Aprovel mapiritsi 300 mg No. 28

Mankhwala

Angiotensin II receptor antagonist. Zimayambitsa kuchuluka reninndi angiotensin II m'magazi ndi kuchepa kwa ndende aldosterone. Kusintha potaziyamumagazi sasintha.
Mlingo wothandizidwa pang'onopang'ono umachepetsa kuthamanga kwa magazi, koma mukamagwiritsa ntchito pamwamba pa 900 mg / tsiku, kuchuluka kwa zotsatira za hypotensive sikungathandize. Kuchepa kwa kuthamanga kwa magazi kumawonedwa pambuyo pa maola 3-6, zotsatira zake zimapitilira kwa maola 24.
Antihypertensive zotsatira limakula masabata 1-2, ndipo kuchuluka kwake kumadziwika pambuyo pa miyezi 1-1.5. Kuchita bwino sikudalira jenda. Mankhwalawa samakhudza kuchuluka kwa uric acid m'magazi. Cancellation syndrome sichikudziwika.

Irbesartan sizikhudza ntchito aimpso odwala matenda ashuga nephropathy, glomerulonephritis, motero, ndi mankhwala osankha mu odwalawa.

Pharmacokinetics

Imatenga bwino, bioavailability wa 60-80%. Kuzindikira kwakukulu kumatsimikiziridwa m'magazi pambuyo pa maola 1.5-2, kuyanjana - pambuyo masiku atatu. Amamangidwa ndi mapuloteni ndi 96%.

Amapangidwa ndi dongosolo la cytochrome P450 CYP2C9 la chiwindi. Amachotseredwa ndi chiwindi ndi impso. T1 / 2 ndi maola 11-14. Kwa odwala omwe ali ndi vuto la ziwalozi, komanso kwa achikulire, kusintha kwa mankhwalawa sikuchitika.

Zizindikiro zogwiritsidwa ntchito

Aprovel imagwiritsidwa ntchito:

Ndi mosamala amayika liti hyponatremia, aortic valve stenosis, aimpso mtsempha wamagazi stenosis, matenda a mtimazolemetsa otupandi kulephera kwa aimpso.

Zotsatira zoyipa

Aprovel angayambitse:

• chizungulire orthostatic hypotension,
• kufooka
• tachycardia,
• kutsokomola, kupweteka pachifuwa,
• kusanza, kusanza, kutsegula m'mimbakutentha kwa mtima
• kusowa pogonana,
• kuchuluka kwa CPK, Hyperkalemia,
• mafupa ndi minofu
• zotupa, urticaria, angioedema.

Malangizo ogwiritsira ntchito Aprovel (Njira ndi Mlingo)

Piritsi imatengedwa pakamwa popanda kutafuna. Chithandizo chimayamba ndi 150 mg kamodzi patsiku, mlingo uwu umapereka kuyendetsa magazi kwa maola 24. Ndi kusakwanira, mlingo umakwera mpaka 300 mg.

At mtundu II matenda a shuga ndi matenda oopsa 150 mg / tsiku limayikidwa koyamba ndi kuwonjezeka kwa 300 mg, popeza kuti mankhwalawa ndi othandizanso pakumwa nephropathy. Kwa anthu osaposa zaka 75 ndi odwala hemodialysis, mankhwalawa ndi mankhwala koyamba 75 mg. Poika diuretic kumawonjezera mphamvu ya mankhwala.

Mankhwala Co Aprovel Kuphatikiza kwa irbesartan + hydrochlorothiazide Mlingo wa 150 mg / 12,5 mg ndi 300 mg / 12,5 mg.

Malangizo ogwiritsira ntchito Aprovel ali ndi chidziwitso chomwe chimapangitsa kuti matenda a impso ndi chiwindi azidwala odwala sichifuna kusintha kwa mlingo.

Bongo

Chikuonetseratu muyezo mpaka 900 mg / tsiku. kwa miyezi iwiri sanali limodzi ndi bongo. Zizindikiro zake: bradycardiakapena tachycardiakutsitsa magazi.

Chithandizo chimakhala ndi zakumwa zam'mimba, kuwunika kwa wodwala, komanso chithandizo chamankhwala.

Kuchita

Aprovel akagwiritsidwa ntchito ndi potaziyamu kukonzekera kungayambitse kuchuluka kwa potaziyamu m'magazi. Thiazide okodzetsa Sinthani mphamvu yake yopatsa chidwi.

Kukonzekera komwe kuli aliskirensingagwiritsidwe ntchito limodzi ndi Aprovel pamene matenda ashuga kapena kulephera kwa aimpso, popeza pali chiopsezo chachikulu cha kuchepa kwambiri kwa kuthamanga kwa magazi, kuwonongeka kwa impso ndi zomwe zimachitika Hyperkalemia.

Mukamagwiritsa ntchito mankhwala osokoneza bongo lifiyamumagazi mandimu akulimbikitsidwa.

NSAIDskufooketsa Hypotensive kwambiri, kuonjezera potaziyamu ndi chiopsezo cha kuwonongeka kwaimpso.

Irbesartan sichikhudza pharmacokinetics digoxin.

Pharmacological zochita za Aprovel

Malinga ndi malangizo, Aprovel amathandizira kuchepetsa kuthamanga kwa magazi popanda kukhudza kugunda kwa mtima. Maola 3-6 mutatenga Aprovel, kuchepa kwambiri kwa magazi kumawonedwa. Zotsatira za mankhwalawa zimatha pafupifupi tsiku limodzi. Ngati mumamwa piritsi la Aprovel pa mlingo wa 150 mg, ndiye kuti achire adzakhala chimodzimodzi ndi kumwa mankhwala 75 mg kawiri. Malinga ndi malangizo, Aprovel amakhala ndi vuto lochita kupanikizika, lomwe limayamba sabata limodzi mpaka ziwiri kuyambira pomwe amamwa mankhwalawo. Chithandizo chachikulu kwambiri chogwiritsa ntchito Aprovel chimakwaniritsa zotsatira zabwino pambuyo pa masabata a 6 kuyambira chiyambi cha mankhwala. Ndemanga za Aprovel amati mukasiya kumwa mankhwalawa, zotsatirapo zake zimapitilira kwakanthawi. Aprovel mankhwala ochotsa matenda palibe. Aprovel imachotsedwa m'thupi ndi bile ndi mkodzo.

Mitundu ya kumasulidwa ndi kupangidwa kwa Aprovel

Makampani opanga mankhwala amapanga Aprovel mu mawonekedwe a mapiritsi a 150 mg ndi 300 mg. Mapiritsi aprovel ali ndi mawonekedwe a biconvex, ndiwopanda pake, oyera. Chotumpacho chili ndi miyala 14. Mu phukusi la mankhwala, Aprovel imachitika m'matumba amodzi, awiri kapena anayi.

Mankhwala omwe ali m'gulu la mankhwalawa ndi irbesartan.

Contraindication

Kuphwanya kugwiritsidwa ntchito kwa Aprovel ndi hypersensitivity kwa chinthu chilichonse chamankhwala. Malinga ndi malangizo, Aprovel sayenera kumwedwa panthawi yoyembekezera komanso mkaka wa m'mawere. Ngati ndi kotheka, mkazi akalandira mankhwalawa Aprovel nthawi yoyamwitsa, ndiye kuti mankhwalawa ayenera kusiya kuyamwitsa. Mosamala, Aprovel amagwiritsidwa ntchito mwa odwala osakwanitsa zaka 18, popeza maphunziro aza chitetezo pamakonzedwe a mankhwalawa sanachitike.

Mlingo ndi makonzedwe

Malinga ndi malangizo, Aprovel amatengedwa pakamwa. Chimaledzedwa mosasamala chakudyacho, kamodzi patsiku. Mlingo woyambirira wa Aprovel ndi 150 mg - ngati kuli kotheka, mutha kuonjezera kwa 300 mg ya mankhwala patsiku. Odwala aimpso kuwonongeka, koyamba mlingo ayenera 75 mg patsiku. Odwala opitilira zaka 75 azitenganso kumwa koyamba wa Aprovel mu 75 mg. Zochizira odwala omwe ali ndi matenda oopsa komanso a 2 shuga, muyeso woyamba wa Aprovel ndi 150 mg patsiku. Kenako ikhoza kuwonjezeka pang'onopang'ono mpaka 300 mg. Ndemanga za Aprovel zimatsimikizira zabwino zomwe zimapangitsa odwala omwe ali ndi matenda oopsa.

Aprovel (APROVEL) malangizo ogwiritsira ntchito

ntchito: piritsi 1 la 75 mg lili ndi 75 mg ya irbesartan, piritsi limodzi la 150 mg lili ndi 150 mg ya irbesartan, piritsi limodzi la 300 mg lili ndi 300 mg ya irbesartan,
zokopa: lactose, wowuma chimanga, croscarmellose sodium, poloxamer 188, hydrate silicon dioxide, cellcrystalline cellulose, magnesium stearate.

Mlingo ndi makonzedwe

Mlingo woyambirira komanso wokonza ndi 150 mg kamodzi tsiku lililonse ndi chakudya kapena pamimba yopanda kanthu. Aprovel pa mlingo wa 150 mg kamodzi patsiku nthawi zambiri amapereka bwino kuwongolera kwa maola 24 kuposa kuthamanga kwa 75 mg. Komabe, kumayambiriro kwa mankhwalawa, mlingo wa 75 mg ungagwiritsidwe ntchito, makamaka kwa odwala pa hemodialysis, kapena kwa odwala omwe ali ndi zaka zopitilira 75.

Kwa odwala omwe magazi awo samayendetsedwera mokwanira pa mlingo wa 150 mg kamodzi patsiku, mlingo wa Aprovel ukhoza kuwonjezeka mpaka 300 mg kamodzi patsiku kapena mankhwala ena a antihypertensive atha kutumizidwa. Makamaka, zidawonetsedwa kuti kuwonjezera kwa okodzetsa, monga hydrochlorothiazide, ku mankhwalawa ndi Aprovel kumawonjezeranso zina.

Kwa odwala omwe ali ndi matenda oopsa komanso mtundu 2 shuga, mankhwalawa amayenera kuyamba ndi 150 mg ya irbesartan kamodzi patsiku, ndiye kuti abweretseni 300 mg kamodzi patsiku, yomwe ndi njira yabwino kwambiri yothandizira odwala pochiza matenda a impso.

Zotsatira zabwino za nephroprotective za Aprovel pa impso mwa odwala omwe ali ndi matenda oopsa komanso mtundu II matenda a shuga adawonetsedwa m'maphunziro pomwe irbesartan adagwiritsidwa ntchito ngati adjunct ndi mankhwala ena a antihypertensive, ngati pakufunika, kuti akwaniritse gawo lomwe akutsikira magazi.

Kulephera kwa Ral Kusintha kwa mankhwalawa sikofunikira kwa odwala omwe ali ndi vuto laimpso. Kwa odwala pa hemodialysis, mlingo woyambira wotsika (75 mg) uyenera kugwiritsidwa ntchito.

Kuchepetsa mu BCC. Kuchuluka kwa madzimadzi / magazi ozungulira ndi / kapena kusowa kwa sodium kumachepetsedwa, ndikofunikira kukonza musanagwiritse ntchito mankhwala "Aprovel".

Kulephera kwa chiwindi. Kwa odwala omwe ali ndi kufatsa pang'ono kwa hepatic osakwanira, kusintha kwa mankhwalawa sikofunikira. Palibe zovuta zokhudzana ndi mankhwalawa pogwiritsa ntchito mankhwalawa odwala omwe ali ndi vuto lalikulu la chiwindi.

Odwala okalamba. Ngakhale chithandizo cha odwala opitirira zaka 75 chiyenera kuyamba ndi mlingo wa 75 mg, nthawi zambiri kusintha kwa mankhwalawa sikofunikira.

Gwiritsani ntchito ana. Irbesartan silivomerezeka kuti athandizire ana ndi achinyamata chifukwa chosakwanira chifukwa cha chitetezo chake.

Zotsatira zoyipa

Kusintha kovutikira kotsatidwa pansipa kumatsimikiziridwa motere: zofala kwambiri (³1 / 10), zofala ((1 / 100, 2% odwala kuposa omwe amalandira placebo.

Kuchokera ku dongosolo lamanjenje. Chizungulire wamba.

Vuto la mtima Hypotension wamba.

Matenda a musculoskeletal, kusokonezeka kwa minofu yolumikizana ndi mafupa. Ululu wamba wamphongo.

Kafukufuku wa Laborator. Hyperkalemia imatha kupezeka mwa odwala matenda a shuga omwe amalandila irbesartan kuposa placebo. Odwala omwe ali ndi matenda a shuga omwe amakhala ndi matenda oopsa, omwe anali ndi microalbuminuria komanso aimpso ntchito, hyperkalemia (³ 5.5 mEq / mol) amawonetsedwa mu 29.4% (zotsatira zoyipa kwambiri) za odwala omwe amalandira 300 mg ya irbesartan komanso 22% ya odwala omwe akulandira placebo . Odwala a shuga omwe ali ndi matenda oopsa, anali ndi vuto la impso komanso proteinuria yayikulu, er 5.5 mEq / mol) amawonekera mu 46.3% (zotsatira zoyipa kwambiri) za odwala omwe amalandila irbesartan komanso 26.3% ya odwala omwe amalandila placebo.

Kutsika kwa hemoglobin, komwe sikunali kofunika kwambiri m'mankhwala, kunawonedwa mu 1.7% (zotsatira zoyipa) za odwala oopsa komanso odwala matenda ashuga othamanga omwe amathandizidwa ndi irbesartan.

Zotsatira zowonjezera zotsatirazi zanenedwa nthawi yakufufuza pambuyo pakutsatsa. Popeza izi zimapezeka kuchokera ku mauthenga okhazikika, sizingatheke kudziwa kuchuluka kwa zomwe zimachitika.

Kuchokera ku chitetezo chamthupi. Monga ndi ena angiotensin II olandilira okokana, hypersensitivity reaction, monga zotupa, urticaria, angioedema, sizinanenedwe kuti.

Kuphwanya kagayidwe kachakudya ndi mayamwidwe michere. Hyperkalemia

Kuchokera ku dongosolo lamanjenje. Mutu.

Kumva kuwonongeka ndi zida zapamwamba. Tinnitus.

Matenda Am'mimba. Dysgeusia (kusintha kukoma).

Machitidwe a heepatobiliary. Hepatitis, chiwindi ntchito.

Matenda a musculoskeletal, kusokonezeka kwa minofu yolumikizana ndi mafupa. Arthralgia, myalgia (nthawi zina amagwirizana ndi kuchuluka kwa ma seramu CPK), kukokana kwa minofu.

Matenda aimpso ndi mkodzo dongosolo. Kuwonongeka kwa impso, kuphatikizapo kulephera kwa aimpso kwa odwala omwe ali pachiwopsezo chachikulu (onani "Makhalidwe Ogwiritsira Ntchito").

Pa khungu ndi subcutaneous minofu. Leukocytoclastic vasculitis.

Gwiritsani ntchito ana. Mu kafukufuku wosasankhidwa pamasabata atatu owona kawiri m'magulu a ana 318 ndi achinyamata wazaka 6 mpaka 16, wokhala ndi matenda oopsa, zotsatirazi zidawoneka: mutu (7.9%), hypotension (2.2%), chizungulire (1.9%), chifuwa (0.9%). Munthawi yamasabata otseguka a 26, kupatuka kuzizindikiro za labotale nthawi zambiri kumawonedwa: kuwonjezeka kwa creatinine (6.5%) komanso kuwonjezeka kwa CPK (SC) mu 2% ya ana omwe amalandila.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Kugwiritsa ntchito mankhwalawa "Aprovel" akuphatikizidwa mu II ndi III trimesters a mimba. Munthawi yachiwiri komanso yachitatu ya kutenga pakati, mankhwala omwe amakhudza mwachindunji dongosolo la renin-angiotensin angayambitse kulephera kwa impso kapena mwana wakhanda, hypoplasia ya chigaza cha fetal ngakhale kufa.

Pofuna kusamala, osavomerezeka kugwiritsa ntchito munthawi yoyambirira ya mimba.

M'pofunika kusinthira ku njira ina yothandizira musanakhale ndi pakati. Ngati amayi apezeka kuti ali ndi pakati, kugwiritsa ntchito irbesartan kuyenera kuimitsidwa posachedwa ndipo vuto la chigoba ndi impso liyenera kuwunikidwa pogwiritsa ntchito ultrasound, ngati chithandizo chosagwirizana chimatenga nthawi yayitali.

Kugwiritsa ntchito mankhwalawa "Aprovel" kumapangidwa pakamayamwa. Sizikudziwika ngati irbesartan yachotsedwa mkaka wa m'mawere. Aprovel amachotseredwa mkaka wa ratimu nthawi ya mkaka wa m'mawere.

Aprovel adawerengeredwa pagulu la ana azaka za 6 mpaka 16, koma zomwe zikupezeka lero sizokwanira kuwonjezera ziwonetsero zake kuti zizigwiritsidwa ntchito mwa ana mpaka idatha yowonjezera itapezeka.

Zolemba zogwiritsira ntchito

Kuchepetsa mu BCC. Zizindikiro zamitsempha yama hypotension, makamaka mutatenga koyamba mlingo, zimatha kupezeka kwa odwala omwe ali ndi BCC yochepa komanso / kapena otsika sodium chifukwa chogwiritsa ntchito diuretic mankhwala, zakudya zokhala ndi mchere wochepa, kutsegula m'mimba, kapena kusanza. Zizindikiro izi ziyenera kubwezeretsedwanso masiku onse musanagwiritse ntchito mankhwala "Aprovel."

Arterial Renovascular Hypertension. Mukamagwiritsa ntchito mankhwala omwe amakhudzanso renin-angiotensin-aldosterone, pamakhala ngozi yowonjezereka yoopsa kwambiri komanso kulephera kwaimpso kwa odwala omwe ali ndi vuto la impso. Ngakhale milandu ngati imeneyi sinachitike ndi kugwiritsa ntchito mankhwala a Aprovel, pogwiritsa ntchito angiotensin I receptor antagonists, zotsatira zofananazi zitha kuyembekezeredwa.

Kulephera kwamkati ndi kupatsirana kwa impso. Pogwiritsa ntchito Aprovel kuchiza odwala omwe ali ndi vuto laimpso, tikulimbikitsidwa kuti kuwunika pafupipafupi kwa seramu potaziyamu ndi milingo ya creatinine kuchitika. Palibe zokuchitikirani ndi Aprovel zochizira odwala omwe akuwonjezeka impso posachedwapa.

Odwala omwe ali ndi matenda oopsa, matenda a impso, ndi matenda a shuga II. Zotsatira za irbesartan pa impso komanso mtima Makamaka, zidapezeka kuti sizabwino kwa azimayi komanso omvera omwe siwoyera.

Hyperkalemia Monga mankhwala ena omwe amakhudza renin-angiotensin-aldosterone, hyperkalemia imatha kupezeka pakumwa mankhwala ndi Aprovel, makamaka pakakhala kulephera kwa aimpso, proteinuria yayikulu chifukwa cha matenda a shuga ndi / kapena kulephera kwa mtima. Kusamalitsa mosamala kwa seramu potaziyamu mozama mwa odwala omwe ali pachiwopsezo akulimbikitsidwa.

Lithium. Nthawi yomweyo, lithiamu ndi aprovel sizikulimbikitsidwa.

Stenosis ya msempha ndi mitral valavu, hypertrophic cardiomyopathy. Monga vasodilators ena, ndikofunikira kugwiritsa ntchito mankhwalawa mosamala kwambiri odwala omwe ali ndi aortic kapena mitral valve stenosis, oletsa hypertrophic Cardiomyopathy.

Kuphatikiza kwakukulu kwa aldosteronism. Odwala omwe ali ndi aldosteronism oyamba nthawi zambiri samayankha mankhwalawa omwe amaletsa kukonzanso kwa renin-angiotensin.Chifukwa chake, Aprovel simalimbikitsidwa kuti athandize odwala.

Zambiri. Odwala omwe mtima wawo wamatsempha ndi aimpso ntchito zimadalira ntchito ya renin-angiotensin-aldosterone (mwachitsanzo, odwala omwe ali ndi vuto lalikulu la mtima kapena matenda a impso, kuphatikizapo aimpso artery stenosis), chithandizo ndi ACE inhibitors kapena angiotensin-II receptor antagonists, zomwe zimakhudza dongosololi zimagwirizanitsidwa ndi hypotension yacute, azotemia, oliguria, ndipo nthawi zina kulephera kwa impso. Monga china chilichonse cha antihypertensive wothandizira, kuchepa kwambiri kwa kuthamanga kwa magazi kwa odwala omwe ali ndi ischemic cardiopathy kapena ischemic mtima matenda angayambitse infarction ya myocardial kapena stroke. Monga zoletsa za angiotensin-akatembenuka enzyme, ma irbesartan ndi ena okana angiotensin mwachiwonekere sangakhale othandiza kuchepetsa kuthamanga kwa magazi mwa oyimira amtundu wakuda kuposa oyimira mafuko ena, mwina chifukwa chakuti malo okhala ndi renin otsika amapezeka kwambiri pakati pa odwala a mtundu wakuda omwe ali ndi matenda oopsa .

Amadzipaka kuti agwiritse ntchito mankhwalawa mankhwalawa odwala omwe ali ndi mavuto osowa mwabadwa - galactose tsankho, kuperewera kwa lappase kapena glucose-galactose malabsorption.

Kutha kukopa momwe zinthu zikuyendera mukamayendetsa magalimoto kapena njila zina

Zotsatira zakutha kuyendetsa galimoto ndikugwira ntchito yofunika chidwi sizinaphunzire. Ma pharmacokinetic katundu a irbesartan amawonetsa kuti ndizokayikitsa kuti zingayambitse izi.

Mukamayendetsa galimoto kapena pogwiritsira ntchito makina, ziyenera kukumbukiridwa kuti chizungulire komanso kutopa kumatha kuchitika pakumwa.

Mankhwala

Mankhwala Aprovel ndi wamphamvu, wokonda pakamwa, kusankha angiotensin II receptor antagonist (mtundu wa AT 1). Amakhulupirira kuti imalepheretsa zotsatira zonse za thupi za angiotensin II zolumikizidwa kudzera mu 1 1 receptor, mosasamala za magwero kapena njira ya kapangidwe ka angiotensin II. Kusankha kosagwirizana ndi ma angiotensin II receptors (AT 1) kumabweretsa kuwonjezeka kwa kuchuluka kwa renin ndi angiotensin II mu plasma ndikuchepa kwa kuchuluka kwa aldosterone mu plasma. Ikagwiritsidwa ntchito pazovomerezeka, seramu potaziyamu sasintha kwambiri. Irbesartan sichikakamiza ACE (kininase II) - enzyme yomwe imatulutsa angiotensin II, limapukusira bradykinin kuti ipange metabolites yosagwira. Kuti awonetse mphamvu yake, irbesartan sikufuna kagayidwe kazinthu.

Mphamvu yamankhwala mu matenda oopsa. Aprovel amachepetsa kuthamanga kwa magazi ndikusintha kocheperako kwamtima. Kutsika kwa kuthamanga kwa magazi mukamamwa kamodzi patsiku kumadalira mankhwalawa, mwanjira yofikira pagome pamiyeso yoposa 300 mg. Mlingo wa 150-300 mg pamene atengedwa kamodzi patsiku amachepetsa kuthamanga kwa magazi komwe kumayikidwa mu supine kapena kukhala kumapeto kwa chochitikacho (ndiye kuti, maora 24 mutatha kumwa mankhwalawa) mwa pafupifupi 8-13 / 5-8 mm RT. Art. (systolic / diastolic) kuposa placebo.

Kutsika kwakukulu kwa kuthamanga kwa magazi kumatheka ndi maola 3-6 mutatha kumwa mankhwalawa, antihypertensive effect imapitilira maola 24.

Maola 24 mutatenga Mlingo wovomerezeka, kuchepa kwa kuthamanga kwa magazi ndi 60-70% poyerekeza ndi kuchepetsedwa kwakukulu kwa diastolic ndi systolic magazi. Kumwa mankhwala osokoneza bongo a 150 mg kamodzi patsiku kumapereka zotsatira (osachepera kuchitapo kanthu komanso maola 24), zofanana ndi zomwe zimachitika pogawa tsiku ndi tsiku Mlingo iwiri.

Mphamvu ya antihypertensive ya mankhwalawa "Aprovel" imawonekera mkati mwa masabata 1-2, ndipo kutchulidwa kokwanira kumakwaniritsidwa masabata 4-6 kuyambira pakuyamba chithandizo. Mphamvu ya antihypertensive imapitirira ndi chithandizo cha nthawi yayitali. Pambuyo pakuleka kulandira chithandizo, kuthamanga kwa magazi pang'onopang'ono kumabwereranso ku mtengo wake woyambirira. Withrawal syndrome mu mawonekedwe a kuchuluka kwa matenda oopsa pambuyo kuchoka kwa mankhwalawa sichinawoneke.

Aprovel ndi thiazide-mtundu diuretics amapereka zowonjezera zowonjezera. Kwa odwala omwe irbesartan yekha sanapereke zotsatira zomwe amafunikira, kugwiritsa ntchito nthawi yomweyo hydrochlorothiazide (12.5 mg) ndi irbesartan kamodzi patsiku kunapangitsa kuchepa kwa kuthamanga kwa magazi ndi osachepera 7-10 / 3-6 mm Hg. Art. (Systolic / diastolic) poyerekeza ndi placebo.

Kugwiritsa ntchito bwino kwa mankhwalawa "Aprovel" sikudalira zaka kapena amuna. Odwala a mtundu wakuda omwe akudwala matenda oopsa amakhala ndi yankho lofooka kwambiri ku monotherapy yokhala ndi irbesartan, komanso mankhwala ena omwe amakhudza dongosolo la renin-angiotensin. Panthawi yomweyo kugwiritsa ntchito irbesartan ndi hydrochlorothiazide muyezo wotsika (mwachitsanzo, 12.5 mg patsiku), kuyankha kwa odwala amtundu wakuda kunafika pakuyankha kwa odwala amtundu woyerawo. Palibe kusintha kwakukulu pamankhwala a seramu uric acid kapena kwamikodzo ya uric acid.

Mu 318 ana ndi achinyamata azaka zapakati pa 6 mpaka 16 omwe anali ndi matenda oopsa kapena chiwopsezo chotenga chake (matenda ashuga, kupezeka kwa odwala oopsa m'mabanja), adaphunzira kuchepa kwa kuthamanga kwa magazi pambuyo pa kuperewera kwa mitsempha ya irbesartan - 0,5 mg / kg (otsika), 1.5 mg / kg (avareji) ndi 4.5 mg / kg (mkulu) kwa masabata atatu. Pamapeto pa sabata lachitatu, kuchepa kwa magazi kwa systolic m'malo okhala (SATSP) kunatsika kuchoka pamlingo woyambira ndi 117 mm RT. Art. (Mlingo wotsika), 9.3 mmHg. Art. (Mlingo waukulu), 13.2 mmHg. Art. (Mlingo wapamwamba). Palibe kusiyana kwakukulu pakati pazotsatira za mankhwalawa. Kusintha kwapakati kosintha kocheperako kukhala m'magazi a magazi a diastolic (DATSP) anali: 3.8 mmHg. Art. (Mlingo wotsika), 3,2 mmHg. Art. (Mlingo waukulu), 5.6 mmHg. Art. (Mlingo wapamwamba). Pambuyo pa milungu iwiri, odwala adasinthidwanso mosintha kuti agwiritse ntchito mankhwala kapena placebo. Odwala omwe adalandira placebo, SATSP ndi DATSP adakula ndi 2.4 ndi 2.0 mm Hg. Art., Komanso kwa omwe amagwiritsa ntchito irbesartan mu Mlingo wosiyanasiyana, kusintha kofananira kunali 0.1 ndi -0.3 mm RT. Art.

Mphamvu yamankhwala kwa odwala omwe ali ndi matenda oopsa, matenda a impso, ndi mtundu II matenda a shuga. Kafukufuku wa IDNT (irbesartan for diabetesic nephropathy) adawonetsa kuti irbesartan imachedwetsa kupitilira kwa kuwonongeka kwa impso kwa odwala omwe ali ndi vuto la aimpso kwambiri komanso proteinuria yayikulu.

IDNT inali yowonera kawiri, yowunikira yomwe ikufanizira kuchepa kwa thupi ndi kufa pakati pa odwala omwe amalandila aprovel, amlodipine, ndi placebo. Adasankhidwa ndi odwala 1715 omwe ali ndi matenda oopsa ndipo amalemba mtundu II shuga mellitus, omwe proteinuria ≥ 900 mg / tsiku ndi mulingo wa serum creatinine pamlingo wa 1.0-3.0 mg / dl. Zotsatira zakutsogolo (pafupifupi zaka 2.6) zamankhwala zomwe zimagwiritsidwa ntchito ngati mankhwalawa "Aprovel" zidawerengedwa - zotsatira zakukula kwa matenda a impso komanso kufa kwathunthu. Odwala adalandira mlingo wa 75 mg mpaka 300 mg (mlingo wokonza) wa Aprovel, 2.5 mg mpaka 10 mg ya amlodipine kapena placebo, kutengera kulolerana. Pagulu lirilonse, odwala nthawi zambiri amalandira mankhwalawa a antihypertensive (mwachitsanzo, okodzetsa, opanga ma beta, alpha-blockers) kuti akwaniritse cholinga chomwe anakonzeratu - kuthamanga kwa magazi pamlingo wa 85 135/85 mm Hg. Art. kapena kuchepa kwa kuthamanga kwa systolic ndi 10 mm RT. Art., Ngati mulingo woyamba anali> 160 mm RT. Art. Mulingo wothamanga wamagazi unakwaniritsidwa kwa 60% ya odwala omwe ali mgululi la placebo, ndipo kwa 76% ndi 78% m'magulu omwe amalandila irbesartan ndi amlodipine, motsatana. Irbesartan amachepetsa kwambiri chiopsezo chokhala ndi gawo lalikulu, lomwe limaphatikizidwa ndi serum creatinine, matenda a impso, kapena kufa kwathunthu. Pafupifupi 33% ya odwala adakwanitsa kumapeto kwa gulu la irbesartan poyerekeza ndi 39% ndi 41% m'magulu a placebo ndi amlodipine; kutsika kwa 20% pangozi poyerekeza ndi placebo (p = 0.024) ndi kutsika kwa 23% chiopsezo poyerekeza ndi amlodipine (p = 0.006). Pamene magawo amodzi a malembawo adasanthula, zidapezeka kuti palibe chomwe chimapangitsa kufa kwathunthu, panthawi imodzimodzi, panali chidwi chofuna kuchepa milandu yomaliza ya matenda a impso komanso kuchepa kwakukulu kwa kuchuluka kwa milandu pobwereza seramu creatinine.

Kuwunika kwa zotsatira zamankhwala kunachitika m'magulu osiyanasiyana, omwe amagawidwa ndi kugonana, mtundu, zaka, kuchuluka kwa matenda ashuga, kuthamanga kwa magazi, serum creatinine ndende ndi kuchuluka kwa chidziwitso cha albumin. M'magulu azimayi ndi oyimira amtundu wakuda, omwe anali 32% ndi 26% ya anthu onse owerengera, motere, padalibe kusintha kwakukulu muzochitika za impso, ngakhale kulimba mtima pakadapanda kupatula izi. Ngati tirikunena za gawo lachiwirilo - chochitika chamtima chomwe chatha (kuphedwa) kapena sichinathere (sichingachitike) imfa, ndiye kuti palibe kusiyana pakati pa magulu atatuwo pagulu lonselo, ngakhale kuti vuto la inffatal myocardial infarction (MI) linali lalikulu kwambiri mwa azimayi komanso ochepa mwa amuna ochokera ku gulu la irbesartan poyerekeza ndi gulu la placebo. Poyerekeza ndi gulu la amlodipine, kuchuluka kwa kuphwanya kwa mtima kosagwirizana ndi matenda osokoneza bongo kunali kwakukulu kwambiri mwa azimayi ochokera ku gulu la irbesartan, pomwe kuchuluka kwa milandu kuchipatala chifukwa cholephera kwamtima muanthu onse kunali kocheperako. Palibe chotsimikizika chotsimikizika chazotsatira zotere chidapezeka mwa akazi.

Kafukufuku "Zotsatira za irbesartan pa microalbuminuria mwa odwala omwe ali ndi mtundu II matenda a shuga komanso matenda oopsa" (IRMA 2) adawonetsa kuti irigesartan ya 300 mg mwa odwala omwe ali ndi microalbuminuria amachepetsa kupita patsogolo ndikuwoneka kuti proteinuria yodziwikiratu. IRMA 2 ndi kafukufuku wowunika kawiri, wowongoleredwa ndi placebo yemwe amayesa kufa kwa odwala 590 omwe ali ndi mtundu II shuga mellitus wokhala ndi microalbuminuria (30-300 mg patsiku) ndi ntchito yachilendo ya impso (serum creatinine ≤ 1.5 mg / dL mwa amuna ndi 300 mg patsiku ndikuwonjezereka kwa SHEAS ndi 30% yokha yoyambira). Cholinga chokonzedweratu chinali kuthamanga kwa magazi pamlingo wa ≤135 / 85 mmHg. Art. Kuti muthandizire kukwaniritsa izi, othandizira owonjezera a antihypertensive adawonjezeredwa momwe amafunikira (kupatula ACE inhibitors, angiotensin II receptor antagonists ndi calcium channel dihydropyridine blockers). M'magulu onse azithandizo, kuchuluka kwa kuthamanga kwa magazi komwe odwala amakumana kunali kofanana, koma mgululi limalandira 300 mg ya irbesartan, maphunziro ochepa (5.2%) kuposa omwe amalandira placebo (14.9%) kapena 150 mg ya irbesartan patsiku (9.7%), adafika pamapeto - proteinuria yowonekera. Izi zikuwonetsa kuchepa kwama 70% pachiwopsezo chochepa pambuyo pa mlingo waukulu poyerekeza ndi placebo (p = 0.0004). Kuchulukana munthawi yomweyo kwamisala yocheperako (GFR) m'miyezi itatu yoyambirira ya chithandizo sikunachitike. Kuchepetsa pang'onopang'ono maonekedwe a proteinuria otchulidwa bwino kunadziwika pambuyo pa miyezi itatu, ndipo izi zinatha ndi sitima yapamtunda wazaka ziwiri. Kukakamira ku Normoalbuminuria (1 voti - mavoti

The zikuchokera mankhwala

Mankhwalawa amachokera ku irbesartan. Izi ndiye ntchito zake. Zina zomwe zimapezeka m'mapiritsi, kuphatikizapo:

1. Magnesium wakuba,
2. Silika
3. Lactose Monohydrate.

Asanayambe chithandizo, odwala ayenera kuwerenga mosamala mankhwala onse. Ndi yoyenera kwa anthu okhawo omwe samayamwa ndi magawo ake. Dokotala amatha kuthandizira kuzindikira izi, yemwe amawona kuti ndikoyenera kulimbikitsa kugwiritsa ntchito matenda oopsa a "Aprovel".

Kutulutsa Fomu

Mankhwalawa ndi a gulu la okonzekera receptor a gulu lachiwiri la angiotensin. Pogulitsa imapezeka pamapiritsi. Mbali imodzi, zolemba zilipo. Amawonetsera zamtima. Kumbali yakusinthaku ndi manambala 2872.

Pali mitundu iwiri ya mankhwala. Amasiyana wina ndi mnzake mu gawo la chinthu chomwe chikugwira. 150 mg ya chinthuchi ilipo pamapiritsi ena, ndipo 300 mg mwa ena. Chifukwa cha izi, madotolo amatha kusankhira wodwalayo njira yabwino, yomwe ingamuthandize kuthana ndi matendawa, koma osayambitsa zovuta zilizonse.

Mankhwala amapangidwa mosiyanasiyana.

Pa mimba ndi mkaka wa m`mawere

"Aprovel" 300 mg ndi 150 mg ndi oletsedwa kugwiritsidwa ntchito pochiza azimayi oopsa omwe ali ndi mwana. Ngati wodwalayo amamwa mankhwalawa, ndiye kuti ayenera kusiya kumwa mankhwalawo atangopereka pakati.

Kugwiritsa ntchito mankhwalawa Aprovel sikungatchedwe koyenera kwa amayi omwe akuyamwitsa. Kukana kutero kudzathandiza kuteteza ana awo ku matenda omwe mankhwala omwe angayambitse.