Drugs

Fibrates

The fibrates (isobutyric acid derivatives) primarily activate lipoprotein lipase which is a key enzyme in the degradation of VLDL resulting in lowering of circulating TGs. This effect is of the fibrates is exerted through paroxisome proliferator-activated receptor ci (PPARc) that is a gene transcription regulating receptor expressed in liver, fat and muscles. Activation of PPARct enhances

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Fenofibrate

Fenofibrate is another 2nd generation prodrug fibric acid derivative which has greater HDL-CH raising and greater LDL-CH lowering action than other fibrates. Hence Fenofibrate may be more appropriate as an adjunctive drug in subjects with raised LDL-CH levels in addition to raised TG levels. No rise in LDL-CH has been observed in patients with high

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Bezafibrate

Bezafibrate is a second generation fibric acid derivative and is used to lower cholesterol levels. It is an alternative for gemfibrozil in mixed hyperlipidaemias (type III, IV and V). Though it has also been indicated in hypercholesterolaemia (type II), it is inferior to statins and resins. Bezafibrate has not shown propensity to increase LDL-CH in

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Minoxidil

Minoxidil is a powerful vasodilator, the pattern of action resembling hydralazine, i.e. direct relaxation of arteriolar smooth muscle with little effect on venous capacitance. Marked vasodilatation elicits strong compensatory reflexes: increased renin release and proximal tubular Na’ reabsorption — marked Na and water retention — oedema and CHF may occur; increased sympathetic activity – palpitation,

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Nipride medication

Nipride medication is a rapidly (within seconds) and consistently acting vasodilator; has brief duration of action (2-5 min)—vascular tone can be titrated with the rate of i.v. infusion. It relaxes both resistance and capacitance vessels which reduces t.p.r. as well as c.o. (by decreasing venous return). Myocardial work is reduced—ischemia is not accentuated, as occurs

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Indapamide

Indapamide is a mild diuretic, chemically related to chlorthalidone; reduces BP at doses which cause little diuresis. Electrolyte disturbances and K loss are minimal at antihypertensive doses. In post-stroke patients, indapamide, with or without ACE inhibitor, reduces the risk of further stroke. It probably has additional vasodilator action exerted through alteration of ionic fluxes across

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Angiotensin Converting Enzyme Inhibitors or ACE Inhibitors

The ACE inhibitors are one of the first choice drugs in all grades of essential as well as renovascular hypertension (except those with bilateral renal artery stenosis). Most patients require relatively lower doses (enalapril 2.5—10 mg/day or equivalent) which are well tolerated. Used alone Angiotensin Converting Enzyme Inhibitors control hypertension in —50% patients, and addition

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Prazosin Side Effects

Prazosin Side Effects are rare at lower dosage that is commonly used. Prazosin is generally well tolerated at low doses. One of the most common prazosin side effects is Postural hypotension. Apart from postural hypotension related symptoms (to which tolerance frequently develops), other side effects are headache, drowsiness, dry mouth, weakness, palpitation, nasal blockade, blurred vision and

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