Indapamide

Description overdue on 04.07.2012

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Diuretic, antihypertensive . Under the influence of the drug increases the excretion of sodium, chloride ion, magnesium and potassium with urination, disrupted the process of re-absorption of sodium in the cortical division in the loop of Henle. The pharmacological properties of indapamide is similar to thiazide diuretics. The drug selectively blocks the "slow" calcium channels, reduces peripheral vascular resistance, increases the elasticity of the arterial vascular wall. Indapamide reduces left ventricular hypertrophy. Under the influence of the drug changes the sensitivity of the vessel wall to angiotensin-2, noradrenaline . Administration of high doses leads to increased diuresis, but does not significantly reduce the Blood Pressure . Repeated, prolonged use leads to achieving a therapeutic effect in the second week of treatment. Indapamide is available in tablet and capsule dosage form.

Indications and contraindications:

Indapamide prescribed for hypertension. The drug does not apply to hypokalemia, severe hepatic pathology system in hepatic encephalopathy . anurii , Renal disease, with decompensated form Diabetes When galactosemia, lactose intolerance. In CHF, with hyponatremia, ascites, kidney failure, pregnancy, urate nefrourolitiaze at gout , Acute cerebrovascular Indapamide administered with caution.

Side effect:

Side effects when taking indapamide are dose-dependent. The digestive tract:   epigastric pain, nausea, dyspepsia . constipation , Diarrheal syndrome, eating disorders, dyspepsia , Dry mouth, gastralgia. Nervous system:   drowsiness, headache, dizziness,   nervousness , Malaise, fatigue, muscle spasms, vertigo , Agitation, irritability, anxiety. Senses:   of the visual perception, conjunctivitis . Cardiovascular system:   palpitations, arrhythmia, hypokalemia displays ECG, orthostatic hypotension . Respiratory system:   sinusitis, cough, pharyngitis, rhinitis. Urinary system:   polyuria, nocturia, frequent infections of the genitourinary system. Also regitriruyutsya allergic reactions vasculitis . hives , Pruritus, hyperglycemia, hypochloremia, hypercalcemia, hypercreatininemia.

Overdose:

Manifested respiratory depression, disorders in the gastrointestinal tract, weakness, nausea, vomiting, excessive drop in blood pressure. The development of hepatic coma is observed at cirrhosis . It requires extra recovery water and electrolyte balance , Gastric lavage, posindromnoe treatment. The specific antidote is not developed.

Mode of application:

Indapamide is recommended to take in the morning, inside. The initial dose for hypertension is 1, 25-2, 5 grams, or 1, 5 mg of sustained release formulation of the drug one time per day. If there is no result after a month to add the medication regimen with a different mechanism of action. The appointment of high doses of the drug does not lead to a proportional reduction in blood pressure, but increases the severity of side effects.

Special instructions:

Older patients and those with hyperaldosteronism When taking laxatives, cardiac glycosides   It requires regular monitoring of serum creatinine, potassium ions. All patients need to control the level of residual nitrogen , Uric acid, glucose, magnesium ions, sodium and potassium. A more thorough examination requires patients with cirrhosis due to the likelihood of developing metabolic alkalosis, which may enhance the symptoms of hepatic encephalopathy. It is important to remember that hypercalcemia while taking the drug may result from undiagnosed hyperparathyroidism. Patients with diabetes need to control glucose, require special monitoring people with hypokalemia. At considerable dehydration develops acute renal failure   because of reduced glomerular filtration rate . At the beginning of therapy requires control over the renal system, required compensation of lost fluids. Indapamide may cause a positive reaction in doping tests. Impact of drug indapamide on children has not been studied.

Drug Interactions:

Indapamide reduces the elimination of lithium ions in the urine, leading to hang their concentration in the blood and the risk of nephrotoxicity of attack. Using iodinated contrast agents is increased severity of side effects, leads to dehydration . Before the procedure, with the introduction of iodine-containing agents is recommended to restore the loss of fluids in the body. Indapamide adversely affects the efficiency anticoagulants : Indandiona, coumarin derivatives. The drug increases the severity of neuromuscular blockade, which is registered at reception non-depolarizing muscle relaxants . Tetrekozaktid, glucocorticosteroids, loop saluretics, laxatives, thiazide saluretics, intravenous amphotericin B causes hypokalemia. Risk digitalis intoxication   increases with indapamide and cardiac glycosides. Pentamidine, erythromycin, antiarrhythmic drugs, disopyramide, quinidine, bretylium tosylate, amiodarone, sotalol, sultopride, astemizole   can cause arrhythmia type "pirouette". The risk increases with hypercreatininemia appointment of cyclosporine. Antipsychotics, tricyclic antidepressants increase the severity of hypotension and can cause orthostatic hypotension, acute renal failure.