I-Ibertan ingeyeqembu lezidakamizwa ze-antihypertensive. Umuthi une-contraindication embalwa, enwebisa ubukhulu bokusebenza kwayo. Ingozi yemiphumela emibi ngesikhathi sokwelashwa iphansi. Inzuzo yesidakamizwa yikhono lokugcina umphumela otholakala ngesikhathi sokwelapha usuku olu-1 ngemuva kokuthatha iphilisi.
Igama Lezwe elingafanele
I-Irbesartan
Igama elingabambezeli le-Ibertan laphesheya kwezwe ngu-Irbesartan.
I-ATX
C09CA04
Khipha amafomu nokwakheka
Ungathenga i-ejenti ye-antihypertensive kumathebhulethi aphelele efilimu. Umsebenzi wento esebenzayo yi-irbesartan. Ithuluzi liyisakhi esisodwa, okusho ukuthi amakhompiyutha asele ekwakhiweni awakhombisi umsebenzi we-antihypertensive. Ukuhlushwa kwe-irbesartan kuthebhulethi engu-1: 75, 150 no-300 mg. Ungawuthenga umkhiqizo ngamabhulashi (ama-14 ama-PC.). Ibhokisi lekhadibhodi liqukethe amaphakethe ama-2 weseli.
Isenzo se-Pharmacological
Umuthi unikeza umphumela we-hypotensive. Into eyinhloko ekwakhekeni kwayo isebenza njenge-anteptonist antagonist. Lokhu kusho ukuthi i-irbesartan iyaphazamisa isenzo se-angiotensin II receptors, enomthelela ekugcineni izindonga zemithambo yegazi ngethoni (kunciphisa ukucaca kwemithambo, imithambo). Ngenxa yalokho, izinga lokugeleza kwegazi lincipha kancane.
Umsebenzi wohlobo lwe-angiotensin awugcini nje ngokunciphisa imithambo yegazi ngokwanda okulandelayo kwengcindezi, kepha futhi nomthethonqubo wokuhlanganiswa kweplatlem nokuhlangana kwawo. Ukusebenzisana kwama-receptors kanye nalesi hormone kuvimbela ukukhiqizwa kwe-nitric oxide, okuyisici se-vasorelaxating. Ngaphansi kwethonya le-Ibertan, izinqubo ezichaziwe zehla kancane.
Ngaphezu kwalokho, kukhona ukwehla kokuqoqwa kwe-aldosterone. Leli yihomoni yeqembu le-mineralocorticoid. Ikhiqizwa yi-adrenal cortex. Umsebenzi wawo oyinhloko ukulawula ukuthuthwa kwezintambo ze-sodium ne-potassium kanye ne-chlorine anions. Le hormone isekela impahla enjalo yezicubu njenge-hydrophilicity. I-Aldosterone yenziwa ngokubandakanyeka kohlobo 2 lwe-angiotensin. Ngakho-ke, ngokwehla komsebenzi wokugcina, umsebenzi owokuqala wama-hormone uyacindezelwa.
Umuthi unikeza umphumela we-hypotensive.
Kodwa-ke, awukho umphumela omubi ku-kinase II, ebandakanyeka ekubhujisweni kwe-bradykinin futhi inomthelela ekwakhekeni kohlobo 2 lwe-angiotensin. I-Irbesartan ayinawo umthelela obalulekile ekushweni kwenhliziyo. Ngenxa yalokhu, ubungozi bezinkinga kusuka ohlelweni lwezinhliziyo alukhuphuki. Kuyaphawuleka ukuthi ithuluzi elishiwoyo alithinti ukwenziwa kwe-triglycerides, cholesterol.
I-Pharmacokinetics
Umuthi awuqali ukwenza ngokushesha. Izinguquko ezinhle zingabonakala emahoreni angama-3-6 ngemuva kokudla umuthi. Ngenxa yalokhu, azikho izingcindezi zokucindezela okubukhali. Ukwehlisa umfutho wegazi kwenzeka kahle. Umphumela oqinile awutholakali ngokushesha, kepha ngemuva kwamasonto amabili okuqala ngemuva kokuqala kokwelashwa. Ukusebenza kahle kwephakeme kuqinisekiswa isikhathi eside. Imiphumela emihle kakhulu nge-antihypertensive therapy ibonwa ngemuva kwezinyanga eziyi-1-1,5.
Ngemuva kokuthatha umthamo owodwa we-irbesartan, ukugxila kwe-plasma ephakeme kufinyelelwa ngemuva kwamahora ama-2. I-bioavailability yale nto ayidluli ngama-80%. Umuthi ungathathwa nganoma yisiphi isikhathi esikahle. Ukudla akubambezeli ukumuncwa futhi akubathinti amandla okuchayeka kulo muthi.
Ngokwelashwa, i-irbesartan ayiqongeleli kakhulu ku-serum yegazi. Lokhu kutholakala ngoguquko ngokukhishwa okulandelayo kwe-1 metabolite - glucuronide. Le nqubo yenzeka njengomphumela we-oxidation. Izindlela ezinkulu zokucwilisa into: kanye ne-bile, ngesikhathi sokuchama. Uma kwenzeka ukungasebenzi kahle kwesibindi nezinso, akukho shintsho olubonakalayo ezimpahleni ze-pharmacokinetic.
Umuthi ubekelwe ukwelashwa kwe-nephropathy, okwaqalwa ngayo ngemuva kwesizinda sikashukela sohlobo 2.
Izinkomba zokusetshenziswa
Inkomba eyinhloko yokusetshenziswa kwomuthi yi-arterial hypertension. Ngaphezu kwalokho, umuthi ungasetshenziswa esimweni se-pathological se-nephropathy (ukulimala kwe-renal parenchyma). Kuyasetshenziswa uma lesi sifo sikhula ngokusemuva kohlobo 2 lwesifo sikashukela noma umfutho wegazi ophezulu.
Contraindication
Kunemikhawulo embalwa ngokuqokwa komuthi okukhulunywa ngawo: ukungabekezelelani kwengxenye esebenzayo, ukuntuleka kwe-lactase, ukumuncwa kwe-galactose, ushukela.
Ngokunakekela
Inani lokuphulwa okuhlobene kuyaphawulwa, lapho kubalulekile ukukhombisa ukunaka okwengeziwe, kufaka phakathi:
- ukwephulwa kokuthuthwa kwezintambo zesodium;
- ukudla okungenawo usawoti;
- umsebenzi wezinso ongonakalisiwe, ikakhulukazi, unciphisa ukukhanya kwethambo lomthambo wezinso;
- ukususwa okusheshayo kokuphuma uketshezi emzimbeni, kufaka phakathi izimo ze-pathological, ezihambisana nokuhlanza, uhudo;
- ukusetshenziswa kwakamuva kwe-thiazide diuretics;
- isikhathi sokululama ngemuva kokufakelwa kwezinso;
- ukunciphisa ijubane lokudlula kwegazi ngokusebenzisa ama-mitral, ama-aortic valves, angabangelwa yi-stenosis;
- ukusetshenziswa kanyekanye namalungiselelo aqukethe i-lithium;
- izifo ze-endocrine ezihambisana nokukhubazeka kwe-aldosterone synthesis;
- izinguquko ze-atherosulinotic emikhunjini yokudla okunebele;
- izifo zesistimu yenhliziyo: ischemia, ukungakwaneli kokusebenza kwalesi sitho.
Ngokuqapha, umuthi ubekelwe isifo sohlelo lwethambo nenhliziyo.
Ungayithatha kanjani i-Ibertan?
Esigabeni sokuqala sokwelashwa, isilinganiso se-irbesartan sincane (150 mg). Ukuphindaphindwa kokwamukelwa - isikhathi esingu-1 ngosuku. Umuthi ungathathwa esiswini esingenalutho, ngesikhathi sokudla noma ngemuva kokudla. Kodwa-ke, kwezinye izimo, ukwehliswa okuqinile kakhulu komthamo kuyadingeka - kuze kufike ku-75 mg ngosuku. Isibonakaliso salokhu ukuqeda amanzi emzimbeni, ukwehla kwethamo legazi elijikelezayo, ukuthatha imithi egqugquzela ukuphuma kwe-fluid, nokudla okungenawo usawoti.
Uma umzimba uphendula ngokuqinile kumthamo omncane, khona-ke inani le-irbesartan lenyuka laya kuma-300 mg ngosuku. Kuyaphawuleka ukuthi ukuthatha imithamo engaphezu kwe-300 mg akukhulisi umphumela we-antihypertensive womuthi. Lapho ushintsha inani lomuthi endaweni enkulu, amakhefu kufanele agcinwe (aze afike kumaviki amabili).
Ukwelashwa kwe-nephropathy: umuthi unqunywe u-150 mg ngosuku. Uma kunesidingo, umthamo wento esebenzayo ukhuphukela kuma-300 mg (hhayi ngaphezulu kwesikhathi esingu-1 ngosuku).
Ngoshukela
Umuthi uvunyelwe ukusetshenziswa. Inkambo yokwelashwa kufanele iqale ngomuthi omncane (150 mg). Uma umuthi ubekezelelwa kahle, inani lezithako ezisebenzayo lingakhula kancane kancane.
Isikhathi sokwelashwa sinqunywa ngawodwana.
Imiphumela emibi ye-Ibertan
Ngesikhathi sokwelashwa, kuye kwaphawuleka ukuphazamiseka okuningana kwemitholampilo, imvamisa yokuvela kwayo kuye ngesimo sesiguli, ukuba khona kwezinye izifo.
Engxenyeni yesitho sombono
Akubhekwa.
Kusuka ezicutshini zemisipha
Ubuhlungu esifubeni, izicubu, namathambo.
Amapheshana wesisu
Isicanucanu, ukugabha, izitulo ezikhululekile, ukushisa kwenhliziyo, ukugaya.
Izitho zeHematopoietic
Ukwanda kokuqukethwe kwe-creatinine phosphokinase, potassium, kanye nokwehla kwe-hemoglobin.
Isistimu yezinzwa ephakathi
Isiyezi, ikhanda, ukuphazamiseka kwengqondo, okuhambisana nokukhathala okwandayo, ukungaxaki, ukukhathazeka.
Kusuka ohlelweni lomchamo
Umsebenzi wokuphazamiseka kwezinso.
Kusuka ohlelweni lokuphefumula
Kuvela ukukhwehlela.
Ngenkathi uphuza umuthi, ukukhwehlela owomile kungaqala.
Kusuka ohlelweni lwezitho zofuzo
Ukungasebenzi ngocansi.
Kusuka ohlelweni lwezinhliziyo
Shintsha izinga lokushaya kwenhliziyo, umuzwa wokushintshela esikhunjeni sobuso.
Allergies
I-Urticaria, vasculitis.
Umthelela ekhonweni lokulawula izindlela
Ngenxa yengozi eyandayo yemiphumela emibi evela ohlelweni lwezinzwa oluphakathi, kufanele kuqashelwe lapho ushayela izimoto. Ucwaningo lokuphepha lwalesi sidakamizwa ngesikhathi semisebenzi edinga ukunakwa alwenziwe.
Imiyalo ekhethekile
Ngesikhathi sokwelashwa ngokumelene nesizinda sokuphelelwa ngamandla, kuphawulwa ukwephulwa kwemali esele ye-electrolyte. Kulokhu, ukuthatha i-Ibertan kungavusa ukuncipha okukhulu kwengcindezi.
Uma kwenzeka umsebenzi wezinso onganele, kunconywa ukulawula okuqukethwe kwe-potasium, i-creatinine.
Ngokuphikisana nesizinda se-renal artery stenosis, kufikelwa uhlobo olunamandla lwe-hypotension.
Uma kwenzeka umsebenzi wezinso onganele, kunconywa ukulawula okuqukethwe kwe-potasium, i-creatinine.
Ukusebenza okuphansi kuka-Ibertan ekwelashweni kweziguli ezitholakele kuyi-hyperaldosteronism eyaziwayo kuyaphawulwa.
Uma kunenkambiso yezinkinga ezivela ohlelweni lwezinhliziyo, udinga ukubheka njalo izinga lomfutho wegazi ngesikhathi sokwelashwa, ngoba lokhu kwandisa ubungozi bokuqunjelwa kwe-myocardial.
Sebenzisa ebudaleni
Iziguli ezineminyaka engaphezu kuka-75 ubudala zinconyelwa ukuthatha umuthi ngamanani amancane - 75 mg ngosuku.
Isabelo sezingane
Ayisetshenziswa.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Akunconyelwe.
Isicelo sokusebenza kokulimala kwezinso
Ukwehluleka kwangempela akusona isizathu sokuyeka ukwelashwa. Ngenkathi udla umuthi ngakwisizinda salesi simo se-pathological, kufanele kuqashelwe.
Ukuthuthukiswa kwe-pathologies yesibindi emnene akusona isizathu sokuhoxiswa kwezidakamizwa.
Sebenzisa umsebenzi wesibindi okhubazekile
Ukuthuthukiswa kwe-pathologies emnene yalesi sitho akusona isizathu sokuhoxiswa kwezidakamizwa. Ukuphepha kokuphuza umuthi ngemuva kwemuva lokwehluleka kwesibindi okukhulu akukaphenywa. Ngakho-ke, kungcono ukwenqaba ukwelashwa nomuthi okukhulunywa ngawo kulesi simo se-pathological.
I-Ibertan Overdose
Kaningi, iziguli zehlise kakhulu umfutho wegazi, akuvamisile ukukhula kwe-tachycardia. Ezimweni ezingazodwa, kuvela izimpawu ze-bradycardia. Ukunciphisa ubukhulu bezibonakaliso ezingezinhle kuzosiza ukugcwala kwesisu, ukuqokwa kwama-sorbents (inqobo nje uma umuthi usanda kuthathwa). Ukuqeda izimpawu ngazinye, kudalwa izidakamizwa ezikhethekile, ngokwesibonelo, ukwenza ijubane lesigqi senhliziyo, izinga lokucindezela.
Ukuxhumana nezinye izidakamizwa
I-Hydrochlorothiazide ayifaki sandla ekuguqukeni kwe-pharmacodynamics nakuma-chemacokinetics e-Ibertan. Umphumela ofanayo uyabonakala ngokusebenzisana kwesidakamizwa okukhulunywa ngaso neWarfarin.
Inhlanganisela ehlanganisiwe
Kanye ne-Ibertan, ezinye izidakamizwa ezisiza ukwehlisa ingcindezi azinqunyelwe.
Musa ukusebenzisa amalungiselelo aqukethe i-lithium. Kulokhu, ubuthi bomuthi okukhulunywa ngabo buyakhula.
IHydrochlorothiazide ene-Ibertan ayihlanganisiwe kahle ne-colestiramine.
Akuhlanganisiwe ukuhlanganisa
Ama-NSAID avusa ukuthuthukiswa kokwehluleka kwe-renal, hyperkalemia.
IHydrochlorothiazide ene-Ibertan ayihlanganisiwe kahle ne-colestiramine.
I-Fluconazole ivimbela inqubo yokuguqulwa komuthi okukhulunywa ngayo.
Inhlanganisela edinga ukuqashelwa
Kuvunyelwe ukusebenzisa ama-beta-blockers, ama-diuretics weqembu le-thiazide, izithinteli ze-calcium blockers kanye ne-Ibertan.
Ukuqapha kufanele kuvikelwe ngenkathi usebenzisa umuthi okukhulunywa ngawo kanye nemithi equkethe i-potassium.
Ukuhambisana notshwala
Njengoba kunikezwe ukuthi i-ethanol inomthelela ekwandeni kwemithambo yegazi, akunconywa ukusebenzisa iziphuzo eziqukethe utshwala ngesikhathi sokwelashwa ne-Ibertan. Kulokhu, umsebenzi we-antihypertgency wesidakamizwa uyanda.
Njengoba kunikezwe ukuthi i-ethanol inomthelela ekwandeni kwemithambo yegazi, akunconywa ukusebenzisa iziphuzo eziqukethe utshwala ngesikhathi sokwelashwa ne-Ibertan.
Ama-Analog
Izinketho ezivumelekile zokubuyisa umuthi okukhulunywa ngawo:
- I-Irbesartan
- I-Irsar;
- Aprovel;
- I-Telmisartan.
Inketho yokuqala esikhundleni sa-Iberta ngqo. Leli thuluzi liqukethe isithako esifanayo esisebenzayo. Umthamo wayo ngu-150 no-300 mg kuthebhulethi eyi-1. Ngokwamapharamitha amakhulu, i-Irbesartan ayihlukile kune-Ibertan.
I-Irsar ingenye i-analogue yesidakamizwa okukhulunywa ngaso. Akufani ekwakhiweni, umthamo wento esebenzayo, izinkomba kanye ne-contraindication. Lezi zimali zisesigaba esifanayo samanani. Okunye ukufaka esikhundleni (i-Aprovel) kubiza okuthe xaxa (ama-ruble angama-600-800). Ukukhishwa ifomu - amaphilisi. Ku-1 pc iqukethe i-150 ne-300 mg ye-irbesartan. Ngokufanele, umuthi ungabekwa futhi esikhundleni somuthi okukhulunywa ngawo.
I-Telmisartan iqukethe ingxenye yegama elifanayo. Inani layo liyi-40 no-80 mg kuthebhulethi eyi-1. Umgomo wokusebenza kwesidakamizwa usekelwe ekuvimbeleni umsebenzi wama-receptors axhumana ne-angiotensin II. Ngenxa yalokhu, ukuncipha kwengcindezi kuyaphawulwa. Ngakho-ke, ngokwendlela yokusebenza, iTelmisartan nomuthi okukhulunywa ngawo ziyefana. Izinkomba zokusetshenziswa: umfutho wegazi ophakeme, ukuvimbela ukuthuthukiswa kwezinkinga (kufaka phakathi ukufa) kwezifo zohlelo lwethambo nenhliziyo.
I-Telmisartan inezimpawu eziningi eziphikisayo. Ukuvinjelwa kokusetshenziswa kwomuthi ngesikhathi sokukhulelwa, ukuqunjelwa, ebuntwaneni, kanye nokwephulwa kwepheji le-biliary, kwesibindi kuyaphawulwa. Akunconywa ukuyihlanganisa nezidakamizwa ezivela eqenjini le-angiotensin-converting enzyme inhibitors. Kwezimali ezibhekwayo, iTelmisartan ukuphela kwento engasetshenziswa esikhundleni se-Ibertan, inqobo nje uma kubakhona ukungabekezelelani kwengxenye esebenzayo, i-irbesartan.
Imibandela yekhefu lekhemisi
Umuthi umuthi.
Ngingakwazi ukuthenga ngaphandle kadokotela?
Cha, udinga ukuthola incwadi kadokotela yokuthenga lo muthi.
Intengo ye-Ibertan
Izindleko ezijwayelekile ngama-ruble angama-350.
Izimo zokugcina zomuthi
Ukushisa okunconyelwayo - okungekho ngaphezulu kuka- + 25 ° ะก.
Isikhathi sokuphelelwa yisikhathi
Umuthi okukhulunywa ngawo ugcina izakhiwo zawo izinyanga ezingama-36 kusukela ngosuku lokukhishwa.
Umkhiqizi
I-Polpharma (Poland).
Umuthi umuthi.
Ukubuyekezwa kwe-Ibertan
UDaria, oneminyaka engama-45, uSaratov
Sithole ukuthi unesifo se-hypertension isikhathi eside. Kusukela ngaleso sikhathi bengilokhu ngifunana nomuthi ongeke uphathe kabi futhi unikeze umphumela omuhle wokwelapha. Ngazama izithasiselo zokudla ezahlukahlukene nemikhiqizo yasekhemisi. Ngithanda umphumela we-Ibertan therapy. Ngenkathi ngiyamukela, ngizwa kahle.
UVeronika, oneminyaka engama-39, uKrasnodar
Waqala inkambo yokwelashwa ngemuva kokudla kwehypochloride. Ngalesi sizathu, udokotela akazange ancome ukuthatha umthamo ojwayelekile, kodwa wanquma u-75 mg ngosuku. Angibonanga umphumela omningi. Lapho udokotela evuma ukwandisa inani lomuthi amahlandla ama-2, umfutho wehle kakhulu, wabuyela kokujwayelekile. Ngaphambi kwalokhu, bekuba nokuphuma njalo komfutho wegazi, kuya phezulu.
