Description overdue on 29.06.2012

Antihypertensives . Active ingredient - enalapril . The mechanism of action is directed to the inhibition of angiotensin converting enzyme, to reduce the formation of angiotensin-2 from the precursor of angiotensin-1 (causes a reduction in aldosterone secretion). The drug reduces the diastolic, systolic blood pressure, reduces the preload, afterload on the myocardium. The drug is active in the artery rather than a vein, does not cause a reflex increase in heart rate. The most pronounced hypotensive effects observed at high levels Renin in blood. Berlipril no effect on the blood circulation in the brain increases renal, coronary blood flow. When long-term therapy with enalapril recorded a decrease in the severity of left ventricular hypertrophy, slows down the process of dilation of the left ventricle, preventing progression Heart Failure . In the damaged myocardium with enalapril improves blood flow. Medicament reduces platelet aggregation. Berlipril contributes to lengthening life expectancy in patients with chronic heart failure. The drug has a faint diuretic effect. Berlipril slows the progression of glomerulosclerosis, intraglomerular reduces hypertension. The basic substance is a "prodrug", which is formed from the hydrolysis of enalaprilat. Enalaprilate inhibits angiotensin-converting enzyme. A oral hypotensive effects recorded after an hour. In order to achieve a stable effect of the drug must be taken for a long time. Berlipril is available in tablet form.

Indications:

Berlipril prescribed for hypertension: renovascular, symptomatic, with Scleroderma . The drug is used to prevent coronary ischemia   in patients with dysfunctional disorders in the left ventricle.

Contraindications:

Berlipril not apply during pregnancy, intolerance to ACE inhibitors enalapril, breastfeeding. When idiopathic and hereditary forms angioedema , Cerebrovascular disease, in severe systemic autoimmune connective tissue diseases, with cerebrovascular insufficiency, when aortic stenosis , Coronary insufficiency, ISF, in scleroderma, systemic lupus erythematosus , Stenosis of renal arteries, the elderly, with diabetes , Hyperkalemia, inhibition of bone marrow hematopoiesis Berlipril used with caution after consulting a doctor.

Side effect:

Cardiovascular system: Orthostatic hypotension , Angina, chest pain, myocardial infarction, excessive drop in blood pressure, thromboembolic pulmonary artery branches, palpitations, Atrial fibrillation , Atrial tachycardia , Atrial bradycardia, arrhythmia. Nervous system:   anxiety, paresthesia, fatigue, headaches, insomnia, dizziness, depression, drowsiness, confusion, fatigue, nervousness . Senses:   the noise in my head, hearing, disorders of the vestibular apparatus. The digestive tract:   yellowness, pancreatitis , Violations of the chair, dyspepsia , Loss of appetite, dry mouth, epigastric pain, nausea, disorders of the liver, biliary excretion disorders, hepatitis. Respiratory system: dyspnea, bronchospasm, pharyngitis, rhinorrhea, interstitial pneumonitis "Dry" non-productive cough. Allergic response : Angioneurotic edema of the lips, face, tongue, skin rashes, dysphonia , Laryngeal edema, toxic epidermal necrolysis, exudative, erythema multiforme, exfoliative dermatitis, vasculitis, serositis, photosensitivity, hives , Glossitis, stomatitis, arthritis, arthralgia, myositis. Urinary system:   proteinuria, abnormalities in the kidneys. Perhaps the development of eosinophilia, libido disorders, agranulocytosis , Eosinophilia, neutropenia, decreased hematocrit, hyperkalemia, alopecia.

Overdose:

Manifested stupor, convulsions, troboembolicheskimi complications , Acute ischemic stroke, myocardial infarction, excessive drop in blood pressure. It is urgent to give the patient a horizontal position, lower the head below the level of the trunk. Effectively gastric lavage, the use of saline solution inside, in severe cases, therapeutic measures should be aimed at stabilizing the blood pressure by intravenous infusion of plasma substitutes, sodium chloride solution. Enalaprilat hemodialysis output at 62 ml per minute. If necessary, intravenously infused angiotensin-2, hemodialysis.

Mode of application:

Berlipril taken regardless of meals. Monotherapy hypertension: an initial dose of 5 mg per day. If there is no effect, increase the dose to 5 mg every 1-2 weeks. After drug administration the patient was observed for two hours until complete stabilization of arterial pressure. With good tolerance dose increased to 40 mg per day dose divided into 2 doses. The average daily dosage for moderate hypertension is 10 mg. The maximum daily amount of the drug - 40 mg. Diuretic drugs canceled 2-3 days before the appointment berdiprila. If renovascular hypertension, the initial dose is 2 mg per day 5-5. In severe hypertension acceptable intravenous enalaprilat under steady observation. At low systolic pressure   treatment is initiated with 1, 25 mg. Dosing of the drug was carried out for 2-4 weeks. When strongly pronounced decrease in blood pressure drug dosage reduced gradually.

Special instructions:

When treating patients with reduced BCC (vomiting, diarrhea, dialysis, limited consumption of salt, diuretic therapy), care must be taken because of the risk of a sharp drop in blood pressure. After stabilization of blood pressure diagnosis transient hypotension   not a contraindication to treatment with enalapril. The risk of developing anaphylactic reactions   increases in applying dialysis, vysokoprotochnyh membranes. Correction mode is performed depending on the performance of blood pressure. It takes control of the parameters of blood, the level of protein in the urine. Careful observation require patients with cerebrovascular disease, a form of decompensated CHF, CHD, as a sharp drop in pressure can cause a stroke, kidney disease, myocardial infarction, renal disorders in the system. With the sudden discontinuation of enalapril syndrome "cancel" is not registered. If oliguria need support renal perfusion , Stabilization of blood pressure, administration of vasopressors and related fluids. Patients with abnormal renal system is recommended to increase the time between doses of the drug Berlipril, reduce the dosage. Prior to the survey features parathyroid glands   drug overturned. In hot weather, intense physical activity need to be careful. Before the surgery is absolutely necessary to notify the anesthesiologist and surgeon about taking enalapril. The drug effect on driving vehicles.

Drug Interactions:

Berdipril slows down the process of removing lithium from the body, strengthens the effects of ethanol. The drug reduces the effect of drugs, which is a part of theophylline . Other antihypertensives diuretic drugs   reinforce and estrogens and NSAIDs reduce the hypotensive effect. When using potassium-sparing diuretics and drugs increases the likelihood of hyperkalemia, which leads to agranulocytosis , Neutropenia, bone marrow depression. Cytotoxic agents, allopurinol , Immunosuppressants enhance the haematotoxicity.