摘要:

The development of angiotensin‐converting enzyme (ACE) inhibitors is of landmark importance in the understanding and treatment of cardiovascular disorders, particularly hypertension and congestive heart failure. Enalapril has recently joined captopril as an approved, orally active ACE inhibitor. Like captopril, it has been effective in the treatment of hypertension and congestive heart failure, with minimal adverse reactions noted. Differences in pharmacology exist between enalapril and captopril which may prove to be of clinical significanc

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1987.tb04039.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1987.tb04040.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1987.tb04041.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Encainide is a class IC antiarrhythmic agent that has been under clinical investigation for the last decade. Laboratory and clinical studies have demonstrated it to be a potent suppressor of ventricular extrasystoles. It is effective in approximately one‐half of patients with malignant ventricular arrhythmias. The preliminary experience in patients with supraventricular arrhythmias indicates that the drug is particularly effective in arrhythmias associated with an accessory pathway. Side effects most commonly include blurred vision, nausea, heart block, and proarrhythmic effects. The hemodynamic effects of oral encainide are insignificant in patients with well‐preserved left ventricular function. Despite minimal myocardial depression in patients with left ventricular dysfunction, there is the potential for worsening of heart failure. Encainide has a short half‐life of 3 hours, but has 2 active metabolites with longer half‐lives. No clinically significant drug interaction has been demonstrated with encainide

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1987.tb04042.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1987.tb04043.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1987.tb04044.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1987.tb04045.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

This review discusses the pharmacokinetics, mechanism of action, clinical use, toxicities, drug interactions, and possible approaches for therapeutic monitoring of azathioprine (AZA). The drug has been used extensively in posttransplant immunosuppressive protocols. Its therapeutic use is hampered by the development of toxicities, however, especially leukopenia, which is a common criterion for dosage adjustment. Azathioprine is rapidly converted in the liver and erythrocytes to 6‐mercaptopurine (6MP), which is eventually metabolized to inactive 6‐thiouric acid (6TU). The terminal half‐lives of AZA and 6MP are 50 and 74 minutes, respectively. While renal dysfunction does not alter the disposition of AZA, hepatic insufficiency attenuates the pharmacologic activity. Immunosuppression depends on the formation of active intracellular thiopurine ribonucleotides, although AZA itself may block antigen recognition. Individualization of AZA regimens by determining tissue concentrations of thioguanine nucleotides, and plasma concentrations of AZA, 6MP, or 6TU may improve the risk:benefit

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1987.tb04046.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Thallium 201 myocardial perfusion imaging is a standard method of evaluating regional myocardial blood flow. Myocardial perfusion is best evaluated at rest and during exercise, however, alternative methods have been sought to increase coronary blood flow in patients incapable of performing adequate exercise. A promising new method is the use of intravenous dipyridamole for pharmacologic stress imaging. It has distinct advantages over traditional treadmill exercise testing. The primary advantage of combining intravenous dipyridamole and thallium 201 is for testing patients in whom exercise is impractical or contraindicated. Examples include patients taking beta blockers and those who have had myocardial infarction or have severe peripheral vascular disease. To date, this agent has been available only to clinical investigators in approved protocols. With continued success, it should be approved for general use in the near future.

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1987.tb04047.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Endocarditis secondary toHemophilus parainfluenzaeis an uncommon entity that appears to be increasing in frequency, perhaps due to improved laboratory isolation techniques. Although controversial, most of the published literature recommends a penicillin, with or without concomitant gentamicin, as definitive therapy. We report the first successful use of the third‐generation cephalosporin ceftizoxime in an ampicillin‐allergic patient. A 55‐year‐old white female was hospitalized after 5 days of experiencing fever, chills, nausea, and vomiting. A cardiac echocardiogram revealed a large mitral valve vegetation, and the patient was treated with intravenous ampicillin, gentamicin, and clindamycin. Two weeks after emergency mitral valve replacement the patient developed spiking fevers and a macular, erythematous rash while receiving ampicillin. Ceftizoxime was initiated and continued to complete a 4‐week period of intravenous antibiotics. Follow‐up at 14 months showed no further evidence of infection. Ceftizoxime appears efficacious in eradicatingH. parainfluenzaein patients allergic to

ISSN:0277-0008    

DOI:10.1002/j.1875-9114.1987.tb04048.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY