I-Pyramil yezidakamizwa: imiyalelo yokusetshenziswa

Phakathi kwemithi yokwelapha umfutho wegazi ophakeme (BP), uPyramil uvelele. Umuthi uvimbela umsebenzi we-enzymatic ekuguqulweni kwe-angiotensin I. Imiphumela ye-Hypotensive kanye ne-cardioprotective iyabonakala. Ngenxa yesenzo esihlanganisiwe salezi zinhlanganisela zombili, kwenzeka ukuthi sinciphise ingozi yokuqalwa kwe-myocardial infarction, stroke kanye nokukhulisa izinga lokuvuselelwa kweziguli ezinezilonda zohlelo lwe-vascular system.

Igama Lezwe elingafanele

URamipril

Phakathi kwemithi yokwelapha umfutho wegazi ophakeme (BP), uPyramil uvelele.

I-ATX

C09AA05

Khipha amafomu nokwakheka

Umuthi uyatholakala ngesimo sethebulethi. Amacwecwe we-Oblong biconvex aqukethe ama-5 noma ama-10 mg we-into esebenzayo ye-ramipril. Njengoba kusetshenziswa izakhi ezisizayo ekukhiqizweni:

• i-colloidal silicon dioxide;
• glyceryl dibehenate;
• i-microcrystalline cellulose;
• i-glycine hydrochloride;
• isitashi pregelatinized.

Amathebulethi we-5 mg angama-pink okhanyayo ngenxa yokufakwa kudayi obomvu osuselwa kunsimbi. Ingozi itholakala ohlangothini olungaphambili kuphela.

I-Microcrystalline cellulose isetshenziswa njengezici ezisizayo ekwakhiweni kwePyramil.

Isenzo se-Pharmacological

Umuthi ungowe-ACE inhibitors (i-angiotensin-converting enzyme). Uma ingena esibindini, i-hydrolyzes esebenzayo yamakhemikhali yokwakha umkhiqizo osebenzayo - i-ramiprilat, eyenza buthaka umphumela we-ACE (angiotensin-oguqula i-enzyme isheshise ukuguqulwa kwe-angiotensin I ku-angiotensin II ekuphenduleni kwamakhemikhali).

URamipril uvimbela ukugcwala kwe-plasma kwe-angiotensin II, kunciphisa ukugcinwa kwe-aldosterone futhi ngasikhathi sinye kube nomphumela we-renin. Kulesi simo, i-kinase II blockade iyenzeka, ukukhiqizwa kwe-prostaglandin kuyenyuka futhi i-bradycardin ayiphukile. Njengomphumela wesenzo sento esebenzayo, inani le-peripheral vascular ukumelana (OPSS) liyancipha, ngenxa yokuthi linwebeka kanjani.

I-Pharmacokinetics

Lapho ihanjiswa ngomlomo, umuthi udonswa ngokushesha emathunjini amancane, kungakhathalekile ukuthi kudliwani. Ngaphansi kwethonya le-esterase, ama-hepatocytes enza ukuguqulwa kwe-ramipril kuya ku-ramiprilat. Umkhiqizo obolile uvimba i-angiotensin-converting enzyme amahlandla ayi-6 inamandla kune-ramipril. Umuthi ufinyelela ekugxambeni okukhulu kwe-plasma kungakapheli ihora ngemuva kokuphathwa, kuyilapho kutholakala inani eliphakeme kakhulu le-ramiprilat ngemuva kwamahora angama-2-4.

Uma ingena egazini, isakhi esisebenzayo sibopha amaprotheni e-plasma ngo-56-73% bese siqala ukusatshalaliswa kuwo wonke izicubu. Ukuphila kwesigamu umuthi nokusetshenziswa okukodwa kungamahora angama-13 kuya kwayi-17. URamipril kanye ne-metabolite esebenzayo ikhishwa ezinso ngama-40-60%.

URamipril kanye ne-metabolite esebenzayo ikhishwa ezinso ngama-40-60%.

Izinkomba zokusetshenziswa

Umuthi ubekelwe ukwelashwa kanye nokuvimbela lezi zifo ezilandelayo:

• i-nephropathy yohlobo lwesifo sikashukela nesingenaso isifo sikashukela esigabeni se-preclinical noma sesibhedlela, esihambisana nomfutho wegazi ophakeme, i-proteinuria kanye nokukhishwa kwe-albhamuin kumchamo;
• isifo sikashukela i-mellitus eyinkimbinkimbi yengezwe yizici zobungozi ezingeziwe ngendlela yomfutho wegazi ophezulu, ukwanda noma ukuncipha kwe-cholesterol kanye ne-lipoproteins ephansi kwabantu, imikhuba emibi;
• umfutho wegazi ophakeme emithanjeni eyinhloko;
• ukwehluleka kwenhliziyo okukhulu, okuqhamuke phakathi nezinsuku ezi-2-9 ngemuva kokuhlaselwa yisifo senhliziyo.

Umuthi usiza ukunciphisa ingozi yokuphinda ungene kubantu abebedlule ngokuxhunyelelwa kwemithambo ye-coronary or aorta, heart attack, angioplasty of the coronary artery, stroke. Umuthi uyingxenye yokwelashwa okuhlanganisa ukwehluleka kwenhliziyo okungapheli.

Contraindication

Kwezinye izimo, umuthi awunconywa noma awunqatshelwe ukuthi usetshenziswe:

• ukungasebenzi kahle kwe-renal noma hepatic;
• ukwethuka kwe-cardiogenic;
• umfutho wegazi ophansi uma ingcindezi ye-systolic ingaphansi kuka-90 mm Hg. st.;
• i-hyperaldosteronism;
• i-stenosis ye-mitral valve, i-aorta, imithambo yezinso;
• i-cardiomyopathy evimbayo;
• ukukhulelwa nokuqunjelwa;
• izingane ezingaphansi kweminyaka engu-18;
• ukwanda kokucasuka kwezicubu ezingxenyeni zezakhi zomuthi.

Ngesikhathi sokukhulelwa, kwezinye izimo, i-Pyramil ayinconywa noma ayenqatshelwe ukusetshenziswa.

Amaphiramidi awanconywa ngaphansi kwengcindezi encishisiwe.

Nge-aortic stenosis, ukusetshenziswa kwePyramil akunconyiwe.

Izingane ezingaphansi kweminyaka engu-18 azivunyelwe ukuthatha iPyramil.

Amaphiramidi anqatshelwe uma kwenzeka kushaqeka i-cardiogenic.

Ngesikhathi sokuqunjelwa, akunconywa ukusebenzisa i-Pyramil.

Ukuqapha kuyalulekwa lapho uthatha ama-immunosuppressants, ama-diuretics, ama-saluretics.

Ungayithatha kanjani iPyramil

Umuthi wenzelwe ukuphathwa ngomlomo. Umthamo wansuku zonke kanye nobude besikhathi sokwelashwa kunqunywa udokotela oya kuye ngokusezingeni lezimpawu zesiguli, umlando wezokwelapha kanye nokuhlolwa kwelebhu. Indima ebalulekile ekunqumeni uhlobo lonyango idlalwa ngobunzima kanye nohlobo lwesifo.

Ngoshukela

Esigabeni sokuqala sokulashwa kwezidakamizwa, kunconywa ukuthatha isigamu sethebhulethi engu-5 mg ngosuku kanye. Ngokuya ngesimo esengeziwe sezempilo, isilinganiso sansuku zonke singaphindiselwa kabili kumthamo ophelele we-5 mg ngokuphazamiseka kwamaviki ama-2-3.

Imiphumela emibi Pyramil

Imiphumela emibi yokuphuza umuthi ibonakaliswa ngokuya ngokwenziwa komzimba kumakhompiyutha ento esebenzayo.

Engxenyeni yesitho sombono

I-Visu acuity iyancipha, kuvela ukuqothuka nokufiphala. Ezimweni ezingavamile, i-conjunctivitis iba.

Kusuka ezicutshini zemisipha

Isistimu ye-musculoskeletal ihlangana ngokubonakaliswa okujayelekileko kokulimazeka kwemisipha nobuhlungu bokuhlangana.

Amapheshana wesisu

Ukuphendula okungalungile kohlelo lokugaya ukudla ngesikhathi sokusebenzisa kabi izidakamizwa kubonakalisa ngesimo se:

• ubuhlungu nokungaphatheki kahle esifundeni se-epigastric;
• isifo sohudo, ukufuthisa, ukuqunjelwa;
• ukugabha, isicanucanu;
• i-dyspepsia;
• umlomo owomile
• kunciphise isifiso sokudla kuze kufinyelele ekwakheni i-anorexia;
• i-pancreatitis enamathuba aphansi okufa.

Umphumela wecala Pyramil - ukuthuthukiswa kwe-conjunctivitis ezimweni ezingavamile.

Ubuhlungu nokungaphatheki kahle esifundeni se-epigastric ngenxa yokwelashwa ngePyramil.

Umphumela oseceleni wokusebenzisa i-Pyramil uhudo, ukuthopha, ukuqunjelwa.

Ukuthuthukiswa kwe-pancreatitis ngenxa yokusetshenziswa kwePyramil.

Umlomo owomile ungalashwa ngePyramil.

Umphumela omubi I-Pyramil ibonakaliswa ngokubonakaliswa okujwayelekile kwama-imisipha cramps nobuhlungu obuhlangene.

Ukuqhephuka, isicanucanu ngenxa yokusebenzisa iPyramil.

Mhlawumbe ukwanda komsebenzi wama-aminotransferase kuma-hepatocytes, ama-hepatocellular deposits. Kukhona secretion ekhulayo ye-pancreatic ijusi, ukwanda kokuhlungwa kwe-plasma ye-bilirubin egazini, ngenxa yokuthi i-cholestatic jaundice ikhula.

Izitho zeHematopoietic

Ngokuphikisana nesizinda sokwelashwa kwezidakamizwa, kunethuba lokuthola i-agranulocytosis eguqukayo ne-neutropenia, ukwehla kwenani lamangqamuzana egazi kanye nezinga le-hemoglobin.

Isistimu yezinzwa ephakathi

Imiphumela emibi ohlelweni lwezinzwa oluphakathi nolwembayo ibonakaliswa njengo:

• isiyezi nekhanda;
• ukulahleka kwemizwa;
• i-parosmia;
• umuzwa ovuthayo;
• ukulahleka kokulinganisela;
• ukuthuthumela kwemilenze.

Ngokuphula ukulinganisela kwengqondo, ukukhathazeka, ukukhathazeka, ukuphazamiseka kokulala kuyabonakala.

Kusuka ohlelweni lomchamo

Kukhona ukwanda kokuphazamiseka kokuhlunga kwe-glomerular, ngenxa yokuthi itholakala ngamuphi amaprotheni umchamo, futhi izinga le-creatinine ne-urea egazini liyakhuphuka.

Kukhona ukwanda kokuphazamiseka kokuhlunga kwe-glomerular, ngenxa yokuthi itholakala ngamuphi amaprotheni umchamo, futhi nezinga le-creatinine ne-urea egazini liyakhuphuka.

Kusuka ohlelweni lokuphefumula

Imiphumela emibi ohlelweni lokuphefumula ibonakaliswa ngesimo se-bronchitis, ukukhwehlela okuvamisile okuvamile, ukushesha komoya, i-sinusitis.

Engxenyeni yesikhumba

Iziguli ezinomkhuba wokubonakalisa ukungahambi kahle komzimba zinobungozi obukhulayo bokuqalwa kwesikhumba, i-urticaria ne-hyperhidrosis. I-photosensitization iyivelakancane - ukuzwela ukukhanya, i-alopecia, izimpawu eziba zimbi ze-psoriasis, onycholysis.

Kusuka ohlelweni lwezitho zofuzo

Kwabesilisa, phakathi nesikhathi sokwelashwa ngezidakamizwa, ukwehla kwe-potency kungenzeka phezulu ekuthuthukiseni ukungasebenzi kahle kwe-erectile (impotence) ne-gynecomastia.

Kusuka ohlelweni lwezinhliziyo

Imiphumela emibi yomuthi ohlelweni lokujikeleza kwegazi ibonakaliswa ngalezi zimo ezilandelayo:

• i-orthostatic hypotension;
• arrhythmia, tachycardia;
• i-vasculitis, isifo sikaRaynaud;
• ukukhukhumala kwe-peripheral;
• ukugcwala kobuso.

Ngokuphikisana nesizinda se-stenosis semikhumbi ye-arterial, ukuthuthukiswa kwezifo zokujikeleza umzimba kungenzeka.

Imiphumela emibi ohlelweni lwezinzwa oluphakathi nolubanzi ngesikhathi sokwelashwa ngePyramil ivela njengokuthuthumela kwemikhawulo.

Iziguli ezinomkhuba wokubonakalisa ukungahambi kahle komzimba zinobungozi obukhulayo bokuqalwa kwesikhumba, i-urticaria ne-hyperhidrosis.

Ukulimala kwekhanda kungabangelwa ngokudla iphiramidi.

Kwabesilisa, ngesikhathi sokwelashwa ngezidakamizwa, ukwehla kwe-potency kungenzeka.

Lapho usebenzisa i-Pyramil, imiphumela emibi ohlelweni lokuphefumula ibonakaliswa ngendlela yokukhwehlela okuhlala njalo komile.

Uma ukulinganisela kwengqondo kuphazamiseka ngenxa yokuthatha i-Pyramil, ukuphazamiseka kokulala kuyabonakala.

Uhlelo lwe-Endocrine

Ngokwe-theoretically, ukubonakala kokukhiqizwa okungalawulwa kwehomoni ye-antidiuretic kungenzeka.

Engxenyeni yesibindi ne-biliary

Ingozi yokuthola i-hepatitis ne-cholecystitis iyanda.

Ngasohlangothini lwe-metabolism

Okuqukethwe kwe-potassium egazini kuyakhuphuka.

Allergies

Lapho kukhona i-hypersensitivity ku-ramipril kanye nezinto ezisizayo zePyramil, kungavela lokhu kulandelayo okulandelayo:

• i-angioedema;
• Isifo sikaStevens-Johnson;
• ukuqunjelwa, ukulunywa, i-erythema;
• i-alopecia;
• ukwethuka kwe-anaphylactic.

Umthelela ekhonweni lokulawula izindlela

Ngesikhathi sokulashwa kwezidakamizwa, kunconywa ukwenqaba ukushayela, ukusebenzisana nezinqubo eziyinkimbinkimbi, nakweminye imisebenzi edinga ukusatshalaliswa nokusabela okusheshayo.

Ngesikhathi sokulashwa kwezidakamizwa, kunconywa ukwenqaba ukushayela.

Imiyalo ekhethekile

Ngaphambi kokuqala ukwelashwa ngezidakamizwa, kubalulekile ukugcwalisa ukuntuleka kwe-sodium futhi uqede i-hypovolemia. Ngemuva kokuthatha umthamo wokuqala, iziguli kufanele zibe ngaphansi kokuqashwa kwezokwelapha amahora angama-8, njengoba kunengozi yokuqalwa kwe-orthostatic hypotension.

Lapho kukhona i-cholestatic jaundice, umlando we-edema, kuyadingeka ukuyeka ukuthatha lo muthi. Esikhathini sokuvuselelwa ngemuva kokuhlinzwa ngaphansi kwe-anesthesia ejwayelekile, ukwehla kwengcindezi yegazi kungenzeka, ngakho-ke, umuthi kufanele ukhanselwe amahora angama-24 ngaphambi kokuhlinzwa.

Sebenzisa ebudaleni

Ukuqwashisa kuyalulekwa lapho kuthathwa abantu abaneminyaka engaphezu kwengama-65 ubudala ngenxa yokwanda kwamathuba okuthola ukuqina kwezinso, inhliziyo nesibindi.

Isabelo sezingane

Kuyenqatshelwa ukusebenzisa iminyaka eyi-18.

Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba

Umuthi unomphumela we-teratogenic ekukhuleni kombungu we-fetus, ngenxa yalokho, ukuthatha i-Pyramil ngesikhathi sokuhlela noma sokukhulelwa akuvunyelwe.

Ngesikhathi sokulashwa kwezidakamizwa, kunconywa ukumisa i-lactation.

Isicelo sokusebenza kokulimala kwezinso

Umuthi akufanele uthathwe ngokuvunyelwa kwe-creatinine ngaphansi kwama-20 ml / min. Ukuqwashiswa kuyelulekwa ezigulini ngemuva kokufakelwa kwezinso.

Sebenzisa umsebenzi wesibindi okhubazekile

Ukuqapha kumele kusetshenziswe lapho isibindi singasebenzi kahle. Ngokuphulwa okukhulu, ukwamukelwa kwePyramil kumele kukhanseliwe.

Iphiramidi ye-overdose

Ngokuhlukumeza umuthi, ukubonakaliswa kwe-overdose kuyabonakala:

• ukudideka nokulahlekelwa ukwazi;
• stupor;
• ukwehluleka kwezinso;
• ukwethuka
• ukwephulwa kwebhalansi kasawoti wamanzi emzimbeni;
• ukwehla kwengcindezi yegazi;
• bradycardia.

Ukunakekelwa kumele kuthathwe lapho kuthathwa iPyramil ngomsebenzi wesibindi ongafanele.

Ngokuhlukunyezwa kwePiramidi, ukulahleka kwengqondo kuyabonakala.

Ukuqwashisa kuyelulekwa lapho kuthathwa abantu abaneminyaka engaphezu kwengama-65 ubudala ngenxa yokwanda kwamathuba okuthuthuka kwe-renal, inhliziyo kanye nesibindi.

Uma sekudlule amahora angama-4 ngemuva kokuthatha umthamo omkhulu, khona-ke kuyadingeka ukuba ohlukunyeziwe ahlanzeke, ahlanze isisu, anikeze i-adsorbent. Ekudakwiseni kakhulu, ukwelashwa kuhloselwe ukubuyisela ama-electrolyte nomfutho wegazi

Ukuxhumana nezinye izidakamizwa

Ngokuphathwa kanyekanye kwePyramil neminye imithi, lokhu kusabela okulandelayo kuyabonakala:

1. Izidakamizwa eziqukethe usawoti we-potassium noma okwandisa ukugxila kwe-serum potassium kanye ne-heparin zibangela i-hyperkalemia.
2. Ukwehla okukhulu kwengcindezi kungenzeka ngokuhambisana namaphilisi okulala, ama-analgesics nezidakamizwa ze-narcotic.
3. Ingozi yokuthuthukisa i-leukopenia ngokuhlanganiswa ne-ramipril ene-allopurinol, i-corticosteroids, i-procainamide iyanda.
4. Izidakamizwa ezingezona ezibangelwa ukuvuvukala zenza buthaka umphumela wePyramil futhi zikhulise nengozi yokwehluleka kwezinso.
5. URamipril ukhulisa amathuba okuqhaqhazeka kwe-anaphylactic ngesikhathi sokulunywa yisinambuzane.

Ukungafaneleki kubhekwa ngokuhlanganiswa nezidakamizwa eziqukethe i-aliskiren, kanye ne-angiotensin II antagonists, stabilizer of membranes cell.

Ukuhambisana notshwala

Lapho uthatha i-ethyl alcohol, kungenzeka ukuthuthukisa isithombe somtholampilo se-vasodilation. URamipril uthuthukisa umphumela onobuthi we-ethanol esibindini, ngakho-ke uma uthatha i-Pyramil, kufanele wenqabe ukuphuza utshwala.

Ama-Analog

Ukufana kwezakhiwo zePyramil kufaka:

• I-Amprilan;
• Amaphilisi wePyramil angeziwe;
• Umkhondo;
• I-Dilaprel.

Ukushintshela komunye umuthi kwenziwa ngemuva kokubonisana nodokotela.

Imibandela yekhefu lekhemisi

Umuthi uthengiswa ngomuthi onikezwe wona.

Ngingakwazi ukuthenga ngaphandle kadokotela

Ngenxa yengozi eyandayo yokuthola ukungaphenduki kahle komzimba, ukuthengiswa kwamahhala kwePyramil akuvunyelwe.

I-Amprilan ingeyokufanekisa okuyisakhiwo kwePyramil.

I-Dilaprel iyi-analogue yePyramil.

I-analogue yePyramil yiTritace.

Intengo yephiramidi

Izindleko ezijwayelekile zomuthi ziyehluka kusuka kuma-ruble ayi-193 kuye kwangama-300.

Izimo zokugcina zomuthi

Kunconywa ukugcina umuthi endaweni eyomile, uvikelekile elangeni, emazingeni okushisa afinyelela ku + 25 ° C.

Isikhathi sokuphelelwa yisikhathi

Iminyaka emi-2

Umkhiqizi

ISandoz, eSlovenia.

Ukubuyekezwa kwepyramil

UTatyana Nikova, oneminyaka engama-37, Kazan

Udokotela unqume amaphilisi ePyramil ngoba nginomfutho wegazi ophakeme. Izingcindezi zokucindezela kusihlwa sezikhohliwe iminyaka emi-2. Kepha udinga ukuphuza umuthi njalo. Umphumela awugciniwe. Ngithanda inani elifanele lemali. Emiphumela emibi, ngiyakwazi ukwahlukanisa ukukhwehlela okuomile.

UMaria Sherchenko, oneminyaka engama-55, u-Ufa

Ngiphuza amaphilisi ukwehlisa ingcindezi ngemuva kokushaywa unhlangothi. Abaningi abasizanga, kodwa base behlangana noPyramil. Ekuqaleni, awuzange ube khona mphumela ngenxa yomthamo omncane, kodwa ngemuva kwamasonto amabili umthamo wenyuswe, ingcindezi yaqala ukuncipha. Ngizizwa ngingcono, kepha ngibhekene nokungalingani kwamaphilisi anezidakamizwa eziningi. Ukuthola inhlanganisela efanele kunzima.