Lisinopril Ratiopharm ali ndi vasodilating chifukwa chokakamira kapangidwe ka angiotensin II. Chifukwa chokwaniritsa njira yothandizira achire, zotsatira zabwino za mankhwalawa pamasamba a ischemic minofu zimawonedwa. Mankhwala amakupatsani kukhala kukana kwa mtima endothelium ndi mtima minofu kukulitsa katundu pa kukula kwa ochepa matenda oopsa. Chifukwa chake, mankhwalawa amagwiritsidwa ntchito ndi akatswiri a mtima kuchiza kuthamanga kwa magazi, kugunda kwamtima ndi mtima komanso kulephera kwa mtima.
Dzinalo Losayenerana
Lisinopril.
Mankhwala amakupatsani kukhala kukana kwa mtima endothelium ndi mtima minofu kukulitsa katundu pa kukula kwa ochepa matenda oopsa.
ATX
C09AA03.
Kutulutsa mafomu ndi kapangidwe kake
Mankhwala amapezeka mu mawonekedwe a mapiritsi ogwiritsira ntchito pakamwa.
Mapiritsi
Kutengera mlingo wa yogwira mankhwala - lisinopril, mapiritsi amasiyana mu utoto wamitundu:
- 5 mg ndi yoyera;
- 10 mg - pinki yopepuka;
- 20 mg - pinki.
Kusintha magawo a pharmacokinetics, piritsi yamapiritsi imakhala ndi zina zowonjezera:
- magnesium wakuba;
- calcium hydrogen phosphate;
- wowuma pregelatinized;
- mannitol;
- croscarmellose sodium.
Madontho
Mtundu wosapezeka.
Zotsatira za pharmacological
Lisinopril amalepheretsa kugwira ntchito kwa angiotensin kutembenuza enzyme (ACE). Zotsatira zake, mulingo wa angiotensin II umachepa, ndikuchepetsa lumen ya chotengera ndikuchepetsa kapangidwe ka aldosterone. The yogwira mankhwala pawiri wa mankhwala amalepheretsa kuwonongeka kwa bradykinin, peptide yokhala ndi vasopressor.
Lisinopril amachepetsa mphamvu ya angiotensin II, yomwe imachepetsa lumen ya chombo.
Potengera maziko a vasodilation, pali kuchepa kwa kuthamanga kwa magazi, kukana kwa zotumphukira. Katundu pa myocardium amachepa. Kugwiritsa ntchito kwa Lisinopril nthawi yayitali, kukana kwa minofu endothelium ndi mtima minofu kukulitsa katundu, kuchuluka kwa ma cellcirculatory m'derali ndi ischemia kumakhala bwino. Mankhwalawa amathandizira kuchepetsa mwayi wokhala ndi kulephera kwamitsempha yamagetsi.
Pharmacokinetics
Mukamamwa pakamwa, kuchuluka kwa madzi a lisinopril kumawonjezeka pambuyo pake mpaka maola 6.7. Kudya kotereku sikukhudza mayamwidwe ndi kukhudzika kwa chinthucho. Lisinopril, akalowa m'magazi, samapanga zovuta ndi mapuloteni a plasma ndipo samasintha m'maselo a chiwindi. Chifukwa chake, chinthu chogwiritsa ntchito chimachoka m'thupi kudzera mu impso ndi mawonekedwe ake. Kuchotsa theka moyo kumafika maola 12.6.
Zizindikiro zogwiritsidwa ntchito
Mankhwalawa amagwiritsidwa ntchito ngati mankhwala ochiritsira:
- aakulu mtima kulephera ndi kumanzere yamitsempha yamagazi epention kochepa zosakwana 30%;
- kuthamanga kwa magazi;
- pachimake m`mnyewa wamtima infarction odwala popanda aimpso kulephera.
Contraindication
Ndi zoletsedwa kumwa mankhwalawa motere:
- munthu tsankho la minyewa kuphatikizika kwa mankhwala;
- stenosis yamitsempha ya impso;
- odwala matenda a impso omwe ali ndi creatinine chilolezo pansi pa 30 ml / min;
- mitral valavu stenosis ndi msempha;
- kuthamanga kwa magazi kwa systolic ya 100 mm Hg ndi kutsikira;
- hemodynamics yosasunthika kumbuyo kwa mawonekedwe owopsa a vuto la mtima;
- amayi apakati ndi oyamwitsa;
- hyperaldosteronism;
- kukonzanso nthawi pambuyo kupatsirana kwa impso.
Ndi chisamaliro
Ndikulimbikitsidwa kupita ku chithandizo cha mankhwala osokoneza bongo moyang'aniridwa ndi dokotala pazinthu zotsatirazi:
- hypovolemia;
- sodium wotsika magazi wochepera 130 mmol / l;
- kuthamanga kwa magazi (BP);
- munthawi yomweyo makonzedwe a okodzetsa, makamaka mlingo waukulu;
- kusakhazikika mtima;
- matenda a impso
- mlingo wamphamvu vasodilator;
- odwala opitilira zaka 70.
Kodi kutenga lisinopril ratiopharm?
Kutalika kwa mankhwalawa ndi milungu 6. Odwala omwe ali ndi vuto la mtima ayenera kutenga Lisinopril mosalekeza. Kuwongolera kosakanikirana ndi Nitroglycerin ndikuloledwa.
Kodi ndiyenera kuthana ndi vuto lotani?
Mankhwalawa amaperekedwa kwa odwala omwe ali ndi kuthamanga kwa magazi omwe amapitilira 120/80 mm RT. Art. Potsika kwambiri panthawi ya systole - osakwana 120 mm RT. Art. musanayambe chithandizo ndi ACE inhibitor kapena masiku atatu oyamba a mankhwalawa, 2,5 mg yokha ya mankhwalawa ayenera kumwa. Ngati chiwonetsero cha systolic kwa mphindi zoposa 60 sichikwera pamwamba pa 90 mm Hg. Art., Muyenera kukana kumwa piritsi.
Kumwa mankhwala a shuga
Matenda a shuga sayenera kukonzanso mtundu wa anti inhibitor wa ACE.
Mlingo wa Hypertension
Odwala omwe ali ndi kuthamanga kwa magazi ayenera kumwa 5 mg ya mankhwalawa m'milungu itatu. Ndi gawo labwino la kulolera, mutha kuwonjezera mlingo wa tsiku ndi tsiku mpaka 10-20 mg ya mankhwala. Nthawi yopitilira kuchuluka kwa mankhwalawa iyenera kukhala masiku osachepera 21. Mulingo wovomerezeka tsiku lililonse ndi 40 mg ya mankhwalawa. Mapiritsi ayenera kumwedwa kamodzi patsiku.
Matenda a shuga sayenera kukonzanso mtundu wa anti inhibitor wa ACE.
Mlingo wa kulephera kwa mtima
Odwala omwe ali ndi vuto la mtima amatenga mankhwalawo nthawi imodzi ndi diuretics Digitalis. Chifukwa chake, mlingo koyamba kwa chithandizo ndi 2,5 mamawa. Mlingo wokonza umakhazikitsidwa ndikuwonjezeka pang'onopang'ono kwa 2.5 mg sabata iliyonse ya 2-4. Mlingo wokhazikika umachokera ku 5 mpaka 20 mg, kutengera mtundu wololera kamodzi pa tsiku. Mlingo waukulu kwambiri ndi 35 mg.
Pachimake myocardial infaration
Kugwiritsa ntchito mankhwala osokoneza bongo kumaperekedwa masana kuyambira nthawi yoyamba kuwonekera kwa matenda owopsa a mtima. Kuchiza kumaloledwa pokhapokha ngati impso ndizokhazikika komanso kupanikizika kwa systolic kukwera kuposa 100 mm Hg. Art. Lisinopril amaphatikizidwa ndi mankhwala osokoneza bongo a thrombolytic, beta-adrenergic blockers, nitrate ndi mankhwala ochepetsa magazi. Mlingo woyambirira ndi 5 mg, pambuyo pa maola 24 ndi khola wodwalayo, mlingo umawonjezeka mpaka pazovomerezeka - 10 mg.
Zotsatira zoyipa
Zotsatira zoyipa zimawonedwa chifukwa cha mlingo wosayenera kapena kusintha kwa minyewa pazigawo za mankhwala.
Matumbo
Zotsatira zoyipa za mankhwala omwe amapezeka m'mimba zimasonyezedwa motere:
- kudzimbidwa, kutsekula m'mimba;
- gag limakhazikika;
- kusowa kwa chakudya
- kusintha kwa kakomedwe;
- cholestatic jaundice, wokwiyitsidwa ndi kukula kwa hyperbilirubinemia.
Hematopoietic ziwalo
Hemolytic anemia imawonedwa mwa glucose-6-phosphate dehydrogenase akusowa. Ndi zoletsa fupa la hematopoiesis, kuchuluka kwa magazi kumachepa.
Pakati mantha dongosolo
Zosokoneza za zotumphukira ndi zamkati zamanjenje zimadziwika ndi mawonekedwe omwe angachitike:
- kupweteka mutu;
- kutopa kwambiri;
- Chizungulire
- kutayika kwa kuyang'ana ndi kusamala m'malo;
- kulira m'makutu;
- chisokonezo ndi kutayika kwa chikumbumtima;
- paresthesia;
- minofu kukokana;
- kutayika kwa malingaliro: kukula kwa kukhumudwa, mantha;
- polyneuropathy.
Mankhwalawa amatha kubweretsa zowawa za minofu.
Kuchokera ku kupuma
Nthawi zina, pamakhala zilonda zapakhosi ndikuwoneka ngati chifuwa chowuma.
Pa khungu ndi subcutaneous minofu
Nthawi zina, n`zotheka kukhala urticaria, totupa, matenda a Stevens-Johnson, erythema, kuchuluka kwa dzuwa, kuchuluka kwa psoriasis. Tsitsi limatha kugwera pamutu.
Kuchokera pamtima
Pali chiopsezo chokhala ndi orthostatic hypotension ndi bradycardia, sensations of kutentha.
Pa mbali ya impso ndi urogenital dongosolo
N`zotheka kusokoneza aimpso ntchito, kuchuluka kwa aimpso kulephera, kukodza pokodza.
Kuchokera kumbali ya kagayidwe
Nthawi zina, hypernatremia kapena hyperkalemia imayamba.
Malangizo apadera
Ndi munthawi yomweyo kugwiritsa ntchito lisinopril ndi dialysis okhala ndi otsika osalimba lipoproteins, pali chiopsezo cha anaphylactic.
Ndi munthawi yomweyo kugwiritsa ntchito lisinopril ndi dialysis okhala ndi otsika osalimba lipoproteins, pali chiopsezo cha anaphylactic.
Odwala omwe amawaganizira kuti angayambitse ziwengo, angioedema angachitike. Ngati kutupa kwa nkhope ndi milomo kumadziwika, antihistamines ayenera kumwedwa. Ndi chotchinga m'misewu yotsutsana ndi malekezero a lilime ndi glottis, chithandizo chadzidzidzi chimafunikira ndi jakisoni wa Epinephrine mosalekeza 0,5 mg kapena 0,5 mg. Ndi chotupa cha m'mimba, ndikofunikira kuyang'anira ma electrocardiogram ndi kuthamanga kwa magazi.
Zokhudza mphamvu pakuwongolera njira
Panthawi ya chithandizo ndi Lisinopril, ndikofunikira kuwongolera kuthamanga kwa magazi, chifukwa kutengera mawonekedwe a wodwala, kukulitsa kwa ochepa hypotension ndikotheka. Chifukwa chochepetsera kuthamanga kwa magazi, pali kuphwanyidwa kwa kukhoza kuwongolera zida zovuta ndikuyendetsa galimoto.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Mankhwalawa saloledwa kuperekedwa kwa amayi apakati chifukwa chosadziwa zambiri zamomwe mankhwala a ACE inhibitor amapangira pa fetal. Pa maphunziro a preclinical, kuthekera kwa chinthu chogwira ntchito kulowa mkati mwa placenta kudawululidwa. Mu trimester yoyamba yakukula kwa fetal, mankhwalawa amatha kupangitsa kukhazikika kwa milomo.
Mukamapereka mankhwala a Lisinopril pa nthawi yoyamwitsa, muyenera kuyimitsa kudyetsa mwana ndikusamutsira ku zakudya zosakanikirana ndi zosakaniza.
Kulemba kwa Lisinopril Ratiopharm kwa ana
Mankhwalawa amaletsedwa kwa ana ndi achinyamata osakwana zaka 18.
Mankhwalawa amaletsedwa kwa ana ndi achinyamata osakwana zaka 18.
Gwiritsani ntchito mu ukalamba
Kwa odwala okalamba, mlingo wa mankhwalawa umasinthidwa malinga ndi chilolezo cha creatinine. Zotsalazo zimawerengeredwa ndi njira ya Cockroft:
| Kwa amuna | (140 - m'badwo) × kulemera (kg) /0.814 × serum creatinine mulingo (μmol / L) |
| Akazi | Zotsatira zake zimachulukitsidwa ndi 0.85. |
Bongo
Kugwiritsa ntchito mankhwala mopitilira muyeso kungayambitse kukula kwa zizindikiro za bongo:
- dontho lakuthwa magazi;
- Cardiogenic mantha;
- kutaya chikumbumtima, chizungulire;
- bradycardia.
Wodwalayo ayenera kusamutsidwa kumalo osamalira odwala kwambiri, komwe seramu yama electrolyte ndi creatinine imayang'aniridwa. Ngati mapiritsi adatengedwa mkati mwa maola 3-4 apitayo, ndiye kuti wodwalayo ayenera kupatsidwa mankhwala othandizira, nadzatsuka m'mimba. Lisinopril amatha kuthetsedwa ndi hemodialysis.
Kuchita ndi mankhwala ena
Ndi kufanana kwa mapiritsi a Lisinopril ndi mankhwala ena, zotsatirazi zimawonekera:
- Ma painkiller ndi mankhwala osapatsirana omwe amaletsa kutupa amathandizira kuti azikhala ndi hypotension.
- Baclofen imawonjezera mphamvu ya achireopril. Chifukwa cha izi, kukula kwa ochepa hypotension ndikotheka.
- Mankhwala a antihypertensive, sympathomimetics, Amifostin amalimbikitsa achire zotsatira za mankhwalawa, zomwe zimatsogolera pakukula kwa ochepa ochepa hypotension.
- Kukonzekera kwa opaleshoni yodwala, mapiritsi ogona ndi ma antipsychotic amachititsa kuti magazi achepe.
- Immunosuppressants, cytostatic ndi anticancer mankhwala amawonjezera chiopsezo cha leukopenia.
- Mankhwala a Oral hypoglycemic m'milungu yoyamba ya zovuta mankhwala amatha kukulitsa mphamvu ya antihypertensive ya lisinopril.
- Maantacid okhala amachepetsa kukhudzana kwa mankhwala othandizira.
Amifostine timapitiriza achire zotsatira za mankhwala, zikubweretsa Kukula kwa ochepa hypotension.
Mankhwala okhala ndi sodium mankhwala ena a chloride amachepetsa mphamvu ya mankhwalawa ndikuwonjezera kukula kwa zizindikiro zakulephera kwa mtima.
Kuyenderana ndi mowa
ACE inhibitor amatha kuwonjezera kuwopsa kwa mowa wa ethyl kupita ku hepatocytes, zimakhala za mtima ndi zamanjenje. Chifukwa chake, munthawi ya antihypertensive chithandizo, muyenera kusiya kumwa.
Analogi
Njira zochizira matenda zimachitika moyang'aniridwa ndi adokotala pakakhala kuti palibe zofunika za antihypertensive pogwira nawo limodzi la mankhwala otsatirawa:
- Dapril;
- Aurolyza;
- Vitopril;
- Diroton;
- Zonixem;
- Amapin-L;
- Amlipin.
Zotsatira za tchuthi Lisinopril Ratiopharm kuchokera ku malo ogulitsa mankhwala
Mapiritsi atha kugulidwa ndi mankhwala.
Kodi ndingagule popanda kulandira mankhwala?
Kumwa mankhwalawa popanda upangiri wachipatala mwachindunji kungayambitse kuchepa kwa magazi, komwe kumapangitsa kuti mukhale ndi bradycardia, kusazindikira, kulephera kwa mtima, chikomokere, kufa. Poteteza wodwala, mankhwalawo sagulitsidwa-wotsutsa.
Mtengo
Mtengo wapakati wamankhwala ndi pafupifupi ma ruble 250.
Zosungidwa zamankhwala
Mankhwalawa amasungidwa pamtunda wochepera + 25 ° C m'malo osiyanitsidwa ndi dzuwa.
Tsiku lotha ntchito
Zaka 4
Wopanga Lisinopril Ratiopharm
Merkle GmbH, Germany.
Ndemanga za Lisinopril Ratiopharm
Ndi kuyang'anira moyenera malingaliro a akatswiri, ndizotheka kupeza mankhwala ofunikira.
Madokotala
Anton Rozhdestvensky, urologist, Yekaterinburg
Mankhwalawa amaloledwa ndi odwala. Zimatsogolera kuzisonyezo zokhazikika, zotsika mtengo kuposa Diroton. Nthawi yomweyo, sindimapereka mankhwala okodzetsa olimba limodzi nawo. Lisinopril sasokoneza ntchito ya erectile. Mapiritsi ayenera kumwedwa kokha m'mawa 1 nthawi patsiku. Kupanikizika kumakhalabe kwa maola 24.
Vitaliy Zafiraki, katswiri wamtima, Vladivostok
Mankhwala sioyenera monotherapy. Ndimapereka malangizo kwa odwala omwe amaphatikiza ndi okodzetsa ochepa. Komanso, munthawi ya chithandizo, kuwunika kosavuta kwa impso kumafunika. Mankhwalawa adutsa ziyeso zofunikira za chipatala ndipo amaloledwa kugwiritsidwa ntchito ndi odwala omwe ali ndi kuthamanga kwa magazi.
Amlipin ndizofanizira zamankhwala.
Odwala
Barbara Miloslavskaya, wazaka 25, Irkutsk
Ndi kusankha kwayekha kwa mankhwala opanikizika, palibe chomwe chinathandiza. Ndinafikira kuchipatala ndili ndi matenda ashuga, komwe mankhwala okwera mtengo ndiwo mankhwala oopsa. Wopangayo adalimbikitsa kusintha mankhwalawa ndi mapiritsi a Lisinopril-Ratiopharm. Ndimamwa kwa zaka 5 pa 10 mg patsiku. Kupanikizika kunabwereranso ku 140-150 / 90 mm Hg. Art. ndipo sanawukenso. BP iyi imandiyenera. Ngati simumamwa mapiritsi, kenako kumadzulo, mavuto amakula ndipo thanzi lanu limakulirakulira.
A Emanuel Bondarenko, wazaka 36, mzinda wa St.
Dokotala adakhazikitsa 5 mg ya lisinopril patsiku. Ndimamwa m'mawa mosamalitsa malinga ndi malangizo nthawi yomweyo.A chipatala adachenjeza kuti mapiritsiwo sanapangidwe mwachangu. The achire zotsatira kudziunjikira, ndipo patatha mwezi umodzi kupanikizika sizinapitirire 130-140 / 90 mm Hg. Art. M'mbuyomu, 150-160 / 110 mmHg zinaonedwa. Art. Chifukwa chake, ndimasiya ndemanga zabwino. Sindinawone zotsatira zoyipa.
