Zochizira matenda oopsa, kuphatikiza mankhwala kwamagulu osiyanasiyana kumagwiritsidwa ntchito. Lozarel kuphatikiza ndi mankhwala omwe amaphatikiza zinthu ziwiri zomwe zimachepetsa kuthamanga kwa magazi ndikuthandizira wina ndi mnzake.
Dzinalo Losayenerana
Hydrochlorothiazide + losartan.
ATX
C09DA01.
Lozarel kuphatikiza ndi mankhwala omwe amaphatikiza zinthu ziwiri zomwe zimachepetsa kuthamanga kwa magazi ndikuthandizira wina ndi mnzake.
Kutulutsa mafomu ndi kapangidwe kake
Piritsi yokhala ndi kanema yokhala ndi filimu yomwe imasungunuka ikakumana ndi michere yamatumbo. Zinthu zotsatirazi zimakhudza:
- Hydrochlorothiazide - 12,5 mg. Thiazide okodzetsa.
- Losartan - 50 mg. Angiotensin Receptor Antagonist 2.
Zowonjezera pazomwe zimapangidwira zilibe ntchito, zimapangidwa kuti zilembedwe piritsi.
Zotsatira za pharmacological
Mawonekedwe a gawo lirilonse amawona momwe amathandizira. Hydrochlorothiazide imasokoneza mayamwidwe obwera wa sodium, potaziyamu, ndi ion ya chlorine mu gawo lachigawo la nephrons mu impso. Zinthu izi zimabisidwa mwachangu ndikuchotsa madzimadzi owonjezera. Kuchotsa mkodzo kukuchulukirachulukira.
Zotsatira zake ndikuchepa kwama voliyumu am'madzi m'magazi. Ntchito ya mahomoni ena amakomoka amawonjezeka. Amapangidwa mu zida za impso za juxtaglomerular. Akatulutsidwa m'magazi, renin imathandizira adrenal cortex ndikuwonjezera katulutsidwe ka aldosterone. Imatha kusunga pang'ono, koma kuwonjezera potaziyamu. Homoniyo amalimbikitsa kusunthira kwa sodium mu malo a intracellular, kumawonjezera hydrophilicity ya zimakhala, imasunthira boma la acid-base ku mbali ya zamchere.
Kutsika kwa kuthamanga kwa magazi mothandizidwa ndi hydrochlorothiazide kumachitika chifukwa cha kuchepa kwa magazi.
Kuchepa kwa kuthamanga kwa magazi mothandizidwa ndi hydrochlorothiazide kumachitika chifukwa chakuchepa kwa magazi, kutsimikiza kwa momwe khoma la chotengera limayendera komanso kuchepa kwa mphamvu ya adrenaline ndi norepinephrine pa izo, zomwe zimapangitsa kupindika komanso kutsekeka kwa lumen ya ziwiya. Ndi kuthamanga kwa magazi, zotsatira za mankhwalawa sizimakula.
Kuchiritsa kwamkodzo kumatheka patatha maola 1-2 mutatha piritsi, mphamvu yake imayamba pambuyo maola 4. The diuretic zotsatira zimakhala mpaka maola 12.
Zochita za losartan potaziyamu zimakwaniritsa okodzetsa. Amasankha mosamala ma angiotensin receptors, omwe amapezeka m'matumbo, gland wa adrenal, impso, ndi mtima. Mankhwalawa amaletsa mphamvu ya angiotensin 2, koma osalimbikitsa bradykinin. Ndi puloteni yomwe imasokoneza mitsempha yamagazi. Chifukwa chake, losartan alibe zoyipa zomwe zimakhudzana ndi peptide iyi.
Kuwonjezeka kwa antihypertensive zotsatira kumachitika ndi kuwonjezeka kwa mlingo wa mankhwalawa. Zochita ndi izi:
- zotumphukira mtima kukana kumachepa;
- kuthamanga kwa magazi ndichabwinobwino;
- aldosterone m'magazi sichimachulukanso kuposa momwe zimakhalira;
- mu kufalikira kwa m'mapapo amachepetsa kuthamanga;
- kuchepetsa katundu pambuyo pamtima;
- kuchuluka kwamkodzo.
Matenda a mtima omwe amadwala, omwe amachititsa kuti munthu asamagwire ntchito, amawonjezera kukana zolimbitsa thupi.
Matenda a mtima omwe amadwala, omwe amachititsa kuti munthu asamagwire ntchito, amawonjezera kukana zolimbitsa thupi. Kuteteza minofu yamtima ku hypertrophy ya fiber.
The Autonomic mantha system reflexes sichikhudzidwa. Kuzunza kwa norepinephrine mothandizidwa ndi mankhwalawa sikusintha.
Pambuyo kumwa mapiritsi, kupanikizika kumatsika pambuyo maola 6, koma zotsatira za hypotensive zimayamba kuchepa. Kutsika kosalekeza kumatheka pambuyo pa masabata 3-6 a mankhwala okhazikika.
M'maphunziro azachipatala, zidatsimikiziridwa kuti kuchotsa mwadzidzidzi kwa losartan sikuti kumayambitsa ziwonetsero zodzipatula komanso kuchuluka. Zimathandizanso chimodzimodzi odwala azaka zosiyanasiyana komanso akazi.
Pharmacokinetics
Mafuta ochokera m'mimba a losartan amapezeka mwachangu komanso mokwanira. Pambuyo podutsa m'chiwindi, metabolite yogwira imapezeka mothandizidwa ndi ma enzymes a cytochrome system. Chakudya sichimakhudzanso bioavailability, omwe ndi 33%. Pambuyo pa ola limodzi, kugwiritsidwa ntchito kwa zinthu zoyambira kumakhala kwakukulu, ndipo pambuyo pa maola 3-4, kuchuluka kwa metabolite yogwira ntchito kumafika pazokwanira zake.
Mafuta a hydrochlorothiazide ochokera m'matumbo amapezeka pa 80% yokha.
Chotchinga muubongo sichimadutsa mu maselo aubongo. 100 mg ya mankhwala omwe amamwa kamodzi patsiku samadzisonkhanitsa ndi plasma. Kuchuluka kwake kumakunguliridwa limodzi ndi ndowe.
Mafuta a hydrochlorothiazide ochokera m'matumbo amapezeka pa 80% yokha. Ma cell a hepatatic samapanga zinthu, motero impso zimakhuthulira m'malo osasinthika. Hafu ya moyo ndi maola 6-8. Poyang'anitsitsa ntchito ya machitidwe a excretory, nthawi ino amatha kuwonjezera mpaka maola 20.
Zizindikiro zogwiritsidwa ntchito
Amalembera mankhwalawa ngati magazi akuwonetsa ngati pali umboni wowonetsa kuti pali ophatikizika.
Contraindication
Hypersensitivity kwa constituent zinthu ndi sulfonamide zotumphukira zimapangitsa chithandizo kukhala chosatheka. Musagwiritse ntchito vuto la chiwindi lomwe silikuyenda bwino, lomwe limapatsidwa 9 9 kapena kuposerapo pa sikelo ya Mwana. Ngati creatinine chilolezo zosakwana 30 ml / mphindi, limodzi ndi aimpso, osagwiritsa ntchito.
Matenda a pachimake omwe kugwiritsa ntchito mankhwalawa amakwiriridwa:
- kwambiri ochepa hypotension;
- matenda osawerengeka a shuga;
- Matenda a Addison;
- gout
- malabsorption syndrome;
- kuchepa kwa lactase.
Ndi kuphwanya kwamphamvu yamagetsi yamagetsi yokhudzana ndi kuchepa kwa potaziyamu, sodium, kuchuluka kwa calcium, komanso hyperuricemia, kugwiritsa ntchito mankhwalawa ndi contraindicated. Ikuthandizanso kusalingalira komwe kulipo kwa ayoni. Ngati ma diuretics ena amagwiritsidwa ntchito omwe amachititsa kuti madzi azisowa madzi m'thupi, ndiye kuti madzi oyenera ayenera kubwezeretsedwanso, ndipo chithandizo chothandizidwacho chimaletsedwa.
Mu anuria, okodzetsa sangathe kugwiritsidwa ntchito mpaka chifukwa chodalira kwamkodzo chithe.
Ndi chisamaliro
Kuphwanya mulingo wa ma elekitiroma ndi kutsekula m'mimba kapena kusanza kumafunika kugwiritsa ntchito mosamala ma diuretics molingana ndi mawonekedwe. Poyang'aniridwa ndi achipatala, imagwiritsidwa ntchito motere:
- aimpso mtsempha wamagazi stenosis;
- mphumu ya bronchial;
- pafupipafupi thupi lawo siligwirizana;
- matenda a zolumikizana minofu;
- arrhythmias yoopsa moyo;
- matenda a mtima;
- aortic stenosis;
- hypertrophic cardiomyopathy;
- kuphwanya magazi kupita ku ubongo;
- pambuyo kupatsirana kwa impso.
Kutsekeka kwa khungu la England ndi myopia kumawonjezera zochita zawo mothandizidwa ndi hydrochlorothiazide.
Momwe mungatengere losarel kuphatikiza?
Poyamba komanso nthawi zonse, kuti musunge chithandizochi, piritsi limodzi patsiku limayikidwa, ngakhale zakudya. Koma ngati kupitiriza kwa hypotensive zotsatira sikukula mkati mwa masabata 3-4, mlingo umakulitsidwa mpaka ma 2 pcs. (25 ndi 100 mg ya mankhwala othandizira).
Poyamba komanso nthawi zonse, kuti musunge chithandizochi, piritsi limodzi patsiku limayikidwa, ngakhale zakudya.
Ndi matenda ashuga
Endocrinologist amayenera kuwunika ndikusintha kuchuluka kwa insulin ya matenda a shuga 1. Mankhwalawa amatha kubweretsa hyperglycemia, mawonekedwe a shuga mumkodzo. Aliskiren kapena mankhwala osokoneza bongo amawononga thanzi la shuga akaphatikizidwa ndi wophatikiza.
Zotsatira zoyipa za Lozarel kuphatikiza
M'maphunziro a zamankhwala ophatikizira a hydrochlorothiazide ndi losartan, palibe zoyipa zomwe zimawonedwa chifukwa chogwiritsa ntchito zinthu ziwiri. Amawoneka mu mawonekedwe omwe amadziwika ndi mankhwala aliwonse payekhapayekha.
Matumbo
Matenda a dyspeptic, nseru, kusanza, kupweteka kwam'mimba, kutsegula m'mimba kumatha kuonedwa. Nthawi zina pakamwa kowuma kumawoneka ngati kutayika kwamadzi. Zilonda za chiwindi, kapamba samadziwika kwenikweni.
Hematopoietic ziwalo
Hemoglobin, kuwerengetsa kupatsidwa zinthu za m'magazi, hematocrit ikhoza kuchepa pang'ono. Nthawi zina pamakhala kuchuluka kwa ma eosinophils am'magazi. Maselo hemolysis ndi osowa.
Nthawi zina kumwa mankhwalawa kumayambitsa nseru.
Pakati mantha dongosolo
Chizungulire, kusowa tulo, kupweteka kwa mutu ndikotheka. Nthawi zina paresthesia, zotumphukira neuropathy, tinnitus, kusokonekera kwa kukoma ndi kuwona, chisokonezo.
Kuchokera ku minculoskeletal system
Pafupifupi pamakhala kupweteka kumbuyo, miyendo, kusasangalala m'malo, minofu yochepa.
Kuchokera ku kupuma
Kukhosomola, kuphatikizika kwamphuno kumatha kuoneka. Kuchulukana kwauma kwa mucous nembanemba kumayambitsa kuwonjezeka kwa matenda opumira, sinusitis, laryngitis.
Pa khungu
Mwa odwala ena, khungu limatha kuyankha ndi hyperhidrosis ndi kukula kwa photosensitivity. Kuchotsa kwamadzimadzi kwambiri kumayambitsa khungu lowuma.
Mwa odwala ena, khungu limatha kuyankha ndi hyperhidrosis.
Kuchokera ku genitourinary system
Kuyimitsa mkodzo kumachitika kawirikawiri. Nthawi zina muyenera kukwera kuchimbudzi usiku. Matenda amtundu wa genitourinary samakonda kujowina, libido ndi potency kuchepa.
Kuchokera pamtima
Mwina chitukuko cha arrhythmias chifukwa cha kusakwanira mu main ion. Vasculitis, orthostatic hypotension imatha kuoneka.
Matupi omaliza
Nthawi zina, pakhungu lanu limakhala ngati mtundu wa urticaria. Zoopsa koma zosowa kwenikweni ndi anaphylaxis, angioedema.
Zokhudza mphamvu pakuwongolera njira
Kugona, kutsika kwa kuchuluka kwa zochita ndi chisamaliro zingakhale zotsatira zachilengedwe pakumwa mankhwalawo. Chifukwa chake, muyenera kukana kuyendetsa galimoto ndikugwira bwino ntchito ndi makina.
Ndikofunika kusiya kuyendetsa galimoto komanso kugwira ntchito moyenera ndi makina.
Malangizo apadera
Odwala a liwiro la Negroid sayankha bwino mankhwalawo. Kuchepa kwake kwapansi kumalumikizidwa ndi limagwirira la chitukuko cha matenda oopsa, omwe amapezeka pamakonzedwe ochepa a renin.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Kuwonetsedwa kwa renin-angiotensin-aldosterone dongosolo kumatha kubweretsa zovuta kwambiri za fetal mu 2nd ndi 3 trimesters ndikupangitsa kufa kwake kwa intrauterine. Chifukwa chake, mutakhazikitsa chowonadi chokhala ndi pakati, ndikulimbikitsidwa kuti m'malo mankhwalawo mukhale otetezeka.
Thiazide diuretics amatha kulowa magazi a fetal ndikutsogolera kukulira kwa embryonic jaundice kapena kukulitsa njira ya thupi ya hyperbilirubinemia mu makanda. Mwa amayi apakati, amatha kutsogolera ku thrombocytopenia, zomwe zimatha kuyambitsa hypocoagulation komanso magazi. Mukamayamwitsa, mankhwalawa amaletsedwa.
Kukhazikitsidwa kwa Lozarel kuphatikiza ana
Mu ana sagwiritsidwa ntchito chifukwa cha kusowa kwa mayesero azachipatala komanso chidziwitso cha chitetezo muubwana.
Pambuyo podziwa kuti mayi ndi woyembekezera, ndikofunika kuti mankhwalawo akhale m'malo otetezeka.
Gwiritsani ntchito mu ukalamba
Kwa odwala opitirira zaka 60, mankhwalawa sanapatsidwe. Ndikofunikira kuganizira za kukhalapo kwa matenda amtima ndi zina zomwe matendawa amatsutsana. Munthawi yokhutiritsa, mlingo wake sasintha.
The ntchito aimpso kuwonongeka
Kulephera kwapakati kwapakati sikutanthauza kusintha kwa mlingo, ngakhale wodwalayo atadwala hemodialysis.
Gwiritsani ntchito ntchito yolakwika ya chiwindi
Sikugwiritsidwa ntchito chifukwa chosowa kwambiri, nthawi zina - mosamala.
Mankhwala osokoneza bongo a losarel kuphatikiza
Mukapitirira mlingo womwe mwalimbikitsa, ndiye kuti mukupanikizika kwambiri. Kuchepa kwa electrolyte kungayambitse kukulitsa kwa arrhythmias, mawonekedwe a tachy- kapena bradycardia.
Kuchulukitsidwa kwamagetsi kwamagetsi kumatha kuyambitsa kukula kwa arrhythmias.
Palibe mankhwala. Chithandizo chimachitika molingana ndi zomwe akuwonetsa.
Kuchita ndi mankhwala ena
Pogwiritsa ntchito nthawi yomweyo ndi Aspirin ndi njira zina za gululi, zomwe zimapangitsa kuti anzanu azikhala ndi mavuto ochepa komanso ochepa mphamvu. Kuwopsa kwa impso kumakulitsidwa, zingayambitse kuphwanya ntchito yawo.
Imaphwanya kutsimikizika kwa impso, chifukwa chake, mankhwala osokoneza bongo sagwiritsidwa ntchito nthawi imodzi.
Kukhazikitsidwa kwina ndi ma diuretics kumawonjezera kuchuluka kwa okodzetsa ndi zotsatira zama hypotensive. Ma Tricyclic antidepressants, antipsychotic, barbiturates, narcotic analgesics amatha kuchepetsa kukakamiza mpaka kutsutsa kapena kuyambitsa orthostatic hypotension.
Mankhwala a gout mukamamwa amafuna kusintha kwa mlingo, chifukwa pali kuchedwa kwa seramu uric acid.
Odwala omwe amagwiritsa ntchito mtima glycosides amatha kukhala tricyularia wamitsempha chifukwa chosowa potaziyamu.
Kukonzekera kwa ayodini kumatha kuwonjezera chiwopsezo cha kuchepa kwambiri kwa chiwindi, kotero kuchepa kwamadzi ndikofunikira musanagwiritse ntchito.
Kuyenderana ndi mowa
Ethanol imatha kukulitsa zovuta zosafunikira, poizoni pazakhungu ndi impso.
Analogi
Mankhwala, mankhwala omwe ali ngati mankhwala osokoneza bongo amaperekedwa:
- Losartan-n;
- Gizaar Forte;
- Lorista ND;
- Lozap kuphatikiza.
Kupita kwina mankhwala
Mankhwala amatanthauza mankhwala omwe mungamwe.
Kodi ndingagule popanda kulandira mankhwala?
Sipezeka popanda kulandira kwa dokotala.
Mtengo wa losarel kuphatikiza
Mtengo wake umachokera ku ruble 230 mpaka 325 pamapiritsi 30.
Zosungidwa zamankhwala
Kunyumba, ndikofunikira kuti ana asamayandikire ana pamatenthedwe osapitirira + 25 ° C.
Tsiku lotha ntchito
Kutengera momwe zimasungidwira, ndizoyenera zaka 2. Pambuyo panthawiyi amaletsedwa kugwiritsa ntchito.
Wopanga
Mankhwalawa amapangidwa ndi kampani ya Sandoz, Slovenia.
Ndemanga pa Lozarel kuphatikiza
Karina Grigoryevna, wazaka 65, Moscow.
Kwa nthawi yayitali ndakhala ndikuvutika ndi matenda oopsa. Dotolo adamuuza mankhwalawa. Ndakhala ndikugwiritsa ntchito kwa masabata awiri, kupanikizika ndikukhazikika ndipo sikukula. Sindinazindikire chilichonse, koma nthawi zina ndimamva kupweteka m'mimba.
Alexander Ivanovich, wazaka 59, St. Petersburg.
Ndinatenga mapiritsiwo padera kwa nthawi yayitali, koma ndinasinthira ku mankhwala osakaniza. Izi ndizothandiza, simukuyenera kukumbukira kuti ndidatenga piritsi iti ndi yomwe ndidayiwala. Kupanikizika ndikukhazikika, palibe magetsi. Koma chimbudzi sikuyenera kuzungulira nthawi zonse.
Elena, wazaka 45, Bryansk.
Adapereka mankhwalawo kwa bambo ake, koma kenako adakana. Abambo ndi onenepa kwambiri ndipo nthawi zina shuga wamagazi amawuka. Ndipo motsutsana ndi zamankhwala, glucose adatuluka mkodzo. Chifukwa chake, anasinthana ndi mankhwala ena. Ndinafunika kuyamba kudya zakudya zopanda mafuta.
