I-Presartan isidakamizwa se-antihypertensive esuselwa esenzweni se-losartan. Into esebenzayo ayilona iqembu le-ACE inhibitors, ngokuba ngumphikisi wama-receptors angiotensitive. Umuthi lo ungasetjenziselwa i-mellitus yesifo sikashukela kanye nokuphathwa okufanayo kwezinye izidakamizwa ezinomphumela we-hypotensive. Umuthi usiza ukuqeda umfutho wegazi ophezulu nge-hypertension ye-arterial kanye ne-hypertrophy yesokunxele.
Igama Lezwe elingafanele
Losartan.
I-Presartan yezidakamizwa ingasetshenziselwa isifo sikashukela.
I-ATX
C09CA01.
Khipha amafomu nokwakheka
Umuthi utholakala ngefomu lethebhulethi, elenzelwe ifilimu. Ithebhulethi ngayinye iqukethe ama-25 noma ama-50 mg we-potassium e-losartan njengendawo esebenza kuyo. Abangenayo bafaka:
- isitashi esinamanzi;
- i-talc;
- i-microcrystalline cellulose;
- i-colloidal silicon dioxide;
- i-methylene chloride;
- sodium isitashi glycolate.
Ithebhulethi ngayinye ye-Presartan iqukethe ama-25 noma ama-50 mg we-potasium e-losartan njengendawo esebenzayo.
Amacwecwe anombala opinki ngenxa yokuqukethwe kudayi obomvu, abe nesiyingi se-biconvex. Umehluko phakathi kwamathebulethi ngomthamo we-50 mg kusuka kumuthi 25 mg ukungabikho kokuhlukanisa izingozi ohlangothini olungaphambili.
Isixha sekhadibhodi siqukethe 1, 2 noma ama-3 blits.
Amacwecwe ayi-10 noma ayi-14 abekwa emaphaketheni e-aluminium blister.
Isenzo se-Pharmacological
Umuthi ungoweqembu labaphikisi be-AT-1 (ama-angiotensin receptors). Umuthi unomphumela we-antihypertensive. Into esebenzayo ye-losartan ingumqondo ophikisayo we-angiotensin II enzyme receptors. Inhlanganisela yamakhemikhali, ngokungafani ne-ACE inhibitors (i-angiotensin eguqula i-enzyme), ayivimbi umsebenzi we-kinase II, odingekayo ekuqhekekeni kwe-vasodilator bradykinin.
Njengomphumela wokucindezelwa kwama-receptors e-AT-1, ukumelana okuphelele kwe-vascular kanye nomfutho wegazi wehla. Kunokwehla kokulayisha ngemuva enhliziyweni. Umuthi wehlisela umfutho wegazi ophakeme ngenxa yokwehla komfutho wegazi ekujikelezeni kwe-pulmonary.
I-Pharmacokinetics
Lapho kuthathwa ngomlomo, i-losartan ikhishwa kwithebhulethi ngenxa yesenzo sezibilini zamathumbu, ezephula ulwelwesi lwamafilimu, futhi zidonswe odongeni lwamathumbu ngenethiwekhi yemikhumbi egxishiwe. Kusuka odongeni lwamathumbu, into esebenzayo ingena ekuhambeni kwegazi, lapho ifinyelela khona amazinga aphezulu e-plasma ngehora. I-Bioavailability ngethamo elilodwa ifinyelela kuma-33%.
Umuthi uthola ukuguqulwa kokuqala lapho kudlula kumaseli wesibindi ngokwakhiwa kwama-metabolites asebenzayo.
Ngesikhathi sokuvivinywa kwemitholampilo, ukubalwa kwezidakamizwa kwezicubu akuzange kubhalwe phansi. Isigamu sempilo singamahora ama-2. Imikhiqizo ye-metabolic ye-losartan ne-compact esebenzayo ngokwayo ibopha i-albhamuin ngama-92-99% futhi, ngenxa yalokhu kuhlanganiswa, iqala ukusatshalaliswa emzimbeni. Umuthi ukhishwa ngohlelo lokuchama ngokuhlunga kwamakhaza futhi ngokwengxenye ishiya umzimba nge-bile.
Izinkomba zokusetshenziswa
Umuthi ubekelwe ukuqeda i-hypertension ye-arterial kanye nesifo senhliziyo (CHD), esibonakaliswa yizimpawu ezishiwoyo zokuhluleka kwenhliziyo.
I-Presartan iyingxenye yendlela yokwelashwa ehlanganiswe ne-diuretics ne-inhliziyo glycosides.
Endabeni yamuva, amaphilisi wePresartan ayingxenye yokwelashwa okuhlanganisiwe ngokuhambisana ne-diuretics ne-inhliziyo glycosides.
Contraindication
Umenzeli we-antihypertgency wenqatshelwe ngokuphelele ukuthatha ubukhona bokukhula okungatheni kwezitho nezicubu ezingxenyeni ezisebenzayo nezisizayo zomuthi. Umuthi awubekelwe abesifazane abakhulelwe nezingane baze baneminyaka eyi-18.
Ngokunakekela
Kunconywa ukuqaphela uma kwenzeka kuphazamiseka ukusebenza kwe-electrolyte metabolism ngenxa yokuntuleka kwe-magnesium, sodium, potionsum ions emzimbeni noma ngokumelene nesizinda sokuvela kwe-hypochloremic alkalosis. Kuyadingeka ukulawula isimo ngokuhlukumeza okulandelayo:
- i-bilatal stenosis yemithambo yezinso ezinso;
- isifo sikashukela mellitus;
- i-pathologies ye-inhliziyo;
- ukukhuphuka kokuhlushwa kwe-calcium;
- gout
- umthamo ophansi wegazi elijikelezayo, ocasulwa ukulahlekelwa uketshezi.
Akunconyelwe ukuthi i-glycosides yenhliziyo inqunywe ngasikhathi sinye lapho uthatha umuthi we-hypotensive.
Ungamthatha kanjani u-Presartan
Ukunciphisa umfutho wegazi ophakeme, umthamo wansuku zonke we-25 mg unqunyelwe esigabeni sokuqala sokwelashwa ngezidakamizwa. Ezinsukwini ezilandelayo zokwelapha, umthamo uphakama kancane kancane uye ku-50 mg futhi ngaphezulu. Umuthi usetshenziswa isikhathi esisodwa ngosuku.
Ngokuphikisana nesizinda sokwehluleka kwenhliziyo okungamahlalakhona, umthamo ojwayelekile wosuku lomuthi ngu-12,5 mg ngethamo elilodwa.
Umphumela omkhulu wokwelapha ubonwa emavikini angama-3-6 ngemuva kokuqala kokwelashwa kwezidakamizwa. Ngokuphendula okuphansi komzimba ngomuthi olwa ne-antihypertensive, umthamo uyandiswa ube ngu-100 mg ngokuvama kokuphathwa izikhathi 2 ngosuku.
Ngokuphikisana nesizinda sokwehluleka kwenhliziyo okuhlala isikhathi eside, umthamo ojwayelekile wosuku ngu-12,5 mg wethamo elilodwa. Umthamo ukhuphuka njalo ngeviki ngu-12,5 mg kusilinganiso esinconyiwe - 50 mg - ngomthamo owodwa.
Ngoshukela
Uma unesifo sikashukela esilawulwayo, kufanele kuqashelwe futhi igciwane le-plasma likashukela wegazi kufanele lihlolwe njalo. Uma kwenzeka unesifo sikashukela esibi, umuthi uyamiswa.
Imiphumela emibi Presartana
Ngokuyisisekelo, umuthi ubekezelelwa kahle, ngakho-ke, imiphumela emibi yenzeka kumaphesenti angama-85 wamacala ngenxa yomthamo ongafanele noma ukubekezelela okuphansi kumthamo ojwayelekile.
Mhlawumbe ukuthuthukiswa kokuvuvukala, ukukhuphuka kokuhlushwa kwe-potassium ku-plasma yegazi, ukuvela kobuhlungu bemisipha.
Imiphumela emibi yesikhashana ihamba yodwa lapho umuthi uqedwa noma umholo wansuku zonke uncishisiwe.
Ukusabela okungalungile ngemuva kokuthatha i-Presartan maqondana nokugaya okubonisa ukubonakala njengesitofu esixegayo (isifo sohudo).
Amapheshana wesisu
Ukusabela okungekuhle emgudwini wokugaya ukudla kuboniswa ngesimo sezitulo ezikhululekile (isifo sohudo) kanye ne-dyspepsia. Ezimweni ezingavamile, ukuthuthukiswa kwe-hyperbilirubinemia kanye nokwanda kwe-heinatic aminotransferase kungenzeka.
Isistimu yezinzwa ephakathi
Umuthi ungavusa ukuthuthukiswa kwesiyezi, ukudideka, ikhanda kanye nokuphazamiseka kokulala. Lezi zimpawu zibonakalisa ukuqwasha noma ukozela.
Kusuka ohlelweni lokuphefumula
Ezimweni ezingavamile, umuthi unobuthi ohlelweni lokuphefumula, yingakho isiguli sihlakulela ukukhwehlela okwomile nokuhluleka kokuphefumula.
Allergies
Ezigulini ezithambekele ekubonakalisweni kokuphendula kwe-anaphylactic, noma kubantu abane-hypersensitivity kuzakhi zesakhiwo, ukuvela kwe-angioedema, ukushaqeka kwe-anaphylactic, i-Quincke edema, i-urticaria kungenzeka.
Isiguli sithatha iPresartan kufanele siqaphele lapho sishayela imoto.
Umthelela ekhonweni lokulawula izindlela
Kunobungozi bemiphumela emibi ohlelweni lwezinzwa oluphakathi (ukozela, isiyezi), yingakho isiguli kufanele siqaphele lapho sishayela imoto, sisebenzisana namadivaysi ayinkimbinkimbi nalapho wenza eminye imisebenzi edinga ukunakwa okwengeziwe kanye nobunzima bokuphendula.
Imiyalo ekhethekile
Lapho kukhona ukomisa ngesikhathi sokulashwa isikhathi eside ngethamo eliphakeme lokugaya esigabeni sokuqala sokusetshenziswa kwe-Presartan, hypotension ye-orthostatic kungenzeka. Ukugwema ukwehla komfutho wegazi, kuyadingeka ukuqeda ukuntuleka kwamanzi emzimbeni ngaphambi kokuthatha umuthi we-antihypertensive noma ukuqala ukwelashwa ngezidakamizwa ngomthamo ophansi.
Iziguli ezinenkinga yesibindi ziyanconywa ukuqoka u-12.5-25 mg ngosuku.
Ikakhulu ngokuwohloka kwamafutha hepatocytes. I-Cirrhosis ivusa ukwanda kokuhlungwa kwe-plasma ye-losartan, okuqinisekiswa ngezifundo zaselebhu.
Ingozi yokuthuthukisa izinqubo ze-pathological lapho uthatha umuthi uyanda ngomsebenzi wokuphazamiseka wezinso.
Kwezinye izimo, lapho uthatha umuthi othinta uhlelo lwe-renin-angiotensin, kungenzeka ukwandisa i-serum creatinine kanye nenani le-urea egazini. Ingozi yokuthuthuka kwezinqubo ze-pathological inyuka ngokusebenza kokuphazamiseka kwezinso.
Sebenzisa ebudaleni
Abantu abangaphezu kweminyaka engama-65 abadingi ukulungiswa okungeziwe kohlobo lwemithamo.
Isabelo sezingane
Ngenxa yokuntuleka kwedatha emiphumeleni yamakhemikhali i-Presartan ekwakhiweni nasekukhuleni komzimba womuntu ebuntwaneni nasebusheni, umuthi uvunyelwe ukusetshenziswa kuze kube iminyaka eyi-18.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Umuthi akufanele unikezwe abesifazane abakhulelwe, ngoba kungenzeka ukuthi ukungena kwe-losartan ngokusebenzisa isithiyo seplacental ngegazi likamama. Izifundo ze-Pharmacological ezilwaneni azivezwanga imiphumela ye-losatoanic ye-losartan, kepha into esebenzayo ingaphazamisa ibhukumaka eliyinhloko le-bookmark. Ngakho-ke, umuthi usetshenziselwa ukunciphisa umfutho wegazi ophakeme kowesifazane okhulelwe kuphela esimweni esibucayi, lapho ubungozi empilweni kamama budlula amathuba okukhula kwengane embungwini.
Ngesikhathi sokulashwa ngomuthi we-antihypertensive, kunconywa ukulahla ukuncelisa ibele.
Ngesikhathi sokulashwa ngomuthi we-antihypertensive, kunconywa ukulahla ukuncelisa ibele.
Isicelo sokusebenza kokulimala kwezinso
Kunconywa ukuba uqaphele umsebenzi wezinso ongafanele futhi uqale ukwelashwa ngethamo eliphansi lomuthi.
Sebenzisa umsebenzi wesibindi okhubazekile
Umuthi uvinjelwe ukusebenza kwesibindi okungalimele kahle.
Ukweqisa kwePresartan
Ngomthamo owodwa womuthi omkhulu wesidakamizwa, i-arterial hypotension iyakhula, ukushaya kwenhliziyo kukhuphuka njengokuphendula komzimba okubuthakathaka. Umuntu ohlukunyezwa ngokweqile udinga usizo olufanele. Ngaphambi kokuthi kufike iqembu le-ambulensi, kuyadingeka ukuthi sidlulisele isiguli endaweni evundlile futhi siphakamise imilenze yaso ukuzama ukuqinisa ingcindezi. Ezimweni zokuma, isithombe somtholampilo se-overdose siyaqedwa. I-Hemodialysis ngenxa yezinga eliphakeme lokubopha i-losartan ku-albhamuin ayisebenzi.
I-Hemodialysis ngenxa yezinga eliphakeme lokubopha kukaPresartan ku-albhamuin ayisebenzi.
Ukuxhumana nezinye izidakamizwa
Ngokuphathwa kanyekanye kwePerzartan nge-diuretic enomphumela wokulondolozwa kwe-potassium, izidakamizwa eziqukethe i-potasium kanye nokufakwa esikhundleni sazo, i-hyperkalemia kungenzeka.
Ezinye izidakamizwa ze-antihypertgency zakha umphumela we-synergistic, lapho umphumela wezokwelapha wazo zombili lezi zidakamizwa uthuthuka khona. Umphumela oqinile we-hypotensive uyabonakala.
Izidakamizwa ezingezona ezokwehlisa ukuvuvukala kanye ne-Indomethacin, uma zinikezwa ngokubambisana ne-losartan, zingawenza buthaka umphumela wezokwelapha walaba bantu.
Lapho uthatha ama-diuretics ngesikhathi sokuvivinya komtholampilo, ukutholwa kwegazi kwatholakala.
Ngokuqokwa ngokufana kwePerzartan nge-diuretic enomphumela wokugcina we-potassium, i-hyperkalemia kungenzeka.
Ukuhambisana notshwala
Ngesikhathi sokulashwa kwezidakamizwa, kwenqatshelwe ukuphuza utshwala. I-Ethyl utshwala ivimbela umsebenzi wesistimu yezinzwa ephakathi futhi inyusa ubuthi kumaseli wesibindi. Ngaphansi kwezimo zokunyuswa komthwalo, ama-hepatocytes awakwazi ukususa ubuthi ku-cytoplasm ngendlela yesikhathi esifanele, yingakho efa en masse. Izindawo ze-Necrotic zithathelwa indawo izicubu ezithintekayo. Ukuwohloka kwomphumela we-antihypertensive wesidakamizwa kuyabonakala.
Ama-Analog
Ukufana kwezakhiwo zesidakamizwa esinezakhiwo ezifanayo zekhemisi kufaka phakathi:
- ULorista
- Cozaar;
- I-Losartan teva;
- Ama-Vasotens;
- I-Lozap.
I-Substartan iyathathelwa indawo lapho kuvela ukusabela okungekuhle, lapho ukuncipha komthamo kungasebenzi, noma kungabikho mphumela wokwelapha. I-analogue ikhethwa ngudokotela oya kuye ngokuya ngezimpawu zomuntu ngamunye zesiguli.
Imibandela yekhefu lekhemisi
Umuthi awuthengiswa ngaphandle kwezinkomba eziqondile zokwelashwa.
Ngingakwazi ukuthenga ngaphandle kadokotela
Ukuthengiswa kwamahhala kukhawulelwe ngenxa yengozi engaba khona yokuthuthukisa i-overdose uma i-Presartan ihlukunyezwa noma ibangela i-hypotension enkulu.
Intengo yePresartan
Izindleko ezijwayelekile zamathebulethi zifinyelela kuma-ruble angama-200.
Izimo zokugcina zomuthi
Kunconywe ukugcina amaphilisi wePresartan emazingeni okushisa angama- + 15 ... + 25 ° C endaweni evikelwe ukukhanya kwelanga, okuhambisana nomthamo oncishisiwe womswakama.
Isikhathi sokuphelelwa yisikhathi
Iminyaka emithathu
I-analogue yePresartan - umuthi weLorista kufanele ugcinwe ekushiseni kwe + 15 ... + 25 ° C.
Umkhiqizi
Ipka Laboratories Limited, India.
Ukubuyekezwa kodokotela mayelana nePresartan
U-Ivan Korenko, udokotela wezokwelapha, uLipetsk
Ikhambi elisebenzayo elinomphumela omnene we-hypotensive. Ifomu lomthamo olula. Ekuzilolongeni kwemitholampilo, imiphumela emibi yabonwa ngesimo se-arrhythmia emnene. Kubalulekile ukunamathela kumthamo wethamo ngokulandela imiyalo. Ngokwesimo esehlukile, umphumela wezokwelapha kunzima ukufeza kanti nezigameko zemiphumela emibi zingandiswa. Umuthi uyikhambi elihle lezinkinga zezinso kanye nokwehluleka kwenhliziyo okungamahlalakhona. Nginikeza iziguli ezinesifo sikashukela sohlobo 2 ukunciphisa umthwalo ezinso.
UVasily Izyumenko, udokotela wezifo zenhliziyo, uTomsk
Ezigulini ezinesifo sikashukela esingeyona i-insulin, isidakamizwa sinciphisa ubungozi be-proteinuria. Ngabona ukusebenza kahle kwabadala - i-tachycardia nengcindezi yehla kancane kancane. Umphumela wokwelapha ubonakala njengoba i-losartan iqoqana emzimbeni, ngakho-ke kungakapheli amasonto angama-3-6 kuyadingeka ukunquma ukutholwa okufanayo komunye umuthi we-antihypertensive wokumboza. Umuthi udambisa ukuvuvukala, ukhulisa ukumelana kwe-myocardium nokuzivocavoca ngokomzimba. Ngomthamo ofanele, kubekezelelwa kahle isiguli.
I-analogue yesidakamizwa okukhulunywa ngaso - Umuthi weCozaar awuthengiswa ngaphandle kwezinkomba eziqondile zezokwelapha.
Ukubuyekezwa kweziguli
UVeniamin Gerasimov, oneminyaka engama-54, eYekaterinburg
Nginezinkinga zomfutho wegazi ophakeme nesifo sikashukela, ngakho-ke akuyona yonke izidakamizwa ezifanele. Udokotela obekhona watusa amaphilisi wePresartan, angaqalanga ukwenza ngokushesha. Kungakapheli amasonto ama-2, ingcindezi yahlala ifana futhi ayizange inciphe. Umphumela uvele kumaviki ama-3 kuphela. Ngemuva kwezinyanga ezi-2, ingcindezi ibuyele kwesejwayelekile kanti futhi nesimo esejwayelekile sathuthuka. Lapho eyeka ukuphuza umuthi, ingcindezi yabuya ngamanani aphezulu. Umuthi awelaphi, kepha unciphisa izimpawu. Ngakho-ke, udinga ukuqaphela lapho uthatha.
U-Alexandra Vlasova, oneminyaka engama-60, e-Arkhangelsk
Ngemuva kokuhlinzwa inhliziyo, umyeni bekufanele njalo aqaphe ingcindezi futhi alinganise izinga lokushaya kwenhliziyo. Ngomfutho wegazi we-180/20, izinkomba ngenyanga zesehlile zaya ku-120/12, izinga lokushaya kwenhliziyo ukusuka ku-120 lehle laya ku-72 beats / min. Kwakungekho miphumela emibi noma ukusabela kwe-allergic, kepha kwakukhona i-hypotension ezinsukwini zokuqala zokuphatha. Umyeni ubesesibhedlela, udokotela wathi lokhu kube yimbangela yokuhlinzwa. Ingcindezi izinzile manje.
