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  • 1
    Electronic Resource
    Electronic Resource
    Pharmacokinetics and pharmacodynamics of lisinopril in advanced renal failure (1994)
    Springer
    European journal of clinical pharmacology 46 (1994), S. 537-543 
    Details
    ISSN: 1432-1041
    Keywords: Lisinopril ; Dose adjustment ; ACE inhibitors ; pharmacokinetics ; pharmacodynamics ; renal failure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Abstract To prevent drug accumulation and adverse effects the dose of hydrophilic angiotensin-converting enzyme (ACE) inhibitors, e. g. lisinopril, must be reduced in patients with renal failure. To obtain a rational basis for dose recommendations, we undertook a prospective clinical trial. After 15 days of lisinopril treatment pharmacokinetic and pharmacodynamic parameters were determined in patients with advanced renal failure (n=8; endogenous creatinine clearance [CLCR]: 18 ml·min−1·1.73m−2) and in healthy subjects with normal renal function (n=16; CLCR: 107 ml·min−1·1.73m−2). The volunteers received 10 mg lisinopril once daily, the daily dose in patients (1.1–2.2 mg) was adjusted to the individual CLCR according to the method of Dettli [13]. After 15 days of lisinopril treatment the mean maximal serum concentration (C max) in patients was lower than in volunteers (30.7 vs 40.7 ng·ml−1, while the mean area under the concentration-time curve (AUC 0–24 h) was higher (525 vs 473 ng·h−1·ml−1). ACE activity on day 15 was almost completely inhibited in both groups. Plasma renin activity, angiotensin I and angiotensin II levels documented marked inhibition of converting enzyme in volunteers and patients. Furthermore, average mean arterial blood pressure in patients decreased by 5 mmHg and proteinuria from 3.9–2.7 g per 24 h after 15 days of treatment with the reduced dose of lisinopril. Adjustment of the dose of lisinopril prevents significant accumulation of the drug in patients with advanced renal failure during chronic therapy. Mean serum levels did not exceed this in subjects with normal renal function receiving a standard dose. Despite substantial dose reduction, blood pressure and proteinuria decreases were observed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00196112
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  • 2
    Electronic Resource
    Electronic Resource
    Myxom des linken Vorhofes bei einem $$8{\raise0.5ex\hbox{$\scriptstyle 1$}\kern-0.1em/\kern-0.15em\lower0.25ex\hbox{$\scriptstyle 2$}}$$ jährigen Mädchen (1965)
    Springer
    European journal of pediatrics 94 (1965), S. 51-62 
    Details
    ISSN: 1432-1076
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Description of a left atrial myxoma in an eight and a half years old girl. Diagnostic pitfalls in this very rare condition are due to its imitation of the symptoms of the much more common mitral valve disease. The diagnosis of left atrial myxoma should be considered if, in addition to clinical signs indicating an elevated resistance to flow at the mitral valve, the following findings are observed: 1. Arterial embolism during sinus rhythm. 2. General signs as fever, anemia, weight loss, increased BSR. 3. Sterile blood cultures, no laboratory findings indicating collagen disease. 4. Rapidly deteriorating general condition. Angiocardiography, though a hazardous procedure in this situation, provides the confirmation of the diagnosis, necessary for surgery. Successful removal of the tumour may be possible. Without surgery the disease proves fatal in most of the cases.
    Notes: Zusammenfassung Es wird über einen Fall von linksseitigem Vorhofsmyxom bei einem 8 1/2jährigen Mädchen berichtet. Die diagnostische Schwierigkeit besteht bei dieser Affektion darin, daß sie nicht nur sehr selten ist, sondern auch die Symptome einer häufigen Krankheit, nämlich eines Mitralvitiums, weitgehend imitiert. Bestehen die klinischen Zeichen eines Strömungshindernisses an der Mitralklappe so muß ein Myxom erwogen werden, wenn 1. Embolien bei Sinusrhythmus 2. Allgemeinerscheinungen wie Fieber, Anämie, Gewichtsverlust, erhöhte Senkung. 3. sterile Blutkulturen, negative Rheumaserologie und 4. eine rasch zunehmende Verschlechterung des Allgemeinzustandes beobachtet werden. Diese Symptomatologie ist die Voraussetzung für die Indikation zur Angiokardiographie, ein in solchen Fällen nicht risikoloser Eingriff. Die Diagnose kann mit dieser Untersuchung gesichert und der Tumor operativ entfernt werden. Unerkannt führt die Krankheit in den meisten Fällen zum Tode.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00439130
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  • 3
    Electronic Resource
    Electronic Resource
    The influence of hydrochlorothiazide on the pharmacokinetics of enalapril in elderly patients (1992)
    Springer
    European journal of clinical pharmacology 43 (1992), S. 173-177 
    Details
    ISSN: 1432-1041
    Keywords: Enalapril ; Hydrochlorothiazide ; pharmacokinetics ; renal impairment ; old patients
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary In a randomized, cross-over, single-dose study of 19 elderly hypertensive patients (aged 62–84 y, SBP 〉 160 mm Hg, DBP 〉 100 mm Hg, creatinine clearance 11–93 ml·min−1) we have studied the pharmacokinetics of the angiotensin converting enzyme (ACE) inhibitor enalapril after a single oral dose of either 10 mg enalapril or 10 mg enalapril + 25 mg hydrochlorothiazide. The pharmacokinetics of enalapril were unaffected by hydrochlorothiazide, but there was a significant reduction in renal clearance and a significant increase in AUC(0–24 h) of enalaprilat after hydrochlorothiazide, resulting in higher serum concentrations of the active drug. This was independent of the individual degree of renal impairment and might be due either to an initial reduction of GFR by hydrochlorothiazide or to interference with the tubular secretion of enalaprilat. The relationships between serum enalaprilat and serum ACE activity were similar after both treatments, both consistent with a value for Ki of enalaprilat of about 0.1 nmol·l−1. Thus, serum ACE activity was not affected by hydrochlorothiazide but completely reflected the pharmacokinetics of enalaprilat in both treatments.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01740666
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  • 4
    Electronic Resource
    Electronic Resource
    Pharmacokinetics and converting enzyme inhibition after morning and evening administration of oral enalapril to healthy subjects (1991)
    Springer
    European journal of clinical pharmacology 40 (1991), S. 95-99 
    Details
    ISSN: 1432-1041
    Keywords: Enalapril ; circadian pharmacokinetics ; ACE inhibition
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary Possible circadian changes in the pharmacokinetics and effect on serum angiotensin-converting enzyme (ACE) activity of the ACE inhibitor enalapril have been studied in 8 healthy subjects after oral ingestion of 10 mg enalapril maleate either at 08.00 h or 20.00 h. The time to peak serum concentration (tmax) of enalapril was increased after administration at 20.00 h compared to 08.00 h (2.4 h versus 1.3 h), where as other kinetic parameters were not significantly altered. The 24 h-kinetics of the active metabolite enalaprilat did not differ significantly between the two treatments, but the area under the curve (AUC (0–24)) and the peak serum concentration (Cmax) were slightly higher after intake at 20.00 h. The relationship between the measured serum enalaprilat level and the degree of inhibition of serum ACE was the same after both treatments. Overall, the evening and morning administration of enalapril did not differ markedly in the pharmacokinetics and the time course of ACE inhibition.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00315146
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  • 5
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    A human immunodeficiency syndrome caused by mutations in 〈i〉CARMIL2〈/i〉 (2017)
    Nature Publishing Group (NPG)
    Details
    Publication Date: 2017-01-24
    Description: A human immunodeficiency syndrome caused by mutations in 〈i〉CARMIL2〈/i〉 Nature Communications, Published online: 23 January 2017; doi:10.1038/ncomms14209 CARMIL2 (Rltpr) is involved in T-cell function. Here, the authors identify human CARMIL2-deficiency as an autosomal recessive primary immunodeficiency disorder characterized by EBV + smooth muscle tumours, CD28 co-signalling deficiency and impaired cytoskeletal dynamics.
    Electronic ISSN: 2041-1723
    Topics: Biology , Chemistry and Pharmacology , Natural Sciences in General , Physics
    Published by Nature Publishing Group (NPG)
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