"Nebivolol": analogue, imiyalelo ukusetyenziswa, ncomo. "Nebivolol Sandoz"

Amalungiselelo evela blocker kwiqela ezisetyenziswa kakhulu unyango lwezifo ezininzi sentliziyo. Phakathi kweli qela iziyobisi kakhulu zabelwe "Nebivolol". Analogs kweli chiza wafumana ithandwa enkulu ngenxa ukusebenza kwayo. Enjani amayeza, nokuba isebenza njani yaye xa ungasebenzisa ngayo?

Yintoni na eli chiza?

"Nebivolol" libhekisela kwiqela ibeta-blocker. Isiphumo iphambili esi siyobisi umfutho (drug kunciphisa uxinzelelo). Le nguqu ke nibonwe emane ethintela beta-receptors ibekwe iimpahla (ifuthe receptors beta-1-adrenergic).

Okwangoku wasebenzisa "Nebivolol Sandoz."

Eli chiza ludibaniso eliquka isomers ezininzi (D- kunye L-ujikeleza). Le yindibaniselwano kwezinto kuluncedo kuphuhliso ukusebenza onyango. Enye isomer unoxanduva lokuphuhlisa amanyathelo umfutho, ngoxa yesibini kunempembelelo enkulu phezu izinga intliziyo.

Ichiza esanda kutshanje, phakathi kwinkulungwane yokugqibela. Ukususela ngoko, abaninzi kule bume intliziyo. "Nebivolol Sandoz" sesona siyobisi yokuzikhethela ukunyanga lwegazi kunye neengxaki ezithile zentliziyo isingqisho.

Njani, ke ngoko, esebenza iziyobisi kunye nabasemagunyeni anoxanduva digestibility wayo?

Pharmacokinetics

Best wendele "Nebivolol Sandoz." Ichiza ako kakuhle kwisiqwenga zesisu. Ngaba zithathwe kunye nokutya (nokufunxwa akukho yonakale). Bioavailability liphantsi kakhulu - malunga ne-12 ekhulwini. Ukuba kunokwenzeka, kuphephe ukwabelana amayeza kunye notywala, ekubeni ithuba yeziphumo ebezingalindelekanga.

Kanye plasma yegazi, ichiza enebana albumin kwaye yenza nezakhiwo ezingenakunyibilika. Oku ebotshiwe uhlobo nokufumaneka ichiza malunga 98 ekhulwini, okt. E. kakhulu bonke wendele "Nebivolol Sandoz". analogue zayo ngendlela efanayo phambi kokuba singene plasma yegazi kwaye ukuba uqhagamshelane ne-protini.

Musa kwakheka ichiza evela iphecana zesisu kunye nezintso. Oku kusingathwa esibindini, apho enebana glucuronic acid.

Kwisiqingatha ubomi beziyobisi izigulane metabolite olukhawulezisiweyo imalunga ngemini. Kwimeko ukutya olucothayo "Nebivolol" uyakwazi Ukuqokelela igcinwe plasma yegazi malunga 48 iiyure.

Zomzimba ichiza a angakhuli ukuba ayisebenzisi libanda (oko kunokwenzeka kuphela xa ukusetyenziswa kwayo xa izigulane kwezintso okanye zesibindi ukuphazamiseka).

Ubungqina obubonakalayo buxela

Kwezinye iimeko, ke bamisela "Nebivolol" analogue amayeza okanye iziyobisi kunye okufanayo imithi?

Uphawu lokuqala ichiza lwegazi. Ngu ukusetyenziswa beta-blocker Kweza ke kwawo ukusebenzisa ACE inhibitors ( "Enalapril", "captopril"). Ukongezelela, "Nebivolol" ukusetyenziswa ezidalwe noxinzelelo lwegazi.

Enye, okubonisa ebaluleke kangako ukuba ukusetyenziswa kwe "Nebivolol" na isifo sentliziyo. Kunye exacerbations rhoqo angina kunye nokuthintela ehlasela abantu, yaye kubonisa "Nebivolol". analogue yayo kulo mzekelo zingathatha ngempumelelo ngakumbi ichiza ecocekileyo ngokwayo.

Oku kuquka i "Nebivolol" yaye inxalenye kwanonyango indibanisela ngenxa yonyango ukusilela kwentliziyo ezigulo ezondeleyo. Kule meko ukulungiselela igalelo kuphuculo intliziyo, yehlisa yaphambi kunye afterload umzimba kwigumbi, kwakunye nokuhla kwamandla.

Uyakwazi ukusebenzisa amayeza kunye nokuthintela iintlekele unesifo, ngokunjalo abo ezithandwa izilonda atherosclerotic nobeempahla nedumbe lengqondo.

Izimo

Xa akukho mfuneko ukusebenzisa i 'Nebivolol "? Imiyalelo yokusebenzisa ngokuqhelekileyo kuquka zonke ezo meko apho sele zichongiwe ngokwezonyango, xa imvelaphi yokusetyenziswa kwemali babona uphuhliso iingxaki ezahlukeneyo. Ngenxa isiphumo olomeleleyo arhente umfutho kufuneka umiselwe obunzima hypotension.

Okokuqala, oko aluvumelekanga ukusebenzisa iziyobisi ukusilela entliziyweni oyingozi. Oku kungenxa yokuba anako ukusebenza inotropic, nto leyo kuchaphazela kakubi umzimba ngenxa yokusilela umsebenzi kwentliziyo.

Ngophuhliso pheochromocytoma kukho kwakhona akuvumelekanga ukuba usebenzise "Nebivolol." Imiyalelo yokusebenzisa lubonisa ukuba kukho amalungiselelo elinikiweyo ithumba ezidalwe zingasetyenziswa kuphela ngokusebenzisana kunye blocker alpha receptor.

Akukho mfuneko yokuba ukuqesha ichiza abantwana kunye nabantu abanengxaki ezikhoyo zempilo yengqondo.

"Nebivolol" into contraindicated xa abantu ukunyamezelana ngamnye ukuya ichiza. Kwimiqondiso yokuqala (ukukrazula, ukuphelelwa umoya) kufuneka ngoko nangoko kupheza ukusebenzisa iziyobisi ukuba bafudukele ukhetho ekhuselekileyo.

imiphumela emibi

Njengaso nasiphi na isiyobisi, "Nebivolol" lineziphumo yayo ecaleni lakhe. Eyona phakathi kwazo zezi:

luvo - intloko ebuhlungu, ukudakumba, ukozela, sokulibala, nemibono, niphele, ukuba nesiyezi.

A isiphumo icala kwinkqubo kokudla isicaphucaphu, ukuqhina, umlomo owomileyo kunye nokugabha. Mhlawumbi ukubonakala ukuphazamiseka dyspeptic, kwaye ngexesha coadministration elwa - dysbiosis.

Inkqubo yegazi uyiphendula ukusungulwa kwenkqubo "Nebivolol" bradycardia, dyspnea, nokudumba, uphuhliso ukusilela kwentliziyo ludlule, ibhloko atrioventricular, Raynaud engqondweni. Libanda, ingakhokelela hypotension ongalawulwayo, nto leyo enokuthi nzima yokuwa kunye syncope. Kwiimeko kakhulu, Njengokungeniswa kuphuhliswa.

ukusebenza Side "Nebivolol" angavela njengoko irhashalala erythematous, ukhwekhwe.

Kwiimeko kakhulu angioneurotic nokudumba (angioedema). Kwiimeko onomoya, kukho uphuhliso uthimla ongenakoyiswa okanye ekhohlela.

Iimpawu lokusebenzisa ichiza

Ichiza isetyenziswa ngobunono izigulane insufficiency kwezintso, iswekile sinwenwa, okanye hormone of hormone. Ukususwa beziyobisi olwenziwa ngokuthe ngcembe iintsuku 10-14. Ekuqaleni unyango ngokuyimfuneko kufuneka alawulwe BP ne HR. Ukuba kunokwenzeka ngexesha lokusebenzisa ichiza kufuneka ayeke ukutshaya. Ngaphambi kokuba ahlinzwe ezayo qiniseka ukuba tufwile ukuba oogqirha ukuba isigulane usebenzisa beta-blocker.

Ngexesha lonke ixesha lokusebenzisa ichiza kufuneka kuyimfuneko ukulawula amaqondo eswekile yegazi, ingakumbi seswekile. Ngaphezulu, kufuneka zivavanywe ukuhluza Ukubanako izintso (ingakumbi amanqanaba creatine kunye urea), ukuba kukho ixesha elide wabelwa "Nebivolol". Imiyalelo yokusebenzisa (analogs zibe nomphumela ofanayo) ilumkisa ngelithi ukuze aphuhlise ukusilela kwezintso xa benikwe ukuqeshwa iziyobisi ngqiqweni.

Akuvunyelwe ukusebenzisa ichiza kubantwana abangaphantsi kweminyaka eli-18 ubudala kunye nezigulane abadala ukusilela ngentliziyo decompensated. Le isalelo kubangelwa ikakhulu ukuba kungenzeka kuphuhliso lokumkelwa pathways kunye ukubonakala ingxaki loxinzelelo.

Ukususela xa usebenzisa ichiza inokuphuhlisa nesiyezi, akukho mfuneko ukuba abele abaqhubi kunye kumagqirha.

Ukusetyenziswa kweziyobisi ukhulelwe

Injongo yale iyeza umfazi okhulelweyo kunokwenzeka kuphela emva kokubonisana kokuba ugqirha kunye therapist. Ichiza kunqabile kusetyenziswa ngenxa nefuthe elibi umama nomntwana.

Ichiza unikwa kuphela xa kuyimfuneko kakhulu, ekubeni kunokwenzeka uphuhliso bradycardia, hypotension, hypoglycemia, ukukhubazeka yokuphefumla, ukuxhuzula.

kwiintsuku ezintathu phambi kokuzalwa kulindeleke kuyimfuneko ukuba bashiye ukusetyenziswa kwale iyeza. Ukuba oku akwenzeki, kwisithuba ekuqaleni Kukudandatheka kufuna esweni ngenyameko impilo yoomama kunye nomntwana. Qiniseka xa usebenzisa zomzimba spinal, lo anesthesiologist ukuba alumkise le blocker oluqhubekayo unyango.

Kufuneka kukhunjulwe ukuba imvelaphi yokusetyenziswa kweziyobisi ukuze aphuhlise hypoxia Palsy. ukusebenza eteratogenic beziyobisi akwenziwanga kwaba, kodwa ke kukho iimeko iziphumo ezifana ekukhuleni kosana olungekazalwa.

Ukuba usafuna ukhulelwe eyabelwe "Nebivolol" umyalelo kwi isicelo ulumkisa ukuba uhlaba isenzo zonyango beziyobisi nokuqeshwa kwakhe wemagniziyam efakwa kunokwenzeka.

Intsebenziswano kunye namanye amaqela amalungiselelo amayeza

Ukwabelana i "Nebivolol" kunye antiarrhythmics class 1 kukhokelela ekwandeni nefuthe elibi inotropic. Mhlawumbi uphuhliso AV block. A nomphumela ofanayo uyabonakala ukuba ukusetyenziswa ngaxeshanye blocker calcium channel kunye "Nebivolol Sandoz."

Imiyalelo emisela ilumkisa ngelithi xa ilawulwa ukubanjwa butofelwe kunokwenzeka cardiac (ukuba ichiza ilawulwa kubanjiswene ne "Verapamil"). Kulo mzekelo, kufuneka cardioversion olungxamisekileyo usebenzisa cardioversion.

Kukho umngcipheko ebalulekileyo hypotension olungamandla xa besenza abantu ichiza ukuba 'nitroglycerin ".

Ukonyulwa ngaxeshanye sympathomimetic kunye "Nebivolol" kunegalelo yokubhuqwa yokugqibela.

Ukusetyenziswa idibene iziyobisi zomzimba inokukhokelela nokwehla okukhulu uxinzelelo lwegazi, nto leyo eya kusebenza inkomba yomatshini kunye nokusetyenziswa kweziyobisi unesifo.

Xa anikela ichiza ukuze aphuhlise insulin ihomoni libanda, kunye yokuzifihla kweempawu kwezonyango hypoglycemia.

balawule

Ngoko into ekufuneka usebenzise ngokwemithamo efanayo ichiza, ukuphuhlisa umphumo kuyimfuneko clinical? Ukuba usebenzisa i "Nebivolol Sandoz", umyalelo manual inika uhlobo zilandelayo nomthamo.

Ithamo kakhulu kangangoko ukuba omdala mg-20 ngosuku. Ichiza lisetyenziswa ngaphakathi kusasa ungatyanga. Isiphumo liphezulu idosi esetyenziswayo iphuhliswa iiveki enye okanye ezimbini uqalisile ngonyango. Ukuba kuyimfuneko, yonke imihla iyeza ukuze kwandiswe ku-10 mg. Kwizigulane abadala, idosi iphezulu ngemihla milligrams-5, kunye eliphezulu unyango - 2.5 milligrams ngosuku. Kuba imali abamithiyo amalungiselelo lukhethiwe ngokungqinelana imiqondiso yezonyango kunye nokutha emzimbeni. Kungcono usebenzise i "Nebivolol Sandoz" (5 mg) amacwecwe.

Kwimeko yokuhlukunyezwa kwesibindi okanye izintso kubhetele ukuba bashiye ukusetyenziswa "Nebivolol" okanye unikeze ukuba idosi lincinane.

Xa ulawulo ehamba sympathomimetics kunye "Nebivolol" isiphumo potentiation kunokwenzeka, eyenza kube lula ukunciphisa inani ithamo alinakunikezelwa olufanelekileyo lwechiza.

Ukusetyenziswa kweziyobisi ngeedosi ezincinane alunasiphumo kwi emzimbeni. Ngamana ukuphuhlisa ukunyamezelana ukuya receptors kweziyobisi kunye nolawulo lwexesha elide amathamo phantsi ichiza.

analogue iziyobisi

Akusoloko lula ukufumana Pharmacy amalungiselelo ayimfuneko, ngoko ke kufuneka babhenele ukusetyenziswa analogs. Ngenxa yokwanda yemarike amayeza, fumana izinto ezifanayo ayikho nzima. Ziziphi amachiza buyisela "Nebivolol"?

Analogs (izifanokuthi) yokulungiselela zimi ngolu hlobo lulandelayo:

• "Binelol";
• "Nebivator";
• "Nebivolol Canon";
• "Nebivolol STADA";
• "Teva Nebivolol;
• "Nebikar";
• "Nebilet";
• "Nebilong";
• "Palates HOD."

Nganye kwezi mithi iimpawu zayo ezintle nezimbi. Ezinye zazo luyenyuka kunokuba Classic "Nebivolol." Imiyalelo zokusetyenziswa nganye kwezi, Noko ke, ulumkisa malunga neziphumo ezibi kakhulu. Ngoko ke, ukuba ukufumanisa lo mbuzo, hlobo luni isiyobisi ngcono, kunceda ugqirha abaqeqeshiweyo nabawaziyo umsebenzi wabo kuphela.

Akukho mfuneko ukusebenzisa ezi mali ngokwabo, ngaphandle kokubonisana ugqirha, kuba kuphela ngale ndlela, kungaba kubi kakhulu imeko yabo impilo yabo bobabini kunye nempilo abahlobo bakho kunye nosapho.

Izimvo ngamalungiselelo

Izigulane ezininzi ngenkuthalo Ndibulele kwi foram iziyobisi ezifana njenge "Nebivolol Sandoz." Izimvo kulo zifumaneka becala HIV, ukususela ichiza banceda ukunyanga okanye ambambe iimpawu zesi sifo, izigulane ezininzi.

Nangona iziphumo ebezingalindelekanga ubephethwe ichiza, loo nto ithathwa njengenye isitshixo kwi unyango xi ephakamileyo kunye insufficiency intliziyo.

Baninzi ingxelo eyakhayo kwaye "Nebivolol." Acocekileyo Analogue beziyobisi umntu ofanelekayo, umntu - ngaphantsi, ukuze izimvo izigulane ziyahluka. Kufuneka kwakhona ithathele comorbidities ingqalelo, nto leyo imoshe isiphumo ichiza kakhulu.

Kufuneka ngokuqinisekileyo uthathe ingqalelo ubudala abanyangwa olu nyango.

Kuzo zonke betaadrenoblokatorov ezisetyenziswa izigulane kwentliziyo, indawo yokuqala i "Nebivolol" (analogue). Izimvo iyeza kwenza kube lula ukulibiza kuyo ichiza isebenzayo eli qela iziyobisi.