Izidakamizwa ze-diuretic zohlobo 2 lwesifo sikashukela zivame ukusetshenziselwa ukwelashwa okwenzeka ngokuqhubeka komfutho wegazi oshukela, ukungapheleli noma lapho kunesidingo sokuqeda i-edema yomlenze.
Kuze kube manje, sekuqhamuke inani elikhulu lemithi ehlukahlukene engakhuphula inani lomchamo ochithiwe.
Ukukhethwa kwe-diuretic, uma kunesidingo, kufanele kwenziwe ngudokotela ohambelayo ngokusekelwe emiphumeleni yokuhlaziywa, kucatshangelwa ubuntu bomzimba wesiguli.
Umuthi owodwa ovamile yi-indapamide.
Indapamide ingeyeqembu le-thiazide-like diuretics. Lesi sidakamizwa sinomphumela we-vasodilating.
Ama-diuretics asetshenziswa njengezakhi zokwelashwa okuyinkimbinkimbi sikashukela. Le mishanguzo ithuthukisa imiphumela ye-ACE inhibitors.
Ama-Taizide-diuretics, afaka i-Indapamide, anomthelela omnene kushukela. Le mishanguzo inethonya elincane enqubweni yokuphuma kwe-potassium kanye nezinga le-glucose namafutha egazini.
Ukwemukelwa kwe-Indapamide yesifo sikashukela sohlobo 2 akuholeli ekungasebenzi kahle ekusebenzeni okuvamile kwezinso zesiguli.
Umuthi unomphumela we-nephroprotective emzimbeni wesiguli kunoma yisiphi isigaba sokulimala kwezinso, okuhambisana nokwakhiwa kwesifo sikashukela sohlobo oluzimele lwe-insulin.
Ukwakheka komuthi, incazelo ejwayelekile ne-pharmacotherapy
Umuthi ukhiqizwa imboni yezemithi ngendlela yamathebulethi okuphatha ngomlomo.
Umuthi ongaphezulu une-coating film.
Isithako esikhulu esisebenzayo somuthi yi-indapamide, ithebhulethi eyodwa iqukethe u-2,5 mg wekhompiyutha.
Ngaphezu kwento esebenzayo, amakhambi ezengeziwe amakhemikhali anendima asizayo alethwa ekwakhekeni komuthi.
Izakhi ezinjalo ezisizayo yizinto ezilandelayo:
- i-lactose monohydrate;
- i-povidone-K30;
- i-crospovidone;
- i-magnesium stearate;
- i-sodium lauryl sulfate;
- i-talcum powder.
Ukwakheka kwegobolondo engaphezulu yethebhulethi kufaka phakathi amakhemikhali alandelayo:
- I-Hypromellose.
- IMacrogol 6000.
- I-Talc.
- I-titanium dioxide
Amathebulethi anomumo oyindilinga, o-convex futhi apendwe mhlophe.
Umuthi ungoweqembu lemithi yokuqola. Izakhiwo zalo ziseduze kakhulu ne-thiazide diuretics.
Ngemuva kokuthatha umuthi, ukumbumbuluzwa komchamo we-sodium ne-chlorine emzimbeni womuntu kuyanda. Ngezinga elincane kuthinta inqubo ye-excretion ye-potassium ne-magnesium ions emzimbeni.
Umuthi unamandla okuvimba iziteshi ze-calcium zezitho futhi ukhuphule ukuqina kodonga lwamathambo wemithambo yegazi, wehlise ukumelana okuphelele kwemisipha yohlelo lwemithambo yegazi oluphelele.
Ukuthatha umuthi kusiza ukunciphisa i-hypertrophy ye-ventricle yenhliziyo yesokunxele.
Ukusetshenziswa kwesidakamizwa akulithinti izinga lokuxineka kwe-lipid egazini futhi akukuthinti ukuqina koshukela.
Ukuthatha umuthi kukuvumela ukuthi unciphise ukuzwela kodonga lwe-vascular emiphumeleni ye-norepinephrine ne-angiotensin II kuyo, futhi ikuvumela ukuthi uthuthukise ukwakheka kwe-prostaglandin E2 emzimbeni.
Ukusetshenziswa kwomuthi kunciphisa ubukhulu bokwakhiwa kwama-radicals mahhala futhi ezinzile emzimbeni.
Umphumela ophikelelayo we-umuthi ukhula ngesonto ngemuva kokuqala komuthi futhi uphikelela usuku ngemuva komthamo owodwa ngosuku.
I-Pharmacokinetics yesidakamizwa
Ngemuva kokuthatha umuthi, umunca ngokuphelele emgudwini wesisu ungene ohlelweni lokujikeleza. Umuthi une-bioavailability ephezulu, ecishe ibe ngu-93%.
Ukudla kunomthelela obambekayo ekufakweni komuthi egazini, kepha kungathinti inani lokudakiswa kwezidakamizwa. Ukuhlushwa okuphezulu kutholakala egazini amahora ama-1-2 ngemuva kokuthatha umuthi ngaphakathi.
Ngokusetshenziswa okuphindaphindiwe kwesidakamizwa, ukuguquguquka kokuhlushwa kwalo emzimbeni phakathi kwemithamo kuyancishiswa. Umuthi ufinyelela ekuhlolweni okulinganayo emzimbeni ngemuva kwezinsuku eziyi-7 zokuphuza umuthi.
Ukuphila kwesigamu umuthi kusuka emahoreni ayi-14 kuye kwangama-24. Umuthi uhlangana nezakhi zamaphrotheni ze-plasma yegazi. Izinga lokubopha amaprotheni cishe lingama-79%.
Ingxenye esebenzayo yesidakamizwa iyakwazi nokubopha nge-elastin yezakhi zemisipha ebushelelezi eyingxenye yodonga lwe-vascular.
Umuthi unamandla okudlula emvinini we-izicubu, uyakwazi ukuwela umgoqo we-placental. Lapho uthatha umuthi, udlulela ebisini lwebele.
Ukumiswa kwemvelo kwengxenye esebenzayo kwenzeka ezicutshini zesibindi. Ukwembiwa kwengxenye esebenzayo kwenziwa ngendlela yama-metabolites yizinso ezinamanani angama-60 kuye kuma-80%. Ngemijovo, cishe i-20% ikhishwa emathunjini.
Uma isiguli sinokuhluleka kwe-renal, i-pharmacokinetics yomuthi ayishintshi. Ukuqongelela imali emzimbeni akwenzeki.
Izinkomba kanye ne-contraindication zokuphuza umuthi
Isibonakaliso esiyinhloko sokuthatha umuthi wesifo sikashukela ukuthuthukiswa kwesiguli esine-hypertension ye-arterial.
Njenganoma iyiphi enye insiza yezokwelapha, i-Indapamide inezinombolo eziningi zokuphikisana okufanele zisetshenziswe.
Ukusetshenziswa kwesidakamizwa kuvunyelwe uma kungekho ezinye izinto eziphikisayo esigulini.
I-contraindication eyinhloko ekusebenziseni umuthi yile elandelayo:
- isiguli sinokuzwela okuphezulu kwezidakamizwa ezenziwe ngesisekelo se-sulfonamide;
- ukungabekezeleli iziguli ezine-lactose;
- isiguli sine-galactosemia;
- uma umuntu embula izimpawu zesifo se-malabsorption se-glucose noma galactose;
- ukuhlonza uhlobo olunamandla lokwehluleka kwezinso esigulini;
- ukuba khona kwezimpawu ze-hypokalemia;
- ukuba khona kokwehluleka okukhulu kwesibindi;
- isifo sikashukela sezinso;
- isikhathi sokukhulelwa nokuncelisa ibele;
- iminyaka yesiguli efinyelela eminyakeni eyi-18;
- ukwenza ukwelashwa lapho ukuphathwa kanyekanye kwama-ejenti okwandisa isikhathi se-QT kwenziwa.
Ngokuqapha, kufanele uphuze umuthi lapho ubona ukungasebenzi kahle kwezinso nezinso, uma kwenzeka ukuphazamiseka kwesiguli ebhalweni le-electrolyte yamanzi, uma kukhona i-hyperparathyroidism emzimbeni.
Ngaphezu kwalokho, i-Indapamide kufanele isetshenziswe ngokucophelela lapho kwenziwa ukwelashwa lapho kusetshenziswa khona izidakamizwa ze-antiarrhythmic.
Ukuqapha kuyasetshenziswa lapho usebenzisa umuthi ukuthuthukisa isifo sikashukela esenkingeni yokubola.
Imiyalo yokusebenzisa amaphilisi
Ukwemukelwa kwalesi sidakamizwa kwenziwa ngaphandle kwesimiso sokudla ukudla. Ukuphuza amaphilisi kufanele kuhambisane nokuphuza amanzi amaningi. Isikhathi esithandwa kakhulu sokuphuza umuthi amahora asekuseni.
Umthamo ojwayelekile wokwelapha ukwelashwa ngu-2,5 mg noma ithebhulethi eyodwa ngosuku. Uma ngemuva kwamaviki angama-4-8 ekwelashwa imiphumela oyifunayo ayitholakali, umthamo akufanele ukhuphuke. Ukwanda komthamo kungasongela intuthuko emzimbeni wemiphumela emibi kusukela ekusebenziseni umuthi.
Uma kungekho imiphumela yokwelashwa, kunconywa ukuthi ushintshe umuthi ube ophumelela kakhudlwana. Uma kwenzeka ukwelashwa kwenziwa kusetshenziswa izidakamizwa ezimbili, umthamo we-Indapamide uhlala ungashintshiwe ku-2,5 mg ngosuku.
Lapho uthatha i-Indapamide kumuntu, eminye imiphumela emibi ingahle ibonakale ekuphazamisweni ekusebenzeni kwezinhlelo zomzimba ezahlukahlukene.
Imiphumela emibi ejwayelekile ye-Indapamide yesifo sikashukela yilena:
- Uhlelo lokugaya. Mhlawumbe ukukhula kwesifo sohudo, ukuqunjelwa, ukubonakala kobuhlungu esiswini. Imvamisa kuba nomuzwa wokucanuzelelwa kwenhliziyo futhi womile emgodini womlomo. Mhlawumbe ukubonakala kokuhlanza ezimweni ezingavamile, ukuthuthukiswa kwe-pancreatitis kungenzeka.
- Isistimu yezinzwa ephakathi. Mhlawumbe ukuthuthukiswa kwesimo se-asthenic, ukubukeka kokukhathazeka okwandayo, ukukhanda ikhanda ngesifo sikashukela, ukwanda kokuqina. Ezimweni ezingavamile, ukukhathala okwandayo nobuthakathaka obujwayelekile kuyavela. Kwesinye isikhathi kuba nomuzwa wokuthi i-malaise ejwayelekile, imisipha yemisipha, ukungasebenzi kanye nemizwa yokukhathazeka.
- Engxenyeni yesistimu yokuphefumula, ukuthuthukiswa kokukhwehlela, i-pharyngitis, i-sinusitis futhi, ezimweni ezingavamile, i-rhinitis kungenzeka.
- Uhlelo lwenhliziyo. Cishe ukuthuthukiswa kwe-orthostatic hypotension, izinguquko ku-electrocardiogram, kungenzeka ukuthi isiguli sihlakulele i-arrhythmias enhliziyweni futhi sikhuphule izinga lokushaya kwenhliziyo.
- Uhlelo lwe-Urinary. Amathuba aphezulu okuthola izifo ezenzeka njalo kanye ne-polyuria.
- Isikhumba. Mhlawumbe ukuthuthukiswa kokungezwani komzimba kuboniswe ngendlela yokuqhuma kwesikhumba, ukulunywa kwesikhumba kanye ne-hemorrhagic vasculitis.
Ngaphezu kwale miphumela emibi, i-thrombocytopenia, i-leukopenia, i-agranulocytosis, kanye nokwanda kwe-systemic lupus erythematosus kungaqhamuka emzimbeni wesiguli.
Izinhlu zomuthi, indlela yokukhishwa, izindleko nezimo zokubekisa
Umuthi uyatholakala ngesimo samaphilisi ahlanganisiwe, ithebhulethi ngayinye iqukethe umuthi ongu-2,5 mg.
Amacwecwe wezingcezu eziyi-10 apakishwa kufayili ekhethekile yeseli eyenziwe ngefilimu ye-polyvinyl chloride futhi ihlanganiswe ne-aluminium foil. Amaphakethe amathathu akhethekile, kanye nemiyalo yokusetshenziswa kwalesi sidakamizwa, atshalwa emaphaketheni amakhadibhodi.
Umuthi unqunyelwe ukuthi ugcinwe endaweni emnyama emazingeni okushisa ukusuka ku-15 kuya ku-25 degrees Celsius. Indawo yokubeka umuthi akufanele ifinyeleleke ezinganeni.
Impilo yeshalofu yesidakamizwa yiminyaka emithathu. Ngemuva kokuphela kwesikhathi sokulondolozwa, umuthi uvunyelwe ngokuphelele. Umuthi ophelelwe yisikhathi ulahlwa.
Ngaphezu kwe-Indapamide, kudalwe nemithi yokwelapha efana nayo.
Okuvame kakhulu futhi kuthandwa kakhulu yizifaniso ezilandelayo zomuthi:
- I-Arifon Repard - i-analog ethandwa kakhulu ye-Indapamide, ayithinti umqubuko we-carbohydrate.
- I-Acriptamide iyi-analog ye-Indapamide, evela emvelaphi yaseRussia.
- I-Indap isidakamizwa esenziwa eCzech Republic.
- I-Noliprel isidakamizwa sokuhlanganisa esisebenza kakhulu.
- I-Perinid isidakamizwa esidumile esilungele inani elikhulu leziguli.
Izindleko ze-Indapamide eRussia Federation ngokwesilinganiso zisuka kuma-ruble ayi-12 kuye kwangama-120, kuya ngomkhiqizi kanye nesifunda lapho kuthengiswa khona lo muthi.
Isazi esivela kuvidiyo ekulesi sihloko sizokhuluma ngezimpawu ze-pharmacological ze-Indapamide.
