Momwe mungagwiritsire ntchito Cozaar?

Zomwe zimagwira wotsutsazolandila angiotensin 2. Katunduyo amatchinga zonse zomwe zimachitika. antiotensin, ngakhale atakhala kuti chidwi linapangidwa, kapena komwe linachokera kuti. Amadziwika kuti angiotensin 2(zamphamvu vasoconstrictor) ndichofunikira pakukula ochepa matenda oopsa. Kuphatikiza apo, zinthu zomwe sizigwira ntchito sizichita ngati angiotensin wotsutsana naye.

Malowo amasankha molumikizana ndi ena Ma receptors a AT1osakhudza zolandila ena mayendedwe a ion ndi mahomoni. Losartan ilibe kanthu kininase 2 ndi bradykinin. Zimatsimikiziridwa kuti zinthu zomwe zimagwiritsidwa ntchito ndi mankhwala sizomwe zimayambitsa edema.

Mutatha kumwa mankhwalawo, mgwirizano womwe ulipo pakati pa kuponderezana umatha angiotensin 2 ndi mayendedwe reninntchito ARPzimawonjezeka.

Pambuyo mankhwala ndi mankhwala kwa milungu 6, ndende angiotensin 2 ukuwonjezeka ndi katatu. Kuletsa kwadongosolo kwa ma receptor enieni kumachitika, komwe kumadziwonetsera kale masiku 14-48 atayamba kumwa mankhwalawa.

Zimatsimikiziridwa kuti mankhwalawo alibe mphamvu zamankhwala n.s. ndi mawonekedwe, shuga ndende magazi. Losartan ndiwosiyana kwambiri ndi mankhwala ACE zoletsazimalepheretsa zotsatira angiotensin 1 ndi 2osakhudza bradykinin(ACE zoletsa khalani mbali ina).

Ndi kuwonjezeka kwa mlingo wa mankhwalawa, mphamvu yake yowonjezera imachulukana.

Mukamachita kafukufuku ndi abambo athanzi, mukatha kumwa 100 mg ya mankhwalawa, mumamwa mchere wochepa kapena mchere wambiri Zakudyaliwiro kusefera kwamadzi,gawo loseferandipo impso ntchito yonse sinasinthe. Komabe, kuchuluka kwamikodzo asidi mwa impso ndi sodium kwamikodzo kumawonjezeka.

Mwa akazi mkati kusintha kwa thupi ndipo nthawi yovutika pakukula kuthamanga kwa magazikudya tsiku lililonse 50 mg ya mankhwalawa kwa mwezi umodzi PGsanasinthe.

M'mayesero azachipatala, cholinga chake chinali kuwunika kudalira thanzi, kufa ndi kufooka kwa mtima, mwa odwala CNS kuchokera pa tsiku losartan, zatsimikiziridwa kuti mankhwala omwe ali mu Mlingo wa 150 mg ndi othandiza kwambiri kuposa 50 mg. Kafukufuku wachitika kwa zaka 4.

Mapiritsi atatha Matumbo, gawo logwira ntchito la Cozaar limayenda bwino komanso limagwira mwachangu, limalowa mu kayendedwe kazinthu ndipo zimapukusidwa (14%) mu zimakhala za chiwindi. Losartan mitundu yogwira (zopelekera) komanso osagwira (N-2-tetrazole-glucuronide) metabolites. Bioavailability pafupifupi 30%. Kuchuluka kwa losartan kumawonedwa pambuyo pa mphindi 60, ma metabolites - atatha maola 3.5. Pharmacokinetic magawo ali osadalira chakudya.

Mankhwalawa ali ndi magawo ambiri omangika kumapulogalamu a plasma - pafupifupi 99%. Zogwira ntchito sizilowamagazi chotchinga magazi.

Mankhwalawa amachotsedwa mu mawonekedwe a metabolites kapena osasinthika ndi impso ndi ndowe, mu mphindi 120 ndi maola 5-6, motsatana. Mukamamwa 100 mg ya mankhwala patsiku, silikukonzekera kudziunjikira mthupi.

Pharmacokinetic magawo osadalira zaka. Komabe, mwa akazi, kuchuluka kwa plasma komwe kumagwira ntchito ndiwokwirirapo kawiri kuposa amuna.

Odwala odwala matenda a chiwindi (ndi matenda amatsenga) plasma ndende ndiwambiri kangapo kuposa wathanzi.

Atchilolezo oposa 10 ml pa mphindi, anthu osatero hemodialysis, Zizindikiro za mankhwalawo sizosiyana kwambiri. Malonda sanachotsedwe nthawi hemodialysis.

Zizindikiro zogwiritsidwa ntchito

• anthu akuvutika ochepa matenda oopsa,
• kuteteza impso pomwe matenda ashugaMitundu iwiri ndi proteinuria,
• Kuchepetsa chiopsezo cha matenda a mtima (stroke, kugunda kwa mtima) kapena kufa kwa odwalalamanzere lamitsempha lamanzere ndi kuchuluka HERE,
• ndi mtima wosalephera, ndi kulolera kapena kusachita bwino ACE zoletsa,
• Kuchepetsa zochitika zachitukuko Kulephera kwa impso (mu gawo lothamangitsa, ngati kumuyika mukufunika kapena hemodialysis).

Contraindication

• at chifuwa pazinthu zake,
• ndi tsankho lactose,shuga galactose malabsorption syndromekapena chinyengo mkanda,
• Anthu odwala matenda owopsa a chiwindi
• osakwana zaka 18,
• molumikizana ndi Aliskiren,
• azimayi oyembekezera komanso oyembekezera.

Chenjezo liyenera kuchitidwa:

• at mgwirizano wapakati mitsempha ya impso kapena aimpso mtsempha wamagazi stenosis (ngati wodwala ali ndi impso imodzi)
• kudwala ndi kulephera kwamtima kwambirimakamaka kuphatikiza ndi kulephera kwa aimpso,
• atMatenda a mtima wa Ischemic kapena mtima arrhythmias,
• pambuyo podziika impso,
• at mitral kapena aortic stenosis,
• odwala ndi matenda amisala, Edema wa Quincke, kuphatikizapo mbiri ya
• kuchepetsedwa Bcc.

Zotsatira zoyipa

Odwala omwe achulukana HERE Mankhwala nthawi zambiri amaloledwa. Zotsatira zoyipa zimakhala chilengedwe chochepa, kudutsa ndi nthawi, kusiya mankhwala sikofunikira.

Zowonetsedwa nthawi zambiri: chizungulirezotupa pakhungu orthostatic zimachitika.

• zosokoneza tulo, mutu, asthenia,
• palpitations, kupweteka pachifuwa, kufooka, kutopa, zotumphukira edema,
• tachycardiakupweteka mkati dera la epigastric,
• kudzimbidwanseru kutsegula m'mimba,
• minofu kukokana, kupweteka kwa msana,
• rhinitiskutsokomola sinusitis, pharyngitis ndi matenda ena a chapamwamba kupuma thirakiti chifukwa cha matenda.

At mtundu 2 shuga zofala kwambiri: kufooka, chizungulire, Hyperkalemia, ochepa hypotension.

Kukula kwake komanso chikhalidwe chake zimadalira mlingo wa tsiku ndi tsiku womwe wodwala amatenga. Chifukwa chake, mutatenga 150 mg ya Cozaar patsiku nthawi zambiri zimachitika: Hyperkalemiakulephera kwa impso, kuchepa HEREkuchuluka kwawonjezeka creatininepotaziyamu ndi urea m'magazi.

Nthawi yolembetsedwera pambuyo polembetsedwera mankhwala

• kusanza, kulephera kwa chiwindi, chiwindi,
• thrombocytopenia, myalgia,
• dysgeusia ndi migraine,
• kuchepa magazi, arthralgia,
• yagwetsa libido ndipo kusabala,
• urticariaredness ndi totupa pakhungu, khungu kuzindikira.

Malangizo ogwiritsira ntchito Cozaar (njira ndi Mlingo)

Mankhwala ndi mankhwala pakamwa, ngakhale chakudya.

Mlingo ndi mankhwalawa amayenera kutsimikiziridwa ndi adokotala, pomwe mankhwalawa amatha kuphatikizidwa ndi mankhwala ena oopsa a matenda oopsa.

Malangizo ogwiritsira ntchito Cozaar

Ndi kuchuluka kwa kuthamanga kwa magazi, mlingo woyambirira = 50 mg patsiku.

Pambuyo masiku 21-42 atayamba chithandizo, mankhwalawa amayamba kugwira ntchito bwino.

Ngati ndi kotheka, Mlingo ungathe kuwonjezeka mpaka 100 mg patsiku.

Kwa odwala omwe ali ndi kuchuluka HERE limodzi ndi lamanzere lamitsempha lamanzere kapena mtundu 2 shuga Mlingo woyamba ulinso = 50 mg patsiku (ndiye umakulitsidwa mpaka 100 mg).

Anthu okhala ndi CHF mu magawo oyamba a mankhwalawa, mutha kumwa mankhwala a 12.5 mg kamodzi patsiku. Mlingo umachulukitsidwa masiku 7 aliwonse (25 mg, 50 mg, 100 mg ndi 150 mg) monga wodwala alili.

Pansi kuzungulira magazi(mutatenga okodzetsa) Mlingo woyambirira ndi 25 mg patsiku.

Komanso, kusintha kwa mlingo ndikofunikira kwa matenda owopsa a chiwindi.

Bongo

Palibe umboni wa mankhwala osokoneza bongo. Amaganiziridwa kuti kumwa Mlingo waukulu wa mankhwalawa kumabweretsa kuchepa kwamphamvu HEREndi tachycardia.

Monga chithandizo, ndimapereka chithandizo chothandizira komanso chothandizira. Hemodialysisosagwira ntchito.

Kuchita

Mankhwalawa sangaphatikizidwe Aliskirenat matenda ashuga kapena ndi kulephera kwa impso.

Akaphatikizidwa kusankha COX-2 zoletsa, mankhwala osapweteka a antiidal ndi Losartan Kuchita bwino kwa magulu onse awiriwa kumachepa.

Kuphatikiza kwa cozaar ndi Spironolactone, Amiloride, Triamterenndi ena potaziyamu wothandiza okodzetsakumabweretsa kuchuluka kwa potaziyamu m'magazi.

Amadziwika kuti Rifampicin Kuchepetsa plasma ndende ya mankhwalawa.

Losartan amasokoneza njira yochotsa lithiamu mthupi.

Mosamala kwambiri, mankhwalawo ndipo PNVS, izi zimatha kutsogolera (makamaka kwa anthu okalamba, odwala matenda am'madzi) kuwonjezera katundu pa impso. Zosintha zimasinthidwa, nthawi zambiri zimatha umodzi wa mankhwala utatha.

Malangizo apadera

Mankhwala siothandiza kuchepetsa pafupipafupi matenda a mtima kwa odwala a liwiro la Negroid. Pankhaniyi, atenolol anali wothandiza kwambiri. Izi zimabweretsa kuti ACE zoletsa ndi angiotensin antagonistsosagwira kwambiri odwala a liwiro la Negroid.

Mankhwalawa samveka bwino akapatsidwa mankhwala chachikulu hyperaldosteronism, sizimachepetsaHERE.

Chifukwa chakuti zina zoyipa zimatha kuthana ndi kuthamanga komanso kulondola kwa ma psychomotor, tikulimbikitsidwa kuti musayendetse galimoto pogwiritsa ntchito mankhwalawa.

Analogs a Cozaar

Mankhwala oyamba ali ndi mitundu ingapo yofanana ndi gulu lofananira:Angizar, Cardomin-Sanovel, Giperzar, Ksartan, Lozap, Closart, Lozartin, Lorista, Losar, Presartan, Pulsar, Erinorm.

Zofanizira za mankhwalawa ndi: Advantan, Votum, Aprovel, Vasar, Valsacor, Vanatex, Diovan, Diocor, Irbetan, Candesar, Cantab, Kasark, Mikardis, Teveten, Firmasta, Hizart, Edarbi.

Pharmacological zimatha mankhwala Cozaar

Mankhwala
Angiotensin II ndi vasoconstrictor wamphamvu, mahomoni othandizira a renin-angiotensin dongosolo komanso chinthu china chofunikira kwambiri mu pathophysiology ya matenda oopsa. Angiotensin II imamangiriza ku receptor ya AT1 yomwe imapezeka m'matipi ambiri (mwachitsanzo, minofu yosalala, mtima wa adrenal, impso, ndi mtima), ndikuwonetsa kuwonongeka kwa zotsatira zachilengedwe zofunika, kuphatikizapo vasoconstriction ndi kumasulidwa kwa aldosterone. Angiotensin II imapangitsanso kuchuluka kwa minofu yosalala. M'mikhalidwe mu vitro ndi mu vivo losartan ndi metabolacologic yogwira metabolite - carboxylic acid (E-3174) amatseka mphamvu zonse mwakuthupi chifukwa cha anigotensin II mosasamala zakomwe gawoli limayambira kapena momwe amapangira. Losartan amamangirira mosamala ku receptor ya AT1, samamanga kapena kutsekereza ma cell ena a mahomoni ndi ma ion ion. Losartan sikuletsa ACE (kininase II), puloteni yomwe imalimbikitsa kuwonongeka kwa bradykinin. Zotsatira zake, zotsatira zosakhudzana mwachindunji ndi blockade ya receptor ya AT1 (mwachitsanzo, kuwonjezeka kwa zovuta za bradykinin) sizinaphatikizidwe ndi kugwiritsidwa ntchito kwa losartan.
Kugwiritsa ntchito losartan kungachepetse kufa kwathunthu ndi matenda amtima, kuchuluka kwa matenda amisempha komanso matenda amitsempha yamagazi kwa odwala matenda oopsa (ochepa matenda oopsa) ndikumanzere kwamitsempha yamagazi, amakhala ndi vuto lofunika kwambiri kwa odwala omwe ali ndi mtundu wachiwiri wa shuga ndi proteinuria.
Pharmacokinetics
Mafuta
Pambuyo pakukonzekera pakamwa, losartan imatengedwa bwino ndipo imayambira pang'onopang'ono pochitika ndi kupangika kwa metabolite yogwira ya carboxylic acid ndi metabolites yogwira. The zokhudza pakamwa bioavailability wa losartan pafupifupi 33%. Pafupifupi kuchuluka kwa losartan ndi yogwira metabolite amafikiridwa pambuyo 1 ora ndi maola 3-4, motengera kumwa mankhwalawa sikukhudza kuchuluka kwa losartan mu madzi am`magazi.
Kugawa
Kumangidwa kwa losartan ndi metabolite yake yogwira ndi mapuloteni a plasma, makamaka okhala ndi albumin, amaposa 99%. Kugawa voliyumu - 34 l. Kafukufukuyu adapeza kuti losartan idalowa BBB kapena kulowa mkatikati.
Kuthetsa
Chilolezo cha plasma kwa losartan ndipo metabolite yake yogwira imakhala pafupifupi 600 ndi 50 ml / min, motsatana. Kuvomerezeka kwa impso kwa losartan ndi metabolite yake yogwira ndi pafupifupi 74 ndi 26 ml / min, motsatana. Pambuyo pakamwa, pafupifupi 4% ya mankhwalawa amachotsedwa mu mkodzo ndi pafupifupi 6% ya mlingo ngati metabolite yogwira. Ndi mkamwa makonzedwe a losartan potaziyamu muyezo wa 200 mg, ndi pharmacokinetics ya mankhwala ndi yogwira metabolite ndi liniya.
Pambuyo m`kamwa makonzedwe, ndende ya mankhwala ndi yogwira metabolite mu madzi am`magazi amachepetsa exponentially ndi theka lomaliza la moyo wa 2 maola losartan ndi maola 8-9 kwa yogwira metabolite. Pambuyo pakamwa makonzedwe a C14 olembedwa kuti losartan, pafupifupi 35% ya radioacaction yapezeka mkodzo, 58% mu ndowe.
Pharmacokinetics pamagulu apadera a odwala
Odwala okalamba
Kuchuluka kwa losartan ndi metabolite yake yogwira m'magazi a okalamba omwe ali ndi matenda oopsa (ochepa matenda oopsa) samasiyana kwambiri ndi odwala omwe ali ndi matenda oopsa (ochepa matenda oopsa) a magulu azaka zazing'ono.
Okwatirana
The kuchuluka kwa losartan mu madzi am`magazi anali 2 times apamwamba odwala matenda oopsa (matenda oopsa wamkazi) kuposa wamkazi. Kuzunza kwa metabolite yogwira m'madzi am'magazi mwa odwala ndi amuna sikunasiyana. Kusiyana kwa pharmacokinetic kumeneku sikofunikira.
Odwala omwe ali ndi vuto la chiwindi ndi impso
Pamene kumwa pakamwa odwala wofatsa pang'ono zolimbitsa matenda a chiwindi, kuchuluka kwa losartan ndi yogwira metabolite mu madzi am`magazi anatsimikiza 5-1.7 nthawi, motero, poyerekeza ndi achinyamata achinyamata odzipereka.
Masautso a losartan m'magazi am'magazi odwala omwe ali ndi creatinine chilolezo choposa 10 ml / min sichinasiyane ndi zomwe zimachitika mwa anthu wamba. AUC kwa odwala omwe akudwala hemodialysis anali 2 times apamwamba poyerekeza ndi odwala omwe ali ndi vuto laimpso. The kuchuluka kwa yogwira metabolite mu madzi am`magazi sizisintha mwa odwala mkhutu aimpso ntchito kapena odwala hemodialysis. Losartan ndi metabolite yake yogwira siichotseredwa ndi hemodialysis.

Pa mimba ndi mkaka wa m`mawere

Mankhwala saloledwa kumwa panthawi wa mimba. Iyenera kusinthidwa kukhala mankhwala ena a antihypertensive.

Kaya mankhwalawa amuchotsa mkaka wa m'mawere sizikudziwika bwinobwino. Chifukwa chake, munthawi ya chithandizo ndi Cozaar yoyamwitsa Ndikulimbikitsidwa kuti ndisiye.

Kutulutsa mawonekedwe ndi kapangidwe kake

Fomu ya kipimo cha Cozaar - mapiritsi okhala ndi mafilimu: oyera 50 mg kwa ma PC 14., 100 mg kwa ma PC 7 kapena 14. M'matumba, pamatcheni okhala ndi matuza 1 kapena 2.

The yogwira ndi losartan potaziyamu, piritsi 1 - 50 kapena 100 mg.

Zothandiza: pregelatinized starch, lactose monohydrate, microcrystalline cellulose, magnesium stearate.

Mapangidwe a Shell: hypromellose, hyprolose (yokhala ndi 0,3% silicon dioxide), sera ya carnauba, titanium dioxide.

Kugwiritsa ntchito mankhwala Cozaar

Cozaar akhoza kumwedwa mosaganizira zakudya. Cozaar imatha kutumikiridwa nthawi imodzi ndi mankhwala ena a antihypertensive.
AH (ochepa matenda oopsa)
Mlingo woyenera komanso wowonjezera wa odwala ambiri ndi 50 mg 1 nthawi patsiku. Mulingo wambiri wa antihypertensive umatheka mkati mwa masabata 3-6 kuyambira poyambira chithandizo. Odwala ena, kuti akwaniritse kutchulidwa, kungakhale kofunikira kuti muwonjezere mlingo mpaka 100 mg kamodzi patsiku.
Mukamapereka mankhwala kwa odwala omwe ali ndi BCC yochepetsedwa (mwachitsanzo, chifukwa cha mankhwala omwe ali ndi kuchuluka kwa ma okosijeni), mlingo woyambirira ungakhale 25 mg kamodzi patsiku (onani MALANGIZO OTHANDIZA).
Palibe chifukwa chosankha koyamba kwa odwala okalamba kapena odwala omwe ali ndi vuto la impso, kuphatikiza odwala pa hemodialysis. Odwala omwe ali ndi mbiri yodwala matenda a chiwindi amatha kupatsidwa mlingo wocheperako.
Kuchepetsa chiwopsezo cha zovuta ndi kufa chifukwa cha mtima wamtima mwa odwala omwe ali ndi matenda oopsa (matenda oopsa) komanso kumanzere kwamitsempha yamagazi.
Mlingo woyamba wa Cozaar ndi 50 mg 1 nthawi patsiku. Kutengera kusintha kwa kuchuluka kwa kuthamanga kwa magazi, mlingo wochepera wa hydrochlorothiazide umagwiritsidwanso ntchito komanso / kapena mlingo wa Cozaar umakulitsidwa mpaka 100 mg kamodzi patsiku.
Nephroprotection odwala ndi mtundu II matenda a shuga ndi proteinuria
Mulingo woyambira woyamba ndi 50 mg kamodzi tsiku lililonse. Mlingo umatha kuwonjezeka mpaka 100 mg kamodzi patsiku, kutengera kusintha kwa kuthamanga kwa magazi. Cozaar imatha kutumikiridwa nthawi yomweyo ndimankhwala ena a antihypertensive (okodzetsa, oletsa calcium, oletsedwa, α- kapena ren-adrenoreceptor blockers ndi mankhwala apakati), komanso insulin ndi mankhwala ena ogwiritsidwa ntchito kwambiri a hypoglycemic (mwachitsanzo sulfonylureas, glitazones ndi glucosidase inhibitors).

Mogwirizana ndi mankhwala Cozaar

M'maphunziro a pharmacokinetic, palibe mayanjano ofunikira a losartan omwe ali ndi hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole ndi erythromycin. Warfarin ndi fluconazole akuti amachepetsa mulingo wa metabolite wogwira wa losartan. Zotsatira zamankhwala pazothandizazi sizinawunikidwe.
Monga ndi zina zolepheretsa za angiotensin II, kugwiritsidwa ntchito kwa potaziyamu poteteza mauretics (spirinolactone, triamteren, amiloride), zina zowonjezera za potaziyamu kapena mchere wa potaziyamu kungayambitse hyperkalemia.
NSAIDs, kuphatikizapo kusankha ma inhibitors a COX-2, amachepetsa mphamvu ya okodzetsa ndi mankhwala ena a antihypertensive. Chifukwa chake, mphamvu ya antihypertensive ya mankhwala - angiotensin II receptor antagonists angachepe ndikugwiritsa ntchito munthawi yomweyo NSAIDs, kuphatikizapo COX-2 inhibitors.
Odwala ena omwe ali ndi vuto laimpso mu mankhwalawa a NSAIDs (kuphatikizapo COX-2 inhibitors), makonzedwe a angiotensin II receptor antagonists angayambitse kuchepa kwa ntchito yaimpso. Zotsatira izi nthawi zambiri zimakhala zosinthika.

Ndemanga za Cozaar

Pama forum pa intaneti za mankhwalawa amalankhula bwino. Ndi makonzedwe mwatsatanetsatane, mankhwalawa amateteza kuthamanga kwa magazi ndipo samayambitsa zovuta zina. Mosavuta, kudya kwake sikugwirizana ndi kudya.

Ndemanga za Cozaar:

"Mankhwala abwinobwino, koma sizinathandize pompopompo, koma pena patatsala sabata lachitatu lokonzekera",

"Pambuyo pa opaleshoni, ndakhala ndikumatenga Cozaar kwa sabata limodzi. Kupanikizika kunachepa kuchoka pa 220 116 mpaka 130 87. Zotsatira zoyipa ndizofooka, koma ndimachimwa. Pambuyo pake ndinayesanso mankhwala ena - sanandithandizenso. "

Pharmacokinetics

Mukamamwa pakamwa, losartan imayamwa ndikuwupaka bwino. Amadziwika ndi mphamvu ya "gawo loyambirira" kudzera m'chiwindi ndikupanga metabolite wa carboxylated ndi pharmacological ntchito, komanso metabolites yogwira. The dongosolo bioavailability wa thunthu mu piritsi mawonekedwe pafupifupi 33%. Zazikuluzikulu za losartan ndi metabolite yogwira zimalembedwa pafupifupi 1 ora ndi maola 3-4 pambuyo pa utsogoleri, motsatana. Mukamadya Cozaar pachakudya chokhacho, mawonekedwe aomwe amagwira m'magazi a magazi amakhalabe osasinthika.

Mlingo womangiriza wa losartan ndi metabolite wake wogwira ndi mapuloteni a plasma (makamaka omwe ali ndi albumin) amafika 99%. Kuchuluka kwa magawo a losartan ndi malita 34. Kuyesa kwa makoswe kunatsimikizira kuti chotchinga chaubongo wamagazi sichitha kupezeka ndi chinthucho.

Pafupifupi 14% ya mlingo wa Cozaar, akagwidwa pakamwa kapena m'mimba, amadutsa mu metabolite yogwira. Kuphatikiza apo, metabolacologic ofooka metabolites adazindikiridwa, mwa omwe ma metabolites awiri amalamulira, omwe amapangidwa chifukwa cha hydroxylation ya mbali butyl unyolo, ndi yachiwiri metabolite - N-2-tetrazole-glucuronide.

Chilolezo cha plasma chogwira ntchito cha Cozaar ndi metabolite yake yogwira pafupifupi 600 ml / min ndi 50 ml / min, motsatana. Kuwulula kwa impso kwa mankhwala awa ndi pafupifupi 74 ml / mphindi ndi 26 ml / min, motsatana. Ndi pakamwa makonzedwe a losartan, pafupifupi 4% ya mankhwalawa amatengedwa osasinthika mumkodzo ndipo pafupifupi 6% ya mankhwalawa amachotsedwanso chimodzimodzi m'njira ya metabolite yogwira. Kwa losartan ndi metabolite yake yogwira, mzere wa magawo a pharmacokinetic ndi makamwa a Cozaar mu Mlingo mpaka 200 mg ndi khalidwe.

Pambuyo pakukonzekera pakamwa, zomwe zimapangidwa ndi losartan ndi metabolite yake yogwira plasma zimachepa kwambiri, ndi theka lomaliza la moyo pafupifupi maola 2 ndi 6-9, motsatana. Mukamamwa Cozaar muyezo wa 100 mg kamodzi patsiku, kuyerekezera kwa losartan kapena metabolite yake yogwira sikumawonedwa m'thupi. Excretion wa losartan ndi metabolites yake yogwira imachitika kudzera mu impso, komanso kudzera matumbo ndi bile. Pambuyo pakukonzekera kwa pakamwa kwa losartan olembedwa ndi maatomu 14 C, mwa odwala amphongo, pafupifupi 35% ya isotope ya radioactive imapezeka mkodzo, ndipo 58% mu ndowe. Ndi mtsempha wa mtsempha wa 14 C wa losartan, pafupifupi 43% ya radioacuction imayikidwa mu mkodzo ndi 50% mwa ndowe.

Magulu a plasma losartan mwa azimayi omwe ali ndi matenda oopsa kwambiri anali okwanira 2 kuposa amuna omwe ali ndi vuto lofanana. Kuzunza kwa yogwira metabolite mwa odwala onse amuna ndi akazi pafupifupi sikunasiyane. Komabe, zodabwitsazi zilibe tanthauzo lachipatala.

Odwala omwe ali ndi chidwi chodwala matenda enaake a chiwindi ndi pakamwa pa Cozaar, zomwe zimachitika mwa losartan ndi metabolite yogwira m'magazi am'magazi anali a 5 ndi 1.7 nthawi zambiri, kuposa anyamata achinyamata athanzi omwe adachita nawo zoyesazo.

Malangizo ogwiritsira ntchito Cozaar: njira ndi mlingo

Mapiritsi a Cozaar amatengedwa pakamwa kamodzi patsiku, nthawi iliyonse, ngakhale atakhala kuti amadya.

Mlingo wa mankhwalawa umaperekedwa ndi adokotala potengera zomwe zikuwonetsa kuchipatala.

Mlingo woyenera wa Cozaar:

• Matenda oopsa a arterial: 50 mg ngati mlingo woyambirira komanso wokonza, ngati kuli koyenera, kuti mukwaniritse kwambiri, 100 mg itha kumwa. A okhazikika hypotensive zotsatira kumachitika pambuyo 3-6 milungu mankhwala. Kwa odwala omwe ali ndi BCC yochepetsedwa, muyeso woyamba wa mankhwalawa umaperekedwa mu 25 mg. Ngati mbiri ya matenda a chiwindi ikuwonetsedwa, mlingo wa mankhwalawa uyenera kuchepetsedwa. Odwala okalamba komanso kulephera kwa aimpso, kuphatikiza odwala omwe ali ndi dialysis, safuna kusintha koyamba Mlingo,
• Kulephera kwamtima kosalekeza: mlingo woyambirira ndi 12,5 mg, kukhudzana kwa mankhwalawa kumalimbikitsidwa kamodzi pa sabata, kubweretsa kwa munthu wokonza mlingo (12,5 mg, 25 mg kapena 50 mg),
• Type 2 shuga mellitus ndi proteinuria: mlingo woyambayo ndi 50 mg, poganizira kuchepa kwa magazi (BP), mlingo uyenera kukwezedwa pang'onopang'ono mpaka 100 mg. Mankhwala ophatikizidwa ndi ma diuretics, alpha ndi adrenoblockers a calcium, ma blockter calcium, mankhwala opatsirana kwambiri, othandizira ena a hypoglycemic (glitazones, sulfonylureas, glucosidase inhibitors) ndi insulin ikuwonetsedwa,
• Arterial matenda oopsa ndi lamanzere yamitsempha yamagazi hypertrophy: Mlingo woyamba wochepetsera mwayi wokhala ndi vuto la mtima ndi kufa ndi 50 mg. Popeza kuchuluka kwa kuchepa kwa kuthamanga kwa magazi, kupitanso patsogolo kwa mankhwalawa kumaphatikizapo kuwonjezeka kwa mlingo mpaka 100 mg kapena kupereka mankhwala ochepa a hydrochlorothiazide.

Zotsatira zoyipa

M'mayeso azachipatala omwe amayendetsa ntchito a Cozaar, zotsatirazi zoyipa zidadziwika:

• Kuchokera pamtima: tachycardia, palpitations,
• Kuchokera pakapumidwe: Kutupa kwammphuno, kutsokomola, matenda am'mimba thirakiti, pharyngitis, sinusitis,
• Kuchokera pamimba yogaya chakudya: nseru, dyspepsia, kutsegula m'mimba,
• Kuchokera kwamanjenje: kusowa tulo, kupweteka mutu, chizungulire,
• Kuchokera ku minculoskeletal system: minofu kukokana, kupweteka kumbuyo,
• Kuchokera mthupi lonse: kutopa ndi kufooka, kupweteka pachifuwa komanso / kapena m'mimba, kutupa,
• Kumbali ya magawo a labotale: hyperkalemia (kuchuluka kwa alanine aminotransferase pambuyo posiya mankhwala nthawi zambiri amabwerera mwachizolowezi).

Zotsatira zoyipa ndi Cozaar makonda zimadziwika mu machitidwe ambiri azachipatala:

• Matumbo ogwiritsa ntchito: chiwindi chimagwira ntchito, osachepera hepatitis,
• Hematopoietic dongosolo: thrombocytopenia, kuchepa magazi,
• Njira ya minofu ndi mafupa: arthralgia, myalgia, osowa - rhabdomyolysis,
• Machitidwe amsempha: migraine, kawirikawiri dysgeusia,
• Dongosolo lothandizira: kutsokomola,
• Dermatological zimachitika: kuyabwa, urticaria, kutupa kwa khungu,
• Thupi lawo siligwirizana: kawirikawiri - vasculitis, matenda a Shenlein-Genoch, angioedema, kuphatikizapo kutupa kwa glottis, larynx, ndi kutsekeka kwa kupuma kwamatumbo, komanso / kapena kutuluka kwa milomo, nkhope, lilime ndi / kapena pharynx (ena mwa odwala adakumana ndi vuto la hypersensitivity ndi mlingo wapitayo ACE zoletsa).

Mwambiri, Cozaar imalekeredwa bwino, zotsatira zoyipa zimachepa ndipo zimawonekera mu mawonekedwe ofatsa omwe safuna kuti mankhwala athetse.

Pharmacological zochita za Cozaar

Malangizo ku Cozaar akuwonetsa kuti mankhwalawa amatha kuchepetsa zotumphukira zamitsempha, kuthamanga kwa magazi mozungulira, magazi, pambuyo pake, komanso kukhala ndi diuretic.

Kuphatikiza apo, monga ndemanga za Cozaar zikusonyeza, mankhwalawa salola kupezeka kwa myocardial hypertrophy. Kwa odwala omwe ali ndi vuto la mtima, Cozaar amatumizidwa kuti asinthire zolimbitsa thupi.

Malinga ndi ndemanga za Cozaar, kumwa mankhwalawa kamodzi kokha, pambuyo maola 6, magazi a systolic ndi diastolic amatsika. Zofanana zimatha maola 24. Njira yonse yothandizira ndi mankhwala kuti mupeze zotsatira zabwino sayenera kukhala osakwana masabata 3-6.

Mlingo ndi makonzedwe

Monga tafotokozera malangizo a Cozaar, mankhwalawa amawamwa asanadye, asanadye kapena atadya. Pochiza matenda enaake, Cozaar yekha ndi omwe angagwiritsidwe ntchito kapena amatha kuphatikizidwa ndi mankhwala ena omwe amalimbana ndi matenda oopsa.

Ngati wodwala akudwala matenda oopsa, chithandizo cha Cozaar chiyenera kuyambitsidwa ndi mlingo wa 50 mg osaposa nthawi 1 patsiku. Zotsatira zabwino za kumwa mankhwalawa zimachitika patadutsa masabata 3-6 atatha kugwiritsa ntchito mankhwalawa. Ngati ndi kotheka, dokotala amatha kuwonjezera kuchuluka kwa tsiku ndi tsiku mpaka 100 mg (nthawi imodzi mu maola 24).

Mu ndemanga ya Cozaar, zikuwonetseredwa kuti odwala omwe ali ndi magazi ochepetsedwa azungulira magazi ayenera kuyamba kulandira chithandizo chokwanira ndi 25 mg yekha nthawi imodzi patsiku.

Okalamba, komanso odwala omwe ali ndi vuto la impso, omwe adakali ndi dialysis, safuna kusintha kwa manambala omwe akuwonetsedwa mu malangizo a Cozaar.

Odwala omwe ali ndi hepatic osakwanira ayenera kutumizidwa kuti athe kuchepetsedwa tsiku lililonse la Cozaar.

Kuchepetsa kupezeka kwa matenda okhudzana ndi mtima, komanso kuchepetsa kufa kwa anthu omwe ali ndi mpweya wamankhwala oopsa komanso matenda oopsa, kwa odwala onse, kusiyapo, mlingo woyambirira wa 50 mg wa Cozaar siwofotokozedwanso nthawi 1 mkati mwa maola 24. Ndemanga za Cozaar zikuwonetsa kuti patapita nthawi, dokotala amakuwonjezerani kuchuluka kwa hydrochlorothiazide, kapena mutha kukulitsa kudya kwa Cozaar (mpaka 100 mg kamodzi patsiku). Pankhaniyi, ndikofunikira kuganizira zomwe zikuwonetsa kuchepetsa magazi.

Kuthandizira ntchito yachibadwa kwa odwala omwe ali ndi matenda a shuga a 2 komanso proteinuria, ayenera kuyamba kulandira chithandizo cha 50 mg kamodzi patsiku. Pambuyo pa izi, kugwiritsa ntchito kwa Cozaar tsiku ndi tsiku kumakulitsidwa mpaka 100 mg, pamene kuwunika kuchepa kwa kuthamanga kwa magazi. Mankhwala omwe anawerengedwa akhoza kuphatikizidwa ndi insulin, okodzetsa, othandizira pakatikati, komanso mankhwala osiyanasiyana a hypoglycemic.

Ngati wodwala akudwala matenda a mtima osakhazikika, mlingo woyamba wa Cozaar sungathe kupitirira 12,5 mg masana, womwe umapitilizidwa tsiku lililonse mkati mwa sabata loyamba la chithandizo. Sabata yachiwiri, mlingo umakwera kufika pa 25 mg patsiku, wachitatu - mpaka 50 mg patsiku.

Kupanga ndi mawonekedwe a kumasulidwa

Mlingo 25 uli ndi 25 mg wa losartan potaziyamu. Piritsi iliyonse yoyera ndi chowulungika, yokutidwa ndi kanema, yokhala ndi 951 mbali imodzi.

Mapiritsi okhala ndi Mlingo wa 50 amasiyana ndi mapiritsi 25 ofooka mwa kulembera ndi kuchuluka kwa zinthu zomwe zimagwira mu 50 mg wa losartan potaziyamu. Piritsi iliyonse yoyera imakhala ndi chowulungika, chomata ndi film, chokhala ndi 952

Mapiritsi okhala ndi mlingo waukulu kwambiri wa 100 mg losartan potaziyamu ali ndi mawonekedwe a mapiritsi oyera ngati mawonekedwe a dontho lokhala ndi chizindikiro cha 960

Kukopa pa kuthekera koyendetsa magalimoto ndi njira zowerengeka

Kafukufuku wowunikira mphamvu ya Cozaar pa kuthekera koyendetsa magalimoto ndi kugwira ntchito ndi zovuta kuzinthu sizinachitike. Komabe, mukatenga maphunziro a antihypertensive, kusamala kumalangizidwa poyendetsa kapena pochita ntchito yoopsa yomwe ingafunike kuikapo chidwi kwambiri ndi ma psychomotor. Izi zimakhudzana ndi chiopsezo cha chizungulire komanso kugona pamene mukumwa mankhwalawa, makamaka kumayambiriro kwa chithandizo kapena kuwonjezeka kwa mlingo.

Njira ndi magwiritsidwe ake

Cozaar imagwiritsidwa ntchito mosasamala ndondomeko yakudya, ndikofunikira kutsatira njira zosankhidwa za mapiritsi tsiku lililonse. Malangizowa amalimbikitsa kumeza mapiritsi osafuna kutafuna ndi madzi akumwa.

Kutengera momwe wodwalayo alili, mlingo woyenera wa mankhwala patsiku umasankhidwa. Gawo loyambirira limaphatikizapo kugwiritsa ntchito mlingo wa 50 kapena 100 mg wa Cozaar mu maola 24. Milandu yodziwitsa kuperewera kwa mankhwalawa pa 25 mg patsiku amadziwika. Tsatirani mosamalitsa malangizo ogwiritsa ntchito ndipo musapitirire mlingo wa 100 mg mu maola 24. Kuchuluka kwa mankhwalawo kumatsimikiziridwa ndi dokotala.

Muyezo kwa odwala kuyambira zaka 6 mpaka 16 amawerengedwa molingana ndi kulemera kwa thupi la mwana.

• 20-49 kg makilogalamu omwe amamwa mankhwalawa ndi 25 mg patsiku, amatha kuwonjezeka mpaka 50 mg pa mlingo umodzi patsiku.
• 50 makilogalamu ndi zina - 50 mg patsiku, zitha kukwera mpaka 100 mg patsiku.

Palibe chifukwa chosintha mankhwalawa kwa odwala omwe ali ndi vuto la impso komanso omwe ali ndi hemodialysis.

Ngati pali kuphwanya mphamvu ya chiwindi m'mbiri yamankhwala, wodwala azigwiritsanso ntchito mlingo wochepa kwambiri.Zachidziwikire zodalirika pakugwiritsa ntchito moyenera komanso kotetezeka kwa mankhwala a Cozaar mwa odwala omwe amalephera kwambiri aimpso, chifukwa chake, kuperekedwa kwa gulu ili la odwala kumatsutsana.

Kwa odwala omwe ali ndi zaka zopitilira 75, mlingo woyambirira wa 25 mg ungaganizidwe, ngakhale kusintha kwa mlingo sikufunika kwenikweni kwa odwalawa.

Mimba komanso kuyamwa

Malinga ndi malangizo, Cozaar saloledwa kupereka mankhwala panthawi yoyembekezera. Kumwa mankhwala osokoneza bongo a II ndi III omwe amayambitsa kukonzanso kwa renin-angiotensin kungayambitse zolakwika zazikulu kapena ngakhale kufa kwa mwana wosabadwayo, chifukwa chake, mankhwalawo amathetsedwa atakhazikika pokhapokha ngati ali ndi pakati. Refinction yokhudzana ndi kukula kwa renin - angiotensin dongosolo limachitika mwana wosabadwayo wachiwiri trimester. Kuopsa kwa mwana wosabadwayo kumakulitsidwa ngati Cozaar imatengedwa wachiwiri kapena wachitatu wa mimba.

Mankhwala a Cozaar pa mkaka wa m'mawere ali osavomerezeka. Zomwe amagwiritsa ntchito losartan m'gulu lino la odwala sizokwanira, ndipo sizikudziwika ngati chinthucho chimalowa mkaka wa m'mawere. Chifukwa chake, ndikofunikira kukonza momwe mankhwalawo angatengere chithandizo cha mayiyo komanso kuopsa kwa mwana ndikuganiza pakuletsa kuyamwitsa kapena kuthetsedwa kwa Cozaar.

Kuyanjana kwa mankhwala osokoneza bongo

Kuyanjana kwakukulu kwa Cozaar ndi digoxin, warfarin, hydrochlorothiazide, cimetidine, ketoconazole, phenobarbital, erythromycin sikunakhazikitsidwe.

Mphamvu ya kuchepa kwa kuchuluka kwa yogwira metabolite pamene mukumwa fluconazole ndi rifampicin pazotsatira zamankhwala sizinaphunzire.

Kukhazikitsidwa munthawi yomweyo kwamankhwala othandizira a potaziyamu, triamteren, spironolactone, amiloride ndi mankhwala ena omwe amaletsa mapangidwe a angiotensin II, mchere wokhala ndi potaziyamu, ungathandizire kuwonjezeka kwa potaziyamu m'magazi.

Akaphatikizidwa ndi kukonzekera kwa lithiamu, losartan amachepetsa kuchotsa ndikuwonjezera ndende yake ya seramu.

Mankhwala osapweteka a antiidal (NSAIDs), COX-2 cycloo oxygenase inhibitors amachepetsa mphamvu ya mankhwala.

Odwala omwe ali ndi vuto laimpso, amagwiritsanso ntchito mankhwalawa komanso ma NSAIDs, kuphatikizapo kusankha ma inhibitors a COX-2, amatha kupititsa patsogolo ntchito yaimpso. Zotsatira zamachitidwe izi zimasinthidwa.

Kutsika kwa plasma wozungulira yogwira metabolite pakagwiritsidwe ntchito ka fluconazole osakanikirana ndi Cozaar kumawonjezera ndende ya losartan m'madzi a m'magazi.

Mafanizo a Cozaar ndi awa: blocktran, Lozap, Losartan, Lorista, Angizar, Kardomin-Sanovel, Giperzar, Ksartan, Klosart, Lozartin, Losar, Presartan, Pulsar, Erinorm, Advantan, Votum, Aprovel, Vazar, Valsacor, Vanatex, Vanatex Irbetan, Candesar, Cantab, Kasark, Mikardis, Teveten, Firmasta, Hizart, Edarbi.

Kugwiritsa Ntchito Mimba

Amayi oyembekezera sayenera kumwa Cozaar chifukwa kumwa mankhwalawa kungakhale koopsa kwa mwana wosabadwayo. Ngati mukufuna kukhala ndi pakati, kambiranani ndi dokotala mankhwala ena omwe mungatenge kuti muchepetse kuthamanga kwa magazi. Mimba ikachitika mukamamwa mankhwalawo, siyani chithandizo chamanthawi yomweyo ndipo pitani kuchipatala.

Sizikudziwika ngati losachedwa limadutsa mkaka wa m'mawere. Popeza kuopsa kwa odwala omwe ali ndi zaka zosakwana 6, muyenera kusiya kudyetsa kwa nthawi yogwiritsa ntchito mankhwalawa.

Malo osungira

Sungani mankhwalawo kutali ndi kuwala kwa dzuwa pa kutentha osapitirira 30 digiri Celsius pamalo pomwe ana ndi ziweto sangathe kuzimva.

Piritsi lililonse limakhala ndi 25, 50, kapena 100 mg ya potaziyamu losartan wogwira. Zowonjezera zina, microcrystalline cellulose ndi hydrate lactose, pregelatinized starch, magnesium stearate ndi hydroxyproxy cellulose ndi hydroxyproxy methyl cellulose, titanium dioxide, wax wa carnauba.