Amlodipine Lisinopril > Kev khomob thiab kev tiv thaiv

Lub npe Latin: Amlodipine + Lisinopril

ATX Code: C09BB03

Tus nquag ua hauj lwm: amlodipine (Amlodipine) + lisinopril (Lisinopril)

Chaw tsim tshuaj paus: Severnaya Zvezda CJSC (Russia)

Hloov kho cov lus piav qhia thiab yees duab: 07/10/2019

Amlodipine + Lisinopril yog cov tshuaj tiv thaiv kev tiv thaiv kabmob uas muaj cov tshuaj calcium calcium blocker qeeb qeeb thiab cov angiotensin hloov mus rau enzyme (ACE) inhibitor.

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Cov tshuaj muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj: puag ncig, tiaj-cylindrical, yuav luag dawb lossis dawb, nrog cov chamfer thiab txoj kab sib cais (10 txhua qhov hauv cov hlwv pob, hauv ib pob ntawv los ntawm 3, 5 lossis 6 pob, 30 daim hauv lub hwj lossis lub hwj, hauv daim thawv ntawv thawv 1 tuaj yeem lossis lub raj mis.Txhua pob muaj cov lus qhia rau kev siv Amlodipine + Lisinopril).

1 ntsiav tshuaj muaj:

cov khoom xyaw nquag: amlodipine (hauv daim ntawv ntawm amlodipine besilate) + lisinopril (hauv daim ntawv ntawm lisinopril dihydrate) - 5 mg (6.95 mg) + 10 mg (10.93 mg), 10 mg (13.9 mg) + 20 mg (21 , 86 mg) lossis 5 mg (6.95 mg) + 20 mg (21.86 mg),
Lub cev ntu: sodium carboxymethyl hmoov txhuv nplej siab, anhydrous aerosil (silicon dioxide colloidal anhydrous), microcrystalline cellulose, magnesium stearate.

Cov Tshuaj Hauv Tshuaj

Amlodipine + Lisinopril yog cov tshuaj tiv thaiv kev tiv thaiv tsis haum tshuaj, lub tshuab ntawm kev coj ua uas yog vim muaj cov yam ntxwv ntawm nws cov khoom nquag - amlodipine thiab lisinopril.

Amlodipine yog calcium calcium blocker, lub zog ntawm dihydropyridine. Nws muaj hypotensive thiab muaj txiaj ntsig antianginal. Nws cov haujlwm antihypertensive yog vim cov nyhuv relaxing exerted ncaj qha rau ntawm cov leeg nqaij mos ntawm lub cev vascular. Cov tshuaj thaiv cov transmembrane hloov ntawm calcium ions kom cov leeg hlwb ntawm cov hlab ntsa thiab cardiomyocytes. Qhov ua tiav antianginal ntawm amlodipine txiav txim siab nthuav dav ntawm cov hlab ntshav thiab txhaws hlab ntsha thiab cov hlab ntsha. Nrog angina pectoris, qhov no pab txo qis qhov mob ntawm myocardial ischemia. Kev nthuav dav ntawm peripheral arterioles ua rau kev txo qis ntawm OPSS (tag nrho peripheral vascular tsis kam), qhov txo qis rau tom qab tawm ntawm lub plawv thiab myocardial oxygen xav tau. Kev nthuav dav ntawm cov hlab ntsha txhaws thiab cov hlab ntsha hauv ischemic thiab tsis hloov pauv thaj chaw ntawm myocardium muab kev nce siab hauv oxygen nkag mus rau myocardium (tshwj xeeb nrog vasospastic angina pectoris). Amlodipine txwv tsis pub spasm ntawm cov hlab ntsha txoj hlab ntshav, uas tuaj yeem tshwm sim, suav nrog kev haus luam yeeb.

Ntev hypotensive nyhuv yog koob tshuaj. Nrog kev mob ntshav siab, noj tshuaj amlodipine ib hnub ib zaug muab qhov ua rau muaj ntshav nce siab ntau (24) teev nyob rau hauv 24 teev nyob rau hauv qhov chaw sawv thiab dag.

Rau amlodipine, qhov tshwm sim ntawm cov mob sib khuav ntawm cov ntshav tsis ruaj khov yog qhov tsis paub txog kev sib txuas nrog qhov pib qeeb ntawm cov nyhuv antihypertensive. Nrog cov angina pectoris ruaj khov, ib koob tshuaj txhua hnub nce kev tawm dag zog ua kom lub cev tsis muaj zog, pab ua rau qeeb ntawm kev txhim kho angina tawm tsam thiab ST ntu kev nyuaj siab ntawm qhov ischemic xwm, thiab txo cov zaus ntawm angina tawm tsam thiab qhov xav tau rau noj nitroglycerin lossis lwm yam nitrates.

Amlodipine tsis cuam tshuam rau myocardial contractility thiab nws txoj kev coj ua, txo qhov kawm ntawm sab laug ventricular myocardial hypertrophy. Nws inhibits platelet kev sib sau, tsis ua rau muaj kev nce qib hauv lub plawv dhia (HR), nce glomerular filtration rate (GFR), thiab muaj cov tsis muaj zog natriuretic.

Kev soj ntsuam mob ntshav siab tshwm sim tom qab 6-10 teev, qhov cuam tshuam ntev li 24 teev. Hauv cov neeg mob uas mob ntshav qab zib nephropathy, noj tshuaj tsis ua rau muaj qhov nce ntxiv ntawm qhov mob microalbuminuria. Tsis muaj qhov tshwm sim tsis zoo ntawm amlodipine rau cov metabolism lossis ntshav plasma lipid concentration tau sau tseg. Nws siv yog qhia rau cov neeg mob nrog concomitant pathologies xws li mob ntsws asthma, mob ntshav qab zib mellitus, gout.

Kev siv cov amlodipine rau angina pectoris, carotid arteriosclerosis, mob rau cov hlab ntshav tawm (los ntawm kev puas tsuaj rau ib lub hlab ntsha mus rau qhov tsis txaus ntawm peb lossis ntau cov hlab ntsha) thiab lwm yam kab mob ntawm cov hlab plawv, nrog rau cov neeg mob uas tau myocardial infarction lossis percutaneous transluminal coronary angioplasty intima-media ntawm cov carotid rau cov hlab ntsha, pab txo qis kev tuag los ntawm myocardial infarction, mob stroke, mob hlab ntsha o hla kev sib tsoo lossis percutaneous transluminal cortex onary angioplasty. Tsis tas li ntawd, tus naj npawb ntawm cov tsev kho mob vim qhov kev hloov kho ntawm mob plawv tsis ua hauj lwm thiab lub siab tsis tuaj yeem raug txo qis, thiab qhov zaus ntawm kev cuam tshuam los kho cov ntshav ntshav khiav haujlwm tsawg dua.

Hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntawm III - IV ua haujlwm hauv chav kawm raws li NYHA kev faib tawm (New York Cardiac Association), tib lub sijhawm siv amlodipine nrog digoxin, ACE inhibitors lossis diuretics tsis ua rau muaj kev pheej hmoo ntawm kev mob thiab tuag taus.

Nrog rau qhov tsis-ischemic etiology ntawm mob plawv tsis ua hauj lwm (NYHA chav kawm III - IV ua haujlwm chav kawm), amlodipine nce kev pheej hmoo ntawm mob ntsws ntsws.

Lisinopril, ua ib qho ACE inhibitor, txo kev tsim cov tshuaj angiotensin II los ntawm angiotensin I, uas ua rau txo qis ntawm kev tsis txaus siab ntawm angiotensin II thiab kev txo qis ncaj qha rau ntawm kev zais ntawm aldosterone. Raws li kev ua ntawm lisinopril, qhov puas tsuaj ntawm bradykinin tsawg dua, thiab kev sib txuas ntawm cov prostaglandins nce. Los ntawm kev txo qis OPSS, preload, ntshav siab thiab ntshav siab hauv cov hlab ntsws capillaries, cov tshuaj tsub kom ntau feeb feeb ntawm cov ntshav thiab nce myocardial siab rau kev ua haujlwm hauv lub cev hauv lub plawv tsis ua haujlwm. Arteries nthuav dav rau ntau dua cov leeg ntshav. Ib feem ntawm cov teebmeem ntawm lisinopril tau piav qhia los ntawm cov nyhuv ntawm cov nqaij mos renin-angiotensin system. Tawm tsam keeb kwm ntawm kev kho mob ntev ntev, muaj qhov txo qis ntawm myocardial hypertrophy thiab phab ntsa ntawm cov hlab ntsha ntawm hom kev tiv thaiv.

Lisinopril kho txhim kho cov ntshav kev rau ischemic myocardium.

Kev siv ACE inhibitors nyob rau hauv cov neeg mob uas mob plawv tsis ua hauj lwm ntev dua lub neej muaj sia, thiab hauv cov neeg mob uas tau myocardial infarction yam tsis muaj kev soj ntsuam ntawm lub plawv tsis ua haujlwm, nws ua rau muaj kev vam meej ntawm sab laug ventricular kawg.

Tom qab qhov ncauj tswj hwm, lisinopril pib ua tom qab 1 teev, qhov siab tshaj plaws hypotensive tshwm sim tom qab 6-7 teev thiab kav rau 24 teev. Hauv cov neeg mob uas mob ntshav tawm, cov kev soj ntsuam tau pom tsuas yog ob peb hnub tom qab pib kev kho mob, thiab kom ua tiav cov nyhuv ntawm cov tshuaj, kev tswj hwm tsis tu ncua yuav tsum muaj 30-60 hnub. Kev tshem tawm tsis nrawm tsis ua rau pom qhov nce ntshav ntxiv. Ntxiv nrog rau cov nyhuv antihypertensive, lisinopril pab txo albuminuria, nrog hyperglycemia, nws normalizes kev ua haujlwm ntawm glomerular endothelium. Hauv cov neeg mob ntshav qab zib mellitus, nws tsis cuam tshuam rau theem ntawm cov piam thaj hauv cov ntshav thiab qhov tshwm sim ntawm cov ntshav qog ntshav qab zib.

Vim tias qhov sib xyaw ua ke ntawm cov khoom ntiag tug ntawm ob qhov kev ua haujlwm hauv ib qho yeeb tshuaj, Amlodipine + Lisinopril tso cai rau koj ua tiav kev tswj hwm ntawm cov ntshav siab thiab tiv thaiv qhov tshwm sim ntawm cov kev mob tshwm sim.

Cov Tshuaj Pharmacokinetics

Tom qab noj Amlodipine + Lisinopril sab hauv, qhov nqus ntawm cov khoom muaj tshwm sim hauv txoj hnyuv (GIT): amlodipine yog nqus maj mam thiab yuav luag tiav, lisinopril hauv ib qho nyiaj

25% ntawm kev noj. Kev noj zaub mov ib txhij tsis cuam tshuam rau lawv qhov nqus. Kev siab tshaj plaws (C_max) hauv cov ntshav ntshav ntawm amlodipine tiav tom qab 6-12 teev, lisinopril - tom qab 6-8 teev tom qab kev tswj hwm. Qhov nruab nrab meej txog bioavailability: amlodipine - 64-80%, lisinopril - 25-29%.

Khoom faib ntim (V_d) amlodipine qhov nruab nrab 21 l ib 1 kg ntawm lub cev qhov hnyav, qhov no qhia nws txoj kev faib khoom tseem ceeb hauv cov ntaub so ntswg.

Kev khi ntawm amlodipine rau ntshav protein yog 97.5% feem ntawm cov ntshav. Nws qhov kev cia siab sib npaug (C_ss) hauv cov ntshav ntshav yog ua tiav tom qab 7-8 hnub uas tau nkag mus.

Lisinopril nrog cov plasma protein khi ua rau lub cev tsis muaj zog.

Ob qho tshuaj yeeb dej cawv kov yeej cov ntshav-hlwb thiab placental teeb meem.

Amlodipine yog maj mam tab sis nquag teeb tsa lub siab nrog kev tsim cov metabolites uas tsis muaj cov haujlwm tseem ceeb pharmacological. Cov nyhuv ntawm "thawj tshooj" los ntawm daim siab ua tsis tau zoo.

Lisinopril hauv lub cev tsis yog biotransformed, nws yog tawm dhau los ntawm lub raum tsis hloov. Ib nrab-lub neej (T_1/2) lisinopril yog 12 teev.

T_1/2 Amlodipine tom qab ib koob tshuaj yuav yog li ntawm 35 mus rau 50 teev, tawm tsam keeb kwm ntawm kev rov siv dua - txog 45 teev. Mus txog 60% ntawm cov koob tshuaj uas tau lees txais yog tawm los ntawm ob lub raum: 10% - tsis hloov pauv, qhov seem - nyob rau hauv daim ntawv ntawm metabolites. Los ntawm txoj hnyuv nrog bile, 20-25% ntawm cov tshuaj tau tawm. Kev tshem tawm tag nrho ntawm amlodipine yog 0.116 ml / s / kg, lossis 7 ml / min / kg. Nrog hemodialysis, amlodipine tsis raug tshem tawm.

Nrog daim siab ua haujlwm T_1/2 Amlodipine lengthens txog li 60 teev, nrog kev kho mob ntev ntev nrog rau cov tshuaj, nws xav kom nws nce zuj zus hauv lub cev.

Hauv kev mob plawv tsis ua haujlwm, muaj qhov txo qis hauv kev nqus thiab tshem tawm ntawm lisinopril, nws cov bioavailability tsis tshaj 16%.

Hauv lub raum tsis ua haujlwm nrog creatinine kev tshem tawm (CC) tsawg dua 30 ml / min, theem ntawm lisinopril hauv cov ntshav ntshav yog ntau zaus ntau dua hauv cov neeg mob uas lub raum tsis ua haujlwm. Lub sijhawm no nce sijhawm kom ncav cuag C_max hauv ntshav ntshav thiab T_1/2.

Hauv cov neeg mob laus, cov theem ntawm lisinopril nyob rau hauv cov ntshav plasma yog nce ntxiv ntawm qhov nruab nrab 60%, AUC (thaj chaw nyob hauv qhov kev cia siab-nkhaus) yog 2 npaug ntau dua li ntawm cov neeg mob hluas.

Lub bioavailability ntawm lisinopril nrog mob ntsws yog txo 30%, thiab tshem tawm - los ntawm 50% ntawm qhov ntsuas zoo sib xws hauv cov neeg mob uas lub siab ua haujlwm.

Kev sib cuam tshuam ntawm amlodipine thiab lisinopril tseem tsis tau tsim, cov chaw muag tshuaj thiab cov chaw muag tshuaj ntawm cov tshuaj nquag ntawm cov tshuaj tsis raug yuam ua piv rau cov ntsuas ntawm txhua yam sib cais.

Lub sijhawm ntev ntawm cov tshuaj hauv lub cev tso cai rau koj kom ua tiav cov txiaj ntsig xav tau nrog kev noj tshuaj 1 lub sijhawm ib hnub.

Cov Yuav Tsum Muaj

keeb kwm ntawm angioedema, suav nrog cov teeb meem cuam tshuam nrog kev siv tshuaj ACE inhibitors,
roj ntsha lossis idiopathic angioedema,
poob siab, suav nrog cardiogenic,
angina tsis khov (tshwj tsis yog rau Prinzmetal angina),
cov leeg ntshav hnyav dua (systolic ntshav siab dua 90 mmHg),
hemodynamically tseem ceeb mitral stenosis, hypertrophic obstructive cardiomyopathy, mob hnyav ntawm aortic orifice thiab lwm yam hemodynamically tseem ceeb ntawm txoj kev tawm ntawm cov leeg ventricle,
hemodynamically tsis khov kho lub plawv tsis ua haujlwm tom qab mob myocardial infarction,
ua ke nrog cov tshuaj uas yog cov neeg tawm tsam ntawm angiotensin II receptors hauv cov neeg mob ntshav qab zib nephropathy,
kev kho qhov muag nrog aliskiren lossis aliskiren-muaj cov neeg sawv cev hauv cov neeg mob uas muaj ntshav qab zib mellitus thiab / lossis muaj mob tsis txaus los sis mob raum ua haujlwm tsis zoo (CC tsawg dua 60 ml / min),
cev xeeb tub lub sij hawm
pub niam mis
hnub nyoog txog 18 xyoo
ua kom lub cev tsis haum rau lwm tus ACE inhibitors lossis dihydropyridine derivatives,
kev tsis qaug rau lub zog ntawm cov tshuaj.

Nrog ceev faj, nws raug nquahu kom siv Amlodipine + Lisinopril ntsiav tshuaj rau kev ua haujlwm tsis zoo hauv lub raum, qhov mob tom qab lub raum hloov pauv, ob leeg lub raum mob hlwb los yog lub raum lub raum artery stenosis, ua rau lub siab ua haujlwm tsis txaus, azotemia, hyperkalemia, thawj aldosteronism, kab mob cerebrovascular, kab mob cerebrovascular tsis txaus, arterial hypotension, mob ntshav siab hauv lub plawv, mob ntshav tawm ntshav ntawm lub cev tsis muaj zog (tachycardia, mob leeg heev), mob plawv txaus, mob plawv tsis ua hauj lwm ntawm tsis yog-ischemic keeb kwm (NYHA chav III - IV ua haujlwm chav), aortic lossis mitral stenosis, mob myocardial infarction thiab tsis pub dhau 30 hnub tom qab nws, inhibition ntawm pob txha hlwb hematopoiesis, autoimmune kab mob ntawm cov nqaij mos sib txuas (suav nrog cov kab mob lupus erythematosus, scleroderma) ua raws li kev noj haus uas txwv tsis pub sodium chloride, hemodialysis siv high-flow dialysis daim nyias nyias (xws li AN69), ntuav, raws plab, thiab lwm yam mob uas ua rau kom tsawg dua CC (ntshav ntim) nyob rau hauv cov neeg laus cov neeg mob.

Cov chaw muag tshuaj

Amlodipine thaiv qeeb calcium calcium channel, muaj suab tshaj tawm antianginal, nrog rau cov nyhuv antihypertensive. Raws li cov tshuaj ntawm cov tshuaj no, cuam tshuam ntawm Ca ions mus rau hauv lub hlwb ntawm cov leeg nqaij thiab ncaj qha rau hauv cov hlwb myocardial txo qis, txo cov ntshav siab thiab peripheral vascular tsis kam. Amlodipine nthuav tawm cov khoom antianginal vim muaj kev nthuav dav tsis tsuas yog cov hlab ntsha, tab sis kuj rau cov hlab ntsha, txo qis tom qab. Oxygen saturation ntawm lawm thaj av myocardial, nrog rau nws qhov chaw ischemic, yog cai. Nws yog tsim nyog sau cia tias Amlodipine tiv thaiv kev tsim ntawm ischemic ST-interval, yam tsis muaj kev cuam tshuam ntawm reflex tachycardia, tsis muaj kev cuam tshuam rau kev coj ua thiab kev cog lus ntawm myocardium. Raws li qhov tshwm sim ntawm cov tshuaj yeeb dej caw no, qhov xav tau ntawm nitroglycerin tsawg dua, thiab qhov zaus ntawm cov hlab ntsha uas pub rau lub plawv cov leeg kuj raug txo qis. Ib lub siab ntev hypotensive nyhuv yog manifested, uas nyob ntawm qhov koob tshuaj ntawm cov tshuaj noj los ntawm tus neeg mob. Tus kab mob ischemic, hais tawm cardioprotective li zoo li los tiv thaiv atherosclerotic muaj cai.

Nrog amlodipine, platelet cell sib txuas qeeb. Glomerular filtration yog qhov ua kom zoo dua qub, ib qho uas tsis muaj qhov hais tau ntawm natriuretic nyhuv yog kaw. Kev siv cov tshuaj ntawm cov neeg raug mob gout, mob ntshav qab zib, nrog rau mob ntsws asthma tuaj yeem tso cai. Kev kho mob ntawm kev txais tos yog pom tom qab 2-4 teev, nws tseem mob siab rau hnub tom qab.

Lisinopril yog ib qho ntawm ATP inhibitor tshuaj, nws txo qis kev tsim ntawm aldosterone, ntxiv rau angiotensin 2, thaum nce ntxiv ntawm bradykinin nws tus kheej. Cov txiaj ntsig ntawm lisinopril tsis txuas ntxiv rau kev ua haujlwm ntawm renin-angiotensin-aldosterone systems. Nyob hauv kev cuam tshuam ntawm lisinopril, qhov txo qis hauv cov ntshav siab, kev ntseeg siab ntawm cov hlab ntsws hauv cov hlab ntsws tau pom, ua ntej- thiab tom qab ua haujlwm poob qis, nrog rau qhov no, ntshav siab raum nce. Qhov tshuaj yeeb tshuaj no pab nthuav cov hlab ntsha, ua kom cov ntshav xa mus rau myocardium, uas tau ua haujlwm ischemia. Thaum siv lub sijhawm ntev, qhov mob hnyav ntawm hypertrophy ntawm phab ntsa ntawm myocardial cov hlab ntsha txo. Nyob rau hauv kev cuam tshuam ntawm lisinopril, ua hauj lwm tsis txaus nyob rau sab laug ventricle, uas feem ntau tau sau tseg tom qab myocardial infarction, yog inhibited.

Lisinopril muaj peev xwm txo qis albuminuria, ua tau zoo ntawm kev mob ntshav siab, nyob rau hauv uas muaj qis ntawm renin.Cov nyhuv antihypertensive ntawm lisinopril tau pom 1 teev tom qab nws siv, nyob rau 6 teev tom ntej no qhov kev kho mob siab tshaj plaws tau sau tseg thiab mob siab rau 24 teev. Nws yog tsim nyog sau cia hais tias nrog kev ua tiav ntawm lisinopril tswj hwm kev loj hlob, qhov kev txhim kho ntawm cov ntawv rho tawm tsis raug sau cia.

Kev sib xyaw ua ke ntawm cov khoom siv xws li lisinopril thiab amplodipine pab tiv thaiv qhov tshwm sim ntawm cov kev xav tsis zoo uas tau npau taws los ntawm qhov kev tawm tsam los ntawm cov yam khoom ntawd. Qhov sib xyaw ua ke no tau sau tseg rau kev siv nyob rau hauv rooj plaub thaum kev siv tshuaj ib leeg tsis muaj qhov xav kom kho tau.

Vim yog lub voj voog ntev hauv cov ntshav ntawm cov tshuaj no tuaj yeem siv ib hnub ib zaug. Lisinopril thiab amplodipine tsis sib txuas.

Kev ntsuas rau siv

Ua kev kho ua ke rau kev mob ntshav siab tseem ceeb.

Txoj kev tswj hwm ntawm amlodipine thiab lisinopril

Ob qho tshuaj yeeb yog npaj rau kev tswj hwm qhov ncauj. Rau cov neeg uas noj cov tshuaj antihypertensive, kev siv cov tshuaj yog sau tseg 1 ntsiav tshuaj hauv ib hnub.

Yog tias koj noj tshuaj diuretics, tom qab ntawd li 2-3 hnub. ua ntej siv amlodipine nrog lisinopril, cov tshuaj diuretic yuav xav tau lawm os.

Txhawm rau txiav txim siab muab thawj cov tshuaj thiab cov uas tsim nyog rau kev kho kev kho mob hauv cov neeg muaj mob raum ua kom tsis zoo, cov koob tshuaj yuav tsum tau suav tshuaj thiab suav ib qho zuj zus, noj ib koob tshuaj amlodipine thiab lisinopril.

Cov tshuaj ntawm qhov ntau npaum ntawm 10 mg / 5 mg yog tau tshaj tawm rau cov neeg uas muaj qhov kev saib xyuas txij nkawm ntawm titrated txog 10 mg thiab 5 mg. Txais ntawm kev txhaj tshuaj ntau yog tau ua tiav raws li txheej txheem teev tseg los ntawm tus kws kho mob koom nrog.

Hauv lub sijhawm ntawm kev kho mob, nws yuav tsum tau saib xyuas kev ua haujlwm ntawm cov qog dej, cov dej kom ntau ntau ntawm K thiab Na. Thaum txoj haujlwm ntawm lub qog hloov pauv zuj zus, kev kho mob raug tso tseg, cov tshuaj ntawm cov tshuaj txo qis rau qhov txiaj ntsig zoo.

Nws yuav tsum tau yug los hauv lub siab tias tej zaum yuav muaj kev ua qeeb ntawm qhov kev zam ntawm amlodipine hauv cov neeg uas muaj daim siab pathologies.

Sab sij huam

Cov tshuaj tau pom zoo zoo, tab sis qee kis, kev siv cov tshuaj no tuaj yeem ua rau muaj kev ua txhaum li no:

NS: qaug zog, mob taub hau heev, ua pa nyuaj siab ntxhov plawv, kev npau taws ntawm lub siab, xav txog kev xav thiab tsis meej pem, tsaug zog.
Kab mob ntsws: hnoos tsis zoo
CVS: palpitations, tachycardia, orthostatic hypotension, txoj kev loj hlob ntawm arrhythmia
Lub plab zom mov: qhov kev xav ntawm kev saib xyuas hauv lub qhov ncauj kab noj hniav, mob epigastric, ua rau lub plab zom mov, txhim kho mob siab lossis mob daj ntseg, cov tsos mob ntawm tus kws kho mob txham, xeev ntuav, raws plab, ntuav ntuav, tsis txaus siab rau cov zaub mov, gingival hyperplasia
Genitourinary system: ua haujlwm tsis zoo hauv lub raum, tso zis tsis zoo, impotence
Cov kab mob hematopoietic: cov cim ntawm agranulocytosis, txo qis rau cov hemoglobin thiab hematocrit, kev txhim kho ntawm erythropenia, leukopenia, thrombocytopenia, thiab neutropenia
Kab mob musculoskeletal: pob qij taws o, cov tsos mob ntawm arthralgia, cov tsos mob ua xua
Qhov ntsuas kev ntsuas: nce ESR, hyperbilirubinemia, nce kev ua si ntawm daim siab enzymes, hypercreatininemia, muaj zog urea nitrogen, hyperkalemia, muaj cov tshuaj tiv thaiv antinuclear.
Daim tawv nqaij: cov pob khaus ntawm hom urticaria, nce tawm hws, khaus heev, tshwm sim ntawm erythema, hyperemia ntawm daim tawv nqaij ntawm lub ntsej muag, alopecia
Lwm tus: qhov tshwm sim ntawm lub xeev febrile, mob mob qab sternum, kev txhim kho ntawm myalgia.

Cov tshuaj sib cuam tshuam

Thaum noj ua ke nrog inducers ntawm microsomal hepatic enzymes, ib qho kev txo qis hauv plasma concentration ntawm amlodipine tuaj yeem pom, thiab thaum lub sijhawm siv microsomal oxidation inhibitors, lub zog txo tau sau tseg.

Kev siv tib txhij ntawm cov poov tshuaj-sparing diuretics thiab lwm yam tshuaj K (potassium) tuaj yeem ua rau kev loj hlob ntawm hyperkalemia. Hauv qhov no, kev nkag mus ntawm cov tshuaj yuav tsum tau nqa tawm tsuas yog tom qab ntsuas qhov xav tias yuav ua kom zoo thiab muaj kev phom sij txog kev noj qab haus huv, nws tseem yuav tau soj ntsuam qib K hauv cov ntshav thiab saib xyuas kev ua haujlwm ntawm lub raum.

Qee cov diuretics tuaj yeem txo cov ntshav siab, thaum noj tshuaj antihypertensive, ib qho txiaj ntsig ntxiv yuav raug pom.

Cov tshuaj estrogen muaj cov tshuaj, NSAIDs, sympathomimetics, zoo li ntau tus adrenostimulants tuaj yeem txo cov kev kho mob ntawm kev sib xyaw ntawm amlodipine thiab lisinopril.

Antacids nrog rau colestyramine pab ua kom qeeb ntawm kev nqus ntawm cov khoom siv ntawm cov ntsiav tshuaj los ntawm kev mob plab hnyuv.

Antipsychotics, amiodarone, α1-blockers, thiab quinidine txhim kho cov kev pom muaj txiaj ntsig hypotensive.

Kev tshem tawm ntawm cov khoom siv cov roj ntsha lithium tuaj yeem ua rau qeeb, thiab cov plasma ntshav ntau ntawm cov roj ntsha yuav tsum tau saib xyuas.

Procainamide, quinidine tuaj yeem ntev QT luv.

Nws yog tsim nyog sau cia tias lisinopril txo qhov "laim" ntawm K thaum ua cov diuretic kho.

Cov tshuaj noj uas suav nrog Ca tuaj yeem txo qhov cuam tshuam ntawm qeeb calcium calcium blockers.

Cimetidine yog sib xyaw nrog amlodipine thiab lisinopril, txoj hauv kev zoo tshaj plaws yog coj los kuaj koj tus kws kho mob.

Noj ntau dhau

Yog hais tias noj ntau dhau, ua pa ntawm qhov ntswg, tachycardia tawm tsam, thiab muaj ntshav nce siab ntau yuav tshwm sim.

Kev pom tias amlodipine maj mam nqus, tsis tas yuav ua txoj kev phais mob plab zom mov; nws raug nquahu kom pib noj cov tshuaj enterosorbent. Nrog rau qhov txo qis hauv cov ntshav siab, iv dopamine thiab calcium gluconate yog qhia. Nyob rau hauv lub neej yav tom ntej, nws yuav tsim nyog tswj ntshav siab, roj ntsha, roj ntsha electro-sib npaug. Nws tsim nyog them sai sai tias qhov txheej txheem hemodialysis hauv qhov no yuav ua rau tsis muaj txiaj ntsig.

Amlodipine thiab lisinopril npaj

Txog rau hnub tim, ntau cov tshuaj tsim tawm, uas suav nrog amlodipine nrog lisinopril: Lisinopril Plus, Kab Paj Yeeb, Kab Luv, Equapril. Cov tshuaj no muaj cov tshuaj tsis haum ntawm txhua qhov sib xyaw. Ua ntej pib txoj kev kho mob, nws tsim nyog mus soj ntsuam txhua yam, sab laj nrog kws kho mob thiab txiav txim siab txog kev kho tus kabmob zoo rau tus kabmob. Yog tias tsim nyog, thaum lub sijhawm kawm kho, nws yuav tuaj yeem hloov kho qhov ntau npaum li cas ntawm cov tshuaj noj.

Thaum twg cov tshuaj amlodipine noj?

Cov Npe Pauv: Amlothop.

Raws li cov pab pawg ntawm calcium channel blockers. Cov tshuaj nquag muaj cov tshuaj tiv thaiv ischemic, antihypertensive, vasodilating (vasodilating) cuam tshuam.

Nws siv rau kev kub siab txhawm rau txo cov ntshav siab, angina pectoris, Raynaud tus kab mob thiab lwm yam kab mob cuam tshuam nrog angiospasm.

Cov nyhuv ntawm amlodipine yog ua los ntawm kev thaiv ntawm cov calcium calcium, qhov kev txo qis hauv kev zoo siab ntawm cov leeg nqaij mos ntawm cov hlab ntsha thiab cov cuab yeej muaj vasodilating.

Cov tshuaj txo cov hemodynamic tsis kam ntawm cov hlab ntsha, txo cov ntshav siab los ntawm qib siab vasoconstrictors - adrenaline, vasopressin, renin renin.

Nrog rau cov kab mob hlab plawv, cov tshuaj txo cov kev thauj mus rau lub plawv, thim rov qab spasm ntawm cov hlab ntshav cov hlab ntshav uas pub myocardium, thiab txhim kho cov ntshav ncig.

Kws Tshuaj

Kev sib xyaw ua ke uas muaj lisinopril thiab amlodipine.

Lisinopril - ACE inhibitor, txo qhov tsim ntawm angiotensin II los ntawm angiotensin I. Txo cov ntsiab lus ntawm angiotensin II ua rau txo qis ncaj qha rau kev tso tawm aldosterone. Txo txo cov kev ua haujlwm ntawm bradykinin thiab nce cov synthesis ntawm PG. Nws txo OPSS, ntshav siab, ua ntej, qhov siab nyob rau ntawm cov hlab ntsws me, ua rau cov ntshav nce ntau feeb thiab nce siab myocardial zam rau kev ntxhov siab hauv cov neeg mob plawv tsis ua haujlwm. Nthuav cov hlab ntsha mus rau qhov ntau dua li cov leeg ntshav. Qee qhov cuam tshuam yog vim muaj kev cuam tshuam cov ntaub so ntswg RAAS. Nrog rau siv ntev, hypertrophy ntawm myocardium thiab phab ntsa ntawm cov hlab ntsha ntawm hom tiv thaiv poob qis. Txhim kho cov ntshav xa mus rau ischemic myocardium.

ACE inhibitors lengthen lub neej cia siab rau cov neeg mob uas lub plawv tsis ua hauj lwm, qeeb kev loj hlob ntawm sab laug ventricular kawg ntawm cov neeg mob tom qab myocardial infarction yam tsis muaj kev soj ntsuam kev mob plawv tsis ua haujlwm.

Qhov kev txiav txim pib 1 teev tom qab noj. Qhov siab tshaj tawm cov nyhuv antihypertensive yog txiav txim siab tom qab 6 teev thiab tawm mus ntev li 24 teev .Thaum muaj mob ntshav nce hlwb, cov nyhuv antihypertensive raug pom nyob hauv thawj hnub tom qab pib kho, qhov ua haujlwm ruaj khov tsim tom qab 1-2 lub hlis. Nrog kev tshem tawm ntawm cov lisinopril ntse, qhov kev nce siab hauv cov ntshav siab tsis tau sau tseg.

Txawm hais tias muaj cov txiaj ntsig tseem ceeb ntawm RAAS, lisinopril tseem ua tau rau cov leeg ntshav siab nrog kev ua haujlwm tsawg. Ntxiv rau qhov txo qis ntshav siab, lisinopril txo cov albuminuria. Lisinopril tsis muaj kev cuam tshuam cov ntsiab lus ntawm cov piam thaj hauv cov ntshav hauv cov neeg mob ntshav qab zib mellitus thiab tsis ua rau muaj kev nce ntxiv hauv cov neeg mob hypoglycemia.

Amlodipine - muab rho tawm ntawm dihydropyridine, BKK, muaj antianginal thiab antihypertensive nyhuv. Nws thaiv cov calcium calcium, txo cov transmembrane hloov ntawm calcium ions mus rau ntawm tes (ntau ntxiv rau cov leeg nqaij muaj ntshav ntawm cov hlab ntshav dua rau cardiomyocytes).

Qhov ua tiav antianginal yog vim muaj kev nthuav dav ntawm txoj hlab ntshav siab thiab mob hlab ntsha hauv lub plawv thiab cov hlab ntsha: nrog angina pectoris nws txo qhov mob ntawm myocardial ischemia, nthuav tawm peripheral arterioles, txo OPSS, txo lub afterload rau lub plawv, thiab txo myocardial oxygen xav tau. Kev nthuav dav ntawm cov hlab ntsha txhaws thiab cov hlab ntsha hauv qhov tsis hloov thiab ischemic thaj chaw ntawm myocardium, nce cov pa mus rau myocardium (tshwj xeeb nrog vasospastic angina), tiv thaiv cov hlab ntsha txhaws (nrog rau cov mob los ntawm kev haus luam yeeb). Hauv cov neeg mob uas muaj angina ruaj khov, ib koob tshuaj txhua hnub ntawm amlodipine nce ib ce kam rau ua, ua rau qeeb ntawm kev loj hlob ntawm angina pectoris thiab ischemic kev nyuaj siab ntawm ntu ntu ST, thiab txo cov zaus ntawm angina tawm tsam thiab noj nitroglycerin thiab lwm yam nitrates.

Amlodipine muaj tshuaj tiv thaiv ntev ntev-siv tshuaj tiv thaiv antihypertensive. Cov nyhuv antihypertensive yog vim muaj cov nyhuv vasodilating ncaj qha rau cov leeg ntawm cov hlab ntshav. Yog tias muaj mob ntshav ntawm cov hlab ntsha, ib qho kev txhaj tshuaj ib qho yuav txo qis ntshav siab ntau dhau los hauv lub sijhawm 24 teev (thaum tus neeg mob pw thiab sawv). Orthostatic hypotension nrog lub sijhawm teem ntawm amlodipine yog qhov tsis tshua muaj neeg pom. Tsis ua rau muaj kev txo qis hauv kev qoj ib ce, ejection feem ntawm sab laug ventricle. Txo qhov degree ntawm sab laug ventricular myocardial hypertrophy. Nws tsis cuam tshuam rau myocardial kev cog lus thiab kev coj ua, tsis ua rau muaj kev ywj pheej ntawm lub plawv dhia, txwv tsis pub platelet tag nrho, nce GFR, thiab muaj cov tsis muaj zog natriuretic. Nrog rau cov ntshav qab zib nephropathy tsis ua rau kom mob hnyav ntawm microalbuminuria. Nws tsis muaj qhov tshwm sim zoo rau cov metabolism thiab cov ntsiab lus ntawm cov ntshav ntshav lipids thiab tuaj yeem siv rau hauv kev kho mob hauv cov neeg mob ntsws asthma, mob ntshav qab zib mellitus thiab gout. Txo tseem ceeb txo cov ntshav siab pom tom qab 6-10 teev, lub sijhawm ntawm cov nyhuv yog 24 teev.

Amlodipine + lisinopril. Kev sib xyaw ntawm lisinopril nrog amlodipine tuaj yeem tiv thaiv kev txhim kho ntawm kev tsis tuaj yeem tshwm sim los ntawm ib qho ntawm cov tshuaj yeeb dej caw. Yog li, BKK, nthuav cov hlab ntsha ncaj qha, tuaj yeem ua rau lub sijhawm qeeb ntawm sodium thiab kua dej hauv lub cev, thiab yog li ntawd, tuaj yeem qhib RAAS. ACE inhibitor thaiv txoj kev no.

Xuas. Tom qab kev tswj hwm ntawm qhov ncauj, lisinopril yog nqus tau los ntawm cov hnyuv, nws txoj kev nqus nws txawv ntawm 6 txog 60%. Bioavailability yog 29%. Noj mov tsis cuam tshuam rau qhov nqus ntawm lisinopril.

Kev xa Khoom. Yuav luag tsis khi rau cov plasma protein. C_max hauv cov ntshav plasma - 90 ng / ml, ua tiav tom qab 6-7 teev. Kev tso cai dhau ntawm BBB thiab qhov chaw tso ntshav tsawg.

Kev zom zaub mov. Lisinopril tsis muaj biotransformed hauv lub cev.

Chaw Sau Ntawv. Nws yog tawm los ntawm lub raum tsis hloov pauv. T_1/2 yog 12.6 teev

Pharmacokinetics ntawm cov neeg mob ib leeg

Laus lub caij nyoog. Hauv cov neeg mob laus, cov concentration ntawm lisinopril hauv ntshav plasma thiab AUC yog 2 npaug ntau dua li ntawm cov neeg hluas.

CHF. Hauv cov neeg mob uas lub plawv tsis ua hauj lwm, qhov nqus thiab tshem cov lisinopril txo.

Tsis hlauv. Hauv cov neeg mob uas lub raum tsis ua haujlwm, qhov kev cia siab ntawm lisinopril yog ntau dua lub sij hawm siab tshaj qhov siab ntawm ntshav hauv ntshav hauv cov neeg tuaj yeem noj qab haus huv, nrog nce T_max hauv ntshav thiab txhab ntev T_1/2 .

Lisinopril raug ntiab tawm los ntawm hemodialysis.

Xuas. Tom qab cov tshuaj qhov ncauj, amlodipine maj mam thiab yuav luag ua tiav (90%) nqus tawm los ntawm cov hnyuv. Lub bioavailability ntawm amlodipine yog 64-80%. Kev noj tsis cuam tshuam rau kev nqus ntawm amlodipine.

Kev xa Khoom. Feem ntau ntawm amlodipine hauv cov ntshav (95 (98%) khi rau cov ntshav protein. C_max hauv cov ntshav dej tau saib xyuas tom qab 6-10 teev C_ss tiav tom qab 7-8 hnub ntawm kev kho. Nruab Nrab V_d yog 20 l / kg, uas qhia tau tias feem ntau ntawm amlodipine nyob rau hauv cov ntaub so ntswg, thiab ib qho me me nyob hauv ntshav.

Kev zom zaub mov. Amlodipine yauv qeeb qeeb tab sis nquag ua metabolism hauv lub siab ua rau qhov tsis muaj kev cuam tshuam tseem ceeb ua ntej. Metabolites tsis muaj cov haujlwm tseem ceeb pharmacological.

Chaw Sau Ntawv. Kev zam tawm muaj ob theem, T_1/2 cov theem kawg yog 30–50 teev. Kwv yees li 60% ntawm kev siv tshuaj yog raug tso tawm los ntawm lub raum feem ntau ua cov tshuaj metabolites, 10% nyob rau hauv daim ntawv tsis hloov pauv, thiab 20-25% nyob rau hauv daim ntawv ntawm metabolites los ntawm txoj hnyuv nrog bile. Kev tshem tawm tag nrho ntawm amlodipine yog 0.116 ml / s / kg (7 ml / min / kg, 0.42 l / h / kg).

Pharmacokinetics ntawm cov neeg mob ib leeg

Laus lub caij nyoog. Hauv cov neeg mob laus (tshaj 65 xyoos), kev tso tawm ntawm amlodipine yog qeeb (T_1/2 - 65 h) piv nrog cov neeg mob hluas, txawm li cas los xij, qhov sib txawv no tsis muaj qhov tseem ceeb hauv kev kuaj mob.

Daim siab ua haujlwm. Hauv cov neeg mob uas lub siab tsis ua haujlwm, nce hauv T_1/2 qhia tias nrog kev siv lub sijhawm ntev, kev txuam nrog amlodipine hauv lub cev yuav siab dua (T_1/2 - txog 60 teev).

Tsis hlauv tsis cuam tshuam loj heev rau pharmacokinetics ntawm amlodipine.

Amlodipine hla lub BBB. Nrog hemodialysis tsis raug tshem tawm.

Kev sib cuam tshuam ntawm cov tshuaj yeeb dej caw uas ua rau sib xyaw ua ke ntawm amlodipine + lisinopril yog qhov tsis zoo. Muaj nuj nqis AUC, T_max thiab C_max , T_1/2 tsis hloov pauv piv nrog kev ua tau zoo ntawm txhua tus neeg cov yeeb tshuaj. Noj mov tsis cuam tshuam rau kev nqus ntawm cov tshuaj nquag.

Ntawv thov kev txwv

Kev mob raum tsis zoo, ob tog lub raum artery stenosis lossis mob hlwb ntawm lub raum artery nrog kev mob azotemia, mob tom qab lub raum hloov pauv, azotemia, hyperkalemia, thawj hyperaldosteronism, lub siab ua haujlwm tsis zoo, mob ntshav qis, kab mob cerebrovascular (suav nrog cerebrovascular tsis txaus) mob plawv, mob ntshav siab tsis txaus, mob ntshav tawm ntawm lub cev tsis muaj zog (cov ntshav liab loj, tachycardia), mob plawv tsis ua hauj lwm yog ntsiag to. kev faib tawm ntawm etiology ntawm III - IV ua haujlwm chav kawm raws li kev faib tawm NYHA, aortic stenosis, mitral stenosis, mob myocardial infarction (thiab tsis pub dhau 1 lub hlis tom qab myocardial infarction), cov kab mob autoimmune uas muaj kab mob ntawm cov nqaij sib txuas (suav nrog scleroderma, kab mob lupus erythematosus), kev txwv tsis pub cov pob txha mob ntshav qab zib, ntshav qab zib mellitus, kev noj zaub mov noj nrog kev txwv ntawm kev ua noj. ntsev, hypovolemic xeev (suav nrograws li qhov tshwm sim ntawm mob raws plab, ntuav), lub hnub nyoog laus, hemodialysis siv high-flow dialysis daim nyias nyias nrog qhov siab permeability (AN69 ®), LDL apheresis, desensitization nrog muv lossis wasp venom.

Cev xeeb tub thiab lactation

Kev siv tsis pom zoo thaum cev xeeb tub. Thaum kuaj pom kev xeeb tub, qhov sib xyaw yuav tsum nres tam sim ntawd.

Kev lees txais ntawm ACE inhibitors nyob rau hauv II thiab III trimesters ntawm cev xeeb tub muaj qhov tshwm sim tsis zoo ntawm cov menyuam hauv plab (lub suab poob qis hauv cov ntshav siab, lub raum tsis ua haujlwm, hyperkalemia, hypoplasia ntawm pob txha pob txha taub hau, kev tuag intrauterine yog ua tau). Tsis muaj pov thawj qhia txog qhov tsis zoo ntawm tus menyuam hauv plab yog siv thaum thawj lub sijhawm cev xeeb tub. Rau cov menyuam mos thiab cov menyuam mos uas muaj kev kis mob rau ACE inhibitors, nws raug nquahu kom ua tib zoo saib xyuas kom ncav sijhawm kom paub tseeb tias yuav txo cov ntshav siab, oliguria, hyperkalemia.

Kev nyab xeeb ntawm amlodipine thaum cev xeeb tub tsis tau tsim, yog li ntawd, kev siv amlodipine tsis pom zoo thaum cev xeeb tub.

Lisinopril hla lub hno mis thiab tuaj yeem tawm hauv cov kua mis. Tsis muaj pov thawj dabtsi txog kev tso tawm amlodipine rau hauv niam mis. Txawm li cas los xij, nws paub tias lwm yam BCC - derivatives ntawm dihydropyridine, raug tawm hauv cov kua mis.

Kev siv ntawm kev sib xyaw thaum lub sijhawm lactation tsis pom zoo. Yog tias tsim nyog, siv thaum lactation, pub mis niam yuav tsum tsis ua mus ntxiv.

Kev sib txuam

Ob chav thaiv ntawm RAAS angiotensin receptor blockers, ACE inhibitors lossis aliskiren cuam tshuam nrog kev pheej hmoo ntawm kev mob ntshav siab, kev mob ntshav hauv lub cev thiab kev ua haujlwm tsis zoo (suav nrog mob raum tsis ua haujlwm) piv nrog kev kho tshuaj nrog cov tshuaj no. Nws yog ib qho tsim nyog yuav tsum tau ua tib zoo saib xyuas ntshav siab, lub raum kev ua haujlwm thiab hluav taws xob sib npaug hauv cov neeg mob tau txais lisinopril ib txhij nrog lwm cov tshuaj uas cuam tshuam rau RAAS.

Cov tshuaj uas cuam tshuam rau cov poov tshuaj ntsiab lus hauv ntshav ntshav: potassium-sparing diuretics (piv txwv li spironolactone, amiloride, triamteren, eplerenone), cov poov tshuaj muaj zaub mov ntxiv, poov tshuaj ntsev hloov chaw, thiab lwm yam tshuaj uas muaj cov ntshiab poov tshuaj ntau ntxiv (piv txwv li heparin) tuaj yeem ua rau hyperkalemia thaum siv ua ke nrog ACE inhibitors, tshwj xeeb hauv cov neeg mob uas muaj keeb kwm mob raum tsis ua haujlwm thiab lwm yam mob raum. Thaum siv cov tshuaj uas cuam tshuam cov poov tshuaj ntsiab lus, cov ntsiab lus poov tshuaj poov tshuaj yuav tsum tau saib xyuas ib txhij nrog lisinopril. Yog li, kev siv tib lub sijhawm yuav tsum tau ua kom zoo thiab ua nrog kev ceev faj thiab kev saib xyuas tsis tu ncua ntawm ob cov ntshiab poov tshuaj ntsiab lus thiab lub raum muaj nuj nqi. Potassium-sparing diuretics tuaj yeem coj ua ke nrog kev sib xyaw ntawm amlodipine + lisinopril tsuas yog nyob hauv qab kev mob ntawm kev saib xyuas kev kho mob kom zoo.

Tso tshuaj: Kev siv cov tshuaj diuretics thaum kho nrog kev sib xyaw ntawm amlodipine + lisinopril, cov nyhuv antihypertensive feem ntau yog txhim kho. Kev siv tib lub sijhawm yuav tsum tau nqa nrog ceev faj. Lisinopril txo cov potassium-diuretic nyhuv ntawm diuretics.

Lwm cov tshuaj tiv thaiv antihypertensive: kev tswj hwm tib lub sij hawm ntawm cov tshuaj no tuaj yeem txhim kho cov nyhuv antihypertensive ntawm kev sib xyaw ntawm amlodipine + lisinopril. Ib txhij tswj hwm nrog nitroglycerin, lwm yam nitrates lossis vasodilators tuaj yeem ua rau txo qis hauv ntshav siab.

Tricyclic antidepressants / antipsychotics / kev tso tshuaj kom tsaug zog / narcotic analgesics: siv cov tshuaj tsis haum nrog ACE inhibitors tuaj yeem ua rau txo cov ntshav siab.

Ethanol txhim kho cov nyhuv antihypertensive.

Allopurinol, procainamide, cytostatics lossis immunosuppressants (cov kab ke corticosteroids) tej zaum yuav ua rau muaj kev pheej hmoo ntau ntawm kev tsim leukopenia thaum siv ACE inhibitors.

Antacids thiab colestyramine thaum noj nrog ACE inhibitors txo qis cov bioavailability ntawm ACE inhibitors.

Sympathomimetics tuaj yeem txo qhov txiaj ntsig ntawm ACE inhibitors, nws yog qhov yuav tsum tau ua tib zoo saib xyuas kev ua tiav ntawm cov txiaj ntsig yam xav tau.

Kev siv tshuaj hypoglycemic: thaum noj ACE inhibitors thiab cov tshuaj hypoglycemic (insulin thiab hypoglycemic cov neeg sawv cev rau qhov ncauj tswj hwm), qhov zoo li yuav txo qis cov concentration ntawm cov piam thaj hauv cov ntshav cov ntshav thiab kev pheej hmoo ntawm hypoglycemia yuav nce ntxiv. Feem ntau, qhov tshwm sim no tau pom thaum thawj lub lim tiam ntawm kev kho mob sib xyaw thiab hauv cov neeg mob raum tsis ua haujlwm.

NSAIDs (suav nrog rau COX-2 inhibitors): Siv sijhawm ntev ntawm NSAIDs, suav nrog kev siv tshuaj ntau ntawm cov acetylsalicylic acid ntau dua 3 g / hnub, tuaj yeem txo cov txiaj ntsig ntawm ACE inhibitors. Cov txiaj ntsig ntxiv thaum noj NSAIDs thiab ACE inhibitors yog ua kom muaj qhov nce siab ntawm cov poov tshuaj potassium thiab tuaj yeem ua rau lub raum tsis ua haujlwm. Cov teebmeem no feem ntau yuav thim rov qab. Nws tsis tshua muaj peev xwm tsim kev mob raum tsis zoo, tshwj xeeb tshaj yog rau cov neeg laus thiab cov neeg mob lub cev qhuav dej.

Cov tshuaj uas muaj lithium: Cov kua roj ntsha lithium tuaj yeem ua rau qeeb dua thaum noj nrog ACE cov tshuaj tiv thaiv kab mob, thiab yog li ntawd, cov concentration ntawm lithium hauv cov ntshav cov ntshav yuav tsum raug saib xyuas lub sijhawm no. Nrog rau kev siv tib lub sijhawm nrog lithium npaj, nws yog qhov ua tau los ua kom muaj kev cia siab ntawm lawv cov neurotoxicity (xeev siab, ntuav, raws plab, ataxia, tshee tshee, tinnitus).

Cov tshuaj muaj kub: nrog rau kev siv ACE inhibitors thiab kev npaj kom kub (sodium aurothiomalate) iv, ib qho kev piav qhia cov tsos mob tau piav qhia, suav nrog kev tso dej tawm ntsej muag, xeev siab, ntuav, thiab leeg ntshav.

Dantrolene (iv): Hauv cov tsiaj txhu, tom qab siv verapamil thiab iv kev tswj hwm ntawm dantrolene, cov neeg mob tuag ventricular fibrillation thiab cov hlab plawv tsis ua haujlwm nrog hyperkalemia tau pom. Muab qhov kev pheej hmoo ntawm kev txhim kho hyperkalemia, kev siv tib lub sij hawm ntawm BCC yuav tsum zam, suav nrog amlodipine, hauv cov neeg mob ntxim rau kev loj hlob ntawm malignant hyperthermia, thiab hauv kev kho mob ntawm malignant hyperthermia.

CYP3A4 isoenzyme inhibitors: cov kev tshawb fawb hauv cov neeg mob laus tau pom tias diltiazem inhibits amlodipine metabolism, tej zaum los ntawm CYP3A4 isoenzyme (ntshav / ntshav nce ntxiv yuav luag 50% thiab cov cuam tshuam ntawm amlodipine nce). Kev tsis tuaj yeem txiav txim tau tias cov tshuaj tiv thaiv muaj zog ntawm CYP3A4 isoenzyme (piv txwv li, ketoconazole, itraconazole, ritonavir) tuaj yeem nce qhov siab ntawm amlodipine hauv cov ntshav cov ntshav kom ntau dua diltiazem. Kev siv tib lub sijhawm yuav tsum tau nqa nrog ceev faj.

Cov kws kho mob ntawm isoenzyme CYP3A4: siv cov tshuaj tiv thaiv kab mob nrog rau cov tshuaj antiepileptic (piv txwv li carbamazepine, phenobarbital, phenytoin, fosphenytoin, primidone), rifampicin, tshuaj uas muaj St. John lub wort, tuaj yeem ua rau txo qis ntawm amlodipine hauv ntshav ntshav. Ib qho kev tswj hwm tau pom nrog kev txiav txim siab koob tshuaj amlodipine thaum kho mob nrog inducers ntawm CYP3A4 isoenzyme thiab tom qab lawv tshem tawm. Kev siv tib lub sijhawm yuav tsum tau nqa nrog ceev faj.

Raws li kev kho mob monotherapy, amlodipine ua ke zoo nrog thiazide thiab voj diuretics, cov neeg ua hauj rau ua kom tsaug zog, beta-blockers, ACE inhibitors, ntev-sawv nitrates, nitroglycerin, digoxin, warfarin, atorvastatin, sildenafil, antacids (txhuas hydroxide, magnesium hydroxide), simethicone, cimetidine, narcotics yuav muab, tshuaj tua kab mob thiab hypoglycemic cov neeg ua hauj rau cov thawj coj ntawm qhov ncauj.

Nws yog ua tau los txhim kho antianginal thiab antihypertensive nyhuv ntawm CCB nrog kev siv tib lub sij hawm thiazide thiab voj diuretics, verapamil, ACE inhibitors, beta-blockers, nitrates thiab lwm cov vasodilators, ntxiv rau kev txhim kho lawv cov nyhuv antihypertensive thaum siv alpha adrenoblockers, tshuaj tiv thaiv kev puas hlwb.

Ceev faj yuav tsum tau tawm dag zog thaum siv nitroglycerin, lwm yam nitrates, lossis lwm yam vasodilators, vim tias qhov txo qis ntxiv ntawm cov ntshav siab yog tau.

Ib koob tshuaj 100 mg sildenafil hauv cov neeg mob uas mob ntshav siab tsis muaj kev cuam tshuam cov pharmacokinetics ntawm amlodipine.

Rov qab siv tshuaj amlodipine ntawm koob tshuaj 10 mg thiab atorvastatin ntawm ib koob ntawm 80 mg tsis yog nrog los ntawm kev hloov pauv hauv pharmacokinetics ntawm atorvastatin.

Baclofen: muaj peev xwm nce antihypertensive nyhuv. Ntshav siab thiab lub raum kev ua haujlwm yuav tsum tau saib xyuas; yog tias tsim nyog, kho qhov koob tshuaj amlodipine.

Corticosteroids (mineralocorticosteroids thiab corticosteroids), tetracosactide: txo qis hauv cov nyhuv antihypertensive (ua kom lub ntsej muag tsis haum thiab sodium ions raws li kev txiav txim ntawm kev ua ntawm corticosteroids).

Amifostine: tej zaum yuav txhim khu lub antihypertensive nyhuv ntawm amlodipine.

Tricyclic cov tshuaj tiv thaiv: nce antihypertensive nyhuv ntawm amlodipine thiab muaj kev pheej hmoo ntawm orthostatic hypotension.

Erythromycin: thaum ua ntawv thov nce C_max amlodipine rau cov neeg mob hluas li 22%, hauv cov neeg mob laus - los ntawm 50%.

Antivirals (ritonavir) nce ntshav ntau ntau ntawm BKK, suav nrog amlodipine.

Antipsychotics thiab isoflurane - nce antihypertensive nyhuv ntawm dihydropyridine derivatives.

Amlodipine tsis ntxim cuam tshuam rau cov chaw muag tshuaj ethanol.

Npaj calcium ntau ntxiv tuaj yeem txo cov nyhuv ntawm BCC.

Nrog rau kev siv amlodipine nrog lithium-muaj cov tshuaj ua tau nce qhia neurotoxicity (xeev siab, ntuav, raws plab, ataxia, tshee, tinnitus).

Tsis cuam tshuam rau qhov ua kom ntshav ntshiab digoxin thiab nws lub raum tshem tawm.

Tsis muaj qhov cuam tshuam tseem ceeb ntawm kev nqis tes ua warfarin (PV).

Cimetidine tsis cuam tshuam rau cov tshuaj pharmacokinetics ntawm amlodipine.

Muaj peev xwm txo qis hauv cov nyhuv antihypertensive ntawm kev sib xyaw ntawm amlodipine + lisinopril thaum siv estrogens, sympathomimetics.

Procainamide, quinidine thiab lwm yam tshuaj uas ncua sijhawm QT ncua sijhawm, tuaj yeem pab txhawb nws qhov tseem ceeb ntev.

Hauv kev tshawb fawb hauv vitro amlodipine tsis cuam tshuam qhov khi protein ntshav digoxin, phenytoin, warfarin thiab indomethacin.

Noj tshuaj amlodipine nrog txiv kab ntxwv qaub tsis pom zoo, zoo li hauv qee cov neeg mob qhov no yuav ua rau muaj qhov nce ntawm bioavailability ntawm amlodipine, uas ua rau muaj kev nce ntxiv hauv nws cov nyhuv antihypertensive.

Tacrolimus: nrog rau kev siv tib lub sijhawm nrog amlodipine, muaj kev pheej hmoo ntawm kev nce ntxiv ntawm tacrolimus nyob rau hauv cov ntshav ntshav, tab sis cov pharmacokinetic mechanism ntawm qhov kev sib txuam no tsis tau kawm tag nrho. Txhawm rau tiv thaiv kom tsis txhob muaj teeb meem ntawm tacrolimus thaum siv amlodipine, kev saib xyuas ntawm tacrolimus hauv cov ntshav ntshav yuav tsum raug saib xyuas thiab cov koob tshuaj tacrolimus yuav tsum tau kho yog tsim nyog.

Clarithromycin: clarithromycin yog ib qho txwv rau CYP3A4 isoenzyme. Nrog rau kev siv amlodipine thiab clarithromycin, kev pheej hmoo ntawm kev txhim kho arterial hypotension tau nce ntxiv. Ua tib zoo saib xyuas kev kho mob ntawm cov neeg mob uas tau txais amlodipine sib txuas nrog clarithromycin yog qhov pom zoo.

Cyclosporin: cov kev kawm sib txuas lus uas siv cyclosporine thiab amlodipine nyob rau hauv cov neeg pab dag zog noj qab haus huv lossis lwm pab pawg ntawm cov neeg mob tsis tau ua, tshwj tsis yog cov neeg mob ua rau lub raum hloov pauv, uas tsis sib luag (qhov nruab nrab qhov tseem ceeb: 0-40%) ntawm cyclosporine tau pom. Nrog rau kev siv amlodipine tib lub sijhawm rau cov neeg mob hloov raum, cov tshuaj cyclosporin hauv cov ntshav plasma yuav tsum raug saib xyuas, thiab yog tias tsim nyog, txo nws cov koob tshuaj.

Simvastatin: tib lub sij hawm rov qab siv amlodipine ntawm ib koob ntawm 10 mg thiab simvastatin ntawm ib koob ntawm 80 mg nce qhov kev cuam tshuam ntawm simvastatin los ntawm 77% piv rau qhov ntawd nrog simvastatin monotherapy. Cov neeg mob uas tau txais amlodipine raug pom zoo kom siv simvastatin hauv ib koob tshuaj tsis ntau tshaj 20 mg / hnub.

Noj ntau dhau

Cov tsos mob cov cim txo qis hauv cov ntshav siab nrog kev loj hlob tau tshwm sim ntawm reflex tachycardia thiab ntau lub vas thuv vasodilation (txoj kev pheej hmoo ntawm qhov mob hnyav thiab tsis tu ncua ntawm txoj hlab ntsha, nrog rau kev loj hlob ntawm kev poob siab thiab tuag).

Kev Kho Mob: lub plab zom mov, noj cov roj carbon activated, tswj kev ua haujlwm ntawm cov hlab plawv thiab lub tshuab ua pa, muab rau tus neeg mob txoj hauj lwm tav toj nrog sawv ceg tsa ceg, tswj bcc thiab zis tawm. Txhawm rau rov qab vascular suab - siv cov vasoconstrictors (hauv qhov tsis muaj contraindications rau lawv siv), txhawm rau tshem tawm cov kev cuam tshuam ntawm kev thaiv ntawm calcium calcium - kev tswj hwm ntawm calcium gluconate. Hemodialysis tsis muaj txiaj ntsig.

Cov tsos mob cim tseg txo ntshav siab, dryness ntawm lub qhov ncauj mucosa, tsaug zog, tso zis tawm tsam, cem quav, ntxhov siab vim, siab txob.

Kev Kho Mob: lub plab zom mov, noj cov pa hluav taws, muab tus neeg mob ua txoj hauj lwm tav toj nrog sawv ceg, rov qab ua bcc - hauv / kev qhia txog plasma-hloov cov kev daws teeb meem, kev kho mob, soj ntsuam lub luag haujlwm ntawm cov hlab plawv thiab lub tshuab ua pa, bcc, urea concentration, creatinine thiab ntshav electrolytes, raws li cov diuresis. Lisinopril tuaj yeem tshem tawm ntawm lub cev los ntawm hemodialysis.

Kev kawm

Ua ke, lisinopril thiab amlodipine muaj nyob hauv kev npaj Equator. Muaj lwm qhov tshuaj, tsis muaj koob nrov npe hauv khw. Nws yog nthuav tawm raws li lub npe "Lisinopril Plus", yog ib ntsiav tshuaj uas muaj 10 mg ntawm ib qho khoom siv thiab 5 mg ntawm ob. Amlodipine cov nyiaj muaj tsawg dua. Ib pob muaj los ntawm peb mus rau rau kaum os tshuaj tsiav. Txhua qhov ua piv txwv yog xim dawb, muaj ib puag ncig lub cev ntawm cov flattened. Kev phom sij foreseen, chamfer. Hauv ib ntsiav tshuaj, amlodipine raug nthuav tawm raws li ib qho kev thov, cov tshuaj thib ob yog muaj nyob hauv daim ntawv ntawm dihydrate. Cov chaw tsim khoom siv cov cellulose, hmoov txhuv nplej siab, magnesium thiab silicon tshuaj ntxiv raws cov kev sib txuas ntxiv.

Vaj huam sib luag rau cov ntsiav tshuaj, uas kuj muaj ob cov khoom xyaw nquag no yog tsim nyob rau hauv daim ntawv ntawm lub voj voos tiaj. Caw, qhov txaus ntshai yog qhov pom tau. Hawj txawm - dawb los yog kom ze rau nws li sai tau. Ib qho ntawm cov nplaim yog txuam nrog engraving. Muaj ntau txoj kev xaiv ntau npaum li cas. Amlodipine muaj nyob hauv cov tshuaj hauv daim ntawv ntawm besylate, lisinopril yog sawv cev los ntawm dihydrate. Muaj cov kev xaiv tshuaj: 5 thiab 10, 5 thiab 20, 10 thiab 10, 10 thiab 20 mg, raws. Ntxiv rau amlodipine thiab lisinopril, cov muaj pes tsawg leeg muaj cov hmoov txhuv nplej siab, cellulose, magnesium cov lwg me me nyob rau hauv daim ntawv ntawm stearate. Ib pob muaj li ntawm 10 txog 60 ntsiav tshuaj. Tus nqi pes tsawg yog hais sab nraud ntawm lub pob. Ntawm no, ntau npaum ntawm cov khoom xyaw uas nquag rau hauv txhua daim qauv sau tseg.

Amlodipine: nta

Feem ntau, cov neeg mob tau sau tshuaj sib xyaw nrog kev sib xyaw nrog amlodipine, indapamide thiab lisinopril hauv txoj haujlwm. Cov tshuaj thawj los ntawm daim ntawv no muaj cov kav ntev (nws lub zog nyob ntawm koob tshuaj) ntawm lub siab. Qhov no yog vim cov nyhuv vasodilating ntawm cov leeg ntsa ntawm cov leeg ntshav. Yog tias muaj ntshav siab, ib koob ntawm cov ntim txaus txaus tuaj yeem lav ib qho qis txaus hauv qhov ntsuas nyob rau ib hnub. Qhov no yog tsau hauv txoj haujlwm thiab sawv ntsug, thiab pw hauv av.

Orthostatic hypotension nyob rau hauv cov neeg mob kawm ib chav nrog kev suav nrog ntawm amlodipine tsis tshua tau kaw.Cov tshuaj tsis txo qis kev ua rau lub cev ua haujlwm. Nrog nws siv, qhov mob hnyav ntawm hypertrophic cov txheej txheem hauv lub ventricle ntawm lub siab ntawm sab laug txo. Hauv qhov no, kev ua kom sib luag, kev cog lus cog lus ntawm lub siab nqaij tsis zoo, tsis muaj qhov cuam tshuam hauv lub plawv dhia. Kev nqus ntawm cov ntsiav tshuaj muaj amlodipine thiab lisinopril ua rau kev nce siab hauv kev ua haujlwm ntawm lub raum glomeruli thiab qeeb qeeb ntawm platelet sib sau ua ke. Muaj ib qho pom tsis zoo ntawm cov nyhuv natriuretic. Nws tsis muaj qhov cuam tshuam zoo rau cov metabolism, rog lub cev ntawm cov ntshav. Amlodipine siv tau rau ntshav qab zib, mob gout, hawb pob. Cov lus tshaj tawm ntawm cov siab nias sau tom qab 6-10 teev, tseem mob siab rau ib hnub.

Lisinopril: nta

Raws li koj tuaj yeem kawm los ntawm kev sib xyaw ua ke uas muaj cov tshuaj lisinopril thiab amlodipine, cov lus qhia rau kev siv, thawj cov khoom hais tau qhia txog lub suab ntsig tom qab ib teev tom qab noj. Kev ua haujlwm siab tshaj plaws tau sau tseg nyob nruab nrab 6.5 teev tom qab no. Lub sijhawm tiv thaiv kev txuag ua haujlwm tau ib hnub. Nrog cov ntshav siab nce ntxiv, cov txiaj ntsig raug pom thawj ob peb hnub tom qab pib ua haujlwm, tom qab ib hlis lossis ob lub zwj ceeb thaum kawg tswj hwm.

Cov kev soj ntsuam uas xav tau kom tshem tawm sai sai ntawm cov tshuaj yeeb dej caw tau pom. Tsis muaj kev nce siab hauv lub siab los ntawm qhov tshem tawm no. Nyob rau hauv kev cuam tshuam ntawm lisinopril, ntshav siab poob, cuam tshuam ntawm albuminuria tsawg dua. Nrog hyperglycemia, cov tshuaj pab ua kom ib txwm muaj kev ntxhov siab glomerular endothelium. Ntawm ntshav qab zib, nws tsis cuam tshuam cov piam thaj hauv cov ntshav ncig. Kev siv cov lisinopril tsis ua rau muaj kev pheej hmoo ntawm kev mob ntshav qab zib.

Ua ke ntawm cov tshuaj yeeb dej caw

Txij li cov lisinopril thiab amlodipine yog qhov muaj txiaj ntsig, cov khoom sib txuam ua ke tau tsim kho. Ib qho ntawm cov no tau tshaj tawm nyob rau hauv lub npe "Equator". Cov tshuaj muaj ob qho tib si ua ke xav. Qhov kev sib xyaw no tso cai rau koj kom txo cov kev pheej hmoo ntawm cov kev mob tshwm sim rau txhua qhov ntawm cov tshuaj nquag ib tus zuj zus. Yog lawm, kev siv cov tshuaj sib xyaw ua ke tau raug tso cai nruj raws li kev saib xyuas ntawm tus kws tshaj lij, txij li cov kev pheej hmoo tseem muaj ntau, tab sis cov tshuaj hauv nqe lus nug raug zam los ntawm cov neeg mob zoo dua li txhua cov tshuaj cais.

Thaum twg nws xav tau?

Raws li tuaj yeem xaus lus los ntawm cov kev txheeb xyuas, ua ke "Amlodipine" thiab "Lisinopril" feem ntau tau sau tseg rau cov tib neeg uas xav tau tshuaj los kho cov ntshav siab. Yav dhau los, tus kws kho mob qhia meej txog qhov tsim nyog ntawm chav ua ke. Siv tshuaj nkaus xwb raws li qhia. Kev tswj hwm tus kheej nrog kev paub txog qib siab uas ua rau muaj kev tsim cov txiaj ntsig tsis tsim nyog. Ntshav siab yog qhov tsuas yog qhia txog nyob rau hauv cov lus qhia nrog tshuaj.

Kev sib xyaw ua ke: nws puas txaus ntshai?

Cov tib neeg uas tau sau cov tshuaj sib xyaw los tswj cov cim ntsuas siab qee zaum txaus siab qhov kev txaus ntshai loj npaum li cas nrog kev muaj feem cuam tshuam ntawm kev sib xyaw ntawm cov khoom xyaw ntawm ib leeg. Raws li kev tshuaj ntsuam pom tau, qhov kev pheej hmoo ntawm kev siv tshuaj lom neeg yog qhov tsawg tsawg. Qhov tos ntawm ib nrab ntawm lub neej, kev siab tshaj plaws lossis kev faib khoom hauv lub cev tau kuaj xyuas. Kev kho cov lus hais no tsis yog tsim los ntawm kev siv pob nyiaj ua ke los sis cais. Tsis muaj kev vam khom rau lub sijhawm ua noj. Khoom noj tsis haum rau qib ntawm kev nqus ntawm cov sib txuas. Lub sijhawm ntev ntawm cov khoom xyaw rau hauv cov ntshav mob pub rau koj siv cov tshuaj ib hnub ib zaug.

Yuav siv li cas?

Cov tshuaj sib xyaw ua ke uas muaj amlodipine thiab lisinopril yuav tsum tau noj qhov ncauj. Txais tos tsis yog nyob ntawm kev noj mov. Nws yuav tsum haus dej haus tshuaj muaj pes tsawg leeg nrog dej huv yam tsis muaj ib qho ntxiv rau hauv tus nqi tsim nyog. Cov koob tshuaj txhua hnub pom zoo yog ib cov tshuaj ntsiav. Nws raug nquahu kom siv cov khoom txhua hnub nyob rau lub sijhawm ruaj khov. Ntau tshaj ib ntsiav tshuaj yuav tsum tsis txhob siv ib hnub.

Cov tshuaj sib xyaw ua ke yuav tsum tau noj yog tias qhov ntau npaum li cas ntawm cov khoom xyaw nquag txuam nrog qhov khoom zoo ntawm lawv txhua tus rau qee kis. Ua ntej, tus kws kho mob txiav txim siab muab cov koob tshuaj rau cov neeg mob tshwj xeeb, tom qab ntawd muab piv rau kev sib txawv ntawm cov tshuaj sib xyaw. Kev tso tawm tau ntawm Equator thiab Lisinopril Plus tshuaj muaj qhia saum toj no. Yog tias nws tsis muaj peev xwm nrhiav tau yam tso tawm uas tsim nyog, koj yuav tsum muab tus neeg mob cais tawm ntawm cov tebchaw no.

Lub nuances ntawm kev kho mob

Yog tias tus kws kho mob tau sau cov tshuaj sib xyaw, uas suav nrog amlodipine thiab lisinopril, tab sis thaum pib ntawm kev siv tshuaj kho mob ntshav siab poob qis, tus neeg mob yuav tsum tuav txoj haujlwm supine thiab tsum tsis noj. Nws yog ib qho tsim nyog yuav tsum tau nrhiav kev pab ntawm kws kho mob. Feem ntau cov transistor tshwm sim tsis yuam kom tso tseg txoj kev kho kom zoo, tab sis qee zaum qee qhov yuav tsum tau txo tshuaj me me. Yog tias nws yuav tsim nyog los sim cov koob tshuaj, cov khoom xyaw tau sau tseg nyob rau hauv daim ntawv ntawm cov khoom lag luam kws tshuaj rau lub sijhawm ntawm qhov kev tsim qauv.

Qee lub sij hawm tus neeg mob tau sau tseg rau ntau yam kev kawm (piv txwv, tib lub sijhawm amlodipine, lisinopril rosuvastatin). Raws li kev coj ua, pom ntau cov ntsiab lus ntawm txoj kev pab cuam tshuaj uas tus neeg mob xav tau, muaj kev pheej hmoo siab ploj ntawm qee yam. Yog tias tus neeg mob tau ncua lub sijhawm siv "Equator", koj yuav tsum tau tos rau lwm zaus. Txhua lub sijhawm siv ib zaug xwb. Yog tias koob dhau los raug nplua lawm, nws tsis tas yuav ntxiv ob leeg tom ntej. Koj tsis tas yuav thim cov nqe hla.

Ib qho kev txwv nruj heev rau kev noj cov "Equator" yog qhov muaj kev cuam tshuam ntau dua ntawm cov khoom xyaw nrog rau hauv cov tshuaj. Qhov no kuj siv rau cov khoom siv tseem ceeb thiab cov khoom sib txuas. Koj tuaj yeem siv tsis tau cov tshuaj yog tias tib neeg lub cev tau cim los ntawm qhov muaj peev xwm ntau ntxiv ntawm cov khoom lag luam ntawm kev ua cov tshuaj dihydropyridine lossis ACE inhibitors. Yog tias tus neeg mob tau siv yav dhau los siv ACE inhibitor thiab qhov no ua rau Quincke's edema, yog tias qhov tshwm sim no tau pom los ntawm lwm qhov laj thawj, "Siv Qhov Nruab Nrab" tsis tuaj yeem siv. Nws yog txwv tsis pub noj cov tshuaj nrog angioedema ntawm idiopathic daim ntawv lossis vim muaj qhov muaj mob muaj keeb, zoo li nyob rau hauv lub xeev poob siab, nrog kev poob siab cardiogenic. Cov tshuaj tsis tau sau tseg rau cov tsis hnov mob angina. Ib kis tshwj tsis yog kis yog ib hom kab mob hu ua Prinzmetal disease. Koj tsis tuaj yeem sau ntawv kho cov kev kho mob rau qhov hnyav ntawm kev txiav txim siab hauv cov hlab ntsha, thaum qhov ntsuas me dua 90 ntu, thiab yog tias lub plawv tsis txaus ua haujlwm rau qhov tsis txaus ntseeg hemodynamic hom yog tias mob plawv nres yav tas los tau kis. Cov tshuaj tsis siv yog tias nws yuav tsum tau noj aliskiren lossis lwm yam tshuaj lag luam uas muaj cov tshuaj muaj pes tsawg leeg, nrog rau cov ntshav qab zib, mob raum lossis mob raum.

"Equator", "Equamer" (tshuaj uas muaj ob qho tib si amlodipine, lisinopril rosuvastatin) tsis siv thaum cev xeeb tub. Koj tuaj yeem siv tsis tau cov tshuaj ua ke rau lactation thiab thaum tiav hluas, yog tias koj xav tau cov tshuaj thaiv lub cev ntawm cov tshuaj receptor rau kev nkag siab ntawm hom thib ob ntawm angiotensin rau nephropathy vim tias mob ntshav qab zib. Cov kev txwv yog raug txwv los ntawm qhov kev cuam tshuam ntawm cov zis sab laug ventricular lub plawv mob ntawm lub hemodynamically tseem ceeb hom, nrog rau cov kem mitral.

Koj tuaj yeem, tab sis ua tib zoo saib

Qee zaum kev sib txuam ua ke yog kho rau tus mob aortic stenosis, qee yam mob myopathy, cerebrovascular pathologies. Cov mob zoo li no yuav tsum tau saib xyuas ntau ntxiv. Nws yog ib qho tseem ceeb uas yuav tsum tau kuaj xyuas tus neeg mob kom tsis tu ncua, saib xyuas kev ua haujlwm ntawm lub nruab nrog cev thiab nruab nrog cev. Qhov tseeb yuav tsum muaj qhov xwm txheej yog tias tus neeg mob yuav tsum siv cov tshuaj diuretics, cov tshuaj poov tshuaj, cov poov tshuaj ntsev hloov chaw. Tshwj xeeb tshaj yog cov tib neeg uas muaj ntau tshaj ntawm cov poov tshuaj hauv lub cev, tsis muaj sodium ntau, nrog rau cov kev txom nyem los ntawm myelosuppression, mob ntshav qab zib, thiab mob raum muaj ntshav muaj ntshav tawm.

Cov tshuaj zoo rau kev mob ntshav siab yog tshuaj yog tias tus neeg muaj lub raum hloov raum, raug yuam kom yauv mus rau hemodialysis, txom nyem los ntawm thawj hom aldosteronism lossis noj zaub mov nrog kev txwv ntsev ntau. Qhov yuav tsum tau siv cov tshuaj uas thaiv cov enzyme compound CYP3A4, cov neeg tawm tsam ntawm qhov enzyme no yuav tsum tau soj ntsuam tas li ntawm tus neeg mob.

Qhov tsis tsim nyog yam tshwm sim

Kev noj tshuaj sib xyaw ua ke, uas suav nrog amlodipine thiab lisinopril, tuaj yeem ua rau txo qis ntawm cov tshuaj hemoglobin, hematocrit hauv cov kab mob ncig. Muaj qhov txaus ntshai ntawm qhov inhibition ntawm hematopoietic muaj nuj nqi. Muaj kev pheej hmoo ntawm kev tsis haum tshuaj, nce lossis tsawg dua ntawm cov piam thaj hauv ntshav. Cov leeg hypertonicity, neuropathy, kev ua kom lub cev ntxiv ntawm cov tshuaj tiv thaiv tsis tshua muaj mob. Muaj kev txaus ntshai ntawm teeb meem tsis pom kev, pw tsaug zog, nco qab. Cov xeev nyuaj siab, ntxhov siab, lability muaj peev xwm ua tau. Ib txhia sau tseg tinnitus. Tsis tshua muaj daim ntawv qhia txog lub plawv nres. Muaj kev pheej hmoo ntawm kev ua txhaum ntawm cov zaus thiab nrawm ntawm lub plawv dhia, atrial fibrillation. Hypotension yog ua tau, muaj kev phom sij ntawm cuam tshuam ntawm cov ntshav khiav hauv lub hlwb. Raynaud's syndrome kuj tuaj yeem tsim.

Cov neeg mob ntsws, mob hlab ntsws, mob rau daim siab. Muaj kev pheej hmoo ntawm daim siab ua haujlwm, qhov tso quav tsis xis nyob, mob hauv plab. Lwm tus tau hnoos, txog siav, thiab qhov ncauj qhuav. Kev kuaj yuav qhia tias qhov nce siab ua rau lub siab ua haujlwm.

Dab tsi yog lisinopril tshuaj rau?

Cov tshuaj yog zwm rau hauv chav kawm ntawm cov tshuaj uas inhibit qhov kev ua si ntawm angiotensin-hloov pauv enzyme. Nws siv rau kev kub siab, spasm ntawm kev mob ntshav ntawm txoj hlab ntshav (angina pectoris, myocardial infarction).

Nws muaj cov nyhuv vasodilating, txo cov nyhuv ntawm lub suab vascular ntawm angiotensin II, nce cov ntsiab lus ntawm bradykinin, uas dilates cov hlab ntsha.

Tsub kev ua siab ntev ntawm cov leeg plawv thaum lub cev nqaij daim tawv thiab lub siab ntxhov siab, txhim kho myocardial trophism, nthuav dav ntawm cov hlab ntsha txhaws. Txo cov leeg tsis kam, tiv thaiv kev ntxhov siab ntawm lub plawv.

Yuav ua li cas noj tshuaj amlodipine thiab lisinopril ua ke?

Amlodipine siv nyob rau ntawm 5 mg rau ib hnub twg rau kev mob plawv thiab mob ntshav siab.

Lisinopril hauv kev kho tshuaj monotherapy yog muab tshuaj 5 mg ib zaug. Yog hais tias cov nyhuv ntawm kev noj tsis tuaj kawm, cov koob tshuaj tau nce. Cov tshuaj txij nkawm yog 20 mg rau ib hnub.

Kev noj tshuaj yog kho raws tus kheej los ntawm tus kws kho plawv.

Cov yam ntxwv ntawm Amlodipine

Cov tshuaj yog rau cov pab pawg ntawm calcium channel blockers. Lub npe lag luam yog Amlodipine. Pab txo qis ntshav siab thiab tiv thaiv angina tawm tsam. Cov tshuaj thim cov hlab ntsha thiab txo txoj kev thauj khoom ntawm lub plawv mob, thiab tseem yuav nrawm xa cov pa mus rau myocardial cov ntaub so ntswg. Cov tshuaj pab txhawm rau tiv thaiv vog leeg voos, uas feem ntau tshwm sim hauv cov laus haus luam yeeb.

Thaum noj cov tshuaj no, kev hloov kho ntawm cov leeg plawv mus rau kev ua haujlwm hauv lub cev.

Tsis tas li ntawd, cov tshuaj nthuav tawm cov lumen ntawm cov hlab ntshav, txhawm rau ua kom ntshav cov ntshav. Cov tshuaj pab txo qis gluing ntawm platelets, tab sis tsis cuam tshuam rau cov txheej txheem hauv lub cev hauv lub cev.

Tom qab kev tswj hwm, cov kev tivthaiv nquag khi rau cov ntshav plasma protein los ntawm 95%, uas ua rau nws txo qis ntshav siab hauv lub sijhawm luv. Cov nyhuv antihypertensive yog manifested tom qab 30-60 feeb. Qhov siab tshaj plaws nyob rau hauv cov ntshav dej yog mus txog hauv 6 teev.

Lisinopril ua haujlwm li cas?

Cov tshuaj yog zwm rau pab pawg ntawm ACE inhibitors, cuam tshuam qhov zais cia ntawm aldosterone. Lub npe thoob ntiaj teb - Lisinopril. Cov tshuaj txo cov ntshav siab thiab ntshav siab rau cov hlab ntsws capillaries. Cov tshuaj yog siv los kho cov neeg mob lub plawv tsis ua haujlwm, vim hais tias txhim kho myocardial kev ua kom haum rau kev qoj ib ce.

Cov cuab yeej pabcuam pab kom nthuav dav cov hlab ntsha thiab ua kom ntshav khiav hauv thaj chaw ntawm ischemia. Cov tshuaj qeeb qeeb qhov kev txhim kho ntawm cov ntaub so ntswg pov tseg ntawm sab laug ventricle. Cov tshuaj yog tuaj yeem txo lub neej ntev ntawm cov neeg mob uas muaj mob hauv lub cev tsis zoo.

Yuav noj amlodipine thiab lisinopril li cas?

Amlodipine pib noj nrog 5 mg ib hnub ib zaug, tsis hais noj zaub mov li cas (sawv ntxov lossis yav tsaus ntuj). Thaum muaj mob hnyav, kws kho mob sau ntawv 2 lub sij hawm muab tshuaj - 10 mg. Lisinopril tseem tseem noj 1 zaug nyob rau ib hnub pib nrog 10 mg, tsis hais tus noj mov (zoo li thaum sawv ntxov). Lub chav kawm ntawm txoj kev kho yog txiav txim los ntawm tus kws kho mob.

Los ntawm lub siab

Nrog rau qhov muaj ntshav siab, Amlodipine raug muab tshuaj 1 mg rau ib hnub, 5 mg, thiab Lisinopril 10-20 mg ib hnub.

Nrog rau kev mob ntshav siab, Amlodipine raug muab tshuaj 1 mg ib hnub twg.

Lub tswv yim ntawm cov kws kho mob

Pavel Anatolyevich, kws kho mob, Novosibirsk

Kuv sau ob qho tshuaj noj rau cov ntshav siab thiab qhov pheej hmoo ntawm lub plawv nres. Vim yog cov txiaj ntsig ua tau zoo, qhov ntxim li yuav muaj tsawg dua. Hauv qee kis, qhov kev sib txuam no tiv thaiv lub hlwb hemorrhage, uas qee zaum fraught nrog kev tuag.

Evgenia Alexandrovna, kws kho plawv, Penza

Kev sib xyaw ntawm cov tshuaj no tau siv hauv kev kho mob ntev ntev, vim hais tias pab txhawm rau txhim kho kev mob ntawm tus neeg mob nrog kev mob ntshav siab thiab mob plawv. Kuv muab cov tshuaj hauv cov koob tshuaj kom txo qis kom txo qhov mob tshwm sim. Nws yog qhov yuav tsum tau ceeb toom rau tus neeg mob tias cov tshuaj diuretics yuav tsum tau tshem tawm 2 hnub ua ntej pib kev kho.

Tamara Sergeevna, kws kho plawv, Ulyanovsk

Cov tshuaj no feem ntau ua ke kom ua tiav qhov txiaj ntsig zoo tshaj plaws hauv kev kho mob ntawm cov neeg mob nrog pathologies ntawm lub plawv thiab cov hlab ntsha. Ua ntej sau tshuaj, Kuv pom zoo kom cov neeg mob mus kuaj X-ray ntawm lub hauv siab hauv siab thiab xeem dhau cov kev kuaj mob uas tsim nyog txhawm rau txheeb xyuas cov kev sib kis.

Kev Ntsuam Xyuas Rau Neeg Mob rau Amlodipine thiab Lisinopril

Peter, 62 xyoo, Kiev

Nws coj cov tshuaj no ua ke tom qab myocardial infarction tiv thaiv kom rov huam dua. Lub siab tau ruaj khov thaum lub sij hawm kho, tab sis thaum nws nres kev kho mob, qhov mob ntawd loj zuj zus. Tam sim no kuv noj tshuaj ntxiv thiab tsis quav ntsej cov lus qhia ntawm tus kws kho plawv.

Igor, 55 xyoo, Otradny

Nrog rau kub siab, ob qho tshuaj tau raug muab tshuaj ib zaug, vim tias surges lub siab tau tas li. Nyob rau hnub thib ob txij li hnub pib kho, Kuv tau zoo, Kuv lub taub hau cia li ua rau mob thiab xeev siab. Noj cov tshuaj tsis tu ncua.

Elena, hnub nyoog 49 xyoos, Salavat

Kuv tau tawm tsam nrog ntshav siab los ntev ntev. Tsis muaj nyiaj pab. Tom qab ntawv tus kws kho mob tau sau cov tshuaj no los sib xyaw. Cov nyhuv tsis ntev rau hauv kev tuaj thiab twb tau ib hnub tom ntej no kuv muaj kev txhim kho.