I-Indapamide ingeyesibili, yesimanje kakhulu, isizukulwane se-thiazide-like diuretics. Umphumela ophambili wesidakamizwa ukwehla okusheshayo, okuqinile futhi okuhlala isikhathi eside kumfutho wegazi. Iqala ukusebenza ngemuva kwengxenye yehora, ngemuva kwamahora ama-2 umphumela uba mkhulu futhi uhlala usezingeni eliphakeme okungenani amahora angama-24. Izinzuzo ezibalulekile zalo muthi ukungabikho komthelela kumetabolism, amandla okuthuthukisa isimo sezinso nenhliziyo. Njengawo wonke ama-diuretics, i-Indapamide ingahlanganiswa nezindlela ezithandwayo neziphephile zokucindezela: ama-sartans kanye ne-ACE inhibitors.
Kuqondiswe kubani indapamide
Zonke iziguli ezinomfutho wegazi ophakeme zifuna ukwelashwa impilo yonke, okubandakanya ukuphuza izidakamizwa nsuku zonke. Lesi sitatimende kade kungabekwa imibuzo emibuthanweni yezokwelapha esebenzayo. Kwatholakala ukuthi ukulawulwa kwengcindezi yezidakamizwa okungenani amahlandla ama-2 kunciphisa amathuba we-pathologies ye-inhliziyo, kufaka phakathi abulalayo. Akukho mpikiswano mayelana nengcindezi yokuthi aqale ukuthatha amaphilisi. Emhlabeni wonke, izinga elibucayi leziguli eziningi libhekwa njenge-140/90, noma ngabe ingcindezi inyuka ngokungajwayelekile futhi ingabangeli ukuphazamiseka. Gwema ukuphuza amaphilisi kuphela nge-hypertension emnene. Ukuze wenze lokhu, kuzodingeka wehlise isisindo, unikeze ugwayi notshwala, ushintshe umsoco.
Okuwukuphela kwenkomba yokusetshenziswa kwe-Indapamide ekhonjiswe kwimiyalo yi-arterial hypertension. Umfutho wegazi ophakeme uvame ukuhlanganiswa nezifo zenhliziyo, izinso, imithambo yegazi, ngakho-ke, izidakamizwa ezibekelwa ukwehlisa, kumele zihlolwe ukuze kuphephe ukusebenza kahle kulamaqembu eziguli.
Yini esiza i-Indapamide:
- Ukwehla okujwayelekile kwengcindezi lapho uthatha i-Indapamide yilena: ephezulu - 25, ephansi - 13 mm Hg
- Ucwaningo luye lwabonisa ukuthi umsebenzi we-antihypertensive we-1.5 g we-indapamide ulingana no-20 mg we-enalapril.
- Ingcindezi yesikhathi eside eyandayo iholela ekwandeni kwe-ventricle yenhliziyo yangakwesobunxele. Izinguquko ezinjalo ze-pathological zigcwele nokuphazamiseka kwesigqi, unhlangothi, ukuhluleka kwenhliziyo. Amathebhulethi e-Indapamide anikela ekunciphiseni kwesobunxele be-myocardial yesokunxele, ngaphezu kwe-enalapril.
- Ngezifo zezinso, i-Indapamide ayisasebenzi kangako. Ukusebenza kwayo kungahlulelwa ngokuwa kwama-46% ezingeni le-albhamuin emchameni, okubhekwa njengolunye lwezimpawu zokuqala zokwehluleka kwezinso.
- Umuthi awunawo umthelela omubi ushukela, potassium kanye ne-cholesterol yegazi, ngakho-ke, singasetshenziswa kabanzi kwisifo sikashukela. Ukwelashwa kwe-hypertension kuma-diabetes, ama-diuretics anqunywa kumthamo omncane, kuhlangene ne-ACE inhibitors noma iLosartan.
- Impahla eyingqayizivele ye-Indapamide phakathi kwama-diuretics ukwanda kwezinga le- "good" cholesterol ye-HDL ngokwesilinganiso esingu-5.5%.
Ngabe usebenza kanjani umuthi?
Impahla enkulu yama-diuretics ukwanda kokuchithwa komchamo. Ngasikhathi sinye, isilinganiso soketshezi kwezicubu nemithambo yegazi sehla, kanti nengcindezi iyancipha. Ngenyanga yokwelashwa, inani lamanzi akhipha i-extracellular lincipha ngo-10-15%, isisindo ngenxa yokulahleka kwamanzi kwehla cishe ngo-1.5 kg.
I-Indapamide eqenjini layo ithatha indawo ekhethekile, odokotela bayibiza nge-diuretic ngaphandle komphumela we-diuretic. Lesi sitatimende sisebenza ngemithamo emincane kuphela. Lo muthi awuthinti umthamo womchamo, kepha unomphumela wokuphumula oqondile emithanjeni yegazi kuphela lapho usetshenziswa kumthamo we-≤ 2,5 mg. Uma uthatha u-5 mg, ukuphuma komchamo kuzonyuka ngama-20%.
Ngenxa yalokho ukucindezela kwehla:
- Kuvinjelwe iziteshi zeCalcium, okuholela ekunciphiseni kokugcotshwa kwe-calcium ezindongeni zemithambo yegazi, bese kuthi ekunwetshisweni kwemithambo yegazi.
- Iziteshi ze-potassium ziyasebenza, ngakho-ke, ukungena kwe-calcium kumaseli kuyancipha, ukuhlanganiswa kwe-nitric oxide ezindongeni zemithambo kuyanda, nemikhumbi iphumule.
- Ukwakheka kwe-prostacyclin kuyashukunyiswa, ngenxa yokuthi amandla amaplatelethi okwenza izingqimba zegazi futhi anamathele ezindongeni zemithambo yegazi ancipha, ithoni yezicubu zezindonga ze-vascular iyancipha.
Khipha ifomu nomthamo
Umuthi wokuqala oqukethe i-indapamide ukhiqizwa yinkampani yezemithi uServier ngaphansi kwegama lomkhiqizo i-Arifon. Ngaphezu kwe-Arifon yasekuqaleni, ama-generics amaningi ane-indapamide abhalisiwe eRussia, kufaka phakathi igama elifanayo i-Indapamide. Ama-analog ama-Arifon enziwa ngendlela yamaphilisi noma amaphilisi aphekwe ngefilimu. Muva nje, izidakamizwa ngokukhishwa okuguquliwe kwe-indapamide kusuka kumathebulethi kuye kwathandwa.
Umfutho wegazi ophezulu kanye nengcindezi yokugcotshwa kwengcindezi kungaba yinto yesikhathi esedlule - mahhala
Ukuhlaselwa yinhliziyo nemivimbo kuyimbangela ecishe ibe yi-70% yabo bonke ukufa emhlabeni. Abantu abayisikhombisa kwabayishumi bafa ngenxa yokuqothuka kwemithambo yenhliziyo noma yobuchopho. Cishe kuzo zonke izimo, isizathu sokuphela okubi kangaka kuyafana - ukucindezela kwegazi kubangelwa umfutho wegazi ophakeme.
Kungenzeka futhi kudingekile ukudambisa ingcindezi, ngaphandle kwalokho akukho lutho. Kepha lokhu akuselaphi lesi sifo uqobo, kepha kusiza kuphela ukulwa nophenyo, hhayi imbangela yalesi sifo.
- Ukucindezela okujwayelekile - 97%
- Ukuqedwa kwe-vein thrombosis - 80%
- Ukuqedwa kokushaya kwenhliziyo okuqinile - 99%
- Ukususa ikhanda - 92%
- Ukwanda kwamandla ngesikhathi sosuku, ngcono ukulala ebusuku - 97%
Kukhiqizwa ngamuphi uhlobo i-Indapamide nokuthi ingakanani:
| Khipha ifomu | Umthamo mg | Umkhiqizi | Izwe | Inani lentengo yenyanga yokwelashwa. |
| Izibhebhe ze-Indapamide | 2,5 | I-Pranapharm | IRussia | kusuka ku-18 |
| I-AlsiPharma | ||||
| I-Pharmstandard | ||||
| Isazi sebhayoloji | ||||
| I-PromomedRus | ||||
| Ozone | ||||
| I-Welfarm | ||||
| Avva-Rus | ||||
| I-Canonpharma | ||||
| Obolenskoe | ||||
| UValenta | ||||
| I-Nizhpharm | ||||
| Teva | Israyeli | 83 | ||
| I-Hemofarm | ISerbia | 85 | ||
| Amakhandlela we-Indapamide | 2,5 | Ozone | IRussia | kusuka ku-22 |
| I-Vertex | ||||
| Teva | Israyeli | 106 | ||
| Izibhebhe ze-indapamide ezisebenza isikhathi eside | 1,5 | I-PromomedRus | IRussia | kusuka ku-93 |
| Isazi sebhayoloji | ||||
| Izvarino | ||||
| I-Canonpharma | ||||
| Ama-Tathimpharmaceuticals | ||||
| Obolenskoe | ||||
| I-AlsiPharma | ||||
| I-Nizhpharm | ||||
| I-Krka-Rus | ||||
| MakizPharma | ||||
| Ozone | ||||
| I-Hemofarm | ISerbia | 96 | ||
| UGideon Richter | IHungary | 67 | ||
| Teva | Israyeli | 115 |
Ngokusho kwezenhliziyo, kungcono ukuthenga i-Indapamide ejwayelekile kumaphilisi. Umuthi ugcinwa emaphashini isikhathi eside, une-bioavailability ephakeme, umunwa ngokushesha, uqukethe izingxenye ezisizayo ezimbalwa, okusho ukuthi zibangela ukungahambelani kahle njalo.
Ifomu lesimanje kakhulu le-indapamide ngamathebulethi asebenza isikhathi eside. Into esebenzayo evela kubo ikhishwa kancane ngenxa yobuchwepheshe obukhethekile: amanani amancane e-indapamide asatshalaliswa ngokufanayo kuselulose. Lapho esegungwini lokugaya ukudla, kancane kancane i-cellulose iphenduka ijeli. Kuthatha cishe amahora angama-16 ukuncibilikisa ithebhulethi.
Uma kuqhathaniswa namathebulethi ajwayelekile, i-indapamide esebenza isikhathi eside inika umphumela ozinzile futhi oqinile we-antihypertensive, ukuguquguquka kwengcindezi yansuku zonke lapho uyithatha kancane. Ngokwamandla esenzo, i-2.5 mg ye-Indapamide ejwayelekile ubude bungu-1.5 mg. Imiphumela emibi eminingi ixhomeke kumthamo, okungukuthi, imvamisa yazo kanye nobukhali bukhuphuka ngethamo elandayo. Ukuthatha amaphilisi e-Indapamide isikhathi eside kunciphisa ubungozi bemiphumela emibi, ngokuyinhloko ukwehla kwamazinga e-potassium egazi.
I-indapamide ehlukanisiwe ehlukanisiwe ingaba kumthamo we-1.5 mg. Kwiphakheji kufanele kube yinkomba "yesikhathi eside", "ukukhishwa okulungisiwe", "ukukhishwa okulawulwayo", igama lingaqukatha "ukubuyisa", "MV", "eside", "SR", "CP".
Ungayithatha kanjani
Ukusetshenziswa kwe-indapamide ukunciphisa ingcindezi akudingi ukwenyuka kancane kancane komthamo. Ngokushesha amaphilisi aqala ukuphuza umthamo ojwayelekile. Umuthi unqwabelana egazini kancane kancane, ngakho-ke kungenzeka ukwahlulela ukusebenza kwawo kuphela ngemuva kweviki le-1 lokwelashwa.
Imithetho yokwamukelwa evela kumiyalo esetshenziswayo:
| Thatha ekuseni noma kusihlwa | Umyalo utusa ukwamukelwa kwasekuseni, kepha uma kunesidingo (ngokwesibonelo, ukusebenza ebusuku noma ukuthambekela kokunyusa ingcindezi emahoreni asekuseni), umuthi ungadakwa kusihlwa. |
| Ukuphindaphindwa okwamukelwa ngosuku | Kanye. Zombili lezi zinhlobo zomsebenzi wezidakamizwa okungenani amahora angama-24. |
| Thatha ngaphambi noma ngemuva kokudla | Akunandaba. Ukudla kubambezela kancane ukumuncwa kwe-indapamide, kepha akukunciphisi ukusebenza kwawo. |
| Izici zohlelo lokusebenza | Amathebulethi e-Indapamide ajwayelekile angahlukaniswa futhi achotshozwe. I-Indapamide yesikhathi eside ingadakwa kuphela. |
| Umthamo ojwayelekile wansuku zonke | I-2.5 mg (noma i-1.5 mg isikhathi eside) yazo zonke izigaba zeziguli. Uma lo muthi unganele ngokwenele ukucindezela, kuvunyelwe esinye isiguli umuthi owodwa. |
| Kungenzeka ukwandisa umthamo | Kuyinto engathandeki, ngoba ukwanda komthamo kuzoholela ekukhuphukeni komchamo, kwandise ingozi yemiphumela emibi. Kulokhu, umphumela we-Indotamide uzohlala usezingeni elifanayo. |
Uyacelwa ukuthi uqaphele: ngaphambi kokuqala ukwelashwa nganoma yisiphi isisu, kuyalulekwa ukuthi ubheke ezinye izingxenye zegazi: potassium, ushukela, i-creatinine, urea. Uma imiphumela yokuhlolwa ihlukile kokujwayelekile, thintana nodokotela wakho, ngoba ukuthatha ama-diuretics kungaba yingozi.
Isikhathi esingakanani ngingathatha i-indapamide ngaphandle kwekhefu
Amaphilisi wokucindezela we-Indapamide avunyelwe ukuphuza isikhathi esingenamkhawulo, inqobo nje uma enikeza izinga lokucindezela futhi abekezelelwa kahle, okungukuthi, awabangeli imiphumela emibi eyingozi empilweni. Ungayeki ukuthatha lo muthi, noma ngabe ingcindezi ibuyele kwesejwayelekile.
Ngaphansi kwe-0,01% yeziguli ezinesifo somfutho wegazi osezingeni eliphakeme ngamaphilisi we-Indapamide kanye nama-analogues alo, izinguquko ekubunjweni kwegazi zivela: ukuntuleka kwe-leukocytes, amaplatelets, hemolytic noma i-aplastic anemia. Ukutholwa kwesikhashana kwalokhu kwephula umthetho, umyalo uncoma ukuthi kuhlolwe igazi njalo ezinyangeni eziyisithupha.
I-Indapamide, ngokwezinga elincane kunamanye ama-diuretics, ikhuthaza ukuqedwa kwe-potassium emzimbeni. Noma kunjalo, iziguli ezinomfutho wegazi osengozini yokusebenzisa amaphilisi isikhathi eside zingakha i-hypokalemia. Izici zobungozi zibandakanya ukuguga, i-cirrhosis, i-edema, isifo senhliziyo. Izimpawu ze-hypokalemia ukukhathala, ubuhlungu bemisipha. Ekubuyekezweni kweziguli ezinesifo segazi esihlangabezane nalesi simo, zibuye zisho ngobuthakathaka obukhulu - "musa ukubamba imilenze yabo", ukuqunjelwa okuvame kakhulu. Ukuvimbela i-hypokalemia ukusetshenziswa kokudla okuphezulu e-potassium: i-legumes, imifino, inhlanzi, izithelo ezomisiwe.
Imiphumela emibi engenzeka
Izenzo ezingafunwa ze-Indapamide nobuningi bazo
| Imvamisa% | Ukuphendula okungafani |
| kufika ku-10 | Allergy Imichilo ye-Maculopapular imvamisa iqala ngobuso, umbala uyahlukahluka kusuka koku-pink-onsomi kuya ku-burgundy egcwele. |
| kufinyelela ku-1 | Ukuqhafaza |
| I-Purple ukuqubuka okubonakalayo esikhunjeni, ama-hemorrhage amancane emalungeni ama-mucous. | |
| kufika ku-0,1 | Ubuhlungu bekhanda, ukukhathala, ukudinwa ezinyaweni noma ezandleni, isiyezi. |
| Izinkinga zokugaya ukudla: isicanucanu, ukuqunjelwa. | |
| kufika ku-0,01 | Izinguquko ekwakhekeni kwegazi. |
| I-Arrhythmia. | |
| Ukwehla kwengcindezi okweqile. | |
| Ukuvuvukala kwepancreatic. | |
| Ukuphendula kwe-allergic ngendlela ye-urticaria, i-edema kaQuincke. | |
| Ukwehluleka kwangempela | |
| Amacala angawodwa, imvamisa ayinqunywa | I-Hypokalemia, i-hyponatremia. |
| Ukulimazeka kokubonakalayo. | |
| IHepatitis. | |
| I-Hyperglycemia | |
| Amanani andayo ama-enzyme wesibindi. |
Imiyalo esetshenzisiwe ikhombisa ukuthi amathuba okuphendula okuphezulu aphakame ngedlubu yethebhulethi ye-Indapamide, ephansi uma usebenzisa ifomu elide.
Contraindication
Uhlu lwe-contraindication lwe-Indapamide lufushane kakhulu. Umuthi awukwazi ukuthathwa:
- uma okungenani ingxenye eyodwa yezakhi zayo ivusa ukungezwani komzimba;
- nge-allergy to sulfonamide derivatives - nimesulide (Nise, Nimesil, njll), celecoxib (Celebrex);
- ngokuqina okungapheli kwe-renal noma hepatic;
- uma kwenzeka kusungulwa i-hypokalemia;
- nge-hypolactasia - amaphilisi aqukethe i-lactose.
Ukukhulelwa, ubuntwana, ukuncelisa amabele akubhekwa njenge-contraindication eqinile. Kulezi zimo, ukuthatha i-Indapamide kuyinto engathandeki, kepha kungenzeka ngokuqokwa nangaphansi kokuqondisa okuqinile kodokotela.
Imiyalo yokusebenzisa i-Indapamide ayikhombisi ukuthi kungenzeka ukuthi uyithathe kanye notshwala. Kodwa-ke, ekubuyekezweni kodokotela, ukuhambisana kotshwala nomuthi kuhlolwa njengokuyingozi empilweni. Ukusetshenziswa okukodwa kwe-ethanol kungadala ukwehla okukhulu kwengcindezi. Ukuhlukumezeka njalo kukhulisa kakhulu ubungozi be-hypokalemia, kwenza kube nzima ukusebenza kwe-Indapamide.
Ama-analog namagama
Umuthi uphindwa ngokuphelele ekwakhekeni nasemthanjeni, okungukuthi, lezi zidakamizwa ezilandelayo ezibhalisiwe kwiRussian Federation ziyizichazi ezigcwele ze-Indapamide:
| Isihloko | Ifomu | Umkhiqizi | Intengo yama-30 ama-pcs., URub. | |
| ezejwayelekile | gcina | |||
| I-Arifon / Arifon retard | ithebhu. | ithebhu. | UServier, eFrance | 345/335 |
| Indap | izigqoko. | - | Ama-ProMedCs, eCzech Republic | 95 |
| I-SR-Indamed | - | ithebhu. | I-EdgeFarma, India | 120 |
| I-Ravel SR | - | ithebhu. | I-KRKA, RF | 190 |
| I-Lorvas SR | - | ithebhu. | I-Torrent Pharmaceuticals, eNdiya | 130 |
| Ionic / Ionic Ibuyayo | izigqoko. | ithebhu. | I-Obolenskoe, iRussia Federation | awekho amakhemisi |
| ITenzar | izigqoko. | - | I-Ozone, RF | |
| Indipam | ithebhu. | - | I-Balkanpharma, eBulgaria | |
| IsiNdiya | ithebhu. | - | EPolfa, ePoland | |
| I-Akuter-Sanovel | - | ithebhu. | ISanovel, eTurkey | |
| Ukuphinda | - | ithebhu. | I-Biopharm, eNdiya | |
| Ipres Long | - | ithebhu. | ISchwartzFarma, ePoland | |
Bangathathelwa indawo yi-Indapamide ngaphandle kokubonisana nodokotela oholayo. Ngokuya kokubuyekezwa kweziguli ezithatha le mishanguzo, ikhwalithi ephezulu kakhulu yalolu hlu ngamaphilisi e-Arifon ne-Indap.
Qhathanisa nezidakamizwa ezifanayo
Phakathi kwe-thiazide ne-thiazide-efana diuretics, i-indapamide ingancintisana ne-hydrochlorothiazide (izidakamizwa iHydrochlorothiazide, iHypothiazide, isakhi se-Enap, i-Lorista nezinye izidakamizwa eziningi ze-antihypertensive) ne-chlortalidone (amaphilisi we-Oxodoline, enye yezingxenye zeTenorik neTenoretik).
Izici zokuqhathanisa zalezi zidakamizwa:
- amandla esenzo se-2,5 mg we-indapamide alingana no-25 mg we-hydrochlorothiazide kanye chlortalidone;
- i-hydrochlorothiazide ne-chlortalidone azikwazi ukubambela i-indapamide kwisifo sezinso. Zikhishwa yizinso ezingashintshiwe, ngakho-ke, ngokwehluleka kwezinso, i-overdose kungenzeka kakhulu. I-Indapamide yenziwa yisibindi, akukho okungaphezu kuka-5% okuchithwa kwifomu elisebenzayo, ngakho-ke kungadakwa kuze kufike ezingeni elibi lokwehluleka kwezinso;
- Uma kuqhathaniswa ne-hydrochlorothiazide, i-indapamide inamandla okuvikela izinso. Ngaphezulu kweminyaka emi-2 yokuphuza kwakhe, i-GFR inyuka ngesilinganiso sama-28%. Lapho uthatha i-hydrochlorothiazide - incishiswe ngo-17%;
- I-chlortalidone isebenza kuze kufike ezinsukwini ezi-3, ngakho-ke ingasetshenziswa ezigulini ezingakwazi ukuphuza umuthi ngokwazo;
- Amathebulethi e-Indapamide awakuthinti kabi i-carbohydrate metabolism, ngakho-ke, angasetshenziselwa isifo sikashukela. IHydrochlorothiazide ithuthukisa ukumelana ne-insulin.
