Quadropril

Quadropril, also known as spirapril, is a medication from the group of angiotensin-converting enzyme inhibitors (ACEIs). It is used to treat hypertension (arterial hypertension) and heart failure.

Here are the main points related to the use of Quadropril (spirapril):

1. Hypertension: Quadropril is used to lower blood pressure in patients with hypertension. It helps to dilate blood vessels and improve blood flow, which in turn reduces pressure in the blood vessels.
2. Heart failure: In patients with heart failure, the drug may be used to improve heart function and reduce symptoms such as shortness of breath, swelling, and fatigue.
3. Kidney protection: Quadropril may have a protective effect on the kidneys, especially in patients with diabetic nephropathy or other conditions that can lead to kidney damage.
4. After myocardial infarction: In some cases, the drug may be prescribed after myocardial infarction to prevent the development of heart failure and improve survival.
5. Contraindications and side effects: The drug may be undesirable for use in some patients, including those who are allergic to the drug components or have certain conditions such as pregnancy or renal artery stenosis. Side effects may include headache, hypotension (low blood pressure), cough, and rarely angioedema.

As with any other medication, the use of Quadropril should be supervised by a doctor who will prescribe the correct dosage and monitor for possible side effects.

Indications Quadropril

1. Hypertension (arterial hypertension): Quadropril is effective in lowering blood pressure in patients with hypertension. It helps to dilate blood vessels and reduce peripheral vascular resistance, leading to lower blood pressure.
2. Heart Failure: This drug may be prescribed to treat heart failure. This drug helps reduce the workload of the heart, improves blood flow, and may increase survival in patients with heart failure.
3. Kidney protection: The use of Quadropril may be indicated for kidney protection in patients with diabetes mellitus or other conditions that can cause kidney damage. This is due to its ability to lower pressure in the kidney arteries and reduce proteinuria (increased protein in the urine).
4. After myocardial infarction: The drug may be prescribed as part of comprehensive therapy after myocardial infarction to improve survival, prevent cardiac remodeling, and reduce the risk of re-infarction.
5. Diabetic Nephropathy: In patients with diabetic nephropathy, which is kidney damage caused by diabetes, Quadropril may be prescribed to protect the kidneys and slow the progression of the disease.

Release form

1. Tablets: This is the most common form of release. Quadropril tablets are usually available in different dosages, which allows you to choose the best dose for each patient. Tablets are usually taken orally, that is, by mouth.
2. Solution: Sometimes the drug may be available as an oral or intravenous solution. This form of release may be preferable for patients who have difficulty swallowing tablets or for those who need a quick onset of action.
3. Other forms: In some countries, the drug may also be available in other forms such as capsules or even intravenous solutions for infusion, but these are less common options.

Pharmacodynamics

1. ACE inhibition: The drug inhibits angiotensin-converting enzyme, which normally converts angiotensin I into active angiotensin II. Angiotensin II is a potent vasoconstrictor and leads to an increase in blood pressure by stimulating the secretion of aldosterone. By inhibiting this enzyme, quadropril reduces the level of angiotensin II, which leads to vasodilation and lower blood pressure.
2. Improved hemodynamics: By lowering blood pressure and increasing blood flow to the heart and other organs, quadropril helps improve hemodynamics, which is especially important for patients with hypertension, heart failure, or other cardiovascular disease.
3. Anti-edema effect: By reducing blood pressure and improving renal function, the drug may also help to reduce edema, especially in patients with heart failure.
4. Protective effects on heart and kidney: Quadropril, besides lowering blood pressure, has some antiproteinurin and cardioprotective properties that may be useful in various conditions such as diabetic nephropathy and chronic renal failure.
5. Antireabsorptive effect on the kidneys: The drug may reduce reabsorption of sodium and water in the kidneys, which also contributes to the reduction of circulating blood volume and blood pressure.

Pharmacokinetics

1. Absorption: Quadropril is generally well absorbed from the gastrointestinal tract after oral administration.
2. Maximum concentration(Cmax): Maximum plasma concentration is usually reached about 1-2 hours after administration.
3. Bioavailability: Bioavailability of the drug is about 25-40% due to its intensive metabolism during its first passage through the liver.
4. Metabolism: Quadropril is metabolized in the liver to form the active metabolite quadroprilate, which also has inhibitory properties against ACE.
5. Half-life (T1/2): The drug has a relatively short half-life of approximately 1-2 hours and its metabolite has a half-life of approximately 13-17 hours.
6. Excretion: Quadropril and its metabolite are excreted mainly through the kidneys.
7. Effect of food: Food intake may decrease the rate, but not the completeness of absorption of the drug.
8. Protein binding: Quadropril binds to plasma proteins at a level of about 97%.

Dosing and administration

1. Dosage:

   • Quadropril dosage is usually prescribed by a physician depending on the specific clinical situation and individual characteristics of the patient.
   • The usual recommended starting dose for adults is 2.5-5 mg once daily. The dose may be increased as needed under the supervision of a physician.
   • For patients with decreased renal function or over 65 years of age, the dosage may be adjusted as recommended by a physician.

2. Method of Application:

   • The drug is usually taken orally, regardless of food intake.
   • Tablets should be swallowed whole with a glass of water.

3. Duration of treatment:

   • The duration of Quadropril treatment is determined by the doctor depending on the nature of the disease and response to treatment.
   • Treatment with the drug is usually long term and continuous, subject to ongoing medical supervision.

4. Individualized recommendations from a physician:

   • The doctor may recommend individual adjustments to the dosage and regimen of Quadropril depending on the nature of the disease and the patient's condition.
   • Patients should strictly follow the doctor's instructions and not change the dosage or regimen without his or her approval.

Use Quadropril during pregnancy

The use of Quadropril (spirapril) during pregnancy is strongly discouraged. Drugs from the class of ACE inhibitors may cause serious birth defects in the fetus, especially when used in the second and third trimesters of pregnancy. These defects may include hypoplasia (underdevelopment) of the lungs, underdevelopment of the skull, delayed fetal growth and development, and other problems.

Contraindications

1. Hypersensitivity: Patients with known hypersensitivity to Quadropril or any other angiotensin-converting enzyme inhibitors (ACEIs) should not use this drug because of the risk of allergic reactions.
2. True arterial hypotension: Use of the drug may be contraindicated in patients with true arterial hypotension (excessively low blood pressure) as it may worsen symptoms.
3. Renal artery stenosis: Quadropril should be used with caution in patients with renal artery stenosis, as worsening of renal function may occur with use of the drug.
4. Pregnancy: Use of the drug during pregnancy may be contraindicated due to potential effects on the fetus. This drug may cause serious fetal side effects such as skull, urethral and lung deformities.
5. Breastfeeding: Quadropril is excreted into breast milk and may have an adverse effect on the infant, therefore discontinuation of breastfeeding may be necessary while taking the drug.
6. Angioedema: The drug may cause angioedema, especially in patients with a previous history of such reactions.
7. Hyperkalemia: Quadropril may cause an increase in blood potassium levels and should therefore be used with caution in patients with hyperkalemia.

Side effects Quadropril

1. Hypotension (low blood pressure): One of the most common side effects of Quadropril is hypotension. This can manifest as dizziness, weakness, or even loss of consciousness.
2. Cough: Some patients taking the drug may develop a cough that is usually dry and irritating. This side effect usually goes away after stopping the drug.
3. Hyperkalemia: Quadropril can cause potassium levels in the blood to rise, which can lead to serious health problems such as heart arrhythmias.
4. Allergic reactions: In rare cases, taking the drug may cause allergic reactions such as hives, itching, swelling of the face, or difficulty breathing. If these symptoms occur, stop taking the drug and seek medical attention.
5. Kidney problems: Quadropril may cause kidney function problems in some patients, especially in those who already have impaired kidney function.
6. Other side effects: Headaches, taste disturbances, fatigue, stomach disorders, changes in hematopoiesis, etc. May also occur.

Overdose

1. Severe lowering of blood pressure: Very high doses of quadropril can cause a critical drop in blood pressure, which can lead to fainting, dizziness, weakness and even loss of consciousness.
2. Electrolyte disorders: Overdose of the drug may cause electrolyte imbalance in the body, which may lead to heart rhythm disturbances, muscle cramps and other serious complications.
3. Renal insufficiency: Excessive effect of quadropril on the kidneys may lead to acute renal failure.
4. Hyperkalemia: Hyperkalemia (increased potassium in the blood) may develop, which can be dangerous for the heart.
5. Other symptoms: Other symptoms of drug overdose may include nausea, vomiting, insomnia, headache, and slow heartbeat.

Treatment of quadropril overdose usually involves urgent measures to maintain vital functions, such as maintaining adequate circulation and respiratory function. This may include administration of intravenous fluids, administration of vasopressors and other measures. In addition, further treatment may be required to restore electrolyte balance and treat other complications.

Interactions with other drugs

1. Diuretics (diuretics): The combination of Quadropril with diuretics may enhance the antihypertensive effect and reduce the risk of edema, especially in patients with heart failure.
2. Drugs that increase the level of potassium in the blood (potassium-saving diuretics, spironolactone, triamterene): Combination with such drugs may lead to hyperkalemia (increased potassium content in the blood), so it is necessary to carefully monitor the level of potassium in the blood.
3. Drugs that reduce potassium in the blood (lithium, cardiotonics): The drug may increase the effect of these drugs, which may lead to the development of hypokalemia (decrease in the level of potassium in the blood).
4. Drugs that increase blood pressure (e.g. Sympathomimetics): Quadropril may lessen the effects of these drugs.
5. Drugs causing hypotension (anesthetics, narcotic analgesics): Combination with the drug may increase hypotensive effect and lead to excessive decrease in blood pressure.
6. Drugs that increase the risk of hyperkalemia (non-steroidal anti-inflammatory drugs, potassium-containing supplements): Quadropril may increase the risk of hyperkalemia when used concomitantly with such drugs.
7. Drugs that increase the risk of angioedema (e.g. Calcineurin inhibitors): Combination with Quadropril may increase the risk of developing angioedema.

Storage conditions

1. Temperature: In general, Quadropril (spirapril) should be stored at room temperature, which is usually between 15°C and 30°C
2. . Avoid storage in areas subject to extreme temperatures.
3. Humidity: The drug should be stored in a place free from excessive humidity to prevent damage to tablets or capsules.
4. Light: It is recommended to store the preparation in a dark place protected from direct sunlight to prevent decomposition of the active ingredients by light.
5. Packaging: The medicinal product should be stored in the original package or container, which provides protection from external factors.
6. Availability to children: Ensure that the drug is stored out of reach of children to prevent accidental use.