How to take anaprilin for hand tremors

DlyaSerdca → Medications → Cardiovascular system → Beta-blockers → Anaprilin: indications and contraindications for use, analogues

Today it has become very fashionable to assemble a home first aid kit yourself, based on the advice of family and friends, or, in extreme cases, on the words of your aunt at the pharmacy.

But often people, suffering from some individual diseases, ignore the doctor’s advice, do not read the instructions, and buy everything at their own discretion.
Increasingly, you can find Anaprilin or its analogues in such boxes, because you can’t live without it. It’s worth figuring out what kind of medicine it is, what it’s used with and why it’s eaten.

Special signs and characteristics

How to find it among the many medicines? Like any tablet, Anaprilin can be identified by its appearance.

White pills. The shape is cylinders, but at the same time they are flattened. Along the edge of the preparation there is a chamfer, on which marks are applied along the perimeter, but they are not always there.

The drug is produced in cardboard packaging or in an orange glass jar. By weight there are 10 mg and 40 mg packages. Each package contains 5 blisters, and each blister contains 10 pills. There are 50 pieces in a jar. Anaprilin has an analogue, its name is propranolol.

Composition of the drug

In a nutshell, Anaprilin is a beta-blocker.

It is considered an antianginal agent and has a hypotensive and antiarrhythmic effect on the body.

Much stronger than its counterparts. The tablet contains:

• Propranolol is the main component of the product, its content is 40 mg.

• Minor additives include:

• Powdered sugar.

Granulated sugar.

• Potato starch.
• Talc.
• Calcium stearate.

How does all this work?

Everything is very easy and simple, despite the abstruse words in medical articles. The drug has an antianginal effect, it would seem - what can be understood here? In fact, anaprilin quickly removes all the symptoms associated with myocardial ischemia.

It works even more simply. The load on the myocardium is reduced, and blood supply to the necessary sections is improved. That is why anipriline is considered a targeted drug.

Thanks to the use of propranolol, a number of coronary vessels expand, adrenergic receptors and calcium channels are blocked, but potassium channels, on the contrary, are activated.

Due to this, venous blood flow decreases, vascular resistance and myocardial oxygen demand decreases. The pain syndrome becomes less pronounced, and the pressure in the atrium and pulmonary artery quickly decreases, and the person feels relief.

The antiarrhythmic effect is created due to the fact that the components of anaprilin act on certain areas of the heart; its use leads to a blockade of the ability of certain channels to conduct electrical impulses. Due to this, the flow of unnecessary impulses stops and arrhythmia decreases.

The hypotensive effect is achieved through a rapid decrease in blood pressure. Medicines with this effect are prescribed to patients to prevent complications, such as myocardial infarction, heart or kidney failure, and tachycardia. Hypotension levels return to normal within 2 weeks with a course of treatment.

Propranolol blocks β2 adrenergic receptors, resulting in a clear reduction in visible tremor.

There is an increase in the atherogenic properties of blood. Promotes increased contraction of the uterus. The tone of the bronchi increases. As the dose increases, it may begin to have a sedative effect.

Price policy

Surprisingly, the price of anaprilin is pleasing.

There are a minimum of 10 tablets in a package, due to which the price can be 20 rubles.

But deciding on the top price is much more difficult. It all depends on the amount of the drug in the package, on the manufacturer, and of course, what kind of markup the pharmacy itself will make. But analogues will cost a little more.

Anaprilin

When used simultaneously with hypoglycemic agents, there is a risk of developing hypoglycemia due to the increased effect of hypoglycemic agents.

When used simultaneously with MAO inhibitors, there is a possibility of developing undesirable manifestations of drug interactions.

Cases of the development of severe bradycardia have been described when using propranolol for arrhythmia caused by digitalis drugs.

When used simultaneously with drugs for inhalation anesthesia, the risk of suppression of myocardial function and the development of arterial hypotension increases.

When used simultaneously with amiodarone, arterial hypotension, bradycardia, ventricular fibrillation, and asystole are possible.

When used simultaneously with verapamil, arterial hypotension, bradycardia, and dyspnea are possible. Cmax in the blood plasma increases, AUC increases, and the clearance of propranolol decreases due to inhibition of its metabolism in the liver under the influence of verapamil.

Propranolol does not affect the pharmacokinetics of verapamil.

A case of severe arterial hypotension and cardiac arrest has been described when used simultaneously with haloperidol.

When used simultaneously with hydralazine, the Cmax in the blood plasma and the AUC of propranolol increase. It is believed that hydralazine may reduce hepatic blood flow or inhibit the activity of liver enzymes, resulting in a slower metabolism of propranolol.

When used simultaneously, propranolol can inhibit the effects of glibenclamide, glyburide, chlorpropamide, tolbutamide, because Non-selective beta2-blockers are able to block pancreatic beta2-adrenergic receptors associated with insulin secretion.

The release of insulin from the pancreas due to the action of sulfonylurea derivatives is inhibited by beta-blockers, which to some extent prevents the development of the hypoglycemic effect.

When used simultaneously with diltiazem, the concentration of propranolol in the blood plasma increases due to inhibition of its metabolism under the influence of diltiazem. An additive depressant effect on cardiac function is observed due to the slowing of impulse conduction through the AV node caused by diltiazem. There is a risk of developing severe bradycardia, stroke and minute volume are significantly reduced.

With simultaneous use, cases of increased concentrations of warfarin and phenindione in the blood plasma have been described.

When used concomitantly with doxorubicin, experimental studies have shown increased cardiotoxicity.

When used simultaneously, propranolol prevents the development of the bronchodilator effect of isoprenaline, salbutamol, and terbutaline.

With simultaneous use, cases of increased concentrations of imipramine in the blood plasma have been described.

When used simultaneously with indomethacin, naproxen, piroxicam, acetylsalicylic acid, the antihypertensive effect of propranolol may be reduced.

When used simultaneously with ketanserin, an additive hypotensive effect may develop.

When used simultaneously with clonidine, the antihypertensive effect is enhanced.

In patients receiving propranolol, severe arterial hypertension may develop if clonidine is abruptly discontinued. It is believed that this is due to an increase in the content of catecholamines in the circulating blood and an increase in their vasoconstrictor effect.

When used simultaneously with caffeine, the effectiveness of propranolol may be reduced.

With simultaneous use, it is possible to enhance the effects of lidocaine and bupivacaine (including toxic ones), apparently due to a slowdown in the metabolism of local anesthetics in the liver.

When used simultaneously with lithium carbonate, a case of bradycardia has been described.

With simultaneous use, a case of increased side effects of maprotiline has been described, which is apparently due to a slowdown in its metabolism in the liver and accumulation in the body.

When used simultaneously with mefloquine, the QT interval increases, and a case of cardiac arrest has been described; with morphine - the inhibitory effect on the central nervous system caused by morphine is enhanced; with sodium amidotrizoate - cases of severe arterial hypotension have been described.

When used simultaneously with nisoldipine, an increase in the Cmax and AUC of propranolol and nisoldipine in the blood plasma is possible, which leads to severe arterial hypotension. There is a report of increased beta-blocking action.

Cases of increased Cmax and AUC of propranolol, arterial hypotension and a decrease in heart rate have been described when used simultaneously with nicardipine.

When used simultaneously with nifedipine in patients with coronary artery disease, severe arterial hypotension may develop, increasing the risk of heart failure and myocardial infarction, which may be due to an increase in the negative inotropic effect of nifedipine.

Patients receiving propranolol are at risk of developing severe hypotension after taking the first dose of prazosin.

When used simultaneously with prenylamine, the QT interval increases.

When used simultaneously with propafenone, the concentration of propranolol in the blood plasma increases and a toxic effect develops. Propafenone is believed to inhibit the hepatic metabolism of propranolol, reducing its clearance and increasing serum concentrations.

With the simultaneous use of reserpine and other antihypertensive drugs, the risk of developing arterial hypotension and bradycardia increases.

With simultaneous use, the Cmax and AUC of rizatriptan increases; with rifampicin - the concentration of propranolol in the blood plasma decreases; with suxamethonium chloride, tubocurarine chloride - the effect of muscle relaxants may change.

With simultaneous use, the clearance of theophylline decreases due to a slowdown in its metabolism in the liver. There is a risk of developing bronchospasm in patients with bronchial asthma or COPD. Beta blockers may block the inotropic effect of theophylline.

When used simultaneously with phenindione, cases of a slight increase in bleeding without changes in blood clotting parameters have been described.

When used concomitantly with flecainide, additive cardiodepressive effects are possible.

Fluoxetine inhibits the CYP2D6 isoenzyme, which leads to inhibition of the metabolism of propranolol and its accumulation and may enhance the cardiodepressive effect (including bradycardia). Fluoxetine and, mainly, its metabolites are characterized by a long T1/2, so the likelihood of drug interactions remains even several days after discontinuation of fluoxetine.

Quinidine inhibits the CYP2D6 isoenzyme, which leads to inhibition of the metabolism of propranolol, while its clearance decreases. Increased beta-blocking action and orthostatic hypotension are possible.

With simultaneous use in the blood plasma, the concentrations of propranolol, chlorpromazine, and thioridazine increase. A sharp decrease in blood pressure is possible.

Cimetidine inhibits the activity of microsomal liver enzymes (including the CYP2D6 isoenzyme), this leads to inhibition of the metabolism of propranolol and its cumulation: an increase in negative inotropic effect and the development of a cardiodepressive effect are observed.

With simultaneous use, the hypertensive effect of epinephrine is enhanced, and there is a risk of developing severe life-threatening hypertensive reactions and bradycardia. The bronchodilator effect of sympathomimetics (epinephrine, ephedrine) decreases.

With simultaneous use, cases of decreased effectiveness of ergotamine have been described.

There are reports of changes in the hemodynamic effects of propranolol when used simultaneously with ethanol.

How to use and when?

Despite the fact that all dosages are prescribed in the instructions, it is still advisable to consult with your doctor. After all, it will be much clearer to him whether you should reduce the minimum dose, or vice versa, increase it. The doctor takes into account your condition.

It is worth noting that taking anaprilin occurs in different ways. If a course of treatment is carried out using tablets, we consider that we have 1 dose of 40 mg. The initial dose is always 1/2 pills. And taking the pill occurs regardless of the time of meal.

When treating arterial hypertension, after the first dose, increase the single dose from 1 to 2 pieces. You should take the medicine no more than 2 or 3 times a day. The maximum dose per day is 8 pieces. In particularly severe cases, as prescribed by the doctor, the dose is increased to 16 doses.

If angina pectoris is indicated or heart rhythm disturbances are present, the initial dose is also 1/2 dose 3 times a day. Then it increases and is set in the range from 2 to 4 pieces. Taken 2-3 times a day. Because of this, the maximum norm is 6 pieces.

For the prevention of headaches and essential tremor, the initial dose will be 2 pills 3 times a day. As prescribed by the doctor, the dose of the drug is increased to 4 pieces per day.

If anaprilin is administered intravenously, the solution should be administered slowly. The initial amount will be 1 mg, after which the same dose is administered again. If there is no effect, then repeated injections may be prescribed as prescribed by the doctor.

The maximum dose for jet application of drugs is 10 mg.

For what diseases is it prescribed?

The list of drug uses is very wide:

1. Ventricular extrasystole.
2. Atrial fibrillation of tachysystal form.
3. Essential tremor (in any manifestation).
4. Supraventricular extrasystole.
5. Pre-migraine.
6. Supraventricular tachycardia.
7. Alcohol withdrawal.
8. Sinus tachycardia.
9. Anxiety.
10. Pheochromocytoma (addition to treatment).
11. Thyrotoxic crisis.
12. Angina pectoris.
13. Arterial hypertension.
14. Sympathoadrenal crisis (caused by diencephalic syndrome).
15. Diffuse toxic goiter.
16. Angina pectoris is unstable.

Anaprilin: instructions for use, what it helps with, indications, price, reviews, analogues

You didn’t manage to pick up a pencil the first time, awkwardly brought a cup of coffee to your mouth, and you also didn’t succeed in sewing on a torn button—you never got the thread into the eye of the needle.

And the culprit was the treacherous shaking of the hands, scientifically speaking - a tremor that more and more often puts you in an awkward position. In order not to be an involuntary prisoner of this physical illness, it is necessary and possible to fight it. Your doctor may prescribe medications for hand tremors.

But first you need to find out the reasons for the trembling of your limbs - after all, the tactics and strategy of treatment, including medication, depend on this.

Why are your hands shaking?

There is an opinion that hand trembling syndrome is the prerogative of only frail old people and experienced alcoholics. Alas, this is just a myth.

Tremor, manifesting itself to a greater or lesser extent, currently poisons the lives of many people, regardless of their age, gender, occupation and lifestyle. Moreover, this symptom appears suddenly and can disappear just as suddenly or remain for a long time.

The phenomenon, of course, is unpleasant, but the most important thing in this situation is to find its cause, and then select remedies for hand tremors.

Among the causes of trembling limbs, doctors note:

• physical fatigue: due to prolonged hard work, the muscles become overstrained and begin to contract involuntarily;
• emotional overload: stress, strong excitement, irritation, nervous excitement;
• hormonal changes in the body: in this case, hand tremors can be observed in adolescents;
• hypothermia or overheating of the body;
• side effects from taking certain medications;
• abuse of coffee, strong tea, narcotic or toxic substances, as well as strong alcoholic beverages.

These reasons are called physiological. In this case, hand tremors go away as soon as the person rests, calms down, or gets into healthy physical shape. Medical (pathological) reasons are much more serious:

• cervical osteochondrosis;
• neuralgic pathologies, including Parkinson's disease;
• diseases of the thyroid gland, kidneys, liver;
• pathologies of the spinal cord or brain;
• problems in the functioning of the musculoskeletal system.

With these and other similar medical diagnoses, it can be difficult to cope with hand tremor, but the doctor will still be able to select a medicine for hand tremor, which will be part of complex therapy.

Overdose

Possible consequences of an overdose of Anaprilin include the following symptoms:

• dizziness;
• severe decrease in pressure;
• slow heart rate;
• heart failure;
• bronchospasms;
• cyanosis of the extremities;
• breathing disorders.

Help measures:

• gastric lavage;
• purpose of sorbents;
• infusion of plasma substitutes;
• administration of Epinephrine, Dopamine;
• taking cardiac glycosides (for impaired heart function);
• use of Atropine, Diazepam;
• use of temporary pacemakers;
• antiarrhythmics (for abnormal heart rhythm).

Treatment

The easiest way to deal with hand tremors is those caused by physiological or psychological reasons. You just need to normalize your emotional and physical state. True, it happens that there is no time for this, and you need to look decent here and now, no matter what.

First aid for tremors from emotional overstrain is light sedatives based on herbal ingredients: valerian tablets, phytosedan, persen, novo-passit, dormiplant.

They can also be taken before any event that could potentially trigger stress, thereby intercepting the tremor symptom before it occurs.

These anti-tremor sedatives are available without a prescription.

For more complex cases of tremor, drugs from other pharmaceutical groups are suitable:

• tranquilizers – block feelings of anxiety, prevent panic attacks, stabilize the functioning of the nervous system. Valium, Lorazepam, Frizium have these properties;
• inhibitors – fight nerve pathologies, enhancing the transmission of nerve impulses. These are drugs such as Pyrazidol, Phenelzine, Neptazan.
• benzodiazepines - affecting the central nervous system, they reduce anxiety, have an anticonvulsant and relaxing effect. This group of drugs includes Nitrazepam, Midazolam, Clorazepate.
• anticonvulsants – eliminate muscle spasms and inhibit processes in the central nervous system. This can include Acediprol, Hexamidine, Primidon.

Important! You cannot choose tablets for hand tremors on your own. The drug must be prescribed by a doctor, based on the symptoms of the pathology and its causes.

Folk remedies for treating hand tremors

Traditional medicine can also offer sedatives for tremors, which advises preparing infusions of sage and motherwort, rose hips and mint, St. John's wort and lavender. 2-3 tbsp. spoons of dry herb should be poured with a glass of boiling water and left for 2-3 hours. Take a third of a glass 30 minutes before meals.

Medicine for tremor can be not only in the form of tablets or infusions and decoctions. Physiotherapy, hydrotherapy, and treatment with bees and leeches provide a good therapeutic effect. The doctor decides how to reduce tremor in each specific case after diagnosis. Seeking medical help must be timely, otherwise it will be difficult to predict the outcome of treatment.

Source: golmozg.ru

Nerve sedatives

It is necessary to take a very thoughtful approach to treatment with medical sedatives for nerves. Some medications can cause tremors.

And incorrect treatment regimens (for example, Dysport or Botox) can lead to the opposite effect. To treat increased hand tremors, non-selective beta blockers (propranoline, anaprilin) ​​are used. Anaprilin is prescribed 40-320 mg per day in 3-4 doses.

Hexamidine also has a calming effect (from 62.5 to 250 mg per day). Severe intention tremor is treated with clonazepam (2 to 6 mg per day). Nadolol (Korgard) is considered especially effective.

The anti-seizure drug Primidone (Misolin) will reduce the intensity of the tremors. Carbonic anhydrase inhibitors are used (metazolamide, acetazolamide, diacarb). If medications are ineffective, patients are prescribed benzodiazepines (Xanax).

Surgical treatment (stereotactic thalamotomy) is used for tremor that is highly resistant to medications, which seriously disrupts the patient’s life (inability to eat independently, etc.). In this case, unilateral surgical intervention is performed and the symptoms of tremor are reduced.

Symptoms:

Tremor is a shaking of the limbs, head, tongue and other parts of the body. The most common are statistical and postural tremor. Benign tremor.

Tremors, whether they have no apparent cause or are benign, are perhaps the most common movement disorder. It is called family, senile or youthful.

However, this tremor is not always benign and can be very severe, and in half of the cases there is no indication of its familial nature. Occurs, as a rule, in adolescence or adolescence.

Hand swelling usually starts with one hand, then spreads to the other. Possible tremor of the head: chin, tongue, and occasionally the torso and legs. A person can write, draw, hold a cup, spoon and other objects. The tremor increases with excitement and alcohol consumption. The shaking is most pronounced when the arms are extended forward.

If the muscles of the tongue and larynx are involved in the process, speech is disrupted. The gait is not changed. Treatment for this type of tremor is not required in most cases. If the shaking is significant, your doctor may prescribe propranolol or primidone. If tremor occurs only during emotional overstrain, then they are limited to a single dose of sedative and hypnotic drugs.

For example, lorazepam 30 minutes before the tremor-provoking situation.

Postural tremor. It can also be benign in nature and be a manifestation of heredity, increased anxiety, thyroid disease, characterized by its hyperfunction.

This type of tremor is also provoked by withdrawal symptoms (withdrawal) as a result of taking alcohol or drugs (cocaine, heroin). An overdose of certain medications or poisoning with chemicals can also cause such “shaking.”

These could be drugs that dilate the bronchi, some psychotropic drugs, or poisoning with heavy metal salts (for example, mercury). Postural tremor is always small-scale and is better noticeable when a person stretches out his arms and spreads his fingers.

Does not disappear with movement, but intensifies with concentration (when the patient tries to reduce it.

Intention tremor. As you know, the cerebellum is responsible for balance when walking and when it is damaged, intention tremor is observed. It is distinguished by rough, large-scale movements that are absent at rest and appear during purposeful movements, especially at the end. The patient cannot reach his nose from a standing position with outstretched arms and closed eyes.

The greatest concern is a type of tremor called asterixis.

Its cause may be: Wilson-Konovalov disease (a severe hereditary disease characterized by the accumulation of copper in the blood, liver and brain tissue), liver, respiratory or renal failure, damage to the midbrain. The movements with it resemble the flapping of wings - this is a slow, irregular flexion and extension of the limbs.

Tremor is also a sign of Parkinson's disease.

Release form

Tablets 10 mg and 40 mg. 10, 25, 30, 50 tablets in blister packs made of polyvinyl chloride film and printed varnished aluminum foil.

10, 20, 30, 50, 60 or 100 tablets in cans made of polyethylene terephthalate for medicines, sealed with screw-on lids with first opening control or a “push-turn” system made of polypropylene or polyethylene or polypropylene cans for medicines, sealed with lids stretched with first opening control made of polyethylene or polypropylene jars for medicines, sealed with tension-controlled lids made of high-density polyethylene.

Causes:

The structures of the nervous system responsible for the occurrence of tremor are not well understood. Tremor is also common in healthy people, but its amplitude is so small that it is usually unnoticeable.

tological tremor can be static (occurs in a part of the body that is at rest), postural (tremor while maintaining a certain position) and intentional (occurs during active movement).

Static tremor is characteristic of parkinsonism, essential tremor, hepatocerebral dystrophy and mercury poisoning. Postural tremor is observed in parkinsonism, thyrotoxicosis, alcohol and lithium poisoning, as well as in anxiety or fatigue.

Intention tremor is usually a consequence of damage to the cerebellum and its connections.

pharmachologic effect

Pharmacological group - β-adrenergic receptor blockers with a non-selective effect, containing Propranolol, cardiovascular and antihypertensive drugs.

The mechanism of action is blocking adrenergic receptors, which are located in the heart, bronchi, uterus and blood vessels.

Pharmacological actions:

• slowing down the conduction of stimuli in the heart;
• decreased strength of heart contractions;
• slowing heart rate;
• reducing the oxygen demand of the heart muscle;
• decrease in pressure. The drug reduces blood pressure within 1-2 hours after taking a single dose;
• decrease in the volume of blood ejected by the myocardium;
• slowing down filtration processes in the glomeruli of the kidneys;
• decreased sweating;
• decreased tremor in the limbs;
• slowing down fat breakdown;
• inhibition of insulin synthesis;
• slowing down the production of thyroid hormones;
• increased tone of the bronchial muscles;
• stimulation of myometrial contractions;
• increased gastrointestinal motility.

The effect of the drug on the body

It is worth noting that doctors often prescribe Anaprilin as a medicine for diseases of the cardiovascular system.

This medicine is a short-acting drug. Therefore, it is used most often to relieve an attack of arrhythmia.

If the patient requires constant therapy, the doctor prescribes pills 3 times a day, and when discontinuing it, they stop taking it gradually.

As for tachycardia, this drug is recommended for use in sinus tachycardia.

Side effects

The use of Anaprilin in some cases is fraught with the occurrence of undesirable reactions from the peripheral nervous system and central nervous system, in particular: weakness, headache, increased fatigue, dizziness, insomnia, depression, drowsiness, vivid dreams, confusion, tremor, hallucinations, anxiety, nervousness.

Sinus bradycardia, AV block (which can lead to complete transverse block or cardiac arrest), arrhythmia, orthostatic hypotension, vasospasm, chest pain and the development of chronic heart failure are also possible.

Changes in the functioning of the sensory organs may include soreness and dryness of the eyes.

From the digestive system, in some cases, nausea, vomiting, diarrhea or constipation, pain in the epigastric region, liver dysfunction, as well as changes in taste and increased activity of liver transaminases are noted.

Nasal congestion and bronchospasm may occur.

In some cases, as noted in the instructions for Anaprilin, thrombocytopenia and leukopenia are likely to occur.

A change in blood glucose concentration may occur.

It is also possible to increase sweating, the occurrence of psoriasis-like reactions, exacerbation of psoriasis symptoms, the appearance of skin rash, itching, and urticaria.

Other adverse reactions to Anaprilin include: arthralgia, withdrawal syndrome, back pain, decreased potency.

What can be replaced?

Here is just a small list of Anaprilin analogues:

Surgery

Over the past 40-50 years, stereotactic thalamotomy has remained the only surgical treatment for essential tremor. This method involves destruction of the ventrolateral part of the thalamus and (or) subthalamic nucleus (subthalamotomy). The impact of the destructive method, including unwanted side effects, is irreversible. High-frequency stimulation of deep brain structures (DBS) by implanting permanent electrodes into the ventral intermediate nucleus of the thalamus was proposed as an alternative treatment method in 1987 and is used successfully to this day.

Criteria for selecting patients for surgical treatment of essential tremor:

1. significant impairment of vital activity associated with ET:
2. impairment of daily activities;
3. restriction of professional activity;
4. social inferiority.
5. drug therapy is ineffective or causes intolerable side effects

Exclusion criteria for surgical treatment of patients with essential tremor:

1. Poor general condition
2. Dementia
3. Severe concomitant mental illnesses:
4. severe depression
5. psychosis
6. alcohol or drug addiction;
7. severe personality disorders leading to patient inadequacy
8. Significant neurosurgical risk factors: (brain atrophy; immunosuppression; anticoagulant treatment)

With DBS, it is possible to achieve a significant reduction in the severity of postural tremor (by two points on the tremor rating scale) in almost 90% of people with ET. The effectiveness of the method against movement tremor is less pronounced. When treated with DBS, complete or almost complete disappearance of tremor (0 or 1 point) is observed in almost 70% of patients.