Noliprel A: Malangizo ogwiritsira ntchito

Munkhaniyi, mutha kuwerengera malangizo ogwiritsira ntchito mankhwalawa Noliprel. Amapereka ndemanga kuchokera kwa alendo omwe amabwera patsamba lino - ogwiritsa ntchito mankhwalawa, komanso malingaliro a madokotala a akatswiri pakugwiritsa ntchito Noliprel pochita zawo. Chopempha chachikulu ndikuti muwonjezere ndemanga zanu za mankhwalawa: mankhwalawo adathandizira kapena sanathandizire kuchotsa matendawa, ndizovuta ziti zomwe zimawoneka ndi zotsatirapo zake, zomwe mwina sizinalengezedwe ndi wopanga. Ma Analogs a Noliprel pamapezeka ma analogues apangidwe. Gwiritsani ntchito pochizira matenda oopsa komanso kutsitsa magazi mu akulu, ana, komanso pa nthawi ya bere.

Noliprel - kaphatikizidwe kamene kamakhala ndi perindopril (ndi ACE inhibitor) ndi indapamide (thiazide-ngati diuretic). Mphamvu ya mankhwalawa yamankhwala imachitika chifukwa cha kuphatikiza kwa zinthu zomwe zimapanga chilichonse. Kugwiritsa ntchito pamodzi kwa perindopril ndi indapamide kumapereka mgwirizano wa antihypertensive kwambiri poyerekeza ndi gawo lililonse palokha.

Mankhwala ali ndi kutchulidwa amadalira antihypertensive kuchuluka kwa systolic ndi diastolic magazi mu supine ndi maimidwe. Zotsatira za mankhwalawa zimatha maola 24. Kupitiliza kwa kachipatala kumachitika pasanathe mwezi umodzi chichitikireni chithandizo ndipo simumayenderana ndi tachycardia. Kuchotsa chithandizo sikumayendetsedwa ndi chitukuko cha matenda obwera nawo.

Noliprel imachepetsa kuchuluka kwa michere yamanzere yamitsempha yamagazi, imayenda bwino kwambiri, imachepetsa OPSS, sichikhudza metabolidi ya lipid (kuchuluka kwa cholesterol, HDL-C, HDL-C, triglycerides).

Perindopril ndi choletsa wa enzyme yomwe imatembenuza angiotensin 1 kupita ku angiotensin 2. Angiotensin akatembenuza enzyme (ACE), kapena kinase, ndi exopeptidase yomwe imakwaniritsa kutembenuka kwa angiotensin 1 kupita ku angiotensin 2, yomwe ili ndi mphamvu ya vasoconstrictor, komanso kuwonongeka kwa magazi omwe alibe. . Zotsatira zake, perindopril imachepetsa kubisala kwa aldosterone, malinga ndi lingaliro la mayankho osalimbikitsa, imachulukitsa ntchito ya renin m'magazi am'magazi, kugwiritsa ntchito nthawi yayitali kumachepetsa OPSS, makamaka chifukwa cha kuthamanga kwa mitsempha yamagazi m'misempha ndi impso. Zotsatira izi siziphatikizidwa ndi kuchepa kwa mchere ndi madzi kapena kukhazikika kwa Reflex tachycardia ndikugwiritsa ntchito nthawi yayitali.

Perindopril ali ndi antihypertensive kwambiri odwala omwe ali ndi ntchito yotsika komanso yachilendo ya plasma.

Pogwiritsa ntchito perindopril, pali kuchepa kwamphamvu kwamwazi komanso ma diastoli mu supine ndi maimidwe. Kuthawa mankhwala sikuchulukitsa magazi.

Perindopril imakhala ndi vasodilating effect, imathandizira kubwezeretsa kukula kwa mitsempha yayikulu ndi kapangidwe ka khoma lamitsempha yama mitsempha yaying'ono, komanso kumachepetsa hypertrophy yamanzere yamanzere.

Perindopril imasinthasintha magwiridwe antchito a mtima, kuchepetsa kutsitsa ndi kutsitsa.

Kugwiritsa ntchito kwa thiazide diuretics kumawonjezera mphamvu ya antihypertensive. Kuphatikiza apo, kuphatikiza kwa ACE inhibitor ndi thiazide diuretic kumachepetsa chiopsezo cha hypokalemia ndi diuretics.

Odwala omwe ali ndi vuto la mtima, perindopril amachititsa kuchepa kwa kuthamanga kwa mpweya wamanzere kumanja ndi kumanzere, kuchepa kwa mtima, kuwonjezeka kwa mtima komanso kuwongolera kwa chidziwitso cha mtima, komanso kuchuluka kwa magazi am'magazi m'misempha.

Indapamide ndi mtundu wa sulfanilamide, womwe umafanana ndi mankhwala omwe amapezeka ndi thiazide diuretics. Iwo amalepheretsa reabsorption wa sodium ion mu gawo lozungulira la Henle loop, yomwe imatsogolera kuwonjezeka kwamikodzo ya sodium, chlorine ndipo, pocheperako, potaziyamu ndi magnesium ion, potero kuonjezera diuresis. Mphamvu ya antihypertensive imawonetsedwa mu Mlingo womwe sachititsa kuti pakhale diuretic.

Indapamide amachepetsa hyperreacaction mtima ponena za adrenaline.

Indapamide sichikhudza plasma lipids (triglycerides, cholesterol, LDL ndi HDL), kagayidwe kazakudwala (kuphatikiza odwala omwe ali ndi matenda a shuga a mellitus).

Indapamide imathandizira kuchepetsa kumanzere kwamitsempha yamagazi.

Kupanga

Perindopril arginine + Indapamide + Excipients.

Pharmacokinetics

Ma paracokinetic magawo a perindopril ndi indapamide osakanikirana sasintha poyerekeza ndi kugwiritsa ntchito kwawo mosiyana.

Pambuyo pakukonzekera pakamwa, perindopril imalowa mwachangu. Pafupifupi 20% ya kuchuluka konsekonse kwa perindopril kamasinthidwa kukhala metabolite yogwira ya perindoprilat. Mukamamwa mankhwala ndi chakudya, kusintha kwa perindopril mpaka perindoprilat kumachepa (izi zilibe phindu lililonse lazachipatala). Perindoprilat amamuchotsa mkodzo. T1 / 2 ya perindoprilat ndi maola 3-5. Kuchulukitsa kwa perindoprilat kumachepetsa m'magazi odwala okalamba, komanso kwa odwala omwe amalephera ndi impso.

Indapamide imagwira mwachangu komanso kwathunthu kuchokera kumimba. Mobwerezabwereza kayendetsedwe ka mankhwalawa sikupangitsa kuti pakhale thupi. Amapakidwa makamaka ndi mkodzo (70% ya mankhwala omwe amaperekedwa) komanso ndowe (22%) mwa ma metabolites osagwira.

Zizindikiro

• yofunika matenda oopsa.

Kutulutsa Mafomu

Mapiritsi 2.5 mg (Noliprel A).

Mapiritsi a 5 mg (Noliprel A Forte).

Mapiritsi 10 mg (Noliprel A Bi-Forte).

Malangizo ogwiritsira ntchito ndi mlingo

Gawani mkati, makamaka m'mawa, musanadye, piritsi limodzi 1 nthawi patsiku. Ngati pambuyo pa mwezi umodzi pambuyo pa chiyambi chamankhwala chithandizo chomwe chikufunikira sichinakwaniritsidwe, mlingowo ungakulidwe kukhala mlingo wa 5 mg (wopangidwa ndi kampani pansi pa dzina la Noliprel A forte).

Okalamba odwala ayenera kuyamba kulandira mankhwala piritsi limodzi 1 nthawi patsiku.

Noliprel sayenera kulembedwa kwa ana ndi achinyamata chifukwa cha kusowa kwa chidziwitso pakuchita bwino komanso chitetezo kwa odwala a m'badwo uno.

Zotsatira zoyipa

• kamwa yowuma
• nseru
• kuchepa kwamtima
• kupweteka kwam'mimba
• mavuto amakomedwe
• kudzimbidwa
• kutsokomola, kumangokhalapo kwa nthawi yayitali ndikumamwa mankhwala a gululi ndikusowa pambuyo pochoka,
• orthostatic hypotension,
• hemorrhagic zotupa,
• zotupa pakhungu,
• kuchuluka kwa zokhudza zonse lupus erythematosus,
• angioedema (edincke's edema),
• photosensitivity reaction
• paresthesia
• mutu
• asthenia
• kugona kusokonezedwa
• kuvuta kwamomwemo
• chizungulire
• minofu kukokana
• thrombocytopenia, leukopenia, agranulocytosis, aplastic anemia, hemolytic anemia,
• hypokalemia (makamaka kwa odwala omwe ali pachiwopsezo), hyponatremia, hypovolemia, zomwe zimatsogolera kuchepa kwa magazi ndi orthostatic hypotension, hypercalcemia.

Contraindication

• mbiri ya angioedema (kuphatikiza ndi zoletsa zina za ACE),
• cholowa / idiopathic angioedema,
• kulephera kwambiri kwa aimpso (CC

Zotsatira za pharmacological

NOLIPREL A ndi kuphatikiza kwa zinthu ziwiri zogwira ntchito, perindopril ndi indapamide. Ichi ndi mankhwala oopsa, amagwiritsidwa ntchito pochiza kuthamanga kwa magazi (matenda oopsa).

Perindopril ndi m'gulu la mankhwala otchedwa ACE inhibitors. Imagwira ndikuwonjezera mphamvu yamitsempha yamagazi, yomwe imathandizira jakisoni wamagazi. Indapamide ndi okodzetsa. Ma diuretics amawonjezera mkodzo womwe umapangidwa ndi impso. Komabe, indapamide ndi yosiyana ndi ma diuretics ena, chifukwa amangokulitsa pang'ono mkodzo womwe umapangidwa. Chilichonse mwazida zomwe zimagwira zimachepetsa kuthamanga kwa magazi ndipo mogwirizana zimayang'anira kuthamanga kwa magazi anu.

Contraindication

• Ngati m'mbuyomu, mukamamwa zoletsa zina za ACE kapena nthawi zina, inu kapena wachibale wanu mudawonetsa zizindikiro monga kugudubuza, kutupa kwa nkhope kapena lilime, kuyabwa kwambiri, kapena zotupa pakhungu (angiotherapy),

• ngati muli ndi matenda oopsa a chiwindi kapena hepatic encephalopathy (matenda oopsa aubongo),

• Ngati mwadwala matenda a impso kapena mukukayikira,

• ngati magazi anu ali ndi potaziyamu kwambiri kapena otsika kwambiri,

• Ngati mukukayikira kuti mtima wanu sunapezeke (kusungidwa kwamchere kwambiri, kupuma movutikira),

• ngati muli ndi pakati kapena mukufuna kubereka,

• ngati mukuyamwitsa.

Mimba komanso kuyamwa

Musatenge NOLIPRELA m'miyezi itatu yoyambirira ya mimba ndipo musatenge kuyambira pa 4 mwezi wapa (onani Contraindication). Ngati pakati mwakonzekera kapena kuti mimba yatsimikiziridwa, ndiye kuti muyenera kusinthira ku mtundu wina wamankhwala posachedwa.

Musatenge NOLIPREL A ngati muli ndi pakati.

Lankhulani ndi dokotala nthawi yomweyo.

Mlingo ndi makonzedwe

Ngati mwalandira NOLIPREL A koposa zomwe mwalimbikitsa:

Ngati mumwa mapiritsi ambiri, kulumikizana ndi chipinda chanu chodzidzimutsa kapena auzeni dokotala nthawi yomweyo. Zotsatira zoyipa kwambiri za bongo ndi kuchepa kwa kuthamanga kwa magazi. Ngati magazi anu atagwa (zizindikiro monga chizungulire kapena kukomoka), kugona pansi ndikukweza miyendo yanu, izi zimatha kuchepetsa vuto lanu.

Ngati mukuyiwala kutenga NOLIPRELA

Ndikofunika kumwa mankhwalawa tsiku lililonse, chifukwa kuwongolera pafupipafupi kumapangitsa kuti chithandizo chithandizire. Komabe, ngati mukuiwala kumwa mlingo wa NOLIPREL A, imwani mlingo wotsatira panthawi yokhayo. Musabwereze kawiri mlingo wotsatira.

Mukasiya kutenga NOLIPRELAA

Popeza mankhwala a antihypertensive nthawi zambiri amakhala ndi moyo, muyenera kufunsa dokotala musanayimitse mankhwalawo.

Ngati muli ndi mafunso ena okhudzana ndi kumwa mankhwalawa, funsani kwa dokotala kapena wamankhwala.

Zotsatira zoyipa

Izi zikuphatikiza:

• zofala (zosakwana 1 mwa 10, koma zopitilira 1 mu 100), matenda am'mimba (kupweteka m'mimba kapena m'mimba, kusowa kwa chilimbikitso, kusanza, kudzimbidwa, kusintha kwa pakamwa), pakamwa pouma, chifuwa chowuma.

• osadziwika (osakwana 1 mwa 100, koma oposa 1 mu 1000): kumva kutopa, chizungulire, kupweteka mutu, kusinthasintha kwa tulo, kukokana, kumva kugwedezeka, kusintha kwa mthupi monga zotupa pakhungu, zofiirira (mawanga ofiira pakhungu), hypotension (kuthamanga kwa magazi), orthostatic (chizungulire pakukula) kapena ayi. Ngati mukuvutika ndi systemic lupus erythematosus (mtundu wa matenda a collagen-vascular), ndiye kuti kuwonongeka ndikotheka.

• chosowa kwambiri (zosakwana 1 mwa 10,000): angioedema (Zizindikiro monga kupindika, kutupa kwa nkhope kapena lilime, kuyabwa kwambiri kapena zotupa pakhungu), chiwopsezo cha kusowa madzi m'thupi mwa okalamba ndi odwala omwe ali ndi vuto la mtima. Pankhani ya vuto la chiwindi (matenda a chiwindi), kumayambira kwa encephalopathy kwa chiwindi (matenda oopsa aubongo) ndikotheka. Kuphwanya magazi, impso, chiwindi, kapamba, kapena kusintha kwa magawo a ma labotale (kuyezetsa magazi) kumatha kuchitika. Dokotala wanu atha kukulemberani kuyezetsa magazi kuti mudziwe momwe muliri.

Lekani kumwa mankhwalawa mwachangu ndikumalumikizana ndi dotolo wanu ngati muli ndi vuto limodzi: nkhope, milomo, pakamwa, lilime kapena khosi kutupa, mukuvutika kupuma, mumamva chizungulire kapena mukumva kuzindikira, kugunda kwamtima kwachilendo kapena kosadziwika.

Zotsatira zoyipa zikakula kwambiri kapena ngati mukuwona zotsatira zosafunikira zomwe sizinalembedwe patsamba lino, auzeni dokotala kapena wamankhwala.

Kuchita ndi mankhwala ena

Pewani kugwiritsa ntchito NOLIPREL A ndi mankhwala otsatirawa:

• lithiamu (amagwiritsidwa ntchito pochiza matenda okhumudwa),

• potaziyamu wotseketsa okodzetsa (spironolactone, triamteren), mchere wam potaziyamu.

Mankhwalawa ndi NOLIPRELOM A atha kukhudzidwa ndikugwiritsa ntchito mankhwala ena.

Onetsetsani kuti mwadziwitsa dokotala ngati mukumwa mankhwalawa, chifukwa muyenera kusamala mukamamwa:

• mankhwala omwe amagwiritsidwa ntchito pochiza matenda oopsa,

• procainamide (pochotsa chizolowezi cha mtima wosakhazikika),

• allopurinol (mankhwalawa gout),

• terfenadine kapena astemizole (ma antihistamines ochizira matenda a hay fever kapena chifuwa),

• corticosteroids, omwe amagwiritsidwa ntchito pochiza machitidwe osiyanasiyana, kuphatikizapo mphumu yayikulu ndi nyamakazi,

• mankhwala a immunosuppressive omwe amagwiritsidwa ntchito pochiza matenda a autoimmune kapena atatha kumuwonjezera opaleshoni kuti asakanidwe (mwachitsanzo, cyclosporin),

• mankhwala opangidwa ndi mankhwala a khansa,

• erythromycin kudzera m'magazi (maantibayotiki),

• halofantrine (yomwe imagwiritsidwa ntchito pochiza mitundu ya malungo),

• pentamidine (amagwiritsidwa ntchito pochiza chibayo),

• vincamine (yogwiritsidwa ntchito ngati chithandizo cha matenda amiseche mu okalamba),

• bepridil (amagwiritsidwa ntchito pochiza angina pectoris),

• sultopride (antipsychotic mankhwala),

• mankhwala zotchulidwa mankhwalawa mtima kusokonezeka (mwachitsanzo, quinidine, hydroquinidine, disopyramide, amiodarone, sotalol),

• digoxin (zochizira matenda a mtima),

• baclofen (zochizira minofu yolimba, yomwe imapezeka m'matenda ena, mwachitsanzo, ndi sclerosis),

• mankhwala a shuga, monga insulin kapena metformin,

• zopatsa mphamvu zolimbikitsa (mwachitsanzo, senna),

• Mankhwala osapweteka a antiidal (mwachitsanzo, ibuprofen) kapena makulidwe apamwamba a salicylates (mwachitsanzo, aspirin),

• amphotericin B kudzera m'mitsempha (pochiza matenda oyamba ndi fungus),

• Mankhwala ochizira matenda amisala, monga kupsinjika, nkhawa, chida, ndi zina (mwachitsanzo, ma cyclic antidepressants atatu, antipsychotic),

• tetracosactide (pochiza matenda a Crohn).

Zolemba zogwiritsira ntchito

Kutenga NOLIPREL A ndi chakudya ndi zakumwa

Ndikofunika kumwa NOLIPREL A musanadye.

Kuyendetsa magalimoto ndi makina owongolera: NOLIPREL A sikukhudzika kwa kukhala maso, koma mwa ena mwa odwala, chifukwa cha kuthamanga kwa magazi, kusintha kosiyanasiyana kumawonekera, mwachitsanzo, chizungulire kapena kufooka. Zotsatira zake, kuthekera kuyendetsa galimoto kapena njira zina zitha kusokonezeka.

Zidziwitso zofunikira pazinthu zina za NOLIPREL A

NOLIPREL A ili ndi lactose, ngati dokotala atakuwuzani kuti mumalolera mitundu ina ya shuga, ndiye kufunsa dokotala musanayambe kumwa mankhwalawa.

Njira zopewera kupewa ngozi

• ngati mukuvutika ndi aortic stenosis (kuchepa kwa mtsempha wamagazi kwakukulu), mtima

• ngati mukudwala matenda ena a mtima kapena a impso,

• ngati muli ndi vuto la chiwindi,

• ngati muli ndi matenda a collagen mtima monga systemic lupus erythematosus kapena scleroderma,

• ngati mukuvutika ndi atherosermosis (kuumitsa khoma lamitsempha yama mitsempha),

• ngati mukuvutika ndi hyperparathyroidism (parathyroid gys dysfunction),

• mukadwala matenda am'mimba,

• ngati muli ndi matenda ashuga,

• Ngati mukumwa zakudya zopanda mchere wambiri kapena mukumwa mchere wina wokhala ndi potaziyamu,

• Ngati mukumwa mankhwala a lithiamu kapena potaziyamu (spironolactone, triamteren), popeza simuyenera kumwa nawo nthawi yomweyo ndi NOLIPREL A (onani. Kutenga mankhwala ena).

Mukamamwa NOLIPREL A, muyeneranso kudziwitsa omwe amakuthandizani pazaumoyo kapena ogwira ntchito zachipatala za awa:

• ngati muli ndi opaleshoni kapena opaleshoni yayikulu,

• Ngati mwayamba kudwala kapena kusanza,

• ngati mukukumana ndi matenda a LDL (kuchotsera kwa mafuta a cholesterol m'mwazi),

• ngati mukukakamira, zomwe zimachepetsa thupi kugwidwa ndi njuchi kapena mavu.

• ngati mukupita kokayezetsa kuchipatala, komwe kumafunika kuyambitsa chinthu chomwe chimakhala ndi ayodini (chinthu chomwe chimapangitsa kupenda ziwalo zamkati, monga impso kapena m'mimba, pogwiritsa ntchito ma x-ray).

Ochita masewera ayenera kudziwa kuti NOLIPREL A ili ndi chinthu chogwira ntchito (indapamide), chomwe chingapereke zotsatira zabwino pakuwongolera.

NOLIPREL A sayenera kupatsidwa kwa ana.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mankhwalawa amapangidwa ngati mapiritsi okhala ndi filimu: oblong, oyera, ali ndi chiopsezo mbali zonse ziwiri (14 kapena 30 aliyense m'botolo la polypropylene wokhala ndi chotulutsira madzi ndi choyimitsa chomwe chimakhala ndi chinyezi chonyamula chinyezi, m'bokosi la makatoni okhala ndi vuto loyamba lotsegulira 1 botolo limodzi 14 ma PC, 1 kapena 3 mabotolo a ma 30 ma PC., Ku zipatala - mu cholembera cha makatoni 30, mu bokosi la makatoni okhala ndi cholembera koyamba 1 pallet ndi malangizo ogwiritsira ntchito Noliprel A).

Piritsi limodzi lili:

• zigawo zikuluzikulu: perindopril arginine - 2,5 mg (lofanana ndi zomwe zikuchitika mu perindopril mu kuchuluka kwa 1.6975 mg), indapamide - 0,625 mg,
• zinthu zina: lactose monohydrate, anhydrous colloidal silicon dioxide, sodium carboxymethyl wowuma (mtundu A), maltodextrin, magnesium stearate,
• kujambula mafilimu: premix ya the kuyanika SEPIFILM 37781 RBC glycerol, macrogol 6000, hypromellose, titanium dioxide (E171), magnesium stearate, macrogol 6000.

Mankhwala

Noliprel A ndi kuphatikiza komwe magawo ake amagwira ntchito monga angiotensin kutembenuza enzyme (ACE) inhibitor ndi diuretic, yomwe ndi gawo la gulu la sulfonamide. Noliprel A ali ndi mphamvu ya zamankhwala chifukwa cha kuphatikiza kwa zamankhwala pazonse zomwe zimagwira, komanso zina zowonjezera.

Perindopril ndi ACE inhibitor (kinase II). Enzyme iyi imatanthauzira ma exopeptidases omwe amasintha angiotensin I kukhala chinthu cha vasoconstrictor, angiotensin II, komanso chiwonongeko cha bradykinin peptide yomwe imapangitsa mitsempha yamagazi kulowa heptapeptide.

Zotsatira za perindopril ndi:

• katemera wa aldosterone
• kuchuluka kwa plasma renin malinga ndi mayankho olakwika,
• kuchepa kwathunthu kwamitsempha yamagazi kukana (OPSS), ndi kugwiritsidwa ntchito kwa nthawi yayitali, komwe kumakhudzana ndi zomwe zimachitika m'mitsempha yamagazi m'misempha ndi impso.

Zotsatira izi sizimabweretsa mchere komanso kusungunuka kwa madzi kapena kukhazikika kwa Reflex tachycardia. Perindopril amawonetsa hypotensive zotsatira zonse zotsika komanso zabwinobwino zamadzi a plasma renin. Zimathandizanso kuti minofu yamtima ikhale yachilengedwe, imachepetsa pre-and afterload. Odwala omwe ali ndi vuto losatha la mtima (CHF), amathandizira kuchepa kwa OPSS, kuchepa kwa kudzaza kwa mpweya kumanzere kwamanja ndi kumanja kwamtima, kuwonjezeka kwa mtima, komanso kuchuluka kwamitsempha yamagazi.

Indapamide - wokodzetsa wa gulu la sulfonamides, ali ndi mankhwala ofanana ndi a thiazide diuretics. Chifukwa chopondereza kusinthanso kwa sodium ion mu gawo lachigawo cha Henle, chinthucho chimathandizira kukulitsa kuchuluka kwa chlorine, sodium, ndipo, pocheperako, maginitoamu ndi potaziyamu ions ndi impso, zomwe zimatsogolera kutulutsa mkodzo komanso kutsika kwa magazi (BP).

Noliprel A amadziwika ndi chiwonetsero chodalirika cha kuchuluka kwa mankhwala kwa maola 24 onse awiri pama diastoli ndi systolic magazi pamalo oimirira komanso pamalo apamwamba. Kutsika kwokhazikika kwa kuthamanga kwa magazi kumakwaniritsidwa osakwana mwezi umodzi chiyambireni chithandizo ndikutsatiridwa ndi mawonekedwe a tachycardia. Kukana kumwa mankhwalawa sikuti kumayambitsa matenda obwera nawo.

Noliprel A imapereka kuchepa kwa digiri ya michere yamanzere yamitsempha yamagazi (GTL), kusintha kwamphamvu kwamitsempha, kuchepa kwa OPSS, sikukukhudza lipid metabolism ya triglycerides, cholesterol yathunthu, kachulukidwe kachulukidwe ka lipoprotein (LDL) ndi mkulu (HDL) cholesterol.

Mphamvu ya kuphatikiza kwa perindopril ndi indapamide pa GTL idakhazikitsidwa poyerekeza ndi enalapril. Odwala GTL ndi ochepa matenda oopsa, kutenga 2 mg perindopril erbumin (ofanana ndi perindopril arginine pa mlingo wa 2.5 mg) / indapamide 0,625 mg kapena enalapril 10 mg 1 nthawi patsiku, ndi kuchuluka kwa perindopril erbumin mpaka 8 mg (ofanana ndi perindopril. arginine mpaka 10 mg) / indapamide mpaka 2.5 mg kapena enalapril mpaka 40 mg kamodzi patsiku; mgulu la perindopril / indapamide, kuchepa kodziwika kwambiri kwa gulu lamanzere lamatumbo am'mbuyo (LVMI) linajambulidwa poyerekeza ndi gulu la enalapril. Zofunikira kwambiri pa LVMI zimawonedwa pamankhwala othandizira ndi perindopril omwe ali ndi erbumin 8 mg / indapamide 2.5 mg.

Njira yodziwika bwino ya antihypertensive imawonekeranso pophatikizana ndi perindopril ndi indapamide poyerekeza ndi enalapril.

Odwala omwe ali ndi mtundu wa 2 matenda a shuga, zizindikiro zapakati: kuthamanga kwa magazi - 145/81 mm RT. Art., Body mass index (BMI) - 28 kg / m², glycosylated hemoglobin (HbA1c) - 7.5%, zaka - zaka 66 adawerengera zovuta pazovuta zazikulu za micro- ndi macrovascular nthawi ya mankhwala ndikusakaniza kwa perindopril / indapamide monga adjunct. kuthandizira muyezo wowongolera glycemic, komanso njira zokulitsa za glycemic (IHC) (chandamale HbA1c

Pharmacokinetics ndi pharmacodynamics

Ma pharmacokinetics a perindopril ndi indapamide akagwiritsidwa ntchito palimodzi ndi omwe amagwiritsidwa ntchito mosiyana. Pambuyo pakamwa, perindopril imayamba adsorbed mwachangu. Mlingo wa bioavailability ndi 65-70%. Pafupifupi 20% ya ma perindopril omwe amamwa nthawi zonse amasinthidwa kukhala perindoprilat (metabolite yogwira). Kuchuluka kwa ma perindoprilat mu plasma kumachitika pambuyo pa maola 3-4. Zochepera 30% zimamangidwa kumapuloteni amwazi, kutengera kuchuluka kwa plasma yamagazi. Hafu ya moyo ndi maola 25. Kupyola mu chotchinga chachikulu, zinthu zimalowa. Perindoprilat imachotsedwa m'thupi kudzera mu impso. Hafu ya moyo wake ndi maola 3-5. Pali pang'onopang'ono makonzedwe a perindoprilat mwa okalamba, komanso odwala omwe ali ndi mtima kulephera komanso aimpso.

Indapamide kwathunthu komanso mwachangu odzipereka kuchokera kugaya chakudya. Kuchuluka kwa ndende ya plasma kumachitika ola limodzi pambuyo pakamwa.

Ndi mapuloteni a plasma, mankhwalawa amamangika ku 79%. Kutha kwa theka-moyo ndi maola 19. Thupi limapukusidwa mu mawonekedwe a metabolites osagwira (pafupifupi 70%) ndi matumbo (pafupifupi 22%). Mwa anthu omwe ali ndi vuto la aimpso, kusintha kwamankhwala am'mimba sikuonekera.

Zisonyezero zogwiritsira ntchito Noliprel

Zisonyezero zogwiritsira ntchito mankhwalawa zimadziwika:

• zofunikiramatenda oopsa,
• kufunikira kochepetsera chiopsezo cha zovuta zam'matumbo mwa anthu omwe ali ndi impso, mtima, komanso matenda amtima omwe akuvutikaochepa matenda oopsakomanso matenda ashuga mtundu wachiwiri.

Zotsatira zoyipa

• Mu ntchito za mtima dongosolo: hypotension kwambiri, kugwa kwa mafupa, nthawi zina: arrhythmia, sitiroko, myocardial infaration.
• Pogwira ntchito ya genitourinary system: kuwonongeka kwaimpso, proteinuria mwa anthu omwe ali ndi glomerular nephropathy, nthawi zina, kulephera kwa impso. Potency ikhoza kuchepetsedwa.
• Mu ntchito za chapakati ndi zotumphukira NS: kutopa, chizungulire, mutu, asthenia, kusakhazikika kosakhazikika, kumva kwamkamwa, masomphenya, kuchepa kwamtima, kukokana, nthawi zina - stupor.
• Mu ntchito za kupuma dongosolo: chifuwa, kupuma movutikira, bronchospasm, kumaliseche kwammphuno.
• Pogwira ntchito yokumba m'mimba: Dyspeptic zviratidzo, kupweteka kwam'mimba, kapamba, cholestasis, kuchuluka kwa transaminases, hyperbilirubinemia.
• Pogwira ntchito yamagazi: motsutsana ndi maziko a hemodialysis kapena pambuyo kupatsirana kwa impso, odwala amatha kuperewera magazi, nthawi zina, thrombocytopenia, pancytopenia, agranulocytosis, hemolytic anemia.
• Mawonetseredwe amatsutsa: kuyabwa pakhungu, zidzolo, edema, urticaria.
• Odwala omwe ali ndi vuto la kusokonekera kwa hepatic amatha kukhala ndi chiwindi encephalopathy. Mwa anthu osokonezeka amagetsi-electrolyte bwino, hyponatremia, hypovolemia, hypokalemia, kuchepa magazi kumatha kuchitika.

Malangizo a Noliprel (njira ndi Mlingo)

Mapiritsi a Noliprel makamaka amatengedwa m'mawa. Mankhwalawa amatchulidwa piritsi limodzi patsiku. Malangizo a Noliprel Forte amapereka malangizo amomwemonso. Noliprel A ndi Noliprel A Bi Forte amapatsidwa odwala piritsi limodzi patsiku. Ngati Odwala creatinine chilolezo ali wofanana kapena wamkulu kuposa 30 ml / mphindi, ndiye kuti palibe chifukwa chochepetsera mlingo. Ngati chilolezocho chikufanana kapena kupitirira 60 ml patsiku, ndiye kuti nthawi ya chithandizo ndikofunikira kuyang'anitsitsa kuchuluka kwa potaziyamu ndi creatinine m'magazi.

Ngati ndi kotheka, pakatha miyezi ingapo ya chithandizo, adotolo amatha kuonjezera mlingo mwa kupereka Noliprel A Forte kapena mtundu wina wa mankhwalawo m'malo mwa Noliprel.

Bongo

Ndi mankhwala osokoneza bongo osokoneza bongo, kumachepa kwambiri kukakamiza, nseru, kusanza,chizungulire, kusakhazikika kwa mthupi, zizindikiro za kulephera kwa impso, kusalinganika kwa elekitirodi. Pankhaniyi, ndikofunikira kubwezeretsa nthawi yomweyo mphamvu zamagetsi zamagetsi kukhala zabwinobwino, kutsuka m'mimba, kutenga enterosorbents. Noliprel metabolites amatha kuchotsedwa pogwiritsa ntchito dialysis. Ngati ndi kotheka, mchere wamkati umaperekedwa.

Zosankha

Phwando Noliprela kuchepa mphamvu kwa thupi m'thupi kumafunikira, chifukwa chitukuko cha matenda oopsa chimatha.
Mankhwalawa amaperekedwa motsogozedwa ndi ma elekitirodi, elexandin, ndi kuthamanga kwa magazi.
Ndi concomitant kulephera kwa mtima kumatha kuphatikizidwa ndi beta-blockers.
Kutenga noliprel kumapereka lingaliro labwino mukamayeseza mayeso a labotale.
Chenjezo liyenera kuchitika mukamayendetsa kapena kugwiritsa ntchito njira zoyenera kwambiri, makamaka mu masabata oyambilira ovomerezeka.

Malangizo apadera

Anthu omwe adalembedwa chithandizo ndi Noliprel amafunikira kuchepa kwamphamvu kwa thupi kuti muchepetse kuthamanga kwakuthwa.

Anthu omwe ali ndi vuto la mtima amatha kuthandizidwa ndi beta-blockers nthawi yomweyo.

Pochiza ndi Noliprel, makonda amayesedwa pamayeso oyeserera.

M'milungu yoyamba ya chithandizo, ndikofunikira kuyendetsa bwino magalimoto kapena kugwira ntchito mosamala munthawi ya chithandizo ndi Noliprel.

Ngati kuchepa kwakukulu kwa nkhawa kumanenedwa pa chithandizo, kuyang'anira 0,9% sodium kolorayidi m`thupi kungafunike.

Chithandizo cha odwala omwe ali ndi vuto lozungulira muubongo kapena matenda a mtima muyenera kuyamba ndi waukulu Mlingo wa Noliprel.

Mwa anthu omwe ali ndi uric acid wambiri m'magazi, chiopsezo chokhala ndi chiwopsezo chambiri chotukula Noliprel ndi gout.

Analogs a Noliprel

Analogs of Noliprel, komanso mankhwala Noliprel A Be Forte, Noliprel A Forte ndi mankhwala ena omwe amagwiritsidwa ntchito pochepetsa kuthamanga kwa magazi ndipo ali ndi zinthu zofananira, ndiye kuti perindopril ndi indapamide. Mankhwalawa ndi mankhwala osokoneza bongo Co-prenesa, Prestarium etc. Mtengo wa analogues ukhoza kutsika kuposa mtengo wa Noliprel ndi mitundu yake.

Mankhwalawa sanalembedwe zochizira ana osaposa zaka 18, popeza palibe chidziwitso chokwanira pakuchitidwa ndi chitetezo chotere.

Pa mimba ndi mkaka wa m`mawere

Amayi oyembekezera ndi amayi nthawi kudyetsa ntchito Noliprel mkaka wa m'mawere ali contraindicated. Kukhazikitsidwa kwadongosolo kwa mankhwalawa kungayambitse kukulitsa zovuta ndi matenda mu fetus, komanso kungayambitse imfa ya fetal. Ngati mayi akudziwa za pakati pa nthawi yochizira, palibe chifukwa chosokoneza pakati, koma wodwalayo ayenera kudziwa zomwe zingachitike. Ngati pakuwonjezeka kuthamanga kwa magazi, njira ina yothandizira antihypertensive imayikidwa. Ngati mayi atenga mankhwalawa m'chiwonetsero chachiwiri ndi chachitatu, ma ultrasound a mwana wosabadwayo amayenera kuchitidwa kuti awone momwe khungu lake limagwirira ndi impso.

Ana akhanda omwe amayi awo adamwa mankhwalawa amatha kuvutika ndi kuwonetseredwa kwa hypotension, kotero ayenera kuwonetsetsa kuyang'anira nthawi zonse ndi akatswiri.

Pakupereka mkaka wa m'mawere, mankhwalawa amakwiriridwa chifukwa chake, mkaka wa mkaka wa mkaka uyenera kuyimitsidwa kapena mankhwala ena ayenera kusankha.

Ndemanga pa Noliprel

Ndemanga pa mabwalo okhudza Noliprel, komanso za mankhwala a Noliprel A, Noliprel A Fort, Noliprel A Bi Forte akuwonetsa kuti mankhwalawa amachepetsa kuthamanga kwa magazi. Mankhwalawa amakhala ndi magazi abwinobwino, kuchepetsa mwayi wokhala ndi stroko komanso myocardial infaration.

Ndemanga pa Noliprel Forte nthawi zambiri zimakhala ndi chidziwitso chakuti mankhwalawa komanso mitundu yake ina imapereka zotsatira zabwino pamene mankhwala ena sangathe. Nthawi zina odwala amawona kukula kwa zovuta zina, makamaka, chifuwa chowuma, kupweteka kwa mutu, koma sizolimba kwambiri.

Madokotala amazindikiranso zabwino za mankhwala, koma nthawi zonse dziwani kuti mankhwalawa amayenera kutengedwa mosamalitsa malinga ndi malangizo ndikupereka malingaliro a katswiri. Makamaka, mankhwalawa amayenera kumwedwa nthawi zonse, osati kokha pakulumpha kwambiri mu magazi.

Mtengo wa Noliprel, komwe mungagule

Mtengo wa Noliprel ndi avareji ma ruble 500 pachaka chilichonse cha ma PC 30. Mtengo ku Moscow wa Noliprel A ndi wochokera ku 500 mpaka 550 rubles. Mtengo wa Noliprel Forte umachokera ku ruble 550 phukusi lililonse. Noliprel A Forte 5 mg ingagulidwe pamtengo wa 650 rubles. Mtengo wa Noliprel A Bi Forte umachokera ku ma ruble 700. pa paketi 30 ma PC.