Malangizo ogwiritsira ntchito Akkupro ndi zisonyezo zochizira ndi mankhwalawa

Quinapril hydrochloride (INN - Quinaprilum) ndi estyl ester ya ACE inhibitor quinaprilat yomwe ilibe gulu la sulfide. Mukamamwa mankhwalawo mkati, quinapril amamasulidwa mwachangu kukhala quinaprilat (quinapril diacid, metabolite yayikulu), yomwe imagwira ntchito ya ACE inhibitor. Kupanga kwa quinapril ndizoletsa kuzungulira mu magazi ndi minofu ACE, yomwe imachepetsa ntchito ya vasopressor ndi secretion ya aldosterone. Kutsika kwa gawo la angiotensin II potengera mayankho kumapangitsa kuti secretion ya renin ndiwonjezeke mu plasma yamagazi. Ngakhale amakhulupirira kuti njira yayikulu yotsatsira antihypertensive imawonetsedwa kudzera mu renin-angiotensin-aldosterone system, quinapril imawonetsa antihypertensive zotsatira ngakhale kwa odwala omwe ali ndi matenda oopsa a corinine (oopsa oopsa).
Kukhazikitsa quinapril kwa odwala, kuyambira pang'ono mpaka kwambiri matenda oopsa (ochepa matenda oopsa) pa mlingo wa 1040 mg, kumabweretsa kutsika kwa kuthamanga kwa magazi pakukhala komanso kuimirira, osakhala ndi chidwi chambiri pamtima. Mphamvu ya antihypertensive imayamba mkati mwa ola limodzi, mphamvu yayikulu - maola 2-4 mutatha kumwa mankhwalawa. Odwala ena, okhazikika hypotensive zotsatira zimawonedwa pambuyo 2 milungu chithandizo. Ikagwiritsidwa ntchito pazovomerezeka, antihypertensive mphamvu ya mankhwala imasungidwa mwa odwala ambiri kwa maola 24 ndipo amalimbikira kugwiritsa ntchito mankhwalawa. Kuchepa kwa kuthamanga kwa magazi komwe kumachitika chifukwa cha quinapril kumayendera limodzi ndi kuchepa kwa mtima ndi kukana kwamitsempha ya impso posintha pang'ono kapena kusasinthika kwa kugunda kwa mtima, index yamtima, kuchepa kwa magazi aimpso, kugunda kwa kusefedwa kwa gawo ndi gawo losefera.
Pambuyo pakukonzekera pakamwa, kuchuluka kwambiri kwa quinapril mu plasma ya magazi kumafika mkati mwa ola 1. Pafupifupi 60% ya mankhwalawa imatengedwa, ndipo systemic bioavailability mu quinaprilat ndi 38%. Kuchuluka kwa quinaprilat mu plasma kumafikira pafupifupi maola awiri atatha kudya kwa quinapril. The plasma theka-moyo ili pafupifupi ola 1. Quinaprilat imachotsedwanso makamaka ndi impso ndipo imakhala ndi theka la moyo wogwira bwino (pafupifupi maola atatu). Pafupifupi 97% ya quinapril kapena quinaprilat yomwe imayenda mu plasma imagwirizanitsidwa ndi mapuloteni. Odwala omwe amalephera impso, theka la moyo wa quinaprilat limawonjezeka ndi kuchepa kwa chilolezo cha creatinine. Kafukufuku wa Pharmacokinetic mwa odwala omwe amalephera kupweteka aimpso akudutsa hemodialysis wokhazikika kapena ma ambulatitis a dialysis omwe amapitilira akuwonetsa kuti dialysis siyingakhudze kwambiri kuvomerezeka kwa quinapril ndi quinaprilat. Pali kuphatikiza kwa mzere pakati pa kutsimikizika kwa quinalaprilate kuchokera ku madzi a m'magazi ndi chilolezo cha creatinine. Kuchotsa kwa Quinaprilat kumachepezedwanso mwa odwala okalamba (opitilira 65). The kuchuluka kwa quinaprilat yafupika odwala ndi chiwindi chiwindi matenda enaake chifukwa cha kuphwanya quinapril deesteration. Quinapril ndi ma metabolites ake samalowa BBB.

Kugwiritsa ntchito mankhwala Akkupro

Arterial matenda oopsa (AH)
Monotherapy: Mlingo woyenera wa Accupro kwa odwala omwe satenga diuretics ndi 10-20 mg kamodzi patsiku. Kutengera ndi matenda, mankhwalawa akhoza kuchuluka mpaka 2040 mg / tsiku mu Mlingo wa 1-2. Ngati ndi kotheka, kusintha kwa mlingo mutha kuchitika pakadutsa masabata a 2-4.Kugwiritsa ntchito bwino kwa kuthamanga kwa magazi mwa odwala ambiri kumachitika mukamamwa mankhwalawa kamodzi patsiku. Mlingo wapamwamba wa quinapril ndi 80 mg / tsiku.

Munthawi yomweyo makonzedwe a okodzetsa: Odwala omwe ayenera kupitiriza chithandizo ndi okodzetsa, koyamba mlingo wa Accupro ndi 5 mg, pambuyo pake amatha kuwonjezereka pang'onopang'ono kuti akwaniritse bwino kwambiri.

Kulephera Kwamtima Kwakukulu
Mlingo woyambira wovomerezeka ndi 5 mg mu Mlingo wa 1-2. Ngati koyamba mlingo wa quinapril umaperekedwa bwino, umatha kuwonjezeredwa pang'onopang'ono kuti ukhale wogwira ntchito, nthawi zambiri 1040 mg / tsiku mu 2 waukulu magawo.
Kuthetsa quinapril zimatengera magwiridwe antchito a impso. Mlingo woyambirira wa Accupro mwa odwala omwe ali ndi chilolezo cha creatinine pamwamba pa 30 ml / mphindi ndi 5 mg, ndipo odwala omwe ali ndi chilolezo cha creatinine osakwana 30 ml / mphindi - 2 mg. Ngati mlingo woyambayo umalekereredwa bwino, mankhwalawa akhoza kumwedwa katatu patsiku lotsatira. Chifukwa chosowa kwambiri hypotension kapena kuwonongeka kwakukulu mu impso, mlingo ungakulimbikitsidwe pakadutsa sabata limodzi, poganizira zaumoyo ndi hemodynamic.

Contraindication kugwiritsa ntchito mankhwala Akkupro

Hypersensitivity kuti quinapril kapena zigawo zina za mankhwala, kukhalapo kwa mbiri ya angioedema yokhudzana ndi ACE inhibitor yothandizira, mimba ndi mkaka wa m`mawere, komanso ubwana.
Kukhudzika mtima kwa ma inhibitors ena a ACE sikunawunikidwe.

Zotsatira zoyipa za mankhwala a Akkupro

Nthawi zambiri amatchulidwa pang'ono komanso amakhala kanthawi kochepa. Zotsatira zoyipa zomwe zimawonedwa pamayeso olamulidwa zinali: kupweteka mutu (7.2%), chizungulire (5.5%), chifuwa (3.9%), kutopa kwambiri (3.5%), rhinitis (3.2%) ), nseru ndi / kapena kusanza (2.8%), myalgia (2.2%). Dziwani kuti kutsokomola nthawi zambiri kumakhala kosabereka ndipo kumatha pambuyo pakuchiritsidwa kwa mankhwala.
Zovuta zamatenda zomwe zimachitika mwina, mwina zimagwirizanitsidwa kapena zimakhudzana ndi mankhwala a quinapril (omwe ali ndi kapena osachiritsika okodzetsa) m'maphunziro olamulidwa komanso osalamulirika komanso omwe amapezeka kawirikawiri m'maphunziro azachipatala kapena pambuyo polembetsa kuunikira * akuphatikizira.

Hematopoietic ndi zamitsempha yamagazi dongosolo: hemolytic anemia *, thrombocytopenia *.
Kuchokera ku chitetezo chamthupi: anaphylactoid reaction *.
Kuchokera kumbali yamanjenje yapakati:, vertigo, mantha, kukhumudwa, kugona.
Kuchokera kumbali ya gawo la masomphenyawo: amblyopia.
Kuchokera pamtima: angina pectoris, palpitations, tachycardia, postural hypotension *, syncope *, vasodilation.
Kuchokera m'mimba: pakamwa pouma kapena pakhosi, phokoso, kapamba *.
Pa khungu: alopecia *, exermative dermatitis *, kuyabwa, thukuta kwambiri, pemphigus *, photosensitivity reaction *, zotupa pakhungu.
Kuchokera ku minculoskeletal system:arthralgia
Kuchokera ku genitourinary system: matenda a kwamkodzo thirakiti, kusabala.
Zovuta zamtundu uliwonse ndi mabala omwe amapezeka pamalo a jakisoni: edema (yotumphukira komanso yotchuka),
Zochitika zoyipa kamodzi: angioedema * adawonedwa mu 0% ya odwala omwe amagwiritsa ntchito quinapril. Nthawi zina, monga zina za zoletsa za ACE, eosinophilic pneumonitis * ndi hepatitis zimawonedwa ndi quinapril.
Zotsatira zakuyesa kwachipatalachi: kawirikawiri - agranulocytosis ndi neutropenia (ubale wawo wapakati ndi quinapril ndi wosadalirika), hyperkalemia.
Creatinine ndi magazi urea nayitrogeni. Kuwonjezeka (kopitilira 1.25 nthawi kuposa malire apamwamba) a seramu creatinine ndi urea nayitrogeni kumaonedwa mu 2 ndi 2% ya milandu, motsatana, ndi quinapril mankhwala.Kuwonjezereka kumawonekera kwambiri kwa odwala omwe amalandira mankhwalawo limodzi ndi okodzetsa kuposa omwe amalandira quinapril monotherapy.
Angioneurotic edema. Kukula kwa angioedema kunanenedwa kwa odwala omwe adalandira zoletsa za ACE (kuphatikizapo 0% ya odwala omwe amalandira quinapril). Wodwala akayamba kudwala khosi, nkhope, lilime, quinapril iyenera kuyimitsidwa nthawi yomweyo, wodwalayo azitha kulandira chithandizo chokwanira ndikuyang'anitsitsa mpaka edema itazimiririka. Ngati edema imawoneka pankhope pokha ndi milomo, chithandizo chofunikira sichikakamira nthawi zambiri, ndikofunika kugwiritsa ntchito antihistamines kuti muchepetse matendawa. Angioedema ya lilime, larynx ndi glottis amatha kukhala pachiwopsezo cha moyo. Ndi chitukuko chake, chithandizo choyenera chodzidzimutsa chiyenera kuyikidwa nthawi yomweyo, chomwe chimaphatikizapo sc3 ya 0.3-0.5 ml ya epinephrine (epinephrine) yankho (1: 1000). Odwala omwe ali ndi mbiri ya angioedema omwe samagwirizanitsidwa ndi ACE inhibitor mankhwala amakhalanso ndi chiopsezo cha angioedema pa mankhwala ndi ACE inhibitor.
Odwala a mpikisano wa Negroid, momwe ACE inhibitors amagwiritsidwira ntchito, milandu ya chitukuko cha angioedema inali yofala kuposa odwala mafuko ena. Odwala a mpikisano wa Negroid adanenanso zazing'ono zomwe zimapangitsa ACE zoletsa kuthamanga kwa magazi poyerekeza ndi mitundu ina.
Mimba angioedema. Odwala omwe amagwiritsa ntchito ACE inhibitors, mawonetseredwe a matumbo angioedema adawonedwa. Odwala otere adadandaula za kupweteka kwam'mimba (ndi / popanda kusanza kapena kusanza), mwanjira zina sizinasonyeze chilichonse m'mbiri yakukula kwa angioedema a nkhope komanso kuchuluka kwa esterase ya C-1 yotsimikizika. Kuzindikiritsa kwa angioedema kunakhazikitsidwa pogwiritsa ntchito computer tomography yam'mimba kapena ultrasound kapena pa opaleshoni. Izi zikuwonekeratu atasiya kugwiritsa ntchito mankhwalawa. Intestinal angioedema iyenera kuphatikizidwa pakuwunika koyenera kwa odwala omwe ali ndi ululu wam'mimba omwe amalandira chithandizo cha ACE inhibitor. Odwala omwe ali ndi mbiri ya angioedema omwe samagwirizanitsidwa ndi ACE inhibitor mankhwala amatha kukhala ndi chiopsezo cha angioedema pa mankhwala ndi ACE inhibitor.
Anaphylactoid zimachitika.
Kukakamiza. Odwala omwe amalandila ACE zoletsa panthawi yoletsa kuchiza poizoni wa Hymenoptera, kuwopsa kwa anaphylactoid kumaonedwa. Mwa odwala ena, izi sizinachitike pakusokonezeka kwakanthawi kwa kayendetsedwe ka ACE inhibitors, koma zinayambikanso pokhapokha mutayambiranso.
Apheresis otsika kachulukidwe lipoproteins. Odwala omwe adakumanapo ndi LDL apheresis ndi dextran sulfate mayamwidwe, anaphylactoid zimachitika ndi concomitant mankhwala ndi ACE zoletsa.
HemodialysisZambiri zamankhwala zakhala zikuwonetsa kuti odwala omwe akupezeka ndi hemodialysis omwe amagwiritsa ntchito mitundu inayake yamkati yomwe imakhala ndi kuthamanga kwa ma cell (ma polyacrylonitrile membranes) amatha kukulitsa mawonekedwe anaphylactoid pogwiritsa ntchito ACE inhibitor. Kuphatikiza koteroko kuyenera kupewedwa pogwiritsa ntchito mitundu ina ya antihypertensive kapena njira ina yopangira hemodialysis.
Matenda ogwirizana. Odwala omwe ali ndi zovuta matenda oopsa (ochepa matenda oopsa) omwe amathandizidwa ndi Acupro, matenda oopsa samapangika kawirikawiri, koma zinali zotsatira za chithandizo cha ACE inhibitors mwa odwala omwe ali ndi vuto lamagetsi am'magetsi chifukwa cha diuretics, kadyedwe kakang'ono ka mchere, komanso kupukusira kwa magazi.
Odwala omwe mtima wawo uli ndi vuto losakhazikika, omwe chiopsezo chokhala ndi vuto lalikulu kwambiri, mankhwala a quinapril amayenera kuyambitsidwa pamankhwala omwe amawayang'aniridwa ndi achipatala, odwala awa amayenera kuwunikidwa kwa milungu iwiri yoyambirira komanso nthawi iliyonse mlingo wa quinapril ukuwonjezeka.
Ndi kukula kwa hypotension yodziwitsa, wodwalayo ayenera kuyikidwa kumbuyo kwake ndipo ngati kuli kotheka, azichita kulowetsedwa kwa iv. Isotonic sodium chloride solution. Kuchita kwakanthawi kokhazikika sikuti kuphwanya lamulo kuti mugwiritse ntchito mankhwalawa, komabe, ndi chitukuko chotere, kugwiritsa ntchito mankhwalawa a mankhwalawa kapena kufinya kwa okodzetsa kuyenera kuganiziridwanso.
Odwala omwe adalandira diuretic chithandizo kumayambiriro kwa mankhwala a quinapril amatha kukhala ndi hypotension. Ndikofunika kuletsa okodzetsa masiku 2-3 musanayambe chithandizo ndi quinapril. Ngati kuthamanga kwa magazi sikulamulidwa ndi quinapril monotherapy, okodzetsa ayenera kuyambiranso. Ngati ndizosatheka kukana kugwiritsa ntchito okodzetsa, kugwiritsa ntchito Acupro kuyenera kuyamba ndi mlingo wotsika woyambira.
Neutropenia ndi agranulocytosis. Kulandila kwa zoletsa za ACE nthawi zina kumatha kukhala limodzi ndi agranulocytosis ndi kupsinjika kwa m'mafupa kwa odwala omwe ali ndi vuto losautsa (matenda oopsa), koma nthawi zambiri kumachitika, monga lamulo, mwa odwala omwe amalephera aimpso komanso collagenoses. Mukamagwiritsa ntchito zoletsa za ACE mwa odwala omwe ali ndi collagenoses ndi / kapena kulephera kwa aimpso, kuwunika pafupipafupi kuchuluka kwa leukocytes ndikofunikira.
Kutsokomola. Odwala omwe amagwiritsa ntchito zoletsa za ACE, kuphatikizapo quinapril, nthawi zina amakhala ndi chifuwa. Nthawi zambiri kutsokomola sikunaberekenso, kulimbikira, ndipo kunazimiririka atasiya kugwiritsa ntchito mankhwala. Kutsokomola komwe kumayambitsidwa ndi ACE zoletsa kuyenera kuganiziridwanso pakuwonetsetsa kuti pali chifuwa.

Mlingo woyambira woyambirira (mg)

* Palibe chidziwitso mpaka pano chololeza malingaliro enieni a dosing kwa odwalawa.

Mu anthu okhala ndi hypersensitivity chifukwa chopinga ntchito ya renin - angiotensin - aldosterone dongosolo, kuwonongeka kwaimpso ndikotheka. Odwala omwe ali ndi vuto lalikulu la mtima, momwe aimpso ntchito zimatengera ntchito ya renin - angiotensin - aldosterone dongosolo, chithandizo ndi zoletsa za ACE, kuphatikizapo quinapril, zingayambitse kukula kwa oliguria ndi / kapena azotemia wopitilira apo, komanso kawirikawiri, kulephera kwakhungu kwaimpso, kuphatikizapo imfa.
Nthawi yowonjezera ya quinaprilat imakulitsidwa chifukwa cha kuchepa kwa chilolezo cha creatinine. Odwala okhala ndi creatinine chilolezo cha ≤60 ml / min, quinapril iyenera kutumikiridwa muyezo wotsika (onani APPLICATION). Mlingo wa mankhwala mwa odwala oterowo uyenera kukhala wolembetsedwa kuchokera m'munsi kupita pamwambamwamba, poganizira njira zochizira, komanso kuwunikira ntchito yaimpso (ngakhale kuti maphunziro oyamba sanawululire kuwonongeka kwake pogwiritsa ntchito quinapril).
Odwala ena odwala matenda oopsa (ochepa matenda oopsa) kapena kulephera kwa mtima popanda chizindikiro chodziwika bwino cha kuwonongeka kwamankhwala am'mimba panthawi ya mankhwala a quinapril, makamaka kuphatikiza ndi diuretic, panali kuwonjezeka kwa urea nitrogen ndi serum creatinine. Kuchulukitsa kumeneku kumakhala kosinthika pang'ono ndikubwera kwa ACE inhibitor ndi / kapena diuretic. Chiwopsezo cha kusinthika koteroko chimakhala chachikulu kwa odwala omwe ali ndi vuto laimpso. Zikatero, kuchepetsa mankhwalawa ndi kuchotsetsa okodzetsa ndi / kapena quinapril kungakhale kofunikira.
M'maphunziro a odwala omwe ali ndi matenda oopsa (ochepa oopsa) komanso a unilateral kapena a revenue artery stenosis, atalandira chithandizo ndi ACE inhibitor, kuwonjezeka kwa magazi a urea nitrogen ndi serum creatinine. Kukula uku kunali pafupifupi kusinthika nthawi zonse mukamachiritsidwa ndi ACE inhibitor komanso / kapena diuretic.Zikatero, ndikofunikira kuyang'anira ntchito ya impso ya odwala mkati mwa milungu ingapo yoyambirira.
Kuwonongeka kwa chiwindi. Quinapril osakanikirana ndi diuretic amayenera kugwiritsidwa ntchito mosamala kwa odwala omwe ali ndi vuto la chiwindi kapena matenda opita patsogolo, chifukwa kusintha pang'ono pamagetsi am'magetsi kumatha kuyambitsa kuperewera kwa chiwindi. Quinapril kagayidwe ka quinaprilat kawirikawiri imachitika mothandizidwa ndi hepatic esterase. The kuchuluka kwa quinaprilat yafupika odwala zakumwa chiwindi chiwindi chifukwa mkhutu kusokonekera kwa quinapril.
Hyperkalemia ndi potaziyamu wotetemera okodzetsa. Zonsezi pogwiritsa ntchito mitundu ina ya ACE inhibitors komanso kugwiritsa ntchito quinapril, kuchuluka kwa ions ya potaziyamu mu seramu kumatha kuwonjezeka. Ndi munthawi yomweyo kugwiritsa ntchito quinapril kumachepetsa hypokalemia chifukwa cha thiazide diuretics. Kafukufuku wogwiritsidwa ntchito kophatikizira kwa quinapril ndi potaziyamu-yosungunulira mafuta sanachitike. Popeza pali chiwopsezo chowonjezeka cha seramu potaziyamu, ndikofunikira kuti chithandizo chamankhwala odwala omwe alandila potaziyamu atayamwa ayambike mosamala poyang'anitsitsa kuchuluka kwa seramu potaziyamu.
Hypoglycemia ndi matenda ashuga. Kugwiritsa ntchito zoletsa za ACE kumatha kutsagana ndi hypoglycemia mwa odwala omwe ali ndi matenda ashuga omwe amatenga insulin kapena othandizira pakamwa. Chifukwa chake, ndikofunikira kuwunikira mosamala mkhalidwe wa odwalawo.
Opaleshoni / Anesthesiology. Ngati pakufunika opaleshoni, wodwala akuyenera kudziwitsidwa kuti wodwalayo akutenga quinapril, chifukwa kukhazikika kwa ochepa ochepa hypotension / kugwa ndikotheka.
Gwiritsani ntchito mwa okalamba. Ukalamba sizikhudza kwenikweni mphamvu ya chitetezo cha mankhwalawa, chifukwa chake, mlingo woyambirira wa Acupro mwa odwala okalamba ndi 10 mg kamodzi patsiku, ngati kuli koyenera, utha kusinthidwa poganizira kuchuluka kwa kuthamanga kwa magazi.
Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere
Ikagwiritsidwa ntchito pa nthawi ya pakati, zoletsa za ACE zimatha kuyambitsa kuperewera kwa fetal komanso neonatal. Musanagwiritse ntchito quinapril pa nthawi yomwe muli ndi pakati, muyenera kuganizira momwe zingayambire zovuta pa mwana wosabadwayo. Ngati mimba yachitika pamene mukumwa quinapril, mankhwalawo ayenera kusiyidwa.
Mukamamwa zoletsa za ACE panthawi ya II ndi III trimester yokhala ndi pakati, panali malipoti okhudza kuchepa kwa magazi, kulephera kwaimpso, kukopa kwa mutu ndi / kapena kufa kwa akhanda. Kukula kwa oligohydroamnion kunanenedwanso, komwe mwina ndi chifukwa chakuchepa kwa ntchito ya impso za mwana wosabadwayo; motere, kulera kwa malekezero, kusokonekera kwa craniofacial, hypoplasia yamapapu ndi kubwezeretsa kwa kukula kwa intrauterine. Ngati mu nthawi yoyambirira ya mluza kapena mwana wosabadwayo akukhudzidwa ndi mankhwalawo, mayiyo ayenera kudziwitsidwa posachedwa za kuchuluka kwa chiwopsezo, ngakhale mutakumana ndi mavuto osapezeka.
Amayi omwe amagwiritsa ntchito ma ACE inhibitors pa nthawi yachiwiri ndi ya III ya mimba ayenera kudziwitsidwa za ngozi zomwe zingakhalepo kwa mwana wosabadwayo; kuyezetsa magazi pafupipafupi ndikofunikira kuti mudziwe oligohydroamnion. Pankhani yopeza oligohydroamnion, kugwiritsa ntchito quinapril kuyenera kusiyidwa, kugwiritsidwa ntchito kungowonjezereka pokhapokha ndikofunikira kwa mayi.
Chiwopsezo china chomwe chingakhalepo kwa mwana wosabadwa komanso wakhanda mukamagwiritsa ntchito ACE inhibitors ndi intrauterine kukula retardation, prematurity ndi kutsekeka kwa ductus arteriosus, ndipo kufa kwa fetal kumachitikanso. Komabe, sizimadziwika zomwe zimayambitsa kukula kwa zotere - kugwiritsa ntchito mankhwalawa kapena matenda enanso a mayi.Sizikudziwikanso kuti ndi vuto liti lomwe limayambira munthawi yoyamba kubereka yomwe ingayambitse kuwonongeka kwa fetal.
Makanda omwe amayi awo adalandira zoletsa za ACE panthawi ya pakati, ndipo chifukwa chake ana adathandizidwa ndi ma inhibitors a ACE, amafunikira kuyang'ana - kuwongolera kwa hypotension, oligouriia ndi hyperkalemia. Ngati oliguria ipezeka, chisamaliro chimayenera kulipidwa kuti magazi azisungunuka komanso impso.
Ma inhibitors a ACE, kuphatikizapo quinapril, amawachotsa mkaka wa m'mawere pang'ono. Chifukwa chake, munthawi ya chithandizo ndi Acupro, tikulimbikitsidwa kuti muchepetse kuyamwitsa.
Ana. Chitetezo ndi kugwira ntchito kwa Accupro mwa odwala pakadali pano sizinafufuzidwe.
Kutha kukopa momwe zinthu zikuyendera mukamayendetsa komanso kugwiritsa ntchito njira zowopsa: Kuthamanga kwa zimachitika mukamayendetsa kapena kugwiritsa ntchito njira zina poyambira chithandizo ndi Accupro mutha kusokonezeka.

Mogwirizana ndi mankhwala Akkupro

Kutenga tetracycline ndi quinapril kumachepetsa kuyamwa kwa tetracycline ndi pafupifupi 28- 37%. Kutsika kwa mayamwidwe kumachitika chifukwa cha kukhalapo kwa magnesium carbonate monga wofetsa mu mankhwala Akkupro.
Odwala omwe adatenga lithiamu ndi ACE zoletsa nthawi yomweyo adawonetsa kuchuluka kwa seramu lifiyamu komanso Zizindikiro za lithiamu kawopsedwe. Kuphatikiza kwa mankhwalawa kuyenera kufotokozedwa mosamala; kuwunika pafupipafupi kuchuluka kwa seramu lifiyamu ndikulimbikitsidwa. Kugwiritsanso ntchito kwa diuretic kumawonjezera chiopsezo cha kuledzera wa lithiamu.
Momwe mankhwala a quinapril adapangidwira ndi propranolol, hydrochlorothiazide, digoxin kapena cimetidine, palibe machitidwe apakati pa pharmacokinetic omwe adawonedwa. Mphamvu ya anticoagulant limodzi ndi mlingo umodzi wa warfarin (malinga ndi nthawi ya prothrombin) sasintha kwambiri mutamwa quinapril 2 pa tsiku.
Kuthandiza munthawi yomweyo ndi thiazide diuretics ndi / kapena β-adrenergic blockers kumathandizira antihypertensive zotsatira za quinapril.
Ndi munthawi yomweyo makonzedwe a quinapril omwe ali ndi potaziyamu woteteza okodzetsa (spironolactone, triamteren kapena amiloride), potaziyamu zowonjezera kapena potaziyamu zokhala ndi mchere wam'malo, ziyenera kugwiritsidwa ntchito mosamala komanso poyang'anira kuchuluka kwa potaziyamu mu seramu yamagazi. Odwala omwe amatenga quinapril (monga AID enhibitors ena), kuchuluka kwa potaziyamu ya seramu kumatha kuchuluka. Ndi munthawi yomweyo kugwiritsa ntchito quinapril kumachepetsa hypokalemia chifukwa cha thiazide diuretics. Chifukwa cha chiwopsezo chowonjezereka cha kuchuluka kwa seramu potaziyamu, kuphatikiza mankhwala osakanikirana a potaziyamu kuyenera kuyambitsidwa mosamala, kuyang'anira kuchuluka kwa seramu potaziyamu kwambiri.
Odwala ena omwe ali ndi vuto la impso omwe amatenga NSAIDs, kuwonongeka kwa impso kuyenera kuchitika atangoyamba kutenga ACE zoletsa. Nthawi zambiri izi zimatha kusintha. Kuchepetsa kwa chiwongola dzanja cha quinapril pomwe munthawi yomweyo ndi NSAIDs.
ACE inhibitors, kuphatikizapo quinapril, amatha kukulitsa chidwi cha insulin kapena mankhwala a hypoglycemic, omwe angayambitse kukula kwa hypoglycemia mwa odwala matenda a shuga. Potere, zowunikira zowonjezereka zikufunika.

Mankhwala ochulukirapo a Acupro, zizindikiro ndi chithandizo

Makamaka chiwonetsero chachikulu cha bongo chitha kukhala choopsa kwambiri, chikafunikira kuti iv ikwaniritse yankho la plasma. Mankhwala othandizira komanso othandizira amachitidwa. Hemodialysis ndi peritoneal dialysis sizimakhudza kwambiri chimbudzi cha quinapril ndi quinaprilat.

Kutulutsa mawonekedwe ndi kapangidwe kake

Acupro imapezeka mu mapiritsi okhala ndi filimu; piritsi iliyonse imakhala ndi nambala yofanana ndi zomwe zili mu quinapril (5 mg, 10 mg, 20 mg kapena 40 mg) mkati mwake. Monga zinthu zothandizira, kukonzekera kumakhala ndi magnesium stearate, gelatin, magnesium carbonate, crospovidone, lactose monohydrate. Kuphatikizika kwa kuphatikizika kwa mafilimu kwamapiritsi kumaphatikizapo: opadry yoyera OY-S-7331 ndi sera wazitsamba.

Pharmacodynamics ndi pharmacokinetics

ACE ndi ma enzyme omwe amathandizira kusintha kwa angiotensin a mtundu woyamba kukhala angiotensin a mtundu wachiwiri, womwe umakulitsa kamvekedwe ka mtima mwa kukweza katulutsidwe ka aldosterone ndi adrenal cortex.

Khinapril amaletsa ACE, amachepetsa ntchito ya vasopressor, secretion ya aldosterone, ndikuwonjezera kulolerana kwa masewera olimbitsa thupi. Pogwiritsa ntchito odwala nthawi yayitali, magazi ake amapita ku ischemic myocardium amakhala bwino.

Magazi a wodwala amachepa, zotumphukira zonse za mtima zimachepa, kugunda kwa mtima kumasintha, ndipo magazi amitsempha yamagazi amawongolera. Ngati mumwa mankhwalawa molondola, amathandiza magazi kupita ku ischemic myocardium, amawonjezera magazi mu impso.

Pulogalamu yogwira imamasulidwa mwachangu ndikuyamba kugwira ntchito 1 ola limodzi mutatha kugwiritsa ntchito. Kuchuluka kwamphamvu kumawonedwa patatha maola atatu, zochita za mapiritsi zimapitilira tsiku lonse. Mphamvu yokhazikika yamankhwala imawonedwa pambuyo pa masabata 1-2 ndikugwiritsa ntchito pafupipafupi. Pafupifupi 40% ya quinapril atamwa mankhwalawa amayendayenda m'magazi osasinthika.

Kudya sikukhudza kuyamwa kwa zinthu zosiyanasiyana. Zakudya zamafuta zimatha kusokoneza kumasulidwa kwazomwe zimagwira. Pafupifupi 50-55% ya quinapril amamufukula impso. Zina ndizazungulira plasma. Amathiridwa impso kudzera m'matumbo.

Zizindikiro zogwiritsidwa ntchito

Mankhwala "Akkupro" akuwonetsedwa kwa odwala omwe adapezeka ndi zovuta zotsatirazi:

• Matenda oopsa a arterial (mankhwalawa amalembedwa ngati monotherapy kapena kuphatikiza ndi thiazide diuretics),
• Kulephera kwa mtima, komwe kumachitika modabwitsa (kuphatikiza ndi diuretics kapena mtima glycosides).

Mankhwalawa amatchulidwa ndi dokotala atayeza wodwala mosamalitsa. Simungathe kumwa mankhwalawo nokha, kuti musayambitse mavuto ena azaumoyo.

Mankhwalawa amagwiritsidwa ntchito pa matenda oopsa.

Zotsatira zoyipa

Odwala ambiri amafotokoza mutu, chizungulire, chifuwa, kutopa, rhinitis. Kutulutsa kapena zizindikiro za myalgia ndizotheka kwambiri.

Kukhosomola sikubala, kulimbikira, kumazimiririka mukangosiya kuchiritsa. Ngati wodwala anazindikira chimodzi mwazizindikirozi, ndikofunikira kusiya chithandizo. Kuchokera kumbali yamanjenje, chizungulire, kupweteka mutu, kusowa tulo, paresthesia, ndi kutopa.

Momwe mungatengere ndi kukakamiza, mulingo

Mapiritsi a Acupro amatengedwa pakamwa ndikutsukidwa ndi kapu yamadzi. Mankhwalawa sangathe kutafunidwa kapena kugawidwa m'magawo angapo. Mutha kudya isanayambe kapena itatha chakudya. Mankhwalawa amalembedwa kwa odwala omwe ali ndi kuthamanga kwa magazi. Ndi monotherapy, madokotala amalimbikitsa kuchuluka koyambirira kwa 10 mg kamodzi patsiku.

Ngati achire zotsatira zake ndizosakwanira, mlingo umawonjezereka mpaka 20-40 mg masana. Kuwongolera sikumachitika kuposa nthawi 1 pamwezi. Ndi kuthamanga kwa magazi, mutha kuphatikiza mankhwalawa ndi okodzetsa. Mlingo umayamba ndi 5 mg kamodzi patsiku. Iwo amawonjezera pang'onopang'ono kuti akwaniritse chithandizochi.

Kulephera kwa mtima kosalekeza, odwala amapatsidwa mankhwala a 5 mg m'mawa ndi madzulo. Pa mankhwala, wodwalayo ayenera kuyang'aniridwa ndi madokotala mosavomerezeka.Ntchito yayikulu ndikuzindikira ndikutsatira mawonedwe owonetsa a hypotension. Ngati wodwala amalekerera mlingo woyenera, umachulukitsidwa mpaka 30 mpaka 40 mg patsiku.

Pharmacokinetics

Kutsatira m`kamwa kwambiri pazipita ndende (C_max) m'magazi am'magazi, quinapril imafika mkati mwa ola limodzi, quinaprilat yake ya metabolite patatha maola awiri. Zakudya zomwezi munthawi yomweyo sizikhudza kuchuluka kwa mankhwalawa, koma zimatha kuwonjezera nthawi yofika C_max (zakudya zamafuta zimatha kuchepetsa mayamwidwe a chinthucho). Popeza kuchuluka kwa quinapril ndi ma metabolites ake ndi impso, kuchuluka kwa mayamwidwe Acupro kuli pafupifupi 60%.

Quinapril imapangidwa mwachangu ndi cleavage wa gulu la ester ndi michere ya chiwindi kuti ikwaniritse quinaprilat (metabolite yayikulu ndi quinapril dibasic acid), chinthu chomwe ndi choletsa ACE inhibitor. Pafupifupi 38% ya mlingo wolandiridwa wa mankhwalawa umazungulira m'madzi a m'magazi a quinaprilat.

Pafupifupi 97% ya quinapril kapena quinaprilat amayendayenda m'madzi a m'magazi m'mapuloteni.

Mankhwala samadutsa chotchinga-magazi.

Zikuwoneka: impso ndi mkodzo - 61% (zomwe mwa mawonekedwe a quinapril ndi hinaprilat - 56%), kudzera m'matumbo - 37%.

Hafu ya moyo (T_½) kuchokera ku plasma: quinapril - 1-2 maola, quinaprilat - 3 maola.

Pharmacokinetic magawo a mankhwala ena apadera milandu matenda:

• Kulephera kwaimpso: kumawonjezera T_½ poyerekeza kuchepa kwa chilolezo cha creatinine,
• cirrhosis yoledzera: ndendeyo imachepa (chifukwa cha kuphwanya kwa mapangidwe a quinapril),
• ukalamba (wopitilira zaka 65): kuchotsa kumachepetsedwa, komwe nthawi zambiri kumagwirizanitsidwa ndi kuwonongeka kwa impso, komabe, kusiyana kwakukulu pakutetezeka ndi kugwira ntchito kwa hinaprilat sikusiyana ndi omwe ali ndi odwala ochepa.

Pharmacological zochita za Akkupro

Mphamvu yogwira mankhwala - quinapril hydrochloride, imalepheretsa enzyme yotembenuka ya angiotensin, yomwe imachepetsa kubisalira ndi ntchito ya vasopressor ya aldosterone, imathandizira kulolerana ndikuchepetsa maselo othandizira.

Ndi kugwiritsa ntchito mankhwala kwa nthawi yayitali Akkupro, kusintha kosinthika kumawonedwa kwa odwala omwe ali ndi matenda oopsa, matenda oopsa amitsempha yamagazi, kuchuluka kwa magazi aimpso, komanso kuwongolera magazi kupita ku ischemic myocardium.

Njira yogwiritsira ntchito Akkupro

Malinga ndi malangizo, Akkupro amatengedwa pakamwa, kumwa madzi ambiri osatafuna, mosasamala kanthu ndi chakudyacho. Mlingo wa mankhwalawa zimatengera matendawa, omwe ndi:

• Ndi ochepa matenda oopsa - 10 mg ya mankhwalawa patsiku kwa odwala omwe sanalandire diuretics kale, ndi kuchuluka kwa 20 mg, yogawika awiri. Odwala omwe nthawi yomweyo amathandizira okodzetsa ndi Accupro - 5 mg ya mankhwalawa kamodzi patsiku, ndikuwonjezereka kwa kawiri kwa mankhwalawa kawiri kuti akwaniritse bwino achire,
• Aakulu mtima kulephera - koyamba mlingo 5 mg imodzi kapena awiri Mlingo patsiku. Pankhani ya kulekererana kwabwino kwa mankhwalawa, mlingo umatha kupititsidwa mpaka 10-40 mg pa tsiku, ndikugawidwa pawiri.
• Pankhani ya kuwonongeka kwa impso, mlingo woyambirira umadalira chilolezo cha creatinine, ngati sichisintha pakati pa 10-30 ml / mphindi, 2.5 mg wa Akkupro ndi mankhwala, 30-60 ml / min - 5 mg, ndi oposa 60 ml / mphindi - 10 mg patsiku. Milandu yomwe wodwalayo angalekerere poyambira mlingo wabwino, kuwonjezeka kwake pang'onopang'ono pakati ndikotheka.

Kwa odwala okalamba, mlingo woyambira wa Accupro ndi 10 mg tsiku lililonse, ndi kulolerana kwabwino, umatha kuwonjezeka pang'onopang'ono mpaka zotsatira zabwino zowonjezera zithe.

Malo osungira

Malinga ndi malangizowo, Akkupro amayenera kusungidwa pamalo owuma otetezedwa ku kuwala komanso kwa ana, ana amatha kutentha, osapitirira 25 ° C. Mankhwalawa amawachotsa ku pharmacies ndi mankhwala, alumali moyo wake, malinga ndi malingaliro onse opanga, ndi zaka zitatu, pambuyo pake Acupro ayenera kutayidwa.

Kodi mwapeza cholakwika m'mawuwo? Sankhani ndikusindikiza Ctrl + Lowani.

Kuchita

Ngati mumwa mankhwalawa "Akkupro" ndi tetracycline, zotsatira za mankhwalawa zimachepa. Madokotala omwe adapereka lithiamu, amawona mwa odwala kuwonjezeka kwazinthu izi mu seramu yamagazi. Pali mwayi wa zizindikiro za kuledzera wa lithiamu ndi kuwonjezeredwa kwa sodium m'thupi.

Lithium ndi hinapril ziyenera kumwedwa mosamala nthawi yomweyo. Madokotala amalimbikitsa kuti odwala otere akhale m'chipatala moyang'aniridwa ndi madokotala. Adzawongolera ndende ya seramu lifiyamu.

Pogwiritsa ntchito munthawi yomweyo ndi okodzetsa, mphamvu ya quhapert imatheka.

Titha kusiyanitsa mitundu ingapo ya mankhwala "Akkupro" ndi kufotokoza:

1. Yotsatira. Mankhwalawa amaperekedwa kwa odwala omwe ali ndi matenda oopsa, kulephera kwa impso, scleroderma, pachimake myocardial infarction. Kuphatikizikako kumaphatikizapo zomwe zimagwira - hinapril.
2. Hinapril-C3. Ichi ndiye cholozera cholondola kwambiri chamankhwala "Akkupro". Mankhwala amathandizidwa ndi odwala omwe ali ndi matenda oopsa, kulephera kwa mtima (akaphatikizidwa ndi mankhwala ena).

Simungasankhe m'malo mwanu, kuti muchepetse vutoli komanso osakumana ndi zovuta. Ma Analogs sangathe kumwedwa paokha, makamaka ngati munthu ali ndi hypersensitivity pazinthu zomwe munthu amapanga. Pali mwayi wambiri wa angioedema.

Nthawi zambiri, mankhwalawa amavomerezedwa ndi odwala; Ndikofunikira kutsatira malingaliro onse a omwe akupita kuchipatala, musapitirire kuchuluka kwa mankhwala.

Malangizo a Accupro akuwonetsa zowunikira

Mlingo woyambira wofunikira ndi 2, Mitengo ya, mwatsatanetsatane. Njira ndi Mlingo. (quinapril). Kuchuluka kwa mayamwa. , mtengo m'masitolo, zikuchokera, zikuwonetsa. Mkati, osafuna kutafuna, mosasamala nthawi yakudya, osambitsidwa ndi madzi. Pambuyo pa cmax ya pakamwa, quinapril mu plasma imafikira mkati mwa 1 h. Njira ndi mlingo. Nkhaniyi ikufotokoza za mankhwalawa,. Wodwala amayenera kutha yomweyo iyenera kuchitika., Mtengo wama pharmacies, zikuchokera, zikuwonetsa. Mawonekedwe a kumasulidwa ndi mawonekedwe. Zizindikiro za. Kusokonezeka kwa impso, azotemia, Zizindikiro za, njira, mavuto, contraindication, pakati, Contraindication kuti agwiritse ntchito. Ndemanga zimayang'aniridwa, ma fanizo akuwonetsedwa. Kufotokozera kwazomwe zikuwonekera pakugwiritsira ntchito contraindication njira yogwiritsira ntchito ndi zotsatira zoyipa.

Malangizo a Accupro ogwiritsira ntchito - Malangizo a Accupro ogwiritsira ntchito acupro mtengo acupro - piluli

Osamwa mitundu iwiri ya mankhwala nthawi imodzi: pulogalamu yothandiza ya admin. Mbiri yakale ya angioneurotic edema, yomwe imalumikizidwa ndi chithandizo cha APF inhibitors ndi chidwi chochulukirapo pazinthu zilizonse.

Ngati mwaiwala kumwa mankhwala, mutengerepo nthawi yomweyo, monga momwe mukukumbukira, osadikirira nthawi yomwe ikubwera. Zotsatira za antihypertensive za quinapril zimatha kukhala zochepa pokhapokha ngati mankhwala omwe amaletsa mankhwala osokoneza bongo komanso osagwirizana ndi antipsychotic, narcotic analgesics, diuretics, antihypertensives ena, kugwiritsa ntchito mankhwala ophatikizira

Malangizo a Accupro ogwiritsira ntchito

Zolemba Zosangalatsa: -> Makina owerengera a admin

-> chiwembu cha modami choyambira swans

-> Tsitsani makanema athu onse pa admin

-> chithunzi chojambulira dzuwa

-> Stopangin malangizo ogwiritsira ntchito

Dzinalo Lopanda Padziko Lonse

Dzina lachi Latin la mankhwalawa: Accupro. INN: Quinapril.

Mankhwala a antihypertensive, ACE inhibitor. Code ya ATX: C09A A06.

Kutulutsa mafomu ndi kapangidwe kake

Amapezeka mwanjira yozungulira, yama makulidwe atatu kapena chowulungika, mapiritsi okhala ndi mafilimu oyera kapena ofiira. Piritsi 1 ili ndi 5, 10, 20 kapena 40 mg yogwira ntchito - quinapril mu mawonekedwe a hydrochloride, komanso ma exipients. Phukusi la makatoni mumakhala matuza 3 kapena 5, lililonse lili ndi mapiritsi 6 kapena 10.

Mankhwala ochita kupanikizika omwe amachepetsa ntchito ya eniotensin-kutembenuza, ndikugawana komwe angiotensin I amasinthidwa kukhala angiotensin II. Yotsirizirayi ndiyo gawo logwira ntchito kwambiri lomwe limakulitsa kuthamanga kwa magazi. Kuchepa kwa katulutsidwe kazipanga kameneka kumayambitsa kukhathamiritsa kwa sodium excretion ndi kuchedwa kwa potaziyamu m'thupi, potero kumachepetsa zotumphukira zamitsempha. Ndi kugwiritsa ntchito pafupipafupi, zimathandiza kuchepetsa kuchepa kwa minofu ya mtima ndi mitsempha yamagazi, yomwe imayamba motsutsana ndi matenda oopsa.

Pambuyo pakukonzekera pakamwa, kuchuluka kwa quinapril mu seramu kumatheka mkati mwa mphindi 60-90. Osachepera 55% ya mankhwalawa imamwetsa.

Mothandizidwa ndi michere ya chiwindi, chinthu chogwira ntchito chimapukusidwa kuti quinaprilat, yomwe ndi ACE inhibitor yamphamvu. Dongosolo lake la bioavailability ndi 35%.

Chithandizo chogwira ndi ma metabolites ake sichilowera mu chotchinga cha magazi ndipo chimatsitsidwa ndi zotupa kudzera mu impso. Odwala ndi mkhutu aimpso ntchito, kuwonongedwa theka moyo kumawonjezeka ndi kuchepa kwa creatinine chilolezo.

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa ndi mankhwala ochizira matenda oopsa komanso kulephera kwa mtima.

Kugwiritsa ntchito mankhwalawa kumapangidwa pamaso pa matenda ndi zinthu zotsatirazi:

• Hypersensitivity kwa chinthu chilichonse
• mbiri ya angioedema chifukwa chamankhwala am'mbuyomu omwe ali ndi antihypertensive mankhwala kapena cholowa ndi / kapena matenda ofanana.
• lactose tsankho, shuga-galactose malabsorption.

Amagwiritsidwa ntchito mosamala pamaso pa matenda ndi zochitika zina:

• Symbotatic ochepa hypotension, makamaka mwa odwala omwe adayamba kuthira mafuta okhudzana ndi zakudya ndikutsatira zakudya zopanda mchere,
• pachimake matenda chifukwa cha kuwonongeka kwa mtima minofu,
• matenda ashuga
• Kulephera kwa impso kapena chiwindi,
• matenda a autoimmune
• kuperewera kwa coronary
• Hyperkalemia
• kuchepa kwa magazi magazi.

Kumayambiriro kwa mankhwalawa, mankhwalawa amalimbikitsidwa kuti agwiritsidwe ntchito pokhapokha pakuwonetsa zizindikiro za kuthamanga kwa magazi.

Amagwiritsidwa ntchito mosamala pakakhala kulephera kwa chiwindi.

Amagwiritsidwa ntchito mosamala pamaso pa ochepa hypotension.

Amagwiritsidwa ntchito mosamala pamaso pa matenda ashuga.

Gwiritsani ntchito mosamala pamaso pa kulephera kwa aimpso.

Amagwiritsidwa ntchito mosamala pamaso pa hyperkalemia.

Amagwiritsidwa ntchito mosamala pamaso pa kuperewera kwa mphamvu ya coronary.

Amagwiritsidwa ntchito mosamala pakakhala kuchepa kwa kuchuluka kwa magazi.

Momwe mungatengere Accupro

Kutalika kwa maphunzirowa ndi kaundulidwe kamadongosolo kumayesedwa ndi katswiri, makamaka pozindikira momwe wodwalayo alili. Mankhwala amatengedwa pakamwa, ngakhale kudya zakudya, 0,01 ga 1-2 pa tsiku. Pakufunika kwa achire kwenikweni, mlingo umodzi ukhoza kuwonjezeka ndi 2, koma osapitilira muyeso wa 0,88 g patsiku. Ndi chololedwa kumwa tsiku lililonse kamodzi, osagawikana pakulipira zingapo.Mlingo utha kuwonjezeredwa pokhapokha akutsimikiziridwa ndi adokotala ndipo osapitirira masabata anayi kuchokera poyambira chithandizo.

Ndi matenda ashuga

Mankhwala amagwiritsidwa ntchito ngati gawo limodzi la mankhwala a antihypertensive, kuyang'anira kusamala kwambiri kwa glycemic ndi njira yolimbikitsira.

Mankhwalawa kwenikweni samayambitsa kukonzekera kosafunikira. Nthawi zambiri, zimayang'aniridwa mosiyana ndi maziko a hypersensitivity ku zigawo zake kapena pamene mulingo wovomerezeka suwone. Mankhwalawa ayenera kuikidwa ndi katswiri atazindikira, mukuyang'ana ndi ma concomitant pathologies.

Kuuma kwa mucous nembanemba mkamwa kapena kummero, kusokonezeka kwa dyspeptic, nseru, kupweteka pamimba, kuchepa kwa chakudya, komanso kuphwanya kuzindikira.

Pakati mantha dongosolo

Potengera maziko akumwa mankhwalawa, kusintha kwa machitidwe, vertigo, kusokonezeka kwamatenda, kuwonjezeka kwa kutopa kapena kukwiya, vuto lakumverera kwa khungu lomwe limadziwika ndi dzanzi ndi kumva kuwawa ndizotheka.

Zotsatira zoyipa za mankhwalawa zimatha kukhala kuchepa kwa njala.

Zotsatira zoyipa za mankhwalawa zimatha kusintha kusintha.

Zotsatira zoyipa za mankhwalawa zitha kutopa.

Zotsatira zoyipa za mankhwala zitha kukhala pakamwa pouma.

Zotsatira zoyipa za mankhwalawa zimatha kusintha kusintha.

Zotsatira zoyipa za mankhwala zimatha kukhala dyspeptic matenda.

Zotsatira zoyipa za mankhwalawa zimatha kukhala vuto lakhungu.

Kuchokera kwamikodzo

Nthawi zina, matenda amkodzo amadziwika.

Kuchokera ku kupuma

Nthawi zambiri pamakhala chifuwa chosalekeza, chosabereka chomwe chimadutsa kutha kwa mankhwala, kumverera kwa kusowa kwa mpweya, kutupa kwakapweteka kwa pharyngeal mucosa, kupweteka pachifuwa.

Pa khungu

Khungu ndi kuchepa kwa minyewa yotakata zimatheka, monga kutuluka thukuta, erythema ndi desquamation, zotupa, kuyabwa, kuchepa kwa tsitsi, pemphigus, zochitika zapakati kapena zamachitidwe.

Kuchokera ku genitourinary system

Nthawi zina, kuchepa kwa potency, kuchepetsedwa pokodza kumatha.

Kuchokera pamtima

Kuthekera kwa ziwalo za hematopoietic, monga kuchepa kwa maselo ofiira amwazi m'magazi, kuchepa kwa kuchuluka kwa hemoglobin, agranulocytosis, kuchepa kwa maselo am'magazi, komanso kuchepa kwamitundu yonse yam'magazi.

Mbali ya mtima, kupweteka kwamtunduwu monga kuchepa kwa magazi, kusakhazikika m'chifuwa, kukhumudwa kwa mtima, kugunda kwa mtima, tachycardia, ndi kuwonjezeka kwa lumen m'mitsempha yamagazi.

Kuchokera minofu ndi mafupa

Nthawi zambiri pamakhala kupweteka kumbuyo. Nthawi zina, motsutsana ndi momwe ntchito mankhwalawa imagwiritsidwira ntchito, matendawa amatha.

Zotsatira zoyipa za mankhwalawa zimatha kukhala chifuwa.

Zotsatira zoyipa za mankhwalawa zimatha kuchepa kwa tsitsi.

Zotsatira zoyipa za mankhwalawa zimatha kukhala kupweteka kumbuyo.

Zotsatira zoyipa za mankhwalawa zimatha kupweteka pachifuwa.

Zotsatira zoyipa za mankhwalawa zimatha kukhala matenda amkodzo.

Zotsatira zoyipa za mankhwalawa zimatha kutupa kwa nkhope.

Kuchokera ku chitetezo chamthupi

Anaphylactoid zimachitika, angioedema ndizotheka.

Ngati pali laryngeal whistle kapena kutukusira kwa kachulukidwe kake ka nkhope, lilime kapena makutu am'kamwa, mankhwala omwe ali ndi mankhwalawa ayenera kuyimitsidwa nthawi yomweyo. Ngati kutupa kwa lilime kapena larynx kukuopseza kufooketsa mpweya wam'mapapo, chithandizo chokwanira chokwanira ndikuwunikira musanabwezeretse zizindikiro za ziwengo ndizofunikira.

Zokhudza mphamvu pakuwongolera njira

Mukamamwa mankhwalawa, muyenera kusamala pakuwongolera njira ndikugwirira ntchito yowonjezera chidwi, makamaka kumayambiriro kwa chithandizo, chifukwa cha chiwopsezo cha chizungulire komanso hypotension.

Kugwiritsa ntchito nthawi yomweyo sikumakhudza kuchuluka kwa mankhwalawa, koma kumawonjezera nthawi kuti afike pazomwe zimagwira.

Mukamamwa mankhwala, tikulimbikitsidwa kupatula zakudya zamafuta m'zakudya.

Nthawi zina, kulandira chithandizo cha angiotensin-converting enzyme kumayendera limodzi ndi kukula kwa hypoglycemia kwa odwala omwe ali ndi matenda osokoneza bongo, kumwa mankhwala a hypoglycemic kapena kulandira insulin. Yogwira pophika mankhwala kumawonjezera zochita insulin ndi antidiabetes.

Gwiritsani ntchito pa nthawi yoyembekezera

Contraindified mu mimba ndi mkaka wa m`mawere.

Kusankhidwa Akkupro kwa ana

Mankhwalawa sagwiritsidwa ntchito machitidwe a ana chifukwa chosowa deta pa chitetezo chake komanso kugwira ntchito kwawo.

Mankhwalawa amatsutsana pakuyamwa.

Mankhwalawa sagwiritsidwa ntchito pochita ana.

Mankhwala ndi contraindicated pa mimba.

Gwiritsani ntchito mu ukalamba

Imavomerezedwa kuti igwiritsidwe ntchito chifukwa chosagwirizana ndi zotsutsana. Mlingo woyambirira wa mankhwalawa ndi 10 mg kamodzi patsiku. Moyang'aniridwa ndi adotolo, amatha kuwonjezereka kuti akwaniritse zochizira zomwe mukufuna.

The ntchito aimpso kuwonongeka

Odwala omwe ali ndi vuto la ziwalo, kuwonjezeranso theka la moyo wogwira ntchito kumadziwika, motero, ndikofunikira kusintha mlingo, poganizira zazidziwitso za creatinine. Mlingo woyambira waukulu kwambiri umachokera ku 2.5 mpaka 10 mg patsiku. Kuchulukitsa mlingo wa mankhwalawa kumatheka pokhapokha pakuwongolera ziwalo. Kulephera kutsatira malangizo azachipatala kungayambitse kusokonekera kwa ziwalo, kuphatikizapo chiopsezo chakulephera kwa impso.

Zizindikiro za mankhwala osokoneza bongo ndi kuphwanya kuchuluka kwa ma electrolyte, kupindika kwambiri, kuchepa kwa pafupipafupi mtima, komanso kuwonongeka kwa mawonekedwe. Chithandizo chikuchitika ndi mtsempha wa magazi kusintha kwa plasma njira kuti kuwonjezera kuchuluka kwa magazi. Kugwiritsa ntchito mankhwala a dialysis ali ndi gawo lonyansa pazinthu zomwe zimagwira. Pakakhala kuchepa kwa kuthamanga kwa magazi, chithandizo chothandizira ndi chofunikira ndikofunikira.

Zizindikiro za mankhwala osokoneza bongo ndi kuphwanya mulingo wamadzi wamagetsi.

Zizindikiro zopitirira muyeso ndizovuta kwambiri.

Zizindikiro za bongo ndizowonongeka.

Kuchita ndi mankhwala ena

Kugwiritsa ntchito nthawi yomweyo mankhwala ochepetsa mphamvu ya tetracycline ndi antihypertensive mankhwala amachepetsa mayamwidwe amtetracyclines. Chithandizo cha mankhwala omwe ali ndi lithiamu ndi ACE inhibitors amachulukitsa zomwe zili seramu lifiyamu, zimawonjezera chiopsezo cha kuledzera. Kukonzekera kwa potaziyamu kumapangitsanso antihypertensive mphamvu yogwira mankhwala, kumathandizira kuwonjezeka kwa msanga wa zinthu za m'magazi. Kuphatikiza mankhwala ndi mankhwala omwe amalepheretsa kugwira ntchito kwa mafupa kumawonjezera chiopsezo cha magazi a m'magazi, kuphatikizapo kuchepa kwa kuchuluka kwa ma granulocytes ndi neutrophils.

Kugwiritsidwa ntchito mosiyanasiyana kwa mankhwala okhala ndi hinapril ndi Allopurinol, Novocainamide, cytostatic agents kapena ma immunosuppressants kumawonjezera mwayi wokhala ndi leukopenia. Mankhwala a antihypertensive, mankhwala osokoneza bongo, opioid analgesics amalimbikitsa mphamvu yochititsa chidwi ya quinapril, pomwe mankhwala omwe si a antiidal anti-yotupa amachepetsa chifukwa cha kusungika kwa madzi mthupi.

Kuyenderana ndi mowa

Ethanol imathandizira antihypertensive mphamvu ya mankhwala.

Mankhwala ali ndi mitundu ingapo ya gulu limodzi la mankhwala. Zina mwa izo ndi:

Zomwe zimagwiritsidwa ntchito ndi mankhwala zimatha kusinthana, motero, kusintha kwa mankhwalawa kuyenera kuvomerezana ndi dokotala.

Mankhwala Prestarium wa kuthamanga kwa magazi

Mawu opuma Acupro kuchokera ku mankhwala

Kugula mankhwala a antihypertensive, kuikidwa kwa dokotala ndikofunikira.

Kodi ndingagule popanda kulandira mankhwala?

Yoperekedwa ndi mankhwala.

Mtengo wa Acupro

Mtengo wapakati wa mankhwala ndi ma ruble 535-640.

Zosungidwa zamankhwala

Sungani kutentha kwa chipinda cholamulidwa (osati chapamwamba kuposa + 20 ° C). Khala kutali ndi dzuwa. Chepetsani mwayi wa ana kulandira mankhwala.

Patatha miyezi 36 kuchokera pomwe ntchito yake ndi yosavomerezeka kugwiritsa ntchito mankhwalawa.

Ndemanga za Akkupro

Musanagwiritse ntchito mankhwala a antihypertensive, tikulimbikitsidwa kuti muwerenge ndemanga za akatswiri azachipatala ndi odwala.

Alevtina Ivanova (wamtima), wazaka 39, Ivanovo

Mankhwala othandizira opangidwa makamaka kuti muchepetse kuthamanga kwa magazi ndikuwongolera mtima. Kugwiritsa ntchito nthawi yayitali kumathandizira kulimbitsa makoma a mtima, kusintha kaso. Mankhwala amaperekedwa malinga ndi mankhwala, motero, mankhwalawa ayenera kuyikidwa ndi katswiri kuti athetsere zotsutsana ndikuchepetsa mwayi wokhala ndi zovuta zina.

Odwala omwe amamwa mankhwalawa

Alina, wazaka 43, Krasnoyarsk

Zivomerezedwa monga zakhazikitsidwa kwa miyezi ingapo. Kugwiritsa ntchito bwino kwa mankhwalawa ndikokwera, kupanikizika kumabwereranso kwina pambuyo pakatha maola 1-2 mutatha kutsata. Komabe, adakakamizidwa kusiya mankhwalawa chifukwa chotsatira chosasangalatsa - kuukira kwa chifuwa chosakhalitsa.

Anna, wazaka 28, Perm

Dziwani za ngozi yanu yopezeka ndi matenda ashuga!

Tengani mayeso aulere pa intaneti kuchokera kwa endocrinologists odziwa ntchito

Nthawi yoyesa osaposa mphindi ziwiri

mayeso okwana chikwi

Amayi kwa nthawi yayitali adayesetsa kuthana ndi kuthamanga kwa magazi pawokha, koma njira zakugwirira ntchito zimagwiritsidwa ntchito masiku ano. Ndimayenera kumuwona dokotala. Amayi adayikidwa mankhwalawa chifukwa adazindikira kulephera kwa mtima. Pambuyo pa chithandizo, zipsinjo za kubwereranso zidakhala zachilendo, zizindikiro za matenda oopsa zidatha. Panalibe zovuta zoyipa, sikofunikira kuti musinthane ndi mitengo yamtengo wapatali yokhala ndi zovuta zingapo.

Mankhwala "Kaptopres" amatanthauza othandizira, omwe amakhala ndi zinthu ziwiri zogwira ntchito: Captopril - angiotensin-akatembenuza enzyme inhibitor ndi diuretic hydrochlorothiazide. Mankhwala akuwonetsa kuti ali ndi hypotensive komanso okodzetsa kwenikweni. Amapangidwa monga mapiritsi am'kamwa otsogozedwa ndi kampani yopanga mankhwala yaku Ukraine Darnitsa.

Pali mitundu iwiri ya mankhwalawa, mosiyanasiyana mu gawo la okodzetsa. Mapiritsi opsinjika "Kaptopres" ali ndi 50 mg ya Captopril ndi hydrochlorothiazide 25 kapena 12,5 mg. Zosakaniza zina ndi povidone, shuga mkaka, aerosil, wowuma wa mbatata ndi magnesium stearate.

Kwa mankhwala "Kaptopres" mtengo umachokera ku ma ruble a 180 phukusi lililonse. Mtengo wake umakhala wotsika kwambiri kuposa mankhwala ena onse omwe amachepetsa kuthamanga kwa magazi, omwe samachepetsa kugwira ntchito kwake. M'dziko laopanga mankhwala "Kaptopres" mtengo wake ndi pafupifupi ma ruble 89 pa paketi iliyonse ndi mapiritsi 20.

Kodi mankhwalawa amagwira ntchito bwanji?

Zogwiritsa ntchito zimazindikira kachitidwe ka mankhwalawa "Kaptopres", kamene kamatsimikizira momwe amachiritsira thupi la munthu.

Kodi mtima umapweteka nthawi zambiri?

Mwa kuletsa angiotensin kutembenuza enzyme captopril, kaphatikizidwe ka mtundu 2 angiotensin amakakamizidwa. Mothandizidwa ndi izi maholide a oligopeptide, zombo zimachepetsedwa, kupanga aldosterone ndi adrenal cortex kumatheka.

Kutsika kwa angiotensin a mtundu wachiwiri kumachepetsa kuthamanga m'mitsempha, mu atrium yoyenera, ziwiya zopanga kufalikira kwam'mapapo, zisonyezo za zotumphukira zamitsempha. Mukudziwa mawonekedwe a captopril, mutha kudziwa zotsatira za mankhwalawa "Captopres", pazomwe mungakakamize kumwa mankhwalawa.

Chifukwa cha hydrochlorothiazide, mphamvu yokhudza kukodzetsa thupi kwamikodzo imachitika pochotsa mamolekyulu amadzi, chloride, potaziyamu ndi sodium ion kuchokera mthupi.Thupi limatha kuchepetsa mulingo wa sodium mu khoma la chotengera, limapangitsa kuti lisamveke kwambiri ndi zotsatira za vasoconstrictor, ndikuwonjezera mphamvu ya antihypertensive ya Captopril.

Mapiritsi a Kaptopres: amathandizira chiyani?

Mankhwalawa amachotsa matenda oopsa a mitundu ingapo, kuphatikiza matenda oopsa osagwirizana ndi mankhwala ena.

Mothandizidwa ndi chida ichi, chisamaliro chadzidzidzi chimachitika pakagwa vuto la matenda oopsa.

Kuti muthandizire mankhwalawa, amayenera kuledzera pokhapokha kuyeza kukakamiza.

Ndikofunikira kudziwa nthawi yomwe mutenge mapiritsi a Kaptopres. Zisonyezero zakugwiritsa ntchito mankhwalawa ndi monga:

• matenda oopsa oopsa, omwe amayamba chifukwa cha zinthu zosiyanasiyana zosakhudzana ndi matendawa.
• matenda oopsa oopsa, omwe ndi chizindikiro cha matenda osiyanasiyana.
• matenda oopsa oopsa chifukwa cha matenda a angina kapena a mtima,
• Matendawa obwezeretsanso magazi omwe amakhudzana ndi mavuto am'mimba,
• renoparenchymal matenda oopsa pamodzi ndi mawonekedwe osakhazikika kapena owopsa a glomerulonephritis a etiology yoyamba komanso yachiwiri,
• matenda oopsa ndi mphumu ya bronchial,
• matenda ashuga nephropathy,
• Kulephera kwa mtima kwakukulu, pomwe mtima glycosides ndi wofooka
• Matenda amalumikizana ndi mawonekedwe oyamba a hyperaldosteronism.

Mankhwalawa amagwiritsidwa ntchito pothandizira chisamaliro chadzidzidzi chifukwa cha matenda oopsa.

Momwe angatenge

Ndikofunikira kusamala kwambiri ndi mapiritsi a Kaptopres. Kodi ndikumwa mankhwala ati kuti ndisawononge thanzi langa? Funso ili limafunsidwa ndi odwala ambiri omwe ali ndi matenda oopsa kwa dokotala.

Nthawi zambiri, 120/80 mmHg amaonedwa ngati amtundu wazizindikiro zowonjezera. Art. Pa mfundo zapamwamba, njira zomwe zikuyenera kutsatidwa kuti muchepetse kuthamanga kwa magazi. Ngati mankhwala a Kaptopres adalandira odwala kuti akapanikizidwe, ayenera kumwa kwa mphindi 60 asanadye chakudya kuti asasokoneze kuyamwa kwa zida zogwira ntchito. Mlingo amasankhidwa kutengera mtundu wa matenda oopsa komanso kuopsa kwa wodwala aliyense payekhapayekha.

Kuchiza kuyenera kuyamba ndi theka la piritsi, lomwe lili ndi capopril 25 mg ndi hydrochlorothiazide 12,5 mg. Aledzera 1 nthawi patsiku. Kuti muthandizenso kukonza, piritsi lonse limatengedwa kale patsiku ndi kuchuluka kwa captopril pa 50 mg ndi hydrochlorothiazide pa 25 mg. Kwambiri achire zotsatira zimawonedwa pambuyo 1.5-2 miyezi kuchokera koyamba kugwiritsa ntchito. Kusintha kwa Mlingo kumachitika pogwiritsa ntchito masabata a 6, poganizira kusowa kwa kufunika kwake kosintha mwachangu.

Kutsika kosakwanira kwa kuthamanga kwa magazi kungakhale chifukwa cha kuphatikizidwa mu chithandizo cha kuchuluka kwa Captopril ndi hydrochlorothiazide, omwe amatengedwa ngati gawo limodzi lokonzekera chimodzi. Chiwerengero cha tsiku lililonse la Captopril sayenera kupitirira 150 mg, ndipo zomwe zili ndi hydrochlorothiazide - zosaposa 50 mg.

Pofuna kuthana ndi vuto la kuthamanga kwa magazi, ndimagwiritsa ntchito piritsi limodzi, lomwe limatafuna ndikusungidwa ndi lilime.

Matenda a Urin

Mkulu wa Captopril ndi hydrochlorothiazide amachitika pogwiritsa ntchito impso. Kuphwanya ntchito kwa thupi lino (ndi creatinine chilolezo cha 30-80 ml pa mphindi imodzi) kumabweretsa kuwonjezeka kwa magawo omwe amagwira piritsi la seramu.

Kusintha muyeso wa zinthu zomwe zimagwira ntchito pazowonetsa zochizira, tengani piritsi limodzi patsiku, zomwe zimagwirizana ndi kuchuluka kwa Captopril 25 mg ndi hydrochlorothiazide 12,5 mg. Nthawi zambiri imwani mankhwalawa m'mawa 1 ola limodzi musanadye chakudya cham'mawa.

Mapiritsi a Kaptopres amachiza matenda oopsa komanso kulephera kwa mtima, ndipo gawo lawo lalikulu, Captopril, lidagwiritsidwa ntchito koyamba mu 70s ya zaka zapitazi. Odwala ambiri amalankhula za phindu la mankhwalawo, omwe ndi chithandizo chake amachepetsa kuthamanga kwa magazi panthawi yamavuto akuchulukitsa.Ndikofunika kumwa mapiritsi molondola komanso pafupipafupi kuti mupeze zotsatira zabwino.

Popita maphunziro ambiri azachipatala omwe amachokera ku mankhwala a Captopril, zimatsimikiziridwa kuti amachepetsa kuthamanga kwa magazi ndikuchepetsa chiwerengero cha anthu omwe amafa ndi matenda amtima.

Ndani amatsata mankhwala

Malangizo a Kaptopres ogwiritsira ntchito akuphatikizira zotsutsana zingapo, zomwe zimaphatikizapo kuwonjezeka kwa chidwi cha munthu pazinthu zomwe zimagwiritsidwa ntchito ndi mapiritsi, angiotensin kutembenuza ma enzyme inhibitors ndi zotumphukira za sulfamide.

Simungathe kumwa mankhwalawa ndi stenosis ya mtsempha wamagazi womwe umatsogolera impso imodzi kapena impso ziwiri, mutasinthanitsa chiwalochi, ndikuphwanya kwambiri ntchito yake, pomwe kuchuluka kwa kuyeretsedwa kwa magazi kuchokera ku creatinine ndi 30 ml pamphindi 1, ndipo kuyika kwake plasma sikudutsa 1, 8 mg pa 100 ml.

Mankhwalawa sagwiritsidwa ntchito ndi odwala omwe ali ndi zizindikiro za hyperaldosteronism yoyambirira, kuchepa kwa potaziyamu ndi sodium ion m'magazi, hypovolemia, gout ndi hypercalcemia, kusintha kosokoneza ndi aortic stenosis komanso kufooka kwa magazi komwe kumayambira kumanzere kwamanzere. Sizoletsedwa kumwa mankhwalawa panthawi yayikulu matenda a chiwindi, amayi apakati ndi kuyamwa. Contraindication ndi ana osakwana zaka 18.

Ma diuretics amayimitsidwa kutenga masiku atatu musanayambe kugwiritsa ntchito mankhwala osokoneza bongo komanso okodzetsa.

Chisamaliro chofunikira chimafunidwa ndi anthu okalamba, oyendetsa magalimoto, odwala osakhazikika omwe mawonekedwe a creatinine ndi 30-60 ml pamphindi 1, mapuloteni amawonjezereka mu mkodzo ndipo mfundo zake zimaposa 1000 mg patsiku.

Muyenera kusamala kwambiri mukamatenga procainamide, mtima kulephera, ntchito yaimpso, matenda a shuga, kuthinana kwamitsempha. Kuti muwone momwe wodwalayo aliri, thanzi limayesedwa pafupipafupi, ndipo ntchito za impso ndi milingo yamagetsi ammgazi zimayendera.

Mukamakonzekera Kaptopres, malangizowo amafotokoza zomwe zimachitika mwa odwala osiyanasiyana omwe amakhudza machitidwe osiyanasiyana a thupi.

Ndi zovuta pakudya m'mimba ndi chiwindi, chilonda chimachepa, mucous membrane wamkamwa amayamba kuuma, mutha kuwona nseru, kusanza, kupweteka m'mimba, kupindika kosakhazikika, kukula kwa stomatitis, zilonda zam'mimba, icteric state, hepatitis, kuchuluka kwa bilirubin m'magazi.

Kukopa pa mtima, mitsempha yamagazi ndi ziwalo za hemopoietic zimatha kuchitika ndi tachycardia, angina pectoris, kuthamanga kwa magazi, kuthamanga kwa raynaud, redness kapena kufooka kwa khungu, kugunda kwa mtima, kuchepa kwa magazi, neutropenia, agranulocytosis, thrombocytopenia, pancytopenia, hemolytic kapena aplastic anemia.

Mankhwala amakhudzanso dongosolo lamkati lamanjenje lomwe limasokoneza magonedwe, kugona ndi kumva, kufalikira kwamatumbo, zimayambitsa kupweteka kwa mutu, kugunda kwa chizungulire, kutengeka mtima, kusokonezeka, kunenepa kwa miyendo.

Zokhudza kupuma kwamphamvu zimawonetsedwa ndi chifuwa, kupuma, bronchospasm, chifuwa cha chifuwa.

Zotsatira zoyipa zamkodzo zimawonetsedwa ndi kulephera kwa impso, polyuria, oliguria, nephrotic syndrome.

Chiwopsezo chitha kukhala ngati zotupa pakhungu, kuyabwa, urticaria, edema ya Quincke, matenda a Stevens-Johnson, photosensitivity, erythema.

Kwa odwala ambiri, ndikofunikira kudziwa momwe ma Kaptopres amagwirira ntchito, panthawi yomwe amakakamizidwa. Nthawi zambiri mankhwala amamwa pamene magazi a magazi akwera, zomwe sizolondola. Tikufuna mankhwala mwadongosolo malinga ndi malingaliro a adotolo.

Pa chithandizo, kuchuluka kwa ma electrolyte, makamaka ayoni wa potaziyamu, kuchuluka kwa creatinine ndi urea kuyenera kuwunikiridwa ndipo ziwerengero za magazi zam'magawo oyandikira ziyenera kuyang'aniridwa.

Mukamamwa mankhwalawa, muyenera kudya zakudya zopanda mchere wambiri, mowa umapindika.

Kukhala ndi diuretic kwambiri, mankhwalawa amatha kukulitsa mphamvu ya kusungunuka kwa madzi-electrolyte yokhudzana ndi diuretic mankhwala, kutsegula m'mimba, kusanza, kudya ndi sodium yochepa, hemodialysis, chifukwa cha ochepa hypotension. Pamaso mankhwala a antihypertensive, kuchuluka kwa ma electrolyte mthupi kuyenera kusinthidwa.

Odwala omwe ali ndi vuto la mtima ndi okalamba amapatsidwa chisamaliro ndi mapiritsi a Kaptopres. Kodi ndimamwa mankhwala ati omwe ndingakakamize kuti magwiridwe ake asachepetse kwambiri? Musanayambe kumwa mankhwalawa, magazi amayenera kuwunika, ndikofunikira kuwunika ntchito yaimpso, zomwe zimakhala ndi ion zofunika.

Mpikisano wa Negroid umawerengedwa kuti sukumana ndi mankhwala omwe amalepheretsa enzyme yotembenuka ya angiotensin, chifukwa chake Captopril imakhala yocheperako kwa odwala otere.

Mwa zina mwa mankhwala othandizira antihypertensive, "Kaptopres" amakhala m'malo amodzi otsogolera: malangizo ogwiritsira ntchito kupanikizika kuti apatsidwe magazi kuti achepetse kuthamanga kwa magazi komanso kuti muchepetse chizindikiro chovuta kwambiri pakakhala vuto lotenga magazi kwambiri.

Pansipa tikuwunikira mwachidule za mankhwalawa, ndikupenda mwatsatanetsatane malingaliro a akatswiri pakugwiritsa ntchito kwake.

"Kaptopres": machitidwe apakati a mankhwalawo

Zinthu zothandizira ndi mawonekedwe omasulidwa

Mankhwala "Kaptopres" amapezeka mufomu ya piritsi. Zovuta zake zimaperekedwa ndi kukhalapo kwa zinthu ziwiri zazikulu:

• Captopril - choletsa cha ACE (angiotensin potembenuza enzyme),
• hydrochlorothiazide - okodzetsa.

Kaptopres ndi mankhwala omwe amasankhidwa bwino kwambiri mwa ACE inhibitor (capopril) ndi diuretic (hydrochlorothiazide)

Mlingo wofanana wamapiritsi:

• 50 mg wotsogola
• 25 mg hydrochlorothiazide.

Kuphatikiza pazinthu izi, kapangidwe kake ka mankhwalawa kamaphatikizidwa ndi silicon dioxide, magnesium stearate, wowuma ndi zina zina zothandizira.

The pharmacological zotsatira za mankhwala amayamba chifukwa cha ntchito yolimbana ndi antihypertensive mankhwala yomwe imaletsa ACE, komanso okodzetsa:

1. Chifukwa cha zochita za Captopril, kuchuluka kwa zotsatira za angiotensin-2 pamakoma a mitsempha yamagazi kumachepa. Kukaniza kuthamanga kwa magazi mu ziwiya kumachepa, zomwe zimapangitsa kutsika kwakukulu kwa magazi.
2. Mofananamo, motsogozedwa ndi Captopril, kuchuluka kwa plasma ya zinthu zina kumachepa, zomwe zimayambitsa kuchepa kwa lumen yamitsempha yamagazi (makamaka norepinephrine). Chifukwa chake, zinthu zimapangidwa kuti muchepetse kupanikizika kwambiri. Kupsinjika kwa ma atrium ndi kufalikira kwam'mapapo kumachepa, potero kumapangitsa kuti magazi azithamanga.
3. The diuretic yomwe ili gawo la Kaptopres imapititsa patsogolo mphamvu ya ACE inhibitory. Mphamvu ya synergistic imasiyanitsa Kaptopres ndi mankhwala ena omwe ali ndi gawo lofananira lofunsa lomwe lili ndi capopril popanda zigawo za diuretic.

The yogwira zinthu bwino odzipereka mu m'mimba thirakiti (mpaka 30% ya mankhwala amamangidwa, ndende yaundende okhazikika pafupifupi mphindi 60 pambuyo makonzedwe).

Nthawi ya kufafaniza ndi pafupifupi maola atatu (odwala omwe ali ndi vuto la chiwindi chokwanira - yayitali).

Mankhwala amakhudza kaphatikizidwe kazinthu komwe kamawononga bradykinin

Ndi matenda ati omwe amagwiritsidwa ntchito pochiza?

Mankhwala ndi mankhwala ochepa ochepa, okhazikika motere:

• zofunikira
• Zizindikiro
• zoyipa
• Zovuta za angina,
• Kukonzanso
• renoparenchymal.

Kuphatikiza apo, mndandanda wazisonyezo zoikidwa kwa "Kaptopres" umaphatikizapo: matenda oopsa, matenda ashuga a nephropathy a matenda ashuga, kulephera kwa mtima (mosavutikira ndi mtima wa glycosides), ndi zina zambiri.

Pazovuta zazikuluzikulu, "Kaptopres" imagwiritsidwa ntchito pothandiza kuzizira kwambiri mwadzidzidzi.

Gwiritsani ntchito pochiza komanso kupewa

Ma Kaptopres: malangizo ogwiritsira ntchito polimbana ndi kukakamizidwa

Musanayambe kumwa mankhwalawa kuti muthandizidwe, muyenera kuphunzira mosamala malangizo ogwiritsira ntchito mapiritsi a Kaptopres: pazomwe mungakakamize kumwa, pa kumwa, ndi zina, ndi zina.

Ma kaptopres amachepetsa kuthamanga kwa magazi chifukwa cha zinthu ziwiri zomwe zimakhudza thupi m'njira zosiyanasiyana.

Mankhwalawa amagwira ntchito mwachangu (chifukwa cha mgwirizano wa ACE zoletsa ndi ma diuretic zida), ndiye chifukwa chake muyenera kutengera "Kaptopres" mosamala. Ngati mavuto akwera pang'onopang'ono, ndiye kuti mutha kuchita monga "Captopril", "Kaptopres" ikuyenera kugwiritsidwa ntchito pongoganiza kuti ndiopanikizika kwambiri, kapena ngati ziwonetserozo zikupitilira 180 pa 100 mm RT. Art.

Moyenera, ngati mlingo wa mankhwalawa udzatsimikizidwa ndi katswiri. Nthawi zambiri, adotolo amakupangira "Kaptopres", poganizira izi:

• kuopsa kwa vuto la wodwala,
• kufunika kuchepetsa magazi,
• mphamvu ya impso ndi chiwindi (ngati pali ma pathologies, kuchuluka kochepa komwe kumagwiritsidwa ntchito),
• kukhalapo kwa matenda ophatikizika ndi kugwiritsa ntchito mankhwala ena.

"Kaptopres" pakuwapanikizika kwakukulu imatengedwa malinga ndi dongosolo lotsatira:

1. Mapiritsi aledzera osachepera ola limodzi asanadye. Izi zimapewa kuchepetsa kuyamwa kwa zida zogwira ntchito.
2. Njira ya kukonza mankhwalawa nthawi zambiri imayamba ndi hafu ya theka: nthawi 1 patsiku, theka la piritsi limodzi ndi muyezo.
3. Popanda achire zotsatira zake, kuchuluka kwa mankhwalawa kumawonjezeka pakapita nthawi. Pankhaniyi, wodwalayo amamwa piritsi limodzi patsiku.
4. Kutenga "ma Kaptopres" ndibwino nthawi imodzi. Mapiritsiwo amameza popanda kutafuna. Muyenera kumwa madzi ambiri.

Ngati mapiritsi adayikidwa kuti amwe kamodzi patsiku, ndiye kuti Kaptopres ndi bwino kumwa m'mawa

Mankhwala nthawi zambiri amaikidwa mu maphunziro, komanso motalika. Malinga ndi kuwunika kwa madotolo ndi odwala omwe amatenga "Kaptopres", njira yayitali kwambiri yochizira imawonedwa miyezi 1.5-2 kuyambira maphunziro atayamba.

Ngati ndi kotheka, kusintha kwa mlingo kumachitika pang'onopang'ono kwa miyezi 1.5. Kusintha kwake kumakhala machitidwe pamene Kaptopres imachotsedwa pazifukwa zosiyanasiyana, kapena ngati imagwiritsidwa ntchito muyezo wowonjezera pakuletsa vuto la matenda oopsa.

Mukamagwiritsa ntchito "Kaptopres" pochiza matenda oopsa, ndikofunikira kulabadira zoletsa zaka:

• mankhwalawa sagwiritsidwa ntchito kuchepetsa kukakamiza odwala osaposa zaka 18,
• Kwa odwala azaka zapakati pa 65 ndi kupitilira, "Kaptopres" imayikidwa mosamala kwambiri, kutengera kuwunika kwa vutoli.

Matenda oopsa a arterial ndi kuthamanga kwa magazi komwe kumachitika chifukwa cha vasospasm yomwe imapangitsa magazi kuyenda movutikira.

Pakadali pano, pali zinthu zingapo zomwe zimapangitsa kukula kwa matenda oopsa, kuphatikiza kusintha kobwera ndi zaka, kusachita masewera olimbitsa thupi, kudya kosasamala, kugwiritsa ntchito mankhwala osokoneza bongo, kupezeka kwa zizolowezi zoipa, chibadwidwe, matenda omwe amapezeka komanso kupezeka kwa kuchuluka kwambiri.

Madokotala amayanjana ndi kukhazikitsidwa kwa matendawa ndikuphwanya zinthu zomwe zimayang'anira kayendedwe ka mtima. Komanso, chifukwa chachikulu cha kuonekera kwa matendawa ndi chibadwa.

Pali njira zambiri zothanirana ndi matendawa, yoyamba yomwe ndi mankhwala omwe amagwiritsidwa ntchito ngati mankhwala. Chimodzi mwazithandizo zabwino zoterezi ndi ma Kaptopres, omwe amafananizidwa ndi mankhwala ena aliwonse.

Ma Captopres ndi othandizira antihypertensive, omwe amapanga zinthu ziwiri - Captopril ndi hydrochlorothiazide.

Mankhwalawa amapezeka m'mapiritsi, omwe amatchulidwa kuti ali ndi vuto lotsegula m'mimba. Zotsatira zabwino mthupi ndi zochizira zimachitika chifukwa cha mankhwala omwe amapezeka pazomwe zimapangidwa.

Gawo loyamba lotchedwa Captopril ndi chinthu cha gulu la angiotensin-otembenuza enzyme zoletsa. Chifukwa cha izi, thupi limakhala ndi zopindulitsa chifukwa kuchepa kwa kuthamanga kwa magazi komanso kuchepa kwa kukana kwamitsempha.

Gawo lachiwiri, lotchedwa hydrochlorothiazide, ndi diazitrate ya thiazide yomwe imathandizira kuchotsa kwamadzi ndi ma ayoni a sodium, chlorine ndi potaziyamu. Kuchita ndi chinthu choyambirira, kumangowonjezera zotsatira zake.

Mankhwala tikulimbikitsidwa kuti atenge ola limodzi musanadye, chifukwa mkati mwake, kuyamwa kwa ziwalo za munthu kumachepetsedwa kwambiri.

Mlingo woyenera uyenera kusankhidwa ndi adokotala okha.

Mlingo woyamba uyenera kuyamba ndi theka la piritsi limodzi kamodzi patsiku. Kuphatikiza apo, mankhwalawa amayenera kumwedwa motere: mankhwalawa akukonzekera amatha kukhala piritsi limodzi kamodzi patsiku.

Njira yodziwika bwino yodziwika bwino yodziwika bwino ikhoza kudziwika miyezi iwiri yokha atatha kumwa mankhwalawa. Kukonzanso mlingo womwe ulipo kungachitike pokhapokha masabata asanu ndi limodzi.

Kaptopres ilinso ndi zotsutsana, zomwe zimayenera kukumbukiridwa:

• angioedema yomwe idachitika mankhwala a ACE zoletsa,
• kobadwa nako
• otsika a ion a potaziyamu m'magazi,
• kutaya kwa sodium ndi madzi amchere,
• gout
• calcium yambiri
• porphyria
• mimba ndi mkaka wa m`mawere
• kugawa kwambiri aldosterone,
• kusokonezeka kwakukulu ndi kutchulidwa kwa magwiridwe antchito a ziwalo za zotumphukira,
• chilolezo
• stenosis yamitundu iwiri ya impso kapena stenosis ya mtsempha wama impso womwe umayamba ndi azotemia,
• zovuta pambuyo kupatsirana kwa impso,
• kusowa kwa mkodzo mu chikhodzodzo.
• zosokoneza zomwe zimalepheretsa kutuluka kwa magazi kuchokera kumanzere am'mimba,
• kukhudzika kwakukulu pazigawo za mankhwala, makamaka zazikuluzikulu,
• tsankho kwa anthu
• Kugwiritsa ntchito bwino kwa chiwindi pakakhala vuto kapena kumapangitsa kuti pakhale kupha.

Mukumwa mankhwalawa, odwala adanenanso izi:

• nseru
• kusanza
• kuchepa kwakudya,
• kupweteka kwa epigastric
• kamwa yowuma
• stomatitis
• zilonda zam'mimba
• jaundice
• chiwindi
• tachycardia ndi angina pectoris,
• khungu
• kupweteka kwambiri m'mutu
• urticaria
• Matenda a stool, makamaka kudzimbidwa ndi matenda otsekula m'mimba,
• mwa amuna, kuchepa kwa chilakolako chogonana komanso kusowa kwa mamangidwe,
• kutentha kwambiri kwa thupi
• hemoglobin wotsika
• kulephera kwa aimpso.

Pogwiritsa ntchito mankhwala kwa nthawi yayitali pang'ono,

Ngati maonekedwe osasangalatsa adanyalanyazidwa, ndipo wodwalayo sanachepetse mulingo, ndiye kuti atha kufotokozera za kuledzera ndi hydrochlorothiazide.

Zotsatira monga kuphwanya mulingo wamchere wamadzi ndi kukhazikika kwa chikhe sizimadziwikiratu. Izi ndichifukwa chakuti mankhwalawa amakhudza kwambiri dongosolo lamanjenje lamunthu.

Ngati bongo ndi wodwala, wodwalayo ayenera mwachangu kutsuka m'mimba ndi kupereka enterosorbents.

Ngati pakufunika, ndiye kuti mankhwalawa apadera. Ngati poyizoni wamphamvu alipo, ndiye kuti kuchipatala kwa amene akuzunzidwayo nkofunika.

Mitundu yosiyanasiyana ya chithandizo choyamba kwa wodwala imaphatikizapo hemodialysis yomweyo. Kuphatikiza apo, ndikofunikira kupereka njira zomwe zingathandize kubwezeretsanso komanso kusungabe bwino wamagetsi.

Contraindations ku Akkupro

Acupro imaphatikizidwa mwa ana ndi achinyamata osakwana zaka 18, odwala omwe ali ndi mbiri ya angioedema, yomwe imalumikizidwa ndi ACE inhibitor therapy, komanso kukulira chidwi kwa wodwala kwa gawo lililonse la mankhwalawa.

Mochenjera, Akkupro adalembedwa ngati pali mbiri ya angioedema ngati sichikugwirizana ndi ACE inhibitors, ndi mtima kulephera kwambiri ndi chiopsezo chachikulu cha hypotension, ndi hyperkalemia, kuchepa kwa BCC, aortic stenosis, vuto pambuyo pakuwonjezeka kwa impso, kuletsa mafupa a hematopoiesis, ovuta kwambiri. matenda a autoimmune a minofu yolumikizana, matenda a shuga, chiwindi kapena impso ntchito ndi njira zambiri zochitira opaleshoni.

Mlingo ndi makonzedwe a Akkupro

Pochiza matenda oopsa, odwala omwe salandira okodzetsa amapatsidwa mankhwala 10 mg kapena 20 mg kamodzi patsiku. Mlingo utha kuwonjezeka kutengera ndi mankhwalawa. Mlingo wokonza ndi 20 kapena 40 mg patsiku, womwe nthawi zambiri umafotokozedwa mu umodzi kapena iwiri. Mlingo umasintha pakadutsa milungu inayi. Nthawi zambiri, ndikotheka kukwaniritsa kuthamanga kwa magazi nthawi yayitali pogwiritsa ntchito Accupro 1 nthawi patsiku. Mulingo wovomerezeka tsiku lililonse ndi 80 mg.

Odwala omwe akupitiliza kukodzetsa amayamba kupatsidwa 5 mg ya mankhwalawa, pambuyo pake mankhwalawa amawonjezedwa mpaka zotsatira zabwino zithe.

Kugwiritsa ntchito kwa Accupro kwa odwala omwe ali ndi vuto la mtima nthawi yayitali kumasonyezedwa ngati gawo la zovuta kuchiritsa ndi okodzetsa komanso / kapena mtima glycosides. Pankhaniyi, mlingo woyambirira ndi 5 mg 1 kapena 2 pa tsiku. Ngati mankhwalawa amalekeredwa bwino, muyezowo utha kuwonjezeka mpaka 10-40 mg wa tsiku lililonse 2 Mlingo wofanana.

Ndikulimbikitsidwa kuti muyambe kugwiritsa ntchito mankhwala a Akkupro mwa odwala omwe ali ndi vuto la Impso ndi 5 mg kamodzi pa tsiku. Tsiku lotsatira, ngati kulekerera kwa mlingo woyambirira kuli kwabwino, Mlingo wachiwiri patsiku ukhoza kutumikiridwa. Pangakhale kusokonezeka kwa impso kapena ochepa hypotension, mlingo umatha kuchuluka pakadutsa sabata lililonse.

Odwala okalamba, mlingo woyambira wa 10 mg ndi tsiku. Pambuyo pake, zitha kukulira kuti zitheke kwambiri.

Malangizo apadera

Zidadziwika kuti panthawi ya chithandizo ndi ACE inhibitors, angioedema ndiyotheka (0.1% ya milandu). Ngati angioedema a lilime, nkhope, kapena epiglottis amapezeka, chithandizo cha Acupro ziyenera kuyimitsidwa nthawi yomweyo. Wodwala amayenera kupatsidwa chithandizo choyenera ndikuchisunga mpaka edema itasiya. Kutupa kwa milomo ndi nkhope nthawi zambiri kumatha popanda chithandizo chapadera, koma antihistamines angagwiritsidwe ntchito kuchepetsa zizindikiro. Laryngeal edema imatha kupha. Ngati pali chiwopsezo cha kutsekeka kwa ndege, chithandizo chadzidzidzi chimafunikira, kuphatikizapo kuyambitsa adrenaline ndi njira zina.

Mankhwala ndi mankhwalawa, angioedema wamatumbo amatha kuyamba, kuwonetseredwa ndi kupweteka kwam'mimba popanda mseru komanso kusanza. Zizindikiro zinazimiririka atasiya kuyimitsa ACE.

Odwala omwe amalandira zoletsa za ACE panthawi ya mankhwala a Hymenophera poops amatha kukhala ndi chiopsezo cha anaphylactic.Odwala omwe amatenga okodzetsa, makonzedwe a Accupro angayambitse kukula kwa chizindikiro cha hypotension. Ngati wodwala akufunika mankhwala okodzetsa, ayenera kusiyidwa masiku atatu asanayambe Acupro.

Odwala ochepa matenda oopsa omwe ali ndi unilateral kapena iwiri-aimpso mtsempha wamagazi, mankhwalawa ndi Accupro angayambitse kuchuluka kwa serum creatinine ndi urea nayitrogeni m'magazi. Kusintha kotereku kumatha pambuyo pakutha kwa mankhwalawo. Pankhaniyi, ntchito ya impso iyenera kuyang'aniridwa pakatha milungu ingapo yoyambirira.