Mineralocorticoid Receptor Antagonists
Sodium Chloride Symporter Inhibitors
Angiotensin-Converting Enzyme Inhibitors
Drug Therapy, Combination
Angiotensin II Type 1 Receptor Blockers
11-beta-Hydroxysteroid Dehydrogenase Type 2
Aldosterone, not estradiol, is the physiological agonist for rapid increases in cAMP in vascular smooth muscle cells. (1/759)BACKGROUND: Steroid-induced gene regulation in the endocrine tissues and vascular wall is achieved through the interaction of specific receptor proteins and promoters of target genes. In addition to these delayed steroid actions, rapid effects of steroids have been reported in various tissues that were clearly incompatible with the classic theory of genomic steroid action. METHODS AND RESULTS: Because high doses of 17beta-estradiol have been shown to modulate intracellular cAMP levels in vascular smooth muscle cells, steroid-induced stimulation of adenylate cyclase stimulation and phosphorylation of cAMP response element binding protein was investigated in porcine coronary artery vascular smooth muscle cells. Aldosterone induces a approximately 1.5- to 2.5-fold increase in intracellular cAMP levels (EC50 approximately 0.01 to 0.1 nmol/L) within 1 minute, whereas 17beta-estradiol and hydrocortisone act only at supraphysiological concentrations (10 micromol/L). Aldosterone-induced changes in intracellular cAMP are calcium dependent; they are not blocked by inhibitors of mineralocorticoid receptors, transcription, or protein synthesis. In addition, aldosterone induces a time-dependent phosphorylation of cAMP response element binding protein with potential transcriptional importance. CONCLUSIONS: A nongenomic modulation of vascular smooth muscle cells by aldosterone is consistent with the data that aldosterone, not estrogen, is the physiological stimulus for cAMP. (+info)
Effects of spironolactone and angiotensin-converting enzyme inhibitor on left ventricular hypertrophy in patients with essential hypertension. (2/759)There is increasing evidence for important cardiovascular effects of aldosterone via classical mineralocorticoid receptors in the heart. Administration of aldosterone with excess salt produces both cardiac hypertrophy and interstitial cardiac fibrosis in rats, and concomitant administration of potassium canrenoate at a dose that only modestly lowers blood pressure completely blocks the cardiac effects of aldosterone. In the present study, we examined the effect on left ventricular hypertrophy of adding a low dose of the mineralocorticoid receptor antagonist spironolactone (25 mg/d) to an angiotensin-converting enzyme inhibitor (enalapril maleate) in patients with essential hypertension. Eighteen untreated patients with moderate to severe essential hypertension based on the WHO/ISH guidelines participated in this study. Subjects were treated with either an angiotensin-converting enzyme inhibitor alone (group I: 10 patients, 4 men and 6 women, mean age 56 +/- 18 yr) or an angiotensin-converting enzyme inhibitor plus spironolactone (group II: 8 patients, 3 men and 5 women, mean age 59 +/- 14 yr) for 9 mo. Left ventricular mass index, various echocardiographic variables, mean blood pressure, plasma renin activity, and plasma aldosterone concentration before treatment were similar in the two groups. Blood pressure of both groups decreased significantly and similarly after antihypertensive treatment (group I, 136 +/- 9/82 +/- 9 mmHg; group II, 133 +/- 9/85 +/- 10 mmHg). Left ventricular mass index also decreased significantly in both groups (group I, -10.2 +/- 7.1%; group II, -18.1 +/- 6.9%). The extent of reduction was significantly greater in the spironolactone group (group II) (p < 0.05 vs. group I). In group II patients, spironolactone did not cause any side effects during the observation period. We conclude that spironolactone may have beneficial effects on left ventricular hypertrophy in patients with essential hypertension who are receiving an angiotensin-converting enzyme inhibitor. (+info)
Brain mineralocorticoid receptor control of blood pressure and kidney function in normotensive rats. (3/759)Brain mineralocorticoid receptors appear to contribute to mineralocorticoid hypertension and may be involved in blood pressure control in normotensive rats. We examined the effect of blockade of central mineralocorticoid receptors with the use of a selective antagonist (RU28318) on cardiovascular and renal function in conscious normotensive rats. The contribution of renal innervation was evaluated in rats with bilaterally denervated kidneys. Young adult, male Wistar rats were trained for systolic blood pressure measurement by a tail sphygmographic method and accustomed to metabolic cages for collection of urine. One week before experimentation, an intracerebroventricular cannula was implanted. Systolic blood pressure was diminished 30 minutes after an intracerebroventricular dose of 10 ng of RU28318. The effect was maximal at 8 hours and was still present after 24 hours. Blood pressure returned to the basal level by 48 hours. During the period 0 to 8 hours after intracerebroventricular injection, rats treated with the antagonist showed an increase in diuresis and urinary electrolyte excretion. No significant effect on plasma renin activity, measured 8 and 30 hours after administration of RU28318, was observed. In denervated rats, the decrease in systolic blood pressure after administration of RU28318 was reduced. The difference was statistically significant compared with controls at 2 hours but not at 8 hours, and blood pressure returned to the basal value by 24 hours. The increases in diuresis and urinary electrolyte excretion induced by RU28318 were abolished in denervated rats. These results show that brain mineralocorticoid receptors are involved in blood pressure regulation and kidney function homeostasis in conscious normotensive rats. The renal nerves appear to participate in the brain mineralocorticoid receptor control of blood pressure. (+info)
Lesion-induced plasticity in rat vestibular nucleus neurones dependent on glucocorticoid receptor activation. (4/759)1. We have recently shown that neurones in the rostral region of the medial vestibular nucleus (MVN) develop a sustained increase in their intrinsic excitability within 4 h of a lesion of the vestibular receptors of the ipsilateral inner ear. This increased excitability may be important in the rapid recovery of resting activity in these neurones during 'vestibular compensation', the behavioural recovery that follows unilateral vestibular deafferentation. In this study we investigated the role of the acute stress that normally accompanies the symptoms of unilateral labyrinthectomy (UL), and in particular the role of glucocorticoid receptors (GRs), in the development of the increase in excitability in the rostral MVN cells after UL in the rat. 2. The compensatory increase in intrinsic excitability (CIE) of MVN neurones failed to occur in animals that were labyrinthectomized under urethane anaesthesia and kept at a stable level of anaesthesia for either 4 or 6 h after UL, so that they did not experience the stress normally associated with the vestibular deafferentation syndrome. In these animals, 'mimicking' the stress response by administration of the synthetic GR agonist dexamethasone at the time of UL, restored and somewhat potentiated CIE in the MVN cells. Administration of dexamethasone in itself had no effect on the intrinsic excitability of MVN cells in sham-operated animals. 3. In animals that awoke after labyrinthectomy, and which therefore experienced the full range of oculomotor and postural symptoms of UL, there was a high level of Fos-like immunoreactivity in the paraventricular nucleus of the hypothalamus over 1.5-3 h post-UL, indicating a strong activation of the stress axis. 4. The GR antagonist RU38486 administered at the time of UL abolished CIE in the rostral MVN cells, and significantly delayed behavioural recovery as indicated by the persistence of circular walking. The mineralocorticoid receptor (MR) antagonist spironolactone administered at the time of UL had no effect. 5. Vestibular compensation thus involves a novel form of 'metaplasticity' in the adult brain, in which the increase in intrinsic excitability of rostral MVN cells and the initial behavioural recovery are dependent both on the vestibular deafferentation and on the activation of glucocorticoid receptors, during the acute behavioural stress response that follows UL. These findings help elucidate the beneficial effects of neuroactive steroids on vestibular plasticity in various species including man, while the lack of such an effect in the guinea-pig may be due to the significant differences in the physiology of the stress axis in that species. (+info)
The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. (5/759)BACKGROUND AND METHODS: Aldosterone is important in the pathophysiology of heart failure. In a doubleblind study, we enrolled 1663 patients who had severe heart failure and a left ventricular ejection fraction of no more than 35 percent and who were being treated with an angiotensin-converting-enzyme inhibitor, a loop diuretic, and in most cases digoxin. A total of 822 patients were randomly assigned to receive 25 mg of spironolactone daily, and 841 to receive placebo. The primary end point was death from all causes. RESULTS: The trial was discontinued early, after a mean follow-up period of 24 months, because an interim analysis determined that spironolactone was efficacious. There were 386 deaths in the placebo group (46 percent) and 284 in the spironolactone group (35 percent; relative risk of death, 0.70; 95 percent confidence interval, 0.60 to 0.82; P<0.001). This 30 percent reduction in the risk of death among patients in the spironolactone group was attributed to a lower risk of both death from progressive heart failure and sudden death from cardiac causes. The frequency of hospitalization for worsening heart failure was 35 percent lower in the spironolactone group than in the placebo group (relative risk of hospitalization, 0.65; 95 percent confidence interval, 0.54 to 0.77; P<0.001). In addition, patients who received spironolactone had a significant improvement in the symptoms of heart failure, as assessed on the basis of the New York Heart Association functional class (P<0.001). Gynecomastia or breast pain was reported in 10 percent of men who were treated with spironolactone, as compared with 1 percent of men in the placebo group (P<0.001). The incidence of serious hyperkalemia was minimal in both groups of patients. CONCLUSIONS: Blockade of aldosterone receptors by spironolactone, in addition to standard therapy, substantially reduces the risk of both morbidity and death among patients with severe heart failure. (+info)
Aldosterone activates Na+/H+ exchange in vascular smooth muscle cells by nongenomic and genomic mechanisms. (6/759)BACKGROUND: In vascular smooth muscle cells (VSMCs), Na+/H+ exchange (NHE) plays an important role in intracellular pH (pHi) regulation. Recently, nongenomic effect of aldosterone (ALDO) on NHE activity has been suggested in VSMCs. However, the nongenomic and genomic effects of ALDO on NHE and the intracellular signaling mechanisms for these effects have not fully been determined in VSMCs. METHODS: The effects of short- (3 hr) and long- (24 hr) term exposure to ALDO on NHE activity were examined in cultured VSMCs from rat thoracic aortae by using single-cell pHi measurement with the pH-sensitive dye 2'7'-bis(carboxyethyl)-5(6)-carboxyfluorescein. The NHE activity was calculated from the initial rate of Na+-dependent pHi recovery after acid load. RESULTS: The NHE activity significantly increased after short- and long-term exposure of VSMCs to ALDO (10(-6) M). The inhibitors of gene transcription (actinomycin D) and of protein synthesis (cycloheximide) had no effect on the short-term ALDO effect, but inhibited the long-term ALDO effect. The antagonists of the mineralocorticoid receptor (MR) (spironolactone) and of the glucocorticoid receptor (GR) (RU38486) caused no effect on the short-term ALDO effect, but inhibited the long-term ALDO effect. Two protein kinase C (PKC) inhibitors (staurosporine A and calphostin C) and PKC down-regulation (24 hr pre-exposure to phobol 12-myristate 13-acetate, PMA) inhibited both the short- and long-term ALDO effects. Exposure of VSMCs to PMA for 3 hours mimicked the short-term effect of ALDO on NHE activity. ALDO significantly increased PKC activity in VSMCs. The short-term ALDO effect was inhibited by disruptors of microtubule (colchicine) and of filamentous-actin (cytochalasin B). Long-term exposure of ALDO caused a threefold increase in NHE (NHE-1) mRNA levels. CONCLUSIONS: The short-term effect of ALDO on NHE activity is not mediated through either MR or GR, occurs independent of gene transcription and protein synthesis, and occurs through a mechanism involving the structural elements of cytoskeleton. The long-term effect of ALDO on NHE activity occurs through both MR and GR and requires gene transcription and protein synthesis. Both short- and long-term effects of ALDO are mediated through PKC activation. Therefore, ALDO activates NHE by nongenomic and genomic mechanisms in VSMCs. (+info)
Influence of spironolactone on neonatal screening for congenital adrenal hyperplasia. (7/759)AIM: To determine if the diuretic spironolactone cross reacts with 17alpha-hydroxyprogesterone (17OHP) in an enzyme linked immunosorbent assay (ELISA) kit used for the mass screening of congenital adrenal hyperplasia. METHODS: Concentrations of 17OHP on a blood filter paper disc were measured using an ELISA kit (kit C-7: ENZAPLATE N-17alpha -OHP-7; Chiron, Tokyo, Japan). The cross reactivity of spironolactone and its metabolites with 17OHP was determined. The concentrations of spironolactone and its metabolites in blood were measured using HPLC (high performance liquid chromatography). RESULTS: Spironolactone cross reacted with 17OHP using kit C-7 (0.01%), by increasing 17OHP concentration in a dose dependent manner. The blood concentration of spironolactone and its metabolites was nearly 900 ng/ml, high enough to show an additive effect on the 17OHP concentration. About 12% of the false positive cases screened using the kit were due to the administration of spironolactone. CONCLUSIONS: Spironolactone interferes with 17OHP concentrations, leading to false positive test results for CAH. (+info)
Effect of poststroke captopril treatment on mortality associated with hemorrhagic stroke in stroke-prone rats. (8/759)We tested the ability of captopril treatment (50 mg/kg/day p.o.), initiated 2 weeks before stroke or up to 5 days after stroke, to alter the onset of stroke and death after stroke in Kyoto Wistar stroke-prone spontaneously hypertensive rats (SHRsp). The benefits of blood pressure and aldosterone suppression during captopril treatment were assessed. SHRsp developed a 100% mortality rate with intracerebral hemorrhage by 16 weeks of age. Captopril treatment, started 2 weeks before or at the initiation of stroke, suppressed plasma aldosterone and equally prevented mortality to a mean age of >27 weeks. Treatment started 5 days after stroke extended the mean lifespan to >23 weeks. The re-elevation of plasma aldosterone (via osmotic pumps to levels in untreated SHRsp) during captopril treatment, before stroke, allowed stroke to develop. The initiation of the latter manipulation in pre- or poststroke captopril-treated SHRsp at a latter age (23 weeks) didn't alter the lifespan of SHRsp (death occurred at about 28 weeks). The antistroke effects of captopril treatment occurred without an antihypertensive effect, weren't altered by enhancing hypertension during treatment (with dexamethasone), and couldn't be duplicated by antihypertensive treatment with hydralazine. Spironolactone treatment didn't duplicate the effects of captopril. The suppression of plasma aldosterone may retard the onset of stroke in SHRsp during captopril treatment but likely other factors prolong life in pre- and poststroke SHRsp receiving long-term captopril treatment. The observation that spironolactone treatment couldn't duplicate the effects of captopril suggests that aldosterone may facilitate stroke through nongenomic receptor mechanisms. (+info)
Causes of Hyperkalemia:
1. Kidney dysfunction: When the kidneys are not able to excrete excess potassium, it can build up in the bloodstream and lead to hyperkalemia.
2. Medications: Certain drugs, such as ACE inhibitors, potassium-sparing diuretics, and NSAIDs, can increase potassium levels by blocking the excretion of potassium in the urine.
3. Diabetic ketoacidosis: High levels of potassium can occur in people with uncontrolled diabetes who have diabetic ketoacidosis.
4. Acute kidney injury: This condition can cause a rapid increase in potassium levels as the kidneys are unable to remove excess potassium from the blood.
5. Heart disease: Potassium levels can rise in people with heart failure or other cardiac conditions, leading to hyperkalemia.
Symptoms of Hyperkalemia:
1. Muscle weakness and fatigue
2. Abnormal heart rhythms (arrhythmias)
5. Nausea and vomiting
6. Abdominal cramps
10. Weakness in the legs and feet
Treatment of Hyperkalemia:
The treatment of hyperkalemia depends on the underlying cause and the severity of the condition. Some of the common methods for lowering potassium levels include:
1. Diuretics: These medications help remove excess fluid and electrolytes, including potassium, from the body.
2. Calcium gluconate: This medication can help stabilize cardiac function and reduce the risk of arrhythmias.
3. Insulin and glucose: Giving insulin and glucose to someone with diabetic ketoacidosis can help lower potassium levels by increasing glucose uptake in the cells.
4. Hemodialysis: This is a process that uses a machine to filter waste products, including excess potassium, from the blood.
5. Potassium-binding resins: These medications can bind to potassium ions in the gut and prevent their absorption into the bloodstream.
6. Sodium polystyrene sulfonate (Kayexalate): This medication can help lower potassium levels by binding to excess potassium in the gut and causing it to be eliminated in the stool.
7. Activated charcoal: This medication can help bind to potassium ions in the gut and prevent their absorption into the bloodstream.
In severe cases of hyperkalemia, hospitalization may be necessary to monitor and treat the condition. In some instances, dialysis may be required to remove excess potassium from the blood. It is important to note that the treatment for hyperkalemia should only be done under the guidance of a healthcare professional, as some medications or procedures can worsen the condition if not properly managed.
Symptoms of hyperaldosteronism may include high blood pressure, low potassium levels, muscle weakness, and heart arrhythmias. Treatment options vary depending on the underlying cause but may include medications to reduce aldosterone production, dietary modifications, and in some cases, surgery or radiation therapy.
It is important for individuals with hyperaldosteronism to receive regular monitoring and treatment from a healthcare provider to manage their condition effectively and prevent complications such as heart disease and stroke.
The term "gynecomastia" comes from the Greek words "gyneco," meaning "womanlike," and "mastos," meaning "breast." The condition can occur at any age, but it is most common in infants, teenagers, and older men.
Gynecomastia can be caused by a variety of factors, including:
1. Hormonal imbalance: An imbalance of testosterone and estrogen hormones can lead to breast tissue growth.
2. Medications: Certain medications, such as antidepressants, anti-anxiety drugs, and heart medications, can cause gynecomastia as a side effect.
3. Medical conditions: Conditions such as hypogonadism (low testosterone levels), hyperthyroidism (high thyroid hormone levels), and liver or kidney disease can contribute to gynecomastia.
4. Genetic factors: Some men may inherit a tendency to develop gynecomastia due to genetic mutations.
5. Other factors: Gynecomastia can also be caused by other factors such as obesity, alcohol consumption, and certain types of foods or supplements.
Symptoms of gynecomastia may include:
* Enlarged breasts
* Breast tenderness
* Nipple sensitivity
* Pain in the breasts
* Swelling in the armpits
Gynecomastia is usually diagnosed through a physical examination and medical history. Imaging tests such as mammography or ultrasound may also be used to help rule out other conditions.
Treatment for gynecomastia depends on the underlying cause of the condition. In some cases, medications may be prescribed to address hormonal imbalances or other medical conditions that are contributing to the development of gynecomastia. Surgery may also be an option to remove excess breast tissue and improve the appearance of the chest.
In conclusion, gynecomastia is a relatively common condition in men that can have a significant impact on their self-esteem and quality of life. Understanding the causes and symptoms of gynecomastia is essential for proper diagnosis and effective treatment.
There are two main types of heart failure:
1. Left-sided heart failure: This occurs when the left ventricle, which is the main pumping chamber of the heart, becomes weakened and is unable to pump blood effectively. This can lead to congestion in the lungs and other organs.
2. Right-sided heart failure: This occurs when the right ventricle, which pumps blood to the lungs, becomes weakened and is unable to pump blood effectively. This can lead to congestion in the body's tissues and organs.
Symptoms of heart failure may include:
* Shortness of breath
* Swelling in the legs, ankles, and feet
* Swelling in the abdomen
* Weight gain
* Coughing up pink, frothy fluid
* Rapid or irregular heartbeat
* Dizziness or lightheadedness
Treatment for heart failure typically involves a combination of medications and lifestyle changes. Medications may include diuretics to remove excess fluid from the body, ACE inhibitors or beta blockers to reduce blood pressure and improve blood flow, and aldosterone antagonists to reduce the amount of fluid in the body. Lifestyle changes may include a healthy diet, regular exercise, and stress reduction techniques. In severe cases, heart failure may require hospitalization or implantation of a device such as an implantable cardioverter-defibrillator (ICD) or a left ventricular assist device (LVAD).
It is important to note that heart failure is a chronic condition, and it requires ongoing management and monitoring to prevent complications and improve quality of life. With proper treatment and lifestyle changes, many people with heart failure are able to manage their symptoms and lead active lives.
The normal range for potassium levels in the blood varies depending on age, gender, and other factors, but generally it is between 3.5 and 5.5 mEq/L (milliequivalents per liter).
Hypokalemia can be caused by a variety of factors such as diarrhea, vomiting, certain medications (diuretics, laxatives), kidney disease or malfunctioning of the parathyroid glands.
The exact cause of endomyocardial fibrosis is not known, but it is believed to be related to inflammation and scarring within the heart. The condition is more common in men than women, and typically affects people between the ages of 20 and 50. Symptoms of endomyocardial fibrosis can include shortness of breath, fatigue, swelling in the legs and feet, and chest pain.
There is no cure for endomyocardial fibrosis, but treatment options may include medications to manage symptoms, surgery to repair or replace damaged heart tissue, and lifestyle changes such as a healthy diet and regular exercise. In severe cases, heart transplantation may be necessary. Early diagnosis and treatment can help slow the progression of the condition and improve quality of life for those affected.
Some of the symptoms of hirsutism include:
* Thick, dark hair on the face, chest, back, and buttocks
* Hair growth on the arms, legs, and other areas of the body
* Thinning or loss of hair on the head
* Acne and oily skin
Hirsutism can be caused by a variety of factors, including:
* Hormonal imbalances: Excessive levels of androgens, such as testosterone, can cause hirsutism.
* Genetics: Inheritance plays a role in the development of hirsutism.
* Medications: Certain medications, such as anabolic steroids and certain antidepressants, can cause hirsutism as a side effect.
* Other medical conditions: Polycystic ovary syndrome (PCOS), congenital adrenal hyperplasia (CAH), and other endocrine disorders can also cause hirsutism.
There are several treatment options for hirsutism, including:
* Medications such as anti-androgens and retinoids to reduce hair growth and improve skin texture
* Electrolysis and laser therapy to remove unwanted hair
* Hormonal therapies such as birth control pills and spironolactone to regulate hormone levels and reduce hair growth
* Plastic surgery to remove excess hair-bearing skin.
It is important for individuals with hirsutism to seek medical attention if they experience any of the following symptoms:
* Sudden or excessive hair growth
* Hair growth on the face, chest, back, or buttocks
* Thinning or loss of hair on the head
* Acne and oily skin.
Early diagnosis and treatment can help manage the symptoms of hirsutism and improve quality of life for individuals affected by this condition.
There are two types of hypertension:
1. Primary Hypertension: This type of hypertension has no identifiable cause and is also known as essential hypertension. It accounts for about 90% of all cases of hypertension.
2. Secondary Hypertension: This type of hypertension is caused by an underlying medical condition or medication. It accounts for about 10% of all cases of hypertension.
Some common causes of secondary hypertension include:
* Kidney disease
* Adrenal gland disorders
* Hormonal imbalances
* Certain medications
* Sleep apnea
* Cocaine use
There are also several risk factors for hypertension, including:
* Age (the risk increases with age)
* Family history of hypertension
* Lack of exercise
* High sodium intake
* Low potassium intake
Hypertension is often asymptomatic, and it can cause damage to the blood vessels and organs over time. Some potential complications of hypertension include:
* Heart disease (e.g., heart attacks, heart failure)
* Kidney disease (e.g., chronic kidney disease, end-stage renal disease)
* Vision loss (e.g., retinopathy)
* Peripheral artery disease
Hypertension is typically diagnosed through blood pressure readings taken over a period of time. Treatment for hypertension may include lifestyle changes (e.g., diet, exercise, stress management), medications, or a combination of both. The goal of treatment is to reduce the risk of complications and improve quality of life.
Fibrosis can occur in response to a variety of stimuli, including inflammation, infection, injury, or chronic stress. It is a natural healing process that helps to restore tissue function and structure after damage or trauma. However, excessive fibrosis can lead to the loss of tissue function and organ dysfunction.
There are many different types of fibrosis, including:
* Cardiac fibrosis: the accumulation of scar tissue in the heart muscle or walls, leading to decreased heart function and potentially life-threatening complications.
* Pulmonary fibrosis: the accumulation of scar tissue in the lungs, leading to decreased lung function and difficulty breathing.
* Hepatic fibrosis: the accumulation of scar tissue in the liver, leading to decreased liver function and potentially life-threatening complications.
* Neurofibromatosis: a genetic disorder characterized by the growth of benign tumors (neurofibromas) made up of fibrous connective tissue.
* Desmoid tumors: rare, slow-growing tumors that are made up of fibrous connective tissue and can occur in various parts of the body.
Fibrosis can be diagnosed through a variety of methods, including:
* Biopsy: the removal of a small sample of tissue for examination under a microscope.
* Imaging tests: such as X-rays, CT scans, or MRI scans to visualize the accumulation of scar tissue.
* Blood tests: to assess liver function or detect specific proteins or enzymes that are elevated in response to fibrosis.
There is currently no cure for fibrosis, but various treatments can help manage the symptoms and slow the progression of the condition. These may include:
* Medications: such as corticosteroids, immunosuppressants, or chemotherapy to reduce inflammation and slow down the growth of scar tissue.
* Lifestyle modifications: such as quitting smoking, exercising regularly, and maintaining a healthy diet to improve overall health and reduce the progression of fibrosis.
* Surgery: in some cases, surgical removal of the affected tissue or organ may be necessary.
It is important to note that fibrosis can progress over time, leading to further scarring and potentially life-threatening complications. Regular monitoring and follow-up with a healthcare professional are crucial to managing the condition and detecting any changes or progression early on.
Here are some examples of how the term "facies" may be used in a medical context:
1. Facial asymmetry: A patient with facial asymmetry may have one side of their face that is noticeably different from the other, either due to a birth defect or as a result of trauma or surgery.
2. Facial dysmorphia: This is a condition in which a person has a distorted perception of their own facial appearance, leading them to seek repeated cosmetic procedures or to feel self-conscious about their face.
3. Facies of a particular syndrome: Certain medical conditions, such as Down syndrome or Turner syndrome, can have distinctive facial features that are used to help diagnose the condition.
4. Facial trauma: A patient who has suffered an injury to their face may have a facies that is disrupted or misshapen as a result of the trauma.
5. Facial aging: As people age, their facial features can change in predictable ways, such as sagging of the skin, deepening of wrinkles, and loss of fat volume. A doctor might use the term "facies" to describe these changes and plan appropriate treatments, such as a facelift or dermal fillers.
In general, the term "facies" is used by healthcare professionals to describe any aspect of a patient's facial appearance that may be relevant to their diagnosis or treatment. It is a useful way to communicate information about a patient's face in a precise and objective manner.
Pharmacodynamics of spironolactone
Feminizing hormone therapy
Comparison of bicalutamide with other antiandrogens
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- The following pharmacokinetic data were obtained from 12 healthy volunteers following the administration of 100 mg of spironolactone (ALDACTONE film-coated tablets) daily for 15 days. (pfizermedicalinformation.com)
- The effect of food on spironolactone absorption (two 100 mg ALDACTONE tablets) was assessed in a single dose study of 9 healthy, drug-free volunteers. (pfizermedicalinformation.com)
- Aldactone 100mg Pill (Spironolactone 100 mg) is a different contrived product introduced by a prominent pharmaceutical company known as RPG Lifescience Pvt Ltd. (cheapmedicinepills.com)
- Aldactone contains Spironolactone which has a place with a gathering of meds called potassium-saving diuretics (water tablets), which assist you with losing overabundance of liquid from your body. (cheapmedicinepills.com)
Effect of spironolactone4
- It may take about 2 weeks or longer before the full effect of spironolactone occurs. (medlineplus.gov)
- The diuretic effect of spironolactone is mediated through its action as a specific pharmacologic antagonist of aldosterone, primarily by competitive binding of receptors at the aldosterone-dependent sodium-potassium exchange site in the distal convoluted renal tubule. (pfizermedicalinformation.com)
- Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, Palensky J, Wittes J: The effect of spironolactone on morbidity and mortality in patients with severe heart failure. (lgmpharma.com)
- The effect of spironolactone versus placebo on outcomes was calculated by BMI and WC using Cox proportional hazard models. (nih.gov)
- Because it increases serum potassium, spironolactone may be useful for treating edema when administration of other diuretics has caused hypokalemia. (nih.gov)
- 001). Assignment to spironolactone, lower estimated glomerular filtration rate, higher baseline K + , diabetes, and lower hemoglobin were associated with incident hyperkalemia, whereas assignment to placebo, lower K + , younger age, lower estimated glomerular filtration rate, and use of diuretics at baseline were associated with hypokalemia. (northwestern.edu)
- Spironolactone is a synthetic 17-lactone steroid which is a renal competitive aldosterone antagonist in a class of pharmaceuticals called potassium-sparing diuretics. (lgmpharma.com)
- On its own, spironolactone is only a weak diuretic, but it can be combined with other diuretics. (lgmpharma.com)
- Spironolactone and hydrochlorothiazide both belong to the family of medications called diuretics (water pills). (rxhealthmed.ca)
- One of the diuretics, spironolactone, is called a potassium-sparing diuretic and helps the body to retain potassium. (rxhealthmed.ca)
- Spironolactone is an aldosterone receptor antagonist used for the treatment of hypertension, hyperaldosteronism, edema due to various conditions, hirsutism (off-label) and hypokalemia. (drugbank.com)
- Background: In patients with heart failure and preserved ejection fraction (HF-PEF) randomized in the Americas as part of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial, treatment with spironolactone enhanced the risk of hyperkalemia but reduced the risk of hypokalemia. (northwestern.edu)
- The combination of spironolactone and an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker was associated with incremental risk for hyperkalemia and protection from hypokalemia. (northwestern.edu)
- In this study, we compared the eﬀectiveness of nebivolol 5 mg, a third generation beta-blocker, with spironolactone 25 mg in patients with resistant hypertension. (nih.gov)
- Spironolactone is indicated as add-on therapy for the treatment of hypertension, to lower blood pressure in patients who are not adequately controlled on other agents. (nih.gov)
- Hydrochlorothiazide and spironolactone in hypertension. (nih.gov)
- Spironolactone and hydrochlorothiazide in normal-renin and low-renin essential hypertension. (nih.gov)
- Spironolactone and hydrochlorothiazide exert antioxidant effects and reduce vascular matrix metalloproteinase-2 activity and expression in a model of renovascular hypertension. (nih.gov)
- Spironolactone is a medication used to treat congestive heart failure and hypertension in dogs and cats. (northbranch-md.com)
- Spironolactone is utilized to treat hypertension and cardiovascular breakdown. (cheapmedicinepills.com)
- In terms of value, at least more than spironolactone hypertension treatment 100 million! (od.ua)
- spironolactone hypertension treatment What, you old this is exercise too? (od.ua)
- But even though she knew that she couldn't persuade Mrs. Li, the old lady was still ready to call the ambulance spironolactone hypertension treatment if something happened. (od.ua)
- There are three treasures of Qianlong Yulan, two treasures of Qianlong Chenhan, and the treasure of the emperor, the treasure spironolactone hypertension treatment of the emperor, the treasure of Tianfu, etc And there are more than a dozen poems written by Emperor Qianlong, as well as promotion But these seals and promotions take up more than two meters of space, which shows that Emperor Qianlong loved it. (od.ua)
- Liu Dong stood up, walked to the side, and stretched spironolactone hypertension treatment out his hand to pick up the sniper rifle that was lying on the ground He saw that the length of this rifle was more than one meter two, and it was equipped with a scope and a steel body. (od.ua)
- hitting the channel of the Yang River, creating these seven lakes, and the gap between each lake There are also spironolactone hypertension treatment waterfalls with different heights! (od.ua)
- Spironolactone and hydrochlorothiazide tablets are effective in significantly lowering the systolic and diastolic blood pressure in many patients with essential hypertension, even when aldosterone secretion is within normal limits. (nih.gov)
- As a diuretic, spironolactone is used to treat fluid retention in people with liver disease, kidney diseases such as nephrotic syndrome, and heart diseases such as congestive heart failure. (forhers.com)
- Spironolactone is a potassium sparing diuretic like eplerenone that competitively inhibits mineralocorticoid receptors in the distal convoluted tubule to promote sodium and water excretion and potassium retention. (drugbank.com)
- Originally spironolactone was only studied for its potassium sparing diuretic effect. (drugbank.com)
- The diuretic and antihypertensive effects of the individual components are potentiated when spironolactone and hydrochlorothiazide are given concurrently. (pfizermedicalinformation.com)
- Spironolactone acts both as a diuretic and as an antihypertensive drug by this mechanism. (lgmpharma.com)
- It is also used to treat swelling ( edema ) caused by certain conditions (such as heart failure, liver disease ) by removing excess fluid and improving symptoms such as breathing problems .This medication is also used to treat conditions in which the body is making too much of a natural substance (aldosterone).Spironolactone is known as a "water pill" ( potassium -sparing diuretic ). (webmd.com)
- Spironolactone is a diuretic that is used in dogs and cats to treat congestive heart failure and other conditions where the body retains excess fluid. (dogandcatpharm.com)
- Spironolactone and hydrochlorothiazide tablets are a combination of two diuretic agents with different but complementary mechanisms and sites of action, thereby providing additive diuretic and antihypertensive effects. (nih.gov)
- The combination of spironolactone and hydrochlorothiazide is used to treat high blood pressure. (nih.gov)
- Spironolactone is superior to hydrochlorothiazide for blood pressure control and arterial stiffness improvement: A prospective study. (nih.gov)
- Both spironolactone and hydrochlorothiazide reduce exchangeable sodium, plasma volume, body weight, and blood pressure. (pfizermedicalinformation.com)
- Each round, biconvex, compressed, ivory tablet, with a peppermint aroma, engraved '25' over '25' on one side and 'novo' on the other side, contains spironolactone 25 mg and hydrochlorothiazide 25 mg. (rxhealthmed.ca)
- Each round, biconvex, compressed, white tablet, with a peppermint aroma, engraved '50' over '50' on one side and 'novo' on the other side, contains spironolactone 50 mg and hydrochlorothiazide 50 mg. (rxhealthmed.ca)
- The recommended adult doses range from 1 tablet (containing 25 mg spironolactone and 25 mg hydrochlorothiazide) daily to 4 tablets (containing 50 mg spironolactone and 50 mg hydrochlorothiazide) daily, taken in single or divided doses as prescribed by the doctor. (rxhealthmed.ca)
- Spironolactone - hydrochlorothiazide may be taken with or without food, however, it should be taken the same way eachday so that levels of the medication in the body remain steady. (rxhealthmed.ca)
- Each tablet of spironolactone and hydrochlorothiazide contains 25 mg of spironolactone, USP and 25 mg of hydrochlorothiazide, USP. (nih.gov)
- Each tablet for oral administration contains 25 mg of spironolactone and 25 mg of hydrochlorothiazide and the following inactive ingredients: colloidal silicon dioxide, corn starch, D&C Yellow No. 10 Aluminum Lake, FD&C Yellow No. 6 Aluminum Lake, lactose monohydrate, magnesium stearate, L-menthol, microcrystalline cellulose, peppermint oil, sodium lauryl sulfate and sodium starch glycolate (potato). (nih.gov)
Uses of Spironolactone1
- Label Off label uses of spironolactone involving its antiandrogenic activity include hirsutism, female pattern hair loss, and adult acne vulgaris. (drugbank.com)
Effects of spironolactone5
- The current presentation, at last week's American Heart Association (AHA) 2014 Scientific Sessions , focused on exploring reasons for this difference and the differing effects of spironolactone in the two populations. (medscape.com)
- Common side effects of spironolactone include headache, nausea, and tiredness. (rxwiki.com)
- If you use other drugs or over the counter products at the same time, the effects of Spironolactone may change. (tabletwise.net)
- Effects of spironolactone towards rabbit atrial remodeling with rapid pacing. (bvsalud.org)
- This study aimed to observe the effects of spironolactone towards the rabbit atrial remodeling with rapid atrial pacing (RAP). (bvsalud.org)
Response to spironolactone6
- These include differences in their prognosis and in their response to spironolactone with regard to blood pressure, potassium, and creatinine, and the effect on clinical outcomes. (medscape.com)
- She added: "Clearly the different response to spironolactone is likely due to patient differences. (medscape.com)
- Effect of Obesity on Response to Spironolactone in Patients With Heart Failure With Preserved Ejection Fraction. (nih.gov)
- Elkholey K, Papadimitriou L, Butler J, Thadani U, Stavrakis S. Effect of Obesity on Response to Spironolactone in Patients With Heart Failure With Preserved Ejection Fraction. (nih.gov)
- Whether obesity modifies the response to spironolactone in patients with HFpEF remains unclear. (nih.gov)
- We aimed to investigate the effect of obesity, defined by body mass index (BMI) and waist circumference (WC), on response to spironolactone in patients with HFpEF enrolled in Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial. (nih.gov)
- Hi, I've been on 100mg Spironolactone a day for about 3-4 years (as well as Microgestin FE 1/20). (medications.com)
- Spironolactone comes as a tablet to take by mouth. (1meds.com)
- Take spironolactone suspension consistently either with food or without food each time. (medlineplus.gov)
- Take spironolactone at around the same time(s) every day. (medlineplus.gov)
- Take spironolactone exactly as directed. (medlineplus.gov)
- Continue to take spironolactone even if you feel well. (medlineplus.gov)
- Your doctor may tell you not to take spironolactone if you are taking this medication. (medlineplus.gov)
- Spironolactone is in a class of medications called aldosterone receptor antagonists. (medlineplus.gov)
- We've also looked at spironolactone benefits and disadvantages in comparison to other acne medications, as well as its potential side effects. (forhers.com)
- As an antiandrogen, spironolactone is sometimes prescribed to treat hormonal acne in women, particularly cases of acne that don't respond to other medications . (forhers.com)
- Drugs & Medications - Viagra lasix and spironolactone . (onlinehome.us)
- Furosemide and spironolactone doses and hyponatremia in patients with heart failure. (nih.gov)
- Spironolactone operates through a different mechanism than furosemide because it allows the body to retain potassium while excreting sodium and chloride. (dogandcatpharm.com)
- Spironolactone may be used alone or with furosemide in difficult cases of congestive heart failure, or fluid retention due to liver failure. (dogandcatpharm.com)
- According to the Verispan database of retail pharmacy prescriptions (Appendix 2), only three drugs (spironolactone, lactulose, and furosemide) were commonly prescribed for liver disease in 2004, for a total of 731,000 prescriptions at a cost of $16 million (Table 3). (nih.gov)
Sodium and water1
- Spironolactone causes increased amounts of sodium and water to be excreted, while potassium is retained. (lgmpharma.com)
- Spironolactone inhibits the effect of aldosterone by competing for intracellular aldosterone receptor in the distal tubule cells. (lgmpharma.com)
- This is not a complete list of spironolactone drug interactions. (rxwiki.com)
- The recommended initial daily dose is 25 to 100 mg of spironolactone administered in either single or divided doses is recommended. (nih.gov)
- Spironolactone is a prescription medication used to treat high blood pressure and fluid retention caused by various conditions. (rxwiki.com)
- Spironolactone is a prescription medication. (forhers.com)
- Spironolactone is a prescription medication that's used to treat a wide range of diseases and health conditions. (forhers.com)
- If you've searched online for products to treat acne, you may have heard of a medication called spironolactone. (forhers.com)
- If you have hormonal acne, your healthcare provider may recommend spironolactone on an "off-label" basis either on its own or in combination with other medication to reduce breakouts and improve your skin. (forhers.com)
- Spironolactone belongs to two medication classes. (forhers.com)
- 3.5 mmol/l) and hyperkalemia (K + ≥5.5 mmol/l) among both placebo- and spironolactone-assigned patients in TOPCAT. (northwestern.edu)
- In conclusion, use of spironolactone in obese patients with HFpEF was associated with a decreased risk of the primary end point, cardiovascular death and HF hospitalizations, compared with placebo. (nih.gov)
- The placebo capsule looks just like the spironolactone capsule but contains no medicine. (nih.gov)
- Spironolactone competitively inhibits aldosterone dependant sodium potassium exchange channels in the distal convoluted tubule. (drugbank.com)
- Berardesca E, Gabba P, Ucci G, Borroni G, Rabbiosi G: Topical spironolactone inhibits dihydrotestosterone receptors in human sebaceous glands: an autoradiographic study in subjects with acne vulgaris. (lgmpharma.com)
- In 17-day-old breastfed (extent not stated) infant whose mother was taking 25 mg of spironolactone 4 times daily since pregnancy, serum sodium and potassium remained normal. (nih.gov)
- CHICAGO, IL - A new post hoc analysis of the TOPCAT trial of spironolactone in patients with heart failure with preserved ejection fraction (HFPEF) has shown that the aldosterone antagonist did appear to produce benefit in patients enrolled in the Americas but not in those from Russia/Georgia, which could be explained by large differences in baseline characteristics between the different populations [ 1 ] . (medscape.com)
- The main results of the TOPCAT trial, as reported last year by heart wire , did not show a significant reduction in the primary outcome, a composite of cardiovascular death, aborted cardiac arrest, or hospitalization for heart failure , with spironolactone in the overall population. (medscape.com)
- Overdosage & Contraindications lasix and spironolactone . (onlinehome.us)
- Spironolactone is indicated for treatment of NYHA Class III-IV heart failure and reduced ejection fraction to increase survival, manage edema, and reduce the need for hospitalization for heart failure. (nih.gov)
- Spironolactone is usually administered in conjunction with other heart failure therapies. (nih.gov)
- And if we have something that can help these 40% to 50% of people with symptomatic heart failure and an impaired prognosis-if we can improve their prognosis and take care of the safety measures-then I will go below this line by stating that our observations in the Americas-that spironolactone was associated with reduced CV deaths and hospitalizations for CHF-should be taken into account. (medscape.com)
- Spironolactone controls high blood pressure, edema, heart failure, and hyperaldosteronism but does not cure these conditions. (medlineplus.gov)
- Spironolactone is used for High blood pressure , Fluid retention in liver or kidney disease, High aldosterone levels, Low potassium levels , Heart failure and other conditions. (tabletwise.net)
- Spironolactone is used to treat high blood pressure and heart failure . (webmd.com)
- Spironolactone is approved to treat high blood pressure, or heart failure in people. (nih.gov)
- The major metabolite of spironolactone, canrenone, was measured in the serum and milk of a 17-day postpartum woman who was taking 25 mg of spironolactone four times daily. (nih.gov)
- Phelps DL, Karim A. Spironolactone: Relationship between concentrations of dethioacetylated metabolite in human serum and milk. (nih.gov)
- A transgender woman took and spironolactone 50 mg twice daily to suppress testosterone, domperidone 10 mg three times daily, increasing to 20 mg four times daily, oral micronized progesterone 200 mg daily and oral estradiol to 8 mg daily and pumped her breasts 6 times daily to induce lactation. (nih.gov)
- progesterone abnormally high during or after spironolactone? (medications.com)
- Spironolactone is structurally similar to progesterone and as a result is associated with progestogenic and antiandrogenic effects. (drugbank.com)
- Spironolactone is effective for hormonal acne and hirsutism. (medscape.com)
- Spironolactone is practically insoluble in water, soluble in alcohol, and freely soluble in benzene and in chloroform. (nih.gov)
- Animal studies found that a medicine called spironolactone, may decrease the amount of alcohol the animals drank. (nih.gov)
- To test a medicine (spironolactone) in people who sometimes drink excessive alcohol in order to understand how the body breaks down spironolactone and if there are any side effects in people who drink alcohol while taking this medicine. (nih.gov)
- Spironolactone is rapidly and extensively metabolized. (pfizermedicalinformation.com)
- By blocking aldosterone, spironolactone helps the body get rid of excess fluid by increasing the amount of salt and water the kidneys remove from the blood, while still keeping potassium in the body. (rxwiki.com)
- By reducing the effects of aldosterone, spironolactone can force the body to excrete extra fluid and lower blood pressure, reducing the level of strain on the heart, kidneys and other organs. (forhers.com)
- Spironolactone is used off label in the treatment of hirsutism, female pattern hair loss, and adult acne vulgaris. (drugbank.com)
- This is not a complete list of spironolactone side effects. (rxwiki.com)
- Although side effects from spironolactone are not common, they can occur. (1meds.com)
- Spironolactone may also cause side-effects not listed here. (tabletwise.net)
- Spironolactone is typically given orally and can cause side effects such as vomiting, diarrhea, and electrolyte imbalances. (northbranch-md.com)
- Spironolactone works by blocking the action of a hormone called aldosterone , which is used by the body to retain water and sodium. (forhers.com)
- Please check for these effects on your body when using Spironolactone. (tabletwise.net)
- It will be calculated by your child's doctor to give 1.65 mg to 3.3 mg of spironolactone per each kilogram of body weight. (rxhealthmed.ca)
- A wonam with Gitleman syndrome took spironolactone in an unspecified dosage along with potassium and magnesium supplements for at least 4 months while breastfeeding her infant. (nih.gov)
- Relative to spironolactone, their binding affinities to the aldosterone receptors in rat kidney slices were 0.19, 0.86, and 0.06, respectively. (pfizermedicalinformation.com)
- Spironolactone also is used to treat certain patients with hyperaldosteronism and in certain patients with low potassium levels. (1meds.com)
High blood pr5
- Spironolactone treats high blood pressure and can help get rid of fluid retention. (rxwiki.com)
- Spironolactone controls high blood pressure but does not cure it. (1meds.com)
- Can Spironolactone be used for high blood pressure and fluid retention in liver or kidney disease? (tabletwise.net)
- Yes, high blood pressure and fluid retention in liver or kidney disease are among the most common reported uses for Spironolactone. (tabletwise.net)
- Please do not use Spironolactone for high blood pressure and fluid retention in liver or kidney disease without consulting first with your doctor . (tabletwise.net)
- Sulfur-containing products are the predominant metabolites and are thought to be primarily responsible, together with spironolactone, for the therapeutic effects of the drug. (pfizermedicalinformation.com)
- Abilify is used for treating agitation caused by schizophrenia or bipolar disorder, depression lasix and spironolactone lasix and spironolactone . (onlinehome.us)
- Spironolactone 75 mg every other day was taken orally by a mother while nursing a newborn. (nih.gov)
- The metabolic pathway of spironolactone is complex and can be divided into two main routes: those in which the sulfur moiety is retained and those in which the sulfur moiety is removed by dethioacetylation. (lgmpharma.com)
- Case of mothers breastfeeding during spironolactone therapy reported no adverse effects in infants. (nih.gov)
- The spironolactone group was composed of 38 patients while the nebivolol group was composed of 43 patients. (nih.gov)
- Spironolactone also may be used to treat certain female patients with abnormal facial hair. (medlineplus.gov)
- 4 Spironolactone is also frequently used for its antiandrogenic effects in transgender female patients due to its low cost and reducing male-pattern hair growth. (drugbank.com)
- Click here and view survey results to find out what other patients report as common uses for Spironolactone. (tabletwise.net)
- Spironolactone is not recommended in patients with renal insufficiency. (medscape.com)