ACE inhibitors amagwiritsidwa ntchito pozungulira matenda oopsa, kulephera kwa mtima komanso kupewa matenda a mtima. Mankhwala osokoneza bongo monga enalapril kapena Captopril amaletsa mankhwala omwe amalimbikitsa vasoconstriction komanso kuwonjezeka kwa mavuto. Amagwiritsidwa ntchito ngati chida chodziyimira pawokha kuti achulukitse kuthamanga kwa magazi, komanso molumikizana ndi mankhwala ena.
Makhalidwe a Enalapril
Enalapril imachepetsa kuthamanga kwa magazi, katundu pa myocardium, imasintha kupuma ndi magazi mu bwalo laling'ono, amalimbikitsa kufalikira kwa magazi m'mitsempha ya impso.
Enalapril kapena Captopril amaletsa mankhwala omwe amalimbikitsa vasoconstriction komanso kuwonjezeka kwa mavuto
Chofunikira chachikulu ndi enalapril, yemwe, atatha kuyamwa, ndi hydrolyzed kuti enalaprilat, ACE inhibitor, dipeptidase ya peptide yomwe imalimbikitsa kutembenuka kwa angiotensin. Chifukwa cha kutsekedwa kwa ACE, mapangidwe a vasoconstrictor factor amachepetsa ndipo mapangidwe a kinins ndi prostacyclin, omwe ali ndi katundu wa vasodilating, adayambitsidwa. Enalapril imakhala ndi diuretic yomwe imakhudzana ndi kuponderezana kwa kaphatikizidwe ka aldosterone.
Kutsika kooneka m'ntchito ya ACE kumachitika patatha maola atatu mutatha kumwa mankhwalawa, kukwera kwa kutsika kwa magazi kumawonedwa pambuyo pa maola 5. Kutalika kwa zotsatira zake kumalumikizidwa ndi mlingo, nthawi zambiri zotsatira za mankhwalawa zimapitirira tsiku lonse. Odwala ena amafunikira chithandizo chamankhwala kwa milungu ingapo.
Mukalowa m'thupi, mankhwalawa amalowetsedwa m'matumbo, pambuyo pake chinthucho chimapukusidwa kuti apange enalaprilat, yomwe imatsitsidwa ndi impso komanso matumbo.
Zisonyezero zogwiritsidwa ntchito:
- matenda oopsa;
- kukomoka kwambiri mtima;
- matenda a mtima;
- bronchospastic zinthu;
- kupewa chitukuko cha matenda a mtima kulephera.
Enalapril amachepetsa kuthamanga kwa magazi ndipo amalimbikitsa magazi kuyenda bwino m'mitsempha ya impso.
Zoyipa:
- tsankho limodzi ndi zigawo zikuluzikulu za mankhwala;
- mimba, nthawi yoyamwitsa;
- stenosis ya msempha orion;
- aimpso mtsempha wamagazi stenosis;
- pambuyo kumuika impso;
- Hyperkalemia
- Kugwiritsa ntchito Aliskiren odwala matenda a shuga, matenda aimpso.
Mankhwalawa sanatchulidwe kwa ana osakwana zaka 18.
Pa enalapril mankhwala, minyewa kukokana, nseru, mutu, m'mimba, khungu lawo siligwirizana, orthostatic hypotension n`zotheka.
Mankhwala amatengedwa pakamwa, mosasamala kanthu za kudya.
Ndi matenda oopsa, muyezo umodzi womwewo wa akulu ndi 0,01-0.02 g mu s
abakha. Mlingo wovomerezeka wa tsiku ndi tsiku ndi 0,04 g. Mulingo woyenera kwambiri ungasankhidwe ndi dokotala aliyense payekha kwa wodwala aliyense. Kutalika kwa njira yochizira kumatengera mphamvu ya mankhwalawa.
Makhalidwe a Captopril
ACE inhibitor amachepetsa kuthamanga kwa magazi ndipo amagwiritsidwa ntchito pa matenda oopsa, nephropathy, matenda ashuga, kulephera kwa mtima. Imakhala ndi vasodilating, imachulukitsa kutulutsa kwamtima ndi kukana kupsinjika, osakhudza kagayidwe ka lipid.
Chosakaniza chachikulu chogwira ntchito ndi capopril, chomwe ndi choyambirira chopangira ACE inhibitor muzochita zamankhwala. Zimalepheretsa kusintha kwa angiotensin I kuti angiotensin II, kuthandizira kuthamanga kwa magazi, kumachepetsa kuuma kwa mapindikidwe amitsempha yamagazi am'mitsempha, kumalepheretsa kukula kwa mtima kulephera, kusintha hemodynamics mu impso, ndikuletsa kukula kwa matenda a shuga.
Captopril imalowa mwachangu, imapangidwa m'chiwindi, imapukusidwa kwambiri ndi impso. Hafu ya moyo ili pafupifupi mphindi 120.
Kuchuluka kwake kulembedwa pambuyo pa maola 1-1.5. Kutalika kwa zochita zimatengera mlingo wa mankhwalawa.
Captopril ndikofunikira pa matenda ngati awa:
- matenda oopsa;
- kulephera kwa mtima;
- myocardial infarction;
- matenda ashuga nephropathy.
Chosakaniza chachikulu chogwira ntchito ndi capopril, chomwe ndi choyambirira chopangira ACE inhibitor muzochita zamankhwala.
Mankhwala amagwiritsidwa ntchito popewa kuwonongeka kwa mtima mwaodwala odwala asymptomatic lamanzere yamitsempha yamagazi yokhala mu mawonekedwe okhazikika mwamankhwala.
Zoyipa:
- Hypersensitivity zigawo zikuluzikulu za mankhwala;
- matenda oopsa a impso;
- Hyperkalemia
- aimpso mtsempha wamagazi stenosis;
- stenosis ya machitidwe aortic ndi kusintha kwina komwe kumasemphana ndi kutuluka kwa magazi kuchokera kumanzere kwamitsempha;
- zinthu pambuyo impso kumuika;
- 2 ndi 3 trimesters a mimba;
- nthawi yoyamwitsa.
Osasankhidwa kwa ana osakwana zaka 14.
Thupi lawo siligwirizana, kusintha kwa kukoma, kusabala, leukopenia, proteinuria, agranulocytosis, kupsinjika, kugwirana kwamtundu wa kayendedwe ndikotheka monga zovuta pakumwa mankhwala.
Mlingo woyenera wa Captopril umakhazikitsidwa ndi katswiri aliyense payekhapayekha ndipo amasiyana kuchokera ku 0,025 g mpaka 0,15 g patsiku. Pankhani yakukwera mwachangu komanso kowopsa m'magazi, tikulimbikitsidwa kuti mutenge mlingo wocheperako, mukumwa piritsi pansi pa lilime. Mankhwala a ana, mulingo woyenera kwambiri amawerengedwa poganizira thupi, kuchuluka kwake ndi 0,001-0.002 g pa 1 kg.
Kuyerekezera Mankhwala
Kufanana
Mankhwalawa ndi gawo la gulu la ACE inhibitor, ali ndi magwiritsidwe ofanana ndipo amagwiritsidwa ntchito pochiza kuthamanga kwa magazi, matenda a mtima. Ali ndi zotsutsana zofanana. The achire zotsatira zimadalira mlingo.
Kodi pali kusiyana kotani?
Kusiyana kwakukulu kumapangidwe. Mankhwalawa onse amachokera pa proline amino acid derivative. Koma enalapril imasiyana ndi ma analogue ake mu kapangidwe kake kazovuta kazinthu: ikalowa thupi, chinthu chachikulu chomwe chimagwira ndi hydrolyzed kupita ku enalaprilat, yomwe imalepheretsa ACE.
Mankhwalawa amasiyana pakayendedwe kamakonzedwe ka makonzedwe. Ndi matenda oopsa, ma enalapril amatengedwa 1 nthawi patsiku. Captopril imakhala ndi mphamvu yochepa, pakukonzekera komwe ndikofunika kumwa mankhwalawa kangapo patsiku.
Captopril imaphatikizidwa bwino ndi okodzetsa. Mukamachitira ndi analogue, ndikofunikira kuti muchepetse mlingo wa mankhwala a diuretic kapena musiyane nawo kwakanthawi.
Zomwe zimakhala zotsika mtengo
Mankhwala ali ndi mtengo wotsika ndipo amapezeka kwa ogula. Mtengo wapakati ndi ma ruble 60-130.
Zabwino kuposa enalapril kapena captopril
Enalapril ndiyoyenereradi kugwiritsidwa ntchito kwakanthawi ngati kuli kofunikira kukhalabe ndi kuthamanga kwa magazi mkati mwazomwe mukufuna, koma osagwiritsidwa ntchito ngati ambulansi. Captopril imathandiza kusintha kwa episodic kwa kuthamanga kwambiri kwa kupanikizika. Mankhwala amathandizanso pa ntchito ya mtima, amalimbikitsa kupirira nthawi zonse, zomwe zimapangitsa kugwiritsidwa ntchito kwake koyenera pamaso pa matenda a mtima.
Momwe mungasinthire kuchokera ku captopril kupita ku enalapril
Mankhwalawa ali m'gulu lomweli la mankhwala ndipo amadziwika kuti amakumana ndi zovuta, zomwe zimakhala zowopsa paumoyo ndipo zimatha kuchepa kwambiri magazi. Pochiza matenda oopsa, mankhwalawa amaperekedwa payekhapayekha. Kuti musinthe kuchoka pa mankhwala kupita ku wina, muyenera kufunsa katswiri yemwe adzasankhe mlingo woyenera, mawonekedwe omasulidwa ndi mtundu wa chithandizo poganizira mbiri yaumoyo, zaka komanso mawonekedwe ena a wodwala.
Ndemanga za Odwala
Marianna P. "Nthawi ndi nthawi mavuto amakula, koma ndimayesetsa kupewa kumwa mapiritsi kuti ndichepetse kuchuluka kwa mankhwala. Chaka chatha ndinali kuchipatala chifukwa cha maulendo pafupipafupi komanso kusintha kwa nyengo. Kuphatikiza kwa njira zakuchipatala sikunathetse nkhawa, ngakhale jakisoni sanalowe m'malo mwake. "Ndinakumbukira kuti mnzanga wina atalimbikitsa Captopril. Ndinaika miyala iwiri pansi pa lilime langa, ndipo patatha pafupifupi mphindi 30 zovuta zinayamba kuchepa. Tsiku lotsatira zinabweranso kwathunthu. Tsopano ndimasunga mankhwala anga mchikwama changa."
Vika A: "Sindikuwona kuti Captopril ndi ambulansi. Magazi a apongozi ake adalumphira kwambiri, ndikuyika 2 pansi pa lilime lake, 3 ina maola angapo pambuyo pake, m'mawa kwambiri 2. Ndipo m'mawa yekha adasintha zina. pang'onopang'ono. Ngati mankhwalawo ali ngati ambulansi, ndiye kuti mankhwalawo amayenera kukhala achangu. Kukakamiza kwa apongoziwo kunabweranso kwawoko pokhapokha dokotala atalandira mankhwala ena ndi okodzetsa. "
Elena R. "Atatulutsidwa kuchipatala, amayi adalembedwa Enalapril. Nthawi yomweyo adazindikira kutsokomola komwe kunalibe kale. Ndidawerenga malangizo omwe amamwa mankhwalawo, zimapezeka kuti sizigwira ntchito kwa aliyense. Ziyenera kutengedwa mosamala, koma ndibwino kupeza zina."
Mankhwalawa amasiyana pakayendedwe kamakonzedwe ka makonzedwe.
Madokotala amawunika za enalapril ndi Captopril
Tsukanova A. A., katswiri wodziwa zaka 5: "Ubwino wokhawo wa Enalapril ndi mtengo wake wotsika mtengo. Sizothandiza pamiyeso yaying'ono, ambiri amamwa pamlingo wovomerezeka. Nthawi zambiri zimayambitsa zovuta pamtundu wa chifuwa chowuma, motero sichili choyenera kwa asthmatics. Ndikupangira mankhwalawa kwa odwala, pali mankhwala othandiza komanso amakono. "
Zafiraki V.K., katswiri wazachipatala wazaka 17, Ph.D: "Odwala ambiri okalamba omwe amadandaula chifukwa cha kusoweka kwake kapena mawu ake ofooka, amagula Captopril, osadziwa kusiyana kwa Kapoten ndi Captopril. Amavomerezanso chimodzimodzi. chinthu, koma woyamba mankhwala amapangidwa ndi kampani yomwe imapanga, yachiwiri ndikutulutsa kwatsopano ndipo kumapangidwa ndi makampani osiyanasiyana. Ndikupangira kuti ndigule onse mankhwalawa ndikufanizira kuti ndi uti wamphamvu. "
