ANTIHYPERTENSIVES (grech, hypo-+ lat. tensio tension, a tension) — the pharmaceuticals reducing arterial pressure.
Of page is divided into three groups.
1. Neurotropic means: the central action — katapresan (see), Methyldopa (see); ganglioblokator — arfonad (see. Ganglioblokiruyushchy means ), petrolhexonium (see), gigroniya (see), Pentaminum (see), Pyrilenum (see), Temechinum (see); sympatholytics — Octadinum (see), Ornidum (see), Reserpinum (see), Raunatinum (see. Rauwolfia ); adrenoblockers — anaprilin (see. Propranolol ), Tropaphenum (see), phentolamine (see), etc.
2. The means influencing electrolytic balance of an organism (saluretics): derivatives of a petrolthiadiazine — dichlothiazide (see), furosemide (see), and antagonists of Aldosteronum — Spironolactonum (see).
Neurotropic means make a basic group of G. of page. The mechanism of their action is based on reduction of tonic influence of sympathetic (adrenergic) nerves by vessels and heart.
Neurotropic central acting agents (katapresan) cause hypotensive effect of hl. obr. thanks to oppression of vasomotor centers.
Ganglioblokatora slow down carrying out excitement in vegetative gangliya. The hypotensive effect caused by them is caused by disturbance of transfer of excitement through sympathetic a ganglion to vessels and heart, as a result to-rogo the general vascular resistance (a vascular tone) and cordial emission decreases. Drugs of this group use hl. obr. for stopping of hypertensive crises. They are applied also for the purpose of creation of the managed hypotonia at surgeries (arfonad, gigroniya).
In therapy of an idiopathic hypertensia sympatholytics are of great importance. Drugs of this group selectively break function of postganglionic adrenergic fibers. Influence of sympathetic nerves on vessels and heart is as a result weakened. The hypotensive effect of these substances is caused by hl. obr. reduction of the general vascular resistance.
Adrenoblockers break function of adrenoceptors, Unlike sympatholytics, they suppress not only nervous, but also humoral adrenergic influences on cardiovascular system. alpha Adrenoblockers (phentolamine, Tropaphenum, etc.), suppressing vasoconstrictive adrenergic influences, reduce the general resistance of peripheral vessels. Usually they are used for stopping of hypertensive crises. beta Adrenoblockers (anaprilin) suppress the stimulating influences on heart and vasodilating adrenergic influences on vessels therefore cordial emission decreases and a little the general vascular resistance increases. Under the influence of ABP beta adrenoblockers decreases equally both at horizontal, and at vertical position of a body.
The means influencing electrolytic balance of an organism (saluretics) widely apply to treatment of an idiopathic hypertensia. Their hypotensive action is connected, apparently, with two factors: on the one hand, they strengthen removal of ions of sodium, chlorine and liquid from an organism, reducing thus the mass of the circulating plasma y cordial emission, with another — lower a vascular tone in connection with reduction of intracellular content of sodium in vessels. The substances influencing electrolytic balance have weak hypotensive effect and pages are usually used in a combination with other G.
Myotropic means exert the direct oppressing impact on smooth muscles of vessels. The hypotensive effect of magnesium sulfate is caused both by direct action on vessels, and the oppressing influence on c. N page and transfer of excitement in sympathetic gangliya. Magnesium sulfate and Dibazolum apply to treatment of hypertensive crises, apressine more often — to systematic treatment of an idiopathic hypertensia.
At treatment of an idiopathic hypertensia usually combine G. of page with various mechanism of action. It allows to gain more expressed hypotensive effect and to reduce by-effects. Most often combine sympatholytics with saluretics.
Kliniko-pharmakol. the main G.' characteristic of the page applied in medical practice — see the table.
Table. Kliniko-pharmakologichesky characteristic of the main antihypertensives
Bibliography: Votchal B. E. Sketches of clinical pharmacology, M., 1965; Glezer G. A. Dynamics of blood circulation at an arterial hypertension, page 113, M., 1970; Mashkovsk and y M. D. Pharmaceuticals, t. 1, with, 339, M., 1972; Pharmacological studying of antihypertensives of the central action, under the editorship of A. V. Valdman, L., 1975; Erina E. B. Treatment of an idiopathic hypertensia, M., 1973, bibliogr.; G ref f K. Pharmakologie moderner Antihypertonika, Med. Welt (Berl.), Bd 26, S. 413, 1975, Bibliogr.; Pomerantz H. Z. Hypotensive drug therapy in the management of hypertension, Amer. Heart J., v. 78, p. 433, 1969; Rossi G. Antihypertensive drugs, Amer. J. Pharm., v. 142, p. 197, 1970; S a n n e r s t e d t R. a.ConwayJ, Hemodynamic and vascular responses to antihypertensive treatment with adrenergic blocking agents, Amer. Heart J., v. 79, p. 122, 1970; Truniger B. Therapie der arteriellen Hypertonie, Z. allg. Med., Bd 51, S. 162, 1975; Zacest R * The clinical pharmacology of hypotensive vasodilator drugs, Med. J. Austr., spec, suppl., v. 1, p. 4, 1975, bibliogr.; Zim-mermanB.G. Drug action of peripheral vascular system, Ann. Rev. Pharmacol., v. 12, p. 125, 1972, bibliogr.
H. V. Kaverina, P. S. Mirzoyan.