Ukwelashwa kwe-hypertension, kusetshenziswa inhlanganisela yezidakamizwa zamaqembu ahlukene. I-Lozarel plus yisidakamizwa esihlanganisa izinto ezi-2 ezinciphisa umfutho wegazi futhi zihambisane.
Igama Lezwe elingafanele
IHydrochlorothiazide + losartan.
I-ATX
C09DA01.
I-Lozarel plus yisidakamizwa esihlanganisa izinto ezi-2 ezinciphisa umfutho wegazi futhi zihambisane.
Khipha amafomu nokwakheka
Ilungiselelo lethebhulethi elenzelwe ifilimu elincibilikayo lapho lidalulwa ama-enzyme amathumbu. Izinto ezilandelayo zinomphumela:
- IHydrochlorothiazide - 12,5 mg. I-Thiazide diuretic.
- I-Losartan - 50 mg. I-Angiotensin Receptor Antagonist 2.
Izinto ezingeziwe ekwakhekeni azinamphumela osebenzayo, zenzelwe ukubumba ithebhulethi.
Isenzo se-Pharmacological
Izici zengxenye ngayinye zinquma indlela yokusebenza. IHydrochlorothiazide iphazamisa ukumunwa okubuyisanayo kwe-sodium, potassium, ne-chlorine ions engxenyeni esekude ye-nephrons ezinso. Lezi zinto zithunyelwa ngenkuthalo futhi zithwala uketshezi ngokweqile. Ukuchithwa kwe-urine kuyanda.
Umphumela walokhu ukwehla kwethamo le-plasma egazini. Umsebenzi we-hormone renin ngokukhanya uyanda. Kwenziwe ngendlela yokuthi kutholakale izinso ze-juxtaglomerular yezinso. Ngemuva kokukhululwa ungene egazini, i-renin ivuselela i-adrenal cortex futhi ithuthukise ukucasulwa kwe-aldosterone. Iyakwazi ukugcina i-sodium kancane, kepha yandisa i-potassium excretion. I-hormone ikhuthaza ukudluliselwa kwe-sodium esikhaleni se-intracellular, ikhulisa i-hydrophilicity yezicubu, iguqule isimo se-acid-base siye ohlangothini lwe-alkaline.
Ukwehla komfutho wegazi ngaphansi kwesenzo se-hydrochlorothiazide kwenzeka ngenxa yokwehla kwethamo legazi.
Ukwehla komfutho wegazi ngaphansi kwesenzo se-hydrochlorothiazide kwenzeka ngenxa yokwehla kwethamo legazi, ukulawulwa kokuphendula kodonga lomkhumbi kanye nokwehla komphumela we-adrenaline ne-norepinephrine kuwo, okufaka isandla ekunciphiseni nasekunciphiseni i-lumen yemikhumbi. Ngomfutho wegazi ojwayelekile, umphumela wesidakamizwa awukhuli.
Ukuchithwa kwe-urine kuthuthukiswa ngemuva kwamahora we-1-2 ngemuva kokuthathwa kwephilisi, umphumela omkhulu uba ngemuva kwamahora ama-4. Umphumela we-diuretic uhlala kuze kufike emahoreni ayi-12.
Isenzo se-losartan potassium sigcwalisa i-diuretic. Ibopha ngokukhetha ama-angiotensin receptors, atholakala emikhunjini, indlala ye-adrenal, izinso nenhliziyo. Umuthi uvimba umphumela we-angiotensin 2, kepha awuvusi i-bradykinin. Kuyiprotheni elungisa imithambo yegazi. Ngakho-ke, i-losartan ayinakho ukusabela okuhlukile okuhambisana nale peptide.
Ukwanda komphumela we-antihypertensive kwenzeka ngokwanda komthamo womuthi. Isenzo sinje:
- ukumelana kwemithambo yegazi yokwehla kuyancipha;
- umfutho wegazi uvamile;
- i-aldosterone egazini ayikhuphuki ngaphezu kokujwayelekile;
- ekujikelezeni kwe-pulmonary kunciphisa ingcindezi;
- ukuncishiswa kokulayisha ngemuva enhliziyweni;
- ukukhipha ukuphuma komchamo.
Izifo zenhliziyo ezingamahlalakhona, okuholela ekungasebenzini, kukhulisa ukumelana nomsebenzi womzimba.
Izifo zenhliziyo ezingamahlalakhona, okuholela ekungasebenzini, kukhulisa ukumelana nomsebenzi womzimba. Vikela izicubu zenhliziyo kusuka ku-fiber hypertrophy.
Izikhombisi zohlelo lwezinzwa ezizimele azithinteki. Iqoqo le-norepinephrine ngaphansi kwethonya lomuthi alishintshi.
Ngemuva kokuphuza iphilisi, ingcindezi yehla emva kwamahora ayi-6, kepha-ke umphumela we-hypotensive uyancipha kancane kancane. Ukwehla okuqhubekayo kutholakala ngemuva kwamaviki ama-3-6 wemithi ejwayelekile.
Ezifundweni zemitholampilo, kwafakazelwa ukuthi ukunqanyulwa okungazelelwe kwe-losartan akubanga zimpawu zokuhoxa kanye nengcindezi eyandayo. Isiza iziguli ngokulinganayo zeminyaka ehlukene nobulili obuhlukile.
I-Pharmacokinetics
Ukuphuza kusuka ohlelweni lokugaya lwe-losartan kwenzeka ngokushesha nangokugcwele. Ngemuva kokudlula esibindini, i-metabolite esebenzayo itholakala ngaphansi kwethonya lama-enzymes wesistimu ye-cytochrome. Ukudla akuphazamisi i-bioavailability, okuyi-33%. Ngemuva kwehora, ukuqoqwa kwento yokuqala iba ngaphezulu, bese kuthi ngemuva kwamahora angama-3-4, inani le-metabolite esebenzayo lifinyelele phezulu.
Ukuqunjelwa kwe-hydrochlorothiazide evela emathunjini kwenzeka kuphela ku-80%.
Isithiyo sobuchopho segazi asidlulisi i-losartan kumaseli obuchopho. I-100 mg yesidakamizwa esithathwa kanye ngosuku asiqokeleli ku-plasma. Ubuningi baso budlulwa kanye nezindunduma.
Ukuqunjelwa kwe-hydrochlorothiazide evela emathunjini kwenzeka kuphela ku-80%. Amangqamuzana we-Hepatic akasebenzisi umbandela, ngakho izinso ziwugqisha esimweni esingashintshiwe. Isigamu sempilo singamahora angama-6-8. Uma kwenzeka wephula umsebenzi wohlelo lwe-excretory, lesi sikhathi singakhuphuka size sifike emahoreni angama-20.
Izinkomba zokusetshenziswa
Kubekelwe ukwelashwa kwe-hypertension ye-arterial uma kunezinkomba zokusetshenziswa kwama-ejenti ahlanganisiwe.
Contraindication
I-Hypersensitivity to the constituent vitu nokuphuma kwe-sulfonamide kwenza ukwelashwa kungenzeki. Ungasebenzisi uma kwenzeka ukungasebenzi kahle kwesibindi, okunikezwe amaphuzu angu-9 noma ngaphezulu esikalini se-Child-Pugh. Lapho imvume ye-creatinine ingaphansi kwama-30 ml / min, okuhambisana ne-pathology ye-renal, ungasebenzisi.
Izifo ze-Somatic lapho kusetshenziswe khona umuthi zaphulwa:
- i-hypotension enkulu ye-arterial;
- isifo sikashukela esingalawulwa;
- Isifo sika-Addison;
- gout
- i-malabsorption syndrome;
- ukuntuleka kwe-lactase.
Ngokuphulwa kwemali esele ye-electrolyte ehambisana nokwehla kwe-potassium, i-sodium, ukwanda kwe-calcium, kanye ne-hyperuricemia, ukusetshenziswa kwalesi sidakamizwa kuyaphikiswa. Izothuthukisa ukungalingani okukhona kwama-ion. Uma kusetshenziswe okunye okokuhlanza okuholele ekuphuthweni komzimba, khona-ke ibhalansi yamanzi kufanele ibuyiselwe, futhi ukwelashwa okunenhlanganisela kwenqatshiwe.
E-anuria, ama-diuretics awakwazi ukusetshenziswa kuze kube yilapho imbangela yokugcinwa komchamo isusiwe.
Ngokunakekela
Ukwephulwa kwebhalansi yama-electrolyte ngesifo sohudo noma ukugabha kudinga ukusetshenziswa ngokucophelela kwama-diuretics ngokusho kwezinkomba. Ngaphansi kokubhekwa kwezokwelashwa okuqinile, isetshenziswa kulezi zimo ezilandelayo:
- i-renal artery stenosis;
- isifuba somoya;
- ukusabela okwenziwa njalo;
- i-pathology yezicubu ezithintekayo;
- ama-arrhythmias asongela impilo
- isifo senhliziyo;
- i-aortic stenosis;
- i-hypertrophic cardiomyopathy;
- ukwephulwa kokuhlinzekelwa kwegazi ebuchosheni;
- emva kokufakwa kwezinso.
Ukuvalwa kwe-glaucoma kwe-angle-myoma ne-myopia kukhathaza kakhulu izifundo zabo ngaphansi kwesenzo se-hydrochlorothiazide.
Ungayithatha kanjani i-losarel plus?
Ekuqaleni futhi emuva kwalokho, ukuze kulondolozwe umphumela wokwelapha, kubekwa ithebhulethi eyi-1 ngosuku, kungakhathalekile ukuthi kudliwani. Kepha uma umphumela ophikelelayo we-hypotensive ungakhuli phakathi kwamaviki ama-3-4, umthamo unyuswa waba ngama-2 ama-pcs. (25 no-100 mg wesithako esisebenzayo).
Ekuqaleni futhi emuva kwalokho, ukuze kulondolozwe umphumela wokwelapha, kubekwa ithebhulethi eyi-1 ngosuku, kungakhathalekile ukuthi kudliwani.
Ngoshukela
Udokotela we-endocrinologist kufanele ahlole futhi alungise umthamo we-insulin wohlobo 1 sikashukela. Umuthi ungaholela ku-hyperglycemia, ukuvela koshukela emchameni. I-Aliskiren noma izidakamizwa ezisuselwa kuyo zithinta kabi inkambo yesifo sikashukela lapho ihlanganiswa ne-ejenti yokuhlanganisa.
Imiphumela emibi Lozarel plus
Ocwaningweni lomtholampilo wokuhlanganiswa kwe-hydrochlorothiazide ne-losartan, akukho ukusabela okungekuhle okwabonwa ngenxa yokusetshenziswa kwezinto ezi-2. Babonakala kuphela ngesimo esibonakaliswa umuthi ngamunye ngamunye.
Amapheshana wesisu
Ukuphazamiseka kwengqondo kwe-dyspeptic, isicanucanu, ukugabha, Ubuhlungu besisu, ukuthopha kuyabonakala. Kwesinye isikhathi umlomo owomile ubangelwa ukuncipha koketshezi. Izilonda zesibindi, i-pancreatitis akuvamile ukubonwa.
Izitho zeHematopoietic
I-hemoglobin, ukubalwa kwe-platelet, i-hematocrit ingancipha kancane. Kwesinye isikhathi kuba nokwanda kwama-eosinophils egazi. I-vascular hemolysis ayivelakancane.
Kwesinye isikhathi ukuphuza umuthi kungadala isicanucanu.
Isistimu yezinzwa ephakathi
Isiyezi, ukuqwasha, ukuphathwa ikhanda kungenzeka. Kwesinye isikhathi i-paresthesia, i-neuropathy yangaphakathi, i-tinnitus, ukunambitheka okungaboni kahle kanye nombono, ukudideka.
Kusuka ohlelweni lwe-musculoskeletal
Akuvamile ukuthi kube khona izinhlungu emhlane, izingalo, ukungajabuli emalungeni, ukuncipha kwemisipha.
Kusuka ohlelweni lokuphefumula
Ukukhwehlela, ukuqubuka kwamakhala kungavela. Ukoma okwandayo kwezimpawu zokuqothuka kuholela ekwandeni kwesibalo sezifo zokuphefumula, i-sinusitis, i-laryngitis.
Engxenyeni yesikhumba
Kwezinye iziguli, isikhumba singaphendula nge-hyperhidrosis kanye nokuthuthukiswa kwe-photosensitivity. Ukususwa ngokweqile kwe-fluid kuholela ku-epidermis eyomile.
Kwezinye iziguli, isikhumba singaphendula nge-hyperhidrosis.
Kusuka ohlelweni lwezitho zofuzo
Ukuchama okungafanele kube yinto esenzeka njalo. Kwesinye isikhathi kufanele uvuke uye endlini yangasese ebusuku. Ukutheleleka kwezitho zezitho zofuzo kuyaqabukela kujoyina, ukwehla kwe-libido ne-potency.
Kusuka ohlelweni lwezinhliziyo
Mhlawumbe ukuthuthukiswa kwe-arrhythmias ngenxa yokungalingani kuma-ion amakhulu. I-vasculitis, i-orthostatic hypotension ingavela.
Allergies
Ezimweni ngazinye, kuqhamuke isikhumba sohlobo lwe-urticaria, ukulunywa kwesikhumba kuvela. Ukusabela okunzima kepha okungavamile i-anaphylaxis, angioedema.
Umthelela ekhonweni lokulawula izindlela
Ukomela, ukwehla kwezinga lokuphendula nokunakwa kungaba umphumela wemvelo wokuthatha umuthi. Ngakho-ke, kufanele wenqabe ukushayela imoto futhi usebenze ngokunembile ngamasu.
Kuyafuneka ukuyeka ukushayela imoto nomsebenzi oqondile ngezinqubo.
Imiyalo ekhethekile
Iziguli zomjaho weNegroid zisabela kabi kulo muthi. Ukusebenza kwaso okuphansi kuhlotshaniswa nendlela yokukhula komfutho wegazi ophezulu, okwenzeka ekuqoqweni okuphansi kwe-renin.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Ukuchayeka ohlelweni lwe-renin-angiotensin-aldosterone kungaholela ekuhlukunyezweni okunzima kwe-fetus ku-2nd ne-3 trimesters futhi kubangele ukufa kwayo kwe-intrauterine. Ngakho-ke, ngemuva kokuthola iqiniso lokukhulelwa, kunconywa ukufaka umuthi endaweni ephephile.
I-Thiazide diuretics iyakwazi ukungena egazini le-fetus futhi iholele ekwakhiweni kwe-embryonic jaundice noma ibe yimbi kakhulu enkambisweni ye-hyperbilirubinemia yezingane emisha. Kwabesifazane abakhulelwe, bangaholela ku-thrombocytopenia, okungaholela ku-hypocoagulation kanye nokopha. Lapho uncelisa ibele, umuthi wenqatshelwe.
Ukuqokwa kwe-Lozarel nezingane
Ezinganeni zasekhaya azisetshenziswa ngenxa yokuntuleka kovivinyo lomtholampilo kanye nemininingwane yokuphepha ebuntwaneni.
Ngemuva kokuthola iqiniso lokukhulelwa, kunconyelwa ukufaka umuthi endaweni ephephile.
Sebenzisa ebudaleni
Ezigulini ezineminyaka engaphezu kwengama-60 ubudala, umuthi awuphulwa. Kuyadingeka ukuthi ucabangele ukuba khona kwezifo zenhliziyo namanye ama-pathologies lapho ukwelashwa kuzobe kubekiwe. Ngokwesimo esanelisayo, umthamo awuguquki.
Isicelo sokusebenza kokulimala kwezinso
Ukwehluleka kwezinso okulinganiselwe akudingi ukuguqulwa komthamo, noma ngabe isiguli siku-hemodialysis.
Sebenzisa umsebenzi wesibindi okhubazekile
Ayisetshenziselwa ukungasebenzi kahle, kwezinye izimo - ngokuqapha.
I-overdose ye-losarel plus
Uma weqa isilinganiso esinconyiwe, kwehla umfutho oshiwo ekucindezelweni. Ukwehla kokulahleka kwama-electrolyte kungaholela ekukhuleni kwe-arrhythmias, ukubonakala kwe-tachy- noma i-bradycardia.
Ukwanda kokulahleka kwama-electrolyte kungaholela ekwakhiweni kwama-arrhythmias.
Asikho isidakamizwa. Ukwelashwa kwenziwa ngokuya ngezimpawu.
Ukuxhumana nezinye izidakamizwa
Ngokusetshenziswa kanyekanye ne-Aspirin nezinye izindlela zaleli qembu, umphumela wokucindezela kanye ne-diuresis uyancishiswa. Umphumela onobuthi ezinso uyakhuliswa, kungahle kube nomphumela wokwephulwa komsebenzi wabo.
Iphula umthetho we-lithium clearance we-lithium, ngakho-ke, izidakamizwa ezisuselwa kuwo azisetshenziswa ngasikhathi sinye.
Ukuqokwa namanye ama-diuretics kuholela ekunyukeni kwemiphumela yokugaya kanye ne-hypotensive. Ama-anticepressants e-Tricyclic, ama-antipsychotic, ama-barbiturates, ama-narcotic analgesics anganciphisa ingcindezi iphuzu elibucayi noma abangele i-orthostatic hypotension.
Izidakamizwa ze-gout ngenkathi uthatha zidinga ukuguqulwa komthamo, ngoba kukhona ukubambezeleka kwe-serum uric acid.
Iziguli zisebenzisa i-glycosides yenhliziyo zingakha i-tricyularia ye-ventricular ngenxa yokuntuleka kwe-potassium.
Amalungiselelo e-iodine ayakwazi ukwandisa ingozi yokuhluleka kwesibindi okukhulu, ngakho-ke ukuphuma komzimba kuyadingeka ngaphambi kokuwasebenzisa.
Ukuhambisana notshwala
I-Ethanol ingakhulisa ukusabela okungekuhle okungafuneki, imiphumela enobuthi esibindini nasezinso.
Ama-Analog
Emakhemisi, kuvezwa iziqubulo ezilandelayo zezidakamizwa:
- I-Losartan-n;
- Gizaar Forte;
- ULorista ND;
- I-Lozap plus.
Imibandela yekhefu lekhemisi
Umuthi usho izidakamizwa ezithithiwe.
Ngingakwazi ukuthenga ngaphandle kadokotela?
Ayitholakali ngaphandle kadokotela.
Intengo ye-losarel plus
Izindleko zivela kuma-ruble angama-230 kuya kwangama-325 wamathebulethi angama-30.
Izimo zokugcina zomuthi
Ekhaya, kuyadingeka ukugcina izingane zingafinyeleleki ezinganeni ngokushisa okungekho ngaphansi kuka- + 25 ° C.
Isikhathi sokuphelelwa yisikhathi
Ngokuya ngemibandela yokubeka, ilungele iminyaka engu-2. Ngemuva kwalesi sikhathi kuyenqatshelwa ukufaka isicelo.
Umkhiqizi
Umuthi ukhiqizwa yinkampani yakwaSandoz, eSlovenia.
Ukubuyekezwa ku-Lozarel plus
UKarina Grigoryevna, oneminyaka engama-65 ubudala, eMoscow.
Kudala ngihlushwa umfutho wegazi ophakeme. Udokotela usinikeze lo muthi. Kade ngiyisebenzisa amaviki ama-2, ingcindezi izinzile futhi ayikhuphuki. Angibonanga lutho olubi olubi olubi, kepha kwesinye isikhathi isisu sami sibuhlungu.
U-Alexander Ivanovich, oneminyaka engama-59, eSt.
Ngithathe amaphilisi ngokwahlukanisa isikhathi eside, kodwa ngashintshela kumuthi wokuhlanganisa. Lokhu kulula, awudingi ukukhumbula ukuthi ngithathe ipilisi yiphi nokuthi ngiyikhohliwe yiphi. Ingcindezi izinzile, azikho i-surges. Kepha indlu yangasese akudingeki ukuba ihlale izungeza njalo.
U-Elena, oneminyaka engama-45, uBryansk.
Babeka lo muthi kuyise, kodwa kwase kufanele wenqabe. Ubaba ukhuluphele futhi kwesinye isikhathi ushukela wegazi uyakhuphuka. Futhi ngokumelene nesizinda sokwelashwa, kwavela ushukela kumchamo. Ngakho-ke, bashintshela kwesinye isidakamizwa. Kwakufanele ngiqale ukudla okungenama-carbohydrate.
