Ukulungiselela okuhlanganisiwe okubandakanya izinto ezi-2 ezisebenzayo, imiphumela ehambelana namakhemikhali, futhi esetshenziselwa ukwelapha umfutho wegazi ophakeme.
Igama
INoliprel (Bi) Forte isidakamizwa esinomthamo ophindwe kabili wezinto ezisebenzayo (i-Perindopril 4 mg + Indapamide 1.25 mg). Uma kudingekile ukusebenzisa imithamo ephezulu ezigulini ezisengozini enkulu (isifo sikashukela, ukubhema, i-hypercholesterolemia), kunikezwe iBi-Forte (Perindopril 10 mg + Indapamide 2.5 mg).
Ukulungiselela okuhlangene okubandakanya izinto ezi-2 ezisebenzayo ezihambisana nemiphumela yemithi.
I-ATX
I-C09BA04 Perindopril ihlangana nama-diuretics.
Khipha amafomu nokwakheka
Amathebulethi embozwe ngefilimu.
Into esebenzayo: Perindopril 2 mg + Indapamide 0,625 mg.
Isenzo se-Pharmacological
Isiza ukuguquguqula ngokwejwayelekile i-systolic ne-diastolic blood pressure (BP) kungakapheli amahora angama-24. Imiphumela ephelele itholakala ngemuva kwenyanga yokudla ejwayelekile. Ukuqedwa kokuphatha akuholeli ekwakhiweni kwezimpawu zokuhoxa
Umuthi unciphisa ijubane lezinqubo zokulungiswa kabusha kwe-myocardial, unciphisa ukumelana kwemithambo yegazi engaphumi ngaphandle kokuthinta izinga lama-lipids noshukela wegazi.
I-Perindopril ivimbela umsebenzi we-enzyme, ohumusha i-angiotensin I ku-enzymotin II esebenzayo, okuyi-vasoconstrictor enamandla. I-ACE futhi ibhubhisa i-bradykinin, i-vasodilator esebenzayo yezinto eziphilayo. Njengomphumela we-vasodilation, ukumelana kwemithambo yegazi kuyancipha futhi umfutho wegazi uyancipha.
Amathebulethi embozwe ngefilimu.
I-Indapamide iyi-diuretic eqenjini le-thiazide. Umphumela we-diuretic kanye nezakhiwo ezi-hypotensive zitholakala ngokunciphisa ukungena kwe-sodium ion ezinso. Kukhona ukwanda kwe-excretion kumchamo we-sodium, ngenxa yalokho ukumelana nemithambo yegazi kuncipha futhi nethamo legazi elikhiqizwa yinhliziyo liyanda.
Ukusetshenziswa okuhlangene kwe-perindopril ne-indapamide kuthuthukisa ukusebenza kwezokwelapha kwe-hypertension, kunciphisa ingozi ye-hypokalemia (umphumela oseceleni wokuthatha i-diuretics).
I-Pharmacokinetics
I-pharmacokinetics yezinto ezisebenzayo ayihlukile ngokusetshenziswa kwazo okuhlangene noma okuhlukile.
Lapho uthathwa ngomlomo, cishe ama-20% womthamo ophelele we-perindopril usetshenziselwa ifomu elisebenzayo. Leli nani lingancipha lapho lisetshenziswa ngokuhlangana nokudla. Okuqukethwe okuphezulu egazini kuqoshwa emahoreni angama-3-4 ngemuva kokuphathwa. Ingxenye encane ye-perindopril ibopha amaprotheni egazi. Kuyakhishwa emchameni.
I-excretion ye-perindopril ingabambezeleka ekwehlulekeni kwezinso, ikakhulukazi ezigulini esezikhulile.
I-Indapamide idonswa emgudwini wamathumbu, ngemuva kwemizuzu engama-60 okuqukethwe okuphezulu kwe-metabolite esebenzayo kulungiswe kuplasma yegazi. I-80% yezidakamizwa ihanjiswa nge-albhamuin yegazi. Kukhishwa ngokuhlunga ngokusebenzisa izinso ngomchamo, u-22% uthululiwe ezinduneni.
Izinkomba zokusetshenziswa
Umfutho wegazi ophezulu (hypertension hypertension).
Umuthi unqunyelwe umfutho wegazi ophakeme.
Contraindication
- ukungabekezeleleki okuthile kwe-thiazide diuretics, i-ACE inhibitors;
- izinga le-potassium legazi elingaphansi kuka-3.5 mmol / l;
- ukuthikamezeka kakhulu kwezinso ngokuncipha kwezinga lokuhlunga le-glomerular elingaphansi kwama-30 ml / min;
- i-atherosulinotic stenosis yemithambo yezinso zombili noma i-stenosis yomthambo wezinso esisodwa esisebenzayo;
- ukungasebenzi kahle kwesibindi;
- ukuphathwa kanyekanye kwezidakamizwa okunomphumela we-proarrhythmogenic;
- ukukhulelwa
- inkathi yokuncelisa.
Ungayithatha kanjani
Ngaphambi kokuqala ukwelashwa, kubalulekile ukufunda imiyalo yokusebenzisa futhi uthinte uchwepheshe.
Umuthi uthathwa ngethebhulethi eli-1 ngomlomo isikhathi esisodwa ngosuku, mhlawumbe ekuseni ngesisu esingenalutho.
Ngingakwazi ukuhlanganyela iphilisi
Ungabelana, iphilisi linengozi kuzo zombili izinhlangothi.
Izinhlobo zezidakamizwa ezinesandulelo esithi "forte" azinazingcipheko futhi zimbozwe ngokuhlanganiswa kwefilimu. Angahlukaniswa.
Yelashwa kanjani isifo sikashukela sohlobo 2
Akuthinti i-glucose metabolism, ukungathathi hlangothi ngokomzimba. Ezigulini ezinesifo sikashukela, ukusetshenziswa kungenzeka ngohlelo olujwayelekile.
Imiphumela emibi
Amapheshana wesisu
Ubuhlungu besisu, obuhambisana nokucanuzelelwa nokuhlanza; ukuphazamiseka kwesitulo; umlomo owomile ukubonakala kokukhamuluka kwesikhumba; ukukhuphuka kwamapharamitha welebhu wesibindi nama-pancreas egazini; ngokuntuleka kokuqina kwesibindi, ukuthuthukiswa kwe-encephalopathy kungenzeka.
Izitho zeHematopoietic
I-anemia (ezigulini ezinesifo sezinso esibuhlungu kakhulu); ukwehla kwenani le-hemoglobin, amaplatelet, ama-leukocytes, ama-granulocytes; kwehle i-hematocrit; i-hemolytic anemia; i-aplastic anemia; ithambo lomongo
Ezigulini ezinesifo sikashukela, ukusetshenziswa kungenzeka ngohlelo olujwayelekile.
Isistimu yezinzwa ephakathi
Ukulimala kwekhanda, isiyezi, ubuthakathaka, ukukhathala, ukungaxwayi, ukudabukisa okungokomzwelo, ukuphazamiseka kokuhlaziya okubonakalayo nokuhlaziya okubonakalayo, ukuqwasha, ukukhulisa ukuzwela okuphathelene necala.
Kusuka ohlelweni lokuphefumula
Ukukhwehlela okuvela ngokuqala kokusetshenziswa, kuphikelela kuso sonke isikhathi sokuthatha umuthi bese unyamalala ngemuva kokuhoxiswa kwawo; ubunzima bokuphefumula isikhala somoya; kuyaqabukela - ukuphuma kwe-mucous kusuka ekhaleni.
Kusuka ohlelweni lomchamo
Kwehlisiwe umsebenzi wezinso; ukuvela kwamaprotheni emchameni; kwezinye izimo, ukulimala kwe-renal acute; ushintsho kumazinga e-electrolyte: ukwehla kwe-potassium kwiplasma yegazi, kuhambisana ne-hypotension.
Allergies
Isikhumba esihehayo, ukuqhuma kohlobo lwe-urticaria; I-edema kaQuincke; i-hemorrhagic vasculitis; kuyaqabukela - erythema multiforme.
Imiyalo ekhethekile
Ukuhambisana notshwala
Ukusetshenziswa okuhlangene ne-ethanol derivatives kungasiza ezingxenyeni zokwehla okukhulu komfutho wegazi, ukuwohloka kwemithambo. Ukusetshenziswa okuvumelanayo akunconywa.
Umthelela ekhonweni lokulawula izindlela
Ekuqaleni kokuthatha umuthi, kufanele uqaphele lapho ushayela izimoto nokwenza umsebenzi odinga ukunakwa nokusabela okusheshayo.
Ngokungasebenzi kahle kwesibindi
Kungadala ukukhula kwe-cholestatic jaundice ngokwanda okukhulu komsebenzi wama-enzyme wesibindi. Lapho lesi simo senzeka, kuyadingeka ukukhansela umuthi futhi ubonane nodokotela.
Ezigulini ezine-cirrhosis, asikho isidingo sokulungiswa kwamthamo.
Ngokuhluleka kwezinso
Lapho kukhona izifo zohlelo lomchamo nokuwohloka okumakiwe emsebenzini wokuhlunga, ukwanda kokuqukethwe kwe-creatinine, i-uric acid ne-urea ku-plasma, kungenzeka ukwanda kokuqukethwe kwe-potasium.
Ezigulini ezine-cirrhosis, asikho isidingo sokulungiswa kwamthamo.
Ngokuncipha kokuvunyelwa kwe-creatinine okungaphansi kwama-30 ml / min. umuthi kufanele ungafakwa ohlotsheni lokwelapha.
Ngesikhathi sokukhulelwa nokuqunjelwa
Ukusetshenziswa kuyaqondiswa lapho kungekho khona ucwaningo ngomphumela wesidakamizwa esibelethweni. Abesifazane abakwi-trimester yesibili neyesithathu kufanele baqaphele ikakhulukazi.
Ebudaleni
Ngaphambi kokuqala ukungena, kuyadingeka ukuqapha izinkomba zomsebenzi wezinso (i-creatinine, urea), ama-enzyme wesibindi (AST, ALT), ama-electrolyte. Ukwelashwa kuqala ngemithamo ephansi futhi kukhethwa ngokwahlukana kubhekwe ukwehla kwengcindezi yegazi.
Ukuqokwa uNoliprel ezinganeni
It is contraindised for izingane kanye nentsha engaphansi kweminyaka engu-18 ngenxa yokuntuleka kwemininingwane yokuphepha kwayo kuleli qembu leziguli.
Ukweqisa
Izimpawu ze-overdose: i-hypotension enzima, isicanucanu, ukuhlanza, isifo sokuqina, i-anuria, ukwehla kwenhliziyo.
Ukunakekelwa okuphuthumayo: ukuhanjiswa kwesisu, ukuphathwa kwekhabhoni ocushiwe, ukulungiswa kwama-electrolyte egazi. Nge-hypotension, isiguli kufanele sinikezwe isikhundla esiphakeme ngemilenze ephakanyisiwe.
Abesifazane abakwi-trimester yesibili neyesithathu kufanele baqaphele ikakhulukazi.
Ukuxhumana nezinye izidakamizwa
Ngokunakekela
Lapho kuhlanganiswa nama-antidepressants noma ama-antipsychotic, kungenzeka ukwanda komphumela wegazi legciwane ngokuthuthukiswa kwe-hypotension.
I-Glucocorticosteroids inciphisa umphumela we-antihypertensive.
Ngokuphikisana nesizinda sokuthatha, kungenzeka ukuthuthukisa umphumela wokwehlisa ushukela wokutholwa kwe-insulin kanye ne-sulfonylurea.
Inhlanganisela ene-glycosides yenhliziyo idinga ukuqapha ngokucophelela kwamazinga we-potassium ne-ECG, nokulungiswa kwe-hypovolemia.
Ngokucwaninga okuhleliwe kwe-X-ray, ukuvikela amanzi emzimbeni kuyadingeka.
Ngokusetshenziswa kanyekanye kwezidakamizwa ezithile (i-Erythromycin, i-Amiodarone, iSotalol, iQuinidine), ingozi yokwanda kwe-arrhythmias yamakhemikhali iyanda.
Inhlanganisela ayinconywa
Ukwabelana ngamalungiselelo we-lithium akuvunyelwe ngenxa yengozi ephezulu ye-lithium overdose.
Ngomsebenzi we-renal oncishisiwe, inhlanganisela nama-diuretics, asiza ukubambezeleka kwama-electrolyte, kanye ne-infusions ye-potassium chloride kufanele kugwenywe.
Ngokuphathwa kanyekanye komlomo ngama-NSAIDs ngokumelene nesizinda sokuphelelwa ngamandla, kungaholela ku-pathology eyingozi yokuhlunga kwe-renal.
Ama-Analog
Ko-Perineva, Ko-Parnawel, Perindapam, Perindid.
Imibandela yekhefu lekhemisi
Ikhishwe ngumbhalo.
Intengo Noliprel
Izindleko zephakethe elilodwa lomuthi (amaphilisi angama-30), abalwa ngenyanga yokwelashwa, aqala kusuka kuma-ruble angama-470.
Izimo zokugcina zomuthi iNoliprel
Gcina ungafinyeleleki ezinganeni. Azikho izimo ezikhethekile zokugcina ezidingekayo.
Isikhathi sokuphelelwa yisikhathi
Iminyaka emithathu
Ukubuyekezwa ku-Noliprel
Izazi zezenhliziyo
I-Zafiraki V.K., eKrasnodar: "Inhlanganisela enhle engakhombisile nje kuphela ngokuya ngokunciphisa umfutho wegazi, kodwa futhi nangokuphathelene nokunciphisa izehlakalo zenhliziyo, nokwehluleka kwenhliziyo."
I-Nekrasova GS, eKrasnodar: "Ukukhetha okufanele kweziguli ezinomfutho wegazi ophezulu."
Iziguli
Uthando, eMoscow: "Umuthi muhle, uyasiza."
U-Alexander, Oryol: "Ingcindezi ijwayelekile."
