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Captopril 10 Indice

The quinine-catalyzed reaction of thiolacetic acid with methyl methacrylate has been studied in several laboratories, but no results have been published, probably because of its potential importance in the commercial synthesis of (- )-Captopril (59). Indications are that optical yields of 20 to 30% can be achieved. [Pg.107]

Captopril, as well as other ACE inhibitors, is indicated in the treatment of hypertension, congestive heart failure, left ventricular dysfunction after a myocardial infarction, and diabetic nephropathy. In the treatment of essential hypertension, captopril is considered first-choice therapy, either alone or in combination with a thiazide diuretic. Decreases in blood pressure are primarily attributed to decreased total peripheral resistance or afterload. An advantage of combining captopril therapy with a conventional thiazide diuretic is that the thiazide-induced hypokalemia is minimized in the presence of ACE inhibition, since there is a marked decrease in angiotensin Il-induced aldosterone release. [Pg.212]

Drug Class Angiotensin-converting enzyme [ACE] inhibitors Suffix -pril Common Examples Captopril, enalapril Primary Indication or Desired Effect (Chapter in Parentheses) Antihypertensive [21], congestive heart failure [24]... [Pg.657]

Studies with [35S]- and [14C]-captopril have indicated complex and extensive metabolism. The disulfide dimer of captopril is observed, as well as mixed disulfides with cysteine, N-acctylcysteine, and glutathione. There is covalent reversible binding to plasma proteins, which is similarly considered to involve disulfide linkages. S-Methylcaptopril and its sulfoxide are also formed (105). [Pg.26]

The main argument in favor of a beneficial effect of ACE inhibition on coronary heart diseases comes from the pooled results of the SOLVE) treatment trial, the SOLVE) prevention trial, and the SAVE, AIRE, and TRACE studies, which indicate a 21% (95% Cl, 11-29%, p <. 001) relative risk reduction for myocardial infarction associated with ACE inhibitor therapy. Enalapril (SOLVE)) significantly reduced hospitalization for unstable angina, and captopril (SAVE) reduced revascularization procedures (291). In patients treated for 38 to 42 months with enalapril or captopril and selected on the basis of a reduction in ejection fraction with or without heart failure, it is necessary to treat 49 patients to avoid one myocardial infarction (95% Cl 32-117). [Pg.52]

In one of the earliest reports it was shown that not only captopril but also minoxidil caused GFR to decrease in a patient with a transplant renal artery stenosis [23], suggesting that it was the fall in blood pressure itself, which caused the reduced GFR. However, in other studies it was found that GFR decreased only during treatment with captopril and enalapril [24] whereas a fall in blood pressure during sodium nitroprusside [25] or minoxidil [26, 27], which do not directly interfere with the renin-angiotensin system, did not result in a decline in GFR. Furthermore, studies from Anderson et al. indicated that during infusion of... [Pg.485]

Angiotensin-converting enzyme (ACE) inhibitors have been important therapeutic tools in human cardiology since the introduction of captopril in the 1970s. Since that time, their use has become universal in canine and feline medicine, with ever-increasing indications however, to date, these drugs have received relatively little attention in equine cardiology. [Pg.212]

First reports on the pharmacokinetics of captopril in man indicate that it is well absorbed orally and is excreted largely unchanged with a... [Pg.63]

Routine laboratory tests may help to identify secondary hypertension. Baseline hypokalemia may suggest mineralocorticoid-induced hypertension. Protein, blood cells, and casts in the urine may indicate renovascular disease. Some laboratory tests are used specifically to diagnose secondary hypertension. These include plasma norepinephrine and urinary metanephrine concentrations for pheochromocytoma, plasma and urinary aldosterone concentrations for primary aldosteronism, and plasma renin activity, captopril stimulation test, renal vein renins, and renal artery angiography for renovascular disease. [Pg.192]

The most common cause of heart failure is ischemic heart disease, where MI results in loss of myocytes, followed by ventricular dilatation and remodeling. Captopril, ramipril, and trandolapril all have been shown to benefit post-MI patients whether they are initiated early (within 36 hours) and continued for 4 to 6 weeks or started later and administered for several years. Collectively, these studies indicate that ACE inhibitors after MI improve overall survival, decrease the development of severe heart failure, and reduce reinfarction and heart failure hospitalization rates. The benefit occurs within the first few days of therapy and persists during long-term treatment. The effects are most pronounced in higher-risk patients, such as those with symptomatic heart failure or reduced EFs, with 20% to 30% reductions in mortality reported in these patients. Post-MI patients without heart failure symptoms or decreases in EF also benefit from ACE inhibitors, but the magnitude of this effect is less pronounced, with all-cause mortality reduced by 7% to 11%. ... [Pg.233]

Initial studies indicate that ARBs and ACE inhibitors produce similar hemodynamic effects and that combination therapy improves exercise capacity, ventricular function, quality of life, and neurohormones in heart failure patients. The ELITE II trial was the first to compare the effects of an ARB (losartan) with those of an ACE inhibitor (captopril) on all-cause mortality in patients with NYHA class II-IV heart failure. No significant difference in mortahty between the two groups was observed, although losartan was better tolerated than captopril. The Val-HeFT trial evaluated whether the addition of valsartan to standard background heart failure therapy (which included an ACE inhibitor in 93% and a /3-blocker in 35% of patients) improved survival. The addition of valsartan had no effect on all-cause mortality but produced a 13% reduction in morbidity and mortality (principally due to reductions in heart failure hospitalizations). Subgroup analysis showed that the benefits were greatest in... [Pg.238]

At this time, there is no evidence to suggest advantage of one ACE inhibitor over another. Their effects appear to be a class effect. Initial doses should be small to moderate in order to avoid hypotension, especially if the patient examination does not indicate volume overload. Examples of initial starting doses are captopril 6.25 mg three times daily, enalapril 2.5 mg/day, or lisinopril 2.5 mg/day. [Pg.364]

Captopril, an angiotensin-converting enzyme inhibitor (ACE), is indicated in the management of hypertension by itself or in combination with other antihypertensive medications, in heart failure when the patients have not responded adequately to digitalis, after myocardial infarction associated with left ventricular dysfunction, and in diabetic nephropathy (Figure 25). [Pg.130]

Chan, D.S. Sato, A.K. Claybaugh, J.R. Degradation of captopril in solutions compounded from tablets and standard powder. Am. J.Hosp.Pharm., 1994,51,1205-1207 [stability-indicating tablets powder] Wakabayashi, H. Yamato, S. Nakajima, M. Shimada, K. Application of an electrochemical detector with a graphite electrode to liquid chromatographic determination of penicillamine and captopril in biological samples. J.Pharm.Biomed.Anal., 1994, 12, 1147-1152 [rat serum liver kidney SPE electrochemical detection LOD 20-300 pg, extracted penicillamine homocysteine (IS)]... [Pg.222]

The client diagnosed with high blood pressure is ordered the angiotensin-converting enzyme inhibitor captopril (Capoten). Which statement by the client indicates to the nurse that the discharge teaching has been effective ... [Pg.48]


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See also in sourсe #XX -- [ Pg.547 ]




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