The list of the best drugs for the treatment of cerebral atherosclerosis: rules for use and contraindications
- 1 When do you need medicine?
- 2 The main groups of drugs
- 3 The most effective means
- 4 General treatment guidelines
The percentage of disability and deaths from strokes is very high, so at the first signs of a cerebral circulation disorder, you need to change your lifestyle and begin treatment. Specific drugs, doses, treatment regimens are selected individually according to the results of the examination and taking into account contraindications.
When do you need medicine?
The process of forming cholesterol plaques in the inner lining of medium and large arteries begins in childhood. With age, it can accelerate, especially if there are provocative factors in the form of heredity, errors in nutrition, the presence of bad habits, physical inactivity, psycho-emotional instability. Usually atherosclerosis is diagnosed in persons over 40 years old, mostly male. The first symptoms indicating the development of the disease:
- systematic headaches, tinnitus, dizziness;
- constantly increased pressure;
- decreased performance, weakness, lethargy, lack of interest in life;
- unreasonable nervousness, irritability, behavioral disorders;
- coordination problems;
- sleep disorders (increased sleepiness or insomnia).
These conditions indicate that cerebral circulation has deteriorated due to the narrowing of the lumen of blood vessels. If, in parallel with the listed pathological signs, an increased concentration of cholesterol or sugar in the blood is detected, there are bad habits, then with high probability we are talking about atherosclerosis. Moreover, the disease is in a stage requiring medical treatment.
Without drugs, you can do only in the early stages of the disease, adjusting lifestyle. Diet, sports, smoking cessation will help to keep blood vessels toned and cholesterol levels under control. Drug treatment also needs to be combined with a healthy lifestyle, but medications are necessary to prevent complications. What happens if untreated atherosclerosis?
Damaged arteries cannot function normally, therefore rupture occurs due to increased blood pressure. If the thrombus comes off and the lumen of the small vessel closes, a part of the brain is deprived of oxygen and gradually dies off. In the first case, hemorrhage occurs (hemorrhagic stroke), in the second case, neurological disorders develop on the background of ischemia. The ability to work is gradually lost, the intellect decreases, and cognitive functions are impaired.
The main groups of drugs
Medical therapy will help prevent complications and significantly improve the general condition. Atherosclerosis cannot be completely cured, but it is possible to slow down or stop the progression of the disease. The drugs that are used belong to different pharmacological groups.
Based on the examination, test results, the state of the patient’s body, the doctor selects one or more drugs. It is absolutely impossible to make a decision on how to treat the vessels. The following medication information is for reference only.
Hypolipidemic agents of this group reduce the concentration of low-density lipoproteins and fatty acid triglycerides in the blood. The mechanism of action is based on blocking the synthesis of these compounds in the body. Clinical studies have shown that taking a single dose lowers cholesterol by more than 30%.
At the same time, statins stimulate the production of “beneficial” fats – high-density lipoproteins – which prevent the formation of plaques on the walls of the vessel. The most popular drugs: Atorvastatin, Lovastatin, Rosuvastatin, Simvastatin, Fluvastatin.
Bile acid sequestrants
FFAs are polymeric ion exchange resins that form insoluble complexes with bile acids in the intestine. Thus isolating the compounds necessary for digestion and removing them from the body, the preparations stimulate their synthesis. And they are produced by the oxidation of cholesterol in the liver cells.
Drugs in this group are usually prescribed as part of the complex therapy of atherosclerosis, taken before meals. Available under the trade names Kolestiramin, Questran, Kolestipol, Kolevelem.
In the modern practice of treating atherosclerosis of cerebral vessels, bile acid sequestrants are used less and less as they are less effective than statins (but more often they cause side effects). The list of negative reactions to FFA from the body includes: constipation, bloating and abdominal pain, anorexia, vomiting, nausea, dyspepsia, pancreatitis, skin rashes.
Prolonged use provokes acidosis, gastric and hemorrhoidal bleeding, lowering blood clotting. The drugs are contraindicated for pregnant, lactating, people with phenylketonuria and hypersensitivity to the components of the drug.
The second most effective group of lipid-lowering drugs that reduce the concentration of triglycerides. Fibrates affect cholesterol to a lesser extent, but they contribute to the synthesis of beneficial lipoproteins. The mechanism of action is to activate the enzyme that breaks down LDL. In addition, platelet aggregation and fibrinogen levels are reduced.
With prolonged use contribute to the destruction of extravascular cholesterol deposits. Available in the dosage form of capsules under the names Lipantil, Fenofibrat, Traykor, Lipanor.
Calcium channel blockers
The basis for the appointment of calcium antagonists in atherosclerosis is their ability to dilate brain vessels, activate blood flow, and reduce pressure. In the pharmacological practice for the production of drugs used several chemical compounds that block calcium channels:
- phenylalkylamines – based on them, the first BPC of verapamil was synthesized;
- benzothiazepines – Klentiazem, Diltiazem;
- diphenylpiperazines – Flunarizin, Cinnarizin;
- 1,4-dihydropyridines – Amlodipine, Nifedipine, Felodipine, Lercanidipine;
- diarylaminopropylamine – Bepridil.
Group drugs also have the property to inhibit platelet aggregation, as well as destroy already formed blood clots. The list of side effects in calcium antagonists is minimal.
Often, the main therapy of atherosclerosis is supplemented by vasodilator drugs to reduce pressure. They are divided into several groups according to the mechanism of action, since they affect different receptors.
Regular intake of drugs such as Papaverine, Vincamine, Xanthinol nicotinate reduces the tone of the cerebral arteries, contributing to their expansion. Vincamine with Xantinol also possess antiplatelet properties, stimulate cerebral circulation.
The category includes various drugs that reduce vascular tone, inhibit platelet aggregation, and activate cerebral circulation. These include calcium antagonists, vasodilators, antihistamines.
The most effective in the treatment of atherosclerosis is betahistine, dipyridamole, nicergolin. Can be used both orally and by intravenous infusion.
This pharmacological group includes many drugs, the most famous and accessible of which is Aspirin. However, due to the negative effect on the digestive system, it is prescribed with caution, in small dosages. Such remedies as Klopidogrel, Klopidex, Zilt less likely to cause adverse reactions, having a similar effectiveness.
The mechanism of action of antiplatelet agents is based on obstructing the adhesion of platelets to red blood cells, which reduces blood viscosity and activates microcirculation.
Lack of these chemical compounds always leads to various disruptions in the functioning of the body. Vitamins with antioxidant properties – ascorbic acid, tocopherol – are of great importance for the health of blood vessels.
But the most significant is niacin or nicotinic acid. She is responsible for the process of fat metabolism, so the scheme of treatment of atherosclerosis is included on a mandatory basis.
The most effective means
The following are the drugs that are most often included in the treatment of cerebral atherosclerosis. Drug therapy should be combined with a diet, some drugs may be prescribed only after it.
You should not take any medications without medical prescription (even vitamins), since it is impossible to determine the type of hyperlipidemia without examination and tests. In some cases, regular monitoring of the condition of the body is required.
Tableted drug is produced by Russian and foreign pharmaceutical companies in dosages from 10 to 80 mg. Reduces the concentration of cholesterol by inhibiting the enzyme necessary for the synthesis of LDL. It is indicated in the case of hyperlipidemia, hypertriglyceridemia, hyperchoheterolemia, and also for the prevention of heart and vascular diseases in the presence of risk factors.
The list of contraindications, in addition to the intolerance of the active and auxiliary components, include pregnancy, lactation, age up to 18 years.
The standard scheme of use is 1 time per day, regardless of the meal, which does not affect absorption. The minimum therapeutic course is 4 weeks. A single dose is determined individually, can vary from 10 to 80 mg of active ingredient. The appointment takes into account the age of the patient, the interaction with other drugs.
The frequency of side effects of atorvastatin does not exceed 2%, the most common adverse reactions from the gastrointestinal tract (dyspepsia, stool disorders, flatulence).
The drug is produced in tablet or capsulated form, containing 200 mg of the active ingredient of the same name.
Fenofibrate in combination with statins is indicated for:
- severe triglyceridemia;
- atherosclerosis of cerebral and peripheral arteries;
- abdominal aortic aneurysm;
Take the drug should be with meals, 1 capsule or tablet every 24 hours. Side effects after administration are rare. Digestive disorders, allergic reactions, changes in blood counts are noted. In some cases, there is a toxic effect on muscle tissue during drug interaction with statins.
Fenofibrate is contraindicated in: liver failure, kidney, the presence of hypersensitivity to the active substance, pregnancy, breastfeeding, as well as in children and adolescents (under 18) age.
Drug for oral administration refers to calcium antagonists, is a derivative of benzothiazepine. By blocking the slow calcium channels in the membranes of muscle cells provides relaxation of the smooth muscles of the arteries. As a result, the vascular lumen expands, the blood flow is activated, and the pressure decreases. It is well absorbed when taken orally, is not addictive, even after months of therapy.
Diltiazem is available in capsulated and tablet form 60 and 90 mg, prolonged preparations – 180 mg each. The maximum daily dose is 360 mg, usually administered 60 mg three times a day. Take pills or capsules before meals with water.
Admission is contraindicated in children, pregnant, lactating, people with intolerance to benzothiazepines, cardiac abnormalities, liver failure. Of the side effects are likely digestive disorders, heart rhythm disturbances, and allergies.
One of the most effective pills for cerebral arteriosclerosis. A broad-spectrum drug that regulates cerebral circulation by reducing vascular tone. In parallel, it prevents gluing and adhesion of platelets, activating blood flow.
It has dosage options in 25, 50 and 75 mg. The course of therapy for atherosclerotic changes in the vessels of the brain is long, at least two months. To enhance the effectiveness, it is recommended to combine the intake of dipyridamole with acetylsalicylic acid in small doses.
Take the medication strictly on an empty stomach every 8 hours. A single dose is determined individually, taking into account the severity of the disease and contraindications. The latter include children’s age, lactation, certain heart diseases, hypersensitivity, gastric ulcer, and liver failure.
Pregnant Dipyridamole can be prescribed in the event that the benefits to women are higher than the potential teratogenic risks. Side effects can cause irregular heartbeat, digestion, and various allergic reactions.
A nicotinic acid
This substance, also known as niacin or vitamin PP, is of great importance for the implementation of redox processes, including fat metabolism. Mandatory prescribed for cerebral atherosclerosis, since it has a diverse therapeutic effect:
- inhibits the synthesis of LDL;
- stimulates the production of “good cholesterol”;
- dilates blood vessels;
- activates fibrinolysis;
- slows down platelet aggregation.
The active substance is used for the production of combined drugs or is produced in pure form. Nicotinic acid in pharmacy chains is sold as a solution for injection and tablets. The latter contain 0.05 g of niacin, consumed after meals.
The recommended daily intake for an adult is 3 g, divided into several doses. The drug has minimal contraindications – hypersensitivity – and rarely causes negative reactions of the body.
General treatment guidelines
First of all, you can take any medication for atherosclerosis only as directed by your doctor. The disease in each case proceeds differently, the mechanism and causes of the formation of atherosclerotic plaques require clinical diagnosis. For example, cholesterol deposition may be associated with an increased concentration of low density lipoproteins or triglycerides. The result is the same, but the treatment must be carried out with different drugs. The general condition of the patient, the presence of concomitant pathologies.
Particular attention is paid to the compatibility of drugs. Since therapy in most cases is complex, antagonism may occur between drugs of different groups, synergism or negative adverse reactions. Often, to prevent the latter, constant monitoring by a specialist and periodic laboratory tests are required. In addition, you need to drink pills in strict accordance with the characteristics of their assimilation: before, during or after a meal.
An important condition for the successful treatment of atherosclerosis – the organization of proper nutrition. Adhere to the low-cholesterol diet should be throughout the entire course of drug therapy, in some cases before it, because bad habits have a negative effect on vascular tone, they must be abandoned, especially from smoking. The effectiveness of drugs is also increased in combination with physical activity, since moderate loads stimulate metabolism.