The Influence of Indomethacin on Some Pharmacological Actions of Atenolol

Salvetti, Antonio; Pedrinelli, Roberto; Magagna, Armando; Abdel-Haq, B.

doi:10.1007/978-1-4684-4277-9_27

Cited by 9 publications

(9 citation statements)

References 21 publications

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“…The mechanism(s) by which captopril, when given acutely, reduced blood pressure seems to be mainly the inhibition of angiotensin II generation [8,10,II] and this hypothesis is in agreement with our finding that the acute hypotensive effect of the drug was directly related to basal renin values [11,16] and that its administration significantly increased PRA and reduced aldosterone [10,11,16],…”

Section: Discussionsupporting

confidence: 82%

“…However, it is unclear why the acute administration of this ACE inhibitor did not achieve the same goal [8], considering acute administration of capto pril exerts its hypotensive effect mainly by inhibiting angiotensin II generation [8,10,11], Therefore, we decided to observe whether acute inhi bition of the renin-angiotensin system induced by a single dose of captopril might predict the surgical outcome of patients with renovascular disease.…”

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confidence: 99%

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Acute Response to Captopril as a Predictive Test for Surgery in Renovascular Hypertension

Salvetti

Arzilli

Nuccorini

et al. 1986

Nephron

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To test the hypothesis that acute angiotensin-converting enzyme (ACE) inhibition might predict the postoperative blood pressure outcome, a single oral dose of captopril ranging from 12.5 to 100 mg, was given to 26 patients with renovascular disease and its hypotensive effect was compared with that of surgery (21 patients) or of percutaneous transluminal angioplasty (PTA) (5 patients). Both systolic and diastolic blood pressure fell significantly (p < 0.001) from 179.9 ± 5.4/114.1 ± 2.1 to 148.4 ± 3.8/94.1 ± 1.9 after captopril and to 141.1 ± 3.7/88.9 ± 2.0 at least 3 months after operation. Postoperative pressure values were directly related to those after captopril (SBP: r = 0.65, p < 0.001; DBP: r = 0.45, p < 0.05) as were their absolute decrements (SBP:r = 0.70, p < 0.001 ;DBP:r = 0.64, p < 0.001). However, after captopril, individual pressure tended to be higher (and their decrements to be lower) than after operation. 12 out of 19 patients cured by surgery were considered cured by captopril, while 5 out of the remaining 7 were improved and 2 not cured. The 6 patients improved by surgery or PTA were also improved by captopril and the only patient not cured by surgery was not cured by captopril. Therefore, if we consider both cure and improvement as a positive result, the captopril test gave 23 true-positive, 1 true-negative and 2 false-negative responses. Taken together, these data suggest that acute ACE inhibition may be an useful tool in predicting postoperative blood pressure of patients with renovascular disease.

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Section: Discussionsupporting

confidence: 82%

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confidence: 99%

Acute Response to Captopril as a Predictive Test for Surgery in Renovascular Hypertension

Salvetti

Arzilli

Nuccorini

et al. 1986

Nephron

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“…For example, the antihypertensive efficacy of propranolol (Durao et al, 1977;Watkins et al, 1980), oxprenolol (Salvetti et al, 1982a) and atenolol (Salvetti et al, 1982b) appear to be attenuated by indomethacin. In contrast, other NSAID such as sulindac (Salvetti et al, 1983), naproxen and aspirin (Chalmers et al, 1983) appear not to be implicated in such effects.…”

Section: Introduction Methodsmentioning

confidence: 99%

Flurbiprofen interaction with single doses of atenolol and propranolol.

Webster¹,

Petrie²,

McLean³

et al. 1984

Brit J Clinical Pharma

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“…Prostaglandins Captopril has been demonstrated to increase prostaglandins, possibly through stimulation of bradykinin, and the hypotensive effects are antagonised by indomethacin, particularly in low-renin hypertenClinical pharmacology of enalapril 221S sive patients (Abe et al, 1980;Salvetti et al, 1980;Moore et al, 1981). Several investigators (Fitz et al, 1982;Oparil et al, 1983;Shoback et al, 1983b) have measured the effect of enalapril on various prostaglandin parameters ( following 10 mg enalapril in normal volunteers (Figure 10 (Figure 11).…”

Section: Effect On Plasma Aldosteronementioning

confidence: 99%

An overview of the clinical pharmacology of enalapril.

Rr¹,

Gómez²,

Jd³

et al. 1984

Brit J Clinical Pharma

106

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Enalapril maleate is a prodrug which when administered orally is hydrolysed to release the active converting enzyme inhibitor enalaprilat. Enalapril maleate is 60% absorbed and 40% bioavailable as enalaprilat. Both compounds undergo renal excretion without further metabolism. The functional half‐life for accumulation of enalaprilat is 11 h, and this is increased in the presence of a reduction in renal function. Inhibition of converting enzyme inhibition is associated with reductions in plasma angiotensin II and plasma aldosterone, and with increases in plasma renin activity and plasma angiotensin I. Acute and chronic effects have been reviewed. When given with hydrochlorothiazide, enalapril attenuates the secondary aldosteronism and ameliorates the hypokalaemia from diuretics. Both acutely and chronically in patients with essential hypertension, enalapril reduced blood pressure with a rather flat dose‐response curve. No evidence of a triphasic response such as seen with captopril has been demonstrated with enalapril, and blood pressure returns smoothly to pretreatment levels when the drug is abruptly discontinued. Once‐ or twice‐daily dosing gives similar results. The antihypertensive effects of enalapril are potentiated by hydrochlorothiazide. Haemodynamically, blood pressure reduction is associated with a reduced peripheral vascular resistance and an increase in cardiac output and stroke volume with little change in heart rate. Renal vascular resistance decreases, and renal blood flow may increase without an increase in glomerular filtration in patients with normal renal function. In patients with essential hypertension and glomerular filtration rates below 80 ml/min/m2, both renal blood flow and glomerular filtration rates may increase.

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The Influence of Indomethacin on Some Pharmacological Actions of Atenolol

Cited by 9 publications

References 21 publications

Acute Response to Captopril as a Predictive Test for Surgery in Renovascular Hypertension

Acute Response to Captopril as a Predictive Test for Surgery in Renovascular Hypertension

Flurbiprofen interaction with single doses of atenolol and propranolol.

An overview of the clinical pharmacology of enalapril.

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