What is losartan and its mechanism of action

Losartan - receptor antagonist of angiotensin II. Losartan - is an international non-proprietary name, pharmaceutical companies it is produced under very different trade names: bloktran, brozaar, vazotenz, Vero losartan zisakar, kardomin (kardomin-sanovel), Cozaar, Losap, losartan, losartan potassium lorista, prezartan, renikard .

Losartan lowers blood pressure and the pressure in the pulmonary (passing through the lungs) circulation. In addition, it has a diuretic effect, promotes the excretion of sodium and uric acid Uric acid - a normal level?   and saving potassium salt required for the heart muscle. It is used for hypertension and congestive heart failure.

The maximum concentration of losartan in the levels achieved after 3-4 hours. To achieve the full clinical effect of the drug must be taken for 1-1, 5 months.

Indications for use

Losartan is indicated for the following diseases:

• hypertension, it is most effective in the early stages of the disease;
• chronic ischemic heart disease accompanied by symptoms of heart failure (in a combination therapy with diuretics and cardiac glycosides).

Accepted losartan usually 1 time per day, regardless of the meal. The maximum antihypertensive effect develops in 3-6 weeks after beginning treatment. Moreover, if the patient receives more and diuretics, the initial dose of losartan reduced. Blood concentrations of losartan in patients with liver cirrhosis is significantly increased, so patients with hepatic disease should use the drug at a lower dose. Losartan may be administered in conjunction with other drugs that reduce blood pressure.

Contraindications

Losartan is contraindicated in:

• In case of hypersensitivity to the drug;
• Pregnancy and breast-feeding Breast-feeding: feed - and no nails! ;
• in childhood.

Side effects and overdose

Generally losartan was well tolerated, side effects are mild and transient and did not require discontinuation of therapy.

On the part of the gastrointestinal tract losartan can cause loose stools, nausea, abdominal pain, dry mouth. On the part of the upper respiratory tract - nasal congestion, cough. Adverse effects of the central nervous system may occur migraine, headache, dizziness Dizziness - if the ground is slipping from under his feet , Insomnia, anxiety, memory disorders Memory Disorders - aggravation as dangerous as the weakening , Tinnitus, taste disturbances, vision changes. Allergic reactions - in the form of angioedema (swollen lips, soft tissues of the face, tongue, throat), urticaria, pruritus.

In rare cases, chronic administration poyavlyayutsyanarusheniya kidney function and muscle pain.

In case of overdose of losartan may decrease blood pressure, the appearance of accelerated heartbeat slow or vice versa. Treatment should be in a hospital setting: a patient is injected with a large amount of fluid diuretics (forced diuresis).

Drug Interactions

Significant interaction of losartan with other major groups of drugs have been identified. When losartan with blood pressure-lowering effect of drugs is synergistic.

In the application of losartan with diuretics, potassium salts contributing to the delay in the body increases the risk of hyperkalemia (high potassium in the blood) that can adversely affect the health of the patient.

Losartan - good medicine for the treatment of hypertension, which can be taken alone or in combination with other medicines.

  Galina Romanenko

Blood pressure as a result of treatment

• 140/90 mm. Hg or below - if you are aged and do not suffer from any illness
• 130/80 mm. Hg or below - if you suffer from chronic kidney disease, diabetes or cardiovascular disease, or if there is a risk of occurrence of cardiovascular disease
• 120/80 mm. Hg or lower - if the work is broken your heart (left ventricular hypertrophy or heart failure) or have a severe form of chronic kidney disease

Despite the fact that 120/80 mm. Hg or below is ideal measure blood pressure, physicians do not find it so that when it is attained by medication.

In the event that an age of over 80 years, and your blood pressure is too high, your doctor may prescribe treatment, focused on getting blood pressure slightly higher than 140/90 mm Hg

The main types of drugs used in the treatment of hypertension, are:

• Thiazide diuretics. Diuretics or diuretics - drugs that act on the kidney and promote the removal from the body of excess fluids and sodium, reducing the volume of blood. Thiazide diuretics - often the first, though not the only measure in the treatment of hypertension. Often it also happens that diuretics do not register at all. If you are not taking diuretics, and the blood pressure remains high, discuss with your doctor the possibility of incorporation into the existing diuretic therapy, or talk about replacing the drug you are taking, along with a diuretic.
• In that case, if your age is 80 years old and older, a diuretic such as indapamide, can be quite successfully used for the treatment of hypertension. In this age group indapamide shown to reduce mortality as a result of smoking, heart failure and other cardiovascular diseases.
• Beta-blockers. These drugs reduce the workload on the heart and dilate blood vessels, which reduces the heart rate and facilitates the work of the heart. In that case, when beta-blockers are appointed as monotherapy, there is their low efficiency in people blacks - they are much more effective in combination therapy - such as thiazide diuretics.
• Inhibitors angeotenzin-converting enzyme (ACE) inhibitors. These drugs can reduce blood pressure by preventing the formation of the body of angiotensin II, which is a potent vasoconstrictor. ACE inhibitors are most useful in the treatment of hypertension in people with damage to the coronary arteries, heart or kidney failure Kidney failure - when treatment is vital . Like beta blockers, ACE inhibitors are ineffective among blacks in the case of monotherapy, so they are administered in combination therapy with thiazide diuretics.
• Receptor blockers angiotensin II. These drugs can reduce blood pressure by neutralizing the action of angiotensin II. Angiotensin II receptor blockers are often successfully used in the same cases as the ACE inhibitors.
• Calcium channel blockers. These drugs reduce the resistance of blood vessels, reduce the number of heart rate. They can be used successfully as monotherapy in blacks. Grapefruit juice, interacting with some of the drugs in this group that increases blood pressure and increases the risk of side effects. Discuss with your doctor how serious it is in your case.
• Renin inhibitors. Preparation aliskiren reduces the production of renin, an enzyme produced by the kidney, which is formed by a series of chemical reactions in angeotenzin II. This drug is not yet fully understood that what should be the dose and the scope of the people suffering from hypertension.

If none of the drugs or their combination does not allow to achieve the desired effect in lowering blood pressure, the doctor may recommend:

• Alpha-1 blockers. These drugs reduce the amount of nerve impulses to the blood vessels, reducing the action of angiotensin II.
• Alpha, beta-blockers. In addition to reducing the number of nerve impulses to blood vessels, alpha, beta-blockers decrease heart rate, thereby reducing the volume of blood in the blood vessels.
• Central-acting agents. These medications protect the brain from the signals of the nervous system to increase heart rate and vasoconstriction.
• Vasodilators. These drugs act directly on the muscles of the walls of blood vessels, preventing the muscles from cramping and thereby preventing the narrowing of the arteries.

When blood pressure is normal, your doctor may recommend a daily aspirin to reduce the risk of cardiovascular disorders.

To reduce the daily dose of the drug required to you doctor may prescribe a combination of several drugs in smaller doses instead of large doses of one of them. Essentially, the two or more antihypertensive drugs often produce a better effect than one. Sometimes finding the best medication - or the combination of several - it's trial and error.

Resistant hypertension: blood pressure is difficult to therapy

In that case, if your blood pressure is consistently failed to decline even in the treatment of three different antihypertensive drugs, one of which should be a diuretic, it is likely to have developed resistant hypertension. It's such a hypertension that is resistant to treatment. It is believed that people who were able to normalize blood pressure, taking up to four different antihypertensive drugs in a single course of treatment, and there is a persistent hypertension.

However, the presence of resistant hypertension does not mean that the blood pressure will never be able to reduce. In fact, if we can determine which is the cause of this hypertension, there is a great opportunity to prescribe treatment that will be much more effective. It may also be a consequence of other diseases that cause hypertension, which you may not be aware - such as apnea Stop breathing (apnea) during sleep - upper airway obstruction   in a dream Dreams: how to understand our dreams   or kidney disease. Perhaps you will need to make lifestyle changes.

Your doctor will assess whether you are suitable drugs and doses that you take to reduce blood pressure. Thus, you get a precisely tailored medications and their dosage. Also, your doctor may prescribe a stronger and long-acting diuretics. It can be recommended and netiazidnye diuretic drugs, such as spironolaktan iplerinan or that alter the process of absorption in the body of sodium and excretion of potassium by blocking the hormone aldosterone. People suffering from resistant hypertension Hypertension - when suffering heart and brain They tend to have high levels of aldosterone.

Together with your doctor you can review the selection of drugs that you used for the treatment of opportunistic diseases. Some foods, dietary supplements and medicines can raise blood pressure and weaken the effect of drugs used to treat hypertension. Be sure to put notify your doctor about any medicines or supplements you are taking.

If you do not regularly take medication prescribed to you as you have been registered, you will be punished consequences that threatens hypertension. If you missed the regular medication, discuss with your doctor the way out of such situations. Do not make any adjustments to the treatment process without the consent of a doctor!