Momwe mungatengere mankhwala a Lozartan ndi maubwino ake

Losartan ndi imodzi mwazamankhwala ogulitsa kwambiri padziko lonse lapansi. Chomwe chimadziwika ndi kutalika kwa nthawi yayitali komanso chitetezo chachikulu cha mankhwalawa. Zochita za Losartan zimatha maola 24, kotero mlingo umodzi ndi wokwanira patsiku. Poyerekeza ndi mapiritsi ena a antihypertensive, mankhwalawa sakhala oyambitsa zovuta. Ichi ndichifukwa chake amadziwika ndi kudzipereka kwakukulu ku chithandizo: akangoyesa Losartan, 92% ya odwala amasankha.

Ndani amakupatsani mankhwala?

Imfa chifukwa chamikwingwirima ndi matenda a mtima ndiwoyamba mwa kufa kwa akulu padziko lonse lapansi. Kuyembekezeredwa kuti posachedwa matendawa azikhala chifukwa chachikulu cha kulumala. Ku Europe, kunali kotheka kusintha izi, kuchuluka kwa anthu omwe amafa chifukwa cha matenda amtima (CVD) kumayamba kuchepa koma ndithudi kukutsika. Asayansi akuyerekeza kuti gawo lalikulu pakuchita bwino kumeneku siali njira zaukadaulo zapamwamba, koma njira zosavuta zopewera ngozi za CVD.

Zofunikira kwambiri ndiz:

• kuthamanga kwa magazi;
• cholesterol owonjezera ndi triglycerides mu zotengera;
• matenda ashuga
• kunenepa

Ngati kupanikizika kwakhala kwabwinobwino, chiwopsezo cha kufa kuchokera ku CVD chiri pafupi 1%, ngati kuthamanga kwatsatana ndi chinthu china 1 - 1.6%, china china 2 - 3,8%. Ntchito ya adotolo pozindikira zinthu zomwe zingawopseze ndikuchepetsa mphamvu zawo mthupi: kuchepetsa kuthinikizidwa kuti muchepetse mfundo, kusintha mapangidwe a lipid ndi glucose wamagazi, komanso kuchepetsa matendawa.

Losartan ali ndi tanthauzo lotsogolera, mtundu wa mankhwalawa umasankhidwa malinga ndi kupanikizika koyambirira komanso komwe akufuna.

Mankhwalawa amalembedwa motere:

Ngati musankha mlingo woyenera ndikutenga Losartan popanda mipata, mutha kukwaniritsa zomwe anzanu akufuna mu 50% ya odwala. Zina ndizofunikira kuphatikizira mankhwala: antihypertensive wothandizila wina amawonjezeredwa ku mtundu wina wa mankhwala. Mankhwala amakono amapereka chithandizo chachilendo muoposa 90% ya odwala.

Ziwerengero zakumwa mankhwala othandizira antihypertensive ku Russia ndizomvetsa chisoni: mwa anthu omwe ali ndi matenda oopsa, pafupifupi 70% ya anthu okhala m'matauni ndi 45% mwa okhala m'mudzimo amadziwa za matendawa. Amawagwirira ntchito molangizidwa komanso amakhala ndi mavuto 23% yokha.

Matenda olembetsa magazi komanso kukakamizidwa kukhala zinthu zakale - zaulere

Matenda a mtima komanso mikwingwirima ndizomwe zimayambitsa pafupifupi 70% ya imfa zonse padziko lapansi. Anthu asanu ndi awiri mwa anthu khumi amafa chifukwa chotseka mitsempha ya mtima kapena ubongo. Pafupifupi nthawi zonse, chifukwa chakumapeto kowopsa ndichofanana - kuthamanga kwa magazi chifukwa cha matenda oopsa.

Ndikotheka komanso kofunikira kuti muchepetse kukakamizidwa, osatero ayi. Koma izi sizichiritsa matendawa, koma zimangothandiza kuthana ndi kafukufuku, osati zomwe zimayambitsa matendawa.

• Matenda a kukakamizidwa - 97%
• Kuthetsa kwa mitsempha thrombosis - 80%
• Kuthetsa kwa kugunda kwamtima kwamphamvu - 99%
• Kuchotsa mutu - 92%
• Kuwonjezeka kwa mphamvu masana, kukonza kugona usiku - 97%

Kodi mankhwala otayika amakhala bwanji?

Zinthu zoyambirira zakale zomwe zidapangitsa kuti Lozartan apangidwe, zidachitika kumapeto kwa zaka za m'ma 1800. Enzime ya renin, yomwe ndi gawo lofunikira pakukhazikitsa magazi, idasiyanitsidwa ndi maselo a impso. Pambuyo pazaka makumi angapo, chinthu chinapezeka m'mitsempha yama impso yomwe imakhudza kwambiri ziwiya, zomwe zimapangitsa kuti ziwonongeke. Amatchedwa angiotensin. Ulalo wotsiriza wa dongosololi udapezeka pakati pa zaka za m'ma 1900. Inakhala mahomoni aldosterone, omwe amapangidwa ndi adrenal gland. Izi zinali zokwanira kumvetsetsa momwe kamvekedwe ka mtima kamasungidwira mthupi ndipo matenda oopsa amathanso kupewa.

M'mawu osavuta, njira yotsatirayi imagwira ntchito m'thupi lathu: kukakamiza kumatsika impso, renin imapangidwa, yomwe imagwira angiotensin. Angiotensin adapangidwira angiotensin I, womwe ndi peptide wosagwira, kenako, ndikutenga nawo gawo kwa ACE enzyme, amasinthidwa kukhala angiotensin II. Zomwe zimapangidwira ndi vasoconstrictor yolimba, zimayambitsa kukwera msanga kwa mphamvu ndikuthandizira kupanga aldosterone, yomwe imayambitsa kagayidwe kamchere wamadzi.

Losartan adapangidwa zaka 90 zapitazo. Iye anali woyamba mankhwala pagulu latsopano la mankhwala kukakamiza, lomwe limatchedwa angiotensin II receptor blockers, chidule cha ARB. Tsopano m'gululi 6 la mankhwala. Dzinalo la onsewa, kupatula Lozartan, limatha -Sartan, chifukwa chake amatchedwanso Sartan.

Zochita za Losartan zimakhazikitsidwa potseketsa zochitika za angiotensin II, pomwe izi sizikhudza mitundu ina ya kayendetsedwe ka kayendedwe ka magazi ndi mtima.

Zomwe mankhwalawa amathandizira:

1. Chochita chachikulu ndicho hypotensive. Mankhwalawa amayamba kuchepetsa kupanikizika pambuyo pa ola limodzi, amayamba kugwira ntchito pambuyo pazaka 6. Nthawi yonse yogwira ndi tsiku limodzi. Losartan nthawi zonse amalembedwa kwa nthawi yayitali, chifukwa amayamba kupereka kuchepa kwamphamvu kwa kupanikizika pokhapokha miyezi 1-1,5.
2. Kupsinjika kwa kayendetsedwe ka kayendedwe ka kupanikizika kumalepheretsa kupita patsogolo kwa kulephera mtima. Ma Ahibuloseti a ACE amagwira ntchito pamenepa, amakhala othandiza kwambiri, koma oloartan amalekeredwa bwino.
3. Kuteteza nephrons impso ku chiwonongeko, amachepetsa kukula kwa aimpso kulephera, akuchedwa kufunika kwa hemodialysis. Losartan itha kuchepetsa kuchuluka kwa mapuloteni mu mkodzo ndi 35%, kuthekera kwa kulephera kwathunthu kwa impso - ndi 28%.
4. Kuteteza bongo ndi matenda oopsa: kumachepetsa chiopsezo cha stroke, kumapangitsa kukumbukira kukumbukira. Asayansi akukhulupirira kuti izi zimagwirizanitsidwa osati ndi kuchepa kwa kukakamiza, komanso ndi zina, zomwe sizinaphunzire zotsatira za mankhwalawa.
5. Zimabweretsa kusintha pamkhalidwe wamtundu wolumikizana: kumalimbitsa makoma amitsempha yamagazi, kumalimbikitsa kuchira kwa minofu. Amakhulupirira kuti zowonjezera za Losartan "ndizolakwika" pazomwe zimapangidwa ndi collagen.
6. Amathandizira kuthetsa uric acid owonjezera, motero amalimbikitsidwa makamaka kuti muchepetse kuthamanga kwa odwala omwe ali ndi gout.

Mlingo wa mapiritsi a losartan

Zomwe zimagwira zomwe ndi gawo la losartan ndi potaziyamu losartan. Chithandizo choyambirira ndi kampani ya American Cozaar Merck. Mankhwala otchedwa losartan ndi majeniki. Amakhala ndi zinthu zomwezo ndipo ali ndi mitundu yofanana ndi yoyambirira ya Cozaar.

Ma analogi otsatirawa adalembetsa ku Russia:

Mlingo wa mapiritsi a losartan:

• 12,5 mg ikhoza kugwiritsidwa ntchito ngati losartan adalembedwa ndi othandizira ena othandizira.
• 25 mg ndi muyezo wofanana wa okodzetsa.
• 50 mg - mogwirizana ndi malangizo, mankhwalawa amalola kuti muchepetse kupanikizika kwa odwala ambiri, amaperekedwa nthawi zambiri.
• 100 mg imatengedwa ngati kuchepetsa kukakamiza kuchokera ku manambala ofunikira kukufunika.

Palinso mapiritsi osakanikirana omwe nthawi yomweyo amakhala ndi zinthu ziwiri zokhala ndi hypotensive zotsatira: losartan potaziyamu ndi diuretic hydrochlorothiazide. Pazina la Lozartan N, amapangidwa ndi Canonfarm, Atoll ndi a George Richter. Mtengo wa Losartan N - 160-430 rubles.

Momwe angatenge

Malamulo a kutenga losartan kuchokera kuzomwe angagwiritse ntchito:

1. Mankhwalawa aledzera 1 kamodzi patsiku, koma mosavuta, piritsi limatha kugawidwa mu 2 Mlingo.
2. Malangizowo akuti zilibe kanthu kuti mutenge liti mankhwalawa m'mawa kapena madzulo. Losartan ndi lotseguka kwa maola osachepera 24. Chachikulu sikuti musinthe nthawi yomwe mwalandira. Ndemanga za odwala zimawonetsa kuti phwando lam'mawa lidakali labwino. Poterepa, nsonga yogwira ntchito ku Losartan imagwera nthawi yogwira ntchito kwambiri masana.
3. Kudya sikumakhudza mayamwidwe ndi magwiritsidwe ntchito a losartan, chifukwa chake amatha kumwedwa musanadye kapena mutatha kudya.
4. Mlingo woyamba wa odwala ambiri ndi 50 mg. Itha kuonjezeredwa osapitilira sabata mutatha kumwa mankhwalawo.
5. Pakulephera kwa mtima, makonzedwe amayamba ndi 12,5 mg, pang'onopang'ono kuchuluka kwa 50 mg.
6. Ndi kulephera kwa chiwindi, kulephera kwambiri kwaimpso, mwa odwala omwe ali ndi zaka zoposa 75, mlingo woyambira ndi 25 mg.
7. Mlingo wambiri watsiku ndi tsiku ndi 100 mg, pamaso pa kulephera kwa mtima mutha kuwonjezereka ndi dokotala mpaka 150 mg.

Ngati piritsi limodzi la Losartan 100 mg silokwanira kuthana ndi zovuta, likhoza kuphatikizidwa ndi antihypertensive mankhwala ochokera m'magulu ena.

Kodi madokotala amalimbikitsa kuti ayambe kumwa mankhwalawa ndi mankhwala otani? Monga lamulo, kuchokera pamlingo wa 140/90. Mlingo uwu umawerengedwa kuti ndiwokweza komanso wowononga boma wamitsempha yamagazi ndi ntchito ya mtima, impso, ndi ubongo. Ndi kupanikizika kosalekeza kapena kulumpha mobwerezabwereza, kudya kosalekeza kwa Losartan kumayikidwa. Matenda oopsa ndi matenda osachiritsika, chifukwa chake amamwa mankhwalawo ngakhale zikuwoneka kuti kupanikizika kwabwereranso. Kuphatikiza pa mapiritsi, njira zabwino zothanirana ndi matenda oopsa ndi kuchepa thupi, kuthamanga, kusiya kusuta fodya, kuchepetsa mowa, kuchepetsa kumwa zamasamba komanso kuchepetsa kuchuluka kwa mchere, komanso kupewa zinthu zopsinja mtima.

Zotsatira zoyipa

Zotsatira zoyipa za losartan zimakhala zofatsa, nthawi zambiri zimachoka pazokha, sizifunikira kusiya chithandizo. Mankhwalawa adadutsa maphunziro angapo olamulidwa ndi placebo, pomwepo zidapezeka kuti kufalikira kwa zosafunikira zomwe zimachitika mutatenga Losartan kumachepetsedwa pang'ono kuposa gulu la placebo (2.3 motsutsana 3.7%).

Malinga ndi odwala matenda oopsa, zovuta zosafunikira ndizochepa kwambiri mwa iwo, ndikotheka kutsata ubale pakati pa kumwa mapiritsi ndi kuwonongeka bwino padera. Monga lamulo, zotsatira zoyipa ndizosakhalitsa m'chilengedwe. Odwala adazindikira chifunga m'mitu yawo, chizungulire, pakamwa pouma koyambirira kwa phwando. Pakutha kwa mwezi 1, zinthuzi zimazimiririka.

Zambiri pazotsatira zoyipa zomwe zimapezeka zoposa 1% (malinga ndi gulu la WHO zimawerengedwa pafupipafupi) kwa odwala omwe amatenga losartan:

Mu 10% ya odwala matenda ashuga komanso aimpso kuwonongeka, panali kuwonjezeka kwa potaziyamu wamagazi mpaka 5.5 ndi kukwera ndi kuchuluka kwa 3.4-5.3. Mukatenga placebo, kuwonjezereka kotereku kunapezeka mu 3.4% ya odwala. Kupanda kutero, losartan amalekeredwa bwino mgulu la odwala.

Malinga ndi malangizo, ndi vuto la mtima, hyperkalemia imawonedwa osakwana 1%, pafupipafupi zotsatira zosafunikira zimawonjezeka ndi mlingo wowonjezereka kuchokera pa 50 mpaka 150 mg.

Contraindication

Malangizo ogwiritsira ntchito losartan ali ndi mndandanda wokwanira wa zotsutsana ndi ntchito yake:

1. Mankhwala angayambitse thupi lawo siligwirizana. Amapezeka osakwana 1% ya odwala matenda oopsa. Anaphylactic zimachitika, choncho, odwala omwe adadwala angioedema ayenera kusamala makamaka kumayambiriro kwa chithandizo. Chiwopsezo chachikulu chili mwa anthu omwe ali ndi chifuwa cha ACE inhibitors.
2. Sizoletsedwa chifukwa chakulephera kwambiri kwa chiwindi, chifukwa chiwindi choperewera m'magazi, chomwe ndi mankhwala osokoneza bongo. Wodwala amatha kudwala matenda oopsa komanso tachycardia.
3. Losartan ndi sartan onse sayenera kuledzera panthawi yapakati. Malinga ndi gulu la FDA, mankhwalawa ndi a m'gulu la D. Izi zikutanthauza kuti pakupanga kafukufuku adakhazikitsidwa ndikuwonetsa zoyipa zake pa mwana wosabadwayo. Kusokonezeka kwa impso za mwana, ndikuchepetsa kukula kwa mafupa a chigaza, oligohydramnios. Mu 1 trimester, kugwiritsa ntchito mankhwalawa sikowopsa. Malangizo ogwiritsira ntchito ali ndi chidziwitso: ngati pakati mumayamwa nthawi ya Losartan, mankhwalawa amathetseka mwachangu. Mzimayi amafunika kuyesedwa mu 2nd trimester - ultrasound ya mwana wosabadwayo kuti azindikire zovuta zomwe zingachitike pakukula kwa impso ndi chigaza.
4. Losartan ndi yoletsedwa mu hepatitis B, chifukwa sichikudziwika ngati ilowa mkaka.
5. Mapiritsi a Lozartan sangathe kugwiritsidwa ntchito mwa ana chifukwa chosowa deta pa chitetezo chake chamoyo chomwe chikukula.
6. Mu kapangidwe ka losartan pali lactose (kapena cellactose), kotero mankhwalawa sayenera kumwa ngati kutengeka kwake kukulephera.
7. Chifukwa cha kuyanjana kwa mankhwalawa, ndizoletsedwa kumwa losartan pamodzi ndi aliskiren (mankhwala ochokera ku Rixil Press, Rasilez, Rasil) kwa odwala omwe ali pachiwopsezo chachikulu cha kulephera kwa impso: ndi matenda a shuga ndi impso.

Mikhalidwe yotsatirayi siyotsutsana kwambiri ndi chithandizo cha Losartan, koma imafunikira chisamaliro chapadera ku thanzi lawo: matenda a impso, hyperkalemia, kulephera kwa mtima, zosokoneza zilizonse m'magazi a magazi kupita ku ubongo, kupanga kwambiri aldosterone.

Popeza losartan samalumikizana ndi Mowa, malangizowo samafotokoza kuchuluka kwa mowa ndi mankhwalawa. Komabe, madokotala amaletsa mwamphamvu kumwa mowa mukamalandira mankhwalawa. Ethanol imalowetsa magazi m'mitsempha yamagazi, imalimbikitsa kukula kwa matenda oopsa ndipo potero kuthetseratu kuchiritsa kwa Losartan.

Analogs ndi choloweza

Pakadali pano, ku Russia kokha ndi ma fanenti angapo a Cozaar omwe adalembetsa, ndipo padziko lapansi pali zochulukirapo. M'mafakitala ambiri, mutha kugula zosankha ziwiri kuti mutulutse Cozaar:

• paketi 14 yamapiritsi 50 a 50 mg ndi pafupifupi ma ruble 110.,
• Phukusi la mapiritsi 28 a 100 mg aliyense - ma ruble 185.

Mitundu yama makampani akulu azamankhwala samawononga ndalama zochepa, ndipo nthawi zina imapitirira pang'ono, kuposa zoyambayo. Koma zitha kugulidwa ku pharmacy yapafupi, ndipo ndizotheka kusankha mlingo woyenera.

Mutha kusintha m'malo mwa losartan ndi mankhwala otsatirawa:

Ma Analogs amatha kusiyanasiyana pang'ono ndi zoyambirira malinga ndi kuchuluka kwa mayamwidwe ndi kulimba kwa zochita, chifukwa chake, madokotala amalimbikitsa kuti asankhe majeniki omwe adutsa mayeso awo azachipatala. Mwachitsanzo, kwa Lozap ndi Lorista, zotsatira zoyipa za maola 24 zinatsimikiziridwa, zotsatira zofananira panthawi yonse yochitapo, zovuta zochepa. Kuunika kwa odwala kumatsimikizira malingaliro a madokotala. Mapiritsi olinganizidwa kwambiri ndi a Lozartan ochokera ku Vertex ndi Ozone (Atoll), Lorista ndi Lozap.

Yerekezerani ndi mankhwala ofanana

Kafukufuku wokhudzana ndi magulu osiyanasiyana a mankhwala a antihypertensive sanawonetse phindu lililonse mu mankhwalawa. Izi zikutanthauza kuti mankhwala onse amakono amachepetsa kupsinjika ndi chiwopsezo cha CVD. Mwachilengedwe, bola kuti mankhwalawa amasankhidwa moyenera, ndipo mapiritsi amatengedwa mosalekeza, osasiyidwa. Kusiyana kwakukulu mu njira yakukakamizika ndiko kulekerera kwawo ndi mphamvu ya zovuta, ndizofunikira mwanjira izi kuti mankhwala ofunikira amasankhidwa.

Losaratan ndi mawonekedwe ake amadziwika ndi kulolerana kwabwino kwambiri:

1. Amakhala ocheperako kuposa ena zomwe zingayambitse kuchepa kwambiri kwa kupanikizika, zomwe sizingayambitse odwala a collaptoid.
2. Mosiyana ndi beta-blockers (propranolol, atenolol, etc.), ma analogi a Losartan samakhudzanso mtima, kuvunda, sikumayambitsa chifuwa cha bronchospasm.
3. Ngati tingayerekeze sartan ndi omwe akupikisana nawo kwambiri, ACE inhibitors (Captopril, enalapril, ramipril, ndi ena otero), ndiye zimapezeka kuti losartan imayambitsa kutsokomola pang'onopang'ono (malangizo omwe amagwiritsidwa ntchito, mafupipafupi ndi 9,9% a Ace inhibitors, 3,1% kwa losartan ), Hyperkalemia, edema ya Quincke.
4. Zotsatira za losartan sizimatengera zaka, mtundu, jenda komanso magawo a hemodynamic.
5. Pakuwona kwa odwala omwe amamwa mankhwalawa, nthawi zambiri pamakhala mawu akuti losartan ndiwofooka kuposa mapiritsi ena opsinjika. Kafukufuku amatsutsa izi. Chowonadi ndi chakuti mphamvu ya mankhwalawa imakulirakulira pang'onopang'ono, imapeza mphamvu zonse mkati mwa masabata 2-5. Kumapeto kwa nthawi ino, kugwira ntchito bwino kwa Losartan ndikofanana ndi mankhwala ena a antihypertensive.
6. Kuwunikira kwa kafukufukuyu kuchokera ku kafukufuku wambiri wokhudza Losartan adawonetsa kuti mawonekedwe ake samasiyana ndi ACE zoletsa. Komanso ali pafupi kuti achepetse pafupipafupi stroketi komanso mtima, mtundu wa moyo, momwe thupi la odwala limakhalira ndi nephropathy komanso matenda ashuga.
7. Nthawi yayitali yomwe imatenga kuti zitheke kwambiri imatha chifukwa cholimbikira ku Losartan. Pogwiritsa ntchito nthawi yayitali, mphamvu ya ACE inhibitors ndi beta-blockers itha kuchepa, ndipo izi ndizochepa kwambiri ndi mapiritsi a Lozartan.
8. Pakulephera kwa mtima, mwayi wa Losartan ndi kufananizira kwake sikunatsimikiziridwe; kafukufuku wa zamankhwala samalola kutsiriza komaliza. Pakadali pano, kuphatikiza kwa aldosterone antagonists (spironolactone) ndi beta-blockers kumawoneka ngati kothandiza kwambiri. Kuphatikiza kwa sartans ndi ACE inhibitors kuli malo achiwiri.

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