Drugs online research references
Am J Hypertens. 1993 Apr;6(4):148S-154S.
Comparative renal hemodynamic effects of lisinopril, verapamil, and amlodipine in patients with chronic renal failure.
August P, Lenz T, Laragh JH.
Cardiovascular Center, New York Hospital-Cornell Medical Center, New York 10021.
We investigated the effects of lisinopril, verapamil, and amlodipine in 26 hypertensive patients with chronic renal disease of varying etiologies. Blood pressure, urine protein excretion, glomerular filtration rate (GFR), and renal blood flow (RBF) (inulin and para-aminohippurate clearance) were determined before and after 2 to 3 months of therapy. All three agents lowered blood pressure with minimal side effects in many, but not all, patients. Patients who had a significant lowering of blood pressure in response to lisinopril and verapamil had favorable renal hemodynamic responses as well--GFR remained stable, RBF was stable or increased, and filtration fraction, renal vascular resistance, and proteinuria tended to decrease. Patients whose blood pressure did not decrease had less favorable responses. In the small number of patients who received amlodipine, lowering of blood pressure was associated with a small decrease in GFR. Our results demonstrate a heterogeneity in response to antihypertensive agents in patients with renal disease. We therefore conclude that treatment of such patients should be individualized, and suggest that choice of therapy depend on adequate blood pressure response in conjunction with stabilization of renal function and urine protein excretion. Our data do not support the use of a drug in these circumstances if it does not lower systemic blood pressure.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8389563&dopt=Abstract
Acta Med Scand Suppl. 1986;714:33-42.
Antihypertensive and hormonal effects of lisinopril, a new angiotensin converting enzyme (ACE) inhibitor in patients with renovascular hypertension.
Karlberg BE, Rosenqvist U.
The antihypertensive and hormonal effects of a new ACE-inhibitor, lisinopril (MK-521), was studied in 11 patients with renal arterial stenosis (bilateral in 1). Oral doses exceeding 5 mg a day significantly reduced blood pressure (BP), the maximum fall occurring 6 h after taking the drug. At higher doses (20-80 mg/day) sustained antihypertensive effects persisted for 24 h. Lisinopril was equally effective in lowering supine and standing BP. When the drug was given stepwise in increasing doses, (5, 10, 20, 40, and in 5 cases 80 mg/day) the BP was successively normalized in 10 of 11 patients (supine BP less than 90 mmHg). 3 patients with low renin hypertension (LRH) responded less well to monotherapy on long-term treatment with lisinopril than the others. A significant increase in heart rate was observed, initially and after 1 month of treatment. After 5 days treatment with increasing doses the plasma concentrations of angiotensin II (AII) and aldosterone (Aldo) fell significantly to very low concentrations. However, on long term treatment (3 months) suppression of AII and Aldo did not always take place. A concomitant decrease in 24 h urinary aldosterone excretion occurred. No changes in renal function or other biochemical tests except for a slight increase in S-K were observed. There were no adverse side-effects. We conclude that lisinopril is an effective and safe medication for renovascular hypertension.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3033998&dopt=Abstract
Am Heart J. 1986 Jul;112(1):121-9.
Acute hemodynamic and hormonal effects of lisinopril (MK-521) in congestive heart failure.
Dickstein K, Aarsland T, Woie L, Abrahamsen AM, Fyhrquist F, Cummings S, Gomex HJ, Hagen E, Kristianson K.
The acute hemodynamic and hormonal effects of the oral angiotensin-converting enzyme (ACE) inhibitor lisinopril (MK-521) were assessed over a period of 96 hours in 12 patients with heart failure. This compound is the lysine analogue of enalaprilat (MK-422), is biologically active following absorption, and is cleared via the urine without any known metabolic transformation. Single doses of lisinopril, ranging from 1.25 mg to 10 mg, were administered on days 1 and 3, each followed by 48 hours of intensive hemodynamic observation. Across all doses, maximal reductions in mean arterial pressure (17.2%), mean pulmonary capillary wedge pressure (28%), and systemic vascular resistance (25.6%) were observed compared to baseline values. No significant changes in heart rate were recorded. Arterial blood was sampled at frequent intervals for angiotensin II, ACE activity, plasma renin activity, renin substrate, plasma aldosterone, and serum drug levels. Right atrial blood was sampled simultaneously for angiotensin I, thus permitting assessment of the degree of pulmonary conversion to angiotensin II. The results indicate potent inhibition of the renin-angiotensin-aldosterone system along with hemodynamic efficacy over a period exceeding 24 hours. Frequent clinical follow-up on long-term chronic therapy has revealed no adverse experience.
online pharmacy ref source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3014850&dopt=Abstract
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