Kodi pali kusiyana kotani pakati pa Ramipril ndi analogues, ndemanga za odwala zimati chiyani ndikugwiritsa ntchito molingana ndi malangizo?

Mapuloteni a plasma omwe amamangirira ramipril ndi 73%, ramiprilat ndi 56%. Bioavailability pambuyo pakamwa makonzedwe a 2,5-5 mg wa ramipril ndi 15-28%, kwa ramiprilat - 45%. Pambuyo potenga ramipril tsiku lililonse pa mlingo wa 5 mg / tsiku, ndende ya plasma ramiprilate yolimba imafika tsiku 4.
T1 / 2 ya ramipril - 5.1 h, pakugawa ndikuchotsa, kutsika kwa ramiprilat mu seramu yamagazi kumachitika ndi T1 / 2 - 3 h, kenako gawo losinthira ndi T1 / 2 - 15 h likutsatira, ndipo gawo lomaliza lalitali kwambiri la ozungulira la ramiprilat mu plasma ndi T1 / 2 - 4-5 masiku. T1 / 2 amawonjezeka chifukwa cha kulephera kwa impso. Vd ramipril - 90 l, ramiprilata - 500 l. 60% imachotsedwa impso, 40% kudzera m'matumbo (makamaka mwa ma metabolites). Pankhani ya kuwonongeka kwa impso, mawonekedwe a ramipril ndi metabolites amachedwa molingana ndi kuchepa kwa CC, vuto la chiwindi silili bwino, kutembenuka ku ramiprilat kumachepetsa, ndipo mu mtima kulephera, kukhazikika kwa ramiprilat kumawonjezeka ndi 1.5-1.8 nthawi.

Zisonyezero zogwiritsidwa ntchito:
Zisonyezero zamankhwala Ramipril Awa ndi matenda oopsa, matenda oopsa a mtima, kulephera kwa mtima komwe kumayamba masiku ochepa pambuyo panjira yodwala, kudwala matenda ashuga ndi matenda a m'mimba, kuchepa kwa kufooka kwa mtima ndi matenda a mtima, kuphatikizapo odwala ndi matenda amitsempha a coronary (kapena osakhala ndi mbiri yodwala kwamtima), odwala omwe amachitidwa mozungulira matembenuzidwe a coronary angioplasty, opaleshoni yam'mimba yodutsa, ndi insulin kuti mbiri ndi odwala ndi zotumphukira wolumikizira matenda occlusive.

Njira yogwiritsira ntchito

Mapiritsi Ramipril kumwa pakamwa, ndi matenda oopsa - woyamba mankhwalawa - 2,5 mg kamodzi patsiku, ndi chithandizo cha nthawi yayitali - 2.5- 20 mg / tsiku mu 1-2 waukulu. Ndi kulephera kwa mtima pambuyo pa infarction nthawi, koyamba mlingo wa 2,5 mg 2 pa tsiku, ngati mukulephera - 5 mg 2 kawiri pa tsiku, kwambiri hypotension kapena motsutsana ndi maziko a okodzetsa - 1.25 mg kawiri pa tsiku. Pakulephera kwa impso (kusefedwa kwa glomerular kosakwana 40 ml / mphindi ndi mtundu wa creatinine woposa 0.22 mmol / l), mlingo woyambirira ndi 1/4 ya mlingo wamba ndi kukwera pang'onopang'ono mpaka 5 mg / tsiku (osatinso).

Zotsatira zoyipa

Kuchokera pamtima dongosolo: ochepa hypotension, osowa - kupweteka pachifuwa, tachycardia.
Kuchokera kumbali ya chapakati mantha dongosolo: chizungulire, kufooka, kupweteka mutu, osowa - zosokoneza tulo, zosangalatsa.
Kuchokera pamimba: kupukusira m'mimba, kudzimbidwa, kusowa kudya, kawirikawiri - stomatitis, kupweteka kwam'mimba, kapamba, cholestatic jaundice.
Kuchokera pakupuma dongosolo: chifuwa chowuma, bronchitis, sinusitis.
Kuchokera kwamikodzo dongosolo: kawirikawiri - proteinuria, kuchuluka kwa kuchuluka kwa creatinine ndi urea m'magazi (makamaka odwala omwe ali ndi vuto laimpso).
Kuchokera ku hemopoietic dongosolo: kawirikawiri - neutropenia, agranulocytosis, thrombocytopenia, kuchepa magazi.
Kumbali ya zowonetsa zasayansi: hypokalemia, hyponatremia.
Thupi lawo siligwirizana: zotupa pakhungu, angioedema ndi zina hypersensitivity zimachitikira.
Zina: kawirikawiri - minofu kukokana, kusabala, alopecia.

Contraindication

Contraindication kugwiritsa ntchito mankhwalawa Ramipril A: aimpso kwambiri ndi hepatic kukanika, zamkati aimpso mtsempha wamagazi, stenosis pambuyo pa kupatsirana kwa impso, chachikulu hyperaldosteronism, hyperkalemia, stenosis wa aortic orifice, kutenga pakati, kuyamwa chidwi cha ramipril ndi zoletsa zina za ACE.

Kuchita ndi mankhwala ena

Pogwiritsa ntchito munthawi yomweyo kugwiritsa ntchito potaziyamu wotsekemera (kuphatikizapo spironolactone, triamteren, amiloride), kukonzekera kwa potaziyamu, mchere wothandizidwa ndi zakudya komanso zowonjezera pazakudya zomwe zimakhala ndi potaziyamu, hyperkalemia imatha kupezeka (makamaka odwala omwe ali ndi vuto la impso), chifukwa ACE zoletsa amachepetsa zomwe zili aldosterone, zomwe zimayambitsa kuchepa kwa potaziyamu m'thupi motsutsana ndi kumbuyo kwa kuchepetsa kwa potaziyamu kapena kuchuluka kwake.
Pogwiritsa ntchito munthawi yomweyo ndi NSAIDs, ndizotheka kuchepetsa mphamvu ya antihypertensive ya ramipril, matenda aimpso.
Pogwiritsa ntchito munthawi yomweyo ndi loop kapena thiazide diuretics, mphamvu ya antihypertensive imatheka. Mokulitsa ochepa hypotension, makamaka atatenga koyamba muyezo wa okodzetsa, akuwoneka kuti ali ndi vuto la hypovolemia, lomwe limapangitsa kuchepa kwapang'onopang'ono kwa mphamvu ya ramipril. Pali chiopsezo cha hypokalemia. Chiwopsezo chowonjezeka cha impso.
Pogwiritsa ntchito munthawi yomweyo ndi othandizira omwe ali ndi vuto la hypotensive, kuwonjezereka kwa hypotensive zotsatira ndikotheka.
Pogwiritsa ntchito munthawi yomweyo ndi ma immunosuppressants, cystostatics, allopurinol, procainamide, chiwopsezo chokhala ndi leukopenia nchotheka.
Ndi munthawi yomweyo kugwiritsa ntchito insulin, hypoglycemic othandizira, sulfonylureas, metformin, hypoglycemia ikhoza kukhala.
Pogwiritsa ntchito munthawi yomweyo ndi allopurinol, cystostatics, immunosuppressants, procainamide, chiwopsezo chokhala ndi leukopenia nchotheka.
Pogwiritsa ntchito munthawi yomweyo ndi lithiamu carbonate, kuwonjezereka kwa seramu lifiyamu ndende ndikotheka.

Bongo

Zizindikiro za mankhwala osokoneza bongo Ramipril: pachimake ochepa hypotension, cerebrovascular ngozi, angioedema, myocardial infarction, thromboembolic zovuta.
Chithandizo: Kuchepetsa mlingo kapena kusiya mankhwala kwathunthu, kupuma kwamatumbo, kusunthira wodwala pambali, ndikuchitapo kanthu kuti achulukitse BCC (yoyang'anira isotonic sodium chloride solution, kufalitsa madzi ena obwezeretsanso magazi), chizindikiro chothandizira: epinephrine (s / c kapena iv), hydrocortisone (iv), antihistamines.

Ramipril - yogwira ntchito

Zomwe zimapangitsa zimagwira ntchito zake pakapangidwe kake. Mapiritsi a Ramipril amachita chifukwa cha chinthu chachikulu - ramipril.

Gome 1. Zinthu zomwe zidagwiritsidwa ntchito ndi Ramipril ndi zotsatira zake.

Chifukwa chiyani mapiritsi a ramipril?

Mankhwala a Ramipril adadzikhazikitsa ngati mankhwala apamwamba komanso othandiza. Makamaka, mankhwalawa amagwiritsidwa ntchito bwino:

1. Kuthamanga kwa magazi. Chipangizochi, mogwirizana ndi malangizo, chimayikidwa kuti chikwaniritse mipherezero ya systolic ndi diastolic.
2. Chithandizo cha matenda angapo a mtima. Momwe mungatenge mapiritsi a Ramipril, pazomwe ndi mu zomwe Mlingo wake umatengera mwachindunji matendawa.
3. Kugwiritsa ntchito kupewa matenda a mtima ndi mitsempha yamagazi pozindikira zoopsa.
4. Kupewa kufa chifukwa cha mtima.

Kutulutsa mawonekedwe ndi kapangidwe kake

Chidachi chimapezeka pamaziko a zomwe zimagwiranso ntchito. Consistency, mayamwa mayamwidwe ndi moyo wautalifufufu amayambitsa zinthu zina.

Malinga ndi malangizo ogwiritsira ntchito, mankhwalawa Ramipril amakhalanso ndi:

1. Lactose mfulu. Vutoli limadziwikanso kuti shuga ya mkaka. Kugwiritsa ntchito ngati kukonza mafuta piritsi, ndiwowonjezera mphamvu.
2. Povidone. Amatanthauzira ma enterosorbents, amalimbikitsa kumasulidwa kwa chinthu chogwira ntchito.
3. Cellulose Kugwiritsa ntchito mawonekedwe a microcrystalline ufa, amalola piritsi kuti ikhalebe.
4. Stearic acid. Yokhazikika mafuta acid, emulsifier ndi okhazikika.
5. Crospovidone. Zimalimbikitsa kumasulidwa ndi kuyamwa kwa zinthu zomwe zimagwira.
6. Sodium bicarbonate. Amadziwika kuti ndi soda, ndi okhazikika.

Ramipril (mawonekedwe a kumasulidwa - mapiritsi okha) akupezeka mu zotsatirazi:

1. 2,5 mg Mapiritsi oyera / pafupifupi oyera, okhala ndi matuza ndi kabokosi katoni. Aliyense zidutswa 10, 14 kapena 28.
2. Ramipril 5 mg. Mapiritsi oyera / oyera-oyera imvi, osadulidwa. M'mutu 10/14/28. Matumba amadzaza pabokosi lamakhadi. Paketi iliyonse ili ndi malangizo ogwiritsa ntchito.
3. Ramipril 10 mg. Amakhala ndi tint yoyera / pafupifupi yoyera, omwe sanapangidwe. Mapiritsi ali m'matumba a zidutswa za 10/14/28. Wogulitsa mu katoni kadongosolo komanso malangizo ogwiritsira ntchito.

Ramipril, mlingo womwe umatsimikiziridwa ndi katswiri, ndi mankhwala.

Ramipril-sz

Ramipril-SZ ndi Ramipril ndi zofananira. Taphunzira malangizo a momwe tingagwiritsire ntchito mankhwalawa, titha kunena kuti kapangidwe kake ndi chimodzimodzi komanso chimodzimodzi.

Ndemanga za odwala zimakhala zabwino. Makamaka:

1. Mapiritsi ochokera ku kupanikizika kwa Ramipril amakhala ndi zotsatira zake mwachangu. Malinga ndi malangizo ogwiritsira ntchito, pakangopita mphindi 15, mkhalidwe wa wodwalayo umayamba kuyenda bwino.
2. Kukhalitsa. Malipiro amakhalapo kwa maola 12- 24.
3. Mukamalemba maphunziro, pamakhala kusintha pamitundu ndi moyo wabwino.
4. Zotsatira zoyipa ndizosowa komanso zimakhala ndi mawonekedwe ofatsa.

Zogulitsa zina zofananira zomwe zimatulutsidwa pansi pa dzina lina. Pyramil ndi Ramipril, kapangidwe kake kamene kamasiyana muzinthu zina zothandizira, ndi mankhwala osinthika. Mankhwala akuwonetsa zotsatira zabwino pochiza matenda oopsa. Ndikulimbikitsidwanso:

• mitundu yosiyanasiyana ya matenda a mtima a ischemic,
• Kulephera kwa mtima,
• nephropathy yoyambitsidwa ndi matenda ashuga,
• ndi mtima pathologies (sitiroko, matenda),
• popewa matenda ena ndi imfa.

Zambiri mwatsatanetsatane pazomwe Pyramil ili, momwe mungatengere molondola, ndipo momwezoletsedwa, ili ndi malangizo ogwiritsa ntchito.

Mankhwala abwino ogwiritsidwa ntchito pochiritsa matenda ambiri a m'magazi. Imakhala ndi zofanana komanso kapangidwe kake. Malinga ndi kafukufuku yemwe adachitika mu 1990s, kuthana ndikwabwino kuposa mankhwala ena ambiri (mwachitsanzo, enalapril). Zovuta zazikulu za Hartil zimaphatikizapo mtengo wake. Pafupifupi, mankhwalawa amawononga mtengo wowirikiza 3-4 kuposa Ramipril (zikuwonetsa kuti ndalama zizigwiritsidwa ntchito chimodzimodzi). Zoletsedwa:

• azimayi amene akukonzekera kutenga pakati, pakati kapena unamwino,
• ana ndi achinyamata ochepera zaka 18.

Odwala opitilira zaka 65 ayenera kutenga Hartil mosamala. Piritsi yoyamba iyenera kuledzera moyang'aniridwa ndi katswiri.

Ndi njira yowonjezera yamankhwala. Kutchuka kokwanira kumachitika chifukwa cha kupezeka kwa kapangidwe kake ka diuretic - hydrochlorothiazide. Thupi limathandizira kuchepetsa kuthamanga kwa magazi ndi kuwonjezeka pang'ono kwa diuresis.

Malinga ndi malangizo ogwiritsira ntchito, mankhwalawa amalimbikitsidwa kwa odwala omwe ali ndi ACE inhibitor monotherapy. Kuti tikwaniritse zotsatira zowoneka bwino, maphunziro a Hartila-D adayikidwa.

Ndani amapanga mankhwala oyamba?

Pali mitundu yambiri yomwe imapanga mankhwala omwe ali ndi mawonekedwe ofanana, koma mwa mayina osiyanasiyana. Ramipril ndi mankhwala oyamba opangidwa ku Russia. Kampani yopanga mankhwala Tatkhimpharmpreparaty ili ku Kazan ndipo yakhala ikugwira ntchito kwa zaka 85. Kampaniyo imatulutsa mitundu yopitilira 100 yamankhwala ndipo imatsimikizira chitetezo cha malonda. Pa tsamba la kampaniyo mutha kupeza malangizo onse kuti agwiritse ntchito.

Zizindikiro zogwiritsidwa ntchito

Mankhwala a Ramipril, malangizo ogwiritsira ntchito omwe ali ndi mndandanda wathunthu wazowonetsa, amawunikira pambuyo pa kufufuza ndi kuwunika. Chida chake chikulimbikitsidwa:

1. Matenda oopsa. Ramipril amathandizira kuchepetsa kukakamiza mu mtundu woyambirira wa matendawa, omwe adatulukira mosiyana ndi ma pathologies ena. Ndiwothandizanso ku matenda oopsa owonjezera chifukwa cha kusokonekera kwa dongosolo.
2. Kulephera kwamtima kosalekeza. Amagwiritsidwa ntchito ngati gawo la mankhwala osakaniza.
3. Matenda a mtima, kuphatikiza pambuyo pobowoleza m'maso.
4. Kuchita zochizira odwala omwe adapulumuka opaleshoni ya mtima (opaleshoni yamkati, angioplasty, etc.).
5. Odwala omwe ali ndi zotupa zam'matumbo, kuphatikizapo mbiri ya sitiroko.
6. Kuchita kupewa matenda amitsempha yamagazi ndi mtima, kupewa.
7. Matenda a shuga ovuta.

Zomwe zimatsimikizira kuthamanga kwa magazi kwa munthu

Malangizo ogwiritsira ntchito

Musanayambe kumwa mankhwalawa, muyenera kudziwa zomwe wopanga amapanga. Malangizo ogwiritsira ntchito ali ndi mndandanda wa zifukwa zoletsa kugwiritsa ntchito mankhwalawa. Mwakutero:

1. Matenda a zokhudza zonse amakhudza minofu yolumikizana (lupus erythematosus, scleroderma).
2. Kusalolera payekhapayekha zigawo zikuluzikulu, kuphatikiza kunyowa kwa lactose.
3. Dokotala wa Quincke edema kapena Quincke edema yemwe adapezeka kale atatenga ndalama zochokera ku ramipril.
4. Matenda a Hypotonic.
5. Kuwonongeka kwa chiwindi kapena impso.
6. Stenosis ya mtsempha wama impso amodzi / awiri, opeza opaleshoni impso.
7. Kuvunda kwa mtima.
8. Kuchuluka kwambiri kwa aldosterone.
9. Gwiritsani ntchito odwala omwe ali ndi shuga omwe amalandila aliskeren ndi ena.

Mndandanda wonse ukuwonetsedwa mu malangizo ogwiritsira ntchito. Musaiwale zowerenga musanayambe kugwiritsa ntchito mankhwala.

Kuchuluka kwa mankhwalawa kumatengera matenda omwe alipo.

Tebulo 2. Mlingo woyenera wa Ramipril matenda osiyanasiyana.

Malinga ndi kafukufuku waposachedwa mu malangizo ogwiritsira ntchito, mankhwalawa ayenera kuyamba kumwa ndi 1.25 mg patsiku. Komabe, lingaliro la wodwala linalake limapangidwa ndi adotolo. Ma regiments atsatanetsatane akuwonetsedwa muzosindikiza.

Kuyenderana ndi mowa

Mankhwala sayenera kuphatikizidwa ndi mowa pazifukwa zina:

1. Mowa umatsogolera mankhwalawa. Kuchepetsa kwambiri magazi kungayambitse zovuta zazikulu kapena kufa kwa wodwalayo.
2. Kuchuluka kwa kawopsedwe. Mankhwala ndi ethanol amawononga thupi, zimapangitsa kuti hangover ikhale yoipa, ndipo zimayambitsa zovuta zina.

Umboni wa odwala omwe amamwa mankhwala kuti akakamizidwe

Maganizo a ogwiritsa ntchito pa intaneti sayenera kukhala njira yayikulu yoyesera mankhwalawa. Kusankhidwa kwa mankhwalawa ndi munthu payekha. Ramipril, ndemanga zomwe zimakhala ndi zotsutsana, zikulimbikitsidwa:

• kuthamanga kwa kuchitapo kanthu
• kukhalitsa
• kuthekera kwa mlingo umodzi,
• mtengo wololera
• mwayi wogula ku pharmacy iliyonse.

Odwala ena amati mankhwalawo analibe mphamvu pambuyo pa utsogoleri kapena adayambitsa mavuto. Nthawi zambiri anthu amadandaula za:

• chifuwa chowuma,
• kuwonongeka mu moyo wa kugonana,
• kutuluka thukuta kwambiri.

Chinsinsi cha Latin

Ramipril (Chinsinsi ku Latin - Tab. Ramiprili) amapangidwa ndi makampani angapo. Kusokonekera kotereku kumakupatsani mwayi wofotokoza chida chomwechi ngakhale pansi pa mayina osiyanasiyana ogulitsa (ma syonyms). Komabe, kugula mankhwala popanda chilolezo cha katswiri sikuyenera.

Pali mitundu ingapo ya mankhwalawa omwe ali ndi vutoli. Ramipril, analogues omwe amaimiridwa kwambiri, amatha m'malo mwa mgwirizano ndi dokotala.

Poganizira za Ramipril ndi Enalapril, zomwe ndizovuta kunena motsimikiza. Mankhwala ali ndi zosiyana zingapo:

1. Zogwira ntchito. Yogwira pophika mu enalapril ndi enalapril.
2. Enalapril amawonedwa ngati mankhwala osagwira bwino, koma lingaliro ili ndilogwirizana. Mwa odwala osiyanasiyana, zotsatira zake zimakhala zosiyana.
3. Mtengo. Enalapril ndi wotsika mtengo kwambiri ngati mankhwala a analogue.

Lisinopril

Malinga ndi kafukufuku wapadziko lonse ndi NORA, Lisinopril siothandiza kwenikweni poyerekeza ndi analogue.

Poganizira za Ramipril ndi Lisinopril, omwe ndi abwino komanso ogwira ntchito, asayansi adazindikira kuti mankhwala oyamba amatha kusintha mtundu komanso chiyembekezo cha moyo wa wodwala wamtima komanso matenda a mtima. Phunziroli lidakhudza anthu 10,000.

Perindopril

Perindopril amadziwika ndi kufooka kwa hypotensive zotsatira, ndizofunikira makamaka pa mlingo woyamba. Ndikulimbikitsidwa kuyisankha ngati vuto la kufalikira kwa magazi. Nthawi zambiri amagwiritsidwa ntchito ngati gawo limodzi la mankhwala othandizira kuphatikiza ndi okodzetsa. Poyerekeza Ramipril ndi Perindopril, omwe ali bwino komanso ogwira ntchito, madokotala ambiri amakonda njira yoyamba. Komabe, lingaliro lomaliza limatengera mlandu womwe waperekedwa.