Vasodilation is the process of relaxation of the muscle layer of the vascular wall. A drug that has a similar mechanism of action and is used in the treatment of heart failure and hypertension is called the appropriate term - a vasodilator. What is it and what means belong to vasodilators, we will consider further.
General information
The decrease in cardiac output that occurs with heart failure activates the adrenergic nervous and renin-angiotensin systems, resulting in the release of angiotensin II and norepinephrine. Active substances bind to receptors, which leads to vasoconstriction.
The first stage of heart failure requires a similar mechanism, as it allows you to maintain the desired level of blood pressure. However, prolonged narrowing of the veins leads to the development of congestive processes in the lungs and a decrease in cardiac output.
Vasodilators - drugs (listnames can be found in the specialized medical and pharmacological literature, in addition, below we list the most popular means of this group) used for vasodilatation. The result is the development of hypotensive action. Another important indication for the appointment of this kind of medication is a heart cough. How can vasodilators help with this condition? Drugs for heart cough are used to expand the coronary vessels.
Classification of drugs
Depending on which parts of the vascular bed the active substances affect, there are three groups of vasodilators:
-
Arterial:
- "Hydralazine";
- calcium antagonists.
- Venous:
- nitrates;
- sydnonimines.
-
Mixed type:
- angiotensin II receptor blockers;
- ACE inhibitors;
- alpha1-blockers;
- sodium nitroprusside.
Venous vasodilators
Venous vasodilator - what is it? This is a drug that causes a decrease in the tone of the venous vascular wall. Venules respond to lower concentrations of active substances than arteries. In such cases, nitrates are used, which help to relax large veins, increase the volume of the bloodstream, reduce the load on the heart, and reduce the need for oxygen in the myocardium.
| Venous vasodilator name | The pathintroductions | Duration | Reception Scheme |
| "Nitroglycerin" |
Sublingual (under the tongue). Inside. Buccal. Patch. Ointment. |
From 30 minutes to 1 day depending on the form of administration |
Sublingual - as needed. Other forms - up to 3 times a day. Patch - 1 time per day. |
| "Isosorbide mononitrate" |
Depo. Inside. |
10 to 24 hours depending on the form of administration | 1-2 times a day |
| "Pentaerythrityl tetranitrate" | Inside | Up to 10 hours | 3 times a day |
| "Isosorbide dinitrate" |
Sublingual. Inside. Aerosol (inside or skin). Intravenous drip. Ointment. |
From 1 to 6 hours depending on the form of administration |
Sublingual and oral aerosol - as needed. Other forms - 1-4 times a day. |
| "Molsidomine" | Inside | Up to 6 hours | 2-3 times a day |
Venous vasodilators - drugs (names, doses are described in the table), which are considered the safest of all antianginal drugs. Side effects are rare and short-lived.
Arterial vasodilators
Arterial vasodilator - what is itlike this? This is a drug, the active substance of which helps to relax the muscle tissue of the arterial wall.
For example, Hydralazine is a drug that increases heart rate, increases blood flow in the kidneys and brain, which occurs as a reflex response to the removal of vascular spasm. Used in various forms of hypertension, hypertensive crisis in combination with other drugs.
Hydralazine side effects:
- cephalgia;
- facial redness;
- appearance of edema;
- worse angina symptoms;
- a condition similar to systemic lupus erythematosus.
"Diazoxide" is a vasodilator that is used exclusively for the relief of a hypertensive crisis. Introduced intravenously, lowers blood pressure after 2-3 minutes. In addition, the remedy causes a strong relaxation of the uterus and water retention in the body.
Calcium antagonists - a group of arterial vasodilators, including the following agents:
- "Nifedipine" - eliminates spasm of the coronary vessels, lowers blood pressure, reduces the work of the heart muscle.
- "Verapamil" - reduces myocardial contractility, restores heart rate and blood pressure.
Mixed drugs
Mixed vasodilator - what is it? This is a remedy whose active substance relieves spasm of arteries and veins. One of the most effective is nitroprussidesodium. By the mechanism of action, it is similar to nitrates. Intravenous administration of the drug causes a quick and strong effect, but it is short-lived.
A vasodilator is used in case of acute and chronic heart failure, hypertensive state against the background of myocardial infarction, encephalopathy against the background of hypertensive manifestations. The introduction of sodium nitroprusside can cause dizziness, headache, loss of consciousness, nausea, tachycardia.
ACE inhibitors - a group of drugs that block the formation of angiotensin-converting enzyme, as a result of which angiotensin II is not produced. In parallel, there is an increase in the effect of diuretic drugs. The classification of ACE inhibitors is based on their chemical structure:
-
Containing a sulfhydryl group:
- "Captopril".
- "Zefenopril".
- "Benazepril".
-
Containing a carboxyl group:
- "Lisinopril".
- "Enalapril".
- "Spirapril".
- Containing a phosphinyl group:
"Fosinopril"
Drugs are beneficial for asymptomatic left ventricular dysfunction, carotid atherosclerosis, metabolic syndrome, microalbuminuria, atrial fibrillation, history of myocardial infarction, non-diabetic nephropathy.
Pediatric vasodilators
Vasodilator drugs for children are used exclusively for severepathologies. As a rule, myotropic agents ("Dibazol", "Papaverine") and ganglionic blockers ("Benzohexonium") are used.
Children receive vasodilator drugs for neurological treatment. The funds are aimed at improving cerebral circulation, are used in conditions of "white" hyperthermia and hydrocephalus.
Any of the medicines is selected individually, it depends on the patient's condition, the severity of the disorders, the form and course of the disease. Self-medication is strongly discouraged.
