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Gustaaf A. Dekker - One of the best experts on this subject based on the ideXlab platform.
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Ketanserin versus Dihydralazine in the management of severe early-onset preeclampsia: Maternal outcome
American Journal of Obstetrics and Gynecology, 1999Co-Authors: Antionette C. Bolte, Jim Van Eyck, Herman P. Van Geijn, H H Kanhai, H W Bruinse, Gustaaf A. DekkerAbstract:Abstract Objective: An open, randomized, prospective, multicenter trial was conducted to compare the efficacy and safety of intravenous ketanserin, a selective serotonin 2 receptor blocker, with that of intravenous Dihydralazine in the management of severe early-onset ( Study Design: Patients with a diastolic blood pressure >110 mm Hg were randomly assigned to receive either ketanserin (n = 22) or Dihydralazine (n = 22) as initial therapy. Plasma volume expansion preceded antihypertensive treatment, which was administered according to a fixed schedule. Results: The reductions in blood pressure with the 2 drugs were similar; however, adequate blood pressure control was reached significantly earlier with ketanserin (84 ± 63 vs 171 ± 142 minutes, P = .017). Occurrence of maternal complications was significantly lower among patients who received ketanserin than among patients who received Dihydralazine (n = 6 vs n=18, P = .0007). A significant difference in favor of ketanserin was noted in daily fluid balance. Conclusion: Antihypertensive efficacies of ketanserin and Dihydralazine were comparable, but significantly fewer maternal complications were noted among the patients receiving ketanserin. Ketanserin is an attractive alternative in the management of severe early-onset preeclampsia. (Am J Obstet Gynecol 1999;180:371-7.)
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Ketanserin versus Dihydralazine in the management of severe early-onset preeclampsia: maternal outcome.
American journal of obstetrics and gynecology, 1999Co-Authors: Antionette C. Bolte, Jim Van Eyck, Herman P. Van Geijn, H H Kanhai, H W Bruinse, Gustaaf A. DekkerAbstract:An open, randomized, prospective, multicenter trial was conducted to compare the efficacy and safety of intravenous ketanserin, a selective serotonin 2 receptor blocker, with that of intravenous Dihydralazine in the management of severe early-onset (<32 weeks' gestation) preeclampsia. End points of this study were blood pressure control and maternal outcome. Patients with a diastolic blood pressure >110 mm Hg were randomly assigned to receive either ketanserin (n = 22) or Dihydralazine (n = 22) as initial therapy. Plasma volume expansion preceded antihypertensive treatment, which was administered according to a fixed schedule. The reductions in blood pressure with the 2 drugs were similar; however, adequate blood pressure control was reached significantly earlier with ketanserin (84 +/_ 63 vs 171 +/- 142 minutes, P = .017). Occurrence of maternal complications was significantly lower among patients who received ketanserin than among patients who received Dihydralazine (n = 6 vs n = 18, P =.0007). A significant difference in favor of ketanserin was noted in daily fluid balance. Antihypertensive efficacies of ketanserin and Dihydralazine were comparable, but significantly fewer maternal complications were noted among the patients receiving ketanserin. Ketanserin is an attractive alternative in the management of severe early-onset preeclampsia.
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The haemodynamic effects of ketanserin versus Dihydralazine in severe early-onset hypertension in pregnancy
British journal of obstetrics and gynaecology, 1998Co-Authors: Antionette C. Bolte, Jim Van Eyck, Rob J. M. Strack Van Schijndel, Herman P. Van Geijn, Gustaaf A. DekkerAbstract:Objective To compare the haemodynamic efficacy of ketanserin (a selective serotonin2-receptor blocker) with Dihydralazine in the management of severe early-onset hypertension in pregnancy. Design Subgroup analysis within a randomised prospective multicentre trial to compare haemodynamic effects as measured by pulmonary artery catherization. Setting Departments of Obstetrics and Gynaecology and Intensive Care Medicine, Free University Hospital, Amsterdam and Sophia Hospital, Zwolle. Participants Thirty-one women with a diastolic blood pressure > 110 mmHg and a gestational age between 26 and 32 weeks. Results The antihypertensive efficacy of both drugs was comparable. Dihydralazine significantly increased cardiac output (P < 0.01), while ketanserin induced only minor changes in cardiac output. Systemic vascular resistance decreased in both groups, but the decrease was significantly more pronounced with Dihydralazine compared with ketanserin. Ketanserin induced a significant but not clinically relevant increase in heart rate (P < 0.01, while Dihydralazine caused marked tachycardia (P < 0.005). Left ventricular stroke work index was reduced to similar values in both groups. Conclusions The antihypertensive profile of ketanserin is characterised by an early and gradual reduction of blood pressure in combination with a moderate decrease in systemic vascular resistance and no significant change in cardiac output. Dihydralazine causes market tachycardia resulting in a considerable increase in cardiac output.
Antionette C. Bolte - One of the best experts on this subject based on the ideXlab platform.
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Ketanserin versus Dihydralazine in the management of severe early-onset preeclampsia: Maternal outcome
American Journal of Obstetrics and Gynecology, 1999Co-Authors: Antionette C. Bolte, Jim Van Eyck, Herman P. Van Geijn, H H Kanhai, H W Bruinse, Gustaaf A. DekkerAbstract:Abstract Objective: An open, randomized, prospective, multicenter trial was conducted to compare the efficacy and safety of intravenous ketanserin, a selective serotonin 2 receptor blocker, with that of intravenous Dihydralazine in the management of severe early-onset ( Study Design: Patients with a diastolic blood pressure >110 mm Hg were randomly assigned to receive either ketanserin (n = 22) or Dihydralazine (n = 22) as initial therapy. Plasma volume expansion preceded antihypertensive treatment, which was administered according to a fixed schedule. Results: The reductions in blood pressure with the 2 drugs were similar; however, adequate blood pressure control was reached significantly earlier with ketanserin (84 ± 63 vs 171 ± 142 minutes, P = .017). Occurrence of maternal complications was significantly lower among patients who received ketanserin than among patients who received Dihydralazine (n = 6 vs n=18, P = .0007). A significant difference in favor of ketanserin was noted in daily fluid balance. Conclusion: Antihypertensive efficacies of ketanserin and Dihydralazine were comparable, but significantly fewer maternal complications were noted among the patients receiving ketanserin. Ketanserin is an attractive alternative in the management of severe early-onset preeclampsia. (Am J Obstet Gynecol 1999;180:371-7.)
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Ketanserin versus Dihydralazine in the management of severe early-onset preeclampsia: maternal outcome.
American journal of obstetrics and gynecology, 1999Co-Authors: Antionette C. Bolte, Jim Van Eyck, Herman P. Van Geijn, H H Kanhai, H W Bruinse, Gustaaf A. DekkerAbstract:An open, randomized, prospective, multicenter trial was conducted to compare the efficacy and safety of intravenous ketanserin, a selective serotonin 2 receptor blocker, with that of intravenous Dihydralazine in the management of severe early-onset (<32 weeks' gestation) preeclampsia. End points of this study were blood pressure control and maternal outcome. Patients with a diastolic blood pressure >110 mm Hg were randomly assigned to receive either ketanserin (n = 22) or Dihydralazine (n = 22) as initial therapy. Plasma volume expansion preceded antihypertensive treatment, which was administered according to a fixed schedule. The reductions in blood pressure with the 2 drugs were similar; however, adequate blood pressure control was reached significantly earlier with ketanserin (84 +/_ 63 vs 171 +/- 142 minutes, P = .017). Occurrence of maternal complications was significantly lower among patients who received ketanserin than among patients who received Dihydralazine (n = 6 vs n = 18, P =.0007). A significant difference in favor of ketanserin was noted in daily fluid balance. Antihypertensive efficacies of ketanserin and Dihydralazine were comparable, but significantly fewer maternal complications were noted among the patients receiving ketanserin. Ketanserin is an attractive alternative in the management of severe early-onset preeclampsia.
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The haemodynamic effects of ketanserin versus Dihydralazine in severe early-onset hypertension in pregnancy
British journal of obstetrics and gynaecology, 1998Co-Authors: Antionette C. Bolte, Jim Van Eyck, Rob J. M. Strack Van Schijndel, Herman P. Van Geijn, Gustaaf A. DekkerAbstract:Objective To compare the haemodynamic efficacy of ketanserin (a selective serotonin2-receptor blocker) with Dihydralazine in the management of severe early-onset hypertension in pregnancy. Design Subgroup analysis within a randomised prospective multicentre trial to compare haemodynamic effects as measured by pulmonary artery catherization. Setting Departments of Obstetrics and Gynaecology and Intensive Care Medicine, Free University Hospital, Amsterdam and Sophia Hospital, Zwolle. Participants Thirty-one women with a diastolic blood pressure > 110 mmHg and a gestational age between 26 and 32 weeks. Results The antihypertensive efficacy of both drugs was comparable. Dihydralazine significantly increased cardiac output (P < 0.01), while ketanserin induced only minor changes in cardiac output. Systemic vascular resistance decreased in both groups, but the decrease was significantly more pronounced with Dihydralazine compared with ketanserin. Ketanserin induced a significant but not clinically relevant increase in heart rate (P < 0.01, while Dihydralazine caused marked tachycardia (P < 0.005). Left ventricular stroke work index was reduced to similar values in both groups. Conclusions The antihypertensive profile of ketanserin is characterised by an early and gradual reduction of blood pressure in combination with a moderate decrease in systemic vascular resistance and no significant change in cardiac output. Dihydralazine causes market tachycardia resulting in a considerable increase in cardiac output.
G Bastert - One of the best experts on this subject based on the ideXlab platform.
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auswirkungen von urapidil in der antihypertensiven therapie bei praeklampsie auf die neugeborenen
Zentralblatt Fur Gynakologie, 2001Co-Authors: M Schulz, J Wacker, G BastertAbstract:OBJECTIVE For the therapy of preeclamptic patients is Urapidil besides Dihydralazine another possible option for iv-therapy with good results in first clinical studies. Effects of both drugs on the newborns were observed. - METHODS The maternal and fetal Urapidil plasma-concentrations and cardiovascular parameters of the newborns were observed in a randomised comparative therapy-study. - RESULTS We found low fetal Urapidil plasma-concentrations as well as a less influence on cardiovascular parameters compared to Dihydralazine. - DISCUSSION With Urapaidil we have another therapeutic option in preeclampsia where we could not show any negative side-effects on the newborns.
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treatment of hypertension in patients with pre eclampsia a prospective parallel group study comparing Dihydralazine with urapidil
Nephrology Dialysis Transplantation, 1998Co-Authors: J Wacker, P Werner, Ingeborg Waltersack, G BastertAbstract:BACKGROUND The primary objective of treatment in women with severe hypertension and pre-eclampsia is to prevent complications such as encephalopathy and haemorrhage. In many countries Dihydralazine is considered the drug of choice for treating hypertension in pregnancy, because it now has been used safely for about 30 years, and the introduction of a new drug in pregnancy is a difficult task with partially unknown hazards. In some other countries combined alpha- and beta-blockers are also used. Taking into account that some patients with pre-eclampsia do not respond to Dihydralazine and the drug has serious side-effects like headache and reflex tachycardia, there is some need for developing alternative treatment strategies using drugs that are more adequate for pregnancy than Dihydralazine. METHODS Urapidil is a post-synaptic alpha 1 adrenoceptor antagonist, which is widely used to control hypertensive crises unrelated to pregnancy. Since it is known that pre-eclampsia is associated with increased sympathetic activity, administration of an alpha 1 adrenoceptor antagonist provides a reasonable therapeutic basis. So far there is only one report describing the i.v. use of urapidil in the treatment of hypertension in pregnancy unresponsive to Dihydralazine and one report which describes the oral use of urapidil. In an earlier pilot study we examined the dose range for i.v. application of urapidil necessary for adequate blood pressure control in patients with pre-eclampsia. In the present randomized controlled study 26 white women with pre-eclampsia and hypertension in pregnancy were included. Treatment was not blinded. During the initial period of intensive intravenous treatment all subjects were under constant surveillance by a physician and a nurse. RESULTS Effective prolonged control of blood pressure (values below 150/100 mmHg) was achieved in all patients of the two groups. In one patient of the Dihydralazine group signs of lightheadedness and near syncope were noted. After this side-effect of Dihydralazine the patient was treated with urapidil. At the end of the observation period the maternal heart rate in the Dihydralazine group was higher than in the urapidil group. CONCLUSIONS Since urapidil decreased the high blood pressure in patients with pre-eclampsia without serious side-effects urapidil appears preferable superior to Dihydralazine. The haemodynamic effects of urapidil were more predictable than those of Dihydralazine. The reduction of intracerebral pressure could be an additional advantage of urapidil in the treatment of patients with pre-eclampsia.
Jean-marc Pequignot - One of the best experts on this subject based on the ideXlab platform.
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Regional specificity of long-term regulation of tyrosine hydroxylase in some catecholaminergic rat brainstem areas. II. Effect of a chronic Dihydralazine treatment
Brain research, 1993Co-Authors: Pierre Schmitt, Jean-marc Pequignot, F. Hanchin, Jean-françois PujolAbstract:Abstract Dihydralazine, which is used in the treatment of hypertension, causes a long-lasting hypotensive action by a direct vasodilator effect on arteriolar smooth muscle. The present study was carried out to investigate the effect of a daily single injection of Dihydralazine (20 mg/kg, s.c.) for 14 days on the tyrosine hydroxylase (TH) protein quantity in some catecholaminergic rat brainstem areas such as the dorsomedial medulla (DMM), the ventrolateral medulla (VLM) and the locus coeruleus (LC). This study demonstrates that the Dihydralazine produced (1) an 85% increase in TH protein quantity exclusively in the rostral part of DMM, (2) a 58% increase of TH protein content exclusively in the rostral part of the LC, and (3) a 37% increase of the TH protein quantity in VLM catecholaminergic area. To determine whether the increase in TH protein quantity could be related to a change in norepinephrine (NE) content, the rate constant of disappearance ( k ) of NE was measured in the catecholaminergic regions of the same rats treated with Dihydralazine. Our results show that Dihydralazine causes an increase of the TH protein, in addition to an elevation of NE content, within the subpopulations of catecholaminergic strctures. These data suggest a selective response of the TH regulation to Dihydralazine within the rostral DMM area which receives barosensory inputs.
Herman P. Van Geijn - One of the best experts on this subject based on the ideXlab platform.
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Ketanserin versus Dihydralazine in the management of severe early-onset preeclampsia: Maternal outcome
American Journal of Obstetrics and Gynecology, 1999Co-Authors: Antionette C. Bolte, Jim Van Eyck, Herman P. Van Geijn, H H Kanhai, H W Bruinse, Gustaaf A. DekkerAbstract:Abstract Objective: An open, randomized, prospective, multicenter trial was conducted to compare the efficacy and safety of intravenous ketanserin, a selective serotonin 2 receptor blocker, with that of intravenous Dihydralazine in the management of severe early-onset ( Study Design: Patients with a diastolic blood pressure >110 mm Hg were randomly assigned to receive either ketanserin (n = 22) or Dihydralazine (n = 22) as initial therapy. Plasma volume expansion preceded antihypertensive treatment, which was administered according to a fixed schedule. Results: The reductions in blood pressure with the 2 drugs were similar; however, adequate blood pressure control was reached significantly earlier with ketanserin (84 ± 63 vs 171 ± 142 minutes, P = .017). Occurrence of maternal complications was significantly lower among patients who received ketanserin than among patients who received Dihydralazine (n = 6 vs n=18, P = .0007). A significant difference in favor of ketanserin was noted in daily fluid balance. Conclusion: Antihypertensive efficacies of ketanserin and Dihydralazine were comparable, but significantly fewer maternal complications were noted among the patients receiving ketanserin. Ketanserin is an attractive alternative in the management of severe early-onset preeclampsia. (Am J Obstet Gynecol 1999;180:371-7.)
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Ketanserin versus Dihydralazine in the management of severe early-onset preeclampsia: maternal outcome.
American journal of obstetrics and gynecology, 1999Co-Authors: Antionette C. Bolte, Jim Van Eyck, Herman P. Van Geijn, H H Kanhai, H W Bruinse, Gustaaf A. DekkerAbstract:An open, randomized, prospective, multicenter trial was conducted to compare the efficacy and safety of intravenous ketanserin, a selective serotonin 2 receptor blocker, with that of intravenous Dihydralazine in the management of severe early-onset (<32 weeks' gestation) preeclampsia. End points of this study were blood pressure control and maternal outcome. Patients with a diastolic blood pressure >110 mm Hg were randomly assigned to receive either ketanserin (n = 22) or Dihydralazine (n = 22) as initial therapy. Plasma volume expansion preceded antihypertensive treatment, which was administered according to a fixed schedule. The reductions in blood pressure with the 2 drugs were similar; however, adequate blood pressure control was reached significantly earlier with ketanserin (84 +/_ 63 vs 171 +/- 142 minutes, P = .017). Occurrence of maternal complications was significantly lower among patients who received ketanserin than among patients who received Dihydralazine (n = 6 vs n = 18, P =.0007). A significant difference in favor of ketanserin was noted in daily fluid balance. Antihypertensive efficacies of ketanserin and Dihydralazine were comparable, but significantly fewer maternal complications were noted among the patients receiving ketanserin. Ketanserin is an attractive alternative in the management of severe early-onset preeclampsia.
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The haemodynamic effects of ketanserin versus Dihydralazine in severe early-onset hypertension in pregnancy
British journal of obstetrics and gynaecology, 1998Co-Authors: Antionette C. Bolte, Jim Van Eyck, Rob J. M. Strack Van Schijndel, Herman P. Van Geijn, Gustaaf A. DekkerAbstract:Objective To compare the haemodynamic efficacy of ketanserin (a selective serotonin2-receptor blocker) with Dihydralazine in the management of severe early-onset hypertension in pregnancy. Design Subgroup analysis within a randomised prospective multicentre trial to compare haemodynamic effects as measured by pulmonary artery catherization. Setting Departments of Obstetrics and Gynaecology and Intensive Care Medicine, Free University Hospital, Amsterdam and Sophia Hospital, Zwolle. Participants Thirty-one women with a diastolic blood pressure > 110 mmHg and a gestational age between 26 and 32 weeks. Results The antihypertensive efficacy of both drugs was comparable. Dihydralazine significantly increased cardiac output (P < 0.01), while ketanserin induced only minor changes in cardiac output. Systemic vascular resistance decreased in both groups, but the decrease was significantly more pronounced with Dihydralazine compared with ketanserin. Ketanserin induced a significant but not clinically relevant increase in heart rate (P < 0.01, while Dihydralazine caused marked tachycardia (P < 0.005). Left ventricular stroke work index was reduced to similar values in both groups. Conclusions The antihypertensive profile of ketanserin is characterised by an early and gradual reduction of blood pressure in combination with a moderate decrease in systemic vascular resistance and no significant change in cardiac output. Dihydralazine causes market tachycardia resulting in a considerable increase in cardiac output.