From this article you will learn: what preparations for improvement of cerebral circulation exist and how they differ. How do vasodilators and nootropics work, anticoagulants and antiaggregants. What other drugs are used to improve cerebral circulation.
The deterioration of the cerebral circulation is the cause of numerous mental disorders, from insignificant memory impairment, insomnia to severe mental disorders( psychosis, dementia) and motor activity. Pathology appears against the background of the narrowing of the lumen of blood vessels( for various reasons: hypertension, atherosclerosis, osteochondrosis), because of which the brain does not get enough blood, oxygen starvation of cells develops and their conductive functions are violated.
Atherosclerosis of the vessels is the main cause of cerebral circulation disorders To restore cerebral circulation, drugs that are able to remove the severe symptoms of pathology( headache, dizziness, fatigue, partial memory loss), improve metabolism in brain cells, restore mental capacityand lost coordination of movements.
There are several large groups of drugs with different mechanisms of action that help to normalize cerebral circulation:
- Vasodilator drugs, their action is based on the ability of the drug in the composition to relax the vascular walls, increasing the lumen of the vessel and the amount of blood entering the brain.
- Anticoagulants, antiaggregants - prevent adhesion( aggregation of platelets, red blood cells) and prevent the formation of thrombi in the lumens of blood vessels, make the blood more fluid, increasing its ability to penetrate through the narrowed vessels into the brain.
- Nootropics - improve metabolism in brain cells( in conditions of oxygen starvation), restore their functions and prevent death, preventing irreversible changes in nerve tissues.
For people with cerebral circulation disorders, which manifest themselves with any symptoms( for example, insomnia or headaches), these medicines are needed, they will help to normalize and even significantly improve the condition. In patients with severe changes( violation of coordination of movements, loss of self-care skills, loss of memory) drugs for a while stop the development of pathology, stabilize the process.
The form of the medication is chosen depending on how serious the consequences of cerebral circulation disorders( incoherent speech after stroke, motor paralysis of the limbs), in the period of exacerbation prescribe funds in pricks, for course or permanent use - in tablets. The choice of the drug, dosage and frequency of admission is regulated by a doctor-therapist or neurologist( with pronounced neurological disorders).
For healthy people these remedies are useless, they do not affect the quality of mental activity or memory in any way, if the blood vessels supplying the brain are healthy.
The vast majority of drugs( more than 80% accurate), which we will talk about further, is available in tablets.
1. Vasodilator drugs
One of the most important roles in the mechanism of development of cerebral circulation disorders is the spasm of blood vessels( narrowing the lumen of the veins or arteries to the extent that their throughput decreases, and the cells of the brain begin to lack oxygen).
Spasm is a protective reaction of blood vessels to high blood pressure in the vein or artery. Because of the increased blood flow capacity, the vessels first acquire an increased tone( tension) and then the thickness of their walls increases. Thus, the lumen of the vessel and the amount of blood flowing through it is reduced, causing the development of disorders of cerebral circulation.
Vasodilators( vasodilators) - a large group of drugs with different active substances in the composition, differing indications and contraindications, side effects and price. They share a common principle - they all affect the relaxation of vascular walls in different ways, relieve their spasm, increasing the lumen of the vessel and the amount of blood entering the brain.
Among the vasodilator drugs that improve cerebral circulation, the following drugs are most effective.
Correctors of the cerebral circulation
Sample preparations: Vinpocetine, Cavinton, Telethol, Vinpoton, Korsavin, Bravinton, Cavintazol.
The mechanism of the vasodilator action of these agents is based on the ability of the drug to block the entry into and out of the cell of calcium and sodium ions, as well as receptors that cause vasospasms.
The drug also participates in the transport of glucose( an energy source for cellular reactions) through the cell membrane, enhances the utilization of glucose and the metabolism of the substance in the brain cells.
Increases their resistance to oxygen starvation, has little effect on blood pressure, pulse, cardiac output, since it acts mainly on small blood vessels( capillaries and arterioles).
These medications to improve the cerebral circulation are not recommended to be used simultaneously with direct anticoagulants( heparin), because this can provoke bleeding.
Combined Correction Correctors
These drugs consist of a set of equivalent active ingredients.
Examples of drugs: Vazobral, Pentoxifylline, Instenon.
These are drugs with various active substances, the mechanism of their action is aimed at improving cerebral circulation by blocking receptors that can cause spasm of small vessels of the brain.
They enhance the processes of glucose utilization in brain cells, metabolism and elimination of oxidation products. Increase the stability of nerve cells to oxygen deficiency, preventing their degeneration and mass death.
Reduces the permeability of vascular walls and the clumping of cellular blood cells( red blood cells and platelets), preventing the appearance of blood clots.
Do not affect the indices of blood pressure, stimulate solely the decrease in the tone of small capillaries and arterioles of the brain.
Calcium antagonists( or calcium channel blockers)
Examples of agents: Corinfar, Felodipine, Verapamil, Gallopamil, Diltiazem, Nicardipine, Amlodipine, Cinnarizine, Nimodipine.
Calcium channel blockers reduce the flow of calcium ions into the cells of the heart muscle and vascular walls. This process reduces the tone and relaxes mostly small peripheral arterioles and capillaries.
As a result, the lumen of blood vessels and the volume of blood flow increases, improving the blood supply of the peripheral parts of the body and brain. The drugs enhance metabolic processes in the brain cells.
Calcium channel antagonists are prescribed for the complex treatment of cerebral circulation disorders in the presence of arterial hypertension.
Adrenoblockers
Adrenoblockers( alpha and beta) with vasodilating( vasodilating properties): Celiprol, Sermion, Nicergoline, Prazosin, Bepantol, Cardura.
Thanks to drugs, the work of brain receptors and smooth muscles, capable of causing spasm of the vascular walls, is blocked.
Adrenoblockers expand not only small arterioles and capillaries, but also large blood vessels( veins), significantly lowering arterial pressure, so they are prescribed for the complex elimination of arterial hypertension and its consequences - oxygen starvation of brain cells
Sometimes after adrenoblockers, a side effect develops -a sharp drop in blood pressure, which can be adjusted by lowering the dose of the drug. At the same time, tachycardia( increased heart rate) may occur.
Nicotinic acid
These vasodilators( vasodilators) are based on nicotinic acid( vitamin PP).
Examples of drugs: Nicotinic acid, Nikospan, Acipimox, Nicofuranose, Enduratin.
The vasodilator property of nicotinic acid is based on the fact that vitamin PP stimulates the production of prostaglandins( hormone-like lipids that can cause relaxation of the walls of small peripheral vessels).The oxidative-reduction effect of vitamin PP enhances the metabolism and promotes the active excretion of oxidation products, supports the normal life of the cell in conditions of oxygen starvation, reduces the level of triglycerides and cholesterol.
Nicotinic acid drugs act as vasodilators only in large doses, they are used to reduce the risk of developing fatal complications( acute myocardial infarction) against ischemic heart disease.
2. Nootropics
Nootropic drugs have no vasodilating effect, but are capable of stimulating the metabolism of cells in the neural tissue, improving its resistance to oxygen deficiency.
The mechanism of action of a part of nootropics( cerebrolysin) has not yet been fully studied, although traditional medicine recognizes them and widely uses them to treat the consequences of ischemic and hemorrhagic strokes( acute oxygen deficiency), dementia( dementia) and Alzheimer's disease.
Examples of drugs: Pyracetam, Phenotropol, Pramiracetam, Cortexin, Cerebrolysin, Epsilon, Pantokalcin, Glycine, Actaebral, Inotropil, Thiocetam.
Neurometabolic agents in various ways( enhancing the synthesis of dopamine, with the help of related amino acids and polypeptides, preventing the destruction of acetylcholine, etc.) improve the metabolism in the brain cells and restore their functions( conduction of a nerve impulse).They increase the cellular utilization of glucose, thereby providing energy for the normal functioning of cells, enhance the resistance of cells in conditions of oxygen starvation.
In the appointment of nootropics, the effect is achieved by special injection regimens and a correctly selected dosage, which are directly dependent on the severity of cerebral circulation.
3. Anticoagulants and antiplatelet agents
Anticoagulants and antiaggregants prevent the second most important cause of cerebral vascular insufficiency - thrombus formation. Acting directly on the chemical parameters of blood viscosity and the process of sticking together the formed elements( adhesion of erythrocytes and platelets), reducing the number of blood coagulating factors, they improve the cerebral blood supply not directly, but indirectly.
Examples of drugs: Dipyridamole, Tiklid, Plavix, Aspirin, Heparin, Clexane, Dicumarin, Urokinase, Streptokinase, Warfarin.
They dilute the blood( in the liquid form, the blood penetrates more easily through the stenoses), improve the blood supply and gas exchange of the cells of the nervous tissue of the brain.
Prevent thrombus formation and overlapping of the lumen of blood vessels, which causes the development of cerebral circulation disorders( up to deadly thromboembolism - clotting with a blood clot of large blood vessels).
Drugs are taken under the control of laboratory indicators of blood coagulability, coagulogram and liver tests.
What other medicines can help
The third significant risk factor for the development of disorders of cerebral blood supply and oxygen starvation of tissues is the atherosclerosis of the vessels and the narrowing of their channels due to the formation of cholesterol plaque. This process triggers violations of lipid metabolism( increase in the level of triglycerides and cholesterol in the blood), so drugs that normalize this metabolism are prescribed for the prevention of atherosclerosis and cerebral circulation disorders.
Statins
Names of preparations: Liprimar, Fluvastatin, Cerivastatin, Mevakor, Lipostat, Zokor.
The mechanism of action is based on the interruption of the chemical reaction of the transformation of precursors of cholesterol.
Statins reduce the risk of developing ischemia of the heart muscle and brain.
In combination with other medicines, vitamins are often used.
Vitamins
What vitamins are used: B group vitamins, folates( vitamin B9), rutin, vitamin K, dihydroquercetin, ascorbic acid( vitamin C).
Independently they are not able to improve cerebral circulation or eliminate its symptoms, but against the background of the main drug:
- stimulate the metabolism;
- strengthens the vascular walls;
- reduces their permeability;
- dilute blood;
- inhibits thrombus formation;
- is needed for normal growth and development of cells.
All listed medicines can be used only after consulting a doctor, self-medication can harm. Preparations for improving blood circulation are prescribed based on the severity of the condition( initial stage, acute disorders of cerebral circulation), depending on this, form( intravenous drip, injections or tablets), dosage and a set of concomitant agents( antiaggregants in combination with adrenoblockers orinhibitors of calcium channels, etc.).
