Momwe mungagwiritsire ntchito Lorista ND pa matenda ashuga

Chithandizo chogwira ntchito cha Lorista ndi losartan, chomwe chimatha kuletsa ma angiotensin 2 receptors mu mtima, impso, mitsempha yamagazi, adrenal cortex, yomwe imayambitsa kuchepa kwa vasoconstriction (kupatula lumen ya mitsempha), kuchepa kwa kukhudzika kwathunthu kwa magazi ndipo, chifukwa chake, kutsika kwa magazi.

Pankhani ya kukomoka kwa mtima kwa Lorista, kuwunikira kumatsimikizira kuti kumawonjezera kupirira kwa odwala omwe ali ndi chidwi chamthupi, komanso kumalepheretsa chitukuko cha myocardial hypertrophy. Kuchuluka kwa losartan m'magazi kumatha kuwonedwa pakapita ola limodzi pambuyo pa kukonzekera kwa pakamwa kwa Lorista, pomwe ma metabolites omwe amapangidwa m'chiwindi amayamba kugwira ntchito pambuyo pa maola 2 mpaka 2,5.

Lorista N ndi Lorista ND ndi mankhwala osakanikirana, zomwe zimagwira omwe ndi losartan ndi hydrochlorothiazide. Hydrochlorothiazide ili ndi diuretic zotsatira, chifukwa cha kuthekera kwa chinthu kupangitsa njira ya gawo lachiwiri pokodza, ndiko kubwezeretsa (mayamwidwe) kwamadzi, magnesium, potaziyamu, chlorine, sodium ions, komanso kuchepetsedwa kwa exretion wa uric acid ndi calcium ion. Hydrochlorothiazide ili ndi malo ochititsa chidwi, omwe amafotokozedwa ndi zochita zake zomwe zikufuna kuwonjezera arterioles.

Mphamvu ya diuretiki ya chinthu ichi imatha kuwonedwa pakatha maola 1-2 pambuyo pa ntchito ya Lorista N, pomwe zotsatira za hypotensive zimayamba mu masiku 3-4.

Zizindikiro Lorista

Malangizowo akuwonetsa kuti mankhwala a Lorista agwiritsidwe ntchito ngati:

• ochepa matenda oopsa
• lamanzere lamitsempha lamanzere ndi matenda oopsa kuti achepetse kuvulala,
• Kulephera kwa mtima, ngati njira yophatikiza,
• nephrology mwa odwala omwe ali ndi matenda a shuga 2 kuti achepetse protenuria (kukhalapo kwa mapuloteni mu mkodzo).

Malinga ndi malangizo, a Lorista N amapatsidwa mankhwala ngati kuli koyenera, kuphatikiza mankhwala a antihypertensive ndi okodzetsa.

Contraindication

Lorista, ntchito kumakhudzana ndi upangiri wamankhwala, isanalembedwe kuchepa kwa magazi, kuchepa magazi, kuchepa kwa magazi, kuchepa kwa magazi, kuchepa kwa shuga ndi galactose mayamwidwe, hypersensitivity to losartan. Muyenera kusiya kugwiritsa ntchito Lorista kwa odwala omwe ali ndi pakati komanso oyamwitsa, komanso anthu azaka zosakwana 18. Lorista N, kuwonjezera pa contraindication pamwambapa, sanalembedwe kupweteka kwambiri kwaimpso kapena kwa chiwindi ndi anuria (kusowa kwamkodzo mu chikhodzodzo).

Mosamala, mapiritsi a Lorista amayenera kumwedwa kwa anthu omwe ali ndi aimpso kapena a hepatic insuffential, okhala ndi vuto lamagetsi am'magetsi, omwe amakhala ndi magazi ochepetsedwa.

Malangizo ogwiritsira ntchito Lorista

Lorista imapezeka mu mapiritsi okhala ndi 100, 50, 25 kapena 12,5 mg wa potaziyamu losartan. Mankhwala ayenera kumwedwa pakamwa kamodzi patsiku.

Pankhani ya matenda oopsa a arterial, kuti muchepetse vuto la stroke, komanso kuteteza impso mwa odwala omwe ali ndi matenda osokoneza bongo, mapiritsi a Lorista akulimbikitsidwa kuti mutenge mapiritsi a Lorista tsiku lililonse 50 mg. Ngati ndi kotheka, kuti mukwaniritse tanthauzo lake, mlingowo utha kuwonjezeka mpaka 100 mg patsiku. Malinga ndi ndemanga, a Lorista amakulitsa mphamvu yake yotsatsira mkati mwa masabata 3-6 Ndi makonzedwe a munthawi yomweyo okodzetsa ambiri, ntchito ya Lorista iyenera kuyamba 25 mg tsiku lililonse. Komanso, m'munsi mlingo wa mankhwalawa umalimbikitsidwa kwa anthu omwe ali ndi vuto la chiwindi.

Pankhani ya kuperewera kwakakwanira, mankhwala a Lorista, momwe ntchito imakhudzira munthawi yomweyo okodzetsa ndi mtima wama glycosides, amagwiritsidwa ntchito molingana ndi chiwembu china. Mkati mwa sabata loyamba la mankhwalawa, Lorista ayenera kumwa 12,5 mg patsiku, ndiye kuti sabata iliyonse mlingo wa tsiku ndi tsiku uyenera kuchuluka ndi 12,5 mg. Ngati mankhwalawa atengedwa molondola, sabata lachinayi la chithandizo lidzayambitsidwa ndi 50 mg ya Lorista patsiku. Mankhwala ena ndi Lorista amayenera kupitilizidwa ndi mlingo wa 50 mg.

Lorista N ndi piritsi lokhala ndi 50 mg ya losartan ndi 12.5 mg ya hydrochlorothiazide.

Mapiritsi a Lorista ND ali ndi kuphatikiza komweko kwa zinthu, kokha kawiri - 100 mg ya losartan ndi 25 mg ya hydrochlorothiazide.

Ndi matenda oopsa kwambiri, mankhwalawa tsiku lililonse a Lorista N ndi piritsi limodzi, ngati kuli kotheka, mapiritsi awiri patsiku amaloledwa. Ngati wodwala akuchepa kuchuluka kwa magazi, magazi amayenera kuyamba ndi 25 mg. Mapiritsi a Lorista N ayenera kutengedwa pambuyo pokonzanso kuchuluka kwa magazi ozungulira komanso kuthetsedwa kwa okodzetsa.

Malinga ndi ndemanga, ndikofunikira kutenga Lorista N pachiwopsezo cha matenda amtima ngati losartan monotherapy sichinathandizire kufikira gawo la kuthamanga kwa magazi. Mlingo woyenera wa mankhwala patsiku ndi mapiritsi a 1-2.

Zotsatira zoyipa

Zotsatira zoyipa za mapiritsi a Lorista ndi mayesero azachipatala amaphatikizapo:

• kupweteka mutu, kugona tulo, kutopa, chizungulire, asthenia, kusokonezeka kwa kukumbukira, kunjenjemera, migraine, kukhumudwa,
• mlingo wodalira mlingo, bradycardia, tachycardia, palpitations, angina pectoris, arrhythmia, vasculitis,
• bronchitis, chifuwa, pharyngitis, kupindika m'mphuno kapena kutupa, kufupika kwa mpweya,
• kupweteka kwam'mimba, kutsegula m'mimba, kusanza, mkamwa wowuma, matenda am'mimba, kuphwanya masana, kudzimbidwa, kusanza, kupweteka mano, kuphwanya chiwindi,
• matenda a kwamkodzo thirakiti, kukodza kosalamulira, ntchito yaimpso, kuwonjezeka kwa seramu creatinine ndi urea,
• kuchepa kwa kugonana, kusabala,
• kupweteka kumbuyo, miyendo, chifuwa, kukokana, kupweteka kwa minofu, nyamakazi, arthralgia,
• conjunctivitis, kuwonongeka kwa mawonekedwe, kusokonezeka kwa kukoma, tinnitus,
• erythema (redness of the khungu, hasira ndi kukula kwa capillaries), kuchuluka thukuta, khungu lowuma, phytosensitization (kuchuluka kwa mphamvu ya radiation ya ultraviolet), kuchepa kwambiri kwa tsitsi,
• gout, hyperkalemia, kuchepa magazi,
• angioedema, zotupa pakhungu, kuyabwa, urticaria.

Monga lamulo, zomwe zalembedwera mosavomerezeka chifukwa cha mankhwala a Lorista ali ndi kanthawi kochepa komanso ofooka.

Zotsatira zoyipa za Lorista N zimachitika m'njira zambiri zofanana ndi zomwe zimachitika munyumba yogwiritsira ntchito Lorista.

Mimba komanso kuyamwa

Dongosolo la epidemiological pa chiopsezo cha teratogenicity mukamamwa ma ACE inhibitors mu trimester yoyamba ya mimba samalola kumaliza komaliza, koma kuwonjezeka pang'ono pangozi sikumayikidwa pambali. Ngakhale kuti palibe deta yolamulidwa ya mliri wa ARA-I, zoopsa zofananazi sizingatengedwenso mgulu la mankhwalawa. Pokhapokha ngati ndizosatheka m'malo mwa ARA-I pogwiritsa ntchito njira zina zochiritsira, odwala omwe akukonzekera kukhala ndi pakati ayenera kusinthidwa kukhala mankhwala osokoneza bongo, momwe malingaliro apamwamba a azimayi apakati amamveka bwino. Mimba ikachitika, ARA-ndiyenera kuyimitsidwa nthawi yomweyo, ndipo ngati pakufunika kutero, mankhwalawa ayenera kuyikidwa. Ndi kugwiritsa ntchito ARA-I mu trimesters yachiwiri ndi yachitatu ya kutenga pakati, chiwonetsero cha fetotoxic zotsatira (mkhutu waimpso, oligohydroamniosis, kuchedwa kwa mafupa a chigaza) ndi neonatal toxity (kulephera kwa impso, hypotension, hyperkalemia). Ngati APA-II idayendetsedwa mu gawo lachiwiri kapena lachitatu la amayi omwe ali ndi pakati, ndikulimbikitsidwa kuti ndichite ultrasound ya impso ndi chigaza mafupa. Mu akhanda omwe amayi awo adatenga ALAMMA, ndikofunikira kuyang'anitsitsa kuthamanga kwa magazi kuteteza kukula kwa hypotension.

Zambiri zakugwiritsa ntchito hydrochlorothiazide pa nthawi ya pakati ndizochepa, makamaka kwa trimester yoyamba. Hydrochlorothiazide idutsa placenta. Kutengera ndi njira ya pharmacological yogwiritsira ntchito, titha kunena kuti kugwiritsa ntchito kwake kwachiwiri komanso kachitatu kwa mimba kumatha kusokoneza kuchulukitsidwa kwa placental ndikuyambitsa kusokonezeka kwa mwana wosabadwayo komanso wakhanda, monga jaundice, electrolyte imbalance ndi thrombocytopenia. Hydrochlorothiazide sayenera kugwiritsidwa ntchito pochotsa edema, gestational matenda oopsa kapena toxicosis yokhala ndi pakati chifukwa choopsa cha kuchepa kwa kuchuluka kwa plasma komanso kukula kwa ploperative hypoperfusion posakhalitsa pakuyenda bwino kwa matendawa.

Hydrochlorothiazide sayenera kugwiritsidwa ntchito pochiza matenda oopsa oopsa mwa azimayi oyembekezera, kupatula nthawi zina zomwe sizingatheke ngati mungagwiritse ntchito njira zina.

Palibe zambiri pakugwiritsa ntchito mankhwalawa Lorista ND panthawi yoyamwitsa. Njira zochiritsira zosagwiritsidwa ntchito masiku onse ziyenera kutumikiridwa ndikugwiritsa ntchito mankhwala omwe amatsimikiziridwa bwino pokhudzana ndi chitetezo panthawi yoyamwitsa, makamaka podyetsa ana akhanda kapena ana asanakwane.

Mlingo ndi makonzedwe

Mankhwala amaloledwa kumwa pamodzi ndi mankhwala ena a antihypertensive.

Mankhwalawa atha kumwa mosasamala chakudya.

Piritsi liyenera kutsukidwa ndi kapu yamadzi.

Kuphatikiza kwa losartan ndi hydrochlorothiazide sikunapangidwe koyamba kuti mugwiritse ntchito mankhwalawa, kugwiritsidwa ntchito kumalimbikitsidwa pakusowa kwa magazi okwanira pogwiritsa ntchito losartan ndi hydrochlorothiazide. Kuphatikizika kwina kwa Mlingo ndikulimbikitsidwa. Ngati pakufunika kuthandizidwa matenda anu, muyenera kuganiziranso za kusintha kwa mankhwalawo kupita ku kuphatikiza kwa mankhwala osakanikirana.

Mulingo wokhazikika wokonza piritsi limodzi la Lorista N (losartan 50 mg / hydrochlorothiazide 12,5 mg) kamodzi patsiku.

Ndi yankho losakwanira la mankhwalawa, mankhwalawa amatha kuchuluka ku piritsi limodzi la Lorista ND (losartan 100 mg / hydrochlorothiazide 25 mg) kamodzi patsiku. Mulingo waukulu ndi piritsi limodzi la Lorista ND (losartan 100 mg / hydrochlorothiazide 25 mg) patsiku.

Monga lamulo, zotsatira za hypotensive zimatheka mkati mwa masabata 3-4 pambuyo poyambira chithandizo.

Gwiritsani ntchito ngati vuto laimpso ndi odwala hemodialysis Odwala omwe ali ndi vuto lochepetsa aimpso (creatinine chilolezo cha 30-50 ml / min), kusintha koyamba kwa mankhwala sikofunikira. Iwo ali osavomerezeka kuti apatsidwe kuphatikiza kwa matenda opweteka kwambiri aimpso (creatinine chilolezo

Bongo

Zambiri mwatsatanetsatane wa Kuphatikiza kwa Losartan 50 mg / Hydrochlorothiazide Kuphatikiza

12,5 mg kulibe.

Mankhwalawa ndi achizindikiro, amathandizira.

Ngati bongo wambiri, mankhwala osokoneza bongo ayenera kusiyidwa, ndipo wodwalayo ayenera kusunthidwa moyang'aniridwa mwamphamvu. Ngati mankhwalawa adatengedwa posachedwa, tikulimbikitsidwa kusanza, komanso kugwiritsa ntchito njira zodziwika bwino zothetsera kupewa kufooka kwa madzi m'thupi, kusalinganika kwa electrolyte, hepatic coma ndi hypotension.

Zambiri zosokoneza bongo ndizochepa. Zizindikiro zotheka, zotheka kukhala izi: hypotension, tachycardia, bradycardia (chifukwa cha kukakamiza kwa parusmpathetic (chifukwa cha kukoka kwa vagus). Ngati hypotension yodziwika bwino ikachitika, chithandizo chamankhwala chiyenera kuyikidwa.

Palibe wolartan kapena metabolite wake wogwira sangatulutsidwe kudzera mu hemodialysis.

Zizindikiro ndizodziwika kwambiri, "hypokalemia, hypochloremia, hyponatremia (chifukwa cha kuchepa kwa kuchuluka kwa ma electrolyte) ndi kuchepa kwa madzi m'thupi (chifukwa cha kuchuluka kwa diresis). Ngati digito yakhazikitsidwa nthawi yomweyo, hypokalemia ikhoza kuyambitsa kuchulukitsa kwa mtima.

Kuchuluka kwa hydrochlorothiazide komwe amamufukula pa hemodialysis sikudziwika.

Kuchita ndi mankhwala ena

Rifampicin ndi fluconazole amachepetsa ndende ya yogwira metabolite. Zotsatira zakuchipatala za kulumikizanaku sizinaphunzire.

Monga momwe zimakhalira ndi mankhwala ena omwe amatchinga angiotensin II kapena amachepetsa mphamvu yake, kugwiritsa ntchito potaziyamu potulutsa diuretics (spironolactone, triamteren, amiloride), komanso zowonjezera za potaziyamu komanso zotulutsa mchere zimatha kuonjezera kuchuluka kwa potaziyamu m'madzi a m'magazi. Kugwiritsa ntchito mankhwalawa munthawi yomweyo sikulimbikitsidwa.

Monga mankhwala ena omwe amakhudza sodium excretion, losartan amatha kuchepetsa kutuluka kwa lithiamu kuchokera mthupi. Chifukwa chake, pogwiritsa ntchito munthawi yomweyo APA-II ndi mchere wa lithiamu, munthu ayenera kuwunika mosamala kuchuluka kwa omwe amapezeka m'madzi a m'magazi.

Ndi kuphatikiza kwa APA-II ndi mankhwala osapatsirana a anti-yotupa (NSAIDs) (mwachitsanzo, kusankha ma cycloo oxygenase-2 inhibitors (COX-2), acetylsalicylic acid mu Mlingo wothana ndi kutupa ndi NSAIDs zosasankha), zotsatira za hypotensive zitha kufooka. Kugwiritsira ntchito kwa ARA-I kapena okodzetsa omwe ali ndi ma NSAIDs kungakulitse chiwopsezo cha ntchito yaimpso, kuphatikizapo kuperewera kwaimpso, komanso kungayambitse kuchuluka kwa plasma potaziyamu (makamaka kwa odwala omwe ali ndi vuto laimpso). Kuphatikiza uku kuyenera kugwiritsidwa ntchito mosamala, makamaka kwa okalamba. Odwala ayenera kulandira kuchuluka kwa madzimadzi, akuyenera kulingaliranso magwiridwe antchito a impso pambuyo poyambira kuphatikizika kwa mankhwala komanso nthawi yamankhwala.

Odwala ena omwe ali ndi vuto laimpso, kuphatikizapo. COX-2 zoletsa, kugwiritsa ntchito kwa APA-II kungapangitse kuti ndizipitilira kuwonongeka kwa impso. Komabe, izi zimasinthidwa.

Mankhwala ena okhala ndi hypotensive zotsatira ndi tricyclic antidepressants, antipsychotic mankhwala, baclofen ndi amifostine. Kugwiritsa ntchito losartan ndi mankhwalawa kumawonjezera chiopsezo cha hypotension.

Ndi kuphatikiza kwa thiazide diuretics ndi mankhwala otsatirawa, kuyanjana kungaoneke.

Ethanol, barbiturates, mankhwala osokoneza bongo komanso antidepressants.

Mankhwala a antiidiabetesic (mkamwa ndi insulin)

Kugwiritsa ntchito thiazides kungakhudze kulolera kwa glucose, chifukwa chomwe kusintha kwa mankhwalawa kwa mankhwala othandizira kungakhale kofunikira. Metformin iyenera kugwiritsidwa ntchito mosamala chifukwa cha chiopsezo cha lactic acidosis chifukwa cha kulephera kwa ntchito kwaimpso komwe kumagwirizana ndi kugwiritsa ntchito hydrochlorothiazide.

Mankhwala ena a antihypertensive Mankhwala othandizira.

Cholestyramine ndi ma colestipol resins

Mafuta a hydrochlorothiazide amachepetsedwa atayatsidwa ma resion othandizira. Mlingo umodzi wa cholestyramine kapena ma colestipol resins umamangiriza hydrochlorothiazide, kuchepetsa kuyamwa kwake m'mimba thirakiti ndi 85% ndi 43%, motero. Corticosteroids, adrenocorticotropic hormone (ACTH)

Kuchepa kutchulidwa mu ndende zamagetsi (makamaka, hypokalemia). Ma Pressor amines (mwachitsanzo adrenaline)

Kufooka kwa mawonekedwe a mabotolo a Pressor ndikotheka, zomwe, komabe, ndizosakwanira kupewa kugwiritsa ntchito.

Mafupa a minofu opuma, osasokoneza bongo (mwachitsanzo tubocurarine) Kuwonjezereka kwa chiwopsezo cha opuma minofu.

Ma diuretics amachepetsa kutsimikizika kwa impso ndi kuonjezera chiopsezo cha zovuta zake. Kugwirizana sikulimbikitsidwa.

Mankhwala omwe amagwiritsidwa ntchito pochiza gout (probenecid, sulfinpyrazone ndi allopurinol)

Kusintha kwa mankhwala omwe amalimbikitsa kuchulukitsidwa kwa uric acid kungakhale kofunikira, popeza kugwiritsa ntchito hydrochlorothiazide kungayambitse kuchuluka kwa uric acid m'madzi a m'magazi. Mungafunike kuwonjezera kuchuluka kwa mankhwala a phenenosis kapena sulfinpyrazone. Mankhwala a Thiazide amatha kukulitsa mwayi wokhala ndi hypersensitivity to allopurinol.

Anticholinergics (mwachitsanzo atropine, biperiden)

Chifukwa cha kuwonongeka kwa matumbo am'mimba komanso kutsekemera kwa m'mimba, bioavailability wa thiazide diuretics imakulanso.

Othandizira a Cytotoxic (mwachitsanzo, cyclophosphamide, methotrexate)

Thiazides amatha kuchepetsa kuchuluka kwa mankhwala a cytotoxic mu mkodzo ndikuwongolera zochita zawo zomwe zimalimbana ndikuwapanikiza ntchito yamafupa.

Mukamagwiritsa ntchito mankhwala a salicylates okwanira, hydrochlorothiazide imatha kuwongolera zovuta zawo pakatikati kwamanjenje. ,

Milandu yapadera ya hemolytic anemia yadziwika ndi kuphatikiza kwa hydrochlorothiazide ndi methyldopa.

Kugwiritsa ntchito cyclosporine moyenera kumawonjezera chiopsezo cha hyperuricemia ndi gouty.

Hypokalemia kapena hypomagnesemia yoyambitsidwa ndi thiazide diuretics imatha kubweretsa kuwukira kwa mtima chifukwa cha digitis.

Mankhwala omwe zochita zawo zimasintha ndikusintha kwa potaziyamu m'magazi

Kutsimikiza kwakanthawi kwamachulukidwe a potaziyamu ndikuwunikira kwa ECG kumalimbikitsidwa pakagwiritsidwa ntchito kosakanikirana ndi losartan / hydrochlorothiazide ndi mankhwala, zotsatira zake zimatengera kuchuluka kwa potaziyamu m'magazi am'magazi (mwachitsanzo, digitalis glycosides ndi antiarrhythmic mankhwala) komanso mankhwala omwe amayambitsa "torsades de point" ( ventricular tachycardia), kuphatikiza mankhwala ena a antiarrhythmic (hypokalemia ndi chinthu chodziwika bwino mu tricyularia yamitsempha yamagazi:

mankhwala a antiarrhythmic mankhwala a class 1a (quinidine, hydroquinidine, disopyramide), gulu la mankhwala a antiarrhythmic (amiodarone, sotalol, dofetilide, ibutilide),

mankhwala ena a antipsychotic (thioridazine, chlorpromazine, levomepromazine, trifluoperazin, cyamemazine, sulpiride, sultopride, amisulpride, tiapride, pimozide, haloperidol, droperidol),

ena (bepridil, cisapride, difemanil, erythromycin (kwa makina othandizira mafupa), halofantrine, misolastine, pentamidine, terfenadine, vincamine (kwa dongosolo la intravenous).

Liazide diuretics imatha kuwonjezera kuchuluka kwa calcium mumadzi am'magazi mwa kuchepetsa kuphipha kwawo. Ngati ndi kotheka, kuikidwa kwa mankhwalawa kuyenera kuwunika kuchuluka kwa calcium ndipo, malinga ndi zotsatira zake, muzichita kusintha kwa mlingo.

Zotsatira pazotsatira zasayansi

Pokhudzana ndi kagayidwe ka calcium, thiazide diuretics imatha kupotoza zotsatira za maphunziro a ntchito ya gathy ya parathyroid.

Pali chiopsezo cha chisonyezo cha hyponatremia. Zotsatira zamankhwala komanso kwachilengedwe kwa wodwalayo ndizofunikira.

Pankhani yakusowa kwamadzi chifukwa cha okodzetsa, chiopsezo cha kulephera kwa impso kumawonjezeka kwambiri, makamaka pamankhwala apamwamba a ayodini. Asanagwiritse ntchito izi, wodwalayo ayenera kuthanso madzi.

Amphotericin B (wa makulidwe a makolo), corticosteroids, ACTH kapena mankhwala opatsa mphamvu

Hydrochlorothiazide imatha kuwonjezera kukondera kwa electrolyte, makamaka hypokalemia.

Zolemba zogwiritsira ntchito

Zotsatira pakutha kuyendetsa galimoto kapena njira zina Mukamachita zinthu zofunika kuwongolera kwambiri (kuyendetsa galimoto, kugwira ntchito ndi zovuta), ziyenera kukumbukiridwa kuti chithandizo cha hypotensive nthawi zina chimayambitsa chizungulire komanso kugona, makamaka kumayambiriro kwa chithandizo kapena pamene kuchuluka kwawonjezera.

Njira zopewera kupewa ngozi

Odwala omwe ali ndi mbiri ya angioedema ayenera kuyang'aniridwa mosamala ndi madokotala (kutupa kwa nkhope, milomo, pakhosi, ndi / kapena lilime).

Hypotension ndi kuchepa kwa intravascular voliyumu

Odwala omwe ali ndi hypovolemia ndi / kapena hyponatremia (chifukwa cha kukodzetsa kwambiri kwa thupi, amadya ndi kuchepetsedwa kwa sodium, kutsegula m'mimba kapena kusanza), hypotension ikhoza kuchitika, makamaka mutatenga mlingo woyamba. Izi zimafunikira kukonza musanayambe chithandizo.

Electrolyte kusalinganika

Kukondera kwa electrolyte nthawi zambiri kumapezeka mwa odwala omwe amalephera Impso, makamaka pamaso pa matenda ashuga. Chifukwa chake, munthawi ya chithandizo, kuchuluka kwa potaziyamu m'magazi am'magazi ndi creatinine chilolezo kuyenera kuyang'aniridwa, makamaka, kwa odwala omwe ali ndi chilolezo cha creatinine 30 - 50 ml / min.

Kuwonongeka kwa chiwindi

Mankhwala a Lorista ND ayenera kugwiritsidwa ntchito mosamala kwa odwala omwe ali ndi mbiri yofatsa kapena yolimbitsa chiwindi.

Popeza palibe chidziwitso chokhudza kugwiritsa ntchito losartan kwa odwala omwe ali ndi vuto loopsa la hepatic, mankhwala a Lorista ND amatsutsana mu gulu ili la odwala. i

Matenda aimpso

Chifukwa cha kuponderezedwa kwa renin-angiotensin-aldosterone-1g-system, kusintha kwa impso, kuphatikizapo kulephera kwa aimpso, kunadziwika (makamaka, mwa odwala omwe akudalira matenda a impso pa renin-angiotensin-aldosterone dongosolo: odwala omwe ali ndi vuto la mtima kwambiri kapena ofooka aimpso.

Monga ndimankhwala ena omwe amakhudza dongosolo la renin-angiotensin-aldosterone, odwala omwe ali ndi vuto limodzi la impso a artery stenosis kapena artery stenosis ya impso imodzi adawonetsa kuwonjezeka kwa urea ndi milingo ya creatinine, zosinthazi zimasinthanso ngati chithandizo chatha. Muyenera kusamala ndi losperan odwala omwe ali ndi aimpso am'minyewa wam'mimba.

Palibe chidziwitso pakugwiritsa ntchito mankhwalawa odwala omwe akuchitidwa opaleshoni ya impso.

Odwala omwe ali ndi hyperaldosteronism yoyamba, monga lamulo, palibe zomwe angachite antihypertensive mankhwala omwe amapondereza renin-angiotensin dongosolo. Chifukwa chake, kugwiritsa ntchito kuphatikiza kwa losartan / hydrochlorothiazide sikulimbikitsidwa.

Matenda a mtima komanso matenda amitsempha yamagazi

Monga mankhwala ena aliwonse a antihypertensive, kuchepa kwakukulu kwa kuthamanga kwa magazi kwa odwala omwe ali ndi matenda a mtima komanso matenda amitsempha yamagazi kumatha kuyambitsa kuphwanya myocardial kapena stroko. Kulephera kwa mtima

Odwala omwe ali ndi vuto la mtima (kapena kapena aimpso kulephera) amakhala ndi chiopsezo chokhala ndi ochepa owopsa komanso aimpso kulephera (nthawi zambiri amakhala pachimake).

Mitral kapena aortic valve stenosis, yolepheretsa hypertrophic cardiomyopathy

Monga ma vasodilator ena, chisamaliro chapadera chiyenera kuthandizidwa popereka mankhwala kwa odwala omwe ali ndi ululu wa m'mimba, mitral valve stenosis, ndi hypertrophic cardiomyopathy.

Zoletsa za angiotensin-kutembenuza enzyme, losartan, ndi zina za angiotensin zikuwonetsedwa kuti sizigwirizana kwambiri ndi anthu amtundu waku Africa. Mwina izi zimafotokozedwa ndikuti gulu ili la odwala nthawi zambiri limakhala ndi renin yotsika m'magazi. Mimba

Angiotensin II receptor inhibitors (ARA-I) sayenera kumwedwa panthawi yomwe ali ndi pakati. Ngati ndi kotheka, ndiye kuti odwala omwe akukonzekera kutenga pakati amayenera kulembedwa mitundu ina ya mankhwala a antihypertensive, omwe adziwonetsa okha momwe angagwiritsire ntchito chitetezo panthawi yomwe ali ndi pakati. Mimba ikakhazikitsidwa, ARA-ndiyenera kusiyidwa pomwepo ndi kugwiritsa ntchito njira zina ngati zikufunika.

Hypotension ndi kusowa kwa madzi mu electrolyte

Monga mankhwala ena a antihypertensive, odwala ena amatha kudwala matenda oopsa. Chifukwa chake, kuwunika mwatsatanetsatane kuyenera kuchitika kuti muzindikire zizindikiro zamatenda amadzimadzi a electrolyte (hypovolemia, hyponatremia, hypochloremic alkalosis, hypomagnesemia kapena hypokalemia), mwachitsanzo, mutatha kusanza kapena kusanza. Mu odwala oterowo, kuwunikira pafupipafupi zinthu zamagetsi ndizofunikira. plasma. Ku yoga, odwala omwe ali ndi edema mwina amachepetsa hyponatremia.

Zokhudza kagayidwe ka metabolism ndi endocrine system

Mankhwala a Thiazide amatha kupangitsa kuti shuga azigwirizana. muyenera kusintha kusintha kwa mankhwala antidiabetes, incl. insulin Mankhwala a thiazide akagwiritsidwa ntchito, shuga Thiazides amatha kuchepetsa kuchuluka kwa calcium mumkodzo ndipo, motero, kumapangitsa kukula kwakanthawi kwakanthawi mu ndende ya magazi. Hypercalcemia yayikulu ikhoza kuwonetsa latent hyperparathyroidism. Musanayang'ane magwiridwe amtundu wa parathyroid, thiazide diuretics iyenera kusiyidwa.

Kugwiritsa ntchito thiazide diuretics kumatha kuphatikizidwa ndi kuwonjezereka kwa cholesterol ndi triglycerides.

Odwala ena, chithandizo cha thiazide chimatha kuyambitsa hyperuricemia komanso / kapena kuukira kwa gout. Popeza losartan imachepetsa kuchuluka kwa uric acid, kuphatikiza kwake ndi hydrochlorothiazide kumachepetsa mwayi wa hyperuricemia wogwirizana ndi kugwiritsa ntchito okodzetsa.

Kuwonongeka kwa chiwindi

Odwala omwe ali ndi vuto la chiwindi kapena matenda a chiwindi omwe akupita patsogolo, ma thiazides ayenera kugwiritsidwa ntchito mosamala, chifukwa amatha kuyambitsa intrahepatic cholestasis, komanso kusintha kwakung'ono m'madzimadzi ndi electrolyte bwino kumatha kuyambitsa kupweteka pachiwindi. Lorista ND imaphatikizidwa kwa odwala omwe ali ndi vuto lotupa kwa chiwindi.

Odwala omwe amatenga thiazides amatha kukumana ndi hypersensitivity, ngakhale atakhala kuti ali ndi vuto la chifuwa. Pali malipoti okokomeza kapena kuyambiranso kwa systemic lupus erythematosus pogwiritsa ntchito mankhwala a thiazide.

Zotsatira zoyipa

Mwambiri, chithandizo chophatikiza ndi hydrochlorothiazide + losartan chinali chovomerezeka. Nthawi zambiri, machitidwe osautsa anali ofatsa, osakhalitsa, ndipo sankafuna kuti chithandiziro chithe.

Pa kuyesedwa kwa matenda azachipatala pochotsa matenda oopsa, chizungulire ndi njira yokhayo yomwe imakhudzana ndi kumwa mankhwalawa, pafupipafupi pomwe amapezeka ndi placebo ndi oposa 1%. Monga taonera mayesero azachipatala olamulidwa, losartan osakanikirana ndi hydrochlorothiazide nthawi zambiri amaloledwa mu odwala omwe ali ndi matenda oopsa ndipo amasiya michere ya michere. Zotsatira zoyipa kwambiri zinali chizolowezi chosakhala mwazinthu, kufooka / kutopa kwambiri. Nthawi yolembetsa pambuyo palembetsedwe, mayesero azachipatala komanso / kapena kulembetsa pambuyo pa ntchito za ophatikizawo, zotsatirazi zina zotsatirazi zidanenedwa.

Kusokonezeka kwa magazi ndi dongosolo la lymphatic: thrombocytopenia, kuchepa magazi, magazi a aplasiki, kuchepa kwa magazi, leukopenia, agranulocytosis.

Matenda owononga chitetezo chamthupi: anaphylactic reaction, angioedema, kuphatikizapo kutupa kwa mkondo ndi makutu am'magazi ndi kukula kwa mpweya wotsekemera komanso / kapena kutupa kwa nkhope, milomo, pharynx ndi / kapena lilime mwa odwala omwe amatenga losartan, sizinawoneke kwenikweni ((0.01% ndi 5.5 meq / l) adawonetsedwa mu 0.7% ya odwala, komabe, m'maphunzirowa padalibe chifukwa choletsa kuphatikiza kwa hydrochlorothiazide + losartan chifukwa cha kupezeka kwa hyperkalemia. Kuwonjezeka kwa ntchito ya planma alanine aminotransferase sikunachitike kawirikawiri ndipo nthawi zambiri amabwereranso kwazonse atatha kusiya ntchito.

Bongo
Palibe deta yeniyeni yokhudzana ndi mankhwala osokoneza bongo omwe amaphatikiza hydrochlorothiazide + losartan. Mankhwalawa ndiwachizindikiro komanso amandithandiza. Mankhwala a Lorista ® ND ayenera kusiyidwa, ndipo wodwalayo ayenera kuyang'aniridwa. Ngati mankhwalawa atengedwa posachedwa, ndikulimbikitsidwa kusanza, komanso kuthetseratu madzi am'mimba, vuto la madzi-electrolyte, chikomokere cha hepatic ndi kuchepa kwa kuthamanga kwa magazi ndi njira zodziwika bwino.

Losartan
Zambiri paz bongo ndizochepa. Chowonekera kwambiri cha mankhwala osokoneza bongo ndi kuchepa kwa kuthamanga kwa magazi ndi tachycardia, bradycardia imatha kuchitika chifukwa cha kukopa kwa parasympathetic (vagal). Pankhani ya kukula kwa ochepa ochepa hypotension, kukonza mankhwala akuwonetsedwa.
Chithandizo: symptomatic mankhwala.
Losartan ndi metabolite yake yogwira siichotseredwa ndi hemodialysis.

Hydrochlorothiazide
Zizindikiro zofala kwambiri chifukwa cha kuperewera kwa electrolyte (hypokalemia, hypochloraemia, hyponatremia) ndi kusowa kwamadzi chifukwa cha kuchuluka kwa diuresis. Ndi munthawi yomweyo makonda a glycosides, hypokalemia ikhoza kukulitsa njira ya arrhythmias.
Sizinakhazikitsidwe kuti hydrochlorothiazide imatha kuchotsedwa bwanji mthupi ndi hemodialysis.

Dzina ndi adilesi ya wogwirizira (wogwirizira) satifiketi yolembetsa

Wopanga:
1. JSC "Krka, dd, Novo mesto", 6marješka cesta 6, 8501 Novo mesto, Slovenia
2. LLC "KRKA-RUS",
143500, Russia, Moscow Region, Istra, ul. Moskovskaya, d. 50
mogwirizana ndi JSC "Krka, dd, Novo mesto", 6marješka cesta 6, 8501 Novo mesto, Slovenia

Mukamayala ndi / kapena kumanga ku bizinesi yaku Russia, akuti:
KRKA-RUS LLC, 143500, Russia, Moscow Region, Istra, ul. Moskovskaya, d. 50

Dzinalo ndi adilesi ya bungweli kuvomereza madandaulo a ogula
LLC KRKA-RUS, 125212, Moscow, Golovinskoye Shosse, Kumanga 5, Kumanga 1

Kutulutsa mafomu ndi kapangidwe kake

Amapezeka piritsi. Cholinga cha pakamwa. Mapiritsiwo ali ndi izi:

• Chofunikira chachikulu ndi losartan, 100 mg,
• hydrochlorothiazide - 25 mg.

Mankhwala amapezeka muyezo wa 12, 25, 50 ndi 100 mg.

Lorista ND ikupezeka piritsi.

Pharmacokinetics

Kuchuluka kwa zinthu zogwira ntchito kumawonekera ola limodzi mutatha kumwa mapiritsi. Achire zotsatira kumatenga maola 3-4. Pafupifupi 14% ya osabadira, otengedwa pakamwa, amapukusidwa kwa metabolite yake yogwira. Hafu ya moyo wa losartan ndi ma 2 maola. Hydrochlorothiazide siimapukusidwa ndipo imathandizidwa mwachangu kudzera mu impso.

Kodi chimathandiza ndi chiyani?

Mankhwalawa amatchulidwa ngati:

1. Matenda oopsa.
2. Monga chithandizo chothandizira kuchepetsa kufa kwa anthu omwe ali ndi vuto lamanzere lamitsempha yamagazi kapena matenda oopsa.
3. Kupewa kuopsa kwa mikwingwirima, kugunda kwamtima, kuwonongeka kwa mtima ndi matenda a mtima.
4. Hypersensitivity ndi kulekerera payekha kwa isoenzyme zoletsa.
5. Matenda oopsa a ubongo, omwe akupanga motsutsana ndi maziko a matenda osokoneza bongo, kulephera kwa impso.
6. Kulephera kwamtima.
7. Myocardial infarction mu pachimake mawonekedwe.
8. Kulephera kwa mtima koyerekeza ndi njira zina zosasinthika.

Mankhwala tikulimbikitsidwa ngati gawo limodzi la mankhwala umalimbikira odwala omwe ali ndi vuto laimpso hem hemalal.

Mankhwala akhoza kukhala ngati gawo limodzi la zovuta mankhwala ochizira odwala mkhutu aimpso ntchito hemodialysis.

Ndi chisamaliro

Ndi kusamala kwakukulu, Lorista amaperekedwa kwa odwala omwe ali ndi matenda omwe adapezeka:

• matenda ashuga
• Mphumu ya bronchial,
• Matenda a magazi,
• kuphwanya kayendedwe ka madzi mu thupi,
• aimpso mtsempha wamagazi,
• kuphwanya kayendedwe ka magazi ndi kukoka kwa magazi,
• matenda amtsempha wamagazi
• cardiomyopathy
• kwambiri arrhythmia pamaso pa kulephera mtima.

Pazochitika zonsezi, mankhwalawa amatchulidwa muyezo, ndipo njira yochizira imayang'aniridwa ndi achipatala.

Momwe mungatenge Lorista ND?

Zapangidwa kuti zizigwiritsidwa ntchito m'nyumba. Mapiritsi amadyedwa mukatha kudya, kutsukidwa ndi madzi oyera ambiri. Mlingo woyenera umasankhidwa malinga ndi chiwembu choganizira msanga wa wodwala ndi matenda omwe wapezeka ndi iye.

Mlingo wapamwamba wa tsiku lililonse wa Lorista sayenera kupitirira 50 mg.

Nthawi zina, mutha kuchuluka kwa dokotalayo mpaka 100 mg la mankhwala patsiku. Nthawi yayitali yachipatala imachokera ku masabata atatu mpaka miyezi 1.5.

Mapiritsi amadyedwa mukatha kudya, kutsukidwa ndi madzi oyera ambiri.

Chithandizo chimayamba ndi Mlingo wochepa - kuyambira 12-13 mg wa Lorista patsiku. Pambuyo pa sabata, tsiku ndi tsiku mlingo umakulitsidwa 25 mg. Kenako mapiritsiwo amatengedwa mu mlingo wa 50 mg.

Ndi ochepa matenda oopsa, mlingo watsiku ndi tsiku umatha kukhala 25 mpaka 100 mg. Popereka mankhwala akuluakulu, tsiku lililonse ayenera kugawidwa pawiri. Panthawi ya chithandizo cha mankhwalawa ndi kuchuluka kwa mankhwala a okodzetsa, Lorista amadzipereka 25 mg.

Mlingo wochepetsedwa umafunika kwa odwala omwe ali ndi vuto la chiwindi, kulephera kwa impso.

Ndi matenda ashuga

Chithandizo chimayamba ndi mlingo wa 50 mg. Mapiritsi amatengedwa 1 nthawi patsiku. M'tsogolomu, mlingo umachulukitsidwa kukhala 80-100 mg, komanso wotengedwa kamodzi patsiku.

Mu matenda a shuga, mankhwalawa amayamba ndi 50 mg.

Matumbo

• chisangalalo
• nseru ndi kusanza
• matenda amkuwa
• gastritis
• kupweteka m'mimba.

Kulandila Lorista kumatha kuyambitsa matenda osokoneza bongo.

Pakati mantha dongosolo

Zovuta zam'mutu, kupsinjika, kugona kugona, kukomoka, matenda a kutopa, chizungulire, kuchepa kukumbukira kukumbukira kwatsopano ndi kusunthika, magwirizano oyenda.

Zovuta zam'mutu zitha kuchitika mutatenga Lorista.

Mankhwala amatha kuyambitsa matupi awo sagwirizana, omwe amawoneka ngati:

• rhinitis
• kutsokomola
• zotupa ngati ming'oma,
• Khungu.

Malangizo apadera

Chifukwa cha kuchuluka kwakukulu pamitsempha yamagazi ndi kuchepa kwa kuthamanga kwa magazi panthawi ya chithandizo, a Lorista ndi bwino kukana kuwongolera makina ndi magalimoto.

Pa chithandizo, Lorista ndi bwino kukana kuyendetsa makina ndi magalimoto.

Munthawi yamankhwala othandizira, tikulimbikitsidwa kuwunika kuchuluka kwa calcium kuti mupewe kukula kwa hypercalcemia.

Kusankhidwa kwa ana a Lorista ND

Chifukwa cha kusaphunzira bwino kwa Lorista pamatupi a ana, mankhwalawa sagwiritsidwa ntchito pochiza ana osaposa zaka zambiri.

Mankhwalawa sagwiritsidwa ntchito pochiza ana osakwana zaka zambiri.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Chifukwa cha poizoni wake, mankhwalawa amatha kusokoneza mapangidwe a mtima ndi ziwonetsero zaimpso za mwana wosabadwayo panthawi ya fetal, yomwe imadzala ndi imfa. Kuopsa kwa mwana wosabadwayo ndikokulira makamaka mu ma trimesters oyambilira a mimba. Pachifukwa ichi, a Lorista sagwiritsidwa ntchito pochiritsa amayi oyembekezera.

Osagwiritsa ntchito Lorista panthawi yoyamwitsa. Ngati ndi kotheka, kugwiritsa ntchito mankhwala a antihypertensive awa amasinthidwa kwakanthawi kuti adyetse maukonde.

The ntchito aimpso kuwonongeka

Mu vuto laimpso wofatsa pang'ono, mankhwala amapatsidwa mankhwala osokoneza bongo. Muzochitika zazikulu kwambiri, lingaliro la mtundu woyenera wa mankhwala ndi kuthekera kwa kugwiritsa ntchito Lorista amatengedwa ndi dokotala payekhapayekha.

Mu vuto laimpso wofatsa pang'ono, mankhwala amapatsidwa mankhwala osokoneza bongo.

Kuchita ndi mankhwala ena

Ndi kugwiritsa ntchito kwa nthawi yomweyo kwa Lorista ndi mankhwala ena a antihypertensive, kuchepa kwamphamvu komanso kosavuta kwazowonetsa magazi kumatheka.

Kuphatikizidwa ndi ma antidepressants ndi ma antipsychotic kungayambitse kukula.

Ma Barbiturates ndi mtima glycosides amaphatikiza bwino ndi Lorista, mosiyana ndi Rifampicin, omwe amachepetsa mphamvu ya mankhwalawa. Asparkam imagwirizana ndi Lorista, koma pogwiritsa ntchito munthawi yomweyo mankhwalawa, kuwongolera kwakukulu pamlingo wa calcium kumafunika.

Kuyenderana ndi mowa

Mankhwala, a Lorista omwe amapezeka motsutsana ndi omwe amamwa zakumwa zoledzeretsa. Mowa wa Ethyl umawonjezera mwayi wodwala wokhala ndi zovuta zowopsa monga kugunda kwamtima ndi stroko.

Mankhwala, a Lorista omwe amapezeka motsutsana ndi omwe amamwa zakumwa zoledzeretsa.

Omwe atenga mmalo mwa mankhwalawa ndi aLorista N. Mankhwala otsatirawa atha kukhala osinthika:

Zosungidwa zamankhwala

Mankhwala tikulimbikitsidwa kuti tisungidwe pamalo amdima, ozizira osatheka ndi ana. Kutentha kwa Optimum kuli mpaka + 30 ° С.

Mankhwala tikulimbikitsidwa kuti tisungidwe pamalo amdima, ozizira osatheka ndi ana.

Omvera zamtima

Valeria Nikitina, katswiri wa zamtima, Moscow

Kugwiritsa ntchito kwa Lorista ND kumakuthandizani kuti muchepetse kukula kwa zovuta za mtima wamagazi monga kugwidwa ndi myocardial infarction. Mlingo wosankhidwa bwino, mankhwalawa amathandizidwa ndi odwala popanda chitukuko cha zovuta.

Valentin Kurtsev, pulofesa, katswiri wamtima, Kazan

Kugwiritsa ntchito kwa Lorista kuli ponseponse m'munda wa mtima. Zochita zachipatala komanso zotsatira za mayeso azachipatala zatsimikizira kuti mankhwalawa amachepetsa kwambiri kufa kwa odwala omwe ali ndi vuto la mtima komanso matenda oopsa.

Mankhwalawa apeza ndemanga zabwino zambiri kuchokera kwa onse odwala ndi madokotala.

Nina Sabashuk, wazaka 35, Moscow

Ndakhala ndikuvutika ndi kuthamanga kwa magazi kwa zaka 10. Nditapezeka kuti ndadwala matenda oopsa, ndinamwa mankhwala ambiri, koma kungogwiritsa ntchito Lorista ND kumandilola kuti ndikhale ndi thanzi labwino komanso ndikubwereranso m'masiku ochepa.

Nikolay Panasov, wazaka 56, Chiwombankhanga

Ndimalola Lorista ND kwa zaka zingapo. Mankhwala amabweretsanso kupanikizika kwachilendo, kumapereka mphamvu yokhudza kukodzetsa. Ndipo mtengo wa mankhwalawo ndiwotsika mtengo, wofunikanso.

Alexander Panchikov, wazaka 47, Yekaterinburg

Ndili ndi vuto la mtima ndikosatha. Ndi kuchulukitsa kwa matendawa, adotolo atilamula kuti atenge mapiritsi a Lorista ND. Ndinkakhutira ndi zotsatira zake. Ngakhale panali zovuta zingapo zoyipa, mankhwalawa adagwira ntchito bwino.