Perindopril arginine, Indapamide
Indications
Perindopril arginine, Indapamide is used for:
PERINDOPRIL
For the treatment of mild to moderate essential hypertension, mild to moderate congestive heart failure, and to reduce the cardiovascular risk of individuals with hypertension or post-myocardial infarction and stable coronary disease
INDAPAMIDE
For the treatment of hypertension, alone or in combination with other antihypertensive drugs, as well as for the treatment of salt and fluid retention associated with congestive heart failure or edema from pregnancy (appropriate only in the management of edema of pathologic origin during pregnancy when clearly needed). Also used for the management of edema as a result of various causes
For the treatment of mild to moderate essential hypertension, mild to moderate congestive heart failure, and to reduce the cardiovascular risk of individuals with hypertension or post-myocardial infarction and stable coronary disease
INDAPAMIDE
For the treatment of hypertension, alone or in combination with other antihypertensive drugs, as well as for the treatment of salt and fluid retention associated with congestive heart failure or edema from pregnancy (appropriate only in the management of edema of pathologic origin during pregnancy when clearly needed). Also used for the management of edema as a result of various causes
Adult Dose
Child Dose
Renal Dose
Administration
Contra Indications
Precautions
Pregnancy-Lactation
Interactions
Adverse Effects
Side effects of Perindopril arginine, Indapamide :
Mechanism of Action
PERINDOPRIL
There are two isoforms of ace: the somatic isoform, which exists as a glycoprotein comprised of a single polypeptide chain of 1277; and the testicular isoform, which has a lower molecular mass and is thought to play a role in sperm maturation and binding of sperm to the oviduct epithelium. Somatic ace has two functionally active domains, n and c, which arise from tandem gene duplication. Although the two domains have high sequence similarity, they play distinct physiological roles. The c-domain is predominantly involved in blood pressure regulation while the n-domain plays a role in hematopoietic stem cell differentiation and proliferation. Ace inhibitors bind to and inhibit the activity of both domains, but have much greater affinity for and inhibitory activity against the c-domain. Perindoprilat, the active metabolite of perindopril, competes with ati for binding to ace and inhibits and enzymatic proteolysis of ati to atii. Decreasing atii levels in the body decreases blood pressure by inhibiting the pressor effects of atii as described in the pharmacology section above. Perindopril also causes an increase in plasma renin activity likely due to a loss of feedback inhibition mediated by atii on the release of renin and/or stimulation of reflex mechanisms via baroreceptors
INDAPAMIDE
Indapamide blocks the slow component of delayed rectifier potassium current (iks) without altering the rapid component (ikr) or the inward rectifier current. Specifically it blocks or antagonizes the action the proteins kcnq1 and kcne1. Indapamide is also thought to stimulate the synthesis of the vasodilatory hypotensive prostaglandin pge2
There are two isoforms of ace: the somatic isoform, which exists as a glycoprotein comprised of a single polypeptide chain of 1277; and the testicular isoform, which has a lower molecular mass and is thought to play a role in sperm maturation and binding of sperm to the oviduct epithelium. Somatic ace has two functionally active domains, n and c, which arise from tandem gene duplication. Although the two domains have high sequence similarity, they play distinct physiological roles. The c-domain is predominantly involved in blood pressure regulation while the n-domain plays a role in hematopoietic stem cell differentiation and proliferation. Ace inhibitors bind to and inhibit the activity of both domains, but have much greater affinity for and inhibitory activity against the c-domain. Perindoprilat, the active metabolite of perindopril, competes with ati for binding to ace and inhibits and enzymatic proteolysis of ati to atii. Decreasing atii levels in the body decreases blood pressure by inhibiting the pressor effects of atii as described in the pharmacology section above. Perindopril also causes an increase in plasma renin activity likely due to a loss of feedback inhibition mediated by atii on the release of renin and/or stimulation of reflex mechanisms via baroreceptors
INDAPAMIDE
Indapamide blocks the slow component of delayed rectifier potassium current (iks) without altering the rapid component (ikr) or the inward rectifier current. Specifically it blocks or antagonizes the action the proteins kcnq1 and kcne1. Indapamide is also thought to stimulate the synthesis of the vasodilatory hypotensive prostaglandin pge2