Ungayisebenzisa kanjani i-drug lisinopril-ratiopharm?

ILisinopril Ratiopharm inomphumela we-vasodilating ngenxa yokucindezela kokuhlanganiswa kwe-angiotensin II. Njengomphumela wokuthola umphumela wokwelapha, umphumela omuhle wesidakamizwa kumasayithi wezicubu ze-ischemic uyabonakala. Umuthi ukuvumela ukuthi uhlakulele ukumelana ne-vasotine endothelium kanye nezicubu zenhliziyo ekwandisweni kwemithwalo ngesikhathi sokuthuthukiswa kwe-arterial hypertension. Ngakho-ke, lo muthi usetshenziswa odokotela bezenhliziyo ukwelapha umfutho wegazi ophakeme, ukushaya kwenhliziyo okushayekile kanye nokwehluleka kwenhliziyo.

Igama Lezwe elingafanele

Lisinopril.

Umuthi ukuvumela ukuthi uhlakulele ukumelana ne-vasotine endothelium kanye nezicubu zenhliziyo ekwandisweni kwemithwalo ngesikhathi sokuthuthukiswa kwe-arterial hypertension.

I-ATX

C09AA03.

Khipha amafomu nokwakheka

Umuthi uyatholakala ngesimo samathebulethi okusetshenziswa ngomlomo.

Amaphilisi

Ngokuya ngomthamo wengxenye esebenzayo - i-lisinopril, amaphilisi ahluka ngobukhulu bemibala:

• Ama-5 mg amhlophe;
• I-10 mg - i-pink ekhanyayo;
• 20 mg - opinki.

Ukwenza ngcono amapharamitha we-pharmacokinetics, umongo wethebhulethi uqukethe izinto ezengeziwe:

• i-magnesium stearate;
• calcium hydrogen phosphate;
• isitashi pregelatinized;
• i-mannitol;
• crodarmellose sodium.

Amaconsi

Uhlobo olungekho.

Isenzo se-Pharmacological

ILisinopril ivimbela umsebenzi osebenzayo we-angiotensin wokuguqula i-enzyme (ACE). Ngenxa yalokho, izinga le-angiotensin II liyancipha, lifiphaza i-lumen yomkhumbi futhi unciphise ukuvela kwe-aldosterone. Ikhemikhali esebenzayo yesidakamizwa ivimbela ukuqhekeka kwe-bradykinin, i-peptide enomphumela we-vasopressor.

ILisinopril yehlisela izinga le-angiotensin II, elibamba ngokukhanya komkhumbi.

Ngokuphikisana nesizinda se-vasodilation, kukhona ukwehla komfutho wegazi, ukumelana nemithambo yethambo. Umthwalo okuyi-myocardium uyancishiswa. Ngokusetshenziswa isikhathi eside kweLisinopril, ukumelana kwe-vasotine endothelium nemisipha yenhliziyo ekhuphukeni kwemithwalo kuyanda, ukujikeleza kwe-microcirculatory endaweni ene-ischemia kuyathuthuka. Umuthi usiza ukunciphisa ingozi yokuhlakuzeka ukwehluleka kwe-ventricular kwesokunxele.

I-Pharmacokinetics

Uma kuthathwa ngomlomo, izinga le-plasma le-lisinopril lifinyelela phezulu ngemuva kwamahora angama-6-7. Ukudla ngokulinganayo kokudla akukuphazamisi ukumuncwa kanye nokuhlanganiswa kwe-bioavailability kwengxenye esebenzayo. ILisinopril, lapho ingena egazini, ayakhi i-protein ngamaprotheni e-plasma futhi ayiguquki kumaseli wesibindi. Ngakho-ke, into esebenzayo ishiya umzimba ungene ezinsweni ngesakhiwo sokuqala. Ukuqedwa kwesigamu sempilo kufinyelela emahoreni ayi-12,6.

Izinkomba zokusetshenziswa

Umuthi usetshenziselwa ukwelashwa okujwayelekile ukwelapha:

• ukuhluleka kwenhliziyo okungapheli ngengxenye encane yesisele se-ejection engaphansi kwama-30%;
• umfutho wegazi ophakeme;
• i-infarction ye-myocardial eyingozi ezigulini ngaphandle kokwehluleka kwezinso.

Contraindication

Akuvunyelwe ukuthatha umuthi ezimweni ezilandelayo:

• ukungabekezelelani komuntu ngamunye kwezicubu ezinhlanganisweni ezihlanganisiwe zomuthi;
• i-stenosis yemithambo yezinso;
• iziguli ezinesifo sezinso ngokuqalwa kwe-creatinine ngaphansi kwe-30 ml / min;
• i-mitral valve stenosis ne-aorta;
• umfutho wegazi we-systolic ka-100 mm Hg nangaphansi;
• i-hemodynamics engazinzile ngemuva kwesimo sefomu elinobunzima bokuhlaselwa yinhliziyo;
• abesifazane abakhulelwe nabancelayo;
• i-hyperaldosteronism;
• isikhathi sokuvuselelwa ngemuva kokufakelwa kwezinso.

Umuthi ukhonjiswa ngezinhlobo ezingamahlalakhona zokuhluleka kwenhliziyo.

Umuthi ukhonjiswa umfutho wegazi ophakeme.

Isidakamizwa siyaphulwa uma kungenzeka ukungabekezeleleki kwezitho zezitho zomuthi.

Ngokuqapha, abantu badinga ukuthatha umuthi ngemuva kweminyaka engama-70.

Ngokuqapha, udinga ukuthatha lo muthi kubantu abanesifo sezinso.

Ngokunakekela

Kunconywe ukwelashwa ngezidakamizwa ezimeni zokumiswa ngaphansi kokuqashwa ngokuqinile kodokotela kulezi zimo ezilandelayo:

• i-hypovolemia;
• i-sodium ephansi yegazi engaphansi kwe-130 mmol / l;
• umfutho wegazi ophansi (BP);
• ukuphathwa okufanayo kwama-diuretics, ikakhulukazi umthamo omkhulu;
• ukwehluleka kwenhliziyo okungazinzi;
• isifo sezinso
• umthamo omkhulu we-vasodilator therapy;
• iziguli ezingaphezulu kweminyaka engama-70.

Ungayithatha kanjani i-lisinopril ratiopharm?

Isikhathi sokwelashwa sinamaviki ayi-6. Iziguli ezinokwehluleka kwenhliziyo kufanele zithathe iLisinopril njalo. Ukuphatha okuhlanganayo neNitroglycerin kuvunyelwe.

Ngiyiphi ingcindezi okufanele ngiyithathe?

Umuthi ubekelwe iziguli ezinamanani wegazi ophakeme angaphezu kwe-120/80 mm RT. Ubuciko. Ekucindezelweni okuphansi ngesikhathi se-systole - ngaphansi kwe-120 mm RT. Ubuciko. ngaphambi kokuqala ukwelashwa nge-ACE inhibitor noma phakathi nezinsuku zokuqala ezingama-3 zokwelashwa, kufanele kuthathwe kuphela umuthi ongu-2,5m wesidakamizwa. Uma inkomba ye-systolic yemizuzu engaphezu kuka-60 ayikhuphuki ngaphezu kuka-90 mm Hg. Ubuciko., Kufanele wenqabe ukuthatha iphilisi.

Ukuthatha umuthi wesifo sikashukela

Isifo sikashukela i-mellitus asidingi ukulungiswa kwenqubo yemithamo ye-ACE inhibitor.

Umthamo wehypertension

Iziguli ezinomfutho wegazi ophakeme kufanele zithathe umuthi ongu-5 mg ekuseni amasonto amathathu. Ngezinga elihle lokubekezelela, ungandisa umthamo wansuku zonke uye ku-10-20 mg wesidakamizwa. Isikhathi sokukhulisa umthamo kumele okungenani sibe yizinsuku ezingama-21. Inani eliphezulu elivumelekile ngosuku ngu-40 mg wesidakamizwa. Amacwecwe kufanele athathwe kanye ngosuku.

Isifo sikashukela i-mellitus asidingi ukulungiswa kwenqubo yemithamo ye-ACE inhibitor.

Umthamo wokuhluleka kwenhliziyo

Iziguli ezinokwehluleka kwenhliziyo zithatha isidakamizwa kanyekanye nge-diuretics Digitalis. Ngakho-ke, umthamo osesigabeni sokuqala sokwelashwa ngu-2,5 mg ekuseni. Umthamo wokulungiswa usungulwa ngokwenyuka kancane kancane kwama-2.5 mg njalo emavikini angama-2. Umthamo ojwayelekile uvela ku-5 kuye ku-20 mg, ngokuya ngezinga lokubekezelelwa komthamo owodwa ngosuku. Umthamo omkhulu ngu-35 mg.

I-infraction ye-myocardial esebenzayo

Ukwelashwa kwezidakamizwa kubekelwa phakathi nosuku kusukela lapho kuvela izimpawu zokuqala zokuhlasela kwenhliziyo okukhulu. Ukwelashwa kuvunyelwe kuphela uma izinso zizinzile futhi ingcindezi ye-systolic ingaphezulu kwe-100 mm Hg. Ubuciko. ILisinopril ihlanganiswe nezidakamizwa ze-thrombolytic, i-beta-adrenergic blockers, ama-nitrate nezidakamizwa ezinciphisa igazi. Umthamo wokuqala ngu-5 mg, ngemuva kwamahora angama-24 anesimo esizinzileyo sesiguli, umthamo wenyukela kokuvunyelwe okuphezulu - 10 mg.

Imiphumela emibi

Imiphumela emibi ibonwa ngenxa yomthamo ongafanele noma ukuthinteka kwezicubu ngakunye ezingxenyeni zomuthi.

Amapheshana wesisu

Ukuphendula okungalungile ngomuthi ohlelweni lokugaya ukudla kubonakaliswa ngokulandelayo:

• ukuqunjelwa, isifo sohudo;
• i-gag reflexes;
• ukulahleka kwesifiso
• ushintsho ekunambithekeni;
• i-cholestatic jaundice, icasulwe ukuthuthukiswa kwe-hyperbilirubinemia.

Umuthi ungadala ukuqunjelwa.

Umuthi ungadala ukulahlekelwa yinhliziyo.

Umuthi ungadala ikhalipha yokuhlanza.

Ngemuva kokuthatha umuthi, isiyezi kuyabonakala.

Izitho zeHematopoietic

I-hememotic anemia ibonwa ezigulini ezine-glucose-6-phosphate dehydrogenase yokushoda. Ngokuvimbela i-hematopoiesis yamathambo, inani lamangqamuzana egazi liyancishiswa.

Isistimu yezinzwa ephakathi

Ukuphazamiseka kwesistimu ye-peripheral ne-central nerve kuboniswa ukubonakala okungenzeka:

• ikhanda;
• ukukhathala okungapheli;
• Isiyezi
• ukulahleka kokuma nokulinganisela esikhaleni;
• ukukhala ezindlebeni;
• ukudideka nokulahlekelwa ukwazi;
• i-paresthesia;
• izicubu zomsipha;
• ukulahleka kokulawulwa okungokomzwelo: ukuthuthukiswa kokudangala, ukwesaba;
• i-polyneuropathy.

Umuthi ungadala ukudabuka kwemisipha.

Kusuka ohlelweni lokuphefumula

Kwezinye izimo, kuba nomphimbo obuhlungu nokubonakala kokhwehlela owomile.

Engxenyeni yesikhumba nezicubu ezingaphansi

Kwezinye izimo, ukuthuthukiswa kwe-urticaria, ama-rashes, iStevens-Johnson syndrome, i-erythema, ukwanda kwe-photosensitivity, ukwanda kwe-psoriasis kungenzeka. Izinwele zingawa ekhanda.

Kusuka ohlelweni lwezinhliziyo

Kukhona ubungozi bokuthuthukisa i-orthostatic hypotension ne-bradycardia, umuzwa wokushisa.

Engxenyeni yezinso nezinso ze-urogenital

Umsebenzi wezinso ongaphazamiseka, okwandisa ukwehluleka kwezinso, ukwanda kokuchama.

Ngasohlangothini lwe-metabolism

Kwezinye izimo, i-hypernatremia noma i-hyperkalemia iyakhula.

Imiyalo ekhethekile

Ngokusebenzisa kanyekanye i-lisinopril kanye nokudayela nge-lipoproteins ephansi kwabantu, kunengozi yokuqhaqha kwe-anaphylactic.

Ngokusebenzisa kanyekanye i-lisinopril kanye nokudayela nge-lipoproteins ephansi kwabantu, kunengozi yokuqhaqha kwe-anaphylactic.

Ezigulini ezimiselwe ukuthuthukiswa komzimba, angioedema kungenzeka. Uma ukudumba kobuso nezindebe kuphawuliwe, ama-antihistamines kufanele athathwe. Ngokuvinjezelwa kwemigwaqo yomoya ephikisana nesizinda sokuvuvukala kolimi kanye ne-glottis, ukwelashwa okuphuthumayo ngomjovo osheshayo we-Epinephrine subcutaneously 0.5 mg noma i-0,1 mg intravenously kuyadingeka. Ngokuvuvukala kwe-larynx, kuyadingeka ukuqapha i-electrocardiogram nomfutho wegazi.

Umthelela ekhonweni lokulawula izindlela

Ngesikhathi sokwelashwa neLisinopril, kuyadingeka ukulawula amanani egxila kwegazi, ngoba ngokuya ngezimpawu ngazinye zeziguli, ukuthuthukiswa kwe-hypotension ye-arterial kungenzeka. Ngenxa yokunciphisa umfutho wegazi kukhona ukwephulwa kwekhono lokulawula amadivaysi ayinkimbinkimbi nokushayela imoto.

Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba

Umuthi awuvunyelwe ukuba unikezwe abesifazane abakhulelwe ngenxa yokuntuleka kolwazi ngomphumela wamakhemikhali we-ACE inhibitor ekukhuleni kwengane. Ngesikhathi sokufunda kuqala, kwembulwa amandla ento esebenzayo yokungena kwi-placenta. Kwi-trimester yokuqala yokukhula kwe-fetus, umuthi ungavusa ukuthuthukiswa kwe-cleft lip.

Lapho unquma iLisinopril ngesikhathi sokuncelisa, udinga ukuyeka ukondla ingane futhi uyidlulisele ekunakekelweni kokudla okunezinhlanganisela.

Ukuyalela uLisinopril Ratiopharm ezinganeni

Umuthi lo awuvunyelwe ezinganeni kanye nasentsheni engaphansi kweminyaka eyi-18.

Umuthi lo awuvunyelwe ezinganeni kanye nasentsheni engaphansi kweminyaka eyi-18.

Sebenzisa ebudaleni

Ezigulini esezikhulile, irejimeni yemithamo iyaguqulwa ngokuya ngemvume ye-creatinine. Lesi sakamuva sibalwa ifomula le-Cockroft:

Ukweqisa

Ukusetshenziswa kabi komuthi kungadala ukukhula kwezimpawu zokweqisa:

• ukwehla okubukhali kwengcindezi yegazi;
• ukwethuka kwe-cardiogenic;
• ukulahlekelwa ukwazi, isiyezi;
• bradycardia.

Isiguli kufanele sidluliselwe kuyunithi yokunakekela enkulu, lapho kulawulwa khona i-serum yama-electrolyte ne-creatinine. Uma amaphilisi athathwe ngaphakathi kwamahora angama-3-4 edlule, khona-ke isiguli kufanele sinikezwe umuthi wokunambitha, hlanza i-patity lesisu. ILisinopril ingaqedwa yi-hemodialysis.

Ukuxhumana nezinye izidakamizwa

Ngokuqokwa ngokufana kwamacwecwe eLisinopril neminye imithi, lokhu kulandelayo okulandelayo kuyabonakala:

1. Ama-Painkiller nezidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala zikhulisa amathuba okuba ne-hypotension.
2. I-Baclofen ithuthukisa umphumela wokwelapha we-lisinopril. Ngenxa yalokhu, ukuthuthukiswa kwe-hypotension ye-arterial kungenzeka.
3. Izidakamizwa ze-antihypertensive, i-sympathomimetics, i-Amifostin zithuthukisa umphumela wokwelapha umuthi, okuholela ekuthuthukisweni okungenzeka kwe-hypotension ye-arterial.
4. Ukulungiselela i-anesthesia ejwayelekile, amaphilisi okulala nama-antipsychotic kuholela ekwehlekeni okukhulu kwengcindezi yegazi.
5. Ama-Immunosuppressants, izidakamizwa ze-cytostatic ne-anticancer zandisa ingozi ye-leukopenia.
6. Izidakamizwa ze-Oral hypoglycemic emasontweni okuqala ezokwelapha eziyinkimbinkimbi zingaqhakambisa umphumela we-antihypertensive we-lisinopril.
7. Ama-antacid anciphisa i-bioavailability yesithako esisebenzayo.

I-Amifostine ithuthukisa umphumela wokwelapha womuthi, okuholela ekuthuthukisweni okungenzeka kwe-hypotension ye-arterial.

Izidakamizwa ezenzelwe i-sodium chloride zenza buthaka umphumela wezokwelapha wesidakamizwa futhi zivuse ukuthuthukiswa kwezimpawu zokuhluleka kwenhliziyo.

Ukuhambisana notshwala

I-ACE inhibitor iyakwazi ukukhuphula ubuthi be-ethyl alcohol kuma-hepatocytes, izicubu zezinhlelo zenhliziyo nezinzwa. Ngakho-ke, ngesikhathi sokwelashwa kwe-antihypertensive, kufanele uyeke ukuphuza utshwala.

Ama-Analog

Ukwelashwa kwesikhashana kwenziwa ngaphansi kokuqondisa kukadokotela okukhona kukho ukungadingeki komphumela we-antihypertensive ngokubamba iqhaza komunye wemithi elandelayo:

• Dapril;
• I-Aurolyza;
• Vitopril;
• Diroton;
• I-Zonixem;
• I-Amapin-L;
• I-Amlipin.

Izimo zeholide Lisinopril Ratiopharm kusuka kumakhemisi

Amaphilisi athengwa ngomuthi.

Ngingakwazi ukuthenga ngaphandle kadokotela?

Ukuthatha lesi sidakamizwa ngaphandle kwezeluleko eziqondile zezokwelapha kungaholela ekwehleni kwengcindezi yegazi, okungaholela ekuthuthukisweni kwe-bradycardia, ukulahlekelwa ukwazi, ukuhluleka kwenhliziyo, ukukhohlisa, ukufa. Ngokuphepha kweziguli, umuthi awuthengiswa ngaphezulu kwekhawuntara.

Intengo

Izindleko ezijwayelekile zomuthi zingama-ruble angama-250.

Izimo zokugcina zomuthi

Umuthi ugcinwa emazingeni okushisa angaphansi kuka + 25 ° C endaweni eseceleni kwesenzo selanga.

Isikhathi sokuphelelwa yisikhathi

Iminyaka emi-4

Umkhiqizi uLisinopril Ratiopharm

Merkle GmbH, eJalimane.

Ukubuyekezwa kweLisinopril Ratiopharm

Ngokuhambisana ngqo nezincomo zochwepheshe, kungenzeka ukuthola umphumela wezidakamizwa oludingekayo.

Odokotela

U-Anton Rozhdestvensky, udokotela wezinhlungu, eYekaterinburg

Umuthi ubekezelelwa kahle yiziguli. Kuholela ezinkomba zokucindezela okuzinzile, okungabizi kakhulu kune-Diroton. Ngasikhathi sinye, angikunqumeli ukuguquguquka okuqinile ngokuhambisana nakho. ILisinopril ayithinti ukusebenza kwe-erectile. Amathebulethi kufanele athathwe kuphela ekuseni 1 isikhathi ngosuku. Ingcindezi iqhubeka amahora angama-24.

UVitaliy Zafiraki, udokotela wezifo zenhliziyo, uVladivostok

Umuthi awulungele i-monotherapy. Ngibhalela iziguli zihambisana ne-low diuretics. Ngaphezu kwalokho, ngesikhathi sokwelashwa, kudingeka ngokucophelela ukuhlungwa ngokucophelela kwe-glomerular yezinso. Umuthi udlulise izivivinyo zomtholampilo ezidingekayo futhi uvunyelwe ukusetshenziswa yiziguli ezinomfutho wegazi ophakeme.

I-Amlipin iyi-analogue yesidakamizwa.

Iziguli

UBarbara Miloslavskaya, oneminyaka engama-25 ubudala, u-Irkutsk

Ngokukhethwa okuzimele kwezidakamizwa zokucindezela, akukho okusize. Ngifike esibhedlela nginesifo sikashukela, lapho kwakudakwa khona umuthi obizayo we-hypertension. Udokotela uphakamise ukuthi esikhundleni somuthi kufakwe amaphilisi eLisinopril-Ratiopharm. Ngiyithatha iminyaka emi-5 ku-10 mg ngosuku. Ingcindezi ibuyele ku-140-150 / 90 mm Hg. Ubuciko. futhi kazange futhi avuke. Le BP iyangifanela. Uma ungaliphuzi leli philisi, bese kuthi kusihlwa, ingcindezi ikhuphuke futhi nempilo yakho iba nzima.

U-Emanuel Bondarenko, oneminyaka engama-36, eSt

Udokotela unqume ama-5 mg we-lisinopril ngosuku. Ngiyithatha ekuseni ngokuqinile ngokwemiyalo ngasikhathi sinye.Umtholampilo uxwayise ngokuthi amaphilisi awahloselwe ukuthatha izinyathelo ngokushesha. Umphumela wokwelapha uqoqiwe, futhi ngemuva kwenyanga ingcindezi ayizange idlule ku-130-140 / 90 mm Hg. Ubuciko. Esikhathini esedlule, i-150-160 / 110 mmHg yabonwa. Ubuciko. Ngakho-ke, ngishiya isibuyekezo esihle. Angizange ngibe nemiphumela emibi.