Umuthi we-antihypertensive ne-diuretic ngokuhlanganiswa kwezinto ezimbili ezisebenzayo. Yenzelwe ukwelashwa kweziguli nge-inhlanganisela ekhonjisiwe yokwelapha ye-hypertension ye-arterial.
Igama Lezwe elingafanele
I-Ramipril + hydrochlorothiazide.
Igama elingelona okuphathelene nomhlaba okungelokuphathelene neHartil-D nguRamipril + hydrochlorothiazide.
Ath
I-ATX Code C09BA05
Khipha amafomu nokwakheka
Umuthi uyatholakala ngesimo samathebulethi aphuzi okwenziwe ngombala ophuzi. Umbhalo uqoshwe ngakolunye uhlangothi, kuya ngomthamo:
- I-2,5 mg - ngakolunye uhlangothi no-12.5 mg - ngakolunye uhlangothi, ezinhlangothini zombili zezingozi ezihlukanisayo;
- I-5 mg ngakolunye uhlangothi no-25 mg ngakolunye uhlangothi, ezinhlangothini zombili zezingozi.
Kwikhadi elilodwa lamakhadibhodi kungaba ngamabhulashi ama-2 ezincezu eziyi-14 inye.
Ukuqanjwa kwamathebhulethi kuqukethe izinto ezi-2 ezisebenzayo:
- i-ramipril kumthamo we-2,5 noma 5 mg;
- hydrochlorothiazide - 12,5 mg noma 25 mg, ngokulandelana.
Ngokwengeziwe - ama-thickeners, odayi nezinye izinto ezifanayo.
Isenzo se-Pharmacological
URamipril uyinto enomfutho ophezulu wegazi. Ibambezela isenzo se-ACE inhibitor (exopeptidase), okuholela kumphumela we-hypotensive: ukumelana okuphelele kwemikhumbi ye-peripheral kanye ne-pulillary capillaries iba yincane, ukuphuma kwenhliziyo kuyanda futhi nokumelana nokukhula kwengcindezi kukhuphuka.
Ngaphezu kwalokho, into esebenzayo ithuthukisa ukugeleza kwegazi iye kwi-myocardium futhi inciphise ukusakazeka kwe-necrotization ekuhlaselweni yisifo senhliziyo, kunciphisa amathuba okuba ne-arrhythmias kanye nobunzima bokwehluleka kwenhliziyo.
Umuthi wesibili osebenzayo - i-hydrochlorothiazide - ubhekisela kuma-thiazides anezimpawu ze-diuretic.
Ishintsha ibhalansi ye-sodium futhi inciphise impendulo ku-norepinephrine nohlobo II angiotensin.
Ngosizo lweHartil-D, ingcindezi esethanjeni lwe-portal iyancishiswa.
Ezigulini ezinesifo sikashukela esine-nephropathy ngosizo lwalesi sidakamizwa, ingcindezi esethanjeni le-portal iyancishiswa futhi ukuthuthukiswa kokuhluleka kwe-renal kuvinjelwe.
Umuthi uqala cishe ihora ngemuva kokuphathwa futhi uthatha cishe usuku.
I-Pharmacokinetics
Ukufakwa kwengxenye ye-antihypertensive kwenzeka ngokushesha, kuthi ngemuva kwehora kube sekufinyelelwe (50-60%). Yakha ama-metabolites asebenzayo futhi angasebenzi abopha engxenyeni yamaprotheni ye-plasma yegazi.
I-diuretic idonswa ngokushesha njenge-ramipril, isatshalaliswa kalula futhi isuswe yi-90% izinso ngesimo sayo sokuqala.
Kukhutshiwe ngokulingana okulingana ngokulingana ngomchamo nezindunduma.
Uma kwenzeka ukungasebenzi kahle kwe-reso, ukuqina kwe-ramiprilat (metabolite esebenzayo) kuyanda, futhi uma kunezinkinga zesibindi, i-ramipril.
Izinkomba zokusetshenziswa
IHartil D ikhonjiswa ngomfutho wegazi ophakeme, kodwa futhi isetshenziselwa izifo ezithile zenhliziyo nezinso.
Kubekelwe ukwelashwa kwezifo ezifana nalezi:
- ukwehluleka kwenhliziyo okungapheli;
- i-arterial hypertension;
- isifo sikashukela noma i-nondiabetesic nephropathy;
- I-IHD yokunciphisa ukuthi kungenzeka ukuthi i-myocardial infarction noma i-cerebral hemorrhage (unhlangothi).
Inkomba yokusetshenziswa yisidingo senhlanganisela ekwelapheni ama-diuretics nama-antihypertensive agents.
Contraindication
Ungathathi umuthi uma:
- hyperreaction kunoma yiziphi izingxenye zomuthi noma kokunye okuvela eqenjini le-sulfonamide;
- ukuba khona kwe-edema yezingqimba ezijulile ze-dermis nezicubu ezi-subcutaneous ku-anamnesis;
- ukunciphisa imithambo ye-hepatic nobunzima ekuhambeni kwegazi noma ukunciphisa imithambo yemithambo yezinso olulodwa;
- cholestasis;
- i-hypertension ye-arterial;
- kuze kube yiminyaka eyi-18, ngenxa yokuntuleka kwemininingwane ethinta umzimba wezingane;
- lapho i-adrenal cortex ifaka i-aldosterone eningi kunokujwayelekile okudingekayo;
- ukwehluleka kwezinso.
Ukwelashwa nabesifazane akunconyelwanga lapho ukhulelwe nalapho uncelisa ibele.
Ngokunakekela
Ngokunemba okukhulu nangaphansi kokuqondisa kukadokotela, kunqunyelwe i-aldosteronism eyinhloko, ukungabekezeleli noma ukungasebenzi kahle kweglucose noma i-galactose, ngesikhathi se-hemodialysis,
Ungayithatha kanjani iHartil D
Umthamo udonswa ngudokotela esimweni ngasinye ngokwehlukana.
Amathebulethi athathwa kakhulu ekuseni, ngaphandle kokuhlafuna. Ngasikhathi sinye bachitha amanzi amaningi. Ungazihlanganisi nokudla ukudla.
Amaphilisi weHartila-D athathwa kaningi ekuseni, ngaphandle kokuhlafuna.
Umthamo omkhulu wansuku zonke akufanele udlule ku-10 mg.
Umthamo wezifo ezahlukahlukene:
- I-Arterial hypertension - i-2,5-5 mg ngosuku, kuya ngomthelela okhiqizwayo.
- Ukwehluleka kwenhliziyo okungapheli - 1.25-2.5 mg. Ngokunyuka komthamo okudingekayo okweqile kwe-2,5 mg kungahlukaniswa kube yimithamo emi-2.
- Ngemuva kwe-infyoction ye-myocardial, inhlanganisela ye-ramipril + hydrochlorothiazide inqunyelwe akukho ngaphambi kosuku lwesithathu ngemuva kwesimo esibuhlungu. Umthamo - 2,5 mg izikhathi 2 ngosuku. Ukwanda okungenzeka kube ngu-5 mg izikhathi ezi-2 ngosuku.
- Ngokuvinjwa kokuhlaselwa yisifo senhliziyo, umthamo wokuqala ngu-2,5 mg, kamuva uphindwe kabili ngemuva kwamasonto ama-2 wokuphatha, futhi izikhathi ezi-2 ngemuva kwamasonto ama-3. Umthamo ophelele wokulungiswa nsuku zonke awudluli ku-10 mg.
Ngoshukela
Ekuqaleni kokwelashwa, uhhafu wethebhulethi ka-2,5 mg uthathwa isikhathi esingu-1 ngosuku. Ngokuzayo, uma kunesidingo, kungenzeka ukwandisa umthamo wansuku zonke kancane kancane ukuya ku-5 mg kumithamo emibili ehlukanisiwe.
Imiphumela emibi yeHartila D
Imvamisa, ukubonakaliswa okungafuneki kwesenzo somuthi kuhlobene nomsebenzi wegayiti yokugaya ukudla, i-hematopoiesis, isimiso sezinzwa esiphakathi, amasistimu wokuchama kanye nowokuzala, uhlelo lokuphefumula, isikhumba, uhlelo lwe-endocrine, isibindi ne-bile ducts.
Amapheshana wesisu
Isicanucanu, ukuhlanza, umlomo owomile, i-stomatitis, ukuphazamiseka kwesitulo.
Izitho zeHematopoietic
Kusukela ezithweni ze-hemopoietic, ushintsho ekuhlaziyweni kwezinkomba kungenzeka:
- izinga le-hemoglobin (ukulahla, ukuvela kwe-anemia);
- inani lamangqamuzana abomvu egazi, amaseli amhlophe egazi namapulatelethi (ukuncipha);
- amazinga we-calcium (eyehla).
Isistimu yezinzwa ephakathi
Ukuqala kokunganaki, ukwanda kokukhathazeka, ukukhathazeka, ukukhala ezindlebeni, isiyezi nobuthakathaka akukona.
Kusuka ohlelweni lomchamo
Ukuchayeka ezinso kungadala i-oliguria,
Kusuka ohlelweni lokuphefumula
I-bronchospasm, i-rhinitis, ukukhwehlela owomile, ukufushane komoya.
Engxenyeni yesikhumba
I-Rash, i-paresthesia, ukukhuphuka kokujuluka, umuzwa wokushisa ezindaweni ezithile zesikhumba, i-alopecia.
Ukusetshenziswa kweHartila-D kungadala ukujuluka kokujuluka.
Kusuka ohlelweni lwezitho zofuzo
Kwehliswe i-libido, i-erectile dysfunction.
Kusuka ohlelweni lwezinhliziyo
Yehla ekucindezelweni kwegazi lapho usukuma noma umile, ukuphazamiseka kwesigqi senhliziyo, okwandisa isifo sikaRaynaud.
Esimweni sokudonsa okubukhali nokuqine kakhulu kwengcindezi yegazi, ukuqubuka kwe-myocardial noma unhlangothi kungakhula.
Uhlelo lwe-Endocrine
Ukwanda ushukela we-serum ne-uric acid.
Engxenyeni yesibindi ne-biliary
I-Jaundice cholestatic, i-hepatitis, ukwehluleka kwesibindi, i-cholecystitis, i-necrosis yesibindi.
Allergies
Ukuvela kwe-allergic kungenzeka ngendlela:
- i-urticaria;
- ukukhulisa isithombe;
- i-angioedema yobuso noma i-larynx;
- ukuvuvukala kwamaqakala;
- i-erythema exudative;
- i-conjunctivitis, njll.
Ukusetshenziswa kwe-Hartila-D kungadala ukusabela komzimba ngendlela ye-urticaria.
Ngokuphendula okunamandla komzimba, amaphilisi akhanseliwe.
Umthelela ekhonweni lokulawula izindlela
Njengoba ukusebenza ngezinqubo eziyinkimbinkimbi kudinga ukunakwa, khona-ke, uma usabela indlela umuntu ngamunye angaphendula ngayo kulo muthi, umuntu kufanele ayeke ukushayela imoto nezimoto ezisebenzayo okungenani ekuqaleni kokwelashwa.
Imiphumela emibi nayo ivela ngesimo se:
- hyperkalemia
- i-hyperazotemia;
- i-hypercreatininemia;
- ukukhuphuka kwe-nitrogen eseleyo;
- ushintsho kwezinye izinkomba zaselebhu.
Isistimu ye-musculoskeletal iphendula umuthi ngemisipha, ukuqaqamba kwamathambo futhi, kuyaqabukela, ukukhubazeka komzimba.
Imiyalo ekhethekile
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Umuthi ubambeke ngokuqinile ku-trimesters yesibili neyesithathu yokukhulelwa. Ngalesi sikhathi, amathuba amahle kakhulu wemiphumela yokudakwa ku-umbungu. Ngenxa yethonya lezithako ezisebenzayo zomuthi, i-fetus kungenzeka:
- umsebenzi wezinso ongonakalisiwe;
- ukubuyiselwa emuva kokukhula;
- oligohydramnios;
- ukubambezeleka kwesikhathi
I-Hartil-D iphikiswe ngokuphelele ku-trimesters yesibili neyesithathu yokukhulelwa.
Esikhathini esizayo, ama-pathologies ezinsana ezisanda kuzalwa angakhula:
- umfutho wegazi ophansi;
- hyperkalemia
- thrombocytopenia.
Njengoba kunokukhishwa komuthi ngobisi lwebele, kuyadingeka ukuyeka ukuncelisa ibele.
Ukuqokwa kweHartil D ezinganeni
Ucwaningo lwethonya lomuthi ezinganeni alwenziwe, ngakho-ke, kuze kube iminyaka eyishumi nesishiyagalombili alunqunyelwe.
Sebenzisa ebudaleni
Nikeza ngokuqapha ngokweqile nangemithamo ephansi kakhulu.
Isicelo sokusebenza kokulimala kwezinso
Ukwehluleka kwezinso, umthamo nenkambo yokwelashwa kufanele kushintshwe.
Umthamo omkhulu wansuku zonke akufanele udlule ku-5 mg.
Ngokuhluleka kwezinso, umthamo we-Hartila-D nenkambo yokwelashwa kufanele ulungiswe.
Sebenzisa umsebenzi wesibindi okhubazekile
Umthamo omkhulu wansuku zonke uma kwenzeka umsebenzi wesibindi ongasebenzi kahle kufanele ungabi ngaphezu kuka-2,5 mg, futhi ukwelashwa, ngenxa yokusabela okunganele komuthi, kwenziwa kuphela ngaphansi kokuqashwa kodokotela okuqinile.
Ukweqisa kwe-Hartil D
Kuvela:
- iminyakazo
- ukwehla okukhulu komfutho wegazi;
- ukugcinwa komchamo;
- ukuvinjwa kwamathumbu;
- ukuphazamiseka kwesigqi senhliziyo, njll.
Isinyathelo esibaluleke kakhulu sokusebenzisa ukusetshenziswa kwekhabhoni futhi sodium sulfate.
Ukwelashwa okwengeziwe kuya ngezimpawu, kanye nesikhathi somuthi nomthamo.
Ukuxhumana nezinye izidakamizwa
Ingasetshenziswa kanye ne-thrombolytics, i-beta-blockers, i-acetylsalicylic acid.
Ukunakwa okubalulekile kuyadingeka ezimweni zokulawulwa okuhlanganyelwe kwomuthi ochaziwe nge:
- okokugcobisa;
- ama-anesthetics;
- ama-anticepressants ama-tricyclic;
- i-organic nitrate;
- ama-vasodilators;
- izidakamizwa ze-antipsychotic.
Mhlawumbe ukusetshenziswa kweHartila-D nge-acetylsalicylic acid.
Ngakho-ke, ukuphathwa kanyekanye nge-diuretics kubangela ukwehla ngokweqile komfutho wegazi.
Lapho isetshenziswa nge-thiazide diuretics, ukwanda kwamazinga e-calcium kungenzeka.
Amanye ama-anesthetics, i-organic nitrate (imvamisa kakhulu nitroglycerin), izidakamizwa ze-antipsychotic, nama-antidepressants ama-tricyclic anikeza umphumela ofanayo.
Izidakamizwa ezikhulisa izinga le-potassium egazini (ngokwesibonelo, i-potureum-sparing diuretics efana neSpironolactone, Triamteren, Renial, njll.), Ama-cyclosporins anganikeza umphumela we-hyperkalemia.
Usawoti weLithium uba yingozi uma uthathwa ngama-inhibitors e-ACE, ngakho-ke, ungahlanganisi kumthamo owodwa.
I-Hypokalemia ingakhula uma ithathwe ngama-glycosides enhliziyo nezidakamizwa ezithile ze-antipsychotic.
Umphumela we-antihypertensive wenza buthaka ukuhlanganiswa ne-sympathomimetics nokusetshenziswa kwesikhathi eside ngezidakamizwa ezingezona ezokuhlasela okwenziwa yi-non-steroidal
Ukuhambisana notshwala
Kungenzeka ukwandisa imiphumela yotshwala, ngakho-ke ukungena okuhlanganisiwe akunconyiwe.
Ama-Analog
Kukhona ukuqondana kwezinto ezifanayo ezisebenzayo kumthamo ofanayo:
- I-Amprilan nl (iSlovenia) - amaphilisi angama-30;
- URamazid n (Malta noma i-Iceland) - izingcezu eziyi-10, 14, 28, 30 nezikhulu.
Izidakamizwa zesenzo esifanayo ziyatholakala, kepha ngezinye izinto ezisebenzayo noma imithamo:
- I-Tritace plus;
- I-Enalapril;
- Vumela i-R;
- Prestarium nabanye
Imibandela yekhefu lekhemisi
Ikhishwa ngemithi kadokotela.
Ngingakwazi ukuthenga ngaphandle kadokotela
Akukho okubhalwe phansi akusatshalwanga.
Intengo yeHartil D
Intengo yamaphilisi okupakisha enanini lezingcezu ezingama-28 yile:
- kusuka kuma-ruble angama-455 - 2,5 mg / 12,5 mg;
- kusuka kuma-ruble angama-590 - 5 mg / 25 mg.
Izimo zokugcina zomuthi
Kunconywa ukugcina umuthi endaweni yokushisa engeqi + 25º C endaweni engatholakali ezinganeni nasezilwaneni.
Kunconywa ukugcina iHartil-D kumazinga okushisa angeqi ku-25º C.
Isikhathi sokuphelelwa yisikhathi
Usuku lokuphela kwesikhathi kumakwe kwiphakeji. Ungasebenzisi ngemuva kweminyaka emi-3 kusuka ngosuku lokukhiqizwa.
Umkhiqizi
Ukukhiqiza okwenziwa yinkampani yaseJalimane "u-Alfamed Farbil Artsnaymittel GmbH" edolobheni laseGottingen.
Ikhiqizwa efektri yePalmaceutical Plant EGIS CJSC eHungary.
Ukubuyekezwa kweHartil D
Izazi zezenhliziyo
U-Anton P., udokotela wezifo zenhliziyo, uTver
Ukuzijwayeza kukhombise ukusebenza kahle kwezidakamizwa ekwelapheni umfutho wegazi ophakeme. Kulula ukuyisebenzisa lapho kuboniswa ngokubambisana kwe-ACE inhibitors kanye ne-diuretics.
Elena A., udokotela wenhliziyo, uMurmansk
Umuthi ophumelelayo we-antihypertensive, ongasetshenziswa futhi ukuvikela ukushaya kwenhliziyo. Okubi kuphela yimiphumela emibi eminingana, kwesinye isikhathi ebi kakhulu.
Iziguli
UVasily, oneminyaka engama-56, uVologda
Sengineminyaka eminingi ngihlushwa umfutho wegazi ophakeme. Cishe ezinyangeni ezi-2 ezedlule ngithole incwadi kadokotela ngalo muthi kudokotela. Ezinsukwini zokuqala, isiyezi sihlukunyezwa kanye nokuhlaselwa okuncane. Utshele udokotela futhi ngemuva kokuthi umthamo ushintshe kancane, konke kwangena endaweni, manje impilo yami sejwayelekile.
I-Ekaterina, eneminyaka engama-45 ubudala, idolobha laseKostroma
Lapho udokotela ebeka la maphilisi, wachaza ukuthi njengoba umuthi wokuhlanganisa uyadingeka ekwelashweni, lona ubukeka ufaneleke kakhulu kuleli cala. Bekulula ukuyithatha kanye ngosuku, futhi asikho isidingo sokukhumbula ukuthi uzithathe ngaphambi kokudla, phakathi noma ngemuva. Uma ukhohliwe ngaphambi kokudla kwasekuseni, ungaphuza kamuva. Ukuphela kokuphazamiseka - ezinsukwini ezimbalwa zokuqala kwadingeka ngiyeke ukushayela, njengoba ikhanda lami lalinesiyezi. Kepha-ke konke kwahamba, manje ngiphuza lo muthi nsuku zonke.
