Momwe mungagwiritsire ntchito mankhwala a Lozap AM?
Hypersensitivity pazinthu zilizonse za mankhwala.
Mimba komanso nthawi yoyamwitsa.
Zaka mpaka zaka 18 (zoyenera ndi chitetezo chogwiritsa ntchito sizinakhazikitsidwe).
Kugwiritsa ntchito nthawi yomweyo ndi mankhwala a aliskiren kapena aliskiren omwe ali ndi odwala omwe ali ndi matenda osokoneza bongo komanso / kapena kuwonongeka kwaimpso (GFR osakwana 60 ml / min / 1.73 m2) (onani MITUNDU YA NKHANI NDI MANKHWALA AINA).
Zowonongeka zamtundu wa chiwindi (palibe chochita ndi ntchito).
Kumanzere kwamitsempha yamkuntho yotchinga (mwachitsanzo, kwambiri aortic stenosis).
Hemodynamically wosakhazikika mtima pambuyo pambuyo pachimake myocardial infarction.
Gwiritsani ntchito odwala omwe ali ndi vuto la impso (creatinine chilolezo chochepera 20 ml / min) kapena odwala hemodialysis.
Zotsatira za pharmacological
Mapiritsi a mankhwalawa ali ndi zida ziwiri zogwiritsidwa ntchito popanga Lozap AM yokhala ndi njira yowonjezera yogwira magazi (BP) yolamulira odwala omwe ali ndi vuto lothana ndi magazi (AH): potaziyamu losartan, angiotensin II receptor antagonist (ARA II), ndi amlodipine, blocker ' wodekha 'calcium chiteshi (BMCC).
Zotsatira zoyipa
Kuchokera ku dongosolo lamanjenje
Zochulukirapo: kufooka, kusapeza bwino m'chifuwa, kupweteka pachifuwa, kumverera kofulumira, kwodandaula.
Kuchokera m'mimba thirakiti
Zosatheka: kusapeza bwino pamimba, dyspepsia, nseru, Reflux esophagitis.
Pa khungu ndi subcutaneous minofu
Zocheperako: kuyabwa pakhungu (generalized), urticaria (generalized).
Kuchokera mumtima
Zochepera: palpitations.
Kuchokera zombo
Zosachepera: kumaso kwa nkhope, orthostatic hypotension.
Kuchokera pakapumidwe, m'chifuwa ndi ziwalo zam'mimba
Kumva ziwalo zamagulu ndi labyrinthine
Kuchokera impso ndi kwamikodzo
Malangizo apadera
Odwala omwe ali ndi BCC yochepetsedwa (mwachitsanzo, kulandira chithandizo chokhala ndi Mlingo waukulu wa okodzetsa) kapena kwambiri ndi aortic stenosis, chizindikiro cha ochepa hypotension chitha kuchitika. Kuwongolera koteroko kuyenera kuchitika asanakhazikitsidwe kwa Lozap AM kapena kuyamba kulandira chithandizo chamankhwala ochepa.
Kutulutsa mawonekedwe ndi kapangidwe kake
Mankhwala amapangidwa monga mapiritsi okhala ndi filimu: biconvex, oblong, mlingo 5 mg + 50 mg - pafupifupi oyera kapena oyera, mbali imodzi ndi zolemba "AT1", mulingo 5 mg + 100 mg - pinki kapena wotumbululuka pinki amodzi mwa mbali yomwe yalembedwa "AT2" (ma PC 10. mu blister, ma PC 300. mu botolo la pulasitiki, pamakatoni 1 kapena 3 matuza, kapena botolo 1 ndi malangizo ogwiritsira ntchito Lozap AM).
Piritsi limodzi lili:
- yogwira zinthu: amlodipine camsylate - 7.84 mg (womwe ndi wofanana ndi amlodipine mu 5 mg), potaziyamu losartan - 50 mg kapena 100 mg,
- zina zowonjezera: sodium carboxymethyl wowuma, butylhydroxytoluene, cellcrystalline cellulose, povidone K30, mannitol, magnesium stearate, crospovidone,
- Chovala cha kanema: hyprolose, talc, hypromellose, titanium dioxide, kuwonjezera pa mulingo wa 5 mg + 100 mg - utoto wa ayoni wachikasu ndi chitsulo oxide.
Mankhwala
Lozap AM - ndi mankhwala osakanikirana a hypotensive omwe amaphatikizapo pang'onopang'ono calcium blockchain (BMCC) ndi angiotensin II receptor antagonist (ARA II). Malinga ndi zotsatira za kafukufuku momwe odzipereka athanzi adatengapo gawo, Lozap AM mu milingo ya 5 mg + 50 mg ndi 5 mg + 100 mg ndi bioequivalent pakuphatikiza kosiyanasiyana kwa Mlingo wa amlodipine camsylate ndi losartan potaziyamu ngati kukonzekera kosiyana.
Zinapezekanso kuti mapiritsi a Lozap AM, momwe amlodipine camsylate amapezeka mlingo wa 5 mg, ali ndi bioequivalent mapiritsi a amlodipine omwe ali nawo.
Limagwirira zake za mankhwala Lozap AM
Magawo omwe amagwira ntchito a Lozap AM - amlodipine (BCC) ndi losartan (ARA II) ali ndi njira yowonjezera yochitira zolimbikitsa kuthamanga kwa magazi (BP) mwa odwala omwe ali ndi matenda oopsa (AH). Losartan amalepheretsa vasoconstrictor zotsatira za angiotensin II komanso kumasulidwa kwotsirizira kwa aldosterone mwa kusankha kosaletseka kumangiriza kwa angiotensin II ku AT receptors1. Amlodipine amatanthauza ma vasodilators a zotumphukira zama mitsempha ndipo amayenda molunjika pamitsempha yosalala ya mitsempha yamagazi, yomwe imayambitsa kufooka kwa kukana kwawo kwapadera komanso kuchepa kwa kuthamanga kwa magazi.
Angiotensin II ikuwonetsa mphamvu ya vasoconstrictor (vasoconstrictive), ndipo ndi gawo lofunikira la ihinotensin-aldosterone system (RAAS) komanso chinthu chofunikira kwambiri cha pathophysiological. Kumangiriza ku AT receptors1kutukusira kwa minyewa yosalala minofu yamagazi, impso, adrenal gland ndi mtima, angiotensin II imapereka vasoconstriction komanso kutulutsa aldosterone kulowa m'magazi. Komanso timadzi timeneti timayambitsa kukula kwa maselo osalala.
Losartan, membala wa gulu la osankhika osankha a ARA II (AT1zolandirira), zimawonetsa kugwira ntchito kwambiri mukamamwa pakamwa. Izi ndi carboxylated metabolite yogwira (E-3174) mu vitro komanso mu vivo zimaletsa zonse zofunikira za angiotensin II, posatengera njira kapena magwero ake. Losartan amasankha kumangirira ku AT1-receptors, pomwe sichimangiriza kapena kulepheretsa zolandilira zamahomoni ena ndi njira za ion zomwe zimayang'anira ntchito ya mtima system (CCC). Komanso, gawo logwira silikugwira ntchito ya angiotensin kutembenuza enzyme (ACE) - kininase II, yomwe inactivates bradykinin. Chifukwa chake, zotsatira za losartan sizikugwirizana ndi zomwe zimachitika mwachindunji chifukwa cha block block.1ma receptors (kuphatikizapo mawonekedwe a edema).
Amlodipine ndi wochokera ku dihydropyridine, wokonda calcium ions kapena BMCC, akuletsa kulowa kwa transmembrane kwa calcium ions mu cardiomyocyte ndi maselo osalala a minofu. Itha kuwerengedwa pamaziko a deta yoyesera yomwe chinthu ichi chimatha kumangiriza pamalo olowera pang'onopang'ono magawo a calcium omwe amakhala ndi dihydropyridine komanso malo osagwirizana ndi dihydropyridine. Amlodipine mosamala amalepheretsa kayendedwe ka calcium kudzera mu zimagwira, zomwe zimakhudza maselo a minyewa yosalala. Thupi silikhudza kuchuluka kwa kashiamu m'magazi.
Losartan, ngati amlodipine, amachepetsa kuthamanga kwa magazi chifukwa chakufooka kwa kukana kwamtunda. Kuletsa kulowerera kwa calcium mu cell ndi kuchepa kwa vasoconstrictor zotsatira zoyambitsidwa ndi zochitika za angiotensin II ndi njira zowonjezera.
Losartan (zowonjezera zamankhwala)
Losartan imalepheretsa kuthamanga kwa magazi a systolic (DBP) ndi diastolic (dAD) chifukwa cha kulowetsedwa kwa angiotensin II. Atafika paziphuphu kwambiri (Cmax) osartan mu plasma atatenga mlingo wa 100 mg, zotsatira zakumwambazi za angiotensin II zimaponderezedwa ndi pafupifupi 85%, ndipo pambuyo pa maola 24 - mwa 26- 39%, motsatana, pakadutsa kamodzi kapena zingapo.
Kulepheretsa kwa kupanga kwa renin ndi angiotensin II (mayankho osalimbikitsa), kuthetsedwa ndi losartan, kumayambitsa kuwonjezeka kwa ntchito ya plasma renin (ARP), yomwe imayambitsa kuwonjezeka kwa plasma angiotensin II level. Pa 6 milungu sabata kumwa 100 mg wa losartan odwala matenda oopsa pa nthawi C ukufikamax panali kuwonjezeka kwa plasma ndende ya angiotensin II nthawi 2-3, ndipo nthawi zina kwambiri, makamaka ndi njira yothandizira masiku 14. Komabe, mphamvu ya antihypertensive ndi kuchepa kwa kuchuluka kwa plasma aldosterone pambuyo pa sabata 2 ndi 6 zamankhwala, zikuwonetsa kuyimitsidwa kogwira mtima kwa angiotensin II receptors. Pambuyo pakutha kwa makonzedwe a losartan, kuchuluka kwa angiotensin II ndi ARP kunatsika masiku atatu mpaka pamiyezo yoyambira.
Poyerekeza zotsatira za losartan mu Mlingo wa 20 ndi 100 mg ndi mphamvu ya ACE inhibitor, zidapezeka kuti losartan, chifukwa cha njira inayake yochitira zinthu, adatseka zotsatira za angiotensin I ndi II popanda kukhudza bradykinin. ACE inhibitor idachepetsa mayankho a angiotensin I ndikuwonjezera zovuta za ntchito za bradykinin osasintha kukula kwa kuyankha kwa angiotensin II, komwe kumatsimikizira kusiyana kwa pharmacodynamic pakati pa ACE zoletsa ndi losartan.
Mphamvu ya antihypertensive ya losartan, momwe iyo ndi yogwira metabolite mu plasma imawonjezeka ndi kuchuluka kwa mankhwalawa. Onse losartan ndi metabolite yake yogwira amakhala ndi vuto lambiri.
Malinga ndi kafukufuku wopezeka, momwe abambo athanzi adachitapo kanthu, ndi kumwa kwa pakamwa pa osapatsa mlingo wa 100 mg motsutsana ndi kadyedwe kochepa komanso kochepa kwambiri, chinthucho sichidakhudze kuchuluka kwa kusefedwa kwa glomerular (GFR), gawo losefera, komanso kutuluka kwa aimpso. Losartan adawonetsa natriuretic zotsatira, zofunikira kwambiri ndi zakudya zamafuta ochepa, komanso zidapangitsa kuti chiwonetsero cha impso chikhale chochepa kwambiri.
Pamaso pa proteinuria (osachepera 2 g / 24 maola) odwala omwe ali ndi matenda oopsa, opanda matenda a shuga, kulandira wolartan pa mlingo wa 50 mg kwa masabata 8 ndikuwonjezeka kwapang'onopang'ono kwa mlingo wa tsiku ndi tsiku mpaka 100 mg, kuchepa kwa proteinuria (mwa 42%) komwe kunalembedwa, ndipo kuchulukitsidwa kwapadera kwa albumin ndi immunoglobulin G (IgG). Odwala a gululi, gawo losefera lidachepetsedwa ndikuyamba kulimbikitsidwa.
Odwala omwe ali ndi vuto la postmenopausal ndi matenda oopsa omwe amatenga 50 mg ya losartan patsiku kwa masabata anayi sanawonetse kuchuluka kwa mankhwalawa pazokhudza systemic ndi aimpso za prostaglandins (PG).
Mankhwala omwe adalandiridwa musanadye (pamimba yopanda kanthu), pakadutsa pafupifupi mpaka tsiku ndi tsiku mpaka 150 mg, sizinachititse kuti pakhale kusintha kwakukulu kwamankhwala a triglycerides, cholesterol yonse (Chs) ndi Chs highensens lipoproteins (HDL), komanso sizinakhudze kuchuluka kwa shuga m'magazi. Zochita za wothandizira zimapereka kuchepa kwa seramu ya uric acid m'magazi (nthawi zambiri imakhala yochepera 0,4 mg / dl), yomwe idatsalira panthawi yayitali.
Mu kafukufuku wamasabata 12 wokhudzana ndi odwala omwe ali ndi vuto lamanzere la II - IV ya kalasi yothandizirana malinga ndi gulu la New York Association of Cardiology (NYHA) kulandira diuretics ndi / kapena mtima glycosides, zotsatira za losartan mu Mlingo watsiku ndi tsiku wa 2,5, 10, 25 poyerekeza 50 mg wothandiza ndi placebo. Mankhwala mu Mlingo wa 25 ndi 50 mg adawonetsa zabwino za neurohormonal ndi hemodynamic pantchito yonseyi. Losartan adakulitsa mtima ndipo adachepetsa kuthinana kwamatumbo, komanso kufooka kwathunthu kwamitsempha yamagazi (OPSS), kuchepa kwa magazi ndi kuthamanga kwa mtima (HR). Mwa odwala, kuchuluka kwa ochepa hypotension kumadalira mlingo. Zotsatira za neurohormonal zinali kuchepa kwamagazi a norepinephrine ndi aldosterone.
Amlodipine (zowonjezera zamankhwala)
Kugwiritsa ntchito amlodipine mu Mlingo wothandizila mu odwala omwe ali ndi matenda oopsa kumabweretsa vasodilation, komanso chifukwa chakuchepa kwa kuthamanga kwa magazi m'magona abodza ndi oyimirira. Hypotensive iyi yogwira ntchito sothandizana ndi kusintha kwakukulu kwa kugunda kwa mtima kapena plasma catecholamine wambiri ndi chithandizo cha nthawi yayitali. Ngakhale chiwonetsero chimodzi cha intravenous (iv) cha amlodipine chikuwonetsa kuchepa kwa kuthamanga kwa magazi ndi kuchuluka kwa mtima mkati mwa maphunziro, kubwereza pakamwa kokhazikika kwa mankhwalawa sikunachititse kusintha kwakukulu kwa kuthamanga kwa mtima kapena kuthamanga kwa magazi mwa odwala omwe ali ndi vuto la magazi komanso ngati angina pectoris.
Poyerekeza ndi kukhazikika kwakanthawi kwamlomo ka amlodipine kamodzi patsiku, mphamvu yake ya antihypertgency imawonedwa kwa maola osachepera 24. Mulingo wa plasma wogwira ntchito m'magazi umagwirizana ndi hypotensive zotsatira zonse zazing'ono ndi okalamba odwala. Zizindikiro za kutsika kwa magazi mukamagwiritsa ntchito amlodipine amathanso kukhudzana ndi kuwopsa kwa kuchuluka kwake komwe kumanenedwa musanayambe chithandizo. Odwala DBP 105-114 mm Hg. Art. (AH ya zolimba mwamphamvu), zotsatira za antihypertensive zimawonedwa pafupifupi 50% kuposa zomwe odwala omwe ali ndi DBP ya 90-104 mm Hg. Art. (AH ya kupsya mtima). Pamaso pa kuthamanga kwa magazi kwa odwala, kusintha kwake kwakukulu sikunalembedwe.
Odwala matenda oopsa motsutsana maziko abwinobwino aimpso, makonzedwe amlodipine mu achire Mlingo ofooketsa kukana kwamitsempha ya impso, kuchuluka kwa aimpso plasma ndikuchulukitsa GFR, osasinthanitsa gawo losasinthika kapena proteinuria.
Odwala omwe akutenga amlodipine, ndi yachilendo yamitsempha yamagazi, kupumula kwa mtima ndi kupuma komwe akuwonetsa kukuwonjezeka kwa kuchuluka kwa mtima popanda chidziwitso kusintha kwakukulu pakuwonjezeka kwa magazi kumayambiriro kwa gawo la kuthamangitsidwa kwa magazi mu patsekeke lamanzere lam'mimbamo, kapena mu kuchuluka kwa ventricle / komaliza kwa DBP. Malinga ndi kuwunika kwa magawo a hemodynamic, mankhwala omwe amagwiritsidwa ntchito pazithandizo zochizira sanawonetse zotsatira zoyipa mwa odzipereka athanzi, ngakhale ataphatikizidwa ndi β-blockers. Nthawi yomweyo, zotsatira zofananazi zidadziwika kwa odwala omwe ali ndi vuto la mtima m'gawo la chiphuphu kapena odwala omwe ali ndiumoyo wathanzi akamagwiritsa ntchito mankhwala omwe ali ndi vuto lotchedwa lina lotropic.
Atrioventricular conduction (AV conduction) kapena ntchito yama sinoatrial mu odzipereka athanzi sanakhudzidwe ndi amlodipine. Mu / kumayambiriro kwa mankhwala muyezo wa 10 mg wokhazikika angina sizinakhudze AH ndi H-V komanso mayendedwe a sinus node pambuyo pacemaker. Zotsatira zomwezo zimawonedwa mwa odwala omwe amatenga amlodipine osakanikirana ndi β-blockers. Mu maphunziro a odwala omwe ali ndi matenda oopsa kapena angina pectoris ophatikizidwa ndi amlodipine ndi β-blockers, zotsatira zosafunikira pazigawo za electrocardiogram (ECG) sizinawonedwe. Odwala omwe ali ndi angina pectoris, kugwiritsidwa ntchito kwa amlodipine sikunakhudze nthawi yayitali ya ECG ndipo sikunachititse kuchuluka kwa AV block.
Pharmacokinetics
Pambuyo pakukonzekera pakamwa, imatenga bwino ndipo imadutsa momwe gawo loyambirira limayendera m'chiwindi ndikupanga imodzi yogwira ya carboxylated metabolite ndi ma metabolites ena osagwira. Kwa olartan mu mawonekedwe apiritsi, a systemic bioavailability pafupifupi 33% ndi khalidwe. Losartan ndi metabolite yake yogwira amafikira pafupifupi ma Cmax 1 ndi maola 3-4 pambuyo pa kutsata, motero. Kudya kulibe vuto lililonse lambiri chifukwa cha kuchuluka kwa plasma ya chinthu.
Ndi mapuloteni a plasma (ambiri okhala ndi albumin), losartan ndi metabolite yake yogwira samanga zosaposa 99%. Gawo Logawa (Vd) losartan ndi malita 34. Malinga ndi kafukufuku wazinyama, mankhwalawo samadutsa chotchinga magazi-ubongo (BBB). Palibe kuchuluka kwa plasma ya losartan ndi metabolite yake yayikulu pakugwiritsa ntchito mankhwalawa 100 mg kamodzi patsiku.Chifukwa pakamwa makonzedwe a losartan mu Mlingo mpaka 200 mg, thunthu ndi yogwira metabolite amawonetsa ozungulira pharmacokinetics.
Ndi iv kapena kugwiritsidwa ntchito pakamwa pa losartan, pafupifupi 14% ya mlingo wake wapanga biotransformed mu metabolite yogwira. Pambuyo pakamwa kapena iv makonzedwe a 14 C a losartan (olembedwa ndi radioactive carbon), plasma radioacaction imayamba makamaka chifukwa cha losartan ndi yogwira mankhwala ake kagayidwe. Pafupifupi, 1% ya omwe adaphunzirayi adawonetsa kusintha kochepa kosinthika kukhala metabolite yogwira. Kuphatikiza pakupangidwe kwa chomaliza panthawi ya kusintha kwa metabolic kwa losartan, ma metabolites awiri osagwira ntchito amapangidwa omwe amayamba chifukwa cha hydroxylation ya mbali butyl unyolo, ndi sekondale imodzi - N-2-tetrazole-glucuronide.
Chilolezo cha plasma cha losartan ndi metabolite yake yogwira chiri pafupifupi 600 ndi 50 ml / min, ndi aimpso - pafupifupi 74 ndi 26 ml / min, motsatana. Mukamamwa pakamwa, osafufutidwa amamuwonetsa impso zosasinthika pafupifupi 4% ya mankhwalawo komanso mu metabolite yogwira - pafupifupi 6% ya mlingo. Kuzindikira kwa losartan ndi metabolite wake wogwira ntchito m'magazi amachepetsa polyexponentially ndi gawo lomaliza la theka-moyo (T1/2) pafupifupi 2 ndi maola 8-9, motero. Losartan ndi metabolite yake amuchotsa impso kudzera m'matumbo ndi bile. Pambuyo pakamwa makonzedwe a losartan 14 C mwa amuna, pafupifupi 35% ya radioactivity amadziwika mkodzo ndi 58% mu ndowe, iv atayang'anira pafupifupi 43% ya radioacase mkodzo ndi 50% mu ndowe.
Pa matenda oopsa mwa azimayi, kuchuluka kwa plasma kwa losartan kunali kokwirikiza katatu kuposa kumene amuna. Magazi a metabolite omwe amagwira ntchito mwa amuna ndi akazi anali ofanana. Komabe, kusiyana kwa pharmacokinetic kumeneku sikofunikira mwakuthupi.
Ndi m`kamwa makonzedwe a amlodipine mu achire Mlingo, Cmax zimachitika pambuyo 6-12 maola. Mtheradi bioavailability ndi 64-90% ya kumwa mkamwa. The bioavailability wa amlodipine palokha popanda chakudya.
Panthawi yophunzira, zidapezeka kuti odwala omwe ali ndi matenda oopsa pafupifupi 93% ya amlodipine ozungulira amamanga mapuloteni a plasma. Ndi kugwiritsa ntchito tsiku ndi tsiku, stationary concentration (Css) ya amlodipine mu plasma imawonedwa pambuyo masiku 7-8.
Pafupifupi 90% ya amlodipine imapukusidwa mu chiwindi kuti metabolites wosagwira, pafupifupi 10% ya mankhwalawa imachotsedwa osagwiritsidwa ntchito ndi impso, ndi 60% mu mawonekedwe a metabolites.
Amlodipine kuchokera ku plasma amachotsedwa m'magawo awiri, gawo lomaliza T1/2 ikhoza kusiyana ndi maola 30 mpaka 50.
Lozap AM, malangizo ogwiritsira ntchito: njira ndi mlingo
Mapiritsi a Lozap AM amatengedwa pakamwa, mosasamala nthawi yakudya, ndi madzi ambiri. Mankhwalawa angagwiritsidwe ntchito limodzi ndi mankhwala ena a antihypertensive.
Odwala omwe alephera kukwaniritsa kuthana ndi magazi mokwanira akamagwiritsa ntchito losartan kapena amlodipine ngati mankhwala a monotherapy amatha kusinthana ndi chithandizo cha Lozap AM. Tengani mankhwalawa kamodzi patsiku piritsi limodzi, mlingo waukulu ndi 5 + 100 mg kamodzi pa maola 24 aliwonse.
Lozap AM 5 + 50 mg imalimbikitsidwa kwa odwala omwe samakwanitsa kuthana ndi magazi mokwanira akamagwiritsa ntchito amlodipine pa mlingo wa 5 mg kapena losartan pa 50 mg mu monotherapy.
Lozap AM 5 + 100 mg ndikulimbikitsidwa kwa odwala omwe sanakwanitse kuwongolera kuthamanga kwa magazi akamagwiritsa ntchito losartan pa mlingo wa 100 mg kapena mankhwala a Lozap AM 5 + 50 mg. Odwala omwe amatenga amlodipine ndi losartan ngati mankhwala osiyana amatha kusintha ku Lozap AM (yokhala ndi Mlingo womwewo wa amlodipine ndi losartan) kuti awonjezere kutsatira kwa mankhwalawa.
Ngati kumwa Lozap AM kuli kofunikira kwa odwala omwe ali ndi BCC yochepetsedwa, omwe ali ndi vuto la chiwindi kapena odwala okalamba, ndiye kuti musanayambe mankhwala osakanikirana ndi mankhwala a amlodipine ndi losartan, kusankhidwa kwa Mlingo wa zinthu izi kuyenera kuchitidwa.
Odwala omwe ali ndi BCC yochepetsedwa (kuphatikiza omwe amalandira chithandizo chamankhwala otupa kwambiri) akulimbikitsidwa kuti atenge losperan muyeso yoyamba ya 25 mg kamodzi patsiku ngati monotherapy, chifukwa Lozap AM ilibe mlingo womwe umaphatikizapo 25 mg wa losartan.
Bongo
Palibe chidziwitso chokhudza bongo wa Lozap AM.
Zambiri zokhudzana ndi mankhwala osokoneza bongo a losartan ndizochepa, makamaka chifukwa cha izi, tachycardia ndi kuchepa kwakukulu kwa magazi kungachitike, kuchitika kwa bradycardia ndikotheka chifukwa cha kukondoweza kwa parasympathetic. Syndrome ya mankhwala imalembedwa, hemodialysis siyothandiza.
Zizindikiro za mankhwala osokoneza bongo a amlodipine akhoza kukhala ophatikizika kwambiri a vasodilation ndi kuchepa kwakukulu kwa kuthamanga kwa magazi komanso kuwoneka kwa Reflex tachycardia. Pali malipoti okhudza nthawi yayitali komanso kowopsa kwambiri, komanso kupweteketsa mtima kwambiri. Ngati bongo, ngati n`koyenera, chapamimba thonje ndi kudya makala adalowetsedwa. Ngati mankhwalawa amayamba kuchuluka kwa mankhwalawa, ndikofunikira kuwunika kupuma komanso hemodynamic magawo, ndipo nthawi zambiri amayeza magazi. Poyerekeza ndi zomwe zimachitika kuti munthu azikhala ndi vuto lochita kusuntha kwamankhwala, kuwongolera koyenera kwamadzimadzi kuyenera kuthandizidwa, miyendo ya wodwalayo imayenera kukwezedwa ndipo njira zina zofunikira ziyenera kuchitidwa kuti pakhale hemodynamics. Ngati njira zosamala sizikuyenda bwino, makonzedwe a phenylephrine kapena vasoconstrictor othandizira atha kutumizidwa, kutengera diuresis ndi bcc.
Kubisika kwa njira za calcium kumachotsedwa ndi iv kulowetsedwa kwa calcium gluconate. Njira ya hemodialysis siyothandiza, chifukwa amlodipine ali ndi miyeso yambiri yomanga mapuloteni a plasma.
Kukopa pa kuthekera koyendetsa magalimoto ndi njira zowerengeka
Kafukufuku wokhudzana ndi zotsatira za Lozap AM pakutha kuyendetsa magalimoto ndi njira zina zovuta sanachitire. Komabe, ziyenera kukumbukiridwa kuti munthawi ya mankhwalawa nthawi zina zovuta sizitha kuoneka zomwe zingakhudze kuthamanga kwa zochitika zama psychomotor komanso ndende.
Mimba komanso kuyamwa
Kulandila Lozap AM pa nthawi ya pakati komanso mkaka wa m`mawere ndi contraindicated. Mankhwala omwe amakhudza RAAS mwachindunji amatha kubweretsa zowonongeka zazikulu ndi imfa kwa mwana wosabadwayo. Pozindikira kuti muli ndi pakati, mankhwalawa ayenera kuperekedwa nthawi yomweyo. Ngati ndi kotheka, sinthani njira ina yothandizira antihypertensive ndi mankhwala omwe ali ndi chivomerezo chovomerezeka kuti mugwiritse ntchito panthawi yomwe muli ndi pakati.
Ngakhale azimayi oyembekezera alibe luso loti atenge Lozap AM, kafukufuku wazinyama yemwe adadziwika kuti losartan amatha kuyambitsa kuvulala kwambiri kwa embryonic ndi neonatal kuvulala komanso kufa kwa fetal. Amaganiza kuti zimagwirira izi zimalumikizana ndi zotsatira za RAAS.
Kugwiritsa ntchito mankhwala osokoneza bongo wachiwiri ndi wachitatu woyeretsa wamankhwala kumapangitsa kuti impso ziwonjezeke komanso kumapangitsa kuti mwana wamwamuna akhale wakhanda komanso wobadwa kumene. Kupezeka kwa oligohydramnios kumatha kuphatikizidwa ndi hypoplasia yamapapu a fetal komanso kufooka kwa mafupa ake. Zosakhumudwitsa chifukwa cha osabereka mwa akhanda zimaphatikizanso ochepa hypotension, cranial bone hypoplasia, anuria, kulephera kwa impso, ndi kufa. Ngati chithandizo cha mankhwala omwe akhudzana ndi RAAS m'chiwonetsero chachiwiri komanso chachitatu cha kubereka sichitha mmalo mwanjira ina, wodwalayo ayenera kudziwitsidwa za chiopsezo chotenga mankhwalawa kwa mwana wosabadwayo.
Kafukufuku owongolera moyenera komanso okwanira kugwiritsa ntchito amlodipine mwa amayi apakati sanachitike.
Kaya losartan ndi amlodipine zimadutsa mkaka wa m'mawere sizikudziwika. Ngati mukufunika kumwa Lozap AM nthawi yotsekemera, muyenera kusiya kuyamwitsa.
Palibe chidziwitso chokhudzana ndi kubereka kwa chonde pa chonde. Pali malipoti amilandu yasintha kusintha kwachilengedwe m'mutu wa umuna, pomwe ena adalandira BMCC. Zambiri zakuchipatala zofunika kuwunika zomwe amlodipine amatha kukhala nazo chokwanira sizokwanira.
Gwiritsani ntchito paubwana
Kugwiritsa ntchito Lozap AM mwa ana ndi achinyamata kumatsutsana, chifukwa odwala omwe ali ndi zaka zosaposera 18 chitetezo ndi kugwiritsa ntchito mankhwalawa sichinakhazikitsidwe.
Makanda obadwa kumene omwe amayi awo adatenga ARA II pa nthawi ya pakati (kuphatikizapo losartan) amafunika kuwunika mosamala kuti azitha kuthana ndi hyperkalemia, oliguria ndi ochepa hypotension. Ngati mavuto omwe ali pamwambawa adadziwika mwa ana awa, chithandizo chamankhwala chimayikidwa kuti chikhalebe ndi impso. Kuika magazi kapena kutsegula m'mimba kungafunike kuti muchepetse hypotension komanso / kapena kuti matenda achulukane.
Ndi mkhutu aimpso ntchito
Pamaso pa kuvulala kwambiri aimpso (CC pansipa 20 ml / mphindi) kapena kufunika kwa hemodialysis chithandizo, kutenga Lozap AM ndi kutsutsana. Kwa odwala omwe ali ndi vuto laimpso loyenera, mankhwalawa salimbikitsidwa. Muyenera kusamala kuti muthane ndi yankho la stenosis ya mtsempha wamagulu a impso kapena wa stenosis wamitsempha, kulephera kwa impso, machitidwe pambuyo pakupatsirana kwa impso. Sizofunikira kusintha mankhwalawa kwa odwala omwe ali ndi vuto la impso kuwonongeka kwa CC - 20-50 ml / min.
Ndi chiwindi ntchito
Kulephera kwambiri kwa chiwindi (maulendo oposa 9 pamakwerero a Mwana-Pugh) - Lozap AM imapangidwa, odwala omwe ali ndi vuto la chiwindi ogwira ntchito modekha komanso modekha (osakwana mfundo za 9 pamiyeso ya Mwana-Pugh) ayenera kugwiritsa ntchito antihypertensive agent mosamala.
Malinga ndi data ya pharmacokinetic yomwe idawonetsa kuwonjezeka kwakukulu kwa plasma losartan mwa odwala omwe ali ndi vuto lodana ndi matenda acirrhosis, odwala omwe ali ndi mbiri ya matenda a cirrhosis kapena chiwindi choopsa samalimbikitsidwa. Amafunikira kuikidwa kwa losartan mu Mlingo wotsika (25 mg kamodzi patsiku) mu monotherapy.
Chifukwa chakuti amlodipine imapangidwa makamaka mu chiwindi, odwala omwe ali ndi vuto la T1/2 ofanana ndi maola 56. Ngati ndi kotheka kugwiritsa ntchito amlodipine mwa odwala omwe ali ndi vuto lalikulu la chiwindi, titration ya mlingo wake imalimbikitsidwa kuti ipangidwe pang'onopang'ono.
Gwiritsani ntchito mu ukalamba
Pochita maphunziro azachipatala kwa odwala azaka zopitilira 65, palibe zomwe zidapezeka pokhudzana ndi kugwiritsa ntchito bwino kwa chithandizo cha losartan. Popeza mwa odwala okalamba, chifukwa cha kufupika kwa amlodipine, dera lomwe lili pansi pa ndende (AUC) limachulukitsidwa pafupifupi 40-60%, nthawi zambiri amalimbikitsidwa kuti ayambe kumwa ndi 2,5 mg, koma kuyambira tsiku lililonse Lozap AM ili ndi 5 mg ya amlodipine, odwala otere ayenera kumwa amlodipine ngati mankhwala a monotherapy.
Kuyanjana kwa mankhwala osokoneza bongo
Kafukufuku wokhudzana ndi mgwirizano wa Lozap AM ndi mankhwala ena sanachitike.
Zotheka zimayenderana ndi osokoneza bongo munthawi yomweyo kugwiritsa ntchito mankhwala ena:
- digoxin, hydrochlorothiazide, cimetidine, warfarin, phenobarbital:
- rifampicin: mulingo wa osowa m'magazi umachepa,
- erythromycin: palibenso china chofunikira pa pharmacokinetics of losartan atamwa pakamwa,
- ketoconazole: palibe mphamvu pa kagayidwe ka losartan pambuyo pake iv makonzedwe mpaka mapangidwe yogwira metabolite,
- fluconazole (inhibitor ya isoenzyme CYP2C9): kuchuluka kwa yogwira metabolites ya losartan kumatsika, kufunikira kwa pharmacodynamic kwa kuphatikiza kwa ophatikizana ndi oletsa ma eyeenzyme CYP2C9 sanaphunzire,
- triamteren, spironolactone, amiloride ndi zina potaziyamu wotetemera okodzetsa, zomwe muli ndi potaziyamu kapena mchere wa potaziyamu: kuwonjezereka kwa serum potaziyamu ndende.
- Kukonzekera kwa lithiamu: kuchepa kwa lithiamu excretion ndikotheka, kuwunika mosamala kuchuluka kwa lifiyamu m'magazi ndikofunikira,
- Mankhwala osapweteka a antiidal (NSAIDs), kuphatikizapo cycloo oxygenase-2 inhibitors (COX-2): n`zotheka kufooketsa mphamvu ya antihypertensive zotsatira za losartan mwa okalamba kapena odwala omwe ali ndi vuto loti amathera madzi am'mimba, kuphatikiza omwe amalandira ma diuretics, ndi kuphatikiza uku, kusokonezeka kwina mu ntchito ya aimpso ndikotheka. , kuphatikizapo kupezeka kwa kulephera kwa impso, kuphatikiza kwa mankhwala kumafuna chisamaliro chapadera,
- awiri blockade wa RAAS (munthawi yomweyo kugwiritsa ntchito ARA II ndi ACE zoletsa kapena renin inhibitor - aliskiren): chiopsezo cha ochepa hypotension, hyperkalemia, syncope ndi vuto laimpso (kuphatikiza pachimake aimpso kulephera) limachulukitsidwa poyerekeza ndi monotherapy, kuwunika kawirikawiri impso. kuchuluka kwa ma elekitirodi m'magazi.
Zotheka zimachitika mogwirizana ndi amlodipine munthawi yomweyo kugwiritsa ntchito mankhwala ena:
- digoxin, phenytoin, warfarin, indomethacin: palibe chomwe chimapangitsa kuti mankhwalawa amangidwe pama protein a plasma malinga ndi maphunziro a vitro,
- cimetidine, ma antacid omwe amaphatikiza ndi magnesium kapena aluminium hydroxide, madzi a mphesa (240 ml): palibe tanthauzo lalikulu pa pharmacokinetics ya amlodipine mukamagwiritsa ntchito limodzi mlingo wotsirizira,
- atorvastatin (pa mlingo wa 80 mg): palibe kusintha kwakukulu pamagawo ofanana a pharmacokinetic a atorvastatin omwe amaphatikizidwa mobwerezabwereza makonzedwe a amlodipine pa 10 mg,
- sildenafil (muyezo umodzi wa 100 mg): motsutsana ndi matenda oopsa, ma pharmacokinetics a amlodipine sakhudzidwa, ndi kuphatikiza uku, chilichonse mwazinthu izi zimawonetsa modekha antihypertensive.
- tacrolimus: chiopsezo chowonjezera kuchuluka kwake kwa plasma chikuwonjezeka, mulingo wa chinthu ichi mu plasma uyenera kuyang'aniridwa,
- simvastatin (pa mlingo wa 80 mg): akaphatikizidwa ndi amlodipine pa 10 mg, kukhudzika kwa simvastatin kumawonjezeka ndi 77%, mlingo wa simvastatin wa tsiku lililonse ndi kuphatikiza uku sikuyenera kupitirira 20 mg,
- dantrolene (iv kayendetsedwe): chiwopsezo cha arrhythmia, kugwa, hyperkalemia ndi kuchepa kwa kugunda kwa mtima;
- cyclosporin: kuwonjezeka kwa kuphatikizika kwake kumakhala kotheka, mwa odwala pambuyo pakupatsirana kwa impso, kuwonjezeka kwa Cmin ya cyclosporin mu plasma ndi 40% kunadziwika, akaphatikizidwa ndi Lozap AM, Cmin ya cyclosporin imayenera kuyang'aniridwa,
- warfarin: palibe kuchuluka kwa prothrombin nthawi,
- ethanol: palibe tanthauzo lalikulu pa pharmacokinetics yake yapezeka,
- itraconazole, ketoconazole, ritonavir (zolimba zoletsa za CYP3A4 isoenzyme): plasma ndende ya amlodipine ingathe kuchuluka, kuwunika pafupipafupi kwa zizindikiro zamankhwala am'mimba komanso edema imafunika,
- diltiazem (pa mlingo wa 180 mg), erythromycin (zoletsa za CYP3A4 isoenzyme): pamene diltiazem ikaphatikizidwa ndi amlodipine pa mlingo wa 5 mg, kuwonjezeka kwapafupipafupi kwa AUC chakumapeto kumapezeka ngati kuphatikiza kumene kumayikidwa kwa odwala okalamba omwe ali ndi matenda oopsa, akaphatikizidwa ndi erythromycin pothandizidwa ndi erythromycin palibe zotsatira zazikulu pa AUC ya amlodipine, komabe, mwa anthu okalamba, kusintha kwakukulu pakuwonetsa kwake kumatha kulembedwa,
- clarithromycin (choletsa CYP3A4 isoenzyme): chiwopsezo cha kuchepa kwa kuthamanga kwa magazi chikuwonjezereka, kuyang'aniridwa mosamala kuchipatala ndikofunikira,
- rifampicin wopaka mafuta a wort wa St. John (olowetsa CYP3A4 isoenzyme): palibe chofunikira pamachitidwe a pharmacokinetic a amlodipine adalembedwa; tikulimbikitsidwa kuwunika magazi pafupipafupi.
Zofanizira za Lozap AM ndi Lortenza, Amzaar, Amozartan, Lozartan, Sardip, etc.
Dzinalo Losayenerana
Losartan ndi dzina lapadziko lonse la mankhwalawa.
C09DB Angiotensin II olimbana nawo BKK.
Lozap AM ndi mankhwala ochepetsa magazi komanso kubwezeretsa CCC.
Kutulutsa mafomu ndi kapangidwe kake
Lozap ndi piritsi lomwe limakhala ngati chipolopolo. Pali mitundu ingapo yamasulidwe, kutengera ndende ya chinthu chachikulu - 12.5, 50, 100 mg.
- zosakaniza zazikulu ndi losartan potaziyamu,
- microcrystalline cellulose, wowuma, sodium stearate, madzi, crospovidone, silicon dioxide.
Mankhwalawa amagulitsidwa makatoni ama 3, 6 kapena 9 matuza.
Ndemanga pa Lozap AM
Ndemanga za Lozap AM ndizabwino. Odwala amadziwa kuchuluka kwa mankhwalawa poyerekeza ndi Lozap, popeza Lozap AM ili ndi zinthu ziwiri zomwe zimagwira, imayikidwa kuti izigwiritsidwa ntchito ndi AH yowopsa kapena ndi chitukuko cha chizolowezi cha Lozap. Mankhwala, malinga ndi mawunikidwe, ali ndi phindu pa CVS ndipo amakupatsani mwayi wowongolera kuthamanga magazi.
Kufotokozera za mankhwalawa
Lozap Am ndi wophatikiza wophatikiza zinthu ziwiri zomwe zimagwira, chimodzi chake, mchere wapadera wa amlodipine ndi camsylate, womwe umakhala wolimba kwambiri poyerekeza ndi enlodipine besylate yomwe imagwiritsidwa ntchito kwambiri. Kutengera ndi mayesero azachipatala ndi kuwunika kosiyanasiyana kwa Lozap Am 5 + 100 mg, zidapezeka kuti, mosiyana ndi mankhwala ena a antihypertensive, mankhwalawa amawonetsa mphamvu yowonjezera ya antihypertensive, pomwe zovuta zoyipa panthawi ya chithandizo ndizochepa. Mutha kugula Lozap Am mu pharmacy mukamapereka malangizo kuchokera kwa dokotala.
Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD
Mankhwalawa amapangidwa ndi kampani yaku Czech Zentiva mu mawonekedwe a piritsi: Lozap Am 5 kuphatikiza 100 mg kapena 5 + 50 mg, nambala yoyamba ikuwonetsa zomwe amlodipine camsylate, wachiwiri - potaziyamu losartan. Mapiritsi amayikidwa m'matumba a zidutswa 10 kapena botolo la pulasitiki la zidutswa 300. Mtengo wa Lozap Am ukhoza kudalira kuchuluka kwa zinthu zogwira ntchito ndi maukonde a mankhwala omwe mankhwalawo amagulidwa.
Zizindikiro zogwiritsidwa ntchito
Mankhwalawa amalembera achikulire ndi ana a zaka 6 zakubadwa:
- matenda oopsa (kuthamanga kwa magazi),
- kupewa myocardial infarction,
- arrhythmia, ischemia ndi matenda ena akuluakulu a CVS,
- matenda oopsa kwa odwala matenda a shuga.
Mankhwalawa amalembera kuthamanga kwa magazi.
Mankhwalawa amalembera othandizira odwala matenda oopsa a shuga.
Mankhwalawa amathandizira kupewa kupewa myocardial infarction.
Ndi chisamaliro
Mutha kumwa mankhwala ochepa Mlingo wokhala ndi izi:
- kulephera kwa mtima
- Hyperkalemia
- kusowa kwa madzi m'magetsi,
- ochepa hypotension ana osakwana zaka 6.
Mutha kumwa mankhwala ochepa Mlingo wa mtima.
Mankhwala contraindicated pa mkaka wa m`mawere.
Mutha kumwa mankhwala osakwanira Mlingo wocheperako wokhala ndi ana osaposa zaka 6.
Momwe mungatenge Lozap AM
Mapiritsi amatengedwa pakamwa, ngakhale zakudya. Mlingo wokhazikika ndi 50 mg patsiku. Amasinthidwa kutengera umunthu wa wodwalayo. Matenda a mtima osagwirizana, mlingo woyamba ndi 12,5 mg. Popanda zovuta, zimawonjezeka mpaka 50 mg kuti zitheke kwambiri.
Pofuna kupewa matenda a mtima wachiwiri, 50 mg amatengedwa kamodzi patsiku. Chithandizo cha mankhwalawa chimatha monga momwe wodwala matenda a mtima adanenera.
Kumwa mankhwala a shuga
Simungatenge kumwa kokwanira nthawi yoyamba. Ndikofunikira kuyang'ana momwe thupi limachitikira, motero tikulimbikitsidwa kuti muyambe ndi 50 mg patsiku. Ndi mankhwala ena, mlingo umakulitsa mpaka 100 mg patsiku. Mutha kugwiritsa ntchito nthawi yomweyo 100 mg kapena 50 mg mu 2 seti.
Mu shuga mellitus, kumwa mankhwala kwathunthu sayenera kumwa nthawi yoyamba.
Hematopoietic ziwalo
Chifukwa cha kudya kosayenera, kuchulukitsa kapena kusowa kwazitsulo, lifiyamu, ndi mavitamini zingachitike. Chifukwa cha izi, matenda angapo amatuluka - kuchepa kwa magazi, leukocytosis, etc.
Chifukwa cha kudya kosayenera, kuchulukitsa kapena kusowa kwazitsulo, lifiyamu, ndi mavitamini zingachitike.
Kodi ndi gulu liti?
Choyamba muyenera kudziwa kuti ndi mankhwala ati a Lozap omwe ndi ake. Mapiritsi ochepetsa kuthamanga kwa magazi ndi a gulu la antihypertensive mankhwala.
Malangizo ogwiritsira ntchito akuti amakhudza thupi poletsa kulumikizana kwa angiotensin 2 okhala ndi angiotensin receptors. Chifukwa cha izi, kufalikira kwa kuthamanga kwa magazi kumachitika.
Kodi mapiritsiwa akuchokera kuti?
Zomwe zikuwunikidwa mu mapiritsi a Lozap, momwe amathandizira, ndi izi:
- kuthamanga kwa matenda
- Kulephera kwamtima kosalekeza - mankhwalawa amaphatikizidwa ndi chithandizo chamankhwala ambiri ndikugwiritsa ntchito kwake kumafunikira kwa odwala omwe ali ndi vuto la ACE inhibitor gulu, komanso chifukwa chosowa mphamvu,
- Kuchepetsa chiwopsezo chowonetsedwa kapena kupindika kwa mtima ndi zotupa zam'mimba mwa anthu omwe ali ndi matenda oopsa ndipo amasiya mpweya wamitsempha yamagazi,
- nephropathy mu matenda ashuga komanso anthu odwala matenda oopsa.
Chikhalidwe china chofunikira cha mankhwalawa ndi kuthekera koonjezera kukana kwa thupi pakuchita masewera olimbitsa thupi. Kuletsa matenda a minofu ya mtima ndi chinthu chinanso chothandiza cha mapiritsi a Lozap. Malangizo ogwiritsira ntchito ali ndi chidziwitso cha mlingo wa matenda aliwonse.
Ngati mukutsatira malangizo ogwiritsira ntchito mankhwalawa ndikudziwa momwe mungamwe mankhwalawa kuchokera pakukakamizidwa, ndiye kuti kuchepetsa kwake kumatheka pambuyo pa maola asanu ndi amodzi pambuyo pa kutsata, ndiye kuti kumachitika tsiku limodzi. Pogwiritsa ntchito mapiritsi pafupipafupi, zotsatira zokhazikika zimatheka patatha mwezi umodzi pambuyo pogwiritsa ntchito mapiritsi a Lozap.
Ndi proteinuria yotchulidwa, mankhwalawa amathandizira kuyimitsa kuwonongeka kwa mapuloteni.
Kuchokera kumbali ya kagayidwe
Kusowa kwa kagayidwe ka mankhwala nthawi zambiri kumachitika pamene mukumwa Lozap ndi mankhwala ena omwe sagwirizana ndi losartan.
Thupi lawo siligwirizana n`zotheka ndi bongo kapena munthu tsankho kwa magawo a zikuchokera. Kuwonetsedwa ndi zotupa, kuyabwa, khungu rede. Nthawi zina, kutsetsereka kapena kutsokomola kumachitika.
Kuyenderana ndi mowa
Mukamagwiritsa ntchito mankhwalawa, ndizoletsedwa kumwa mowa, chifukwa losartan imagwirizana kwathunthu ndi mowa wa ethyl.
Mukamagwiritsa ntchito mankhwalawa, ndizoletsedwa kumwa mowa.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Sizoletsedwa kugwiritsa ntchito mankhwalawa mu oyambilira komanso achitatu, chifukwa pamakhala chiwopsezo cha kukula kwamthupi. Pa HBV, sikulimbikitsidwanso kugwiritsa ntchito mankhwala a antihypertensive, kuti musavulaze mwana. Kafukufukuyu adawonetsa kuti losartan ikhoza kuyambitsa kuzizira kwa fetal.
Kodi ndiyenera kuthana ndi vuto lotani?
Zizindikiro zopsinjika za chitukuko cha matenda oopsa kwa munthu aliyense zimayang'aniridwa ndi dokotala. Ndi yekhayo amene amasankha nthawi yoikidwiratu ndi kusankhidwa. Ndi zoletsedwa popanda kuchitira mankhwala ndi Lozap. Malangizo ogwiritsira ntchito sanena kuti pakugwiritsa ntchito mankhwala ali ndi nkhawa yotani, chifukwa chake chithandizo chimayenera kuperekedwa kwa katswiri.
Mitundu ya Hypertension
Kutenga?
Mapiritsi a Lozap opsinjika mogwirizana ndi malangizo ogwiritsira ntchito amawonetsedwa kumwa kamodzi patsiku, kuyambira mankhwalawa ochepetsa. Musanayambe mankhwala osokoneza bongo, kukonza kwa madzi osankhidwa ndi electrolyte kumachitika. Malinga ndi malangizo a chitukuko cha matenda amitsempha, Mlingo wocheperako ndizovomerezeka.
Komanso, kuchuluka kwa potaziyamu kumawonjezeka mwa okalamba, kotero kwa iwo, malinga ndi malangizo, kugwiritsa ntchito Mlingo wocheperako kumakhazikitsidwanso.
Mankhwalawa sasokoneza kuthekera kwa kayendedwe ndikuwongolera chidwi - mawonekedwe awa akuwonetsedwa mu malangizo omwe angagwiritsidwe ntchito. Mapiritsi amayenera kuledzera ndi kuchuluka kwakukulu kwamadzimadzi kuti pasakhale zovuta zina pogwira ntchito ya m'mimba. Kodi ndizotheka kumwa Lozap pamavuto otsika - sichoncho, chifukwa malinga ndi malangizo ogwiritsira ntchito, adapangira anthu omwe ali ndi matenda oopsa kuti achepetse kuthamanga kwa magazi.
Asanadye kapena pambuyo chakudya?
Atafunsidwa momwe angamwere Lozap asanadye kapena atatha kudya, madotolo amayankha kuti palibe kusiyana kwakukulu, chifukwa mogwirizana ndi malangizo ogwiritsira ntchito, mankhwalawa amatengedwa pakamwa, mosasamala nthawi yakudya.
Madokotala amafotokoza kuti akafunsidwa pogwiritsa ntchito Lozap, ndi mankhwalawa omwe alipo, milandu ingapo ingathe kusiyanasiyana molingana ndi malangizo a mankhwalawa:
- Mukapezeka ndi matenda oopsa a m'magazi, Lozap nthawi zambiri amatchulidwa, mlingo patsiku ndi 50 mg malinga ndi malangizo. Nthawi zina, pochita bwino kwambiri, mlingo umachulukitsidwa, koma amatengedwa nthawi 1.
- Kwa anthu omwe ali ndi vuto la mtima wosalephera, mlingo ndi 12,5 mg kamodzi patsiku. Zimachuluka sabata iliyonse mpaka pafupifupi 50 mg. Kulekerera kwa mankhwalawa ndi contraindication malinga ndi malangizo kuyenera kukumbukiridwa.
- Kwa odwala omwe akuchita chithandizo cha mankhwala ambiri okodzetsa, kudya koyamba kumachepetsedwa mpaka 25 mg patsiku.
- Mwa okalamba, poyamba dokotala sasintha muyezo wa 50 mg patsiku.
- Mukamagwiritsa ntchito mankhwalawo akuwonetsedwa kuti muchepetse chiwopsezo cha matenda amtima komanso kupewa kufa kwa anthu omwe ali ndi matenda oopsa, malingana ndi malangizo, mlingo woyambirira ndi 50 mg patsiku. Popita nthawi, imakwera mpaka 100 mg.
- Kwa odwala matenda a shuga mellitus ndi proteinuria, mlingo woyambirira ndi 50 mg patsiku, pang'onopang'ono ukuwonjezeka mpaka 100 mg. Koma adotolo ayenera kuganizira zisonyezo za kuthamanga kwa magazi.
- Pamaso pa concomitant chiwindi matenda kapena kuchepa magazi pambuyo hemodialysis pa zida, patatha zaka 75, muyenera choyamba kuchepetsa kuchuluka kwa 25 mg patsiku.
Mlingo uliwonse ndi mankhwala a mankhwalawa amatha kupezeka mu malangizo omwe angagwiritsidwe ntchito.
Zimatenga nthawi yayitali bwanji?
Popereka mankhwala, odwala nthawi yomweyo amafunsa kuti Lozap atenge nthawi yayitali bwanji. Mukasankha mlingo woyenera, kugwiritsidwa ntchito kwake kumatha miyezi ingapo komanso zaka zingapo. Zonse zimatengera kutha kwake.
Ngati palibe zoyipa, kupanikizika kumakhazikika, ndiye kuti simuyenera kusintha chidacho. Kupuma kwamankhwala kungachitike pokhapokha akutsimikiziridwa ndi dokotala. Mankhwala atathetsedwa, kuchulukitsa kowopsa kumatha kuchitika. Nthawi yeniyeni yomwe adzatenge Lozap panthawi yake imatsimikiziridwa ndi adokotala.
Zoyimira
Zotsatira zoyipa zomwe zikufotokozedwa mu malangizo ogwiritsira ntchito komanso kudutsa mwachangu ndi kayendetsedwe kosalekeza ndikuphatikizapo:
- kupweteka m'mimba
- kupweteka pachifuwa,
- kutopa mwachangu
- kutupa pang'ono kwa miyendo ndi manja,
- kutsegula m'mimba
- kugunda kwa mtima
- nseru
- mutu
- kukokana mu minofu ya ng'ombe
- kugona kusokonezedwa
- kutsokomola
- kuchulukana kwammphuno.
Ndi ntchito yayitali
Zotsatira zoyipa za Lozap pogwiritsa ntchito nthawi yayitali zimatha kukhudzana ndi ziwalo zosiyanasiyana ndi machitidwe, chifukwa kudziunjikira kwa mankhwala m'thupi kumachitika pang'onopang'ono. Amayambitsa kuphwanya zotsatirazi:
- kuchepa kwa tsitsi mpaka pamdazi chifukwa cha kuchuluka kwa khungu ndikutulutsa thukuta,
- ziwengo madera okhala ndi khungu labwino,
- kusagwira bwino ntchito kwa mtima: - kupweteka mtima, mphuno.
- kuphwanya ntchito ya m'mimba thirakiti: bata, kudzimbidwa ndi kutsegula m'mimba, kusowa kudya,
- kuwonongeka pakumveka kafungo ndi masamba,
- pafupipafupi pamakhala za nkhawa
- kukodza pafupipafupi.
Kugwirizana ndi kugwiritsidwa ntchito kofanana
Pakati pa mankhwalawa, wodwalayo amayenera kuwonetsetsa kuti amamwa mankhwala ati, monga momwe angagwirizanirane, ndibwino kuwonjezera malangizo omwe angagwiritsidwe ntchito. Komanso, malingaliro osemphana ndi omwe amachitika chifukwa chomwa mowa panthawi yomwe mumagwiritsa ntchito mankhwalawa.
Kodi ndizotheka kutenga Lozap ndi mowa - anthu amakonda. Odwala ena amakhulupirira kuti mowa sudzakhala wowopsa panthawi ya chithandizo ndikugwirizana kwina kwa Lozap ndi mowa.
Ndemanga za iwo omwe adakumana ndi izi adziwonetsa zosiyana. Kupatula apo, mphamvu ya mankhwalawa imakhala kwa tsiku limodzi kuyambira pakukonzekera, ndipo chifukwa cha zotsatira zake zimachitika pakapita nthawi yayitali. Pankhaniyi, Lozap ndi mowa sizigwirizana kwathunthu.
Bisoprolol
Bisoprolol ndi Lozap - kuphatikiza kwa mankhwala ndikuloledwa. Mankhwalawa amachokera m'magulu osiyanasiyana a mankhwala. Malinga ndi malangizo ogwiritsira ntchito, Bisoprolol ndi block ya adrenergic, yomwe imayang'anira kuchuluka kwa mtima, ndikuchepetsa.
Lozap - amachepetsa kuthamanga kwa magazi. Pamodzi, mankhwalawa amagwira ntchito pakuwonjezeka kwa pathological mu kukakamira kwa tachycardia, arrhythmia, ndi kulephera kwamtima kosalekeza.
Ichi ndi mankhwala odziwika bwino omwe amagwiritsidwa ntchito molingana ndi malangizo othandizira matenda oopsa, ndikupanga edema yayikulu chifukwa cha kulephera kwa mtima kapena pazifukwa zina. Ichi ndi diuretic yomwe, pamene yopanga matenda oopsa, imagwira ntchito ngati vasodilator. Funso lomwe limabuka: ndizotheka kutenga Lozap ndi Indapamide palimodzi.
Kapoten ndi Lozap - mawonekedwe awo ndiwotsutsana kwambiri, ngakhale sitinganene kuti sagwirizana.
Nthawi zina, angiotensin receptor blocker amatha kuyikidwa limodzi ndi angiotensin kutembenuza enzyme inhibitory mankhwala, omwe amalola kuti pakhale hypotensive zotsatira zabwino. Komabe, pochita izi, madokotala samapereka mankhwala nthawi imodzi ndi mankhwalawa.
Eprosartan
Eprosartan imatha kutengedwa kamodzi kapena kufotokozedwa ndi maphunzirowo. Pogwiritsa ntchito kamodzi, kupsinjika kumakhalabe kwabwinobwino tsiku lonse. Chithandizo chokhazikika chodalirika chitha kuchitika pokhapokha masabata angapo ogwiritsidwa ntchito pafupipafupi.
Eprosartan ndi Lozap ali ndi zofanana, koma kapangidwe kosiyanasiyana. Pankhaniyi, funso limabuka ngati ndizotheka nthawi yomweyo Eprosartan ndi Lozap. Simuyenera kuchita izi, kuti musatengeke kwambiri komanso musayambitse zoyipa, zomwe, mogwirizana ndi malangizo ogwiritsira ntchito, ndalamazi zikufanana.
Umboni wa iwo omwe adamwa mankhwalawa
Mutha kupeza ndemanga zambiri zabwino za anthu za mankhwalawa. Amachepetsa kupsinjika, imagwirizira ntchito yamtima ndikugona, amachotsa chizungulire. Odwala amati Lozap amachita mwachangu, koma zotsatira zazitali sizimawonedwa. Malangizowo adati zotsatira zake zimakhala tsiku limodzi, koma nthawi zina zimatha maola anayi. Koma ngati muchepetsa mlingo wake osatenga nthawi 1, koma nthawi zambiri, ndiye kuti zotsatira zake ndikokwanira maola 24. Odwala amadziwa kuti kugwiritsa ntchito mlingo wotsika kumathandizira kuchepetsa chiopsezo cha mavuto. Koma ndi njira iyi, zotsatira zake mutamwa mapiritsi sizibwera m'mphindi 30, koma m'maola 1.5.
Komanso, odwala amazindikira kuti kumwa Lozap sikophweka kwambiri chifukwa champhamvu chodukitsa, kuchokera pamenepo kumakhala kukakamiza pafupipafupi kukodza. Izi zidadziwika kwambiri ndi anthu ogwira ntchito. Ndemanga izi zikufotokozanso za chifuwa choyambitsa usiku pambuyo poyambanso kudya, zomwe zimavuta kuchotsa ngakhale atachotsa.
Mankhwalawa ali ndi ma analogues ambiri kapena mankhwala ofananawo omwe ali ndi zotsatira zofananira, awa ndi angati otchipa a Lozap. Koma malangizo awo ali ndi kusiyana kwawo, ndipo ndi dokotala wokhayo amene angadziwe momwe angasinthire Lozap.
Poyerekeza Lozartan ndi Lozap, zomwe zili bwino ndi funso lomwe limafunsidwa nthawi zambiri.Malinga ndi malangizo ogwiritsira ntchito, mankhwalawa onse akuwonetsedwa kuti athe kukonza matenda oopsa. Iwo ndi angiotensin receptor antagonists.
Lozap ndi Losartan ndi ofanana, popeza kuti mphamvu zonse ziwiri zimagwirizana. Mankhwala onse awiriwa amagwiranso ntchito ku matenda oopsa, koma ichi sichiri chifukwa chosankha mosaganizira wina ndi mnzake. Dokotala yekha ndi amene ayenera kupereka malangizo oyenera.
Ngati tizingolankhula za mankhwala a Lozap kapena a Lorista, ndi ati omwe ali bwino, palibe kusiyana kwakukulu. Amasiyana mu opanga okha komanso mtengo wake. Lozap ndi yotsika mtengo kwambiri, yonse ndiyofanana malinga ndi malangizo ogwiritsira ntchito.
Musanadziwe Valsartan kapena Lozap, zomwe zili bwino, muyenera kumvetsetsa zabwino zawo. Ubwino wa Valsartan ndi mtundu wake wogwiritsa ntchito, makamaka umapezeka kudzera m'matumbo osasinthika - 83%, ndi 13% ndi impso. Pankhani imeneyi, nthawi zambiri amaloleza matenda a chiwindi ndi impso, chifukwa samonjezereka ziwalo izi.
Malinga ndi malangizo ogwiritsira ntchito, mankhwalawa cholinga chake ndi kukulitsa ziwiya ndi mitsempha. Chifukwa chake limasinthasintha ndikukhala wopanikizika. Kuti musankhe Valsacor kapena Lozap - zomwe zili bwino, muyenera kudziwa kusiyana pakati pa ndalamazi: Valsacor ndi analogue yachindunji ya Valsartan, zomwe zikutanthauza kuti imagwiranso ntchito mfundo yomweyo, osakhudza chiwindi komanso pafupifupi osakhudza impso. Komanso, zotsatira zake zazikulu ndizofunikira zingapo.
Chifukwa cha kukwera mtengo kwa malonda, odwala ali ndi chidwi ndi zomwe zili bwino kuposa Valz kapena Lozap. Chifukwa chake, Valz ndi mankhwala osokoneza bongo, blocker of AT1 receptors of angiotensin II. Malinga ndi malangizowo, alibe zotsutsana polumikizana ndi mankhwala ena, zotsatira zake zapamwamba zimaphunziridwa mwatsatanetsatane, kumwa mankhwalawa kumathandizira pakukula kwa matendawa.
Mankhwala a antihypertensive, ACE inhibitor. Mukamayankha funsoli, lomwe ndi labwinoko, Lozap kapena Enalapril, muyenera kumveketsa kuti mankhwala achiwiri amachepetsa kuthamanga mwachangu komanso mochuluka. Mtengo wa Enalapril, m'malo mwake, ndi wotsika mtengo kwambiri. Koma ziyenera kukumbukiridwa kuti, monga ma inhibitors onse a ACE, nthawi zambiri zimayambitsa chifuwa cham'mbali.
Awa ndi mankhwala a antihypertensive omwe, malinga ndi malangizo, amachepetsa kuthamanga kwa magazi popanda kuchuluka kwambiri pamtima. Ngakhale mtengo wokwera mtengo wa Enap, madotolo, poyankha funso lomwe ndi labwino, Enap kapena Lozap, amalimbikitsa woyamba kuti alowe.
Lisinopril
Mankhwalawa amachokera ku gulu la zoletsa zoletsa za ACE. Zomwe zili bwino, Lozap kapena Lisinopril, ndi funso lomwe limafunsidwa pafupipafupi kwa odwala. Mankhwala onse omwe ali ndi matenda oopsa amathanso kuchita chimodzimodzi, koma malinga ndi malangizo, kutsokomola kumakhala zotsatira zoyipa za Lisinopril. Mtengo wake ndi womwewo.
Ichi ndi mankhwala amphamvu, ACE inhibitor, malinga ndi malangizo, nthawi yayitali ikuchitika tsiku limodzi. Chofunikira chachikulu cha Diroton ndi lisinopril, ndipo zotsatira za mankhwalawa ndizofanana. Chifukwa chake, kuti mumvetsetse Diroton kapena Lozap, zomwe zili bwino, muyenera kudziwa kuti madokotala amalocha Diroton Lozap pokhapokha ndi tsankho la lisinopril.
Prestarium
Kuti mumvetsetse zomwe zili bwino - Lozap kapena Prestarium, muyenera kumvetsetsa zosiyana zawo. Prestarium ndi choletsa ACE, malinga ndi malangizo omwe amagwiritsidwa ntchito pamafupa olimbitsa thupi, chifukwa cha kusokonezeka kwakukulu m'mitsempha yamagazi ndi mtima, chifukwa amachepetsa kuthamanga bwino. Mtengo wake ndi wotsika. Koma Lozap alibe zotsatira zoyipa za gulu la zoletsa la ACE - chifuwa chowuma.
Noliprel ndi mankhwala ophatikiza. Mu kapangidwe kake pali magawo awiri a yogwira a perindopril ndi indapamide, omwe amakhudza thupi nthawi imodzi, chifukwa chake limachita bwino.
Kupitiliza kwakanthawi kwamankhwala kumawonedwa pakatha mwezi umodzi wamagwiritsidwe ndipo sikuyenda ndi kukwera kwa mtima. Pankhaniyi, yankho la funso lomwe lili bwino - Lozap kapena Noliprel ndiwodziwikiratu.
Kunena motsimikiza Concor kapena Lozap yomwe ili yabwino kwambiri sadzalephera. Nthawi zambiri amalembedwa kuti amwe nthawi yomweyo mu zovuta. Concor ndi beta-blocker yomwe imangotsitsa kuthamanga kwa magazi, komanso imathandizira kugunda kwamtima. Malinga ndi malangizo, Lozap amatengedwa m'mawa, ndi Concor - madzulo. Kuphatikizidwa kwina kumasankhidwa ndi adokotala mogwirizana ndi momwe alili ndi thupi la wodwalayo.
Equator ndi mankhwala ophatikiza antihypertensive. Kuyankha funso Equator kapena Lozap - zomwe zili bwino, zotsatirazi ziyenera kudziwika: poyerekeza ndi Equator, Lozap ali ndi zotsutsana zochepa malinga ndi malangizo ogwiritsira ntchito.
Mankhwala a Lozap AM amadziwika ndi mphamvu zambiri, chifukwa ali ndi magawo awiri omwe amagwira ntchito: losartan potaziyamu ndi amlodipine. Ichi ndi chida chothandiza kwambiri ndipo kugwiritsidwa ntchito kwake malinga ndi malangizo akuwonetsedwa pazochitika zovuta pamene Lozap sithandizira kapena atakhala kuti ali ndi vuto m'thupi.
Migwirizano ndi magwiritsidwe akusungidwa
Mukasunga Lozap Am, ndikofunikira kusunga kutentha kwa chipinda kosaposa 30 digiri Celsius. Alumali moyo wa mankhwalawa ndi miyezi makumi awiri mphambu inayi, atatha nthawi imeneyi mankhwalawo saloledwa kugwiritsa ntchito ndipo ayenera kutayidwa. Mutha kuyitanitsa kutumiza kwa Lozap Am ku Moscow ndi dera patsamba lathu.
The ntchito aimpso kuwonongeka
Zotsatira zamaphunziro a pharmacokinetic, zidapezeka kuti chifukwa chotenga Lozap, kulephera kwa impso kumatha kupanga, chifukwa chake, anthu omwe ali ndi vuto laimpso amayenera kugwiritsa ntchito mlingo wochepa kamodzi patsiku. Ngati sichingawonedwe, ndizotheka kusokoneza kotheratu chiwalocho, zomwe zingayambitse kupatsirana kwa impso.
Kuphatikiza kophatikizidwa
Sizoletsedwa kugwiritsa ntchito Lozap kuphatikiza ndi diuretics, zomwe zimapangitsa kuti pakhale potaziyamu, mwachitsanzo ndi Amiloride, Spironolactone, chifukwa hyperkalemia imatha kuyambitsidwa.
Sizoletsedwa kugwiritsa ntchito Lozap kuphatikiza ndi diuretics, zomwe zimapangitsa kuti pakhale potaziyamu.
Kuphatikiza komwe kumafunikira kusamala
Ndi munthawi yomweyo kugwiritsa ntchito mankhwala omwe si a antiidal a anti-yotupa ndi gulu, zotsatira za ulesi zimatha kuchepa, chifukwa chake kufalikira kwa matenda oopsa kudzakhala kopanda tanthauzo, monga mankhwala a placebo group (omwe si a mankhwala).
Ngati, pazifukwa zina, Lozap sichingatengedwe, itha kuthandizidwa ndi mankhwala omwewa:
- kutengera hydrochlorothiazitis - Angizar, Amlodipin, Amzaar, Gizaar, Lorista, Lozap kuphatikiza (mankhwala aku Russia),
- kutengera ndi candersartan - Kandekor, Kasark, Hizart-N,
- Gawo lalikulu la telmisartan ndi Mikardisplyus, Telpres, Talmista.
Musanagwiritse ntchito analog, muyenera kufunsa katswiri. Kwa odwala okalamba omwe ali ndi tsankho, Lozap m'malo mwake ndi Amlodipine.
Amlodipine ndi amodzi mwa fanizo la mankhwala a Lozap AM.
Kasark ndi amodzi mwa fanizo la mankhwala a Lozap AM.
Mikardisplyus - imodzi mwazofanana ndi mankhwala a Lozap AM.
Omvera zamtima
Svetlana Aleksandrovna, Phlebologist, Rostov-on-Don
Ndikupangira odwala ambiri kuti atenge Lozap, chifukwa imagwira bwino CVS ndikuchepetsa kuthamanga kwa magazi, kupewa matenda ambiri. Kutengera ndi manambala azachipatala, iyi ndi imodzi mwamankhwala abwino kwambiri polimbana ndi matenda oopsa.
Sergey Dmitrievich, katswiri wa zamtima, Irkutsk
Ndikulembera odwala ambiri atachitidwa opaleshoni kuti akhalebe ndi nkhawa, kuti athane ndi matenda oopsa.
Malangizo a Lozap AMC a mtima
Olga Vasilievna, wa zaka 56, Kurganinsk
Ndakhala ndikutenga Lozap kwazaka zoposa 5. Ndili ndi matenda ashuga 2. Mankhwala amakhutira kwathunthu, kupanikizika kumakhala kwacibadwa, palibe mavuto.
Ivan, wazaka 72, Moscow
Dokotala wamtima woletsa matenda a mtima, chifukwa ndili ndi matenda amitsempha yamagazi. Ngakhale zimathandiza, ndimadziona kuti ndine wazaka 30.
Zofananira zotsika mtengo
Madokotala nthawi zambiri amapereka mankhwala Lozap. Ma analogs ndi choloweza mmalo mwa mankhwalawa amagwiritsidwa ntchito ngati mukulimbana ndi thupi.
- Vazotens ndi cholowa m'malo mwa mapiritsi a Lozap. Ili ndi gawo limodzi lofanana, komanso mndandanda wazofanana. Kugwiritsira ntchito mankhwalawa kumapangidwa kwa amayi apakati komanso munthawi yoyambira, komanso ana osakwana zaka 18.
- Blocktran ndi cholowa m'malo mwa Lozap chopangidwa ku Russia. Ali ndi chinthu chimodzi chomwe chimagwira, kotero kugwiritsidwa ntchito kwake nthawi zambiri kumayikidwa m'malo mwa Lozap pochizira kulephera kwa mtima ndi matenda oopsa.
- Lozarel ndi analogue ya Lozap. Chosakaniza chophatikizira ndi chimodzimodzi komanso muyezo womwewo. Chifukwa chake, malangizo ogwiritsira ntchito mankhwalawa amayanjananso ndi mndandanda wazisonyezo ndi zoyipa.
Kodi mungasinthe bwanji ngati Lozap sakukakamira?
Momwe mungasinthire Lozap ngati sichipanikiza ndi funso lomwe limakhala pafupipafupi pomwe njira yothetsera vutoli ikutha. Akatswiri amalo m'malo mwake ndi mankhwala ena omwe ali ndi zofanana malinga ndi malangizo ogwiritsira ntchito.
Izi zimachitika nthawi zambiri chifukwa chakuti matenda oopsa amathamanga pang'onopang'ono ndipo mankhwalawa amayamba kugwira ntchito. Pali njira zitatu zothetsera vutoli:
- kuchuluka kwa mlingo
- Kukhazikitsa mankhwala osakanikirana, ndiko kuti, kuwonjezera kwa mankhwala ena,
- m'malo mwa zomwe zimagwiritsidwa ntchito.
Mndandanda waiwo waperekedwa pamwambapa. Malinga ndi njira yomwe wodwalayo amadwala komanso malangizo a mankhwalawo, dokotalayo amasankha njira zamankhwala ndikuwonetsetsa momwe zimayendera pazochitika zina.