What Are Peripheral Vasodilators?

Peripheral vasodilators are drugs that directly dilate small blood vessel smooth muscle or relax the surrounding blood vessels by acting on adrenergic receptors. Angiotensin-converting enzyme inhibitors have also been regarded as vasodilators. Peripheral vasodilators are mainly used clinically for peripheral circulation disorders such as acral arterial spasm, migraine, Meniere's disease, occlusive vasculitis, and lowering blood pressure. They are also used to prevent heart failure.

Chinese name: Peripheral vasodilators

Function: Small vasodilatation

Peripheral vasodilators

The following are commonly used:

Peripheral vasodilators act directly on vascular smooth muscle

Peripheral vasodilator

Relax the small artery smooth muscle directly, reduce peripheral resistance and lower blood pressure. Can cause reflex heart rate to increase faster and increase cardiac output. Prolonged use can lead to increased renin secretion, increased aldosterone, and water and sodium retention, reducing the effectiveness. It is characterized by a significant decrease in diastolic blood pressure and can increase renal blood flow. It is mostly used in patients with renal hypertension and higher diastolic blood pressure. The route of administration is oral. Adverse reactions include headache, dizziness, vomiting, and palpitations. Long-term high-dose use of this drug can cause rheumatoid arthritis and lupus erythematosus-like reactions. Use with caution in patients with coronary heart disease and cardiac insufficiency. ^[1]

Peripheral vasodilators

Relax the arterioles and venous smooth muscles directly, lower blood pressure, and reduce the anterior and posterior load, so the myocardial load is reduced, the oxygen demand is reduced, and the pulmonary artery pressure can be significantly reduced. The effect is strong and rapid, and it takes effect 5 minutes after administration, and the effect can be maintained for 2 to 15 minutes after stopping the drug. For hypertensive emergencies, including hypertension crisis, hypertensive encephalopathy and malignant hypertension, and heart failure. It is usually administered by intravenous drip. During medication, blood pressure and heart rate should be closely monitored in order to adjust the dosage at any time. When the drug is stopped, the dose should be gradually reduced, and oral vasodilators should be added to avoid rebound symptoms. Prolonged or high-dose use can cause severe hypotension. The solution of this product should be prepared immediately before use, and used up within 12 hours. Due to the deterioration of light, the drip bottle should be covered with black paper. Nausea, vomiting, nervousness, muscle cramps, headache, anorexia, rash, sweating, fever, etc. may occur during the medication. Long-term application can cause hypothyroidism due to thiocyanide storage.

Peripheral vasodilator

It acts directly on the blood vessel wall, dilates the arterioles, reduces peripheral resistance, lowers blood pressure, and has no effect on the volume of blood vessels, so it can improve venous return. Can significantly increase myocardial blood flow. The principle of action is similar to that of hydrazine, and its antihypertensive effect is stronger than that of hydrazine. Can be used for refractory hypertension and renal hypertension. It works synergistically with comfort. The route of administration is oral. Adverse reactions are often water and sodium retention, tachycardia, often accompanied by ST segment reduction, and T waves are flat or inverted. A few patients develop rashes and thrombocytopenia. Long-term use can cause hairy. ^[2]

Peripheral vasodilator indamine (Suphan)

It mainly inhibits calcium influx of vascular smooth muscle, reduces vascular tension, and reduces peripheral vascular resistance. Unlike general calcium antagonists, it does not slow down heart rate and does not inhibit myocardial contractility. Diuretic effect. This product is taken orally, and the adverse reactions are very light. Some of them have dizziness, headache, nausea, and insomnia.

Peripheral vasodilator nicotinic acid

It has a strong peripheral vasodilator effect, which is effective after several minutes of oral administration, and can be maintained for several minutes to one hour. It is used for vascular migraine, headache, cerebral arterial thrombosis, pulmonary embolism, Meniere's disease, frostbite, and central retinochoroiditis. Usage is oral. Large doses can lower blood lipids. Adverse reactions were: skin flushing, heat sensation, itching, nausea, vomiting, palpitations, etc. Ulcer disease, liver disease, gout, diabetes, etc. are prohibited.

Peripheral vasodilator

It has a direct relaxation effect on vascular smooth muscle, which reduces blood pressure and is used for mild hypertension and cerebral vasospasm. The route of administration is oral or intravenous.

Papaverine

It has a relaxing effect on blood vessels, bronchial tubes, gastrointestinal tract, bile ducts and other smooth muscles, expanding coronary arteries, reducing peripheral resistance and cerebrovascular resistance, and is used for cerebral thrombosis, pulmonary embolism, acral arterial spasm and arterial embolism pain. . The route of administration is oral, intramuscular or intravenous. Excessive or rapid bolus injection can lead to atrioventricular block, ventricular fibrillation, and even death. It should be slowly pushed in after dilution. ^[3]

Peripheral vasodilator cinnarizine

It has a direct expansion effect on vascular smooth muscle, improves cerebral circulation and coronary circulation, and is used for cerebral thrombosis, cerebral embolism, cerebral arteriosclerosis, cerebral hemorrhage and subarachnoid hemorrhage recovery period, sequelae of traumatic brain injury, inner ear vertigo, coronary arteries Hardening, etc. The route of administration is oral or intravenous. Adverse reactions were drowsiness, rash, gastrointestinal reactions, and so on.

Fluphenazine

Has a direct dilation effect on blood vessels. Its effect and use are similar to cinnarizine, in addition, it has a certain effect on attention loss, memory impairment, dizziness, and balance dysfunction. Usually served at night.

Peripheral vasodilator anti-glazidine (petatadine)

A histamine drug, which has the effect of dilating capillaries, can increase cerebral blood flow and inner ear blood flow, and eliminates inner ear vertigo, tinnitus and ear sensation. It is also used for cerebral arteriosclerosis, ischemic cerebrovascular disease, and head trauma. Usage: oral or intramuscular injection. Adverse reactions were dry mouth, upset stomach, palpitations, and itching of the skin. Use with caution in patients with peptic ulcer, bronchial asthma, and pheochromocytoma. ^[4]

- - Peripheral vasodilator -adrenergic receptor blocker (-blocker)

The following are commonly used:

() Peripheral vasodilator phentolamine (Razithine)

It has vasodilation and cardiac excitement, and has a direct relaxation effect on vascular smooth muscle. It is clinically used for diagnostic tests of vasospasm diseases such as acromegaly arteriospasm (Raynaud's disease), cyanosis of hands and feet, toxic shock of infection and pheochromocytoma. It is also used for hepatitis B, which has a dilating effect on liver blood vessels and improves blood circulation. Usage: The treatment of vasospasm is intramuscular or intravenous injection. For anti-shock, use the drip method. Diagnosis of pheochromocytoma, intravenous injection of 5mg, blood pressure measurement every 30 seconds after injection, can be continuously measured for 10 minutes, if the blood pressure decreased by 4.67 / 3.33kPa (35 / 25mmHg) more than 2 to 4 minutes, a positive result . Adverse reactions were orthostatic hypotension, nasal congestion, itching, nausea, and vomiting. Hypotension, arteriosclerosis, organic damage to the heart, and impaired renal function are contraindicated.

Peripheral vasodilator

It can dilate peripheral blood vessels, lower blood pressure, slow heart rate, and has a central sedative effect. For arterial endometritis, acral arterial spasm, vasospasm migraine and so on. Usage: intramuscular or subcutaneous injection, or sublingual administration. Adverse reactions are orthostatic hypotension, which is contraindicated in patients with hypotension, arteriosclerosis, cardiac organic damage, renal dysfunction, and the elderly. ^[2]

Prazosin

It is a selective post-synaptic 1-receptor blocker that dilates arteries and veins, reduces peripheral vascular resistance and blood pressure, and can reduce pre- and post-loads and improve cardiac function. It can be used to treat congestive heart failure and post-myocardial infarction Exhaustion. It does not affect 2-receptors, does not cause significant reflex tachycardia, and does not increase renin secretion. The route of administration is oral, and the adverse reaction is that the first dose can cause the "first dose phenomenon". After taking the medicine for 30 to 90 minutes, there will be a significant decrease in blood pressure in the standing position, fainting, weakness, and palpitations. The first dose should be taken just before bedtime and started with a small dose. Adverse reactions were mild, including headache, fatigue, nausea, edema, difficulty urinating, stuffy nose, constipation, and allergic rash.

Angiotensin-converting enzyme inhibitor

The following are commonly used:

Peripheral vasodilator meproprolide (captopril)

An effective angiotensin-converting enzyme inhibitor, which competes with AG (angiotensin I) or bradykinin to bind to AG-converting enzyme, thereby inhibiting its normal function and preventing inactive AGI from being converted into active AG Reduced aldosterone secretion and vasopressin secretion. At the same time, the hydrolysis of bradykinin was hindered, and the concentration of bradykinin in blood increased, followed by the increase of PGE2 and PGI2 formation. The overall effect leads to vasodilation, reduced peripheral resistance, and decreased blood pressure. At the same time, the anterior and posterior loads of the heart are reduced, so it can be used for refractory chronic heart failure. Take it 1 hour before meals to lower blood pressure. Adverse reactions were rash, pruritus, taste disorders, dizziness, headache, hypotension, and gastrointestinal disorders. Few have proteinuria, agranulocytosis, and impaired renal function. ^[2]

() Peripheral vasodilator Butyl proline (Enalapril)

Inhibition of angiotensin-converting enzyme in the body is 8.5 times stronger than meproprolic acid, and it is well absorbed orally. It is metabolized in the body to remove the ethyl group to produce a dicarboxylic acid metabolite, and then plays a role. Its indications are the same as those of meproproline. Because it does not contain thiol groups, it rarely causes meprocapillate-like reactions, and rashes and taste disorders are mild. ^[5]