Buy trenbolone enanthate inhibitor. Inhibition of results in a reduction of angiotensin II in the blood plasma, and resulting in reduced secretion of aldosterone.
Perindopril acts through its active metabolite, perindoprilat. Eliminates the vasoconstrictor action of angiotensin II of, increases the concentration of bradykinin and vasodilatory prostaglandins (converts the inactive angiotensin I to angiotensin II, providing vasoconstriction, as well as causing the degradation of bradykinin and prostaglandin having vasodilating activity); reduces production and release of aldosterone, inhibits the release of noradrenaline from the nerve endings of the sympathetic fibers and the formation of endothelin in the vascular wall. Reducing the formation of angiotensin II is accompanied by increased activity of plasma renin activity (due to inhibition of the negative feedback).
Inhibition accompanied by increased activity of both circulating and tissue kallikrein-kinin system, it also activates prostaglandin system. Helps restore elasticity of large arteries (reduction in the formation of excessive amounts of subendothelial collagen), reduces the pressure in the pulmonary capillaries, with long-term administration reduces the severity hypertrophy left ventricular myocardium and interstitial fibrosis, normalizes the isoenzyme profile of myosin; It normalizes the functioning of the heart. Lowers preload and afterload (reduces systolic and diastolic blood pressure
. Increases concentration of HDL (high density lipoprotein), in patients with hyperuricemia reduces the concentration of uric acid. increases renal blood flow, does not change the glomerular filtration rate. in patients with heart failure causes a significant reduction in the severity of clinical signs of heart failure, increases exercise tolerance (according to bicycle stress test), did not significantly reduce blood pressure. After ingestion the mean single dose maximum antihypertensive effect is achieved within 4-6 hours and lasts for 24 hours. The stabilization of the hypotensive effect is observed after 1 month of therapy and maintained for a long time. Discontinuation of treatment is not accompanied by the development of the syndrome of “cancellation”.
Absorption – 25%, bioavailability – 65-70%. . The time to reach maximum plasma concentration – 1 hour, perindoprilat – 03.04 h
in the metabolism of 20% of the active metabolite is transformed -perindoprilat (reception buy trenbolone enanthate perindopril after meals reduces the proportion perindoprilat formed – has substantial clinical significance in); remainder – 5 inactive compounds. T? (Half-life) of perindopril -1 h Communication perindoprilat to plasma proteins -. Insignificant with ACE – less than 30% (depending on concentration). The volume of distribution of free perindoprilat 0.2 l / kg. Perindoprilat excreted by the kidneys, T? Free fraction metabolite -. 3-5 hours Dissociation of perindoprilat bound to ACE, slow. Because of this “efficient” T? Is 25 hours. Reappointment of perindopril does not lead to its accumulation, and T? Perindoprilat Repeated dose corresponds to the period of its activity.
Excretion of perindoprilat is slowed in elderly patients and in patients with chronic heart failure and chronic renal failure (chronic renal failure) (the latter dose adjustment should be based on creatinine clearance). Perindopril dialysis clearance is 70 ml / min.
In patients with hepatic clearance perindopril cirrhosis is reduced by 2 times, while the total number remains unchanged formed perindoprilat and correct dosing regimen buy trenbolone enanthate is not required.