Medical University of Sofia Faculty of M Department

Medical University of Sofia, Faculty of M Department of Pharmacology and Toxico Angio (vaso)protectors (Summary) © Dr Ivan Lambev, 2008 E-mail: itlambev@mail. bg

I. Drugs improving capillary func (capillarotonic drugs) They reduce capillary fragility and permeability and prevent basal edothelium membrane damage. They act like antioxyd and prevent vitamin C and adrenaline oxid These drugs also inhibit lipid oxidation an synthesis of active oxygen species.

Drugs improving capillary functio Bioflavonoids: Diosmin Hesperidin, Hyperoside, Naringin, Quercetin, Rutin Rutascorbin® (rutin/ascorbic acid) Semisynthetic flavonoids: Troxerutin w Saponins: Escin (derived from Aescul hippocastanum – Horse-chestnut) x Synthetic preparations: Calcium dobe (Doxium® – in retinopathy)

Bioflavonoids • Fr. Cynosbati (Dog rose) • Hb. Hyperici (St. John’s wort) • Fr. Crataegi (Hawthorn) • Fruits of citrus

Drugs improving capillary functio are indicated in haemorrhagic diathesis skin and retinal haemorrhages, different forms of capillary dysfunctions, radiation disease, infections and allergic diseases, varicose veins, atherosclerosis, hyperten rheumatism, hepatitis, glomerulonephriti meno- and methrorhagias, paradontosis, drug capillary dysfunctions (caused by NSAIDs, glucocorticoids, rese anticoagulants, arsene compounds, gold

Atherosclerotic gangrene of foot

Warfarin necrosis of breast skin 5 days after intaking of warfarin

II. VENOTONIC DRUGS Detralex®, Endotelon®, Phelobod Troxerutin (Troxevasin®) Detralex® (diosmin/hesperidine) improves capillary functions, has venotonic and antiexudative actio too, due to inhibition of PGs releas It inhibits leukocyte adhesion and migration. Detralex enhances lymphatic flow and drainage.

® Detralex. Its venotonic effects is is due to the prolonged NA action. Detralex improves skin perfusion and rheological properties of the blood. It effective in chronic venous insufficien venous ulcer, hemorrhoids. Dosage: 2 x 1 tablet daily.

Endotelon® is purified and standardized extract of of grape seeds, contains procyanido oligomeres. It has endothelium protective and venotonic effect. Endotelon is prescribed p. o. in chro venous and lymphatic insufficiency

Varicose veins Varicose ulcer

Troxerutin (trihydroxyethylrutin) has venotonic, antiexuditive and haemos activity. It improves capillary function an inhibits thrombocyte aggregation too. Troxerutin is used in varicose ulcers, chronic venous insufficiency, superfacia thrombophlebitis, haemorrhoids, phlebo sclerosis, muscle cramps, pain of trauma origin (sprain, luxation). It is administere orally or locally, applied on the damaged area (2% gel).

III. Heparin containing ointments (used in superficial thrombophlebitis and varicose veins): Heparoid®, Lioton® 1000 gel IV. Antihaemorrhoidal drugs Detralex® (orally) Doloproct® (fluocortolone/lidocaine): su and ointment Procto-Glyvenol® (tribenoside/lidocaie) Ultraproct® (fluocortolone/cinchocaine) and ointment