Effects of Oral and Intravenous Terazosin and Head-up Tilt on Blood Pressure Responses in Patients with Hypertension
| Autor: | Balakrishna Hosmane, Albert Cohen, Paul Linnen, Ramanuj Achari, John H. Cavanaugh, Paolo Baroldi |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male Posture Administration Oral Hemodynamics Blood Pressure Placebo Dizziness Terazosin Orthostatic vital signs Double-Blind Method Heart Rate Oral administration Heart rate medicine Humans Pharmacology (medical) Infusions Intravenous Adrenergic alpha-Antagonists Antihypertensive Agents Pharmacology Cross-Over Studies business.industry Nausea Prazosin Middle Aged Crossover study Blood pressure Anesthesia Hypertension business medicine.drug |
| Zdroj: | The Journal of Clinical Pharmacology. 38:545-553 |
| ISSN: | 0091-2700 |
| DOI: | 10.1002/j.1552-4604.1998.tb05793.x |
| Popis: | Terazosin is a selective alpha1-adrenoceptor antagonist. A double-blind, randomized, placebo-controlled, two-period study evaluated the effects of posture and of oral and intravenous administration of terazosin on blood pressure and heart rate in patients with hypertension. At least one week after withdrawal of all antihypertensive medications, 31 patients with sitting diastolic blood pressure of 95 to 114 mmHg were enrolled in the study. After a 24-hour, single-blind, placebo lead-in phase, the patients were randomized to receive either oral terazosin (1 mg on day 1, 2 mg on day 2, and 5 mg on days 3 and 4), a 12-hour intravenous infusion of terazosin (2.5 mg, 5 mg, or 7.5 mg), or placebo for 4 consecutive days. Head-up tilt (60 degrees for 20 minutes) evaluations were performed before and 0.5, 1.5, 2.5, 6, 12, and 16 hours after start of administration during the placebo lead-in phase and on each of the 4 days of the double-blind treatment phase. Blood pressure and heart rate were monitored every 2 minutes during the 20-minute tilt. Statistically significantly larger mean changes in blood pressure and heart rate were observed with the 7.5-mg intravenous dose of terazosin compared with those after oral terazosin or placebo. With respect to intravenous terazosin, the orthostatic changes were maximal on the first day of the 4-day treatment and increased with increasing doses of terazosin. Maximum orthostatic changes in blood pressure after oral administration of terazosin were not significantly different from those observed with placebo. The most common treatment-emergent adverse events during tilt were dizziness and nausea. Dizziness occurred more frequently with intravenous terazosin than with oral terazosin. The results of this study indicate that oral dose titration of terazosin rather than a slower rate of terazosin infusion minimized the postural effects on blood pressure and associated symptoms during head-up tilt. |
| Databáze: | OpenAIRE |
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