Mankhwala Akkuzid: malangizo ogwiritsira ntchito

Mankhwala osakanikirana ndi antihypertensive kwenikweni, omwe amaphatikizapo zinthu ziwiri: quinapril (choletsa ACE) ndi hydrochlorothiazide (diuretic) m'magulu atatu a mankhwala.

Hinapril Chothandizira angiotensin IIzomwe zimachitika chifukwa cha kukondoweza kwa adrenal cortex (kupanga aldosterone), imakhudza kamvekedwe ka mtima ndipo imakhala ndi mphamvu ya vasoconstrictor. Hinapril zoletsa ACE (minofu ndikuzungulira) ndikuchepetsa ntchito ya vasopressor ndi chimbudzi aldosterone. Kuletsa zoyipa angiotensin II kukhala reninkumabweretsa ntchito yowonjezereka renin.

Kukana HERE kumachitika motsutsana maziko a kuchepa kwa aimpso mtima kukana ndipo OPSSnthawi yomweyo, kusintha kochokera mu mtima, Kufika pamtima, kusefedwa kwa glomerular ndi kuchuluka kwa magazi aimpso sikunyalanyaza ngakhale kusakhalapo. Hinapril amachepetsa kuchepa kwa potaziyamu chifukwa cha zochita hydrochlorothiazideomwe, okhala ndi diuretic kwambiri, amonjezera ntchito ya magazi, amalimbitsa katulutsidwe aldosterone, kumawonjezera zinthu za potaziyamu m'magazi ndikuwonjezera kutuluka kwake kudzera mu impso. Mphamvu ya antihypertgency imayamba mkati mwa ola limodzi ndikufika pazambiri pambuyo maola atatu, ndikupitilira tsiku lonse.

Hydrochlorothiazide - amatanthauza gulu la okodzetsa, amakhudza ntchito ya impso, kukulitsa chimbudzi cha sodium, potaziyamu, chloride, bicarbonate ayoni ndi madzi ukuchepetsa calcium calcium. Mphamvu ya kukodzetsa imawonetsedwa pambuyo 2 maola, mphamvu yayitali imakhala pambuyo maola 4 ndipo kutalika kwake ndi maola 6-12.

Kuphatikiza kwa zinthu zogwira ntchito (quinapril ndi hydrochlorothiazide) imapereka kuchepa kochulukira HEREkuposa machitidwe a aliyense wa iwo payekhapayekha.

Pharmacokinetics

Zinthu zonse izi sizikhudzana.

Hinapril - Cmax imafikiridwa patatha maola awiri. Mlingo wa mayamwidwe uli pafupifupi 60%. Kumangidwa kwakukulu kumapuloteni am magazi. Mu chiwindi, biotransformed kuti quinaprilatakukhala choletsa cholimba ACE. Osalowetsa BBB. Amayamwa makamaka kudzera mu impso, T1 / 2 - pafupifupi maola atatu.

Hydrochlorothiazide - ali ndi kuyamwa pang'onopang'ono, kuchuluka kwa mayamwidwe kwa 50-80%. Cmax imafikiridwa mu maola 1-3. Osalowetsa BBB. Thupi silimapukusidwa, kuwachotsa osasinthika kudzera impso. T1 / 2 - kuyambira maola 4 mpaka 15.

Contraindication

• Kuzindikira kwambiri mankhwala.
• mu anamnesis - angioedema Pambuyo mankhwala ndi zoletsa ACE,
• Matenda a Addison,
• anuria,
• wazaka 18
• matenda ashuga,
• mimba ndi mkaka wa pansi.
• kutchulidwa aimpsokulephera kwa chiwindi
• kusocha mkanda.

Akkuzid, malangizo ogwiritsira ntchito (njira ndi Mlingo)

Mapiritsi a Akkuzit amatengedwa nthawi imodzi patsiku popanda kutanthauza chakudya. Mlingo woyenera tsiku lililonse kwa odwala omwe salandira okodzetsa ndi 10 mg + 12,5 mg (piritsi limodzi la Accuzit 10), ngati pakufunika, mlingo woyambira tsiku lililonse umakulirakulira mpaka 20 mg 25 mg wa piritsi limodzi la 20. Monga lamulo, zotsatirapo zake zimachitika pomwa mankhwalawa mosiyanasiyana kuchokera pa 10 +12,5 mpaka 20 +12.5 mg mg patsiku. Odwala okalamba safuna kusintha kwa mlingo. Pamaso pa matenda aimpso kwambiri odwala, mankhwalawa sayenera kugwiritsidwa ntchito ngati chithandizo choyambirira.

Bongo

Zizindikiro zazikuluzikulu za mankhwala osokoneza bongo omwe amagwiritsidwa ntchito kwa nthawi yayitali mu Mlingo wambiri kuposa mankhwala othandizira ndizochulukirapo HERE, zosokoneza m'madzi ndi zamagetsi zamagetsi, zowonetsedwa hypochloremia, hyponatremia, hypokalemia.

Kuchita

Ndi munthawi yomweyo makonzedwe a Accuzide ndi maantibayotiki a gulu machez kuyamwa mchiyama kuchepetsedwa ndi wachitatu. Sitikulimbikitsidwa kupereka kukonzekera kwa lithiamu limodzi ndi okodzetsa, chifukwa okodzetsa amachepetsa kuvomerezeka kwa lithiamu ndipo chiopsezo cha kuledzera chimawonjezeka kwambiri. Mukutenga ndi Accid Mowaopioid analgesics, barbiturates ndi Mankhwala osokoneza bongo c kwa ambiri opaleshoni chiwopsezo cha kukula orthostatic hypotension. Nthawi yomweyo kutenga Accudis ndi insulin kapena mankhwala a hypoglycemic Mlingo kusintha kwa hypoglycemic wothandizira ndikofunikira. Hydrochlorothiazide monga gawo la Akkuzid timalimbitsa zochita za antihypertensive mankhwala omwe amatengedwa nthawi yomweyo.

Ndi munthawi yomweyo makonzedwe a corticosteroid mankhwala okhala ndi Accuid, kuwonjezeka kwa kutayika kwa potaziyamu ndi ma elekitirodiya ena ndizotheka. Phwando NSAIDs amachititsa kufooketsa antihypertensive, okodzetsa ndi natriuretic kanthu okodzetsa. Ndi makonzedwe a munthawi yomweyo opuma a minofu ndi Akkuzid, machitidwe awo akhoza kukhala opindulitsa.

Mlingo ndi makonzedwe

Mlingo wamba wa Accuid ndi piritsi limodzi (10 mg / 12.5 mg) tsiku lililonse tsiku lililonse. Dokotala wanu angakulitseni mapiritsi kukhala mapiritsi awiri patsiku, omwe amatha kumwedwa kamodzi patsiku kapena payokha - piritsi limodzi m'mawa, lina madzulo.

Nthawi zonse tengani Accuzide monga momwe dokotala wanenera. Osamamwa mapiritsi ochulukirapo kuposa omwe dokotala wakupatsani.

Yesani kumwa mapiritsi nthawi yomweyo tsiku lililonse, osasamala chakudya.

• Ngati mwayiwala kumwa mankhwalawa, amwe pompopompo, monga mukukumbukira, osadikira nthawi ina mukamamwa mankhwalawo. Musamamwe mankhwala awiri.
• Ngati mukuganiza molakwika kumwa mapiritsi ochuluka a Akkuzid, dziwitsani dokotala wanu wanu ngati simungathe kuchita izi, lumikizanani ndi dipatimenti yodzidzimutsa ya chipatala chapafupi. Tengani ma CD a mankhwalawo, ngakhale ngati palibe mapiritsi otsala kuti ogwira ntchito kuchipatala azitha kudziwa kuti mwamwa mankhwala ati.
• Accid siyikulimbikitsidwa kwa ana. Mankhwalawa sanaphunziridwe kwa odwala osakwana zaka 18.

Zotsatira zoyipa

Monga mankhwala ena omwe amagwiritsidwa ntchito pakuwala kwanu, Accuzide nthawi zina imatha kukhala ndi zotsatira zoyipa (zoyipa). Ngati mukukhala ndi zizindikirozi, muyenera kufunsa dokotala.

• Kutsokomola kokhazikika.
• Kusanza, kusanza, kutsegula m'mimba, kudzimbidwa, kudzimbidwa, kugona, kugona, kapena kupweteka m'mimba.
• Mutu, chizungulire, kugona tulo, kugona tulo, kugona, kutopa, kusamva bwino kapena kutopa, kapena kumva mwanjira zofooka.
• Ululu kumbuyo, chifuwa, minofu, kapena mafinya (gout).
• Zotupa pakhungu, kuyabwa kapena Hypersensitivity kuwala, thupi lawo siligwirizana.
• Matenda a impso (nthawi ndi nthawi, ngati dokotala akuwaganizira za matenda a impso, dokotala wanu angakupatseni mayeso a mkodzo).

Zotsatira zoyipa zomwe zimachitika kawirikawiri sizikuphatikizapo: thukuta kwambiri, pakamwa / pakhosi, kutsuka tsitsi, kusabala, matenda a kwamikodzo (kuyanika kwa mucosal kungayambitse matenda), kumva kugundika m'manja kapena m'miyendo, matuza, kukhumudwa , chisokonezo, kusakwiya, tinnitus, masomphenya osalala, kulawa kwamkati, edema (zotumphukira).

Ngati mukukhala ndi zizindikirozi, muyenera kufunsa dokotala.

Ngati mwayamba chizungulire, ndiye kuti muyenera kupewa kuyendetsa galimoto ndi njira zina.

Zovomerezeka zimatha kusintha zina mu chithunzi cha magazi. Chifukwa chake, wopereka chithandizo chaumoyo atha kukulemberani kuyezetsa magazi kuti muwone izi. Ngati muli ndi mabala, kumva kutopa kwambiri, ngati muli ndi matenda ashuga ndipo mukaona kuchuluka kwa shuga m'magazi, ndiye kuti dziwitsani dokotala ndipo ngati pakufunika kutero, mudzakayezetsa magazi.

Zotsatira zotsatirazi ndizosowa kwambiri, koma ndizovuta, chifukwa chake ngati muli nazo, uzani dokotala nthawi yomweyo.

• Angioneurotic edema (kutupa kwa nkhope, lilime, trachea - kungayambitse kupuma kwakukulu). Nthawi yomweyo, edema ya m'mimba ndi m'matumbo (matumbo angioedema - matumbo edema) imatha kukhala palokha. Potere, simumasowa; kusanza komanso kupweteka m'mimba kumatha kuoneka. Izi ndizosowa kwambiri, koma zovuta kwambiri, ndipo ngati mwazikulitsa, muyenera kuyimbira ambulansi nthawi yomweyo.
• Kuzizira pachifuwa, kupweteka pachifuwa, palpitations, phokoso kapena kufupika kwa mpweya.
• Zilonda zopweteka kapena zilonda pakamwa. Ngati muli ndi vuto la impso kapena mwayamba kudwala matendawa, mutha kukhala ndi neutropenia / agranulocytosis (ma cell oyera osakwanira), omwe ungayambitse matenda, zilonda zapakhosi, kapena kutentha thupi. Ngati mwadwala matenda opatsirana minofu, dokotala angakupatseni mayeso a magazi kuti muwone ngati ali ndi matendawa.
• Kukomoka, makamaka poyimirira, kungatanthauze kuti magazi anu ndi ochepa kwambiri. Vutoli limayamba kuchitika mukamamwa diuretics (okodzetsa), mankhwala ena omwe amachepetsa kuthamanga kwa magazi, komanso mowa ngati mukumwa madzi kwambiri kapena mukakhala ndi hemodialysis mukamamwa pamodzi ndi Accuzide. Ngati maso anu achita khungu kapena mukumva kuti mukumwalira, khalani pamalo oyimirira ndikugona pamenepo mpaka kumverera kudutsa.
• Zina zomwe zimachitika kawirikawiri koma zovuta kwambiri zimaphatikizira chikaso cha sclera ya m'maso ndi khungu (jaundice), kupweteka kwambiri pamimba ndi kumbuyo (kapamba), kufooka pamphepete ndi m'munsi, kapena kuvuta kuyankhula (mwina ndi sitiroko).

Mimba

Kugwiritsa ntchito mankhwala osokoneza bongo Zowonjezera contraindified pa mimba, azimayi akukonzekera kukhala ndi pakati, komanso azimayi azaka zosabereka omwe sagwiritsa ntchito njira zodalirika zakulera.
Amayi azaka zakubadwa omwe akutenga Accuside® ayenera kugwiritsa ntchito njira zodalirika zakulera.
Mimba ikachitika pakumwa mankhwala ndi Accuzide, mankhwalawo ayenera kusiyidwa posachedwa.
Kukhazikitsidwa kwa ma inhibitors a ACE pa nthawi ya pakati kumayendera limodzi ndi chiopsezo chowonjezeka cha matenda amtundu wamtima komanso wamanjenje kwa mwana wosabadwayo. Kuphatikiza apo, motsutsana ndi kagwiritsidwe ntchito ka zoletsa za ACE pa nthawi ya pakati, milandu ya oligohydramnios, kubadwa msanga, kubadwa kwa ana omwe ali ndi vuto loti ubongo, kuphwanya kwaimpso, kuphatikizapo kulephera kwaimpso, hypoplasia ya mafupa a chigaza, contractures ya nthambi, craniofacial anomalies, pulmonary hypoplasia, pulmonra hypoplasia. , lotseguka la ductus arteriosus, komanso milandu ya kufa kwa fetal komanso imfa yatsopano. Nthawi zambiri, oligohydramnios amadziwika mwana wosabadwayo atawonongeka mosavomerezeka.
Makanda obadwa kumene omwe amakhala ndi ma inhibitor a ACE ayenera kuwunikiridwa kuti adziwe kuchuluka kwa hypotension, oliguria ndi hyperkalemia. Oliguria ikawoneka, kuthamanga kwa magazi ndi kunenepa kwa impso kuyenera kusamalidwa.
Thiazides amadutsa chotchinga ndipo amapezeka m'magazi a chingwe cha umbilical. Zotsatira zosagwirizana ndi thiazides zimaphatikizapo jaundice ndi thrombocytopenia ya mwana wosabadwayo ndi / kapena mwana wakhanda, ndipo mwayi wazinthu zina zovuta zomwe zimawonedwa mwa achikulire zimaloledwa.
Ma inhibitors a ACE, kuphatikiza hinapril, amachepetsa mkaka wa m'mawere. Liazide diuretics imapukusidwa mkaka wa m'mawere. Popeza kuthekera kotengera khanda zovuta mu khanda, Accuzide sayenera kugwiritsidwa ntchito mkaka wa mkaka, ndipo ngati kuli kotheka, kuyamwitsa kuyenera kuyimitsidwa.

Kutulutsa Fomu

tabu. zokutira filimu, 10 mg + 12,5 mg: 30 ma PC.
tabu. zokutira filimu, 20 mg + 12,5 mg: 30 ma PC.
tabu. zokutira filimu, 20 mg + 25 mg: 30 ma PC.

Piritsi 1Zowonjezera muli: quinapril hydrochloride 10,832 mg, womwe umagwirizana ndi zomwe quinapril 10 mg
hydrochlorothiazide 12,5 mg.
Omwe amathandizira: lactose monohydrate - 32.348 mg, magnesium carbonate - 35.32 mg, povidone K25 - 4 mg, crospovidone - 4 mg, magnesium stearate - 1 mg.
Kuphatikizidwa kwa malaya a filimuyi: opadray pink OY-S-6937 (hypromellose, hyprolose, titanium dioxide, macrogol 400, iron oxide utoto wachikasu, utoto wazitsulo utoto) - 3 mg, herbafa wazitsamba - 0,05 mg.
1 piritsi Akkuzid ili ndi: quinapril hydrochloride 21.664 mg, womwe umagwirizana ndi quinapril 20 mg.
hydrochlorothiazide 12,5 mg.
Omwe amathandizira: lactose monohydrate - 77.196 mg, magnesium carbonate - 70.64 mg, povidone K25 - 8 mg, crospovidone - 8 mg, magnesium stearate - 2 mg.
Kuphatikizidwa kwa chovala cha filimuyi: opadray pink OY-S-6937 (hypromellose, hyprolose, titanium dioxide, macrogol 400, iron oxide utoto wachikasu, utoto wazitsulo utoto) - 6 mg, herbal wax - 0.1 mg.
Piritsi 1Zowonjezera ili ndi: quinapril hydrochloride 21.664 mg, womwe umagwirizana ndi quinapril 20 mg.
hydrochlorothiazide 25 mg
Omwe amathandizira: lactose monohydrate - 64.696 mg, magnesium carbonate - 70.64 mg, povidone K25 - 8 mg, crospovidone - 8 mg, magnesium stearate - 2 mg.
Kuphatikizidwa kwa chovala cha filimuyi: opadray pink OY-S-6937 (hypromellose, hyprolose, titanium dioxide, macrogol 400, iron oxide utoto wachikasu, utoto wazitsulo utoto) - 6 mg, herbal wax - 0.1 mg.

Mlingo ndi makonzedwe

Akkuzid adapangidwa kuti azigwiritsa ntchito pakamwa. Kuchuluka kwa kudya - 1 nthawi patsiku, ngakhale kudya.

Odwala omwe sanakodzetse okodzetsa mankhwala amapatsidwa mapiritsi a Accuzid 12.5 mg + 10 mg, 1 pc iliyonse. patsiku. Ngati ndi kotheka, ndikotheka kutumiza Accuid 25 mg + 20 mg, 1 pc. patsiku.

Kuyendetsa bwino kwa magazi kumachitika kawirikawiri pogwiritsa ntchito Mlingo wa mankhwala tsiku lililonse kuchokera pa 12,5 mg + 10 mg mpaka 12,5 mg + 20 mg.

Mlingo wothandizidwa ndi magulu apadera a odwala:

• aimpso kuwonongeka ntchito wofatsa zovuta (creatinine chilolezo zosakwana 60 ml / mphindi): Accuzide 12,5 mg + 10 mg - 1 pc. patsiku
• aimpso kuwonongeka kwa zolimbitsa zovuta (kulengedwa kwa creatinine chilolezo 60-30 ml / mphindi.) mlingo woyambira wa quinapril ndi 5 mg wothandizanso kuchepa, odwala a gululi sakhazikitsidwa ngati Accuzide ngati chithandizo choyambirira.
• ukalamba: Accuzide 12,5 mg + 10 mg - 1 pc. patsiku, kusintha kwa mankhwala sikofunikira.

Zotsatira zoyipa

Zochitika zoyipa zomwe zimachitika oposa 1% ya odwala omwe amalandila quinapril osakanikirana ndi hydrochlorothiazide:

• magawo a labotale: hypercreatininemia, hyperazotemia,
• zina: kupweteka mutu, chizungulire, mseru, kusanza, kusokonezeka kwam'mimba, kupweteka kwa minofu, kupweteka pachifuwa, kupweteka kwam'mimba, kupweteka kwam'mimba, matenda am'mimba, bronchitis, sinusitis, pharyngitis, matenda apamwamba a kupuma thirakiti, chifuwa chosapumira Zizindikiro za vasodilation, kutopa, asthenic syndrome, kusowa tulo.

Zochitika zoyipa zomwe zinachitika mu 0.5-1% ya odwala omwe amalandira quinapril osakanikirana ndi hydrochlorothiazide:

• hematopoietic dongosolo: kuchepa kwa mulingo wa leukocytes, mapulateleti, granulocytes, hemolytic anemia,
• dongosolo lamanjenje: kukhumudwa, kugona, kuchuluka kwa kusokonekera, kumva tulo komanso kumva kulira kwa miyendo,
• Mtima
• kupuma dongosolo: sinusitis, kufupika kwa mpweya,
• Kutupa kwam'mimba: kusokonezeka kwa chopondapo, kuphimba kwamkamwa, kupweteka kwamkamwa ndi pakhosi, angioedema, edema yamatumbo, kapamba, hepatitis, kuyesa kwamatenda a chiwindi, magazi ochokera m'matumbo am'mimba,
• ziwengo: zotupa pakhungu, urticaria, pruritus, edincke's edens, photosensitivity, Stevens-Johnson syndrome, zotupa zapakhungu, pemphigus, anaphylactoid zimachitika, thukuta kwambiri,
• minofu ndi mafupa a minyewa: arthralgia,
• genitourinary dongosolo: kwamikodzo thirakiti matenda, kukanika kwaimpso, kulephera kwaimpso, kuletsa kwa potency,
• mawonekedwe amaso
• Matenda ena: hyperkalemia, alopecia, limodzi ndi kukonzekera golide: nseru, kusanza, kuchepa kwa thupi, kuchepa kwa kuthamanga kwa magazi, matenda a chimfine.

Zizindikiro zotsatirazi ndizomwe zimachitika ndi kuchuluka kwa Akkuzid: kusokonezeka kwa kagayidwe kamchere wamadzi, kuchepa kwambiri kwa magazi, kuchepa kwa bcc motsutsana ndi maziko a kukakamiza kukakamiza. Kuphatikiza ndi mtima glycosides, mwayi wokhala ndi arrhythmias ukuwonjezeka.

Mankhwala osokoneza bongo: kuyimitsa mankhwalawa, kupweteka kwam'mimba, kutsekemera kwa adsorbents, intravenous (iv) makonzedwe a 0.9% sodium kolorayidi yankho, njira yothandizira komanso yodziwika bwino.

Malangizo apadera

Pali umboni wa milandu ya angioedema ya khosi ndi nkhope nthawi yamankhwala a ACE zoletsa, kuphatikiza mu 0.1% ya odwala omwe amalandila hinapril. Pankhani ya angioedema a nkhope, lilime, makutu am'kamwa, maso kapena likhweru laryngeal ndikuvuta kupuma, kumeza chakudya, Akkuzid ayenera kuti kuthetsedwa. Wodwala amayenera kupatsidwa chithandizo chokwanira ndikuwunika momwe aliri mpaka mawonekedwe a edema atha, antihistamines angagwiritsidwe ntchito pakuwachepetsa. Ndi angioedema yokhudza larynx, zotsatira zakupha ndizotheka. Ngati, chifukwa cha kutukusira kwa makutu am'magulu, lilime, kapena larynx, kupanga njira yotseka kwa mpweya ndikotheka, ndiye kuti chithandizo chokwanira chokwanira chiyenera kuchitidwa, kuphatikiza poyendetsa njira ya adrenaline pazovuta za 1: 1000 (0.3-0.5 ml).

Odwala omwe kale adakumana ndi angioedema omwe samagwirizanitsidwa ndi kutenga Acuzide ndi ACE zoletsa, mwayi wake wa chitukuko ukuwonjezeka pogwiritsa ntchito mankhwala a gululi.

Accuzide ingayambitse kuchepa kwapang'onopang'ono kwa kuthamanga kwa magazi, komabe, osati kawirikawiri kuposa ndi monotherapy yokhala ndi zonse ziwiri zogwira ntchito. Matenda ambiri ochitika m'magazi amakhala ndi vuto lochepetsa matenda oopsa, koma amathanso kukulira mwa odwala omwe ali ndi BCC yochepetsedwa, mwachitsanzo, pambuyo poti achepetse mankhwalawa, chifukwa chakudya kwamchere pang'ono kapena hemodialysis.

Panthawi ya matenda ochepa hypotension, wodwalayo ayenera kugona. Ngati ndi kotheka, kulowetsedwa kwa 0,9% sodium kolorayidi kumachitika. Kutsika pang'onopang'ono kwa kuthamanga kwa magazi sikufuna kuti Akkuzid achotsedwe, komabe, kusintha kwa mankhwalawa ndikofunikira.

Odwala omwe ali ndi vuto la mtima wosakhazikika komanso / wopanda vuto laimpso, kutenga Accuzide kumapangitsa kuchepa kwa kuthamanga kwa magazi, limodzi ndi oliguria ndi azotemia. Nthawi zina, kukula kwa impso kulephera ngakhale kufa nkotheka. Gulu ili la odwala liyenera kuyang'aniridwa ndi achipatala.

Pafupipafupi, chithandizo cha Accuzide chimatha kutsatiridwa ndi kuchepa kwa ma granulocytes m'mwazi mpaka kumalo ovuta ndi kuponderezedwa kwa marow hematopoiesis, pomwe kuchuluka kwa leukocytes m'magazi kuyenera kuyendetsedwa.

Maonekedwe a zizindikiro zazing'onoting'ono za matenda (malungo, zilonda zapakhosi) akuwonetsa kufunikira kukaonana ndi dokotala, chifukwa angasonyeze neutropenia.

Accuzide sinafotokozeredwe kupweteka kwambiri kwa impso (kulengedwa kwa creatinine osakwana 30 ml / min), chifukwa azotemia ndi kuwonjezereka kungayambike chifukwa chogwiritsidwa ntchito kwa nthawi yayitali.

Odwala omwe ali ndi vuto lalikulu la mtima, kugwiritsa ntchito ma ACE inhibitors kungayambitse kuchepa kwambiri kwa magazi, zomwe zingapangitse kuchepa kwa mkodzo wambiri ndi impso komanso / kapena kuchuluka kwa misempha ya nitrogenous metabolism yopangidwa ndi impso. Kulephera kwa impso kapena / kapena kufa sizimadziwikiratu.

Pa mankhwala omwe ali ndi Accuside, kuthamanga kwa magazi, ntchito ya impso, komanso kuchuluka kwa ma plrma electrolyte kuyenera kuyang'aniridwa. Kugwiritsa ntchito munthawi yomweyo quinapril ndi othandizira kutsutsana ndi renin-angiotensin-aldosterone system (RAAS) kuyenera kupewedwa. Kuphatikiza uku kumangoyenera pazochitika za aliyense payekha moyang'aniridwa ndi aimpso ndi plasma potaziyamu yambiri.

Odwala omwe ali ndi vuto la chiwopsezo cha hepatic kapena matenda a chiwindi omwe amapita patsogolo, a Accuzide amagwiritsidwa ntchito mosamala, popeza kusintha pang'ono pamagetsi am'magetsi kumatha kuyambitsa kuperewera kwa chiwindi.

Pafupifupi 2% odwala omwe amathandizidwa ndi quinapril anali ndi hyperkalemia. Kugwiritsa ntchito munthawi yomweyo kugwiritsa ntchito Accuzide ndi potaziyamu potetezera osavomerezeka.

Chloride akusowa chifukwa cha kutenga Accuzide nthawi zambiri amakhala ofatsa ndipo amafunika chithandizo chapadera pokhapokha (mwachitsanzo, ndi matenda a chiwindi ndi / kapena impso).

Mukutentha, kutenga Accuzide mwa odwala omwe ali ndi zotumphukira edema kungayambitse kuchepa kwa sodium m'thupi. Izi zimalowa m'malo.

Hinapril amachepetsa kuwononga kashiamu, kumawonjezera kuchuluka kwa magnesium mkodzo, komwe kungayambitse hypomagnesemia.

Quinapril amatha kuwonjezera seramu cholesterol, uric acid ndi triglycerides. Nthawi zambiri zotsatirazi zimakhala zofatsa, komabe, nthawi zina, zimatha kuyambitsa gout ndi matenda a shuga.

Kutenga Mlingo wambiri wa Accuzide kumatha kuyambitsa hyperkalemia (kuchuluka kwa mlingo wa ≥100 mg patsiku), kusokoneza kayendetsedwe ka magazi m'magazi. Pa mankhwala, tikulimbikitsidwa kuwongolera kuchuluka kwa shuga m'magazi ndipo ngati kuli kotheka, sinthani mankhwala a hypoglycemic.

Asanachite opareshoni, wodwalayo ayenera kuchenjeza dokotala kuti akutenga Accuzide.

Panthawi ya mankhwala, mankhwalawa adayamba kukhazikika osabereka. Zimadutsa atayimitsa mankhwalawo.

Hydrochlorothiazide ingayambitse kukulitsa glaucoma ya pachimake-kutsekeka kwa glaucoma ndi myopia osakhalitsa. Popanda chithandizo choyenera, vuto la glaucoma limakhala lambiri.

Amayi azaka zakubadwa pogwiritsa ntchito Akkuzid ayenera kutetezedwa ku mimba. Zikatere, mankhwalawa amachotsedwa posachedwa.

Pochita mankhwala ndi Accuside, muyenera kusamala mukamagwira ntchito zamtundu zomwe zimafuna chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor, kuphatikizapo kuyendetsa galimoto ndi njira zina zovuta, makamaka kumayambiriro kwa chithandizo.

Kuyanjana kwa mankhwala osokoneza bongo

• okodzetsa: kuchuluka kwamphamvu kwa Akkuzid,
• ethanol, zotumphukira za barbituric acid, narcotic analgesics: chiwopsezo cha kugwa kwa orthostatic,
• glucocorticosteroids (GCS), ma adrenocorticotropic mahomoni (ACTH): kutayika kowonjezereka kwa ma elekitirodi, makamaka potaziyamu,
• digoxin: kuchuluka kwa kuledzera kwa digoxin (kuphatikizapo kusokonezeka kwa malingaliro akathina),
• hypoglycemic mankhwala: kukula kwa hyperglycemia, kuchuluka kwa kulolera kwa shuga.
• vasoconstrictor mankhwala: kuchepa kwa zotsatira zawo,
• tetracycline ndi mankhwala ena omwe amalumikizana ndi magnesium: kuchepetsa kuchepa kwa zinthu zawo,
• Mankhwala okhala ndi lifiyamu: kufalikira kwa impso, kuwonjezeka kwa zochitika zoyipa, chiopsezo cha kuledzera wa lithiamu,
• Mankhwala ena a antihypertensive: kukulitsa zochita zawo, makamaka a beta-blockers ndi ganglion blockers,
• mankhwala osapweteka a antiidal (NSAIDs): kufooketsa kwa hypotensive, diuretic, natriuretic zochita za Accuzide, kuwonongeka kwaimpso kwa odwala okalamba komanso kuchepa kwa BCC komanso kusowa kwa impso,
• mankhwala omwe amalimbikitsa kuchuluka kwa potaziyamu m'magazi: kuwonjezereka kwa mwayi wokhala ndi hyperkalemia,
• kusinthana kwa ma ion komwe kumapangitsa: kuyamwa kwa hydrochlorothiazide,
• anti-gout mankhwala: kuwonongeka kwa mawonekedwe a odwala omwe ali ndi gout, kuwonjezereka kwa pafupipafupi kwa hypersensitivity zimachitika ndi zinthu zotsutsana ndi gout,
• mankhwala osokoneza bongo a narcotic, analcics ya narcotic, mankhwala ochepetsa kuthamanga kwa magazi: kuchuluka kwa hypotensive Akkuzida,
• immunosuppressants, cytostatics, allopurinol, procainamide: chiwopsezo chotenga leukopenia,
• mtima glycosides ndi mankhwala ena omwe angapangitse kuti pirouette mtundu arrhythmias: chiwopsezo cha hypokalemia, chiwopsezo chowonjezera,
• aliskiren: mwayi wa blockade iwiri ya ntchito ya RAAS, yomwe imawonetsedwa ndi kuchepa kwa magazi, kusintha kwa impso, hyperkalemia,
• MTOR ndi DPP-4 enzyme zoletsa: kuchulukitsa mwayi wopanga Quincke edema.