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Hypertension Screening and Treatment Program - Full Text View - ClinicalTrials.gov
Primary Hypothesis: A variety of clinical questions of major importance can be addressed using clinical data routinely obtained in the VA Hypertension Screening and Treatment Program. For example, treatment of mild hypertension reduces the risk of strokes and heart attacks.. Secondary Hypothesis: Target organ damage occurs despite blood pressure control.. Intervention: Chlorthalidone, furosemide, hydrochlorothiazide, metolazone, indapamide, amiloride, spironolactone, triamterene, atenolol, metoprolol, nadolol, pindolol, propranolol, timolol, acebutolol, penbutolol, clonidine, guanethidine, methydopa, prazosin, guanadrel, labetalol, reserpine, guanfacine, hydralazine, minoxidil, captopril, enalapril, lisinopril, diltiazem, nifedipine, verapamil, nicardipine, dyazide, maxzide, pargyline, terazosin, other anti-hypertensives.. Primary Outcomes: Blood Pressure and Target Organ Damage. Study Abstract: Hypertension is one of the most common medical problems in the United States and in the VA health ...
Antenatal Bartter Syndrome, Information for Medical Personnel : BartterSite.org
Despite the recent sucesses in elucidating the molecular pathogenesis of the Bartter-like syndromes, therapies designed to arrest or correct the primary defects are not yet available. Therefore, the main therapeutic objective is to ameliorate the hypokalemic, hypochloremic, metabolic alkalosis. Potassium chloride supplementation is the mainstay of therapy. Oral supplementation alone is usually ineffective, however, in normalizing serum potassium concentrations, probably because large amounts of exogenous K further stimulates aldosterone synthesis with resultant increases in hyperkaliuria. The addition of K-sparing diuretics, eg, spironolactone, amilioride, or triamterene, may help to correct the total body K balance. In fact, the therapeutic combination of the K supplementation and K-sparing diuretics has been associated with increased growth rates in affected children. In young infants, marked urinary salt wasting may also occur and necessitate NaCl supplementation. Indomethacin therapy ...
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A 35-year-old male presented with complaints of excessive daytime sleepiness. His medical history included major depression, necessitating electroconvulsive therapy and psychiatric hospitalization, hypertension, and severe headaches since childhood. He had failed numerous headache prophylactic medications and ultimately was prescribed opioids. At initial presentation to the sleep clinic, his medications included fentanyl lollipops, fentanyl transdermal patch, hydrocodone, triamterene, fluoxetine, and venlafaxine. He was also using dextroamphetamine/amphetamine and methylphenidate for sleepiness and ramelteon and temazepam to aid sleep initiation. His sleep schedule was suboptimal: bedtime was 02:00; perceived sleep latency was 30 min, with awakenings up to 4 times during the sleep period for various reasons; rise-time was 07:00; and sleep was described as non-refreshing.. The patient complained of excessive sleepiness (Epworth score of 16), mild snoring, and witnessed apneas. Physical exam ...
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2,8 DHA Crystalline Nephropathy - Arkana Laboratories
The renal biopsy shown here has crystals present within the tubular lumens and cytoplasm with a brownish appearance by H&E (A) that are strongly silver positive on the Jones methenamine silver stain (B). The crystals are birefringent when viewed under polarized light (C). These findings are characteristic of 2,8 DHA crystal deposition in the kidney resulting from a deficiency of adenine phosphoribosyltransferase. 2,8 dihydroxyadeninuria is an autosomal recessive disease resulting from pathogenic variants in the APRT gene. It is an important disease to recognize as treatment with a low purine diet and allopurinol therapy blocks formation of 2,8 DHA and can improve renal function. The differential diagnosis includes other crystalline nephropathies. One that is less well known but has a similar histopathology is triamterene crystalline nephropathy, which can be distinguished from 2,8 DHA by the presence of Maltese crosses under polarized light. ...
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Spironolactone (IARC Summary & Evaluation, Volume :79, 2001)
Spironolactone is a steroidal potassium-sparing diuretic used in the treatment of oedema, hypertension and hyperaldosteronism.. 5.2 Human carcinogenicity data. Spironolactone was mentioned specifically in two cohort studies and one case control study. In one cohort study carried out in the USA, an excess risk for pharyngeal cancer was found, which persisted with longer follow-up. No evidence for an association with breast cancer was found in the other cohort study, and use of spironolactone was not associated with thyroid cancer in one case control study. All three studies were based on small numbers of cases.. In five case control studies of renal-cell carcinoma, use of potassium-sparing diuretics was not clearly identified as a risk factor independently of hypertension.. 5.3 Animal carcinogenicity data. Spironolactone was tested by oral administration in one study in rats. Increased incidences of thyroid follicular-cell adenomas and Leydig-cell tumours of the testis were reported. ...
Acne at the AAD: Updates for 2015 | MDedge Dermatology
At the recent 73rd Annual Meeting of the American Academy of Dermatology (AAD) in San Francisco, California, acne was once again a hot topic. Considerably more attention was paid to the role of androgens and, by default, antihormonal therapy as compared to prior years. Here are some of the highlights.. Spironolactone for Acne Although not US Food and Drug Administration approved for the treatment of acne, spironolactone can be quite effective in the treatment of adult female acne due to its ability to block androgen receptors, decrease androgen production, inhibit 5α-reductase, and increase sexual hormone-binding protein. The question that often comes up is, how frequently do you need to check serum potassium levels, given that this drug is a potassium-sparing diuretic? According to both a poster at the AAD (P1296) and a study (the largest of its kind) published online on March 22 by Plovanich et al in JAMA Dermatology, the answer is not often or possibly not at all in young, otherwise-healthy ...
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ANS: C. In the distal tubule, sodium is typically exchanged for potassium and hydrogen. Blocking this exchange is what makes these agents potassium-sparing diuretics. Thiazide diuretics block NaCl reabsorption at the distal tubule. Loop diuretics are often called high-ceiling diuretics because they can cause 20% of the filtered load of NaCl and water to be excreted in the urine. They inhibit the reabsorption of NaCl at the thick ascending limb of the loop of Henle, where about 20% of filtered NaCl is usually reabsorbed. Carbonic anhydrase inhibitors (CAIs) prevent the normal breakdown of carbonic acid and decrease bicarbonate reabsorption. CAIs also inhibit NaCl reabsorption at the proximal tubule. The decreased osmotic gradient for water reabsorption results in increased delivery of NaHCO3, NaCl, and water from the proximal tubule. Osmotic diuretics are freely filtered at the glomerulus but are not reabsorbed. These agents remain in the tubule lumen and impair the ability of the proximal ...
Patiromer - Wikipedia
Patiromer (USAN, trade name Veltassa) is a drug used for the treatment of hyperkalemia (elevated blood potassium levels), a condition that may lead to palpitations and arrhythmia (irregular heartbeat). It works by binding potassium in the gut. Patiromer is used for the treatment of hyperkalemia, but not as an emergency treatment for life-threatening hyperkalemia, because it acts relatively slowly. Such a condition needs other kinds of treatment, for example calcium infusions, insulin plus glucose infusions, salbutamol inhalation, and hemodialysis. Typical reasons for hyperkalemia are renal insufficiency and application of drugs that inhibit the renin-angiotensin-aldosterone system (RAAS) - e.g. ACE inhibitors, angiotensin II receptor antagonists, or potassium-sparing diuretics - or that interfere with renal function in general, such as nonsteroidal anti-inflammatory drugs (NSAIDs). Patiromer was generally well tolerated in studies. Side effects that occurred in more than 2% of patients included ...
Aldactone 25mg film-coated tablets | Patient Info | Pfizer Healthcare Ireland | Medicines.ie
Section 4.4, Special warnings and precautions for use. Potassium-sparing diuretics should be used with caution in hypertensive paediatric patients with mild renal insufficiency because of the risk of hyperkalaemia. (Spironolactone is contraindicated for use in paediatric patients with moderate or severe renal impairment; see section 4.3). Section 5.1, Pharmacodynamic properties. Paediatric population:. There is a lack of substantive information from clinical studies on spironolactone in children.. This is a result of several factors: the few trials that have been performed in the paediatric population, the use of spironolactone in combination with other agents, the small numbers of patients evaluated in each trial, and the different indications studied. The dosage recommendations for paediatrics are based upon clinical experience and case studies documented in the scientific literature.. Section 5.2, Pharmacokinetic properties. Paediatric population:. There are no pharmacokinetic data available ...
Aldactone - Blood Pressure :: Canadian Pharmacy
Magnium and potassium-sparing diuretic and aldosterone antagonist. It competitively associates with aldosterone receptors in in the distal parts of the nephron. It has a diuretic effect, increases excretion of natrium ions and decreases excretion of potassium and magnium, decreases urinary acidity. The diuretic effect of the medicine is moderate and appears usually after 2-5 days of treatment and continues during 2-3 days after discontinuance of the medicine intake. A weak hypotension effect appear usually in 2-3 weeks of treatment. Aldactone is used in combination with other drugs to treat hypertension. It also facilitates removal of excess fluid from the body in congestive heart failure, cirrhosis of the liver, and kidney disease ...
Aldactone - Blood Pressure :: Discount Drugstore
Magnium and potassium-sparing diuretic and aldosterone antagonist. It competitively associates with aldosterone receptors in in the distal parts of the nephron. It has a diuretic effect, increases excretion of natrium ions and decreases excretion of potassium and magnium, decreases urinary acidity. The diuretic effect of the medicine is moderate and appears usually after 2-5 days of treatment and continues during 2-3 days after discontinuance of the medicine intake. A weak hypotension effect appear usually in 2-3 weeks of treatment. Aldactone is used in combination with other drugs to treat hypertension. It also facilitates removal of excess fluid from the body in congestive heart failure, cirrhosis of the liver, and kidney disease ...
Aldactone - Blood Pressure :: Discount Pharmacy
Magnium and potassium-sparing diuretic and aldosterone antagonist. It competitively associates with aldosterone receptors in in the distal parts of the nephron. It has a diuretic effect, increases excretion of natrium ions and decreases excretion of potassium and magnium, decreases urinary acidity. The diuretic effect of the medicine is moderate and appears usually after 2-5 days of treatment and continues during 2-3 days after discontinuance of the medicine intake. A weak hypotension effect appear usually in 2-3 weeks of treatment. Aldactone is used in combination with other drugs to treat hypertension. It also facilitates removal of excess fluid from the body in congestive heart failure, cirrhosis of the liver, and kidney disease ...
Aldactone - Blood Pressure :: Canadian Drugstore
Magnium and potassium-sparing diuretic and aldosterone antagonist. It competitively associates with aldosterone receptors in in the distal parts of the nephron. It has a diuretic effect, increases excretion of natrium ions and decreases excretion of potassium and magnium, decreases urinary acidity. The diuretic effect of the medicine is moderate and appears usually after 2-5 days of treatment and continues during 2-3 days after discontinuance of the medicine intake. A weak hypotension effect appear usually in 2-3 weeks of treatment. Aldactone is used in combination with other drugs to treat hypertension. It also facilitates removal of excess fluid from the body in congestive heart failure, cirrhosis of the liver, and kidney disease ...
Aldactone - Heart Disease :: Cheapest Pharmacy
Magnium and potassium-sparing diuretic and aldosterone antagonist. It competitively associates with aldosterone receptors in in the distal parts of the nephron. It has a diuretic effect, increases excretion of natrium ions and decreases excretion of potassium and magnium, decreases urinary acidity. The diuretic effect of the medicine is moderate and appears usually after 2-5 days of treatment and continues during 2-3 days after discontinuance of the medicine intake. A weak hypotension effect appear usually in 2-3 weeks of treatment. Aldactone is used in combination with other drugs to treat hypertension. It also facilitates removal of excess fluid from the body in congestive heart failure, cirrhosis of the liver, and kidney disease ...
Aldactone - Heart Disease :: Cheap Drugstore
Magnium and potassium-sparing diuretic and aldosterone antagonist. It competitively associates with aldosterone receptors in in the distal parts of the nephron. It has a diuretic effect, increases excretion of natrium ions and decreases excretion of potassium and magnium, decreases urinary acidity. The diuretic effect of the medicine is moderate and appears usually after 2-5 days of treatment and continues during 2-3 days after discontinuance of the medicine intake. A weak hypotension effect appear usually in 2-3 weeks of treatment. Aldactone is used in combination with other drugs to treat hypertension. It also facilitates removal of excess fluid from the body in congestive heart failure, cirrhosis of the liver, and kidney disease ...
Aldactone - Heart Disease :: Discount Pharmacy
Magnium and potassium-sparing diuretic and aldosterone antagonist. It competitively associates with aldosterone receptors in in the distal parts of the nephron. It has a diuretic effect, increases excretion of natrium ions and decreases excretion of potassium and magnium, decreases urinary acidity. The diuretic effect of the medicine is moderate and appears usually after 2-5 days of treatment and continues during 2-3 days after discontinuance of the medicine intake. A weak hypotension effect appear usually in 2-3 weeks of treatment. Aldactone is used in combination with other drugs to treat hypertension. It also facilitates removal of excess fluid from the body in congestive heart failure, cirrhosis of the liver, and kidney disease ...
Aldactone - Heart Disease :: Cheap Drugstore
Magnium and potassium-sparing diuretic and aldosterone antagonist. It competitively associates with aldosterone receptors in in the distal parts of the nephron. It has a diuretic effect, increases excretion of natrium ions and decreases excretion of potassium and magnium, decreases urinary acidity. The diuretic effect of the medicine is moderate and appears usually after 2-5 days of treatment and continues during 2-3 days after discontinuance of the medicine intake. A weak hypotension effect appear usually in 2-3 weeks of treatment. Aldactone is used in combination with other drugs to treat hypertension. It also facilitates removal of excess fluid from the body in congestive heart failure, cirrhosis of the liver, and kidney disease ...
Aldactone - Heart Disease :: Online Pharmacy
Magnium and potassium-sparing diuretic and aldosterone antagonist. It competitively associates with aldosterone receptors in in the distal parts of the nephron. It has a diuretic effect, increases excretion of natrium ions and decreases excretion of potassium and magnium, decreases urinary acidity. The diuretic effect of the medicine is moderate and appears usually after 2-5 days of treatment and continues during 2-3 days after discontinuance of the medicine intake. A weak hypotension effect appear usually in 2-3 weeks of treatment. Aldactone is used in combination with other drugs to treat hypertension. It also facilitates removal of excess fluid from the body in congestive heart failure, cirrhosis of the liver, and kidney disease ...
Aldactone - Heart Disease :: Cheapest Pharmacy
Magnium and potassium-sparing diuretic and aldosterone antagonist. It competitively associates with aldosterone receptors in in the distal parts of the nephron. It has a diuretic effect, increases excretion of natrium ions and decreases excretion of potassium and magnium, decreases urinary acidity. The diuretic effect of the medicine is moderate and appears usually after 2-5 days of treatment and continues during 2-3 days after discontinuance of the medicine intake. A weak hypotension effect appear usually in 2-3 weeks of treatment. Aldactone is used in combination with other drugs to treat hypertension. It also facilitates removal of excess fluid from the body in congestive heart failure, cirrhosis of the liver, and kidney disease ...
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Dofetilide or ketanserin because the risk of irregular heartbeat may be increased adrenocorticotropic hormone acth , barbiturates eg, phenobarbital , corticosteroids eg, prednisone , diuretics eg, furosemide , narcotic pain medicines eg, morphine , or other medicines for high blood pressure because they may increase the risk of avalide s side effects cholestyramine, colestipol, or nonsteroidal anti-inflammatory drugs nsaids eg, ibuprofen because they may decrease avalide s effectiveness diazoxide, digoxin, lithium, nondepolarizing muscle relaxants eg, tubocurarine , potassium, or potassium-sparing diuretics eg, spironolactone because risk of their side effects and toxic effects may be increased by avalide diabetes medicine eg, glipizide, metformin , insulin, or pressor amines eg, norepinephrine because their effectiveness may be decreased by avalide ...
Evaluation of the Diuretic Activity of Aqueous and 80% Methanol Extrac | JEP
Evaluation of the Diuretic Activity of Aqueous and 80% Methanol Extracts of Croton macrostachyus(Euphorbiaceae) Leaves in Saline-Loaded Rats
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Effects of a K+ channel blocker on glomerular filtration rate and electrolyte excretion in conscious rats were observed. Effects of K+ channel modulation on glomerular filtration rate and electrolyte excretion were studied using the adenosine-triphosphate- (ATP)-sensitive K+ channel blocker 4-morpholinecarboximidine-N-1-adamantyl-N-cyclohexylhydr ochloride (U-37883A) in conscious rats previously equipped with catheters for clearance studies. In saline-loaded rats, i.v. doses of U-37883A of 1.7, 5.0 and 15 mg/kg increased absolute and fractional Na+ excretion dose-dependently without changing K+ excretion. The glomerular filtration rate remained constant during diuresis. In water-loaded (hypotonic dextrose) rats, free-water clearance studies revealed that the ATP-sensitive K+ channel blocker significantly decreased an index of solute reabsorption (free-water clearance adjusted for chloride clearance) in the diluting segment during peak natriuretic activity. In addition, U-37883A significantly ...
Congestive Heart Failure (Congestive Cardiac Failure) Current Management
Congestive heart failure (CHF) is a condition in which the heart fails to work adequately as a pump that can deliver oxygen rich blood to the body.
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Katewa A, Vaideeswar P, Khandekar JV, Sajid S, Jawale RM, Agrawal NB, Sathe PA. Isolated pericardial and intracardiac hydatidosis: presentation as congestive cardiac failure and fatal pulmonary embolism. Cardiovasc Pathol. 2009 Mar-Apr; 18(2):114-8 ...
S127 Is healthcare associated pneumonia a distinct clinical phenotype? | Thorax
Results This study analysed 1111 consecutive patients. Of these, 224 (20.2%) met the criteria for HCAP (39.3% hospitalised within 3 months, 37.5% nursing home residents, 10.7% recent outpatient appointments, 12.5% other). 96.4% of HCAP patients received standard CAP antibiotic therapy without coverage of Pseudomonas aeruginosa or MRSA. Demographic comparison of HCAP and CAP patients showed HCAP patients were significantly older (median age 76 vs 64, p,0.0001) and more likely to have co-morbidities, for example, congestive cardiac failure (30% vs 17%, p,0.0001), COPD (33.5% vs 20.8%, p,0.0001). HCAP patients had higher markers of severity and worse outcomes on univariate analysis. Mean admission CURB65 score was greater (2.32 vs 1.78, p,0.0001), median length of stay was longer (7 vs 5 days, p=0.01) and 30-day mortality was double that of CAP patients (16.5% vs 8.2%, p=0.0004). Kaplain-Meier analysis showed higher mortality for HCAP patients (Log rank test χ2 13.24 df=1, p=0.0003) as shown ...
Mechanistic Insights into Diuretic-Induced Insulin Resistance | Hypertension
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Reversal of diuretic-induced hepatic encephalopathy with infusion of albumin but not colloid - UCL Discovery
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NRS 212-Acute I by Rebecca McCay on Prezi
Surgical excision of the affected adrenal gland (A period of hypoadrenalism can occur producing clinically significant hyponatremia and hyperkalemia-Monitor and correct as needed. Once the potassium level is stable, Na restriction and po KCL supplements may be used as effectively as, or in addition to, potassium-sparing ...
The collaboration of healthcare specialists concerning this problem could decrease the effect of possible DDIs on public health...
Captopril/enalapril in combination with potassium-sparing medicines could enhance the threat of hyperkalemia . Fluoxetine interacting with an anti-inflammatory