Hauv kev mob plawv tsis ua haujlwm, nws muaj peev xwm siv lisinopril ib txhij nrog diuretics thiab / lossis mob plawv glycosides. Yog tias ua tau, koob tshuaj ntawm diuretic yuav tsum tau txo ua ntej noj tshuaj lisinopril. Thawj koob tshuaj yog 2.5 mg 1 zaug / hnub, yav tom ntej nws tau maj mam nce (los ntawm 2.5 mg hauv 3-5 hnub) txog 5-10 mg / hnub. Qhov ntau tshaj plaws yog 20 mg / hnub.
Hauv qhov mob myocardial infarction (raws li ib feem ntawm kev sib xyaw ua ke hauv thawj 24 teev, cov neeg mob uas tsis muaj zog hemodynamic tsis xws li) tau sau tseg 5 mg hauv thawj 24 teev, tom qab ntawd 5 mg txhua lwm hnub, 10 mg tom qab ob hnub thiab tom qab ntawd 10 mg ib hnub ib zaug. Hauv cov neeg mob uas muaj mob myocardial infarction, cov tshuaj siv tau rau 6 lub lis piam. Thaum pib kho lossis thaum thawj 3 hnub tom qab muaj tus mob myocardial infarction, cov neeg mob uas tsis tshua mob systolic ntshav siab (120 hli Hg lossis qis dua) tau xaj tshuaj 2.5 mg. Thaum muaj kev cuam tshuam ntawm cov hlab ntsha hypotension (systolic ntshav siab hauv qab lossis sib npaug li 100 mm Hg), qhov tshuaj txhua hnub 5 mg tuaj yeem txo qis mus rau 2.5 mg. Thaum muaj mob ntau dua ntawm cov hlab ntsha hypotension (systolic ntshav siab dua 90 hli Hg rau ntau dua 1 teev), Irumed yuav tsum tsis ua hauj lwm.
Hauv nephropathy mob ntshav qab zib rau cov neeg mob uas muaj mob ntshav qab zib 1 mellitus (tus kab mob insulin-tiv thaiv tsis tau), Iramed ® yog tau txhaj tshuaj ntawm 10 mg 1 zaug / hnub. Yog tias tsim nyog, qhov koob tshuaj tuaj yeem raug nce ntxiv rau 20 mg / hnub thiaj li ua tiav diastolic cov ntshav siab qis dua 75 hli Hg. hauv ib txoj hauj lwm zaum. Hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus (non-insulin-dependant), qhov koob tshuaj yog tib yam thiaj li ua tiav diastolic ntshav siab qis dua 90 hli Hg. hauv ib txoj hauj lwm zaum.
Sab Sab Irumed
Feem ntau: kiv taub hau, mob taub hau, qaug zog, raws plab, hnoos qhuav, xeev siab.
Los ntawm cov hlab plawv: cim txo qis rau hauv cov ntshav siab, mob hauv siab, tsis tshua muaj - orthostatic hypotension, tachycardia, bradycardia, cov kev mob tshwm sim ntawm lub plawv tsis ua hauj lwm, kho tsis tau AV conduction, myocardial infarction.
Los ntawm ib sab ntawm lub hauv nruab nrab lub paj hlwb thiab lub paj hlwb ntawm lub paj hlwb: txhawm rau lub zog, tsis meej pem, mob caj dab, nkees nkees, txha taub ntswg ntawm cov leeg ntawm nqaj thiab daim di ncauj, tsis tshua muaj - asthenic syndrome.
Los ntawm lub plab zom mov: qhov ncauj qhuav, tsis nco qab, dyspepsia, saj hloov, mob plab, mob caj dab, kab mob siab, mob siab, mob daj ntseg, daj ntseg, kab mob siab, nce kev ua haujlwm ntawm hepatic transaminases, hyperbilirubinemia.
Los ntawm cov txheej txheem ua pa: dyspnea, bronchospasm.
Kev ua kom mob Dermatological: nce tawm hws, tawv nqaij ua pob khaus, alopecia, photosensitivity.
Los ntawm cov ntshav hemopoietic plab hnyuv siab raum: leukopenia, thrombocytopenia, neutropenia, agranulocytosis, ntshav txhaws (txo qis hematocrit, hemoglobin, erythrocytopenia).
Los ntawm ib sab ntawm cov metabolism: hyperkalemia, hyponatremia, hyperuricemia, nce creatinine hauv cov ntshav.
Los ntawm cov kab mob urinary: ua rau lub raum khiav tsis zoo, oliguria, anuria, uremia, proteinemia.
Kev tsis haum tshuaj: urticaria, angioedema ntawm lub ntsej muag, nqua, daim di ncauj, tus nplaig, epiglottis thiab / lossis mob caj dab, ua pob rau ntawm daim tawv nqaij, khaus, ua npaws, muaj cov tshuaj tiv thaiv kab mob ua kom zoo ntxiv, nce ESR, eosinophilia, leukocytosis, qee zaum - mob pob txha caj - mob interstitial angioeurotic.
Lwm yam: arthralgia / mob caj dab, myalgia, vasculitis, txo qis potency.
Cov tsos mob: cim tau poob qis hauv cov ntshav siab, qhov ncauj qhuav, tsaug zog, tso zis tawm tsam, cem quav, ntxhov siab, muaj zog ntxiv.
Kev Kho Mob: Kev kho mob kom zoo, kev tswj hwm cov dej qab ntsev thiab, yog tias tsim nyog, kev siv cov vasopressor tshuaj nyob rau hauv kev tswj cov ntshav siab thiab cov dej-electrolyte sib npaug. Tej zaum kev siv cov tshuaj hemodialysis.
Nrog rau kev siv ua ib txhij nrog Irumed nrog potassium-sparing diuretics (spironolactone, triamteren, amiloride), cov tshuaj potassium npaj, ntsev hloov pauv muaj cov poov tshuaj, qhov kev pheej hmoo ntawm hyperkalemia nce, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob uas lub raum tsis ua haujlwm.
Nrog rau kev siv ua ntu zus ntawm Irumed nrog diuretics, qhov cim tseg txo hauv cov ntshav siab yog sau tseg.
Nrog rau kev siv ua ib txhij ntawm Irumed nrog lwm cov tshuaj tiv thaiv kabmob, ib qho kev tiv thaiv ntxiv tau sau tseg.
Nrog rau kev siv tib txhij ntawm Irumed nrog NSAIDs, estrogens, adrenostimulants, cov nyhuv antihypertensive ntawm lisinopril txo.
Nrog rau kev siv tib lub sij hawm ntawm Irumed nrog lithium, lithium excretion los ntawm lub cev maj mam poob qis.
Nrog rau siv ua ntu zus ntawm Irumed nrog antacids thiab colestyramine, qhov nqus ntawm lisinopril los ntawm cov hnyuv hauv lub cev ua kom tsawg.
Ethanol txhim kho cov nyhuv ntawm cov tshuaj.
Nws yuav tsum tau yug los rau hauv lub siab tias qhov cim tseg txo cov ntshav siab tshwm sim nrog qhov txo qis hauv lub cev los ntawm kev kho diuretic, nrog rau cov ntsev hauv cov zaub mov tsawg dua, thaum lub cev lim ntshav thiab rau cov neeg mob raws plab lossis ntuav. Hauv cov neeg mob uas muaj lub plawv mob tsis ua hauj lwm nrog lub raum tsis ua haujlwm lossis tsis muaj nws, cov tsos mob hypotension tshwm sim, feem ntau pom tau hauv cov neeg mob lub plawv tsis ua hauj lwm loj, vim kev siv cov tshuaj loj ntawm diuretic, hyponatremia, lossis ua rau lub raum tsis ua haujlwm. Hauv cov neeg mob no, kev kho yuav tsum tau pib los ntawm kev tswj hwm ntawm tus kws kho mob (nrog ceev faj, xaiv ib koob tshuaj thiab tshuaj diuretics). Yuav tsum tau ua ib qho kev qhia zoo sib xws thaum teem sijhawm Irumed rau cov neeg mob uas muaj mob rau cov hlab ntshav ntawm lub cev, tsis muaj ntshav tawm ntawm lub cev, tsis txaus ntshav nce siab tuaj yeem ua rau myocardial infarction lossis mob stroke.
Kev tsim kho ntawm kev cim tseg txo ntshav siab, tus neeg mob yuav tsum tau muab txoj hauj lwm tav toj thiab, yog tias tsim nyog, iv 0.9% sodium chloride tov. Kev hloov pauv hypotensive tsis yog kev sib kis rau kev noj cov tshuaj txuas ntxiv ntawm cov tshuaj.
Thaum siv Irumed hauv qee cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev ntev, tab sis nrog ib txwm los sis qis ntshav siab, qhov txo qis hauv ntshav yuav tshwm sim, uas feem ntau tsis yog lub laj thawj rau kev kho mob. Nyob rau hauv rooj plaub arterial hypotension dhau los ua tsos mob, nws yog qhov tsim nyog los txo cov koob tshuaj lossis txiav kev kho mob nrog Irumed.
Hauv cov mob myocardial infarction, kev siv cov qauv kev kho mob (thrombolytics, acetylsalicylic acid, beta-blockers) yog qhia. Irumed ® tuaj yeem siv sib xyaw nrog rau / hauv cov lus qhia lossis nrog siv cov txheej txheem hloov chaw ntawm nitroglycerin.
Iramed ® yuav tsum tsis txhob raug rau cov neeg mob uas muaj mob myocardial infarction, uas muaj kev pheej hmoo ntawm kev tshaj tawm tsis zoo hauv hemodynamics tom qab siv vasodilators: rau cov neeg mob systolic ntshav siab ntawm 100 hli Hg. lossis qis dua, lossis nrog lub zog cardiogenic.
Hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev, qhov cim tseg ntawm cov ntshav siab tom qab pib kho nrog ACE inhibitors tuaj yeem ua rau cov ntshav tsis zoo ntxiv mus. Cov kev tshwm sim ntawm kev loj hlob ntawm cov mob raum tsis zoo yog tau sau tseg. Hauv cov neeg mob uas muaj ob lub raum mob ntshav liab los yog txoj hlab ntshav ntawm lub raum ib leeg tau kho nrog ACE inhibitors, muaj qhov nce ntshav ntawm urea thiab creatinine, feem ntau yog qhov thim rov qab tom qab tsis kho kev kho mob (ntau dua li cov neeg mob lub raum tsis ua haujlwm).
Lisinopril tsis muaj kev kho mob rau cov mob myocardial infarction hauv cov neeg mob uas lub raum tsis zoo nrog cov ntshav creatinine ntau dua 177 mmol / l lossis nrog proteinuria ntau dua 500 mg / hnub. Yog tias lub raum tsis ua haujlwm nrog kev siv tshuaj yaj yeeb (cov ntsiab lus ntawm cov tshuaj creatinine ntau dua 265 mmol / l lossis nce 2-npaug piv nrog qhov ntsuas ua ntej kho), qhov xav tau kev kho mob txuas ntxiv nrog Iramed ® yuav tsum raug ntsuas.
Cov neeg mob noj tshuaj ACE inhibitors, suav nrog lisinopril, tsis tshua muaj kev txhim kho angioedema ntawm lub ntsej muag, nqaj, daim di ncauj, tus nplaig, epiglottis thiab / lossis lub suab nrov, thiab nws txoj kev loj hlob yog qhov ua tau txhua lub sijhawm thaum kho. Hauv qhov no, kev kho mob nrog Irumed yuav tsum nres sai li sai tau thiab tus neeg mob yuav tsum tau saib xyuas kom txog thaum tus tsos mob rov qab ua tiav. Txawm li cas los xij, nyob rau kis mob edema tsuas yog tshwm sim ntawm lub ntsej muag thiab daim di ncauj thiab tus mob feem ntau ib txwm tsis muaj kev kho mob, antihistamines tuaj yeem kho tau.
Nrog rau kev kis tus mob ntawm angioedema mus rau tus nplaig, epiglottis lossis larynx, thaiv kev ua pa tuaj yeem ua rau neeg tuag taus, vim li ntawd, txoj kev kho kom tsim nyog yuav tsum tau nqa tawm tam sim (0.3-0.5 ml 1: 1000 epinephrine daws s / c) thiab / lossis ntsuas kom ua tau zoo rau txoj hlab pa. Nws tau sau tseg tias nyob rau hauv cov neeg mob ntawm cov haiv neeg Negroid noj ACE inhibitors, angioedema tau tsim muaj ntau dua rau cov neeg mob ntawm lwm haiv neeg. Hauv cov neeg mob uas muaj keeb kwm mob hlwb tsis yog cuam tshuam nrog kev kho mob yav dhau los nrog ACE inhibitors, kev pheej hmoo ntawm nws txoj kev loj hlob thaum kho nrog Iramed yuav raug nce.
Hauv cov neeg mob noj tshuaj ACE inhibitors, thaum lub sijhawm tso siab rau cov tshuaj hymenoptera (ua pa, muv, ntsaum), qhov tshuaj tiv thaiv anaphylactoid tuaj yeem tsis tshua muaj tshwm sim. Qhov no tuaj yeem zam tau los ntawm kev ncua kev saib xyuas ib ntus nrog ACE inhibitor ua ntej txhua qhov kev tshem tawm.
Nws yuav tsum tau yug hauv siab tias nyob rau hauv cov neeg mob noj ACE inhibitors thiab tab tom mob hemodialysis siv cov tshuaj tiv thaiv kev lim ntshav ntau (piv txwv li AN69), qhov tshuaj tiv thaiv anaphylactic kuj yuav tshwm sim. Hauv cov xwm txheej zoo li no, nws yog ib qho tsim nyog yuav tau xav txog kev siv qhov sib txawv ntawm daim nyias nyias rau cov tshuaj lim ntshav lossis lwm cov tshuaj tiv thaiv kab mob siab.
Thaum siv ACE inhibitors, hnoos tau sau tseg (qhuav, ntev ntev, uas ploj tom qab kev tseg rau kev kho mob nrog ACE inhibitor). Hauv kev kuaj xyuas qhov sib txawv ntawm hnoos, hnoos tshwm sim los ntawm kev siv tshuaj ACE inhibitor yuav tsum raug txiav txim siab.
Thaum siv cov tshuaj uas txo cov ntshav siab rau cov neeg mob nrog kev phais mob ntau los yog thaum lub sijhawm tso tshuaj loog, lisinopril tuaj yeem thaiv kev tsim cov tshuaj angiotensin II, qhov thib ob nrog kev hwm rau kev ua kom rov qab zoo li qub. Lub cim txo qis hauv cov ntshav siab, uas yog suav tias yog qhov tshwm sim ntawm qhov kev ua no, tuaj yeem tshem tawm los ntawm kev nce bcc. Ua ntej kev phais mob (suav nrog kev phais hniav), tus kws phais mob / tshuaj loog yuav tsum paub txog kev siv tshuaj ACE inhibitor.
Hauv qee kis, pom muaj hyperkalemia. Txoj hauv kev pheej hmoo rau kev loj hlob ntawm hyperkalemia muaj xws li lub raum tsis ua haujlwm, mob ntshav qab zib mellitus thiab kev siv tam sim no ntawm cov tshuaj potassium-sparing diuretics (spironolactone, triamteren lossis amiloride), potassium npaj lossis ntsev hloov pauv muaj cov poov tshuaj, tshwj xeeb tshaj yog nyob hauv cov neeg mob uas lub raum tsis ua haujlwm. Yog tias tsim nyog, kev siv ntawm cov kev sib txuas no yuav tsum ua ntu zus saib qib ntawm cov poov tshuaj hauv ntshav cov ntshav.
Hauv cov neeg mob uas muaj kev pheej hmoo ntawm kev tsim cov tsos mob hypotension (ntawm qhov tsis muaj ntsev los yog ntsev tsis muaj zaub mov noj) nrog / tsis muaj hyponatremia, zoo li hauv cov neeg mob uas tau txais cov tshuaj diuretics zoo, cov xwm txheej saum toj no yuav tsum tau them nyiaj ua ntej kev kho mob (poob kua thiab ntsev). Nws yog ib qho tsim nyog los tswj cov txiaj ntsig ntawm kev pib siv tshuaj ntawm Iromed omed ntawm tus nqi ntawm cov ntshav siab.
Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab
Tsis muaj cov ntaub ntawv hais txog cov nyhuv ntawm Irumed, siv nyob rau hauv kev siv tshuaj kho mob, ntawm kev muaj peev xwm tsav tsheb thiab cov txheej txheem, tab sis nws yuav tsum tau yug los hauv lub siab tias kiv taub hau yog ua tau. Yog li, nyob rau lub sijhawm kho mob, cov neeg mob yuav tsum ceev faj thaum tsav tsheb thiab ua haujlwm xav tau kom muaj kev mloog zoo dua thiab ceev ntawm cov kev puas hlwb psychomotor.
Daim foos tso tawm Irumed, ntim tshuaj thiab muaj pes tsawg leeg.
Cov ntsiav tshuaj yog xim dawb, puag ncig, biconvex, nrog ib qho nqis siab ntawm ib sab.
1 tab
lisinopril (nyob rau hauv daim ntawv ntawm dihydrate)
5 mg
Cov muaj mob: mannitol, calcium phosphate dihydrate, pob kws hmoov txhuv, pregelatinized pob kws hmoov txhuv nplej siab, colloidal silicon dioxide, magnesium stearate.
30 pcs - hlwv (1) - pob khoom los ntawm cardboard.
Cov ntsiav tshuaj yog xim dawb, puag ncig, tiaj tus cylindrical, nrog kev nqis siab ntawm ib sab.
1 tab
lisinopril (nyob rau hauv daim ntawv ntawm dihydrate)
5 mg
Cov muaj mob: mannitol, calcium phosphate dihydrate, pob kws hmoov txhuv, pregelatinized pob kws hmoov txhuv nplej siab, colloidal silicon dioxide, magnesium stearate.
30 pcs - hlwv (1) - pob khoom los ntawm cardboard.
Cov ntsiav tshuaj yog lub teeb daj hauv xim, puag ncig, tiaj-cylindrical, muaj qhov pheej hmoo ntawm ib sab.
1 tab
lisinopril (nyob rau hauv daim ntawv ntawm dihydrate)
10 mg
Cov muaj mob: mannitol, calcium phosphate dihydrate, pob kws hmoov txhuv, pregelatinized pob kws hmoov txhuv, daj hlau oxide zas xim (E172), colloidal silicon dioxide, magnesium stearate.
30 pcs - hlwv (1) - pob khoom los ntawm cardboard.
Peach-kob ntsiav tshuaj, puag ncig, tiaj-cylindrical, muaj kev pheej hmoo ntawm ib sab.
1 tab
lisinopril (nyob rau hauv daim ntawv ntawm dihydrate)
20 mg
Cov tsis muaj zog: mannitol, calcium phosphate dihydrate, pob kws nplej siab, pregelatinized pob kws hmoov txhuv, daj hlau zas xim (E172), zas xim liab hlau (E172), colloidal silicon dioxide, magnesium stearate.
30 pcs - hlwv (1) - pob khoom los ntawm cardboard.
Cov lus piav qhia ntawm cov tshuaj yog ua raws cov lus qhia raug pom zoo rau kev siv.
Pharmacological kev txiav txim siab Irumed
ACE inhibitor. Cov tshuaj antihypertensive. Qhov kev ua haujlwm ntawm kev coj ua yog txuam nrog kev txwv tsis pub ACE kev ua haujlwm, uas ua rau kev tawm tsam ntawm kev tsim cov tshuaj angiotensin II los ntawm angiotensin I thiab txo qis ncaj qha rau kev tso tawm aldosterone. Txo cov kev ua haujlwm ntawm bradykinin thiab nce cov synthesis ntawm prostaglandins.
Txo OPSS, ntshav siab, preload, siab nyob rau hauv cov hlab ntsws capillaries, ua rau nce ntshav cov feeb thiab nce kev tawm dag zog hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev. Lisinopril muaj cov nyhuv vasodilating, thaum nthuav cov hlab ntsha mus rau ntau dua li cov leeg ntshav. Qee qhov cuam tshuam tau piav qhia los ntawm cov nyhuv rau cov ntaub so ntswg renin-angiotensin. Txhim kho cov ntshav xa mus rau ischemic myocardium. Nrog rau siv ntev, hypertrophy ntawm myocardium thiab phab ntsa ntawm cov hlab ntsha ntawm hom tiv thaiv poob qis.
Kev siv ACE inhibitors nyob rau hauv cov neeg mob uas mob plawv tsis txaus ua rau muaj kev cia siab ntxiv hauv lub neej, hauv cov neeg mob uas tau myocardial infarction, yam tsis muaj kev soj ntsuam kev mob plawv tsis txaus, mus rau kev txhim kho qeeb ntawm sab laug ventricular kawg.
Qhov pib ntawm kev ua tau sau tseg 1 teev tom qab noj tshuaj, qhov siab tshaj plaws pom tau tom qab 6-7 teev, lub sijhawm ua haujlwm yog 24 teev. Nrog rau kev kub siab, cov nyhuv pom tau nyob rau thawj hnub tom qab pib kho, qhov ua haujlwm ruaj khov tshwm sim tom qab 1-2 lub hlis.
Nrog kev ncua tsis meej ntawm cov tshuaj, qhov cim nce siab hauv ntshav siab tsis pom. Ntxiv rau qhov txo qis ntshav siab, lisinopril txo cov albuminuria. Hauv cov neeg mob hyperglycemia, nws pab ua kom lub cev ua haujlwm ntawm glomerular endothelium tsis ua haujlwm. Lisinopril tsis cuam tshuam rau lub plasma glucose concentration nyob rau hauv cov neeg mob ntshav qab zib mellitus thiab tsis ua rau muaj kev nce ntxiv hauv cov neeg mob ntshav qab zib.
Pharmacokinetics ntawm cov tshuaj.
Tom qab noj cov tshuaj hauv, kwv yees li 25% ntawm lisinopril yog nqus los ntawm cov hnyuv plab. Noj mov tsis cuam tshuam rau qhov nqus ntawm lisinopril. Kev nqus tau yog qhov nruab nrab 30%. Bioavailability yog 29%. Cmax hauv ntshav tau txog tom qab kwv yees li 6-8 teev.
Tsis muaj zog ua txhua yam rau cov protein plasma. Lisinopril ib nyuag nkag mus rau ntawm BBB, dhau ntawm qhov muab tso rau hauv qhov chaw.
T1 / 2 - 12 teev. Lisinopril tsis yog metabolized thiab ua rau tsis txawv txav ntawm cov zis.
Kev taw qhia rau kev siv:
- arterial hypertension (nyob rau hauv daim ntawv ntawm monotherapy los yog ua ke nrog lwm cov tshuaj antihypertensive),
- mob plawv tsis ua hauj lwm (raws li ib feem ntawm txoj kev kho ua ke rau kev kho mob ntawm cov neeg mob noj digitalis thiab / lossis diuretics),
- kev kho mob thaum ntxov ntawm tus mob myocardial infarction (raws li ib feem ntawm kev sib xyaw ua ke hauv thawj 24 teev hauv cov neeg mob uas tsis muaj peev xwm tiv thaiv hemodynamic, kom tswj cov ntsuas no thiab tiv thaiv sab laug ventricular kawg thiab lub plawv tsis ua haujlwm),
- mob ntshav qab zib nephropathy (kom txo tau cov kab mob albuminuria hauv kev tiv thaiv cov kab mob insulin-cov neeg mob ntshav siab thiab cov neeg mob tsis haum tshuaj muaj kev mob ntshav siab).
Dosage thiab txoj hauv kev ntawm kev tswj hwm tshuaj.
Cov tshuaj yog tshuaj ntawm qhov ncauj. Kev noj mov tsis cuam tshuam rau kev nqus, yog li cov tshuaj muaj peev xwm noj ua ntej, thaum lossis tom qab noj mov. Qhov ntau zaus ntawm kev tswj hwm yog 1 zaug / hnub (kwv yees nyob rau tib lub sijhawm).
Hauv kev kho mob ntawm qhov kub siab tseem ceeb, nws raug nquahu kom pib kho thawj zaug ntawm 10 mg. Kev saib xyuas txij nkawm yog 20 mg / hnub. Qhov nyiaj pab ntau tshaj txhua hnub yog 40 mg. Rau tag nrho txoj kev loj hlob ntawm cov nyhuv, ib lub sijhawm 2-4 lub lim tiam ntawm kev kho nrog cov tshuaj yuav tsum tau (qhov no yuav tsum tau coj mus rau hauv qhov kev xav thaum nce ntxiv). Yog tias siv cov tshuaj hauv qhov siab tshaj plaws tsis ua rau muaj kev kho mob txaus, tom qab ntawd yuav tau siv tshuaj ntxiv ntawm lwm tus neeg sawv cev tiv thaiv kab mob siab.
Rau cov neeg mob noj cov tshuaj diuretics, kho nrog diuretics yuav tsum tau txiav 2-3 hnub ua ntej pib kho nrog Irumed. Rau cov neeg mob uas nws tsis tuaj yeem cheem kev kho mob nrog diuretics, Iramed yog kho hauv thawj koob tshuaj 5 mg / hnub.
Yog tias kev kho lub plawv tawg lossis lwm yam kev mob nrog kev ua haujlwm ntawm renin-angiotensin-aldosterone system, Irumed raug kho nyob rau hauv thawj zaug ntawm 2.5-5 mg / hnub nyob rau hauv kev tswj hwm ntawm ntshav siab, raum kev ua haujlwm, poov tshuaj concentration hauv cov ntshav. Cov kev saib xyuas txij nkawm yog tsim raws li ntshav siab.
Hauv cov neeg mob uas mob raum tsis ua haujlwm thiab cov neeg mob rau mob hemodialysis, cov koob tshuaj thawj zaug tau teem raws li QC. Tus saib xyuas txij nkawm yog txiav txim siab los ntawm ntshav siab (nyob rau hauv kev tswj hwm ntawm lub raum kev ua haujlwm, cov poov tshuaj thiab sodium qib hauv cov ntshav).
QC
Thawj hnub txhaj
30-70 ml / min
5-10 mg
10-30 ml / feeb
2.5-5 mg
2013-03-20
Cov Txheej Txheem Pom Zoo Irumed
- keeb kwm ntawm angioedema (suav nrog nrog siv tshuaj ACE inhibitors),
- txais keeb kwm Quincke lub edema,
- hnub nyoog txog 18 xyoo (qhov ua tau zoo thiab kev nyab xeeb tsis tau tsim tsa),
- cev xeeb tub
- ua kom txo tau cov tshuaj lisinopril thiab lwm yam ACE inhibitors,
Nrog ceev faj cov tshuaj yuav tsum yog rau kev tiv thaiv mob aortic stenosis, hypertrophic cardiomyopathy, ob leeg lub raum artery stenosis, tib lub raum artery stenosis nrog cov mob azotemia, nyob rau hauv cov xwm txheej tom qab hloov raum, thawj hyperaldosteronism, mob ntshav siab, pob txha caj qaum hypoplasia, hyponatremia hauv cov neeg mob uas muaj kev pheej hmoo ntawm kev loj hlob ntawm kev noj zaub mov kom txhob muaj ntsev ntau los yog ntsev tsawg), hyperkalemia, tej yam kev mob uas muaj los ntawm qhov kev txo qis hauv cov ntshav ncig (xws li mob raws plab, ntuav), cov kab mob sib txuas ntawm cov nqaij mos (nrog rau cov kab mob lupus erythematosus, scleroderma), mob ntshav qab zib mellitus, gout, hyperuricemia, IHD, cerebrovascular tsis txaus, cov neeg laus.
Kev pom zoo rau kev siv
Cov tshuaj yog tshuaj ntawm qhov ncauj. Kev noj mov tsis cuam tshuam rau kev nqus, yog li cov tshuaj muaj peev xwm noj ua ntej, thaum lossis tom qab noj mov. Ntau lub sijhawm pub nkag 1 zaug nyob rau ib hnub (kwv yees tib lub sijhawm).
Ntawm kev kho mob tawg tshwj xeeb Qhov pom zoo thawj zaug ntawm 10 mg yog qhov pom zoo. Qhov tshuaj nruab nrab cov tshuaj nruab nrab yog 20-40 mg rau ib hnub. Qhov nyiaj pab ntau tshaj txhua hnub yog 80 mg.
Rau cov neeg mob noj cov tshuaj diuretics, koob tshuaj tau xaiv ib tus zuj zus, vim tias cov neeg mob zoo li no yuav ua rau muaj ntshav siab lossis qis qis hauv cov ntshav ncig, uas tuaj yeem ua rau txoj kev loj hlob ntawm cov tsos mob hypotension. Kev kho mob nrog cov tshuaj diuretics yuav tsum tsis txhob ncua 2-3 hnub ua ntej pib kho nrog Irumed thiab, yog tias tsim nyog, rov qab pib tom qab xaiv cov koob tshuaj Irumed, nyob ntawm qhov xwm txheej kho mob. Rau cov neeg mob uas nws tsis tuaj yeem nres kev kho mob nrog diuretics, Iramed yog raug kho hauv thawj koob tshuaj 5 mg / hnub, txuas ntxiv nce nws nce raws li kev kho mob thiab tiv taus tshuaj. Yog tias tsim nyog, kev kho mob nrog diuretics tuaj yeem rov ua dua.
Kev siv ntawm Irumed thaum cev xeeb tub thiab lactation
Kev siv ntawm Irumed thaum cev xeeb tub yog contraindicated. Lisinopril hla kev tso chaw nyob nruab nrab.
Yog tias cev xeeb tub tshwm sim, kev kho nrog Iromed yuav tsum nres tam sim ntawd, tshwj tsis yog tias muaj txiaj ntsig rau leej niam tshaj qhov muaj feem yuav ua rau muaj menyuam hauv plab (tus neeg mob yuav tsum tau txais kev ceeb toom txog kev pheej hmoo rau tus menyuam hauv plab). Kev lees txais ntawm ACE inhibitors nyob rau hauv II thiab III trimesters ntawm cev xeeb tub tuaj yeem ua rau tuag ntawm tus menyuam thiab tus menyuam tshiab. Hauv cov menyuam mos yug tshiab, pob txha taub hau hypoplasia, oligohydramnios, kev hloov kho ntawm pob txha ntawm pob txha taub hau thiab ntsej muag, hypoplasia ntawm lub ntsws, thiab kev txhim kho lub raum tsis zoo. Rau cov menyuam mos thiab cov menyuam mos uas nws niam tau noj los ntawm ACE inhibitors thaum cev xeeb tub, nws raug nquahu tias yuav tau saib xyuas kom zoo kom ncav sijhawm kom paub tseeb tias yuav txo cov ntshav siab, oliguria, hyperkalemia.
Tsis muaj ntaub ntawv qhia txog kev nkag mus ntawm lisinopril rau hauv niam mis. Thaum kho nrog Irumed, nws yog ib qho tsim nyog yuav tsum tshem tawm kev pub mis niam.
Irumed yog ACE inhibitor. Cov tshuaj antihypertensive. Qhov kev ua haujlwm ntawm kev coj ua yog txuam nrog kev txwv tsis pub ACE kev ua haujlwm, uas ua rau kev tawm tsam ntawm kev tsim cov tshuaj angiotensin II los ntawm angiotensin I thiab txo qis ncaj qha rau kev tso tawm aldosterone. Txo cov kev ua haujlwm ntawm bradykinin thiab nce cov synthesis ntawm prostaglandins.
Txo OPSS, ntshav siab, preload, siab nyob rau hauv cov hlab ntsws capillaries, ua rau nce ntshav cov feeb thiab nce kev tawm dag zog hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev. Lisinopril muaj cov nyhuv vasodilating, thaum nthuav cov hlab ntsha mus rau ntau dua li cov leeg ntshav. Qee qhov cuam tshuam tau piav qhia los ntawm cov nyhuv rau cov ntaub so ntswg renin-angiotensin. Txhim kho cov ntshav xa mus rau ischemic myocardium. Nrog rau siv ntev, hypertrophy ntawm myocardium thiab phab ntsa ntawm cov hlab ntsha ntawm hom tiv thaiv poob qis.
Kev siv ACE inhibitors hauv cov neeg mob plawv tsis zoo ua rau muaj kev cia siab ntxiv hauv lub neej, hauv cov neeg mob tom qab myocardial infarction, yam tsis muaj kev soj ntsuam kev mob plawv tsis txaus, ua rau muaj kev cuam tshuam qeeb ntawm sab laug ventricular kawg.
Qhov pib ntawm kev nqis tes yog sau tseg 1 teev tom qab noj tshuaj, qhov siab tshaj plaws pom tau tom qab 6-7 teev, lub sijhawm ua haujlwm yog 24 teev. Nrog rau kev kub siab, cov nyhuv raug pom nyob rau thawj hnub tom qab pib kho, qhov ua haujlwm ruaj khov tshwm sim tom qab 1-2 lub hlis.
Sab sij huam Irumed
Los ntawm cov kab mob plawv: cim tau txo qis hauv cov ntshav siab, mob hauv siab, orthostatic hypotension, tachycardia, bradycardia, cov tsos mob hnyav zuj zus ntxiv ntawm lub plawv tsis ua haujlwm, kho tsis tau AV conduction, myocardial infarction.
Los ntawm lub plab zom mov: mob plab, qhov ncauj qhuav, dyspepsia, mob tsis nco qab, saj hloov, kab mob pancreatitis, kab mob siab hepatocellular lossis cholestatic mob siab, mob daj ntseg, nce kev ua haujlwm ntawm hepatic transaminases, hyperbilirubinemia.
Los ntawm sab hauv lub hauv nruab nrab ntawm cov hlab hlwb: lability ntawm mus ob peb vas, tsis meej pem, paresthesia, tsaug zog, tawv nqaij ntshiv ntawm cov leeg ntawm nqaj thiab daim di ncauj, asthenic syndrome, tsis meej pem.
Los ntawm tus txheej txheem ua pa: dyspnea, bronchospasm, apnea.
Ntawm feem ntawm daim tawv nqaij: urticaria, tawm hws, plaub hau poob, photosensitivity.
Los ntawm cov kabmob hemopoietic: leukopenia, thrombocytopenia, neutropenia, agranulocytosis, ntshav txhaws (tsis muaj hematocrit, erythrocytopenia).
Los ntawm genitourinary system: uremia, oliguria / anuria, lub raum tsis ua haujlwm, mob raum tsis ua haujlwm, txo qis potency.
Kev tsis haum tshuaj: angioedema ntawm lub ntsej muag, nqua ceg, daim di ncauj, tus nplaig, epiglottis thiab / lossis lub qhov ntsej muag, ua pob rau ntawm daim tawv nqaij, khaus, kub cev, cov tshuaj tiv thaiv kab mob zoo tshuaj tiv thaiv kab mob, nce ESR, eosinophilia, leukocytosis.
Lwm yam: hyperkalemia, hyponatremia, hyperuricemia, arthralgia, myalgia.
Feem ntau ntawm cov neeg mob, cov kev mob tshwm sim tau mob me me thiab sij hawm dhau mus.
Nws yuav tsum tau yug los rau hauv lub siab tias qhov cim tseg txo cov ntshav siab tshwm sim nrog qhov txo qis hauv lub cev los ntawm kev kho diuretic, nrog rau cov ntsev hauv cov zaub mov tsawg dua, thaum lub cev lim ntshav thiab rau cov neeg mob raws plab lossis ntuav. Hauv cov neeg mob uas muaj lub plawv mob tsis ua hauj lwm nrog lub raum tsis ua haujlwm lossis tsis muaj nws, cov tsos mob hypotension tshwm sim, feem ntau pom tau hauv cov neeg mob lub plawv tsis ua hauj lwm loj, vim kev siv cov tshuaj loj ntawm diuretic, hyponatremia, lossis ua rau lub raum tsis ua haujlwm. Hauv cov neeg mob no, kev kho yuav tsum tau pib los ntawm kev tswj hwm ntawm tus kws kho mob (nrog ceev faj, xaiv ib koob tshuaj thiab tshuaj diuretics). Yuav tsum tau ua ib qho kev qhia zoo sib xws thaum teem sijhawm Irumed rau cov neeg mob uas muaj mob rau cov hlab ntshav ntawm lub cev, tsis muaj ntshav tawm ntawm lub cev, tsis txaus ntshav nce siab tuaj yeem ua rau myocardial infarction lossis mob stroke.
Kev tsim kho ntawm kev cim tseg txo ntshav siab, tus neeg mob yuav tsum tau muab txoj hauj lwm tav toj thiab, yog tias tsim nyog, iv 0.9% sodium chloride tov. Kev hloov pauv hypotensive tsis yog kev sib kis rau kev noj cov tshuaj txuas ntxiv ntawm cov tshuaj.
Thaum siv Irumed hauv qee cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev ntev, tab sis nrog ib txwm los sis qis ntshav siab, qhov txo qis hauv ntshav yuav tshwm sim, uas feem ntau tsis yog lub laj thawj rau kev kho mob. Nyob rau hauv rooj plaub arterial hypotension dhau los ua tsos mob, nws yog qhov tsim nyog los txo cov koob tshuaj lossis txiav kev kho mob nrog Irumed.
Hauv cov mob myocardial infarction, kev siv cov qauv kev kho mob (thrombolytics, acetylsalicylic acid, beta-blockers) yog qhia. Iramed tuaj yeem siv nrog kev tswj hwm kev siv dej khov lossis nrog rau kev siv cov tshuab hloov pauv transdermal nitroglycerin.
Hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev, qhov cim tseg ntawm cov ntshav siab tom qab pib kho nrog ACE inhibitors tuaj yeem ua rau cov ntshav tsis zoo ntxiv mus. Cov xwm txheej ntawm kev loj hlob ntawm qhov mob raum tsis zoo thaum siv ACE inhibitors tau sau tseg. Hauv cov neeg mob uas muaj ob lub raum mob ntshav liab los yog txoj hlab ntshav ntawm lub raum ib leeg tau kho nrog ACE inhibitors, muaj qhov nce ntshav ntawm urea thiab creatinine, feem ntau yog qhov thim rov qab tom qab tsis kho kev kho mob (ntau dua li cov neeg mob lub raum tsis ua haujlwm).
Cov neeg mob noj tshuaj ACE inhibitors, suav nrog lisinopril, tsis tshua muaj kev txhim kho angioedema ntawm lub ntsej muag, nqaj, daim di ncauj, tus nplaig, epiglottis thiab / lossis lub suab nrov, thiab nws txoj kev loj hlob yog qhov ua tau txhua lub sijhawm thaum kho. Hauv qhov no, kev kho mob nrog Irumed yuav tsum nres sai li sai tau thiab tus neeg mob yuav tsum tau saib xyuas kom txog thaum tus tsos mob rov qab ua tiav. Txawm li cas los xij, nyob rau kis mob edema tsuas yog tshwm sim ntawm lub ntsej muag thiab daim di ncauj thiab tus mob feem ntau ib txwm tsis muaj kev kho mob, antihistamines tuaj yeem kho tau.
Nrog kev sib kis ntawm cov mob caj dab mus rau tus nplaig, mob epiglottis lossis larynx, kev thaiv cov hlab pas yuav tshwm sim, yog li, kev kho tsim nyog thiab / lossis kev ntsuas yuav tsum tau ua kom paub tseeb tias thaiv cov hlab cua. Nws tau sau tseg tias nyob rau hauv cov neeg mob ntawm cov haiv neeg Negroid noj ACE inhibitors, angioedema tau tsim muaj ntau dua rau cov neeg mob ntawm lwm haiv neeg. Hauv cov neeg mob uas muaj keeb kwm mob hlwb tsis yog cuam tshuam nrog kev kho mob yav dhau los nrog ACE inhibitors, kev pheej hmoo ntawm nws txoj kev loj hlob thaum kho nrog Iramed yuav raug nce.
Hauv cov neeg mob noj tshuaj ACE inhibitors, thaum lub sijhawm tso siab rau cov tshuaj hymenopter (nkawj, muv, ntsaum thiab lwm yam hymenoptera), qhov tshuaj tiv thaiv anaphylactoid tuaj yeem tsis tshua muaj tshwm sim. Qhov no tuaj yeem zam tau los ntawm kev ncua kev saib xyuas ib ntus nrog ACE inhibitor ua ntej txhua qhov kev tshem tawm.
Nws yuav tsum tau yug los rau hauv lub siab tias nyob rau hauv cov neeg mob noj ACE inhibitors thiab tab tom mob hemodialysis siv high-permeability dialysis membranes, qhov tshuaj tiv thaiv anaphylactic yuav pib loj tuaj. Hauv cov xwm txheej zoo li no, nws yog ib qho tsim nyog yuav tau xav txog kev siv qhov sib txawv ntawm daim nyias nyias rau cov tshuaj lim ntshav lossis lwm cov tshuaj tiv thaiv kab mob siab.
Thaum siv ACE inhibitors, hnoos tau sau tseg (qhuav, ntev ntev, uas ploj tom qab kev tseg rau kev kho mob nrog ACE inhibitor). Hauv kev kuaj xyuas qhov sib txawv ntawm hnoos, hnoos tshwm sim los ntawm kev siv tshuaj ACE inhibitor yuav tsum raug txiav txim siab.
Thaum siv cov tshuaj uas txo cov ntshav siab rau cov neeg mob nrog kev phais mob ntau los yog thaum lub sijhawm tso tshuaj loog, lisinopril tuaj yeem thaiv kev tsim cov tshuaj angiotensin II, qhov thib ob nrog kev hwm rau kev ua kom rov qab zoo li qub. Lub cim txo qis hauv cov ntshav siab, uas yog suav tias yog qhov tshwm sim ntawm lub tshuab no, tuaj yeem tshem tawm los ntawm qhov nce ntawm qhov ntim ntawm cov ntshav ncig.
Hauv qee kis, pom muaj hyperkalemia. Txoj hauv kev pheej hmoo rau kev loj hlob ntawm hyperkalemia muaj xws li lub raum tsis ua haujlwm, mob ntshav qab zib mellitus thiab kev siv tam sim no ntawm cov tshuaj potassium-sparing diuretics (spironolactone, triamteren lossis amiloride), potassium npaj lossis ntsev hloov pauv muaj cov poov tshuaj, tshwj xeeb tshaj yog nyob hauv cov neeg mob uas lub raum tsis ua haujlwm. Yog tias tsim nyog, kev siv ntawm cov kev sib txuas no yuav tsum ua ntu zus saib qib ntawm cov poov tshuaj hauv ntshav cov ntshav.
Hauv cov neeg mob uas muaj kev pheej hmoo ntawm kev tsim cov tsos mob hypotension (ntawm kev noj zaub mov kom tsis muaj ntsev los yog ntsev tsawg) nrog lossis tsis muaj hyponatremia, zoo li hauv cov neeg mob uas tau txais cov tshuaj diuretics zoo, cov xwm txheej saum toj no yuav tsum tau them ua ntej kev kho mob (poob kua thiab ntsev).
Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab
Tsis muaj cov ntaub ntawv hais txog cov nyhuv ntawm Irumed, thov hauv kev siv tshuaj kho mob, ntawm kev muaj peev xwm tsav tsheb thiab cov txheej txheem, tab sis nws yuav tsum tau yug los hauv lub siab tias kiv taub hau yog ua tau.
Cov tsos mob cim txo nyob rau hauv cov ntshav siab.
Kev Kho Mob: nws yog qhov tsim nyog los ua kom ntuav thiab / los yog yaug lub plab, rau yav tom ntej, kev kho mob cov tsos mob yog nqa los kho cov dej qhuav thiab cuam tshuam hauv dej-ntsev sib npaug. Nrog arterial hypotension, ib qho tshuaj isotonic yuav tsum muab tshuaj, vasopressors tau sau tseg. Tej zaum kev siv cov tshuaj hemodialysis.Cov tsos mob cim txo nyob rau hauv cov ntshav siab.
Kev Kho Mob: nws yog qhov tsim nyog los ua kom ntuav thiab / los yog yaug lub plab, rau yav tom ntej, kev kho mob cov tsos mob yog nqa los kho cov dej qhuav thiab cuam tshuam hauv dej-ntsev sib npaug. Nrog arterial hypotension, ib qho tshuaj isotonic yuav tsum muab tshuaj, vasopressors tau sau tseg. Tej zaum kev siv cov tshuaj hemodialysis.
Nrog rau kev siv ua ib txhij nrog Irumed nrog potassium-sparing diuretics (spironolactone, triamteren, amiloride), cov tshuaj potassium npaj, ntsev hloov pauv muaj cov poov tshuaj, qhov kev pheej hmoo ntawm hyperkalemia nce, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob uas lub raum tsis ua haujlwm.
Nrog rau kev siv ua ntu zus ntawm Irumed nrog diuretics, qhov cim tseg txo hauv cov ntshav siab yog sau tseg.
Nrog rau kev siv ua ib txhij ntawm Irumed nrog lwm cov tshuaj tiv thaiv kabmob, ib qho kev tiv thaiv ntxiv tau sau tseg.
Nrog rau kev siv tib txhij ntawm Irumed nrog NSAIDs, estrogens, cov nyhuv antihypertensive ntawm lisinopril txo.
Nrog rau kev siv tib lub sij hawm ntawm Irumed nrog lithium, lithium excretion los ntawm lub cev maj mam poob qis.
Nrog rau kev siv ua ntu zus ntawm Irumed nrog antacids thiab colestyramine, qhov nqus ntawm lisinopril hauv cov hnyuv hauv lub cev yog txo qis.
Tsis muaj kev cuam tshuam tseem ceeb ntawm pharmacokinetic nyob rau hauv cov mob uas lisinopril tau siv nrog propranolol, digoxin, lossis hydrochlorothiazide.
Cov tshuaj yuav tsum khaws cia ntawm qhov kub txog 25 ° C. Hnub tas sij hawm: 3 xyoos.
Cov tshuaj Irmed: cov lus qhia rau kev siv
Irumed yog tus neeg sawv cev hypotensive siv rau hauv kev kho kab mob ntshav siab thiab lwm yam kab mob ntawm lub plawv thiab cov hlab ntsha cuam tshuam nrog kev nce siab hauv cov hlab ntsha. Yog tias siv tsis raug, nws tuaj yeem ua rau muaj kev phom sij txog lub neej, yog li koj tuaj yeem pib noj tshuaj tsuas yog kev tso cai ntawm tus kws kho mob.
Lub Npe Tsis Muaj Npe International
Lisinopril - lub npe ntawm cov tshuaj nquag ntawm cov tshuaj.
Irumed yog ib qho yeeb tshuaj hypotensive siv rau hauv kev kho kab mob ntshav siab thiab lwm yam kab mob pathologies ntawm lub plawv thiab cov hlab ntshav.
С09АА03 - cai rau kev tso tawm tswv yim-kho-tshuaj lom cov tshuaj lom neeg.
Tso cov ntaub ntawv thiab cov nyob ua ke
Cov tshuaj muaj cov ntsiav tshuaj daim ntawv tso tawm. Cov qov ntawm cov ntsiav tshuaj suav nrog:
- lisinopril dihydrate (10 lossis 20 mg),
- mannitol
- cov hmoov txhuv nplej siab
- calcium phosphate dihydrate,
- hlau oxide daj,
- silicon dioxide anhydrous,
- pregelatinized qos hmoov txhuv nplej siab
- magnesium stearate.
Cov ntsiav tshuaj muab nkag rau hauv 30-cell polymeric hlwb, uas tau muab tso rau hauv cov thawv ntawv los ua ke nrog cov lus qhia.
Dab tsi yog xaj tshuaj
Cov lus qhia rau kev teem caij ntawm Irumed yog:
- kub siab (raws li tsuas yog kho tus neeg sawv cev lossis hauv kev sib xyaw nrog lwm cov tshuaj),
- mob plawv tsis ua hauj lwm (ua ke nrog diuretics lossis plauv plawv glycosides),
- kev tiv thaiv thiab kho myocardial infarction (nyob rau thawj hnub cov tshuaj raug tswj los tswj cov hemodynamic thiab kev tiv thaiv cov mob plawv),
- mob ntshav qab zib rau lub raum (kom txo qis ntawm cov tshuaj albumin ua rau tso zis hauv cov neeg muaj ntshav qab zib hom 1 thiab ntshav qab zib hom 2).
Nosological kev faib tawm (ICD-10)
| Ntsiav tshuaj | 1 tab. |
| yam tshuaj: |
| lisinopril dihydrate (hais txog lisinopril anhydrous) | 10/20 mg |
| kev tshem tawm (10 mg): mannitol, calcium phosphate dihydrate, pob kws hmoov txhuv, pregelatinized pob kws hmoov txhuv, daj hlau oxide zas xim (E172), colloidal silicon dioxide, magnesium stearate |
| kev tshem tawm (20 mg): mannitol, calcium phosphate dihydrate, pob kws hmoov txhuv, pregelatinized pob kws hmoov txhuv, daj hlau oxide zas (E172), liab hlau oxide zas xim (E172), colloidal silicon dioxide, magnesium stearate |
Tsuas tshuaj thiab tswj hwm
Sab hauv ua ntej lossis tom qab noj mov, 1 zaug nyob rau ib hnub, nyiam dua nyob rau tib lub sijhawm.
Qhov tseem ceeb tawg. Qhov tshuaj thawj zaug yog 10 mg ib hnub ib zaug, kev saib xyuas txij nkawm yog 20 mg / hnub, thiab qhov ntau tshaj yog 40 mg / hnub.
Rau tag nrho txoj kev loj hlob ntawm cov nyhuv, ib lub sijhawm 2 week4-lub lim tiam ntawm kev kho nrog cov tshuaj yuav tsum tau (qhov no yuav tsum tau coj mus rau hauv qhov kev txiav txim siab thaum nce ntxiv) Yog tias siv cov tshuaj hauv qhov siab tshaj plaws tsis ua rau muaj kev kho mob txaus, tom qab ntawd yuav tau siv tshuaj ntxiv ntawm lwm tus neeg sawv cev tiv thaiv kab mob siab.
Hauv cov neeg mob uas tau txais diuretics yav dhau los, nws yog ib qho tsim nyog yuav tsum tshem lawv li 2-3 hnub ua ntej pib siv tshuaj. Yog tias nws tsis tuaj yeem tshem tawm cov tshuaj diuretics, qhov pib ntawm lisinopril yuav tsum tsis pub ntau tshaj 5 mg / hnub.
Thaum lub txim kho tshiab tawg lossis lwm yam mob nrog RAAS ua haujlwm ntau ntxiv. Cov tshuaj Iramed ® tau muab tshuaj rau thawj zaug ntawm 2.5-5 mg / hnub nyob rau hauv kev tswj ntshav siab, raum kev ua haujlwm, poov tshuaj concentration hauv cov ntshav cov ntshav.
Cov kev saib xyuas txij nkawm yog tsim raws li ntshav siab.
Hauv cov neeg mob raum tsis ua haujlwm thiab cov neeg mob rau mob hemodialysis, koob thawj zaug tau teeb tsa nyob ntawm Cl qib ntawm creatinine. Tus saib xyuas txij nkawm yog txiav txim siab los ntawm ntshav siab (nyob rau hauv kev tswj hwm ntawm lub raum kev ua haujlwm, cov poov tshuaj thiab sodium qib hauv cov ntshav).
Koob tshuaj rau raum tsis ua hauj lwm. Koob tshuaj yog txiav txim siab nyob ntawm Cl tus nqi ntawm creatinine, raws li qhia hauv qab rooj.
| Cl creatinine, ml / min | Thaum pib koob tshuaj, mg / hnub |
| 30–70 | 5–10 |
| 10–30 | 2,5–5 |
| lub lis piam |
Thaum pib kho lossis thaum thawj 3 hnub tom qab muaj mob myocardial ntau hauv cov neeg mob uas muaj SBP tsawg (120 hli Hg lossis qis dua), koob tshuaj qis dua 2.5 mg yuav tsum raug kho. Thaum muaj ntshav nce siab li qis (SBP ≤100 mm Hg), qhov tshuaj txhua hnub ntawm 5 mg tuaj yeem, yog tias tsim nyog, yuav tsum raug txo ib pliag mus rau 2.5 mg. Yog tias lub cim ntev dhau los ua kom txo tau cov ntshav siab (CAD mm Hg ntau dua li 1 teev), kev kho tshuaj yuav tsum tsis ua ntxiv.
Ntshav qab zib nephropathy. Hauv cov neeg mob uas tsis mob ntshav qab zib tsis yog insulin, 10 mg ntawm lisinopril yog siv ib hnub ib zaug. Yog tias tsim nyog, qhov koob tshuaj yuav raug nce ntxiv rau 20 mg ib hnub ib zaug txhawm rau kom ua tiav cov txiaj ntsig dAD hauv qab 75 hli Hg. hauv ib txoj hauj lwm zaum.
Hauv cov neeg mob uas muaj ntshav qab zib insulin-tiv thaiv kev mob ntshav qab zib - tib cov tshuaj yog siv kom ua tiav cov nqi hauv qab qis dua 90 hli Hg. hauv ib txoj hauj lwm zaum.
Chaw tsim tshuaj paus
BELUPO, tshuaj thiab tshuaj pleev ib ce dd, Koom pheej ntawm Croatia. 48000, Koprivnitsa, st. Danica, 5.
Tus sawv cev chaw ua haujlwm ntawm BELUPO, tshuaj thiab tshuaj pleev ib ce dd, koom pheej ntawm Croatia hauv Russia (chaw nyob rau cov lus tsis txaus siab): 119330, Moscow, 38 Lomonosovsky Prospect, apt. 71–72.
Xov Tooj: (495) 933-72-13, fev: (495) 933-72-15.
