Momwe mungagwiritsire ntchito Lorista N pa matenda ashuga

Lorista ® N - mankhwala ophatikiza, ali ndi vuto lodziletsa.

Losartan. Kusankha angiotensin II receptor antagonist (mtundu AT 1) wochita pakamwa, osakhala ndi mapuloteni. Mu vivo ndi mu vitro losartan ndi yogwira yogwira carboxy metabolite (EXP-3174) imalepheretsa zovuta zonse za thupi mwakuthupi za angiotensin II pa AT 1 receptors.

Losartan mosayambitsa amachititsa kuyambitsa kwa AT 2 receptors powonjezera kuchuluka kwa angiotensin II.

Losartan sikuletsa ntchito ya kininase II, enzyme yomwe imakhudzidwa ndi metabolism ya bradykinin.

Amachepetsa OPSS, kuthamanga mu mzere "wawung'ono" wamagazi, kumachepetsa pambuyo pake, kumakhudzanso okodzetsa.

Zimasokoneza kukula kwa hypertrophy ya myocardial, kumawonjezera kulolera kwa odwala omwe ali ndi vuto la mtima. Kutenga losartan kamodzi patsiku kumabweretsa kutsika kwakukulu mu SBP ndi DBP. Losartan wogawana amawongolera kupanikizika tsiku lonse, pomwe mphamvu ya antihypertensive imafanana ndi nyimbo yachilengedwe yozungulira. Kuchepa kwa kuthamanga kwa magazi kumapeto kwa mlingo wa mankhwalawa kunali pafupifupi 70-80% ya zotsatira za mankhwalawa, maola 5-6 atatha kutsata. Withdawal syndrome sichimawonedwa, ndipo losartan alibe kwambiri machitidwe pamtima kugunda kwa mtima.

Losartan imagwira ntchito mwa amuna ndi akazi, komanso achikulire (zaka zopitilira 65) ndi odwala achichepere (osakwana zaka 65).

Hydrochlorothiazide. A thiazide diuretic, mphamvu yotsitsa yomwe imalumikizidwa ndi kuphwanya kwa sodium, chlorine, potaziyamu, magnesium, mapiritsi am'madzi mu distal nephron, amachedwa mayendedwe a calcium ion, uric acid. Ili ndi katundu wa antihypertensive. Pafupifupi palibe vuto lililonse pamagazi.

Mphamvu ya diuretic imachitika pambuyo pa maola 1-2, imafika patadutsa maola 4 ndipo imatha maola 6- 12. Mphamvu ya antihypertensive imachitika pakatha masiku 3-4, koma zimatha kutenga masabata atatu kuti zitheke.

Pharmacokinetics

Ma pharmacokinetics a losartan ndi hydrochlorothiazide pamene atengedwa nthawi imodzi samasiyana ndi omwe amaperekedwa mosiyana.

Losartan. Amayamwa bwino m'mimba. Imakhala ndi kagayidwe kofunikira mu "gawo loyambirira" kudzera m'chiwindi, ndikupanga metabolite yogwira (EXP-3174) ndi carboxylic acid ndi metabolites ena osagwira. Bioavailability pafupifupi 33%. Kutenga mankhwalawa ndi chakudya kulibe mphamvu pakukhudzidwa kwawoko kwa seramu. T max - 1 ora pambuyo pokonzekera pakamwa, ndi metabolite yake yogwira (EXP-3174) - maola 3-4.

Zoposa 99% za losartan ndi EXP-3174 zimamangidwa kumapuloteni a plasma, makamaka okhala ndi albumin. Kuchuluka kwa magawo a losartan ndi malita 34. Imalowa mkatikati mwa BBB.

Losartan imapangidwa ndi kupangika kwa metabolite yogwira (EXP-3174) metabolites (14%) komanso yopanda mphamvu, kuphatikiza ma metabolites awiri opangidwa ndi hydroxylation a gulu la butyl la unyolo, ndi metabolite yofunikira kwambiri - N-2-tetrazole glucuronide.

Chilolezo cha plasma cha losartan ndi metabolite yake yogwira pafupifupi 10 ml / s (600 ml / min) ndi 0,83 ml / s (50 ml / min), motsatana. Kutsimikizika kwa impso kwa losartan ndi metabolite yake yogwira ndi pafupifupi 1.23 ml / s (74 ml / min) ndi 0.43 ml / s (26 ml / min). T 1/2 ya losartan ndi metabolite yogwira ndi maola 2 ndi maola 6-9, motsatana. Amachotseredwa makamaka ndi bile - 58%, impso - 35%.

Hydrochlorothiazide. Pambuyo pakamwa, kuphatikiza kwa hydrochlorothiazide ndi 60-80%. C max hydrochlorothiazide m'magazi amakwaniritsidwa maola 1-5 atatha kumeza.

Kumangiriza kwa mapuloteni a plasma a hydrochlorothiazide ndi 64%.

Hydrochlorothiazide siimapukusidwa ndipo imathandizidwa mwachangu kudzera mu impso. T 1/2 ndi maola 5-15.

Mikhalidwe yapadera

• 1 tabu potaziyamu losartan 100 mg hydrochlorothiazide 25 mg Othandizira: pregelatinized wowuma - 69.84 mg, cellcrystalline cellulose - 175.4 mg, lactose monohydrate - 126.26 mg, magnesium stearate - 3.5 mg. Zomwe zimapanga filimu ya kanema: hypromellose - 10 mg, macrogol 4000 - 1 mg, utoto wa quinoline chikasu (E104) - 0,11 mg, titanium dioxide (E171) - 2.89 mg, talc - 1 mg. losartan potaziyamu 100 mg hydrochlorothiazide 12,5 mg Othandizira: pregelatinized starch, microcrystalline cellulose, lactose monohydrate, magnesium stearate. Mapangidwe a Shell: hypromellose, macrogol 4000, utoto wachikasu utoto (E104), titanium dioxide (E171), talc. losartan potaziyamu 100 mg hydrochlorothiazide 25 mg Othandizira: pregelatinized starch, microcrystalline cellulose, lactose monohydrate, magnesium stearate. Mapangidwe a Shell: hypromellose, macrogol 4000, utoto wachikasu utoto (E104), titanium dioxide (E171), talc. potaziyamu losartan 50 mg hydrochlorothiazide 12,5 mg Othandizira: pregelatinized starch, microcrystalline cellulose, lactose monohydrate, magnesium stearate Shell kapangidwe: hypromellose, macrogol 4000, quinoline chikasu (E104), titanium dioxide (E171), tal. losartan potaziyamu 50 mg hydrochlorothiazide 12.5 mg Othandizira: pregelatinized starch, microcrystalline cellulose, lactose monohydrate, magnesium stearate. Mapangidwe a Shell: hypromellose, macrogol 4000, utoto wachikasu utoto (E104), titanium dioxide (E171), talc.

Lorista N zolakwika

• Hypersensitivity los losan, mankhwala opangidwa ndi sulfonamides ndi zina za mankhwala, anuria, kuvulala kwambiri kwaimpso (creatinine chilolezo (CC) ochepera 30 ml / min., Hyperkalemia, kuchepa madzi m'thupi (kuphatikiza ndi kuchuluka kwa okodzetsa) kwambiri chiwindi kukanika, Reflexory hypokalemia, mimba, mkaka wa m`mawere, ochepa hypotension, pansi pa zaka 18 (mphamvu ndi chitetezo osakhazikitsidwa), lactase akusowa, galactosemia, kapena shuga / gal malabsorption. Amachita. Mochenjera: Magetsi amagetsi amagetsi am'magazi, hypochloremic alkalosis, hypomagnesemia, hypokalemia), matenda amitsempha yamafupa kapena stenosis a mtsempha wama impso, matenda oopsa a shuga, hypercalcemia, hyperuricemia komanso / kapena gouta. adapangidwa kale ndi mankhwala ena, kuphatikiza AP inhibitors

Lorista N mavuto

• Pa gawo lamwazi ndi zamitsempha yamagazi: kanthawi kochepa: kuchepa magazi, Shenlane-Genokha purpura. Pa mbali ya chitetezo chamthupi: kawirikawiri: anaphylactic reaction, angioedema (kuphatikizapo kutupa kwa mkaka ndi lilime, kuyambitsa kutsekeka kwa mpweya ndi / kapena kutupa kwa nkhope, milomo, pharynx). Kuchokera kumbali ya chapakati mantha dongosolo ndi zotumphukira mantha dongosolo: Nthawi zambiri: mutu, systemic ndi sanali chizungulire, kusowa tulo, kutopa, infrequently: migraine. Kuchokera pamtima dongosolo: Nthawi zambiri: orthostatic hypotension (kumwa modalira), palpitations, tachycardia, kawirikawiri: vasculitis. Kuchokera kupuma dongosolo: Nthawi zambiri: chifuwa, kupumira kwapakati thirakiti, pharyngitis, kutupa kwa mphuno. Kuchokera m'mimba thirakiti: pafupipafupi: kutsekula m'mimba, kukomoka, kusanza, kusanza, kupweteka kwam'mimba. Kuchokera ku hepatobiliary system: kawirikawiri: hepatitis, chiwindi ntchito. Kuchokera pakhungu ndi mafuta osunthika: ochepa: urticaria, kuyabwa kwa khungu. Kuchokera ku minculoskeletal system ndi minofu yolumikizana: nthawi zambiri: myalgia, kupweteka kwa msana, infrequently: arthralgia. Zina: nthawi zambiri: asthenia, kufooka, zotumphukira edema, kupweteka pachifuwa. Zowonetsa zasayansi: pafupipafupi: hyperkalemia, kuchuluka kwa hemoglobin ndi hematocrit (osati mozama), kuchepa: kuchuluka kwa serum urea ndi creatinine, kawirikawiri: ntchito yowonjezera ya chiwindi ndi micirubin.

Malo osungira

• sitolo firiji 15-25 madigiri
• osayandikira ana

Chaka chilichonse, anthu ochulukirapo amadwala chifukwa cha matenda amtima. Malinga ndi ziwerengero, posachedwapa, ngakhale ana ang'ono adakumana ndi vutoli. Masiku ano, pali mankhwala ambiri omwe amathandiza kulimbana ndi matenda oopsa. Mmodzi wothandiza kwambiri ndi a Lorista N.

Lorista N ndi mankhwala ophatikiza omwe ali ndi hypotensive. Zinthu zomwe zimapangidwa momwe zimapangidwira magazi zimathandizanso kuthamanga kwa magazi ndikuthandizira kuthetsa kulephera kwa mtima. Zotsatira zabwino za mapiritsi zimatsimikiziridwa ndi wopangira wamkulu -. Zimayambitsa zopinga za angiotensin II zolandilira mu mtima, mitsempha yamagazi ndi impso. Chifukwa cha izi, kuchepa kwa vasoconstriction kumawonedwa.

Mosiyana ndi Lorista

M'mafakitala aku Russia, zinthu zingapo zofananira zikugulitsidwa nthawi imodzi - Lorista N ndipo ambiri sakudziwa kusiyana pakati pawo.

Kusiyanitsa kwakukulu kumapangidwa ndi mankhwalawa. Ku Lorista, losartan ndiwothandizanso kwambiri. Udindo wazinthu zowonjezera umachitika ndi: wowonda chimanga, cellactose, magnesium stearate.

Mwakusintha kwa mankhwalawa ndi prefix H, mndandandawo umathandizidwa ndi hydrochlorothiazide. Zimathandizira kuchepetsa Na + pamlingo wa gawo la cortical reabsorption. Palibenso chifukwa chosankha payekha mlingo woyambira wa akulu msinkhu.

Kusiyana kwina pakati pa mankhwalawa ndi mtengo. Mtengo wapakati wa Lorista ndi wotsika pang'ono ndipo umakhala ma ruble 100-130. Ponena za momwe mungagwiritsire ntchito, mankhwalawa onse amathandizira kuthamanga kwa magazi.

Mtundu ndikuyerekeza mtengo wa mankhwalawo

Mankhwala amapezeka mu mawonekedwe a mapiritsi omwe amakhala ndi chikasu chikasu. Nthawi zina pamakhala mapiritsi amtundu wobiriwira. Ndiwocheperako kukula komanso mawonekedwe ozungulira, zomwe zimapangitsa kuti madyererowo akhale osavuta momwe mungathere. Kumbali imodzi kuli mzere wogaŵanitsa (Lorista ND, wokhala ndi mawonekedwe azinthu zambiri, palibe).

Pambuyo popititsa mayeso ndikuwonana ndi katswiri, wodwalayo amatha kumvetsetsa zomwe zili bwino m'malo mwake - N kapena ND. Sikoyenera kuti mupereke mankhwala nokha, kuti musavulaze thupi. Mtengo wapakati ndi ma ruble 230.

The zikuchokera, limagwirira ntchito ndi katundu

Piritsi lililonse ndilophatikizidwa ndi filimu ndipo lili ndi: losartan potazium (50 mg), hydrochlorothiazide (12.5 mg), pregelatinized starch, MCC, magnesium stearate ndi lactose monohydrate. Komanso, mapiritsi amapezeka ndi kuchuluka kwa losartan (100 mg). Amadziwika kuti Lorista ND. 25 mg ya hydrochlorodisiad adawonjezeredwa pazomwe amapanga. Zothandizira zothandizira zinakhalabe chimodzimodzi.

Popanga zokutira filimu, opanga amagwiritsa ntchito talc, utoto wachikasu, E 171 (titanium dioxide), hypromellose, macrogol 4000.

Kupanga kwamachitidwe kwa magawo othandizira ndikuchepetsa kuthamanga kwa magazi ndikuchepetsa kutsitsa pamtima. Zomwe zili pamapiritsi zimathandizira kuwonjezeka kwa ntchito ya plasma renin, kuchepa kwa mankhwala a seramu potaziyamu komanso kusintha kwa secretion ya aldosterone.

Chofunikira chachikulu cha mankhwalawa chimadziwika ndi uricosuric kanthu. Zimalepheretsa zolimbitsa thupi za angiotensin II. Pamodzi ndi hydrochlorothiazide, mankhwalawa amachepetsa kwambiri hyperuricemia. Mankhwalawa sasokoneza pafupipafupi minofu ya mtima. Mphamvu ya antihypertensive imachitika ndi kukula kwa mitsempha. Pambuyo maola 2-3, zimachitika zimatenga tsiku limodzi.

Losartan bwino odziwidwa bwino kuchokera m'mimba, thirakiti ya bioavailability ndi 32-33%. Thupi limalumikiza mapuloteni a plasma. Pafupifupi 58% ya mankhwalawa amachotsedwa m'thupi ndi bile, ndipo 35% imachotsedwa impso. Pambuyo pakuyamwa, hydrochlorothiazide imakumana ndi mapuloteni a plasma (pafupifupi 65%). Pakadutsa maola 5 mpaka 10 kuchokera mthupi ndi mkodzo.

Zizindikiro ndi malire

Mankhwalawa amagwira ntchito ngati imodzi mwazinthu zovuta kupatsirana pogwiritsa ntchito matenda oopsa. Zowonetseranso zikuphatikizapo:

1. Kuchepetsa chiopsezo chopanga minyewa yamtima komanso mtima.
2. Kuthetsa zizindikiro zosasangalatsa ndi lamanzere yamitsempha yamagazi.

Hypertrophy yamanzere yamanzere

Lorista N ali ndi zotsutsana zingapo, zomwe zimayenera kulipira chidwi chisanachitike:

• kusowa kwamadzi
• kusowa kwa lactose mthupi,
• anuria
• kulephera kwa aimpso
• kuthamanga kwa magazi
• mimba
• kusalolera payekha kapena Hypersensitivity zigawo zikuluzikulu.

Komanso, mankhwalawa saikidwa kwa ana osakwana zaka 18. Ndi gout, shuga, mphumu, matenda amwazi, mankhwalawa amaloledwa, koma amayang'aniridwa ndi adokotala.

Kudzichitira nokha mankhwala kungakulitse vutolo. Musanamwe mankhwalawa, muyenera kudziwa kuti ndi mankhwala ati omwe amakakamizidwa.

Malangizo ogwiritsira ntchito

Mankhwalawa adapangira pakumwa pakamwa, ngakhale kudya zakudya. Kudya kwakovuta ndi mankhwala ochepetsa kuthamanga kwa magazi kumaloledwa. Mlingo umatengera mtundu wa matenda.

Malinga ndi malangizo ogwiritsa ntchito, ndi ochepa matenda oopsa patsiku, amaloledwa kumwa piritsi limodzi. Mlingo waukulu ndi 2 ma PC. Kufunika kwa kuchuluka kwa mlingo kumatsimikiziridwa ndi adokotala.

Pozindikira kumanzere kwamitsempha yamagazi, mankhwala oyamba tsiku lililonse amakhalanso 50 mg, ndiye piritsi limodzi. M'mawa kapena madzulo - zilibe kanthu.

Odwala ali ndi chidwi chofuna kumwa mankhwalawo kwa moyo wonse kapena ayi. Pofuna kupanikizika kuti matenda asinthe komanso kuti matendawo asinthe, ndikofunikira kuchita zonse (pafupifupi masiku 30). Pambuyo pake, adotolo adzayesereranso ndipo adzanenanso zochita zina. Mwakuwukira mobwerezabwereza, mungafunikire kuchitanso maphunzirowo.

Ndikofunikira kuganizira momwe mankhwalawa amayendera:

Zotsatira zoyipa ndi bongo

Ngati mankhwalawa atengedwa mosayenera, zotsatira zoyipa zingachitike (Gome 2).

Zotsatira zoyipa zimatha kuonekeranso ngati totupa pakhungu, lomwe limayendera limodzi ndi kuyabwa. Pankhani ya bongo, wodwalayo ali:

• kupezeka kwa bradycardia / tachycardia,
• kutsika kwakukulu kwa kuthamanga kwa magazi,
• hyponatremia,
• hypochloremia.

Ngati zizindikiro zoyambirira za bongo zikuwonekera, ndikofunikira kukaonana ndi katswiri. Thandizo loyamba pazinthu zotere ndi kuphulika kwa m'mimba. Kupitilira apo, wodwalayo afunika chithandizo chamankhwala.

Pochizira matenda a mtima, komanso kuthamanga kwa magazi, othandizira a Lorista N. amagwiritsidwanso ntchito. Nthawi zambiri, izi zimachitika chifukwa cha kusagwirizana kwa zinthu zina.

Kuphatikiza apo, ma analogu ena ndi otsika mtengo kwambiri a Lorista N. Mndandanda wamankhwala omwe ali ndi machitidwe ofananirako amaphatikizapo:

1. Co-Centor (50 mg). Mtengo wake ndi ma ruble a 130.
2. (Na. 30). Mankhwala angagulidwe kwa ma ruble 100-110.
3. Lozap 100 Plus (ma ruble 250).
4. Simartan-N.

Musanagwiritse ntchito mankhwala omwe dokotala wakupatsani, muyenera kufunsa iye, kuti musadzutse zomwe zimachitika.

Mawonekedwe ndi mawonekedwe a mankhwalawa

Mapiritsi okhala ndi mafilimu kuchokera wachikasu mpaka wachikasu wokhala ndi tint wobiriwira, chowulungika, biconvex pang'ono, wokhala ndi chiopsezo kumbali imodzi, mtundu wa piritsi pamtanda wopingasa ndi gawo lalikulu la phale loyera.

Othandizira: pregelatinized starch - 34.92 mg, cellcrystalline cellulose - 87,7 mg, lactose monohydrate - 63.13 mg, magnesium stearate - 1.75 mg.

Zomwe zimapangidwa ndi chipolopolo: hypromellose - 5 mg, macrogol 4000 - 0,5 mg, utoto wa quinoline chikasu (E104) - 0,11 mg, titanium dioxide (E171) - 1.39 mg, talc - 0.5 mg.

Ma PC 10 - matuza (3) - mapaketi a makatoni.
Ma PC 10 - matuza (6) - mapaketi a makatoni.
Ma PC 10 - matuza (9) - mapaketi a makatoni.

Zotsatira za pharmacological

Zotsatira za pharmacological - zochititsa chidwi .

Mankhwala

Lorista ® N - mankhwala ophatikiza, ali ndi vuto lodziletsa.

Losartan. Kusankha angiotensin II receptor antagonist (mtundu AT 1) wochita pakamwa, osakhala ndi mapuloteni. Mu vivo ndi mu vitro losartan ndi yogwira yogwira carboxy metabolite (EXP-3174) imalepheretsa zovuta zonse za thupi mwakuthupi za angiotensin II pa AT 1 receptors.

Losartan mosayambitsa amachititsa kuyambitsa kwa AT 2 receptors powonjezera kuchuluka kwa angiotensin II.

Losartan sikuletsa ntchito ya kininase II, enzyme yomwe imakhudzidwa ndi metabolism ya bradykinin.

Amachepetsa OPSS, kuthamanga mu mzere "wawung'ono" wamagazi, kumachepetsa pambuyo pake, kumakhudzanso okodzetsa.

Zimasokoneza kukula kwa hypertrophy ya myocardial, kumawonjezera kulolera kwa odwala omwe ali ndi vuto la mtima. Kutenga losartan kamodzi patsiku kumabweretsa kutsika kwakukulu mu SBP ndi DBP. Losartan wogawana amawongolera kupanikizika tsiku lonse, pomwe mphamvu ya antihypertensive imafanana ndi nyimbo yachilengedwe yozungulira. Kuchepa kwa kuthamanga kwa magazi kumapeto kwa mlingo wa mankhwalawa kunali pafupifupi 70-80% ya zotsatira za mankhwalawa, maola 5-6 atatha kutsata. Withdawal syndrome sichimawonedwa, ndipo losartan alibe kwambiri machitidwe pamtima kugunda kwa mtima.

Losartan imagwira ntchito mwa amuna ndi akazi, komanso achikulire (zaka zopitilira 65) ndi odwala achichepere (osakwana zaka 65).

Hydrochlorothiazide. A thiazide diuretic, mphamvu yotsitsa yomwe imalumikizidwa ndi kuphwanya kwa sodium, chlorine, potaziyamu, magnesium, mapiritsi am'madzi mu distal nephron, amachedwa mayendedwe a calcium ion, uric acid. Ili ndi katundu wa antihypertensive. Pafupifupi palibe vuto lililonse pamagazi.

Mphamvu ya diuretic imachitika pambuyo pa maola 1-2, imafika patadutsa maola 4 ndipo imatha maola 6- 12. Mphamvu ya antihypertensive imachitika pakatha masiku 3-4, koma zimatha kutenga masabata atatu kuti zitheke.

Contraindication

Hypersensitivity kwa losartan, ku zinthu zochokera ku sulfonamides ndi zina za mankhwala, anuria, kuvulala kwambiri kwaimpso (Cl creatinine wazaka 65) ndi odwala achichepere (

Pharmacokinetics

Mikhalidwe yapadera

• 1 tabu potaziyamu losartan 100 mg hydrochlorothiazide 25 mg Othandizira: pregelatinized wowuma - 69.84 mg, cellcrystalline cellulose - 175.4 mg, lactose monohydrate - 126.26 mg, magnesium stearate - 3.5 mg. Zomwe zimapanga filimu ya kanema: hypromellose - 10 mg, macrogol 4000 - 1 mg, utoto wa quinoline chikasu (E104) - 0,11 mg, titanium dioxide (E171) - 2.89 mg, talc - 1 mg. losartan potaziyamu 100 mg hydrochlorothiazide 12,5 mg Othandizira: pregelatinized starch, microcrystalline cellulose, lactose monohydrate, magnesium stearate. Mapangidwe a Shell: hypromellose, macrogol 4000, utoto wachikasu utoto (E104), titanium dioxide (E171), talc. losartan potaziyamu 100 mg hydrochlorothiazide 25 mg Othandizira: pregelatinized starch, microcrystalline cellulose, lactose monohydrate, magnesium stearate. Mapangidwe a Shell: hypromellose, macrogol 4000, utoto wachikasu utoto (E104), titanium dioxide (E171), talc. potaziyamu losartan 50 mg hydrochlorothiazide 12,5 mg Othandizira: pregelatinized starch, microcrystalline cellulose, lactose monohydrate, magnesium stearate Shell kapangidwe: hypromellose, macrogol 4000, quinoline chikasu (E104), titanium dioxide (E171), tal. losartan potaziyamu 50 mg hydrochlorothiazide 12.5 mg Othandizira: pregelatinized starch, microcrystalline cellulose, lactose monohydrate, magnesium stearate. Mapangidwe a Shell: hypromellose, macrogol 4000, utoto wachikasu utoto (E104), titanium dioxide (E171), talc.

Malangizo a Lorista N

• * Matenda oopsa a magazi (kwa odwala omwe akuwonetsedwa kuphatikiza mankhwala). * Kuchepetsa chiopsezo cha kuchepa kwa mtima ndi kufa kwa odwala omwe ali ndi matenda oopsa ndipo amasiya mpweya wamitsempha yamagazi.

Lorista N zolakwika

• Hypersensitivity los losan, mankhwala opangidwa ndi sulfonamides ndi zina za mankhwala, anuria, kuvulala kwambiri kwaimpso (creatinine chilolezo (CC) ochepera 30 ml / min., Hyperkalemia, kuchepa madzi m'thupi (kuphatikiza ndi kuchuluka kwa okodzetsa) kwambiri chiwindi kukanika, Reflexory hypokalemia, mimba, mkaka wa m`mawere, ochepa hypotension, pansi pa zaka 18 (mphamvu ndi chitetezo osakhazikitsidwa), lactase akusowa, galactosemia, kapena shuga / gal malabsorption. Amachita. Mochenjera: Magetsi amagetsi amagetsi am'magazi, hypochloremic alkalosis, hypomagnesemia, hypokalemia), matenda amitsempha yamafupa kapena stenosis a mtsempha wama impso, matenda oopsa a shuga, hypercalcemia, hyperuricemia komanso / kapena gouta. adapangidwa kale ndi mankhwala ena, kuphatikiza AP inhibitors

Mlingo wa Lorista H

• 100 mg + 25 mg 12,5,5 mg + 100 mg 12,5 mg + 50 mg 25 mg + 100 mg 25 mg + 100 mg 50 mg + 12,5 mg

Lorista N mavuto

• Pa gawo lamwazi ndi zamitsempha yamagazi: kanthawi kochepa: kuchepa magazi, Shenlane-Genokha purpura. Pa mbali ya chitetezo chamthupi: kawirikawiri: anaphylactic reaction, angioedema (kuphatikizapo kutupa kwa mkaka ndi lilime, kuyambitsa kutsekeka kwa mpweya ndi / kapena kutupa kwa nkhope, milomo, pharynx). Kuchokera kumbali ya chapakati mantha dongosolo ndi zotumphukira mantha dongosolo: Nthawi zambiri: mutu, systemic ndi sanali chizungulire, kusowa tulo, kutopa, infrequently: migraine. Kuchokera pamtima dongosolo: Nthawi zambiri: orthostatic hypotension (kumwa modalira), palpitations, tachycardia, kawirikawiri: vasculitis. Kuchokera kupuma dongosolo: Nthawi zambiri: chifuwa, kupumira kwapakati thirakiti, pharyngitis, kutupa kwa mphuno. Kuchokera m'mimba thirakiti: pafupipafupi: kutsekula m'mimba, kukomoka, kusanza, kusanza, kupweteka kwam'mimba. Kuchokera ku hepatobiliary system: kawirikawiri: hepatitis, chiwindi ntchito. Kuchokera pakhungu ndi mafuta osunthika: ochepa: urticaria, kuyabwa kwa khungu. Kuchokera ku minculoskeletal system ndi minofu yolumikizana: nthawi zambiri: myalgia, kupweteka kwa msana, infrequently: arthralgia. Zina: nthawi zambiri: asthenia, kufooka, zotumphukira edema, kupweteka pachifuwa. Zowonetsa zasayansi: pafupipafupi: hyperkalemia, kuchuluka kwa hemoglobin ndi hematocrit (osati mozama), kuchepa: kuchuluka kwa serum urea ndi creatinine, kawirikawiri: ntchito yowonjezera ya chiwindi ndi micirubin.

Kuyanjana kwa mankhwala osokoneza bongo

Bongo

Malo osungira

• sitolo firiji 15-25 madigiri
• osayandikira ana

Chaka chilichonse, anthu ochulukirapo amadwala chifukwa cha matenda amtima. Malinga ndi ziwerengero, posachedwapa, ngakhale ana ang'ono adakumana ndi vutoli. Masiku ano, pali mankhwala ambiri omwe amathandiza kulimbana ndi matenda oopsa. Mmodzi wothandiza kwambiri ndi a Lorista N.

Lorista N ndi mankhwala ophatikiza omwe ali ndi hypotensive. Zinthu zomwe zimapangidwa momwe zimapangidwira magazi zimathandizanso kuthamanga kwa magazi ndikuthandizira kuthetsa kulephera kwa mtima. Zotsatira zabwino za mapiritsi zimatsimikiziridwa ndi wopangira wamkulu -. Zimayambitsa zopinga za angiotensin II zolandilira mu mtima, mitsempha yamagazi ndi impso. Chifukwa cha izi, kuchepa kwa vasoconstriction kumawonedwa.

Mosiyana ndi Lorista

M'mafakitala aku Russia, zinthu zingapo zofananira zikugulitsidwa nthawi imodzi - Lorista N ndipo ambiri sakudziwa kusiyana pakati pawo.

Kusiyanitsa kwakukulu kumapangidwa ndi mankhwalawa. Ku Lorista, losartan ndiwothandizanso kwambiri. Udindo wazinthu zowonjezera umachitika ndi: wowonda chimanga, cellactose, magnesium stearate.

Mwakusintha kwa mankhwalawa ndi prefix H, mndandandawo umathandizidwa ndi hydrochlorothiazide. Zimathandizira kuchepetsa Na + pamlingo wa gawo la cortical reabsorption. Palibenso chifukwa chosankha payekha mlingo woyambira wa akulu msinkhu.

Kusiyana kwina pakati pa mankhwalawa ndi mtengo. Mtengo wapakati wa Lorista ndi wotsika pang'ono ndipo umakhala ma ruble 100-130. Ponena za momwe mungagwiritsire ntchito, mankhwalawa onse amathandizira kuthamanga kwa magazi.

Mtundu ndikuyerekeza mtengo wa mankhwalawo

Mankhwala amapezeka mu mawonekedwe a mapiritsi omwe amakhala ndi chikasu chikasu. Nthawi zina pamakhala mapiritsi amtundu wobiriwira. Ndiwocheperako kukula komanso mawonekedwe ozungulira, zomwe zimapangitsa kuti madyererowo akhale osavuta momwe mungathere. Kumbali imodzi kuli mzere wogaŵanitsa (Lorista ND, wokhala ndi mawonekedwe azinthu zambiri, palibe).

Pambuyo popititsa mayeso ndikuwonana ndi katswiri, wodwalayo amatha kumvetsetsa zomwe zili bwino m'malo mwake - N kapena ND. Sikoyenera kuti mupereke mankhwala nokha, kuti musavulaze thupi. Mtengo wapakati ndi ma ruble 230.

The zikuchokera, limagwirira ntchito ndi katundu

Piritsi lililonse ndilophatikizidwa ndi filimu ndipo lili ndi: losartan potazium (50 mg), hydrochlorothiazide (12.5 mg), pregelatinized starch, MCC, magnesium stearate ndi lactose monohydrate. Komanso, mapiritsi amapezeka ndi kuchuluka kwa losartan (100 mg). Amadziwika kuti Lorista ND. 25 mg ya hydrochlorodisiad adawonjezeredwa pazomwe amapanga. Zothandizira zothandizira zinakhalabe chimodzimodzi.

Popanga zokutira filimu, opanga amagwiritsa ntchito talc, utoto wachikasu, E 171 (titanium dioxide), hypromellose, macrogol 4000.

Kupanga kwamachitidwe kwa magawo othandizira ndikuchepetsa kuthamanga kwa magazi ndikuchepetsa kutsitsa pamtima. Zomwe zili pamapiritsi zimathandizira kuwonjezeka kwa ntchito ya plasma renin, kuchepa kwa mankhwala a seramu potaziyamu komanso kusintha kwa secretion ya aldosterone.

Chofunikira chachikulu cha mankhwalawa chimadziwika ndi uricosuric kanthu. Zimalepheretsa zolimbitsa thupi za angiotensin II. Pamodzi ndi hydrochlorothiazide, mankhwalawa amachepetsa kwambiri hyperuricemia. Mankhwalawa sasokoneza pafupipafupi minofu ya mtima. Mphamvu ya antihypertensive imachitika ndi kukula kwa mitsempha. Pambuyo maola 2-3, zimachitika zimatenga tsiku limodzi.

Losartan bwino odziwidwa bwino kuchokera m'mimba, thirakiti ya bioavailability ndi 32-33%. Thupi limalumikiza mapuloteni a plasma. Pafupifupi 58% ya mankhwalawa amachotsedwa m'thupi ndi bile, ndipo 35% imachotsedwa impso. Pambuyo pakuyamwa, hydrochlorothiazide imakumana ndi mapuloteni a plasma (pafupifupi 65%). Pakadutsa maola 5 mpaka 10 kuchokera mthupi ndi mkodzo.

Zizindikiro ndi malire

Mankhwalawa amagwira ntchito ngati imodzi mwazinthu zovuta kupatsirana pogwiritsa ntchito matenda oopsa. Zowonetseranso zikuphatikizapo:

1. Kuchepetsa chiopsezo chopanga minyewa yamtima komanso mtima.
2. Kuthetsa zizindikiro zosasangalatsa ndi lamanzere yamitsempha yamagazi.

Hypertrophy yamanzere yamanzere

Lorista N ali ndi zotsutsana zingapo, zomwe zimayenera kulipira chidwi chisanachitike:

• kusowa kwamadzi
• kusowa kwa lactose mthupi,
• anuria
• kulephera kwa aimpso
• kuthamanga kwa magazi
• mimba
• kusalolera payekha kapena Hypersensitivity zigawo zikuluzikulu.

Komanso, mankhwalawa saikidwa kwa ana osakwana zaka 18. Ndi gout, shuga, mphumu, matenda amwazi, mankhwalawa amaloledwa, koma amayang'aniridwa ndi adokotala.

Kudzichitira nokha mankhwala kungakulitse vutolo. Musanamwe mankhwalawa, muyenera kudziwa kuti ndi mankhwala ati omwe amakakamizidwa.

Malangizo ogwiritsira ntchito

Mankhwalawa adapangira pakumwa pakamwa, ngakhale kudya zakudya. Kudya kwakovuta ndi mankhwala ochepetsa kuthamanga kwa magazi kumaloledwa. Mlingo umatengera mtundu wa matenda.

Malinga ndi malangizo ogwiritsa ntchito, ndi ochepa matenda oopsa patsiku, amaloledwa kumwa piritsi limodzi. Mlingo waukulu ndi 2 ma PC. Kufunika kwa kuchuluka kwa mlingo kumatsimikiziridwa ndi adokotala.

Pozindikira kumanzere kwamitsempha yamagazi, mankhwala oyamba tsiku lililonse amakhalanso 50 mg, ndiye piritsi limodzi. M'mawa kapena madzulo - zilibe kanthu.

Odwala ali ndi chidwi chofuna kumwa mankhwalawo kwa moyo wonse kapena ayi. Pofuna kupanikizika kuti matenda asinthe komanso kuti matendawo asinthe, ndikofunikira kuchita zonse (pafupifupi masiku 30). Pambuyo pake, adotolo adzayesereranso ndipo adzanenanso zochita zina. Mwakuwukira mobwerezabwereza, mungafunikire kuchitanso maphunzirowo.

Ndikofunikira kuganizira momwe mankhwalawa amayendera:

Zotsatira zoyipa ndi bongo

Ngati mankhwalawa atengedwa mosayenera, zotsatira zoyipa zingachitike (Gome 2).

Zotsatira zoyipa zimatha kuonekeranso ngati totupa pakhungu, lomwe limayendera limodzi ndi kuyabwa. Pankhani ya bongo, wodwalayo ali:

• kupezeka kwa bradycardia / tachycardia,
• kutsika kwakukulu kwa kuthamanga kwa magazi,
• hyponatremia,
• hypochloremia.

Ngati zizindikiro zoyambirira za bongo zikuwonekera, ndikofunikira kukaonana ndi katswiri. Thandizo loyamba pazinthu zotere ndi kuphulika kwa m'mimba. Kupitilira apo, wodwalayo afunika chithandizo chamankhwala.

Pochizira matenda a mtima, komanso kuthamanga kwa magazi, othandizira a Lorista N. amagwiritsidwanso ntchito. Nthawi zambiri, izi zimachitika chifukwa cha kusagwirizana kwa zinthu zina.

Kuphatikiza apo, ma analogu ena ndi otsika mtengo kwambiri a Lorista N. Mndandanda wamankhwala omwe ali ndi machitidwe ofananirako amaphatikizapo:

1. Co-Centor (50 mg). Mtengo wake ndi ma ruble a 130.
2. (Na. 30). Mankhwala angagulidwe kwa ma ruble 100-110.
3. Lozap 100 Plus (ma ruble 250).
4. Simartan-N.

Musanagwiritse ntchito mankhwala omwe dokotala wakupatsani, muyenera kufunsa iye, kuti musadzutse zomwe zimachitika.

Mawonekedwe ndi mawonekedwe a mankhwalawa

Mapiritsi okhala ndi mafilimu kuchokera wachikasu mpaka wachikasu wokhala ndi tint wobiriwira, chowulungika, biconvex pang'ono, wokhala ndi chiopsezo kumbali imodzi, mtundu wa piritsi pamtanda wopingasa ndi gawo lalikulu la phale loyera.

Othandizira: pregelatinized starch - 34.92 mg, cellcrystalline cellulose - 87,7 mg, lactose monohydrate - 63.13 mg, magnesium stearate - 1.75 mg.

Zomwe zimapangidwa ndi chipolopolo: hypromellose - 5 mg, macrogol 4000 - 0,5 mg, utoto wa quinoline chikasu (E104) - 0,11 mg, titanium dioxide (E171) - 1.39 mg, talc - 0.5 mg.

Ma PC 10 - matuza (3) - mapaketi a makatoni.
Ma PC 10 - matuza (6) - mapaketi a makatoni.
Ma PC 10 - matuza (9) - mapaketi a makatoni.

Zotsatira za pharmacological

Wophatikiza antihypertensive wothandizira. Losartan ndi hydrochlorothiazide ali ndi mphamvu yowonjezera ya antihypertensive, kutsitsa kuthamanga kwa magazi kwakukulu kwambiri kuposa gawo lililonse palokha.

Losartan ndiwotsutsa wosankha wa angiotensin II receptors (mtundu wa AT 1) wowongolera pakamwa. Mu vivo ndi vitro, losartan ndi metabolite yogwira metabolite E-3174 imalepheretsa zovuta zonse zam'magazi a angiotensin II pa AT 1 receptors, mosasamala kanthu ndi kapangidwe kake: Zimapangitsa kuwonjezeka kwa ntchito za magazi komanso kuchepa kwa kuchuluka kwa aldosterone m'madzi a m'magazi. Losartan mosayambitsa amachititsa kuyambitsa kwa AT 2 receptors powonjezera kuchuluka kwa angiotensin II.Sichiletsa ntchito ya kininase II, puloteni yomwe imakhudzidwa ndi metabolism ya bradykinin. Amachepetsa OPSS, kuthamanga mu kufalikira kwa m'mapapo, kumachepetsa kutsitsa pa myocardium, kumakhala ndi diuretic. Zimasokoneza chitukuko cha myocardial hypertrophy, zimawonjezera kulolerana kwa odwala omwe ali ndi vuto la mtima (CHF). Kutenga losartan 1 nthawi / tsiku kumabweretsa kutsika kwakukulu mu systolic ndi diastolic magazi.

Losartan mofananamo amawongolera kuthamanga kwa magazi masana, pomwe mphamvu ya antihypertgency imafanana ndi nyimbo yachilengedwe yozungulira. Kuchepa kwa kuthamanga kwa magazi kumapeto kwa mlingo wa mankhwalawa kunali pafupifupi 70-80% ya mphamvu yayikulu ya losartan, maola 5-6 atayamba kumwa. Palibe kuchotsera matenda.

Losartan alibe kwambiri matendawa pamlingo wamtima, amakhala ndi mphamvu komanso yochepa pang'onopang'ono.

Hydrochlorothiazide- ndi thiazide diuretic, mphamvu yotsitsa yomwe imalumikizidwa ndi kuphwanya kwa sabsorption wa sodium, chlorine, potaziyamu, magnesium, ma ayoni am'madzi mu distal nephron, amachedwa mayendedwe a calcium ion, uric acid. Ili ndi antihypertensive zotsatira, zomwe zimachitika chifukwa cha kukulira kwa ma arterioles. Pafupifupi palibe vuto lililonse pamagazi. Mphamvu ya diuretic imachitika pambuyo pa maola 1-2, imafika patadutsa maola 4 ndipo imatha maola 6- 12. Mphamvu yotsutsa antihypertensive imachitika pambuyo pa masiku 3-4, koma zimatha kutenga masabata 3-4 kuti zitheke kwambiri pochiritsa.

Chifukwa cha diuretic, hydrochlorothiazide imawonjezera ntchito ya plasma, imathandizira kubisalira kwa aldosterone, imawonjezera kuchuluka kwa angiotensin II ndikuchepetsa kuchuluka kwa potaziyamu m'madzi a m'magazi. Kulandila losartan kumatseketsa zovuta zonse za thupi za angiotensin II ndipo, chifukwa cha kuponderezedwa ndi zotsatira za aldosterone, kungathandize kuchepetsa kutayika kwa potaziyamu komwe kumakhudzana ndi kutenga diuretic. Hydrochlorothiazide imapangitsa kuwonjezeka pang'ono kwa kuchuluka kwa uric acid m'magazi, kuphatikiza kwa losartan ndi hydrochlorothiazide kumathandizira kuchepetsa kuopsa kwa hyperuricemia yoyambitsidwa ndi diuretic.

Pharmacokinetics

Ma pharmacokinetics a losartan ndi hydrochlorothiazide omwe amagwiritsidwa ntchito panthawi imodzi samasiyana ndi omwe amagwiritsidwa ntchito ndi monotherapy.

Pambuyo pakukonzekera pakamwa, losartan imatengedwa bwino kwambiri kuchokera m'mimba. Imakhala ndi kagayidwe kofunikira mu "gawo loyambirira" kudzera m'chiwindi, ndikupanga metabolacologic yogwira carboxylated metabolite (E-3174) ndi metabolites yogwira. Bioavailability pafupifupi 33%. Wapakati wa C max wa losartan ndi metabolite yake yogwira imafikiridwa pambuyo pa ola limodzi ndi pambuyo pa maola 3-4, motsatana. Losartan ndi metabolite yogwira imagwira mapuloteni a plasma (makamaka c) ndi oposa 99%. V d wa losartan ndi malita 34. Imalowa mkatikati mwa BBB.

Losartan imapangidwa kuti ipange metabolite yogwira (E-3174) metabolite (14%) komanso yopanda ntchito, kuphatikiza ma metabolites awiri opangidwa ndi hydroxylation a gulu la butyl la unyolo ndi metabolite yofunikira kwambiri, N-2-tetrazolglucuronide. Chilolezo cha plasma cha losartan ndi metabolite yake yogwira pafupifupi 10 ml / sec (600 ml / min) ndi 0.83 ml / sec (50 ml / min), motsatana. Kutsimikizika kwa impso kwa losartan ndi metabolite yake yogwira ndi pafupifupi 1.23 ml / sec (74 ml / min) ndi 0.43 ml / sec (26 ml / min). T 1/2 ya losartan ndipo metabolite yogwira ndi maola 2 ndi maola 6-9, motero. Amapakidwa makamaka ndi bile kudzera m'matumbo - 58%, impso - 35%. Sichikupanga.

Mukamwa pakamwa mpaka 200 mg, losartan ndi yogwira metabolite amakhala ndi lolo pharmacokinetics.

Pambuyo pakamwa, kuphatikiza kwa hydrochlorothiazide ndi 60-80%. C max m'magazi a m'magazi amatheka pambuyo pofika maola 1-5. Kumangiriza kwa mapuloteni am'madzi am'magazi - 64%. Imalowa mkati mwa chotchinga chachikulu. Wotsekedwa mkaka wa m'mawere. Hydrochlorothiazide simapukusidwa ndipo impso mofulumira kwambiri. T 1/2 ndi maora 5 mpaka 5. Osachepera 61% ya mankhwalawa omwe atengedwa pakamwa samachotsedwa mkati mwa maola 24.

Matenda oopsa a magazi (kwa odwala omwe akuwonetsedwa kuphatikiza chithandizo), achepetsa kuchepa kwa mtima ndi kufa kwa odwala omwe ali ndi matenda oopsa komanso osagwirizana ndi hypertrophy yamitsempha.

Contraindication

Anuria, kulephera kwambiri kwaimpso (CC