Safety and efficacy of urapidil and sodium nitroprusside in the treatment of hypertensive emergencies

Hirschl, Michael M.; Binder, Michael; Bur, Andreas; Herkner, Harald; Müllner, Marcus; Woisetschläger, Christian; Laggner, Anton N.

doi:10.1007/s001340050426

Cited by 48 publications

(22 citation statements)

References 7 publications

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“…Fifteen RCTs (869 patients) were found that satisfied the inclusion criteria [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] ( Table 2). Two trials were placebo controlled.…”

Section: Resultsmentioning

confidence: 99%

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Pharmacological interventions for hypertensive emergencies: a Cochrane systematic review

Perez

Musini

2008

J Hum Hypertens

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Hypertensive emergencies occur when high blood pressure is associated with the presence of acute endorgan damage, such as hypertensive encephalopathy. There is controversy as to when and which antihypertensive drugs to use in these situations. Using a comprehensive search strategy in electronic sources, MEDLINE, EMBASE and Cochrane clinical trial register, we conducted a systematic review to look all randomized control trials (RCTs) that compare an antihypertensive drug versus placebo, no treatment or another antihypertensive drug. Fifteen RCTs (representing 869 patients) met the inclusion criteria. Two trials included a placebo arm. All studies (except one) were open-label trials. Seven drug classes were evaluated in those trials: nitrates (nine trials), angiotensin-converting enzyme inhibitors (seven), diuretics (three), calcium channel blockers (six), a-1 adrenergic antagonists (four), direct vasodilators (two) and dopamine agonists (one). Mortality event data were reported in seven trials. Due to insufficient data, no meta-analysis was performed for clinical outcomes. Differences in blood pressure changes between antihypertensives were minor. There is no RCT evidence demonstrating that antihypertensive drugs reduce mortality or morbidity in patients with hypertensive emergencies. Furthermore, there is insufficient RCT evidence to determine which drug or drug class is most effective in reducing mortality and morbidity. There were some minor differences in the degree of blood pressure lowering when one class of antihypertensive drug is compared to another. However, the clinical significance is unknown. RCTs are needed to assess different drug classes to determine initial and longer-term mortality and morbidity outcomes.

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“…Fifteen RCTs (869 patients) were found that satisfied the inclusion criteria [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] ( Table 2). Two trials were placebo controlled.…”

Section: Resultsmentioning

confidence: 99%

“…Two trials compared the A1A, urapidil, with nitrates. 13,20 The first trial used nitroprusside and the second used nitroglycerine as comparator. The SBP lowering effect of the two nitrates was similar (À58.4 mm Hg for nitroprusside and À59.5 mm Hg for nitroglycerine).…”

Section: Non-fatal Cardiovascular Eventsmentioning

confidence: 99%

Pharmacological interventions for hypertensive emergencies: a Cochrane systematic review

Perez

Musini

2008

J Hum Hypertens

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“…Также урапидил сравнивали с нитропрус-сидом натрия при ГК. При сопоставимом снижении АД (р=0,18) в группе нитропруссида натрия побочные эф-фекты наблюдались у 7 пациентов, а в группе урапи-дила -лишь у 2 [16].…”

Section: Discussionunclassified

Arresting of Complicated Hypertensive Crises in the Physician’s Practice: Urapidil Value and Study Results

Arutyunov¹,

Oganezova²

2011

Racionalʹnaâ farmakoterapiâ v kardiologii

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“…[5,6] Intravenous urapidil is effective in the treatment of hypertensive crises. [7,8] Furthermore, lipid levels and glucose metabolism are not adversely affected and may improve with urapidil in patients with lipid or glucose abnormalities. [2] There have been several methods published for the determination of urapidil in different biological matrices such as high performance liquid chromatography (HPLC) [9][10][11] and chemiluminescence (CL).…”

Section: Introductionmentioning

confidence: 98%

Determination of Urapidil Hydrochloride in Rabbit Plasma by Lc-MS-MS and Its Application to a Pharmacokinetic Study

Lin

Wang

et al. 2011

Journal of Liquid Chromatography & Related Technologies

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A sensitive and selective liquid chromatography tandem mass spectrometry (LC-MS-MS) method for determination of urapidil hydrochloride in rabbit plasma was developed and validated. After addition of doxapram hydrochloride as the internal standard (IS), protein precipitation by 10% trichloroacetic acid was used as the sample preparation. Chromatographic separation was achieved on a Zorbax SB-C18 (2.1 mm Â 50 mm, 3.5 lm) column with acetonitrile-water as the mobile phase with gradient elution. Electrospray ionization (ESI) source was applied and operated in positive ion mode; multiple reaction monitoring (MRM) mode was used to quantification using target fragment ions m=z 387.9 ! 204.6 for urapidil hydrochloride and m=z 378.9 ! 291.8 for the IS. Calibration plots were linear over the range of 5-1000 ng=mL for urapidil hydrochloride in plasma. Lower limit of quantitation (LLOQ) for urapidil hydrochloride was 5 ng=mL. Mean recovery of urapidil hydrochloride from plasma was in the range 93.5%-96.4%. RSD of intra-day and inter-day precision were both less than 12%. This developed method is successfully used in pharmacokinetic study of urapidil hydrochloride in rabbit.

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Safety and efficacy of urapidil and sodium nitroprusside in the treatment of hypertensive emergencies

Abstract: Urapidil is equally effective, compared to sodium nitroprusside, in the treatment of hypertensive emergencies. Due to a smaller number of adverse events, urapidil is a reasonable alternative to nitroprusside in the treatment of hypertensive emergencies.

Cited by 48 publications

References 7 publications

Pharmacological interventions for hypertensive emergencies: a Cochrane systematic review

Pharmacological interventions for hypertensive emergencies: a Cochrane systematic review

Arresting of Complicated Hypertensive Crises in the Physician’s Practice: Urapidil Value and Study Results

Determination of Urapidil Hydrochloride in Rabbit Plasma by Lc-MS-MS and Its Application to a Pharmacokinetic Study

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