Trvanie účinku, dôležitá vlastnosť antihypertenzívnych liekov

English version

Autoři: Rainer Düsing
Působiště autorů: Medizinische Klinik und Poliklinik Bonn, Deutschland (Germany)
Vyšlo v časopise: Forum Diab 2013; 2(1): 10-17
Kategorie: Hlavná téma

Souhrn

Pri liečbe hypertenzie sú dostupné rôzne lieky. Tradične sú charakterizované spôsobom účinku, napr. diuretiká, ACE-inhibítory, antagonisti angiotenzínových receptorov, blokátory vápnikových kanálov. Ich prognostický efekt je podobný, napriek výrazne odlišným mechanizmom zníženia krvného tlaku. Viedlo to ku konsenzu, že samotné zníženie krvného tlaku pomocou antihypertenzívnej liečby je hlavným sprostredkovateľom kardiovaskulárnej ochrany. Trvanie účinku môže byť ďalším dôležitým aspektom, ktorý charakterizuje antihypertenzívny liek. Väčšina dostupných liekov, ktoré sa užívajú raz denne, dostatočne znižuje TK počas obdobia 24 hodín. Nonkompliancia k antihypertenzívnej liečbe môže značne predĺžiť interval dávkovania, keď je užitie lieku oneskorené alebo dokonca vynechané. V klinických štúdiách s elektronickým liekovým monitorovaním, približne bolo 10 % plánovaných dávok vynechaných v ktorýkoľvek deň a takmer polovica z týchto opomenutí bola súčasťou niekoľkých dní. Lieky s predĺženým intervalom dávkovania a súčasne s predĺženým účinkom vystupujú ako tolerantné lieky (forgiving drugs), ktoré napriek nepravidelnému užívaniu poskytujú terapeutické krytie. Prítomný prehľad sa zameriava na tento dôležitý aspekt antihypertenzívnej liečby a poukazuje na skutočnosť, že okrem tiazidového diuretika chlórtalidónu a blokátora vápnikového kanála amlodipínu, je takisto charakteristický predĺženou účinnosťou, teda toleranciou priamy inhibítor renínu aliskirén.

Kľúčové slová:
aliskirén – antihypertenzívne lieky – kompliancia – trvanie účinku – tolerancia

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