Dapril 20 mg: malangizo ogwiritsira ntchito

Dapril imapezeka mu mawonekedwe a mapiritsi (zidutswa 10 chimodzi m'matumba a chithuza, mu bokosi la makatoni: 5 mg ndi 10 mg iliyonse - 3 mapaketi, 20 mg aliyense - 2 mapaketi).

Piritsi limodzi lili:

• yogwira mankhwala: lisinopril - 5 mg, 10 mg kapena 20 mg,
• zothandiza: calcium hydrogen phosphate, mannitol, iron oxide (E172), magnesium stearate, gelatinized wowuma, wowuma.

Contraindication

• mbiri ya angioedema,
• chachikulu hyperaldosteronism,
• kuvulala kwambiri aimpso,
• Mgwirizano wamitsempha wamagazi wamanjenje kapena chotupa cha impso imodzi yaazotemia,
• azotemia
• pambuyo kupatsirana kwa impso,
• Hyperkalemia
• stenosis ya machitidwe aortic ndi zovuta zina hemodynamic,
• zaka za ana
• II ndi III oyang'anira nyengo ya kubereka,
• yoyamwitsa
• Hypersensitivity kuti ACE zoletsa ndi mankhwala zigawo zikuluzikulu.

Mlingo ndi makonzedwe

Mapiritsi amatengedwa pakamwa.

Dokotala amafotokoza kuchuluka kwa mankhwalawo payekhapokha malinga ndi zomwe zikuwonetsa kuchipatala ndipo munthu aliyense ayenera kuchita zomwe zingachitike.

• ochepa matenda oopsa: woyamba mlingo - 10 mg 1 nthawi patsiku. Kenako, mankhwalawa amasankhidwa payekhapayekha, poganizira kuchuluka kwa kuthamanga kwa magazi (BP) ya wodwalayo, mlingo woyenera wokonzanso ndi 20 mg kamodzi patsiku, pakalibe njira zochiritsira zokwanira pambuyo masiku 7 a chithandizo, imatha kuwonjezeka mpaka 40 mg. Mlingo wapamwamba tsiku lililonse ndi 80 mg,
• aakulu mtima kulephera: koyamba mlingo ndi 2,5 mg patsiku, yokonza mlingo 5-5 mg wa patsiku.

Ngati aimpso ntchito, a tsiku lililonse mlingo kukhazikitsidwa chifukwa creatinine chilolezo (CC):

• QC yoposa 30 ml / mphindi: 10 mg,
• KK 10-30 ml / mphindi: 5 mg,
• CC zosakwana 10 ml / mphindi: 2,5 mg.

Zotsatira zoyipa

• Kuchokera pamtima dongosolo: kawirikawiri - tachycardia, orthostatic hypotension,
• Kuchokera kwamanjenje: kumva kutopa, kupweteka mutu, chizungulire, nthawi zina - chisokonezo, kusakhazikika kwa malingaliro,
• Kuchokera ku hemopoietic dongosolo: agranulocytosis, neutropenia, kutsika kwa hemoglobin, kuchepa kwa maselo ofiira a m'magazi,
• Kuchokera mmimba dongosolo: nseru, kawirikawiri - mkamwa youma, kupweteka kwam'mimba, kutsegula m'mimba, nthawi zina - kuchuluka kwa michere ya chiwindi, kuchuluka kwa bilirubin m'magazi a seramu,
• thupi lawo siligwirizana: kawirikawiri - zotupa pakhungu, nthawi zina - edema ya Quincke,
• Kuchokera pakapumidwe: kupuma kouma,
• ena: nthawi zina - hyperkalemia, mkhutu aimpso ntchito.

Malangizo apadera

Kugwiritsidwa ntchito kwa ACE inhibitors kumatha kuyambitsa zovuta pakhungu louma, lomwe limazimiririka atasiya mankhwala. Izi ziyenera kuganiziridwanso pakuwonetsetsa kuti chifuwa chimadwala wodwala akutenga Dapril.

Chomwe chimapangitsa kuchepa kwa kuthamanga kwa magazi ndi kuchepa kwamphamvu kwamatenda amthupi omwe amayamba chifukwa cha kutsegula m'mimba kapena kusanza, kugwiritsa ntchito mankhwalawa pakukodzetsa magazi, kuchepa kwa magazi, kapena kufinya thupi. Chifukwa chake, tikulimbikitsidwa kuti muyambe kumayang'aniridwa ndi dokotala ndipo mosamala muonjezere kuchuluka kwa mankhwalawa.

Pamene hemodialysis imagwiritsa ntchito nembanemba yokhala ndi chokwanira chokwanira, pamakhala chiwopsezo cha anaphylactic reaction. Chifukwa chake, pochita dialysis, ndikofunikira kugwiritsa ntchito ziwalo zamtundu wina kapena kusintha mankhwalawo ndi wothandizirana ndi antihypertensive.

Kuyanjana kwa mankhwala osokoneza bongo

Ndi munthawi yomweyo kugwiritsa ntchito Dapril:

• potaziyamu yosalekerera okodzetsa (triamteren, spironolactone, amiloride), mankhwala okhala ndi potaziyamu omwe amalowa m'malo mwa mchere wa potaziyamu - amalimbikitsa chiopsezo cha hyperkalemia, makamaka chifukwa cha kuwonongeka kwa impso,
• okodzetsa, antidepressants - amachititsa kuchepa kwakukulu kwa kuthamanga kwa magazi,
• Mankhwala osapweteka a antiidal - kuchepetsa mphamvu ya antihypertensive
• Kukonzekera kwa lifiyamu - kumachepetsa mphamvu ya kutuluka kwa thupi,
• Mowa - timapitiriza mphamvu ya mankhwala.

Ma Dapril analogu ndi awa: mapiritsi - Diroton, Lisinopril, Lisinopril-Teva, Lisinoton.

Zotsatira za pharmacological

Dapril ndi mankhwala osokoneza bongo a antihypertensive kuchokera ku gulu la angiotensin-inhibiting enzyme (ACE) zoletsa zomwe zimakhala ndi nthawi yayitali. The yogwira mankhwala lisinopril ndi metabolite wa enalapril (enalaprilat). Lisinopril, oletsa ACE, amalepheretsa mapangidwe a angiotensin II kuchokera ku angiotensin I. Zotsatira zake, vasoconstrictor zotsatira za angiotensin II amachotsedwa. mapangidwe a angiotensin III, omwe ali ndi mphamvu yodziwika bwino, amachepetsa, kutulutsidwa kwa norepinephrine kuchokera ku presynaptic vesicles ya dongosolo lamasoni lachilengedwe kumachepa, kubisala kwa aldosterone mu glomerular zone ya adrenal cortex ndi hypokalemia komwe kumayambira ndi kusungidwa kwa sodium ndi madzi kumachepetsedwa. Kuphatikiza apo, pali kudzikundikira kwa bradykinin ndi ma prostaglandins omwe amachititsa vasodilation. Izi zonse zimayambitsa kutsika kwa kuthamanga kwa magazi, pang'onopang'ono komanso pang'ono pang'onopang'ono kuposa kusankhidwa kwa kapitawo wofulumira. Chifukwa chake, kuwonjezeka kwa kugunda kwa mtima sikuchitika. Lisinopril amachepetsa kukhathamira kwamitsempha yamagazi kukana (OPSS) ndi kutsitsa, zomwe zimapangitsa kuwonjezeka kwa mtima, kutulutsa kwa mtima, komanso kuthamanga kwa magazi aimpso. Kuphatikiza apo, mphamvu ya venous imachulukitsa, kutsitsa, kukakamiza mu atrium yoyenera, mitsempha yam'mapapo ndi mitsempha imachepa, i.e. mu kufalikira kwammapapo, kupsinjika kwa diastoli kumapeto kwamitsempha yamanzere kumachepa, kukomoka kumawonjezereka. Kupsinjika kwa kusefukira kwa glillerular capillaries kumachepa, proteinuria imachepa ndipo kukula kwa glomerulosclerosis kumachepetsa. Zotsatira zimachitika 2 mawola kumwa mankhwalawa. Kuchuluka kwake kumachitika pambuyo pa maola 4-6 ndipo kumatenga pafupifupi maola 24.

Mlingo ndi makonzedwe

Mankhwalawa matenda oopsa, koyamba mlingo wa 5 mg 1 nthawi patsiku. Kukonza mlingo mpaka 20 mg kamodzi tsiku lililonse. Ndi mankhwala a sabata iliyonse, mlingo wogwira umawonjezereka mpaka 20-40 mg wa patsiku. Kusankhidwa kwa Mlingo kumachitika aliyense payekha kutengera ndendende zamagazi. Mulingo waukulu ndi 80 mg patsiku.

Aakulu mtima kulephera, koyamba mlingo wa 2,5 mg patsiku. Mulingo wamba wokonza ndi 5 mpaka 20 mg patsiku.

Ngati matenda aimpso ayambitsidwa, mlingo umakhazikitsidwa kutengera chilolezo cha creatinine (QC). Ndi CC oposa 30 ml / min, mlingo womwe umalimbikitsa ndi 10 mg / tsiku. Ndi CC kuchokera 30 mpaka 10 ml / min, mlingo ndi 5 mg kamodzi patsiku. Ndi CC ochepera 10 ml / mphindi 2,5 mg.

Zizindikiro zogwiritsidwa ntchito

Dapril amagwiritsidwa ntchito pochiza:

• ochepa matenda oopsa (kuphatikizapo kukonzanso) - mankhwalawa amatha kugwiritsidwa ntchito limodzi ndi mankhwala ena a antihypertensive kapena mawonekedwe a monotherapy.
• aakulu mtima kulephera (mankhwalawa odwala kutenga okodzetsa ndi / kapena kukonzekera kwa digito monga gawo la mankhwala osakanikirana).

Kutulutsa mawonekedwe, zikuchokera

Dapril imapezeka mu mawonekedwe a convex round pink mapiritsi. Mitengo yaying'ono ndi marbulo amaloledwa. Mapiritsi amayikidwa m'matumba a chithuza, kenako m'matumba a makatoni.

Piritsi lililonse lili ndi lisinopril (yogwira pophika), komanso zinthu zothandizira - mannitol, E172, calcium hydrogen phosphate, gelatinized starch, starch, magnesium stearate.

Kuchita ndi mankhwala ena

Kugwiritsa ntchito munthawi yomweyo Dapril ndi potaziyamu zowonjezera, mchere wa potaziyamu, potaziyamu wochepetsa mphamvu ya diuretics (amiloride, triamteren, spironolactone) kumawonjezera chiopsezo cha hyperkalemia (makamaka kwa odwala omwe ali ndi vuto la impso), ndi NSAIDs, ndizotheka kufooketsa mphamvu ya lisinopril. kwambiri hypotension, kukonzekera kwa lithiamu - kuchedwa kuchotsedwa kwa lifiyamu m'thupi.

Kugwiritsa ntchito mowa kumathandizira chidwi cha gawo logwira.

Pa nthawi yoyembekezera

Wopangayo amayang'ana kwambiri za kuthekera kwa kugwiritsa ntchito lisinopril pa nthawi ya bere. Zowona zake zikangotsimikizika, mankhwalawa amayenera kuyimitsidwa nthawi yomweyo.

Ndikofunika kukumbukira kuti chithandizo ndi ACE zoletsa mu 3 ndi 2 trimesters zimayipa mwana wosabadwayo (zovuta zomwe zingaphatikizidwe ndi hyperkalemia, kufa kwa intrauterine, kuchepa kwa kuthamanga kwa magazi, chigaza hypoplasia, kulephera kwa aimpso).

Nthawi yomweyo, palibe umboni uliwonse wosonyeza kuti mankhwalawo ali ndi vuto pa mwana wosabadwayo woyamba.

Ngati khanda lobadwa kumene kapena khanda litulutsidwa ndi zoletsa za ACE m'mimba, ndikofunikira kuyang'anitsitsa momwe ziliri. Izi ndizofunikira kuti mupeze vuto la hyperkalemia, oliguria, kuchepa kwa magazi.

Ndizodziwika bwino kuti lisinopril imatha kulowa mu placenta, komabe palibe zambiri pazomwe zimalowetsa mkaka wa m'mawere.

Monga chisamaliro, tikulimbikitsidwa kusiya kuyamwitsa kwa nthawi yonse ya mankhwalawa ndi Dapril.

Migwirizano ndi magwiritsidwe akusungidwa

Wopanga Dapril amatsimikizira ogula kuti ayenera kusankha malo owuma, amdima osungira mankhwalawo.

Potere, kutentha kwa mpweya mchipindacho sikuyenera kupitirira 25 digiri. Pokhapokha ngati zomwe tafotokozazi zikwaniritsidwa, malonda amatha kusungidwa amoyo wonse wazaka 4.

Pafupifupi, paketi imodzi ya Dapril imawononga kwa nzika ya Russian Federation Ma ruble 150.

Wodwala wokhala ku Ukraine, angagule phukusi la mankhwala pafupifupi 40 hryvnia.

Zofanizira za Dapril zimaphatikizapo mankhwala monga Diroton, Diropress, Iramed, Zoniksem, Lizigamma, Lizakard, Lisinopril, Lisinoton, Lisinopril dihydrate, Lisinopril granate, Rileys-Sanovel, Lizoril, Liziprex, Lizonlir, Lilonop,

Mwambiri, ndemanga za ogwiritsa ntchito intaneti pa mankhwala Dapril ndi zabwino.

Odwala ndi madokotala amayankha bwino mankhwalawo, poganizira momwe amagwirira ntchito komanso kuthamanga kwake.

Ogwira ntchito zaumoyo amayang'ana izi: ngakhale pali zovuta zambiri zomwe zikuwonetsedwa mu malangizowa, ndizosowa kwambiri (kufalikira kwa mawonekedwe osafunikira kumakhala pakati pa 0,01 mpaka 1%).

Mutha kuwerengera ndemanga za odwala enieni okhudzana ndi mankhwalawo kumapeto kwa nkhani.

Chifukwa chake, Dapril amaikidwa ngati mankhwala othandizira antihypertensive.

Mankhwala akufuna, chifukwa cha kupezeka kwake, mtengo wotsika kwambiri.

Kuti mugule mankhwala ku pharmacy, muyenera kupereka mankhwala a dokotala.

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

Mkati, ndi ochepa matenda oopsa - 5 mg kamodzi patsiku. Popanda kuchitapo kanthu, mlingo umakulitsidwa masiku onse awiri 2 mg ndi 5 mg mpaka muyezo wa 20 mg mg / tsiku (kuwonjezera kuchuluka kwa 20 mg / tsiku nthawi zambiri sikuti kumabweretsa kuchepa kwa kuthamanga kwa magazi). Mlingo wapamwamba tsiku lililonse ndi 80 mg.

Ndi HF - yambani ndi 2.5 mg kamodzi, ndikutsatira kuchuluka kwa 2,5 mg pambuyo masiku 3-5.

Okalamba, nthawi yayitali imakhala ikuwonekera, komwe kumalumikizidwa ndi kuchepa kwa mankhwala a lisinopril (tikulimbikitsidwa kuti muyambe kulandira mankhwala ndi 2.5 mg / tsiku).

Pakulephera kwa impso, kuchepa kumachitika ndi kuchepa kwa kusefera kwa zosakwana 50 ml / min (mlingo uyenera kuchepetsedwa nthawi 2, ndi CC zosakwana 10 ml / min, mlingo uyenera kuchepetsedwa ndi 75%).

Ndi matenda oopsa a arterial, chithandizo chokonzanso kwakanthawi chimawonetsedwa pa 10-15 mg / tsiku, ndi vuto la mtima - pa 7.5-10 mg / tsiku.

Mankhwala

Dapril imalepheretsa kupangika kwa mahomoni a oligopeptide, omwe ali ndi vasoconstrictor effect. Pali kuchepa kwathunthu kwa zotumphukira zamitsempha, kukonzanso komanso kutsekemera pamtima, sizingakhudze kuchuluka kwa mtima ndi kuchuluka kwa magazi.

Kuphatikiza apo, kukana kwa mitsempha yaimpso kumachepa ndipo kufalikira kwa magazi m'thupi kumayenda bwino. Nthawi zambiri, kutsika kwa mankhwalawa mukamamwa mankhwalawo kumadziwika pambuyo pa maola 1-2 (pazotheka pambuyo pa maola 6-9).

Kuthandizira achire zotsatira zimawonedwa pambuyo pa masabata atatu kuyambira chiyambi cha chithandizo. Matenda ochotsa mankhwalawa samakula.

Pa chithandizo, pali kuwonjezeka kwa kusakhazikika kwa zochitika zolimbitsa thupi, pomwe odwala omwe ali ndi kuthamanga kwa magazi amachepetsa kupanikizika popanda chitukuko cha Reflex tachycardia.

, , , ,

Pharmacokinetics

Dapril imalowetsedwa pafupifupi 25-50%. Kuchuluka kwa mankhwalawa kwa mankhwalawa sikukhudzidwa ndi chakudya.

Mu madzi am'magazi, mankhwalawa amayamba kuchuluka kwake pazitali za maola 6-8.

Palibe chomangira mankhwalawo kumapuloteni ndi metabolism, mankhwalawa amachotsedwa osasinthika ndi impso.

Ngati aimpso ntchito, nthawi ya mankhwala exretion ukuwonjezeka malinga ndi kuchuluka kwa magwiridwe antchito.

, , , , , ,

Kugwiritsa ntchito dapril pa nthawi yapakati

Chofunikira chachikulu cha Dapril ndi lisinopril, yemwe amatha kulowa mu zotchinga, kotero kumwa mankhwalawa ndi kwa amayi apakati. Kutenga Dapril panthawi yoyembekezera kungasokoneze kukula kwa mwana wosabadwayo. Kumwa mankhwalawo mwa mankhwala oyamba ndi oyambilira kungayambitse kufa kwa fetal, chigaza hypoplasia, kulephera kwaimpso ndi mavuto ena.

Bongo

Mukamudyetsa mopitilira muyeso womwe wakonzedwa, dapril imapangitsa kuchepa kwa magazi, kupindika kwambiri pamlomo, kulephera kwa impso, kuchuluka kwa mtima komanso kupuma, chizungulire, kusokonezeka kwa mphamvu yamagetsi am'madzi, nkhawa, kusakwiya, kugona.

Ngati bongo wa mankhwala, chapamimba thonje ndi makonzedwe a enterosorbents tikulimbikitsidwa.

,

Kuchita ndi mankhwala ena

Ndi munthawi yomweyo Dapril ndi mankhwala ena omwe amachepetsa kuthamanga kwa magazi (makamaka ndi okodzetsa), chiwopsezo chowonjezera chimawonedwa.

Mankhwala osaphatikizana ndi anti-yotupa (acetylsalicylic acid, ibuprofen, ndi zina), kloridi wa sodium ndi Dapril amachepetsa achire zotsatira zake.

The munthawi yomweyo mankhwala a mankhwala ndi potaziyamu kapena lifiyamu kumabweretsa kuchuluka kwa zinthuzi m'magazi.

Mankhwala a Immunosuppress, antitumor mankhwala, alopurinol, mahomoni a steroid, procainamide osakanikirana ndi Dapril amachititsa kutsika kwa leukocytes.

Dapril imawonjezera chiwonetsero cha zakumwa zakumwa zoledzeretsa.

Mankhwala a narcotic, ma pinkiller amathandizira kuchiritsa kwa Dapril.

Ndi kuyeretsa kwa magazi, ma anaphylactic zimachitika.

, , , , , ,