Selective alpha adrenergic blocker for the treatment of hypertension

Consider the options of the work of this kind of blockers which are manifested in relation to some techniques of the human physique. Let’s begin with the cardiovascular system.

So, alpha-adrenergic blockers have a pronounced enjoyable impact in relation to precapillary sphincters, arterioles and veins. Arteries are much less affected by these substances. The fall in OPSS results in a lower in blood strain. This results in a lower in the load on the coronary heart muscle and prevents its attainable coronary heart assault.

Of the damaging penalties, it’s value noting the risk of creating orthostatic hypotension and, presumably, tachycardia.

The organs of imaginative and prescient for suppressing receptors with the use of α-1 adrenergic blockers might effectively reply with pupil myosis.

The digestive system responds with a rise in secretory operate and peristalsis.

It is contraindicated to make use of antihypertensive medication of this kind, if there’s:

  1. Severe hypotension;
  2. Ischemia;
  3. Narrowing of the lumen of the aorta;
  4. Tachycardia;
  5. Arrhythmia;
  6. Stomach ulcer.

Of course, the anticipated damaging results brought on by these medication. Here are the most attribute of them:

  1. Vertigo;
  2. Headache;
  3. Edema;
  4. Orthostatic collapse;
  5. Stool problems;
  6. The narrowing of the pupil.

Beta-blockers

Recall that beta-blockers have lengthy been fairly efficiently utilized in scientific remedy in the treatment of hypertension. They have an antihypertensive impact that’s not inferior to such well-known courses of hypotensives as ACE inhibitors, diuretics, calcium antagonists or angioteginzin-II receptor antagonists.

With their look, a quantity of classical therapeutic issues in the treatment of blood strain had been solved. These duties are:

  • Pressure stabilization inside the physiological norm;
  • Risk administration in relation to mortality;
  • Target organ safety;
  • Treatment of concomitant and related well being problems.

β-blockers are represented by three principal generations.

The first consists of non-selective medication that wouldn’t have a protracted publicity interval, however which at the similar time have a quantity of undesirable uncomfortable side effects.

The outcomes of treatment with these medication for ailments similar to:

  • Arterial hypertension;
  • Ischemia;
  • Heart rhythm problems.

Here are the beta blockers that make up the checklist of generally used medication for hypertension:

  1. Anaprilin. Non-selective. Able to spasm vessels. Sometimes its use results in impotence. However, this drug has pronounced antiarrhythmic properties.
  2. Propranolol. The ancestor of the group of non-selective adrenergic blockers and the principal lively ingredient of first-generation medication of such medication. By performing on the myocardium, it considerably reduces the quantity of cardiac output. In addition to the decreasing impact, it enhances the joint motion of thyreostatics used with it (Merkazolil, potassium perchlorate and the like). It normalizes the coronary heart rhythm when the affected person has a historical past of sinus tachycardia. Increases the tone of the bronchi.
  3. Timolol This non-selective blocker with respect to the coronary heart has a pronounced capability to deal with glaucoma.

The introduction of the second era of β-adrenergic blockers (selective) allowed physicians to resolve a a lot wider vary of issues. The prognosis for treatment of hypertension with the use of such medication was no much less optimistic than with ACE inhibitors or calcium antagonist medication.

This second era is represented by:

  1. Atenolol The drug compares favorably with related substances as a result of Atenolol doesn’t trigger drowsiness because of the weak capability to penetrate the blood-brain barrier. Somewhat worse than different beta-blockers, it prevents coronary heart assault. Successfully resists cardiac arrhythmias.
  2. Metoprolol. />

The third era of beta-blockers, which haven’t solely pronounced selectivity, but in addition extra vasodilating features, is represented by such medication:

  • Carvedilol. At the preliminary stage of remedy, in opposition to the background of a pointy discharge, Blood strain is considerably extra doubtless than analogues to result in vertigo and related uncomfortable side effects.
  • Bisogamma It must be remembered that this drug should be discontinued no later than two days earlier than the begin of the introduction of basic anesthesia.

Due to the widespread prevalence of a illness similar to diabetes, many will likely be serious about how completely different generations of beta-blockers have an effect on the sensitivity of tissues to insulin. Vasodilator blockers considerably improve this attribute of the physique, however non-selective adrenergic blockers cut back this property of tissues.

Hemodynamics

Let us make some comparability of the hemodynamics of medication which are α and β-blockers.

  1. Heart charge. α-blockers easily enhance this indicator, in distinction to fairly rapidly lowering the pulse of β-blockers.
  2. Both varieties of blood strain positively decrease blood strain.
  3. The atrioventricular conduction of the impulse from the synotrial node to the ventricle of the coronary heart leaves α-blockers unchanged, and β-blockers considerably decrease.
  4. Myocardial contractility underneath the motion of medication represented by α-blockers stays unchanged or will increase barely. β-adrenergic blockers barely decrease this indicator.
  5. Both varieties of blockers decrease complete peripheral vascular resistance, and α-blockers do that extra explicitly.
  6. The impact on the renal blood circulation is precisely the reverse: α-blockers improve this indicator, and β-blockers act as their antagonists.

In the scientific manifestations of these varieties of adrenergic blockers, there’s additionally a similarity, and a few distinction.

Acting on blood strain, each of these varieties lowered the systolic strain border by 6 factors. In relation to the diastole section, the strain decreased by 4 marks. Heart charge dropped by 5 beats per minute. All these information relate to sufferers uncovered to hypertension in delicate to reasonable type.

With a rise in the dose of the medication, in each circumstances the coronary heart charge dropped considerably, however the dynamics of strain discount remained virtually unchanged.

Incompatibility with different medication

When prescribing a complete treatment of any illness, three probabilistic strains of growth of drug interactions are attainable. So this is usually a mutual enhancement of the optimistic therapeutic impact of each one of the medication concerned in the medical scheme, and their basic impact on the physique.

  1. Perhaps a impartial, detached angle of medication to one another throughout treatment.
  2. Possible inhibition of the motion of any medication underneath the affect of different medication used.
  3. Their harmful mixtures are attainable.

Consider such harmful circumstances.

  • The mixture of beta-blockers with antihypertensive medication of the nonhydropyridone group of calcium channel blockers. Recall that these are Verapamil, Nifedipine, Isoptin and the like. The use of a drug of both of these two courses in itself results in a drop in coronary heart charge. The inaccurate function is harmful as a result of the mixed impact of the mixed calcium channel blockers and adrenergic blockers results in a essential slowdown in coronary heart charge. The solely justified case of the want for such a mix is the management of the rhythm of the ventricles in opposition to the background of steady inconsistency in the work of the coronary heart departments.
  • The mixture of beta-blockers with centrally performing medication. The group of CD medication consists of medication that have an effect on the sympathetic exercise of the mind. This is Guangfacin, Clonidine, Methyldopa. The hazard is a mutual enhance in uncomfortable side effects with a mix of adrenergic blockers with these medication.

Feedback and suggestions

Employees BOU VPO MGMSU (Moscow) Evdokimov V., Markova L.I. they write: “Hypertension is a critical risk factor. Nevertheless, adequate comprehensive treatment with beta-blockers can not only reduce neurological problems, but also significantly improve the prognosis for recovery and improve the quality of life of the patient. This is confirmed by the clinical use of drugs of the bisoprolol group (Concor, Takeda and the like). ”

Based on the evaluation of randomized scientific trials, the so-called “Cochrane reviews” (Wong GWK, Laugerotte A, Wright JM) notice: “Any subclasses of beta-blockers equally lower the boundaries of both systolic and diastolic pressure. Unlike other types of antihypertensive drugs, they have no (or minimal) effect on pulse pressure. ”

In the work on this text, scientific supplies offered by scientists from the Moscow State Medical-Dental University had been used. Let’s strive, primarily based on the work of these scientists, to summarize the information that we introduced above.

In quick, each alpha-blockers and beta-blockers are capable of concurrently block two varieties of adrenergic receptors. Drugs of this class are fairly aggressive with different antihypertensives.

Taking under consideration the outcomes of research carried out by MOSES, PROGRESS and related firms, we are able to safely say that the therapeutic use of beta-blockers for the treatment of hypertension reduces the danger of stroke by 40%.

In relation to the central nervous system, the extended use of such medication is probably capable of restore the self-regulation of cerebral vessels. This applies to the early phases of hypertension and vascular pathologies of this part of the central nervous system.

Practical drugs in the scientific use of this kind of antihypertensive drug depends primarily on beta-1-selective medication. They are nearly devoid of such undesirable uncomfortable side effects as bronchospasm, vasoconstriction, elevated OPSS. And these processes usually result in a violation of metabolic features involving carbohydrates and lipids.

The hottest selective beta-blocker, which is at the moment broadly used to deal with hypertension, is Bisoprolol.

Operating precept

Alpha-blockers for hypertension have a pronounced vasodilating impact. Drugs enhance the adrenergic exercise of receptors. Relieve spasm of arterioles situated on the periphery, enhance the lumen of blood vessels. This results in a lower in the return of venous blood to the atrium, a lower in the load on the coronary heart muscle and a drop in blood strain.

Provide a lower in ldl cholesterol and triglycerides, enhance the quantity of excessive density lipoproteins. Affect carbohydrate metabolism – enhance the susceptibility of cells to insulin and stop a rise in blood glucose.

The principal indications for use are the medication used for the deliberate treatment of hypertension. In addition, adrenergic blockers are prescribed in parallel with different medication to alleviate an acute situation – a hypertensive disaster, in an effort to stop the growth of issues after crises, strokes, and coronary heart assaults. They are indicated for folks affected by coronary coronary heart illness, arrhythmia and different ailments of the cardiovascular system.

How to use

The use of alpha-blockers must be carried out underneath medical supervision. This will permit you to select the minimal efficient dosage in an effort to obtain stabilization of blood strain.

Tablets must be taken throughout or after meals. It is advisable to drink the drugs at the similar time. In this case, it’s worthwhile to monitor the eating regimen, don’t overload the digestive tract with heavy meals, restrict the use of spicy, salty, fried.

Take alpha-blockers want a very long time, for a number of months. If the therapeutic impact is weakened or issues develop, it’s essential to notify the attending doctor about this. This will remedy the query of the want for its alternative or dosage adjustment.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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