Ebrantil

Ebrantil is a postsynaptic α ₁ -adrenergic receptor blocker that reduces blood pressure.

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Indications Ebrantil

Ebrantil is prescribed for stroke, acute coronary syndrome, aortic aneurysm, and to reduce blood pressure during surgery.

Pharmacodynamics

Ebrantil blocks peripheral postsynaptic α ₁ - adrenoreceptors. To some extent, it is capable of blocking beta receptors. Stimulates serotonin receptors of the medulla oblongata. The study of Ebrantil's effect on coronary blood flow continues. Clinical studies are being conducted that clearly show positive dynamics on the ECG, in particular, normalization of the ST segment. Patients in the group achieve normal blood pressure in 15 minutes. This saves the lives of many of them.

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Pharmacokinetics

Ebrantil is mostly metabolized by the liver. The drug is excreted in the urine. The half-life when administered intravenously is 2.7 hours.

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Dosing and administration

In case of hypertensive crisis, 10-50 mg of the drug is administered intravenously. It is also administered intravenously by drip or continuously with a perfusion pump at 9 mg/h. 250 mg of the drug Ebrantil ^® (10 ampoules of 5 ml or 5 ampoules of 10 ml) in 500 ml of infusion solution (1 mg = 44 drops = 2.2 ml). A 5% glucose solution is used to prepare the solution. The maximum initial rate is 2 mg/min. Intravenous drip administration allows for a smooth reduction in blood pressure, without sudden jumps. Doctors know that it is necessary to reduce blood pressure by 25% in the first hour (applies to patients with hypertensive crisis). A controlled drop in high blood pressure during a stroke makes the prognosis more favorable. Urapidil helps reduce arteriolar spasm and increase the speed of cerebral blood flow. The rate of hematoma growth decreases, which is very important in case of a stroke. The large size of the hematoma does not allow the damaged areas of the brain to be restored, its function suffers greatly, and long-term consequences of the disease are possible. Urapidil helps to normalize the neurological status.

The use of Ebrantil allows controlling blood pressure in the acute period of stroke. Patients receiving it recover faster. The drug is well suited for artificially inducing hypotension during surgery. In a group of patients with GC and pulmonary edema, an increase in blood oxygen saturation was found during a clinical study. Urapidil also has a positive effect on the course of benign prostatic hyperplasia. This disease is common in men at an older age.

The capsules are taken orally in the morning and evening with food. The capsule should be swallowed whole. It is better to take the drug at equal time intervals. The usual dose is 30 mg of Ebrantil 2 times a day. But in severe cases, it can be increased to 120 mg per day. The maximum dose is 180 mg.

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Use Ebrantil during pregnancy

You should not take Ebrantil during pregnancy and lactation - there is insufficient data on its effect on the child.

Contraindications

The solution is contraindicated in case of hypersensitivity, open Botallo's duct, during pregnancy and breastfeeding, it is not used in children and patients with critically low liver and kidney function. It is not recommended to prescribe Ebrantil for aortic stenosis and pericardial structure disorders. It is not prescribed to patients with alcoholism.

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Side effects Ebrantil

Ebrantil may cause nausea, proteinuria, nephropathy, tachycardia, dyspnea, increased sweating and allergic reactions, bradycardia, vomiting, dizziness, frequent urination, nasal congestion, possible dry mouth, anxiety, signs of easy fatigue, irregular heartbeat, headache, swelling, itching of the skin. These side effects are very rare.

There were no cases recorded when additional medical assistance was needed to correct side effects (among patients who sought emergency care with high blood pressure). Rarely, but still, allergic reactions and skin itching developed. Cases of "serotonin syndrome" have also been described. This condition manifests itself as anxiety, tremor, and muscle hypertonicity. It is also necessary to prescribe capsules rationally. The doctor must understand that there are cases when oral administration of the drug alone is not enough. It is not allowed to prescribe a daily dose of the drug in capsules at one time.

There are no data on the use of Ebrantil in pediatrics.

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Overdose

Symptoms of overdose include dizziness and fatigue. Infusion of vasoconstrictors should be started under blood pressure control. In case of overdose of capsules, activated carbon is recommended. There is no specific antidote. Regular blood pressure measurement is recommended if there is a suspicion of overdose. In case of a sharp drop in pressure, physiological saline should be administered.

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Special instructions

The drug should be taken very carefully, at the same time of day. It is not allowed to stop taking the medicine on your own. After 35 years, even absolutely healthy people should measure their blood pressure regularly. Walk a lot and do exercises.

With age, the arterial walls become more rigid, which leads to a steady increase in blood pressure. Bad habits, a passion for salty foods, a sedentary lifestyle, kidney and heart problems can also contribute to the fact that the fight against arterial hypertension ends in defeat. In addition, not all patients with high blood pressure have symptoms: no headaches, no spots before the eyes, the patient considers himself healthy. To achieve results, Ebrantil is combined with drugs from another class of antihypertensive drugs. This is necessary in severe cases, when there is a significant increase in blood pressure for a long time. Ebrantil and other alpha-blockers have such a remarkable property as improving fat metabolism. This is especially important for patients with hypertension, they often have excess weight, which is the cause of increased stress on the heart and blood vessels.

Signs of a correctly prescribed drug for blood pressure control: its effect during the day is very smooth, it does not lead to sharp pressure jumps, has a protective effect on target organs, does not affect performance, has a minimum of side effects and contraindications, it can be taken for a long time without much harm to internal organs. The effect of the drug should be monitored by the patient himself, measuring blood pressure in the morning and evening. Before measuring, do not drink coffee, do not exercise, do not eat heavy food. Often, treatment must be carried out throughout life, so its success depends on your determination. The prognosis is determined by the activity of the therapy.

When Ebrantil is administered intravenously, the pressure decreases very quickly – within 4 minutes. This is especially important during hypertensive crises. During a hypertensive crisis, the so-called target organs suffer greatly.

Only a doctor can prescribe therapy. Side effects such as memory and sleep disorders, depression and fatigue are possible. When taking medications, it is necessary to monitor blood glucose, regularly measure blood pressure and do an ECG. First of all, the doctor prescribes diuretics. Beta-blockers effectively reduce blood pressure and heart rate. They can be used both for monotherapy and in combination therapy for hypertension. Calcium channel blockers relax heart cells. This reduces blood pressure in the bloodstream. ACE inhibitors are best suited for patients whose blood pressure increases due to kidney disease.

Unfortunately, the problem of hypertension treatment will not lose its relevance in the future, because even in developed countries there is no adequate control of pressure among the population. This leads to a steady increase in complications that the disease gives to target organs. Every year in Russia alone, 10,000 ambulance calls are recorded for patients with a hypertensive crisis. Patients forget that with secondary hypertension, it is necessary to persistently treat the underlying disease and not ignore visits to the doctor. This leads to fatal consequences. Do not risk your health. Particular attention should be paid to pressure with a family tendency to heart and vascular diseases. Eliminate harmful psychological factors, treat neuroses and overcome stress. If the pressure is already high, you may want to think about changing your job or profession. With excess body weight, a low-calorie diet may be recommended with the exclusion of salty foods: cucumbers, sausages, herring. Beer is excluded.

Hypertension threatens with pathological thickening of the vascular wall. Myocardial mass increases, the risk of infarction increases. Kidney diseases and endocrine diseases are frequent companions of patients with hypertension. Many patients have protein in the urine - the first sign that the kidneys are not coping with their work. Hypertension can be caused by congenital malformations of the heart and blood vessels. The lack of adequate therapy leads to their premature wear. Examination of the fundus reveals hemorrhages or narrowing of the retinal arteries. At first, at the first stage of hypertension, there is no damage to target organs. Then narrowing of large arteries is noted, turning into coronary heart disease, cerebral ischemia and renal failure. From this we can conclude that by choosing the right treatment for hypertension, we prevent a whole bunch of other diseases or alleviate their course. It is reliably known that drug control reduces the incidence of strokes in patients with hypertension several times. In case of persistently high blood pressure, pharmacological treatment should be started as soon as possible. In such patients, lifestyle modification cannot have a positive effect unless medications are prescribed in addition. This is especially important for patients who have had a heart attack. If hypertension therapy is not started in time, death may occur. This risk increases by 50% compared to patients with normal blood pressure after a myocardial infarction. After a heart attack, calcium antagonists are best prescribed.

Another risk factor is myocardial hypertrophy, which reduces the coronary reserve and leads to arrhythmia. Heart rhythm disorders wear it out and lead to earlier death. Combination therapy is the most reasonable approach to treating myocardial hypertrophy. Combination therapy may also include alpha-blockers and, in particular, Ebrantil. It significantly reduces the load on the heart muscle. Diuretics have the least effect on the treatment of myocardial hypertrophy.

Calcium antagonists are most effective in slowing down the development of atherosclerotic plaques and increasing the elasticity of blood vessels. They allow increasing the capacity of large arteries. From physics we know that the larger the lumen, the lower the fluid pressure.

Ebrantil has not yet entered into widespread practice among emergency physicians. They usually use more accessible and proven drugs, but they do not always give the desired effect. These are nifedipine, dibazol, magnesium and others. It is preferable to use more modern drugs, such as Ebrantil with a fast and short action. For patients with cerebrovascular accidents in the form of hemorrhagic stroke, a more aggressive tactic of hypotensive therapy may be justified than in the ischemic form of stroke. ¾ of patients need combination therapy, i.e., it is impossible to normalize blood pressure with only one drug. To minimize side effects, doctors use a stepwise approach: they prescribe drugs sequentially. The use of a combination of two drugs can cause an additive effect (1 + 1 = 1.75), summarize (1 + 1 = 2) or potentiate (1 + 1 = 3) the effect. Diuretics are well combined with beta-blockers and ACE inhibitors, as well as alpha1-blockers (Ebrantil belongs to this class), calcium antagonists - with ACE inhibitors. There are other schemes.

Try to understand why your doctor prescribed this or that drug. Ask your doctor to explain it to you in detail. Preference should be given to drugs that can be taken 1 or 2 times a day, i.e., for example, in the morning with breakfast and before bed. This is very convenient, you can be sure that you will not miss a dose. Even those people who are not bothered by anything should know what their blood pressure is - it is enough to measure it once a year. In Kyiv pharmacies, free blood pressure measurements are regularly carried out for everyone who wants it. Ask your doctor to teach you how to measure your blood pressure yourself. If your vision has worsened, your limbs are numb, urine output has decreased, you are short of breath at rest, this means that your high blood pressure has caused complications. If this has happened, you need to undergo a comprehensive examination, possibly in a hospital, and decide what to do next. You will be hospitalized for complicated hypertensive crisis, if you have had a stroke in the past, a heart attack or angina, if atrial fibrillation, general cerebral symptoms, palpitations, tremor and anxiety are recorded during heart auscultation and ECG. This is the only way to stabilize your condition. You should not refuse hospitalization in the above cases. You may need intensive care: installation of a venous catheter, drug correction, which cannot be done at home due to a special method of administration, for example, drip. In a hospital, it is much more convenient to regularly take an ECG, monitor blood and urine, glucose and cholesterol levels in the blood, conduct ultrasound and other studies. The 2013 recommendations on hypertension, reflected in a special document compiled by European scientists, fully reflect the modern vision of the problem of combating this disease. Cases are clearly specified when hospitalization is unavoidable. The Working Group on the Treatment of Arterial Hypertension of the European Society of Hypertension asks to pay attention to the great importance of regular home blood pressure monitoring. If you do it, the risk of suddenly ending up in hospital can be reduced to a minimum. For young and elderly people, the European Society of Hypertension indicates the same upper limit of normal blood pressure - 140/90 mm Hg. Lower figures for those who suffer from severe concomitant diseases, such as diabetes. For people in the high-risk category, the tactics of treatment differs from the tactics for people with low cardiovascular risk. In young people, the cardiovascular risk is always lower, even in the presence of other aggravating factors. This is especially true for young women - their risk is always significantly lower compared to men. The female heart is stronger, since a woman is a potential mother. Women are also less susceptible to bad habits. It is best to determine the "vascular age" of young patients before starting treatment. It is also important to determine the state of the target organs.

Who is included in the "dangerous" category of patients? The high cardiovascular risk group includes patients who, in addition to hypertension, have diabetes, coronary heart disease, kidney disease, congenital heart disease and other disorders. For such patients, monotherapy with Ebrantil will clearly not be enough. There is a method for calculating the risk of death from cardiovascular diseases in the next 10 years based on age, bad habits, blood pressure indicators, active/sedentary lifestyle, glucose tolerance level, heredity for cardiovascular pathology.

Ebrantil is good because it prevents vascular spasm. It complies with the three main principles of blood pressure correction accepted in medicine - it maintains a normal level of cardiac output, circulating blood volume, and normal linear blood flow velocity. Another positive aspect is that the drug is available in two dosage forms. The doctor can choose which form - capsules or a solution for intravenous administration and droppers - to prescribe. The drug has been used abroad for a long time, so it has solid clinical experience. The cost of Ebrantil is low.

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