Uncle Yang, 64 years old, suffering from high blood pressure for many years, recently took antihypertensive drugs but did not play a role in lowering blood pressure, every day at home to measure, elevated on the take nifedipine tablets, recently increased blood pressure 150/80, several consecutive days are high, and then continuously take nifedipine tablets until today, one pill a day, after taking the drug blood pressure dropped to 120/80, in recent days found that after taking the drug calf and face puffiness phenomenon, before there was no such situation, come to the hospital to check to know that this is a side effect of large antihypertensive drugs, has been eliminated.
Uncle Yang's case gives us a lot of vigilance, now the older hypertension patients still do not know that these three hypohypertensive drugs have been eliminated, let us understand together which three types of antihypertensive drugs have been eliminated, and how to choose the right antihypertensive drugs.
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Reason for elimination
1. Short-acting drugs can not increase the dose can not be taken for a long time:
The available literature suggests that when the dose is increased due to the course of treatment, it will cause all blood vessels except the total blood vessels of the heart to expand rapidly, and the blood flow is excessive, which will cause low blood pressure. Hypotension caused by overdose increases blood flow during surgery or surgical resection, which is very dangerous, and ventilation circulation should be given immediately and vital signs of patients should be monitored in real time, and blood flow can also be controlled with drugs. Patients with hepatic and renal impairment have a prolonged time to clear the drug, and no method has been found to completely eliminate nifedipine.
2. Pharmacological toxicity: nifedipine is a natural antioxidant calcium inhibitor, which selectively inhibits calcium entering the low concentration of myocardial fibers and striated muscle cells to run in a high concentration ladder, and prevents it from volatilizing from the cells, but also does not change the plasma concentration. So the accumulation of too many calcium ions in the body leads to:
(1) Diseases of the blood system: multiple myeloma, which destroys bone mass and threatens our motor system.
(2) Diseases of the endocrine system: hypersymphatic paradenoblastics, in which when the glandular hormones are secreted too much, calcium and phosphorus metabolism is abnormal, resulting in hypercalcemia.
3. Too many side effects:
(1) Hypotension: the vast majority of patients will have a slight hypotension reaction after using nifedipine, when the dosage increases due to the course of treatment or when the dosage suddenly decreases, a very small number of patients will have serious symptoms. The use of nifedipine in surgically removed patients will increase blood flow very quickly, and blood flow will not be stopped, which will be life-threatening.
(2) Angina myocardial infarction: a very small number of patients with insufficient heart pumping, taking nifedipine, blood flow is very large, but the heart system can not keep up, it will lead to angina.
(3) Peripheral edema: blood vessels dilate, blood vessels are enlarged, and more water and blood pass through the blood vessels, making the skin look swollen. Most of the edema occurs at the end of the lower limbs, and you can drink more water to reduce the swelling.
(4) Drug "rebound" symptoms: destroy the effect of other drugs.
(5) Congestive heart failure: a small number of patients receiving β-blockers can develop heart failure after starting to take nifedipine, and the probability of cardiovascular stenosis is greater.
(6) Elevated blood urea nitrogen and creatinine: patients with hepatic and renal insufficiency and those who are taking β-blockers will induce or aggravate hypotension, causing elevated blood urea nitrogen and creatinine.
Recommended alternatives: nifedipine tablets extended-release and controlled-release tablets
<h1 class="pgc-h-arrow-right" data-track="4" >2, compound formulations containing bishydral hydralazine</h1>
Reasons for elimination: Compound preparations containing bishydral hydrazine, such as compound reserpin tablets and compound robin tablets, may cause the heart to pump blood too quickly and cause more diseases. Its side effects are significant:
1. Common side effects: there is runny nose, endocrine abnormalities, and other parasympathetic dominant phenomena. In addition, there is fatigue, weight gain, etc
2. Mental side effects: Some patients can have very obvious depression when taking compound reserpine tablets for a long time.
3. Side effects on the heart: Some patients who take compound reserpine for a long time will have bradycardia (less than 60 times per minute), and even the side effects of cardiac arrest.
4. Side effects when combined with other drugs: When patients with reserpinization take digitalis, it will cause side effects such as sudden cardiac arrest or arrhythmia.
<h1 class="pgc-h-arrow-right" data-track="4" >3, compound preparations containing clonidine</h1>
Compound preparations containing clonidine, such as Chrysanthemum antihypertensive tablets, have great side effects:
1. Water electrolyte disorder: the side effects caused by water electrolyte disorders are commonly dry and thirsty, muscle spasms, nausea and vomiting, and neck fatigue and weakness. Includes prone to decreased kidney function, palpitations. Some patients will be comatose, or even hallucinate, and hallucinations are only a small number of people.
2. It can interfere with the increase of uric acid excreted in the glomeruli and destroy normal kidney function.
3. Blood sugar rises.
4, can make the low-density albumin egg rise and high-density fat, which will lead to cardiovascular congestion by blood lipids, when the blockage is too much when the blood flow can not pass, it will lead to hardening of the arteries, hardening of the blood vessels leading to the appearance of dry cracks in the vascular membrane, vascular aging, etc., this situation will be seriously dangerous to our lives, so we do not recommend the use of such drugs.
5. It can lead to allergic reactions, such as urticaria, or erythema on the skin, and vomiting, which are common reactions to allergies to this drug, but are relatively rare.
6. Purpura appears.
<h1 class="pgc-h-arrow-right" data-track="4" > how to choose the right antihypertensive drug for you</h1>
1. Hypertension in the elderly is mainly manifested by increased systolic blood pressure, due to the weakening of blood vessels and liver and kidney organs in the elderly, as well as decreased kidney function. Therefore, the drug selection of elderly hypertension should follow the principles of stability, effectiveness, safety, few adverse reactions, simple and convenient to take, and good compliance. We will also be based on the patient's medical history, and ask the patient whether there are other diseases of the drug need to be taken at the same time, then we will be based on the drug compatibility contraindications to rational dispensing, to create a suitable treatment plan for the patient.
2. A situation, first of all, to determine whether it is secondary hypertension, of which renal hypertension needs special attention, followed by endocrine diseases or vascular diseases, relatively rare single gene genetic diseases, before treatment, first look for the cause, symptomatic treatment can effectively reduce blood pressure. Of course, most children and adolescents have high blood pressure that is primary, and obesity and excessive salt consumption are common causes.
Keep in mind these three types of drugs, be sure to check whether you have a home, but also to see if the elderly at home have it, and popularize science to more people. Patients with high blood pressure are mainly dietary problems, eat a light diet, exercise appropriately, enhance their physical fitness, and do not increase or decrease the amount of medicine by themselves.