Momwe mungagwiritsire ntchito Captopril pa matenda ashuga?

Kupezeka kwa Captopril kanyumba kachipatala chanyumba sikungathandize kokha ndi kuthamanga kwa magazi, komanso kuwonetsa kwa nephropathy yomwe imayamba chifukwa cha matenda ashuga. Ndikulimbikitsidwa kugwiritsa ntchito mankhwalawa pokhapokha ngati mumalandira mankhwala, monga Mlingo wosalondola ungayambitse zovuta zina.

ATX

C09AA01 (Captopril)

Kupezeka kwa Captopril kanyumba kachipatala chanyumba sikungathandize kokha ndi kuthamanga kwa magazi, komanso kuwonetsa kwa nephropathy yomwe imayamba chifukwa cha matenda ashuga.

Kutulutsa mafomu ndi kapangidwe kake

Kukonzekera ndi chinthu choyera cha khristalo, chosungunuka mosavuta mu methyl, mowa wa ethyl ndi madzi, wokhala ndi fungo losalala la sulufule. The solubility ya mankhwala mu ethyl acetate ndi chloroform ndi dongosolo la kukula kwambiri. Thupi silisungunuka mu ether.

Mapiritsi

Chogulikacho chimapezeka m'mapiritsi okhala ndi mafuta a kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka zinthu. Kuphatikiza pa chophatikizira chachikulu mu 12,5-100 mg, piritsi imakhala ndi zinthu zina zothandiza: silicon dioxide, stearic acid, MCC, wowuma, etc.

Zimagwira bwanji?

The pharmacological mphamvu ya Captopril akadali kuphunzira.

Kuponderezedwa kwa dongosolo la renin-angiotensin-aldosterone (PAA) ndi mankhwalawa kumabweretsa zotsatira zake zabwino pothandizira kulephera kwa mtima komanso kuthamanga kwa magazi.

Renin wopangidwa ndi impso amagwira ntchito m'magazi a plasma globulin, zomwe zimatsogolera pakupanga kwa decapeptide ndi angiotensin. Kenako, mothandizidwa ndi ACE (angiotensin-kutembenuza enzyme), mankhwala a vasoconstrictor a endo native, angiotensin l amasinthidwa kukhala angiotensin ll, omwe amachititsa kaphatikizidwe ka aldosterone ndi adrenal cortex. Zotsatira zake, madzi ndi sodium amazisungira.

Zochita za Captopril ndikuchepetsa kufooka kwa mtima kwaponseponse kwamitsempha yamagazi (OPSS).

Kukonzekera ndi chinthu choyera cha khristalo, chosungunuka mosavuta mu methyl, mowa wa ethyl ndi madzi, wokhala ndi fungo losalala la sulufule.

Chogulikacho chimapezeka m'mapiritsi okhala ndi mafuta a kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka kayendetsedwe ka zinthu.

Kuphatikiza pa chophatikizira chachikulu mu 12,5-100 mg, piritsi imakhala ndi zinthu zina zothandiza: silicon dioxide, stearic acid, MCC, wowuma, etc.

Zochita za Captopril ndikuchepetsa kufooka kwa mtima kwaponseponse kwamitsempha yamagazi (OPSS). Poterepa, zotsatira za mtima zimachuluka kapena sizimasinthika. Kuchuluka kwa kusefera mu impso glomeruli sikusintha.

Kukhazikika kwa hypotensive mphamvu ya mankhwalawa kumachitika 60-90 patatha mphindi imodzi.

Mankhwalawa amalembedwa kwa nthawi yayitali, chifukwa kuthamanga kwa magazi m'matumbo kumachepa pang'onopang'ono mothandizidwa ndi mankhwalawa. Pogwiritsa ntchito kuphatikiza kwa Captopril ndi thiazide diuretics, kuwonjezera kwawo kumawonedwa. Chikuonetseratu kuphatikiza ndi beta-blockers sichiyambitsa kukonzekera kwa izi.

Kuthamanga kwa magazi kumafikira manambala pang'onopang'ono, osatsogolera pakukula kwa tachycardia ndi orthostatic hypotension. Palibe kukwera mwachangu kwa kuthamanga kwa magazi komanso kuthamangitsa mankhwalawo.

Kutsika kwa kugunda kwa mtima, kuchepa kwa kuthamanga kwa magazi, kuthamanga kwa mtima, kukokana kwa mtima, kuwonjezereka kwa mtima komanso zomwe zikuwonetsa kuyeserera kochita masewera olimbitsa thupi zimawonedwa mwa odwala omwe ali ndi matenda a mtima pa nthawi ya capopril. Komanso, zotulukazi zimapezeka mwa odwala mutatha kumwa koyamba, kupitiriza chithandizo.

Kutsika kwamtundu wa mtima kumawonedwa mwa odwala omwe ali ndi matenda amtima wamthupi panthawi ya mankhwala ndi Captopril.

Pharmacokinetics

Zinthu zomwe zimagwira zimasungunuka m'madzi a m'mimba ndipo zimalowa m'magazi kudzera m'matumbo. Kuzindikira kwakukulu m'magazi kumafika pafupifupi ola limodzi.

Kudzera m'magazi, chinthucho chimagwira ntchito pa puloteni ya ACE m'mapapu ndi impso ndipo imalepheretsa. Mankhwalawa amachotseredwa woposa theka mosasintha. Mwanjira ya metabolite yogwira ntchito, imapukusidwa kudzera mu impso ndi mkodzo. 25-30% ya mankhwala imalowa mukulumikizana ndi mapuloteni amwazi. 95% ya mankhwala amuchotsa impso pambuyo pa maola 24. Maola awiri atakhazikitsa, ndende yamagazi imachepa pafupifupi theka.

Kulephera kwamkati kwa odwala omwe amamwa mankhwalawa kumabweretsa kuchepa kwake m'thupi.

Zomwe zimathandiza

Mankhwala anagwiritsidwa ntchito pochiza:

1. Matenda oopsa: mawonekedwe a piritsi amagwiritsidwa ntchito ngati chithandizo chachikulu kwa odwala omwe ali ndi impso yosungidwa. Odwala omwe ali ndi vuto laimpso, makamaka omwe ali ndi collagenosis, sayenera kugwiritsa ntchito mankhwalawa atapezeka kale pa mankhwala ena. Chidacho chitha kugwiritsidwa ntchito ngati monotherapy kapena kuphatikiza ndi zinthu zina zamankhwala.
2. Kulephera kwa mtima kwamphamvu: Captopril therapy imagwiritsidwa ntchito limodzi ndi digitis ndi diuretics.
3. Kuphwanya kwaposachedwa kwa kuphwanya kwamanzere kwamkati ntchito: kuchuluka kwa opulumutsira odwala kumawonjezereka chifukwa cha kuchepa kwa kachigawo kotulutsa mtima mpaka 40%.
4. Matenda a diabetesic nephropathy: kufunikira kwa dialysis ndi kupatsirana kwa impso kumachepetsedwa ndikuchepetsa kupitilira kwa vuto la nephrotic. Amagwiritsidwa ntchito ngati insulin yodalira matenda a shuga komanso nephropathy okhala ndi proteinuria yoposa 500 mg / tsiku.
5. Matenda oopsa.

Captopril cholinga chake ndi matenda aimpso.

Contraindication

Malinga ndi malangizo ogwiritsira ntchito, mankhwalawa amakwiriridwa:

1. Hypersensitivity to ACE zoletsa.
2. Hyperaldosteronism yoyamba.
3. Pali umboni wa mbiri ya milandu ya edema ya Quincke ndi zomwe zimachitika m'gululi.
4. Mimba
5. Kuchepetsa

Timaletsedwanso kumwa pakati pa maola 36 mutatha kumwa Valsartan komanso kuphatikiza Aliskiren (mankhwala omwe amagwiritsidwa ntchito ngati matenda ashuga).

Yang'anirani mosamala, mutawunika maubwino ndi kuopsa kogwiritsa ntchito mankhwalawa:

1. Mu ana.
2. Ndi impso yosinthika wodwala.
3. Ngati aimpso ntchito.
4. Ndi kutupa miyendo.
5. Ndi unilateral (ngati impso ndi yosiyana) kapena mayiko awiri aimpso mtsempha wamagazi.
6. Ndi kuchepa kwa kuchuluka kwa mapulosi am'magazi ndi leukocytes m'magazi.
7. Ndi kugunda kwam'mimba chifukwa cha ma pathologies osiyanasiyana otsekereza omwe amachepetsa kuyenda kwa magazi kuchokera mumtima kupita ku ziwiya.
8. Ndi kuwonjezeka kwa potaziyamu m'magazi.

Mankhwala amatengedwa mosamala pakutupa miyendo.

Malinga ndi malangizo ogwiritsira ntchito, mankhwalawa amakwiriridwa.

Mimba ndi kuphwanya kutenga Captopril.

Captopril imatengedwa mosamala pakuchepetsa kuchuluka kwa ma thrombotic ndi leukocytes m'magazi.

Momwe mungatengere

Pansi pa lilime kapena chakumwa

Pa kuthamanga kwa magazi, imwani pang'onopang'ono pakudya.

Ndikofunikira kumwa mankhwalawa ola limodzi musanadye, monga zomwe zili m'mimba zimatha kuchepetsa mayamwidwe a zinthuzo ndi 30-40%.

Chithandizo cha nthawi yayitali chimatsatana ndikumwa mankhwalawo mkati. Ngati mankhwalawo amagwiritsidwa ntchito pochiritsa mwadzidzidzi ndi kuwonjezeka kwa kuthamanga kwa magazi komwe kumachitika chifukwa cha kutengeka mtima kapena thupi, umaperekedwa pansi pa lilime.

Zimatenga nthawi yayitali bwanji

Patha mphindi 15 kuchokera pakamwa, chinthucho chimazungulira m'magazi.

Ndi sublingual makonzedwe, bioavailability ndi kuchuluka kwa mwadzidzidzi zotsatira.

Ndingamwe kangati

Kuyamba kwa mankhwala kumayendetsedwa ndi kuperekera mankhwala omwe amagawidwa m'mankhwala amadzulo ndi m'mawa.

Chithandizo cha kulephera kwa mtima chimaphatikizapo kugwiritsa ntchito mankhwala katatu patsiku. Ngati cholinga cha Captopril chokha sichitha kuchepetsa kukakamira, hydrochlorothiazide imatchulidwa ngati antihypertensive yachiwiri. Palinso mtundu wina wapadera wa mulingo womwe umaphatikizapo zinthu zonsezi (Caposide).

Ndi vuto la kuthamanga kwa magazi, mankhwalawa amatengedwa pakamwa mutatha kudya.

Ngati Captopril ikugwiritsidwa ntchito pochiritsa mwadzidzidzi ndi kuwonjezeka kwa kuthamanga kwa magazi komwe kumachitika chifukwa cha kutengeka mtima kapena thupi, umaperekedwa pansi pa lilime.

Patha mphindi 15 kuchokera pakamwa, chinthucho chimazungulira m'magazi.

Mlingo

Pakanikizidwa

Chithandizo cha kupanikizika kwakukulu chimayamba ndi tsiku la 25-50 mg. Kenako mlingo umakulitsidwa, monga momwe dokotala amafotokozera, pang'onopang'ono mpaka kuthamanga kwa magazi ndikwabwinobwino. Komabe, siziyenera kupitirira muyeso wokwanira 150 mg.

Kulephera kwamtima kosalekeza

Chithandizo cha kulephera kwa mtima zimaphatikizapo kuyambira ndikugwiritsa ntchito Mlingo umodzi wa 6.5-12,5 mg ndi kuwonjezeka kowonjezereka ngati pakufunika.

Ndi myocardial infaration

Kuyamba kukhazikitsa kumachitika tsiku lachitatu pambuyo kuwonongeka kwa minofu yamtima. Mankhwalawa aledzera malinga ndi chiwembu:

1. 6.25 mg kawiri tsiku lililonse kwa masiku atatu oyamba.
2. Pakati pa sabata, 12,5 mg kawiri pa tsiku.
3. Masabata 2-3 - 37,5 mg, wogawidwa 3 waukulu.
4. Ngati mankhwalawa amaloledwa popanda chovuta, mlingo wa tsiku ndi tsiku umasinthidwa kukhala 75 mg, ndikuwonjezera ngati 150 mg.

Kumwa mankhwala a shuga

Matenda a shuga a shuga okhala ndi mkodzo wambiri mu mkodzo amafunika kugwiritsa ntchito mankhwala osokoneza bongo kawiri pa tsiku, ofanana ndi 50 mg. Ngati kuchuluka kwa mapuloteni kupitirira 500 mg mu mkodzo watsiku ndi tsiku - 25 mg katatu.

Ndi matenda ashuga nephropathy

Ndi limodzi ndi matenda a shuga a mellitus l l nephropathy, mlingo wa 75-100 mg / tsiku umagawidwa mu Mlingo wa 2-3.

Malangizo apadera

Kuyenderana ndi mowa

Kugwiritsira ntchito pamodzi kwa ethanol ndi captopril kumabweretsa kuwonjezeka kwa zotsatira zakumapeto kwake chifukwa cha kumwa kwa vasodilating. Zizindikiro za kuledzera: syncope, kugwedeza kosalamulirika, kuzizira, kufooka.

Kuphatikiza apo, kuphatikiza kwawo kumachepetsa mulingo wa potaziyamu m'mwazi chifukwa chophwanya mayamwidwe ake. Hypokalemia ikhoza kuwonjezera, kuwonjezera magazi.

Pambuyo pakuphatikizira kwa ethanol ndi capopril, kuledzera kwa zizindikiro monga kugwedezeka kosalamulirika ndi kuzizira kumatha kuchitika.

Kuyendetsa magalimoto kumafuna chisamaliro chochuluka, monga mankhwalawa amayambitsa mavuto ambiri, kugwiritsa ntchito kwake kumatha kubweretsa ngozi.

Kufunika kwa mankhwalawa kwa matenda oopsa pakuyamwa kumayambitsa kusintha kwa kudya kwachilendo.

Momwe thupi limagwirira ntchito komanso kuchuluka kwa zakumwa zomwe zimamwa zimakhudzana ndikugwirizana kwa zinthu ziwiri izi.

Zokhudza mphamvu pakuyendetsa magalimoto

Kuyendetsa magalimoto ndikugwiritsa ntchito njira zimafunikira chisamaliro chochuluka. mankhwalawa amayambitsa mavuto ambiri, kugwiritsa ntchito kwake kumatha kubweretsa ngozi. Ndikulimbikitsidwa kuti muchepetse kuyendetsa galimoto kwakanthawi.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Kulembera amayi apakati kumafunika chidwi chapadera kuchokera kwa akatswiri a mtima. Kuperewera kwa momwe zinthu zimakhudzira mwana wosabadwayo, pakakhala zovuta zimayambitsa kusiya kugwiritsa ntchito mankhwalawa popanda chofunikira.

Ngati mankhwalawa adalembedwabe, kuwunika kwa mwana pafupipafupi kuyenera kuchitika.

Kufunika kwa mankhwalawa kwa matenda oopsa pakuyamwa kumayambitsa kusintha kwa kudya kwachilendo. Ngati, pazifukwa zina, kuchepa kwa mkaka wa m'mawere sikutheka, mankhwalawa amagwiritsidwa ntchito poyang'anira mkhalidwe wa mwana: milingo ya potaziyamu, ntchito yaimpso, magazi.

Zotsatira zoyipa

Matumbo

1. Kuchepetsa thupi mwadzidzidzi.
2. Zilonda ndi pakamwa pouma, stomatitis.
3. Dysphagia
4. Dysgeusia.
5. Mawonekedwe a Dyspeptic.
6. Angioedema wamatumbo.
7. Kuphwanya dongosolo la hepatobiliary: hepatitis, cholestasis, necrosis ya maselo a chiwindi.

Kugwiritsa ntchito mankhwalawa kungayambitse kuchepa thupi mwadzidzidzi.

Bowel angioedema ndi zotsatira zoyipa za Captopril.

Mukatha kugwiritsa ntchito mankhwalawa, kukhumudwa, kukhumudwa kwa mitsempha kumatha kuchitika.

Hematopoietic ziwalo

1. Agranulocytosis.
2. Anachepetsa ma protein ndi ma neutrophils m'mwazi.
3. Ma eosinophils okwera.

Pakati mantha dongosolo

1. Kukhumudwa, kupsinjika kwa mitsempha.
2. Kukokana, kusokoneza.
3. Zosintha pamalo akachetechete: kuphwanya kununkhira, masomphenya, kunjenjemera miyendo.
4. Mawonekedwe a kupanda chidwi: kugona, chizungulire.

Kuchokera ku kupuma

1. Kuphipha, kutupa kwa bronchi.
2. Kutupa kwa khoma la ziwiya za alveolar - pneumonitis.
3. Kuuma chifuwa, kufupika.

Mukatha kugwiritsa ntchito Captopril, edema ya Quincke ndiyotheka.

Kuphwanya potency - osafunika chifukwa mutatha Captopril.

Pa gawo la kupuma kwamphamvu, chifuwa chowuma ndicotheka.

Kuchokera ku genitourinary system

1. Kuchulukitsidwa kwa mapuloteni mu mkodzo, oliguria, kuphwanya kwaimpso.
2. Kuwonongeka kwa potency.

Chikopa ndi minofu yofewa

1. Kuchepetsa tsitsi.
2. Exfoliative ndi Photodermatitis.
3. Epidermal necrolysis yoyambitsidwa ndi poizoni.
4. Tinea versicolor.

Matupi omaliza

Steven-Johnson syndrome, anaphylactoid zimachitika, Quincke edema.

Bongo

Kumwa Mlingo wowonjezera pamiyeso yomwe imalimbikitsa kungayambitse kutsika kwa magazi. Kuphatikiza apo, pakhoza kukhala zovuta mu mawonekedwe a thromboembolism ikuluikulu yamitsempha yamagazi, mitsempha yamagazi ya mtima ndi ubongo, zomwe, zimatha kuyambitsa matenda a mtima ndi stroke.

Monga njira yothandizira, ntchito zotsatirazi zimachitika:

1. Muzimutsuka m'mimba mutachotsa kapena kuchepetsa kuchuluka kwa mankhwalawo.
2. Bwezeretsani magazi, ndikupatsa wodwalayo malo okhala ndi miyendo, ndikukweza kulowetsedwa kwa mchere, Reopoliglyukin kapena plasma.
3. Yambitsani epinephrine kudzera m'mitsempha kapena mozungulira kuti muwonjezere magazi. Monga othandizira, gwiritsani ntchito hydrocortisone ndi antihistamines.
4. Chitani hemodialysis.

Kutenga Mlingo wokwera kuposa momwe amalimbikitsira kungayambitse stroke.

Ngati mankhwala osokoneza bongo a mankhwala, ndikofunikira kuti muzitsuka m'mimba.

Ngati njira yochizira ngati munthu ali ndi bongo wambiri, hemodialysis imachitidwa.

Kuchita ndi mankhwala ena

Azathioprine osakanikirana ndi Captopril amalepheretsa zochitika za erythropoietin, kuchepa kwa magazi kumachitika.

Kugwiritsa ntchito palimodzi ndi cytostatics - kuchepa kwa kuchuluka kwamaselo oyera.

Hyperkalemia - kuphatikiza mankhwala ndi potaziyamu-yosalekerera okodzetsa.

Zitha kukulitsa zovuta za digoxin, zomwe zingayambitse kuledzera.

Aspirin ndi capopril amachepetsa mphamvu ya hypotensive.

Analogi

Zofanizira za mankhwalawa ndi monga: Kapoten, Kaptopres, Normopres, Angiopril, Blockordil, Captopril STI, AKOS, SANDOZ, FPO ndi ena.

Amasiyana mu kuchuluka kwa chinthu chomwe chimagwira piritsi limodzi, mndandanda wazinthu zina zomwe sizigwira ntchito. Nthawi zina, mawonekedwe ndi mtundu wa piritsi zimasiyana. Mphamvu ya mankhwalawa, Kapoten, malinga ndi madokotala omwe amapanga, ndi wamphamvu kuposa mitundu ina ya mankhwalawa.

Malo opumulira a captopril kuchokera ku mankhwala

Pokhapokha malinga ndi Chinsinsi cholembedwa pa fomu yapadera mu Chilatini, mwachitsanzo:

1. Rp. Captoprili 0.025.
2. D.t.d. N 20 mu tabulettis.
3. S. 1 piritsi theka la ola musanadye m'mawa ndi madzulo.
   

   Kapoten amadziwika ndi Captopril analogues.

   

   Captopril imangotulutsidwa pa mankhwala okhaokha, yolembedwa pafomu yapadera ya Chilatini.

   

   Mtengo wa mankhwalawa umasiyanasiyana pakati pa ma ruble 9-159.

Zochuluka motani

Mtengo wa mankhwalawa umasiyanasiyana pakati pa ma ruble 9-159.

Malo osungira

Kusunga, kutengera kutentha kwa + 15 ... + 25 ° C, kuchokera kwa ana.

Alumali moyo wa Captopril

Oyenera pazaka 4.

Ndemanga za madotolo ndi odwala za Captopril

Oksana Aleksandrovna, Pskov, dokotala wazachipatala: "Ndimagwiritsa ntchito Captopril ngati ambulansi pazovuta. Nthawi zambiri zimalephera, choncho ndibwino kumvetsera mosamala kuti ndi mankhwala apadera kapena enieni."

Maria, wazaka 45, ku Moscow: "Ndimamwa mankhwalawo ndikulimbikitsidwa ndi katswiri wazachipatala pazokakamiza. Zotsatira zake sizoyipa kuposa za a Moxonidine. Amagwira ntchito yake mothandizidwa bwino, komanso pamtengo wabwino."

Vitaliy Konstantinovich, Krasnodar, dokotala wamtima: "Ngati wodwala atasankha, kuphatikiza ndi Kapoten kapena Captopril, ndingakulimbikitseni woyamba. Inde, zomwe zimagwiritsidwa ntchito m'mankhwala onsewa ndizofanana, koma chimodzi ndi choyambirira, chachiwiri ndi kukopera. "ngakhale ikagwiritsidwa ntchito ngati thandizo likuyenera kukhala lachangu komanso lothandiza. Ndikupangira Kapoten kwa odwala omwe ali ndi vuto lotenga magazi kwambiri, chifukwa inenso ndimamwa mankhwalawo. Komanso, mtengo umalola."