Aprovel ndi mankhwala opangira zochizira matenda oopsa komanso nephropathy. Amaloledwa kugwiritsa ntchito mankhwala a shuga. Pankhaniyi, mankhwalawa sayambitsa achire matenda atasiya ntchito. Mankhwalawa amapezeka mu mawonekedwe a mapiritsi, omwe amalola madokotala kuti asamalamulire mankhwalawo. Odwala pawokha amatha kusintha njira zina zochizira mankhwalawa panthawi yoyenera.
Dzinalo Losayenerana
Irbesartan.
Aprovel ndi mankhwala opangira zochizira matenda oopsa komanso nephropathy.
ATX
C09CA04.
Kutulutsa mafomu ndi kapangidwe kake
Mankhwalawa amapezeka m'mapiritsi otsekemera olimbitsa thupi. Gawo lamankhwala lili ndi 150, 300 mg yogwira ntchito - irbesartan. Monga zida zothandizira popanga zimagwiritsidwa ntchito:
- shuga mkaka;
- hypromellose;
- colloidal dehydrate silicon dioxide;
- magnesium wakuba;
- croscarmellose sodium.
Utoto wamafilimuwo umakhala ndi sera wa carnauba, macrogol 3000, hypromellose, titanium dioxide ndi shuga mkaka. Mapiritsiwo ali ndi mawonekedwe owuma a biconvex ndipo amapaka utoto woyera.
Zotsatira za pharmacological
Zochita za Aprovel zimakhazikitsidwa ndi irbesartan, wokonda kwambiri wosankha angiotensin II receptors. Chifukwa cha kuponderezana ndi zochitika za receptor, kuchuluka kwa aldosterone m'madzi a m'magazi kumachepa. Mlingo wa sodium ions mu seramu yamagazi sasintha ngati wodwala sagwiritsa ntchito molakwika mankhwalawo ndipo amangomvera mlingo wovomerezeka wa tsiku ndi tsiku.
Chifukwa cha momwe amapangira mankhwala, kuchepa kwa kuthamanga kwa magazi kumawonedwa. Poterepa, palibe kuchepa kwa kugunda kwa mtima. Ndi kumwa kamodzi kwa 300 mg, kutsika kwa magazi kuthamanga mwachindunji kumatengera mlingo womwe umatenge. Ndi kuwonjezeka kwa chizolowezi cha tsiku lililonse chogwira ntchito, palibe kusintha kwamphamvu kwambiri pazowonetsa magazi.
Kuchuluka kwa hypotensive kwambiri kumawonedwa patatha maola 3-6 mutamwa mapiritsi. Achire zotsatira kumatenga maola 24. Pambuyo pa tsiku kuchokera nthawi yomwe mwalandira kumwa kamodzi, kuthamanga kwa magazi kumatsika kokha ndi 60-70% yamtengo wapatali.
The pharmacological zotsatira za Aprovel pang'onopang'ono zimayamba kupitirira masiku 7-14, pomwe pazofunikira kwambiri pochiritsira zimawonedwa pambuyo pa masabata a 4-6. Pankhaniyi, zotsatira za hypotensive zimapitirira. Mankhwala akasiya, kupanikizika kwa magazi pang'onopang'ono kumabwerera pamlingo wake woyambirira.
Pharmacokinetics
Pambuyo pakukonzekera pakamwa, mankhwalawa amalowetsedwa m'matumbo ang'onoang'ono ndi 60-80% ya mlingo womwe umamwa. Ikalowa m'magazi, chinthu chogwira ntchito chimamangiriza mapuloteni a plasma ndi 96% ndipo, chifukwa cha zovuta zopangidwa, chimagawidwa minofu yonse.
The yogwira thunthu ukufika pazipita plasma ndende pambuyo 1.5-2 mawola.
Kutha kwa theka la moyo kumapangitsa maola 11-15. Osakwana 2% ya gawo lomwe limagwira mu mawonekedwe ake oyambirira limapukusidwa kudzera mu kwamikodzo.
Zizindikiro zogwiritsidwa ntchito
Mankhwalawa adakonzedwa kuti athandizidwe komanso kupewa kuthamanga kwa magazi monga monotherapy kapena kuphatikiza mankhwala ena omwe ali ndi antihypertensive zotsatira (beta-adrenergic blockers, thiazide diuretics). Akatswiri azachipatala amapereka aprovel ya nephropathy pamaso pa matenda a shuga a 2, limodzi ndi matenda oopsa. Muzochitika zotere, monotherapy simachitika, koma chithandizo chovuta chimayikidwa kuti muchepetse kuthamanga kwa magazi.
Contraindication
Mankhwala osavomerezeka kapena oletsedwa kugwiritsidwa ntchito pazotsatira zotsatirazi:
- kuchuluka kumva kwa zimakhala ndi zigawo zikuluzikulu za mankhwala;
- tsankho kuti lactose, lactase;
- malabsorption a monosaccharides - galactose ndi shuga;
- kukanika kwambiri kwa chiwindi.
Chifukwa cha kuchepa kwa maphunziro azachipatala okwanira, mankhwala amaletsedwa kwa anthu ochepera zaka 18.
Ndi chisamaliro
Chenjezo tikulimbikitsidwa otsatirawa:
- stenosis ya msempha kapena mitral valavu, aimpso minyewa;
- kupatsidwa impso;
- CHD (matenda a mtima);
- ndi kulephera kwa aimpso, ndikofunikira kuwongolera mulingo wa potaziyamu ndi creatinine m'magazi;
- matenda amitsempha yamagazi;
- Zakudya zopanda mchere, limodzi ndi matenda am'mimba, kusanza;
- mtima wowononga;
- Hypovolemia, kusowa kwa sodium pazoyambira zamankhwala osokoneza bongo okodzetsa.
Ndikofunikira kuyang'anira mkhalidwe wa odwala pa hemodialysis.
Momwe mungatenge Aprovel
Mankhwala adapangira pakamwa. Nthawi yomweyo, kuthamanga ndi mphamvu ya mayamwidwe m'matumbo ang'onoang'ono ndizoyima pawokha pakudya. Mapiritsi ayenera kuledzera kwathunthu osafuna kutafuna. Mlingo wokhazikika pamlingo woyamba wa chithandizo ndi 150 mg patsiku. Odwala omwe matenda awo oopsa amafuna mankhwala owonjezera a antihypertensive amalandira 300 mg patsiku.
Ndi kuchepa kosakwanira kwa kuthamanga kwa magazi, kuphatikiza chithandizo ndi Aprovel, beta-blockers, othandizira a calcium ion amagwiritsidwa ntchito kuti akwaniritse zomwe akufuna.
Ndikofunika kukumbukira kuti mulingo ndi nthawi ya mankhwalawa imangokhazikitsidwa ndi katswiri wazachipatala pokhapokha pazochitika za wodwalayo, kuchuluka kwa ma data ndi mayeso amthupi.
Kumwa mankhwala a shuga
Kulandila kwa matenda a shuga 1 kuyenera kukambidwa ndi dokotala wanu, yemwe angaletse kugwiritsa ntchito Aprovel kapena kukonza kusintha kwa tsiku ndi tsiku. Mtundu 2 wa shuga wosadalira insulini, mulingo woyenera ndi 300 mg patsiku kamodzi.
Odwala omwe ali ndi matenda ashuga ali ndi chiopsezo chowonjezereka cha hyperkalemia.
Momwe mungakane
Cancellation syndrome atatha lakuthwa kutenga Aprovel sichimawonedwa. Mutha kusinthira ku mankhwala ena osokoneza bongo kapena kusiya kumwa mankhwalawo.
Zotsatira zoyipa za Aprovel
Chitetezo cha mankhwalawo chidatsimikiziridwa m'mayesero azachipatala omwe odwala 5,000 adatenga nawo gawo. Othandizira 1300 adadwala matenda othamanga magazi ndipo adamwa mankhwalawa kwa miyezi 6. Kwa odwala 400, kutalika kwa mankhwalawa kunatha chaka. Kuchuluka kwa zoyipa sizidalira kuchuluka kwa omwe adatengedwa, jenda komanso msinkhu wa wodwala.
Phunziro lolamulidwa ndi placebo, odzipereka a 1965 adalandira chithandizo cha irbesartan kwa miyezi 1-3. Mu 3.5% ya milandu, odwala adakakamizidwa kusiya mankhwala ndi Aprovel chifukwa cha magawo ena a labotale yoyipa. 4.5% anakana kutenga placebo, chifukwa sanamve kusintha.
Matumbo
Mawonetsero olakwika m'magawo am'mimba otsogola amawonekera monga:
- kutsegula m'mimba, kudzimbidwa;
- kusanza, kusanza;
- kukulitsa ntchito ya aminotransferases mu hepatocytes;
- dyspepsia;
- kutentha kwa mtima.
Kumbali ya chiwindi ndi chindapusa, hepatitis ingachitike, kuchuluka kwa plasma ndende ya bilirubin, komwe kumabweretsa cholestatic jaundice.
Pakati mantha dongosolo
Zosokoneza pakuyankhulana kwa neuronal chifukwa chogwiritsa ntchito antihypertensive mankhwala omwe amawonetsedwa ngati chizungulire komanso kupweteka kwa mutu. Nthawi zina, chisokonezo, malaise wamba, kukokana kwa minofu, kufooka kwa minofu, ndi vertigo zimawonedwa. Odwala ena adamva tinnitus.
Kuchokera ku kupuma
Zotsatira zoyipa zokha za kupuma kwamphamvu ndi kutsokomola.
Kuchokera ku genitourinary system
Odwala omwe ali pachiwopsezo chotenga kulephera kwa impso, vuto la impso limatha kukula.
Kuchokera pamtima
Orthostatic hypotension nthawi zambiri imawonetsedwa.
Matupi omaliza
Mwa zina mwazomwe zimawonekera m'magazi osiyanasiyana, pali:
- Edema ya Quincke;
- anaphylactic mantha;
- zotupa, kuyabwa, kuphimba;
- urticaria;
- angioedema.
Odwala omwe amakonda anaphylactic anachita amafunikira kuyesedwa. Ngati zotsatirapo zake zili zabwino, mankhwalawo ayenera kusinthidwa.
Zokhudza mphamvu pakuwongolera njira
Mankhwala samakhudza mwachindunji ntchito yamunthu. Pankhaniyi, ndizotheka kukulitsa zovuta kuchokera pakatikati ndi zotumphukira zamitsempha, chifukwa chake ndikulimbikitsidwa kukana kuyendetsa galimoto, kugwira ntchito ndi njira zovuta komanso pazinthu zina zomwe zimafuna kuchitapo kanthu mwachangu ndikuwunikira panthawi yamankhwala.
Malangizo apadera
Odwala omwe amagwira ntchito molakwika a mtima kapena ali ndi vuto lambiri laimpso ali ndi chiopsezo chowonjezereka cha hypotension, oliguria, komanso kuchuluka kwa nayitrogeni m'magazi. Ndi kuchepa kwamphamvu kwa kuthamanga kwa magazi chifukwa cha ischemia, infarction ya myocardial kapena mitsempha yamitsempha yam'mimba imatha kuchitika.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Mankhwalawa amaletsedwa kugwiritsidwa ntchito panthawi ya bere. Monga mankhwala ena omwe amakhudza dongosolo la renin-angiotensin-aldosterone, irbesartan imalowa mopanda zotchinga. Gawo lomwe limagwira limatha kukhudza chitukuko cha intrauterine nthawi iliyonse ya bere. Pankhaniyi, irbesartan amachotseredwa mkaka wa m'mawere, chifukwa chake ndikofunikira kusiya kuyamwa.
Kukhazikitsidwa kwa ana kwa ana
Sichikulimbikitsidwa kwa odwala omwe ali ndi zaka zosakwana 18, chifukwa palibe chidziwitso cha mankhwalawa pa chitukuko muubwana ndi unyamata.
Gwiritsani ntchito mu ukalamba
Kuwongolera kowonjezereka kwa chizolowezi cha tsiku ndi tsiku kwa anthu pambuyo pa zaka 50 sikofunikira.
The ntchito aimpso kuwonongeka
2% yokha ya mankhwalawa imachoka m'thupi kudzera mu impso, kotero anthu omwe ali ndi matenda a impso safunikira kuchepetsa mlingo.
Gwiritsani ntchito ntchito yolakwika ya chiwindi
Kusokoneza kwambiri hepatocytes, kumwa mankhwalawa osavomerezeka.
2% yokha ya mankhwalawa imachoka m'thupi kudzera mu impso, kotero anthu omwe ali ndi matenda a impso safunikira kuchepetsa mlingo.
Mankhwala osokoneza bongo a Aprovel
M'maphunziro azachipatala, pamene munthu amatenga 900 mg pa tsiku ndi munthu wamkulu kwa masabata 8, panalibe zizindikilo za kuledzera kwa thupi.
Ngati zizindikiro za mankhwala osokoneza bongo atayamba kuonekera pakumwa mankhwala osokoneza bongo, ndiye kuti muyenera kupita kuchipatala kuti mupewe kumwa mankhwalawo. Palibe chinthu chotsutsana, mwanjira iyi, chithandizo chimalingaliro kuti athetse chithunzi.
Kuchita ndi mankhwala ena
Ndi munthawi yomweyo kugwiritsa ntchito Aprovel ndi mankhwala ena, zotsatirazi zimawonedwa:
- Synergism (kukulitsa njira zochiritsira zamankhwala onse awiriwo) kuphatikiza ndi mankhwala a antihypertensive, calcium njira inhibitors, thiazide diuretics, beta-adrenergic blockers.
- Serum potaziyamu ndende m'magazi amadzuka ndi heparin komanso mankhwala okhala ndi potaziyamu.
- Irbesartan imawonjezera kawopsedwe wa lithiamu.
- Kuphatikiza ndi mankhwala osapweteka a anti-yotupa, chiwopsezo cha kulephera kwa impso, hyperkalemia imakulanso, chifukwa chake, munthawi yamankhwala othandizira, ndikofunikira kuwongolera ntchito yaimpso.
Gawo lazogwiritsa ntchito la Aprovel silikhudza zochizira za Digoxin.
Kuyenderana ndi mowa
Wothandizira antihypertensive ndi oletsedwa kutengedwa nthawi yomweyo ndi zinthu zakumwa zoledzeretsa. Mowa wa Ethyl umatha kuyambitsa maselo ofiira am'magazi, kuphatikiza komwe kumatha kubisa lumen ya chotengera. Kutuluka kwa magazi kumakhala kovuta, komwe kumayambitsa kuchuluka kwa mtima komanso kuchuluka kwa mavuto. Potengera maziko a mankhwala, izi zimapangitsa kugwa kwamitsempha.
Analogi
Mwa mawonekedwe a analogues, zomwe zimachitika pazochitika za irbesartan, pali mankhwala a Russian ndi akunja kupanga. Mutha kusintha mapiritsi a Aprovel ndi awa:
- Irbesartan
- Ibertan;
- Firmastoy;
- Irsar;
- Irbesan.
Ndikofunika kukumbukira kuti musanasinthane ndi mankhwala atsopano ndikofunikira kufunsa dokotala. Kudzilowetsa ndekha koletsedwa.
Kupita kwina mankhwala
Mankhwala amagulitsidwa ndi mankhwala.
Mtengo wa aprovel
Mtengo wapakatikati wamakatoni okhala ndi mapiritsi 14 a 150 mg amasiyana kuchokera ku 310 mpaka 400 rubles.
Zosungidwa zamankhwala
Amayenera kukhala ndi mankhwalawo pamalo owuma osapezekanso kuti aziwala komanso ana kutentha mpaka 30 ° C.
Tsiku lotha ntchito
Zaka zitatu
Wopanga
Sanofi Winthrop Viwanda, France.
Ndemanga pa Aprovel
Ndemanga zabwino za momwe mankhwalawa amathandizira pamaforamu angapo pa intaneti amathandizira kulimbikitsa udindo wa Aprovel pamsika wamankhwala.
Omvera zamtima
Olga Zhikhareva, katswiri wamtima, Samara
Njira yothandiza yochepetsera kuthamanga kwa magazi. Ndimagwiritsa ntchito kuchipatala monga monotherapy kapena chithandizo chovuta. Sindinawone chizolowezi. Odwala samalimbikitsa kuti atenge nthawi yopitilira 1 patsiku.
Antonina Ukravechinko, katswiri wamtima, Ryazan
Ubwino wa ndalama, koma ndikulimbikitsa kuchenjeza kwa iwo omwe ali ndi mitral kapena aortic valve stenosis. Ana ndi amayi oyembekezera saloledwa kumwa mapiritsi a Aprovel. Zina mwazotsatira zoyipa zomwe zimachitika. Nthawi yomweyo, ngakhale panali zovuta zina mthupi, mankhwalawa adathandizira kuchepetsa kuthamanga kwa magazi.
Ngati mankhwalawa azachipatala atayamba kuonekera, ndiye kuti muyenera kupita kuchipatala.
Odwala
Cairo Airam, wazaka 24, Kazan
Ndili ndi matenda oopsa oopsa. M'mawa limadzuka kufika pa 160/100 mm Hg. Art. Anamwa mankhwala ambiri kutsitsa magazi, koma mapiritsi a Aprovel okha ndi omwe adathandiza. Pambuyo pakugwiritsa ntchito, nthawi yomweyo imakhala yosavuta kupuma, mkokomo wamagazi m'makachisi umadutsa. Chachikulu ndichakuti zotsatira pambuyo posiya mankhwala zimatha nthawi yayitali. Muyenera kumwa maphunziro komanso kuyendera dokotala wanu pafupipafupi. Sindinazindikire mavuto aliwonse.
Anastasia Zolotnik, wazaka 57, Moscow
Mankhwalawa sanakwane ndi thupi langa. Pambuyo mapiritsi, zotupa, kutupa ndi kuyabwa kwambiri. Ndinayesa kuyanjanitsa kwa sabata limodzi, chifukwa kupanikizika kunachepa, koma ziwengo sizinathe. Ndinafunika kupita kwa dokotala kuti ndikasankhe mankhwala ena. Ndinkakonda kuti matenda obwera nawo sanatuluke, mosiyana ndi njira zina zochepetsera kuthamanga kwa magazi.
