Mankhwala a antihypertensive komanso okodzetsa omwe ali ndi zinthu ziwiri zogwira ntchito. Cholinga cha odwala ndi anasonyeza kuphatikiza mankhwala ochepa matenda oopsa.
Dzinalo Losayenerana
Ramipril + hydrochlorothiazide.
Dzina ladziko lonse losakhala la Hartil-D ndi Ramipril + hydrochlorothiazide.
Ath
ATX Code C09BA05
Kutulutsa mafomu ndi kapangidwe kake
Mankhwalawa amapezeka ngati mapiritsi okhala ndi mawonekedwe achikasu. Mawu olembedwa mbali imodzi, kutengera mlingo:
- 2,5 mg - mbali imodzi ndi 12.5 mg - mbali inayo, mbali zonse ziwiri za ziopsezo;
- 5 mg mbali imodzi ndi 25 mg mbali inayo, mbali zonse ziwiri za zoopsa.
Mu katoni imodzi, mutha kukhala matuza awiri a zidutswa 14 chimodzi.
Mapiritsiwo ali ndi zinthu ziwiri:
- ramipril mu mlingo wa 2,5 kapena 5 mg;
- hydrochlorothiazide - 12,5 mg kapena 25 mg, motero.
Kuphatikiza apo - makulidwe, utoto ndi zinthu zina zofanana.
Zotsatira za pharmacological
Ramipril ndi mankhwala oopsa. Imachepetsa ntchito ya ACE inhibitor (exopeptidase), yomwe imapangitsa kuti pakhale zotsatira zowopsa: kukana kwathunthu kwa zotumphukira ndi zotumphukira za m'magazi kumakhala kocheperako, kutulutsa kwamtima kumawonjezeka ndikukana kukana ndi nkhawa kumachuluka.
Kuphatikiza apo, chinthu chogwira bwino chimathandizira kutsika kwa magazi kupita ku myocardium ndikuchepetsa kufalikira kwa vuto la mtima, kumachepetsa mwayi wokhala ndi mtima wovuta.
Wachiwiri wogwira mankhwala - hydrochlorothiazide - amatanthauza thiazides okhala ndi okodzetsa.
Zimasintha mulingo wa sodium ndipo zimachepetsa mayankho ku norepinephrine ndi mtundu II angiotensin.
Mothandizidwa ndi Hartil-D, kupanikizika kwa mitsempha ya portal kumachepa.
Odwala omwe ali ndi matenda a shuga omwe ali ndi nephropathy mothandizidwa ndi mankhwalawa, kupanikizika kwa mitsempha ya portal kumachepetsedwa ndikukula kwa kulephera kwa impso kumalepheretsedwa.
Mankhwalawa amayamba pafupifupi ola limodzi pambuyo pa kukhazikitsa ndipo amatha pafupifupi tsiku limodzi.
Pharmacokinetics
Kuyamwa kwa chinthu cha antihypertensive kumachitika mwachangu, ndipo patatha ola limodzi kutalika kwake kumafika (50-60%). Amapanga metabolites yogwira komanso yolimba yomwe imamangiriza gawo la protein.
The diuretic imatengedwa mwachangu ngati ramipril, imagawidwa mosavuta ndikuchotseredwa ndi 90% ndi impso mu mawonekedwe awo apoyamba.
Amayikidwamo m'njira zofanana ndendende ndi mkodzo komanso ndowe.
Mu vuto laimpso, kuwonongeka kwa ramiprilat (yogwira metabolite) kumawonjezeka, komanso vuto la chiwindi, ramipril.
Zizindikiro zogwiritsidwa ntchito
Hartil D amawonetsedwa chifukwa cha kuthamanga kwa magazi, koma amagwiritsidwanso ntchito pa matenda ena a mtima ndi impso.
Amanenanso zochizira matenda otere:
- kulephera kwa mtima;
- matenda oopsa;
- matenda ashuga kapena nondiabetesic nephropathy;
- IHD kuchepetsa kuthekera kwa myocardial infarction kapena ubongo hemorrhage (sitiroko).
Chizindikiro chogwiritsidwa ntchito ndikofunikira kwa kuphatikiza mankhwalawa okodzetsa ndi othandizira antihypertensive.
Contraindication
Musamwe mankhwala ngati:
- zophatikizika pazigawo zilizonse za mankhwala kapena zochokera ku gulu la sulfonamide;
- kukhalapo kwa edema ya zigawo zakuya za dermis ndi zotumphukira zimakhala mu anamnesis;
- Kuchepetsa kwamitsempha yama chiwindi ndi vuto la kuthamanga kwa magazi kapena kuchepa kwa mitsempha ya impso imodzi;
- cholestasis;
- ochepa hypotension;
- mpaka zaka 18, chifukwa chosowa deta pazokhudza thupi la ana;
- pamene adrenal cortex imabisalira aldosterone yambiri kuposa momwe amafunikira;
- kulephera kwa aimpso.
Kuchiza ndi akazi sikulimbikitsidwa pakakhala pakati komanso poyamwitsa.
Ndi chisamaliro
Ndi kulondola kwambiri ndikuyang'aniridwa ndi dokotala, amalembedwa ngati aldosteronism yoyamba, tsankho kapena malabsorption a shuga kapena galactose, pa hemodialysis.
Momwe mungatenge Hartil D
Mlingo wofotokozedwa ndi dokotala aliyense payekhapayekha.
Mapiritsi amatengedwa nthawi zambiri m'mawa, osafuna kutafuna. Nthawi yomweyo amamwa madzi ambiri. Osayanjana ndi zakudya zamafuta.
Mapiritsi a Hartila-D amatengedwa nthawi zambiri m'mawa, osafuna kutafuna.
Pazipita tsiku mlingo sayenera upambana 10 mg.
Mlingo wamatenda osiyanasiyana:
- Matenda oopsa a arterial - 2.5-5 mg patsiku, kutengera mphamvu yomwe apanga.
- Kulephera kwa mtima kosatha - 1.25-2.5 mg. Ndi kuchuluka kwa kuchuluka kwa kuchuluka kwa 2.5 mg akhoza kugawidwa mu 2 waukulu.
- Pambuyo pa kulowetsedwa kwa myocardial, kuphatikiza kwa ramipril + hydrochlorothiazide sichikuperekedwa kale kuposa tsiku lachitatu pambuyo povuta. Mlingo - 2,5 mg kawiri pa tsiku. Kuchuluka kwa 5 mg 2 kawiri pa tsiku.
- Pofuna kupewa matenda a mtima, mulingo woyambira ndi 2,5 mg, pambuyo pake pakapita milungu iwiri, komanso ngakhale kawiri pambuyo pa masabata atatu. Mlingo wokwanira wokonza tsiku ndi tsiku si oposa 10 mg.
Ndi matenda ashuga
Kumayambiriro kwa mankhwalawa, theka la mapiritsi a 2.5 mg amatengedwa 1 nthawi patsiku. M'tsogolomu, ngati pakufunika kutero, muthanso kuchuluka kwa tsiku ndi tsiku mpaka 5 mg pawiri.
Zotsatira zoyipa za Hartila D
Nthawi zambiri, osafunikira kuwonetsa zochita za mankhwalawa zimagwirizana ndi ntchito ya m`mimba thirakiti, hematopoiesis, chapakati mantha dongosolo, kwamikodzo ndi genitourinary, kupuma dongosolo, khungu, endocrine dongosolo, chiwindi ndi biliary thirakiti.
Matumbo
Kusanza, kusanza, kamwa youma, stomatitis, kusokonezeka kwa chopondapo.
Hematopoietic ziwalo
Kuchokera ku ziwalo za hemopoietic, kusintha pakuwunika kwa zizindikiro kumatha:
- mulingo wa hemoglobin (dontho, kupezeka kwa magazi m'thupi);
- kuchuluka kwa maselo ofiira am'magazi, maselo oyera am'magazi ndi mapulateleti (kuchepa);
- kuchuluka kwa calcium (dontho).
Pakati mantha dongosolo
Kuyamba kwa mphwayi, kuchuluka kugona, nkhawa, kulira m'makutu, chizungulire komanso kufooka sikuwonetsedwa.
Kuchokera kwamikodzo
Kuwonekera kwa impso kungayambitse oliguria,
Kuchokera ku kupuma
Bronchospasm, Rhinitis, chifuwa chowuma, kupuma movutikira.
Pa khungu
Kutupa, paresthesia, kutuluka thukuta kwambiri, kumva kutentha m'malo ena a khungu, alopecia.
Kugwiritsa ntchito Hartila-D kungayambitse thukuta kwambiri.
Kuchokera ku genitourinary system
Anachepetsa libido, erectile kukanika.
Kuchokera pamtima
Dontho mu kuthamanga kwa magazi mukayimirira kapena mukuyimirira, kusinthasintha kwa mtima, kusokonekera kwa matenda a Raynaud.
Pothana ndi kuthamanga kwa magazi komanso kuthina kwambiri, magazi obwera chifukwa cha m'mimba.
Dongosolo la Endocrine
Kuchuluka kwa seramu glucose ndi uric acid.
Pa mbali ya chiwindi ndi biliary thirakiti
Jaundice cholestatic, hepatitis, chiwindi kulephera, cholecystitis, chiwindi necrosis.
Matupi omaliza
Thupi lawo siligwirizana angathe kuchitika mu:
- urticaria;
- kuchuluka kwa zithunzi;
- angioedema a nkhope kapena larynx;
- kutupa kwa maondo
- kukokoloka kwachabe;
- conjunctivitis, etc.
Kugwiritsidwa ntchito kwa Hartila-D kungayambitse kuyipa kwamtundu wa urticaria.
Ndi zovuta zonse zomwe zimachitika, mapiritsiwo adathetsa.
Zokhudza mphamvu pakuwongolera njira
Popeza kugwira ntchito mosiyanasiyana kumafuna chisamaliro, ndiye, poganizira zomwe zingachitike ndi mankhwalawo, munthu ayenera kupewa kuyendetsa galimoto ndi magalimoto oyambira koyambirira koyambirira kwa chithandizo.
Zotsatira zoyipa zimawonekeranso monga:
- Hyperkalemia
- Hyperazotemia;
- hypercreatininemia;
- kuchuluka asafe otsalira;
- kusintha zina zalabu zasayansi.
Thupi lam'mimba limayankha mankhwalawo ndi kukokana minofu, nyamakazi ndipo, kawirikawiri, ziwalo.
Malangizo apadera
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Mankhwala okhazikika contraindicated wachiwiri ndi wachitatu trimesters wa mimba. Pakadali pano, mwayi wambiri wa kuledzera kumabweretsa mluza. Chifukwa cha zochita za mankhwala, mwana wosabadwayo angathe:
- aimpso kuwonongeka;
- kukula kubwezeretsa;
- oligohydramnios;
- kuchedwa kugundidwa kwa chigaza.
Hartil-D ndiwotsutsana kwathunthu mu wachiwiri ndi wachitatu trimesters wa mimba.
M'tsogolomu, zovuta za akhanda zimatha kukhala:
- kuthamanga kwa magazi;
- Hyperkalemia
- thrombocytopenia.
Popeza pali kutulutsidwa kwa mankhwalawa mkaka wa m'mawere, ndikofunikira kusiya kuyamwitsa.
Kukhazikitsidwa kwa Hartil D kwa ana
Kafukufuku wokhudzana ndi mankhwalawa kwa ana sanachitike, chifukwa, kufikira zaka khumi ndi zisanu ndi zitatu sizinalembedwe.
Gwiritsani ntchito mu ukalamba
Lembani mosamala kwambiri komanso muyezo wotsika kwambiri.
The ntchito aimpso kuwonongeka
Pakulephera kwa aimpso, mlingo ndi njira ya chithandizo ziyenera kusinthidwa.
Pazipita tsiku mlingo sayenera upambana 5 mg.
Pakulephera kwa aimpso, mlingo wa Hartila-D ndi njira ya chithandizo uyenera kusinthidwa.
Gwiritsani ntchito ntchito yolakwika ya chiwindi
Mulingo wambiri watsiku ndi tsiku ngati vuto la chiwindi likulephera kukwera kuposa 2,5 mg, ndipo chithandizo, chifukwa cha kusakwanira kwa zomwe zimachitika ndi mankhwalawa, chimachitika pokhapokha kuyang'aniridwa ndi dokotala.
Mankhwala osokoneza bongo a Hartil D
Zikuwoneka:
- kukokana
- kuchepa kwakukulu kwa kuthamanga kwa magazi;
- kusungika kwamikodzo;
- matumbo kutsekereza;
- kusinthasintha kwa mtima, etc.
Njira yofunika kuchitapo kanthu mwachangu ndikugwiritsa ntchito mpweya woyambitsa ndi sodium sulfate.
Kuperekanso chithandizo kumatengera zizindikirocho, komanso nthawi ya mankhwalawa komanso mlingo.
Kuchita ndi mankhwala ena
Itha kugwiritsidwa ntchito limodzi ndi thrombolytics, beta-blockers, acetylsalicylic acid.
Chisamaliro chofunikira chimafunikira pakatha kuphatikizana kwa mankhwala omwe afotokozedwa ndi:
- okodzetsa;
- opaleshoni;
- ma tridclic antidepressants;
- organic nitrate;
- vasodilators;
- antipsychotic mankhwala.
Mwina kugwiritsa ntchito Hartila-D ndi acetylsalicylic acid.
Chifukwa chake, munthawi yomweyo makonzedwe opatsa mphamvu amachititsa kuti magazi achepe.
Mukamagwiritsidwa ntchito ndi thiazide diuretics, kuchuluka kwa calcium kwamankhwala kumatheka.
Ma anesthetics, ma organic nitrate (nthawi zambiri nitroglycerin), mankhwala a antipsychotic, ndi ma tridclic antidepressants amapereka chimodzimodzi.
Mankhwala omwe amalimbikitsa kuchuluka kwa potaziyamu m'magazi (mwachitsanzo, okonza potaziyamu monga Spironolactone, Triamteren, Renial, etc.), cyclosporins ikhoza kupereka mphamvu ya hyperkalemia.
Mchere wa lithiamuum umakhala wowopsa mukamamwa ndi zoletsa za ACE, chifukwa chake, musaphatikizane mu gawo limodzi.
Hypokalemia imatha kuchitika mukamamwa ndi mtima wama glycosides ndi mankhwala ena a antipsychotic.
Mphamvu ya antihypertensive imafooketsa kuphatikiza ndi sympathomimetics ndikugwiritsa ntchito nthawi yayitali ndi mankhwala osapweteka a antiidal.
Kuyenderana ndi mowa
Ndikothekanso kukulitsa zovuta za mowa, chifukwa chake olowa nawo samalimbikitsidwa.
Analogi
Pali ma fanizo omwe ali ndi zinthu zomwezo ndi zomwezo.
- Amprilan nl (Slovenia) - mapiritsi 30;
- Ramazid n (Malta kapena Iceland) - zidutswa 10, 14, 28, 30 ndi 100.
Mankhwala ofanana nawo amapezekanso, koma ndi zinthu zina zomwe zingagwire ntchito:
- Tsata kuphatikiza;
- Enalapril;
- Enani R;
- Prestarium ndi ena
Kupita kwina mankhwala
Amamasulidwa pa mankhwala.
Kodi ndingagule popanda kulandira mankhwala?
Palibe mankhwala omwe sanapatsidwe.
Mtengo wa Hartil D
Mtengo wa mapiritsi olongedza kuchuluka kwa zidutswa 28 ndi:
- kuchokera pa ma ruble 455 - 2.5 mg / 12.5 mg;
- kuchokera ma ruble 590 - 5 mg / 25 mg.
Zosungidwa zamankhwala
Ndikulimbikitsidwa kusunga mankhwalawo pamtunda osapitirira + 25º C m'malo osapezeka ndi ana ndi nyama.
Ndikulimbikitsidwa kusunga Hartil-D pa kutentha osaposa + 25º C.
Tsiku lotha ntchito
Tsiku lotha ntchito limalembedwa pa ma CD. Musagwiritse ntchito zaka 3 kuchokera tsiku lopangira.
Wopanga
Kupanga kwa Germany kwa kampani "Alfamed Farbil Artsnaymittel GmbH" mumzinda wa Gottingen.
Amapangidwa ku fakitale ya Pharmaceutical Plant EGIS CJSC ku Hungary.
Ndemanga za Hartil D
Omvera zamtima
Anton P., katswiri wamtima, Tver
Kuchita kwawonetsera mphamvu ya mankhwalawa pochiza matenda oopsa. Ndiosavuta kugwiritsa ntchito ngati mgwirizano wa ACE inhibitors ndi okodzetsa wasonyezedwa.
Elena A., katswiri wamtima, Murmansk
Mankhwala othandizira a antihypertensive, omwe angagwiritsidwenso ntchito kupewa matenda a mtima. Zomwe zimangoyambitsa ndi mavuto ambiri, nthawi zina zoopsa.
Odwala
Vasily, wazaka 56, Vologda
Ndakhala ndikuvutika ndi matenda oopsa kwa zaka zambiri. Pafupifupi miyezi iwiri yapitayo ndinalandira mankhwala a udokotala kuchokera kwa dokotala. M'masiku oyambira, chizungulire chimazunza ndikusokoneza pang'ono. Adauza adotolo ndipo atatha kusintha pang'onopang'ono, zonse zidakhala m'malo, tsopano thanzi langa ndilabwino.
Ekaterina, wazaka 45, mzinda wa Kostroma
Dotolo atayala mapiritsiwo, adalongosola kuti popeza mankhwala ophatikizika ndi ofunika kuchipatala, awa akuwoneka kuti ndi abwino kwambiri pankhaniyi. Zinali zosavuta kuudya kamodzi patsiku, ndipo palibe chifukwa chokumbukira kuti muzidya musanadye, nthawi ya chakudya kapena itatha. Ngati mwayiwala musanadye chakudya cham'mawa, ndiye kuti mutha kumwa pambuyo pake. Zovuta zokhazokha - m'masiku angapo oyambirirawo ndinasiya kuyendetsa galimoto, chifukwa mutu wanga unayamba chizungulire. Koma kenako zonse zidapita, ndipo tsopano ndimamwa mankhwalawa tsiku lililonse.
