Lozap kapena Lorista

Ndi mankhwala ati ali bwino: Lozap kapena Lorista? Mankhwalawa onse ali ndi machitidwe osiyanasiyana, koma cholinga chawo chachikulu ndikuchepetsa kuthamanga kwa magazi. Kuti muzindikire kusiyanasiyana pakati pa mankhwalawo ndikuwona kuti ndi yani yothandiza kwambiri pochiza matenda oopsa, muyenera kuwerengera payokha malangizo a Lozapa ndi Lorista, komanso kuonana ndi katswiri kuti aliyense asankhe kuchuluka kwa mankhwalawo ndikukhazikitsa nthawi ya maphunzirowo.

ZOFUNIKA KUDZIWA! Tabakov O. "Nditha kupereka lingaliro limodzi chithandizo chanthawi yocheperako" werengani.

Kupanga ndi kuchitapo kanthu

Mankhwala "Lorista" ndi "Lozap" ali ndi losowa monga chinthu chogwira ntchito. Zothandiza "Lorista":

• kukhuthala
• chakudya chowonjezera E572,
• CHIKWANGWANI
• cellulose
• chakudya chowonjezera E551.

Zowonjezera zamankhwala "Lozap" ndizothandiza motere:

• hypopellose,
• sodium croscarmellose,
• MCC
• povidone
• chakudya chowonjezera E572,
• mannitol.

Kuchita kwa chida cha chipatala cha Lozap ndikufuna kuchepetsa kuthamanga kwa magazi, zotumphukira zambiri za mitsempha ya magazi, kuchepetsa katundu pamtima, ndikuchotsa madzi ndi mkodzo wambiri mthupi ndi mkodzo. Mankhwalawa amalepheretsa kukhala ndi hypertrophy ya myocardial komanso kumawonjezera kupirira kwa anthu omwe ali ndi vuto la mtima. Lorista imalepheretsa zolandirira za AT II mu impso, mtima, ndi mitsempha yamagazi, zomwe zimathandizira kuchepetsa kuchepa kwa ma arterial lumen, OPSS yotsika, ndipo, chifukwa chake, kutsika kwa magazi.

Zizindikiro ndi contraindication

Kukonzekera kochokera ku losartan kumalimbikitsidwa kuti mugwiritse ntchito pazotsatirazi:

Amalephera kugwiritsa ntchito mankhwala pokonzekera omwe amakhala ndi amayi omwe ali ndi ana oyamwitsa, ana osaposa zaka 18, komanso ndi njira zotsatirazi:

• kuthamanga kwa magazi
• kuchuluka kwa potaziyamu m'magazi,
• kusowa kwamadzi
• kusalolera pakumwa mankhwala,
• lactose tsankho.

Zofananira zina

Ngati pazifukwa zina sizingatheke kugwiritsa ntchito "Lozap" ndi "Lorista", madokotala amapereka mayendedwe awo:

• Brozaar
• Karzartan
• Nyanja
• Blocktran
• "Lozarel"
• Presartan
• Zisakar
• Losacor
• Ma Vazotens
• "Renicard"
• Cozaar
• "Lotor".

Mankhwala aliwonse, omwe ndi analogue a Lorista ndi Lozapa, ali ndi malangizo ake ogwiritsira ntchito, zomwe zikutanthauza kuti ayenera kumwedwa pokhapokha atakambirana ndi dokotala wazopanga yemwe amapereka chithandizo chamankhwala payekhapayekha kwa wodwala aliyense. Ndi mankhwala omwe mumadzipatsa nokha, chiopsezo chokhala ndi mavuto amtsogolo chimakulanso.

Makhalidwe wamba

Mankhwalawa onse ndi okhazikika pa losartan, zomwe zimayambitsa kusankha kwakukulu - mphamvu yakuwona pamitundu yolandirana bwino, osakhudza zochitika zina za thupi, zomwe zimapangitsa magawo otetezedwa. Amapezeka m'mapiritsi, omwe amakulitsa njira yabwino yolandirira. Zogwira ntchito sizimakhudza kagayidwe kazakudya zam'mimba ndi lipids, zomwe zimapangitsa kugwiritsa ntchito mankhwala osokoneza bongo ngakhale ndi matenda a shuga. Mankhwalawa onse sagwiritsidwa ntchito ngati ana.

Kodi pali kusiyana kotani?

Lozap monga gawo lina la zinthu zina mulibe mafuta a lactose, zomwe zimapangitsa kuti ntchito yake igwiritsike ntchito makamaka chifukwa cha tsankho.

Lorista imapezeka mu mawonekedwe a mapiritsi, koma ndi mitundu yosiyanasiyana (yokhala ndi zinthu zosiyanasiyana), yomwe imakupatsani mwayi wosankha Mlingo wa matenda kapena matenda.

Ngati wodwalayo ali ndi tsankho lactose, ndiye kuti Lozap adayikidwa. Nthawi zina, adokotala amatha kukupatsani mankhwala ena kapena ena, popeza amafanana mu kapangidwe kake ndi zotsutsana. Amawerengera kuthamanga kwa magazi, monga kupewa kuwonekera kwa ma pathologies a mtima, komanso mitsempha yamagazi, mu mawonekedwe osokonezeka a minofu ya mtima, komanso ngati kuwonongeka kwa mitsempha ya impso (mu shuga).

Nthawi zambiri, odwala amawonetsa kuti a Loriste amawakonda chifukwa cha mitundu yosiyanasiyana ya mankhwala omwe amapezeka m'mapiritsi, zomwe zimapangitsa kumwa mankhwalawo kukhala kosavuta. Koma muyenera kudziwa kuti mankhwalawa ali ndi mitengo yapamwamba kwambiri. Amalandira kwa ochepa matenda oopsa, monga gawo la kupewa kwa matenda a sitiroko, ngati mtima sulephera.

Makhalidwe a Lozap

Mankhwala ali ndi izi:

1. Kupanga ndi mawonekedwe a kumasulidwa. Lozap imapangidwa ngati mawonekedwe a mapiritsi okhala ndi mawonekedwe osungunuka amtundu woyera kapena wachikasu ndi mawonekedwe ozungulira. Kuphatikizika kwa mankhwalawa kumaphatikizapo 12.5 kapena 50 mg wa potaziyamu losartan, selstalline cellulose, mannitol, silicon dioxide, magnesium stearate, hypromellose, macrogol. Mapiritsi ali ndi matuza a ma PC 10. Bokosi la makatoni lili ndi maselo 3, 6 kapena 9.
2. Zotsatira za pharmacological. Mankhwala amachepetsa mphamvu ya ziwopsezo za angiotensin popanda kuletsa ntchito ya kininase. Potengera maziko otenga Lozap, kukana kwa zotumphukira, kuchuluka kwa adrenaline m'magazi ndi kuthamanga kwa magazi m'mitsempha yamagazi kumatsika. Potaziyamu losartan ali ofatsa okodzetsa kwenikweni. Phindu la mankhwala pa mtima ndi kuwonekera popewa kukanika kwa mtima komanso kusinthika kwa moyo wa odwala omwe ali ndi matenda a mtima.
3. Pharmacokinetics Zinthu zomwe zimagwira mwachangu zimalowa m'magazi, zikangodutsa m'chiwindi, zimasinthidwa kukhala metabolite yogwira. Kuchuluka kwa losartan ndi michere yake mu plasma imatsimikizika mphindi 60 pambuyo pa makonzedwe. 99% ya chinthu chogwira chimamangiriza mapuloteni amwazi. Thupi silidutsa chotchinga-ubongo. Losartan ndi metabolites ake amuchotsa mkodzo.
4. Kukula kwa ntchito. Mankhwalawa amagwiritsidwa ntchito ngati gawo limodzi la zovuta zochizira matenda oopsa komanso kulephera kwa mtima. Mankhwala amathandiza kuchepetsa mwayi wokhala ndi mavuto oopsa a matenda oopsa komanso kukulitsa kwa kathandizira kwamanzere. Ndizotheka kugwiritsa ntchito Lozap pa matenda ashuga nephropathy, limodzi ndi kuwonjezeka kwa kuchuluka kwa proteinin mu protein.
5. Contraindication Mankhwalawa sagwiritsidwa ntchito pa mimba, mkaka wa m'mawere ndi kusalolera kwa munthu pazigawo zake. Kuchita bwino ndi chitetezo cha mankhwala a antihypertensive kwa ana sichinakhazikitsidwe. Mochenjera, Lozap amagwiritsidwa ntchito pozungulira magazi, kuchepa kwa magazi, magazi amachepetsa mchere wamitsempha, komanso kufinya kwamitsempha yamafupa, komanso kuwonongeka kwa chiwindi.
6. Njira yogwiritsira ntchito. Mapiritsi amagwiritsidwa ntchito mosasamala zakudya 1 kamodzi patsiku. Mlingo umakhazikitsidwa ndi mtundu ndi mtundu wa matendawa. Mlingo wa tsiku ndi tsiku umachepetsedwa ndikugwiritsa ntchito Lozap molumikizana ndi okodzetsa komanso mankhwala ena a antihypertensive. Kuchiza kumatenga mpaka magazi atachepa.
7. Zotsatira zosasangalatsa. Kukula kwa zoyipa zimatengera mlingo womwe umaperekedwa. Matenda ofala kwambiri a m'mitsempha (asthenic syndrome, kufooka wamba, mutu), matenda am'mimba (m'mimba, nseru ndi kusanza) komanso chifuwa chowuma. Thupi lawo siligwirizana mu urticaria, kuyabwa kwa khungu ndi rhinitis ndizochepa.

Makhalidwe a Lorista

Lorista ali ndi izi:

1. Kutulutsa Fomu. Mankhwalawa ali ngati mapiritsi, ophatikizidwa ndi utoto wachikasu.
2. Kupanga. Piritsi lililonse limakhala ndi 12,5 mg wa potaziyamu losartan, cellulose ufa, mkaka wa shuga wa monohydrate, wowuma wa mbatata, deicated diiconic dioxide, calcium stearate.
3. Zotsatira za pharmacological. Lorista ndi wa antihypertensive mankhwala a gulu la nonpeptide angiotensin receptor blockers. Mankhwala amachepetsa kuwopsa kwa mtundu wa angiotensin 2 pamitsempha yamagazi. Mukumwa mankhwalawa, pali kuchepa kwa kaphatikizidwe ka aldosterone komanso kusintha kwa kukana kwa arterial. Izi zimalola Lorista kugwiritsidwa ntchito kuteteza kukula kwa sitiroko ndi kugunda kwa mtima komwe kumayenderana ndi kusokonekera kwa minofu ya mtima. Mankhwalawa amatha nthawi yayitali.
4. Zogulitsa ndi kugawa. Mukamamwa pakamwa, zinthu zomwe zimayamba kugwira ntchito zimalowa mwachangu m'magazi. Thupi limafulumira pafupifupi 30% ya mankhwala omwe amaperekedwa. Mu chiwindi, losartan amasinthidwa kukhala yogwira carboxy metabolite. The achire ndende ya yogwira mankhwala ndi kagayidwe kachakudya mu magazi wapezeka pambuyo 3 maola. Kutha kwa theka la moyo kumapangitsa maola a 6-9. Ma metabolabol a losartan amuchotsa mkodzo ndi ndowe.
5. Zizindikiro zogwiritsidwa ntchito. Mankhwala amagwiritsidwa ntchito kuchepetsa ngozi za odwala omwe ali ndi matenda oopsa komanso matenda amtima. Lorista angagwiritsidwe ntchito ndi odwala omwe ali ndi matenda osokoneza bongo omwe ali ndi proteinuria yayikulu.
6. Zoletsa ntchito. Antihypertgency wothandizila sangathe kugwiritsidwa ntchito panthawi yoyembekezera komanso mkaka wa m`mawere, matupi awo sagwirizana ndi losartan ndi ubwana (mpaka zaka 18).
7. Njira yogwiritsira ntchito. Mlingo wovomerezeka tsiku lililonse ndi 50 mg. Mankhwala amatengedwa kamodzi m'mawa. Pambuyo poteteza matenda a kuthamanga kwa magazi, mlingo umachepetsedwa ndikukonzanso mlingo wa 25 mg patsiku.
8. Zotsatira zoyipa. Mlingo wapakatikati ndi wapamwamba wa losartan ungayambitse kuchepa kwambiri kwa magazi, limodzi ndi chizungulire, kufooka kwa minofu ndi kufinya. Zotsatira zoyipa za mankhwalawa m'matumbo a thupi zimawonetsedwa ndi matenda am'mimba, nseru ndi kusanza, kupweteka m'mimba, ntchito yowonjezera ya michere ya chiwindi. Nthawi zina, thupi limagwidwa mu mawonekedwe a kutupa kwa nkhope ndi larynx.

Kuyerekezera Mankhwala

Poyerekeza mawonekedwe a mankhwala a antihypertensive, zonse zomwe zimadziwika komanso ndizosiyana zimawululidwa.

Zofanana ndi mankhwalawa zili m'makhalidwe awa:

• onse a Lozap ndi a Lorista ali m'gulu la angiotensin receptor blockers,
• Mankhwala ali ndi mndandanda womwewo wa zomwe zingagwiritse ntchito,
• Mankhwala onse awiriwa ndi otsekemera pa losartan,
• ndalama zimapezeka piritsi.

Lingaliro la akatswiri a mtima

Svetlana, wazaka 45, Yekaterinburg, dokotala wamtima: "Lozap ndi analogue Lorista adakhazikitsidwa bwino muzochita zamtima. Amagwiritsidwa ntchito pochiza matenda oopsa. Kutenga mankhwala kumathandizira kuthana ndi kuthamanga kwa magazi. Mapiritsi ndiwofunikira kugwiritsa ntchito, ndizokwanira kuchotsa zizindikiro za matenda oopsa. 1 nthawi patsiku. Zotsatira zake ndizosowa kwambiri. "

Elena, wazaka 34, Novosibirsk, dokotala wamtima: "Lorista ndi Lozap ndi othandizira odwala matenda othamanga. Amachepetsa magazi mosavuta popanda kutsogoleredwa kwa kugwa kwa orthostatic. Mosiyana ndi njira zotsika mtengo zochizira matenda oopsa, mapiritsiwa samayambitsa chifuwa chowuma. amathandizira kuchotsa madzi ochulukirapo popanda kusokoneza mchere wamchere.

Ndemanga za Odwala za Lozap ndi Lorista

Eugenia, wazaka 38, Barnaul: "Poyerekeza ndi kupsinjika, kuthamanga kwa magazi kunayamba kuchuluka. Wodziwitsayo adalemba Lozap. Ndimamwa mapiritsi m'mawa, omwe amalepheretsa kuwoneka kwa mutu komanso zina zosasangalatsa za matenda oopsa. Mankhwalawa alinso ndi chiwopsezo chotsika mtengo - Lorista. Ndidayesa mapiritsi awa koma adawoneka kuti sagwira ntchito bwino. "

Katundu wa Lozap

Kutulutsa mawonekedwe - mapiritsi. Mankhwalawa atha kugulidwa m'mafakisoni a 30, 60 ndi 90 zidutswa pa paketi iliyonse. Chofunikira chachikulu mwa iwo ndi losartan. Piritsi limodzi limatha kukhala ndi 12,5, 50 ndi 100 mg. Kuphatikiza apo, pali zida zothandizira.

Zokonzekera Lozap ndi Lorista ndizofananira ndipo ndi gulu limodzi lachipatala - angiotensin 2 receptor antagonists.

Zotsatira za mankhwala Lozap cholinga chake kutsitsa magazi. Kuphatikiza apo, mankhwalawa amachepetsa kukana konsekonse. Chifukwa cha chida, katundu pa minofu ya mtima amathanso kuchepa. Madzi ndi mchere wambiri umachotsedwa m'thupi limodzi ndi mkodzo.

Lozap imalepheretsa kusokonezeka mu ntchito ya myocardium, hypertrophy yake, imawonjezera kupirira kwa mtima ndi mitsempha yamagazi kugwira ntchito zolimbitsa thupi, makamaka kwa anthu omwe ali ndi matenda opatsirana a matenda amtunduwu.

Hafu ya moyo wa chigawocho chikugwira ntchito kuyambira 6 mpaka 9 maola. Pafupifupi 60% ya metabolite yogwira imatulutsidwa limodzi ndi bile, enawo ndi mkodzo.

Zizindikiro zogwiritsa ntchito Lozap ndi izi:

• ochepa matenda oopsa
• kulephera kwa mtima
• zovuta za mtundu 2 shuga mellitus (nephropathy chifukwa cha hypercreatininemia ndi proteinuria).

Kuphatikiza apo, mankhwalawa adapangidwira kuti athe kuchepetsa mwayi wopezeka ndi matenda amtima (kuphatikizapo matenda a stroke), komanso kuchepetsa kuchuluka kwa anthu omwe ali ndi kuthamanga kwa magazi komanso matenda oopsa a mtima.

Lozap imalepheretsa kusokonezeka mu ntchito ya myocardium, hypertrophy yake, imawonjezera kupirira kwa mtima.
Kwa ana ochepera zaka 18, mankhwalawa amakhalanso osayenera.
Mimba ndi mkaka wa m`mawere ndi contraindication ntchito Lozap.
Zotsatira za mankhwala Lozap cholinga chake kutsitsa magazi.
Fomu yotulutsidwa ya Lozap ndi miyala.

Zoyeserera pakugwiritsa ntchito Lozap ndi:

• Mimba ndi kuyamwa
• Hypersensitivity mankhwala ndi zida zake.

Ana ochepera zaka 18 nawonso sioyenera.

Chenjezo muyenera kutenga mankhwala oterewa kwa anthu omwe ali ndi vuto lamchere lamchere, kuthamanga kwa magazi, mtima wa stenosis mu impso, chiwindi kapena kulephera kwa impso.

Kodi a Lorista amagwira ntchito bwanji?

Kutulutsidwa kwa mankhwala a Lorista ndi magome. Phukusi limodzi lili ndi zidutswa 14, 30, 60 kapena 90. Chofunikira chachikulu ndi losartan. Piritsi limodzi lili 12,5, 25, 50, 100 ndi 150 mg.

Zochita za Lorista cholinga chake ndikulepheretsa ma 2 receptors a mtima, mtima komanso impso. Chifukwa cha izi, lumen ya mitsempha, kukana kwawo kumachepa, chizindikiro cha magazi amachepa.

Zizindikiro zogwiritsidwa ntchito ndi motere:

• matenda oopsa
• Kuchepetsa chiopsezo cha sitiroko ndi matenda oopsa ndipo
• kulephera kwa mtima
• kupewa mavuto okhudza impso mu mtundu 2 shuga ndi zina proteinuria.

Lorista adalembedwa kuti apewe zovuta zomwe zimakhudza impso za 2 mtundu wa mellitus ndi proteinuria ina.
Kuchita kwa Lorista cholinga chake ndikuchepetsa kuthamanga kwa magazi.
Mankhwala amathandizidwa kuti achepetse chiopsezo cha stroke ndi matenda oopsa komanso kufooka kwa mtima.Kutulutsidwa kwa mankhwala a Lorista ndi magome.

Contraindations akuphatikiza:

• kuthamanga kwa magazi
• kusowa kwamadzi
• kusowa kwamchere wamchere,
• lactose tsankho,
• kuphwanya njira ya mayamwidwe a shuga,
• mimba ndi mkaka wa m`mawere.
• Hypersensitivity mankhwala kapena zida zake.

Kwa ana ochepera zaka 18, mankhwalawa samalimbikitsidwanso. Chenjezo liyenera kuperekedwa kwa anthu omwe ali ndi impso komanso kwa chiwindi, stenosis yamitsempha yama impso.

Kuyerekeza kwa Lozap ndi Lorista

Kuti mudziwe mankhwala ati - Lozap kapena Lorista - oyenera kwambiri kwa wodwalayo, ndikofunikira kudziwa kufanana kwawo komanso momwe mankhwalawa amasiyana.

Lozap ndi Lorista ali ndi zofanana zambiri, monga Izi ndi fanizo:

• Mankhwala onsewa ndi a gulu la angiotensin 2 receptor antagonists,
• khalani ndi zofananira zomwe mungagwiritse ntchito,
• muli ndi zomwe zimapangidwa - losartan,
• njira zonse ziwiri zimapezeka piritsi.

Zomwe mulingo watsiku ndi tsiku, ndiye kuti 50 mg patsiku ndikokwanira. Lamuloli ndi chimodzimodzi kwa Lozap ndi Lorista, monga Kukonzekera kumakhala ndi ofanana. Mankhwala onsewa angagulidwe m'mafakisoni pokhapokha ngati mwalandira kuchokera kwa dokotala.

Lozap ndi Lorista zimatha kubweretsa zovuta kugona.
Mutu, chizungulire - nawonso ndi mavuto osokoneza bongo.
Mukamatenga Lorista ndi Lozap, arrhythmia ndi tachycardia zimatha kuchitika.
Kupweteka kwam'mimba, nseru, gastritis, kutsekula m'mimba ndi mavuto obwera chifukwa cha mankhwalawa.

Mankhwala amaloleredwa bwino, koma nthawi zina zizindikiro zosafunikira zimawonekera. Zotsatira zoyipa za Lozap ndi Lorista ndizofanana:

• kuvutika kugona
• mutu, chizungulire,
• kutopa kosalekeza
• arrhythmia and tachycardia,
• kupweteka kwam'mimba, nseru, matenda am'mimba, kutsegula m'mimba,
• kupindika, kutupa kwa zigamba za mucous,
• chifuwa, bronchitis, pharyngitis.

Kuphatikiza apo, ziyenera kukumbukiridwa kuti kukonzekera kosakanikirana kumapezekanso - Lorista N ndi Lozap Plus. Mankhwala onse awiriwa samangokhala ndi losartan ngati othandizira, komanso phula lina - hydrochlorothiazide. Kupezeka kwa chinthu chothandizira pokonzekera kumawonetsedwa mu dzinalo. Kwa Lorista, awa ndi N, ND kapena H100, ndipo kwa Lozap, mawu akuti "kuphatikiza".

Lozap Plus ndi Lorista N ndizofananira. Mankhwala onsewa ali ndi 50 mg ya losartan ndi 12.5 mg ya hydrochlorothiazide.

Kukonzekera kwa mitundu yosakanikirana kumapangidwira kuti azitsogolera nthawi yomweyo njira ziwiri zomwe zimakhudza kuthamanga kwa magazi. Losartan lowers vascular tone, ndi hydrochlorothiazide adapangidwa kuti achotse madzi owonjezera mthupi.

Gwiritsani ntchito mankhwalawa matenda oopsa ndi mankhwala LozapLorista - mankhwala kuchepetsa magazi Lozap ndi malangizo

Kodi pali kusiyana kotani?

Kusiyana pakati pa Lozap ndi Lorista ndizochepa:

• Mlingo (Lozap ali ndi zosankha zitatu zokha, ndipo Lorista ali ndi zosankha zambiri - 5),
• opanga (Lorista amapangidwa ndi kampani yaku Slovenia, ngakhale kuli nthambi ya Russia - KRKA-RUS, ndipo Lozap imapangidwa ndi bungwe la Slovak Zentiva).

Ngakhale akugwiritsa ntchito chinthu chimodzi chomwe chimagwira, mndandanda wazopeza ulinso wosiyana. Zigawo zotsatirazi zimagwiritsidwa ntchito:

1. Cellactose Zingokhalani ku Lorist. Pulogalamuyi imapezeka pamaziko a lactose monohydrate ndi mapadi. Koma yotsirizira imapezekanso ku Lozap.
2. Wokoma. Pali mu Lorist kokha. Komanso, pali mitundu iwiri ya mankhwala omwewo - gelatinized ndi wowuma chimanga.
3. Crospovidone ndi mannitol. Muli ku Lozap, koma mulibe ku Lorist.

Zotsatira zina zonse za Lorista ndi Lozap ndizofanana.

Zomwe zili bwino kuposa Lozap kapena Lorista

Mankhwala onse awiriwa amagwira ntchito pagulu lawo. Thupi la losartan lili ndi izi:

1. Kusankha. Mankhwalawa cholinga chake ndi kumangomanga ndi ma receptors ofunikira. Chifukwa cha izi, sizikhudza machitidwe ena a thupi. Chifukwa cha izi, mankhwalawa onse amawoneka otetezeka kuposa mankhwala ena.
2. Mkulu ntchito pamene mukumwa mankhwala pakamwa.
3. Zilibe mphamvu pa kagayidwe kachakudya ka mafuta ndi chakudya, motero mankhwalawa onse amaloledwa mu shuga.

Losartan amadziwika kuti ndi chimodzi mwazinthu zoyambirira kuchokera ku gulu la blockers, lomwe lidavomerezedwa pochiza matenda oopsa mu 90s. Mpaka pano, mankhwala omwe amakhazikitsidwa amagwiritsidwa ntchito kuthamanga kwa magazi.

Onse a Lorista ndi Lozap ndi mankhwala othandiza chifukwa cha kupsinjika kwa losartan mu ndende yomweyo. Koma posankha mankhwala, contraindication imathandizidwanso.

Lorista amawonedwa ngati owopsa pang'ono kwa anthu kuposa Lozap. Izi ndichifukwa choti zotsatira zoyipa zimatha kuchitika. Kuphatikiza apo, mankhwalawa amaletsedwa kwa anthu omwe ali ndi vuto lactose komanso sayanjana ndi wowuma. Koma nthawi yomweyo, mankhwalawa ndi otsika mtengo.

Lorista amawonedwa ngati owopsa pang'ono kwa anthu kuposa Lozap.

Ndemanga za akatswiri a mtima za Lozap kapena Lorista

Danilov SG: "Pazaka zonse zomwe akuchita, mankhwalawa a Lorista adziwonetsa okha. Ndiwotsika mtengo koma koma othandiza. Amathandiza kupirira matenda oopsa. Mankhwalawa ndi osavuta kutenga, pamakhala zotsatira zoyipa zochepa, ndipo sizimachitika kawirikawiri."

Zhikhareva EL: "Lozap ndi mankhwala ochizira matenda oopsa. Amakhala ofatsa, motero kukakamiza sikucheperachepera. Pali zotsatira zoyipa zochepa."

Zotsatira za pharmacological

Mankhwala a antihypertensive. Enieniotensin II wolandila wapadera (subtype AT1). Sizimaletsa kininase II, puloteni yomwe imathandizira kusintha kwa angiotensin I kukhala angiotensin II. Imachepetsa OPSS, kuchuluka kwa magazi a adrenaline ndi aldosterone, kuthamanga kwa magazi, kuthamanga kwa kufalikira kwa m'mapapo, kumachepetsa pambuyo pake, kumakhudzanso diuretic. Zimasokoneza kukula kwa hypertrophy ya myocardial, kumawonjezera kulolera kwa odwala omwe ali ndi vuto la mtima. Losartan sikuletsa ACE kininase II ndipo, motero, sikulepheretsa kuwonongeka kwa bradykinin, chifukwa chake, zotsatira zoyipa zomwe zimagwirizanitsidwa ndi bradykinin (mwachitsanzo, angioedema) ndizosowa kwenikweni.

Odwala omwe ali ndi matenda oopsa osaneneka a shuga ogwirizana ndi proteinuria (oposa 2 g / tsiku), kugwiritsa ntchito mankhwalawa kumachepetsa proteinuria, kuchuluka kwa albumin ndi immunoglobulins G.

Imakhazikika pamlingo wa urea m'madzi am'magazi. Sichikukhudzana ndi mawonekedwe akumasamba ndipo siyikhala ndi mphamvu yayitali pakulimbikitsidwa kwa norepinephrine mu plasma yamagazi. Losartan pa mlingo wofika mpaka 150 mg pa tsiku sizikhudza kuchuluka kwa triglycerides, cholesterol yathunthu ndi cholesterol ya HDL mu seramu yamagazi mwa odwala omwe ali ndi matenda oopsa. Pa mlingo womwewo, losartan sichikhudzana ndi kusala kwamwazi wamagazi.

Pambuyo pakamwa kamodzi, mphamvu ya hypotensive (systolic ndi diastolic magazi imatsika) imafika pazowonjezera pambuyo pa maola 6, kenako amayamba kuchepa mkati mwa maola 24.

Kuzindikira kwakukulu kumayamba masabata 3-6 pambuyo pa kuyamba kwa mankhwalawa.

Pharmacokinetics

Ikamamwa, losartan imatengedwa bwino, ndipo imagwira metabolism panthawi "yoyamba" kudzera m'chiwindi ndi carboxylation ndi gawo la cytochrome CYP2C9 isoenzyme ndikupanga metabolite yogwira. Systemic bioavailability wa losartan pafupifupi 33%. Cmax ya losartan ndi yogwira metabolite imatheka mu seramu ya magazi pambuyo pafupifupi ola limodzi ndi maola 3-4 atatha kudya, motero. Kudya sikumakhudza bioavailability wa losartan.

Zoposa 99% za losartan ndipo metabolite yake yogwira imamangiriza mapuloteni a plasma, makamaka okhala ndi albumin. Vd losartan - 34 l. Losartan mothandizidwa samalowa mu BBB.

Pafupifupi 14% ya osapsa omwe amapatsidwa mankhwala mkati kapena pakamwa amasinthidwa kukhala metabolite yogwira.

Chilolezo cha plasma cha losartan ndi 600 ml / min, ndipo metabolite yogwira ndi 50 ml / min. Kuvomerezeka kwa impso kwa losartan ndi metabolite yake yogwira ndi 74 ml / min ndi 26 ml / min, motsatana. Pakumeza, pafupifupi 4% ya mlingo womwe umatengedwa umalowetsedwa ndi impso osasinthika ndipo pafupifupi 6% imachotsedwa impso ndi mawonekedwe a metabolite yogwira. Losartan ndi metabolite yake yogwira imadziwika ndi ma linear pharmacokinetics atamwa pakamwa mpaka 200 mg.

Pambuyo pakamwa, plasma woipa wa losartan ndi yogwira metabolite amachepetsa motsimikiza ndi womaliza T1 / 2 wa losartan pafupifupi 2 maola, ndipo yogwira metabolite pafupifupi maola 6-9. Mukamamwa mankhwalawa mlingo wa 100 mg /, osatinso kapena metabolite wogwira amadzaza kwambiri magazi a m'magazi. Losartan ndi metabolites ake amuchotsa m'matumbo ndi impso. Ogwira ntchito zathanzi, atamwetsa 14C yokhala ndi isotope yolembedwa kuti losartan, pafupifupi 35% ya mapepala okhala ndi radio radio amapezeka mu mkodzo ndi 58% mu ndowe.

Pharmacokinetics mu milandu yapadera yamankhwala

Odwala omwe ali ndi vuto loledzeretsa makamaka matenda osokoneza bongo omwe anali oledzera anali maulendo 5, ndipo metabolite yogwira inali yokwanira nthawi 1,7 kuposa antchito odzipereka aamuna athanzi.

Ndi creatinine chilolezo choposa 10 ml / min, kuchuluka kwa losartan m'madzi a m'magazi sikusiyana ndi zomwe zimachitika mwachilengedwe. Odwala omwe amafunikira hemodialysis, AUC ndi yokwanira 2 times kuposa odwala omwe ali ndi vuto laimpso.

Palibe wolartan kapena metabolite wake wogwira ntchito samachotsedwa mthupi ndi hemodialysis.

Kuzungulira kwa losartan ndi metabolite yake yogwira m'magazi am'magazi okalamba omwe ali ndi vuto losakanikirana kwa matenda oopsa samasiyana kwambiri ndi zomwe matendawa amagwira kwa anyamata omwe ali ndi matenda oopsa.

Kuzungulira kwa plasma kwa losartan mwa azimayi omwe ali ndi matenda oopsa kwambiri kunthawi ziwiri kuposa momwe amagwiritsidwira ntchito amuna omwe ali ndi matenda oopsa. Kuzindikira kwa metabolite yogwira amuna ndi akazi sikusiyana. Kusiyana kwa pharmacokinetic kumeneku sikofunikira.

Zisonyezero zogwiritsira ntchito mankhwalawa LOZAP ®

• ochepa matenda oopsa
• Matenda a mtima osachiritsika (monga gawo limodzi la mankhwala, osalolera kapena osagwiritsa ntchito mankhwala a ACE zoletsa),
• Kuchepetsa chiopsezo chokhala ndi matenda amtima (kuphatikizapo stroke) ndi kufa kwa odwala omwe ali ndi matenda oopsa komanso otsala amitsempha yamagazi,
• diabetesic nephropathy ndi hypercreatininemia ndi proteinuria (chiŵerengero cha mkodzo albumin ndi creatinine wopitilira 300 mg / g) mwa odwala omwe ali ndi matenda a shuga a 2 komanso ofanana ndi matenda oopsa (kuchepetsa kuchepa kwa matenda ashuga a nephropathy mpaka kulephera.

Mlingo ndi makonzedwe

Mankhwala amatengedwa pakamwa, ngakhale chakudyacho. Kuchulukitsa kuvomerezeka - 1 nthawi patsiku.

Ndi ochepa matenda oopsa, pafupifupi tsiku lililonse 50 mg. Nthawi zina, kuti mupeze njira yothandizira kwambiri, tsiku lililonse mlingo ungathe kuwonjezeka mpaka 100 mg mu 2 kapena 1 piritsi.

Mlingo woyamba wa odwala omwe ali ndi vuto la mtima nthawi zonse ndi 12,5 mg kamodzi patsiku. Monga lamulo, mlingo umakulitsidwa ndi gawo la sabata (i.e. 12.5 mg patsiku, 25 mg patsiku, 50 mg patsiku) kwa avareji yokwanira ya 50 mg 1 nthawi patsiku, kutengera kulekerera kwa mankhwalawa.

Popereka mankhwala kwa odwala omwe amalandira okodzetsa pamiyeso yambiri, mlingo woyambirira wa Lozap® uyenera kuchepetsedwa mpaka 25 mg kamodzi patsiku.

Kwa odwala okalamba, palibe chifukwa chosinthira mlingo.

Popereka mankhwala kuti muchepetse vuto la matenda amtima (kuphatikizapo sitiroko) ndi kufa kwa odwala omwe ali ndi matenda oopsa ndipo lamanzere lamitsempha yamagazi, mankhwala oyamba ndi 50 mg tsiku lililonse. M'tsogolomu, mlingo wa hydrochlorothiazide wocheperako utha kuwonjezeredwa ndipo / kapena mlingo wa kukonzekera kwa Lozap® utha kuwonjezeka mpaka 100 mg patsiku la Mlingo wa 1-2.

Kwa odwala omwe ali ndi mtundu wachiwiri wa matenda a shuga omwe amakhala ndi proteinuria, mlingo woyambirira wa mankhwalawa ndi 50 mg kamodzi patsiku, mtsogolomo, mlingo umakulitsidwa mpaka 100 mg tsiku lililonse (poganizira kuchuluka kwa kuthamanga kwa magazi) mu Mlingo wa 1-2.

Odwala omwe ali ndi mbiri ya matenda a chiwindi, kuchepa madzi m'thupi, munthawi ya hemodialysis, komanso odwala omwe ali ndi zaka zopitilira 75, akulimbikitsidwa kuchepa kwa mankhwalawa - 25 mg (1/2 piritsi ya 50 mg) kamodzi patsiku.

Zotsatira zoyipa

Mukamagwiritsa ntchito losartan pochiza matenda oopsa pamagazi oyesedwa, pazotsatira zonse, zotsatira za chizungulire zomwe zimasiyana ndi placebo ndi oposa 1% (4.1% motsutsana ndi 2.4%).

Odwala amadalira orthostatic zochita za antihypertensive othandizira, pogwiritsa ntchito losartan adawonedwa osakwana 1% ya odwala.

Kutsimikiza kwamafupipafupi a zovuta: kawirikawiri (≥ 1/10), nthawi zambiri (> 1/100, ≤ 1/10), nthawi zina (≥ 1/1000, ≤ 1/100), kawirikawiri (≥ 1/10 000, ≤ 1 / 1000), kawirikawiri kwambiri (≤ 1/10 000, kuphatikiza mauthenga amodzi).

Zotsatira zoyipa zomwe zimachitika pafupipafupi 1%:

Zotsatira zoyipa za losartan nthawi zambiri zimakhala zosakhalitsa ndipo sizikufuna kusiya kwa mankhwalawa.

Zotsatira zoyipa zimachitika ndi pafupipafupi 1%

Kuchokera pamtima dongosolo: orthostatic hypotension (amadalira mlingo), mphuno, bradycardia, arrhythmias, angina pectoris, vasculitis, myocardial infarction.

Kuchokera pamimba yodyetsera: anorexia, mucosa wowuma pamlomo, mano, kusanza, kupindika, gastritis, kudzimbidwa, hepatitis, kuphwanya chiwindi ntchito, kawirikawiri - kuwonjezeka kwapakati pa ntchito ya AST ndi ALT, hyperbilirubinemia.

Dermatological zimachitika: khungu lowuma, erythema, ecchymosis, photosensitivity, kuchuluka thukuta, alopecia.

Thupi lawo siligwirizana: urticaria, zotupa pakhungu, kuyabwa, kuphatikizira kutupa kwa lilime ndi lilime, kuyambitsa kutsekeka kwa mpweya ndi / kapena kutupa kwa nkhope, milomo, pharynx.

Pa gawo la hematopoietic dongosolo: nthawi zina kuchepa magazi (kuchepa pang'ono kwa ndulu ya hemoglobin ndi hematocrit, pafupifupi 0,11 g% ndi 0,09 voliyumu, motsatana, kawirikawiri - mwa kufunikira kwamankhwala), thrombocytopenia, eosinophilia, Shenlein-Genokha Ensura.

Kuchokera ku minculoskeletal system: arthralgia, nyamakazi, kupweteka mapewa, bondo, fibromyalgia.

Kuchokera kumbali ya chapakati mantha dongosolo ndi zotumphukira mantha dongosolo: nkhawa, kugona kugona, kugona, kugona kukumbukira, kugwedezeka, ataxia, kupsinjika, kukomoka, migraine.

Kuchokera pamalingaliro am'mimba: tinnitus, kusokonezeka kwa kukoma, kuwonongeka kwa mawonekedwe, conjunctivitis.

Kuchokera kwamikodzo dongosolo: kukodza kwamkodzo, matenda amkodzo, kuwonongeka kwa impso, nthawi zina - kuchuluka kwa urea ndi nitrojeni wotsalira kapena mu cell seramu.

Kuchokera pakubala: kuchepa kwa libido, kusabala.

Kuchokera kumbali ya kagayidwe: kawirikawiri - hyperkalemia (mulingo wa potaziyamu m'madzi am'magazi ndi oposa 5.5 mmol / l), gout.

Zotsatira pa kugwiritsa ntchito mankhwala LOZAP ®

• mimba
• kuyamwa
• zaka mpaka 18 - (kuchita bwino ndi chitetezo sizinakhazikitsidwe),
• Hypersensitivity pamagawo a mankhwala.

Mochenjera, mankhwalawa amayenera kugwiritsidwa ntchito pakuwonetsa kuchepa kwa magazi, kuchepa kwa bcc, kusungunuka bwino kwa madzi, electrolyte, kuperewera kwa mafupa a minyewa kapena kupindika kwa minyewa ya impso imodzi, komanso kuperewera kwa impso / hepatic.

Kugwiritsa ntchito kwa LOZAP® pa nthawi yobereka komanso mkaka wa m`mawere

Palibe zambiri pakugwiritsa ntchito mankhwalawa Lozap ® pa nthawi yapakati. Komabe, zimadziwika kuti mankhwalawa omwe amakhudza RAAS mwachindunji, akagwiritsidwa ntchito koyambirira kwachiwiri komanso kwachitatu, amatha kupundula kapena ngakhale kuphedwa kwa mwana wosabadwayo. Chifukwa chake, ngati pakhale pakati, mankhwalawo amayenera kuyimitsidwa nthawi yomweyo.

Ngati kuli kofunikira kugwiritsa ntchito Lozap panthawi yotseka, lingaliro liyenera kuchitika posiya kuyamwitsa, kapena kusiya kumwa mankhwalawa.

Malangizo apadera

Ndikofunikira kukonza kuchepa kwam'madzi musanapange mankhwala a Lozap® kapena kuyamba kulandira mankhwala pogwiritsa ntchito mankhwalawa.

Mankhwala osokoneza bongo omwe amakhudza RAAS amatha kuwonjezera urea wa magazi ndi serum creatinine mwa odwala omwe ali ndi vuto limodzi la impso.

Odwala matenda a chiwindi, kuchuluka kwa losartan mu madzi am`magazi kumawonjezeka kwambiri, chifukwa chake, ngati pali mbiri yodwala matenda a chiwindi, ayenera kufotokozedwa pamiyeso yotsika.

Munthawi ya chithandizo, kuchuluka kwa potaziyamu m'magazi kuyenera kuyang'aniridwa pafupipafupi, makamaka odwala okalamba, omwe ali ndi vuto laimpso.

Kuyanjana kwa mankhwala osokoneza bongo

Mankhwala amatha kutumikiridwa ndi ena othandizira. Kulimbikitsana komwe kumachitika chifukwa cha ma beta-blockers ndi sympatholytics kumawonedwa. Ndi kuphatikiza kwa losartan ndi okodzetsa, zowonjezera zimawonedwa.

Palibe kuyanjana kwa pharmacokinetic wa losartan ndi hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole ndi erythromycin adadziwika.

Rifampicin ndi fluconazole akuti amachepetsa kuchuluka kwa yogwira metabolites wa losartan m'madzi am'magazi. Kukula kwakukhalirana kwa kudalirana kumeneku sikumadziwikabe.

Monga othandizira ena omwe amalepheretsa angiotensin II kapena momwe zimakhalira, kuphatikiza kwa losartan ndi potaziyamu ochepera okodzetsa (mwachitsanzo, spironolactone, triamteren, amiloride), kukonzekera kwa potaziyamu ndi mchere wokhala ndi potaziyamu kumawonjezera chiopsezo cha hyperkalemia.

NSAIDs, kuphatikizapo kusankha ma inhibitors a COX-2, amachepetsa mphamvu ya okodzetsa ndi mankhwala ena a antihypertensive.

Pogwiritsa ntchito angiotensin II ndi ma lithium receptor antagonists, kuwonjezeka kwa plasma lithiamu ndende ndikotheka. Popeza izi, ndikofunikira kuyesa maubwino ndi zoopsa za mgwirizano wa lospan ndi kukonzekera kwa mchere wa lithiamu. Ngati kugwiritsidwa ntchito kophatikizana ndikofunikira, kuchuluka kwa lifiyamu m'madzi a m'magazi kuyenera kuyang'aniridwa pafupipafupi.