Antihypertensive Agents Using ALZET Osmotic Pumps
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Table 2. 2012 AGS Beers Criteria for Potentially
Table 2. 2012 AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults Strength of Organ System/ Recommendat Quality of Recomm Therapeutic Category/Drug(s) Rationale ion Evidence endation References Anticholinergics (excludes TCAs) First-generation antihistamines Highly anticholinergic; Avoid Hydroxyzin Strong Agostini 2001 (as single agent or as part of clearance reduced with e and Boustani 2007 combination products) advanced age, and promethazi Guaiana 2010 Brompheniramine tolerance develops ne: high; Han 2001 Carbinoxamine when used as hypnotic; All others: Rudolph 2008 Chlorpheniramine increased risk of moderate Clemastine confusion, dry mouth, Cyproheptadine constipation, and other Dexbrompheniramine anticholinergic Dexchlorpheniramine effects/toxicity. Diphenhydramine (oral) Doxylamine Use of diphenhydramine in Hydroxyzine special situations such Promethazine as acute treatment of Triprolidine severe allergic reaction may be appropriate. Antiparkinson agents Not recommended for Avoid Moderate Strong Rudolph 2008 Benztropine (oral) prevention of Trihexyphenidyl extrapyramidal symptoms with antipsychotics; more effective agents available for treatment of Parkinson disease. Antispasmodics Highly anticholinergic, Avoid Moderate Strong Lechevallier- Belladonna alkaloids uncertain except in Michel 2005 Clidinium-chlordiazepoxide effectiveness. short-term Rudolph 2008 Dicyclomine palliative Hyoscyamine care to Propantheline decrease Scopolamine oral secretions. Antithrombotics Dipyridamole, oral short-acting* May -
ALPHA ADRENOCEPTORS and HUMAN SEXUAL FUNCTION Alan
8 1995 Elsevier Science B. V. All rights reserved. The Pharmacology of Sexual Function and Dysfunction J. Bancroft, editor 307 ALPHA ADRENOCEPTORS AND HUMAN SEXUAL FUNCTION Alan J Riley Field Place, Dunsmore, Buckinghamshire, HP22 6QH, UK Introduction Sexual functioning involves complex physiological processes which rely on the interplay of many central and peripheral neurotransmitter systems. Disturbances in any one of these systems might be associated with disturbed sexual function which, when recognised, may be alleviated by appropriate pharmacological manipulation, although at the present time this is more hypothesis than reality, The sympathetic nervous system is involved actively at various levels in the normal control of sexual responses. The effects of sympathetic activation are mediated by the release of noradrenaline from nerve terminals and the increased secretion of adrenaline from the adrenal medulla. These catecholamines selectively activate specific cellular sites in target tissues known as adrenoceptors (previously termed adrenergic receptors) to mediate responses. Almost fifty years ago, Alquist realised that tissue responses to catecholamines were mediated through two distinct types of receptors which he designated a and/? [1]. This review focuses on the involvement of a-adrenoceptors in human sexual functioning and dysfunction. Alpha adrenoceptors are located both pre- and post- synaptically and they were classified as either ar or af adrenoceptors according to location; or, being postsynaptic and az presynaptic. This classification continues to be used in some texts. However, as highly specific and selective pharmacological tools became available, this locational subclassification is found not always to be appropriate. Nowadays, classification of a-adrenoceptors is more appropriately based on pharmacological activity and additional subtypes of a-adrenoceptors have been identified by radioligand binding and molecular biological techniques [2]. -
Pindolol of the Activation of Postsynaptic 5-HT1A Receptors
Potentiation by (-)Pindolol of the Activation of Postsynaptic 5-HT1A Receptors Induced by Venlafaxine Jean-Claude Béïque, Ph.D., Pierre Blier, M.D., Ph.D., Claude de Montigny, M.D., Ph.D., and Guy Debonnel, M.D. The increase of extracellular 5-HT in brain terminal regions antagonist WAY 100635 (100 g/kg, i.v.). A short-term produced by the acute administration of 5-HT reuptake treatment with VLX (20 mg/kg/day ϫ 2 days) resulted in a inhibitors (SSRI’s) is hampered by the activation of ca. 90% suppression of the firing activity of 5-HT neurons somatodendritic 5-HT1A autoreceptors in the raphe nuclei. in the dorsal raphe nucleus. This was prevented by the The present in vivo electrophysiological studies were coadministration of (-)pindolol (15 mg/kg/day ϫ 2 days). undertaken, in the rat, to assess the effects of the Taken together, these results indicate that (-)pindolol coadministration of venlafaxine, a dual 5-HT/NE reuptake potentiated the activation of postsynaptic 5-HT1A receptors inhibitor, and (-)pindolol on pre- and postsynaptic 5-HT1A resulting from 5-HT reuptake inhibition probably by receptor function. The acute administration of venlafaxine blocking the somatodendritic 5-HT1A autoreceptor, but not and of the SSRI paroxetine (5 mg/kg, i.v.) induced a its postsynaptic congener. These results support and extend suppression of the firing activity of dorsal hippocampus CA3 previous findings providing a biological substratum for the pyramidal neurons. This effect of venlafaxine was markedly efficacy of pindolol as an accelerating strategy in major potentiated by a pretreatment with (-)pindolol (15 mg/kg, depression. -
The (Pro)Renin Receptor: a New Kid in Town
The (Pro)Renin Receptor: A New Kid in Town Geneviève Nguyen, MD, PhD Summary: Renin inhibitors are now available in therapeutic doses and it is accepted that they decrease blood pressure as efficiently as the classic inhibitors of the renin-angiotensin system (RAS): angiotensin converting enzyme inhibitors and angiotensin II–receptor blockers (ARBs). One major issue will be to know how, beyond the normalization of blood pressure, renin inhibitors (RIs) will compare with angiotensin converting enzyme inhibitors and ARBs for their ability to protect the organs against the tissue damage associated with overactivation of the RAS. The mechanism(s) of tissue protection may involve the inhibition of a direct cellular effect of renin and prorenin mediated by the (pro)renin receptor ([P]RR). This review updates the recent findings on (P)RR; its role in hypertension, cardiac fibrosis, diabetic nephropathy, and retinopathy; and the effects of a putative (P)RR antagonist. Semin Nephrol 27:519-523 © 2007 Elsevier Inc. All rights reserved. Keywords: Renin-angiotensin system, renin, prorenin, and (pro)renin receptor he renin-angiotensin system (RAS) is be- THE (P)RR coming more and more complex. In 3 The (P)RR receptor is a 350-amino acid protein Tdecades, the classic intravascular system with no homology with any known protein. aimed at the generation of angiotensin II (Ang The primary structure analysis showed the ex- II), considered a unique biologically active pep- istence of the following: (1) a signal peptide, tide, has been enriched with new enzymes, which is indicative of a secreted protein; (2) a such as angiotensin converting enzyme 2 and large ectodomain responsible for renin and pro- chymase, and new receptors such as for angio- renin binding; (3) a single transmembrane do- tensin IV and for (pro)renin ([pro]renin refers main; and (4) a short cytoplasmic domain in- 1 to renin and prorenin collectively). -
Inline-Supplementary-Material-1.Pdf
Appendix 1: STOPP/START criteria version 2 applied to the TRUST dataset Physiological system Criteria Criteria included Number (%) (The relevant () criteria for each participant were applied to the dataset and recorded in of Microsoft Office Excel ® (2013)) criteria included out of total criteria STOPP criteria Indication of medication A1. Any drug prescribed without an evidence-based clinical indication. X 1/3 (33.3) A2. Any drug prescribed beyond the recommended duration, where treatment duration is X well defined. A3. Any duplicate drug class prescription e.g. two concurrent NSAIDs, SSRIs, loop diuretics, ACE inhibitors, anticoagulants (optimisation of monotherapy within a single drug class should be observed prior to considering a new agent). Cardiovascular system B1. Digoxin for heart failure with preserved systolic ventricular function (no clear evidence X 7/13 (53.8) of benefit). B2. Verapamil or diltiazem with NYHA Class III or IV heart failure (may worsen heart failure). B3. Beta-blocker in combination with verapamil or diltiazem (risk of heart block). B4. Beta blocker with symptomatic bradycardia (< 50/min), type II heart block or complete heart block (risk of profound hypotension, asystole). B5. Amiodarone as first-line antiarrhythmic therapy in supraventricular tachyarrhythmias X (higher risk of side-effects than beta-blockers, digoxin, verapamil or diltiazem). B6. Loop diuretic as first-line treatment for hypertension (safer, more effective alternatives available). B7. Loop diuretic for dependent ankle oedema without clinical, biochemical evidence or radiological evidence of heart failure, liver failure, nephrotic syndrome or renal failure (leg elevation and /or compression hosiery usually more appropriate). B8. Thiazide diuretic with current significant hypokalaemia (i.e. -
Imidazoline Antihypertensive Drugs: Selective I1-Imidazoline Receptors Activation K
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by FarFar - Repository of the Faculty of Pharmacy, University of Belgrade REVIEW Imidazoline Antihypertensive Drugs: Selective I1-Imidazoline Receptors Activation K. Nikolic & D. Agbaba Faculty of Pharmacy, Institute of Pharmaceutical Chemistry, University of Belgrade, Vojvode Stepe, Belgrade, Serbia Keywords SUMMARY α2-Adrenergic receptors; Centrally acting antihypertensives; Clonidine; Hypertension; Involvement of imidazoline receptors (IR) in the regulation of vasomotor tone as well as in Imidazoline receptors; Rilmenidine. the mechanism of action of some centrally acting antihypertensives has received tremen- dous attention. To date, pharmacological studies have allowed the characterization of three Correspondence main imidazoline receptor classes, the I1-imidazoline receptor which is involved in central K. Nikolic, Faculty of Pharmacy, Institute of inhibition of sympathetic tone to lower blood pressure, the I2-imidazoline receptor which Pharmaceutical Chemistry, University of is an allosteric binding site of monoamine oxidase B (MAO-B), and the I3-imidazoline re- Belgrade, Vojvode Stepe 450, 11000 Belgrade, ceptor which regulates insulin secretion from pancreatic β-cells. All three imidazoline re- Serbia. ceptors represent important targets for cardiovascular research. The hypotensive effect of + Tel: 381-63-84-30-677; clonidine-like centrally acting antihypertensives was attributed both to α2-adrenergic re- + Fax: 381-11-3974-349; ceptors and nonadrenergic I1-imidazoline receptors, whereas their sedative action involves E-mail: [email protected] activation of only α2-adrenergic receptors located in the locus coeruleus. Since more selec- tive I1-imidazoline receptors ligands reduced incidence of typical side effects of other cen- trally acting antihypertensives, there is significant interest in developing new agents with higher selectivity and affinity for I1-imidazoline receptors. -
Properties and Units in Clinical Pharmacology and Toxicology
Pure Appl. Chem., Vol. 72, No. 3, pp. 479–552, 2000. © 2000 IUPAC INTERNATIONAL FEDERATION OF CLINICAL CHEMISTRY AND LABORATORY MEDICINE SCIENTIFIC DIVISION COMMITTEE ON NOMENCLATURE, PROPERTIES, AND UNITS (C-NPU)# and INTERNATIONAL UNION OF PURE AND APPLIED CHEMISTRY CHEMISTRY AND HUMAN HEALTH DIVISION CLINICAL CHEMISTRY SECTION COMMISSION ON NOMENCLATURE, PROPERTIES, AND UNITS (C-NPU)§ PROPERTIES AND UNITS IN THE CLINICAL LABORATORY SCIENCES PART XII. PROPERTIES AND UNITS IN CLINICAL PHARMACOLOGY AND TOXICOLOGY (Technical Report) (IFCC–IUPAC 1999) Prepared for publication by HENRIK OLESEN1, DAVID COWAN2, RAFAEL DE LA TORRE3 , IVAN BRUUNSHUUS1, MORTEN ROHDE1, and DESMOND KENNY4 1Office of Laboratory Informatics, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark; 2Drug Control Centre, London University, King’s College, London, UK; 3IMIM, Dr. Aiguader 80, Barcelona, Spain; 4Dept. of Clinical Biochemistry, Our Lady’s Hospital for Sick Children, Crumlin, Dublin 12, Ireland #§The combined Memberships of the Committee and the Commission (C-NPU) during the preparation of this report (1994–1996) were as follows: Chairman: H. Olesen (Denmark, 1989–1995); D. Kenny (Ireland, 1996); Members: X. Fuentes-Arderiu (Spain, 1991–1997); J. G. Hill (Canada, 1987–1997); D. Kenny (Ireland, 1994–1997); H. Olesen (Denmark, 1985–1995); P. L. Storring (UK, 1989–1995); P. Soares de Araujo (Brazil, 1994–1997); R. Dybkær (Denmark, 1996–1997); C. McDonald (USA, 1996–1997). Please forward comments to: H. Olesen, Office of Laboratory Informatics 76-6-1, Copenhagen University Hospital (Rigshospitalet), 9 Blegdamsvej, DK-2100 Copenhagen, Denmark. E-mail: [email protected] Republication or reproduction of this report or its storage and/or dissemination by electronic means is permitted without the need for formal IUPAC permission on condition that an acknowledgment, with full reference to the source, along with use of the copyright symbol ©, the name IUPAC, and the year of publication, are prominently visible. -
Health Reports for Mutual Recognition of Medical Prescriptions: State of Play
The information and views set out in this report are those of the author(s) and do not necessarily reflect the official opinion of the European Union. Neither the European Union institutions and bodies nor any person acting on their behalf may be held responsible for the use which may be made of the information contained therein. Executive Agency for Health and Consumers Health Reports for Mutual Recognition of Medical Prescriptions: State of Play 24 January 2012 Final Report Health Reports for Mutual Recognition of Medical Prescriptions: State of Play Acknowledgements Matrix Insight Ltd would like to thank everyone who has contributed to this research. We are especially grateful to the following institutions for their support throughout the study: the Pharmaceutical Group of the European Union (PGEU) including their national member associations in Denmark, France, Germany, Greece, the Netherlands, Poland and the United Kingdom; the European Medical Association (EMANET); the Observatoire Social Européen (OSE); and The Netherlands Institute for Health Service Research (NIVEL). For questions about the report, please contact Dr Gabriele Birnberg ([email protected] ). Matrix Insight | 24 January 2012 2 Health Reports for Mutual Recognition of Medical Prescriptions: State of Play Executive Summary This study has been carried out in the context of Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application of patients’ rights in cross- border healthcare (CBHC). The CBHC Directive stipulates that the European Commission shall adopt measures to facilitate the recognition of prescriptions issued in another Member State (Article 11). At the time of submission of this report, the European Commission was preparing an impact assessment with regards to these measures, designed to help implement Article 11. -
Mechanism of Action of Nicotine in Isolated Urinary Bladder of Guinea-Pig
Br. J. Pharmacol. (1988), 95, 465-472 Mechanism of action of nicotine in isolated urinary bladder of guinea-pig Tetsuhiro Hisayama, Michiko Shinkai, lIssei Takayanagi & Toshie Toyoda Department of Chemical Pharmacology, Toho University School of Pharmaceutical Sciences, 2-2-1, Miyama, Funabashi, Chiba 274, Japan 1 Nicotine produced a transient contraction of isolated strips of guinea-pig urinary bladder. The response to nicotine was antagonized by the nicotinic receptor antagonist, hexamethonium but was insensitive to tetrodotoxin. 2 The nicotine-induced contraction was potentiated by the cholinesterase inhibitor, physostig- mine, and was reduced to 50% and 70% by the muscarinic cholinoceptor antagonist, atropine and the sympathetic neurone blocking drug, guanethidine, respectively. Chemical denervation with 6- hydroxydopamine abolished the inhibitory effect of guanethidine. Simultaneous treatment with atropine and guanethidine did not abolish the response to nicotine, but the degree of inhibition was comparable to that obtained with atropine alone. 3 The nicotine-induced contraction was insensitive to bunazosin and yohimbine (al- and Cc2-adrenoceptor antagonists, respectively), and exogenously applied noradrenaline did not cause a contraction even in the presence of blockade of noradrenaline uptake mechanisms with desipramine and normetanephrine and of fi-adrenoceptors with propranolol, suggesting a non-adrenergic nature of the sympathomimetic effect of nicotine in this tissue. 4 The nicotine-induced contraction in the presence of atropine was abolished after desensitization of P2-purinoceptors with a, ,B-methylene adenosine 5'-triphosphate, a slowly degradable ATP ana- logue selective for P2-purinoceptors. By this desensitization, the response to ATP, but not to hista- mine, was also abolished. 5 A cyclo-oxygenase inhibitor flurbiprofen partially inhibited the nicotine-induced contraction. -
)&F1y3x PHARMACEUTICAL APPENDIX to THE
)&f1y3X PHARMACEUTICAL APPENDIX TO THE HARMONIZED TARIFF SCHEDULE )&f1y3X PHARMACEUTICAL APPENDIX TO THE TARIFF SCHEDULE 3 Table 1. This table enumerates products described by International Non-proprietary Names (INN) which shall be entered free of duty under general note 13 to the tariff schedule. The Chemical Abstracts Service (CAS) registry numbers also set forth in this table are included to assist in the identification of the products concerned. For purposes of the tariff schedule, any references to a product enumerated in this table includes such product by whatever name known. Product CAS No. Product CAS No. ABAMECTIN 65195-55-3 ACTODIGIN 36983-69-4 ABANOQUIL 90402-40-7 ADAFENOXATE 82168-26-1 ABCIXIMAB 143653-53-6 ADAMEXINE 54785-02-3 ABECARNIL 111841-85-1 ADAPALENE 106685-40-9 ABITESARTAN 137882-98-5 ADAPROLOL 101479-70-3 ABLUKAST 96566-25-5 ADATANSERIN 127266-56-2 ABUNIDAZOLE 91017-58-2 ADEFOVIR 106941-25-7 ACADESINE 2627-69-2 ADELMIDROL 1675-66-7 ACAMPROSATE 77337-76-9 ADEMETIONINE 17176-17-9 ACAPRAZINE 55485-20-6 ADENOSINE PHOSPHATE 61-19-8 ACARBOSE 56180-94-0 ADIBENDAN 100510-33-6 ACEBROCHOL 514-50-1 ADICILLIN 525-94-0 ACEBURIC ACID 26976-72-7 ADIMOLOL 78459-19-5 ACEBUTOLOL 37517-30-9 ADINAZOLAM 37115-32-5 ACECAINIDE 32795-44-1 ADIPHENINE 64-95-9 ACECARBROMAL 77-66-7 ADIPIODONE 606-17-7 ACECLIDINE 827-61-2 ADITEREN 56066-19-4 ACECLOFENAC 89796-99-6 ADITOPRIM 56066-63-8 ACEDAPSONE 77-46-3 ADOSOPINE 88124-26-9 ACEDIASULFONE SODIUM 127-60-6 ADOZELESIN 110314-48-2 ACEDOBEN 556-08-1 ADRAFINIL 63547-13-7 ACEFLURANOL 80595-73-9 ADRENALONE -
Immunologic Effects of the Renin-Angiotensin System
BRIEF REVIEW www.jasn.org Immunologic Effects of the Renin-Angiotensin System Steven D. Crowley and Nathan P. Rudemiller Division of Nephrology, Department of Medicine, Durham Veterans Affairs and Duke University Medical Centers, Durham, North Carolina ABSTRACT Inappropriate activation of the renin-angiotensin system (RAS) exacerbates renal cell lineages that constitute the immune and vascular injury. Accordingly, treatment with global RAS antagonists attenuates system have the capacity to express RAS cardiovascular risk and slows the progression of proteinuric kidney disease. By re- components,11,12 and the effects of the ducing BP, RAS inhibitors limit secondary immune activation responding to hemo- RAS peptides and enzymes on inflamma- dynamic injury in the target organ. However, RAS activation in hematopoietic cells tory responses are quite diverse. How- has immunologic effects that diverge from those of RAS stimulation in the kidney ever, one recurring theme that emerges and vasculature. In preclinical studies, activating type 1 angiotensin (AT1) receptors from the work of several laboratories in- in T lymphocytes and myeloid cells blunts the polarization of these cells toward cluding our own is that activating AT1 proinflammatory phenotypes, protecting the kidney from hypertensive injury and receptors directly on hematopoietic cells fibrosis. These endogenous functions of immune AT1 receptors temper the patho- may provide a feedback, immunosup- genic actions of renal and vascular AT1 receptors during hypertension. By counter- pressive signal to temper or limit the acting the effects of AT1 receptor stimulation in the target organ, exogenous pathogenic actions of inappropriate administration of AT2 receptor agonists or angiotensin 1–7 analogs may similarly RAS activation in the kidney, vascula- limit inflammatory injury to the heart and kidney. -
(12) Patent Application Publication (10) Pub. No.: US 2010/014.3507 A1 Gant Et Al
US 2010.0143507A1 (19) United States (12) Patent Application Publication (10) Pub. No.: US 2010/014.3507 A1 Gant et al. (43) Pub. Date: Jun. 10, 2010 (54) CARBOXYLIC ACID INHIBITORS OF Publication Classification HISTONE DEACETYLASE, GABA (51) Int. Cl. TRANSAMINASE AND SODIUM CHANNEL A633/00 (2006.01) A 6LX 3/553 (2006.01) A 6LX 3/553 (2006.01) (75) Inventors: Thomas G. Gant, Carlsbad, CA A63L/352 (2006.01) (US); Sepehr Sarshar, Cardiff by A6II 3/19 (2006.01) the Sea, CA (US) C07C 53/128 (2006.01) A6IP 25/06 (2006.01) A6IP 25/08 (2006.01) Correspondence Address: A6IP 25/18 (2006.01) GLOBAL PATENT GROUP - APX (52) U.S. Cl. .................... 424/722:514/211.13: 514/221; 10411 Clayton Road, Suite 304 514/456; 514/557; 562/512 ST. LOUIS, MO 63131 (US) (57) ABSTRACT Assignee: AUSPEX The present invention relates to new carboxylic acid inhibi (73) tors of histone deacetylase, GABA transaminase, and/or PHARMACEUTICALS, INC., Sodium channel activity, pharmaceutical compositions Vista, CA (US) thereof, and methods of use thereof. (21) Appl. No.: 12/632,507 Formula I (22) Filed: Dec. 7, 2009 Related U.S. Application Data (60) Provisional application No. 61/121,024, filed on Dec. 9, 2008. US 2010/014.3507 A1 Jun. 10, 2010 CARBOXYLIC ACID INHIBITORS OF HISTONE DEACETYLASE, GABA TRANSAMNASE AND SODIUM CHANNEL 0001. This application claims the benefit of priority of Valproic acid U.S. provisional application No. 61/121,024, filed Dec. 9, 2008, the disclosure of which is hereby incorporated by ref 0004 Valproic acid is extensively metabolised via erence as if written herein in its entirety.