Noliprel A: cov lus qhia rau kev siv

Hauv tsab xov xwm no, koj tuaj yeem nyeem cov lus qhia rau kev siv tshuaj yaj yeeb NoliprelCov. Muab tswv yim los ntawm cov neeg tuaj saib rau ntawm thaj chaw - cov neeg siv khoom ntawm cov tshuaj no, nrog rau kev xav ntawm cov kws kho mob ntawm cov kws tshaj lij txog kev siv Noliprel hauv lawv cov kev coj ua. Qhov kev thov loj yog nquag ntxiv kev tshuaj xyuas koj ntawm cov tshuaj: cov tshuaj tau pab lossis tsis pab ua kom tshem tawm ntawm tus kabmob, muaj dab tsi tshwm sim thiab cov kev mob tshwm sim, tejzaum nws tsis tshaj tawm los ntawm tus tsim khoom hauv cov lus piav qhia. Cov cim ntawm Noliprel nyob rau hauv muaj cov qauv txheej txheem. Siv rau kev kho mob ntshav siab thiab txo ntshav siab rau cov neeg laus, menyuam yaus, nrog rau thaum cev xeeb tub thiab lactation.

Noliprel - kev npaj ua ke muaj perindopril (ib qho ACE inhibitor) thiab indapamide (thiazide-zoo li diuretic). Cov nyhuv pharmacological ntawm cov tshuaj yog vim muaj kev sib txuas ntawm cov khoom ntiag tug ntawm txhua qhov sib xyaw. Kev siv sib xyaw ntawm perindopril thiab indapamide muab kev sib txuam ntawm cov nyhuv antihypertensive piv nrog txhua yam ntawm cov khoom sib cais.

Cov tshuaj muaj cov lus hais tawm koob tshuaj tiv thaiv kab mob rau ob leeg systolic thiab diastolic ntshav siab rau hauv qhov chaw supine thiab sawv. Cov nyhuv ntawm cov tshuaj kav ntev li 24 teev Cov teebmeem kev mob tshwm sim tsawg dua 1 hlis tom qab pib kho thiab tsis nrog tachycardia. Kev txiav tawm ntawm kev kho mob tsis yog nrog los ntawm kev loj hlob ntawm kev tshem tawm tus mob.

Noliprel txo qis qib ntawm hypertrophy ntawm sab laug ventricle, txhim kho lub elasticity ntawm cov hlab ntsha, txo OPSS, tsis cuam tshuam rau lipid metabolism (tag nrho cov roj, HDL-C, HDL-C, triglycerides).

Perindopril yog ib qho inhibitor ntawm ib qho enzyme uas hloov angiotensin 1 rau angiotensin 2. Ib qho tshuaj angiotensin hloov enzyme (ACE), lossis kinase, yog ib qho exopeptidase uas ua tau ob qho kev hloov pauv ntawm angiotensin 1 rau angiotensin 2, uas muaj cov vasoconstrictive effect, thiab ua rau cov hlab ntsha tsis muaj teebmeem. Cov. Yog li ntawd, perindopril txo qis kev zais ntawm aldosterone, raws li lub hauv paus ntsiab lus ntawm cov lus tsis zoo, tsub kom muaj kev ua si ntawm renin hauv cov ntshav ntshav, nrog kev siv ntev nws txo OPSS, uas yog qhov tseem ceeb vim qhov cuam tshuam rau cov hlab ntshav hauv cov leeg thiab raum. Cov teebmeem no tsis yog nrog rau kev ncua hauv qab ntsev thiab dej los yog kev txhim kho ntawm reflex tachycardia nrog kev siv lub sijhawm ntev.

Perindopril muaj cov nyhuv antihypertensive rau cov neeg mob uas muaj ob qho qis thiab ib txwm plasma renin kev ua si.

Nrog rau kev siv perindopril, muaj ib qho kev poob qis hauv ob qho systolic thiab diastolic cov ntshav siab rau hauv thaj chaw supine thiab sawv. Kev tshem tawm ntawm cov tshuaj tsis ua rau muaj ntshav siab.

Perindopril muaj cov nyhuv vasodilating, pab kho qhov ywj pheej ntawm cov hlab ntsha loj thiab cov qauv ntawm cov leeg ntshav ntawm cov hlab ntsha me, thiab kuj tseem txo cov leeg ntshav ventricular hypertrophy.

Perindopril normalizes kev ua haujlwm ntawm lub siab, txo qis ua ntej thiab tom qab thauj.

Kev siv ua ke ntawm thiazide diuretics kho cov nyhuv antihypertensive. Ntxiv rau, kev sib xyaw ntawm ACE inhibitor thiab thiazide diuretic kuj txo qhov kev pheej hmoo ntawm hypokalemia nrog diuretics.

Hauv cov neeg mob uas lub plawv tsis ua hauj lwm, perindopril ua rau muaj qhov txo qis hauv txoj hlab pa hauv txoj cai thiab sab laug ventricle, txo lub plawv dhia, qhov nce hauv lub plawv tawm thiab kev txhim kho hauv lub plawv mob plawv, thiab kev nce hauv cheeb tsam ntshav txaus hauv cov leeg.

Indapamide yog sulfanilamide derivative, zoo ib yam li hauv pharmacological zog rau thiazide diuretics. Nws inhibits reabsorption ntawm sodium ions nyob rau hauv lub cortical ntu ntawm Henle voj, uas ua rau kom tso zis ntau ntxiv ntawm cov dej qab ntsev, chlorine thiab, rau qhov tsawg dua, potassium thiab magnesium ions, yog li nce diuresis. Cov nyhuv antihypertensive yog manifested nyob rau hauv cov koob tshuaj uas xyaum tsis ua rau mob diuretic.

Indapamide txo qis vascular hyperreactivity nrog kev hwm rau adrenaline.

Indapamide tsis cuam tshuam rau cov ntshav lipids (triglycerides, cov roj cholesterol, LDL thiab HDL), cov metabolism hauv cov metabolism (nrog rau cov neeg mob concomitant ntshav qab zib mellitus).

Indapamide pab txo qis rau sab laug ventricular hypertrophy.

Muaj pes tsawg leeg

Perindopril arginine + Indapamide + excipients.

Cov Tshuaj Pharmacokinetics

Cov tshuaj pharmacokinetic ntawm perindopril thiab indapamide hauv kev sib txuam tsis hloov pauv piv rau lawv kev siv cais.

Tom qab kev tswj hwm qhov ncauj, perindopril yog nqus tau nrawm. Kwv yees li 20% ntawm tag nrho cov nyiaj ntawm perindopril nqus tau hloov mus rau hauv cov xeb nquag ntawm perindoprilat. Thaum noj tshuaj nrog cov zaub mov, kev hloov pauv ntawm perindopril rau perindoprilat poob qis (cov nyhuv no tsis muaj qhov tseem ceeb hauv cov nqi kuaj mob). Perindoprilat ua tawm hauv cov zis. T1 / 2 ntawm tus mob perindoprilat yog 3-5 teev .Txais ntawm perindoprilat qeeb hauv cov neeg laus, thiab hauv cov neeg mob raum tsis ua haujlwm thiab lub plawv tsis ua haujlwm.

Indapamide nrawm thiab nrawm los ntawm lub plab zom mov. Rov ua dua ntawm cov tshuaj tsis ua rau nws txoj kev khaws cia hauv lub cev. Nws tawm hauv cov zis feem ntau nrog cov zis (70% ntawm kev siv tshuaj) thiab nrog quav (22%) nyob rau hauv kev siv lub cev tsis muaj zog.

Cov Khoom Qhia

• qhov tseem ceeb arterial tawg.

Tso Tawm Cov Ntawv

Ntsiav tshuaj 2.5 mg (Noliprel A).

5 mg ntsiav tshuaj (Noliprel A Forte).

Ntsiav tshuaj 10 mg (Noliprel A Bi-Forte).

Cov lus qhia rau kev siv thiab ntau npaum li cas

Tso rau sab hauv, nyiam dua thaum sawv ntxov, ua ntej noj mov, 1 ntsiav tshuaj 1 zaug hauv ib hnub. Yog tias tom qab 1 hlis tom qab pib txoj kev kho mob qhov xav tau hypotensive tsis tau tiav, qhov koob tshuaj tuaj yeem raug nce ntxiv rau qhov koob tshuaj 5 mg (tsim los ntawm cov tuam txhab nyob hauv cov npe lag luam Noliprel A forte).

Cov neeg laus yuav tsum pib kho nrog 1 ntsiav tshuaj 1 zaug hauv ib hnub.

Noliprel yuav tsum tsis txhob raug rau cov menyuam yaus thiab cov hluas vim tias tsis muaj cov ntaub ntawv hais txog kev ua tau zoo thiab kev nyab xeeb rau cov neeg mob ntawm cov pab pawg hnub nyoog no.

Sab sij huam

• qhov ncauj qhuav
• xeev siab
• tsis qab los
• mob plab
• saj kev ntxhov siab
• cem quav
• hnoos qhuav, pheej yaum ntev ntev thaum siv tshuaj ntawm pab pawg no thiab ploj mus tom qab lawv tshem tawm
• orthostatic hypotension,
• hemorrhagic pob,
• daim tawv nqaij ua pob,
• exacerbation ntawm systemic lupus erythematosus,
• angioedema (Quincke's edema),
• photosensitivity kev hloov pauv
• paresthesia
• mob taub hau
• asthenia
• kev ntxhov siab vim pw tsaug zog
• lability ntawm mus ob peb vas
• kiv taub hau
• mob leeg
• thrombocytopenia, leukopenia, agranulocytosis, aplastic anemia, hemolytic anemia,
• hypokalemia (tshwj xeeb tseem ceeb rau cov neeg mob uas muaj kev pheej hmoo), hyponatremia, hypovolemia, ua rau lub cev qhuav dej thiab orthostatic hypotension, hypercalcemia.

Cov Yuav Tsum Muaj

• keeb kwm ntawm mob hlwb (suav nrog nrog ACE lwm yam tshuaj tiv thaiv kab mob),
• mob raws keeb kwm / idiopathic angioedema,
• mob raum tsis ua haujlwm (CC

Pharmacological kev txiav txim

NOLIPREL A yog kev sib txuam ntawm ob qho khoom ua ke, perindopril thiab indapamide. Qhov no yog qhov tshuaj tiv thaiv hypotensive, nws yog siv los kho ntshav siab (tawg).

Perindopril belongs rau cov chav kawm ntawm cov tshuaj hu ua ACE inhibitors. Nws ua los ntawm kev siv lub zog ntawm cov hlab ntsha nthuav dav, uas pab txoj kev txhaj ntshav ntawm cov ntshav. Indapamide yog cov diuretic. Cov tshuaj diuretics nce tso zis ntau ntxiv uas tsim los ntawm lub raum. Txawm li cas los xij, indapamide txawv ntawm lwm cov tshuaj diuretics, vim nws tsuas yog nce me ntsis cov zis uas tsim tawm. Txhua ntawm cov khoom xyaw nquag txo qis ntshav siab thiab ua ke lawv tswj hwm koj cov ntshav siab.

Cov Yuav Tsum Muaj

• Yog tias ua ntej, thaum noj lwm yam tshuaj ACE inhibitors lossis nyob rau lwm qhov xwm txheej, koj lossis koj ib tus txheeb ze tau pom tsos mob xws li hawb pob, o ntsej muag lossis tus nplaig, khaus heev, lossis ua rau tawv nqaij ua xua (mob caj dab),

• Yog tias koj muaj mob rau daim siab mob siab lossis mob rau daim siab mob hlwb txhaws qog (mob hlwb rau lub hlwb),

• yog tias koj lub raum tsis ua haujlwm zoo lossis yog tias koj raug lim ntshav,

• Yog tias koj cov ntshav poov tshuaj muaj ntshav siab dhau lossis qis dhau,

• Yog tias koj xav tias tsis kho qhov ua kom lub plawv tsis ua hauj lwm zoo (tsis nco qab ntsev heev, ua tsis taus pa),

• Yog tias koj xeeb tub los yog tab tom npaj lub cev xeeb tub,

• yog koj pub mis niam rau menyuam.

Cev xeeb tub thiab lactation

Tsis txhob noj NOLIPRELA hauv thawj peb lub hlis uas cev xeeb tub thiab tsis txhob noj nws pib txij thaum lub 4 hlis ntawm kev xeeb tub (saib Contraindications). Yog tias cev xeeb tub tau npaj tseg lossis qhov tseeb ntawm cev xeeb tub yog paub tseeb, ces koj yuav tsum hloov mus rau lwm txoj kev kho mob kom sai li sai tau.

Tsis txhob noj NOLIPREL A yog tias koj xeeb tub.

Tham nrog koj tus kws kho mob tam sim ntawd.

Tsuas tshuaj thiab tswj hwm

Yog tias koj tau noj ntau dua NOLIPREL A dua li qhov tau pom zoo rau koj:

Yog tias koj noj tshuaj ntau dhau lawm, tiv tauj koj lub chaw khomob xwmtxheej ceev lossis qhia koj tus kws khomob tamsid. Qhov ntxim nyiam tshaj plaws nyob rau hauv rooj plaub ntawm kev noj ntau dua yog qhov txo qis hauv ntshav siab. Yog tias koj cov ntshav siab poob qis (cov tsos mob xws li kiv taub hau lossis tsaus muag), pw thiab tsa koj ob txhais ceg, qhov no yuav ua rau koj tus mob yooj yim dua.

Yog tias koj tsis nco qab noj NOLIPRELA

Nws yog ib qho tseem ceeb uas yuav tsum noj cov tshuaj txhua txhua hnub, txij li lub sijhawm ib txwm coj los ua kev kho kom zoo dua. Txawm li cas los xij, yog tias koj tsis nco qab noj tshuaj NOLIPREL A, noj tshuaj ntxiv nyob rau tib lub sijhawm. Tsis txhob txhaj ob koob tom ntej.

Yog tias koj tsum tsis noj NOLIPRELAA

Txij li cov tshuaj tiv thaiv kab mob feem ntau kav ntev mus ib sim neej, koj yuav tsum sab laj nrog koj tus kws kho mob ua ntej txiav cov tshuaj.

Yog tias koj muaj lus nug ntxiv txog kev siv tshuaj, hu rau koj tus kws kho mob lossis kws muag tshuaj.

Sab sij huam

Cov no suav nrog:

• nquag (tsawg dua 1 hauv 10, tab sis ntau dua 1 nyob rau hauv 100), mob plab zom mov (mob hauv plab lossis plab, tsis qab los, xeev siab, cem quav, hloov pauv), lub qhov ncauj qhuav, hnoos qhuav.

• tsis nquag (tsawg dua 1 hauv 100, tab sis ntau dua 1 nyob rau hauv 1000): zoo li nkees nkees, kiv taub hau, mob taub hau, hloov lub siab, pw tsaug zog ntxhov siab, mob nqaij ntshiv, hnov ​​mob ib ce, ua xua xws li pob khaus tawv, liab doog (liab tawm ntawm daim tawv), hypotension (ntshav siab), orthostatic (kiv taub hau thaum nce) lossis tsis. Yog tias koj raug kev txom nyem los ntawm cov kab mob lupus erythematosus (ib hom kab mob collagen-vascular), tom qab ntawd ua kom tsis muaj zog.

• muaj tsawg heev (tsawg dua 1 nyob rau hauv 10,000 leej): mob angioedema (cov tsos mob xws li hawb pob, o ntawm lub ntsej muag lossis tus nplaig, khaus khaus lossis tawm pob ntawm daim tawv), ua rau lub cev qhuav dej ntau dua rau cov neeg laus thiab cov neeg mob plawv tsis ua haujlwm. Yog tias daim siab ua haujlwm (daim siab mob siab), qhov pib ntawm encephalopathy ntawm daim siab (ua rau mob hlwb tawg) yuav ua tau. Kev ua txhaum hauv cov ntshav, ob lub raum, nplooj siab, tus txiav, lossis hloov hauv chav kuaj (kuaj ntshav) yuav tshwm sim. Koj tus kws kho mob yuav sau ntawv mus kuaj ntshav los kuaj xyuas koj tus mob.

Tsis txhob noj cov tshuaj no tam sim ntawd thiab hu rau koj tus kws kho mob yog tias koj muaj ib qho ntawm cov kev mob hauv qab no: koj lub ntsej muag, daim di ncauj, qhov ncauj, tus nplaig lossis lub caj pas o tuaj, koj ua pa nyuaj, koj xav tias kiv taub hau lossis koj tsis nco qab, koj lub plawv dhia ceev ceev lossis txawv txav.

Yog tias muaj cov kev mob tshwm sim loj heev los sis yog tias koj pom qhov tshwm sim tsis xav yuav uas tsis muaj npe hauv phau ntawv no, qhia rau koj tus kws kho mob lossis kws muag tshuaj.

Kev cuam tshuam nrog lwm yam tshuaj

Zam kev siv cov tshuaj NOLIPREL A nrog cov tshuaj hauv qab no:

• lithium (siv los kho kev ntxhov siab),

• potassium-sparing diuretics (spironolactone, triamteren), ntsev qab ntsev.

Txoj kev kho nrog NOLIPRELOM A yuav cuam tshuam los ntawm kev siv lwm yam tshuaj.

Nco ntsoov qhia koj tus kws kho mob yog tias koj noj cov tshuaj hauv qab no, vim tias koj yuav tsum tau ceev faj tshwj xeeb thaum noj lawv:

• cov tshuaj uas siv los kho mob tawg,

• procainamide (rau kev kho mob ntawm lub plawv tsis xwm yeem),

• allopurinol (rau kev kho mob gout),

• Terfenadine lossis astemizole (antihistamines los kho kev kub taub hau lossis ua xua),

• corticosteroids, uas yog siv los kho ntau yam mob, suav nrog mob hawb pob thiab mob pob qij txha,

• cov tshuaj tiv thaiv kab mob uas tau siv los kho qhov mob autoimmune los yog tom qab phais mob txhawm rau tiv thaiv kev tsis lees txais (piv txwv, cyclosporin),

• cov tshuaj kws kho kho cancer,

• erythromycin txhaj tshuaj (tshuaj tua kab mob),

• halofantrine (siv los kho qee hom mob npaws),

• pentamidine (siv los kho mob ntsws),

• vincamine (siv rau cov kev mob tshwm sim ntawm kev txawj ntse ntawm cov neeg laus cov neeg laus),

• bepridil (siv los kho angina pectoris),

• sultopride (tshuaj tiv thaiv kev puas tsuaj),

• cov tshuaj uas tau kho hauv kev kho lub plawv ntxhov siab (piv txwv li, quinidine, hydroquinidine, disopyramide, amiodarone, sotalol),

• digoxin (kho mob plawv),

• baclofen (rau kev kho mob leeg txhav, uas tshwm sim hauv qee cov kab mob, piv txwv, nrog sclerosis),

• cov tshuaj ntshav qab zib, xws li insulin lossis metformin,

• cov tshuaj sim plab (piv txwv li, senna),

• cov tshuaj uas tsis yog tshuaj steroidal (piv txwv li, ibuprofen) los yog muaj koob tshuaj salicylates ntau (piv txwv li tshuaj aspirin),

• amphotericin B leeg ntshav (rau kev kho mob ntawm tus kab mob fungal loj),

• tshuaj rau kev kho mob hauv kev puas hlwb, xws li kev nyuaj siab, ntxhov siab, mob schizophrenia, thiab lwm yam (piv txwv li, peb ntu kev tiv thaiv tiv thaiv kab mob, kev tiv thaiv kabmob hlwb),

• tetracosactide (rau kev kho mob ntawm Crohn's disease).

Daim ntawv thov nta

Noj NOLIPREL A nrog zaub mov thiab haus

Nws yog qhov zoo dua rau noj NOLIPREL A ua ntej noj mov.

Tsav tsheb thiab tswj cov tshuab: NOLIPREL A tsis cuam tshuam qhov tsis saib xyuas, tab sis nyob rau qee tus neeg mob, vim tias ntshav siab dhau los, muaj ntau yam tshwm sim tuaj yeem tshwm sim, piv txwv li kiv taub hau lossis tsis muaj zog. Yog li ntawd, lub peev xwm ntawm kev tsav lub tsheb lossis lwm cov tshuab yuav raug tsis taus.

Cov ntaub ntawv tseem ceeb ntawm qee cov khoom xyaw hauv NOLIPREL A

NOLIPREL A muaj lactose, yog tias tus kws kho mob tau hais koj tias koj tsis txaus siab rau qee yam piam thaj, ces sab laj nrog koj tus kws kho mob ua ntej pib siv cov tshuaj no.

Kev tiv thaiv kev nyab xeeb

• yog tias koj muaj mob aortic stenosis (txoj hlab ntshav loj tuaj ntawm lub plawv), hypertrophic cardiomyopathy (mob plawv) lossis mob raum artery stenosis (ua kom txoj hlab ntshav muab ntshav rau lub raum),

• Yog koj tau mob los ntawm lwm lub plawv lossis raum mob,

• Yog hais tias koj raug kev txom nyem los ntawm lub siab ua tsis taus haujlwm,

• Yog tias koj raug mob los ntawm tus kab mob collagen vascular xws li kab mob lupus erythematosus lossis scleroderma,

• Yog tias koj raug mob los ntawm atherosclerosis (tawv ntawm phab ntsa ntawm cov hlab ntsha),

• Yog tias koj raug mob los ntawm hyperparathyroidism (parathyroid caj ces ua haujlwm),

• yog tias koj raug mob gout,

• yog tias koj muaj ntshav qab zib,

• Yog koj tau noj ntsev qis los yog noj ntsev uas muaj cov poov tshuaj,

• Yog tias koj noj tshuaj lithium lossis potassium-sparing diuretics (spironolactone, triamteren), uas koj yuav tsum tsis txhob noj ib txhij nrog NOLIPREL A (saib kev noj lwm yam tshuaj).

Thaum koj noj NOLIPREL A, koj yuav tsum qhia rau koj tus kws saib xyuas kev noj qab haus huv lossis cov neeg ua haujlwm kho mob txog cov hauv qab no:

• Yog tias koj muaj tshuaj loog lossis phais ib qho loj,

• yog tias koj nyuam qhuav ntuav lossis ntuav,

• Yog tias koj tau raug mob ntawm LDL (kho kho cov roj hauv cov ntshav),

• Yog tias koj hla tawm qhov tso zis, uas yuav tsum txo qhov kev tsis haum rau ntab lossis ntxig quav,

• Yog tias koj tab tom kuaj mob, uas yuav tsum muaj cov tshuaj radiopaque uas muaj tshuaj (cov khoom uas ua rau nws tuaj yeem kuaj xyuas cov khoom nruab nrog sab hauv, xws li lub raum lossis lub plab, siv xoo hluav taws xob).

Cov neeg ncaws pob yuav tsum paub tias NOLIPREL A muaj cov khoom siv tsis ua hauj lwm (indapamide), uas tuaj yeem ua rau muaj kev cuam tshuam zoo thaum tswj hwm kev haus yeeb tshuaj.

NOLIPREL A yuav tsum tsis txhob raug siv rau menyuam yaus.

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Cov tshuaj yog tsim nyob rau hauv daim ntawv ntawm cov yeeb yaj kiab-cov ntsiav tshuaj: oblong, dawb, nrog kev pheej hmoo ntawm ob sab (14 lossis 30 txhua qhov hauv cov polypropylene lub raj mis nruab nrog lub thoob thiab cov nres uas muaj cov dej noo-nqus gel, hauv ib lub thawv ntawv sau nrog cov thawj qhib tswj 1 lub raj mis ib 14 pcs., 1 lossis 3 fwj ntawm 30 pcs., Rau cov tsev kho mob - hauv daim npav ntoo ntawm 30 lub raj mis, hauv daim ntawv thawv ntawv nrog lub qhov qhib thawj tswj 1 pallet thiab cov lus qhia siv Noliprel A).

1 ntsiav tshuaj muaj:

• cov khoom siv ua haujlwm: perindopril arginine - 2.5 mg (sib raug rau cov ntsiab lus ntawm perindopril hauv cov nyiaj ntawm 1.6975 mg), indapamide - 0.625 mg,
• cov tshuaj ntxiv: lactose monohydrate, anhydrous colloidal silicon dioxide, sodium carboxymethyl hmoov txhuv nplej siab (hom A), maltodextrin, magnesium stearate,
• zaj duab xis txheej: premix rau txheej SEPIFILM 37781 RBC glycerol, macrogol 6000, hypromellose, titanium dioxide (E171), magnesium stearate, macrogol 6000.

Cov Tshuaj Hauv Tshuaj

Noliprel A yog kev npaj ua ke uas cov cov khoom siv sib xyaw ua ke yog cov tshuaj angiotensin hloov kho enzyme (ACE) inhibitor thiab diuretic, uas yog ib feem ntawm sulfonamide derivative pawg. Noliprel A muaj cov tshuaj pharmacological vim yog qhov txiaj ntsig ntawm pharmacological ntawm txhua qhov ntawm nws cov khoom siv, nrog rau lawv cov txiaj ntsig ntxiv.

Perindopril yog ib qho ACE inhibitor (kinase II). Qhov enzyme no hais txog exopeptidases uas hloov angiotensin I rau hauv vasoconstrictor tshuaj, angiotensin II, nrog rau cov kev puas tsuaj ntawm bradykinin peptide uas dilates cov hlab ntsha mus rau ib qho tsis txaus heptapeptide.

Qhov tshwm sim ntawm perindopril yog:

• tsawg dua aldosterone secretion,
• nce plasma renin kev ua haujlwm raws li lub hauv paus ntsiab lus ntawm cov lus tsis zoo
• ib qho kev txo qis hauv tag nrho peripheral vascular tsis kam (OPSS), nrog kev siv lub sijhawm ntev, cuam tshuam nrog kev ua haujlwm ntawm cov hlab ntsha hauv cov leeg thiab ob lub raum.

Cov teebmeem no tsis ua rau kom cov ntsev thiab kua dej rov qab lossis kev txhim kho reflex tachycardia. Perindopril ua kom pom kev muaj txiaj ntsig hypotensive ob qho tib si ntawm kev qis thiab ib txwm plasma renin kev ua si. Nws tseem ua rau kom muaj qhov tsis zoo ntawm cov leeg plawv plawv, txo qis ua ntej thiab tom qab. Hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev (CHF), nws ua rau txo qis OPSS, kev txo qis hauv kev txhaws hauv lub plawv sab laug thiab txoj hlab ntsws ntawm lub plawv, qhov nce ntawm cov hlab plawv tawm, thiab nce ntxiv ntawm cov leeg cov hlab ntshav.

Indapamide - ib qho diuretic rau cov pab pawg ntawm sulfonamides, muaj cov tshuaj pharmacological zoo ib yam li cov thiazide diuretics. Raws li qhov tshwm sim ntawm kev txwv tsis pub rov qab kho cov sodium ions nyob rau hauv lub cortical ntu ntawm Henle voj, cov khoom pab ua rau kom muaj qhov feem ntau ntawm cov tshuaj chlorine, sodium, thiab kom tsawg dua li magnesium thiab potassium ions los ntawm ob lub raum, ua rau cov zis muaj zog thiab txo cov ntshav siab (BP).

Noliprel A yog qhov txawv txav ntawm cov txiaj ntsig-koob tshuaj hypotensive rau 24 teev rau ntawm ob leeg diastolic thiab systolic ntshav siab rau hauv txoj haujlwm sawv thiab hauv txoj haujlwm supine. Qhov yuav txo qis nyob rau hauv cov ntshav siab yog ua tiav tsawg dua li ib hlis tom qab pib kho thiab tsis yog nrog cov tsos ntawm tachycardia. Kev tsis kam lees noj tshuaj tsis ua rau muaj tus mob rho tawm.

Noliprel A muab qhov txo qis hauv qib ntawm sab laug ventricular hypertrophy (GTL), kev txhim kho ntawm kev ywj pheej ntawm cov hlab ntsha, qhov txo qis hauv OPSS, nws tsis cuam tshuam rau lipid metabolism ntawm triglycerides, tag nrho cov roj (cholesterol), qis lipoprotein (LDL) thiab ntshav roj (HDL) ntau.

Cov nyhuv ntawm kev ua ke ntawm kev siv perindopril thiab indapamide ntawm GTL tau tsim los sib piv nrog enalapril. Hauv cov neeg mob nrog GTL thiab kev mob ntshav ntawm cov ntshav, noj 2 mg perindopril erbumin (sib npaug rau perindopril arginine ntawm koob tshuaj 2.5 mg) / indapamide 0.625 mg lossis enalapril 10 mg 1 lub sijhawm hauv ib hnub, nrog nce ntxiv ntawm perindopril erbumin txog 8 mg (sib npaug rau perindopril arginine txog 10 mg) / indapamide txog li 2.5 mg lossis enalapril txog 40 mg ib zaug ib hnub; hauv pawg perindopril / indapamide, ntau tshaj tawm txo nyob rau sab laug ventricular huab cua Performance index (LVMI) tau muab piv nrog pawg enalapril. Cov txiaj ntsig tseem ceeb ntawm LVMI tau pom thaum kho nrog perindopril nrog erbumin 8 mg / indapamide 2.5 mg.

Ib cov lus tshaj tawm los tiv thaiv kev tiv thaiv kuj tau pom hauv kev kho mob sib xyaw nrog perindopril thiab indapamide piv nrog enalapril.

Hauv cov neeg mob uas muaj hom 2 mob ntshav qab zib mellitus, cov cim taw qhia: ntshav siab - 145/81 hli RT. Art., Lub cev huab hwm coj Performance index (BMI) - 28 kg / m², glycosylated hemoglobin (HbA1c) - 7.5%, hnub nyoog - 66 xyoo kawm txog qhov cuam tshuam ntawm lub ntsiab micro- thiab macrovascular muaj teeb meem thaum kho nrog kev sib txuam ntawm perindopril / indapamide ua ib qho txuas kom txheem glycemic tswj kev kho mob, thiab raws li kev siv glycemic tswj (IHC) cov tswv yim (phiaj HbA1c

Pharmacokinetics thiab cov chaw muag tshuaj

Tus pharmacokinetics ntawm perindopril thiab indapamide thaum siv los ua ke yog tib yam li thaum siv cais. Tom qab lub qhov ncauj tswj hwm, perindopril yog sai adsorbed. Qib qeb kev nyab xeeb yog 65-70%. Kwv yees li 20% ntawm tag nrho cov tshuaj perindopril tom qab hloov dua siab tshiab rau perindoprilat (ib qho kev siv ua kom zoo). Qhov siab tshaj plaws ntawm perindoprilat hauv ntshav tau pom tom qab 3-4 teev. Tsawg dua 30% khi rau cov qe ntshav, nyob ntawm lub ntsiab ntawm cov ntshav ntshav. Ib nrab-lub neej yog 25 teev. Los ntawm cov nyom placental, cov tshuaj nkag mus. Perindoprilat ua tawm hauv lub cev los ntawm lub raum. Ib nrab-lub neej ntawm nws yog 3-5 teev. Muaj kev tswj hwm qeeb qeeb ntawm perindoprilat hauv cov neeg laus, nrog rau cov neeg mob lub plawv tsis ua haujlwm thiab lub raum tsis ua haujlwm.

Indapamide kiag li thiab kuj sai sai nqus los ntawm cov hnyuv. Qhov siab tshaj plaws ntawm ib yam khoom hauv ntshav yog pom ib teev tom qab kev tswj hwm ntawm qhov ncauj.

Nrog cov plasma protein, cov tshuaj khi rau 79%. Qhov kev tshem tawm ib nrab-lub neej yog 19 teev. Cov tshuaj tawm hauv cov roj ntsha hauv lub cev ua kom lub cev tsis ua haujlwm los ntawm lub raum (kwv yees li 70%) thiab cov hnyuv (kwv yees li 22%). Hauv cov neeg muaj lub raum tsis ua haujlwm, kev hloov pauv hauv chaw muag tshuaj ntawm cov tshuaj yeeb yam tsis pom.

Cov lus qhia rau kev siv Noliprel

Kev qhia rau kev siv tshuaj tau sau tseg:

• qhov tseem ceebntshav siab,
• qhov xav tau kom txo tau kev pheej hmoo ntawm microvascular cov teeb meem hauv cov neeg muaj lub raum, vascular, thiab kab mob plawv uas raug mobleeg ntshav siabli qub mob ntshav qab zib hom ob.

Sab sij huam

• Hauv kev ua haujlwm ntawm cov hlab plawv: Mob siab ntsws hypotension, orthostatic cev qhuav dej, nyob rau hauv tsis tshua muaj mob: arrhythmia, mob stroke, myocardial infarction.
• Nyob hauv txoj haujlwm ntawm genitourinary system: Lub raum khiav tsis zoo, proteinuria hauv cov neeg muaj tus mob glomerular nephropathy, muaj qee zaus, mob raum tsis ua haujlwm. Muaj peev xwm tsawg.
• Hauv cov haujlwm ntawm qhov nruab nrab thiab nruab nrab NS: qaug zog, kiv taub hau, mob taub hau, asthenia, tsis txaus ntseeg, tsis hnov ​​lus, hnov ​​lus, tsis pom kev, qis qis, qee zaum - zais.
• Nyob hauv txoj haujlwm ntawm lub tshuab ua pa: hnoos, ua pa ua pa, bronchospasm, mob ntswg.
• Hauv cov haujlwm ntawm txoj hnyuv zom zaub mov: mob plab zom mov, mob plab, pancreatitis, cholestasis, nce kev ua haujlwm ntawm transaminases, hyperbilirubinemia.
• Hauv cov haujlwm ntawm cov ntshav: tiv thaiv keeb kwm yav dhau los ntawm hemodialysis lossis tom qab lub raum hloov pauv, cov neeg mob yuav ua mob qog ntshav, tsis tshua muaj mob, thrombocytopenia, pancytopenia, agranulocytosis, hemolytic anemia.
• Ua xua qhov tshwm sim: daim tawv nqaij khaus, tawm pob, edema, urticaria.
• Cov neeg mob nrog rau daim siab tsis muaj peev xwm ua tau rau tus mob hepatic encephalopathy. Hauv cov neeg muaj kev cuam tshuam nrog dej-electrolyte tshuav, hyponatremia, hypovolemia, hypokalemia, lub cev qhuav dej tuaj yeem tshwm sim.

Cov lus qhia rau siv Noliprel (txoj kev thiab qhov ntau npaum li cas)

Noliprel ntsiav tshuaj yog qhov zoo dua thaum sawv ntxov. Cov tshuaj yog sau ntawv rau ib ntsiav tshuaj ib hnub. Cov lus qhia rau Noliprel Forte muab cov qauv kev kho mob zoo sib xws. Noliprel A thiab Noliprel A Bi Forte raug kho rau cov neeg mob ntawm 1 ntsiav tshuaj ib hnub. Yog tias nyob hauv cov neeg mob creatinine tshem tawm muaj sib npaug lossis ntau dua 30 ml / min, ces tsis tas yuav txo qhov tshuaj. Yog tias kev tshem tawm yog sib npaug lossis ntau dua 60 ml ib hnub, tom qab ntawd thaum kho nws yog qhov yuav tsum tau ua tib zoo saib xyuas theem ntawm poov tshuaj thiab creatinine hauv cov ntshav.

Yog tias tsim nyog, tom qab ntau lub hlis ntawm kev kho mob, tus kws kho mob tuaj yeem nce qhov ntau ntxiv los ntawm sau ntawv Noliprel A Forte lossis lwm hom tshuaj no hloov Noliprel.

Noj ntau dhau

Nrog kev noj tshuaj ntau dhau, muaj qhov ua kom lub zog txo qis, xeev siab, ntuav,kiv taub hau, kev xav hauv lub siab tsis tuaj yeem, cov tsos mob ntawm lub raum tsis ua haujlwm, hluav taws xob tsis txaus. Hauv qhov no, nws yog ib qho tsim nyog yuav tsum tau rov qab tam sim ntawd cov dej-electrolyte sib npaug rau qhov qub, yaug lub plab, noj cov tshuaj enterosorbents. Noliprel metabolites tuaj yeem tshem tawm uas siv lim. Yog tias tsim nyog, tso dej qab ntsev yog muab.

Yeem

Ntawm kev txais tos Noliprela tsim nyog lub cev qhuav dej ntawm lub cev yog qhov xav tau, txij li thaum txoj kev txhim kho ntawm kev ua haujlwm hypotension hnyav yog tau.
Cov tshuaj yog tswj hwm hauv qab tswj qhov ntsuas electrolytes, creatinine thiab ntshav siab.
Nrog concomitant lub siab tsis ua haujlwm tuaj yeem ua ke nrog beta-blockers.
Noj noliprel muab txoj kev xav zoo thaum ua kev sim ntsuas rau tshuaj doping.
Kev ceev faj yuav tsum tau siv thaum tsav tsheb lossis kev siv lub tshuab ntsuas kev ntsuas siab, tshwj xeeb tshaj yog nyob rau thawj lub lim tiam ntawm kev txais neeg kawm.

Cov lus qhia tshwj xeeb

Cov neeg uas tau muab tshuaj kho nrog Noliprel xav tau lub cev qhuav dej kom txaus lub cev kom tiv thaiv qhov txo qis hauv lub siab.

Cov neeg muaj lub plawv tsis zoo tuaj yeem kho nrog beta-blockers tib lub sijhawm.

Thaum kho nrog Noliprel, cov tshuaj tiv thaiv zoo tau sau tseg thaum kuaj doping.

Hauv thawj lub lis piam ntawm kev kho, nws yog ib qho tseem ceeb kom ua tib zoo tsav tsheb los yog ua haujlwm nrog cov txheej txheem npliag thaum kho nrog Noliprel.

Yog tias qhov tseem ceeb txo qis hauv lub siab tau sau tseg thaum kho, kev tswj hwm ntawm 0.9% sodium chloride txhaj tshuaj yuav tsum tau ua.

Kev kho mob ntawm cov neeg mob uas muaj mob rau lub hlwb lossis nrog mob plawv plawv koj yuav tsum tau pib mob me me ntawm Noliprel.

Hauv cov neeg uas muaj ntshav uric acid siab nyob hauv cov ntshav, txoj kev pheej hmoo ntawm kev pheej hmoo ntawm kev tsim Noliprel yog mob gout.

Cov lus qhia ntawm Noliprel

Analogs ntawm Noliprel, zoo li cov tshuaj Noliprel A Be Forte, Noliprel A Forte yog lwm yam tshuaj uas siv los txo cov ntshav siab thiab muaj cov tshuaj zoo sib xws, uas yog, perindopril thiab indapamide. Cov tshuaj no yog cov tshuaj siv Co-prenesa, Pheej Yig thiab lwm yam Tus nqi ntawm cov analogues yuav qis dua tus nqi ntawm Noliprel thiab nws ntau yam.

Cov tshuaj tsis tau sau tseg rau kev kho mob rau cov menyuam yaus hnub nyoog qis dua 18 xyoo, vim tias tsis muaj ntaub ntawv qhia meej txog kev ua haujlwm thiab kev nyab xeeb ntawm kev kho mob.

Thaum cev xeeb tub thiab lactation

Cov poj niam cev xeeb tub thiab niam nyob thaum kev pub mis siv cov Noliprel hauv niam mis yog contraindicated. Kev kho cov kab mob hauv nruab nrog cev yuav ua rau kev txhim kho ntawm qhov txawv txav thiab kab mob ntawm tus menyuam hauv lub cev, tuaj yeem ua rau tus menyuam tuag. Yog tias tus poj niam pom txog kev cev xeeb tub nyob rau lub sijhawm kho, tsis tas yuav muaj kev cuam tshuam thaum cev xeeb tub, tab sis tus neeg mob yuav tsum paub txog cov xwm txheej yuav muaj tshwm sim. Thaum muaj ntshav nce ntxiv, lwm txoj kev kho mob ua ke tiv thaiv kab mob. Yog tias tus poj niam tau noj cov tshuaj no hauv qib thib ob thiab thib peb, txoj haujlwm xaj hluav taws xob ntawm tus me nyuam hauv plab yuav tsum tau ua los ntsuas tus mob ntawm nws lub pob txha taub hau thiab lub raum kev ua haujlwm.

Cov menyuam mos uas lawv niam noj cov tshuaj yuav raug kev txom nyem los ntawm cov ntshav txoj hlab ntshav hypotension, yog li ntawd lawv yuav tsum xyuas kom muaj kev soj ntsuam tas li los ntawm cov kws tshwj xeeb.

Thaum pub mis niam, cov tshuaj yog contraindicated, yog li ntawd, lactation thaum txoj kev kho yuav tsum tau nres lossis lwm yam tshuaj yuav tsum tau xaiv.

Kev txheeb xyuas ntawm Noliprel

Kev txheeb xyuas cov lus sib tham txog Noliprel, nrog rau cov tshuaj Noliprel A, Noliprel A Fort, Noliprel A Bi Forte qhia tias cov tshuaj no ua rau cov ntshav qis. Cov tshuaj kho mob ntshav siab, txo qhov ntxim nyiam ntawm kev mob hlab ntsha tawg thiab myocardial infarction.

Kev tshuaj xyuas ntawm Noliprel Forte feem ntau kuj muaj cov ntaub ntawv qhia tias cov tshuaj no thiab nws lwm yam muaj cov txiaj ntsig zoo hauv lwm qhov chaw uas lwm qhov tshuaj tsis muaj txiaj ntsig. Qee lub sij hawm cov neeg mob nco ntsoov txhim kho qee qhov kev mob tshwm sim, tshwj xeeb, hnoos qhuav, mob taub hau, tab sis lawv tsis khaus heev.

Cov kws kho mob tseem nco ntsoov cov txiaj ntsig zoo ntawm cov tshuaj, tab sis nco ntsoov nco ntsoov tias cov tshuaj yuav tsum tau coj nruj raws li cov lus qhia thiab ua raws li cov lus pom zoo ntawm tus kws tshaj lij. Hauv kev tshwj xeeb, cov tshuaj yuav tsum noj tsis tu ncua, thiab tsis tas thaum lub sijhawm tawg siab hauv cov ntshav siab.

Noliprel nqe, qhov twg yuav

Tus nqi ntawm Noliprel yog qhov nruab nrab ntawm 500 rubles rau pob ntawm 30 pcs. Tus nqi hauv Moscow rau Noliprel A yog los ntawm 500 txog 550 rubles. Tus nqi ntawm Noliprel Forte yog los ntawm 550 rubles rau ib pob. Noliprel A Forte 5 mg tuaj yeem yuav tom tus nqi ntawm 650 rubles. Tus nqi ntawm Noliprel A Bi Forte yog los ntawm 700 rubles. ib pob 30 pcs.