ACE inhibitors - new generation preparations. The most innovative: APE inhibitors of the new generation and the nuances of their use of ACE instructions for use

The date: 04.07.2020

Content

Hypertension is a common cardiovascular disease. Often, the increase in pressure provokes biologically inactive angiotensin I. To prevent its effect, the treatment scheme should include drugs that oppress the action of the hormone. Such means are inhibitors of angiotensin-converting enzyme.

What is AFF

Inhibitors of an angiotensin glider enzyme (ACE) - a group of natural and synthetic chemical compounds, the use of which helped achieve great success in the treatment of patients with cardiovascular pathologies. ACE has been used for more than 40 years. The first to preparation was captive. Further, the lysinopril and Enalapril were synthesized, the new generation inhibitors came to replace. In Cardiology, ACE drugs are used as the main tools that have a vasoconstrictor action.

The benefits of inhibitors consists in a long blocking of hormone angiotensin II - the main factor that has an impact on the increase of blood pressure. In addition, the means of angiotensification enzyme warn bradykinin decay, contribute to a decrease in the resistance of the efferent arteriole, the nitrogen oxide release is released, the vasodilating prostaglandin I2 increases (prostacyclin).

Preparations of ACE new generation

In the pharmacological group of drugs APF drugs with repeated reception (enalapril) are considered obsolete, because They do not provide the necessary complence. But at the same time, Enalapril remains the most popular tool that demonstrates excellent efficiency in the treatment of hypertension. In addition, there are no confirmed data that the Last Generation ACE blockers (perindopril, fozinopril, Ramipril, Zofensoid, Lisinopol) have more advantages over inhibitors released 40 years ago.

What medicines treat ACE inhibitors

The vasodilating powerful means of angiotensin glider enzyme in cardiology are often used to treat arterial hypertension. Comparative characteristics and list of ACE inhibitors, which are most popular among patients:

Enalapril

The indirect cardioprotector quickly reduces blood pressure (diastolic, systolic) and reduces the load on the heart.
Specifies up to 6 hours, excreted by the kidneys.
It rarely cause impairment.
Price - 200 rubles.

Captor

Tool of short term.
Well stabilizes the pressure, but the drug requires multiple reception. Only a doctor can install the dosage.
It has antioxidant activity.
It rarely provoke tachycardia.
Price - 250 rubles.

Lysinopril

The drug has a long exposure.
It works independently, he does not need to be metabolized in the liver. Exchanged through the kidneys.
The medicine is suitable for all patients, even those who suffer obese.
You can use patients with chronic kidney disease.
May cause headache, ataxia, drowsiness, tremor.
The cost of the drug is 200 rubles.

Lottenzine

Protect pressure reduction.
It has vasodilative activity. Leads to a decrease in bradykinin.
Contraindicated for nursing and pregnant women.
Rarely can cause vomiting, nausea, diarrhea.
Cost of medication within 100 rubles.

Monoph.

Slows bradykinin metabolism. The volume of circulating blood does not change.
The effect is achieved in three hours. The drug, as a rule, is not addictive.
With caution, the remedy must be taken in patients with chronic kidney disease.
Price - 500 rubles.

Ramipril.

Cardioprotector produces ramiprilates.
Reduces general vascular peripheral resistance.
The use of meaningful hemodynamically arterial stenosis is contraindicated.
The cost of funds is 350 rubles.

Accomplished.

Promotes pressure reduction.
Eliminates resistance in pulmonary vessels.
Rarely the drug may cause vestibular disorders and loss of taste.
Price - on average 200 rubles.

Perindopril.

Helps to form an active metabolite in the body.
Maximum efficiency is achieved after 3 hours after use.
It rarely provoke diarrhea, nausea, dry mouth.
The average cost of the drug in Russia is approximately 430 rubles.

Trandolapril.

With long use reduces the severity of myocardial hypertrophy.
Overdose may cause sharp hypotension and angioedema edema.
Price - 500 rubles.

Hinapril.

Affects the renin angiotensin system.
Significantly reduces the load on the heart.
Rarely can cause allergic reactions.
Price - 360 rubles.

Classification of APF inhibitors

There are several inhibitory classifications of ACE, their foundation includes a chemical group in a molecule that interacts with the ACE center; the path of removal from the body; Action activity. Based on the nature of the group, which is connected to the zinc atom, inhibitors are divided into 3 categories. In modern medicine, the chemical IAP-classification of drugs containing:

sulfhydryl group;
carboxyl group (dicarboxylate-containing drugs);
phosphinyl group (phosphonate-containing drugs);
group of natural compounds.

Sulfgidrile group

With the help of specific reagents, sulfhydryl groups of enzymes cause full or partial inhibition of activity of different enzymes. The means of this group are calcium antagonists. List of most famous means of sulfhydryl group of enzymes:

Benazepril (potential drug);
Captopril (means of Epsitron, Kozoten, Alkadil);
Zofensoid (drug Zocardis).

ACE inhibitors with carboxyl group

Functional monovalent carboxyl group has a positive effect on the life of patients with hypertension. As a rule, dicarboxylate-containing drugs use only once a day. It is impossible to use such funds with ischemic heart disease, diabetes, renal failure. List of the most famous dicarboxylate-containing drugs:

Perindopril (prescript);
Enalapril (ENAP, Edith, Enam, Renipril, Berlipril, Rheniete);
Lysinopol (dotroid, lysiotone);
Ramipril (Tritacea, Hartil, Amprilan);
Spirapril (quadropryl);
QuinaPril;
Transdolapril;
Cilaproke.

Phosphonate-containing drugs

The phosphinyl group is associated with zinc ion in the active center of ACE, while inhibiting its activity. Treatments are used to treat renal failure and hypertension. Phosphonate-containing ACE preparations are usually considered to be the means of a new generation. They have a high ability to penetrate the tissue, so pressure stabilizes for a long period. The most popular preparations of ACE of this group:

Fozinopid;
Fozicard.

Natural Infibers APF.

The preparations of the ACE of natural origin were open when studying the peptides, which are contained in the roe of the flashers. Such means act as peculiar coordinators that limit the processes of strong tensile cells. Pressure is reduced by reducing peripheral vascular resistance. Natural ACE inhibitors that enter the organism with dairy products are called lactuineins and Kazokinins. In small quantities, they may be contained in garlic, hibiscus, serum.

ACE inhibitors - indications for use

Means with angiotensin gluttering enzymes are used even in plastic surgery. But, as a rule, it is most often prescribed to patients to reduce blood pressure and those patients who have violations in the activities of the cardiovascular system (for the treatment of arterial hypertension). It is not recommended to use drugs on our own, since these tools have many side effects and contraindications. The main indications for the use of ACE inhibitors:

diabetic nephropathy;
lV dysfunction (left ventricle) hearts;
atherosclerosis of sleepy arteries;
suffered myocardial infarction;
diabetes;
microalbuminuria;
obstructive disease of the bronchi;
atrial fibrillation;
high activity of the renin-angiotensive system;
metabolic syndrome.

ACF inhibitors with hypertension

APE drugs block an angiotensin-converting enzyme. These modern drugs have positive effects on human health, protecting his kidney and heart. In addition, an ACE inhibitors with diabetes have found a wide use of sugar diabetes. These drugs increase the sensitivity of cells to insulin, improve the absorption of glucose. As a rule, all means from hypertension must be accepted only a day. The list of drugs used in hypertension:

MOOKSZHRIL;
Lodzil (Dotroton, Lizoril);
Ramipril (Tritacea);
Talinolol (beta blocker);
Fisinopril;
Cilaproke.

ACE inhibitors in heart failure

Often the treatment of chronic heart failure involves the use of inhibitors. This cardioprotectory group in tissues and blood plasma prevents the transformation of inactive angiotensin I to active angiotensin II, thereby preventing its adverse effect on the heart, kidney, vascular peripherals, neurohumoral status. List of cardiosaped drugs that are allowed to take with heart failure:

Enalapril;
Captopril;
antianginal verapamil;
Lysinopril;
Trandolapril.

ACE inhibitors with renal failure

For a long time it was believed that inhibitors poorly affect the work of the kidneys and therefore they were contraindicated even at the initial stage of renal failure. Today, these funds, on the contrary, prescribe patients to treat a violation of the function of the kidneys along with diuretics. The drugs of angiotensin-converting enzyme reduce proteinuria and improve the overall condition of the kidneys. You can take the following ACE inhibitors at CPN:

Captopril;
Lysinopril;
Perindopril;
Trandolapril.

ACE inhibitors - action mechanism

The mechanism of action of ACE inhibitors consists in reducing the activity of an angiotensin-converting enzyme, which accelerates the transition of biologically inactive angiotensin I to Active II, which has a vasopressor pronounced effect. APE preparations are constrained by the bradykinin decay, which is considered a powerful vasodilator. In addition, these funds reduce blood flow to the heart muscle, while reducing the load, protect the kidneys from the influence of diabetes and hypertension. Applying inhibitors, you can limit the activity of the kallicrein-kinin system.

Reception of APF inhibitors

Many patients with hypertension are often interested in how to take Blockers APF? The use of any drugs must be coordinated with a doctor. As a rule, inhibitors should be taken an hour before eating an empty stomach. Dosage, frequency of use, the gap between receptions must define a specialist. During treatment with the help of inhibitors, it is worth abandoning anti-inflammatory non-steroidal means (nurofen), substitutes of salt and products rich in potassium.

ACE inhibitors - Contraindications

List of relative contraindications of intake of inhibitors:

arterial moderate hypotension;
chronic severe renal failure;
childhood;
heavy anemia.

Absolute contraindications IAPF:

hypersensitivity;
lactation;
bilateral stenosis of renal arteries;
severe hypotension;
aortic heavy stenosis;
pregnancy;
pronounced hypercalemia;
porphyry;
leukopenia.

Side Effects of ACE inhibitors

During the intake of inhibitors, it is necessary to remember the development of by-metabolic effects. Often, dizziness, angioedema edema, dry cough, potassium growth in blood can appear. These complications can be completely eliminated if you stop taking the drug. There are other side effects of ACE:

itching, rash;
weakness;
hepatotoxicity;
reducing libido;
fetopathic potential;
stomatitis, fever, rapid heartbeat;
swelling of legs, neck, language, faces;
there is a risk of falling and fractures;
diarrhea or severe vomiting.

The price of APF inhibitors

You can buy inhibitors in the specialized department of the store or in any pharmacy of Moscow. Their price may differ, based on the form of release and manufacturer's company. Here is a small list of recent generation inhibitors and their approximate cost:

Name	Price in Rubble
Captor
Enalapril
Spirapril
Perindopril
Benazepril
Lysinopril
Trandolapril
Quinapril
Phosinkle
MEXPRIL
Ramipril

Video: APE drugs

Attention! The information presented in the article is familiarized. Article materials do not call for independent treatment. Only a qualified doctor may diagnose and give recommendations on treatment, based on the individual characteristics of a particular patient.

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Discuss

ACE inhibitors - a list of drugs. The mechanism of action of ACE inhibitors of the new generation and contraindications

In the article, consider the list of ACE inhibitors.

Hypertension acts as a common disease of the heart system. Often an increase in pressure can provoke an influence of inactive angiotensin I. In order to prevent its influence in the medical scheme, drugs depressing this hormone include. Such medicines are inhibitors further presented a list of the late generation ACE inhibitors.

What are these drugs?

ACE inhibitors belong to the group of synthetic and natural chemical compounds, whose use helped to achieve success in patient therapy with vascular pathologies and hearts. Applied ACE for more than forty years. The top medicine was "captopril". Next was synthesized "Lisinopril" and "Enalapril". Then the new generation inhibitors came to replace them. In the field of cardiology, such drugs are used as the main tools that have a vasoconstrictor effect.

The benefits of the latest ACE inhibitors are to continuously block a special hormone, which is angiotensin II. This hormone is the main factor affecting the increase in pressure in humans. In addition, the antihiotensin-converting enzyme drug can prevent bradykinin decay, contributing to a decrease in the stability of the efferent arteriole, and the nitrogen oxide emission is carried out and the concentration of vasodilating prostaglandin increases.

New generation

In the pharmacological group of ACE inhibitors, medicines that need to be repeatedly (for example, "Enalapril") are considered outdated, as they cannot provide the necessary effect. True, Enalapril still remains a popular tool demonstrating excellent efficiency in hypertension therapy. In addition, there are no confirmed evidence that the APE drugs from the last generation (for example, drugs such as "Perjdopril", "Fozinopril", "Ramipril", Zofensoid and Lisinopril) have much more advantages over their analogues , released forty years ago.

The list of drugs of ACE inhibitors is quite extensive.

Vasodilatory medicines of APF.

Vasasculating drugs of ACE in cardiology are often used for therapy of arterial hypertension. Let us give a comparative characteristic and list of ACE inhibitors that are most popular among patients:

The drug "Enalapril" is a cardioprotector of indirect effects, rapidly reduce pressure and reducing the load on the heart. It acts on the body this means up to six hours and is displayed, as a rule, by the kidneys. It is rarely able to cause vision. The cost is 200 rubles.
"Captive" is a means of a short exposure time. This drug will well stabilize pressure, however, this drug may require multiple reception. Dosing establishes a doctor. It has a drug antioxidant activity. In rare cases, it can provoke tachycardia. Its cost is 250 rubles.
The "Lisinopol" medicine has a long validity period. It works absolutely independently, it is not required to be metabolized in the liver. Displays this kidney medicine. The drug is suitable for all patients, even suffering obesity. It can be used to patients with chronic kidney disease. This medicine can cause headaches along with ataxia, drowsiness and tremor. The cost is 200 rubles.
The "Lottenzine" medicine contributes to a pressure reduction. This agent has vasodilative activity. It leads to a decrease in bradykinin. This agent is contraindicated with nursing and pregnant women. The drug is rarely capable of causing vomiting with nausea and diarrhea. The cost of the medication is held within 100 rubles.
Medication "Monophil" slows the processes of bradykinine metabolism. The effect of its application is achieved, as a rule, after three hours. This drug is not addictive. Its caution should be prescribed to patients with chronic kidney disease. The cost is 500 rubles.
Medicine "Ramipril" is a cardiographic criterion producing ramiprilates. This medication reduces peripheral vascular resistance, it is contraindicated in the presence of arterial stenosis. The cost is 350 rubles.
The drug "accumulated" can contribute to a pressure reduction. This medicine can eliminate resistance in pulmonary vessels. Pretty rarely, this drug is able to cause a vestibular violation and loss of taste (the side effect of ACE inhibitors). The average price is 200 rubles.
The "Perindopol" medicine helps an active metabolite to form in the human body. Its maximum efficiency can be achieved over three hours after use. It rarely provoke diarrhea with nausea and dry mouth. The cost is 400 rubles. The list of preparations of the inhibitors of the UPE of the last generation does not end.
Medicine "Transdolapril" against the background of long use reduces the severity of myocardial hypertrophy. Overdose by the drug can cause a sharp hypotension along with angioedema edema. The cost is 100 rubles.
The drug "Hinapril" affects renin angiotensin functions. This drug significantly reduces the load on the heart. It is very rarely able to cause an allergic reaction and costs 360 rubles.

What it is - the drug-inhibitors of ACE, not everyone knows.

Classification

There are several inhibitory classifications at once. These drugs are classified depending on the method of eliminating them from the body and activity activity. Modern medicine is widely used by a chemical APF classification of drugs, which includes the following groups:

sulfhydryl group;
carboxyl group (we are talking about dicarboxylate-containing preparations);
phosphinyl group (phosphonate-containing medicines);
a group of natural compounds.

Sulfgidrile group

Inhibitors of the ACE of this group are calcium antagonists.

Here are a list of the most famous medicines from the sulfhydryl group:

"Benazepril";
"Captive", along with Epsitron, Kopotne, and "Alkadil";
"Zofensoid" and "Zokardis".

Carboxyl group

This category of medicines has a positive effect on the life of patients with hypertension. Such drugs are used only once a day. It is impossible to take them in ischemic heart disease, against the background of diabetes and with renal failure. Let us give a list of the most famous drugs from this group: "Perindopril" along with "Enalapril", "Lisinopril", "Dotroton", "Lisoinotone", "Ramipril", "Spirapril", "Quinapril" and so on. Mostly, such means are used for the treatment of kidney deficiency and with hypertension.

Phosphonate-containing inhibitors

These drugs have a high ability to penetrate into the tissue of the human body, due to their use, pressure is usually stabilized for a long period. The most popular means from this group are "Fozinopil" and "Fozicard".

Choose the best ACE inhibitors will help the doctor.

Last Generation Natural Inhibitors

Such means are peculiar coordinators limiting the process of strong tension of cells. The pressure against the background of their reception decreases due to a decrease in vascular peripheral resistance. Natural inhibitors entering the organism with dairy products are called Kazokinins and Lactokinin. In small quantities, they are contained in garlic, serum and hibiscus.

Indications for use

The latest generation funds presented above are used even in plastic surgery. True, more often they are prescribed patients to reduce pressure and patients who have disorders in the work of the heart and vessels for the treatment of arterial hypertension. It is not recommended to apply these medications yourself, as they have a lot of contraindications and side effects. The main indications for the use of these drugs are the following pathologies:

the presence of a patient with diabetic nephropathy;
with dysfunctions of the left ventricle of the heart;
against the development of atherosclerosis of the carotid arteries;
against the background of the myocardial infarction;
with sugar diabetes;
against the background of the obstructive disease of the bronchi;
in the presence of atrial fibrillation;
against the background of metabolic syndrome.

The last generation of ACE inhibitors today are used very often.

Use with hypertension

These drugs effectively block angiotensin-converting enzymes. These modern drugs produce a positive effect on human health and protect the kidneys and heart. In addition, inhibitors are widely used with diabetes mellitors. These medicines increase the cell sensitivity to insulin, improving the absorption of glucose. As a rule, all new means from hypertension take once a day. We give a list of contemporary inhibitors that are widely used in hypertension: "MOOKSZHRIL" along with "Lozřota", "Ramipril", "Talinolol", "Fisinopril" and "Cylazapral".

List of late generation ACE inhibitors can be continued.

Inhibitors with heart failure

Often the treatment of chronic heart failure involves the use of inhibitors. This category of cardioprotectors in the blood plasma prevents the transformation of inactive angiotensin I to active angiotensin II. Due to this, its adverse effects on the kidneys, heart and vascular peripherals are prevented. We give a list of cardioprotable preparations allowed in the insufficiency of the heart: "Enalapril" along with "Captive", "Verapamil", "Lepensing" and "Trandolapril".

The mechanism of exposure inhibitors

The mechanism of operation of inhibitors is to reduce the activity of angiotensin-converting enzymes, which accelerate the transition of inactive angiotensin into active. These drugs are constrained by the process of bradykinin decay, which is considered a powerful vasodilator. Such means reduce the influx of blood to the heart, reducing the load and protecting the kidneys from the effects of diabetes and hypertension.

Reception of modern inhibitors

Many patients with hypertension are often wondering how to make the ACF inhibitors of the new generation? Responding to this question, it must be said that the use of any drugs of this group must be coordinated with the doctor. Typically, inhibitors are accepted an hour before meals, that is, an empty stomach. Dosing, the frequency of use and the gap between the techniques is determined by the specialist. During therapy with inhibitors, it is necessary to abandon anti-inflammatory non-steroidal medicines, products rich in potassium.

Inhibitors and contraindications to their use

The list of relative contraindications of the use of inhibitors is as follows:

the presence of patient with arterial moderate hypotension;
the presence of chronic severe shortness of the kidneys;
in childhood;
in the presence of severe anemia.

Absolute contraindications include hypersensitivity, lactation, bilateral stenosis of renal arteries, pronounced hypotension, pregnancy and hypercalemia.

People can have side effects from the ACE inhibitors in the form of itching, allergic rash, weakness, hepatotoxicity, a decrease in libido, stomatitis, fever, rapid heartbeat, leg edema, and so on.

Side effect

Long-term reception of these tools may result in the oppression of blood formation. As a result, the content of red blood cells, leukocytes and platelets is reduced. Therefore, during the treatment period, regular repetition of the overall blood test is required.

Allergic reactions and intolerance may also develop. It manifests itself, as a rule, itching, redness of the skin, urticaria, photosensitization.

In addition, the function of the digestive system may violate, which will lead to perversion of taste, nausea and vomiting, discomfort in the area of \u200b\u200bthe stomach. Sometimes people are tormented by diarrhea or constipation, the liver ceases to work normally. In some cases, ulcers (AFTs) in the mouth occur.

The tone of the parasympathetic nervous system can be enhanced by the action of drugs, as well as to activate the synthesis of prostaglandins. There is a dry cough and a voice change. It is possible to facilitate the symptoms by the reception of nonsteroidal anti-inflammatory drugs, but not by the use of antitussive agents. If patients have a pronounced, the paradoxical increase in blood pressure is not excluded. Hypercalemia occurs in some cases, the fractures of the limbs bones when falling happens more often.

The article covered the inhibitors of the Last Generation ACE.

The basis of the complex treatment of arterial hypertension is the inhibitors of ACE - blockers of angiotensin gloculating enzyme. Together with diuretics, they stabilize pressure in a short time, and long time hold it within the normal range.

For the treatment of arterial hypertension, ACE inhibitors are used

ACE inhibitors - what is it?

Angiotensin glittering inhibitors - These are natural and synthetic substances that depress the cultivation of an angiotensin vasoconsturing enzyme kidney.

Such an action makes it possible to use preparations for:

reduce blood flow to the heart, which reduces the load on the vital organ;
protection of kidneys from pressure surges (hypertension) and excess sugar in the body (diabetes).

Modern antihypertensive means of the group of ACE inhibitors have a long effect and stable effect. Medicines are distinguished by the minimum list of side effects and are convenient to use.

Classification of APF inhibitors

Depending on the chemical composition, the inhibitors of angiotensin surgery include several main groups - carboxyl, phosphinyl, sulfhydryl. All of them have a different degree of removal from the body and differences in assimilation. There is a difference in the dosage, but it depends on the characteristics of the disease and is calculated by the doctor.

Table "Comparative characteristics of groups of contemporary inhibitors of angiotensin surgery enzyme"

Group and list of the best preparations (names)	Half-life from the body, hours	Kidney Billing,%	Dosage and the number of techniques per day
Carboxyl
Lysinopril	12–13	72	From 2.5 to 10 mg 1 time per day
Enalapril	11	89
Quinapril	3	77	From 10 to 40 mg 1 time per day
Ramipril	11	85	From 2.5 to 10 mg 1 time per day
Cilaproke	10	82	1.25 mg 1 time per day
Sulfgidrile
Captor	2	96	From 25 to 100 mg 3 times a day
Benazepril	11	87	From 2.5 to 20 mg 2 times a day
Zofenopril	4–5	62	From 7.5 to 30 mg
Phosphinyl
Fozinopril	12	53	From 10 to 40 mg 1 time per week

In the duration of therapeutic effects, drugs also have several groups:

Preparations of short action (captopril). Such inhibitors must be taken 3-4 times a day.
Medicines of medium duration (Benazepril, Zofensoid, Enalapril). On a day, it is enough to make such medicines at least 2 times.
ACE Long-acting blockers (cilaproiled, lysinopril, quinapril, fozinopril). Medicines are well helped from pressure at one reception per day.

The list of drugs belongs to the preparations of the last generation and contributes to the suppression of the ACE in the blood, tissues (kidneys, heart, vessels). At the same time, the inhibitors of the angiotensin gluttering enzyme of a new generation not only reduce the high pressure, but also protect the internal organs of a person - they have a positive effect on the heart muscle and strengthen the walls of the vessels of the brain, kidneys.

Action of APF inhibitors

The mechanism of operation of the ACE blockers is to brake the production of a vasoconductive enzyme, which is produced by the kidneys (angiotensin). The medicine affects the renin-angiotenzon system, prevents the conversion of angiotensin 1 to angiotensin 2 (hypertension provocateur), which leads to normalization of pressure.

Using the emission of nitrogen oxide, angiotensin receptor blockers slow down the bradykinin decay, which is responsible for expanding the walls of the vessels. As a result, the main therapeutic effect of hypertension is achieved - blocking angiotensin 2 receptors, removal of high tone in arteries and pressure stabilization.

The testimony of angiotensin gluttering enzyme

Antihypertensive drugs of the Last Generation ACE Blockers Group belong to the preparations of a comprehensive action.

This allows them to be used in the following states:

with hypertension of different etymology;
in heart failure (decrease in the fraction of emission of left ventricle or its hypertrophy);
with renal failure (glomerulonephritis, pyelonephritis, diabetic nephropathy, hypertonic nephropathy);
after the stroke with pressure jumps towards the increase;
with the myocardial infarction suffered.

The use of ACE blockers is limited or replaced by other drugs in the event of a strong decrease in creatinine clearance (it happens with renal failure and threatens hyperkalemia).

Features of the use of ACE inhibitors

Antihypertensive drugs will produce a higher therapeutic effect if they take into account the main features of their application:

Inhibitors should be taken an hour before meals, observing the dosage and the number of receptions specified by the doctor.
Do not use salt substitutes. Such food analogues contain potassium, which is already accumulated in the body during the treatment of APF blockers. For the same reason, it is not recommended to abuse food containing potassium (cabbage, lettuce leaves, oranges, bananas, apricots).
It is impossible in parallel with inhibitors to take anti-inflammatory drugs of nonsteroidal origin (ibuprofen, nurofen, bruphen). Such drugs are delayed from the body of water and sodium, which reduces the effect of the angiotensin gloculating enzymes.
Constantly control the pressure and work of the kidneys.
Do not interrupt the course of treatment without a doctor's knowledge.

It is not recommended to combine drugs with drinks containing caffeine, as well as alcohol, the best tablet or droplets to drink in conventional water.

Cannot be taken with Ibuprofen inhibitors and Similar drugs

Contraindications

Along with wide use in the treatment of arterial hypertension, ACE blockers have many contraindications. They can be divided into absolute (categorically prohibited for use) and relative (use depends on the clinical picture when the result justifies possible damage).

Table "Basic contraindications to the use of angiotensin surgery enzyme inhibitors"

Type of restrictions	Contraindications
Absolute	Pathological narrowing of the walls of both renal arteries
	Reducing the work of the kidneys (increase in creatinine to 300 μmol / l)
	Hypercalemia (excess potassium in the body, which can break the heart rhythm)
	Increased sensitivity to any of the drug components
	Pregnancy and lactation period
	Children's age up to 5 years
Relative	Reduced systolic pressure below 95 mm. RT. Art. If with secondary reception, the pressure has normalized, treatment can be continued
	Renal failure and hypercalemia in moderation
	Hepatitis in the aggravated stage
	Blooming of blood sprouts (agranulocytosis, pronounced anemia, thrombocytopenia)

It is important to understand that the preparations of ACE inhibitors are serious drugs that can not only benefit, but also harm. Therefore, it is necessary to strictly adhere to the recommendations of the specialist and not ignore the contraindications.

Side Effects of ACE inhibitors

The ACE receptor blockers have a positive effect on the human body in the treatment of arterial hypertension.

Despite this, drugs can cause certain negative reactions from vital systems:

Cough. There are no such ACE inhibitors that do not cause cough. In one way or another, antihypertensive drugs cause a similar symptom. With his strong severity, it is better to consult a doctor.
Violations in the work of the digestive tract in the form of severe vomiting and long-term diarrhea.
Itching and red skin.
An increase in the number of potassium in the blood, which is accompanied by a violation of the rhythm of the heart, shortness of breath, tingling in the limbs, irritably, confusion of consciousness.
Empire throat, language, faces. Temperature, sore throat, discomfort in the chest, the ethnicity of the lower extremities.

When receiving inhibitors, swelling may appear in the throat

With the first reception, the medicine may occur a metal or salt flavor in the mouth. In addition, at the beginning of therapy, the most pronounced will be dizziness, it is possible to decline.

Another important side effect of the use of ACE inhibitors is the violation of the kidneys. This happens when renal failure occurs in an acute stage.

Inhibitors of ACE are considered to be the most effective drugs in the treatment of hypertension. Medicines are depressing the production of angiotensin kidneys and, thereby contribute to the normalization of pressure. Due to the wide mechanism of action, similar preparations are used in cardiac and renal failure, in the treatment of arterial hypertension of various origin. The main thing is not to engage in self-medication and about all changes are able to inform the doctor. This will help to avoid negative consequences.

ACE inhibitors (IAPF) - new generation medicines, the action of which is aimed at reducing blood pressure. Currently, in pharmacology, over 100 types of such drugs are presented.

All of them have a common mechanism of action, but differ from each other by structure, the method of deriving from the body and the duration of exposure. The generally accepted classification of the IAPF is absent, and all divisions of this group of drugs are conditional.

Conditional classification

According to a method of pharmacological action, there is a classification that divides ACE inhibitors into three groups:

IAPF with a sulfhydryl group;
JAPP with carboxyl group;
IAPF with phosphinyl group.

The classification is based on such indicators as a way of eliminating the body, half-life, etc.

To drug preparations 1 include:

Captopril (Kopoten);
Benazepril;
Zofenopril.

These drugs have indications for the use of patients whose hypertension is combined with ischemic heart disease. They quickly absorbed into blood. For more efficient action, they are taken 1 hour before eating, to speed up the process of suction. In some cases, ACE inhibitors can be appointed with diuretics. Medicines of this group can also be taken diabetics, patients with light pathology and heart failure.

With caution should be treated with patients with a disease of the urinary system, as the medicine is excreted by the kidneys.

List of drugs 2 groups:

Enalapril;
QuinaPril;
Renietec;
Ramipril;
Transdolapril;
Perindopril;
Lysinopril;
Spirapril.

ACE inhibitors containing a carboxyl group have a longer action mechanism. Subjected to metabolic transformation in the liver, having a vasodilator effect.

Third Group: Fozinopil (Monophil).

The mechanism of action of the fosinopril is directed mainly to control the morning plows. It is belonging to the preparations of the last generation. It has a long exposure (about a day). It is removed from the body with the help of liver and kidneys.

There is a conditional classification of new generation ACE inhibitors, which are a combination with diuretics and calcium antagonists.

ACE inhibitors in combination with diuretics:

Caposide;
Elanopril N;
Iruzide;
Squad plus;
Ramazide H;
Accumulated;
Fozicard N.

The combination with a diuretic has the effect of a faster action.

ACE inhibitors in combination with calcium antagonists:

Koripren;
Ecquacard;
Triapine;
Egips;
Tarka.

The mechanism of action of these medicines is aimed at strengthening the extensiveness of large arteries, which is especially important for older hypertensive.

Thus, the combination of drugs provides for an increase in the action of the drug in case of insufficient EAPF effectiveness separately.

Benefits

The advantage of the preparations of the IAPF is not only their ability to reduce blood pressure: the main mechanism of their action is aimed at protecting the internal organs of the patient. They are well affected by myocardium, kidneys, brain vessels, etc.

With myocardial hypertrophy Inhibitors of ACE more intensively reduce the heart muscle of the left ventricle, unlike other drugs from hypertension.

The JAPF improves the kidney function in chronic renal failure. It is also noted that these drugs improve the overall condition of the patient.

Indications

Main indications for use:

hypertension;
myocardial infarction;
atherosclerosis;
left ventricle dysfunction;
chronic heart failure;
coronary heart disease;
diabetic nephropathy.

How to take an ACE inhibitors

It is forbidden during the IAPF reception to use salt substitutes. The substitutes include potassium, which is delayed in the body with drugs against hypertension. It should not be used in food products enriched by potassium. These include potatoes, walnuts, kuraga, sea cabbage, peas, prunes and beans.

During treatment inhibitors, it is impossible to take such anti-inflammatory non-steroids, as nurofen, bruphen, etc. These medicines are delayed in the body liquid and sodium, thereby reducing the effectiveness of the IAPF.

It is very important to control the level of blood pressure and the function of the kidneys. It is not recommended to independently cancel drugs without a consultation with your doctor. A short treatment of inhibitors may not show its effectiveness. Only with long-term treatment, the medicine is capable of adjusting the level of blood pressure and be very effective with such concomitant diseases as heart failure, ischemic heart disease, etc.

Contraindications

Inhibitors of ACF exist both absolute and relative contraindications.

Absolute contraindications:

pregnancy;
lactation;
hypersensitivity;
hypotension (below 90/60 mm);
stenosis of the renal arteries;
leukopenia;
heavy aortic stenosis.

Relative contraindications:

moderate arterial hypotension (from 90 to 100 mm);
severe chronic renal failure;
severe anemia;
chronic pulmonary heart in the decompensation stage.

Indications for use with the above diagnoses are determined by the attending specialist.

Side effects

ACE inhibitors most often are well tolerated. But sometimes the side effects of the medicine can occur. These include headache, nausea, dizziness and fatigue. The appearance of arterial hypotension, aggravation of renal failure, the occurrence of allergic reactions is not excluded. Less often there are such side effects as dry cough, hypercalemia, neutropenia, proteinuria.

You should not independently appoint yourself an ACE inhibitors. Indications for use are determined by a purely doctor.

Hypertension is the most common disease of the cardiovascular system. Preparations of various pharmacological groups are used to treat this disease. Among them are highlighted ACE inhibitors - a rather young class of antihypertensive agents, which is popular with doctors and patients. This is explained by their high efficiency along with a good portability profile.

The first ACE inhibitor, namely captopril, was synthesized in 1975. Since then, the active development of new drugs of this pharmacological group began. Today there are several dozen chemicals of the group, but the use in medicine has yet been found a little more than a dozen representatives.

Classification

There is no single classification of APE inhibitors. They are divided into classes for the chemical structure, biological activity, the duration of the existing effect, etc.

One of the options for the classification of ACE inhibitors involves their separation by the chemical structure for substances, including the group:

sulfhydryl
carboxyalkyl,
phosphinyl
hydroxami.

Comparison of ACE inhibitors of these subgroups showed that the presence of any of the groups in the composition of the drug does not attach significant differences in the properties.

Depending on biological activity, 2 types of IAPF are distinguished:

Active medicines that themselves show biological activity. This subgroup is represented by leaser, cappos, cenappril and libenzapil.
Prodrugs converted into active metabolites after entering the body. All representatives of the group are ranked here, except 4 described above.

Inhibitors of angiotensin glider enzyme have different duration of therapeutic effect. Accordingly, they are divided into drugs having:

continued effect (fozinopril, leaser and others, the reception of which is carried out 1 time in 24 hours);
the average for the duration effect (enalapril, taken 1-2 times per day);
the short effect that requires drinking the drug 2-3 times a day (captopril).

Pharmacological properties of the IAPF

The manifestable effects of ACE inhibitors are ensured by their property to coal the activity of the angiotensin glossy enzyme, which ensures the regulation of the renin angiotensin system.

An angiotensin-glossing enzyme is an active participant in blood pressure regulation and water-electrolyte balance. Under the action of this substance, angiotensin-I is converted to angiotensin-II, which has a powerful vasoconstrictor effect.

ACE blockers, inhibiting angiotensin-impregnating enzyme, eliminate pressor and other neurohumoral effects of angiotensin-II on the cardiovascular system. During the taking of these drugs, education is braked:

arginine-Vasopressin;
norepinephrine;
other substances exhibiting anti-zero system and vasoconstricture properties.

In addition, representatives of the group warn the collapse of bradykinin and other kinines, contributing to their accumulation in the body. These substances have sodium-ethical and vasodilatory properties.

ACE blockers exhibit their antihypertensive effect at the same time reducing the formation of vasoconstric and contributing to the accumulation of vasodilant substances. Peripheral arterial and venous vasodulation during treatment with drugs of the Group is not accompanied by the participation of heart abbreviations. They reduce blood flow resistance in vessels, increase the cardiac output, improve overall blood flow.

An impassment of angiotensin II, in addition to lowering pressure, leads to an increase in the lumen of the renal glomerular arteriole, which causes a decrease in intraccurine hydrostatic pressure. It:

eliminates intracleum hypertension;
warns the progression of kidney lesions, including diabetic.

Such a nephroprotective effect makes it possible to use the IAPF for the treatment of diabetic nephropathy that are not accompanied by an increase in blood pressure. To ensure the effectiveness of treatment, a low-stage diet should be observed.

Thanks to the reduction of post-and preloading on the heart muscle, the dilatation of myocardial cavities is reduced and the portability of physical exertion is improved. This allows the use of group preparations in patients with heart failure.

Class-specific properties of the IAPF are cardioprotective, which are manifested by the regression of the GLB (left ventricular hypertrophy) and the warning of ischemic and reperfusion damage to the heart muscle.

List of pharmacodynamic effects IAPF:

expansion of veins and arteries;
reduction of preload and postload;
lowering intraculum hypertension;
regression GLB;
prevention of changes in the thickness of myocardium, sizes and shapes of chambers and dilatation of the left ventricle;
raising diuresis and sodium;
nephroprotection;
improving insulin susceptibility.

The action of APE blockers is more pronounced in middle-aged people, whose hypertension is most often caused by the increased activity of sympathetic and adrenal and renin-angiotensin systems.

Indications

ACE inhibitors are mainly prescribed for hypertension therapy. However, based on numerous extended effects, the list of readings is significantly expanded and as follows:

symptomatic and essential hypertension;
clinically pronounced heart failure;
reducing the left ventricular emission fraction;
chronic renal failure;
diabetic kidney damage.

APE blockers are shown primarily in the presence of related:

heart failure;
diabetes;
myocardial infarction suffered in the past.

Contraindications

Although ACE inhibitors have a high security profile, however, there are conditions and diseases in which their reception is prohibited. It:

narrowing of renal arteries;
pregnancy;
severe renal failure;
intolerance of the substances of the group;
lactation;
hypercalemia;
childhood.

The simultaneous intake of IAPP with allopurinol, rifampicin, indomethacin, lithium-containing drugs, cytostatics, potassium-saving means, immunosuppressants and phenothiazine-row psychotropes are not recommended.

Side effects

All side effects of ACE inhibitors are separated by 2 types: specific and nonspecific. To the first type of negative impacts include:

dry cough;
hypotension;
kidney dysfunction;
swelling quinque;
hypercalemia.

Negative actions of a non-specific nature may manifest itself:

anemia;
headache;
violations of vision and taste perception;
rashes on the skin;
digestion disorders;
leukopenia;
dizziness;
allergic reactions;
asthenia;
impotence;
rhinitis;
pain in muscles;
blood disorders;
dry mouth;
bronchospasm and others.

Advantages of the EAPP

Numerous studies have proven that the high antihypertensive activity of representatives of the IAPF is complemented by a number of additional advantages. It:

nephroprotective action;
reducing the frequency of the development of stroke and myocardial infarction;
high security profile;
organoprotector action;
metabolic neutrality (do not worsen lipid and carbohydrate profile);
anti-seaterosclerotic action (in some drugs);
the possibility of applying diabetes;
the slowdown in the development of stagnant heart failure.

Characteristics of individual representatives

It is believed that captopril with the shortest action time is outdated. A similar opinion about Enalapril, to drink which you need 2 times a day. However, these drugs are as popular as the inhibitors of the APE of the new generation, holding the blood pressure in the norm when using 1 tablet per day. This is due to their effectiveness and affordable price. In addition, there are no reliable research results confirming noticeable advantages of the newest generation of the IAPF.

Captor

This drug has the shortest, but at the same time the fastest effect. This makes it an indispensable tool with a hypertension. When taking a tongue, the pressure decrease begins after 10-15 minutes, and when taken inside - after 30-40 minutes.

Due to the short action, rarely used for long-term treatment of hypertension. In such cases, its 3-time use is required. Also available under the trading title of Kapoten.

Enalapril

One of the most used ACE inhibitors. It has the widest list of readings, is available for the price and is quite effective. Tablets are used 1-2 times a day (depending on the dose) regardless of food. In the body is converted into an active metabolite, called enalaprilat.

Many pharmaceutical firms are made under various names:

Berlipril,
Envipril
Enam,
Invoril
Renietee,
Ednit,
ENAP.

Ramipril

Another representative of the group with advanced testimony. It is her preference to choose a medication for preventing stroke, as well as a heart attack.

The drug limits the zone of propagation of necrosis with a heart attack and increases survival. The action is developing 1-2 hours after the reception and lasts the day.

List of drugs with ramipril in composition:

Hartil
Pyramil,
Corpril
Ramiconde,
Tritana.

Perindopril

This medicinal substance has a relatively weak antihypertensive effect, so in most cases it is used in combination with other means. More often appointed for the treatment of heart failure than hypertension.

After one-time use, the action manifests itself after 4-6 hours. With repeated applications, the duration of the effect is preserved for 36 hours.

In pharmacies can be found under the names:

Perines,
Prestarium
Palane
Angle Press
Covelex.

Lysinopril

Also a rather popular drug, which is less common other representatives of the group provokes a dry cough.

The medicine begins to act in an hour, reaching a maximum for 6 hours and maintaining the effect during the day. Released by many pharmaceutical manufacturers called:

Dotroton
Irumed,
Daping
Litan
Zonix
Leisioton.

Trandolapril

The medicine manifests its hypotensive action after 1 hour after reception and saves within 24 hours. Preference is given to him with hypertension with concomitant hearts.

Transdolapril called Gopden.

Fozinopril

This is the only medicine that belong to the latest generation of IAPF. Its feature is the removal of kidney and liver from the body in equal proportions, which allows it to be prescribed to persons with various kidney diseases. Reception medication is carried out once every 24 hours.

A substance is produced under the names:

Fozicard,
Fozinap
Monopol
Fozinotek.

Choosing a representative of the IAPF for the treatment of hypertension

ACE inhibitors are used both independently and in a complex with other drugs. The decision to appoint them should take a doctor after a complete examination of the patient to detect the availability of possible contraindications, as well as states in which the groups of the Group will be ineffective.

Choosing a specific agent, preference gives drugs with a long action, while taking into account the individual portability of the drug by the patient and the body's reaction to its reception.
The dose of medication is selected empirically, with the appointment of the minimum of the recommended and gradually increases if necessary.
The resistant decrease in blood pressure is observed after 2-3 weeks of therapy at the correctly selected drug and its dose.

In the event of the ineffectiveness of treatment inhibitors, combined therapy with other hypotensive means is prescribed. The safest and effective is the reception of an AAP with calcium antagonist or a diuretic. If necessary, the appointment of other combinations under the supervision of the doctor is allowed.