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  • 1
    Electronic Resource
    Electronic Resource
    Safety and antihypertensive efficacy of carvedilol and atenolol alone and in combination with hydrochlorothiazide (1990)
    Springer
    European journal of clinical pharmacology 38 (1990), S. S143 
    Details
    ISSN: 1432-1041
    Keywords: carvedilol ; atenolol ; hydrochlorothiazide ; safety ; efficacy ; essential hypertension
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Carvedilol has been shown to be effective and safe in patients with essential hypertension when given as monotherapy. In this double-blind, randomized, group-comparative study, 2 groups of 59 patients with mild to moderate essential hypertension [median supine systolic/diastolic blood pressure at baseline (SBP/DBP), 168/105 mm Hg] were treated with either 25 mg carvedilol once daily (o. d.) or 50 mg atenolol o. d. for 4 weeks. Responders at 4 weeks (DBP, 〈 90 mmHg) terminated the study. Nonresponders continued the study. Hydrochlorothiazide (HCTZ) was added at 25 mg o. d. for a further 6 weeks. The median blood pressure decreased under monotherapy with carvedilol (n = 59) from 167/105 at baseline to 155/94 mmHg after 4 weeks, and in the atenolol group (n=59) it decreased from 168/105 to 162/97 mmHg. The patients who received carvedilol in combination with HCTZ and were evaluated for efficacy (n = 38) showed a decrease in SBP/DBP from 156/97 at the end of monotherapy to 145/88 mmHg after 10 weeks; the combination of atenolol with HCTZ (n = 44) reduced BP from 162/97 to 147/88. Both carvedilol and atenolol were safe when given either alone or in combination with HCTZ. In conclusion, after long-term administration, 25 mg carvedilol o. d. and 50 mg atenolol o. d. significantly reduced both SBP and DBP over 24 h. The addition of HCTZ led to a further increase in antihypertensive efficacy. Combined treatment with carvedilol or atenolol and HCTZ was very well tolerated, without hypotensive events or relevant changes in objective safety parameters.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01409485
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  • 2
    Electronic Resource
    Electronic Resource
    Influence of carvedilol and propranolol on coronary blood flow (1990)
    Springer
    European journal of clinical pharmacology 38 (1990), S. S122 
    Details
    ISSN: 1432-1041
    Keywords: carvedilol ; propranolol ; coronary blood flow ; beta-blockade ; vasodilation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary A total of 17 patients with angiographically proven coronary artery disease and at least one stenosis blocking ≥ 70% of the left anterior descending or circumflex artery were included in a double-blind, randomized study. They received either 5 mg carvedilol or 6 mg propranolol intravenously. Heart rate, aortic pressure, mean coronary sinus pressure and coronary flow (thermodilution) were measured and coronary resistance and the rate-pressure product were calculated before and 25 min after injection. Carvedilol significantly (P 〈 0.05) lowered the heart rate (mean, 76 to 69 beats/min), aortic pressure (mean, 153/80–135/72 mmHg), rate-pressure product (mean, 117–93 mmHg/min), and coronary flow (mean, 114–94 ml/min). Coronary resistance (mean, 0.97–1.07 mmHg × min/ml) and coronary flow related to the rate-pressure product (mean, 1.0–1.02 ml/mm Hg) showed no significant change after carvedilol treatment. Propranolol lowered the heart rate (mean, 76–64/min;P 〈 0.05) and rate-pressure product (mean, 109–96 mm. Hg/min; not significant). Aortic pressure (mean, 145/72–147/74 mmHg), coronary flow (mean 109–101 ml/min), coronary resistance (mean, 1.1–1.2 mmHg × min/ml), and coronary flow related to the rate-pressure product (mean,1.12–1.19 ml/mmHg) showed no significant change after propranolol administration. Following single application, carvedilol lowered the rate-pressure product more markedly than did propranolol on account of its acute blood-pressure-lowering effect. No differences in the hemodynamic effects of carvedilol and propranolol were found. Neither drug seems to influence the adaption of coronary flow to myocardial oxygen demand.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01409480
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  • 3
    Electronic Resource
    Electronic Resource
    Efficacy and safety of carvedilol in comparison with atenolol in hypertensive patients pretreated with hydrochlorothiazide (1990)
    Springer
    European journal of clinical pharmacology 38 (1990), S. S147 
    Details
    ISSN: 1432-1041
    Keywords: hypertension ; combination treatment ; hydrochlorothiazide ; carvedilol ; atenolol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Carvedilol [25 mg once daily] (o. d.) was compared to atenolol (50 mg o. d.) as an adjunct to pre-existing hydrochlorothiazide (HCTZ) monotherapy in patients with mild to moderate hypertension [diastolic blood pressure (DBP),100–115 mm Hg]. After a placebo run-in phase of 2 weeks, 131 patients received 25 mg HCTZ o. d. for 4 weeks. In all, 122 patients were transferred to the double-blind phase, in which 25 mg carvedilol or 50 mg atenolol was randomly added to HCTZ. After an additional 6 weeks of treatment, 112 patients were evaluable for efficacy (C/HCTZ group,n = 54; A/HCTZ group,n = 58). Blood pressure was measured and the heart rate was counted before medication, at 2-week intervals throughout the trial, and 2 h after medication on the 1st and the last day of the combination treatment period. Serum lipids were measured in addition to routine laboratory variables. A therapeutic response was defined as a reduction in supine and standing diastolic blood pressure to values of 〈 90 mmHg. In a relatively low number of patients (6 of 131), a response as defined above was achieved with HCTZ alone. This may be accounted for by the fact that patients were required to have a diastolic blood pressure of at least 100 mgHg and by the relatively short period of monotherapy. The two groups of patients receiving different combination treatments were well matched for demographic data and blood pressure values before the adjunct was added. In both groups there was a marked additional blood pressure decrease on the initiation of combined treatment. At the end of the study the medians of all blood pressure values were well within normal ranges, which was not the case with HCTZ alone. On the last day of the trial, the responders comprised 67% of the C/HCTZ group and 71% of the A/HCTZ group. No relevant changes in lipid values were observed with combination treatment vs diuretic monotherapy. No serious adverse event attributable to one of the study drugs was reported. The results of the present trial suggest that the antihypertensive efficacy of both combinations is superior to that of HCTZ alone and that there is no difference in efficacy between the two combinations. Adding carvedilol or atenolol to pre-existing HCTZ appears to be safe. The tolerability of the antihypertensive treatment does not seem to decline, despite considerable additional decreases in blood pressure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01409486
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  • 4
    Electronic Resource
    Electronic Resource
    Comparison of the hemodynamic effects of metoprolol and carvedilol in hypertensive patients (1996)
    Springer
    Cardiovascular drugs and therapy 10 (1996), S. 113-117 
    Details
    ISSN: 1573-7241
    Keywords: hypertension ; hemodynamics ; beta-blockade ; metoprolol ; carvedilol
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Metoprolol and carvedilol are widely used in the treatment of hypertension, but no randomized comparison of their hemodynamic activity has been previously reported. Their comparative effects on heart rate, systemic blood pressure, and echocardiographically determined aortic and femoral artery blood flow were measured at rest and at 2 and 24 hours after the first dose of each drug, and again after 4 weeks of sustained monotherapy in 12 male and 12 female patients, aged 36–68 years with uncomplicated sustained hypertension according to a randomized single-blind protocol. Nine patients in each drug group achieved the target diastolic blood pressure of 〈90 mmHg on the initial doses of each drug; this was achieved in the remainder following doubling of each dose. Neither drug occasioned withdrawal of any patient due to adverse reactions. Both drugs significantly reduced heart rate, although the reduction at 2 hours was significantly greater after metoprolol than after carvedilol. Both drugs reducd systolic pressure throughout the study; the reduction at 2 hours was significantly greater after carvedilol than after metoprolol. In contrast, the diastolic blood pressure was persistently reduced only by carvedilol. The cardiac output, determined as the aortic systolic blood flow, after carvedilol was not significantly different from pretreatment values throughout the study but was significantly reduced in the metoprolol-treated patients at each point of measurement. After metoprolol the systemic and femoral vascular resistances derived from conventional formulae were consistently and significantly increased over pretreatment values throughout the study and were significantly greater than in the carvedilol group at all measurement points. The hemodynamic differences between these two beta-blocking drugs may be explained by the additional vasodilator activity of carvedilol associated with its alpha1-adrenoceptor blocking activity. The long-term clinical and prognostic implications of these pharmacodynamic differences between beta-adrenoceptor antagonists with and without additional vasodilator activity in the treatment of hypertensive patients remain to be determined.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00823588
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  • 5
    Electronic Resource
    Electronic Resource
    Omeprazole (1991)
    Springer
    Pharmacy world & science 13 (1991), S. 215-219 
    Details
    ISSN: 1573-739X
    Keywords: Cimetidine ; Costs and cost analysis ; Drug utilization ; Epidemiology ; Omeprazole ; Ranitidine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology
    Notes: Abstract A pharmaco-epidemiologic study in hospitalized patients was carried out in order to establish the place and use of omeprazole (Losec®), a new and promising drug in the treatment of acid-related diseases. A comparison is made with cimetidine and ranitidine use. It appeared that prescribed omeprazole doses were high in relation to the established defined daily doses and that substitution of H2 receptor antagonists by omeprazole led to tremendously increased drug costs. From the clinical indication data it could be established that the drug was prescribed appropriately.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01988878
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  • 6
    Electronic Resource
    Electronic Resource
    A stochastic growth model applied to repeated tests of academic knowledge (1989)
    Springer
    Psychometrika 54 (1989), S. 451-466 
    Details
    ISSN: 1860-0980
    Keywords: Rasch model ; growth curves ; regression ; itembanking
    Source: Springer Online Journal Archives 1860-2000
    Topics: Psychology
    Notes: Abstract In the course of the medical program at the University of Limburg, students complete a total of 24 progress tests, consisting of items drawn from a constant itembank. A model is presented for the growth of knowledge reflected by these results. The Rasch model is used as a starting point, but both ability and difficulty parameters are taken to be random, and moreover the logistic distribution is replaced by the normal. Both individual and group abilities are estimated and explained through simple linear regression. Application to real data shows that the model fits very well.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02294628
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