A high-performance liquid chromatographic procedure is presented for the determination of hydrochlorothiazide (HCT) and enalapril maleate (EM) in pharmaceutical tablets. An aliquot of the sample is ...dissolved in 15% acetonitrile (ACN) containing thiophylline as an internal standard and chromatographed on a Supelcosil LC-8 (5 $\mu$ m), (150 mm x 4.6 mm i.d.) column. The mobile phase was 3.0 mM tetrabutylammoniumhydrogen sulfate (TBAHS) in ACN/water/triethylamine (TEA), (14, 85.6, 6.4 V/V) adjusted to pH 4.1 by glacial acetic acid. The detection was at 220 nm. The method was tested for linearity, accuracy, recovery, and specificity.
A differential pulse polarographic (DPP) method has been developed for the quantitative analysis of enalapril maleate. Enalapril maleate gives a peak at -1.4 V in methanol. A calibration curve was ...constructed for the 20 -100 $\mu$ g $ml^{-1}$ concentration range. As a reference method, a reversed phase high performance liquid chromatographic procedure has been developed. Commercially available tablets were analysed by the two methods. Statistical evaluations indicated that there was no significant difference between the mean values and precisions of the two methods at a 95% confidence level.
1.
The aim of this study was to investigate the effects of enalapril maleate on ischemia-reperfusion injury of the myocardium, after cardioplegic arrest in isolated guinea pig hearts, in a modified ...Langendorff model.
2.
Animals were subjected to 90 min of normothermic global ischemia, followed by 30 min of reperfusion. Cardioplegic arrest was achieved by administering St. Thomas Hospital cardioplegic solution (STHCS).
3.
The hearts were randomly allocated into four groups
n=8
in each group
. The first group was utilized as control. In the second group, oral pretreatment was made (0.2 mg/kg enalapril maleat was given twice a day for 10 days). In the third group, enalapril maleat (1 μmol/l) was added to STHCS. In the fourth group, hearts were arrested with enalapril maleat-enriched STHCS, and enalapril maleat-enriched (1 μmol/l) Krebs-Henseleit solution was applied during the reperfusion period.
4.
Although the study groups showed better recovery of contractility than did the control group, in the last group, the hearts had the best recovery of left ventricular systolic function, where
dp/
dt maximum was 89.7±6.9% of the preischemic values. Group 1, group 2 and group 3 achieved 44.2±4.5%, 79.4±5.8% and 68.1±6.7% of their preischemic
dp/
dt values. A similar observation was found for left ventricular developed pressure (LVDP); LVDP values were 52.4±2.1% (in group 1), 79.6±2.8% (in group 2), 72.8±4.6% (in group 3) and 86.7±5.8% (in group 4) of control after reperfusion. Creatine kinase leakage was significantly lower and postischemic coronary flows were significantly higher in group 4.
5.
We concluded that usage of enalapril maleat in the reperfusion period was more effective for improving myocardial recovery after cardioplegic arrest. The additional protective effects of enalapril maleat not only were by angiotensin-converting-enzyme-inhibition-dependent coronary vasodilation and thiol-dependent limitation of oxidative injury, but could also be related to an oxygen-free-radical-scavenging effect.
O angioedema é uma condição potencialmente fatal que pode surgir em qualquer momento no perioperatório. Pode decorrer da liberação de histamina, em uma reação de hipersensibilidade a drogas ou ser ...desencadeado pela bradicinina, em reações não alérgicas, de etiologia hereditária ou adquirida. O objetivo desse relato é descrever um caso de angioedema, no pós‐operatório imediato, em um paciente em uso de medicação anti‐hipertensiva da classe dos inibidores da enzima conversora da angiotensina.
Paciente de 67 anos, masculino, negro, hipertenso e em uso do maleato de enalapril, foi submetido a cirurgia ortopédica de ombro sob anestesia geral associada a bloqueio do plexo braquial. O procedimento durou 3 horas, sem intercorrências. Após a alta da sala de recuperação pós‐anestésica, apresentou angioedema com grave comprometimento das vias aéreas. Tentou‐se fazer intubação traqueal, mas foi impossível devido ao edema que acometia os lábios, a língua e região orofaringeana. Fez‐se a cricotireoidostomia de emergência. O aparecimento do angioedema não apresentou relação causal com a administração de qualquer medicação, não houve manifestações cutâneas e também não respondeu à terapêutica para reação de hipersensibilidade a drogas, como anti‐histamínicos, corticoide e adrenalina. Foi considerado como mediado pela bradicinina, pois o paciente já havia apresentado dois episódios semelhantes e estava em uso regular de medicação (enalapril). A evolução foi satisfatória.
O angioedema é uma condição potencialmente fatal quando atinge as vias aéreas e deve ser de conhecimento do anestesiologista e dos médicos que trabalham nos setores de emergência.
Angioedema is a potentially fatal condition that may occur at any time in the perioperative period. It may result from histamine release, hypersensitivity reaction to drugs, or be triggered by bradykinin, in non‐allergic reactions of hereditary or acquired etiology. The aim of this report is to report a case of angioedema in the early postoperative period in a patient on antihypertensive medication involving angiotensin‐converting enzyme inhibitors.
A 67‐year‐old male, Afro‐descendant, hypertensive, and taken enalapril maleate underwent orthopedic shoulder surgery under general anesthesia combined with brachial plexus block. The procedure lasted 3hours uneventfully. After discharge from the post‐anesthesia care unit, the patient presented with angioedema and severe airway impairment. Tracheal intubation was attempted but it was impossible due to edema affecting the lips, tongue, and oropharyngeal region Emergency cricothyroidotomy was performed. The onset of angioedema had no causal relationship with the administration of any medication; there were no cutaneous manifestations and also not response to therapy for hypersensitivity reaction to drugs, such as antihistamines, corticoid, and adrenaline. It was considered to be mediated by bradykinin, as the patient had already had two similar episodes and was on regular medication (enalapril). The evolution was satisfactory.
Angioedema is a potentially fatal condition when it affects the airway, and should be recognized by anesthesiologists and physicians working in the emergency departments.
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