Losartan - malangizo ogwiritsira ntchito, ndemanga, ma analogi ndi mafomu otulutsira (mapiritsi 12, 5 mg, 25 mg, 50 mg ndi 100 mg a Teva, Richter, N ndi diuretic) mankhwala ochizira matenda oopsa komanso kutsitsa kuthamanga kwa magazi mwa akulu, ana ndi mimba

Munkhaniyi, mutha kuwerengera malangizo ogwiritsira ntchito mankhwalawa Losartan. Amapereka ndemanga kuchokera kwa alendo omwe amabwera patsamba lino - ogwiritsa ntchito mankhwalawa, komanso malingaliro a akatswiri azachipatala pakugwiritsa ntchito Losartan machitidwe awo. Chopempha chachikulu ndikuti muwonjezere ndemanga zanu za mankhwalawa: mankhwalawo adathandizira kapena sanathandizire kuchotsa matendawa, ndizovuta ziti zomwe zimawoneka ndi zotsatirapo zake, zomwe mwina sizinalengezedwe ndi wopanga. Analogs a Losartan pamaso pa zomwe zimapangidwa kale. Gwiritsani ntchito pochizira matenda oopsa komanso kutsitsa magazi mu akulu, ana, komanso pa nthawi ya bere.

Losartan - antihypertensive wothandizira. Ndi block-non-peptide angiotensin 2 receptor 2. Ili ndi kusankha kwapamwamba komanso kuyanjana kwambiri kwa AS1 receptors (ndi kutenga nawo gawo komwe zotsatira zazikulu za angiotensin 2 zimakwaniritsidwa). Poletsa izi zolandirira, losartan imalepheretsa ndikuchotsa vasoconstrictive mphamvu ya angiotensin 2, mphamvu yake yolimbikitsa pakubisika kwa aldosterone ndi adrenal gland komanso zina mwanjira ina ya angiotensin 2. Imadziwika ndi zotsatira zazitali (maola 24 kapena kupitilira), chifukwa cha kupangika kwa metabolite yake yogwira.

Kupanga

Losartan potaziyamu + woyambitsa.

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, losartan imatengedwa mwachangu kuchokera mumimba. Bioavailability pafupifupi 33%. Amapukusidwa pa "gawo loyambirira" kudzera m'chiwindi ndikupanga carboxyl metabolite, yomwe ili ndi zochitika zambiri zam'magulu kuposa losartan, ndi ma metabolites angapo osagwira. Kumangiriza kwa mapuloteni a plasma a losartan ndi metabolite yogwira ndi apamwamba - oposa 98%. Losartan amamuchotsa mkodzo ndi ndowe (ndi bile) osasinthika komanso mawonekedwe a metabolites. Pafupifupi 35% imachotsedwa mu mkodzo ndi pafupifupi 60% - yokhala ndi ndowe.

Zizindikiro

ochepa matenda oopsa
kuchepa kwa chiwopsezo cha kufooka kwa mtima ndi kufa kwa odwala omwe ali ndi vuto losakanikirana ndi matenda amitsempha yamagazi, kumawonetsedwa ndi kuchepa kwapafupipafupi kwa kufa kwamtima, kufooka kwa ziwopsezo zam'mimba ndi kupunduka kwa mtima.
Chitetezo cha impso mwa odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga ndi proteinuria - kuchepa kwa kupitilira kwa impso, kuwonetsedwa ndi kuchepa kwa Hypercreatininemia, kuchuluka kwa kulephera kwa impso, kufunikira hemodialysis kapena kupatsirana kwa impso, kuchuluka kwa kufa, komanso kuchepa kwa proteinuria,
aakulu mtima kulephera ndi mankhwala olephera a ACE zoletsa.

Kutulutsa Mafomu

Mapiritsi okhala ndi 12,5 mg, 25 mg, 50 mg ndi 100 mg (opangidwa ndi Richter, Teva, H mawonekedwe ndi diuretic hydrochlorothiazide).

Malangizo ogwiritsira ntchito ndi mlingo

Wosuta mankhwalawa amatengedwa pakamwa, ngakhale chakudyacho. Mapiritsiwo amameza popanda kutafuna, kutsukidwa ndi madzi. Kuchulukitsa kuvomerezeka - 1 nthawi patsiku.

Ndi ochepa matenda oopsa, pafupifupi tsiku lililonse 50 mg 1 nthawi patsiku. Kuti mukwaniritse zochizira zazikulu, mlingo umakulitsidwa mpaka 100 mg patsiku.

Kulephera kwamtima kosalekeza

Mlingo woyamba wa odwala omwe ali ndi vuto la mtima nthawi zonse ndi 12,5 mg kamodzi patsiku. Monga lamulo, mlingo umawonjezeka ndi nthawi yapakati pa sabata (i.e. 12.5 mg patsiku, 25 mg patsiku ndi 50 mg patsiku) kwa pafupifupi gawo lokonza 50 mg 1 nthawi patsiku, kutengera momwe wodwalayo amalolera.

Palibe kusintha kwa mlingo kumene kwa odwala okalamba.

Kuchepetsa chiwopsezo cha chitukuko, matenda amtima (kuphatikizapo stroke) ndi kufa kwa odwala omwe ali ndi matenda oopsa ndipo amasiya chamitsempha cha ziwongo

Mlingo woyambirira wa mankhwalawa ndi 50 mg 1 nthawi patsiku. M'tsogolomu, hydrochlorothiazide ikhoza kuwonjezeredwa mu Mlingo wocheperako kapena mlingo wa Losartan ukhoza kuwonjezeka mpaka 100 mg mu 1 kapena 2, mukuganizira kuchepa kwa kuthamanga kwa magazi.

Odwala omwe ali ndi vuto la 2 la shuga ndi proteinuria

Mankhwala ndi mankhwala koyamba 50 mg kamodzi patsiku ndi kuwonjezereka kwa mlingo wa 100 mg tsiku lililonse, poganizira kuchuluka kwa kuchepetsa magazi) limodzi kapena awiri Mlingo.

Odwala omwe ali ndi BCC yochepetsedwa (mwachitsanzo, akamamwa mankhwala okodzetsa kwambiri, muyezo wa Losartan ndi 25 mg kamodzi patsiku.

Odwala omwe ali ndi hepatic insuffuffence (osakwana 9 mfundo pa Child-Pugh), panthawi ya hemodialysis, komanso odwala azaka zopitilira 75, mlingo woyambirira wamankhwala umalimbikitsidwa - 25 mg kamodzi patsiku.

Palibe chokwanira pakugwiritsa ntchito mankhwalawa odwala omwe ali ndi vuto lalikulu la chiwindi, motero, mankhwalawa ali osavomerezeka m'gulu lino la odwala.

Mankhwalawa alibe pazochitika pazochitika zoyambirira kapena zitatha, koma kuthamanga kwa magazi ndikofunikira ngati mukumwa mankhwala a antihypertensive.

Kulandila kwa antihypertensive mankhwala kuyenera kuchitika nthawi yomweyo pa kupempha kwa dokotala kuti achulukitse achire. Ngati mungadumphe kumwa kamodzi, muyenera kumwa mankhwalawa panthawi yomwe mwalandira nthawi yayitali kapena nthawi yomwe mukukumbukira kuti mwaphonya mlingo wotsatira. Osamwa kawiri mlingo wa mankhwalawa.

Zotsatira zoyipa

chizungulire
asthenia / kutopa,
mutu
kusowa tulo
nkhawa
kugona kusokonezedwa
kugona
mavuto amakumbukiro
zotumphukira neuropathies,
paresthesia
migraine
kunjenjemera
kukhumudwa
kulira m'makutu
kulakwira
kusintha kwa masomphenya
conjunctivitis
mphuno
kutsokomola
matenda apamwamba am'mapapo thirakiti (malungo, zilonda zapakhosi),
sinusitis
pharyngitis
rhinitis
kusanza, kusanza,
kutsegula m'mimba
dyspeptic phenomena
kupweteka kwam'mimba
mucosa wowuma mkamwa,
kukomoka
kukokana
myalgia
kupweteka kumbuyo, chifuwa, miyendo,
arthralgia,
tachy kapena bradycardia,
arrhythmias
angina pectoris
kuchepa magazi
myocardial infaration
kondani kukodza
yafupika libido
kusabala
khungu lowuma
kuthamanga kwa magazi
zithunzi,
kutuluka thukuta kwambiri
alopecia
urticaria
zotupa pakhungu
kuyabwa
angioedema, kuphatikizapo nkhope, milomo, pharynx ndi / kapena lilime,
malungo
gout
vasculitis
eosinophilia
Ensura Shenlein-Genoch.

Contraindication

mimba
kuyamwa
wazaka 18
kulephera kwambiri kwa chiwindi (mfundo zoposa 9 pamakwerero a Mwana-Pugh),
cholowa cha galactose tsankho, kuchepa kwa lactase kapena glucose-galactose malabsorption syndrome,
Hypersensitivity pamagawo a mankhwala.

Mimba komanso kuyamwa

Kugwiritsa ntchito mankhwala osokoneza bongo pa nthawi ya pakati kumapangidwa. Amadziwika kuti mankhwala omwe amakhudza mwachindunji dongosolo la renin-angiotensin-aldosterone (RAAS), akagwiritsidwa ntchito mu 2nd ndi 3 trimesters ya mimba, amatha kuyambitsa kukulira kwakatundu kapenanso kufa kwa mwana wosabadwayo. Chifukwa chake, pozindikira kuti muli ndi pakati, kutenga Losartan kuyenera kuyimitsidwa nthawi yomweyo.

Sizikudziwika ngati munthu wosiyidwa ndi mkaka wa m'mawere wachotsedwa. Iwo ali osavomerezeka kuti amwe mankhwala osokoneza bongo. Ngati kumwa kwa Losartan ndikofunikira panthawi yoyamwitsa, ndiye kuti kuyamwitsa kuyenera kuyimitsidwa.

Gwiritsani ntchito odwala okalamba

Palibe kusintha kwa mlingo kumene kwa odwala okalamba.

Odwala a zaka zopitilira 75 amalimbikitsidwa kuti ayambe kutsika pang'ono pa mankhwalawa - 25 mg kamodzi patsiku.

Gwiritsani ntchito ana

Odalirika ana ndi achinyamata osakwana zaka 18.

Malangizo apadera

Kwa odwala omwe ali ndi vuto la mtima omwe ali ndi vuto losakhazikika chifukwa chogwiritsa ntchito ACE zoletsa, sikulimbikitsidwa kuti musinthe pakulimbana ndi angiotensin 2 receptor antagonists, kuphatikiza mankhwala osokoneza bongo.

Odwala omwe ali ndi matenda a chiwindi (osakwana 9 pazinthu za Chaydd-Pugh, makamaka makamaka ndi matenda enaake), kuphatikizapo mu anamnesis, ndikofunikira kusankha madontho ang'ono.

Kwa odwala omwe ali ndi vuto losowa madzi mthupi, mwachitsanzo, kulandira chithandizo chamankhwala okweza m'mitsempha, ma hypotension ofunikira angayambike kumayambiriro kwa chithandizo cha osartan (ndikofunikira kukonza kuchepa kwa magazi musanapange mankhwala osweka kapena kuyamba kumwa mankhwala ochepa.

Odwala omwe ali ndi vuto laimpso, komanso odwala matenda ashuga, nthawi zambiri amakhala osokonezeka a electrolyte (hyperkalemia), omwe amayenera kuthana nawo. Pamaso pa matenda owopsa kapena aimpso kulephera, a losartan angayambitse vuto laimpso kapena popanda hyperkalemia.

Pa chithandizo ndi losartan, kuchuluka kwa potaziyamu m'magazi kuyenera kuyang'aniridwa pafupipafupi, makamaka kwa odwala okalamba komanso vuto laimpso. Kugwiritsira ntchito munthawi yomweyo losperan wokhala ndi potaziyamu wothandiza kupewetsa mankhwala kuyenera kupewedwa.

Odwala okalamba omwe amagwiritsa ntchito mankhwala osapweteka a anti-yotupa, akumwa mankhwala okodzetsa, kapena ntchito yaimpso, kugwiritsa ntchito losartan kungayambitse matenda aimpso, kuphatikizapo kuperewera kwaimpso. Zotsatira izi nthawi zambiri zimakhala zosinthika. Ndikofunikira kuwunikira ntchito ya impso mwa odwala omwe amatenga mankhwala osokoneza bongo omwe amatenga mankhwala osokoneza bongo.

Zambiri pa chitetezo ndi mphamvu ya mankhwalawa kwa ana sikokwanira.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Kugwiritsa ntchito mankhwalawa kukopa kuthamanga kwa ma psychomotor zimachitikira komanso kuthekera koyendetsa magalimoto kapena njira zina zamakono sikunaphunzire. Chenjezo liyenera kuchitika mukamachita zinthu zoopsa zomwe zimafuna kuti anthu azisamalira komanso aziganiza mwachangu.

Kuyanjana kwa mankhwala osokoneza bongo

Mankhwala osokoneza bongo amatha kugwiritsidwa ntchito nthawi imodzi ndi mankhwala ena a antihypertensive.

Mosiyanasiyana kumawonjezera zotsatira za beta-blockers ndi sympatholytics.

Kuphatikizika kwa ntchito kwa losartan ndi okodzetsa kumapangitsa zowonjezera.

Palibe mankhwala a pharmacokinetic a losartan omwe ali ndi hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole ndi erythromycin adadziwika.

Rifampicin ndi fluconazole akuti amachepetsa kuyika kwa metabolite yogwira m'madzi a m'magazi. Kukula kwakukhalirana kwa kudalirana kumeneku sikudziwikabe.

Monga othandizira ena omwe amalepheretsa angiotensin kapena zotsatira zake, kugwiritsa ntchito kosakaniza kwa potartum-sparing diuretics (mwachitsanzo, spironolactone, triamteren, amiloride), kukonzekera kwa potaziyamu, ndi mchere wokhala ndi potaziyamu kumawonjezera chiopsezo cha hyperkalemia.

Mankhwala osagwirizana ndi ma antisteroidal anti-kutupa (NSAIDs), kuphatikizapo kusankha ma cycloo oxygenase-2 inhibitors (COX-2), amachepetsa mphamvu ya okodzetsa ndi mankhwala ena a antihypertensive.

Pogwiritsa ntchito angiotensin 2 ndi ma lithium receptor antagonists, kuwonjezeka kwa plasma lithiamu ndende ndikotheka. Popeza izi, ndikofunikira kuyesa maubwino ndi zoopsa za mgwirizano wa losartan ndi mchere wa lithiamu. Ngati ndi kotheka, kuphatikiza kugwiritsa ntchito mankhwalawa, ndikofunikira kuyang'anitsitsa kuchuluka kwa lifiyamu m'madzi a m'magazi.

Mndandanda wa mankhwala Losartan

Zofanana muzochitika zamagulu:

Blocktran
Brozaar
Vasotens,
Vero Losartan
Zisakar
Cardomin Sanovel,
Karzartan
Cozaar
Nyanja
Lozap,
Lozarel
Zosangalatsa za Losartan,
Losartan Richter,
Losartan teva,
Lorista
Losacor
Lotor
Presartan,
Renicard.

Kutulutsa Fomu

mapiritsi achikasu, ovala-biconvex oblong wachikaso, wokhala ndi loyera (kapena loyera), burashi la aluminiyamu kapena filimu ya PVC, bokosi la makatoni

Yogwira pophika

Losartan Potaziyamu (50, 100 mg)

Othandizira

Microcrystalline cellulose, sodium stearyl fumarate, anhydrous colloidal silicon dioxide (Aerosil), croscarmellose sodium, prosolv HD 90

Ma Shell: titanium dioxide, cellcrystalline cellulose, macrogol stearate, hypromellose

Mankhwala

Losartan ndi mankhwala osokoneza bongo. Pokhala cholepheretsa chopanda peptide cha AT2 receptors, chimatseka mpikisano wa AT1 receptors, kuletsa angiotensin II kumangiriza kwa iwo. Mankhwala amamasulidwa kutulutsa kwa vasopressin, catecholamines, aldosterone ndi renin, kumalepheretsa kukula kwa matenda oopsa ndipo kumanzere kwamitsempha yamagazi. Zilibe mphamvu yolepheretsa puloteni ya angiotensin-kutembenuza, sizikhudza dongosolo la kinin-kallikrein, komanso sililola kuti bradykinin iwundike.

Metabolite yogwira ya Losartan, yopangidwa mwanjira ya kusintha kwachilengedwe, imapanga antihypertensive.

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, mankhwalawa (muyezo mpaka 200 mg) amatengeka bwino, ndipo, pambuyo pa kagayidwe kachakudya, amapanga metabolite ya carboxylic acid mozungulira magazi. The dongosolo bioavailability wa Losartan ndi 33%. Mukamamwa pakamwa, pasanathe ola limodzi chimafika magazi ambiri, ndikupanga 99% ku albumin. Kuchuluka kwa magawa ndi 34 malita. Pambuyo maola 3-4, C max amafikira metabolite yogwira mankhwala. Hafu ya moyo wa Losartan ndi maola 2, metabolite yake yogwira ndi maola 9. Mulingo wambiri wa antihypertensive chifukwa chogwiritsa ntchito mankhwalawa umawonedwa pambuyo pa masabata 2-4 kuyambira pachiwonetsero cha oyang'anira odwala azaka zilizonse, amuna ndi akazi komanso mtundu.

4% ya mlingo ndi impso osasinthika, 6% - mu mawonekedwe a metabolite yogwira. Pambuyo pakukonzekera pakamwa, 35% ya masamba omayidwa ndi mkodzo, 58% - yokhala ndi ndowe. Ndi ntchito imodzi yokha siziunjikira m'thupi.

Odwala azaka zapambuyo akudwala ochepa matenda oopsa, kugwiritsidwa ntchito kwa zinthu zomwe zimagwira ntchito ndi metabolite yake yogwira kwenikweni sikusiyana ndi kuchuluka kwa achinyamata omwe ali ndi matenda oopsa. Mwa azimayi, kuchuluka kwa mankhwalawa m'madzi a m'magazi kumachulukitsa kawiri kuchuluka kwa amuna. Kuzunza kwa metabolite yogwira amuna ndi akazi kumakhala chimodzimodzi.

Kodi losartan ndi chiyani?

Chofunikira kwambiri pamizere yamagazi,
Matenda oopsa a magazi ndi kumanzere kwamitsempha yamitsempha yamagazi (kuchepetsa chiopsezo cha kufooka komanso kupewa kufa),
Kulephera kwamtima kosalekeza (monga mankhwala omwe ali mgulu la mankhwala osakanikirana),
Matenda a shuga a nephropathy omwe amaphatikizidwa ndi proteinuria ndi hypercreatininemia odwala omwe ali ndi mtundu II matenda a shuga.
Ngati mankhwala kwa zovuta mankhwala a antihypertensive mankhwala.

Contraindication

Hypersensitivity / tsankho la munthu pazigawo za mankhwala,
Mimba komanso kuyamwa
Kulephera kwa chiwindi
Kuthetsa madzi m'thupi (kuchepa madzi m'thupi)
Refypory hyperkalemia,
Glucose-galactose malabsorption, tsankho lactose, kufupika kwa lactase,
Kugwiritsa ntchito limodzi ndi aliskiren (vuto laimpso kapena matenda a shuga),
Zaka mpaka 18.

Losartan iyenera kumwedwa mosamala pazinthu zotsatirazi:

kulephera kwa mtima komwe kumachitika pamaso pa kulephera kwamkaka,
arrhythmias
Matenda a mtima wa Ischemic,
Bilateral (kwambiri unilateral) aimpso mtsempha wamagazi,
Hyperkalemia
kuphwanya mulingo wamagetsi wamadzi,
kutsika kwa bcc (kuchuluka kwa magazi ozungulira),
matenda amisala
kulephera kwa aimpso
mitral kapena aortic stenosis,
chachikulu hyperaldosteronism,
angioedema,
hypertrophic cardiomyopathy.

Mlingo ndi makonzedwe

Odwala omwe ali ndi matenda oopsa, Losartan amaperekedwa kamodzi patsiku pa 50 mg, mankhwalawa amayenera kumwa mosasamala chakudya, osafuna kutafuna komanso kumwa madzi ambiri. Pokhapokha pakuyembekezeredwa achire, zotsatira za tsiku lililonse zimaloledwa kuukitsidwa 100 mg. Mphamvu yayikulu yotsika ya mankhwalawa imayamba pambuyo pa masabata 3-6 kuyambira poyambira kugwiritsidwa ntchito. Anthu omwe ali ndi magazi ochepetsedwa azungulira amalimbikitsidwa kutenga 25 mg tsiku lililonse.

Ndi kulephera kwa aimpso komanso kwa okalamba, mlingo wa tsiku ndi tsiku wa mankhwalawa sukonzedwa. Odwala omwe ali ndi vuto lalikulu la mtima akuwonetsa kuti akutenga Losartan koyamba mlingo wa 12,5 mg. Kuti mukwaniritse mlingo womwe mukufuna (50 mg), kuwonjezereka kwapang'onopang'ono kwa mlingo wopitilira kwa masabata awiri ndi atatu amafunikira.

Ngati chiwindi ntchito, kuchepa kwa tsiku ndi tsiku mlingo wa mankhwala chofunika.

Kuyanjana kwa mankhwala osokoneza bongo

Mankhwala sayanjana ndi warfarin, erythromycin, phenobarbital, cimetidine, digoxin.

Pogwiritsa ntchito munthawi yomweyo ndi fluconazole kapena rifampicin mu plasma, kuchepa kwa gawo la metabolite yogwira ntchito kumadziwika. Losartan amatha kuwonjezera zochita za okodzetsa, IAAF ndi ma adrenergic blockers.

Mukamagwiritsidwa ntchito limodzi ndi potaziyamu woleketsa okodzetsa kapena pokonzekera potaziyamu, hyperkalemia imatha kupanga (kuyang'anira ma labotale pafupipafupi kuchuluka kwa potaziyamu m'magazi ndikofunikira).

Mankhwala osokoneza bongo a nonsteroidal (kuphatikizapo kusankha CO2 inhibitors) amachepetsa mphamvu ya Losartan.

Zotsatira zoyipa

chizungulire, kupweteka mutu,
kufooka
kusowa tulo
kutsitsa magazi
chizindikiro ochepa ochepa hypotension,
tachycardia
migraine
myalgia
dyspepsia, nseru, kupweteka m'mimba,
Zizindikiro za matenda kupuma
hepatitis ndi zina chiwindi kukanika,
mucosa wowuma mkamwa,
eosinophilia, thrombocytopenia, kuchepa magazi,
Hyperkalemia
kuchuluka kwa proteinin ya creatinine, urea, nitrogen yotsalira,
thupi siligwirizana
angioedema,
anaphylaxis,
kuchuluka kwa gout,
mphuno.

Malangizo apadera

Odwala ndi kuchepa magazi kuzungulira magazi (pafupipafupi zotsatira za kuchuluka kwa okodzetsa), losartan angayambitse kukula kwa matenda oopsa. Chifukwa chake, musanayambe chithandizo ndi mankhwalawa, ndikofunikira kuti muchepetse kuphwanya komwe, kapena kumwa mankhwalawa.

Odwala omwe ali ndi vuto lachiwindi cha chiwindi (mawonekedwe ofatsa kapena olimbitsa) atatha kugwiritsa ntchito hypotensive othandizira, kugwiritsidwa ntchito kwa gawo lomwe limagwira komanso metabolite yake yogwira ndi yayitali kuposa mwa anthu athanzi. Pankhaniyi, munthawi iyi, komanso pakachitika mankhwala, Mlingo wotsika umafunika.

Mu vuto la impso, kukanika kwa hyperkalemia (kuchuluka kwa ndende ya potaziyamu m'magazi) ndikotheka. Chifukwa chake, munthawi ya chithandizo, mukuyenera kuwunika pafupipafupi kuchuluka kwa mphamvu iyi.

Ndi munthawi yomweyo makonzedwe a mankhwala omwe amakhudzanso renin-angiotensin dongosolo mwa odwala aimpso stenosis (osakwatiwa kapena awiri mbali), serum creatinine ndi urea achuluke. Mukamaliza kumwa mankhwalawo, matendawo nthawi zambiri amakhazikika. Pankhaniyi, ndikofunikira kuyang'anitsa pafupipafupi labotale kuchuluka kwa mapangidwe amomwe am'magawo a impso.

Zambiri zaku Losartan pakutha kuyendetsa galimoto kapena kugwira ntchito yofunika chidwi ndi kuthamanga kwa zochitika zama psychomotor sizinadziwikebe.

Kodi losartan

INN (dzina losavomerezeka padziko lonse lapansi) - Losartan. Mu radar, registry ya mankhwala osokoneza bongo, Losartan amadziwika kuti ndi gulu la pharmacological la angiotensin 2 antagonists omwe ali ndi hypotensive zotsatira. Pambuyo pakukonzekera, zotsatira zake zimapitirira kwa tsiku limodzi, motero mankhwala a Lozartan ndi mawonekedwe ake amadziwika ndi madokotala ngati njira imodzi yothandiza kwambiri.

Mankhwalawa ali ndi zinthu zofunika komanso zothandiza. Mankhwala omwe amagwira ntchito, omwe amathandizira kuti azigwira bwino ntchito, ndi Losartanum potaziyamu, mawu ofanana ndi losartan potaziyamu. Zowonjezera zomwe zimathandizira kulumikiza zinthu zomwe zimagwira ndi monga:

lactose monohydrate,
magnesium wakuba,
povidone
colloidal silicon dioxide,
cellcrystalline mapadi,
croscarmellose sodium.

Njira yamachitidwe

Limagwirira ntchito zachokera blockade wa angiotensin ma receptors 2. The yogwira thunthu amagwiritsa spasmodic kwambiri ziwiya, amathandiza ntchito ya mtima minofu. Tizilombo ta adrenal timayamba kupanga mahomoni aldosterone, kuchepa kwa kuthamanga kwa magazi. Kuphatikiza apo, losartan amachita ngati okodzetsa, amathandizira kuwonjezera zotulutsa zamadzimadzi m'thupi.

Uric acid ndi mchere wa sodium umatuluka ndi mkodzo, ndipo mchere wa potaziyamu wofunikira pakuchita bwino kwa mtima ukhazikika. Mapiritsiwo atalowa mkati, mankhwala ogwiritsira ntchito losartan potaziyamu amasungunuka ndikufikiridwa kudzera m'mimba. Bioavailability pafupifupi 33%. Kuphatikizika kokwanira m'magazi kumachitika pambuyo pa maola 1-1,5. Kusweka kwa mankhwalawa kumachitika m'chiwindi, kumakhudzidwa m'matumbo.

Zizindikiro zogwiritsidwa ntchito

Mankhwala ndi a gulu la mankhwalawa omwe sangathe kugwiritsidwa ntchito popanda malangizo a dokotala. Katswiri angakuthandizeni kusankha mlingo woyenera, kukambirana za zoyeserera zazikulu ndi zotsatira zoyipa. Kuti muwone ngati mukufuna kuwona othandizira, muyenera kuyeza kukakamizidwa nthawi zonse ndikuyang'ana momwe akumvera.

Ngati zisonyezo za tonometer zikupitilira 140 ndi 90, ndipo munthu akumva kugunda kwamtima mwachangu, kufooka, kupweteka kwamutu mkati mwa masiku asanu ndi amodzi ndi asanu ndi limodzi, muyenera kupita ku ofesi ya dotolo ndikusankha njira yochizira matenda oopsa. Zizindikiro zazikulu zogwiritsidwa ntchito ndi:

gawo loyambira matenda oopsa,
matenda a mtima oopsa,
lembani matenda ashuga a 2 omwe ali ndi proteinuria (kuteteza impso),
kulephera kwa mtima.

Kugwiritsa ntchito mankhwalawa pafupipafupi kungathandize kuchepetsa chiopsezo cha kufooka kwa mtima komanso kuchuluka kwa kufa pakati pa odwala. Kuphatikiza apo, losartan imagwiritsidwa ntchito poletsa mikwingwirima ndi kulowetsedwa kwa myocardial mwa odwala omwe ali ndi vuto lamanzere lamitsempha yamagazi komanso kuthamanga kwa magazi. Mothandizidwa ndi chida ichi, akukonzekera kupakidwa ndi kusinthika kwa impso. Kukhazikitsidwa kwa mankhwalawa kwa mtima kulephera kumachitika pambuyo pakumwa mankhwala ena osagwira ntchito.

Malangizo a losartan

Mlingo ndi nthawi ya makonzedwe amawerengedwa ndi ochiritsira kutengera malangizo. Njira zowonjezeramo njira zodziwira njira zamankhwala zifunsa wodwala, kupenda mbiri yachipatala yowonetsa matenda osachiritsika. Malinga ndi kunena kwa mankhwalawa, ngati losperan amatchulidwa koyamba, muyenera kumwa theka kuti mudziwe ngati pali zovuta zilizonse pa mankhwalawo. Pa matenda aliwonse, pali mitundu ina ya mankhwala.

Matenda oopsa

Popereka mankhwala a Losartan pochiza matenda oopsa malinga ndi malangizo, tikulimbikitsidwa kumwa mapiritsi osafunafuna, lembani ngakhale mutagwiritsa ntchito. Munthawi yamankhwala, muyenera kuyang'ana mphamvu za matendawa pogwiritsa ntchito muyeso wa tsiku ndi tsiku. Kutengera ndi kuopsa kwa vutoli, odwala amayenera kumwa 50 mg patsiku. Pakuwona kwa katswiri, mankhwalawa akhoza kuwonjezeredwa mpaka mtengo wokwanira tsiku lililonse wa 100 mg.

Kulephera kwamtima kosalekeza

Pofuna kuchepetsa mwayi wamavuto obwera chifukwa cha kulephera kwa mtima, mapiritsi a Losartan amayamba ndi kuchuluka kwa 12,5 mg / tsiku. Sabata iliyonse, mlingo umachulukitsidwa. Kukonza mankhwalawa a mtima Kulephera kugwiritsa ntchito zoposa 50 mg patsiku. Kuwunikira pafupipafupi ndi polojekiti wamagazi amalimbikitsidwa kuti muchepetse kuchepa kwambiri kwa magazi.

Zofananira zofananira za Losartan zimaphatikizapo mankhwala omwe ali ndi zotsatira zathanzi. Zonsezi zili ndi chinthu chofananira. Losartan yoyambirira imasiyana pakawoneka phukusi, mtundu wa kumasulidwa, Mlingo ndi wopanga. Pokonzekera, zinthu zina zothandizira zimagwiritsidwa ntchito.

Zilonda zamankhwala zimaperekedwa ngati zotsutsana zimadziwika. Kuti mudziwe mankhwala ati omwe ali oyenereradi matenda oopsa, dokotala woyenera ayenera. Mndandanda wa mayendedwe omwe amagwiritsidwa ntchito kwambiri ndi awa:

Blocktran
Lorista
Lozap Plus,
Renicard
Lozarel
Vasotens,
Brozaar
Presartan,
Nyanja
Zisakar
Losartan Richter,
Karzartan
Hypothiazide,
Losacor
Lotor
Vero Losartan
Losartan Canon.

Mtengo wa osowa

Mtengo wa losartan ndiwotsika, ndi imodzi mwazomwe zimagulitsa mankhwala osokoneza bongo. Mtengo wake umatengera dera lomwe kugulitsako kumachitika, kuchuluka kwa mapiritsi omwe ali muphukusili. Ku Moscow ndi St. Petersburg, mutha kugula mankhwalawa motsika mtengo, osati kudzera mumafakitale, komanso m'misika yapaintaneti.

Kupanga ndi mawonekedwe a kumasulidwa

potaziyamu losartan,
magnesium wakuba,
titanium dioxide
mowa wa polyvinyl,
talcum ufa.

Fomu yotulutsira ili pamapiritsi okhala ndi mawonekedwe ozungulira, ndi ufa wa makhiristo. Amakhala oyera. Kuchuluka kwa zosakaniza piritsi limodzi ndi 25, 50, 100 ml.

Pharmacological kanthu, pharmacodynamics

Mukamamwa mankhwalawa, kuthamanga kwa magazi kumayamba kuchepa pang'onopang'ono, chifukwa chomwe mankhwalawa amalembera mitundu yosiyanasiyana ya matenda oopsa. ACE inhibitor.

Amamwa mwachangu kuchokera mumimba. Kuchuluka kwake kumachitika pambuyo pa maola 6-7 mutamwa mapiritsi. Excretion - wokhala ndi ndowe ndi mkodzo osasinthika. The bioavailability wa yogwira pophika ali pafupifupi 65%. Amakhala ndi mapuloteni a plasma ndi 99%. Kuti kukakamizidwa kumveke bwino, ndikofunikira kulandira chithandizo chamankhwala - osachepera miyezi iwiri.

Losartan amalembedwa osati kokha chifukwa cha matenda oopsa, komanso matenda ena.

Njira za ntchito, mulingo woyenera

Mapiritsi a Losartan amatsukidwa ndi madzi pang'ono. Ufawo umasungunuka m'madzi mpaka makristali atasungunuka kwathunthu. Mutha kudya musanadye komanso mutatha kudya. Mlingo uliwonse umakhazikitsidwa payekhapayekha kwa wodwala aliyense.

Malangizowo akuwonetsa kuti mwalimbikitsa.

Pa mlingo woyamba, tikulimbikitsidwa kumwa mlingo wa 50 ml. Imapitilira njira yonse ya chithandizo, ngati mkhalidwe wa odwala suwonjezereka. Ndi osakwanira pharmacological a mankhwala, mlingo umachulukitsidwa. Ngati wamkulu atenga mankhwala ena omwe amachepetsa kuthamanga kwa magazi, mlingo umachepetsedwa mpaka 25 mg.

Odwala omwe ali ndi vuto lalikulu la chiwindi amapatsidwa mlingo woyenera (25 mg). Kulephera kwa mtima kosatha - osaposa 12,5 mg. Chithandizo muzochitika zotere zimachitika moyang'aniridwa ndi achipatala.

Ndikofunikira kumwa mapiritsi kamodzi patsiku, nthawi yomweyo. Ndikofunika kutsatira mlingo womwe dokotala wakupatsani kuti mupewe kumwa mopitirira muyeso komanso mavuto.

Ana sapatsidwa mankhwala. Ngati pakufunika izi, mulingo woyenera umachepetsa - 12,5 mg patsiku.

Kulandila pa nthawi yapakati komanso yoyamwitsa

Mankhwala contraindicated mu mimba, ngakhale akuti. Kuvomerezedwa kumatha kubweretsa imfa ya fetal kapena matenda a chitukuko. Zovuta pakukula kwa mwana wosabadwa zimatha kukhala motere: kufupika kwa mafupa, kuthinikizidwa kowonjezereka, kulephera kwa mtima.

Mu nthawi ya kuyamwa, chinthu chogwira ntchito chimalowa mthupi la mwana limodzi ndi mkaka wa mayi. Zotsatira zake ndiku kuphwanya kwam'mimba, kuphwanya msana, mapando otayirira, kukomoka, ndi mavuto ena akulu.

Zotsatira zoyipa zomwe zingachitike

palpitations
kusanza
chifuwa
kuletsa kwa chapakati mantha dongosolo,
laryngeal edema,
kusintha kwa chopondapo (kudzimbidwa, kutsekula m'mimba),
zotupa pakhungu,
zilonda zam'mimba
kutupa kwa mucous nembanemba,
kuchepa kowoneka bwino,
nseru
kukomoka
angina pectoris
chifuwa chowuma
leukopenia
Hypersensitivity dzuwa,
mutu
kugona
kusowa tulo
bronchospasm
matupi awo sagwirizana
kuphwanya kukoma
kusokonezeka kwa magazi muubongo,
gamu magazi
kutupa kwa chiwindi
kuchepa kwa hemoglobin.

Pakachitika zovuta, mankhwalawo amasiya. Dokotala amasankha njira ina.

Kuchita ndi mankhwala ena

Zithandizo zochiritsa za losartan mutamwa okodzetsa zimayamba kukulira.

Sizoletsedwa kugwiritsa ntchito njira zina nthawi imodzi, kuchitapo kanthu komwe kumakhala kofunikira kuti muchepetse kukakamizidwa.

Mankhwala amalimbikitsa achire zotsatira za mankhwala okhala ndi potaziyamu, omwe amachititsa zoyipa.

Kugwiritsa ntchito mosagwirizana ndi mankhwala omwe si a steroidal amawonongera impso. Mayeso a ultrasound amafunikira.

Ngati wodwala akumwa mankhwala ena, kufunsa dokotala ndikofunikira.

Mitengo muma pharmacies

Mtengo wake umatengera phukusi - kuchokera ku ma ruble 100 mpaka 500. Pakeji yayikulu ndikwanthawi yonse ya chithandizo.

Lozap,
Alkadil
Kapoten,
Lorista
Normio
Zisakar
Golten
Lortenza
Hyperium
Blockordil
Ma laputopu,
Norton
Captopril
Epistron
Renicard
Biosynthesis
Blocktran.

Ndemanga za mankhwala

Mankhwala abwino opaka matenda oopsa oopsa kwa odwala okalamba ndi achinyamata. M'pofunika kuganizira kuchuluka kwa mankhwalawa, kumbali ina, palibe kulepheretsa ngati kuthetsedwa kwa enalapril. Kulimbikitsidwa kwa odwala: kuti chiwopsezo cha matenda a mtima ndi stroko chikuchepa, izi ndizosangalatsa kwambiri kwa odwala.

Sindinakumanepo ndi tsankho komanso zovuta zoyeserera.

Losartan ndi chithandizo chabwino komanso chothandiza kuthamanga kwa magazi. Mwansanga zimathandiza kuti zibwerere mwakale. Mwanjira, chida chake ndi chotsika mtengo. Momwe ndikudziwira, sizimayambitsa mavuto. Inemwini, ndimapirira bwino. Zotsatira zoyipa sizinakhalepo. Anatenga maphunziro, anathandizadi kuchotsa matenda oopsa omwe ndinali nawo kuyambira ndili mwana.

Marina Klimenko, Nizhnekamsk (wodwala)

Sanakhalepo ndi kuthamanga kwa magazi. Koma posachedwa, adayamba kuchuluka. Dokotala adapereka chithandizo ndi mapiritsi a lozartan. Mlingo - piritsi lonse. Matenda akewo adakhala bwino patapita masiku ochepa, ngakhale izi zisanachitike, mutu wake udali wopweteka. Kupsinjika kunabwereranso kwina atatha kulandira chithandizo. Chida chachikulu pamtengo wotsika mtengo.

Makhalidwe

Malangizo a Losartan akuwonetsa kuti mankhwalawo amawerengedwa ngati wolimbana ndi ena wa angiotensin II receptors. Mankhwala osokoneza bongo, omwe ali ndi vuto lochepetsa, amachepetsa kuphatikizira kwamitsempha yamagazi.

Amathandizira kuchepetsa kuthamanga kwa magazi, kuchepetsa milingo ya adrenaline ndi aldosterone m'magazi, kuchepetsa katundu pa minofu ya mtima, komanso popereka diuretic. Losartan amathandizira kukulitsa kulolera kwa odwala omwe ali ndi vuto la mtima, komanso amalepheretsa kukula kwa myocardial hypertrophy.

Malangizo azachipatala ogwiritsira ntchito

Kodi olartan amafunsidwa ndi mavuto otani? Odwala omwe ali ndi matenda oopsa, Losartan amaperekedwa kamodzi patsiku pa 50 mg, mankhwalawa amayenera kumwa mosasamala chakudya, osafuna kutafuna komanso kumwa madzi ambiri. Pokhapokha pakuyembekezeredwa achire, zotsatira za tsiku lililonse zimaloledwa kuukitsidwa 100 mg. Mphamvu yayikulu yotsika ya mankhwalawa imayamba pambuyo pa masabata 3-6 kuyambira poyambira kugwiritsidwa ntchito. Anthu omwe ali ndi magazi ochepetsedwa azungulira amalimbikitsidwa kutenga 25 mg tsiku lililonse.

Ngati chiwindi ntchito, kuchepa kwa tsiku ndi tsiku mlingo wa mankhwala chofunika.

Gwiritsani ntchito panthawi yoyembekezera komanso mkaka wa m`mawere

Kutenga ana?

Odalirika ana ndi achinyamata osakwana zaka 18.

Blocktran
Brozaar
Vasotens,
Vero Losartan
Zisakar
Cardomin Sanovel,
Karzartan
Cozaar
Nyanja
Lozap,
Lozarel
Zosangalatsa za Losartan,
Losartan Richter,
Losartan teva,
Lorista
Losacor
Lotor
Presartan,
Renicard.

Mukamasankha analogi, muyenera kukumbukira kuti malangizo ogwiritsira ntchito losartan, mtengo ndi kuwunika kwa mankhwala amtunduwu sagwira ntchito. Kusintha kwa mankhwalawo ndikovomerezeka pokhapokha akutsimikiziridwa ndi dokotala.

Kodi ndemanga zikuyankhula chiyani?

Mwachidule, ndemanga za mankhwalawa ndizabwino, zomwe zimatsimikizira phindu la kumwa mankhwalawo. Komabe, palinso ndemanga, makamaka za Lozartan Richter, pomwe anthu amadandaula za kuwonekera pafupipafupi kwa zotsatira zoyipa. Tiyenera kunena kuti kusintha kosiyanasiyana kumachitika pambuyo pa Mlingo wambiri wa mankhwalawa.