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  • Hypertonie  (2)
  • Labelled Compound  (2)
  • 1
    Electronic Resource
    Electronic Resource
    Erythropoietin und Hypertonie (1988)
    Springer
    Journal of molecular medicine 66 (1988), S. 914-919 
    Details
    ISSN: 1432-1440
    Keywords: Erythropoietin ; Hypertension ; Erythropoietin ; Hypertonie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die Wirksamkeit von rekombinantem humanem Erythropoietin (rhEpo) bei der Korrektur der Anämie des terminal niereninsuffizienten dialysepflichtigen Patienten ist in mehreren Studien belegt. Eine deutliche Verbesserung der physischen Leistungsfähigkeit konnte durch ergometrische Untersuchungen dokumentiert werden. Neben seltenen Shunt-Thrombosen ist die einzige relevante unerwünschte Wirkung von rhEpo die Entwicklung oder Aggravierung einer Hypertonie bei etwa 30% der behandelten Patienten. Bei ca. 2% der Patienten kam es zur hypertensiven Enzephalopathie mit zentralnervöser Symptomatik. Als Ursache für diese Hypertonie-Entwicklung ist ein Anstieg des peripheren Widerstands anzunehmen. Belege dafür sind Messungen des regionalen Blutflusses mit Plethysmographie vor und nach Anämie-Korrektur mit rhEpo. Ursache für den Widerstandsanstieg wiederum dürfte eine Zunahme der Vollblutviskosität und eine Abnahme der peripheren hypoxiebedingten Vasodilatation sein. Zur Prävention der hypertensiven Komplikationen bei rhEpo-Therapie werden eine langsame Hämatokrit-Korrektur über 12–16 Wochen und eine Begrenzung des Ziel-Hämatokrits auf 30–35 Vol. % bei strikter Blutdruck- und Volumenkontrolle empfohlen.
    Notes: Summary Recombinant human erythropoietin (rhEpo) has been demonstrated in several studies to be effective in correcting the anemia of regular dialysis patients. This was accompanied by a significant improvement of the physical work capacity shown by exercise testing. The main side effect of rhEpo treatment has been the development or aggravation of hypertension in approximately 30% of the treated patients. In 2% hypertensive encephalopathy and convulsions occured. Data obtained by measurements of regional blood flow indicate the peripheral resistance did increase probably due to rise of blood viscosity and reversal of preexisting hypoxic vasodilatation. To avoid hypertensive complications anemia should be corrected slowly over a period of 12–16 weeks. Target hematocrit should not exceed 30–35 vol. %. Blood pressure and volume status should be monitored closely.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01728954
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  • 2
    Electronic Resource
    Electronic Resource
    Langzeitbetreuung von Dialysepatienten I. Hochdruck und Anämie (1999)
    Springer
    Der Internist 40 (1999), S. 55-63 
    Details
    ISSN: 1432-1289
    Keywords: Schlüsselwörter Dialyse ; Hypertonie ; Hypertonie ; Dialyse ; Dialyse ; Anämie ; Anämie ; Dialyse ; Nierenversagen ; Erythropoetin ; Dialyse ; Eisenstoffwechsel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Zum Thema Die Urämie stellt ein außerordentlich komplexes Krankheitsbild dar und kann zu klinischen Manifestationen an nahezu allen Organsystemen führen. Entsprechend komplex gestaltet sich die chronische Betreuung von Dialysepatienten. Angesichts der Vielzahl von klinischen Problemen ist eine umfassende Diskussion der Langzeitbetreuung von Dialysepatienten (z.B. auch der psychologischen Betreuung) in der nachfolgenden Übersicht nur fragmentarisch möglich. Wir haben uns auf zentrale internistische Probleme von Dialysepatienten beschränkt und werden detailliert die Hypertonie, die renale Anämie und zwei bedeutsame Langzeitkomplikationen der Dialyse, die β2-Mikroglobulin assoziierte Amyloidose sowie die erworbene zystische Nierenkrankheit (siehe Teil II), besprechen. Zur Klinik und Therapie einer weiteren bedeutsamen Komplikation der chronischen Urämie, d.h. der renalen Osteopathie, sei auf den Beitrag von Schulz et al. in diesem Heft verwiesen. Zu den Themen „Ernährung bei chronischer Niereninsuffizienz” sowie der sekundären Hyperurikämie bzw. Gicht bei Niereninsuffizienz siehe den Beitrag von Hörl et al. in diesem Heft bzw. unsere kürzlich in Der Internist publizierte Übersicht [48].
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001080050308
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  • 3
    Electronic Resource
    Electronic Resource
    β-Methyl-digoxin (1972)
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 272 (1972), S. 32-45 
    Details
    ISSN: 1432-1912
    Keywords: Cardioglycoside ; Labelled Compound ; Absorption ; Cardiac Output ; Guinea-Pig
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Glycosides were injected into a ligated loop of the small intestine of guinea-pigs under urethane anaesthesia. From the residual radioactivity in the intestinal loop at various times after the injection the amount absorbed was determined and from that the rate of absorption, assuming exponential absorption. β-Methyl-digoxin was absorbed more rapidly than digoxin and its derivatives β-acetyl-digoxin and lanatoside C but slower than digitoxin. β-Methyl-digoxin was much better absorbed from a suspension than from a solution; this caused the difference from digitoxin to disappear to a large extent. The high rate of absorption of β-methyl-digoxin in humans is probably explicable in this way. The rate of absorption of β-methyl-digoxin was independent of the dose until the appearance of arrhythmias; it decreased with progressing intoxication. Absorption was delayed when cardiac output was decreased by barbital anaesthesia. The amount absorbed at the onset of arrhythmias can be calculated from the injected dose, the rate of absorption and the time. For β-methyl-digoxin and digoxin it corresponded to the effective doses determined by intravenous infusion and to the cardiotoxicity after intraduodenal injection. The cardiotoxicity of β-acetyl-digoxin and digitoxin was less than that expected from the amounts absorbed suggesting metabolic inactivation during absorption. The relative enteral activity is not only determined by the absorption but also by the rate of elimination. The rate at which the material should leave the intestine in order to maintain arrhythmia was calculated. It was considerably greater for digitoxin than for β-methyl-digoxin or digoxin.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00498792
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    β-Methyl-digoxin (1972)
    Springer
    Naunyn-Schmiedeberg's archives of pharmacology 272 (1972), S. 46-64 
    Details
    ISSN: 1432-1912
    Keywords: Cardioglycoside ; Labelled Compound ; Drug Metabolism ; Pharmacokinetics ; Absorption
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary β-Methyl-digoxin was much more resistant to enzymatic degradation than digoxin, β-acetyl-digoxin and digitoxin. Only in the bile was an appreciable percentage of the radioactivity attributable to a hydrophilic metabolite. The distribution volume of β-methyl-digoxin increased with time, but was independent of the dose and of the mode of administration. The blood levels during i. v. infusion and after i. d. injection can be used for calculating the speed of absorption during the first 20 min only. The correlations between blood levels and pharmacodynamic activity were investigated by varying the dose injected intraduodenally or the speed of i. v. infusion. Although the effective doses were constant, the blood levels expected at the onset of arrhythmias decreased with decreasing speed of administration. Signs of acute tolerance were observed when the experiment lasted for more than 30 min. In the heart, the equilibrium between blood and tissue levels of radioactivity was reached sooner than in the rest of the body. Whereas maximal blood levels were observed about 30 min after oral administration in man, they continued to rise for at least 60 min after i.d. injection in guineapigs. This confirms earlier observations that β-methyl-digoxin is absorbed more rapidly in man than in guinea-pigs.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00498793
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    Paper (German National Licenses)
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