Chemical Structure and Pharmacokinetics
The sole primary representative of this group is nicergoline. Chemically, it is a synthetic ergot alkaloid derivative. A unique feature of its molecular structure is an attached brominated nicotinic acid residue.
The drug can be administered via various routes depending on the clinical situation:
- Enterally (oral administration).
- Parenterally (including intravenous administration).
Mechanism of Pharmacological Action
The pharmacological response of the body to the drug is due to a combined mechanism that includes two major components:
- Alpha-adrenergic blocking effect — consists of the targeted blockade of vasoconstrictive alpha-adrenoceptors.
- Direct myotropic effect — provides direct relaxation of the smooth muscle in the vascular wall (spasmolytic effect).
Pharmacodynamic Effects and Hemodynamics
Due to the combination of receptor and myotropic properties, the drug exerts a pronounced effect on the vascular system. The primary vascular targets are the cerebral arterioles and peripheral vessels.
The systemic hemodynamic response manifests as follows:
- Dilation of cerebral arterioles.
- Dilation of the peripheral vascular bed.
- Overall improvement in hemodynamics and blood supply across various vascular beds: cerebral, pulmonary, renal, and in the extremities.
Therapeutic doses taken orally do not affect blood pressure. However, intravenous administration carries a risk of inducing a hypotensive effect (blood pressure reduction).
Indications for Use and Adverse Reactions
Its vasodilating properties determine the primary clinical indications for prescribing the medication:
- Cerebral circulation disorders developing against the background of atherosclerosis or thromboembolism.
- Peripheral circulation disorders.
Adverse effects may develop during pharmacotherapy:
- Vestibular disturbances such as dizziness.
- Allergic and cutaneous manifestations (pruritus).
- Gastrointestinal disorders (dyspepsia).