Pa kukakamizidwa mankhwala Enap ndi malangizo kwa mankhwala

Enap ndi chida chogwiririra piritsi chomwe chimapangidwa kuti magazi azithamanga. Mbali yogwira mankhwala, enalapril, ndi mankhwala otchuka kwambiri a antihypertensive ku Russia, Belarus, Ukraine. Imaphunziridwa bwino, yagwiritsidwa ntchito kwazaka zopitilira 12, kuyesayesa kwatsimikiziridwa ndi maphunziro ambiri. WHO yaphatikizira enalapril mndandanda wake wa mankhwala ofunikira ofunikira. Mankhwala okhawo othandiza kwambiri, otetezeka komanso nthawi yomweyo otchipa omwe amapangidwira kuchiza matenda oopsa komanso oopsa omwe amagwera pamndandandawu.

Ndani amakupatsani mankhwala?

Hypertension ndi vuto lodziwika bwino la akatswiri othandizira, akatswiri a mtima, ma endocrinologists, ndi ma nephrologists. Kuthamanga kwa magazi ndi mnzake wa shuga komanso matenda a metabolic, chofunikira kwambiri pakupezeka kwa matenda a mtima ndi mitsempha ya magazi. Ngakhale kuwonjezeka pang'ono kwa kupsinjika pamwamba pa chandamale ndi koopsa, makamaka kwa odwala omwe ali ndi zovuta zamtima zambiri. Pazovuta zakuposa kwa 180/110, chiopsezo chowonongeka pamtima, ubongo, ndi impso zimachulukitsa kawiri.

Hypertension ndi matenda osachiritsika, motero odwala ayenera kumwa mankhwala tsiku lililonse pamoyo wawo wonse. Pa kukakamizidwa kuti muyambe kumwa mapiritsi kumadalira matenda oyamba. Kwa anthu ambiri, 140/90 imawerengedwa kuti ndi gawo lovuta. Kwa odwala matenda ashuga, ndi ochepa - 130/80, omwe amakupatsani mwayi woteteza chiwalo chimodzi chovuta kwambiri mwa odwala - impso. Pakulephera kwa impso, ndikofunika kuti kupanikizika kukhale pang'ono, kotero mapiritsi amayamba kumwa, kuyambira pamlingo wa 125/75.

Monga lamulo, mapiritsi a Enap amawonetsedwa kumayambiriro kwa matendawa, atadziwika kuti magazi azithamanga. Mankhwala amakulolani kuti muchepetse mulingo wapamwamba, systolic, kukakamizidwa ndi 20, komanso kutsika, diastolic, mwa magawo khumi. Kuchepetsa kumeneku kumapangitsa kuti matendawa akhale achilendo mu 47% ya odwala. Zachidziwikire, tikulankhula za zizindikiro zapakatikati. Kwa odwala omwe sanafike pa chandamale, mankhwala ena owonjezera a antihypertensive amaperekedwa.

Malinga ndi malangizo, mapiritsi a Enap amagwiritsidwa ntchito pazotsatirazi:

1. Chizindikiro chachikulu chogwiritsa ntchito Enap ndi matenda oopsa, ndiye kuti, kukakamizidwa kwakukulu. Enalapril imawerengedwa kuti ndi imodzi mwazithandizo zapamwamba kwambiri, chifukwa chake, mu maphunziro ambiri azachipatala, mankhwala atsopano amafananizidwa mogwirizana ndi momwe amagwiritsira ntchito. Zinapezeka kuti kuchuluka kwa kuchepetsa nkhawa mukamalandira mankhwala a Enap kuli chimodzimodzi ngati mukumwa mankhwala ena a antihypertensive omwe amaphatikiza omwe amakono kwambiri. Pakadali pano, palibe mankhwala omwe ali othandiza kuposa ena. Madokotala, posankha mapiritsi ena kuti akakamizidwe, amatsogozedwa makamaka ndi katundu wawo wowonjezera komanso kuchuluka kwa chitetezo kwa wodwala wina.
2. Enap imakhala ndi zotsatira za mtima, motero, imayikidwa matenda a mtima: kudziwika mtima kulephera, chiopsezo chachikulu chakulephera kwa odwala amanzere amitsempha yamagazi. Malinga ndi akatswiri a zamtima, kugwiritsa ntchito kwa Enap ndi kufananizidwa ndi gulu mwa odwala koteroko kumachepetsa kufa, kuchepetsa kuchuluka kwa zipatala, kuchepetsa kuchepa kwa matendawa, ndipo nthawi zina kumathandizanso kulolerana zolimbitsa thupi komanso kuchepetsa zovuta. Chiwopsezo cha kufa mwa odwala omwe amachepetsa kuthamanga kwa magazi ndi Enap kapena kuphatikiza kwa Enap ndi okodzetsa ndi 11% kutsika kuposa omwe amangogwiritsa ntchito okodzetsa okha kuwongolera matenda oopsa. Pakulephera kwa mtima, mankhwalawa nthawi zambiri amapatsidwa mankhwala waukulu, osakwanira pakatikati.
3. Enap ali ndi anti-atherosranceotic katundu, motero amalimbikitsidwa kwa coronary ischemia. Kugwiritsidwa ntchito kwake m'matumbo a mtima kumakupatsani mwayi wochepetsera chiopsezo cha 30%, komanso chiwopsezo cha kufa ndi 21%.

Kodi mankhwalawo amagwira ntchito bwanji?

Zomwe zimagwira mapiritsi a Enap ndi enalapril maleate. Mwanjira yake yoyambirira, ilibe mankhwala chifukwa chake, amatanthauza za mankhwala opanga mankhwala. Enalapril imalowetsedwa m'magazi ndipo imasamutsidwa ku chiwindi ndi iyo, pomwe imasinthidwa kukhala enalaprilat - chinthu chokhala ndi katundu wotchulidwa. Pafupifupi 65% ya enalapril imalowa m'magazi, 60% yake yomwe imalowa m'chiwindi imasinthidwa kukhala enalaprilat. Chifukwa chake, kuchuluka kwantchito yonse ya mankhwalawa pafupifupi 40%. Izi ndizotsatira zabwino. Mwachitsanzo, ku lisinopril, omwe akugwirabe ntchito piritsi ndipo safuna kulowerera kwa chiwindi, chiwerengerochi ndi 25%.

Mlingo ndi kuchuluka kwa mayamwidwe a enalapril ndikusintha kwake kukhala enalaprilat sikudalira chidzalo cha m'mimba, kotero kuti musadandaule, tengani mankhwalawa musanadye kapena pambuyo pake. M'magawo onse awiriwa, kuchuluka kwa zinthu zomwe zimagwira ntchito m'magazi zidzafika pambuyo pa maola 4 kuyambira nthawi yoyang'anira.

Kuvala sikuti ndi mankhwala othamangira mwachangu, ndikosayenera kumwa kuti muchepetse vuto lalikulu kwambiri. Koma ndi kuvomerezeka pafupipafupi, kumawonetsa kokhazikika. Malinga ndi ndemanga ya odwala omwe amamwa mankhwalawo, kukakamiza kwa Enap ndikosowa kwenikweni. Kuti mapiritsi azitha kugwira ntchito mwamphamvu, amafunika kukhala oledzera kwa masiku osachepera atatu popanda zosokoneza panthawi yomweyo.

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%

Pafupifupi 2/3 ya enalapril imapukusidwa mkodzo, 1/3 - yokhala ndi ndowe. Ndi kulephera kwa aimpso, chimbudzi chitha kukhala chovuta, kuchuluka kwa enalapril m'magazi kumawonjezeka, kotero odwala angafunikire kuchepetsa mlingo wochepera muyeso.

Malinga ndi gulu lauphatikizidwe wa zam'magulu, mankhwalawa amapezeka mu ACE inhibitor. Idapangidwa mu 1980 ndipo idakhala yachiwiri pagulu lake pambuyo pa Captopril. Ntchito ya uvuni imafotokozedwa mwatsatanetsatane mu malangizo ogwiritsira ntchito. Cholinga chake ndi kuponderezera dongosolo la kupanikizika - RAAS. Mankhwalawa amaletsa enzyme yotembenuza angiotensin, yofunikira pakapangidwe ka angiotensin II - mahomoni omwe amapanga mitsempha yamagazi. Kubisa kwa ACE kumabweretsa mpumulo wa minofu ya ziwiya zotumphukira komanso kuchepa kwa mavuto. Kuphatikiza pa hypotensive zotsatira, Enap imakhudzanso kaphatikizidwe ka aldosterone, mahomoni antidiuretic, adrenaline, potaziyamu ndi renin m'magazi, chifukwa chake, mankhwalawa ali ndi zinthu zambiri zomwe zimathandiza kwa odwala oopsa, osawerengera kuchepa kwa kukakamizidwa:

1. Hypertension imapangitsa kuti mbali yamanzere (chipinda chachikulu cha mtima) igwire ntchito kwambiri, zomwe nthawi zambiri zimapangitsa kuti ikukulidwe. Kufooka, kutayika kwa khoma lamtima kumawonjezera mwayi wokhala ndi kupindika komanso kuchepa kwa mtima nthawi 5, kugunda kwa mtima katatu. Mapiritsi olowa sangangoteteza kupitirira kumanzere kwamitsempha yamagazi, komanso kumayambitsa kukhumudwa kwake, ndipo izi zimawonekera ngakhale mwa okalamba omwe ali ndi matenda oopsa.
2. Pakati pamagulu onse amankhwala osokoneza bongo opanikizika, Enap ndi zina za ACE zoletsa zomwe zili ndi tanthauzo lalikulu la nephroprotective. Ndi glomerulonephritis, matenda a shuga a nephropathy nthawi iliyonse, mankhwalawa amachedwa kukula kwa kuwonongeka kwa impso. Kutalika kwa nthawi yayitali (kuwunikira kunali kupitirira zaka 15) chithandizo cha enalapril chimalepheretsa nephropathy mu matenda ashuga omwe ali ndi microalbuminuria.
3. Njira zofananira monga momwe amapitira kumanzere ventricle (kupumula, kuchepetsedwa), pamene Enap imagwiritsidwa ntchito, imapezeka m'matumbo onse. Zotsatira zake, ntchito za endothelium zimabwezeretsedwa pang'onopang'ono, zotengera zimakhala zolimba komanso zowonjezereka.
4. Kusamba kwa azimayi nthawi zambiri kumapangitsa kuti thupi lizioneka owonjezera kapena kuwonjezereka kwa kupweteka kwa zomwe zilipo. Chomwe chimapangitsa izi ndi kuchepa kwa estrogen, komwe kumabweretsa kuwonjezeka kwa ntchito ya ACE. Ma A inhibitors omwe ali ndi vuto lofanananso ndi estrogen pa RAAS, chifukwa chake, amagwiritsidwa ntchito kwambiri azimayi a postmenopausal. Malinga ndi ndemanga, mapiritsi a Enap omwe ali m'gulu lino la odwala samangochepetsa kuthamanga kwa magazi komanso amaloledwa mosavuta, komanso amafooketsa kusintha kwa thupi: kuchepetsa kutopa ndi kusangalala, kuonjezera libido, kusintha kusintha, kuchotsa kutentha ndi thukuta.
5. Matenda a m'mapapo angayambitse matenda a m'mapapo. Kulowa mu odwala kumatha kuchepetsa kuthamanga kwa mapapu, kuonjezera kupirira, komanso kulepheretsa mtima kulephera. Kupitilira milungu isanu ndi itatu yoyang'anira, kutsika kwakukulu kumapanikizika ndi magawo 6 (kuchokera 40.6 mpaka 34.7).

Kutulutsa mawonekedwe ndi mlingo

Wopanga Enap - kampani yapadziko lonse Krka, yomwe imapanga mankhwala opangidwa ndi mitundu. Enap ndi analogue ya enalapril yoyambirira yopangidwa ndi Merck pansi pa dzina la mtundu wa Renitec. Chosangalatsa ndichakuti kutchuka ndi malonda a Enap ku Russia ndiwokwera kwambiri poyerekeza ndi a Renitek, ngakhale mtengo wa mankhwalawo uli wofanana.

Enalapril maleate, mankhwala opangira mankhwala a Enap, amapangidwa ku Slovenia, India ndi China. M'mafakitala a kampaniyo, kuwongolera kwapamwamba kwamitundu yambiri kwayambitsidwa, chifukwa chake, mosasamala malo opanga enalapril, mapiritsi omalizidwa ali ndi magwiridwe antchito ambiri. Kuponda ndikunyamula mapiritsi kumachitika ku Slovenia ndi Russia (KRKA-RUS chomera).

Enap ali ndi mitundu ingapo:

Kuphatikiza pa gawo limodzi la Enap, Krka imapanga mankhwala ophatikiza ndi enalapril ndi diuretic hydrochlorothiazide (Enap-N, Enap-NL) pazosankha zitatu.

Zomwe zimathandizira kuphatikiza ndi Enap-N:

• amachepetsa kupanikizika kwa odwala oopsa, omwe antihypertgency wothandizira samapereka kufunika;
• amachepetsa kuopsa kwa mavuto. Enalapril imatha kumwedwa pang'onopang'ono ngati muwonjezera okodzetsa;
• Mapiritsi ophatikizika a Enap-N amatsimikiziridwa kuti azigwira ntchito kwa maola 24 kapena kupitilira apo, chifukwa chake amawonetsedwa kwa odwala omwe zotsatira za enalapril zimawonjezeka pofika tsiku.

Enalapril yokhala ndi hydrochlorothiazide ndi imodzi mwazabwino kwambiri komanso zosavuta. Zinthu izi zimathandizana wina ndi mnzake, chifukwa chake zomwe zimapangitsa kuti zotsatira zake zitheke, ndipo chiwopsezo cha zotsatira zoyipa chimachepa.

Palinso mankhwala othandizira msanga mu mzere wa Enap, womwe umapezeka mu njira yankho. Madokotala amazigwiritsa ntchito kuti achepetse kupanikizika pakagwa mavuto. Mosiyana ndi mapiritsi, Enap-R si mankhwala. Chithandizo chake chogwira ntchito ndi enalaprilat, imayamba kugwira ntchito pambuyo pakukonzekera kwamitseko, ndende yayikulu imafikiridwa pambuyo pa mphindi 15.

Zosankha zonse zamapiritsi a Enap:

Momwe angatenge

Malangizo ogwiritsira ntchito Enap sikuwonetsa kuti atenge liti: m'mawa kapena madzulo, mapiritsi awa. Madokotala nthawi zambiri amapereka mankhwala a m'mawa kuti mankhwalawa azikwaniritsa zolimbitsa thupi, kupsinjika ndi zina. Komabe, pali umboni kuti pakutha kwa tsiku mphamvu ya enalapril ikuipiraipira. Ngakhale kuti kuchepa kwa vutoli kumawonedwa kukhala kochepa (okwanira 20%), odwala ena amatha kuwonjezera kukakamiza m'mawa.

Kufalikira kwamankhwala ndikofunikira pakuwongolera matenda oopsa. Kuvala kumakhala kuledzera tsiku lililonse, kupewa zosokoneza. Mankhwalawa amadziunjikira m'thupi kwa masiku angapo mphamvu yake isanakwane. Chifukwa chake, kudutsa kamodzi kumatha kuyambitsa kutalika (mpaka masiku atatu), koma nthawi zambiri kumangowonjezera kukakamizidwa. Osangokhala zofunikira pafupipafupi, komanso nthawi yomweyo yovomerezedwa. Malinga ndi kafukufuku, Enap imapereka zotsatira zabwino kwambiri kwa odwala omwe amamwa mapiritsi pa alamu yoletsa, kupewa kupewa kupatuka pa dongosolo kwa ola limodzi.

Malinga ndi malangizo, makonzedwe a Enap amayamba ndi mlingo woyambirira, womwe adokotala amawaganizira, poganizira kuchuluka kwa kupsinjika ndi kupezeka kwa matenda ena. Nthawi zambiri, 5 kapena 10 mg amatengedwa ngati mlingo woyambirira. Pambuyo piritsi loyamba, kuthamanga kwa magazi kumayeza kangapo patsiku, ndipo zotsatira zake zimalembedwa. Ngati mulingo wothinikizidwa (140/90 kapena kutsika) sukufikiridwa kapena ngati pakukumizidwa kupanikizika, mulingo umachulukitsa pambuyo masiku 4. Nthawi zambiri zimatenga pafupifupi mwezi kuti musankhe mtundu. Enap ali ndi mitundu yambiri yosankha. Kuphatikiza apo, mapiritsi onse, kuyambira ndi 5 mg, ali ndi notch, ndiye kuti, amatha kugawidwa pakati. Chifukwa cha mankhwalawa, mutha kusankha molondola momwe mungathere.

Kwa odwala ambiri, mtengo wochizira matenda oopsa ndiwofunika, ndipo nthawi zina umakhala wosankha. Enap amatanthauza mankhwala okwera mtengo, ngakhale atamwa mankhwala okwanira. Mtengo wapakati wamaphunziro a pamwezi, owerengedwa malinga ndi ndemanga za odwala, ndi ma ruble 180. Ma inhibitors ena a ACE siokwera mtengo kwambiri, mwachitsanzo, ma perindopril a opanga omwewo (Perinev) adzagula ma ruble 270.

Mtengo wa Enap umawononga ndalama zingati:

Zotsatira zoyipa

Malinga ndi zotsatira za kafukufuku wazachipatala, asayansi amawunika kulekerera kwa Enap ndikwabwino. Komabe, kukokomeza kwa mankhwalawa kumadzetsa zovuta zina, choncho chithandizo chiyenera kuyambitsidwa mosamala. Mapiritsi oyamba samayenera kutengedwa ngati thupi lili ndi vuto lam'mimba chifukwa cha kutsegula m'mimba, kusanza, kudya mosakwanira kwa madzi ndi mchere. Pakati pa sabata, katundu wambiri, pokhala kutentha, kuyendetsa galimoto, kugwira ntchito kutalika sikuloledwa.

Zotsatira zoyipa za Enap malinga ndi malangizo:

Contraindication

Mndandanda wa zotsutsana mwamphamvu potenga Enap:

1. Hypersensitivity enalapril / enalaprilat ndi mankhwala ena okhudzana ndi ACE zoletsa.
2. Angioedema atatha kugwiritsa ntchito mankhwalawa.
3. Mu matenda a shuga ndi matenda a impso, kugwiritsa ntchito Enap ndi aliskiren ndikutsutsana (Rasilez ndi analogues).
4. Hypolactasia, chifukwa Piritsi ili ndi lactose monohydrate.
5. Matenda a hematological - kuchepa magazi m'thupi, matenda a porphyrin.
6. Kuyamwitsa. Enalapril m'miyeso yaying'ono imalowera mkaka, motero, imatha kuyambitsa kuchepa kwa mavuto mwa mwana.
7. Zaka za ana. Kugwiritsa ntchito enalapril kunaphunziridwa mu gulu lochepera la ana opitirira zaka 6, kutenga 2,5 mg patsiku limawoneka kukhala lotetezeka. Chilolezo chogwiritsa ntchito Enap mu ana sichinapezeke, chifukwa chake, malangizo ake, zaka za ana zimatchulidwa kuti contraindication.
8. Mimba Mu trimesters 2 ndi 3, Enap imatsutsana, mu trimester ya 1 sikulimbikitsidwa.

Kutenga mapiritsi a Enap a akazi amisinkhu yakubereka kumafuna chisamaliro chapadera. Njira zogwira mtima za kulera ziyenera kugwiritsidwa ntchito popereka chithandizo. Mimba ikachitika, mankhwalawo amachotsedwa atapezeka. Kuchotsa mimba sikofunikira, popeza chiwopsezo cha mluza chomwe sichinafike milungu 10 yakukula ndichochepa.

Malangizo ogwiritsa ntchito akuchenjeza: ngati Enap adatengedwa mu 2 trimester, pali chiopsezo cha oligohydramnios, kuphwanya kwaimpso kwa mwana wosabadwayo, komanso kupangika kwachilendo kwa mafupa a chigaza. Kuti muganize za kupitilira kwa pakati, mudzafunika ndi ma impso, chigaza, kutsimikiza kuchuluka kwa madzi amniotic. Mwana wakhanda yemwe amayi ake adatenga Enap panthawi yoyembekezera amakhala pachiwopsezo chachikulu cha matenda oopsa.

Enap ndi mowa ndizosayenera kuphatikiza. Ngakhale ndi muyezo umodzi wa ethanol wodwala amene akumwa mankhwala a antihypertensive, amatha kubweretsanso mavuto. Kugwa kwa Orthostatic kumachitika nthawi zambiri: kupsinjika kumachepetsa msanga komanso kusintha kwa mayendedwe. Hypertension imachita khungu m'maso, chizungulire chachikulu chimachitika, ndipo kukomoka ndikotheka. Ndi kuponderezedwa mobwerezabwereza, kugwirizanitsa kwa mowa ndi mankhwalawo kumayipa koposa. Chifukwa cha kuledzera, wodwalayo amatha kupindika kwamatumbo, zomwe zimapangitsa kuti azikhala ndi nkhawa. Spasm imapitirira pafupifupi masiku atatu mutatha kumwa kwa ethanol.

Analogs ndi choloweza

Pali mapiritsi ochulukitsa opitilira 12 omwe ali ndi mawonekedwe ofanana mu Russian Federation. Pakati pa odwala matenda oopsa, zolemba zathunthu za Enap ndizodziwika kwambiri:

• Swiss Enalapril Hexal kuchokera ku kampani yopanga mankhwala Sandoz;
• Enalapril FPO wa Russia wopanga Obolenskoye;
• Enalapril waku Russia wochokera ku Izvarino ndi Ozone;
• Kusintha kwa Kampani ya Enalapril;
• Enalapril wochokera ku Hemofarm, Serbia;
• Ednit waku Hungary, a George Richter;
• German Burlipril, BerlinHemi;
• Renetek, Merck.

Enap ikhoza kusinthidwa ndi mankhwalawa tsiku lililonse; kufunsa kwa dokotala sikofunikira. Chofunikira ndikumwa mankhwala atsopano muyezo womwewo komanso pafupipafupi. Mankhwala otsika mtengo pamndandandawu ndi Enalapril Renewal, mapiritsi 20. 20 mg ndi ma ruble 22 okha. Wotsika mtengo kwambiri ndi Renitek, mapiritsi 14. 20 mg iliyonse igula 122 ma ruble.

Ngati zoletsa za ACE zimayambitsa chifuwa, mapiritsi a hypotensive ochokera m'magulu ena akhoza kukhala olowa m'malo a Enap. Mankhwala enieni amasankhidwa ndi adotolo atatha kuyesa matenda oopsa. Malinga ndi malingaliro a WHO, diuretics (odziwika kwambiri ndi hydrochlorothiazide ndi indapamide), calcium antagonists (amlodipine) kapena beta-blockers (atenolol, bisoprolol, metoprolol) ndi omwe amalembedwa. Ma Sartan ndi osafunika, popeza amagwirizana ndi zomwe Enap amachita ndipo amatha kuyambitsa mavuto ambiri.

Mimba ikachitika, mankhwala ena a antihypertensive amaperekedwa m'malo mwa Enap. Mapiritsi okha ndi omwe amagwiritsidwa ntchito omwe chitetezo chawo cha mwana chimatsimikiziridwa. Monga lamulo, awa ndi mankhwala akale. Mankhwala a mzere woyamba amadziwika kuti ndi methyldopa (Dopegit). Ngati singathe kufotokozedwa pazifukwa zina, sankhani atenolol kapena metoprolol.

Yerekezerani ndi mankhwala ofanana

Mitundu ya mankhwala a ACE inhibitors sakhala ofanana kwenikweni. Modabwitsa, mphamvu ya zinthuzi pathupi lake imafanana. Kapangidwe ka ntchito, ndandanda ya zosayenera zochita ndipo ngakhale contraindication ali pafupi kwambiri kwa iwo. Kuchita bwino kwa antihypertensive kumawerengedwa ndi asayansi chimodzimodzi.

Komabe, zosiyana zina mu ACE inhibitors zikadalipo:

1. Choyamba, mlingo ndi wosiyana. Mukasintha kuchokera ku Enap kupita pa analogue yamagulu, mlingo umayenera kusankhidwa mwatsopano, kuyambira wochepera.
2. Captopril imayenera kuledzera pamimba yopanda kanthu, ndi mankhwala ena onse pagululi - osasamala nthawi yakudya.
3. Ma enalapril otchuka kwambiri, Captopril, lisinopril, perindopril amathandizidwa makamaka kudzera mu impso, chifukwa chake, ndi kulephera kwaimpso, pamakhala chiopsezo cha bongo. Impso zimagwira nawo ntchito yochotsa trandolapril ndi ramipril pang'ono, mpaka 67% ya chinthucho imapangidwa mu chiwindi.
4. Zambiri zoletsa za ACE, kuphatikizapo enalapril, ndizopanga mankhwala. Amagwira ntchito kwambiri m'matenda a chiwindi ndi m'mimba. Captopril ndi lisinopril poyamba amagwira ntchito, mphamvu zawo sizidalira mkhalidwe wam'mimba wamagetsi.

Kusankha mtundu winawake wa mankhwala, dokotala samalingalira izi zokha, komanso kupezeka kwa mankhwalawa. Ngati Enap yakupangidwira ndipo imalekeredwa bwino, sikulimbikitsidwa kuti musinthe ngati mapiritsi ena. Ngati Enap sapereka chiwongolero chokhazikika, wothandizirana ndi antihypertgency amawonjezeredwa ku regimen yothandizira.

Ndemanga za Odwala