Ukuhlanganiswa kwe-Amlodipine neLisinopril kuchaziwe lapho ukuphathwa kwabo kukodwa kunganikeli umphumela olindelekile. Manje bakhiqiza nemithi, lapho ukulungiselela okulodwa kuqukethe imithamo yento ngayinye (amagama okuhweba: i-Equator, i-Equacard, ne-Equapril).
Isimo se-Amlodipine
I-Amlodipine yi-blocker yesiteshi se-calcium emalungeni amaseli. Kumaseli emithambo yegazi, laba baphikisi balawula ukuhamba kwama-ion e-calcium, ukusiza ukuvimbela imiphumela ye-hypotensive kanye ne-antianginal.
I-Amlodipine yi-blocker yesiteshi se-calcium emalungeni amaseli.
Ngaphansi kwethonya le-Amlodipine:
- hyperkalemia ayikhishwa;
- ama-arterioles nemithambo yemithambo ayanda;
- umfutho wegazi uyancipha;
- amaseli enhliziyo agcwele umoya-mpilo;
- umsebenzi wesibeletho wokubeletha uyabuyiselwa (uyancipha nge-tachycardia, uyanda nge-bradycardia).
Ukusebenza kwomuthi:
- ngisho umthamo owodwa unganikeza umphumela we-antihypertensive;
- isiza nge-angina pectoris ne-ischemia;
- inethonya le-natriuretic elibuthakathaka;
- ayithinti i-metabolism;
- kunciphisa umthwalo osenhliziyweni, okukuvumela ukuthi ulawule ukweqisa kwezitho zesifuba ngesikhathi sokuzivocavoca.
Isebenza kanjani i-lisinopril?
ILisinopril isebenza njenge-ACE inhibitor evimbela ukwakheka kwe-aldosterone (ihomoni ebhekele ukwenziwa kwe-Na ne-K nosawoti) kanye ne-angiotensin 2 (i-hormone ebangela i-vasoconstriction), ekhuthaza ukukhiqizwa kwe-bradykinin (isithambo segazi esihlanza i-peptide).
Ngaphansi kwesenzo se-lisinopril:
- umfutho wegazi uyancipha;
- ingcindezi engaphakathi kwama-pulillary capillaries iyancipha;
- ukuphuma kwegazi lezinso;
- ukunikezwa kwegazi oku-myocardial ngokwejwayelekile;
- I-hypertrophy ye-stenotic artery iyancishiswa.
Ukusebenza kwomuthi:
- kuthuthukisa ukuhanjiswa kwegazi nge-ischemia;
- ibuyisela ukungasebenzi kahle kwe-ventricular ngemuva kwe-infraction ye-myocardial eyingozi;
- kunciphisa i-albhamuinuria (iprotheni emchameni);
- akuholeli ku-hypoglycemia.
Umphumela wokuhlangana
Imiphumela ehlangene yezidakamizwa ezi-2 iholela ekuphenduleni:
- i-antihypertensive (ukwehla kwengcindezi);
- i-vasodilating (vasodilating);
- i-antianginal (ukususa izinhlungu zenhliziyo).
Umphumela ohlangene wezidakamizwa ezi-2 uholela ekuphenduleni kwe-antianginal (izinhlungu zenhliziyo ziyaqedwa).
Izinkomba zokusetshenziswa ngasikhathi sinye
Le yinkimbinkimbi yandisa umphumela wokwelapha ku-hypertension okubangelwa:
- ukwehluleka kwenhliziyo;
- ukunciphisa imithambo yezinso (i-stenosis yemithambo yezinso);
- ukwehluleka okungapheli kwezinso (umsebenzi wokulimala wezinso);
- i-thyrotooticosis (i-pathology ye-gland yegilo);
- i-atherosclerosis ye-aorta (ama-plaque odongeni);
- i-pathologies yohlelo lwe-endocrine (kufaka phakathi isifo sikashukela).
Contraindication
I-Amlodipine ene-lisinopril ayinqunyelwe ukuthi:
- hypersensitivity;
- ukuvuvukala komphimbo;
- ukwethuka kwe-cardiogenic;
- umunyu we-arterial hypotension;
- i-angina engazinzile (ngaphandle kwesimo se-Prinzmetal);
- ukufakelwa kwezinso;
- ukungasebenzi kahle kwe-hepatic;
- systemic lupus erythematosus;
- i-metabolic acidosis;
- ukukhulelwa nokuqunjelwa;
- ngaphansi kweminyaka eyi-18.
Ungayithatha kanjani i-amlodipine ne-lisinopril?
Izidakamizwa zitholakala kumithamo ye-5, 10, 20 mg futhi isetshenziswa ngomlomo. Uhlobo lokwelashwa lwakudala:
- Umthamo owodwa we-10 mg kanye ngosuku (ekuseni noma kusihlwa);
- womabili la macwecwe asikisela ukuphathwa ngasikhathi sinye;
- ukugeza phansi ngenani elanele lamanzi;
- ukusetshenziswa akuzimele kokudla.
Ngokuqapha, ama-antihypertgency agents anikezwa iziguli ezathola i-hemodialysis.
Ngokuqapha, ama-antihypertensives anqunyelwa ezigulini ezathola i-hemodialysis (ukuhlanzelwa okwengeziwe kwe-plasma yegazi) futhi ezimweni eziyinkimbinkimbi ngokuphelelwa ngamandla emzimbeni (ukukhipha amanzi emzimbeni).
Umthamo wokuqala wokulashwa kokulungiswa kubantu abanomsebenzi wezinso okhubazekile ukhethwa ngamunye.
Kuyo yonke le nkambo, kuyadingeka ukuqapha ukusabela kwezinso, izinga le-K ne-Na kwiseramu yegazi. Uma izinkomba zanda, umthamo uyancishiswa noma uqedwe.
Ngoshukela
Ukuhlanganiswa kwesifo sikashukela kanye nomfutho wegazi ophakeme kwandisa ingozi yezinkinga ezi-micro- and macrovascular. Ukwelashwa nge-lisinopril ne-amlodipine kuthuthukisa umsebenzi wamasipha ezigulini ezinesifo sikashukela kanye ne-hypphinosis. Esikhathini sikashukela, imithi iboniswa ngaphansi kokuqondisa udokotela.
Esikhathini sikashukela, ukuphathwa kwezidakamizwa okukhulunywa ngazo kukhonjiswa ngaphansi kokuhlolwa udokotela.
Ukusuka ekucindezelweni
Lawa ma-antihypertensives aboniswa ekwelashweni kwegazi eliphezulu, ngaphandle kwamasonto amane okuqala ngemuva kokuhlaselwa yisifo senhliziyo. Ngemuva kokuphela kwesikhathi esidingekile sokubuyisa izinkomba zomtholampilo, le nkimbinkimbi ithathwa ngokuya ngohlelo lwe-classical (10 + 10 mg kanye ngosuku).
Imiphumela emibi ye-Amlodipine neLisinopril
Imiphumela emibi ibangelwa ukweqisa kwemithi. Ukuboniswa okungenzeka:
- ikhanda
- ubuthakathaka
- ukunciphisa isikhathi sokunakwa;
- arrhythmia;
- ukukhwehlela
- i-pancreatitis
- i-hepatitis;
- i-arthralgia;
- i-myalgia;
- iminyakazo
- neutropenia;
- i-bronchospasm;
- i-psoriasis
Umbono wodokotela
I-Antonova M.S., i-Therapist, iTver
Isikhathi eside le yinkimbinkimbi izisungulele ngokwayo. I-Amlodipine ingavusa ukusabela okungalungile ngendlela ye-edema. Futhi ukubonakala kokuhlaselwa kususwa ukuqokwa kwePhenytoin.
Kotov S.I., udokotela wezifo zenhliziyo, eMoscow
Inhlanganisela edumile neyisebenzayo. Okunconywayo kuphela - ungathengi i-Amlo yasekhaya futhi ungafaki okokugcoba
I-Skurikhina L.K., i-endocrinologist, idolobha laseNaro-Fominsk
Ungazindli. Zombili lezi zidakamizwa zinohlu olukhudlwana lwe-contraindication. Kuyadingeka ukubheka njalo umfutho wegazi, ngaphandle kwalokho ungaphuthelwa ukuqala kwe-hypotension eyingozi.
Ukubuyekezwa kweziguli kwe-Amlodipine neLisinopril
U-Ana, oneminyaka engama-48, uPenza
I-Amlodipine kule nkimbinkimbi inqunywe i-5 mg. UWarfarin naye wanezelwa kulolo hlelo. Kepha kwavela imiphumela emibi - izinsini ezopha igazi (okungenzeka zivela eWarfarin, zihluza igazi).
UTatyana, oneminyaka engama-53, u-Ufa
Ngabelwa nenkambo ehlukile - i-Amlodipine 5 mg noLisinopril 10 mg. Kodwa ngine-cystitis ejwayelekile, engatshela udokotela ngayo.
UPeter, oneminyaka engama-63, eMoscow
Ngokuhluleka kwenhliziyo, wathatha i-Digoxin ne-diuretic Allopurinol iminyaka eminingi. Ngokweseluleko sikadokotela, washintshela ekwakhiweni okusha, kodwa kwaqala ukukhwehlela owomile, futhi udokotela wangena esikhundleni seLisinopril nge-Indapamide. Musa ukukhetha uhlelo ngokwakho, iya kudokotela.
