Hypotensive agents. Part I: Vasodilators.
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Biomedical subjects
Publications and source records attributed to J A Romankiewicz.
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A survey of selected drug labelers was conducted to generate a list of drug products that should not be refrigerated. Letters asking for information on products adversely affected by refrigeration were mailed to 109 drug product labelers. A second letter was sent to nonresponders and to labelers providing incomplete information. Responses were received from 97 labelers, 43 of whom stated that none of their products would be harmed by refrigeration. Eleven labelers were unable to provide conclusive data or a list of specific drug products that refrigeration would harm. Lists of drug products not to be refrigerated were provided by 43 labelers, some including explanations of the adverse effects of refrigeration. Pharmacists may find the survey's data useful in their patient education activities.
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The clinical pharmacology and appropriate choice of antihypertensive agents useful in the treatment of hypertensive emergencies are reviewed. The antihypertensive agents discussed are diazoxide, sodium nitroprusside, hydralazine hydrochloride, trimethaphan camsylate, methyldopa, reserpine and phentolamine mesylate.
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Antacids interfere with gastrointestinal drug absorption by either increasing or decreasing the rate at which a drug is absorbed, or the total quantity absorbed. Antacids influence drug absorption by alteration of ionization state or solubility, factors dependent upon pH. Antacids also delay gastric emptying and are capable of chelation and adsorption with susceptible products. Many of these factors participate to produce the effect on gastrointestinal drug absorption in individual patients.
The development of patient medication instruction cards for use in patient education is described. Writing of the cards, their use in practice and predischarge teaching are discussed.
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The drug interaction between warfarin and rifampin is not well known. Rifampin has been reported to increase the warfarin requirements in human subjects ingesting these agents simultaneously. The concomitant administration of rifampin and warfarin resulted in the need for an unusually high maintenance dose of warfarin (20 mg per day) in order to produce a therapeutic effect. Withdrawal of rifampin decreased the warfarin requirement by 50%. This effect may be mediated by the ability of rifampin to induce microsomal enzymes and, thus, the catabolism of warfarin. The effect of rifampin on the warfarin requirement of our patient appeared to be maximal 5 to 7 days after the initiation of rifampin and extended a similar length of time after rifampin withdrawal. This interaction appears to be clinically significant.