Medicines for the treatment of atherosclerosis
Atherosclerosis is recognized as a dangerous and insidious disease, because pathological changes with it are present inside the vessels and in the early stages of the development of pathology, a person does not even suspect the presence of such.Atherosclerosis is dangerous because it is a risk factor for the development of complex cardiovascular diseases and often represents a threat to the life of the patient.
Atherosclerosis is a disease associated with metabolic disorders: the vessels are negatively affected by too much cholesterol in the blood.When diagnosing atherosclerosis, doctors categorically do not recommend letting the disease on its own - it is necessary not only to undergo a full-fledged examination, but also constantly / regularly conduct therapeutic activities.Table of contents: Classification of drugs for the treatment of atherosclerosis Statins Fibrates Sequets( cholestyramine) Omega-3-triglycerides Vegetable preparations Combined drugs
Classification of drugs for the treatment of atherosclerosis
To support the body in the development of atherosclerosis and prevent the onset of irreversible pathological processes,Doctors use the drugs of the following groups:
- Fibrates - fenofibrate;
- Omega-3 fatty acids;Statins - rosuvastatin, fluvastatin, Pitavastatin;
- ;Fatty acid sequestrants - cholestyramine;
- Herbal preparations;
- Combined hypolipidemic drugs.
Drugs from this group have an effect on a particular enzyme HMG-CoA, inhibiting its activity.This enzyme provides the origin of several chemical reactions, as a result of which cholesterol is formed.That is, a small activity of the enzyme HMG-CoA leads to a small number of chemical reactions, and therefore, cholesterol in the human body will be formed much less.
In addition to the above action, statins also have other effects:
- inhibition of proliferation( multiplication) and migration of smooth muscle cells;
- improved vascular endothelial function;
- has a positive effect on the composition of the fibrinolysis system;
- oppression of cellular adhesion processes;
- decreased cholesterol saturation of bile;
- reduced risk of development of oncological pathologies;
- prophylaxis of vascular dementia and Alzheimer's disease;
- prevention of osteoporosis.
This type of medication is prescribed in the following cases:
- elevated cholesterol level in the blood;
- prevention of cardiac and vascular pathology;
- prophylaxis of angina pectoris, strokes and congestive heart failure.
There are also contraindications for taking statins:
- liver diseases that occur in an acute form;
- pregnancy and lactation period;
- severe liver failure;
- individual intolerance of the components of drugs from the group under consideration;
- severe renal dysfunction.
Statins are prescribed only after the patient is selected a diet to reduce lipid levels in the blood and the patient's lifestyle is changed.Here if the doctor does not observe any effect from these non-medicamentous measures, medicamentous appointments will be made.
Note: during the period of taking medications from the statin group, it is necessary to monitor the liver function.If minor violations are noted, then the tactics of therapy should be changed and drugs replaced.
As a rule, preparations from the group of statins are well perceived by patients, but there may be some side effects:
- allergic reactions - skin itching, rashes, anaphylactic shock;
- headaches, dizziness, memory impairment, decreased sensitivity;
- sleep disturbance, unmotivated irritability, depression;
- complete lack of appetite, increase, or lowering of blood sugar;
- nausea, vomiting, belching, flatulence, constipation, abdominal pain;
- hair loss - alopecia;
- general weakness, increased fatigue, pain in the chest, edema of the upper and lower extremities;
- muscle and joint pain, convulsions.
Types of statins:
Produced in the form of tablets.When ingested, the active substance is quickly absorbed by the mucosa of the gastrointestinal tract, and the maximum concentration in the blood is determined 2 hours after ingestion.The period of partial excretion from the body is an average of 15 hours, this process occurs with bile.
Doctors recommend taking this medication at a dosage of 10-80 mg per day, more precise indications will be determined by the attending physician in view of the clinical picture.The tablet is taken regardless of the meal, at any time of the day.You do not need to chew the tablet, just drink it with plenty of water.
After 15-30 days from the beginning of treatment with the drug under examination, the patient needs to undergo a control examination - to pass blood tests to lipids, according to which the doctor will adjust the treatment regimen.
Duration of treatment is individual and can range from 3 months to lifelong use.
Produced in the form of tablets, when ingested, the active substance of the drug is rapidly absorbed by the mucosa of the digestive tract.The period of partial excretion is 2-3 hours, this process is carried out with the help of bile and urine.
The effect manifests itself two weeks after the start of the drug, its maximum reaches 4-6 weeks and if the patient continues to take simvastatin later, the effect remains at the maximum level for a long time.
The initial dose is 10 mg per day( the pill is taken once a day).The drug is taken in the evening.
Please note : It is strictly forbidden to drink alcoholic beverages when taking this medication.If Simvastatin has pain in muscles and joints, then it's worth changing the tactics of treating atherosclerosis.
Produced in the form of tablets, extremely slowly absorbed in the organs of the digestive tract.The maximum concentration is noted already in 2 hours after taking the tablets, but after a day the content of the drug in the blood is only 10%.
A stable therapeutic effect is achieved only two weeks after the daily intake of Lovastatin, the maximum effect will be visible after 4-6 weeks.
For mild forms of atherosclerosis, the drug in question should be taken at a dosage of 20 mg once a day at night.With more severe forms of the disease, a doctor can increase the daily dosage to 40-80 mg per day.
When taking Lovastatin, there is a risk of developing myopathy, especially often this risk is noted while taking the drug and antifungals, antiviral drugs, HIV medicines, antibiotics, fibrates and cyclosporins at the same time.
Produced in the form of tablets, almost immediately absorbed by the mucous membrane of the digestive organs, binds with blood proteins.The period of partial elimination of the drug is 2 hours, this process is carried out through stool.
The fluvastatin pill should be taken once a day at any time, regardless of food intake, without chewing and washing down with plenty of water.
The daily dosage for adults is 80 mg.The maximum effect is observed after a month of daily intake of the drug in question and is maintained for the period of the full course of therapy.
Produced in tablets, very slowly absorbed by the mucosa of the digestive tract, accumulates in the liver.The period of partial elimination of the drug from the body is 19 hours, the process is carried out with the help of stool.
After seven days of a stable intake of rosuvastatin, the clinical effect is already developing, the maximum effect is reached by the end of the month.
Adults considered the drug is administered at a dosage of 5-10 mg per day.During the month from the beginning of taking the tablets, the doctor must monitor the patient's condition and if there is no visible effect of the treatment, he can increase the daily dosage.
Produced in the form of tablets, very quickly absorbed by the mucous membrane of the digestive system, the maximum concentration of the active substance is determined as early as an hour after taking the tablet inside.
The initial adult dose is 1 mg once daily.A month after the start of treatment, the doctor can adjust the dose.
Note : Pitavastatin contains lactose, so patients who have lactase deficiency should refuse it.
To this group of drugs that are used to treat atherosclerosis, include many substances.But to date, the most widely used Fenofibrate.
Active active substance of this drug is fibroic acid, which enhances the processes of fat splitting and promotes the removal of lipoproteins from the blood plasma.
After ingestion, the drug is exposed to enzymes that convert it to fibroic acid.The maximum concentration of the active substance in the blood is noted only 5 hours after taking the tablet inside, the partial elimination period is 20 hours.From the body, the drug is excreted by feces and urine.
- high triglycerides in the blood;
- Mixed hyperlipidemia in persons with an anamnesis of cardiovascular pathology;
- retinal vascular injury in diabetes mellitus.
It is strictly forbidden to take the drug in question under the following conditions:
- Severe renal and hepatic impairment;
- acute and / or chronic pancreatitis;
- calculous cholecystitis;
- Individual intolerance of fenofibrate and its other components;
- simultaneous administration of medications that are capable of exerting toxic effects on the liver.
Quite often, against the background of the application of the drug in question, side effects may appear:
- general weakness, dizziness and headaches;
- spasms in the muscles, myositis;
- impaired function of the genitals;
- allergic reactions;
- susceptibility to thrombus formation;
- hair loss;
- interstitial lung disease.
Note: during pregnancy and breastfeeding Fenofibrate is not accepted.
Produced in the form of powder for the preparation of a suspension.Stimulates the formation of bile acids in the liver from cholesterol, thereby reducing the absorption of the latter.
The drug does not dissolve in water, is not absorbed by the mucous membrane of the digestive tract and is not exposed to the destructive effects of enzymes.
Therapeutic effect develops only after 4 weeks of regular intake of the drug in question.The course of treatment with this drug is short, as long-term admission may develop bleeding, digestive disorders, lowering the level of folic acid in the blood.
Indications for use of Cholestyramine:
- elevated cholesterol in the blood;
- prevention of atherosclerosis;
- partial obstruction of the biliary tract.
- pregnancy and breast-feeding period;
- obstruction of the bile duct;
- pregnancy planning period;
- individual intolerance of the active substance.
The dosage of the drug in question is selected in a strictly individual order.Take Cholestyramine before eating: the contents of one sachet are poured into a cup and 70 ml of water are added.All must be thoroughly mixed and left for 10-15 minutes to form a complete suspension.The recommended daily intake for adults is 4-24 grams.
Against the background of taking the drug in question, side effects may appear in patients:
- skin rashes, itching;
- nausea, vomiting and pain in the intestines;
- appetite impairment, increased gas production, diarrhea, or constipation;
- a tendency to bleeding.
Please note: should be extremely careful to take the drug to people over 60 years of age.Throughout the course of treatment you need to control the level of cholesterol in the blood.With increased bleeding, the patient is prescribed vitamin K.
Produced in the form of soft capsules, fluid and oil for oral administration. The main effects of taking medications considered include:
- decrease in blood fats;
- prevention of blood clots;
- increased immunity;
- control of inflammatory processes.
Indications for use:
- Prevention of early atherosclerosis;
- reduced risk of recurrence of myocardial infarction;
- treatment of diseases that are accompanied by a violation of the balance of lipids in the blood.
Contraindications to the use of omega-3-triglycerides:
- pancreatitis in acute or chronic form;
- tuberculosis in active form;
- individual intolerance of the drug components;
- cholecystitis in acute or chronic form;
- hypervitaminosis D;
Take the drug after eating, with plenty of water.Adults should take 1 capsule three times a day, if disease prevention is carried out, but in the treatment the dosage will be 2 capsules three times a day.
The duration of treatment with the drug in question is 2-3 months, but in each case it is selected by a specialist individually.
This medication can cause side effects:
- nausea, vomiting, heaviness in the stomach, heartburn, belching, diarrhea;
- exacerbation of chronic diseases of the gastrointestinal tract;
- allergic reactions;
- lowering of blood pressure;
- dryness of the nasal mucosa;
- dizziness and headache;
- pregnancy and the period of child feeding.
Please note: should not be taken concomitantly with anticoagulants and vitamin A and B-based agents. If the course of treatment is long, the patient should conduct a study every two to three months about the level of coagulation.
Pumpkin seed oil
Pumpkin has a lot of useful properties - it has a laxative, hepatoprotective, diuretic, antihelminthic, hypolipidic effect.Pumpkin oil is used to prevent atherosclerosis, as well as to treat hyperlipidemia.
This tincture, which includes fruits of Sophora, horsetail grass, clover flowers, mistletoe leaves, horse chestnut seeds, grass vinca and hawthorn fruits.All components of Ravisol contribute to a decrease in the level of total lipoproteins of blood, cholesterol.In addition, the drug in question significantly improves the blood supply of blood vessels in the brain, reduces peripheral resistance of blood vessels, has a mild diuretic and antiaggregatory effect.
Ravisol is categorically contraindicated in case of individual intolerance of at least one of the listed components, as well as in acute and chronic kidney pathologies and severe arterial hypotension.
Adults should take 1 teaspoon three times a day before meals, the course of treatment is 10 days.Before use Ravisol should be shaken and dissolved in a small amount of water.
Against the background of taking the considered drug of plant origin, side effects may develop:
- nausea, vomiting, diarrhea, abdominal pain;
- back pain and during urination;
- lowering blood pressure;
- heart palpitations.
These drugs consist of two drugs that help reduce lipids in the blood, but there can be only one hypolipidemic and one antihypertensive component.
Inegi - simvastatin + ezetimibe
Produced in tablets, actively affects the level of lipids in the blood.It is used for primary hypercholesterolemia, as an auxiliary therapy in diet and lifestyle modification, in patients who have not received the therapeutic effect of taking statins.
The dosage regimen is selected individually, it all depends on the purpose for which the combined preparation of Inegia is prescribed, and also on the severity of pathologies.If the initial dose did not give the desired effect after a month of daily intake, the doctor should review the therapy regimen and, possibly, replace the drug.
Contraindications to ingestion of Inegi:
- simultaneous administration of ketoconazole, nefosodone, cyclosporine, erythromycin;
- increased level of hepatic enzymes, which is observed for a long time;
- chronic liver diseases that are in the acute stage;
- period of pregnancy and lactation;
- individual intolerance of at least one of the components of Inegia.
On the background of taking the drug in question, side effects may develop:
- headache, increased fatigue, dizziness, sleep disturbance, malaise;
- nausea, vomiting, bloating, pain in the abdomen;
- skin rashes and itching - allergic reactions;
- pain in the joints and muscles, myasthenia gravis;
- appearance in urine protein;
- increase in blood levels of hepatic enzymes.
If the patient has a malfunction of the liver or kidneys, the physician should adjust the dose of the drug taking into account the degree of insufficiency.
Many patients with myocardial infarction have myopathy. Risk factors for the development of this pathological condition are:
- impaired renal function;
- female gender;
- the age of the patient is over 65;
- decreased thyroid function;
Stasis - Ezetimibe + Atorvastatin
This combined preparation reduces the level of total cholesterol in the blood, low and very low density lipoproteins, triglycerides and increases the concentration of high density lipoproteins.Statesy is used for violations of the balance of fat in the blood.This combination drug is contraindicated in acute and chronic liver pathologies, during pregnancy and breast-feeding.
Stagesy is used only if nonpharmacologic methods of lowering lipid levels in the blood do not give the desired effect.It is worth knowing that the intake of the combined drug in question does not exclude, but rather complements the medication.
The recommended dose of Statesy for adults is 1 tablet once a day daily.The therapeutic effect becomes noticeable after two weeks of regular intake of the drug.
On the background of receiving Statesy, side effects may appear:
- allergic reactions;
- lack of appetite( or increase), decrease( or increase) in blood sugar, diabetes;
- depression, insomnia, nightmares;
- headache, dizziness, confusion, memory disorder( forgetfulness);
- dry mouth, nausea, eructation, pain in the stomach and intestines, heartburn, bloating, diarrhea, or constipation;
- increased blood pressure, strokes;
- gynecomastia, impotence and decreased libido in men;
- pain in muscles and joints;
- ringing in the ears, hearing loss;
- stagnation of bile.
Naturally, these side effects are extremely rare, many patients even do not notice any deterioration even after long-term use of the combined drug in question.
Amlostat / Biperin / Duplexer / Atorvastatin + amlodipine kaduet
These drugs successfully combine atorvastatin and amlodipine, but only in different proportions.These combined medicines are used in cases of arterial hypertension, which is combined with a high level of cholesterol in the blood, as well as in the hereditary disease, homozygous hypercholesterolemia.Primary treatment, as a rule, is absent - the physician must choose an effective dosage individually for each component included in the composition of these drugs.
Contraindications to the administration of a combination of atorvastatin and amlodipine are:
- stenosis of the aortic aortic stenosis;
- increased individual sensitivity to components;
- Decompensated heart failure;
- recently suffered myocardial infarction;
- acute liver disease;
- steadily lowered blood pressure;
- unstable angina;
- pregnancy, the period of her planning and breastfeeding;
- increase in the level of hepatic enzymes.
Only one patient out of 100 may experience side effects when taking the medications under consideration:
- allergic reactions;
- nausea, vomiting, diarrhea, or constipation;
- increase in blood glucose;
- nasal bleeding;
- pain in the muscles and joints;
- muscle spasms;
- general weakness;Periodic chest pain.
The considered medications in this article are very serious, have a lot of contraindications and can cause complex side effects.Therefore, in no case should you perceive the presented material as a "guide to action"!Only the attending physician can prescribe a particular drug for the treatment of atherosclerosis.
Tsygankova Yana Aleksandrovna, medical reviewer, therapeutist of the highest qualification category.