
Keyword(s):  
Blood Pressure ◽  
Diabetic Nephropathy ◽  
Angiotensin Converting Enzyme ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Mean Difference ◽  
Channel Blockers ◽  
Converting Enzyme

Background: The angiotensin-converting enzyme inhibitors (ACEIs) could improve the symptoms of diabetic nephropathy. Whether the calcium channel blockers (CCBs) could be as effective as ACEIs on treating diabetic nephropathy is controversial. Here, we aimed to compare the efficacy of ACEIs with CCBs on the treatment of diabetic nephropathy by performing a meta-analysis of randomized controlled trials (RCTs). Methods: The Pubmed, Medline, Embase and The Cochrane Database were searched up to July 2017 for eligible randomized clinical trials studies. Effect sizes were summarized as mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (P-value<0.05). Results: Seven RCTs involving 430 participants comparing ACEIs with CCBs were included. No benefit was seen in comparative group of ACEIs on systolic blood pressure（SBP） (MD=1.05 mmHg; 95% CI: -0.97 to 3.08, P=0.31), diastolic blood pressure (DBP) (MD= -0.34 mmHg; 95% CI: -1.2 to 0.51, P=0.43), urinary albumin excretion rates (UAER) (MD=1.91μg/min; 95% CI: -10.3 to 14.12, P=0.76), 24-h urine protein (24-UP) (SMD=-0.26; 95%CI: -0.55 to 0.03, P=0.08), glomerular filtration rate (GFR) (SMD=0.01; 95% CI: -0.38 to 0.41, P=0.95). On safety aspect, the risk of adverse reactions between ACEIs group and CCBs group are similar (RR=1.18; 95% CI: 0.61 to 2.28; P=0.61). Conclusion: Both ACEIs and CCBs could improve the BP, UAER, 24h-UP, and GFR of diabetic nephropathy to a similar extent

Antiproteinuric effects of antihypertensive agents in non-diabetic hypertensive population

Open Medicine ◽  
2008 ◽  
Vol 3 (3) ◽  
pp. 287-293
Author(s):  
Zorica Jovic ◽  
Vidojko Djordjevic ◽  
Karin Vasic ◽  
Snezana Cekic ◽  
Jankovic Irena
Keyword(s):  
Blood Pressure ◽  
Calcium Channel ◽  
Antihypertensive Drug ◽  
Calcium Channel Blockers ◽  
Ace Inhibitors ◽  
Statistical Significance ◽  
Antihypertensive Agents ◽  
Channel Blockers ◽  
Significant Difference ◽  
Change In Mean

AbstractArterial hypertension and proteinuria are important factors associated with the progression of both diabetic and nondiabetic chronic kidney disease. The objective of the present study was to determine the influence of different antihypertensive drug groups on urinary albumin excretion (UAE) as related to blood pressure in non-diabetic population. Subjects (n=39) with chronic renal disease accompanied by mild to moderate hypertension and varying degrees of proteinuria were divided into 3 groups based on UAE values and placed on nonpharmacological and/or treatment with an antihypertensive drug regimen (consisting of one or more antihypertensive drugs [beta blocker, ACE inhibitor or calcium-channel blocker]) to achieve a target blood pressure ≤ 130/85 mmHg. Periodic UAE measurements were performed. A reduction was observed over time in most patients, however, it reached statistical significance only in the microalbuminuric group (P<0.01). Patients were further stratified into 5 groups depending on assigned therapy: 0, nonpharmacological treatment; 1-drug group 1; 12-drug groups 1 and 2; 13-drug groups 1 and 3; 123-all 3 drug groups (1-ACE inhibitors, 2-beta blockers, 3-calcium channel blockers). A statistically significant change in mean UAE values at the start and end of the study period in patients assigned to drug groups 12, 13, and 123 was achieved (P < 0.05). Also, there was a statistically significant difference in the average reduction of proteinuria under varying antihypertensive drug regimens (P < 0.05). In conclusion, in patients with hypertension, changes in UAE depend on initial UAE values and administered antihypertensive treatment. ACE inhibitors combined with calcium channel blockers resulted in a higher UAE reduction than other drug groups.

scholarly journals Determinants of the Morning-Evening Home Blood Pressure Difference in Treated Hypertensives: The HIBA-Home Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Lucas S. Aparicio ◽  
Jessica Barochiner ◽  
Paula E. Cuffaro ◽  
José Alfie ◽  
Marcelo A. Rada ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Calcium Channel ◽  
Total Cholesterol ◽  
Calcium Channel Blockers ◽  
Target Organ Damage ◽  
Linear Regression Analysis ◽  
Home Blood Pressure ◽  
Channel Blockers ◽  
Analysis Model ◽  
Home Based

Background. The morning home blood pressure (BP) rise is a significant asymptomatic target organ damage predictor in hypertensives. Our aim was to evaluate determinants of home-based morning-evening difference (MEdiff) in Argentine patients.Methods. Treated hypertensive patients aged≥18 years participated in a cross-sectional study, after performing home morning and evening BP measurement. MEdiff was morning minus evening home average results. Variables identified as relevant predictors were entered into a multivariable linear regression analysis model.Results. Three hundred sixty-seven medicated hypertensives were included. Mean age was 66.2 (14.5), BMI 28.1 (4.5), total cholesterol 4.89 (1.0) mmol/L, 65.9% women, 11.7% smokers, and 10.6% diabetics. Mean MEdiff was 1.1 (12.5) mmHg systolic and 2.3 (6.1) mmHg diastolic, respectively. Mean self-recorded BP was 131.5 (14.1) mmHg systolic and 73.8 (7.6) mmHg diastolic, respectively. Mean morning and evening home BPs were 133.1 (16.5) versus 132 (15.7) systolic and 75.8 (8.4) versus 73.5 (8.2) diastolic, respectively. Significant beta-coefficient values were found in systolic MEdiff for age and smoking and in diastolic MEdiff for age, smoking, total cholesterol, and calcium-channel blockers.Conclusions. In a cohort of Argentine medicated patients, older age, smoking, total cholesterol, and use of calcium channel blockers were independent determinants of home-based MEdiff.

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