Ua li cas thiab thaum twg kuv yuav tsum noj Hartil ntsiav tshuaj?

Hartil-D yog antihypertensive cov tshuaj uas tseem muab tshuaj kho mob ntawv. Antihypertensive qhov kev txiav txim ntawm cov tshuaj nquag ntawm cov tshuaj yog sib txuam, thaum lub sijhawm ramipril txo qis hypokalemic nyhuvhydrochlorothiazide.

Pharmacodynamics thiab pharmacokinetics

Cov nquag ua ke ntawm cov cuab yeej no tau siv rau ntshav siab.

Ramiprilat (nquag ramipril metabolite) muaj kev nyuaj siab ACECov. Ntxiv rau, nws txo emissions. aldosterone. Ramipril kuj ua rau neeg txo qis peripheral vascular tsis kam.

Feem ntau antihypertensive qhov kev txiav txim yog pom tom qab 1-2 teev. Nws mob tsawv rau ib hnub. Qhov siab tshaj plaws ntawm kev ua haujlwm loj yog ua tiav tom qab 3-6 teev. Nrog kev kho mob ntev, qhov siab tshaj plaws feem ntau pom tau tom qab kwv yees li 3 lub lis piam. Nrog rau cov kev kho mob ntev ntev, nws tau tswj hwm tau 2 xyoo.

Hydrochlorothiazide tshwm sim thiazide diureticCov. Qhov xwm txheej zoo ntawm nws antihypertensive kev ua xws li hloov cov ntsev tshuav thiab kev tiv thaiv ntawm cov hlab ntsha hauv lub plawv, ntxiv rau txo cov theem ntawm cov kua dej ntxiv, ntshav, thiab cov tshuaj tiv thaiv angiotensin II thiab norepinephrine.

Qhov siab tshaj plaws tau pom tshwm sim tom qab 3-6 teev thiab kav ntev txog 12 teev. Antihypertensive cov nyhuv tau tiav tom qab 3-4 hnub ntawm kev kho mob thiab kav ib lub lim tiam tom qab ua tiav kev ua tiav. Nrog lub sijhawm ntev kho, qhov tsawg dua ntshav siab ua tiav los ntawm kev siv cov tshuaj me dua li tsim nyog rau tshuaj kho mob nyhuv. Txo ntshav siab muaj qhov nce me ntsis hauv kev nrawm glomerular pomkev ua si renin hauv ntshav ntshav ib yam nkaus vascular tsis kam ntawm lub raum pwCov. Thaum siv hydrochlorothiazide hauv cov tshuaj siab, ntshav ntim thiab nrawm yog txo glomerular pom, txhais tias ntshav siab thiab lub raum khiav ntshav. Nrog lub caij nyoog ntev hauv kev kho mob me me, qhov ntau ntawm cov ntshav ntshav, mauj lub cev tsis kam thiab txhais tias ntshav siab nyob qis qis txaus nyob rau tib lub sijhawm ceev glomerular pom thiab feeb ntim rov qab mus rau qhov ntsuas yav dhau los.

Cov Yuav Tsum Muaj

Cov cuab yeej no tsis pom zoo siv nrog:

• cholestasis,
• Quincke's edema hauv keeb kwmas Well as cov muaj keeb / idiopathic,
• teeb meem tseem ceeb nrog lub raum ua haujlwm,
• anusia,
• thawj aldosteronism,
• hemodialysis,
• intolerance galactose,
• roj ntsha tsis muaj peev xwm lactases lossis nyob rau hauv rooj plaub ntawm malabsorption piam thaj galactose,
• pub niam mis,
• cev xeeb tub,
• thaum yau
• teeb meem loj hauv lub siab,
• arterial hypotension,
• mob tom qab hloov raum,
• intolerance mus rau Cheebtsam ntawm cov tshuaj.

Nrog kev ceev faj, Hartil-D yog qhov tsim nyog rau aortic thiab mitral stenosis, cov kab mob ntawm cov kabmob ntawm cov nqaij mob sib txuas, mob txhab rau ntawm cov hlab ntshav txhaws thiab hlab hlwb, decompensated "pulmonary plawv", mob ventricular arrhythmias ntau, inhibition ntawm pob txha hlwb hematopoiesis, ob leeglub raum leeg mob stenosis, mob gout, tshuaj mob siab ntsws, hypercalcemia, lub raum tsis ua hauj lwm, mob ntswstsis khov angina pectorismob ntev lub plawv tsis ua hauj lwm (theem plaub), txo qis Bcc, mob ntshav qab ziblaus lawm hypertrophic obstructive cardiomyopathy, hyperkalemia, ib lub raum artery stenosis, hypokalemia, Ischemic mob plawv, daim siab ua hauj lwm.

Sab sij huam

Thaum noj cov tshuaj thaum pib kho thiab tom qab ntau zog tshuaj, hais tawm arterial hypotensionCov. Cov tsos mob tuaj yeem suav nrog kiv taub hauqhov muag plooj ua ntej, qhov ua kom tsis muaj zog, tsaus muag. Tsis tas li ntawd, ib tug neeg kis ntawm kev sib tsoo ntawm cerebrovascular tau raug tshaj tawm, tachycardia, arrhythmias, myocardial infarctionkev hais tawmleeg ntshav siab, angina pectoris thiab poob siab. Thaum siv ACE inhibitors ntawm arterial hypotension muaj peev xwm ua hemorrhage hauv lub hlwb thiab ischemic mob stroke.

Cov kev mob tshwm sim hauv qab no kuj yog:

• metabolism - hyperglycemiantxiv cov qib acid hypokalemia, mob gout, hyperkalemia, hypomagnesemia, hypercalcemia, tshuaj mob siab ntsws, hyperchloremia,
• cov leeg hlwb - apathykev tshee mob taub hauqaug zog, zoo nkaus li qaug zog, tsaug zog,
• kabmob ntawm lub zeem muag - pom mob pob txha, blepharitis,
• hlab plawv system - muaj qhov tseem ceeb txo ntshav siab, o tuaj qij taws
• kev ua pa - qhov pom ntawm hnoos qhuav, mob ntsws,
• plab zom mov - xeev siab, ntuav, mob plab, dyspepsiacramping nyob rau hauv epigastric cheeb tsam, cem quavdulling qab los noj mov, nqhis dej, zawv plab,
• daim tawv nqaij integument - urticaria, photosensitization, khaus,
• qhov system urinary - tshuaj proteinuria,
• kev muaj me nyuam - txo qis libido.

Tsawg tsawg zaus, cov hauv qab no muaj peev xwm ua tau:

• circulatory system thiab cov lymph - txo hauv cov ntsiab lus hematocrit thiab hemoglobin, thrombocytopenia, eosinophilia, leukopenia, tus mob pancytopenia, agranulocytosis,hemolytic anemia (muaj tsis txaus piam thaj-6-phosphate dehydrogenase),
• cov metabolism thiab khoom noj khoom haus - dej tsis haum-electrolyte tshuav, metabolic alkalosis, tshuaj tiv thaiv hypochloremiance cov ntsiab lus triglycerides hauv ntshav dej thiab ntshav dej amylases, hypercholesterolemiadecompensation mob ntshav qab zib mellitus,
• cov leeg hlab ntsha - kev ntxhov siab, tsis txaus ntseeg, tsw ntxhiab tsw, paresthesia,
• kabmob ntawm lub zeem muag - sijhawm myopia,
• lub cev hnov ​​- nrov hauv pob ntseg,
• kev mob plawv rau lub cev - kev ua tsis zoo ntawm lub hlwb mus ncig, tsaus muag, muaj teeb meem thromboembolic, vasculitis, mob ntsws vwmkev txom nyem Raynaud's diseaseleeg ntshav kab mob embolism,
• kev ua pa - ua pa luv, rhinitis, glossitisua xua mob ntsws interstitial mob ntsws, mob hlab ntsws, pharyngitis, bronchospasm, Quincke's edemapulmonary edema
• lub plab zom mov - lub plab ntawm qhov hnyuv, qhov ncauj qhuav, saj ntxhias, sialadenitisntuav, o ntawm cov leeg nrog, hemorrhagic pancreatitis,
• mob siab - nce kev ua si bilirubin thiab mob siab enzymes, cholestatic mob daj ntseg, cholecystitis, kab mob siab, necrosis mob siab
• daim tawv nqaij integument - mauj lupus erythematosus, erythema multiforme, yaug ntsej muag, plhaw plhaw, tawm hws, Lyell cov tsos mobkev txom nyem psoriasis, Stevens-Johnson mob, kev fab tshuaj tsis haum, alopecia, onycholysis,
• musculoskeletal system thiab cov nqaij sib txuas - cov leeg nqaij pob txha, arthralgia, mob caj dab, myalgialeeg tsis muaj zog tuag tes tuag taw,
• cov kab mob hauv lub raum - lub raum khiav tsis zoo, lub cev qhuav dej, nce ntawm cov pa nitrogen ntau thiab ntshiab kev creatinine, cov tsos mob nephroticmob huam lub raum tsis ua hauj lwm, oliguria, interstitial nephritis,
• kev muaj me nyuam - impotence,
• lwm tus - anaphylactic kev tawm tsam.

Quincke's edema feem ntau tshwm sim hauv cov neeg mob ntawm cov haiv neeg Negroid. Ntxiv rau, ib pawg me muaj angioedema ntsej muag thiab oropharyngeal thaj chaw vim kev noj ACE inhibitors.

Nrog hais cov kev mob tshwm sim los ntawm daim tawv nqaij, koj yuav tsum sab laj ib tus kws tshaj lij.

Soj ntsuam kev kho mob yog qhia thaum twg dajntoo thiab muaj ntau ntxiv kev ua daim siab enzymes.

Cov lus qhia rau kev siv Hartil-D (Txoj kev thiab ntau npaum li cas)

Cov tshuaj yog npaj rau kev siv ib zaug thaum sawv ntxov nrog cov kua txaus. Cov lus qhia rau kev siv Hartil-D qhia tias kev noj mov tsis cuam tshuam rau nws cov nyhuv. Cov ntsiav tshuaj tsis tuaj yeem muab faib ua feem.

Siv lub cuab yeej no nkaus xwb tom qab tus kws kho mob xaiv tau ntau npaum li cas thiab kev coj txawv. Raws li txoj cai, 2.5 mg yog tau pib los pib qhov kev kawm ramiprilthiab 12,5 mg hydrochlorothiazideCov. Cov tshuaj kho yuav zoo ib yam lossis ob zaug siab dua, ntsig txog, rau txhua qhov tshuaj yeeb dej caw. Cov koob tshuaj nce ntxiv yog tias tsim nyog nrog luv nrog 3 lis piam. Pom zoo kom ntau kawg cov tshuaj ib hnub twg yog 5 mg. ramipril thiab 25 mg hydrochlorothiazide.

Rau cov neeg muaj hnub nyoog laus dua, nrog rau cov uas muaj teeb meem tsis zoo ntawm lub raum thiab mob siab, cov koob tshuaj ntawm txhua feem tau xaiv ib tus zuj zus ua ntej hloov mus rau cov tshuaj sib xyaw ua ke Khartil-D. Nws txoj kev muab tshuaj yuav tsum yog qhov tsawg kawg nkaus.

Noj ntau dhau

Thaum siv cov tshuaj no hauv kev noj tshuaj ntau npaum li cov cai, cov hauv qab no yog qhov ua tau: tso zis cia, ib qho tseem ceeb txo ntshav siabcramps arrhythmia, poob siab mob, txoj hnyuv khaus, electrolyte tsis txaus, coma, paresis, bradycardia, lub raum tsis ua hauj lwm.

Kev kho mob yog coj ntawm tus kheej. Raws li kev ntsuas dav dav, pais plab lav, sodium sulfate thiab qhib hluav ncaig hluav taws xob tuaj yeem raug kho. Ntxiv rau, kev txhawb nqa kev siv tau siv.

Ramipril tshem tawm ntawm lub cev los ntawm lim ntshav.

Nrog tus nqi tseem ceeb ntshav siab ntim ua kua yog rov qab los ntawm physiological saline. Yog tias qhov no tsis ua tiav cov txiaj ntsig yam xav tau, kev tswj hwm ntawm kev ua haujlwm yog muaj peev xwm ua tau. angiotensin II, kev ua noj ua hausCov. Nws yog ib qho tseem ceeb heev yuav tsum taug qab cov Bcc, KShchS, diuresis, theem cov electrolytes thiab ntshav qabzib hauv cov ntshav. Nrog mob hnyav bradycardia lub pacemaker yog ntsia. Ntawm hypokalemia cov qib potassium ib txwm yuav tsum tau rov qab los.

Lub neej hem thawj angioedema Cov kev siv hauv qab no:

• kev siv tshuaj subcutaneous txog 0.5 mg epinephrine lossis tswj kav dej kom qeeb adrenaline nrog tswjhwmECG thiab ntshav siab,
• taw qhia antihistamines tshuaj
• tswj hwm dej los yog intramuscular glucocorticoids,
• adrenaline tuaj yeem tsim nyog C₁ inactivatoryog hais tias tus neeg mob nws lub cev tsis muaj peev xwm.

Kev sib txuam

Sib txuam ua ke ramipril thiab tshuaj kho mob tej zaum yuav loj tuaj antihypertensive nyhuv. Tsis tas li ntawd, ib qho tseem ceeb txo yog ua tau. ntshav siabCov. Yog li nws pom zoo kom tsis txhob muaj kev sib koom ua ke.

Antihypertensive cov nyhuv yuav tau ua kom zoo dua thaum noj ramipril ib txhij nrog cov organic nitrates lossis vasodilatorsCov. Ntxiv rau, nws tsis muaj zog thaum noj. NSAIDsCov. Cov peev nyiaj no tseem tuaj yeem ua rau sib xyaw nrog ramipril tsis hnov ​​mob raum muaj nuj nqi. Nyob rau hauv tsawg zaus, pom lub raum tsis ua hauj lwmCov. Qhov kev pheej hmoo ntawm nws txoj kev loj hlob nce thaum noj Hartil-D nrog Allopurinol (tej zaum kuj tuaj yeem tshwm leukopenia) thiab CyclosporineCov. Kawg li kev zoo siab Lovastatinthiab trimethoprim tuaj yeem ua rau thiab hyperkalemia. Leukopenia kuj muaj kev txhim kho thaum Hartil-D los ua ke nrog Procainamide, txhaj tshuaj tiv thaiv kab mob thiab cytostatics.

Kev sib txuam ramipril nrog lithium npaj ua rau kev nce qib hauv cov ntshiab lithium ntau ntau, kev txhim kho ntawm kev ua rau muaj kuab lom yog ua tau. Kev sib xyaw ua ke no tsis pom zoo, tab sis yog tias nws muaj kev cia siab, kev saib xyuas ntawm tus neeg mob tus mob yuav tsum ua. Lithium intoxication tej zaum yuav mob heev dua thaum noj.thiazide diuretics.

Arterial hypotension amplified los ntawm kev sib cuam tshuam ramipril nrog qee qhov Tshuaj loog, tshuaj thaiv kabmob txhais tau tias thiab tricyclic cov tshuaj tiv thaiv kev ntxhov siab.

Qhov xwm txheej ntawm tus neeg mob yuav tsum tau saib xyuas thaum Hartil-D los ua ke nrog sympathomimeticsCov. Thiab thaum muaj kev sib cuam tshuam nrog tshuaj qog ntshav txhais tau tias tuaj yeem nce lawv cov nyhuv kom txog thaum zoo li ntawd ntshav qogCov. Qhov no yog qhov tshwj xeeb tshaj yog thaum pib ntawm txoj kev kho thiab nrog lub raum rov ua haujlwm.

Sib txuam ua ke lim ntshav nrog ACE inhibitors contraindicated, li no yuav ua rau anaphylactoid kev tawm tsam.

Hydrochlorothiazide thaum sib tham nrog Amphotericin B, GKSmob plab Carbenoxolonelossis Corticotropin tej zaum yuav ua rau electrolyte tsis txaus. Thiab thaum ua ke nrog calcium ntsev, cov tsos ntawm hypercalcemianrog lub siab glycosides – digital intoxication thiab hypokalemianrog Sotalolom – arrhythmianrog dej qab ntsev - nce lawv kev phiv tshuaj lom neeg nyob rau hauv nruab nrab lub paj hlwb.

Xuas hydrochlorothiazide txo los ntawm roj resins thiab Kauj ruamCov. Yog li ntawd, nruab nrab ntawm lawv kev txais neeg nws yog ib qho tsim nyog yuav tau ua kom muaj qhov sib nrug ntawm ib mus rau ob peb teev.

Cov tshuaj nquag no Hartil-D kuj tseem txhim kho cov nyhuv. tsis-depolarizing nqaij relaxants.

Ib yam ntxiv antihypertensive cov nyhuv ntawm cov tshuaj yog txo thaum ua ke nrog sodium tshuaj dawb.

Kev tshuaj xyuas txog Hartil-D

Kev tshuaj xyuas ntawm Hartil-D qhia tau hais tias qhov zoo ntawm cov tshuaj no. Nws cov nyhuv yog pom los ntawm qhov pib thaum kawg ntawm chav kawm. Qee tus neeg mob, txawm li cas los xij, yuav tsum tau ntsuas ntau npaum li cas, vim tias kev txo ntshav siab ntau dhau los tau. Tias yog vim li cas qhov cuab yeej no yuav tsum tsuas yog siv los ntawm kev saib xyuas ntawm tus kws tshaj lij. Yog tias ua raws li cov lus pom ntawm kws kho mob, nws tau txais txiaj ntsig zoo nrog leeg ntshav siab.

Nqe, qhov twg yuav

Tus nqi ntawm cov cuab yeej no hauv cov ntsiav tshuaj ntawm 2.5 mgramipril thiab 12,5 mg hydrochlorothiazide - txog 300 rubles. Tus nqi ntawm cov ntsiav tshuaj nyob rau hauv uas 5 mg ramipril thiab 25 mg hydrochlorothiazide - txog 400 rubles.

Txoj kev sib xyaw thiab cov tshuab ntawm kev txiav txim

Ib ntsiav tshuaj muaj nyob rau hauv nws muaj pes tsawg leeg cov tshuaj muaj zograws li ramipril hauv ib qho nyiaj ntawm 5 mg lossis 10 mg. Cov Pab Tub Koom Xeeblub Cheebtsam cov chaw kho mob yog:

• sodium bicarbonate,
• croscarmellose sodium,
• sodium stearyl fumarate,
• pregelatinized hmoov txhuv nplej siab
• lactose monohydrate,
• hlau oxide liab,
• hlau oxide daj.

Cov tshuaj muaj peev xwm muaj cov kabmob cardioprotective thiab angioprotective. Tsis tas li, cov tshuaj muaj peev xwm ua kom cov txheej txheem ntawm resorption ntawm cov ntshav txhaws nyob rau ntawm phab ntsa ntawm cov hlab ntsha, rhuav tshem cov plahaum plahaum, ua rau kom cov fibrinogen ntau thiab txo cov txheej txheem ntawm gluing cov hlwb ua ke, uas yog, platelet sib sau ua ke.

Qhov txiaj ntsig zoo ntawm kev noj Hartil ntsiav tshuaj pib ua kom pom tseeb tom qab 1-2 teev. Kev ua haujlwm ntawm cov tshuaj no tseem muaj nyob ntev li 24 teev. Cov khoom siv los tiv thaiv kab mob tsis zoo nyob ntawm tus tub los ntxhais, qhov hnyav thiab hnub nyoog ntawm tus neeg mob tau txais nws.

Thiab nyob rau hauv ntau dua kev nthuav dav txog ramipril thiab nws cov yam ntxwv pharmacological tuaj yeem nrhiav tau los ntawm saib cov yeeb yaj kiab tom ntej.

Daim ntawv tso tawm

Cov tshuaj yog nyob rau hauv daim ntawv foos. Hauv cov khw muag tshuaj koj tuaj yeem yuav cov ntawv ntim khoom, uas suav nrog xya lub teeb liab lossis paj yeeb-xim liab hauv cov hlwv.

Cov ntsiav tshuaj lawv tus kheej muaj ib lub vojvoog kheej kheej, ntawm lawv nto koj tuaj yeem pom tus engraving "R3". Cov tshuaj no muaj 5 mg ntawm lub ntsiab tseem ceeb tshuaj - ramipril.

Tsis tas li ntawd nyob rau hauv cov chaw muag tshuaj koj tuaj yeem yuav ib pob xya pob tshuaj dawb ntawm lub ntsej muag zoo ib yam, tab sis nrog engraving "R4", uas txhais tau tias kev npaj muaj 10 mg ntawm lub ntsiab tseem ceeb xyaw.

Dab tsi yog Hartil ntsiav tshuaj noj?

Cov kws kho mob sau ntawv muab tshuaj rau cov neeg mob uas muaj kab mob xws li:

• leeg ntshav siab
• mob plawv tsis ua hauj lwm
• ntshav qab zib nephropathy,
• lub plawv tsis ua haujlwm los ntawm kev mob plawv.

Kev kho plawv tshwj xeeb sau tseg tias kev noj cov tshuaj txo cov kev pheej hmoo ntawm lub plawv nres thiab hlab ntsha tawg, txawm tias cov neeg mob uas tau phais.

Cev xeeb tub thiab lactation

Cov tshuaj Hartil-D yog contraindicated thaum cev xeeb tub, yog li qhov tseem ceeb ntawm kev xeeb tub yuav tsum tau muab cais tawm ua ntej pib nws. Yog tias tus neeg mob npaj yuav cev xeeb tub, nws yuav tsum tsis txhob noj ACE inhibitors thiab hydrochlorothiazide thiab hloov lawv nrog lwm cov tshuaj tiv thaiv kabmob. Yog tias cev xeeb tub tshwm sim thaum noj cov tshuaj Hartil-D, tom qab ntawd nws yuav tsum tau hloov pauv sai li sai tau (muaj qee qhov, ua ntej thaum kawg ntawm thawj peb hlis) nrog rau cov tshuaj uas tsis muaj ACE inhibitor nyob rau hauv kev txiav txim kom tsis txhob muaj kev pheej hmoo ntawm menyuam hauv plab.

Txij li thaum ramipril thiab hydrochlorothiazide raug nthuav tawm hauv cov kua mis, kev pub niam mis thaum kho kho nrog Hartil-D tsis raug tso cai.

Tsuas tshuaj thiab tswj hwm

Hartil-D yuav tsum noj txhua hnub ib hnub ib zaug thaum sawv ntxov. Cov ntsiav tshuaj yuav tsum tau nqos yam tsis muaj kev zom thiab haus dej ntau (yam tsawg ib nrab khob). Cov tshuaj Hartil-D tuaj yeem noj tsis hais lub pluas noj: lawv tuaj yeem noj rau hauv plab khoob, thaum noj mov lossis tom qab noj mov tas. Cov ntsiav tshuaj tuaj yeem muab faib ua ib nrab, tawg thaum muaj teeb meem.

Noj tshuaj Hartil-D, soj ntsuam xyuas tus kws kho mob li tshuaj. Qhov kev pib noj ib txwm rau cov neeg laus yog 2.5 mg ntawm ramipril thiab 12.5 mg ntawm hydrochlorothiazide. Cov koob tshuaj tuaj yeem nce ntxiv nrog ncua sij hawm tsawg kawg 3 asthiv. Cov koob tshuaj saib xyuas li ib txwm yog 2.5 mg ntawm ramipril thiab 12.5 mg ntawm hydrochlorothiazide lossis 5 mg ntawm ramipril thiab 25 mg ntawm hydrochlorothiazide. Qhov siab tshaj plaws niaj hnub noj yog 10 mg ramipril thiab 50 mg hydrochlorothiazide. Lub sijhawm tiv thaiv ntawm kev kho mob yog txiav txim los ntawm tus kws kho mob.

Cov koob tshuaj rau cov neeg laus laus thiab cov neeg mob uas lub siab tsis zoo los yog lub raum feem ntau qis dua li niaj zaus thiab yuav tsum tau xaiv los ntawm tus kws kho mob, suav nrog kev ua haujlwm ntawm lub raum thiab mob siab.

Sab sij huam

Ntawm kev pom zoo koob tshuaj, cov tshuaj feem ntau tiv thaiv zoo. Muaj qee kis, qhov tshwm sim ntawm qhov tsis tsim nyog xav tau yog qhov ua tau, uas feem ntau tsis tas yuav tsum tsis txiav tawm cov tshuaj. Yog tias koj muaj kev mob tshwm sim loj heev los sis cov kev mob tshwm sim tsis tau hais hauv phau ntawv no, sab laj nrog koj tus kws kho mob lossis kws muag tshuaj.

Thaum pib ntawm cov chav kawm ntawm kev kho mob thiab tom qab nce qhov koob tshuaj, kev txo ntshav siab ntau ntau yuav tshwm sim - txhim kho hypotensionpom los ntawm cov tsos mob xws li kiv taub hau, tsis muaj zog ntau, qhov muag plooj, qee zaum muaj tsaus muag lossis tsis nco qab. Qhov ntxim nyiam ntawm kev txhim kho hypotension muaj ntau dua nyob rau hauv cov neeg mob uas tsis muaj dej tsis txaus - electrolyte tshuav, nrog kev mob plawv tsis ua hauj lwm, thiab lub raum tsis ua haujlwm. Nrog rau kev txhim kho kev mob siab, tus neeg mob yuav tsum tau txav mus rau txoj hauj lwm tav toj, yog tias tsim nyog, ua kom txoj hlab ntshav txhawm rau nce qhov ntim ntawm cov ntshav ncig. Cov kev hloov pauv hypotensive tsis yog kev sib kis rau kev tswj hwm tom qab ntawm cov tshuaj. Nrog rau qhov mob ntshav siab thiab mob siab ntev, qhov txo qis dua ntawm qhov tsis noj tshuaj lossis tsis cuam tshuam kev kho mob tej zaum yuav xav tau.

Nws paub zoo tias kev siv ACE inhibitors tuaj yeem nrog nrog hnoos qhuav, uas nce thaum hmo ntuj thiab nyob rau hauv ib txoj hauj lwm ntxim nyiam, yog qhov muaj ntau rau cov poj niam thiab cov tsis haus luam yeeb. Qhov hnoos no yuav ploj mus tas li tom qab tsis txuas ntxiv ntawm cov tshuaj. Qee zaum hnoos yuav nres thaum tus neeg mob hloov mus rau lwm ACE inhibitor.

Cov hauv qab no yog lwm cov kev mob tshwm sim tshaj plaws thaum lub sijhawm sim tshuaj thiab kev siv tshuaj ACE inhibitors, suav nrog ramipril nrog hydrochlorothiazide.

Kev ntshaib plab metabolic: qhov kev txo qis tseem ceeb hauv cov qib poov tshuaj nyob hauv cov ntshav, hauv kev mob hnyav nrog qaug dab peg lossis cov leeg tsis muaj zog, nce qib ntawm urea thiab creatinine nyob rau hauv cov ntshav, gout, kev nce qib hauv cov piam thaj hauv cov ntshav, thiab kev nce qib tsis txaus ntawm cov poov tshuaj hauv ntshav.

Ua txhaum ntawm lub paj hlwb: kiv taub hau, qaug zog, mob taub hau, qaug zog, tsaug zog.

Kev cuam tshuam los ntawm cov hlab plawv: arterial hypotension, pob taws sawv hlwv.

Digestive ntshawv siab: xeev siab, mob plab, tshem tawm plab zom mov, mob plab, nqhis dej, cem quav, zawv plab, tsis qab los noj mov.

Cov mob ua pa: hnoos, mob ntsws, mob ntsws, mob ntsws.

Lub raum khiav tsis zoo: lub raum khiav tsis zoo, nce qib ntawm urea hauv cov ntshav thiab ntshav dej creatinine, lub cev qhuav dej.

Hnov tsis hnov ​​lus: mob ntsws, mob blepharitis, mob ntxiv ua kom qhov muag tsis pom kev, mob ntsws.

Cov kev tawm tsam ntawm lub cev, ua xua, tawv nqaij tawv: kev ua xua, ntau dua nyob rau hauv daim ntawv ntawm cov tawv nqaij hloov pauv, tsis tshua muaj dua - urticaria, tawv nqaij ua pob nrog nrog khaus, qhov tshwm sim ntawm hlwv lossis thaj chaw flaking, o ntawm daim tawv nqaij thiab hnoos qeev, kev tawm hws, kev tawm hws ntau dhau, mob pob qij txha, exacerbation ntawm psoriasis, mob caj dab lupus erythematosus, vasculitis.

Daim ntawv thov nta

Thaum kho nrog Hartil-D kev saib xyuas mob raws sijhawmCov. Ntxiv rau ntshav siab, lub raum kev ua haujlwm, kev suav cov ntshav thiab biochemical tsis dhau los yuav tsum tau saib xyuas tsis tu ncua. Kev ua txhaum ntawm dej - electrolyte tshuav yuav tsum tau muab tshem tawm ua ntej siv tshuaj.

Hartil-D yuav ua rau kev txo ntshav siab ntau nyob rau hauv cov ntshav siab, tshwj xeeb yog tom qab noj thawj koob lossis tom qab noj thawj koob tshuaj. Qhov ntxim nyiam ntawm kev txhim kho hypotension muaj ntau dua nrog qhov txo qis ntawm cov ntshav ntawm cov ntshav vim yog cov kua thiab cov ntsev, thiab hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev uas muaj ntshav siab lossis qis. Nrog rau kev txhim kho kev mob siab, tus neeg mob yuav tsum tau txav mus rau txoj hauj lwm tav toj thiab, yog tias tsim nyog, txoj hlab ntshav liab qab ntsev yog tsim nyog los ua kom qhov ntim ntshav ntau ntxiv. Cov tshuaj tiv thaiv hypotensive ib ntus tsis yog sib kis rau kev tswj hwm tom qab ntawm cov tshuaj. Nrog lub caij nyoog ntev thiab mob ntshav siab ntshav qis, nws yuav tsim nyog los txo cov koob tshuaj lossis nres kev kho mob nrog nws.

Hauv cov xwm txheej hauv qab no, yuav tsum tau saib xyuas tshwj xeeb thaum siv tshuaj Hartil-D:

- hauv cov neeg mob nrog lub cev qhuav dejyog tias raws plab thiab ntuav,
- hauv cov neeg mob noj tshuaj kho mob,
- hauv cov neeg mob uas muaj qhov zam ntxiv adrenal cortex cov tshuaj hormones (Conn's mob)
- hauv cov neeg siv kev noj ntsev tsawgnoj cov khoom noj uas hais ntxiv txog cov tshuaj noj hu ua potassium lossis ntxiv raupoov tshuaj tshuaj
- hauv cov neeg mob kev txom nyem raum mob ntshav siabhnyav lub plawv tsis ua hauj lwm, hypertrophic cardiomyopathy,
- hauv cov neeg mob nrog mob ntshav qab zibleej twg yuav tsum tau mus saib xyuas tsis tu ncua qib ntawm glycemia. Tej zaum nws yuav tsim nyog xaiv ib qho zuj zus los xaiv cov koob tshuaj txo cov tshuaj qab zib lossis hloov los ntawm ntsiav tshuaj npaj rau insulin,
- hauv cov neeg mob nrog mauj lupus erythematosus lossis psoriasis exacerbation ntawm tus kab mob yog tau.

Yuav tsum zam hemodialysis tawm tsam keeb kwm ntawm kev kho mob nrog tshuaj Hartil-D. Yog tias lim ntshav tsim nyog, koj yuav tsum hloov mus rau noj lwm cov tshuaj tiv thaiv kabmob ntshav uas tsis yog ACE inhibitor.

Nws yog qhov yuav tsum tau qhia rau tus kws kho mob txog kev noj tshuaj Hartil-D ua ntej kev phais mob thiab Tshuaj loog, suav nrog nrog tshuaj loog ntawm cov txheej txheem kho hniav.

Kev kho Hartil-D yuav ua rau hnoos qhuavuas ib txwm ploj mus tom qab tsis cuam tshuam txog kev kho.

Hartil-D muaj lactose monohydrateCov. Qhov no yuav tsum tau coj mus rau hauv kev kho mob ntawm cov neeg mob lactase tsis muaj peev xwm thiab lwm yam tsis tshua muaj teeb meem metabolic (galactosemia lossis glucose / galactose malabsorption syndrome).

Yog tias koj tsis nco qab noj Hartil-D kom ncav sijhawm, noj cov koob tshuaj uas ploj lawm kom sai li sai tau, thiab tom qab ntawd siv cov tshuaj raws li koj tus kws kho mob tau qhia. Yog tias, txawm li cas los xij, ob peb xuab moos tshuav ua ntej koob tshuaj ntxiv lossis nws yog lub sijhawm yuav tsum tau rov qab noj dua tom qab koob tshuaj tsis nco qab, tsis txhob noj tshuaj Hartil-D ob zaug txhawm rau los them rov qab. Hauv qhov no, ua tsis tiav lub koob tshuaj tsis noj raws sijhawm thiab txuas ntxiv noj cov tshuaj raws li lub sijhawm niaj zaus.

Tsis txhob cuam tshuam lossis tsum tsis txhob noj Hartil-D ntawm koj tus kheej! Kev tsis nkag Hartil-D lossis koob tshuaj hloov pauv yuav tsum nqa tawm raws li kws kho mob tau soj ntsuam thiab saib xyuas tus kws kho mob.

Kev tiv thaiv kev nyab xeeb

Ua rau ABILITY tsav tsheb lossis lub tshuab ua phom sij uas yuav ua tau

Hartil-D, nyob ntawm tus neeg li tshuaj tiv thaiv kev noj tshuaj, tuaj yeem muaj qhov tsis zoo rau lub peev xwm los ua haujlwm uas yuav tsum muaj kev nce siab ntxiv. Thaum pib ntawm kev kho mob nrog Hartil-D thiab tom qab nce qhov koob tshuaj, nws tsis pom zoo rau tsav tsheb los yog ua lwm yam haujlwm uas yuav tsum muaj kev saib xyuas ntau dua thiab nrawm ntawm cov kev tiv thaiv psychomotor. Hauv lub neej tom ntej, lub peev xwm los ua txoj haujlwm saum toj no thiab txiav txim siab qhov koob tshuaj nyab xeeb yog nqa tawm ntawm tus kws kho mob.

Yuav noj li cas?

Cov tshuaj Hartil tuaj yeem ua cawv thaum nws yooj yim, uas yog, tsis tas ua ntej noj mov, tom qab lossis thaum nws. Cov tshuaj tsis tuaj yeem zom, koj yuav tsum nqos tawm cov tshuaj tag nrho nrog cov roj huv.

Neeg mob txom nyem leeg ntshav siab, kws kho plawv yuav pom zoo kom haus 2.5 mg ntawm cov tshuaj ib hnub ib zaug. Yog tias tsim nyog, tom qab ntawd cov koob tshuaj ntawm cov tshuaj noj yuav maj mam nce ntxiv. Nws yog tsim nyog sau cia tias tag nrho cov nyiaj ntawm Hartil noj ib hnub yuav tsum tsis pub ntau dua 10 mg.

Neeg mob txom nyem lub plawv tsis ua hauj lwm hauv daim ntawv ntev, tus kws kho mob sau ntawv rau haus 1.25 mg ntsiav tshuaj txhua hnub. Yog tias tsim nyog, kws kho plawv kho qhov tshuaj ntau dua. Tag nrho cov tshuaj uas qaug cawv ib hnub twg yuav tsum tsis ntau tshaj 10 mg.

Ib tus neeg uas tau raug kev txom nyem plawv nres, cov tshuaj yog tau sau tseg rau 2-9 hnub. Tus neeg mob yuav tsum haus 2.5 mg ntawm cov tshuaj ib hnub ob zaug. Yog tias tsim nyog, kws kho plawv yuav pom zoo ob zaug Hartil.

Cov uas muaj mob nephropathy, koj yuav tsum haus 1.25 mg ntawm cov tshuaj ib hnub. Hauv qee qhov teeb meem uas muaj tus kab mob no, cov koob tshuaj tau raug hloov kho rau 5 mg ib hnub.

Raws li kev tiv thaiv ntawm lub plawv nres lossis mob stroke nrog pathologies mob tus kws kho mob yuav sau ntawv rau tus neeg mob kom haus Hartil li ntawm 2.5 mg ib hnub twg. Nws ntau npaum li cas kuj tseem tuaj yeem nce thiab maj mam ncav cuag 10 mg.

Kev siv Hartil rau menyuam yaus, thaum cev xeeb tub thiab lactation

Cov tshuaj yog txwv tsis pub noj thaum lub sijhawm coj menyuam thiab pub niam mis. Hartil muaj peev xwm ua rau qhov tshwm sim ntawm kev ua txhaum cai ntawm kev tsim lub raum ntawm cov me nyuam hauv plab, txo nws cov ntshav siab. Tsis tas li ntawd, cov tshuaj txaus ntshai nyob rau hauv uas nws tuaj yeem pab txhawb kev txhim kho hyperkalemia hauv plab, pob txha taub hau hypoplasia thiab nws cov deformation, mob ntsws hypoplasia, mob pathological ntawm nqua.

Kev nyab xeeb ntawm kev noj Hartil thiab nws cov txiaj ntsig hnub nyoog qis dua 18 xyoo tsis tau teeb tsa. Hauv qhov no, koj tsis tuaj yeem coj nws.

Ua tau contraindications thiab phiv

Hartil yuav tsum tsis txhob coj mus ua qee yam hauv qab no:

• keeb kwm ntawm angioedema,
• kev tiv thaiv tsis haum rau cov tshuaj hauv cov tshuaj,
• cev xeeb tub nyob rau txhua lub sijhawm
• kev pub mis
• lub raum leeg mob stenosis,
• thawj hyperaldosteronism,
• ob leeg lub raum leeg mob stenosis,
• lub raum tsis ua hauj lwm
• tsis ruaj khov hemodynamics.

Ib qho ntxiv, cov tshuaj no tuaj yeem ua rau cov tshuaj tiv thaiv tsis zoo tus kab mob thaum noj, uas tuaj yeem suav nrog:

• txos cov ntshav siab
• arrhythmia
• thrombocytopenia
• orthostatic hypotension,
• nce proteinuria,
• hnoos qhuav
• mus ob peb vas siab
• kev puas tsuaj nyob rau hauv txoj kev ncig,
• lub raum tsis ua haujlwm,
• tshee hnyo
• rhinorrhea
• myocardial ischemia thiab lub hlwb
• txo qis libido
• qhov zoo li tsis muaj zog
• tsaug zog
• poob siab excitability
• tsis hnov ​​kev hnov ​​los ntawm hnov, hnov ​​tsw, saj thiab tsis pom kev,
• cramps
• bronchospasm
• alopecia
• vestibular kev ntshawv siab
• txo cov tshuaj hemoglobin thiab hematocrit,
• rhinitis, mob ntsws,
• mob ntsws
• mob leeg
• kev npau suav,
• tsis qab los
• pom mob pob txha
• xeev siab, raws plab, lossis cem quav
• txog siav ua tsis taus pa, qhov ncauj qhuav,
• hemolytic anemia
• pob, tawv nqaij khaus.

Vim tias muaj ntau qhov tshwm sim tsis zoo thaum lub sijhawm noj cov ntsiav tshuaj, koj yuav tsum haus lawv, soj ntsuam kev tiv thaiv kev nyab xeeb. Nws yog ib qho tseem ceeb kom nkag siab tias thaum kho nrog Hartil, kev tswj hwm los ntawm kws kho mob yog xav tau. Qhov no yog qhov tshwj xeeb tshaj yog nyob rau lub sijhawm thaum lub sijhawm tom qab ntau npaum li cas ntawm cov tshuaj tau nce. Hauv yim teev tom qab noj Hartil hauv kev noj tshuaj ntau ntxiv, koj feem ntau yuav tsum ntsuas ntshav siab thiab soj ntsuam cov cai hauv qhov ntsuas.

Tsis tas li, kev saib xyuas tas li los ntawm kws kho mob yog qhov yuav tsum tau los ntawm cov neeg mob lub raum mob voos, lub raum tsis ua haujlwm, uas tau hloov raum.

Cov kev ua si sib txawv uas xav tau qhov kev mloog zoo yuav tsum tso tseg rau lub sij hawm kho nrog cov tshuaj no.

Kev sib xyaw ntawm Hartil nrog lwm cov tshuaj thiab dej cawv

Kev sib koom tes ntawm cov ntsiav tshuaj nrog ntau cov tshuaj muaj peev xwm ua tau rau kev kho mob. Tab sis nws tsim nyog txiav txim siab tias kev sib txig siv cov tshuaj no thiab cov tshuaj ntawm cov pab pawg neeg pharmacological li cytostatics thiab corticosteroids, ua rau muaj qhov pom ntawm kev hloov pauv ntawm cov sib xyaw ntawm cov ntshav thiab tuaj yeem ua rau muaj kev cuam tshuam ntau yam hauv cov ntshav ncig.

Nws kuj tseem txaus ntshai los ua ke ntawm kev siv cov tshuaj no nrog insulin thiab lwm yam tshuaj los tiv thaiv kev mob ntshav qab zib, zoo li qhov no muaj cov ntshav qab zib tsawg, uas tuaj yeem ua rau muaj kev phom sij.

Cov kws kho plawv tau hais kom meej tias yuav tsum tsis pub haus dej haus cawv thaum kho nrog cov ntsiav tshuaj no, vim lawv pab ntxiv cov cawv uas muaj cawv txaus.

Cov tshuaj no hauv daim foos tsim nyog raug tso tawm muaj muag yuav luag txhua lub khw muag tshuaj. Koj tuaj yeem yuav cov tshuaj hauv online chaw muag tshuaj. Thaum yuav ib qho tshuaj, yuav tsum tau tshuaj los ntawm kws kho mob uas koom nrog.

Tus nqi nruab nrab rau ib cov tshuaj pib los ntawm 370 rubles hauv khw muag tshuaj hauv Moscow. Hauv cov khw muag tshuaj online koj tuaj yeem yuav cov tshuaj kom pheej yig dua - tus nqi tshuaj pib ntawm 297 rubles.

Cov tshuaj zoo ib yam thiab lawv tus nqi

Cov tshuaj hauv qab no tuaj yeem raug ntaus nqi rau cov kab mob sib piv ntawm cov tshuaj no:

• Amprilan - los ntawm 220 rubles,
• Pyramil - los ntawm 202 rubles,
• Tritace - los ntawm 996 rubles,
• Dilaprel - los ntawm 115 rubles,
• Ramimed - los ntawm 280 rubles.

Ua ntej yuav cov tshuaj analogues ntawm cov tshuaj, koj yuav tsum xyuas nrog koj tus kws kho mob yog tias lawv tuaj yeem hloov cov tshuaj no kom tiav lossis tsis tau.

Hartil yog ib hom tshuaj uas muaj zog, yog li ntawd, nws yog ib qho tsim nyog yuav tau coj nws tsuas yog nrog lub sijhawm teem sijhawm los kho tus kws kho mob thiab ua raws nraim li cov tshuaj noj. Txwv tsis pub, koj tuaj yeem tau txais kev txhim kho ntawm qhov tshwm sim tsis zoo.

Kev sib xyaw thiab kev ua

Cov lus piav meej hais tias Hartil belongs rau cov pab pawg ntawm ACE inhibitors. Cov tshuaj nquag hauv nws cov muaj pes tsawg leeg yog ramipiril. Vim qhov thaiv ntawm angzyensin-hloov mus rau ntawm cov enzyme, tus neeg sawv cev muaj qhov cim meej hypotensive.

Ua tib zoo mloog! Cov tshuaj pib txo qis siab hauv 1.5-2 teev tom qab kev tswj hwm. Cov kev kho mob ua suab nrov tau tshwm sim tom qab 3.5-6 thiab kav ntev li 24 teev. Hartil yuav tsum tau siv tsis tu ncua thiab siv sijhawm ntev, nws tsis tuaj yeem haus cov ntsiav tshuaj los ntawm ib kis mus rau ib kis.

Tsis tas li ntawd, ramipyril:

• txhawb nqa kev thim rov qab kev kub siab ntawm hypertrophy ntawm cov leeg plawv (nrog rau siv ntev),
• txhim kho cov ntshav ncig hauv myocardium,
• txo qhov zaus ntawm arrhythmias,
• normalizes lub siab nyob rau hauv portal txoj hlab ntsha nrog portal tawg,
• inhibits qhov tsis zoo ntawm lub raum ua haujlwm hauv cov neeg mob ntshav qab zib.

Kev ntsuas rau siv

Tau nkag siab txog cov txheej txheem ntawm kev ua ntawm cov tshuaj, peb sib tham txog qhov ntsuas rau nws txoj kev siv.

• leeg ntshav siab
• CHF,
• mob myocardial infarction, mob stroke hauv keeb kwm (kom txo qis kev pheej hmoo ntawm cov teeb meem vascular dua),
• nephropathy, nrog rau mob ntshav qab zib.

Tso Tawm Cov Ntawv

Hartil yog tsim los ntawm lub tuam txhab Hungarian kev lag luam EGIS Pharmaceuticals PLC. Daim ntawv ntawm kev tso tawm tsuas yog cov ntsiav tshuaj nrog qhov tshuaj ntawm 5 lossis 10 mg. Hauv pob ntawv cardboard, ntxiv rau 28 lub teeb paj yeeb dawb lossis xim dawb, cov lus qhia ntxaws ntxiv rau kev siv. Tus nqi nruab nrab ntawm ib lub thawv yog 410 p. rau qhov ntau npaum ntawm 5 mg thiab 460 r rau 10 mg.

Ua tib zoo mloog! Nws yog qhov zoo dua los yuav 10 milligram ntsiav tshuaj. Txhua ntawm lawv tuaj yeem faib ua ib nrab, rhuav kev pheej hmoo.

Ib qho ntxiv, cov khw muag khoom lag luam muaj cov tshuaj sib xyaw ua ke raws li ramipiril thiab lwm cov tshuaj tiv thaiv kab mob:

• Hartil Amlo (AM) (ramipiril + amlodipine) 5 mg + 5 mg, 10 mg + 10 mg,
• Hartil D (ramipiril + hydrochlorothiazide) 2.5 mg + 12.5 mg, 5 mg + 25 mg.

Txoj kev siv

Hartil noj qhov ncauj tsis tas yuav zom, ntxuav nrog dej (qhov ntau, kwv yees li 200-250 ml) dej. Koj yuav tsum tau haus cov tshuaj txhua hnub, txhua 24 teev.

Tus kws kho mob teev qhov ntau npaum li cas thiab kev kho mob ntev npaum li cas rau txhua tus neeg mob. Cov lus pom zoo cov qauv raug muab rau hauv qab hauv qab no.

Rooj 1: Txheej Txheem Kev Pom Zoo rau Hartil Noj xaiv:

Tseem Ceeb! Kev saib xyuas tshwj xeeb yog qhov yuav tsum tau xaiv qhov ntau npaum ntawm Hartil rau cov neeg laus laus noj cov tshuaj diuretics thiab raug mob los ntawm cov kab mob tsis haum (lub plawv tsis ua haujlwm, kev ua haujlwm tsis zoo ntawm cov kab mob somatic).

Kev kho mob ntshav siab hauv ntshav qab zib

Hartil puas tsim nyog rau kev kho mob tawg rau cov neeg laus muaj mob ntshav qab zib hom 2?

Nyob zoo Nyob rau hauv dav dav, muaj: cov tshuaj muaj cov txiaj ntsig zoo nyob rau hauv chav kawm ntawm mob ntshav qab zib macroangiopathy thiab nephropathy. Txawm li cas los xij, rau txhua tus neeg mob, ib qho tshuaj tiv thaiv kab mob siab yuav tsum tau xaiv ib tus zuj zus.

Ntxiv rau, kev siv cov tshuaj Hartil nrog cov tshuaj txhaj cov ntshav hypoglycemic los ua rau cov ntshav qabzib nce siab. Yog li no, qee zaum, tawm tsam cov keeb kwm yav dhau los ntawm kev kho tshuaj, nws yog ib qho tsim nyog yuav tau kho cov koob tshuaj insulin.

Pharmacokinetics ntawm cov tshuaj.

Ramipril
Xuas
Tom qab lub qhov ncauj tswj hwm, ramipril yog qhov nqus tau nrawm. Kev txiav txim los ntawm lub xov tooj hluav taws xob raug kuaj pom nyob rau hauv cov zis tom qab noj cov tshuaj uas muaj lub npe hu ua ramipril (kev nthuav tawm los ntawm ob lub raum tsuas yog ib ntawm ob peb txoj kev), tsawg kawg yog 56% ntawm cov tshuaj tau nqus. Kev noj ib txhij tsis cuam tshuam rau kev nqus.
Ramipril yog prodrug, nws nyob rau hauv cov metabolism hauv "thawj nqe" los ntawm daim siab, vim qhov kev ua haujlwm ntawm qhov tsuas yog metabolite ramiprilat yog tsim (vim yog hydrolysis, feem ntau yog nyob hauv daim siab). Ntxiv rau qhov dhau los ua ib qho kev tawm dag zog ntawm ramiprilat, ramipril conjugates nrog glucuronic acid thiab hloov mus rau hauv diketopiperazine ester ntawm ramipril. Ramiprilat tseem tseem sib xyaw nrog glucuronic acid thiab hloov mus rau diketopiperazine-ramiprilat (acid). Vim tias qhov ua kom / metabolism ntawm ramipril, bioavailability tom qab kev tswj hwm ntawm qhov ncauj yog kwv yees li 20%.
Cmax ntawm ramipril hauv plasma tau mus txog hauv 1 teev tom qab kev tswj hwm ntawm qhov ncauj. Cmax ntawm ramiprilat nyob rau hauv ntshav tau mus txog li ntawm 2-4 teev tom qab kev noj ntawm ramipril.
Kev xa Khoom
Kev khi rau cov ntshav plasma rau ramipril thiab ramiprilat yog kwv yees li 73% thiab 56%, feem.
Hauv kev sim tshuaj, nws tau pom tias ramipril raug nthuav tawm hauv niam cov kua mis.
Chaw Sau Ntawv
T1 / 2 ntawm ramipril yog kwv yees li 1 teev Ib qho zuj zus hauv qhov kev txiav txim siab ntawm ramiprilat hauv cov ntshav plasma muaj ntau yam nyob hauv. Qhov pib faib tawm thiab kev tshem tawm theem tau pom los ntawm T1 / 2 sib npaug txog li 3 teev. Tom qab ntawd cov theem nrab (T1 / 2 txog 15 teev) thiab theem kawg, thaum lub sijhawm ramiprilat concentration hauv ntshav plasma muaj tsawg heev (T1 / 2 - 4-5 hnub), ua raws. ) Qhov kawg theem no yog vim muaj kev cuam tshuam qeeb ntawm ramiprilat los ntawm cov khoom muaj zog tab sis noo nrog ACE. Txawm hais tias lub sijhawm dhau los ntawm kev tshem tawm theem, Css ntawm ramipril tau mus txog nyob hauv thaj tsam li 4 hnub nrog kev siv txhua hnub ntawm 2.5 mg lossis ntau dua ntawm ramipril. Siv tau T1 / 2 (ntsuas txog qhov yuav tsum tau xaiv) yog 13-17 teev tom qab noj ntau yam tshuaj.
Tom qab qhov ncauj tswj hwm ntawm 10 mg ntawm daim ntawv lo ramipril, kwv yees li 40% ntawm lub xov tooj cua yog tawm los ntawm txoj hnyuv thiab 60% los ntawm lub raum. Hauv 24 teev tom qab noj 5 mg ntawm ramipril los ntawm cov neeg mob nrog lub raj yas uas qhia txog cov kua tsib cov txiaj ntsig, cov nqi sib npaug ntawm cov ramipril thiab nws cov metabolites los ntawm lub raum thiab bile tau pom. Kwv yees li 80-90% ntawm cov tshuaj tiv thaiv kab mob zais uas tso zais los ntawm lub raum thiab bile tau sawv cev los ntawm ramiprilat thiab tshuaj rau nws cov metabolism ntxiv. Glucuronide thiab diketopiperazine derivative ntawm ramipril suav txog kwv yees li 10-20%, thiab ramipril tsis suav nrog muaj txog kwv yees li 2% ntawm tag nrho cov nyiaj ntawm ramipril.

Dosage thiab txoj hauv kev ntawm kev tswj hwm tshuaj.

Cov tshuaj yuav tsum noj 1 zaug / hnub ib hnub thaum sawv ntxov, haus dej kom ntau. Cov tshuaj yuav noj tau yam tsis xav noj mov. Cov ntsiav tshuaj tsis tas yuav tsum tau muab faib ua feem.
Rau cov neeg laus, cov tshuaj Hartil-D raug pom zoo kom tsuas yog tom qab ib leeg xaiv cov koob tshuaj ntawm txhua yam ntawm cov khoom siv. Cov koob tshuaj tuaj yeem nce ntxiv nrog ncua sij hawm tsawg kawg 3 asthiv. Qhov kev pib noj ib txwm yog 2.5 mg ntawm ramipril thiab 12.5 mg ntawm hydrochlorothiazide. Cov koob tshuaj saib xyuas li ib txwm yog 2.5 mg ntawm ramipril thiab 12.5 mg ntawm hydrochlorothiazide lossis 5 mg ntawm ramipril thiab 25 mg ntawm hydrochlorothiazide. Qhov pom zoo siab tshaj plaws txhua hnub koob yog 5 mg ntawm ramipril thiab 25 mg ntawm hydrochlorothiazide.
Rau cov neeg mob laus thiab cov neeg mob CC los ntawm 30 txog 60 ml / min, ib koob tshuaj twg ntawm txhua qhov sib xyaw (ramipril thiab hydrochlorothiazide) yuav tsum ua tib zoo xaiv ua ntej hloov mus rau cov tshuaj sib xyaw Hartil-D.
Cov koob tshuaj ntawm Hartil-D yuav tsum tsawg li sai tau. Qhov pom zoo siab tshaj plaws txhua hnub koob yog 5 mg ntawm ramipril thiab 25 mg ntawm hydrochlorothiazide.
Hartil-D yog contraindicated rau hauv cov neeg mob uas muaj qhov tsis zoo hauv lub raum ua haujlwm (CC tsawg dua 30 ml / min / 1.73 m2).
Ua ntej hloov mus rau Hartil-D, cov neeg mob siab me los yog mob siab daim siab ua haujlwm yuav tsum tau txhaj ib koob tshuaj ramipril.
Nws tsis raug tso cai los noj cov tshuaj Hartil-D hauv cov neeg mob uas muaj lub siab ua haujlwm tsis zoo thiab / lossis cholestasis.
Hartil-D tsis pom zoo rau cov menyuam yaus thiab cov hluas (muaj hnub nyoog qis dua 18 xyoo) vim tsis muaj ntaub ntawv kev nyab xeeb thiab ua tau zoo rau cov pab pawg hnub nyoog no.