ABSTRACT
Contemporary data on mechanisms of development, types, and clinical picture of hypertensive crisis (HC) are presented. Algorithms of rational therapy of uncomplicated and complicated HC are considered. Appropriateness of the use in HC of antihypertensive drugs with multifactorial action is stressed. These drugs include urapidil - an antihypertensive agent with complex mechanism of action. Blocking mainly the postsynaptic 1-adrenoreceptors urapidil attenuates vasoconstrictor effect of catecholamines and decreases total peripheral resistance. Stimulation of 5HT1-receptors of medullary vasculomotor center promotes lowering of elevated vascular tone and prevents development of reflex tachycardia.
Subject(s)
Antihypertensive Agents , Aortic Aneurysm , Aortic Dissection , Heart Failure , Hypertension, Malignant , Hypertensive Encephalopathy , Algorithms , Aortic Dissection/etiology , Aortic Dissection/prevention & control , Antihypertensive Agents/classification , Antihypertensive Agents/pharmacology , Antihypertensive Agents/therapeutic use , Blood Pressure/drug effects , Disease Management , Emergencies , Emergency Treatment/methods , Heart Failure/etiology , Heart Failure/prevention & control , Humans , Hypertension, Malignant/complications , Hypertension, Malignant/diagnosis , Hypertension, Malignant/etiology , Hypertension, Malignant/physiopathology , Hypertension, Malignant/therapy , Hypertensive Encephalopathy/etiology , Hypertensive Encephalopathy/prevention & control , Piperazines/pharmacology , Piperazines/therapeutic useABSTRACT
Chronic obstructive pulmonary disease (COPD) is a systemic disease that affects not only the respiratory system. Sex hormones deficiency in men can be correlated with the COPD stages and make a negative contribution during its progression. Up to date, there are no long-term trials evaluating the effects of androgens on the parameters of respiratory function in patients with COPD. Changes of testosterone levels in patients with COPD correlate with forced expiratory volume, and hypoxemia and hypercapnia levels. Glucocorticosteroids exacerbate androgen deficiency in patients with COPD, and the use of hormone replacement therapy with testosterone in these patients is justified. Androgens, in particular drug nebido, testosterone depot, can be effectively used in treatment and rehabilitation of patients with COPD.
