Cov lus qhia Tritace rau siv, contraindications, phiv, tshuaj xyuas

Tshuaj tiv thaiv kab mob siab, ACE inhibitor
Tshuaj: YOOJ YIM
Cov tshuaj nquag ntawm cov tshuaj: ramipril
Kev saib xyuas ATX: C09AA05
KFG: ACE inhibitor
Reg. tooj: P No. 016132/01
Hnub sau npe: 12.29.04
Tswv reg reg. acc: AVENTIS PHARMA Deutschland GmbH

Daim ntawv tso tawm Tritace, ntim tshuaj thiab muaj pes tsawg leeg.

Cov ntsiav tshuaj yog oblong, lub teeb daj hauv xim nrog cov cim qhia ntawm ob sab thiab sau nrog "2.5 / stylized duab ntawm tsab ntawv h" thiab "2.5 / HMR" ntawm qhov tod tes.
1 tab
ramipril
2.5 mg

Cov muaj mob: hypromellose, pregelatinized hmoov txhuv nplej siab, microcrystalline cellulose, sodium stearyl fumarate, xim daj hlau zas.

14 pcs. - blister packagings (2) - pob ntawv los ntawm cardboard.

Cov ntsiav tshuaj yog oblong, lub teeb liab nyob rau hauv xim nrog muab cov cim ntawm ob sab thiab sau nrog "5 / stylized duab ntawm tsab ntawv h" thiab "5 / HMR" nyob rau sab nraud.

1 tab
ramipril
5 mg

Cov muaj mob: hypromellose, pregelatinized hmoov txhuv nplej siab, microcrystalline cellulose, sodium stearyl fumarate, hlau zas xim liab oxide.

14 pcs. - blister packagings (2) - pob ntawv los ntawm cardboard.

Cov lus piav qhia ntawm cov tshuaj yog ua raws cov lus qhia raug pom zoo rau kev siv.

Pharmacological action Tritace

Tshuaj tiv thaiv kab mob siab, ACE inhibitor. Ramiprilat, ib qho tshuaj lom metabolite ntawm ramipril, yog ACE ua rau muaj kev tiv thaiv ntev. Hauv cov ntshav thiab cov nqaij mos, qhov enzyme catalyzes hloov dua siab tshiab ntawm angiotensin I rau angiotensin II (ib qho vasoconstrictor) thiab rhuav tshem ntawm vasodilator nquag bradykinin. Ib qho kev txo qis ntawm kev tsim cov tshuaj angiotensin II thiab kev nce siab hauv kev ua si ntawm bradykinin ua rau vasodilation thiab pab txhawb cov hlab plawv thiab cov nyhuv endothelioprotective ntawm ramipril.

Angiotensin II stimulates kev tso tawm ntawm aldosterone, hauv qhov no, ramipril ua rau txo qis ntawm aldosterone secretion.

Noj ramipril ua rau muaj kev txo qis tseem ceeb hauv OPSS, feem ntau yam tsis muaj kev hloov pauv hauv cov ntshav lub raum thiab cov ntshav kev txhaws. Kev noj ramipril ua rau txo qis ntshav siab ob qho tib si rau hauv txoj hauj lwm supine thiab hauv txoj haujlwm sawv tsis muaj qhov txwv txiav rau lub plawv dhia. Cov nyhuv antihypertensive pib 1-2 teev tom qab noj ib qho tshuaj ib zaug ntawm cov tshuaj thiab mob siab rau 24 teev. Qhov siab tshaj plaws antihypertensive nyhuv ntawm Tritace loj hlob tau feem ntau los ntawm 3-4 lub lim tiam ntawm kev tswj hwm cov tshuaj thiab tau khaws cia ntev. Kev txiav tsis noj ib pliag tam sim ntawd tsis siv tshuaj tiv thaiv cov ntshav siab sai thiab tseem ceeb.

Kev siv cov tshuaj txo cov neeg tuag (suav nrog kev tuag sai), qhov pheej hmoo ntawm lub plawv tsis ua haujlwm ntau, txo cov tsev kho mob ntau ntau ntawm cov neeg mob uas muaj cov tsos mob ntawm kev mob plawv tsis ua haujlwm tom qab mob myocardial infarction.

Hauv cov neeg mob uas muaj ntshav qab zib thiab tsis mob ntshav qab zib hais qhia nephropathy, cov tshuaj txo tus nqi ntawm kev muaj mob ntawm lub raum tsis ua hauj lwm, thiab nyob rau ntawm qhov theem preclinical uas mob ntshav qab zib thiab mob ntshav qab zib nephropathy, ramipril txo albuminuria.

Cov tshuaj pom zoo cuam tshuam rau cov metabolism hauv cov metabolism thiab lipid profile, ua rau txo qis ntawm myocardial hypertrophy thiab leeg ntshav phab ntsa.

Pharmacokinetics ntawm cov tshuaj.

Tom qab kev tswj hwm ntawm qhov ncauj, nws nqus tawm ntawm lub plab zom mov (50-60%). Khoom noj khoom haus tsis muaj kev cuam tshuam tag nrho ntawm kev nqus, tab sis poob qis dua nqus.

Cmax ntawm ramipril thiab ramiprilat tau mus txog hauv cov ntshav plasma tom qab 1 thiab 3 teev, raws li.

Kev faib khoom thiab cov metabolism

Ua lub prodrug, ramipril yauv yauv ua kom lub cev muaj zog ntawm cov metabolism hauv presystemic (feem ntau yog nyob hauv daim siab los ntawm hydrolysis), vim tias nws tsuas yog ua kom cov metabolite, ramiprilat, tsim. Ntxiv nrog rau qhov tsim ntawm qhov kev nquag ntawm metabolite, glucuronidation ntawm ramipril thiab ramiprilat cov ntaub ntawv tsis muaj zog metabolites - ramipril diketopiperazine thiab ramiprilat diketopiperazine. Ramiprilat muaj kwv yees li ntawm 6 npaug ntau dua nyob rau hauv inhibiting ACE dua li ramipril.

Kev khi ntawm ramipril rau plasma protein yog 73%, ramiprilata - 56%.

Vd ntawm ramipril thiab ramiprilat yog kwv yees li 90 litres thiab 500 litres.

Tom qab ib hnub, ib zaug saib xyuas ib zaug tshuaj nyob rau hauv ib koob ntawm 5 mg Css hauv ntshav, nws tau mus txog rau hnub 4. Lub plasma concentration ntawm ramiprilate txo nyob rau hauv ntau theem: qhov pib faib thiab nthuav tawm theem ntawm ramiprilat nrog T1 / 2 kwv yees li 3 teev, tom qab ntawd nruab nrab theem nrog ramiprilat T1 / 2 lub sijhawm kwv yees li 15 teev thiab theem kawg nrog qhov tsis tshua muaj siab ntawm ramiprilat hauv ntshav thiab T1 / 2 ramiprilata kwv yees li 4-5 hnub. Qeb kawg no yog cuam tshuam nrog qeeb kev sib cuam tshuam ntawm ramiprilat vim kev koom nrog ACE receptors. Txawm hais tias lub sijhawm ntev dhau los nrog kev txhaj tshuaj ib zaug ntawm ramipril ntawm koob tshuaj 2.5 mg lossis ntau dua Css, cov concentration ntawm ramiprilat hauv ntshav tau mus txog tom qab li 4 hnub ntawm kev kho mob.

Nrog rau chav kawm ntawm qhov tshuaj T1 / 2 yog 13-17 teev.

Thaum noj, kwv yees li 60% ntawm cov tshuaj nquag tawm hauv cov zis thiab li 40% nrog cov kua tsib, nrog tsawg dua 2% ua rau tsis hloov pauv.

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Tritace muaj nyob hauv daim foos:

2.5 mg ntsiav tshuaj: lub teeb daj, oblong, ntawm ob sab nrog tus cim thiab kos duab (ntawm ib sab - "2.5" thiab tsab ntawv stylized h, nyob rau sab nraud - "2.5" thiab HMR) (14 daim ib qho) .u blisters, hauv cardboard ntim ob lub hlwv),
5 mg ntsiav tshuaj: lub teeb liab hauv cov xim nrog sib dua los yog tsaus dua, suav nrog, ntawm ob sab nrog tus cim thiab engraving (ntawm ib sab - "5" thiab cov ntawv stylized h, nyob rau lwm qhov - "5" thiab HMR) (14 txhua) pcs hauv blisters, hauv ib lub thawv ob blisters),
10 mg ntsiav tshuaj: yuav luag dawb lossis dawb, oblong, ntawm ob sab nrog tus nqis thiab "constrictions" ntawm ob sab hauv thaj tsam ntawm kev pheej hmoo, sau rau ntawm ib sab (HMO / HMO) (14 pcs. Hauv blisters, hauv ib lub thawv sawv hlwv).

Composition 1 ntsiav tshuaj:

cov tshuaj nquag: ramipril - 2.5, 5 lossis 10 mg,
Cov khoom ua haujlwm pabcuam: microcrystalline cellulose, hypromellose, sodium stearyl fumarate, pregelatinized starch, daj hlau oxide zas xim (2.5 mg ntsiav tshuaj), liab hlau oxide zas (5 mg ntsiav tshuaj).

Kev ntsuas rau siv

CHF (mob plawv tsis ua haujlwm ntev) - hauv txoj kev kho mob nyuaj, suav nrog nrog kev muab tshuaj kho mob,
lub plawv tsis ua hauj lwm uas tsim los ntawm 2 txog 9 hnub tom qab mob myocardial infarction,
tseem ceeb arterial tawg,
nce kev pheej hmoo ntawm cov hlab plawv (cov neeg mob muaj keeb kwm ntawm mob stroke, nrog paub tseeb txog kab mob plawv thiab keeb kwm ntawm myocardial infarction, nrog peripheral arterial occlusive lesions, muaj ntshav qab zib mellitus thiab tsawg kawg yog ib qho kev pheej hmoo ntxiv) - kom txo qis kev mob plawv kev pheej hmoo ntawm kev tsim mob stroke lossis myocardial infarction,
nephropathy (mob ntshav qab zib lossis tsis mob ntshav qab zib), suav nrog cov proteinuria hnyav.

Cov Yuav Tsum Tau Ua

ntshav siab (systolic ntshav siab tsawg dua 90 hli Hg), nrog rau cov xwm txheej tsis zoo tsis ruaj khov hemodynamic,
CHF nyob rau theem ntawm decompensation (vim tias muaj cov ntaub ntawv tsis txaus ntawm kev siv hauv kev soj ntsuam),
hypertrophic obstructive cardiomyopathy lossis hemodynamically tseem ceeb stenosis ntawm mitral lossis aortic valve,
unilateral (nrog ib lub raum) lossis ob sab sib luag hemodynamically raum leeg ntshav hlab ntsha,
nephropathy (hauv kev kho mob ntawm immunomodulators, tshuaj tsis-steroidal anti-inflammatory, glucocorticosteroids thiab / lossis lwm yam tshuaj cytotoxic, vim tias muaj cov ntaub ntawv tsis txaus ntseeg),
hemodialysis (vim tias tsis muaj kev khomob hauv lub chaw khomob),
mob raum tsis ua haujlwm,
hemofiltration lossis hemodialysis siv lub cev muaj zog (polyacrylonitrile membranes) siab (vim muaj kev pheej hmoo ntawm kev tsis haum lub siab),
keeb kwm ntawm angioedema,
hyposensitizing kev kho mob rau qhov ua haujlwm tsis haum rau wasp thiab muv venoms,
apheresis ntawm LDL (qis lipoproteins tsawg), uas siv dextran sulfate (vim tias muaj kev phom sij rau qhov tsis haum lub zog),
thawj hyperaldosteronism,
cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog qis dua 18 xyoo (vim tsis muaj kev ntsuam xyuas mob dhau los),
lub sijhawm cev xeeb tub thiab pub niam mis,
muaj qhov tsis haum rau ib qho twg ntawm kev siv tshuaj lossis lwm yam tshuaj tiv thaiv ACE.

Hauv kev mob siab ntawm myocardial infarction, Tritace kuj tseem contraindicated hauv qab no:

lub plawv dhia
lub siab tsis ruaj ntseg,
lub plawv dhia tsis zoo
txoj sia tu ventricular arrhythmias.

Tus txheeb ze (Daim duab yog siv nrog ceev faj):

ua rau lub siab ua haujlwm tsis zoo (muaj peev xwm ua kom tsis muaj zog lossis nce siab ntxiv ntawm ramipril),
lub raum ua haujlwm tsis zoo rau me los mus rau mob hnyav
postoperative lub sijhawm tom qab hloov raum,
mob ntshav qab zib mellitus
hyperkalemia
cirrhosis ntawm daim siab nrog edema thiab ascites,
tej yam kev mob ntshav qis ua rau muaj kev phom sij ntxiv (piv txwv li, nrog cov leeg txhab ntawm lub hlwb thiab cov hlab ntshav txhaws),
cov kab mob ntawm cov kab mob sib txuas (scleroderma, cov kab mob lupus erythematosus, nrog rau kev kho cov tshuaj uas muaj peev xwm ua rau muaj kev hloov pauv hauv daim duab peripheral ntshav),
tej yam kev mob hauv kev ua haujlwm ntawm RAAS (renin-angiotensin-aldosterone system) nce, thiab thaum ACE raug tiv thaiv, muaj kev pheej hmoo ntawm cov ntshav tsis txaus thiab ua rau lub raum tsis ua haujlwm (mob plawv tsis txaus, ntshav khiav ceev, ua kom cov dej-electrolyte tshuav, ua ntej siv cov tshuaj diuretic, thiab lwm yam) .),
lub hnub nyoog dhau los (vim tias muaj kev pheej hmoo ntawm cov nyhuv hypotensive nce).

Tsuas tshuaj thiab tswj hwm

Tritace tablets yog noj qhov ncauj tsis tas yuav zom thiab haus dej ntau. Kev noj tshuaj tsis yog nyob ntawm lub sijhawm noj mov. Cov koob tshuaj yog xaiv ib tus zuj zus coj mus rau hauv tus account lub siab ntev ntawm cov tshuaj thiab cov txiaj ntsig tshwm sim los kho. Txoj kev kho mob feem ntau yog kav ntev, thiab nws lub sijhawm raug txiav txim siab los ntawm kws kho mob.

Pom zoo kom noj koob tshuaj ntawm Tritace nrog lub siab thiab lub raum ua haujlwm:

CHF: koob thawj zaug yog 1.25 mg ib hnub ib zaug, yav tom ntej, coj mus rau hauv tus account qhov ua siab ntev ntawm cov tshuaj, nws muaj peev xwm ua ob npaug rau koob tshuaj txhua 1-2 lub lis piam, koob tshuaj txhua hnub tau txais, yog tias ntau dua 2.5 mg, tuaj yeem faib ua ob koob tshuaj, qhov siab tshaj plaws yog 10 mg rau ib hnub,
lub plawv tsis ua hauj lwm uas tau tsim nyob rau hauv ob peb hnub tom qab myocardial infarction: koob tshuaj thawj zaug - 5 mg ib hnub nyob rau hauv ob txoj kev faib (thaum sawv ntxov thiab yav tsaus ntuj), nrog kev tsis haum rau thawj koob tshuaj (ntau dhau ntawm cov ntshav siab), nws raug nquahu kom txo nws thiab muab rau tus neeg mob 2 hnub , 5 mg ntawm cov tshuaj ib hnub hauv ob zaug muab faib. Hauv ob peb hnub tom qab no, muab los ntawm tus neeg mob cov tshuaj tiv thaiv, koj tuaj yeem nce lub koob tshuaj los ntawm ob zaug nws nyob rau hauv txhua 2-3 hnub, qhov siab tshaj plaws yog 10 mg ib hnub,
qhov tseem ceeb ntawm txoj hlab ntshav siab: qhov kev xav thawj zaug yog 2.5 mg ib hnub ib zaug (thaum sawv ntxov), yog tias nyob rau 3 lossis ntau lub lim tiam ntawm kev kho mob hauv thawj qhov kev kho mob tsis txaus siab, tsis tuaj yeem ua rau nce lub koob tshuaj rau 5 mg ib hnub, tom qab lwm 2-3 lub lis piam ntawm kev kho mob, thaum tsis muaj txiaj ntsig ntawm kev siv tshuaj txhua hnub ntawm 5 mg, koob tshuaj Tritace yog ob npaug rau qhov siab tshaj plaws pom zoo, uas yog 10 mg ib hnub twg, lossis sab laug zoo li qub, tab sis lwm cov tshuaj tiv thaiv antihypertensive ntxiv rau kev kho mob,
kev txo qis kev mob plawv thiab kev pheej hmoo mob stroke lossis myocardial infarction hauv cov neeg mob uas muaj kev pheej hmoo mob plawv ntau dua: 2.5 mg ib hnub ib zaug thaum pib kho, tom qab ntawd cov tshuaj tiv thaiv kab mob nce ntxiv, suav txog qhov tshuaj tiv thaiv kev quav tshuaj, muab ob npaug rau koob tom qab 1 lub lis piam, thiab dhau 3 lub lis piam tom ntej no, nqa mus rau qhov kev saib xyuas ib txwm, uas yog 10 mg rau ib hnub hauv ib koob,
nephropathy yog mob ntshav qab zib lossis tsis mob ntshav qab zib: thawj koob yog 1.25 mg ib hnub ib zaug, yav tom ntej nws muaj peev xwm nce qhov ntau ntxiv rau 5 mg ib zaug ib hnub, kev siv Tritace hauv kev txhaj tshuaj ntau dua hauv cov mob no tsis to taub zoo.

Thaum lub cev tsis muaj peev xwm ua lub raum (kev ua kom zoo ntawm 50–20 ml / min) thiab mob siab, hauv cov neeg mob nrog kev kho mob yav dhau los nrog cov diuretics, cov neeg laus laus, cov neeg mob ntshav siab tsis zoo, tsis tiav kho los ntawm kev xau ntawm electrolytes thiab kua dej, nrog rau cov uas muaj kev txo qis heev. ntshav siab tawm tsam qee qhov kev pheej hmoo, qhov pib koob ntawm Tritace yuav tsum tsis pub tshaj 1.25 mg rau ib hnub.

Yog tias lub raum ua rau lub raum tsis zoo, qhov ntau kawg yuav tsum tsis pub ntau tshaj 5 mg, thiab rau lub siab ua haujlwm tsis zoo - tsis pub ntau tshaj 2.5 mg.

Sab sij huam

plab zom mov: feem ntau - lub plab zom mov, xeev siab, ntuav, tsis xis nyob hauv plab, mob tshwm sim hauv cov hnyuv thiab lub plab, raws plab, dyspepsia, qee zaum - qhov ncauj qhov ncauj qhuav, kab mob rau lub plab, mob plab, mob plab, mob plab, mob plab, mob hnyuv angioedema, nce pancreatic enzyme kev ua si, tsis tshua muaj - mob ntawm tus nplaig, tsis paub ntau zaus - mob plab,
kev mob plawv: feem ntau - orthostatic hypotension, ntau dhau los ntawm cov ntshav siab, tsaus muag, qee zaum - cov tsos lossis kev cuam tshuam ntawm cov neeg tsis muaj zog, tsis nco qab, txhawm rau tsis tuaj yeem, mob ntshav siab, txhaws ntawm lub ntsej muag, tachycardia, tsis tshua muaj - vasculitis, circulatory ntshawv siab, nquag tsis paub txog. Raynaud's syndrome
cov kab mob ua pa: feem ntau - ua pa luv, mob ntsws, ua paug hnoos, mob ntsws, qee zaum - txhaws ntswg, bronchospasm (suav nrog kev cuam tshuam ntawm tus mob ntsws asthma),
kev ua haujlwm hauv lub hauv nruab nrab: feem ntau - ib qho kev xav ntawm lub siab nyob hauv lub taub hau, mob taub hau, qee zaum - ib qho kev ua txhaum lossis poob ntawm saj tsis hnov qab, pw tsaug zog, muaj kev ntxhov siab, tsaug zog, tsaug zog, kiv taub hau, ntxhov siab, lub cev muaj zog, poob siab, tsis tshua - tsis meej pem, tsis txaus, tshee tsis paub - tsis hnov qab ntawm cov ntxhiab tsw, kab ntsig, tsis hnov lus thiab hnov qab psychomotor, cerebral ischemia,
yam khoom ntawm lub zeem muag thiab hnov lus: qee zaum - pom kev tsis sib haum, suav nrog cov duab plooj plooj, tsis tshua pom - kab mob pob ntseg, hnov lus tsis zoo, mob pob ntseg,
musculoskeletal system: feem ntau - mob leeg, mob leeg, qee zaum - mob pob qij txha,
kev ua me nyuam thiab cov qog mammary: qee zaum - txo qis libido, mob tsis muaj zog, tsis paub ntau zaus - gynecomastia,
cov kab mob zis: qee zaum - polyuria, muaj proteinuria ntau zog, lub raum khiav tsis zoo, nce siab ntawm creatinine thiab urea hauv cov ntshav,
hepatobiliary system: qee zaum - nce kev ua haujlwm ntawm daim siab enzymes, tsis tshua muaj - kab mob siab hepatocellular, cholestatic jaundice, qhov ntau zaus tsis paub txog - cytolytic lossis cholestatic mob siab, mob siab tsis ua haujlwm,
hematopoietic system: qee zaum - eosinophilia, tsis tshua muaj - thrombocytopenia, leukopenia, txo qis hemoglobin concentration, qhov tsawg ntawm cov qe ntshav liab tsawg, qhov ntau zaus tsis paub - pancytopenia, inhibition ntawm hematopoiesis hauv cov leeg pob txha, ntshav tsawg ntshav,
cov roj ntsha thiab cov kev ntsuas hauv lub zog: feem ntau - kev nce siab ntawm cov poov tshuaj hauv cov ntshav, qee zaum - poob qis ntawm lub cev tsis qab los, tsis nco qab, qhov ntau zaus tsis paub txog - qhov txo qis ntawm cov tshuaj sodium,
kev tiv thaiv kabmob hauv lub cev: dhau los tsis paub - anaphylactoid lossis tshuaj tiv thaiv anaphylactic, nce ntxiv ntawm cov tshuaj tiv thaiv kab mob,
daim tawv nqaij thiab mob rau hauv daim tawv nqaij: feem ntau - ua pob rau ntawm daim tawv nqaij, qee zaum - khaus, Quincke's edema, hyperhidrosis, tsis tshua muaj - urticaria, exfoliative dermatitis, exfoliation ntawm cov ntsia hlau, tsis tshua muaj tshwm sim - qhov tsis haum tshuaj, ntau zaus tsis paub - erythema multiforme, psoriasis-zoo li dermatitis, exfoliation ntawm cov ntsia hlau phaj, tsis tshua muaj tshwm sim - qhov tsis haum tshuaj, ntau zaus tsis paub - erythema multiforme, psoriasis zoo li dermatitis, , pemphigus, alopecia, Stevens-Johnson syndrome, lichen-zoo li lossis pemphigoid pob, paug ntawm psoriasis,
cov kev tawm tsam: feem ntau - zoo nkaus li qaug zog, mob hauv siab, qee zaum - ua npaws, tsis tshua muaj - asthenic syndrome.

Cov lus qhia tshwj xeeb

Ua ntej siv Tritace, hypovolemia thiab hyponatremia yuav tsum tau muab tshem tawm. Yog tias tus neeg mob noj cov tshuaj diuretics, lawv yuav tsum raug tshem tawm lossis cov koob tshuaj txo 2-3 hnub ua ntej pib kev kho mob ramipril.

Tom qab noj thawj zaug ntawm Tritace thiab nrog txhua qhov nce hauv nws cov koob tshuaj thiab / lossis koob tshuaj diuretics noj tib lub sijhawm, kev saib xyuas kev kho mob ntawm tus neeg mob yuav tsum tau xyuas kom meej yam tsawg kawg 8 teev, yog li ntawm kev txiav txim siab ntau dhau ntawm cov ntshav siab, ntsuas tau sijhawm.

Nrog rau cov ntshav siab tshaj plaws thiab lub plawv tsis ua haujlwm, tshwj xeeb tshaj yog mob myocardial infarction, kev kho mob nrog ramipril yuav tsum pib hauv cov tsev kho mob tshwj xeeb xwb.

Hauv cov neeg mob uas lub plawv tsis ua hauj lwm, noj Tritace tuaj yeem ua rau txo cov ntshav siab ntau, qee zaum nrog azotemia lossis oliguria, thiab qee zaus, mob raum tsis ua haujlwm.

Nyob rau hauv huab cua kub thiab / lossis thaum tawm dag zog lub cev, qhov kev pheej hmoo ntawm lub cev qhuav dej thiab nce tawm hws, uas tuaj yeem ua rau txo qis ntawm cov dej qab ntsev ntawm cov ntshav thiab txo qis ntim ntawm cov ntshav ncig, thiab, yog li ntawd, txhawm rau txhim kho cov hlab ntsha hypotension.

Thaum kho, nws tsis pom zoo kom haus dej haus cawv kom tsawg.

Xws li kev txhim kho cov mob caj pas, mob hauv zej zog hauv lub ntsws, pharynx thiab tus nplaig, noj Tritace yuav tsum nres tam sim ntawd thiab nqis tes los tiv thaiv qhov mob o.

Ua ntej kev phais mob, suav nrog kev phais hniav, nws yog ib qho tsim nyog ceeb toom cov kws kho mob txog kev siv ACE inhibitors.

Cov menyuam mos uas tau tso cov ntshav nrog tus mob ramipril yuav tsum ua tib zoo saib kom paub txog oliguria, hyperkalemia, thiab hypotension arterial.

Hauv thawj 3-6 lub hlis ntawm kev kho mob nrog Tritace, nws yog ib qho tsim nyog los soj ntsuam lub raum kev ua haujlwm, lub zog electrolyte, lub zog hematological, kev ua rau daim siab enzyme thiab bilirubin concentration hauv cov ntshav.

Thaum kho nrog cov tshuaj, ib qho yuav tsum tsis kam tsav tsheb thiab ua haujlwm rau lwm cov kev phom sij, vim tias kiv taub hau, hnov qab tsis tau, thiab qhov ceev ntawm psychomotor cov tshuaj tiv thaiv yuav tshwm sim thaum noj Tritace.

Yeeb tshuaj sib cuam tshuam

Cov tshuaj tsis pom zoo kom noj ib txhij nrog cov tshuaj potassium-sparing diuretics thiab ntsev ntsev.

Thaum ua ke nrog cov tshuaj uas txo cov ntshav siab (tricyclic antidepressants, diuretics, nitrates, thiab lwm yam), lub zog ntawm cov nyhuv hypotensive yog pom.

Narcotic, tshuaj mob taub hau thiab tshuaj tsaug zog tuaj yeem ua rau txo cov ntshav siab ntau dua.

Vasopressor sympathomimetics txo cov nyhuv hypotensive ntawm Tritace.

Immunosuppressants, cytostatics, systemic glucocorticosteroids, procainamide, allopurinol thiab lwm yam tshuaj uas cuam tshuam rau cov hematological tsis ua rau muaj kev pheej hmoo ntawm kev tsim leukopenia.

Nrog rau kev siv ua ke nrog insulin thiab tshuaj tiv thaiv kab mob hypoglycemic, nws yog ib qho ua tau los nce cov nyhuv hypoglycemic ntawm cov tshuaj no.

Qhov sib xyaw ua ke nrog cov roj ntsha lithium ua rau muaj kev nce ntxiv ntawm cov dej lithium concentration thiab qhov nce ntawm neurotoxic thiab cardiotoxic cov teebmeem ntawm lithium.

Nonsteroidal anti-inflammatory tshuaj tuaj yeem ua rau tsis muaj zog ntawm Tritace, ntxiv rau qhov nce ntshav ntau ntxiv ntawm cov poov tshuaj thiab nce qhov ntxim nyiam ntawm lub raum lub ntsej muag.

Nrog rau kev siv ua ke nrog ethanol, vasodilation thiab lub txiaj ntsig tsis zoo ntawm ethanol ntawm lub cev yog kho kom zoo.

Estrogens thiab sodium chloride ua kom cov nyhuv tsis muaj zog ntawm ramipril.

Kev sib xyaw nrog heparin tuaj yeem ua rau nce siab ntau ntxiv rau hauv potassium.

Cov lus piv txwv ntawm Tritace yog: Amprilan, Dilaprel, Ramipril, Ramipril-SZ, Pyramil, Khartil.

Dosage thiab txoj hauv kev ntawm kev tswj hwm tshuaj.

Cov tshuaj tau noj ntawm qhov ncauj. Cov ntsiav tshuaj yuav tsum nqos tag nrho (tsis yog zom) ua ntej, thaum lub sijhawm noj mov lossis tom qab noj mov thiab ntxuav nrog cov dej txaus (1/2 khob) ntawm cov dej. Cov koob tshuaj tau suav nyob ntawm qhov xav tias yuav kho kom tau txais txiaj ntsig thiab kev sib thev ntawm cov tshuaj rau cov neeg mob hauv txhua kis.

Yog tias tus neeg mob tau txais cov tshuaj diuretics, tom qab ntawd lawv yuav tsum raug tshem tawm 2-3 hnub (nyob ntawm lub sijhawm ntawm kev ua ntawm diuretics) ua ntej pib kho nrog Tritace, lossis tsawg kawg txo qhov koob tshuaj diuretics noj.

Xws li lub raum ua rau lub raum tsis zoo (CC 50-20 ml / min / 1.73 m2 ntawm lub cev nqaij daim tawv), qhov pib koob yog 1.25 mg. Qhov nyiaj pab ntau tshaj txhua hnub yog 5 mg.

Yog tias ua rau lub siab ua haujlwm tsis zoo, qhov ntau tshaj plaws txhua hnub yog 2.5 mg.

Hauv cov neeg mob yav dhau los noj cov tshuaj diuretics, qhov pib txhaj yog 1.25 mg.

Yog tias nws tsis tuaj yeem ua tiav kom tshem tawm qhov kev ua txhaum ntawm cov dej-electrolyte sib npaug ntawm kev mob ntshav siab, ntxiv rau cov neeg mob rau cov tshuaj tiv thaiv hypotensive ua rau muaj qee qhov kev pheej hmoo (piv txwv li, txo qis ntshav txaus vim qhov nqaim ntawm cov hlab ntshav ntawm lub plawv lossis hlab ntsha hlab ntsha), cov koob tshuaj thaum pib yog 1.25 mg.

CC tuaj yeem xam tau siv ntsuas qhov ntsuas cov cim creatinine raws li cov qauv mis hauv qab no (kab zauv Cockcroft):

Lub cev hnyav (kg) x (140 - hnub nyoog)

72 x ntshiab creatinine (mg / dl)

rau cov poj niam: khij qhov tshwm sim tau hauv cov kab zauv saum toj no los ntawm 0.85.

Kev kho mob Tritace feem ntau yog ntev thiab nws lub sijhawm hauv txhua kis tau txiav txim los ntawm tus kws kho mob.

Hauv kev kho mob ntshav siab, cov tshuaj yog tawm 1 lub sijhawm / hnub, koob tshuaj thawj zaug yog 2.5 mg, yog tias tsim nyog, qhov koob tshuaj tau kho ob npaug tom qab 2-3 lub lis piam, nyob ntawm tus neeg mob cov lus teb rau txoj kev kho, kev saib xyuas txhua hnub koob yog 2.5-5 mg, thiab qhov siab tshaj plaws niaj hnub noj yog 10 mg

Hauv kev kho mob ntawm kev mob plawv tsis zoo, qhov pib tshuaj rau txhua hnub yog -1.25 mg 1 zaug / hnub. Nyob ntawm tus neeg mob cov lus teb, cov tshuaj tuaj yeem nce ntxiv. Nws raug nquahu kom txhaj ob npaug ntawm kev ncua sijhawm 1-2 lub lis piam. Cov koob tshuaj ntawm 2.5 mg lossis ntau dua yuav tsum noj ib zaug lossis faib ua 2 zaug. Qhov nyiaj pab ntau tshaj txhua hnub yog 10 mg.

Hauv kev kho mob ntawm mob plawv tsis ua hauj lwm tom qab myocardial infarction, thawj koob tshuaj yog 5 mg hauv 2 koob - 2.5 mg thaum sawv ntxov thiab yav tsaus ntuj. Yog tias qhov tshuaj no tsis txaus siab, nws yuav tsum raug txo kom 1.25 mg 2 zaug / hnub rau 2 hnub. Yog tias muaj kev nce ntxiv, nws raug nquahu kom faib ua 2 zaug hauv thawj 3 hnub. Tom qab ntawd, tag nrho cov koob tshuaj txhua hnub, pib muab faib ua 2 koob tshuaj, tuaj yeem noj ib zaug los noj ib zaug. Qhov nyiaj pab ntau tshaj txhua hnub yog 10 mg.

Hauv kev mob plawv mob ntshav hnyav (IV degree raws li NYHA kev faib tawm) tom qab myocardial infarction, cov tshuaj tau tawm ntawm koob tshuaj 1.25 mg 1 zaug / hnub. Hauv pawg no ntawm cov neeg mob, nce cov koob tshuaj yuav tsum tau nrog ceev faj.

Hauv kev kho mob ntshav qab zib thiab tsis mob ntshav qab zib nephropathy, kev noj tshuaj thawj zaug yog 1.25 mg 1 zaug / hnub. Cov koob tshuaj saib xyuas yog 2.5 mg. Nrog rau qhov nce ntxiv rau hauv koob tshuaj, nws yuav tsum tau muab doubled nrog qhov luv ntawm 2-3 lub lis piam. Qhov nyiaj pab ntau tshaj txhua hnub yog 5 mg.

Txhawm rau tiv thaiv myocardial infarction, mob hlab ntsha tawg lossis "mob tuag rau txoj hlab ntshav", kev txhaj tshuaj thawj zaug yog 2.5 mg 1 zaug / hnub. Cov koob tshuaj yuav tsum tau nce ntxiv los ntawm nws ob npaug tom qab 1 lub lim tiam ntawm kev kho mob. Tom qab 3 lub lis piam, cov koob tshuaj tuaj yeem nce ntxiv 2 zaug, qhov kev txhaj tshuaj ntau tshaj yog 10 mg.

Sab Cuam Tshuam ntawm Tritace:

Los ntawm cov kab mob tso zis: muaj ntshav ntau, muaj hypercreatininemia (tshwj xeeb nrog kev kho mob tib txhij), ua rau lub raum khiav tsis zoo, lub raum tsis ua haujlwm, tsis tshua muaj - hyperkalemia, proteinuria, hyponatremia, muaj proteinuria ntau dua lossis tso zis ntau ntxiv.

Ntawm ib feem ntawm cov hlab plawv: tsis tshua - muaj qhov cim txo qis hauv cov ntshav siab, postural hypotension, myocardial lossis cerebral ischemia, myocardial infarction, arrhythmia, syncope, ischemic stroke, transient cerebral ischemia, tachycardia, peripheral edema (hauv pob qij txha).

Kev tsis haum tshuaj: kev mob caj dab ntawm lub ntsej muag, daim di ncauj, tawv muag, tus nplaig, lub ntsej muag thiab / lossis lub suab nrov, liab ntawm daim tawv nqaij, qhov hnov ntawm tshav kub, mob pob txha, khaus, urticaria, lwm yam tawm pob rau ntawm daim tawv nqaij lossis cov qog ua kua (maculopapular exanthema thiab enanthema, erythema multiforme) (suav nrog Stevens-Johnson syndrome), pemphigus (pemphigus), serositis, exacerbation ntawm tus mob psoriasis, mob ua paug rau tus mob (Lyell syndrome), onycholysis, photosensitivity, qee zaum alopecia, kev txhim kho ntawm Raynaud's syndrome, nce titer ntawm cov tshuaj tiv thaiv kev tiv thaiv kab mob. , eosinophilia, vasculitis, myalgia, arthralgia, mob caj dab.

Los ntawm cov kab mob ua pa: feem ntau - qhov hnoos qhuav qhuav, mob heev dua thaum hmo ntuj thaum tus neeg mob nyob hauv kab rov tav, feem ntau nws tshwm sim hauv cov poj niam thiab cov tsis haus luam yeeb (nyob rau qee kis, hloov ACE inhibitor yog siv tau). Yog tias hnoos tsis tu ncua, yuav tsum tshem tawm cov tshuaj tawm tuaj. Ua tau - catarrhal rhinitis, sinusitis, mob ntsws, bronchospasm, dyspnea.

Los ntawm lub plab zom mov: xeev siab, mob epigastric, nce kev ua si ntawm daim siab thiab mob hlab ntsha enzymes, bilirubin, tsis tshua muaj cholestatic jaundice, mob plab zom mov, ntuav, raws plab, cem quav thiab tsis qab los noj mov, hloov pauv (saj "hlau" saj), txo qis saj qhov kev hnov thiab qee zaum txawm tias tsis hnov qab, qhov ncauj qhuav, stomatitis, glossitis, pancreatitis, tsis tshua muaj - kev mob ntawm txoj hnyuv plab hnyuv, mob plab hnyuv, ua kom lub siab tsis zoo, nrog kev loj hlob tau ntawm kev mob siab tsis ua haujlwm. ochnosti.

Los ntawm cov kab mob hemopoietic: tsis tshua muaj - kev txo qis ntawm cov ntshav liab thiab txo qis ntshav tsawg los ntawm mob me mus rau qhov tseem ceeb, thrombocytopenia thiab leukopenia, qee zaum neutropenia, agranulocytosis, pancytopenia, hemolytic anemia.

Los ntawm sab hauv nruab nrab ntawm lub hauv nruab nrab lub paj hlwb thiab mob hlwb: tsis txaus, mob taub hau, poob siab, tshee tshee, pw tsaug zog, ntxhov siab, ntxhov siab, ntxhov siab, ntxhov siab, mob plab, mob leeg.

Los ntawm cov khoom hauv lub siab: qhov ua kom lub cev tsis haum, ua kom tsis hnov tsw, tsis hnov tsw, hnov lus thiab lub zeem muag, pom kev.

Lwm yam: txo qis erection thiab tsav pw ua ke, ua npaws.

Siv thaum cev xeeb tub thiab lactation.

Cov tshuaj Tritace yog contraindicated hauv kev xeeb tub. Yog li, ua ntej pib kev kho, nco ntsoov tias tsis muaj menyuam hauv plab.

Yog tias tus neeg mob tau xeeb tub hauv lub sijhawm kho, nws yog ib qho tsim nyog los hloov Tritace nrog lwm cov tshuaj sai li sai tau. Txwv tsis pub, muaj qhov pheej hmoo ntawm cov me nyuam puas tsuaj, tshwj xeeb tshaj yog nyob rau thawj thawj peb hlis thaum cev xeeb tub. Nws tau pom tias cov tshuaj ua rau kev txhim kho tsis zoo ntawm lub raum ntawm lub cev, txo cov ntshav siab ntawm lub cev xeeb tub thiab cov menyuam yug tshiab, lub raum tsis ua haujlwm, hyperkalemia, pob txha taub hau hypoplasia, oligohydramnios, ceg tawv kev sib deev, pob txha taub hau deformation, mob ntsws hypoplasia.

Rau cov menyuam yug tshiab uas raug rau cov tshuaj tiv thaiv ACE inhibitors, nws raug nquahu kom saib xyuas txhua qhov kom paub txog txoj kev kho ntshav tshiab, txoj kab mob ntshav qab zib thiab hyperkalemia. Hauv oliguria, nws yog qhov tsim nyog los tswj cov ntshav siab thiab lub raum zoo nkauj los ntawm kev qhia cov kua dej kom tsim nyog thiab vasoconstrictors. Hauv cov menyuam mos thiab menyuam mos, muaj kev pheej hmoo ntawm tus mob oliguria thiab hlab ntsha hlwb, tej zaum yuav ua rau lub raum thiab ntshav hlwb khiav qis vim qhov ntshav nce qis los ntawm ACE inhibitors (tau los ntawm cov poj niam cev xeeb tub thiab tom qab yug menyuam). Pom zoo kom pom zoo.

Yog tias nws yog qhov yuav tsum tau muab los ua Daim Ntawv Tritace thaum lactation, yuav tsum tsis txhob pub mis.

Cov lus qhia tshwj xeeb rau kev siv Tritace.

Kev kho mob Tritace feem ntau yog siv ntev, nws lub sijhawm hauv txhua kis txiav txim los ntawm tus kws kho mob. Nws tseem yuav tsum tau saib xyuas kev kho mob tsis tu ncua, tshwj xeeb hauv cov neeg mob uas lub siab thiab lub raum tsis ua haujlwm. Nws feem ntau pom zoo tias lub cev qhuav dej, hypovolemia, lossis ntsev tsis muaj peev xwm raug kho ua ntej kev kho.

Yog tias muaj xwm txheej ceev, kev kho mob nrog cov tshuaj tuaj yeem pib lossis txuas ntxiv yog tias muaj kev tiv thaiv tsim nyog thaum tib lub sijhawm los tiv thaiv kom tsis txhob poob siab ntau hauv cov ntshav siab thiab lub raum tsis ua haujlwm.

Nws yog qhov tsim nyog los tswj lub raum ua haujlwm, tshwj xeeb tshaj yog nyob rau thawj lub lim tiam ntawm kev kho mob. Hauv cov neeg mob uas mob raum lub raum (piv txwv, nrog lub raum leeg mob raum tseem tsis tau muaj kev kho mob tseem ceeb, lossis muaj cov teeb meem tsis muaj ntshav tsis muaj ntshav tsis txaus) los ntawm kev tsis zoo lub raum kev ua haujlwm, zoo ib yam li cov neeg mob uas tau hloov raum mob raum, yuav tsum tau saib xyuas tshwj xeeb.

Ntshav dej ntsev thiab sodium ntau yuav tsum tau saib xyuas tsis tu ncua. Hauv cov neeg mob uas lub raum tsis zoo, yuav tsum tau soj ntsuam ntau dua ntawm cov ntsuas no.

Nws yog qhov tsim nyog los tswj cov leukocytes (kuaj mob ntawm leukopenia). Tshwj xeeb kev tshuaj xyuas tas li yog pom zoo thaum pib kho, nrog rau cov neeg mob uas muaj kev pheej hmoo - txog li 1 zaug hauv ib hlis hauv thawj 3-6 lub hlis ntawm kev kho mob hauv cov neeg mob uas muaj kev pheej hmoo ntawm neutropenia - nrog kev tsis zoo lub raum kev ua haujlwm, cov kab mob ntawm cov nqaij sib txuas lossis tau txais kev txhaj tshuaj siab diuretics, thiab tseem nyob rau thawj cov tsos mob ntawm tus mob.

Raws li kev lees paub ntawm neutropenia (neutrophil suav tsawg dua 2000 / μl), ACE inhibitor txoj kev kho yuav tsum tsis ua mus ntxiv.

Yog tias muaj cov cim qhia tias tsis muaj zog tiv thaiv vim yog leukopenia (piv txwv li kub cev, mob qog ntshav, tonsillitis), yuav tsum tau soj ntsuam ceev cov duab peripheral ntshav yog qhov tsim nyog. Nyob rau hauv cov ntaub ntawv ntawm cov cim los ntshav (tsawg tshaj plaws petechiae, liab-xim av ua pob rau daim tawv nqaij thiab cov qog ua kua), nws tseem yuav tsum tswj hwm cov platelets hauv cov ntshav ib puag ncig.

Ua ntej thiab thaum kho, tswj ntshav siab, raum kev ua haujlwm, hemoglobin qib hauv cov ntshav peripheral, creatinine, urea, electrolyte concentration thiab daim siab enzyme ua haujlwm hauv cov ntshav yog qhov tsim nyog.

Kev ceev faj yuav tsum tau siv thaum kho cov tshuaj rau cov neeg mob noj cov zaub mov muaj ntsev tsawg los yog ntsev tsawg (muaj kev pheej hmoo ntawm kev txhim kho arterial hypotension). Hauv cov neeg mob nrog BCC txo qis (vim muaj diuretic txoj kev kho) thaum txo qis sodium noj, raws plab thiab ntuav tuaj yeem tsim muaj cov tsos mob ntawm txoj hlab ntshav hypotension.

Kev hloov pauv ntawm cov hlab ntsha tsis yog qhov sib txuam rau txoj kev kho mob txuas ntxiv tom qab tswj kev tswj ntshav khov. Yog tias rov tshwm sim ntau zaus ntawm cov kev mob ntshav dhau los, yuav tsum txo qhov koob tshuaj lossis cov tshuaj yuav tsum tsis ua haujlwm ntxiv.

Yog tias cov keeb kwm muaj qhov qhia txog kev txhim kho kev mob hlwb tsis cuam tshuam nrog kev siv ACE inhibitors, ces cov neeg mob li no tseem muaj kev pheej hmoo ntawm nws txoj kev loj hlob thaum noj Tritace.

Ceev faj yuav tsum tau siv thaum ua kev tawm dag zog lub cev thiab / lossis huab cua kub vim qhov txaus ntshai ntawm lub cev qhuav dej thiab txoj hlab ntaws hypotension vim qhov txo qis hauv lub cev ntim.

Kev haus dej haus cawv tsis pom zoo.

Ua ntej kev phais mob (suav nrog kws kho hniav), nws yog qhov yuav tsum ceeb toom rau tus kws phais mob / tshuaj loog txog kev siv tshuaj ACE inhibitors.

Yog tias edema tshwm sim, piv txwv li hauv lub ntsej muag (daim di ncauj, tawv muag) lossis tus nplaig, lossis yog tias nqos lossis ua pa tsis tau, tus neeg mob yuav tsum tsis txhob noj cov tshuaj tam sim ntawd. Mob Hlwb Hau (Angioedema) nyob rau thaj chaw ntawm tus nplaig, mob taub hau, lossis ntsej muag (cov tsos mob tshwm sim tuaj yeem ua tsis taus pa lossis ua pa) tuaj yeem ua rau muaj kev phom sij thiab ua rau xav tau kev kho mob ceev.

Cov kev paub ntawm kev siv Tritace rau menyuam yaus, hauv cov neeg mob uas lub raum tsis zoo (CC qis dua 20 ml / min nrog lub cev ntawm 1,73 m2), zoo li hauv cov neeg mob tau txais kev kho mob hemodialysis, tsis txaus.

Tom qab noj thawj koob, nrog rau nce ntxiv cov tshuaj ntawm diuretic thiab / lossis ramipril, cov neeg mob yuav tsum nyob hauv kev saib xyuas kev noj qab haus huv rau 8 teev kom tsis txhob muaj kev txhim kho ntawm kev tiv thaiv tsis haum hypotensive. Hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev, noj cov tshuaj tuaj yeem ua rau muaj kev loj hlob ntawm cov hlab ntsha txoj hlab ntshav siab, uas qee zaum muaj tus kab mob oliguria lossis azotemia, thiab tsis tshua muaj, kev txhim kho ntawm lub raum tsis ua haujlwm.

Cov neeg mob uas muaj mob ntshav ntau dua los yog lub plawv tsis ua haujlwm loj yuav tsum pib kho nyob hauv tsev kho mob.

Hauv cov neeg mob uas tau txais ACE, ua kom muaj sia nyob, muaj kev tiv thaiv sai sai, muaj kev tiv thaiv anaphylactoid ntau yam piav qhia, qee zaum txog kev txhim kho ntawm kev poob siab, thaum hemodialysis siv qee qib siab-ua pa (piv txwv li polyacrylonitrile). Tawm tsam keeb kwm ntawm kev kho mob nrog Tritace, kev siv ntawm cov qog ua ke yuav tsum zam, piv txwv, rau kev kho mob sai sai lossis hemofiltration. Yog tias nws yog qhov yuav tsum tau ua cov txheej txheem no, nws yog qhov zoo dua los siv lwm daim nyias nyias los yog thim cov tshuaj. Cov kev cuam tshuam zoo ib yam tau pom nrog LDL apheresis siv cov dextran sulfate. Yog li, hom no yuav tsum tsis txhob siv rau hauv cov neeg mob uas tau txais ACE inhibitors.

Kev Siv Khomob

Qhov kev nyab xeeb thiab muaj txiaj ntsig ntawm cov tshuaj hauv cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog qis dua 18 xyoo tsis tau tsim, vim li ntawd, kev teem sijhawm yog contraindicated.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab

Thaum lub sijhawm kho mob, tus neeg mob yuav tsum yauv tsum tsis txhob koom nrog cov kev phom sij uas yuav tsum muaj kev kub siab mloog thiab ceev ntawm cov kev puas siab puas ntsws, vim tias kiv taub hau yog ua tau, tshwj xeeb tshaj yog tom qab pib koob tshuaj Tritace thaum noj tshuaj diuretics.

Kev siv tshuaj ntau dhau:

Cov tsos mob: tus cim txo nyob rau hauv cov ntshav siab, poob siab, loj heev bradycardia, kev puas tsuaj nyob rau hauv dej-electrolyte tshuav, mob raum tsis ua hauj lwm, tub ntxhais hluas.

Kev Kho Mob: pais plab lav, kom tsawg ntawm adsorbents, sodium sulfate (yog tias ua tau hauv thawj 30 feeb). Cov kev txhim kho ntawm txoj kev loj hlob ntawm txoj hlab ntsha hauv lub plawv, cov lus qhia ntawm alpha1-adrenostimulants (norepinephrine, dopamine) thiab angiotensin II (angiotensinamide) tuaj yeem ntxiv rau txoj kev kho kom rov ua kom zoo bcc thiab rov qab ntsev sib npaug.

Kev cuam tshuam ntawm Tritace nrog lwm yam tshuaj.

Nrog rau kev siv cov ntsev tom qab ua ke, cov tshuaj potassium-sparing diuretics (piv txwv li amiloride, triamteren, spironolactone) nrog Tritace, hyperkalemia yog pom (tshuaj xyuas poov tshuaj potassium yog tsim nyog).

Kev siv tib lub sijhawm Tritace nrog cov tshuaj tiv thaiv kabmob (tshwj xeeb, nrog diuretics) thiab lwm yam tshuaj uas txo cov ntshav siab yuav ua rau muaj kev nce ntxiv hauv cov nyhuv ntawm ramipril.

Nrog rau kev siv ua ke nrog hypnotics, opioids thiab analgesics, txo qis hauv cov ntshav siab yog tau.

Vasopressor sympathomimetic tshuaj (epinephrine) thiab estrogens tuaj yeem ua rau qaug zog ntawm ramipril.

Nrog rau kev siv Tritace nrog rau allopurinol, procainamide, cytotoxic tshuaj, tshuaj tiv thaiv kab mob, corticosteroids systemic, thiab lwm yam tshuaj uas tuaj yeem hloov cov ntshav ntshav, ua kom cov ntshav dawb hauv lub cev txo qis.

Nrog tib lub sijhawm siv nrog cov roj ntsha lithium, qhov kev nce siab ntawm cov roj ntsha lithium hauv cov ntshav yog qhov ua tau, uas ua rau muaj qhov nce ntawm cardio- thiab neurotic cuam ntawm lithium.

Nrog rau kev siv ua ke nrog Tritace nrog lub qhov ncauj hypoglycemic (sulfonylureas, biguanides), insulin, hypoglycemia sib zog.

NSAIDs (indomethacin, acetylsalicylic acid) tuaj yeem txo qis kev ua haujlwm ntawm ramipril.

Nrog rau kev siv thooj txhij nrog heparin, kev nce siab ntawm cov poov tshuaj hauv cov ntshav cov ntshav yog ua tau.

Ntsev txo cov txiaj ntsig ntawm ramipril.

Ethanol txhim kho cov nyhuv hypotensive ntawm ramipril.

Qhov tseem ceeb tawg

Qhov qauv pib noj tshuaj yog 2.5 mg ib hnub ib zaug thaum sawv ntxov (tablets 5 mg ntsiav tshuaj yog lees paub). Yog tias cov tshuaj tau siv rau 3 lub lis piam ntawm kev muab koob tshuaj thiab ntshav siab tsis rov qab zoo li qub, qhov siab tshaj plaws niaj hnub noj tau nce mus rau 5 mg. Nrog cov txiaj ntsig tsis txaus tom qab 2-3 lub lis piam, qhov siab tshaj plaws txhua hnub tau tso cai kom nce ntxiv mus rau 10 mg.

Lwm txoj kev kho mob zoo nrog qhov tsis txaus antihypertensive nyhuv ntawm cov tshuaj suav nrog kev siv sib xyaw ua ke ntawm lwm cov tshuaj tiv thaiv kabmob (piv txwv, qeeb calcium channel blockers lossis diuretics).

Dosage daim ntawv

5 mg thiab 10 mg ntsiav tshuaj

Ib ntsiav tshuaj 5 mg

cov tshuaj nquag - ramipril 5 mg

tus zam: hypromellose, pregelatinized pob kws hmoov txhuv nplej siab, microcrystalline cellulose, hlau oxide liab (E 172), sodium stearyl fumarate

Ib qho 10 mg ntsiav tshuaj muaj

cov tshuaj nquag - ramipril 10 mg

tus zam: hypromellose, pregelatinized pob kws hmoov txhuv nplej siab, microcrystalline cellulose, sodium stearyl fumarate

Oval tablets muaj xim liab daj, muaj qhov pheej hmoo ua txhaum ntawm ob sab ntawm lub ntsiav tshuaj, sau nrog "5 / tuam txhab logo" ntawm ib sab thiab "5 / HMP" nyob rau sab nraud

Oval ntsiav tshuaj muaj xim dawb lossis yuav luag xim dawb, muaj kev pheej hmoo rau kev tawg ntawm ob sab ntawm lub ntsiav tshuaj, nrog kev txua "HMO / HMO" ntawm ib sab.

Mob plawv nres

Thaum nyob rau 1.25 mg ib hnub ib zaug (siv ½ ntsiav tshuaj ntawm 2.5 mg). Raws li cov tshuaj tiv thaiv rau kev kho mob, qhov nce ntxiv ntawm cov tshuaj tau tso cai. Cov koob tshuaj yuav tsum tau muab ob npaug, tswj lub sijhawm ntawm 1-2 lub lis piam. Yog tias qhov koob tshuaj txhua hnub yog 2.5 mg lossis siab dua, nws tuaj yeem noj ob zaug ib zaug lossis muab faib ua 2 koob. Nws tsis raug nquahu kom tshaj cov koob tshuaj ntau tshaj txhua hnub ntawm 10 mg.

Txo txoj kev pheej hmoo ntawm cov hlab plawv tuag, mob stroke, lossis myocardial infarction hauv cov neeg mob uas muaj feem ntau rau cov kab mob plawv

Kev kho mob pib nrog 2.5 mg ib hnub ib zaug (1 ntsiav tshuaj 2.5 mg lossis ½ ntsiav tshuaj 5 mg). Nyob ntawm qhov tshuaj tiv thaiv ntawm lub cev mus rau yeeb tshuaj, nce qib hauv koob rau ib hnub ib zaug raug tso cai. Tom qab ib lub lim tiam ntawm kev kho mob, nws raug nquahu kom txhaj ob npaug, thiab nyob rau 3 lub lis piam tom ntej, nce nws mus rau kev tswj hwm niaj hnub noj tshuaj 10 mg, uas noj ib zaug.

Kev siv cov tshuaj rau hauv cov tshuaj ntau dua 10 mg, thiab hauv cov neeg mob CC tsawg dua 0.6 ml / min, tsis tau kawm txaus.

Lub plawv tsis ua haujlwm tau tsim los ntawm 2nd mus rau 9 hnub tom qab mob myocardial infarction

Kev kho mob pib nrog kev noj tshuaj 5 mg ib zaug, muab faib ua 2 koob tshuaj 2.5 mg, uas noj thaum sawv ntxov thiab yav tsaus ntuj (2.5 mg ntsiav tshuaj lossis ½ 5 mg ntsiav tshuaj). Nrog txoj kev mob ntshav siab rau hauv tus neeg mob rau 2 hnub, Tritace yog tshuaj 1.25 mg 2 zaug hauv ib hnub (½ ntsiav tshuaj 2.5 mg). Tom qab ntawd, nyob rau hauv kev saib xyuas ntawm tus kws kho mob, qhov tshuaj yog nce qeeb, ua ob npaug rau nws txhua 1-3 hnub. Tom qab ntawd, cov koob tshuaj txhua hnub, uas tau muab faib ua ob zaug, tuaj yeem muab ib zaug. Nws tsis raug nquahu kom tshaj cov koob tshuaj ntau tshaj txhua hnub ntawm 10 mg.

Kev siv Tritace rau kev kho mob ntawm cov neeg mob uas muaj cov tsos mob hnyav ntawm lub plawv tsis ua haujlwm (III - IV ua haujlwm hauv chav kawm raws li NYHA kev faib tawm) tsis nkag siab zoo, yog li ntawd, hauv kev kho mob ntawm cov neeg mob ntawd, kev noj haus qis tshaj plaws yog tau sau tseg: 1.25 mg ib hnub ib zaug (½ ntsiav tshuaj 2.5 mg). Ua kom cov tshuaj ntau ntxiv nrog kev ceev faj.

Siv rau hauv cov neeg mob uas lub raum tsis ua hauj lwm zoo

Nrog CC los ntawm 50 txog 20 ml / min, Tritace yog qhov tshuaj kho nyob rau hauv thawj hnub ntawm 1.25 mg (½ ntsiav tshuaj 2.5 mg). Qhov pom zoo kom noj txhua hnub yog 5 mg. Cov kev kho mob zoo li qub yog siv rau cov neeg mob uas muaj mob ntshav tawm heev, tsis tuaj yeem kho qhov tsis txaus los ntawm kev xeb hluav taws xob thiab lub cev qhuav dej, nrog rau cov neeg mob uas txo ntshav siab ntau dhau yog ua rau muaj qhov tsis zoo (piv txwv li, nrog atherosclerotic qhov txhab ntawm lub paj hlwb thiab hlab ntsha).

Siv rau hauv cov neeg mob nrog kev kho mob ua ntej diuretic

2-3 hnub ua ntej yuav pib kho nrog Tritace, nyob ntawm seb siv tshuaj lom ntev ntev li cas, nws yog ib qho tsim nyog yuav tsum tsis txhob noj cov tshuaj no los yog txo lawv cov koob tshuaj. Cov neeg mob zoo li no tau pom zoo kom pib kho nrog qhov qis tshaj ntawm 1.25 mg (½ ntsiav tshuaj ntawm 2,5 mg), uas noj 1 zaug hauv ib hnub thaum sawv ntxov. Tom qab noj thawj koob tshuaj, nce ntxiv ntawm koob tshuaj Tritace thiab / lossis cov voj-hom diuretics, cov neeg mob yuav tsum nyob hauv kev saib xyuas mob tsawg kawg 8 teev kom tiv thaiv ib qho tshuaj tiv thaiv tsis muaj tshuaj tiv thaiv hypotensive.

Siv rau hauv cov neeg mob uas lub siab ua tsis ua haujlwm

Hauv pawg no ntawm cov neeg mob, kev noj cov tshuaj tuaj yeem ua rau ob qho kev nce ntxiv thiab txo qis hauv cov ntshav siab. Yog li no, Txoj kev kho Tritace yuav tsum tau ua nyob rau hauv kev saib xyuas los ntawm tus kws kho mob nruj. Nws raug nquahu kom tsis txhob tshaj li ib koob tshuaj txhua hnub ntawm 2.5 mg (1 ntsiav tshuaj 2.5 mg lossis ½ ntsiav tshuaj 5 mg).

Cov tsos mob ntawm kev noj haus ntau dhau yog mob raum tsis ua haujlwm, kev tso pa ntawm lub cev ntau ntau nrog qhov tshwm sim ntawm kev poob siab thiab qhov cim tseg ntawm cov ntshav siab, qhov cuam tshuam ntawm cov dej-electrolyte metabolism, bradycardia, stupor. Hauv qhov no, lub plab ntxuav thiab sodium sulfate yog cov tshuaj (yog tias ua tau, nws yuav tsum tau noj hauv thawj 30 feeb tom qab noj ntau dhau heev lawm ntawm cov tshuaj) thiab adsorbents. Nrog cov lus tshaj tawm hauv cov ntshav siab, angiotensinamide (angiotensin II) thiab alpha raug tswj hwm₁-adrenergic agonists (dopamine, norepinephrine). Nyob rau hauv rooj plaub ntawm bradycardia refractory rau kev kho tshuaj, ib qho khoom sib nraus cuav yog qee zaum tsim ib ntus. Nyob rau hauv cov ntaub ntawv ntawm kev haus ntau dhau, kev saib xyuas lub sij hawm ntawm cov ntshav ntau ntawm electrolytes thiab creatinine yog kev pom zoo.

Cov chaw muag tshuaj

Cov Tshuaj Pharmacokinetics

Tom qab kev tswj hwm ntawm qhov ncauj, ramipril yog nqus tawm sai sai ntawm lub plab zom mov: ntshav siab kawg ntshav ntawm ramipril tau mus txog hauv ib teev. Qib ntawm kev nqus yog tsawg kawg yog 56% ntawm qhov kev noj tshuaj thiab ua ywj pheej ntawm kev noj zaub mov. Nws yuav luag tag nrho cov tshuaj tiv thaiv (feem ntau hauv daim siab) nrog kev tsim cov nquag metabolite - ramiprilat (nws yog 6 npaug ntau dua kev cuam tshuam ntawm ACE-angiotensin-hloov enzyme dua li ramipril). Lub bioavailability ntawm ramiprilat yog 45%.

Qhov siab tshaj plaws ntawm ramiprilat hauv plasma tau mus txog tom qab 2-4 teev. Pab txhawb cov ntshav muaj zog ntawm ramiprilat tom qab ib koob nkaus xwb ntawm ib txwm hno ramipril tau mus txog rau hnub 4.

Plasma protein khi yog kwv yees li 73% rau ramipril thiab 56% rau ramiprilat.

Ramipril yuav luag txhua qhov ua tiav rau ramiprilat, diketopiperazinovy ester, diketopiperazinovy acid thiab glucuronides ntawm ramipril thiab ramiprilat.

Kev ua noj ua haus ntawm metabolites tsuas yog dhau los ntawm ob lub raum. Lub plasma cov ntsiab lus ntawm ramiprilat yog txo polyphase. Vim nws lub zog muaj txiaj ntsig ua rau ACE thiab qeeb kev cuam tshuam los ntawm cov enzyme, ramiprilat ua kom pom qhov kev tshem tawm ntev ntev ntawm qhov ntshav tsawg heev. Qhov zoo ib nrab-lub neej ntawm ramiprilat yog los ntawm 13 txog 17 teev rau kev txhaj tshuaj ntawm 5 thiab 10 mg.

Cov nyhuv antihypertensive pib 1-2 teev tom qab noj ib koob ntawm cov tshuaj, cov txiaj ntsig siab tshaj plaws tsim tawm 3-6 teev tom qab kev tswj hwm thiab kav rau 24 teev. Nrog kev siv txhua hnub, kev ua ub no los tiv thaiv kev nce qeeb zuj zus dhau 3-4 lub lis piam.

Nws tau pom tias cov nyhuv antihypertensive kav ntev li 2 xyoos nrog kev kho mob ntev. Qhov kev cuam tshuam ntse ntawm kev noj cov tshuaj ramipril tsis ua rau muaj ntshav nce siab ("rov qab").

Cov pab pawg neeg tshwj xeeb

Hauv cov neeg mob uas lub raum tsis ua hauj lwm zoo Lub raum tsis zoo ntawm ramiprilat yog txo qis, lub raum tshem tawm ntawm ramiprilat yog ncaj qha sib luag rau creatinine tshem tawm. Qhov no ua rau muaj kev nce ntxiv ntawm ntshav ramiprilat concentration, uas ua rau qeeb qeeb dua hauv kev kawm nrog lub raum kev ua haujlwm.

Hauv cov neeg mob uas lub siab ua tsis taus haujlwm ramipril metabolism hauv ramiprilat qeeb vim txo qis kev ua si ntawm hepatic esterases. Xws li cov neeg mob ua rau muaj qib ntshav plasma ramipril ntau ntau. Txawm li cas los xij, kev mob ntshav plasma ramiprilat ntau yog zoo tib yam rau cov neeg mob hauv lub siab ua haujlwm.

Tom qab siv ib zaug tshuaj ramipril tau noj ntawm qhov ncauj, tshuaj thiab nws cov metabolite tsis pom nyob hauv niam cov kua mis. Txawm li cas los xij, cov txiaj ntsig ntawm kev txhaj tshuaj ntau npaum li cas tseem tsis tau paub.

Cov Tshuaj Hauv Tshuaj

Lub angiotensin-converting enzyme ACE, tseem hu ua dipeptidyl carboxypeptidase Kuv), uas ua rau muaj qhov hloov pauv ntawm angiotensin I rau angiotensin II, muaj vasoconstrictor nquag, thiab tseem ua rau tawg ntawm bradykinin, vasodilator, tau pom tias yog ib qho tseem ceeb hauv kev txhim kho kev mob ntshav siab.

Ramiprilat, ib qho metabolite ntawm Tritace®inhibiting ACE hauv cov ntshav thiab cov ntaub so ntswg, incl. lub vascular phab ntsa, tiv thaiv kev tsim cov tshuaj angiotensin II thiab tawg ntawm bradykinin, uas ua rau vasodilation thiab txo ntshav siab.

Nrog rau kev poob qis hauv kev ua haujlwm ntawm angiotensin II hauv cov ntshav, nws cov nyhuv inhibitory ntawm kev zais ntawm renin los ntawm hom kev tawm tsam tsis zoo yog tshem tawm, uas ua rau muaj kev nce ntxiv ntawm cov kev ua ntawm renin hauv ntshav ntshav.

Kev nce ntxiv hauv kev ua haujlwm ntawm kallikrein-kinin lub cev nyob rau hauv cov ntshav thiab cov ntaub so ntswg txiav txim siab cov txiaj ntsig cardioprotective thiab endothelioprotective ntawm ramipril vim kev ua haujlwm ntawm prostaglandin system thiab, raws li, kev nce ntxiv hauv cov synthesis ntawm prostaglandins, uas txhawb kev tsim ntawm nitric oxide (TSIS) nyob rau hauv endotheliocytes.

Angiotensin II stimulates zus ntawm aldosterone, yog li noj Tritace® ua rau muaj kev txo qis hauv cov zais ntawm aldosterone thiab nce ntxiv hauv cov ntshav ntau ntawm cov potassium ions.

Hauv cov neeg mobnrog leeg ntshav siab Txais tos txiv yawg® ua rau txo qis ntshav siab thaum dag thiab sawv ntsug, yam tsis muaj nyiaj cheem nce siab hauv lub plawv (HR). Phiv® nws txo qis tag nrho peripheral vascular tsis kam (OPSS), suab tsis ua rau muaj kev hloov hauv lub plawv raum khiav thiab lub plawv txhaws.

Hauv cov neeg mob uas mob ntshav tawm tsam, ramipril qeeb txoj kev txhim kho thiab kev hloov kho ntawm myocardial hypertrophy thiab leeg ntshav phab ntsa.

Nrog cov tshuaj diuretics thiab mob glycosides (raws kev qhia los ntawm kws kho mob) Tritace® zoo rau cov neeg mob plawv tsis ua hauj lwm qib II-IV raws li kev tso cai kev faib tawm ntawm NYHA (New York Cardiology Association).

Phiv® nws muaj cov txiaj ntsig zoo ntawm hemodynamics ntawm lub siab - nws txo OPSS (txo qis tom qab lub siab), txo cov puv ntawm cov leeg sab laug thiab sab laug ventricles, nce cov txiaj ntsig ntawm lub plawv, thiab txhim kho kev ntsuas plawv 1.

Nrog mob ntshav qab zib thiab tsis mob ntshav qab zib nephropathy Txais tos txiv yawg® Ua kom qis tus nqi ntawm qhov muaj mob ntawm lub raum tsis ua haujlwm thiab qhov pib ntawm lub davhlau ya nyob twg theem ntawm lub raum tsis ua haujlwm thiab, yog li, txo qhov xav tau hemodialysis lossis hloov raum. Rau mob ntshav qab zib lossis tsis mob ntshav qab zib nephropathy Tritace® txo qhov hnyav ntawm cov proteinuria.

Hauv cov neeg mob uas muaj qhov pheej hmoo loj los tsim muaj cov kab mob plawv vim muaj vascular lesions (mob plawv, keeb kwm kab mob txha caj qaum, keeb kwm ntawm mob hlab ntsha tawg), lossis mob ntshav qab zib mellitus muaj tsawg kawg yog ib qho kev pheej hmoo ntxiv (microalbuminuria, mob ntshav siab, nce ntau ntawm tag nrho cov roj cholesterol OX, poob qis ntawm cov ntshav siab lipoprotein cholesterol XC-HDL, haus luam yeeb), noj ramipril ua ke nrog kev kho mob txheem lossis hauv kev kho mob monotherapy txo qis kev tshwm sim ntawm myocardial infarction, mob hlab ntsha tawg, thiab kev tuag ntawm kev mob plawv. Tsis tas li ntawd, Tritace® txo cov kev tuag tag nrho, nrog rau cov kev xav kom rov ua kom rov ua haujlwm, thiab ua rau qeeb qeeb ntawm kev pib mob lossis kev loj hlob ntawm lub plawv tsis ua haujlwm.

Hauv cov neeg mob uas lub plawv tsis ua hauj lwm uas tau tsim los thaum ntxov ntawm tus mob myocardial infarction (2-9 hnub)), thaum noj Tritace®Pib txij hnub 3 mus rau 10 hnub ntawm tus mob myocardial infarction, qhov kev pheej hmoo ntawm kev tuag thim rov qab los ntawm 5.7%, tus txheeb ze pheej hmoo los ntawm 27%.

Hauv cov pej xeem neeg mob dav dav, nrog rau cov neeg mob ntshav qab zib mellitus, ob qho tib si nrog cov leeg ntshav thiab nrog ntshav siab Phiv® txo txoj kev pheej hmoo ntawm nephropathy thiab tshwm sim ntawm microalbuminuria.

Tsuas tshuaj thiab tswj hwm

Txog kev tswj hwm qhov ncauj.

Tritace pom zoo® txhua hnub nyob rau tib lub sijhawm.

Phiv® tuaj yeem noj nrog lossis tsis muaj zaub mov noj, vim tias bioavailability yog ywj pheej ntawm kev noj zaub mov. Phiv® yuav tsum tau noj nrog cov kua txaus. Koj tsis tuaj yeem zom lossis txhuam cov ntsiav tshuaj.

Cov Neeg Mob Txais Kev Kho Mob Diuretic

Thaum pib ntawm kev kho mob nrog Tritace® hypotension yuav tshwm sim, cov nyhuv no zoo dua hauv cov neeg mob tau txais diuretics. Hauv qhov no, kev ceev faj yuav tsum ua kom tawm dag zog, vim tias hauv cov neeg mob li ntawd cov kua dej los yog ntsev yuav tshwm sim.

Yog tias ua tau, tshuaj diuretics yuav tsum tso tseg 2 lossis 3 hnub ua ntej pib ntawm Txoj Kev Kho Mob Tritace.®.

Hauv cov neeg mob ntshav siab tsis ua txuas ntxiv ntawm kev kho mob diuretics, kho nrog Tritace® yuav tsum pib nrog tshuaj ntau npaum 1.25 mg. Nws yog qhov tsim nyog los tswj hwm cov poov tshuaj qib thiab diuresis. Cov tshuaj ntxiv rau Tritace® yuav tsum muab kho raws li qib raug mob ntshav siab.

Arterial kub siab

Cov koob tshuaj yog xaiv tau ib tus zuj zus raws li tus neeg mob daim ntawv qhia thiab cov ntshav siab. Phiv® tuaj yeem siv los ua cov tshuaj kho mob lossis ua kom sib xyaw nrog lwm cov tshuaj tiv thaiv kab mob siab.

Tritace Kev Kho Mob® yuav tsum pib ua ntu zus. Qhov pom zoo kom pib noj yog 2.5 mg rau ib hnub.

Hauv cov neeg mob uas tau ua haujlwm ntau ntxiv ntawm renin-angiotensin-aldosterone system, qhov kev poob siab tseem ceeb yuav tshwm sim tom qab noj thawj koob. Rau cov neeg mob zoo li no, pom zoo kom noj thawj zaug yog 1.25 mg. Txoj kev kho yuav tsum pib ua kev tswj hwm ntawm kws kho mob.

Koob tshuaj titration thiab txij nkawm tsuas tshuaj

Yog tias tsim nyog, ntau npaum li cas tuaj yeem muab ob npaug ntawm kev ncua sijhawm ob lossis plaub lub lis piam, kom pom tseeb cov phiaj siab yuav maj mam tiav. Qhov Siab Ntau Ntau Tsis Tshua Sib Tw® yog 10 mg rau ib hnub. Cov tshuaj tau coj ib hnub ib zaug.

Kev Tiv Thaiv Kab Mob Tiv Thaiv Kab Mob

Qhov pom zoo kom pib noj yog 2.5 mg Tritace® ib hnub.

Koob tshuaj titration thiab txij nkawm tsuas tshuaj

Nyob ntawm qhov kam rau ua los ntawm cov tshuaj nquag, khwv tau yog maj mam nce. Nws raug nquahu kom txhaj koob tshuaj ob zaug hauv 1-2 lub lis piam tom qab pib kho thiab tom qab 2-3 lub lis piam kom nce ntxiv rau hauv lub hom phiaj tswj kev noj tshuaj ntawm 10 mg Tritace® ib hnub.

Kuj pom kev noj tshuaj hauv cov neeg mob noj cov tshuaj diuretics.

Kho Mob Raum

Cov neeg mob ntshav qab zib thiab microalbuminuria

Qhov pom zoo kom pib noj yog 1.25 mg Tritace ib hnub.

Koob tshuaj titration thiab txij nkawm tsuas tshuaj.

Nyob ntawm qhov muaj peev xwm tiv taus ntawm cov tshuaj, ntau npaum cov tshuaj yog nce ntxiv. Ua ob npaug rau koob tshuaj rau 2,5 mg rau ib hnub tom qab ob lub lis piam thiab tom qab ntawd txog 5 mg rau ib hnub tom qab txuas ntxiv ob lub lis piam.

Cov neeg mob qab zibntshav qab zib thiab yam tsawg kawgib qho kev pheej hmoo ntxiv

Qhov pom zoo kom pib noj yog 2.5 mg Tritace® ib hnub.

Koob tshuaj titration thiab txij nkawm tsuas tshuaj

Nyob ntawm qhov kam rau ua los ntawm cov tshuaj nquag, khwv tau yog maj mam nce. Nws raug nquahu kom txhaj ob npaug rau 5 mg rau ib hnub tom qab ib mus rau ob lub lis piam thiab tom qab ntawd txog 10 mg rau ib hnub tom qab ntxiv ob mus rau peb lub lis piam. Qhov siab tshaj plaws uas pom zoo rau kev siv tshuaj txhua hnub yog 10 mg rau ib hnub.

Cov neeg mob uas tsis mob ntshav qab zib nephropathy thiab macroproteinuria dhau 3 g / hnub

Qhov pom zoo kom pib noj yog 1.25 mg Tritace® ib hnub.

Koob tshuaj titration thiab txij nkawm tsuas tshuaj

Nyob ntawm qhov kam rau ua los ntawm cov tshuaj nquag, khwv tau yog maj mam nce. Nws raug nquahu kom txhaj ob npaug rau 2,5 mg rau ib hnub tom qab ob lub lim tiam ntawm kev kho mob thiab tom qab ntawd mus rau 5 mg ib hnub tom qab ntxiv ob lub lis piam.

Cov tsos mob lub plawv tsis ua hauj lwm

Rau cov neeg mob uas kho cov tshuaj ua ntej tso, qhov pib pom zoo yog 1.25 mg Tritace® ib hnub.

Koob tshuaj titration thiab txij nkawm tsuas tshuaj

Kev suav rau yuav tsum tau ua los ntawm kev suav ob npaug ntau npaum ntawm Tritace® txhua txhua ib lossis ob lub lis piam mus txog kev siv tshuaj ntau tshaj txhua hnub ntawm 10 mg. Pom zoo kom faib cov koob tshuaj ua ob zaug ib hnub.

Thib ob prophylaxis tom qab mob myocardial infarction nrog lub plawv tsis ua haujlwm

Qhov tshuaj thawj zaug yog 2.5 mg ob zaug ib hnub rau 3 hnub, thiab pib siv 48 teev tom qab myocardial infarction hauv chaw kho mob thiab hemodynamically cov neeg mob ruaj khov. Yog tias qhov tshuaj thawj zaug ntawm 2.5 mg yog qhov ua tsis zoo rau siab, ces qhov koob tshuaj tau muab faib ua ob zaug tshuaj ntawm 1.25 mg rau 2 hnub kom txog thaum qhov koob tshuaj ntxiv rau 2.5 mg thiab 5 mg ob zaug ib hnub. Yog tias qhov tshuaj tsis tuaj yeem nce ntxiv rau 2.5 mg ib hnub ob zaug, kev kho yuav tsum tsis ua mus ntxiv.

Kuj pom kev noj tshuaj rau sab saud rau cov neeg mob noj tshuaj diuretics.

Koob tshuaj titration thiab txij nkawm tsuas tshuaj

Kev noj tshuaj txhua hnub yog ua ntu zus nce los ntawm qhov ntsuas ob zaug ntawm ncua sijhawm ntawm 1 mus rau 3 hnub rau cov phiaj phiaj kev noj tshuaj txhua hnub ntawm 5 mg ob zaug ib hnub. Yog tias ua tau, kev saib xyuas txij nkawm yuav tsum tau faib ua ob zaug.

Yog tias qhov tshuaj tsis tuaj yeem nce ntxiv rau 2.5 mg ib hnub ob zaug, kev kho yuav tsum tsis ua mus ntxiv. Txog kev kho mob rau cov neeg mob uas muaj lub plawv tsis ua haujlwm tsis zoo (NYHA chav IV) tam sim ntawd tom qab myocardial infarction, kev paub tsuas muaj tsawg. Yog tias kev txiav txim siab txiav txim siab rau kev kho mob ntawm cov neeg mob ntawd, nws raug nquahu kom pib nrog tshuaj ntawm 1.25 mg ib hnub ib zaug, thiab siv kev ceev faj heev nrog kev noj tshuaj ntau ntxiv.

Pab Pawg Neeg Tshwj Xeeb

Cov neeg mob uas lub raum tsis ua hauj lwm zoo

Kev noj tshuaj txhua hnub hauv cov neeg mob uas tsis muaj mob raum lub raum yuav tsum txiav txim siab raws li creatinine tshem tawm:

- yog tias creatinine tshem tawm ≥ 60 ml / min, qhov hloov pauv ntawm thawj zaug kev noj tshuaj (2.5 mg / hnub) tsis tas yuav tsum tau, qhov tshuaj ntau tshaj txhua hnub yog 10 mg.

- yog tias creatinine tshem tawm yog nyob hauv thaj tsam 30-60 ml / min, kev noj tshuaj thawj zaug tsis hloov (2.5 mg / hnub), qhov tshuaj ntau kawg txhua hnub yog 5 mg.

- yog tias creatinine tshem tawm yog nyob rau hauv thaj tsam ntawm 10-30 ml / min, kev siv tshuaj thawj zaug yog 1.25 mg / hnub, qhov tshuaj ntau tshaj txhua hnub yog 5 mg.

- cov neeg mob ntshav siab mob hemodialysis: ramipril tsis zoo los ntawm kev lim ntshav, thawj zaug tshuaj yog 1.25 mg / hnub, qhov ntau kawg txhua hnub noj yog 5 mg. Cov tshuaj yuav tsum tau haus ob peb teev tom qab ua tiav ntawm cov txheej txheem lim ntshav.

Cov neeg mob uas muaj lub siab ua haujlwm tsis zoo

Hauv cov neeg mob uas lub siab tsis ua haujlwm, Tritace therapy® yuav tsum tsuas yog pib nyob rau hauv kev saib xyuas kev kho mob nruj, qhov ntau tshaj txhua hnub ntau npaum ntawm Tritace® yog 2.5 mg.

Cov koob tshuaj thaum pib rau pawg neeg mob no yuav tsum muaj tsawg li sai tau, thiab tom qab ntawv txuas ntxiv ntawm qhov ntau npaum li cas, txij li muaj qhov cuam tshuam ntau ntxiv rau cov kev mob tshwm sim rau cov neeg laus thiab cov neeg mob depleted. Qhov qes thaum pib ntau npaum ntawm 1.25 mg ntawm ramipril yuav tsum raug txiav txim siab.

Phiv® tsis pom zoo siv rau cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog qis dua 18 xyoo vim tsis muaj ntaub ntawv tsis txaus ntseeg txog kev nyab xeeb thiab ua tau zoo. Tsuas muaj kev paub tsawg dhau los nrog ramipril hauv cov menyuam yaus.

Tso cov ntaub ntawv thiab cov nyob ua ke

Koj tuaj yeem yuav cov tshuaj nyob hauv daim foos. Cov khoom tseem ceeb hauv cov muaj pes tsawg leeg yog ramipril. Hauv 1 lub ntsiav tshuaj, cov tshuaj muaj nyob hauv ib qho kev txiav txim siab ntawm 2.5 mg. Muaj lwm txoj kev xaiv ntxiv rau cov tshuaj: 5 thiab 10 mg. Hauv txhua cov qauv, qhov me tsis sib thooj yog qhov qub. Cov tshuaj yeeb yaj kiab tsis pom kev ua haujlwm tawm tsam. Cov no suav nrog:

hypromellose,
pregelatinized hmoov txhuv nplej siab
microcrystalline cellulose,
sodium stearyl fumarate,
dyes.

Hauv 1 lub ntsiav tshuaj, cov tshuaj muaj nyob hauv ib qho kev txiav txim siab ntawm 2.5 mg.

Koj tuaj yeem yuav cov tshuaj hauv pob ntawv uas muaj 2 lub hlwv, hauv txhua 14 ntsiav tshuaj.

Dab tsi yog xaj tshuaj

Tus nab npawb ntawm qhov ntsuas rau kev siv tshuaj:

arterial hypertension (mob ntev thiab mob),
lub plawv tsis ua hauj lwm, hauv qhov no, cov tshuaj tau sau tseg tsuas yog ib feem ntawm txoj kev kho mob nyuaj,
Lub raum khiav tsis zoo uas yog mob ntshav qab zib,
kev tiv thaiv cov kab mob ntawm cov hlab plawv (mob stroke, myocardial infarction, thiab lwm yam) hauv cov neeg mob uas muaj kev pheej hmoo siab ntawm cov kev tsis zoo no,
mob plawv ischemia, tshwj xeeb, cov tshuaj yog qhov tsim nyog rau cov neeg uas nyuam qhuav dhau los myocardial infarction, mob hlab ntsha o by grafting, los yog arterial angioplasty,
pathological tej yam kev mob provoked los ntawm kev hloov nyob rau hauv tus qauv ntawm cov phab ntsa ntawm peripheral hlab ntsha.

Qhov tseem ceeb qhia tias kev noj tshuaj yog ntshav tawm ntshav.
Tritace yog qhov tsim tawm rau kev ua txhaum ntawm lub raum plab, ua rau mob ntshav qab zib mellitus.
Tritace yog kho rau myocardial infarction.

Nrog saib xyuas

Ib tug xov tooj ntawm cov txheeb ze contraindications sau tseg:

atherosclerotic hloov pauv ntawm phab ntsa ntawm cov hlab ntsha,
mob plawv tsis ua hauj lwm
malignant arterial kub siab,
nqaim ntawm lub lumen ntawm cov hlab ntsha ntawm ob lub raum hauv kev zoo, muab tau tias txoj kev no tsuas tshwm sim ntawm ib sab,
siv cov diuretic tsis ntev los no
tsis muaj kua hauv lub cev tiv thaiv kev ntuav, raws plab thiab lwm yam kab mob pathological,
hyperkalemia
mob ntshav qab zib mellitus.

Cov tshuaj tsis tau sau tseg rau cov mob plawv thiab mob plawv tsis zoo.
Cov tshuaj no yog contraindicated nyob rau hauv lub raum tsis ua hauj lwm.
Nrog kev ceev faj, cov tshuaj siv nrog qhov tsis muaj kua hauv lub cev tawm tsam ntuav.

Yuav Ua Li Cas Peb Leeg

Chew ntsiav tshuaj yuav tsum tsis txhob muaj. Kev kho qhov tseeb yog xaiv tau coj mus rau hauv tus account pathological. Feem ntau, qhov kev txhaj tshuaj ntawm cov tshuaj nquag tau nce zuj zus. Feem ntau tau muab tshuaj 1.25-2.5 mg ntawm cov khoom siv no 1 zaug hauv ib hnub. Tom qab ib ntus, qhov ntau ntawm cov tshuaj nce ntxiv. Hauv qhov no, koob tshuaj tau txiav txim siab tus kheej rau txhua tus neeg mob, noj mus rau hauv tus account lub zog ntawm tus kabmob. Tsawg tsawg zaus, ib chav kawm ntawm txoj kev kho yog pib nrog 5 mg ntawm cov tshuaj.

Nrog ntshav qab zib

Cov cuab yeej siv yog qhov tsis ntau tshaj 1.25 mg ib hnub. Yog tias tsim nyog, cov koob tshuaj no tau nce ntxiv. Txawm li cas los xij, cov tshuaj no rov ua dua li 1-2 lub lis piam tom qab pib ua haujlwm.

Nrog rau cov ntshav qab zib, cov tshuaj no tau siv hauv qhov nyiaj tsis tshaj li 1,25 mg rau ib hnub.

Nruab nrab hauv lub paj hlwb

Mob taub hau, kiv taub hau, tshee tshee ntawm qhov kawg, ua rau tsis hnov tus kheej, poob ntawm qhov sib luag nyob hauv txoj hauj lwm ncaj ncees, mob ntshav liab, nrog rau cov ntshav khiav tsis zoo.

Los ntawm ib sab ntawm lub hauv nruab nrab cov hlab hlwb, yuav muaj mob taub hau tom qab noj Tritace.

Endocrine system

Kev ua txhaum ntawm cov txheej txheem biochemical: muaj qhov txo qis lossis nce ntxiv hauv kev xav ntawm ntau yam (sodium, potassium, magnesium, calcium).

Los ntawm qhov system musculoskeletal, tej zaum yuav muaj mob plab tom qab noj Tritace.

Los ntawm lub cev tiv thaiv kab mob

Cov ntsiab lus ntawm cov tshuaj tiv thaiv kev ua kom tsis taus nce ntxiv, qhov tshuaj tiv thaiv anaphylactoid tshwm sim.

Nws tsis pom zoo kom tsav tsheb vim tias qhov kev pheej hmoo siab ntawm qhov tshwm sim tsis zoo.

Urticaria, nrog los ntawm khaus, tawm pob, liab ntawm qee qhov ntawm sab nraud integument thiab o.

Siv rau lub raum tsis zoo muaj nuj nqi

Cov ncauj lus sib kis yog pathologies loj ntawm qhov hloov khoom no. Cov tshuaj tsis tau sau cia nrog txo qis ntawm creatinine tshem tawm mus rau 20 ml / min.

Hauv cov laus, kev ceev faj yuav tsum ua kom tawm dag zog, vim tias qhov kev pheej hmoo ntawm qhov muaj zog txaus txo qis.

Kev cuam tshuam nrog lwm yam tshuaj

Muab cov tshuaj tiv thaiv tsis zoo ntawm cov tshuaj hauv nqe lus nug, yuav tsum ceev faj thaum xaiv cov tshuaj rau cov kev kho nyuaj.

Yog hais tias haus ib ce ntau dhau, kev muaj lub plawv dhia tsis zoo yuav pib ua mob.

Tej kev sib txuam uas xav tau ceev faj

Pab pawg no suav nrog cov tshuaj uas ua rau txo lub siab. Nws yog ib qho tsim nyog yuav tau soj ntsuam qhov tshuaj tiv thaiv ntawm lub cev thaum siv tshuaj heparin, ethanol thiab sodium chloride.

Tsis pub haus dej haus cawv muaj ntau yam nrog rau cov lus nug yog tsis pom zoo.

Cawv tau zoo

Tsis pub haus dej haus cawv muaj ntau yam nrog rau cov lus nug yog tsis pom zoo.

Nws yog ib qho tsim nyog yuav tau xaiv cov tshuaj uas raug pom los ntawm cov kev mob tshwm sim tsawg dua, tab sis tib lub sijhawm ua rau muaj kev tiv thaiv qhov kub siab thiab coj mus rau regression ntawm lub plawv ventricular hypertrophy.

Kev txheeb xyuas txog Tritac

Nws raug nquahu kom koj tau txais cov ntaub ntawv ntau li ntau tau txog qhov ua tau zoo ntawm cov tshuaj. Qhov no pab rau kev soj ntsuam cov neeg siv khoom thiab cov kws tshaj lij.

Zafiraki V.K., kws kho plawv, 39 xyoo, Krasnodar

Nrog tswj pathologies ntawm cov hlab plawv, cov tshuaj no ua haujlwm zoo: nws normalizes ntshav siab thiab tsis ua rau muaj kev phiv. Txawm li cas los xij, hauv feem ntau cov neeg mob, cov kab mob sib kis tau txheeb xyuas, vim tias nws yog qhov muaj teeb meem los sau tshuaj - kev tshuaj xyuas tas li ntawm lub xeev ntawm lub cev yog yuav tsum tau ua.

Alanina E. G., kws kho mob, 43 xyoo, Kolomna

Cov tshuaj no yuav tsum tau noj tshuaj kom zoo, koj tsis tuaj yeem nce ntxiv hauv ib hnub, koj yuav tsum saib xyuas koj kev noj qab haus huv. Thaum thawj qhov tsos mob tshwm sim, txoj kev kho mob cuam tshuam. Kuv yuav tsis lees paub qhov ua tau zoo ntawm cov tshuaj, tab sis kuv sim muab tshuaj rau nws tsawg dua, vim tias muaj qhov pheej hmoo ntawm kev tsim muaj mob hnyav heev.

Maxim, 35 xyoo, Pskov

Qee lub sij hawm kuv noj tshuaj, vim hais tias kuv tau raug mob los ntawm kev kub siab ntev ntev. Nws ua kom sai. Tus kws kho mob tau sau me me, vim tias kuv tsis muaj mob hnyav. Vim li no, cov kev mob tshwm sim tsis tau tshwm sim.

Veronika, 41 xyoo, Vladivostok

Vim yog cov teeb meem ntawm lub nkoj, lub siab feem ntau dhia. Kuv tsis tseg hloov cov tshuaj tiv thaiv kabmob txhawm rau kev pom zoo ntawm kws kho mob. Kuv sim siv tshuaj sib txawv. Cov tshuaj nyob rau hauv nqe lus nug yog qhov zoo heev, vim hais tias cov txiaj ntsig tau pom sai sai. Tab sis qhov no yog cov khoom siv txhoj puab heev. Kuv siv nws tsawg dua li tsis siv analogues.