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Tolerance and Side Effects During Long Term Treatment of Hypertension with Debrisoquine
Author(s) -
Jackson W. B.
Publication year - 1972
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1972.tb03937.x
Subject(s) - debrisoquine , medicine , grading (engineering) , blood pressure , drug , drug tolerance , surgery , pharmacology , civil engineering , cyp2d6 , cytochrome p450 , metabolism , engineering
Summary: One hundred and fifty patients completing from twelve to seventy‐five months treatment with debrisoquine were assessed from the point of therapeutic efficacy, drug tolerance and side effects. Despite strict criteria in grading results, a satisfactory blood pressure response to debrisoquine was achieved in 80% of patients. No toxic effects were found, and only 2% of subjects stopped treatment because of side effects. Increase in drug requirement occurred in nearly half the series when assessed from the sixth to final month of treatment. Drug tolerance in this sense was most marked in the first year. With treatment over three years, progressively fewer patients needed drug increments, and if needed increments were smaller. Tolerance was of clinical significance in only four patients, and none had treatment stopped for this reason. Post‐exertion hypotension determined the tolerated debrisoquine dose in 14% of subjects, with resulting poorer therapeutic grading. In addition to the mortality encountered, a minority of patients showed electrocardiographic or radio‐logical deterioration independent of blood pressure control. For these reasons earlier effective treatment of youngerpatients with less severe hypertension seems desirable. Pre‐therapy clinic assessment using beta blocking drugs seems helpful in such patients in deter‐mining when to start debrisoquine treatment.