From this article you will learn: what is adrenoblockers, what groups they are divided into. The mechanism of their action, indications, a list of drugs-adrenoblockers.
Adrenolytics( adrenoblockers) are a group of drugs that block nerve impulses that react to norepinephrine and epinephrine. The medicinal effect is opposite to that of adrenaline and norepinephrine on the body. The name of this pharmaceutical group speaks for itself - the drugs that enter it, "interrupt" the action of adrenoreceptors located in the heart and walls of blood vessels.
Such medications are widely used in cardiological and therapeutic practice for the treatment of vascular and cardiac diseases. Often, cardiologists assign them to elderly people who have arterial hypertension, heart rhythm disturbances and other cardiovascular pathologies.
Classification of adrenoblockers
There are 4 types of receptors in the vessel walls: beta-1, beta-2, alpha-1, alpha-2-adrenergic receptors. The most common are alpha and beta-adrenoblockers, which "turn off" the corresponding adrenaline receptors. There are also alpha-beta-blockers that block all receptors at the same time.
The means of each of the groups can be selective, interrupting selectively only one type of receptor, for example, alpha-1.And non-selective with simultaneous blocking of both types: beta-1 and -2, or alpha-1 and alpha-2.For example, selective beta-blockers can only affect beta-1.
Adrenolytic subgroups:
| Types of alpha blockers | Types of beta-blockers |
|---|---|
| Alpha-1-adrenoblockers | Selective beta-1 blockers |
| Alpha-2 blockers | Non-selective beta-1,2 receptor blockers |
| Alpha-1 and -2-adrenoblockers |
General mechanism of action of adrenoblockers
When norepinephrine or adrenaline is released into the bloodstream, adrenergic receptors react instantly by binding to it. As a result of this process, the following effects occur in the body:
- vessels narrow;
- the heart rate increases;
- increases blood pressure;
- increases blood glucose levels;
- dilates the bronchi.
If there are certain diseases, for example, arrhythmia or hypertension, then such effects are undesirable for a person, because they can provoke hypertensive crisis or relapse of the disease. Adrenoblockers "turn off" these receptors, so they act directly opposite:
- dilates blood vessels;
- reduces the heart rate;
- prevents the increase of sugar in the blood;
- narrow the clearance of the bronchi;
- lower blood pressure.
These are common actions, characteristic for all types of drugs from the adrenolithic group. But drugs are divided into subgroups depending on the effect on certain receptors. Their actions are slightly different.
Common side effects of
Common for all adrenoblockers( alpha, beta) are:
- Headache.
- Fast fatigue.
- Drowsiness.
- Dizziness.
- Increased nervousness.
- Possible short-term syncope.
- Disorders of normal stomach and digestion.
- Allergic reactions.
As preparations from different subgroups have slightly different therapeutic actions, the undesirable consequences from their reception also differ.
General contraindications for selective and nonselective beta-blockers:
- bradycardia;
- syndrome of the weak sinus node;
- acute heart failure;
- atrioventricular and sinoatrial block;
- hypotension;
- Decompensated heart failure;
- is an allergy to medication components.
Non-selective blockers should not be taken with bronchial asthma and obliterating vascular disease, selective - in the pathology of peripheral circulation.
Click on the picture to enlarge Such medications should be prescribed by a cardiologist or therapist. Independent uncontrolled reception can lead to serious consequences up to a lethal outcome due to cardiac arrest, cardiogenic or anaphylactic shock.
Alpha-blockers
The action of
Adrenoblockers of alpha-1 receptors dilate the vessels in the body: peripheral ones are noticeable in the redness of the skin and mucous membranes;internal organs - in particular the intestines with the kidneys. Due to this, the peripheral blood flow increases, microcirculation of tissues improves. The resistance of the vessels to the periphery decreases, and the pressure decreases, without a reflex increase in heart rate.
By reducing the return of venous blood to the atrium and expanding the "periphery", the cardiac load is significantly reduced. Because of the ease of his work, the degree of hypertrophy of the left ventricle, characteristic of hypertensive patients and elderly people with cardiac problems, decreases.
Other effects:
- Affects fat metabolism. Alpha-AB reduces the level of triglycerides, "bad" cholesterol and increases the high-density lipoproteins. This additional effect is good for people suffering from hypertension burdened by atherosclerosis.
- Affect the metabolism of carbohydrates. When taking drugs, the susceptibility of cells to insulin increases. Because of this, glucose is absorbed faster and more efficiently, which means that its level does not rise in the blood. This effect is important for diabetics, in whom alpha-adrenoblockers reduce the level of sugar in the bloodstream.
- Reduces the signs of inflammation in the organs of the genitourinary system. These drugs are successfully used in hyperplasia of the prostate to eliminate certain characteristic symptoms: partial emptying of the bladder, burning in the urethra, frequent and nocturnal urination.
The blockers of alpha-2 adrenaline receptors have the opposite effect: narrow vessels, increase blood pressure. Therefore, in cardiological practice are not used. But they successfully treat impotence in men.
List of
preparations The table below lists the international non-proprietary names of drugs from the α-receptor blocker group.
| means related to the alpha 1-blockers | Drugs from the group consisting of alpha-2-adrenoceptor antagonists | List alpha-1, -2-blockers |
|---|---|---|
| Doxazosin | Yohimbine | Nicergoline |
| Alfuzosin | Phentolamine | |
| Silodosin | Dihydroergotoxin | |
| terazosin | Proroksan | |
| Tamsulosin | Dihydroergotamine | |
| Prazosin | ||
| Urapidil |
Indications for use
Because the effect of drugs from this subgroup on the vessels is somewhat different, their areas of application are also different.
| Indications for the appointment of alpha-1-blockers | Indications for alpha 1, -2-blockers |
|---|---|
| Hypertension | Disturbances in the soft tissues of the extremities - ulceration due to pressure sores, frostbite, with thrombophlebitis, severe atherosclerosis |
| Chronic heart failure with hypertrophymyocardium | Diseases accompanied by peripheral blood flow disorder - diabetic microangiopathy, endarteritis, Reno disease, acrocyanosis |
| Hyperplasia of the prostate | Migraine |
| Coupétion effects | |
| stroke Senile dementia | |
| Failed vestibular apparatus due to problems with blood vessels | |
| corneal dystrophy | |
| Rectifying the neurogenic bladder | |
| Prostatitis | |
| optic neuropathy |
indications for alpha-2-blockers one - erectile dysfunction in men.
Side effects of alpha-adrenolytic drugs
In addition to the general side effects listed in the article above, these drugs have the following side effects:
| Side effects of alpha 1-blockers | Adverse effects with the administration of alpha-2 receptor blockers | Side effects of alpha 1,-2-adrenoblockers |
|---|---|---|
| Edema | Increased blood pressure | Loss of appetite |
| Strong decrease in blood pressure | Appearance of anxiety, irritability, increased excitability, motor activity | Insomnia |
| Arrhythmia, tachycardia | Tremor( tremor in body) | Sweating |
| Appearance of dyspnea | Decrease in frequency of urination and volume of excreted urine | Coldness of limbs |
| Runny nose | Heat in body | |
| Dryness of oral mucosa | Acidity increase of gastric juice | |
| Chest pain | ||
| Decreased sex drive | ||
| Urinary incontinence | ||
| Painful erections |
Contraindications
- Pregnancy.
- Lactation period.
- Allergy or intolerance to active active ingredients or excipients.
- Severe disorders of liver, kidneys.
- Arterial hypotension - low blood pressure.
- Bradycardia.
- Severe heart defects, including aortic stenosis.
Beta-blockers
Cardioselective beta-1-adrenoblockers: the principle of action of
Drugs from this subgroup are used to treat heart diseases, because they generally have a positive effect on this organ.
Effects:
- Antiarrhythmic action due to a decrease in the activity of the pacemaker - the sinus node.
- Reduced heart rate.
- Reducing excitability of the myocardium under conditions of psychoemotional and / or physical stress.
- Antihypoxic effect due to decreased oxygen demand of the heart muscle.
- Decrease in blood pressure.
- Preventing the expansion of the foci of necrosis with a heart attack.
A group of selective beta-blocker drugs reduce the frequency and ease the onset of angina pectoris. They also improve the tolerability of physical and mental stress on the heart in patients with heart failure, which prolong life. These funds significantly improve the quality of life for patients who have suffered a stroke or myocardial infarction, suffering from coronary heart disease, angina, hypertension.
Diabetics are warned of a rise in blood sugar levels, reduce the risk of bronchial spasm in people with bronchial asthma.
Non-selective beta-1, -2-adrenoblockers: the action of
In addition to antiarrhythmic, antihypertensive, antihypoxic effects, such agents have other actions:
- Antithrombotic effect is possible due to the prevention of clumping of platelets.
- Strengthens contractions of the muscular layer of the uterus, intestine, sphincter of the esophagus, while relaxing the sphincter of the bladder.
- During childbirth, blood loss is reduced in a woman in labor.
- Increases bronchial tone.
- Decreases intraocular pressure by decreasing fluid in the anterior chamber of the eye.
- Reduce the risk of acute heart attack, stroke, development of IHD.
- Reduce mortality from heart failure. Enumeration
preparations
| Beta-1 blockers( cardioselective) | Nonselective beta-1,2-adrenoceptors |
|---|---|
| Atenolol | bopindolol |
| bisoprolol | nadolol |
| acebutolol | metipranolol |
| talinolol | Propranolol |
| Betaxolol | oxprenolol |
| Nebivolol | Pindolol |
| Esmolol | Sotalol |
| Celiprolol | Timolol |
There are currently no medicines related to the pharmacological subgroup of beta-2-adrenergic receptors.
Indications
| Indications for use of selective beta-blockers | Indications for use of non-selective beta-blockers |
|---|---|
| CHD | Hypertension |
| Hypertension | Left ventricular hypertrophy |
| infarction Hypertrophic cardiomyopathy | Angina |
| voltage Most types of arrhythmias | heart Myocardial |
| prevention of migraine attacks | Mitral valve prolapse |
| Mitral valve prolapse | Sinus tachycardia |
| Treatmentof a heart attack and prevention of recurrence | Glaucoma |
| Neurocirculatory dystonia( hypertonic type) | Prevention of massive bleeding during childbirth or gynecological operations |
| Motor arousal removal - akathisia - against the background of neuroleptic drugs | Minor disease is a disease of the hereditary nervous system manifested by a single symptom -brushes of hands. |
| In the complex treatment of thyrotoxicosis |
Side effects of
| Common side effects of this drug group | Non-selective beta blockers can also cause |
|---|---|
| Weakness | Vision problems: fog, double vision, burning sensation, foreign body sensation, lacrimation |
| Deceleration of reactions | Runny nose |
| Drowsiness | Cough, possible asthma |
| Depression | Acute reduction in blood pressure |
| Temporal decrease in vision and deterioration of taste perception | Syncope |
| Coldness and numbness of feet and hands | Ischemia of the heart |
| Bradycard | Impotence |
| Conjunctivitis | Colitis |
| Dyspepsia | Increase in blood potassium, triglycerides, uric acid |
| Increase or decrease in heart rate |
Alpha beta blockers
Action
Drugs from this subgroup lower arterial and intraocular pressure, normalize lipid metabolism, te. lower the level of triglycerides, cholesterol, low density lipoproteins, while simultaneously increasing high density. The hypotensive effect is achieved without changing the renal blood flow and increasing the total peripheral resistance of the vessels.
When they are taken, the heart adapts to physical and psychoemotional stresses, and the contractile function of the heart muscle improves. This leads to a decrease in the size of the heart, the normalization of the rhythm, relief of the condition in the heart disease or stagnation of its insufficiency. If IHD is diagnosed, the frequency of her attacks against the background of taking alpha-beta-adrenoblockers decreases.
List of medicines
- Carvedilol.
- Butylamine hydroxypropoxyphenoxymethyl methyl oxadiazole.
- Labetalol.
| Indications | Side effects other than "common for adrenoblockers" |
|---|---|
| Hypertensive illness( both for regular administration and for normalization of pressure in hypertensive crisis) | Reduction of platelets and leukocytes in the blood |
| Open angle glaucoma | Impairment of conduction of cardiac pulses until their blockade |
| Stable angina | Impairment of peripheral circulation |
| Arrhythmias | Appearance of blood in urine |
| Heart defects | Increased levels of sugar, cholesterol,bilirubin |
| Chronic heart failure |
Octoputinal glaucoma Contraindications
Adrenoblockers from this subgroup can not be taken with the same pathologies as described above, supplementing them with obstructive pulmonary disease, type I diabetes, peptic ulcer and duodenal ulcer.