Verapamil HCl, Trandolapril,
Indications
Verapamil HCl, Trandolapril, is used for:
VERAPAMIL
For the treatment of hypertension, angina, and cluster headache prophylaxis
TRANDOLAPRIL
For the treatment of mild to moderate hypertension, as an adjunct in the treatment of congestive heart failure (chf), to improve survival following myocardial infarction (mi) in individuals who are hemodynamically stable and demonstrate symptoms of left ventricular systolic dysfunction or signs of chf within a few days following acute mi, and to slow progression of renal disease in hypertensive patients with diabetes mellitus and microalbuminuria or overt nephropathy
For the treatment of hypertension, angina, and cluster headache prophylaxis
TRANDOLAPRIL
For the treatment of mild to moderate hypertension, as an adjunct in the treatment of congestive heart failure (chf), to improve survival following myocardial infarction (mi) in individuals who are hemodynamically stable and demonstrate symptoms of left ventricular systolic dysfunction or signs of chf within a few days following acute mi, and to slow progression of renal disease in hypertensive patients with diabetes mellitus and microalbuminuria or overt nephropathy
Adult Dose
Child Dose
Renal Dose
Administration
Contra Indications
Precautions
Pregnancy-Lactation
Interactions
Adverse Effects
Side effects of Verapamil HCl, Trandolapril, :
Mechanism of Action
VERAPAMIL
Verapamil inhibits voltage-dependent calcium channels. Specifically, its effect on l-type calcium channels in the heart causes a reduction in ionotropy and chronotropy, thuis reducing heart rate and blood pressure. Verapamil's mechanism of effect in cluster headache is thought to be linked to its calcium-channel blocker effect, but which channel subtypes are involved is presently not known
TRANDOLAPRIL
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. Trandolaprilat, the active metabolite of trandolapril, 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. Trandolaprilat 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
Verapamil inhibits voltage-dependent calcium channels. Specifically, its effect on l-type calcium channels in the heart causes a reduction in ionotropy and chronotropy, thuis reducing heart rate and blood pressure. Verapamil's mechanism of effect in cluster headache is thought to be linked to its calcium-channel blocker effect, but which channel subtypes are involved is presently not known
TRANDOLAPRIL
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. Trandolaprilat, the active metabolite of trandolapril, 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. Trandolaprilat 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