ACEBUTOLOL MERCK 200 Mg

ACEBUTOLOL MERCK 200 Mg

ACÉBUTOLOL MERCK 200 Mg Acébutolol in sectile tablets of 200 Mg Action
Beat-blocking.
In are a general way, the beat-blockings used to decrease the blood pressure, to reduce the disorders of the cardiac rhythm, to slow down C? ur and thus to make economies on its operation. For all these reasons, they are also used in the coronary insufficiency.
The beat-blocking is a substance which has the capacity to be fixed on receivers that one calls beta-receptors or receivers adrenergic (see hereafter).
The beat-blockings can have side effects on the pulmonary tree, like the bronchoconstriction (asthma). They are thus contra-indicated at the asthmatic one. There exists an interaction between the beat-blockings, the system sympathetic nerve and thus the regulation of the glycemia (which is disturbed, succeed with hypoglycemias). Does this molecule tend to becoming increasingly cardiosélective (exclusive action on beta, receivers prevailing in C? ur).
One also distinguishes the beat-blockings by their intrinsic sympathicomimetic activity (ASI) or not. The presence of an intrinsic sympathicomimetic activity is at the origin of a less bradycardia lower at rest, of less bronchoconstricteurs effects or vasoconstricteurs and of less metabolic disturbances. This variety of beat-blockings is ineffective to treat the migraines.
Among is the beat-blockings, Acébutolol an inhibiter entering in competition with catecholamines on the level of the receivers beta adrenergic and particularly those of C? ur, of the vessels and the lungs.
Acébutolol belongs to the beat-blockings cardiosélectifs which must theoretically have an action on the receivers beta 1 cardiac. It has in addition a light intrinsic activity sympathicomimetic likely to reduce the importance of the bradycardia.
Acébutolol also has, like the whole of the beat-blockings, an effect antiarythmic, a antiangoreux effect and a antihypertensor effect.

Indications
· Angor
· Tachyarythmy

The injectable form is used in urgency, under electrocardiographic monitoring, to treat various types of tachycardia and particularly jonctionnelle tachycardia, flutter, auricular fibrillation like certain cases of ventricular extrasystoles.

Counter-indications
· Angor de Prinzmetal pure
· Asthma
· Auriculo-ventricular block of high degree not installed
· Important bradycardia (cardiac rhythm lower than 40 beats per minute)
· Pregnancy and breast feeding (of the beat-blockings can be prescribed if necessary after medical consensus). There does not exist, seems there, of known teratogenic effect. To supervise nevertheless the newborn the first five days: glycemia, frequency and respiratory state like heart rate
· Orthostatic arterial hypotension
· Not compensated cardiac failure
· Disease of the sine including sino-auricular block
· Phéochromocytome untreated
· Syndrome of Raynaud and arterial disorders peripheral in their severe forms

Undesirable effects
· Asthenia at the beginning of the treatment
· Asthma
· Auriculo-ventricular block
· Severe bradycardia
· Nightmares and insomnia
· Dermatoses
· Diarrheas
· Gastralgies
· Hypoglycemia
· Arterial hypotension
· Orthostatic hypotension
· Cardiac failure
· Nauseas
· Paraesthesia of the ends
· Syndrome of Raynaud
· Vomiting
The acute intoxication is responsible for a fall of the blood pressure and a deceleration of the heart rate and electric conduction between the auricle and the ventricle.

Posology
· Angor and tachyarythmy: 400 to 800 Mg per day in three catches per day preferably.
· Infarction: 200 Mg the morning and the evening to be begun as from the third day.
· Arterial hypertension: 400 Mg per day in a catch the morning or 200 Mg morning and evening

Use and precautions for use
Never not to stop the treatment, particularly when there exists an angina pectoris, because there exists a risk of myocardial infarction, serious disorders of the rate/rhythm and sudden death.
Posology must be reduced in the event of impaired renal function.
The monitoring of the treatment must seek occurred of signs of cardiac failure, especially when there are antecedents of this type, and particularly in the elderly
At the subject diabetic: the signs announcing a hypoglycemia, like palpitations and sweats, can be masked. It is preferable to use a cardiosélectif beat-blocking and to reinforce controls glycemic at the beginning of the treatment.
The use of the beat-blockings must be done with prudence when there exists a auriculo-ventricular block of the first degree.
Precaution also in the event of phéochromocytome: to always associate alpha blocking to avoid a hypertensive crisis.
Precautions in the presence of an obstructive chronic bronchopathy and in the event of antecedents of bronchospasme
The patients suffering from a syndrome of Raynaud will have to take beat-blockings only after medical consensus.
Molecule to be used with prudence when there exist antecedents of shock anaphylactic.
In the presence of an impaired renal function or hepatic, it is preferable to privilege a beat-blocking which is not eliminated by the insufficient body, or to reduce posology.
In the event of general anesthesia, it is recommended to stop the treatment 48 hours before or to envisage a premedication of atropine so necessary.

Medicamentous interactions
· Amiodarone
· Anesthetic volatile halogens
· Antiacids
· Tricyclic antidepressants
· Antidiabétiques
· Anti-inflammatory drugs not stéroïdiens
· Bépridil
· Cimétidine
· Corticoids
· Diltiazem
· Disopyramide
· Floctafénine
· Lidocaïne
· Liorésat
· Méfloquine
· Nerve sedatives
· Nifedipine
· Iodized products of contrast
· Quinidiniques
· Sultopride
· Tacrine (risk of excessive bradycardia)
· Vérapamil