Zotsatira zakugwiritsa ntchito Captopril-AKOS mu shuga

Captopril-AKOS: malangizo ogwiritsa ntchito ndi kuwunikira

Dzina lachi Latin: Captopril-AKOS

Code ya ATX: C09AA01

Zogwira pophika: Captopril (Captopril)

Wopanga: Synthesis, Open Society (Russia)

Kusintha kufotokozera ndi chithunzi: 11/30/2018

Mitengo muma pharmacies: kuchokera ku ruble 10.

Captopril-AKOS ndi cholembera wa angiotensin (ACE) osokoneza bongo, antihypertensive.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mankhwala amapezeka mu mawonekedwe a mapiritsi: flat-cylindrical, ali ndi chamfer, pafupifupi oyera kapena oyera, amakhala ndi fungo labwino, marbling opepuka amaloledwa, chiopsezo cholekanitsidwa chimagwiritsidwa ntchito pamapiritsi a 50 mg (Mlingo wa 25 mg: 10 kapena 25 ma PC). , pamakatoni a 1, 2, 3 kapena 4, mulingo wa 50 mg: 10 kapena 20 ma PC, m'matumba, pamatayala a 1, 2, 3, 4 kapena 5, 10, 20, 30, 40 , Ma 50, 60, 80 kapena 100 ma PC. M'matumba apulasitiki, pamatoni 1 a katoni 1, paketi iliyonse ilinso ndi malangizo za ntchito captopril-ICCO).

Piritsi limodzi lili:

ntchito yogwira: Captopril (malinga ndi kulemera kowuma) - 25 kapena 50 mg,
othandizira: Mlingo 25 mg - wowuma chimanga, shuga mkaka, magnesium stearate, talc, mlingo 50 mg - lactose monohydrate (mkaka wa shuga), colloidal silicon dioxide (aerosil), cellcosestalline cellulose, crospovidone (CL-M collidone, CL collidone), magnesium yakuwotcha, talc.

Mankhwala

Captopril-AKOS ndi antihypertensive mankhwala, limagwirira zake zomwe zimachitika chifukwa cha zinthu zomwe zimagwira - capopril. Captopril ndi cholembera cha m'badwo woyamba wa ACE wokhala ndi gulu la SH (gulu la sulfhydryl). Mwa kuletsa ACE, amachepetsa kutembenuka kwa angiotensin I kuti angiotensin II ndikuchotsa mphamvu yake ya vasoconstrictor pama venous and arteryial. Kutsika kwa kuchuluka kwa angiotensin II kumalimbikitsa kuwonjezeka kwachiwiri kwa ntchito ya plasma renin, ndikupangitsa kuchepa mwachindunji kwa aldosterone ndi adrenal cortex. Izi zimapangitsa kutsika kwa zotumphukira zamitsempha zosakanikirana (OPSS) ndi kuthamanga kwa magazi (BP), kukana m'mitsempha yam'mapapo, komanso kutsika kwa pre-ndi pambuyo pamtima. Kuchulukitsa kwa mtima, kuleza mtima.

Mothandizidwa ndi Captopril, mitsempha imakulitsa mpaka kukula kwambiri kuposa mitsempha. Komanso, kutenga Captopril-AKOS kumabweretsa kuwonjezeka kwa kaphatikizidwe ka prostaglandin komanso kuchepa kwa kuwonongeka kwa bradykinin.

Mphamvu ya antihypertensive ya captopril sizitengera ntchito ya plasma renin. Zotsatira zake pa minye renin-angiotensin-aldosterone system (RAAS) zimayambitsa kuchepa kwa kuthamanga kwa magazi panthawi yachilendo komanso kuchepa kwa ntchito ya timadzi.

Captopril imakulitsa magazi otsogola komanso aimpso, imasintha magazi kupita ku ischemic myocardium. Kugwiritsa ntchito kwanthaŵi yayitali kumapangitsa kuchepa kwa kuopsa kwa myocardial hypertrophy komanso makoma a mitsempha yotsitsimutsa, kumalepheretsa kupita patsogolo kwa kulephera kwa mtima, ndikulepheretsa kukula kwa kuchepa kwamitsempha yamanzere.

Kutenga Captopril-AKOS kumabweretsa kuchepa kwa kuphatikizika kwa maplatelet, mu mtima kulephera - kuchepa kwa zomwe zili mu sodium ions.

Kuchepetsa thumbo la ma arterioles a imperentions a impso kumathandizira kukonza intracubule hemodynamics komanso kupewa mawonekedwe a matenda a shuga.

Tsiku lililonse mlingo wa 50 mg, captopril amawonetsa angioprotective katundu motsutsana Mitsempha ya microvasculature. Odwala odwala matenda ashuga nephroangiopathy, amachepetsa kukula kwa matenda aimpso.

Mosiyana ndi vasodilators mwachindunji, monga hydralazine ndi minoxidil, kuchepa kwa magazi pomwe mukumwa Captopril-AKOS sikuyenda ndi Reflex tachycardia ndikuthandizira kuchepetsa kufunikira kwa myocardial oxygen. Mlingo wowonjezera wa odwala omwe ali ndi vuto la mtima samakhudza kuthamanga kwa magazi.

Pambuyo pakukonzekera kwa pakamwa, kuchepa kwambiri kwa kuthamanga kwa magazi kumachitika mu 1-1.5 maola. Kutalika kwa hypotensive zotsatira zimatengera mlingo womwe umatenge; umakwanira pazabwino zingapo patatha milungu ingapo ya mankhwala.

Simungalepheretse mwadzidzidzi, zomwe zingayambitse magazi.

Pharmacokinetics

Pambuyo pakukonzekera pakamwa, kuponyera mwachangu pafupifupi 75% ya mlingo wa Captopril-AKOS wotengedwa kumachitika. Kudya munthawi yomweyo kumachepetsa kuyamwa ndi 3040%. Pa gawo loyambirira kudzera pachiwindi, 35-40% yogwira ntchito imaphatikizidwa. Kuzindikira kwakukulu (C_max) mu plasma yamagazi imatheka mkati mwa maola 0,5-1,5 ndipo ndi 114 ng / ml.

Kumangiriza kumapulogalamu amadzi a m'magazi - 25-30% (makamaka ndi albumin).

Imagunda zotchinga-magazi ndi zotchinga zazing'ono zochulukirapo (zosakwana 1%). Ndi mkaka wa m'mawere, mpaka 0.002% ya mlingo wotengedwa umatulutsidwa.

Captopril imapukusidwa mu chiwindi ndikupanga ma cellacologic osagwira metabolite - Captopril disulfide dimer ndi Captopril-cysteine sulfide.

Hafu ya moyo (T_1/2) captopril ndi pafupifupi maola 2-3. Pafupifupi 95% ya mlingo wovomerezeka umapukutidwa kudzera mu impso m'maola 24 (kuphatikiza 40-50% osasinthika).

Kulephera kwa aimpso, mankhwalawa amadziunjikira, T_1/2 amatha kuyambira 3.5 mpaka 32 maola. Odwala omwe ali ndi vuto laimpso amayenera kuchepetsa kamodzi ndi / kapena kuwonjezera nthawi pakati Mlingo wa Captopril-AKOS.

Zizindikiro zogwiritsidwa ntchito

matenda oopsa oopsa (kuphatikizapo kukonzanso matenda oopsa),
Kulephera kwamtima kosalekeza - monga gawo la zovuta mankhwala,
kukanika kwa kumanzere kwamitsempha pambuyo pakuchitika m'mitsempha yamagazi kwa odwala omwe ali ndi chikhalidwe chokhazikika,
diabetesic nephropathy mu mtundu 1 shuga mellitus (albinuria oposa 30 mg / tsiku).

Contraindication

kwambiri aimpso kukanika, aimpso mtsempha wamagazi stenosis, mmodzi impso stenosis ndi patsogolo azotemia, Reflexory hyperkalemia, chachikulu hyperaldosteronism, pambuyo kupatsirana kwa impso,
kukanika kwambiri kwa chiwindi,
kugwiritsa ntchito munthawi yomweyo mankhwala a aliskiren ndi aliskiren okhala ndi odwala omwe ali ndi matenda a shuga 2 kapena odwala omwe ali ndi vuto la impso ndi creatinine chilolezo (CC) osakwana 60 ml / min,
lactose tsankho, shuga-galactose malabsorption kapena kuperewera kwa lactase,
nthawi yapakati
yoyamwitsa
wazaka 18
cholowa ndi / kapena idiopathic angioedema motsutsana ndi chithandizo cham'mbuyomu chothandizira ndi ACE zoletsa (kuphatikizapo mbiri),
Hypersensitivity kwa zoletsa zina za ACE, kuphatikizapo mbiri
tsankho limodzi ndi zigawo zikuluzikulu za mankhwala.

Mochenjera, mapiritsi a Captopril-AKOS ayenera kutumikiridwa kwa matenda oopsa a mtima matenda a minofu matenda, chopinga wa m`mafupa hematopoiesis, cerebrovascular pathologies, matenda a shuga, Hyperkalemia, kuphwanya ntchito ya chiwindi, kutsekedwa kwa zakudya za sodium chloride, hemodialysis, kutsegula m'mimba, kusanza, kapena zina zomwe zimapangitsa kuchepa kwa magazi mozungulira pakanthawi ya opaleshoni kapena opaleshoni yayikulu, hemodialysis ikugwiritsa ntchito zimitsempha zamagazi kwambiri (kuphatikizapo AN69 polyacrylonitrile high-flow membranes), concomitant desensitizing mankhwala, apheresis wa otsika kachulukidwe lipoproteins (LDL), limodzi ndi potaziyamu-yosakhalitsa okodzetsa, kukonzekera potaziyamu, potaziyamu okhala ndi mchere, kukonzekera kwa lithiamu, odwala a mtundu wa Negroid, atakalamba.

Zotsatira zoyipa

Mavuto osafunikira kumbali ya machitidwe ndi ziwalo (malinga ndi kuchuluka kwa kakulidwe kawo, zimawerengedwa motere: pafupipafupi - ≥ 1/10, nthawi zambiri - ≥ 1/100 ndi 9 pa 1 lita imodzi amayeserera magazi ambiri, pansipa 1 x 10 9 pa lita imodzi - mankhwalawa Pakakhala zizindikiro zamatenda opatsirana, kuphatikiza zilonda zapakhosi kapena kutentha thupi, kuyezetsa magazi kwamankhwala kokhala ndi leukocyte kofunikira kumafunikira.

Tisaiwale kuti kutenga Captopril-AKOS kumbuyo kwa njira yochotsera mankhwala opweteka a hymenoptera ndipo zina zimawonjezera chiopsezo cha anaphylactoid.

Ngati chiwopsezo chowonjezeka cha hepatic transaminases kapena mawonekedwe a jaundice, mankhwalawa ndi capopril ayenera kusiyiratu.

Mwa anthu a mpikisano wa Negroid, zoletsa ma ACE, kuphatikizapo Captopril-AKOS, zimawonetsa mphamvu yotsutsa ya antihypertensive.

Kuyesa kwa mkodzo kwa acetone kwa odwala omwe amamwa mankhwalawa kungapereke zotsatira zabodza.

Mimba komanso kuyamwa

Kugwiritsidwa ntchito kwa Captopril-AKOS kumapangidwa pakakomoka ndi kuyamwitsa.

Amayi azaka zoyambira kubereka omwe akukonzekera kutenga pakati ayenera kupewa kugwiritsa ntchito zoletsa za ACE (kuphatikizapo capopril). Ayenera kupereka chithandizo chamankhwala othandizira antihypertensive.

Ngati kutenga pakati kumachitika panthawi ya Captopril-AKOS, kuletsa kuyenera kumafunikira ndikuwunika pafupipafupi kukulira kwa fetal. Kugwiritsidwa ntchito kwa Captopril mu trimester yoyamba ya kubereka kungakulitse mwayi wokhala ndi vuto la kubadwa kwa mwana wosabadwayo. Kugwiritsa ntchito mankhwala kwa nthawi yayitali mu II ndi III trimesters kumakhala koopsa kwa mwana wosabadwayo ndipo kumayambitsa kuchepa kwa mafupa a chigaza, kuchepa kwa ntchito yaimpso, oligohydramnios, tikulimbikitsidwa kuwunika momwe mafupa a chigaza ndi ntchito yaimpso ya mwana wosabadwayo ndi ultrasound (ultrasound).

Mu akhanda omwe amayi awo akhala akutenga nthawi yayitali mu II ndi III trimesters ya mimba, kukulira kwa kulephera kwamitsempha, hyperkalemia, hypotension ndikotheka.

Mu vuto laimpso

Kugwiritsa ntchito Captopril-AKOS kuchitira odwala omwe ali ndi vuto laimpso kwam'mimbamo, kupweteka kwa impso imodzi ndi azotemia, Referrory hyperkalemia, hyperaldosteronism, komanso vuto pambuyo pakuwonjezeka kwa impso.

Mochenjera, mankhwalawa amayenera kuperekedwa kwa odwala omwe ali ndi vuto laimpso.

Ndi digiri yaimpso yolimbitsa thupi (CC 30 ml / mphindi ndi pamwamba), Captopril-AKOS imatha kutumikiridwa mu tsiku lililonse la 75-100 mg.

Ndi kuvulala kwambiri kwa aimpso (CC osakwana 30 ml / min), mlingo woyambirira wa tsiku lililonse sayenera kupitirira 12,5 mg. Ngati ndi kotheka, mlingo umatha kuwonjezeka pang'onopang'ono, kuwunika nthawi yayitali, koma mankhwalawa ayenera kukhala ocheperako kuposa momwe amagwiritsidwa ntchito pochiza matenda oopsa.

Mwina cholinga chowonjezerapo cha "loop" okodzetsa, koma osati zokomera mzere wa thiazide.

Malangizo a dongosolo la mankhwalawa ngati vuto laimpso liyenera kuchitika polingalira za wodwala wa QC zotsatirazi:

CC 40 ml / mphindi: Mlingo woyamba wa tsiku lililonse ndi 25-50 mg, mlingo waukulu wa tsiku lililonse ndi 150 mg,
KK 21-40 ml / mphindi: Mlingo woyamba wa tsiku lililonse ndi 25 mg, mlingo waukulu wa tsiku lililonse ndi 100 mg,
KK 10-20 ml / mphindi: Mlingo woyamba wa tsiku lililonse ndi 12,5 mg, mlingo waukulu wa tsiku ndi tsiku ndi 75 mg,
QC yochepa kuposa 10 ml / min: muyeso woyamba wa tsiku ndi tsiku ndi 6.25 mg, mlingo waukulu wa tsiku ndi tsiku ndi 37,5 mg.

Gwiritsani ntchito mu ukalamba

Chenjezo liyenera kuperekedwa kwa Captopril-AKOS mu odwala okalamba.

Mlingo woyambirira wa odwala okalamba ndi 6.25 mg 2 kawiri pa tsiku. Malangizo a dosing amenewa amalepheretsa impso kugwira ntchito, chifukwa chake imapezeka kuti ndi yoyenera. Ndikulimbikitsidwa kusintha mlingo wa Captopril-AKOS poganizira momwe wodwala amayankhira pafupipafupi, kuusunga pamalo otsika kwambiri.

Kuyanjana kwa mankhwala osokoneza bongo

angiotensin II receptor antagonists (ARA II), aliskiren ndi mankhwala ena omwe amakhudza RAAS: kuonjezera chiopsezo cha kuchepa kwa kuthamanga kwa magazi, kusokonezeka kwa impso (kuphatikizapo kuperewera kwaimpso), hyperkalemia. Pankhaniyi, ngati kuli kotheka, kuikidwa kwa mankhwala ena omwe amakhudza RAAS kuyenera kuyang'anitsitsa kuthamanga kwa magazi, Zizindikiro za ntchito yaimpso, ma electrolyte a plasma. Ndi vuto lalikulu laimpso ndi mtundu wachiwiri wa shuga, kuphatikiza ndi aliskiren kuyenera kupewedwa,
potaziyamu wothandiza okodzetsa (amiloride, triamteren, spironolactone, eplerenone), kukonzekera kwa potaziyamu, zowonjezera potaziyamu, mchere m'malo mwake: kukulitsa chiopsezo cha hyperkalemia, ndikofunikira kuthana ndi zinthu za potaziyamu,
okodzetsa (thiazide ndi "loop"): Mlingo wambiri umawonjezera mwayi wokhudzana ndi hypotension
okodzetsa, omaliza minofu, aldesleukin, alprostadil, zamtima, alpha₁-Blockers, beta-blockers, alpha apakati₂-adrenomimetics, pang'onopang'ono calcium blockers blockers, nitrate, minoxidil, vasodilators: angakwanitse hypotensive zotsatira za Captopril-AKOS,
mapiritsi ogona, antipsychotic, anxiolytics, antidepressants: onjezerani antihypertensive mphamvu ya capopril,
mankhwala osapweteka a antiidal (NSAIDs), kuphatikizapo indomethacin, ma cycloo oxygenase-2 inhibitors, estrogens: pogwiritsa ntchito nthawi yayitali, amachepetsa kugwira ntchito kwa captopril. Kuphatikiza apo, kuphatikiza kwa NSAIDs ndi ACE inhibitors kungakhale ndi gawo lowonjezera pakukulitsa kuchuluka kwa seramu potaziyamu motsutsana ndi kuchepa kwakanthawi yomweyo kwa ntchito yaimpso (kuphatikizapo kuperewera kwaimpso), makamaka kwa odwala omwe ali ndi mbiri yovuta yaimpso, odwala okalamba, kapena ochepetsedwa magazi ozungulira ,
General opaleshoni: kuchepa kwamphamvu kwa magazi pakuchitika kwakanthawi ndikotheka, makamaka ngati mankhwala opaleshoni ali ndi antihypertensive zotsatira,
Kukonzekera kwa lifiyamu kumachitika pang'onopang'ono ndipo kuyeza kwake m'magazi kumakwera,
allopurinol, procainamide: chiwopsezo chowonjezeka cha neutropenia ndi / kapena matenda a Stevens-Johnson,
glucocorticosteroids, epoetin, estrogens komanso kuphatikiza kwapakati pamlomo, naloxone, carbenoxolone: kufooketsa zomwe Captopril-AKOS,
Kukonzekera kwa golide: iv yoyendetsedwa ndi sodium aurothiomalate imatha kuyambitsa zovuta mu wodwala, kuphatikizapo kuchepa kwa kuthamanga kwa magazi, nkhope yake yoyipa, nseru, kusanza,
sympathomimetics: itha kuchepetsa zovuta zamatenda,
hypoglycemic othandizira pakamwa, insulin: kuonjezera ngozi ya hypoglycemia,
Maantacid: kuchepetsa mayamwidwe am'matumbo m'mimba,
ethanol: imawonjezera kukhudzika kwa zotsatira za Captopril-AKOS,
probenecid: amathandiza kuchepetsa impso chilolezo cha Captopril, zomwe zimapangitsa kuti chiwopsezo chake chikhale mu seramu,
azathioprine, cyclophosphamide: onjezerani mwayi wokhala ndi zovuta za hematological,
propranolol: kuyanja kwachilengedwe kumachulukirachulukira,
cimetidine: imathandizira kuonjezera kuchuluka kwa yogwira magazi m'magazi am'magazi,
clonidine: amachepetsa kuopsa kwa antihypertensive kwambiri.

Zofanizira za Captopril-AKOS ndi: Captopril, Captopril-Ferein, Captopril-FPO, Captopril-UBF, Captopril Velfarm, Kapoten, Katopil, Epsitron, Alkadil, Angiopril-25, Blockordil, Vero-Captopril, Captopril-STI ndi ena.

Njira yamachitidwe

Chithunzi chomwe chili pansipa chikuwonetsa mphamvu ya ACE inhibitor pazinthu ziwiri zosintha zinthu:

Kuletsa mapangidwe a angiotensin II, kuchepa kwa ndende yake m'magazi.
Kutsekeka kwa chiwonongeko cha bradykinin kuzinthu zopanda ndale, zomwe zikutanthauza kuti zimathandizira kuti pakhale kudziunjikira

Chiwembu cha mphamvu ya ACE inhibitor pazinthu ziwiri zosinthika

Poyankha kuchepa kwa magazi kapena zovuta zina, renin peptide imayamba kutulutsidwa impso. Imagwira pamapuloteni angiotensinogen ndikusintha kukhala angiotensin I. Kenako, imasandulika angiotensin II mothandizidwa ndi eniotensin yotembenuza. Dongosolo lonse limatchedwa renin-angiotensin-aldosterone (RAAS).

Angiotensin II ali ndi izi:

imachepetsa minofu ya makoma amitsempha yamagazi, kuchepetsa kufinya. Izi zimapangitsa kuchuluka kwa magazi, kukulitsa katundu pamtima, kumapangitsa magazi kulowa ziwalo zamkati,
kumawonjezera ndende ya aldosterone. Aldosterone, imawonjezera kuchuluka kwa madzimadzi m'thupi. Izi zimabweretsa edema ndi kupsinjika kowonjezereka pa mtima. Pachifukwa ichi, aldosterone mu njira ya impso imatenga sodium ndikuchotsa potaziyamu,
imalimbikitsa kaphatikizidwe kazinthu zingapo zotupa - cytokines. Amawononga ndikuwonjezera sclerosis ya makoma amitsempha yamagazi, mtima ndi minyewa yaimpso.

Kuphatikiza pa RAAS, ACE inhibitors imalepheretsa dongosolo la kinin-kallikrein. Bradykinin amayang'anira njira ziwiri:

kumasuka kwamitsempha yamagazi, i.e. kutsitsa kupsinjika,
zotupa ndi thupi lawo siligwirizana.

Mlingo ndi makonzedwe

Captopril-AKOS imaperekedwa pakamwa ola limodzi asanadye. Mlingo woyeserera umakhazikitsidwa payekhapayekha. Mukapereka mankhwala a captopril malinga ndi zomwe zikuwonetsedwa, ndikofunikira kugwiritsa ntchito Captopril mu mawonekedwe a mitundu: mapiritsi a 12,5 mg.

Ndi ochepa matenda oopsa, mankhwalawa amayamba ndi mlingo wochepa kwambiri wa 12,5 mg 2 kawiri pa tsiku (kawirikawiri ndi 6.25 mg 2 kawiri pa tsiku). Kuyang'aniridwa kuyenera kulipidwa pakubweza kwa nthawi yoyamba paola loyamba. Ngati matenda ochititsa chidwi apambuka pamenepa, wodwalayo ayenera kupita kumalo opingasa (kutengera koyamba kwa mlingo woyamba sayenera kukhala cholepheretsa kupititsa patsogolo mankhwala). Ngati ndi kotheka, kumwa pang'onopang'ono (pang'onopang'ono kwa masabata awiri ndi awiri) kumawonjezeka mpaka pakhale bwino. Ndi ochepa kapena olimbitsa ochepa ochepa, tsiku lililonse mlingo wokwanira 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.

Mwa odwala okalamba, mlingo woyambirira ndi 6.25 mg 2 kawiri pa tsiku.

Kulephera kwa mtima kosalekeza, kumayikidwa limodzi ndi okodzetsa komanso / kapena kuphatikizira kukonzekera kwa digito (pofuna kupewa kuchepa kwambiri kwa kuthamanga kwa magazi, okodzetsa amathetsedwa kapena kuti mlingo umachepetsedwa musanayambike Captopril-AKOS). Mlingo woyambirira ndi 6.25 mg kapena 12,5 mg katatu patsiku, ngati kuli kotheka, onjezani msanga pang'onopang'ono (pakadutsa milungu iwiri) mpaka 25 mg katatu patsiku. Mlingo wambiri watsiku ndi tsiku ndi 150 mg.

Ngati vuto la kusowa kwa kwamanzere kwamitsempha pambuyo povutika m'mitsempha yamatenda odwala omwe ali ndi matenda okhazikika, kugwiritsa ntchito Captopril-AKOS kumatha kuyamba patangotha masiku atatu pambuyo poti myocardial infarction. Mlingo woyambirira ndi 6.25 mg / tsiku, ndiye kuti tsiku lililonse mlingo ungathe kuchuluka mpaka 37,5-75 mg mu 2-3 Mlingo (kutengera kupirira kwa mankhwalawa). Ngati ndi kotheka, mlingo umakulitsidwa pang'onopang'ono mpaka kukhala Mlingo wa tsiku lililonse wa 150 mg / tsiku. Ndi kukula kwa ochepa hypotension, kuchepetsa mlingo kungafunike. Kuyesera kotsatira kugwiritsa ntchito mlingo waukulu wa tsiku ndi tsiku wa 150 mg kuyenera kutengera kulekerera kwa odwala a Captopril-AKOS.

Ndi matenda ashuga nephropathy, tsiku lililonse 75-100 mg / tsiku amapatsidwa 2-3 waukulu. Pankhani ya matenda a shuga omwe amadalira insulin ndi microalbuminuria (kutulutsidwa kwa albumin 30-300 mg patsiku), mlingo ndi 50 mg kawiri pa tsiku. Ndi chilolezo chokwanira cha protein zoposa 500 mg patsiku, mankhwalawa amagwira ntchito pa 25 mg katatu pa tsiku.

Ndi mulingo wofatsa waimpso ntchito (kulengedwa kwa clearinine clearance (CC) - osachepera 30 ml / mphindi / 1.73 m), Captopril-AKOS imatha kutumikiridwa pa mlingo wa 75-100 mg / tsiku. Ndi kuchuluka kutalika kwa aimpso kukanika (CC - osakwana 30 ml / mphindi / 1.73 m), muyezo woyamba sayenera kupitirira 12,5 mg / tsiku, ndiye, ngati kuli kotheka, mlingo wa Captopril-AKOS umakulitsidwa pang'onopang'ono mosalekeza. nthawi, koma ntchito wocheperako poyerekeza ndi matenda a matenda oopsa, tsiku lililonse mlingo wa mankhwalawa. Ngati ndi kotheka, zida zotsekemera zimayikidwa, osati zotulutsa m'miyeso yama hyazide.

Zotsatira zoyipa

Mwa odwala okalamba, mlingo woyambirira ndi 6.25 mg 2 kawiri pa tsiku.

Bongo

Zizindikiro: kuchepa kwa magazi, mpaka

kugwa, kulowerera m'mitsempha, kulowerera pachaka, kuwonongeka kwa mtima.

Chithandizo: ikani wodwalayo ndi miyendo yokwezeka, miyeso yofuna kubwezeretsa magazi (kuchuluka kwa magazi mozungulira, kuphatikizapo iv kulowetsedwa kwa 0.9% sodium chloride solution), chizindikiro chamankhwala. Mwina kugwiritsa ntchito hemodialysis, peritoneal dialysis sikugwira ntchito.

Kuchita ndi mankhwala ena

Mankhwala omwe amachepetsa ntchito zachisoni amaperekedwa kwa odwala omwe amamwa mankhwalawa mosamala. Beta-blockers imawonjezera mphamvu yowonjezera ya antihypertensive ikaonjezeredwa capropril, koma mphamvu yonseyo ndiyochepa kuposa momwe amayembekezera.

Mphamvu ya antihypertensive imafooka ndi mankhwala osagwiritsa ntchito mankhwala a anti-yotupa (NSAIDs) (idachedwetsa Na + ndikuchepetsa kaphatikizidwe ka prostaglandin), makamaka motsutsana ndi maziko am'mbuyo mwa renin, komanso estrogen (ikuchedwa Na +). Kuphatikizidwa ndi thiazide diuretics, vasodilators (minoxidil), verapamil, beta-blockers, tricyclic antidepressants, Mowa umapititsa patsogolo hypotensive.

Ntchito zophatikizidwa ndi potaziyamu-yosaleketsa okodzetsa (mwachitsanzo, triamteren, spironolactone, amiloride), kukonzekera kwa potaziyamu, cyclosporine, mkaka wochepa wamchere (atha kukhala ndi K + mpaka 60 mmol / l), zowonjezera zam potaziyamu, zolowa mmalo amchere (zimakhala ndi kuchuluka kwa K +) chiopsezo cha matenda oopsa.

Imachepetsa kuchotsedwa kwa kukonzekera kwa lifiyamu.

Ndi kusankha kwa captopril pamene mukumwa allopurinol kapena procainamide, chiwopsezo cha kukhala ndi matenda a Stevens-Johnson ndi immunosuppression chikuwonjezeka. Kugwiritsidwa ntchito kwa captopril odwala omwe akutenga ma immunosuppressants (mwachitsanzo, azathioprine kapena cyclophosphamide) kumawonjezera mwayi wokhala ndi vuto la hematological. Kugwiritsa ntchito pamodzi kwa ACE zoletsa ndi insulin, komanso mankhwala amkamwa a hypoglycemic kungayambitse kukula kwa hypoglycemia. Chiwopsezo chachikulu cha kukhala ndi hypoglycemia chimawonedwa pakapita milungu ingapo yophatikiza mankhwala, komanso mwa odwala omwe ali ndi vuto laimpso. Odwala omwe ali ndi matenda ashuga amafunika kuwunika kwambiri glycemia, makamaka mwezi woyamba wa chithandizo ndi ACE inhibitor.

Zolemba ntchito

Musanayambe, komanso pafupipafupi pa mankhwala a Captopril-AKOS, ntchito yaimpso iyenera kuyang'aniridwa. Odwala omwe ali ndi vuto lalikulu la mtima, amagwiritsidwa ntchito moyang'aniridwa ndi achipatala. Poyerekeza ndi kugwiritsidwa ntchito kwa nthawi yayitali kwa Captopril-AKOS, pafupifupi 20% ya odwala ali ndi chiwonetsero chokhazikika cha urea ndi serum creatinine woposa 20%, poyerekeza ndi kuchuluka kapena mtengo woyambirira. Osakwana 5% odwala, makamaka omwe ali ndi nephropathy yayikulu, amafunikira kuleka kulandira chithandizo chifukwa cha kuchuluka kwa ndende ya creatinine. Odwala ochepa matenda oopsa a Captopril-AKOS, owopsa ochepa amawonekera pokhapokha, mwayi wokhala ndi vutoli umawonjezeka ndi kuchepa kwa madzimadzi ndi kuwonongeka kwa mchere (mwachitsanzo, pambuyo poti muthandizidwe kwambiri ndi okodzetsa), mwa odwala omwe ali ndi vuto la mtima kapena akutsekeka. . Kuthekera kwa kuchepa kwambiri kwa kuthamanga kwa magazi kumatha kuchepetsedwa ndi kuyimitsidwa koyambirira (masiku 4-7) kwa okodzetsa kapena kuwonjezeka kwa kudya kwa sodium mankhwala enaake (pafupifupi sabata isanayambike makonzedwe), kapena ndi utsogoleri wa captopril kumayambiriro kwa mankhwalawa ang'onoang'ono (6.25- 12,5 mg / tsiku). Pa mankhwala pamalopo, chenjezani wodwalayo za mawonekedwe a matenda, kufunsidwa kwa mayeso kuchipatala, kuyezetsa kuchipatala ndi ma labotale. M'miyezi itatu yoyambirira. mankhwala pamwezi kuwunika kuchuluka kwa maselo oyera, ndiye - 1 nthawi m'miyezi itatu: odwala omwe ali ndi matenda a autoimmune m'miyezi itatu yoyambirira. - milungu iwiri iliyonse, ndiye - miyezi iwiri iliyonse. Ngati kuchuluka kwa leukocytes ndi kutsika kuposa 4000 / μl, kuyezetsa magazi kofotokozedwa konse, pansi pa 1000 / μl, mankhwalawa amayimitsidwa. Ngati zizindikiro zoyambirira za matenda opatsirana zikuchitika motsutsana ndi myeloid hypoplasia, kuyezetsa magazi mwatsatanetsatane kuyenera kuchitidwa nthawi yomweyo. M'pofunika kusiyiratu kudziletsa kwa mankhwalawo komanso kuwonjezeka kwakukulu pakulimbitsa thupi. Nthawi zina, motsutsana ndi kugwiritsidwa ntchito kwa ACE zoletsa, kuphatikiza Captopril, pali kuwonjezeka kwa kuchuluka kwa potaziyamu mu seramu yamagazi. Chiwopsezo cha kukhala ndi hyperkalemia ndi kugwiritsa ntchito zoletsa za ACE zimachulukitsidwa kwa odwala omwe amalephera kupweteka kwa minyewa komanso matenda a shuga, komanso kumwa mankhwala osokoneza bongo a potaziyamu, kukonzekera kwa potaziyamu kapena mankhwala ena omwe amachititsa kuchuluka kwa potaziyamu m'magazi (mwachitsanzo, heparin). Kugwiritsa ntchito munthawi yomweyo mankhwala osokoneza bongo a potaziyamu komanso kukonza potaziyamu kuyenera kupewedwa. Mukamayendetsa hemodialysis mwa odwala omwe alandira Captopril-AKOS, kugwiritsa ntchito ma membala a dialysis okwera kwambiri (mwachitsanzo AN69) kuyenera kupewedwa, chifukwa nthawi zotere chiopsezo chokhala ndi anaphylactoid zimachitika. Pankhani ya kukula kwa angioedema, mankhwalawa amathetsedwa ndikuyang'aniridwa kwathunthu kwa mankhwala ndi dalili zimachitika. Mukamamwa Captopril-AKOS, mungaganizire zinthu zabodza mukamayang'ana mkodzo wa acetone. Kuthekera kwa mankhwala kusuntha machitidwe kapena magwiridwe antchito amthupi, kulumikizana ndi fodya, mowa, chakudya: munthawi yamankhwala, ndikofunikira kupewa kuyendetsa magalimoto ndikuchita nawo zinthu zoopsa zomwe zimafunikira chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor, chifukwa chizungulire n`chotheka, makamaka mutatenga koyamba mlingo.

Njira zopewera kupewa ngozi

Mankhwala osamala: gwiritsani ntchito matenda oopsa a autoimmune (makamaka a systemic lupus erythematosus kapena scleroderma), chopinga cha mafupa a hematopoiesis (chiopsezo cha neutropenia ndi agranulocytosis), matenda a ischemia, shuga mellitus (chiwopsezo cha hyperkalemia), mwa odwala hemodialysis kuletsa kwa sodium, hyperalosteronism yoyamba, matenda amkati, kumayendera limodzi ndi kuchepa kwa magazi kuzungulira magazi (kuphatikizapo kutsegula m'mimba, kusanza), muukalamba.

Mosamala, odwala omwe ali ndi zakudya zopanda mchere kapena wopanda mchere (chiwopsezo chowonjezereka cha matenda oopsa) ndi hyperkalemia ndi mankhwala.

Kodi ndiyenera kuthana ndi vuto lotani?

Akuluakulu amalingalira kuchuluka kwa kuthamanga kwa magazi kuposa 140/90 mm RT. Art. Captopril AKOS ndi mankhwala osokoneza bongo. Zotsatira zake zimakhala pafupifupi maola 6. Chifukwa chake, nthawi zambiri, madokotala amalamula kuti pakhale matenda oopsa kwambiri, kuti azigwiritsa ntchito mankhwala oopsa kwa nthawi yayitali.

Mutha kumwa mankhwalawa kuwonongedwa kwa matenda oopsa, pamene kuchuluka kwa magazi kulibe kanthu komanso kosowa, ndiye kufunsa dokotala. Koma sizikusonyezedwa mu malangizo ogwiritsa ntchito Captopril AKOS pazomwe akuyenera kuthiridwa. Chifukwa chake, ngati zotsatira za mankhwalawo zikugwirizana ndi wodwala ndi dokotala, ndiye kuti mutha kusiya njira yochiritsirayi ngati mukugwirabe ntchito.

Malangizo ogwiritsira ntchito

Popewa zoyipa, amayamba kumwa mankhwalawo. Nthawi zambiri zotchulidwa 6 mpaka 12 mg katatu patsiku.
Zotsatira zake zimayesedwa patatha masiku angapo, mankhwala osokoneza bongo ayenera kudziunjikira m'thupi.
Ngati Mlingo woyambirira sangakwanire kuti mupeze vutoli, ndiye kuti mlingo umakulitsidwa pang'onopang'ono mpaka 25-50 mg 2 kawiri pa tsiku.
Monga momwe mungathere masana, mutha kumwa mpaka 150 mg ya mankhwalawa.
Ndi vuto la matenda oopsa, ndiye kuti, kuthamanga kwa magazi kukafika pamanambala oposa 180/110 mm RT.Art., Tengani 25 mg ya Captopril ndikudikirira kuchepa kwa kuthamanga kwa theka la ola.
Ngati zotsatira zake sizikupezeka, ndiye kuti mutha kubwereza kumwa mapiritsi ena.

Captopril AKOS imathandizira mpaka pati?

Mankhwalawa amapezeka m'magazi pambuyo pa mphindi 15, kuchuluka kwake kwa zinthu kumachitika mkati mwa mphindi 60-90, ndiye kuti pang'ono ndi pang'ono amachepetsa.

Captopril imachita pafupifupi maola 6, kotero pafupipafupi makonzedwe amakhala katatu.

Ndemanga za wodwala pamayendedwe

Ndemanga za Katopril AKOS ndizabwino.

Ubwino wa mankhwalawa ndi monga:

kusuntha kwamphamvu kwa zotsatira
mtengo wotsika
kukula kwapang'ono kakang'ono piritsi, kosavuta kumeza,
amachotsa mseru, mutu,
itha kugwiritsidwa ntchito kunyumba ngati thandizo,
Itha kugwiritsidwa ntchito pazowonjezera zomwe zimapangitsa kuti mavuto azituluka.

Izi ndi zovuta za mankhwalawa:

kukoma kosasangalatsa wowawasa
kanthawi kochepa
sioyenera kugwiritsidwa ntchito tsiku ndi tsiku,
Palinso mankhwala othandiza pochiza matenda oopsa.

Kodi pali kusiyana kotani pakati pa Captopril ndi Captopril AKOS?

Malangizo a Captopril AKOS siosiyana ndi malangizo a Captopril. Ndiye pali kusiyana kotani pakati pa Captopril ndi Captopril AKOS? Chiwonetsero cha AKOS chimangotanthauza kuti mankhwalawa amapangidwa ndi gulu la anthu amgwirizano wa Kurgan pazokonzekera zamankhwala ndi zinthu "Synthesis". Kampaniyi yakhala ikugwira ntchito kuyambira 1958. Mtengowo umatulutsa zopitilira 3% zamankhwala kuchokera ku msika wama Russian mankhwala. Zonthu zonse zimaposa kuwongolera kwapamwamba pamitundu yonse ya kupanga.

Kuchita ndi mankhwala ena

Mankhwala a gulu la diuretic amalimbikitsa mphamvu ya capopril, kukulitsa kuchuluka kwake m'magazi kangapo. Kupanda Hypotensive zotsatira zimawonedwa mukutenga ndi NSAIDs iliyonse, makamaka indomethacin.

Komanso, kugwiritsa ntchito mankhwalawa kumachepetsa ngati kuphatikiza ndi ma estrogens omwe amaperekedwa mwanjira imodzi ndipo nthawi yomweyo, clonidine imagwiritsidwa ntchito.

Kuphatikiza koyipa ndi potaziyamu ndi mchere wa sodium kuchititsa kuchedwa kwa thupi, ndi kuledzera.

Kukhazikika kwa mseru, kusanza ndi kusokonezeka kwa chikumbumtima kumadziwika ndi kugwiritsa ntchito nthawi yomweyo mawu osonyeza kukonzekera ndi golide.

Ndi zoletsedwa kuphatikiza ndi mankhwala monga:

Allopurinol ndi procainamide - zimabweretsa chitukuko cha matenda a Stevens-Jones, komanso zimawonjezera chiopsezo cha mapangidwe ndi kuchuluka kwa neutropenia.
Insulin - imachulukitsa mwayi wokhala ndi hypoglycemia (kuchuluka kwambiri kwa shuga m'magazi).
Cyclosporins - oliguria amakula, pomwe kulephera kwa aimpso kumayamba.
Azathioprine-based immunosuppressants - kumabweretsa mapangidwe a hematological pathologies (magazi kuvala chisokonezo, kusalinganika kwa maselo amwazi).

Ngati mukufuna kugwiritsa ntchito Captopril ndi mankhwala ena nthawi imodzi, muyenera kufunsa dokotala nthawi zonse pokhudzana ndi zovuta zomwe zingachitike.

Kanema: Kulephera Kwachiwiri

Pa nthawi yoyembekezera

Captopril sagwiritsidwa ntchito pochiritsa amayi apakati, chifukwa izi zimatha kusokoneza mkhalidwe wa mwana wosabadwayo, kuyambitsa mavuto obadwa nawo pamtima. Muyeneranso kukana kumwa mapilitsi mukamayamwitsa, popeza gawo lomwe limalowerera limalowa mkaka wa m'mawere ndipo lingayambitse kuchepa kwamphamvu kwa mwana wakhanda.

Migwirizano ndi magwiritsidwe akusungidwa

Moyo wa alumali wa Captoril Akos ndi miyezi 24 kuyambira tsiku lopanga, lomwe likuwoneka phukusi. Sungani pamalo owuma, amdima, pamtunda wosaposa 25 ° C.

Mtengo wapakati mumafakitoreti aku Russia a Captopril Akos sapitilira 25 ma ruble pachimake pa mapiritsi 10. Ku Ukraine, mankhwalawa atha kugulidwa pamtengo wotsika mtengo - 25 hryvnia.

Mwa mankhwala omwe ali ndi antihypertensive zotsatira, titha kusiyanitsa:

Ndemanga zambiri za odwala omwe amagwiritsa ntchito Captopril Akos ngati mankhwala zimawonetsa kugwira ntchito kwake bwino. Odwala samangodziwa kukwera kwambiri, komanso zinthu zina zabwino:

mtengo wololera
wolekeredwa bwino ndi thupi,
palibe zovuta
bwino zimadziwika pambuyo woyamba mlingo,
itha kugwiritsidwa ntchito ngati gawo la zovuta mankhwala.

Ndi pokhapokha pokhapokha pomwe panali kusagwirizana kwa kapepalaka komwe kamafotokozedwa mwa njira ina yaying'ono yamkati (urticaria).

Pomaliza

Mwanjira imeneyi Captopril Akos imaphatikiza ntchito zapamwamba komanso mtengo wotsika mtengo, kumakupatsani mwayi wogula mankhwalawo mufamu iliyonse. Malinga ndi malingaliro ndi malangizo onse a dokotala, mankhwalawo sanatchulidwe zoyipa. Pamaso pa thupi lawo siligwirizana, musanayambe maphunziro, kuyesedwa kwa mayeso komwe kumachitika motsutsana ndikofunikira.

Mitundu, mayina, kapangidwe ndi mawonekedwe amasulidwe

Captopril pano ilipo mu mitundu ingapo:

Captopril
Captopril Vero
Captopril Hexal,
Captopril Sandoz,
Captopril-AKOS,
Captopril Acre
Captopril-Ros,
Captopril Sar,
Captopril-STI,
Captopril-UBF,
Captopril-Ferein,
Captopril-FPO,
Captopril Stada,
Captopril Egis.

Mitundu yamtunduwu ya mankhwalawo imasiyananso wina ndi mnzake pokhapokha ngati pali dzina lowonjezera mdzina, lomwe limawonetsera chidule kapena dzina lodziwika la wopanga mtundu wina wa mankhwala. Kupanda kutero, mitundu ya Captopril siili yosiyana ndi inzake, popeza imapangidwa mu mtundu womwewo, imakhala ndi zinthu zomwezo, zina. Komanso, nthawi zambiri chinthu chogwiritsidwa ntchito mu mitundu ya Captopril chimakhala chofanana, popeza chimagulidwa kwa opanga akuluakulu China kapena India.

Kusiyana m'm mayina a mitundu ya Captopril kumakhala chifukwa chofunikira kuti kampani iliyonse yopanga mankhwala iwlembetse mankhwala omwe amapanga pansi pa dzina loyambirira, lomwe limasiyana ndi ena. Ndipo kuyambira kale, mu nthawi ya Soviet, awa opanga mankhwala opanga mankhwala omwewo adatulutsa Captopril yemweyo pogwiritsa ntchito luso limodzimodzi, amangowonjezera liwu limodzi ku dzina lodziwika bwino, lomwe ndi chidule cha dzina la bizinesiyo, motero, dzina lapadera limapezeka kuchokera pamalamulo akuwonekera osiyana ndi ena onse.

Chifukwa chake, palibe kusiyana kwakukulu pakati pa mitundu ya mankhwalawa, chifukwa chake, monga lamulo, amaphatikizidwa pansi pa dzina limodzi lotchedwa Captopril. Kuphatikizanso m'mawu a nkhaniyi tidzagwiritsanso ntchito dzina limodzi - Captopril - kutanthauza mitundu yake yonse.

Mitundu yonse ya Captopril imapezeka mu mtundu umodzi - izi mapiritsi amkamwa. Monga yogwira mankhwala mapiritsi ali ndi chinthu kapitawo, dzina lomwe, lomwe, adalipatsa dzina la mankhwalawo.

Mitundu ya Captopril imapezeka mu mitundu yosiyanasiyana, monga 6.25 mg, 12,5 mg, 25 mg, 50 mg ndi 100 mg piritsi limodzi. Mitundu yosiyanasiyana yotere imakupatsani mwayi wosankha bwino kwambiri kuti mugwiritse ntchito.

Monga zida zothandizira Mitundu ya Captopril ikhoza kukhala ndi zinthu zosiyanasiyana, chifukwa bizinesi iliyonse imatha kusintha kapangidwe kake, kuyesera kukwaniritsa zizindikiritso zoyenera. Chifukwa chake, kufotokozera kapangidwe kazigawo zothandiza za mtundu uliwonse wa mankhwalawo, ndikofunikira kuphunzira mosamala kabuku kamalamulo ndi malangizo.

Chinsinsi cha Captopril m'Chilatini chalembedwa motere:
Rp: Tab. Captoprili 25 mg No. 50
D.S. Tengani 1/2 - mapiritsi 2 katatu patsiku.

Mzere woyamba wa mankhwalawo mutatha chidule "Rp" chikusonyeza mtundu wa mankhwalawa (panthawiyi Tab. - mapiritsi), dzina la mankhwalawa (pano, Captoprili) ndi mlingo wake (25 mg). Pambuyo pa "Ayi" chithunzi, kuchuluka kwa mapiritsi omwe amisiri omwe amapanga mankhwalawo amayenera kuwamasula kwa omwe akumwa akuwonetsedwa. Mu mzere wachiwiri wachinsinsi mutatha chidule "D.S." zambiri zimaperekedwa kwa wodwala yemwe ali ndi malangizo a momwe amwe mankhwalawo.

Chomwe chimathandiza Captopril (achire zotsatira)

Captopril amachepetsa kuthamanga kwa magazi ndipo imachepetsa katundu pamtima. Momwemo, mankhwalawa amagwiritsidwa ntchito pochiza matenda oopsa a matenda oopsa, matenda a mtima (kulephera kwa mtima, kulowetsedwa kwa myocardial, myocardial dystrophy) komanso matenda ashuga a shuga.

Zotsatira za Captopril ndikubwezeretsa ntchito ya enzyme, yomwe imawunikira kutembenuka kwa angiotensin I kuti angiotensin II, motero, mankhwalawo ndi a gulu la ACE inhibitors (angiotensin-akatembenuka enzyme). Chifukwa cha machitidwe a mankhwalawa, angiotensin II samapangidwa m'thupi - chinthu chomwe chili ndi mphamvu yayikulu ya vasoconstrictor ndipo, motero, chimawonjezera kuthamanga kwa magazi. Pamene angiotensin II sichikupanga, mitsempha yamagazi imangokhala kuchepetsedwa, motero, kuthamanga kwa magazi ndikwabwinobwino komanso osakwezedwa. Chifukwa cha Captopril, tikamamwa pafupipafupi, kuthamanga kwa magazi kumachepa ndipo kumapitilira malire ovomerezeka ndi ovomerezeka. Kutsika kwakukulu kwa kupanikizika kumachitika maola 1 - 1.5 mutatenga Captopril. Koma kuti akwaniritse kutsika kosalekeza kwa mankhwalawa, mankhwalawa amayenera kumwedwa kwa milungu ingapo (4-6).

Komanso mankhwala amachepetsa kupsinjika pamtima, kukulitsa kuunikira kwamatumbo, chifukwa chomwe minofu yamtima imafunikira kuyesayesa kochepera kukankhira magazi mu mtsempha wamagazi ndi m'mapapo. Chifukwa chake, Captopril imakulitsa kulolerana kwa kupsinjika kwakuthupi ndi kwamalingaliro mwa anthu omwe ali ndi vuto la mtima kapena omwe adakumana ndi vuto la myocardial. Chuma chofunikira cha Captopril ndiko kusowa kwa phindu pa kuthamanga kwa magazi mukamagwiritsa ntchito pochotsa mtima.

Komanso Captopril kumawonjezera kuyenda kwa magazi aimpso ndikutulutsa magazi kumtimaZotsatira zake zomwe mankhwalawa amagwiritsidwa ntchito popanga matenda a mtima kulephera ndi matenda a shuga.

Captopril ndi yoyenera kuphatikizidwa muzophatikiza zosiyanasiyana ndi zina antihypertensive mankhwala. Kuphatikiza apo, Captopril sakusungabe madzi mthupi, omwe amawasiyanitsa ndi mankhwala ena a antihypertensive omwe ali ndi katundu wofanana. Ichi ndichifukwa chake, mutatenga Captopril, simuyenera kugwiritsa ntchito zida zowonjezera zina kuti muchepetse edema yoyambitsidwa ndi mankhwala a antihypertensive.

General mankhwala ndi Mlingo

Captopril iyenera kumwedwa ola limodzi asanadye, kumeza piritsi lonse, osaluma, kutafuna kapena kupsinjika mwanjira ina iliyonse, koma ndi madzi ambiri (osachepera theka lagalasi).

Mlingo wa captopril amasankhidwa payekha, kuyambira ndi zochepa, ndipo pang'onopang'ono zimabweretsa. Mutamwa mlingo woyamba wa 6.25 mg kapena 12,5 mg, magazi amayenera kuwunika theka lililonse kwa maola atatu kuti adziwe momwe mankhwalawo alili komanso kuopsa kwa mankhwalawo. M'tsogolomo, ndi kuchuluka kwa Mlingo, kukakamira kuyenera kuyesedwa pafupipafupi ola limodzi mutatha kumwa mapiritsi.

Tiyenera kukumbukira kuti mulingo wovomerezeka wa tsiku ndi tsiku ndi 300 mg. Kumwa mankhwalawa mopitilira 300 mg tsiku lililonse sikuti kumayambitsa kutsika kwamphamvu kwa magazi, koma kumawonjezera kuwopsa kwa zovuta zoyipa. Chifukwa chake, kutenga Captopril muyezo woposa 300 mg patsiku ndizosatheka komanso kosathandiza.

Captopril kukakamiza (ndi ochepa matenda oopsa) amayamba kumwa 25 mg kamodzi patsiku kapena 12,5 mg kawiri pa tsiku. Ngati pakatha milungu iwiri, kuthamanga kwa magazi sikutsikira pazovomerezeka, ndiye kuti mankhwalawa amawonjezeka ndipo amatengedwa 25-50 mg kawiri pa tsiku. Ngati mukumwa Captopril mu kuchuluka, kuchuluka kwake sikumatsikira ku mfundo zovomerezeka, ndiye kuti muyenera kuwonjezera Hydrochlorothiazide 25 mg patsiku kapena beta-blockers.

Ndi matenda oopsa kapena ochepa kwambiri, mlingo wokwanira wa captopril nthawi zambiri umakhala 25 mg 2 kawiri pa tsiku. Pa matenda oopsa kwambiri, mulingo wa Captopril umasinthidwa kukhala 50-100 mg 2 kawiri pa tsiku, ndikuwonjeza mobwerezabwereza milungu iwiri iliyonse. Ndiye kuti, m'masabata awiri oyamba, munthu amatenga 12.5 mg 2 kawiri pa tsiku, kenako sabata ziwiri zotsatira - 25 mg 2 kawiri pa tsiku, ndi zina zambiri.

Ndi kuthamanga kwa magazi chifukwa cha matenda a impso, Captopril iyenera kumwedwa pa 6.25 - 12,5 mg katatu patsiku. Ngati pambuyo pa masabata 1 - 2 kupanikizika sikumatsika kuzinthu zovomerezeka, ndiye kuti kuchuluka kwake kumakulitsidwa ndikumwedwa 25 mg katatu pa tsiku.

Kulephera kwa mtima kosatha Captopril iyenera kuyamba kutengedwa pa 6.25 - 12.5 mg katatu pa tsiku. Pambuyo pa milungu iwiri, mlingo umachulukitsidwa, kubweretsa 25 mg katatu pa tsiku, ndipo mankhwalawa amatengedwa kwa nthawi yayitali. Pakulephera kwa mtima, Captopril imagwiritsidwa ntchito limodzi ndi diuretics kapena mtima glycosides.
Zambiri Zolephera Mtima

Ndi myocardial infaration Captopril imatha kuchitika tsiku lachitatu kumapeto kwa nthawi yovuta kwambiri. M'masiku oyamba a 3-4, ndikofunikira kumwa 6.25 mg 2 kawiri pa tsiku, ndiye kuti mlingo umakulitsidwa mpaka 12,5 mg 2 kawiri pa tsiku ndikuledzera sabata limodzi. Zitatha izi, ndikulolerana kwabwino kwa mankhwalawa, tikulimbikitsidwa kusinthana ndi 12,5 mg katatu patsiku kwa masabata awiri mpaka atatu. Pambuyo pa nthawi yino, pansi pa kuvomerezeka kwa mankhwalawa, amasinthana ndi 25 mg katatu pa tsiku ndikuwongolera kwakanthawi. Pa mlingo uwu, Captopril amatengedwa kwa nthawi yayitali. Ngati mulingo wa 25 mg 3 katatu pa tsiku ndiwosakwanira, ndiye kuti amaloledwa kuuchulukitsa - 50 mg katatu pa tsiku.
Zambiri Ponena za Myocardial infarction

Ndi matenda ashuga nephropathy Captopril tikulimbikitsidwa kuti atenge 25 mg katatu pa tsiku kapena 50 mg 2 kawiri pa tsiku. Ndi microalbuminuria (albumin mu mkodzo) oposa 30 mg patsiku, mankhwalawa amayenera kumwedwa 50 mg 2 kawiri pa tsiku, ndipo ndi proteinuria (mapuloteni mu mkodzo) oposa 500 mg patsiku Captopril amamwa 25 mg katatu patsiku. Mlingo womwe akuwonetsedwa ukupita patsogolo pang'onopang'ono, kuyambira zochepa, ndikuwonjezeka kawiri sabata iliyonse. Mlingo wocheperako wa captopril wa nephropathy ukhoza kukhala wosiyana, chifukwa umatsimikiziridwa ndi kuchuluka kwa matenda a impso. Mlingo wocheperako womwe ungayambire kutenga Captopril wa matenda a shuga a shuga, kutengera ntchito ya impso akuwonetsedwa patebulo.

*Chilolezo cha Creatinine, ml / mphindi (yotsimikiziridwa ndi mayeso a Reberg)*	*Mlingo woyamba wa Captopril, mg*	*Pazipita tsiku lililonse la Captopril, mg*
40 ndi kupitirira	25 - 50 mg	150 mg
21 – 40	25 mg	100 mg
10 – 20	12,5 mg	75 mg
Zosakwana 10	6.25 mg	37,5 mg

Mlingo wofananitsidwa watsiku ndi tsiku uyenera kugawidwa pawiri kapena katatu pa tsiku. Okalamba (opitilira 65), mosasamala kanthu kuti aimpso, ayenera kuyamba kumwa mankhwalawa 6.25 mg 2 kawiri pa tsiku, ndipo pakatha milungu iwiri, ngati kuli koyenera, muwonjezere kuchuluka kwa 12,5 mg 2 mpaka 3 pa tsiku.

Ngati munthu akudwala matenda aliwonse a impso (osati matenda a shuga), ndiye kuti kuchuluka kwa Captopril kwa iye kumatsimikizidwanso ndi chilolezo cha creatinine ndipo akufanana ndi matenda a shuga.

Gwiritsani ntchito panthawi yoyembekezera komanso poyamwitsa

Captopril imayesedwa kuti igwiritsidwe ntchito panthawi yonse yoyembekezera, popeza kafukufuku woyeserera wazinyama wawonetsa kuyipa kwake kwa mwana wosabadwayo. Kutenga mankhwalawa kuyambira sabata la 13 mpaka sabata la 40 la mimba kumatha kubweretsa imfa ya fetal kapena kusokonezedwa.

Ngati mayi akutenga kachilombo, ndiye kuti ayenera kuimitsidwa nthawi yomweyo, zikadziwika.

Captopril imalowa mkaka, kotero ngati kuli koyenera, muyenera kukana kuyamwitsa mwana ndikuwusintha ku zosakaniza zosapanga.

Malangizo apadera

Kwa ana ochepera zaka 18, Captopril amagwiritsidwa ntchito pokhapokha mwadzidzidzi, kuwerengera mlingo payekha malinga ndi kulemera kwa thupi, kutengera kuchuluka kwa kulemera kwa 1 - 2 mg pa kilogalamu 1 patsiku.

Ngati mwaphonya piritsi lotsatira, ndiye kuti nthawi ina mukadz kumwa mankhwalawa, osati pawiri.

Musanayambe captopril, ndikofunikira kubwezeretsa kuchuluka kwa madzimadzi ndi kuchuluka kwa ma electrolyte m'mwazi ngati apezeka kuti ali ndi vuto chifukwa cha kukodzetsa, kutsegula m'mimba kwambiri, kusanza, ndi zina zambiri.

Munthawi yonse yogwiritsa ntchito Captopril, ndikofunikira kuwongolera ntchito ya impso. Mu 20% ya anthu, akamamwa mankhwalawa, mapuloteni (mkodzo mumkodzo) amatha kuwoneka, omwe pakangodutsa milungu 4 mpaka 6 osalandira chithandizo chilichonse. Komabe, ngati kuchuluka kwa mapuloteni mumkodzo ndi apamwamba kuposa 1000 mg patsiku (1 g / tsiku), ndiye kuti mankhwalawo ayenera kusiyidwa.

Captopril iyenera kugwiritsidwa ntchito mosamala komanso moyang'aniridwa ndi achipatala ngati munthu ali ndi zotsatirazi kapena matenda:

Systemic vasculitis,
Matenda owopsa a minofu yolumikizika,
Bilateral aimpso mtsempha wamagazi,
Kulandila kwa immunosuppressants (Azathioprine, Cyclophosphamide, etc.), Allopurinol, Procainamide,
Kugwiritsa ntchito mankhwala olemetsa (mwachitsanzo, njoka zam'mimba, SIT, ndi zina).

Muyenera kuyezetsa magazi masabata awiri aliwonse miyezi itatu yoyambirira. Pambuyo pake, kuyezetsa magazi kumachitika nthawi ndi nthawi, mpaka kumapeto kwa Captopril. Ngati kuchuluka kwa leukocytes kumachepera 1 G / l, ndiye kuti mankhwalawo ayenera kusiyidwa. Nthawi zambiri, kuchuluka kwa maselo oyera m'magazi kumabwezeretsedwa masabata awiri atachotsedwa pamankhwala. Kuphatikiza apo, ndikofunikira kudziwa kuchuluka kwa mapuloteni mumkodzo, komanso creatinine, urea, mapuloteni athunthu ndi potaziyamu m'magazi nthawi yonse ya kutenga Captopril mwezi uliwonse. Ngati kuchuluka kwa mapuloteni mumkodzo ndi apamwamba kuposa 1000 mg patsiku (1 g / tsiku), ndiye kuti mankhwalawo ayenera kusiyidwa. Ngati kuchuluka kwa urea kapena creatinine m'magazi kumawonjezeka pang'onopang'ono, ndiye kuti mlingo wa mankhwalawo uyenera kuchepetsedwa kapena uyenera kuthetsedwa.

Kuti muchepetse chiopsezo chochepetsetsa kwambiri zovuta kumayambiriro kwa captopril, ndikofunikira kusiya kuchiritsa kapena kuchepetsa kuchuluka kwake mwa 2 mpaka 3 masiku 4 mpaka 7 masiku piritsi loyamba lisanachitike. Ngati, mutatenga Captopril, kuthamanga kwa magazi kumatsika kwambiri, ndiye kuti, hypotension imayamba, ndiye kuti muyenera kugona kumbuyo kwanu pamalo opingasa ndikukweza miyendo yanu kuti ikhale yokwera kuposa mutu wanu. Potere, ndikofunikira kugona pansi kwa mphindi 30-60. Ngati hypotension ndi yayikulu, ndiye kutiithetsa mwachangu, mutha kulowa njira yovomerezeka yamchere wamitsempha.

Popeza Mlingo woyamba wa Captopril nthawi zambiri umayambitsa Hypotension, tikulimbikitsidwa kusankha kuchuluka kwa mankhwalawa ndikuyamba kugwiritsidwa ntchito kuchipatala moyang'aniridwa ndi ogwira ntchito zachipatala.

Potengera momwe ntchito ya Captopril, kuchitapo kanthu pochita opaleshoni, kuphatikizapo mano (mwachitsanzo, kuchotsa mano), kuyenera kuchitidwa mosamala. Kugwiritsa ntchito mankhwala ochita kupanga pambiri pakumwa Captopril kumatha kupangitsa kuti anzanu azitsika kwambiri, choncho wodwalayo akuyenera kuchenjezedwa kuti munthu akumwa mankhwalawa.

Ndi chitukuko cha jaundice, muyenera kusiya kumwa Captopril.

Munthawi yonse yogwiritsira ntchito mankhwalawa, tikulimbikitsidwa kusiya kwathunthu kumwa zakumwa zoledzeretsa.

Pazotsatira za kumwa mankhwalawo, kuyesedwa koyenera kwa mkodzo mumkodzo kungaoneke, komwe kuyenera kukumbukiridwa ndi adokotala komanso wodwalayo.

Kumbukirani kuti ngati zotsatirazi zikuwonekera pazithunzi za Captopril, muyenera kufunsa dokotala:

Matenda opatsirana aliwonse, kuphatikizapo chimfine, chimfine, ndi zina zambiri,
Kuchepa kwamadzi (mwachitsanzo, kusanza, kutsegula m'mimba, thukuta kwambiri, ndi zina).

Kugwiritsidwa ntchito kwa captopril nthawi zina kumayambitsa hyperkalemia (kuchuluka kwa potaziyamu m'magazi). Makamaka chiopsezo cha hyperkalemia mwa anthu omwe ali ndi vuto la matenda a impso kapena matenda a shuga, komanso omwe amatsata zakudya zopanda mchere. Chifukwa chake, motsutsana ndi momwe ntchito ya Captopril ikuyendera, ndikofunikira kukana kutenga potaziyamu okhathamiritsa (Veroshpiron, Spironolactone, ndi zina), kukonzekera kwa potaziyamu (Asparkam, Panangin, etc.) ndi heparin.

Potengera momwe ntchito ya Captopril imakhalira, munthu amatha kuyamba kuzimiririka thupi lake, ndipo nthawi zambiri limachitika mu masabata 4 oyamba a mankhwalawa ndikusowa ndi kuchepa kwa mulingo kapena makina owonjezera a antihistamines (mwachitsanzo Parlazin, Suprastin, Fenistil, Claritin, Erius, Telfast, ndi ena otero.). Komanso, mukamamwa Captopril, kutsokomola kosalekeza kumatha kuchitika (popanda kutaya khosi), kukomoka ndi kuchepa thupi, komabe, mavuto onsewa amatha miyezi iwiri mpaka itatu mankhwala atayimitsidwa.

Kuchita ndi mankhwala ena

Captopril imakulitsa mphamvu ya mankhwala a hypoglycemic (Metformin, Glibenclamide, Gliclazide, Miglitol, Sulfonylurea, ndi ena), chifukwa chake, akaphatikizidwa, kuchuluka kwa shuga wamagazi kuyenera kuyang'aniridwa nthawi zonse. Kuphatikiza apo, Captopril imathandizira zotsatira za mankhwala osokoneza bongo, ma pinkiller ndi mowa.

Ma diuretics ndi vasodilators, antidepressants, antipsychotic, Minoxidil ndi Baclofen amachulukitsa kwambiri mphamvu ya Captopril, chifukwa chomwe, ikagwiritsidwa ntchito limodzi, magazi amatha kuchepa kwambiri. Ma Beta-blockers, ganglion blockers, perarama ndi ma interleukin-3 mwabwino amathandizira Hypotensive zotsatira za Captopril, osapangitsa kutsika kwakukulu.

Pogwiritsa ntchito Captopril kuphatikiza ndi nitrate (nitroglycerin, sodium nitroprusside, etc.), ndikofunikira kuchepetsa mulingo wotsatira.

NSAIDs (Indomethacin, Aspirin, Ibuprofen, Nimesulide, Nise, Movalis, Ketanov, etc.), aluminium hydroxide, magnesium hydroxide, carbonate hydroxide, orlistat ndi clonidine amachepetsa kuopsa kwa Captopril.

Captopril imawonjezera ndende ya lithiamu ndi digoxin m'magazi. Chifukwa chake, kutenga kukonzekera kwa lifiyamu ndi Captopril kumatha kuyambitsa kukula kwa zizindikiro za lithiamu kuledzera.

Kugwiritsa ntchito nthawi yomweyo kwa Captopril ndi ma immunosuppressants (Azathioprine, Cyclophosphamide, etc.), Allopurinol, kapena Procainamide kumawonjezera chiopsezo cha neutropenia (kutsitsa maselo oyera a m'magazi pansi pazovomerezeka) ndi matenda a Stevens-Johnson.

Kugwiritsidwa ntchito kwa captopril poyambira kumbuyo kwa kuponderezana kopitilira muyeso, komanso kuphatikiza ndi estramustine ndi gliptins (linagliptin, sitagliptin, ndi zina zambiri) kumawonjezera chiopsezo cha anaphylactic reaction.

Kugwiritsa ntchito kwa captopril ndikukonzekera golide (Aurothiomolate ndi ena) kumayambitsa khungu, kutsekemera, kusanza komanso kuchepa kwa kuthamanga kwa magazi.

Zotsatira zoyipa za Captopril

Mapiritsi a Captopril amatha kuyambitsa zotsatirazi zosiyanasiyana kuchokera ku ziwalo ndi machitidwe osiyanasiyana:

1.Machitidwe amsempha ndi zotupa:

Kutopa,
Chizungulire
Mutu
Kuponderezedwa kwamkati wamanjenje,
Kugona
Chisokonezo,
Kukhumudwa
Ataxia (kusakanikirana kwa kayendedwe)
Zingwe
Paresthesia (kumverera kwa dzanzi, kumva kuwawa, "goosebumps" miyendo),
Masoka kapena fungo
Kukhumudwa
Kukhumudwitsa.

2.Mtima ndi magazi:

Hypotension (kuthamanga kwa magazi)
Orthostatic hypotension (dontho lakuthwa la kupsinjika mukasunthika pampando kapena pogona pamalo opumira),
Angina pectoris,
Myocardial infaration
Arrhasmia
Kusweka mtima
Ngozi yamitsempha yamagazi kwambiri,
Peripheral edema,
Lymphadenopathy
Anemia
Kupweteka pachifuwa
Syndrome la a Raynaud
Mafunde
Kukongola kwa khungu
Cardiogenic mantha,
Pulmonary thromboembolism,
Neutropenia (kuchepa kwa chiwerengero cha neutrophils m'magazi),
Agranulocytosis (kusowa kwathunthu kwa basophils, ma eosinophils ndi neutrophils kuchokera pagazi),
Supombocytopenia (kuchepa kwa maselo a cholesterya pansipa),
Eosinophilia (kuchuluka kwa ma eosinophils kuposa abwinobwino).

3.Machitidwe opatsirana:

Bronchospasm,
Kupuma pang'ono
Interstitial pneumonitis,
Bronchitis
Rhinitis
Chifuwa chosabereka (popanda chotupa).

4.Matumbo:

Anorexia
Kukhumudwa
Stomatitis
Zilonda zam'mimba zamkamwa ndi m'mimba,
Xerostomia (kamwa youma chifukwa cha kuperewera kwa malovu),
Glossitis (kutupa kwa lilime),
Gingival hyperplasia,
Kumeza kovuta.
Kuchepetsa mseru
Kubweza
Dyspepsia (flatulence, bloating, m'mimba kupweteka, kumva kupsinjika m'mimba mutatha kudya, etc.),
Kudzimbidwa
Kutsegula m'mimba
Pancreatitis
Cholestasis
Cholestatic hepatitis
Hepatocellular cirrhosis.

5.Njira zamakina olera:

Matenda a impso, mpaka kuwonongeka kwaimpso,
Polyuria (kuchuluka kwamkodzo poyerekeza ndi kwachilendo),
Oliguria (kutsitsa kwamkodzo pang'onopang'ono),
Proteinuria (mapuloteni mumkodzo),
Kuchulukitsa pafupipafupi komanso kuchuluka kwa maumuna
Kulephera.

6.Khungu ndi minofu yofewa:

Matupi ofiira
Kuzungulira thupi
Khungu loyera
Dermatitis yapadera,
Toxic epidermal necrolysis,
Pemphigus
Erythroderma,
Tinea versicolor
Alopecia (dazi),
Photodermatitis.

7.Zotsatira zoyipa:

Stevens-Johnson Syndrome
Urticaria,
Edincke's edema,
Kugwedezeka kwa anaphylactic.

8.Ena:

Thupi
Zovuta
Sepsis (poyizoni wamagazi),
Arthralgia (kupweteka kwaphatikizidwe)
Myalgia (kupweteka kwa minofu),
Hyperkalemia (kuchuluka kwa potaziyamu m'magazi pamwamba pazabwino),
Hyponatremia (kutsika kwa mulingo wa sodium m'magazi m'munsi mwabwinobwino),
Hypoglycemia (shuga wotsika wamagazi) mwa anthu omwe amatenga mankhwala a insulin kapena mankhwala ena a hypoglycemic,
Gynecomastia
Matenda a Seramu
Kuchulukitsidwa kwa ma enzymes a chiwindi (AsAT, AlAT, alkaline phosphatase, ndi zina).
Kuchuluka kwa urea, creatinine ndi bilirubin m'magazi, komanso ESR,
Anachepetsa hemoglobin ndi hematocrit
Acidosis
Kuyesedwa kwabwino kwabwino kwa kukhalapo kwa antigen wa nyukiliya.

Captopril - Analogs

Pakadali pano, mu msika wogulitsa mankhwala, Captopril ili ndi mitundu iwiri ya analogues - awa ndi malekedwe ndipo, makamaka, analogues. Ma Synonyms amaphatikiza mankhwala omwe ali ndi zinthu zomwezo monga Captopril. Ma analogues amaphatikizapo mankhwala omwe ali ndi chinthu chogwiritsidwa ntchito mosiyana ndi Captopril, koma ali m'gulu la zoletsa zoletsa za ACE ndipo, motero, ali ndi mawonekedwe ofananizanso othandizira.

Zosagwirizana ndi Captopril Mankhwala awa ndi awa:

Mapiritsi a Angiopril-25,
Mapiritsi a blockordil
Mapiritsi a Kapoten

Captopril analogues kuchokera pagulu la ACE inhibitors ndi mankhwala otsatirawa:

Mapiritsi a Acupro
Mapiritsi a Amprilan
Mapiritsi a Arentopres,
Mapiritsi a Bagopril
Burlipril 5, Burlipril 10, mapiritsi 20 a Burlipril,
Wazolong Caps,
Mapiritsi a Hypernick,
Zilonda zapamwamba,
Mapiritsi a Dapril
Dilaprel makapisozi,
Mapiritsi a Diropress
Mapiritsi a Diroton
Zokardis 7.5 ndi mapiritsi a Zokardis 30,
Mapiritsi a Zonixem
Mapiritsi a Inhibeys,
Mapiritsi olusa
Mapiritsi a Quadropril
Mapiritsi amkati mwake,
Mapale a Coverex,
Mapiritsi a Corpril
Mapiritsi a Lysacard,
Mapiritsi a Lysigamma,
Mapiritsi a Lisinopril,
Mapiritsi a Lisinotone,
Mapiritsi a Lysiprex
Mapiritsi a Lizonorm,
Mapiritsi a Lysoril
Mapiritsi a Listril
Mapiritsi
Mapiritsi a Methiapril,
Mapiritsi a Monopril
Mapiritsi a Moex 7.5 ndi Moex 15,
Mapiritsi a Parnawel ndi makapisozi,
Mapiritsi a Perindopril
Mapiritsi a Perineva ndi Perineva Ku-tab,
Mapiritsi a Perinpress
Mapiritsi a piramidi
Mapiritsi a Pyristar,
Mapiritsi abambo,
Mapiritsi a Prestarium ndi Prestarium,
Mapiritsi a Ramigamma,
Kapikidwe ka Ramicardia,
Mapiritsi a Ramipril
Mapiritsi a Ramepress,
Mapiritsi a Renipril
Mapiritsi a Renitec
Mapiritsi a Rileys-Sanovel,
Mapiritsi a Sinopril
Mapiritsi a Stopress,
Otsatira mapiritsi,
Mapiritsi a Fosicard,
Mapiritsi a Fosinap,
Mapiritsi a Fosinopril,
Mapiritsi a Fosinotec
Mapiritsi a Hartil
Mapiritsi a Hinapril,
Mapiritsi a Ednit
Mapiritsi a Enalapril,
Mapiritsi a Enam
Mapiritsi a Enap ndi Enap P,
Mapiritsi a Enarenal
Mapiritsi a Enapharm,
Mapiritsi akuvomerezeka.

Ndemanga zambiri za Captopril (zopitilira 85%) ndizabwino, chifukwa cha kuchuluka kwa mankhwalawa pakuchepetsa kuthamanga kwa magazi. Ndemanga zikuwonetsa kuti mankhwalawa amagwira ntchito mwachangu komanso bwino amachepetsa kupsinjika, potero amakhala bwino. Zowunikirazi zikuwonetsanso kuti Captopril ndi mankhwala abwino kwambiri ochepetsera mavuto mwadzidzidzi. Komabe, pakugwiritsa ntchito nthawi yayitali mu matenda oopsa, Captopril si njira yosankhira, popeza ili ndi zotsatira zoyipa zomwe sizipezeka mu mankhwala amakono ambiri.

Pali ndemanga zochepa zochepa za Captopril ndipo nthawi zambiri zimayamba chifukwa cha zovuta zoyipa zomwe zimakakamizidwa kukana kumwa mankhwalawo.

Captopril kapena Enalapril?

Captopril ndi Enalapril ndi mankhwala osokoneza bongo, ndiye kuti, ali m'gulu lomweli la mankhwala ndipo ali ndi mawonekedwe ofanana. Izi zikutanthauza kuti onse a Captopril ndi enalapril amachepetsa kuthamanga kwa magazi ndikuwongolera mkhalidwe wamtima wosalephera. Komabe, pali kusiyana pakati pa mankhwalawa.

Choyamba, kuti kufatsa kwamphamvu pakhale magazi ochulukirapo, Enalapril ndi wokwanira kumwa kamodzi patsiku, ndipo Captopril amayenera kuledzera katatu patsiku chifukwa chakufupika nthawi. Kuphatikiza apo, enalapril amakhala ndi nkhawa nthawi yayitali ngati amatha kugwiritsa ntchito nthawi yayitali.

Chifukwa chake, titha kunena kuti enalapril ndi mankhwala omwe amawakonda kwambiri kuti agwiritsidwe ntchito kwakanthawi kuti magazi azikhala ndi magazi ovomerezeka. Ndipo Captopril imakhala yoyenera kwambiri pakuchepetsa kwa episodic ya mavuto ochulukira.

Komabe, Captopril, poyerekeza ndi Enalapril, imakhala ndi zotsatira zabwino pamkhalidwe wa mtima kulephera kwa mtima, kusintha moyo, kukulitsa kulolerana kwa kupsinjika kwakuthupi ndi zina, komanso kupewa kuphedwa mwadzidzidzi kwamtima. Chifukwa chake, ngati matenda a mtima akulephera kapena matenda ena a mtima, captopril ndiye mankhwala omwe angafune.
Zambiri pa Enalapril