Evaluation of the Relative Incidence of Adverse Effects Leading to Treatment Discontinuation of Recommended Antihypertensive Drugs

Abstract

This study aimed at evaluating the incidence of adverse effects leading to treatment discontinuation of antihypertensive drugs within the same therapeutic class. Individual medical records were searched to identify those hypertensive patients who had been commenced on antihypertensive therapy during a 24-month period and who had subsequently for a reason(s) discontinued the therapy. The results showed variation in discontinuation rates for drugs within same class, and that might be related to the relative frequency of specific adverse effects. Cough was the reason cited for discontinuation of angiotensin converting enzyme inhibitors, with linosopril appearing to be better tolerated than captopril (39% vs 48%) ; peripheral oedema with calcium channel blockers, with amlodipine appearing to be better tolerated than nifedipine (29% vs 38%) and bradycardia with beta adrenergic receptor blockers, with propranolol better tolerated than atenolol (0% vs 48%). Diuretics showed the lowest discontinuation rate (3.3%) mainly due to hypokalemia, with thiazide better tolerated than frusemide (11% vs 43%). Prescribers should verify their use of antihypertensive drugs to ensure that they prescribe drugs with lower adverse effect rates, in order that patients with hypertension continue using the medication in the long term, thereby reducing the risk of developing cardiovascular complications associated with uncontrolled blood pressure.

Adverse drug reactions of antihypertensive agents at tertiary care hospital in central Nepal

“…This finding is supported by the study of Ibn et al 9 The commonest CNS complaint was dizziness. Others are headache and insomnia.…”

A UV spectrophotometric method for the determination of folic acid in pharmaceutical tablets and dissolution tests

“…The UV spectrum of folic acid solutions is known to be severely affected by pH changes. 18 To analyse the pH effect, six folic acid solutions with different pH's were tested: 0.875 ml of a folic acid stock solution (500.00 mg ml À1 ) was diluted to a volume of 25 ml with 0.10 mol l À1 of phosphate buffer to obtain working standard solutions with a pH range between pH 7.0 and pH 9.5 with pH increments of 0.5 and a concentration of 17.50 mg ml À1 . These solutions were measured on a UV spectrophotometer at a temperature of 25 C (controlled room temperature).…”

Sensitive Electrochemical Determination of Folic Acid Using ex–situ Prepared Bismuth Film Electrodes

“…[4] Due to importance of FA in human health, methods for its determination have been received increasing interest Beside traditional microbiological methods, based on Lactobacillus rhamnosus, other analytical methods have been proposed for the detection and quantification of folic acid such as: high-performance liquid chromatography (HPLC) combined with UV detection, [5,6,7,8] ion-pair based liquid chromatography (IP-LC) using mass spectroscopy, [9,10] capillary electrophoresis with mass spectrometry, [11] UV spectrophotometer, [12] flow injection chemiluminescence, [13] commercially available enzyme-linked immunosorbent assay (ELISA) test and fluorometric method. [14] However, some of the above mentioned methods are nonspecific and laborious, also needed harmful and expensive substances which in combination with long-time sample preparation and well-trained operators drastically increased the time and cost of analysis.…”