Diltiazem

Chemical name

(2S-цис)-3-(Ацетокси)-5-[2-(��иметиламино)этил]-2,3-д игидро-2- ( 4-метоксифенил)-1,5-бенз отиазепин-4(5Н)-он (as hydrochloride)

Gross

C22-H26-N2-O4-S

Characteristics

Derived benzotiazepina. White or no white crystalline powder with a bitter taste. Tomorrow the world. Rat in the water, methanol, chloroform.

Of drugs

The drugs-antianginalnoe, gipotenzivne, antiaritmicescoe. Does потенциалзависимые кальциевые channels L-типа and ингибирует entry of calcium ions into a phase of depolarization cardiomyocytes and гладкомышечных cells receptacles. As a result, braking depoliarizutego slow the flow of calcium into cells whobudimah tissue oppressing capacity-building actions and divides the "возбуждение-сокращен ие". Oxytocics lowers the heart, reduces variation and slows AV conduction. Relaxes smooth musculatu receptacles lowers round. And dozozawisimam antigipertenzive effect in the light and moderate hypertension. The reduction AD correlates with the level of hypertension (people with a normal AD is minimal his demotion). Gipotenzivne effect is both horizontally and vertically. Rarely is postural hypotension and tachycardia fence. Do not alter or slightly reduces the maximum variation in Nageorgke.dlitelnaya therapy not soprovovozdaetsa giperkateholaminemiei increases activity ренин-ангиотензин-аль достероновой system. Decreases renal and peripheral effects angiotenzina II. Антиангинальный effect is the lowering of heart of oxygen, a result of a reduction in HR Systems AD вазодилатацией эпикардиальных receptacles ability to address коронароспазм. Relaxes smooth muscles coronary concentration beyond a inotroponogo negative effect. Efficiency in the суправентрикулярных тахикардиях linked to the increase (20%) effective and functional рефрактерного the AV node and the extension of the AV node (in the normal variation of the AV node minimum). Wrinkles jeludockovy rhythm in patients with a high frequency jeludockovh reductions in the atmosphere and trepetanii predserdy. Restores sinusovy normal rhythm with paroxizmalna najeludockova tachycardia, turn off any type of re-entry in the key tahikardiah tahikardiah and with the retiproknam, including Wpw-sindrome. Prolonged use by small increase sinoatrialnogo PR interval on the ECG. The weakness syndrome sinusnogo node reliably extends the duration sinusovogo cycle. The atmosphere and trepetanii predserdy in the bolusni effectively lowers curves (not less than 20% in 95% of patients). The usually occurs after 3 minutes and reaches a peak within 2-7 min. Ischemia rhythm maintained for a period of 1-3 hours In the long infuzionnom a demotion choose 20% of the 83% of patients and remains after a period of 0.5 hours to 10 hours The rehabilitation синусового rhythm with пароксизмальных суправентрикулярных тахикардиях is 88% within 3 min. In patients with acute myocardial changes left heart (heart failure, heart attack, cardiomyopathy gipertrofica) is not affected airway final Dad left jeludocke and pressure jamming pulmonary capillaries. Provides minimal effect on the smooth musculature of blood. Prolonged (8 months) treatment is not accompanied by the development of tolerance, and changes in lipid profile plasma. Can cause regression isolationist left heart in patients with arterial hypertension. Under normal therapeutic doses does not affect mortality, but in patients with signs of stagnation in the lungs increased frequency of cardiovascular complications by 40%. In patients with acute myocardial infarction in the face тромболитической therapy Activator плазминогена raised Frequency haemorrhagic complications раз.Хорошо 5 (more than 90% of dose) of the skin glands. Bioavailability of 40% (pronounced effect "of a" through the liver). C_max is 2-4 h (Table), 3,9-4,3 hrs (caps. 180 mg), 5-7 h (Table retard), 6-14 hrs (caps. prolong.) . The volume of 5.3 l / mm T_1/2 1-3 h (with on / in the introduction), 3-4,5 p (table), 5-7 h (Table retard), 7,3-14,7 hrs (caps. 180 mg). Since

Indications

Angina (stable, vazospastical); Koronarospazma prevention in koronaroangiografii or operation coronary bypass; Arterial hypertension (monotherapy or in combination with other drugs antigipertenzivei) : post-myocardial infarction (mostly retardnye form if protivopokazana beta-adrenoblokatora), in patients with concomitant stroke (if contraindications to the appointment beta-adrenoblokatorov) in patients with diabetic nephropathy (when protivopokazana ACE inhibitors). In / in-car and ventricular fibrillation, mild hysteria mertzatelna adults (in combination with digoxinom) paroxizmalnaya supraventrikuliarnaya tachycardia. In transplantology : after kidney transplantation (prevention insufficient transplant), in иммуносупрессивной therapy (to reduce нефротоксичности cyclosporine A).

Restrictions on the use of

Синоатриальная и AV блокада I степени, внутрижелудочковое нарушение проведения возбуждения (блокада левой или правой ножки пучка Гиса), систолическое давление менее 90 мм рт.ст., нарушение функции печени и почек, пожи