Mankhwala osokoneza bongo a matenda a shuga a mtundu wachi 2 amagwiritsidwa ntchito kwambiri mankhwalawa omwe amapezeka ndikukula kwa matenda oopsa a shuga, kusakwanira kapena ngati pakufunika kuthetsa edema ya mwendo.
Mpaka pano, pali mitundu yambiri yamankhwala osiyanasiyana omwe apangidwa omwe amatha kuwonjezera mkodzo wambiri.
Kusankha kwa diuretic, ngati kuli kotheka, kuyenera kuchitika ndi adokotala pozindikira zotsatira za kusanthula kwake, poganizira umunthu wa thupi la wodwalayo.
Chimodzi mwa mankhwala wamba ndi indapamide.
Indapamide ndi ya gulu la thiazide-ngati diuretics. Mankhwala ali vasodilating.
Ma diuretics amagwiritsidwa ntchito ngati mankhwala othandizira odwala matenda ashuga. Mankhwalawa amalimbikitsa zotsatira za ACE inhibitors.
Taizide-ngati diuretics, kuphatikizapo Indapamide, amathandiza kwambiri matenda ashuga. Mankhwalawa sakukhudzidwa pang'ono ndi njira ya potaziyamu komanso kuchuluka kwa shuga ndi mafuta m'magazi.
Kuvomerezedwa kwa Indapamide kwa matenda a shuga a 2 sikuti kumayambitsa zovuta mu kugwira ntchito kwa impso za wodwalayo.
Mankhwalawa ali ndi phindu lalikulu m'thupi la wodwalayo nthawi iliyonse yovulala impso, yomwe imayendera limodzi ndi matenda a shuga a mtundu wodziimira pawokha a insulin.
Kuphatikizika kwa mankhwalawa, kufotokoza kwina ndi pharmacotherapy
Mankhwalawa amapangidwa ndi makampani azachipatala momwe amapangira mapiritsi amkamwa.
Mankhwala omwe ali pamwambapa ali ndi zokutira zamafuta.
Chofunikira chachikulu chothandizira cha mankhwalawa ndi indapamide, piritsi limodzi lili ndi 2,5 mg ya pawiri.
Kuphatikiza pazomwe zimagwira, mankhwala ena owonjezera omwe ali ndi gawo lothandizira amathandizidwa ndikupanga mankhwala.
Mapulogalamu othandizira ndi awa:
- lactose monohydrate;
- povidone-K30;
- crospovidone;
- magnesium wakuba;
- sodium lauryl sulfate;
- talcum ufa.
Zomwe zikuchokera pamwamba pa chiganamba cha mapiritsi ndi izi:
- Hypromellose.
- Macrogol 6000.
- Talc.
- Titanium dioxide
Mapiritsiwo amakhala ndi mawonekedwe ozungulira, opindika ndipo amakhala utoto woyera.
Mankhwala ndi a gulu la mankhwala a diuretic. Malo ake ali pafupi kwambiri ndi thiazide diuretics.
Pambuyo kumwa mankhwalawa, kwamikodzo excretion wa sodium ndi chlorine kuchokera mthupi la munthu umachuluka. Pocheperako zimakhudza njira ya excretion wa potaziyamu ndi magnesium ayoni thupi.
Mankhwalawa amatha kuletsa njira zamkati mwa michere ndikuwonjezera kukhuthala kwa khoma lamitsempha yama mitsempha, kuchepetsa kukanikizika kwathunthu kwamitsempha yama thupi.
Kumwa mankhwalawa kumathandiza kuchepetsa hypertrophy ya mtima wamanzere ventricle.
Kugwiritsa ntchito mankhwalawa sikukhudza kuchuluka kwa kuchuluka kwa lipid m'magazi ndipo sikukhudza kagayidwe kazakudya.
Kumwa mankhwala kumakuthandizani kuti muchepetse kuzindikira kwa khoma lamitsempha ku zotsatira za norepinephrine ndi angiotensin II pamenepo, ndipo amakupatsani mwayi wophatikiza kuphatikizika kwa prostaglandin E2 m'thupi.
Kugwiritsa ntchito mankhwala kumachepetsa kukula kwa mapangidwe a ma free radicals komanso okhazikika mthupi.
Kupitilira kwamphamvu kwa mankhwalawa kumachitika sabata pambuyo pa kuyamba kwa mankhwalawa ndikupitilira tsiku limodzi pakapita tsiku limodzi.
Pharmacokinetics wa mankhwala
Mutatha kumwa mankhwalawa, umatengetsa kwathunthu kuchokera m'matumbo amkati ndikuzungulira magazi. Mankhwalawa ali ndi bioavailability yayikulu, pafupifupi 93%.
Kudya kumakhala kolepheretsa kupezeka kwa mankhwala kulowa m'magazi, koma sikukhudza kuchuluka kwa mankhwala omwe amamwa. Kuzindikira kwamphamvu kumatheka m'magazi 1-2 patatha kumwa mankhwalawo mkati.
Pogwiritsa ntchito mankhwalawa mobwerezabwereza, kusinthasintha kwake komwe kumapangitsa chidwi chake mthupi pakati pamadontho kumachepetsedwa. Mankhwalawa amafika pamtunda wofanana mu thupi pambuyo masiku 7 atatha kumwa mankhwalawa.
Hafu ya moyo wa mankhwalawa imachokera ku maola 14 mpaka 24. Mankhwalawa amakumana ndi mapuloteni a m'magazi a m'magazi. Mlingo wa zomanga mapuloteni ndi pafupifupi 79%.
Gawo lomwe limagwiritsa ntchito mankhwalawo limatha kumangiriza ndi elastin yopanga minofu yosalala yomwe ili mbali ya khoma la mtima.
Mankhwala amatha kudutsa zotchinga minofu, amatha kudutsa chotchinga chachikulu. Mukamwa mankhwala, imadutsa mkaka wa m'mawere.
Kupanga kagayidwe kogwira ntchito kumachitika m'ziwindi za chiwindi. Excretion wa gawo yogwira ikuchitika mu mawonekedwe a metabolites ndi impso mu 60% 80%. Ndi ndowe, pafupifupi 20% imachotsedwa m'matumbo.
Ngati wodwala walephera, a pharmacokinetics a mankhwalawa sasintha. Kudzikundikira ndalama mthupi sikumachitika.
Zizindikiro ndi contraindication chifukwa cha mankhwala
Chizindikiro chachikulu cha kumwa mankhwala a shuga ndikutukuka kwa wodwala yemwe ali ndi matenda oopsa.
Monga chida china chilichonse chachipatala, Indapamide imakhala ndi zotsutsana zingapo kuti zigwiritsidwe.
Kugwiritsira ntchito mankhwalawa kumaloledwa pokhapokha ngati pali zotsutsana ndi wodwala.
Milandu ikuluikulu yomwe imagwiritsidwa ntchito ngati mankhwala ndi awa:
- wodwala amakhala ndi chidwi chachikulu ndi mankhwala omwe amapangidwa pamaziko a sulfonamide;
- tsankho kwa odwala ndi lactose;
- wodwala ali ndi galactosemia;
- ngati munthu awonetsa zizindikiro za matenda a malabsorption a shuga kapena galactose;
- chizindikiritso choopsa cha aimpso kulephera kwa wodwala;
- kukhalapo kwa zizindikiro za hypokalemia;
- kukhalapo kwa chiwindi kwambiri;
- matenda a shuga a impso;
- nthawi ya bere ndi kuyamwitsa;
- wodwala mpaka zaka 18;
- kuchitira chithandizo momwe munthawi yomweyo makonzedwe a othandizira amatha kutalikitsa nthawi ya QT akuchitika.
Mosamala, muyenera kumwa mankhwalawa mukazindikira kuti pali vuto la impso ndi chiwindi, ngati wodwala akupezeka m'magazi a electrolyte, ngati pali hyperparathyroidism m'thupi.
Kuphatikiza apo, Indapamide iyenera kugwiritsidwa ntchito mosamala popanga mankhwala omwe mankhwala a antiarrhythmic amagwiritsidwa ntchito kale.
Chenjezo limagwiritsidwa ntchito ngati mankhwala akupanga matenda a shuga kumapeto kwa kuwonongeka.
Malangizo ogwiritsira ntchito mapiritsi
Kuvomerezeka kwa mankhwalawa kumachitika mosasamala ndondomeko yakudya. Zakudya zam'mapiritsi zimayenera kutsatiridwa ndikumwa madzi ambiri. Nthawi yabwino kwambiri yothira mankhwalawa ndi m'mawa.
Mlingo wamba wabwinowu wothandizidwa ndi 2,5 mg kapena piritsi limodzi patsiku. Ngati pambuyo pa masabata 4-8 a chithandizo chomwe mukufuna sichikwaniritsidwa, mankhwalawa sayenera kuchuluka. Kuwonjezeka kwa mlingo kungawononge chitukuko m'thupi la zotsatira zoyipa chifukwa chogwiritsa ntchito mankhwalawa.
Pakakhala zotsatila zamankhwala, tikulimbikitsidwa kusintha mankhwalawo kukhala othandiza kwambiri. Zikachitika kuti mankhwalawa amachitika pogwiritsa ntchito mankhwala awiri, mlingo wa Indapamide amakhalabe wosasinthika pa 2,5 mg patsiku.
Mukamamwa Indapamide mwa munthu, zotsatira zina zoyipa zimatha kuonekera zomwe zimawoneka m'magwiridwe antchito osiyanasiyana amthupi.
Zotsatira zoyipa zomwe zimapezeka ku Indapamide pa matenda ashuga ndi:
- Matumbo oyenda. Mwina chitukuko cha kutsegula m'mimba, kudzimbidwa, kuwoneka kwa ululu pamimba. Nthawi zambiri pamakhala kugunda kwamkamwa komanso kuwuma pamkamwa. Mwina kuwoneka kusanza nthawi zina, kukula kwa kapamba kumatheka.
- Pakati mantha dongosolo. Mwina chitukuko cha dziko la asthenic, mawonekedwe a manjenje owonjezereka, kupweteka kwa mutu ndi matenda ashuga, kuwonjeza kugona. Nthawi zina, kufooka kwambiri ndi kufooka wamba kumawonekera. Nthawi zina pamakhala kumverera kwazonsezi, kuchepa kwa minofu, kusakwiya komanso kumva nkhawa.
- Pa gawo la kupuma kwamphamvu, kukula kwa chifuwa, pharyngitis, sinusitis, ndipo nthawi zina, Rhinitis ndiyotheka.
- Mtima wamtima. Mwinanso kukulitsa kwa orthostatic hypotension, kusintha kwa electrocardiogram, ndizotheka kuti wodwalayo akhale ndi arrhythmias pamtima ndikuchulukitsa kugunda kwa mtima.
- Njira yamikodzo. Kuthekera kwakukulu kokulitsa matenda pafupipafupi ndi polyuria.
- Khungu. Mwina chitukuko cha thupi lawo siligwirizana akuwoneka ngati zotupa pakhungu, kuyabwa kwa khungu ndi hemorrhagic vasculitis.
Kuphatikiza pazotsatira zoyipa izi, thrombocytopenia, leukopenia, agranulocytosis, komanso kuchulukitsa kwa systemic lupus erythematosus kumatha kukhala mthupi la wodwalayo.
Mndandanda wamankhwala, mawonekedwe omasulidwa, mtengo wake komanso malo osungira
Mankhwala amapezeka mu mawonekedwe a mapiritsi okhala ndi piritsi, piritsi lililonse lili ndi 2.5 mg ya mankhwalawa.
Mapiritsi amtundu wa 10 zidadzaza mu cell contour wapadera ma CD opangidwa ndi polyvinyl chloride film ndipo yokutira ndi aluminiyamu zojambulazo. Mapaketi atatu apadera, komanso malangizo ogwiritsira ntchito mankhwalawa, aikidwa m'mathumba a makatoni.
Mankhwalawa amawaika kuti azisungidwa pamalo amdima pamtunda wa 15 mpaka 25 digiri Celsius. Malo osungira mankhwalawa sayenera kupezeka kwa ana.
Alumali moyo wa mankhwala ndi zaka 3. Ikatha nthawi yosungirako, mankhwalawo ndi oletsedwa. Mankhwala omwe atha ntchito amataya.
Kuphatikiza pa Indapamide, mankhwala adapangidwa omwe amafananizira.
Odziwika kwambiri ndi otchuka ndi awa:
- Arifon Repard - analog wotchuka kwambiri a Indapamide, samakhudza kagayidwe kazachilengedwe.
- Acriptamide ndi analog ya Indapamide, yomwe ndi yaku Russia.
- Indap ndi mankhwala opangidwa ku Czech Republic.
- Noliprel ndi mankhwala osakanikirana omwe ndi othandiza kwambiri.
- Perinid ndi mankhwala otchuka omwe ali oyenera odwala ambiri.
Mtengo wa Indapamide m'gawo la Russian Federation pafupifupi 12 mpaka 120 ma ruble, kutengera wopanga ndi dera lomwe mankhwalawo amagulitsidwa.
Katswiri kuchokera pa kanema munkhaniyi azikamba za zamtundu wa Indapamide.
