Perindopril is a long acting ACE inhibitor with a 24- hour lasting effect. Its positive effect on a reduction in cardiovascular events has been confirmed in a range of large randomized clinical trials and in a wide spectrum of patients: hypertonic patients, diabetics, patients with stable ischaemic heart disease, elderly patients, or patients who have undergone a cerebrovascular accident. The extending range of various fixed combinations as well as new pharmaceutical dosage forms, including the newly introduced orodispersible tablets of perindopril, enables optimization of treatment for every patient, an increase in the patients treatment adherence, and also improvement in longterm blood pressure control with a consequent effect on reduction of morbidity and mortality.
- MeSH
- antihypertenziva aplikace a dávkování farmakokinetika MeSH
- aplikace orální MeSH
- hypertenze farmakoterapie MeSH
- inhibitory ACE aplikace a dávkování farmakokinetika MeSH
- kardiovaskulární nemoci farmakoterapie MeSH
- lidé MeSH
- perindopril aplikace a dávkování farmakokinetika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- antihypertenziva MeSH
- inhibitory ACE MeSH
- perindopril MeSH
Angiotensin-converting enzyme (ACE) inhibitors improve the prognosis in mild, moderate and severe heart failure, as well as preventing the onset of heart failure in patients with chronic asymptomatic left-ventricular dysfunction and in those with reduced ejection fraction after myocardial infarction (MI). Imidapril is a long-acting ACE inhibitor that is rapidly converted in the liver to its active metabolite, imidaprilat. Maximum plasma concentrations of imidapril and imidaprilat are achieved after 2 and 5-6 hours, respectively, with corresponding elimination half-lives of 1.1-2.5 and 10-19 hours. Imidapril is used in the treatment of hypertension, chronic heart failure, acute MI and diabetic nephropathy. In patients with mild-to-moderate chronic heart failure, imidapril 10 mg once-daily increased exercise time and physical working capacity, decreased plasma atrial natriuretic peptide and brain natriuretic peptide levels and reduced blood pressure. It also improved left ventricular ejection fraction, being significantly more effective than bisoprolol, in patients with acute MI. Imidapril is well tolerated and preliminary studies suggest it has an advantage over captopril and enalapril in terms of a lower incidence of cough. In conclusion, imidapril is a well-investigated versatile ACE inhibitor for the treatment of a range of cardiovascular diseases.
- MeSH
- imidazolidiny farmakokinetika farmakologie terapeutické užití MeSH
- inhibitory ACE farmakokinetika farmakologie terapeutické užití MeSH
- léková rezistence genetika MeSH
- lidé MeSH
- nežádoucí účinky léčiv MeSH
- nízký srdeční výdej farmakoterapie MeSH
- polymorfismus genetický MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Názvy látek
- imidapril MeSH Prohlížeč
- imidazolidiny MeSH
- inhibitory ACE MeSH
Fixed verapamil SR/trandolapril combinations 180/1 mg and 180/2 mg (Tarka, Knoll AG) have a significantly superior antihypertensive effect compared to equal dosages of either agent alone. Verapamil SR/trandolapril 180/2 mg combination produces the best dose-response ratio of different dose combinations of these two drugs. Combination therapy has the most pronounced effect on blunting the early morning rise in blood pressure. Thus, verapamil SR/trandolapril combination therapy may be an appropriate treatment option in patients with moderate essential hypertension, particularly in those who have a tendency toward the early morning rise in blood pressure. The adverse effect profile of the fixed combination of verapamil SR/trandolapril includes the typical side effects of its monocompounds. The fixed combination of verapamil SR/trandolapril is also effective and safe in the treatment of hypertension in the elderly. The fixed low-dose combination therapy with verapamil SR/trandolapril 180/2 mg is a suitable treatment option for patients with moderate essential hypertension and Type 2 diabetes mellitus, because it improves parameters of carbohydrate metabolism and uricaemia and does not alter the lipid profile. The insulin-sensitising effect of angiotensin converting enzyme (ACE) inhibitor monotherapy with its theoretical risk of hypoglycaemia is completely neutralised in the combination with verapamil SR. Comparative studies have shown that the low-dose combination of verapamil SR/trandolapril may be a suitable alternative to combinations containing a thiazide diuretic or a beta-blocking agent for the long-term management of hypertensive patients for whom combination therapy is indicated. The combination of an ACE inhibitor with a non-dihydropyridine calcium channel blocker reduces proteinuria to a greater extent than either agent alone. A combination of an ACE inhibitor and a calcium channel blocker may provide additional benefit in inducing the regression of left ventricular hypertrophy. Combination therapy leads to a significant increase in left ventricular ejection fraction, improvement of wall motion index and increases exercise duration time in patients with coronary heart disease and left heart failure. It also improves the ratio of exercise to rest rate-pressure product and decreases the number of angina attacks. These findings support the hypothesis that the combination of verapamil and trandolapril might be useful in patients with attenuated left ventricular function and angina pectoris. Thus, Tarka is an effective and well-tolerated antihypertensive agent with a good safety profile and positive metabolic effects.
- MeSH
- antihypertenziva škodlivé účinky farmakokinetika terapeutické užití MeSH
- blokátory kalciových kanálů aplikace a dávkování škodlivé účinky farmakokinetika terapeutické užití MeSH
- fixní kombinace léků MeSH
- hypertenze komplikace farmakoterapie patofyziologie MeSH
- indoly aplikace a dávkování škodlivé účinky farmakokinetika terapeutické užití MeSH
- inhibitory ACE aplikace a dávkování škodlivé účinky farmakokinetika terapeutické užití MeSH
- krevní tlak účinky léků MeSH
- léky s prodlouženým účinkem MeSH
- lidé MeSH
- verapamil aplikace a dávkování škodlivé účinky farmakokinetika terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- antihypertenziva MeSH
- blokátory kalciových kanálů MeSH
- fixní kombinace léků MeSH
- indoly MeSH
- inhibitory ACE MeSH
- léky s prodlouženým účinkem MeSH
- trandolapril MeSH Prohlížeč
- verapamil MeSH
ACE inhibitors which till recently were used only in the treatment of cardiovascular diseases are becoming a perspective group of drugs also in the treatment of chronic nephropathies. It was revealed that they are effective in particular in the treatment of proteinuria of different etiology and have also a marked renoprotective effect and are therefore recommended to slow down the progression of renal failure. They reduce intraglomerular hypertension, increase glomerular filtration and the renal blood flow, and it is assumed that they can retard the progression of chronic glomerulonephritis and diabetic nephropathy. It may be excepted that their therapeutic application will in the near future be extended also to clinical nephrology.
- MeSH
- inhibitory ACE škodlivé účinky farmakokinetika terapeutické užití MeSH
- lidé MeSH
- nemoci ledvin farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- inhibitory ACE MeSH
- MeSH
- hemodynamika účinky léků fyziologie MeSH
- hypertenze farmakoterapie patofyziologie MeSH
- inhibitory ACE škodlivé účinky farmakokinetika terapeutické užití MeSH
- lidé MeSH
- srdeční selhání farmakoterapie patofyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- inhibitory ACE MeSH
