Determination Of Antihypertensive Drugs Research Articles

Fine-tuning Fluorescence of Amlodipine Adopting on Blocking of Photoinduced Electron Transfer (PET): Application in Human Plasma.

Assessing medication adherence through the determination of antihypertensive drugs in biological matrices holds significant importance. Amlodipine (AP), a potent antihypertensive medication extensively prescribed for hypertensive patients, is particularly noteworthy in this context. This article aims to introduce a rapid, simple, improved sensitivity, and reproducibility in detecting AP in its pure form, tablet formulation, and spiked human plasma than the other reported methods. The proposed method utilizes a fluorescence approach, relying on the inhibition of the intramolecular photoinduced electron transfer (PET) effect of the lone pair of the N-atom in the primary amino moiety of AP. This inhibition is achieved by acidifying the surrounding medium using 0.2M acetic acid. By blocking PET, the target AP drug is sensitively detected, at [Formula: see text] 423nm over a concentration range 25-500 ng mL- 1 showcasing an exceptionally low quantitation limit of 1.41 ng mL- 1. Notably, this innovative technique was successfully applied to detect AP in its solid dosage form and spiked human plasma. Remarkably, matrix interference was found to be insignificant, underscoring the robustness and applicability of the established approach. The combination of speed, sensitivity, and reproducibility makes this method particularly suitable for assessing medication adherence in patients prescribed AP for hypertension.

A SPECIFIC 3 MONTHS-PROGRAM TO IMPROVE NON-ADHERENCE IN UNCONTROLLED HYPERTENSION IMPROVES BLOOD PRESSURE CONTROL AND ASSOCIATED ORGAN DAMAGE (ATHAN CLINICAL TRIAL)

Objective: To evaluate whether a specific 3-month(m) action plan to improve therapeutic adherence in patients with uncontrolled hypertension on ◊ 2 drugs results in a decrease in BP and whether this is maintained at 12m. Secondly, to assess if this correlates with an improvement in subclinical organ damage. Design and Method: Prospective, randomized clinical trial where patients attended consecutively in a Hypertension Unit with ambulatory 24h-BP ◊130/80 mmHg despite receiving at least 2 antihypertensive drugs and with therapeutic non-compliance confirmed by the determination of antihypertensive drugs in the urine, were randomized (1:1) to receive a specific 3-month program to improve adherence (INT = intervention) or routine follow-up (C = control). Antihypertensive treatment was not modified, but beyond 3m all patients received usual care. Before randomization, and at 3m and 12m, urinary screening for antihypertensive drugs and albuminuria, and 24h-ambulatory BP monitoring were determined. Results: Forty-six patients were randomized. At 3m, mean (95%CI) baseline-adjusted BP differences (INT vs. C) were -14.7 mmHg (-5.4 to -24.1), p = 0.001 and -10.0 mmHg (-3.9 to -16.2), p<0.001 for 24h-SBP and 24h-DBP, respectively. The INT group maintained the BP decrease at 12m. vs. baseline: mean(95%CI) variation of 24h-SBP = -16.1 mmHg (-22.8 to -9.4), p<0.001 and variation of 24h-DBP = -7.8 (-12.8 to -2.7), p = 0.002. In the INT group, the percentage of non-detected antihypertensive drugs decreased compared to baseline: median [IQR]: 40% [20-85.7], 0% [0-25], and 18.3 % [0-40] at baseline, 3m and 12m respectively; Z = -3.295 (p<0.001) and Z = -3.055 (p = 0.002) for changes at 3m and 12m, respectively. Albuminuria (median [IQR]) decreased in the INT group: 27.1 mg/g [11.2-116.2] and 22.4 mg/g [6.4-91.9] at baseline and 12m, respectively (Z = -2.207, p = 0.027). At 12m, variation of albuminuria correlated with variation of 24h-BP but not with variation of percentage of non-detected antihypertensive drugs. Conclusions: a 3-month specific nursing intervention to improve therapeutic adherence results in improved BP control in patients with inadequate therapeutic compliance. This improvement continues beyond the completion of this program. Decreased BP correlates with a regression of albuminuria.

MEDICATION NON-ADHERENCE IN UNCONTROLLED HYPERTENSION: SELECTIVE DETECTION AND EFFICIENCY AND EFFECTIVENESS OF A PROGRAM TO IMPROVE COMPLIANCE (ATHAN TRIAL)

Objective: To assess whether the implementation of a specific action plan to improve adherence for 3 months results in reduced peripheral 24h-systolic blood pressure (SBP) in patients with resistant hypertension (RH) or uncontrolled hypertension with at least 2 drugs. Design and method: Interventional, prospective, randomized, controlled, parallel groups, open study of patients consecutively attended in a specialized Hypertension Unit with ambulatory 24h-BP equal or more than 130 and/or 80mmHg although receiving at least 2 antihypertensive drugs. The partially or completely non-adherent patients (confirmed by determination of antihypertensive drugs in urine) were randomized (1: 1) to receive a specific program to improve adherence (intervention group) or routine follow-up (control group), with determination of antihypertensive drugs in urine, office-BP measurement and 24h-ambulatory BP monitoring at pre-randomization and 3 months. Results: Forty-three patients were randomized (mean age 59+/-14yr, 70% male). Mean+/-S.D. baseline SBP/DBP(mmHg) were 150.4+/-17.1 and 90.7+/-15.5, and the number of prescribed non-detected drugs in urine was 2+/-1.4. At 3 months, the variation of SBP-24 h for the intervention group and the control group was (mean[95%CI]) = -14.3 mmHg (-20.5 to -8.1), p < 0.001 and -3.3 mmHg (-10.2 to 3.7), p = 0.339, respectively. See table. At 3 months, the variation of the number of non-detected antihypertensive drugs in urine was (mean[95%CI]) = -1.29 mmHg (-2.06 to -0.53), p = 0.002 and -0.53 mmHg (-1.26 to 0.2), p = 0.144, respectively. Conclusions: A specific nursing intervention to improve therapeutic adherence results in an improvement of BP control in patients with difficult-to-control hypertension and inadequate therapeutic compliance.

Determination of antihypertensive drugs by using ratio difference spectrophotometric method

An accurate, sensitive and time saving spectrophotometric method has been developed and validated for the determination of two antihypertensive drug mixtures. Mixture 1 contains spironolactone (SPIR), furosemide (FUR) and anthranilic acid (ANTH) (impurity of furosemide) and mixture 2 contains triamterene (TRI), hydrochlorothiazide (HCZ) and chlorothiazide (CZ) (impurity of hydrochlorothiazide). In mixture 1, the determination of drugs depends on dividing the spectrum of ternary mixture by the spectrum of 10 µg/mL of standard furosemide and then spironolactone and anthranilic acid were determined using the difference in amplitude between 242.3 and 254.6 nm, and between 250.8 and 242.4 nm in the ratio spectrum, respectively. On the other hand, furosemide could be determined by dividing the spectrum of ternary mixture by the spectrum of 10 µg/mL of standard spironolactone and then it was determined using the difference in amplitude between 244.8 and 229.7 nm in the ratio spectrum. In mixture 2, the determination of drugs depends on dividing the spectrum of ternary mixture by spectrum of 10 µg/mL of standard triamterene and then hydrochlorothiazide and chlorothiazide were determined using the difference in amplitude between 268.9 and 232.8 nm, and between 292.9 and 250.7 nm in the ratio spectrum, respectively. On the other hand, triamterene could be determined by dividing spectrum of ternary mixture by spectrum of 10 µg/mL of standard hydrochlorothiazide and then triamterene was determined using the difference in amplitude between 230.1 and 244 nm in the ratio spectrum. The developed analytical methods were validated regarding good accuracy and precision according to The International Conference on Harmonisation guidelines, and they were applied to pharmaceutical preparations in addition to laboratory prepared mixtures successfully. Statistically the results were compared with those obtained by reported method and no significant difference was found.