Captopril 25 Ntshav Qab Zib Tau

Cov kev coj noj coj ua kom zoo rau kev kho mob ntawm cov neeg mob ntshav siab yog thawj zaug kev tswj hwm ntawm monotherapy nrog kev siv tshuaj tiv thaiv kab mob nrog koob tshuaj titration kom zoo tshaj plaws, tom qab ntawd cov tshuaj thib ob thiab thib peb tau ntxiv. Txawm li cas los xij, cov kauj ruam no ntev heev thiab tsis yog ib txwm ua tau zoo. Hauv kev tsim cov kev tshawb fawb hauv kev kho mob ntshav siab, nws tau pom meej tias kev kho mob monotherapy tsuas yog siv tau 50% ntawm cov neeg mob thiab tsuas yog muaj kev nce siab hauv cov ntshav siab. Feem ntau, ntau yam kab mob pathogenetic nyob rau hauv kev txhim kho kev mob ntshav siab, thiab vim li ntawd cov kev kho mob monotherapy tsis tuaj yeem cuam tshuam txhua yam ua rau muaj ntshav nce ntxiv hauv txhua tus neeg mob.

Ntxiv rau, qhov ua tiav ntawm lub hom phiaj tseem ceeb ntawm cov ntshav siab (140/90 hli RT. Daim Duab. "W />
Tus qauv ntawm cov tshuaj tiv thaiv ntshav siab nyob hauv cov neeg mob ntshav qab zib nrog ntshav siab> 140/90 hli RT. Kos duab.

Multicenter soj ntsuam cov kev sim siv tau qhia tias 2 rau 4 tshuaj ntawm ntau pab pawg yuav tsum ua tiav cov ntshav siab cov hom phiaj.

Qhov zoo ntawm kev sib txuas ua ke ntawm kev kub siab ua ntej monotherapy yog pom tseeb:
• kev sib txuam ua ke tso cai rau koj ua ntau yam kev siv ntawm kev txhim kho kev kub siab, uas ua rau nws ua hauj lwm zoo dua,
• kev sib txuam ua ke tso cai siv cov tshuaj qis dua ntawm cov tshuaj siv yam tsis tas yuav ua rau lub txiaj ntsig antihypertensive,
• qee qhov kev sib txuam ntawm cov tshuaj tshem tawm (lossis ua kom tsis muaj zog) cov kev phiv ntawm cov khoom siv tsis sib xws.

Raws li cov lus pom zoo los ntawm 2003 ntawm VII Pawg Neeg Sib Koom Tes hauv Tebchaws Meskas rau Kev Tiv Thaiv thiab Kev Kho Kab Mob Ntshav Qib (JNC 7), kev sib xyaw ua ke yuav tsum tau kho rau txhua tus neeg mob uas nws cov ntshav siab dhau 20/10 mmHg. Kos duab. nqe qhov tseem ceeb, i.e. 140/90 mmHg. Kos duab. hauv cov neeg mob tsis muaj ntshav qab zib thiab 130/80 hli RT. Kos duab. hauv cov neeg mob ntshav qab zib.

Ib lub tswv yim rau kev xaiv los tiv thaiv kev kho mob rau cov neeg mob ntshav qab zib tau nthuav tawm.

Lub tswv yim kho mob ntshav qab zib ua rau mob ntshav qab zib

Kev kho kom sov siab yog muaj peev xwm ua tau nrog tus mob ntshav nce siab ntau> 130/80 hli RT. Kos duab

Lub hom phiaj tseem ceeb hauv kev kho mob rau cov neeg mob ntshav qab zib yog kev tiv thaiv kev txhim kho lossis kev nthuav dav sai ntawm cov vascular cov yam ntxwv ntawm tus kab mob no (DN, DR, kev puas tsuaj rau cov hlab ntsha hauv lub plawv, lub hlwb, thiab lwm cov hlab ntsha loj). Tsis muaj kev ntseeg tias qhov teeb meem tseem ceeb tau qhia.

Cov neeg tsim cov khoom yog protein ntawm cov cytoskeleton ntawm lub cell. Nws xav tias, ntawm ib sab, adductins xa cov cim hauv lub cell, thiab ntawm qhov tod tes, hauv kev cuam tshuam nrog lwm cov cytoskeletal protein, lawv thauj ions los ntawm cell cell. Hauv tib neeg, txhua lub tshuaj tawm yog tsim los ntawm ob zaug.

Tso cov ntaub ntawv thiab cov nyob ua ke

Cov ntsiav tshuaj muaj cov xim dawb, muaj tus ntxhiab tsw tshwj xeeb, ib lub tiaj-cylindrical puab. Ntawm cov blockers, cov tshuaj sawv tawm rau nws lub peev xwm los txo cov vascular tsis kam thiab ua rau muaj qhov cuam tshuam zoo ntawm phab ntsa ntawm cov hlab ntsha.

Cov tshuaj yeeb dej caw muaj nyob hauv ib qho nyiaj ntawm 25 mg.

Daim ntawv tso tawm - ntsiav tshuaj, 25 mg, 10 pcs. Ntim cov contour, ntawm tes, nruab nrog cov lus qhia rau kev siv. 20 Pcs. cov ntsiav tshuaj tau ntim rau hauv lub thawv tso rau hauv lub thawv ntawv thawv.

Cov tshuaj yog tsim nyob rau hauv ib koob ntawm 12,5 mg thiab 50 mg. Cov tshuaj muaj cov tshuaj sulfhydryl uas tiv thaiv kev puas tsuaj rau myocardium.

Cov tshuaj muaj cov tshuaj sulfhydryl uas tiv thaiv kev puas tsuaj rau myocardium.

Pharmacological kev txiav txim

Cov tshuaj tshem tawm ACE kev ua si, yog li ntawd, qhov kev hloov pauv ntawm enzyme I mus rau angiotensin II, uas muaj cov nyhuv vasoconstrictor, txo.

Hauv lub adrenal cortex, ntau lawm aldosterone nce. Cov tshuaj cuam tshuam rau lub zog kinin-kallikrein, khaws cia bradykinin.

Cov Tshuaj Pharmacokinetics

Tom qab siv cov tshuaj ntawm cov tshuaj tso tawm ib zaug xwb, 75% ntawm cov tshuaj raug tshem tawm cov zom zaub mov. Kev noj tau cuam tshuam rau kev nqus ntawm cov tshuaj, txo nws cov nyhuv li ntawm 40%.

Hauv ntshav ntshav, cov tshuaj khi rau cov protein (albumin) thiab raug ntuav tawm hauv niam cov kua mis.

Tom qab siv cov tshuaj ntawm cov tshuaj tso tawm ib zaug xwb, 75% ntawm cov tshuaj raug tshem tawm cov zom zaub mov.Hauv ntshav ntshav, cov tshuaj khi rau cov protein (albumin).
Cov tshuaj puas tsuaj nyob rau hauv lub siab mob hlwb.

Cov tshuaj zom rau hauv lub siab mob hlwb, ua rau cov lus sib txuas hauv qab no:

• disulfide dimer ntawm cov tshuaj nquag,
• cysteine ​​disulfide.

Kev rho tawm tsis ua haujlwm. Ib nrab-lub neej ntawm cov tshuaj tsis pub dhau 3 teev. Nrog lub raum tsis ua haujlwm, cov tshuaj muaj ntau ntxiv hauv lub cev, vim li ntawd, cov concentration ntawm urea thiab creatinine hauv ntshav cov ntshav nce ntxiv.

Dab Tsi Captopril pab 25

Tus sawv cev tshuaj lom yog qhia rau cov kab mob xws li:

• arterial hypertension (ua ib feem ntawm txoj kev kho mob sib xyaw),
• ib qho kev hloov pauv ntawm txoj haujlwm ntawm sab laug ventricle vim yog myocardial infarction,
• ntshav qab zib nephropathy,
• lub plawv tsis ua hauj lwm.

Cov lus qhia rau kev siv tus neeg sawv cev kho mob taw qhia tias muaj kev tawm tsam, vascular nyhuv ntawm lub blocker. Cov tshuaj yog siv los muab kev pabcuam thaum muaj xwm txheej ceev ntxiv rau cov ntshav siab nyob rau theem prehospital.

Cov tshuaj yog siv los muab kev pabcuam thaum muaj xwm txheej ceev ntxiv rau cov ntshav siab nyob rau theem prehospital.

Npaum li cas tsis siab poob

ACE inhibitors txog li 150 mg rau ib hnub, siv nyob rau hauv kev kho mob ib txwm nrog kev mob plawv glycosides thiab diuretic, txo txoj kev pheej hmoo ntawm kev tuag los ntawm 40%.

Qhov pib noj tshuaj ntawm 6.25 mg maj mam nce mus txog 25 mg 2-3 zaug ib hnub. Txhawm rau kom tsis txhob poob tawm hauv cov ntshav siab, qhov kev nce siab hauv cov tshuaj noj tau nqa tawm rau ob peb hnub (koob tshuaj ob npaug yog tso cai nrog systolic ntshav siab dua 90 hli Hg thiab tsis pub ntau tshaj 1 zaug hauv ib lub lis piam).

Cov qib siab ntawm cov tshuaj sai txo cov ntshav siab, tab sis ua rau kev txhim kho ntawm kev phiv, mus txog myocardial infarction lossis mob stroke.

Cov Yuav Tsum Tau Ua

Ib yam tshuaj tsis raug sau tseg yog cov ntaub ntawv ntawm cov kabmob xws li:

• anaphylactic kev poob siab (keeb kwm),
• lub raum tsis ua hauj lwm zoo,
• ntshav siab nitrogen
• kev phais raum
• nqaim ntawm aortic orifice,
• mitral valve stenosis,
• kab mob siab
• cirrhosis ntawm daim siab,
• arterial hypotension,
• cardiogenic poob siab nrog myocardial infarction.

Ib qho tshuaj tsis raug sau tseg yog cov ntaub ntawv ntawm lub raum tsis ua haujlwm yog qhia hauv keeb kwm kho mob.

Hypotension thiab pib tshwm sim ntawm lub raum ua haujlwm tsis yog meej contraindications rau kev teem caij cov tshuaj.

Nrog myocardial infarction

Cov tshuaj tau sau tseg nyob rau thaum ntxov, muaj cov nyhuv hauv qab no:

• txo lub nra ntawm lub plawv,
• txo txoj kev pheej hmoo ntawm fibrosis,
• normalizes endothelial muaj nuj nqi,
• ua kom cov receptors ntawm peptide uas ua kom txoj hlab ntshav tawg.

Cov tshuaj yog qaug rau ntawm kev tswj hwm ntawm cov ntshav siab rau 5 lub lis piam. Tom qab noj tshuaj tas, lub siab ntawm cov nyhuv antihypertensive yog pom tom qab 3-5 teev.

Kev muab tshuaj thawj zaug yog 6.25 mg.

Cov tshuaj yog kws kho rau 3-16 hnub tom qab mob myocardial infarction. Tom qab 2 teev, qhov tshuaj ntawm ACE inhibitors tau nce ntxiv rau 12,5 mg thiab noj 3 zaug hauv ib hnub.

Cov kev kho mob yog ntev, nqa tawm los ntawm kev tswj ntshav siab (tus neeg mob systolic siab yuav tsum tsis txhob poob qis dua 100 hli Hg. Art.).

Captopril, muab thaum ntxov, pab txo kev ntxhov siab hauv lub siab.

Hauv qab lub siab

Thawj qhov tshuaj thawj zaug yog 25 mg 2 zaug hauv ib hnub. Yog tias qhov kev xav tau sawv tuaj, qhov tshuaj ntawm cov tshuaj tau nce ntxiv rau 14-28 hnub kom txog thaum pom qhov kev siv tshuaj.

Kev kub siab ntawm qib I-II, kev kho mob yog nqa tawm siv ACE inhibitors ntawm koob tshuaj 25 mg 2 zaug hauv ib hnub. Qhov ntau npaum li cas txhua hnub ntawm qhov tshuaj yog 100 mg.

Hauv cov ntshav siab heev, koob tshuaj 30 mg 3 zaug ib hnub tau tso cai. Thaum muab tshuaj, qhov kev pheej hmoo ntawm kev poob hauv cov ntshav siab nce siab yog tias tus neeg mob tau mob plawv tsis txaus, ua rau nws cov ntshav qis.

Hauv lub plawv tsis ua haujlwm

Rau kev kho mob ntawm lub plawv tsis ua hauj lwm, cov tshuaj tau pom zoo yog tias kho nrog diuretics tsis muaj kev soj ntsuam. Thawj qhov tshuaj yog 6.25 mg 3 zaug ib hnub.

Cov tshuaj txij nkawm tsis ntau tshaj 25 mg 3 zaug ib hnub.

Qhov siab tshaj plaws ntawm lub blocker yog 150 mg ib hnub twg.

Nrog rau cov ntshav qab zib nephropathy

Yog tias muaj lub raum lub raum tsis ua haujlwm, uas tsim kho hauv tus neeg mob ntshav qab zib mellitus, nrog creatinine tshem tawm ntawm 30 ml / min, cov tshuaj yog tshuaj ntawm 75-100 mg / hnub.

Cov tshuaj yog qaug cawv ntawm qhov siab siab 1 teev ua ntej noj mov.

Ntev li cas?

Qhov siab txo qis dua 1-1.5 teev tom qab siv ib zaug ntawm cov tshuaj. Cov kev siv tshuaj kho mob tsis tu ncua tshwm sim 8 lub lis piam tom qab cov thawj coj ntawm kev siv tshuaj tiv thaiv kab mob siab.

Kev muab tshuaj ntawm Captopril 25 yog txiav txim los ntawm tus kws kho mob.

Lub plab zom mov

Thaum siv cov tshuaj, koj tuaj yeem ntsib cov kev tsis zoo xws li:

• xeev siab
• tsis qab los noj mov
• saj hloov
• epigastric mob
• cem quav
• kab mob siab
• pancreatic o,
• ua txhaum ntawm kev tsim khoom lag luam tsib,
• khaus tawv
• mob hauv qhov yog hypochondrium.

Hematopoietic plab hnyuv siab raum

Cov xwm txheej tshwm sim tom qab siv yeeb tshuaj yog txiav txim siab:

• anemia
• platelet suav txo,
• theem qis ntawm neutrophils hauv cov ntshav.

Qhov siab tshaj plaws ntawm cov tshuaj nyob rau hauv cov neeg tshaj 65 ua rau kev txo qis hauv cov qe ntshav dawb, ib qho kev nce ntxiv hauv kev muaj peev xwm kis tus kab mob fungal, uas yog qhov tshwj xeeb tshaj yog rau cov neeg mob uas muaj cov kabmob autoimmune.

Nruab nrab hauv lub paj hlwb

Thaum kho, qhov tshwm sim ntawm cov kev xav tsis zoo xws li:

• kiv taub hau
• nkees
• ua txhaum ntawm kev sib koom tes
• hloov pauv ntawm daim tawv rhiab.

Hauv cov neeg laus cov neeg mob, pom kev tsis meej, tsaug zog, mob taub hau, tsis pom kev, lossis pob txha lov muaj peev xwm ua tau.

Thaum kho, kiv taub hau yog sau tseg.

Los ntawm cov kab mob zis

Ib ce tsis txaus lub cev ua raws li:

• lub raum tsis ua hauj lwm zoo,
• polyuria
• nce ntxiv nyob rau hauv cov protein nyob rau hauv cov zis,
• nce sclerotic cov txheej txheem nyob rau hauv cov ntaub so ntswg ntawm lub plab zais.

Hauv cov neeg mob uas mob raum tsis ua haujlwm, qhov kev pheej hmoo ntawm kev tsim microalbuminuria nce ntxiv, tus nqi ntawm creatinine nce ntau dua 30% los ntawm thawj theem. Hauv qee tus neeg mob, kev ua haujlwm ntawm txoj hlab ntaws hloov pauv zuj zus, ischemic nephropathy kev loj hlob.

Los ntawm lub tshuab ua pa

Thaum kho, qhov tshwm sim ntawm cov kev xav tsis zoo xws li:

• bronchospasm,
• hnoos qhuav qhuav,
• txhaws qa thiab txhaws suab,
• mob caj pas
• txog siav thaum ua pa.
• laryngeal stenosis,
• pulmonary edema.

Cov menyuam mos yug tshiab tau mob oliguria thiab hlab ntsha tsis zoo.

Captopril yuav ua rau qhov hnoos qhuav thiab mob heev.

Ntawm ib sab ntawm daim tawv nqaij

Thaum siv ACE inhibitor, tus neeg mob yuav ntsib pom qhov tsis zoo xws li:

• infiltrated ntom papules,
• khaus khaus
• daj ntseg liab blisters.

Cov tsos mob ntawm daim tawv nqaij tshwm sim li ob peb feeb tom qab siv tshuaj, cov tsos mob rov qab tom qab noj cov tshuaj ntxiv.

Cov pob xoo tshwm sim tawm tsam keeb kwm yav dhau los ntawm qhov txha caj qaum ntawm sab caj npab, kub taub hau tshwm, tawv nqaij nruj, uas hloov mus rau qhov tsis zoo, qhov fossa tsis ncaj rau lub sijhawm ntev los ntawm nias nrog tus ntiv tes.

Los ntawm genitourinary system

Ib cov tshuaj tom qab siv ntev heev tuaj yeem ua rau impotence, ua haujlwm tsis zoo hauv lub raum.

Cov kev mob tshwm sim ntawm tus neeg tom qab noj cov tshuaj yog cim los ntawm vascular edema thiab urticaria. Kev txhim kho ntawm qhov tsis haum yog qhov txuas nrog cov tsos ntawm khaus khaus nyob rau sab sauv thiab sab hauv qab, ntsej muag, lub qhov ncauj ntawm qhov ncauj, submucosal txheej ntawm lub qhov ncauj ntawm lub pa ua pa thiab cov hnyuv.

Cov kev mob tshwm sim ntawm tus neeg tom qab noj cov tshuaj yog cim los ntawm cov tsos ntawm ua tsis tau pa.

Tus neeg mob muaj cov tsos mob li nram no:

• aphonia,
• ua pa nyuaj
• zawm caj pas
• tuag taus tshwm sim.

Cov Tshuaj Hauv Tshuaj

Captopril yog ib qho angiotensin hloov mus rau enzyme (ACE) inhibitor uas thaiv qhov kev hloov pauv ntawm angiotensin I mus rau angiotensin II, uas ua rau txo qis ntawm kev tso tawm aldosterone. Cov nyhuv no ua rau qhov txo qis ntawm txhua qhov kev tawm tsam mob ntshav khov, tiv thaiv ntshav (BP), xaib - thiab preload hauv lub siab.

Plasma renin kev ua ub no tsis cuam tshuam rau cov nyhuv hypotensive. Kev poob hauv ntshav siab tshwm sim ob qho tib si ntawm cov qog qis thiab qis ntawm qhov hormone, uas tau piav qhia los ntawm cov nyhuv ntawm cov nqaij mos renin-angiotensin system.

Lub sijhawm ntev siv ntawm captopril txo qhov hnyav ntawm myocardial hypertrophy, zoo li lub phab ntsa ntawm cov hlab ntsha tiv thaiv kab mob.

Tsis tas li, cov tshuaj muaj cov teebmeem hauv qab ntawm lub cev:

• txhim kho lub raum thiab mob ntshav ntshav khiav,
• txo cov platelet aggregation,
• nce ntshav mov rau ischemic myocardium,
• pab txo qis rau ntawm sodium ions hauv cov neeg mob plawv,
• txo cov kev ua haujlwm ntawm bradykinin thiab nce cov synthesis ntawm prostaglandin.

Captopril ceev cov hlab ntsha mus rau qhov ntau dua li cov leeg ntshav.

Hauv kev sib piv rau kev siv cov vasodilators ncaj qha (minoxidil, hydrazine, thiab lwm yam), qhov kev txo qis ntshav siab tom qab noj captopril tsis ua rau muaj kev cuam tshuam ntawm reflex tachycardia thiab txo qhov xav tau myocardium hauv kev xa oxygen. Hauv lub plawv tsis ua haujlwm, ib qho tshuaj noj txaus yuav tsis cuam tshuam qhov ntshav siab.

Tom qab kev tswj hwm ntawm qhov ncauj, qhov siab tshaj plaws nyob rau hauv cov ntshav yog pom tom qab 1-1.5 teev. Lub sijhawm ntawm qhov kev tiv thaiv hypotensive yog koob tshuaj-ncav thiab nce mus txog nws qhov txiaj ntsig zoo nyob rau ntau lub lis piam.

Cov lus qhia rau kev siv Captopril: txoj kev thiab ntau npaum li cas

Captopril ntsiav tshuaj noj ntawm qhov ncauj 1 teev ua ntej noj mov.

Tus kws kho mob sau ntawv muab rau qhov noj ib hnub ib zaug zuj zus raws li cov cim ntsuas tau pom.

Cov koob tshuaj pom zoo kom zoo rau kev mob plawv tsis ua hauj lwm (nrog rau kev sib xyaw ua ke), thaum tsis muaj txiaj ntsig zoo los ntawm kev siv tshuaj kho mob: thawj koob 6.25 mg 2-3 zaug ib hnub. Cov koob tshuaj tau hloov kho rau qhov nruab nrab ntawm kev saib xyuas txij nkawm - 25 mg 2-3 zaug hauv ib hnub maj mam, nrog rau ncua sijhawm ntawm 2 lossis ntau lub lim tiam. Yog tias nws yog ib qho tsim nyog yuav tau nce ntxiv cov koob tshuaj, qhov nce siab tau ua 1 zaug hauv 2 lub lis piam,

Pom zoo kom noj koob tshuaj ntawm captopril rau kev ua kom mob nrog cov leeg ntshav: thawj koob 25 mg 2 zaug hauv ib hnub. Yog tias qhov kev kho mob tsis txaus, qhov koob tshuaj raug pom zoo nce ntau zuj zus, 1 zaug hauv 2-4 lub lis piam. Kev saib xyuas cov koob tshuaj rau cov mob ntshav nruab nrab ntawm 25 xoos 2 zaug hauv ib hnub, tab sis tsis ntau tshaj 50 mg, rau daim ntawv hnyav - 50 mg 3 zaug ib hnub.

Qhov siab tshuaj ntau tshaj plaws txhua hnub yog 150 mg.

Kev noj tshuaj rau txhua hnub rau cov neeg mob uas lub raum tsis zoo lub ntsws ua haujlwm yog pom zoo: rau qhov kev txiav txim siab nruab nrab (kev ua kom tsis pom kev zoo (CC) ntawm tsawg kawg 30 ml / min / 1.73 m 2) - 75-100 mg, nrog qhov ua txhaum cai (CC hauv qab 30 ml / min / 1.73 m 2) - thawj koob tshuaj 12,5-25 mg rau ib hnub. Yog tias tsim nyog, nce ntxiv rau lub sijhawm ntev, tab sis cov tshuaj ib txwm siv hauv ib hnub ib hnub tsawg dua li ib txwm.

Rau cov neeg mob laus, cov koob tshuaj tau xaiv nruj me ntsis ntawm tus kheej, kev kho mob raug pom zoo kom pib nrog 6.25 mg 2 zaug hauv ib hnub thiab sim ua kom tswj hwm qhov tshuaj ntawm theem no.

Yog tias tsim nyog, yuav tsum tau tso tshuaj ntxiv rau cov tshuaj diuretics, lub voj diuretic ntau dua li ntawm thiazide koob.

Sab sij huam

Kev siv cov captopril tuaj yeem ua rau tshwm sim:

• Los ntawm cov hlab plawv system: ib qho tseem ceeb txo qis ntshav siab, orthostatic hypotension, peripheral edema, tachycardia,
• Los ntawm kev mob plab hnyuv, mob caj dab, kab mob siab: lub qhov ncauj qhuav, saj tsis hnov ​​qab, tsis qab los noj mov, xeev siab, mob plab, tsis tshua muaj - mob plab, raws plab, hyperbilirubinemia, nce kev ua haujlwm ntawm daim siab enzymes, kab mob siab,
• Los ntawm cov kab mob zis: ua rau lub raum khiav tsis zoo (nce ntawm creatinine thiab urea hauv cov ntshav), proteinuria,
• Los ntawm cov kab mob hauv lub cev: nkees nkees, kiv taub hau, mloog zoo li nkees, mob taub hau, mob caj dab, mob khaub thuas, athenia, asthenia, tsis pom kev,
• Los ntawm cov kab mob hemopoietic: tsis tshua muaj tshwm sim - muaj ntshav liab, neutropenia, agranulocytosis, thrombocytopenia,
• Los ntawm cov kab mob ua pa: bronchospasm, hnoos qhuav (hloov), mob ntsws,
• Kev ntsuas ntsuas: hyponatremia, hyperkalemia, acidosis, hauv cov neeg mob ntshav qab zib mellitus - hypoglycemia (nrog rau cov kab mob hypoglycemic hauv qhov ncauj thiab insulin)
• Kev ua xaj: ua kom lub ntsej muag zoo nkauj, khaus, tawm pob, ua pob ntawm daim tawv nqaij, feem ntau maculopapular, feem ntau tsis zoo lossis hlwv,
• Ua xua thiab ua kom cov tshuaj tiv thaiv kab mob: mob hlwb ntawm lub qhov ncauj ntawm lub qhov ncauj, tus nplaig, lub suab thiab lub ntsej muag, daim di ncauj, lub ntsej muag thiab nqaj, muaj tsawg kawg - kev mob plab hnyuv, lymphadenopathy, mob ntshav tawm, thaum tsis tshua muaj, muaj cov tshuaj tiv thaiv kab mob hauv cov ntshav,
• Lwm yam: paresthesia.

Cov lus qhia tshwj xeeb

Nrog rau kev teem caij thiab tsis tu ncua nyob rau hauv tus txheej txheem ntawm kev noj cov tshuaj, nws yog ib qho tsim nyog los saib xyuas lub raum ua haujlwm.

Kev kho mob ntawm cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev yuav tsum tau ua nrog kev saib xyuas mob nkeeg.

Nrog kev ceev faj, tshwj xeeb tiv thaiv keeb kwm ntawm qhov tsis hnov ​​mob lub raum, Captopril yog cov tshuaj tiv thaiv kab mob (nrog rau cyclophosphamide, azathioprine), allopurinol lossis procainamide, cov neeg mob uas muaj kab mob vasculitis los yog diffuse connective nqaij pathologies. Txhawm rau tiv thaiv cov mob hnyav, ua ntej pib siv, thaum thawj 3 lub hlis (1 zaug hauv 2 lub lis piam) thiab ntu ib ntus thaum siv tshuaj tag, nws tsim nyog los tswj cov duab ntawm cov ntshav peripheral.

Hauv cov neeg mob uas muaj keeb kwm ntawm lub raum, captopril nce qhov ntau ntxiv ntawm kev txhim kho proteinuria, yog li ntawm cov neeg mob no, cov theem ntawm cov protein nyob hauv cov zis yuav tsum tau soj ntsuam thaum thawj 9 lub hlis (1 lub sijhawm hauv 4 lub lis piam), thiab yog tias nws tshaj li qhov txwv, qhov teeb meem ntawm kev tshem tawm yeeb tshuaj yuav tsum tau hais Cov.

Txoj kev pheej hmoo ntawm kev txhim kho lub raum ua haujlwm nyob rau hauv cov neeg mob raum leeg mob raum, nrog rau kev nce qib ntawm creatinine lossis urea hauv cov ntshav, nws yog qhov tsim nyog los txo cov koob tshuaj lossis tshem tawm nws.

Txhawm rau tiv thaiv qhov kev loj hlob ntawm anaphylactoid tshua nyob rau hauv cov neeg mob noj Captopril, nws raug nquahu tias cov ntshav ua kom ntshav khov nrog qhov siab permeability (suav nrog AN69) tsis siv rau kev kho mob hemodialysis.

Txoj kev pheej hmoo ntawm kev txhim kho arterial hypotension los ntawm kev siv cov tshuaj tuaj yeem raug txo yog tias, ua ntej pib kho (4-7 hnub), qhov hno raug txo qis lossis kev siv diuretics raug tso tseg.

Yog hais tias cov tsos mob ntawm txoj hlab ntsha o tuaj yeem tshwm sim thaum noj cov tshuaj, tus neeg mob raug pom zoo coj txoj hauj lwm tav toj thiab tsa nws ob txhais ceg.

Nrog rau txoj kev mob ntshav ntau heev, tus neeg mob yuav tsum ua ib qho tshuaj sodium isotonic sodium chloride tov.

Nrog rau kev txhim kho cov tshuaj tiv thaiv mob hlwb, cov tshuaj yuav tsum tsis ua ntxiv thiab kws kho mob yuav tsum tau sab laj nrog nws. Txog kev txhawm rau txhawm rau hauv cheeb tsam ntawm lub ntsej muag, feem ntau, kev kho mob tshwj xeeb tsis tas yuav tsum muaj, tshwj tsis yog noj tshuaj antihistamines kom txo qhov hnyav ntawm cov tsos mob. Yog tias muaj kev pheej hmoo ntawm kev tsim ua cov hlab cua thaiv (o ntawm tus nplaig, pharynx lossis lub plab), 0.5 ml ntawm epinephrine (adrenaline) yuav tsum tau muab tshuaj subcutaneously hauv qhov sib piv ntawm 1: 1000.

Kev siv cov captopril yuav ua rau kiv taub hau, tshwj xeeb tshaj yog thaum pib kho, yog li cov neeg mob tau qhia kom tsis txhob tsav tsheb thiab cov txheej txheem, nrog rau cov haujlwm uas muaj peev xwm txaus ntshai uas xav tau kev xav thiab qhov siab ceev ntawm cov kev tiv thaiv psychomotor.

Yeeb tshuaj sib cuam tshuam

Cov tshuaj tiv thaiv kev tiv thaiv kev tsis haum ntawm captopril yog muaj zog los ntawm vasodilators (minoxidil) thiab diuretics.

Kev sib xyaw nrog clonidine, estrogens, indomethacin thiab lwm yam tshuaj tsis-steroidal anti-inflammatory pab txo qis cov nyhuv hypotensive ntawm cov tshuaj.

Nrog rau kev siv txhij ntawm captopril:

• Potassium-sparing diuretics thiab potassium npaj tuaj yeem ua rau hyperkalemia,
• Kev npaj kub (sodium aurothiomalate) thiab angiotensin-hloov pauv enzyme inhibitors ua rau muaj cov tsos mob ntau yam, suav nrog xeev ntuav, ntuav, tawm ntsej muag, txo ntshav siab,
• Procainamide thiab allopurinol ua rau muaj kev pheej hmoo ntawm kev tsim mob Stevens-Johnson syndrome thiab / lossis neutropenia,
• Lithium ntsev ntau ntxiv ua kom muaj cov ntshiab lithium cov ntsiab lus,
• Cyclophosphacin, azathioprine thiab lwm yam tshuaj tiv thaiv kab mob siab ntxiv ua rau muaj kev cuam tshuam ntawm cov ntshav tsis zoo,
• Cov tshuaj insulin thiab lub qhov ncauj hypoglycemic ua rau muaj kev phom sij ntawm hypoglycemia.

Captopril analogues suav nrog: Capoten, Captopril-STI, Captopril-AKOS, Captopril Sandoz, Captopres, Alkadil.

Siv thaum cev xeeb tub thiab lactation

Hauv ib tug niam tom ntej, kev kho mob ntawm txoj kev mob ntshav siab yog nqa tawm ntawm kev siv tshuaj Methyldopa.

Lub blocker tsis tau teev tseg, vim tias nws hu:

• lub raum tsis ua hauj lwm hauv tus menyuam mos,
• nqaim kev cog lus thiab ntsej muag pob txha taub hau deformity,
• underdevelopment ntawm lub ntsws cov ntaub so ntswg,
• kev tuag ntawm tus me nyuam.

Ib cov tshuaj rau hauv niam cov kua mis muaj qhov tsis zoo rau kev noj qab haus huv ntawm tus menyuam.

Cawv tau zoo

Cov tshuaj tsis tuaj yeem noj ib txhij nrog cov dej haus uas muaj cawv ethyl cawv, txhawm rau kom zam kev txhim kho kev phiv.

Yog hais tias Captopril lom, tus neeg mob lub qhov muag pom muaj qhov muag tsis hnov ​​lus.

Noj ntau dhau

Thaum raug lom los ntawm ACE inhibitor, tus neeg mob txhim kho:

• hypotension
• myocardial infarction
• mob stroke
• thromboembolism
• lub raum tsis ua hauj lwm
• pom kev pom.

Txog kev kho mob, nws raug nquahu kom ntxuav cov hnyuv, muab tshuaj rau ntawm cov vasoconstrictor tshuaj txhaj tshuaj. Rau kev kho, kev daws teeb meem colloidal, tshuaj Dopamine thiab Norepinephril yog siv.

Kev cuam tshuam nrog lwm yam tshuaj

Qhov sib koom ua ke ntawm cov tshuaj nrog vasodilator ua rau nce ntxiv hauv cov nyhuv hypotensive.

Kev siv cov tshuaj ACE inhibitor nrog cov tshuaj uas tsis yog tshuaj steroidal los yog Clonidine ua rau txo qis qhov kev ua tau zoo ntawm cov tshuaj.

Siv cov tshuaj nrog lub diuretic ua rau muaj kev xav ntau ntawm potassium ions.

Ceev faj yuav tsum tau siv nrog kev siv tib lub sijhawm ntawm lithium thiab cov tshuaj tiv thaiv hypotensive, txij li qhov kev xav ntawm cov tshuaj tiv thaiv inorganic hauv cov ntshav cov ntshav nce ntxiv.

Kev siv ntawm captopril nrog cov tshuaj uas tsis yog tshuaj steroidal ua rau txo qis rau qhov kev ua tau zoo ntawm cov tshuaj.

Cov neeg mob noj Allopurinol thiab ACE inhibitor yog qhov pheej hmoo muaj tus mob Stevens-Johnson cov tsos mob.

Raws li kev hloov pauv rau tus neeg sawv cev tshuaj lom neeg, siv:

Ib qho tshuaj tiv thaiv ntawm lub tuam txhab Sandoz (Lub teb chaws Yelemees) muaj 6.25 mg ntawm cov khoom xyaw dhia hauv 1 ntsiav tshuaj. Cov tshuaj yog siv rau kev kho mob ntawm kev kho mob ntshav siab, mob plawv tsis ua hauj lwm, ntshav qab zib nephropathy hauv ntshav qab zib hom 1.

Alkadil tuaj yeem ua qhov hloov chaw rau cov tshuaj thiab yog cov tshuaj zoo. Cov tshuaj yog tshuaj rau qhov tsis ua tiav ntawm kev kho mob.

Angiopril muaj cov txiaj ntsig zoo ib yam nrog ACE inhibitor. Cov tshuaj yog tshuaj rau lub zog LV ua haujlwm ntawm lub siab, tom qab myocardial infarction, nrog albuminuria tsis ntau tshaj 30 mg / hnub.

Qhia txog CaptoprilCapoten cov lus qhiaBerlipril cov lus qhia

Koj tuaj yeem hloov cov tshuaj nrog tshuaj xws li Kapoten. Cov tshuaj yog coj raws li kws kho mob tau teev 1 teev ua ntej noj mov.

Kev txheeb xyuas rau Captopril 25

Vasily, 67 xyoo, Voronezh

Kuv tau txais los ntawm ntshav siab. Xyoo tas los, muaj ib qho kev kub ntxhov ob zaug. Lub siab tsis plam los ntawm dab tsi, txawm tias tom qab txhaj rau hauv tsev kho mob nws tsis yooj yim. Kuv nco qab cov tshuaj, muab ib ntsiav tshuaj 25 mg rau hauv kuv tus nplaig, thiab tom qab 30 feeb lub siab poob qis. Kuv ib txwm khaws cov tshuaj hauv lub txee tshuaj.

Margarita, 55 xyoo, Cheboksary

Thaum tsaus ntuj, lub siab yog 230 rau 115. Kuv muab 2 ntsiav tshuaj ntawm cov tshuaj tso rau hauv kuv tus nplaig, tom qab ntawd thaum tsaus ntuj lwm 2. Thaum sawv ntxov, lub siab poob rau 160 rau 100. Tus kws kho mob txhaj tshuaj diuretic thiab lub siab rov qab los rau qub. Kuv ntseeg tias nws zoo dua yog siv cov tshuaj qub Kapoten rau kev kho mob.

Tamara, 57 xyoo, Derbent

Kuv noj tshuaj ACE inhibitor rau 15 xyoo, 1 ntsiav tshuaj 0.25 mg ib hnub ib zaug. Txoj haujlwm niaj hnub tau hloov pauv, cov haujlwm qoj ib ce tau poob qis, yog li kuv haus 2 ntsiav tshuaj ntawm cov tshuaj ib hnub. Tsis muaj kev mob tshwm sim. Cov tshuaj yuav siv tau.

Dosage daim ntawv

Ib ntsiav tshuaj muaj

cov tshuaj nquag - captopril 25 mg

tus zam: lactose monohydrate, microcrystalline cellulose, magnesium lossis calcium stearate, silicon dioxide, colloidal anhydrous

Cov ntsiav tshuaj muaj xim dawb, xim-cylindrical, nrog tus chamfer ntawm ob sab, nrog tus ntoo khaub lig zoo li tus kheej rau ntawm ib sab thiab tus engraving "G" nyob rau lwm yam.

Cov chaw muag tshuaj

Cov Tshuaj Pharmacokinetics

Tom qab lub qhov ncauj tswj hwm, nws tau nrawm thiab nrawm rau ntawm txoj hnyuv. Kev noj ib txhij kom txo tau kev nqus los ntawm 30-55%. Qhov siab tshaj plaws (Cmax) hauv cov ntshav ntshav tau mus txog tom qab 30-90 feeb. Hauv cov ntshav, nws khi rau cov protein los ntawm 25-30%. Nws tau faib tawm thoob plaws txhua lub plab hnyuv siab raum thiab cov ntaub so ntswg, hla lub tsho me me, rau hauv niam mis, thiab cov ntshav-hlwb teeb meem tsis dhau. Nws yog metabolized hauv lub siab nrog kev tsim ntawm captopril disulfide dimer thiab captopril cysteine ​​disulfide. Qhov kev tshem tawm ib nrab-lub neej ua rau 2-3 teev. 40-50% yog tawm los ntawm lub raum tsis hloov pauv, tus so nyob rau hauv daim ntawv ntawm metabolites.

Cov Tshuaj Hauv Tshuaj

Captopril muaj qhov hypotensive, vasodilating, cardioprotective effect. Nws inhibits cov kev ua ntawm angiotensin-hloov mus rau enzyme, uas ua rau txo qis ntawm qhov kev hloov pauv ntawm angiotensin I rau angiotensin II (nws muaj cov nyhuv vasoconstrictor, txhawb txoj kev tso tawm ntawm aldosterone) thiab tiv thaiv qhov tsis ua haujlwm ntawm cov huab cua tsis zoo rau cov ua pa - bradykinin thiab prostoglandin E2. Nws tsub kom cov kev ua haujlwm ntawm kallikrein-kinin system, nce qhov kev tso tawm ntawm cov tshuaj lom biologically uas muaj cov natriuretic thiab vasodilating siv, thiab txhim kho cov ntshav ntws rov qab. Txo tag nrho tawm peripheral vascular tsis kam, ua ntej- thiab tom qab ua rau lub siab, nias ntawm lub voj voog me thiab hauv cov hlab ntsws capillaries, nce plawv tawm.

Kev ntsuas rau siv

arterial hypertension (mono-thiab ua ke nrog txoj kev kho)

mob plawv tsis ua hauj lwm (raws li ib feem ntawm kev sib xyaw

Kev ua haujlwm ntawm sab laug ventricle thaum ruaj khov nyob rau hauv

cov neeg mob tom qab myocardial infarction

mob ntshav qab zib nephropathy muaj ntshav qab zib mellitus hom I

Tsuas tshuaj thiab tswj hwm

Cov tshuaj yog noj ntawm qhov ncauj, tsis hais txog ntawm cov zaub mov noj.

Thawj koob tshuaj 25-50 mg 2 zaug hauv ib hnub, yog tias tsim nyog, ib koob tshuaj ntxiv tau nce mus rau 100-150 mg 2 zaug ib hnub, nrog lub sijhawm luv ntawm 2-4 lub lis piam. Kev saib xyuas qhov koob tshuaj 25 mg 2-3 zaug ib hnub. Qhov siab tshuaj ntau tshaj plaws txhua hnub yog 150 mg.

Mob plawv nres

Thawj koob tshuaj ntawm 6.25 -12,5 mg 2-3 zaug hauv ib hnub, tom qab ntawd nce ntxiv txhua 2-3 lub lis piam, txog txij nkawm 25 mg 2-3 zaug ib hnub lossis nce txog 50 mg 3 zaug hauv ib hnub. Qhov siab tshuaj ntau tshaj plaws txhua hnub yog 150 mg.

Sab laug ventricular kawg

Kev kho mob feem ntau pib nyob rau hauv ntu nruab nrab ntawm 3rd rau 16th hnub tom qab myocardial infarction. Thawj koob tshuaj captopril yog 6.25 mg / hnub rau thawj hnub. Tom qab ntawd, hnub tom qab, nws nce ntxiv rau 12,5 mg peb zaug ib hnub rau ob hnub nrog maj mam nce ntxiv mus rau 25-50 mg ntawm captopril peb zaug ib hnub. Cov koob tshuaj no tau tiav tiav zuj zus hauv ntau lub lis piam. Thaum muaj mob hypotension, raws li nyob rau hauv lub plawv tsis ua hauj lwm, koob tshuaj ntawm diuretics thiab / los yog lwm yam kev pom tseeb vasodilators tuaj yeem raug txo kom thiaj li ua tiav lub xeev khov kho ntawm captopril.

Qhov siab tshuaj ntau tshaj plaws txhua hnub yog 150 mg.

Ntshav qab zib nephropathy nrog mob ntshav qab zib-insulin muaj mellitus

Qhov hno thawj zaug yog 6.25 mg / hnub. Yog tias tsim nyog, nce qhov koob ntxiv rau 75-100 mg / hnub (hauv 2-3 koob). Thaum insulin-mob ntshav qab zib qis nrog microalbuminuria (tso tawm albumin 30-300 mg rau ib hnub), qhov koob tshuaj yog 50 mg ob zaug ib hnub. Nrog kev txiav tawm ntawm cov protein ntau tshaj 500 mg rau ib hnub, cov tshuaj muaj txiaj ntsig ntawm koob tshuaj 25 mg peb zaug ib hnub.

Thaum tsis ua haujlwm lub raum

Thawj koob tshuaj 6.25 mg 2-3 zaug hauv ib hnub, tom qab ntawv nce ntxiv. Qhov txhaj tshuaj ntau tshaj yog nyob ntawm creatinine tshem tawm.