High blood pressure. Causes, symptoms, treatments

Clostridium difficile infection associated with levofloxacin treatment.

2017-05-02

Data were extracted by one author (DAL) and checked by the other (GYHL). Eligible studies were excluded when results presentation prevented adequate extraction of data and enquiries to authors did not yield raw data.

Minoxidil is a potent antihypertensive used as an adjunctive agent in refractory hypertension. It exerts an antihypertensive effect through two mechanisms: selective arterial vasodilation by activation of potassium channels in the vascular smooth muscle and stimulation of carotid and aortic baroreceptors, leading to downstream release of renin and norepinephrine. Although frequently cited in reviews of antihypertensive agents, limited data about the use of minoxidil in neonates are available. We describe an infant girl, born at 35 weeks of gestation, who was diagnosed with idiopathic hypertension after extensive diagnostic evaluation. Adequate blood pressure control was not achieved with captopril, amlodipine, and clonidine. Oliguria secondary to captopril and rapid-onset congestive heart failure due to persistent hypertension led to the introduction of intravenous agents labetalol and nitroprusside. Although adequate blood pressure control was achieved, attempts to transition back to oral agents were unsuccessful, prompting the use of minoxidil as an alternative agent. Although good blood pressure control was achieved, the infant's oral intake plummeted from 210 to 63 ml/kg/day. The anorexia quickly resolved after stopping minoxidil, and she was discharged home at 5 months of age receiving propranolol, amlodipine, and doxazosin. Use of the Naranjo adverse drug reaction probability scale indicated a definite relationship (score of 10) between the patient's development of anorexia and minoxidil therapy. To our knowledge, there have been no previous reports of minoxidil-associated anorexia in preterm or term infants. Clinicians should be aware that anorexia is a possible adverse effect of minoxidil in this patient population when initiating the drug in similar patients.

This post hoc analysis of the Medical Therapy of Prostatic Symptoms trial examined the effect of finasteride alone compared to placebo on the clinical progression of benign prostatic hyperplasia in men with a baseline prostate volume less than 30 ml, or 30 ml or greater.

Our objective in this study was summing up of results of clinical studies on effectiveness of a selective alpha-adrenoblocker doxazosine in the pharmacotherapy of reflex and spastic disorders of outflow of urine. Doxazosine ("Cardura", Pfizer Inc.) was prescribed per os once per day in the morning after meal in a dose of 2-4 mg. The drug can be used not only as a hypotensive agent but also in conservative treatment of patients with prostate hyperplasia. It was found to be very effective in attempts to bring the disordered outflow of urine back to normal in patients presenting with calculi in the lower third of ureters as well as those with prior prostata resection; in affections of and injuries to the brain and spinal cord.

Pheochromocytoma--a catecholamine secreting tumor.

The effect of treatment with the alpha 1-specific adrenoceptor blocker, Doxazosin, on lipid parameters was studied in male Golden hamsters fed a cholesterol-enriched diet. Within 1 week the Doxazosin-treated animals had a lower plasma (-12%) and hepatic (-30%) cholesterol content than the cholesterol-fed controls. De novo cholesterol synthesis in the liver was lowered by 39% in the Doxazosin-treated animals. These data indicate that the reported beneficial effect of alpha 1-blockade on plasma cholesterol levels may be due to lowering of the hepatic cholesterol synthesis.

Cardura XL, at a daily dose of 4 mg daily for 3 months, is a safe and effective regimen in BPH patients. Significant improvement is observed for lower urinary tract symptoms, IPSS and QOL. A longer medication may lead to further improvement of IPSS and QOL. After dosing, both systolic and diastolic blood pressures fall down significantly. No significant effect on heart rate is found. And most patients have an excellent tolerance.

In this study we evaluated the effects of once-daily administration of oral doxazosin in patients with chronic congestive heart failure (CHF). After a stabilization period of at least 2 weeks with digitalis and diuretics, 73 patients with chronic CHF were randomized to receive additionally either doxazosin or placebo in double-blind fashion. Patients underwent weekly dose adjustments with increasing doses of doxazosin (1, 2, 4, 8, and 16 mg daily) or placebo for 5 weeks, and 67 were evaluated for 12 additional weeks on maximally tolerated doses of blinded study drugs. Treatment groups were evaluated with respect to symptoms of heart failure, indexes of quality of life and left ventricular function, frequency and type of arrhythmia, adverse events, and mortality rates. Doxazosin (11.9 +/- 0.9 mg) given once daily produced a favorable trend in the investigators' and patients' assessments of symptomatic change. Doxazosin was associated with a significantly higher level of voluntary submaximal exercise and a favorable trend on left ventricular ejection fraction (increase of 9.8% of the baseline value vs 2.7% with placebo; p = NS). During the 3-month steady-dosing period, patients treated with doxazosin had a significant (p less than 0.004) reduction in ventricular arrhythmias and significantly fewer morbid and mortal cardiac events (including episodes of worsening heart failure severe enough to prompt discontinuation of the study, myocardial infarction, and death). Doxazosin was well tolerated, producing no major side effects and only a slightly higher frequency of minor treatment-related side effects compared with placebo (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)