Detailed explanation of hypertension medication
I. calcium antagonists
There are two kinds of calcium antagonists commonly used.
Dihydropyridines: nifedipine sustained-release tablets (nifedipine), nifedipine controlled-release tablets (Baixintong), felodipine (Boydine) and amlodipine (Luohuoxi, Analgin). Si Laiping, the official name is Laxidipine.
Non-dihydropyridines: verapamil (verapamil), diltiazem (Tianerxin, Hebei Shuang).
2. What are the calcium antagonists? Increase the risk of heart disease? Really? For calcium antagonists? Will the risk of heart disease increase? Say, mainly refers to heartache. Studies have found that propranolol may increase blood pressure fluctuation, accelerate heart rate and increase target organ damage. Therefore, if you need to take nifedipine for a long time, you should pay attention to monitoring and change the medicine if necessary.
3. Does calcium antagonist affect liver and kidney function? Did nimodipine cause it? Hepatitis? Really? How to prevent it? Because many calcium antagonists are metabolized in the liver and excreted by the kidneys, patients with hepatic and renal insufficiency should not take too much. Nimodipine mainly acts on cerebral vascular smooth muscle, but does not cause. Hepatitis? This report.
4. What's the difference between Poyiding and Luohuoxi and Xintongding? Which is better? How to choose? The US Food and Drug Administration (FDA) stipulates that the valley/peak ratio of drugs should exceed 66% to meet the requirements of long-term blood pressure reduction. 30% ~ 50% povidone, 70% luohuoxi,
While propranolol is less than 30%. Obviously, povidone and propranolol are not suitable for long-term antihypertensive treatment.
5. Do you still have time to take amlodipine? Before or after meals?
Amlodipine is quickly absorbed orally, once a day 1 time, 5 mg each time, before and after meals. Some people are dizzy and red after taking the medicine, indicating that they are absorbed too quickly and can be taken after meals.
6. An elderly patient has been using nitrendipine because? Stroke? After being hospitalized, the doctor asked me to change nimodipine. Can I not change it?
Although nitrendipine and nimodipine are both calcium antagonists, their action sites are different. Nimodipine mainly dilates cerebral vessels, which is beneficial to the recovery of brain function and cognitive function of stroke patients. Nitrendipine mainly dilates systemic circulation arteries. Therefore, the dressing should be changed.
Seven, long-term use of nifedipine controlled-release tablets, blood triglycerides and cholesterol will increase? The survey results show that only about 5.9% of these patients' blood lipids are affected.
8. What problems should I pay attention to when taking nifedipine for a long time? Nifedipine is a short-acting calcium antagonist. Fast absorption and rapid blood pressure drop will lead to reflex tachycardia, myocardial ischemia and acute vasodilation; Because of rapid excretion, taking medicine many times a day can't inhibit the peak of cardiovascular events in the morning. So it is not suitable for long-term use.
9. Will Luohuoxi cause myocardial infarction? What should I pay attention to when taking it for a long time?
Luohuoxi belongs to the third generation calcium antagonist and is a long-acting antihypertensive drug. Taking 1 tablet every day can control blood pressure for 24 hours and is suitable for patients with mild to moderate hypertension. Will not cause myocardial infarction. However, if you use it for a long time, you should pay attention to whether there is swelling and pain of gums and edema of feet and ankles.
Ten, the elderly with hypertension and coronary heart disease, with verapamil. Recently, left bundle branch block was found, and the doctor asked for dressing change. Is it serious? Or is the drug side effect big? His wife has the same disease. Does she need a dressing change?
This has nothing to do with side effects. Verapamil is a non-dihydropyridine calcium antagonist, and its adverse reactions include atrioventricular block and inhibition of cardiac function. The patient has left bundle branch block and should change the dressing. Angiotensin Ⅱ receptor antagonist (ARB) or calcium antagonist amlodipine are interchangeable. As for his wife, there is no need to change.
1 1. Patients with moderate hypertension also have gout. Is it appropriate to use sloping to reduce blood pressure? The cause of gout is the high concentration of uric acid in blood, which forms uric acid crystals and deposits in tissues.
It is suggested to switch to Hyatt 62.5 mg/kloc-0 once a day, which can reduce both blood pressure and serum uric acid. Twelve, a patient taking Sanjingpo for 2 months, the body is swollen, the limbs are cold, and it is easy to catch cold. If he touches ice water, his hands will be red, swollen and itchy. Is this caused by Sanjingsi Leping?
Trispermine can cause edema. If the patient is not complicated with other diseases and does not take other drugs, it may be caused by Silepin. It is suggested to add diuretics such as hydrochlorothiazide to relieve edema symptoms or switch to other antihypertensive drugs. As for cold hands and feet, you can stop taking medicine first, or go to the rheumatism department to rule out other diseases.
First,? Puli? kind
These drugs are angiotensin-converting enzyme inhibitors (ACEI), and commonly used drugs are captopril (captopril), benazepril (Lotensin), enalapril (Etsu), perindopril (Astar), ramipril (ruitai), fosinopril (Monro) and so on.
Second, after taking captopril, I feel headache and dizziness. Do I need to stop taking it? What medicine should I use after stopping taking medicine?
First of all, it is necessary to find out whether headache and dizziness are symptoms of hypertension itself or adverse drug reactions. If the blood pressure rises after stopping the drug, the symptoms of headache and dizziness will be alleviated, and it will appear again after taking captopril.
Symptoms can basically be identified as adverse drug reactions. You can switch to other antihypertensive drugs, such as calcium antagonists (amlodipine, nitrendipine). ? Receptor blockers (metoprolol, atenolol), etc. You can also take angiotensin Ⅱ receptor antagonists (ARB), such as losartan and valsartan.
3. What drugs can't captopril be used with? Can I use ibuprofen for a cold and fever? Captopril should be avoided in combination with potassium-preserving diuretics and potassium-supplementing preparations, such as spironolactone, triamcinolone acetonide, amiloride and potassium chloride. When combined with other antihypertensive drugs, pay attention to the blood pressure can not be too low. Ibuprofen can still be used for colds and fever, but the antihypertensive effect of captopril may be reduced.
4. What's the difference between Lotensin and Captopril? What are the side effects? Can it be used for a long time? Lotensin is the trade name of Benazepril, which belongs to angiotensin converting enzyme inhibitor (ACEI) together with captopril. But captopril is a short-acting antihypertensive drug, and lotion is a new long-acting antihypertensive drug. So captopril often needs to take medicine three times a day, while Lotion needs 1 time a day. The main side effect of Lotensin is cough. Other rare side effects include angioneurotic edema, constipation, gastrointestinal discomfort, rash and neutropenia. If there are no side effects, it can be used for a long time.
5. What kind of medicine is Yishu? Can it cause gout? Etsu, commonly known as enalapril, is one of the angiotensin converting enzyme inhibitors, which has good antihypertensive and protective effects on target organs such as heart, brain and kidney. But there are also some side effects, such as dry cough, which will not cause gout.
First,? Sartin? kind
These drugs are angiotensin Ⅱ receptor antagonists (ARBs), and the commonly used drugs are losartan, valsartan, candesartan (Vilja), irbesartan (Ambovi) and telmisartan (Mecamate). If you add12.5mg hydrochlorothiazide, Kosoya will become Hai Jie and Dai Wen.
Then it becomes complicated words, and Ambovi becomes Ambono.
Second, what are the side effects of taking Dai Wen for a long time? Dai Wen is the trade name of valsartan, which has almost no side effects, such as headache, dizziness, digestive tract symptoms, rash and so on. If there are no side effects, it can be used for a long time.
3. What's the difference between Xiao Sumi, Dai Wen and Hai Jieya? How to choose?
Both Kosova and Devin belong to angiotensin Ⅱ receptor antagonists (ARBs). The former requires liver transformation, and the latter can take effect directly. Although both of them are long-acting antihypertensive drugs, it is generally enough to take/kloc-0 once a day. However, Dai Wen maintained blood pressure longer than Kosoya. Haijieya is a compound antihypertensive preparation of losartan and hydrochlorothiazide. Its advantages are rapid onset and strong antihypertensive effect, and it is more suitable for patients with moderate hypertension.
First, diuretics
Commonly used drugs are dichlorothiazide, amiloride, indapamide (Shoubishan) and spironolactone.
Second, under what circumstances should I consider taking Shoubishan? How to take it? Can I take it for a long time?
Shoubishan (indapamide) is a long-acting diuretic and antihypertensive drug with calcium antagonism. It can be used as a single drug for mild to moderate essential hypertension, and can also be combined with other antihypertensive drugs. You can start from 1 time every day, 2.5 mg each time. Then it can be adjusted according to blood pressure. Shoubishan can be taken for a long time. A few patients will cause dizziness, headache, insomnia, lethargy, nausea, diarrhea, rash and so on. Individual patients will cause blood uric acid to rise, even induce gout, and some will have hypokalemia, so long-term use should pay attention to monitoring. It is not suitable for patients who are allergic to sulfonamides, severely deficient in liver function and acute cerebrovascular accident.
Third, long-term use of diuretics, potassium deficiency? What will happen? How to prevent it?
If taking diuretics leads to potassium deficiency, patients will have symptoms such as fatigue, muscle weakness, nausea, vomiting, weakened intestinal peristalsis and arrhythmia. The key point of prevention is that when taking potassium-expelling diuretics, blood potassium should be detected regularly and supplemented according to the blood potassium level. Once low potassium is produced, potassium diuretics can be stopped, or potassium chloride (Budaxiu) or potassium magnesium aspartate can be taken orally to correct it; In case of severe potassium deficiency, potassium chloride needs intravenous drip. In addition, diuretics and antihypertensive drugs can cause hypokalemia, mainly thiazide diuretics. Potassium-preserving diuretics not only do not produce low potassium, but also increase blood potassium. Therefore, if necessary, the combination of two diuretics can also reduce the abnormality of blood potassium.
First,? Receptor blocker
Commonly used drugs are metoprolol (betaloc), bisoprolol (Kangke) and carvedilol (Lode, Daliquan). 2. If you have eye pain after taking betaloc, what medicine can you use? It is reported that taking betaloc for a long time will cause Parkinson's disease. Is it true?/You don't say. Betaloc has side effects, such as headache and eye pain. In this case, you can stop using betaloc first. If the symptoms of eye pain disappear after stopping using betaloc for a period of time and reappear after taking betaloc, it means that it is related to betaloc. At this time, under the guidance of a doctor, patients can switch to angiotensin Ⅱ receptor antagonist (ARB), angiotensin converting enzyme inhibitor (ACEI) or diuretic according to their condition. As for Parkinson's syndrome, it is rare. For patients, there is no need to sit in the right position.
First,? Chinese patent medicine? And Chinese and western medicine
Second, can compound apocynum venetum cause gout? What side effects does it have?
Compound Apocynum venetum is a compound preparation of Chinese and western medicines, which consists of leaves of Apocynum venetum, Flos Chrysanthemi Indici, dihydralazine sulfate, hydrochlorothiazide and promethazine hydrochloride. Wherein hydrochlorothiazide may
It can cause the increase of blood uric acid, so compound apocynum venetum is not suitable for gout patients. However, because the amount of hydrochlorothiazide contained in compound apocynum venetum is not large, if the patient's uric acid is not high, it is not a big problem to take only 2 ~ 3 tablets a day. If you are worried, you can go to the hospital clinic to check your blood uric acid. If it is not high, you can continue to take it. In addition, excessive use of this product will also cause symptoms of central sedation and hypokalemia.
3. How about Zhenju Jiangya Tablet? What are the side effects?
Zhenju Jiangya Tablet is also a mixed preparation of Chinese and western medicine. Each tablet contains 30 micrograms of clonidine, 5 milligrams of hydrochlorothiazide, wild chrysanthemum, mother-of-pearl and Sophora japonica. It has the side effects of diuretics and central antihypertensive drugs at the same time, and the adverse reactions caused by taking the drug in large doses are related to the diuretics contained in it. Patients with mild hypertension (blood pressure140 ~150/90 ~100 mm Hg) accompanied by dizziness and pain can try Zhenju Jiangya Tablet.
4. A 40-year-old patient, with a height of 1.60m and a weight of 70kg, has been on a strict diet but can't lose weight. Now I feel OK after taking Niuhuang Jiangya Tablet, but my blood pressure has not dropped, and it has been 160/ 100 mmHg. Ask experts for advice. Body mass index (weight? Height 2) has exceeded 27 (normal 23 ~ 24), so there is a certain relationship between hypertension and obesity. Niuhuang Jiangya Tablet is a traditional Chinese medicine preparation, which has a slight hypotensive effect, so it is difficult to control blood pressure when used alone. It is suggested that patients go to the hospital to check the causes of obesity and related risk factors such as blood sugar and blood lipid. It is best to rule out secondary hypertension and check the kidney, renal blood vessels and adrenal gland. While dieting, increasing exercise, losing weight and controlling risk factors, patients are advised to use calcium antagonists, angiotensin Ⅱ receptor antagonists (ARB), angiotensin converting enzyme inhibitors (ACEI) or diuretics to lower their blood pressure to an ideal level. In addition, you can also choose a compound preparation such as Haijieya, once a day 1 tablet.
1 time.
Verb (abbreviation of verb) How to take antihypertensive tablets of Baihua Eucommia ulmoides 1 year? Is it credible? This drug is not commonly used at present, and it has not been proved to be an effective antihypertensive drug in large-scale clinical trials. ? Take 1 year without taking medicine in my life? Even less credible. Hypertension will rise again without medication. Don't believe advertisements.
First, other antihypertensive drugs
Third, can reserpine be taken for a long time? What side effects will it have?
Reserpine is not a basic antihypertensive drug, but it can still be used in view of the national conditions. There are side effects such as nasal congestion, mental depression, bradycardia and peptic ulcer. If there is no such side effect during use, it can still be used for a long time.
4. What is the composition of Beijing Jiangya No.0? What are the side effects of long-term use?
Beijing Jiangya No.0 is a compound antihypertensive drug, which contains reserpine, hydrochlorothiazide, triamcinolone acetonide, hydralazine and librium. In 2004, the prescription was adjusted to reduce sedative ingredients and changed its name? No.0 hypotensive tablet? . The main side effect of long-term use comes from reserpine (see the previous question for details); Because it contains triamcinolone acetonide, we should pay attention to the increase of blood potassium.
5. What medicine is Youjiangning? What problems should I pay attention to when taking it?
Glucagon is a monooxygenase inhibitor, and its antihypertensive mechanism has not been fully clarified. When taking this medicine, pay attention to postural hypotension, sometimes dry mouth, gastrointestinal discomfort, insomnia, dreaminess and so on. This medicine is generally used for moderate to severe hypertension. During taking this medicine, you should not eat food containing cheese, otherwise you will have pheochromocytoma-like attacks (sudden increase in blood pressure and limb convulsions).
6. Will taking antihypertensive drugs for a long time affect sexual function? How to judge whether sexual dysfunction is caused by antihypertensive drugs? Not all antihypertensive drugs will reduce sexual function. Some antihypertensive drugs can also improve sexual function, such as valsartan. Think so far? Receptor blockers, diuretics (including Shoubishan) and glibenclamide may have certain effects on sexual function, while angiotensin Ⅱ receptor antagonist (ARB), angiotensin converting enzyme inhibitor (ACEI), and? Receptor blockers have little effect on sexual function. The easiest way to judge whether sexual dysfunction is caused by drugs is to stop taking drugs 1 ~ 2 weeks and observe whether sexual function can be restored. Generally speaking, sexual dysfunction caused by antihypertensive drugs can be recovered after drug withdrawal.
First, combined medication.
A patient's systolic blood pressure170mmhg and diastolic blood pressure110mmhg. Take Sanjingpo 1 tablet in the morning and evening, 50 mg betaloc twice a day; I also take 2 aspirin every morning, 100 mg. Is this reasonable? If blood pressure can be effectively controlled, trimethoprim plus betaloc is a reasonable combination drug. But it is not appropriate to take aspirin 100 mg in the morning. As an anti-platelet aggregation drug, it is reasonable to take it at night, and it should be enteric-soluble.
Is it reasonable to take captopril, betaloc and Shoubisan at the same time? How long does it take to change the dressing?
Captopril is an angiotensin converting enzyme inhibitor, and betaloc is? Receptor blockers, Shoubishan are diuretics and antihypertensive drugs, and the combination of the three drugs is very reasonable. This reasonable combination of drugs is not? Mixed? , is a combination. If the treatment is effective, frequent dressing change is not advisable. If the blood pressure reaches the target value and is relatively stable, you can try to withdraw one. However, when to adjust the drug variety and dosage depends on blood pressure level, risk factors and organ damage.