Angiotensin receptor protection

Canderel aspartame, candesartan candesartancilexetil. eandesartan cilexetil (Amias ) is a benzimidazole-carboxylic acid derivative, an (AT,) ANGIOTENSIN RECEPTOR ANTAGONIST, used as an antihypertensive. It is an ethyl ester prodrug of candesartan (CV 11974). It has experimental renal protective effects. 

In the patient with chronic angina, the drugs commonly used seem to offer important myocardial protection Thus, (3-blockers, ACE inhibitors and most probably angiotensin receptor blockers, statins, Ca2+ channel blockers, all are in their way cardioprotective. Nitrates and more importantly nicorandil are worthwhile options. Trimetazidine and drugs producing a shift towards preferential glucose oxidation would also be a consideration. A number of studies stress that they may produce an improvement in ischemic cardiomyopathy, probably through an anti-inflammatory action.261... 

Shoda, J, Kanno, Y, Suzuki, H A five-year comparison of the renal protective effects of angiotensin-con-verting enzyme inhibitors and angiotensin receptor blockers in patients with non-diabetic nephropathy. Intern. Med. 45 193-198, 2006. 

Mechanisms of action. The tonus of vascular smooth muscle can be decreased by various means. ACE inhibitors, antagonists at ATI-receptors and antagonists at a-adrenoceptors protect against the effects of excitatory mediators such as angiotensin 11 and norepinephrine, respectively. Prostacyclin an-Ltillmann, Color Atlas of Pharmacology 2000 Thieme All rights reserved. Usage subject to terms and conditions of license. 

If a patient is diabetic, ACE-I will be advised, because it may reduce new-onset of HE and protect against nephropathy. The use of an Angiotensin-II receptor blocker (ARB) is also a good choice for these diabetic patients and for their nephropathy. The basic concept of drug selection will be combination therapy using different classes such as ACE-I and... 

Rossing K, Jacobsen P, Pietraszek L, Parving HH. Reno-protective effects of adding angiotensin II receptor blocker to maximal recommended doses of ACE inhibitor in diabetic nephropathy a randomized doubleblind crossover trial. Diabetes Care 2003 26 2268-74. 

Inhibition of the renin-angiotensin system by ACE inhibitors has proved efficacious in the treatment of hypertension, cardiac failure, myocardial infarction, in secondary prevention after myocardial infarction, and for kidney protection in diabetic and non-diabetic nephropathy. The development of specific antagonists to subtype 1 of the angiotensin II receptor (ATi) has provided a new tool for inhibiting the renin-angiotensin system. 

M. Sato, R. M. Engelman, H. Otani, N. Maulik, J. Rousou, J. Flack, D. W. Deaton, D. K. Das, Myocardial protection by preconditioning of heart with losartan, an angiotensin II type 1-receptor blocker. Implication of bradykinin-dependent and bradykinin-independent mechanisma, Circulation 120, suplIII III—346—III—351 (2000). 

Combination studies Dual blockade of the renin-angiotensin-aldosterone system by combined use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists may provide more renal protection than monotherapy in chronic kidney disease. In 45 patients with chronic kidney disease who took either enalapril 20 mg/day or candesartan 16 mg/ day for 16 weeks followed by treatment, with incremental dosing of enalapril (target... 

---