Plantago ovata (Isabgol) and Rauvolfia serpentina (Indian Snakeroot)
Azamal Husen in Herbs, Shrubs, and Trees of Potential Medicinal Benefits, 2022
P. ovata seed husk contains a high proportion of polysaccharides. The extracted polysaccharides have been studied as a super disintegrant for fast-dissolving tablets. Valsartan, used for treating hypertension, was the model drug for the study. Tablets with concentration of 7.5% w/w polysaccharide showed rapid wetting and disintegration time when compared with the same concentration of the control Crospovidone, a synthetic super disintegrant (Pawar and Varkhade, 2014). Another study used P. ovata husk powder in the manufacture of orodispersible tablets of the model drug meloxicam. The formulations having lowest wetting and disintegration time with highest water absorption ratio had 16 mg of psyllium husk powder. It outperformed the control and other formulations. Thus, P. ovata can be used in orodispersible tablets and its formulations (Draksiene et al., 2019). The P. ovata husk polysaccharide is inexpensive and nontoxic and has fewer side effects, good stability, patient compliance; it is also highly bioavailable, and manufacture-friendly. Thus, P. ovata could be used as a natural super-disintegrant (Pawar and Varkhade, 2014).
Is too much neurohormonal blockade harmful?
ILEANA PIÑA, SIDNEY GOLDSTEIN, MARK E DUNLAP in The Year in Heart Failure, 2005
rate, did not show any difference in the valsartan or placebo groups of patients who died or were alive at the end of the Val-HeFT study 1381. The only exception was a paradoxical greater beneficial effect of valsartan on brain natriuretic peptide in patients who died. Therefore, changes in the physiological markers of heart failure mortality and morbidity do not appear to explain the unexpected adverse outcome observed in patients with heart failure receiving valsartan in addition to concomitant therapy with ACE inhibitors and 13 blockers. It is therefore likely that the increased mortality seen in the triple therapy group could be due to a play of chance. In contrast, in the CHARM 1331 and VALIANT 1371 trials, no adverse effect of candesartan or valsartan was seen in patients receiving both an ACE inhibitor and 13 blockers, despite a much higher baseline use of 13 blockers (over 50%) than in the Val-HeFT. Indeed, these patients received the same benefit as those not taking ACE inhibitors and/or 13 blockers at baseline. Thus, the initial concern regarding excessive neurohormones with triple therapy does not seem to have been substantiated with later studies. It should be noted, however, that the populations studied in VALIANT and CHARM were different, with the former being a post-myocardial infarction group and the latter a chronic heart failure group.
Retinal Changes
Giuseppe Mancia, Guido Grassi, Konstantinos P. Tsioufis, Anna F. Dominiczak, Enrico Agabiti Rosei in Manual of Hypertension of the European Society of Hypertension, 2019
The analysis of retinal arterioles has lately been extended to assess parameters of retinal capillary rarefaction by the SLDF technique and based on RCF measurements (Figure 34.2). Since the assessment of retinal capillary rarefaction is flow-dependent, a distinction between functional and structural capillary rarefaction is not possible. The measurement includes the assessment of intercapillary distance (defined as distance between two pixels localised in a capillary) and capillary area (32) (Figure 34.2). The first result was, in accordance with the literature reporting of capillary rarefaction in other vascular beds, that patients with arterial hypertension stage 1 or 2 showed capillary rarefaction compared to healthy individuals. In addition, it has been shown that short-term treatment with valsartan in hypertension stage 1 or 2 improves retinal capillary rarefaction to a level that is statistically not different from healthy individuals (33).
The effects of valsartan on scar maturation in an experimental rabbit ear wound model
Published in Journal of Plastic Surgery and Hand Surgery, 2020
Muzaffer Kurt, Funda Akoz Saydam, Mehmet Bozkurt, Merdan Serin, Aysel Caglar
There are number of shortcomings related to the study. Further investigation of the effects of Valsartan on scar formation using polymerase chain reaction, immunohistochemical staining and western blots techniques are essential to shed light on the subject. In addition, we have several concerns regarding the clinical translation of these results. Valsartan is a very well-known and is a relatively safe drug for the treatment of high blood pressure. But despite this there are various side effects of this drug including dizziness, lightheadedness, and headache caused by hypotension and hyperkalemia. Another matter in terms of clinical translation is the dosage of the drug to be used for human subjects. In current clinical practice, 80–320 mg/day of Valsartan are used for the treatment of high blood pressure. Further studies are required to determine the required doses of valsartan for the prevention of pathological scars.
Pharmacokinetic interaction study between ligustrazine and valsartan in rats and its potential mechanism
Published in Pharmaceutical Biology, 2020
Yang Liu, Jiaqi Zhang, Di Wu, Liran Cui
Valsartan is a commonly used drug in cardiac disease with relatively low absolute bioavailability (Jung et al. 2015). Valsartan is usually applied in the treatment of hypertension due to its properties of lowing blood pressure, and it also co-administrated with other drugs to make the treatment more efficient in the clinic (Cheng et al. 2001; Liu et al. 2019a). Previously, the co-administration of valsartan and quercetin could exert greater cardiac protection and this kind of combination affected the pharmacokinetics of valsartan (Challa et al. 2013). The combination of valsartan and amlodipine has been demonstrated to control blood pressure efficiently and the pharmacokinetic and transport of valsartan were influenced by the administration of amlodipine (Cai et al. 2011). The combination of ligustrazine and valsartan has been reported to have a protective effect on hippocampal neuronal loss with vascular dementia (Qin et al. 2011). However, the drug–drug interaction between ligustrazine and valsartan was still unclear.
An evaluation of the fixed-dose combination sacubitril/valsartan for the treatment of arterial hypertension
Published in Expert Opinion on Pharmacotherapy, 2020
Markus Wehland, Ulf Simonsen, Niels Henrik Buus, Marcus Krüger, Daniela Grimm
Upon ingestion, LCZ696 dissociates into the two compounds, valsartan, and sacubitril. Valsartan is an angiotensin II receptor antagonist with high affinity (IC50 = 2.7 nmol/l) to the AT1 receptor [28]. The AT1 receptor is the most abundantly found angiotensin receptor in adults and has been localized in the kidney, the heart, vascular smooth muscle cells, the brain, the adrenal gland, platelets, adipocytes, and placenta. Practically all clinically meaningful effects of angiotensin II are mediated by the AT1 receptors, including vasoconstriction, sodium retention, increased endothelin secretion, vasopressin release, and elevated sympathetic activity, all leading to increased BP by either increased vascular tone or fluid retention [28]. By blocking angiotensin from binding to AT1, valsartan can effectively lower BP. Valsartan treatment increases plasma angiotensin II levels [29], which may lead to activation of cardioprotective AT2, Mas, and AT4 receptors [30] (Figure 2).
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