I-Captopril-FPO isidakamizwa esivimbayo ngenxa yomphumela we-vasodilating. Umphumela wokwelapha ubangelwa ukuvimbela i-ACE nokuvinjwa okungaqondile kokuwohloka kwe-bradykinin. Umuthi uvimba ukwakheka kwe-angiotensin 2. Ngenxa yokwanda kwemithambo eyinhloko nethambile, ukujikeleza kwegazi endaweni ye-ischemia kuyathuthukiswa, isimo sesiguli sithuthuka ngemuva kwesizinda se-pathologies yesistimu yenhliziyo yemvelaphi ehlukahlukene. Umuthi kumele uphuzwe ngokuqinile ngokuya ngemiyalo kadokotela obonayo.
Igama Lezwe elingafanele
I-Captopril.
I-Captopril-FPO isidakamizwa esivimbayo ngenxa yomphumela we-vasodilating.
I-ATX
C09AA01.
Khipha amafomu nokwakheka
Umuthi uyatholakala ngesimo samaphilisi amhlophe nge-tint enokhilimu, aqukethe u-25 noma 50 mg wento esebenzayo - i-Captopril. Ukwandisa ukumuncwa nokukhiqizwa kwe-bioavailability ngesikhathi sekwenziwa inqubo, izinhlanganisela ezisizayo ziyafakwa engxenyeni esebenzayo:
- i-microcrystalline cellulose;
- isitashi sommbila;
- ushukela wobisi;
- i-magnesium stearate;
- i-aerosil.
Amayunithi emithi angaba nephunga eliyisimilo. Amathebulethi ahlanganiswa emaphaketheni okulimaza izingcezu ezi-5-10.
Isenzo se-Pharmacological
Umuthi ungowesigaba sezidakamizwa ze-antihypertensive, indlela yawo esekelwe ekuvinjelweni kwe-angiotensin ukuguqula i-enzyme (ACE). Njengomphumela womthelela wokwelapha, ukuguqulwa kwe-angiotensin I kuFomu II kuyehla, okuholela ku-vasoconstriction - isikhala se-vascular endothelium. Ngokuncipha kokukhanya kwesitsha kuphambane nesizinda sevolumu ejwayelekile yokujikeleza kwegazi, umfutho wegazi uyakhuphuka. Umuthi uvimbela i-spasm, ngaleyo ndlela uvimbe ukuqhekeka kwe-bradykinin, i-enzyme ethambisa imithambo yegazi.
ICaptopril FPO ibambezela ukuthuthukiswa kokuhluleka kwenhliziyo.
Ngenxa yalokhu, izikebhe ziyanda futhi ingcindezi yehla iye kwesejwayelekile, inqobo nje uma umthamo wokuhlinzekwa kwegazi wanele ukugcwalisa umbhede ongashadile. I-ACE inhibitor ngenxa yokuqina kwengcindezi inezenzo ezilandelayo:
- kunciphisa ukumelana emithanjeni ye-pulmonary kanye neye-peripheral;
- kwandisa ukumelana kwemithambo yemithwalo, kunciphisa ingozi yokuqhekeka kodonga lokugeleza kwegazi;
- kuvimbela ukwephulwa komsebenzi we-ventricle yangakwesobunxele, okubangelwa umfutho wegazi ophakeme (BP);
- kubambezela ukuthuthukiswa kokuhluleka kwenhliziyo;
- kunciphisa ukuhlangana kwe-sodium ku-plasma yegazi ngokumelene nesizinda sefomu elingapheli lokuhluleka kwenhliziyo;
- kuthuthukisa ukusebenza kwe-coronary artery kanye ne-microcirculation ezindaweni ezise-ischemic.
Umuthi uvimbela ukunamathela kweplatelet.
I-Pharmacokinetics
Ngemuva kokuphathwa ngomlomo, i-Captopril idonswe odongeni lwe-jejunum. Ngokudla okuhambisanayo, ukumuncwa kuncishiswa ngo-35-40%. Ingxenye esebenzayo ifinyelela amanani aphezulu ku-serum kungakapheli imizuzu engama-30-90. Izinga lokubopha i-albhamu ye-plasma uma lingena egazini elingezansi lincane - 25-30%. Ngokwesimo esiyinkimbinkimbi enjalo, isidakamizwa sakhiwe kuma-hepatocytes ngokwakhiwa kwemikhiqizo ye-biotransfform engenamphumela yezidakamizwa.
Ngaphezu kwe-95% yamakhaphu okushiya umzimba ngosizo lwezinso, kuthiwe ama-50% abuyiselwe ngendlela obuyiyo ekuqaleni.
Ingxenye-yokuphila ingaphansi kwamahora ama-3. Isikhathi sanda ngokubhekela emuva ngemuva kokuhluleka kwezinso ngamahora angama-1-29, kuya ngobunzima besifo. Ngaphezu kwe-95% yamakhaphu okushiya umzimba ngosizo lwezinso, kuthiwe ama-50% abuyiselwe ngendlela obuyiyo ekuqaleni.
Okusizayo
Umuthi usetshenziswa kwezokwelapha ekwelapheni nasekuvimbeleni izinqubo ezilandelayo ze-pathological:
- umfutho wegazi ophakeme, kufaka phakathi i-renovascular hypertension;
- njengengxenye yokwelashwa okuphelele kokuqeda ukuhluleka kwenhliziyo okungapheli;
- ukuphazamiseka komsebenzi osebenzayo we-ventricle yangakwesobunxele ngemuva kokuhlaselwa yinhliziyo, uma nje isiguli sizinzile;
- ukulimala kwekhompiyutha yokusebenza kanye ne-renal parenchyma yohlobo 1 sikashukela.
Contraindication
Umuthi awuvunyelwe ukusetshenziswa ngabantu abangabekezeleli umuntu ngamunye ukuze afake izidakamizwa nezinye izinto ezakha umuthi. Ngenxa yokuba khona kwe-lactose monohydrate, i-Captopril ayinconyelwanga ukusetshenziswa kubantu abaphethwe yi-malabsorption ye-monosaccharides, ukungabekezeleli noma i-lactase.
Umthamo
Umthamo usungulwa ngamunye yisazi senhliziyo, othembela kuzinkomba zaselebhu kanye nobunzima be-pathology. Umuthi wenzelwa iziguli ezindala ezingaphezulu kweminyaka engu-18. Umthamo wokuqala onconywayo ngu-12.5 mg izikhathi ezi-2 ngosuku.
Nge-diphicathy yesifo sikashukela
Ngokuvimbela kanye nokwelashwa kwe-nephropathy ngokumelene nesizinda sikashukela exhomeke ku-insulin, kuyadingeka ukuthatha kusuka ku-75 kuya ku-100 mg wesidakamizwa ngosuku.
Ekuhlulekeni kwenhliziyo okungapheli
Ukwehluleka kwenhliziyo okudala isikhathi eside kudinga ukusetshenziswa kwama-25 mg izikhathi ezi-3 ngosuku esigabeni sokuqala sokwelashwa. Ngomfutho wegazi ojwayelekile noma ophansi, kanye neziguli ezine-hypovolemia ne-sodium ephansi egazini, kunconyelwa ukunciphisa umthamo ukuya ku-6.25-12.5 mg ngokuvama kokuphatha kufinyelela kathathu ngosuku. Njengokwelashwa kokulungiswa, izikhathi ezi-3 ngosuku kufanele zithathwe 12,5 noma 25 mg, kuya ngezinga lokubekezelela umuthi.
Ngaphansi kwengcindezi
Ukuqinisa umfutho wegazi wobunzima obunzima noma obulinganisile ekuqaleni kokwelashwa, ama-25 mg kufanele athathwe izikhathi ezingama-2-3 ngosuku. Ngokuphendula okuphansi kwezokwelapha, umthamo owodwa kufanele ukhuphuke ube ngu-50 mg kuphela uma ubekezelelwa kahle. Umthamo omkhulu ovunyelwe ngosuku ngu-150 mg.
Uma izinkomba zomfutho wegazi ezifunwayo zingatholakalanga phakathi kwezinsuku eziyi-14-21 zokwelashwa, i-thiazide diuretics yengezwe ku-Captopril-FPO monotherapy. Ukusabela komzimba kubonwa emavikini angu-1-2. Ukuqeda inqubo eqinile ye-pathological, ungangezela umthamo owodwa kuya ku-100-150 mg ngokuvama kokuphatha kufinyelela izikhathi ezi-2-3 ngosuku.
Ukuqeda ubunzima be-hypertensive, kuyadingeka ukubeka umuthi ngaphansi kolimi ngomthamo ongu-6.25-50 mg.
Ukuqeda ubunzima be-hypertensive, kuyadingeka ukubeka umuthi ngaphansi kolimi ngomthamo ongu-6.25-50 mg. Umphumela wokwelapha ubonwa ngemuva kwemizuzu engu-15-30.
Nge-infyoction ye-myocardial
Umuthi ubekelwe izinsuku ezingama-3 ngemuva kokuqothuka kwe-myocardial. Umthamo ekuqaleni kokwelashwa kwezidakamizwa ngu-6.25 mg ngosuku. Ngokuphendula okuhle komzimba kulo muthi, ukwanda okujwayelekile kwansuku zonke kuya ku-12,5 mg ngokuvama kokuphathwa kufinyelela kathathu ngosuku kuvunyelwe. Emavikini ambalwa, umthamo uyakhuphuka ufike ezingeni eliphakeme elibekezelelwe.
Ungayithatha kanjani i-Captopril-FPO
Amacwecwe athathwa esiswini esingenalutho imizuzu engama-60 ngaphambi kokudla, ngoba ukudla kubambezela noma kuphazamisa ukumuncwa okujwayelekile komuthi.
Ngaphansi kolimi noma isiphuzo
I-subopual Captopril isetshenziswa kuphela ukusheshisa umphumela wokwelapha. Ukwehla ngokushesha komfutho wegazi kuyadingeka uma kwenzeka kuba nesifo segazi.
Kuthatha isikhathi esingakanani
Ngokuphatha okungaphansi, umphumela we-hypotensive ubonwa imizuzu eyi-15-30 ngemuva kokuthi ithebhulethi ichithwe ngaphansi kolimi. Lapho ungenile, umphumela omkhulu wokwelapha utholakala kungakapheli amahora angama-3-6, owokuqala - ngemuva kwamahora angama-1-2.
Ngingaphuza kangaki
Ukuphindaphindeka kwesicelo - izikhathi ezingama-2-3 ngosuku.
Imiphumela emibi
Imiphumela emibi ikhula njengomphumela werejimeni yemithamo engafanele. Lapho zivela, kunconywa ukunciphisa umthamo.
Amapheshana wesisu
Imiphumela emibi esegodini lokugaya ivela njenge:
- isicanucanu
- ukwehla kwesifiso sokudla;
- ukunambitheka komoya;
- Ubuhlungu besisu;
- ukwanda komsebenzi we-enzymatic we-hepatic transaminases;
- i-hyperbilirubinemia;
- isifo sohudo, ukuqunjelwa;
- ukuthuthukiswa kokonakala kwamafutha kwesibindi.
Ezimweni ezingavamile, ukushuba kwe-bile kungenzeka. Kube nezigameko ezingajwayelekile zokuvuvukala kwamanyikwe.
Izitho zeHematopoietic
Ukwephulwa kwethambo lomongo wethambo akuvamile ukuba kubhalwe phansi:
- i-anemia
- ukwehla kwenani lama-neutrophils;
- ukwehla ekwakhiweni kweplatelet.
Ezigulini ezinezifo ze-autoimmune, i-agranulocytosis kungenzeka.
Isistimu yezinzwa ephakathi
Ngomonakalo ohlelweni lwezinzwa, kunengozi yesiyezi, ikhanda elibi, ukukhathala okungamahlalakhona, i-paresthesias. Ukugxila kungenzeka kukhubazeke.
Kusuka ohlelweni lomchamo
Kwezinye izimo, amaprotheni angafakwa emchanjeni, okuqukethwe i-uric acid ne-creatinine epulini yegazi kuphakama, i-acidosis iyakhula.
Kusuka ohlelweni lokuphefumula
Ukuvela kokhwehlela owomile kungenzeka.
Engxenyeni yesikhumba
Ukuphendula kwesikhumba kubonakale njengokuqhuma kwe-maculopapular noma ukulunywa. Ezigulini ezimiselwe ukuthuthuka kokungezwani komzimba, kungavela i-Stevens-Johnson syndrome, i-urticaria, noma i-dermatitis.
Kusuka ohlelweni lwezitho zofuzo
Kwabesilisa, ukukhuliswa kwesifuba noma ukuthuthukiswa kokungasebenzi kahle kwe-erectile kungenzeka.
Allergies
Umzimba ubonakala ngendlela yokuqubuka kwesikhumba, i-bronchospasm nge-airway barriers, i-edema ye-Quincke's, ukushaqeka kwe-anaphylactic, ukugula kwe-serum kanye nokuba khona kwama-antibodies egazini.
Umthelela ekhonweni lokulawula izindlela
Umuthi awuthinti umsebenzi wamakhono amahle wezimoto, isimo sengqondo nangokomzimba sesiguli. Ngakho-ke, ngesikhathi sokulashwa nge-Captopril, asikho isidingo sokunciphisa isikhathi sokushayela imoto noma sokusebenza ngamasu ayinkimbinkimbi.
Imiyalo ekhethekile
Ukuqapha kuyalulekwa lapho kuthatha lezi zimo ezilandelayo:
- i-stenosis yemithambo yezinso;
- isifo senhliziyo;
- ingozi ye-cerebrovascular;
- izifo ze-autoimmune;
- ukucindezelwa kokwakhiwa kwegazi;
- isifo sikashukela mellitus;
- isikhathi sokuvuselelwa ngemuva kokufakelwa kwezinso;
- i-aortic stenosis;
- Ukudla okuphansi kwe-sodium
- ubudala
- umthamo ophansi wegazi elijikelezayo, ukomisa.
Ngesikhathi sokulashwa kwezidakamizwa, kuyadingeka ukuthi uxwayise abasebenzi beLaboratri ngokutholakala kwemiphumela emihle yamanga lapho kuhlaziywa umchamo ngobukhona be-acetone.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Ukusetshenziswa kwesidakamizwa ku-II kanye ne-III trimesters of development embryonic shows theumo we-fetotoxicity, ngenxa yokuthi ukubekelwa phansi kwezitho zomzimba ezinganeni kungakhubazeki. Amathuba okuzalwa ngaphambi kwesikhathi ayakhula. Abesifazane abakhulelwe benqatshelwe ngokuphelele ukusebenzisa umuthi.
I-Captopril ikhishwa kanye nobisi lwebele, ngakho-ke, ngesikhathi sokuqunjelwa, kubalulekile ukumisa ukukhipha isisu.
Ukuhambisana notshwala
Umuthi wenqatshelwe ngokuphelele ukusisebenzisa ngokuhambisana nophuzo oludakayo, futhi ngenxa yalokho, phakathi nesikhathi sokwelashwa ngezidakamizwa, akufanele uphuze utshwala noma uthathe imikhiqizo equkethe i-ethanol. I-ethyl utshwala yehlisa umphumela we-antihypertensive, yandisa ingozi yokuqhekeka kwegazi ngenxa yokuhlanganiswa kwe-platelet futhi ikhuphule amathuba okuwa.
Ukweqisa
Uma kwenzeka kweqa izidakamizwa, ukwehla okubukhali kwengcindezi yegazi kungenzeka. Njengomphumela we-hypotension ye-arterial, umuntu angalahlekelwa ingqondo, awele ku-coma noma ku-coma, futhi ukuboshwa kwenhliziyo kungenzeka. Ngokusebenzisa kabi umuthi, ikhanda liqala ukugoqa, izinga lokushisa emilenzeni liyancipha.
Ukulungisa umfutho wegazi ngokwejwayelekile, kuyadingeka ukuphoqa isisulu ukuba silele emhlane wakhe siphakamise imilenze. Ezimweni zokuma, kunikezwa ukwelashwa okubonakalayo.
Ukuxhumana nezinye izidakamizwa
Ukusetshenziswa okufanayo kwe-Captopril nezinye izidakamizwa kubonakaliswa kokusabela okulandelayo:
- Izidakamizwa ze-Cytostatic kanye ne-immunosuppressive, i-azathioprine ikhulisa amathuba okukhulisa i-leukopenia. I-Azathioprine ikhuthaza ukwehla komthambo we-hematopoiesis.
- I-potassium-sparing diuretics kanye nezidakamizwa ezingezona ze-antiidalidal anti-inflammatory zingadala i-hyperkalemia. I-ACE inhibitor inciphisa ukuqoqwa kwe-aldosterone, ngenxa yokuthi kukhona ukubambezeleka kwama-ion e-potassium.
- Ngokusetshenziswa kanye kanye nezidakamizwa ze-diuretic, umphumela oqinile we-hypotensive uyabonakala. Njengomphumela, ukuthuthukiswa kokuqina kwe-arterial hypotension, hyperkalemia, kanye nokuqina kwezinso kungenzeka. Futhi, ukwehla okubukhali kwengcindezi yegazi kuyabonakala ngokufakwa kwemali yokuhlanza izinzwa okuvamile.
- I-Allopurinol ikhulisa amathuba okuthola ukungezwani komzimba nokuphazamiseka kwe-hematological.
- I-Acetylsalicylic acid, ibuprofen ne-indomethacin banciphisa umphumela wokwelapha we-Captopril.
- I-Captopril inyusa ukugcwala kwe-plasma kwe-digoxin.
Imithi elwa nama-cyclosporin ingadambisa ukukhula kwe-oliguria futhi yenze umsebenzi wezinso ube buthaka.
Ama-Analog
Amathebhulethi e-Captopril-FPO lapho kungekho khona umphumela we-antihypertensive ofanele ungathathelwa indawo ngemithi elandelayo:
- Kapoten;
- I-blockordil;
- UCaptopril Sandoz;
- I-Angiopril;
- I-Rilcapton;
- I-Captopril-STI;
- I-Captopril-Akos.
I-Captopril-FPO ihluke kanjani ku-Captopril
IGeneric, ngokungafani nomuthi wokuqala, inomphumela omude kakhulu futhi inethonya lokwelapha elenziwe.
Izimo zokuphumula ze-Captopril-FPO kusuka ekhemisi
Kuvunyelwe ukuthenga ngezizathu eziqondile zokwelashwa.
Ngingakwazi ukuthenga ngaphandle kadokotela
Njengomphumela wokusetshenziswa okungafanele, ukuthuthukiswa kwe-hypotension ye-arterial kungenzeka, ngakho-ke ukuthengwa kweCaptopril ngaphandle kadokotela akunqatshelwe.
Intengo ye-Captopril-FPO
Intengo ephakathi kumakhemisi ngama-ruble ayi-128.
Izimo zokugcina zomuthi
Kunconywa ukugcina umuthi endaweni ehlukaniswe ukukhanya kwelanga, emazingeni okushisa angeqi ku-25 ° C
Isikhathi sokuphelelwa yisikhathi
Iminyaka emithathu
Umkhiqizi we-Captopril-FPO
I-CJSC FP Obolenskoye, eRussia.
Ukubuyekezwa kodokotela neziguli mayelana ne-Captopril-FPO
U-Olga Kabanova, udokotela wezifo zenhliziyo, eMoscow
Ngabona ukuthi i-Captopril nama-generics ayo akasebenzi kuzo zonke iziguli. Ngingasincoma isidakamizwa ukwehlisa umfutho wegazi ezimweni eziphuthumayo. Ungaphuza umuthi izikhathi ezi-3 ngosuku. Kwezinye izimo, iziguli zikhononda ngokukhwehlela okukhulu. Sebenzisa ngokuqapha uma wehluleka wezinso.
Ulyana Solovyova, oneminyaka engama-39, uVladivostok
Ngishiya isibuyekezo esihle. Ithebhulethi elincane elimhlophe lihlukaniswe kalula izingxenye ezine ngokubonga kumanothi akhethekile. Ngokwami, udokotela uncome ukufaka lesi sidakamizwa ngaphansi kolimi ukuze sisebenze ngokushesha. Umiselwe ukuncishiswa okuphuthumayo kwe-hypertension. Isenzo sibonwa imizuzu emi-5. Angitholanga i-Cons, ngaphandle kokuthi ukunambitheka okumunyu. Angizimisele ngokufaka umuthi esikhundleni somuthi. Ayikho imiphumela emibi.
