Lizoril - (Lisoril) malangizo ogwiritsira ntchito

Kufotokozera kogwirizana ndi 28.12.2014

• Dzina lachi Latin: Lisinopril
• Code ya ATX: C09AA03
• Chithandizo: Lisinopril (Lisinopril)
• Wopanga: Avant (Ukraine), Skopinsky Pharmaceutical Plant, ALSI Pharma, ZiO-Zdorovye, Severnaya Zvezda, Ozon LLC, Biochemist, Obolenskoye - bizinesi yamankhwala, Canonfarm Production CJSC, VERTEX (Russia)

Gawo lalikulu la mankhwalawo ndi lisinopril dihydrate. Koma, kutengera wopanga mankhwalawa, kapangidwe kazinthu zina zimatha kukhala zosiyana.

Kampani yaku Ukraine ya Avant imapanga Lisinopril ndi zinthu zothandizira monga wowuma chimanga,calcium hydrogen phosphate,iron oxide, mannitol,magnesium wakuba.

Ndipo wopanga waku Russia ALSI Pharma amatulutsa chogulitsa ndi zinthu zina zowonjezera: pregelatinized wowuma,silicon dioxide colloidal,talcum ufa,lactose monohydrate, microcrystalline mapadi,magnesium wakuba.

Kuphatikiza apo, mitundu yotereyi yotulutsira mankhwalawa imadziwika kuti Lisinopril-Ratiopharm, Lisinopril-Astrafarm, Lisinopril Teva, Lisinopril Stada. Ali ndi izi:

• Lisinopril-Astrapharm - wowuma chimanga,silicon dioxide colloidal,mannitol,calcium hydrogen phosphate, magnesium wakuba,
• Lisinopril-Ratiopharm - mannitol,calcium hydrogen phosphate, magnesium wakuba, pregelatinized wowuma, croscarmellose sodium (Mapiritsi 20 mg alinso ndi utoto PB-24824, ndipo mankhwalawa mapiritsi a 10 mg ali ndi utoto PB-24823).

Lisinopril Stada ali ngati othandizira lisinopril hydrate. Kuphatikiza apo, zinthu zina zotsatirazi: pregelatinized wowuma,silicon oxide colloidal anhydrous, mannitol,magnesium wakuba,wowuma chimanga, calcium phosphate disubstituted dihydrate.

Pharmacodynamics ndi pharmacokinetics

Lisinopril mapiritsi ACEonjezani okhutira endo native vasodilating GHG ndikulepheretsa kusintha angiotensin I mu angiotensin II. Amachepetsa kutembenuka. arginine-vasopressinndi endothelin-1, kuchepetsa myocardial afterload, zotumphukira zamitsempha, kukakamira kwa magazi ndi kupanikizika kwa magazi. Odwala kulephera kwa mtima onjezerani kulolerana myocardial kuchita masewera olimbitsa thupi komanso kutulutsa kwamtima. Thandizani kuntchito yowonjezereka renin plasma.

Mankhwalawa amatchinga minofu renin-angiotensin dongosolo la mtima, limalepheretsa kuwoneka kwa myocardial hypertrophy ndi dilatations kumanzere kwamitsempha kapena kuthandizira pakutha kwawo.

Mphamvu ya mankhwalawa imawonekera patatha pafupifupi mphindi 60, imawonjezeka kwa maola 6-7 ndipo imakhala kwa tsiku limodzi. Zolemba malire antihypertensivemomwe zimawonekera pakapita milungu ingapo.

Zinthu zomwe zimagwira zimatengedwa ndi pafupifupi 25%. Nthawi yakudya siyimakhudza mayamwidwe. Kuyankhulana ndi mapuloteni a plasma ndizochepa. Chidacho sichidapangidwe ndipo chimasulidwa ndi impso osasinthika. Kuchotsa theka moyo ndi maola 12.

Contraindication

Mankhwala sayenera kumwedwa Hypersensitivity ku zigawo zake, kuyamwa ndi mimba.

Sichabwino kupereka mankhwala awa:

• Hyperkalemia,
• anaphylactoid zimachitika,
• collagenoses,
• choperewera mu mtima,
• matenda a impso ndi chiwindi.
• mayiko awiri aimpso mtsempha wamagazi stenosis,
• anaika impso
• gout,
• ukalamba
• Edema wa Quincke mu mbiri,
• kupsinjika kwa m'mafupa,
• hypotension,
• Zosintha zomwe zimalepheretsa kutuluka magazi kuchokera mumtima
• hyponatremia, komanso mukamadya zakudya zochepa za sodium,
• stenosis ya mtsempha wama impso umodzi,
• Hyperuricemia,
• zaka za ana.

Zotsatira zoyipa

Zotsatira zoyipa zimatha kukhala zosiyana, zimachokera ku kachitidwe ndi ziwalo zosiyanasiyana:

Kuphatikiza apo, mawonetsedwe otsatirawa ndi otheka: kukula kwa matenda, kuchepa thupi, thukuta, matenda ashugakukweza antiinuclear antibody titer komanso okhutira urea, goutkuchuluka kwawonjezeka creatinine, Hyperkalemia, Hyperuricemia, malungo, ziwengo, kusowa kwamadzi, hyponatremia.

Ngati mavuto aliwonse apezeka, muyenera kufunsa katswiri.

Bongo

Pankhani ya bongo, nthawi zambiri zimawonekera pachimake ochepa hypotension. Monga chithandizo, saline yakuthupi imayendetsedwa. Mankhwala othandizira amachita.

Kuphatikiza apo, kugwedezeka kuli kotheka, Hyperventilation, pachimake aimpso kulephera, bradycardia, kutsokomola, kusasamala ma elekitirodi m'magazi tachycardiakugunda kwa mtima chizungulirekumva kuda nkhawa.

Mankhwala ayenera kuthetsedwa. Wodwalayo akazindikira, amatsuka m'mimba, kumugoneka kumbuyo kwake ndi mutu wochepa, miyendo yodzutsidwa ndi mutu wakhazikika. Kuphatikiza apo, amapatsa ammayankhoma.

Mukamamwa mankhwala makamaka waukulu, wodwala amayenera kugonekedwa kuchipatala msanga. Ku chipatala, chithandizo chimachitika ndikutsimikiza kupanikizika kwa mafuta, kuthamanga kwa magazi, kupuma, kubwezeretsa kuchuluka kwa magazi ndi magazi ake. Kugwiritsa hemodialysis. Onetsetsani kuti mukuwonetsetsa zomwe zikuwonetsa ntchito zofunika, komanso mulingo creatinine ndi ma elekitirodimu seramu yamagazi.

Kuchita

Kumwa mankhwala antihypertensivemankhwala amatha kuyambitsa antihypertensive kwambiri.

Potaziyamu-yosasamala okodzetsa, cholowa m'malo mwa mchere wotsekemera ndi potaziyamu, komanso mankhwala omwe ali ndi potaziyamu kumawonjezera mwayi wakukula Hyperkalemia.

Kuphatikiza ndi blockers ACE ndi NSAIDskumawonjezera mwayi kwa vuto laimpso. Nthawi zina, ndizotheka Hyperkalemia.

Ndipo ntchito mogwirizana matembenukidwe ndi thiazide okodzetsa onenepa ndi kukwezedwa antihypertensive machitidwe. Izi zimathandizanso kwambiri kupewetsa matenda aimpso.

Indomethacin kapena ndalama ndi estrogen kuphatikiza ndi lisinopril kumabweretsa kuchepa antihypertensive machitidwe a omaliza. Kulandila nthawi yomweyo Insulin ndihypoglycemic mankhwala amatha kuyambitsa hypoglycemia.

Kuphatikizika ndi clozapine kumabweretsa kuwonjezeka kwa zomwe zili mu plasma. Mukutenga lithiamu carbonate mulingo wake mu seramu yamagazi ukuwonjezeka. Izi zitha kutsatiridwa ndi zizindikiro za kuledzera wa lithiamu.

Mankhwala amathandizanso mphamvu ya Mowa. Zizindikiro za kuledzera zimakulitsidwa. Nthawi yomweyo, kuwonjezereka kumatheka antihypertensive Mphamvu ya lisinopril, choncho ndikofunikira kupewa kumwa mukamamwa mankhwalawa kapena osamamwa pakatha maola 24 mutamwa mowa.

Kugwiritsa ntchito mankhwalawa molumikizana ndi ndalama za opaleshonizamwano analgesics, antidepressants, opuma minofu ndi zododometsa kuchitapo kanthu, komanso mapiritsi ogona kumabweretsa kuwonjezeka antihypertensive zotsatira.

Maulonda onjezerani mwayi ochepa hypotension. Kuphatikiza uku kuyenera kufotokozedwa mosamala ndikuwonetsetsa momwe wodwalayo alili.

Sympathomimetics kufooketsani antihypertensive mphamvu ya mankhwala. Kuphatikiza ndi mankhwala omwe amapereka myelosuppresskuchitira chiwopsezo agranulocytosis ndi / kapena neutropenia.

Ntchito mogwirizana Allopurinol, immunosuppressants, Procainamide, cytostatics, corticosteroids zingayambitse leukopenia.

At dialysismankhwalawa ndizotheka anaphylactoid zimachitika pa ntchitokuthamanga kwa polyacrylonitrile zitsulo sulfonate nembanemba.

Tulutsani mawonekedwe, ma CD ndi mapangidwe a Lizoril ®

Ma PC 10 - matumba otumphukira (3) - mapaketi a makatoni.
14 ma PC. - mapepala otumphukira (2) - mapaketi a makatoni.

Othandizira: wowuma, mannitol, dical calcium phosphate dihydrate, magnesium stearate, utoto wazitsulo utoto wofiira.

Ma PC 10 - matuza (3) - mapaketi a makatoni.
14 ma PC. - matuza (2) - mapaketi a makatoni.

Othandizira: wowuma, mannitol, dical calcium phosphate dihydrate, magnesium stearate, utoto wazitsulo utoto wofiira.

Ma PC 10 - matumba otumphukira (3) - mapaketi a makatoni.
14 ma PC. - mapepala otumphukira (2) - mapaketi a makatoni.

Othandizira: wowuma, mannitol, dical calcium phosphate dihydrate, magnesium stearate, utoto wazitsulo utoto wofiira.

Ma PC 10 - matumba otumphukira (3) - mapaketi a makatoni.
14 ma PC. - mapepala otumphukira (2) - mapaketi a makatoni.

Zotsatira za pharmacological

ACE inhibitor. Zimalepheretsa kupangika kwa angiotensin II kuchokera ku angotensin I. Zimachepetsa zomwe zili za angiotensin II ndipo zimatsogolera kutsika kwachindunji kutulutsidwa kwa aldosterone. Amachepetsa kuchepa kwa bradykinin ndikuwonjezera kaphatikizidwe ka prostaglandin. Kuchepetsa kwathunthu zotumphukira mtima kukana, kuthamanga kwa magazi, preps, pulmonary capillary pressure, kumayambitsa kuchuluka kwa mtima komanso kuchuluka kwa kulolerana kwa nkhawa kwa odwala omwe ali ndi vuto la mtima. Imakulitsa mitsempha pamlingo wokulirapo kuposa mitsempha. Zotsatira zina zimafotokozedwa ndi kuthana ndi machitidwe a minye renin-angiotensin. Pogwiritsa ntchito nthawi yayitali, hypertrophy ya myocardium ndi makhoma amitsempha ya mtundu wotsalira amachepa. Amasintha magazi kupita ku ischemic myocardium. ACE inhibitors imakulitsa chiyembekezo cha moyo kwa odwala omwe ali ndi vuto la mtima komanso kuchepa kwa kupitirira kwa vuto lamanzere kwa odwala pambuyo pa kulowetsedwa kwa myocardial popanda chiwonetsero cha matenda a mtima kulephera.

Kukhazikika kwa zochita kumachitika pambuyo pa ola limodzi. The pazipita zimatsimikiza pambuyo 6-7 maola, nthawi - maola 24. Ndi ochepa matenda oopsa, zotsatira zake zimawonedwa m'masiku oyambira pambuyo pa kuyamba kwa mankhwalawa, mokhazikika umayamba pambuyo pa miyezi 1-2

Pharmacokinetics

The bioavailability ya mankhwalawa 25-50%, ofowoka mphamvu mapuloteni a plasma. C max mu seramu amafikira pambuyo maola 7. Kudya sizimakhudza mayamwidwe.

Chilolezo kudzera mu BBB ndipo chotchinga chachikulu ndi chotsika.

Lysoril samapangidwira ndipo amachotsa mu mkodzo. Ambiri amamasulidwa mgawo loyambirira (ma T 1/2 - maola 12), kutsatiridwa ndi gawo lakutali (T 1/2 pafupifupi maola 30)

Mlingo ndi makonzedwe

Mkati. At matenda oopsa: mlingo woyambirira ndi 5 mg kamodzi patsiku, ngati pangafunike mpaka 40 mg / tsiku. At Kulephera kwamtima: mlingo woyambira ndi 2,5 mg, ngati pangafunike mpaka 20 mg / tsiku. Potengera maziko a kuphwanya kwamphamvu yamagetsi yamagetsi, diuretic mankhwala aimpso kulephera, ndi kukonzanso kwamitsempha yamagazi, gawo loyamba ndi 1.25 mg / tsiku.

Mafotokozedwe a magulu a nosological

Siyani ndemanga yanu

Chidziwitso Chaposachedwa Chosowa Chidziwitso, ‰

Kulembetsa Lizoril

• P N014842 / 01-2003

Webusayiti yovomerezeka ya kampani RLS ®. Ensaikulopediya yayikulu ya mankhwala osokoneza bongo ndi katundu wa mankhwala omwe amapezeka ku Russia Internet. Ndondomeko yamankhwala Rlsnet.ru imapatsa ogwiritsa ntchito malangizo, mitengo ndi mafotokozedwe a mankhwala, zowonjezera pazakudya, zida zamankhwala, zida zamankhwala ndi zina. Maupangiri a pharmacological akuphatikiza chidziwitso cha kapangidwe ndi mawonekedwe amamasulidwe, zochitika zamankhwala, zisonyezo zogwiritsidwa ntchito, contraindication, zotsatira zoyipa, kuyanjana kwa mankhwala, njira yogwiritsira ntchito mankhwala, makampani opanga mankhwala. Ndondomeko ya mankhwala ili ndi mitengo yamankhwala ndi mankhwala ku Moscow ndi mizinda ina ya Russia.

Sizoletsedwa kufalitsa, kukopera, kufalitsa zambiri popanda chilolezo cha RLS-Patent LLC.
Mukamagwiritsa ntchito zidziwitso zofalitsidwa pamasamba a webusayiti ya www.rlsnet.ru, kulumikizana ndi gwero lachidziwitso ndikofunikira.

Zinthu zina zambiri zosangalatsa

Maumwini onse ndi otetezedwa.

Kugwiritsa ntchito malonda pazinthu sikuloledwa.

Chidziwitsochi cholinga chake ndi akatswiri azachipatala.

Zizindikiro zogwiritsidwa ntchito

Matenda oopsa a arterial (kuphatikiza chizindikiro), CHF, chithandizo choyambirira cha kulowetsedwa kwak pachimake kwa odwala omwe ali ndi vuto la hemodynamically (monga gawo la mankhwala osakanikirana).

Monga gawo la mankhwala othandizira pachimake myocardial infarction (mu maola 24 oyambirira, okhala ndi hemodynamics yokhazikika).

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.

Malangizo apadera

Chisamaliro chofunikira chimafunikira pakulamula odwala omwe ali ndi vuto la mtima lamitsempha kapena stenosis yamitsempha imodzi yamkati (mwina kuwonjezeka kwa kuchuluka kwa urea ndi creatinine m'magazi), odwala omwe ali ndi matenda amitsempha yamagazi kapena matenda amisempha, otaya mtima. Odwala ndi mtima kulephera, ochepa hypotension angayambitse matenda aimpso.

Mukamagwiritsa ntchito mankhwala omwe amachepetsa kuthamanga kwa magazi kwa odwala omwe akuchita opaleshoni yayikulu kapena panthawi ya opaleshoni, lisinopril imatha kuletsa mapangidwe a angiotensin II, sekondale kupita kukakamiza renin secretion.

Chitetezo ndi luso la lisinopril mwa ana silinakhazikitsidwe.

Musanayambe chithandizo, ndikofunikira kulipirira kutayika kwa madzimadzi ndi mchere.

Kugwiritsa ntchito panthawi yomwe muli ndi pakati kumatsutsana, pokhapokha ngati simungathe kugwiritsa ntchito mankhwala ena kapena sangathe (wodwalayo ayenera kudziwitsidwa za chiopsezo cha mwana wosabadwayo).

Mafunso, mayankho, ndemanga pa mankhwala Lizoril

Zomwe zimaperekedwa zimakonzekera akatswiri azamankhwala komanso zamankhwala. Chidziwitso chokwanira chokhudza mankhwalawa chili m'malangizo omwe amaphatikizidwa ndi zomwe amapanga ndi wopanga. Palibe chidziwitso chomwe chatumizidwa patsamba lino kapena tsamba lililonse la tsamba lathu chomwe chingagwire ntchito ngati cholowa m'malo mwapadera kwa katswiri.

Zotsatira zoyipa

Kuchokera pa mtima

Kuchokera kumbali yamanjenje: chizungulire, kupweteka mutu, kutopa, kugona, kupindika kwa minofu ya miyendo ndi milomo, kawirikawiri - asthenic syndrome, kusinthasintha kwa mitsempha, chisokonezo.

Kuchokera m'mimba thirakiti: nseru, dyspepsia, anorexia, kusintha kwa kukoma, kupweteka kwam'mimba, kutsekula m'mimba, pakamwa kowuma.

Hematopoietic ziwalo: leukopenia, thrombocytopenia, neutropenia, agranulocytosis, kuchepa magazi (kuchepa hemoglobin, erythrocytopenia).

Kuchokera pakapumidwe: dyspnea, bronchospasm, apnea.

Thupi lawo siligwirizana: Angeoneurotic edema, zotupa pakhungu, kuyabwa.

Laborator Zizindikiro: hyperkalemia, hyperuricemia, kawirikawiri - kuchuluka kwa "hepatic" transaminases, hyperbilibinemia.

Zina, chifuwa chowuma, kuchepa kwa potency, kawirikawiri - kulephera kwaimpso, arthralgia, myalgia, malungo, edema (lilime, milomo, miyendo), kusokonezeka kwa impso za fetal.

Zolemba zogwiritsira ntchito

Chisamaliro chofunikira chimafunikira pakulamula odwala omwe ali ndi vuto la mtima lamitsempha kapena stenosis yamitsempha imodzi yamkati (mwina kuwonjezeka kwa kuchuluka kwa urea ndi creatinine m'magazi), odwala omwe ali ndi matenda amitsempha yamagazi kapena matenda amisempha, otaya mtima. Odwala ndi mtima kulephera, ochepa hypotension angayambitse matenda aimpso.

Kuchepetsa kwa kuthamanga kwa magazi panthawi ya mankhwala kumachitika kawirikawiri kumachitika ndi kuchepa kwa BCC komwe kumachitika chifukwa cha kukodzetsa, kuyimitsidwa kwamchere, kutsekeka, kutsegula m'mimba, kapena kusanza.

Chithandizo cha lisinopril mu infarction yovuta yam'mimba imachitika motsutsana ndi maziko a chithandizo chokwanira (thrombolytics, ASA, beta-blockers). Kugwirizana ndi iv makonzedwe a nitroglycerin kapena TTC nitroglycerin.

Mukamagwiritsa ntchito mankhwala omwe amachepetsa kuthamanga kwa magazi kwa odwala omwe akuchita opaleshoni yayikulu kapena panthawi ya opaleshoni, lisinopril imatha kuletsa mapangidwe a angiotensin II, sekondale kupita kukakamiza renin secretion. Opaleshoni isanachitike (kuphatikizapo opaleshoni yamano), dokotala wa opaleshoni / opaleshoni ayenera kudziwitsidwa za kugwiritsidwa ntchito kwa ACE inhibitor.

Kutengera ndi zotsatira za maphunziro a miliri, ndikuganiza kuti kugwiritsa ntchito nthawi yomweyo kwa ACE inhibitors ndi insulin, komanso mankhwala amkamwa a hypoglycemic, kungayambitse kukula kwa hypoglycemia. Chiwopsezo chachikulu cha chitukuko chimawonedwa m'milungu yoyamba yophatikiza mankhwala, komanso mwa odwala omwe ali ndi vuto laimpso. Odwala omwe ali ndi matenda ashuga amafunika kuwunika kwambiri glycemia, makamaka mwezi woyamba wa chithandizo ndi ACE inhibitor.

Musanayambe chithandizo, ndikofunikira kulipirira kutayika kwa madzimadzi ndi mchere.

Zomwe zimayambitsa kukulitsa kwa hyperkalemia zimaphatikizaponso kulephera kwa aimpso, matenda a shuga komanso kugwiritsa ntchito munthawi yomweyo potaziyamu (spironolactone, triamteren kapena amiloride), kukonzekera kwa K + kapena m'malo mwa mchere omwe muli K +. Kuyang'anira kuwunika kwa kuchuluka kwa K + m'madzi a m'magazi kumalimbikitsidwa.

Odwala omwe atenga ma inhibitors a ACE panthawi yofunitsitsa kupitilizidwa ndi hymenopter, ndizosowa kwambiri kuti moyo wa anaphylactoid wowopsa ungachitike. M'pofunika kusiya kwakanthawi chithandizo ndi ACE inhibitor musanayambe maphunziro okakamira.

Kuchitikira kwa anaphylactoid kumatha kuchitika pomwe hemodialysis ikuchitika pogwiritsa ntchito ma membrane othamanga (kuphatikizapo AN 69). Ndikofunikira kulingalira za mwayi wogwiritsa ntchito mtundu wina wa nembanemba wa dialysis kapena mankhwala ena a antihypertensive.

Chitetezo ndi luso la lisinopril mwa ana silinakhazikitsidwe.