23 November, 2024
    Chithandizo ndi kupewa

    Captopril ndi matenda ashuga

    Captopril ya mankhwala ndi mankhwala onse omwe amachepetsa kuthamanga kwa magazi. Amagwiritsidwanso ntchito kupewa matenda a shuga ndi oncology.

    Captopril yatsimikizika pa mankhwalawa matenda oopsa, nthawi zambiri sayambitsa zovuta.

    Wopanga: Kampani yopanga mankhwala ku India Shreya House, yomwe ili ndi ofesi yoimira boma ku Russia.

    Kupanga ndi mawonekedwe a kumasulidwa

    • kapitawo
    • magnesium wakuba,
    • kukhuthala
    • lactose monohydrate,
    • talcum ufa.

    Kutulutsa mawonekedwe - mapiritsi okhala ndi mawonekedwe osalala a cylindrical. Amakhala ndi fungo lokhazikika komanso loyera loyera.

    Kuchuluka kwa zosakaniza piritsi limodzi ndi 25 mg.

    Mankhwala, pharmacodynamics

    ACE inhibitor. Mukamamwa mankhwalawa, kuthamanga kwa magazi kumayamba kuchepa pang'onopang'ono, chifukwa chomwe mankhwalawa amaperekedwa kwa odwala ambiri.

    Amatengeka mwachangu ndi m'mimba. Kuchitapo kanthu kumachitika patatha maola awiri mutamwa mapiritsi. Kupereka - ndi mkodzo osasinthika. 25-35% imamangiriza kumapuloteni amwazi. The bioavailability wa yogwira pophika ali 70%.

    Captopril sanangokhala ndi matenda oopsa, komanso matenda ena.

    Zizindikiro zogwiritsidwa ntchito

    • monga thandizo mankhwalawa matenda oopsa,
    • pambuyo pa vuto la mtima.
    • matenda a mtima
    • Kulephera kwamtima kwambiri (monga chithandizo chowonjezera),
    • ndi matenda ashuga nephropathy,
    • kusokoneza kwamitsempha yamanzere,
    • ndi matenda amtima wamtundu wotchulidwa.

    Mankhwalawa amalembera kuthamanga kwa magazi, mankhwala ena akapanda kugwira ntchito.

    Njira za ntchito, mulingo woyenera

    Mapiritsi a Captopril amatsukidwa ndi madzi pang'ono. Chithandizo - theka la ola musanadye. Mlingo uliwonse umakhazikitsidwa payekhapayekha kwa wodwala aliyense, poganizira matendawo komanso matchulidwe a thupi.

    Malangizowo akuwonetsa kuti mwalimbikitsa.

    Matenda oopsa - kawiri patsiku kwa theka la piritsi. Ngati ndi kotheka, mlingo umachulukitsidwa, koma pakapita milungu iwiri kapena inayi.

    Matenda oopsa - poyamba amatengedwa piritsi limodzi kawiri pa tsiku. Mlingo pang'onopang'ono umakulitsidwa piritsi limodzi. Amatengedwa katatu patsiku.

    Ngati mukufuna chithandizo cha mtima kulephera, imayang'aniridwa ndi akatswiri othandizira odwala. Masiku oyamba ayenera kumwedwa katatu pamankhwala ¼ a mankhwalawa. Pang'onopang'ono onjezerani mlingo mpaka theka la piritsi, kenako kwa lonse.

    Pambuyo pa vuto la mtima The mankhwala zotchulidwa pa tsiku lachitatu la mankhwala. Amamwa katatu patsiku, mlingo ndi mapiritsi a ¼. Kenako mlingo umakulitsidwa mpaka wokwanira.

    Ndi matenda ashuga nephropathy kuvomereza kumagawika pawiri kapena katatu patsiku. Mlingo womwe umalimbikitsa sioposa 100 ml.

    Odwala okhala ndi mapapo olimbitsa, Mankhwala amatchulidwa katatu Mlingo wa 75 ml (wogawidwa katatu.). Ngati matenda am'mapapo ali akulu, mlingo wa tsiku ndi tsiku sayenera kupitirira 12,5 mg.

    Kwa anthu azaka zopitilira 65, mankhwalawa amawerengera payekhapayekha, poganizira zomwe zimachitika, matenda opatsirana. Chithandizo tikulimbikitsidwa kuti muyambe ndi mankhwala ochepa.

    Contraindication

    1. Hypersensitivity a thupi.
    2. Matenda oyipa ophatikizidwa ndi kupuma movutikira.
    3. Mimba (yachiwiri, trimester yachitatu).
    4. Kutopa kwambiri.
    5. Nthawi yonyamula.
    6. Ndi matenda a impso.
    7. Stenosis mkamwa mwa msempha.
    8. Kuchulukitsa kwa matenda a chiwindi.
    9. Ana osakwana zaka 18.
    10. Ndi zovuta kutuluka kwa magazi kuchokera kumanzere kwamitseko.
    11. Edema wa Quincke.
    12. Hyperkalemia
    13. Pambuyo kupatsirana kwa impso.
    14. Ndi tsankho kwa thupi la lactose.

    Mankhwala ndi ntchito mosamala vuto la mseru, odwala kwambiri, kuwonongeka kwaimpso ntchito, minofu yolumikizana, oletsedwa fupa, magazi ischemia. Chithandizo chimachitika motsogozedwa ndi anthu okalamba, ndi matenda am'mimba, atatha kulowererapo.

    Kulandila pa mimba ndi mkaka wa m`mawere

    Captopril imakhudzidwa panthawi yoyembekezera mu trimesters yachiwiri ndi yachitatu. Mu trimester yoyamba, mankhwalawa sayambitsa kuyipa kwa mwana wosabadwayo. Komabe, chithandizo sichovomerezeka. Poyang'aniridwa ndi katswiri.

    Ngati pakufunika kutenga ACE inhibitor kwa odwala omwe akukonzekera kutenga pakati, amasamutsidwa kupita kuchipatala mosamala kwambiri, komwe kumaphatikizaponso mankhwala ena.

    Kafukufuku awonetsa kuti kutenga Captopril mchaka chachiwiri komanso chachitatu kumasokoneza njira ya kubereka komanso kumayambitsa matenda opatsirana mwa fetal. Ngati mayi woyembekezera atenga Captopril, kafukufuku wathunthu wazachipatala ndi ma ultrasound ayenera kuchitidwa kuti awone momwe mayi ndi mwana aliri. Anomalies mu chitukuko cha mwana wosabadwa akhoza kukhala motere: Kukula kwa chigaza, kulephera kwaimpso, matenda oopsa.

    Mkaka wa m'mawere ukadyetsedwa, chinthu chogwira ntchito chimalowa m'thupi la mwana. Zotsatira zake ndiku kuphwanya kwam'mimba, kuphwanya msana, mapando otayirira, kukomoka, ndi mavuto ena akulu.

    Zotsatira zoyipa zomwe zingachitike

    • kukomoka mtima,
    • akukumbutsa
    • thupi lawo siligwirizana
    • kuletsa kwa chapakati mantha dongosolo,
    • laryngeal edema,
    • phokoso mokhumudwa
    • zilonda zam'mimba
    • khungu red
    • kuchepa kwamawonedwe owoneka,
    • nseru
    • kukomoka
    • kuchuluka kwa nayitrogeni ku urea,
    • angina pectoris
    • chifuwa chowuma chopanda,
    • zotupa pakhungu,
    • Hypersensitivity dzuwa,
    • mutu
    • ndimavuto ogona,
    • bronchospasm
    • kamwa yowuma
    • kuphwanya kukoma
    • zilonda zam'mimba
    • kusokonezeka kwa magazi muubongo,
    • gamu magazi
    • kutupa kwa chiwindi
    • kugona

    Zotsatira zoyipa zikachitika, mankhwalawo amasiya. Dokotala amasankha njira ina.

    Kuchita ndi mankhwala ena

    The achire zotsatira za captopril pamene kumwa okodzetsa amayamba kuchuluka.

    Sizoletsedwa kuphatikiza mankhwala ena omwe machitidwe awo cholinga chake ndi kuchepetsa kukakamizidwa.

    Mukamamwa ndi allopurinol, chiopsezo cha neutropenia chimakulanso.

    Matenda amtundu wa hememologic amayamba chifukwa cha munthawi imodzimodzi ndi ma immunosuppressants.

    Mankhwala amawonjezera achire zotsatira za othandizira omwe ali ndi lithiamu, omwe amachititsa kuyipa kosiyanasiyana.

    Ngati wodwala akumwa mankhwala ena, kufunsa dokotala ndikofunikira.

    Malangizo apadera

    Ngati mapiritsi adayikidwa pafupipafupi kapena kwa nthawi yayitali, pakufunika kuyeserera impso.

    Ngati chifuwa chowuma chitayamba mutatha, siyani kumwa.

    Kugwiritsa ntchito limodzi ndi mowa ndikuloledwa.

    Chidacho chimatha kuyambitsa kugona, chizungulire, chisokonezo. Chifukwa chake, ndizoletsedwa kuchita nawo zinthu zomwe zimafuna kuti anthu azikumbukira, ndikuyendetsa galimoto.

    Choguliracho chimasungidwa pamalo otetezedwa ndi kuwala, kutentha osapitirira +25 degrees. Moyo wa alumali ndi zaka zinayi kuyambira tsiku lomwe kampani yopanga zamankhwala ili phukusi. Mankhwala omwe mumalandira amamasulidwa.

    Zomwe hypertonics imanena za mankhwalawa

    Tatyana
    Captopril ndi chithandizo chabwino, chothandiza kuthamanga kwa magazi. Mwansanga zimathandiza kuti zibwerere mwakale. Mwanjira, chida chake ndi chotsika mtengo. Momwe ndikudziwira, wotchuka kwambiri kuposa onse omwe analipo. Ngati chiwopsezo ndichachikulu, nthawi yomweyo ndimavomera No-shpa kapena mankhwala ena a antispasmodic. Nthawi zonse zimathandiza. Zotsatira zoyipa sizinakhalepo.

    Marina
    Sanakhalepo ndi kuthamanga kwa magazi. Koma tsiku lina zidakhala zoyipa. Ndinapita kuchipatala, zinapezeka kuti ndinali ndi vuto la 170 mpaka 100. Dokotala nthawi yomweyo adatumiza Captopril. Mlingo - theka piritsi. Litatha mphindi 10, kupanikizika kudatsikira mpaka 140 ndi 80. Zinthu zidayenda bwino, ngakhale m'mbuyomu mutuwo udali wopweteka komanso osautsa. Tsopano, mwina nditha kupita ndi mankhwalawo, ndikamamwa ndikangomva kufunika kwake.

    Nthawi zambiri ndimatenga Diraton kuchokera kuthamanga kwambiri kwa magazi, nthawi zonse mosataya nthawi komanso popanda mavuto amachepetsa kuthamanga kwa magazi. Mnzake adandiwuza kuti nditenge Captopril, ndidaganiza zoyesera, ndinayetsa kukakamizidwa, sizinali zochuluka kwambiri za 140/96, ndinamwa theka la piritsi ya Captopril ndipo ndinapita kunyumba kuchokera kuntchito. Ku minibus ndidamva bwino kwambiri kotero kuti ndimangodabwitsidwa, ndinalibe chilichonse choti ndipume, manja anga adayamba kutentha. Kugwiritsa ntchito zala zokhala ndi kiyi yachitsulo, zimawoneka kuti ndikukhudza ayezi. Nditafika kunyumba, ndinayetsa kupanikizika, panali kale 190/110, sindinakhalepo ndi zipsinjo zotere m'moyo wanga. Ndinafunika kuyitanira ambulansi, koma monga momwe ndikanakhalira ndi mwayi, sindinabwere, ndinamwa theka la piritsi la Diraton, kenanso. Ambulansi sinafike, ndipo kupanikizika kunayamba kuchepa. Ndipo posachedwa ndidaganiza, chabwino, mwina chinali china ndi ine kapena nyengo, ndikuganiza kuti ndisiye kuyeserera nditagona, kuyeza kukakamiza kwake kunali 138/95, ndidayamba kupukusa theka la piritsi ya captopril. Popeza ndinalibe nthawi yodzipatula, ndinamva kugunda kwamtima, kuthamangira kukakamira, kuwuma mpaka 146/96, kuthamanga ndikuwotcha miyala yotsalira ndi madzi, kunayamba kuipiraipira, manja anga adayamba kutentha, mapazi anga anali atanyowa kale, kupsinjika kwanga kunali kale 171/106 Sindinadikire nthawi yayitali ndipo nthawi yomweyo ndinamwa piritsi lonse la Diraton. Pambuyo pang'ono kosavuta, komanso nthawi yomaliza. Chifukwa chake sindilandira Captopril m'moyo wanga ndipo sindikukulangizani.

    Kapoten ndi matenda ashuga

    • 1 Kuphatikizika ndi mawonekedwe a kumasulidwa
    • 2 Zisonyezo
    • Malangizo a "Kapoten" ogwiritsira ntchito shuga
    • 4 Kutsutsana
    • 5 Zotsatira zoyipa
    • 6 Omvera
    • Malangizo apadera

    Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

    Mavuto osiyanasiyana amatsagana ndi odwala matenda a shuga ndipo m'modzi mwa iwo ndi matenda ashuga. Polimbana ndi matenda awa, "Kapoten" akuimirira - mankhwala omwe ali ndi mawonekedwe osiyanasiyana, omwe amasiyanitsidwa ndi kuthamanga kwa kuyambiranso kwa chithandizo chamankhwala. Zowonjezera zochizira za Kapoten zimafikira ku matenda ena omwe nthawi zambiri amapezeka ndi matenda osokoneza bongo - matenda oopsa. Kuthamanga kwa magazi kwa anthu omwe ali ndi matenda ashuga ndi owopsa kwambiri motero amafunika kuchitapo kanthu mwachangu.

    Malangizo ogwiritsira ntchito "Kapoten" mu shuga

    Kufunsira kuchipatala musanamwe mankhwala kumafunika.

    Musanayambe njira yothandizira achire ndi mankhwala a Kapoten, ndikofunikira kukaonana ndi dokotala wapadera, popeza kuti kuchuluka kwa mankhwalawa kofotokozedwera kumankhwala kumakhala kofanana. Dokotalayo amupatsa mankhwala Mlingo wokhazikika komanso wodalirika malinga ndi matenda ake, zaka zake komanso momwe wodwalayo alili.

    Mankhwalawa amamwa pakamwa popanda kanthu, makamaka ola limodzi asanadye. Mapiritsiwo samaphwanyidwa konse, koma kumezedwa kwathunthu, kutsukidwa ndi madzi oyeretsedwa, kapu imodzi ya ½. Amayamba kulandira chithandizo chochepa kwambiri, ndipo pang'onopang'ono amawonjezera masiku 14 aliwonse 2. Mlingo wovomerezeka wa mankhwala a Kapoten ndi 0,6 g patsiku, madotolo amalimbikitsa kuti osaposa 300 mg, chifukwa akukhulupirira kuti kupitirira kuchuluka kwa phindu kumeneku kumadzetsa mavuto osaneneka. Nthawi zambiri, pochizira matenda a shuga a shuga, tikulimbikitsidwa kumwa Kapoten 25 mg katatu patsiku. Ngati mulingo woyenera, ndiye kuti pakatha milungu iwiri muonjezere mpaka 50 mg m'mawa ndi madzulo.

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    Zotsatira zoyipa

    Pogwiritsa ntchito "Kapoten", zotsatirazi zoyipa zingachitike:

    Mukamamwa mankhwalawa, mapapu a edema nthawi zina amapezeka.

    • chifuwa chowuma
    • ululu wowawa,
    • Kuchepetsa mphamvu ya bronchi,
    • kutupa kwamapapo, makoma am'mimba mwa larynx, miyendo, mkamwa ndi nkhope,
    • kuchuluka kwa potaziyamu, sodium m'magazi,
    • kupezeka kwa mapuloteni mumkodzo,
    • kuphwanya bwino-acid,
    • kuchepa magazi
    • kuchepa kwa kuchuluka kwamapulateleti, ma neutrophils,
    • kuphwanya kukoma ndi kuwona, kamwa yowuma
    • kuwawa pamimba, kupumira kosalekeza,
    • kugona, chizungulire komanso kupweteka m'mutu,
    • malungo
    • zotupa pakhungu ndi kuyabwa.

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    Ogonjera

    Wogulitsa mankhwala "Kapoten" akhoza m'malo mwa ma syonyms, ndiye kuti, mankhwala omwe ali ndi chinthu chofanana pakuphatikizika, ndi ma analogues - omwe ali ndi vuto lofananalo. Chifukwa chake, ngati sikotheka kugwiritsa ntchito Kapoten, madokotala amadzawa ndi imodzi mwamankhwala otsatirawa:

    Captopril ili ndi mawonekedwe ofanana komanso katundu omwewo.

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    Type 2 matenda a shuga

    Njira yodwala matenda ashuga a 2 ikuyenera kuwongoleredwa pafupifupi poyerekeza ndi matenda ashuga 1. Kuphatikiza pa kuchuluka kwa shuga m'magazi, kuwunika mayendedwe monga cholesterol yamagazi, kuthamanga kwa magazi, ndi kulemera kwa thupi kumafunikanso. Zinthu zonsezi zimathandizira kukulitsa matenda a mtima, ndipo zinthu izi zimapezeka nthawi zonse m'm wodwala wokhala ndi matenda ashuga a 2.

    Kuti muwone momwe shuga yachiwiri imaperekedwera, mutha kuyang'ana kwambiri zomwe zikuwonetsedwa patebulopo.

    Matenda a shuga oipawa amalipiridwa, ndikovuta kwambiri komanso momwe angatengere zovuta zowonjezera zovuta, amatha kuwonekera posachedwa komanso kuwonjezedwa. Choyipa chachikulu ndikufunika kwa chithandizo chamankhwala ndikusintha kwa moyo wanu.

    Kuyesa Kulipira Matenda a shuga

    Shuga wamagazi ndi mkodzo

    Magazi ndi mkodzo wambiri mumayezedwa nthawi zonse pogwiritsa ntchito njira zomwe zafotokozedwera shuga 1. Zowona, ndi matenda a shuga a mtundu 2, palibe chifukwa chochitira izi musanadye chilichonse: ndikokwanira kudziwa kuchuluka kwa shuga mu mkodzo kamodzi patsiku, komanso m'magazi kamodzi pa masiku 3-5. Pa matenda aliwonse (mwachitsanzo, chimfine), komanso ngati mutha kuwonongeka, ndikofunikira kudziwa zomwe zili m'magazi ndi mkodzo pafupipafupi.

    Ndi zotsatira ziti zoyesedwa zomwe zingaoneke zokhutiritsa kwa wodwala yemwe ali ndi matenda a shuga a 2? Zimatengera msinkhu wanu, ndikuti, popanda vuto, pazaka zingati mutakhala ndi matenda anu a shuga. Ndi msempha wamagazi osapitirira 8 mmol / L, zovuta zazikulu zam'mitsempha zimatha kukuwopsezani pokhapokha zaka 30, ndi shuga pamtunda wa 10 mmol / L - kale pambuyo pa zaka 15-20.

    Tanena kale kuti kagayidwe kamagawika "mitundu" - carbohydrate, lipid (mafuta), mapuloteni - kwambiri. Ndi matenda a shuga, kagayidwe kazakudya umachepa, koma izi sizingakhudze mitundu ina ya kagayidwe. Pankhaniyi, kumakhala kuphwanya kwa lipid metabolism, yomwe ndiyo chiopsezo chachikulu cha atherosulinosis, matenda a mtima komanso infarction ya myocardial - chifukwa chachikulu cha imfa m'dziko lamakono.

    Chizindikiro chotere cha metabolidi ya lipid, monga zomwe zili mu cholesterol yathunthu m'magazi, sichili "chofunikira" kwambiri. Ndikulimbikitsidwa kwa odwala omwe ali ndi matenda osokoneza bongo kuti azichita pafupipafupi (osachepera 1 pachaka) kupanga lipidogram - kuwunika kwa kuchuluka kwa "mitundu" yosiyanasiyana (kapena, monga akunena mu mankhwala, tizigawo) a lipids m'magazi.

    Ma lipids am'magazi (monga zinthu zamafuta) amaimiridwa ndi triglycerides ndi cholesterol, omwe amalumikizidwa ndi mapuloteni, kotero kuti "mafuta" koma "mapuloteni amafuta" amayendayenda m'magazi - lipoproteins. Onse ali ndi katundu wosiyanasiyana.

    "Lipoproteins okhala ndi cholesterol" ndi amitundu iwiri. Mtundu umodzi ndi tinthu tating'onoting'ono kwambiri, timatchedwa lipoproteins apamwamba, kapena, mwachidule, HDL.Cholesterol yomwe ilimo imatchedwa "cholesterol yabwino": sikuti samangoyambitsa matenda atherosulin, koma, m'malo mwake, imalepheretsa kukula kwake.

    Mtundu wina ndi wokulirapo komanso wowoneka bwino, ndipo amachedwa lipoproteins, kapena LDL. Nthawi zambiri, ili ndiye gawo lalikulu la magazi a lipoprotein. Komabe, cholesterol yomwe ali nayo imatchedwa cholesterol "yoyipa", chifukwa atherosulinosis imakula ndikuwonjezereka kwa 80%.

    "Lipoproteins okhala ndi triglycerides" amakhalanso m'mitundu iwiri: ma chylomicrons ndi ochepa osalimba lipoproteins (VLDL). Ma chylomicrons nthawi zambiri amapezeka m'magazi okha mwa makanda atatha kudyetsa, LDL-C m'magawo otsika amapezeka mu plasma yothamanga.
    Nthawi zambiri, ma lipids m'magazi amagawidwa malinga ndi "lamulo 1, 2, 3, 4, 5" (m'magawo a mmol / l, tebulo):

    Lipids wamba wamagazi


    Chiwopsezo cha kukhala ndi atherosclerosis chimawonjezeka ndi zochepa za HDL m'magazi, komanso ndi kuchuluka kwa LDL ndi VLDL. Mu matenda a shuga, nthawi zambiri mumakhala kuti mumakonda kuchepetsa cholesterol yabwino (HDL) ndikuwonjezera "yoyipa", komanso triglycerides (LDL ndi VLDL).

    Kwa nthawi yayitali, akatswiri azakudya amalimbikitsa kuti anthu omwe ali ndi cholesterol yambiri "yoyipa" m'magazi awo achepetse kapena asamamwe zakumwa zilizonse zamafuta a nyama: mafuta anyama, nkhumba mafuta, ng'ombe ndi mutton, masoseji, batala, zonona mafuta ndi zonona wowuma. komanso zakudya zopezeka mu cholesterol: mazira a mazira, impso, nsomba zamkati, ubongo, chiwindi. Tsopano zakhazikitsidwa kuti ndizosatheka kupatula kolesterol kwathunthu muzakudya, izi ndizodzala ndi zotsatira zambiri zosasangalatsa kwa thupi. Komabe, kugwiritsa ntchito mankhwala osokoneza bongo olemera mu cholesterol, inde, sikuyeneranso, ndipo palibe, komanso odwala okha omwe ali ndi matenda ashuga.

    Ngati mankhwala othandizira pakudya kwa miyezi iwiri samatulutsa zotsatira (monga momwe zingawereredwere ndi mbiri ya lipid), mankhwala opatsirana ndi lipid amalembedwa - ma statins (lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin, etc.) ndi fibrate (clofibrate, gemfibrozil, befibrat, tifenofibrate) .

    Kupsinjika kwa magazi

    Malinga ndi tanthauzo la WHO, kupanikizika kwapamwamba (systolic) kumawerengedwa kuti kumakulitsidwa, kuyambira ndi chizindikiro cha 140 mm RT. Art., Otsika (diastolic) - kuchokera 90 mm RT. Art. Pali magawo atatu a kuchuluka kwa kukakamizidwa:

    • • mpaka 160/100 mm. Hg. Art. - Matenda a 1st degree (ofatsa),
    • • mpaka 180/110 mm. Hg. Art. - matenda oopsa a digiri yachiwiri (yapakatikati)
    • • zopitilira 180/110 mm. Hg. Art. - matenda oopsa a digiri ya 3 (kwambiri).


    Pafupifupi 75% ya odwala matenda a shuga amayamba kudwala matenda oopsa, ngakhale kuti sizinganene kuti chachikulu ndi chachiwiri ndi chiyani.

    Hypertension imatchedwa kuthamanga kwa magazi. Agawidwa m'magawo atatu, osatengera kuchuluka, koma kuwonongeka kwa ziwalo zamkati. Mu siteji ine palibe chowonongeka cha chiwalo pakali pano, ndipo kupanikizika kwake kuli kwakukulu. Pakadali pano, sipangakhale zodandaula zilizonse kapena ndizosamveka - kupweteka mutu, chizungulire, nthawi zina tinnitus, "ntchentche" pamaso pa maso, palpitations. Monga lamulo, mankhwalawa saikidwa pakadali pano kuti achepetse kuthamanga kwa magazi - wodwalayo amangolimbikitsidwa kuti achepetse kugwiritsa ntchito mchere, kuchepetsa kulemera komanso momwe amakhalira moyo. Komabe, ngati matenda olembetsa magazi amaphatikizidwa ndi matenda a shuga, ndiye kuti mu gawo loyamba, chithandizo chamankhwala ndichofunika, chifukwa pamaso pazinthu ziwiri zowopsa, chiopsezo chokhala ndi myocardial infarction ndi stroko zimachulukanso.

    Ngati magazi a systolic wodwala omwe ali ndi matenda ashuga aposa 130 mm Hg. Art., Ndi diastolic - 85 mm RT. Art., Ndiye adalembedwa mankhwala kuti achepetse kuthamanga kwa magazi, makamaka okhudzana ndi gulu la ACE zoletsa: berlipril, enalapril, capopril, capoten. Nthawi yomweyo, zosagwiritsa ntchito mankhwala, monga kunenepa kwambiri, kuchita masewera olimbitsa thupi, kuchepetsa magazi, komanso kusiya kusuta, ndizofunikirabe.

    Malangizo a paptopril ogwiritsira ntchito

    Mukamagwiritsa ntchito Captopril, malangizo ake ogwiritsira ntchito akunena kuti mankhwalawa ndi a gulu la zoletsa. Zinaonekera koyambirira kwa zaka 70 zapitazo ndipo zakhala zikugwiritsidwa ntchito pochiza matenda oopsa komanso kulephera kwa mtima. Mankhwalawa amapangidwa mwanjira ya mapiritsi, omwe amaphatikizapo chinthu chachikulu chogwira ntchito ndi othandizira othandizira (wowonda chimanga, talc, etc.). Gwiritsani ntchito mapiritsi a Captopril ayenera kukhala okhawo malinga ndi malangizo. Chifukwa chiyani? Kodi ndi mwayi wanji wogwiritsa ntchito?

    Zambiri

    Captopril imakhudza kwambiri thupi. Amachepetsa mitsempha ya magazi, imachepetsa kuthamanga kwa magazi, imagwiranso ntchito kwa mtima ndi kwamikodzo.

    Kodi mankhwalawa amagwira ntchito bwanji:

    1. Imachepetsa kupanga mahomoni omwe amalimbikitsa kuthamanga kwa magazi.
    2. Amachepetsa katundu pamisempha ya mtima.
    3. Imalimbikitsa kukula kwa mitsempha.
    4. Amasintha magazi kudzera mu impso ndi mtima.
    5. Imalepheretsa njira ya gluing (kuphatikiza) ya mapulateleti.

    Ngati mutenga captopril nthawi yayitali, minofu yamtima ndi mitsempha yamagazi imakhala yolimba. Kuphatikiza apo, kuthamanga kwa magazi kwa ischemic myocardium kumakhala bwino.

    Kusintha kumachitika pafupifupi ola limodzi mutamwa mapiritsi. Kuti musunge zotsatira zake, mankhwalawo amayenera kuti aledzeretse malinga ndi dongosolo. Mlingo uliwonse umathandizira zotsatira zamankhwala.

    M'mafakisi, mutha kupeza mitundu ingapo ya captopril. Zonsezi sizosiyana kwa wina ndi mnzake. Kusiyanitsa ndiko dzina. Choyambirira pafupi naye chikunena za bizinesi yomwe mapiritsiwa adapangira.

    Pochizira mafupa, owerenga athu adagwiritsa ntchito DiabeNot bwino. Kuwona kutchuka kwa malonda, tidaganiza zoperekera chidwi chanu.

    Mankhwala amapezeka zingapo Mlingo:

    Aliyense akhoza kusankha mlingo wa Captopril, womwe ukufotokozedwa muzomwe dokotala wakulembera.

    Malinga ndi malangizo ogwiritsira ntchito, mankhwalawa amachepetsa kuthamanga kwa magazi, kusintha kwa mtima, komanso kumachepetsa mitsempha yamagazi ndikufinya magazi.

    Zizindikiro ndi contraindication

    Zowonetsa kugwiritsa ntchito Captopril ndizambiri:

    1. Matenda oopsa. Mankhwalawa amagwiritsidwa ntchito ngati gawo la zovuta mankhwala kapena paokha. Mwambiri, imayikidwa limodzi ndi okodzetsa ndi othandizira thiazide.
    2. Mavuto oopsa.
    3. Kulephera kwamtima kosalekeza.
    4. Kusokonezeka kwa magazi m'magazi.
    5. Nephropathy, yomwe imayamba chifukwa cha matenda ashuga amtundu woyamba.
    6. Mitundu ina ya zovuta za autoimmune, monga lupus erythematosus kapena scleroderma.
    7. Mphumu ya bronchial. Pankhaniyi, Captopril ndi gawo la kukonza mankhwalawa.

    Pali nthawi zina pamene kugwiritsa ntchito mankhwalawa kumatsutsana:

    1. Hypotension kapena kutsika kwambiri.
    2. Mavuto pantchito ya impso.
    3. Kulephera kwa chiwindi.
    4. Azotemia. Awa ndi matenda omwe amadziwika ndi kuchuluka kwa zinthu za nayitrogeni m'magazi.
    5. Kuchepetsa kwamitsempha yama impso.
    6. Kubwezeretsanso pambuyo kumuika impso.
    7. Kuchepetsedwa kwa lumen kwa orortice.
    8. Matenda momwe magazi amatuluka kuchokera pansi pamtima amasokonezekera.
    9. Hyperaldosteronism (kuchuluka kwa mahomoni ena) pagawo loyamba.
    10. Mulingo wa potaziyamu kwambiri.
    11. Cardiogenic mantha.
    12. Nthawi yobereka mwana. Captopril yomwe imatengedwa panthawi yoyembekezera imatha kubweretsa kumwalira kwa fetal kapena kufooka.
    13. Kuyamwitsa. Chidacho chogwira ntchito chimatha kulowa mkaka. Chifukwa chake, ngati pakufunika kumwa mankhwalawo, muyenera kusiya kuyamwitsa.
    14. Zaka mpaka 18.
    15. Kusagwirizana ndi chimodzi mwazinthu zomwe zimapanga mapiritsi.

    Zowukira zonse pamwambapa zimatchedwa kuti mtheradi. Anthu omwe ali ndi matendawa sayenera kutenga magazi nthawi zina.

    Pali zotsutsana.

    Mankhwalawa amatha kumwa, koma moyang'aniridwa ndi dokotala yemwe, ngakhale asanayambe chithandizo, adawunika chiopsezo ndi kupindula:

    1. Anachepetsa magazi oyera.
    2. Kutsika kwa maplateleti.
    3. Zoipa pakapangidwe ka maselo amwazi.
    4. Matenda a mtima.
    5. Zakudya zochiritsa zomwe kudya sodium ndizochepa.
    6. Hemodialysis
    7. Zaka zopitilira 65.
    8. Mkhalidwe wakuthupi, womwe umadziwika ndi kuchepa kwa magazi. Kungakhale kusanza, kutsegula m'mimba, thukuta.
    9. Kuchepa kwamphamvu kwa mitsempha ya impso.
    10. Hypertrophic cardiomyopathy.

    Malamulo ogwiritsira ntchito

    Pamafunika kugwiritsa ntchito captopril, mlingo umadalira momwe wodwalayo aliri ndi matenda ake:

    1. Ndi matenda oopsa, mapiritsi awiri patsiku nthawi zambiri amawayika. Ngati mankhwala atatha masiku angapo osachita bwino, mlingo wake ukuwonjezeka. Izi zikuyenera kuchitika pang'onopang'ono.
    2. Ngati matenda oopsa azikhala pang'ono, mapiritsi amatengedwa chimodzimodzi. Ngati ndi kotheka, ikhoza kuwonjezeka mpaka 50 mg.
    3. Matenda oopsa oopsa amathandizidwa ndi mlingo waukulu wovomerezeka (150 mg) patsiku.
    4. Mlingo wa mankhwalawa mu mawonekedwe osalephera a mtima amakhala ochepa (6.25 mg katatu patsiku). Ngati ndi kotheka, zitha kusintha. Mlingo woyenera wovomerezeka motere ndi 150 mg patsiku.

    Momwe mungamwere mapiritsi? Ayenera kuyikidwa pansi pa lilime. Mankhwalawa ayenera kukhalapo mpaka atasungunuka kwathunthu. Kupanikizika kumatsika patatha kotala la ola limodzi.

    Kuti muchepetse kukonzaku, piritsiyo imatha kuphwanyidwa kukhala ufa ndikutsanuliridwa motere pansi pa lilime. Zotsatira zake ziwoneka maminiti ochepa.

    Koma bwanji ngati pambuyo piritsi limodzi kuthina sikuchepa? Mutha kutenga wina. Ngakhale zitakhala kuti izi sizikuchitika, muyenera kuyimbira foni dokotala kapena ambulansi.

    Kumwa mankhwala kumakhala ndi mavuto. Kuphatikiza apo, bongo wambiri umatha kubweretsa mavuto. Imfa ndi imodzi mwazomwezi.

    Zotsatira zoyipa

    Mndandanda wazotsatira zakugwiritsira ntchito mapiritsi a Captopril ndiwopatsa chidwi. Ndiye chifukwa chake, asanayambe kulandira chithandizo, adokotala amayenera kuwunika kuchuluka kwa chiwopsezo ndikupindula.

    Chifukwa chake, zoyipa za Captopril zikuphatikiza:

    • kugona
    • kutopa kosalekeza ndi kutopa,
    • mutu
    • Kukhumudwa
    • kuwonongeka kwamawonekedwe ndi kununkhira
    • kukomoka
    • dontho lakuthwa kwambiri,
    • vuto la mtima
    • kukomoka mtima,
    • hemoglobin wotsika
    • kupweteka mumtima
    • kusintha kwa magazi (agranulocytosis, neutropenia, etc.),
    • kupuma movutikira
    • mphuno
    • chifuwa chowuma
    • stomatitis
    • zilonda mkamwa ndi pa m'mimba,
    • kumeza mavuto
    • nseru
    • kusanza
    • kutulutsa ndi kumva kuthengo m'mimba,
    • Kulakwitsa matumbo (kutsegula m'mimba kapena kudzimbidwa),
    • kapamba
    • kuchepa kapena kuchuluka kwa mkodzo wothira,
    • kuwoneka kwa mapuloteni mumkodzo,
    • kukodza pafupipafupi
    • kusabala
    • redness khungu ndi kuyabwa,

    • urticaria
    • Edincke's edema,
    • kuzizira
    • kupweteka kwa minofu
    • kutsitsa shuga.

    Ngati chizindikiro chimodzi kapena zingapo zikuwoneka pamndandandayo, pitani kuchipatala mwachangu.

    Atha kusiya mankhwalawo, kapena m'malo mwanjira ina komanso yoyenera.

    Bongo

    Mukamamwa mankhwalawa, mankhwala osokoneza bongo amachitika ngati gawo limodzi limapitirira malire ovomerezeka.

    Matendawa ali ndi zizindikiro zake:

    1. Kuchepetsa kwambiri kukakamiza.
    2. Gwedeza dziko.
    3. Stupor.
    4. Kuyenda pang'onopang'ono. Nthawi zina zimatsika mpaka kumenyedwa ndi 50 pamphindi.
    5. Mitsempha yamagazi yotupa.
    6. Matenda a mtima
    7. Kutupa kwa magazi (thromboembolism) kapena kufalikira kwa chotupa chamagazi ndi magazi omwe atuluka ndipo ali mkati mwake.
    8. Angioneurotic edema. Uku ndimomwe thupi limasokoneza, lomwe limafotokozedwa potupa pakhungu ndi mucous nembanemba.
    9. Kulephera kwina.
    10. Kuphwanya mulingo wamagetsi wamadzi.

    Mutha kuchotsa zizindikiritso pamwambapa pokhapokha mothandizidwa ndi madokotala. Poyamba, amatsuka m'mimba kuti amasule thupi ku Captopril. Pambuyo, kuyika wodwalayo pang'onopang'ono, kubwezeretsanso magazi. Pachifukwa ichi, njira ya saline, zinthu zina m'malo mwa plasma, etc. zimagwiritsidwa ntchito. Malinga ndi zidziwitso zamankhwala, munthu amapatsidwa adrenaline, yomwe imawonjezera kuthamanga kwa magazi, ndipo ma antihistamines amaperekedwa kuti athandizire kutupa. M'mikhalidwe yovuta kwambiri, hemodialysis imachitika - njira yotsuka magazi popanda kuthandizidwa ndi impso.

    Captopril, mogwirizana ndi malangizo ogwiritsira ntchito, ndimankhwala othamanga omwe amathandiza kuthamanga kwa magazi. Chifukwa cha kapangidwe kake, zinthu zooneka zimatheka patangopita mphindi zochepa mutatha kugwiritsa ntchito piritsi. Komabe, chisamaliro chiyenera kumwedwa panthawi ya chithandizo. Mankhwala ali ndi mavuto. Kuphatikiza apo, muyeso wa mankhwala omwe dokotala amakupatsani ukhoza kupititsa patsogolo thanzi.

    Chifukwa chiyani Captopril FPO?

    Angiotensin-II amatanthauza ma mahomoni omwe amagwira ntchito mozama pamagazi, amasunga sodium mthupi. Kutembenuka kwake kuchokera ku angiotensin-I kumachitika ndikugawana kwa angiotensin-kutembenuza enzyme (ACE). Captopril ndi gawo lamankhwala omwe ali m'gulu la ACE zoletsa. Izi zikutanthauza kuti imalepheretsa zochitika za ACE, zomwe zimachepetsa magazi a angiotensin-II.

    Zotsatira zake, kukana kwa ziwiya zotumphukira kumachepa, kutuluka kwa mtima kumawonjezeka komanso kuthekera kunyamula katundu kumakulira. Captopril yowonjezera imathandizira kayendedwe ka magazi, kamene kamadyetsa impso ndi mtima. Kugwiritsa ntchito nthawi yayitali kumachepetsa hypertrophy ya zotupa zam'mimba ndi myocardium.

    Malinga ndi malangizo ogwiritsira ntchito, Captopril FPO yokhudza kuthamanga kwa magazi iyenera kutengedwa pazinthu izi:

    • matenda oopsa
    • myocardial infaration ndi mkhutu kumanzere kwamitsempha,
    • kumasuka ku mavuto oopsa,
    • Kukonzanso kwamphamvu kwamphamvu
    • matenda a parenchymal ndi patsogolo pang'onopang'ono wa glomerulonephritis,
    • kuthamanga kwa magazi ku mphumu ya bronchial,
    • nephropathy mu shuga
    • Kulephera kwamtima kosagundika, makamaka ngati kugwiritsa ntchito zida zodzetsa magazi ndi mtima glycosides sikungathandize,
    • chachikulu hyperaldosteronism (matenda a Conn).

    Kodi ndiyenera kuthana ndi vuto lotani?

    Captopril ndi imodzi mwazida zotchuka zomwe zimagwiritsidwa ntchito pakuthamanga kwa magazi. Ogwiritsa ntchito ambiri angafune kudziwa za mawonekedwe omwe amamwa mankhwalawa. Pakupsinjika komwe ndiyenera kutenga Captopril FPO, kodi malangizo ogwiritsira ntchito akuti chiyani pamenepa? Captopril ikhoza kugwiritsidwa ntchito pakuthana kwa matenda oopsa, ndiye kuti, kukakamira kupitirira malire. Ndikofunikira kuchepetsa kuchuluka kwa mchere wa sodium.

    Mlingo wa mankhwala pang'onopang'ono umakulitsidwa kuti ufike pazovomerezeka - 150 mg / tsiku. Ndiye kuti, malangizo ogwiritsidwira ntchito akuti chida chikugwirira ntchito poyerekeza ndi kuchuluka kwa kuthamanga kwa magazi, milingo imakhala yosiyana munthawi zosiyanasiyana. Kuchita bwino kumachulukitsidwa mukamaphatikizidwa ndi mankhwala othandizira.

    Magawo a Hypertension

    Malangizo ogwiritsa ntchito Captopril FPO

    Captopril FPO imapangidwa ngati mapiritsi a 25 ndi 50 milligram. Apake mu maselo apadera azinthu khumi. Mu bokosi limodzi, pakhoza kukhala magome khumi kapena zana a mankhwala.

    Pogwiritsa ntchito Captopril FPO, yomwe imachepetsa kuthamanga kwa magazi, mulingo wotsatira umalimbikitsidwa pamagulu osiyanasiyana a odwala:

    • ochepa matenda oopsa - 25 mg kawiri,
    • matenda oopsa kwambiri - osapitirira 150 mg (katatu),
    • kulephera kwa mtima ndi matenda osapitilira - 6.25-12,5 mg katatu,
    • okalamba - 6.2 mg kawiri patsiku,
    • odwala matenda a shuga a nephropathy kuyambira 75 mpaka 100 mg / tsiku. ,
    • impso yolakwika yakhazikika - kuyambira 75 mpaka 100 mamililita patsiku,
    • aakulu aimpso kuwonongeka - ndi mlingo osaposa 12,5 mg wa patsiku.

    Malangizo ogwiritsira ntchito Captopril FPO akuti mutatha kumwa koyamba kwa mankhwalawa, muyenera kuthana ndi kukakamiza kulikonse theka la ola. Izi ndizofunikira kumvetsetsa momwe mankhwalawa amathandizira thupi: ikayamba kutsika, ikafika pachimake, ikayamba kukwera.

    Mulingo wovomerezeka wa mankhwalawa ndi 150 mg patsiku. Ngati mutenga ndalama zochulukirapo, ndiye kuti zochita zake sizikukulira, koma chiwopsezo chokhala ndi mavuto. Odwala omwe amalephera kupweteka aimpso sawonjezeranso mamiligalamu zana limodzi patsiku. Kwa okalamba, mlingo wa Captopril suyenera kukwezedwa pamwamba pa 6.25 mg, kumwa kawiri pa tsiku.

    Ndemanga za Odwala

    Captopril ndi njira imodzi yodziwika bwino yothandizira matenda oopsa. Zimathandizira munthawi yochepa kuchepetsa kuthamanga kwa magazi kukhala manambala wamba.

    Captopril FPO, ndemanga zake zosiyanasiyana, zakhala zikulandidwa mokwanira mankhwala kuti magazi achulukane. Koma ndikofunikira kukumbukira kuti ngati munthu ali ndi kuthamanga kwa magazi, muyenera kumayesedwa kwathunthu kuti mudziwe chomwe chimayambitsa matenda oopsa.

    Wodwala m'modzi yemwe akudwala kuthamanga kwa magazi (mpaka 190 mmHg) kwa zaka zisanu adadandaula kuti Captopril sichidamuthandize konse ndipo akufuna kuyesanso mankhwala ena. Nthawi yomweyo, palibe mawu omwe adanenedwa, omwe adapereka mankhwalawa kwa iye komanso omwe akufuna kukambirana naye mtsogolo. Kwa omwe angayankhe kuti ndi njira iyi, sayembekeza chilichonse chabwino, chifukwa mankhwalawa amayenera kutumizidwa ndi dokotala.

    Wogwiritsa ntchito Milena adadwala kuntchito: mutu wake udadwala kwambiri. Patatha tsiku logwirira ntchito, adapita kwa bwenzi lake, wafizesi. Anayezera kupanikizika kwake, komwe kunapezeka kuti ndi 195/117, adamupatsa mapiritsi a язык a Captopril pansi pa lilime lake. Pambuyo pake, zinthu zinasintha. Izi zikuwonetsa kuyendetsa bwino ntchito. Koma mayi amalimbikitsidwa kupita kuchipatala kukayezetsa. Kupsinjika kwake ndikokwera kwambiri, ndi izi - pamakhala chiwopsezo chachikulu cha kubadwa kwa myocardial infarction ndi stroke.

    Makhalidwe wamba. Zopangidwa:

    Zogwira pophika: 25 mg ya Captopril malinga ndi 100% ya piritsi limodzi.

    Omwe amathandizira: magnesium stearate, microcrystalline cellulose, lactose (mkaka wa shuga), wowuma chimanga, colloidal silicon dioxide (aerosil).

    Amagwiritsidwa ntchito pochiza matenda oopsa oopsa komanso ochepa matenda oopsa, kulephera kwa mtima, matenda a shuga.

    Katundu

    Mankhwala Kupanga kwa antihypertensive kanthu kumalumikizidwa ndi kupikisana kwa ntchito ya ACE, komwe kumayambitsa kuchepa kwa kusintha kwa angiotensin I kupita ku angiotensin II ndikuchotsa mphamvu yake ya vasoconstrictor.

    Zotsatira zakuchepa kwa kuchuluka kwa angiotensin II, kuwonjezereka kwachiwiri kwa ntchito ya plasma renin kumachitika chifukwa kuchotsedwa kwa mayankho olakwika pakumasulidwa kwa renin komanso kuchepa mwachindunji kwa secretion ya aldosterone. Chifukwa cha vasodilating, amachepetsa kutumphukira kwamitsempha pakukaniza (kutsitsa), kuthinana kwamankhwala m'matumbo am'mapapu (kutsitsa) komanso kukana m'mitsempha yam'mapapo, kumawonjezera kutuluka kwa mtima ndi kulolerana zolimbitsa thupi. Zisakhudze kagayidwe ka lipid.

    Pharmacokinetics Pambuyo pakukonzekera pakamwa, osachepera 75% ya mankhwalawa amatengedwa mwachangu, ndipo pazowonjezera zabwino zimawonedwa m'magazi pambuyo pa mphindi 30-90. Kudya munthawi yomweyo kumachepetsa mayamwidwe ndi 30-40%. Kuyankhulana ndi mapuloteni am'madzi am'magazi, makamaka ndi albumin, ndi 25-30%. Imalowa bwino m'magazi ndi mu ubongo (1%).

    Mlingo ndi makonzedwe:

    Captopril-FPO ndi mankhwala pakamwa ola limodzi asanadye. Rimage regimen imakhazikitsidwa ndi adokotala. Kuti muwonetsetse muyezo womwe uli pansipa, ndizotheka kugwiritsa ntchito Captopril mu anyezi. mawonekedwe: mapiritsi a 12.5 mg.

    Ndi ochepa matenda oopsa. Mankhwala ndi mankhwala koyamba 12,5 mg 2 kawiri pa tsiku. Ngati ndi kotheka, kumwa pang'onopang'ono (pang'onopang'ono kwa masabata awiri ndi awiri) kumawonjezeka mpaka pakhale bwino. Ndi ochepa kapena owonjezera gawo la ochepa matenda oopsa, mlingo woyenera wokonza ndi 25 mg 2 kawiri pa tsiku, mlingo waukulu ndi 50 mg kawiri pa tsiku. Pa matenda oopsa kwambiri, ochepa kwambiri ndi 50 mg katatu patsiku. Mlingo wambiri watsiku ndi tsiku ndi 150 mg.

    Zochizira matenda a mtima osalephera. Captopril-FPO imayikidwa ngati gawo la mankhwala osakanikirana (kuphatikiza pamodzi ndi okodzetsa ndi / kapena kukonzekera kwa dijiti). Mlingo woyambirira ndi 6.25 mg katatu patsiku. M'tsogolo, ngati kuli kotheka (pakadali pafupifupi masabata awiri), mlingo umakulitsidwa pang'onopang'ono. Mlingo wapakati wokonza ndi 25 mg katatu patsiku. Mlingo waukulu kwambiri ndi 150 mg / tsiku.

    Odwala ndi mkhutu aimpso ntchito. Ndi mulingo woyenera waimpso ntchito (kulengedwa kwa clearinine chilolezo (CC) pafupifupi 30 ml / mphindi / 1.73 m2), kapitawo akhoza kutumikiridwa pa mlingo wa 75-100 mg / tsiku. Ndi kuchuluka kutchulidwa kwa aimpso kukanika (CC zosakwana 30 ml / mphindi / 1.73 m2), mlingo woyambayo sayenera kupitirira 12,5 mg patsiku, ndiye, ngati kuli koyenera, muwonjezere mlingo wa captopril, wokhala ndi nthawi yayitali, koma gwiritsani ntchito zochepa poyerekeza ndi tsiku.

    Mukakalamba, mlingo wa mankhwalawa umasankhidwa payekhapayekha, tikulimbikitsidwa kuti muyambitse mankhwala ndi 6.6 mg 2 kawiri patsiku ndipo, ngati zingatheke, muzisamalira.

    Ngati ndi kotheka, ma loop okodzetsa amawonjezeranso, osati thiazide diuretics.

    Kupanga, katundu ndi mawonekedwe akumasulidwa

    Captopril FPO ndi zoletsa za ACE, mankhwala otsimikiziridwa a antihypertensive, omwe amalimbikitsidwa pochiza matenda oopsa. Wopezeka mu mawonekedwe a mapiritsi, mawonekedwe awo ndi mtundu oyera kapena oyera ndi kukhudza kwa zonona.

    Chofunikira chachikulu ndi capopril, piritsi limodzi lili 50 mg.

    Zowonjezera:

    • magnesium wakuba,
    • cellulose
    • lactose
    • wowuma chimanga
    • silika.

    Captopril FPO imalowa mwachangu m'mimba ndi m'matumbo, ndikulimbikitsidwa kuti idye musanadye, chifukwa chakudya chimachepetsa kuyamwa ndi 40%. Wopangidwira m'chiwindi. Amadzipukusa ndi impso pafupifupi kwathunthu - ndi 95%. Amachepetsa kupanikizika, ngakhale ali ndi zaka zambiri.

    Captopril FPO Machitidwe:

    • amachepetsa kusintha kwa angiotensin 1 mpaka angiotensin 2,
    • imalepheretsa kuwonongeka kwa bradycardin, yokhudza kinin-kallikreinovy ​​system,
    • imalimbikitsa kumasulidwa kwa aldosterone,
    • imayendetsa magazi, imayenda bwino,
    • Imachepetsa katundu pamtima, imakweza kukana kwake,
    • Amachepetsa sodium m'magazi,
    • Amathandizira magazi kupita ku myocardium,
    • Imalepheretsa maselo am'magazi kuti asamatikane, omwe amateteza ku mapangidwe a magazi,
    • samayamba ndi matenda ashuga.

    Popeza chiwonetsero cha Captopril FPO sichimangolembedwa, komanso chifukwa cha kulephera kwa mtima, kusokonezeka kwamitsempha yamanzere pambuyo pakuwonekera kwa myocardial infaration, komanso nephropathy ya matenda ashuga a mtundu woyamba.

    Kutenga?

    Captopril FPO imagwiritsidwa ntchito pozungulira matenda oopsa, koma ndikofunikira kulingalira zolembera zovuta. Mlingo umatengera izi. Mlingo woyambirira umachokera pa 6 mpaka 12,5 mg, katatu patsiku, ngati kuli kotheka, kuchuluka kwa mapiritsi kumawonjezeka mpaka 50 mg. Mlingo waukulu kwambiri ndi 150 mg. Ndondomeko ya kumwa mankhwalawa imatsimikiziridwa payekhapayekha, poganizira momwe wodwalayo alili ndi matenda ena okhudzana ndi matendawa.

    Kodi pamakhala zoyipa zilizonse?

    Ndi mndandanda wochepetsetsa wa contraindication, mankhwalawa ali ndi kayendedwe kake kosiyanasiyana, kamene kamatha kuchitika mbali zingapo za thupi. Ngati mukumva zilizonse zomwe zalembedwa pamndandandawu, muyenera kusintha mankhwalawa mothandizidwa ndi dokotala.

    Kuwonetsedwa kwa zoyipa:

    1. Machitidwe amanjenje. Chizungulire, kupweteka mutu, kutopa, kumverera kwa "tsekwe".
    2. Mtima ndi mitsempha yamagazi. Kuchepa kwamphamvu kwa kupanikizika, tachycardia.
    3. Chimbudzi. Kugunda kwa msana, kusokonezeka kwa kukomoka, kutsekula m'mimba kapena kudzimbidwa, hyperbilirubinemia - kusintha kwa khungu pakhungu chifukwa cha bilirubin. Nthawi zambiri, cholestasis.
    4. Hematopoietic dongosolo. Neutropenia - kuchepa kwa neutrophils m'magazi, kuchepa magazi, thrombocytopenia - kuchepa kwa maselo, okhala ndi matenda a autoimmune - agranulocytosis.
    5. Kupenda. Hyperkalemia - kuchuluka kwa potaziyamu m'thupi, acidosis - kuchuluka acidity.
    6. Njira yamkodzo. Kuchulukitsa kwa kuchuluka kwa urea ndi creatinine m'magazi, proteinuria - mapuloteni mumkodzo.
    7. Ziwalo zopumira. Youma chifuwa.
    8. Ziwengo Rash, bronchospasm, nthawi zina - edema ya Quincke, lymphadenopathy - kuwonjezeka kwa ma lymph node.

    Kodi mankhwalawa amatha bwanji kuphatikiza ndimankhwala ena?

    Ndikofunikira kukumbukira kuti zoletsa za ACE sizimaphatikizidwa ndi mankhwala onse. Chifukwa chake, ngati wodwala amatenga mankhwala ena aliwonse, muyenera kuchenjeza adokotala za izi.

    Kuphatikiza kwa Captopril FPO:

    1. Ndi ma immunosuppressants, cytostatics - chiopsezo chokhala ndi leukopenia ukuwonjezeka.
    2. Ndi okodzetsa, makonzedwe okhala ndi potaziyamu, mmalo amchere, trimethoprim - kukula kwa hyperkalemia. Izi ndichifukwa choti ACE inhibitors amasunga potaziyamu m'thupi, ndipo pang'onopang'ono amayamba kudziunjikira.
    3. Ndi mankhwala osapweteka a anti-yotupa - ntchito ya impso imatha kusokoneza.
    4. Ndi thiazide diuretics - kuchepa kwamphamvu kwa kupanikizika, kukula kwa hypokalemia.
    5. Mankhwala osokoneza bongo - kumachitika kwambiri ochepa ochepa hypotension.
    6. Ndi azathioprine - chiopsezo cha magazi m'thupi, leukopenia.
    7. Ndi allopurinol - kukula kwa matenda a hematological, wamphamvu hypersensitivity zimachitika.
    8. Captopril imagwira bwino bwino kuchokera ku aluminium hydroxide, magnesium hydroxide, magnesium carbonate.
    9. Ndi acetylsalicylic acid - mphamvu ya chinthu chachikulu imachepetsedwa, chiopsezo chotsitsa zotsatira za mtima ndi odwala omwe ali ndi vuto la mtima.
    10. Ndi indomethacin, ibuprofen, captopril ndi yofooka.
    11. Ndi insulin, kukula kwa hypoglycemia.
    12. Ndi mitundu ya interferon - chiopsezo cha granulocytopenia - kuchepa kwa granulocytes m'mwazi.
    13. Ndi lifiyamu ya carbonum - ndende ya lithiamu imachuluka, komanso kuledzera.
    14. Ndi minoxidil, sodium nitroprusside - mphamvu ya capopril imawonjezeka.
    15. Ndi orlistat - chinthu chachikulu ndichoperewera, chomwe chingapangitse vuto lalikulu kwambiri.
    16. Ndi pergolide - antihypertensive zotsatira zimawonjezeka.
    17. Ndi probenecid, capopril sakhala chilolezo chaimpso.
    18. Ndi procainamide - chiopsezo chokhala ndi leukopenia.
    19. Ndi chlorpromazine, kupanikizika kumatsika kwambiri.
    20. Ndi cyclosporine - chiopsezo cha kupweteka kwambiri kwaimpso.
    21. Ndi erythropoietins, capopril ndiyofooka.
    22. Ndi digoxin - kuchuluka kwa mankhwalawa kumawonetsedwa. Sizachilendo kwa odwala omwe ali ndi vuto la impso.

    Mimba komanso kuyamwa

    Ma inhibitors a ACE ndi oletsedwa kwa amayi apakati omwe ali ndi matenda oopsa, chifukwa m'magawo apambuyo pake pamakhala chiopsezo cha kufa kwa fetal. Matenda otheka kukula mu mwana. Mukamayamwitsa, mankhwalawa sayeneranso kuperekedwa, chifukwa mankhwalawa amachotseredwa mkaka wa m'mawere, womwe umakhala wowopsa kwambiri kwa mwana.

    Matenda a impso

    Ngati matenda oopsa a impso, mlingo umayikidwa mosiyanasiyana payekhapayekha. Pankhani ya kulephera kwa impso kapena pambuyo pochulukitsa, nzoletsedwa kumwa mankhwalawo - katundu wolimba amagwera impso.

    Ngati mavuto a impso ayamba nthawi ya chithandizo, mlingo umachepetsedwa.

    Mtengo ndi fanizo

    Captopril FPO ndi yotsika mtengo - pafupifupi ma ruble 10, koma pali mitundu ingapo yomwe imalowetsa mmalo, komanso inzake. Kusiyanitsa pakati pawo kumangokhala mayina, kapangidwe kake ndi zotsatira zake ndizofanana.

    Mankhwala ophatikizika:

    1. Kapoten. Kuchokera pamndandanda wa ACE inhibitors. Piritsi limodzi lili ndi 25 mg ya Captopril, mwa omwe amapezeka - mapadi, kukhuthala, lactose, stearic acid. Amathandizira ochepa matenda oopsa, kuperewera kwamtima kosalekeza, kusokonezeka kwamitsempha yamanzere pambuyo pakuwonekera kwa myocardial. Moyo wautumiki - zaka 5, ziyenera kusungidwa pa kutentha osaposa 25 digiri. Werengani zambiri zamomwe mungatenge Kapoten pa matenda oopsa - werengani apa.
    2. Chibv. Kuchokera pamndandanda wofanana wa zoletsa. Katundu wake wamkulu ndi capopril, 25 g piritsi limodzi. Amawerengera matenda oopsa, kulephera kwa mtima. Alumali moyo - zaka 5, pa kutentha kwa madigiri 10 mpaka 25.
    3. Blockordil. ACE inhibitor. Pansi pake ndi capopril, 25 mg, pazinthu zothandizira - mapadi, lactose, wowuma, stearic acid. Zimathandizira kuthana ndi matenda oopsa kwambiri, kulephera kwamtima kosalekeza. Moyo wa alumali - zaka 3, kutentha sikuyenera kupitirira 25 digiri.

    Ndemanga za akatswiri a mtima ndi odwala

    Captopril FPO yatola ndemanga zosiyanasiyana, zabwino ndi zoyipa. Madokotala amati mankhwalawo amathandiza odwala omwe ali ndi vuto lalikulu la shuga omwe amafunika kumuwunikira mwatsatanetsatane komanso mulingo woyenera. Mankhwalawa amapangidwira chisamaliro chodzidzimutsa. Odwala amadziwa kuti pali zomwe zimachitika nthawi yomweyo, koma mankhwalawa sathandiza kuti kukakamira kwawo kuzikhala kwakanthawi.

    Makasitomala amawunikira

    Alesia Cherepanova, katswiri wamtima. Nthawi zambiri ndimapereka Captopril FPO kuti ipereke chisamaliro chadzidzidzi pamavuto oopsa kwambiri. Kuchita bwino sikuwonetsedwa nthawi zonse, ndikulongosola izi ndi kusiyana pakati pa zoyambira ndi zamagetsi.

    Vladimir Zaitsev, katswiri wamtima. Nthawi zambiri ndakhala ndikumva kwa odwala kuti zoterezi zimakhala zopanda mphamvu, koma nthawi yomweyo, kupanikizika kosasintha kumachitika. Imagwira ntchito mokwanira nthawi zambiri.

    Antonina Vasilieva, katswiri wamtima. Ndikupangira mankhwalawa chifukwa amachepetsa kuthamanga kwa magazi, koma bwino. Ndikofunika kuti musapitirire mlingo. Ndipo koposa zonse - kuchita mayeso athunthu, chifukwa mlingo umatsimikiziridwa payekhapayekha.

    Ndemanga za odwala

    Olga, hypertonic, wazaka 45. Amakhala ndi moyo wakhama, koma mavuto atangofika 200, mwina chifukwa cholemetsa kwambiri. Kwa chaka chopanikizika chakhala chikukwera, ndikungogwetsa kapitawo wa FPO.

    Vitaliy, hypertonic, wazaka 52. Kwa nthawi yoyamba, kupanikizika kunayamba kuwononga pafupifupi zaka 5 zapitazo. Ndinayesa mankhwala osiyanasiyana. Dokotala adalemba Captopril FPO katatu patsiku. Sizinandithandizire, popeza manambala anali 170 mpaka 110, amakhalabe.

    Irina, wazaka 60, wodwala matenda oopsa. Ndi kuthamanga kwa magazi kwa nthawi yayitali, ndipo popeza ndimakhala m'nyumba yanga, ndimagwira ntchito zambiri, ndinasinthira kuwombera FPO ndi Captopril. Zimathandiza bwino, ndizotsika mtengo.

    Captopril FPO ndi mankhwala amphamvu, okhala ndi mndandanda wocheperako, koma ali ndi zoyipa zoyenera kuziganizira. Imagwiritsidwa ntchito ngati mufunika kuchepetsa kukakamiza, koma kuti muthe kukhazikika, muyenera kuigwiritsa ntchito masana katatu. Chifukwa chake, sioyenera kukakamiza kwapanthawi yonse.

    Zomwe Mungagwiritse Ntchito:

    Musanayambe, komanso pafupipafupi pa mankhwala a capopril, ntchito yaimpso iyenera kuyang'aniridwa. Odwala omwe ali ndi vuto la aimpso kulephera, amagwiritsidwa ntchito moyang'aniridwa ndi achipatala.

    Odwala omwe ali ndi matenda oopsa kwambiri, mwayi wokhala ndi chidwi chachikulu kwambiri chokhala ndi kaphatikizidwe kazachuma umachulukirachulukira ndikusowa kwamadzi ndi mchere, mwachitsanzo, ndi chithandizo chokwanira ndi diuretics, kugwiritsa ntchito zakudya zochepa komanso zopanda mchere. Kutheka kwa kuchepa kwambiri kwa kuthamanga kwa magazi kumachepetsedwa ndikuwonetsa (masiku 4-7) kuthetsedwera kwa diuretic kapena kuchepa kwa mlingo wake.

    Kulephera kwa mtima kosatha, mankhwalawa amagwiritsidwa ntchito pokhapokha amayang'aniridwa mosamala ndi madokotala.

    Ndiwosamala kwambiri, Captopril imaperekedwa kwa odwala omwe ali ndi matenda a autoimmune (kuphatikiza matenda a minofu, systemic vasculitis), odwala omwe amalandira allopurinol, procainamide, immunosuppressants, makamaka pamaso pa vuto la aimpso (chiwopsezo cha matenda oopsa omwe sangathe kuthana ndi mankhwala othandizira). Zikatero, milingo ya leukocyte iyenera kuyang'aniridwa milungu iwiri iliyonse pakapita miyezi itatu yoyambirira ya mankhwala a Captopril., Kenako miyezi iwiri iliyonse. Ngati kuchuluka kwa leukocytes ndi ochepera 1,000 / μl - mankhwalawa amaletsedwa.

    Amagwiritsidwa ntchito mosamala mu odwala omwe ali ndi mbiri ya matenda a impso, chifukwa chiopsezo chokhala ndi proteinuria chikuwonjezeka. Zikatero, kuchuluka kwa mapuloteni mumkodzo kuyenera kuwunikidwa mwezi uliwonse m'miyezi 9 yoyambirira ya chithandizo chamankhwala. Ngati kuchuluka kwa mapuloteni mumkodzo kumaposa 1 g / tsiku, ndikofunikira kusankha pakuyenera kugwiritsa ntchito mankhwalawa. Mochenjera, Captopril imalembedwa kwa odwala aimpso a stenosis, monga pali chiopsezo chotenga kukanika kwa impso, ngati pakuwonjezeka kuchuluka kwa urea ndi / kapena kulenga kwa magazi, kuchepetsa kwa Captopril kapena kuleka kwa mankhwala kungafunike.

    Odwala omwe amalephera kupezekanso kwa impso komanso matenda a shuga, komanso kumwa mankhwala a potaziyamu. Kugwiritsa ntchito munthawi yomweyo mankhwala osokoneza bongo a potaziyamu komanso kukonza potaziyamu kuyenera kupewedwa.

    Pochita hemodialysis mwa odwala omwe amalandila capopril, kugwiritsa ntchito ma membala a dialysis okhala ndi vuto lalikulu kwambiri kuyenera kupewedwa, chifukwa ngati izi zimachitika kuti chiwopsezo cha anaphylactoid chikuwonjezereka.

    Mukamamwa mankhwalawa, zotsatira zoyipa zimawonedwa pokambirana mkodzo wa acetone.

    Munthawi ya chithandizo, chisamaliro chimayenera kuchitika mukamayendetsa magalimoto ndikuchita zina zomwe zingakhale zowopsa zomwe zimafuna kuti chidwi chachikulu komanso kuthamanga kwa zochitika zama psychomotor (chizungulire zitheke, makamaka mutatha kumwa koyamba).

    Zotsatira zoyipa:

    Kuchokera pamtima dongosolo: tachycardia, kutsitsa magazi, orthostatic hypotension, zotumphukira edema.

    Kuchokera pakati mantha dongosolo: chizungulire, kupweteka mutu, kumva kutopa, asthenia, paresthesia, ataxia, kugona, kuwona kuwonongeka.

    Kuchokera kwamikodzo dongosolo: proteinuria, hyponatremia, mkhutu matenda aimpso (kuchuluka kwa urea ndi magazi creatinine).

    Pa gawo la madzi-electrolyte ndi acid-base state: hyperkalemia, acidosis.

    Kuchokera kupuma dongosolo: chifuwa chowuma, nthawi zambiri chimadutsa atasiya kugwiritsa ntchito mankhwala, bronchospasm, pulmonary edema.

    Thupi lawo siligwirizana ndi immunopathological: angioedema malekezero, nkhope, milomo, mucous membrane lilime, pharynx ndi larynx, kutupa kwa magazi pakhungu la nkhope, zidzolo (maculopapular chilengedwe, kawirikawiri - vesicular kapena bully chikhalidwe), kuyabwa, kuwonjezereka kwa khungu, matenda a seramu, lymphadenopathy, nthawi zina - mawonekedwe a antiinodar antibodies m'magazi.

    Kuchokera mmimba thirakiti: nseru, kusowa kwa chakudya, pakamwa pouma, kusokonezeka kwa chisokonezo, stomatitis, chiseyeye m'mimba, kupweteka kwam'mimba, kuwonjezeka kwa chiwindi ntchito, zizindikiro za kuwonongeka kwa hepatocellular, cholestasis (nthawi zina), hepatitis, hyperbilirubinemia.

    Mogwirizana ndi mankhwala ena:

    Kuchulukitsa kuchuluka kwa digoxin m'madzi a m'magazi. Kuchulukitsa bioavailability wa propranolol.

    Cimetidine amalimbikitsa kuchuluka kwa mankhwalawa m'magazi am'magazi.

    Ma diuretics ndi vasodilators (mwachitsanzo, minoxidil), B-blockers, "osakwiya" calcium njira blockers, tricyclic antidepressants, Mowa umalimbitsa chidwi cha hypopensive.

    Mankhwala osokoneza bongo a nonsteroidal ndi clonidine amachepetsa hypotensive zotsatira za Captopril.

    Kugwiritsira ntchito limodzi ndi potaziyamu mosalekerera okodzetsa, kukonzekera kwa potaziyamu, cyclosporine kungayambitse hyperkalemia.

    Ndi munthawi yomweyo kugwiritsa ntchito lifiyamu salt, kuwonjezeka kwa ndende ya lithiamu m'magazi seramu ndikotheka.

    Kugwiritsidwa ntchito kwa Captopril odwala omwe akutenga allopurinol kapena procainamide kumawonjezera chiopsezo cha neutropenia ndi / kapena Stevens-Johnson.

    Kugwiritsidwa ntchito kwa captopril odwala omwe akutenga ma immunosuppressants (cyclophosphacin, azathioprine ndi ena) kumawonjezera mwayi wokhala ndi vuto la hematological.

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