Posted by policebox on March 29, 2012, at 2:17:40
Does anyone have a link to a resource (webpage, journal article) that details the pharmacokinetics of antihypertensive drugs? I'm specifically interested in a comparison of onset and duration of action of either specific drugs or classes.
After six months of taking Parnate (30 mg bid) without any issues, I recently had to discontinue it due to a recurrent elevation of blood pressure (150/100 mmHg) generally appearing about an hour after administering a dose and remitting between 60 and 90 minutes later. Attempts at changing the dosing schedule (20 mg tid) or spreading out the time between doses was ineffective at preventing the spontaneous hypertensive events. MAOi dietary restrictions and drug contraindications were adhered to. I don't have hypertension, but I do have an idiopathic tachycardia, which when coupled with the elevated blood pressure, created intolerable discomfort.
I read a journal article which presented three case studies in which an antihypertensive drug in the calcium channel blocker class (amlodipine) was successfully administered with Parnate to alleviate these types of spontaneous elevations in blood pressure. I was recently diagnosed with diabetes and am insulin dependent. When diagnosed, I prescribed an antihypertensive drug in the class of ACE inhibitors (lisinopril) because of its renal-protective profile.
However, since I am not hypertensive nor do I have impaired kidney function I am reluctant to begin taking the lisinopril. The reasons are two-fold. First, I do not like the side effect profile of this class of drug. Second, several research articles I have read have indicated that while ACE inhibitors are effective renal-protective agents in diabetic patients with compromised kidney function, there is no evidence to support their ability to prevent new onset kidney damage from occurring. So, taking a drug which may not help me but may cause unwanted side effects seemed sufficient reason to not begin this drug therapy.
So, I would like to find an antihypertensive drug that would have an onset of action of about 30 minutes and duration of action of about 4 hours, with minimal side effects. Particularly, I want to avoid any drug which would aggravate my chronic fatigue or create cognitive slowness.
poster:policebox
thread:1014419
URL: http://www.dr-bob.org/babble/20120328/msgs/1014419.html