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Abstract Purpose Antihypertensive drugs are one of the most commonly prescribed drugs during pregnancy. Both Methyldopa, labetalol, and nifedipine have been shown to be safe to use during breastfeeding and are therefore included in international guidelines on hypertension treatment. Based on this review, 67 full-text papers were deemed out to maintain 30 PK reports, two of which featured methyldopa, 12 labetalol, and 16 nifedipine. No fetal deposits have been found for any of the antihypertensive drugs tested. Conclusion We conclude that despite decades of prescribing methyldopa, labetalol, and nifedipine during pregnancy, descriptions of their PK during pregnancy are hampered by a large number of available studies. Aiming for evidence-based and personalized dosing of antihypertensive drugs in the future, Aiming for evidence-based and personalized dosing of antihypertensive drugs, further research into pregnancy and pregnancy-related pathology is urgently required to avoid unnecessary prescription, overtreatment, and side effects.
Source link: https://doi.org/10.1007/s00228-022-03382-3
SBP values decreased from 94 u00b1 2 to 83 mm Hg at the end of pregnancy, and CCR increased dramatically. When compared to P rats, NAME rats had significantly lower CCR values and increased urinary excretion at the end of pregnancy. In P and P rats treated with methyldopa, UNO 3 boosted significantly in P and P rats. Diltiazem dropped SBP by a significant degree, but had no effect on renal function or UNO 3 and daltroban had no effect, but UNO 3 and daltroban had no effect. Conclusion: The increased UNO 3 content in NAME rats treated with methyldopa has shown that the increased sympathetic activity may be partially attributed to increased sympathetic activity. The effectiveness of the sympathetic antagonist methyldopa may not only be due to its antihypertensive results but also its stimulating effect on NO synthesis, contributing to an improvement in renal function.
Source link: https://doi.org/10.1159/000046020
Methyldopa is used for pregnancy hypertension therapy. Many medications cause anemia by triggering suicidal erythrocyte death or eryptosis, which is characterized by cell shrinkage and cell membrane scrambling, and cell membrane scrambling, leading to phosphatidylserine exposure at the erythrocyte surface. Increased cytosolic Ca 2+ concentration and ceramide are among the causes of erythrocyte membrane scrambling. The present research investigated whether eryptosis could be triggered by methyldopa. Methyldopa did not improve [Ca 2+ ], but it led to an increase in ceramide formation that culminated in significant phosphatidylserine exposure and cell shrinkage in higher doses.
Source link: https://doi.org/10.1159/000153250
Objects: Although magnesium is now the drug of choice for the prevention of eclamptic seizures, only few studies have investigated whether magnesium can reduce blood pressure in pregnancies with hypertension. The therapy involved a 48-hour magnesium infusion followed by oral magnesium tablets until three days after delivery, or 250 mg methyldopa 4 times a day in a similar period. Patients treated with magnesium had a statistically significant lower systolic blood pressure one day after introduction compared to the methyldopa group's level, but no difference was found in diastolic blood pressure. Both systolic and diastolic blood pressure levels were lower in the magnesium group in comparison to the methyldopa group, according to a single analysis that included all blood pressure measurements in a single study. Conclusion: Magne magnesium therapy reduces blood pressure in pregnancies with hypertension that are difficult.
Source link: https://doi.org/10.1159/000010265
Following the introduction of a new dual-release and conventional slow-release levodopa/benserazide in a dose ratio of 4:1, the goal was to determine the single- and multiple-dose pharmacokinetics of levodopa and 3-O-methyldopa. The first dose of 200 mg levopa and 50 mg benserazide was administered on day 1, u2019125 mg t. i. d. The pharmacokinetics of levodopa after a single-dose administration of Madopar DR and Madopar HBS were highly different, as shown by the respective mean values of maximum plasma concentration, time to reach maximum concentration, and area under the plasma concentration-time curve. The observed differences in C max, t max, and AUC are linear, with a faster rate and greater amount of levodopa absorption following Madopar DR's administration. The kinetic results showed that Madopar DR is not bioequivalent to Madopar HBS, according to a sturgeon.
Source link: https://doi.org/10.1159/000067025
In this paper, we present a biomarker discovery approach that has been applied to the plasma of 172 NB patients. Plasma samples from a first cohort of NB patients and age-matched healthy controls were used for untargeted metabolomics analysis based on high-resolution mass spectrometry. Among them, 3-O-methyldopa was tested in a second cohort of NB patients using a targeted metabolite profiling strategy, and its prognostic ability was also evaluated by survival analysis on patients with a three-year follow-up. High expression of 3-O-MD was correlated with poorer prognosis in the subset of patients with stage M tumor, and, among them, it was established as a prognostic factor with the ability to stratify high-risk patients older than 18 months. 3-O-MD may be considered as a novel prognostic biomarker of NB who is eligible to be included at diagnosis among catecholamine metabolite panels in prospective clinical trials.
Source link: https://doi.org/10.3389/fonc.2022.845936
In a hypertensive crisis of acute cardiac dysfunction, a 2-week-old infant with normal intracardiac anatomy presented to the emergency department with a rapid heart arrest. Although the rebound hypertensive effects of u03b1-adrenergic agonists in the adult population are well established, this study shows unexpected adverse phenotype of methyldopa in utero.
Source link: https://doi.org/10.1542/peds.2013-1438
This prospective observational cohort study was designed to determine the prevalence of major birth defects and spontaneous abortions among women with methyldopa therapy for persistent hypertension in women. According to the German Embryotox pharmacovigilance institute, outcomes of 261 pregnancies in the first trimester of chronic hypertension were assessed in comparison pregnancies without persistent hypertension. Compared to the comparison cohort, the prevalence of major birth defects in the exposed cohort was not significantly different than that of the comparison cohort. In the methyldopa group, the risk of preterm birth was significantly higher, and adjusted birth weight scores were significantly lower. In a sensitivity review comparing monotherapies with methyldopa to metoprolol, there were no signs of an elevated risk of birth defects or rise in early pregnancy loss, no evidence for growth limitation or a decreased head circumference.
Source link: https://doi.org/10.1161/hypertensionaha.117.09110
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