Mapiritsi a Diroton okhala ndi Mlingo wa 2,5 mg amagulitsidwa mumatumba a aluminium / PVC mapiritsi 14, nthawi zambiri matuza amodzi kapena 2 amakhala phukusi limodzi.

Mapiritsi okhala ndi Mlingo wa 5 mg / 10 mg / 20 mg amagulitsidwanso mumapaketi a aluminium / PVC mapiritsi 14, nthawi zambiri matuza 1, 2 kapena 4 amakhala phukusi limodzi.

Pharmacodynamics ndi pharmacokinetics

Diroton (INN: Lisinopril) amadziwika ngati choletsa zinthu za kutembenuka kwa angiotensin, amatha kusokoneza chingwe chopangidwa kuchokera ku angiotensin II - mkati Ine. LisinoprilAmachepetsa msinga wa vasoconstrictor mphamvu ya thunthu - angiotensin IIpamene ndende aldosterone m'magazi amachepetsa.

Lisinoprilamathandiza kuchepetsa kuchuluka kwa atria kukana. Mankhwala Diroton, kugwiritsa ntchito kwake kutsitsa magazi, sikukhudza kugunda kwa mtima (kugunda kwamtima) ndipo kumabweretsa kuchuluka kwa miniti yamagazi, komanso kuthamanga kwa magazi aimpso. Kuti mukwaniritse bwino kwambiri, zimatenga maola 6. Mtsogolomo, zimapitilira pafupifupi tsiku limodzi ndipo zimatha kusintha malinga ndi kuchuluka kwa mankhwalawo. Diroton kuchokera pamavuto ndikugwiritsa ntchito nthawi yayitali amachepetsa mphamvu yake.

Data ya Pharmacokinetics

Njira yonyamulira imachokera m'mimba, ndiye lisinoprilkulowa m'madzi a m'magazi sikugwirizana ndi mapuloteni. Mwachilengedwe, kuphatikiza kwa bioavailability kopitilira 25-30%, ndipo zakudya sizimasintha mayamwidwe. Mankhwala amachotsedwa pambuyo maola 12. Popeza chinthu chomwe sichikupangika, mafuta amkati samasinthika limodzi ndi mkodzo. Mankhwala Diroton samayambitsa matenda achire ndi kufinya kwamankhwala.

Zizindikiro zogwiritsa ntchito Diroton

mankhwala amagwira ntchito kulephera kwa mtima kosatha (monga gawo la mankhwala ophatikiza),
ngati pakufunika kupewa lamanzere kwamitsempha yamagazi, kulephera kwa mtimakomanso kuthandizira pakuchita bwino hemodynamics — Mapiritsi a Diroton amagwiritsidwa ntchito - kuchokera kwa iwo omwe amagwira ntchito, kuphatikizapo at pachimake myocardial infaration,
at matenda ashuga nephropathy (amachepetsa albinuria),
Zowonetsa kugwiritsa ntchito mapiritsi a Diroton mulinso zofunikirandi Kukonzanso kwamitsempha yamagazi(monga monotherapy kapena mankhwala ophatikiza ndi antihypertensive mankhwala ena).

Contraindication

mbiri yakale za idiopathic angioedema, kuphatikizapo milandu yogwiritsira ntchito ACE zoletsa,
Quincke a edema cholowa,
ana (≤ wazaka 18),
amayi apakati ndi othira pansi,
Hypersensitivity mpaka pano lisinoprilkapena zigawo zothandizira, komanso zina ACE zoletsa.

Pressure Medication Diroton imayikidwa mosamala

ndi aimpso mtsempha wamagazi stenosis kapena orortise orifice,
pambuyo kupatsidwa impso,
odwala aimpso kulephera ndi CC zosakwana 30 ml / min,
at hypertrophic cardiomyopathy,
mu gawo loyambirira hyperaldosteronism,
at ochepa hypotension,
Odwala omwe ali ndi matenda amisempha kapena ubongo
mafomu olemera matenda ashuga,
at scleroderma, Matenda a mtima wa Ischemic, zokhudza zonse lupus erythematosus,
kulephera kwamtima kwambiri,
odwala oponderezedwa mafupa a hematopoiesis,
mu mwachinyengochikhalidweat hyponatremia,
odwala okalamba
anthu hemodialysiskuthamanga kwa ma dialysis nembanemba (AN69)momwe zingathere anaphylactic reaction.

Zotsatira zoyipa

Mapiritsi opanikizika awa amatha kuyambitsa zotsatira zosasangalatsa monga chizungulire ndi mutu (pafupifupi 5-6% ya odwala), kufooka, kutsegula m'mimba, zotupa pakhungu, kusanza, kusanza, chifuwa chowuma (mu 3%), orthostatic hypotensionkupweteka pachifuwa (1-3%).

Zotsatira zina zoyipa zomwe zimachitika mosakwana 1% zitha kugawidwa pazogwirizana ndi zomwe zimachokera:

STS: kuthamanga kwa magazi, tachycardia, bradycardia, kuwonetsedwa kwa mtima kulephera, kuwonongeka kwa atrioventricular conduction, kotheka myocardial infaration.
Matumbo oyenda: kukomokakamwa yowuma, kudzimbidwa, kusokoneza kusokoneza, chitukuko kapamba, chiwindi, jaundice, hyperbilirubinemia, kuchuluka kwa chiwindi michere - transaminases.
Chiwonetsero cha khungu: urticariathukuta kwambiri zithunzi, alopeciaKhungu.
CNS: kusintha kwadzidzidzi, kusokonezeka, paresthesiakutopa ndi kugona, chisokonezo, kupindika kwa miyendo ndi milomo, asthenic syndrome.
Njira yothandizira: ziphuphu, dyspnea, bronchospasm.
Hematopoietic dongosolo: neutropenia, leukopenia, thrombocytopenia, agranulocytosis, kuchepa magazi.
Dongosolo lachitetezo: vasculitis, angioedemazoyenera (zojambula) za antibodies antiinuclear, kuchuluka ESR, eosinophilia.
Dongosolo la genitourinary: kuchepa kwa potency, anuria, uremia, oliguria, kukanika kwa aimpso mpaka kukanika kwa impso.
Kupenda: kuchuluka kapena kuchepetsedwa kwa potaziyamu m'mwazi, kuchepetsedwa kwa sodium, magnesium, chlorine, kuchuluka kwa calcium, uric acid, urea, creatinine, cholesterol, hypertriglyceridemia.
Pakati pa ena: arthralgia, malungo, nyamakazi, myalgiakuchuluka gout.

Ndi matenda oopsa

Pokhapokha akaperekedwa antihypertensive othandizira, ndiye kuti gawo loyambirira la tsiku lililonse loyambirira siliyenera kupitirira 10 mg, kuthandizira nthawi zambiri mpaka 20 mg. Pambuyo pa kafukufuku Mphamvu za BP Itha kuwonjezereka mpaka 40 mg, poganizira kuti chitukuko chokwanira chimawonedwa pakadutsa masabata 2-2. Ngati wodwalayo alibe kutanthauza kuti achire, ndiye kuti mankhwalawo amathandizidwanso ndi enanso antihypertensive mankhwala.

Yang'anani! Musanatenge Diroton, ndikofunikira kusiya mankhwalawaokodzetsa pafupifupi masiku 2-3, apo ayi, koyamba mlingo wa Diroton suyenera kupitirira 5 mg / tsiku. Chithandizo chimachitika moyang'aniridwa ndi achipatala chifukwa choopsa cha chizindikiro ochepa hypotension.

Pankhani ya kukonzanso kwamitsempha yamagazi ndi zina zomwe zimachitika chifukwa cha kuchuluka kwa mphamvu ya mahomoni a RAAS

Ndikulimbikitsidwa kuti muyambe kulandira chithandizo chamankhwala tsiku lililonse mosiyanasiyana kwa 2,5-5 mg / tsiku, makamaka kuchipatala choyang'aniridwa mwamphamvu, kuphatikizapo kuwunika HEREntchito impso, seramu potaziyamu ndende. Njira yokonza imatsimikizika potengera mphamvu yamagazi.

Anthu okhala ndi vuto la impso

Kusintha kwa mlingo kumafunikira, komwe kumakhazikika pakuwunika kwa creatinine chilolezo. Momwemo ndi Cl pa 30-70 ml / min, mankhwalawa amayamba ndi 5-10 mg lisinoprilpatsiku, pa 10-30 ml / mphindi - 2,5-5 mg / tsiku.

Analimbikitsa tsiku lililonse odwala hemodialysissayenera kupitirira 2,5 mg.

Kulephera kwa mtima kosatha

Mankhwala oyamba tsiku lililonse a 2.5 mg amatha kuwonjezeka pang'onopang'ono pambuyo masiku 3-5 mpaka muyeso wokonzanso wa 5 mpaka 20 mg. Ngati kale ntchito okodzetsa, ndiye kuti mlingo wawo umakhala wochepa kwambiri. Kuchiza kuyenera kuyamba ndi kuphunzira ndikutsatira poyang'anira. HERE, ntchito ya impso, kuzungulira kwa potaziyamu ndi sodium, zomwe zingalepheretse chitukuko ochepa hypotensionkomanso matenda aimpso.

Malangizo ogwiritsira ntchito Diroton kwa odwala pambuyo poyambitsa myocardial infarction

Mu tsiku loyamba pambuyo podziwa kulowetsedwa kwa myocardial, wodwalayo amapatsidwa mlingo woyambirira wa 5 mg, muyezo wachiwiri wa 5 mg, pa mlingo wachiwiri wa 10 mg, kupitiliza chithandizo ndi kukonzanso tsiku lililonse osaposa 10 mg kwa masabata 6. Ngati odwala ali otsika syst.AD, tikulimbikitsidwa kuti muyambe kulandira chithandizo chamankhwala ochepa - 2,5 mg.

Zochizira

kusankhidwa kaboni yodziyambitsa,
chapamimba,
kubwezeretsanso Bcc(km. iv plasma cholowa mayankho),
symptomatic mankhwala
hemodialysis,
kuwunika ntchito zofunika.

Kuchita

Kuchita zochizira nthawi imodzi kuteteza potaziyamuokodzetsa(mwachitsanzo, Spironolactone, Triamteren, Amiloride) ndi mankhwala ena okhala ndi potaziyamu amathandizira kuti akhale ndi vuto Hyperkalemia.
Ndi sodium aurothiomalate adzauka Zizindikiro zovutakuphatikizapo nseru, kusanza, kugulukankhope ndi ochepa hypotension.
β-blockers, wodekha Ca blockers, okodzetsandi ena antihypertensiveszotheka hypotensive kwenikweni.
Ndi NSAIDskuphatikiza kusankha COX zoletsa - 2, estrogen, adrenomimetics antihypertensive zotsatira zimachepa.
Ndi vasodilators, tridclic antidepressants, barbiturates, phenothiazines, zokhala ndi ethanolHypotensive zotsatira zimapezekanso m'njira.
Ndikukonzekera kwa lifiyamu, kutsikira pang'onopang'ono kumachitika. lifiyamu, yomwe imalimbikitsa zotsatira zake za mtima ndi mtima.
Maantacidndi Colestyraminekuchepetsa kuchuluka kwa kuyamwa kuchokera m'mimba.
Lisinoprilkuphatikiza neurotoxicity salicylateskufooketsa izi othandizira a hypoglycemic, Epinephrine, Norepinephrine, mankhwala a goutzolimbikitsa (kuphatikiza zosafunika) mtima glycosides, zotumphukiraopuma minofu, chepetsani kuchuluka kwa zotulutsa Quinidine.
Imachepetsa kuchitapo kanthu kulera kwamlomo.
Ndi Methyldopachiopsezo chowonjezereka cha hemolysis.

Pa mimba ndi mkaka wa m`mawere

Chifukwa chakuti mankhwalawa amatha kulowa mkati mwa chotchinga, pali chiopsezo cha mwana wosabadwayo (II ndi III trimester):

chigaza hypoplasia,
kutchulidwa kuchepa HERE,
Hyperkalemia,
kulephera kwa aimpso
ndizotheka imfa — imfa ya fetal.

Achinyamata Omwe Akuwonekera ACE zoletsaamafunika kuyang'aniridwa mosamala kuchipatala chifukwa choopseza kulimbikira kutsitsa magazi, Hyperkalemia, oliguria.

Ma analogi a Diroton

Mtengo wa ma analogues a Diroton sasintha mosiyanasiyana - ma ruble 50-100. kutengera kuchuluka kwa mapiritsi, dziko lopanga ndi zinthu zina zamtengo. Kufufuza momwe mungachotsere antihypertensive mankhwala awa kuyenera kutsata kuwunika kwa kuthamanga kwa magazi ndi kuthamanga kwa thupi, kufunsa dokotala. Pali mankhwala omwe amagwirizana ndi zomwe zimagwira, pakati pawo pali:

Aurolyza,
Vitopril,
Dapril,
Lysinocore.

Ndemanga za Diroton

Diroton nthawi zambiri amatengedwa ndikuvomereza kwa mtima ndipo patatha milungu ingapo amamva kuti akumva bwino, kudutsa zosasangalatsa mumtima, ndipo kupuma kumakhala bwino. Ndemanga za Diroton pamaforamu mulinso abwino, koma ambiri amati mukufuna dokotala wabwino yemwe angakuthandizeni kusankha mlingo woyenera.

Zotsatira za pharmacological

Diroton wanena kuti ndi hypotensive (kutsitsa magazi) komanso ndizowonjezera za vasodilating.

Zomwe zimagwiritsa ntchito mankhwalawa ndi lisinopril.

Pambuyo pakugwiritsa ntchito, Diroton amayamba kuchita pambuyo pa mphindi 60, mphamvu yayikulu imawonedwa pambuyo maola 6.7 ndipo imapitirira tsiku lonse.

Diroton. Malangizo ogwiritsira ntchito. Pa mavuto ati?

Mapiritsi a Diroton ali m'gulu la zoletsa za ACE, amalembedwa ndi mtima kuti azitha kuthamanga magazi, munthawi zonse chithandizo cha matenda amtima ndi mtima.

Chomwe chimagwiritsa ntchito mankhwalawa ndi lisinopril. Sikuti amachepetsa kuthamanga kwa magazi, komanso amachepetsa katundu m'mitsempha yamapapu, kuwonjezera kuchuluka kwa kuchuluka kwa magazi omaliza.

Mankhwala amapangidwa mapiritsi - 2,5 - 20 mg. Kwa iwo omwe akukonzekera kumwa D Iroton, malangizo omwe angagwiritsidwe ntchito angakuuzeni kuchuluka kwa mankhwalawa, koma ndibwino kuti musatenge nokha, koma kukaonana ndi dokotala.

Choyamba, zomwe zimayambitsa matendawa zimadziwika, diagnostics amachitika, ndiye kuti chithandizo chokwanira chokhacho chimayikidwa.

Kodi mankhwalawa amagwira ntchito bwanji?

Poyerekeza ndi zoletsa zoletsa za ACE, Diroton amachepetsa kuthekera kwa kutembenuka kwa angiotensin 2 kuchokera pa 1, chifukwa chomwe kupanga kwa aldosterone kumachepa, ndipo ma prostaglandins amawonjezeka. Kugwiritsa ntchito mankhwalawa pafupipafupi kumathandizira pa myocardium, kumachepetsa kukakamiza, kumapangitsa mitsempha.

Odwala odwala matenda a coronary, mankhwalawa amatithandizanso kuti magazi azithamanga. Malinga ndi kafukufuku, zotsatira za Diroton zimathandizira kuwonjezera moyo wa odwala omwe ali ndi vuto la mtima nthawi yayitali. Mthupi lomwe lakhala ndi vuto la mtima, Diroton amachepetsa kukula kwa pathologies am'manzere amitsempha yama cell.

Kuyambira pa nthawi yomwe mumamwa mapiritsi, mphamvu ya mankhwalawa imadziwika pambuyo pa ola limodzi, ndipo mphamvu yake yambiri imawonekera patatha maola 6 ndipo imatha tsiku. Pambuyo pa miyezi ingapo yothandizira, nthawi zambiri zimakhala zotheka kukhazikika magazi, kukana mankhwalawa sikuyambitsa matenda achiwonetsero.

Kwa omwe Diroton adalembedwa

Mapiritsi a Diroton sagwiritsidwa ntchito osati kungopanikiza, koma ma pathologies osiyanasiyana. Mwa mitundu ingapo ya matenda, omwe amapezeka pakumwa mankhwalawa ndi awa:

matenda oopsa (ofunika, kukonzanso). Mankhwalawa amagwiritsidwa ntchito ngati monotherapy kapena kuphatikiza ndi mankhwala ena.
kugunda kwamtima mu mawonekedwe owopsa. Mapiritsi amatchulidwa kuyambira tsiku loyamba ndi chidaliro cha hemodynamics. Nthawi zambiri, Diroton amakhala ngati gawo limodzi la mankhwalawa ophatikizira mankhwala oletsa kupewetsa kugunda kwa mbali yamanzere yamitsempha yama mtima ndi mtima,
kulephera kwa mtima,
kulephera kwa aimpso mu shuga. Mankhwalawa amachepetsa albinuria mwa anthu omwe amadalira insulin komanso kukakamizidwa pamlingo woyenera, mwa odwala omwe ali ndi kuthamanga kwa magazi popanda kudalira insulin.

Momwe mungamwe mapiritsi opanikizika

Piritsi limodzi la Diroton la mlingo woyenera ndi wokwanira patsiku, ndikofunika kumwa mankhwalawa m'mawa, musanadye kapena mutatha - zilibe kanthu. Poyamba, 10 mg ya mankhwalawa imayikidwa, mtsogolomo, mlingo umabweretsedwa pang'onopang'ono mpaka 20 mg. Pambuyo pa masabata pafupifupi 2-4 ogwiritsira ntchito pafupipafupi, mphamvu ya mankhwala yokwanira imatheka.

Ngati wodwalayo adatenga diuretics, masiku awiri asanatenge Diroton, ayenera kuti adathetsedwa. Ngati njirayi siyabwino, ndiye kuti mlingo wa Diroton umachepetsedwa mpaka 5 mg.

Ngati matenda oopsa aphatikizidwa ndi magazi ovuta kupita ku impso, chithandizo cha Diroton chimayambira ndi 2,5 mg, ndiye kuti mankhwalawa amasintha malinga ndi kuwerenga kwa tonometer. Pofuna kulephera kwa mtima, mapiritsi opanikizika amaphatikizidwa ndi mankhwala a diuretics ndi a digitalis. Ngati matenda a impso apezeka, dokotalayo amaganizira chilolezo cha mankhwala asanawerengere mankhwalawa. Chithandizo cha mankhwalawa chimayamba ndi 2.5-10 mg, ndipo Mlingo wokonzanso umawerengedwa makamaka poganizira kukakamiza.

Mankhwalawa chifukwa cha matenda a mtima oopsa, mapiritsi a Diroton akhale gawo la njira yophatikizika. Patsiku loyamba - 5 mg, mutapanga tsiku yopuma ndikuyambiranso, pambuyo pa masiku awiri - 10 mg ya mankhwalawa, ndiye - 10 mg tsiku lililonse. Pa mankhwala, mankhwalawa amatengedwa pakapita miyezi 1.5.

Pakutsika kwambiri kwa systolic, akatswiri a zamankhwala amapereka 2,5 mg wa Diroton, koma, ngati nthawi yolamulira itadutsa, kupanikizika kumatsalira, ndiye kuti mapiritsi ayenera kusiyidwa.

Mayendedwe akugwiritsidwa ntchito ndi Mlingo

Mankhwalawa amapangidwira kukonzekera pakamwa kamodzi patsiku nthawi imodzi, ngakhale osadya.

Zochizira matenda oopsa, odwala ndi mankhwala 10 mg. Kukonza tsiku lililonse mlingo, monga lamulo, sizidutsa 20 mg, koma pazovomerezeka pazokwanira - 40 mg.

Kuchiritsa kwathunthu kumawonekera patatha masabata atatu atatha chithandizo, chomwe chiyenera kukumbukiridwa pakuwonjezera mlingo. Ndikothekanso kuphatikiza Diroton ndi mankhwala ena a antihypertensive.

Ngati wodwalayo alandila chithandizo cham'mbuyomu, makonzedwe awo amayenera kuyimitsidwa masiku 3-4 asanayambe chithandizo ndi Diroton. Ngati ndizosatheka kuletsa kukodzetsa, mankhwala oyamba a mankhwalawa sayenera kupitirira 5 mg patsiku. Mutamwa mlingo woyamba, muyenera kuyang'aniridwa ndi achipatala kwa maola 1-2, chifukwa kuchuluka kwa magazi ndizotheka.

Pankhani ya kukonzanso kwamitsempha yamagazi ndi zina zomwe zimayendetsedwa ndi ntchito ya renin-angiotensin-aldosterone dongosolo, mlingo woyambira wa 2.5-5 mg wa patsiku umayikidwa.

Kulephera kwa mtima komanso pachimake pamtima, malinga ndi malangizo opita kwa Diroton, mlingo woyambirira uyenera kukhala wofanana ndi 2,5 mg, womwe umayenera kuwonjezeka pang'onopang'ono mpaka 5-20 mg. Pa mankhwala ndi mankhwalawa, ndikofunikira kuyang'anira ntchito yaimpso, kuthamanga kwa magazi, sodium ndi potaziyamu m'magazi.

Mu kuphwanya myocardial infarction m'masiku awiri oyamba, 5 mg Diroton ndi mankhwala. Pambuyo yokonza mlingo sayenera upambana 10 mg. Kutalika kwa mankhwala osachepera milungu 6.

Mu matenda a shuga a nephropathy odwala matenda a shuga omwe amadalira shuga, mankhwalawa amadziwitsidwa pa 10 mg patsiku. Ngati ndi kotheka, mlingo utha kuwonjezeka mpaka 20 mg.

Zotsatira zoyipa za Diroton

Malangizo kwa Diroton adanenanso kuti mankhwalawa amatha kuyambitsa zovuta zingapo mthupi la wodwalayo:

Matenda a mtima: kuchepa kwa kuthamanga kwa magazi, kupweteka pachifuwa, tachycardia, bradycardia, infarction ya myocardial,
Matumbo: Kusanza, kukamwa kowuma, kupweteka kwam'mimba, kutsegula m'mimba, kugona, kupezeka, kukomoka, hepatitis, kapamba, jaundice, hyperbilirubinemia,
Khungu: kutuluka thukuta kwambiri, urticaria, photosensitivity, kuchepa kwa tsitsi, kuyabwa,
Pakati mantha dongosolo: nkhawa mavuto, kusokonezeka kwa mphamvu, paresthesia, kugona, kutopa, kupweteka,
Njira yothandizira: Kupuma pang'ono, dyspnea, ziphuphu, bronchospasm,
Dongosolo la circulatory: thrombocytopenia, leukopenia, neutropenia, kuchepa magazi, agranulocytosis, kuchepa pang'ono mu hematocrit ndi hemoglobin,
Dongosolo la genitourinary: oliguria, uremia, anuria, kulephera kwa impso, kutsika kwa libido ndi potency.

Zolemba za mankhwala

Asanapereke mankhwala, crustacean ayenera kusintha kukakamiza kwa wodwalayo ngati wasokonezedwa ndi okodzetsa, mchere wochepa mu chakudya, kutsekula m'mimba kapena kusanza. Dokotala amafunikira kuwongolera zomwe zili mgululi m'thupi la wodwalayo, kuonjezera ngati pakufunika, ndikubwezeretsanso madzi.

Ndi kukhazikitsidwa kwa Lisinopril pambuyo pakuchita opaleshoni yayikulu kapena mankhwala amphamvu omwe amachepetsa kuthamanga kwa magazi, kugwa kwakuthwa kwakanthawi kungachitike. Ndikofunika nthawi zonse kuwunika kuchuluka kwa magazi mu labotale, chifukwa kulephera kwa mtima limodzi ndi vuto la impso kungayambitsenso kutsika kwambiri. Ngati matenda aimpso akuwonongeka, chithandizo cha Diroton chikuchitika moyang'aniridwa ndi dokotala, mlingo amawerengedwa mosamala.

Kuphatikiza Diroton ndi mowa sikulimbikitsidwa, popeza ethanol imathandizira kutsitsa-kuthamanga. Kusamala makamaka kuyenera kuchitidwa pakachitika masewera olimbitsa thupi, nyengo yotentha, popeza kuthanso kwamadzi m'malo otere, kupsinjika kumatha kugwera mpaka kuwopsa.

Ngati chizungulire chachitika kapena zotsatira zake zikuchepa mukamamwa mankhwalawo, simungayendetse galimoto, komanso simungagwire ntchito yomwe imafunika chisamaliro.

Mankhwala

Angiotensin-akatembenuka enzyme kapena ACE ndi othandizira kutembenuza kwa angiotensin I kukhala angiotensin II. Enzyme angiotensin II imalimbikitsa kubisala kwa aldosterone, pansi pa kuchitapo kwake kumachepa mitsempha yamagazi komanso kuwonjezeka kwa kuthamanga kwa magazi. Mankhwala a ACE amakhudza dongosolo la renin-angiotensin, kuletsa kuchuluka kwa aldosterone, potero kutsekereza njira ya kukulitsa kamvekedwe ka mtima.

Diroton amakhudza mwachindunji njira za chitukuko cha matenda oopsa, osati chifukwa cha matendawa - kuthamanga kwa magazi. Kukhazikika kwa mankhwalawa kumalepheretsa kupanikizika komanso kumateteza ku mavuto obwera chifukwa cha matenda oopsa.

kutsitsa magazi
kuchuluka kwa potaziyamu m'magazi,
kupewa kupsinjika,
ntchito impso
kutsika kwa katundu pa myocardium.

The kuchuluka kwa yogwira thupi m'thupi pang'onopang'ono kumawonjezeka pasanathe maola 7 mutamwa mapiritsi. Mankhwalawa sakupangika. Pakatha pafupifupi maola 12 mpaka 1313, gawo lina la chinthucho limatulutsidwa mosasinthika mkodzo. Pankhaniyi, kuchepa kwa kuchuluka kwa zinthu zomwe zimagwira m'magazi am'magazi kumachitika pang'onopang'ono, zomwe zimatsimikizira kusowa kwa zotsatira zowonjezera, ndipo nthawi yomweyo sizimayambitsa kupsinjika kwakuthwa kumapeto kwa zochita za lisinopril.

Mlingo wa Mlingo ndi Malamulo

Mapiritsi a Diroton ayenera kumwedwa kamodzi patsiku, nthawi yomweyo. Izi zitsimikiza mosalephera mphamvu ya mankhwalawa popanda kusintha kwakukulu pa mankhwalawa amagwira ntchito mu seramu yamagazi. Momwe mungatenge Diroton - zimatengera umboni.

Ndi matenda oopsa, mankhwalawa amayamba ndi 10 mg ya Diroton kwa masabata angapo. M'masiku oyambira, muyenera kukhala okonzekera kuchepa kwamphamvu kwa kuthamanga kwa magazi komanso kuwoneka kwa zizindikiro za hypotension. Pambuyo pa milungu ingapo, ndikofunikira kukayezetsa kuti muwone ngati mankhwalawo ali othandizika. Potsatira malangizo a dokotala, njira ina yogwiritsidwira ntchito mankhwalawa imatha kusinthidwa onse kuti iwonjezere kapena kuchepetsa mlingo wovomerezeka. Mlingo wapamwamba tsiku lililonse wokhudzana ndi matenda oopsa ndi 80 mg wa lisinopril.
Pakulephera kwa mtima, mankhwalawa adapangidwira kuwonjezera pamatumbo. Mlingo woyambirira ndi 2.5 mg (theka la piritsi la Diroton 5 mg). Pambuyo milungu iwiri, mlingo umakulitsidwa 5 mg, pambuyo masiku 14 - mpaka 10 mg wa lisinopril.
Mankhwalawa pachimake myocardial infarction, intravenous makonzedwe a lisinopril amachitika, koma nthawi zina, mapiritsi a Diroton ndi omwe amapatsidwa. Patsiku loyamba, muyenera kumwa 5 mg ya mankhwalawa, tsiku lachiwiri kenako - 10 mg ya mankhwalawa. Ngati wodwala amakhala ndi vuto lochepa kwambiri m'masiku ochepa pambuyo pa vuto la mtima, 2,5 mg wa Diroton akulimbikitsidwa. Patatha masiku atatu atadwala matenda a mtima, amasinthana ndi kumwa kwa 10 mg wa Diroton tsiku lililonse. Chithandizo chimatenga milungu 4-6.
Mankhwalawa a matenda a shuga a nephropathy, Diroton amatengedwa pa 10 mg patsiku kwa masabata angapo oyambira, kenako ndikuwonjezera kuchuluka kwa 20 mg.

Makapiritsi ndi mapiritsi Diroton amayenera kumwedwa mosasamala chakudya, ndi madzi ambiri. Kulandila kumachitika bwino m'mawa. Diroton itha kutumizidwa kwa odwala okalamba. Kusintha kwa vutoli pamenepa sikufunika pokhapokha dokotala atasankha mwanjira ina.

Kupatsa ana ntchito

Mlingo wa mankhwalawa kwa ana amalembedwa ndi dokotala aliyense payekha

Diroton amagwiritsidwa ntchito pochita ana. Mankhwalawa amalembera ana omwe ali ndi matenda oopsa kwambiri kuposa zaka 6. Ngati kulemera kwa mwana kupitirira 20 makilogalamu, 2.5 mg ya mankhwala patsiku amadziwika, omwe amafanana ndi theka la piritsi pamlingo wochepera 5 mg.

Masabata ochepa atayamba kumwa mankhwalawa, adotolo amatha kuwirikiza kawiri muyezo ngati wodwalayo alola bwino chithandizo cha Diroton.

Kulandila pa mimba ndi mkaka wa m`mawere

Diroton, kugwiritsidwa ntchito kwake komwe kumachitika molingana ndi malangizo, ndizoletsedwa kutenga nthawi yapakati. Zowona molondola pazomwe zimapangitsa kuti mankhwalawa akwaniritse kukula kwa mimba ndi mwana wosabadwayo sizikupezeka. Ngati kutenga pakati pa Diroton chithandizo, mankhwala ayenera kusiyidwa.

Amayi omwe akukonzekera kutenga pakati sayenera kumwa mankhwalawo. Diroton mankhwala ayenera kutayidwa osachepera miyezi itatu isanachitike lingaliro.

Pa mkaka wa m`mawere, kumwa mankhwala zoletsedwa. Ngati chithandizo chikufunika, kuyamwitsa kuyenera kusiyidwa.

Zizindikiro zosokoneza bongo

Ndi zizindikiro za mankhwala osokoneza bongo, nthawi yomweyo muzimutsuka m'mimba

Milandu yamiyeso yambiri siinalembedwe, chifukwa chake palibe chidziwitso chazidziwitso pazotheka. Mwina kumwa mankhwala mosiyanasiyana kungayambitse:

kuchepa kwamphamvu kwa mavuto,
kulephera kwa aimpso
tachycardia
bradycardia
kuphwanya mulingo wamadzi-electrolyte.

Ngati mukukayikira mankhwala osokoneza bongo, mwachangu tsukani m'mimba mwanu ndikuyambitsa kusanza. Chotsatira, chithandizo chamankhwala chimachitika, motero ndikofunikira kuyimbira ambulansi kunyumba.

Malangizo apadera

Diroton wokhala ndi matenda oopsa kuchokera kukakamizidwa amayenera kumwedwa pokhapokha ngati akuwongolera dokotala. Pofuna kupewa kuyambika kwa zizindikiro za hypotension, muyenera kusiya mankhwala ena, ndikuyamba kumwa Diroton. Izi ndizofunikira kwambiri kwa okodzetsa, popeza kugwiritsidwa ntchito limodzi kwa mankhwalawa ndi ACE inhibitors koyambirira kwa chithandizo kumatha kupangitsa kuti kuchepa kwamphamvu kukakamize.

Odwala omwe ali ndi vuto losautsa kwambiri magazi, zizindikiro za kuchepa pang'ono sizimawoneka koyambirira kwa kutenga Diroton. Chiwopsezo cha kuchepa kwambiri kwa mapanikizidwe chimawonjezeka pamaso pa zovuta zamagazi.

Ngati wodwala ali ndi chiopsezo chambiri chochepetsera kuthamanga kwa magazi pazofunikira kwambiri pamene akumwa mankhwala a antihypertensive, tikulimbikitsidwa kuti ayambe kuchita ndi Diroton muyezo wochepera.

Odwala omwe amalephera kupezekanso kwa impso komanso matenda a shuga, pali chiopsezo chotenga matenda oopsa (hyperkalemia) ndi kugwiritsa ntchito mankhwalawa Diroton, chifukwa cha mankhwala ndi mankhwalawa, muyenera kuyeserera pafupipafupi kuti mupeze vutoli munthawi yake.

Odwala omwe ali ndi matenda ashuga ayenera kuyang'anitsitsa kusintha kwa shuga m'magazi mwezi woyamba wamwa mankhwala atsopano a antihypertensive.

Kuyanjana kwa mankhwala osokoneza bongo

Kugwiritsa ntchito mapiritsi a Diroton kuyenera kuvomerezana ndi adokotala, chifukwa mankhwala ena akhoza kusokoneza zochita za antihypertensive mankhwala. Pankhaniyi, muyenera kudziwitsa dokotala za mankhwala onse omwe wodwala amamwa mosalekeza.

Kugwiritsa ntchito munthawi yomweyo mankhwala a antihypertensive kumathandizira mphamvu ya mankhwala Diroton, omwe angapangitse kuchepa kwakukulu kwa kupanikizika ndikuwonekera kwa zizindikiro za hypotension.
Mukamamwa ndi aliskiren, chiopsezo chokhala ndi mavuto akulu chimawonjezeka, chifukwa chake kuphatikiza koletsedwa.
Pankhani yovuta ya matenda oopsa, okodzetsa ayenera kuperekedwa pamene akutenga Diroton pang'onopang'ono, chifukwa cha chiwopsezo chotsika kwambiri pakukakamizidwa.
Kugwiritsira ntchito limodzi ndi potaziyamu osagwiritsa ntchito diuretics kumawonjezera chiopsezo cha hyperkalemia.
Mphamvu ya antihypertensive ya mankhwala Diroton imatsika ndikumwa mankhwala osapatsirana a antiidal (acetylsalicylic acid, diclofenac, ibuprofen, etc.).
Kugwiritsira ntchito mosiyanasiyana kwa Diroton ndi kukonzekera kwa lifiyamu sikulimbikitsidwa chifukwa cha kuwopsa kwa owopsa.
Kumwa mankhwala ochepetsa shuga pa nthawi ya Diroton mankhwala kumawonjezera chiopsezo cha hypoglycemia mwa odwala matenda a shuga.
Kutenga sympathomimetics kumachepetsa antihypertensive mphamvu ya ACE inhibitor.
Ndi munthawi yomweyo makonzedwe okhala ndi ma tridclic antidepressants kapena sedative, hypotensive zotsatira za mankhwala kwa matenda oopsa.

Mndandanda watsatanetsatane wokhudzana ndi zochitika zamankhwala umaperekedwa m'malamulo ovomerezeka kuti mugwiritse ntchito.

Mtengo ndi fanizo

Wodziwika kwambiri komanso wotsika mtengo Diroton wogwirizira

Pogwiritsa ntchito mankhwalawa kwa nthawi yayitali, Diroton wofunika amagwira ntchito yofunika. Mtengo wa mankhwalawa umasiyanasiyana pakati pa ma ruble a 300-700, kutengera mlingo ndi kuchuluka kwa ma CD. Chifukwa chake, mankhwala omwe ali mu Mlingo wa 5 mg amatenga ma ruble 350 pamapiritsi a 56, mu kipimo cha 20 mg - 730 rubles kwa phukusi lomweli.

Ngati ndi kotheka kusintha mankhwala Diroton, analogi ayenera kusankha pakati mankhwala chimodzimodzi yogwira mankhwala. Izi zikuphatikiza mapiritsi a Vitopril, Irume, Lizoril. Mankhwala okwera mtengo kwambiri ndi Lisinopril wa kupanga zoweta. Mtengo wa kulongedza mapiritsi mu 20 mg wa 20 rubles kokha pa mapiritsi 30.

Ndemanga za mankhwala

Ngati dokotala adalamulira Diroton, kuwunika kwa odwala kumathandizira kuwunikira bwino ndi chitetezo cha mankhwalawa. Popeza mankhwalawa ndiwotchuka kwambiri, ogula ambiri amagawana malingaliro awo ndi zochitika zawo pakumwa mapiritsi.

"Anatenga Diroton kwa miyezi yopitilira atatu kuti atsitse magazi pambuyo pakubadwa kwachiwiri. Mankhwala amabwera kwa ine, anachita ntchito yabwino kwambiri ndi ntchito yake. Zotsatira zoyipa zake, ndinakumana ndi mseru komanso chizungulire chokha, chomwe chinasowa patatha masiku atatu chichitikireni chithandizo. ”

"Dotolo adasankha Diroton kwa nthawi yayitali. Nditamwa Mlingo wa 20 mg, koma mavuto anayambika, kotero kuti mankhwalawo amayenera kuchepetsedwa. Ndamwa mankhwalawa mwezi wachiwiri - kupanikizika ndizabwinobwino, panalibe zovuta panthawiyi, pazonse, malingaliro anga anali abwino. "

“Diroton amamwa miyezi iwiri, zonse zidayenda bwino. Mwanjira ina iye sanali m'mankhwala, ndinayenera kutenga analogue ya kunyumba ma ruble 50. Kuchokera ku mtengo wotsika mtengo, zotsatira zoyipa zimawonekera nthawi yomweyo - nseru, kuchepa kwamphamvu kwa chikakamizo, chizungulire, mpaka kukayika. Zotsatira zake, adabwereranso ku Diroton m'masiku angapo ndipo sizinachitike. Ndikupangira kuti ndisapulumutse thanzi lanu, chifukwa sizikudziwika kuti ndi mankhwala otsika mtengo otani omwe amapangidwa. ”

Zochita Zosiyana kuchokera ku Diroton

Popeza kuchuluka kwa zoyipa zomwe Diroton zimayambitsa, simuyenera kupereka nokha. Zotsatira zotsatirazi zikuwonetsedwa mu malangizo:

kupweteka kumbuyo, kutsika kwakuthwa, mavuto, mtima,
mawonetseredwe a ziwengo khungu - urticaria ndi kuyabwa, zizindikiro za hyperhidrosis, kutupa kwa nkhope ndi manja / mapazi,
kusokonezeka kwa m'mimba thirakiti - kupweteka kwam'mimba, kusanza, kutsekula m'mimba. Madandaulo amkamwa owuma nthawi zambiri amapezeka, nthawi zina zizindikiro za hepatitis ndi kapamba,
Kuchokera pakapumidwe - ziphuphu, kutsokomola, kupsinjika mu bronchi,
mbali zina zamanjenje zimagwira ndi kuchepa chidwi, kutopa kwambiri kochokera kunthawi zina, kugona osagwirizana. Zochititsa mantha, kukomoka,
mankhwalawa amayambitsa mavuto a potency, uremia, kulephera kwa impso,
mu kuyezetsa magazi, kuchepa kwa hemoglobin kwapezeka motsutsana ndi kumbuyo kwa kukwera kwa ESR,
malungo.

Ndani sayenera kutenga Diroton

Sikuti wodwala aliyense amatha kupereka mankhwalawa pokakamizidwa. Pali zotsutsana zingapo zomwe dokotala amayenera kusankha mtundu wina wa mankhwala kwa wodwala.

matupi awo sagwirizana ndi mankhwala
kupatsidwa impso kwaposachedwa
aimpso mtsempha wamagazi,
kulephera kwa aimpso
zaka zazing'ono
kuchuluka kwamwazi wamagazi ochepa, makamaka potaziyamu yambiri.

Mankhwala oyembekezera komanso oyamwa sakhazikitsidwa, kupatula zomwe zimachitika pamene moyo wa wodwalayo uli pachiwopsezo.Zomwezo zimagwiranso ntchito poyamwitsa - ngati mapiritsi opsinjika akufunika, mwana amasamutsidwa ku zosakanikirana zopanga.

Mochenjera, Diroton amapatsidwa mtundu wovuta wa matenda ashuga, 2-mbali ya stenosis yamitsempha yama impso, mtima kulephera kosatha. Diroton sayenera kumwedwa ndi scleroderma ndi lupus erythematosus.

Ngakhale mankhwalawa atavomerezedwa kuti agwiritsidwe ntchito, ndikofunikira kuyang'anitsitsa dongosololo lomwe adalimbikitsa ndi dokotala kuti asayambitse bongo. Zizindikiro za kuledzera kwa mankhwala ali motere:

kulephera kwa electrolyte,
Kuzungulira kwa kuzungulira
dontho lakuthwa mopanikizika,
Hyperventilation yamapapo
kulephera kwa aimpso
chifuwa chowuma,
tachycardia ndi bradycardia,
nkhawa zosagwirizana
chizungulire.

Mankhwala osokoneza bongo amafuna chithandizo. Ndikofunikira kuyimba ambulansi, kutsuka m'mimba mwa wodwalayo, kupereka mankhwala othandizira kugona ndi kugona. Ndi kuledzera kwambiri, hemodialysis iyenera kuchitidwa.

Ngati wodwalayo sangatengedwe Diroton, adotolo amasankha mankhwala kuchokera ku gulu lina lomwe limathandizanso. Mndandanda wapafupi kwambiri ndi hydrochlorothiazide, womwe umachepetsa kuthamanga kwa magazi pakukulitsa arterioles. Mankhwala ena omwe adapangidwira m'malo mwa Diroton adzakhala: Dapril, Sinopril, Irumed.

Malinga ndi ndemanga za madotolo ndi odwala, Diroton amalimbana ndi ntchito yomwe adapatsidwa. Zotsatira zoyipa, ngakhale zili zambiri, ndizosowa. Nthawi zambiri odwala amakumana ndi mavuto osiyanasiyana okhala ndi mankhwala osokoneza bongo.

Akatswiri a mtima amawona kuti zoyipa zomwe zimachitika muzochita zawo zimapezeka mu mawonekedwe a tsankho la munthu pazigawo za mankhwala. Zikakhala zoterezi, yankho lavuto limalowa m'malo mankhwalawo.

Pazonse, Diroton amalimbana bwino ndi kutsitsa kukakamiza mu chithandizo chovuta, monga mankhwala amodzi sangathe. Mtengo wotsika mtengo, womwe umayenerera odwala omwe amakakamizidwa kumwa antihypertensive mankhwala kwa nthawi yayitali.

Kuti mupewe izi zisakuchitikireni ndikupeza lingaliro labwino, muyenera kuigwiritsa ntchito mosamalitsa monga momwe dokotala amafotokozera, kuyang'anira mlingo ndi malingaliro ena a mtima kuti akonze regimen, moyo, zakudya, ndi zina zambiri.