Cov lus qhia rau kev siv Akkupro thiab kev taw qhia rau kev kho nrog tshuaj
Quinapril hydrochloride (INN - Quinaprilum) yog ib qho ethyl ester ntawm ACE inhibitor quinaprilat uas tsis muaj ib pawg sulfide. Thaum noj cov tshuaj hauv, quinapril yog sai sai deesterified rau quinaprilat (quinapril diacid, cov tshuaj metabolite), uas yog ACE inhibitor zoo. Tus txheej txheem ntawm kev txiav txim ntawm quinapril yog qhov kev txwv tsis pub mus rau hauv cov ntshav thiab cov nqaij mos ACE, uas txo cov kev ua vasopressor thiab aldosterone secretion. Ib qho kev txo qis ntawm theem ntawm angiotensin II los ntawm cov kev tawm tsam ua rau muaj kev zais ntshis ntawm renin thiab nws cov haujlwm hauv cov ntshav ntshav. Txawm hais tias nws ntseeg tau hais tias lub ntsiab tseem ceeb ntawm cov nyhuv antihypertensive yog pom los ntawm renin-angiotensin-aldosterone system, quinapril nthuav tawm cov nyhuv antihypertensive txawm nyob hauv cov neeg mob uas tsis muaj mob ntshav qis (mob ntshav tawm).
Kev tswj hwm ntawm quinapril rau cov neeg mob, pib txij li theem nrab mus rau mob ntshav siab (mob ntshav siab) ntawm kev txhaj tshuaj ntawm 10-40 mg, ua rau txo qis ntshav siab ob leeg hauv kev zaum thiab sawv ntsug, nrog cov tsawg cuam tshuam rau lub siab plawv. Cov nyhuv antihypertensive tshwm sim hauv 1 teev, cov nyhuv siab tshaj plaws - 2-4 teev tom qab siv tshuaj. Hauv qee tus neeg mob, txoj kev mob siab hypotensive yog pom tom qab 2 lub lim tiam ntawm kev kho mob. Thaum siv hauv cov koob tshuaj pom zoo, cov nyhuv antihypertensive ntawm cov tshuaj yog tswj hauv feem ntau cov neeg mob rau 24 teev thiab tseem mob siab nrog kev siv lub sijhawm ntev ntawm cov tshuaj. Kev poob qis hauv cov ntshav siab tshwm sim los ntawm quinapril yog nrog kev txo lub plawv thiab lub zog ntawm cov hlab ntsha ntawm lub raum nrog kev hloov me ntsis lossis tsis tuaj yeem hloov pauv hauv lub plawv dhia, lub plawv dhia ntshav, lub plawv raum khiav, lub plawv txhaws thiab qhov feem lim.
Tom qab kev tswj hwm ntawm qhov ncauj, qhov siab tshaj plaws ntawm quinapril hauv cov ntshav plasma tau mus txog hauv 1 teev. Kwv yees li 60% ntawm cov tshuaj tau nqus, thiab lub cev tsis muaj zog ntawm cov tshuaj quinaprilat yog 38%. Qhov siab tshaj plaws ntawm quinaprilat hauv plasma tau mus txog kwv yees li 2 teev tom qab noj ntawm quinapril. Lub plasma ib nrab-lub neej yog nyob ntev txog 1 teev. Kwv yees li 97% ntawm quinapril lossis quinaprilat ncig hauv cov ntshav muaj feem nrog cov protein. Hauv cov neeg mob uas lub raum tsis ua haujlwm, ib nrab ntawm lub neej ntawm quinaprilat nce nrog kev txo qis ntawm creatinine tshem tawm. Pharmacokinetic cov kev tshawb fawb nyob rau hauv cov neeg mob uas mob raum tsis zoo ua rau mob hemodialysis los yog cov tshuaj tiv thaiv mob ua paug rau lub cev lim ntshav qhia tau tias kev lim ntshav tsis cuam tshuam rau kev tshem tawm ntawm quinapril thiab quinaprilat. Muaj txoj kab sib txuas ntawm qhov pom ntawm quinalaprilate los ntawm cov ntshav ntshav thiab lub luag tawm ntawm creatinine. Quinaprilat tshem tawm tseem txo hauv cov neeg mob laus (tshaj 65). Qhov kev xav ntawm quinaprilat yog txo qis hauv cov neeg mob uas lub siab tsis txaus ntseeg lub siab vim muaj kev ua txhaum ntawm quinapril deesterification. Quinapril thiab nws cov metabolites tsis nkag rau hauv BBB.
Kev siv ntawm cov tshuaj Akkupro
Arterial tawg (AH)
Kho Mob Tshuaj Kho Mob: Qhov pom zoo kom pib koob tshuaj Accupro rau cov neeg mob uas tsis noj tshuaj diuretics yog 10-20 mg ib hnub ib zaug. Ua raws li kev kho mob tus mob, cov koob tshuaj yuav tau nce ntxiv rau 20-40 mg / hnub hauv 1-2 koob. Yog tias tsim nyog, kev hloov kho tshuaj tuaj yeem nqa ntawm 2-4 lub lis piam.Kev tswj tau ntshav siab ntawm cov neeg mob feem ntau tau ua tiav thaum noj cov tshuaj 1 zaug hauv ib hnub. Qhov siab tshaj plaws ntawm quinapril yog 80 mg / hnub.
Ib txhij tuav tswj ntawm diuretics: hauv cov neeg mob uas yuav tsum tau txuas ntxiv kho nrog diuretics, thawj zaug pom zoo koob tshuaj Accupro yog 5 mg, tom qab ntawd nws tuaj yeem maj mam nce ntxiv kom ua tiav cov nyhuv siab.
Kev Ua Si Tsis Txaus Ntseeg Hauv Siab
Qhov pom zoo kom pib lub koob tshuaj yog 5 mg hauv 1-2 koob tshuaj. Yog tias thawj zaug tshuaj ntawm quinapril muaj kev tiv thaiv zoo, nws tuaj yeem maj mam nce mus rau qhov tau txais txiaj ntsig zoo, feem ntau 10-40 mg / hnub hauv 2 faib ua ke.
Kev tshem tawm ntawm quinapril nyob ntawm lub xeev kev ua haujlwm ntawm lub raum. Qhov pom zoo pom zoo koob pom zoo ua ntej ntawm Accupro hauv cov neeg mob nrog creatinine tshem tawm saum toj 30 ml / min yog 5 mg, thiab hauv cov neeg mob creatinine tshem tawm tsawg dua 30 ml / min - 2.5 mg. Yog tias thawj zaug tshuaj tau zoo siab, qhov tshuaj yuav tau noj 2 zaug hauv ib hnub txij hnub tom qab. Vim tias tsis muaj ntshav siab ntau dhau los yog qhov tsis zoo hauv lub raum kev ua haujlwm, qhov koob tshuaj yuav raug nce nrog lub sijhawm 1 lub hlis, suav txog qhov kev kuaj mob thiab hemodynamic nyhuv.
Cov tshuaj tiv thaiv kom tsis txhob siv tshuaj Akkupro
Hypersensitivity rau quinapril lossis lwm yam tshuaj, keeb kwm ntawm kev mob caj dab cuam tshuam nrog yav dhau los ACE inhibitor txoj kev kho, kev xeeb tub thiab lactation, thiab menyuam yaus.
Cross-rhiab rau lwm tus ACE inhibitors tsis tau raug ntsuas.
Kev phiv tshuaj ntawm Akkupro
Feem ntau me ntsis hais tawm thiab luv-nyob. Cov xwm txheej uas tshwm sim feem ntau hauv cov kev sim tshuaj tswj tau mob taub hau (7.2%), kiv taub hau (5.5%), hnoos (3.9%), nce rog (3.5%), mob ntsws (3.2%) ), xeev siab thiab / lossis ntuav (2.8%), myalgia (2.2%). Nws yuav tsum nco ntsoov tias qhov hnoos yog feem ntau tsis muaj txiaj ntsig thiab ploj mus tom qab kev tso tseg ntawm txoj kev kho.
Cov kev mob tshwm sim tsis zoo yuav tshwm sim, muaj peev xwm los yog muaj feem cuam tshuam nrog lossis kev tsis txaus siab rau kev kho mob quinapril (nrog lossis tsis muaj kev kho qhov tseeb) hauv kev tswj hwm thiab tswj tsis tau thiab tsis tshua pom pom hauv kev tshawb fawb soj ntsuam lossis tom qab sau npe soj ntsuam * suav nrog.
Hematopoietic thiab lymphatic system mob: hemolytic anemia *, thrombocytopenia *.
Los ntawm lub nruab zog: tshuaj tiv thaiv anaphylactoid *.
Los ntawm sab ntawm lub hauv nruab nrab hauv lub paj hlwb:, mob ntsws daj, puas siab ntsws, poob siab, tsaug zog.
Los ntawm sab ntawm cov khoom ntawm lub zeem muag: amblyopia.
Los ntawm cov kab mob plawv: angina pectoris, palpitations, tachycardia, postural hypotension *, syncope *, vasodilation.
Los ntawm lub plab zom mov: qhov ncauj qhuav los yog caj pas, plooj, mob caj pas *.
Ntawm feem ntawm daim tawv nqaij: alopecia *, kev ua kom zoo rau daim tawv nqaij * ua pob, khaus, tawm hws ntau dhau, pemphigus *, kev tawm tsam rau qhov muag *, ua pob rau ntawm daim tawv.
Los ntawm cov leeg musculoskeletal:arthralgia
Los ntawm genitourinary system: mob txeeb zig, mob impotence.
Kev cuam tshuam dav dav thiab kev txiav tawm ntawm qhov chaw txhaj tshuaj: edema (cuab yeej thiab qhov dav dav),
Tib qho xwm txheej tsis zoo: angioedema * tau pom nyob rau hauv 0.1% ntawm cov neeg mob siv quinapril. Qee zaum, zoo ib yam li lwm tus ACE inhibitors, eosinophilic pneumonitis * thiab kab mob siab tau pom nrog quinapril.
Cov qhabnias ntawm kev soj ntsuam kuaj mob: tsawg tsawg - agranulocytosis thiab neutropenia (lawv qhov kev sib raug zoo nrog kev siv quinapril yog qhov tsis txaus ntseeg), hyperkalemia.
Creatinine thiab ntshav urea nitrogen. Ib qho kev nce ntxiv (ntau dua 1.25 npaug siab dua qhov muaj cai sab sauv ntawm qhov ib txwm) ntawm cov ntshiab si creatinine thiab urea nitrogen tau pom nyob hauv 2 thiab 2% ntawm tus neeg mob, feem, nrog quinapril kev kho.Ib qho kev nce ntxiv yog tshwm sim rau cov neeg mob uas tau txais cov tshuaj nyob rau hauv kev sib xyaw nrog tshuaj diuretics tshaj li cov tau txais quinapril monotherapy.
Angioneurotic edema. Kev txhim kho ntawm cov tshuaj mob taub hau raug ceeb toom tawm hauv cov neeg mob uas tau txais ACE inhibitors (suav nrog 0.1% ntawm cov neeg mob tau txais quinapril). Yog hais tias tus neeg mob txhim kho angioedema ntawm lub suab ntawm lub ntsej muag, ntsej muag, nplaig, quinapril yuav tsum nres tam sim ntawd, tus neeg mob yuav tsum tau txais kev kho kom tsim nyog thiab soj ntsuam kom txog thaum lub edema ploj tag. Yog tias edema tsuas pom ntawm lub ntsej muag thiab daim di ncauj, kev kho mob tshwj xeeb tsis tas yuav tsum muaj nyob rau hauv Feem ntau, nws raug nquahu kom siv cov tshuaj antihistamines kom tshem tawm cov tsos mob. Angioedema ntawm tus nplaig, lub larynx thiab glottis tuaj yeem yog kev phom sij txog lub neej. Nrog nws txoj kev txhim kho, kev kho mob maj mam tsim nyog yuav tsum tau ua tam sim ntawd, uas tsim nyog suav nrog kev tswj hwm ntawm 0.3-0.5 ml ntawm epinephrine (epinephrine) tov (1: 1000). Cov neeg mob uas muaj keeb kwm mob tiv thaiv kab mob angioedema tsis txuam nrog ACE inhibitor txoj kev kho kuj tseem muaj kev pheej hmoo ntawm tus mob angioedema thaum kho nrog ACE inhibitor.
Hauv cov neeg mob ntawm cov haiv neeg Negroid, nyob rau hauv leej twg ACE inhibitors tau siv, cov xwm txheej ntawm kev txhim kho kev mob hlwb ntau dua li cov neeg mob ntawm lwm haiv neeg. Cov neeg mob ntawm cov haiv neeg Negroid kuj tau sau tseg txog qhov cuam tshuam me ntsis ntawm ACE inhibitors ntawm cov ntshav siab piv rau lwm yam kev sib tw.
Mob hnyuv angioedema. Hauv cov neeg mob siv ACE inhibitors, kev pom ntawm txoj hnyuv angioedema tau pom. Cov neeg mob zoo li no tau yws yws tias mob plab (nrog / tsis muaj xeev siab lossis ntuav), qee qhov xwm txheej tsis muaj keeb kwm ntawm kev txhim kho kev mob caj dab ntawm lub ntsej muag thiab ib theem ntawm C-1 esterase tau txiav txim siab. Kev kuaj mob ntawm tus mob angioedema tau tsim los ntawm kev siv cov duab tom qab ntawm lub plab hauv plab lossis ultrasound lossis thaum phais. Cov tsos mob no ploj mus tom qab tsis ua txuas ntxiv ntawm cov tshuaj. Mob pob txha taub hau yuav tsum suav nrog kev kuaj mob txawv hauv cov neeg mob plab uas tau txais ACE inhibitor kev kho. Cov neeg mob uas muaj keeb kwm mob tiv thaiv kab mob angioedema tsis txuam nrog ACE inhibitor txoj kev kho yuav muaj kev pheej hmoo ntawm tus mob angioedema thaum kho nrog ACE inhibitor.
Anaphylactoid kev tsis haum.
Lub siab xavCov. Hauv cov neeg mob uas tau txais ACE cov tshuaj tiv thaiv thaum lub sijhawm tshuaj kho cov kab mob Hymenoptera lom, kev tiv thaiv lub neej tsis muaj teeb meem tshwm sim tau pom. Hauv qee tus neeg mob, cov tshuaj tiv thaiv no tsis tshwm sim thaum muaj kev cuam tshuam ib ntus hauv kev tswj hwm ntawm ACE cov tshuaj tiv thaiv kab mob, tab sis rov ua haujlwm thaum muaj kev cia siab.
Apheresis ntawm cov roj ntsha uas tsis muaj lipoproteins. Hauv cov neeg mob uas muaj mob LDL apheresis nrog kev dextran sulfate haum, anaphylactoid tshua tau pom nrog cov kev kho kom haum nrog ACE inhibitor.
HemodialysisCov ntaub ntawv soj ntsuam tau pom tias cov neeg mob ua rau mob hemodialysis siv qee yam kev tiv thaiv kev tiv thaiv nrog qhov muaj kev tso zis ntau (polyacrylonitrile daim nyias nyias) tuaj yeem tsim cov tshuaj tiv thaiv anaphylactoid thaum siv ACE inhibitor. Xws li kev sib xyaw ua ke yuav tsum zam thaum siv lwm cov tshuaj tiv thaiv kabmob ntshav lossis tshuaj pleev ib ce rau hemodialysis.
Arterial hypotension. Hauv cov neeg mob uas tsis mob ntshav siab (mob ntshav qab zib) kho nrog Acupro, hypotension tsis tshua muaj kev loj hlob, tab sis nws yog qhov tshwm sim ntawm kev kho mob nrog ACE inhibitors hauv cov neeg mob uas tsis muaj dej-electrolyte tshuav vim diuretics, noj ntsev tsawg, thiab lim ntshav.
Hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm siab, uas nws txoj kev pheej hmoo ntawm kev loj hlob ntawm cov ntshav khov yog tshwj xeeb tshaj plaws, kev kho mob quinapril yuav tsum tau pib ntawm qhov kev pom zoo raws li kev saib xyuas kev kho mob, cov neeg mob no yuav tsum tau soj ntsuam thawj 2 lub lis piam ntawm kev kho mob thiab txhua zaus cov koob tshuaj quinapril tau nce.
Nrog rau kev txhim kho cov tsos mob hypotension, tus neeg mob yuav tsum tau pw ntawm nws sab nraub qaum thiab, yog tias tsim nyog, nqa tawm iv infusion ntawm isotonic sodium chloride tov. Cov tshuaj tiv thaiv hypotensive luv luv tsis yog qhov cuam tshuam rau kev siv tshuaj ntxiv, txawm li cas los xij, nrog kev txhim kho ntawm cov tshuaj tiv thaiv zoo li no, kev siv cov tshuaj qis dua lossis txo cov tshuaj diuretics yuav tsum raug txiav txim siab.
Cov neeg mob uas tau txais kev kho mob diuretic thaum pib ntawm kev kho mob quinapril tej zaum yuav tsim muaj cov kev mob tshwm sim. Nws raug nquahu kom tshem tawm cov diuretic 2-3 hnub ua ntej pib kho nrog quinapril. Yog tias ntshav siab tsis tswj hwm los ntawm quinapril monotherapy, diuretics yuav tsum rov ua haujlwm. Yog tias nws tsis tuaj yeem tsis lees paub txog kev siv tshuaj diuretics, kev siv Acupro yuav tsum pib nrog kev pib siv tshuaj tsawg.
Neutropenia thiab agranulocytosisCov. Kev lees txais ntawm ACE inhibitors qee zaum tuaj yeem nrog agranulocytosis thiab mob pob txha mob siab rau hauv cov neeg mob uas tsis mob ntshav siab (mob ntshav siab), tab sis feem ntau tshwm sim, raws li txoj cai, hauv cov neeg mob raum tsis ua haujlwm, nrog rau collagenoses. Thaum siv ACE inhibitors hauv cov neeg mob collagenoses thiab / lossis lub raum tsis ua haujlwm, kev tshuaj xyuas tas li ntawm cov naj npawb ntawm cov leukocytes yog qhov tsim nyog.
Hnoos. Cov neeg mob siv tshuaj ACE inhibitors, suav nrog quinapril, qee zaum tau hnoos. Feem ntau qhov hnoos yog qhov tsis zoo, tawm dag zog, thiab ploj mus tom qab tsis muaj kev kho. Qhov hnoos tshwm sim los ntawm kev siv tshuaj ACE inhibitors yuav tsum tau muab xam rau qhov sib txawv ntsuas mob hnoos.
Xav Pom Ntau Tshaj Plaws Thaum Ntxov (mg)
* Nws tsis muaj kev paub dhau los txog rau hnub rau kev tso cai tshwj xeeb rau kev txhaj tshuaj rau cov neeg mob no.
Hauv cov neeg uas muaj qhov mob hypersensitivity vim inhibition ntawm cov kev ua ntawm renin - angiotensin - aldosterone system, kev ua haujlwm tsis zoo hauv lub raum yog qhov ua tau. Hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm tsis zoo, hauv kev ua haujlwm lub raum yog nyob ntawm kev ua si ntawm renin - angiotensin - aldosterone system, kev kho mob nrog ACE inhibitors, suav nrog quinapril, tuaj yeem ua rau muaj kev txhim kho oliguria thiab / lossis mob azotemia, thiab tsis tshua muaj, mob raum tsis ua haujlwm, suav nrog kev tuag.
Lub caij nyoog tshaj tawm ntawm quinaprilat yog nce vim muaj kev txo qis ntawm creatinine tshem tawm. Hauv cov neeg mob nrog creatinine tshem tawm ≤60 ml / min, quinapril yuav tsum tau txhaj tshuaj kom tsawg dua (saib APPLICATION). Cov koob tshuaj ntawm cov tshuaj hauv cov neeg mob zoo li no yuav tsum yog suav txij li qis dua mus rau siab dua, suav txog qhov txiaj ntsig kho, thiab tseem niaj zaus saib xyuas lub raum ua haujlwm (txawm hais tias kev tshawb fawb thaum xub thawj tsis qhia nws qhov kev tsis zoo ntxiv thaum siv quinapril).
Hauv qee tus neeg mob ntshav siab (mob hlab ntsha tawg) lossis lub plawv tsis ua haujlwm tsis pom tseeb ntawm lub raum mob viav vias thaum kho nrog quinapril, tshwj xeeb tshaj yog ua ke nrog diuretic, muaj kev nce qib ntawm urea nitrogen thiab ntshav creatinine. Qhov nce no feem ntau yuav thim rov qab nrog kev rho tawm ntawm ACE inhibitor thiab / lossis diuretic. Txoj kev pheej hmoo ntawm cov kev hloov pauv zoo li no ntau dua hauv cov neeg mob uas lub raum tsis ua haujlwm. Nyob rau hauv cov xwm txheej zoo li no, yuav tsum tau txhaj tshuaj txo qis thiab tshem tawm ntawm diuretic thiab / lossis quinapril.
Hauv kev tshawb fawb soj ntsuam ntawm cov neeg mob ntshav siab (kev mob ntshav siab) thiab cov tsis tuaj yeem sab nraud los sis ob tog lub raum leeg mob, tom qab kev kho nrog ACE inhibitor, kev nce ntshav hauv urea nitrogen thiab ntshav dej creatinine tau pom. Qhov nce no yuav luag ib txwm thim rov qab thaum kev kho tau txiav nrog ACE inhibitor thiab / lossis diuretic.Hauv cov xwm txheej zoo li no, nws yog ib qhov tsim nyog los saib xyuas lub raum kev ua haujlwm ntawm cov neeg mob thaum thawj ob peb lub lim tiam ntawm kev kho.
Lub siab ua haujlwm tsis zoo. Quinapril nyob rau hauv kev sib xyaw nrog diuretic yuav tsum tau siv nrog kev ceev faj rau cov neeg mob uas ua tsis taus lossis mob siab, vim tias muaj kev hloov me me hauv cov dej-electrolyte tshuav yuav ua rau muaj kev loj hlob ntawm hepatic coma. Quinapril metabolism rau quinaprilat ib txwm tshwm sim nyob rau hauv kev cuam tshuam ntawm hepatic esterase. Qhov kev xav ntawm quinaprilat yog txo qis hauv cov neeg mob uas haus cawv lub siab vim muaj kev ua txhaum ntawm esterification ntawm quinapril.
Hyperkalemia thiab potassium-sparing diuretics. Ob qho tib si nrog kev siv ntawm lwm tus ACE inhibitors, thiab nrog kev siv ntawm quinapril, qib cov poov tshuaj ions hauv cov ntshav yuav nce ntxiv. Nrog rau kev siv thooj txhij quinapril tuaj yeem txo qis hypokalemia los ntawm thiazide diuretics. Cov kev tshawb fawb txog kev siv ntau yam tshuaj quinapril thiab potassium-sparing diuretics tsis tau coj los ua. Txij li thaum muaj kev pheej hmoo los nce cov poov tshuaj poom tshuaj, nws yog ib qho tseem ceeb tias kev sib txuas ua ke hauv cov neeg mob tau txais cov tshuaj potassium-sparing diuretic txoj kev kho yuav tsum tau ua tib zoo saib xyuas hauv kev soj ntsuam cov poov tshuaj ntau ntau.
Kev mob ntshav qab zib thiab ntshav qab zib. Kev siv cov tshuaj ACE inhibitors yuav nrog los ntawm hypoglycemia hauv cov neeg mob ntshav qab zib uas noj tshuaj insulin los yog hauv lub qhov ncauj hypoglycemic. Yog li, nws yog ib qho tsim nyog yuav tau ua tib zoo saib xyuas cov xwm txheej ntawm cov neeg mob ntawd.
Kev phais / tshuaj loog. Yog tias qhov kev phais mob tsim nyog, tus kws qhia tshuaj loog yuav tsum paub tias tus neeg mob noj quinapril, txij li thaum txoj kev loj hlob ntawm txoj kev mob ntshav qis los ntshav qis / kev puas tsuaj tau.
Siv rau cov laus. Lub hnub nyoog tsis cuam tshuam rau qhov muaj txiaj ntsig thiab kev nyab xeeb ntawm cov tshuaj, yog li cov tshuaj pom zoo thawj zaug ntawm Accupro hauv cov neeg laus yog 10 mg ib hnub ib zaug, yog tias tsim nyog, nws tuaj yeem hloov kho mus rau hauv tus lej ntawm cov ntshav siab.
Siv thaum cev xeeb tub thiab lactation
Thaum siv thaum cev xeeb tub, ACE inhibitors tuaj yeem ua rau tus me nyuam hauv plab thiab lub cev nqaij daim tawv thiab muaj lub peev xwm tuag. Ua ntej siv quinapril thaum cev xeeb tub, koj yuav tsum xav txog nws qhov muaj peev xwm cuam tshuam rau tus me nyuam hauv plab. Yog tias muaj menyuam hauv plab thaum noj quinapril, cov tshuaj yuav tsum tau tsum tsis ua haujlwm.
Thaum noj ACE inhibitors thaum lub sijhawm II thiab III ntawm lub sijhawm cev xeeb tub, muaj cov lus tshaj tawm txog kev ua haujlwm siab, lub raum tsis ua haujlwm, pob txha taub hau hypoplasia thiab / lossis kev tuag ntawm cov menyuam yug tshiab. Txoj kev loj hlob ntawm oligohydroamnion kuj tau tshaj tawm, uas yog qhov pom los ntawm qhov kev txo qis hauv kev ua haujlwm ntawm lub raum ntawm tus menyuam; hauv qhov no, kev cog lus ntawm qhov kawg, craniofacial deformities, hypoplasia ntawm lub ntsws thiab kev loj hlob qeeb qeeb ntawm lub ntsws. Yog tias nyob rau thawj lub hlis tam sim no lub embryo lossis fetus muaj kev cuam tshuam los ntawm yeeb tshuaj, niam yuav tsum ceeb toom kom sai li sai tau ntawm qhov kev pheej hmoo, txawm tias qhov tshwm sim ntawm cov xwm txheej tsis zoo tsis tau txheeb xyuas.
Cov poj niam uas tau siv tshuaj ACE inhibitors thaum lub sijhawm II thiab III ntawm cev xeeb tub yuav tsum paub txog kev pheej hmoo rau tus me nyuam hauv plab; kev kuaj mob ultrasound dhau los yog yuav tsum muaj los kuaj xyuas tus mob oligohydroamnion. Kev kuaj mob ntawm tus mob oligohydroamnion, kev siv tshuaj quinapril yuav tsum tsis ua mus ntxiv, kev siv tsuas tuaj yeem txuas ntxiv yog tias nws tseem ceeb heev rau leej niam.
Lwm qhov kev pheej hmoo rau tus me nyuam hauv plab thiab cov me nyuam tshiab thaum siv ACE inhibitors yog qhov ua rau mob sai sai, sai thiab tsis kaw qhov mob plab ductus, thiab kev tuag ntawm tus me nyuam kuj tseem yuav tshwm sim. Txawm li cas los xij, nws tseem tsis paub hais tias dab tsi ua rau kev txhim kho ntawm cov kev mob tshwm sim zoo li no - kev siv tshuaj yeeb los yog kev kis mob ntawm niam.Nws kuj tseem tsis tau paub tias muaj qhov tsis zoo twg tshwm sim hauv thawj peb lub hlis thaum cev xeeb tub tuaj yeem ua rau muaj me nyuam hauv plab.
Cov menyuam mos uas lawv niam tau txais ACE inhibitor thaum cev xeeb tub, thiab yog li ntawd cov menyuam yaus raug cuam tshuam los ntawm ACE inhibitors, xav tau kev soj ntsuam - kev tswj ntawm hypotension, oligouriia thiab hyperkalemia. Yog tias muaj tus mob oliguria, yuav tsum muaj kev saib xyuas cov ntshav siab thiab lub raum zoo nkauj.
ACE inhibitors, suav nrog quinapril, tawm hauv cov kua mis hauv cov khoom tsawg. Yog li, nyob rau lub sijhawm kho Acupro, nws raug nquahu kom tsis pub niam mis.
Cov menyuam. Cov kev nyab xeeb thiab kev ua haujlwm ntawm Accupro hauv cov menyuam yaus mob tseem tsis tau raug tshawb fawb.
Lub peev xwm los cuam tshuam cov tshuaj tiv thaiv tus nqi thaum tsav tsheb thiab ua haujlwm nrog cov phom sij phom sij: Kev ceev los ntawm kev tsis haum thaum tsav tsheb lossis ua haujlwm nrog lwm cov txheej txheem thaum pib ntawm kev kho nrog Accupro tej zaum yuav cuam tshuam.
Kev sib tham ntawm cov tshuaj Akkupro
Noj tetracycline nrog quinapril txo qis tetracycline kev nqus los ntawm kwv yees li 28-37%. Qhov txo qis hauv nqus yog vim muaj cov magnesium carbonate uas yog tus muab tshuaj tso rau hauv cov tshuaj Akkupro.
Cov neeg mob uas siv cov roj ntsha lithium thiab ACE inhibitors tib lub sijhawm qhia tau nce cov qib lithium ntau ntxiv thiab cov tsos mob ntawm lithium lom. Kev sib xyaw ntawm cov tshuaj no yuav tsum tau sau tseg nrog kev ceev faj; kev saib xyuas ntau zaus ntawm cov roj ntsha lithium raug pom zoo. Kev siv ntxiv ntawm diuretic nce qhov kev pheej hmoo ntawm lithium intoxication.
Thaum cov chaw kho mob tau txhaj tshuaj quinapril nrog propranolol, hydrochlorothiazide, digoxin lossis cimetidine, tsis muaj kev sib txuam ntawm cov chaw muag tshuaj tseem ceeb. Qhov txiaj ntsig anticoagulant nrog ib qho tshuaj warfarin (hais txog lub sijhawm prothrombin) tsis hloov pauv ntau thaum noj quinapril 2 zaug hauv ib hnub.
Ib txhij kho nrog thiazide diuretics thiab / lossis β-adrenergic blockers txhim kho cov nyhuv antihypertensive ntawm quinapril.
Nrog rau kev tswj hwm tib lub sijhawm ntawm quinapril nrog cov potassium-sparing diuretics (spironolactone, triamteren lossis amiloride), cov tshuaj ntxiv los yog cov ntsev ntxiv ntsev, lawv yuav tsum siv nrog kev ceev faj thiab nrog kev tswj tsim nyog ntawm cov theem ntawm cov potassium hauv cov ntshav ntshav. Hauv cov neeg mob noj quinapril (zoo li lwm yam ACE inhibitors), ntau ntau cov poov tshuaj yuav nce ntxiv. Nrog rau kev siv thooj txhij quinapril tuaj yeem txo qis hypokalemia los ntawm thiazide diuretics. Vim tias muaj kev pheej hmoo ntxiv ntawm cov poov tshuaj poov tshuaj kom ntau ntxiv, kev sib txuas ua ke nrog cov tshuaj potassium-sparing diuretics yuav tsum tau pib nrog kev ceev faj, tswj xyuas qib ntshiab poov tshuaj ntau ntau.
Hauv qee tus neeg mob uas ua tsis zoo lub raum uas tau noj NSAIDs, ua rau lub raum ua haujlwm ntxiv tom qab pib noj ACE inhibitors. Feem ntau cov mob no yuav thim rov qab. Muaj peev xwm txo qis hauv kev kho mob ntawm quinapril thaum concomitantly nrog NSAIDs.
ACE inhibitors, suav nrog quinapril, tuaj yeem nce rhiab rau insulin lossis tshuaj tiv thaiv qhov ncauj hypoglycemic, uas tuaj yeem ua rau kev txhim kho hypoglycemia hauv cov neeg mob ntshav qab zib mellitus. Hauv qhov no, yuav tsum muaj kev saib xyuas ntxiv.
Kev noj tshuaj ntau dhau ntawm cov tshuaj Akkupro, cov tsos mob thiab kev kho mob
Qhov feem ntau yuav muaj kev soj ntsuam mob tshaj plaws ntawm kev noj ntau dhau yuav ua rau mob ntshav liab ntau heev, xav tau iv kev tswj hwm ntawm cov ntshav hloov ntshav. Muaj kev kho mob thiab kev pab txhawb nqa tau. Hemodialysis thiab peritoneal lim ntshav tsis muaj kev cuam tshuam loj tshaj li qhov tsis pom tseeb ntawm quinapril thiab quinaprilat.
Tso tawm daim ntawv thiab muaj pes tsawg leeg
Acupro muaj nyob rau hauv daim ntawv ntawm cov yeeb yaj kiab-cov ntsiav tshuaj; txhua lub ntsiav tshuaj muaj tus lej xov tooj sib xyaw nrog cov ntsiab lus ntawm cov tshuaj nquag quinapril (5 mg, 10 mg, 20 mg lossis 40 mg) hauv nws. Raws li cov tshuaj pab, cov npaj muaj magnesium stearate, gelatin, magnesium carbonate, crospovidone, lactose monohydrate. Cov sib xyaw ua ke ntawm cov zaj duab xis txheej ntawm cov ntsiav tshuaj suav nrog: opadry dawb OY-S-7331 thiab siv quav ciab.
Pharmacodynamics thiab pharmacokinetics
ACE yog ib qho enzyme uas catalyzes hloov dua siab tshiab ntawm angiotensin ntawm thawj hom rau angiotensin ntawm hom thib ob, uas nce vascular suab los ntawm kev ua kom lub plab zais ntawm aldosterone los ntawm adrenal cortex.
Khinapril inhibits ACE, txo vasopressor kev ua si, aldosterone secretion, tsub kom ib ce muaj zog. Nrog rau kev siv ntev hauv cov neeg mob, cov ntshav txaus rau lub ischemic myocardium txhim kho.
Tus neeg mob cov ntshav txo qis, qhov kev tawm tsam ntawm cov leeg tag nrho yuav txo qis, lub siab hloov pauv, thiab lub plawv ntshav khiav tau txais kev tswj hwm. Yog tias koj noj cov tshuaj kom raug, nws txhim kho cov ntshav rau ischemic myocardium, nce ntshav kev hauv cov raum.
Cov tshuaj yeeb dej caw sai tso tawm thiab pib ua 1 teev tom qab thov. Qhov siab tshaj plaws tau pom tom qab 3 teev, qhov kev ua ntawm lub ncoo txuas ntxiv thoob plaws ib hnub. Cov nyhuv tshuaj khov kho tau pom nyob tom qab 1-2 asthiv nrog kev siv li niaj zaus. Kwv yees li 40% ntawm quinapril tom qab noj cov ntau ntawm cov tshuaj circulates hauv cov ntshav ntshav tsis hloov.
Kev noj tsis cuam tshuam rau kev nqus ntawm cov khoom. Cov rog rog tuaj yeem cuam tshuam nrog kev tso tawm dawb ntawm cov tshuaj nquag. Li ntawm 50-55% ntawm quinapril yog ua tawm los ntawm lub raum. Tus so yog mob hauv ntshav. Nws yog tawm los ntawm lub raum thiab los ntawm txoj hnyuv.
Kev ntsuas rau siv
Cov tshuaj "Akkupro" tau qhia rau cov neeg mob uas tau kuaj pom muaj teebmeem kev noj qab haus huv li nram no:
- Arterial hypertension (cov tshuaj yog kws kho raws li kev kho mob monotherapy lossis hauv kev sib xyaw nrog thiazide diuretics),
- Lub plawv tsis ua haujlwm, uas tshwm sim hauv ib daim ntawv uas muaj mob ntev (ua ke nrog diuretics lossis plauv plawv glycosides).
Cov tshuaj yog kws kho mob sau los ntawm kws kho mob tom qab kev soj ntsuam zoo ntawm tus neeg mob. Koj tsis tuaj yeem noj cov tshuaj koj tus kheej, thiaj li tsis ua rau lwm cov teeb meem kev noj qab haus huv.
Cov tshuaj yog siv rau kev kub siab.
Sab sij huam
Ntau tus neeg mob qhia txog mob taub hau, kiv taub hau, hnoos, qaug zog, rhinitis. Ntuav lossis cov cim ntawm myalgia yog qhov ua tau.
Qhov hnoos yog qhov tsis zoo, qhov ua siab ntev, ploj mus sai li sai tau tom qab tsis ua tiav ntawm kev kho. Yog tias tus neeg mob sau tseg ib ntawm cov tsos mob saum toj no, nws yog ib qho tsim nyog yuav tsum tau kho tam sim ntawd. Los ntawm sab hauv ntawm cov leeg poob siab, kiv taub hau, mob taub hau, pw tsaug zog, txha caj dab, thiab qaug zog yuav tshwm sim.
Yuav ua li cas noj thiab nyob li cas siab, noj ntau npaum li cas
Acupro ntsiav tshuaj noj ntawm qhov ncauj thiab ntxuav nrog lub khob ntawm dej dawb. Cov tshuaj tsis tuaj yeem zom lossis faib ua ntau yam. Koj tuaj yeem nqa nws ua ntej lossis tom qab noj mov. Cov tshuaj yog raug rau cov neeg mob ntshav siab. Nrog rau cov tshuaj kho mob, cov kws kho mob pom zoo kom pib noj ntau npaum li 10 mg ib hnub ib zaug.
Yog tias qhov kev kho mob tsis txaus, qhov tshuaj ntau dua rau 20-40 mg thaum nruab hnub. Kev kho ua tiav tsis ntau tshaj 1 zaug hauv ib hlis. Nrog ntshav siab, koj tuaj yeem ua ke cov tshuaj nrog diuretics. Cov koob tshuaj pib nrog 5 mg ib hnub ib zaug. Nws tau maj mam nce ntxiv txhawm rau kom ua tiav qhov txiaj ntsig kho kom zoo.
Hauv kev mob plawv mus ntev, cov neeg mob raug xaj 5 mg ntawm cov tshuaj thaum sawv ntxov thiab yav tsaus ntuj. Thaum kho, tus neeg mob yuav tsum nyob hauv qab kev saib xyuas ntawm kws kho mob hauv qhov chaw pw.Cov haujlwm tseem ceeb yog txheeb xyuas thiab taug qab cov tsos mob tshwm sim ntawm kev mob ntshav hypotension. Yog hais tias tus neeg mob zam cov tshuaj tsawg kawg, nws tau nce mus rau 30-40 mg ib hnub twg.
Cov Tshuaj Pharmacokinetics
Ua raws li kev tswj hwm qhov ncauj ntawm kev siab tshaj (Cmax) hauv cov ntshav ntshav, quinapril nce mus txog hauv ib teev, nws cov tshuaj metabolin quinaprilat - hauv ob teev. Kev noj zaub mov ib txhij tsis cuam tshuam rau qib ntawm kev nqus ntawm cov tshuaj, tab sis yuav nce sijhawm kom ncav cuag Cmax (Cov khoom noj muaj rog tuaj yeem txo qhov nqus ntawm cov khoom). Muab kev nthuav dav ntawm quinapril thiab nws cov metabolites los ntawm ob lub raum, qhov neeg nqus ntawm Acupro yog li ntawm 60%.
Quinapril tau nrawm los ntawm kev txaug ntawm cov ester pab pawg los ntawm daim siab enzymes rau quinaprilat (cov metabolite tseem ceeb yog quinapril dibasic acid), cov tshuaj uas yog lub zog ACE inhibitor. Kwv yees li 38% ntawm qhov tau txais ntawm cov tshuaj kis rau hauv cov ntshav ntshav hauv daim ntawv ntawm quinaprilat.
Kwv yees li 97% ntawm quinapril lossis quinaprilat nthuav tawm hauv ntshav cov ntshav hauv daim ntawv uas muaj cov protein.
Cov tshuaj tsis hla ntshav-lub hlwb teeb meem.
Nws zoo nkaus li: lub raum nrog cov zis - 61% (ntawm uas nyob rau hauv daim ntawv ntawm quinapril thiab hinaprilat - 56%), los ntawm txoj hnyuv - 37%.
Ib nrab-lub neej (T½) los ntawm ntshav: quinapril - 1-2 teev, quinaprilat - 3 teev.
Pharmacokinetic cov yam ntxwv ntawm cov tshuaj hauv cov chaw kho mob tshwj xeeb:
- lub raum tsis ua haujlwm: nce T½ hauv kev faib ua feem rau kev txo qis hauv creatinine kev tshem tawm,
- cov kab mob cawv siab: lub siab poob qis (vim qhov kev ua txhaum ntawm esterification ntawm quinapril),
- lub hnub nyoog laus (tshaj 65 xyoo): kev txo qis yog txo qis, uas feem ntau cuam tshuam nrog lub hnub nyoog ntsig txog lub raum, txawm li cas los xij, qhov sib txawv ntawm kev nyab xeeb thiab kev ua haujlwm ntawm hinaprilat tsis txawv ntawm cov neeg mob hauv cov hluas.
Pharmacological kev txiav txim siab ntawm Akkupro
Cov tshuaj tseem ceeb ntawm cov tshuaj - quinapril hydrochloride, yog ib qho inhibitor ntawm angzyensin-hloov mus rau enzyme, uas txo cov kev zais cia thiab vasopressor kev ua haujlwm ntawm aldosterone, nce kev tawm dag zog thiab txo platelet aggregation.
Nrog rau kev siv lub sijhawm ntev ntawm cov tshuaj Akkupro, kev txhim kho rov qab yog pom nyob rau hauv cov neeg mob mob txoj hlab ntshav siab, myocardial hypertrophy, cov ntshav siab raum thiab mob ntshav nce ntshav, nrog rau kev txhim kho cov ntshav txaus rau ischemic myocardium.
Txoj kev siv ntawm Akkupro
Raws li cov lus qhia, Akkupro noj ntawm qhov ncauj, haus dej ntau thiab tsis zom, tsis hais noj mov dabtsi. Qhov ntau npaum ntawm cov tshuaj yog nyob ntawm tus kabmob, namely:
- Nrog rau kev mob ntshav siab - 10 mg ntawm cov tshuaj ib hnub rau cov neeg mob uas tsis tau txais tshuaj diuretics ua ntej, muaj qhov yuav tshwm sim ntau ntxiv rau 20 mg, muab faib ua ob zaug. Cov neeg mob uas tau tso tshuaj ntsuab ib zaug rau txoj kev kho mob thiab Accupro - 5 mg ntawm cov tshuaj ib hnub ib zaug, nrog rau qhov txiaj ntsig txuas ntxiv yuav muab ob zaug ntxiv kom ua tiav cov txiaj ntsig zoo tshaj plaws,
- Hauv kev mob plawv tsis ua haujlwm ntev - thawj koob tshuaj yog 5 mg hauv ib lossis ob zaug ib hnub. Thaum muaj kev zam zoo rau kev siv tshuaj, cov koob tshuaj tuaj yeem nce ntxiv txog 10-40 mg ib hnub, muab faib ua ob zaug sib luag,
- Yog tias lub raum ua rau lub raum tsis zoo, thawj koob tshuaj yog nyob ntawm creatinine tshem tawm, yog li yog tias nws txawv ntawm 10-30 ml / min, 2,5 mg ntawm Akkupro raug kho, 30-60 ml / min - 5 mg, thiab ntau dua 60 ml / min - 10 mg ib hnub twg. Nyob rau hauv rooj plaub uas tus neeg mob zam lub koob tshuaj thawj zaug zoo, nws qhov nce zuj zus hauv ib nrab yog ua tau.
Rau cov neeg mob laus, qhov kev xav kom pib ntawm Accupro yog 10 mg rau ib hnub, nrog kev thev taus zoo, nws tuaj yeem maj mam nce ntxiv kom txog thaum qhov kev kho mob zoo tshaj plaws tau tiav.
Cia rau cov neeg mob
Raws li cov lus qhia, Akkupro yuav tsum muab cia rau hauv qhov chaw qhuav tiv thaiv los ntawm lub teeb thiab tawm ntawm qhov chaw ncav cuag ntawm cov menyuam, ntawm chav sov tsis tshaj 25 ° C. Cov tshuaj yog raug faib tawm los ntawm cov chaw muag tshuaj nrog cov tshuaj, nws lub neej txee, raug rau txhua tus tswv lag luam cov lus pom zoo, yog peb xyoos, tom qab uas Acupro yuav tsum tau muab pov tseg.
Pom qhov yuam kev hauv cov ntawv nyeem? Xaiv nws thiab nias Ctrl + Enter.
Kev sib txuam
Yog tias koj noj tshuaj "Akkupro" nrog tetracycline, cov nyhuv ntawm cov tshuaj txo qis. Cov kws kho mob tau sau cov tshuaj lithium, pom hauv cov neeg mob nce ntxiv ntawm cov tshuaj no hauv cov ntshav cov ntshav. Muaj ib lub caij nyoog ntawm cov cim ntawm lithium intoxication nrog kev muaj zog ntxiv ntawm sodium los ntawm lub cev.
Lithium thiab hinapril yuav tsum tau ua nrog ceev faj tib lub sijhawm. Cov kws kho mob pom zoo tias cov neeg mob zoo li no yuav tsum nyob hauv tsev kho mob los ntawm kev saib xyuas ntawm kws kho mob. Lawv yuav tswj cov ntshiab cov roj ntsha lithium.
Nrog rau kev siv tib lub sijhawm nrog cov tshuaj diuretics, kho cov nyhuv ntawm quinapril ntau dua.
Peb tuaj yeem paub ntau qhov sib txawv ntawm cov yeeb tshuaj "Akkupro" nrog cov lus piav qhia:
- Quinafar. Cov tshuaj no tau sau rau cov neeg mob ntshav liab, lub raum tsis ua haujlwm, scleroderma, mob myocardial infarction. Cov nkauj muaj nyob nrog tib yam khoom sib xyaw - hinapril.
- Hinapril-C3. Qhov no yog qhov tseeb tshaj plaws ntawm cov tshuaj ntawm cov tshuaj "Akkupro". Cov tshuaj yog tawm rau cov neeg mob ntshav liab, mob plawv tsis ua hauj lwm (thaum ua ke nrog lwm cov tshuaj).
Koj tsis tuaj yeem xaiv qhov hloov pauv ntawm koj tus kheej, yog li kom tsis txhob ua kom qhov teeb meem no hnyav ntxiv thiab yuav tsis muaj kev rau txim loj. Kev ntsuas ntshav tsis tau noj rau lawv tus kheej, tshwj xeeb yog muaj ib tus neeg mob siab rau tus kheej ntawm cov tshuaj. Muaj qhov muaj feem ntau ntawm cov mob angioedema.
Feem ntau, cov tshuaj tau zoo rau cov neeg mob tau txais txiaj ntsig; kev txhim kho tau sau tseg yog 7-10 hnub tom qab pib kho. Nws yog ib qho tseem ceeb kom ua raws li tag nrho cov lus pom zoo ntawm tus kws kho mob koom, tsis pub tshaj qhov muab tshuaj noj.
Cov lus qhia soj ntsuam rau kev siv xyuas cov cim qhia
Qhov pom zoo kom pib siv cov tshuaj yog 2, Nqe rau, cov ncauj lus kom ntxaws. Txoj kev thiab ntau npaum li cas. (quinapril) Qhov ntim ntawm nqus. , nqe hauv khw muag tshuaj, muaj pes tsawg leeg, taw qhia sab hauv, tsis ntxo, tsis hais lub sijhawm noj mov, ntxuav hauv dej li cas. Tom qab qhov ncauj tswj hwm ntawm cmax, quinapril hauv ntshav tau mus txog li 1 teev. Tsab xov xwm piav qhia txog txoj kev siv tshuaj,, .- tag nrho cov ntsiab lus ntawm cov tshuaj. Tus neeg mob yuav tsum tau txiav tawm tam sim ntawd yuav tsum tau nqa tawm., Tus nqi hauv khw muag tshuaj, muaj pes tsawg leeg, kev taw qhia. Daim ntawv tso tawm thiab muaj pes tsawg leeg. Cov qauv rau rau kev mob raum tsis zoo, ntshav qab zib ,. Kev qhia rau, hom, phiv, contraindications, cev xeeb tub,. Cov kev ntsuas pom ntawm kev siv Cov tshuaj xyuas tau saib xyuas, cov qauv qhia tau hais qhia. Cov lus qhia piav qhia kom siv cov tshuaj contraindications ntawm kev siv thiab koob tshuaj phiv.
Cov lus qhia Accupro rau kev siv - Cov lus qhia Accupro rau kev siv acupro tus nqi acupro - piluli
Tsis txhob noj 2 lub tshuaj ntawm cov tshuaj tib lub sijhawm: ib qho kev pab cuam zoo rau hauv xov tooj ntawd. Keeb kwm ntawm angioneurotic edema, uas cuam tshuam nrog kev kho mob ntawm APF inhibitors nrog rau kev hnov mob ntau ntxiv rau ib qho ntawm cov khoom siv.
Nyob rau hauv rooj plaub koj tsis nco qab noj qhov tshuaj ntawm cov khoom, coj nws tam sim ntawd, thaum koj sim nco ntsoov, tsis tas tos rau lub sijhawm los txog ntawm kev noj cov khoom. Qhov tshwm sim ntawm cov tshuaj tiv thaiv quinapril tuaj yeem dhau los tsawg dua nrog kev teem sijhawm tsis siv tshuaj tiv thaiv tsis haum tshuaj thiab nce ntxiv nrog tus qauv ntawm cov tshuaj tiv thaiv kev tiv thaiv kabmob, narcotic analgesics, diuretics, lwm yam tshuaj tiv thaiv kab mob, kev siv tshuaj loog rau kev sib koom tes.
Cov lus qhia Accupro rau kev siv
Cov ntawv nthuav dav: -> rub lub laij zauv rau hauv
-> txheej txheem ntawm modular origami swans
-> rub tawm lub ntim puv los ntawm cov lauj kaub nyob rau hauv
-> daim duab qhia kab ke hnub ci
-> stopangin tshuaj txau qhia kev siv
Lub Npe Tsis Muaj Npe International
Latin lub npe ntawm cov tshuaj: Accupro. INN: Quinapril.
Tshuaj tiv thaiv kab mob siab, ACE inhibitor. ATX Code: C09A A06.
Tso cov ntaub ntawv thiab cov nyob ua ke
Muaj nyob rau hauv daim ntawv ntawm puag ncig, daim duab peb sab lossis oval, zaj duab xis-ntsiav tshuaj ntawm cov xim dawb lossis xim liab-xim av. 1 ntsiav tshuaj muaj 5, 10, 20 lossis 40 mg ntawm cov tshuaj nquag - quinapril nyob rau hauv daim ntawv ntawm hydrochloride, nrog rau cov neeg tshaj lij. Ib pob ntawv cardboard muaj 3 lossis 5 hlwv, txhua tus muaj 6 lossis 10 ntsiav tshuaj.
Cov tshuaj hypotensive uas txwv qhov kev ua haujlwm ntawm angiotensin-hloov mus rau hauv cov enzyme, nrog kev koom tes ntawm uas angiotensin Kuv tau hloov mus rau hauv angiotensin II. Qhov tom kawg yog qhov ua kom nquag plias endogenous ntau uas ua rau muaj ntshav nce ntxiv. Ib qho kev txo qis ntawm kev tso tawm ntawm cov kab ke no ua rau muaj kev nrawm nrawm ntawm sodium excretion thiab qeeb hauv cov poov tshuaj hauv lub cev, uas txo qis qhov tsis kam ntawm cov hlab ntsha thiab cov ntshav qis. Nrog rau kev siv tsis tu ncua, nws pab ua rau qeeb qeeb ntawm txoj kev ua kom tuab ntawm lub siab nqaij thiab cov hlab ntshav, uas txhim kho tiv thaiv keeb kwm yav dhau los ntawm kub siab.
Tom qab kev tswj hwm ntawm qhov ncauj, qhov siab ntawm quinapril hauv cov ntshav dej tau tiav hauv 60-90 feeb. Tsawg kawg 55% ntawm cov tshuaj yog nqus.
Raws li kev ua ntawm daim siab enzymes, cov tshuaj nquag ua haujlwm yog metabolized rau quinaprilat, uas yog ib qho muaj zog ACE inhibitor. Nws cov khoom nruab nrog cev muaj peev xwm yog 35%.
Cov tshuaj nquag thiab nws cov khoom ua rau lub cev tsis nkag rau cov ntshav-hlwb teeb meem thiab raug nteg tawm los ntawm kev tawm ntawm lub raum. Hauv cov neeg mob uas lub raum tsis ua haujlwm, qhov kev tshem tawm ib nrab ntawm lub neej muaj ntau ntxiv nrog kev txo qis ntawm creatinine tshem tawm.
Kev ntsuas rau siv
Cov tshuaj yog tawm rau kev kho mob ntawm txoj kev mob ntshav siab thiab mob plawv tsis xwm yeem.
Kev siv cov tshuaj yog contraindicated nyob rau hauv muaj cov kab mob thiab cov mob hauv qab no:
- hypersensitivity rau ib qho twg
- keeb kwm mob hlwb vim yav dhau los siv tshuaj tiv thaiv kab mob siab tiv thaiv kab mob los yog tshuaj tiv thaiv kab mob thiab / lossis idiomatic muaj kev tsis haum tshuaj,
- lactose intolerance, qab zib-galactose malabsorption.
Nws yog siv nrog ceev faj thaum muaj cov kab mob zoo li no:
- Cov tsos mob arterial hypotension, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob uas tau noj yav dhau los ua tshuaj diuretics thiab ua raws li kev noj zaub mov nrog ntsev tsawg,
- mob syndrome tshwm sim los ntawm kev txiav txim siab tsis ua haujlwm ntawm lub siab nqaij mob,
- mob ntshav qab zib mellitus
- raum lossis mob siab raum tsis ua haujlwm,
- kab mob sib kis hauv cov nqaij mos,
- xiam hlwb tsis txaus
- hyperkalemia
- txo nyob rau hauv cov ntshav ncig.
Thaum pib ntawm txoj kev kho, cov tshuaj raug pom zoo kom siv rau hauv kev soj ntsuam ntsuas ntshav ntsuas.
Nws yog siv nrog kev ceev faj nyob rau hauv lub xub ntiag ntawm daim siab ua haujlwm.
Nws yog siv nrog faj seeb nyob ib puag ncig ntawm arterial hypotension.
Nws yog siv nrog ceev faj thaum muaj ntshav qab zib.
Siv nrog ceev faj nyob rau hauv muaj cov raum tsis ua hauj lwm.
Nws yog siv nrog ceev faj nyob rau hauv lub xub ntiag ntawm hyperkalemia.
Nws yog siv nrog faj seeb nyob rau hauv lub xub ntiag ntawm coronary tsis txaus.
Nws yog siv nrog kev ceev faj nyob rau hauv lub xub ntiag ntawm txo qis nyob rau hauv lub ntim ntawm cov ntshav ncig.
Yuav Ua Li Cas Txais Accupro
Lub sijhawm ua haujlwm thiab kev tswj hwm tus kws kho mob yog tus kws kho mob tshwj xeeb, suav txog tus mob thiab tus yam ntxwv ntawm tus neeg mob. Cov tshuaj noj yog noj ntawm qhov ncauj, tsis hais txog noj zaub mov, 0.01 g 1-2 zaug ib hnub. Thaum tsis siv tshuaj kho uas tsim nyog, ib koob tshuaj yuav raug nce siab 2 zaug, tab sis tsis pub tshaj qhov siab tshaj plaws ntawm 0.08 g ib hnub. Nws raug tso cai kom noj cov tshuaj txhua hnub ib zaug, yam tsis tas yuav muab faib ua ntau zaug.Koj tuaj yeem nce ntxiv tsuas yog nyob rau kev pom zoo ntawm tus kws kho mob tuaj koom thiab tsis ntxov dua 4 lub lis piam los ntawm kev pib kho.
Nrog ntshav qab zib
Cov tshuaj yog siv raws li ib feem ntawm kev kho mob los tiv thaiv kev kub ntxhov, soj ntsuam kev ceev faj glycemic thiab kev pom zoo ntau npaum cov tshuaj.
Cov tshuaj yeeb yaj kiab tsis ua rau muaj qhov tsis tsim nyog. Feem ntau cov feem ntau, lawv raug tiv thaiv tawm tsam keeb kwm ntawm qhov tsis txaus siab rau nws cov khoom siv lossis thaum twg txoj kev noj tshuaj tsis pom zoo. Kev kho yuav tsum yog kws kho los ntawm tus kws tshaj lij tom qab kuaj mob, coj mus rau hauv tus account concomitant pathologies.
Lub cev qhuav ntawm lub qog ua kua rau ntawm lub qhov ncauj lossis caj pas, dyspeptic cuam tshuam, xeev siab, mob hauv plab, poob qab los noj mov, thiab ib qho kev ua txhaum ntawm kev saj saj yog sau tseg.
Nruab nrab hauv lub paj hlwb
Tawm tsam keeb kwm yav dhau los ntawm kev noj cov tshuaj, hloov pauv mus rau lub siab, ua kom lub ntsej muag, mob hlwb, ua kom qaug zog lossis ua kev txob taus, tawv nqaij tsis haum lub cev ua rau lub cev yuag thiab tingling ua tau.
Kev phiv los sis yeeb tshuaj yuav yog qhov ua kom qab los noj mov.
Kev phiv los ntawm cov tshuaj yuav yog qhov hloov pauv ntawm lub saj.
Kev phiv los sis yeeb tshuaj yuav ua rau lub cev qaug zog.
Kev phiv loj heev ntawm cov tshuaj yuav yog lub qhov ncauj qhuav.
Kev phiv los ntawm cov tshuaj yuav yog qhov hloov pauv hauv siab.
Kev phiv los sis yeeb tshuaj tej zaum yuav yog mob dyspeptic.
Qhov tshwm sim phiv los ntawm cov tshuaj tuaj yeem yog cov tawv nqaij tiv thaiv qhov muag tsis zoo los ntawm lub cev ua pob thiab tingling.
Los ntawm cov kab mob zis
Nyob rau hauv kis raug, cais mob txeeb zig yog sau tseg.
Los ntawm lub tshuab ua pa
Feem ntau muaj qhov hnoos tsis tu ncua, tsis muaj txiaj ntsig uas kis tau tom qab tas qhov kawg ntawm txoj kev kho, qhov kev xav ntawm huab cua tsis txaus, qhov mob ntawm lub pharyngeal mucosa, mob hauv siab.
Ntawm ib sab ntawm daim tawv nqaij
Cov tawv nqaij thiab cov nqaij ua xua ua rau muaj peev xwm ua tau, xws li nce tawm hws, erythema thiab desquamation, tawm pob, khaus khaus, plaub hau pathological poob, pemphigus, hauv zos lossis lub cev ua kom lub cev hloov xim.
Los ntawm genitourinary system
Hauv qee qhov tsis tshua muaj, kev txo qis hauv potency, tso zis qeeb yog ua tau.
Los ntawm cov hlab plawv system
Cov teeb meem tshwm sim ntawm hematopoietic plab hnyuv siab raum, xws li txo qis ntawm cov ntshav liab hauv cov ntshav, txo qis ntawm cov ntshav ntshav, agranulocytosis, txo qis ntawm cov platelets, thiab cov tsis muaj peev xwm ntawm txhua hom qe ntshav.
Ntawm ib feem ntawm cov hlab plawv, cov tsis muaj qhov tsis haum zoo li txo qis ntshav siab, tsis xis nyob hauv thaj chaw hauv siab, lub plawv dhia, lub plawv dhia, lub zog tachycardia, thiab nce ntxiv lumen ntawm cov hlab ntsha tuaj yeem tau.
Los ntawm cov leeg nqaij thiab cov leeg sib txuas
Feem ntau muaj mob nrob qaum. Hauv qee qhov tsis tshua muaj tshwm sim, tawm tsam keeb kwm yav dhau los ntawm kev siv tshuaj yeeb, cov kab mob sib kis tshwm sim.
Kev phiv los sis yeeb tshuaj yuav yog hnoos.
Ib sab phiv ntawm cov tshuaj yuav plaub hau poob.
Kev phiv los sis yeeb tshuaj tej zaum yuav ua rau mob rov qab.
Kev phiv los sis yeeb tshuaj tej zaum yuav mob lub hauv siab.
Phiv los sis fab yuav yog mob txeeb zig.
Qhov tshwm sim ib sab ntawm cov tshuaj yuav tuaj yeem o ntawm lub ntsej muag.
Los ntawm lub cev tiv thaiv kab mob
Kev phiv tshuaj tiv thaiv, mob taub hau tuaj yeem yog tau.
Yog tias muaj lub laryngeal xuav lossis o ntawm cov nqaij mos ntawm lub ntsej muag, tus nplaig lossis lub suab nrov, kev kho nrog cov tshuaj yuav tsum nres tam sim ntawd. Yog hais tias o ntawm tus nplaig lossis lub suab lus hem ua rau cuam tshuam qhov ntws ntawm huab cua mus rau hauv lub ntsws, yuav tsum tau txais kev kho mob kub ntxhov sai thiab saib xyuas ua ntej sau cov tsos mob ntawm kev fab tshuaj yog qhov tsim nyog.
Cuam tshuam rau lub peev xwm los tswj cov tshuab
Thaum noj tshuaj, ceev faj yuav tsum ua kom zoo thaum tswj cov txheej txheem thiab ua haujlwm ua haujlwm uas yuav tsum tau saib xyuas ntxiv, tshwj xeeb tshaj yog thaum pib kho, vim muaj kev pheej hmoo ntawm kiv taub hau thiab mob hypotension.
Kev siv khoom noj ib txhij tsis cuam tshuam rau qib ntawm kev nqus ntawm cov tshuaj, tab sis nce lub sijhawm kom ncav cuag qhov siab tshaj plaws ntawm cov tshuaj nquag.
Thaum noj tshuaj, nws raug nquahu kom tsis suav cov khoom noj muaj roj los ntawm kev noj haus.
Qee qhov xwm txheej, kev kho nrog angiotensin-hloov mus rau enzyme inhibitors yog nrog kev loj hlob ntawm hypoglycemia hauv cov neeg mob ntshav qab zib mellitus, noj tshuaj hauv qhov ncauj hypoglycemic los yog tau txais insulin. Cov tshuaj nquag ntawm cov tshuaj pab txhim kho kev ua haujlwm ntawm cov tshuaj insulin thiab cov tshuaj tiv thaiv kab mob.
Siv thaum cev xeeb tub thiab lactation
Contraindicated nyob rau hauv cev xeeb tub thiab lactation.
Kev Sib Tham Akkupro rau menyuam yaus
Cov tshuaj tsis siv rau hauv kev kho mob hauv cov tshuaj vim tias tsis muaj cov ntaub ntawv ntawm nws txoj kev nyab xeeb thiab ua haujlwm.
Cov tshuaj yog contraindicated nyob rau hauv kev pub niam mis.
Cov tshuaj tsis yog siv hauv kev kho mob hauv cov laus.
Cov tshuaj yog contraindicated nyob rau hauv cev xeeb tub.
Siv rau lub sijhawm qub
Nws raug pom zoo rau kev siv nyob rau hauv qhov tsis muaj contraindications. Qhov pom zoo thaum pib ntawm cov tshuaj yog 10 mg ib hnub ib zaug. Raws li kev saib xyuas ntawm tus kws kho mob uas tuaj koom, nws tuaj yeem raug nce ntxiv kom ua tiav cov txiaj ntsig kho kom haum.
Daim ntawv thov rau lub raum khiav tsis zoo
Hauv cov neeg mob uas lub cev tsis muaj peev xwm ua haujlwm, kev nce ntxiv hauv ib nrab-lub neej ntawm cov tshuaj yeeb dej caw tseem ceeb, yog li ntawd, nws yog qhov tsim nyog yuav tau kho qhov tshuaj, coj mus rau hauv tus account creatinine tshem tawm qhov ntsuas. Qhov siab tshaj plaws thawj zaug tshuaj yog los ntawm 2.5 txog 10 mg rau ib hnub. Ua kom nce siab ntawm cov tshuaj yog ua tau tsuas yog nyob hauv kev tswj ntawm qhov haujlwm. Ua tsis tau raws li cov lus pom zoo kho mob tuaj yeem ua rau lub nruab nrog cev tsis ua haujlwm, suav nrog kev pheej hmoo ntawm kev tsim muaj mob raum tsis zoo.
Cov tsos mob ntawm kev haus ib ce yog kev ua txhaum ntawm cov dej-electrolyte tshuav, kev loj hlob tuaj, kev txo qis ntawm lub siab ntawm qhov mob plab, thiab qhov muag pom. Txoj kev kho yog ua tiav los ntawm kev saib xyuas ntshav ntawm cov ntshav-cov kev daws teeb meem nyob rau hauv txhawm rau nce ntim ntawm cov kua dej muaj zog. Kev siv tshuaj lim ntshav muaj qhov tsis lees paub txog kev ua haujlwm ntawm cov tshuaj nquag. Thaum yuav txo qis hauv cov ntshav siab, cov tsos mob thiab txhawb kev kho mob yog qhov tsim nyog.
Cov tsos mob ntawm kev haus ib qho zuj zus yog qhov kev ua txhaum ntawm cov dej-electrolyte tshuav.
Overdose cov tsos mob yog arrhythmia heev.
Cov tsos mob ntawm kev noj haus ntau dhau yog qhov muag pom.
Kev cuam tshuam nrog lwm yam tshuaj
Kev siv tshuaj tiv thaiv tetracycline tib lub sijhawm thiab ib qho tshuaj tiv thaiv kabmob tuaj yeem txo qhov nqus ntawm tetracyclines. Kev kho mob nrog lithium npaj thiab ACE inhibitors tsub kom cov ntshiab cov roj ntsha lithium, nce kev pheej hmoo ntawm intoxication. Cov tshuaj poov tshuaj npaj txhim kho cov nyhuv antihypertensive ntawm cov tshuaj nquag ntawm cov tshuaj, pab txhawb kev nce qib ntawm cov kab hauv cov ntshav hauv cov ntshav. Kev kho ua ke nrog kev siv yeeb tshuaj uas ua kom cov hlwb pob txha muaj peev xwm ua rau muaj kev pheej hmoo ntawm cov ntshav pathologies, nrog rau kev txo qis hauv cov concentration ntawm granulocytes thiab neutrophils.
Kev tswj hwm ib txhij ntawm cov tshuaj muaj hinapril nrog Allopurinol, Novocainamide, cov neeg ua haujlwm cytostatic lossis cov tshuaj tiv thaiv kab mob ua rau muaj kev pheej hmoo ntawm kev tsim leukopenia. Cov tshuaj tiv thaiv kab mob siab, tshuaj rau tshuaj loog, opioid analgesics txhim kho hypotensive nyhuv ntawm quinapril, thaum cov tshuaj tsis-steroidal los tiv thaiv kev mob tsis muaj zog nws vim muaj cov kua dej hauv lub cev.
Cawv tau zoo
Ethanol txhim kho cov nyhuv antihypertensive ntawm cov tshuaj.
Cov tshuaj muaj qee tus lej ntawm cov yeeb yaj kiab uas zwm rau tib pawg muab tshuaj. Ntawm lawv yog:
Cov tshuaj nquag ntawm cov tshuaj yuav txawv, yog li ntawd, hloov chaw ntawm cov tshuaj yuav tsum pom zoo nrog kws kho mob.
Cov tshuaj Prestarium rau cov ntshav siab
Cov nqe lus so haujlwm Acupro los ntawm lub tsev muag tshuaj
Txhawm rau nqus ib qho tshuaj tiv thaiv kabmob, yuav tsum tau teem sijhawm mus ntsib kws kho mob.
Kuv tuaj yeem yuav yam tsis tas yuav tshuaj
Tso tawm los ntawm kev kho mob.
Acupro Nqe
Tus nqi nruab nrab ntawm cov tshuaj yog 535-640 rubles.
Cia rau cov neeg mob rau cov tshuaj
Khaws nyob ntawm chav tswj qhov kub thiab txias (tsis siab tshaj + 20 ° C). Cia kom deb ntawm kev tshav ntuj. Txwv tsis pub cov menyuam yaus siv tshuaj.
36 lub hlis tom qab tas lub sijhawm uas tsis tsim nyog siv cov tshuaj.
Kev txheeb xyuas rau Akkupro
Ua ntej siv cov tshuaj antihypertensive, nws raug nquahu kom koj nyeem cov kev tshuaj xyuas ntawm tus kws kho mob tshwj xeeb thiab cov neeg mob.
Alevtina Ivanova (kws kho plawv), hnub nyoog 39 xyoo, Ivanovo
Ib cov tshuaj zoo tsim feem ntau los txo qis ntshav siab thiab txhim kho lub plawv. Kev siv mus sij hawm ntev pab txhawm rau txhim kho cov phab ntsa ntawm cov hlab plawv system, txhim kho lawv cov elasticity. Cov tshuaj yog raug faib tawm raws li daim ntawv sau tshuaj, yog li kev kho kom raug yuav tsum yog tus kws kho mob tshwj xeeb thiaj li tsis tuaj yeem tawm tsam kev tsis sib haum xeeb thiab txo qhov kev pheej hmoo ntawm kev tsim cov kev tsis haum xeeb.
Cov neeg mob noj tshuaj
Alina, 43 xyoo, Krasnoyarsk
Txais raws li cov tshuaj kho rau ntau lub hlis. Kev ua haujlwm ntawm cov tshuaj no yog qhov siab, lub siab rov qab rau qhov qub tom qab 1-2 teev tom qab kev tswj hwm. Txawm li cas los xij, nws raug yuam kom tso tseg cov tshuaj no hauv kev sib txuas nrog qhov tsis zoo tshwm sim - kev tawm tsam ntawm kev hnoos.
Anna, 28 xyoo, Perm
Tshawb nrhiav koj qhov kev pheej hmoo rau kev tsim muaj ntshav qab zib!
Mus kuaj online dawb los ntawm cov kws paub txog endocrinologist
Lub sijhawm ntsuas tsis pub ntev tshaj 2 feeb
txhiab vam xeem
Niam rau lub sijhawm ntev sim los daws ntshav siab rau nws tus kheej, tab sis cov txiaj ntsig ntawm txoj kev nyiam ntawm pej xeem yog luv-nyob. Kuv yuav tsum mus ntsib kws kho mob. Niam tau muab cov tshuaj no rau vim lawv nrhiav pom lub plawv nres. Tom qab kho, qhov ntsuas lub siab rov tuaj rau qhov qub, qhov cim ntawm kub siab ploj. Tsis muaj cov kev mob tshwm sim loj heev, nws tsis tas yuav hloov mus rau cov analogues kim dua nrog cov kev phiv tshuaj tsawg dua.
Cov tshuaj "Kaptopres" yog hais txog cov neeg sawv cev uas tsis yooj yim, uas muaj ob yam tshuaj: captopril - ib qho tshuaj angiotensin-hloov pauv enzyme inhibitor thiab diuretic hydrochlorothiazide. Cov tshuaj ua rau pom qhov tseeb hypotensive thiab diuretic nyhuv. Nws yog tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj rau qhov ncauj kev tswj hwm los ntawm lub tuam txhab lag luam Ukrainian Darnitsa.
Muaj ob qhov tshuaj ntawm cov tshuaj, sib txawv hauv qhov ntau npaum li cas ntawm diuretic tivthaiv. Ntsiav tshuaj kom ceev "Kaptopres" muaj 50 mg ntawm captopril thiab hydrochlorothiazide 25 lossis 12.5 mg. Cov tshuaj ntxiv yog povidone, mis qab zib, aerosil, qos hmoov txhuv nplej siab thiab magnesium stearate.
Rau cov tshuaj "Kaptopres" tus nqi yog li ntawm 180 rubles rau ib pob. Tus nqi yog ntau tsawg dua li lwm cov tshuaj noj uas txo cov ntshav siab, uas tsis txo nws cov hauj lwm zoo. Hauv lub teb chaws ntawm cov neeg tsim khoom rau cov tshuaj "Kaptopres" tus nqi yog li 89 rubles rau ib pob nrog 20 ntsiav tshuaj.
Cov tshuaj ua haujlwm li cas?
Cov nquag ua ke txiav txim siab cov txheej txheem ntawm kev txiav txim ntawm cov tshuaj "Kaptopres", uas txiav txim siab nws txoj kev kho ua rau tib neeg lub cev.
Lub siab ib txwm mob?
Los ntawm inhibiting lub angiotensin hloov mus rau enzyme captopril, qhov hluavtaws ntawm hom 2 angiotensin yog suppressed. Hauv qab ntawm cov oligopeptide cov tshuaj hormones no, cov hlab ntsha nqaim, kev tsim tawm ntawm aldosterone los ntawm adrenal cortex yog txhawb.
Kev txo qis ntawm angiotensin ntawm hom thib ob txo cov kev nyuaj siab ntawm cov hlab ntsha, nyob rau hauv txoj cai atrium, cov hlab ntsha ua rau lub plawv ntsig, qhov ntsuas ntawm tag nrho peripheral vascular tsis kam, thiab lub nra rau lub plawv mob. Paub txog cov yam ntxwv ntawm captopril, koj tuaj yeem txiav txim siab txog qhov tshwm sim ntawm cov tshuaj "Captopres", ntawm dab tsi ceev yuav siv cov tshuaj no.
Ua tsaug rau hydrochlorothiazide, cov nyhuv diuretic zoo rau lub tso zis yog nqa tawm los ntawm kev tshem cov dej molecules, chloride, potassium thiab sodium ions los ntawm lub cev.Cov tshuaj muaj peev xwm txo cov dej qab ntsev ntau ntau hauv cov hlab ntsha phab ntsa, ua rau nws tsis raug rau cov teebmeem vasoconstrictor, thiab txhim kho cov nyhuv antiophexial ntawm captopril.
Kaptopres ntsiav tshuaj: dab tsi lawv pab los ntawm?
Cov tshuaj tshem tawm cov kev mob ntshav siab ntawm ntau cov ntawv, suav nrog kev kub siab tiv taus lwm yam tshuaj.
Nrog kev pabcuam ntawm cov khoom siv no, kev saib xyuas kub ntxhov yog ua tiav thaum muaj kev kub ntxhov.
Txhawm rau pab rau cov tshuaj, nws yuav tsum quag cawv tom qab ntsuas qhov siab.
Nws yog ib qho tseem ceeb kom paub tias thaum twg yuav siv Kaptopres ntsiav tshuaj. Kev qhia rau kev siv tshuaj muaj xws li:
- qhov tseem ceeb ntawm kev kub siab, uas nthuav dav raws li kev ua ntawm kev ua ntawm ntau yam tsis muaj feem rau tus kabmob,
- cov tsos mob kub siab, uas yog cov tsos mob ntawm ntau yam kab mob,
- malignant kub siab nrog angina tawm tsam lossis lub plawv tsis ua haujlwm,
- Renovascular tawg muaj feem xyuam nrog teeb meem lub raum,
- renoparenchymal hypertension ua ke nrog cov mob ntev los yog mob hnyav ntawm cov mob glomerulonephritis ntawm thawj thiab theem nrab etiology,
- kub siab nrog bronchial hawb pob,
- ntshav qab zib nephropathy,
- congestive plawv tsis ua hauj lwm, thaum mob glycosides tsis muaj zog
- Kab mob Conn nrog cov thawj hauv hyperaldosteronism.
Cov tshuaj siv rau thaum muaj xwm ceev kho mob rau kev kub ntxhov.
Yuav noj li cas
Nws yog ib qho tsim nyog yuav tsum tau ceev faj heev nrog Kaptopres ntsiav tshuaj. Dab tsi ntawm lub siab Kuv yuav tsum noj cov tshuaj kom tsis txhob ua mob rau kuv lub cev? Lo lus nug no tau nug los ntawm ntau tus neeg mob uas kub siab rau lawv tus kws kho mob.
Feem ntau, 120/80 mmHg yog suav tias yog qhov ntsuas lub zog siab. Kos duab. Ntawm tus nqi siab dua, yuav tsum ntsuas kom txo cov ntshav siab. Yog tias Kaptopres tshuaj kho mob raug muab rau cov neeg mob siab, nws yuav tsum haus cawv 60 feeb ua ntej noj mov kom tsis txhob cuam tshuam qhov nqus ntawm cov khoom siv nquag. Cov koob tshuaj yog xaiv nyob ntawm daim ntawv tawg thiab qhov hnyav ntawm txhua tus neeg mob ib tus zuj zus.
Kev kho mob yuav tsum pib nrog ib nrab ntawm cov ntsiav tshuaj, uas muaj captopril 25 mg thiab hydrochlorothiazide 12,5 mg. Nws qaug cawv 1 zaug nyob rau ib hnub. Rau kev kho ntxiv mus ntxiv, ib ntsiav tshuaj tag nrho twb tau noj ib hnub nrog tus nqi ntawm captopril ntawm 50 mg thiab hydrochlorothiazide ntawm 25 mg. Qhov siab tshaj plaws kho tau tshwm sim tom qab 1.5-2 lub hlis los ntawm kev siv thawj zaug. Dosage txoj kev kho kom haum yog nqa tawm uas siv nrog 6-lub lis piam sib tham, suav txog qhov tsis muaj qhov xav tau rau nws hloov pauv sai.
Kev txo qis ntshav tsis txaus yuav yog qhov laj thawj rau kev koom nrog kev kho mob ntawm ib qho ntxiv ntawm captopril thiab hydrochlorothiazide, uas tau ua los ntawm kev sib koom nrog cov kev npaj ib leeg. Tus naj npawb ntawm cov koob tshuaj niaj hnub ntawm captopril yuav tsum tsis pub ntau tshaj 150 mg, thiab cov ntsiab lus ntawm hydrochlorothiazide - tsis ntau dua 50 mg.
Txhawm rau kom tsis txhob muaj teeb meem kub ntxhov, Kuv siv ib ntsiav tshuaj, uas yog zom thiab khaws cia hauv qab nplaig.
Cov mob txeeb zig
Kev tshem tawm ntawm captopril thiab hydrochlorothiazide yog nqa tawm siv lub raum. Kev ua txhaum nyob rau hauv kev ua haujlwm ntawm lub cev no (nrog creatinine tshem tawm ntawm 30-80 ml ib 1 feeb) ua rau muaj kev nce qib hauv qib ntawm cov khoom ua haujlwm ntawm cov ntsiav tshuaj hauv cov ntshav dej.
Txhawm rau kho cov koob tshuaj ntawm cov tshuaj nquag rau kev ntsuas kho, noj ib nrab ib ntsiav tshuaj ib hnub, uas tau sib haum nrog tus nqi ntawm captopril 25 mg thiab hydrochlorothiazide 12,5 mg. Feem ntau noj tshuaj thaum sawv ntxov 1 teev ua ntej noj tshais.
Kaptopres ntsiav tshuaj kho cov ntshav siab thiab lub plawv tsis ua haujlwm, thiab lawv lub ntsiab lus tseem ceeb, captopril, tau siv thawj zaug hauv 70s ntawm lub xyoo pua xeem. Ntau tus neeg mob tham txog cov txiaj ntsig zoo ntawm cov tshuaj, uas nrog nws cov kev pab sai sai txo ntshav siab thaum muaj teeb meem kub siab.Nws yog ib qho tseem ceeb kom noj tshuaj kom raug thiab kom xwm yeem kom tau txais txiaj ntsig zoo.
Hauv kev tshawb nrhiav ntau cov kev tshawb fawb ntawm cov tshuaj captopril-based, nws tau ua pov thawj tias lawv txo cov ntshav siab thiab txo qis cov neeg tuag los ntawm cov kab mob ntawm cov hlab plawv.
Leej twg yog contraindicated rau hauv kev kho mob
Kaptopres cov lus qhia txog kev siv tshuaj suav nrog ntau tus naj npawb ntawm contraindications, uas suav nrog cov tib neeg muaj kev cuam tshuam rau cov tshuaj ua haujlwm ntawm cov ntsiav tshuaj, angiotensin hloov mus rau enzyme inhibitors thiab sulfamide derivatives.
Koj tsis tuaj yeem noj cov tshuaj nrog cov hlab ntsha txhaws mus rau ib lub raum lossis ob lub raum, tom qab hloov pauv ntawm cov khoom no, nrog kev ua txhaum ntau hauv nws txoj haujlwm, thaum tus nqi ntawm kev ua ntshav tawm los ntawm creatinine yog 30 ml ib 1 feeb, thiab nws cov ntsiab lus hauv plasma tsis ntau dua 1, 8 mg rau 100 ml.
Cov tshuaj tsis yog siv los ntawm cov neeg mob uas muaj cov cim ntawm thawj hyperaldosteronism, txo cov poov tshuaj thiab sodium ions nyob rau hauv cov ntshav, hypovolemia, gout thiab hypercalcemia, hloov obstructive nrog aortic stenosis thiab cuam tshuam ntawm cov ntshav nyob rau ntawm sab laug ventricle. Nws yog txwv tsis pub noj cov tshuaj thaum mob siab mob siab, poj niam cev xeeb tub thiab poj niam khaus. Txoj kev tiv thaiv tsis pub lwm tus yog cov menyuam hnub nyoog qis dua 18 xyoo.
Diuretics raug tso tseg tsis noj 3 hnub ua ntej siv thawj zaug ntawm captopril thiab diuretic noj tshuaj.
Kev saib xyuas tshwj xeeb yog cov neeg laus, cov tsav tsheb, cov tshuaj tiv thaiv kab mob rau cov neeg mob uas muaj cov kabmob tawm yog 30-60 ml rau 1 feeb, cov ntsiab lus protein ntxiv nyob rau hauv cov zis thiab nws cov nqi tshaj 1000 mg toj ib hnub.
Koj yuav tsum tau ceev faj heev thaum noj procainamide, lub plawv tsis ua hauj lwm, lub raum khiav tsis zoo, ntshav qab zib mellitus, muaj zog nce rau lub raum cov hlab ntsha. Txhawm rau soj qab xyuas tus neeg mob lub xeev ntawm kev noj qab haus huv, kev ntsuas lub siab kom tsis tu ncua yog ntsuas, thiab lub raum kev ua haujlwm thiab ntshav cov ntshav tau raug ntsuas.
Thaum noj Kaptopres kev npaj, kev qhia yuav piav qhia qhov tshwm sim hauv qee cov neeg mob ntawm cov kev mob tshwm sim uas cuam tshuam rau cov kev sib txawv ntawm lub cev.
Nrog txoj kev tsis zoo ntawm lub plab zom mov thiab lub siab, qab los noj mov tsawg, cov qog ua kua ntawm lub qhov ncauj ua kom qhuav, koj tuaj yeem soj ntsuam xeev siab, ntuav, mob hauv plab, tso quav tsis xwm yeem, kev txhim kho stomatitis, mob plab peptic, icteric lub xeev, kab mob siab, ua kom muaj bilirubin hauv cov ntshav.
Cawv rau lub siab, cov hlab ntsha thiab cov ntshav hemopoietic plab hnyuv siab tuaj yeem tshwm sim nrog tachycardia, angina pectoris, ntshav siab qis, Raynaud's syndrome, liab lossis pallor ntawm daim tawv nqaij, mob cardiogenic poob siab, neutropenia, agranulocytosis, thrombocytopenia, pancytopenia, mob ntshav qab zib lossis mob ntshav qab zib.
Cov tshuaj muaj cov nyhuv hauv lub hauv nruab nrab cov hlab ntsha uas cuam tshuam tus qauv pw tsaug zog, tsis pom kev thiab saj, lub hlwb khiav ncig, ua rau mob taub hau, tawm tsam mob kiv taub hau, lub siab ua haujlwm, tsis meej pem, loog ntawm nqua.
Qhov cuam tshuam ntawm lub tshuab ua pa yog pom los ntawm hnoos, ua pa tsis ua haujlwm, bronchospasm, ua xua rhinitis.
Cov kev mob tshwm sim ntawm cov kab mob tso zis yog qhia los ntawm lub raum tsis ua haujlwm, polyuria, oliguria, nephrotic syndrome.
Kev ua xua tuaj yeem txhim kho nyob rau hauv daim ntawv ntawm daim tawv nqaij ua pob, khaus, urticaria, Quincke's edema, Stevens-Johnson syndrome, photosensitivity, erythema.
Rau ntau tus neeg mob, nws yog ib qho tseem ceeb kom paub tias Kaptopres tshuaj ua haujlwm tau li cas, thaum muaj dab tsi ceev nws. Feem ntau ib qho tshuaj yog qaug thaum ntshav siab nce siab, uas tsis yog qhov tseeb. Peb xav tau ib cov tshuaj raws li kws kho mob pom zoo.
Thaum kho, cov tshuaj electrolyte, tshwj xeeb tshaj yog potassium ions, tus nqi ntawm creatinine thiab urea yuav tsum kuaj xyuas thiab ntshav ntshav ntawm ntu ntu yuav tsum tau saib xyuas.
Thaum noj tshuaj, koj yuav tsum noj zaub mov nrog qhov tsawg kawg nkaus sodium ntsiab lus, cawv yog contraindicated.
Muaj cov nyhuv diuretic, cov tshuaj tuaj yeem ua rau lub xeev cuam tshuam dej-electrolyte sib txuam nrog kev kho mob diuretic, zawv plab, ntuav, zaub mov noj nrog cov tshuaj sodium tsawg, hemodialysis, uas ua rau mob ntshav hypotension. Ua ntej cov tshuaj tiv thaiv kev kub ntxhov, theem ntawm electrolytes hauv lub cev yuav tsum kho.
Cov neeg mob uas tsis muaj lub plawv dhia tsis zoo thiab cov neeg laus yuav tsum tau ceev faj nrog Kaptopres ntsiav tshuaj. Dab tsi lub siab kuv yuav tsum noj cov tshuaj thiaj li hais tias qhov kev ua tau zoo tsis dhau qis? Ua ntej noj tshuaj, ntshav siab yuav tsum kuaj xyuas, nws tseem yuav tsum soj ntsuam lub raum kev ua haujlwm, cov ntsiab lus ntawm ions tseem ceeb.
Cov haiv neeg Negroid suav tias yog qhov muaj peev xwm tiv taus cov tshuaj uas thaiv cov angiotensin-hloov pauv enzyme, uas yog vim li cas captopril muaj kev cuam tshuam tsawg dua rau cov neeg mob no.
Nrog rau cov tshuaj uas tiv thaiv tsis tu ncua ntau, "Kaptopres" nyob rau ib qho ntawm cov chaw: cov lus qhia rau kev siv lub siab kho nws kom ua kom cov ntshav siab thiab daws cov mob tshwj xeeb tshaj plaws thaum lub sijhawm muaj teeb meem kub siab.
Hauv qab no peb muab luv luv tsom tshuaj, tshuaj ntsuam hauv kev nthuav dav cov lus pom zoo ntawm cov kws tshaj lij ntawm nws siv.
"Kaptopres": cov yam ntxwv tseem ceeb ntawm cov tshuaj
Cov tshuaj muaj sia thiab cov foos tso tawm
Cov tshuaj "Kaptopres" muaj nyob hauv daim ntawv foos. Cov txiaj ntsig ua tau los ntawm qhov pom ntawm ob lub ntsiab:
- captopril - ib qho ACE inhibitor (angiotensin hloov kev enzyme),
- hydrochlorothiazide - lub diuretic.
Kaptopres yog cov tshuaj uas qhov feem ntau zoo ntawm kev pom ntawm ACE inhibitor (captopril) thiab diuretic (hydrochlorothiazide) yog xaiv
Cov txheej txheem ntau npaum ntawm cov ntsiav tshuaj:
- 50 mg captopril
- 25 mg hydrochlorothiazide.
Ntxiv rau cov tshuaj no, cov tshuaj muaj pes tsawg leeg suav nrog cov tshuaj silicon dioxide, magnesium stearate, cov hmoov txhuv nplej siab thiab lwm yam tshuaj txuam nrog.
Cov nyhuv pharmacological ntawm cov tshuaj yog vim muaj kev sib koom ua ke ntawm cov tshuaj tiv thaiv tshuaj tiv thaiv uas tiv thaiv ACE, thiab diuretic:
- Vim qhov kev ua ntawm captopril, qhov kev sib zog ntawm cov nyhuv ntawm angiotensin-2 ntawm cov phab ntsa ntawm cov hlab ntsha poob qis. Kev tawm tsam cov ntshav ntws hauv cov hlab ntsha txig, uas ua rau lub cim txo qis hauv cov ntshav siab.
- Nyob rau hauv tib si, nyob rau hauv kev cuam tshuam ntawm captopril, qhov kev kub siab hauv cov ntshav ntawm lwm yam khoom poob, uas ua rau muaj qhov lumen ntawm cov hlab ntshav qis (feem ntau norepinephrine). Raws li, cov xwm txheej raug tsim rau qhov hnyav dua qhov txo qis. Lub siab hauv txoj cai atrium thiab pulmonary ncig txo qis, yog li tsim cov kev mob rau qhov kev txo qis rau cov ntshav siab.
- Cov diuretic uas yog ib feem ntawm Kaptopres ua rau cov nyhuv ACE inhibitory zoo dua. Cov nyhuv synergistic txawv Kaptopres los ntawm lwm cov tshuaj nrog thaj teb zoo sib xws ntawm cov ntawv thov uas muaj captopril tsis muaj cov tshuaj diuretic.
Cov tshuaj yeeb dej caw cuam tshuam tau zoo nyob rau hauv cov zom zaub mov (txog 30% ntawm cov tshuaj khi, cov ntsiab lus siab yog tsau nrog kwv yees li 60 feeb tom qab tswj hwm).
Lub sijhawm tshem tawm yog li 3 teev (hauv cov neeg mob uas lub raum tsis ua haujlwm lub siab - ntev dua).
Cov tshuaj cuam tshuam rau kev sib txuas ntawm cov tshuaj uas rhuav tshem bradykinin
Cov kab mob dab tsi yog siv los kho?
Cov tshuaj yog tawm rau cov hlab ntsha arterial, tsau hauv cov ntaub ntawv hauv qab no:
- qhov tseem ceeb
- khuv xim
- phem
- nyuab los ntawm kev tawm tsam angina,
- Renovascular
- renoparenchymal.
Ntxiv rau, cov npe ntawm cov cim rau kev teem caij "Kaptopres" suav nrog: kev mob ntshav siab, mob ntshav qab zib ntawm lub cev ntshav qab zib, lub plawv tsis ua haujlwm (nrog kev tsis muaj zog ntawm cov mob glycosides), thiab lwm yam.
Rau cov kev ntxhov siab kub ntxhov, "Kaptopres" yog siv los daws cov tsos mob hnyav tshaj plaws thaum muaj xwm ceev.
Siv rau hauv kev kho thiab tiv thaiv
Kaptopres: cov lus qhia rau kev siv tawm tsam lub siab
Ua ntej noj cov tshuaj rau cov hom phiaj kho, koj yuav tsum ua tib zoo kawm cov lus qhia rau kev siv Kaptopres ntsiav tshuaj: ntawm dab tsi los haus, ntawm kev noj tshuaj, thiab lwm yam.
Kaptopres ua haujlwm txo qis ntshav siab ua tsaug rau ob yam uas cuam tshuam rau lub cev ntawm kev sib txawv.
Cov tshuaj nquag nquag (vim yog lub synergy ntawm ACE inhibitors thiab diuretic Cheebtsam), yog li koj yuav tsum noj "Kaptopres" nrog ceev faj. Yog tias lub siab ceev tau nce siab me ntsis, tom qab ntawd koj tuaj yeem ua qhov ib txwm ua “Captopril”, “Kaptopres” yuav tsum siv rau kev kub ntxhov uas xav tias tsam kub ntxhov, lossis thaum ntsuas ntsuas siab ntau dua 180 rau 100 hli RT. Kos duab.
Qhov zoo tshaj, yog tias qhov ntau npaum ntawm cov tshuaj yuav txiav txim los ntawm tus kws tshwj xeeb. Feem ntau, tus kws kho mob sau ntawv rau "Kaptopres", coj mus rau hauv tus account xws li ntsuas:
- tus mob hnyav rau tus neeg mob lub,
- qhov xav tau kom nrawm txo ntshav siab,
- kev ua haujlwm ntawm lub raum thiab mob siab (yog tias muaj pathologies, kev siv tshuaj tsawg kawg nkaus yog siv),
- muaj cov concomitant kab mob thiab siv lwm yam tshuaj.
"Kaptopres" ntawm kev kub siab tau noj raws li cov phiaj xwm hauv qab no:
- Cov ntsiav tshuaj yuav qaug cawv tsawg kawg 1 teev ua ntej noj mov. Qhov no ua kom tsis txhob txo qhov kev nqus ntawm cov yam nquag.
- Lub chav kawm ntawm kev saib xyuas kev kho mob feem ntau yog pib nrog ib nrab koob: 1 ib hnub, ib nrab ib ntsiav tshuaj nrog tus qauv muab tshuaj.
- Thaum tsis muaj qhov ua kom muaj txiaj ntsig kho, cov tshuaj kom ntau dua sijhawm. Hauv qhov no, tus neeg mob haus 1 ntsiav tshuaj ib hnub.
- Noj “Kaptopres” yuav zoo tshaj rau tib lub sijhawm. Cov ntsiav tshuaj yog nqos tsis tau zom. Koj yuav tsum haus dej kom ntau.
Yog tias cov ntsiav tshuaj tau sau rau haus ib hnub ib zaug, tom qab ntawd Kaptopres zoo dua tuaj thaum sawv ntxov
Cov tshuaj feem ntau tau sau tseg hauv cov chav kawm, thiab ntev heev. Raws li kev tshuaj xyuas ntawm cov kws kho mob thiab cov neeg mob noj "Kaptopres", qhov siab tshaj plaws kho tau pom tias yog 1.5-2 lub hlis tom qab pib kawm.
Yog tias tsim nyog, kev hloov kho tshuaj yog ua tiav ntawm lub sijhawm ntawm 1.5 hlis. Qhov tshwj tsis yog muaj xwm txheej thaum Kaptopres raug muab tso tseg rau ntau yam laj thawj, lossis nws tau siv rau hauv qhov ntau zog ntau ntau kom nres qhov kub ntxhov.
Thaum siv "Kaptopres" hauv kev kho mob ntshav siab, nws yog ib qho tsim nyog yuav tsum them sai sai rau cov kev txwv hauv hnub nyoog:
- cov tshuaj tsis siv los txo qhov siab nyob hauv cov neeg mob hnub nyoog qis dua 18,
- rau cov neeg mob uas muaj hnub nyoog 65 xyoos thiab tshaj saud, "Kaptopres" raug kho nrog kev ceev faj, raws li kev ntsuas ntawm qhov mob hnyav.
Arterial hypertension yog qhov hloov ntshav siab tas li uas tshwm sim los ntawm vasospasm uas ua rau cov ntshav ncig tsis yooj yim.
Nyob rau lub sijhawm tam sim no, muaj ntau lub ntsiab lus uas cuam tshuam txog kev txhim kho kev mob ntshav siab, suav nrog kev hloov pauv lub hnub nyoog, kev tsis txaus ntseeg lub cev, kev noj zaub mov tsis muaj txiaj ntsig, kev noj zaub mov rau qab ntsev, kev phem ntawm cov zaub mov tsis zoo, kev muaj keeb, kis tau cov kab mob thiab muaj lub cev nyhav dhau los.
Cov kws kho mob koom nrog txoj kev txhim kho ntawm cov mob no nrog rau kev ua txhaum ntawm cov yam uas tau ua lub luag haujlwm rau kev tswj hwm kev ua haujlwm ntawm lub cev. Ntxiv mus, lub ntsiab yog vim li cas rau qhov tsos ntawm tus kab mob no yog noob.
Muaj ntau ntau txoj hauv kev los tiv thaiv tus kab mob no, thawj zaug ntawm cov tshuaj tau siv los ua kev kho mob. Ib qho ntawm cov tshuaj zoo li no yog Kaptopres, cov tshuaj tiv thaiv kab mob muaj nyob hauv txhua lub tsev muag tshuaj.
Captopres yog cov neeg sawv cev los tiv thaiv cov nyom, uas muaj ob yam khoom xyaw - captopril thiab hydrochlorothiazide.
Cov tshuaj muaj nyob rau hauv cov ntsiav tshuaj, uas muaj qhov hais tawm hypotensive thiab diuretic kev ua si. Cov txiaj ntsig zoo ntawm lub cev thiab kev kho mob yog vim cov khoom muaj txiaj ntsig pharmacological ntawm cov khoom tseem ceeb uas ua rau muaj pes tsawg leeg.
Thawj feem hu ua captopril yog cov tshuaj ntawm pab pawg ntawm angiotensin-hloov pauv enzyme inhibitors. Ua tsaug rau qhov no, lub cev tau muaj txiaj ntsig zoo vim tias txo qis ntshav siab thiab txo qis hauv kev tawm tsam vascular.
Qhov thib ob tivthaiv, hu ua hydrochlorothiazide, yog thiazide diuretic uas ua rau kom muaj kev tshem tawm cov kua thiab ions ntawm sodium, chlorine thiab potassium. Sib cuam tshuam nrog cov khoom ua si thawj zaug, tsuas yog txhim kho nws cov nyhuv.
Cov tshuaj raug pom zoo kom noj kwv yees li ib teev ua ntej noj mov, txij li thaum lub sijhawm nws nqus ntawm ib leeg ib qho twg raug txo.
Cov koob tshuaj tsim nyog yuav tsum tau xaiv tsuas yog los ntawm tus kws kho mob tuaj koom.
Thawj koob tshuaj yuav tsum pib nrog ib nrab ntawm ib ntsiav tshuaj ib hnub ib zaug. Ntxiv mus, cov tshuaj yuav tsum noj nyob rau hauv txoj kev no: koob tshuaj txij nkawm tuaj yeem yog ib ntsiav tshuaj ib hnub ib zaug.
Cov txiaj ntsig kho tau zoo tshaj plaws yuav qhia tau tsuas yog ob lub hlis tom qab pib noj cov tshuaj no. Kev kho dua ntawm cov tshuaj tam sim no tuaj yeem nqa tawm tsuas yog tom qab rau lub lis piam.
Kaptopres tseem muaj cov contraindications, uas yuav tsum tau coj mus rau hauv tus account:
- angioedema uas tau tshwm sim thaum kho nrog ACE inhibitors,
- yug los ua neeg mob hlwb,
- tsawg cov ntsiab lus ntawm cov poov tshuaj ions nyob rau hauv cov ntshav,
- cov dej qab ntsev thiab ua kua ntsev,
- mob gout
- ntshav calcium ntau heev
- porphyria
- cev xeeb tub thiab lactation
- ntau dhau ntawm kev faib tawm ntawm aldosterone,
- muaj kev cuam tshuam loj thiab hais tsis meej nyob hauv kev coj ua haujlwm zoo li qub hauv nruab nrog cev hauv kev tso dej tawm,
- kev tshem tawm tswv yim
- ob leeg mob leeg ntawm cov hlab ntsha loj raum lossis stenosis ntawm ib lub raum leeg ntshav nrog cov ntshav azotemia,
- mob hnyav tom qab lub raum hloov pauv,
- tsis muaj zis nyob rau hauv lub zais zis,
- kev puas tsuaj uas tiv thaiv cov tawm ntawm cov ntshav los ntawm sab laug ventricle,
- siab rhiab heev rau ib tug neeg cov tshuaj, tshwj xeeb tshaj yog rau cov uas tseem ceeb,
- ib nrab intolerance mus rau lub cheeb tsam,
- ua rau lub siab tsis ua haujlwm thaum muaj mob ua ntej lossis qhov tseem ceeb hu ua mob hepatic coma.
Thaum noj cov tshuaj, cov neeg mob tau sau tseg txog cov kev tsis txaus siab txuas ntxiv no:
- xeev siab
- ntuav
- ib tug tseem ceeb txo nyob rau hauv qab los noj mov,
- epigastric mob
- qhov ncauj qhuav
- mob plab
- peptic rwj
- dajntoo
- kab mob siab
- tachycardia thiab angina pectoris,
- pallor ntawm daim tawv nqaij,
- mob taub hau heev
- urticaria
- cov quav tsis xis nyob, tshwj xeeb yog cem quav thiab zawv plab,
- nyob rau hauv cov txiv neej, txo qis kev sib deev muaj siab thiab tsis muaj kev kho tau erection,
- siab lub cev kub
- tsawg hemoglobin
- lub raum tsis ua hauj lwm.
Nrog kev siv lub sijhawm ntev dua ntawm cov tshuaj tiv thaiv me ntsis ntawm cov tshuaj no, cov neeg mob tau sau tseg txog kev tshwm sim xws li ntshav siab, tachycardia, mob taub hau, xeev siab, ntuav, quav tsis zoo thiab txo lub cev hnyav.
Yog tias qhov pom ntawm qhov tsis zoo tshwm sim tau raug tsis quav ntsej, thiab tus neeg mob tsis txo qis qhov koob tshuaj, tom qab ntawd nws yuav tsim kho kom muaj kev pom zoo ntawm intoxication nrog hydrochlorothiazide.
Qhov tshwm sim xws li ua txhaum ntawm cov dej-ntsev sib npaug thiab kev txhim kho ntawm lub cev tsis xeev yog tsis tswj hwm. Qhov no vim hais tias cov tshuaj no muaj qhov ua rau lub zog nruab nrab ntawm tus tib neeg.
Yog hais tias noj ntau dhau, tus neeg mob yuav tsum yaug lub plab thiab muab tshuaj kom nkag mus.
Yog tias muaj kev xav tau, tom qab ntawd cov kev kho mob tshwj xeeb yuav tsum tau nqa tawm. Yog tias muaj tshuaj lom loj, yuav tsum tau mus pw hauv tsev kho mob sai sai.
Cov theem ntawm cov kev ntsuas rau cov pab ua ntej rau tus neeg mob suav nrog kev kho mob sai sai. Ntxiv rau nws, nws yog qhov yuav tsum tau muab cov txheej txheem uas yuav pab ua kom rov zoo thiab tswj tuav dej-electrolyte sib npaug.
Cov Lus Qhia Rau Akkupro
Acupro yog sib kis rau cov menyuam yaus thiab cov neeg hluas hnub nyoog qis dua 18 xyoo, cov neeg mob uas muaj keeb kwm ntawm kev mob caj dab, uas cuam tshuam nrog ACE inhibitor txoj kev kho, thiab nrog cov neeg mob siab rau ib feem ntawm cov tshuaj.
Nrog kev ceev faj, Akkupro yog muaj kev kho mob yog tias muaj keeb kwm ntawm kev mob hlwb yog tias nws tsis cuam tshuam nrog ACE cov tshuaj tiv thaiv, nrog lub plawv tsis zoo uas muaj kev pheej hmoo siab heev, nrog rau hyperkalemia, txo qis hauv BCC, aortic stenosis, ib qho mob tom qab hloov raum, inhibition ntawm cov pob txha mob hematopoiesis, mob hnyav autoimmune kab mob ntawm cov nqaij mob sib txuas, mob ntshav qab zib mellitus, ua rau lub siab lossis lub raum tsis ua haujlwm thiab kev phais mob ntxiv.
Tsuas tshuaj thiab kev tswj hwm Akkupro
Hauv kev kho mob ntshav siab, cov neeg mob uas tsis tau txais diuretics raug xaj 10 lossis 20 mg ntawm cov tshuaj ib hnub ib zaug. Cov koob tshuaj yuav raug nce ntxiv nyob ntawm qhov siv tshuaj ntsuam. Cov kev saib xyuas txij nkawm yog 20 lossis 40 mg ib hnub twg, feem ntau yog hais qhia hauv ib lossis ob zaug. Cov koob tshuaj nws txawv ntawm cov sijhawm ntawm plaub lub lis piam. Feem ntau, nws muaj peev xwm ua tiav tau tswj kev tswj ntshav siab thaum lub sij hawm kho ntev los ntawm kev siv Accupro 1 zaug hauv ib hnub. Qhov siab tshaj plaws tau tso cai rau noj txhua hnub yog 80 mg.
Cov neeg mob uas niaj hnub noj cov tshuaj diuretics yog thawj zaug tau txhaj 5 mg ntawm cov tshuaj, tom qab ntawd cov koob tshuaj tau nce ntxiv kom txog thaum pom cov txiaj ntsig zoo tshaj plaws.
Kev siv ntawm Accupro hauv cov neeg mob uas mob plawv tsis ua hauj lwm ntev tau qhia tias yog ib feem ntawm txoj kev kho kom ncaj ncees nrog diuretics thiab / lossis mob plawv glycosides. Hauv qhov no, qhov pib koob tshuaj yog 5 mg 1 lossis 2 zaug ib hnub. Yog tias cov tshuaj muaj kev tiv thaiv zoo, qhov tshuaj tuaj yeem nce ntxiv txog 10-40 mg ib hnub twg hauv 2 koob tshuaj sib npaug.
Nws raug nquahu kom pib kho Akkupro hauv cov neeg mob kev txom nyem los ntawm lub raum lub raum muaj nuj nqi nrog 5 mg ntawm cov tshuaj ib hnub ib zaug. Hnub tom qab, yog tias thev taus ntawm thawj koob tshuaj zoo, ob koob tshuaj ib hnub tuaj yeem tsim kho. Thaum lub sijhawm tsis ua haujlwm uas tsis ua haujlwm rau lub raum lossis txoj hlab ntsha hypotension, qhov kev tuaj yeem nce ntxiv nyob rau ntawm ncua sijhawm txhua asthiv.
Hauv cov neeg mob laus, cov tshuaj pib xav yog 10 mg ib hnub ib zaug. Tom qab, nws tuaj yeem nce ntxiv kom ua tiav qhov kev kho mob tau zoo tshaj plaws.
Cov lus qhia tshwj xeeb
Nws tau sau tseg tias thaum kho nrog ACE inhibitors, mob hlwb yog qhov muaj peev xwm ua tau (0.1% ntawm tus neeg mob). Yog hais tias angioedema ntawm tus nplaig, ntsej muag, lossis mob epiglottis tshwm sim, Kev kho mob Acupro yuav tsum nres tam sim ntawd. Tus neeg mob yuav tsum tau txais kev kho kom tsim nyog thiab saib xyuas nws kom txog thaum lub qhov ntshav tau nres. Kev nrawm ntawm daim di ncauj thiab lub ntsej muag feem ntau ploj mus yam tsis tau siv tshwj xeeb, tab sis antihistamines tuaj yeem siv los txo cov tsos mob. Laryngeal edema tuaj yeem ua rau neeg tuag taus. Yog tias muaj kev pheej hmoo ntawm cov hlab ntsws thaiv, yuav tsum tau kho mob xwm txheej ceev, suav nrog kev qhia txog adrenaline thiab lwm yam kev ntsuas.
Nrog rau kev kho mob nrog cov tshuaj, angioedema ntawm txoj hnyuv tuaj yeem tshwm sim, tshwm sim los ntawm kev mob plab tsis muaj xeev siab thiab ntuav. Cov tsos mob yuav ploj mus tom qab siv tshuaj ACE inhibitors.
Cov neeg mob uas tau txais ACE inhibitors thaum kho nrog Hymenophera lub cev yuav ua rau muaj kev phom sij txog txoj sia nyob hauv anaphylactic.Hauv cov neeg mob uas siv cov tshuaj diuretics, kev tswj hwm ntawm Accupro yuav ua rau muaj kev loj hlob ntawm cov tsos mob ntawm txoj hlab ntsha o. Yog tias tus neeg mob xav tau kev kho mob diuretic, nws yuav tsum tsum tsis txhob tso 2-3 hnub ua ntej pib Acupro.
Hauv cov neeg mob mob ntshav liab, kev txom nyem los ntawm ob leeg los yog ob leeg txha raum mob raum leeg, kev kho mob nrog Accupro tej zaum yuav ua rau muaj kev ntshiab ntawm ntshav creatinine thiab urea nitrogen rau hauv cov ntshav. Cov kev hloov zoo ploj mus tom qab tsis cuam tshuam nrog cov tshuaj. Hauv qhov no, lub raum kev ua haujlwm yuav tsum tau saib xyuas thaum thawj ob peb lub lis piam ntawm kev kho mob.