Pharmaka mit Wirkung auf das kardiovaskuläre System

Zusammenfassung

Neben ihren Wirkungen auf das Herz-Kreislauf-System beeinflussen kardiovaskuläre Pharmaka zahlreiche andere Strukturen des menschlichen Organismus, was sowohl in erwünschten als auch unerwünschten Nebenwirkungen, unter anderem auf die Hämostase, resultieren kann. So können, aufgrund der Interaktionen des Renin-Angiotensin-Systems mit dem Kallikrein-Kinin- und dem Fibrinolysesystem, Inhibitoren des Angiotensin-Converting-Enzyms (ACE) bzw. Angiotensin-II-Rezeptor-Antagonisten profibrinolytische und antithrombotische Effekte hervorrufen. Unter den Pharmaka, die zur Therapie der koronaren Herzkrankheit eingesetzt werden, sind vor allem vasoaktive Substanzen wie Nitroverbindungen von Interesse, da sie die Plättchenaggregation hemmen. Die zur Senkung des Lipidspiegels verwendeten HMG-CoA-Reduktase-Inhibitoren oder Statine haben antithrombotische Eigenschaften, die auf spezifischen, nicht mit der Lipidsenkung verbundenen Wirkungsmechanismen beruhen. Hinsichtlich unerwünschter Nebenwirkungen kardiovaskulärer Pharmaka auf die Hämostase ist nur wenig bekannt. Bei Anwendung von ACE-Inhibitoren und vasoaktiven Substanzen wurden vereinzelt Blutungen, insbesondere im Bereich des Magen-Darm-Traktes, beobachtet. Einige Diuretika und β-Blocker können den Fettstoffwechsel mit Auftreten einer Hyperlipidämie beeinflussen.

Summary

Besides their action on the cardiovascular system cardiovascular drugs may cause both desired and undesired effects on various other structures of the organism. Because of the interaction between the renin-angiotensin system with the kallikrein-kinin and the fibrinolytic system angiotensin-converting enzyme (ACE) inhibitors as well as angiotensin II-receptor antagonists can induce profibrinolytic and antithrombotic effects. Amongst the drugs used for the therapy of coronary artery disease especially vasoactive compounds such as organic nitrates are known to inhibit platelet reactions. Independent of their lipid-lowering action HMG-CoA-reductase inhibitors or statins exert antithrombotic effects which are based on specific mechanisms of action. Only little information is available on undesired side effects of cardiovascular drugs on the hemostatic system. There are some reports on bleeding complications especially in the gastrointestinal tract after administration of ACE inhibitors and vasoactive compounds. Some diuretics and β-blockers may cause hyperlipidemia.

Schlüsselwörter

Kardiovaskuläre Pharmaka - Fibrinolyse - Plättchen - Thrombose

Keywords

Cardiovascular drugs - fibrinolysis - platelets - thrombosis

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