avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2012-0-1-46-52avk-52Research ArticleБОЛЕЗНИ СЕРДЦА И СОСУДОВПРИМЕНЕНИЕ НИКОРАНДИЛА ПРИ СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЯХ И ОПТИМИЗАЦИЯ СХЕМ ЕГО НАЗНАЧЕНИЯПРИМЕНЕНИЕ НИКОРАНДИЛА ПРИ СЕРДЕЧНО-СОСУДИСТЫХ ЗАБОЛЕВАНИЯХ И ОПТИМИЗАЦИЯ СХЕМ ЕГО НАЗНАЧЕНИЯБелоусовЮ. Б.БелоусовЮ. Б.

кафедра госпитальной терапии № 2 лечебного факультета

кафедра госпитальной терапии № 2 лечебного факультета

belousov@mail.ruГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.ПироговаRussian Federation201228022012014652Copyright © Белоусов Ю.Б., 20122012Белоусов Ю.Б.Белоусов Ю.Б.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/52

Никорандил – антиангинальный препарат с уникальным двойным фармакологическим действием: он является активатором АТФ-зависимых калиевых каналов (КК) и проявляет нитратоподобные свойства. Цель данного обзора — представить современный взгляд на лечение никорандилом. Приводятся показания к применению никорандила, объясняется механизм его действия. Обсуждается феномен ишемического и фармакологического прекондиционирования, особое внимание уделяется роли КК. Рассматриваются аспекты клинической практики, связанные с прекондиционированием ишемии и ее медикаментозной профилактикой с помощью никорандила, а также влияние препарата на улучшение прогноза, оптимизацию функции эндотелия, регулирование работы вегетативной нервной системы и стабилизацию атеросклеротической бляшки. Обсуждается вопрос переносимости никорандила.

Nicorandil is a dual pharmacological mechanism anti-anginal agent with adenosinetriphosphat-esensitive potassium (Кatp) channel agonist and nitrate-like properties. The aim of this review is to provide an update on the efficacy of treatment with nicorandil. First, the rationale for nicorandil treatment and its pharmacological effects are reviewed. We explain the mechanisms underlying ischemic preconditioning, with a focus on those that involve the KAТР. Next, clinical practice related lo ischemic preconditioning and pharmacological preconditioning with nicorandil as well as other favourable mechanisms of improvement of prognosis, in which it plays a role in improving endothelial function, modulating autonomic nervous system activity and stabilizing plaque are summarized. Finally, the tolerability of nicorandil is discussed.

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The authors declare that there are no conflicts of interest present.