From this article you will learn: what are angioprotectors, the mechanism of their action, a review of popular groups of tools.
- The effect of angioprotectants, their types and classification
- Pentoxifylline and its analogs
- Prostaglandins
- Nitro group-dilators extending the vessels
- Metabolic products
- Phlebotonics
- Anticoagulants and disaggregants
Angioprotectors are a group of drugs aimed at strengthening or restoring blood vessels, as well as improving blood circulation. The main indication for the appointment of angioprotectors is circulatory disorders caused by diseases of large or small arterial and venous vessels.
Vascular pathology to date in terms of the prevalence and number of fatal complications ranks first. Since there are vessels in every system of the human body, these medications are prescribed by doctors of different specialties:
- vascular and general surgeons - with diseases of the aorta, large arteries, venous system of the extremities( obliterating atherosclerosis, varicose veins);
- neuropathologists - with vascular pathology of the brain( stroke against the background of atherosclerosis of the cerebral arteries);
- therapists and cardiologists - in case of heart and lung damage on the background of violation of the patency of arteries or veins( ischemic heart disease).
The special feature of the action of angioprotectors is that they can not completely restore the wall structure and the lumen of the altered vessel, but either partially do this, or contribute to the accelerated formation of bypass routes of blood flow. Thus, the circulatory processes in the zone of blood supply of the affected vessels are maintained at the proper level.
In this article you will be able to get acquainted with the five most common angioprotector groups and the peculiarities of their action:
- normalizers of blood microcirculation and rheology( Pentoxifylline, Vazaprostan, Ilomedin);
- preparations that dilate blood vessels - donors of the nitro group( Tivortin, Tivomax);
- metabolic agents( Actovegin, Solcoseryl, Cytoflavin);
- phlebotonics( venous preparations): Detralex, Flebodia, Troxevasin;
- anticoagulants and disaggregants( Heparin, Aspirin, Clopidogrel).
The action of angioprotectants, their types and classification
Angioprotectors, which improve the circulation of blood in very shallow vessels, are called normalizers of microcirculation. Their action is aimed at reducing the viscosity of blood( improving rheology) and reducing the resistance of the inner layer of vessels to its progress. This improves blood circulation in small vessels, which account for the main load in the foci with chronic microcirculatory disorders.
The general classification, types and list of preparations are given in the table.
| Generation | first | second | ||
|---|---|---|---|---|
| active substance and preparations | Pentoxifylline | Tablets | Injections | Prostaglandin( alprostadil) only in solution for injections |
| Pentilin | + | + | ||
| Trental | + | + | Vazaprostan, Alprostan | |
| Pot | + | - | Ilomedin |
Pentoxifylline and its analogs
Pentoxifylline derivatives have an average strength of action for improving microcirculatory processes. It is noted that such an original preparation Pentoxifylline is less effective than the brand analogues of foreign pharmaceutical companies( Trental, Pentilin).But its price is lower, which significantly reduces the cost of course treatment, despite the introduction of the drug in high dosages.
Recommendations for use Pentoxifylline:
- Indications - diseases of the arteries of the legs, aorta, neck, brain, internal organs, accompanied by a narrowing of the vascular lumen( mainly atherosclerosis).
- The main contraindication is severe heart disease( arrhythmia, ischemic disease, heart attack, heart failure).
- To start therapy better with intravenous injection in the form of a dropper course for about 2 weeks, followed by a transition to taking tablets.
- An existing long-acting form( Vazonite preparation) in one tablet contains the entire daily dose, which is very convenient for long-term treatment.
Prostaglandins
A new generation of stimulants of microcirculation - a group of prostaglandin drugs( Vazaprostan, Alprostan, Ilomedin).These angioprotectors are distinguished by a pronounced vasodilator effect, which is ten times greater than the result of drugs of the pentoxifylline series. But the price of these funds and the cost of course treatment is also ten times higher.
Features of therapy with alprostadil derivatives:
- Indication - obliterating diseases of lower limb arteries( atherosclerosis, diabetic angiopathy).
- Contraindications - old age, severe heart and internal disease, hemorrhagic stroke in history, bleeding.
- Entered exclusively intravenously in the form of a long dropper( at least 6 hours).
- Do not require the continuation of tablet forms, since they do not exist.
Donators of the nitro group, dilatation vessels
Combined products consisting of amino acids( arginine) of their derivatives - preparations Tivortin and Tivomax. Their action on the vascular wall is mediated through the enzyme NO-synthetase, which participates in the formation of the nitro group. The latter, like nitroglycerin, has a powerful vasodilating effect. In addition, the preparations improve the nutrition of the affected tissues in the zone of branching of the narrowed arteries.
Usage features:
- Indications - arterial diseases of any location( coronary heart disease, brain atherosclerosis, and lower limbs).
- Contraindications - only allergic reactions to administration. Usually, the tolerance of drugs is good.
- Entered exclusively intravenously in the form of a dropper;
- It is optimal to assign a course of 10-14 days.
- Admissible use in pediatric practice( in children older than 3 years).
Metabolic agents
Metabolic drugs have a mixed mechanism of action on blood vessels and tissues that are affected by circulatory failure. Such angioprotectors support metabolic processes in damaged cells in conditions of oxygen starvation. In this case, a secondary restoration of the microcirculatory bed occurs( capillaries, small arteries).The most common drugs used for the complex treatment of vascular diseases are Actovegin, Solcoseryl, Cytoflavin.
Usage features:
- Indications - severe disorders of cerebral circulation, arterial insufficiency of the lower extremities against the background of atherosclerosis.
- Contraindications - are extremely rare( with allergic reactions).
- There is a possibility of stepwise therapy - an appointment in the form of intravenous injections, with a gradual transition to intramuscular injection and tablets.
- To achieve a quick effect, the initial dose of the drug in the acute period of the disease should be very high.
- The full course of treatment should last about a month( it all depends on the pathology).
Phlebotonics
A group of drugs that have a strengthening effect on the wall and valves of venous vessels are called phlebotonics. These are very popular angioprotectors and are widely used in practice due to the prevalence of venous diseases. The most effective phlebotonics, containing as active ingredient diosmin and hesperidin:
- Detralex - well strengthens the veins, but it lasts about 12 hours after taking the pill, which requires double application per day;
- Flebodia is as effective as Detralex, but this action occurs more quickly and lasts for about a day, which requires a one-day daily intake.
Indication for the use of phlebotonics is exclusively the pathology of the venous system( chronic venous insufficiency, varicose and postthrombophlebitic disease).Produced only in tablets, are transferred well.
Anticoagulants and disaggregants
Angioprotectors, whose action on blood circulation in blood vessels is mediated through the dilution of blood, is called anticoagulants and disaggregants. The most powerful drug is Heparin. It acts quickly( in 15-20 minutes), but for a short time. It is available in the form of a solution for injections and is used for severe circulatory disorders against the background of blood clots in the vessels( heart attack, stroke, thromboembolism, arterial thrombosis, thrombophlebitis veins).Modern anticoagulants on the basis of heparin( Clexane, Fraksiparin) last about a day.
The most common disaggregant is Aspirin. It is produced in tablet form, adapted for long-term administration( for years).These drugs are Magnikor, Cardiomagnolo, Losirin. Stronger and safer are Clopidogrel and its derivatives( Tromboneet, Plavix, Plagril).Systematic reception of each of these funds by 30-50% reduces the risk of the most dangerous vascular complications - heart attack and stroke.
Despite the relative safety of these drugs - do not take angioprotectors without the appointment of a specialist!
