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Lupus erythematosus syndrome induced by drugs
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Within 1 year after the introduction of hydralazine to control malignant hypertension in 1952, the first report appeared of a late-onset ‘collagen disease’ resembling systemic lupus erythematosus (SLE) in 17 out of 211 hydralazine-treated patients.1 Although procainamide was introduced for the treatment of cardiac arrhythmia at about the same time, it was not until 1962 that Ladd reported a patient who developed lupus-like features after 6 months of procainamide therapy.2 By 1966 a scattering of cases of lupus-like disease as a side-effect of therapy with isonizid, diphenylhydantoin, sulfamethoxypyradazine, primidone and tetracycline appeared. In the ensuing years a diverse array of more than 50 different drugs has been implicated in the de-novo development of autoantibodies and clinical features similar to those seen in patients with idiopathic SLE.
Integrated Omics Technology for Basic and Clinical Research
Published in Jyoti Ranjan Rout, Rout George Kerry, Abinash Dutta, Biotechnological Advances for Microbiology, Molecular Biology, and Nanotechnology, 2022
Kuldeep Giri, Vinod Singh Bisht, Sudipa Maity, Kiran Ambatipudi
Cardiovascular diseases, a general term used to specify the ailment of heart vessels and blood pumping effort, include angina and heart stroke—causing significant mortality in developed as well as developing countries. Certain drugs such as carvedilol, isosorbide-dinitrate and hydralazine (Bidil), metoprolol, and warfarin have been the choice of drugs for effective treatment by clinicians. Similarly, treatment of infectious diseases such as Hepatitis, HIV, leprosy, and tuberculosis, drugs such as Abacavir, Boceprevir, Dapsone, and Isoniazid respectively, have been successfully implemented to target certain biomarkers (e.g., HLA-B57:01, IFNL3, G6PD, and NAT1; NAT2) (Weinshilboum and Wang, 2017).
Composition of Proprietary Products Approved in the United States
Published in Sarfaraz K. Niazi, Handbook of Pharmaceutical Manufacturing Formulations, Third Edition, 2019
BiDil is a fixed-dose combination of isosorbide dinitrate and hydralazine hydrochloride. Each BiDil tablet for oral administration contains 20 mg of isosorbide dinitrate and 37.5 mg of hydralazine hydrochloride. The inactive ingredients in BiDil tablets include anhydrous lactose, microcrystalline cellulose, sodium starch glycolate, colloidal silicon dioxide, magnesium stearate, hypromellose, FD&C Yellow No. 6 Aluminum Lake, polyethylene glycol, titanium dioxide, and polysorbate 80.
Optimizer Smart System for the treatment of chronic heart failure: Overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2021
Habib Hymie Chera, Mohammed Al-Sadawi, Nickolaos Michelakis, Michael Spinelli
HF is classified based on left ventricular ejection fraction (EF) into HF with reduced EF (HFrEF; EF < 40%), HF with mid‐range EF (HFmrEF; EF 40–49%) and HFpEF (EF ≥ 50%). (9) HFmrEF and HFpEF management is limited in terms of medical and device therapies. The American heart Association/American College of Cardiology (AHA/ACC) classify HF into four stages: stage A: patients with no structural heart disease but at risk of HF; stage B: patients with structural heart disease but no clinical symptoms of HF; stage C: patients who have structural heart disease and have HF symptoms; stage D: patients with refractory HF necessitating the use of advanced intervention. Several pharmacological and device therapies for HFrEF management are associated with a reduced mortality and improved quality of life. Beta-blockers, angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARBs), and aldosterone antagonists are considered the optimal medical treatments for HFrEF and are recommended by the appropriate guidelines [1,8]. Combination of hydralazine and isosorbide dinitrate is effective in African American patients with HFrEF and is recommended by guidelines in stage C patients already on background optimal medical therapy [8,9]. Loop diuretics are associated with improved quality of life but not a reduction of mortality [10]. Combination of valsartan and neprilysin inhibitor (sacubitril) is associated with a reduction of HF hospitalization and cardiovascular mortality and has been added to HF management guidelines [11]. The sinoatrial nodal pacing inward funny current blocker, ivabradine, showed a reduction in the composite outcome of mortality and rehospitalization in patients with HFrEF who are in sinus rhythm with a heart rate above 70 bpm [12]. Sodium‐glucose cotransporter‐2 (SGLT‐2) inhibitors were found to decrease mortality in HFrEF in DAPA-HF and DEFINE-HF trials [13,14] (Figure 1-5).
Interatrial shunts: technical approaches to percutaneous closure
Published in Expert Review of Medical Devices, 2018
Gianluca Rigatelli, Marco Zuin, Nguyen Tuong Nghia
Despite the fact that transcatheter device closure is a safe and efficient treatment, even in the long term, some procedural complications may occur. Firstly, the use of general anesthesia, which is generally performed in children, is related to the well-known intra-procedural risks. Conversely, adult patients are generally premedicated with conscious sedation or in some cases with deep sedation. However, the diffusion of ICE has drastically limited the use of general anesthesia in these patients, since TEE is not required for the procedure. Moreover, as any other interventional cardiac procedure, vessel or cardiac perforation, pericardial effusion or cardiac tamponade and endocarditis have been rarely reported [54]. The risk of contrast reactions, which could be prevented in most of cases with an adequate prophylactic administration (either oral or intravenous) of an H-1 receptor antagonist or corticosteroids, is generally low. However, the procedure is generally performed electively, so a careful anamnestic evaluation is mandatory to assess potential risk factors for either anaphylactoid or non-anaphylactoidreactions, especially in patients with atopic tendencies. Moreover, patients with a previous history of sickle cell disease, polycythemia, paraproteinemias, diabetes mellitus, chronic kidney disease or in treatment with b-blockers, interleukin-2 or nephrotoxic agents as nonsteroidal anti-inflammatories, methotrexate, aminoglycosides, biguanides and hydralazine, should be adequately prepared before the procedure and administration of contrast medium. Complications related to the vascular access, which are unusual as the vein is a low-pressure district, are still possible. Haematomas are generally self-imitating and rarely require blood transfusions. Similarly, retroperitoneal hematomas have been rarely described for inadvertent arterial puncture. Device embolization or malposition depend on anatomical properties, careful evaluation of the device’s size and expertise of the operator. These adverse events could be managed by surgical retrieval or using an endovascular technique. Arrhythmias are another possible common complication. The most frequently observed is AF which could require pharmacological or electrical cardioversion, followed by atrio-ventricular blocks and paroxysmal supraventricular tachycardia. Ventricular arrhythmias are rare but should promptly managed in the cath-lab.