Pyramil ya mankhwala: malangizo ogwiritsira ntchito

Pakati pa mankhwala ochizira kuthamanga kwa magazi (BP), Pyramil adadziwika. Mankhwalawo amalepheretsa ntchito ya enzymatic pakusintha kwa angiotensin I. Zotsatira za Hypotensive ndi mtima zimawonedwa. Chifukwa cha kuphatikiza kwa mankhwala onse awiriwa, zidatheka kuchepetsa chiopsezo chokhala ndi myocardial infarction, stroke ndikuwonjezera kuchuluka kwa odwala omwe ali ndi zotupa zam'mimba.

Dzinalo Losayenerana

Ramipril

Pakati pa mankhwala ochizira kuthamanga kwa magazi (BP), Pyramil adadziwika.

ATX

C09AA05

Kutulutsa mafomu ndi kapangidwe kake

Mankhwala amapezeka piritsi. Mapiritsi a Oblong biconvex ali ndi 5 kapena 10 mg yogwira mankhwala a ramipril. Monga zida zothandizira popanga zimagwiritsidwa ntchito:

• colloidal silicon dioxide;
• glyceryl dibehenate;
• ma cellcose a microcrystalline;
• glycine hydrochloride;
• pregelatinized wowuma.

Mapiritsi a 5 mg ndi a pinki opepuka chifukwa chowonjezera pa utoto wofiira wochokera ku chitsulo. Chiwopsezo chimapezeka kokha kumbali yakutsogolo.

Microcrystalline cellulose imagwiritsidwa ntchito ngati zida zothandiza popanga Pyramil.

Zotsatira za pharmacological

Mankhwalawa ndi a ACE inhibitors (angiotensin-akatembenuka enzyme). Ikafika m'chiwindi, ma hydrolyzes omwe amagwira ntchito amapanga mankhwala omwe agwira - ramiprilat, yomwe imafooketsa mphamvu ya ACE (angiotensin-kutembenuza enzyme imathandizira kutembenuka kwa angiotensin I kupita ku angiotensin II pamachitidwe a mankhwala).

Ramipril amalepheretsa plasma ndende ya angiotensin II, amachepetsa kubisalira kwa aldosterone ndipo nthawi yomweyo amalimbikitsa mphamvu ya renin. Pankhaniyi, kinase II blockade imachitika, kupanga kwa prostaglandin kumawonjezeka ndipo bradycardin sikuphwanyidwa. Zotsatira za zomwe zimagwira, zinthu zonse zotumphukira mtima (OPSS) zimachepa, chifukwa zomwe zimakulitsa.

Pharmacokinetics

Pakaperekedwa pakamwa, mankhwalawa amalowetsedwa m'matumbo ang'onoang'ono, osasamala chakudyacho. Mothandizidwa ndi esterase, hepatocytes amasintha a ramipril kukhala ramiprilat. Chovunda chimaletsa angiotensin-kutembenuza enzyme nthawi 6 mwamphamvu kuposa ramipril. Mankhwalawa amafikira pazomwe zimachitika mu plasma patatha ola limodzi pambuyo pa makonzedwe, pomwe mankhwalawa amapezeka pambuyo pa maola 2-4.

Ikalowa m'magazi, gawo lathanzi limamangidwa kumapuloteni a plasma ndi 56-73% ndikuyamba kugawidwa minofu yonse. Hafu ya moyo wa mankhwala osagwiritsidwa ntchito kamodzi ndi maola 13 mpaka 17. Ramipril ndi metabolite yogwira amuchotsera impso ndi 40-60%.

Ramipril ndi metabolite yogwira amuchotsera impso ndi 40-60%.

Zizindikiro zogwiritsidwa ntchito

Mankhwala amathandizidwa kuti athandizidwe komanso kupewa matenda otsatirawa:

• nephropathy ya matenda ashuga komanso osadwala matenda oyamba kapena gawo la chipatala, limodzi ndi matenda oopsa, proteinuria ndi kutulutsa kwa albumin mkodzo;
• shuga mellitus wophatikizidwa ndi zinthu zowonjezera mu mawonekedwe a matenda oopsa, kuchuluka kapena kuchepa kwa cholesterol ndi otsika Mlomo lipoprotein, zizolowezi zoipa;
• kuthamanga kwa magazi m'mitsempha yayikulu;
• Kulephera kwamtima kwambiri, komwe kunayamba patangopita masiku 2-9 pambuyo pa vuto la mtima.

Mankhwalawa amathandiza kuchepetsa chiopsezo chobwereranso kwa anthu omwe adalumikizana ndi kuthamanga kwa ziwiya za mtima kapena aorta, matenda amtima, angioplasty amitsempha yama coronary, stroke. Mankhwala ndi gawo limodzi la mankhwala ochizira matenda a mtima osalephera.

Contraindication

Nthawi zina, mankhwalawa ali osavomerezeka kapena oletsedwa kugwiritsidwa ntchito:

• kwambiri aimpso kapena kwa chiwindi kusakwanira;
• Cardiogenic mantha;
• kuthamanga kwa magazi ngati magazi a systolic ali pansi pa 90 mm Hg. st.;
• hyperaldosteronism;
• stenosis ya mitral valavu, msempha, aimpso minyewa;
• mtima wowononga;
• mimba ndi mkaka wa m`mawere;
• ana ochepera zaka 18;
• kuchuluka kwa zimakhala ndi zigawo zikuluzikulu za mankhwala.

Panthawi yapakati, nthawi zina, Pyramil siyikulimbikitsidwa kapena kuletsedwa kuti igwiritsidwe ntchito.

Ma piramidi samalimbikitsidwa pakuchepetsedwa.

Ndi aortic stenosis, kugwiritsa ntchito Pyramil sikulimbikitsidwa.

Ana osakwana zaka 18 saloledwa kutenga Pyramil.

Ma piramidi ndi oletsedwa pokhapokha ngati pali vuto la cardiogenic.

Panthawi yoyamwa, sikulimbikitsidwa kugwiritsa ntchito Pyramil.

Chenjezo limaperekedwa mukamamwa ma immunosuppressants, okodzetsa, saluretics.

Momwe mungatenge Pyramil

Mankhwala adapangira pakamwa. Mlingo wa tsiku ndi tsiku komanso nthawi yayitali ya mankhwala amatsimikiziridwa ndi kupezeka dokotala potengera momwe wodwalayo aliri, mbiri ya zamankhwala ndi mayeso a labotale. Udindo wofunikira kwambiri pakupeza njira zamankhwala umayimbidwa ndi kuuma komanso mtundu wa matenda.

Ndi matenda ashuga

Pa gawo loyambirira la mankhwala, ndikulimbikitsidwa kutenga piritsi ya 5 mg tsiku limodzi. Kutengera ndi mtundu wina waumoyo, muyezo watsiku ndi tsiku umatha kuwonjezeredwa kawiri mpaka muyeso wa 5 mg mosokoneza masabata awiri.

Zotsatira zoyipa Pyramil

Zotsatira zoyipa za kumwa mankhwalawa zimawonekera kutengera momwe thupi limapangidwira ndi mankhwala omwe amapanga.

Pa mbali ya gawo la masomphenyawo

Kuwona kwamphamvu kumachepa, kuwonekera ndikusokonekera. Nthawi zina, conjunctivitis imayamba.

Kuchokera minofu ndi mafupa

Mphamvu ya minofu ndi mafupa amakumana ndi mawonetsedwe pafupipafupi a minofu kukokana komanso kupweteka kwa molumikizana.

Matumbo

Zotsatira zoyipa zamagetsi pazomwe zimagwiritsa ntchito mankhwala osokoneza bongo zimadziwonetsera monga:

• kupweteka ndi kusapeza bwino mu dera la epigastric;
• kutsegula m'mimba, kusefukira, kudzimbidwa;
• kusanza, nseru;
• dyspepsia;
• kamwa yowuma
• Anachepetsa chilimbikitso mpaka kukula kwa anorexia;
• kapamba wokhala ndi chiyembekezo chochepa cha kufa.

Zotsatira zoyipa Pyramil - kukula kwa conjunctivitis nthawi zina.

Ululu komanso kusapeza bwino mu gawo la epigastric chifukwa cha chithandizo cha Pyramil.

Zotsatira zoyipa za kugwiritsa ntchito Pyramil ndi kutsekula m'mimba, kusokonekera, kudzimbidwa.

Kukula kwa kapamba chifukwa chogwiritsa ntchito Pyramil.

Pakamwa pakamwa pamatha kuthandizidwa ndi Pyramil.

Zotsatira zoyipa Pyramil imawonetsedwa ndi kuwonetsa pafupipafupi minofu kukokana komanso kupweteka kwa molumikizana.

Kusungunula, mseru chifukwa chogwiritsa ntchito Pyramil.

Mwina kuwonjezeka kwa ntchito ya aminotransferase mu hepatocytes, hepatocellular amana. Pali chinsinsi cha pancreatic madzi, kuchuluka kwa magazi a bilirubin m'magazi, chifukwa cha zomwe amayambitsa cholestatic jaundice.

Hematopoietic ziwalo

Poyerekeza ndi momwe mankhwalawo amathandizira pakumwa mankhwala, pali mwayi wokhala ndi kusintha kwa agranulocytosis ndi neutropenia, kuchepa kwa maselo amwazi ndi kuchuluka kwa hemoglobin.

Pakati mantha dongosolo

Zotsatira zoyipa pakatikati ndi zotupa zamanjenje zimawonetsedwa ngati:

• chizungulire ndi mutu;
• kutaya mtima;
• parosmia;
• kumverera koyaka;
• kutayika kwa bwino;
• kugwedezeka kwamiyendo.

Pophwanya ufulu wamaganizidwe, nkhawa, kuda nkhawa, kusokonezeka kwa tulo kumayang'aniridwa.

Kuchokera kwamikodzo

Pali kuwonjezeka kwa kusokonezeka kwa kusefukira kwa glomerular, chifukwa mapuloteni omwe amapezeka mumkodzo, ndipo mulingo wa creatinine ndi urea m'magazi umakwera.

Pali kuwonjezeka kwa kusokonezeka kwa kusefukira kwa glomerular, chifukwa mapuloteni omwe amapezeka mumkodzo, ndipo mulingo wa creatinine ndi urea m'magazi umakwera.

Kuchokera ku kupuma

Zotsatira zoyipa za kupuma zimawonekera mwa mawonekedwe a bronchitis, chifuwa chowuma pafupipafupi, kupuma movutikira, sinusitis.

Pa khungu

Odwala omwe ali ndi chizolowezi chowonetsa thupi lawo siligwirizana ali ndi chiopsezo chowonjezereka cha khungu la khungu, urticaria ndi hyperhidrosis. Photosensitization sichachilendo - kuzindikira kuwala, alopecia, zizindikiro zowipira za psoriasis, onycholysis.

Kuchokera ku genitourinary system

Mwa amuna, munthawi ya mankhwala, mankhwalawa amayamba kuchepa kwa mphamvu ya erectile dysfunction (kusabala) ndi gynecomastia.

Kuchokera pamtima

Zotsatira zoyipa za mankhwala pamagetsi zimawonekera m'njira zotsatirazi:

• orthostatic hypotension;
• arrhythmia, tachycardia;
• vasculitis, matenda a Raynaud;
• zotumphukira kufalikira;
• kusefukira kwa nkhope.

Poyerekeza ndi mbiri ya stenosis yamitsempha yamavuto, kukula kwamatenda oyendayenda ndikotheka.

Zotsatira zoyipa za chapakati komanso zotumphukira zamitsempha yamafuta pakumwa mankhwala ndi Pyramil zimawoneka ngati thambalala lakumapeto.

Odwala omwe ali ndi chizolowezi chowonetsa thupi lawo siligwirizana ali ndi chiopsezo chowonjezereka cha khungu la khungu, urticaria ndi hyperhidrosis.

Mutu umatha chifukwa cha kudya piramidi.

Mwa amuna, munthawi yamankhwala, kuchepa kwa potency ndikotheka.

Mukamagwiritsa ntchito Pyramil, zotsatira zoyipa pa kupuma zimawonetsedwa ngati chifuwa chowuma pafupipafupi.

Ngati malingaliro osokoneza bongo asokonezeka chifukwa chotenga Pyramil, kusokonezeka kwa kugona kumawonedwa.

Dongosolo la Endocrine

Mwachizolowezi, kuoneka kopanga kosalamulika kwa mahomoni a antidiuretic ndikotheka.

Pa mbali ya chiwindi ndi biliary thirakiti

Chiwopsezo chokhala ndi hepatitis ndi cholecystitis chikuwonjezeka.

Kuchokera kumbali ya kagayidwe

Zolemba za potaziyamu m'magazi zimachuluka.

Matupi omaliza

Pamaso pa hypersensitivity ku ramipril ndi gawo lothandizira la Pyramil, zotsatirazi zimayambitsa mavuto:

• angioedema;
• Matenda a Stevens-Johnson;
• zotupa, kuyabwa, kuphimba;
• alopecia;
• anaphylactic mantha.

Zokhudza mphamvu pakuwongolera njira

Munthawi yamankhwala omwe mumalandira mankhwalawa, ndikofunikira kuti musayendetse kuyendetsa galimoto, kugwiritsa ntchito njira zovuta, komanso zochitika zina zomwe zimafuna kuti anthu aziganiza bwino komanso aziganiza mwachangu.

Munthawi yamankhwala omwe mumalandira, ndikofunikira kuti musayendetse.

Malangizo apadera

Musanayambe mankhwala osokoneza bongo, ndikofunikira kudzaza kuchepa kwa sodium ndikuchotsa hypovolemia. Mutatenga mlingo woyamba, odwala ayenera kuyang'aniridwa ndi achipatala kwa maola 8, popeza pamakhala ngozi yotenga orthostatic hypotension.

Pamaso pa cholestatic jaundice, mbiri ya edema, ndikofunikira kusiya kumwa mankhwalawa. Pakukonzanso pambuyo pakuchita opaleshoni yayikulu, kutsika kwa magazi ndikotheka, chifukwa chake, mankhwalawa amayenera kuthetsedwa maola 24 asanafike opaleshoni.

Gwiritsani ntchito mu ukalamba

Chenjezo limaperekedwa tikamamwa ndi anthu azaka zopitilira 65 chifukwa cha kuchuluka kwa matenda aimpso, mtima komanso chiwindi.

Kupatsa ana

Ndi zoletsedwa kugwiritsa ntchito mpaka zaka 18.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Mankhwala ali ndi teratogenic pa kakulidwe kazakudya ka mwana wosabadwayo, chifukwa chake, kutenga Pyramil panthawi yakukonzekera kapena kutenga pakati ndikuloledwa.

Pa mankhwala, tikulimbikitsidwa kusiya kuyamwa.

The ntchito aimpso kuwonongeka

Mankhwala sayenera kumwedwa ndi creatinine chilolezo zosakwana 20 ml / min. Chenjezo limaperekedwa kwa odwala pambuyo pakutsala kwa impso.

Gwiritsani ntchito ntchito yolakwika ya chiwindi

Chenjezo liyenera kuchitidwa pamene chiwindi sichikugwira ntchito moyenera. Zophwanya kwambiri, kulandiridwa kwa Pyramil kuyenera kuti kuthetsedwe.

Piramidi ya overdose

Ndi mankhwala osokoneza bongo, mawonetsedwe osokoneza bongo amawonekera:

• chisokonezo ndi kutayika kwa chikumbumtima;
• tsinde;
• kulephera kwaimpso;
• kugwedeza
• kuphwanya mulingo wamchere wamchere m'thupi;
• dontho la kuthamanga kwa magazi;
• bradycardia.

Chisamaliro chiyenera kutengedwa mukamatenga Pyramil ndi vuto losayenera la chiwindi.

Ndi nkhanza ya Pyramil, kutha kwa chikumbumtima kumawonedwa.

Chenjezo limaperekedwa tikamamwa ndi anthu azaka zopitilira 65 chifukwa cha kuchuluka kwa matenda aimpso, mtima komanso chiwindi.

Ngati maola ochepera 4 adatha mutatha kumwa mankhwala ambiri, ndiye kuti akuyenera kuti asambe, asambe m'mimba, ndikupatseni adsorbent. Mukumwa kwambiri, mankhwalawa cholinga chake ndicho kubwezeretsanso ma electrolyte ndi kuthamanga kwa magazi

Kuchita ndi mankhwala ena

Ndi munthawi yomweyo Pyramil ndi mankhwala ena, zotsatirazi zimachitika:

1. Mankhwala omwe ali ndi mchere wa potaziyamu kapena kuchuluka kwa seramu potaziyamu ndi heparin amachititsa hyperkalemia.
2. Kutsika kwakanthawi kwa kupanikizika ndikotheka pamodzi ndi mapiritsi ogona, analgesics ndi mankhwala osokoneza bongo a narcotic.
3. Chiwopsezo chokhala ndi leukopenia kuphatikiza ndi ramipril ndi allopurinol, corticosteroids, procainamide ichulukitsidwa.
4. Mankhwala osagwirizana ndi antisteroidal amachepetsa mphamvu ya Pyramil ndikuwonjezera mwayi wa kulephera kwa impso.
5. Ramipril amachulukitsa mwayi wokhala ndi mantha a anaphylactic panthawi yakudya.

Kusagwirizana kumawonedwa limodzi ndi mankhwala okhala ndi aliskiren, okhala ndi angiotensin II olimbana nawo, olimbitsa ma cell membrane.

Kuyenderana ndi mowa

Mukamamwa ethyl mowa, ndizotheka kukulitsa chithunzi cha matenda a vasodilation. Ramipril amalimbikitsa poizoni wama ethanol pachiwindi, motero mukamamwa Pyramil, muyenera kupewa kumwa mowa.

Analogi

Zofanizira za Pyramil ndizophatikizira:

• Amprilan;
• Mapiritsi a Pyramil Owonjezera;
• Tsata;
• Dilaprel.

Kusinthira ku mankhwala ena kumachitika pambuyo poyankhulana ndi dokotala.

Kupita kwina mankhwala

Mankhwala amagulitsidwa ndi mankhwala.

Kodi ndingagule popanda kulandira mankhwala?

Chifukwa cha chiwopsezo chowonjezeka chomanga thupi, kugulitsa kwaulere kwa Pyramil koletsedwa.

Amprilan ndi amodzi mwa mawonekedwe a Pyramil.

Dilaprel ndi analogue ya Pyramil.

Analogue ya Pyramil ndi Tritace.

Mtengo wa piramidi

Mtengo wapakati wa mankhwalawa umasiyanasiyana kuyambira 193 mpaka 300 rubles.

Zosungidwa zamankhwala

Ndikulimbikitsidwa kuti mankhwalawo akhale m'malo owuma, otetezedwa ndi dzuwa, kutentha mpaka + 25 ° C.

Tsiku lotha ntchito

Zaka 2

Wopanga

Sandoz, Slovenia.

Ndemanga za piramidi

Tatyana Nikova, wazaka 37, Kazan

Dotolo adayikira mapiritsi a Pyramil chifukwa ndimadwala matenda oopsa. Kupanikizika kwa mafunde m'mawa kuliwalika zaka ziwiri. Koma muyenera kumwa mankhwalawo pafupipafupi. Zotsatira zake sizipulumutsidwa. Ndimakonda mtengo wabwino. Zotsatira zoyipa, ndimatha kusiyanitsa chifuwa chowuma.

Maria Sherchenko, wazaka 55, Ufa

Ndimamwa mapiritsi ochepetsa kuthana ndi sitiroko. Ambiri sanathandize, koma kenako anakumana ndi Pyramil. Poyamba, sizinachitike chifukwa cha kuchuluka kwa mankhwalawa, koma patatha milungu iwiri, kuchuluka kwa mankhwalawa kunawonjezeka, kupanikizika kunayamba kuchepa. Ndimamva bwino, koma ndikukumana ndi kulephera kwa mapiritsi okhala ndimankhwala angapo. Kupeza kuphatikiza koyenera ndikovuta.