Isifo esijwayelekile kakhulu senhliziyo yi-hypertension. Ukwelashwa kwayo, kusetshenziswa amaqembu amaningana emithi enezindlela ezihlukile zokwelapha ekwelapheni umfutho wegazi ophakeme. Isici esibalulekile esithinta ukushona kwesifo senhliziyo ukwanda kwengcindezi yegazi. Ukulawula izinga lezibalo zokucindezela, kusetshenziswa umuthi i-Vazotens N.
Ukulawula izinga lezibalo zokucindezela, kusetshenziswa umuthi i-Vazotens N.
Igama Lezwe elingafanele
I-Losartan ihlanganiswe ne-diuretic (hydrochlorothiazide).
I-ATX
C09D A01
Khipha amafomu nokwakheka
Lesi sidakamizwa siyatholakala ngesimo samathebulethi efakwe kumafilimu. Amathebulethi atholakala kwimithamo elandelayo:
- Ithebhulethi eyi-1 iqukethe u-100 mg we-losartan no-25 mg we-hydrochlorothiazide, kuthebhulethi eyi-1 blister 10, 3 blims in package.
- Ithebhulethi eyi-1 iqukethe ama-50 mg we-losartan no-12.5 mg we-hydrochlorothiazide, kumathebhulethi ayi-1, amalinge ayi-10 kwiphakeji.
Lesi sidakamizwa siyatholakala ngesimo samathebulethi efakwe kumafilimu.
Isenzo se-Pharmacological
Indlela eyinhloko yokusebenza ukuvimba ama-receptors e-angiotensin II, okuyi-main contractile element emzimbeni maqondana nemikhumbi. I-Angiotensin, exhuma nama-receptors ayo ezindongeni zemithambo yegazi, ibangela ukuba inkontileka kuwo wonke umzimba, okuvusa ukukhula kwengcindezi. Ukuqanjwa kwalolu hlobo kwenzeka ezithweni zezinso ezinamaprotheni e-renin ngaphansi kwethonya le-enixens-eguqula i-enzyme.
Ukuvimba ama-angiotensin receptors akubangeli i-vasoconstriction, ngenxa yalokho ukwanda kwengcindezi kungenzeki. Into esebenzayo yesidakamizwa ixhumana kuphela nama-angiotensin 2 receptors, ngakho-ke ayinawo eminye imiphumela kwamanye ama-receptors.
Indlela eyinhloko yokusebenza ukuvimba ama-receptors e-angiotensin II, okuyi-main contractile element emzimbeni maqondana nemikhumbi.
Indlela yokusebenza ye-hydrochlorothiazide: ukukhiqizwa komchamo okwandisiwe, ukwehla kwengcindezi ngenxa yokususwa koketshezi oluningi emzimbeni.
I-Pharmacokinetics
ILosartan iconswa ngokushesha isuka emathunjini, lapho ingena khona esibindini futhi iba ngaphansi kwe-biotransformation. I-33% kuphela yomthamo othathwe awuthelwanga umzimba. Ngesikhathi se-biotransformation, i-losartan iguqulwa ibe yi-metabolite esebenzayo. I-ejenti eyi-hypotensive futhi ayinaphansi kwe-losartan ekusebenzeni kahle.
Ukuqoqwa okuphezulu kakhulu kwento esebenzayo emzimbeni kudalwa amahora ama-2 ngemuva kokuphathwa. Umphumela wethebhulethi eyodwa uhlala amahora angama-24. Umphumela wokuqina wesidakamizwa ukhula isikhathi esingamaviki 1 kuya ku-3.
Izinkomba zokusetshenziswa
Izinkomba eziphambili zokwamukelwa yilezi:
- Umfutho wegazi ophakeme.
- I-hypertension ye-Arterial yemisuka ehlukahlukene.
- Umfutho wegazi ophakeme kwabasakhulayo nasezinganeni ezincane.
- Ukwelashwa kwesondlo kwezimo zangemva kokuqothuka.
- Ukwehluleka kwenhliziyo (esikhundleni sezinto ezivela eqenjini le-angiotensin-converting enzyme inhibitors).
Contraindication
Lo muthi une-contraindication ngokuphelele elandelayo:
- ukwehluleka kwezinso nge-creatinine imvume ngaphansi kwe-30 ml ngomzuzu;
- i-trimester yesibili neyesithathu yokukhulelwa nayo yonke inkathi yokuncelisa;
- ukwehluleka kwesibindi okukhulu futhi okungamahlalakhona;
- isiguli sinomdlavuza we-biliary cirrhosis, hepatocellular carcinoma.
Ngokunakekela
Uma isiguli sine-revenue artery stenosis noma i-renal artery stenosis enezinso zesibili ezilahlekile, umuthi usetshenziswa kuphela ngokuhlola ubungozi obukhona kanye nomphumela olindelekile ofanele.
Ungayithatha kanjani i-vasotens N
Ngaphambi kokuqala ukwelashwa, kuyadingeka ukuthi kwenziwe uhlolo oluphelele lwezinto eziphilayo emzimbeni. Ama-lipids egazi ayizinkomba ezibalulekile zokwelashwa okwanele kwe-hypertension kanye nokuvinjwa kwezinkinga zayo. Kubandakanya ukuqoqwa kwe-cholesterol, triglycerides kanye ne-low density lipoprotein, njengoba lezi zinto zibandakanyeka ekwakhiweni kwama-atherosclerotic plaques.
Umthamo umuthi kubantu abadala ithebhulethi 1 isikhathi 1 ngosuku. Uma kungenzeka, kufanele uguqukele ekutholeni izilinganiso. Ngokusetshenziswa njalo, umfutho wegazi uyancipha futhi uzinze emavikini ama-4 wokuphuza umuthi.
Ngokuhluleka kwenhliziyo, umuthi kumele usetshenziswe isikhathi esisodwa ngosuku. Sebenzisa umuthi ngokuqapha. Umphumela ungalawulwa ngokunyamalala kwesifuba somoya nokuqubuka emilenzeni. Uma kwenzeka ukungasebenzi okwanele komuthi, ungangezelela ukugcwala kwemishanguzo ngendlela yemithi ezimele.
Umthamo umuthi kubantu abadala ithebhulethi 1 isikhathi 1 ngosuku.
Ngoshukela
Iziguli ezinesifo sikashukela zithambekele ezifweni zezinso. Izifo ezifanayo zihambisana nomsebenzi wokuphazamiseka wezinso. Lokhu kufanele kubhekwe lapho kunqunywa umuthi, ngoba kudalwa ikakhulukazi yizinso, futhi ukubambezeleka kwezinto ezisebenzayo emzimbeni kuthuthukisa imiphumela emibi yomuthi.
Imiphumela emibi
Imiphumela engathandeki ingenzeka ezithweni nasezinhlelweni ezihlukile.
Amapheshana wesisu
Lapho uthatha umuthi, Ubuhlungu besisu, isisu okuxegayo, isicanucanu, nokuhlanza kuvame ukwenzeka. Ukuqunjelwa kanye nefulethi kwenzeka kaningi. Kungenzeka futhi ukwandisa ama-enzyme wesibindi ezifundweni zaselebhu.
Lapho uthatha umuthi, ubuhlungu besisu buvame ukuvela.
Kusuka ohlelweni lwe-musculoskeletal
Imvamisa kuba nobuhlungu emuva, izinhlungu emilenzeni. Ukulimala kwemisipha kwenzeka kaningi.
Isistimu yezinzwa ephakathi
Ukwemukela i-losartan kuvame ukuhambisana nesiyezi futhi kuvame kakhulu - ukuphathwa ikhanda. Ezimweni ezingavamile, i-paresthesia, ukwethuka kwemikhawulo, i-migraine kungenzeka. Ezimweni ezingavamile kakhulu - ukulahlekelwa ukwazi okwesikhashana.
Kusuka ohlelweni lokuphefumula
Ngesikhathi sokulashwa nomuthi, ukukhwehlela, izehlakalo ze-catarrhal zomgudu wokuphefumula ongenhla, i-sinus yesinal nokuqunjelwa kwamakhala kungenzeka.
Ngesikhathi sokulashwa nomuthi, ukukhwehlela kungenzeka.
Engxenyeni yesikhumba
Ukubonakaliswa kwe-urticaria noma ukulunywa kwesikhumba kungenzeka. Lezi zinto azibalulekile futhi zidlula ngemuva kokuphela kwenkambo yokwelashwa. Ezimweni ezinzima, umuthi ungasetshenziselwa ukunciphisa imiphumela emibi.
Kusuka ohlelweni lwezitho zofuzo
Mhlawumbe ukuchama okuvame ukuhlotshaniswa nesenzo se-hydrochlorothiazide.
Kusuka ohlelweni lwezinhliziyo
Ukusetshenziswa isikhathi eside futhi okungalawulwa kwesidakamizwa kwandisa ingozi yokushaywa yi-ischemic kanye ne-myocardial infarction kubantu abane-atherosulinosis.
Ukusetshenziswa isikhathi eside nokungalawulwa kwesidakamizwa kwandisa ingozi yokushaywa yi-ischemic.
Allergies
Ngaphambi kokusebenzisa lesi sidakamizwa, kubalulekile ukwenza ukuhlolwa kokuzwela komuntu ngamunye. Uma kwenzeka kuvela ukungalingani ngendlela ye-urticaria noma ukulunywa kwesikhumba, ukusetshenziswa kwalesi sidakamizwa akuvunyelwe.
Imiphumela yokungezwani komzimba, efana ne-angioedema noma ukubonakaliswa kwe-vasculitis, kungenzeka ngesikhathi sokuphatha. Lezi zimo azivamile kakhulu, kepha ukukhula kwazo ngeke kukhishwe ngesikhathi sokwelashwa kwe-losartan.
Umthelela ekhonweni lokulawula izindlela
ILosartan ayisithinti ngqo isimo sohlelo lwezinzwa oluphakathi, kepha isiyezi sivame ukwenzeka phakathi kwemiphumela emibi. Ngokusekelwe kulokhu, ngesikhathi sokwelashwa kubalulekile ukwenqaba ukusebenzisa izimoto noma izindlela ezidinga ukugxunyekwa.
Isikhathi sokulashwa, kubalulekile ukwenqaba ukusebenzisa izimoto.
Imiyalo ekhethekile
Njengoba ukusetshenziswa komuthi kungadala ukubambezeleka kwe-potassium emzimbeni, ukusetshenziswa okuhlangene okukhona nemikhiqizo equkethe i-potassium, i-potassium-sparing diuretics (ethinta uhlelo lwe-aldosterone futhi kubangele ukulibaziseka kwe-potassium emzimbeni), kanye nezidakamizwa ezingadalulanga ngokungaqondile zidala ukwanda kwenqwaba ye-potassium kwiplasma yegazi, akufanelekile ngenxa yengozi yokuthuthukisa i-hyperkalemia.
Uma udinga ukuthatha umuthi othinta ukwakheka kwama-electrolyte egazi (ikakhulukazi i-potassium), udinga ukuvivinya njalo i-potassium esegazini.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Lesi sidakamizwa, njenganoma yiliphi elinye iqembu le-angiotensin II receptor inhibitors, sinqunyelwe ngokuqinile ukuthi sisetshenziswe abesifazane abakhulelwe ku-trimester yesibili neyesithathu, kanye nesikhathi sonke sokuncelisa. Uma kuba nesidingo sokunciphisa umfutho wegazi ophakeme ngesikhathi sokukhulelwa, kuyadingeka ukuba usebenzise ukusetshenziswa kwezidakamizwa ezivela kwamanye amaqembu okwelapha.
Lesi sidakamizwa siphulwe ngokuphelele ukuze sisetshenziswe abesifazane abakhulelwe ku-trimester yesibili neyesithathu.
Ukuyalela iVazotenza N ezinganeni
Akukho datha ekusebenziseni okuphephile kwalo muthi kubantu abangaphansi kweminyaka engu-18. Ngokusekelwe kulokhu, lesi sidakamizwa asinconywa ezinganeni, ngoba akunakwenzeka ukubikezela umphumela wazo emzimbeni wezingane.
Sebenzisa ebudaleni
Imithamo ye-losartan asebekhulile ayifani nemithamo yabantu abadala. Kepha abantu asebekhulile bavame ukuba nezinkinga ngezinso nesibindi, okufanele kucatshangwe lapho kunqunywa umuthi.
Isicelo sokusebenza kokulimala kwezinso
Endabeni ye-serum creatinine ekuqoqweni okufika ku-500 μmol (lesi sikhombisi sihambelana nesigaba 2 sesifo sezinso esingamahlalakhona), umthamo womuthi awukwazi ukuguqulwa, ngoba umsebenzi wezinsalela wezinso unele ukususwa kwesikhathi kwesidakamizwa emzimbeni.
Imithamo ye-losartan asebekhulile ayifani nemithamo yabantu abadala.
Uma imvume ye-creatinine ingaphansi kwama-30 ml ngomzuzu, khona-ke ukusetshenziswa komuthi akuvunyelwe, ngoba ngisho ne-hemodialysis inomphumela ongabazekayo maqondana nokukhishwa kwento esebenzayo emzimbeni.
Sebenzisa umsebenzi wesibindi okhubazekile
Ngokuhluleka kwesibindi, awukwazi ukunquma umuthi, ngoba i-metabolism yento esebenzayo incike kakhulu ekusebenzeni kwesibindi.
Ukweqisa
Uma kwenzeka kuba ne-overdose, i-hypotension ye-arterial ezinzima ingenzeka, okungaholela ekuthuseni, ukuwa kanye nokulahlekelwa ukwazi. Ukwelashwa okubonakalayo kusetshenziselwa ukubuyisela umfutho wegazi ojwayelekile. I-Hemodialysis ayisebenzi ekususeni izidakamizwa ngokweqile emzimbeni.
Ukuxhumana nezinye izidakamizwa
Ukwelashwa kwe-hypertension, kwesinye isikhathi kuyasebenza ukusebenzisa izidakamizwa eziningana ezivela emaqenjini ahlukene ukufezekisa izibalo zengcindezelo ezidingekayo. Imvamisa, lezinto zitholakala ndawonye ngaphakathi kwamathebulethi. Ukuhlanganiswa okuphumelela kakhulu ngalo muthi kufaka phakathi lokho kufaka phakathi i-thiazide diuretics (ummeleli oyinhloko weqembu - hydrochlorothiazide) noma i-calcium blockers (ummeleli oyinhloko weqembu onomphumela omude wokuqinisa - i-amlodipine).
Ukwelashwa kwe-hypertension, kwesinye isikhathi kuyasebenza ukusebenzisa izidakamizwa eziningana ezivela emaqenjini ahlukene ukufezekisa izibalo zengcindezelo ezidingekayo.
Ukusetshenziswa kwe-angiotensin-conver factor factor, njenge-lisinopril, kanye nezinto ezivela eqenjini lababhlokhi, akunconyiwe, ngoba indlela yokwenza isenzo iqukethe ukusebenza ohlelweni olufanayo, kepha kwezixhumanisi ezihlukile. Lokhu kubizwa ngokuthi i-blockade ephindwe kabili yohlelo lwe-renin-angiotensin. Le nhlanganisela ayithuthukisi umphumela wokwelapha, kepha yandisa ubuthi bezidakamizwa zomzimba.
Ukusebenzisana ngokubambisana ne-angiotensin-converting enzyme inhibitors kungakhulisa ukugcwala kwe-lithiamu egazini. Ukugxila okuphezulu kwe-lithium kunomthelela onobuthi emzimbeni. Le nhlanganisela yezidakamizwa kufanele igwenywe.
Lapho usebenzisa izidakamizwa ezingezona ze-steroidal ezilwa nokuvuvukala (izidakamizwa ezivimba i-cycloo oxygenase 2), ukuwohloka kwomphumela we-hypotensive kungahle kube ndawonye nalo muthi. Ukusetshenziswa okuhlangene kwale mishanguzo kubangela ukulibaziseka kwe-potassium emzimbeni, okusongela izinkinga ngohlelo lwethambo nenhliziyo.
Kufanele kuqashelwe lapho kuhlanganiswa le mishanguzo, futhi uma amapharamitha elabhorethri eshintsha noma isiguli siba sibi, kufanele kunikezwe ukuciphisa imithamo noma ukuhoxisa umuthi owodwa.
Ukuhambisana notshwala
Njengoba umuthi ufakwa emzimbeni wesibindi, utshwala kufanele bugwemeke ngenkathi uphuza umuthi. Lokhu kuzokwehlisa umthwalo esibindini futhi kuthuthukise ukusebenza kwawo.
Njengoba umuthi ufakwa emzimbeni wesibindi, utshwala kufanele bugwemeke ngenkathi uphuza umuthi.
Ama-Analog
Analogue enjengeLozart yethulwa emakethe.
Umehluko phakathi kweVazotenza neVazotenza N
Ukungeza uhlamvu H egameni lesi sidakamizwa kusho ukuthi ngaphezu kwento esebenzayo, i-hydrochlorothiazide, okuyi-diuretic, ifakiwe. Lokhu kufanele kubhekwe lapho kunqunywa umuthi, ngoba ukuba khona kwe-hydrochlorothiazide kunezela imiphumela eyengeziwe ye-hypotensive kanye nemiphumela yayo emibi.
Izimo zokuphumula Vazotenza N kusuka ekhemisi
Ngingakwazi ukuthenga ngaphandle kadokotela
Njengazo zonke izidakamizwa eqenjini le-angiotensin II receptor blockers, ihlakazwa ekhemisi ngaphandle kadokotela.
Intengo yeVazotens N
Intengo iyahlukahluka kusuka kuma-ruble angama-250 kuya kwangama-650.
Njengazo zonke izidakamizwa eqenjini le-angiotensin II receptor blockers, ihlakazwa ekhemisi ngaphandle kadokotela.
Izimo zokugcina zomuthi
Umuthi ugcinwa emaphaketheni awo okuqala endaweni yokushisa yasekamelweni. Gcina ungafinyeleleki ezinganeni.
Isikhathi sokuphelelwa yisikhathi
Iminyaka emithathu kusukela ngosuku lokukhiqizwa eliboniswe kuphakheji.
Umkhiqizi uVazotenza N
I-Actavis (Iceland).
Ukubuyekezwa mayelana neVasotense N
Odokotela
USergey, oneminyaka engama-52 ubudala, udokotela wezifo zenhliziyo, eMoscow
Ama-angiotensin receptor inhibitors yizidakamizwa ezibalulekile ekwelapheni umfutho wegazi ophezulu kubantu abadala. Imvamisa sisebenzisa i-losartan njengesidakamizwa esiyinhloko ezigulini ezikhononda ngokukhwehlela emuva kokusebenzisa isikhathi eside i-ACE inhibitors.
U-Oksana, oneminyaka engama-48, udokotela ojwayelekile, uChelyabinsk
Umuthi osebenzayo ekwelapheni umfutho wegazi ophakeme esigabeni sesibili nesesithathu. Ngibekela iziguli njengomuthi oyinhloko, lapho i-losartan kuphela ingasenele ukunciphisa ingcindezi.
Iziguli
U-Alexander, oneminyaka engama-57 ubudala, uKazan
Sekuphele iminyaka eyi-10 ngiphuza lesi sidakamizwa, njengoba ngihlaselwa umfutho wegazi ophakeme. Bengihlala ngithatha i-lisinopril, kepha bekukhona ukukhwehlela okungasuswa. Udokotela womndeni uthe bekungumphumela we-lisinopril, futhi wangidlulisela ezidakamizweni ezivela eqenjini le-angiotensin receptor inhibitors. Nge-losartan kulula ukulawula izibalo zomfutho wegazi, futhi ukukhwehlela sekunyamalala cishe.
UDmitry, oneminyaka engama-68, u-Astrakhan
Sekuphele iminyaka engaphezu kwengu-20 ngihlaselwa umfutho wegazi ophakeme. Muva nje, odokotela bathola ukwehluleka kwenhliziyo. Bathe lokhu kungenxa yokuncipha kwenxephezelo lomfutho wegazi ophakeme, futhi banquma lesi sidakamizwa. Ngokwami, ngizwa sengathi ukufupheka komzimba kuye kwehla kancane futhi amandla amancane athe xaxa, okuyinto engijabulayo.
