Lisinopril Stada: malangizo a mapiritsi

Lisinopril amapangidwa ndi makampani ambiri azamankhwala, monga Avant, ALSI Pharma, Severnaya Zvezda, Ozone LLC, Stada, Teva ndi ena. Chifukwa chake, mankhwalawa ali ndi mayina osiyanasiyana omwe amagwiritsidwa ntchito pamsika wamankhwala:

• Lisinopril Stada,
• Lisinopril Teva,
• Lisinopril SZ,
• Diroton
• Dapril ndi ena.

Mankhwalawa onse amachita chifukwa cha lisinopril dihydrate.

Ndiye lisinopril amasiyana bwanji ndi lisinopril stad? Choyamba, amapangidwa ndi makampani osiyanasiyana azamankhwala, omwe ali ndi njira zosiyanasiyana zopangira. Lisinopril Stada amapangidwa ndi Makiz-Pharma LLC (ku Moscow) ndi Hemofarm (ku Obninsk). Opanga awa ndi a kampani Stad ndipo amatulutsa mankhwala kutengera ndi European Europe.

Kachiwiri, zinthuzo zimakhala ndi zotuluka zosiyanasiyana. Mwachitsanzo, Lisinopril ya Alsi Pharma imakhala ndi shuga wa mkaka, MCC, wowuma, silika, talc, magnesium stearate. Kukonzekera kwa kampani Stada, molingana ndi malangizo omwe amagwiritsidwa ntchito, kuwonjezera pazomwe zalembedwa pamwambapa, zimaphatikizapo zinthu monga mannitol, ludipress (shuga mkaka ndi povidone), croscarmellose sodium, calcium hydrogen phosphate.

Zizindikiro zogwiritsidwa ntchito

Malangizowo amalola kugwiritsidwa ntchito kwa Lisinopril Stad kwa:

• matenda oopsa (okha kapena ndi mankhwala ena),
• kulephera kwa mtima (kuphatikiza ndi mtima glycosides, okodzetsa),
• myocardial infarction (odwala omwe ali ndi hemodynamics yokhazikika. Kugwiritsa ndikofunikira pa tsiku loyamba),
• matenda a impso oyambitsidwa ndi matenda ashuga (amachepetsa mapuloteni mu mkodzo ndi mtundu 1 wa shuga wokhala ndi zovuta zake komanso kwa odwala omwe ali ndi matenda a shuga 2.

Kupanga, kufotokozera, mawonekedwe a gulu, gulu

Kampaniyi Stada imatulutsa Lisinopril mwanjira ya mapiritsi a 5, 10 ndi 20 mg. Amayikidwa mu PVC ndi zojambulazo. Katundu woyambirira amakhala pabokosi lamakhadi. Palinso malangizo ogwiritsira ntchito. Pogulitsa mungapeze mapiritsi 20 ndi 30 mapiritsi.

Mankhwalawa akuphatikiza lisinopril dihydrate ndi zinthu zothandizira zomwe zalembedwa pamwambapa.

Malangizo ogwiritsa ntchito amapereka chidziwitso kuti Lisinopril Stada ndi piritsi loyera (zonona), ma cylindrical, okhala ndi malekezero a oblique kumtunda ndi chiwopsezo.

Malangizowo amatanthauza mankhwalawo ku gulu la zoletsa zoletsa za ACE. Gulu la mankhwala:

• imachepetsa kutembenuka kwa angiotensin I kukhala angiotensin II, komwe kumabweretsa kuchepa kwa kumasulidwa kwa aldosterone,
• imaletsa kusokonekera kwa bradykinin,
• imawonjezera mapangidwe a ma prostaglandins.

Njira izi zimayambitsa zoletsa za renin-angiotensin-aldosterone. Chifukwa chake, chifukwa chogwiritsa ntchito mankhwalawa, vasodilation ndi kuchepa kwa magazi kumachitika.

Kukhazikika kwa izi kumachitika ola limodzi pambuyo pa kukhazikitsa ndipo kumatenga mpaka tsiku. Mphamvu yokhazikika imachitika pakatha masiku 30-60 ogwiritsa ntchito Lisinopril Stad. Malangizowo akuti palibe “achire ena” omalizira kugwiritsa ntchito. Komanso mankhwalawa amachepetsa kuchuluka kwa mapuloteni mumkodzo.

Njira Zogwiritsa Ntchito

Malangizowo akuti mankhwalawa Lisinopril Stada adapangira pakamwa. Mapiritsiwo amatsukidwa ndi madzi. Cholandilidwa mosasamala chakudya.

Nthawi zambiri gwiritsani piritsi limodzi patsiku. Mlingo amatchulidwa ndi dokotala malinga ndi momwe wodwalayo alili. Kuchuluka kofunikira kwa ndalama kumasankhidwa mpaka kuchuluka kwa kuthamanga kwa magazi kufikire. Sipangiri kuwonjezera kuchuluka kwa mankhwalawa kale kuposa masiku awiri atayamba kugwiritsa ntchito. Malangizowa akuwonetsa njira ndi njira zogwiritsira ntchito:

• vuto la matenda oopsa, mlingo woyambira ndi 10 mg pa tsiku, mlingo wokonza ndi 20 mg,
• kugwiritsa ntchito kwakukulu kwa 40 mg tsiku limodzi.
• Musanayambe chithandizo ndi Lisinopril, muyenera kusiya kugwiritsa ntchito okodzetsa kwa masiku angapo.
• ngati sizotheka kuzimitsa, ndiye kuti mankhwalawa akumayamba, malinga ndi malangizo, sangakhale apamwamba kuposa 5 mg patsiku.
• Mlingo woyamba amatengedwa moyang'aniridwa ndi achipatala.

Ndi matenda oopsa oopsa omwe amayamba chifukwa chochepetsera ziwiya za impso, amayamba ndi mlingo wa 5 mg poyang'aniridwa kuchipatala. Malangizowa amayenera kuwunika kuthamanga kwa magazi, mawonekedwe a impso, ndi kuchuluka kwa potaziyamu m'magazi. Mlingo wokonza umatengera kuthamanga kwa magazi. Amayikidwa ndi dokotala.

Kwa mavuto a impso, mlingo umasankhidwa, poganizira chilolezo cha creatinine, kuchuluka kwa sodium ndi potaziyamu m'magazi.

Mu CHF, malangizowa akuwonetsa kugwiritsidwa ntchito kwa Lisinopril Stad:

• poyambira mlingo - 2,5 mg patsiku,
• othandizira - 5-10 mg patsiku,
• pazipita 20 mg patsiku.

Pamodzi, kugwiritsa ntchito glycosides, diuretics ndikofunikira.

Ndi ischemic necrosis ya mtima (kugunda kwa mtima), Lisinopril Stada amagwiritsidwa ntchito kuchipatala palimodzi. Kuchuluka kwa ndalama kumasankhidwa ndi adokotala. Kulandila kumayamba patsiku loyamba. Kugwiritsidwa ntchito kwa odwala omwe ali ndi hemodynamics yokhazikika.

Malangizo ogwiritsira ntchito amalimbikitsa kugwiritsa ntchito chiwembu chotere:

• tsiku loyamba - 5 mg,
• itatha 1 tsiku - 5 mg,
• itatha masiku 2 - 10 mg,
• Pambuyo pake - 10 mg patsiku.

Kwa matenda a shuga a nephropathy, Lisinopril Stada amagwiritsa ntchito 10 mg patsiku. Ngati ndi kotheka, onjezani kuchuluka kwa 20 mg.

Kuchita

Malangizo ogwiritsira ntchito lembani zochitika zotsatirazi:

• ndi potaziyamu kukonzekera, potaziyamu woleketsa okodzetsa (Veroshpiron ndi ena) ndi cyclosporine pamakhala chiwopsezo cha kuchuluka kwa potaziyamu m'magazi,
• ndi mankhwala ena omwe amachepetsa kuthamanga kwa magazi - kugwiritsa ntchito kuphatikiza kumapangitsa kuchuluka kwa zotsatira,
• ndi psychotropic ndi vasodilator - kuchepa kwamphamvu kwa kuthamanga kwa magazi,
• Kukonzekera kwa lifiyamu - kuchuluka kwa lifiyamu m'thupi,
• ndi maantacid - kuchepa kwa mayamwidwe a lisinopril m'mimba
• ndi hypoglycemic - malangizo amakhudzanso ngozi ya hypoglycemia,
• ndi NSAIDs, estrogens, adrenergic agonists - kuchepa kwa hypotensive zotsatira,
• ndi kukonzekera kwa golide - redness pakhungu, kusokonekera kwa magazi, kutsitsa magazi,
• ndi allopurinol, novocainamide, cytostatics - kuphatikiza pamodzi kungapangitse leukopenia,
• ndi ethyl mowa - kuchuluka kwa lisinopril.

Contraindication

Hypersensitivity kuti lisinopril kapena zoletsa zina za ACE, kutenga pakati, kuyamwa. Mbiri ya angioedema pamankhwala othandizira ndi ACE zoletsa, cholowa kapena idiopathic angioedema, aortic stenosis, matenda a ubongo (kuphatikizapo cerebrovascular insuffence), matenda a mtima, kuperewera kwa m'mimba, matenda oopsa a autoimmune. , scleroderma), chopewera cha m'matumbo a hematopoiesis, matenda a shuga, matenda oopsa a m'mitsempha, chotupa cha mtsempha wamagazi, stenosis yamitsempha imodzi ya impso, vuto pambuyo pakupatsirana kwa impso, kulephera kwaimpso, chakudya chokhala ndi zoletsa za Na +, mikhalidwe yotsatana ndi kuchepa kwa BCC (kuphatikiza kutsegula m'mimba, kusanza), ukalamba, zaka mpaka zaka 18 (chitetezo ndi kufunikira sizinaphunzire).

Momwe mungagwiritsire ntchito: Mlingo ndi njira ya chithandizo

Mkati, ndi ochepa matenda oopsa - 5 mg kamodzi patsiku. Popanda kuchitapo kanthu, mlingo umakulitsidwa masiku onse awiri 2 mg ndi 5 mg mpaka muyezo wa 20 mg mg / tsiku (kuwonjezera kuchuluka kwa 20 mg / tsiku nthawi zambiri sikuti kumabweretsa kuchepa kwa kuthamanga kwa magazi). Mlingo wapamwamba tsiku lililonse ndi 80 mg.

Ndi HF - yambani ndi 2.5 mg kamodzi, ndikutsatira kuchuluka kwa 2,5 mg pambuyo masiku 3-5.

Okalamba, nthawi yayitali imakhala ikuwonekera, komwe kumalumikizidwa ndi kuchepa kwa mankhwala a lisinopril (tikulimbikitsidwa kuti muyambe kulandira mankhwala ndi 2.5 mg / tsiku).

Pakulephera kwa impso, kuchepa kumachitika ndi kuchepa kwa kusefera kwa zosakwana 50 ml / min (mlingo uyenera kuchepetsedwa nthawi 2, ndi CC zosakwana 10 ml / min, mlingo uyenera kuchepetsedwa ndi 75%).

Ndi matenda oopsa a arterial, chithandizo chokonzanso kwakanthawi chimawonetsedwa pa 10-15 mg / tsiku, ndi vuto la mtima - pa 7.5-10 mg / tsiku.

Zotsatira zoyipa

Malangizo ogwiritsira ntchito akunena kuti mukamalandira mankhwala a Lisinopril Stad, zosafunikira zimachitika m'magawo ndi machitidwe awa:

• mtima ndi mtsempha wamagazi (orthostatic hypotension, nthawi zambiri pamakhala kuchuluka kwamtima, kusokonezeka kwa mitsempha m'matumbo a miyendo, vuto la mtima, sitiroko),
• CNS (chizungulire, kupweteka mutu, kusinthasintha kwa mtima, kusowa tulo, kukhumudwa),
• ziwalo zopumira (chifuwa chowuma, mphuno, bronchospasm ndizosowa),
• zam'mimba dongosolo (dyspepsia, gastralgia, youma mucous nembanemba, kapamba, chiwindi sichimachitika),
• kwamikodzo dongosolo (nthawi zambiri pamakhala kusokonezeka kwa impso),
• khungu (kuyabwa, zotupa, dazi, psoriasis, thukuta kwambiri, etc.),
• ziwengo mu mawonekedwe a urticaria, edema ya Quincke, erythema, malungo ndi mawonekedwe ena.

Nthawi zambiri pamakhala kuchuluka kwa urea, creatinine, potaziyamu m'magazi.

Nthawi zina mukatha kugwiritsa ntchito pamakhala kutopa kochulukira, hypoglycemia.

Malangizowo amagawa zovuta zonse zoyambitsidwa ndi mankhwala osokoneza bongo nthawi zambiri, osowa komanso osowa kwambiri.

Pankhani ya mankhwala osokoneza bongo, pali kuchepa kwakukulu kwa kukakamiza, kutsokomola, ma mucous nembanemba, chizungulire, kusokonekera, kugona, kupuma pafupipafupi, palpitations kapena, m'malo mwake, kuchepa kwake, kusowa kwa madzi ndi ma elekitiroma m'magazi, kulephera kwa aimpso, oliguria. Ndi zochitika izi, malangizowo akuwonetsa kugwiritsa ntchito mankhwalawa.

Zotsatira za pharmacological

ACE inhibitor, amachepetsa kupangika kwa angiotensin II kuchokera ku angiotensin I. Kuchepa kwa zomwe angiotensin II kumabweretsa kutsika kwachindunji kutulutsidwa kwa aldosterone. Amachepetsa kuchepa kwa bradykinin ndikuwonjezera kapangidwe ka Pg. Amachepetsa OPSS, kuthamanga kwa magazi, kutsitsa, kukakamiza m'matumbo am'mapapo, kumayambitsa kuwonjezeka kwa IOC ndikukulitsa kulolerana kwa mtima ndi nkhawa kwa odwala omwe ali ndi vuto la mtima. Imakulitsa mitsempha pamlingo wokulirapo kuposa mitsempha. Zotsatira zina zimafotokozedwa ndi kuthana ndi machitidwe a minye renin-angiotensin. Pogwiritsa ntchito nthawi yayitali, hypertrophy ya myocardium ndi makhoma amitsempha ya mtundu wotsalira amachepa. Amasintha magazi kupita ku ischemic myocardium.

ACE inhibitors imakulitsa chiyembekezo cha moyo kwa odwala omwe ali ndi vuto la mtima, osachedwa kupita patsogolo kwa kukomoka kwa LV mwa odwala pambuyo poyambitsa myocardial popanda kuwonetsa kwakanthawi kwamankhwala.

Kuyamba kwa zochita kumachitika pambuyo pa ola limodzi. Kuchuluka kwake kumatsimikiziridwa pambuyo pa maola 6-7, kutalika kwake ndi maola 24. Ndi matenda oopsa, zotsatira zake zimawonedwa m'masiku oyamba pambuyo pa kuyamba kwa mankhwala, zotsatira zokhazikika zimayamba pambuyo pa miyezi 1-2.

Kupanga ndi mawonekedwe a kumasulidwa

Piritsi limodzi limaphatikizapo 5 mg, 10 mg ndi 20 mg ya chinthu chachikulu, chomwe chimayimiriridwa ndi lisinopril dihydrate. Mulinso:

• MCC
• Mannitol
• Povidone
• Shuga wamkaka
• Stearic Acid Magnesium
• Calcium calcium phosphate
• Croscarmellose sodium
• Colloidal silicon dioxide.

Mapiritsi a kirimu wowoneka bwino amtundu wa cylindrical amaikidwa pachimake. paketi ya 10 Mukati mwa paketiyo pali maluwa 2 kapena 3. kulongedza.

Kuchiritsa katundu

Mothandizidwa ndi ACE inhibitor, kuchepa kwa mapangidwe a angiotensin 1 ndi 2. P kuchepa kwa kuchuluka kwa angiotensin 2, kuchepa kwa kutulutsa kwa aldosterone palokha kumawerengedwa. Pamodzi ndi izi, kuchepa kwa bradykinin kumachepa, kupanga ma prostaglandins kumawonjezeka. Mankhwalawa amathandizira kulepheretsa kwa dongosolo la renin-angiotensin-aldosterone. Zotsatira zake, kuchepa kwa kuthamanga kwa magazi ndi kutsegulira zimawonedwa, kupindika kwamitsempha yamagazi ndi kukakamiza mkati mwa ma capillaries kumachepa, ndipo mwa odwala omwe ali ndi vuto la CVS, kulolerana kwamtolo wamatenda kumachuluka. Zotsatira zabwino za lisinopril zimawonetsedwa ndi kukula kwa mitsempha.

Mphamvu ya antihypertensive imawonetsedwa ola limodzi mutatha kumwa mapiritsi, plasma yapamwamba kwambiri ya chinthu yogwira imafikira maola 7 ndipo tsiku lotsatira limawonedwa. Ndi kuchuluka kwa kuthamanga kwa magazi, kuchuluka kwa mankhwalawa amalembedwa patsiku loyamba la mankhwala, njira yokhazikika imatheka mu miyezi 1-2. Ngati mwadzidzidzi mapiritsi akukonzekera, matenda oopsa sanawoneke.

Mankhwala amathandizira kuchepetsa kutuluka kwa mapuloteni mu mkodzo. Mwa anthu omwe ali ndi zizindikiro za hyperglycemia, kubwezeretsanso ntchito za kuvulala kwa glomerular endothelium kumadziwika.

Ndi kudya kwa nthawi yayitali kwa mapiritsi a Lisinopril Stad, kusintha kwa hypertrophic mu myocardium, komanso kukonzanso kwa matenda a m'mimba mu CVS, kugwira ntchito kwa endothelium limodzi ndi magazi kupita ku myocardium kumawonedwa.

Ndizofunikira kudziwa kuti zoletsa za ACE zimachulukitsa kuchuluka kwa moyo mwa anthu omwe ali ndi vuto losatha la mtima, komanso kupita patsogolo kwa vuto lakumanzere kwa anthu omwe adakumana ndi vuto la myocardial popanda zizindikiro zakulephera kwa mtima kulephereka.

Kuperewera kwa mucosa m'mimba kumawonedwa 30%. Mukamadya, palibe kuchepa kwa mayamwa. Chizindikiro cha bioavailability ndi 25-30%.

Ubale wa lisinopril ndi mapuloteni a plasma amalembedwa pa 5%. Zomwe zimagwiritsidwa ntchito ndi mapiritsi sizidutsa mu njira ya biotransfform mthupi. Kutupa kwa lisinopril pamtundu wake wapadera kumachitika ndi impso. Hafu ya moyo ili pafupifupi maola 12. Kuchulukitsa kwa chinthu kumajambulidwa ndi zizindikiro zazikulu za kulephera kwa impso.

Lisinopril Stada: malangizo onse ogwiritsira ntchito

Mtengo: kuchokera 85 mpaka 205 rubles.

Mapiritsi a Lisinopril Stada adapangidwira kuti azigwiritsa ntchito pakamwa.

Pankhani ya kuthamanga kwa magazi, amapatsidwa kumwa mankhwalawa 5 mg kamodzi patsiku. Pakakhala palibe zotchulidwa kuti achire zotsatira, n`zotheka kuchuluka kwa 5 mg (aliyense masiku 2-3) mpaka pafupifupi tsiku lililonse 20-25 mg wa kuchuluka. Pa kukonza mankhwala, tsiku lililonse 20 mg ndi mankhwala. Dziwani kuti mlingo waukulu wa mankhwalawa patsiku sayenera kupitirira 40 mg.

Achire zotsatira amakula pambuyo 2-4 milungu. kuyambira paukhazikitsidwa kwa zamankhwala, izi ziyenera kukumbukiridwa pakukweza Mlingo wa mankhwala. Ndi kuopsa pang'ono kwa achirewo, zomwe zingamwe mankhwala ena othandizira antixypertgency angadziwike.

Zotsatira zoyipa

Kuchokera ku CCC: kuchepa 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, lability yodandaula, chisokonezo.

Kuchokera pamatumbo am'mimba: nseru, dyspepsia, kusowa kwa chakudya, kusintha kwa kukoma, kupweteka kwam'mimba, kutsegula m'mimba, pakamwa kowuma.

Hematopoietic ziwalo: leukopenia, thrombocytopenia, neutropenia, agranulocytosis, kuchepa magazi (kuchepa Hb, erythrocytopenia).

Thupi lawo siligwirizana: angioedema, zotupa pakhungu, kuyabwa.

Laborator Zizindikiro: hyperkalemia, hyperuricemia, osowa - kuchuluka kwa "chiwindi" transaminases, hyperbilirubinemia.

Ena: Kutsokomola "kouma", kuchepa kwa potency, kawirikawiri - kulephera kwa impso, arthralgia, myalgia, malungo, edema (lilime, milomo, miyendo), kusokonezeka kwa impso za mwana wosabadwayo.

Malangizo apadera

Kusamalidwa kwapadera kumafunikira pakulamula odwala omwe ali ndi vuto la mtima lamitsempha lamitsempha kapena stenosis yamitsempha imodzi yamkati (mwina kuwonjezeka kwa kuchuluka kwa urea ndi creatinine m'magazi), odwala omwe ali ndi matenda amitsempha yamagazi kapena matenda amitsempha, ofooka mtima. Odwala ndi mtima kulephera, ochepa hypotension angayambitse matenda aimpso.

Mukamagwiritsa ntchito mankhwala omwe amachepetsa kuthamanga kwa magazi kwa odwala omwe akuchita opaleshoni yayikulu kapena panthawi ya opaleshoni, lisinopril imatha kuletsa mapangidwe a angiotensin II, sekondale kupita kukakamiza renin secretion.

Chitetezo ndi luso la lisinopril mwa ana silinakhazikitsidwe.

Musanayambe chithandizo, ndikofunikira kulipirira kutayika kwa madzimadzi ndi mchere.

Kugwiritsa ntchito panthawi yomwe muli ndi pakati kumatsutsana, pokhapokha ngati simungathe kugwiritsa ntchito mankhwala ena kapena sangathe (wodwalayo ayenera kudziwitsidwa za chiopsezo cha mwana wosabadwayo).

Mafunso, mayankho, ndemanga pa mankhwala a Lisinopril Stada

Zomwe zimaperekedwa zimakonzekera akatswiri azamankhwala komanso zamankhwala. Chidziwitso chokwanira chokhudza mankhwalawa chili m'malangizo omwe amaphatikizidwa ndi zomwe amapanga ndi wopanga. Palibe chidziwitso chomwe chatumizidwa patsamba lino kapena tsamba lililonse la tsamba lathu chomwe chingagwire ntchito ngati cholowa m'malo mwapadera kwa katswiri.

Ndemanga za odwala pakumwa mankhwala

Kuyesa kwa malingaliro pakugwiritsa ntchito Lisinopril Stada kunachitika. Ndemanga zimapezeka zabwino komanso zoipa.

Pakati pa "pluses", odwala adatinso:

• magwiridwe antchito
• njira yabwino yolandirira
• Mtengo wabwino wa ndalama.

"Cons" zidawonetsedwa motere:

• kupezeka kwa zoyipa (zosonyezedwa mu malangizo ogwiritsira ntchito, kutsokomola, kutsegula m'mimba, kutentha kwa mtima, nseru, kupweteka pamutu ndizofala),
• zotsatira sizibwera nthawi yomweyo
• zofunika diuretic achire pamaso mankhwala,
• owopsa kwa okalamba pambuyo pa zaka 65, malinga ndi malangizo.

Madokotala amafufuza

Ganizirani malingaliro a akatswiri pa mankhwalawa Lisinopril Stada. Kuunikiridwa kwa madokotala kumadziwitsa kuti mankhwalawa ndi othandizadi, omwe nthawi zambiri amalekerera.

Nthawi yomweyo, madotolo amawona kuti Lisinopril Stada samangokhala payekha, ndikofunikira kugwiritsa ntchito mankhwala ovuta. Ndikosavuta kuyang'anira momwe impso zimayendera, monga, kuyesa kuchuluka kwa creatinine.

Zotsatira za mankhwala Lisinopril Stada

Woletsa, kapena mwanjira ina, blocker, "suppressor" wa ACE amaletsa kupanga mahomoni angiotensin, omwe amakhumudwitsa vasoconstriction ndipo, chifukwa chake, amakulitsa mphamvu. Kuphatikiza apo, angiotensin amachititsa kuti aldosterone ya mahomoni, yomwe imalepheretsa kuchotsa zamadzimadzi mu minofu. Nthawi zambiri, zimathandizira kuwonjezera kuchuluka kwa magazi ndikuwonjezera kukakamiza, koma nthawi zina zimakhala ndi mawonekedwe osakhala bwino mu mawonekedwe a edema, kuthamanga kwambiri komanso kulephera kwa mtima.

Zonsezi zitha kupewedwa ndikumapondereza kupitiliza kwa angiotensin munthawi, ndizomwe amasinopril amachita. Mphamvu yake imathandizira kukulitsa mitsempha yayikulu pamlingo wokulirapo kuposa mitsempha yam'mphepete. Izi ziyenera kuganiziridwa pophatikiza lisinopril ndi mankhwala ena.

Ngakhale mutangosiya kumwa mankhwalawo mwadzidzidzi, mphamvu zake zikhala kwakanthawi: sipangakhale kulumpha lakuthwa mopanikizika. Kugwiritsa ntchito nthawi yayitali, lisinopril imathandizira kubwezeretsa minofu yamatumbo omwe amakhudzidwa ndi ischemia.

Kwa iwo omwe avutika ndi myocardial infaration popanda zizindikiro zazikulu, izi zikutanthauza kuchepa pang'ono pang'onopang'ono pang'onopang'ono kwa gawo lamanzere lamanzere. Ndipo kwa iwo omwe akukhala ndi vuto la mtima wosalephera, uwu ndi mwayi wowonjezera moyo wawo.

Bongo

Mukapitirira muyeso wa mankhwalawa, zizindikiro zotsatirazi zimawonekera:

• kuchepetsa kupsinjika pofika 90/60,
• ziume ziuma, chifuwa,
• mantha, nkhawa, kusakwiya, kapena mosemphanitsa - kugona kwambiri,
• aimpso ntchito, kwamikodzo posungira.

Ngati mankhwala osokoneza bongo atsimikiziridwa, choyambirira muyenera kuchotsa zotsalira za mankhwalawa zomwe zalowa m'thupi: muzimutsuka m'mimba ndi kumwa mankhwala othandiza. Kenako, ngati kuli kofunikira, ndikofunikira kuchepetsa mphamvu ya lisinopril: osavomerezeka, ndikokwanira kuthandiza wodwalayo kuti ayime moyang'ana ndikukweza miyendo. Ngati mankhwalawa atengedwa kwambiri, mankhwala a vasoconstrictor ndi yankho la intravenous sodium chloride adzafunika.

Ngati mankhwalawa muyezo waukulu kwambiri walowa kale m'magazi, hemodialysis ndi mankhwala.

Kuyanjana ndi mankhwala ena ndi mowa

Lisinopril atha kugwiritsidwa ntchito limodzi ndi calcium channel blockers ndi adrenergic blockers, koma ziyenera kukumbukiridwa kuti mphamvu ya mankhwalawa imalimbikitsidwa.

Ndikwabwino kuletsa kuchuluka kwa okodzetsa kapena, momwe mungathere, kuchepetsa kuchuluka kwake. Mankhwala osokoneza bongo a potaziyamu pamene akumamwa angayambitse hyperkalemia.

Lizonopril Stada sayenera kuphatikizidwa ndi barbiturates, antipsychotic ndi antidepressants - kupanikizika kudzatsika kwambiri komanso modabwitsa.

Kumwa mankhwala a zilonda zam'mimba ndi gastritis kumasokoneza kuyamwa kwa lisinopril.

Kugwiritsa ntchito kwa lisinopril ndi ma insulin ndi ma hypoglycemic othandizira amakhumudwitsa hypoglycemia, makamaka m'mwezi woyamba wamaphunziro a lisinopril.

Mankhwala osagwirizana ndi antisteroidal amachepetsa mphamvu ya mankhwalawo.

Simungathe kuphatikiza mankhwalawa ndi cytostatics, allopurinol ndi procainamide kuti mupewe kukula kwa leukopenia.

Moyo wa alumali ndi malo osungira

Mankhwalawa amatha kukhalabe ndi zinthu zake kwa zaka zitatu, pokhapokha ngati nthawi yonseyi amasungidwa m'malo amdima, kutentha osaposa 25 digiri.

Mankhwalawa sayenera kusungidwa m'malo omwe ana angathe kuwapeza, ndikuwatengedwa atatha tsiku lotha ntchito.

Mtengo wa mankhwala zimatengera muyeso wa mankhwalawo komanso dera lomwe amagulitsidwa. Mtengo wa ma CD, momwe mapiritsi 30 okhala ndi mulingo wa 5 mg, ali pafupifupi ma ruble 110. Pafupifupi 20 mapiritsi 20 omwe ali ndi 10 mg. Phukusi lomwe lili ndi mapiritsi 20 a 20 mg limatha pafupifupi ma ruble 170.

Pali mankhwala ambiri okhala ndi zinthu zomwezi zomwe zimagwira mosiyanasiyana pazinthu zothandizira komanso m'dziko lopanga. Ngati mukufuna inhibitor ya ACE ya gulu lina, muyenera kuphunzira mankhwala ozikidwa pa Captopril, kufenopril, benazepril ndi fosinopril.

Ngati mukufuna mankhwala kuti muchepetse kukakamizidwa kuchokera ku gulu lina, mutha kulabadira calcium blockers (verapamil, diltiazem) kapena antispasmodics (drotaverine ndi mankhwala ozikidwa).

Lizonopril Stada - mankhwala ochepetsera kuthamanga kwa magazi ndikusintha kayendedwe ka magazi mu minofu ya mtima. Musanayambe kumwa mankhwalawa, muyenera kuonetsetsa kuti palibe zotsutsana ndikupita kwa dokotala.

Zisonyezero za mankhwala Lisinopril Stada

Arterial hypertension, aakulu mtima kulephera (monga adjunct ngati osakwanira potaziyamu-okodzetsa okodzetsa kapena, ngati n`koyenera, kuphatikiza digitis kukonzekera), pachimake myocardial infarction ndi khola magawo amitsempha yamagazi (kwa odwala omwe ali ndi mawonekedwe a hemodynamic magawo omwe ali ndi SBP pamtunda wa 100 mm Hg. Art., Serum creatinine mulingo wotsika 177 μmol / L (2 mg / dL) ndi proteinuria yochepera 500 mg / tsiku) kuwonjezera pa chithandizo chokwanira cha kulowetsedwa kwa myocardial, makamaka mu kuphatikiza ndi nitrate.

Mimba komanso kuyamwa

Gwiritsani ntchito panthawi yoyembekezera. Asanayambe chithandizo, amayi omwe ali ndi zaka zakubala ayenera kuwonetsetsa kuti sanatenge pakati. Pa chithandizo, amayi ayenera kutenga njira zopewa kutenga pakati. Ngati mimba ikupezekabe pakumwa, ndikofunikira, malinga ndi malingaliro a dokotala, kusintha mankhwalawo ndi kwina, koopsa kwa mwana, popeza kugwiritsa ntchito mapiritsi a Lisinopril Stada, makamaka m'miyezi 6 yapitayi ya mimba, ikhoza kuvulaza mwana wosabadwayo.

Ma Ahibuloseti a ACE amatha kuchotseredwa mkaka wa m'mawere. Zotsatira zawo pa makanda oyamwitsa sizinaphunzire. Chifukwa chake, pa mankhwalawa ayenera kusiya kuyamwitsa.

Mlingo ndi makonzedwe

Mkati monga lamulo, kamodzi m'mawa, mosasamala kanthu za zakudya, kudya ndi madzi okwanira (mwachitsanzo, kapu yamadzi).

Matenda oopsa a arterial: Mlingo woyamba - 5 mg / tsiku, m'mawa. Kusankha kwa dose kumachitika kuti magazi akwaniritse bwino. Musachulukitse mlingo wa mankhwalawa pasanathe milungu 3. Nthawi zambiri, mlingo wokonza ndi 10-20 mg kamodzi patsiku. Amaloledwa mu umodzi - 40 mg 1 nthawi patsiku.

Ndi kukanika kwa aimpso, kulephera kwa mtima, kulolera kusiyanitsa kukokoloka, hypovolemia ndi / kapena kuchepa kwa mchere (mwachitsanzo, chifukwa cha kusanza, kutsegula m'mimba kapena chithokomiro), matenda oopsa kapena okonzanso, komanso odwala okalamba, mlingo woyambira wa 2.5 mg 1 nthawi ikufunika patsiku m'mawa.

Kulephera kwa mtima (kungagwiritsidwe ntchito limodzi ndi okodzetsa ndi kukonzekera kwa digito): mlingo woyambirira - 2,5 mg kamodzi tsiku lililonse m'mawa. Mlingo wokonza umasankhidwa m'magawo, ndikukulitsa mlingo ndi 2,5 mg. Mlingo ukuwonjezeka pang'onopang'ono, kutengera kutengera kwa wodwalayo. The pakati pakati kuchuluka kuchuluka ayenera 2, makamaka 4 milungu. Mlingo waukulu kwambiri ndi 35 mg.

Acute myocardial infarction yokhazikika magawo a hemodynamic magawo (ayenera kufotokozeredwa kuwonjezera ma nitrate omwe amagwiritsidwa ntchito, mwachitsanzo, iv kapena mawonekedwe amkati mwa khungu komanso kuwonjezera pazomwe zimachitika nthawi zonse chithandizo cha matenda am'mnyewa wamatumbo pang'onopang'ono magawo a hemodynamic wodwala. Mlingo woyamba ndi 5 mg, kenako 5 mg pambuyo maola 24 ndi 10 mg pambuyo maola 48, ndiye pa 10 mg / tsiku. Ndi CAD yotsika (mmHg), pakadali koyamba kwa chithandizo chamankhwala kapena m'masiku atatu oyamba atakumana ndi vuto la mtima, muyeso wochepetsedwa wa 2.5 mg uyenera kukhazikitsidwa.

Pankhani ya ochepa hypotension (SBP pansipa 100 mmHg), mlingo wokonza tsiku ndi tsiku sayenera kupitirira 5 mg ndipo, ngati pakufunika, kuchepetsa mpaka 2,5 mg ndikotheka. Ngati, ngakhale kuchepa kwa mlingo wa tsiku ndi tsiku mpaka 2,5 mg, ochepa hypotension (SBP pansi 90 mm Hg kwa ola limodzi) akupitilira, lisinopril iyenera kusiyidwa.

Kutalika kwa kukonza mankhwala ndi 6 milungu. Osachepera yokonza tsiku ndi tsiku 5 mg. Ndi zizindikiro za kulephera kwa mtima, chithandizo cha lisinopril sichitha.

Lisinopril imagwirizana ndi concomitant iv kapena cutaneous (patches) makulidwe a nitroglycerin.

Mlingo wocheperako wama impso (Cl creatinine 30-70 ml / min) ndi odwala okalamba (wopitilira zaka 65): mlingo woyambirira - 2,5 mg / tsiku, m'mawa, kumwa kosamalira (kutengera kukwanira kwa kuthamanga kwa magazi) - 5-5 10 mg / tsiku. Pazipita tsiku mlingo sayenera upambana 20 mg.

Kuti muthandizire kusankha kwa mankhwalawo, mapiritsi a Lisinopril Stada 2,5, 5, 10 ndi 20 mg ali ndi notch yogawa (kuti ikhale yosavuta kugawa mapiritsiwo magawo awiri kapena anayi ofanana).

Kutalika kwa mankhwala kumatsimikiziridwa ndi adokotala.

Kutulutsa mawonekedwe, kapangidwe kake ndi ma CD

Mankhwala a mtima Lizinopril Stada, omwe mankhwala athu amapereka kuti agule, amapezeka ngati mapiritsi oyera opanda chipolopolo omwe amakhala ndi matuza a pulasitiki, khumi lililonse. Matumba adadzaza m'mapaketi okhala ndi makatoni, pomwe adasindikiza dzina la mankhwalawo, deti la kupanga, zambiri za wopanga, ndi zina zofunika. Phukusi lililonse mulinso malangizo ogwiritsira ntchito mankhwalawa Lisinopril Stada, okhala ndi kufotokoza kwatsatanetsatane. Mtengo wa mankhwalawa Lisinopril Stada zimatengera kuchuluka kwa mapiritsi omwe ali phukusi - akhoza kukhala 10, 20, kapena 30. Kuphatikiza apo, kuchuluka kwa piritsi limodzi la yogwira, lisinopril, kumatha kusiyana. Itha kukhala 5, 10 ndi 20 mg, motsatana. Patsamba lathu mutha kufotokozera za mawonekedwe kapena mtundu wina wa mankhwalawo, kukonza zokapereka kunyumba, ndikuwerenga ndemanga pa Lisinopril Stada otsalira ndi anthu omwe agwiritsa kale ntchito mankhwalawa. Kuphatikiza pa lisinopril, kapangidwe kamankhwala awa kamakhala ndi zotsatirazi: • Asanu-atomu mowa-aldite, • Microcrystalline cellulose, • Lactose, • Disubstituted calcium phosphate, • Mchere wa magnesium ndi stearic acid, • Omwe amapezekera. Zomwe zimapangidwira komanso kuchuluka kwa magawo a anthu obwera kudzapezekanso mu kupezeka kwa mafotokozedwe a mankhwalawo.

Njira zopewera kupewa ngozi

Kuchiza ndi lisinopril chifukwa cha matenda a mtima osakhazikika kuyenera kuyamba kuchipatala ndi kuphatikiza othandizira kapena okodzetsa pamiyeso yambiri (mwachitsanzo, zoposa 80 mg ya furosemide), kuchepa kwa madzimadzi kapena mchere (hypovolemia kapena hyponatremia: seramu sodium ochepera 130 mmol / l), kuthamanga kwa magazi , mtima wosakhazikika, kuchepa kwa impso, mankhwala omwe ali ndi Mlingo waukulu wa vasodilators, wodwalayo ndi wamkulu kuposa zaka 70.

Kuchulukitsidwa kwa ma electrolyte ndi creatinine mu seramu yamagazi ndi zizindikiro zama cell am magazi kuyenera kuyang'aniridwa, makamaka kumayambiriro kwa mankhwalawa komanso m'magulu omwe ali pachiwopsezo (odwala omwe amalephera aimpso, matenda a minofu yolumikizana), komanso kugwiritsa ntchito munthawi yomweyo ma immunosuppressants, cytostatics, allopurinol ndi procainamide.

Matenda ogwirizana. Mankhwalawa angayambitse kuchepa kwambiri kwa kuthamanga kwa magazi, makamaka pambuyo pa mlingo woyamba. Zizindikiro zamitsempha yamagazi kwa odwala omwe ali ndi kuthamanga kwa magazi popanda zovuta ndizosowa. Nthawi zambiri, chizindikiro cha ochepa hypotension chimachitika mwa odwala omwe ali ndi kuchepa kwa electrolyte kapena madzimadzi, kulandira okodzetsa, kutsatira mchere wopanda mchere, mutatha kusanza kapena kutsegula m'mimba, kapena hemodialysis. Zizindikiro ochepa ochepa hypotension anali kudziwika makamaka odwala matenda a mtima kuphatikizika ndi chifukwa aimpso kulephera kapena popanda izo, komanso odwala kulandira waukulu Mlingo diuretics akudwala hyponatremia kapena mkhutu aimpso ntchito. Odwala otere, chithandizo chamankhwala chiyenera kuyambitsidwa ndi kuyang'aniridwa mosamalitsa kuchipatala, makamaka kuchipatala, pamlingo wotsika ndipo mlingo uyenera kusinthidwa mosamala. Pa nthawi yomweyo, kuwunika ntchito zaimpso ndi kuchuluka kwa seramu potaziyamu ndikofunikira. Ngati ndi kotheka, siyani chithandizo cha mankhwala okodzetsa.

Kusamala ndikofunikira kwa odwala omwe ali ndi vuto la angina pectoris kapena matenda a cerebrovascular, momwe kuchepa kwambiri kwa magazi kumatha kubweretsa myocardial infarction kapena stroke.

Chiwopsezo cha chizindikiro chamadongosolo owonjezera panthawi ya chithandizo cha lisinopril chitha kuchepetsedwa poimitsa diuretic musanayambe chithandizo ndi lisinopril.

Pakakhala vuto la kuthana ndi magazi, wodwalayo ayenera kugona pansi, kumwa kapena kumwa jekeseni (kuti apangitse kuchuluka kwa madzimadzi). Atropine angafunikire kuchitira bradycardia yokhudzana. Pambuyo kuthetseratu kwa ochepa hypotension chifukwa chotenga muyezo woyamba wa mankhwalawa, palibe chifukwa chosiya kuchenjera mosamala kwa mlingo. Ngati matenda oopsa m'magazi omwe ali ndi vuto la mtima akakhala mwatsatanetsatane, kuchepetsa mlingo ndi / kapena kuchotsetsa okodzetsa ndi / kapena lisinopril kungafunike. Ngati ndi kotheka, masiku 2-3 isanayambike mankhwala ndi lisinopril, mankhwalawa okhudzana ndi okodzetsa ayenera kusiyidwa.

Arterial hypotension mu pachimake myocardial infarction. Mu kuphwanya kwa myocardial infarction, chithandizo cha lisinopril sichitha kuyambika ngati, chifukwa cha chithandizo cham'mbuyomu ndi mankhwala a vasodilator, pamakhala chiwopsezo chowonjezereka cha magawo a hemodynamic. Izi zikugwira ntchito kwa odwala omwe ali ndi CAD ya 100 mm RT. Art. ndipo pansipa kapena ndi cardiogenic shock. Ndi CAD ya 100 mm RT. Art. ndipo pansipa, mlingo wokonza uyenera kuchepetsedwa kukhala 5 mg kapena mpaka 2,5 mg. Mu pachimake m`mnyewa wamtima infarction, kutenga lisinopril kungachititse ochepa ochepa hypotension. Ndi okhazikika ochepa ochepa hypotension (SBP zosakwana 90 mm Hg.kwa 1 h) lisinopril mankhwala iyenera kusiyidwa.

Odwala omwe ali ndi vuto la mtima atadwala pambuyo poyipa wam'mnyewa wamtima, amasinopril ayenera kutumikiridwa ndi magawo okhazikika a hemodynamic.

Matenda obwezeretsanso / a impso artery stenosis (onani "Contraindication"). Ndi kukonzanso kwamitsempha yamagazi komanso ma mtima awiri (kapena osagwirizana ndi impso imodzi) impso yamitsempha yamagazi, kugwiritsa ntchito lisinopril kumayenderana ndi chiopsezo chambiri chakuchepa kwa kuthamanga kwa magazi ndi kulephera kwa aimpso. Ngoziyi imatha kuchulukirachulukira ndikugwiritsa ntchito okodzetsa. Ngakhale odwala omwe ali ndi matenda amitsempha yamagazi a unilateral, kulephera kwaimpso kungayende limodzi ndi kusintha kwapadera kwa seramu creatinine. Chifukwa chake, chithandizo cha odwala chotere chikuyenera kuchitika kuchipatala moyang'aniridwa ndi achipatala, kuyamba ndi mlingo wochepa, ndipo kuchuluka kwa mankhwalawa kuyenera kukhala pang'onopang'ono komanso mosamala. Mu sabata yoyamba ya chithandizo, chithandizo cha diuretic chiyenera kusokonezedwa ndikuwunikira ntchito ya impso.

Matenda aimpso. Gwiritsani ntchito mosamala odwala omwe ali ndi vuto laimpso. Odwala otere amafunikira mlingo wocheperako kapena kwakanthawi pakati pa Mlingo (onani "Mlingo ndi Ulamuliro").

Malipoti aubwenzi pakati pa matenda a lisinopril ndi kulephera kwa aimpso amakhudzana ndi odwala omwe ali ndi vuto la mtima kapena kupezekanso kwa impso (kuphatikizanso aimpso). Ndi matenda anthawi yake komanso chithandizo choyenera, kulephera kwaimpso komwe kumayenderana ndi lisinopril mankhwala kumatha kusintha.

Odwala ena ochepa matenda oopsa popanda kudziwika kuti aimpso kuwonongeka, kuphatikizika kwa mankhwala a lisinopril ndi okodzetsa kunawonetsa kuchuluka kwa urea ndi creatinine. Muzochitika zoterezi, zitha kukhala zofunikira kuchepetsa mlingo wa ACE inhibitor kapena kuletsa kukodzetsa, muyeneranso kuganizira za kukhalapo kwa aimpso a minyewa ya m'mitsempha.

Lisinopril mankhwala ochizira pachimake myocardial infarction sayenera kutumizidwa kwa odwala omwe ali ndi vuto la impso: a serum creatinine ndende yaopitilira 177 μmol / L (2 mg / dL) ndi / kapena proteinuria woposa 500 mg patsiku. Lisinopril iyenera kusiyidwa ngati vuto laimpso likukula mu mankhwala (serum ACE Cl creatinine ikhoza kutchulidwa kwambiri kuposa achichepere. Chifukwa chake, odwala okalamba ayenera kuthandizidwa mosamala. komanso kuwunika kuthamanga kwa magazi ndi ntchito ya impso.

Ana. Kuchita bwino ndi chitetezo cha lisinopril mwa ana sizimamveka bwino, chifukwa chake sikuti amavomerezeka.

Hyperaldosteronism yoyamba. Mu aldosteronism yoyamba, antihypertensive mankhwala, zomwe zimachitika chifukwa cha kuletsa kwa dongosolo la renin-angiotensin, nthawi zambiri sizothandiza, chifukwa chake, kugwiritsa ntchito lisinopril sikulimbikitsidwa.

Proteinuria Zovuta za chitukuko cha proteinuria zidanenedwa, makamaka kwa odwala omwe amachepetsa mphamvu yaimpso kapena atamwa mokwanira mankhwala a lisinopril. Ndi proteinuria yofunika kwambiri (yoposa 1 g / tsiku), mankhwalawa ayenera kugwiritsidwa ntchito pokhapokha kuyerekeza mosamala phindu lomwe lingachitike ndi zoopsa zomwe zingachitike ndikuwunikira magawo a chipatala ndi a labotale.

LDL-phoresis / desensitization. Chithandizo chophatikizana ndi ACE inhibitors chimatha kuyambitsa chiopsezo cha anaphylactic reaction pa LDL phoresis pogwiritsa ntchito dextransulfate. Izi zimachitika (mwachitsanzo, kutsika kwa magazi, kupuma movutikira, kusanza, khungu lanu siligwirizana) ndikothekanso ndi kutsegula kwa lisinopril panthawi yoletsa kuchiza matenda osokoneza bongo (mwachitsanzo, njuchi kapena mavu).

Ngati ndi kotheka, LDL-phoresis kapena kukana mankhwala opha tizirombo toyambitsa matenda tizisintha kwakanthawi ndi mankhwala ena (koma osagwiritsa ntchito ACE inhibitor) pochizira matenda oopsa kapena kulephera kwa mtima.

Kutupa kwa minofu / angioedema (onani. "Contraindication"). Pali zosowa zambiri za angioedema a nkhope, miyendo, milomo, lilime ndi nasopharynx mwa odwala omwe ali ndi ACE zoletsa, kuphatikizapo lisinopril. Edema imatha kukhala panthawi iliyonse ya zamankhwala, yomwe mwa izi iyenera kuyimitsidwa nthawi yomweyo ndikuwunika momwe wodwalayo alili.

Ngati kutupa kumacheperachepera kumaso ndi milomo, nthawi zambiri kumatha popanda kuthandizidwa, ngakhale antihistamines angagwiritsidwe ntchito pochepetsa zizindikiro.

Chiwopsezo chokhala ndi angioedema pamankhwala othandizira ndi ACE inhibitors ndiwokwera kwambiri mwa odwala omwe ali ndi mbiri ya angioedema yomwe siyimayenderana ndi kugwiritsidwa ntchito kwa ACE inhibitors.

Angioedema ya lilime ndi nasopharynx ndizowopsa pamoyo. Pankhaniyi, njira zofunikira zikuwonetsedwa, kuphatikiza kupendekera kwaposachedwa kwa 0.3-0.5 mg ya adrenaline kapena ulesi pang'onopang'ono wa 0.1 mg wa adrenaline poyang'anira ECG ndi kuthamanga kwa magazi. Wodwala ayenera kuchipatala. Asanayambe kumuchiritsa wodwalayo ayenera kuwonedwa kwa maola osachepera 12-24, mpaka zizindikilo zonse zitatha.

Aortic stenosis / hypertrophic cardiomyopathy. ACE zoletsa ayenera kugwiritsidwa ntchito mosamala odwala ndi kutsekeka kwa magazi kutuluka kwa lamanzere yamitsempha. Ndi hemodynamically yofunika kusokonezeka, lisinopril imatsutsana.

Neutropenia / agranulocytosis. Milandu yocheperako ya neutropenia kapena agranulocytosis imadziwika kwambiri kwa odwala omwe ali ndi vuto loopsa la matenda oopsa omwe amachitidwa ndi ACE zoletsa. Sizinawoneke kwambiri pamankhwala osavuta, koma zinali zofala kwambiri kwa odwala omwe amalephera kupweteka kwa impso, makamaka ndi zotupa za mtima kapena zotupa (mwachitsanzo, lupus erythematosus kapena dermatossteosis) kapena munthawi yomweyo. Odwala oterewa amawonetsedwa kuyang'anira maselo oyera. Pambuyo pakuchotsa kwa zoletsa za ACE, neutropenia ndi agranulocytosis zimatha.

Ngati kuwonjezeka kwa kutentha kwa thupi, kuwonjezeka kwa mitsempha komanso / kapena zilonda zapakhosi pakumwa mankhwala, muyenera kufunsa dokotala kuti mudziwe kuchuluka kwa maselo oyera amwazi m'magazi.

Zochita pa opaleshoni / opaleshoni wamba. Odwala omwe akuchitidwa opaleshoni yayikulu ndikulandila mankhwala oletsa kuthamanga kwa magazi, mankhwala osokoneza bongo amalepheretsa mapangidwe a angiotensin II chifukwa chobwezeretsa kutulutsa kwa renin. Ngati matenda ochitika m'magazi akayamba motero, amatha kuwongolera mwa kukonzanso voliyumu (onani "Kuchita").

Zikadachitika matenda oopsa kapena kuperewera kwamtima kosalekeza, kuyamba kwa mankhwala, komanso kusintha kwa mlingo, kuyenera kuchitika kuchipatala.

Ngati mukumwa mankhwalawo pansipa ya mlingo womwe wapatsidwa kapena kudumpha mlingo, ndizosavomerezeka kubwereza mlingo wotsatira. Ndi dokotala yekhayo amene angakulitse mlingo.

Ngati zosokoneza kwakanthawi kapena kusiya kuchira kwa odwala omwe ali ndi vuto la mtima, zizindikiro zimatha kubwereranso. Osasokoneza chithandizo popanda kufunsa dokotala.

Palibe maphunziro pazotsatira za mankhwalawa pakukonzekera kuyendetsa magalimoto. Komabe, munthu ayenera kuganizira kuthekera kwa kusokonezeka kwa magalimoto ndi njira, komanso kugwira ntchito popanda kudalirika chifukwa cha chizungulire komanso kutopa kwambiri.

Kuyanjana kwa mankhwala

Pali chidziwitso chokhudzana ndi kugwiritsidwa ntchito kwa mankhwalawa Lisinopril Stada ndi mankhwala ena: • Kugwiritsidwa ntchito palimodzi ndi ma diuretics kumapangitsa chidwi chochepetsa kuthamanga kwa magazi, ngakhale kuzisonyezo zomwe zimakhala zowopsa paumoyo. Ngati ndi kotheka, ma diuretics ayenera kuchepetsedwa musanalandire chithandizo. • Mochenjera, muyenera kumwa lisinopril limodzi ndi njira zilizonse zomwe zimakhala ndi potaziyamu, chifukwa izi zimapangitsa kuti magazi azikhala mokwanira, • Kuwonjezeka kwa antihypertensive kungapangitse kuti mankhwalawa atengedwe limodzi ndi zomwe zimapangitsa, Stad, chifukwa chake, chizindikirochi chikuyenera kuyang'aniridwa panthawi ya chithandizo. • Kukonzekera mankhwalawa kutentha kwa mtima ndi matenda ena am'magazi omwe amachepetsa m'mimba, kuchepetsa kuchepa kwa chinthu. Colestyramine imachitanso chimodzimodzi. • Kugwirizana kwamankhwala osokoneza bongo a lisinopril omwe ali ndi insulin komanso othandizira ena othandizira odwala matendawa amatha kuchepetsa kuchuluka kwa shuga m'magazi mpaka 3.5 mmol / L, omwe amadziwika kuti ndi matenda. • Kugwiritsa ntchito ma pinkillers, antipyretic mankhwala osachokera ku steroidal, kuthandiza kuthana ndi kutentha thupi ndi njira zotupa, kuchepetsa mphamvu ya lisinopril potengera kuchepa kwa magazi. • Mankhwala okhala ndi golide omwe amagwiritsidwa ntchito pochizira nyamakazi, atha kutengedwa ndi lisinopril, amatha kupangitsa magazi kusefukira kumaso, khungu rede, kusanza, nseru. • Mankhwala a Cytostatic, antiarrhythmic, xanthine oxidase inhibitors, akaphatikizidwa ndi lisinopril, angayambitse kuchepa kwa maselo oyera m'magazi. • Kuphatikiza pamodzi kwa mankhwalawo kumaloledwa limodzi ndi mankhwala omwe amachititsa blockade ya betoadrenoreceptors, mankhwala a nitrate, mankhwala omwe amathandiza kulimbana ndi mapangidwe akuchulukitsa kwa magazi. • Mukamamwa ndi acetylsalicylic acid, muyezo wake umayenera kukhala wochepa, kuti mankhwalawa athe kuchepa. Mlingo wovomerezeka wa acetylsalicylic acid si woposa 300 mg patsiku.

Migwirizano ndi magwiritsidwe akusungidwa

Sungani mankhwalawo pamalo otetezedwa ku chinyezi ndi dzuwa lowala. Kutentha kolimbikitsidwa sikupitirira 25 digiri Celsius. Pewani kufikira ana. Alumali moyo wa mankhwala Lisinopril Stada ndi zaka 3 kuyambira tsiku lopangidwa lomwe lasonyezedwa pa phukusi. Pakumapeto kwake, ndizoletsedwa kumwa mankhwalawa - adzafunika kutayidwa ndikutsatira njira zofunikira mosamala.