Lozarel amathandizira kuchepa kwa magazi

Mankhwala Lozarel amagwiritsidwa ntchito mu mtima, endocrinology ndi nephrology. Malangizo ogwiritsira ntchito ali ndi malingaliro othandizira ogwiritsa ntchito mankhwalawo, kutengera mawonekedwe azachipatala.

Maziko a mankhwalawa ndi losartan potaziyamu mu 50 mg. Zina zomwe zimaphatikizapo silicon dioxide, magnesium stearate, lactose, wowuma. Kuphatikizikako kumakhalanso ndi cellcose ya microcrystalline.

Kutulutsa Fomu

Mankhwalawa atha kugulidwa m'mapiritsi, omwe amaikidwa mu chithuza chamtundu wa mapiritsi 10. Phukusi limodzi muli matuza atatu.

Piritsi imakhala ndi mtundu woyera (nthawi zambiri imakhala ndi chikasu chachikasu) ndi mawonekedwe ozungulira. Kumbali imodzi kuli ziwopsezo. Pamwamba pa piritsi pali filimu.

Zochita zochizira

Angiotensin 2 ndi ma enzyme omwe, pomangiriza ma receptor mu mtima, impso ndi ma adrenal gland, amatsogolera pakuchepa kwa kuwala kwa mitsempha yawo yamagazi. Zimakhudzanso kutulutsidwa kwa aldosterone. Zotsatira zonsezi zimayambitsa kuchuluka kwa magazi.

Losartan imalepheretsa angiotensin 2, mosasamala kanthu za mapangidwe ake. Chifukwa cha izi, zosintha zotsatirazi zimachitika mthupi:

• kuchepa kwathunthu zotumphukira mtima,
• kuchuluka kwa magazi a aldosterone kumachepa
• kuthamanga kwa magazi kumachepa
• kuchuluka kwa kuthamanga kwa kufalikira kwam'mapapo kumachepa.

Kuthamanga kwa magazi kumachepa chifukwa cha mphamvu yochepa ya diuretic ya mankhwalawa. Ndi kuvomereza pafupipafupi, chiopsezo cha matenda a minofu ya mtima amachepetsa, kulimbitsa thupi mwa anthu omwe ali ndi vuto lochepa la myocardial kumatheka.

Kuchuluka kwake kumachitika pakatha masiku 21 kuyambika kwa makonzedwe. Mphamvu ya antihypertensive imadziwika mkati mwa tsiku limodzi.

Lozarel ndi mankhwala mtima, aimpso ndi kuwonongeka kwa kagayidwe kachakudya matenda. Mankhwala akuwonetsedwa kuti akuwonjezera kuthamanga kwa magazi chifukwa cha matenda oyambitsidwa, kapena matenda oopsa a etiology yosadziwika.

Mankhwalawa amawonetsedwa chifukwa cha kulephera kwa mtima, kulephera kwa mtima, komwe sikuchotsedwa ndi angiotensin-converting enzyme inhibitors. Ndi kuphatikiza kwa kuthamanga kwa magazi, kukalamba, kusowa kwamitsempha yamagazi ndi zina, zimagwiritsidwa ntchito pochepetsa kufa ndi ngozi ya mtima (kugunda kwa mtima, sitiroko).

Mankhwalawa amagwiritsidwa ntchito pamavuto amtundu wa 2 matenda a shuga - nephropathy, chifukwa amachepetsa kuchepa kwa matenda.

Malangizo ogwiritsira ntchito

Losartan amatengedwa 1 nthawi patsiku. Mlingo wa 50 mg umagwiritsidwa ntchito pochiza matenda oopsa. Ngati magulu ena a mankhwala a antihypertensive atchulidwa, yambani ndi theka la piritsi. Ngati ndi kotheka, onjezani mlingo mpaka 100 mg, womwe ungatenge kamodzi kapena kugawidwa pawiri.

Mu matenda osalephera a mtima, osachepera 12,5 mg ndi mankhwala. Masiku 7 aliwonse imachulukitsa, pang'onopang'ono ikukula mpaka 50 mg. Potere, amayang'ana kwambiri momwe mankhwalawa amatha kuonekera. Ndili ndi theka la 25 mg, ngati wodwalayo ali ndi vuto la impso kapena chiwindi, ali pa hemodialysis.

Kuwongolera proteinuria mu shuga, mankhwalawa amadziwitsidwa pa mlingo wa 50 mg / tsiku. Mlingo wapamwamba wa tsiku lililonse wa matenda awa ndi 100 mg.

Kulandila sikudalira chakudya ndipo kuyenera kukhala tsiku ndi tsiku.

Contraindication

Losartan potaziyamu sinafotokozeredwe magulu oterewa:

• kuyamwa kwa shuga kapena galactose,
• glucose tsankho,
• galactosemia
• wosakwana zaka 18
• woyembekezera
• kunyambita
• anthu osalolera pazigawo za mankhwala.

Kuyang'anira momwe zinthu ziliri kumafuna kuperekedwa kwa njira yothetsera matenda a impso kapena chiwindi, aimpso. Mosamala, Lozarel imagwiritsidwa ntchito pakubwera kwa electrolyte.

Zizindikiro zogwiritsidwa ntchito

Mankhwala Lozarel zotchulidwa ngati pali:

1. Zizindikiro zomveka zoopsa.
2. Kuchepetsa chiopsezo cha kufooka kwa mtima mwa anthu omwe akudwala matenda oopsa kapena obisika kumanzere kwamitsempha yamagazi, komwe kumawonetsedwa ndi kuchepa pafupipafupi kwa kufa kwamtima, kugwidwa ndi matenda a mtima.
3. Kupereka chitetezo cha impso kwa odwala omwe ali ndi matenda a shuga a 2.
4. Kufunika kuchepetsa proteinuria.
5. Kulephera kwa mtima kosalekeza ndi kulephera kwa mankhwala ndi ACE zoletsa.

Zotsatira zoyipa

Kulandiridwa kwa mankhwalawa kumatha kutsatiridwa ndi zovuta, zomwe sizofooka ndipo sizikufunika kuimitsidwa kwake. Amawonetsedwa pagome.

Zotsatira zoyipa zomwe sizili m'gulu lililonse zimaphatikizapo gout.

Zizindikiro zochuluka

Mankhwala osokoneza bongo amakhala ndi mawonekedwe: kugunda kwamtima mwachangu, kuchepa kwambiri kwa kuthamanga kwa magazi, kugunda kwamtima kosowa pokondweretsa nyini.

Ma diuretics ndi othandizira othandizira amagwiritsidwa ntchito kukonza zomwe zimachitika. Njira ya hemodialysis ilibe kanthu, popeza losartan samachotsedwera kuchokera kwawayilesi mwanjira imeneyi.

Kuyanjana kwa mankhwala

Kuphatikizidwa pamodzi ndi okodzetsa ku gulu la potaziyamu, komanso kukonzekera komwe kumakhala ndi potaziyamu kapena mchere wake, kumawonjezera chiopsezo cha hyperkalemia. Chenjezo Lozarel limayikidwa ndi mchere wa lithiamu, chifukwa kuchuluka kwa lifiyamu m'magazi kumatha kuchuluka.

Kugwiritsa ntchito mankhwalawa limodzi ndi fluconazole kapena rifampicin kungachepetse kuchuluka kwa metabolite yogwira plasma. Kuchepa kwa mphamvu ya mankhwalawa kumachitika pamene othandizira limodzi ndi omwe si a antiidal anti-kutupa mankhwala omwe amaposa 3 g.

Losartan sayanjana ndi mankhwala:

• warfarin
• hydrochlorothiazide,
• digoxin
• phenobarbital,
• cimetidine
• erythromycin
• ketoconazole.

Mankhwala amathandizira zotsatira za β-blockers, okodzetsa ndi mankhwala ena omwe amachepetsa kuthamanga kwa magazi.

Malangizo apadera

Losartan sichimakhudzanso chidwi, kotero mutatha kuyendetsa mutha kuyendetsa galimoto ndikugwira ntchito pamakina. Masewera omwe mankhwalawa akusowa, piritsi lotsatira limakhala kuti limamwa nthawi yomweyo mwayi ukapezeka. Ngati nthawi yakwana kumwa lotsatira, iwo amamwa muyezo umodzi - piritsi limodzi (piritsi la 2 silikulimbikitsidwa).

Pogwiritsa ntchito mankhwalawa kwa nthawi yayitali, plasma K imayang'aniridwa. Ngati mankhwalawa agwiritsidwa ntchito motsutsana ndi zotsatira zazikulu za kukodzetsa, pamakhala chiopsezo cha hypotension. Lozarel imachulukitsa kuchuluka kwa creatinine ndi urea ngati matenda a impso a stenosis a impso imodzi, komanso a stenosis amitsempha imodzi.

Analogi: Presartan, Lozap, Cozaar, Blocktran, Lorista, Cardomin-Sanovel.

Zofananira zotsika mtengo: Vazotens, Losartan.

Kutengera ndemanga zambiri, Lozarel imalekeredwa bwino ndikugwiritsa ntchito nthawi yayitali, imayendetsa kuthamanga masana. Ndizotchuka pakati pa odwala, ndipo nthawi zambiri zimasankhidwa ndi akatswiri - othandizira, akatswiri a mtima, madokotala a mabanja. Ndemanga zina zimakhala ndi zomwe zikuwonetsa zovuta.

Kusunga ndi moyo wa alumali

Mankhwalawa amatha kugwiritsidwa ntchito patatha zaka ziwiri kuyambira tsiku lomwe wamasulidwa. Amasungidwa m'chipinda chomwe kutentha kwake sikupitirira 25 °.

Mankhwala tikulimbikitsidwa kuti atengedwe pokhapokha ngati akufufuza, labotale, kuwunika mozama, kuzindikira za concomitant pathology. Kugwiritsa ntchito Lozarel kumatha kubweretsa zovuta.

Zotsatira zoyipa

Pochiza ndi Losarel, mavuto samawonetsedwa kawirikawiri, ndipo palibe chifukwa chosiya mankhwala.

Kwa anthu omwe ali ndi mavuto a mtima.

Ndi kuphwanya kwam'mimba thirakiti, nseru, kupweteka kwam'mimba, kudzimbidwa, mano, hepatitis, gastritis, ndi kuwonongeka kwamtundu wamawonekedwe nthawi zambiri kumawonekera. Zizindikirozi sizimachitika nthawi zonse kwa achinyamata.

Ponena za kupweteka kwa m'mimba, zotupa zam'mimba, khungu lowuma, ndi thukuta kwambiri sizitha kuchitika.

Pa ziwengo, kuyabwa, zotupa pakhungu, ndipo ming'oma iwoneka.

Kuchokera kumbali ya minofu ndi mafupa nthawi zambiri pamakhala kupweteka kumbuyo, miyendo, chifuwa, nyamakazi, kukokana.

Ndi kuphwanya kwamphamvu kupuma, kutsokomola, kutsinana kwammphuno, bronchitis, pharyngitis.

Mu kwamikodzo dongosolo - mkhutu aimpso ntchito, kwamikodzo thirakiti matenda.

Mlingo ndi makonzedwe

Ndikofunikira kumwa mapiritsiwo kamodzi kamodzi patsiku, mosasamala kanthu za chakudyacho.

Ndi ochepa matenda oopsa koyamba komanso kukonza dosing nthawi zambiri imakhala 50 mg kamodzi tsiku lililonse. Ngati ndi kotheka, ikhoza kubweretsedwa mpaka 100 mg.

Kwa odwala ndi mtima wosalephera tengani koyamba mlingo wa 12,5 mg, kenako pawiri sabata, kubweretsa 50 mg pa tsiku.

Ndi matenda a shuga a 2, yomwe imayendetsedwa ndi proteinuria, mlingo woyambirira umayenera kukhala 50 mg kamodzi patsiku.

Mukamachita mankhwala, malinga ndi kuthamanga kwa magazi a wodwalayo, amaloledwa kuwonjezera kuchuluka kwa mankhwalawa tsiku lililonse mpaka 100 mg.

Chifukwa kuchepetsa chiopsezo cha kukhala ndi mtima Mavuto mwa anthu omwe ali ndi matenda oopsa, komanso matenda amitsempha yamanzere, mlingo woyambirira wa 50 mg kamodzi patsiku amasankhidwa. Pankhaniyi, mlingo umatha kuwonjezeka pang'onopang'ono mpaka 100 mg patsiku.

Migwirizano ndi magwiritsidwe akusungidwa

Sungani ku kutentha kosaposa 25 ° C. Pewani mankhwalawa kwa ana aang'ono.

Tsiku lotha ntchito Mankhwalawa ndi zaka 2.

Osagwiritsa ntchito mankhwalawa tsiku likatha.

Mtengo wa mankhwalawa Lazorel umasiyanasiyana malinga ndi wopanga komanso ma network a ma pharmacies, ku Russia pafupifupi amatenga ma ruble 200.

Ku Ukraine mankhwalawa siofala ndipo amalipira 200 UAH.

Ngati ndi kotheka, mutha kusintha "Lozarel" ndi imodzi mwazomwezi:

• Brozaar
• Blocktran
• Vero-Losartan
• Ma Vazotens
• Cardomin-Sanovel
• Zisakar
• Cozaar
• Karzartan
• Lozap,
• Nyanja
• Losartan A,
• Losartan Canon
• "Losartan potaziyamu",
• Losartan Richter,
• Losartan MacLeods,
• Teva Losartan
• "Lozartan-TAD",
• Losacor
• Lorista
• Presartan
• Lotor
• "Renicard."

Kugwiritsa ntchito ma analogues pamankhwala kumafunika makamaka ngati wodwala ali ndi vuto la mankhwala. Komabe, ndi dokotala yekhayo amene angakupatseni mankhwala ena alionse.

Kuunikiridwa kwa mankhwalawa kumapezeka pa intaneti, mwachitsanzo, Anastasia akulemba kuti: "Matenda anga a shuga amabweretsa mavuto ambiri. Posakhalitsa, ndinakumana ndi mawonekedwe atsopano a matenda. Anandipezanso ndi nephropathy. Dokotala adapereka mankhwala ambiri, kuphatikizapo Lozarel. Ndiye amene anathandizira kukonza bwino impso. Kutupa kwamiyendo kwatha. ”

Ndemanga zina zimapezeka kumapeto kwa nkhaniyi.

Mankhwala Lozarel amadziwika kuti ndi mankhwala othandiza pochiza matenda oopsa komanso kulephera kwa mtima. Ili ndi chiwonetsero chofutukuka chofanana ndi zigawo zikuluzikulu zofananira, sizikulimbikitsidwa pamavuto a chiwindi ndi impso, komanso panthawi yoyembekezera komanso osakwanitsa zaka 18. Popewa kupezeka kwa zovuta, tikulimbikitsidwa kumwa mankhwalawa monga momwe dokotala wakanenera.

Mlingo

Mapiritsi okhala ndi mafilimu 12,5 mg, 25 mg, 50 mg, 75 mg, 100 mg

Piritsi imodzi yokutidwa ndi kanema ili

ntchito yogwira - losartan potaziyamu 12,5 mg kapena 25 mg kapena 50 mg kapena 75 mg kapena 100 mg

zotuluka: microcrystalline cellulose, povidone, sodium starch glycolate (mtundu A), silicon dioxide colloidal anhydrous, magnesium stearate,

makanema ophatikizira a filimu: opadray yoyera (OY-L-28900), lactose monohydrate, hypromellose, titanium dioxide (E 171), macrogol, indigo carmine (E 132) alarnum varnish (kwa 12,5 mg).

Mapiritsi okhala ndi mafilimu, ozungulira, abuluu, olembedwa ndi "1" mbali imodzi (kwa mulingo wa 12,5 mg).

Mapiritsi okhala ndi mafilimu amakhala ozungulira, oyera pamtundu, ali ndi notch imodzi mbali iliyonse ndikulemba "2" mbali imodzi (kwa 25 mg).

Mapiritsi okhala ndi filimuyo ndi owotcha, oyera pamtundu, wokhala ndi notchi imodzi mbali iliyonse ndi "3" wolemba mbali imodzi (kwa mulingo wa 50 mg).

Mapiritsi, okhala ndi film, oblong, oyera, okhala ndi zoopsa ziwiri mbali iliyonse ndipo adalemba "4" mbali imodzi (kwa mulingo wa 75 mg).

Mapiritsi, okhala ndi film, oblong, oyera, okhala ndi zoopsa zitatu mbali iliyonse ndipo analemba "5" mbali imodzi (kwa mulingo wa 100 mg).

Zotsatira za pharmacological

Pambuyo pakukonzekera pakamwa, losartan imatengedwa bwino ndipo imapangidwa ndi metabolism yokhala ndi kupangika kwa metabolite yogwira ya carboxylic acid, komanso ma metabolites ena osagwira. The dongosolo bioavailability wa losartan piritsi mawonekedwe pafupifupi 33%. Kuyerekeza kwapakati kwa losartan ndi metabolite yake yogwira kumafikira pambuyo pa ola limodzi ndi pambuyo pa maola 3-4, motsatana.

Losartan ndi metabolite yake yogwira imakhala ≥ 99% yomanga mapuloteni a plasma, makamaka ku albumin. Kuchuluka kwa magawo a losartan ndi malita 34.

Pafupifupi 14% ya mlingo wa losartan, akapatsidwa mankhwala amkati kapena akatengedwa pakamwa, amasintha kukhala yogwira metabolite. Pambuyo pokonzekera mtsempha wa magazi kapena kumeza 14C yokhala ndi potasiamu losartan, ma radioac omwe amatulutsa magazi m'magazi amayimiriridwa ndi losartan ndi metabolite yake yogwira. Kusintha kochepera kwa losartan ku metabolite yake yogwira kunawonedwa pafupifupi 1% ya odwala mu maphunziro. Kuphatikiza pa metabolite yogwira, metabolites yolimba imapangidwanso.

Chilolezo cha plasma cha losartan ndi metabolite yake yogwira imakhala pafupifupi 600 ml / miniti ndi 50 ml / miniti, motsatana. Kuwonekera kwa impso kwa losartan ndi metabolite yake yogwira pafupifupi pafupifupi 73 ml / mphindi ndi 26 ml / miniti, motsatana. Mukamamwa losartan, pafupifupi 4% ya mankhwalawa amachotsedwa mu mkodzo ndipo pafupifupi 6% ya mankhwalawa imayikidwa mu mkodzo ngati metabolite yogwira. The pharmacokinetics of losartan ndi yogwira metabolite ndi lofanana pamene ingestion wa losartan potaziyamu mu Mlingo mpaka 200 mg.

Pambuyo pakamwa, kutsekemera kwa losartan ndi metabolite yake yogwira m'magazi amachepetsa kwambiri, theka lomaliza la moyo limakhala pafupifupi maola awiri ndi maola 6-9, motsatana.

Losartan ndi metabolite yake yogwira siziunjikira kwambiri m'madzi am'magazi pamene mlingo wa 100 mg umagwiritsidwa ntchito kamodzi patsiku.

Losartan ndi metabolite yake yogwira imapukusidwa mu ndulu ndi mkodzo. Pambuyo pakukonzekera pakamwa, pafupifupi 35% ndi 43% amuchotsa mkodzo, ndipo 58% ndi 50% ndi ndowe, motero.

Pharmacokinetics m'magulu odwala

Odwala okalamba omwe ali ndi matenda oopsa oopsa, kuchuluka kwa maartartan ndi metabolite yake yogwira m'magazi sikusiyana kwambiri ndi omwe amapezeka mwa odwala achinyamata omwe ali ndi matenda oopsa.

Odwala omwe ali ndi matenda oopsa a azimayi ochepa, kuchuluka kwa losartan m'magazi am'magazi ndiwokwirirapo kuposa kwa odwala omwe ali ndi matenda oopsa, pomwe milingo ya metabolite yogwira m'magazi a magazi siimasiyana mwa amuna ndi akazi.

Odwala omwe ali ndi chiwindi chodwala komanso chopatsa chidwi cha chiwindi, milingo ya losartan ndi metabolite yake yogwira m'magazi am'magazi pambuyo pakukonzekera kwa pakamwa inali 5 komanso 1.7 nthawi, motero, apamwamba kuposa odwala achimuna.

Odwala okhala ndi creatinine chilolezo pamwamba pa 10 ml / mphindi, plasma wozama wa losartan sunasinthe. Poyerekeza ndi odwala omwe ali ndi vuto laimpso, odwala omwe ali ndi hemodialysis, AUC (malo omwe ali ndi nthawi yopondera) ya losartan imakhala yokwanira 2 times.

Odwala omwe ali ndi vuto la impso kapena odwala hemodialysis, plasma wozungulira wa metabolite yogwira ndi chimodzimodzi.

Losartan ndi metabolite yake yogwira siichotseredwa ndi hemodialysis.

Losartan ndi mankhwala opangira angiotensin II receptor antagonist (mtundu wa AT1) wogwiritsa ntchito pakamwa. Angiotensin II - wamphamvu vasoconstrictor - ndi mphamvu yogwira ya renin-angiotensin dongosolo ndipo imodzi mwazinthu zofunika kwambiri mu pathophysiology ya arterial hypertension. Angiotensin II imamangirira ma receptors a AT1, omwe amapezeka mu minofu yambiri (mwachitsanzo, mu minofu yosalala yamitsempha yamagazi, gland ya adrenal, impso ndi mtima), kudziwa zotsatira zingapo zofunika zachilengedwe, kuphatikizapo vasoconstriction komanso kumasulidwa kwa aldosterone.

Angiotensin II imapangitsanso kuchuluka kwa minofu yosalala.

Losartan amasankha mosamala AT1 receptors. Losartan ndi metabolacogic yogwira metabolac - carboxylic acid (E-3174) - amatchinga mphamvu zonse mwakuthupi za angiotensin II, posatengera magwero kapena njira ya kaphatikizidwe.

Losartan alibe mphamvu yotsutsana ndipo satseketsa ma cell ena kapena ma ion omwe amakhudzidwa ndi kayendetsedwe ka mtima. Komanso, losartan sikuletsa ACE (kininase II), puloteni yomwe imalimbikitsa kuwonongeka kwa bradykinin. Zotsatira zake, palibe kuwonjezereka kwa kupezeka kwa zotsatira zoyipidwa ndi bradykinin.

Pogwiritsa ntchito mankhwala Lozarel kuthetseratu mavuto obwera chifukwa cha angiotensin II kukonzanso katulutsidwe kumabweretsa kuchuluka kwa plasma renin ntchito (ARP). Kuwonjezeka koteroko kumapangitsa kuti chiwopsezo cha angiotensin II chiwonjezeke. Ngakhale izi zikuwonjezeka, ntchito ya antihypertgency ndi kuchepa kwa kuchuluka kwa aldosterone m'magazi am'magazi kulimbikira, zomwe zikuwonetsa kutsekeka kwothandiza kwa angiotensin II receptors. Pambuyo pakutha kwa losartan, plasma renin ntchito ndi angiotensin II magawo 3 masiku obwerera.

Onse losartan ndi metabolite yake yayikulu ali ndi mgwirizano wapamwamba kwambiri wa AT1 receptors kuposa AT2. Metabolite yogwira imakhala yogwira 10 mpaka 40 nthawi zambiri kuposa losartan (ikasinthidwa kukhala misa).

Mlingo umodzi wa osowa mu odwala omwe ali ochepa kwambiri ochepa matenda oopsa amasonyezera kuchepa kwakukulu kwa kuchuluka kwa magazi a systolic ndi diastolic. Kuchuluka kwa losartan kumachitika pambuyo pa maola asanu ndi amodzi pambuyo pa makonzedwe, njira yothandizira odwala imapitirira maola 24, kotero ndikokwanira kuitenga kamodzi patsiku.

Pharmacodynamics ndi pharmacokinetics

Losartan ndi wolimbana mwapadera wa receptor angiotensin II (mtundu wa AT1).

• imamangirira ku receptors a AT1, omwe amakhala m'mitsempha yosalala ya mitsempha yamagazi, mtima, impso, komanso ma gren adrenal.
• imakhala ndi vasoconstrictive, yotulutsa aldosterone,
• amalimba bwino angiotensin II,
• sichimathandizira kuponderezana kwa kinase II - enzyme yomwe imawononga bradykinin.

"Lozarel," monga momwe akufotokozera mankhwalawo, amayamba kuchitapo kanthu. Pambuyo pa ola limodzi, kuchuluka kwa lazortan kumafika pazovuta zake, zomwe zimachitika kwa maola 24. Mokhazikika, kupanikizika kumachepera maola 6 mutamwa mapiritsi. Mulingo woyenera kwambiri wa antihypertensive umawonedwa pambuyo pa masabata 3-6. Losartan amamangirira kachigawo kakang'ono ka albumin ndi 99%, yotupa ndi impso.

Bongo

Zizindikiro: Palibe milandu ya mankhwala osokoneza bongo yomwe yanenedwapo. Zizindikiro zodziwika bwino za bongo zimakhalapo ochepa hypotension, tachycardia, bradycardia ikhoza kuchitika chifukwa cha kukhudzika kwa parasympathetic (vagal).

Chithandizo: Hypotension ikakhala ndi chizindikiro, ayenera kupatsidwa chithandizo chothandizira. Kuchiza kumatengera kutalika kwa nthawi mutatha Lozarel, komanso mtundu ndi kuuma kwa zizindikirazo. Chofunika kwambiri ziyenera kuperekedwa pakukhazikika kwa mtima ndi mtima. Cholinga cha kukonzanso kaboni. Kuwunikira ntchito zofunika. Hemodialysis siyothandiza, popeza losapatsa kapena metabolite yake yogwira samachotsedwa pa hemodialysis.

Pharmacokinetics

Pambuyo pakamwa, losartan imatengedwa bwino kuchokera m'mimba. Pa gawo loyamba kudzera m'chiwindi, limadutsa kagayidwe kake ka carboxylation ndi gawo la CYP2C9 isoenzyme ndikupanga metabolite yogwira. Mwa dongosolo bioavailability wa losartan pafupifupi 33%. Kuzindikira kwakukulu (C_max) yogwira mankhwala Lozarel m'magazi seramu imafikira pafupifupi ola limodzi, ndipo metabolite yake yogwira pambuyo pa maola 3-4. Zakudya zomwezi munthawi yomweyo sizikhudza bioavailability wa losartan. Pa mlingo wa mpaka 200 mg, losartan amakhazikika ozungulira pharmacokinetics.

Kumangiriza kumapulogalamu amadzi a m'magazi (makamaka ndi albumin) - kuposa 99%.

V_d (voliyumu yogawa) ndi malita 34.

Pafupifupi sikulowa mu zotchinga magazi.

Mpaka 14% ya mlingo wa pakamwa wa losartan amasinthidwa kukhala metabolite yogwira.

Chilolezo cha plasma cha losartan ndi 600 ml / min, chilolezo cha impso ndi 74 ml / min, metabolite yake yogwira ndi 50 ml / min ndi 26 ml / min, motsatana.

Pafupifupi 4% amachotseredwa kudzera mu impso osasinthika, mpaka 6% ya mlingo wovomerezeka mu mawonekedwe a metabolite yogwira. Zotsalazo zimatsitsidwa m'matumbo.

Hafu yotsiriza ya moyo wogwira ntchito nthawi zonse ili pafupifupi maola 2, metabolite yake yogwira - mpaka maola 9.

Potengera momwe ntchito ya Lozarel tsiku lililonse ya 100 mg, kuwerengera pang'ono kwa losartan ndi metabolite yake yogwira m'magazi a magazi kumawonedwa.

Ndi kufatsa pang'ono pakati pa zakumwa zoledzeretsa za chiwindi, kuchuluka kwa okoka mankhwalawa kumawonjezeka kasanu, ndipo yogwira metabolite - nthawi 1.7, poyerekeza ndi odwala omwe alibe matendawa.

Masautso a losartan m'magazi am'magazi odwala a creatinine chilolezo (CC) pamwambapa 10 ml / min ali ofanana ndi omwe ali ndi matenda abwinobwino aimpso. Ndi CC ochepera 10 ml / min, mtengo wa kuchuluka kwa mankhwalawa (AUC) m'magazi amwazi umakwera pafupifupi nthawi ziwiri.

Ndi hemodialysis, losartan ndi metabolite yake yogwira samachotsedwa m'thupi.

Amuna omwe ali ndi matenda oopsa okalamba, kuchuluka kwa kuchuluka kwa mankhwala osokoneza bongo m'magazi sikusiyana kwambiri ndi magawo ofanana ndi anyamata.

Ndi ochepa matenda oopsa mu akazi, plasma ndende ya losartan ndi 2 peresenti kuposa amuna. Zomwe zili metabolite yogwira ndizofanana. Kusiyana kwa pharmacokinetic sikutanthauza kufunika kwachipatala.

Momwe mungatengere ndi kukakamiza, mulingo

"Lozarel", malangizo ogwiritsira ntchito omwe amafotokozera bwino kuchuluka kwa mitundu ya matenda osiyanasiyana, amagwiritsidwa ntchito mosasamala chakudya. Mapiritsiwo amamwa nthawi yomweyo kamodzi patsiku mu mlingo womwe adokotala amawalimbikitsa.

Ndi matenda oopsa (kuthamanga kwa magazi kumakhazikika pamwamba pa 140/90 mm Hg), mankhwalawa amatengedwa pa 50 mg patsiku. Malinga ndi zomwe zikuwonetsa, mlingo umawonjezereka mpaka 100 mg. Ndi BCC yochepetsedwa, chithandizo cha matenda oopsa chimayamba ndi 25 mg. Pa kuchuluka kwa mankhwalawa komwe mankhwalawo akuwonetsedwa, m'mbali iliyonse madokotala amasankha.

Kulephera kwa mtima kumathandizidwa motsatira chiwembu china. Chithandizo cha mankhwalawa chimayamba ndi 12.5 mg wa mankhwala patsiku. Sabata iliyonse, mlingo umachulukitsidwa: 25, 50, 100 mg. Ngati ndi kotheka, mutha kulandira 150 mg ya "Lozarel" patsiku.

Ndi nephropathy yotsatana ndi mtundu wachiwiri wa shuga, odwala amatenga 50 mg patsiku patsiku. Ndikotheka kuwonjezera mlingo mpaka 100 mg. Dongosolo lomweli ndilothandiza kwa odwala omwe ali ndi kumanzere kwamitsempha yamagazi.

Zofunika! Kwa odwala okalamba (a zaka zopitilira 75), odwala omwe ali ndi matenda osiyanasiyana a chiwindi kapena impso, njira yochiritsira imasinthidwa ndi adokotala kuti athandizire kuchepetsa kuchuluka kwa tsiku lililonse.

Kuchita

Kuphatikizidwa kwa "Lozarel" ndi NSAIDs kungayambitse kulephera kwa impso. Mphamvu ya antihypertensive mankhwala imachepetsedwa kwambiri.

Kuphatikizidwa ndi mankhwala omwe ali ndi lithiamu kumapangitsa kuwonjezeka kwa plasma lithiamu.

Potaziyamu wothandiza kukokomeza zinthu zomwe zimayenderana ndi "Lozarel" zimatha kupangitsa kuti hyperkalemia ichuluke.

Mankhwalawa amalimbikitsa mphamvu ya mankhwala a antihypertensive. Mukamapereka "Lozarel" limodzi ndi ATP zoletsa, ndikofunikira kuyang'anitsitsa momwe impso zimayambira, popeza kuti zovuta zomwe zimachitika zimawonjezeka kwambiri.

"Lozarel" ikhoza m'malo mwa mankhwala ena omwe ali ndi vuto lofananalo. Zitsanzo:

Mankhwala osokoneza bongo amasiyana mumtengo komanso wopanga. Koma simuyenera kusintha palokha “Lozarel” woperekedwa ndi dokotala kuti mupeze mtundu wina. Analogue iyenera kusankhidwa ndi katswiri yemwe amawunika momwe wodwalayo alili ndi kuchuluka kwa mankhwalawa.

Lozarel, malangizo ntchito: njira ndi mlingo

Mapiritsi a Lozarel amatengedwa pakamwa, ngakhale chakudyacho.

• ochepa matenda oopsa: koyamba ndi yokonza mlingo - 50 mg kamodzi patsiku. Pokhapokha patakhala chokwanira chachipatala mu odwala ena, kuchuluka kwa mlingo wa mpaka 100 mg ndikuloledwa, mwanjira imeneyi, mapiritsi amatengedwa 1 kapena 2 pa tsiku. Ndi chithandizo chothandizirana ndi mitundu yambiri ya okodzetsa, kugwiritsa ntchito Lozarel kuyenera kuyamba ndi 25 mg (piritsi 1/2) kamodzi patsiku,
• aakulu mtima kulephera: woyamba mlingo - 12,5 mg (piritsi 1/4) 1 pa tsiku, masiku 7 aliwonse kuchuluka kwa 2 kawiri, pang'onopang'ono kumawonjezera mpaka 50 mg patsiku, poganizira kulekerera kwa mankhwalawa.
• lembani matenda ashuga a 2 a shuga ndi proteinuria (kuchepetsa chiopsezo cha kukhala ndi hypercreatininemia ndi proteinuria): mlingo woyambirira ndi 50 mg kamodzi patsiku. Kutengera ndi magawo a kuthamanga kwa magazi panthawi ya mankhwala, mlingo ungathe kuwonjezeka mpaka 100 mg mu 1 kapena 2 waukulu,
• ochepa matenda oopsa kwa odwala ndi lamanzere yamitsempha yamagazi hypertrophy (kuchepetsa chiopsezo cha matenda a mtima ndi kufa): mlingo woyambirira ndi 50 mg kamodzi patsiku, ngati kuli kotheka, utha kuwonjezeka mpaka 100 mg.

Kwa odwala omwe ali ndi vuto la impso (CC osakwana 20 ml / min), mbiri yodwala matenda a chiwindi, kuchepa mphamvu kwa thupi, kupitirira zaka 75 kapena nthawi ya dialysis, muyezo wa tsiku lililonse wa Lozarel uyenera kufotokozedwa kuchuluka kwa 25 mg (1/2 piritsi).

Ndi mkhutu aimpso ntchito

Muyenera kusamala pochiza odwala ndi aimpso, kulephera kwamitsempha yamafupa, ndi stenosis ya mtsempha wama impso umodzi.

Mlingo woyenera wovulala impso (CC zosakwana 20 ml / min): mlingo woyambirira - 25 mg (piritsi 1/2) 1 nthawi patsiku.

Ndemanga pa Lozarel

Ndemanga za odwala ndi akatswiri a Lozarel ndiabwino. Madokotala amati mankhwalawo, kuphatikiza pa antihypertensive kanthu, ali ndi mphamvu yowonjezera okodzetsa. Kulandila Lozarel amathandizira katundu ndikuletsa kuyambika ndi kukula kwa myocardial hypertrophy. Kulephera kwa mtima kosatha, kuthekera kopirira zolimbitsa thupi kumawonjezeka.

Odwala omwe ali ndi matenda osokoneza bongo a mellitus ndi nephropathy, kutenga Lozarel amathandizira kuchotsa kwa edema.