CARDIOVASCULAR DRUG THERAPY
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1 3303- (o(o$ CARDIOVASCULAR DRUG THERAPY FRANZ H. MESSERLI, M.D. Ochsner Clinic and Alton Ochsner Medical Foundation New Orleans, Louisiana 1990 W.B. SAUNDERS COMPANY Harcourt Brace Jovanovich, Inc. Philadelphia London Toronto Montreal Sydney Tokyo
2 CONTENTS I II EMERGING CONCEPTS IN CARDIOVASCULAR DRUG THERAPY 1 Chapter 1 Acute Myocardial Infarction in Perspective 2 Randall E. Genton, M.D., and Burton E. Sobel, M.D. Chapter 2 Angina Pectoris: Pathogenesis and Relationship to Therapy '. 9 C. Richard Conti, M.D. Chapter 3 Congestive Heart Failure 12 William W. Parmley, M.D. Chapter 4 Arrhythmias 16 Borys Surawicz, M.D. Chapter 5 Hypertension 20 Franz H. Messerli, M.D., and John H. Laragh, M.D. DRUG TREATMENT OF CARDIOVASCULAR. EMERGENCIES 23 Chapter 6 Acute Pulmonary Edema 24 Dwight Davis, M.D., and Robert Zelis, M.D. Chapter 7 Acute Myocardial Infarction 36 David W. Snyder, M.D., and Allan S. Jaffe, M.D. Chapter 8 Hypertensive Emergencies, 58 James F. Burris, M.D., and Edward D. Freis, M.D.' Chapter 9 Acute Thromboembolism 75 Mark W. I. Webster, M.B., Ch.B., James H. Chesebro, M.D., and Valentin Fuster, M.D. Chapter 10 Acute Tachyarrhythmias 92 Eric L. Michelson, M.D., and Leonard S. Dreifus, M.D. Chapter 11 Cardiovascular Drug Use in Cardiopulmonary Resuscitation 121 Joseph P. Ornato, M.D., Edgar R. Gonzalez, Pharm.D., and AllanS. Jaffe, M.D. xx i
3 XXli / CONTENTS 111 SPECIAL CLINICAL SITUATIONS 139 Chapter 12 Cardiovascular Therapy in the Elderly 140 Adam Schneeweiss, M.D. Chapter 13 Cardiovascular Therapy in Patients with Organ Failure 181 LuigiX. Cubeddu, M.D., Ph.D., and John M. Kessler, Pharm.D. Chapter 14 Cardiovascular Therapy Interacting with Exercise Physiology 202 Zebulon V. Kendrick, Ph.D., David T. Lowenthal, M.D., Ph.D., and Vincent J. Paolone, Ed.D. Chapter 15 Cardiovascular Therapy and Stress Roland E. Schmieder, M.D., Heinz Riiddel, M.D., and August W. von Eiff, M.D. Chapter 16 Cardiovascular Therapy During Pregnancy and Lactation : 229 William B. White, M.D. Chapter 17 Cardiovascular Therapy in Black Patients 242 W. Dallas Hall, M.D. Chapter 18 Silent Myocardial Ischemia To Treat or Not to Treat 254 Bramah N. Singh, M.D., D.Phil., F.R.C.P. ; Chapter 19 Cardiovascular Receptors and Drug Therapy 265 Peter A. van Zwieten, M.D., Ph.D. IV DIURETICS 283 PART I PRINCIPLES AND PRACTICE OF DIURETIC THERAPY 284 Chapter 20 Diuretics in Renal Failure 284 Ralph A. Kelly, M.D., and William E. Mitch, M.D. Chapter 21 Diuretics in Hypertension 298 Ray W. Gifford, Jr., M.D. Chapter 22 Diuretics in Congestive Heart Failure 310 Norman K. Hollenberg, M.D., Ph.D.
4 CONTENTS / XXiii PART II LOOP DIURETICS 318 Chapter 23 Furosemide 318 Murray Epstein, M.D., and Barry J. Materson, M.D. Chapter 24 Bumetanide, 328 Andrew Whelton, M.D., and Paul K. Whelton, M.D. PART III THIAZI.DE DIURETICS AND DERIVATIVES 337 Chapter 25 Thiazide Diuretics, Chlorthalidone and Metolazone 337 Barry J. Materson, M.D., and Murray Epstein, M.D. Chapter 26 Indapamide 348 Paul R. Wilson, M.D., and David C. Kern, M.D. PART IV POTASSIUM-SPARING DIURETICS 357 Chapter 27 Triamterene 357 Jurgen K. Rockstroh, M.D., Ulrich R. Kdsser, M.D., Christoph J. Losem, M.D., and Franz H. Messerli, M.D. Chapter 28 Amiloride 368 Garabed Eknoyan, M. D. Chapter 29 Spironolactone 382 Kwan Eun Kim, M.D. (3-ADRENORECEPTOR BLOCKERS 393 PART I PRINCIPLES AND PRACTICE OF fi-adrenoreceptor BLOCKADE 394 Chapter 30 P-Adrenergic Blocking Drugs in Cardiac Disorders 394 William H. Frishman, M.D. Chapter 31 p-adrenoreceptor Blockers in Hypertension 408 Lennart Hansson, M.D., Ph.D. PART II NONCARDIOSELECTIVE &-ADRENORECEPTOR BLOCKERS 420 Chapter 32 Propranolol 420 Alan S. Nies, M.D. Chapter 33 Timolol 442 Terje R. Pedersen, M.D.
5 xxiv / CONTENTS Chapter 34 Acebutolol 446 Aram V. Chobanian, M.D. Chapter 35 Nadolol 453 Michael H. Crawford, M.D. Chapter 36 Ultrashort-acting p-adrenoreceptor Blocking Drugs: Esmolol and Flestolol 461 William H. Frishman, M.D., V. Shrinivas Murthy, M.D., Ph.D., and Joel A. Strom, M.D. Chapter 37 Pindolol 471 ArieJ. Man in't Veld, M.D., Ph.D., and Antonie H. van den Meiracker M.D. PART III CARDIOSELECTIVE &-ADRENORECEPTOR BLOCKERS 485 Chapter 38 Metoprolol 485 Gunnar Olsson, M.D., Ph.D., Goran Bondjers, M.D., Ph.D., Cart Dahlof, M.D.., Ph.D., Ake Hjalmarsson, M.D., Ph.D., Anders Sandberg, M.Sc, Bengt Ablad, M.D., Ph.D., and John Wikstrand, M.D., Ph.D. Chapter 39 Atenolol 506 Jay M. Sullivan, M.D. Chapter 40 Bevantolol 518 William H. Frishman, M.D., and Rente J. Goldberg Arnold, Pharm.D. Chapter 41 Betaxolol 545 F. Gilbert McMahon, M.D. Chapter 42 Celiprolol 554 John L. Reid, M.D., M.A., DM., F.R.C.P. Chapter 43 Bisoprolol 561 Peter Bolli, M.D., and Fritz R. Biihler, M.D. PART IV a- AND &-ADRENORECEPTOR BLOCKERS 573 Chapter 44 Labetalol 573 Walter Flamenbaum, M.D., and Alan Dubrow, M.D. Chapter 45 Dilevalol 592 /. David Wallin, M.D. Chapter 46 Carvedilol 603 William D. Carlson, M.D., Ph.D.
6 CONTENTS / XXV VI VASODILATORY DRUGS 623 PART I ANTIADRENERGIC THERAPY 624 Chapter 47 Principles and Practice of a-antiadrenergic Therapy 624 B. N. C. Prichard, M.D. PART II CENTRALLY ACTING ANTIADRENERGIC DRUGS 641 Chapter 48 Methyldopa 641 Edward D. Frohlich, M.D., and Franz H. Messerli, M.D. Chapter 49 Clonidine 652 William F. Graettinger, M.D., Deanna G. Cheung, M.D., and Michael A. Weber, M.D. Chapter 50 Guanabenz 660 Deanna G. Cheung, M.D., William F. Graettinger, M.D., and Michael A. Weber, M.D. Chapter 51 Rilmenidine : 667 Michel E. Safar, M.D., and B. M. Pannier, M.D. Chapter 52 Guanfacine 678 Michael H. Alderman, M.D., and Bernard Lamport, M.D. PART III PERIPHERALLY ACTING ANTIADRENERGIC DRUGS! 691 Chapter 53 Prazosin 691 Myron H. Weinberger, M.D. Chapter 54 Terazosin 698 James L. Pool, M.D. Chapter 55 Urapidil 708 Clive Rosendorff, M.D., Ph.D. Chapter 56 Doxazosin 714 Stanley H. Taylor, M.D. VII ANGIOTENSIN-CONVERTING ENZYME INHIBITORS 731 PART I PRINCIPLES AND PRACTICE OF ANGIOTENSIN- CONVERTING ENZYME INHIBITION 732
7 xxvi / CONTENTS Chapter 57 Angiotensin-Converting Enzyme Inhibitors in Arterial Hypertension 732 Hans R. Brunner, M.D., Bernard Waeber, M.D., and Jiirg Nussberger, M. D. Chapter 58 Angiotensin-Converting Enzyme Inhibitors in Chronic Heart Failure 761 Milton Packer, M.D. PART II SPECIFIC ANGIOTENSIN-CONVERTING ENZYME INHIBITORS 770 Chapter 59 Captopril 770 Henry A. Punzi, M.D., F.C.P., and Randall M. Zusman, M.D. Chapter 60 Enalapril 792 Irene Gavras, M.D., and Haralambos Gavras, M.D. Chapter 61 Lisinopril 800 John B. Kostis, M.D., and Daniel M. Shindler, M.D. Chapter 62 Spirapril 807 Deanna G. Cheung, M.D., William F. Graettinger, M.D., and Michael A. Weber, M.D. Chapter 63 Ramipril 810 William J. Mroczek, M.D., and Kent S. Allenby, M.D. Chapter 64 Perindopril 817 Kennedy R. Lees, B.Sc, M.D., M.R.C.P., and John L. Reid, M.D., M.A., D.M., F.R.C.P. VIII VENOUS AND ARTERIOLAR VASODILATORS 825 PARTI VASODILATATION 826 Chapter 65 Principles and Practice of Vasodilatation 826 Michel E. Safar, M.D., Girard M. London, M.D., and Jacques E. Chelly, M.D. PART II ARTERIOLAR VASODILATORS 834 Chapter 66 Hydralazine 834 Phillip A. Reece, Ph.D., and Rudolf Zacest, M.D. Chapter 67 Minoxidil '. 849 Vito M. Campese, M.D.
8 CONTENTS / XXvii PART III ARTERIOLAR AND VENOUS VASODILATORS Chapter 68 Nitroprusside 861 Joseph Murphy, M.B., M.R.C.P.I., M.R.C.P. (U.K.), Carl J. Lavie, M.D., and Dennis Bresnahan, M.D. Chapter 69 Nitroglycerin 871 Bruce Charash, M.D., and Stephen Scheldt, M.D. Chapter 70 Long-Acting Nitrates 881 Alexander Shaknovich, M.D., and Stephen Scheidt, M.D. PART IV POTASSIUM-CHANNEL BLOCKERS...: 887 Chapter 71 Pinacidil 887 Prince K. Zachariah, M.D., Ph.D. CALCIUM-CHANNEL BLOCKERS 895 PART I PRINCIPLES AND PRACTICE OF CALCIUM-CHANNEL BLOCKADE 896 Chapter 72 Cardiovascular Uses of Calcium-Channel Blockers William H. Frishman, M.D., and Edmund H. Sonnenblick, M.D. Chapter 73 Calcium-Channel Blockers in the Prevention of Atherosclerosis 910 William W. Parmley, M.D. Chapter 74 Calcium-Channel Blockers in Arterial Hypertension 918 Fritz R. Buhler, M.D. PART II SPECIFIC CALCIUM-CHANNEL BLOCKERS 926 Chapter 75 Nifedipine 926 Leon Resnekov, M.D. Chapter 76 Diltiazem 939 Peter E. Pool, M.D. Chapter 77 Nicardipine 975 CarlJ. Pepine, M.D., and Charles R. Lambert, M.D. Chapter 78 Verapamil 992 Prince K. Zachariah, M.D., Ph.D., and Sheldon G. Sheps, M.D.
9 XXVlii / CONTENTS Chapter 79 Nitrendipine 1003 Wolfgang Kiowski, M.D., and Fritz R. Buhler, M.D. Chapter 80 Isradipine 1010 Ehud Grossman, M.D., Shmuel Oren, M.D., and Franz H. Messerli, M.D. Chapter 81 Amlodipine 1017 William H. Frishman, M.D. Chapter 82 Felodipine, Jiirgen K. Rockstroh, M.D., Franz H. Messerli, M.D., Alberto Zanchetti, M.D., and Margareta I. L. Nordlander, Ph.D. X SEROTONIN ANTAGONISTS 1045 Chapter 83 Ketanserin 1046 A. E. Doyle, M.D. XI POSITIVE INOTROPIC AGENTS 1055 PART I DIGITALIZATION 1056 Chapter 84 Principles and Practice of Digitalization 1056 James E. Doherty, M.D.. PART II INOTROPIC THERAPY 1066 Chapter 85 Principles and Practice of Inotropic Therapy 1066 Wilson S. Colucci, M.D. PART III SPECIFIC POSITIVE INOTROPIC AGENTS 1072 Chapter 86 Dobutamine ;..: 1072 David O. Taylor, M.D., James A. Thompson, M.D., Stephen M. Ayres, M.D., and Michael L. Hess, M.D. Chapter 87 Dopamine 1083 Leon I. Goldberg, M.D., Ph.D., and Michael B. Murphy, M.D. Chapter 88 Amrinone 1090 Mark A. Wood, M.D., and Michael L. Hess, M.D. Chapter 89 Milrinone 1103 Robert DiBianco, M.D.
10 CONTENTS / xxix Chapter 90 Enoximone 1114 Karl T. Weber, M.D., Leslie A. Brookfield, M.D., Jeanette Vega, M.D., Gopal Gadodia, M.D., and Joseph S. Janicki, Ph.D. Chapter 91 Xamoterol 1123 Hubert Pouleur, M.D., Michel F. Rousseau, M.D., and Hilary F. Marlow, B.M., B.Ch. PART IV DOPAMINE AGONISTS 1138 Chapter 92 Fenoldopam 1138 James B. Young, M.D., and Carlos A. Leon, M.D. ANTIARRHYTHMIC DRUGS 1149 PART I PRINCIPLES AND PRACTICE OF ANTIARRHYTHMIC THERAPY 1150 Chapter 93 Supraventricular Arrhythmias 1150 Borys Surawicz, M.D. Chapter 94 Ventricular Arrhythmias 1167 Peter R. Kowey, M.D., Ted D. Friehling, M.D., and Roger A. Marinchak, M.D. Chapter 95 Aggravation of Arrhythmia by Antiarrhythmic Drugs 1182 Philip J. Podrid, M.D. PART II SPECIFIC ANTIARRHYTHMIC DRUGS 1193 Chapter 96 Quinidine 1193 Jean M. Nappi, Pharm. D., and Jay W. Mason, M. D. Chapter 97 Procainamide 1202 Frank C. McGeehin III, M.D., and Eric L. Michelson, M.D. Chapter 98 Tocainide 1212 John C. Somberg, M.D. Chapter 99 Encainide 1224 Joel Morganroth, M.D. Chapter 100 Amiodarone 1236 Mauricio B. Rosenbaum, M.D., and Pablo A. Chiale, M.D.
11 XXX / CONTENTS Chapter 101 Bretylium Tosylate 1257 Jeffrey L. Anderson, M.D. Chapter 102 Flecainide 1269 Mark D. Carlson, M.D., Richard W. Henthorn, M.D., and Albert L. Waldo, M.D. Chapter 103 Moricizine 1288 Joel Morganroth, M.D. Chapter 104 Mexiletine 1296 Philip J. Podrid, M.D. Chapter 105 Cifenline 1314 John C. Somberg, M.D. Chapter 106 Disopyramide 1324 /. Marcus Wharton, M.D., and Eric N. Prystowsky, M.D. Chapter 107 Propafenone 1353 Katherine T. Murray, M.D., and Eric N. Prystowsky,,M.D. XIII ANTITHROMBOTIC THERAPY ; 1367 PART I PRINCIPLES AND PRACTICE OF ANTITHROMBOTIC THERAPY 1368 Chapter 108 Antithrombotic Therapy for the Prevention of Cardiac and Arterial Thromboembolism 1368 Douglas H. Israel, M.D., Bernardo Stein, M.D., James H. Chesebro, M.D., and Valentin Fuster, M.D. Chapter 109 Thrombolysis in Acute Myocardial Infarction Allan S. Lew, M.D., F.R.A.C.P., and William Ganz, M.D. PART II SPECIFIC ANTITHROMBOTIC DRUGS 1423 Chapter 110 Acetylsalicylic Acid 1423 Carlo Patrono, M.D. Chapter 111 Dipyridamole 1434 Mark W. I. Webster, M.B., Ch.B., James H. Chesebro, M.D., and Valentin Fuster, M.D. Chapter 112 Warfarin Prophylaxis 1444 Stanford Wessler, M.D.
12 CONTENTS / xxxi Chapter 113 Heparin 1457 Marc Verstraete, M.D., Ph.D., F.R.C.P., F.A.C.P. (Honorary) Chapter 114 Urokinase 1470 Anthony J. Comerota, M. D. Chapter 115 Streptokinase 1479 Sol Sherry, M.D., D.Sc. (Honorary) Chapter 116 Anisoylated Plasminogen-Streptokinase Activator Complex 1496 Jeffrey L. Anderson, M.D. Chapter 117 Tissue-Type Plasminogen Activator 1510 Alan J. Tiefenbrunn, M.D., F.A.C.C. Chapter 118 Single-Chain Urokinase-Type Plasminogen Activator (Prourokinase) 1524 Desiri Collen, M.D., Ph.D., and David C. Stump, M.D. XIV OTHER DRUGS USED FOR THE TREATMENT OF CARDIOVASCULAR DISORDERS 1534 Chapter 119 Pentoxifylline 1536 John A. Spittell, Jr., M.D., F.A.C.P., F.A.C.C. XV COMBINATION DRUG THERAPY 1541 Chapter 120 Combination Therapy in Angina Pectoris 1542 Gert-Hinrich Reil, M.D., and Paul R. Lichtlen, M.D. Chapter 121 Combination Therapy in Hypertension 1556 Norman M. Kaplan, M.D. Chapter 122 Combination Therapy in Congestive Heart Failure 1566 Kanu Chatterjee, M.B., F.R.C.P. Chapter 123 Combination Therapy in Arrhythmias 1586 Leonard N. Horowitz, M. D. Chapter 124 Combination Therapy in Pulmonary Hypertension 1594 Stuart Rich, M.D.
13 xxxii / CONTENTS Chapter 125 Therapy for Postural Hypotension 1608 Michael G. Ziegler, M.D. Chapter 126 Combination Therapy in Vasoocclusive Disease 1618 Douglas H. Israel, M.D., Valentin Fuster, M.D., Bernardo Stein, M.D., and James H. Chesebro, M.D. Chapter 127 Cardiovascular Drug Interactions 1632 Lionel H. Opie, M.D., D.Phil. INDEX '. 1641
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