Treatment of Essential Hypertension With Chlorothiazide (Diuril)

Freis, Edward D.; Wanko, Annemarie; Wilson, Ilse M.; Parrish, Alvin E.

doi:10.1001/jama.1958.02990020025004

Cited by 131 publications

(24 citation statements)

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“…Although (2) there is a delay in hypotensive action of at least 1 to 2 hours, and (3) there is an increase in urinary output and decrease in cardiac output.8' 9 When diazoxide is administered intravenously, (1) it is more effective than by mouth, (2) there is an immediate onset of hvpotensive action within 1 to 2 minutes, and (3) there is a decrease in urinary output5 and an increase in cardiac output. Like chlorothiazide, diazoxide causes hyperglyeemia.…”

Section: Methodsmentioning

confidence: 99%

Clinical Evaluation of Diazoxide

et al. 1963

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Forty-six hypertensive patients have received diazoxide intravenously. Three hundred milligrams (one ampule) administered rapidly undiluted resulted in a 27 per cent average reduction in mean arterial pressure in 1 to 2 minutes. During the next 3 to 5 minutes the arterial pressure increased gradually to a 15 per cent average reduction as compared to the control. The average duration of diazoxide in these patients was 4.7 ± 1.7 hours. No signs of postural hypotension, cerebral ischemia, or collapse were noted. At the peak of hypotensive action there was a 41 per cent average reduction in total peripheral resistance. Repeated doses of diazoxide in both nonpregnant patients with acute hypertension and pregnant patients with toxemia adequately controlled the arterial pressure and were not associatetd with the development of drug resistance. The standard dosage of 300 mg. (one ampule), the immediate onset of action and the moderately long duration of action, the maintenance of cardiac output, the lack of significant side effects, and the fact that it can be administered repeatedly without the development of drug resistance make diazoxide administered intravenously the ideal therapy for acute hypertension.

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Section: Methodsmentioning

confidence: 99%

Clinical Evaluation of Diazoxide

et al. 1963

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“…Since their introduction in 1957, thiazide-type diuretics have been widely in use for the management of arterial hypertension [1] and are one of the most frequently prescribed drugs today. However, their use has risks, and thiazides can induce potentially life-threatening hyponatremia.…”

Section: Introductionmentioning

confidence: 99%

Thiazide-Associated Hyponatremia, Report of the Hyponatremia Registry: An Observational Multicenter International Study

et al. 2017

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Background: Hyponatremia is a frequent and potentially life-threatening adverse side effect of thiazide diuretics. This sub-analysis of the Hyponatremia Registry database focuses on current management practices of thiazide-associated hyponatremia (TAH) and compares differences between TAH and syndrome of inappropriate antidiuretic hormone secretion (SIADH). Methods: We analyzed 477 patients from 225 US and EU sites with euvolemic hyponatremia ([Na⁺] ≤130 mEq/L) who were receiving a thiazide diuretic. Of these, 118 met criteria for true thiazide-induced hyponatremia (TIH). Results: Thiazide was withdrawn immediately after hyponatremia was diagnosed only in 57% of TAH; in these patients, the median rate of [Na⁺] change (Δ_daily[Na⁺]) was significantly higher than those with continued thiazide treatment (3.8 [interquartile range: 4.0] vs. 1.7 [3.8] mEq/L/day). The most frequently employed therapies were isotonic saline (29.6%), fluid restriction (19.9%), the combination of these two (8.2%), and hypertonic saline (5.2%). Hypertonic saline produced the greatest Δ_daily[Na⁺] (8.0[6.4] mEq/L/day) followed by a combination of fluid restriction and normal saline (4.5 [3.8] mEq/L/day) and normal saline alone (3.6 [3.5] mEq/L/day). Fluid restriction was markedly less effective (2.7 [2.7] mEq/L/day). Overly rapid correction of hyponatremia occurred in 3.1% overall, but in up to 21.4% given hypertonic saline. Although there are highly significant differences in the biochemical profiles between TIH and SIADH, no predictive diagnostic test could be derived. Conclusions: Despite its high incidence and potential risks, the management of TAH is often poor. Immediate withdrawal of the thiazide is crucial for treatment success. Hypertonic saline is most effective in correcting hyponatremia but associated with a high rate of overly rapid correction. We could not establish a diagnostic laboratory-based test to differentiate TIH from SIADH.

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“…Na sreću, tim istraživača na čijem čelu je bio hemičar Karl Bejer (Karl H. Beyer), uglavnom kroz proces pokušaja i grešaka, modifikuje formulu i razvija hlorotiazid, relativno siguran ali efikasan diuretik. Kada ga je 1958. godine primenio doktor Frajs (Edward D. Freis) kod deset bolesnika sa arterijskom hipertenzijom ovaj lek je snizio KP kod svih pacijenata gotovo na normalan nivo u roku od nekoliko dana [13].…”

Section: šKolski Primer Toka Nelečene Hipertenzije Ilustruje Slučaj Punclassified

Brief historical review of blood pressure measurement and arterial hypertension treatment

Joksimović¹

2018

Timočki medicinski glasnik

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Sažetak:Arterijska hipertenzija je kao posebna nozološka jedinica definisana početkom XX veka. Način merenja krvnog pritiska, kako ga je koncipirao Riva Rocci i kasnije 1905. godine usavršio Korotkov, u suštini, ostaje nepromenjen skoro ceo vek. U čitavom XX veku sfigmomanometrija je u kliničkoj praksi pri izučavanju i lečenju kardiovaskularne patologije doprinela više nego bilo koja druga tehnika merenja. Međutim, savremena i efikasna terapija hipertenzije počinje tek u drugoj polovini tog stoleća. U radu su navedeni postupci za merenja pulsa i krvnog pritiska od početak ljudske civilizacije do savremenog doba. Prikazan je pristup kliničkom značaju i principi lečenja arterijske hipertenzije od početka do kraja XX veka. Ključne reči: arterijska hipertenzija, merenje krvnog pritiska, terapija , Abstract:Hypertension as a separate clinical unit was defined at the beginning of the twentieth century. The method of blood pressure measurement , conceived by Riva Rocci in 1905 and later mastered by Korotkov, remains essentially unchanged for almost a century. Throughout the twentieth century sphygmomanometry has contributed more than any other measurement technique_ to clinical practice in the study and treatment of cardiovascular pathology. However, contemporary and effective treatment of hypertension has begun in the second half of this century. In this paper methods for pulse measurement and blood pressure measurement from the beginning of human civilization to the modern age are presented, as well as the access to clinical importance and principles of hypertension treatment from the beginning to the end of the twentieth century. Keywords:arterial hypertension, blood pressure measurement, treatment Prvi zapis iz oblasti "kardiologije" je, verovatno, na staroegipatskom papirusu (oko 3000 g. p.n.e.) koji sadrži spise arhitekte i lekara (kasnije proglašenog polubogom) Imhotepa. Ovaj papirus sadrži opasku da je "puls indeks srca i stanja pacijenta". U periodu 2840-2600. g. p. n. e. su drevni kineski lekari (Sheng Nung i Huang Ti) utvrđivali bolesti pipanjem pulsa. Razlikovali su na taj način 23 vrste bolesti. Znali su da srce reguliše svu krv u telu i da krv neprestano kruži [1].Otac evropske medicine Hipokrat (Hippokrates, 460-370. g. p. n. e.) je opisao simptome i znake brojnih bolesti. Neke je prikazao tako detaljno da se i danas skoro u potpunosti slažu sa savremenim opisom. I danas koristimo eponime: succussio hippocratica, digiti hippocratici, facies hippocratica. U spisima koji su ostali iza Hipokrata malo je podataka koji se odnose na srce, krvne sudove ili puls, ali je on opisao kako prestaje krvarenje iz arterije kada nastupi smrt. Stara Grčka civilizacija je dala jednog "anatoma" (Heropphilos iz Kalcedonije 300. g. p. n e.) koji je opisao arterije i vene, a puls je brojao pomoću klepsidre -vodenog sata i jednog "fiziologa" (Erasistratos iz Kiosa 290. g. pre n. e.) koji je shvatio da krvni sudovi polaze iz srca, a pretpostavio je i postojanje kapilarnih veza između arterija i vena [2].Znameniti starorimski lek...

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Treatment of Essential Hypertension With Chlorothiazide (Diuril)

Cited by 131 publications

References 3 publications

Clinical Evaluation of Diazoxide

Clinical Evaluation of Diazoxide

Thiazide-Associated Hyponatremia, Report of the Hyponatremia Registry: An Observational Multicenter International Study

Brief historical review of blood pressure measurement and arterial hypertension treatment

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