This is one of the major side effects of amlodipine. Increased heart rate leads to an increase in myocardial oxygen demand, which is undesirable for patients with coronary heart disease. Being selective blocker of β 1 adrenergic receptor, atenolol eliminates reflex tachycardia caused by amlodipine. Clinical studies in recent years have demonstrated a beneficial effect of therapy blockers “slow” calcium channels on the blood lipid profile, thereby reducing the risk of cardio – vascular outcomes. The complementary mechanism of action of amlodipine reduces the total peripheral vascular resistance and Atenolol, reduces cardiac output, resulting in a more pronounced antihypertensive effect and better tolerability compared with monotherapy with amlodipine and atenolol, improving the efficiency / side effects. Atenolol: has antianginal, hypotensive and antiarrhythmic effect .It has no membrane stabilizing and intrinsic sympathomimetic activity.
Reduces catecholamines stimulate the formation , reduces the current intracellular . In the first 24 hours after oral administration due to lower cardiac output marked reactive increase in total peripheral vascular resistance, the severity of which is within 1-3 days gradually reduced. The hypotensive effect was associated with reduced cardiac output, decreased activity of the renin-angiotensin system, barotsereptorov sensitivity and influence on the central nervous system. The antihypertensive effect is a decrease in systolic and diastolic blood pressure, decrease stroke and minute volumes. The average therapeutic doses has no effect on the tone of the peripheral arteries. Antihypertensive effect lasts for 24 hours, when taken regularly is stabilized by the end of proviron for women weeks of treatment. Antianginal effect is determined by a decrease in myocardial oxygen demand by reducing heart rate (diastole lengthening and improving myocardial perfusion) and contractility and decrease myocardial sensitivity to the effects of the sympathetic innervation . It slows the heart rate at rest and during exercise. By increasing the tension of the muscle fibers and ventricular end-diastolic pressure in the left ventricle may increase myocardial oxygen demand, especially in patients with chronic heart failure. Antiarrhythmic effect is the suppression of sinus tachycardia and due to the elimination of arrhythmogenic sympathetic effects on the conducting system of the heart, the inhibition of heterogeneous automaticity, decrease in the rate of propagation of excitation through sinoauricular node and extension of refractory period. Inhibits the conduction of impulses in the antegrade and to a lesser proviron for women extent, in the retrograde direction through the atrioventricular node, and on additional routes. Increases the survival of patients with myocardial infarction (reduces the incidence of ventricular arrhythmias and seizures stenakardy).
At therapeutic concentrations, has no effect on the beta-2 adrenergic receptors, unlike nonselective beta adrenoborkatorov it has a less pronounced effect on the bronchial smooth muscle and peripheral arteries and on lipid metabolism. Slightly reduces vital capacity, hardly weakens the bronchodilatory effect of isoproterenol. When receiving more than 100 mg per day may provide the beta-2-adrenoceptor blocking effect. Negative chronotropic effect appears after 1 hour after administration, reaching its maximum after 2-4 hours and lasts up to 24 hours. Amlodipine: dihydropyridine derivative. It has antihypertensive, atnianginalnym, antispasmodic and vasodilating action. Blocks the flow of calcium ions across cell membranes proviron for women into the smooth muscle cells of the myocardium and blood vessels. Mechanism hypotensive action is due to direct a relaxing effect on vascular smooth muscle. Antianginal effect of the drug caused, firstly, by its ability to expand peripheral arterioles, leading to a decrease in total peripheral vascular resistance.