Hinapril mankhwala: malangizo ntchito

Mankhwala a antihypertensive, ACE inhibitor.

Quinapril hydrochloride ndi mchere wa quinapril, estyl ester wa ACE inhibitor quinaprilat, yemwe alibe gulu la sulfhydryl.

Quinapril amayamba mwachangu kupangidwe kwa quinaprilat (quinapril diacid ndiye metabolite wamkulu), yomwe ndi ACE inhibitor wamphamvu. ACE ndi peptidyldipeptidase yomwe imapangitsa kutembenuka kwa angiotensin II, yomwe ili ndi mphamvu ya vasoconstrictor ndipo imathandizira pakuwongolera kamvekedwe ka minofu ndi ntchito zosiyanasiyana, kuphatikizapo kukondoweza kwa kupanga kwa aldosterone ndi adrenal cortex. Quinapril amalepheretsa kugwira ntchito kozungulira ndi minofu ACE ndipo potero amachepetsa ntchito ya vasopressor ndikupanga aldosterone. Kutsika kwa gawo la angiotensin II ndi makina a mayankho kumabweretsa kuwonjezeka kwa renin secretion ndi ntchito yake m'madzi a m'magazi.

Makina apamwamba a antihypertensive zotsatira za quinapril amawonedwa kuti ndi kuponderezedwa kwa ntchito ya RAAS, komabe, mankhwalawa amawonetsa zomwe zimachitika ngakhale kwa odwala omwe ali ndi matenda ochepa oopsa. ACE ndi ofanana mu kininase II, puloteni yomwe imasokoneza bradykinin, peptide yokhala ndi katundu wamphamvu wa vasodilating. Sizikudziwika ngati kuwonjezeka kwa milingo ya bradykinin ndikofunikira pazithandizo zamankhwala za quinapril. Kutalika kwa mphamvu ya antihypertensive ya quinapril kunali kokulirapo kuposa nthawi yake yolepheretsa kuzungulira kwa ACE. Kuwongolera kwapakati pa kuponderezedwa kwa minofu ACE ndi nthawi ya antihypertensive mphamvu ya mankhwala kunawululidwa.

Ma inhibitors a ACE, kuphatikizapo quinapril, amatha kukulitsa chidwi cha insulin.

Kugwiritsa ntchito quinapril pa 10 mg mg kwa odwala omwe ali ndi vuto lochepa kwambiri pa matenda oopsa kumabweretsa kuchepa kwa kuthamanga kwa magazi pakukhala komanso kuimirira ndipo kumapangitsa kugunda kwamtima kwambiri. Mphamvu ya antihypertensive imadziwonetsera mkati mwa ola limodzi ndipo nthawi zambiri imafika pakatha maola 2-4 mutatha kumwa mankhwalawa. Odwala ena, antihypertensive kwambiri amaonedwa pakatha masabata awiri chiyambireni chithandizo.

Mphamvu ya antihypertensive ya mankhwala mukamagwiritsira ntchito Mlingo woyenera odwala ambiri amakhala ndi maola 24 ndipo amalimbikira nthawi yayitali.

Kafukufuku wa hemodynamic mwa odwala omwe ali ndi matenda oopsa kwambiri adawonetsa kuti kuchepa kwa kuthamanga kwa magazi motsogozedwa ndi hinapril kumayendetsedwa ndi kuchepa kwa OPSS ndi mtima waimpso, pomwe kugunda kwamtima, mtima wamkati, kutsekeka kwa magazi aimpso, kuchuluka kwa kusefera kwa gawo ndi kusefa kachigawo kosasintha pang'ono kapena sikusintha.

Zowonjezera zachipatala zomwe zimapezeka mu Mlingo womwewo tsiku lililonse zimafananizidwa ndi anthu okalamba (opitilira 65) komanso odwala omwe ali ndi zaka zochepa, mwa anthu okalamba pafupipafupi zochitika zowonjezera sizikula.

Kugwiritsa ntchito hinapril kwa odwala omwe ali ndi matenda osatha a mtima kumabweretsa kuchepa kwa OPSS, kumatanthauza kuthamanga kwa magazi, kuthamanga kwa magazi, kuthamanga kwa magazi komanso kuthamanga kwa mtima.

Mu 149 odwala omwe adalumikizidwa pamitsempha yama coronary, kumugwiritsa ntchito mankhwala a quinapril pa 40 mg patsiku poyerekeza ndi placebo kunatsitsa kuchepa kwa zovuta za postoperative ischemic pasanathe chaka chimodzi atachitidwa opaleshoni.

Odwala omwe ali ndi coronary atherosulinosis omwe alibe ochepa matenda oopsa kapena mtima kulephera, quinapril imayenda bwino chifukwa cha kutsekeka kwa mitsempha ndi mitsempha ya mitsempha.

Zotsatira za quinapril pa endothelial ntchito zimagwirizanitsidwa ndi kuwonjezeka kwa kupanga kwa nitric oxide. Endothelial dysfunction imawerengedwa kuti ndi yofunika popanga coronary atherosulinosis. Kufunika kwachipatala pakusintha ntchito ya endothelial sikunakhazikitsidwe.

Pharmacokinetics

Mafuta, kugawa, kagayidwe

Pambuyo pakulowetsa Cmax ya quinapril mu plasma, imatheka mkati mwa ola la 1. Kuchuluka kwa mayamwa kwa pafupifupi 60%. Kudya sikumakhudza kuchuluka kwa mayamwidwe, koma kuchuluka ndi mayamwidwe a quinapril kumachepetsedwa ndikumatenga zakudya zamafuta.

Quinapril imapukusidwa kuti Quinaprilat (pafupifupi 38% ya mlingo wapakamwa) komanso chiwerengero chochepa cha zina zopanda mphamvu za metabolites. T1 / 2 ya quinapril kuchokera ku plasma ndi pafupifupi ola limodzi. Cmax ya quinaprilat mu plasma imafika pafupifupi maola awiri atatha kudya kwa quinapril. Pafupifupi 97% ya quinapril kapena quinaprilat imayenda mo plasma m'njira yolumikizira mapuloteni. Hinapril ndi ma metabolites ake samalowa BBB.

Quinapril ndi quinaprilat amathandizidwa makamaka mu mkodzo (61%), komanso ndowe (37%), T1 / 2 pafupifupi maola atatu.

Mlingo

Pochita monotherapy yophatikiza matenda oopsa, mlingo woyambira wa Accupro® kwa odwala omwe salandira okodzetsa ndi 10 mg kapena 20 mg kamodzi patsiku. Kutengera ndi mankhwalawa, mankhwalawa atha kuwonjezereka (kuwirikiza kawiri) pa mlingo wokonza 20 mg kapena 40 mg patsiku, womwe nthawi zambiri umafotokozedwa mu 1 piritsi kapena magawo awiri. Monga lamulo, mlingo uyenera kusinthidwa pakapita masabata anayi. Odwala ambiri, kuwongolera kwa magazi nthawi yayitali pakatha nthawi yayitali kumatheka pogwiritsa ntchito mankhwalawa kamodzi patsiku. Mlingo wapamwamba tsiku lililonse ndi 80 mg.

Odwala omwe akupitiliza kukodzetsa, mankhwala oyamba a Accupro® ndi 5 mg, mtsogolomo amawonjezereka (monga tafotokozera pamwambapa) mpaka phindu lokwanira litakwaniritsidwa.

Kulephera kwa mtima kosalekeza, kugwiritsa ntchito mankhwalawa kumawonetsedwa ngati zowonjezera pothandizana ndi okodzetsa komanso / kapena mtima glycosides. Mlingo woyambitsidwa kwa odwala omwe ali ndi vuto la mtima nthawi zonse ndi 5 mg 1 kapena 2 kawiri patsiku, mutamwa mankhwalawa, wodwalayo ayenera kuonedwa kuti adziwe chizindikiro cha hypotension. Ngati kulekerera kwa koyamba mlingo wa Accupro® kuli bwino, ndiye kuti imatha kuwonjezeredwa ku mlingo wogwira, womwe nthawi zambiri umakhala 10-40 mg patsiku mu 2 Mlingo wofanana kuphatikiza ndi concomitant mankhwala.

Mu vuto la impso, njira yoyambirira ya Accupro® ndi 5 mg kwa odwala omwe ali ndi 30 ml / min ndi 2,5 mg mwa odwala CC osakwana 30 ml / min. Ngati kulekerera kwa koyamba mlingo ndikwabwino, ndiye kuti tsiku lotsatira Accupro® itha kutumikiridwa 2 Pakalibe kuvuta kwambiri kwa matenda ochepa kapena kuwonongeka kwakukulu mu ntchito yaimpso, muyezo ungakulimbikitsidwe pakadutsa sabata, poganizira zotsatira za matenda ndi hemodynamic.

Popeza kuchuluka kwa mankhwalawa ndi a pharmacokinetic mu odwala omwe ali ndi vuto la impso, muyeso woyamba umalimbikitsidwa kuti asankhidwe motere.

Njira yogwiritsira ntchito

Kutengera ndi mankhwalawa, mankhwalawa atha kuwonjezeredwa (kuwirikiza kawiri) pamankhwala akukonzanso 20 kapena 40 mg / tsiku, omwe nthawi zambiri amawerengedwa mu 1 kapena 2 waukulu. Monga lamulo, mlingo uyenera kusinthidwa pakapita masabata anayi. Odwala ambiri, kugwiritsa ntchito mankhwala Hinapril-SZ 1 nthawi patsiku kumakupatsani mwayi wothandizira wodalirika. Mlingo wapamwamba tsiku lililonse ndi 80 mg / tsiku.
Kugwiritsa ntchito nthawi yomweyo ndi okodzetsa: Mankhwala oyamba a Hinapril-SZ omwe ali ndi matendawa kwa odwala omwe akupitiliza kumwa mankhwala okodzetsa ndi 5 mg kamodzi patsiku, ndipo pambuyo pake amawonjezeredwa (monga tafotokozera pamwambapa) mpaka chithandiziro chokwanira chokwanira.
CHF
Mlingo woyamba wa Hinapril-SZ ndi 5 mg 1 kapena 2 kawiri pa tsiku.
Pambuyo kumwa mankhwalawa, wodwalayo ayenera kuyang'aniridwa ndi achipatala kuti azindikire owonetsa ochepa hypotension. Ngati mlingo woyambirira wa Hinapril-SZ umalekeredwa bwino, utha kuwonjezeredwa mpaka 1040 mg / tsiku mwakugawana mu 2 waukulu.
Matenda aimpso
Popeza kuchuluka kwa mankhwalawa ndi a pharmacokinetic mu odwala omwe ali ndi vuto la impso, muyeso woyamba umalimbikitsidwa kuti asankhidwe motere:
Cl Clininine woposa 60 ml / mphindi, koyamba mlingo woyambira ndi 10 mg, 30-60 ml / mphindi - 5 mg, 10-30 ml / mphindi - 2,5 mg (1/2 tab. 5 mg).
Ngati kulolera kwa koyamba mlingo kumakhala kwabwino, ndiye kuti mankhwala a Hinapril-SZ angagwiritsidwe ntchito kawiri pa tsiku. Mlingo wa Hinapril-SZ utha kuchulukitsidwa pang'onopang'ono, osapitirira kamodzi pa sabata, poganizira zaumoyo, zotsatira za hemodynamic, komanso ntchito yaimpso.
Odwala okalamba
Mlingo woyamba wa Hinapril-SZ mu okalamba odwala ndi 10 mg kamodzi patsiku, m'tsogolomu umawonjezeredwa mpaka mulingo woyenera wabwino kwambiri.

Zotsatira zoyipa

Zochitika zoyipa ndi quinapril nthawi zambiri zimakhala zofatsa komanso zosakhalitsa. Kwambiri, mutu (7.2%), chizungulire (5.5%), chifuwa (3,9%), kutopa (3.5%), rhinitis (3.2%), nseru ndi / kapena kusanza. (2.8%) ndi myalgia (2.2%). Dziwani kuti nthawi zambiri, kutsokomola sikubala, kulimbikira, ndikusowa pambuyo posiya kulandira chithandizo.
Pafupipafupi kuchuluka kwa quinapril chifukwa cha zotsatira zoyipa kunawonedwa mu milandu 5.3%.
Otsatirawa ndi mndandanda wazotsatira zoyipa zomwe zimagawidwa ndi ziwalo zamagulu ndi pafupipafupi zochitika (Gulu la WHO): nthawi zambiri kuposa 1/10, nthawi zambiri kuchokera zoposa 1/100 mpaka pasanathe 1/10, modabwitsa kuyambira zoposa 1/1000 mpaka zosakwana 1/1 100, kawirikawiri - kuchokera zoposa 1/10000 mpaka ochepera 1/1000, kawirikawiri kwambiri - kuchokera ochepera 1/10000, kuphatikiza mauthenga amodzi.
Kuchokera kumbali yamanjenje: Nthawi zambiri - kupweteka mutu, chizungulire, kusowa tulo, kupweteka kwa m'mimba, kutopa, kusakhazikika - kukhumudwa, kuchuluka kwa kusokonekera, kugona, vertigo.
Kuchokera pamimba yokhudza kugaya chakudya: Nthawi zambiri - nseru ndi / kapena kusanza, kutsegula m'mimba, kupweteka kwa m'mimba, kupweteka kwapafupipafupi - kupweteka kwamkamwa pakamwa, pakhosi, pancreatitis *, angioedema wamatumbo, magazi am'mimba, kawirikawiri - hepatitis.
Matenda osokonezeka komanso kusokonezeka pamalo a jakisoni: pafupipafupi - edema (zotumphukira kapena zowonekera ponseponse), malaise, matenda opatsirana ndi ma virus.
Kuchokera kwazinthu zozungulira ndi zamitsempha yama cell: pafupipafupi - hemolytic anemia *, thrombocytopenia *.
Kumbali ya CVS: nthawi zambiri - kuchepa kwamphamvu kwa kuthamanga kwa magazi, pafupipafupi - angina pectoris, palpitations, tachycardia, kulephera kwa mtima, kulowerera m'mitsempha, kukhumudwa, kuwonjezeka kwa magazi, kugunda kwa mtima, kuchepa kwa mtima kwaposachedwa, kukomoka *, zizindikiro za vasodilation.
Kuchokera pakapumidwe, m'chifuwa ndi pakatikati mwa ziwalo: nthawi zambiri - chifuwa, dyspnea, pharyngitis, kupweteka pachifuwa.
Pa khungu ndi subcutaneous zimakhala: ochepa - alopecia *, exfoliative dermatitis *, kuchuluka thukuta, pemphigus *, photosensitivity zimachitika *, kuyabwa, zidzolo.
Kuchokera kumbali ya minculoskeletal ndi minofu yolumikizana: nthawi zambiri - kupweteka kumbuyo, infrequently - arthralgia.
Kuchokera impso ndi kwamikodzo thirakiti: pafupipafupi - matenda a kwamikodzo, kuperewera kwaimpso.
Kuchokera kumaliseche ndi mammary gland: kwambiri - kuchepa kwa potency.
Kuchokera kumbali ya gawo la masomphenyawo: kawirikawiri - masomphenya owonongeka.
Kuchokera kumbali ya chitetezo chamthupi: pafupipafupi - anaphylactic reaction *, kawirikawiri - angioedema.
Zina: kawirikawiri - eosinophilic pneumonitis.
Zizindikiro zasayansi: kawirikawiri - agranulocytosis ndi neutropenia, ngakhale ubale wapamtima wa hinapril sunakhazikitsidwe.
Hyperkalemia: onani "Malangizo apadera."
Creatinine ndi magazi urea nayitrogeni: kuwonjezeka (nthawi zopitilira 1.25 poyerekeza ndi VGN) wa serum creatinine ndi urogen nitrogen unaonedwa mu 2 ndi 2% ya odwala omwe amalandila quinapril monotherapy, motero. Kuthekera kwa kuwonjezereka kwa magawo awa mwa odwala omwe amalandila okodzetsa kumakhala kwapamwamba kuposa kugwiritsa ntchito quinapril kokha. Ndi chithandizo chowonjezereka, zizindikiro zimabwereranso ku nthawi zonse.
* - Zosachitika pafupipafupi zochitika kapena zomwe zidatchulidwa pakafukufuku wa malonda.
Pogwiritsa ntchito munthawi yomweyo ACE zoletsa komanso kukonzekera golide (sodium acurothiomalate, iv), chizindikiro chafotokozedwa, kuphatikiza mawonekedwe amaso amaso, nseru, kusanza, ndi kuchepa kwa magazi.

Mawonekedwe ndi mawonekedwe a mankhwalawa

Chofunikira chachikulu cha mankhwala Hinapril ndi quinapril hydrochloride.

Komanso mu kapangidwe kake pali zinthu zina zothandiza:

• shuga mkaka (lactose monohydrate),
• madzi oyambira a magnesium carbonate,
• primellose (croscarmellose sodium),
• povidone
• magnesium wakuba,
• aerosil (colloidal silicon dioxide).

Njira yotulutsira mankhwala Hinapril ndi miyala yozungulira, yokutidwa ndi utoto wakanema wachikasu. Ndi a biconvex ndipo ali pachiwopsezo. Mu gawo la mtanda, pachimake pali mtundu woyera, kapena pafupifupi woyera.

Mankhwalawa amaperekedwa m'matumba otumphuka okhala ndi mapiritsi 10 kapena 30. Imapezekanso m'mitsuko ndi m'mabotolo opangidwa ndi ma polymer.

Zizindikiro zogwiritsidwa ntchito

Mapiritsi a Hinapril amapatsidwa mankhwala ochizira matenda monga:

Mankhwalawa amatha kugwiritsidwa ntchito onse mu mono-therapy, komanso kuphatikiza ndi beta-blockers ndi thiazide diuretics.

Kuchita ndi mitundu ina ya mankhwala

Mukumwa mankhwalawa a Hinapril ndi kukonzekera kwa lithiamu, odwala amatha kuwonjezera zomwe zili mu seramu yamagazi. Kuopsa kwa kuledzera wa lithiamu kumawonjezereka ngati othandizira limodzi ndi okodzetsa amathandizira.

Kugwiritsa ntchito kwa quinapril pamodzi ndi mankhwala a hypoglycemic kumawonjezera zochita zawo.

Kugwiritsa ntchito mapiritsi awa okhala ndi ethanol sikovomerezeka. Zotsatira zoyipa za kuyanjana uku ndikuwonjezera kwakukulu mu zotsatira za antihypertgency.

Bongo

Ngati wodwala mwangozi amatenga kwambiri kuposa Mlingo wovomerezeka wa Hinapril, izi zimapangitsa kuchepa kwambiri kwa magazi, kusawona bwino ntchito, kufooka komanso chizungulire.

Muzochitika zotere, ndikofunikira kuchita mankhwala mosakhalitsa ndipo kwakanthawi musamwe kumwa mankhwalawo.

Mutha kuyambiranso kusankhidwa kokha mukakambirana ndi adokotala.

Contraindication

Mapiritsi a Hinapril amatsutsana mu:

• tsankho pamagawo a mankhwala,
• kuwonongeka kwaimpso,
• Hyperkalemia
• mbiri ya angioedema,
• angioedema, omwe ndi obadwa mwatsopano kapena idiopathic m'chilengedwe,
• matenda ashuga
• mimba ndi mkaka wa m`mawere.

Kuphatikiza apo, mankhwalawa sagwiritsidwa ntchito pochiza odwala osakwana zaka 18.

Migwirizano ndi magwiritsidwe akusungidwa

Moyo wa alumali wa mapiritsi a Hinapril ndi zaka zitatu kuyambira tsiku lopanga. Ndikulimbikitsidwa kuti zizisungidwa pamatenthedwe mpaka +25 madigiri, m'malo osafikirika ndi ana, otetezedwa ku kuwala ndi chinyezi mwachindunji.

Mu malo ogulitsa mankhwala aku Russia kugula mankhwala a Hinapril, muyenera kupereka mankhwala. Mtengo wapakati wa mapiritsi awa ndi wotsika ndipo umakhala ma ruble 80-160 phukusi lililonse.

Ku Ukraine Mtengo wa Hinapril ulinso wotsika - pafupifupi 40-75 hryvnia.

Makampani amakono azamankhwala, mapiritsi angapo ogwira mtima a mapiritsi a hinapril amaperekedwa. Otchuka ndi kufunidwa kwambiri ndi awa:

Sitikulimbikitsidwa kusankha analog ya Hinapril pachokha. Pazifukwa izi, muyenera kufunsa dokotala woyenera yemwe angakupatseni njira yabwino kwambiri yozindikirira zazowonetsa za wodwala ndi zomwe wodwalayo ali nazo.

Mankhwala Hinapril amalandila zowunikira chifukwa chakuyenda bwino kwambiri, mtengo wotsika mtengo komanso kulolera kosavuta kwa odwala ambiri.

Anthu omwe adagwiritsa ntchito mapiritsi awa prophylactic ndi achire, amawona kuti hinapril amachepetsa kuthamanga kwa magazi, komanso amachepetsa kwambiri vuto la mtima. Zotsatira zoyipa zochepa nthawi zambiri zimagwirizanitsidwa ndi kusatsatira malamulo a kumwa mankhwalawa.

Mutha kuwerenga zambiri za ndemanga kumapeto kwa nkhaniyi.

Ngati mukuzidziwa bwino mankhwala a Hinapril, tengani kanthawi pang'ono ndikusiya ndemanga yanu. Izi zithandiza ogwiritsa ntchito ena posankha mankhwala.

Pomaliza

Ngati mukufuna kumwa mankhwalawa Hinapril kuti muchiritse achire kapena prophylactic, onetsetsani kuti mwalingalira zazikuluzikulu zake.

1. Hinapril amapezeka mu mawonekedwe a mapiritsi ogwiritsira ntchito pakamwa.
2. Kutengera ndi kuzindikirika kwa wodwala, mlingo woyambirira wa mankhwalawa ndi 5 kapena 10 mg. Popita nthawi, motsogozedwa ndi dokotala, amatha kuonjezereka mwakugawikana m'njira ziwiri.
3. Mlingo wapamwamba tsiku lililonse wa mankhwala ndi 80 mg.
4. Sizovomerezeka kumwa mankhwalawa kwa amayi pa nthawi yoyembekezera komanso mkaka wa m'mawere.
5. Ngati mankhwala ambiri osokoneza bongo, kutsika kwamphamvu kwa kuthamanga kwa magazi ndi kupezeka kwa kufooka wamba ndikotheka. Kuti muthane ndi vutoli, mankhwala othandizira amafunikira.
6. Hinapril sinafotokozeredwe odwala osakwana zaka 18.
7. Kugwiritsa ntchito mapiritsi a Hinaprir pamodzi ndi mankhwala omwe ali ndi lithiamu ndi ethanol sikuvomerezeka.

Mlingo wa mankhwala

Monga tanena kale, mankhwalawa amayenera kumwa ndi pakamwa. Kutafuna piritsi ndilosafunika kwenikweni. Imwani ndi madzi ambiri. Mlingo wa mankhwalawa zimatengera matenda omwe akulimbana nawo.

Ndi ochepa matenda oopsa, monotherapy ndi mankhwala. Pankhaniyi, muyenera kumwa 10 mg a "Hinapril" kamodzi patsiku. Pambuyo pa masabata atatu, kuwonjezeka kwa mlingo wa tsiku lililonse mpaka 20-40 mg ndikuloledwa. Itha kugawidwa m'magawo awiri patatha nthawi yofanana.

Ngati ndi kotheka, mlingo wa mankhwalawa kwa wodwala ochepa matenda oopsa uwonjezeka mpaka 80 mg. Njira zoterezi nthawi zambiri zimakhala zofunikira ngati, pambuyo pa masabata atatu atayamba chithandizo, kusintha kwakumveka sikuwoneka.

Ngati matenda a mtima atha kudwala, tikulimbikitsidwa kuyamba kumwa Hinapril ndi 5 mg. Munthawi yonse ya chithandizo, amafunika kukhala moyang'aniridwa ndi katswiri kuti athe kudziwa kukula kwa hypotension wodwala.

Ngati vuto la mtima silisintha, mlingo wa mankhwalawa umakulitsidwa mpaka 40 mg patsiku. Madokotala omwe amalemba ndemanga za mankhwalawa amatsimikizira kusintha kwa vutoli kukhala bwinoko ndikusintha koteroko pamankhwala.

Ndikofunikira kumwa mapiritsi nthawi imodzi.

Gwiritsani ntchito muubwana ndi ukalamba

Mankhwalawa adapangidwa kwa anthu omwe sanakwanitse zaka 18. Chifukwa chake, kugwiritsidwa ntchito kwake muubwana kumawonedwa ngati kosavomerezeka.

Odwala omwe ali ndi zaka zopitilira 65 ayenera kuyamba kumwa mankhwalawa ndi 10 mg. Pambuyo pake, kuchuluka kwake kumaloledwa mpaka kufikira pomwe zotsatira zabwino za chithandizo zikuwonetsedwa.

Asanayambe maphunziro, odwala okalamba amayenera kukayezetsa m'chipatala. Izi ndizofunikira zomwe zimatsimikizira chitetezo cha chithandizo chake ndi Hinapril.

Odwala okalamba amafunika kuwunika asanayambe kulandira chithandizo

Matenda a chiwindi ndi impso

Odwala omwe ali ndi matenda a chiwindi ndi impso amatha kumwa mankhwalawa, koma amayang'aniridwa ndi dokotala. Mankhwala oterewa ndi ovomerezeka pokhapokha patokha ma pathologies ena omwe amasokoneza momwe thupi limagwirira ntchito. Ngati zilipo, muyenera kuwunika mosamala mlingo wa "Hinapril" ndipo musayese kuwonjezera kuti mupeze popanda thandizo ndikupeza chilolezo kwa katswiri.

Malangizo apadera

Malangizo ogwiritsira ntchito "Hinapril" ali ndi malangizo apadera omwe amayenera kukumbukiridwa pokonzekera dongosolo lachipatala lotengera mankhwalawa.

Mankhwalawa sangathe kugwiritsidwa ntchito nthawi iliyonse yomwe mayi ali ndi pakati. Siyenera kutengedwa ndi azimayi amsinkhu wobereka omwe amapewa kugwiritsa ntchito njira zakulera zamasiku ano pakugonana. Ngati mimba yachitika mwachindunji pakayendetsedwe ka Hinapril, ndiye kuti wodwalayo ayenera kusiya kugwiritsa ntchito kwina nthawi yomweyo. Mankhwala akangochotsedwa, vutoli limayambitsa mwana wosabadwayo komanso mayi woyembekezera.

Milandu idalembedwa mwana akabadwa popanda zozizwitsa zina zilizonse. Zikatero, ana omwe amayi awo amamwa mankhwalawa amayang'aniridwa mosamala. Madokotala amakonda kwambiri magazi a mwana.

Mosamala, mankhwalawa amaperekedwa kwa odwala omwe apezeka kuti ali ndi vuto la Impso kapena kwa chiwindi. Mankhwala okhala ndi matendawa amatengedwa pokhapokha malinga ndi mankhwala osankhidwa. Kuphatikiza apo, wodwalayo amakhala akukumana ndi mayeso ena, omwe amalola kuwonongeka kwakanthawi kovulaza mkati mwa ziwalo zovuta zamkati chifukwa chothandizira ndi Hinapril.

Kuyanjana kwa mankhwala osokoneza bongo

Ngati mumwa mankhwalawo ndi tetracycline nthawi yomweyo, mutha kukwaniritsa kuchepetsedwa kwakukulu kwa chinthu chachiwiri. Izi zimachitika chifukwa cha ntchito yapadera ya magnesium carbonate, yomwe imagwira ntchito ngati Hinapril.

Ngati wodwala amatenga lithiamu palimodzi ndi ACE inhibitors, ndiye kuti zomwe zili mu seramu yamagazi zimawonjezeka. Zizindikiro za kuledzera ndi chinthuchi zimayambikanso chifukwa cha kuwonjezereka kwa sodium. Chifukwa chake, tifunika kugwiritsa ntchito mankhwalawa mosamala kwambiri ngati pakufunika kutero, mogwirizana.

Kugwiritsa ntchito nthawi yomweyo okodzetsa ndi Hinapril ndikololedwa. Koma nthawi yomweyo pali kuwonjezeka kwa zotsatira za hypotensive. Chifukwa chake, amafunika kusankha mosamala kuchuluka kwa onse a mankhwalawa pofuna kupewa zovuta zaumoyo wa wodwalayo.

Mosamala komanso mosamala kwambiri kuchuluka kwa potaziyamu m'magazi, mutha kumwa mankhwalawa pamodzi ndi mankhwala omwe ali m'gulu la potaziyamu osagwiritsa ntchito mankhwala. Zinthu zopangidwa ndi potaziyamu ndi mchere wotsekemera, zomwe zilinso ndi chinthu ichi, ndi gulu limodzi.

Ndi munthawi yomweyo mankhwala ndi mowa, kuwonjezereka kwa yogwira "Hinapril" anati.

Mapiritsi mobwerezabwereza amalimbikitsa mphamvu ya mankhwalawa, omwe ali ofanana ndi bongo

Kuchiza ndi ACE zoletsa kungayambitse kuwoneka kwa hypoglycemia mwa odwala. Vutoli limadziwika mwa anthu omwe ali ndi matenda ashuga omwe amatenga insulin kapena ma hypoglycemic othandizira kuti agwiritse ntchito mkati. Mankhwalawa amangowonjezera zotsatira zawo.

Kugwiritsa ntchito mobwerezabwereza mankhwalawa 80 mg ndi atorvastatin mu mlingo wa 10 mg sikuti kumabweretsa kusintha kwakukulu mu ntchito ya chinthu chachiwiri.

Mankhwala amatha kuwonjezera mwayi wokhala ndi leukopenia mwa odwala omwe nthawi yomweyo amamwa allopurinol, immunosuppressants, kapena cytostatic mankhwala.

Kulimbikitsa machitidwe a yogwira Hinapril amawonedwa akaphatikizidwa ndi narcotic analgesics, mankhwala oletsa ululu kwambiri ndi mankhwala a antihypertensive.

Kuyimitsidwa kawiri kwa ntchito ya RAAS kumabweretsa kuyendetsa munthawi yomweyo aliskiren kapena ACE zoletsa. Zotsatira zoyipa zimawonedwa motsutsana ndi maziko ochepetsa kuthamanga kwa magazi, komanso kukula kwa hyperkalemia.

Akatswiri amalimbikitsa kwambiri kuti odwala asamagwire limodzi mankhwala omwe ali ndi aliskiren ndi mankhwala omwe ali ndi izi, komanso mankhwala omwe amaletsa RAAS pazinthu zotsatirazi:

1. Pamaso pa matenda a shuga komanso kuwonongeka kwa ziwalo zomwe mukufuna, komanso popanda zovuta,
2. Ngati aimpso ntchito,
3. Ndi chitukuko cha mkhalidwe wa hyperkalemia, womwe umadziwika ndi zizindikiro zoposa 5 mmol / l,
4. Ndi mtima kulephera kapena kukula kwa matenda oopsa.

Mankhwala omwe amatsogolera kulepheretsa ntchito kwa marowine amawonjezera mwayi wa agranulocytosis kapena neutropenia.

Odwala omwe amaphatikiza mankhwalawa ndi estramustine kapena DPP-4 zoletsa ali pachiwopsezo chachikulu cha kukulira angioedema.

Analogi ndi mtengo

Imodzi mwa fanizo la hinapril lomwe limagwira ntchito yomweyo

Kugula Hinapril muchipatala, muyenera kupereka mankhwala kuchokera kwa dokotala kupita kwa opanga mankhwala. Mtengo wake umatengera kuchuluka kwa mapiritsi omwe adagulidwa phukusi. Mtengo wapakati wa mankhwalawo umangokhala ma ruble 80-160. Mndandanda watsatanetsatane wamankhwala amapezeka mu pharmacy.

Pazifukwa zina, madokotala amayenera kusintha mankhwala omwe amaperekedwa kwa wodwala chifukwa cha analogue. Mankhwala otsatirawa amaperekedwa m'malo mwa Hinapril:

Ma Analogs amatha kusankhidwa ndi adokotala omwe amapezekapo. Wodwalayo sayenera kuchita izi payekha, chifukwa akakhala pachiwopsezo cholakwitsa chomwe chingakhudze mankhwalawo komanso thanzi lake.

Ngati pazifukwa zina wodwala sayenera kulandira chithandizo ndi Hinapril, ayenera kudziwitsa adokotala za nkhaniyi. Adzayesa kumusankhira mankhwala oyenera, akumayang'ana zovuta za wodwalayo komanso thanzi lakelo. Monga lamulo, zosowa zotere zimachitika ngati wodwalayo ali ndi contraindication kumwa mankhwalawo kapena kukula kwa mayankho osiyana kuchokera mthupi kupita ku chinthu chogwiritsa ntchito mankhwalawa.

Khinapril adayamba kuzilandira ngakhale pamene anali kulandira chithandizo kuchipatala. Dotoloyo nthawi zonse ankawunika momwe ndimaonera, chifukwa amawopa zovuta zoyipa chifukwa cha vuto la impso. Mwamwayi, palibe zovuta zomwe adadziwonetsa. Mwambiri, ndimayenera kumwa mankhwalawa kwa miyezi isanu ndi umodzi. Kangapo konse, pamawu a dokotala, adakulitsa mlingo wake. Kuchita kwa "Khinapril" ndikokwanira, chifukwa kunathandizira kuthetsa vutoli ndi kuthamanga kwa magazi, komwe kwasokoneza zaka zaposachedwa. Ngakhale nthawi ndi nthawi, kuthamanga kwa magazi kumakulirabe, ngakhale osakhala kofanana ndi momwe adayamba mankhwala.

Ndidayamba kukhala ndimavuto opsinjika kwambiri. Ngakhale nthawi zambiri matenda oterewa amasokoneza okalamba. Adotolo adalimbikitsa kuti amenyane nawo ndi Hinapril. Nthawi yomweyo anachenjeza za kupezeka kwa mavuto, chifukwa chake adamwa mankhwala ochepera. Ndidagwiritsa ntchito mankhwalawa ngati mankhwala akukonzanso. Chilichonse chinali kuyenda bwino. Koma posachedwa, kugona mosafunikira kunayamba kuda nkhawa, ngakhale ndimayesetsa kugona mokwanira. Ili ndiye gawo lokhalo lomwe ladziwikitsa. Ngati zinthu sizikuyenda bwino, ndikupempha dokotalayo kuti andipatse chithunzi cha "Hinapril," chifukwa izi sizikukwanira konse.

Gulu la Nosological (ICD-10)

Mankhwala

ACE ndi ma enzyme omwe amathandizira kusintha kwa angiotensin I kukhala angiotensin II, yemwe ali ndi vasoconstrictor zotsatira ndikuwonjezera mamvekedwe a mtima, kuphatikiza chifukwa cha kukondoweza kwa kubisalira kwa aldosterone ndi adrenal cortex. Quinapril amapikisana maphikidwe ndipo amalowetsa kuchepa kwa ntchito ya vasopressor ndi secretion ya aldosterone.

Kuthetsa mavuto obwera chifukwa cha angiotensin II pa renin secretion ndi mayankho machitidwe kumabweretsa kuwonjezeka kwa plasma renin ntchito. Nthawi yomweyo, kuchepa kwa kuthamanga kwa magazi kumayendetsedwa ndi kuchepa kwa mtima komanso kukana kwamitsempha, pomwe kusintha kwa mtima, kutulutsa kwamkati, kutsika kwa magazi aimpso, kuchuluka kwa kusefera kwa gawo ndi gawo losefera ndilosafunikira kapena kulibe.

Hinapril imakulitsa kulolerana kwa masewera olimbitsa thupi.Kugwiritsa ntchito nthawi yayitali, kumapangitsa kuti chitukuko cha matenda obwera chifukwa cha matenda oopsa azikhala ndi magazi, kusintha magazi ndikupita ku ischemic myocardium. Imawonjezera kuyenda kwa magazi ndi impso. Imachepetsa kuphatikizika kwa mapulosi. Kukhazikika kwa chochita pambuyo pa kumwa kamodzi ndikutenga 1 ora, kuchuluka pambuyo pa maola 2-5, kutalika kwa zochita kumatengera kukula kwa mlingo womwe mwatenga (mpaka maola 24). Matenda omwe amadziwika kuti ali ndi matenda amakula pakapita milungu ingapo chichitikireni mankhwala.

Mimba komanso kuyamwa

Kugwiritsira ntchito kwa mankhwala Hinapril-SZ amatsutsana panthawi yomwe ali ndi pakati, mwa amayi omwe akukonzekera kutenga pakati, komanso azimayi azaka zakubala omwe sagwiritsa ntchito njira zodalirika zakulera.

Amayi azaka zakubala omwe akutenga Hinapril-SZ ayenera kugwiritsa ntchito njira zodalirika zakulera.

Pozindikira kuti muli ndi pakati, mankhwalawa Hinapril-SZ ayenera kusiyidwa posachedwa.

Kugwiritsa ntchito zoletsa za ACE pa nthawi ya pakati kumayendera limodzi ndi chiopsezo chowonjezereka cha zotupa mu mtima ndi machitidwe amanjenje a mwana wosabadwayo. Kuphatikiza apo, motsutsana ndi maziko otenga ma inhibitors a ACE pa nthawi ya pakati, milandu ya oligohydramnios, kubadwa msanga, kubadwa kwa ana omwe ali ndi vuto loti ubongo, aimpso, kuphatikizapo kulephera kwaimpso), cranial hypoplasia, contractures ya miyendo, kusokonekera kwa craniofacial, pulmonary hypoplasia. chitukuko, ductus arteriosus yotseguka, komanso kufa kwa fetal ndi imfa yatsopano. Nthawi zambiri, oligohydramnios amadziwika mwana wosabadwayo atawonongeka mosavomerezeka.

Makanda obadwa kumene omwe adakumana ndi zoletsa za ACE mu utero ayenera kuyang'aniridwa kuti azindikire ochepa omwe ali ndi hypotension, oliguria ndi hyperkalemia. Oliguria ikawoneka, kuthamanga kwa magazi ndi kunenepa kwa impso kuyenera kusamalidwa.

Mankhwala Hinapril-SZ sayenera kutumikiridwa poyamwitsa chifukwa chakuti ACE zoletsa, kuphatikiza hinapril, zimalowerera mkaka wa m'mawere. Popeza kuthekera kokhala ndi zovuta zowononga mwana wakhanda, mankhwalawa Hinapril-SZ ayenera kuthetsedwera pakukhanda kapena kusiya kuyamwitsa.

Kutulutsa Fomu

Mapiritsi okhala ndi mafilimu, 5 mg, 10 mg, 20 mg, 40 mg. 10 kapena 30 mapiritsi. pakukumata matuza. 30 mapiritsi mumtsuko wa polymer kapena mu botolo la polymer. Bokosi lililonse kapena botolo, 3, 6 matuza a mapiritsi 10. kapena 1, 2 matuza a mapiritsi 30. anayikidwa mu katoni.