Ebrantil

Ebrantil - a blocker of postsynaptic α ₁ -adrenoceptors, which reduces blood pressure.

[1]

Indications Ebrantil

Ebrantil is prescribed for stroke, acute coronary syndrome, aortic aneurysm, to reduce blood pressure during surgery.

Pharmacodynamics

Ebrantil blocks peripheral postsynaptic α ₁ -adrenoceptors . To some extent, it is able to block beta receptors. Stimulates the serotonin receptors of the medulla oblongata. The study of the influence of Ebrantil on coronary blood flow continues. Clinical studies are conducted, clearly showing the positive dynamics on the ECG, in particular, the normalization of the ST segment. Patients from the group achieve normal blood pressure after 15 minutes. This saves lives for many of them.

[2], [3], [4], [5]

Pharmacokinetics

 For the most part, Ebrantil is metabolized by the liver. Excretion of the drug occurs with urine. Half-life when administered intravenously - 2.7 hours.

[6], [7]

Dosing and administration

At a hypertensive crisis enter 10-50 mg of preparation iv. Also injected intravenously drip or continuously with a perfusion pump 9 mg / h. 250mg Ebrantil ^® (10 Amp. For 5 ml ampoules or 5. 10 ml) in 500 ml of a solution for infusion (1 mg = 44 drops = 2.2 ml). 5% glucose solution is used to prepare the solution. The maximum initial speed is 2 mg / min. Intravenous drip introduction allows smoothly to lower blood pressure, without sharp jumps. Doctors know that it is necessary to reduce the pressure in the first hour by 25% (concerns patients with hypertensive crisis). The controlled drop in high blood pressure during stroke makes the prognosis more favorable. Urapidil helps reduce arteriolar spasm and increase the rate of cerebral blood flow. The growth rate of the hematoma decreases, which is very important for stroke. The large size of the hematoma does not allow repairing damaged areas of the brain, its function is severely affected, long-term consequences of the disease are possible. Urapidil helps normalize the neurological status.

Using Ebrantil allows you to monitor blood pressure in an acute period of a stroke. Patients who receive it, recover faster. The drug is well suited for the artificial challenge of hypotension during surgery. In the group of patients with HA and pulmonary edema, an increase in the oxygen saturation of the blood was observed during the clinical study. Urapidil also positively affects the course of benign prostatic hyperplasia. This disease in men often occurs in old age.  

Capsules are taken inside morning and evening with food. The capsule should be swallowed whole. Take the drug better through equal time intervals. Usually the dose is 30 mg of Ebrantil 2 times a day. But in severe cases, it can be increased to 120 mg per day. The maximum dose is 180 mg.

[15], [16], [17]

Use Ebrantil during pregnancy

Do not take Ebrantil during pregnancy and lactation - there is insufficient evidence of its effect on the child.

Contraindications

The solution is contraindicated in case of hypersensitivity, open Botallus duct, during pregnancy and during breastfeeding, do not use in children and patients with critically low liver and kidney function. It is not recommended to appoint Ebrantil for stenosis of the aorta and pericardial structure disorders. Do not prescribe alcoholism to patients.

[8], [9], [10]

Side effects Ebrantil

Ebrantil can cause nausea, proteinuria, nephropathy, tachycardia, dyspnea, increased sweating and allergic reactions, bradycardia, vomiting, dizziness, frequent urination, nasal congestion, possible dryness of the oral mucosa, anxiety, signs of mild fatigue, heart rhythm disturbances, headache, swelling, itching of the skin. These side effects are very rare.

There were no cases when additional medication was needed to correct for side effects (among patients who applied with increased pressure to the First Aid). Seldom, but nevertheless allergic reactions, a skin itch developed. Cases of "serotonin syndrome" are also described. This condition manifests itself with anxiety, tremor, hypertension of muscles. It is also necessary to rationally administer the capsules. The doctor should understand that there are cases when only the oral administration of the drug can not be avoided. It is not allowed to prescribe the daily dose of the drug in capsules at one time.

There is no data on the use of Ebrantil in pediatrics.

[11], [12], [13], [14]

Overdose

Symptoms of overdose - dizziness and fatigue. It is necessary to begin infusion of vasoconstrictors under the control of blood pressure. When overdosing capsules it is recommended to take activated charcoal. There is no specific antidote. It is recommended that blood pressure be measured regularly if there is a suspicion that an overdose has occurred. With a sharp drop in pressure, you should enter saline.

[18], [19]

Special instructions

The drug should be taken very gently, at the same time of day. Do not allow yourself to stop taking medication. After 35 years, pressure should be measured regularly even for absolutely healthy people. Do a lot of exercise and exercise.

With age, artery walls increase rigidity, which leads to a steady increase in blood pressure. Harmful habits, a passion for salty, inactive life, problems with the kidneys and the heart can also contribute to the fact that the fight against hypertension ends in defeat. In addition, not all patients with high blood pressure have symptoms: the head does not hurt, the flies before their eyes do not flash, the patient considers himself healthy. To achieve this result, Ebrantil is combined with drugs from another class of antihypertensive drugs. This is necessary in severe cases, when there is a significant increase in blood pressure for a long time. Ebrantil and other alpha-blockers have such a remarkable property as improving fat metabolism. This is especially true for patients with hypertension, often they have excess weight, which is the cause of increased stress on the heart and blood vessels.

Signs of a properly prescribed drug for monitoring blood pressure: its effect during the day is very smooth, it does not lead to sudden pressure surges, has a protective effect on target organs, does not affect performance, has a minimum of side effects and contraindications, it without much harm to the internal organs can be taken for a long time. The effect of the drug should be monitored by the patient himself, by measuring the pressure in the morning and evening. Before measuring, do not drink coffee, do not exercise, do not eat heavy food. Often, treatment must be carried out throughout life, so that its success depends on your commitment. The prognosis is determined by the activity of the therapy.

With intravenous administration of Ebrantil, the pressure decreases very rapidly - already within 4 minutes. This is especially important for hypertensive crises. During the hypertensive crisis, so-called. Target organs.

Only the doctor chooses therapy. There are side effects in the form of memory and sleep disorders, depression and fatigue. It is necessary when taking drugs to control glucose in the blood, regularly measure blood pressure and do an ECG. First of all, the doctor prescribes diuretics. Beta-blockers effectively reduce blood pressure and reduce heart rate. Can be used for both monotherapy and complex therapy of hypertension. Calcium channel blockers relax the heart cells. So the blood pressure in the bloodstream decreases. ACE inhibitors are best suited for patients who have high blood pressure due to kidney disease.

Unfortunately, the problem of treatment of hypertension will not lose its relevance in the future, too. Even in developed countries there is no adequate control of pressure among the population. This leads to a steady increase in the complications that the disease gives to the target organs. Annually only in Russia 10,000 ambulance calls are registered to patients with hypertensive crisis. Patients forget that with secondary hypertension, one must persistently treat the underlying disease, do not ignore visits to the doctor. This leads to fatal consequences. Do not risk your health. Particular attention should be given to pressure with a family inclination to heart and vascular disease. Eliminate harmful psychological factors, tackle the treatment of neuroses and overcome stress. If the pressure is already high, it may be worthwhile to think about changing the place of work or profession. With excessive body weight, a low-calorie diet can be recommended, with the exception of salted dishes: cucumbers, sausages, herring. Beer is excluded.

AG threatens with the fact that there is a pathological thickening of the vascular wall. The mass of the myocardium increases, the risk of a heart attack increases. Kidney diseases and endocrine diseases are frequent companions of patients with AH. Many patients can find a protein in the urine - the first sign that the kidneys with their work can not cope. The cause of AH can be congenital malformations of the heart and blood vessels. The lack of adequate therapy leads to their premature wear. When examining the fundus, hemorrhages or narrowing of the arteries of the retina are detected. First, in the first stage of hypertension, there are no lesions of target organs. Then there is a narrowing of large arteries, which changes into coronary artery disease, cerebral ischemia and renal insufficiency. From this we can conclude that correctly selecting the treatment of AH, we warn a whole bunch of other diseases or facilitate their flow. It is well known that the drug control several times reduces the incidence of strokes in patients with AH. With a consistently high blood pressure, pharmacological treatment should begin as soon as possible. In such patients, lifestyle correction can not produce a positive effect unless medications are prescribed in addition to it. This is especially important for patients who have had a heart attack. If you do not start therapy with AG in their time, death may occur. This risk increases by 50% compared with patients who have normal pressure after myocardial infarction. After a heart attack, it is best to prescribe calcium antagonists.

The risk factor is also hypertrophy of the myocardium, which reduces the coronary reserve and leads to arrhythmia. Heart rhythm disturbances wear it and lead to an earlier death. Combination therapy is the most reasonable approach in the treatment of myocardial hypertrophy. The combination therapy may also include alpha-blockers and, in particular, Ebrantil. It significantly reduces the load on the heart muscle. Diuretics have the least effect on the treatment of myocardial hypertrophy.

With the greatest success inhibit the development of atherosclerotic plaques and increase the elasticity of the vessels of calcium antagonists. They allow increasing the capacity of large arteries. From the course of physics we know that the greater the clearance, the lower the fluid pressure.

Ebrantil has not yet entered the general practice of ambulance doctors. They usually use more accessible and proven means, but not always giving the desired effect. This nifedipine, dibazol, magnesia and others. It is preferable to use more modern preparations, such as Ebrantil with a quick and short action. For patients with impaired cerebral circulation in the form of a hemorrhagic stroke, a more aggressive tactic of antihypertensive therapy may be justified than with ischemic stroke. ¾ patients need a combination therapy, ie, it is impossible to normalize blood pressure with only one drug. To minimize side effects, doctors use a stepwise approach: prescribe drugs sequentially. The use of a combination of two drugs can cause an additive effect (1 + 1 = 1.75), add up (1 + 1 = 2) or potentiate (1 + 1 = 3) effect. Diuretics are well combined with beta-blockers and ACE inhibitors, as well as with alpha-blockers (Egrantil belongs to this class), calcium antagonists - with ACE inhibitors. There are other schemes.

Try to understand why the doctor has prescribed this or that drug. Ask your doctor to explain this in detail. Preference should be given to drugs that can be taken 1 or 2 times a day, ie, for example, in the morning at breakfast and before bedtime. This is very convenient, you can be sure that you do not miss the reception. Even those people who do not care about anything should know what pressure they have - it is enough to measure it once a year. In Kiev pharmacies, there are regular free pressure measurements to all comers. Ask the doctor to teach you self-tonometry. If your vision has worsened, your limbs become numb, your urine is diminished, you are in dyspnea restless, which means that your increased blood pressure has caused complications. If this happens, you need to undergo a comprehensive examination, possibly in the hospital and decide what to do next. You will be admitted to a hospital with a complicated hypertensive crisis, if you have had a stroke in the past, a heart attack or angina, if at cardiac listening and ECG removal there will be atrial fibrillation, cerebral symptoms, palpitations, tremors and anxiety. This is the only way to stabilize your condition. Do not refuse hospitalization in these cases. You may need intensive therapy: the installation of a venous catheter, a medication correction that can not be performed at home due to a particular mode of administration, for example, a drop. The hospital is much more convenient to regularly take ECG, monitor blood and urine, glucose and cholesterol in the blood, conduct ultrasound and other studies. The 2013 AH recommendations, reflected in a special document compiled by European scientists, fully reflect the current vision of the problem of fighting this disease. Clearly stipulated cases where no hospitalization can not do. The working group on the treatment of arterial hypertension of the European Society of Hypertension asks to pay attention to the great importance of constant home blood pressure control. If it will be conducted by you, the risk of being suddenly hospitalized will be minimized. For young people and the elderly, the European Society of Hypertension indicates the same upper threshold for the norm of AD - 140/90 mm Hg. Art. Below figures for those who suffer from serious concomitant diseases, for example, diabetes mellitus. In persons at high risk, treatment tactics are different from those for people with low cardiovascular risk. In young people, cardiovascular risk is always lower, even in the presence of other aggravating factors. This is especially true for young women - they always have a significantly lower risk than men. Women's heart is stronger, because a woman is a potential mother. Women are also less prone to bad habits. Young patients are more likely to determine "vascular age" before starting treatment. It is also important to determine the state of target organs.

Who are the "dangerous" categories of patients? The group of high cardiovascular risk includes patients who, in addition to AH, have diabetes, coronary heart disease, kidney disease, congenital heart disease and other disorders. Such patient monotherapy Ebrantilom is clearly not enough. There is a methodology for calculating the risk of death from cardiovascular diseases in the next 10 years based on age, bad habits, blood pressure, active / sedentary lifestyle, glucose tolerance level, heredity in cardiovascular disease.

Ebrantil is good because he warns a spasm of blood vessels. It corresponds to three basic principles of correction of blood pressure, accepted in medicine - maintains a normal level of cardiac output, the volume of circulating blood, the normal linear velocity of blood flow. A positive point is also the release of the drug in two dosage forms. The doctor has the opportunity to choose which form - capsules or solution for intravenous administration and droppers to appoint. Abroad, the drug has been used for a long time, so that it has a solid clinical experience. The cost of the drug Ebrantil is low.

[20]