Sublingual vs. Oral Captopril in Hypertensive Crisis

Kaya, Adnan; Tatlısu, Mustafa Adem; Kaya, Tugba Kaplan; Yıldırımtürk, Özlem; Güngör, Barış; Karataş, Baran; Yazıcı, Selçuk; Keskin, Muhammed; Avşar, Şahin; Murat, Ahmet

doi:10.1016/j.jemermed.2015.07.017

Cited by 31 publications

(21 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There were nine trials of ace inhibitors (one retrospective cohort, 14 two prospective cohorts, 23 , 24 five RCTs, 16 , 25 – 28 one non-randomized controlled trial 29 ). All used captopril in doses ranging from 6.25 to 25 mg in both PO and SL formulations.…”

Section: Resultsmentioning

confidence: 99%

Pharmacologic Treatment of Hypertensive Urgency in the Outpatient Setting: A Systematic Review

et al. 2018

View full text Add to dashboard Cite

BackgroundHypertensive urgency (HU), defined as acute severe uncontrolled hypertension without end-organ damage, is a common condition. Despite its association with long-term morbidity and mortality, guidance regarding immediate management is sparse. Our objective was to summarize the evidence examining the effects of antihypertensive medications to treat.MethodsWe searched the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), Cochrane Database of Systematic Reviews, Web of Science, Google Scholar, and Embase through May 2016. Study selection: We evaluated prospective controlled clinical trials, case–control studies, and cohort studies of HU in emergency room (ER) or clinic settings. We initially identified 11,223 published articles. We reviewed 10,748 titles and abstracts and identified 538 eligible articles. We assessed the full text for eligibility and included 31 articles written in English that were clinical trials or cohort studies and provided blood pressure data within 48 h of treatment. Studies were appraised for risk of bias using components recommended by the Cochrane Collaboration. The main outcome measured was blood pressure change with antihypertensive medications. Since studies were too diverse both clinically and methodologically to combine in a meta-analysis, tabular data and a narrative synthesis of studies are presented.ResultsWe identified only 20 double-blind randomized controlled trials and 12 cohort studies, with 262 participants in prospective controlled trials. However, we could not pool the results of studies. In addition, comorbidities and their potential contribution to long-term treatment of these subjects were not adequately addressed in any of the reviewed studies.ConclusionsLongitudinal studies are still needed to determine how best to lower blood pressure in patients with HU. Longer-term management of individuals who have experienced HU continues to be an area requiring further study, especially as applicable to care from the generalist.Electronic supplementary materialThe online version of this article (10.1007/s11606-017-4277-6) contains supplementary material, which is available to authorized users.

show abstract

Section: Resultsmentioning

confidence: 99%

Pharmacologic Treatment of Hypertensive Urgency in the Outpatient Setting: A Systematic Review

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Such administration guarantees faster drug action. However, 1 h after administration the antihypertensive activity of sublingual Captopril is comparable to that for tablets which have been swallowed immediately 11 .…”

Section: Mucosal Administration Routementioning

confidence: 86%

“…Sublingual Captopril acts faster within first 30 min, however, there are no differences in blood pressure reduction 1 h after drug delivery in comparison to the conventional p.o. route 11,38 .…”

Section: Nitrendipinementioning

confidence: 99%

Mucosal delivery systems of antihypertensive drugs: A practical approach in general practice

Biały¹,

Wojcik²,

Młynarczuk-Biały³

2018

BIOMED PAP

View full text Add to dashboard Cite

Patients who are unable to receive oral medication (p.o.) are a major problem in outpatient settings, especially in home health care systems. Mucosal administration of drugs offers an alternative to the oral route, especially when the parenteral mode cannot be used. There are three main pathways of mucosal administration: sublingual/buccal, intranasal and rectal. We discuss the possibility of mucosal delivery of antihypertensive drugs. Perindopril arginine and Amlodipine besylate are registered in the EU as orodispersible tablets for oromucosal delivery, however, they are not available in all countries. For this reason, we describe other drugs suitable for mucosal delivery: Captopril and Nitrendipine in the sublingual system and Metoprolol tartrate, Propranolol and Furosemide by the transrectal route. Based on the published data and common clinical practice we discuss the use of mucosal delivery systems of all these antihypertensive drugs with special attention to their pharmacokinetics. We illustrate this mini-review with a case report of the prolonged-term use of mucosal delivery of sublingual Captopril and Nitrendipine combined with rectal Metoprolol tartrate and Furosemide in a patient with severe hypertension unable to receive medication p.o. This is also a report on the first human use of Furosemide-containing suppositories as well as prolonged-term transmucosal administration of these four drugs, describing a practical approach leading to successful control of severe hypertension with four antihypertensive drugs delivered via the mucosal route. The treatment was effective and without side effects; however, the long-term safety and efficacy of such therapy must be confirmed by randomized clinical trials.

show abstract

“…В то же время преимущество сублингвального применения каптоприла у пациентов, которые обратились в отделение неотложной помощи по поводу неосложненного ГК (n = 212), было подтверждено в ходе выполнения открытого рандомизированного клинического исследования [16]. Результаты исследования свидетельствовали о том, что в течение первых 10 мин.…”

Section: южно-российский журнал терапевтической практикиunclassified

Changing Perceptions of Tactics in Acute Marked Increase in Blood Pressure in the Absence of Damage to Target Organs

Гиляревский

2020

jour

View full text Add to dashboard Cite

В 2019 г. группа экспертов в лечении артериальной гипертонии (АГ) Европейского общества кардиологов предложила отказаться от термина «неосложненный гипертонический криз», сохраняя понятие гипертонического криза только для случаев развития осложненного гипертонического криза, при котором требуется госпитализация и, как правило, немедленное начало внутривенной антигипертензивной терапии. Эксперты Европейского общества кардиологов при выявлении высокого уровня артериального давления (АД), но в отсутствие поражения органов-мишеней, предлагают формулировать диагноз как «неэффективно леченая АГ». Необходимо учитывать, что из указанных пероральных препаратов для более быстрого снижения АД пациентам в Российской Федерации широко доступен только каптоприл. Следует избегать приема коротко действующего нифедипина при высоком уровне АД, особенно у лиц пожилого возраста, в связи с непредсказуемостью ответной реакции, проявляющейся в чрезмерном снижении АД. Ключевые слова: артериальная гипертония, гипертонический криз, отсутствие поражения органов-мишеней.

show abstract

Sublingual vs. Oral Captopril in Hypertensive Crisis

Cited by 31 publications

References 18 publications

Pharmacologic Treatment of Hypertensive Urgency in the Outpatient Setting: A Systematic Review

Pharmacologic Treatment of Hypertensive Urgency in the Outpatient Setting: A Systematic Review

Mucosal delivery systems of antihypertensive drugs: A practical approach in general practice

Changing Perceptions of Tactics in Acute Marked Increase in Blood Pressure in the Absence of Damage to Target Organs

Contact Info

Product

Resources

About