Antianginal effect is dianabol results due to the expansion of the coronary and peripheral arteries and arterioles: angina reduces the severity of myocardial ischemia; expanding peripheral arterioles. decreases total peripheral vascular resistance, decreases the preload on the heart, reducing myocardial oxygen demand.
Expanding the major coronary arteries and arterioles in the unaltered and ischemic areas of the myocardium increases the supply of oxygen to the myocardium (especially in vasospastic angina); It prevents the development of constriction of the coronary arteries (including those caused by smoking). In patients with angina single daily dose of amlodipine increases the run-time physical activity slows the development of angina and “ischemic” ST segment depression. reduces the frequency of angina attacks and nitroglycerin consumption. Has a long dose-dependent hypotensive effect. The antihypertensive effect is due to the direct vasodilating effect on vascular smooth muscle. When hypertension single dose provides a clinically significant reduction in blood pressuredianabol results for 24 hours (in the patient supine and standing). It does not cause a sharp decline in blood pressure, reduce exercise tolerance, left ventricular ejection fraction.
It reduces the degree of left ventricular hypertrophy, has anti-atherosclerotic and cardioprotective effect in ischemic heart disease . No effect on myocardial contractility and conductivity, does not cause reflex increase in heart rate, inhibits platelet aggregation, increases glomerular filtration rate, has a weak natriuretic effect. In diabetic nephropathy does not increase the severity of microalbuminuria. It has no adverse effects on lipid metabolism and blood plasma. Time of onset of effect -. 4.2 hours, the duration of effect of 24 hours
Following oral amlodipine slowly dianabol results absorbed from the gastrointestinal tract. The absolute bioavailability is 64%, the maximum concentration of the drug and the serum is observed after 6-9 hours. The concentration of stable equilibrium is reached after 7 days of treatment. Food has no effect on the absorption of amlodipine. The mean volume of distribution of 21 l / kg body weight, indicating that most of the drug is in the tissues and relatively smaller – in the blood. Most of the drug present in the blood (95%), bind to plasma proteins.
Amlodipine undergoes slow but extensive metabolism (90%) in the liver into inactive metabolites, has the effect of “first pass” through the liver. Metabolites not possess significant pharmacological activity. After a single oral elimination half-life (T ½ ) varies og 31 to 48 hours, with the reappointment of T ½ is approximately 45 hours. About 60% of an oral dose is excreted in the urine mainly as metabolites, 10% unchanged and 20-25% in the faeces, as well as breast milk. Amlodipine Total clearance is 0.116 ml / sec / kg (7 ml / min / kg and 0.42 L / h / kg). In older patients (over 65 years) amlodipine delayed excretion (T ½ 65ch) compared to younger patients, however, this difference has no clinical significance.Patients with liver failure elongation assumed T ½ and accumulation of long-term administration of the drug in the body is higher than (T ½ to 60 hours). Renal failure has no significant effect on the kinetics of amlodipine. The drug crosses the blood-brain barrier. When hemodialysis is not removed.
- hypertension (in monotherapy or in combination with other agents)
- angina and vasospastic angina (Prinzmetal angina).
- Hypersensitivity to amlodipine. dihydropyridine or other ingredients;
- severe hypotension (blood pressure less than 90 mm Hg);
- collapse, cardiogenic shock;
- unstable angina (except Prinzmetal’s angina);
- pregnancy and lactation;
- age of 18 years (effectiveness and safety have been established).
With caution: liver dysfunction, sick sinus syndrome (bradycardia, tachycardia), chronic heart failure decompensation, mild or moderate degree of hypotension, aortic stenosis, mitral stenosis, hypertrophic obstructive cardiomyopathy, acute myocardial infarction (and for 1 months after), diabetes mellitus, lipid profile, old age.
Dosing and Administration
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Inside, the initial dose for treatment of hypertension and angina is 5 mg 1 time per day. The dose may be increased to a maximum of 10 mg once a day. When hypertension maintenance dose may be 5 mg per day.
When angina and vasospastic stenokardii- 5 – 10 mg per day, once.
No dose adjustment is required, while the appointment with thiazide diuretics, beta-blockers, angiotensin-converting enzyme dianabol results, long-acting nitrates and sublingual nitroglycerin. steroiden kaufen
anabolika steroide kaufen
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