Diuretics

Wilson, Graham M.

doi:10.1136/bmj.1.5326.285

Cited by 21 publications

(3 citation statements)

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“…The main properties of the drugs are that they cause a diuresis, increase sodium excretion, and antagonize noradrenaline (Wilson, 1963). There is also a hypotensive action which cannot be solely explained by relating it to increased salt excretion (Pickering et al, 1961 ;Villarreal et al, 1962).…”

Section: Discussionmentioning

confidence: 99%

Controlled Trial of Chlorothiazide in Treatment of Early Pre-eclampsia

Menzies¹

1964

BMJ

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MEDICALOURL 7391960) and a central effect (Gillespie et alc., 1962) may play some part. Agar et al. (1958) discussed the underlying theories of pre-eclamptic hypertension production in view of mecamylamine and the ganglion-blocking hypotensive agents being ineffectual in controlling this condition. Recently, Senior et al. (1963) have suggested that 5-hydroxytryptamine (serotonin) may have some role in the production of toxaemia of pregnancy and that antagonists of this substance may be of value in treatment. It is of interest that methyldopa interferes with the formation of serotonin in the body (Oates et al., 1960). SummaryMethyldopa and the chlorothiazide diuretics have been used in 15 patients with severe pre-eclamptic toxaemia. All but one showed a marked and satisfactory fall in blood-pressure, a diminution in proteinuria, and improvement in well-being.The foetus died early in treatment in three patients. All three had severe toxaemia occurring early in the third trimester and showed blood ureas above normal-one of them had the unsuccessful blood-pressure response. The other patients were able to continue with the pregnancies and all were delivered of healthy normal babies except one baby who died of an obstetric cause.The dose of methyldopa was relatively small and the only complication was a drug rash, but other drugs were being given at the same time. However, the number of patients was small and other side-effects may occur. No deterioration has been noted in following the condition of these patients.We should like to thank Mr. Alan Brews for permission to publish his cases. Gillespie, L., Oates, J. A., Crout, J. R., and Sjoerdsma, A. (1962).Circulation, 25, 281.Hamilton, M., and Kopelman, H. (1963). Brit. med. 7.,1, 151. Landesman, R., Ollstein, R. N., and Quinton, K. J. (1959 Pre-eclampsia remains a common complication of pregnancy in this country. Although the foetal wastage appears to be slightly less now than ten years ago, the figures from the National Birthday Trust Perinatal Mortality Survey show that in pregnancies resulting in stillbirth or neonatal death there is still a raised incidence of pre-eclampsia (D. G. Bonham, personal communication, 1963). It is also one of the three most common features of the history where the mother has died ; 18% of maternal deaths are associated with pre-eclampsia (Ministry of Health, 1963).In spite of the importance of the condition the cause remains obscure, and treatment, although relatively successful, is still largely empirical. Hypotensive drugs may have value if given early in pregnancy, but this treatment is possible only for those women who show early hypertension. In cases of non-toxaemic hypertension reserpine seems to have a place but does not reduce foetal loss (Landesman and Ollstein, 1958). In true preeclampsia hypotensive drugs can only be given late and the results are disappointing. A large number of clinicians still rely on prescribing a sedative and advising bed rest, and of these two methods rest in bed is the least empirical. It is kno...

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Section: Discussionmentioning

confidence: 99%

Controlled Trial of Chlorothiazide in Treatment of Early Pre-eclampsia

Menzies¹

1964

BMJ

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“…med. J., 1966, 2, 333-336 The benzothiadiazine drugs have recently been incriminated as diabetogenic (Wilkins, 1959;Goldner et al, 1960;Sugar, 1961;Zatuchni and Kordasz, 1961;Wilson, 1963;Samaan et al, 1963;Rapoport and Hurd, 1964;Wolff and Parmley, 1964), and the onset of asymptomatic chemical diabetes has often been reported during their use. The related diuretic, chlorthalidone, has also been implicated.…”

Section: Summarmentioning

confidence: 99%

Effect of frusemide on carbohydrate metabolism, blood-pressure, and other modalities. A comparison with chlorothiazide.

Jackson¹,

Nellen²

1966

BMJ

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Ataxia-telangiectasis-Oppenheim et al.BEncsm 333 studies of Oppenheim et al. (1965a) and Moynihan et al. (1965) suggest that the proportions of immunocompetent lymphocytes may be temporarily increased in the peripheral circulation of normal humans and monkeys at such a time. The five ataxia-telangiectasis patients studied here manifested both a selective IgA immunoglobulin deficiency and a failure to react to a number of fungal, viral, parasitic, and mycobacterial antigens. However, they rejected skin homografts and could be sensitized to 2,4-dinitrochlorobenzene in a normal fashion. Therefore they were only partially defective immunologically, and, similarly, their in vitro lymphocyte transformation was only variably and partially impaired.The aetiology of the impaired leucocyte growth in ataxiatelangiectasis patients was investigated by varying the in vitro environment. Only when the patients' cells were cultured in medium with homologous instead of autologous plasma did survival of lymphocytes improve. Both the size and proportions of transforming lymphocytes stimulated with phytohaemagglutinin significantly improved and often approached normal in those cultures employing homologous plasma. However, the response to streptolysin-O and other antigens was not significantly influenced by homologous plasma. Conversely, normal cells were not adversely affected when cultured in the patients' fresh plasma. These findings argue against the presence of a toxic factor in the patients' plasma, but suggest that there may be a partial deficiency of factor(s) necessary for cell growth. The data also suggest that the decreased survival and impaired proliferation of the viable lymphocytes in ataxia-telangiectasis leucocyte cultures may not be due to an intrinsic abnormality of their lymphocytes, but be secondary to some non-lethal genetic deficiency, which can be rectified to some extent by factors present in normal plasma. The identification of these plasma factors, their relationship to clinically expressed immune-incompetence, and the impaired lymphocyte transformation noted in other disorders require further study. SummarThe leucocytes of five patients with typical ataxiatelangiectasis, IgA immunoglobulin deficiency, and partial anergy were repeatedly cultured with phytohaemagglutinin-M and antigens such as streptolysin-O, vaccinia vaccine, and homologous leucocytes. The cultures manifested more damaged lymphocytes and higher macrophage survival than did 18 normal controls. Lymphocyte proliferation, as measured by transformation, mitotic indices, and tritiated thymidine uptake in response to both phytohaemagglutinin and antigens, was significantly impaired. The Brit. med. J., 1966, 2, 333-336 The benzothiadiazine drugs have recently been incriminated as diabetogenic (Wilkins, 1959;Goldner et al., 1960;Sugar, 1961;Zatuchni and Kordasz, 1961;Wilson, 1963;Samaan et al., 1963;Rapoport and Hurd, 1964;Wolff and Parmley, 1964), and the onset of asymptomatic chemical diabetes has often been reported during their use. The...

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“…Σχηματική άπεικόνισις τοϋ νεφρώνος δεικνύουσα τας θέσεις έπα ναρροφήσεως τών ιόντων νατρίου καί άπεκκρίσεως τών ιόντων υδρογόνου καί καλίου. 'Επίσης τάς θέσεις δράσεως της άλδοστερόνης καί τών ανταγωνιστών αυτής (Wilson, 1963).…”

Section: ρύθμισις τοΰ καλίου τοΰ οργανισμούunclassified

Μεταβολαι Του Καλιου Του Ορου Κατα Την Αμφοτεροπλευρον Νεφρεκτομην Και Την Μεταμοσχευσιν Νεφρου: Πειραματικη Και Κλινικη Εργασια

Κρητικοσ¹

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τοΰ παρόντος θέματος και των πολυτίμου συμβουλών του μεγάλως συνέβαλεν εις την εκπόνησιν της παρούσης εργασίας. 'Ωσαύτως θεωρώ υποχρέωσιν όπως εκφράσω θερμας ευχαριστίας προς την Κυρίαν Σ. Καμβύση -Δέα, Α/ντήν του Άναισθησιολογικοΰ Τμήματος τοΰ Γενικού Νοσοκομείου 'Αθηνών «Βάσους Παύλος» τόσον δια την πολύτιμον διδασκαλίαν της κατά τον χρόνον της παρ' αυτή μαθητείας μου προς άπόκτησιν της ειδικό τητος της Άναισθησιολογίας, όσον και δια την βοήθειαν κατά την εκτέλεσιν και συγγραφήν της παρούσης μελέτης. 'Οφείλω επίσης ευχαριστίας προς τον Ύφηγητήν Κύριον Α. Μπίλλην, Α/ντήν της Α' Παθολογικής Κλινικής τοΰ Γενικού Κρατικού Νοσοκομείου 'Αθηνών, τοΰ οποίου ή συμβολή οπήρξεν ιδιαιτέρως πολύτιμος. Δ 2 Ε 2 ΣΤ 2 Ζ 2 Τιμαι καλίου εις δείγματα αίματος mEq/l © ®20< ©20' ©20' ®<θ' ©60' προ της μετά την μετά την μετά την μει μετά την με μετά την αναισθησία »αιοθτισιαν νεφρεκιομην ιαμοοχευοιν ταμοσχευ» αφυπνιοιν 4,1 V 48 4,2

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Diuretics

Cited by 21 publications

References 82 publications

Controlled Trial of Chlorothiazide in Treatment of Early Pre-eclampsia

Controlled Trial of Chlorothiazide in Treatment of Early Pre-eclampsia

Effect of frusemide on carbohydrate metabolism, blood-pressure, and other modalities. A comparison with chlorothiazide.

Μεταβολαι Του Καλιου Του Ορου Κατα Την Αμφοτεροπλευρον Νεφρεκτομην Και Την Μεταμοσχευσιν Νεφρου: Πειραματικη Και Κλινικη Εργασια

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