Kugwiritsa ntchito mankhwala blocktran, zabwino zake ndi zonyansa

Mtundu wa blocktran ndi mapiritsi a 12,5 mg (film-wokutira) ndi 50 mg (filimu-wokutira) (ma PC 10. M'matumba, muthumba la makatoni 1, 2, 3, 5, kapena 6 mapaketi).

Zogwira pophika: losartan potaziyamu, piritsi limodzi - 12,5 kapena 50 mg.

Zothandiza monga: sodium carboxymethyl starch (sodium starch glycolate), microcrystalline cellulose, lactose monohydrate, colloidal silicon dioxide (aerosil), povidone (polyvinylpyrrolidone, povidone K17), wowonda wa mbatata.

Mapangidwe a Shell: titanium dioxide (E171), Copovidone, polysorbate 80 (pakati 80), talc, hypromellose (hydroxypropyl methylcellulose), utoto.

Kutulutsa Fomu

• Mapiritsi ozungulira-lalanje a biconvex. Mapiritsi 10 mu phukusi la contour, 1, 3, 2, 5 kapena 6 mapaketi a katoni katoni.
• Mapiritsi a biconvex apinki amitundu yozungulira, yopuma - mtundu woyera. Mapiritsi 10 mu phukusi la contour, 1, 3, 2, 5 kapena 6 mapaketi a katoni katoni.

Pharmacodynamics wa losartan

Angiotensin amtundu wachiwiri ndi vasoconstrictor wamphamvu, mkhalapakati wamkulu renin-angiotensin dongosolo ndi cholumikizira chachikulu cha pathophysiological ochepa matenda oopsa. Losartan Receptor blocker angiotensinMitundu iwiri. Angiotensin kusankha kumangirira Ma receptors a mtundu wa AT1ili mu tiziwalo timene timatulutsa, m'mitsempha yamagazi, impso ndi mtima ndipo imalimbikitsa vasoconstriction ndi kupanga aldosteroneamathanso kutsutsa kukula kwa maselo osalala. Izi ndi ntchito metabolite lekani zonse zomwe zingachitike angiotensin Mitundu iwiri posatengera komwe magwiritsidwe ake kapena njira yake.

Losartan sichimalepheretsa zolandirira ena onse mahomoni kapena njira za ion zomwe zimayendetsa dongosolo la mtima. Sichiletsa angiotensin akatembenuka enzymeudindo wa inactivation bradykininchifukwa zoyipa zomwe zimayenderana bradykinin zimachitika kawirikawiri. Mukamagwiritsa ntchito losartan pali kuwonjezeka kwa ntchito ya plasma renin, zomwe zimapangitsa kuti ziwonjezeke zamtundu wa 2 angiotensin mkati magazi. Ntchito za antihypertgency ndikuchepetsa ndende aldosteronemagazi amasungidwa, omwe akuwonetsa blockade yothandiza angiotensin zolandilira.

Losartan ndipo metabolite yake yayikulu imakhala yotentha kwa ma receptors angiotensin Mtundu 1 wokulirapo kuposa ma receptor angiotensin Mitundu iwiri. Metabolite yotchulidwa imakhala yogwira ntchito losartan Nthawi 1040. Pambuyo pa utsogoleri, mchitidwewo umafika pakulimba pambuyo maola 6, kenako ndikuchepetsa pang'onopang'ono kwa maola 24. Kuphatikiza kwakukulu kwa antihypertensive amalemba pambuyo pa masabata a 6 kuyambira chiyambi cha mankhwala. Izi zimawonjezeka ndi kuchuluka kwa mlingo. losartan.

Losartan sizimakhudzanso mawonekedwe osinthika komanso sizimasintha ndende norepinephrine m'magazi kwa nthawi yayitali.
Odwala ndi kukulira lamanzere yamitsempha yamagazi ndipo ochepa matenda oopsalosartan, kuphatikiza ndi hydrochlorothiazide, umachepetsa mwayi wa kufera kwamtima ndi chithaphwi.

Pharmacodynamics wa hydrochlorothiazide

Njira yamachitidwe thiazide-mtundu diuretics osadziwika. Nthawi zambiri sizimakhudza kupanikizika kwina.

Hydrochlorothiazide ndi onse antihypertensive mankhwala, ndi okodzetsa. Zimakhudzanso kusinthasintha kwa ma electrolyte m'matumbo a impso. Pafupifupi kuwonjezereka komweko kwa ayoni mankhwala a chlorine ndi sodium. Natriurez limodzi ndi kuchepa mphamvu bicarbonateanyezi potaziyamu ndi kuchedwa calcium. Mphamvu ya diuretic inalembedwa patapita maola awiri pambuyo pa utsogoleri, imafika patatha maola 4 ndipo imatha maola 7-12.

Ndani anapatsidwa

Mu malangizo, zomwe zikuwonetsa kugwiritsa ntchito Blocktran ndizochepa pamfundo ziwiri zokha:

1. Ndi matenda oopsa, kutumikiridwa kwa mankhwalawo kumapangitsa kuchepa kwakanthawi kwamankhwala. Blocktran yachizindikiro ichi iyenera kumwa tsiku lililonse kwa nthawi yayitali.
2. Pakulephera kwa mtima, mankhwala osokoneza bongo apamwamba amalembedwa ngati m'malo mwa ACE zoletsa (mapiritsi a antihypertensive omwe amatha - adj) ngati atayambitsa mavuto.

Kuyerekeza mphamvu ya blocktran ndi mawonekedwe ake ndi mankhwala oopsa omwe ali m'magulu ena azachipatala akuwonetsa kuti mankhwalawa ali pafupi kuchitapo kanthu: amapereka zochepetsera zofanana, amatetezedwa ku mavuto osokoneza bongo komanso zovuta zawo.

Blocktran ndi mankhwala ena omwe ali ndi losartan ali ndi zosiyana zingapo zingapo kuchokera ku mankhwala ena a antihypertensive. Ndiwo kusiyana kumene kumapangitsa kukula kwa magwiritsidwe ake.

Zomwe zimathandiza Blocktran:

• Mapiritsi amatha kuchemerera. Kuti muthe kuchita bwino kwambiri, zimafunikira tsiku lililonse kwa masabata 2-5.
• kuchepetsedwa kwa zopanikizika ndi blocktran ndikulimbikira. Kuzolowera mankhwalawa ndikuchepetsa mphamvu yake pakanthawi kochepa chithandizo kumachitika kangapo kofanana ndi beta-blockers kapena ACE inhibitors,
• mphamvu yaku blocktran siigwirizana ndi mtundu, jenda, zaka za wodwalayo,
• ma sartan onse, kuphatikiza ndi blocktran, amaleredwa bwino. Mankhwalawa ndiwotetezeka kuposa mankhwala onse a antihypertensive, pafupipafupi zovuta zawo ndizochepa. Poyerekeza ndi ACE inhibitors, ndizochepa zomwe zimayambitsa kutsokomola, Hyperkalemia, zotsatira zoyipa zamagetsi,
• Kwa nthawi yayitali, Blocktran adaganiziridwa kuti sangatenge nawo mbali m'thupi. Tsopano ndikudziwika kuti zimathandizira kuchepetsa kukana kwa insulin ndi cholesterol, kotero imatha kugwiritsidwa ntchito kwambiri kuchepetsa kuthamanga kwa magazi mu matenda a shuga mellitus,
• mankhwalawa sasokoneza bronchial patency (sayambitsa chifuwa) komanso erectile ntchito,
• sartans ndi omwe amapikisana kwambiri ndi ACE zoletsa pakulephera kwa mtima. Pali umboni kuti losartan imapereka moyo wofanana, kuchepetsa chiopsezo cha matenda a mtima ndi sitiroko, kukonza mkhalidwe wa odwala omwe ali ndi nephropathy, myocardial hypertrophy, komanso ACE inhibitors.
• ndi nephropathy, kugwiritsidwa ntchito kwa nthawi yayitali kwa mapiritsi aBtrtrtran kungachepetse proteinuria ndi 35%, kuchepetsa chiopsezo cha kulephera kwa impso ndi omaliza, odwala, gawo 28%,
• losartan ali ndi antiarrhythmic zotsatira,
• mankhwalawa ali ndi mphamvu pa purine metabolism: imalimbikitsa chimbudzi cha uric acid, imapangitsa odwala omwe ali ndi gout.

Chifukwa chake, kugwiritsa ntchito kwa Blocktran muzochita zamankhwala ndizofala kwambiri kuposa momwe tafotokozera.

Kodi mankhwalawa amagwira ntchito bwanji?

Makina a zochita za losartan ndikutseka ma receptors a angiotensin mtundu II AT-1. Angiotensin II ndi imodzi mwazinthu zazikulu za peptides zomwe zimakhudzidwa ndi kayendetsedwe kazinthu zolimbitsa thupi. Imagwira mwachindunji pamlingo wopsinjika: imapanga mitsempha yamagazi, imawonjezera kukana kwake, imathandizira kupanga aldosterone (mahomoni omwe amayang'anira kuchuluka kwa mchere wamadzi), ndikuchepetsa kutulutsa kwamkodzo.

Mapiritsi a blocktran amachita mosankha: amangoletsa zolowa zokha za angiotensin zomwe zimakhudza zinthu zomwe zimayambitsa matenda oopsa. Chifukwa cha kutsekereza kotere, kamvekedwe ka mtima kamachepa, kuponderezana kumatsika.

Kodi blocktran iyenera kutengedwa: matenda oopsa amadziwika msanga pamene kuthamanga kwatsiku ndi tsiku kumafikira 140/90. Poyambirira, kufatsa kwambiri kwamankhwala, odwala amalimbikitsidwa kuti achepetse thupi, azolimbitsa thupi, komanso kudya. Ngati njirazi sizothandiza, perekani mankhwala oponderezedwa. Posankha mankhwala ena, nthawi zambiri amayang'ana kwambiri pazowonjezera zake. Mwachitsanzo, okodzetsa amawonetsedwa chifukwa cha kulephera kwa mtima, otsutsana ndi calcium - pambuyo pa stroke. Malo a sartan muulamuliro uwu ndikuletsa mtima wa ischemia. Nthawi zambiri amasinthidwa ndi ACE zoletsa ngati ayambitsa zotsatira zoyipa. Malinga ndi odwala, losartan amadziwika ngati woyamba mankhwala osowa.

Mankhwala a Blocktran mapiritsi:

Mosiyana ndi ACE zoletsa, Blocktran sayambitsa hypotension kumayambiriro kwa chithandizo. Mapiritsi atathetsedwa, kupanikizika pang'onopang'ono kumkafika pamlingo wapitalo, kulumpha kowopsa sikuchitika.

Contraindication

kwambiri ochepa hypotension,

- aimpso kuwonongeka (kulengedwa kwa creatinine zosakwana 30 ml / min),

- Kugwiritsa ntchito munthawi yomweyo kukonzekera kwa potaziyamu, kugwiritsa ntchito potaziyamu,

- kukanika kwambiri kwa chiwindi (mfundo zoposa 9 pamakwerero a Mwana-Pugh), cholestasis,

- mimba ndi nthawi yoyamwitsa,

- azaka zapakati pa 18 (mphamvu ndi chitetezo cha ntchito sizinakhazikike),

- Hypersensitivity pamagawo a mankhwala, zotumphukira zina za sulfonylamide,

- tsankho lactose, kuchepa kwa lactase, shuga-galactose malabsorption.

Momwe angatenge

Kuchita bwino kwa mankhwalawa ndi mapiritsi a blocktran kumadalira mlingo woyenera ndi kutsatira malamulo ovomerezeka. Odwala omwe amapereka mankhwala nthawi zambiri amakhala ndi mafunso osakhazikika kapena osakwanira omwe amapezeka mu malangizo ogwiritsa ntchito. Tiyeni tizingokhalira kuganizira zambiri za iwo.

Kodi mungasankhe bwanji mulingo woyenera?

Chithandizo cha matenda oopsa chimayamba ndi 50 mg. Ngati wodwala amatenga diuretics - kuchokera 25 mg, ndi vuto la mtima - kuchokera 12,5 mg. Mlingo waledzera sabata 1, kuwunika mosamala mkhalidwe wawo ndi kuchuluka kwa mavuto. Ngati kupanikizika sikunatsikire kufikira gawo la chandamale (kuchokera pa 125/75 mpaka 140/90, dokotala amawona), ndipo mankhwalawo sanayambitse zotsatira zoyipa, mlingo umakulitsidwa pang'onopang'ono. Kuyambira kumayambiriro kwa sabata latsopanoli, 12,5 mg imawonjezeredwa ndipo kuwunika kumapitilira. M'magawo angapo, mlingo umatha kuwonjezeka mpaka 100 mg. Ngati sichikupereka chiwopsezo chopondera, malangizowo akutsimikizira kuti m'malo mwa Blocktran mudzakhale Blocktran GT.

Kodi mufunika blocktran musanadye kapena pambuyo chakudya?

Kuchokera pakuwona momwe mankhwalawa amathandizira, nthawi yoyendetsera ntchito ilibe kanthu, popeza chakudya sichimakhudza kuchuluka kwa mayeso a losartan. Komabe, mapiritsi ambiri amalekeredwa bwino ngati mumamwa mukatha kudya.

Kodi ndibwino kumwa mankhwalawa m'mawa kapena madzulo? Malangizo ogwiritsira ntchito Blocktran samawonetsa nthawi yokwanira yolandirira. Popeza mphamvu ya mankhwalawa ndi yosagwirizana (maola 6 atatha kuperekera), mphamvu yake yotsitsa imatha kuwongoleredwa. Mwachitsanzo, ngati kupanikizika kumakonda kukwera masana, ndikomveka kumwa mapiritsi m'mawa, ngati m'mawa kwambiri - asanagone.

Kodi mukufunikira kuchuluka kwa Mlingo wambiri tsiku lililonse?

Kwa odwala ambiri, kumwa kamodzi ndi koyenera. Ngati mulingo woposa 50 mg, utha kugawidwa ndi 2 times.

Doctor of Medical Science, Mutu wa Institute of Diabetesology - Tatyana Yakovleva

Ndakhala ndikuphunzira matenda a shuga kwa zaka zambiri. Zimakhala zowopsa anthu ambiri akamwalira, ndipo makamaka amakhala olumala chifukwa cha matenda ashuga.

Ndithamangira kunena mbiri yabwino - Endocrinological Research Center ya Russia Academy of Medical Science idatha kupanga mankhwala omwe amachiritsiratu matenda ashuga. Pakadali pano, kugwiritsa ntchito bwino kwa mankhwalawa kuyandikira 98%.

Nkhani ina yabwino: Unduna wa Zaumoyo wateteza kukhazikitsidwa kwa pulogalamu yapadera yomwe imalipira mtengo wa mankhwalawo. Ku Russia, odwala matenda ashuga mpaka Meyi 18 (kuphatikiza) nditha kuipeza - Kwa ma ruble 147 okha!

Kodi ndingamwe kumwa mapiritsi a blocktran ndi ziphuphu ziti? Kuphatikiza kwakukulu kwa losartan ndizotsutsana ndi calcium ndi okodzetsa, kuphatikiza kovomerezeka ndi osartan ndi beta-blockers. Blocktran imakhala ndi contraindication chifukwa chogwirizana ndi mankhwala omwe ali ndi machitidwe ofanana: ma sartans ena, ACE inhibitors. Kugwiritsira ntchito pamodzi ndi potaziyamu osunga diuretics (Veroshpiron) kumafuna kuwongolera kowonjezereka chifukwa cha chiwopsezo cha hyperkalemia.

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

Yovomerezeka pakamwa, mosasamala kanthu za kudya kwa niche, pafupipafupi kulandira Blocktran GT - 1 nthawi patsiku.

Mlingo woyamba ndi kukonza ndi piritsi 1 nthawi imodzi patsiku. Mu 13 osiyana milandu, kuti akwaniritse kwambiri, mlingo umakulitsidwa 2 mapiritsi 1 kamodzi patsiku. Mulingo wambiri watsiku ndi tsiku ndi mapiritsi awiri a blocktran GT.

Sikuti ndikusintha kwa mankhwalawa kwa odwala okalamba komanso odwala omwe ali ndi vuto lochepetsa aimpso (CC 30-50 ml / min).

Kuchepetsa chiopsezo cha matenda amtima komanso kufa kwa odwala omwe ali ndi matenda oopsa ndipo amasiya zamitsempha yamagazi

Zotsatira za pharmacological

Zomwe zimapangidwa ndi blocktran GT zimakhala ndi zowonjezera antihypertensive, zimachepetsa kuthamanga kwa magazi (BP) kwakukulu kwambiri kuposa zigawo chilichonse payokha. Chifukwa cha diuretic zotsatira, hydrochlorothiazide imachulukitsa ntchito ya plasma renin (ARP), imathandizira kubisalira kwa aldosterone, imakulitsa kuchuluka kwa aigiotensin II ndikuchepetsa zomwe zili serum potaziyamu. Kulandila losartan kumatseketsa zovuta zonse za thupi za aigiotensin II ndipo, chifukwa cha kuponderezedwa ndi zotsatira za aldosterone, kungathandize kuchepetsa kutaya kwa potaziyamu komwe kumakhudzana ndi kutenga diuretic.

Hydrochlorogiazide imapangitsa kuwonjezeka pang'ono kwa kuchuluka kwa uric acid m'madzi am'magazi, losartan imakhala ndi kuchepa komanso kosakhalitsa kwa uricosuric. Kuphatikiza kwa losartan ndi hydrochlorothiazide kumathandizira kuchepetsa zovuta za hyperuricemia chifukwa cha okodzetsa.

Losartan: Angiotensin II ndi wamphamvu vasoconstrictor, mahomoni othandizira kwambiri m'thupi la renin-angiotensin-aldosterone, komanso cholumikizira chofunikira kwambiri cha pathophysiological pakukula kwa matenda oopsa kwambiri. Losartan ndi wotsutsa wa aigiotensin II receptors (mtundu wa AT1). Angiotensin II amamangirira mosamala ku zolandilira za AT1 zopezeka m'matumbo ambiri (mu minofu yosalala ya mitsempha yamagazi, zotupa za adrenal, impso ndi mtima) ndikuchita ntchito zingapo zofunika zachilengedwe, kuphatikizapo vasoconstriction ndi kutulutsidwa kwa aldosterone. Angiotensin II imapangitsanso kuchuluka kwa minofu yosalala.

Zotsatira zoyipa

M'maphunziro azachipatala ndi losartan / hydrochlorothiazide, palibe zochitika zotsutsana ndi mankhwalawa zomwe zimawonedwa. Zochitika zoyipa zinali zochepa kwa omwe adanenedwa kale ndi losartan ndi hydrochlorothiazide okha.

Kumbali ya magazi ndi zamitsempha yamagazi dongosolo: pafupipafupi - kuchepa magazi, Shenlein-Genoch phenura, ecchymosis, hemolytic anemia.

Thupi lawo siligwirizana: kawirikawiri - anaphylactic zimachitika, angioedema, urticaria.

Kumbali ya kagayidwe ndi zakudya: pafupipafupi - anorexia, kuchulukitsa kwa njira ya gout.

Kuchokera pakatikati wamanjenje: kawirikawiri - kupweteka mutu, chizungulire, kusowa tulo, nkhawa - nkhawa, paresthesia, zotumphukira, kupsinjika, migraine, kukomoka, nkhawa, nkhawa, nkhawa, kusokonezeka, kukhumudwa, kugona, kusokonezeka kwa kukumbukira, .

Kuchokera kumbali ya gawo la masomphenyawo: kawirikawiri - mawonekedwe owonongeka, kumva kowuma komanso kuyaka m'maso, conjunctivitis, kunachepetsa maonekedwe.

Kuchokera kumbali ya chiwalo chogonera: mosapumira - vertigo, tinnitus.

Kumbali ya magazi ndi zamitsempha yamagazi dongosolo: pafupipafupi - agranulocytosis, aplastic anemia, hemolytic anemia, leukopenia, purpura, thrombocytopenia.

Thupi lawo siligwirizana: kawirikawiri - anaphylactic zimachitika.

Kuchokera kumbali ya kagayidwe ndi zakudya: pafupipafupi - anorexia, hyperglycemia, hyperuricemia, hypokalemia, hyponatremia.

Kuchokera kwamanjenje: Nthawi zambiri - kupweteka mutu, pafupipafupi - chizungulire, kusowa tulo.

Kuchokera kumbali ya gawo la masomphenyawo: pafupipafupi - kuchepa kwakanthawi kowoneka, xanthopsia.

Kuchokera pamtima dongosolo: pafupipafupi - necrotizing vasculitis.

Malangizo apadera

Blocktran GT, komanso mankhwala ena omwe amakhudza renin-angiotensin-aldosterone, amatha kuwonjezera kukhudzika kwa magazi urea ndi serum creatinine mwa odwala omwe ali ndi vuto la impso. Kusintha uku kwa impso kunasinthiratu ndikusowa pambuyo pakuchotsa chithandizo.

Sichikulimbikitsidwa kuti mankhwalawa athandizidwe kuti azindikire kuchuluka kwa uric acid komanso gout.

Kuchita

Zitha kutumikiridwa ndi othandizira ena othandizira.

Pogwiritsa ntchito nthawi yomweyo ndi barbiturates, narcotic analgesics, ethanol, orthostatic hypotheisia ikhoza kukhala. Pogwiritsa ntchito munthawi yomweyo mankhwala a hypoglycemic (operekera pakamwa ndi insulin), mungafunike kusintha kwa mankhwala a hypoglycemic. Chifukwa cha chiopsezo chokhala ndi lactic acidosis chifukwa cha kuwonongeka kwa impso, metformnn iyenera kugwiritsidwa ntchito mosamala mukamagwiritsa ntchito hydrochlorothornazide.

Ndi kugwiritsa ntchito pamodzi kwa blocktran GT ndi mankhwala ena a antihypertensive, zotsatira zowonjezera zimawonedwa.

Pharmacokinetics

Pakuperekedwa, losartan imatengedwa bwino kuchokera m'matumbo am'mimba ndikuwupanga m'chiwindi ndikutenga gawo la CYP2C9 isoenzyme, ndikupanga carboxylated yogwira metabolite (pafupifupi 14% ya mlingo wovomerezeka umalowa mwa iwo) ndi ma cellacologic ambiri osagwira. Yake bioavailability ukufika 33%. Zozama kwambiri za losartan ndi metabolite yake yayikulu zimalembedwa pambuyo pa ola limodzi ndi maola 3-4 mutatha kutenga Blocktran, motsatana.

Mlingo wogwirizira wa gawo lina la Blocktran kupita ku mapuloteni a plasma (makamaka albin) ali pafupifupi 99%. Losartan kwenikweni simalowera mu zotchinga magazi muubongo.

Hafu ya moyo wa losartan ndi 1.5-2 maola, ndipo pharmacologically yogwira metabolite ndi maola 8-9. Pafupifupi 35% ya mankhwalawa imachotsedwa impso, ndipo pafupifupi 60% kudzera m'matumbo.

Kafukufuku wachipatala amatsimikizira kuti zomwe losartan mu plasma yamagazi mwa odwala omwe ali ndi vuto lachiwindi zimachulukitsidwa kwambiri, chifukwa chake, odwala omwe ali ndi mbiri ya matenda a chiwindi amafunikira kusintha kwa blocktran kutsikira.

Malangizo ogwiritsira ntchito Blocktran: njira ndi mlingo

Blocktran iyenera kutengedwa pakamwa nthawi imodzi patsiku. Chakudya sichimakhudza mayamwidwe.

Ndi ochepa matenda oopsa, 50 mg patsiku nthawi zambiri amakhazikitsidwa. Nthawi zina, ndizotheka kuwonjezera kuchuluka kwa tsiku lililonse mpaka 100 mg mu Mlingo wa 1-2.

Kulephera kwa mtima, mankhwalawa amayamba ndi mlingo wa 12,5 mg. Kenako, kamodzi pa sabata, mlingo umakulitsidwa kutengera chithunzi cha chipatala: koyamba mpaka 25 mg, kenako mpaka 50 mg.

Mlingo woyamba wa tsiku ndi tsiku wa odwala omwe ali ndi vuto la mtima kulandira kulandira okodzetsa ambiri ndi 25 mg.

Ndi chiwindi cirrhosis, kuchuluka kwa losartan m'madzi a m'magazi kumachulukanso, chifukwa chake, blocktran imagwiritsidwa ntchito pazenera zotsika.

Malangizo ogwiritsira ntchito Blocktran GT

Mankhwala ayenera kumwedwa pakamwa kamodzi patsiku.

At ochepa matenda oopsa Mlingo woyambira ndi kukonza - piritsi limodzi kamodzi patsiku. Nthawi zina, kuti mupeze phindu labwino, mulingo wake umakulitsidwa mapiritsi 2 kamodzi patsiku. Mulingo wapamwamba tsiku lililonse ndi mapiritsi awiri a mankhwalawa.

Mukamagwiritsa ntchito kuchepetsa ngozi matenda amtima ndi kufa mwa anthu ndi ochepa matenda oopsa ndi kuchuluka kwa kumanzere kwamitsempha yoyambira losartan wofanana ndi 50 mg kamodzi patsiku. Odwala 50 mg losartan tsiku lomwe kuchuluka kwakukakamizidwa sikukanakhoza kufikiridwa, kusankha kwa chithandizo ndi kuphatikiza kumafunika losartanMlingo wotsika hydrochlorothiazide (12.5 mg), ndipo ngati ndi kotheka, kuwonjezera kuchuluka kwake losartanmpaka 100 mg patsiku ndi 12,5 mg hydrochlorothiazide patsiku. Kenako imaloledwa kuwonjezera kuchuluka kwa mapiritsi awiri a Blocktran GT patsiku.

Bongo

Ngati bongo, ntchito mankhwala ayenera anasiya, wodwalayo ayenera kupatsidwa ulamuliro wa mtima ndi mapapo, ntchito mankhwala - chapamimba kukwiya, kuchotsa kwa kusokonekera kwa elekitirodi, kusowa kwamadzi hepatic chikomokerendi kukhumudwa chifukwa cha njira zofananira.

Zotsatira zoyipa

Malinga ndi kafukufuku, pakati pa mapiritsi a antihypertensive, sartani amadziwika ndi kupindika bwino. Izi zikutanthauza kuti odwala amawalandira mowirikiza, sangathe kusiya kulandira chithandizo chokha. Cholinga chakuchita bwino ndikusavuta kwa oyang'anira (nthawi imodzi yokha), kumasuka kwa kusankha kwa mankhwalawa, chiwerengero chochepa cha zoyipa.

Kulekerera kwa blocktran ndikufanana ndi placebo (piritsi la dummy). Zotsatira zoyipa zambiri za mankhwalawa sizimakhudzana ndi thanzi labwino, koma kuyankha kwa thupi pakuchepa kwa magazi. Monga lamulo, m'mwezi woyamba wa mankhwala oopsa amamva bwino, mwa iye kupanikizika kwa nthawi yayitali kunali kokwezeka.

Zotsatira zoyipa zomwe, pogwiritsa ntchito Blocktran, zimachitika kawirikawiri kuposa gulu la placebo:

Odwala oopsa omwe ali ndi matenda a impso, okalamba, mapiritsi a Blocktran amaloledwa komanso odwala ena. Ndi kulephera kwa chiwindi ndi matenda enaake, chiwopsezo cha bongo chimakhala chambiri chifukwa chophwanya metabolism ya losartan. Ngati bongo, hypotension, tachycardia, bradycardia ndizotheka.

Odwala omwe ali ndi vuto losowa madzi m'thupi, odwala matenda ashuga omwe ali ndi nephropathy, omwe amatenga Veroshpiron kapena kukonzekera kwa potaziyamu ali pachiwopsezo chachikulu cha hyperkalemia. Vutoli litha kukayikiridwa chifukwa cha kufooka kwa minofu, kukokana kwanuko, kusokonezeka kwa mtima. Ngati Hyperkalemia yapezeka (potaziyamu> 5.5 malinga ndi kusanthula), Blocktran yathetsedwa.

Analogs ndi choloweza

Ma analogi a Blocktran amapangidwa ndi ambiri odziwika opanga mankhwala. Poyerekeza ndi ndemanga ya odwala omwe ali ndi matenda oopsa, mankhwala otsatirawa ndi otchuka kwambiri ku Russia:

Mabulogu a blocktran omwe ali ndi zotsatira zapafupi kwambiri ndi valsartan (mapiritsi a Valsacor, Diovan, ndi ena), candesartan (Ordiss), telmisartan (Mikardis, Telzap).

Kufotokozera ndi pharmacodynamics ya mankhwala

Kugwiritsa ntchito mankhwalawa kumathandizira kuchepetsa kukana kwa zotumphukira, kuchepetsa msambo wa ndende ya aldosterone ndi angiotensin m'magazi. Mapiritsi a blocktran, malangizo ogwiritsira ntchito omwe ali ndi tsatanetsatane wokhudzana ndi mankhwalawa, amathandizidwa ndi mtima kuti azisinthasintha zochitika zamtima pakati pa okalamba ndi odwala okalamba. Piritsi limodzi lili ndi osachepera 50 mg a losartan pamodzi ndi othandizira, kuphatikizapo lactose, starch, magnesium stearate ndi zinthu zina zingapo.

Zofunika! Mankhwala blocktran GT adapangidwa kuti achepetse kupsinjika ndikuwabwezeretsa mwakale mwa odwala omwe ali ndi matenda angapo amtima odziwika. Zomwe zimagwira - losartan ndi hydrochlorothiazide - zimakhala ndi zovuta.

Mukamamwa mankhwalawa odwala, kuchepa kwamphamvu pa minofu ya mtima kumadziwika, zomwe zimalepheretsa kuwonongeka kwa hypertrophic myocardial. Losartan imaperekanso diuretic zotsatira ndipo saletsa enzyme ya AP yomwe imawononga bradykinin. Chifukwa cha izi, Blocktran sichimapangitsa kuti pakhale chifuwa chouma, monga mankhwala ena a gulu lomweli.

Mphamvu yotchulidwa imachitika pakatha maola 6 pambuyo pa utsogoleri, ndiye kuti kuthamanga kwazitsulo kumachepa masana ndikukhala ndi zovomerezeka. Kugwiritsa ntchito kosalekeza, mankhwalawa amakhala ndi mphamvu yogwira patatha mwezi umodzi.

Mtima

Zochita za Kinetic

Malinga ndi malangizo ogwiritsira ntchito, mankhwalawa amatengedwa mwachangu kuchokera kugaya chakudya ndi bioavailability osachepera 30%. The kuchuluka kwa yogwira chimafika chimafika ola limodzi pambuyo makonzedwe. Zomwe zimapezeka piritsi m'maselo a chiwindi zimasinthidwa kukhala metabolites zomwe zimayambitsa hypotensive. Metabolite imakhala yokhazikika m'magazi pambuyo pa maola anayi. Losartan imachotsedwa m'thupi pambuyo pa maola 1.5-2, zinthu zake zama metabolic zimatsika pang'onopang'ono, nthawi yake yotuluka imatenga maola 6-9. Zinthu zambiri zimatsitsidwa ndi impso ndi matumbo.

Zizindikiro ndi contraindication

The mankhwala Blocktran ndi fanizo la mankhwala zotchulidwa pokhapokha ngati dokotala akutsimikizira kuti ali ndi vutoli. Kumwa mankhwalawa ndikofunikira kwa ochepa matenda oopsa komanso kulephera kwa mtima. Mankhwala atha kukhala gawo la zovuta mankhwala kwa odwala omwe amalolera ku ACE zoletsa.

Amachepetsa chiopsezo chokhala ndi matenda oopsa a mtima ndi mitsempha ya magazi, kuchuluka kwa anthu omwe akudwala matenda oopsa osakanikirana ndi hypertrophy yamanzere. Mndandanda wa contraindication ogwiritsira ntchito akuphatikizapo:

• hypotension
• kufooka kwamadzi ndi hyperkalemia,
• wazaka 18
• mimba ndi mkaka wa m`mawere
• chidwi chachikulu ndi zinthu zomwe zimapangidwa ndi mankhwala,
• kuchuluka kwa ayoni a potaziyamu mu seramu yamagazi,
• kusowa kwamadzi.

Odwala omwe ali ndi mavuto mu ntchito ya impso ndi chiwindi amapatsidwa mankhwala a blocktran ocheperako kuti asawonongeka. Kuchuluka kwa mapiritsi pa nthawi ya mankhwalawa kuyenera kukhala kwabwinobwino, kuchuluka kwa zinthu zochulukirapo kungayambitse zovuta zazikulu mpaka kufa.

Mapiritsi oopsa

Njira yogwiritsira ntchito

Zikafika pazomwe blocktran imathandizira, ndikofunikira kutchulanso payokha momwe imagwiritsidwira ntchito. Chogwiritsidwacho chikuyenera kutengedwa kamodzi pakamwa, osapitirira muyeso womwe dokotala akuwonetsa. Odwala omwe ali ndi matenda oopsa amapatsidwa 50 mg pa tsiku. Ngati cholinga ndikupeza tanthauzo lotchulika, kuchuluka kwake kumachulukitsidwa mpaka 100 mg patsiku kapena kugawidwa ndi 50 mg pamene amatengedwa kawiri patsiku. Odwala omwe ali ndi vuto la mtima amapatsidwa 12,5 mg tsiku lililonse.

Nthawi zambiri, kumwa mankhwalawa kumawonjezeka pakapita sabata imodzi mpaka muyeso, komaliza pamakhala osachepera 50 mg patsiku. Ngati wodwala atenga waukulu kukula kwa okodzetsa, mlingo umachepetsedwa mpaka 25 mg patsiku. Ndi cirrhosis ya chiwindi, Blocktran imayikidwa mosamala komanso pamiyeso yotsika. Tiyenera kukumbukira kuti munthawi yamankhwala mumayenera kuwunika nthawi zonse kuchuluka kwa potaziyamu m'magazi, makamaka pakakhala zovuta za odwala okalamba kapena impso.

Zotsatira zoyipa ndi bongo

Mankhwala a Blocktran adapangidwira kuti achepetse kuthamanga kwa magazi ndipo amatha kuthandiza wodwalayo pakuwona mlingo womwe dokotala watchulidwa. Pakakhala vuto la bongo, phwando limayimitsidwa, mtima ndi mapapu a wodwalayo amapezeka, ndipo amathandizidwa ndi chithandizo chamankhwala. Izi zikuphatikiza kuchuluka kwamatumbo, kuthana ndi mavuto a electrolyte, chikomokere ndi madzi osowa madzi, kuyika kwa mankhwala kuti achulukitse mavuto.

Mndandanda wazotsatira zoyipa ndi izi:

• mavuto a kugona, kupweteka mutu komanso chizungulire, kusokonezeka kwa kukumbukira, kutopa kwambiri ndi kukhumudwa,
• kuwonongeka kwamawonekedwe, kusokonezeka kwa zokonda, tinnitus,
• bronchitis, chifuwa chowuma, matenda a rhinitis,
• dyspepsia, kusowa kapena chidwi cha kudya, gastritis, kudzimbidwa, kumva pakamwa lowuma,
• kupweteka ndi kukokana mu minofu ya miyendo ndi kumbuyo, mawonekedwe a nyamakazi,
• mavuto ndi kupanikizika, arrhythmia, angina pectoris kapena tachycardia,
• kutupa kwamikodzo.

Odwala ena amatha kukumana ndi zovuta zina, edema, zidzolo, kumva kwambiri dzuwa. Nthawi zambiri, mankhwalawa amalekeredwa bwino pamagulu onse a makonzedwe, choncho amatha kuikidwa popanda zoletsa pakakhala kuti pali zotsutsana. Zotsatira zoyipa zambiri zimatha pambuyo posiya mankhwala, omwe amasinthidwa ndi analogue.

Kumwa mankhwala

Malangizo apadera

Ngati wodwalayo adwala madzi am'mimba nthawi yomweyo monga chithandizo cha blocktran, ndikofunika kuyamba kumwa mankhwalawa pamankhwala ochepa. Ndi stenosis ya mitsempha ya impso, mankhwalawa amatha kuwonjezera kuchuluka kwa creatinine ndi urea mu seramu yamagazi. Ngakhale kumwa mankhwalawa, ndikofunikira kuyang'anira kuchuluka kwa potaziyamu m'magazi, izi zimagwira ntchito kwa okalamba ndi odwala omwe ali ndi vuto laimpso.

Kulephera kwa renti sikuti chifukwa chochepetsera mulingo, kumangofunika kuchepetsedwa. Mankhwalawa sanalembedwe mpaka zaka 18, kugwiritsidwa ntchito kwake kumaloledwa kwa anthu okalamba, chifukwa chowunikira nthawi zonse zamomwe mtima wawo umayendera, kuyesedwa kwa magazi ndi zisonyezo zina. Blocktran itha kugulidwa ku malo ogulitsa mankhwala pokhapokha ngati mwalandira mankhwala.

Zambiri pazamankhwala zimafotokozedwanso mu kanema pansipa:

Hypertension - ndi chiyani?

Potanthauza kuti "ochepa matenda oopsa" amatanthauza kuwonjezeka kwa kuthamanga kwa magazi oposa 140/90 mm Hg. Art. Nthawi zina ndimayendedwe oyambira kapena odziimira pawokha omwe amakula mwa wodwala popanda chifukwa chofunikira (matenda oopsa). Ndipo nthawi zina imakhala yovuta kapena chotsatira cha matenda ena (matenda oopsa). Matenda amtima oterewa ndi ofala kwambiri, amachititsa kuti anthu mamiliyoni ambiri padziko lonse lapansi apite kwa dokotala tsiku lililonse kuti akathandizidwe. Ndi ochepa omwe amadziwa kuti ndi chiyani.

Matenda oopsa a arterial si kungokhalira kukakamiza kowonjezera. Matendawa amabisala mndandanda wonse wazovuta zosiyanasiyana zamtundu wamanjenje, mitsempha yamagazi, impso ndi mtima, zomwe zimakhudza thanzi la wodwalayo.

Matenda oopsa a arterial ndi chimodzi mwazomwe zimayambitsa kufa pakati pa achinyamata okalamba, chifukwa chowopsa kwambiri cha matenda otere ndikuphwanya kufalikira kwa magazi muubongo kapena sitiroko.

The zikuchokera mankhwala

Piritsi limodzi la mankhwala a Blocktran limaphatikizapo ma milligram makumi asanu a losartan potaziyamu. Zowonjezera: microcrystalline cellulose, lactose monohydrate, otsika molekyulu povidone, sodium carboxymethyl wowuma, silicon dioxide, mbatata wowuma, magnesium stearate. Mapangidwe a Shell: utoto wa titanium, utoto wachikasu, kulowa kwa dzuwa, hypromellose, talc, Copovidone, polysorbate 80.

Piritsi limodzi la blocktran GT limaphatikizapo hydrochlorothiazide (12.5 mg) ndi potaziyamu losartan (50 mg). Zowonjezera: microcrystalline cellulose, lactose monohydrate, otsika molekyulu povidone, sodium carboxymethyl wowuma, mbatata wowuma, silicon dioxide, magnesium stearate.

Zomwe zimapangidwa ndi membrane zimaphatikizapo hypromellose, polydextrose, utoto wofiirira, sing'anga wotchedwa triglycerides, talc, maltodextrin, titanium dioxide.

Kodi mapiritsi a blocktran GT ndi ati? Tidzakambirana pambuyo pake.

Mankhwala osamala

Mosamala, Blocktran GT imagwiritsidwa ntchito motere:

• Kuphwanya mulingo wamadzi-electrolyte, mwachitsanzo, motsutsana ndi kusanza kapena kutsekula m'mimba (hyponatremia, hypokalemia, hypomagnesemia, hypochloremic alkalosis).
• Odwala aimpso kulephera (creatinine chilolezo oposa 30 ml / mphindi), ndi stenosis a mtsempha wama impso (osakwatiwa) ndi mayiko awiri a stenosis a mitsempha ya impso.
• Pankhani ya vuto la chiwindi lomwe silikuyenda bwino (pansipa mfundo 9 monga Mwana-Pugh).
• Pamaso pa gout ndi / kapena hyperuricemia, hypercalcemia, matenda osokoneza bongo, omwe ali ndi mbiri yofupika ya mbiri yakale (anakulitsa angioedema mwa odwala ena m'mbuyomu ogwiritsa ntchito mankhwala ena, kuphatikiza ACE inhibitors), mphumu ya bronchial, yokhala ndi systemic pathologies ya minofu yolumikizika (kuphatikizapo systemic lupus erythematosus) .
• Ndi hypovolemia (kuphatikiza kumbuyo kwa milingo yayikulu ya okodzetsa),
• Odwala omwe ali ndi vuto lalikulu la kutsekeka kwa khungu.
• Mukafotokozera limodzi ndi anti-yotupa-non-steroidal othandizira, kuphatikizapo mitundu iwiri ya cycloo oxygenase inhibitors, ndi mtima glycosides.
• Odwala omwe ali ndi matenda a mtima, okalamba.

Mlingo wa mankhwala

Chida "blockchain GT" chokhala ndi matenda oopsa chimagwiritsidwa ntchito mkati, ngakhale zakudya, kuchuluka kwa makonzedwe - kamodzi patsiku.

Mankhwala okonza ndi oyambira ndi ofanana ndi piritsi limodzi kamodzi patsiku. Nthawi zina, pofuna kukwaniritsa zambiri, zimachulukitsidwa kukhala zidutswa ziwiri kamodzi patsiku. Mlingo wambiri patsiku ndi miyala iwiri ya Blocktran GT.

Kusintha muyezo kwa okalamba kapena kwa odwala omwe ali ndi vuto la impso sikokwanira.

Kuchepetsa mwayi wokhala ndi matenda amtima komanso wamitsempha ndi kufa kwa odwala omwe ali ndi vuto lamanzere am'mimba komanso ochepa matenda oopsa, mankhwalawa ndi mankhwala mogwirizana ndi chiwembu chomwe chili pansipa. Mlingo woyambira wa blocktran GT ndi 50 mg kamodzi tsiku lililonse. Odwala omwe sanathe kukwaniritsa kupanikizika kwakanthawi pamene akumamwa mlingo wotere wa losartan amafunika kusankha chithandizo ndikuphatikiza losartan ndi hydrochlorothiazide wocheperako, ngati pakufunika, Mlingo wa losartan ukuwonjezeka mpaka 100 mg munthawi yomweyo ndi 12.5 mg ya hydrochlorothiazide patsiku, ndiye kuti muwonjezere mlingo mapiritsi awiri (mamiligalamu okwana 25 a hydrochlorothiazide ndi 100 milligrams a losartan kamodzi patsiku).

Zotsatira zoyipa

Zotsatira zoyipa za GT Blocktran ndi ziti? Chiwerengero cha zosakondweretsa zomwe zimafotokozedwa zimatengera zomwe zimakhazikitsidwa ndi World Health Organisation.

M'mayesero azachipatala omwe ali ndi hydrochlorothiazide / losartan, palibe zoyipa zomwe zimaphatikizidwa ndi wophatikiza uyu zidawonedwa. Zochitika zoyipa zinali zochepa kwa zomwe zidzafotokozeredwe pambuyo pake (poyang'ana hydrochlorothiazide ndi losartan payokha).

Zotsatira zoyipa zomwe zidatchulidwa pansipa zidawonedwa pogwiritsa ntchito hydrochlorothiazide ndi losartan mu monotherapy.

Zochita Zosiyana ndi Losartan

Lymphatic dongosolo ndi magazi: pafupipafupi - hemolytic anemia, ecchymoses, Shenlein-Genoch wofiirira, magazi m'thupi.

Thupi lawo siligwirizana: kawirikawiri - urticaria, angioedema, anaphylactic zimachitika.

Kuchokera kumbali ya zakudya ndi kagayidwe: pafupipafupi - kuchulukitsa kwa chikhalidwe cha gout, anorexia.

Kuchokera pakatikati wamanjenje: kawirikawiri - kukumbukira, kukumbukira, kugona, kupuma, kusokonezeka, kusokonezeka, kusokonezeka kwa mitsempha, mantha, kukomoka, nkhawa, nkhawa, nthawi zambiri kusowa tulo, chizungulire, kupweteka mutu. .

Kuchokera kumbali ya ziwalo zowoneka: pafupipafupi - mphamvu yoyaka ndi maso owuma, kusawona bwino, kuchepa kwa maonedwe acuity, conjunctivitis.

Kuchokera pamiyambo yolumikizira ziwalo: pafupipafupi - tinnitus, vertigo.

Pa mbali ya kupuma dongosolo: Nthawi zambiri - chifuwa, mphuno, kupuma thirakiti matenda (pharyngitis, sinusitis, sinusopathy, zilonda zapakhosi, kutentha kwambiri kwa thupi, infrequent - kusapeza bwino mu pharynx, mphuno, rhinitis, bronchitis, dyspnea, laryngitis pharyngitis.

Kuchokera ku ziwalo zam'mimba: pafupipafupi - zizindikiro za dyspeptic, kutsegula m'mimba, kupweteka kwam'mimba, nseru, osachepera - mano, kupweteka kwamkati pamlomo wamkamwa, kudzimbidwa, gastritis, flatulence, kusanza.

Musculoskeletal system: pafupipafupi - kupweteka pabondo, phewa, mikono, arthralgia, fibromyalgia, nyamakazi, kufooka kwa minofu, kupweteka kwa minofu ndi mafupa, kutupa, kulumikizana nthawi zambiri.

Kuchokera kumbali ya mtima ndi mitsempha yamitsempha yamagazi: machitidwe ochepa - odalira orthostatic hypotension, ochepa hypotension, brady kapena tachycardia, palpitations, angina pectoris, arrhythmias, II degree ya AV block, kupweteka pachifuwa, vasculitis, myocardial infarction, zochitika za cerebrovascular.

Kuchokera ku genitourinary system: pafupipafupi - kusabereka, kutsika kwa libido, matenda amkodzo thirakiti, kukodza pafupipafupi, nocturia.

Kuchokera pakhungu lopindika: pafupipafupi - erythema, khungu louma, magazi "amathamangira" pakhungu la nkhope, dermatitis, photosensitivity, alopecia, kuyabwa kwa khungu, thukuta kwambiri, zotupa pakhungu.

Mawonetsero ena: nthawi zambiri - kutopa kwambiri, asthenia, mosachepera - malungo, kutupa kwa nkhope.

Laborator Zizindikiro: pafupipafupi - zapamwamba za creatinine ndi urea, nthawi zambiri - kuchepa kwa hemoglobin ndi hematocrit, hyperkalemia, osowa kwambiri - kuchuluka kwa transaminases ya chiwindi.

Pa hydrochlorothiazide

Lymphatic dongosolo ndi magazi: pafupipafupi - thrombocytopenia, agranulocytosis, purpura, aplastic anemia, leukopenia, hemolytic magazi.

Thupi lawo siligwirizana: kawirikawiri - anaphylactic zimachitika.

Zopatsa thanzi komanso kagayidwe: kawirikawiri - hyponatremia, anorexia, hypokalemia, hyperglycemia, hypokalemia, hyperuricemia.

Kuchokera kumachitidwe amanjenje: pafupipafupi - kusowa tulo, chizungulire, nthawi zambiri - mutu.

Kuchokera kumbali ya ziwalo zowoneka: pafupipafupi - xantopsia, zoperewera zowoneka mosakhalitsa.

Kuchokera pamachitidwe a mtima ndi mitsempha yamagazi: kawirikawiri - necrotizing vasculitis.

Matupi opatsirana: pafupipafupi - pulmonary edema, chibayo, kupuma pamavuto.

Matumbo dongosolo: kawirikawiri - sialodenitis, kapamba, intrahepatic cholestasis (jaundice), kuyimitsa kwam'mimba thirakiti, epermermal poizoni necrolysis, nseru, jaundice, kusanza, kudzimbidwa, kutsekula m'mimba.

Kuchokera minofu ndi khungu lolumikizira: pafupipafupi - urticaria, photosensitivity.

Kuchokera ku minculoskeletal system: kawirikawiri - minofu kukokana.

Kuchokera kwamikodzo dongosolo: kawirikawiri - kusokonezeka kwa impso, glucosuria, kulephera kwa impso, pakati.

Mavuto apakati: kawirikawiri - malungo.

Ngati panali malonda otsatsa pambuyo pa hydrochlorothiazide / losartan, ndiye kuti zotsatirazi zidadziwika:

• Kuchokera kugaya chakudya mthupi - hepatitis,
• Laborator kusanthula zizindikiro: kawirikawiri - kuchuluka chiwindi transaminase ntchito, hyperkalemia.

Ndemanga za Mankhwala

Ndemanga za GT Blocktran zikuchitira umboni kuti amatha kuchepetsa kukakamizidwa, koma nthawi yomweyo, mavuto amabwera mukamagwiritsa ntchito mankhwalawa nthawi zambiri, makamaka ululu wolumikizika ndi kutopa.

Anthu amati mankhwalawa ndi othandiza, pali zinthu zina zabwino zomwe boma limachita. Vuto lokhalo lomwe limakondweretsa odwala ambiri ndikusowa kwa mankhwalawa m'masitolo ogulitsa mankhwala, anangotayika mwadzidzidzi pazifukwa zosadziwika.

Nthawi zina kugwiritsa ntchito bwino mankhwala kumaonekera pakapita nthawi, koma pakatha chaka zotsatira zake zimafooka.

Mtengo wa Blocktran GT ku Russia ukuyambira pa ruble 160. Zimatengera dera komanso maukonde opangira mankhwala.