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1. Introduction

Lung function is a vital part of the body that is characterized by a wide range of conditions affecting the respiratory system. It is also known as nephrolithiasis or obstructive pulmonary diseases, and it is the most common cause of pulmonary hypertension in adults [

]. In the past, lung function tests, such as the Doppler echocardiogram, were the main diagnostic methods used for diagnosing lung diseases [

However, more recent research has shown that the Doppler-based test is not only more accurate, but also more reliable than other methods [

,

Furthermore, the use of echocardiographic measurements of the right atrium, pulmonary artery and pulmonary venous blood flow is helpful in the diagnosis of pulmonary hypertension [

This study aimed to compare the accuracy of the Doppler echocardiographic measurement of the pulmonary veno-venous insufficiency and pulmonary vascular volume of the right atrium with the use of the Doppler ultrasound in pulmonary hypertension.

2. Materials and Methods

This was a retrospective study performed at the Department of Pulmonary Hypertension, Central Hospital of Beijing μg Hospital (Qinglong University Hospital) from January 2010 to July 2019. The study was approved by the Institutional Ethics Review Board of the Central Hospital of Beijing μg Hospital (No. ZP-2019-03-02). All participants signed an informed consent.

The study was carried out in accordance with the ethical principles of the Declaration of Helsinki and the International Conference on Harmonization (ICH) guidelines. Before inclusion, all patients had been diagnosed with pulmonary hypertension by the WHO guidelines [

All patients with pulmonary hypertension were eligible for enrollment, and all patients were treated with a diagnosis of pulmonary hypertension in accordance with the recommendations of the WHO and published by the American Thoracic Society (ATS) [

The study was approved by the institutional review board of Beijing μg Hospital, and all participants provided informed consent. The patients were divided into two groups: Group 1 was treated with a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a treatment of pulmonary hypertension [

The combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a treatment of pulmonary hypertension (group 2) was selected by the study authors. The group 1 received a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a treatment of pulmonary hypertension (group 1) and a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a combination of a treatment of pulmonary hypertension (group 2) by a specialist.

The study was approved by the institutional review board of Beijing μg Hospital. The study was performed in accordance with the ethical principles of the Declaration of Helsinki and the International Conference on Harmonization (ICH) guidelines. The study was performed according to the approved guidelines.

2.1. Diagnostic Measurements

2.1.1. Doppler Echocardiographic Measurements

The Doppler echocardiographic measurements of pulmonary veno-venous insufficiency and pulmonary vascular volume of the right atrium, pulmonary artery and pulmonary venous blood flow were obtained using an echocardiographic device (Hytrun Inc., Tokyo, Japan) according to the manufacturer's instructions [

A Doppler echocardiographic image was recorded from the right atrium, pulmonary artery and pulmonary venous blood flow and analyzed using an echocardiographic instrument with the following steps:

  • The echocardiographic images were obtained with a transducer attached to a computer with a 3.0 mm-thick-thick-thickness optical disk, and the Doppler images were analyzed using the following step:
  • The Doppler images were analyzed using a handheld transducer (Hytrun Inc., Tokyo, Japan).
  • The Doppler images were processed using a computerized software (CiteXv2, version 6.

Interactions

A. Top Drug-Drug Interactions:

1.Nitrates (e.g., nitroglycerin, isosorbide dinitrate): Cialis and nitrates both lower blood pressure. Taking them together can cause a significant and potentially life-threatening drop in blood pressure (hypotension), leading to dizziness, fainting, or even heart attack or stroke. It is contraindicated to use Cialis with nitrates or recreational "poppers" (amyl nitrites).

2.Alpha-blockers (e.g., prazosin, terazosin, tamsulosin): Both Cialis and alpha-blockers relax blood vessels, which can lead to excessive blood pressure reduction when used together. This may result in dizziness, fainting, or orthostatic hypotension (a sudden drop in blood pressure when standing). If needed, your doctor may adjust the dosage or recommend spacing the medications.

3.Other antihypertensive drugs (e.g., atenolol, propranolol, enalapril, lisinopril): Cialis can enhance the blood-pressure-lowering effects of these medications. While this interaction is usually less severe than with nitrates or alpha-blockers, it can still cause dizziness or fainting in sensitive individuals. Close monitoring of blood pressure is recommended.

Other Drug-Drug interactions:

  • Ketoconazole, itraconazole (used to manage fungal infection)
  • Protease inhibitors (used to manage HIV infection) Ex. ritonavir, lopinavir
  • Phenobarbital, phenytoin, carbamazepine (medicines used for fits)
  • Rifampicin, erythromycin, clarithromycin (medicines used for bacterial infections)
  • Other medicines used to improve blood flow to the penis (Ex. sildenafil)

B. Drug-Food Interactions:

Cialis (tadalafil) can interact with certain foods and beverages, potentially altering its effectiveness or increasing the risk of side effects. Here are the key drug-food interactions to be aware of:

  1. Grapefruit and Grapefruit Juice: Grapefruit can increase the levels of tadalafil in your blood by interfering with its metabolism. This may amplify side effects, such as headaches, dizziness, or low blood pressure. Avoid consuming grapefruit or grapefruit juice while taking Cialis.
  2. Alcohol: Drinking alcohol with Cialis can enhance the blood pressure-lowering effects of the medication, leading to symptoms like dizziness, lightheadedness, or fainting. Limiting alcohol intake is recommended while using Cialis.
  3. High-Fat Meals: While Cialis can be taken with or without food, consuming it with a high-fat meal may delay its onset of action. Opt for lighter meals if rapid effectiveness is needed.
  4. Caffeine: Though not a direct interaction, combining Cialis with high caffeine intake might worsen side effects like headaches or increase heart rate in sensitive individuals.
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This article:Date: 11 May 2024

More about Cialis

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Contraindications

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Interactions

A. Top Drug-Drug Interactions:

1.Nitrates (e.g., nitroglycerin, isosorbide dinitrate): Cialis and nitrates both lower blood pressure. Taking them together can cause a significant and potentially life-threatening drop in blood pressure (hypotension), leading to dizziness, fainting, or even heart attack or stroke. It is contraindicated to use Cialis with nitrates or recreational "poppers" (amyl nitrites).

2.Alpha-blockers (e.g., prazosin, terazosin, tamsulosin): Both Cialis and alpha-blockers relax blood vessels, which can lead to excessive blood pressure reduction when used together. This may result in dizziness, fainting, or orthostatic hypotension (a sudden drop in blood pressure when standing). If needed, your doctor may adjust the dosage or recommend spacing the medications.

3.Other antihypertensive drugs (e.g., atenolol, propranolol, enalapril, lisinopril): Cialis can enhance the blood-pressure-lowering effects of these medications. While this interaction is usually less severe than with nitrates or alpha-blockers, it can still cause dizziness or fainting in sensitive individuals. Close monitoring of blood pressure is recommended.

Other Drug-Drug interactions:

  • Ketoconazole, itraconazole (used to manage fungal infection)
  • Protease inhibitors (used to manage HIV infection) Ex. ritonavir, lopinavir
  • Phenobarbital, phenytoin, carbamazepine (medicines used for fits)
  • Rifampicin, erythromycin, clarithromycin (medicines used for bacterial infections)
  • Other medicines used to improve blood flow to the penis (Ex. sildenafil)

B. Drug-Food Interactions:

Cialis (tadalafil) can interact with certain foods and beverages, potentially altering its effectiveness or increasing the risk of side effects. Here are the key drug-food interactions to be aware of:

  1. Grapefruit and Grapefruit Juice: Grapefruit can increase the levels of tadalafil in your blood by interfering with its metabolism. This may amplify side effects, such as headaches, dizziness, or low blood pressure. Avoid consuming grapefruit or grapefruit juice while taking Cialis.
  2. Alcohol: Drinking alcohol with Cialis can enhance the blood pressure-lowering effects of the medication, leading to symptoms like dizziness, lightheadedness, or fainting. Limiting alcohol intake is recommended while using Cialis.
  3. High-Fat Meals: While Cialis can be taken with or without food, consuming it with a high-fat meal may delay its onset of action. Opt for lighter meals if rapid effectiveness is needed.
  4. Caffeine: Though not a direct interaction, combining Cialis with high caffeine intake might worsen side effects like headaches or increase heart rate in sensitive individuals.
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Other Drug-Food interactions:

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  • Alcoholism
  • Arfi (thailandian herbal medicine)
  • Alzheimer's disease
  • Bunayume (thailandian medicine)
  • Dongyuan (thailandian medicine)
  • Nanthiri (thailandian medicine)
  • Nizweong (thailandian medicine)
  • Thin interdigital spaces (Ex. blood vessels)
  • Aloe vera ( Leafy root)
  • Alinut ( Japanese green leafy vegetables)
  • Alpharetta (Ex. gum disease and acid reflux)
  • Algabix (Ex. gum)
  • Almasol (Ex. alginates)
  • Alkem (Ex. gingko biloba)
  • Alpinal (Ex. rhubarb)

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