Lisinopril - mapiritsi awa ndi otani? Malangizo ogwiritsira ntchito, ma analogu, ndemanga

Malangizo ogwiritsira ntchito:

Mitengo muma pharmacie opezeka pa intaneti:

Lisinopril ndi angiotensin kutembenuza enzyme (ACE) inhibitor yomwe imachepetsa mapangidwe a angiotensin II kuchokera ku angiotensin I.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mlingo wa Lisinopril - mapiritsi: poterera, mozungulira, komanso m'mphepete mwa beve, ndi chiopsezo mbali imodzi (ma PC 10. M'matumba, pamatumba a 2, 3, 4, 5 kapena 6, ma PC 14. ma CD ma CD, pamakatoni a 1, 2, 3 kapena 4).

Chithandizo chogwira mankhwalawa ndi lisinopril mu mawonekedwe a dihydrate. Zomwe zili pamapiritsi, kutengera utoto:

• Orange lalanje 2,5 mg
• Orange 5 mg
• Pinki - 10 mg
• Choyera kapena pafupifupi choyera - 20 mg.

Zigawo zothandiza: lactose monohydrate, wowuma chimanga, methylene chloride, povidone, magnesium stearate. M'mapiritsi a 2,5 ndi 5 mg, kuwonjezera apo, utoto wa dzuwa wachikasu umakhala, mapiritsi a 10 mg - utoto azorubine, mapiritsi a 20 mg - titanium dioxide.

Zizindikiro zogwiritsidwa ntchito

• Oyambirira (m'maola 24) oyamba ndi kulowetsedwa kwamatenda am'mimba mwa odwala omwe ali ndi magawo a hemodynamic (monga gawo limodzi la mankhwalawa kuti akhalebe ndi ziwonetserozi komanso kupewa kulephera kwa mtima ndi vuto lakumanzere kwamanzere),
• Kulephera kwamtima kosalekeza (monga gawo la zovuta mankhwala),
• Kukonzanso kwamphamvu komanso kofunikira kwa matenda oopsa (monga mankhwala amodzi kapena kuphatikiza ndi mankhwala ena a antihypertensive),
• Matenda ashuga nephropathy (kuchepetsa Albinuria odwala ndi mtundu I matenda osokoneza bongo amtundu wamagazi othamanga komanso odwala omwe ali ndi mtundu II matenda a shuga ndi ochepa matenda oopsa).

Contraindication

• Herederal idiopathic edema kapena Quincke angioedema,
• Mbiri ya angioedema, kuphatikizapo chifukwa chogwiritsa ntchito ACE inhibitors,
• Lactose tsankho, shuga-galactose malabsorption, kufupika kwa lactase,
• Osakwana zaka 18
• Mimba
• Kuchepetsa
• Hypersensitivity pazigawo za mankhwala kapena zoletsa zina za ACE.

Wachibale (chisamaliro chowonjezera chikufunika):

• Ukalamba
• Hypertrophic obstriers Cardiomyopathy,
• Stenosis wa msempha wokongola,
• Maganizo ankhondo,
• Kulephera kwamtima kwambiri,
• Matenda a mtima
• Cerebrovascular matenda (kuphatikizapo cerebrovascular insuffuffence),
• Kuletsa mafupa hematopoiesis,
• Hyperaldosteronism yoyamba,
• Matenda a shuga
• Matenda a matenda a minofu yolumikizira (kuphatikizapo scleroderma ndi zokhudza zonse lupus erythematosus),
• Hyperkalemia
• Hyponatremia,
• Mikhalidwe ya Hypovolemic (kuphatikiza kutsegula m'mimba ndi kusanza),
• Mgwirizano wamitsempha wamagazi wamanjenje kapena stenosis ya mtsempha wama impso, kulephera kwambiri kwaimpso (kulengedwa kwa creatinine osakwana 30 ml / min), vuto pambuyo pakupatsirana kwa impso,
• Hemodialysis, yomwe imagwiritsa ntchito ma membala a dialysis okwera kwambiri (AN69).

Mlingo ndi makonzedwe

Lisinopril ayenera kumwedwa pakamwa kamodzi patsiku, mosasamala kanthu za kudya, koma makamaka nthawi yomweyo.

Chithandizo cha matenda oopsa zimayamba ndi tsiku la 10 mg. Mlingo wokonza ndi 20 mg, pazipita tsiku lililonse ndi 40 mg. Ndi kuchuluka kwa mankhwalawa, ndikofunikira kuganizira kuti zotsatira zokhazikika za hypotensive pambuyo pa miyezi iwiri ya 1-2. Ngati mukumwa mankhwalawa okwanira tsiku lililonse la mankhwala othandizira sikokwanira, mankhwala ena othandizira amatha. Odwala omwe adalandira diuretics kale, masiku 2-3 asanaikidwe mankhwala awa, ayenera kuti adathetsedwa. Ngati izi sizingatheke, ndiye kuti mlingo woyambirira wa Lisinopril sayenera kupitirira 5 mg patsiku.

Mlingo woyamba wa kukonzanso kwamitsempha yamagazi ndi zina zomwe zimachulukitsa ntchito ya renin-angiotensin-aldosterone ndi 2,5 mg tsiku lililonse. Chithandizo chimachitika motsogozedwa aimpso, kuthamanga kwa magazi (BP), seramu potaziyamu. Dokotalayo ndi amene amawonetsetsa kuti muyezo wa kukonzanso umatengera magazi. Mu kulephera kwa aimpso, tsiku ndi tsiku mlingo umatsimikiziridwa malinga ndi clearinine chilolezo (CC): ndi CC 30-70 ml / mphindi - 5-10 mg, ndi CC 10-30 ml / mphindi - 2.5-5 mg, ndi CC ochepera 10 ml / miniti ndi odwala omwe akudwala hemodialysis - 2,5 mg. Mlingo wokonza umadalira kuthamanga kwa magazi.

Chithandizo cha matenda osalephera a mtima amayamba ndi 2,5 mg wa patsiku (munthawi yomweyo ndi mtima wama glycosides ndi / kapena okodzetsa). Pakadutsa masiku atatu, pang'onopang'ono amawonjezeka - ndi 2,5 mg - mpaka mlingo wokonza wa 5-10 mg patsiku ufike. Mlingo wovomerezeka tsiku lililonse ndi 20 mg. Ngati ndi kotheka, mlingo wa diuretic uyenera kuchepetsedwa musanatenge Lisinopril.

Kwa anthu okalamba, kutchulidwa kotenga nthawi yayitali nthawi zambiri kumadziwika, chifukwa chake mankhwala amalimbikitsidwa kuti ayambe ndi mlingo wa 2,5 mg wa tsiku lililonse. Mu pachimake myocardial infarction, 5 mg amadziwika mu maola 24 oyambirira, 5 mg patsiku, 10 mg m'masiku ena awiri kenako 10 mg kamodzi patsiku, njira yochepetsetsa yamankhwala ndi masabata 6. Pankhani ya kuchepa kwa systolic kuthamanga kwa 100 mm RT. Art. ndikuchepetsa mlingo kumachepetsedwa kukhala 2,5 mg. Ndi nthawi yayitali (kupitirira ola limodzi) kutchulidwa kuchepa kwa kuthamanga kwa systolic pansipa 90 mm RT. Art. Mankhwala atha. Kwa odwala omwe ali ndi vuto lochepa kwambiri la systolic (120 mmHg. Art. Ndipo pansipa), 2.5 mg amadziwika mu masiku atatu oyamba pambuyo poti pachimake myocardial infarction kapena kumayambiriro kwa chithandizo.

Mlingo woyamba wa matenda a shuga a nephropathy ndi 10 mg tsiku lililonse. Ngati ndi kotheka, amawonjezeredwa mpaka 20 mg: kuti odwala omwe ali ndi mtundu wa matenda a shuga I apezeke chizindikiro cha kupanikizika kwa diastolic pansi pa 75 mm Hg. Art., Komanso odwala omwe ali ndi mtundu II matenda a shuga - pansi pa 90 mm RT. Art. (kukakamizidwa kumayesedwa pamalo okhala).

Zotsatira zoyipa

Zotsatira zoyipa kwambiri: kutopa, kupweteka mutu, chizungulire, nseru, kutsekula m'mimba, kutsokomola.

• Matenda a mtima: kuchepa kwa kuthamanga kwa magazi, bradycardia, tachycardia, palpitations, kupweteka pachifuwa, kusokonezeka kwa atrioventricular conduction, kuwoneka kapena kukulira kwa zizindikiro za kulephera kwa mtima, orthostatic hypotension, infarction ya myocardial,
• Pakati mantha dongosolo: kugwedeza mwamphamvu milomo ndi minofu ya malekezero, paresthesia, asthenic syndrome, kusokonezeka chidwi, kuchuluka kutopa, kutopa mtima, kugona, kusokonezeka,
• Matumbo: Masinthidwe amakoma, ma mucosa owuma mkamwa, kupweteka kwam'mimba, dyspepsia, anorexia, jaundice (cholestatic kapena hepatocellular), kapamba, hepatitis,
• Dongosolo la genitourinary: anuria, oliguria, proteinuria, uremia, mkhutu waimpso, kulephera kwa impso, kuchepa potency,
• Njira yothandizira: Kupuma kouma, dyspnea, bronchospasm,
• Hematopoietic dongosolo: agranulocytosis, neutropenia, thrombocytopenia, leukopenia, kuchepa kwa magazi (erythropenia, kuchepa kwa hemoglobin, hematocrit),
• Khungu: photosensitivity, alopecia, thukuta lochulukitsa, kuyabwa,
• Thupi lawo siligwirizana: angioedema ya malekezero, nkhope, milomo, lilime, epiglottis ndi / kapena larynx, zotupa pakhungu, urticaria, kuchuluka kwa ESR, malungo, eosinophilia, zotsatira zabwino zoyesa kwa antibodies a antinuclear, leukocytosis, matumbo angioedema,
• Zina: arthralgia / nyamakazi, myalgia, vasculitis,
• Laborator Zizindikiro: kuchuluka kwa hepatic transaminases, hyperbilirubinemia, hyponatremia, hypercreatininemia, hyperkalemia, kuchuluka urea ndende.

Pogwiritsa ntchito munthawi yomweyo kukonzekera golide (sodium aurothiomalate) mkati mwa ACE inhibitor, kufotokozeredwa kwa vuto, kuphatikizaponso mseru ndi kusanza, kudzitukumula, kumaso.

Malangizo apadera

Lisinopril ndi contraindicated mu cardiogenic mantha ndi pachimake myocardial infarction, ngati vasodilator akhoza kwambiri hemodynamic magawo, mwachitsanzo, pamene systolic magazi si oposa 100 mm Hg. Art.

Kuchepa kwa kuthamanga kwa magazi pomwe mukumwa mankhwalawa nthawi zambiri kumachitika ngati magazi akuchepetsa (BCC) chifukwa cha kupukusa kwa m'mimba, kutsegula m'mimba kapena kusanza, hemodialysis, ndi kuchepa kwa kuchuluka kwa mchere mu chakudya. Odwala omwe ali ndi vuto la mtima nthawi zonse amakhalanso ndi vuto la kuchepa kwa magazi. Nthawi zambiri amapezeka odwala odwala kwambiri matenda a mtima chifukwa cha hyponatremia, mkhutu aimpso ntchito kapena kumwa okodzetsa kwambiri. Magulu ofotokozedwa a odwala kumayambiriro kwa chithandizo ayenera kuyang'aniridwa ndi achipatala, kusankha kwa Mlingo wa Lisinopril ndi okodzetsa kuyenera kuchitika mosamala kwambiri. Malamulo omwewo ayenera kutsatiridwa popereka mankhwala kwa odwala omwe ali ndi matenda a mtima komanso kuchepa kwa magazi m'magazi, komwe kuchepa kwambiri kwa magazi kungayambitse kukomoka kapena kuphwanya magazi. Musanayambe mankhwala, tikulimbikitsidwa kuti pakhale kuchuluka kwa sodium m'magazi ndi / kapena kubwezeretsanso bcc, kenako onani mosamala momwe mankhwalawo amayambira.

Mankhwalawa ochepa ochepa hypotension, kugona pogona kuyenera kuperekedwa, ngati ndi kotheka, kukonzekera kwamadzi amadzimadzi (a saline) ndi mankhwala. Kutsika kwakanthawi kochepa kwa magazi si kuphwanya Lisinopril, koma kungafune kuchepetsa kapena kuchepetsa kufalikira kwa mankhwalawo.

Kuchepetsa mphamvu yaimpso (plasma creatinine ndende yaopitilira 177 μmol / L ndi / kapena proteinuria yoposa 500 mg / maola 24) kwa odwala omwe ali ndi infral myocardial infarction ndi kuphwanya kugwiritsa ntchito kwa Lisinopril. Ndi kupanga aimpso kulephera (plasma creatinine ndende yoposa 265 μmol / L kapena 2 kuchulukitsa kuposa gawo loyambirira) panthawi ya mankhwalawa, dokotala waganiza zosiya kulandira chithandizo.

Angioedema yokhudza malekezero, nkhope, lilime, milomo, epiglottis ndi / kapena larynx ndizosowa, koma imatha kuchitika nthawi iliyonse yamankhwala. Pankhaniyi, chithandizo chiyenera kuyimitsidwa nthawi yomweyo ndikuwunika wodwalayo kuyenera kukhazikitsidwa mpaka zizindikirazo zimatha. Laryngeal edema imatha kupha. Ngati larynx, epiglottis, kapena lilime lidakutidwa, kutsekeka kwa mpweya ndikotheka, motero, chithandizo chofunikira mwachangu ndi / kapena njira zowonetsetsa kuti patumizidwe kanjira ndi zofunika.

Mankhwalawa akathandizidwa ndi ACE inhibitors, pamakhala chiopsezo chokhala ndi agranulocytosis, motero ndikofunikira kuwongolera chithunzi cha magazi.

Pankhani ya kuchuluka kwa hepatic transaminases kapena mawonekedwe a cholestasis, mankhwalawa ayenera kusiyidwa, chifukwa pali chiopsezo chotenga cholestatic jaundice, kupita patsogolo kwa chiwindi necrosis.

Nthawi yonse ya mankhwalawa sayenera kumwa zakumwa zoledzeretsa, komanso samalani nyengo yotentha komanso mukamachita masewera olimbitsa thupi, monga kuchepa magazi komanso kuchepa kwambiri kwa magazi.

Malinga ndi kafukufuku wamatsenga, kugwiritsa ntchito nthawi yomweyo kwa ACE zoletsa ndi insulin kapena mankhwala opatsirana pakamwa kungayambitse kukula kwa hypoglycemia, makamaka masabata oyamba ophatikizira mankhwala, komanso kwa odwala omwe ali ndi vuto laimpso. Pazifukwa izi, odwala matenda a shuga ayenera kuyang'anira glycemia mosamala, makamaka mwezi woyamba wogwiritsa ntchito Lisinopril.

Pankhani ya zoyipa kuchokera ku dongosolo lamanjenje, ndikulimbikitsidwa kuti musayendetse magalimoto ndikuchita ntchito zowopsa.

Kuyanjana kwa mankhwala

Beta-blockers, diuretics, calcium pang'onopang'ono calcium blockers ndi mankhwala ena a antihypertensive amalimbikitsa mphamvu ya Lisotopril.

Pogwiritsa ntchito munthawi yomweyo kukonzekera kwa potaziyamu, mchere wotsekemera wokhala ndi potaziyamu kapena potaziyamu wotsekemera okodzetsa (amiloride, triamterene, spironolactone), chiopsezo chokhala ndi hyperkalemia chikuwonjezeka, makamaka kwa odwala omwe ali ndi vuto laimpso. Pazifukwa izi, ndi dokotala yekha yemwe ayenera kuyambitsa kuphatikiza koteroko, ndipo chithandizo chikuyenera kuchitika pang'onopang'ono kuwunika kwa aimpso ndi serum potaziyamu.

Pogwiritsa ntchito munthawi yomweyo ma vasodilators, barbiturates, antidepressants, phenothiazine ndi ethanol, antihypertensive zotsatira za Lisinopril zimatheka. Maantacid ndi colestyramine amachepetsa mayamwidwe ake m'matumbo.

Mankhwala osokoneza bongo a nonsteroidal (kuphatikizapo kusankha cycloo oxygenase-2 inhibitors), adrenostimulants ndi estrogens amachepetsa mphamvu ya mankhwala.

Pogwiritsa ntchito munthawi yomweyo lisinopril, imachepetsa mayendedwe a lithiamu kuchokera mthupi, chifukwa chake zotsatira zake zamtima ndi mitsempha zimathandizidwa.

Kugwiritsa ntchito ndi methyldopa kungayambitse kukula kwa hemolysis, ndikusankha ma serotonin reuptake inhibitors - kwambiri hyponatremia, wokhala ndi cytostatics, procainamide, allopurinol - leukopenia.

Lisinopril imawonjezera ntchito ya zotumphukira minofu, imachepetsa mphamvu ya njira yolerera pakamwa, imachepetsa kuchuluka kwa mankhwala a quinidine, imachepetsa mphamvu ya mankhwala a hypoglycemic, epinephrine (adrenaline), norepinephrine (norepinephrine) ndi zina zomwe zimapangitsa kuti zotsatira zake zithandizidwe. .

Ndi munthawi yomweyo kugwiritsa ntchito kwa Lisinopril ndi kukonzekera golide, ndikotheka kukulitsa nkhope, miseru, kusanza, komanso kuyereketsa thupi.

Zotsatira zoyipa zomwe zingachitike

Mulimonsemo, ndikofunikira kutenga magome a Lisinopril mosamala. Malangizowo akuwonetsa zomwe zimachitika:

• mutu, chizungulire,
• nseru, kutsegula m'mimba,
• kutopa,
• chifuwa chowuma.

Si kawirikawiri zomwe zimachitika chifukwa cha mankhwalawa:

1. Kugona, chisokonezo.
2. Kupweteka pachifuwa, kufupika, bronchospasm.
3. Bradycardia
4. Kugwa mwadzidzidzi m'magazi.
5. Kuchulukitsa thukuta.
6. Zilonda zam'mimba, kunjenjemera, kukokana.
7. Kuchepetsa tsitsi.
8. Hypersensitivity ku radiation ya ultraviolet.
9. Thupi lawo siligwirizana.
10. Kusintha pakuwerengera magazi.

Musanagwiritse ntchito mankhwalawa, pitani kuchipatala. Adzakusankhirani mlingo woyenera. Izi zikuthandizira kuchepetsa chiwopsezo cha mavuto.

Zotsatira za pharmacological

Lisinopril imawonjezera mamvekedwe a ziwiya zotumphukira ndikulimbikitsa adrenal secretion ya aldosterone. Chifukwa cha kugwiritsa ntchito mapiritsi, mphamvu ya vasoconstrictor ya angiotensin imachepetsedwa kwambiri, ndipo m'magazi am'magazi mumakhala kuchepa kwa aldosterone.

Kumwa mankhwalawa kumathandizira kuchepetsa kuthamanga kwa magazi, komanso mosasamala kanthu za thupi (kuyimirira, kunama). Lisinopril amapewa kupezeka kwa Reflex tachycardia (kuchuluka kwa mtima).

Kutsika kwa kuthamanga kwa magazi panthawi yopereka mankhwala kumachitika ngakhale ndi zotsika kwambiri za renin m'madzi a m'magazi (mahomoni opangidwa mu impso).

Katundu wa mankhwala osokoneza bongo

Mphamvu ya mankhwalawa imayamba kuonekera pakatha ola limodzi kuchokera pakamwa.Kuchuluka kwa Lisinopril kumawonedwa patatha maola 6 pambuyo pa utsogoleri, pomwe izi zikuchitika tsiku lonse.

Kuchepetsa kwakumwa kwa mankhwalawa sikupangitsa kuti magazi azikula kwambiri, kuwonjezereka kungakhale kopanda tanthauzo kuyerekezera ndi kuchuluka komwe kunalipo mankhwala asanayambike.

Ngati Lisinopril amagwiritsidwa ntchito ndi odwala omwe ali ndi vuto la mtima, motsatana ndi digitis ndi diuretic therapy, imakhala ndi zotsatirazi: imachepetsa kukana kwa zotumphukira, imawonjezera stroke komanso kuchuluka kwa magazi a miniti (popanda kuwonjezeka kugunda kwa mtima), imachepetsa katundu pamtima, ndikukulitsa kulolera kwa thupi kupsinjika kwa thupi .

Mankhwalawa amathandizira kwambiri mkati mwamitsempha. Kuyamwa kwa mankhwalawa kumachitika kuchokera m'matumbo am'mimba, pomwe kuphatikiza kwakukulu m'magazi kumawonedwa mosiyanasiyana kuyambira maola 6 mpaka 8 pambuyo pa kuperekedwa.

Malangizo ogwiritsira ntchito

Lisinopril (zikuonetsa kuti amatenga mankhwala osiyanasiyana) amapezeka m'mapiritsi okhala ndi 2,5 mg, 5 mg, 10 mg ndi 20 mg yogwira ntchito. Tengani malangizo a Lisinopril kamodzi patsiku, makamaka nthawi imodzi.

Kugwiritsa ntchito mankhwalawa kwa matenda oopsa ayenera kuyamba ndi 10 mg patsiku, kenako ndikusintha kwa mankhwalawa 20 mg patsiku, pomwe muzovuta kwambiri, mlingo waukulu wa 40 mg wololedwa.

Ndemanga za lisinopril zikuwonetsa kuti chithandizo chokwanira cha mankhwalawa chimatha kupezeka patatha masabata 2-4 atatha chithandizo. Ngati mutatha kugwiritsa ntchito mlingo waukulu wa mankhwalawo zotsatira zake sizinachitike, kuchuluka kwa mankhwala ena a antihypertgency ndikofunikira.

Odwala omwe amatenga okodzetsa, masiku awiri 2-3 Lisanopril isanayambe, muyenera kusiya kumwa. Ngati pazifukwa zina kuletsa kukodzetsa sikutheka, mlingo wa tsiku ndi tsiku wa lisinopril uyenera kuchepetsedwa mpaka 5 mg.

Mothandizidwa ndi renin-angiotensin-aldosterone dongosolo lomwe limayendetsa kuchuluka kwa magazi ndi kuthamanga kwa magazi, Lisinopril amalimbikitsa kugwiritsa ntchito mlingo wa 2,5-5 mg wa tsiku lililonse. Mlingo wokonza wa mankhwalawa umapangidwa mwanjira iliyonse malinga ndi kufunikira kwa magazi.

Momwe mungatengere ndi matenda

Pakulephera kwa impso, tsiku ndi tsiku mlingo wa lisinopril umatengera chilolezo cha creatinine ndipo amatha kusiyanasiyana kuchokera ku 2.5 mpaka 10 mg patsiku.

Kukhalitsa kwa matenda oopsa okhudzana ndi nkhawa kumatenga kutenga 10-15 mg pa tsiku kwa nthawi yayitali.

Kumwa mankhwala osachiritsika kwa mtima kumayambira ndi 2,5 mg patsiku, ndipo patatha masiku atatu ndikuwonjezeredwa mpaka 5 mg. Mlingo wokonza matendawa ndi 5-20 mg patsiku.

Kwa matenda a shuga a nephropathy, Lisinopril amalimbikitsa kutenga 10 mg mpaka 20 mg patsiku.

Kugwiritsira ntchito kuphwanya kwakhungu kwa myocardial kumakhudzana ndi zovuta ndipo kumachitika molingana ndi chiwembu chotsatira: tsiku loyamba - 5 mg, kenako mlingo womwewo patsiku, pambuyo pake kuchuluka kwa mankhwalawa kumachulukitsidwa ndikumwedwa kamodzi masiku awiri, gawo lomaliza ndi 10 mg kamodzi patsiku. Lisinopril, Zizindikiro zimazindikira kutalika kwa mankhwalawa, chifukwa chithupsa chowopsa chimatenga milungu isanu ndi umodzi.

Mlingo ndi makonzedwe

Mkati. Kamodzi patsiku, ngakhale kudya kudya. Pankhani ya matenda oopsa, odwala osalandira mankhwala ena a antihypertgency amapatsidwa 5 mg kamodzi patsiku, yokonza mlingo wake ndi 20 mg / tsiku. Mlingo wambiri watsiku ndi tsiku ndi 40 mg. Zotsatira zathunthu zimakhazikika pakatha milungu iwiri kapena inayi kuyambira pachiyambireni chithandizo. Ndi osakwanira matenda, kuphatikiza mankhwala ndi mankhwala ena a antihypertgency ndikotheka.

Ngati wodwalayo alandila chithandizo choyambirira ndi okodzetsa, ndiye kuti kumwa mankhwalawa kuyenera kuyimitsidwa masiku 2-3 Lisinopril isanayambike. Ngati izi sizingatheke, ndiye kuti mankhwalawa a mankhwalawa sayenera kupitirira 5 mg patsiku. Pankhaniyi, mutatenga mlingo woyamba, kuyang'aniridwa kwa achipatala kumalimbikitsidwa kwa maola angapo (mphamvu yayitali imatheka pambuyo pafupifupi maola 6), chifukwa kuchepa kwakukulu kwa magazi kumatha kuchitika.

Kulephera kwa mtima kosatha - yambani ndi 2.5 mg kamodzi, ndikutsatira kuchuluka kwa 2,5 mg pambuyo masiku atatu mpaka asanu. Mlingo wapamwamba tsiku lililonse ndi 20 mg.

Pachimake myocardial infarction (monga gawo la mankhwala opangira maola 24 okhala ndi hemodynamics yokhazikika): mu maola 24 oyambirira - 5 mg, kenako 5 mg pambuyo pa tsiku limodzi, 10 mg patatha masiku awiri kenako 10 mg kamodzi patsiku. Njira ya mankhwala osachepera milungu 6.

Okalamba, kutchulidwa kwa nthawi yayitali kwambiri kumawonedwa, komwe kumalumikizidwa ndi kuchepa kwa kuchuluka kwa lisinopril (ndikulimbikitsidwa kuti muyambe kulandira mankhwala ndi 2.5 mg / tsiku).

At odwala ndi mkhutu aimpso ntchito Mlingo umayikidwa kutengera zofunikira za QC.

70 - 31 (ml / min) (serum creatinine

Zotsatira zoyipa

Kuchokera pamtima: kuchepa kwa kuthamanga kwa magazi, arrhythmias, kupweteka pachifuwa, kawirikawiri - orthostatic hypotension, tachycardia.

Kuchokera ku dongosolo lamanjenje: chizungulire, kupweteka mutu, kutopa, kugona, kupindika kwa minofu ya miyendo ndi milomo, kawirikawiri - asthenia, kukhumudwa, chisokonezo, kusowa tulo, kusanza.

Kuchokera m'mimba: nseru, kusanza, kutsegula m'mimba, kusowa kwa chakudya, kuchepa kwa chidwi, kusintha kwa kukoma, kupweteka m'mimba, pakamwa lowuma.

Zotsatira zoyipa: angioedema (edema yapakhungu pakhungu, minyewa yolumikizira komanso / kapena mucous membranes wophatikizana ndi urticaria kapena popanda iyo), zotupa pakhungu, kuyabwa.

Zina: "Kuuma" kutsokomola, kuchepa kwa potency, kawirikawiri - malungo, kutupa (lilime, milomo, miyendo).

Bongo

Zambiri zamankhwala pa bongo la lisinopril mwa anthu sizikupezeka.

Zizindikiro zake: ochepa hypotension.

Chithandizo: wodwalayo ayenera kupatsidwa mpata wopingasa ndi miyendo yokwezeka, ngati kuli kotheka, saline imalowetsedwa kudzera m'mitsempha, hemodialysis imachitika.

Kuchita ndi mankhwala ena

Mowa, diuretics ndi othandizira ena a antihypertensive (blockers of α- ndi β-adrenergic receptors, calcium antagonists, etc.) atha kutulutsa mphamvu ya lisinopril.

Mankhwala osokoneza bongo oletsa kuponderezana, ma estrogens, adrenostimulants amachepetsa mphamvu ya mankhwala.

Pogwiritsa ntchito munthawi yomweyo ndi okodzetsa, kuchepa kwa mankhwala a potaziyamu.

Mukamagwiritsa ntchito mankhwala omwe ali ndi lithiamu, ndizotheka kuchedwetsa kuchotsedwa kwa lithiamu m'thupi ndipo, chifukwa chake, kuonjezera ngozi yake. Ndikofunikira kuyang'anira nthawi zonse mulingo wa lifiyamu m'magazi.

Ntchito zophatikizidwa ndi beta-blockers, ma calcium blockers odekha, okodzetsa ndi zina zama antihypertensive zimathandizira kuwopsa kwa hypotensive.

Maantacid ndi colestyramine amachepetsa kuyamwa kwa lisinopril m'mimba.

Zolemba ntchito

Mosamala, Lisinopril akuyenera kugwiritsidwa ntchito mwa odwala omwe ali ndi matenda amitsempha yamagazi kapena matenda amitsempha yamagazi kuti muchepetse kuchepa kwambiri kwa kuthamanga kwa magazi m'gululi.

Mochenjera, Lisinopril amaperekedwa kwa odwala omwe ali ndi vuto la impso, pambuyo pakuwonjezeka kwa impso, ndi mphamvu yapamtima yotupa ya m'mimba kapena stenosis ya mtsempha wama impso, ochepa hypotension, matenda osakwanira a ziwalo, autoimmune systemic matenda, ndi ena.

Osakhalitsa ochepa hypotension si kuphwanya kugwiritsidwa ntchito kwa mankhwala pambuyo kukhazikika kwa kuthamanga kwa magazi. Ndi kuchepa kwa kuthamanga kwa magazi, ndikofunikira kuchepetsa mlingo kapena kusiya kumwa Lisinopril kapena diuretic.

Odwala omwe ali ndi vuto lalikulu la mtima, kugwiritsidwa ntchito kwa ACE inhibitors kungayambitse kusokonezeka kwa aimpso. Odwala ena omwe ali ndi matenda oopsa kwambiri, osakanikirana ndi a minyewa yamitsempha yamagazi ya minyewa ya m'mimba kapena a minyewa yotupa ya impso imodzi, milingo ya urea nayitrogeni ndi creatinine imatha kuchuluka.

Odwala omwe ali ndi matenda a mtima osakhazikika komanso othamanga magazi, kutenga Lisinopril kungayambitse kuchepa kwa kuthamanga kwa magazi, koma ichi sichiri chifukwa chosiya kulandira chithandizo.

Panthawi yopanga opaleshoni kugwiritsa ntchito mankhwala omwe ali ndi hypotensive chifukwa cha opaleshoni, kupatsanso laminolo ndikotheka. Arterial hypotension chifukwa cha limagwirira amachotsedwa ndi kuchuluka kwa magazi oyendayenda.

Kukula kwa hyperkalemia mwa odwala ndi aimpso kulephera, matenda ashuga, kuphatikizika kwa mankhwala a potaziyamu (spironolactone, triamteren, amiloride) ndi mchere wam potaziyamu. Ndi kuphatikiza kwa lisinopril ndi mankhwala omwe ali pamwambawa, kuwunika pafupipafupi kuchuluka kwa potaziyamu m'magazi a seramu ndikofunikira.

Ndi kusiyiratu mwadzidzidzi kumwa kwa Lisinopril, palibe kuwonjezereka kwina kapena kowonjezereka kwa kuthamanga kwa magazi poyerekeza ndi msinkhu wake musanamwe mankhwalawo.

Kuchita bwino ndi chitetezo cha Lisinopril ndizodziyimira pawokha pazaka zodwala.

Mimba komanso kuyamwa

Lisinopril amatsutsana ndi pakati komanso kuyamwa.

Kugwiritsa ntchito mankhwalawa mu II ndi III trimester ya mimba kungayambitse kuchepa kwa kuchuluka kwa amniotic madzimadzi, kuwonetsa kwa anuria, hypotension yakale komanso kusokoneza mapangidwe a mafupa a chigoba cha fetal.

Kukopa pa kuyendetsa galimoto ndikugwira ntchito ndi zinthu.

Pa mankhwala, munthu ayenera kupewa kuyendetsa galimoto ndikuchita zoopsa zomwe zimafuna kuyang'aniridwa ndikuwonjezera kuthamanga kwa zochitika zama psychomotor, chifukwa chizungulire nchotheka, makamaka kumayambiriro kwa chithandizo.