Ama-inhibitors e-ACE asetshenziselwa umfutho wegazi ophakeme, ukuhluleka kwenhliziyo kanye nokuvimbela izifo zohlelo lwethambo nenhliziyo. Izidakamizwa ezifana ne-enalapril noma i-Captopril zivimbela amakhemikhali akhuthaza i-vasoconstriction kanye nengcindezi eyandayo. Zisetshenziswa njengethuluzi elizimele ukuze i-kutholakale ngokweqile kwengcindezi yegazi, kanye nokuhlangana neminye imithi.
Izici ze-Enalapril
I-Enalapril inciphisa umfutho wegazi, umthwalo okuyi-myocardium, uvuselela ukuphefumula nokugeleza kwegazi embuthanweni omncane, ukhuthaza ukuhamba kwegazi okunempilo emithanjeni yezinso.
I-Enalapril noma iCaptopril ivimbela amakhemikhali akhuthaza i-vasoconstriction kanye nengcindezi eyandayo
Isithako esikhulu esisebenzayo yi-enalapril, okuthi, ngemuva kokufakwa, ifakwe i-hydrolyzed ku-enalaprilat, i-ACE inhibitor, dipeptidase ye-peptide ekhuthaza ukuguqulwa kwe-angiotensin. Ngenxa yokuvinjwa kwe-ACE, ukwakhiwa kwento ye-vasoconstrictor kuncishisiwe nokwakhiwa kwama-kinins ne-prostacyclin, okunempahla ye-vasodilating. I-Enalapril inomphumela we-diuretic ohambisana nokucindezelwa kwe-aldosterone synthesis.
Ukwehla okubonakalayo komsebenzi we-ACE kwenzeka ngemuva kwamahora ama-3 ngemuva kokuphuza umuthi, inani eliphakeme kakhulu lokwehla komfutho wegazi libonakala ngemuva kwamahora ama-5. Isikhathi somphumela sixhumene nomthamo, ezimweni eziningi umphumela wesidakamizwa uphikelela usuku lonke. Ezinye iziguli zidinga amasonto ambalwa zokwelashwa ukuze zithole umfutho wegazi ophelele.
Lapho ungena emzimbeni, umuthi udonswa ngokushesha emgudwini wesisu, emva kwalokho into i-hydrolyzed ukuze yakhe i-enalaprilat, ekhishwa ngokwengeziwe ezinsweni, kanye nangamathumbu.
Izinkomba ezisetshenziswayo:
- i-arterial hypertension;
- ukuhluleka kwenhliziyo okukhulu ngokomzwelo;
- isifo senhliziyo;
- izimo ze-bronchospastic;
- ukuvimbela ukuthuthukiswa kokuhluleka kwenhliziyo ngokomqondo okukhulu.
I-Enalapril yehlisa umfutho wegazi futhi ikhuthaza ukuhamba kwegazi okunempilo emithanjeni yezinso.
Contraindication:
- ukungabekezelelani komuntu ngamunye ezingxenyeni zomuthi;
- ukukhulelwa, isikhathi sokuncelisa ibele;
- i-stenosis ye-aortic orifice;
- i-renal artery stenosis;
- emva kokufakelwa kwezinso;
- hyperkalemia
- ukusetshenziswa okuhlangene ne-Aliskiren ezigulini ezinesifo sikashukela, isifo sezinso esiphazamisekile.
Umuthi awubekelwe izingane ezingaphansi kweminyaka engu-18.
Ngesikhathi sokwelashwa kwe-enalapril, izicubu zomsipha, isicanucanu, ikhanda, isifo sohudo, ukusabela komzimba wesikhumba, i-orthostatic hypotension kungenzeka.
Umuthi uphuzwa ngomlomo, kungakhathalekile ukuthathwa kokudla.
Ngomfutho wegazi ophakeme, umthamo owodwa ojwayelekile kubantu abadala ngu-0,01-0.02 g in s
amadada. Umthamo ovumelekile wansuku zonke ngu-0,04 g. Umthamo ophelele ungakhethwa kuphela ngudokotela ohamba yedwa esigulini ngasinye. Isikhathi senkambo yokwelapha sincike ekusebenzeni kokwelashwa.
Izici Zekhompiyutha
I-ACE inhibitor yehlisa umfutho wegazi futhi isetshenziselwa umfutho wegazi ophakeme, i-nephropathy, isifo sikashukela, ukuhluleka kwenhliziyo. Inomphumela we-vasodilating, yandisa ukuphuma kwenhliziyo nokumelana nokucindezela, ngaphandle kokuthinta i-lipid metabolism.
Isithako esiyisisekelo esisebenzayo yi-Captopril, okuyi-synthetic yokuqala ye-ACE ekusebenzeni kwezokwelapha. Ivimbela ukuguqulwa kwe-angiotensin I ukuya ku-angiotensin II, isiza ukwehlisa umfutho wegazi, inciphise ubulukhuni be-hypertrophy yengqondo yesobunxele, ivimbela ukukhula kokuhluleka kwenhliziyo, ithuthukise i-hemodynamics ezinso, futhi ivimbele ukuthuthukiswa kwe-nephropathy yesifo sikashukela.
I-Captopril ingena ngokushesha, ifakwe kusibindi esibindini, ekhishwa ngezinga elikhulu yizinso. Isigamu sempilo singaba yimizuzu eyi-120.
Umphumela omkhulu uqoshwa ngemuva kwamahora angu-1-1,5. Isikhathi sokusebenza sincike kumthamo womuthi.
I-Captopril iyelulekwa ngalezi zifo:
- i-arterial hypertension;
- ukwehluleka kwenhliziyo;
- infarction myocardial;
- isifo sikashukela se-nephropathy.
Isithako esiyisisekelo esisebenzayo yi-Captopril, okuyi-synthetic yokuqala ye-ACE ekusebenzeni kwezokwelapha.
Umuthi usetshenziselwa ukuvikela ukwehluleka kwenhliziyo okubonakalayo ezigulini ezine-asymptomatic left dysfunction in esimweni somtholampilo.
Contraindication:
- hypersensitivity kuzakhi zomuthi;
- isifo sezinso esinzima;
- hyperkalemia
- i-renal artery stenosis;
- i-stenosis ye-aortic orifice nezinye izinguquko ezephula ukuphuma kwegazi okujwayelekile kusuka kwi-ventricle yesobunxele;
- isimo ngemuva kokufakelwa kwezinso;
- Ama-trimesters ama-2 no-3 okukhulelwa;
- inkathi yokuncelisa.
Ayibekelwe izingane ezingaphansi kweminyaka eyi-14.
Imisipha ye-allergic, ushintsho lokunambitha, ukungabi namandla, i-leukopenia, i-proteinuria, i-agranulocytosis, ukwehluleka, ukuhlangana kahle kokunyakaza kungenzeka njengemiphumela emibi lapho uthatha umuthi.
Umthamo ofanele we-Captopril usungulwa uchwepheshe ngamunye futhi uhluka kusuka ku-0,025 g kuya ku-0,15 g ngosuku. Endabeni yokukhuphuka ngokushesha futhi okubukhali komfutho wegazi, kunconywa ukuthatha umthamo omncane, uthatha ithebhulethi ngaphansi kolimi. Ekwelapheni kwezingane, umthamo ophelele ubalwa ucatshangelwe isisindo somzimba, isilinganiso esinconyelwe ngu-0.001-0.002 g nge-1 kg.
Ukuqhathanisa Izidakamizwa
Ukufana
Le mishanguzo iyingxenye yeqembu le-ACE inhibitor, inomshini ofanayo wesenzo futhi isetshenziselwa ukwelapha umfutho wegazi ophakeme, izifo zesistimu yenhliziyo. Bacishe babe ne-contraindication ecishe ifane. Umphumela wokwelapha uncike kumthamo.
Uyini umehluko
Umehluko omkhulu ekwakhiweni. Zombili lezi zidakamizwa zisuselwa kwe-proline amino acid derivative. Kepha i-enalapril ihlukile kwe-analogue esakhiweni sayo samakhemikhali esiyinkimbinkimbi: lapho ingena emzimbeni, into esemqoka esebenza yi-hydrolyzed to enalaprilat, evimbela i-ACE.
Le mishanguzo ihlukile kumvamisa yokuphatha onconyelwe. Ngomfutho wegazi ophansi, i-enalapril ithathwa isikhathi esingu-1 ngosuku. I-Captopril inomphumela ongapheli, ukuze kugcinwe kuyadingeka ukuphuza umuthi kaningana ngosuku.
I-Captopril ihlanganiswe kangcono ne-diuretics. Lapho ulapha nge-analogue yayo, kunconywa ukunciphisa umthamo wezidakamizwa ze-diuretic noma ubashiye okwesikhashana.
Yikuphi okushibhile
Imithi inentengo ephansi futhi iyatholakala kubathengi. Izindleko ezijwayelekile ngama-ruble angama-60-130.
Yini engcono i-enalapril noma i-capopril
I-Enalapril ilungele ngokuphelele ukusetshenziswa isikhathi eside uma kunesidingo ukuze kulondolozwe umfutho wegazi ngaphakathi kwebanga olifunayo, kepha ayisetshenziswa njenge-ambulensi. I-Captopril iyasebenza ngokulungiswa kwe-episodic yengcindezi ekhuphuke kakhulu. Umuthi ubuye ube nomthelela omuhle emsebenzini wenhliziyo, ukhuphula ukukhuthazela ngemithwalo ejwayelekile, okwenza ukusetshenziswa kwayo kufaneleke phambi kwe-pathologies yesistimu yethambo nenhliziyo.
Ungashintsha kanjani kusuka ku-Captopril uye ku-enalapril
Le mishanguzo ingeyeqembu elifanayo le-pharmacological futhi ibonakala ngokuxhumana okungekuhle, okuyingozi empilweni futhi kungadala ukuncipha okukhulu komfutho wegazi. Ekwelapheni umfutho wegazi ophakeme, izidakamizwa zikhishwa ngawodwana. Ukuze ushintshe usuka kwesinye isidakamizwa uye kwesinye, udinga ukubonana nodokotela ozoqoka umthamo ofanele, uhlobo lokukhipha kanye nerejimeni yokwelashwa kucatshangelwa umlando wezokwelapha, ubudala kanye nezinye izici zomuntu ogulayo.
Ukubuyekezwa kweziguli
UMarianna P. "Ngezikhathi ezithile ingcindezi iyakhuphuka, kepha ngizama ukugwema ukuphuza amaphilisi ukwehlisa umthwalo wezidakamizwa. Ngonyaka owedlule ngangisesibhedlela ngenxa yokuhamba kaningi nokushintshwa kwesimo sezulu. Inqubo yezindlela zezokwelapha ayikwazanga ukudambisa ingcindezi, ngisho nomjovo awuzange uthuthukise isimo kakhulu "Ngakhumbula ukuthi lapho umngani wami etusa i-Captopril. Ngabeka amaphilisi ama-2 ngaphansi kolimi lwami, kwathi ngemuva kwemizuzu ecishe ibe ngu-30 ingcindezi yaqala ukuncipha. Ngakusasa yaphenduka into esejwayelekile. Manje ngihlala ngigcina lesi sidakamizwa esikhwameni sami."
UVika A: "Angibheki ukuthi i-Captopril iyi-ambulensi. Umfutho wegazi lomkhwekazi wagxuma kakhulu, wafaka ama-2 ngaphansi kolimi, amanye ama-3 ngaphezulu kwamahora ambalwa, wasondela ekuseni futhi. Futhi ekuseni kwaba noshintsho olungcono. yehlisa ijubane. Uma umuthi ubekwe njenge-ambulensi, khona-ke lesi sidakamizwa kufanele sisheshe. Ingcindezi kumamezala ibuyele kwesejwayelekile kuphela ngemuva kokuthi udokotela ejova umuthi othile ngomphumela wokugaya ukudla. "
U-Elena R. "Ngesikhathi ekhishwa esibhedlela, umama wabelwa u-Enalapril. Wabona ngokushesha ukuthi kukhona ukukhwehlela okwakungekho lapho ngaphambili. Ngifunde imiyalo yomuthi, kuvela ukuthi awusebenzi wonke umuntu. Kufanele kuthathwe ngokuqapha, kodwa kungcono ukuthola okunye."
Le mishanguzo ihlukile kumvamisa yokuphatha onconyelwe.
Odokotela babuyekeza mayelana ne-enalapril ne-Captopril
UTsukanova A. A., udokotela onolwazi ngeminyaka engu-5 yokuhlangenwe nakho: "Okuwukuphela kwenzuzo ye-Enalapril intengo yayo engabizi. Akusebenzi ngampela emithanjeni emincane, abaningi bayiphuza ngomthamo owamukelekayo. Ngokuvamile kubangela ukusabela okungalungile ngendlela yokukhwehlela owomile, ngakho-ke ayifanele i-asthmatics. Ngincoma lo muthi ezigulini, kunezidakamizwa ezisebenza kahle nezanamuhla. "
I-Zafiraki V.K., isazi sezinhliziyo esisebenza kweminyaka engu-17, Ph.D. "Iziguli eziningi esezikhulile ezikhononda ngokungasebenzi noma inkulumo yaso ebuthaka, zithenge i-Captopril, zingazi mehluko phakathi kweKapoten neCaptopril. umuthi, kepha umuthi wokuqala wakhiqizwa yinkampani ewukhiqizayo, owesibili uyikhophi e kabusha yohlobo lwangempela futhi ukhiqizwa yizinkampani ezahlukahlukene. Ngincoma ukuthenga zombili lezi zidakamizwa futhi siqhathanise ukuthi yisiphi esinamandla. "
