Anti-hypotensive agents

Amphotericin B is the mainstay of treatment of patients with severe endemic fungal infections. The conventional deoxycholate formulation of the drug can be associated with substantial infusion-related adverse effects (e.g., chills, fever, nausea, rigors, and in rare cases hypotension, flushing, respiratory difficulty, and arrhythmias). Pre-medication with low doses of hydrocortisone, acetaminophen, nonsteroidal anti-inflammatory agents, and meperidine is common to reduce acute infusion-related reactions. Venous irritation associated with the drug can also lead to thrombophlebitis, hence central venous catheters are the preferred route of administration in patients receiving more than a week of therapy. 

Hydrochlorides of dibenzazonines 14b, 106,107, and 108 have been tested by Pecherer and Brossi (29) for analgesic and anti-inflammatory activity, antiappetite and blood pressure effects, and activity against a series of infections. The alkaloid protostephanine (3) exerts a moderately strong and persistent hypotensive effect. Most of the other compounds show some central nervous activity. Independent studies have also found CNS activity for compounds 107, 109, and 110, all of which behave as hypotensive agents (30). 

Diuretics and Hypotensives. One of the side effects of sulfanilamide therapy recognized during the early development of the sulfa drugs as anti-infection agents was the loss of sodium in patients. This observation led to the discovery... 

Nevertheless, in general, the anti-spasmodic potencies of several phthalides in different isolated tissue preparations are relatively weak and their vasorelaxing properties in vitro often fail to translate to hypotensive effects in vivo. The potential benefits of phthalides as anti-hypertensive agents remain to be verified. 

Actions Antibacterial, antiviral, circulatory stimulant, anti-inflammatory, diaphoretic, antispasmodic, antiemetic, antifungal, hypotensive, anti-clotting agent, carminative, antiarthritic, analgesic, antitussive. 

Prostaglandins - The hypotensive action of prostaglandins continues to be of interest as a possible basis for the development of a new type of anti-hypertensive agent. Arterial infusion of FGEg ( 10 M.) reduced the amount of norepinephrine released by nerve stimulation. Such inhibition was suggested as a possible mechanism for its hypotensive effect. ... 

Dried ripe ihiits of Ziziphus are used to tonify the spleen and stomach, moisten heart and lungs, nourish and pacify the spirit, smooA herbal action, and harmonize drugs. The roots have hypotensive effects, and the leaves can decrease the intake of sweets (as a taste-modifier and anti-obesity agent) (52). 

The pyrrolizidines and indolizidines are a group of alkaloids that are characterized by the presence of the basic azabicyclo[3.3.0]octane and azabicyclo[4.3.0]nonane frameworks, respectively. These alkaloids exhibit remarkably diverse types of biological activity and have been reported to act as antitumor, hypotensive, anti-inflammatory, carcinogenic, or hepatoxic agents. Various pyrrolizidines and indolizidines have been prepared by 1,3-dipolar cycloaddition.115 Synthesis of these is described in the section 8.2 discussing cycloaddition. 

Beta-blockers interact with a large number of other medications. The combination of beta-blockers with calcium antagonists should be avoided, given the risk for hypotension and cardiac arrhythmias. Cimetidine, hydralazine, and alcohol all increase blood levels of beta-blockers, whereas rifampicin decreases their concentrations. Beta-blockers may increase blood levels of phenothiazines and other neuroleptics, clonidine, phen-ytoin, anesthetics, lidocaine, epinephrine, monoamine oxidase inhibitors and other antidepressants, benzodiazepines, and thyroxine. Beta-blockers decrease the effects of insulin and oral hypoglycemic agents. Smoking, oral contraceptives, carbamazepine, and nonsteroidal anti-inflammatory analgesics decrease the effects of beta-blockers (Coffey, 1990). 

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