Asunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Indometacina/uso terapéutico , Fenilpropionatos/uso terapéutico , Enfermedades Reumáticas/tratamiento farmacológico , Método Doble Ciego , Evaluación de Medicamentos , Femenino , Humanos , Indometacina/efectos adversos , Masculino , Persona de Mediana Edad , Fenilpropionatos/efectos adversosRESUMEN
In a randomized double-blind, parallel group study, the effects of piretanide on serum electrolytes and on symptoms of congestive heart failure were compared with those of the combination piretanide plus triamterene in out-patients with mild to severe congestive heart failure. A total of 60 patients entered the study; 13 patients were excluded from the statistical analysis (4 due to premature end of the study, 2 due to dose increase, 7 due to concomitant medication (antihypertensive or antihypotensive agents), so that the results of 47 patients were statistically analyzed, 26 of them in the piretanide and 21 of them in the piretanide plus triamterene group. Piretanide (6 mg once daily) and piretanide plus triamterene (6 mg + 50 mg once daily) both produced a significant reduction in certain symptoms of congestive heart failure which was evident at 2 weeks and was maintained and further enhanced over the ensuing 12-week trial period. Improvement in a number of symptoms of congestive heart failure was attained in 54% of the patients in the piretanide group and 67% in the piretanide plus triamterene group. This difference, however, was not clinically relevant, since the symptoms which are expected to improve in this short time showed no great difference between the two groups. There were no significant changes in serum potassium and serum magnesium within groups or differences between the groups. There were decreases in serum sodium, calcium and inorganic phosphorus in the piretanide plus triamterene group. In the piretanide group, only a temporary drop in inorganic phosphorus was observed.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Diuréticos/uso terapéutico , Electrólitos/sangre , Insuficiencia Cardíaca/tratamiento farmacológico , Sulfonamidas/uso terapéutico , Adulto , Anciano , Presión Sanguínea/efectos de los fármacos , Peso Corporal/efectos de los fármacos , Ensayos Clínicos como Asunto , Método Doble Ciego , Femenino , Insuficiencia Cardíaca/sangre , Insuficiencia Cardíaca/fisiopatología , Frecuencia Cardíaca/efectos de los fármacos , Humanos , Magnesio/sangre , Masculino , Persona de Mediana Edad , Potasio/sangre , Distribución Aleatoria , Triantereno/uso terapéuticoRESUMEN
In a randomized double-blind parallel group study conducted in three centres the hypotensive activity of piretanide 6 mg b.i.d. was compared with that of hydrochlorothiazide (HCT) 25 mg b.i.d. and HCT 50 mg b.i.d. Ninety-three patients entered the study and sixty-one completed a 16-week trial period. All three treatments produced a significant reduction in supine diastolic and systolic blood pressure after only 2 weeks of active treatment and this was maintained for the duration of the study. The mean maximal reduction in supine diastolic blood pressure was 18% in the piretanide group, 18.8% in the HCT 25 mg b.i.d. group, and 20% in the HCT 50 mg b.i.d. group. The corresponding figures for the percentage of patients attaining a supine diastolic pressure below 95 mm Hg were 83%, 62% and 89%. There were no significant differences between the three groups. Side-effects were generally mild and transient, except for polyuria which was noted in all three groups but more commonly in the piretanide group. Two patients were withdrawn because of side-effects: one patient in the high dose HCT group developed severe postural symptoms; and one patient in the low dose HCT group was withdrawn because of restlessness, nausea, weakness, dizziness and somnolence. All three treatments caused a significant increase in serum uric acid concentrations. Four patients in each of the HCT groups developed hypokalaemia, but no patients in the piretanide group did so.
Asunto(s)
Diuréticos/uso terapéutico , Hidroclorotiazida/uso terapéutico , Hipertensión/tratamiento farmacológico , Sulfonamidas/uso terapéutico , Adulto , Anciano , Presión Sanguínea/efectos de los fármacos , Ensayos Clínicos como Asunto , Diuréticos/efectos adversos , Método Doble Ciego , Femenino , Humanos , Hidroclorotiazida/efectos adversos , Masculino , Persona de Mediana Edad , Poliuria/inducido químicamente , Distribución Aleatoria , Estimulación Química , Sulfonamidas/efectos adversos , Factores de Tiempo , Ácido Úrico/sangreRESUMEN
The metabolic effects of piretanide (2 x 6 mg daily) were compared with those of hydrochlorothiazide, in doses of 2 x 25 mg or 2 x 50 mg daily, in a double-blind study consisting of three parallel groups totalling 15 patients with uncomplicated essential hypertension. Thirteen patients completed the 3-months' study. At the end of the 2-week run-in period on placebo, systolic and diastolic blood pressures (lying) were 200.0 +/- 8.2/100.0 +/- 0 mmHg in the piretanide group, 185.0 +/- 17.3/102.5 +/- 5.0 mmHg in the 2 x 25 mg hydrochlorothiazide group, and 200.0 +/- 10.0/102.0 +/- 11.0 mmHg in the 2 x 50 mg hydrochlorothiazide group. After 3 months of active treatment blood pressures had decreased by 19.5%/18.8%, 7.0%/9.8% and 20.4%/18.9% in the three groups, respectively, to normotensive levels. The results showed that the antihypertensive effect of piretanide was comparable to that of 2 x 50 mg hydrochlorothiazide daly and greater than that with the lower dose hydrochlorothiazide regimen (2 x 25 mg daily). There were no differences between the three groups with regard to serum adrenaline, noradrenaline or dopamine levels. Plasma renin activity increased slightly in all three groups but, despite this, plasma aldosterone levels did not increase. Thus, no secondary hyperaldosteronism was seen. No clinically relevant changes in acid-base balance were observed. No severe side-effects occurred; the frequency of disturbing diuresis was slightly greater in the 2 x 50 mg hydrochlorothiazide group than in patients receiving piretanide.