Malamulo a kumwa mapiritsi a kukakamiza Noliprel ndi kuwunika kwa wodwala

Noliprel ndi mankhwala amakono othandizira othandizira kuchepetsa magazi. Zigawo ziwiri zogwira ntchito mkati mwa piritsi limodzi zimakwaniritsa zofunikira za njira zamakono zochizira matenda oopsa. Mankhwalawa ndi othandiza kwambiri kuposa masiku onse, kuphatikiza apo, samayambitsa zotsatira zoyipa. Kuti mufike pazomwe zimapanikizika kwambiri (nthawi zambiri zimakhala pansi pa 140/90), 50% ya odwala matenda oopsa amayenera kumwa mankhwala angapo nthawi zosiyanasiyana. Malangizo a mankhwalawa nthawi zambiri amakhala osathandiza, chifukwa odwala ambiri amaiwala kumwa piritsi panthawi. Kuphatikizika kwa noliprel kumathandizira kwambiri kutsatira mankhwalawa, chifukwa amatengedwa kamodzi patsiku.

Ndani amakupatsani mankhwala?

Anthu opitilira theka la anthu opitilira 60 amadwala matenda oopsa. Chaka chilichonse, vutoli limachulukirachulukira, monga m'moyo wamunthu wamakono pamakhala zinthu zambiri zowopsa zowonjezereka: kupsinjika, kusayenda, kulemera, zizolowezi, mpweya wowipitsidwa. Hypertension ndi chimodzi mwazomwe zimayambitsa matenda a sitiroko ndi matenda a mtima, choncho muyenera kuthandizira mukangopezeka kuti mwapeza.

Kutsutsana komwe kumayambira kumwa mapiritsi kwatha. Malinga ndi gulu lomwe limavomerezedwa padziko lonse lapansi, kuchuluka kwa 120/80 kumadziwika kuti ndikwabwino, ndikuwonjezeka mpaka 139/8. Matenda oopsa a Level 1 amapezeka kuyambira pa mulingo wa 140/90. Ndi matenda a shuga ndi matenda a impso, malire ochepa amakhala ochepa, mapiritsi amaperekedwa, kuyambira manambala 130/80. Kumayambiriro kwa matendawa, kupanikizika kumakhala kwachilendo nthawi zambiri, kumangokulira apo ndi apo. Njira zosagwiritsa ntchito mankhwalawa ndizothandiza panthawiyi: kudya, kusiya chikonga ndi mowa, zochitika za tsiku ndi tsiku, kuchepetsa thupi. Mankhwala amalumikizidwa ngati nkotheka kutulutsa nkhawa ndi izi.

Malinga ndi madokotala, kwanthawi yoyamba, odwala ambiri amangofunika mankhwala amodzi omwe ali ndi chinthu chimodzi chogwira ntchito. Ngati chithandizo chotere sichothandiza, gwiritsani ntchito mankhwala angapo a antihypertensive kapena osakaniza chimodzi. Noliprel imakhala ndi imodzi mwaziphatikizo zogwira bwino kwambiri, zophatikiza ACE inhibitor ndi diuretic.

Ubwino wa mapiritsi osakaniza:

1. Zinthu zomwe zimapanga Noliprel zimakhudza zomwe zimayambitsa kupezeka kwa matenda oopsa kuchokera kumbali zosiyanasiyana, chifukwa chake, kuphatikiza kwake kumakhala kwamphamvu komanso kukhazikika.
2. Kuchepetsa kupanikizika kumatheka ndi milingo yotsika ya zinthu zomwe zimagwira, kotero pafupipafupi pazotsatira zosafunikira ndizochepa.
3. Chifukwa cha kuphatikizika bwino, chinthu chimodzi chimachepetsa zotsatira zoyipa za chinzake - okodzetsa amachepetsa hyperkalemia, yomwe imatha kupangitsidwa ndi ACE inhibitor.
4. Zotsatira zophatikizika za Noliprel zimayamba mwachangu.
5. Wodwala amafunikira kumwa piritsi limodzi lokha patsiku, zosiyidwa zimachitika kangapo ngati mumwa mankhwala osiyanasiyana a 2-3, kotero kugwiritsa ntchito bwino mankhwalawa kumakhala kwakukulu.

Chizindikiro chokha chogwiritsa ntchito Noliprel ndi matenda oopsa. Awa ndi mankhwala ochepetsa mphamvu yotsika omwe angagwiritsidwe ntchito kwa wodwala aliyense yemwe alibe contraindication. Kusankhidwa kwa mapiritsi ena kukakamiza kumadalira matenda oopsa oopsa. Malinga ndi malangizo, Noliprel ndi imodzi mwazomwe amathandizira kuti achepetse kupanikizika kwa odwala matenda ashuga, popeza ili ndi imodzi mwazotetezedwa kwambiri pa matenda ashuga - indapamide. Amadziwikanso mwachangu matenda a metabolic, kuperewera kwamtima, matenda a mtima, nephropathy, atherosulinosis.

Kodi mankhwalawa ali bwanji Noliprel

Kuphatikiza kwa zinthu zomwe zimagwira pamapiritsi a Noliprel sikuti amangothandiza, komanso ogwira ntchito kwambiri. Imakhudzanso zinthu ziwiri zomwe zimayambitsa matenda oopsa:

1. Thupi perindopril ndi la gulu la mankhwala a ACE inhibitor. Zimasokoneza ntchito yamakonzedwe a renin-angiotensin, chifukwa cha momwe kupsinjika kwa thupi lathu kumayendetsedwa. Perindopril imalepheretsa kupangika kwa mahomoni angiotensin II, omwe ali ndi mphamvu ya vasoconstrictor. Imachulukitsa zochita za bradykidin - peptide yomwe imafinya mitsempha yamagazi. Zomwe zimathandizira perindopril: kugwiritsa ntchito nthawi yayitali, sikuti zimangochepetsa kukakamiza, komanso zimachepetsa katundu m'mitsempha yama mtima ndi mtima, zimathandizira mkhalidwe wamakhoma wamitsempha, zimachepetsa pang'ono insulin kukana.
2. Thupi lachiwiri pakupanga kwa Noliprel, indapamide, limagwira ntchito mofanananso ndi thiazide diuretics: limathandizira kuphipha kwa mkodzo, kumawonjezera kuchulukitsidwa kwa sodium, chlorine, magnesium, potaziyamu ndi mkodzo. Nthawi yomweyo, kuchuluka kwa madzi mthupi kumachepa, komwe kumapangitsa kutsika kwa ziwiya.

Chimodzi mwazotsatira zoyipa za ACE zoletsa, ndipo perindopril, makamaka, ndi hyperkalemia, yomwe imatha kusokoneza kusokonekera kwa mtima. Vutoli limayamba chifukwa chosowa mahomoni aldosterone, kaphatikizidwe kamene kamayendetsedwa ndi angiotensin II. Chifukwa cha kukhalapo kwa indapamide, yomwe imachotsa potaziyamu yambiri, mukamamwa Noliprel, kuchuluka kwa Hyperkalemia kumakhala kotsika poyerekeza ndi chithandizo ndi perindopril chokha.

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%

Ndemanga za akatswiri odziwa za mtima za Noliprel ndizabwino. Mbiri yabwino ya mankhwalawa imathandizidwa ndi maphunziro ambiri.

Zomwe zikuchitika pa Noliprel:

• m'mwezi woyamba wa chithandizo, kuthamanga kwa magazi kumachepa mu 74% ya odwala, pofika mwezi wachitatu - mu 87%;
• mu 90% ya okalamba odwala matenda oopsa, pakatha mwezi wokhazikitsa, kuponderezedwa kumatsitsidwa mpaka 90;
• patatha chaka chogwiritsidwa ntchito, kulimbikira kumapitirira 80% ya odwala.
• mankhwalawa amagwira ntchito bwino kwa odwala omwe amafuna chithandizo chankhanza: Mlingo wambiri kapena mankhwala angapo a antihypertensive. Amawonetsa zotsatira zabwino ndi diabetesic nephropathy, komanso hypertrophy yamanzere yamanzere.
• Noliprel amadziwika ndi chitetezo chachikulu. Zotsatira zoyipa zoyipa siziri zosiyana ndi placebo.

Pochiza matenda oopsa, bungwe la WHO limalangiza m'malo kuwonjezera kuchuluka kwa mankhwala omwe amapanga gawo limodzi kuti asinthane ndikuphatikiza mankhwalawa, ndipo ndikofunika kuyamba kumwa mankhwala ochepetsa mphamvu. Mapiritsi a Noliprel amatsatira kwathunthu malangizo awa.

Kutulutsa mawonekedwe ndi mlingo

Wopanga Noliprel ndi kampani ya ku France yopangira mankhwala, dzina lake Servier, yomwe imadziwika chifukwa cha chitukuko pakuthandiza pa matenda a mtima ndi matenda ashuga. M'mbuyomu, mankhwalawa amapangidwa m'mitundu iwiri: Noliprel / Noliprel Forte. Kuyambira 2006, kapangidwe kake kasintha, mchere wina wa perindopril unayamba kugwiritsidwa ntchito. Chifukwa cha izi, moyo wa alumali wa mapiritsi osataya mawonekedwe adatha kuwonjezeka ndi theka. Chifukwa cha kuchuluka kwa mchere wamchere, mulingo wa mapiritsiwo unayenera kusintha pang'ono. Tsopano mankhwalawa akupezeka m'mitundu itatu:

Noliprel amapangidwa ndi mafakitale a Servier omwe amakhala ku France ndi Russia. Zinthu zothandizira pazosankha zonse zamankhwala zimapangidwa ku France kokha.

Mapiritsi a Noliprel ali ndi mawonekedwe amtali, amatetezedwa ndi membala wamakanema, chifukwa chophweka chogawa theka limaperekedwa ndi notch. Kupaka - botolo la pulasitiki lokhala ndi mapiritsi 30. Makina ena opangira sanaperekedwe.

Momwe angatenge

Ndi kupanikizika koyambirira, Noliprel amatha kukhazikitsidwa atazindikira matendawa. Ngati vutoli siliri loopsa (ndi matenda oopsa 1), mankhwala omwe ali ndi gawo limodzi amasankhidwa.

Malinga ndi malangizo, kusankha kwa mlingo wa Noliprel kumayamba ndi milingo yaying'ono kwambiri. Ngati ndi thandizo lawo sizinali zotheka kukwaniritsa chandamale chokulirapo, mlingo umakulitsidwa. Mankhwalawa safika pazomwe amatha nthawi yomweyo, motero mukupangirabe kudikira osachepera mwezi umodzi musanakulitse mlingo.

Okalamba odwala matenda oopsa asanatenge Noliprel, malangizo ogwiritsira ntchito amalimbikitsa kuti mupimidwe kuyesedwa kuti muone ngati impso zili bwino.

Zotsatira zoyipa

Ma inhibitors onse a ACE amaonedwa ngati mankhwala omwe ali ndi chitetezo chachikulu. Kwa Noliprel, mawonekedwe olekerera samasiyana kwambiri ndi placebo.

Zotsatira zoyipa za Noliprel ndi:

• hypotension kumayambiriro kwa makonzedwe ndi bongo (pafupipafupi mpaka 10%);
• kutsokomola, kukulitsa moyo, koma osawopsa m'mapapu (pafupifupi 10%);
• kusintha kwa potaziyamu wamagazi (mpaka 3%);
• pachimake aimpso kulephera pamaso pa matenda a impso (mpaka 0,01%);
• kuphwanya mapangidwe kapena kukhazikitsa kwa mwana wosabadwayo (pafupipafupi sikunatsimikizidwe, popeza Noliprel amaletsedwa panthawi yapakati);
• ziwengo kwa zigawo za Noliprel, edema ya Quincke (mpaka 10%);
• zovuta zamavuto (mpaka 10%);
• kuchepa kwa hemoglobin (mpaka 0.01%).

Malinga ndi malangizo, zotsatira zoyipa kwambiri za Noliprel ndi chifuwa chake ndi chifuwa chowuma, chosapweteketsa, chofanana ndi chifuwa chonse. Zimachitika mchaka choyamba cha mankhwala. Kukula kwa izi sikukutengera dzina la mankhwalawo komanso thanzi la wodwalayo. Komabe, kutsokomola kumakhala kofupika kawiri mwa amuna kuposa akazi (pagulu lonse la ACE zoletsa, 6% motsutsana 14%), ndi ku Caucasian nthawi zambiri kuposa ku Asia.

Malinga ndi ndemanga ya odwala omwe amamwa mankhwalawo, nthawi zambiri chifuwa chimayamba chifukwa cha kuwuma kapena kutsokomola, m'malo mwake komwe kumakulirakulira. Mukamatenga Noliprel, pafupipafupi mphamvu zoyambira izi, malinga ndi kuyerekezera kosiyanasiyana, kuchokera pa 5 mpaka 12%. Nthawi zina vuto la chifuwa limatha kuthana ndi antihistamines, komabe pafupifupi 3% ya odwala amakakamizidwa kusiya mankhwala ndi Noliprel.

Vuto lachiwiri lodziwika bwino la mankhwalawa ndi hypotension m'masiku oyamba a mankhwala. Malangizo ogwiritsira ntchito akuwonetsa kuti chiwopsezo ndichipamwamba kwambiri mwa okalamba odwala matenda oopsa, okhala ndi madzi am'mimba (kuphatikizapo chifukwa chosagwiritsa ntchito ma okosi), matenda a impso ndi mitsempha yawo. Odwala omwe ali ndi chiopsezo chachikulu cha hypotension ayenera kuyamba kulandira chithandizo motsogozedwa ndi dokotala, makamaka kuchipatala. Kwa odwala ena oopsa, ndikokwanira kutsatira malamulo osavuta: yambani kulandira mankhwala osachepera pang'ono, kudya madzi ambiri, kuchepetsa mchere kwakanthawi, ndikukhala kunyumba masiku oyamba.

Mapiritsi a Noliprel angakhudze potaziyamu wamagazi. Kuperewera kwa potaziyamu, hypokalemia, kumawonedwa pafupifupi 2% ya odwala, nthawi zambiri amadziwonetsa ngati kutopa kowonjezereka, kupweteka kapena kukokana m'matumbo. Pafupipafupi pazovuta zotsutsana, hyperkalemia, zomwe zikuwonetsedwa mu malangizo, ndizochepera 1%. Vutoli limachitika kawirikawiri mu matenda a shuga ndi impso.

Zotsatira za Noliprel pa hemoglobin ndizopanda pake komanso sizikuwonetsa ngozi, nthawi zambiri zimatha kupezeka ndi njira zothandizira ntchito.

Matenda okomoka amatha kukhala osasangalatsa kwambiri. M'mawunikidwe awo, odwala matenda oopsa amawatanthauzira ngati kukoma kapena zitsulo, kuchepa kwa kakomedwe, ndipo kawirikawiri samakhala ngati mkamwa wowopsa mkamwa. Muzovuta kwambiri, mavutowa amatsogolera pakuwonongeka kwa kukana komanso kukana kutenga Noliprel. Mbali iyi imadalira mlingo wa mankhwalawa ndipo nthawi zambiri imatha yokha pakapita miyezi itatu.

Contraindication

Mankhwala osakanikirana ali ndi zotsutsana zingapo kuposa zomwe zimachitika mwatsatanetsatane, popeza opanga amawunika kuopsa kogwiritsa ntchito iliyonse yogwira ntchito mosiyana.

Malangizo ogwiritsira ntchito Noliprel amaletsa kugwiritsa ntchito zotsatirazi:

1. Ndi hypersensitivity kwa zinthu zomwe zimagwira kapena zinthu zina za Noliprel, kupita ku mankhwala ena a ACE inhibitor gulu, kuti sulfonamides.
2. Ngati m'mbuyomu, mutatenga zoletsa za ACE, wodwalayo anali ndi Quincke edema.
3. Ndi hypolactasia: piritsi Noliprel pafupifupi 74 mg wa lactose.
4. Muubwana, popeza chitetezo chamtundu uliwonse wa mankhwala chawerengedwa.
5. Odwala omwe ali ndi matenda a shuga kapena aimpso ntchito (GFR <60), Noliprel sayenera kumwedwa nthawi yomweyo ndi aliskiren chifukwa chogwiritsa ntchito mankhwala.
6. Mu diabetesic nephropathy, Noliprel ndi oletsedwa kuti azilemba pamodzi ndi a sartani (Losartan, Telmisartan ndi analogues), chifukwa kuphatikiza uku kumawonjezera chiopsezo cha hyperkalemia ndi hypotension.
7. Chifukwa cha kukhalapo kwa okodzetsa, impso ndi chiwindi kulephera kwambiri ndi contraindication. Pachiwopsezo chachikulu cha kulephera kwa impso, kuwunika kowonjezera ndikofunikira: kuyesedwa pafupipafupi kwa miyezi iwiri iliyonse ya magazi a potaziyamu ndi a creatinine.
8. Pa nthawi ya GW. Mankhwala linalake ndipo tikulephera kuyamwa, angayambitse hypokalemia mu khanda, hypersensitivity kuti sulfonamides. Chiwopsezo ndicholimba kwambiri m'miyezi yoyambirira ya moyo. Malangizo ogwiritsira ntchito akutsimikizira kuti Noliprel asinthane ndi wina, wophunziranso woposanso nthawi yayitali kwambiri
9. Nthawi yapakati, Noliprel akhoza kukhala wopanda vuto kwa mwana wosabadwayo. Perindopril amawoloka placenta m'magazi aana ndipo zimayambitsa kukula. M'masabata oyamba, pamene ziwalo zimapangidwa, Noliprel siowopsa, motero palibe chifukwa chothana ndi pakati posakonzekera. Mkaziyo amatumizidwa mwachangu kupita ku mankhwala ena a antihypertensive ndikuwongolera mwapadera kuti athe kuzindikira kuti angaphwanye. Kuyambira pa 2nd trimester, Noliprel angayambitse kuperewera kwa magazi m'thupi, kulephera kwa impso, kuperewera kwa magazi m'thupi ndi kuperewera kwa mapapo mwa khanda, oligohydramnios, ndi kuperewera kwa placental.
10. Ndi kuphatikiza kwa Noliprel ndi othandizira mankhwalawa a arrhythmias, antipsychotic, antipsychotic, erythromycin, moxifloxacin, tachycardia angachitike. Mndandanda wathunthu wazinthu zowopsa umaperekedwa mu malangizo.

Kuphatikiza kwa mowa ndi mankhwalawa sikabwino. Ethanol samalumikizana ndi zigawo za Noliprel, motero, sikuti ndi kutsutsana kokwanira pakugwiritsa ntchito kwake.Komabe, mwa kugwiritsa ntchito pafupipafupi, mowa umakwiyitsa kwambiri, ndiye kuti umakhala wosiyana ndi Noliprel. Malinga ndi ndemanga, ngakhale kumwa kamodzi kokha kwamowa ndi mankhwalawa kumabweretsa kupsinjika koopsa ndi thanzi labwino masiku angapo.

Analogs ndi choloweza

Ma analogi athunthu ndi mankhwala omwe ali ndi zinthu zomwezo zomwe zikufanana mu mapiritsi enieni. Mphamvu ya mankhwalawa ndi yofanana, kotero amatha m'malo mwa Noliprel nthawi iliyonse, nthawi yokonzekera komanso kusankha kwa mankhwala atsopano sikofunikira.

Zofananira zonse za Noliprel ndi:

Malangizo atsopano othandizira odwala matenda oopsa amaonetsa kuti kusintha kwa mankhwala pafupipafupi, kusintha kwa mankhwalawa ndikosayenera ndipo kungayambitse kupsinjika. Kumwa mankhwala ophatikiza amawonedwa kukhala othandiza kwambiri kuposa kuchiza ndi mankhwala awiri omwe ali ndi zinthu zomwezo. Ngati sizotheka kugula Noliprel wolemba, ndibwino kuti m'malo mwake mukhale ndi chithunzi chonse. Pankhaniyi, ndikofunikira kusankha mankhwala kuchokera kumakampani odziwika bwino ku Europe komanso akuluakulu azachipatala ku Russia.

Mwazowopsa, mutha kusintha Noliprel ndi miyala iwiri. Chachikulu ndikusankha mlingo woyenera, uyenera kufanana ndendende ndi omwe adokotala adawauza.

Zosankha zotengera izi:

Yerekezerani ndi mankhwala ofanana

Kuti achepetse kupanikizika, odwala ambiri oopsa amayenera kumwa mankhwala 2 mpaka 4. Kumayambiriro kwa matendawa, sartans kapena ACE inhibitors (β-pril) amalembedwa, chifukwa amateteza impso ndi mtima kuposa mankhwala ena. Atangokhala osakwanira, okodzetsa amawonjezeranso wodwala: okodzetsa a m'mimba nthawi zambiri amalimbikitsidwa ngati vuto la impso, a thiazide - pakalibe.

Kuphatikiza kosasunthika kumawonedwa ngati kusankha kwabwino kwambiri, ndiko kuti, magawo a zinthu zingapo zomwe zimawerengedwa ndikutsimikiziridwa mu mayeso azachipatala mkati mwa piritsi limodzi.

Kuphatikiza kwa thiazide diuretic ndi ntchentche ndizodziwika kwambiri komanso mwamphamvu kwambiri. Imagwira mu okalamba odwala matenda oopsa omwe ali ndi vuto la mtima. Nthawi zambiri, hydrochlorothiazide imaphatikizidwa ndi enalapril (Enap, Enafarm, Enam H), fosinopril (Fozid, Fozikard), lisinopril (Lisinoton, Lisinopril), Captopril (Caposide). Ubwino wophatikizira uku ndi kuchepetsedwa pafupipafupi kwa zotsatira zoyipa. Pakati pa mankhwalawa, Noliprel amadziwika kuti ndi imodzi mwamtundu wabwino kwambiri komanso wabwino kwambiri. Zofanana mu gulu lakale la mankhwalawa ndizophatikiza ma diuretics ndi sartan - Lozartan N, Lozap Plus, Valsacor, Duopress ndi ena.

Ndikosatheka kusankha zothandiza kwambiri pazophatikizika pamwambazi, chifukwa ali pafupi mwamphamvu kuchitapo kanthu. Palibe maphunziro amodzi omwe angatsimikizire mwayi weniweni wa mankhwala amodzi kuposa ena onse.

Noliprel amalowa ndi zinthu zina zogwira ntchito (ngakhale zitakhala za gulu lomwelo) zitha kutengedwa pokhapokha mukaonana ndi dokotala. Mukasinthira ku mankhwala ena, muyenera kusankha mankhwalawo ndipo, nthawi zambiri kuposa momwe zimakhalira, onetsetsani kuthinikizidwa kuti mupewe hypotension.

Ndemanga za Odwala