Summary
The haemodynamic effects and pharmacokinetics of single intravenous doses of tolmesoxide, a new vasodilator agent, were studied in 6 patients with severe cardiac failure secondary to ischaemic cardiomyopathy and refractory to concentional therapy. The mean (±SEM) baseline cardiac index (CI) and pulmonary artery diastolic pressure (PADP) were 1.7±0.11/ min/m2 and 30.5±4.1 mm Hg respectively. The mean % rise in CI was 78.8±23.3 and the mean % fall in PADP was 35.2±5.2. The mean half life of tolmesoxide in these patients was markedly prolonged at 15.6±6.6h. Side effects were minimal — vomiting was seen in 1 patient. This agent warrants further study in the long term management of refractory cardiac failure.
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References
Awan NA, Miller RR, Maxwell KS (1978) Development of systemic vasodilator tolerance to prazosin with chronic use of the agent in ambulatory therapy of severe congestive heart failure. Am J Cardiol 41:367
Chatterjee K, Parmley W (1977) Vasodilator treatment for acute and chronic heart failure. Br Heart J 39:706–720
Chatterjee K, Parmley WW, Massie B, Greenberg B, Berner J, Klausner S, Norman A (1976) Oral hydralazine therapy for chronic refractory heart failure. Circulation 54:879–883
Cohn JN, Franciosa JA, (1977) Vasodilator therapy of cardiac failure. N Engl J Med 297:27–31
Collier JG, Lorge RE, Robinson BF (1978) Comparison of effects of tolmesoxide (R × 71107), diazoxide, hydralazine, prazosin, glyceryl trinitrate and sodium nitroprusside on forearm arteries and dorsal hand veins of man. Br J Clin Pharmacol 5:35–44
Doxey JC (1978) Tolmesoxide, a drug that lowers blood pressure by a direct relaxant effect on vascular smooth muscle. Br J Pharmacol 63:111–118
Franciosa JA, Mikulic E, Cohn JN et al. (1974) Haemodynamic effects of chewable isosorbide dinitrate in patients with congestive heart failure. Circulation 50:1020–1024
Franciosa JA, Pierpont G, Cohn JN (1977) Haemodynamic improvement after oral hydralazine in left ventricular failure: a comparison with nitroprusside infusion in 16 patients. Ann Intern Med 86:388–393
Guiha NH, Cohn JN, Mikulic E et al. (1974) Treatment of refractory heart failure with infusion of nitroprusside. N Engl J Med 291:587–592
O'Boyle CP, Laher M, O'Brien ET, O'Malley K, Kelly JG (1981) The clinical pharmacology of tolmesoxide, a new vasodilator antihypertensive agent. Eur J Clin Pharmacol 21 (in press)
O'Malley K, O'Boyle C, McGarry K, O'Brien ET (1980) Vasodilator and α-adrenoceptor blocking drugs in the treatment of hypertension. The Royal Society of Medicine, Int., Congress & Symposium Series. No.26:73–81
Piafsky KM, Sitar DS, Rangno RE, Ogilvie RI (1974) Disposition of theophylline in acute pulmonary oedema. Clin Res 22:726A
Pierpont G, Franciosa JA, Cohn JN (1976) Equivalent haemodynamic effects of nitroprusside and hydralazine — nitrate combination in left ventricular failure. Circulation 54 (Suppl II):215
Stenson RE, Constantino RE, Harrison DC (1971) Inter-relationship of hepatic blood flow, cardiac output and blood levels of lidocaine in man. Circulation 43:205–211
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O'Boyle, C.P., McGarry, K., Fitzgerald, D. et al. Clinical pharmacology of tolmesoxide in refractory heart failure. Eur J Clin Pharmacol 21, 169–172 (1981). https://doi.org/10.1007/BF00627915
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DOI: https://doi.org/10.1007/BF00627915