Sodium Chloride Symporter Inhibitors
Low and conventional dose cyclopenthiazide on glucose and lipid metabolism in mild hypertension. (1/8)In a double-blind, placebo controlled, randomised parallel study we investigated the antihypertensive activity and metabolic adverse effects of three doses of cyclopenthiazide in 53 patients with mild hypertension. After a 4 week placebo washout period, patients with diastolic blood pressures between 90-110 mm Hg were randomly assigned to receive 50 micrograms, 125 micrograms and 500 micrograms of cyclopenthiazide or matching placebo, over an 8 week active treatment period. Blood pressure was recorded at 2 weekly intervals during the trial. Venous samples were taken for evaluation of drug effect on indices of carbohydrate and lipid metabolism just prior to, and on completion of, the active treatment period. Systolic and diastolic blood pressure decreased significantly (P less than 0.05) with the 125 micrograms and 500 micrograms doses of cyclopenthiazide. No change was apparent in any index of glucose and lipid metabolism over time. Low and conventional doses of cyclopenthiazide lower blood pressure without alteration to the metabolic profile in the short term. (+info)
The case for low dose diuretics in hypertension: comparison of low and conventional doses of cyclopenthiazide. (2/8)In a double blind placebo controlled randomised parallel study the antihypertensive activity and adverse biochemical effects of three doses of cyclopenthiazide were evaluated in patients with mild essential hypertension that had been recently diagnosed or was being treated with a single drug. After a four week placebo washout period 53 patients with diastolic blood pressures between 90-110 mm Hg were randomly assigned to 50, 125, or 500 micrograms cyclopenthiazide or matching placebo for an eight week period of treatment. Blood pressure was measured in the patients' homes by the same observer every two weeks. Serum urea, electrolytes, urate, and creatinine concentrations and 24 hour urinary sodium excretion were monitored every four weeks and serum magnesium concentration and plasma renin activity at the end of the washout and treatment periods. After eight weeks of treatment systolic and diastolic blood pressures were significantly reduced in patients taking 125 and 500 micrograms cyclopenthiazide when compared with those taking placebo. The decrement in serum potassium concentration (0.6 mmol/l) and increase in serum urate concentration 0.06 mmol/l) were greatest with the 500 micrograms dose, the increase in serum urate concentration alone being significant. No change in serum magnesium concentration or 24 hour urinary sodium excretion was noted with any dose of cyclopenthiazide. Only the 500 micrograms dose of cyclopenthiazide significantly increased the mean plasma renin activity (1.8 (95% confidence interval 0.2 to 3.4)-5.4 (3.9 to 6.8) nmol angiotensin I/l/h); the other doses like the placebo had no effect. Cyclopenthiazide 125 micrograms, a dose lower than is currently marketed, produced a similar hypotensive response to 500 micrograms of the drug without upsetting the biochemical profile. (+info)
Drugs, including alcohol, that act as risk factors for cataract, and possible protection against cataract by aspirin-like analgesics and cyclopenthiazide. (3/8)A case-control study of cataract in Oxfordshire explored the risks and benefits associated with a variety of drugs. Steroids including the diuretic spironolactone, nifedipine, heavy smoking, and beer drinking were associated with a raised risk. On the other hand aspirin-like analgesics (paracetamol, ibuprofen, aspirin, etc. appeared to protect against cataract. Cyclopenthiazide appeared to provide a similar protection. (+info)
The breast pain clinic: a rational approach to classification and treatment of breast pain. (4/8)Three hundred and fifty women complaining of breast pain symptoms of sufficient severity to interfere with their normal lifestyle were reviewed in a special breast pain clinic over a 5 year period. Seventy-two patients (21%) had spontaneous resolution of breast pain and they required reassurance only before discharge. Of the remaining 278 patients, accurate classification of breast pain syndromes was achieved in 89%, the commonest syndrome being cyclical breast pain which accounted for 54% of the women followed up. The remaining womens' breast pain was classified as trigger zone (14%), continuous (8%), Tietze's disease (5%), spinal root (4%), duct ectasia (4%) and psychological depression (2%). In the remaining 25 patients (9%) the breast pain could not be classified. The experience from this clinic is that a majority of women complaining of severe breast pain symptoms can be accurately classified and appropriate therapy instituted. (+info)
Arrhythmogenic potential of diuretic induced hypokalaemia in patients with mild hypertension and ischaemic heart disease. (5/8)In view of evidence suggesting an association of mild hypokalaemia with cardiac arrhythmia, the arrhythmogenic potentials of potassium losing and potassium sparing diuretic treatments were compared in a controlled prospective crossover study of 10 patients with mild hypertension and ischaemic heart disease. Mean (SEM) plasma potassium was 4.3(0.06) mmol/l and 3.3(0.07) mmol/l after potassium sparing and potassium losing treatments respectively. Blood pressure and volume depletion as assessed by weight change, plasma renin activity, and noradrenaline concentrations did not differ significantly in the two treatment periods. The potassium losing treatment phase was associated with an increased frequency of ventricular extrasystoles, a higher Lown grading during ambulatory electrocardiographic monitoring, prolonged duration and decreased phase 0 velocity of the monophasic action potential, a prolonged ventricular effective refractory period, and increased myocardial electrical instability as assessed by programmed ventricular stimulation. It is concluded that minor changes in plasma potassium concentration are associated with increased ventricular electrical instability in patients with ischaemic heart disease. Mild hypokalaemia in such patients may predispose to life threatening arrhythmias and should be avoided. (+info)
Comparison of the beta-adrenoceptor blocking activity of oxprenolol, slow release oxprenolol and a combined oxprenolol diuretic preparation. (6/8)1 Observations were made in five healthy subjects who exercised before and 2, 3, 6, 8 and 24 h after the oral administration on separate occasions of 160 mg oxprenolol, 160 mg slow release oxprenolol, 160 mg slow release oxprenolol with 0.25 mg cyclopenthiazide and placebo. Blood samples were obtained before and at 1, 2, 3, 6, 8, 12 and 24 h after drug administration and assayed for oxprenolol concentration. 2 The three formulations produced maximum reductions of 29% in the exercise tachycardia 3 to 6 h after drug administration. At 24 h the effects of the three preparations were not significantly different from placebo. 3 There were no significant differences in the plasma concentrations produced by the three formulations during the 24 h period. 4 These observations suggest that the slow release formulations of oxprenolol should be given twice daily to maintain cardiac beta-adrenoceptor blockade throughout a period of 24 h. (+info)
Xipamide and cyclopenthiazide in essential hypertension--comparative effects on blood pressure and plasma potassium. (7/8)1 The blood pressure lowering effect of xipamide, a non-thiazide diuretic given for 6 weeks was compared in a randomised cross-over trial with that of cyclopenthiazide in 14 patients with essential hypertension. 2 Xipamide 10 or 20 mg given once daily was as effective in lowering supine blood pressure as daily cyclopenthiazide 0.5 mg. There was no difference in the blood pressure lowering effect of 10 mg xipamide daily for 2 weeks compared to 20 mg daily given for a further 4 weeks. 3 Plasma potassium was reduced by both drugs, but markedly more after both 10 mg and 20 mg xipamide than after cyclopenthiazide 0.5 mg. By the sixth week of treatment 13 of 14 patients on xipamide but only 6 of 14 on cyclopenthiazide has plasma potassium concentrations of, or less than, 3.5 mmol/l. The fall in plasma potassium was significantly greater and the final plasma potassium concentration was significantly lower after either dose of xipamide than after cyclopenthiazide. 4 These results suggest that 10 mg or 20 mg of xipamide daily is effective in lowering blood pressure in hypertensive patients but is associated with hypokalaemia. In view of recent evidence linking diuretic-induced hypokalaemia with cardiac dysrhythmias in patients with essential hypertension we would suggest that thiazide diuretics be used in preference to xipamide for the routine management of essential hypertension. Our results also suggest that the currently recommended dose of xipamide (20 mg) for the treatment of hypertension is excessive, and lower amounts than 10 mg per day might possibly be as effective in lowering blood pressure with less adverse metabolic consequences. (+info)
Diuretic treatment of resistant hypertension. (8/8)In patients with hypertension resistant to three or four drugs including a thiazide diuretic substitution of frusemide for the thiazide, or the addition of spironolactone, produced significant reductions in blood pressure and body weight. The response did not depend on the presence of overt fluid retention, renal impairment, or the use of antihypertensive drugs of high potency. Women had larger responses than men. Expansion of the plasma or extracellular fluid volume is an important cause of resistance to treatment even when a thiazide diuretic is used. An increase in diuretic treatment should be tried before using the postganglionic adrenergic blockers or minoxidil in resistant hypertension. (+info)
Cyclopenthiazide is a type of thiazide diuretic, which is a class of medications used to treat high blood pressure and edema (fluid retention) by promoting the excretion of urine. Specifically, cyclopenthiazide works by inhibiting the reabsorption of sodium and chloride ions in the distal convoluted tubule of the kidney, which leads to increased water loss in the urine.
The medical definition of 'Cyclopenthiazide' is:
A long-acting thiazide diuretic with a prolonged duration of action, used in the treatment of hypertension and edema associated with congestive heart failure, cirrhosis, and renal disease. It has a slower onset but longer duration of action than other thiazides, making it useful for once-daily dosing.
Cyclopenthiazide is available in oral form and is typically prescribed at a dose of 0.5 to 1 mg per day. Common side effects include electrolyte imbalances (such as low potassium levels), dehydration, dizziness, headache, and muscle cramps. It may also increase blood glucose levels in people with diabetes.
It is important to note that the use of cyclopenthiazide should be under the supervision of a healthcare professional, as it can interact with other medications and have potentially serious side effects if not used properly.
Xipamide is a loop diuretic medication that is primarily used to treat edema (fluid retention) associated with conditions such as heart failure, liver cirrhosis, and kidney disease. Diuretics help the body eliminate excess fluid and sodium by increasing urine production. Xipamide specifically inhibits the sodium-potassium-chloride cotransporter in the ascending loop of Henle in the kidneys, which leads to increased excretion of sodium and chloride ions, as well as water.
The increase in urine output helps reduce fluid accumulation in various parts of the body, alleviating symptoms such as shortness of breath, swelling, and weight gain. Xipamide is available in oral tablet form and should be used under the supervision of a healthcare professional due to its potential side effects and interactions with other medications.
Common side effects of xipamide include electrolyte imbalances (such as low potassium levels), increased thirst, headache, dizziness, and gastrointestinal disturbances like nausea and diarrhea. Rare but serious side effects may include hearing loss, kidney damage, or severe allergic reactions. It is essential to follow the prescribed dosage regimen closely and monitor electrolyte levels regularly while taking xipamide.
Sodium chloride symporter inhibitors are a class of pharmaceutical agents that block the function of the sodium chloride symporter (NCC), which is a protein found in the kidney's distal convoluted tubule. The NCC is responsible for reabsorbing sodium and chloride ions from the filtrate back into the bloodstream, helping to regulate electrolyte balance and blood pressure.
Sodium chloride symporter inhibitors work by selectively binding to and blocking the NCC, preventing it from transporting sodium and chloride ions across the cell membrane. This leads to increased excretion of sodium and chloride in the urine, which can help lower blood pressure in patients with hypertension.
Examples of sodium chloride symporter inhibitors include thiazide diuretics such as hydrochlorothiazide and chlorthalidone, which have been used for many years to treat hypertension and edema associated with heart failure and liver cirrhosis. These medications work by reducing the amount of sodium and fluid in the body, which helps lower blood pressure and reduce swelling.
It's worth noting that while sodium chloride symporter inhibitors can be effective at treating hypertension, they can also cause side effects such as electrolyte imbalances, dehydration, and increased urination. As with any medication, it's important to use them under the guidance of a healthcare provider and to follow dosing instructions carefully.
Diuretics are a type of medication that increase the production of urine and help the body eliminate excess fluid and salt. They work by interfering with the reabsorption of sodium in the kidney tubules, which in turn causes more water to be excreted from the body. Diuretics are commonly used to treat conditions such as high blood pressure, heart failure, liver cirrhosis, and kidney disease. There are several types of diuretics, including loop diuretics, thiazide diuretics, potassium-sparing diuretics, and osmotic diuretics, each with its own mechanism of action and potential side effects. It is important to use diuretics under the guidance of a healthcare professional, as they can interact with other medications and have an impact on electrolyte balance in the body.