Lisinopril (10 mg, Himfarm AO) Lisinopril

5 mg, 10 mg thiab 20 mg ntsiav tshuaj

Ib ntsiav tshuaj muaj

cov tshuaj nquag - lisinopril dihydrate 5.5 mg, 11.0 mg lossis 22.0 mg

(sib npaug rau lisinopril 5.0 mg, 10.0 mg lossis 20.0 mg)

tus zam: lactose monohydrate, microcrystalline cellulose, sodium starch glycolate, calcium stearate.

Cov ntsiav tshuaj yog dawb rau qab zib xim tiaj-cylindrical nyob rau hauv cov duab, ntawm ib sab ntawm lub ntsiav tshuaj muaj chamfer, nyob rau lwm qhov - chamfer thiab tuam txhab logo nyob rau hauv daim ntawv ntawm tus ntoo khaub lig (rau tshuaj ntawm 5 thiab 20 mg).

Cov ntsiav tshuaj yog dawb rau qab zib xim dawb-cylindrical, ntawm ib sab ntawm lub ntsiav tshuaj muaj chamfer thiab muaj kev pheej hmoo, nyob rau lwm qhov - chamfer thiab tuam txhab logo nyob rau hauv daim ntawv ntawm tus ntoo khaub lig (rau ntau npaum ntawm 10 mg).

Cov tshuaj pab pawg kho mob

Cov tshuaj uas cuam tshuam rau renin-angiotensin system. Angiotensin-hloov ua enzyme (ACF) inhibitors. Lisinopril.

Tus lej ATX C09AA03

Farmacological zog

Cov Tshuaj Pharmacokinetics

Noj mov tsis cuam tshuam rau kev nqus ntawm cov tshuaj. Qhov siab tshaj plaws hauv cov ntshav ntshav tau mus txog kwv yees li 6 teev tom qab kev tswj hwm ntawm lisinopril. Bioavailability yog 29%. Tsuas yog zam ntawm nws lub koom haum ua ke nrog angiotensin-hloov pauv enzyme, nws nyuaj los txog rau hauv kev sib cuag nrog lwm cov ntshav protein. Nws tsis yog metabolized, nws yog tawm tag nrho los ntawm lub raum tsis hloov pauv. Ib nrab-lub neej yog 12,6 teev. Lisinopril hla kev tso chaw nyob nruab nrab.

Cov Tshuaj Hauv Tshuaj

Lisinopril belongs rau cov pab pawg ntawm angiotensin-hloov pauv enzyme inhibitors. Kev tsuj ntawm ACF ua rau txo qis tsim cov tshuaj angiotensin II (nrog rau cov vasoconstrictor effect) thiab kom txo qis ntawm kev zais ntawm aldosterone. Lisinopril tseem thaiv cov khoom tawg ntawm bradykinin, ib qho muaj zog vasodepressor peptide. Raws li qhov tshwm sim, nws txo cov ntshav siab, tag nrho peripheral vascular tsis kam, ua ntej- thiab tom qab ua haujlwm ntawm lub siab, nce feeb ntau ntau, tso zis tawm ntshav, nce myocardial thev taus mus rau cov thauj khoom thiab txhim kho ntshav muab rau ischemic myocardium. Hauv cov neeg mob uas muaj mob myocardial infarction, lisinopril nrog rau nitrates txo qhov tsim ntawm sab laug ventricular kawg los yog lub plawv tsis ua haujlwm.

Koom nrog kev kho ntawm kev ua haujlwm endothelial uas puas lawm hauv cov neeg mob hyperglycemia.

Kev poob qis hauv ntshav siab pib ib teev tom qab noj cov tshuaj hauv thiab nce mus txog nws qhov siab tshaj plaws tom qab 6 teev. Lub sijhawm sijhawm ntawm lisinopril yog koob tshuaj-siv thiab kwv yees li 24 teev, uas tso cai rau koj siv cov tshuaj 1 zaug nyob rau ib hnub. Nrog rau kev kho mob ntev, qhov ua tau ntawm cov tshuaj tsis txo. Nrog kev txiav tsis meej ntawm kev kho, kev hloov pauv tseem ceeb hauv ntshav siab (tshem tawm mob) tsis tshwm sim.

Txawm hais tias qhov tseem ceeb ntawm lisinopril muaj feem xyuam nrog renin-angiotensin-aldosterone system, cov tshuaj tseem ua tau zoo nyob rau hauv kev kub siab nrog cov ntsiab lus tsawg ntawm renin.

Ntxiv rau qhov txo qis hauv cov ntshav siab, lisinopril txo albuminuria vim hloov ntawm keeb kwm thiab hemodynamics ntawm lub plawv glomerular ntawm lub raum.

Tsuas tshuaj thiab tswj hwm

Lisinopril yog noj ntawm qhov ncauj, tsis hais noj mov, 1 zaug ib hnub, nyiam dua nyob rau tib lub sijhawm.

Lisinopril tuaj yeem siv los ua kev kho mob lossis ua ke nrog lwm cov tshuaj tiv thaiv kabmob.

Nrog rau kev mob ntshav ncig, qhov tsis tu ncua thaum pib ntawm cov tshuaj yog 10 mg. Hauv cov neeg mob uas muaj kev ua haujlwm loj ntawm renin-angiotensin-aldosterone system (tshwj xeeb, nrog kev kho mob ntshav siab, lub plawv tsis ua haujlwm, lossis mob ntshav siab), txo qis hauv cov ntshav siab tom qab thawj koob tshuaj yuav tshwm sim. Yog li, cov neeg mob zoo li no raug pom zoo kom muab cov tshuaj pib ntawm 2.5-5 mg los ntawm kev saib xyuas ntawm kws kho mob.

Kev kho mob yuav tsum pib nrog 5 mg txhua hnub thaum sawv ntxov. Lub sijhawm sijhawm nruab nrab ntawm qhov nce ntxiv hauv ntau npaum li cas yuav tsum yog tsawg kawg 3 asthiv. Qhov kev saib xyuas niaj zaus yog 10-20 mg ntawm Lisinopril 1 zaug hauv ib hnub, thiab qhov siab tshaj plaws ib hnub yog 40 mg 1 zaug nyob rau ib hnub. Txhawm rau kom txo qis ntshav siab, Lisinopril yuav tsum tau ua ke nrog lwm cov tshuaj tiv thaiv kabmob ntshav.

Feem ntau, cov tshuaj nruab nrab kho yog 20 mg ib hnub ib zaug. Yog tias cov txiaj ntsig ua kom zoo tsis tiav hauv 2-4 lub lis piam, cov koob tshuaj yuav raug nce ntxiv.

Kev siv tshuaj diuretic yuav tsum tsum tsis pub tu 2-3 hnub ua ntej pib noj Lisinopril. Yog tias tsis muaj kev tshem tawm ntawm diuretics, tom qab ntawd nws raug nquahu kom pib Lisinopril txoj kev kho nrog 5 mg rau ib hnub. Nws yog ib qho tsim nyog los tswj lub raum thiab cov poov tshuaj poov tshuaj ntau ntau.

Lisinopril yog ntxiv rau kev kho mob uas twb muaj lawm nrog diuretics, mob plawv glycosides lossis beta-blockers. Hauv qhov no, ua ntej, kom deb li deb tau, qhov koob tshuaj ntawm diuretic yuav tsum raug txo kom tsawg. Thawj qhov tshuaj yog 2.5 mg thaum sawv ntxov. Cov koob tshuaj txij nkawm yog tsim nyob rau hauv cov qib nrog nce ntawm 2.5 mg nrog ib nrab ntawm 2-4 lub lis piam. Cov koob tshuaj saib xyuas li niaj zaus yog 5-20 mg ib hnub ib zaug. Nws tsis pom zoo kom ntau tshaj 35 mg rau ib hnub.

Thaum kho, koj yuav tsum tau saib xyuas cov ntshav siab, lub raum kev ua haujlwm, kev saib xyuas cov poov tshuaj thiab sodium hauv cov ntshav txhawm rau kom tsis txhob muaj kev loj hlob ntawm hypotension thiab cuam tshuam txog kev ua haujlwm hauv lub raum.

Mob myocardial infarction rau cov neeg mob uas muaj hemodynamics ruaj khov

Kev kho mob nrog lisinopril tuaj yeem pib hauv 24 teev tom qab ruaj khov myocardial infarction (systolic ntshav siab ntau dua 100 mmHg, tsis muaj cov cim ntawm lub raum tsis ua haujlwm), ntxiv rau cov txheej txheem kho mob rau myocardial infarction (thrombolytic agents, acetylsalicylic acid, beta-blockers, nitrates hauv raws li cov leeg cev nqaij daim tawv thiab transdermal).

Thawj koob tshuaj yog 5 mg, tom qab 24 teev - lwm 5 mg, tom qab 48 teev - 10 mg ntawm Lisinopril. Tom qab ntawd qhov koob tshuaj yog 10 mg 1 zaug nyob rau ib hnub.

Cov neeg mob uas tsis tshua systolic ntshav siab (≤ 120 mm Hg) yuav tsum tau txhaj tshuaj qis dua ntawm Lisinopril, 2.5 mg, ua ntej pib kho lossis thaum thawj 3 hnub tom qab lub plawv nres.

Txoj kev kho yuav tsum txuas ntxiv rau 6 lub lis piam. Kev saib xyuas txij nkawm ntawm cov tshuaj yog 10 mg ib hnub twg. Cov neeg mob uas muaj cov tsos mob ntawm lub plawv tsis ua hauj lwm zoo raug pom zoo kom txuas ntxiv txoj kev kho nrog Lisinopril.

Cov yam ntxwv ntawm kev siv hauv lub raum tsis ua haujlwm

Txij li kev tshem tawm ntawm lisinopril yog dhau los ntawm ob lub raum, qhov pib koob tshuaj yog nyob ntawm creatinine qhov kev tshem tawm, kev saib xyuas txij nkawm nyob ntawm qhov lus teb soj ntsuam, thiab raug xaiv nrog kev saib xyuas tas li ntawm lub raum kev ua haujlwm, ntshiab poov tshuaj thiab sodium ntau.

Kev tshem tawm Creatinine (ml / min)

Koob tshuaj thaum pib (mg / hnub)

3 g / hnub, tuaj yeem txo qhov hypotensive nyhuv ntawm ACF inhibitors. Siv tib lub sijhawm ntawm NSAIDs thiab ACF inhibitors tuaj yeem ua rau hyperkalemia, uas cuam tshuam tsis zoo rau lub raum kev ua haujlwm. Cov nyhuv no feem ntau thim rov qab, thiab nws qhov kev tshaj tawm yog qhov ua tau, ua ntej ntawm txhua yam, hauv cov neeg mob uas muaj lub raum yav dhau los. Kev sib xyaw ua ke ntawm ACF inhibitors thiab NSAIDs yuav tsum tau kho nrog ceev faj, tshwj xeeb tshaj yog rau cov neeg laus lossis cov neeg lub cev qhuav dej. Cov neeg mob yuav tsum tswj hwm nws cov dej kom txaus, tom qab ib txoj kev kho nws tsim nyog los kuaj xyuas lub raum ua haujlwm.

Thaum ACF cov tshuaj tiv thaiv thiab kub tau muab los raws li kev txhaj tshuaj (piv txwv li sodium aurothiomalate), cov tshuaj tiv thaiv nitrate-zoo li (cov tsos mob vasodilation, suav nrog kev yaug dej, xeev siab, kiv taub hau thiab hypotension, uas qee zaum tuaj yeem loj) tuaj yeem tshwm sim ntau zaus.

Siv tib lub sijhawm siv lwm cov tshuaj tiv thaiv kabmob tuaj yeem ua rau muaj kev cuam tshuam hypotensive ntawm lisinopril. Kev siv tshuaj sib xyaw nrog lisinopril nrog nitroglycerin, lwm yam nitrates, lossis lwm yam vasodilators tuaj yeem txo qis ntshav siab.

Nrog kev ceev faj, muab tshuaj lisinopril nrog kev siv tshuaj loog tib lub sijhawm, tricyclic cov tshuaj tiv thaiv kab mob thiab tshuaj tiv thaiv kev tiv thaiv nrog ACF inhibitors vim muaj cov nyhuv hypotensive nce.

Sympathomimetics yuav txo qhov txo hypotensive nyhuv ntawm ACF inhibitors.

Siv cov tshuaj Lisinopril thiab tshuaj tiv thaiv kab mob uas tsis haum tshuaj (insulin, tshuaj hauv lub qhov ncauj hypoglycemic)

ntxiv dag zog rau cov kev mob hypoglycemic kawg ntawm qhov kawg nrog kev pheej hmoo ntawm kev mob ntshav qab zib. Cov nyhuv no muaj feem ntau nyob hauv thawj lub lis piam ntawm kev kho mob sib xyaw thiab hauv cov neeg mob raum tsis ua haujlwm.

Lisinopril tuaj yeem siv ua ke nrog acetylsalicylic acid (hauv kev siv tshuaj muab cov nyhuv antiplatelet), thrombolytics, beta-blockers thiab / lossis nitrates.

Cov lus qhia tshwj xeeb

Pkev txhim khomob txoj hlab ntshahypotension nws ua tau rau cov neeg mob hyponatremia thiab / lossis txo qis cov ntshav ncig uas yog los ntawm kev kho mob nrog diuretics, kev siv cov zaub mov tshwj xeeb lossis lub cev qhuav dej ntawm lub cev rau lwm qhov laj thawj (hws tawm hws, rov ntuav, zawv plab, lim ntshav) thiab nrog lub plawv tsis ua haujlwm. Kev kho mob ntawm hypotension muaj lub txaj so thiab, yog tias tsim nyog, kho txoj kev lis ntshav. Kev hloov ntshav qis dua tsis yog qhov sib txuam rau kev kho mob nrog Lisinopril, txawm li cas los xij, kev txiav tsis siv tshuaj ib ntus lossis txo qis qis dua yuav raug tseev kom muaj.

Cov kev kho mob nrog Lisinopril yuav tsum tau ua ntej los ntawm qhov ib txwm muaj dej-electrolyte tsis txaus thiab tshem tawm ntawm cov ntshav txaus ntim, ntxiv rau, kev saib xyuas kev hloov pauv hauv ntshav siab tom qab noj thawj zaug yog qhov tsim nyog.

Hauv cov kab mob cerebrovascular thiab kev mob plawv hauv lub plawv, nws yuav tsum tau yug los hauv lub siab tias qhov txo qis ntshav siab tuaj yeem ua rau txoj kev txhim kho mob stroke lossis myocardial infarction.

Hauv cov kab mob myocardial infarction kev kho mob nrog lisinopril tsis pom zoo kom pib mob hauv cov neeg mob uas muaj cov cim tsis ua haujlwm ntawm lub raum, uas tau txiav txim siab los ntawm cov ntshav creatinine siab tshaj 177 μmol / L thiab / lossis proteinuria ntau dua 500 mg / 24 h. 265 μmol / l), tom qab ntawd nws yog qhov tsim nyog yuav tsum tshem tawm.

Kev kho nrog lisinopril yog contraindicated nyob rau hauv tus neeg mob cardiogenic poob siab thiab nrog mob myocardial infarctionyog tias qhov kev teem caij vasodilator tuaj yeem cuam tshuam ntau dua hemodynamics, piv txwv li, thaum systolic siab tsis siab tshaj 100 hli Hg

Nrog systolic lub siab tsis tshaj 120 hli Hg, qis ntawm Lisinopril yog tau sau tseg hauv thawj 3 hnub ntawm myocardial infarction - 2.5 mg / hnub. Nrog arterial hypotension, qhov kev saib xyuas txij nkawm yog txo rau 5 mg / hnub lossis ib ntus rau 2.5 mg / hnub. Nrog lub siab ntev hypotension, nrog systolic siab hauv qab 90 hli Hg, cov tshuaj raug muab tso tseg.

Nroglub raum mob leeg (ob leeg los sis ib leeg) nrog ibraum)

Hauv qee tus neeg mob uas muaj ob lub raum mob raum ua rau lub raum lub siab los yog lub cev ntawm lub raum txoj leeg ntshav, qhov muaj peev xwm ntawm urea thiab creatinine nyob rau hauv cov ntshav cov ntshav nce ntxiv, uas, raws li txoj cai, yog qhov thim rov qab tom qab tsis txiav kev kho, thaum Lisinopril yog tshuaj. Qhov no feem ntau muaj rau cov neeg mob lub raum tsis ua haujlwm.

NtawmRenovascular tawg tseem muaj qhov pheej hmoo ntawm kev tsim muaj mob ntshav khov ntau heev thiab lub raum tsis ua haujlwm. Hauv cov neeg mob no, kev kho mob nrog lisinopril yuav tsum pib ua kev tswj hwm nruj nrog kev noj tshuaj me me, tom qab ntawv titration.

Aortic, mitral valve stenosis, hypertrophic cardiomyopathy

Zoo ib yam li lwm tus ACF inhibitors, lisinopril yuav tsum siv nrog ceev faj hauv cov neeg mob uas muaj mitral valve stenosis, aortic pob valve, lossis hypertrophic cardiomyopathy.

Angioedema tsis tshua muaj rau cov neeg mob uas tau txais ACF inhibitors. Hauv cov xwm txheej zoo li no, cov tshuaj yuav tsum nres tam sim ntawd thiab kev kho tsim nyog yuav tsum tau kho kom txog thaum pom cov tsos mob ntawm edema raug tshem tawm tag nrho.

Hauv cov kev phais mob sab nraud lossis nyob rau hauv cov tshuaj uas muaj lub zog hypotensive, Lisinopril thaiv qhov kev hloov pauv ntawm kev them nyiaj rov qab los ntawm kev rov qab zoo rau angiotensin-II. Hypotension, qhov yuav tshwm sim los ntawm cov txheej txheem saum toj no, tuaj yeem tshem tawm los ntawm kev rov ua dua qhov ntim ntawm cov ntshav ncig.

Hemodialysis/ LDLlipid apheresis / desensitization kev kho mob

Nrog rau kev tswj hwm tib lub sijhawm ntawm Lisinopril thiab kev lim ntshav nrog polyacryl-nitrile membrane lossis LDL (qis lipoprotein) apheresis nrog dextran sulfate lossis desensitization tiv thaiv cov kab mob kab mob (muv, nkawj), anaphylactic poob siab yuav tshwm sim.

Nws raug nquahu kom koj siv cov roj ntsha txawv txawv lossis ib ntus hloov Lisinopril nrog lwm cov tshuaj tiv thaiv kabmob (tsis yog ACF inhibitors).

Ua ntej desensitization, lisinopril yuav tsum tsis ua mus ntxiv.

Neutropenia, agranulocytosis, thrombocytopenia thiab ntshav liab tau pom muaj tsawg kawg hauv cov neeg mob tau txais ACF inhibitors. Cov kev tshwm sim no yog qhov thim rov qab tom qab kev txiav tawm ntawm Lisinopril. Cov tshuaj yuav tsum tau siv nrog kev ceev faj heev rau cov neeg mob autoimmune uas tau txais cov tshuaj tiv thaiv kab mob, allopurinol, lossis procainamide. Thaum siv lisinopril nyob rau hauv cov neeg mob li ntawd, kev soj ntsuam ib ntus ntawm cov theem ntawm cov leukocytes hauv cov ntshav tau pom zoo.

Nroj ntshaayintolerancegalactose tsis txaus Lapp lactase,piam thaj malabsorption syndrome - galactose

Lisinopril yuav tsum tsis txhob raug rau cov neeg mob uas tsis tshua pom muaj kev tiv thaiv kab mob galactose tsis txaus, Lapp lactase tsis txaus lossis cov tsos mob ntawm lub cev tsis muaj cov kua qab zib - galactose vim muaj lactose monohydrate hauv nws cov lus qhia.

Cov yam ntxwv ntawm cov nyhuv ntawm cov tshuaj ntawm lub peev xwm tsav lub tsheb lossis cov phom sij phom sij

Thaum noj Lisinopril, nws tsis pom zoo kom tsav tsheb thiab ua haujlwm nrog cov kev phom sij uas muaj peev xwm, vim tias muaj kev txhim kho uas muaj kev tsis haum (kiv taub hau).

Noj ntau dhau

Cov tsos mob Kev mob ntshav siab ceev mus txog rau lub xeev poob siab, hyperkalemia, bradycardia, tachycardia, ua tsis taus pa, lub raum tsis ua haujlwm, hnoos, kiv taub hau, ntxhov siab.

Kev Kho Mob: pais plab lav, kev noj adsorbents thiab sodium sulfate tom qab noj Lisinopril ntsiav tshuaj sab hauv. Nws yog qhov tsim nyog los tswj cov dej-electrolyte sib npaug thiab cov tshuaj creatinine siab.

Kev kho cov tsos mob yog tshuaj kho, tso ntshav tswj hwm ntawm 0.9% sodium chloride tov, adrenergic agonists nrog mob ntshav siab ntau heev. Nrog rau bradycardia, atropine yog muab tshuaj, yog tias tsim nyog, nws yog qhov tsim nyog los xav txog kev txhim kho lub tshuab nqus tsev. Lisinopril raug ntiab tawm los ntawm hemodialysis.

Daim ntawv tso tawm thiab ntim khoom

Ntawm 10 ntsiav tshuaj hauv lub ntsej muag hle khaub ncaws ntim los ntawm zaj duab xis ntawm polyvinyl chloride thiab txhuas ntawv ci.

3, 5 contour pob ua ke nrog cov lus qhia pom zoo rau kev siv kho mob hauv lub xeev thiab Lavxias lus yog muab tso rau hauv pob ntawv los qhia.

Pub cov hlwv ntim cov pob (tsis muaj qhov txuas ntxiv rau cov pob ntawv ntawm daim cardboard) muab tso rau hauv cov thawv ntawv thawv. Raws li tus naj npawb ntawm cov pob, cov lus qhia rau kev siv kho mob hauv lub xeev thiab Lavxias lus yog muab tso rau hauv txhua lub thawv.