Kukonzekera kophatikizidwa komwe kumapangidwa ndi zinthu ziwiri zogwiritsidwa ntchito, njira zowonjezera zamankhwala, ndikugwiritsira ntchito pochotsa matenda oopsa.
Dzinalo
Noliprel (Bi) Forte ndi mankhwala omwe ali ndi Mlingo wambiri wa zinthu zomwe zimagwira (Perindopril 4 mg + Indapamide 1.25 mg). Ngati kuli kofunikira kugwiritsa ntchito Mlingo woyenera mwa odwala omwe ali pachiwopsezo chachikulu (matenda ashuga, kusuta, hypercholesterolemia), Bi-Forte (Perindopril 10 mg + Indapamide 2.5 mg) ndi mankhwala.
Kukonzekera kophatikiza kwa zinthu ziwiri zothandizira zomwe zimakwaniritsa zotsatira za pharmacological.
ATX
C09BA04 Perindopril molumikizana ndi okodzetsa.
Kutulutsa mafomu ndi kapangidwe kake
Mapiritsi okhala ndi mafilimu.
Chithandizo chogwira ntchito: Perindopril 2 mg + Indapamide 0,625 mg.
Zotsatira za pharmacological
Imathandizira kusintha mawonekedwe a systolic ndi diastolic magazi (BP) mkati mwa maola 24. Zotsatira zathunthu zimadziwika pambuyo pa mwezi umodzi wodya pafupipafupi. Kutsiliza kwamakonzedwe sikumabweretsa kukula kwa zizindikiro zochoka
Mankhwala amachepetsa kuthamanga kwa myocardial remodeling process, amachepetsa kukana kwa mitsempha ya magazi popanda kukhudza mulingo wa lipids ndi shuga wamagazi.
Perindopril amalepheretsa kugwira ntchito kwa enzyme, yomwe imamasulira angiotensin I kukhala yogwira eniotensin II, yomwe ndi vasoconstrictor yamphamvu. ACE amawonongeranso bradykinin, vasodilator wogwiritsa ntchito kwachilengedwe. Chifukwa cha vasodilation, kukana kwamitsempha kumachepa ndipo kuthamanga kwa magazi kumachepa.
Mapiritsi okhala ndi mafilimu.
Indapamide ndi okodzetsa ochokera pagulu la thiazide. The okodzetsa zotsatira ndi katundu hypotensive amazindikira ndi kuchepetsa kusintha mayamwidwe a sodium mu impso. Pali kuwonjezeka kwa excretion mu mkodzo wa sodium, chifukwa chomwe kukana kwamitsempha kumachepa komanso kuchuluka kwa magazi omwe amayamba ndi mtima kumawonjezeka.
Kugwiritsira ntchito pamodzi kwa perindopril ndi indapamide kumawonjezera mphamvu ya mankhwala oletsa matenda oopsa, kumachepetsa chiopsezo cha hypokalemia (zotsatira zoyipa za okodzetsa).
Pharmacokinetics
Ma pharmacokinetics a zinthu zomwe amagwira sizimasiyana ndi zogwiritsidwa ntchito palimodzi kapena mosiyana.
Mukamamwa pakamwa, pafupifupi 20% ya mlingo wonse wa perindopril umapukusidwa ku fomu yogwira. Mtengo uwu ukhoza kuchepa utagwiritsidwa ntchito limodzi ndi chakudya. Zambiri zomwe zili m'magazi zimalembedwa patatha maola 3-4 Gawo laling'ono la perindopril limamangiriza kumaproteni amwazi. Amathira mkodzo.
Kutulutsa kwa perindopril kumatha kuchedwa kuchepa kwa impso, makamaka kwa okalamba.
Indapamide imatengedwa kuchokera m'mimba, pambuyo pa mphindi 60 pazomwe zimagwira metabolite yokhazikika m'madzi a m'magazi. 80% ya mankhwalawa amayendetsedwa ndi magazi albin. Amadzipukuta ndi kusefera kudzera mu impso, 22% imachotsedwamo.
Zizindikiro zogwiritsidwa ntchito
Matenda oopsa (matenda oopsa).
Mankhwala ndi mankhwala ochepa ochepa.
Contraindication
- kusalolera kwa thiazide okodzetsa, ACE zoletsa;
- magazi potaziyamu wochepera 3.5 mmol / l;
- kwambiri kuwonongeka kwa impso ndi kuchepa kwa kusefukira kwa glomerular osachepera 30 ml / min;
- atherosulinotic stenosis yamitsempha ya impso zonse kapena stenosis ya mtsempha wamagulu a impso imodzi;
- kwambiri chiwindi ntchito;
- munthawi yomweyo makonzedwe a mankhwala ndi proarrhythmogenic zotsatira;
- mimba
- nthawi yoyamwitsa.
Momwe angatenge
Musanayambe chithandizo, ndikofunikira kuwerenga malangizo kuti mugwiritse ntchito ndikufunsira katswiri.
Mankhwala amatengedwa piritsi 1 pakamwa kamodzi patsiku, makamaka m'mawa pamimba yopanda kanthu.
Kodi ndingagawire piritsi
Mutha kugawana, piritsi ili ndi chiopsezo mbali zonse ziwiri.
Mitundu ya mankhwala omwe ali ndi prefix "forte" alibe zoopsa ndipo amaphimbidwa ndi zokutira filimu. Sizingagawanike.
Momwe angapangidwire matenda a shuga a 2
Zilibe kukhudzana kagayidwe kachakudya kagayidwe, kagayidwe kachakudya. Kwa odwala matenda ashuga, kugwiritsidwa ntchito kumatheka malinga ndi dongosolo loyenera.
Zotsatira zoyipa
Matumbo
Kupweteka kwam'mimba, limodzi ndi mseru komanso kusanza; kusokonezeka kwa chopondapo; kamwa yowuma maonekedwe a khungu lopepuka; kuwonjezeka kwa magawo a labour ya chiwindi ndi kapamba m'magazi; ndi kuphatikizika kwa chiwindi kukanika, kukula kwa encephalopathy ndikotheka.
Hematopoietic ziwalo
Matenda a anemia (odwala omwe ali ndi vuto lalikulu la impso); kutsika kwa kuchuluka kwa hemoglobin, mapulateleti, leukocytes, granulocytes; kuchepa kwa hematocrit; hemolytic anemia; aplastic anemia; mafupa kupanikizana.
Kwa odwala matenda ashuga, kugwiritsidwa ntchito kumatheka malinga ndi dongosolo loyenera.
Pakati mantha dongosolo
Mutu, chizungulire, kufooka, kutopa, kusokonezeka, kusakhazikika m'maganizo, kusokonezeka kwa makina owonera ndi kuwunika, kusowa tulo, kuchuluka kwa padera.
Kuchokera ku kupuma
Kutsokomola komwe kumawoneka ndikuyamba kugwiritsa ntchito, kupitilira nthawi yonse ya kumwa mankhwalawa ndikusowa pambuyo poti wachoka; kuvutika kupuma kupanikizika kwa mpweya; kawirikawiri - kutuluka kwa mucous kuchokera pamphuno.
Kuchokera kwamikodzo
Kuchepa kwa impso; mawonekedwe a mapuloteni mumkodzo; Nthawi zina, kuwonongeka kwa impso; kusintha kwa milingo yama electrolyte: kuchepa kwa potaziyamu m'madzi am'magazi, limodzi ndi hypotension.
Matupi omaliza
Khungu loyenda, zotupa za mtundu wa urticaria; Edema ya Quincke; hemorrhagic vasculitis; kawirikawiri - erythema multiforme.
Malangizo apadera
Kuyenderana ndi mowa
Kugwiritsa ntchito molumikizana ndi ethanol komwe kumachokera kumatha kupangitsa kuti magazi azithamanga, kutsika kwa mtima. Kugwiritsa ntchito mosavomerezeka sikulimbikitsidwa.
Zokhudza mphamvu pakuwongolera njira
Kumayambiriro kwa kumwa mankhwalawa, muyenera kusamala mukamayendetsa magalimoto ndikuchita ntchito yomwe imafunikira chidwi komanso kuyankha mwachangu.
Ndi chiwindi ntchito
Zitha kuyambitsa kukula kwa cholestatic jaundice ndi kuwonjezereka kwa ntchito ya chiwindi michere. Izi zikachitika, ndikofunikira kusiya mankhwalawo ndikuonana ndi dokotala.
Odwala omwe ali ndi vuto la cirrhosis, palibe chifukwa chosinthira mlingo.
Ndi kulephera kwa aimpso
Pamaso pa matenda a kwamikodzo ndi kuwonongeka kwina mu kusefera kwake, kuwonjezeka kwa zoleinine, uric acid ndi urea mu plasma, kuchuluka kwa potaziyamu ndikotheka.
Odwala omwe ali ndi vuto la cirrhosis, palibe chifukwa chosinthira mlingo.
Ndi kuchepa kwa creatinine chilolezo chochepera 30 ml / min. mankhwalawa sayenera kuphatikizidwa ndi mankhwala othandizira.
Pa mimba ndi mkaka wa m`mawere
The ntchito contraindicated chifukwa kulibe maphunziro pazokhudza mankhwala pa mwana wosabadwayo. Amayi omwe ali mu trimester yachiwiri ndi yachitatu ayenera kukhala osamala kwambiri.
Mukalamba
Musanayambe kuvomereza, ndikofunikira kuwunika chizindikiro cha impso (creatinine, urea), ma enzymes a chiwindi (AST, ALT), ma elekitiroma. Mankhwalawa amayamba ndi Mlingo wotsika ndipo amasankhidwa payekha poganizira kuchepa kwa kuthamanga kwa magazi.
Kusankhidwa Noliprel kwa ana
Imasungidwa kwa ana ndi achinyamata osakwana zaka 18 chifukwa cha kusowa kwa chidziwitso pachitetezo chake pagululi la odwala.
Bongo
Zizindikiro za bongo: kwambiri hypotension, nseru, kusanza, kugonthetsa matenda, anuria, kuchepa kwa mtima.
Thandizo la mwadzidzidzi: chapamimba cham'mimba, kukhazikitsa kaboni yokhazikitsidwa, kukonza ma electrolyte amwazi. Ndi hypotension, wodwalayo ayenera kupatsidwa malo apamwamba ndi miyendo yokwezeka.
Amayi omwe ali mu trimester yachiwiri ndi yachitatu ayenera kukhala osamala kwambiri.
Kuchita ndi mankhwala ena
Ndi chisamaliro
Akaphatikizidwa ndi ma antidepressants kapena ma antipsychotic, kuwonjezeka kwa kuthamanga kwa magazi ndi chitukuko cha hypotension kumatha kuchitika.
Glucocorticosteroids amachepetsa mphamvu ya antihypertensive.
Poyerekeza ndi maziko otenga, ndizotheka kupititsa patsogolo kuchepa kwa shuga kwa insulin ndi zotumphukira za sulfonylurea.
Kuphatikiza kwa mtima ndi mtima glycosides kumafunikira kuwunika mozama milingo ya potaziyamu ndi ECG, ndikukonzanso kwa hypovolemia.
Ndi kafukufuku wosiyana ndi X-ray, kupewa madzi m'thupi ndikofunikira.
Pogwiritsa ntchito munthawi yomweyo mankhwala ena (Erythromycin, Amiodarone, Sotalol, Quinidine), chiopsezo cha kuphatikiza kwamitsempha yamagazi chimawonjezeka.
Kuphatikiza sikofunikira
Kugawana ndi kukonzekera kwa lithiamu sikuloledwa chifukwa choopsa cha mankhwala osokoneza bongo a lithiamu.
Ndi kuchepetsedwa kwaimpso, kuphatikiza ndi okodzetsa, omwe amathandizira kuchepa kwa ma elekitirodi, ndi kulowetsedwa kwa potaziyamu mankhwala enaake ayenera kupewedwa.
Ndi munthawi yomweyo makonzedwe a NSAIDs motsutsana maziko am'madzi, zimatha kutsogolera matenda owopsa a impso kusefedwa.
Analogi
Ko-Perineva, Ko-Parnawel, Perindapam, Perindid.
Kupita kwina mankhwala
Yoperekedwa ndi mankhwala.
Mtengo Noliprel
Mtengo wa phukusi limodzi la mankhwalawa (mapiritsi 30), owerengeredwa pamwezi wazithandizo, umayamba kuchokera ku ma ruble 470.
Kusunga mankhwala Noliprel
Pewani kufikira ana. Palibe machitidwe osungirako apadera omwe amafunikira.
Tsiku lotha ntchito
Zaka zitatu
Ndemanga pa Noliprel
Omvera zamtima
Zafiraki V.K., Krasnodar: "Kuphatikiza kwabwino komwe kwadzionetsera osati kokha pochepetsa kuthamanga kwa magazi, komanso pankhani yochepetsera zochitika zamtima, ndi kulephera kwa mtima."
Nekrasova GS, Krasnodar: "Chisankho choyenera kwa odwala omwe ali ndi matenda oopsa."
Odwala
Love, Moscow: "Mankhwalawa ndi abwino, amathandiza."
Alexander, Oryol: "Kupanikizika ndikwabwino."
