Kodi bisoprolol ndi lisinopril zitha kugwiritsidwa ntchito nthawi yomweyo?

Kodi wogulitsa kwambiri mankhwala a mtima ndi mtima wamatenda - Concor? Mawonekedwe ake osiyanitsa ndikufanizira ndi analogues, zonsezi muphunzira kuchokera m'nkhaniyi.

Concor ili ndi yogwira mankhwala bisoprolol. Ichi ndi β1-blocker chomwe chimalepheretsa zochita za adrenaline (homon) pamisempha ya mtima.

Zotsatira zazikulu za Concor zimaphatikizapo:

• Kuchepetsa kusefuka kwa minofu ya mtima - ma extrasystoles amatha (mawonekedwe achilendo amtima) ndipo kugunda kwamtima kumachepetsa (kugunda kwa mtima),
• Mphamvu ya contractions imachepetsedwa, yomwe imathandizira:
  • Kutsika kwa magazi (BP),
  • Kuchepetsa kufunikira kwa myocardial oxygen,
  • Angina akuwukira (kupweteka kwa mtima pakuchita masewera olimbitsa thupi) kumayamba kucheperachepera ndikuchepera.
  • Pogwiritsa ntchito nthawi yayitali, kukula kwa minofu ya mtima kumachepa, komwe kumapangitsa kuti m'tsogolo mukhale kupulumuka ndikuchepetsa zovuta za mtima.

Mankhwalawa amagwira ntchito tsiku lonse ndipo amatengedwa kamodzi patsiku. Concor imagwiritsidwa ntchito pazotsatira izi:

• Matenda oopsa a magazi (kuthamanga kwa magazi pamwamba pa 140/90 mm Hg) - amachepetsa kupsinjika,
• Matenda a mtima a Coronary (CHD) (cholakwika pakati pa kufunika ndi kutumiza kwa okosijeni ku myocardium) - kumachepetsa kufunika kwa myocardium mu oxygen,
• Tachycardia (kugunda kwa mtima kupitilira 90 / mphindi) - imachepetsa kugunda kwa mtima,
• Extrasystole ndi chisokonezo chilichonse cha mtima (arrhythmias) - chimalepheretsa chitukuko,
• Kulephera kwa mtima (edema ndi kufupika kwa mpweya chifukwa cha kulimbitsa thupi) chikhululukiro - kumathandizira ntchito yamtima, kumachepetsa kudutsa kwa matendawa, kumathandizira kudwala kwa matenda.

Concor ikhoza kuyambitsa kuchepa kwambiri kwa kugunda kwa mtima, kukulitsa kwa conduction blockade (kuphwanya njira yokhazikika yamagetsi amagetsi kudzera pamtima).

Kodi zoletsa ACE ndi ma sartani ndi chiyani?

Kuphatikiza pa β-blockers, pali magulu angapo a mankhwala omwe amachepetsa kuthamanga kwa magazi. Chimodzi mwazo chimakhudza otchedwa renin-angiotensin-aldosterone system (RAAS) ndipo imaphatikizapo angiotensin-akatembenuza enzyme inhibitors (ACE inhibitors) ndi angiotensin II receptor blockers (sartans).

RAAS ndi zochitika zamitundu mitundu zosiyanasiyana. Zimayamba mu impso, pamene ma receptor apadera mu ziwalo izi amatsimikiza kuchepa kwa magazi pang'onopang'ono, zomwe zimapangitsa kuchepa kwamkodzo. Pankhani ya matenda ena (kuchepetsa mitsempha ya impso, matenda a impso), dongosolo limayendetsedwa, zomwe zimapangitsa kuti pakhale matenda oopsa.

Mankhwala ochokera ku gulu la ACE inhibitor ndi sartans amagwiritsidwa ntchito kuchepetsa ntchito ya RAAS komanso kuthamanga kwa magazi. Chinsinsi chachikulu cha mankhwalawa ndikuchepa kwa mitsempha ya impso. Limagwirira ntchito a ACE zoletsa amatengera kupewa kupewa mapangidwe angiotensin, wamphamvu vasoconstrictor. Ma Sartan amalepheretsa zomwe angiotensin omwewo poletsa ma receptors kuti azimvera.

Kuphatikiza pakuchepetsa kuthamanga kwa magazi, maubwino a ACE zoletsa akuphatikizapo:

• Kupititsa patsogolo mkhalidwe wa impso ndi matenda ashuga, matenda a impso,
• Kuchepetsa chiopsezo chokhala ndi myocardial infaration, kusintha kwa moyo wa matenda amtima,
• Kuchepetsa kukula kwa mtima kulephera.

Choyipa chachikulu cha ACE inhibitors ndi kuthekera kwawo poyambitsa chifuwa chowuma. Nthawi zina, zimayambitsa kuchoka kwa mankhwalawa.

Ma Sartan ali ndi izi:

• Sinthani mkhalidwe wa impso m'mikhalidwe yofananayi,
• Osayambitsa chifuwa chowuma,
• Tsatirani njira ya gout (kuchuluka kwa mchere wa uric acid muzinthu zofewa),
• Sinthani njira zamachiritso,
• Musachepetse chiopsezo cha matenda amtima komanso musalimbikitse matenda a mtima,
• Osachedwetsa kupita patsogolo kwa kulephera kwa mtima.

Izi ndizofunikira!
Ma inhibitors onse a ACE ndi sartan amakhala ndi mphamvu yayikulu kwambiri ya teratogenic (yowononga mwana wosabadwayo). Palibe chifukwa chomwe mankhwalawa angagwiritsidwe ntchito mwa amayi panthawi yomwe ali ndi pakati, popeza akutsimikiziridwa kuti adzayambitsa kukulitsidwa kwa vuto losabereka mwa mwana wosabadwayo.

Kusiyana Kaptoena

Chithandizo chogwira ntchito ku Kapoten ndi captopril - choletsa ACE cha m'badwo woyamba. Chomwe chimasiyanitsa ndi kuthamanga kwa kutsitsa magazi, makamaka ngati kumatengedwa pansi pa lilime, komanso nthawi yochepa yochita (mpaka maola 6 - 8). Izi zimapangitsa kuti Kapoten akhale wofunikira pakuthandizira panthawi yamavuto oopsa kwambiri. Kugwiritsa ntchito pafupipafupi, mankhwalawa samakhala bwino chifukwa chofunikira kutenga katatu patsiku.

Enalapril ndi Enap - mawonekedwe

Zomwe zimagwira mu Enap ndi Enalapril. Nthawi yomweyo, pansi pa dzina la "Enalapril" adaperekanso mankhwala ambiri kuchokera kumakampani osiyanasiyana opanga mankhwala. Enalapril ndi wa m'badwo wachiwiri wa zoletsa zoletsa za ACE ndipo wakhala akugwira ntchito kwa maola 12, zomwe zimapangitsa kuti ikhale yosavuta kugwiritsa ntchito - amatengedwa kawiri patsiku nthawi imodzi (mwachitsanzo, 7 am ndi 7 pm kapena 9 pm ndi 9 pm ndi 9 pm, 9).

Gawo lachiwiri losiyanitsa ndi enalapril ndi lipophilicity - mgwirizano wapamwamba wa minofu ya adipose. Katunduyu amapanga Enap mankhwala osankhira kuchiza kuthamanga kwa magazi mwa anthu onenepa kwambiri.

Kuyika kapena Concor - ndibwino bwanji?

Enap ndizovomerezeka kuti zigwiritsidwe ntchito kwa odwala omwe ali ndi matenda a impso, onenepa kwambiri komanso matenda a shuga. Concor ndibwino kwa odwala omwe ali ndi phokoso losokoneza, tachycardia, pafupipafupi kuukira kwa angina pectoris. Ngati munthu ali ndi kupuma kwamtima mkati mwa 50-60 kumenyedwa / mphindi, pali ma conduction blockaries, ndiye kuti Enap ayenera kukondedwa, chifukwa Concor imangokulitsa izi.

Concor ndi Enalapril - Kugwirizana

Kugwiritsa ntchito kwa β1-blocker ndi ACE inhibitor ndiko kuphatikiza kwakukulu kwambiri kwa mankhwalawa motsutsana ndi matenda oopsa. Onse a Concor ndi Enalapril ndi ena mwa oimira abwino kwambiri pamagulu awo azachipatala. Kugwiritsa ntchito mankhwalawa kukupatsirani zotsatirazi:

• Kuchepetsa kwambiri kuthamanga kwa magazi (kupitirira 180/110 mm Hg),
• Kuchepetsa kukula kwa mtima ndi impso,
• Kuchepetsa kukula kwa mtima kulephera.

Kusiyana Lisinopril

Lisinopril ndi wa m'badwo wachiwiri wa zoletsa zoletsa za ACE, koma zimasiyana ndi enalapril. Choyamba, mankhwalawa amagwira ntchito maola 24, omwe amakupatsani mwayi wowamwa kamodzi patsiku. Kachiwiri, Lisinopril amatanthauza ma hydrophilic mankhwala, omwe amachititsa kuti asamagwire bwino ntchito kwa odwala omwe amalemera kwambiri thupi. Chifukwa cha mtengo wotsika mtengo, zotsatira zabwino pakuchitika kwa matenda oopsa, matenda obwera chifukwa cha matenda ashuga, matenda a impso ndi kulephera kwa mtima, Lisinopril ndi enalapril ndi zoletsa zotchuka kwambiri za ACE.

Lisinopril ndi Concor - zingatengedwere limodzi?

Kugwiritsira ntchito kophatikizidwa kwa Concor β1-blocker ndi ACE inhibitor Lisinopril ndi gawo labwino kwambiri pakuphatikiza kwa Concor + Enalapril: onse mankhwalawa amatengedwa kamodzi patsiku, ndipo mphamvu ya izi sizikuchepa. Kusiyana kwake ndi anthu onenepa kwambiri omwe Lisinopril sangayambitse kuchepa kwa magazi.

Zambiri za Prestarium

Prestarium imaphatikizapo imodzi mwazomaliza za ACE zoletsa perindopril. Mankhwalawa amakhala ndi maola 24 ndipo amatengedwa kamodzi patsiku. Prestarium, monga Enalapril, amatanthauza ma lipophilic, chifukwa ndi othandiza kwambiri kwa odwala onenepa kwambiri. Zoyipa za mankhwalawa ndizokwera kwake (2 mpaka 3 nthawi zambiri poyerekeza ndi Lisinopril ndi Enalapril).

Poyamba, Prestarium idapita patsogolo monga ACE inhibitor, yomwe imatha kuteteza zotumphukira kuti zisamatulutsidwe ndi cholesterol plaques. Komabe, maphunziro akulu adatsutsa zomwe zimagwirizana ndi mankhwalawo.

Prestarium ndi Concor - Kugwirizana

Monga zoletsa zina zonse za ACE, Prestarium imaphatikizana bwino kwambiri ndi Concor β1-blocker. Mankhwalawa amathandizirana modabwitsa, kukonza patsogolo kwa kupulumuka ndikuchepetsa chiopsezo cha zovuta zakupha kwa anthu omwe ali ndi vuto la mtima, kunenepa kwambiri, matenda ashuga, komanso matenda a impso.

Momwe mungatenge Concor ndi Prestarium palimodzi?

Kusankhidwa kwa Mlingo pophatikiza Concor ndi Prestarium, monga ACE inhibitor iliyonse ndi with1-blocker, kumachitika motere. Ngati imodzi mwa mankhwalawa idatengedwa kale, ndiye kuti mlingo wake umakhalabe womwewo. Mankhwalawa, omwe amalembedwa koyamba, amagwiritsidwa ntchito koyamba mlingo (wa Concor ndi 2.5 mg, wa Prestarium - 2 mg). M'masiku 2 - 3 atamwa mankhwala osakanikirana, magazi amayenda. Ngati amachepetsa poyankha chithandizo, ndiye kuti kuchuluka kwa mankhwalawa kuyenera kuchitika pambuyo pa miyezi iwiri mpaka iwiri, mpaka zizindikirozo zizikafika pansi pa 140/90 mm Hg. Ngati, patadutsa masiku 2 kapena 3, kuthamanga kwa magazi sikucheperachepera kapena kuchepera ndi 20% ya woyamba, ndiye kuti mankhwalawa amawonjezeredwa mpaka atakwanira (20 mg ya Concor ndi 8 mg ya Perindopril) kapena pokhapokha patachitika zovuta.

Lorista ndi mawonekedwe ake

Lorista imaphatikizapo valsartan, mankhwala omwe ali m'gulu la sartani. Nthawi zambiri, Lorista ndi mankhwala ofananawo amapatsidwa mankhwala othandizira kutsokomola chifuwa chifukwa cha ACE zoletsa. Mosiyana ndi zomwe zidachitika kale, Sartan sangathe kukonza zowonjezereka za kulephera kwa mtima ndipo samachepetsa chiopsezo cha zovuta zoopsa za matenda a mtima.

Kuphatikiza pa tsankho la ACE inhibitors, a Lorista amatha kugwiritsidwa ntchito mwa odwala omwe ali ndi kuthamanga magazi pambuyo pakuchita opaleshoni. Ichi ndichifukwa cha kukhoza kwa sartan onse kukonza njira zochizira minofu. Kupatula ndikununkha (kukhazikitsa "kasupe" wapadera yemwe amakulitsa mphamvu ya chotupa) - apa Lorista adzatsogolera kubwezeretsa chombo mobwerezabwereza.

Concor kapena Lorista - zabwinoko ndi ziti?

Ngati tilingalira Concor ndi Lorista ngati njira yochizira matenda oopsa ochepa, ndiye kuti β1-adrenergic blocker imawoneka bwino: sizimangokhudza kuchuluka kwa kuthamanga kwa magazi, komanso kumalepheretsa kukula kwamavuto ambiri, kumapangitsa mkhalidwe wa minofu yamtima.

Osati maLorista okha, koma ma sartan onse amagwiritsidwa ntchito pochiza magazi othamanga limodzi ndi mankhwala ena, nthawi zambiri ndi β1-blockers.

Concor ndi Lorista - Kugwirizana

Zachidziwikire, kuphatikiza kwa Concor ndi Lorista kumakhala kotsika poyerekeza ndi kuphatikiza kwa Concor ndi choletsa chilichonse cha ACE chifukwa cha kutchulidwa kochepa kwambiri pakutha kwa mtima komanso chiwopsezo cha kulowerera kwa myocardial. Komabe, kuphatikiza kwa mankhwalawa kumatha kukakamizidwa chifukwa cha kukhazikika kwa chifuwa chowuma poyankha kutenga ACE inhibitor. Potengera zomwe zimachitika pa impso komanso nthawi ya matenda ashuga, Sartan Lorista sakhala otsika ku ACE inhibitors.

Makhalidwe a Bisoprolol

Bisoprolol ndi amodzi mwa otchuka beta-blockers, ili ndi dzina lina lodziwika - Concor.

Ili ndi moderate hypotensive and antianginal (anti-ischemic). Chidacho chimathandizira kuchepetsa kugunda kwa mtima pakupuma komanso panthawi yochita masewera olimbitsa thupi.

Amatchulidwa ngati mankhwala amodzi, komanso ngati gawo la zovuta mankhwala osiyanasiyana a mtima dongosolo.

Kodi lisinopril

Lisinopril ndi mtsogoleri pakati pa ACE inhibitors (angiotensin-converting enzyme), omwe amagwiritsidwa ntchito pochiza matenda oopsa a arterial. Chifukwa cha mankhwalawa, ndizotheka:

• ndi kugwiritsa ntchito pafupipafupi, pangani kuchepa kwamphamvu kwa kuthamanga kwa magazi kufikira milingo yabwinobwino,
• chepetsani chiopsezo chamanzere am'mitsempha yamagazi ochepa ndikuchepetsa kukula,
• sinthani ntchito ya mtima,
• chepetsani kuthekera kwa kulowerera m'mitsempha,
• chepetsa kuchepa kwa vuto la mtima.

Tilowetsedwe, kulowa mu magazi kumachitika nthawi yoyamba, kukwera mpaka kufika maola 6. Ntchito ya mankhwala yogwira imapitilira kwa maola ena 16 mpaka 17.

Mphamvu ya antihypertensive imadziunjikira ndikufikira pazambiri pambuyo pa miyezi iwiri. Chifukwa chake, mankhwalawo si njira yochepetsera kupanikizika.

Kuphatikizika kwa bisoprolol ndi lisinopril

Zimatsimikiziridwa kuti kugwiritsa ntchito mankhwalawa kuphatikiza kumakhala ndi mphamvu yotsutsa antihypertensive. Ngakhale kuti satha kuthana ndi mavuto, kuphatikiza kwa nthawi yayitali kumagwiranso ntchito.

Kuphatikiza apo, motsutsana ndi maziko a kuchepa kwa kuthamanga kwa magazi, kuthamanga kwa mtima kumabwerera kwazonse, kugunda kwa mtima kumachepa, tachycardia ndi michere yamitsempha yam'mimba imatha.

Kuphatikiza Bisoprolol ndi mankhwala Lisinopril motsutsana ndi kutsika kwa kuthamanga kwa magazi, kugunda kwa mtima kumabwerera kwazonse, kugunda kwa mtima kumachepa, ndipo tachycardia imasowa.

Zizindikiro zogwiritsidwa ntchito munthawi yomweyo

Pamodzi, onsewa mankhwalawa ndi ofunikira kwa ma pathologies otsatirawa:

• matenda oopsa pankhondo iliyonse
• kulephera kwa mtima
• angina pectoris
• michere
• pambuyo infaration mkhalidwe
• kuchuluka kwa matenda oopsa,
• tachycardia
• matenda a mtima.

Momwe mungatenge bisoprolol ndi lisinopril

Popeza zabwino zomwe mapiritsiwa akukhala ndi kupanikizika zimachitika pokhapokha ngati zikugwiritsidwa ntchito kwa nthawi yayitali, ziyenera kuyikidwa ndi cardiologist kapena akatswiri a zamankhwala. Kudzichitira nokha mankhwala oopsa sikovomerezeka.

Imwani mankhwala 1 nthawi patsiku. Mutha kumwa mapiritsi m'mawa nthawi yopatsidwa. Komabe, akatswiri ena amakhulupirira kuti ndibwino kumwa mankhwalawa usiku, chifukwa nthawi yopumula usiku, kuthekera kwa kuphwanya myocardial kumawonjezeka.

Kutengera ndi kuopsa kwa matendawa, adotolo atha kukupatsani 5-10 mg wa Lisinopril ndi 5 mg wa Bisoprolol kamodzi patsiku koyamba kwa chithandizo. Kutengera ndi kusinthasintha kwa kukakamizidwa, katswiri amatha kukulitsa kapena kuchepetsa mlingo.

Muyenera kumwa mankhwalawo mkati, mosasamala chakudya, ndi madzi ambiri.

Ndikofunika kukumbukira kuti muyenera kumwa mapiritsi pafupipafupi, moyo wanu wonse, makamaka mukatha zaka zapakati komanso zaka zotsatila. Ndi chithandizo cha episodic, palibe zotsatira. Kulumpha kulikonse pakukakamiza kumayambitsa matenda a mtima kapena sitiroko, kuphatikizapo kufa.

Bisoprolol iyenera kumwedwa pakamwa, mosasamala kanthu za kudya, ndi madzi ambiri.

Zotsatira zoyipa

Pogwiritsa ntchito nthawi yayitali ya Lisinopril, nthawi zina, kuoneka ngati chifuwa chouma ndicotheka. Pankhaniyi, muyenera kufunsa dokotala.

Kugwiritsa ntchito mankhwalawa kungayambitse kutopa, bradycardia, chizungulire, kugona, kuchepa kwambiri kwa nkhawa, m'malo osowa kwambiri matendawa - kukhumudwa, kusanza, kutsekula m'mimba.

Malingaliro a madotolo

Oleg, dokotala wamtima: “Ndimaona ngati kuphatikiza kwa ACE inhibitor ndi beta-blocker oyenera kuchitira matenda oopsa. Pogwiritsa ntchito nthawi yayitali, zimapangitsa kuti ziwonjezeke komanso kuti zichepetse kupanikizika. "

Anastasia, katswiri wa zamankhwala: "Bisoprolol-Lisinopril tata yatsimikizira ngakhale pa matenda oopsa kwambiri. Imalekeredwa bwino, kuphatikiza ndi odwala okalamba, ndipo ndiyotheka kuitenga - kamodzi kokha patsiku. Kuphatikiza apo, mankhwalawa ali ndi mitengo yokwera mtengo, yomwe imawathandiza kusankha anthu opuma pantchito. ”

Ndemanga za Odwala

Alexander, wazaka 68, Vladivostok: “Madotolo atazindikira matenda oopsa ndipo anayamba kusankha mankhwala, omwe sanayeserepo. China chake chinathandiza kwakanthawi, ndipo china chinali chopanda ntchito. Atayesa Lisinopril, pang'onopang'ono kupanikizika kunayamba kuchepa. Bisoprolol itawonjezedwa, njirayi idapita patsogolo. Tsopano ndimamwa piritsi limodzi lamankhwala ndikulimbikitsa usiku ndipo nthawi zambiri ndimapanikizika. ”

Tatyana, wazaka 44, Khabarovsk: "Lisinopril adawonetsedwa mwachangu, atapezeka kuti ali ndi digiri yachiwiri ya matenda oopsa. Pang'onopang'ono kupanikizika kunabwereranso ku malire, koma tachycardia wamphamvu adawonekera. Pamene kudya kwa Bisoprolol tsiku ndi tsiku kumawonjezeredwa, zimachitika mobwerezabwereza, ndipo thanzi langa linayamba kuyenda bwino. ”

Contraindication ku Bisoprolol ndi Lisinopril

Iwo contraindicated poyambira mankhwala ena matenda ndi zina, kuphatikizapo:

• mimba
• nthawi yoyamwitsa,
• Angina pectoris,
• kuchuluka kwa mahomoni a chithokomiro m'magazi,
• metabolic acidosis
• matupi awo sagwirizana ndi mankhwala
• kuchepetsedwa kupanikizika
• pambuyo infaration mkhalidwe
• kukhalapo kwa pheochromocytoma,
• Matenda a Raynaud ali kumapeto,
• kuchuluka kwa matenda oopsa,
• mphumu waukulu wa bronchial,
• kutsitsa kwamtima,
• kuphwanya mapangidwe kapena kulimba kwa zimachitika mu sinus node,
• Cardiogenic mantha
• kulephera kwamtima
• Mbiri ya edema ya Quincke,
• hypertrophic cardiomyopathy yokhala ndi mkhutu wamagazi m'mitsempha,
• kutsekeka kwa kutseguka kwa msempha, mitsempha ya impso kapena valavu ya mitral,
• kugawa kwambiri aldosterone,
• ana ochepera zaka 18,
• ntchito ndi mankhwala okhala ndi Aliskiren,
• impso yaimpso yokhala ndi mtundu wa creatinine wosakwana 220 220mol / l,
• kobadwa nako galactose,
• kuchepa kwa lactase.

Pa mankhwalawa, hemodialysis yogwiritsira ntchito ma membala oyenda kwambiri amaletsedwa.

Amlodipine ndi mowa zotsatirapo zoyipa

• Zoyambira zazikulu za mankhwalawo
• Mankhwala osokoneza bongo ndi zotsatira zake
• Mowa kugwiritsa ntchito amlodipine

Amlodipine ndi mankhwala osokoneza bongo omwe amalepheretsa kuthamanga kwa calcium m'njira zambiri. Nthawi zambiri amalembera kuthamanga kwa magazi, nthawi zina amagwiritsidwa ntchito ngati mankhwala osokoneza bongo. Chifukwa chake, muyenera kulingalira za Amlodipine ndi chiyani ndikugwirizana kwake ndi mowa.

Amlodipine ali ndi izi:

Imatha kuchepetsa mitsempha yamagazi, i.e., kamvekedwe ka makoma awo amachepa, chifukwa chake, lumen imawonjezeka. Antihypertensive zotsatira - zoyambira pakhungu lamkati la thupi. Machitidwe a antianginal, i.e., mankhwalawa amatha kuthetsa zonse zomwe zikuwonetsa kuwonekera kwa matenda omwe amakhudza mitsempha ya mtima. Imagwira ngati antispasmodic, zimakhala zosavuta kunena, kamvekedwe ka minofu kachepa.

Zotsatira za kusintha kwa mankhwalawa kuchoka pamalo amodzi kupita kwina, zotengera zimakulitsa, chifukwa, mtima umayamba kugunda osati kawirikawiri. Zomwe zimachitika chifukwa cha kumwa mankhwalawa ndizochepa mphamvu pamitsempha ya mtima komanso kuchepa kwa kugwiritsa ntchito kwa okosijeni ndi myocardium.

Malinga ndi malangizo, zomwe zikuwonetsa kwambiri:

Amagwiritsidwa ntchito pothamanga kwambiri. Nthawi zina zimakhala ngati mono-wothandizira pakulimbikitsa matenda oopsa, ndipo nthawi zina Amlodipine amaloledwa kugwiritsidwa ntchito ngati tazem ndi theazadnes, ziletsa ndipo, a, β - adreno blockers. Chidacho chimachotsa kufunika kwa kusinthasintha kwa myocardial ndi chithandizo kuchipatala chifukwa cha IHD kapena angina pectoris. Ngati angina adapezeka, ndiye kuti Amlodipine amalembedwa ngati chida chachikulu. Komanso, ndiye mankhwala oyamba mukakumana ndi myocardial ischemia, yomwe imayamba chifukwa cha kupindika kapena kuchepa kwa mitsempha ya m'mimba kapena kutsekeka kwawo. Amasankhidwa kuti achepetse kuwoneka kwa owopsa a ischemia a minofu ya mtima, makamaka stroke ndi vuto la mtima. Ngati dokotala akhazikitsa ma neoplasms pamakoma amitsempha yamagazi chifukwa cha ma spasms kapena kufupika kwa lumen ya mitsempha yamagazi, koma kuwunikira sikunapangidwe ndendende, ndiye kuti kugwiritsa ntchito mankhwalawa kumaloledwa. Itha kugwiritsidwa ntchito ngati monotherapy, ndipo nthawi zina ngati njira yowonjezera pamodzi ndi mankhwala a antianginal.

Mlingo wokhazikitsidwa ndi malangizo:

Ngati angina pectoris ali kale wodwala, ndiye kuti Amlodipine ayenera kumwedwa nthawi imodzi mu maola 24, piritsi limodzi (poganizira kuti lili ndi 5 mg), kuwona momwe wodwalayo amvera. Mlingo ungathe kuchuluka, mpaka 10 ml, komanso 1 nthawi patsiku, koma mkati mwa masiku 14. Ngati matenda a coronary apezeka, ndiye kuti mlingo sayenera kupitirira 5-10 mg, kamodzi pa maola 24 aliwonse.

Mukuyenera kudziwa kuti ngakhale mankhwalawo atakhala ngati wowonjezera, ndiye kuti mlingo sayenera kuchepetsedwa.

Ndikofunikanso kuganizira kuti phwandoli liyenera kuchitidwa pa maola okhazikika, i.e, maola 24 enieni ayenera kuchokera kuchokera nthawi yolandilidwa koyamba, kenanso.

Pali kuthekera kwakukulu kwa bongo.

Zotsatira zake ndi:

• Chulukani kuzindikiritsa zopangidwa ndi thupi lonse,
• Zosangalatsa pamtima
• Kupumula kwamphamvu kwamitsempha yamagazi, kuwonetsedwa pakukula kwawo, chifukwa, kutsika kwakukulu kwa kuthamanga kwa magazi.

Ngati dotolo awona kuchuluka kwa mankhwalawa, kapena munthu yemwe adalemba zomwe tafotokozazi, ndiye kuti thandizo liyenera kuperekedwa mwachangu:

• Choyambirira kuchita ndikutsuka m'mimba, kapena kusambitsa mwadala, kapena kuyika enema yoyeretsa,
• Chotsatira, muyenera kumwa ma enterosorbents, omwe angakuthandizeni kuyeretsa m'mimba ndikuchotsa zotsalira,
• Gona pabedi kapena pa sofa, ndi kuyika mapilo angapo pansi pa mapazi anu.
• Yang'anirani kugunda kwamtima kwanu ndi kupumira, chidzalo cha chikhodzodzo ndi magazi,
• Dokotala amayenera kukupatsani mankhwala othandiza kuponderezedwa ndi dopamine, mesatone ndi gluconate,
• Hemodialysis pamenepa sichingakhale chothandiza.

Malinga ndi malangizo, zotsutsana zazikuluzikulu zogwiritsira ntchito Amlodipine ndi:

Ngati munthu amadziwika ndi kusalolera kwa mankhwalawo wonse kapena ziwalo zake zina. Mukazindikira a angina pectoris, omwe ali ndi vuto losakhazikika. Chosiyana ndi Prinametal's angina pectoris. Ngati kuchuluka kwambiri kwamanzere kwamitsempha yamagetsi, kapena, mwa kuyankhula kwina, kugunda kwa mtima. Ngati dokotala watsimikiza kwambiri ndi matenda aortic stenosis. Ndi zoletsedwa kumwa mankhwalawa nthawi yakubala, popeza imalowerera mkati mwa placenta. Komanso, saloledwa kupereka mankhwala ngati mayi akuyamwitsa mwana wake. Ana aang'ono ndi oletsedwa kumwa mankhwalawa.

Ndikofunika kumvetsetsa kuti mutatenga Amlodipine, kupanikizika kwa zotsatira ndi zovuta zina zimatha kuchitika, ndichifukwa chake madokotala sanalimbikitse kuyendetsa kwakanthawi ndikusiya ntchito yomwe imafuna kuti anthu azikhala ndi chidwi chambiri kapena ndi zida zowopsa. Kuphatikiza apo, dokotala yemwe akupezekapo ayenera kutchulanso kuti kugwiritsa ntchito bwino mankhwalawa sikungotengera mankhwalawo, komanso mwakugwiritsira ntchito chithandizo chamankhwala. Cholinga chake chachikulu ndikuchepetsa kuchuluka kwa mchere womwe anthu amawotcha.

Kutengera kuwunikira konse ndi machitidwe azachipatala, mndandanda wazotsatira zoyipa zochokera kugwiritsidwa ntchito kwa mankhwalawo zidapangidwa.

Mavuto a mtima

• Kutupa m'mapewa, ana ang'ono ndi chidendene,
• Champhamvu tachycardia,
• Kudumphadumpha kwakukulu pamavuto, kutsika kwake kukuvuta,
• Kutupa kwamitundu yonse yamatombo,
• Kusweka kwa mtima, makamaka pafupipafupi.
• Kuwonongeka kwadzidzidzi, kodziwika ndi dziko la syncopal.

Zovuta zamkati mwa dongosolo lamanjenje:

• Kudumpha mu kutentha kwa thupi la munthu
• Maso a nkhope ndi thupi,
• Kutopa kukhazikika,
• Mutu waukulu
• Nthawi zambiri chizungulire,
• Hyperhidrosis,
• Kutopa ndi kugona kosalekeza,
• Mwambiri, munthu amamva kuwawa,
• Masomphenya akutsikira
• Makutu olimba, phokoso limveka
• Kukonda chakudya kumatha,
• Kutunda kwa miyendo yonse.

Kusakhudzidwa ndi dongosolo la genitourinary la munthu:

• Chikhumbo chokhazikika komanso chopanda chifukwa chopita "pang'ono pang'ono"
• Zomverera zosasangalatsa mukamapita kuchimbudzi,
• Groin kusapeza poyenda.

Mavuto ogaya:

• Zowawa kwambiri mu peritoneum,
• Kusilira ndi mseru
• Matenda a Dyspeptic
• Kuuma kwa nembanemba yamunthu,
• Kuchulukana,
• Matenda am'mimba
• Nthawi zina, chiwopsezo cha matenda a chiwindi chayamba.

Mphamvu ya minofu ndi mafuwa imavutikanso:

• Zosasangalatsa, ndikusintha ndikupweteka kwambiri padziko lonse la msana.
• Minofu kukokana
• Minofu minofu nthawi zonse imakhala yovuta.

Matendawa amagwiranso ntchito pakufalikira kwa magazi, koma pankhaniyi, machitidwewa sanalembe mlandu. Komabe, pali kuthekera kwakuti munthu angadwale ndi tropical tropical, alembe kuchepa kwamlingo wa leukocytes m'mwazi, komanso kuchuluka kwa mapulateleti.

Kumbali ya kupuma, palinso mavuto:

• Pomwe akuthamanga ndikuyenda, munthu amawona kufupika,
• Mphuno zopanda pake
• Kutsokomola kumachitika popanda chifukwa.

Khungu limadwalanso - kuyabwa kwambiri, redness ndi zotupa. Matenda a nkhumba samapezeka kawirikawiri.

Mwakuthupi - kulemera kumadumpha, kuchepa kwambiri, ndiye kukhathamiritsa thupi.

Funso lomwe limadziwika kwambiri pakati pa odwala omwe amamwa mankhwalawa ndi "kodi ndizotheka kugwiritsa ntchito zinthu izi mozungulira ndipo zotsatira zake zingakhale chiyani?".

Dokotala aliyense, popanda kuganiza, adzanena kuti kumwa mowa ndi mankhwala osayenera. Mosakayikira, pali magulu ambiri, ena amaletsa mgwirizanowu, ena amalola, koma ochepa, komabe ena ndi ovomerezeka ndi mowa uliwonse. Chowonadi ndi chakuti, ethanol ndi chinthu choopsa chomwe chimagwira mkati mwa dongosolo lamanjenje, ndipo monga tikuwonera pamndandanda wazotsatira, Amlodipine amakhudzanso izi.

Kuphatikiza apo, Amlodipine amalowa m'chiwindi, kuti akonzenso, mowa umachotsedwanso chimodzimodzi, zomwe zikutanthauza kuti zinthu zikafika m'thupi, zimayamba kugwira ntchito mpaka pamapeto. Zotsatira za "kugwidwa" kotero, chiwindi chimafooka, ndipo zotsatira zake zimatha kubweretsa imfa.

Malinga ndi malangizo, Amlodipine ndi mowa zitha kutengedwa mu tandem, koma osafunikira. Zigawo zomwe ndi gawo la kapangidwe kameneka zimayamba kusamwa bwino magazi mothandizidwa ndi mowa, pambuyo pake mankhwalawa amatha kutchedwa opanda kanthu.

Kuphatikizikaku ndikovomerezeka, koma funso ndi lakucha, bwanji mulimbikitsidwe ngati mukufuna kuwononga thupi lanu ndikusokoneza dongosolo lamanjenje lamkati ndi mowa?

Ndikofunika kudziwa kuti mowa, kumangolowa mthupi, komanso Amlodipine kumatsitsa mitsempha ya magazi, kutsitsa mamvekedwe awo, ndipo izi zimapangitsa kutsika kwa kupsinjika. Popita nthawi, ndi mulingo wowonjezereka, kupanikizika sikungobwerera kumene m'mbuyomu, kumalumpha pazikhalidwe zazikulu. Zimapezeka kuti zinthu ziwiri cholinga chake ndi zotsatira zosiyana.

Momwe munthu amathandizidwa ndi mankhwalawa, ndibwino kusiya kumwa kuti mupewe zomwe zingachitike mutayamwa. Mgwirizano wotere sukubweretsera chilichonse chabwino; mudzangokulitsa zowopsa m'machitidwe anu onse.

Amlodipine ndi mankhwala omwe amakhudza munthu aliyense munjira zosiyanasiyana, komanso kuphatikiza mowa, amathanso kuyankha. Ndi chikhumbo chonse, muyenera kukana mankhwalawa milungu iwiri ya mowa, kuti pambuyo pa maphunzirowa mukhale ndi thanzi labwino.

Chovulaza chochepa chomwe mungabweretse mthupi lanu pakumwa mowa ndimankhwala ndikutaya phindu la mankhwalawo. Zotsatira zoyipa kwambiri ndizo kuwonongeka kwa chiwindi ndi kuphulika kwa dongosolo lamanjenje lamkati. Osanyalanyaza thanzi lanu, ndikosavuta kusamalira lero kuposa kupulumutsa mawa.

Munkhaniyi, mutha kuwerengera malangizo ogwiritsira ntchito mankhwalawa Bisoprolol. Amapereka ndemanga kuchokera kwa alendo omwe amabwera patsamba lino - ogwiritsa ntchito mankhwalawa, komanso malingaliro a akatswiri azachipatala pakugwiritsa ntchito Bisoprolol pochita zawo.Chopempha chachikulu ndikuti muwonjezere ndemanga zanu za mankhwalawa: mankhwalawo adathandizira kapena sanathandizire kuchotsa matendawa, ndizovuta ziti zomwe zimawoneka ndi zotsatirapo zake, zomwe mwina sizinalengezedwe ndi wopanga. Bisoprolol analogues kukhalapo kwa masanjidwe ena okhala. Gwiritsani ntchito mankhwalawa angina pectoris ndikuchepetsa kupsinjika kwa akuluakulu, ana, komanso panthawi yoyembekezera komanso mkaka wa m'mawere. The zikuchokera ndi mogwirizana ndi mankhwala ndi mowa.

Bisoprolol - kusankha beta-blocker popanda zochita zake zomvera, ali ndi antihypertensive, antiarrhythmic ndi antianginal zotsatira. Mwa kutseka beta1-adrenergic receptors a mtima pamiyeso yotsika, amachepetsa mapangidwe a cyclic adenosine monophosphate (cAMP) omwe amalimbikitsidwa ndi ma catecholamines ochokera ku adenosine triphosphate (ATP), amachepetsa mayendedwe amkati mwa calcium ion (Ca2 +), ali ndi vuto la chrono-, poyambira. contractions, linalake ndipo tikulephera conduction ndi excitability, amachepetsa myocardial contractility).

Ndi kuchuluka kwa mlingo, imakhala ndi beta2-adrenergic blocking.

Kutumphukira kwathunthu kwa mtima kumayambiriro kwa kugwiritsa ntchito kwa beta-blockers, mu maola 24 oyamba, kumawonjezeka (chifukwa cha kubwereza kowonjezereka kwa zochitika za alpha-adrenergic receptors ndi kuchotsedwa kwa beta2-adrenoreceptor kukondoweza, komwe kumabwerera ku chiyambi chake pambuyo masiku 1-3, ndikuchepera pakukhazikika kwa nthawi yayitali.

Mphamvu ya antihypertensive imalumikizidwa ndi kuchepa kwa miniti yamagazi, kukondoweza kwachisoni kwa ziwiya zotumphukira, kuchepa kwa ntchito ya renin-angiotensin-aldosterone dongosolo (kofunika kwambiri kwa odwala omwe ali ndi hypersecretion ya renin), kubwezeretsa chidwi cha aortic arch baroreceptors (palibe kuchepa kwa kuthana ndi magazi awo ) ndi zotsatira zamagulu amanjenje. Ndi ochepa matenda oopsa, zotsatira zake zimachitika pambuyo masiku 2-5, zotheka - pambuyo pa miyezi 1-2.

Mphamvu ya antianginal imayamba chifukwa cha kuchepa kwa mphamvu ya okosijeni wam'mweya chifukwa chakuchepa kwa kugunda kwa mtima komanso kuchepa kwa contractility, kutalika kwa diastole, ndikusintha kwa myocardial perfusion. Mwa kuwonjezera kukakamira kwa diastoli komaliza kumapeto kwa michere yam'mimba ndikuwonjezera kutalika kwa minofu yamitsempha yama ventricles, imatha kuwonjezera kufunikira kwa mpweya wa myocardial, makamaka kwa odwala omwe ali ndi vuto la mtima (CHF).

Mosiyana ndi osagwiritsa ntchito beta-blockers, akagwiritsidwa ntchito pakatikati Mlingo wowonjezera, imakhala yovuta kutchula ziwalo zomwe zili ndi beta2-adrenergic receptors (kapamba, minofu yolimba, minofu yosalala ya zotumphukira m'mitsempha, bronchi ndi chiberekero) ndipo sizimayambitsa kusungika kwa sodium ion (Na +) m'thupi. Ikagwiritsidwa ntchito mu Mlingo waukulu, imakhala yolepheretsa ma subtypes onse a beta-adrenergic receptors.

Kupanga

Bisoprolol fumarate + Excipients.

Pharmacokinetics

Bisoprolol pafupifupi imatengedwa kwathunthu kuchokera m'mimba thirakiti (80-90%). Kudya sizikhudzana ndi mayamwa. Chilolezo kudzera mu chotchinga cha magazi ndi chotchinga cha m'magazi ndichochepa, kubisalira mkaka wa m'mawere ndikotsika. Wopangidwira m'chiwindi. Amadzipukusa ndi impso - 50% osasinthika, ochepera 2% - kudzera m'matumbo.

Zizindikiro

• Matenda oopsa
• Matenda a mtima (CHD): kupewa matenda oopsa a angina pectoris.

Kutulutsa Mafomu

Mapiritsi 2.5 mg, 5 mg ndi 10 mg.

Malangizo ogwiritsira ntchito ndi mlingo

Mkati, m'mawa pamimba yopanda kanthu, osatafuna, ndimadzi pang'ono.

Ndi ochepa matenda oopsa komanso matenda a mtima (kupewa kupewa khola la angina pectoris), tikulimbikitsidwa kumwa 5 mg kamodzi. Ngati ndi kotheka, onjezani mlingo mpaka 10 mg kamodzi patsiku. Mlingo wapamwamba tsiku lililonse ndi 20 mg.

Odwala omwe ali ndi vuto la impso (creatinine chilolezo chochepera 20 ml / min) kapena wolowa kwambiri chiwindi ntchito, mlingo wokwanira tsiku lililonse ndi 10 mg.

Kusintha kwa Mlingo kwa okalamba sikofunikira.

Zotsatira zoyipa

• Mutu
• Chizungulire
• Kusowa tulo
• Asthenia
• Kukhumudwa
• Kugona
• Kutopa,
• Kutaya chikumbumtima
• Zizindikiro
• Maloto "oopsa",
• Zingwe
• Chisokonezo kapena kuiwalika kwakanthawi
• Zowonongeka
• Kutulutsa kwamasamba amadzimadzi,
• Maso owuma ndi owawa
• Kumva kuwonongeka
• Conjunctivitis
• Sinus bradycardia,
• Amawerengera kuchepa kwa kuthamanga kwa magazi,
• Kuphwanya lamulo la AV,
• Orthostatic hypotension,
• Kubweza kwa CHF,
• Peripheral edema,
• Mawonekedwe a angiospasm (kuwonongeka kwa kufalikira kwa zotumphukira, kuzirala kwa malekezero am'munsi, a raynaud's syndrome, paresthesia),
• Kupweteka pachifuwa
• Kutsegula m'mimba
• Kusanza, kusanza,
• Kuuma pamlomo
• Kudzimbidwa
• Kuchuluka kwamkati
• Kupuma movutikira kotchulidwa muyezo waukulu (kuchepa kwa chidwi),
• Odwala odziwikiratu - laryngo - ndi bronchospasm,
• Hyperglycemia (mtundu 2 matenda a shuga),
• Hypoglycemia (mtundu 1 matenda a shuga),
• Khungu loyera
• Kutupa
• Urticaria,
• Thupi lawo siligwirizana
• Kupititsa patsogolo,
• Hyperemia wa pakhungu,
• Kuchulukitsa kwa zizindikiro za psoriasis,
• Alopecia
• Kufooka minofu
• Kukokana mu minofu ya ng'ombe
• Arthralgia,
• Supombocytopenia, agranulocytosis,
• Mphamvu yovunda,
• Syndrome "kuletsa" (kuwonjezeka kwa chiwopsezo cha angina pectoris, kuthamanga kwa magazi).

Contraindication

• Kulephera kwamtima kapena kuperewera kwamtima kwakakomoka pakuwombera (komwe kumafunikira mankhwala othandizira),
• Cardiogenic mantha,
• Atrioventricular block 2 ndi 3 degrees, popanda pacemaker,
• Chinsinsi
• Odwala sinus syndrome
• Bradycardia (kugunda kwa mtima kosachepera 60 kugunda / mphindi),
• Cardiomegaly (wopanda chizindikiro cha kulephera kwa mtima),
• Arterial hypotension (systolic anzawo osakwana 100 mm Hg)
• Mitundu yayikulu ya mphumu ya bronchial ndi matenda opatsirana a m'mapapo,
• Mavuto azachulukidwe akufalikira, a raynaud's syndrome,
• Kuchepetsa
• Kugwiritsa ntchito zoletsa za MAO mosakanizira kupatula Mao-B,
• Herederal lactose tsankho, kuperewera kwa lactase, shuga-galactose malabsorption syndrome,
• Pheochromocytoma (popanda kugwiritsa ntchito nthawi yomweyo alpha-blockers),
• Metabolic acidosis,
• Kugwiritsira ntchito kwina kwa flactaphenin, suloprid,
• Kutsutsana kwamkati mwa verapamil, diltiazem,
• Zofika zaka 18 (mphamvu ndi chitetezo sizinakhazikitsidwe),
• Hypersensitivity kwa bisoprolol, zigawo za mankhwala ndi kwa beta-blockers ena.

Mimba komanso kuyamwa

Kugwiritsa ntchito pa nthawi ya pakati ndikotheka ngati mwayi kwa mayi umaposa chiwopsezo cha mavuto obwera chifukwa cha mwana wosabadwayo.

Zokhudza mwana wosabadwayo: kukula kwa msana, kuperewera kwa m'mimba, bradycardia, kupuma kwamatenda a neonatal asphyxia

Ngati kuli kofunikira kugwiritsa ntchito Bisoprolol panthawi yoyamwa, kuyamwitsa kuyenera kuyimitsidwa, popeza Bisoprolol imachotsedwa mkaka wa m'mawere.

Gwiritsani ntchito ana

Contraindified mu ana osaposa zaka 18 (mphamvu ndi chitetezo osakhazikitsidwa).

Malangizo apadera

Kuwunika kwa odwala omwe akutenga Bisoprolol kuyenera kuphatikizapo kuwunika kwa kugunda kwa mtima komanso kuthamanga kwa magazi (kumayambiriro kwa chithandizo tsiku ndi tsiku, ndiye kamodzi pamiyezi 3-4), electrocardiogram (ECG), kuchuluka kwa shuga kwa odwala omwe ali ndi matenda a shuga (1 nthawi 4-5 miyezi). Odwala okalamba, tikulimbikitsidwa kuwunika ntchito yaimpso (1 nthawi m'miyezi 4-5).

Odwala ayenera kuphunzitsidwa njira yowerengera kugunda kwa mtima ndikuwalangizidwa pakufunika kwa upangiri wachipatala wokhudza kugunda kwa mtima kosakwana 50 kugunda / mphindi.

Musanayambe chithandizo, ndikofunikira kuti muphunzire ntchito ya kupuma kwakunja kwa odwala omwe ali ndi mbiri yolemetsa ya bronchopulmonary.

Pafupifupi 20% ya odwala omwe ali ndi angina pectoris, beta-blockers satha.Zomwe zimayambitsa ndizovuta kwambiri coronary atherosulinosis yokhala ndi gawo lotsika la ischemia (kugunda kwa mtima kosakwana 100 beats / min) komanso kuwonjezeka kwa voliyumu yomaliza ya diastoli voliyumu yamanzere yamitsempha, yomwe imaphwanya gawo la magazi a subendocardial. Mu "osuta" mphamvu ya beta-blockers ndiyotsika.

Odwala omwe amagwiritsa ntchito magalasi oyenera ayenera kukumbukira kuti, poyerekeza ndi chithandizo cha mankhwala, kuchepa kwa kupanga kwamadzimadzi kumatheka.

Mukamagwiritsidwa ntchito kwa odwala omwe ali ndi pheochromocytoma, pamakhala chiopsezo chotenga matenda oopsa a matenda oopsa (ngati alpha-adrenoblockade yogwira siinapezeke kale).

Ndi thyrotoxicosis, Bisoprolol ikhoza kubisa zina mwazizindikiro zamatenda a thyrotooticosis (mwachitsanzo, tachycardia). Kuchoka mwadzidzidzi kwa odwala omwe ali ndi thyrotooticosis kumapangidwa, chifukwa amatha kupititsa patsogolo zizindikiro.

Mu matenda a shuga, amatha kumasula tachycardia yoyambitsidwa ndi hypoglycemia. Mosiyana ndi osagwiritsa ntchito beta-blockers, sikuti imathandizira hypoglycemia yokhala ndi insulin ndipo sachedwa kubwezeretsanso kuchuluka kwa glucose m'magazi pazomwe zikuchitika.

Ndi munthawi yomweyo makonzedwe a clonidine, kayendetsedwe kake amatha kuyimitsidwa patangotha ​​masiku ochepa atachotsedwa kwa bisoprolol.

N`zotheka kuonjezera zovuta za hypersensitivity reaction komanso kusowa kwa zotsatira za mwachizolowezi cha epinephrine (adrenaline) motsutsana ndi mbiri yakale yovuta.

Ngati kuli koyenera kuchitira opaleshoni yomwe mukufuna kukonzekera, kusiya mankhwala kumachitika maola 48 isanayambike opaleshoni yayikulu. Ngati wodwalayo atamwa mankhwalawo asanamuchitidwe opaleshoni, ayenera kusankha mankhwala ochita opaleshoni yamagetsi ochepa.

Kubwezeretsa kuchititsa nyini ya vagus kumatha kuthetsedwa ndi mtsempha wa magazi a atropine (1-2 mg).

Mankhwala omwe amachepetsa masitolo a catecholamine (mwachitsanzo, reserpine) amatha kupititsa patsogolo zotsatira za beta-blockers, kotero odwala omwe amaphatikiza mankhwalawa ayenera kukhala moyang'aniridwa ndi adokotala kuti azindikire ochepa ochepa kapena bradycardia.

Cardioselective adrenoblockers atha kutumikiridwa kwa odwala omwe ali ndi matenda a bronchospastic pofuna kutsata komanso / kapena osagwiritsa ntchito mankhwala ena a antihypertensive, koma mlingo uyenera kuyang'aniridwa mosamala. Mankhwala osokoneza bongo ndi owopsa pakukula kwa bronchospasm.

Pankhani ya odwala okalamba omwe ali ndi bradycardia yowonjezereka (osakwana 50 kumenyedwa / mphindi), ochepa hypotension (systolic magazi m'munsimu 100 mm Hg), AV block, bronchospasm, ventricular arrhythmias, chiwindi choopsa ndi kuperewera kwa impso, ndikofunikira kuchepetsa mlingo kapena kusiya chithandizo. Ndikulimbikitsidwa kuti musiye chithandizo chamankhwala ndikutulutsa kukhumudwa komwe kumachitika chifukwa chakuletsa beta-blockers.

Simungasokoneze mwadzidzidzi chithandizo chifukwa chowopsa chamtundu wa arrhythmias komanso infarction ya myocardial. Kuletsa kumachitika pang'onopang'ono, kuchepetsa mankhwalawa kwa masabata awiri kapena kupitirira apo (kuchepetsa mlingo ndi 25% m'masiku 3-4).

Iyenera kuchotsedwa usanayambe kuphunzira zomwe zili m'magazi ndi mkodzo wa makatekolamaini, syntetanephrine ndi vanillyl mindic acid, komanso ma antinuclear antibody titers.

Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu

Munthawi ya chithandizo, chisamaliro chimayenera kuchitika poyendetsa magalimoto ndi kuchita zina zomwe zingakhale zoopsa zomwe zimafuna kuti anthu azisamalira komanso azithamanga kwambiri.

Kuyanjana kwa mankhwala

Ma allergen omwe amagwiritsidwa ntchito chifukwa cha immunotherapy kapena ma allergen omwe amapanga mayeso a khungu amathandizira kuti azikhala ndi zotsatira zovuta za asicgic kapena anaphylaxis odwala omwe akulandira bisoprolol.

Phenytoin ndi mtsempha wamagazi, mankhwala a inhalation general anesthesia (ma hydrocarbon zotumphukira) kumawonjezera kukula kwa mtima ndi kuchititsa kutsika kwa magazi.

Iodine-yokhala ndi radiopaque diagnostic othandizira amkati mwa mtsempha wamagetsi amathandizira kuwonongeka kwa anaphylactic.

Bisoprolol imasintha magwiridwe amtundu wa insulin ndi hypoglycemic pakuyendetsa pakamwa, masks zizindikiro za kukhala hypoglycemia (tachycardia, kuthamanga kwa magazi).

Mphamvu ya antihypertensive imafooketsedwa ndi mankhwala osapatsa mankhwala a anti-yotupa (sodium ion poster ndi prostaglandin synthesis blockade ndi impso), glucocorticosteroids ndi estrogens (posungira sodium ion).

Cardiac glycosides, methyldopa, reserpine, ndi guanfacine zimawonjezera chiopsezo cha kukulira kapena kukulira kwa bradycardia, chipika cha atrioventricular, kulephera kwa mtima, ndi kulephera kwa mtima.

Kuphatikiza kwa Bisoprolol ndi calcium antagonists (verapamil, diltiazem, bepridil) sikulimbikitsidwa pakulandiridwa mwachisawawa, chifukwa cha kuwonjezeka kwa zotsatira zoyipa pazakugwira ntchito kwa myocardium, AV conductor ndi kuthamanga kwa magazi.

Kugwiritsa ntchito pamodzi kwa nifedipine ndi bisoprolol kungayambitse kuchepa kwakukulu kwa kuthamanga kwa magazi.

Ndi munthawi yomweyo kugwiritsa ntchito mankhwala a Bisoprolol ndi class 1 antiarrhythmic mankhwala (disopyramide, quinidine, hydroquinidine), atric ventricular conduction komanso zotsatira zoyipa zam'kati zitha kuwonjezeka (kuwunika ndi kuwunika kwa electrocardiography ndikofunikira).

Pogwiritsa ntchito munthawi yomweyo mankhwala osokoneza bongo a bisoprolol ndi antiarrhythmic a kalasi 3 (mwachitsanzo, amiodarone), kutsekemera kwa atrial kungakulire.

Ndi munthawi yomweyo kugwiritsa ntchito mankhwala Bisoprolol ndi ena beta-blockers, kuphatikizapo omwe ali mu madontho amaso, mgwirizano wogwirizana ungatheke.

Kugwiritsa ntchito pamodzi kwa Bisoprolol ndi beta-adrenergic agonists (mwachitsanzo, isoprenaline, dobunamine) kungayambitse kuchepa kwa zotsatira za mankhwalawa onse.

Kuphatikizidwa kwa Bisoprolol ndi beta - ndi alpha-adrenergic agonists (mwachitsanzo, iorepinephrine, epinephrine) kumatha kukulitsa zotsatira za vasoconstrictor mwa othandizira awa omwe amachitika ndi kutenga nawo gawo la alpha-adrenergic receptors, zomwe zimabweretsa kuwonjezeka kwa magazi.

Diuretics, clonidine, sympatholytics, hydralazine ndi mankhwala ena a antihypertensive angayambitse kuchepa kwambiri kwa magazi.

Pogwiritsa ntchito munthawi yomweyo bisoprolol ndi mefloquine, chiopsezo cha bradycardia chikuwonjezeka.

Kugwiritsira ntchito kwa tekoprolol mosakanikirana ndi flactaphenin ndi sultopride kumatsutsana.

Kuchita kwa osapondereza minofu kupumula ndi zotsatira zoyipa za ma coumarin pochiza ndi Bisoprolol zitha kupitilira.

Zitatu - ndi tetracyclic antidepressants, antipsychotic (antipsychotic), ethanol (mowa), mankhwala osokoneza bongo komanso oopsa oonjezera bongo amachititsa kukhumudwa kwapakati. Kugwiritsa ntchito nthawi yomweyo kwa Bisoprolol ndi ma MA inhibitors (kupatula MAO-B) sikulimbikitsidwa chifukwa cha kuwonjezeka kwakukulu kwa zotsatira za hypotensive. Kupumula kwa mankhwalawa pakati pa kutenga mao inhibitors ndi Bisoprolol ayenera kukhala osachepera masiku 14.

Amachepetsa chilolezo cha lidocaine ndi xanthines (kupatula diprofillin) ndikuwonjezera kuchuluka kwake m'magazi am'magazi, makamaka odwala omwe ali ndi vuto loyambirira la theophylline.

Sulfasalazine imawonjezera ndende ya bisoprolol m'madzi a m'magazi.

Rifampicin amafupikitsa kuthetseratu theka la moyo wa bisoprolol.

Mndandanda wa mankhwala Bisoprolol

Zofanana muzochitika zamagulu:

• Arithel
• Aritel Cor
• Bidop
• Biol
• Biprol
• Bisogamma
• Msuzi
• Bisomor,
• Bisoprolol OBL,
• Bisoprolol Meadow,
• Bisoprolol Prana,
• Bisoprolol ratiopharm,
• Bisoprolol Sandoz
• Bisoprolol Teva,
• Bisoprolol hemifumarate,
• Bisoprolol fumarate,
• Bisoprolol Fumarate Pharmaplant,
• Concor
• Concor Cor
• Corbis
• Cordinorm
• Chiphuphu
• Hypertin
• Tyrez.

Munkhaniyi, mutha kuwerengera malangizo ogwiritsira ntchito mankhwalawa Lisinopril. Amapereka ndemanga kuchokera kwa alendo omwe amabwera patsamba lino - ogwiritsa ntchito mankhwalawa, komanso malingaliro a akatswiri azachipatala pakugwiritsa ntchito Lisinopril pamachitidwe awo.Chopempha chachikulu ndikuti muwonjezere ndemanga zanu za mankhwalawa: mankhwalawo adathandizira kapena sanathandizire kuchotsa matendawa, ndizovuta ziti zomwe zimawoneka ndi zotsatirapo zake, zomwe mwina sizinalengezedwe ndi wopanga. Mndandanda wa lisinopril kukhalapo kwa analogue omwe amapezeka. Gwiritsani ntchito pochizira matenda oopsa komanso kutsitsa magazi mu akulu, ana, komanso pa nthawi ya bere. The zikuchokera ndi mogwirizana ndi mankhwala ndi mowa.

Lisinopril - ACE inhibitor, amachepetsa mapangidwe a angiotensin 2 kuchokera ku angiotensin 1. Kuchepa kwa zomwe angiotensin 2 kumabweretsa kutsika kwachindunji kutulutsidwa kwa aldosterone. Amachepetsa kuchepa kwa bradykinin ndikuwonjezera kaphatikizidwe ka prostaglandins. Kuchepetsa kwathunthu zotumphukira mtima kukana, kuthamanga kwa magazi (BP), preload, kukakamira m'mapapo m'mimba, kumapangitsa kuchuluka kwa magazi kwa miniti ndi kukweza kulolerana kwa mtima ndi 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 losatha la mtima, achepetsa kudutsa kwamanzere kwamitsempha yamagazi kwa odwala pambuyo poyambitsa myocardial infarction popanda mawonekedwe a mtima olephera. Mphamvu ya antihypertensive imayamba patatha pafupifupi maola 6 ndipo imatha kwa maola 24. Kutalika kwa zotsatirazi kumadaliranso mlingo. Kukhazikika kwa zochita kumachitika pambuyo pa ola limodzi. Kuchuluka kwake kumatsimikiziridwa pambuyo pa maola 6.7. Ndi matenda oopsa, zotsatira zake zimawonedwa m'masiku oyambilira pambuyo poyambira chithandizo, zotsatira zoyenda zimayamba pambuyo pa miyezi 1-2.

Ndi kusiyiratu kwakumwa kwa mankhwalawo, kuchuluka kwakukulu kwa magazi sikunawonedwe.

Kuphatikiza pakuchepetsa kuthamanga kwa magazi, lisinopril imachepetsa albuminuria. Odwala omwe ali ndi hyperglycemia, zimathandizanso kuti mawonekedwe a glomerular endothelium awonongeke.

Lisinopril sasokoneza kuchuluka kwa shuga m'magazi omwe ali ndi odwala omwe ali ndi matenda osokoneza bongo ndipo samayambitsa kuwonjezeka kwa hypoglycemia.

Kupanga

Lisinopril (mwanjira ya dihydrate) + ochulukitsa.

Pharmacokinetics

Mutatha kumwa mankhwalawo mkati, pafupifupi 25% ya lisinopril imayamwa kuchokera m'mimba. Kudya sizikhudzana ndi mayamwa. Pafupifupi sizigwirizana ndi mapuloteni a plasma. Chilolezo kudzera mu magazi-ubongo ndi chotchinga chachikulu. Lisinopril samapangidwa mwachilengedwe m'thupi. Imafufutidwa ndi impso zosasinthika.

Zizindikiro

• Matenda oopsa a arterial (mu monotherapy kapena kuphatikiza mankhwala ena a antihypertensive),
• Kulephera kwamtima kosalekeza (monga gawo limodzi la mankhwala ochiritsira odwala omwe amatenga dijito ndi
• Mankhwalawa poyambira kulowetsedwa pachimake (mu maora 24 oyamba ndi hemodynamics yokhazikika kuti muzitha kuzitsimikizira ndikuletsa kusowa kwamitsempha yama mtima komanso kulephera kwa mtima),
• Diabetesic nephropathy (yafupika albuminuria mwa odwala omwe amadalira insulin omwe amakhala ndi magazi abwinobwino komanso odwala osagwirizana ndi insulin omwe amadwala matenda ochepa).

Kutulutsa Mafomu

Mapiritsi 2.5 mg, 5 mg, 10 mg, 20 mg.

Malangizo ogwiritsira ntchito ndi mlingo

Mkati, ngakhale zakudya. Ndi ochepa matenda oopsa, odwala osalandira mankhwala ena a antihypertensive amapatsidwa 5 mg kamodzi patsiku. Ngati palibe zotheka, mlingo umakulitsidwa tsiku lililonse la 2-3 ndi 5 mg mpaka muyezo wa 20 mg mg pa tsiku (kuwonjezera kuchuluka kwa 40 mg patsiku nthawi zambiri sikuti kumayambitsa kuchepa kwa magazi). Mulingo wamba wokonzanso tsiku lililonse ndi 20 mg. Mlingo wambiri watsiku ndi tsiku ndi 40 mg.

Zotsatira zonse zimayamba pambuyo pa masabata 2-4 kuyambira pa chiyambi cha mankhwala, zomwe zimayenera kukumbukiridwa pakukweza mlingo.Ndi matenda osakwanira azaumoyo, ndizotheka kuphatikiza mankhwalawa ndi mankhwala ena a antihypertensive.

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 Lisinopril 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.

Pankhani ya kukonzanso kwamitsempha yamagazi kapena zochitika zina ndi kuchuluka kwa dongosolo la renin-angiotensin-aldosterone, timafunikanso kupereka mankhwala ochepa a 2.5-5 mg patsiku, motsogozedwa ndi achipatala (kuwongolera kuthamanga kwa magazi, ntchito ya impso, potaziyamu yambiri mu seramu yamagazi). Mlingo wokonza, popitiliza kuthandizira, uyenera kutsimikiziridwa kutengera mphamvu ya magazi.

Ndi wolimbitsa ochepa matenda oopsa, kukonzekera kwakanthawi kochepa kwa 10-15 mg patsiku kukuwonetsedwa.

Matenda osalephera a mtima - yambani ndi 2,5 mg 1 nthawi patsiku, kenako ndikuwonjezereka kwa 2,5 mg mu masiku 3-5 mwachizolowezi, kumathandizira tsiku lililonse la 5-20 mg. Mlingo sayenera kupitirira 20 mg patsiku.

Mwa okalamba, kutchulidwa kochulukirapo kwa nthawi yayitali kumawonedwa, komwe kumalumikizidwa ndi kuchepa kwa kuchuluka kwa lisinopril (ndikulimbikitsidwa kuti muyambe kulandira mankhwala ndi 2,5 mg patsiku).

Pachimake myocardial infarction (monga gawo la mankhwala osakanikirana)

Patsiku loyamba - 5 mg pakamwa, ndiye 5 mg tsiku lililonse, 10 mg masiku awiri aliwonse komanso 10 mg kamodzi patsiku. Odwala omwe ali ndi kupweteka kwambiri myocardial infarction, ayenera kugwiritsidwa ntchito kwa milungu 6. Kumayambiriro kwa mankhwalawa kapena masiku oyamba atatu pambuyo panjira yodwala kwambiri odwala omwe ali ndi magazi ochepa (120 mmHg kapena kuchepera), mlingo wochepetsetsa uyenera kutumikiridwa - 2.5 mg. Pankhani ya kuchepa kwa kuthamanga kwa magazi (magazi a systolic m'munsi kapena ofanana ndi 100 mm Hg), tsiku lililonse mlingo wa 5 mg ukhoza, ngati pakufunika, uchepetse mpaka 2,5 mg. Pankhani ya kuchepa kwakanthawi kwa kuthamanga kwa magazi (kuthamanga kwa magazi m'munsi mwa Hg 90 mm. Art. Kupitilira ola limodzi), chithandizo ndi Lisinopril ziyenera kusiyidwa.

Odwala omwe ali ndi matenda osokoneza bongo omwe amadalira shuga, 10 mg ya Lisinopril amagwiritsidwa ntchito kamodzi patsiku. Mlingo umatha, ngati pakufunika, uwonjezeke mpaka 20 mg kamodzi patsiku kuti akwaniritse kuthamanga kwa magazi m'munsi mwa 75 mm Hg. Art. m'malo okhala. Odwala omwe ali ndi matenda a shuga omwe amadalira insulin, mlingo ndi womwewo, kuti akwaniritse kuthamanga kwa magazi m'munsi mwa 90 mm Hg. Art. m'malo okhala.

Zotsatira zoyipa

• Chizungulire
• Mutu
• Zofooka
• Kutsegula m'mimba
• Youma chifuwa
• Kusanza, kusanza,
• Zotupa pakhungu
• Kupweteka pachifuwa
• Angioneurotic edema (nkhope, milomo, lilime, larynx kapena epiglottis, malekezero apamwamba ndi otsika),
• Amawerengera kuchepa kwa kuthamanga kwa magazi,
• Orthostatic hypotension,
• Matenda a impso,
• Kusinthasintha kwa mtima
• Zosangalatsa pamtima
• Kutopa,
• Kugona
• Kutikita minofu ya miyendo ndi milomo,
• Leukopenia, neutropenia, agranulocytosis, thrombocytopenia,
• Kusweka mtima
• Tachycardia
• Myocardial infaration
• Cerebrovascular stroke mwa odwala omwe ali ndi chiwopsezo chachikulu cha matendawa, chifukwa cha kuchepa kwa magazi,
• Pakamwa pakamwa
• Anorexia
• Dyspepsia
• Zosintha
• Kupweteka kwam'mimba
• Urticaria,
• Kuchulukitsa thukuta
• Khungu loyera
• Alopecia
• Matenda a impso,
• Oliguria
• Anuria
• Kulephera kwaimpso,
• Asthenic syndrome
• Kuchepa kwa malingaliro
• Chisokonezo,
• Unachepa mphamvu
• Myalgia
• Thupi
• Kukula kwa fetal.

Contraindication

• Mbiri ya angioedema, kuphatikizapo kugwiritsa ntchito zoletsa ACE,
• Quincke's edema cholowa,
• Zofika zaka 18 (mphamvu ndi chitetezo sizinakhazikitsidwe),
• Hypersensitivity kuti lisinopril kapena zoletsa zina za ACE.

Mimba komanso kuyamwa

Kugwiritsa ntchito kwa lisinopril pa nthawi ya pakati kumapangidwa. Mimba ikakhazikitsidwa, mankhwalawo amayenera kusiyidwa posachedwa. Kulandila kwa zoletsa za ACE mu nyengo yachiwiri ndi 3 ya mimba imakhala ndi vuto pa mwana wosabadwayo (kuchepa kwa kuthamanga kwa magazi, kulephera kwa impso, hyperkalemia, chigaza hypoplasia, kufa kwa intrauterine ndikotheka). Palibe zambiri pazotsatira zoyipa za mankhwalawa mwana wosabadwa ngati agwiritsidwa ntchito nthawi yoyamba. Kwa makanda ndi makanda omwe amakhala ndi intrauterine kukhudzana ndi ma inhibitors a ACE, tikulimbikitsidwa kuyang'anira mosamala kuti mupeze nthawi yomwe kuchepa kwa magazi, oliguria, hyperkalemia.

Lisinopril amawoloka placenta. Palibe chidziwitso pakulowerera kwa lisinopril mkaka wa m'mawere. Kwa nthawi ya mankhwala ndi mankhwalawa, ndikofunikira kusiya kuyamwitsa.

Malangizo apadera

Nthawi zambiri, kutsika kwamphamvu kwa kuthamanga kwa magazi kumachitika ndi kuchepa kwamphamvu kwamadzimadzi chifukwa cha kukodzetsa, kuchepa kwa mchere mu chakudya, kudzimbidwa, kutsegula m'mimba, kapena kusanza. Odwala omwe ali ndi vuto la mtima losalephera limodzi ndi kulephera kwaimpso kapena popanda iwo, kuchepa kwamphamvu kwa magazi kumatheka. Nthawi zambiri zimapezeka kwa odwala omwe ali ndi vuto lalikulu la mtima, chifukwa chogwiritsa ntchito milingo yayikulu ya kukodzetsa, hyponatremia, kapena matenda aimpso. Odwala otere, chithandizo ndi Lisinopril ziyenera kuyamba kuyang'aniridwa ndi dokotala (mosamala, sankhani mankhwalawa ndi mankhwala okodzetsa).

Malamulo omwewo ayenera kutsatiridwa popereka odwala omwe ali ndi matenda a mtima, kuchepa kwa magazi m'thupi, komwe kuchepa kwambiri kwa magazi kumatha kubweretsa kuphwanya pansi kwa myocardial kapena stroko.

Kuchepetsa mphamvu kwa nthawi yochepa sikukutsutsana pakumwa mlingo wotsatira wa mankhwalawa.

Mukamagwiritsa ntchito Lisinopril mwa odwala ena omwe ali ndi vuto la mtima losalephera, koma ndi vuto labwinobwino kapena lotsika magazi, kuchepa kwa kuthamanga kwa magazi kumatha kuchitika, zomwe nthawi zambiri sizikhala chifukwa chosiya kulandira chithandizo.

Musanayambe chithandizo ndi Lisinopril, ngati kuli kotheka, sinthani kuchuluka kwa sodium ndi / kapena kupanga kuchuluka kwa madzi otayika, yang'anirani mosamala momwe mankhwalawo akumayambiriro a Lisinopril.

Pankhani ya aimpso mtsempha wamagazi stenosis (makamaka ndi mbali imodzi ya stenosis, kapena pamaso pa impso imodzi ya stenosis), komanso kulephera kwa magazi chifukwa chosowa sodium ndi / kapena madzimadzi, kugwiritsa ntchito kwa Lisinopril kumatha kubweretsanso vuto laimpso, kulephera kwaimpso. Amakhala osasinthika atasiya kumwa mankhwalawo.

Mu pachimake myocardial infarction

Kugwiritsidwa ntchito kwa mankhwala othandizira (thrombolytics, acetylsalicylic acid, beta-blockers) akuwonetsedwa. Lisinopril angagwiritsidwe ntchito molumikizana ndi mtsempha wamagetsi kapena kugwiritsa ntchito njira zina za nitroglycerin.

Opaleshoni / General Opaleshoni

Ndi njira zambiri zopangira opaleshoni, komanso kugwiritsa ntchito mankhwala ena omwe amachepetsa kuthamanga kwa magazi, lisinopril, kutsekereza mapangidwe a angiotensin 2, kungayambitse kuchepa kosadziwika kwa kuthamanga kwa magazi.

Odwala okalamba, kumwa womwewo kumawonjezera kuchuluka kwa mankhwalawa m'magazi, chifukwa chake, chisamaliro chapadera chimafunikira pakudziwa mlingo.

Popeza chiopsezo cha agranulocytosis sichingathetsedwe, kuwunika kwa chithunzi cha magazi kumafunika. Mukamagwiritsa ntchito mankhwalawa pansi pa dialysis ndi polyacryl-nitrile membrane, mantha a anaphylactic angachitike, motero, tikulimbikitsidwa kuti mitundu ina ya membrane wa dialysis, kapena poika ma antihypertgency agents ena.

Kukopa pa luso loyendetsa magalimoto ndi zida

Palibe chidziwitso pakusintha kwa lisinopril pakutha kuyendetsa magalimoto ndi njira zomwe zimagwiritsidwa ntchito pochizira Mlingo, koma muyenera kukumbukira kuti chizungulire nchotheka, motero muyenera kusamala.

Kuyanjana kwa mankhwala

Lisinopril amachepetsa mayendedwe a potaziyamu m'thupi panthawi ya mankhwala okodzetsa.

Kusamalidwa kwapadera kumafunika mukamagwiritsa ntchito mankhwalawa ndi:

• Potaziyamu yosunga diuretics (spironolactone, triamteren, amiloride), potaziyamu, potaziyamu wam'malo (imawonjezera chiopsezo chokhala ndi vuto la Hyperkalemia, makamaka ndi vuto laimpso), kotero, iwo amatha kuyikidwa limodzi pamaziko a lingaliro la dokotala payekha pang'onopang'ono pakuwonetsetsa kuchuluka kwa seramu potaziyamu magazi ndi impso.

Gwiritsani ntchito mosamala limodzi:

• Ndi diuretics: ndi makonzedwe owonjezera a okodzetsa kwa wodwala yemwe akutenga Lisinopril, monga lamulo, antihypertensive yowonjezera imachitika - chiwopsezo cha kuchepa kwa magazi,
• Ndi othandizira ena antihypertgency (zowonjezera zotsatira),
• Ndi mankhwala osapweteka a antiidal (NSAIDs) (indomethacin, etc.), ma estrogens, komanso adrenostimulants - kuchepa kwa mphamvu ya antihypertensive ya lisinopril,
• Ndi lifiyamu (kumasulidwa kwa lifiyamu itha kuchepa, motero, seramu lifiyamu iyenera kuyang'aniridwa pafupipafupi),
• Ndi maantacid ndi colestyramine - kuchepetsa mayamwidwe m'mimba.

Mowa umawonjezera mphamvu ya mankhwalawo.

Mndandanda wa mankhwala Lisinopril

Zofanana muzochitika zamagulu:

• Dapril
• Diropress
• Diroton
• Anayesa
• Lysacard
• Lysigamm
• Lisinopril Grindeks,
• Lisinopril Organics,
• Lisinopril Pfizer,
• Lisinopril Stada,
• Lisinopril OBL,
• Lisinopril Teva,
• Lisinopril dihydrate,
• Lysinotone
• Lizonorm,
• Lysoryl
• Lister,
• Liten,
• Zavomerezedwa
• Rileis Sanovel,
• Sinopril.

Kuphatikiza ndi hydrochlorothiazide:

• Zoniksem ND,
• Zonixem NL,
• Iruzid,
• Co Diroton
• Lisinopril N,
• Lysinotone H,
• Wachikulire
• Lister Plus,
• Liten N,
• Rileys Sanovel kuphatikiza,
• Scopril kuphatikiza.

Kuphatikiza ndi amlodipine:

Mutu wa dipatimenti ya General Cardiology, Woyankha wa Sayansi ya Zamankhwala, Cardiologist wa gulu lapamwamba kwambiri (GCP). Membala wa Russia ndi European Society of Cardiology (RKO, ESC), National Society of Evidence-based Pharmacotherapy. Imakudziwitsa za matenda ndi matenda oopsa a matenda oopsa a m'magazi, matenda a mtima, kuchepa kwa mtima, mtima wamatenda, komanso kupewa matenda amtima komanso zovuta zawo.

Bisoprolol - malangizo, ntchito, maupangiri, ndemanga ...

Bisoprolol ndi m'gulu la omwe amasankha beta-blockers omwe amakhala pamitsempha yosalala ya mtima ndi mitsempha yamagazi. Vutoli limalepheretsa beta-adrenergic receptors, yomwe imalandira zokoka kuchokera kumanjenje, zomwe zimachepetsa kugunda kwa mtima. Kupsinjika kwa magazi kumachepa, kumakhala kosavuta kuti mtima uzipopa.

Kuunikira kwa zochita zamankhwala zomwe mumakonda ...

Bisoprolol ndi mankhwala ochita bwino omwe amasamalira matenda amtima: ochepa matenda oopsa, angina pectoris ndi ena. Kuphatikizika kwapadera kumeneku kumakhala ndi antihypertensive kwambiri, motero amachepetsa kuthamanga kwa magazi.

Bisoprolol diuretic kapena ayi: Zizindikiro, gwiritsani ntchito

Angiotensin akatembenuza enzyme inhibitors (ACE inhibitors) Angiotensin receptor antagonists (blockers kapena ARA kapena ARB) Direct renin inhibitors (PIR) Beta blockers (BB) Calcium antagonists (AK) m'mitundu iwiri - pulsating (AKP) ndi dihydropyridine (ACP) ndi diydropyridine pakati kuchitira okodzetsa Kodi kuphatikiza mankhwala ndi chothandiza?

Bisoprolol: malangizo ogwiritsira ntchito, pazipsinjo ziti

1 Kufotokozera1.1 Kuphatikizika ndi mawonekedwe a kumasulidwa 1.2 Zochita kupondaponda 1.3 Zowonetsa ndi ntchito2 Malangizo ogwiritsira ntchito 2.1 Malangizo a akatswiri 2.2 Zotsatira zoyipa 2.3 Kupitilira 3 Kulumikizana ndi mankhwala ena ndi zinthu 4 Lisinopril m'mafakitore 5 Kumaliza Kutenga Lisinopril kukakamiza kumalimbikitsa akatswiri ambiri. Pamodzi ndi analogues, mankhwalawa amapereka kuchepa kwakukulu kwa kuthamanga kwa magazi, komanso kumachepetsa kukana kwawo.

Mankhwala osakanikirana a matenda oopsa. Tsamba lonena za chithandizo ...

1 Zotsatira zazikulu2 Pharmacokinetics3 Zowonetsa ndi njira zogwiritsira ntchito4 Contraindication kuti mugwiritse ntchito5 Zosafunika zotsatira6 Kuyanjana ndi mankhwala a magulu ena7 Fomu ya kumasulidwa ndi fanizo M'machitidwe a mtima, B-blocker ngati bisoprolol imagwiritsidwa ntchito kwambiri. Malangizo ogwiritsira ntchito athandiza kumvetsetsa momwe mankhwalawa amagwira ntchito, momwe angagwiritsidwire ntchito, momwe angachitire moyenera, ndi zotsatirapo zoyipa zomwe zingachitike. Koma palibe chifukwa chomwe mungamwe mankhwalawa popanda upangiri wa dokotala, apo ayi mutha kuwononga thanzi lanu.

Bisoprolol (Concor) | Mankhwala | Mayankho | Bisoprolol ...

Zoyenerana. Zigawozi zilibe magulu omwe amagwira ntchito omwe angapangitse kupanga kwanyengo kapena gulu latsopano la mankhwala. Zosasokoneza mayamwidwe. Mankhwalawa sasintha pH ya madzi am'mimba, microflora yachilendo, kuyenda kwa m'mimba, glycoprotein P zochitika (mapuloteni odalira a ATP) ndikuwononga matumbo a mucosa.

Lisinopril: malangizo ogwiritsira ntchito, potsatira kupanikizika, ndemanga, analogues

Kuthamanga kwa magazi (BP) pachikhalidwe kwakhala mtsogoleri pakati pa matenda omwe amakula ndi ukalamba. Mpaka 50% ya anthu omwe ali ndi matenda oopsa (AH), ndipo m'gulu lakale chizindikiro ichi ndi 80% kapena kuposa. Chithandizo cha matenda oopsa chimachitika ndimankhwala osiyanasiyana. Chimodzi mwazomwe chimagwiritsidwa ntchito ndi dipeptidyl carboxypeptidase inhibitors, yomwe imatchedwanso angiotensin kutembenuza enzyme (ACE). Pakati pa zoletsa za ACE, malo apadera amatengedwa ndi mankhwala a Lisinopril.

Bisoprolol: ndemanga za madotolo ndi fanizo la mankhwalawa :: SYL.ru

Mankhwala okwera mtengo, omwe amagwiritsidwa ntchito mwachangu ngati mankhwala amakono amatchedwa "Bisoprolol". Kodi mapiritsiwa akuchokera kuti? Yankho lolondola pafunsoli limaperekedwa ndi malangizo ogwiritsira ntchito mankhwalawa, omwe amapezeka phukusi. Komabe, ngati pali kufunitsitsa kothana ndi izi popanda kupeza mankhwala, ndiye kuti nkhaniyi ikukuthandizani.

Chithandizo cha matenda oopsa, mankhwala, kuyezetsa, mtima

Matenda amtima wam'mimba amapezeka pafupifupi munthu aliyense amakono. Zimaphatikizidwa ndi kudumphadumpha kokhazikika kwa magazi. Chifukwa chake, munthu aliyense amene ali ndi vuto lotere amafunafuna njira yothanirana ndi mavuto. Popeza izi zimasokoneza moyo wabwino. Chimodzi mwazithandizo zabwino kwambiri ndi Bisoprolol, malangizo ogwiritsidwira ntchito ayenera kuphunziridwa mwatsatanetsatane, ndikuwunikanso pazovuta ziti zomwe zimagwiritsidwa ntchito.

Ndingotenga nthawi yayitali bwanji Bisoprolol popanda yopuma komanso ...

Odwala ambiri omwe ali ndi matenda oopsa, kuti muchepetse kuthamanga kwa magazi kuti mukhale manambala otetezeka, muyenera kumwa mitundu itatu ya mapiritsi nthawi imodzi. Mankhwala amodzi amachepetsa kuthamanga kwa magazi osaposa 20-30% ya odwala omwe ali ndi matenda oopsa. 70-80% yotsala ya odwala amafunikira chithandizo cha mankhwala, ndiye kuti, mankhwala osiyanasiyana nthawi imodzi. Mankhwala osakanikirana a matenda oopsa - omwe ali ndi zinthu zitatu zomwe zimagwira piritsi limodzi. Tikambirana mwatsatanetsatane pansipa.

Bisoprolol: ndemanga za madotolo ndi fanizo la mankhwalawa :: SYL.ru

Zisonyezero zogwiritsira ntchito Contraindication Momwe ma sapopolol amagwiritsidwa ntchito mopitirira muyeso Zotsatira za bisoprolol Amayi oyembekezera amatha kugwiritsa ntchito bisoprolol Kugwirizana kwa bisoprolol ndi mowa Momwe mungasinthire bisoprolol

Mphamvu ya bisoprolol ndi lisinopril pochiza ...

Bisoprolol ndi imodzi mwamtundu wa beta-blockers wapamwamba kwambiri. Ubwino wogwiritsa ntchito bisoprolol kwa ochepa matenda oopsa, kugwiritsa ntchito kwake mitundu yosiyanasiyana yamatenda a mtima ndi kusankha kwa mankhwala abwino kumalingaliridwa.

Muzochita zenizeni zamankhwala, beta-blockers (BAB) ndi amodzi mwa mankhwala omwe amagwiritsidwa ntchito kwambiri pochiza matenda a mtima (CVD). Nkhani zosankha BAB ndizothandizabe.

Home »Chithandizo» ACE inhibitors »Tsatanetsatane wa malangizo ogwiritsira ntchito mapiritsi a Lisinopril: pazotsatira zomwe zimagwiritsidwa ntchito, kuwunika kwa wodwala

Kuthamanga kwa magazi (BP) pachikhalidwe kwakhala mtsogoleri pakati pa matenda omwe amakula ndi ukalamba. Mpaka 50% ya anthu omwe ali ndi matenda oopsa (AH), ndipo m'gulu lakale chizindikiro ichi ndi 80% kapena kuposa.

Chithandizo cha matenda oopsa chimachitika ndimankhwala osiyanasiyana. Chimodzi mwazomwe chimagwiritsidwa ntchito ndi dipeptidyl carboxypeptidase inhibitors, yomwe imatchedwanso angiotensin kutembenuza enzyme (ACE). Pakati pa zoletsa za ACE, malo apadera amatengedwa ndi mankhwala a Lisinopril.

Malangizo ogwiritsira ntchito mankhwalawa ndi mutu wa nkhaniyi. Kufikira izi, mafunso aphunziridwa momwe angatengere Lisinopril kuchokera kukapanikizika, ndi nthawi yanji ya tsiku yomwe kuli bwinoko kuchita, komanso contraindication, mavuto ndi zina.

Lisinopril (m'Chilatini - Lisinoprilum) amapezeka mu mawonekedwe apiritsi, omwe amatha kukhala ndi 2,5 mpaka 40 mg wa chinthu chimodzi chogwiritsa ntchito (mankhwala amodzi). Chifukwa chake, mwachitsanzo, mapiritsi a 10 mg a Lisinopril ali ndi 10.89 mg wa lisinopril dihydrate, yomwe, monga momwe amanenera malangizo, ndi ofanana ndi 10 mg ya lisinopril.

Kuphatikizika kwa mankhwalawa, kuphatikiza pa yogwira ntchito - chopondera cha ACE, chimayimiriridwa ndi zinthu zina zothandizira zomwe sizikhala ndi zotsatira zochizira: mchere wosiyanasiyana, wowuma, utoto, ndi zina zambiri.

HYPERTENSION - AMAKHALA PAKUTI!

Kusweka mtima ndi mikwingwirima ndiye komwe kumayambitsa pafupifupi 70% ya imfa zonse padziko lapansi. Anthu asanu ndi awiri mwa anthu khumi amafa chifukwa chotseka mitsempha ya mtima kapena ubongo. Pafupifupi nthawi zonse, chifukwa chomaliza chotsirizika ndichofanana - kuthamanga kwa magazi chifukwa cha matenda oopsa ...

HYPERTENSION - AMAKHALA PAKUTI!

Kusweka mtima ndi mikwingwirima ndiye komwe kumayambitsa pafupifupi 70% ya imfa zonse padziko lapansi. Anthu asanu ndi awiri mwa anthu khumi amafa chifukwa chotseka mitsempha ya mtima kapena ubongo. Pafupifupi nthawi zonse, chifukwa chakumapeto kowopsa ndichofanana - kuthamanga kwa magazi chifukwa cha matenda oopsa. 'Wopha anthu chete,' monga momwe akatswiri a mtima amatchulira, chaka chilichonse chimapha anthu mamiliyoni ambiri.

Njira yamachitidwe

Mphamvu ya mankhwalawa imafotokozedwa ndi mphamvu ya inhibitory ya lisinopril pokhudzana ndi ntchito ya dipeptidyl carboxypeptidase. Izi zimathandizira kusintha kwa magawo awiri m'magulu awiri:

M'dongosolo la renin-angiotensin, dipeptidyl carboxypeptidase imathandizira kusintha kwa angiotensin kuchokera ku fomu yoyamba mpaka yachiwiri, yomwe imapangitsa khoma lamitsempha, kuti magazi azitha. Mu kallikrein-kinin system, ma enzyme amenewa amachititsa chidwi cha bradykinin, peptide yomwe imakhala ndi Vasodilating.

Malangizo ogwiritsira ntchito adanenanso kuti mankhwala a Lisinopril, omwe amagwira ntchito monga lisinopril dihydrate, amalepheretsa njira zonse ziwiri, zomwe ndi:

• imalepheretsa kusintha kwa angiotensin,
• amachepetsa chiwerengero cha cleavage wa bradykinin.

Chifukwa cha izi, vasodilating zotsatira, kusintha magazi, zimatheka.

Kuphatikiza apo, chinthu chogwira ntchito chimakhudza kagayidwe kazinthu zina zamomwe timagwira m'thupi. Ndi izi kuti zovuta zingapo za mankhwalawa Lisinopril zimagwirizanitsidwa, zomwe zazikulu zimatsokomola.

Kupanga kachitidwe kofotokozedwa m'ndime yapitayi kumapereka chidziwitso pakuwonetsa kwa kugwiritsidwa ntchito kwa mankhwala Lisinopril. Zomwe mapiritsiwa amachokera zimatsimikiziridwa ndi kuthekera kwa chinthu chogwira ntchito kuti tiletse kusintha kwa angiotensin ndi bradykinin, zomwe zimapangitsa kuchepa kwa magazi.

Kuphatikiza apo, Lisinopril, monga momwe malangizo akugwiritsidwira ntchito, ali ndi zotsatirazi:

• Amachepetsa michere yamitsempha yamanzere,
• Amakonza ntchito yamitima ya mtima,
• kuchuluka magazi aimpso,
• Amagwira bwino ntchito ya impso,
• ali nephroprotective kwambiri.

Chifukwa cha zovuta zake, mawonekedwe a kugwiritsidwa ntchito kwa mapiritsi a Lisinopril, mogwirizana ndi malangizo omwe angagwiritse ntchito, samangokhala ndi matenda oopsa, komanso kulephera kwa mtima (monga gawo la zovuta zina), kulowerera kwamtima, kusokonezeka kwa impso pamaso pa matenda a shuga.

Anthu omwe ali ndi vuto la kuthamanga kwa magazi ayenera kudziwa kuti chithandizo cha matenda oopsa chimaphatikizapo kugwiritsa ntchito nthawi zonse mankhwala oyenera, mosasamala za kuchuluka kwa kuthamanga kwa magazi. Izi zimatsimikiziridwa mosasamala ndi malangizo ogwiritsira ntchito ndi Lisinopril: kukakamiza komwe amamwa mankhwalawo sikunadziwike m'mawu akutiwakuti.

Kuphatikiza apo, chifukwa cha maphunziro azachipatala, adawonetsedwa kuti chithandizo chamankhwala omwe amamwa mankhwalawo, makamaka kuwongolera kwamanzere amitsempha yamagazi, kumawonekera pokhapokha pakugwiritsidwa ntchito kwa nthawi yayitali.

Lisinopril, monga chinthu chogwira ntchito, ali m'gulu la mankhwala ambiri a mono ndi ovuta. Ambiri a iwo amatchedwa Lisinopril. Opanga onse ndi mabungwe azamalonda apadziko lonse lapansi komanso akunja.

Mankhwala Lisinopril wochokera ku kampani yaku Russia ya Organika ndiye njira yankholi ya mankhwalawa. Pachifukwa ichi, nthawi zambiri amasankhidwa ndi odwala omwe sangakwanitse kugula mapiritsi a lisinopril. Mankhwalawa alandila ndemanga zabwino.

Mankhwala Lisinopril amapangidwa ndi Russia Nizhny Novgorod wogulitsa mankhwala, komanso makampani omwe si a ku Russia omwe ali mamembala a nkhawa yapadziko lonse a Stada AG. Odwala ambiri amasankha mankhwala kuchokera kwa wopangayo, ngakhale kuti ndi okwera mtengo kwambiri kuposa ma Organics.

Mwa mazana a mankhwala omwe amapangidwa ndi gulu lodziwika bwino lazachipatala ku Germany, palinso Lisinopril. Kugwiritsidwa ntchito kwake ndikofanana ndi mankhwala ena onse omwe ali ndi chinthu ichi. Kusiyanako kungakhale kofunikira kwa odwala ena: Ratiopharm, ndipo izi zikuwonetsedwa mu malangizo omwe angagwiritsidwe ntchito, zimapangitsa kuti mankhwalawa a lactose akhale opanda.

Fakitale yopanga mankhwala ku Ukraine Astrapharm imapereka imodzi mwazinthu zosankha kwambiri za mankhwala Lisinopril. Maganizo a wodwala okhudza iye amakhala abwino, omwe amatsimikiziridwa ndi mtengo wake, komanso kuchepa kwa lactose pakupanga mankhwala.

Kuchokera pa nkhawa yapadziko lonse lapansi Teva, Lisinopril kupita kumsika waku East Europe amapangidwa mufakitale yamankhwala ku Hungary. Chifukwa chake, mtundu uwu wa mankhwalawo, monga mankhwala omwe akuitanitsidwa, ndi wokwera mtengo kuposa omwe takambirana pamwambapa.

Uwu si mndandanda wathunthu wazosiyanasiyana zamankhwala omwe ali ndi dzina lomwelo: adzalembetsedwa osachepera awiri.

Monga lamulo, posankha Lisinopril, makamaka yemwe wopanga ndi wabwino, ogula amadalira kwambiri pamtengo. Komabe, odwala ayenera kudziwa kuti mitengo yodula kwambiri imatha kulekerera komanso kuyambitsa mavuto pang'ono (izi sizikugwirizana ndi chifuwa).

Magawo a matenda oopsa

Mafunso ndi mkulu wa Institute of Red Cross Cardiology

Matenda oopsa komanso kupanikizika kwamphamvu chifukwa cha iwo - mu 89% ya milandu, amapha wodwala matenda a mtima kapena sitiroko! Momwe mungapiririre kuthana ndi kupsinjika ndi kupulumutsa moyo wanu - kuyankhulana ndi mutu wa Institute of Cardiology of the Red Cross ya Russia ...

Zotsatira za pharmacological

Lisinopril, malangizo ogwiritsira ntchito amatsimikizira izi, kumawonjezera 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

Monga mankhwala aliwonse, Lisinopril ayenera kugwiritsidwa ntchito pokhapokha ngati dokotala wamuwuza. Monga tafotokozera pamwambapa, chinthu chogwira ntchito chimakhudza thupi, ndikusintha kuchuluka kwa michere yogwira ntchito. Ngakhale kuti mafotokozedwe a lisinopril omwe aperekedwa m'malangizo ogwiritsira ntchito amakhala otopetsa, upangiri waluso ndiwofunikira musanayambe kugwiritsa ntchito.

Aliyense amene wawerenga malangizo ogwiritsira ntchito, apeza chidziwitso pakugwiritsa ntchito mankhwalawa Lisinopril. Takambirana kale funsoli pamafunika piritsi kuti nditenge piritsi. Apanso, tikuwona kuti izi zikuyenera kuchitidwa tsiku ndi tsiku, mosasamala kanthu za zomwe zikuwonetsa pa tonometer.

Palibe chovuta momwe mungatengere Lisinopril. Izi zikuyenera kuchitika kamodzi patsiku, kumeza piritsi lonse ndi kumwa ndi kuchuluka kwa madzi. Monga mapiritsi ena ambiri, muyenera kumwa Lisinopril nthawi yomweyo: izi zidzakuthandizani kuti mupindule kwambiri ndi mankhwalawa.

Funso lina lomwe odwala matenda oopsa nthawi zambiri amafunsa kumayambiriro kwa chithandizo cha mankhwala ndi Lisinopril ndikuti nditha kumwa mankhwalawa nthawi yayitali bwanji. Ndi kulekerera bwino, chithandizo cha AH chitha kukhala nthawi yayitali: mpaka chitakhala ndi zotsatira zomwe mukufuna. Panthawi yogwiritsidwa ntchito nthawi yochepa, mwachitsanzo, pambuyo poti myocardial infarction, nthawi yoyendetsera imatsimikiziridwa payekhapayekha.

Malangizo ogwiritsira ntchito mulibe kufotokozera mwatsatanetsatane momwe mungatengere Lisinopril molondola - m'mawa kapena madzulo. Komabe, njira zochizira zimawonetsa kuti kudya kwam'mawa ndikofunikira.

Piritsi imayamwa m'matumbo am'mimba, ndipo mogwirizana ndi malangizo ogwiritsira ntchito, zomwe zili m'magaziwo sizikukhudza kuyamwa kwa zinthu lisinopril. Momwe mungamwe - musanadye kapena mutatha kudya - ndimankhwala osafunikira zilibe kanthu.

Lisinopril si choletsa "ACE" chothamanga.Zotsatira zake, monga momwe zalembedwera mu malangizo ogwiritsira ntchito, amakula pang'onopang'ono pakutha kwa ola loyamba pambuyo pa utsogoleri, kenako limayamba kuwonjezeka kwa maola 6 ndikupitilira kwa maola ena 15-17.

Pazifukwa izi, zilibe kanthu kwa odwala kuti mankhwalawa ndi othandiza motani. Lisinopril si chithandizo chadzidzidzi ndipo sayenera kugwiritsidwa ntchito ngati piritsi kuti achepetse kuthamanga kwa magazi.

Njira zochizira, monga zina za zoletsa za ACE, zimaphatikizapo kuyamba kulandira chithandizo chochepa ndi mlingo, womwe umatha kuwonjezeredwa ngati pakufunika. Mankhwala, mutha kupeza mapiritsi a Lisinopril okhala ndi mankhwala omwe ali ndi 2,5 mpaka 40 mg, omwe ndiwothandiza kwa matenda aliwonse oopsa.

Kutengera ndi kuopsa kwa matenda oopsa ndi mankhwalawa omwe analandiridwa, muyeso woyambirira wa lisinopril, mogwirizana ndi malangizo ogwiritsira ntchito, ndi 2,5 kapena 5 mg. Ngati chithandizo pa mlingo wa 2,5 mg chikuwonetsa kugwira ntchito kwake, ndiye kuti mankhwalawa sayenera kuchuluka.

Kutalika kwa mankhwalawa kumatengera mlingo womwe watengedwa.

Malangizo ogwiritsidwira ntchito ndi lisinopril 5 mg akufotokozera kuti nthawi zambiri, mankhwalawa amakhala okwanira komanso okwanira pochiza matenda oopsa. Ngati zotsatira zakukonzekera sizikuchitika, kuchuluka kwa mankhwala omwe amamwa amatha kuwonjezeredwa ndi 5 mg masiku atatu alionse. Ndi kuchuluka kwa mankhwalawa omwe ayenera kumwedwa, zotsatirazi za antihypertensive mphamvu ya lisinopril ziyenera kukumbukiridwa:

• kuchepa kwa kupanikizika kumaonekera m'masiku oyamba kuvomerezedwa,
• antihypertensive zotsatira zimadziunjikira ndikufika pazokwanira mkati mwa miyezi iwiri ya chithandizo.

Kuchulukitsa mlingo wa mankhwalawa malinga ndi malangizo ogwiritsira ntchito ndikotheka mpaka 20 mg patsiku (nthawi zambiri) kapena mpaka 40 mg patsiku (pazambiri). Kuwonjezeranso kwina kwa mlingo (woposa 40 mg) sikuti kumawonjezera mphamvu ya achire.

Lisinopril adafotokozedwanso monga gawo la zovuta za mankhwalawa pochiza kulephera kwa mtima, patatha nthawi ya infaration, ndi matenda a shuga. Mlingo muzochitika izi umayikidwa payekhapayekha, koma mwazinthu zambiri, ma algorithm pakupanga kwake amafanana ndi zomwe zili pamwambapa.

Kuthana ndi mlingo ndi gawo lofunikira la mankhwalawa Lisinopril. Mankhwala osokoneza bongo ndi otheka: mu malangizo ogwiritsira ntchito, amadziwika kuti, makamaka, amawonetsedwa pakuchepa kwambiri kwa kuthamanga kwa magazi komanso kuwoneka kwa zizindikiro zogwirizana ndi izi:

• kugona
• mphwayi
• chizungulire
• orthostatic hypotension,
• nseru

Kuchepa kwambiri kwa magazi kumatheka ndi kuwonjezeka pang'ono kwa mulingo wamba. Chifukwa chake, odwala ayenera kusamala, kuphunzira malangizo ogwiritsira ntchito ndipo nthawi zonse amatsata njira zomwe adotolo amayesedwa ndi adokotala.

Pamwambapa, tidazindikira kuti chinthu chogwira ntchito cha mankhwalawa chimakhudza zinthu zosiyanasiyana zogwira ntchito mthupi. Zotsatira zina sizinaphunziridwe mokwanira, koma ndi zomwe zimayambitsa zovuta, zomwe zimadziwika kuti mavuto.

Mwa iwo, mu malangizo ogwiritsira ntchito, choyambirira, chifuwa chowuma chimadziwika, chomwe malinga ndi data yomwe ikupezeka imayenda limodzi ndi aliyense wodwala khumi amatenga Lisinopril. Zotsatira zoyipa, kuphatikiza, zimatha kuchitika mwanjira ya:

• mutu
• chizungulire
• kuchepa kwambiri kwa magazi,
• kupanda chidwi, kugona ndi kutopa,
• nseru ndi m'mimba.

Malangizo ogwiritsira ntchito ali ndi mndandanda wokwanira bwino wazotsatira zoyipa. Komabe, onsewa amayenda ndi zinyalala “kawirikawiri”.

Zotsatira zoyipa, zotsutsana ndi lisinopril ndizofanana kwa zoletsa zonse za ACE:

• tsankho la lisinopril kapena mankhwala ena a gulu la ACE, komanso othandizira pazinthu,
• Mimba, kuyamwa,
• wazaka 18
• makomedwe amtundu wambiri.

Kugwiritsa ntchito mankhwalawa kuli ndi mndandanda wosangalatsa wa zoletsa zomwe zimafuna kusamala pochiza magulu ena a odwala.Zambiri pazambiri izi zitha kupezeka m'mayendedwe ovomerezeka kuti mugwiritse ntchito.

Malangizo ogwiritsira ntchito sakhala ndi chidziwitso ngati mapiritsi amatha kuchepetsa kukakamiza kwa ntchito ya e-sofil. M'maphunziro omwe adachitika pamutuwu, kuwonjezeka kwa magazi a testosterone aulere ndi dehydroepiandrosterone sulfate adadziwika panthawi ya chithandizo ndi ACE inhibitors. Izi zimakuthandizani kuti muyankhe funso ngati Lisinopril amakhudza potency, molakwika.

Komabe, odwala matenda oopsa ayenera kumvetsetsa kuti matenda oopsa ndi kusokonekera kwa erectile ali ndi njira yofanana yogwiritsira ntchito pathogenetic, komwe ndiko kuphwanya kwamasewera a mtima, kuphatikizapo omwe ali ndi udindo wopanga erection. Amuna omwe akukumana ndi mavuto potency pachizindikiro cha matenda oopsa ayenera kulandira chithandizo cha antihypertensive ndi ACE inhibitors (pakalibe zotsutsana).

Monga momveka bwino ndi malangizo omwe angagwiritsire ntchito, Lisinopril amatsogolera kuchepa kwa kamvekedwe ka mtima komanso matenda a kuthamanga kwa magazi, omwe mankhwalawa amapatsidwa. Mowa umapezekanso ndi vasodilating, womwe, ukamatengedwa nthawi yomweyo ndi wothandizitsa hypotensive, umawonjezera chiopsezo cha zotsatirazi: kuchepa kwambiri kwa kuthamanga kwa magazi, kupweteka kwa mutu, kufooka ndi zinthu zina.

Madokotala samalimbikitsa kuti mutenge mankhwalawa nthawi yomweyo. Kuphatikiza kwawo ndizowona, makamaka, odwala ambiri oopsa amazindikira kuti kuphatikiza koteroko sikubweretsa vuto lililonse ndipo sikuwonjezera vuto. Komabe, owerenga ayenera kuzindikira kuti mowa, monga cardio- ndi vasotoxic wothandizila, amathetsa chithandizo chomwe amalandila ndikuwonjezera kudwala kwa nthawi yayitali kwa wodwala wokhala ndi matenda oopsa.

Zochizira matenda oopsa, ACE inhibitors nthawi zambiri amawagwiritsa ntchito ngati mankhwala othandiza kwambiri, kuphatikizapo mankhwalawa Lisinopril. Ndemanga za odwala omwe amamwa mankhwalawa, pachifukwa ichi, ndi ambiri. Ambiri mwaiwo ndi abwino.

Anthu amadziwa zotsatirazi zofunika za mankhwala:

• 'Imagwira bwino kupanikizika'
• amafunika kutengedwa kamodzi patsiku,
• zotsika mtengo.

Nthawi zina, odwala adazindikira kuchepa kwambiri kwa kuthamanga kwa magazi, maonekedwe ofooka, osapumira - zizindikiro za mankhwala osokoneza bongo, ndikuwonetsa kuti mankhwalawa adasankhidwa molakwika.

Pali ndemanga pomwe milandu yogulitsa mankhwala achinyengo pansi pa dzina loti Lisinopril adalembedwa. Ogwiritsa ntchito ayenera kusamala ndikugula mankhwalawo mu phukusi lodziwika bwino, kuchokera kwa wopanga odziwika komanso pamtengo wamba.

Onaninso akatswiri a mtima okhudzana ndi mankhwalawa

Malangizo ntchito onani yofunika kwambiri ya mankhwala Lisinopril, monga biotransformability mu thupi. Ndemanga za akatswiri amtima zimaganiziranso za chinthu chomwe sichimagwira mu chiwindi, koma chimasinthika osasinthika. Izi zimasiyanitsa lisinopril ndi zinthu zina za dipeptidyl carboxypeptidase zoletsa zinthu.

Komabe, izi zimafunikira kuyang'anira impso mosamala, makamaka m'magulu a creatinine, monga momwe zalembedwera malangizo. Ndi kuchepa kwa kuchuluka kwa kusefera kwa glomerular, mulingo wa lisinopril m'magazi umakwera, zomwe zimayambitsa chiopsezo cha zizindikiro zochulukirapo.

Mwambiri, akatswiri a mtima amayankha bwino Lisinopril, kuzidziwitsa kuti ndi njira yothandiza kuchepetsa kuthamanga kwa magazi, komwe kumakhala ndi zotsatira zazitali. Ndi mankhwala osankha odwala omwe ali ndi vuto la chiwindi, hepatitis, cirrhosis.

Ngati titalankhula za kuphatikiza monga Lisinopril ndi mowa, ndiye kuti malingaliro a akatswiri amtima pazokhudza nkhaniyi amasiyana pamagulu osiyanasiyana. Kwa anthu omwe amamwa mowa kwambiri kapena kumwa pafupipafupi, kukana kwathunthu izi kungapangitse kuti masoka achete atha kuphedwa.Ndikofunika kuti anthu omwe amamwa mowa nthawi zina ("patchuthi") akane kumwa mokwanira, popeza kuopsa kwa zotsatira zoyipa mukamalandira chithandizo ndi Lisinopril kumakulitsa kwambiri zoopsa zina zonse.

Chinsinsi cha Latin

Masiku ano, madokotala ochulukirapo, ngakhale oyenerera kwambiri, amalemba mankhwala osati m'Chilatini. Popeza mwalandira kalata yogulira mankhwala m'chinenedwe chanu, musadabwe. Kwa iwo omwe anali m'gulu la omwe anali ndi mwayi omwe adalandira mankhwala a Lisinopril mchilatini, nayi mawonekedwe ake:

Rp. Tabulettae Lisinoprili (akuwonetsa mlingo, mwachitsanzo, 5 mg kapena 0,005 g).

S. 1 piritsi mkati 1 r / d.

Chithandizo cha matenda oopsa, kulephera kwa mtima, boma lodzilowetsa m'mbuyomu nthawi zambiri zimachitika pogwiritsa ntchito mankhwala ochokera kumagulu osiyanasiyana a mankhwala. Izi ndizofanananso ndi Lisinopril.

Kuphatikizidwa kwa zinthu zamankhwala ndi imodzi mwothandiza kwambiri pochiza matenda ambiri a mtima, limodzi ndi matenda oopsa komanso kuchita kwakukulu kwa matenda aherosselotic.

Kuphatikiza kwa amlodipine, lisinopril ndi rosuvastatin, posagwirizana ndi chilichonse cha iwo, chitha kuperekedwa kwa:

• AH
• pachimake coronary syndrome
• kulephera kwa mtima
• fibrillation ya atria.

Kuphatikiza konseku komwe kuli ndi magawo onse atatuwo kumapangidwa ndi kampani yopanga zamankhwala ku Hungary a George Richter omwe amadziwika ndi dzina la Ekwamer.

Kuphatikizidwa kwa ACE inhibitor ndi diuretic ndizodziwika bwino pochiza matenda oopsa. Lisinopril ndi hydrochlorothiazide amatha kuyendetsa bwino zovuta pazovuta zomwe kufunika kwake sikumatheka mwa kumwa imodzi mwazomwezi. Mankhwala, mutha kupeza mankhwala omwe ali ndi zinthu zonse ziwiri (pa mlingo wa 10 kapena 20 mg wa lisinopril ndi 12.5 mg wa hydrochlorothiazide):

• Iruzid,
• Co Diroton
• Lysinotone H,
• Wachikulire
• Rileys-Sanovel kuphatikiza.

Madokotala samapereka mankhwala a lisinopril ndi indapamide, m'malo mwa iwo ndi hydrochlorothiazide. Palibe zokonzekera zonse pamodzi. Chifukwa chake, ngati mukufuna kudziwa ngati Indapamide ndi Lisinopril zitha kutengedwa nthawi yomweyo, ndiye kuti muyenera kupewa. Indapamide, monga lamulo, imaphatikizidwa ndi analog ya Lisinopril - Enalapril.

Gulu lazachipatala lomwe Lisinopril ndi wake (mankhwala omwe amaletsa dipeptidyl carboxypeptidase) amaimiridwa ndi anthu angapo mankhwala. Kuphatikiza apo, pali mankhwala ochokera m'magulu ena:

• angiotensin receptor blockers (ARBs),
• wodutsa calcium blockers (BMKK),
• beta-blockers (BAB), -

- onse ali ndi antihypertensive kwambiri ndipo, pazochitika zina, amatha kukhala ngati analogue ndi kusintha kwa mankhwala Lisinopril.

Mankhwala okhala ndi Enalapril amagwiritsidwa ntchito kwambiri pothandizira matenda oopsa komanso matenda ena a mtima.

Alibenso zopindulitsa kuposa lisinopril. Monga lamulo, amafunika nthawi ya 2 kawiri pa tsiku.

Mankhwala Berlipril amachokera pa enalapril yomwe ili pamwambapa. Ngati tizinena za zomwe zili zabwinoko, ndiye kuti Lisinopril kwa odwala ambiri ndi njira yabwinoko.

Kusankha Lisinopril kapena Prestarium, yomwe ndi yabwinoko kwa matenda oopsa, ziyenera kukumbukiridwa kuti perindopril, yomwe ndi gawo la Prestarium, imapangidwa mu chiwindi, chomwe chingakhale chofunikira kwa odwala ndi matenda a cirrhosis komanso kulephera kwa chiwindi. Kuphatikiza apo, perindopril imawonetsa mphamvu yake mwachangu (pambuyo pa maola atatu), koma imayenera kuledzera kwambiri asanadye, popeza kupezeka kwa chakudya kumachepetsa mayamwidwe ake.

Kuphatikiza kwa mankhwala Lisinopril ndi ambiri. Chimodzi mwa zotsika mtengo kwambiri ndi mankhwala omwe amapangidwa ndi a ku Hungary a George Richter, Diroton. Imawoneka ngati analogue yabwinoko, yomwe imawonetsedwa mu ndemanga pamutu womwe ndiwabwino - Lisinopril kapena Diroton. Odwala omwe sakakamizidwa pazachuma, amasankha izi.

Mankhwala opangidwa ndi Captopril amachita mwachangu (mkati mwa theka la ola), koma zotsatira zake sizikhala motalika, zomwe zimafuna katatu pa tsiku. Chifukwa cha izi, mankhwala okhala ndi captopril sioyenera kwambiri kupitiliza mankhwala: zimatsimikiziridwa kuti ndi gawo lochepa chabe la odwala lomwe limatha kutsatira njira yayitali kwambiri kwanthawi yayitali. Izi ziyenera kukumbukiridwa posankha Lisinopril kapena Captopril, yomwe ndi yabwino kwambiri.

Pakati pa dipeptidyl carboxypeptidase inhibitors, ramipril ndi amodzi mwa asanu omwe, pakupita mayesero akuluakulu azachipatala, zinatsimikiziridwa kuti kugwiritsa ntchito kwawo odwala omwe ali ndi matenda oopsa kumachepetsa kufa.

Mwanjira iyi, kusankha pakati pa mankhwala a Ramipril kapena Lisinopril, omwe ali bwino kwa iwo, sikungapangike pazotsatira za cholinga. Komabe, ndizotheka kuti kulekerera kwapadera kwa mankhwala ena ake kudzakhala kosiyana.

Ngati chifuwa chikuchokera ku Lisinopril, ndiye funso loti mungalithetse bwanji ndikofunika. Njira imodzi ikhoza kukhala Lorista.

The yogwira thunthu - losartan potaziyamu - ali osiyana limagwirira a zochita chifukwa sayambitsa kutsokomola. Komabe, posankha ngati Lisinopril kapena Lorista alibwino, ziyenera kukumbukiridwa kuti mankhwalawa amachepetsa kuthinikizidwa kosakwanira (ndi 8 mm Hg motsutsana ndi 20 mm Hg mu lisinopril, malinga ndi maphunziro azachipatala). Kuphatikiza apo, Lorista amayenera kuledzera kawiri pa tsiku, ndipo amakhalanso ndi mndandanda wochititsa chidwi wazotsatira komanso zoyipa, monga momwe zalembedwera mu malangizo ogwiritsira ntchito.

Mankhwala a Valz (chinthu chomwe chikugwira ntchito ndi valsartan) ali m'gulu lomwelo la mankhwala monga Lorista, komabe, poyerekeza ndi omalizirawa, ali ndi mwayi wofunikira - kutalika kwa zotsatira zake, zomwe zimakupatsani mwayi wowamwa kamodzi patsiku. Monga ma ARB ena, ma valsartan nthawi zambiri amaphatikizidwa ndi mankhwala ena. Ngati tikulankhula za monotherapy, ndiye kuti Lisinopril atha kuwonedwa ngati abwino komanso othandiza.

Mankhwala okhala ndi Bisoprolol amatseketsa ma adrenergic receptors a mtima ndi aorta, potero amachepetsa kugunda kwa mtima ndi kuchuluka kwa magazi, kutsitsa kuthamanga. Dziwani kuti njira yochepetsera kupanikizika kwa mankhwala a gulu la BAB sichidziwika bwino, monga momwe malangizo amagwiritsidwira ntchito. Kusankha lisinopril kapena bisoprolol, komwe kuli bwino kwa wodwalayo, dokotala aziganizira zinthu zambiri ndikupanga nthawi yoyenera.

Mutha kudziwa zambiri zokhudzana ndi matenda oopsa pa kanemayo:

Pamodzi ndi nkhaniyi adawerenga:

Khodi ya Atx: c07ab07 Gulu la apolisi: beta-blockers

Bisoprolol ilibe zochitika zake zothandizira komanso ma membrane-okhazikika. Chifukwa cha milomo yake ya lipophilic, mankhwalawa amatengedwa mwachangu kuchokera m'mimba. Chifukwa chotalika ndi theka la moyo (maola 10-12), bisoprolol ndi nthawi 1 patsiku. Kuchuluka kwa bisoprolol ndi maola 2-4 pambuyo pa kuperekera, kutalika kwa mankhwalawa ndi maola 24. Bisoprolol simalumikizana ndi mankhwala ena omwe amagwiritsidwa ntchito pochiza matenda amtima. Kudya sikukhudza pharmacokinetics of bisoprolol. Kuwonongeka kwa impso pafupifupi sikukhudzanso kuchuluka kwa mankhwalawa m'magazi, kokha ndi kulephera kwaimpso kumafuna kusintha kwa mlingo.

Pharmacokinetics yomwe amadalira mlingo wa mankhwala a bisoprolol ndiwofanana, kusinthasintha kwake mosiyanasiyana komanso mosiyanasiyana kuli kochepa, komwe kumatsimikizira kuti mankhwalawo amatha mosalekeza.

Zomwe zimapangidwa ndi betoprolol metabolism zimawonetsa zabwino zake zamankhwala: kuthekera kotenga kamodzi patsiku, kusowa kwa kufunika kwa kusintha kwa mankhwalawa mu chiwindi ndi pathologies a impso mwa okalamba, mukamagwiritsa ntchito limodzi ndi mankhwala ena, komanso chitetezo chachikulu chothandizira odwala omwe ali ndi matenda opatsirana monga shuga matenda a shuga, matenda osapatsika a m'mapapo, matenda am'mitsempha yamagazi.

Matenda a mtima a Ischemic (coronary).BAB ndiye mankhwala akuluakulu pochotsa khola la angina pectoris. Kuthamanga kwawo chifukwa cha zotsatira zoyipa za poyropic ndi chronotropic, komwe kumabweretsa kuchepa kwa mphamvu ya mpweya m'moyo, komanso chifukwa chokwanira kutulutsa minofu, kufikira nthawi yakukwaniritsidwa kwa minofu ya mtima. Kuphatikiza apo, kuwonjezeka kwa kutalika kwa myocardial perfume mu diastole chifukwa cha kuchepa kwa kugunda kwa mtima kumapangitsa kusintha kwa kuperekera kwa oksijeni ku myocardium. Ngati pali kusankha kwina kwamakono kwa gulu la BAB, madokotala ena amapereka mankhwala othandiza mosakwanira.

Muyenera kuyika pati chithandizo cha BAB: 1) ngati pali kulumikizana kowoneka bwino pakati pa kukhazikika kwa matenda a angina ndi zochitika zolimbitsa thupi, 2) ndi matenda ogwirizana, 3) kupezeka kwa mtima wa mtima (supraventricular kapena ventricular arrhythmia), 4) ndi myocardial infarction.

Mlingo wa BAB wotere umawonedwa kuti ndi wofanana, womwe umathandizira kuchepa komweko pakuwonjezeka kwa kugunda kwa mtima panthawi yochita masewera olimbitsa thupi (propranolol 100 mg, atenolol 100 mg, metoprolol 100 mg, bisoprolol 10 mg).

Malinga ndi zotsatira za kafukufuku wa ATP-kafukufuku wa Angina (Angina Treatment Pattern) *, posankha mankhwala opanga ma antianginal ndi hemodynamic zochita zake mu monotherapy regimen, nitrate (11.9%) amasankhidwa ku Russia, akutsatiridwa ndi BAB (7.8%) ndi otsutsana ndi calcium (2 , 7%). Komabe, ndi mankhwala a BAB ophatikizika (omwe amaphatikizidwa ndi ma organic nitrate) nthawi zambiri amadziwika - 75% ya milandu.

Kuwunika kwa meta kosiyanitsa zingapo kwawonetsa kuti zotsatira za mtima wa BAB ndizoyimira pawokha kapena kusapezeka kwa β-selectivity, koma momveka bwino zimadalira katundu wowonjezerapo monga mkati mwa sympathomimetic ntchito (ICA) ndi lipophilicity.

Odwala omwe ali ndi myocardial infarction, zotsatira zotchulidwa kwambiri za mtima zimaperekedwa ndi mankhwala a lipophilic (kuchepetsa kufa ndi pafupifupi 30%): betaxolol, carvedilol, metoprolol, propranolol, timolol, etc. ndi BAB yopanda ICA (pafupifupi 28%), monga metoprolol, propranolol ndi timolol. Nthawi yomweyo, BAB yokhala ndi ICA (alprenolol, oxprenolol ndi pindolol), kapena mankhwala a hydrophilic (atenolol ndi sotalol) omwe amagwiritsidwa ntchito kwa nthawi yayitali sateteza kufa m'gulu lino la odwala. Pakati pa BAB odwala omwe ali ndi matenda a coronary artery matenda, bisoprolol (5-20 mg / tsiku), atenolol (25-100 mg / tsiku), metoprolol (50-200 mg / tsiku), carvedilol (25-50 mg / tsiku), nebivolol (5 mg / tsiku). Mankhwala osokoneza bongo omwe ali ndi mtima (bisoprolol, atenolol, metoprolol, betaxolol) ali ndi choletsa kwambiri on- adrenoreceptors, komanso chithandizo chazitali, kulekerera kwawo sikofunikira kwenikweni.

Zambiri mwa kafukufukuzi zidawonetsa kuti kugwiritsa ntchito bisoprolol, carvedilol sikuti kumangoleketsa kuzitsika kwa zizindikiro, komanso kumakweza bwino kwambiri matendawo. Odwala ndi angina pectoris, kuchuluka ndi kutalika kwa nthawi yochepa ya ischemia kungachepe. Kuphatikiza apo, chithandizo chimayendetsedwa ndi kuchepa kwa zizindikiro monga kufa ndi kufooka, komanso kusintha kwa odwala.

Bisoprolol imathandizira kukulitsa kulolerana kochita masewera olimbitsa thupi kwakukulu kuposa kugwiritsidwa ntchito kwa atenolol ndi metoprolol, kumapangitsa kuwonjezeka kwakukulu kwa zochitika zolimbitsa thupi komanso kudalira kwa mlingo wokhudzana ndi kulolerako zolimbitsa thupi. Zinawonetsedwa kuti bisoprolol pamlingo waukulu kwambiri kuposa atenolol ndi metoprolol imawongolera moyo wabwino wa odwala ndikuchepetsa nkhawa, kutopa. Ndikofunikira kwambiri kuti bisoprolol imachepetsa kufa kwa mtima ndi chiopsezo chokhala ndi infaration yotsitsimutsa mwa odwala omwe ali pachiwopsezo chachikulu pakuchita opaleshoni yamtima.

Kafukufuku wa TIBBS adayesa zotsatira za bisoprolol poyerekeza ndi nifedipine pa chosakhalitsa ischemia mwa odwala 330 omwe ali ndi angina pectoris okhazikika ndi myocardial ischemia yotsimikiziridwa ndi electrocardiography ndi ECG, yotsimikiziridwa ndi kuyesa kwa treadmill ndi kuwunika kwa Holter.Pambuyo pa milungu 4 ya chithandizo mu gulu la bacoprolol (20 mg / tsiku), kuchuluka kwa zochitika za myocardial ischemia kutsika (kuyambira 8.1 ± 0.6 mpaka 3.2 ± 0.4), kutalika konse kwa myocardial ischemia kunachepa (kuchokera 99.3 ± 10.1 mpaka 31.2 ± 5.5 min), kuchuluka kwa zowukira m'mawa kwambiri kunachepa. Odwala omwe adachotsa pang'onopang'ono myocardial ischemia chifukwa cha chithandizo anali ndi chiopsezo chochepa cha kufa poyerekeza ndi odwala omwe amalimbikira zochitika za ischemic. Olembawo adawonjezeranso kuwonjezeka kwa kusinthasintha kwa mtima wakati wamankhwala ndi bisoprolol. Nthawi yomweyo, kusowa kwa zotsatira za mawonekedwe obwezeretsera (nifedipine 40 mg / tsiku) pazowonetsa modabwitsa kumeneku kunawonetsedwa.

Kafukufuku wina adawonetsa zotsatira zoyipa zochepa, mphamvu yayikulu ya zosoprolol poyerekeza ndi nifedipine, komanso kufalikira koyenera komanso kulolerana kwabwino poyerekeza ndi amlodipine. Zawonetsedwa kuti kuwonjezera kwa kashiamu wotsutsa ku bisoprolol kulibe phindu lalikulu mankhwalawa odwala omwe ali ndi angina pectoris okhazikika. Kuphatikiza kwa antianginal ndi anti-ischemic kwa bisoprolol kunawonetsedwa mu kafukufuku wa MIRSA, momwe bisoprolol inachepetsa chiwerengero cha ischemia panthawi yochita masewera olimbitsa thupi ndikupititsa patsogolo kudwala kwa odwala omwe ali ndi matenda amitsempha yamagazi. Zotsatira zoyipa za BAB zogwirizana ndi β blockadema receptors omwe ali mu bronchopulmonary system. Kufunika kolamulira poika β-blockers ndi zotsatira zoyipa (bradycardia, hypotension, bronchospasm, kuchuluka kwa kulephera kwa mtima, kugunda kwa mtima, sinus node kufooka matenda, kutopa, kusowa tulo) kumabweretsa chifukwa chakuti dokotala samagwiritsa ntchito mankhwala ofunikira awa nthawi zonse. Komabe, posankha BAB zochitika izi zimadziwika nthawi zambiri. Zolakwika zazikulu zachipatala pakupereka BAB kwa odwala omwe ali ndi matenda a mtima ndi kugwiritsa ntchito mankhwala ochepa, makonzedwe awo nthawi zambiri kuposa momwe amafunikira, komanso kusiya mankhwala osokoneza bongo pakachitika zosaposa 60 kumenyedwa. Tiyeneranso kukumbukiranso kuthekera kwa chitukuko cha kulera, motero, BAB iyenera kuchotsedwa pang'onopang'ono. Chifukwa chake, BAB imawerengedwa kuti ndi gawo loyenera poperekera matenda amtundu uliwonse wamatumbo, chifukwa chogwira bwino ntchito yawo kwa odwala pambuyo poyambitsa myocardial infarction. Kuchepetsa 25% kwa kubwereranso kwam'mnyewa wamatumbo ndikufa kunawonetsedwa kwa odwala omwe ali ndi matenda amitsempha yamagazi ogwiritsira ntchito BAB. Mankhwala osokoneza bongo a gululi ndi chisankho choyambirira chothandizira odwala omwe ali ndi angina pectoris, makamaka kwa odwala pambuyo poyambitsa matenda amiseche, chifukwa zimayambitsa kutsika kwa kufedwa komanso kuchuluka kwa kubwerezabwereza kwa myocardial.

Bisoprolol poyerekeza ndi atenolol ndi metoprolol imakhala ndi mtima wodziwika bwino (mu mulingo wachifundo umaletsa kokha β-adrenoreceptors) komanso nthawi yayitali yochitapo kanthu. Amagwiritsidwa ntchito IHD kamodzi patsiku, kutengera mtundu wa magwiridwe a angina pectoris pa mlingo wa 2.5-20 mg. Ngati BAB monotherapy sikokwanira, ndiye kuti ma nitrate kapena calcium antagonists ochokera ku gulu la dihydropyridine amawonjezeredwa ku chithandizocho (GFCF, 2008). Kuwunika momwe odwala akutenga bisoprolol kuyenera kuphatikizapo: kuyeza kugunda kwa mtima ndi kuthamanga kwa magazi (koyambirira kwa chithandizo tsiku ndi tsiku, ndiye kuti 1 nthawi iliyonse miyezi itatu), ECG, kudziwa kuchuluka kwa shuga kwa odwala omwe ali ndi matenda a shuga (1 nthawi iliyonse 4-5 miyezi ) Odwala okalamba, tikulimbikitsidwa kuwunika ntchito yaimpso (1 nthawi m'miyezi 4-5). Ndi kuvulala kwambiri aimpso (creatinine chilolezo chochepera 20 ml / min) komanso kwa odwala omwe ali ndi vuto lalikulu la chiwindi, mlingo waukulu wa tsiku ndi tsiku ndi 10 mg.

Matenda oopsa. Kuchulukitsa kwa zotsatira za bisoprolol kumalumikizidwa ndi kuchepa kwa miniti yamagazi, kuthamanga kwa mtima, kukondoweza kwachisangalalo cha zotumphukira, kuchepa kwa ntchito ya renin-angiotensin dongosolo (lofunika kwambiri kwa odwala omwe ali ndi vuto la renal hypersecretion), kubwezeretsa chidwi chokhudzana ndi kuchepa kwa kuthamanga kwa magazi ndi zotsatira zake pamagawo apakati amanjenje pa malo a vasomotor).Ndi matenda oopsa, zotsatira zake zimachitika pambuyo pa masiku 2-5, zotsatira zokhazikika - pambuyo pa miyezi 1-2. Chifukwa chake, zotsatira za mankhwalawa zimakhazikika pakuchepa kwa mtima wake, kuchepa kwa mtima, kuchepa kwa chobisalira ndi kuchuluka kwa renin mu plasma, komanso kuletsa zotsatira za malo a vasomotor. Mankhwala a Bisoprolol sayenera kusokonezedwa mwadzidzidzi, makamaka kwa odwala omwe ali ndi matenda amitsempha yamagazi. Ngati kusiyidwa kwa chithandizo ndikofunikira, ndiye kuti mlingo uyenera kuchepetsedwa pang'onopang'ono.

Kuchita bwino kwa bisoprolol mu matenda oopsa kwawonetsedwa mu maphunziro angapo azachipatala. Mlingo wogwira tsiku lililonse wa mankhwalawa unachokera ku 5 mpaka 10 mg, ngakhale maphunziro ena adagwiritsa ntchito 20 mg. Zinawonetsedwa kuti kutalika kwa hypotensive zotsatira za bisoprolol kuli pafupifupi maola 24, ndipo mukayerekezera zomwe zimachitika ndi BAB, monga atenolol ndi metoprolol, sizikhala zotsika kwa iwo pachilichonse.

Pakufufuza kwakanthawi kwamaso kwa BISOMET mwa anthu 87 odwala matenda oopsa, zidawonetsedwa kuti bisoprolol (n = 44) pa mlingo wa 10 mg / tsiku akufanana ndi metoprolol (n = 43) pa mlingo wa 100 mg / tsiku malinga ndi kuchepa kwa kuthamanga kwa magazi pakupuma, koma kwakukulu imaposa mphamvu yake pamlingo wa kuchuluka kwa magazi a systolic komanso kugunda kwa mtima panthawi yochita masewera olimbitsa thupi (maora 24 pambuyo pa mlingo womaliza wa bisoprolol, kuthamanga kwa magazi kwa systolic pamtunda wa 100 watts kunatsitsidwa mpaka 85% ya mphamvu yayikulu ya maola atatu a 3%, ndipo ndi 63% yokha ya gulu la metoprolol) (p = 0.02) Chifukwa chake, bisoprolol adapezeka kuti adakondedwa fulakesi metoprolol mankhwalawa matenda oopsa, makamaka odwala ndi hypersympathicotonia.

Kafukufuku wa BIMS adayerekezera mphamvu ya antihypertensive ya bisoprolol ndi atenolol mwa omwe amasuta. Bisoprolol ndi atenolol anali othandiza mu 80 ndi 52% ya milandu, motsatana.

Mphamvu ya antihypertensive ya bisoprolol siyotsika kwambiri poyerekeza ndi calcium antagonists (nifedipine) ndi angiotensin-akatembenuza enzyme inhibitors (ACE inhibitors, enalapril). Pakuyerekeza kwaposachedwa kwa miyezi 6, bisoprolol pa mlingo wa 10-20 mg / tsiku kunapangitsa kuchepa kwakukulu kwa cholesterular myocardial misa index ndi 11%, yomwe inali yofanana ndi mphamvu ya enalapril pa mlingo wa 20-40 mg / tsiku.

Odwala omwe ali ndi vuto lochepa kwambiri pakati pa tsiku limodzi ndi mlingo umodzi patsiku, bisoprolol imachepetsa kuthamanga kwa magazi ndi 15-20%. M'maphunziro owunika magazi pafupipafupi kuchipatala pansi pa njira yolumikizira wodwala aliyense, bisoprolol pa 10 mg kamodzi patsiku anali ndi "yosalala" antihypertensive kwambiri masana poyerekeza ndi zotsatira za metoprolol kapena propranolol, omwe adalembedwa 2 kamodzi patsiku. Ponena za kuchuluka kwa kuthamanga kwa magazi kwa diastolic, kuchuluka kwa zotsatira zomaliza kufika pachimake kunali 91.2% kwa bisoprolol. Amakhulupirira kuti mtengo wocheperako wa chizindikiro ichi kutsimikizira mphamvu ya "yosalala" masana ndi 50%.

Kafukufuku wina, kugwiritsa ntchito kwa kuphatikiza kwa bisoprolol ndi hydrochlorothiazide ophatikizidwa mu 512 odwala omwe ali ndi vuto lochepa kwambiri adaphunziridwa, ndipo mankhwala aliwonse amalembedwa mu Mlingo wosiyanasiyana (bisoprolol kuyambira 2.5 mpaka 20 mg, hydrochlorothiazide kuchokera 6.25 mpaka 25 mg). Zinawonetsedwa kuti kugwiritsidwa ntchito kwa mankhwalawa muyezo wocheperako kumalekeredwa bwino ndi odwala, pomwe pali kuchepa kwa kuthamanga kwa magazi kwa diastolic mpaka 90 mm RT. Art. ndi kutsika mu 61% ya odwala.

Kugwiritsa ntchito kwa nthawi yayitali kwa bisoprolol kwa odwala omwe ali ndi matenda oopsa kungayambitse kusintha kwamanzere kwamitsempha yamagazi. Popeza kugwiritsa ntchito mankhwala osokoneza bongo kuyenera kuchitika pafupipafupi komanso kwa nthawi yayitali, mankhwala operekedwa chifukwa chaichi ayenera kukhala osavuta kugwiritsa ntchito komanso kuvomerezedwa ndi odwala. Mankhwalawa matenda oopsa, kufalikira kwakukulu pakumagwiritsa ntchito BAB kukugwirizana ndi kuwopa kukhala ndi zotsatira zoyipa za metabolic (kuchuluka kwa insulin kukana, kusintha kwa proatherogenic m'magazi a lipid sipekitiramu) ndikuwonjezereka kwa maphunziro a concomitant chronic obstriers pulmonary matenda (COPD) kapena matenda apamtima.

Kusinthasintha kwa mtima. Ku Institute of Clinical Cardiology.AL Myasnikov adagwira ntchito yofanizira mphamvu ya bisoprolol ndi amiodarone pochiza minyewa yamitsempha yama cell extrasystole (PVC) mwa odwala metabolic syndrome. Mwa odwala 52 omwe ali ndi metabolic syndrome omwe ali ndi vuto la ZhE, amiodarone 200 mg kamodzi patsiku masiku 5 pa sabata amagwiritsidwa ntchito ngati mankhwala a antiarrhythmic, odwala 55 amatenga 10 mg bisoprolol tsiku lililonse madzulo. Kuchita bwino kunayesedwa pogwiritsa ntchito kuwunika tsiku ndi tsiku kwa ECG pambuyo pa miyezi 1, 3, 6, 9, ndi 12. Pamapeto pazowonera, mwayi waukulu wa bisoprolol poyerekeza ndi amiodarone wapezeka kuti ndi wothandiza (50% ya odwala omwe amathandizidwa bwino poyerekeza ndi 17.3%, p = 0.02). Anasiya kumwa mankhwalawa chifukwa cha kuchepa kwa mphamvu, 20% motsutsana 46.1% (p = 0.004). Chiwerengero cha odwala omwe akukana chithandizo chifukwa cha zovuta m'magulu onsewa chinali chofanana.

Mu kafukufuku wolemba A.Plewan et al. Kuchita kofananako kwa bisoprolol pa mlingo wa 5 mg ndi sotalol pa mlingo wa 160 mg popewa ma paroxysms a atria fibrillation odwala atatha kuonetsa mtima. Nthawi yomweyo, bisoprolol idapangitsa zotsatira zoyipa zochepa kuposa sotalol. Bisoprolol sanali wocheperapo kwa amiodarone popewa kufinya kwa odwala omwe ali ndi matenda amitsempha yamagazi pambuyo pa opaleshoni yam'mitsempha ya m'magazi. Kuchita kwapamwamba kwambiri kwa bisoprolol ngati mankhwala ochepetsa mphamvu ya mankhwalawa pochizira ma cyricular ndi supraventricular extrasystoles yokhala ndi mawonekedwe a atrial fibrillation adawonetsedwanso. Kuthekera kwa β-blockers, kuphatikiza bisoprolol, kulepheretsa chitukuko cha pangozi yozungulira moyo wamagulu m'magulu a odwala omwe ali pachiwopsezo cha kufa mwadzidzidzi ndikofunikira kwambiri.

Zizindikiro zina zakusankhidwa kwa bisoprolol. Bisoprolol ndi othandiza komanso yotetezeka kwa anthu odwala matenda ashuga, mankhwalawa samakhudza kuchuluka kwa shuga m'magazi omwe ali ndi matenda osokoneza bongo, safuna kusintha kwa mankhwalawa a mankhwala amkamwa. Bisoprolol sichikhudza kuchuluka kwa mahomoni a chithokomiro m'magawo a hyperthyroid, samayambitsa hypokalemia. Zambiri zam'mabuku zimawonetsera kusowa kwa vuto pakuloweka kwa lipid mwa odwala omwe akutenga bisoprolol nthawi yayitali.

Kukhazikitsidwa kwa BAB kumatha kupititsa patsogolo patsogolo kwa moyo wa odwala omwe amachitidwa maopareshoni ena pamtima ndi m'mitsempha yamagazi. Chifukwa chake, zidawonetsedwa kuti kuikidwa kwa bisoprolol panthawi ndi pambuyo pa ntchito zotere kumachepetsa mwayi wa imfa kuchokera pazifukwa zilizonse komanso mwayi wokhala wopanda vuto la myocardial infarction mwa odwala omwe anali ndi chiwopsezo cha zovuta zamtima.

Chomwe chimathandiza lisinopril?

Zisonyezo zogwiritsa ntchito mankhwalawa ndi monga:

• diabetesic nephropathy (kutsitsa kwa albinuria odwala omwe amadalira insulin omwe amakhala ndi magazi abwinobwino komanso osagwirizana ndi insulin omwe amadalira matenda oopsa)
• Kulephera kwamtima kosalekeza (monga gawo limodzi la mankhwala ochiritsira odwala omwe amatenga digito ndi / kapena okodzetsa),
• matenda oopsa a arterial (mu monotherapy kapena kuphatikiza mankhwala ena a antihypertensive),
• chithandizo choyambirira cha kulowetsedwa pachimake (mu maola 24 oyamba ndi magawo a hemodynamic okhazikika kuti muzitha kuzitsatira ndikuletsa kukomoka kwamitsempha yama mtima komanso kukomoka kwa mtima).

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.

Malangizo apadera

Mu pachimake myocardial infarction, mankhwalawa amagwiritsidwa ntchito motsutsana ndi maziko a zovuta zovuta pogwiritsa ntchito thrombolytics, beta-blockers ndi acetylsalicylic acid.

Asanachite opareshoni, adokotala ayenera kuchenjezedwa za kutenga Lisinopril. Anthu omwe ali ndi matenda ashuga amafunikira kuwunika kawirikawiri shuga.

Kuyanjana kwa mankhwala

Kuphatikiza ndi kukonzekera komwe kumakhala ndi lithiamu, chomaliza chimachotsedwa m'thupi. Ndi kuphatikiza uku, kuyang'anitsitsa kosasunthika kwa lithiamu m'magazi kumafunika.

Lisinopril amalimbikitsa machitidwe a ethanol. Mankhwala osagwirizana ndi antisteroidal, estrogens ndi acetylsalicylic acid amachepetsa mphamvu ya antihypertensive.

Mndandanda wa mankhwala Lisinopril

Kapangidwe kamene kamayimira fanizo:

1. Liteni.
2. Lysinotone.
3. Zavomerezedwa.
4. Lizonorm.
5. Sinopril.
6. Lisinopril dihydrate.
7. Dapril.
8. Lysigamm.
9. Lisinopril Grindeks (Stada, Pfizer, Teva, OBL, Organics).
10. Lister.
11. Anakwiyitsa.
12. Lizoril.
13. Rileis Sanovel.
14. Diroton.
15. Lysacard.
16. Diropress.

Kuphatikiza ndi hydrochlorothiazide:

1. Scopril kuphatikiza.
2. Liten N.
3. Lister Plus.
4. Iruzide.
5. Rileys Sanovel kuphatikiza.
6. Co-Diroton.
7. Wachikulire.
8. Lisinopril N.
9. Zoniksem ND.
10. Lysinoton N.
11. Zonixem NL.

Kuphatikiza ndi amlodipine:

Maholide ndi mtengo

Mtengo wamba wa Lisinopril (mapiritsi 10 mg No. 30) ku Moscow ndi 44 rubles. Ku Kiev, mutha kugula mankhwala a homeznias 45, ku Kazakhstan - kwa 1498 tenge. Ku Minsk, malo ogulitsa mankhwala amapereka mankhwala kwa 2-3 bel. ruble. Imapezeka ku pharmacies ndi mankhwala.

Mankhwala okwera mtengo, ogwiritsidwa ntchito mwachangu ngati mankhwala amakono, amatchedwa "Bisoprolol." Kodi mapiritsiwa akuchokera kuti? Yankho lolondola pafunsoli limaperekedwa ndi malangizo ogwiritsira ntchito mankhwalawa, omwe amapezeka phukusi. Komabe, ngati pali kufunitsitsa kothana ndi izi popanda kupeza mankhwala, ndiye kuti nkhaniyi ikukuthandizani.

"Bisoprolol": mapiritsi awa ndi otani?

Mankhwalawa adapangidwira kuti azigwiritsidwa ntchito pakuwonjezera matenda oopsa a mtima komanso matenda a mtima, imathandizanso pakuthandizira matenda a mtima, kuperewera kwa mtima (CHF), angina pectoris, mavuto a mtima pambuyo patillillitis. Monga lamulo, amadziwika ngati mtima arrhythmias amawonedwa ndi extrasystoles, arrhythmias, thyrotoxicosis.

Ma Analogs a "Bisoprolol" ogulitsidwa amawonetsedwa m'malo osiyanasiyana. Kukonzekera ndi dzina lomweli, koma kuchokera kwa opanga osiyanasiyana ndiosiyana pamtengo. Zina zomwe wopanga atha kuwonjezera pa dzina: "Teva", "Vertex", "North Star". Kutengera ndi kuchuluka kwa mapiritsi omwe ali mgululi, zomwe zimapangidwira, wopanga, phukusi limodzi limatengera 20 mpaka 200 rubles.

Kodi ndizotheka kusintha mankhwalawo ndi analogue?

Ma Analogs a "Bisoprolol" omwe amagulitsidwa amaimiridwa ndi zinthu izi:

Zina mwa izo zimapezeka pamtengo wotsika mtengo, monga mankhwala omwe amafunsidwa, ena ndi okwera mtengo kwambiri. Ngati dotolo adalangiza kugwiritsa ntchito Bisoprolol, mphamvu ya mankhwalawa imakhala yayikulupo kuposa ya analogues. M'malo mwake mankhwalawo ndi mankhwalawa (ma jeniki) ndi zotheka pokhapokha povomerezana ndi adokotala. Kudzilowetsa m'malo mwa mankhwala ena osavomerezeka, makamaka makamaka kuchokera pamalingaliro a bajeti kulibe phindu, ndipo kulolera kwa Bisoprolol kuli bwino kuposa ma analogu ambiri.

Momwe mungagwiritsire ntchito?

Bisoprolol ndi wa gulu la kusankha beta1-blockers. Chogulirachi chimapezeka ngati mapiritsi, chilichonse chomwe chimakhala ndi chipolopolo - filimu yopyapyala yomwe imathandizira kutsata.

Momwe mungatengere "Bisoprolol" amafotokozedwa mwatsatanetsatane mu malangizo omwe aphatikizidwa ndi mankhwala. Nthawi zambiri amamwa m'mawa asanadye chakudya cham'mawa chopanda kanthu. Mlingo wonse wa tsiku ndi tsiku umagwiritsidwa ntchito nthawi imodzi, kuwameza nthawi yomweyo, osafuna kutafuna. Monga lamulo, kuyambira 5 mpaka 10 mg ndi mankhwala patsiku. Mlingo wa tsiku ndi tsiku wa Bisoprolol kwa munthu wamkulu sayenera kupitirira 20 mg. Mikhalidwe yapadera yovomerezedwa imapangidwira iwo omwe amapezeka ndi vuto la impso ndi / kapena chiwindi (mlingo wapamwamba kwambiri wa tsiku ndi tsiku ndi theka mpaka 10 mg).

Zolemba ntchito

Malinga ndi malangizowo, "Bisoprolol" imalimbikitsidwa kuti ichitidwe kuyambira pa mlingo wa 1.25 mg patsiku (pochizira kulephera kwa mtima). Imasungidwa sabata yonse yoyamba yamankhwala. Mu sabata yachiwiri, ndende imachulukitsidwa mpaka 2,5 mg, pambuyo pa sabata ina iwonjezanso, ndipo tsiku lililonse mlingo umafikira 3,75 mg. Kenako, kwa masabata angapo (kuyambira wachinayi mpaka wachisanu ndi chitatu), 5 mg amatengedwa tsiku lililonse m'mawa, ndipo kuyambira lachisanu ndi chinayi mpaka khumi ndi ziwiri, 7.5 mg. Gawo lotsatira ndi 10 mg mu maola 24. Mlingowu umasungidwa mpaka adokotala atalimbikitsa kumaliza maphunziro. Chidacho chidapangidwa kuti chithandizire kwa nthawi yayitali, nthawi zambiri chimagwiritsidwa ntchito zaka, nthawi zina chimatumizidwa kuti chigwiritsike ntchito kwa moyo wonse.

Ngati munthawi ya chithandizo ndi Bisoprolol (mogwirizana ndi malangizo) wodwalayo wasintha momwemo, maphunzirowo sayenera kusokonezedwa popanda chilolezo cha adokotala. Mutha kufunsa dokotala ngati kuli koyenera kusiya kulandira chithandizo, koma popanda chilolezo cha katswiri, ndizoletsedwa kuti musamwe mankhwala. Matendawa sangangobwerera ku zomwe zinali zisanayambike mankhwala, komanso zimayamba kukhala zowawa kwambiri.

Kudziwa: simupereka liti "Bisoprolol"?

Zotsutsana pakugwiritsa ntchito "Bisoprolol" zimaphatikizapo izi:

• bradycardia
• matenda opatsirana a m'mapapo (COPD),
• khaloku
• hypotension
• Cardiogenic mantha
• kwambiri mawonekedwe a zotumphukira kufalitsidwa.

Komanso, mankhwalawa sagwiritsidwa ntchito munthawi yodyetsa mwana komanso pogwiritsa ntchito monoamine oxidase inhibitors (MAOs), ngati sakhala m'gulu la MAO-B.

Zimagwira bwanji?

Zotsatira motengera malangizo a "Bisoprolol" (ndemanga zimatsimikizira izi), mankhwalawa ali ndi mphamvu kwambiri poyerekeza, amathandizira kulimbana ndi arrhythmia. Mankhwalawa amachita mosankha ndipo ali m'gulu la ophatikiza ndi beta1-blockers. Zimakhudza ma beta1 receptors mu mtima Chipangizocho chimachepetsa kugunda kwa mtima chifukwa cha kulepheretsa kusangalala komanso kuthekera kwa myocardium.

Zochita: Kodi china ndichofunika chiyani?

Tsimikizani magwiridwe antchito a "Bisoprolol" olemba mankhwalawa, omwe amasindikizidwa ambiri pa World Wide Web. Monga wopanga amafotokozera, zabwino zimachitika chifukwa chakuchepetsa kwa kuchuluka kwa magazi. Kuphatikiza apo, yogwira pophika yamankhwala imalimbikitsa ziwiya zotumphukira, dongosolo la renin-angiotensin-aldosterone limalepheretsa. Baroreceptors mothandizidwa ndi "Bisoprolol" amakhala ozindikira. Ndi matenda oopsa, mphamvu yoyamba imatha kuwonedwa pakatha masiku angapo chiyambireni kukhazikitsa (koma osapitirira masiku asanu), ndipo kukhazikika kwa mkhalidwe wa wodwalayo kumawonedwa mwezi umodzi kapena iwiri atayamba chithandizo.

Mphamvu zomwe zimachotsa zovuta za mtima pambuyo pa angina zimatsimikizidwanso ndikuwunika kwa Bisoprolol. Monga wopanga amafotokozera, mphamvu yake imakhala yotsimikizika chifukwa chakuti mothandizidwa ndi gawo la myocardium amalandira mpweya wofunikira, popeza kugunda kwa mtima kumachepa, diastole imakhala yotalikirapo, kupatsirana kwa myocardial ndikwabwino. Kupanikizika kwa diastolic kumachulukitsa, minyewa yam'mitsempha yama minyewa yamtima imatambasuka bwino.

"Bisoprolol" mu arrhythmias: kutsimikizika kugwira ntchito

Poganizira za umboni wa "Bisoprolol", munthu sangathe kuiwala za arrhasmia.Kugwiritsa ntchito mankhwalawa kwa odwala omwe ali ndi vutoli kumatsimikizika chifukwa cha kuletsa kwa zinthu zomwe zimapangitsa kuti thupi lizigwirizana. Zodzikongoletsa zokha zimakhala zosatheka.

Mankhwalawa akuwonekera motsutsana ndi maziko a mankhwala osagwiritsa ntchito beta-adrenergic, chifukwa zovuta zoyipa za Bisoprolol pazinthu zina zimakhala zochepa poyerekeza ndi chithandizo chamankhwala. Choyamba, izi zimagwira ntchito kumakina omwe mumakhala ndi beta2-adrenergic receptors. Zotsatira zoyipa za kaboni ndi sodium metabolism zimachezedwanso (zotsalazo sizisonkhana m'thupi).

Zotsatira zoyipa za "Bisoprolol"

Zotsatira zoyipa ndizosowa (m'modzi mwa odwala zana). Monga momwe amaonera mankhwalawa, odwala amakumananso ndi mavuto amodzimodzi kawirikawiri, kulolera mankhwala ndibwino. Nthawi yomweyo, muyenera kukhala okonzekera zovuta zina, pakuwonekera koyamba kwa vuto lomwe likukula, muyenera kufunsa dokotala nthawi yomweyo.

Mwa odwala ena, mukamagwiritsa ntchito Bisoprolol, kutopa kumawonjezera, kugona, masomphenya, ndi kupweteka kwa maso kumawonekera. Mwina chitukuko cha sinus bradycardia, kuchepetsa mavuto. Pafupipafupi, mumatha kumva zodandaula za kuuma kwa mucosa wamlomo komanso mavuto a chopondapo. Ngati mankhwalawa agwiritsidwa ntchito mu mlingo waukulu kwambiri, pamakhala ngozi yoti angayambitse kupuma. Ndi matenda a shuga, kuthekera kwa hyperglycemia, hypoglycemia (kutengera mtundu wa matenda) kumakulanso. Osowa kawirikawiri, thupi lawo siligwirizana limawonetsedwa, kuwonetseredwa ndi urticaria kapena kuyabwa khungu, mawonekedwe a zotupa amatha. Mukamagwiritsa ntchito mankhwala pa nthawi yomwe muli ndi pakati, pamakhala mwayi wakuchedwa kwa fetal. Nthawi zina, omwe amadziwika kuti ndi achire amadziwika kuti, kumapeto kwa chithandizo, angina pectoris adakula. Komanso nthawi zina, kuchepa kwa potency kudadziwika.

Zogwiritsira ntchito

Mukamasankha "Bisoprolol" ndikofunikira kuwunika nthawi zonse wodwala. Ndikofunikira kutsatira kuthamanga kwa mtima, kukakamiza. Kumayambiriro kwa kugwiritsa ntchito "Bisoprolol", zizindikiro zimayang'aniridwa tsiku lililonse, ndi kulolera bwino, mawonekedwe a wodwalayo amatha kuyang'aniridwa miyezi iliyonse ya 3-4. Ndikulimbikitsidwa kuti nthawi zonse muzikumana ndi ECG, yemwe ali ndi matenda ashuga, muperekeni magazi kwa miyezi inayi iliyonse. Mukamagwiritsa ntchito mankhwala a Bisoprolol muukalamba, tikulimbikitsidwa kuwunika ntchito yaimpso, kuwunika kogwirizana kumaperekedwa katatu pachaka. Ngati mankhwalawa agwiritsidwa ntchito pochiza kulephera kwa mtima ndi muyeso woyamba wa 1.25 mg, thupi liyenera kutengedwa kwa maola anayi oyamba. Wopanga amalimbikitsa kuwunika kuthamanga, kugunda kwa mtima, komanso kuwerenga kuwerenga kwa ECG.

Kuti awongolere kwambiri matenda ake, wodwala yemwe amathandizidwa ndi Bisoprolol ayenera kuwerengetsa yekha kuchuluka kwa mtima ndi iye. Ngati mtengo wake umakhala wocheperako kumamenya pa 50 pamphindi, muyenera kufunsa dokotala.

Zina zomwe muyenera kuyang'ana?

Ngakhale zikuwonetsa "Bisoprolol", nthawi zina ndi angina pectoris, mankhwalawa alibe ntchito yabwino. Izi ndichifukwa cha matendawa: Izi zimadziwika kuti mankhwalawa onse omwe amapezeka pagulu la beta-blockers samapereka zotsatira pafupifupi pafupifupi wachisanu aliyense. Monga lamulo, izi zimachitika chifukwa cha coronary atherosulinosis, momwe muli malo ochepa a ischemic. Kugwiritsa ntchito bwino kwa mankhwalawa kumachepa ngati munthu amasuta kwa nthawi yayitali, komanso ngati magazi ake ali ochepa.

Asanapereke mankhwala a Bisoprolol, adokotala amafufuza ntchito ya kupuma kwakunja kwa odwala omwe ali ndi mbiri ya katundu wa bronchopulmonary. Ngati wodwala agwiritsa ntchito magalasi olumikizana, ziyenera kukumbukiridwa kuti kugwiritsa ntchito "Bisoprolol" nthawi zina kumayambitsa kuchepa kwa chinsinsi cha madzi osalala. Ndi pheochromocytoma yokhazikitsidwa, pali mwayi wamtundu wina wamagazi, ngati sizinatheke kukwaniritsa alpha-adrenoblock. Mukamasankha Bisoprolol pochiza odwala omwe ali ndi vutoli, muyenera kukumbukira kuti mankhwalawo sangathetsedwe mwadzidzidzi.

Kugwirizana kwina ndi mankhwala ena

Zimadziwika kuti kuphatikiza kwa Bisoprolol ndi othandizira omwe amakhala ndi clonidine amalola kugwiritsa ntchito mankhwalawa nthawi imodzi, koma ndikosavomerezeka kuletsa mankhwalawa onse nthawi imodzi. Choyamba siyani kumwa kamodzi, ndipo patatha masiku angapo - chachiwiri. Pogwiritsa ntchito mankhwalawa, mothandizidwa ndi momwe kuchuluka kwa makatekilamin amachepetsedwa, mphamvu ya beta-blockers ikhoza kuchuluka. Ndikofunikira kudziwitsa dokotala zamankhwala onse omwe atchulidwa ndi akatswiri ena. Dokotala amayenera kuwunika wodwalayo nthawi zonse, mwinanso kuopsa kwa hypotension, bradycardia imakulanso.

Chidachi chitha kugwiritsidwa ntchito pa matenda ashuga. Mankhwalawa samakhudza ma hypoglycemia nthawi zambiri, koma ndi tachycardia yomwe imayamba chifukwa cha izi, kugwiritsa ntchito Bisoprolol nthawi zonse kumatha kubisa zizindikirazo. Mankhwala omwe amafunsidwa samasokoneza kubwezeretsanso kwa glucose m'magazi kukhala achilendo.

Ndemanga: Kodi odwala amati chiyani?

Pa intaneti pali mayankho ambiri abwino okhudzana ndi Bisoprolol. Mankhwalawa ndiokwera mtengo ndipo amathandizira kukhazikika mtima kwa wodwalayo ngakhale ali ndi matenda oopsa, ngati agwiritsidwa ntchito molingana ndi adokotala komanso kuwunikira pafupipafupi matendawo. Zovuta zoyipa zambiri zimachitika chifukwa chodzilamulira nokha popanda kugwiritsa ntchito mankhwala, kapena chifukwa chonyalanyaza thupi lomwe limakhudzana ndi umunthu wake. Komanso, odwala ena adazindikira zovuta za kuphatikiza gawo loyambira la Bisoprolol ndi zinthu zomwe zimapezekanso m'mankhwala ena. Kuyanjana kumeneku kumapangitsa kuti pakhale kofunikira kugwiritsa ntchito mankhwalawa pokhapokha ngati akutsimikiziridwa ndi adokotala omwe amadziwa omwe odwala ake amamwa.

Nthawi yomweyo, pali ndemanga za Bisoprolol, omwe amati mankhwalawo sanathandize pa vuto linalake. Monga momwe kampani yopanga ikusonyezera, izi ndizotheka mu chisanu chilichonse komanso chifukwa cha zovuta zina zaumoyo kapena machitidwe a munthu payekha. Muyenera kukhala okonzekera zoterezi.

Lisinopril ndi metoprolol ndi mankhwala onse omwe amathandizira kuthamanga kwa magazi. Kusiyanitsa kwakukulu pakati pa lisinopril ndi metoprolol ndikuti lisinopril ndi angiotensin kutembenuza enzyme (ACE) inhibitor, pomwe metoprolol ndi beta blocker. Chifukwa ndi mitundu iwiri yosiyanasiyana ya mankhwala, lisinopril ndi metoprolol amathandizira kuwongolera kuthamanga kwa magazi m'njira zosiyanasiyana. Kusiyana kwina pakati pa lisinopril ndi metoprolol kumaphatikizapo mlingo, njira zowonjezera zamankhwala zomwe amathandizira, komanso nkhawa za chitetezo kwa amayi apakati kapena oyembekezera.
Kuthamanga kwa magazi ndi mkhalidwe wachipatala pomwe mtima umapopa magazi ndi mphamvu kwambiri kudzera m'mitsempha. ACE inhibitor amachepetsa kuthamanga kwa magazi, kuletsa mapangidwe a angiotensin II mthupi. Angiotensin II imapangitsa mtima kugwira ntchito molimbika ndipo imayambitsa kuthamanga kwa magazi chifukwa imakhala ndimitsempha yamagazi. Wotchinga beta, Komano, amachepetsa kuthamanga kwa magazi poteteza zomwe adrenaline zimachitika mthupi. Mwa kuletsa adrenaline, beta blocker imalola mtima kugunda pang'onopang'ono komanso pang'ono.

Lisinopril amaperekedwa mu mawonekedwe a piritsi, ndipo mankhwala omwe mumalandira ndikuwamwa kamodzi patsiku. Kuphatikiza pa kuthamanga kwa magazi, lisinopril imathandizanso pochiza kulephera kwa mtima, kuphatikizapo mankhwala ena. Metoprolol imabweretsanso mawonekedwe a mapiritsi, komanso piritsi yotulutsidwa yotulutsira, mankhwala omwe amapezeka kuti piritsi limakhala kamodzi kapena kawiri patsiku, ndi piritsi yotulutsidwa kamodzi patsiku. Kugwiritsiridwa ntchito kowonjezereka kumapangidwa kuti amalola mankhwalawo kuti amasulidwe pang'onopang'ono kulowa mthupi kwakanthawi, chifukwa chake mankhwalawa amakhalabe m'dongosolo motalikirapo.Mosiyana ndi lisinopril, metoprolol iyenera kutsagana ndi kutsatira chakudya. Zochitika zina zachipatala zomwe zimathandizira metoprolol zimaphatikizapo kupweteka pachifuwa, kulephera kwa mtima, komanso kugunda kwamtima kosagwirizana.

Amayi oyembekezera kapena oyembekezera sayenera kugwiritsa ntchito lisinopril. Mwa amayi apakati, lisinopril ikhoza kuyambitsa zoperewera mwa khanda. Sizikudziwika ngati lisinopril imapezeka mkaka wa m'mawere, koma popeza amayi apakati sayenera kumwa mankhwalawa, ndi lingaliro lofala kuti amayi oyamwitsa asamwe mankhwalawa. Kwa metoprolol, amayi oyembekezera kapena oyamwitsa ayenera kumwa mankhwalawo ngati dokotala akuwavomereza. Zimatengera mkhalidwe wawo, ndipo ngati zingakhale zothandiza kwa mayi. Izi ndichifukwa sichikudziwika ngati metoprolol imakhudzira ana osabadwa.

Amayi sayenera kugwiritsa ntchito lisinopril poyamwitsa.

Mayi woyembekezera ayenera kufunsira kwa othandizira ake asanalandire metoprolol kapena mankhwala ena aliwonse.

Lisinopril ndi mankhwala omwe amatchinga ma enzymes ena m'thupi omwe amachititsa kuti mitsempha ya magazi ikhale yochepa.

Muzochita zenizeni zamankhwala, beta-blockers (BAB) ndi amodzi mwa mankhwala omwe amagwiritsidwa ntchito kwambiri pochiza matenda a mtima (CVD). Nkhani zosankha BAB ndizothandizabe.

Amadziwika kuti ma beta-1-osankha AB amakhala apamwamba kuposa omwe sanasankhe: amathandizira kwambiri kupanikizika kwamitsempha, kuchepetsa kuchepa kwa vasoconstrictor poyankha ma catecholamines ndipo, chifukwa chake, amagwira ntchito kwambiri kwa osuta, omwe nthawi zambiri samayambitsa hypoglycemia kwa odwala omwe ali ndi matenda osokoneza bongo a mellitus (DM). chifukwa achire matenda. Beta-1-yosankha AB ingagwiritsidwe ntchito kwa odwala omwe ali ndi matenda am'mapapo am'mimba, osasintha pang'ono momwe amapangira magazi a lipid.

Bisoprolol (Bidop) ndi imodzi mwazomwe zili ndi mtima wa BAB. Chiyanjano cha bisoprolol cha beta-1-adrenergic receptors ndichopitirira 75 kuposa cha beta-2-adrenergic receptors. Mlingo wovomerezeka, mankhwalawa alibe pafupifupi chilichonse choletsa beta-2-adrenergic receptors ndipo alibe mawonekedwe ambiri osayenera. Bisoprolol mu achire Mlingo (2.5-10.0 mg / tsiku) samayambitsa bronchospasm ndipo samalepheretsa kupuma kwa anthu omwe ali ndi matenda osatha a pulmonary matenda a COPD. Kuphatikiza apo, bisoprolol siyimasokoneza impso ndi intrarenal hemodynamics, sichikhudza kagayidwe kazakudya, ndipo sichulukitsa cholesterol ya plasma ndi lipoproteins.

Katunduyu ndi amene amagwiritsa ntchito ma bisoprolol mu ma CVD osiyanasiyana, makamaka mu matenda oopsa (AH) komanso matenda a mtima (CHD).

Ubwino wa Bisoprolol mu Hypertension

Zizindikiro zazikulu zakugwiritsidwa ntchito kwa BAB kwa odwala omwe ali ndi matenda oopsa ndi: matenda a mtima, mbiri ya kulowetsedwa kwa mtima, kulephera kwamtima (CHF), tachyarrhythmia, glaucoma.

Bisoprolol siyotsika mtengo kwa ena a BAB mu zochita za antihypertensive ndipo imawapyola modutsa zingapo. Kafukufuku wachiwiri, wakhungu la BISOMET adawonetsa kuti bisoprolol, ngati metoprolol, imachepetsa kuthamanga kwa magazi (BP) popumula, koma kwambiri imadutsa metoprolol molingana ndi momwe imakhudzira kuyeserera kwa magazi ndi kugunda kwa mtima (HR) panthawi yochita masewera olimbitsa thupi. Mphamvu yotchedwa bisoprolol mu odwala otsogola, amalimbikitsa kupereka mankhwala kwa achinyamata omwe ali ndi matenda oopsa.

Pankhaniyi, ndikofunikira kukumbukira zazabodza zokhudza mphamvu ya BAB pa erectile ntchito. Nthawi zambiri, BAB imalumikizidwa ndi kuthekera kwa kusokonezeka kwa kugonana. Pankhani ya bisoprolol, kusapezeka kwa vuto lachiwerewere mwa amuna kwatsimikiziridwa motsimikiza. Katunduyu wa bisoprolol amathandizira kutsatira chithandizo cha achinyamata achimuna odwala omwe amayamba kudwala matenda oopsa pazaka zogwira ntchito. Pakufufuza kwa L. M. Prisant et al.Zinawonetsedwa kuti pafupipafupi kukomoka kwa kugonana ndi bisoprolol sikunasiyanane ndi zomwe zili ndi placebo.

Poyerekeza bisoprolol ndi calcium antagonists (nifedipine) ndi angiotensin potembenuza enzyme inhibitors (ACE inhibitors) (enalapril), zinapezeka kuti ilibe ntchito yochepa ya antihypertensive. Kuphatikiza apo, mu kafukufuku wofanizira wosasinthika, bisoprolol (10-20 mg / tsiku) adatsitsa kuchepa kwakukulu kwa lamanzere yamitsempha yama cell molocardial misa index (LVML) ndi 11%, yomwe inali yofanana ndi ACE inhibitor zotsatira (enalapril, 2040 mg / tsiku).

Kafukufuku wina adawunika mphamvu ya bisoprolol mu Mlingo wa 5-10 mg mwa odwala omwe ali ndi matenda oopsa ndipo amasiya ma ventricular myocardial hypertrophy (LVH). Pambuyo pa miyezi isanu ndi umodzi, kalozera wa MMVL adatsika kwambiri ndi 14.6%, kukula kwa myocardium ya khoma lanyumba yakumanzere kwamitseko yamkati yamanzere (LV) ndi septum yapakati ndi 8% ndi 9%, motsatana, ndi kuchuluka kwa milomo ndi gawo laling'ono la LV sizinasinthe. Nthawi yomweyo, kukonzanso kwa LV hypertrophy sikunathe kufotokozedwa ndi zotsatira za hypotensive yokha; mwa odwala 5 omwe sanafikire kuchuluka kwa kuthamanga kwa magazi, kuchepa kwa index ya LVM kunadziwikanso.

Kuwunika kwa organoprotective katundu, kuphatikizapo mphamvu yama antihypertensive mankhwala ena pa kuuma kwa khoma lakale, pakali pano ndi nkhani yophunzira mwachangu ndi kukambirana. Popeza kupezedwa kwa chidziwitso chatsopano cha chiwopsezo cha mtima, tikufotokozera zambiri za zotsatira za bisoprolol pakukakamiza kwapakati, kupanikizika kwa mtima, komanso kuuma kwa khoma la mtima. Kuuma kwa khoma la mtima ndi chimodzi mwazinthu zazikulu zodziwitsa kuthamanga kwa magazi. Kuuma kwa mtima komanso kukhosi kwa mtima kumalumikizidwa kwambiri ndi zomalizira monga kufa kwamtima, kuphatikizika kwa myocardial, ndi sitiroko. Ubwenzi wapamtima kwambiri ndi chiopsezo cha mtima wamtima ndi wapakati, kapena kungozi, kwamphamvu.

Bisoprolol pa 10 mg ya odwala omwe ali ndi matenda oopsa anachititsa kutsika kwakukulu kwa kugunda kwamitsempha yamagetsi, komanso kuwongolera pakukula kwa chotupa cha brachial.

Kafukufuku wa ADLIB adayang'ana zotsatira zamagulu osiyanasiyana am'magulu a antihypertensive (amlodipine 5 mg, doxazosin 4 mg, lisinopril 10 mg, bisoprolol 5 mg ndi bendroflumethiazide 2,5 mg) pazowonetsa za kukhoma kwa mtima - kukhathamira kwapakati, kuwonetsera mafunde ndi cholozera. Kuchepetsa kwambiri kwa kuthamanga kwa magazi mu mitsempha ya brachial kunayambitsidwa ndi lisinopril ndi bisoprolol. Bisoprolol limodzi ndi lisinopril ndi amlodipine adachepetsa kuthamanga kwa magazi. Nthawi yomweyo, bisoprolol inali yofanana ndi mzere wa augmentation ndikuwonetsa velocity velocity: index yolimbikitsira inali yokwera ndi mankhwala ena, ndipo mawonekedwe a velocity yowonekera anali okwanira panthawi ya chithandizo cha bisoprolol.

Sitingayime pamitundu yochizira matenda oopsa kwa odwala onenepa kwambiri. AH amapezeka mu 88% ya odwala omwe ali ndi vuto la m'mimba.

Ngakhale kuti BAB ili m'gulu lalikulu la mankhwalawa pochotsa matenda oopsa, kunenepa kwambiri komanso matenda a metabolic samagwira ntchito ngati chisonyezo choyambirira cha kayendetsedwe kawo, ngakhale kugwiritsidwa ntchito kwa BAB mu odwala omwe ali ndi zonenepa ndikulondola kwa pathogenetic, chifukwa chofunikira kwambiri pakutsutsana ndi vuto lamanjenje pakupanga matenda oopsa.

Kuopa kutumiza BAB kwa wodwala yemwe ali ndi metabolic syndrome kumachitika chifukwa cha mantha a matenda a shuga. BAB ali ndi kuthekera kosiyanasiyana kwa prodiabetogenic. Chifukwa chake, mukutenga bisoprolol ndi nebivolol mwa odwala omwe ali ndi matenda oopsa komanso matenda ashuga, sizinasinthe mu glucose wamagazi, pomwe chithandizo ndi atenolol chinawonjezera kuchuluka kwake. Zinapezeka kuti bisoprolol sasintha kuchuluka kwa glucose m'magazi a odwala omwe ali ndi matenda ashuga, pomwe kusintha kwa mankhwalawa kwa othandizira a hypoglycemic sikufunika, zomwe zikuwonetsa kuti kusakanikirana kwa metabolic.

Kafukufuku wokhudzana ndi odwala omwe ali ndi matenda a shuga opangidwa ndi bisoprolol adawonetsa kuti, chifukwa cha kusankha kwambiri, mankhwalawa samakhudza kwambiri kagayidwe kazakudya ndi lipid metabolism ndipo angagwiritsidwe ntchito kwa odwala omwe ali ndi matenda ashuga.

Ubwino wa bisoprolol yoyendetsera odwala omwe ali ndi matenda oopsa ndi luso lake lapadera losungunulira zonse m'mafuta ndi m'madzi (amphiphilicity). Bisoprolol chifukwa cha kuchulukana kwa zinthu 50% ya biotransformed mu chiwindi, chotsalacho chimapukusidwa ndi impso osasinthika. Popeza kupezeka pafupipafupi kwa odwala omwe ali ndi matenda a chiwindi "osakhazikika" omwe ali ndi vuto la mafuta osagwirizana ndi chiwindi, kugwiritsa ntchito bisoprolol kumakhala koyenera kuchitira matenda oopsa mu gulu ili la odwala. Amphiphilicity imayambitsa chilolezo cha bisoprolol moyenera, chomwe chimalongosola kuchepetsedwa kwake kwokhudzana ndi mankhwala ena ndi chitetezo chachikulu pamene chikugwiritsidwa ntchito kwa odwala omwe ali ndi hepatic kapena hepatatic yolimba.

Ma polymorbidity ndi kukhalapo kwa COPD ndi CVD mwa wodwala m'modzi nthawi imodzi zimapangitsa kuti zikhale zofunikira kusankha BAB mosamala. Zinakhazikitsidwa kuti kuyendetsa kwa BAB kwa odwala omwe ali ndi COPD omwe anali ndi myocardial infarction kumachepetsa kufa kwa 40% (poyerekeza ndi gulu lofananalo la odwala opanda BAB). Malinga ndi S. Chatterjece, odwala omwe ali ndi mphumu ya bronchial, kusintha kwa bronchial patency ndi 10 ndi 20 mg ya bisoprolol sikunasiyana kwenikweni ndi omwe ali ndi placebo.

Cardioselective BAB bisoprolol mwa odwala CVD ndi concomitant COPD siyimakhudzanso vuto la bronchial patency ndikuwongolera moyo wa odwala, pomwe kusankha kwa atenolol ndi metoprolol kumakulitsa mawonekedwe a airway patency m'gulu lino la odwala.

Kugwiritsa ntchito bisoprolol m'malo osiyanasiyana a ischemic matenda a mtima

Malangizo apakhomo pofotokozera za matenda ndi matenda a mtima. Ndi mikhalidwe yachipatala iyi yomwe ma BAB amatha kukonza kupita patsogolo kwa odwala.

Katundu wa antianginal amalola kuperekera bisoprolol popewa kuvulala kwamitsempha mwa odwala omwe ali ndi khola la angina pectoris. Mu multicenter clinical TIBBS (Total Ischemic Burden Bisoprolol Study), zidawonetsedwa kuti bisoprolol imachotsa bwino magawo a kanthawi kochepa myocardial ischemia mwa odwala omwe ali ndi khola la angina ndikuwonjezera kusinthasintha kwa mtima. Kafukufukuyu akuwonetseranso zomwe zimapangitsa kusintha kwa matenda a mtima a coronary ndi bisoprolol. Zatsimikiziridwa kuti pafupipafupi zochitika zapamtima zokhala ndi mankhwala a sapoprolol ndizotsika kwambiri kuposa nifedipine ndi placebo.

Zinapezekanso kuti pokhudzana ndi kugwira ntchito kwa antianginal, bisoprolol ndiyofanana ndi atenolol, betaxolol, verapamil ndi amlodipine. Kafukufuku wina wawonetsa kuti bisoprolol bwino imalepheretsa kuchitika kwa kugunda kwamitsempha ndipo imakulitsa kulolerana kwa nkhawa kwakukulu kuposa isosorbide dinitrate (yogwiritsidwa ntchito ngati monotherapy) ndi nifedipine. Odwala omwe ali ndi angina okhazikika, bisoprolol angagwiritsidwe ntchito limodzi ndi ma antianginal othandizira (makamaka, nitrate ndi calcium antagonists).

Zinapezeka kuti bisoprolol kwambiri imachepetsa chiopsezo cha kufa kwa myocardial infarction ndi mtima wamtima mwa odwala omwe akuchitidwa opaleshoni yamitsempha yayikulu. Monga njira yachiwiri yoletsera kupunduka kwa myocardial infarction, kugwiritsa ntchito bisoprolol mwa odwala okhazikika omwe adadwala matenda a myocardial infarction (kuyambira masiku 5-7 atadwala) ndi chifukwa.

Kusankha kwa bisoprolol

Popeza mitundu ingapo ya mankhwala pamsika waku Russia komanso kufunika kosankha kokwanira, vuto la kusinthana kwa mankhwala oyamba kwa omwe ali ovomerezeka pazifukwa zachuma ndilofunika kwambiri. Kuchepetsa kwakukulu pakugwiritsa ntchito kwambiri mitundu yoyambirira ya mankhwala ndi mtengo wawo wokwera. Kumbali inayo, zodziwika bwino za mankhwalawo oyambira amadziwika bwino. Mukamasankha generic, ndikofunikira kukhala ndi chidziwitso pazomwe mungagwiritse ntchito ngati mankhwala oyamba.Kuti muwonetsetse kufanana kwa zochizira, kafukufuku wazachipatala amafunika poyerekeza maphunziro azachipatala ndi mankhwala oyambirirawo kuti aphunzire bwino komanso chitetezo chake.

Tikhala tsatanetsatane wa zambiri zamaphunziro a zamankhwala okhudzana ndi odwala aku Russia omwe ali ndi matenda oopsa komanso matenda a mtima malinga ndi mphamvu ya mankhwala a Bidop (bisoprolol).

Mu 2012, K.V. Protasov et al. Mphamvu yachipatala komanso chitetezo chamakonzedwe apadera komanso opangidwa ndi zosafunikira zapadera kwa odwala omwe ali ndi matenda oopsa komanso odwala omwe ali ndi zina angina amafananizidwa. Tidasanthula odwala 30 omwe ali ndi AH ya madigiri a 1-2 (zaka zapakati - 47 zaka). Odwala adasinthidwa mwachisawawa ku magulu oyambilira a bacoprolol ndi a Bidop, omwe adafotokozedwa poyambira pa 5 mg / tsiku. Pambuyo pa milungu 6 ya chithandizo ndi milungu iwiri yotsuka, mankhwalawa adasinthidwa ndi njira ina, pambuyo pake mankhwalawa adapitilizidwa mpaka milungu 6. Njira yofufuzira imawonetsedwa ku mkuyu.

Poyamba, pamasabata a 2 ndi a 6, chithandizo cha kuthamanga kwa magazi, kugunda kwa mtima, zosakhudzidwa zosagwirizana zinajambulidwa, ndipo zotsatira za kudziwunika kwa kuthamanga kwa magazi (SCAD) zidawunikidwa. Pazoyambira komanso pa sabata la 6, kuwunika magazi pafupipafupi (BPM) kunachitika. Pofika sabata la 6 la chithandizo, kuthamanga kwa magazi ku ofesi kunachepa kwambiri mu gulu loyambirira la bacoprolol ndi 23.0 / 10.5 mm Hg. Art., Gulu la generic - lolemba 21.2 / 10.0 mm RT. Art., Kusiyana kwamagulu osiyanasiyana sikodalirika. Kuthamanga kwa magazi (Metoprolol: malangizo ogwiritsira ntchito

Zotsatira za pharmacological	Kusankha beta1 blocker. Zimachepetsa mphamvu yolimbikitsa yomwe adrenaline ndi mahomoni ena a catecholamine amakhala nayo pa mtima. Chifukwa chake, mankhwalawa amalepheretsa kuwonjezeka kwa kugunda kwa mtima, kuchuluka kwa miniti ndikuwonjezera mphamvu ya mtima. Ndi kupsinjika kwamalingaliro ndi kulimbitsa thupi, kutulutsa kwamphamvu ma catecholamines kumachitika, koma kuthamanga kwa magazi sikuwonjezereka kwambiri.
Pharmacokinetics	Metoprolol imayenda mwachangu komanso kwathunthu. Kulandilidwa nthawi yomweyo ngati chakudya kumachulukitsa bioavailability pofika 3040%. Mapiritsi okhala ndi nthawi yayitali amakhala ndi ma micogranules pomwe chinthu chogwira, metoprolol chimaperekedwa, pang'onopang'ono. The achire zotsatira kumatha oposa 24 maola. Mapiritsi olimbitsa thupi a metoprolol tartrate amasiya kuchita pasanathe maola 10-12. Mankhwalawa amapezeka kagayidwe ka oxidative m'chiwindi, koma pafupifupi 95% ya mlingo wothandizidwa ndi impso.
Zizindikiro zogwiritsidwa ntchito	ochepa matenda oopsa angina pectoris kukhazikika kwa mtima kosakhazikika ndi chiwonetsero chazachipatala (IIHA - IV yogwira ntchito molingana ndi gulu la NYHA) ndi kuperewera kwa systolic ntchito yam'mimba yamanzere ngati adjunct chithandizo chachikulu cha chithandizo, Kuchepetsa imfa ndi kubwerezanso kwa vuto la mtima pambuyo pachimake cha kuphwanya myocardial, kusinthasintha kwa mtima, kuphatikizapo tachycardia ya supraventricular, kuchepa kwa pafupipafupi mphamvu ya michere pakachulukidwe ka michere ndi michere yam'mimba, matenda a mtima ntchito, limodzi ndi tachycardia, kupewa matenda a migraine.

Zofunika! Kulephera kwa mtima, kuchepa kwaimfa komanso kuchuluka kwa kugunda kwa mtima pafupipafupi ndizizindikiro zokhazokha za mapiritsi a metoprolol, omwe amawonjezera. Mapiritsi olimbitsa mtima a metoprolol tartrate a mtima kulephera ndi vuto la mtima sayenera kufotokozedwa.

Onaninso kanema wonena za chithandizo cha matenda a mtima ndi angina pectoris

Mlingo	Werengani zambiri za kuchuluka kwa metoprololidi komanso kuwonda kwa odwala omwe ali ndi matenda oopsa, angina pectoris, kulephera kwa mtima - werengani apa. Mapiritsi amatha kugawidwa pakati, koma osatha kutafuna kapena kuwononga. Itha kuthandizidwa ndi chakudya kapena pamimba yopanda kanthu, ngati nkotheka. Mlingo uyenera kusankhidwa payekhapayekha kwa wodwala aliyense ndikuwonjezereka pang'onopang'ono kuti bradycardia isatukuke - kugunda kumakhala pansi pa 45-55 kumenyedwa pamphindi.
Zotsatira zoyipa	Zotsatira zoyipa: bradycardia - zimachitika kugunda kwa 45-55 kumenyedwa, orthostatic hypotension, miyendo kuzirala kupuma movutikira ndi kulimbitsa thupi, kutopa, mutu, chizungulire, kugona kapena kugona tulo, zolakwika, mseru, m'mimba kupweteka, kudzimbidwa kapena kutsegula m'mimba, Osowa: kutupa kwa miyendo kupweteka kwa mtima kukhumudwa kapena kuda nkhawa, zotupa pakhungu bronchospasm kuwonongeka kwamaso, kuwuma kapena kuwonetsa m'maso, kunenepa. Zotsatira zilizonse zovuta kapena zovuta, funsani dokotala nthawi yomweyo!
Contraindication	Hypersensitivity to Metoprolol, Matupi a beta-blockers kapena magawo othandizira a mapiritsi, amaganiza kuti pamwala wamatumbo woipa kwambiri, zaka mpaka 18 - (kuchita bwino ndi chitetezo sizinakhazikitsidwe), Milandu yambiri yamtima (kambiranani ndi dokotala wanu!).
Mimba komanso Kuyamwitsa	Kugwiritsa ntchito mapiritsi a metoprolol othamanga kapena "osakwiya" panthawi yomwe ali ndi pakati kumatheka pokhapokha ngati phindu la mayi limaposa chiwopsezo kwa mwana wosabadwayo. Monga beta-blockers, metoprolol imatha kuyambitsa mavuto - bradycardia mwana wosabadwayo kapena wakhanda. Pang'ono pake mankhwalawa amachotseredwa mkaka wa m'mawere. Mukamapereka mankhwala ochepetsa pakati, chiwopsezo cha mavuto obwera chifukwa cha mwana sichikhala chachikulu. Komabe, wina ayenera kuwunika mosamala mawonekedwe a beta-adrenoreceptor blockade mwa mwana.
Kuyanjana kwa mankhwala	Mankhwala osagwirizana ndi antisteroidal amachepetsa mphamvu ya metoprolol pakuchepetsa kuthamanga kwa magazi. Mankhwala ena ophatikiza matenda oopsa - m'malo mwake, mulimbikitseni. Osamamwa mankhwalawa nthawi yomweyo ndi verapamil kapena diltiazem. Mndandanda wazinthu zomwe zimagwiritsidwa ntchito ndi mankhwala a metoprolol sizokwanira. Uzani dokotala wanu za mankhwala onse, zowonjezera, ndi zitsamba zomwe mumatenga musanalandire mankhwala othandizira matenda oopsa komanso matenda a mtima.
Bongo	Zizindikiro - kuthamanga kwa mtima komanso mavuto ena a mtima. Komanso, kuponderezedwa kwa ntchito yamapapo, kusokonezeka kwa chikumbumtima, mwina kunjenjemera kosalamulirika, kukokana, kuchuluka thukuta, nseru, kusanza, kusinthasintha kwa shuga m'magazi. Chithandizo, choyamba, kutenga makala othandizira ndi kutsuka m'mimba. Chotsatira - kupulumutsidwanso kumalo osamalira odwala.
Kutulutsa Fomu	25 mg, 50 mg, 100 mg, mapiritsi a 200 mg okhala ndi mafilimu.
Migwirizano ndi magwiritsidwe akusungidwa	Sungani kutentha osapitirira 30 ° C, moyo wa alumali - zaka zitatu. Osagwiritsa ntchito tsiku lotha ntchito likusonyezedwa phukusi.
Kupanga	Zomwe zimagwira ndi metoprololced kapena tartrate. Omwe amathandizira: methyl cellulose, glycerol, starch chimanga, ethyl cellulose, magnesium stearate. Sheath kanema: hypromellose, stearic acid, titanium dioxide (E171).

Momwe mungatenge metoprolol

Choyamba, onetsetsani kuti mwapatsidwa mankhwala omwe mankhwala omwe amagwiritsidwa ntchito ndi metoprolol. Mpaka pano, palibe chifukwa chogwiritsira ntchito mapiritsi akale omwe ali ndi metoprolol tartrate. Amayenera kumwedwa kangapo patsiku, zomwe ndizovuta kwa odwala. Amayambitsa kulumpha mu kuthamanga kwa magazi. Ndizowopsa m'mitsempha yamagazi. Tengani Betalok ZOK kapena Egilok C pa mlingo womwe adokotala akuwonetsa, komanso bola adokotala akuwalimbikitsa. Mankhwalawa amayenera kumwa kwa nthawi yayitali - zaka zingapo, kapena ngakhale moyo wonse. Sali malo oyenera komwe mungafunike kutsitsa magazi kapena kuthana ndi kupweteka pachifuwa.

Kodi ndingatenge metoprolol mpaka liti?

Metoprolol iyenera kutengedwa malinga ngati adokotala akuwonetsa. Pitani kwa omwe amakupatsani chithandizo chazaumoyo pafupipafupi kuti mukamayesere mayeso ndi mayeso. Simungathe kupuma mokakamira, kusiya mankhwala kapena kuchepetsa kuchuluka kwake. Kutenga beta blocker ndi mankhwala ena omwe mumalandira kuti mukhale ndi moyo wathanzi. Uwu ndi chithandizo chachikulu cha matenda oopsa komanso mtima. Ngati simutsatira malangizowo chifukwa chokhala ndi moyo wathanzi, pakapita nthawi ngakhale mapiritsi okwera mtengo amasiya kuthandiza.

Momwe mungatengere metoprolol: musanadye kapena mutatha?

Malangizo a boma samawonetsa momwe metoprolol amayenera kumwedwa - asanadye kapena pambuyo chakudya.Webusayiti yovomerezeka ya Chingerezi (Ht. Chakudya chimawonjezera mphamvu ya mankhwala, poyerekeza ndi kusala. Dziwani kuti zakudya zamagulu ochepa ndizotani komanso momwe zimathandizira matenda oopsa oopsa komanso mtima. Lankhulani ndi dokotala wanu ngati mungathe kutsatira.

Kodi metoprolol ndi mowa zimagwirizana?

Mapiritsi okhala ndi metoprolol tartrate samatha kulekerera, ndipo kumwa mowa kumathandizanso zotsatira zake zoyipa. Hypotension ikhoza kuchitika - kuthamanga kwa magazi kutsika kwambiri. Zizindikiro za hypotension: chizungulire, kufooka, ngakhale kugona. Mankhwala omwe pophika ndi metoprolol supplement amagwirizana ndi kumwa moyenera. Mutha kumwa mowa pokhapokha ngati mutha kupitilirabe zochuluka. Kuledzera ndi beta blockers ndizowopsa. Ndikofunika kuti musamwe mowa kwa masabata awiri oyambilira kuyambira pachiwonetsero cha mankhwala ndi metoprolol, komanso mutatha kuchuluka kwa mankhwalawa. Munthawi yakusinthaku, magalimoto ndi makina owopsa sayeneranso kuyendetsedwa.

Mitengo yamankhwala omwe zimagwiritsidwa ntchito ndi metoprolol

Mitengo ya mankhwala omwe amagwiritsidwa ntchito ndi metoprolol tartrate

Kugwiritsa ntchito metoprolol

Metoprolol ndi mankhwala otchuka padziko lonse lapansi a matenda oopsa, matenda a mtima, kusokonezeka kwa mitsempha ya mtima. Kuyambira mu 2000s, mawonekedwe owonjezera ogwiritsira ntchito awonekera. Analembedwanso kuti azitha kulephera mtima, komanso mankhwala achikhalidwe - ACE inhibitors, okodzetsa ndi ena. Tiyeni tiwone momwe metoprolol imagwirira ntchito, momwe mitundu yake ya mankhwala ilili komanso momwe amasiyana.

• Njira zabwino zochiritsira matenda oopsa (mwachangu, zosavuta, zathanzi, popanda mankhwala omwe ali ndi "mankhwala"
• Hypertension ndi njira yodziwika bwino yobwereranso ku gawo 1 ndi 2
• Zoyambitsa matenda oopsa komanso momwe mungazithetsere. Kuyesa kwa matenda oopsa
• Kugwiritsa ntchito bwino matenda oopsa popanda mankhwala

Adrenaline ndi mahomoni ena omwe ndi catecholamines amasangalatsa minofu yamtima. Chifukwa cha izi, kugunda kwa mtima ndi kuchuluka kwa magazi omwe mtima wake umapompa ndi kumenya kulikonse kumawonjezeka. Kupsinjika kwa magazi kumakwera. Beta-blockers, kuphatikiza metoprolol, imafooketsa (block) mphamvu ya makatekitalamu pamtima. Chifukwa cha izi, kuthamanga kwa magazi ndi kugunda kwa milomo kumatsika. Katundu pamtima amachepa. Chiwopsezo cha matenda amtima woyamba komanso wachiwiri amachepa. Nthawi yokhala ndi chiyembekezo cha anthu omwe ali ndi matenda a mtima kapena matenda a mtima osaletseka ikukwera.

Mlingo wa metoprolol: tartrate ndikuthandizira

M'mapiritsi, metoprolol imakhala mumtundu wamchere - tartrate kapena supplement. Pachikhalidwe, metoprolol tartrate adagwiritsidwa ntchito kumasula mapiritsi olimbikira, pomwe mankhwalawo amalowa m'magazi. Katemera ndi wa fomu yoyenera yomasulira. Mapiritsi okhala ndi nthawi yayitali a metoprololcedine amapangidwa pogwiritsa ntchito CR / XL (Controlled Release / Extended Release) kapena ZOK (Zero-Order-Kinetics) tekinoloje. Metoprolol tartrate yochita mwachangu ili ndi zovuta zazikulu. Imakhala yotsika mtengo kwambiri kwa ogulitsa atsopano a beta ndipo imalekeredwa moyipa.

Kangati patsiku kuti mutenge2-4 pa tsikuNdikokwanira kutenga nthawi imodzi patsiku. Mlingo uliwonse wotengedwa umagwira pafupifupi maola 24. Khola ndende ya yogwira magaziAyiInde Imachepetsa chitukuko cha atherosulinosisAyiInde, zimawonjezera pang'ono zotsatira za mankhwala a statin Kulekerera, pafupipafupi pamavutoWolekeredwa moyipa kuposa mapiritsi a metoprolol osasunthikaKulekerera kwabwino, mavuto - osowa Kugwiritsa Ntchito Kulephera KwamtimaZofookaInde, kufananizidwa ndi ena opanga beta amakono

Maphunziro ambiri omwe atsimikizira mphamvu ya metoprolol yamatenda a mtima agwiritsa ntchito njira zopulumutsira zomwe zimakhala ndi mphamvu. Opanga metoprolol tartrate sakanatha kuwona mopanda chidwi ndipo adabwezera. Cha m'ma 2000s, "kuyenda pang'onopang'ono" kotchedwa Egilok retard kunayamba kugulitsidwa ku mayiko olankhula Chirasha.

Kutulutsa kwadzalemba m'magazini azachipatala kutsimikizira kuti sikuthandizira kuposa kupezeka kwa metoprolol, makamaka, mankhwala oyamba a Betalok ZOK. Komabe, zolemba izi sizodalirika. Chifukwa adalipira bwino ndi opanga mapiritsi a Egiloc Retard. Zikakhala zotere, ndizosatheka kuchititsa maphunziro ofananitsa a mankhwala. M'mabuku achingerezi, sizotheka kupeza zidziwitso zakonzedwa kwa metoprolol tartrate kumasulidwa kosasunthika.

Maphunziro azachipatala

Mapiritsi a Metoprolol amaperekedwa kwa odwala omwe ali ndi matenda oopsa komanso matenda a mtima kuyambira 1980s. Maphunziro ambiri a beta-blocker awa apangidwa, ophatikizira zikwizikwi za odwala. Zotsatira zawo zimasindikizidwa mumajambulidwe azachipatala.

Hjalmarson A., Goldstein S., Fagerberg B. et al. Zotsatira za metoprolol yoyendetsedwa molamulidwa pa kufa kwathunthu, zipatala, komanso kukhala bwino ndi odwala omwe ali ndi vuto la mtima: Metoprolol CR / XL mwachisawawa mayesero olowererapo mwa kulephera kwa mtima kwaponseponse (MERIT-HF). JAMA 2000,283: 1295-1302.Zotsatira za metoprolol pamapiritsi okhazikika omasulidwa pa kufa kwathunthu, kuchuluka kwa zipatala ndi moyo wabwino kwa odwala omwe ali ndi vuto la mtimaMetoprolol supplement mu fomu yosasunthika yotulutsidwa imagwira ntchito pakulephera kwa mtima. Komabe, muphunziroli, silinkafanizidwa ndi beta blockers ena. Deedwania PC, Giles TD, Klibaner M, Ghali JK, Herlitz J, Hildebrandt P, Kjekshus J, Spinar J, Vitovec J, Stanbrook H, Wikstrand J. Mwachangu, chitetezo ndi kulolerana kwa metoprolol CR / XL odwala omwe ali ndi matenda ashuga komanso mtima wosalephera kulephera: zokumana nazo kuchokera ku MERIT-HF. American Heart Journal 2005, 149 (1): 159-167.Kuchita bwino, chitetezo, ndi kulolerana kwa metoprolol zimathandizira odwala matenda ashuga komanso mtima wosalephera. Zotsatira zamaphunziro a MERIT-HF.Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri amalekerera metoprolol, omwe adawalangiza pochiza matenda osalephera a mtima. Mankhwala amasintha kupulumuka ndikuchepetsa pafupipafupi kugonekedwa kuchipatala. Komabe, silimawonjezera shuga. Wiklund O., Hulthe J., Wikstrand J. et al. Zotsatira zamatulutsidwe otulutsidwa / kutulutsidwa kwa metoprolol pa makulidwe a carotid intima-media makulidwe a hypercholesterolemia: kafukufuku wazaka zitatu. Stroko 2002.33: 572-577.Mphamvu ya metoprolol mu mapiritsi okhazikika omasulidwa pa makulidwe a intima-media zovuta za carotid artery kwa odwala omwe ali ndi mafuta ambiri m'magazi. Zambiri kuchokera pa kafukufuku wazaka 3, kuyerekeza ndi placebo.Metoprolol mu mapiritsi otsekemera otsekemera (othandizira) amalepheretsa chitukuko cha atherosulinosis, ngati adalangizidwa kwa odwala kuwonjezera pa ma statins. Heffernan KS, Suryadevara R, Patvardhan EA, Mooney P, Karas RH, Kuvin JT. Zotsatira za atenolol vs metoprolol zimagwira ntchito ya mtima kwa odwala omwe ali ndi matenda oopsa. Clin Cardiol. 2011, 34 (1): 39-44.Kuyerekeza zotsatira za atenolol ndi metoprolol zimagwira ntchito ya mtima kwa odwala omwe ali ndi kuthamanga kwa magazi.Atenolol ndi metoprolol amathandizanso kuthamanga kwa magazi. Potere, metoprolol imateteza mitsempha yamagazi bwino. Cocco G. Erectile kukanika pambuyo mankhwala ndi metoprolol: mphamvu ya hawthorne. Cardiology 2009, 112 (3): 174-177.Kuchepetsa kwa Erectile pamene akutenga metoprolol.Kuchepa kwa potency mwa abambo kugwiritsa ntchito metoprolol kumathandizira pafupifupi 75% ya milandu kumachitika chifukwa cha malingaliro, osati chifukwa chenicheni cha mankhwalawa. A placebo imabwezeretsa potency yoyipa kuposa tadalafil (cialis).

Tikugogomezera kuti metoprolol yekha wothandizidwa ndi umboni wokwanira. Zimathandiza bwino, makamaka kuphatikiza ndi mankhwala ena, ndipo nthawi zambiri sizimayambitsa mavuto. Makamaka, beta iyi ya blocka siziwononga mphamvu zazimuna. Metoprolol tartrate sangathe kudzitamandira pazabwino zilizonse. Mpaka pano, sikulinso koyenera kugwiritsa ntchito, ngakhale mtengo wotsika.

Yerekezerani ndi beta blockers ena

Kumbukirani kuti metoprolol yakhala ikugwiritsidwa ntchito pazamankhwala kuyambira 1980s. Ngakhale mapiritsi a metoprolol okhazikika otulutsidwa omwe ali ndi mawonekedwe osinthika sanalinso achilendo. Wogulitsa beta uyu amakhala pamsika waukulu wamankhwala. Madokotala amamudziwa bwino ndipo amalamula odwala awo mwachidwi. Komabe, mankhwala ena amafuna kumukankha.

Beta-blockers - mpikisano wa metoprolol:

Espinola-Klein C, Weisser G, Jagodzinski A, Savvidis S, Warnholtz A, Ostad MA, Gori T, Munzel T. Beta-blockers mwa odwala omwe ali ndi vuto la kuchepa kwa mafupa komanso matenda oopsa: zotsatira za nebivolol kapena metoprolol mu matenda osakanikirana a cell. Hypertension 2011, 58 (2): 148-54Zotsatira za beta-blockers kwa odwala omwe amatha kudandaula pang'ono komanso kuthamanga kwa magazi. Zotsatira zakuyerekeza kafukufuku wa nebivolol ndi metoprolol pazovuta zamagazi.Metoprolol ndi nebivolol bwino amathandizanso odwala omwe ali ndi vuto loyenda m'miyendo. Palibe kusiyana pakukhazikika pakati pa mankhwala. Kampus P, Serg M, Kals J, Zagura M, Muda P, Karu K, Zilmer M, Eha J. Zosiyanasiyana za nebivolol ndi metoprolol pa central aortic pressure ndikusiya kakhoma kokhazikika kwa khoma. Matenda oopsa. 2011, 57 (6): 1122-8.Zosiyanasiyana mu zotsatira za nebivolol ndi metoprolol pa kukakamiza kwapakati mu msempha ndi khoma lakumanja kwamitsempha yamtima.Nebivolol ndi metoprolol nawonso amachepetsa kugunda kwa mtima komanso kuchuluka kwa kuthamanga kwa magazi. Komabe, nebivolol yokha imasintha kwambiri mkati mwa SBP, DBP, kukoka kwamkati kwapakati komanso makulidwe a khoma lakumanzere kwamtima.

Phillips RA, Fonseca V, Katholi RE, McGill JB, Messerli FH, Bell DS, Raskin P, Wright JT Jr, Iyengar M, Anderson KM, Lukas MA, Bakris GL. Demographic imawunika zotsatira za carvedilol vs metoprolol pa glycemic control ndi insulin sensitivity kwa odwala omwe ali ndi matenda a 2 matenda a shuga komanso matenda oopsa mu Glycemic Zotsatira mu Diabetes Mellitus: Kafukufuku wa Carvedilol-Metoprolol mu Hypertensives (GEMINI). Zolemba za CardioMetabolic Syndrome 10/2008, 3 (4): 211-217.	Kuwunikira kwa demographic za zotsatira za carvedilol ndi metoprolol pa glycemic control ndi insulin sensivivity kwa odwala omwe ali ndi matenda a shuga a 2 komanso matenda oopsa. GEMINI kafukufuku.	Odwala omwe ali ndi matenda a shuga a mtundu wachiwiri, carvedilol ali ndi zotsatira zabwino za metabolism kuposa metoprolol. Komabe, metoprolol tartrate adagwiritsidwa ntchito phunziroli, osapatsa mphamvu.
Acikel S, Bozbas H, Gultekin B, Aydinalp A, Saritas B, Bal U, Yildirir A, Muderrisoglu H, Sezgin A, Ozin B. Kuyerekeza mphamvu ya metoprolol ndi carvedilol popewa kufalikira kwa fibrillation pambuyo pa opaleshoni ya coronary bypass. International Journal of Cardiology 2008, 126 (1): 108-113.	Kuyerekeza mphamvu ya metoprolol ndi carvedilol popewa kuwonongeka kwa fibrillation pambuyo pa opaleshoni yam'mimba yodutsa.	Odwala omwe akuchitidwa opaleshoni yam'mimba yodutsa, carvedilol imalepheretsa atrrillation ya atiria kuposa metoprolol.
Remme WJ, Cleland JG, Erhardt L, Spark P, Torp-Pedersen C, Metra M, Komajda M, Moullet C, Lukas MA, Poole-Wilson P, Di Lenarda A, Switzerlandberg K. Zotsatira za carvedilol ndi metoprolol pamayendedwe a Imfa mwa odwala omwe ali ndi vuto la mtima. European Journal of Mtima Kulephera kwa 2007, 9 (11): 1128-1135.	Zotsatira za carvedilol ndi metoprolol pazomwe zimayambitsa kufa kwa odwala omwe ali ndi vuto la mtima.	Odwala omwe ali ndi vuto la mtima, carvedilol bwino amachepetsa kufa pazifukwa zonse kuposa metoprolol tartrate, makamaka kufa kwa stroko.

Opikisana ndi beta-blockers atha kukhala apamwamba kuposa metoprolol pakuyenda bwino. Komabe, mapiritsi a metoprolol anathandizira kutulutsa-amathandizanso amathandizanso. Ndipo madotolo amasintha. Sakufulumira kuti alowe m'malo mwa mankhwala omwe adayamba kuzolowera kupereka kwa odwala, kwa ena. Komanso, kukonzekera kwa metoprolol kuli ndi mtengo wotsika mtengo. M'mafakitala, kufunikira kwa mapiritsi a Betalok ZOK, Egilok S, Metoprolol-Ratiopharm amatsika, ngati pang'onopang'ono, kapena kukhalabe okwera.

Mlingo wa Metoprolol wa matenda osiyanasiyana

Metoprolol imakhala m'mapiritsi amtundu wa mchere umodzi - tartrate kapena supplement. Amachita mosiyanasiyana, amapereka mitundu yosiyanasiyana yolowera zinthuzo m'magazi. Chifukwa chake, mapiritsi othamanga kwambiri a metoprolol tartrate, dosing regimen, ndi "slowly" Metoprolol, wina. Chonde dziwani kuti metoprolol tartrate sichinawonetse kulephera kwa mtima.

Metoprolol Succinate: Mapiritsi Akutulutsidwa Kwatulutsidwa

Metoprolol tartrate: mapiritsi olimbitsa mwachangu

Matenda oopsa50-100 mg kamodzi patsiku. Ngati ndi kotheka, mlingo ungathe kuwonjezeka mpaka 200 mg patsiku, koma ndi bwino kuwonjezera mankhwala ena a antihypertensive - a diuretic, calcium antagonist, ACE inhibitor.25-50 mg kawiri patsiku, m'mawa ndi madzulo. Ngati ndi kotheka, mlingowo ungathe kuwonjezeka mpaka 100-200 mg patsiku kapena kuwonjezera mankhwala ena omwe amachepetsa kuthamanga kwa magaziAngina pectoris100-200 mg kamodzi patsiku. Ngati ndi kotheka, mankhwala ena a antianginal angawonjezeke pamankhwala.Mlingo woyambirira ndi 25-50 mg, amatengedwa katatu patsiku. Kutengera ndi zotsatira zake, mankhwalawa amatha kuwonjezeka pang'onopang'ono mpaka 200 mg patsiku kapena kuwonjezera mankhwala ena a angina pectoris.Khola lachiwiri la mtima kulephera kugwira ntchito kalasi IIMlingo woyambira wabwino ndi 25 mg kamodzi tsiku lililonse. Pambuyo pa milungu iwiri yamankhwala, mlingo umatha kuwonjezeka mpaka 50 mg kamodzi patsiku. Yotsatira imakhala yowonjezera milungu iwiri iliyonse. Mlingo wokonza kwa chithandizo cha nthawi yayitali ndi 200 mg kamodzi patsiku.Sikuwonetsedwa

• Amayambitsa, Zizindikiro, matenda, mankhwala osokoneza bongo ndi wowerengeka yothetsera vuto la mtima
• Mankhwala okodzetsa a edema mu kulephera kwa mtima: zambiri
• Mayankho a mafunso wamba okhudza kulephera kwa mtima - kuchepetsedwa kwa madzi ndi mchere, kufupika, chakudya, mowa, kulemala
• Kulephera kwa mtima mwa okalamba: mawonekedwe azithandizo

Onaninso vidiyo:

Khola yolephera mtima yolimba ya III-IV	Ndikulimbikitsidwa kuyamba ndi mlingo wa 12,5 mg (piritsi 1/25 la 25 mg) kamodzi patsiku kwa masabata awiri oyamba. Mlingo amasankhidwa payekha. Pambuyo pa masabata 1-2 kuyambira pa chiyambi cha mankhwala, mlingo umatha kuwonjezeka mpaka 25 mg kamodzi patsiku. Kenako, pakatha milungu iwiri, mlingo umatha kuwonjezeredwa mpaka 50 mg kamodzi patsiku. Ndi zina zotero. Odwala omwe amalekerera beta-blocker bwino amatha kuwirikiza kawiri milungu iwiri iliyonse mpaka atapeza mlingo waukulu - 200 mg kamodzi patsiku.	Sikuwonetsedwa
Vuto la mtima	100-200 mg kamodzi patsiku.	Mlingo woyambirira ndi katatu pa tsiku kwa 25-50 mg. Ngati ndi kotheka, tsiku ndi tsiku mlingo ungathe kuwonjezeka mpaka 200 mg / tsiku kapena kuwonjezera chida china chomwe chimapangitsa kugunda kwa mtima.
Thandizo lothandizira pambuyo poyambitsa myocardial	Mlingo wa chandamale ndi 100-200 mg patsiku, muyezo umodzi kapena iwiri.	Mulingo wamba wa tsiku ndi tsiku ndi 100-200 mg, wogawidwa pawiri, m'mawa ndi madzulo.
Ntchito zosokoneza mtima, limodzi ndi tachycardia	100 mg kamodzi tsiku lililonse. Ngati ndi kotheka, mlingo utha kuwonjezeka mpaka 200 mg patsiku.	Muli wamba tsiku lililonse 2 kawiri patsiku, 50 mg, m'mawa ndi madzulo. Ngati ndi kotheka, ikhoza kuwonjezeka mpaka 2 times 100 mg.
Kupewa kugwidwa ndi migraine (mutu)	100-200 mg kamodzi patsiku	Mulingo wamba wa tsiku ndi tsiku ndi 100 mg, wogawidwa pakawiri, m'mawa ndi madzulo. Ngati ndi kotheka, ikhoza kuwonjezeka mpaka 200 mg / tsiku, ndikugawidwanso 2 Mlingo.

Zindikirani pa Mlingo wa metoprolol wothandiza mu mtima kulephera. Ngati wodwala akukhala ndi bradycardia, ndiye kuti, kugunda kumatsika pansi pa 45-55 kumenyedwa pamphindi, kapena kuthamanga kwa magazi "kumunsi" kumakhala pansi pa 100 mmHg. Art., Mungafunike kuchepetsa kwakanthawi mlingo wa mankhwalawo. Kumayambiriro kwa mankhwalawa, pakhoza kukhala ochepa hypotension. Komabe, patapita kanthawi, mwa odwala ambiri, thupi limasinthasintha, ndipo nthawi zambiri amalola kuti mugwiritse ntchito mankhwalawa. Kumwa mowa kumathandizira zotsatira zoyipa za metoprolol, chifukwa chake ndi bwino kupewa mowa.

Momwe mungasinthire ku bisoprolol kapena carvedilol

Zitha kuchitika kuti wodwalayo afunika kusintha kuchokera ku metoprolol kupita ku bisoprolol (Concor, Biprol kapena wina) kapena carvedilol. Zifukwazi zimakhala zosiyanasiyana. Mwachidziwitso, kulowetsa beta imodzi ndi ina sikupereka zabwino zambiri. Pochita izi, phindu limatha kuchitika. Chifukwa magwiridwe antchito ndi kulolerana kwa mankhwala kwa munthu aliyense ndi amodzi. Kapena mapiritsi abwinobwino a metoprolol atha amangochokera pamalonda, amisala ndi mankhwala ena. Gome lili pansipa lingakhale lothandiza kwa inu.

Source - DiLenarda A, Remme WJ, Charlesworth A. Kusinthana kwa beta-blockers mu olephera amtima. Zokumana nazo za gawo la posttudy la COMET (Carvedilol kapena Metoprolol European kesi). European Journal of Kulephera kwa Mtima 2005, 7: 640-9.

Gome limawonetsera ngati metoprolol. Kwa metoprolol tartrate m'mapiritsi otulutsidwa msanga, kuchuluka kofanana tsiku lililonse kuli pafupifupi 2 times. Bisoprolol imatengedwa nthawi 1 patsiku, carvedilol - 1-2 kawiri pa tsiku.

Mafunso Ofunsidwa Kawirikawiri

Pansipa pali mayankho a mafunso omwe nthawi zambiri amakumana ndi odwala omwe amatenga metoprolol kuthamanga kwa magazi ndi matenda a mtima.

Metoprolol kapena Betalok ZOK: ndibwino bwanji?

Betalok ZOK ndilo dzina lamalonda lazachipatala lomwe mankhwala ake othandizira amapangidwa ndi metoprolol. Izi sizikutanthauza kuti metoprolol ndiwabwino kuposa Betalok ZOK, kapena mosemphanitsa, chifukwa ndiofanana. Betalok ZOK ndiyabwino kuposa mapiritsi aliwonse okhala ndi metoprolol tartrate. Zomwe zimayambitsa izi zikufotokozedwa mwatsatanetsatane. Lero metoprolol tartrate titha kumuwona ngati mankhwala achikale.

Metoprolol kapena Concor: Ubwino ndi uti?

Pakati pa 2015, kafukufuku adamalizidwa omwe adafanizira kugwira ntchito kwa metoprololced ndi concor (bisoprolol) pochiza matenda oopsa.Zinapezeka kuti mankhwalawa onse amachepetsa kuthamanga kwa magazi chimodzimodzi ndipo amalekeredwa bwino. Tsoka ilo, palibe chidziwitso chodalirika chomwe mankhwalawa ndi abwino kwa odwala omwe ali ndi vuto la mtima, matenda a mtima ndi angina pectoris. Zomwe zili bwino: Concor, Betalok ZOK kapena Egilok C? Siyani chisankho pankhaniyi mwakufuna kwa dokotala. Komabe, musamatenge mapiritsi omwe othandizira awo ndi metoprolol tartrate. Ndizowopsa kuposa mankhwala omwe atchulidwa pamwambapa.

Kodi metoprolol imathandizira popsinjika?

Metoprololced amathandizira pamavuto opitilira beta-blockers amakono - bisoprolol, nebivolol, carvedilol. Palibe chidziwitso chodalirika chomwe mankhwalawa ali bwino kuposa enawo. Komabe, ndikudziwika bwino kuti metoprolol tartrate ndi mankhwala achikale omwe angapewe bwino. Mapiritsiwa amafunika kumwa nthawi zambiri patsiku, zomwe ndizovuta kwa odwala. Amayambitsa kudumpha kwakukulu mu kuthamanga kwa magazi. Ndizowopsa m'mitsempha yamagazi. Metoprolol tartrate samachepetsa mokwanira chiopsezo cha kugunda kwa mtima ndi zovuta zina zamagazi.

Ngati dokotala walamula kuti metoprolol azikakamizidwa, tengani Betalok ZOK kapena Egilok S. Kumwa mankhwala ochepetsa mphamvu yotsika mtengo kuli bwino kuposa mankhwala ambiri. Kumbukirani kuti chithandizo chachikulu cha matenda oopsa ndi moyo wathanzi. Ngati simutsatira malangizo pazakudya, masewera olimbitsa thupi ndi kuwongolera kupsinjika, ndiye kuti posachedwa ngakhale mapiritsi okwera mtengo amasiya kuthandizira.

Kodi nditha kutenga beta blocker iyi ndi lisinopril palimodzi?

Inde, metoprolol ndi lisinopril zitha kutengedwa palimodzi monga momwe dokotala wakupangira. Izi ndi mankhwala ogwirizana. Osamamwa mankhwala aliwonse omwe atchulidwa munkhaniyi pachangu. Pezani dokotala wodziwa bwino kuti apeze mankhwala abwino kwambiri othandizira magazi. Musanakupatseni mankhwala, muyenera kuyezetsa mayeso ndikuyezetsa. Onaninso dokotala kamodzi pa miyezi ingapo kuti mukonze zolembetsa zamankhwala malinga ndi zotsatira zamankhwala munthawi yapitayo.

Adandipatsa mankhwala metoprolol (Egiloc C) kuti andikakamize. Ndinayamba kuzilandira - ndimaso anga anagwa ndipo nthawi zambiri ndimadzuka kuchimbudzi usiku. Zilonda zam'miyendo zimapezeka m'miyendo, kuchira. Kodi izi ndizotsatira zoyipa za mapiritsi?

Ayi, mapiritsi a Egilok alibe chochita nawo. M'malo mwake, muli ndi zovuta za matenda ashuga amtundu wa 2. Phunzirani nkhani ya "Zizindikiro za Matenda a shuga kwa Akuluakulu," kenako pitani labu kuti mukayezetse magazi. Ngati matenda a shuga apezeka, chithandizirani.

Kuthamanga kwa magazi kumagwera mwachangu bwanji mutalandira metoprolol?

Mapiritsi, zomwe zimagwira ntchito ngati metoprolol zimathandizira. Sali oyenera ngati mukufunikira kuti muchepetse vuto la matenda oopsa. Mankhwala omwe ali ndi metoprolol tartrate amayamba kutsitsa kupanikizika pambuyo pa mphindi 15. Mphamvu yonse imayamba pambuyo pa maola 1.5-2 ndipo imatha pafupifupi maola 6. Ngati mukufuna chithandizo chamankhwala mwachangu, werengani nkhaniyo "Momwe mungaperekere chisamaliro chadzidzidzi pamavuto oopsa."

Kodi metoprolol ikugwirizana ndi ... zotere ndi zotere?

Werengani malangizo a mankhwalawa omwe amakusangalatsani. Pezani gulu lake. Itha kukhala diuretic (diuretic), ACE inhibitor, angiotensin-II receptor blocker, calcium antagonist (calcium channel blocker). Ndi magulu onse omwe adatchulidwa kwa matenda oopsa, metoprolol imagwirizana. Mwachitsanzo, muli ndi chidwi ndi Prestarium. Malangizo, pezani kuti ndi choletsa ACE. Metoprolol imagwirizana ndi izo. Indapamide ndi okodzetsa. Pamodzi ndi iye, muthanso kutenga. Ndi zina zotero. Nthawi zambiri, odwala amapatsidwa mankhwala 2-3 panthawi imodzi kuchokera kukakamizidwa.Werengani zambiri munkhani yakuti "Mankhwala ophatikiza matenda oopsa ndiamphamvu kwambiri."

Metoprolol ndi beta blocker. Simungatenge ma blocka a beta awiri nthawi imodzi. Chifukwa chake, musatenge pamodzi ndi bisoprolol (Concon, Biprol, Bisogamma), nebivolol (Nebilet, Binelol), carvedilol, atenolol, anaprilin, etc. Mwambiri, mankhwala awiri a matenda oopsa, omwe ali m'gulu lomweli, sangatengedwe nthawi imodzi.

Kodi chiwopsezo chakuti psoriasis chidzafika poipa bwanji chotenga Egiloc C kapena Betalok ZOK?

Palibe okwera kuposa opanga ma beta amakono. Palibe zambiri zenizeni m'mabuku.

Ndili ndi matenda oopsa chifukwa chamanjenje, pafupipafupi zotukwana. Dotoloyo adalangiza kuti atenge metoprolol. Ndinawerenga kuti kukhumudwa ndi zina mwa mavuto. Ndipo ine ndiri kale mitsempha yonse. Kodi ndiyenera kumwa mapiritsiwa?

Kupsinjika ndi kukhumudwa kwamanjenje ndi zotsutsana. Kukhumudwa ndi kusabala, kusilira, kukhumba. Poyerekeza lembalo la funsoli, mumakumana ndi zotsutsana. Mwinanso kumwa metoprolol kumakhala ndi zotsatira zoyeserera, ndipo zikuthandizani.

Metoprolol adachepetsa kuthamanga kwa magazi, koma mikono ndi miyendo idayamba kuzizirira. Kodi izi ndizomwe zili bwino kapena ndiyenera kuzimva?

Manja ndi miyendo idayamba kuzizira - iyi ndi njira yodziwika bwino yodziwira-beta-blockers, kuphatikiza metoprolol. Ngati mukuwona kuti mapindu anu kumwa mankhwalawa ndi akulu kuposa kuvulaza kwake, pitilizani kumwa. Ngati mukumva kusowa - funsani dokotala kuti akutengeni mankhwala ena. Dziwani kuti mutatenga beta-blockers sabata yoyamba, thanzi lanu limatha kukulirakulira, koma thupi limasinthasintha. Chifukwa chake ndikofunikira kuti mudikire ngati kupanikizika "kopitilira" kukhale pamwamba pa 100 mmHg. Art. ndipo zimachitika kuti sizigwera pansi pa 55 kumenyedwa.

Adotolo adalangiza kuti athetse mankhwalawo kuti alembetse Metoprolol-Ratiopharm ndi a Betalok ZOK okwera mtengo kwambiri. Kodi ndizoyenera?

Inde, zilipo. Zomwe zimagwira pakukonzekera kwa kampani Ratiopharm ndi metoprolol tartrate, ndipo Betalok ZOK ndiwofatsa. Kusiyana pakati pawo kukufotokozedwa mwatsatanetsatane pamwambapa. Simungathe kumva bwino momwe mankhwala atsopano amatetezerera ku vuto la mtima. Koma mosakayikira mukadakonda kuti mapiritsi amatha kumwa kamodzi kokha patsiku. Kuthamanga kwa magazi kwanu kumayandikira pafupipafupi, kudumpha kwake kumachepa masana.

Metoprolol - mapiritsi otchuka padziko lonse lapansi chifukwa cha kuthamanga kwa magazi, matenda a mtima (angina pectoris), kulephera kwa mtima, ndi arrhythmia. Nkhaniyi imafotokoza zonse za mankhwalawa omwe madokotala ndi odwala angafunike. Maulalo amaperekedwera ku magwero oyambira - zotsatira za mayeso azachipatala, pakuphunzira mozama.

Mpaka pano, tikulimbikitsidwa kugwiritsa ntchito metoprolol yekha - - mapiritsi otulutsidwa. Chida ichi ndi chokwanira kutenga nthawi 1 patsiku. Mankhwala omwe mankhwala ake ali metoprolol tartrate amayenera kumwa kawiri patsiku. Amakhala otsika pochita bwino ndi ena opanga ma beta ndipo amaloledwa mopitirira. Ngati mukumwa, kambiranani ndi dokotala ngati mungasinthe mankhwala ena.

Mwina bisoprolol, carvedilol ndi nebivolol amathandiza odwala bwino kuposa metoprololced komanso makamaka tartrate. Izi zikuwonetsedwa ndi zolemba zambiri zomwe zatuluka m'magazini azachipatala kuyambira m'ma 2000s. Komabe, mapiritsi a Betalok ZOK ndi a Egilok S sakhala achangu kupereka gawo lawo la msika kwa opikisana nawo. Chifukwa madokotala akhala akupereka mankhwala kwa nthawi yayitali, amadziwa bwino zotsatira zawo ndipo sathamangira kuwakana. Komanso, kukonzekera kwa metoprolol kumakhala ndi mtengo wokongola kwambiri poyerekeza ndi ena opanga ma beta.

• Beta blockers: zambiri
• Mankhwala osokoneza bongo
• Malangizo othandizira odwala okalamba

1. Angiotensin Kutembenuza Enzyme Inhibitors (ACE)
2. Angiotensin II receptor blockers (ARBs)

Calcium Channel blockers (a calcium calcium Antagonists)

Diuretics (okodzetsa)

Mankhwala owonjezera a antihypertensive

Imidazoline receptor agonists

Methyldopa (Dopegit, Aldomet)

Clonidine (Clonidine)

Direct renin inhibitor

Alfa oletsa

Ndalama zophatikizika

Ngati mankhwala akulu safunika

Pomaliza

Pakakhala kupsinjika mopitirira muyeso, funsoli limakhalapo pothana ndi mankhwala. Mapiritsi a kuthamanga kwa magazi amasankhidwa ndi adokotala okha. Kufunsira nokha mankhwala pazowopsa. Mankhwala aliwonse amakhala ndi zodziwikiratu komanso zoyipa. Popanda chidziwitso chapadera, ndizovuta kuganizira zovuta zonse ndipo zitha kuvulaza.

Pakadali pano pali magulu akuluakulu asanu a antihypertensive mankhwala. Amagwiritsidwa ntchito palokha komanso molumikizana. Koma palinso zinthu zina zamankhwala zomwe zimangogwiritsidwa ntchito pokhapokha pochiritsa zotsatira zake.

Angiotensin Kutembenuza Enzyme Inhibitors (ACE)

Ili ndiye gulu lalikulu kwambiri lothana ndi mavuto. ACE inhibitors nthawi zambiri amagwiritsidwa ntchito mu monotherapy. Kuphatikiza pa kuchitapo kanthu kwakukulu, amateteza ziwalo zomwe sizikufuna koma sizimayambitsa kuchotsedwa kwina. Kuchiza nthawi zonse kumayamba ndi kamwana kakang'ono, pang'onopang'ono kumabweretsa mphamvu. Kuti mupeze zotsatira zokhazikika, masabata awiri mpaka anayi a chithandizo chanthawi zonse amafunikira. Komabe, mankhwalawa ali ndi zovuta zake:

1. Kukula kwa matenda a "kuthawa" hypotensive kwenikweni. Panthawi imodzimodziyo, motsutsana ndi kumbuyo kwa chithandizo, sizingatheke kuti muchepetse kukakamizidwa pamlingo woyenera.
2. Maonekedwe a chifuwa chouma, chomwe chikufunika kulekeka kwa mankhwala.
3. Mndandanda wosangalatsa wazotsatira zoyipa, kuphatikiza edema ya Quincke.
4. Kuwongolera kosakanikirana ndi mankhwala osapweteka a antiidal (NSAIDs) kumayambitsa kuchepa kwa hypotensive.
5. Zimayambitsa kuchepa kwa potaziyamu m'thupi, zomwe zimayenera kuganiziridwa ndikugwiritsa ntchito, mwachitsanzo, potaziyamu-yosasamala okodzetsa.

Zambiri zoletsa za ACE sizothandiza. Kuchepetsa kwakukulu kwa kupanikizika kumachitika ndi metabolite yogwira (prilat), yomwe imapangidwa m'chiwindi kapena mucous membrane wa m'mimba thirakiti chifukwa cha njira ya biotransfform. Ndi chifukwa chake ndikuphwanya dongosolo la chimbudzi, nthawi zambiri pamakhala kusowa kwa zotsatira zabwino panthawi ya mankhwala. Chosiyana ndi mankhwala 2: Captopril ndi lisinopril.

Ma inhibitors a ACE amatengedwa kamodzi patsiku, mosasamala kanthu za kudya, popanda zosowa. Zomwe zimachitika nthawi zambiri zimatha ola limodzi pambuyo pa kayendetsedwe, zimafika mpaka maola 6 ndipo zimatha mpaka tsiku. Ma metabolites othandizira komanso osagwira ntchito amathandizidwa makamaka ndi impso. Izi ziyenera kuganiziridwa ngati kulephera kwa impso. Koma pali ma inhibitors a ACE omwe ali ndi njira ziwiri zochokera kunja: kudzera impso ndi matumbo. Ndiwotetezedwa, kotero, palibe kusintha kwa mlingo komwe kumafunikira.

1. Enalapril. Renitec anali woyamba kulengedwa, kenako amafanana nawo: Burlipril, Renipril, Enapharm, Attoril, Enam, Enap. Enalapril amakhala ndi nthawi yayitali yochitapo kanthu, motero amalimbikitsidwa kuti azilandira m'mawa ndi madzulo.
2. Lisinopril - Diroton, Diropress, Lysigamm, Lisinoton, Lysoril, Lister. Lisinopril yoyambirira salembetsedwa ku Russia. Imakhala ndi zabwino mu matenda a chiwindi.
3. Perindopril. Oyambirira ndi A. Generiki Prestarium: Perineva, Parnawel. Ili ndi zochepa zoyipa ndi kutchulidwa kwa organoprotective. Mitundu yotsalira yamapiritsi imapangidwa yomwe safunika kutsukidwa ndi madzi. Amatengedwa pamimba yopanda kanthu.
4. Ramipril. Tritace anali woyamba. Pambuyo pake, malo ake adatengedwa ndi ofanana nawo opezeka: Amprilan, Dilaprel, Wazolong, Priramil, Hartil. Imakhala ndi njira ziwiri: kudzera impso ndi chiwindi. Nthawi zambiri amatchulidwa chifukwa cha kugundana kwa mtima komanso pambuyo poyambira.
5. Fosinopril - Monopril (wapachiyambi), Fosicard, Fosinap, Fizinotek. Amachotseredwa m'chiwindi ndi impso.
6. Zofenopril - Zokardis. Imakhala ndi maubwino mu infarate yovuta yam'mimba.
7. Moexipril - Moex. Zimathandizira kuchepetsa ntchito yamafupa, omwe amalepheretsa kuwonongeka kwa minofu ya mafupa. Izi ndizofunikira kwambiri popewa matenda a mafupa kwa azimayi am'mbuyo. Ili ndi njira ziwiri zokumbira.
8. Tsilazapril - Inhibeys. Ndiokwera mtengo. Iyenera kumwedwa pamimba yopanda kanthu.
9. Supandolapril - Gopten. Yovomerezeka mpaka maola 24-36. Koma kuzipeza mumafakisi ndizovuta. Njira yodzipatula ndi iwiri.
10. Spirapril - Quadropril. Imafufutidwa kudzera mu impso ndi matumbo.
11. Hinapril - Akkupro. Zilibe zabwino zapadera.

Mpaka pano, mankhwala a m'badwo wa 1 - Captopril (Kapoten) sanatayidwe. Siyenera kulandira chithandizo chokhazikika, koma monga ambulansi ndikofunika kuti ikhale nayo pafupi. Pambuyo pakukonzekera pakamwa, zotsatira zake zimachitika pambuyo pa mphindi 15-60, ngati mutayika piritsi - patatha mphindi 5. Itha kugwiritsidwa ntchito pazovuta. Amapezeka mu Mlingo wa 25 ndi 50 mg.

Angiotensin II receptor blockers (ARBs)

Gululi limachita chimodzimodzi ndi ACE inhibitors. Koma chifukwa cha njira yosinthira yosiyanasiyana, kutsokomola kouma sikumachitika ndipo palibenso vuto lotha "kungochokapo". Chifukwa chake, ma ARB ndi njira yabwino kwambiri yotsatsira ACE inhibitors. Contraindication ndi zoyipa ndizofanana. Kulandila kumachitika kamodzi patsiku, ngakhale zakudya. Zotsatira zimatha pafupifupi maola 24.

1. Lozartan - Cozaar (woyambayo), Blocktran, Vazotens, Lozap, Lozarel, Lorista, Presartan. Amachepetsa mulingo wa uric acid, womwe umalola kuti uthandizidwe kwa anthu omwe akudwala gout.
2. Valsartan koyambirira adadziwika kuti "Diovan", Pambuyo pake Valz, Valsacor, Nortian, Sartavel adawonekera. Ili ndi chitetezo chalimba. Ili ndi zovuta zochepa.
3. Makandulo. Zoyambirira ndi Atakand. Zida Zambiri - Hyposart, Candecor, Xarten. Imakhala ndi kudalira mlingo.
4. Irbesartan. Woimira woyamba - Aprovel, analogues - Ibertan, Irsar, Firmast. Amapereka zowongolera masana.
5. Olmesartan Medoxomil - Cardosal (choyambirira), Olimestra. Imagwira ntchito bwino, koma maola oposa 24.
6. Telmisartan. Zoyambazo zinali zoyambirira, koma ku Russia Mikardis adazika mizu yambiri. The kuchuluka ndende mu magazi ukufika pambuyo ola, ndipo kulimbikira hypotensive zotsatira pambuyo 3 maola ndipo kumatha kuposa tsiku.
7. Eprosartan - Teveten (wapachiyambi), Naviten. Imalekeredwa bwino, popeza ili ndi zovuta zoyipa. Imakhala ndi chomumvera chisoni.
8. Azilsartan Medoxomil - Edarby. Ili ndi mphamvu yotsutsa antihypertensive. Ili ndi njira ziwiri zokumbira.

Gulu ili lawerenga momveka bwino. Zotsatira zazikulu zamagulu ndikuchepetsa kugunda kwa mtima. Ngati zimachitika kuti mwina zimachitika kawirikawiri, ndiye kuti kumwa mankhwala ngati amenewa kumatha kubweretsa vuto lalikulu la bradycardia ngakhalenso kumangidwa kwamtima. Chizindikiro cha kuikidwa kwake ndi matenda oopsa ogwirizana ndi maziko a tachycardia, matenda a mtima a ischemic, hyperthyroidism.

Chithandizo chimayamba ndi milingo yocheperako, yomwe pang'onopang'ono imayamba. Odwala okalamba, izi zimachitika mosamala kwambiri, osapitilira kamodzi sabata iliyonse. Ndikofunikira kuyang'anira nthawi zonse osati kukakamiza kokha, komanso zimachitika. Ngati kupanikizika ndikokwera, ndipo zimachitika kuti mufika pa 55-60 pamphindi, ndiye kuti kuwonjezera kuchuluka kwa magazi ndi koletsedwa. Koma ngati pakufunika kusiya chithandizo, ndiye kuti izi ziyenera kuchitika pang'onopang'ono, chifukwa n`zotheka kukulitsa vuto lochotsa magazi.

Gululi liyenera kugwiritsidwa ntchito mosamala kwambiri odwala omwe ali ndi COPD omwe ali ndi mphumu, popeza pali mwayi wokhala ndi bronchospasm. B-blockers amathandizira kagayidwe kazakudya, komwe kumayenera kuganiziridwa pamaso pa matenda a shuga. Pa mankhwala, kuwonda kumawonedwa.

• Metaprolol tartrate. Betalok ndi choyambirira, ma analogs - Vazokardin, Corvitol, Metokard, Serdol, Egilok.Fomu yayitali - Egilok retard. Mapiritsi amatchulidwa 2 pa tsiku, mosasamala kanthu za kudya. Egilok retard imatengedwa m'mawa. Piritsi imatha kugawidwa ngati mukufuna.
• Metaprolol Succinate - Betalok ZOK, Egilok C, Metozok. Awa ndi mankhwala omwe akhala akuchita kwa nthawi yayitali. Simungagawe mapiritsi. Kumeza zonse popanda kutafuna. Chochitikacho chimatha maola opitilira 24. Uwu ndiye mwayi wawukulu wanthawi yayitali.
• Bisoprolol - Kokor (choyambirira), Bidop, Coronal, Niperten, Cordinorm, Aritel, Biol, Bisogamm, Biprol. Mapiritsi amatha kusiyanasiyana. Chifukwa chake, Concor ili ndi mawonekedwe a mtima, Cordinorm ndi mtundu wa gulugufe wokhala ndi chiopsezo chabwino. Biol ili ndi zoopsa ziwiri zomwe zimakupatsani mwayi wogawa piritsi pagawo 4 ndi chala chimodzi. Ndi yosavuta kugwiritsa ntchito posankha mlingo. Amatengedwa kamodzi patsiku.
• Carvedilol. Poyamba, Dilatrend adagwiritsidwa ntchito, ndiye adayamba kulowa m'malo mwa Acridilol, Carvitrend, Coriol, Kardivas, Carvedigamm. Sichimalamulidwa kawirikawiri. Amasiyana ndi ma B-blockers ena chifukwa amatchinga ma alpha1-adrenergic receptors. Ndipo izi zimawonjezera vasodilator kwenikweni. Zimakhala ndi phindu pa metabolism yamafuta, kuchepetsa zomwe zimakhala ndi cholesterol yoyipa ndikuwonjezera phindu. Nthawi zambiri imadyedwa kawiri patsiku chakudya.
• Betaxolol - Lokren (choyambirira), Betoptik, Betak, Betoftan, Xonef, Optibetol. Sichimayambitsa bronchospasm, choncho ndikofunikira kugwiritsa ntchito odwala omwe ali ndi mphumu kapena COPD. Piritsi imatha kugawidwa. Amatengedwa m'mawa, ndizovomerezeka kwa tsiku limodzi.
• Nebivolol. Kwa nthawi yayitali, Nebilet yekha adadziwika adagulitsa kumsika wazamankhwala. Tsopano ma analogi ambiri okwera mtengo apangidwa: Bivotens, Nebilong, Binelol, Nebilan. Imalimbikitsa kutulutsa kwa nitric oxide kuchokera ku endothelium khoma lamitsempha. Izi zimatsogolera ku vasodilation yofatsa. Mankhwalawa amatengedwa nthawi imodzi patsiku, mosasamala kanthu za kudya. Oyenera maola 24.

Pali ma B-blockers ena omwe kale anali ogwiritsidwa ntchito molimbika, koma masiku ano amagwiritsidwa ntchito pang'ono, popeza pali mankhwala amakono. Ichi makamaka ndi Atenolol, yemwe amalimbikitsidwa kuti amwe nthawi 1-2 patsiku musanadye.

Woimira wina wa m'badwo woyamba wa B-blockers ndi propranolol (Anaprilin). Chifukwa cha kusasiyanitsa kokha osati kokha pama receptors ofunikira a B1, komanso ma receptors a B2, mwayi wokhala ndi zovuta zowonjezereka umawonjezeka. Zochizira matenda oopsa sagwiritsidwa ntchito. Itha kukhala yothandiza pokhapokha titayimitsa mabungwe oopsa kwambiri.

Calcium Channel blockers (a calcium calcium Antagonists)

Mphamvu ya antihypertensive imachitika chifukwa cha vasodilation, komwe kumapangitsa kutsika kwa zotumphukira zamitsempha. Ma calcium calcium blockers samakhudzana ndi metabolic process, kupewa thrombosis, ndikuchepetsa kupitilira kwa atherosulinosis. Makamaka othandiza anthu okalamba.

Mwa othandizira calcium Gulu la dihydropyridines limagwiritsidwa ntchito pochiza matenda oopsa a m'magazi: nifedipine, amlodipine, ndi zina. Kutheka kwa tachycardia ndi kufiyira kwa nkhope.

1. Nifedipine - Adalat (choyambirira), Phenigidin, Nifecard, Corinfar, Cordipine, Cordaflex. Calcium mdani wa m'badwo woyamba. Imagwira mwachangu: mukameza, vutoli limachitika pambuyo pa mphindi 30-60, mutayika pansi pa lilime - pambuyo pa mphindi 5 mpaka 10. Mphamvu ya antihypertensive imatha mpaka maola 3-4, kotero nifedipine sioyenera kupitiliza mankhwala. Itha kugwiritsidwa ntchito pokhapokha kuchepetsa kuthamanga kwa magazi kapena pazovuta popanda tachycardia yayikulu.
2. Nifedipine wautali - calcigard retard, Cordipin retard, Corinfar retard.Mapiritsi amatengedwa 2 pa tsiku mukatha kudya. Cordaflex RD, Cordipin HL, Corinfar UNO, komanso Nifecard HL amapereka mawongolero owongolera maola 24 patsiku. Timalandila nthawi 1 patsiku. Mapiritsi sangathe kugawidwa.
3. Amlodipine. Norvask ndiye woyamba komanso wophunziridwa kwambiri, koma wokwera mtengo. Mitundu yambiri idapangidwa: Amlothop, Kulchek, Normodipin, Stamlo, Tenok. Mphamvu ya antihypertensive imatha kuwonedwa pambuyo pa maola 1-2 pambuyo pa kukhazikitsa. Imapitilira tsiku limodzi. Amlodipine ndiwofatsa kuposa nifedipine. Adapanga levorotatory isomer ya amlodipine - EsCordi Cor. Pafupifupi palibe chotupa. Mlingo amafunika 2 zina zochepa.
4. Felodipine ndiye Felodip woyambirira komanso Mgwirizano. Poyerekeza ndi othandizira am'mbuyomu a calcium, amachititsa kuti miyendo isatupe. Amatengedwa kamodzi patsiku.
5. Lercanidipine. Zanidip anali woyamba, kenako Lerkamen adamasulidwa. Amadyedwa musanadye. Edema ndi osowa.
6. Isradipine - Lomir. Zovomerezeka kwa maola 12. Imwani mapiritsi 2 kawiri pa tsiku. Palinso makapisozi osakhalitsa.

Verapamil ndi ya phenylalkylamines. Imapezekanso pansi pa dzina loti Isoptin ndi Finoptin. Amachita ngati B-blockers. Zizindikiro ndi contraindication ndizofanana kwambiri. Koma amakonda kuperekedwa kwa mankhwalawa, mwachitsanzo, ngati wodwalayo ali ndi mphumu ya bronchial komanso matenda ena ofunika a m'mapapo.

Mabenzodiazepines, omwe amaphatikiza ndi diltiazem, pakadali pano sagwiritsidwa ntchito pochiza matenda oopsa.

Diuretics (okodzetsa)

Gulu la antihypertensive mankhwala limagwiritsidwa ntchito kuphatikiza mankhwala. Ma diuretics amachepetsa kuthamanga kwa magazi pochotsa madzi ndi sodium yambiri m'thupi. Amatengedwa m'mawa. Amakhala ndi vuto pa potency.

1. Hydrochlorothiazide (hypothiazide). Zochizira matenda oopsa, mapiritsi 25 mg amagwiritsidwa ntchito, omwe amalimbikitsidwa kuti agawidwe pakati. Mlingowu ndi wokwanira kukwaniritsa zotsatira zomwe mukufuna. Nthawi yomweyo, mwayi wazotsatira zoyipa ndizochepa. Mwapadera chidziwitso ndi choyipa cha diuretiki iyi pa kagayidwe: kuchuluka kwa shuga, uric acid ndi cholesterol m'magazi, pomwe potaziyamu amatayika.
2. Indapamide - Arifon (choyambirira), Indap. Mapiritsi ali ndi 2,5 mg yogwira pophika. Zotsatira zimapitilira maola 24. Pali mitundu yapadera: Arifon retard, Ravel-SR ndi Indapamide retard. Amasiyana muyezo wa 1.5 mg. Mankhwalawa amakonda, chifukwa amachita mosiyanasiyana tsiku lonse. Indapamide imakhudza kagayidwe, koma pang'ono.
3. Spironolactone - Aldactone (choyambirira), Veroshpiron, Veroshpilakton. Amasiyana ndi ma diuretics ena chifukwa amasunga potaziyamu ndipo amakhala ndi antialdosterone. Zisonyezero zogwiritsidwa ntchito ndi Refractory ochepa ochepa matenda oopsa kapena edematous syndrome. Pogwiritsa ntchito amuna kwa nthawi yayitali, kuchuluka kwa mabere am'mimba kumatha - gynecomastia.
4. Torasemide - Diuver, Britomar, Trigrim. Mankhwala oyambirirawa sanalembedwe ku Russia. Ili ndi mphamvu ya antialdosterone. Mulingo wa potaziyamu sukhudzidwa kwenikweni. Mphamvu ya diuretic imatha mpaka maola 18, koma mkodzo umatulutsidwa pang'onopang'ono tsiku lonse.

Pali mankhwala monga furosemide (Lasix). Imakhala ndi diuretic yamphamvu, koma imakhala ndi vuto loyipa. Kugwiritsa ntchito mosagwiritsa ntchito sikugwiritsidwa ntchito. Nthawi zina, itha kugwiritsidwa ntchito pothana ndi mavuto ambiri pakagwa mavuto.

Pali wina diuretic - chlortalidone. Nthawi zambiri zimaphatikizidwa pokonzekera kuphatikiza hypotensive zotsatira.

Imidazoline receptor agonists

Maselo apadera a I2-imidazoline omwe amapezeka mu medulla oblongata amalimbikitsidwa. Zotsatira zake, zotsatira zamachitidwe amanjenje amtima ndi mitsempha yamagazi zimachepa.Amakhala ndi zotsatira zabwino pakachitidwe ka metabolic mthupi, chifukwa chake mankhwalawa amalimbikitsidwa kwa anthu omwe ali ndi vuto la kunenepa kwambiri komanso matenda a shuga. Gululi limaphatikizapo:

1. Moxonidine - Physiotens (anali woyamba), Moxarel, Moxonitex, Tenzotran. Amapezeka mu Mlingo wa 0,2 ndi 0,4 mg. Itha kugwiritsidwa ntchito pakulandila kosalekeza komanso kuyimitsa mabvuto.
2. Rilmenidine - Albarel. Mapiritsi ali ndi 1 mg yogwira pophika.

Direct renin inhibitor

Pakadali pano, izi zikuphatikiza woimira yekha - Aliskiren (Rixila, Rasilez). Kugwira magawo oyamba kukhazikitsa RAAS. Kuteteza mtima ndi impso, Imachepetsa kupitilira kwa atherosulinosis. Amagwiritsidwa ntchito kamodzi patsiku. Imasunga kupanikizika kwa tsiku limodzi, kutseka m'mawa kwambiri, pomwe masoka ambiri am'mimba amachitika.

Alfa oletsa

Omwe akuyimira ndi awa: doxazosin (Kardura, Kamiren) ndi prazosin. Mankhwala osokoneza bongo omwe ali mgululi ali ndi phindu pamachitidwe a metabolic ndi cholesterol yotsika. Kugwiritsa ntchito alpha-adrenergic blockers mwa amuna omwe ali, kuwonjezera pa matenda oopsa, matenda a prostate adenoma ndi oyenera. Doxazosin amatengedwa nthawi imodzi patsiku, ndipo prazosin amalimbikitsidwa kuti agwiritsidwe ntchito katatu patsiku.

Ndalama zophatikizika

Izi zimaphatikizapo mankhwala a kuthamanga kwa magazi, okhala ndi 2, kapenanso 3 mankhwala piritsi limodzi. Izi ndizothandiza, chifukwa kuchuluka kwa mapiritsi omwe amamwa masana kumachepetsedwa.

Nthawi zambiri, ACE zoletsa ndi ma diuretics amaphatikizidwa:

• enalapril + hydrochlorothiazide - Co-Renitec, Enap N, Berlipril kuphatikiza, Renipril GT,
• lisinopril + hydrochlorothiazide - Co-Diroton, Iruzide, Lysoretic,
• ramipril + hydrochlorothiazide - Tritace kuphatikiza, Wazolong N, Hartil D, Amprilan NL,
• fosinopril + hydrochlorothiazide - Fosicard N, Fosinotek N,
• kufenopril + hydrochlorothiazide - Zokardis kuphatikiza,
• hinapril + hydrochlorothiazide - Akkuzid,
• perindopril + indapamide - Noliprel, Noliprel forte, Ko-Perineva, Ko-Parnavel.

Kuphatikiza kwa ma ARB ndi ma diuretics amagwiritsidwa ntchito bwino:

• losartan + hydrochlorothiazide - Gizaar, Blocktran GT, Vazotens N, Lozap kuphatikiza, Lorista N,
• valsartan + hydrochlorothiazide - Co-Diovan, Duopress, Valz N, Valsacor N,
• irbesartan + hydrochlorothiazide - Coaprovel, Firmasta N, Ibertan Plus,
• telmisartan + hydrochlorothiazide - MikardisPlus,
• eprosartan + hydrochlorothiazide - Teveten Plus,
• candesartan + hydrochlorothiazide - Atacand Plus, Candecor N,
• Olmesartan Medoxomil - Cardosal Plus,
• azilsartan medoxomil + chlortalidone - Edarby Clough.

Ndi ma diuretics, ma B-blockers amathanso kuphatikizidwa:

• bisoprolol + hydrochlorothiazide - Lodose, Bisangil, Biprol kuphatikiza ndi Aritel Plus,
• nebivolol + hydrochlorothiazide - Nebilong N,
• atenolol + chlortalidone - Tenorik, Tenoretik.

Pakuyerekeza kwambiri matenda oopsa, kuphatikiza kwa ACE zoletsa, ma ARB, ndi ma B-blockers omwe ali ndi zotsutsana ndi calcium nthawi zambiri amaloledwa:

• ramipril + amlodipine - Egipres,
• perindopril + amlodipine - Prestans, Parnavel Amlo, Dalneva,
• lisinopril + amlodipine - Equator, Equacard,
• enalapril + lercanidipine - Coriprene,
• losartan + amlodipine - Amzaar, Lortenza, Amozartan,
• valsartan + amlodipine - Exforge, Vamloset,
• irbesartan + amlodipine - Aprovask,
• bisoprolol + amlodipine - Concor AM,
• nebivolol + amlodipine - Nebilong AM,
• atenolol + amlodipine - Tenochok,
• metoprolol + felodipine - Logimax.

Mpaka pano, pali kuphatikiza kamodzi kokha, kuphatikiza indapamide, perindopril ndi amlodipine - Ko-Dalnev.

Ngati mankhwala akulu safunika

Ngati kuchuluka kwa kuthamanga kwa magazi sikokwanira kwambiri ndipo mankhwala osafunikira safunikira, ndiye kuti mankhwala opepuka a antihypertensive adalembedwa kuti athetse vuto:

• Dibazole - amachita ngati calcium blockers, amalimbikitsa vasodilation. Mapiritsi ali ndi 20 mg yogwira pophika. Itha kutengedwa katatu patsiku m'maphunziro ochepa kapena mwanjira.
• Papaverine - nayenso amachepetsa mitsempha ya magazi, chifukwa ndi myotropic antispasmodic. Amapezeka m'mapiritsi a 40 mg. Amayikidwa katatu pa tsiku kapena amagwiritsidwa ntchito pochotsa thanzi.
• Andipal - imakhala ndi dibazole, papaverine, phenobarbital, metamizole sodium. Chifukwa cha magawo awiri oyamba, mankhwalawa amathandizira kuchepetsa kupanikizika. Phenobarbital calms, ndi metamizole sodium amathandiza kuthana ndi mutu. Amatengedwa piritsi ndi kuwonjezeka pang'ono kwa mavuto. Pambuyo pa theka la ola, posagwirizana, njira ikhoza kubwerezedwa.

Pomaliza

Kusankhidwa kwa mankhwala ndi kwakukulu. Munthu aliyense angathe kusankha mtundu wa chithandizo chamankhwala. Koma mapiritsi ochokera kuthamanga kwambiri amatha kusankhidwa moyenera ndi dokotala. Izi sizigwira ntchito nthawi yoyamba, nthawi zina muyenera kusankha njira zosiyanasiyana komanso mitundu. Zimatenga nthawi komanso kuleza mtima. Koma ngati mutsatira malangizowo, amwa mankhwala pafupipafupi, ndiye kuti zotsatirapo zake zidzakhaladi.