Dapril 20 mg: cov lus qhia rau kev siv

Dapril muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj (10 daim ib qho hauv cov hlwv pob, hauv ib lub thawv ntawv cardboard: 5 mg thiab 10 mg rau txhua - 3 pob, 20 mg ib - 2 pob).

1 ntsiav tshuaj muaj:

• cov tshuaj nquag: lisinopril - 5 mg, 10 mg lossis 20 mg,
• Cov khoom siv pabcuam: calcium hydrogen phosphate, mannitol, hlau oxide (E172), magnesium stearate, gelatinized hmoov txhuv nplej siab, hmoov txhuv nplej siab.

Cov Yuav Tsum Muaj

• keeb kwm ntawm angioedema,
• thawj hyperaldosteronism,
• mob raum tsis zoo,
• ob leeg lub raum leeg mob stenosis los yog leeg ntshav ntawm ib raum nrog mob azotemia,
• azotemia
• mob tom qab hloov raum,
• hyperkalemia
• stenosis ntawm aortic orifice thiab zoo ib yam li hemodynamic cuam tshuam,
• cov me nyuam muaj hnub nyoog
• II thiab III trimesters ntawm lub sijhawm cev xeeb tub,
• pub niam mis
• muaj qhov hloov pauv tau rau ACE inhibitors thiab tshuaj tiv thaiv tshuaj.

Tsuas tshuaj thiab tswj hwm

Cov ntsiav tshuaj yog noj ntawm qhov ncauj.

Tus kws kho mob sau ntawv muab lub koob txhaj tshuaj ib lub zuj zus raws li kev ntsuas tus kheej thiab cov tib neeg xav tau ua kom tiav cov txiaj ntsig zoo.

• arterial hypertension: thawj koob tshuaj - 10 mg 1 zaug ib hnub. Tom ntej no, lub koob tshuaj tau xaiv ib tus zuj zus, coj mus rau hauv tus lej theem ntawm ntshav siab (BP) ntawm tus neeg mob, cov tshuaj txij nkawm ib txwm yog 20 mg ib hnub ib zaug, thaum tsis muaj cov tshuaj kho txaus tom qab 7 hnub ntawm txoj kev kho, nws tuaj yeem nce ntxiv rau 40 mg. Qhov koob tshuaj txhua hnub yog 80 mg,
• mob plawv tsis ua hauj lwm: thawj koob tshuaj yog 2.5 mg rau ib hnub, koob tshuaj txij nkawm yog 5-20 mg ib hnub twg.

Yog tias muaj teeb meem lub raum tsis ua haujlwm, koob tshuaj txhua hnub yog tsim tsa rau hauv tus account creatinine tshem tawm (CC):

• QC ntau dua 30 ml / min: 10 mg,
• KK 10-30 ml / min: 5 mg,
• CC tsawg dua 10 ml / min: 2.5 mg.

Sab sij huam

• los ntawm cov hlab plawv: tsis tshua muaj - tachycardia, orthostatic hypotension,
• los ntawm cov leeg hlwb: zoo nkaus li qaug zog, mob taub hau, kiv taub hau, qee zaum - tsis meej pem, tsis khov ntawm kev xav,
• los ntawm cov kab mob hemopoietic: agranulocytosis, neutropenia, qis dua ntshav hemoglobin ntau ntau, txo qis cov qe ntshav liab tsawg,
• los ntawm lub plab zom mov: xeev siab, tsis tshua muaj - lub qhov ncauj qhuav, mob plab, zawv plab, qee zaum - nce kev ua si ntawm daim siab enzymes, nce qib ntawm bilirubin hauv cov ntshav,
• kev ua xua: tsis tshua muaj - tawv nqaij ua pob, qee zaum - Quincke's edema,
• los ntawm kev ua pa: qhuav hnoos,
• lwm tus: qee zaum - hyperkalemia, cuam tshuam ntawm lub raum tsis ua haujlwm.

Cov lus qhia tshwj xeeb

Kev siv cov tshuaj ACE inhibitors tuaj yeem ua rau muaj kev cuam tshuam rau hauv daim ntawv hnoos qhuav, uas ploj mus tom qab tshem yeeb tshuaj. Qhov no yuav tsum tau coj mus rau hauv qhov kev kuaj mob sib txawv ntawm hnoos hauv tus neeg mob noj Dapril.

Qhov laj thawj rau qhov cim tseg rau hauv cov ntshav siab yog qhov txo qis hauv lub cev lub cev qhov tshwm sim los ntawm kev zawv plab los yog ntuav, siv cov tshuaj diuretics, txo qis ntsev noj, lossis lim ntshav. Yog li, nws raug nquahu kom pib kho nyob rau hauv kev saib xyuas nruj ntawm tus kws kho mob thiab nrog ceev faj nce qhov ntau ntawm cov tshuaj.

Thaum hemodialysis siv daim nyias nyias nrog qhov siab permeability, muaj kev pheej hmoo siab ntawm kev tsis haum tshuaj. Yog li ntawd, rau kev lim ntshav, nws yog ib qho tsim nyog yuav tsum tau siv tsuas yog daim nyias nyias ntawm lwm yam sib txawv lossis hloov cov tshuaj nrog lwm tus neeg sawv cev antihypertensive.

Yeeb tshuaj sib cuam tshuam

Nrog tib lub sijhawm siv Dapril:

• potassium-sparing diuretics (triamteren, spironolactone, amiloride), cov khoom noj muaj potassium ntxiv cov muaj ntsev ntxiv ntsev - ua rau muaj kev pheej hmoo ntawm hyperkalemia, tshwj xeeb tshaj yog muaj kev tsis zoo hauv lub raum,
• diuretics, tshuaj tiv thaiv kab mob - ua rau txo qis ntshav siab,
• non-steroidal anti-inflammatory tshuaj - txo cov nyhuv antihypertensive ntawm cov tshuaj,
• lithium npaj - qeeb tus nqi ntawm lawv cov kev nthuav tawm los ntawm lub cev,
• ethanol - txhim kho cov nyhuv ntawm cov tshuaj.

Dapril analogues yog: ntsiav tshuaj - Diroton, Lisinopril, Lisinopril-Teva, Lisinoton.

Pharmacological kev txiav txim

Dapril yog cov tshuaj tiv thaiv kev tsis haum tshuaj los ntawm cov pab pawg ntawm angiotensin-inhibiting enzyme (ACE) inhibitors uas muaj cov kev ua kom ntev ntev. Cov tshuaj ntxaug nquag lisinopril yog tshuaj metabolite ntawm enalapril (enalaprilat). Lisinopril, inhibiting ACE, inhibits qhov tsim ntawm angiotensin II los ntawm angiotensin Kuv. Raws li qhov txiaj ntsig, vasoconstrictor nyhuv ntawm angiotensin II yog tshem tawm. kev tsim cov tshuaj angiotensin III, uas muaj qhov ua rau pom zoo inotropic, txo qis, kev tso tawm ntawm norepinephrine los ntawm presynaptic hlwv ntawm cov leeg hlwb qhov kev xav txo qis, kev zais ntawm aldosterone nyob rau hauv thaj chaw glomerular ntawm adrenal cortex thiab hypokalemia los ntawm nws thiab kev tuav cia ntawm sodium thiab dej raug txo. Tsis tas li ntawd, muaj kev sib txuam ntawm bradykinin thiab prostaglandins uas ua rau vasodilation. Tag nrho cov no ua rau txo qis ntshav siab, qeeb qeeb thiab maj mam dhau ntawm kev teem sijhawm luv luv-captopril. Yog li, kev nce siab hauv lub plawv tsis tshwm sim. Lisinopril txo tag nrho cov kev tawm tsam mob ntshav tawm tsam (OPSS) thiab tom qab ua haujlwm, uas ua rau muaj qhov nce ntxiv ntawm cov hlab plawv, cov kab mob hauv lub plawv, thiab cov ntshav ntws rov qab. Tsis tas li ntawd, cov leeg muaj peev xwm nce, thauj khoom, ua kom lub siab nyob rau hauv txoj cai atrium, txoj hlab ntsws thiab cov leeg ntshav qis, i.e. hauv cov hlab ntsws, qhov xaus-diastolic siab nyob rau sab laug ventricle tsawg, diuresis nce ntxiv. Qhov siab ua rau lub ntsej muag glomerular capillaries poob qis, proteinuria poob qis thiab kev txhim kho ntawm glomerulosclerosis qeeb qeeb. Cov nyhuv tshwm sim 2 teev tom qab siv tshuaj. Cov txiaj ntsig siab tshaj plaws yuav tshwm sim tom qab 4-6 teev thiab kav tsawg kawg 24 teev.

Tsuas tshuaj thiab tswj hwm

Hauv kev kho mob ntshav siab, thawj koob tshuaj 5 mg 1 zaug nyob rau ib hnub. Txij nkawm koob tshuaj kom txog li 20 mg ib hnub ib zaug. Nrog rau kev kho mob txhua lub lim tiam, cov tshuaj zoo tau nce ntxiv txog 20-40 mg ib hnub twg. Kev xaiv koob tshuaj yog nqa tawm ntawm tus kheej nyob ntawm seb ntsuas ntshav siab li cas. Qhov siab tshaj plaws yog 80 mg rau ib hnub.

Hauv kev mob plawv tsis ua haujlwm, thawj koob tshuaj 2.5 mg ib hnub twg. Qhov kev saib xyuas ib txwm muaj li 5 mus rau 20 mg rau ib hnub.

Yog tias muaj teeb meem lub raum tsis zoo, lub koob tshuaj raug teeb tsa raws li creatinine qhov kev tshem tawm (QC). Nrog CC ntau dua 30 ml / feeb, qhov koob tshuaj pom zoo yog 10 mg / hnub. Nrog CC los ntawm 30 txog 10 ml / min, cov koob tshuaj yog 5 mg ib hnub ib zaug. Nrog CC tsawg dua 10 ml / min 2.5 mg.

Kev ntsuas rau siv

Dapril yog siv los kho:

• arterial hypertension (suav nrog kev kho mob tshiab) - cov tshuaj yeeb yaj kiab tuaj yeem siv nrog lwm cov tshuaj tiv thaiv kabmob ntshav lossis hauv kev kho mob,
• mob plawv tsis ua hauj lwm (rau kev kho mob rau cov neeg mob noj tshuaj diuretics thiab / lossis digitalis npaj ua ib feem ntawm kev sib xyaw ua ke).

Tso tawm daim ntawv, muaj pes tsawg leeg

Dapril muaj nyob rau hauv daim ntawv ntawm convex round liab ntsiav tshuaj. Txwv tsis pub cov neeg tsawg thiab marbling raug tso cai. Cov ntsiav tshuaj muab tso rau hauv cov hlwv pob, thiab tom qab ntawv ntim rau hauv cov duab los qhia.

Txhua lub ntsiav tshuaj muaj lisinopril (nquag ua haujlwm sib xyaw), nrog rau cov tshuaj tiv thaiv - mannitol, E172, calcium hydrogen phosphate, gelatinized hmoov txhuv nplej siab, hmoov txhuv nplej siab, magnesium stearate.

Kev cuam tshuam nrog lwm yam tshuaj

Siv tib lub sijhawm Dapril nrog cov poov tshuaj pab ntxiv, poov tshuaj ntsev, potassium-sparing diuretics (amiloride, triamteren, spironolactone) ua rau muaj kev pheej hmoo ntawm hyperkalemia (tshwj xeeb tshaj yog nyob rau hauv cov neeg mob uas tsis zoo lub raum kev ua haujlwm), nrog NSAIDs, nws muaj peev xwm ua kom tsis muaj zog ntawm cov tshuaj lisinopril, nrog cov tshuaj tiv thaiv kab mob thiab tshuaj tua kab mob. kev mob siab hypotension, nrog lithium npaj - ncua kev tshem tawm ntawm lithium los ntawm lub cev.

Kev siv dej cawv ua rau muaj kev cuam tshuam ntawm kev ua haujlwm ntawm lub siab ua haujlwm.

Thaum cev xeeb tub

Lub chaw tsim khoom lag luam tsom mus rau qhov ua tsis tau ntawm kev siv lisinopril thaum yauv tes taw. Sai li qhov tseeb ntawm kev xeeb tub yog paub tseeb, cov tshuaj yuav tsum tau nres tam sim ntawd.

Nws yog ib qho tseem ceeb kom nco ntsoov tias kev kho mob nrog ACE inhibitors nyob rau hauv koob thib 3 thiab 2 txiav tawm muaj qhov cuam tshuam rau lub cev xeeb tub (qhov teeb meem tshwm sim muaj xws li hyperkalemia, mob ntshav tuag, qhov cim txo qis hauv ntshav siab, pob txha taub hau hypoplasia, lub raum tsis ua haujlwm).

Nyob rau tib lub sijhawm, tsis muaj pov thawj pom qhov tsis zoo ntawm cov tshuaj ntawm tus menyuam hauv thawj lub hlis.

Yog tias cov menyuam mos lossis menyuam mos kis rau ACE cov tshuaj tiv thaiv nyob hauv plab, nws yuav tsum tau ua tib zoo saib nws mob. Qhov no yog qhov tsim nyog rau kev kuaj xyuas raws sij hawm ntawm hyperkalemia, oliguria, ib qho cim txo qis hauv cov ntshav siab.

Nws paub meej tias lisinopril muaj peev xwm nkag mus rau qhov tus me nyuam, tab sis tseem tsis muaj ntaub ntawv qhia tias nws nkag mus rau hauv niam mis.

Raws li kev ceev faj, nws raug nquahu kom tsis txhob pub niam mis rau lub sijhawm tag nrho ntawm kev kho nrog Dapril.

Cov lus thiab cov xwm txheej ntawm kev cia

Cov chaw tsim khoom ntawm Dapril ua rau cov neeg tau txais kev pab xav tau xaiv qhov chaw qhuav, tsaus muag los khaws cov tshuaj.

Hauv qhov no, huab cua hauv chav yuav tsum tsis pub tshaj 25 degrees. Tsuas yog tias cov xwm txheej saum toj saud, tau muab cov khoom tso rau tag nrho cov txee lub neej ntawm 4 xyoo.

Hauv nruab nrab, ib pob ntawm Dapril nqi rau cov pej xeem ntawm Lavxias Federation 150 rubles.

Tus neeg mob nyob hauv Ukraine, tuaj yeem yuav ib pob tshuaj ntawm cov tshuaj nyob rau nruab nrab rau 40 hryvnia.

Dapril analogues suav nrog cov tshuaj xws li Diroton, Diropress, Iramed, Zoniksem, Lizigamma, Lizakard, Lisinopril, Lisinoton, Lisinopril dihydrate, Lisinopril granulate, Rileys-Sanovel, Lizoril, Liziprex, Lizonlir, Lilonopril, Lilonopril, Lilonopril, Lilonopril, Lilonopril, Lilonopril, Lilonopril, Lilonopril, Lilonopril

Feem ntau, kev tshuaj xyuas cov neeg siv Internet txog kev siv tshuaj Dapril yog qhov zoo.

Cov neeg mob thiab kws kho mob teb tau zoo rau cov tshuaj, tsom rau nws cov txiaj ntsig thiab kev nrawm ntawm kev txiav txim siab.

Cov neeg ua hauj lwm kev noj qab haus huv tsom rau cov hauv qab no: txawm hais tias muaj ntau qhov tshwm sim hauv cov lus qhia, lawv tsis tshua muaj tshwm sim (qhov nquag muaj tshwm sim ntawm ib tus neeg tsis xav tau nyob hauv thaj tsam li ntawm 0.01 txog 1%).

Koj tuaj yeem nyeem cov kev txheeb xyuas ntawm cov neeg mob tiag tiag txog cov tshuaj nyob rau hauv qhov kawg ntawm tsab xov xwm.

Yog li, Dapril tau tso rau qhov kev siv tshuaj los tiv thaiv kev tiv thaiv zoo.

Cov tshuaj yog nyob rau hauv kev thov, vim nws muaj, tus nqi qis.

Kev yuav tshuaj hauv khw muag tshuaj, koj yuav tsum muab daim ntawv qhia tshuaj los ntawm kws kho mob.

Yuav siv li cas: noj ntau thiab hom tshuaj kho

Sab hauv, nrog txoj hlab ntshav tawg - 5 mg ib hnub ib zaug. Thaum tsis muaj txiaj ntsig, qhov koob tshuaj tau nce ntxiv txhua 2-3 hnub los ntawm 5 mg rau qhov nruab nrab cov tshuaj kho 20-40 mg / hnub (nce qhov koob tshuaj saum toj 20 mg / hnub feem ntau tsis ua rau txo qis ntshav siab). Qhov nyiaj pab ntau tshaj txhua hnub yog 80 mg.

Nrog HF - pib nrog 2.5 mg ib zaug, tom qab ntawd koob tshuaj nce siab dua 2.5 mg tom qab 3-5 hnub.

Hauv cov neeg laus, ib qho kev tshaj tawm ntev dua hypotensive nyhuv yog feem ntau pom, uas cuam tshuam nrog kev txo qis ntawm lisinopril excretion (nws tau pom zoo kom pib kho nrog 2.5 mg / hnub).

Hauv kev mob raum tsis ua haujlwm, kev sib txuam tau tshwm sim nrog qhov txo tsawg dua lim pom tsawg dua 50 ml / min (qhov koob tshuaj yuav tsum raug txo 2 zaug, nrog CC tsawg dua 10 ml / min, qhov tshuaj yuav tsum raug txo 75%).

Nrog cov kev mob ntshav siab ntev, kev kho mob mus ntev yog qhia ntawm 10-15 mg / hnub, nrog lub plawv tsis ua haujlwm - 7,5-10 mg / hnub.

Cov Tshuaj Hauv Tshuaj

Dapril thaiv qhov tsim ntawm oligopeptide hormone, uas muaj vasoconstrictor effect. Tseem muaj qhov txo qis ntawm tag nrho cov kev tawm tsam mob vascular, ua ntej- thiab tom qab ua rau lub siab, xyaum tsis muaj feem cuam tshuam rau lub plawv dhia thiab feeb ntawm cov ntshav.

Tsis tas li ntawd, cov tsis kam ntawm cov hlab ntsha txo thiab lub ntshav kev hauv cov hloov khoom nruab nrog. Feem ntau, qhov poob siab tom qab noj tshuaj dua yog sau tseg tom qab 1-2 teev (siab tshaj plaws tom qab 6-9 teev).

Txhawb cov kev ua kom zoo yog pom tom qab 3-4 lub lis piam los ntawm kev pib kho. Cov tsos mob tshem tawm cov tshuaj tsis txhim kho.

Thaum kho, muaj qhov nce ntawm qhov tsis txaus ntseeg lub cev, thaum nyob rau hauv cov neeg mob ntshav siab muaj qhov txo qis siab yam tsis muaj kev txhim kho ntawm reflex tachycardia.

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Cov Tshuaj Pharmacokinetics

Dapril yog nqus los ntawm kwv yees li 25-50%. Qhov qib ntawm nqus ntawm cov tshuaj tsis cuam tshuam los ntawm kev noj zaub mov.

Hauv cov ntshav ntshav, cov tshuaj nce mus txog nws qhov kev xav ntau tshaj plaws tom qab 6-8 teev.

Tsis muaj kev khi ntawm cov tshuaj mus rau cov protein thiab metabolization, cov tshuaj yog tawm tsis pauv los ntawm ob lub raum.

Yog tias lub raum tsis ua haujlwm, lub sijhawm tshem tawm ntawm cov tshuaj nce ntxiv raws li qhov ntsuas tsis ua haujlwm tau zoo.

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Kev siv dapril thaum cev xeeb tub

Cov khoom siv tseem ceeb ntawm Dapril yog lisinopril, uas muaj peev xwm nkag mus rau hauv qhov chaw tiv thaiv kab mob, yog li kev noj tshuaj yog contraindicated rau cov poj niam cev xeeb tub. Noj Dapril thaum cev xeeb tub tuaj yeem cuam tshuam tsis zoo rau kev loj hlob ntawm tus me nyuam hauv plab. Noj cov tshuaj hauv thawj thiab thib ob txiav plaub ntug tuaj yeem ua rau me nyuam hauv plab tuag, pob txha taub hau hypoplasia, lub raum tsis ua haujlwm thiab lwm yam kev cuam tshuam.

Noj ntau dhau

Thaum noj ntau dhau ntawm cov koob tshuaj pom zoo, dapril ua rau muaj qhov txo qis hauv cov ntshav siab, noj ntau dhau ntawm lub qhov ncauj qhov ntswg, lub raum tsis ua haujlwm, lub plawv dhia thiab ua pa, kiv taub hau, cuam tshuam ntawm cov dej-electrolyte tshuav nyiaj li cas, ntxhov siab, chim siab, nkees.

Nyob rau hauv rooj plaub ntawm kev siv ntau dhau ntawm cov tshuaj, pais plab lav thiab kev coj ntawm enterosorbents pom zoo.

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Kev sib cuam tshuam nrog lwm yam tshuaj

Nrog rau kev tswj hwm tib lub sijhawm ntawm Dapril nrog rau lwm cov tshuaj uas txo cov ntshav siab (tshwj xeeb nrog tshuaj diuretics), muaj kev cuam tshuam hypotensive yog pom.

Cov tshuaj nonsteroidal nrog cov nyhuv tshuaj tiv thaiv (acetylsalicylic acid, ibuprofen, thiab lwm yam), sodium chloride nrog Dapril txo cov kev kho mob ntawm cov tom kawg.

Kev tswj hwm ib txhij ntawm cov tshuaj nrog cov poov tshuaj lossis lithium ua rau nce theem ntawm cov tshuaj no hauv cov ntshav.

Cov tshuaj tiv thaiv Immunosuppressive, tshuaj antitumor, alopurinol, tshuaj steroid, procainamide nrog Dapril ua rau txo qis hauv qib ntawm leukocytes.

Dapril nce qhov yuav tsum paub tias muaj cawv lom.

Cov tshuaj yeeb dej cawv, tshuaj pleev xim txhim kho cov nyhuv kho mob ntawm Dapril.

Nrog rau cov ntshav ua kom huv, cov tshuaj tiv thaiv anaphylactic ua tau.

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