I-Captopril 25 iyi-ACE inhibitor esetshenziselwa ukwelashwa okuyinkimbinkimbi komfutho wegazi ophezulu. Umuthi unesenzo esifushane futhi awusetshenziselwa ukwelashwa okuhlala njalo komfutho wegazi ophakeme.
Igama Lezwe elingafanele
I-Captopril (Kaptopril).
I-Captopril 25 iyi-ACE inhibitor esetshenziselwa ukwelashwa okuyinkimbinkimbi komfutho wegazi ophezulu.
Ath
I-Co 9AA01 Captopril.
Khipha amafomu nokwakheka
Amathebulethi anombala omhlophe, iphunga elikhethekile, ukwakheka okuyisicaba. Phakathi kwama-blocker, lesi sidakamizwa sivelele amandla aso okunciphisa ukumelana kwemithambo futhi sibe nomphumela odongeni ezindongeni zemithambo yegazi.
Into esebenzayo iqukethwe ngesilinganiso sama-25 mg.
Ukukhishwa ifomu - amaphilisi, 25 mg, 10 ama-pcs. Ukupakisha i-contour, iseli, kufakwe imiyalo yokusebenzisa. Ama-20 ama-PC. amaphilisi afakwe embizeni ebekwe ebhokisini lekhadibhodi.
Umuthi ukhiqizwa ngomthamo we-12.5 mg no-50 mg. Umuthi uqukethe iqembu le-sulfhydryl elivimbela ukulimala kwe-myocardium.
Umuthi uqukethe iqembu le-sulfhydryl elivimbela ukulimala kwe-myocardium.
Isenzo se-Pharmacological
Umuthi uqeda umsebenzi we-ACE, ngenxa yalokho, izinga lokuguqulwa kwe-enzyme I ukuya ku-angiotensin II, enomphumela we-vasoconstrictor effect, lehla.
Ku-adrenal cortex, ukukhiqizwa kwe-aldosterone kuyanda. Umuthi uthinta uhlelo lwe-kinin-kallikrein, ulondoloze i-bradykinin.
I-Pharmacokinetics
Ngemuva kokusebenzisa umthamo owodwa womenzeli wamakhemikhali, izidakamizwa ezingama-75% zisuswa emgodini wokugaya ukudla. Ukudla kuthinta ukufakwa kwesidakamizwa, kunciphisa ukusebenza kwawo ngo-40%.
Ku-plasma yegazi, umuthi ubopha amaprotheni (i-albhamuin) futhi udlulwa ubisi lwebele.
Umuthi uqubuka kumaseli wesibindi, enza izinhlanganisela ezilandelayo:
- ukungahambi kahle kufiphele kwento esebenzayo;
- cysteine disulfide.
Imikhiqizo yokubola ayisebenzi. I-Half-life yesidakamizwa ayidluli amahora ama-3. Ngokuhluleka kwe-renal, umuthi unqwabelana emzimbeni, ngenxa yalokho, ukuqoqwa kwe-urea ne-creatinine ku-serum yegazi kuyanda.
Yini i-Captopril esiza 25
Umenzeli wamakhemikhali uboniswa ngezifo ezifana:
- i-arterial hypertension (njengengxenye yokwelashwa okuhlanganisayo);
- ushintsho ekusebenzeni kwe-ventricular yesobunxele ngenxa yokufakelwa kwe-myocardial;
- isifo sikashukela se-nephropathy;
- ukuhluleka kwenhliziyo.
Imiyalo yokusetshenziswa kwe-ejenti yokwelapha ikhombisa i-anti-ischemic, umphumela wamathambo we-blocker. Umuthi usetshenziselwa ukunikeza ukunakekelwa okuphuthumayo okwandisa umfutho wegazi esiteji se-prehospital.
Umuthi usetshenziselwa ukunikeza ukunakekelwa okuphuthumayo okwandisa umfutho wegazi esiteji se-prehospital.
Ingcindezi yehla kangakanani
Ama-inhibitors e-ACE afinyelela ku-150 mg ngosuku, asetshenziswa ekwelapheni kwendabuko kanye nama-glycosides e-cardiac kanye ne-diuretic, anciphisa ingozi yokufa ngama-40%.
Umthamo wokuqala we-6.25 mg kancane ukhuphuka ufike kuma-25 mg izikhathi ezi-2 ngosuku. Ukuvimbela ukwehla kwengcindezi yegazi, ukukhuphuka kwenani lomuthi othathwe kwenziwa izinsuku eziningana (umthamo ophindwe kabili uvunyelwe ngegazi le-systolic ngenhla kuka-90 mm Hg hhayi ngaphezulu kwesikhathi esingu-1 ngeviki).
Izingxenye eziphakeme zomuthi zisheshe zinciphise umfutho wegazi, kepha ziholele ekwakhiweni kwemiphumela emibi, kuze kufike ekuqhekekeni kwe-myocardial noma stroke.
Contraindication
Umuthi awubekiwe uma imininingwane ngezifo ezinjengokuthi:
- ukwethuka kwe-anaphylactic (umlando);
- umsebenzi wezinso ongonakalisiwe;
- i-nitrogen ephezulu yegazi;
- ukuhlinzwa kokufakwa kwezinso;
- ukuncipha komlomo we-aorta;
- i-mitral valve stenosis;
- i-hepatitis;
- ukuqina kwesibindi;
- i-hypertension ye-arterial;
- ukwethuka kwe-cardiogenic nge-infyoction ye-myocardial.
Umuthi awunqunyelwe uma imininingwane ekhombisa ukusebenza kwe-renal engasebenzi kahle ikhonjisiwe emlandweni wezokwelapha.
I-Hypotension kanye nokubonakaliswa kokuqala kokungasebenzi kwezinso akuyona ukungqubuzana okuphelele kokuqokwa komuthi.
Umthamo we-Captopril 25
Umuthi wamakhemikhali uthathwa ngomlomo ngo-6.25-12.5 mg izikhathi ezingama-2-3 ngosuku. Uma bekungenzeki ukufeza umphumela obonakalayo, inani lemithi lenyuswa laya ku-25-30 mg futhi liphuzwe izikhathi ezi-3 ngosuku. Umthamo omkhulu wansuku zonke yi-150 mg.
Nge-infyoction ye-myocardial
Umuthi unqunywe ezigabeni zokuqala, unomphumela olandelayo:
- kwehlisa umthwalo enhliziyweni;
- kunciphisa ingozi ye-fibrosis;
- Kujwayelekile umsebenzi we-endothelial;
- isebenze ama-receptors e-peptide afaka imithambo yegazi.
Umuthi udakiwe ngaphansi kokulawulwa kwengcindezi yegazi amasonto ama-5. Ngemuva kokuthatha umuthi, inani eliphakeme lomphumela we-hypotensive libonakala ngemuva kwamahora ama-3-5.
Umthamo wokuqala wesidakamizwa ngu-6.25 mg.
Umuthi unqunyelwe izinsuku ezingama-3-16 emva kokuqothuka kwe-myocardial. Ngemuva kwamahora ama-2, umthamo we-ACE inhibitors uyanda ube ngu-12,5 mg futhi uthathwe kathathu ngosuku.
Ukwelashwa isikhathi eside, kwenziwa ngaphansi kokulawulwa kwengcindezi yegazi (ingcindezi ye-systolic yesiguli akufanele iwele ngaphansi kuka-100 mm Hg. Art.).
I-Captopril, enikezwe kusenesikhathi, isiza ukunciphisa ukucindezeleka kwenhliziyo.
Ngaphansi kwengcindezi
Umthamo wokuqala womuthi ungama-25 mg izikhathi ezi-2 ngosuku. Uma kuphakama isidingo, inani lomuthi landa ngezinsuku eziyi-14- 28 kuze kube yilapho umphumela womtholampilo utholwa.
Ngomfutho wegazi we-I-II degree, ukwelashwa kwenziwa kusetshenziswa ama-inhibitors e-ACE ngethamo lama-25 mg izikhathi ezi-2 ngosuku. Inani eliphezulu lomuthi nsuku zonke liyi-100 mg.
E-hypertension enkulu, umuthi wama-30 mg izikhathi ezi-3 ngosuku uvunyelwe. Lapho unquma umuthi, ingozi yokuncipha kwengcindezi yegazi iyanda uma isiguli sinezinkinga ezinzima zenhliziyo, sinomfutho wegazi ophansi.
Ekuhlulekeni kwenhliziyo okungapheli
Ekwelapheni ukwehluleka kwenhliziyo, umuthi uyanconywa uma ukwelashwa nge-diuretics kungabi nomthelela emtholampilo. Umthamo wokuqala ngu-6.25 mg izikhathi ezi-3 ngosuku.
Inani lokugcina lomuthi alidluli izikhathi ezingama-25 mg kathathu ngosuku.
Umthamo omkhulu we-blocker ungu-150 mg ngosuku.
Nge-diphicathy yesifo sikashukela
Uma kwenzeka ukungasebenzi kahle kwe-renal, okwakhula esigulini esinesifo sikashukela i-mellitus, ngokucaciswa kwe-creatinine ka-30 ml / min, umuthi unqunywe ku-umthamo we-75-100 mg / ngosuku.
Umuthi udakwe ingcindezi ephezulu 1 ihora ngaphambi kokudla.
Ungayithatha kanjani incwadi-25
Umuthi udakwe ingcindezi ephezulu 1 ihora ngaphambi kokudla. Indlela yokusebenzisa yomenzeli wezokwelapha incike esimweni sesiguli.
Ithebhulethi ayinconywa ukugaya noma ukuluma.
Umuthi ugezwa phansi nge-125 ml wamanzi abilisiwe.
Ngaphansi kolimi noma isiphuzo
Ngenhlupho ye-hypertensive, ungabeka lethebhulethi ngaphansi kolimi. Ngemuva kokuthatha i-6.25 mg noma i-12.5 mg yesidakamizwa, umfutho wegazi ulinganiswa ngemuva kwemizuzu engama-30 amahora ama-3. Ngokukhula komthamo, kunconywa ukulawula ingcindezi ihora eli-1 ngemuva kokuphatha.
Ngingaphuza kangaki
Uhlobo lomthamo lubekwa ngudokotela. Inani eliphezulu lomuthi alidluli kuma-300 mg ngosuku. Ukungezelela umthamo kuholela ekuwohlokeni enhlalakahleni yesiguli nasekuthuthukiseni imiphumela emibi.
Kuthatha isikhathi esingakanani
Ingcindezi yehla amahora angama-1-1,5 ngemuva kokusebenzisa umthamo owodwa womuthi. Umphumela ophikelelayo womtholampilo wenzeka emavikini angama-8 ngemuva kokusetshenziswa njalo kwezidakamizwa ze-antihypertensive.
Uhlobo lomthamo we-Captopril 25 lunqunywa ngudokotela.
Imiphumela emibi
Imiphumela evelayo yamathebulethi ayithinti ukufakwa kwayo ohlwini lwezidakamizwa ezibalulekile, ngoba umuthi kukhulunywa ngawo ku-database ye-Pubucol izikhathi eziyi-12 500.
Amapheshana wesisu
Lapho usebenzisa umuthi, ungahlangabezana nokubonakaliswa okungekuhle njengoku:
- isicanucanu
- ukuntuleka kokudla;
- ushintsho lokunambitha;
- Ubuhlungu be-epigastric;
- ukuqunjelwa
- i-hepatitis;
- ukuvuvukala kwamanyikwe;
- ukwephulwa kokukhiqizwa kwe-bile;
- isikhumba esikhanyayo;
- usizi ku-hypochondrium efanele.
Izitho zeHematopoietic
Izimo ezijwayelekile ngemuva kokusebenzisa umuthi zithathwa njengezi:
- i-anemia;
- ukwehla kwesibalo seplatlem;
- amazinga aphansi we-neutrophils egazini.
Umthamo omkhulu wesidakamizwa kubantu abangaphezu kweminyaka engama-65 uholela ekwehlekeni kokubalwa kwamaseli amhlophe egazi, ukwanda kokutholwa kwezifo zokukhunta, okuyingozi kakhulu ezigulini ezinezifo ze-autoimmune.
Isistimu yezinzwa ephakathi
Ngesikhathi sokwelashwa, ukubonakala kokungaphenduki okungalungile njengokuthi:
- Isiyezi
- ukukhathala
- ukuntuleka kokuxhumana;
- ushintsho ekuzwelweni kwesikhumba.
Ezigulini esezikhulile, ukonakala okubonakalayo, ukozela, ikhanda, ukuwohloka kwengqondo, ukuwa kwe-orthostatic kungenzeka.
Ngesikhathi sokulashwa, isiyezi kuyaphawulwa.
Kusuka ohlelweni lomchamo
Ukungaphenduki kahle komzimba kubonakaliswa njenge:
- umsebenzi wezinso ongonakalisiwe;
- i-polyuria;
- ukukhuphuka kwenani lamaprotheni kumchamo;
- izinqubo ezikhulayo ze-sclerotic ezicutshini zesitho somchamo.
Ezigulini ezinokwehluleka kokuqina kwezinso, ubungozi bokukhula kwe-microalbuminuria luyanda, inani le-creatinine lenyuka ngamaphesenti angaphezu kwama-30 ukusuka kwinqanaba lokuqala. Kwezinye iziguli, ukusebenza kwe-renal artery worsens, bese kuba ne-ischemic nephropathy.
Kusuka ohlelweni lokuphefumula
Ngesikhathi sokwelashwa, ukubonakala kokungaphenduki okungalungile njengokuthi:
- i-bronchospasm;
- ukukhwehlela kobuhlungu obomile;
- ukuqina nokuzwakala kwezwi;
- ukungaphatheki kahle umphimbo;
- ukushesha komoya lapho ulele phansi.
- i-laryngeal stenosis;
- i-pulmonary edema.
Izingane ezisanda kuzalwa zithuthukisa i-oliguria nokuphazamiseka kwemizwa.
I-Captopril ingadala ukukhwehlela okuomile, okuhlungu.
Engxenyeni yesikhumba
Lapho usebenzisa i-ACE inhibitor, isiguli singathola ukuvela okubi njengoku:
- ukungena kwamaphasethi aminyene;
- ukulunywa kabuhlungu;
- amabhulukwe apinki aphuzi.
Ukubonakaliswa kwesikhumba kwenzeka imizuzu embalwa ngemuva kokuphuza umuthi, izimpawu ziqala emuva kokuthatha umuthi olandelayo womuthi.
Ukuqhuma kwenzeka ngemuva kwesizinda se-edema esibuhlungu somlenze, kuqhamuke umkhuhlane, isikhumba siqine, esisuka kabi, i-fossa ayiqondile isikhathi eside ngokucindezela ngomunwe.
Kusuka ohlelweni lwezitho zofuzo
Umuthi ngemuva kokusetshenziswa isikhathi eside ungadala ukungasebenzi kahle, ukungasebenzi kahle kwezinso.
Allergies
Ukubonakaliswa komuntu ngamunye ngemuva kokuthatha umuthi kubonakaliswa i-vasema edema ne-urticaria. Ukuthuthukiswa kokuphendula kwe-anaphylactoid kuhambisana nokuvela kokuklanywa okuyi-itchy emaphethelweni aphezulu nangaphansi, ubuso, umthambo womlomo, ungqimba lwepheshana lokuphefumula eliphezulu nepheshana lesisu.
Ukubonakaliswa komuntu ngamunye ngemuva kokuthatha umuthi kubonakaliswa ukubonakala kokuqina.
Isiguli sinezimpawu ezilandelayo:
- i-aphonia;
- umoya we-stridor;
- ukujaha;
- umphumela obulalayo.
Umthelela ekhonweni lokulawula izindlela
Ngesikhathi ukwelashwa nge-ejenti antihypertensive, kuyadingeka ukwenqaba ukushayela nezinye izindlela ezidinga ukunakwa okwengeziwe.
Imiyalo ekhethekile
Ngesikhathi sokwelashwa, ukuqapha kuyadingeka ezigulini ezinesifo sezinso. Abantu abanenkinga yokuhluleka kwenhliziyo ngesikhathi sokwelashwa bangaphansi kokuqondisa udokotela. Ukuqapha okukhethekile kusebenza ezigulini ezinezifo ezithinta izicubu uma zithatha i-Allopurinol noma i-Cyclophosphamide.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Kumama wesikhathi esizayo, ukwelashwa kwe-hypertension ye-arterial kwenziwa ngokusebenzisa isidakamizwa iMethyldopa.
I-blocker ayinqunyelwe, ngoba ubiza:
- ukwehluleka kwezinso kusanda kuzalwa;
- ukuwohloka kwamalunga nemilenze nobuso besigebhezi;
- ukuthuthukiswa okungaphansi kwezicubu zamaphaphu;
- ukufa kwengane.
Umuthi obisini lobisi unethonya elibi empilweni yengane.
Ukuhambisana notshwala
Umuthi awukwazi ukuthathwa kanyekanye neziphuzo eziqukethe i-ethyl alcohol, ukugwema ukuthuthukiswa kwemiphumela emibi.
Uma kwenzeka ubuthi be-Captopril bufika, isiguli sihlakulela ukungaboni kahle.
Ukweqisa
Uma kwenzeka ubuthi bufakwa yi-ACE inhibitor, isiguli siyakhula:
- hypotension;
- infarction myocardial;
- isifo sohlangothi;
- i-thromboembolism;
- ukwehluleka kwezinso;
- ukungaboni kahle
Ukuze uthole ukwelashwa, kunconyelwa ukuhlanza amathumbu, kunqume imijovo ye-intravenous yezidakamizwa ze-vasoconstrictor. Kwezokwelapha, izixazululo ze-colloidal, izidakamizwa i-Dopamine ne-Norepinephril ziyasetshenziswa.
Ukuxhumana nezinye izidakamizwa
Ukusetshenziswa okuhlangene kwesidakamizwa nge-vasodilator kubangela ukwanda komphumela we-hypotensive.
Ukusetshenziswa kwe-inhibitor ye-ACE ngezidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala noma i-clonidine kuholela ekwehleni kokusebenza kwomuthi.
Ukusebenzisa umuthi nge-diuretic kubangela ukweqisa kwama-ion we-potassium.
Ukuqapha kufanele kusetshenziswe ngokusetshenziswa kanyekanye kosawoti we-lithium kanye nomenzeli we-hypotensive, ngoba ukugcwala kwenhlanganisela ye-inorganic kwisethi yegazi kukhuphuka.
Ukusetshenziswa kwe-Captopril ngezidakamizwa ezingezona ezika-antiidal eziholela ekunciphiseni ukusebenza komuthi.
Iziguli ezithatha i-Allopurinol ne-ACE inhibitor zisengozini yokuthola uphawu lukaSteven-Johnson.
Ama-Analog
Njengokuthi ungene esikhundleni se-ejenti yamakhemikhali, sebenzisa:
- I-Angiopril;
- I-blockordil;
- I-Normopress;
- UCapril;
- Kapoten;
- Burlipril;
- I-Enap;
- I-Renetek.
I-inhibitor yenkampani iSandoz (Germany) iqukethe u-6.25 mg wesithako esisebenzayo kuthebhulethi engu-1. Umuthi usetshenziselwa ukwelashwa kwe-renovascular hypertension, ukuhluleka kwenhliziyo, i-nephropathy yesifo sikashukela ngohlobo 1 sikashukela.
I-Alkadil ingasebenza njengento ebambela lesi sidakamizwa futhi isidakamizwa esisebenzayo. Umuthi ubekelwe ukwehluleka ukwelashwa okujwayelekile.
I-Angiopril inomphumela ofanayo ne-ACE inhibitor. Umuthi unqunyelwe umsebenzi we-LV ophazamisekile wenhliziyo, ngemuva kokufakelwa kwe-myocardial, nge-albhamuinuria engadluli kuma-30 mg / ngosuku.
Ungabuyisela umuthi onomuthi onjengeKapoten. Umuthi uthathwa njengokuyalelwa udokotela ihora eli-1 ngaphambi kokudla.
Imibandela yekhefu lekhemisi
Umuthi uhanjiswa ngencwadi kadokotela.
Ngingakwazi ukuthenga ngaphandle kadokotela
Umuthi awunakuthengwa ngaphandle kwemvume ebhaliwe kadokotela.
Intengo ye-Captopril 25
Ithebhulethi 25 mg, ama-40 ama-PC. thengisa ngentengo yama-ruble ayi-12. (ukukhiqiza i-OZON OO, Russia). I-ACE inhibitor, amaphilisi angu-25 mg, ama-20 ama-pcs. kubiza ama-ruble ayi-8. (ukukhiqiza i-OZON OO, Russia).
Izimo zokugcina zomuthi
Umuthi ugcinwa endaweni eyomile, enomoya omuhle, emazingeni okushisa angaphansi kwama-30 ° C.
Isikhathi sokuphelelwa yisikhathi
Umuthi ufanele ukusetshenziswa iminyaka emi-3.
Umuthi ufanele ukusetshenziswa iminyaka emi-3.
Umkhiqizi
Umuthi uyakhiqizwa:
- I-Ozone OO, (Russia);
- I-Borisov isitshalo semithi (JSC "BZMP"), Belarus.
Ukubuyekezwa kwe-Captopril 25
UVasily, oneminyaka engama-67, uVoronezh
Ngihlaselwa umfutho wegazi ophakeme. Ngonyaka owedlule, kube nenkinga enkulu kakhulu yegazi ngokweqile. Ingcindezi ayilahlekanga ngalutho, ngisho nangemva kokuba umjovo esibhedlela awuzange ube lula. Ngakhumbula umuthi, ngafaka i-25 mg tablet ngaphansi kolimi lwami, kwathi ngemuva kwemizuzu engama-30 ingcindezi yancipha. Ngihlala ngigcina umuthi ekhabetheni lomuthi.
UMargarita, oneminyaka engama-55, uCheboksary
Ebusuku, ingcindezi yayingu-230 kuye ku-115. Ngafaka izibhebhe ezimbili zesidakamizwa ngaphansi kolimi lwami, kwathi ebusuku enye enye 2. Ekuseni, ingcindezi yehla yaya ku-160 kwabangu-100. Udokotela wajova i-diuretic kwathi ingcindezi yabuya yaya ejwayelekile. Ngikholelwa ukuthi kungcono ukusebenzisa umuthi wokuqala we-Kapoten ukwelashwa.
UTamara, oneminyaka engama-57, uDerbent
Ngithatha i-inhibitor ye-ACE iminyaka engu-15, ithebhulethi eyi-0,25 mg kanye ngosuku. Indlela yansuku zonke isishintshile, ukusebenza kwezimoto kunciphile, ngakho-ke ngiphuza amaphilisi amabili womuthi ngosuku. Ayikho imiphumela emibi. Umuthi uyasebenza.
