{"id":51517,"date":"2023-09-20T09:22:36","date_gmt":"2023-09-20T09:22:36","guid":{"rendered":"https:\/\/medsname.com\/alphadopa\/"},"modified":"2026-05-01T10:49:11","modified_gmt":"2026-05-01T10:49:11","slug":"alphadopa","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/alphadopa\/","title":{"rendered":"Alphadopa"},"content":{"rendered":"

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\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Alphadopa?<\/h3>\n

Alphadopa<\/strong> je Tableta methyldopy 250 mg<\/strong> od Lupin \u2014 centr\u00e1ln\u011b p\u016fsob\u00edc\u00ed agonista alfa-2 adrenergn\u00edch receptor\u016f (prost\u0159ednictv\u00edm aktivn\u00edho metabolitu alfa-methyl-noradrenalinu)<\/strong>, p\u016fsob\u00ed na centr\u00e1ln\u00ed alfa-2 adrenergn\u00ed receptory v mozkov\u00e9m kmeni \u2014 p\u016fsob\u00ed prost\u0159ednictv\u00edm fale\u0161n\u00e9ho neurotransmiterov\u00e9ho metabolitu alfa-methyl-noradrenalinu, kter\u00fd je ukl\u00e1d\u00e1n v adrenergn\u00edch neuronech a uvol\u0148ov\u00e1n m\u00edsto noradrenalinu, preferen\u010dn\u011b stimuluje inhibi\u010dn\u00ed alfa-2 receptory a sni\u017euje centr\u00e1ln\u00ed sympatick\u00fd v\u00fddej<\/strong>. Methyldopa byla uvedena spole\u010dnost\u00ed Merck Sharp & Dohme v roce 1960 jako Aldomet<\/strong>. P\u016fvodn\u011b vyvinuta jako experiment\u00e1ln\u00ed inhibitor DOPA-dekarboxyl\u00e1zy, jej\u00ed antihypertenzn\u00ed \u00fa\u010dinek v klinick\u00fdch studi\u00edch vedl k jej\u00edmu uveden\u00ed jako jednoho z prvn\u00edch l\u00e9k\u016f na hypertenzi zalo\u017een\u00fdch na d\u016fkazech. Studie VA Cooperative Study on Antihypertensive Agents (1967) potvrdila terapii zalo\u017eenou na methyldop\u011b jako v\u016fbec prvn\u00ed d\u016fkaz, \u017ee l\u00e9\u010dba hypertenze sni\u017euje kardiovaskul\u00e1rn\u00ed p\u0159\u00edhody \u2014 historick\u00fd v\u00fdsledek. Modern\u00ed pou\u017eit\u00ed se dramaticky z\u00fa\u017eilo s p\u0159\u00edchodem t\u0159\u00edd ACEi, ARB, CCB a beta-blok\u00e1tor\u016f, ale methyldopa z\u016fst\u00e1v\u00e1 zlat\u00fdm standardem pro hypertenzi v t\u011bhotenstv\u00ed<\/strong>, kde 40 let bezpe\u010dnostn\u00edch dat j\u00ed d\u00e1v\u00e1 jedine\u010dn\u00e9 postaven\u00ed. Polo\u010das 2 hodiny (mate\u0159sk\u00e1 slou\u010denina); d\u00e9lka centr\u00e1ln\u00edho \u00fa\u010dinku 6-12 hodin po peror\u00e1ln\u00edm pod\u00e1n\u00ed; n\u00e1stup 4-6 hodin; vrchol antihypertenzn\u00edho \u00fa\u010dinku 4-6 hodin; pln\u00fd \u00fa\u010dinek v ust\u00e1len\u00e9m stavu (24-48 hodin). Hlavn\u00ed indikace: hypertenze v t\u011bhotenstv\u00ed (zlat\u00fd standard, prvn\u00ed volba), rezistentn\u00ed hypertenze jako dopl\u0148kov\u00e1 l\u00e9\u010dba, historick\u00e9 antihypertenzivum<\/strong>. Typick\u00e9 d\u00e1vkov\u00e1n\u00ed: Hypertenze v t\u011bhotenstv\u00ed:<\/strong> Za\u010dn\u011bte s 250 mg dvakr\u00e1t a\u017e t\u0159ikr\u00e1t denn\u011b; titrujte ka\u017ed\u00e9 2\u20133 dny na 500\u20132000 mg\/den ve dvou a\u017e \u010dty\u0159ech d\u00edl\u010d\u00edch d\u00e1vk\u00e1ch (typick\u00e1 udr\u017eovac\u00ed d\u00e1vka 500 mg TDS a\u017e 750 mg TDS). C\u00edlov\u00fd krevn\u00ed tlak v ordinaci <140\/90. Up\u0159ednost\u0148uje se kv\u016fli nejv\u011bt\u0161\u00ed bezpe\u010dnostn\u00ed datab\u00e1zi v t\u011bhotenstv\u00ed ze v\u0161ech antihypertenziv (40+ let, tis\u00edce t\u011bhotenstv\u00ed, \u017e\u00e1dn\u00e1 teratogenita nebo sign\u00e1l ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f u novorozenc\u016f). Dosp\u011bl\u00ed net\u011bhotn\u00ed pacienti s rezistentn\u00ed hypertenz\u00ed:<\/strong> 250 mg dvakr\u00e1t a\u017e \u010dty\u0159ikr\u00e1t denn\u011b, s titrac\u00ed na 2000 mg\/den. Mimo t\u011bhotenstv\u00ed se z\u0159\u00eddka pou\u017e\u00edv\u00e1 jako l\u00e9k prvn\u00ed volby kv\u016fli l\u00e9pe tolerovan\u00fdm modern\u00edm alternativ\u00e1m. Pravideln\u011b monitorujte jatern\u00ed testy a kompletn\u00ed krevn\u00ed obraz (vz\u00e1cn\u011b idiosynkratick\u00e1 hepatitida; Coombs-pozitivn\u00ed an\u00e9mie). Preferovan\u00e9 antihypertenzivum v t\u011bhotenstv\u00ed.<\/strong> U v\u011bt\u0161iny hypertonik\u016f modern\u00ed l\u00e9\u010dba za\u010d\u00edn\u00e1 ACE inhibitorem\/ARB, blok\u00e1torem kalciov\u00fdch kan\u00e1l\u016f, thiazidem a spironolaktonem, ne\u017e se p\u0159istoup\u00ed k alfa-blok\u00e1toru nebo centr\u00e1ln\u011b p\u016fsob\u00edc\u00edmu l\u00e9ku.<\/p>\n<\/div>\n

\nCo z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n

\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n

Co je Alphadopa?<\/h2>\n

Alphadopa jsou peror\u00e1ln\u00ed tablety Methyldopy 250 mg od spole\u010dnosti Lupin, dod\u00e1van\u00e9 v balen\u00ed po 30\u201390 tablet\u00e1ch. Methyldopa byla uvedena na trh spole\u010dnost\u00ed Merck Sharp & Dohme v roce 1960 jako Aldomet<\/strong>. P\u016fvodn\u011b vyvinuta jako experiment\u00e1ln\u00ed inhibitor DOPA-dekarboxyl\u00e1zy, jej\u00ed antihypertenzn\u00ed \u00fa\u010dinek v klinick\u00fdch studi\u00edch vedl k jej\u00edmu uveden\u00ed jako jednoho z prvn\u00edch l\u00e9k\u016f na hypertenzi zalo\u017een\u00fdch na d\u016fkazech. Studie VA Cooperative Study on Antihypertensive Agents (1967) potvrdila terapii zalo\u017eenou na methyldop\u011b jako v\u016fbec prvn\u00ed d\u016fkaz, \u017ee l\u00e9\u010dba hypertenze sni\u017euje kardiovaskul\u00e1rn\u00ed p\u0159\u00edhody \u2014 historick\u00fd v\u00fdsledek. Modern\u00ed pou\u017eit\u00ed se dramaticky z\u00fa\u017eilo s p\u0159\u00edchodem t\u0159\u00edd ACEi, ARB, CCB a beta-blok\u00e1tor\u016f, ale methyldopa z\u016fst\u00e1v\u00e1 zlat\u00fdm standardem pro hypertenzi v t\u011bhotenstv\u00ed<\/strong>, kde 40 let bezpe\u010dnostn\u00edch dat j\u00ed poskytuje jedine\u010dn\u00e9 postaven\u00ed.<\/p>\n

Jak Methyldopa funguje<\/h2>\n

Methyldopa p\u016fsob\u00ed na centr\u00e1ln\u00ed alfa-2 adrenergn\u00ed receptory v mozkov\u00e9m kmeni \u2014 p\u016fsob\u00ed prost\u0159ednictv\u00edm fale\u0161n\u00e9ho neurotransmiterov\u00e9ho metabolitu alfa-methyl-noradrenalinu, kter\u00fd je ukl\u00e1d\u00e1n v adrenergn\u00edch neuronech a uvol\u0148ov\u00e1n m\u00edsto noradrenalinu, preferen\u010dn\u011b stimuluje inhibi\u010dn\u00ed alfa-2 receptory a sni\u017euje centr\u00e1ln\u00ed sympatick\u00fd v\u00fddej<\/strong>. N\u00e1sledn\u00e9 \u00fa\u010dinky:<\/p>\n

    \n
  • P\u0159em\u011bna na alfa-methyl-noradrenalin<\/strong> v centr\u00e1ln\u00edch adrenergn\u00edch neuronech \u2014 methyldopa je vychyt\u00e1v\u00e1na do stejn\u00fdch neuron\u016f jako endogenn\u00ed dopa, dekarboxylov\u00e1na stejn\u00fdmi enzymy a ulo\u017eena jako \u201cfale\u0161n\u00fd neurotransmiter\u201d<\/li>\n
  • Preferen\u010dn\u00ed stimulace inhibi\u010dn\u00edch alfa-2 receptor\u016f<\/strong> \u2014 fale\u0161n\u00fd p\u0159ena\u0161e\u010d je uvol\u0148ov\u00e1n nervovou aktivitou, ale preferen\u010dn\u011b stimuluje inhibi\u010dn\u00ed alfa-2 autoreceptory, \u010d\u00edm\u017e potla\u010duje dal\u0161\u00ed uvol\u0148ov\u00e1n\u00ed noradrenalinu<\/li>\n
  • Sn\u00ed\u017een\u00fd perifern\u00ed sympatick\u00fd v\u00fddej<\/strong> \u2014 plynul\u00e9 a trval\u00e9 sn\u00ed\u017een\u00ed TK; minim\u00e1ln\u00ed reflexn\u00ed tachykardie, proto\u017ee centr\u00e1ln\u00ed sympatick\u00fd sign\u00e1l je skute\u010dn\u011b sn\u00ed\u017een, nikoli pouze vyv\u00e1\u017een<\/li>\n
  • \u017d\u00e1dn\u00fd p\u0159\u00edm\u00fd vaskul\u00e1rn\u00ed, ren\u00e1ln\u00ed nebo kardi\u00e1ln\u00ed \u00fa\u010dinek<\/strong> \u2014 cel\u00fd klinick\u00fd \u00fa\u010dinek je centr\u00e1ln\u00ed<\/li>\n
  • \u017d\u00e1dn\u00fd vliv na syst\u00e9m renin-angiotensin, elektrolyty ani gluk\u00f3zu<\/strong> \u2014 hlavn\u00ed d\u016fvod jeho p\u0159ijateln\u00e9ho metabolick\u00e9ho profilu v t\u011bhotenstv\u00ed<\/li>\n
  • Placent\u00e1rn\u00ed p\u0159estup je omezen\u00fd<\/strong> \u2014 methyldopa prostupuje placentou, ale za 40 let pou\u017e\u00edv\u00e1n\u00ed v t\u011bhotenstv\u00ed nevykazuje m\u011b\u0159iteln\u00fd \u00fa\u010dinek na fet\u00e1ln\u00ed nebo neonat\u00e1ln\u00ed TK<\/li>\n<\/ul>\n

    Schv\u00e1len\u00e9 a v\u011bdecky podlo\u017een\u00e9 indikace<\/h2>\n
      \n
    • Hypertenze v t\u011bhotenstv\u00ed (zlat\u00fd standard, prvn\u00ed volba), rezistentn\u00ed hypertenze jako dopl\u0148kov\u00e1 l\u00e9\u010dba, historick\u00e9 antihypertenzivum<\/strong><\/li>\n
    • Hypertenze v t\u011bhotenstv\u00ed<\/strong> \u2014 prvn\u00ed volba dle NICE, ACOG a ISSHP; zlat\u00fd standard<\/li>\n
    • Rezistentn\u00ed hypertenze<\/strong> mimo t\u011bhotenstv\u00ed \u2014 dopl\u0148kov\u00e1 l\u00e9\u010dba \u010dtvrt\u00e9\/p\u00e1t\u00e9 volby<\/li>\n
    • Historick\u00e9 antihypertenzivum prvn\u00ed volby<\/strong> (VA Cooperative Study 1967) \u2014 vytla\u010deno modern\u011bj\u0161\u00edmi l\u00e9pe sn\u00e1\u0161en\u00fdmi t\u0159\u00eddami<\/li>\n<\/ul>\n

      Kl\u00ed\u010dov\u00e9 d\u016fkazy z klinick\u00fdch studi\u00ed:<\/strong> VA Cooperative Study (1967, 1970)<\/strong> \u2014 methyldopa + hydrochlorothiazid + reserpin sn\u00ed\u017eily fat\u00e1ln\u00ed i nefat\u00e1ln\u00ed kardiovaskul\u00e1rn\u00ed p\u0159\u00edhody u hypertonik\u016f. Prvn\u00ed a definitivn\u00ed d\u016fkaz, \u017ee l\u00e9\u010dba hypertenze zachra\u0148uje \u017eivoty. Redman et al. (1976, 1982)<\/strong> \u2014 methyldopa v t\u011bhotenstv\u00ed neovlivnila negativn\u011b neurov\u00fdvoj potomk\u016f b\u011bhem 7,5let\u00e9ho sledov\u00e1n\u00ed. studie CHIPS (2015)<\/strong> \u2014 p\u0159\u00edsn\u011bj\u0161\u00ed vs m\u00e9n\u011b p\u0159\u00edsn\u00e1 kontrola krevn\u00edho tlaku v t\u011bhotenstv\u00ed; methyldopa a labetalol byly nej\u010dast\u011bji pou\u017e\u00edvan\u00e9 l\u00e9ky; p\u0159\u00edsn\u011bj\u0161\u00ed kontrola sn\u00ed\u017eila z\u00e1va\u017enou mate\u0159skou hypertenzi bez zhor\u0161en\u00ed v\u00fdsledk\u016f pro plod. sm\u011brnice NICE \/ ACOG \/ ISSHP<\/strong> konzistentn\u011b uv\u00e1d\u011bj\u00ed methyldopu, labetalol a nifedipin jako l\u00e9ky prvn\u00ed volby u hypertenze v t\u011bhotenstv\u00ed.<\/p>\n

      D\u00e1vkov\u00e1n\u00ed Alphadopa<\/h2>\n

      Z\u00e1kladn\u00ed d\u00e1vka:<\/strong> Hypertenze v t\u011bhotenstv\u00ed:<\/strong> Za\u010dn\u011bte s 250 mg dvakr\u00e1t a\u017e t\u0159ikr\u00e1t denn\u011b; titrujte ka\u017ed\u00e9 2\u20133 dny na 500\u20132000 mg\/den ve dvou a\u017e \u010dty\u0159ech d\u00edl\u010d\u00edch d\u00e1vk\u00e1ch (typick\u00e1 udr\u017eovac\u00ed d\u00e1vka 500 mg TDS a\u017e 750 mg TDS). C\u00edlov\u00fd krevn\u00ed tlak v ordinaci <140\/90. Up\u0159ednost\u0148uje se kv\u016fli nejv\u011bt\u0161\u00ed bezpe\u010dnostn\u00ed datab\u00e1zi v t\u011bhotenstv\u00ed ze v\u0161ech antihypertenziv (40+ let, tis\u00edce t\u011bhotenstv\u00ed, \u017e\u00e1dn\u00e1 teratogenita nebo sign\u00e1l ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f u novorozenc\u016f). Dosp\u011bl\u00ed net\u011bhotn\u00ed pacienti s rezistentn\u00ed hypertenz\u00ed:<\/strong> 250 mg dvakr\u00e1t a\u017e \u010dty\u0159ikr\u00e1t denn\u011b, s titrac\u00ed a\u017e na 2 000 mg\/den. Mimo t\u011bhotenstv\u00ed se z\u0159\u00eddka pou\u017e\u00edv\u00e1 jako l\u00e9k prvn\u00ed volby kv\u016fli l\u00e9pe tolerovan\u00fdm modern\u00edm alternativ\u00e1m.<\/p>\n

      Dal\u0161\u00ed indikace:<\/strong> Methyldopa se pou\u017e\u00edv\u00e1 t\u00e9m\u011b\u0159 v\u00fdhradn\u011b pro hypertenzi \u2014 zejm\u00e9na v t\u011bhotenstv\u00ed. Historicky se pou\u017e\u00edvala u hypertenzn\u00ed encefalopatie a p\u0159\u00edpravy na feochromocytom (nyn\u00ed nahrazena).<\/p>\n

      Pod\u00e1v\u00e1n\u00ed:<\/strong> u\u017e\u00edvejte s j\u00eddlem nebo bez; denn\u00ed d\u00e1vku rozd\u011blte do 2\u20134 pod\u00e1n\u00ed. Ve\u010dern\u00ed d\u00e1vka m\u016f\u017ee b\u00fdt nejv\u011bt\u0161\u00ed, aby se sedace p\u0159esunula do sp\u00e1nku.<\/p>\n

      Monitorovac\u00ed pl\u00e1n:<\/strong><\/p>\n