Sartans subsequently arose in-depth studies of the pathogenesis of diseases of the cardiovascular system. This is a promising group of drugs that already occupies a leading position in cardiology.
Sartans are considered low-cost medicines that lower blood pressure. In people with a predisposition to hypertension, these drugs are one of the important ways to normalize life.
These drugs contain substances that have a corrective effect on pressure throughout the day, they prevent the onset of hypertensive attacks and prevent diseases. What is the classification of sartans?
Mechanism of action
These drugs are not inferior in effectiveness to popular medicines for high blood pressure, practically do not provoke side effects, eliminate the symptoms of hypertension, have a protective effect on the heart and blood vessels, as well as the kidneys and brain. In addition, these drugs are called angiotensin-II receptor blockers.
Indications
Sartans are prescribed for hypertension. They effectively lower the pressure, but the result can be seen only 3-4 weeks after the start of therapy. In addition, sartans are prescribed for chronic heart failure, and they also prevent heart damage in the early stages.
Medicines of this group eliminate chronic heart failure, heart attacks and strokes. Sartans are effective for nephropathy.
In addition, angiotensin II receptor blockers are used to eliminate the following conditions:
- Heart and vascular diseases in type 2 diabetes.
- Damage to the heart and blood vessels with dyslipidemia.
Sartans classification
According to the active substance, four groups are noted:
- Telmisartan is a non-biphenyl derivative of tetrazole.
- Eprosartan is non-biphenyl non tetrazole.
- Valsartan is a non-cyclic compound.
- Losartan, irbesartan and candesartan are biphenyl derivatives of tetrazole.
The use of sartans began only in the nineties of the last century. Today on sale you can find many brands with these substances in the composition. They are in any pharmacy.
Generational classification of sartans:
- Losartan is produced under the following names: "Vazotens", "Zisakar", "Lozap", "Lozartan", "Lotor", "Blocktran".
- Olmesartan: “Cardosal”, “Olimestra”.
- Azilsartan: Edarby.
- Eprosartan - "Teveten."
- Valsartan is also available under the following trade names: "Valaar", "Valz", "Valsacor", "Diovan".
- Irbesartan: Ibertan, Irsar, Firmasta.
- Candesartan: Angiakand, Atakand, Candecor, Ordiss.
- Telmisartan: Mikardis, Prirator.
In addition, ready-made combinations of sartans with diuretics and calcium antagonists are produced. Next, the most popular antihypertensive drugs will be considered.
"Lozap"
The medication helps to reduce the overall peripheral resistance of blood vessels, and also has a diuretic effect, reduces afterload and pressure in the pulmonary circulation.
What instructions for use, price and reviews does Lozap have? In people with chronic heart failure, the use of this drug increases exercise tolerance and prevents cardiac muscle hypertrophy.
The medicine "Lozap" promotes uniform control of blood pressure throughout the day, in accordance with circadian rhythms, does not provoke withdrawal. The cost of Lozap varies from 120 to 1100 rubles.
People who suffer from cirrhosis of the liver, after applying the antihypertensive drug, note a high content of the active substance and its more active metabolism than in healthy patients. In this connection, it is necessary to take lower dosages.
In case of impaired renal function, the appearance of hyperkalemia is possible. Therefore, during therapy, it is recommended to constantly monitor the level of this trace element.
With a combination of drugs that affect the renin-angiotensin system, creatinine and urea in the blood may increase in people with renal stenosis. After stopping the drug, the patient's condition, as a rule, stabilizes. The drug has positive reviews among patients, effectively lowers blood pressure and normalizes the general condition.
You also need to conduct regular laboratory monitoring of the level of biochemical indicators of the function of the glomerular apparatus of the kidneys, since the drug is contraindicated in people with impaired functioning.
"Valsacor"
A medication is a medication for oral administration, the pharmacological effect of which is aimed at stabilizing the level of blood pressure and improving the functioning of the heart and blood vessels.
The drug does not affect the heart rate, unlike other medicines with antihypertensive effect. People who used Valsacor noted the elimination of shortness of breath, as well as swelling of the limbs and pain in the heart.
The pharmacological effect of the use of the drug is observed two weeks after the start of therapy. The active substances of the drug provide rapid excretion of salts, chlorine, potassium and excess fluid from the body. With a single use of the pill, the therapeutic effect persists for twenty-four hours.
During therapy with Valsacor, the patient may experience reduced attention and a deterioration in the reaction rate, which must be taken into account when driving a car.
This medication is prescribed with extreme caution to people with autoimmune inflammation of the vascular wall and systemic lupus erythematosus, narrowing of the aorta and mitral valve, as well as to patients with hypertrophic cardiomyopathy, which is accompanied by obstruction of large blood vessels.
The dosage of the drug and the duration of treatment are determined by the doctor individually for the patient. It depends on the diagnosis, as well as age, general condition of the body and other factors.
Blocktran
Blocktran can be used in combination with other medicines for hypertension. In this case, blood pressure should be monitored, since it is proved that the active substance helps to exert a hypotensive effect on drugs from the groups of beta-blockers, diuretics and sympatholytic drugs.
In people suffering from renal artery stenosis, the medication provokes an increase in the content of urea and creatinine in the blood.
The use of "Blocktran" requires periodic monitoring of the concentration of potassium in the blood, especially with kidney disease and in patients of retirement age.
With renal impairment, the dosage of the drug is not reduced, but the patient's condition should be under the constant supervision of medical specialists. With liver damage, it is necessary to reduce the concentration of the drug, as well as observe the state of organs and systems.
For people of retirement age, there is no need to carry out dose adjustment. Children under eighteen years of age are contraindicated in using Blocktran.
Symptoms of a strong excess dosage are:
- tachycardia;
- bradycardia;
- marked lowering of blood pressure below normal.
In case of poisoning, forced diuresis is prescribed, as well as symptomatic treatment that eliminates arrhythmia and hypotension. Hemodialysis is not recommended due to its inefficiency.
"Diovan"
After a single use, the antihypertensive effect is observed in the first two hours, and the maximum pharmacological effect appears after four to six hours. Efficiency after use lasts more than a day.
A sharp cessation of medication does not lead to a rapid increase in blood pressure or other negative consequences. Clinical evidence confirms that Diovan 80 has no effect on the amount of uric acid, as well as total cholesterol, glucose and triglycerides in the blood.
The main component (valsartan) of the drug "Diovan" in small quantities accumulates in the body. It is eliminated with feces and urine.
When treating people with essential hypertension with medication, it is not necessary to regularly monitor laboratory parameters.
In people with a pronounced lack of sodium in the body, sometimes at the beginning of treatment, blood pressure may decrease and symptoms of arterial hypotension may occur.
When hypotension occurs, the patient should be laid with raised legs and injected saline. After normalization of blood pressure, therapy with the medicine "Diovan 80" can be continued further.
In people with renovascular hypertension, which appeared after unilateral renal artery stenosis, renal hemodynamics, the number of creatinine and blood urea nitrogen do not change during treatment.
But, considering that other similar drugs can increase the amount of creatinine and urea in the blood, it is important to follow safety measures and monitor these indicators.
Patients who have impaired renal function need not have a dose adjustment. With significant lesions, therapy should be carried out with extreme caution.
Mikardis
The drug from the classification of sartans belongs to telmisartans. With caution, the drug is prescribed for people with narrowing of the mitral valve and aorta, as well as both renal arteries, obstructive hypertrophic cardiomyopathy, with lesions of the gastrointestinal tract, severe liver, kidney and heart diseases.
In patients who have dehydration due to diarrhea and vomiting, as well as diuretic therapy, the medication is prescribed in minimal concentrations.
It is contraindicated to use the medication for patients with fructose intolerance and primary aldosteronism. If you are planning a pregnancy, then before that you should find a replacement for "Mikardis."
When combining a drug for the treatment of hypertension with lithium medications, it is important to monitor the concentration of lithium in the body, since there is a possibility of a temporary increase in its level.
With extreme caution, "Mikardis" should be used for patients who drive a car or engage in work requiring increased attention. The drug may cause mild dizziness or drowsiness.
People suffering from diabetes mellitus, coronary heart disease or other cardiovascular ailments due to the use of a medication increase the likelihood of a fatal myocardial infarction and sudden death.
Cardiac ischemia in diabetes can occur without visible symptoms and may not be diagnosed initially. Therefore, before treatment with "Mikardis" it is necessary to conduct a diagnosis that determines IHD.
The drug is allowed to be used together with diuretics, which have an additional hypotensive effect. Recommended dosages for complex treatment with hydrochlorothiazide are: Mikardis 40 mg or 80 mg + 12.5 mg of a diuretic substance.
Edarby
According to the instructions for use, azilsartan is part of the antihypertensive drug. After the start of treatment in people with a reduced volume of circulating blood or with hyponatremia, clinically significant hypotension may appear. Before treatment, hypovolemia should be adjusted. Starting to use "Edarbi" is necessary with 20 milligrams per day.
People with primary hyperaldosteronism in most situations are resistant to treatment with antihypertensive drugs that affect the renin-angiotensin-aldosterone system, so they are not recommended to prescribe medication.
In patients with hypertension, complex treatment with Edarbi medicine with potassium-sparing diuretics or potassium salt substitutes can lead to hyperkalemia.
Patients of retirement age, with kidney diseases, as well as diabetes mellitus or other concomitant diseases, increase the risk of hyperkalemia, including fatal. This category of people is recommended to monitor the concentration of potassium in the blood.
Valz
Before starting therapy with this medicine, it is necessary to restore the level of electrolytes and fluids. To do this, reduce the concentration of diuretics. If a person has renovascular hypertension, it is necessary to ensure regular monitoring of the level of creatinine and urea in the blood.
According to the instructions for use, it is known that when using the sartan drug for chronic heart failure at the very beginning of therapy, blood pressure may decrease, therefore, its regular monitoring is important.
When treating with a medication, changes in the functioning of the kidneys are sometimes noted. During the course of therapy, drugs must be careful to drive and engage in other activities that require increased attention.
Cardosal
According to the instructions for use, olmesartan is part of the drug. The medication is in tablet form, it is intended for oral use. When using the drug for people with impaired renal function, it is necessary to constantly monitor potassium and creatinine in the blood.
It must be remembered that a strong decrease in pressure in patients with cardiac ischemia or with cerebral changes can cause a heart attack or stroke. Driving a car during therapy with this drug requires care.
According to the instructions for use, olmesartan is not recommended to be used simultaneously with potassium medications, potassium-sparing diuretics, or other drugs that can increase the concentration of potassium in the blood. The antihypertensive effect of olmesartan therapy is enhanced by the combined use with other antihypertensive agents.
Reviews
The responses of doctors and patients about most of the medications described above indicate that these antihypertensive drugs are an effective method of lowering high blood pressure.
According to patients, the following drugs from sartans are most effective - “Myocardis”, “Diovan”, “Valsacor”.
These medicines, when used and dosed correctly, help lower blood pressure and improve the general well-being of the patient. In the responses it is also noted that with a sharp cessation of the use of the drug, there is no withdrawal syndrome.