Pharmacology of Oedema Protective Drugs

Abstract

Objective: To review the drugs used in the treatment of chronic venous diseases of the lower limb. Data sources: Published papers referring to the pharmacology of drugs used in the management of chronic venous insufficiency and varicose veins of the lower limb. Study selection: Sixty-four papers referring to the use of horse chestnut extract (aescin), flavonoids, tribnoside and calcium dobesilate have been included. Data extraction: Papers were examined to establish the mechanism of action of ‘oedema protective’ drugs. Data synthesis: Oedema protective drugs modify the permeability of the microcirculatory endothelium in animal models of oedema and probably in patients with venous disease to reduce transcapillary loss of fluid into the tissues. The exact mechanisms of action remain unclear. Conclusion: Animal and clinical studies demonstrate that drugs of the four types included in this review moderate the development of tissue oedema.