Ungayisebenzisa kanjani i-Captopril yesifo sikashukela?

Ukuba khona kweCaptopril kwikhabhathi yemithi yasekhaya akusizi kuphela ngomfutho wegazi ophakeme, kodwa futhi nokuboniswa kwe-nephropathy evela kwisifo sikashukela. Kunconywa ukusebenzisa umuthi kuphela ngomuthi kadokotela, njengoba Imithamo engalungile ingadala imiphumela emibi.

I-ATX

C09AA01 (i-Captopril)

Ukuba khona kweCaptopril kwikhabhathi yemithi yasekhaya akusizi kuphela ngomfutho wegazi ophakeme, kodwa futhi nokuboniswa kwe-nephropathy evela kwisifo sikashukela.

Khipha amafomu nokwakheka

Ukulungiswa kuyinto emhlophe ekristali, i-soluble etholakala kalula ku-methyl, i-ethyl yotshwala namanzi, enephunga elibuthakathaka lesibabule. I-solubility yesidakamizwa ku-ethyl acetate ne-chloroform ingumyalo wesisindo esibi kakhulu. Into ayincibiliki ku-ether.

Amaphilisi

Umkhiqizo uyatholakala kumathebulethi ahlanganisiwe wokuphatha kwangaphakathi noma okufakwayo. Ngaphezu kwesithako esiyisisekelo esisebenzayo enanini le-12.5-100 mg, ithebhulethi iqukethe ezinye izinto ezisizayo: i-silicon dioxide, i-stearic acid, i-MCC, isitashi, njll.

Kusebenza kanjani

Umphumela we-pharmacological we-Captopril usafundwa.

Ukucindezelwa kohlelo lwe-renin-angiotensin-aldosterone (PAA) nomuthi kuholela emiphumeleni yawo emihle ekwelapheni ukwehluleka kwenhliziyo nomfutho wegazi ophakeme.

I-Renin eyenziwe yizinso zisebenza egazini ku-plasma globulin, okuholela ekwakhekeni kwe-decapeptide engasebenzi kanye ne-angiotensin. Ngemuva kwalokho, ngaphansi kwethonya le-ACE (i-angiotensin-converting enzyme), into ye-vasoconstrictor yemvelaphi ye-endo native, i-angiotensin l iguqulwa ibe yi-angiotensin ll, evuselela ukuhlanganiswa kwe-aldosterone yi-adrenal cortex. Ngenxa yalokhu, amanzi nesodium kugcinwa izicubu.

Isenzo se-Captopril ukwenza buthaka inani eliphakeme lomzimba we-vasipension (OPSS).

Ukulungiswa kuyinto emhlophe ekristali, i-soluble etholakala kalula ku-methyl, i-ethyl yotshwala namanzi, enephunga elibuthakathaka lesibabule.

Umkhiqizo uyatholakala kumathebulethi ahlanganisiwe wokuphatha kwangaphakathi noma okufakwayo.

Ngaphezu kwesithako esiyisisekelo esisebenzayo enanini le-12.5-100 mg, ithebhulethi iqukethe ezinye izinto ezisizayo: i-silicon dioxide, i-stearic acid, i-MCC, isitashi, njll.

Isenzo se-Captopril ukwenza buthaka inani eliphakeme lomzimba we-vasipension (OPSS). Kulokhu, ukuphuma kwenhliziyo kuyanda noma kuhlale kungashintshiwe. Izinga lokuhlunga ku-renal glomeruli nalo alishintshi.

Ukuqala komphumela we-hypotensive womuthi kwenzeka emizuzwini engama-60-90 ngemuva kokuthatha umthamo owodwa.

Umuthi ubekelwe isikhathi eside, ngoba umfutho wegazi ezitsheni wehla kancane kancane ngaphansi kwethonya lomuthi. Ngokusetshenziswa okuhlangene kwe-Captopril ene-thiazide diuretics, ukungezwa kwabo kuyabonakala. Ukwemukela kuhlanganiswe ne-beta-blockers akubangeli ukwanda komphumela.

Umfutho wegazi ufinyelela izinombolo ezijwayelekile kancane kancane, ngaphandle kokuholela ekwakhiweni kwe-tachycardia kanye ne-orthostatic hypotension. Akukho ukwanda okusheshayo kwengcindezi yegazi nangokukhishwa ngokuqinile komuthi.

Ukwehla kwesilinganiso senhliziyo, ukwehla komfutho wegazi, umthwalo wenhliziyo, ukumelana kwemithambo yegazi, ukukhuphuka kokukhishwa kwenhliziyo, kanye nezinkomba zokuhlolwa kokuvivinya umzimba konke kubonwa ezigulini ezine-pathology yesistimu yenhliziyo ngesikhathi se-Captopril therapy. Ngaphezu kwalokho, le miphumela iyatholakala ezigulini ngemuva kokuthatha umthamo wokuqala, uphikelela kukho konke ukwelashwa.

Ukwehla komthamo wenhliziyo kuyabonakala ezigulini ezine-pathology yesistimu yenhliziyo ngesikhathi sokwelashwa nge-Captopril.

I-Pharmacokinetics

Umuthi osebenzayo uyancibilika ujusi we-gastric bese ungena egazini ungena emathunjini. Ukuhlushwa okuphezulu egazini kufinyelelwa cishe ihora.

Ngegazi, le nto isebenza ku-ensaini ye-ACE emaphashini nasezinso futhi iyakuvimbela. Umuthi ukhishwa ngaphezulu kwesigamu esimweni esingashintshiwe. Ngendlela ye-metabolite engasebenzi, itafakwa ezingxenyeni zomchamo ngomchamo. I-25-30% yezidakamizwa ingena ekuxhumaneni namaprotheni egazi. U-95% wento udonswa izinso ngemuva kwamahora angama-24. Ngemuva kwamahora amabili ukuphathwa, ukugxila egazini kuncipha cishe ngesigamu.

Ukwehluleka kwangempela kwiziguli ezisebenzisa umuthi kuholela ekubambezelweni kwawo emzimbeni.

Okusizayo

Umuthi uhloselwe ukwelashwa kwe:

1. I-hypertension ye-arterial: ifomu lethebhulethi lisetshenziswa njengokwelashwa okuyinhloko kwiziguli ezinomsebenzi wezinso ogcinwe. Iziguli ezinenkinga yokusebenza kwe-renal, ikakhulukazi lezo ezine-collagenosis e-systemic, akufanele ziyisebenzise uma imiphumela emibi isivele ikhonjwe kwezinye izidakamizwa. Ithuluzi lingasetshenziswa njenge-monotherapy noma lihlanganiswe nezinye izinto ze-pharmacological.
2. Ukwehluleka kwenhliziyo kwe-Congestive: I-Captopril therapy isetshenziswa ngokuhambisana ne-digitalis ne-diuretics.
3. Ukwephulwa kwe-infarction kwasemuva komsebenzi we-ventricular wesobunxele: izinga lokusinda kweziguli ezinjalo lenyuswa ngenxa yokwehla kwengxenyana yokukhipha kwenhliziyo kuya ku-40%.
4. I-nephropathy yesifo sikashukela: isidingo se-dialysis kanye nokufakelwa kwezinso sincishiswa ngokunciphisa ukuqhubekela phambili kokuphazamiseka kwe-nephrotic. Isetshenziselwa i-insulin ethembele kwesifo sikashukela kanye nephropathy ene-proteinuria engaphezu kuka-500 mg / ngosuku.
5. Umfutho wegazi ophakeme.

I-Captopril yenzelwe ukwelashwa kwe-renal hypertension.

Contraindication

Ngokuya ngemiyalo esetshenziswayo, umuthi uphethwe ku:

1. I-Hypersensitivity to ACE inhibitors.
2. I-hyperaldosteronism eyisisekelo.
3. Kunobufakazi bomlando wamacala edema kaQuincke nanoma yikuphi okunye ukuxabana kwezidakamizwa kuleli qembu.
4. Ukukhulelwa
5. Isisu

Futhi kwenqatshelwe ukusithatha kungakapheli amahora angama-36 ngemuva kokuphuza i-Valsartan kanye nokuhlanganiswa ne-Aliskiren (umuthi osetshenziselwa isifo sikashukela).

Thatha ngokucophelela, ngemuva kokuhlola izinzuzo nezingozi zokusebenzisa umuthi:

1. Ezinganeni.
2. Kanye nezinso ezifakelwe isiguli.
3. Uma kwenzeka ukungasebenzi kahle kwezinso.
4. Ngokuvuvukala kwemilenze.
5. Nge-unilateral (uma izinso lihlukile) noma i-artery stenosis ye-bilatal.
6. Ngokuncipha kwenani lamaplatelet kanye nama-leukocytes egazini.
7. Ngokunciphisa kwe-ishayela ngenxa ye-pathologies ehlukahlukene evimbayo eyehlisa ukuhamba kwegazi kusuka enhliziyweni kuya emithanjeni.
8. Ngokukhula kwe-potassium egazini.

Umuthi uthathwa ngokuqapha ngokuxhamazela kwemilenze.

Ngokusho kwemiyalo esetshenziswayo, umuthi ubekiwe ku-lactation.

Ukukhulelwa kungukuphikisana nokuthatha i-Captopril.

I-Captopril ithathwa ngokuqapha lapho kunciphisa inani lama-thrombotic nama-leukocytes egazini.

Ungayithatha kanjani i-Captopril

Ngaphansi kolimi noma isiphuzo

Ngomfutho wegazi ophakeme, thatha kancane noma ngomlomo ngemuva kokudla.

Kuyadingeka ukuphuza umuthi ihora ngaphambi kokudla, njengoba okuqukethwe esiswini kunganciphisa ukumunyaniswa kwento ngama-30- 40%.

Ukwelashwa isikhathi eside kuhambisana nokuthatha umuthi ngaphakathi. Uma lo muthi usetshenziselwa ukunakekelwa okuphuthumayo nokwenyuka komfutho wegazi obangelwa ngumzwelo noma ngokomzimba, unikezwa ngaphansi kolimi.

Kuthatha isikhathi esingakanani

Imizuzu eyi-15 ngemuva kokuphathwa ngomlomo, into ijikeleza egazini.

Ngokuphatha okungaphansi, i-bioavailability kanye nezinga lokuvela kokukhula komphumela.

Ngingaphuza kangaki

Ukuqala kokwelashwa kuhambisana nokuphathwa kwomuthi ohlukaniswe ngemithamo yakusihlwa neyasekuseni.

Ukwelashwa kokuhluleka kwenhliziyo kubandakanya ukusetshenziswa kwesidakamizwa kathathu ngosuku. Uma inhloso ye-Captopril kuphela ingakwazi ukunciphisa kahle ingcindezi, i-hydrochlorothiazide ichazwe njenge-antihypertensive yesibili. Kukhona nefomu lomthamo elikhethekile elibandakanya zombili lezi zinto (iCaposide).

Ngomfutho wegazi ophakeme, i-captopril ithathwa ngomlomo ngemuva kokudla.

Uma i-Captopril isetshenziselwa ukunakekelwa okuphuthumayo nokwenyuka komfutho wegazi okuvuswa ukuzikhandla ngokomzwelo noma ngokomzimba, kunikezwa ngaphansi kolimi.

Imizuzu eyi-15 ngemuva kokuphathwa ngomlomo, into ijikeleza egazini.

Umthamo

Ngaphansi kwengcindezi

Ukwelashwa onomfutho omkhulu kuqalwa ngomthamo wansuku zonke we-25-50 mg. Lapho-ke umthamo uyanda, njengoba kuyalelwe udokotela, kancane kancane kuze kube yilapho umfutho wegazi uvamile. Noma kunjalo, akufanele idlule inani eliphakeme le-150 mg.

Ukwehluleka kwenhliziyo okungapheli

Ukwelashwa kokuhluleka kwenhliziyo kuhlanganisa ukuqala ngokusebenzisa imithamo eyodwa ye-6.5-12.5 mg ngokunyuka okuthe xaxa uma kunesidingo.

Nge-infyoction ye-myocardial

Ukuqala kokuphatha kwenzeka ngosuku lwesithathu ngemuva kokulimala kwemisipha yenhliziyo. Umuthi udakiwe ngokuya ngohlelo:

1. I-6.25 mg kabili nsuku zonke ezinsukwini zokuqala ezingama-3-4.
2. Phakathi nesonto, i-12.5 mg izikhathi ezi-2 ngosuku.
3. Amaviki ama-2-3 - 37,5 mg, ahlukaniswe ngemithamo emithathu.
4. Uma umuthi ubekezelelwa ngaphandle kokuphendula okungahambi kahle, umthamo wansuku zonke uguqulwa ube ngu-75 mg, ukhuphuke njengoba kudingeka ku-150 mg.

Ukuthatha umuthi wesifo sikashukela

Isifo sikashukela i-mellitus enokuqukethwe okuphezulu kwe-albhamuin kumchamo sidinga ukusetshenziswa komthamo ophindwe kabili wezidakamizwa ngosuku, olingana no-50 mg. Uma inani lamaprotheni lidlula ku-500 mg kumchamo wansuku zonke - 25 mg kathathu.

Nge-diphicathy yesifo sikashukela

Ngokuhambisana nesifo sikashukela se-mellitus uhlobo l nephropathy, umthamo we-75-100 mg / ngosuku uhlukaniswe ngemithamo engu-2-3.

Imiyalo ekhethekile

Ukuhambisana notshwala

Ukusetshenziswa okuhlanganisiwe kwe-ethanol ne-captopril kuholela ekwandeni komphumela wokugcina ngenxa yemiphumela ye-vasodilating yotshwala. Izimpawu zokudakwa: i-syncope, ukuthuthumela okungalawulwa, ukubanda, ubuthakathaka.

Ngaphezu kwalokho, inhlanganisela yabo yehlisa izinga le-potassium egazini ngenxa yokwephulwa kokufakwa kwayo. I-Hypokalemia ingakhuphula umfutho wegazi.

Ngemuva kokusetshenziswa okuhlangene kwe-ethanol ne-Captopril, kuzovela izimpawu zokudakwa ezinjengokuthuthumela okungalawulwa nokushiswa.

Ukushayela izimoto kudinga ukunakwa okuningi, njengoba umuthi ubangela imiphumela emibi eminingi, ukusetshenziswa kwawo kungaholela ezingozini.

Isidingo somuthi we-hypertension ye-arterial ngesikhathi sokuncelisa ibanga lokuguqukela ekunikezelweni kokudla okufakelwe.

Isimo esijwayelekile somzimba kanye nenani lotshwala obuthathiwe kuthinta umphumela wokuhambisana kwalezi zinto ezimbili.

Umthelela ekhonweni lokushayela izimoto

Ukushayela izimoto nokusebenza ngamasu kudinga ukunakwa okuningi. umuthi ubangela imiphumela emibi eminingi, ukusetshenziswa kwawo kungaholela ezingozini. Kunconywa ukumisa okwesikhashana ukushayela.

Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba

Ukuyalela abesifazane abakhulelwe kudinga ukunakwa okukhethekile kusuka kuma-cardiologists. Ukuntuleka kwedatha yokuthi le nto iyithinta kanjani ingane, lapho kukhona ukusabela okungekuhle kuholela ekushiyeni kokusetshenziswa kwomuthi ngaphandle kwesidingo esibalulekile.

Uma umuthi usabekiwe, kufanele kuqhutshekwe nokuhlolwa okwenziwa njalo kwe-Ultra.

Isidingo somuthi we-hypertension ye-arterial ngesikhathi sokuncelisa ibanga lokuguqukela ekunikezelweni kokudla okufakelwe. Uma, ngasizathu simbe, ukuqedwa kwe-lactation kungenakwenzeka, umuthi usetshenziswa ngaphansi kokulawulwa okuqinile kwesimo sengane: amazinga e-potassium, umsebenzi wezinso, umfutho wegazi.

Imiphumela emibi

Amapheshana wesisu

1. Ukwehla kwesisindo okungazelelwe.
2. Izilonda nomlomo owomile, i-stomatitis.
3. I-Dysphagia
4. Dysgeusia.
5. Ukubonakaliswa kwe-dyspeptic.
6. I-Angioedema yamathumbu.
7. Ukwephulwa kohlelo lwe-hepatobiliary: hepatitis, cholestasis, necrosis yamaseli wesibindi.

Ukusetshenziswa kwomuthi kungaholela ekunciphiseni isisindo.

I-Bowel angioedema ingumphumela weCaptopril.

Ngemuva kokusebenzisa umuthi, ukudana, ukudangala kohlelo lwezinzwa kungenzeka.

Izitho zeHematopoietic

1. I-Agranulocytosis.
2. Kwehlisiwe ama-platelet nama-neutrophils egazini.
3. Ama-eosinophils aphakanyisiwe.

Isistimu yezinzwa ephakathi

1. Ukudana, ukudangala kohlelo lwezinzwa.
2. Ukuqina, ukuphazamiseka kwe-gait.
3. Izinguquko endaweni ebucayi: ukwephula iphunga, umbono, ukudonsa emilenzeni.
4. Ukubonakaliswa kokunganaki: ukozela, isiyezi.

Kusuka ohlelweni lokuphefumula

1. I-Spasm, ukuvuvukala kwe-bronchi.
2. Ukuvuvukala kodonga lwemithambo ye-alveolar - i-pneumonitis.
3. Ukukhwehlela owomile, ukufushane komoya.

Ngemuva kokusebenzisa i-Captopril, i-edema kaQuincke kungenzeka.

Ukwephulwa kwe-potency - umphumela ongathandeki ngemuva kokuthatha i-Captopril.

Ngokwengxenye yohlelo lokuphefumula, ukukhwehlela okungenzeka kungenzeka.

Kusuka ohlelweni lwezitho zofuzo

1. Ukwanda ngamaprotheni emchameni, e-oliguria, ekusebenzeni kwe-renal.
2. Ukwephulwa kwe-potency.

Isikhumba nezicubu ezithambile

1. Ukulahlekelwa izinwele.
2. I-Exfoliative ne-Photodermatitis.
3. I-Epidermal necrolysis ebangelwa ubuthi.
4. Tinea versicolor.

Allergies

I-Steven-Johnson syndrome, ukusabela kwe-anaphylactoid, i-Quincke edema.

Ukweqisa

Ukuthatha imithamo ewedlula imithamo enconyiwe kungadala ukwehla okukhulu komfutho wegazi. Ngaphezu kwalokho, kungahle kube nokuxakanana ngendlela ye-thromboembolism yeziqu ezinkulu zempi, imithambo yegazi yenhliziyo nobuchopho, okuthe, kungaholela ekuhlaselweni yisifo senhliziyo nokushaywa unhlangothi.

Njengecebo lokwelapha, imisebenzi elandelayo yenziwa:

1. Hlanza isisu ngemuva kokukhansela noma ukunciphisa umthamo womuthi.
2. Buyisela umfutho wegazi, unikeze isiguli isikhundla sokuqamba amanga nemilenze yaso iphakanyisiwe, bese ufaka ukumfaka kwe-saline, i-Reopoliglyukin noma i-plasma.
3. Yethula i-epinephrine ngokungena noma ngokujikijela ukwandisa umfutho wegazi. Njengama-desensitizing agents, sebenzisa i-hydrocortisone nama-antihistamines.
4. Yenza i-hemodialysis.

Ukuthatha imithamo ephakeme kunalokho okunconyiwe kungaholela ekuhlaselweni yisifo sohlangothi.

Uma kwenzeka okweqa umuthi, kubalulekile ukuhlanza isisu.

Njengecebo lokwelapha uma kungenzeka kusetshenziswe ngokweqile, i-hemodialysis iyenziwa.

Ukuxhumana nezinye izidakamizwa

I-Azathioprine ehambisana ne-Captopril ivimbela umsebenzi we-erythropoietin, i-anemia yenzeka.

Ukusetshenziswa okuhlanganayo nge-cytostatics - ukwehla kwenani lamaseli amhlophe egazi.

I-Hyperkalemia - ngenhlanganisela yokwelapha ne-potassium-sparing diuretics.

Kwangathi kungathuthukiswa imiphumela ye-digoxin, okuholele ekudakweni.

I-Aspirin ene-Captopril yenza buthaka umphumela we-hypotensive.

Ama-Analog

Ukufana kwesidakamizwa kufaka phakathi: I-Kapoten, i-Kaptopres, i-Normopres, i-Angiopril, iBlockordil, i-Captopril STI, i-AKOS, i-SANDOZ, i-FPO nabanye.

Zihlukile ngenani lezinto ezisebenzayo kuthebhulethi eyodwa, kuhlu lwezinto ezingezekile ezingasebenzi. Kwezinye izimo, ukwakheka nombala wethebhulethi kungahluka. Umphumela wesidakamizwa sokuqala, iKapoten, ngokusho kodokotela abawubekayo, unamandla ukwedlula ezinye izinhlobo zomuthi.

Izimo zokuphumula ze-Captopril ezivela ekhemisi

Kuphela ngokuya ngeresiphi ebhalwe kwifomu elikhethekile ngesiLatini, isibonelo:

1. I-Rp. I-Captoprili 0.025.
2. D.t.d. I-20 ku-tabulettis.
3. S. 1 ithebhulethi isigamu sehora ngaphambi kokudla ekuseni nakusihlwa.
   

   I-Kapoten kuthiwa yi-Captopril analogues.

   

   I-Captopril ikhishwa kuphela emgqonyeni kadokotela, obhalwe kwifomu elikhethekile ngesiLatini.

   

   Intengo yesidakamizwa iyahluka phakathi kwama-ruble ayi-9-159.

Malini

Intengo yesidakamizwa iyahluka phakathi kwama-ruble ayi-9-159.

Izimo zokugcina

Isitoreji, kuncike emazingeni okushisa we- + 15 ... + 25 ° C, kude nezingane.

Impilo yeshelf yeCaptopril

Ifanele iminyaka emi-4.

Ukubuyekezwa kodokotela neziguli mayelana ne-Captopril

U-Oksana Aleksandrovna, uP Pskov, udokotela wezifo zamehlo: "Ngisebenzisa i-Captopril njenge-ambulensi yezinkinga. Imvamisa yehluleka, ngakho-ke kungcono ukunaka ukuthi ngabe wumuthi ojwayelekile noma wangempela."

UMaria, oneminyaka engama-45 ubudala, eMoscow: "Ngiphuza lesi sidakamizwa nginconywa udokotela wenhliziyo ngezikhathi zokucindezela. Umphumela awubi mkhulu kunowaseMoxonidine ojwayelekile. Wenza umsebenzi wawo wosizo ngokuphelele, futhi ngentengo enhle kakhulu."

UVitaliy Konstantinovich, uKrasnodar, isazi sezinhliziyo: "Uma isiguli sinokuzikhethela, silingane neKapoten noma i-Captopril, ngincoma owokuqala. Yebo, into esebenzayo kuzo zombili lezi zidakamizwa iyefana, kepha eyodwa ingeyokuqala, kanti eyesibili iyikhophi. Iziguli zivame ukukhala ngomphumela obuthakathaka. "yize isetshenziswa ezimweni lapho usizo kufanele lusheshe futhi lusebenze. Ngincoma iKapoten ezigulini ezinenkinga ye-hypertensive, ngoba nami bengizothatha lesi sidakamizwa. Ngaphezu kwalokho, intengo iyasivumela."