Method for treating arrhythmic syndrome in case of progressing stenocardia

FIELD: medicine, cardiology.

SUBSTANCE: the present innovation deals with introducing nitrates, heparin, beta-blocking agents, calcium antagonists, aspirin. Additionally, one should intravenously inject dalargin once daily at the rate of about 5-7 mcg/kg/h at the dosage of 25-30 mcg/kg daily per 100 ml sodium chloride physiological solution for about 5-6 d against the onset of hospitalization period. The innovation provides favorable impact upon diastolic function of left ventricle by decreasing the risk of dangerous arrhythmias and coronary lethality.

EFFECT: higher efficiency of therapy.

2 ex

 

The invention relates to medicine, particularly cardiology, and is a method for the treatment of arrhythmic syndrome with progressive angina.

There is a method of treatment of arrhythmic syndrome with progressive angina (Sveli. Beta-blockers in the treatment of acute coronary syndromes (or do I need to prove proven?). - CONSILIUM medicum, 2001, vol. 3, No. 10, s-472), including application β-blockers. β-blockers limit the damaging effect of stress implements (gipotalyamo-pituitary-adrenal system by the blockade of peripheral β-adrenergic receptors, have antiarrhythmic and antiischemic action.

The disadvantages of this method are: insufficient antiarrhythmic and cardioprotective effects on the myocardium, resulting from incomplete elimination β-blockers damaging action of catecholamines on the myocardium, we β-blockers no ability to reduce elevated levels of intracellular calcium during ischemia and thereby reduce the risk of calcium-dependent arrhythmias. β-blockers do not have a pronounced stabilizing effect on the myocardium by reducing the dispersion of QT intervals and JT markers occurrence of ischemic arrhythmias. β-blockers does not possess the ability to activate the stress-limiting system that is not is required to prevent the damaging effects of the stress response of the body to attack and achieve the required level of cardioprotective.

There is a method of treatment of progressive angina (acute coronary syndromes without ST elevation. Russian recommendations. Developed by the Committee of experts of the all-Russian scientific society of cardiologists. CONSILIUM MEDICUM. Annex 2001, p.9-10), including the use of nitrates, heparin, β-blockers, calcium antagonists in the presence of contraindications to β-blockers, or in addition to β-blockers and aspirin.

The disadvantages of this method, taken as a prototype, are insufficient cardioprotective effect, absence of the stabilizing action of drugs on the heart by reducing the dispersion of QT intervals and JT markers occurrence of ischemic life-threatening and fatal arrhythmias. We β-blockers no ability to reduce elevated levels of intracellular calcium during ischemia and thereby reduce the risk of calcium-dependent arrhythmias, and calcium antagonists reduce the level of intracellular calcium, only blocking slow calcium channels. None of the components of treatment does not possess the ability to activate the stress-limiting system that is necessary to prevent the damaging effects of the stress response of the body to attack and achieve the required level of cardioprotective. None of the components of treatment has no analgesic and and tioxidants effect.

Object of the invention is the prevention and treatment of arrhythmic syndrome, including life-threatening arrhythmias and sudden arrhythmic death in progressive angina.

This task is solved by the fact that according to the method for the treatment of arrhythmic syndrome with progressive angina, including nitrates, heparin, β-blockers, calcium antagonists and aspirin; additionally, five to six days from the beginning of hospitalization injected dalargin once a day with a speed of 5-7 g/kg/hour dose of 25-30 mg/kg per day in 100 ml of physiological sodium chloride solution.

The use of the claimed invention will result in a more pronounced cardioprotective effect in progressive angina, which lies in the interaction of dalargin with opioid receptors and activation of stress-limiting mechanism and to reduce the damaging action of catecholamines on the myocardium, which leads to a reduction in the need of oxygen. The claimed method has antinociceptive effect, limits the emotional-pain stress and also reduces the activation gipotalyamo-pituitary-adrenal system. Dalargin has a strong antioxidant multi-component action that is additional protection of myocardial cells from which samii, stabilizes and prevents the destruction of cell membranes, resulting in reduced revenues calcium not only through damaged cell membranes from the outside, but from sarcoplasmatic reticulum of the cell. For the first time revealed that this property of dalargin when used in the adjuvant therapy contributes to the stabilization processes of depolarization, decrease electrical heterogeneity of the myocardium, which is a reduction of the interval QT and JT and their variances, which are predictors of the development of a number of serious rhythm disorders, including sudden death, i.e. it is actually anti-arrhythmic action. For the first time revealed that the claimed method has a positive effect on diastolic left ventricular function, reduces the risk of life-threatening arrhythmias and coronary mortality compared with treatment taken as a prototype. It should be noted pharmacoeconomic value of the drug due to its small market value.

Thus, the use of the claimed invention allows to achieve a higher level of predotvrashyayet occurrence of arrhythmic syndrome and coronary mortality in progressive angina compared with treatment taken as a prototype.

The method is implemented as follows: a patient with progressive angina in the first five or six days hospital the organization, in addition to therapy with nitrates, heparin, calcium antagonists, β-blockers and aspirin, is injected dalargin once a day with a speed of 5-7 g/kg/hour, with a daily dose of 25-30 mg/kg per day in 100 ml of physiological sodium chloride solution.

Example 1. Patient A. 56 years. The diagnosis of CHD. Progressive angina (2 days) at discharge: stable angina FC (CL). The cardiac rhythm disorders by type of single ventricular arrythmia (ECG). Arterial hypertension Art. III, risk 4. HSN IIa, FK. ECG at admission single ventricular premature beats, increasing the dispersion of QT intervals and JT. After treatment, including the use of nitrates, heparin, β-blockers, aspirin, intravenous injection of dalargin once a day at 7 g/kg/hour, with a daily dose of 25 mg/kg per day for 5 days, issued with improvement: the intensity and frequency of anginal pain decreased, dyspnea on exertion, decreased, interruptions in heart work there. ECG arrythmia no, dispersion of QT intervals and JT is normalized.

Example 2. Patient Century 50 years. Diagnosis: Progressive angina (acute coronary syndrome) with transient ischemia in septal-apical region of the left ventricle at discharge: stable angina FKZ (CL). Frequent single nadgauda the new and ventricular premature beats on the type bigeminy (ECG). Postinfarction cardiosclerosis. Arterial hypertension Art. III, risk 4 HSN IIa, FC, discharge HSN I FC. Admission: recurrent pain in the chest, shortness of breath, weakness, sweating, severe disruption of the heart. Heart sounds arrhythmic (frequent single extrasystole type bigeminy 10 minutes On ECG at admission acute subendocardialnah ischemia in septal-apical region of the left ventricle, the cardiac rhythm disorders by type of frequent single supraventricular and ventricular arrythmia type bigeminy, increasing the dispersion of QT intervals and JT. After treatment, including the use of nitrates, heparin, use β-blockers, aspirin, intravenous injection of dalargin once a day at 5 mcg/kg/hour, with a daily dose of 25 mg/kg per day, is discharged with improvement: the intensity and frequency of anginal pain decreased, arrythmia no. ECG after 4 days of infusion disappeared acute subendocardialnah ischemia in septal-apical region of the left ventricle and arrythmia, decreased dispersion of QT intervals and JT to the norm, normalized diastolic function of the left ventricle.

A method for the treatment of arrhythmic syndrome with progressive angina, including nitrates, heparin, β-blockers, calcium antagonists and aspirin characterized in that it further within five to six days from the beginning of hospitalization injected dalargin once a day with a speed of 5-7 mg/kg/h at a dose of 25-30 mg/kg per day in 100 ml of physiological sodium chloride solution.



 

Same patents:

FIELD: medicine, cardiology.

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1 ex, 1 tbl

FIELD: organic chemistry, medicine, pharmacy.

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9 cl, 5 sch, 36 tbl, 70 ex

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40 cl, 51 tbl, 741 ex

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14 cl, 5 dwg, 2 tbl, 7 ex

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4 cl, 4 ex

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2 ex

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3 cl, 1 tbl, 1 ex

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1 tbl, 1 ex

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EFFECT: valuable medicinal properties of compounds.

21 cl, 2 sch, 4 tbl, 183 ex

FIELD: medicine, cardiology.

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EFFECT: higher efficiency of therapy.

3 ex

FIELD: pharmaceutical chemistry, medicine.

SUBSTANCE: invention relates to new compounds of formula I ,

solvates or pharmaceutically acceptable salts having antiarrhythmic activity, including ventrical fibrillation, as well as pharmaceutical compositions containing the same. Compounds of present invention are useful in treatment or prevention of arrhythmia, modulation of ion channel activity, for topic or local anesthesia, etc. In formula I X is direct bond, -C(R6,R14)-Y- and C(R13)=CH-; Y is direct bond, O, S, and C1-C4-alkylene; R13 is hydrogen, C1-C6-alkyl, C3-C8-cycloalkyl, unsubstituted aryl or benzyl; R1 and R2 are independently C3-C8-alkoxyalkyl, C1-C8-hydroxyalkyl and C7-C12-aralkyl; or R1 and R2 together with nitrogen atom directly attached thereto form ring of formula II ,

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EFFECT: new antiarrhythmic drugs.

30 cl, 12 dwg, 34 ex

FIELD: organic chemistry, pharmacology.

SUBSTANCE: invention relates to compounds of formula I ,

where R(1), R(2), R(3), R(4), R(5), R(6), R(7), R(8), R(30), and R(31) are disclosed in claims. Compound of present invention are particularly useful as new antiarrythmia bioactive substances, in particular for treatment and prophylaxis of atrial arrhythmia (e.g., atrial fibrillation or auricular flutter).

EFFECT: higher efficiency.

13 cl, 18 ex, 1 tbl

FIELD: organic chemistry, heterocyclic compounds, purines, medicine.

SUBSTANCE: invention relates to a method for treatment of arrhythmia in mammal. Method involves administration of agonist of adenosine A1-receptors in the therapeutically effective minimal dose of the formula:

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EFFECT: improved treatment method, valuable medicinal properties of substances.

11 cl, 1 dwg, 2 ex

FIELD: organic chemistry, chemical technology, medicine.

SUBSTANCE: invention relates to synthesis of new biologically active substance, namely, to γ-hydroxypropylammonium-5-hydroxynicotinate of the formula (I): , eliciting an anti-ischemic, anti-arrhythmic and hypolipidemic activity. This compound shows low toxicity and absence of cardiodepressive effect. Compound of the formula (I) is prepared by interaction of 5-hydroxynicotinic acid with 3-amino-1-propanol in the presence of a solvent at heating.

EFFECT: valuable medicinal properties of compound.

1 cl, 7 tbl, 3 ex

FIELD: medicinal pharmacology.

SUBSTANCE: the present innovation deals with minor peptides which could be characterized with the following formula: X-A-B-C-Y-NH2, where X - α-aminoisobutiryl, tranexamyl (i.e.4-(aminomethyl)cyclo-hexane carbonyl), isonipecotinyl, γ-aminobutiryl, hydrogen or imidazolylacetyl, A - D-2-methyltryptophan, D-β-(2-naphthyl)alanine or D-tryptophan, B - D-2-methyltryptophan, D-β-(2-naphthyl)alanine, D-tryptophan or is absent, C - D-2-methyltryptophan, phenylalanine or is absent, Y - lysine or arginine, where D means dextroisomer, or pharmaceutically acceptable salt of peptide that induces penile erection. Also, pharmaceutical composition is suggested that contains these peptides, and methods for treating erectile dysfunctions.

EFFECT: higher efficiency.

12 cl, 7 ex

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