I-Aprovel umuthi ohloselwe ukwelashwa kwe-arterial hypertension kanye nephropathy. Kuvunyelwe ukusebenzisa umuthi wesifo sikashukela. Kulokhu, umuthi awubangeli ukuhoxiswa kwesifo ngemuva kokuyeka ukwelashwa. Umuthi uyatholakala ngesimo samathebulethi, okuvumela odokotela ukuthi bangawulawuli umuthi. Iziguli ngokwazo zingaguqula irejimeni yokwelashwa kwezidakamizwa ngesikhathi esikahle kubo.
Igama Lezwe elingafanele
I-Irbesartan.
I-Aprovel umuthi ohloselwe ukwelashwa kwe-arterial hypertension kanye nephropathy.
I-ATX
C09CA04.
Khipha amafomu nokwakheka
Umuthi uyatholakala kumathebulethi e-enteric-camera. Iyunithi yemithi iqukethe i-150, 300 mg yento esebenzayo - i-irbesartan. Njengoba kusetshenziswa izakhi ezisizayo ekukhiqizweni:
- ushukela wobisi;
- i-hypromellose;
- i-silloon dioxide ye-colloidal dehydrate;
- i-magnesium stearate;
- crodarmellose sodium.
I-membrane yefilimu iqukethe i-carnauba wax, i-macrogol 3000, i-hypromellose, i-titanium diabetes noshukela wobisi. Amathebulethi anomumo wokusaqanda we-biconvex futhi apendwe mhlophe.
Isenzo se-Pharmacological
Izenzo ze-Aprovel zisuselwa ku-irbesartan, umphikisi onamandla we-angiotensin II receptors onamandla. Ngenxa yokucindezelwa komsebenzi we-receptor, ukuhlushwa kwe-aldosterone ku-plasma yegazi kuyancipha. Izinga lama-ion e-sodium ku-serum yegazi alishintshi uma isiguli singasebenzisi kabi umuthi futhi sithatha kuphela umthamo wansuku zonke onconywayo.
Njengomphumela wesenzo sokuhlanganiswa kwamakhemikhali, kwehla umfutho wegazi (BP). Kulesi simo, akukho ukwehla kwesilinganiso senhliziyo. Ngomthamo owodwa ofinyelela kuma-300 mg, ukwehla komfutho wegazi ngokuqondile kuncike kumthamo othathwe. Ngokukhuphuka kwesimo sezinto zansuku zonke esisebenzayo, azikho izinguquko eziqinile ezinkombeni zomfutho wegazi.
Umphumela we-hypotensive omkhulu ubonwa amahora angama-3-6 ngemuva kokuthatha iphilisi. Umphumela wokwelapha uhlala amahora angama-24. Ngemuva kosuku kusuka esikhathini sokuthatha umthamo owodwa, umfutho wegazi wehla kuphela ngama-60-70% wenani eliphakeme.
Umphumela we-pharmacological we-Aprovel ukhula kancane kancane esikhathini esiyizinsuku eziyi-7-14, ngenkathi amanani aphezulu womphumela wokwelapha abonwa ngemuva kwamasonto angama-4-6. Kulokhu, umphumela we-hypotensive uphikelela. Lapho ukwelashwa kunqatshwa, umfutho wegazi kancane kancane ubuyela ezingeni lawo lasekuqaleni.
I-Pharmacokinetics
Ngemuva kokuphathwa ngomlomo, umuthi udonswa ngokushesha emathunjini amancane ngo-60-80% womthamo othathwe. Uma ingena egazini, into esebenzayo ibopha amaprotheni e-plasma ngamaphesenti angama-96 futhi, ngenxa yenqubo eyinkimbinkimbi, isatshalaliswa kuzo zonke izicubu.
Umuthi osebenzayo ufinyelela ekugxileni okukhulu kwe-plasma ngemuva kwamahora 1.5-2 emva kokuphathwa.
Ukuqedwa kwesigamu sempilo kwenza amahora ayi-11-16. Ngaphansi kuka-2% kwengxenye esebenzayo efomini layo lasekuqaleni kudalulwa ngohlelo lobuchwepheshe.
Izinkomba zokusetshenziswa
Umuthi wenzelwe ekwelashweni nasekuvimbeleni umfutho wegazi ophakeme njenge-monotherapy noma uhlanganiswe nezinye izidakamizwa ezinomphumela we-antihypertensive (beta-adrenergic blockers, thiazide diuretics). Ochwepheshe bezokwelapha banquma i-Aprovel ye-nephropathy lapho kunesifo sikashukela sohlobo 2, esihambisana nomfutho wegazi ophakeme. Esimweni esinjalo, i-monotherapy ayenziwa, kepha kunikezwa ukwelashwa okuyinkimbinkimbi ukunciphisa umfutho wegazi.
Contraindication
Umuthi awunconywa noma awunqatshelwe ukuthi usetshenziswe kumacala alandelayo:
- ukuzwela okwengeziwe kwezicubu ezingxenyeni zezakhi zomuthi;
- ukungabekezeleli i-lactose, i-lactase;
- malabsorption of monosaccharides - galactose noshukela;
- ukungasebenzi kahle kwesibindi.
Ngenxa yokuntuleka kwezifundo zokwelashwa ezanele, ukwelashwa akuvunyelwe kubantu abangaphansi kweminyaka eyi-18.
Ngokunakekela
Ukuqapha kunconywa emacaleni alandelayo:
- i-stenosis ye-aorta noma i-mitral valve, imithambo yezinso;
- ukufakelwa kwezinso;
- I-CHD (isifo senhliziyo);
- ngokwehluleka kwezinso, kuyadingeka ukulawula izinga le-potassium ne-creatinine egazini;
- i-arrososososis yobuchopho;
- ukudla okungenawo usawoti, kuhambisana nohudo, ukugabha;
- i-cardiomyopathy evimbayo;
- I-hypovolemia, ukuntuleka kwe-sodium ngemuva kokwelashwa kwezidakamizwa nge-diuretics.
Kuyadingeka ukuqapha isimo seziguli ku-hemodialysis.
Ungayithatha kanjani i-Aprovel
Umuthi wenzelwe ukuphathwa ngomlomo. Ngasikhathi sinye, ijubane namandla okufakelwa emathunjini amancane azimele ekudleni kokudla. Amathebulethi kufanele adakwe aphelele ngaphandle kokuhlafuna. Umthamo ojwayelekile esigabeni sokuqala sokwelashwa ngu-150 mg ngosuku. Iziguli ezinomfutho wegazi ophezulu odinga ukwelashwa okwengeziwe kwe-antihypertensive zithola ama-300 mg ngosuku.
Ngokuncipha okunganele kwengcindezi yegazi, ukwelashwa okuhlangene ne-Aprovel, i-beta-blockers, i-calcium ion antagonists isetshenziselwa ukufeza okuhlosiwe.
Kubalulekile ukukhumbula ukuthi umthamo nobude besikhathi sokwelashwa kusungulwa kuphela uchwepheshe wezokwelapha ngokusekelwe ezimweni eziqondene nesiguli, idatha yaselebhu kanye nokuhlolwa ngokomzimba.
Ukuthatha umuthi wesifo sikashukela
Ukwemukelwa kwesifo sikashukela sohlobo loku-1 kufanele kuxoxwe nodokotela wakho, ozokwenqabela ukusetshenziswa kwe-Aprovel noma enze ushintsho lwedosi yansuku zonke. Uhlobo 2 lwesifo sikashukela esinga-insulin, umthamo onconywayo ungama-300 mg ngosuku kanye.
Iziguli ezinesifo sikashukela zinengozi eyengeziwe yokuba ne-hyperkalemia.
Unganqaba kanjani ukwamukela
Ukukhanselwa kwe-syndrome ngemuva kokuqedwa okubukhali kokuthatha i-Aprovel akubonwa. Ungashintshela kwelinye ikhambi lokwelapha izidakamizwa noma uyeke ukuthatha umuthi.
Imiphumela emibi ye-Aprovel
Ukuphepha komuthi kwaqinisekiswa esivivinyweni somtholampilo lapho iziguli ezingama-5,000 zahlanganyela. Amavolontiya angama-1300 ahlushwa umfutho wegazi ophakeme futhi aphuza umuthi izinyanga eziyisithupha. Ezigulini ezingama-400, isikhathi sokwelashwa sadlula unyaka. Imvamisa yemiphumela emibi ayincikanga kumthamo othathwe, ubulili kanye nobudala besiguli.
Esifundweni esilawulwa yi-placebo, amavolontiya angu-1965 athola ukwelashwa kwe-irbesartan izinyanga ezi-1-3. Ezimweni eziyi-3.5%, iziguli zaphoqeleka ukuthi zilahle ukwelashwa nge-Aprovel ngenxa yemingcele emibi yeelebhu. I-4.5% yenqabile ukuthatha i-placebo, ngoba azizwanga ngcono.
Amapheshana wesisu
Ukubonakaliswa okungalungile endaweni yokugaya ukudla kuboniswa njenge:
- isifo sohudo, ukuqunjelwa, ukuthopha;
- isicanucanu, ukuhlanza;
- ukuthuthukisa umsebenzi wama-aminotransferases kuma-hepatocytes;
- i-dyspepsia;
- ukushaya kwenhliziyo.
Engxenyeni yesibindi ne-biliary tract, i-hepatitis kungenzeka, ukwanda kokuhlungelwa kwe-plasma ye-bilirubin, okuholela ku-jaundice ye-cholestatic.
Isistimu yezinzwa ephakathi
Ukuphazamiseka ekuxhumaneni kwe-neuronal ngenxa yokusebenzisa izidakamizwa ze-antihypertgency zivame ukubonakaliswa ngendlela yesiyezi nekhanda. Ezimweni ezingavamile, ukudideka, i-malaise ejwayelekile, imisipha yokulimala, ukuqina kwemisipha, kanye ne-vertigo kwaqashelwa. Ezinye iziguli zizwe i-tinnitus.
Kusuka ohlelweni lokuphefumula
Umphumela kuphela wohlelo lokuphefumula ukukhwehlela.
Kusuka ohlelweni lwezitho zofuzo
Ezigulini ezisengozini yokuthola ukwehluleka kwezinso, ukungasebenzi kwezinso kungaqala ukukhula.
Kusuka ohlelweni lwezinhliziyo
I-Orthostatic hypotension ivame ukubonakaliswa.
Allergies
Phakathi kokubonakaliswa kokungafani komzimba, kukhona:
- I-edema kaQuincke;
- ukwethuka kwe-anaphylactic;
- ukuqunjelwa, ukulunywa, i-erythema;
- i-urticaria;
- i-angioedema.
Iziguli zithambekele ekuphenduleni kwe-anaphylactic zidinga ukuhlolwa kokungezwani komzimba. Uma umphumela uba muhle, umuthi kufanele ushintshwe.
Umthelela ekhonweni lokulawula izindlela
Umuthi awuthinti ngqo ukusebenza kwengqondo komuntu. Ngasikhathi sinye, kungenzeka ukuthuthukisa ukusabela okungekuhle kusuka ohlelweni lwezinzwa oluphakathi nolwezinsizakalo, yingakho kunconywa ukwenqaba ukushayela imoto, ukusebenza ngezinqubo eziyinkimbinkimbi, nakweminye imisebenzi edinga ukuphendula okusheshayo nokuhlushwa ngesikhathi sokwelashwa kwezidakamizwa.
Imiyalo ekhethekile
Iziguli ezisebenza ngokungafanele kwesistimu yezinhliziyo noma ukungasebenzi kahle kwezinso zinengozi eyandayo yokuthola i-hypotension eyingozi, i-oliguria, kanye ne-nitrogen eyandayo egazini. Ukwehla okunamandla komfutho wegazi ngenxa ye-ischemia, i-myocardial infarction noma i-cerebral vascular stroke kungenzeka.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Umuthi awuvunyelwe ukusetshenziswa ngesikhathi sokukhulelwa. Njengezinye izidakamizwa ezithinta uhlelo lwe-renin-angiotensin-aldosterone, i-irbesartan ingena ngokukhululekile emgoqweni we-placental. Ingxenye esebenzayo iyakwazi ukuthinta ukuthuthukiswa kwe-intrauterine kunoma yisiphi isigaba sokukhulelwa. Kulokhu, i-irbesartan ikhishwa ubisi lwebele, mayelana nakho okudingekayo ukuyeka ukuphuma kwe-lactation.
Ukuqokwa kokuphikisana nezingane
Akunconyelwe iziguli ezingaphansi kweminyaka engu-18 ubudala, ngoba akukho datha emiphumeleni yomuthi ekukhuleni ebusheni nasebusheni.
Sebenzisa ebudaleni
Ukulungiswa okwengeziwe kwesimo sansuku zonke sabantu ngemuva kweminyaka engama-50 akufuneki.
Isicelo sokusebenza kokulimala kwezinso
2% kuphela wezidakamizwa oshiya umzimba ungene ezinso, ngakho-ke abantu abane-pathologies yezinso abadingi ukwehlisa umthamo.
Sebenzisa umsebenzi wesibindi okhubazekile
Ngokuphazamiseka okukhulu kwe-hepatocytes, ukuphuza lo muthi akunconywa.
2% kuphela wezidakamizwa oshiya umzimba ungene ezinso, ngakho-ke abantu abane-pathologies yezinso abadingi ukwehlisa umthamo.
Ukweqisa kwe-Aprovel
Ezifundweni zemitholampilo, lapho kuthathwa abantu abadala kuze kube ngama-900 mg ngosuku kumaviki awu-8, kwakungekho zimpawu zokudakwa komzimba.
Uma izimpawu zomtholampilo ze-overdose ziqala ukuvela ngesikhathi sokusebenzisa kabi izidakamizwa, kuzodingeka ufune usizo lodokotela futhi uyeke ukuphuza umuthi. Ayikho into ethile ephikisayo, ngakho-ke, ukwelashwa kuhloselwe ukuqeda isithombe sophawu.
Ukuxhumana nezinye izidakamizwa
Ngokusebenzisa kanyekanye i-Aprovel neminye imithi, ukusabela okulandelayo kuyabonakala:
- I-Synergism (ethuthukisa imiphumela yokwelapha yazo zombili izidakamizwa) ngokuhlanganiswa nezidakamizwa ze-antihypertensive, i-calcium Channel inhibitors, i-thiazide diuretics, i-beta-adrenergic blockers.
- I-Serum potaziyamu egazini ikhuphuka ngemithi ye-heparin kanye ne-potassium.
- I-Irbesartan inyusa ubuthi be-lithium.
- Ngokuhambisana nezidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala, ingozi yokuhluleka kwezinso, i-hyperkalemia iyanda, futhi ngenxa yalokho, ukusebenza kwezinso kufanele kugadwe ngesikhathi sokwelashwa kwezidakamizwa.
Ingxenye esebenzayo ye-Aprovel ayithinti umphumela wokwelapha we-Digoxin.
Ukuhambisana notshwala
Umenzeli we-antihypertgency wenqatshelwe ukuthathwa kanyekanye ngemikhiqizo yotshwala. I-ethyl alcohol ingadala ukuhlangana kwamangqamuzana abomvu egazi, ukuhlanganiswa kwayo okungavimba ukukhanyiswa komkhumbi. Ukuphuma kwegazi kunzima, okubangela ukwanda kwesilinganiso senhliziyo nokwanda kwengcindezi. Ngokuphikisana nesizinda sokulashwa kwezidakamizwa, lesi simo sizobangela ukuwa kwemithambo yegazi.
Ama-Analog
Phakathi kwama-analogues ahlelekile, isenzo sawo esuselwa ku-irbesartan esetshenziswayo, kunezidakamizwa zombili zokukhiqiza zaseRussia nezangaphandle. Ungafaka amaphilisi we-Aprovel ngemithi elandelayo:
- I-Irbesartan
- Ibertan;
- Firmastoy;
- I-Irsar;
- I-Irbesan.
Kubalulekile ukukhumbula ukuthi ngaphambi kokushintsha umuthi omusha kuyadingeka ukubonisana nodokotela wakho. Ukuzifaka esikhundleni sakho akuvunyelwe.
Imibandela yekhefu lekhemisi
Umuthi uthengiswa ngomuthi onikezwe wona.
Intengo ye-aprovel
Izindleko ezijwayelekile zepakethe le-carton equkethe amaphilisi ayi-14 we-150 mg ziyahlukahluka kusuka kuma-ruble angama-310 kuya kwangama-400.
Izimo zokugcina zomuthi
Kuyadingeka ukuthi uqukethe umuthi endaweni eyomile ongafinyeleleki ekukhanyeni nezingane emazingeni okushisa afinyelela ku-30 ° C.
Isikhathi sokuphelelwa yisikhathi
Iminyaka emithathu
Umkhiqizi
ISanofi Winthrop Imboni, eFrance.
Ukubuyekezwa ku-Aprovel
Ukuphawula okuhle ngemiphumela yesidakamizwa ezinhlaka ezahlukahlukene ze-inthanethi kusiza ukuqinisa isikhundla sika-Aprovel ezimakethe zamakhemikhali.
Izazi zezenhliziyo
U-Olga Zhikhareva, udokotela wezifo zenhliziyo, uSamara
Ikhambi elisebenzayo lokwehlisa umfutho wegazi ophakeme. Ngisebenzisa ekwelashweni komtholampilo njenge-monotherapy noma ukwelashwa okuyinkimbinkimbi. Angigcinanga umlutha. Iziguli azincomi ukuthatha isikhathi esingaphezu kwe-1 ngosuku.
U-Antonina Ukravechinko, udokotela wezifo zenhliziyo, uRyazan
Inani elifanele lemali, kepha ngincoma ukuqaphela kulezi ziguli ezine-mitral noma i-aortic valve stenosis. Izingane nabesifazane abakhulelwe benqatshelwe ngokuphelele ukuthatha amaphilisi e-Aprovel. Phakathi kwemiphumela emibi, ukuvela komzimba kuye kwenzeka. Ngasikhathi sinye, naphezu kokungaphenduki kahle okuvela emzimbeni, isidakamizwa sisize ukwehlisa umfutho wegazi ophakeme.
Uma izimpawu zomtholampilo zokweqisa kwemithi ziqala ukuvela, lapho-ke udinga usizo lodokotela.
Iziguli
ICairo Airam, eneminyaka engama-24, iKazan
Nginomfutho wegazi ophakeme. Ekuseni ikhuphukela ku-160/100 mm Hg. Ubuciko. Wathatha izidakamizwa eziningi ukwehlisa umfutho wegazi, kepha amaphilisi we-Aprovel kuphela asizayo. Ngemuva kokufaka isicelo, ngokushesha kuba lula ukuphefumula, kuzwakale umsindo wegazi emathempelini. Into esemqoka ukuthi umphumela ngemuva kokuhoxiswa kwezidakamizwa uhlala isikhathi eside. Udinga ukuphuza izifundo futhi uvakashele udokotela wakho njalo. Angibonanga imiphumela emibi.
U-Anastasia Zolotnik, oneminyaka engama-57, eMoscow
Umuthi wawungalingani nomzimba wami. Ngemuva kwamaphilisi, kwaqhamuka imidumba, ukuvuvukala kanye nokuhanjiswa kanzima. Ngazama ukubuyisana isonto lonke, ngoba ingcindezi inciphile, kepha ukungahambisani nakho akusalanga. Kwakudingeka ngiye kudokotela ukuze ngizokhetha esinye isidakamizwa. Ngithande ukuthi ukuvela kwesifo kungaqhamuki, ngokungafani nezinye izindlela zokunciphisa umfutho wegazi.
