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Communications to the Editor |

Diazoxide and Trimethaphan Used? FREE TO VIEW

Gerard W. Frank, MD
Author and Funding Information

Affiliations: Los Angeles, California,  Baylor College of Medicine Houston, Texas Washington Hospital Center Washington, DC

Correspondence to: Gerard W. Frank, MD, 1701 Cesar Chavez Ave, Suite 100, Los Angeles, CA 90033



Chest. 2001;119(1):316. doi:10.1378/chest.119.1.316
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Published online

To the Editor:

Regional variation in medical practice gets a lot of press. I first read about the use of diazoxide and trimethaphan in hypertensive emergencies as a medical student in the late 1970s and most recently in CHEST (July 2000).1 Yet for > 2 decades of practice in at least a half-dozen Southern California hospitals, I have never seen either agent used. This may be a parochial view, but it seems hazardous to recommend drugs with which ICU staffs have little or no familiarity. I am reminded of the old saw, “Be neither the first nor the last to use a drug.”

References

Varon, J, Marik, PE (2000) The diagnosis and management of hypertensive crisis.Chest118,214-227. [CrossRef] [PubMed]
 
To the Editor:

We appreciate Dr. Frank’s comments regarding the use of diazoxide and trimethaphan in our review of hypertensive crises in CHEST.1 It is true that regional variations exist in the use of antihypertensive agents. The pharmacopeia of individual hospitals are clearly different, and we must understand that the readership of CHEST is quite diverse, including physicians from around the world. Drugs like trimethaphan and diazoxide have been supplanted by other agents in most areas of the United States. However, these agents remain available here and around the world. A review of hypertensive crises would be incomplete without mentioning these treatment alternatives.

References
Varon, J, Marik, PE The diagnosis and management of hypertensive crises.Chest2000;118,214-227. [CrossRef] [PubMed]
 

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Tables

References

Varon, J, Marik, PE (2000) The diagnosis and management of hypertensive crisis.Chest118,214-227. [CrossRef] [PubMed]
 
Varon, J, Marik, PE The diagnosis and management of hypertensive crises.Chest2000;118,214-227. [CrossRef] [PubMed]
 
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