From this article you will find out which preparations for cerebral vessels are used in clinical practice. Indications for the use of this group of drugs, mechanisms of action and the rules of admission.
Content of the article:
- Acetylsalicylic acid( aspirin)
- Statins
- Preparations based on Ginkgo Biloba
- Vinpocetine
- Cinnarizine
- Nimodipine
- Nicergoline
- Instenon
Drugs affecting cerebral vessels are most commonly used in neurology for the treatment of cerebrovascular diseases,ischemic and hemorrhagic strokes, transient ischemic attack, discirculatory encephalopathy, vascular dementia. Also this group of medicines is widely used for migraines, tension headaches, Meniere's disease, head injuries and other diseases.
Drugs that act on the vessels of the brain have very different mechanisms of action. Some of them reduce the risk of thrombosis, others - counteract the formation of atherosclerotic plaques, the third - eliminate the spasm of blood vessels. Below is an approximate list of the most popular tablets for cerebral vessels, starting with the most commonly prescribed medications and descending.
The choice of a suitable drug is performed by a neurologist.
1. Acetylsalicylic acid( aspirin)
Strictly speaking, aspirin does not act directly on blood vessels, it suppresses platelet aggregation, that is, prevents their attachment to the damaged endothelium( inner shell of vessels) and gluing together. But low-dose aspirin is one of the most frequent appointments of neurologists in the treatment and prevention of cerebrovascular diseases. This is one of the few drugs that has a proven positive effect on the results of prevention and therapy of ischemic strokes and transient ischemic attacks.
Previously, aspirin was widely used for the primary prevention of cardiovascular and cerebrovascular diseases, that is, its doctors recommended practically healthy people to prevent myocardial infarction and strokes. However, in recent years, the use of this drug has been questioned, since at times the risk from its use exceeded possible benefits. Now, aspirin is prescribed for the purpose of secondary prevention of patients who have already had a heart attack or stroke, as well as people who have a high risk of these complications.
Contraindications to the use of aspirin:
- Gastric ulcer or duodenal ulcer.
- Recently suffered hemorrhagic stroke.
- Allergy to aspirin.
- Asthma, whose symptoms worsen after taking acetylsalicylic acid.
- Blood clotting disorders( hemophilia).
- Severe violations of the liver and kidneys.
- Pregnancy and breastfeeding.
- Children's age( the use of aspirin can cause the development of Ray's syndrome).
- Deficiency of glucose-6-phosphate dehydrogenase( the use of aspirin can cause hemolysis of erythrocytes).
Possible side effects include the following:
- Dyspepsia and stomach pain - you can reduce the risk of their occurrence by taking the drug along with the food.
- Increased bleeding.
- Allergic reactions - hives, Quincke's edema, skin rash and itching, nasal congestion.
- Ringing in the ears.
- Gastrointestinal bleeding.
- Hemorrhagic stroke.
The recommended dose is 75-100 mg of acetylsalicylic acid per day. This product is available in tablets or capsules with an enteric coating. The most popular drugs aspirin - Cardiomagnolo, Magnikor, Aspirin Cardio, Aspekard. Doctors recommend taking them once a day, better - in the evening at the same time.
2. Statins
Statins are a group of drugs that reduce the level of harmful cholesterol in the blood. Due to this action, these drugs can reduce the risk of atherosclerotic plaques in the walls of the arteries of the whole organism, including the vessels of the brain.
At present, other useful effects of statins, to which the following belong, continue to be actively studied:
- Improvement of the functional state of the endothelium.
- Weakened damage caused by oxidative and inflammatory stress.
- Promoting the formation of new blood vessels( angiogenesis) in the area of impaired blood flow.
- Reduction of platelet aggregation and red blood cells.
| Possible side effects of statins | Contraindications |
|---|---|
| statins Epistaxis | hypersensitivity to preparations |
| Sore throat | active liver disease |
| Nasal congestion | pregnancy and breastfeeding |
| Headaches | Alcohol abuse |
| Nausea and vomiting | |
| constipation or diarrhea | |
| Rash | |
| Muscle weakness and pain | |
| Liver failure | |
| Damage to muscle tissue( rhabdomyolysis) |
The mostknown drugs of this group are atorvastatin( Atoris, Lipitor), rosuvastatin( Crestor, Roxer), simvastatin( Vasilip, Zocor).They are available in the form of tablets for oral administration, which should be taken in the evening at the same time.
In most cases, statin treatment lasts until the end of life, since discontinuation of their use leads to an increase in cholesterol levels within a few weeks.
3. Drugs Based on Ginkgo Biloba
For many thousands of years, the leaves of the Ginkgo tree have been widely used in Chinese medicine. Today, drugs made from his extract are one of the most popular drugs in patients with neurological diseases.
The active substances of this extract expand the cerebral vessels, improve blood flow, prevent platelet aggregation and protect the neurocytosis from damage caused by oxygen deficiency.
Indications for the prescription of medicines based on Ginkgo Biloba:
- Effects of blood supply disorders in the brain( headaches, ringing in the ears, vertigo, dizziness, mood swings, difficulty concentrating).
- Cognitive impairment and memory impairment caused by vascular disorders.
- Headache and sleep disturbances.
Ginkgo-based extracts are also used for other indications not related to their effect on cerebral vessels.
Contraindications to the taking of such drugs:
- Individual intolerance of the drug.
- Pregnancy and breastfeeding.
- Child's age.
The most famous drugs based on this extract are Bilobil, Memoplant, Ginkgo Biloba, Memorin. They are available in the form of drops, tablets or capsules for oral administration.
4. Vinpocetine
Vinpocetine is a synthetic derivative of vincamine - an alkaloid derived from a small Barvinus plant. This drug is widely used only in Eastern Europe. It is believed that he can improve cerebral circulation due to the expansion of cerebral vessels, and also has antiaggregant and antihypoxic effects.
Most of the studies on the efficacy and safety of vinpocetine were carried out before 1990, their results are difficult to be called reliable due to the application of different evaluation criteria. In 2007, the Russian Academy of Medical Sciences named vinpocetine an "obsolete drug with unproven efficacy", which does not prevent neurologists from prescribing it often enough.
| Indications for the appointment of vinpocetine | Contraindications |
|---|---|
| Symptoms of various disorders of the blood supply to the brain: memory impairment, dizziness, headache, movement disorders | |
| Hypersensitivity to | |
| Cerebral spasm, cerebrovascular insufficiency | Severe cardiac rhythm disorders |
| Retinal vascular pathology | Severe ischemic diseaseheart |
| Ménière disease, vascular hearing impairment | Acute stage of hemorrhagicstroke |
| Intracranial hypertension | |
| Pregnancy and breastfeeding | |
| Child age |
Vinpocetine is available in the form of tablets for oral administration or as a solution for slow intravenous infusion. The most famous drugs with this active substance are Cavinton, Vinpocetine, Bravinton.
5. Cinnarizine
Cinnarizine is a drug that belongs to calcium channel blockers and has antihistamine properties.
Cinnarizine is primarily prescribed for the treatment of nausea and vomiting associated with motion sickness in transport, vertigo, Meniere's disease. In fact, this is one of the few drugs that have shown positive effects when used to treat these diseases.
However, these properties of cinnarizine are not associated with its effect on the blood vessels of the brain, but with interference in the transfer of impulses between the vestibular apparatus of the inner ear and the center of vomiting in the hypothalamus.
Due to blockade of calcium channels, cinnarizine increases the elasticity of the vascular wall, thereby increasing the flexibility of the vessels. It also reduces the viscosity of the blood. Due to these effects, the blood flows better through the narrowed arteries, delivering more oxygen to the damaged parts of the brain. Therefore, cinnarizine is also prescribed for disorders of cerebral circulation( ischemic and hemorrhagic stroke, dyscirculatory anemia, vascular dementia, transient ischemic attack) and peripheral circulation( Raynaud's disease obliterating diseases of the lower limbs).
Contraindications:
- Hypersensitivity to the drug.
- Pregnancy and breastfeeding.
- Age under 12 years.
Cinnarizine is available in the form of tablets or capsules for oral administration.
6. Nimodipine
Nimodipine also belongs to the group of calcium channel blockers. This drug was developed to treat high blood pressure, but for this purpose is used very rarely.
Nimodipine has a certain selectivity of action on the vessels of the brain. Therefore, the main indication for its use is the prevention of cerebral vasospasm arising from subarachnoid hemorrhage.
Contraindications to the use of nimodipine:
- Hypersensitivity to the drug.
- Acute porphyria.
- Recently suffered myocardial infarction or episode of unstable angina.
Nimodipine is available in the form of tablets for oral administration.
7. Nicergoline
Nicergoline is a medicament derived from an ergot plant that is most commonly used to treat senile dementia and other diseases of vascular origin.
It is believed that nicergoline reduces vascular resistance and increases arterial blood flow in the brain, thereby improving the utilization of oxygen and glucose by its cells.
| Nicergoline is used in the following situations | Contraindications |
|---|---|
| Acute and chronic cerebrovascular diseases | hypersensitivity to the drug |
| migraine vascular origin | Severe hypotension |
| Vascular lesions of the retina( diabetic retinopathy, angiosclerosis retina) | Angina |
| Problems with vestibular apparatus vascular origin | Myocardial infarction |
In 2013, the European Medicines Agency recommendeduse of preparations containing ergot derivatives, including nicergoline. They said: "These medicines should no longer be used to treat certain diseases, including circulatory or memory problems and sensations, or to prevent migraines, since the risks are higher than the benefits of using them for these indications."Despite this statement, many neurologists continue to actively assign nicergoline to their patients.
The most famous agents with this active substance are Sermion, Nitzerium, Nicergoline. They are available in the form of tablets for oral administration.
8. Instune
Instenon is a combined preparation for improving cerebral circulation and metabolism. It contains the following active ingredients:
- hexobendine dihydrochloride;
- Etamivan;
- Ephofilin.
All components of Instenon affect various mechanisms of brain damage caused by impaired blood flow and oxygen deficiency.
| testimony to his appointment | Contraindications |
|---|---|
| Vascular lesions | brain hypersensitivity to the drug |
| consequences of violations of brain blood supply | intracranial hypertension |
| dizziness caused by vascular disease | Epilepsy and seizures |
| Intracerebral hemorrhage |
Available Instenon in tablet form for oral administration and inform ampoules for intramuscular or intravenous administration.
