Iyeza "Captopril" kwintoni? Isicelo, Impendulo, Intengo

Iyintoni na isilwanyana "iCaptopril", ukusuka kwintoni esetyenziswayo kwaye yiziphi iipropati ezinayo? Iimpendulo kuzo zonke iimbuzo zikwimeko yeli nqaku. Ukongeza, siya kukuxelela ukuba ungathabatha njani eli liyeza, kunye nawuphi na umphumo wempembelelo kunye nokuchasene nokusetyenziswa kwayo.

Ulwazi olubanzi malunga nemveliso yeyeza

Isilwanyana "iCaptopril" kwisiLatini sinjenge "Captopril". Eli nyanga liyi-inhibitor yokwenziwa kwe-enzyme (i-angiotensin-converting enzyme) okanye i-ACE). Kusetyenziswa ngokubanzi kwiindlela zonyango ngokunciphisa ngokukhawuleza kwegazi.

Ukubunjwa kunye nefom yeyeza

Amachiza "I-Captopril" - yintoni na le nyanga echazwe? Njengomthetho, oogqirha bayayichazela abo bahlala bexinzelelo lwegazi. Iyeza elinikezwayo lithengiswa kuphela kwifom yeipilisi eziseplates-cylindrical, ezifakwe kwiipakethe zekhadibhodi. Icandelo elisebenzayo lale nkunkuma yi-captopril. Umxholo walo kwipilisi nganye i-25 okanye 50 mg. Kwiphakheji enye ingaba ngama-100, 50, 40, 30, 20 okanye ama-10.

Isenzo se-Pharmacological yesilwanyana

Njengoko kuchazwe ngasentla, iifomsile "iCaptopril", umyalelo odibeneyo kwiipakethi zekhadibhodi, iyimithi ye-enzyme yokuguqula i-angiotensin (i-ACE).

Kufuneka kuqatshelwa ngokukodwa ukuba iipropati ezichasene nale nkunkuma zihambelana nokukhuseleka komncintiswano we-ACE, okukhokelela ekunciphiseni okukhulu kwinqanaba lokuguqulwa kwe-angiotensin 1 ukuya kwi-angiotensin 2, eyona nto iyinxalenye ye-vasoconstrictor.

Emva kokuncipha okuphawulekayo kwinkxalabo ye-angiotensin 2, umsebenzi we-plasma renin ukwanda kwakhona ngenxa yokupheliswa kwengxelo engalunganga ngexesha lokukhululwa kwayo, kunye nokunciphisa ngokuthe ngqo kwimveliso ye-aldosterone. Ukongezelela, isilwanyana "iCaptopril", esichazwe apha ngezantsi, iyakwazi ukuphazamisa inkqubo ye-kinin-kallikrein, oko kukuthintela ukutshatyalaliswa kwe-bradykinin.

Ngenxa yempembelelo ye-vasodilator, le nkunkuma inciphisa kakhulu ukuxhatshazwa kwe-vascular (pipeline), uxinzelelo lokutshata kwi-capillaries yemiphunga kunye nokuxhathisa kwimikhumbi yabo. Ukongeza, iyakwazi ukwandisa umthamo wemizuzu yentliziyo yentliziyo kunye nokunyamezela umthwalo.

Ukuba isilwanyana "i-Captopril", ukuphononongwa malunga nokuba yiyiphi into enhle, kuthatha ixesha elide kakhulu, ngoko kukuthintela ukuphuhliswa kwentliziyo, kuyanciphisa i- hypertrophy echazwe kwimiyobhodium ye- ventricular, kunye nokunciphisa ukuqhubela phambili kwe-dilatation.

Phakathi kwezinye izinto, le nkunkuma iyakwazi ukuthintela ukuqhubela phambili kwe-nephropathy yesifo sikashukela, ukunciphisa itoni ye-arterioles ephethe i-glomeruli yeentso kwaye iphucule kakhulu i-intraclubic hemodynamics.

Pharmacokinetics yeziyobisi

Emva kokuthabatha inkunkuma ngaphakathi ngaphakathi ngokukhawuleza. Qalisa lo myeza uqala malunga nemizuzu engama-40-60. Uxinzelelo oluphezulu emzimbeni womntu lufikelelwe emva kokuphela kweyure yokuqala.

Kufuneka kuqatshelwa ngokukodwa ukuba ukutya okufanayo kunye neziyobisi okwehliswayo kwanciphisa ubunzima bayo ukuya kuma-30-40%. Yingakho amapilisi anjalo acetyiswa ukuba athathe iyure eli-1 ngaphambi kokutya okanye iiyure eziyi-1-1,5 emva kwayo.

Ubungakanani bezenzo emva kokusebenzisa le nyilisi (ukunciphisa uxinzelelo lwegazi) kuxhomekeke kwimizuzu yolawulo lwayo kunye neelayi. Ukuphuhlisa impembelelo epheleleyo yokunyanga, isigulane sinokudinga iiveki ezininzi zonyango.

Izixhobo kunye neepropati zesilwanyana "iCaptopril"

Ngoku uyazi ukuba isilwanyana "iCaptopril" sisiphi, ukususela kwindlela esetyenziswa ngayo nendlela isebenza ngayo ngokumalunga nomzimba womntu. Kodwa ukuze uqonde ukuba kutheni le nkunkuma idume kakhulu, umntu kufuneka acinge ngezinto zayo.

I-substance esebenzayo, eyinxalenye yesilwanyana "iCaptopril", ine-vasodilator, i-hypotensive kunye nepropoprophic properties.

Esi sidakamizwa sikwazi ukwandisa ukukhululwa kwezinto eziphilayo ezisebenzayo ezinomphumela wendalo. Ngenxa yeli propati, ukuhamba kwegazi kwiintso kuphuculwe ngokuphawulekayo. Ukongezelela, isilwanyana "iCaptopril" ukusuka kwingcinezelo inciphisa i-post-post and preload in heart, kwaye iyakwandisa intliziyo.

Imiqondiso yokusetyenziswa kwemveliso yeyeza

Isilwanyana esinikezelweyo siboniswe ukuba unyango lwezinto eziqhelekileyo zilandelayo:

• Uxinzelelo lweengcinezelo kunye nokuvuselelwa kwakhona. Ingasetyenziselwa zombini kunye kunye ne-monotherapy.
• Ukuphulwa kwe-ventricle ekhohlo. Njengomgaqo, le nkunkuma isetyenziswe ngokumelene nalabo bantu abafumana i-infarction ye-myocardial kwaye ngoku bahlala kwiimeko ezisemgangathweni.
• Isifo soshukela seNifropathy. Inqunyelwe kuphela kulabo abane-type 1 yeswekile yesifo sikashukela, oko kukuthi, abantu abaxhomekeke kwi-insulin.
• Cardiomyopathy.

Isilwayo "iCaptopril" - yintoni enye into echazwe yile mithi? Njengoko kuyaziwa, isilwanyana esinikeziweyo singasetyenziselwa njengenxalenye yonyango oluyinkimbinkimbi yokwehluleka kwentliziyo (ekugqibeleni).

Ukungqinelana nokusetyenziswa kweyeza

Ngokomyalelo, isilwanyana "iCaptopril" ayinqatshelwe ukuba kuthathe amacala alandelayo:

• Ngobukhulu bentsebenzo kwiqumrhu elisebenzayo - i-captopril. Kufuneka kuphawulwe ukuba le nyanga ayinconywa ngabo banokungaxolisi ngokucacileyo kwiqela leziyobisi, eziyi-inhibitors ze-enzyme (i-patients) ezakhe i-angioedefrophic edema ngexesha lokunyanga nezinye i-ACE inhibitors).
• Kwiimeko ezichasene nomsebenzi wesibindi.
• Ukutshatyalaliswa kwemizimba.
• Ukuphazamiseka kwephepha lokutya.
• Kwizinto eziphazamisayo zomsebenzi weentso, imeko emva kokutshintshwa kwelungu elinikeziwe, i-stenosis ebantwini yeetriyeri, i-azotemia, i-hyperkalemia, kunye ne-hyperaldosteronism ephambili.
• Ngoxinzelelo lweengxaki.
• Ngezifo ze-immunological.
• I-mitral stenosis kunye ne-stenosis ye-aortic.

Phakathi kwezinye izinto, isilwanyana "iCaptopril", iifaneli zalo myeza ayikhuthazwa ngabasetyhini abakhulelweyo, abantwana abangaphantsi kweminyaka eyi-18 ubudala kunye nabahlengikazi.

Isilwayo "iCaptopril": umyalelo, intlawulo yonyango

Ngokomyalelo oqhotyoshelweyo, eli chiza kufuneka lithathwe malunga neyure elilodwa ngaphambi kokutya. Ubungakanani bonyango, kunye neerimi yeerayithi yonyango enikezelweyo, kufuneka imiselwe kuphela ngumgqirha ngamnye, kuxhomekeke kwimihlobo kunye nesifundo sezifo ezikhoyo.

Ngoko ndingayithatha njani isilwanyana "Captopril"? I-dose (yokuqala) yale nyilisi ekuxilongweni komfutho wexinzelelo ku-12.5 mg kabini ngosuku. Ngexesha elifunekayo ngokukhawuleza ungasebenzisa iipilisi ezi-2 zesilwanyana ezingama-25 mg. Kodwa kulo mzekelo kunqweneleka ukwahlula ukufunyanwa ngamaxesha amathathu. Umthamo omkhulu wemihla ngemihla yeli gciwane ngu-150 mg.

Ukuba ugqirha uye wachaza unyango lokulondoloza ixesha elide, ngoko isilwanyana "iCaptopril", isibonakaliso esiyihlolisayo ngasentla, kufuneka sithathwe kwipilisi yokuqala (25 mg) kathathu okanye kabini ngosuku.

Ngomsoco we-hypertension we-renovascular and renal, isilinganisi sokuqala sesilisi sikwi-6.25 mg kathathu ngosuku. Unyango oluxhasayo kufuneka lubandakanye i-tablet 1 yeyeza (25 mg) kathathu ngosuku.

Ukuba ufumene ukuba unesifo esingapheliyo senhliziyo kwaye kukho ukungaqhelekanga ezintsheni, isilinganisi sokuqala kufuneka sibe ngu-12,5 okanye 6.25 mg kathathu ngosuku. Ngexesha elifanayo rhoqo kwiiveki 2-3 kufuneka ziziswe kwimizi yesondlo ye-25-50 mg kunye nexesha elifanayo. Ngethuba lokugqibela, indlela yokuthatha le mayeza ifana nayo.

Amaqela eziyobisi i-ACE ekuguga imiselwe kuphela yiphrotheli. Kule meko, unyango kufuneka lukhethwe ngabanye. Thatha isilwanyana "iCaptopril" abantu abanjalo kufuneka babe kwi dose encinci. Ukongezelela, akukhuthazwa kakhulu ukunyusa kulo lonke unyango. Ukuba kuyimfuneko, i-loop diuretics inokusetyenziswa kwakhona.

Ngokumalunga nexabiso, iipilisi ezingama-40 zalesi sidakamizwa uya kufuneka unike malunga nama-ruble ase-Rashiya angama-50-60. Njengoko ubona, isilwanyana "iCaptopril" imishanguzo enokungabibizi okukuvumela ukuba unciphise kakuhle ingcinezelo yegazi ngaphandle kokulimaza kwimpilo yakho.

Thatha ngokuqaphela okukhulu

Iyeza elinikezelweyo kufuneka lithathwe ngokuqaphela xa lithe:

• Ukunyanzeliswa kwemibhobho yomongo we-bone;
• Izifo ezithintekayo ngokuzimela;
• Isifo sikashukela;
• Ischemia yengqondo ;
• Ischemic heart disease.

Iziphumo eziPhakathi

Ngokwemiyalelo, emva kokusetyenziswa kweziyobisi "iCaptopril", ukuphendula oku kulandelayo kungakwenzeka kwizigulane:

• I-bronchospasm, i-bronchitis, i-dyspnea, isiqhumane esomileyo esingakhulayo;
• Ukunyanzeliswa kwinkqubo yesantya ephakathi, intloko, ukuxubha, i-ataxia, ukuxakeka, ukuxubha, ukuxubha kwiindawo eziphezulu kunye nezantsi, kunye nokuvakalelwa, ukudideka, ukungahambi kakuhle kombono nombono, ukhathala okwenyukayo, ukuxinezeleka;
• I-dermatitis exfoliative, isikhumba sesikhumba, ukugqabhuka kwesikhumba, i-photodermatitis, pemphigus, i-edema ka-Quincke, i-urticaria, ukunyanyiswa kwe-anaphylactic, i-epidermal necrolysis, i- alopecia;
• Intliziyo yesifo sengqondo, i-angina pectoris, i-orthostatic hypotension, i-myocardial infarction, i-tachycardia;
• Ingxaki yokukhathazeka, ukunyanzelisa, ukulahleka kwesidlo, i-stomatitis, isicupunu, isilumkiso, i-glossitis, izilonda zesilonda zesisu esiswini kunye nomlomo womlomo, isifo sohudo, ukuhlanza, i-xerostomia, intlungu yesisu;
• I-Pherehesia, i-arthritis, i-peripheral polyneuropathy;
• I-neutropenia, i-hyperkalemia, i-thrombocytopenia, i-agranulocytosis, i-eosinophilia;
• U-Oliguria, iproteinuria, umsebenzi ongenakukhubazeka;
• I-hepatitis ye-Cholestatic, i-pancreatitis, i-cholestasis, i-hepatocellular necrosis.

Ngokweengxelo eziye zishiye abathengi malunga nale myeza, iziphumo zempembelelo zikwazi ukuzibonakalisa ngakumbi xa, ngelixa uthabatha amayeza, ugcine isonka esisezantsi okanye isidlo esingenalutho.

Isilwayo "iCaptopril": ukugqithisa

Xa kunokudlula ngaphezulu kwesi siluleko, iimpembelelo ezinjenge-myocardial infarction, ukuchithwa ngokukhawuleza nokukhawuleza koxinzelelo lwe-arterial, ukuphulwa kancinci kokujikeleza kwegazi kwengqondo kunye neengxaki ze-thromboembolic zingavela kwizigulane.

Ukuqapha

Ngokweengcali, akukhuthazwa ukuthatha le mayeza kunye ne-potassium-sparing diuretics, kunye nezinye iziyobisi ezandisa kakhulu ukuxinwa kwe-potassium kwi-plasma yegazi. Ukuba ungayithobeli le ngcebiso, kukho umngcipheko omkhulu we hyperkalemia.

Ukongezelela, isilwanyana "iCaptopril" kufuneka isetyenziswe ngokucwangcisa ngokukhawuleza ukuphathwa kweemali "iPrainamid", "Allopurinol", "Azathioprin" okanye ezinye iimpawu zokugonya, ikakhulukazi ngenxa yokuphulwa komsebenzi wezintso.

Ngenxa yezifo ezahlukileyo zezicubu ezinxibelelwano, kunye nokungafezeki kwintliziyo, le meyeza kufuneka ithathwe kuphela phantsi kweliso lonyango.

Kufuneka kwakhona kuqatshelwe ukuba, ngokweengxelo zezigulane kunye noogqirha, impembelelo yokuxhomekeka kwalo myeza inciphisa isilwanyana "i-Indomethacin" kunye ne-estrogens.

Izimo zokugcina

Isilwanyana "iCaptopril" sibhekisela kwizidakamizwa zoluhlu B. Le nyanga ihanjiswa kwiinkonzo zoshishino lwekhemisi kuphela kwimigomo. Ixesha lokugcina liyiminyaka emithathu ukususela kumhla wokuveliswa. Qinisekisa eso sixhobo ngokuchanekileyo kwindawo ekhuselekileyo neyomileyo, kwiqondo lokushisa elingekho ngaphezu kwama-25 ° C.

Amayeza afana nawo

Ezi zilandelayo zilungelelaniso zesakhiwo salolu lungiselelo lukhona kwiqumrhu elisebenzayo:

• Captopril Ferein;
• Angiopril-25;
• Captopril Acry;
• Alkadil;
• Captopril Sandoz;
• "Vero Captopril";
• I-Captopril UBF;
• "Blokordil";
• Captopril AKOS;
• Captopril Hexal;
• "Kapoten";
• Captopril FPO;
• Captopril Sar;
• "Catopilus";
• Captopril Aegis;
• "Epsetron";
• I-Captopril STI.

Njengoko uyakubona, imveliso enikezelweyo inamanani amaninzi. Kule nkalo, izigulane zihlala zibuza umbuzo malunga nokuba yintoni engcono - isilwanyana "uCaptopril" okanye "iKapoten." Akukho mvelaphi ebalulekileyo phakathi kwababini. Bahluke omnye komnye kuphela ngumenzi. Ngesizathu esifanayo, i-"Kapoten" isilungiso samaxabiso angama-3.5 axabisa ngaphezu kwesilwanyana "Captopril".

Uphononongo malunga neziyobisi

Nangona kunjalo, i-"Captopril" iyanciphisa ngokunyanisekileyo uxinzelelo lwegazi. Izigulane ezisebenzise ngokuphindaphindiweyo eli chiza, phawula ukuba umphumo walo ubonakala emva kweeyure ezingama-1-3 emva kokungena.

Ukuphendula komntu ngamnye emva kokusetyenziswa kwesi siluleko kufumaneka malunga nama-5-8% abantu. Abaninzi bathi ukulungiselela okunjalo kubangela i-edema enzima. Yingakho ngaphambi kokuba uyisebenzise, kufuneka uqhagamshelane nogqirha. Ukuba izidakamizwa "iCaptopril" ibangela ubuncinci besiphumo esisodwa, ngoko kuyinqweneleka ukuyiyeka kwaye ishintshe kwiyeza elithile ukusuka kwinyanzelo ephuma kwelinye iqela.

Kukho ukuhlaziywa okumbalwa ukuba izidakamizwa "iCaptopril", "iKapoten" kunye nezinye iifaneli zamachiza ngokufanelekileyo zinceda ekugqibeleni ukupheliswa komfutho wegazi okhulileyo. Kodwa ngaphambi kokumkela loo mcimbi kufuneka uhlale ebonisana nogqirha. Ukongezelela, kucetyiswa ukuba kusetyenziswe kuphela umthamo ophantsi weyeza kumntu osekhulile ukwenzela ukuphelisa uxinzelelo lwegazi oluphezulu nokuphatha ezinye izifo.

Ukhuselekile kangakanani le chiza?

Ngenxa yesibhedlele sengingqi yesithili saseRivne (iUkraine) ngo-2010, kwaqhutyelwa uphando malunga neziganeko ezimbi ezibangelwa ukuthatha izilwanyana "iCaptopril". Kule ndlela, abantu abanomdla wokuxinzelela ophezulu kunye nobuthathaka obunomdla babambe iqhaza. Ngenxa yoko, kwizifundo ezingama-500, abantu abangama-73 kuphela abakhalazo ngemiphumo emibi. Kule mihla, i-53 - yachithwa isilwanyana, kunye ne-20 eqhubekayo, kuba bekucingwa ukuba kwimpilo inokufumana inzuzo eninzi kunokuba yingozi.