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Pol Merkuriusz Lek. 1999 Mar;6(33):125-7.
[Studies of lymphocyte membrane transport of sodium in patients with essential hypertension]

[Article in Polish]

Negrusz-Kawecka M.

Katedry i Kliniki Kardiologii AM we Wroclawiu.

The aim of this study was to investigate abnormalities in lymphocyte membrane sodium fluxes in patients with essential hypertension with and without familial history of hypertension and the influence of selected hypotensive drugs on these fluxes. 121 patients (pts) with positive family histories of primary hypertension (PFH) and 73 pts with negative family histories of primary hypertension (NFH) were examined. The total sodium efflux rate constant (wswc), ouabaine-sensitive (wswou) and furosemide-sensitive (wswf) were measured by the method of Heagerty et al. To examine the influence of selected hypotensive drugs on sodium fluxes wswc, wswou and wswf were measured before and after 7 days of treatment with hydrochlorothiazide (H) or propranolol (P). Wswou was decreased in 61% pts with PFH and in 19% pts with NFH, wswf was decreased in 38% pts with PFH and in 22% pts with NFH. Both, wswou and wswf, were decreased in 49% pts with PFH and only in 2.7% pts with NFH. Wswou and wswf rose significantly after 7 days of treatment with H or P only in pts with PFH and in pts with decreased wswou and wswf before treatment. These data suggest that abnormal lymphocytes membrane sodium transport often occurs in pts with PFH and has familial component. Changes in transport systems observed after 7 days treatment with H or P may contribute, at least in part, to its antihypertensive action in familial hypertension.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10365594&dopt=Abstract




Clin Chim Acta. 1981 Feb 19;110(1):27-33.
A study of erythrocyte membrane cation transport adenosine triphosphatases in pregnancy-induced hypertension and of in vivo effects of diuretic treatment.

Kaplay SS, Prema K.

Plasma and erythrocyte Na+ and K+ and erythrocyte membrane (EM) Na+, K+ ATPase, Mg2+ ATPase and Ca2+, Mg2+ Atpase activities were studied in four groups of women -- non-pregnant, normal pregnant, with pregnancy edema (PE) and with pregnancy induced hypertension (PIH). The effect of diuretic therapy in PE and PIH was also evaluated. Plasma Na+ concentration was higher in PE and PIH. There was a significant reduction in (Na+ + K+) ratio between cell and plasma in these two groups. EM Na+, K+ ATPase was unaltered in PE and PIH. The Mg2+ ATPase was elevated by 44% in PE and by 100% in PIH subjects. There was a 50% reduction in Ca2+, Mg2+ ATPase activity in PE. Diuretic therapy had no effect either on electrolyte levels or on any of the EM ATPases. From these results it may be concluded that Na, K, ATPase -- which in kidney is a site of action for furosemide, a potent diuretic -- is unaffected in PE and PIH and, hence, treatment with diuretics -- is unaffected in PE and PIH and, hence, treatment with diuretics in such patients may be ineffective.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=6111403&dopt=Abstract

spinn.net

Treatment of tuberculous meningitis should begin with an anti-tuberculous regimen of at least three drugs: isoniazid, pyrazinamide, and rifampin. Early in the course of therapy, ethambutol or streptomycin may be of some added benefit. If the local incidence of drug resistance to Mycobacterium tuberculosis is greater than 4%, or is unknown, then a fourth drug (ethambutol or streptomycin) should be added. If the patient is from an area with organisms resistant to multiple drugs, or is likely to be infected with a multiply resistant organism for any reason, then the patient should be on enough drugs to insure that at least two active anti-tubercular drugs are included in the therapy. An expert should be consulted Length of therapy is not standardized. For sensitive organisms, a regimen of three drugs daily for 2 months, followed by two-drug therapy (isoniazid and rifampin) has been recommended. The American Thoracic Society (ATS) and the Centers for Disease Control (CDC) have recommended a minimum of 12 months of therapy for tuberculous meningitis. If cultures remain positive for extended periods, or signs or symptoms respond slowly, therapy should be extended to 18 months. Patients with HIV also may need longer courses of therapy. The severity of tuberculous meningitis can be classified based on a system devised by the British Medical Research Council. Stage I patients are fully conscious, rational, and do not have neurologic signs. Stage II patients are confused or have neurologic signs such as cranial nerve palsy or hemiparesis. Stage III patients are comatose or stuporous with more severe neurologic signs. Corticosteroids are recommended if the patient is mentally confused, has neurologic signs, or is comatose (Stages II and III). In patients with moderate disease (Stage II), corticosteroids appear to improve neurologic sequelae and survival. Dexamethasone 6 to 12 mg per day and prednisone 60 to 80 mg per day tapered over 4 to 8 weeks has been used. Symptoms of central nervous system (CNS) inflammation may recur if the corticosteroid taper is implemented too soon or too fast. Steroids and diuretics such as furosemide and acetazolamide are sometimes used to treat hydrocephalus. Ventriculoperitoneal or ventriculoatrial shunting may be required to relieve signs and symptoms of hydrocephalus.

online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11487456&dopt=Abstract [PubMed - as supplied by publisher]





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