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 20 kg ndi 50 kg, kawirikawiri mlingo umodzi ndi 50 mg 1 nthawi patsiku. Mwachilendo, mlingo umatha kupititsidwa mpaka -100 mg 1 nthawi patsiku. Kugwiritsa ntchito Mlingo wopitilira 1.4 mg / kg) kapena 100 mg) patsiku, silinaphunziridwe ana.Losartan silivomerezeka kuti lizigwiritsidwa ntchito mwa ana ochepera zaka 6, popeza palibe chidziwitso chokwanira pakugwiritsa ntchito mankhwalawa pagulu la odwala.
Mankhwala osavomerezeka kwa ana omwe ali ndi kusefukira kwa msana wa 5.5 mmol / l) adawonedwa mu 1.5% ya odwala omwe ali ndi matenda oopsa.
Odwala omwe ali ndi kumanzere kwamitsempha yamagazi

Kuchokera kumbali ya chiwalo chothandizira kumva komanso moyenera: nthawi zambiri - vertigo.

Kulephera kwamtima kosalekeza
Kuchokera kwamanjenje: pafupipafupi - chizungulire, kupweteka mutu, kawirikawiri - paresthesia.
Kuchokera kumbali yamtima: kawirikawiri - syncope, atrive fibrillation, stroke.
Kuchokera mtima dongosolo: pafupipafupi - ochepa hypotension, kuphatikizapo orthostatic hypotension.
Matenda opatsirana, thoracic komanso ma mediastinal: pafupipafupi - dyspnea.
Kuchokera mmimba thirakiti: pafupipafupi - kutsegula m'mimba, kusanza, kusanza.
Pa khungu ndi subcutaneous zimakhala: pafupipafupi - urticaria, kuyabwa, zotupa.
Zomwe zimachitika ndi zovuta zomwe zimakhudzana ndi njira yogwiritsira ntchito mankhwalawa: pafupipafupi - asthenia / kufooka.
Zowonetsa zasayansi: pafupipafupi - kuchuluka kwa urea, creatinine mu seramu ndi potaziyamu mu seramu.

AH ndi mtundu II matenda a shuga komanso matenda a impso
Kuchokera kwamanjenje: kawirikawiri - chizungulire.
Kuchokera mtima dongosolo: Nthawi zambiri - ochepa hypotension.
Zambiri ndi zovuta zomwe zimakhudzana ndi njira yogwiritsira ntchito mankhwalawa: nthawi zambiri - asthenia / kufooka.
Zizindikiro zasayansi: nthawi zambiri - hypoglycemia, hyperkalemia.
Zotsatira zotsatirazi zidachitika pafupipafupi kwa odwala omwe amatenga mankhwala osokoneza bongo kuposa odwala omwe ali mu gulu la placebo:
Kuchokera ku magazi ndi dongosolo la lymphatic: losadziwika - kuchepa kwa magazi.
Kuchokera kumbali yamtima: chosadziwika - syncope, palpitation.
Kuchokera mtima dongosolo: losadziwika - orthostatic ochepa ochepa hypotension.
Kuchokera pamimba yogaya: osadziwika - kutsegula m'mimba.
Kuchokera ku minculoskeletal system ndi minofu yolumikizika: chosadziwika - kupweteka kumbuyo.
Kuchokera impso ndi kwamikodzo thirakiti: chosadziwika - matenda a kwamikodzo.
Matenda ambiri ndi zovuta zomwe zimakhudzana ndi njira yogwiritsira ntchito mankhwalawa: zizindikiro zosadziwika - ngati chimfine.
Zizindikiro zasayansi: odwala omwe ali ndi matenda a 2 a shuga ndi nephropathy omwe amathandizidwa ndi mapiritsi a losartan anali ndi hyperkalemia> 5.5 mEq / L poyerekeza ndi odwala omwe ali m'gulu la placebo.

Kuyang'anira pambuyo pa malonda
Powona zotsatsa pambuyo pazotsatsa, zotsatirapo zoyipa zidanenedwa:
Kuchokera ku magazi ndi dongosolo la lymphatic: losadziwika - kuchepa magazi, thrombocytopenia.
Kuchokera kumbali ya chiwalo chakumva ndi maze: chosadziwika - kulira m'makutu.
Pa mbali ya chitetezo chamthupi: kawirikawiri - hypersensitivity reaction (anaphylactic reaction, angioedema, kuphatikizapo kutupa kwa mphuno ndi glottis, komwe kumayambitsa kutsekeka kwa mpweya ndi / kapena kutupa kwa nkhope, milomo, pharynx ndi / kapena lilime, odwala ena anali ndi mbiri ya angioneurotic) edema, yomwe imagwirizanitsidwa ndi kugwiritsa ntchito mankhwala ena, kuphatikiza ACE inhibitors, vasculitis, kuphatikizapo Shenlain-Genocha purpura.
Kuchokera ku dongosolo lamanjenje: losadziwika - migraine, dysgeusia.
Matenda opatsirana, thoracic komanso mediastinal: osadziwika - chifuwa.
Kuchokera pamimba yam'mimba: Zosadziwika - kutsegula m'mimba, kapamba, kusanza.
Kuchokera ku hepatobiliary system: kawirikawiri - hepatitis, yosadziwika - kuwonongeka kwa chiwindi.
Kuchokera pakhungu ndi minofu yodutsa: yosadziwika - urticaria, pruritus, zidzolo, photosensitivity, erythroderma.

Kuchokera musculoskeletal system ndi minofu yolumikizana: yosadziwika - myalgia, arthralgia, rhabdomyolysis.
Kuchokera ku kubereka ndi ma tezi a tezi: zomwe sizikudziwika - kusowa kwa erectile / kusabala.
Kumbali ya impso ndi kwamkodzo thirakiti: chifukwa cha kuletsa kwa renin-angiotensin-aldosterone, kusintha kwa ntchito yaimpso, kuphatikizapo kulephera kwa aimpso kwa odwala omwe ali pachiwopsezo, akuti, kusintha koteroko kumatha kusintha ngati chithandizo chitha.
Mavuto am'malingaliro: osadziwika - kukhumudwa.
Zizindikiro zasayansi: osadziwika - hyponatremia.
Ana . Mbiri yamomwe ana amakhudzidwira imakhala yofanana ndi ya anthu akuluakulu. Zambiri pazomwe zimachitika mwa ana zimakhala zochepa.

Maganizo ankhondo,
Hyperkalemia
- kusowa kwamadzi,
- tsankho
- galactosemia kapena glucose / galactose malabsorption syndrome,
- mimba
- nthawi yoyambira,
- zaka mpaka 18 (kuchita bwino ndi chitetezo sizinakhazikitsidwe),
- Hypersensitivity kwa losartan ndi / kapena zigawo zina za mankhwala.
Ndi chisamaliro Mankhwala ayenera kugwiritsidwa ntchito kwa hepatic ndi / kapena kulephera kwaimpso, kuchepa kwa BCC, kusowa bwino kwa madzi m'magazi a electrolyte, a revenue stenosis kapena artery stenosis a impso imodzi.

Angioedema
Mwina kupezeka kwa angioedema. Odwala omwe ali ndi edema ya angioneurotic (kutupa kwa nkhope, milomo, khosi, ndi / kapena lilime) ayenera kuwunikidwa pafupipafupi.
Arterial hypotension ndi kusowa kwa madzi mu electrolyte
Zizindikiro zamitsempha. Mikhalidwe yotere imafunikira kukonza musanayambe chithandizo ndi Lorista kapena kutsitsa koyamba kwa mankhwalawo. Malangizo omwewo amagwiranso ntchito kwa ana azaka 6.

Electrolyte kusalinganika
Electrolyte kusalinganika nthawi zambiri kumawonedwa kwa odwala omwe ali ndi vuto la Impso (omwe ali ndi matenda osokoneza bongo kapena opanda shuga), omwe akuyenera kukumbukiridwa.
Pakafukufuku wazachipatala wokhudzana ndi odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga komanso nephropathy, chiwopsezo cha hyperkalemia chinakwera kwambiri ndi losartan poyerekeza ndi gulu la placebo.
Chifukwa chake, muyenera kuyang'anira kuchuluka kwa potaziyamu m'magazi a plasma ndi chilolezo cha creatinine, makamaka odwala omwe ali ndi vuto la mtima ndi chilolezo chaininine 30-50 ml / min.
Kugwiritsa ntchito munthawi yomweyo mankhwala osokoneza bongo a losartan ndi potaziyamu, zothetsera za potaziyamu, zinthu zina zamchere sizili bwino.

Kuwonongeka kwa chiwindi
Kutengera ndi pharmacokinetic data yowonetsa kuwonjezeka kwakukulu kwa kuchuluka kwa losartan m'magazi am'magazi a odwala matenda a chiwindi, kuganiziridwaku kuyenera kuperekedwa kuti muchepetse mlingo wa odwala omwe ali ndi vuto la chiwindi.
Palibe chidziwitso pakugwiritsidwa ntchito kwa losartan kwa odwala omwe ali ndi vuto la chiwindi kwambiri, chifukwa chake, losartan sayenera kumwedwa mwa odwala.
Losartan ali osavomerezeka kuti ana ana vuto la chiwindi ntchito.

Matenda aimpso
Kusintha kwa ntchito zamankhwala kunanenedwapo, kuphatikizapo kulephera kwa aimpso, komwe kumalumikizidwa ndi kuponderezedwa kwa dongosolo la renin-angiotensin (makamaka odwala omwe ali ndi vuto la aimpso-angiotensin-aldosterone, odwala a. .
Mankhwala omwe amakhudzanso dongosolo la renin-angiotensin-aldosterone angayambitse kuchuluka kwa serum urea ndi creatinine mwa odwala omwe ali ndi vuto la impso. Kusintha uku kwa impso kumatha kusinthanso pambuyo pakuchotsa kwamankhwala. Losartan iyenera kugwiritsidwa ntchito mosamala odwala omwe ali ndi vuto la mtima lamitsempha lamitsempha.
Gwiritsani ntchito ana omwe ali ndi vuto laimpso
Losartan ali osavomerezeka kuti agwiritsidwe ntchito mwa ana omwe ali ndi mpweya wosefera

Njira yogwiritsira ntchito

Lorista mankhwala onse osakanikirana ndi mankhwala ena a antihypertensive, komanso monotherapy. Kudya sizikhudzana ndi mayamwa.
Matenda oopsa a arterial (AH):
Mlingo woyambirira wa 50 mg, nthawi zambiri mlingowu ndi wokwanira ngati kukonza. Mlingo wovomerezeka wazakudya za tsiku ndi tsiku ndi 100 mg ya Lorista. Mphamvu yayitali kwambiri ya antihypertensive imatheka ndi masabata 3-6. chithandizo. Odwala omwe ali ndi hypovolemia (mwachitsanzo, akamamwa ma diuretics mu waukulu) kapena kukanika kwa chiwindi, mlingo woyambirira uyenera kuchepetsedwa mpaka 25 mg. Kwa odwala okalamba, odwala omwe amachepetsa impso ndipo / kapena hemodialysis, kusintha kwa mankhwalawa sikofunikira.
Kulephera kwa mtima kosatha:
Pa matenda amtunduwu, kuchepa kwa mankhwalawa (kuchuluka pang'onopang'ono kwa mlingo) kumalimbikitsidwa: sabata yoyamba, 12,5 mg wa Lorista akulimbikitsidwa patsiku, wachiwiri 25 mg wa mankhwala patsiku, kuyambira sabata lachitatu, pakhale mlingo wa 50 mg patsiku.
Kupewa (kupewa) kwa ngozi zamtima, kuphatikizapo zakupha, odwala omwe ali pachiwopsezo chachikulu (matenda oopsa oopsa komanso kumanzere kwamitsempha yamagazi):

Nephropathy ndi proteinuria odwala mtundu 2 matenda oopsa:
Mlingo woyambirira wa Lorista ndi 50 mg, ngati kuli kotheka, mlingowo ukhoza kuwonjezeka mpaka 100 mg.

Kutulutsa Mafomu

• 10 - matuza (3) - mapaketi a makatoni. 30 tabu mu mabizinesi osagwirizana 7 - matuza (14) - mapaketi a makatoni. 7 - matuza (14) - mapaketi a makatoni. 7 - matuza (2) - mapaketi a makatoni. 7 - matuza (4) - mapaketi a makatoni. 7 - matuza (8) - mapaketi a makatoni. 7 - matuza (12) - mapaketi a makatoni. 7 - matuza (14) - mapaketi a makatoni.100 mg + 25 mg mapiritsi okhala ndi mafilimu - 30 tabo. 100 mg + 25 mg mapiritsi okhala ndi mafilimu - 60 mapiritsi kulongedza mapiritsi 30 30 mapiritsi 60 mapiritsi 90 mapiritsi

Kufotokozera za mtundu wa kipimo

• Mapiritsi okhala ndi filimu Ambale mapiritsi, okhala utoto wachikaso kupita pachikasu ndi tint yobiriwira, amawotcha, biconvex pang'ono, ali ndi chiopsezo mbali imodzi. Mapiritsi, omwe amaphatikizidwa ndi utoto kuchokera wachikasu mpaka wachikasu ndimtundu wamtambo wobiriwira, amakhala ozungulira, pang'ono ndi biconvex.

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.

Zomwe zimathandiza

Awa ndi mankhwala othandizira ophatikiza matenda oopsa komanso kulephera kwa mtima.

Woikidwa pamilandu yotsatirayi:

• chachikulu matenda oopsa atakula,
• mankhwalawa matenda a impso mwa achikulire odwala ochepa matenda oopsa ndi mtundu 2 matenda a shuga ndi proteinuria,
• mawonekedwe osalephera a mtima olephera, pamene nkosatheka kugwiritsa ntchito ma othandizawa chifukwa cha tsankho,
• kupewa sitiroko ndi kukwezedwa kwa magazi ndi kutsimikiziridwa kumanzere kwamitsempha yamagazi.

Malo osungira

• sitolo firiji 15-25 madigiri
• osayandikira ana

Lorista N ndi mankhwala ophatikiza antihypertensive okhala ndi kusankha kosankha kwa angiotensin receptor blocker (mtundu wa AT1) losartan ndi thiazide diuretic hydrochlorothiazide. Cholinga chachikulu cha matenda oopsa ndicho kuletsa kukula kwa vuto la mtima, zochitika zam'mtima, kulephera kwa impso, komanso kuchepetsa ngozi ya kufa kwamtima. Popeza kuti mwatsoka lomwe monotherapy nthawi zambiri siligwirizana ndi ntchito yokwaniritsa kuthamangitsidwa kwa magazi, m'zaka zaposachedwa, akatswiri a mtima akudalira kwambiri mankhwala ophatikiza antihypertensive. Kuphatikiza "angiotensin receptor blocker (sartan) + thiazide diuretic" pakali pano kumadziwika kuti ndi imodzi yabwino kwambiri. Pokhala ndi machitidwe ofanana ofanana ndi kuphatikiza "angiotensin-kutembenuza enzyme inhibitor (ACE inhibitor) + thiazide diuretic", "kusakaniza" kwamankhwala awa kuli ndiubwino wosapindulitsa woyamba. Chifukwa chake, mosiyana ndi ACE inhibitors, ma sartans amapereka kutsekeka kwathunthu kwa "ma cell" zotsatira za renin-angiotensin-aldosterone system. Amakhalanso ndi kulolera bwino, popanda kuyambitsa, mosiyana ndi ACE inhibitors, chifuwa chowuma chopumira ndi angioedema chifukwa chodzikundikira bradykinin owonjezera mthupi. Zotsatira za mayeso azachipatala a multicenter osasinthika zawonetsa kufunikira kwakukulu kwa osowa mu matenda oopsa. Masiku ano a Sartan ali ndi imodzi mwamaudindo apamwamba kwambiri pakulimbikitsa matenda padziko lonse lapansi, kukhala mankhwala oyambira oyenerera omwe amapitiliza kuperekanso mankhwala ena mosalekeza. A Lorista N a ku kampani yopanga mankhwala ku Slovenia Krka adatulukira mdziko lathu mchaka cha 2008 ndipo pofika pano atha kale kulemekeza madokotala komanso kukhulupirika kwa odwala. Makina a lorista N amatengera luso la losartan (tiyeni tisiye hydrochlorothiazide pakali pano) kuti tipeze mwayi wa angiotensin II ku zolandilira "zomwe", chifukwa amazindikira kuthekera kwa vasopressor.

Zotsatira zake, mankhwalawa amayambitsa kupuma kwamitsempha yamagazi, kutsekeka koyamba komanso pambuyo pake pa myocardium, kufalikira kwamitsempha yamagazi ndikutchingira kumanzere kwamitsempha. Mosiyana ndi mankhwala ena a antihypertensive, a Lorista N ali ndi uricosuric, samawononga ntchito ya erectile, amawonetsa katundu wotsutsana ndi yotupa komanso antiaggregant (antithrombotic), ndikuwongolera ntchito zazidziwitso (zazidziwitso). Kuchita bwino komanso kwabwino kwa chitetezo cha Lorista N kudatsimikiziridwa osati mayeso azachipatala okha, komanso nthawi ya maphunziro a malonda atachitika, i.e. mankhwala atalowa m'msika. Pambuyo pakukonzekera pakamwa, losartan imatengedwa mwachangu m'mimba. Kachitidwe kake ka bioavailability ndi 33%, komwe kumalumikizidwa ndi mphamvu ya gawo loyambirira kudzera pachiwindi. Chiwonetsero chachikulu cha osowa m'magazi chinajambulidwa ola limodzi pambuyo pa makonzedwe. Lorista N angagwiritsidwe ntchito mosasamala kanthu za chakudya. Gawo lachiwiri la mankhwalawa - a thiazide diuretic hydrochlorothiazide - amalepheretsa kuyamwa kwa distal nephron wa sodium ions, ndi chlorine, komanso madzi ndi potaziyamu, magnesium ndi calcium ion. Mphamvu yake yotsutsa antihypertensive imachitika chifukwa cha kukula kwa ma arterioles. Mphamvu ya diuretic imawonedwa pakatha maola 1-2 mutatha kumwa mankhwalawa, imafikira pakatha maola 4 ndipo imatenga maola 12. Mlingo woyambirira (komanso wothandizira) wa lorista N wokhudzana ndi matenda oopsa ndi piritsi 1 nthawi imodzi patsiku. Achire achire kwambiri amayenera kuyembekezeredwa m'milungu itatu yoyambirira ya pharmacotherapy. Ndi osakwanira mankhwalawa, mankhwalawa amatha kuwonjezeredwa kumapiritsi awiri. Lorista N amayenda bwino ndi mankhwala ena a antihypertensive. Odwala okalamba safuna kusintha kwa mlingo. Kupezeka kwa hydrochlorothiazide pakukonzekera kumawonjezera chiopsezo cha hypotension ndi kusokonezeka kwa mchere wamchere.

Ndi chisamaliro

Chisamaliro makamaka chiyenera kulipidwa popereka mankhwala kwa ana ndi achinyamata osakwana zaka 18 chifukwa chodziwa zochepa zomwe zimapangitsa thupi la ana komanso kakulidwe kake.

Mosamala ndi kuyang'aniridwa ndi ogwira ntchito zachipatala, ndalama zimatengedwa panthawi yochepetsetsa yamitsempha yamafupa, pambuyo pake ndikuwonjezera impso, pakuchepa kwa aorta kapena mitral valavu, makulidwe a khoma lamanzere kapena lamanja lamtima, matenda aimpso ofooka, kulephera kwa mtima, matenda amitsempha yamagazi, matenda amitsempha yama ubongo, kuchuluka kwa aldosterone, kumwa mankhwala ambiri okodzetsa.

Momwe mungatenge Lorista 12.5

Tengani pakamwa kamodzi patsiku, osayang'ana kwambiri pakudya (kale, pambuyo pa chakudya).

Makonda omwe angathe kupezeka molumikizana ndi mankhwala ena a antihypertensive.

Ndi kuthamanga kwa magazi, 50 mg imayikidwa koyamba, kenako, monga momwe odwala ena alili, mlingo umawonjezeka mpaka 100 mg patsiku.

Mu matenda a chiwindi, kutengera kuuma kwawo ndi maphunziridwe awo, kuchuluka kwa mankhwalawa nthawi zina kumachepetsedwa mpaka 25 mg patsiku.

Kulephera kwa mtima kosatha, poyamba perekani 12,5 mg patsiku, kenako ndikuchulukitsa mpaka 150 mg patsiku, nthawi iliyonse kumachulukitsa mlingo kawiri ndi sabata. Kukhazikitsidwa kwa makonzedwe oterowo kumalimbikitsidwa limodzi ndi okodzetsa ndi mtima wama glycosides.

Tengani pakamwa kamodzi patsiku, osayang'ana kwambiri pakudya (kale, pambuyo pa chakudya).

Ndi matenda ashuga

Ngati wodwala ali ndi matenda amtundu II omwe amakhala ndi mapuloteni owonjezereka mkodzo, kuti muchepetse kusowa kwa dialysis ndi kufa, mlingo woyambirira wa mankhwalawa udzakhala 50 mg ndi chiwonjezeko chamtsogolo mpaka 100 mg patsiku kutengera momwe angachepetse kuthamanga kwa magazi. Kulandila ndi insulin ndi mankhwala omwe amachepetsa shuga (glitazone, etc.). Amaloledwa kutenga diuretics ndi mankhwala ena a antihypertensive.

Zotsatira zoyipa

Zotsatira zoyipa zochepa zimakhala mu mankhwala, koma pali zina zomwe zimakhala zosakwanira mthupi kuchokera ku ziwalo zosiyanasiyana. Chifukwa chake, dongosolo la mtima limatha kuyankha ndi kuthamanga kwa mtima, kusinthasintha kwa mtima, etc.

Kuchulukana kwamkati, kutupa kwa larynx ndi bronchi, kukokana, kupweteka m'mbuyo, miyendo ndi minofu, komanso kuphwanya malire amagetsi a m'magazi. Koma nthawi zambiri mayankho ake amakhala ofooka komanso opitilira nthawi kotero kuti kusintha kapena kusintha kwa mankhwala sikofunikira.

Pharmacology

Wophatikiza antihypertensive mankhwala.

Losartan ndi mdani wosankha wa angiotensin II receptors mtundu II AT wopanda mapuloteni.

Mu vivo ndi vitro, losartan ndi yogwira popanga carboxy metabolite (EXP-3174) imalepheretsa zovuta zonse za thupi mwatsatanetsatane wa angiotensin II pa AT 1 receptors, mosasamala kanthu ndi kapangidwe kake: kumapangitsa kuwonjezeka kwa ntchito ya plasma ndi kuchepa kwa kuchuluka kwa aldosterone m'madzi a m'magazi.

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 kufalikira kwa m'mapapo, kumachepetsa kulumikizana, kumakhala ndi diuretic.

Zimasokoneza kukula kwa hypertrophy ya myocardial, kumawonjezera kulolera kwa odwala omwe ali ndi vuto la mtima.

Kutenga losartan 1 nthawi / tsiku kumabweretsa kutsika kwakukulu mu systolic ndi diastolic magazi. Masana, wolartan wogawana amawongolera kuthamanga kwa magazi, pomwe mphamvu ya antihypertgency imafanana ndi mtundu wa masinthidwe achilengedwe. 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 bwino ntchito mwa amuna ndi akazi, komanso achikulire (≥ zaka 65) ndi odwala ang'onoang'ono (≤ zaka 65).

Hydrochlorothiazide ndi thiazide diuretic yemwe diuretic yake imalumikizidwa ndi kuphwanya kwa reabsorption wa sodium, chlorine, potaziyamu, magnesium, madzi a ayoni ku distal nephron, akuchepetsa mawonekedwe a calcium ions, uric acid. Ili ndi antihypertensive katundu, hypotensive zotsatira zimayamba chifukwa cha kukula kwa arterioles. Pafupifupi palibe vuto lililonse pamagazi. Mphamvu ya diuretic imachitika pambuyo pa maola 1-2, imafika pakatha maola 4 ndipo imatha maola 6-12.

Mphamvu ya antihypertensive imachitika patatha masiku 3-4, koma zimatha kutenga masabata 3-4 kuti zitheke bwino.

Malangizo apadera

Odwala omwe adakumana ndi zovuta zam'mbuyomu, chiwindi kapena matenda a impso ayenera kulandira chithandizo chokhazikitsidwa ndi dokotala komanso pazifukwa zaumoyo.

Mankhwalawa sayenera kugwiritsidwa ntchito ndi odwala limodzi ndi aliskiren kapena aliskiren okhala ndi matenda a shuga.

Gwiritsani ntchito pa nthawi yoyembekezera

Pa nthawi yobereka komanso yoyamwitsa, mankhwalawa sanakhazikitsidwe, ndipo mimba ikakhazikitsidwa, imathetsedwa nthawi yomweyo, chifukwa pali chiopsezo cha mwana wosabadwayo (hypoplasia yamapapu ndi chigaza, kusinthika kwa mafupa, kupatsanso impso kwa mwana wosabadwayo, etc.). Zokhudza momwe ana akhanda a mankhwala omwe amapezeka mkaka wa m'mawere sanaphunzirepo, ndiye chifukwa chake simuyenera kugwiritsa ntchito chifukwa chosadziwika momwe thupi la mwana limayendera.

Mukamayamwa, mankhwalawa saikidwa mankhwala.

Kuchita ndi mankhwala ena

Imagwirizana bwino ndi hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital ndi ena ambiri. Mankhwala osokoneza bongo a potaziyamu osagwirizana ndi kukonzekera kwa potaziyamu (Triamteren, Amiloride, ndi zina) angapangitse kuwonjezeka kwa chinthuchi m'magazi. Kuphatikiza ndi mankhwala osapweteka a antiidal

Zowotchera zowopsa kuphatikiza ndi losartan zimabweretsa kutsika kosalamulira kwa kupanikizika m'mitsempha.

Kulandiridwa ndi mankhwala ena a antihypertgency kungachepetse kuthamanga kwa magazi.

Mankhwala omwe amathandizira RAAS (Captopril, Lisinopril, ndi ena otero) amatha kusokoneza ntchito ya impso ndikukulitsa zomwe zili urea ndi creatinine malinga ndi magawo a labotale.

Kuyenderana ndi mowa

Popewa zosafunikira zamagetsi pamtima sizingakhale pamodzi ndi zakumwa zoledzeretsa. Kugwiritsa ntchito nthawi imodzi kumatha kubweretsa kuchepa kwambiri kwa kuthamanga kwa magazi, kuphwanya ntchito zam'mimba, chiwindi, ndi impso.

1. Angizar (India).
2. Gizaar (USA).
3. Cardomin-Sanovel (Turkey).
4. Losartan (Israel).
5. Lozarel (Switzerland).
6. Lorista ND (Slovenia).
7. Lozap kuphatikiza (Czech Republic).
8. Erinorm (Serbia).

Omvera zamtima

Arina Ivanovna, katswiri wamtima, Omsk

Mukamamwa mankhwalawa, ndikofunikira kuganizira za contraindication ndi nuances ambiri a kumwa. Ndikofunikira mosamala kwambiri kuti mukhale ndi anthu omwe ali ndi vuto la impso, osalolera kwa gawo lalikulu, omwe ali ndi matenda a mtima, pakati komanso kuyamwitsa. Ndikofunika kuchenjeza kuti kumapeto kwa maphunzirowa kumapeto kwa maphunzirowa ndikofunikira kupewa kumwa kwa nthawi yonse ya mankhwalawa ndikulanda kwa masiku 5-7 mutatha kumwa mapiritsi kuti chinthu chithe m'thupi.

Pavel Anatolyevich, katswiri wamtima, Samara

Amagwiritsidwa ntchito makamaka kuphatikiza ndi mankhwala ena, ndipo monga kudzipatula sikumawonetsa kuyeserera kwakukulu. Khalidwe lofunika lomwe ndimaona kuti nditha kuteteza impso mwa odwala omwe ali ndi matenda a shuga a 2 omwe ali ndi proteinuria. Mtengo ndiwofatsa, zomwe zimapangitsa kuti mankhwalawo akhale okwera mtengo pafupifupi pafupifupi magulu onse odwala.

Choyipa chake ndi embryotoxicity yapamwamba, zomwe zimapangitsa kuti zikhale zosavuta kugwiritsa ntchito nthawi ya pakati.

Alexey Stepanovich, katswiri wa zamtima, Norilsk

Malinga ndi odwala, imalekeredwa bwino, kupanikizika kumachepa pang'onopang'ono komanso modekha, koyenera kwa achinyamata ndi okalamba.

Ndinaona zoyipa kamodzi kokha - bambo wazaka 49 anayamba kumva kuti ali ndi chizungulire, chifukwa chomwe sakanatha kuyendetsa galimoto. Pankhaniyi, mankhwalawa adasinthidwa.

Andrey, wazaka 30, Kursk

Adamwa mapiritsi monga adanenera ndi mtima. Mlingo woyambayo unali 50 mg, kenako pang'onopang'ono unakwera mpaka 150 mg. Zimagwira bwino, kunalibe mavuto. Ndipo mtengo wake siwokwera kwambiri.

Olga, wazaka 25, Aktyubinsk

Dziwani za ngozi yanu yopezeka ndi matenda ashuga!

Tengani mayeso aulere pa intaneti kuchokera kwa endocrinologists odziwa ntchito

Nthawi yoyesa osaposa mphindi ziwiri

7 zosavuta
za nkhani

94% kulondola
kuyesa

Zikwi 10 zopambana
kuyesa

Anapatsidwa amayi kuti ateteze impso, chifukwa ali ndi matenda a shuga. Malinga ndikuwona, amayi adamva bwino: kupanikizika kumakhala kosakhazikika. Ndipo kuwunika pakuwunikira, kuchuluka kwa mapuloteni mumkodzo kunachepa. Mankhwalawa adapita mwangwiro ndipo osakhala ndi zotsatirapo zoyipa zakumwa nawo adazindikira.

Kutulutsa Fomu

Mapiritsi, omwe amaphatikizidwa ndi utoto wachikasu mpaka wachikasu ndi utoto wonyezimira, amakhala ozungulira, pang'ono ndi biconvex.

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

Zomwe zimapanga filimu ya kanema: 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.

Mankhwala amatengedwa pakamwa, ngakhale chakudyacho. Lorista N akhoza kuphatikizidwa ndi othandizira ena othandizira.

Ndi ochepa matenda oopsa, oyambira ndi okonzanso mlingo ndi 1 tabu. 1 nthawi / tsiku Mulingo wambiri wa antihypertensive umatheka mkati mwa masabata atatu a mankhwala. Kuti mukwaniritse kutchulidwa kokwanira, ndizotheka kuwonjezera kuchuluka kwa mankhwalawa 2 tab. 1 nthawi / tsiku Pazipita tsiku lililonse mapiritsi awiri.

Ndi BCC yochepetsedwa (mwachitsanzo, motsutsana ndi kumbuyo kwa kutenga ma diuretics muyezo waukulu), mlingo woyambira wa osartan wodwala ndi 25o 1 nthawi / tsiku. Pankhaniyi, chithandizo cha Lorista N chiyenera kuyambitsidwa pambuyo poti ma okisitiwo athe ndipo ma hypovolemia adakonzedwa.

Odwala okalamba komanso odwala omwe ali ndi vuto lochepetsa aimpso (CC 30-50 ml / min), kuphatikiza odwala omwe ali ndi dialysis, palibe kusintha koyamba kwa mankhwala komwe kumafunikira.

Kuchepetsa chiopsezo cha kuchepa kwa mtima ndi kufa kwa odwala omwe ali ndi vuto losakanizira kwa matenda oopsa ndi kumanzere kwamitsempha yamagazi, muyezo woyambira wa losartan ndi 50 mg 1 nthawi / tsiku. Odwala omwe sanathe kukwaniritsa kuchuluka kwa kuthamanga kwa magazi pomwe akumamwa osapatsa 50 mg / tsiku amafunikira chithandizo ndikuphatikiza losartan ndi milingo yotsika ya hydrochlorothiazide (12.5 mg), ndipo, ngati pakufunika, muwonjezere mlingo wa losartan mpaka 100 mg kuphatikiza hydrochlorothiazide pa mlingo wa 12,5 mg / tsiku, m'tsogolo - onjezerani mankhwala a Lorista N mpaka mapiritsi 2. 1 nthawi / tsiku

Bongo

Zizindikiro: kuchepa kwa kuthamanga kwa magazi, tachycardia, bradycardia chifukwa cha kukondoweza kwa parasympathetic (vagal).

Chithandizo: kukakamiza diuresis, symptomatic mankhwala, hemodialysis sikuthandiza.

Zizindikiro: Zizindikiro zofala kwambiri ndizotsatira za kuchepa kwa electrolyte (hypokalemia, hypochloremia, hyponatremia) ndi kusowa kwamadzi chifukwa cha kuchuluka kwa diuresis. Ndi munthawi yomweyo makonda a glycosides, hypokalemia ikhoza kukulitsa njira ya arrhythmias.

Chithandizo: Chithandizo cha mankhwala.

Momwe mungagwiritsire ntchito Lorista N pa matenda ashuga. Maupangiri a Mankhwala a Geotar

Tsambali lili ndi malangizo ogwiritsa ntchito Achikhulupiriro . Imapezeka m'mitundu yosiyanasiyana ya mankhwalawa (mapiritsi a 12,5 mg, 25 mg, 50 mg ndi 100 mg, N ndi ND kuphatikiza ndi diuretic hydrochlorothiazide), komanso imakhala ndi mitundu yambiri. Izi zimatsimikiziridwa ndi akatswiri. Siyani ndemanga yanu pankhani yogwiritsira ntchito Lorista, yomwe ithandiza alendo ena omwe adzafike pamalopo. Mankhwalawa amagwiritsidwa ntchito pamatenda osiyanasiyana (kuchepetsa kukakamiza kwa matenda oopsa). Chidachi chimakhala ndi zotsatirapo zingapo zoyipa ndi mawonekedwe a kuyanjana ndi zinthu zina. Mlingo umasiyana wa akulu ndi ana. Pali zoletsa kugwiritsa ntchito mankhwalawa pa nthawi yoyembekezera komanso nthawi yochepa. Chithandizo cha a Lorista chitha kuperekedwa ndi dokotala woyenera. Kutalika kwa mankhwalawa kumatha kukhala kosiyanasiyana komanso kutengera matenda enieni.

Malangizo ogwiritsira ntchito ndi mlingo

Mankhwala amatengedwa pakamwa, ngakhale chakudya, pafupipafupi makonzedwe - 1 nthawi patsiku.

Ndi ochepa matenda oopsa, pafupifupi tsiku lililonse 50 mg. Mulingo wambiri wa antihypertensive umatheka mkati mwa masabata 3-6 a mankhwala. Ndikotheka kukwaniritsa kutchulidwa kochulukirapo pakukulitsa mlingo wa mankhwalawa kufika pa 100 mg patsiku kawiri pa mlingo waukulu kapena umodzi.

Mukumwa mankhwala okodzetsa pamiyeso yambiri, tikulimbikitsidwa kuti muyambitse mankhwala a Lorista ndi 25 mg patsiku limodzi.

Okalamba, odwala omwe ali ndi vuto la impso (kuphatikiza odwala pa hemodialysis) safunika kusintha koyamba mankhwalawa.

Odwala omwe ali ndi vuto la chiwindi, mankhwala ayenera kutumikiridwa muyezo wotsikirapo.

Kulephera kwa mtima kosalekeza, muyeso woyamba wa mankhwalawa ndi 12,5 mg tsiku lililonse limodzi. Kuti mukwaniritse njira yokhayo yokonza 50 mg patsiku, mlingo uyenera kuchuluka pang'onopang'ono sabata limodzi (mwachitsanzo, 12,5 mg, 25 mg, 50 mg patsiku). Lorista nthawi zambiri imayikidwa limodzi ndi okodzetsa ndi mtima glycosides.

Kuchepetsa chiopsezo cha matenda opha ziwonetsero kwa omwe ali ndi ochepa matenda oopsa ndipo magazi akumanzere ochepa, 50 mg patsiku. M'tsogolomu, hydrochlorothiazide ikhoza kuwonjezeredwa mu Mlingo wotsika komanso / kapena mlingo wa Lorista ukhoza kuwonjezeka mpaka 100 mg patsiku.

Kuteteza impso kwa odwala omwe ali ndi matenda a shuga a 2 omwe ali ndi proteinuria, muyezo woyambira wa Lorista ndi 50 mg patsiku. Mlingo wa mankhwalawa utha kuwonjezeka mpaka 100 mg patsiku, poganizira kuchepa kwa kuthamanga kwa magazi.

Mapiritsi 12,5 mg, 25 mg, 50 mg ndi 100 mg.

Lorista N (kuwonjezera apo pali 12.5 mg ya hydrochlorothiazide).

Lorista ND (kuwonjezera apo ili ndi 25 mg ya hydrochlorothiazide).

Losartan potaziyamu + woyambitsa.

Potaziyamu losartan + hydrochlorothiazide + Excipients (Lorista N ndi ND).

Lorista - Kusankha angiotensin 2 receptor antagonist mtundu wa AT1 osakhala mapuloteni.

Losartan (yogwira mankhwala ya Lorista) ndi yogwira popanga carboxy metabolite (EXP-3174) imalepheretsa zovuta zonse za thupi za angiotensin 2 pama receptors a AT1, mosasamala kanthu ndi kapangidwe ka kaphatikizidwe kake: kumawonjezera kuchuluka kwa ntchito ya plasma ndi kuchepa kwa kuchuluka kwa aldosterone m'magazi a m'magazi.

Losartan mosayambitsa amachititsa kuyambitsa kwa AT2 receptors powonjezera kuchuluka kwa angiotensin 2. Losartan sikuletsa ntchito ya kininase 2, enzyme yomwe imakhudzidwa ndi metabolism ya bradykinin.

Amachepetsa OPSS, kuthamanga mu kufalikira kwa m'mapapo, kumachepetsa kulumikizana, kumakhala ndi diuretic.

Zimasokoneza kukula kwa hypertrophy ya myocardial, kumawonjezera kulolera kwa odwala omwe ali ndi vuto la mtima.

Kulandila Lorista kamodzi patsiku kumabweretsa kutsika kwakukulu kwa kuchuluka kwa magazi a systolic ndi diastolic. Masana, wolartan wogawana amawongolera kuthamanga kwa magazi, pomwe mphamvu ya antihypertgency imafanana ndi mtundu wa masinthidwe achilengedwe. 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 bwino ntchito mwa amuna ndi akazi, komanso achikulire (≥ zaka 65) ndi odwala ang'onoang'ono (≤ zaka 65).

Hydrochlorothiazide ndi thiazide diuretic yemwe diuretic yake imalumikizidwa ndi kuphwanya kwa reabsorption wa sodium, chlorine, potaziyamu, magnesium, madzi a ayoni ku distal nephron, akuchepetsa mawonekedwe a calcium ions, uric acid. Ili ndi antihypertensive katundu, hypotensive zotsatira zimayamba chifukwa cha kukula kwa arterioles. Pafupifupi palibe vuto lililonse pamagazi. Mphamvu ya diuretic imachitika pambuyo pa maola 1-2, imafika pakatha maola 4 ndipo imatha maola 6-12.

Mphamvu ya antihypertensive imachitika patatha masiku 3-4, koma zimatha kutenga masabata 3-4 kuti zitheke bwino.

Ma pharmacokinetics a losartan ndi hydrochlorothiazide omwe amagwiritsidwa ntchito nthawi imodzi samasiyana ndi omwe amagwiritsidwa ntchito mosiyana.

Amayamwa bwino m'mimba. Kutenga mankhwalawa ndi chakudya kulibe mphamvu pakukhudzidwa kwawoko kwa seramu. Pafupifupi sikulowa mu magazi-ubongo (BBB). Pafupifupi 58% ya mankhwalawa amachotsedwa mu ndulu, 35% - mu mkodzo.

Pambuyo pakamwa, kuphatikiza kwa hydrochlorothiazide ndi 60-80%. Hydrochlorothiazide simapukusidwa ndipo impso mofulumira kwambiri.

• ochepa matenda oopsa
• Kuchepetsa chiopsezo cha matenda opha ziwopsezo cha kuchepa kwa magazi ndi kumanzere kwamitsempha yamagazi,
• Matenda a mtima osachiritsika (monga gawo limodzi la mankhwala, osalolera kapena osagwiritsa ntchito mankhwala a ACE zoletsa),
• kuteteza ntchito ya impso kwa odwala omwe ali ndi mtundu wachiwiri wa matenda osokoneza bongo omwe ali ndi proteinuria kuti achepetse proteinuria, kuchepetsa kupitirira kwa kuwonongeka kwa impso, kuchepetsa mwayi wokhala ndi siteji yoletsa (kuletsa kufunika kwa kupukutira kwina, kuthekera kwa kuchuluka kwa serum creatinine) kapena kufa.

• ochepa hypotension,
• Hyperkalemia
• kusowa kwamadzi
• lactose tsankho,
• galactosemia kapena glucose / galactose malabsorption syndrome,
• mimba
• kuyamwa
• zaka mpaka 18 (Kuchita bwino ndi chitetezo cha ana sizinakhazikike),
• Hypersensitivity kwa losartan ndi / kapena zigawo zina za mankhwala.

Odwala ochepetsedwa magazi ozungulira (mwachitsanzo, munthawi ya mankhwala omwe ali ndi Mlingo wambiri okodzetsa) amatha kukhala ndi chizindikiro cha hypotension. Musanatenge losartan, ndikofunikira kuti muchepetse kuphwanya komwe kuli, kapena yambani ndi mankhwala ochepa.

Odwala omwe ali ndi vuto la chiwindi chofewa komanso cholimbitsa, chiwindi cha losartan ndi metabolite yake yogwira m'magazi am'magazi pambuyo pakukonzekera pamlomo ndiwopamwamba kuposa omwe ali ndi thanzi. Chifukwa chake, odwala omwe ali ndi mbiri ya matenda a chiwindi ayenera kupatsidwa chithandizo chochepa.

Odwala omwe ali ndi vuto la impso, omwe alibe komanso alibe matenda ashuga, matenda oopsa nthawi zambiri amakula, omwe amayenera kukumbukiridwa, koma pokhapokha chifukwa cha izi, chithandizo chimayimitsidwa. Munthawi ya chithandizo, kuchuluka kwa potaziyamu m'magazi kuyenera kuyang'aniridwa pafupipafupi, makamaka odwala okalamba, omwe ali ndi vuto laimpso.

Mankhwala okhala pa renin-angiotensin amatha kuonjezera seramu urea ndi creatinine mwa odwala omwe ali ndi vuto la mtima lamitsempha. Zosintha mu impso zingathe kusintha pambuyo pakuchotsa kwamankhwala. Pa mankhwala, ndikofunikira kuwunika pafupipafupi kuchuluka kwa creatinine mu seramu yamagazi pafupipafupi.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Palibe zambiri pazokhudza Lorista pakutha kuyendetsa magalimoto kapena njira zina zaluso.

• chizungulire
• asthenia
• mutu
• kutopa
• kusowa tulo
• nkhawa
• kugona kusokonezedwa
• kugona
• mavuto amakumbukiro
• zotumphukira neuropathy,
• paresthesia
• hyposthesia
• migraine
• kugwedezeka
• kukhumudwa
• orthostatic hypotension (wodalira mlingo),
• kugunda kwa mtima
• tachycardia
• bradycardia
• arrhythmias
• angina pectoris
• mphuno
• kutsokomola
• bronchitis
• kutupa kwa mphuno,
• kusanza, kusanza,
• kutsegula m'mimba
• kupweteka kwam'mimba
• kukomoka
• kamwa yowuma
• kupweteka kwa dzino
• chisangalalo
• kudzimbidwa
• kondani kukodza
• kuwonongeka kwaimpso,
• yafupika libido
• kusabala
• kukokana
• kupweteka kumbuyo, chifuwa, miyendo,
• kulira m'makutu
• kulakwira
• kuwonongeka kwamawonekedwe
• conjunctivitis
• kuchepa magazi
• Shenlein-Genoch wofiirira
• khungu lowuma
• kutuluka thukuta kwambiri
• alopecia
• gout
• urticaria
• zotupa pakhungu
• angioedema (kuphatikiza kutupa kwa larynx ndi lilime, kuyambitsa kutsekeka kwa mpweya ndi / kapena kutupa kwa nkhope, milomo, pharynx).

Palibe zovuta zamankhwala zomwe zimachitika ndi hydrochlorothiazide, digoxin, anticoagulants, cimetidine, phenobarbital, ketoconazole ndi erythromycin.

Munthawi yogwiritsidwa ntchito palimodzi ndi rifampicin ndi fluconazole, kuchepa kwa metabolite yogwira potaziyamu kunadziwika. Zotsatira zakuchipatala za izi zimadziwika.

Kugwiritsa ntchito munthawi yomweyo ndi potaziyamu woteteza okodzetsa (mwachitsanzo, spironolactone, triamteren, amiloride) ndi potaziyamu kukonzekera kumawonjezera chiopsezo cha hyperkalemia.

Kugwiritsa ntchito munthawi yomweyo mankhwala osapweteka a antiidal, kuphatikizapo COX-2 inhibitors, kungachepetse mphamvu ya okodzetsa komanso mankhwala ena a antihypertensive.

Ngati Lorista adayikidwa nthawi imodzi ndi thiazide diuretics, kuchepa kwa kuthamanga kwa magazi kuli ngati kungowonjezera zachilengedwe. Zowonjezera (kutulutsa) zotsatira zamankhwala ena a antihypertensive (okodzetsa, obeta-blockers, amamu achifundo).

Mndandanda wa mankhwala Lorista

Zofanana muzochitika zamagulu:

• Blocktran
• Brozaar
• Vasotens,
• Vero Losartan
• Zisakar
• Cardomin Sanovel,
• Karzartan
• Cozaar
• Nyanja
• Lozap,
• Lozarel
• Losartan
• Losartan potaziyamu,
• Losacor
• Lotor
• Presartan
• Renicard.

Mimba komanso kuyamwa

Palibe zambiri pakugwiritsa ntchito Lorista panthawi yomwe ali ndi pakati. Kukonzanso kwamkati kwa mwana wosabadwayo, komwe kumatengera kukula kwa dongosolo la renin-angiotensin, amayamba kugwira ntchito mu 3 trimester ya mimba. Kuopsa kwa mwana wosabadwayo kumawonjezeka mukamamwa ma losartan mu 2nd ndi 3 trimesters. Mimba ikakhazikitsidwa, chithandizo cha losartan chimayenera kutha nthawi yomweyo.

Palibe deta pakugawidwa kwa losartan mkaka wa m'mawere. Chifukwa chake, funso losiya kuyamwitsa kapena kuletsa chithandizo chamankhwala ndi losartan liyenera kulingaliridwa chifukwa chakufunika kwake kwa mayi.

Mliri waumunthu wamakono - matenda amtima amayamba kukhala achichepere chaka chilichonse. Malinga ndi ziwerengero, munthu aliyense padziko lapansi pano ali ndi matenda oopsa, ndipo aliyense wokhala padziko lapansi adakumana ndi kuthamanga kwa magazi kamodzi. Mwa mankhwala ambiri omwe alipo chifukwa chothinitsidwa kwambiri, ndikufuna kusankha yomwe idzagwire ntchito ndikubwezeretsa munthuyo ku moyo wabwinobwino. Malangizo ogwiritsira ntchito mankhwalawa Lorista N adzakuthandizani kuti muunikire zabwino ndi zovuta za mankhwalawa, zomwe zingakuthandizeni posankha chithandizo choyenera pamaso pa matenda oopsa.

Gwiritsani ntchito chida chochepetsera kuthamanga kwa magazi pamagazi. The yogwira thunthu - losartan ali ndi matenda oopsa, amachepetsa kuchuluka kwa zotumphukira mtima mavuto ndipo pang'ono diuretic kwenikweni. Gawoli limatetezeranso myocardium kuchokera ku chitukuko cha hypertrophy ndikuwonjezera maluso a anthu mwakuchita masewera olimbitsa thupi.

Kudya kamodzi tsiku lililonse kumathandizira kukhalabe ndi magazi abwinobwino tsiku lonse. Pachimake pantchito zake zimatheka patadutsa maola 4-5 atayamba kumwa.

Kuti akwaniritse kutsikira kwakanthawi kwamankhwala, mankhwalawa amayenera kumwedwa pakatha mwezi umodzi, ndikuyamba koyamba kuonekera tsiku lachitatu lovomerezeka.

Lorista N wachotsedwa - ndi bile pafupifupi 58%, mkodzo - 35%.

• ndi matenda oopsa pamodzi
• Kuchepetsa kufa kwa ochepa matenda oopsa chifukwa chamanzere am'mitsempha yamagazi.

Malangizo ogwiritsira ntchito ndi mlingo

Imwani mankhwalawa m'mawa, kamodzi patsiku, pakamwa, ngakhale mutamwa. Monga lamulo, chithandizo chimaphatikizidwa ndi mankhwala ena omwe amapangidwa kuti achepetse kuthamanga kwa magazi. Imwani piritsi ndi madzi ochepa.

Yambani kumwa ndi 50 mg. Kuchuluka kwa mankhwalawa kumayamba pambuyo pa masabata 3-6 ogwiritsidwa ntchito mosalekeza.

Ngati ndi kotheka, onjezani mlingo mpaka 100 mg, omwe amamwa limodzi kapena awiri Mlingo - m'mawa ndi madzulo.

Ngati chithandizo chikutsatiridwa ndimagwiritsidwe ntchito okodzetsa, ndiye kuti Mlingo woyamba wa Lorista N ndi 25 mg.

Pamaso pa kulephera kwa mtima, mankhwalawa amayamba kumwa ndi 12,5 mg, ndipo mlingo umakulitsidwa pang'onopang'ono mpaka 50 mg. Mwachitsanzo, kwa sabata loyamba, wodwalayo amatenga mankhwalawa 12.5 mg kamodzi patsiku, sabata yachiwiri mlingo umakwezedwa mpaka 25 mg, ndipo sabata lachitatu mpaka 50 mg.

Kuchepetsa chiopsezo cha stroke, mankhwalawa amayamba ndi 50 mg, ndipo patatha milungu iwiri mlingo umachulukitsidwa mpaka 100 mg. Ndondomeko yomweyo ya kumwa mankhwala imaperekedwa kwa odwala omwe ali ndi matenda ashuga a 2.

Pofuna kukonza mankhwala, mankhwalawa amatha kuikidwa moyo wonse.

Zotsatira zoyipa

Mwambiri, mankhwalawa amalekeredwa bwino ndi odwala, komabe, akatengedwa, mavuto omwe amadza ndi omwe amawonekera:

• mutu, migraine ndi chizungulire,
• kusanza ndi kusanza
• nkhawa ndi kugona tulo,
• asthenia
• kutopa ndi kugona,
• kukhumudwa ndi kukumbukira,
• kuphwanya zamkati pamiyendo,
• zala zakunjenjemera ndi zala,
• kusinthasintha kwa mtima (arrhythmias, tachycardia, bradycardia, palpitations),
• kuchulukana kwammphuno,
• mawonekedwe a bronchitis ndi chifuwa,
• kupweteka kwam'mimba, kusefukira kwam'mimba, kutsekula m'mimba kapena kudzimbidwa,
• kukomoka
• kamwa yowuma
• kupweteka kwa dzino
• kukokana
• kupweteka pachifuwa ndi kumbuyo
• kulira m'makutu, kulawa kwamkati ndi kuwona,
• kuchepa magazi
• conjunctivitis,
• gout
• kutuluka thukuta
• mawonetseredwe osiyanasiyana amisala yosokoneza (kuyabwa, urticaria, zotupa, milomo, larynx, lilime), ndi zina zambiri.

Chizindikiro chimodzi kapena zingapo pamwambapa zikachitika, muyenera kusiya kumwa mankhwalawo ndikuonana ndi dokotala.

Mtengo wa mankhwalawa 50 mg m'masamba opezeka pa intaneti ndi:

• Mapiritsi a 90 - ma ruble 641,
• Mapiritsi 60 - ma ruble 435,
• Mapiritsi 30 - 281 ma ruble.

Mlingo wa 100 mg ungagulidwe pamtengo wotsatirawu:

• Mapiritsi a 90 - ma ruble 769,
• Mapiritsi 30 amatenga ma ruble 355.

Mtengo wamankhwala ungasiyane pang'ono, kutengera dera komanso maukonde a pharmacy.

Pali mankhwala ambiri ofanana ndi a Loriste N omwe ali ndi kapangidwe kake ndi zotsatira zake. Palibe chifukwa cholemba onsewo, popeza ali ofanana pamachitidwe ndi kapangidwe kake. Pansipa tidzatchulidwa okha otchuka kwambiri.

Kuchokera pagome pamwambapa zitha kuwoneka kuti mitundu yotsika mtengo ya mankhwala a Lorista N sinayipirepo, ndipo kusiyana kwake kumawonedwa pokhapokha pamtengo ndi wopanga.

Mtundu wamankhwala

Mankhwala "Lorista" amapezeka m'mitundu ingapo: mwa njira yokhazikitsira "Lorista", mitundu yophatikizidwa ya "Lorista N" ndi "Lorista ND", yomwe imasiyana muyezo wa zinthu zomwe zimagwira ntchito. Mitundu iwiri ya mankhwala imakhala ndi antihypertensive ndipo imakhala ndi diuretic.

Mapiritsi a Lorista a gawo limodzi amakonzekeretsa amapezeka mwanjira zitatu zomwe zimagwira ntchito ya losartan potaziyamu 12,5 mg, 25 mg, 50 mg aliyense. Monga zida zothandizira, chimanga ndi wowuma pregelatinized, chisakanizo cha shuga mkaka ndi cellulose, aerosil, stearate ya magnesium imagwiritsidwa ntchito. Utoto wamafilimu a 25 mg kapena 50 mg wa potaziyamu wosakaniza umakhala ndi hypromellose, talc, propylene glycol, titanium dioxide, ndi utoto wachikasu wa quinoline amagwiritsidwanso ntchito pa 12,5 mg.

Mapiritsi a Lorista N ndi a Lorista ND amapangidwa ndi maziko ndi chipolopolo. Pachapakati pali zinthu ziwiri zogwira ntchito: potaziyamu losartan 50 mg (wa N fomu) ndi 100 mg (wa N fomu) ndi hydrochlorothiazide 12,5 mg (wa fomu "N") ndi 25 mg (wa fomu "N"). Popanga maziko, zida zina zimagwiritsidwa ntchito mu mawonekedwe a pregelatinized starch, microcrystalline cellulose, mkaka wa shuga, magnesium stearate.

Mapiritsi a Lorista N ndi a Lorista ND ndi ophatikizidwa ndi filimu yopanga ya hypromellose, macrogol 4000, utoto wachikasu wa utoto, titaniyidi dayosi ndi talc.

Kodi mankhwalawa amagwira ntchito bwanji?

Wophatikiza antihypertensive wothandizila (mankhwala a Lorista) amafotokozera malangizo a mankhwala omwe ali mgawo lililonse lomwe limagwira.

Chimodzi mwazinthu zomwe zimagwira ndi losartan, yomwe imakhala ngati njira yotsutsana ndi enzyme angiotensin mtundu 2 pazinthu zopanda mapuloteni.

Kafukufuku wa inro ndi nyama adawonetsa kuti zochita za losartan ndi carboxyl metabolite cholinga chake ndicholetsa zotsatira za angiotensin pa mtundu 1 angiotensin receptors. Izi zimayambitsa renin m'magazi am'magazi ndipo zimayambitsa kuchepa kwa kuchuluka kwa aldosterone mu seramu yamagazi.

Kupangitsa kuwonjezeka kwa zolemba za 2 mtundu wa angiotensin, wolartan amathandizira zolandilira za enzyme iyi, pomwe nthawi yomweyo sizimasintha zochitika za mtundu wa 2 wa kininase enzyme yomwe imayambitsa metabolism ya bradykinin.

Zochita za yogwira mankhwala a "Lorista" cholinga chake ndi kuchepetsa kutalika konsekonse kwa bedi lamitsempha, kukakamizidwa m'mitsempha yamagazi, pambuyo pake, komanso kutsekeka kwa kukodzetsa mphamvu.

Losartan salola kukula kwa pathological kukulira kwa minofu ya mtima, kumathandizira kukana ntchito yokhudza thupi, momwe mtima wosalephera umawonedwa.

Kugwiritsa ntchito tsiku ndi tsiku limodzi la losartan kumapangitsa kuchepa kwamphamvu kwa magazi (systolic) komanso kutsika (diastolic) kwa magazi. Masana onse, mothandizidwa ndi chinthu ichi, kuthamanga kwa magazi kumayendetsedwa mosiyanasiyana, ndipo antihypertensive zotsatira zimagwirizana ndi mtundu wamayendedwe achilengedwe. Kutsika kwa kupanikizika kumapeto kwa mlingo wa losartan ndi 80% poyerekeza ndi zochuluka za gawo yogwira. Ndi mankhwala osokoneza bongo, palibe vuto pamlingo wamtima, ndipo mukasiya kumwa mankhwalawo, palibe chizindikiro chodziletsa. Kuchita bwino kwa losartan kumafikira ku thupi la wamwamuna ndi wamkazi wazaka zonse.

Monga gawo la njira zophatikizira, ntchito ya hydrochlorothiazide monga thiazide diuretic imalumikizidwa ndi kuyamwa kwa chlorine, sodium, magnesium, potaziyamu ndi madzi a ayoni mu mkodzo wamkati, kubwerera m'magazi am'magazi a impal impal. Thupi limalimbikitsa kusunga calcium ndi uric acid ndi ion. Hydrochlorothiazide ikuwonetsa katundu wa antihypertensive chifukwa cha kukula kwa arterioles. Mphamvu ya kukodzetsa imayamba pambuyo pa mphindi 60-120, ndipo mphamvu yayikulu ya kukodzetsa imatenga maola 6 mpaka 12. Mulingo woyenera kwambiri wa antihypertensive wa mankhwala ndi mankhwalawa umachitika pakatha mwezi umodzi.

Kodi chimagwiritsidwa ntchito ndi chiyani?

Mankhwala "Lorista", mapiritsi, malangizo ogwiritsira ntchito amalimbikitsa kugwiritsa ntchito:

• zochizira matenda oopsa, momwe zimagwirira ntchito mankhwalawa.
• Kuchepetsa mwayi wamatenda amitsempha yamagetsi komanso kuchuluka kwaimfa komanso kusintha kwa ma pathological kumanzere kwamitsempha.

Zolemba ntchito

Mukamalandira mankhwala a "Lorista" (mapiritsi), malangizo omwe mungagwiritse ntchito amakulolani kuwonjezera mitundu ina ya antihypertensive mankhwala. Kwa okalamba, kusankha kwapadera koyambirira sikofunikira.

Zochita za mankhwala zingapangitse kuti chiwopsezo cha creatinine ndi urea m'mitsempha yamagazi ya odwala omwe ali ndi vuto la impso kapena starosis ya impso imodzi.

Mothandizidwa ndi hydrochlorothiazide, ochepa hypotension imakulirakulira, electrolyte bwino imasokonekera, yomwe imadziwika ndi kuchepa kwa kuchuluka kwa magazi, hyponatremia, hypochloremic alkalosis, hypomagnesemia, hypokalemia. Mphamvu ya okodzetsa umalimbana ndikuwonjezera kuchuluka kwa cholesterol ndi triglycerides, kusintha kulolerana kwa thupi kukhala mamolekyu a glucose, kuchepetsa kuchoka kwa calcium ion mu mkodzo, zomwe zimawonjezera kuwonjezeka kwa seramu yamagazi. Hydrochlorothiazide imatha kuyambitsa hyperuricemia ndi gout.

Kuphatikizika komweku kumakhala ndi mkaka wa shuga, womwe umapangidwa mwa odwala omwe ali ndi vuto la kuchepa kwa lactase, wokhala ndi galactosemia kapena shuga ndi galactose tsankho.

Pa magawo oyambirira a chithandizo cha mankhwala ndi hypotensive agent, kuchepa kwa kukakamiza ndi chizungulire ndikutheka, komwe kumaphwanya ntchito ya psychophysical ya thupi. Chifukwa chake, odwala omwe ntchito yawo imalumikizidwa ndi chidwi chowonjezereka poyendetsa magalimoto kapena maginito azovuta ayenera kudziwa momwe alili asanamalize ntchito yawo.

JSC Krka, dd, Novo mesto ndiopanga mankhwala othandizira odwala matenda oopsa a Lorista (mapiritsi). Zotsatira za chida ichi popanga zimakhala ndi yogwira pot losum. Mitundu yophatikizika, mankhwala omwewo ali ndi magawo awiri ogwira ntchito: losartan potaziyamu ndi hydrochlorothiazide.

Kwa Lorista, analogueyo idzakhala ndi zotsatira zofanana za antihypertensive komanso zotulukapo zofanana. Njira imodzi yothanirana ndi mankhwalawa ndi a Kozaar, mapiritsi a 50 kapena 100 mg wa potaziyamu wolertan. Opangawo ndi Merck Sharp & Dome B.V. Campaign, The Netherlands.

Mwa mitundu yophatikizika, ma analogi ndi Gizaar ndi Gizaar forte. Opangawo ndi Merck Sharp ndi Dome B.V., The Netherlands. Mapiritsi ang'onoang'ono omwe ali ndi utali wokutidwa ndi ululu wachikasu, chowumbirira, cholembedwa "717" pamalo amodzi ndi chizindikiro chogawika mbali inayi, ndipo mapiritsi okulirapo amtundu wokutira ndi wokutira ndi chovala choyera cha filimu yoyera "745" mbali imodzi.

Kuphatikizidwa kwa mankhwalawa "Gizaar Forte" kumaphatikizapo potaziyamu losartan mu 100 mg ndi hydrochlorothiazide, yomwe ili ndi 12,5 mg. Kapangidwe ka mankhwala "Gizaar" akuphatikiza potaziyamu losartan mu 50 mg ndi hydrochlorothiazide, yomwe ili ndi 12,5 mg.

Mosiyana ndi mankhwala "Lorista ND", mankhwalawa "Gizaar forte" ali ndi hydrochlorothiazide kawiri, komanso zomwe potaziyamu losertan zimachitika. Mankhwalawa onse ali ndi antihypertensive kwambiri ndi mawonekedwe ochepetsa mphamvu.

Analogue yophatikizika ndi mankhwala "Lozap kuphatikiza" opangidwa ndi "Zentiva A.S.", Czech Republic. Imapezeka mu mawonekedwe a mapiritsi ataliatali omwe ali ndi chiopsezo pazojambula zonse zophatikizika ndi filimu yachikasu. Kuphatikizika kwa mankhwalawa kumakhala ndi potaziyamu losartan mu 50 mg ndi hydrochlorothiazide, yomwe imakhala ndi 12,5 mg.

Mankhwala ofanana ndi a Lorista N ndiwo mankhwala a Vazotens N, opangidwa ndi Actavis Gulu a.o., Iceland. Amapezeka mumagawo awiri. Mapiritsi otsika a 50 mg ali ndi losperan potaziyamu ndi 12,5 mg wa hydrochlorothiazide, pomwe mapiritsi a mlingo waukulu amakhala ndi 100 mg ya losartan potaziyamu ndi 25 mg ya hydrochlorothiazide.

matenda oopsa oopsa (kwa odwala omwe akuwonetsedwa monga othandizira),

Kuchepetsa chiopsezo cha kuchepa kwa mtima ndi kufa kwa odwala omwe ali ndi vuto losakanikirana kwa magazi ndi kumanzere kwamitsempha yamagazi.

Pharmacodynamics wa mankhwala a Lorista N

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

Losartan. Kusankha angiotensin II receptor antagonist (mtundu AT1) wowongolera pakamwa, chikhalidwe chosakhala ndi mapuloteni. Mu vivo ndi vitro, losartan ndi yogwira thupi yogwiritsa ntchito carboxy metabolite (EXP-3174) imalepheretsa zovuta zonse za thupi zokhudza angiotensin II pa receptors a AT1.

Losartan mosayambitsa amachititsa kuyambitsa kwa AT2 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 pambuyo pa 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.

The okodzetsa zotsatira kumachitika pambuyo maola 1-2, ukufika kwambiri pambuyo maola 4 ndipo kumatenga maola 6-12.

Ntchito mankhwala Lorista N pa mimba

Palibe deta pakugwiritsa ntchito losartan panthawi yomwe muli ndi pakati.

Kukonzanso kwamkati kwa mwana wosabadwayo, komwe kumatengera kukula kwa dongosolo la renin-angiotensin, amayamba kugwira ntchito yachitatu ya trimester ya mimba. Chiwopsezo kwa mwana wosabadwayo chimawonjezeka ndi losartan wachiwiri ndi wachitatu trimesters. Mimba ikakhazikitsidwa, chithandizo cha Lorista® N chiyenera kuthetsedwa nthawi yomweyo.

Ngati ndi kotheka, poika mankhwala pa mkaka wa m`mawere, m`pofunika kusiya kuyamwitsa.