Carvedilol

Chemical name

({+})-1-(9Н-Карбазол-4-илок си)-3-[[2-(2-метоксифенок��и)этил]амино]пропанол

Gross

C24-H26-N2-O4

Indications

Arterial hypertension, stenocardia voltage chronic heart failure.

Contraindications

Hypersensitivity, asthma heart failure (IV functional class NYHA) expressed aetiology, AV blockade II extent sinoatrialnaya blockade syndrome weakness sinusnogo hub shock, chronic obstructive lung diseases, bronchial asthma, severe liver damage, pregnancy, breastfeeding (for the treatment of a non-breast-feeding), Children and Youth age (up to 18 years).

Side-Effects

Dizziness, headache, weakness, sincopale state (rarely, and usually only at the beginning of treatment), sleep disorders, depression, parestesia, aetiology, the AV conduction, posturalnaya hypertension, oedema, the deterioration of peripheral blood circulation, the progression of heart failure, acute renal failure, zalojennosti nose, bronhospasticskie reaction nausea, pain in the abdomen, diarrhoea, obstipation, vomiting, pain in the extremities, xeroftalmia, raising transaminaz in blood, anaemia, lakopenia, giperglikemia, increased body mass index, skin allergic skin.

Patient interaction

In applying jointly with cardiac glycosides or diltiazem may slow AV conduction. Increases of digoxin in the blood serum. Anaesthetics reinforce negative inotropony and gipotenzivny carvedilola effects. Phenobarbital, rifampicin up metabolism and reduce the concentration in plasma. Dioretiki inhibitors and angiotensin potenziruut tissues. Incompatible with the / in the introduction of calcium antagonists.

Overdosing

Symptoms : expressed hypertension (Sad 80 mm Hg and below), the aetiology (less than 50 strokes per minute), cardiac failure, cardiogenny shock of the respiratory Funktion.lechenie : cardiotoniki, monitoring of the cardiovascular and respiratory systems, the functions of the kidneys.

Precautions

The caution should be used in the elderly (appointed polovinne dose), diabetes (masks clinical manifestations gipoglikemii) recent deterioration in the current heart failure. In all cases, treatment are low doses followed by slow compared them to the good. If the heart failure in the face of treatment is recommended to increase the dose dioretikov, and in renal failure dose regulate depending on the functional state of the kidneys. To prevent the development of the syndrome dose should be reduced gradually. The combination therapy of heart failure in the case expressed downward AD recommended initially lower dose dioretikov or ACE inhibitors. During treatment excludes alcohol. Be wary appoint people whose work is the need for greater attention and speed of reaction.

Dosing and Administration

Inside. In hypertension - 50 mg once a day (the initial dose in the first two days may be 12.5 mg) in pain on 25-50 mg twice per day, with chronic heart failure on 12,5-25 mg twice per day (maximum, 100 mg / day).

Literature

1. Mareyev VY Treatment of heart failure : inotroponaya stimulation or unloading of the heart (communication 3) / / 14.00.06-1995 .- T. 35 N-12 - C. 4-12.2. R. Bristow, Gilbert M. Improvement of cardiac myocyte function by biological effects of medical therapy : a new concept in the treatment of heart failure / / Eur. Heart J. 1995 .- V. 16 (suppl.) .- P. 20-31.3. Cleland J.G.F., tells K., A. Poole-Wilson Successes and failures of current treatment of heart failure / / Lancet .- 1998 .- V. 352 (suppl.) .- P. 19-28.

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