What is an ACE inhibitor

In the body under the action of the enzyme renin resulting in kidney, produced angiotensin I, which is under the influence of the angiotensin-converting enzyme (ACE) Angiotensin II is formed, causing the active spasm of blood vessels.

There are drugs that can inhibit the activity of angiotensin converting enzyme, they are called ACE inhibitors.

Enalapril and its mechanism of action

Enalapril belongs to the drugs, ACE inhibitors and produced by different pharmaceutical companies under different names. But the international drug name is written on the packaging always, it enalapril. In our country, the most widely used drugs are Enap (KRKA, Slovenia), Enam (India).

Enalapril - lowering blood pressure drug mechanism of action is associated with inhibition of the activity of angiotensin-converting enzyme (ACE) inhibitors. Inhibition of ACE results in vasodilation, an increased formation of substances (kinins and prostacyclin) also possessing vasodilating action, and has some diuretic action. Along with a reduction in blood pressure medication reduces the load on the heart muscle, improves blood circulation and respiratory function, lowers resistance in the blood vessels of the kidneys, which helps normalize the blood flow in them.

Enalapril gradually lowers blood pressure and usually does not cause any changes in heart rate and minute volume. It prevents expansion of the left ventricle, improves blood flow to the heart, reduces the sensitivity of the heart to ischemic injury. After myocardial infarction drug reduces the development of cell death of heart muscle, improves metabolism and reduces the incidence of arrhythmias that occur after the restoration of blood supply to the heart muscle.

Indications

Indications for use of enalapril are the following conditions:

• hypertonic disease;
• increased blood pressure in kidney diseases (also in renal failure Kidney failure - when treatment is vital   and kidney disease in diabetes mellitus);
• Chronic heart failure (in combination therapy);
• dysfunction of the left ventricle of the heart as a consequence of increased load due to high blood pressure (in combination therapy).

Enalapril may be used in combination with other blood pressure lowering agents.

Contraindications for use

Contraindications for use of enalapril (Enap, Enam et al.) Are:

• Hypersensitivity to enalapril, formerly an allergic reaction in its application;
• angioedema in the past (including those associated with the use of ACE inhibitors);
• chronic renal failure;
• porphyria (violation of pigment metabolism);
• Pregnancy and breast-feeding Breast-feeding: feed - and no nails! .

Caution should be used enalapril in violation of the liver and kidneys, as well as in combination with a diuretic drug, since it is possible sharp decline in blood pressure.

In all cases, too marked decrease in blood pressure gradually reduce the dose.

Side effects with the use of enalapril

Enalapril is generally well tolerated and in most cases does not cause side reactions requiring discontinuation of the drug, however the side effects are:

• Central nervous system: headache, dizziness, fatigue;
• The respiratory system: dry compulsive cough, dyspnea;
• the gastro-intestinal tract include nausea, diarrhea, sometimes dysfunction of the pancreas Diabetes and pancreas - the things you need to know , Liver abnormalities stool;
• on the part of the cardiovascular system: a sharp drop in blood pressure, especially at sharp rising, irregular heartbeat, heart pain Pain in the heart - always consult a doctor , Fainting;
• Allergic reactions: skin rash, isolated cases of angioedema of the face, throat.

Very rarely, when used in high doses can appear neurological disorder: insomnia, increased nervous irritability, bad mood, impaired balance, tinnitus. The rare side effects are also hair loss, inflammation in the area of ​​language.

During treatment with enalapril is forbidden to drink alcohol, as Alcohol increases blood pressure lowering effect of the drug.

What if I overdose

If overdose can occur a sharp drop in blood pressure, up to fainting. In that case, should:

• put the patient with elevated legs;
• release from compressing the chest of clothes and open the window or the window;
• to drink lightly salted water;
• if the condition does not improve, then call an ambulance.

If your doctor has prescribed enalapril and you have no side effects when it is received, then, with proper reception and lack of complications of hypertension, you forget about what suffering this disease.

Galina Romanenko

Treatment - a man must not hear the noise, but the sound

If tinnitus is caused by any underlying disease, it is necessary to treat it, to get rid of the noise. When tinnitus occurs because of the accumulation of earwax, it is recommended to use special ear drops. Sometimes doctors perform the procedure to remove earwax. In most cases, however, tinnitus can not be cured so easily; furthermore, there is no drug that could quickly remove this symptom. As a rule, it requires a systematic treatment to cope with this unpleasant symptom. The following description of some forms of treatments that can be used in the treatment of patients suffering from constant tinnitus.

Correction hearing

If any degree of hearing loss as soon as possible to see a doctor as a regular power of hearing in an attempt to hear better results in the worsening of tinnitus. Due to the correction of hearing the load on the parts of the brain responsible for hearing, it will become more uniform, so that tinnitus will weaken or disappear altogether. Hearing aids can be used, special devices and / or surgical treatments.

Sound therapy

Tinnitus is usually most noticeable when the person is in silence. Sound therapy is the replacement of silence neutral often - repeated sounds that will distract a person from tinnitus.

Some people help included the TV or radio. Others prefer something more neutral, such as the noise of the sea or the "space sounds". There are special sound generators that emit soft sounds - the rustle of leaves in the wind, the rain and others. People suffering from permanent tinnitus, they help to fill normally and focus on the work that silence can be very difficult. Often, these generators have a timer so that they can shut down some time after a person falls asleep.

There are small generators of sounds resembling hearing aids - they are suitable for people with normal hearing or slight hearing loss. People suffering simultaneously from permanent tinnitus and severe hearing loss, it is recommended to wear hearing aids with built-in sound generator.

Cognitive-behavioral therapy

This type of therapy can be given to patients who have tinnitus causes severe anxiety Anxiety - how to distinguish normal from disease? And other symptoms associated with mental activity. The task of therapy - to change the way of thinking of the person in respect of its problems in a way that changed his behavior. And although it does not relieve a person from tinnitus, cognitive-behavioral therapy can seriously improve the quality of life of patients.

Self-treatment

Some people manage to cope with tinnitus Tinnitus - no disease and disorder   using techniques such as:

• Relaxation - Stress How to beat stress? Create an oasis   It may cause worsening of tinnitus, so you need to relax on a regular basis, doing yoga, exercise, walking or meditating;
• Music also helps to relax and relieve stress, moreover, masks the tinnitus;
• Support Groups - talking to people, faced with the same problem, it has an excellent therapeutic effect.