Nadolol

Chemical name

цис-5-[3-[(1,1-Диметилэтил )амино]-2-гидроксипроп��кси]-1,2,3,4-тетрагидро-2, 3-нафталиндиол

Gross

C17-H27-N-O4

Characteristics

The white crystalline powder. It is soluble in ethanol, hydrochloric acid, little water and chloroform, poorly soluble in sodium gidrookside.

Of drugs

The drugs-gipotenzivne, antianginalnoe, antiaritmicescoe. Does beta_1- beta_2-adrainoretseptora and has no internal and simpatomimeticescoy мембраностабилизирую щей activity. Stops central impulsaciu sympathetic to the field, reduces the sensitivity of peripheral tissues to kateholaminam, suppressing the renin secretion. Urejaet frequency and force of heart, reduces the spontaneous initiation sinusnogo and ectopiceski drivers rhythm slows AV conduction. Lowers Sad and Dad, cordial release and the need heart of oxygen (for instance, the physical strength). Decreases risk of repeated myocardial infarction and improves blood circulation in the Cerebral delays the development of reflex tachycardia. Gipotenzivne to develop within 24 hours Improves kidney function (at normal doses kidney bloodstream increased by 17-26%). Decreases often migraine attacks (prevents vazokonstricciu in the inner artery sleeping and overnutrition adrenergic impulsaciu, leading to the expansion of the outer sleeping artery). In experimental studies on rabbits using doses up to 10 times higher than NHDRs, provided embriotoksicescoe and fetotoksicescoe effect. In 2-letnem study in rats and mice have been detected cancer and tertogennogo Effecta.posle intake of poor and uneven skin of Stomach (about 30%). C_max plasma states in 3-4 hours Equilibrium concentration in the blood is achieved through 6-9 days of the regular admission. Linking blood plasma is 18-30%. T_1/2-p 14-24, with renal failure there is a trend to increase. Do not metabolised in the body, displayed with urine and jelchew in an unmodified form. After receiving a single fully excreted through 4 days. Hardly permeates through GEB etc. gistogematicalkie barriers secretiruetsa in breast milk passes through the placental barrier (gipoglikemii risk, bradikardii, hypotension, difficulty in breathing the fetus and newborn).

Indications

Arterial hypertension, stenocardia voltage sinusova tachycardia; Prevention paroxizmalna najeludockova and ventricular arrhythmia, bigeminii, trigeminii; Gipertrofica cardiomyopathy, mitral prolapse valve myocardial infarction (with clinically stable condition patient), giperkineticeski cardialny syndrome, tremor (essencialny), anxiety (symptomatic treatment), migraine (prevention).

Restrictions on the use of

Violations of the liver and kidney failure, diabetes mellitus, hypoglycaemia, Ray, chronic obstructive lung diseases, coupled allergic history, the old and the child.

Pregnancy and lactation

Perhaps if the effect of therapy outweighs the potential risk to the fetus. At the time of treatment should stop breastfeeding.

Contraindications

Hypersensitivity expressed aetiology (less than 50 u. / min), AV blockade II extent syndrome weakness sinusnogo unit cardiogenny shock chronic and refrakternaya to treat severe heart failure, legern-serdecnaya deficiency, gipotenzia, obliterirute diseases of the blood vessels (Reynaud syndrome), bronchial asthma (incl. disease), breast-feeding.

Side-Effects

From the nervous system and sensory organs : a sense of fatigue, headache, insomnia and speech parestesia, disorders of view, Libido.so reduce the respiratory system : zalojennosti nose, cough, rarely Bronhospazm.so the circulatory system and blood (blood, gemostaz) : aetiology, AV blockade gipotenzia, heart failure, cooling Konernstei.so part of the intestine : dry mouth, anorexia, nausea, vomiting, neuralgia, flatulence, diarrhea or Zapor.prochie : impotence, skin rashes, prurigo, dry eyes and skin, rash, oedema, alopecia, changing body mass index.

Specific guidance

The treatment may change the test results of laboratory studies.

Patient interaction

It should not be used in conjunction with MAO inhibitors. Digidropiridinove calcium antagonists, simpatolitiki and peripheral vazodilatatora, dioretiki potenziruet hypotension; And epinephrine - izoprenalin weaken. Probability of automaticity, and conduction sokratimosti hearts increases in the face of evidence, diltiazema, verapamila, hinidinovykh drugs and general anesthetics.

Overdosing

Symptoms : dizziness, aetiology, incredible, gipotenzia, difficulty in breathing, akrozianoz, heart failure, in the most severe cases - Kollaps.lechenie : the Haemodialysis introduction atropine (in / in the 0,25-1 mg), beta-adrainomimetikov (izoprenalin), tranquilizers (diazepam, lorazepam), cardiotonikov (dobutamin, dopamine, epinephrine, norapinefrin, heart glycosides) dioreticakih drugs, etc. symptomatic funds.

Precautions

Treatment out gradually over a period of about two weeks (prevention of the syndrome). There is a need for dose adjustment in older patients. Masks symptoms gipoglikemii (tachycardia, changing AD) and hyperthyroidism (tachycardia). With immunotherapy or aggravated allergologicaki history should be replaced by others of this product pharmacological Group (increases the severity and duration anaphylacticakih reactions to allergens, reduces the effect of conventional doses of epinephrine). It should refrain from the use in paediatric practice, since safety and efficacy of the children are not defined. Should be repealed, a few days before the surgery, using skin narcosis (including dental surgery), or select an anaesthetic with the lowest inotrope negative effect. The patient is the partial tireoidektomii within 10 days made with potassium iodide. Be wary of during the drivers of vehicles and people skills relate to the high concentration of attention. At the time of treatment is recommended that the admission of alcohol.

Dosing and Administration

Inside, regardless of the meal. The pain, arrhythmia, migraines, 40 mg once a day, if necessary dose increase (once a week), with the strokes to 120-160 mg / day, keep up to 160 mg / day and migraines to 80-160 mg / sut. In hypertension, 80-240 mg, once. In gipertireoze-160 mg per day. If any cold interval between meals with Cl creatinine 50 ml / min should be set at 20 hours, 31-50 ml / min, p 24-36, 10-30 ml / min-48 h, 10 ml / min, at 40-60

Literature

DV Preobrazhensky, A. Sidorenko, Romanov NE, Shatunov IM Clinical pharmacology major classes of drugs antigipertenziveh / / Consilium Medicum. - 2000. Vol.2-N-3 C. 99-127.

Directory → Wegetotropona funds → Adrainoliticaskie funds → Beta-adrenoblokatora → Nadolol