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Peripheral Vasadilators PowerPoint Presentation

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Description : Check out this medical presentation on Pharmacology, which is titled "Peripheral vasadilators", to know about peripheral vasadilators.

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Published on : Jul 18, 2021 | Views : 2296 | Downloads : 0

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Peripheral vasadilators (Summary) Assoc. Prof. Iv. Lambev E-mail: itlambev@mail.bg
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I. Alpha (Alfa)-blockers  Non-selective alpha-blockers (used in peripheral vascular disease): a) Ergot-alkaloids (from Secale cornutum) and their derivatives: Ergotamine (with ISA) Ergotoxine, Dihydroergocristine, Dihydroergotoxine, Dihydroergotamine b) Synthetic drugs Nicergolin (used in peripheral vascular spasms and cerebral vascular disease) Phentolamine (used in hypertensive emergencies)
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Blockade of postsynaptic 1-receptors lowers blood pressure by: Lowering tone in arteriolar resistance vessels. Dilating venous capacitance vessels, which reduces venous return and cardiac output. Selective 1-adrenoceptor antagonists spare the presynaptic 2-adrenoceptors and do not produce reflex tachycardia.  Postsynaptic a1-blockers
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Postsynaptic a1-blockers Doxazosin Prazosin
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Prazosin – indications: - Arterial hypertension - Congestive chronic heart failure Potentially beneficial effect: an increase in HDL and a reduction in triglycerides. Adverse reactions (ARs) - Postural hypotension due to venous pooling (this can be troublesome after the first dose) - Lethargy
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Alfuzosin (Xatral SR®), Doxazosin, Tamsulosin (Omnic®) Selective postsynaptic alpha-1А-blockers: block alpha-1А-receptors into the smooth muscles of the prostate gland, and the prostatic part of the urethra. Indication: hyperplasia of prostate gland
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ATP cAMP 3’,5’-AMP AC PDE (-) (+) PKA Effects II. Phosphodiesterase inhibitors Pentoxifylline Drotaverine, Papaverine Sildenafil, Tadalafil, Vardenafil
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a) Methylxanthines Pentoxifylline: in cerebrovascular disease and peripheral vascular disease Poppy  Nonselective inhibitors of PDE Pentoxifylline blocks PDE and TGFβ1-receptors. Acting through TGFβ1 inhibition in dose 400 mg/24 h it is also reported to be effective in Peyronie's disease (induratio penis plastica).
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ANGIOGENESIS PDGF TGF-b TNF-b (+) (+) (-) VEGF (+)
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b) Papaverine and their analogues (spasmolytics) - Drotaverine (No-Spa®) - Papaverine (alkaloid, isolated from Poppy) Poppy
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Selective inhibitors of PDE5 (used to treat erectile dysfunction) Sildenafil (Viagra®) Tadalafil (Cialis®) Vardenafil (Levitra®) PDE3 (1/4000) PDE6 (1/10)
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III. Prostaglandine analogues (adenylate cyclase activators) Prostacycline (PGI2) has peripheral vasodilating and coronary dilating effects. It also inhibits thrombocyte aggregation. Iloprost (Ilomedin) is its PGI2- analogue, used i.v. in oblitering thromboangitis and limb ischemia.
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Prostavasin® Caverject® Alprostadil is a prodrug, which is transformed in the organism to PGE1. It has a vasodilating effect in the treatment of trophic ulcers and erectile dysfunction. Alprostadil is injected intracavernously in erectile dysfunction.
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21 No comments
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IV. PHYTOPREPARATIONS Extr. Ginkgo bilobae (Tanakan®) – NO donor, used in peripheral vascular disease, cerebrovascular disease, and atherosclerotic hearing disorders V. 5-HT2-RECEPTOR BLOCKERS Naftidrofuryl – used in peripheral vascular disease and cerebrovascular disease
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Ginkgo biloba
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VI. CEREBRAL VASCULAR DILATORS Calcium antagonist (used in cerebral vascular disease, ischemic cerebral stroke, hearing disorders)
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 Combined preparations: Phezam (cinnarizine/piracetam) Methylxantines (PDE inhibitors): Pentoxyfilline  Phytopreparations – NO donors: Extractum Ginkgo bilobae  Other preparations: Naftidrofuryl, Vinpocetine
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Vinpocetine is an ethylester of apovincaminic acid, extracted from Vinca minor plant (Lesser periwinkle). It increases brain blood flow and inhibits thrombocyte aggregation. Vinpocetine has antihypoxic and neuroprotective effect exerted by NMDA-glutamate receptor blockade. It increases glucose and oxygen supply and utilization in the brain prevents oxidative stress.