Angiopril - malangizo ogwiritsira ntchito

Mayina apadziko lonse lapansi - kapitawo

Kupanga ndi mawonekedwe a kumasulidwa. Zomwe zimagwira ndi capopril. Mapiritsi 0.025 ndi 0.05 g, ma PC 10. mu phukusi.

Kugwiritsa ntchito mankhwala angiopril pokhapokha ngati adokotala adafotokoza, malongosoledwe amaperekedwa kuti awathandize!

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Mankhwala

Antihypertensive, vasodilator, mtima, natriuretic. Imalepheretsa ACE, imalepheretsa kusintha kwa angiotensin II ndi angiotensin II ndikulepheretsa ma inactivation amkati vasodilators. Mphamvu ya antihypertensive imawonetsedwa mphindi 15-60 pambuyo pakupita pakamwa, imafika patadutsa mphindi 60-90 ndipo imatenga maola 6-12. Imachepetsa kugunda kwa mtima, pre-and afterload pamtima, kuthamanga mu mzere wam'mapapo komanso kukana kwa zotupa zam'mapapo, kumawonjezera kutulutsa kwamtima (HR) sasintha). Imakhala ndi zotsatira zamtima. Mwansanga komanso kumamwa kwathunthu kuchokera mumimba. Kugwiritsira ntchito kwamothandizirana kumathandizanso kuti kukhale kofunikira kwambiri ndipo kumathandizira poyambira kuchitapo kanthu. Imadutsa zotchinga za histoeticological, kupatula BBB, kudzera mu placenta ndikudutsa mkaka wa m'mawere. Kutha kwa theka la moyo kumapangitsa maola 2-3. Chosangalatsa makamaka ndi impso.

Zizindikiro zogwiritsidwa ntchito

Matenda oopsa a magazi, kuphatikiza kukonzanso (kofatsa kapena kosasintha monga mankhwala oyambira kusankha, wamphamvu ngati chithandizo chokwanira sichithandiza kapena kulekerera bwino), CHF (kuphatikiza mankhwala), kukomoka kwa LV pambuyo pofundira kwa myocardial munthawi yokhazikika, matenda a shuga ndi nephropathy yokhala ndi matenda a shuga 2. 1 (ndi albinuria zoposa 30 mg / tsiku).

Contraindication

Hypersensitivity kwa Captopril kapena zoletsa zina za ACE, kutenga pakati, kuyamwa (ku Russia, mankhwalawa saloledwa kugwiritsidwa ntchito mwa anthu osaposa zaka 18.) Chenjezo. Mbiri ya angioedema pa mankhwala a ACE zoletsa, cholowa kapena idiopathic angioedema, aortic stenosis, matenda a mtima komanso a mtima (kuphatikizapo matenda a kuchepa kwa magazi, matenda a mtima, kuchepa kwa mtima), matenda oopsa a autoimmune SLE, scleroderma), chopewera cha m'matumbo a hematopoiesis, matenda a shuga, matenda oopsa, matenda amitsempha yamagazi, stenosis yamitsempha yama impso, vuto pambuyo pakupatsirana impso, Kulephera kwa impso ndi / kapena chiwindi, chakudya chokhala ndi malire a Na +, mikhalidwe yotsatana ndi kuchepa kwa BCC (kuphatikiza kutsegula m'mimba, kusanza), ukalamba.

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

Mkati, ola limodzi musanadye chakudya, komanso matenda oopsa, mankhwalawa amayamba ndi mankhwala ochepa kwambiri a 12,5 mg 2 kawiri pa tsiku (kawirikawiri ndi 6.25 mg 2 kawiri pa tsiku). Kuyang'aniridwa kuyenera kulipidwa pakubweza kwa nthawi yoyamba paola loyamba. Ngati matenda oopsa amayamba pakali pano, wodwalayo ayenera kupita kumalo opingasa (zoterezi zikachitika kwa mlingo woyamba sayenera kukhala cholepheretsa kupititsa patsogolo mankhwala). Ndi Captopril monotherapy, zotsatira zabwino zitha kupezeka mwa munthawi yomweyo kuchepetsa kudya kwa Na + mthupi.

Ndi njira ya chithandizo, mlingo, ngati pakufunika, umawonjezereka pambuyo pa masabata 2-4, momwe mungathere - mpaka 50 mg katatu pa tsiku. Mu matenda oopsa kwambiri a arterial hypertension (magazi a diastolic a 115 mm Hg kapena apamwamba), nthawi zambiri amaphatikizidwa ndi mankhwala ena a antihypertensive, nthawi zambiri amakhala ndi thiazide diuretics (hydrochlorothiazide - 25-50 mg / tsiku). Mlingo wa diuretic ungathe kuwonjezeredwa ndi gawo la milungu iwiri mpaka mulingo woyenera womwe umagwiritsidwa ntchito pochiza matenda oopsa.

Mlingo wokonza wa "wofatsa" komanso ochepa ochepa ochepa oopsa (95 mg 14 mm Hg) ndi 25 mg (nthawi zina 12,5 mg) kawiri pa tsiku.

Mwa odwala okalamba, mlingo woyambirira ndi 6.25 mg 2 kawiri pa tsiku.

Pankhani ya kulephera kwa mtima, imayikidwa limodzi ndi okodzetsa komanso / kapena kuphatikizira kukonzekera kwa digito (pofuna kupewa kuchepa kwambiri kwa kuthamanga kwa magazi musanayambe kuperekera kapitawo, diuretic imathetsedwa kapena kuti mlingo umachepetsedwa). Mlingo woyambirira ndi 6.25 mg kapena 12,5 mg katatu patsiku, ngati kuli kotheka, onjezani mlingo kuti 25 mg katatu pa tsiku. Mlingo wambiri watsiku ndi tsiku ndi 150 mg.

Ngati vuto la LV layimitsidwa pambuyo povutika m'mitsempha yamatumbo mwa odwala omwe ali ndi matenda okhazikika, mankhwalawa amatha kuyambika patangotha ​​masiku atatu pambuyo poti myocardial infarction. Mlingo woyambirira ndi 6.25 mg / tsiku, ndiye kuti tsiku lililonse mlingo ungathe kuchuluka mpaka 37,5-75 mg mu 2-3 Mlingo (malingana ndi kulekerera kwa mankhwalawa) mpaka mpaka 150 mg / tsiku.

Ndi kukula kwa ochepa hypotension, kuchepetsa mlingo kungafunike. Kuyesera kotsatira kugwiritsa ntchito mlingo waukulu wa tsiku ndi tsiku wa 150 mg kuyenera kutengera kulolera kwaposachedwa.

Mu matenda a shuga a nephropathy, mlingo wa 75-150 mg / tsiku ndi mankhwala.

Ndi mulingo woyenera waimpso ntchito (CC osachepera 30 ml / mphindi / 1.73 sq.m), Captopril ikhoza kutumikiridwa pa mlingo wa 75-100 mg / tsiku. Ndi kuchuluka kutalika kwa aimpso kukanika (CC zosakwana 30 ml / mphindi / 1.73 m), mlingo woyambirira sayenera kupitirira 12,5 mg / tsiku, ndiye, ngati kuli koyenera, mlingo wa captopril umakulitsidwa pang'onopang'ono mosalekeza kwakanthawi, koma gwiritsani ntchito ochepera Pankhani ya chithandizo cha matenda oopsa, tsiku lililonse mankhwala.

Ana (ku Russia kugwiritsa ntchito ana sikuloledwa) amangolembera okhawo oopsa oopsa (osagwirizana ndi zina zamankhwala) pa mlingo wa 0.1-0.4 mg / kg kawiri pa tsiku.

Makanda obadwa kumene - mlingo woyambirira wa 0,01 mg / kg katatu patsiku, ana okulirapo - mlingo woyambirira wa 0.3 mg / kg katatu pa tsiku, ngati kuli kotheka, muwonjezere mlingo ndi 0,3 mg / kg mosalekeza kwa maola 8 mpaka atatu mpaka muyezo wogwira .

Zotsatira za pharmacological

ACE inhibitor. Imachepetsa kupangika kwa angiotensin II kuchokera ku angiotensin I. Kutsika kwa zomwe angiotensin II kumabweretsa kutsika kwachindunji kutulutsidwa kwa aldosterone. Nthawi yomweyo, OPSS, kuthamanga kwa magazi, kutumiza- ndikuyika pamtima kumachepa. Imakulitsa mitsempha pamlingo wokulirapo kuposa mitsempha. Zimayambitsa kuchepa kwa kuchepa kwa bradykinin (imodzi mwazotsatira za ACE) ndikuwonjezereka kwa kapangidwe ka Pg.

Mphamvu ya antihypertensive siyidalira ntchito ya plasma renin, kuchepa kwa kuthamanga kwa magazi kumadziwika mwazonse komanso ngakhale kuchepetsedwa kwa mahomoni, zomwe zimachitika chifukwa cha mphamvu ya minyewa ya renin-angiotensin. Imawonjezera kuyenda kwa magazi ndi impso.

Kugwiritsa ntchito nthawi yayitali, kumachepetsa kuopsa kwa hypertrophy ya myocardium komanso makoma amitsempha ya mtundu wotsalira. Amasintha magazi kupita ku ischemic myocardium. Imachepetsa kuphatikizika kwa mapulosi. Zimathandizira kuchepetsa zomwe zili Na + mu odwala omwe ali ndi vuto la mtima.

Pa Mlingo wa 50 mg / tsiku, imawonetsa katundu wokhudzana ndi ziwiya za microvasculature ndipo imachepetsa kupitilira kwa matenda aimpso kulephera kwa matenda ashuga nephroangiopathy.

Kutsika kwa kuthamanga kwa magazi, mosiyana ndi vasodilators owongolera (hydralazine, minoxidil, etc.) sikuyenda ndi Reflex tachycardia ndipo kumabweretsa kutsika kwa kufunikira kwa myocardial oxygen. Ngati mtima kulephera mu mlingo wokwanira sikukhudza phindu la kuthamanga kwa magazi.

Kutsika kwakukulu kwa kuthamanga kwa magazi pambuyo pakukonzekera pakamwa kumawonedwa pambuyo pa mphindi 60-90. Kutalika kwa hypotensive zotsatira kumadalira mlingo ndipo kumafika pazabwino zochuluka mwa masabata ochepa.

Zotsatira zoyipa

Kuchokera ku CCC: tachycardia, kutsika kwa magazi, orthostatic hypotension.

Kuchokera kwamanjenje: chizungulire, kupweteka mutu, kumva kutopa, asthenia, paresthesia.

Kuchokera kwamikodzo dongosolo: proteinuria, mkhutu aimpso (kuchuluka kwa urea ndi creatinine m'magazi).

Kuchokera kumbali ya madzi-electrolyte metabolism: hyperkalemia, acidosis.

Kuchokera ku ziwalo za hemopoietic: neutropenia, kuchepa magazi, thrombocytopenia, agranulocytosis.

Thupi lawo siligwirizana: angioedema, kutupa kwa magazi pakhungu la nkhope, malungo, zotupa pakhungu, maculopapular, osavulala kwamaso kapena amphongo), kuyabwa, photosensitivity, bronchospasm, seramu matenda, lymphadenopathy, kawirikawiri, mawonekedwe a antinuclear antibodies m'magazi.

Kuchokera pamimba: kukomoka kulawa, kuchepa kwa chakudya, kuchepa kwa matumbo, zizindikiro za kukomoka, mseru, kupweteka kwam'mimba, kudzimbidwa kapena kutsegula m'mimba, kuchuluka kwa hepatic transaminases, hyperbilirubinemia, zizindikiro za kuwonongeka kwa hepatocellular (hepatitis) ndi cholestasis (nthawi zina), kapamba (padera).

Ena: "youma" chifuwa, kudutsa atasiya mankhwala, asthenia, kutupa miyendo. Zizindikiro: kuchepa kwakukulu kwa kuthamanga kwa magazi, mpaka kugwa, kulowerera m'mitsempha, ngozi ya pachimake ya magazi, zovuta za thromboembolic.

Chithandizo: ikani wodwalayo ndi miyendo yokwezeka, miyeso yofuna kubwezeretsa kuthamanga kwa magazi (kuchuluka kwa BCC, kuphatikizapo iv kulowetsedwa kwa 0.9% NaCl yankho), dalili zochizira. Akuluakulu, hemodialysis ndiyotheka, peritoneal dialysis siyothandiza.

Malangizo apadera

Musanayambe, komanso pafupipafupi pa mankhwala a capopril, ntchito ya impso iyenera kuyang'aniridwa. Odwala omwe ali ndi CHF, amagwiritsidwa ntchito moyang'aniridwa ndi achipatala.

Poyerekeza ndi kugwiritsidwa ntchito kwa nthawi yayitali kwa Captopril pafupifupi 20% ya odwala, pali kuwonjezeka kosasunthika kwa urea ndi creatinine mu seramu ndi oposa 20% poyerekeza ndi kuchuluka kapena mtengo woyambirira. Osakwana 5% odwala, makamaka omwe ali ndi nephropathy yayikulu, amafunikira kuleka kulandira chithandizo chifukwa cha kuchuluka kwa ndende ya creatinine.

Odwala omwe ali ndi vuto losakanikira kwamankhwala lodziwika bwino ndi hypopension, ochepa owopsa amawonedwa nthawi zina, mwayi wokhala ndi vutoli umawonjezeka ndi kuchepa (kutayika) kwamadzimadzi ndi mchere (mwachitsanzo, pambuyo pa chithandizo chokwanira ndi diuretics), mwa odwala omwe ali ndi vuto la mtima kapena akudwala matenda amitsempha.

Kuthekera kwa kuchepa kwambiri kwa kuthamanga kwa magazi kumachepetsedwa ndi kuyimitsidwa koyambirira (masiku 4-7) a okodzetsa kapena kuwonjezeka kwa kudya kwa NaCl (pafupifupi sabata 1 isanayambike makonzedwe), kapena mwa kutumiza kapitawo kumayambiriro kwa mankhwalawa pamiyeso yaying'ono (6.25-12,5 mg / tsiku).

Pa mankhwala pamalopo, chenjezani wodwalayo za mawonekedwe a matenda, kufunsidwa kwa mayeso kuchipatala, kuyezetsa kuchipatala ndi ma labotale. M'miyezi itatu yoyambirira ya mankhwalawa, kuchuluka kwa magazi a leukocytes kumayang'aniridwa pamwezi (apa - kamodzi pa miyezi itatu), mwa odwala omwe ali ndi matenda a autoimmune m'miyezi itatu yoyamba - milungu iwiri iliyonse, ndiye - miyezi iwiri iliyonse. Ngati kuchuluka kwa leukocytes ndi ochepera 4,000 / μl, kuyezetsa magazi konse kumasonyezedwa, pansi pa 1 chikwi / μl, mankhwalawa amayimitsidwa. Ngati zizindikiro zoyambirira za matenda opatsirana zikuchitika motsutsana ndi myeloid hypoplasia, kuyezetsa magazi mwatsatanetsatane kuyenera kuchitidwa nthawi yomweyo.

M'pofunika kusiyiratu kudziletsa kwa mankhwalawo komanso kuwonjezeka kwakukulu pakulimbitsa thupi.

Nthawi zina, motsutsana ndi kugwiritsidwa ntchito kwa ACE zoletsa, kuphatikiza Captopril, pali kuwonjezeka kwa kuchuluka kwa K + mu seramu. Chiwopsezo chotenga hyperkalemia chogwiritsa ntchito ACE inhibitors chikuwonjezeka mwa odwala omwe amalephera kupweteka kwa minyewa komanso matenda a shuga, komanso omwe amamwa mankhwala a potaziyamu posachedwa, mankhwala a K + kapena mankhwala ena omwe amachititsa kuchuluka kwa kuchuluka kwa K + m'magazi (mwachitsanzo, heparin). Kugwiritsa ntchito munthawi yomweyo mankhwala osakanikirana a potaziyamu komanso kukonzekera kwa K + kuyenera kupewedwa.

Pochita hemodialysis odwala omwe alandila capopril, kugwiritsa ntchito kwapamwamba kwambiri kwa dialysis membrane (mwachitsanzo AN69) kuyenera kupewedwa, chifukwa nthawi zotere chiopsezo chokhala ndi anaphylactoid zimachitika.

Pankhani ya kukula kwa angioedema, mankhwalawa amathetsedwa ndikuyang'aniridwa kwathunthu kwa mankhwala ndi dalili zimachitika.

Mukamamwa mankhwalawa, zotsatira zoyipa zimawonedwa pokambirana mkodzo wa acetone.

Odwala omwe amadya mchere wopanda mchere kapena wopanda mchere ali ndi chiopsezo chowonjezereka cha kuthamanga kwa magazi komanso kukula kwa hyperkalemia.

Munthawi ya chithandizo, chisamaliro chimayenera kuchitika mukamayendetsa magalimoto ndikuchita zina zomwe zingakhale zowopsa zomwe zimafunikira chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor (chizungulire ndikotheka, makamaka mutatha kumwa koyamba).

Kuchita

Kuchulukitsa kuchuluka kwa digoxin mu plasma ndi 15-20%.

Cimetidine, akuchepetsa kagayidwe kachakudya ka chiwindi, kamakulitsa kuchuluka kwa kapangidwe kake mu plasma.

Mphamvu ya antihypertensive imafooketsedwa ndi NSAIDs (Na + posungira ndikuchepetsa kapangidwe ka Pg), makamaka motsutsana ndi maziko a ndende yotsika, komanso estrogens (Na + kuchepera).

Kuphatikiza ndi thiazide diuretics, vasodilators (minoxidil), verapamil, beta-blockers, tricyclic antidepressants, Mowa umapititsa patsogolo hypotensive.

Kugwiritsa ntchito kosakanikirana ndi potaziyamu-yosasamala okodzetsa, K + kukonzekera, cyclosporine, mkaka wocheperako wa Na + (ukhoza kukhala ndi K + mpaka 60 mmol / l), zowonjezera za potaziyamu, zotulutsa mchere (zimakhala ndi K + zochulukirapo) zimawonjezera chiopsezo cha hyperkalemia.

Imachepetsa kuchotsera kwa mankhwala a Li +.

Clonidine amachepetsa kuopsa kwa hypotensive zotsatira.

Ndi kusankha kwa captopril pamene mukumwa allopurinol kapena procainamide, chiwopsezo cha kukhala ndi matenda a Stevens-Johnson ndi immunosuppression chikuwonjezeka.

Kugwiritsidwa ntchito kwa Captopril mwa odwala omwe amalandila ma immunosuppressants (mwachitsanzo azathioprine kapena cyclophosphamide) kumawonjezera mwayi wokhala ndi vuto la hematologic.

Chenjezo pakugwiritsa ntchito

Chithandizo chikuchitidwa moyang'aniridwa ndi achipatala pafupipafupi. Pa mankhwala, kuwunika kuthamanga kwa magazi, mawonekedwe a magazi ofunda, kuchuluka kwa mapuloteni, plasma potaziyamu, urea nayitrogeni, creatinine, ntchito ya impso, thupi, komanso kudya ndizofunikira. Ndi chitukuko cha hyponatremia, kuchepa madzi m'thupi, kukonza mankhwalawa ndikofunikira. Chenjezo limafunikira pochita opaleshoni yothandizira (kuphatikizapo mano), makamaka mukamagwiritsa ntchito mankhwala oletsa kupanikizika omwe ali ndi vuto lotsogolera. Ndikulimbikitsidwa kupatula kumwa zakumwa zoledzeretsa pamankhwala. Gwiritsani ntchito mosamala mukamagwira ntchito yoyendetsa magalimoto ndi anthu omwe ntchito yawo imalumikizidwa ndi chidwi chochuluka. Ngati mulibe mankhwala, mankhwalawa sawonjezereka. Mukamayesa acetonuria, zotsatira zabwino zimakhala zotheka.

Zotsatira zoyipa

Kuchokera kumbali yamanjenje yamanjenje ndi ziwalo zam'maganizo: kutopa, chizungulire, kupweteka mutu, kukhumudwa kwa chapakati mantha, kugona, chisokonezo, kukhumudwa, ataxia, kukokana, dzanzi kapena kugwedezeka pamphepete, kusawona bwino komanso / kapena kununkhira. Kuchokera pamtima ndi magazi (hematopoiesis, hemostasis): Hypotension, kuphatikizapo orthostatic, angina pectoris, myocardial infarction, mtima arrhythmias (atria tachy kapena bradycardia, atraya fibrillation), palpitations, pachimake cerebrovascular ngozi, zotumphukira edema, lymphadenopathy, kuchepa magazi, chifuwa, pulmona embolism, pulmonary embolism. ndi mkhutu aimpso ntchito, motsutsana ndi maziko a collagenoses), thrombocytopenia, eosinophilia. Kuchokera kupuma dongosolo: bronchospasm, kufupika, interstitial pneumonitis, bronchitis, osabereka chifuwa. Kuchokera mmimba thirakiti: matenda anorexia, vuto la kukoma, kuchepa kwamatumbo, zotupa zamkamwa ndi m'mimba, xerostomia, glossitis, kumeza kupweteka, kusanza, kusanza, kupweteka kwam'mimba, kupweteka kwam'mimba, kupweteka kwa m'mimba, kuwonongeka kwa chiwindi (cholestasis) , cholestatic hepatitis, hepatocellular necrosis). Kuchokera ku genitourinary system: mkhutu waimpso, oliguria, proteinuria, kusabala. Kuchokera pakhungu: redness of the nkhope, zotupa, kuyabwa, kukoka kwa khungu, poyizoni wa khungu, necrolysis, pemphigus, herpes zoster, alopecia, Photodermatitis. Zotsatira zamagetsi: Matenda a Stevens-Johnson, urticaria, edincke's edema, anaphylactic mantha, ndi ena Zoyenera kuchita poyesa ma antibodies a antigen nyukiliya.

Mlingo ndi makonzedwe

Mkati, 1 ora musanadye. Mlingo woyeserera umakhazikitsidwa payekhapayekha.

Ndi ochepa matenda oopsa - mu koyamba mlingo wa 25 mg 2 kawiri pa tsiku. Ngati ndi kotheka, kumwa pang'onopang'ono (pang'onopang'ono kwa masabata awiri ndi awiri) kumawonjezeka mpaka pakhale zotsatira zabwino. Ndi ochepa kapena olimbitsa ochepa ochepa, tsiku lililonse mankhwalawa 25 25 kawiri pa tsiku. Mlingo wapamwamba ndi 50 mg 2 kawiri pa tsiku. Pa matenda oopsa kwambiri, ochepa kwambiri ndi 50 mg katatu patsiku. Mlingo wambiri watsiku ndi tsiku ndi 150 mg.

Kulephera kwamtima kosalekeza, Angiopril amalembedwa nthawi yomwe kugwiritsa ntchito okodzetsa sapereka kokwanira. Mlingo wapakati wokonza ndi 25 mg katatu patsiku. M'tsogolomu, ngati kuli kotheka, onjezani mlingo (wokhala ndi masabata osachepera awiri). Mlingo wambiri watsiku ndi tsiku ndi 150 mg.

Kwa odwala omwe ali ndi vuto laimpso lozungulira (Cl creatinine osachepera 30 ml / min), Angiopril akhoza kutumikiridwa pa mlingo wa 75-100 mg / tsiku. Ndi digiri yotchulidwa yaimpso kuwonongeka (Cl creatinine ® -25

Pewani kufikira ana.

Dzinalo Losayenerana

Dzinalo losayenerana ndi malonda padziko lonse lapansi ndi Captopril.

Pazithandizo zawo zamitsempha yamagazi, chithandizo chovuta ndichofunikira, chomwe chimaphatikizapo kumwa mankhwala, monga angiopril.

Mankhwalawa ali ndi nambala yotsatirayi ya ATX: C09AA01.

Kutulutsa mafomu ndi kapangidwe kake

Kutulutsidwa kwa mankhwalawa kumachitika mwa mawonekedwe a mapiritsi omwe amayikidwa mu mizere ya 10 ma PC ndi 4 ma PC. Mtolo wa makatoni ukhoza kukhala ndi mapiritsi 1, 3, 10 a mapiritsi 10 lililonse kapena 1 strip yokhala ndi mapiritsi 4. Chosakaniza chophatikizacho ndi capopril - 25 mg. Kuphatikiza apo, stearic acid, lactose, wowuma chimanga, colloidal silicon dioxide ndi microcrystalline cellulose amagwiritsidwa ntchito.

Pharmacokinetics

Mutatenga mapiritsi, imatengedwa mwachangu m'mimba chifukwa cha bioavailability 60-70%. Kutsika pang'ono kumawonedwa ndi kugwiritsa ntchito njira imodzi ndi chakudya. Hafu ya moyo amatanthauza kutenga maola 2-3. Hafu ya mankhwala ophatikizira amadzazidwa mu mkodzo mwanjira yosasintha.

Ndi matenda ashuga

Ngati wodwala ali ndi matenda ashuga a nephropathy, ndiye kuti mankhwalawa amatengedwa pa 75-150 mg patsiku. Mlingo ungasinthidwe ndi omwe akukuthandizani.

Ngati wodwala ali ndi matenda ashuga a nephropathy, ndiye kuti mankhwalawa amatengedwa pa 75-150 mg patsiku.

Kugwiritsa ntchito kwa vuto la chiwindi

Mosamala komanso moyang'aniridwa ndi achipatala, amamwa mankhwalawa pamavuto a chiwindi.

Kuyenderana ndi mowa

Pa mankhwala, amaletsedwa kumwa mowa. Kuyanjana kwawo ndi gawo lomwe limagwira kungayambitse matenda oopsa.

Pa mankhwala, amaletsedwa kumwa mowa.

Ngati ndi kotheka, mankhwalawo amasinthidwa ndi analog. Ena mwa iwo ndi awa:

Kusintha kwa mankhwalawa kuyenera kuchitika ndi dokotala yemwe angasankhe mankhwalawa poganizira zomwe zimachitika m'thupi la wodwalayo komanso kuopsa kwa matenda.