Diroton lossis Lisinopril - uas yog ib qho zoo dua? Backstage secrets!

Diroton - cov no yog cov ntsiav tshuaj uas txo cov kev tsim ntawm angiotesin II los ntawm angiotensin I, uas txo qis kev puas tsuaj ntawm bradykinin thiab nce cov synthesis ntawm prostaglandins. Xws li cov nyhuv ntawm cov tshuaj hauv lub cev pab txo OPSS, ntshav siab, preload thiab siab hauv cov hlab ntsws. Tsis tas li ntawd, cov tshuaj yeeb tshuaj tuaj yeem ua rau nce ntxiv hauv cov feeb ntawm cov ntshav thiab nthuav cov hlab ntsha.

Diroton, zoo li nws cov analogues, tuaj yeem ua rau lub neej ntev dua ntawm cov neeg mob uas muaj mob plawv tsis ua hauj lwm thiab qeeb kev txhim kho ntawm cov leeg tsis ua hauj lwm hauv cov neeg mob tom qab myocardial infarction.

Cov tshuaj nquag hauv cov muaj pes tsawg leeg ntawm Diroton yog lisinopril. Muaj ntau ntau cov analogues ntawm cov tshuaj rau cov tshuaj nquag. Cov lus nug: "Dab tsi tuaj yeem hloov Diroton?" Feem ntau tshwm sim thaum tus neeg mob tau contraindications rau noj cov tshuaj, yog li peb yuav tham txog nws qhov nrov tshaj plaws hloov chaw.

Lisinopril thiab Diroton muaj ntau yam zoo sib xws. Lawv raug tawm hauv tib daim ntawv - ntsiav tshuaj ntawm 5 mg, 10 mg thiab 20 mg, thiab tseem noj ib hnub ib zaug, tsis hais txog kev noj zaub mov. Tab sis tsuas yog Diroton yuav tsum noj ob zaug ntau dua - 10 mg ib hnub ib zaug, thiab Lisinopril tsuas yog 5 mg. Hauv ob qho xwm txheej no, tag nrho cov txiaj ntsig tau tiav nyob hauv ob lossis plaub lub lim tiam.

Cov kev sib txawv tseem ceeb yog contraindications, txij li Diroton raug txwv rau cov neeg mob muaj keeb Quincke's edema, thiab Lisinopril rau cov neeg mob lactose tsis txaus, nrog lactose deficiency, thiab tseem muaj cov piam thaj-galactose malabsorption. Tus so ntawm lub contraindications kom noj cov tshuaj yog tib yam nkaus:

• cev xeeb tub
• kev pub mis
• keeb kwm ntawm angioedema,
• hypersensitivity rau cov tshuaj.

Cov tshuaj nquag hauv enalapril yog enalapril - qhov no yog qhov sib txawv tseem ceeb ntawm cov tshuaj. Ntxiv mus, cov tshuaj muaj qhov pom nqaim ntawm cov teebmeem, tsis zoo li Diroton nws tsuas yog siv rau ob hom kab mob:

• leeg ntshav siab
• mob plawv tsis ua hauj lwm.

Nws tsis tuaj yeem txwv tsis pub siv yog tias muaj lub raum lub raum tsis ua haujlwm, tom qab lub raum hloov pauv thiab thawj hyperaldosteronism. Cov contraindications ntxiv yog zoo ib yam rau Diroton.

Diroton thiab Lozap kuj tseem txawv hauv cov tshuaj nquag, txij li kis ob yog Lozartan. Vim yog dab tsi, cov tshuaj no tseem siv los kho kom deb ntawm txhua yam kab mob hauv lub plawv, tab sis tsuas yog nrog txoj hlab ntshav siab thiab lub plawv tsis ua haujlwm. Hauv qhov no, contraindications ntawm cov tshuaj zoo ib yam. Yog li no, Diroton hloov los ntawm Lozap tsuas yog nyob rau kis uas tus neeg mob hypersensitive rau lisinopril.

Tshaj tawm tuaj, peb tuaj yeem hais tias txhua qhov tshuaj tau nws tus kheej kom zoo. Diroton cov lus piv txwv yog qhov txawv txav los ntawm contraindications lossis cov tshuaj nquag, uas feem ntau ua rau kev txiav txim siab xaiv tshuaj.

Raws li cov pharmacological kev faib tawm ntawm cov tshuaj, Diroton belongs rau cov pab pawg ntawm angiotensin-hloov enzyme inhibitors, lossis ACE inhibitors rau luv.

Lawv siv rau ntau qhov muaj ntau yam kabmob, suav nrog asymptomatic atherosclerosis, lub raum tsis ua haujlwm, uas tau pom los ntawm albuminuria.

Tab sis cov cim tseem ceeb rau kev teem sijhawm ntawm cov tshuaj no yog cov kab mob pathologies ntawm lub plawv hlab ntsha, nrog rau cov hlab ntaws nrog kev puas tsuaj rau cov hlab ntshav ntawm ntshav, mob ntshav tsis tuaj yeem.

Tsis zoo li lwm cov tshuaj uas kws kho mob kho mob kom kho cov kab mob, Diroton, zoo li nws txoj kev noj tshuaj hauv tsev thiab txawv teb chaws los ntawm pawg ACE inhibitors, tsis ua rau mob ntshav qab zib, yog li nws tuaj yeem siv ntshav qab zib kom nyab xeeb.

Txhawm rau kom nkag siab txog cov txheej txheem ntawm kev ua ntawm cov tshuaj, cia peb nyob ntawm kev ua haujlwm ntawm renin-angiotensin-aldosterone system thiab nws txoj haujlwm ua haujlwm hauv kev tswj hwm ntawm cov ntshav siab.

Raws li lub npe ntawm cov pab pawg tshuaj uas Diroton belongs, nws cov tshuaj tiv thaiv lisinopril ua rau txo qis ntawm ACE nyob rau hauv cov ntshav thiab cov nqaij thiab tiv thaiv kev hloov pauv ntawm angiotensin I rau nws lub xeev nquag, angiotensin II, cuam tshuam lub cascade ntawm cov kev coj ua piav saum toj no.

Yog li, Diroton muaj qhov tsim nyog muaj kev ua haujlwm los txo cov kev ua kom pom kev mob ntshav siab, mob plawv, mob plawv.

Nws cov yeeb tshuaj lisinopril muab cov nyhuv tshuaj ntawm lub cev hauv qab no:

• Antihypertensive.
• Vasodilating thiab pleiotropicCov. Diroton inhibits cov kev ua ntawm kinase II enzyme thiab nce kev tsub zuj zuj ntawm bradykinin. Qhov no ua rau kom muaj qhov tsis tu ncua ntawm cov hlab ntsha endothelium, nce ua ke ntawm nitric oxide. Cov tshuaj kuj tseem muaj cov nyhuv tawm tsam, txo qis qib C-reactive protein thiab fibrinogen.
• Txhim kho cov ntshav txaus hauv plawv thiab lwm yam kabmob, uas cuam tshuam txo kev pheej hmoo ntawm cov teeb meem nrog cov mob ntshav liab.
• CardioprotectiveCov. ACE inhibitors ua rau qhov rov qab txhim kho ntawm sab laug ventricular hypertrophy ntawm lub plawv, thiab qhov tsos mob no yog qhov kev ntsuas rau qhov tsis txaus ntseeg ntawm kev ua haujlwm ntawm lub plawv. Diroton tseem yuav ua rau muaj kev poob siab thiab cov ntshav teev hauv lub sijhawm, txo qis ua ntej thiab tom qab ua haujlwm ntawm lub myocardium, uas pab ua kom nws lub zog thiab cov kev sib cog lus tsis nce lub plawv. Qhov no ua rau muaj kev vam meej qeeb dua ntawm kev mob plawv tsis zoo hauv ib tus neeg mob thiab nce qhov kev tawm tsam mus rau lub cev.
• DiureticCov. Diroton tshem tawm cov kua dej ntau dhau thiab sodium ions tawm hauv lub cev, uas kuj yog ib qho kev ua rau txo qis ntshav siab.

Lisinopril yog ib qho ntawm cov paub zoo tshaj plaws thiab zoo-kawm ACE inhibitors. Nws cov tshuaj lom neeg muaj pes tsawg leeg, uas yog cov ntsiab lus ntawm pawg carboxyl, txiav txim siab ua kom ntev ntev dua thiab muaj kev siab dua zoo dua piv rau lwm cov neeg sawv cev ntawm pab pawg no.

Raws li cov lus piav qhia, kev siv lub cev ntawm Diroton yog los ntawm 25-50%, thiab kev noj zaub mov kom tsis cuam tshuam rau qhov no. Qhov siab tshaj plaws ntawm lisinopril hauv plasma tshwm sim tom qab 6 teev. Kev nqhis dej ntawm cov tshuaj los ntawm ob lub raum yog nqa hauv ob qib. Thawj zaug - tom qab 12 teev, thib ob - tom qab 30 teev, uas cuam tshuam nrog lub sijhawm ntawm kev sib txuas nrog cov kabmob angiotensin-hloov mus rau hauv.

Hauv qhov no, kom ua tiav cov nyhuv hypotensive ruaj khov, Diroton txaus noj 1 zaug nyob rau ib hnub (qhov no tau teev nyob rau hauv cov lus qhia rau cov tshuaj). Qhov siab ruaj khov ntawm lisinopril hauv cov ntshav tshwm sim rau hnub thib 2 - 3 ntawm kev noj cov ntsiav tshuaj, thiab ib qho kev kho mob tas mus li - 2 lub lis piam tom qab pib siv.

Diroton hla kev ntshav-hlwb teeb meem thiab tuaj yeem cuam tshuam lub chaw ua pa nyob hauv lub hlwb. Ib qho kev mob tshwm sim xws li hnoos yog txuam nrog cov yeeb yam no ntawm cov tshuaj. Ib qho ntxiv, lisinopril nkag mus rau hauv cov hlab ntshav, uas txwv nws txoj kev siv thaum cev xeeb tub.

Muab kev sib raug zoo ntawm no tus sawv cev ntawm ACE inhibitors nrog diuretics, kev sib koom ua ke Co-Diroton tau tsim kho. Ntxiv rau lisinopril, nws kuj muaj cov diuretic tivthaiv hydrochlorothiazide. Cov tshuaj yeeb tshuaj no ua kom sib zog ua kom tau zoo nyob hauv txhua qhov kev mob siab.

Raws li cov kws kho mob, tsis yog lub luag haujlwm me me hauv kev nthuav dav ntawm Diroton yog ua si los ntawm nws tus nqi qis. Qhov no tso cai rau koj los ua cov kev kho mob ntev ntev yam tsis muaj kev ntshai tias tus neeg mob yuav cuam tshuam kev kho mob tus kheej vim tias tsis muaj peev nyiaj.

Cov tshuaj Diroton yog tsim los ntawm lub tuam txhab Hungarian GEDEON RICHTER (Gideon Richter). Cov tshuaj yog tsim hauv daim ntawv ntawm cov ntsiav tshuaj hauv qhov ntau npaum ntawm 2.5, 5, 10 thiab 20 mg. Yuav muaj ob peb lub hlwv ntim rau hauv pob, tag nrho cov ntsiav tshuaj yog 14, 28 lossis 56 daim.

Cov lus qhia rau kev teem caij noj tshuaj Diroton yog cov kev ua pathologies:

• leeg ntshav siab
• cov kab mob hauv lub plawv tsis ua haujlwm, feem ntau muaj cov kab mob zoo sib xws, cov tshuaj siv nrog lwm cov tshuaj,
• mob myocardial infarction, nrog cov hemodynamic ruaj khov, noj cov ntsiav tshuaj los ntawm lub siab Diroton pib hauv thawj hnub tom qab kev tawm tsam,
• kev puas tsuaj rau sab hauv cov qauv thiab cov nqaij ntawm lub raum (mob hlwb) los ntawm ntshav qab zib.

Kev siv cov lisinopril muaj qhov txwv hauv qab no:

• muaj kev tsis haum rau lisinopril nws tus kheej lossis lwm qhov sib xyaw ntawm cov ntsiav tshuaj,
• keeb kwm muaj tus mob angioedema hauv tus neeg mob nws tus kheej lossis tus mob muaj keeb (muaj lub npe paub ntau thiab dav yog Quincke's edema),
• Ob leeg lub raum leeg mob stenosis los yog txoj hlab ntshav ntawm lub raum
• mob siab ntshav siab,
• mob aortic mob heev,
• hyperkalemia (poov tshuaj ion concentration saum toj no 5.5 mmol / l).

Nrog faj seeb, siab ntsiav tshuaj Diroton yog tshuaj tom qab hloov raum, nyob rau hauv qhov muaj malignant los yog benign formations uas tiv thaiv cov ntshav ntawm cov hlab ntshav sab laug ventricle, leukopenia, ntshav liab. Kev saib xyuas tus neeg mob tus mob yog qhov yuav tsum muaj rau cov kab mob ntawm cov kab mob sib txuas.

Kev saib xyuas tshwj xeeb yog xav tau hauv cov neeg mob uas mob raum tsis ua haujlwm. Tom qab sau cov tshuaj rau lub siab, Diroton tas li tsom kwm cov qib creatinine thiab cov poov tshuaj potassium ntau zuj zus. Nrog ib qho kev txo qis ntawm glomerular pom tus nqi tsawg dua 60 ml / min, qhov koob tshuaj lisinopril yog ib nrab, tsawg dua 30 ml / min - los ntawm ¾.

Nrog kev cuam tshuam ntxiv hauv lub raum ua haujlwm, nws raug nquahu kom xaiv lwm ACE inhibitor uas yog tshuaj tiv thaiv hauv lub siab. Nws tseem yuav tsum tau sau tseg tias muab cov vasodilator thiab hypotensive nyhuv ntawm Diroton ntsiav tshuaj, lawv zoo tshaj tsis yog thaum sawv ntxov, tab sis yav tsaus ntuj, nyiam dua tib lub sijhawm.

Qhov ntau npaum li cas ntawm cov tshuaj Diroton yuav txawv nyob ntawm tus kab mob. Yog li, thawj cov nyiaj rau qhov tseem ceeb ntawm txoj hlab ntshav siab yog 10 mg rau ib hnub ib zaug. Yog hais tias tus neeg mob zam rau lisinopril zoo, ces nws yog nce rau 20 mg. Nrog rau qhov tsis txaus ntseeg ntawm cov nyhuv, cov tshuaj Diroton yog noj nyob rau 40 mg ib hnub twg. Txawm li cas los xij, qhov tshuaj no ntau tshaj plaws; dhau qhov nws muaj kev phom sij.

Yog tias yav dhau los tus neeg mob tau kho nrog lwm cov tshuaj (tshwj xeeb, diuretics thiab vasodilators), lawv yuav tsum tau tsum tsis tu ncua tsawg kawg 24 teev (hom phiaj 2-4 hnub) ua ntej pib lisinopril. Yog tias qhov no ua tsis tau rau ib qho laj thawj, thawj zaug ntawm Diroton yuav tsum tsis pub tshaj 5 mg rau ib hnub.

Hauv qhov no, nws yog ib qhov tsim nyog los tswj cov theem ntawm cov ntshav siab. Lub sij hawm txaus ntshai tshaj plaws yog 6 teev tom qab txhaj tshuaj thawj zaug. Tom qab ntawd, qhov zoo tshaj plaws ntawm lisinopril los yog qhov sib txuam ua ke ntawm cov tshuaj yog xaiv.

Raws li tau hais los saum no, noj Diroton zoo dua thaum tav su. Yog li, cov ntshav siab thaum sawv ntxov tawm tsam sib tshooj, uas qhov tshwj xeeb tshaj yog rau cov neeg laus.

Kev siv cov tshuaj Diroton rau kev kub siab tshwm sim los ntawm kev ua haujlwm ntawm lub renin-angiotensin-aldosterone system pib nrog qhov tsawg kawg ntawm 2.5-5 mg. Ib zaug txhua txhua 3 hnub, nws tau maj mam nce mus rau 10 mg ib hnub lossis tiv taus raws li qhov ua tau. Nyob rau lub sijhawm no, lub raum kev ua haujlwm, ntshav siab, thiab cov poov tshuaj thiab sodium ntau ntau hauv cov ntshav ntshav tau raug saib xyuas.

Hauv kev kho mob hauv lub plawv ntev, Diroton tau noj nrog koob tshuaj 2.5 mg, uas yog nce rau 5-20 mg dhau 5 hnub. Kev xaiv qhov zoo tshaj plaws txhua hnub ntawm lisinopril hauv cov neeg mob nephropathy mob ntshav qab zib mellitus tshwm sim tib txoj kev. Cov theem ntawm cov ntshav diastolic hauv qhov no yuav tsum tsis txhob ntau dua 85-90 hli Hg.

Xaj Diroton tom qab myocardial infarction yog qhia rau cov neeg mob tsis muaj cov tsos mob ntawm hypotension.Nyob rau thawj hnub thiab thib ob tom qab kev tawm tsam, qhov kev npaj ntawm 5 mg yog tau sau tseg, ces 10 mg tau noj. Lisinopril noj tsawg kawg 6 lub lis piam. Nrog rau qhov txo qis hauv cov ntshav siab, qhov ntau npaum no yog halved.

Nws yuav tsum raug sau tseg txoj kev muaj peev xwm ntawm kev siv tshuaj kho Diroton pathologies ntawm cov hlab plawv hlab ntsha thaum menyuam yaus. Raws li cov kws kho mob, tsis tau muaj lub hom phiaj xav tshuaj rau cov txiaj ntsig ntawm lisinopril rau ntawm tus menyuam. Hauv kev hais txog qhov no, cov tshuaj tsis raug sau kom txog hnub nyoog 18, txawm tias yog kev mob nkeeg.

Kev siv cov tshuaj Diroton thaum cev xeeb tub yog contraindicated. Lisinopril hla lub cev placental thiab muaj feem ntau ua rau hypoplasia thiab lub raum tsis ua haujlwm hauv tus me nyuam hauv plab, pob txha pob txha tsis ua haujlwm, thiab tsis muaj dej-electrolyte tsis txaus. Xws li cov pathologies feem ntau tsis sib xws nrog kev xeeb tub ntxiv.

Yog tias lub cev xeeb tub tau paub thaum lub sijhawm kho nrog cov tshuaj Diroton, txoj kev kho yuav tsum tau txiav tawm sai li sai tau, thiab tom qab yug menyuam, saib xyuas tus menyuam qhov kev mob yog qhov tsim nyog. Tsis tas li, cov kws kho plawv tsis muaj cov ntaub ntawv los ntawm kev nkag mus ntawm lisinopril rau hauv niam mis. Txawm li cas los xij, nws siv tawm tsam lactation tsis pom zoo.

Ntawm kev cuam tshuam ntawm cov tshuaj Diroton hauv5-6%cov neeg mob sau tseg:

• mob taub hau
• kiv taub hau
• qhuav, ntev hnoos
• tus nqi txo cov ntshav siab heev nrog kev hloov chaw hauv lub cev,
• xeev ntuav lossis ntuav
• mob hauv siab
• daim tawv nqaij ua pob.

Qhov kev phiv ntxiv lwm yam kuj cuam tshuam nrog kev cuam tshuam rau kev tsim cov tshuaj aldosterone thiab muaj feem tsawg.

Cov neeg mob yws yws txog cov tsos mob no:

• arrhythmia,
• qhov ncauj qhuav
• lub cev ua haujlwm tsis txaus (tsis muaj qab los noj mov, tso quav tsis haum, lub siab ua rau lub siab),
• nce hws
• kev nkag siab ntawm tshav ntuj,
• nkees nkees nkees, xav tsis zoo, uas yuav tsum tau txiav txim siab thaum tsav tsheb, thiab lwm yam.
• mus ob peb vas sw
• kev ua tsis taus pa ua pa
• kev tsis haum tshuaj,
• kev ua txhaum ntawm cov ntshav hematopoietic (ib qho poob qis hauv qib ntawm leukocytes, hemoglobin, platelets, neutrophils thiab lwm yam khoom tsim ntawm cov ntshav),
• tsawg potency
• tso zis muaj feem cuam tshuam nrog kev raum tsis ua haujlwm,
• leeg nqaij, mob leeg, exacerbation ntawm gout.

Nrog rau qhov pom tshwm sim ntawm cov teeb meem no, cov tshuaj tsis tuaj yeem muab tshem tawm sai vim tias qhov kev pheej hmoo ntawm kev ua kom tsis zoo rau lub siab ntawm lub plawv tsis ua haujlwm.

Tshaj dhau qhov niaj hnub noj tshuaj Diroton yog qhov txaus ntshai los ntawm qhov txo cov ntshav siab thiab lub raum tsis ua haujlwm. Ntxiv nrog rau kev kho mob ntsig txog tus mob, lub plab zom mov thiab adsorbent, hemodialysis ntawm "lub raum cuav" yuav pab kom tshem tawm cov tshuaj tseem ceeb ntawm cov tshuaj lisinopril.

Cov tshuaj Diroton mus rau ib qib lossis lwm qhov muaj qhov cuam tshuam rau txhua yam hauv nruab nrog cev thiab tshuab, yog li cov thawj coj ntawm cov tshuaj ntxiv yuav tsum pom zoo nrog kws kho mob. Yog li, thaum muaj teeb meem lub raum tsis ua haujlwm nyob hauv tus neeg mob, kev ceeb toom tshwj xeeb yog tsim nyog thaum sib txuas nrog cov tshuaj potassium (sparing diuretics) (Veroshpiron, Aldacton) nrog lisinopril vim qhov pheej hmoo ntawm hyperkalemia.

Cov tshuaj hauv qab no txhim kho cov nyhuv hypotensive ntawm Diroton:

• beta blockers,
• calcium antagonists
• tshuaj kho mob
• barbiturates, tshuaj tiv thaiv kab mob,
• vasodilators.

Kev sib xyaw ntawm Diroton nrog haus cawv muaj cawv tuaj yeem ua rau muaj kev tiv thaiv ntshav siab ntau.

Cov tshuaj sib xyaw ua ke ntawm cov tshuaj Diroton lisinopril poob nws cov hauj lwm zoo thaum siv nws nrog cov tshuaj hauv qab no:

• cov tshuaj uas tsis yog tshuaj steroidal los kho,
• lithium npaj
• antacids (txo qhov nqus ntawm lisinopril nyob rau hauv lub plab zom mov).

Ib qho ntxiv, kev hloov kho cov tshuaj hypoglycemic yog qhov tsim nyog rau cov neeg mob ntshav qab zib mellitus.Cov poj niam yuav tsum paub tias cov tshuaj Diroton txo txoj kev tiv thaiv zoo ntawm qhov ncauj tshuaj hormonal los tiv thaiv kev xeeb tub.

Hungarian Diroton hauv nqe tsis ntau txawv ntawm cov neeg sib txawv hauv tsev.

Tus nqi ntawm pob khoom ntawm 28 daim yog nyob ntawm tus naj npawb ntawm cov nquag:

• 2.5 mg - 120 rubles,
• 5 mg - 215 rubles,
• 10 mg - 290 rubles.

Cov tshuaj ntawm cov tshuaj Diroton yog Lisinopril, Lisinopril Teva, Iramed, Lisinoton, Diropress, Lysigamma, Lizoril, Listril, Liten.

Kev txheeb xyuas ntawm cov kws kho plawv qhia tau tias cov tshuaj Diroton muab cov nyhuv antihypertensive ruaj khov thiab kev tiv thaiv ntawm cov plab hnyuv siab raum kev mob plawv. Ib qho ntxiv, cov cuab yeej tshwj xeeb ntawm cov tshuaj ua rau nws raug pom zoo rau ntau tus neeg mob uas muaj kev kub siab nrog concomitant rog thiab mob siab.

Luam tawm hauv phau ntawv journal:
“System hypertension”, 2010, No. 3, p. 46-50

A.A. Abdullaev, Z.Yu. Shahbieva, U.A.Islamova, R.M. Gafurova
Dagestan State Medical Academy, Makhachkala, Russia

A.A. Abdullaev, Z. J. Shahbieva, U. A. Islamova, R. M. Gafurova
Dagestan lub xeev cov tsev kho mob kho mob, Makhachkala, Russia

Ntsiab lus
Lub Hom Phiaj: los piv qhov ua tau zoo, kev nyab xeeb thiab chaw muag tshuaj-kev khwv nyiaj txiag ntawm kev kho mob nrog cov ntawv tso cai thiab cov tshuaj ACE inhibitors lisinopril (Irumed (Belupo) thiab Diroton (Gideon Richter) hauv kev kho mob monotherapy thiab hauv kev sib xyaw nrog hydrochlorothiazide hauv cov neeg mob uas muaj qib 1-2 txhaws los ntshav.
Cov ntaub ntawv thiab cov hau kev: 50 cov neeg mob uas mob AH ntawm 1-2 tbsp tau suav nrog kev tshawb fawb raws qib kev xav tom ntej. (22 tus txiv neej thiab 28 tus poj niam) 35-75 xyoo, nrog rau nruab nrab ntev ntawm kev kub siab ntawm 7.1 ± 3.3 xyoo. Rau tus neeg mob tawm ntawm txoj kev tshawb no: 2 ntawm keeb kwm ntawm kev kho mob nrog Irumed thiab 4 ntawm keeb kwm ntawm kev kho nrog Diroton. Kev soj ntsuam txhua hnub ntawm cov ntshav siab (BPM) tau ua tiav siv cov twj SL90207 thiab 90202 (SpaceLabsMedical, USA).
Ntsiab: kev kho mob nrog Iramed ua rau txo qis ntshav siab ntau dua (-27.8 ± 8.6 / -15.1 ± 6.9 hli Hg) piv nrog Diroton (-21.1 ± 6.9 / -9.0 5.9 mmHg), pXaus: Kev kho mob nrog Irumed hauv cov neeg mob AH ntawm 1-2 mob hnyav yog tus yam ntxwv zoo tshaj plaws antihypertensive thiab yog cov kws muag tshuaj ntau dua li Diroton kho.
Cov ntsiab lus: arterial kub siab, lisinopril, Irumed, Diroton.

Aim: los sib piv cov kev ua tau zoo thiab kev pom zoo ntawm kev tso cai kho mob thiab cov tshuaj ACE inhibitor lisinopril (Irumed, Belupo thiab Diroton, Gedeon Richter) hauv kev kho tshuaj thiab sib xyaw nrog hydrochlorothiazide ntawm cov neeg mob ntshav siab (AH).
Cov ntaub ntawv thiab cov hau kev: kev sib tham qhib kev tshawb nrhiav tshiab muaj 50 tus neeg mob AH (22 tus txiv neej thiab 28 tus pojniam hnub nyoog 35-75 xyoo) txhais tau ntev li 7.1 ± 3.3 xyoo. 6 tus neeg mob tau tawm hauv kev kawm (Irumed -2 ​​thiab Diroton - 4). Ntshav siab (BP) tau saib xyuas 24 xuab moos nrog lub twj SL 90207 thiab 90202 (Chaw Kho Mob Hauv Tsev, Tebchaws Asmeskas).
Ntsiab: Irumed ntau qhov txo qis hauv tsev kuaj mob BP (-27.8 ± 8.6 / -15.1 ± 6.9 hli Hg) dua li Diroton (-21.1 ± 6.9 / -9.0 ± 5.9 hli Hg ), pXaus: Txoj kev kho Irumed pom qhov ua tau zoo tshaj plaws thiab kev siv nyiaj tsawg dua li kev kho mob Diroton hauv cov neeg mob qib 1-2 txhaws tawm ntshav.
Ntsiab lus: Rauv arterial kub siab, lisinopril, Irumed, Diroton

Cov ntaub ntawv hais txog cov neeg sau ntawv
Abdullaev Aligadzhi Abdullaevich - Dr. med. kawm xaiv kawm, hau. Department ntawm Sab Nraum Kho, Kev Kho Kab Mob Hlawv thiab Kev Kho Mob General
GOU VPO Dagestan State Medical Academy
Shakhbieva Zarema Yusupovna - kawm tiav tub ntxhais kawm ntawm tib lub department
Islamova Ummet Abdulhakimovna - Cand. zib ntab xaiv kawm txuj ci, tus pab cuam ntawm tib lub department. 367030, RD, Makhachkala, I. Shamily Ave., 41, apt. 94.
Gafurova Raziyat Magomedtagirovna - Cand. zib ntab xaiv kawm txuj ci, tus pab cuam ntawm tib lub department. 367010, RD, lub nroog Makhachkala, ul. Mendeleev, d.12.

Taw qhia
Kev kho mob rau cov neeg mob ntshav siab (AH) tam sim no yog ib qho haujlwm tseem ceeb, vim nws txoj kev pab rau kev mob plawv (SS) cov neeg tuag txog 40%, thiab nrog kev kho kom zoo thiab muaj kev nyab xeeb, nws hais txog kev hloov phom sij rau kev txhim kho cov hlab plawv ( IHD) thiab lwm yam kab mob SS. Cov txiaj ntsig ntawm ntau cov kev tshawb fawb tau ua pov thawj tias kev kho mob monotherapy tsuas yog siv tau ib qho me me (li 30%) ntawm cov neeg mob ntshav siab. Kev siv ob lub tshuaj tso cai rau koj kom ua tiav qhov kev xav txog qib ntshav siab (Tom qab lub sijhawm tag nrho ntawm lub sijhawm tiv thaiv patent, ib lub tuam txhab tshuaj muaj peev xwm tsim thiab muag cov tshuaj no. Vim li ntawd, tib cov tshuaj los ntawm ntau lub tuam txhab tuaj yeem muag hauv khw muag tshuaj. Ntxiv rau, cov tshuaj no tuaj yeem sib txawv heev hauv kev ua haujlwm thiab kev nyab xeeb. Tag nrho cov txiaj ntsig ntawm cov tshuaj, muaj pov thawj hauv cov tshuaj tiv thaiv mob sib kis tau, muaj feem rau cov tshuaj qub. thiab cov tshuaj kho mob raws li daim ntawv tso cai.Cov tshuaj feem ntau yuav tsum muaj pov thawj kev sib txig hauv kev sim tshuaj thaum sib piv ncaj qha rau cov thawj. Hauv qhov no, peb tuaj yeem hais tawm tias cov tshuaj feem ntau yuav muaj txiaj ntsig zoo thiab muaj kev nyab xeeb zoo li qhov qub, thiab cov ntaub ntawv tau ntawm cov tshuaj muaj peev xwm muab faib rau nws. Hmoov tsis zoo, tsuas muaj tsawg ntawm cov tshuaj feem ntau, cov kev tshawb fawb zoo sib xws tau ua.

Nyob rau hauv xyoo tas los no, muaj kev txaus siab tseem ceeb ntawm nyiaj txiag ntawm kev kho mob tshuaj. Qhov no raug thawb los ntawm kev tau txais nyiaj tsawg ntawm cov chaw kho mob thiab, feem ntau, cov khoom siv los ntawm tus neeg mob nws tus kheej. Txhawm rau daws cov teeb meem no hauv qhov xwm txheej tam sim no, nws yuav tsum tau txiav txim siab tsis yog qhov chaw kuaj mob siv tau thiab muaj kev nyab xeeb ntawm ib qho tshuaj, tab sis kuj tseem cuam tshuam txog kev lag luam rau tus neeg mob thiab rau kev kho mob. Rational pharmacotherapy ntawm ib yam kab mob yuav tsum yog los ntawm pharmacoeconomics.

Tshawb nrhiav lub hom phiaj - sib piv cov kev ua tau zoo, kev nyab xeeb thiab pharmacoeconomic ua pov thawj ntawm kev kho mob nrog cov ntawv tso cai thiab cov tshuaj ACE inhibitors lisinopril (Irumed (Belupo) thiab Diroton (Gideon Richter) hauv kev kho mob monotherapy thiab hauv kev sib xyaw nrog hydrochlorothiazide nyob rau hauv cov neeg mob uas muaj qib 1-2 txhaws ntshav.

Cov khoom thiab txoj kev: txoj kev tshawb no suav nrog 50 cov neeg mob uas mob ntshav siab ntawm 1-2 qhov hnyav, ntawm 6 leej neeg mob tawm thaum lub sijhawm rov qab soj ntsuam: 2 thaum kho mob Irumed thiab 4 thaum kho nrog Diroton. Tag nrho ntawm 44 tus neeg mob ua tiav txoj kev tshawb no. Thaum pib, pawg tsis muaj qhov sib txawv ntawm lub hnub nyoog, poj niam txiv neej, thiab lwm yam ntxwv (Cov Lus 1). Txoj kev tshawb no suav nrog cov neeg mob hnub nyoog 18-75 xyoo uas nyuam qhuav tawm tsam tshiab lossis tus uas tsis nquag noj tshuaj tiv thaiv kabmob thaum lub hli dhau los. Nyob rau lub sijhawm suav nrog, pab pawg nruab nrab systolic ntshav siab (SBP) chaw kuaj mob (chav kawm) yog 158.5 ± 7.5 hli Hg. Daim duab., Diastolic ntshav siab (DBP) C. 97.5 ± 5.0 mmHg. Art., Lub plawv dhia 74.7 ± 8.8 neeg ntaus / min. Qhov tsis suav cov ntsiab lus yog: cov ntawv ntxiv ntawm kev kub siab, mob ntshav qab zib cerebrovascular, mob myocardial infarction nyob rau 6 lub hlis dhau los, angina pectoris II-III FC, lub plawv tsis ua haujlwm, mob plawv dhia tsis ua hauj lwm, lub siab thiab lub raum kev ua haujlwm.

Rooj ntawv 1. Thawj qhov kev soj ntsuam thiab kev ua neeg thiab kev ntsuas ntawm cov pab pawg

Tus Qauv Kawm: qhov kev tshawb fawb yog kev xaiv, qhib-xaus, yav tom ntej, thiab tau ua hauv GCP cov cai (Zoo Cov Kev Ntsuas Ua Zoo) thiab 2000 Helsinki Kev Tshaj Tawm. Lub sijhawm saib xyuas yog 24-25 lub lis piam. Ua ntej kev koom rau hauv txoj kev tshawb fawb, keeb kwm kev kho mob tiav tau sau hauv txhua tus neeg mob, kev tshuaj xyuas lub cev tau ua tiav, ntshav siab tau ntsuas los ntawm Korotkov txoj kev, tom qab ntawd cov neeg mob uas tau ua raws li cov txheej txheem suav nrog thiab tsis muaj qhov tshwj xeeb cais tau cia li muab yuam kev rau 2 pawg sib luag, thawj zaug pib kho mob nrog Iramed thiab lub thib ob nrog Diroton ntawm koob tshuaj 10 mg / hnub. Tom qab 2 lub lis piam, thaum lub hom phiaj ntawm cov ntshav siab tsis tiav (kev soj ntsuam ntshav siab tau txhais tias qhov nruab nrab ntawm 3 ntsuas kev ntsuas ntshav nrog phau ntawv sphygmomanometer nyob rau hauv qhov chaw zaum tom qab 10-15 feeb ntawm so, thiab tseem sawv ntsug, 1 feeb ua ntej noj tshuaj rau hnub mus ntsib. Rau cov qauv tshuaj rau qhov muaj txiaj ntsig ntawm kev tiv thaiv kabmob ntshav rau AD cov qe ntshav, lawv tau txo qis hauv DBP cov hlwb li 10% lossis 10 hli Hg thiab GARDEN hlwb li 15 hli Hg los ntawm theem pib. software pob Statistiсa 6.0 (Statsof t, Tebchaws USA), muab rau qhov ua tau ntawm parametric thiab nonparametric tsom xam.Qhov qhov sib txawv tau txiav txim siab tseem ceeb ntawm pCov txiaj ntsig thiab kev sib tham

Ob qho tib si kawm txog tshuaj muaj qhov ua tau zoo antihypertensive, ua kom nrov nrov ntxiv rau kev hloov pauv ntawm cov neeg mob mus rau kev kho ua ke. Irumed txo qis ntshav siab xws li tom cl. HELL, thiab raws li luag. Tom qab 2 lub lis piam ntawm kev noj tshuaj lisinopril ntawm ib koob ntawm 10 mg / hnub hauv pawg Irumed, cov ntshav siab poob qis los ntawm 158.4 ± 7.4 / 98.2 ± 4.4 hli Hg. Kos duab. mus txog 146.1 ± 9.1 / 93.1 ± 6.1 mmHg. Kos duab. (p. 6)Rooj 2. Lub zog ntawm cov ntshav siab. thaum kho nrog Irumed thiab Diroton.

Puas yog lisinopril lossis diroton zoo dua? Dab tsi yog qhov txawv?

Cov ntawv npaj muaj Lisinopril Lisinopril, ATX code ATC C09AA03 Feem ntau ntsib cov ntawv tso tawm rau ntau tshaj 100 muab hauv chaw muag tshuaj Moscow Diroton Diroton.

Qhov no yuav luag tau tib yam. Muaj cov contraindications (ntau). Tham nrog kws kho mob ua ntej noj.
Cov kev sib txawv tseem ceeb yog contraindications, txij li Diroton raug txwv rau cov neeg mob muaj keeb Quincke's edema, thiab Lisinopril rau cov neeg mob lactose tsis txaus, nrog lactose deficiency, thiab tseem muaj cov piam thaj-galactose malabsorption.

Cov no yog cov tsis zoo ib yam tshuaj.
Diroton tsuas yog ib ntawm cov npe lag luam lag luam rau lisinopril
Qhov sib txawv tsuas yog nyob rau hauv cov chaw tsim khoom thiab tus nqi

Qhov ntawd pab tau. Tshuaj ua txawv rau txhua tus

Cov lus tseem ceeb ntawm txoj hlab ntshav siab, lisinopril, Irumed, Diroton.If monotherapy nrog lisinopril Irumed lossis Diroton tsis tau tso cai kom ncav cuag lub hom phiaj ntshav siab, tom qab ntawd 2 lub lis piam hydrochlorothiazide hydrochlorothiazide GCT tau ntxiv 12,5 mg ib hnub ua kev sib xyaw pub dawb.

Kuv tus kheej tsis haum ib qho los yog lwm qhov ... tsis muaj kev cuam tshuam

Lub hauv paus ntawm cov tshuaj yog lisinopril dihydrate, thiab qhov sib txawv yog nyob rau hauv cov khoom sib ntxiv, uas yog lub npe nrog cov lus ua ntej hauv Latin Teva, Actavis, Ratiopharm, Stada, ntxiv rau ib pawg ntawm cov sib cais ntawm kev tso tawm Indapamide, Diroton, Irumed, Dapril, Captopril, Sinopril ...

Yog lawm, koj yog tus ruam tiag. Ua piv txwv peb cov tshuaj aspirin, thiab cov tshuaj aspirin los ntawm Asmeskas yog ib qho thiab tib yam, thiab qhov sib txawv ntawm tus nqi yog wow. Kuv ua haujlwm hauv lub tsev muag tshuaj, yog li kuv paub txog qhov xwm txheej ntawd

Diroton lisinopril cov lus qhia Tus tsim khoom nplua nuj Gteron Ltd, Hungary. Leej twg tau qhia Diroton. Arterial hypertension nyob rau hauv daim ntawv ntawm monotherapy lossis hauv kev sib xyaw nrog lwm tus neeg sawv cev antihypertensive.

Yog lawm. Peb ruam tshaj ruam txog poj.
Peb them nyiaj rau kev tshaj tawm, rau kev ntim khoom zoo nkauj.

Kuv xav tias yog, ntawm no Suav feem ntau ntse, lawv tau siv tshuaj ntsuab ib txwm tau txhiab xyoo, thiab tseem tsis cia lawv noj !!

Zoo saib kawg li. Muaj 3 hom ntsev: rooj noj mov, hiav txwv, thiab thev naus laus zis. Fomula ib yog sodium chloride. Thiab lub impurities yog txawv ... koj puas ncuav kev ntsev rau koj saucepan? Yog li nws yog nrog cov tshuaj. qub yog ib txwm txias. Rau nws hla nruj tswj.

Muaj cov tshuaj zoo li no. Duphaston raug nqi txog 500 rubles, muaj cov npe tshuaj Lavxias (tsis nco qab npe) -120 rubles. - tsis muaj qhov sib txawv. Tab sis tib lub sijhawm, peb acyclovir tsis pab txhua yam, txawm hais tias nws raug nqi ib lub hnab nyiaj, thiab kev ncaj ncees-170p pab tam sim.

Kuv tsis xav hais tias acyclovir tsis pab, tab sis muaj ntau qib ntawm ib tus kab mob, nws tau pab lwm tus neeg tam sim ntawd, thiab tus neeg tsis tshua
Tab sis! Kuv lees txais diroton (ntshuam), hloov nrog peb lisinopril (cov tshuaj muaj zog yog lisinopril, ntau npaum li cas yog ib qho)-cuam tshuam 0. Muaj qhov sib txawv, txawm hais tias tus nqi sib txawv yog 30%. Kuv sim coj hauv tsev tsis txhob ntshuam

Thiab ka yog zoo dua diroton lossis prestarium, dab tsi yog qhov sib txawv ntawm cov tshuaj Diroton lisinopril yog ib qho ntawm ACE inhibitors. Prestarium perindopril yog lwm qhov tshuaj los ntawm tib pab pawg.

Kuv tuaj yeem hais txog Acetylsalicylic acid ntawm peb cov ntau lawm thiab Bayer (Kuv tsis paub txog teb chaws USA): peb cov neeg sib tw (sib xyaw) ntawm 2- (Acetyloxy) benzoic acid thiab 4- (Acetyloxy) benzoic acid, thiab cov chaw tsim khoom hauv German tau muab tshem tawm ntawm 4- (Acetyloxy ) benzoic acid, thiab yog li ntawd zoo dua qub. (Yog li peb tus kws kho mob organic ntawm tshuaj ntsuab kev tshawb fawb tau hais rau kuv).
Thiab tom qab ntawd muaj cov tshuaj feem ntau thiab cov tshuaj dhau los (Cov tshuaj feem ntau yuav muaj lwm cov neeg zam dua li qhov qub - thiab tag nrho cov tshuaj muaj cov neeg zam nyob rau hauv qhov ntau uas cuam tshuam rau cov kev ua ntawm cov tshuaj muaj tshuaj (tus nqi tso tawm tshuaj (nce / txo), thiab lwm yam))
Thawj cov tshuaj: tsim, undergoes tag nrho cov kev tshawb fawb, patented, thiab lwm yam ... (nws raug nqi nyiaj) .... thiab cov qauv ntau yog tsim tom qab tas sij hawm ntawm kev ua tiav ntawm patent ntawm qhov qub thiab / lossis thaum hloov Aux.
Li no, peb ua las voos, uas zoo dua ....

Ib lub hom lag luam yog tus nqi. Leej twg yuav them rau nws yog tias tsis yog peb?

Ntawm qhov kev nyuab siab no, koj yuav tsum hu rau lub tsheb thauj neeg mob, txwv tsis pub koj tuaj yeem txav mus tus nees

Cov tshuaj ntawm cov ntsiav tshuaj Diroton. Diroton ntsiav tshuaj Qhov nruab nrab ntawm cov qhab nia ntawm lub suab 8. Cov Chaw Tsim Tshuaj Gideon Richter Hungary Cov Ntawv Tso Tawm Muaj cov qauv duab ntawm cov Diroton. Lisinopril ntsiav tshuaj Ntsuas qhov ntsuas nruab nrab ntawm cov npav 18. Cov qauv ntsuas yog pheej yig los ntawm 60 rubles.

Sim LYSINOPRIL 10 lossis 20 txawm tias koj tsis noj 10. Haus 1 ntsiav tshuaj thaum tsaus ntuj.

Yog li koj yuav tsum qhia tus kws kho mob thiab khaws cov tshiab, ntxiv rau koj yuav tsum tau haus tshuaj diuretics

Tsheb tos neeg mob, lawv yuav txhaj tshuaj. Qhov yuav tsum tau ua kom sai sai los daws qhov siab, yog li ntawm cov tshuaj rau nws tus kheej hauv qhov no tsis tsim nyog.

Cov khoom siv tseem ceeb ntawm Diroton yog lisinopril Tus nqi ntawm Diroton 20 mg yog 600 rubles. Pheej yig analogues ntawm Diroton nrog cov tshuaj tseem ceeb lisinopril.

Xws li lub siab raug rho tawm los ntawm kev poob cev qhev (kapoten) - 1 ntsiav tshuaj thiab hauv qab tus nplaig (nws yuav nqus tau sai dua thiab yuav ua. Thiab tom qab 30 feeb lub siab ntsuas tau ntsuas - thiab nyob ntawm nws - lwm cov ntsiav tshuaj. Tab sis cov tshuaj no haum rau crises, nws tsis haum rau kev kho mob, yog li ntawd hais tias nws yog luv-taw thiab tsis tuav siab rau lub sij hawm ntev.
Yog tias koj tau noj tshuaj, tom qab ntawd lawv cov txiaj ntsig raug soj ntsuam tsuas yog tom qab tsawg kawg 2 lub lis piam, thiab feem ntau - tom qab 4 lub lis piam. Yog li tsis txhob maj mus rau cov lus xaus.

Rau tus kws kho mob, thiab yog tias cov ntsiav tshuaj tsis pab, ces koj yuav tsum sim lwm tus. txhua tus ua nws!

Oooooh los yog dab tsi rau koj tus kheej! Sai li lub siab tawm sai nyob rau hauv tus nplaig, volidol lossis nitroglycerin hauv tus nplaig thiab hu rau lub tsheb thauj neeg mob sai !! ! Koj yuav tsum tau muab tso rau hauv chav kho tsev kho mob lossis hauv chav kho plawv! Tab sis ntawm koj lub hnub nyoog qhov no tsis nyob rau txhua qhov qub !! ! Kuv nkag siab tias yog koj yog ib tug poj niam laus !! ! Tab sis tsis nyob rau ntawm lub hnub nyoog

Ntawm qhov siab no, koj yuav tsum hno dibazole nrog papaverine (qhov no yog tsheb thauj neeg mob) Thiab yog lawm koj yuav tsum xaiv cov tshuaj los kho nrog ib lub diuretic hauv cov muaj pes tsawg leeg ...

Ёёёёё….
Diroton tus lej 10, koj tuaj yeem tus lej 5
thaum muaj xwm txheej ceev, ua kom da dej kub ntawm lub dab teg, tab sis tsis pub ntau tshaj 5 feeb - cov hlab ntsha yuav nthuav dav sai, lub siab yuav qis thaum lub tsheb thauj neeg mob mus ncig ....
Koj puas tau tshuaj xyuas? koj yuav tsum paub qhov teeb meem yog dab tsi.

Diroton tsis yog qhov siv lisinopril. Gideon Richter, tus tsim nws, yog tsob ntoo hauv Hungary, qhov chaw uas lawv nqa cov khoom uas kuv tsis paub. Kuv pom zoo raws li Mikhail Yuryevich qhov kev hwm tias qhov sib txawv ntawm ib lossis ob qho atoms tuaj yeem zais qhov txawv!

Cov lus ntawm analogues thiab cov nqi

Diroton (Lisinopril) - cov lus qhia ntawm nom rau siv (paub daws teeb)

Ib tsab xov xwm los ntawm tus sau ntawm lub xaib, kws kho plawv, ntawm kev kho mob ntshav siab

Txhua txog tonometers

Muaj cov contraindications. Tham nrog kws kho mob ua ntej noj.

Cov npe lag luam (txawv teb chaws) - Acebitor, Acemin, Acerbon, Acinopril, Carace, Cipril, Coric, Diotril, Hipril, Lanatin, Linoxal, Lipril, Lisihexal, Lisinostad, Lisitec, Lisodura, Lisotec, Nivant, Novatecos, Odace, , Prinivil, Ranopril, Renotens, Secubar, Sedotensil, Sinopren, Tensiphar, Tensopril, Tevalis, Tobicor, Trupril, Vivatec, Zestomax, Zestril.

Lwm ACE inhibitors nyob ntawm no.

Txhua yam tshuaj uas siv hauv kev kho plawv yog nyob ntawm no.

Koj tuaj yeem nug ib lo lus nug lossis tawm kev rov tshuaj xyuas txog cov tshuaj (thov tsis txhob hnov ​​qab qhia lub npe ntawm cov tshuaj hauv cov ntawv sau) ntawm no.

Kev Npaj Muaj Lisinopril (Lisinopril, ATX code (ATC) C09AA03):

Cov qauv twg yog qhov zoo dua?

Cov chaw kho mob thiab chaw muag tshuaj:

ACE Inhibitor (Angiotensin Kev Hloov Enzyme)

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

ACE inhibitors lengthen lub neej nyob ntev hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev, qeeb cov kev vam meej ntawm sab laug ventricular kawg ntawm cov neeg mob tom qab myocardial infarction yam tsis muaj kev soj ntsuam mob plawv tsis ua haujlwm.

Qhov pib ntawm cov tshuaj - tom qab 1 teev, nce mus txog qhov siab tshaj plaws tom qab 6-7 teev thiab kav rau 24 teev. Lub sijhawm ntawm cov nyhuv kuj nyob ntawm qhov loj npaum li cas ntawm cov koob tshuaj. Nrog rau cov hlab ntsha o, cov nyhuv tshwm sim hauv thawj hnub tom qab pib kev kho mob, cov nyhuv ruaj khov tshwm sim tom qab 1-2 lub hlis. Nrog kev tshem tawm sai ntawm cov tshuaj, tsis muaj qhov cim tseg hauv ntshav siab tau pom.

Diroton® txo cov albuminuria. Hauv cov neeg mob hyperglycemia, nws pab ua kom lub cev ua haujlwm ntawm glomerular endothelium tsis ua haujlwm. Nws tsis cuam tshuam rau cov ntshav qabzib hauv cov neeg mob ntshav qab zib mellitus thiab tsis ua rau muaj kev nce ntxiv hauv cov neeg mob ntshav qab zib.

Tom qab noj cov lisinopril sab hauv, Cmax tau mus txog tom qab 7 teev. Qhov nruab nrab ntawm kev nqus ntawm lisinopril yog kwv yees li 25%, nrog qhov kev cuam tshuam tseem ceeb ntawm tus kheej (6-60%). Noj mov tsis cuam tshuam rau qhov nqus ntawm lisinopril.

Lisinopril tsis muaj zog khi rau cov ntshav plasma. Kev tso cai hla dhau ntawm BBB thiab qhov chaw nruab siab tsis tshua muaj.

Lisinopril tsis yog metabolized.

Nws yog tsuas yog cais tshwj xeeb los ntawm ob lub raum tsis hloov. Tom qab kev rov ua dua, kev ua tau zoo T1 / 2 yog 12 teev.

Hauv cov neeg mob uas muaj lub plawv tsis ua hauj lwm ntev, kev nqus thiab tshem tawm ntawm lisinopril txo.

Lub raum ua haujlwm tsis zoo ua rau muaj kev nce ntxiv hauv AUC thiab T1 / 2 ntawm lisinopril, tab sis cov kev hloov pauv no ua rau thaj chaw tseem ceeb tsuas yog thaum lub ntsej muag glomerular tsawg dua 30 ml / min.

Hauv cov neeg mob laus, cov tshuaj ntawm cov ntshav hauv plasma thiab AUC yog 2 npaug ntau dua li ntawm cov neeg hluas.

Lisinopril raug ntiab tawm los ntawm hemodialysis.

Kev noj tshuaj ntxiv

Cov tshuaj tau noj ntawm qhov ncauj 1 zaug hauv ib hnub, rau txhua qhov ntsuas, tsis hais noj zaub mov, nyiam nyob tib lub sijhawm ntawm ib hnub.

Nrog rau qhov tseem ceeb ntawm kev kub siab, cov neeg mob tsis tau txais lwm cov tshuaj tiv thaiv kev tiv thaiv kab mob tau muab 10 mg ib hnub ib zaug. Cov koob tshuaj saib xyuas txhua hnub li 20 mg. Qhov nyiaj pab ntau tshaj txhua hnub yog 40 mg.

Tag nrho cov txiaj ntsig feem ntau tshwm sim tom qab 2-4 lub lis piam los ntawm kev pib kho, uas yuav tsum tau coj mus rau hauv tus account thaum nce qhov koob tshuaj. Nrog cov kab mob tsis txaus ntseeg, nws muaj peev xwm los sib xyaw cov tshuaj nrog lwm cov tshuaj tiv thaiv kabmob.

Yog tias tus neeg mob tau txais kev kho mob ua ntej nrog diuretics, tom qab ntawd lawv qhov kev txais tos yuav tsum nres 2-3 hnub ua ntej pib siv Diroton. Yog tias nws tsis tuaj yeem thim cov tshuaj diuretics, tom qab ntawd thawj koob tshuaj Diroton yuav tsum tsis pub tshaj 5 mg rau ib hnub. Hauv qhov no, tom qab noj thawj koob, kev saib xyuas kev noj qab haus huv raug pom zoo rau ob peb teev (qhov siab tshaj plaws yog ua tiav tom qab li 6 teev), vim tias lub cim txo nyob rau hauv cov ntshav siab yuav tsim.

Nyob rau hauv kev tshwm sim ntawm kev kho mob ntshav siab los yog lwm yam mob nrog RAAS kev ua haujlwm ntau ntxiv, nws tseem raug nquahu kom txo qis qis ntawm thawj zaug ntawm 2.5-5 mg ib hnub nyob rau hauv kev saib xyuas kev kho mob (tswj ntshav siab, lub raum kev ua haujlwm, ntshav poov tshuaj concentration). Cov koob tshuaj txij nkawm yuav tsum txiav txim siab nyob ntawm qhov kev hloov pauv ntawm cov ntshav siab.

Hauv lub raum tsis ua haujlwm, vim qhov tseeb tias lisinopril yog tawm los ntawm lub raum, thawj koob tshuaj yuav tsum txiav txim siab nyob ntawm qhov kev tshem tawm ntawm KK, tom qab ntawd, raws li qhov tshuaj tiv thaiv, ib qho kev saib xyuas yuav tsum tau tsim nyob rau hauv cov xwm txheej ntawm kev saib xyuas nquag ntawm lub raum kev ua haujlwm, kev suav tshuaj ntawm poov tshuaj thiab sodium hauv ntshav ntshav.

Hauv kev mob plawv tsis ua hauj lwm, kev txhaj tshuaj thawj zaug yog 2.5 mg 1 zaug nyob rau ib hnub, uas tuaj yeem maj mam nce hauv 3-5 hnub mus rau ib txwm, txhawb kev noj tshuaj txhua hnub ntawm 5-20 mg. Qhov koob tshuaj yuav tsum tsis pub tshaj qhov siab tshaj qhov niaj hnub noj 20 mg. Nrog rau kev siv nrog rau diuretics, qhov muab tshuaj ntawm lub diuretic yuav tsum txo ua ntej, yog tias ua tau. Ua ntej pib txoj kev kho mob nrog Diroton® thiab tom qab ntawd, thaum lub sijhawm mus kho mob, ntshav siab, lub raum kev ua haujlwm, poov tshuaj thiab sodium hauv cov ntshav yuav tsum tau saib xyuas tsis tu ncua kom tsis txhob muaj cov hlab ntsha hypotension thiab cuam tshuam rau lub raum ua haujlwm.

Hauv cov mob myocardial infarction (raws li ib feem ntawm kev sib xyaw ua ke), 5 mg yog kho nyob rau thawj hnub, 5 mg rau hnub thib ob, 10 mg rau hnub thib peb, thiab kev saib xyuas txij nkawm ntawm 10 mg ib hnub ib zaug. Hauv cov neeg mob uas muaj mob myocardial infarction, cov tshuaj yuav tsum tau siv tsawg kawg 6 lub lis piam. Nrog systolic ntshav qis (tsawg dua 120 hli Hg. Kos Duab.), Kev kho mob pib nrog qhov txhaj tshuaj qis (2.5 mg /). Nyob rau hauv cov ntaub ntawv ntawm kev loj hlob ntawm arterial hypotension, thaum systolic ntshav siab yog tsawg dua 100 mm Hg. Txuj Ci., Koob tshuaj txij nkawm yog txo rau 5 mg rau ib hnub, yog tias tsim nyog, koj tuaj yeem muab teem ib ntus 2.5 mg ib hnub. Nyob rau hauv rooj plaub ntawm lub cim ntev dhau los txo cov ntshav siab (systolic ntshav qis dua 90 hli Hg. Daim duab. Ntau dua 1 teev), nws tsim nyog yuav tsum tau txiav kev kho mob nrog cov tshuaj.

Hauv kev mob ntshav qab zib nephropathy hauv cov neeg mob uas muaj ntshav qab zib insulin-tiv thaiv kev mob ntshav qab zib, Diroton® yog siv ntawm koob tshuaj 10 mg ib hnub ib zaug.Yog tias tsim nyog, koob tshuaj tuaj yeem raug nce ntxiv rau 20 mg ib hnub ib zaug txhawm rau kom ua tiav diastolic ntshav siab qis qis dua 75 hli Hg. Kos duab. hauv ib txoj hauj lwm zaum. Hauv cov neeg mob uas tsis mob ntshav qab zib tsis yog insulin-mellitus, cov tshuaj tau raug sau hauv tib lub tshuaj, txhawm rau kom ua tiav diastolic ntshav siab qis dua 90 hli Hg. hauv ib txoj hauj lwm zaum.

Cov kev mob tshwm sim feem ntau yog kiv taub hau, mob taub hau (5-6%), tsis muaj zog, zawv plab, hnoos qhuav (3%), xeev ntuav, ntuav, orthostatic hypotension, tawv nqaij ua pob, mob hauv siab (1-3%).

Qhov ntau zaus ntawm lwm cov kev tsis sib haum yog tsawg dua 1%.

Los ntawm cov hlab plawv system: cim txo qis hauv cov ntshav siab, mob hauv siab, tsis tshua muaj - orthostatic hypotension, tachycardia, bradycardia, cov tsos mob tshwm sim ntawm lub plawv tsis ua haujlwm, kho tsis tau AV conduction, myocardial infarction.

Los ntawm lub plab zom mov: xeev siab, ntuav, mob plab, lub qhov ncauj qhuav, raws plab, dyspepsia, anorexia, saj tsis meej, pancreatitis, mob siab (kab mob siab thiab mob cholestatic), mob daj ntseg (hepatocellular lossis cholestatic), hyperbilirubinemia, ua rau daim siab mob siab.

Ntawm ib feem ntawm daim tawv nqaij: urticaria, nce hws, photosensitivity, khaus, plaub hau poob.

Los ntawm ib sab ntawm lub hauv nruab nrab cov hlab ntsha: lability ntawm lub siab, tsis hnov ​​qab lub zog, lub cev txhav, muaj zog qaug zog, nkees nkees, tawv nqaij ntawm cov leeg ntawm nqaj thiab daim di ncauj, tsis tshua muaj - asthenic syndrome, tsis meej pem.

Los ntawm cov txheej txheem ua pa: dyspnea, hnoos qhuav, bronchospasm, apnea.

Los ntawm cov kab mob hemopoietic: leukopenia, thrombocytopenia, neutropenia, agranulocytosis, anemia (kev txo qis hauv cov ntshav ntawm hemoglobin, hematocrit, erythrocytopenia), nrog rau kev kho mob ntev, ib qho zuj zus ntawm hemoglobin thiab hematocrit yog tau, qee qhov mob - agranul.

Kev tsis haum tshuaj: kev mob hlwb ntawm lub ntsej muag, tes taw, daim di ncauj, tus nplaig, epiglottis thiab / lossis mob caj pas, mob hnyuv angioedema, vasculitis, cov tshuaj tiv thaiv zoo rau cov tshuaj tiv thaiv kev tiv thaiv kab mob, nce ESR, eosinophilia, nyob hauv qee qhov mob tsawg - interstitial angioedema (mob ntsws los ntawm lub ntsws tsis muaj qhov nqaij interstitial tawm ntawm transudate rau hauv lumen ntawm lub alveoli).

Los ntawm cov kab mob genitourinary: uremia, oliguria, anuria, lub raum tsis ua haujlwm, mob raum tsis ua haujlwm, txo qis potency.

Kev ntsuas kev ntsuas: hyperkalemia thiab / lossis hypokalemia, hyponatremia, hypomagnesemia, hypochloremia, hypercalcemia, hyperuricemia, muaj ntshav ntau dhau ntawm urea thiab creatinine, hypercholesterolemia, hypertriglyceridemia, txo qis cov ntshav qabzib.

Lwm yam: arthralgia, mob caj dab, mob myalgia, kub taub hau, exacerbation ntawm gout.

Nrog kev ceev faj, cov tshuaj yuav tsum tau muab rau kev noj qab haus huv ob lub raum artery stenosis los yog mob ntawm lub raum tib leeg, cov mob tom qab lub raum hloov pauv, lub raum tsis ua haujlwm (CC tsawg dua 30 ml / min), stenosis ntawm lub aortic orifice, hypertrophic obstructive cardiomyopathy, thawj hyperaldosteronism, hlab ntsha hypotension, mob ntshav qab zib suav nrog cerebrovascular tsis txaus), mob plawv, mob ntshav qab zib mellitus ntau dua, mob plawv tsis ua haujlwm ntev, kab mob rau lub cev cov nqaij mos (suav nrog scleroderma, cov kab mob lupus erythematosus), kev txwv tsis pub cov leeg pob txha hematopoiesis, kev mob hypovolemic (suav nrog los ntawm kev mob plab zawv, ntuav), hyponatremia (hauv cov neeg mob rau cov zaub mov ntsev tsawg lossis ntsev tsawg, muaj kev pheej hmoo ntawm kev tsim cov hlab ntsha) hypotension), cov neeg laus laus uas muaj cov hemodialysis siv high-flow dialysis nyias (AN69®).

Kev siv Diroton thaum cev xeeb tub yog contraindicated. Lisinopril hla kev tso chaw nyob nruab nrab. Thaum cev xeeb tub yog tsim los, cov tshuaj yuav tsum raug txiav tu sai li sai tau. Kev lees txais ntawm ACE inhibitors nyob rau hauv II thiab III trimesters ntawm cev xeeb tub muaj qhov tshwm sim tsis zoo ntawm cov menyuam hauv plab (lub suab txo qis hauv cov ntshav siab, lub raum tsis ua haujlwm, hyperkalemia, pob txha taub hau hypoplasia, kev tuag intrauterine yog ua tau).Tsis muaj cov ntaub ntawv qhia txog cov tshuaj tsis zoo ntawm cov tshuaj ntawm cov menyuam hauv plab yog siv hauv thawj ib hlis. Rau cov menyuam mos thiab cov menyuam mos uas tau txais tshuaj tiv thaiv ACE inhibitors, nws raug nquahu kom ua tib zoo saib xyuas kom ncav sijhawm txhawm rau pom qhov txo qis hauv cov ntshav siab, oliguria, hyperkalemia.

Tsis muaj ntaub ntawv qhia txog kev nkag mus ntawm lisinopril rau hauv niam mis. Yog tias tsim nyog, kev teem sij hawm tshuaj thaum lactation, pub mis rau noj yuav tsum tsis ua ntxiv.

Hauv lub raum tsis ua haujlwm, vim qhov tseeb tias lisinopril yog tawm los ntawm lub raum, thawj koob tshuaj yuav tsum txiav txim siab nyob ntawm creatinine kev tshem tawm, tom qab ntawd ua raws li cov tshuaj tiv thaiv, ib qho kev saib xyuas yuav tsum tau tsim nyob rau hauv cov xwm txheej ntawm kev saib xyuas nquag ntawm lub raum kev ua haujlwm, cov poov tshuaj thiab sodium concentration hauv cov ntshav.

Nrog kev ceev faj, cov tshuaj yuav tsum tau raug rau cov mob raum tsis zoo, ob tog lub raum mob ntshav siab los yog txoj hlab ntsha hauv lub raum ntawm lub raum nrog cov mob azotemia, qhov mob tom qab lub raum hloov pauv, lub raum tsis ua haujlwm, azotemia.

Feem ntau, qhov cim tseg ntawm cov ntshav siab tshwm sim nrog qhov txo qis cov dej hauv lub cev los ntawm kev kho diuretic, txo qis ntsev hauv zaub mov, lim ntshav, raws plab, lossis ntuav. Hauv lub plawv mob tsis ua haujlwm nrog ib lub raum tsis ua haujlwm lossis tsis muaj nws, qhov cim tseg txo qis hauv ntshav yog qhov ua tau. Ib qho qhia tau ntau dua nyob rau hauv cov ntshav siab tau pom nyob hauv cov neeg mob uas muaj kev mob ntshav siab ntau ntawm lub plawv ntev, los ntawm kev siv cov tshuaj diuretics hauv siab, hyponatremia, lossis lub raum tsis ua haujlwm. Hauv cov neeg mob zoo li no, kev kho mob nrog Diroton yuav tsum tau pib nyob rau hauv kev saib xyuas nruj ntawm tus kws kho mob (nrog ceev faj, xaiv ib koob tshuaj thiab tshuaj diuretics).

Cov kev cai zoo ib yam yuav tsum tau ua thaum coj Diroton rau cov neeg mob ua mob rau cov hlab ntshav ntawm lub cev, tsis muaj ntshav tawm ntawm lub cev, uas tsis tshua muaj ntshav siab tuaj yeem ua rau myocardial infarction lossis mob stroke.

Kev hloov pauv hypotensive tsis yog kev sib kis rau kev noj cov tshuaj ntxiv tom ntej.

Ua ntej pib txoj kev kho mob nrog Diroton, yog tias ua tau, ua kom lub ntsev tsis haum thiab / lossis ua rau kom ploj ntawm cov kua dej, ua tib zoo saib xyuas qhov tshwm sim thaum pib ntawm Diroton ntawm tus neeg mob ntshav siab.

Kev kho mob ntawm cov tsos mob arterial hypotension muaj kev muab lub txaj so thiab, yog tias tsim nyog, iv kua dej tswj hwm (saline infusion). Kev hloov pauv ntawm txoj hlab ntaws tsis yog kev sib kis rau kev kho mob nrog Diroton®, txawm li cas los xij, nws yuav xav tau tshem tawm ib ntus, lossis txo qhov koob tshuaj.

Dirotonir kev kho mob yog contraindicated nyob rau hauv kev mob cardiogenic poob siab thiab nyob rau hauv mob myocardial infarction, yog hais tias kev teem sij hawm ntawm vasodilator yuav cuam tshuam loj dua hemodynamics, piv txwv li, thaum systolic ntshav siab tsis dhau 100 mmHg. Kos duab.

Hauv cov neeg mob uas muaj tus mob myocardial infarction, txo qis hauv lub raum lub luag haujlwm (ntshav creatinine concentration ntau dua 177 μmol / L thiab / lossis proteinuria ntau dua 500 mg / 24 h) yog qhov tsis sib haum rau kev siv tshuaj Diroton®. Thaum muaj kev loj hlob ntawm lub raum tsis ua haujlwm thaum kho nrog lisinopril (qhov concentration ntawm creatinine hauv cov ntshav plasma ntau dua li 265 μmol / L lossis ob zaug pib thawj zaug), tus kws kho mob yuav tsum txiav txim siab txog qhov yuav tsum tau kho.

Nrog ob tog kev mob ntshav ntawm lub raum thiab lub raum artery stenosis ntawm ib lub raum, nrog rau hyponatremia thiab / los yog txo qis hauv bcc lossis lub plawv mob tsis ua haujlwm, kev mob ntshav qis los ntawm kev noj tshuaj Diroton® tuaj yeem ua rau lub raum tsis zoo nrog kev txhim kho tom qab (tom qab kev tshem tawm tshuaj) mob raum rov qab. tsis txaus. Kev nce me ntsis ib ntus nyob rau hauv kev ua kom tau zoo ntawm urea hauv cov ntshav thiab creatinine tuaj yeem pom nyob rau hauv qhov xwm txheej ntawm lub raum tsis zoo, tshwj xeeb tshaj yog tiv thaiv tom qab ntawm kev kho mob nrog diuretics.Yog tias muaj qhov txawv txav hauv lub raum (CC tsawg dua 30 ml / min), yuav tsum ceev faj thiab tswj kev ua haujlwm lub raum.

Angioedema ntawm lub ntsej muag, nqua, daim di ncauj, tus nplaig, epiglottis thiab / lossis lub suab nrov yog tsis tshua pom muaj hauv cov neeg mob kho nrog ACE inhibitors, suav nrog cov tshuaj Diroton®, uas tuaj yeem tshwm sim tau txhua lub sijhawm thaum kho. Hauv qhov no, kev kho mob nrog Diroton® yuav tsum tau nres sai li sai tau thiab tus neeg mob yuav tsum tau saib xyuas kom txog thaum pom cov tsos mob rov qab. Nyob rau hauv rooj plaub uas muaj o ntawm lub ntsej muag thiab daim di ncauj, tus mob feem ntau ploj mus yam tsis tau txais kev kho mob, txawm li cas los xij, nws muaj peev xwm sau ntawv muab tshuaj antihistamines. Angioneurotic edema nrog laryngeal edema tuaj yeem ua rau neeg tuag taus. Thaum tus nplaig, epiglottis lossis larynx yog them, kev thaiv cov hlab pa tuaj yeem tshwm sim, yog li, kev kho tsim nyog yuav tsum tau nqa tawm tam sim (0.3-0.5 ml ntawm epinephrine (adrenaline) daws 1: 1000 sc, kev tswj hwm ntawm GCS, antihistamines) thiab / lossis ntsuas kom muaj peev xwm thaiv tau cov hlab cua txoj kev. Hauv cov neeg mob uas muaj keeb kwm mob hlwb tsis yog cuam tshuam nrog kev kho mob yav dhau los nrog ACE inhibitors, txoj kev pheej hmoo ntawm nws txoj kev txhim kho thaum kho nrog ACE inhibitor yuav nce ntxiv.

Anaphylactic cov tshuaj tiv thaiv kuj tseem tau sau tseg hauv cov neeg mob mob hemodialysis siv high-flow dialysis daim nyias nyias (AN69®), uas tib txhij noj Diroton®. Hauv cov xwm txheej zoo li no, yuav tsum tau txiav txim siab los siv ntau hom kev lim ntshav lossis lwm yam tshuaj tiv thaiv kab mob siab.

Hauv qee kis ntawm desensitization tiv thaiv arthropod allergens, kev kho mob nrog ACE inhibitors tau nrog los ntawm cov tshuaj tiv thaiv kev tsis haum. Qhov no tuaj yeem zam tau yog tias koj tso tseg kev noj tshuaj ACE inhibitors ib ntus.

Hauv cov neeg mob uas muaj kev phais mob ntau ntxiv lossis thaum lub sij hawm tshuaj loog, ACE inhibitors (tshwj xeeb, lisinopril) tuaj yeem thaiv kev tsim cov angiotensin II. Kev txo qis hauv cov ntshav siab txuam nrog qhov kev ua haujlwm ntawm kev ua haujlwm no raug kho los ntawm kev nce siab hauv bcc. Ua ntej kev phais mob (suav nrog kws kho hniav), nws yog qhov yuav tsum ceeb toom rau tus neeg siv tshuaj loog txog kev siv tshuaj Diroton®.

Kev siv cov koob tshuaj pom zoo hauv cov neeg mob hauv cov neeg laus tej zaum yuav muaj nrog los ntawm kev nce siab ntawm lisinopril hauv cov ntshav, yog li kev xaiv koob tshuaj yuav tsum muaj kev tshwj xeeb thiab tau ua nyob ntawm tus neeg mob lub raum ua haujlwm thiab ntshav siab. Txawm li cas los xij, hauv cov neeg laus thiab cov neeg mob hluas, cov nyhuv antihypertensive ntawm cov tshuaj Diroton® zoo ib yam li hais tawm.

Thaum siv ACE inhibitors, hnoos tau sau tseg (qhuav, ntev ntev, uas ploj tom qab kho nrog ACE inhibitors tsis ua haujlwm ntxiv lawm). Nrog kev kuaj xyuas qhov sib txawv ntawm hnoos, hnoos tshwm sim los ntawm kev siv ACE inhibitors yuav tsum raug txiav txim siab.

Hauv qee kis, pom muaj hyperkalemia. Kev pheej hmoo rau kev tsim cov mob hyperkalemia muaj xws li lub raum tsis ua haujlwm, mob ntshav qab zib mellitus, cov tshuaj ntxiv poov tshuaj, lossis cov tshuaj uas nce ntshav ntau ntxiv (xws li heparin), tshwj xeeb tshaj yog nyob rau cov neeg mob uas lub raum tsis ua haujlwm.

Thaum lub sijhawm kho cov tshuaj no, yuav tsum saib xyuas cov poov tshuaj, qabzib, អ៊ុយ, lipids hauv cov ntshav ntshav yog tsim nyog.

Thaum kho, nws tsis pom zoo kom haus dej cawv, li cawv txhim kho cov nyhuv hypotensive ntawm cov tshuaj.

Ceev faj yuav tsum tau siv thaum ua cov kev tawm dag zog lub cev thaum huab cua kub (qhov kev pheej hmoo ntawm lub cev qhuav dej thiab txo ntshav siab ntau vim tias bcc poob qis).

Vim tias qhov teeb meem pheej hmoo ntawm agranulocytosis tsis tuaj yeem tswj hwm tau, yuav tsum muaj kev soj ntsuam cov ntshav saib ntshav ib zaug.

Thaum muaj kev phiv tshuaj los ntawm lub hauv nruab nrab lub paj hlwb tshwm sim, nws tsis pom zoo rau tsav tsheb los yog ua haujlwm cuam tshuam nrog kev pheej hmoo siab.

Cov tsos mob: cim tau poob qis hauv cov ntshav siab, qhov ncauj qhuav, tsaug zog, tso zis tawm tsam, cem quav, ntxhov siab, muaj zog ntxiv.

Kev Kho: mob plab zom mov, noj lub tshuab hluav taws xob, muab tus neeg mob ua txoj kab rov tav nrog sawv ceg, rov qab ua haujlwm bcc (iv kev tswj hwm ntawm lub plasma-hloov cov kev daws teeb meem), kev kho mob, soj ntsuam lub luag haujlwm ntawm cov hlab plawv thiab cov pa ua pa, bcc, urea, creatinine thiab ntshiab electrolytes. raws li cov diuresis. Lisinopril tuaj yeem tshem tawm ntawm lub cev los ntawm hemodialysis.

Nrog rau kev siv ua ke nrog cov potassium-sparing diuretics (spironolactone, triamteren, amiloride), kev npaj poov tshuaj, ntsev hloov chaw muaj cov potassium, qhov kev pheej hmoo ntawm kev tsim hyperkalemia nce, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob uas tsis zoo lub raum kev ua haujlwm. Yog li, kev muab coj los sib koom ua ke tsuas yog ua tau raws tus kws kho mob qhov kev txiav txim siab nrog kev soj ntsuam cov poov tshuaj poov xab thiab lub raum kev ua haujlwm.

Nrog rau kev siv ib txhij nrog beta-blockers, qeeb calcium calcium blockers, diuretics thiab lwm yam tshuaj tiv thaiv kev tiv thaiv, kev nce siab hauv cov nyhuv hypotensive ntawm cov tshuaj yog pom.

Nrog rau kev siv ntawm ACE inhibitors thiab kev npaj kub (sodium aurothiomalate) iv, cov ntsiab lus piav qhia cov tsos mob tau piav qhia, suav nrog kev yaug ntsej muag, xeev siab, ntuav, thiab ntshav liab.

Nrog tib lub sijhawm siv nrog vasodilators, barbiturates, phenothiazines, tricyclic antidepressants, ethanol, cov nyhuv hypotensive ntawm cov tshuaj yog kho kom zoo.

Nrog tib lub sijhawm siv nrog NSAIDs (suav nrog xaiv COX-2 inhibitors), estrogens, ntxiv rau adrenergic agonists, cov nyhuv antihypertensive ntawm lisinopril txo.

Nrog rau kev siv tib lub sijhawm nrog lithium kev npaj, kev tshem tawm cov lithium los ntawm lub cev qeeb (nce cardiotoxic thiab neurotoxic zoo ntawm lithium).

Nrog rau kev siv ua ke nrog antacids thiab colestyramine, kev nqus ntawm lub plab zom mov yog txo qis.

Cov tshuaj pab txhim kho cov neurotoxicity ntawm salicylates, ua kom lub cev tsis muaj zog ntawm hypoglycemic cov neeg ua hauj lwm rau lub qhov ncauj kev tswj hwm, norepinephrine, epinephrine thiab tshuaj tiv thaiv gout, txhim kho cov teebmeem (suav nrog phiv) ntawm cov ntshav glycosides, cov nyhuv ntawm cov leeg peripheral relaxants, thiab txo qhov kev nthuav dav ntawm quinidine.

Txo cov nyhuv ntawm qhov kev tiv thaiv qhov ncauj.

Nrog rau kev tswj hwm tib lub sij hawm ntawm methyldopa, txoj kev pheej hmoo ntawm kev tsim hemolysis nce.

Cov tshuaj yog ntawv yuav tshuaj.

Sau npe B. Cov tshuaj yuav tsum muab cia kom ncav tsis cuag ntawm cov menyuam ntawm qhov kub ntawm 15 ° txog 30 ° C. Hnub tas sij hawm - 3 xyoos

Lisinopril thiab Diroton, dab tsi yog qhov txawv?

Lisinopril yog ib cov tshuaj uas muab natriuretic (ua kom cov sodium ions tawm hauv lub cev los ntawm lub raum), cardioprotective (tiv thaiv lub plawv mob) thiab hypotensive (txo cov ntshav siab) cov nyhuv.

Diroton yog yeeb tshuaj nrog peripheral (deb) vasodilating (so ntawm cov leeg du ntawm cov phab ntsa ntshav) thiab muaj cov nyhuv hypotensive rau tib neeg lub cev.

• Lisinopril - cov tshuaj txuam hauv cov tshuaj no yog lisinopril dihydrate. Txuas ntxiv, qhov muaj pes tsawg leeg suav nrog cov tshuaj tsim nyog los muab daim ntawv pom zoo tshaj tawm. Cov tshuaj no yog tsim los ntawm cov tuam txhab pharmacological Lavxias.
• Diroton - cov tshuaj txuam hauv cov tshuaj no yog lisinopril. Tsis tas li, kom muab qhov zoo tshaj plaws pharmacological daim ntawv, cov tshuaj ntxiv muaj nyob rau hauv qhov muaj pes tsawg leeg. Cov tshuaj no yog tsim los ntawm lub chaw muag tshuaj Gideon Richter (Hungary).

Mechanism ntawm kev ua

Lisinopril - cov tshuaj nquag ntawm cov tshuaj no, txo cov tshuaj aldosterone (ua rau adrenal ua lub luag haujlwm rau dej thiab ion tshuav, nrog rau nqaim ntawm cov hlab ntsha), uas txo cov ntsev sodium ions uas nqus dej hauv tib neeg lub cev, uas ua rau muaj kev nce hauv bcc ( ntim ntawm cov roj tawm hauv lub cev), uas yog tsub kom lub nra rau lub siab. Tsis tas li, lisinopril so cov leeg ntawm cov leeg ntshav ntawm cov hlab ntshav, uas txo cov ntshav siab.

Diroton - txij li nyob rau hauv cov tshuaj no, cov tshuaj ua kom nquag plias yog lisinopril, nws cov tshuab ntawm kev coj ua zoo ib yam li cov tshuaj tau piav saum toj no.

• Arterial hypertension (mob los ntawm kev nce siab hauv cov ntshav siab),
• Mob plawv nres
• Raws li ib feem ntawm cov kev kho mob nyuaj, hauv kev kho mob ntawm tus mob myocardial infarction,
• Kev mob ntsws (mob raum vim ntshav qab zib).

• Kev taw qhia yog zoo ib yam li cov tshuaj saum toj no.

Cov Yuav Tsum Tau Ua

• Hypersensitivity rau lub Cheebtsam ntawm cov tshuaj,
• Lactose thev tsis tau.

• Tus neeg tsis qaug rau cov tshuaj,
• Cev xeeb tub thiab lactation,
• Cov kab mob tsis haum rau Quincke edema (kev tsis haum tshuaj tiv thaiv, cov yam ntxwv ntawm tus kabmob sab sauv),
• Hnub nyoog (tsis tso rau cov menyuam hnub nyoog qis dua 18 xyoo).

Sab sij huam

• Ua xua (liab liab, tawm pob, thiab khaus ntawm daim tawv nqaij),
• Cov tsos mob ua tsis taus pa (xeev siab, ntuav, raws plab thiab quav tawv, tsuav thiab tsam plab, mob hauv plab),
• Mob taub hau, kiv taub hau,
• Kev txhim kho ntawm myocardial infarction (yog tias ntau dua kev noj tshuaj hauv cov neeg mob uas muaj mob plawv),
• Nkees nkees, qaug zog,
• Mob qab lub pob tw
• Txog siav
• Qhuav hnoos
• Tachycardia (nce siab hauv lub plawv) lossis bradycardia (txo qis hauv lub plawv),
• Tsis qab los noj mov
• Muaj hws ntau
• Cov plaub hau poob lawm
• Erectile kawg (kev sib deev muaj siab) nyob rau hauv cov txiv neej,
• Mob leeg
• Photophobia.

• Cov kev mob tshwm sim yog zoo li cov tshuaj saum toj no.

Tso daim ntawv thiab nqi

• 5 mg ntsiav tshuaj, 30 pcs, - "los ntawm 89 r",
• 10 mg ntsiav tshuaj, 30 pcs, - "los ntawm 115 r",
• 10 mg ntsiav tshuaj, 60 pcs, - "txij xyoo 197 r",
• Cov ntsiav tshuaj ntawm 20 mg, 30 pcs, - "los ntawm 181 p."

• 2.5 mg ntsiav tshuaj, 28 pcs, - "los ntawm 105 r",
• 5 mg ntsiav tshuaj, 28 pcs, - "los ntawm 217 r",
• 5 mg ntsiav tshuaj, 56 pcs, - "los ntawm 370 r",
• 10 mg ntsiav tshuaj, 28 pcs, - "los ntawm 309 r",
• 10 mg ntsiav tshuaj, 56 pcs, - "los ntawm 516 r",
• 20 mg ntsiav tshuaj, 28 pcs, - "los ntawm 139 r",
• Cov ntsiav tshuaj ntawm 20 mg, 56 pcs, - "los ntawm 769 p."

Diroton lossis Lisinopril - uas yog ib qho zoo dua?

Txhawm rau txiav txim siab seb qhov tshuaj tiv thaiv kev tiv thaiv zoo dua, nws yog qhov tsim nyog kom nkag siab txog lawv qhov sib txawv, vim tias cov tshuaj no muaj tib yam tshuaj, thiab raws li cov cim taw qhia thiab cov kev mob tshwm sim zoo ib yam.

Coob tus neeg xav yuam kev tias cov tshuaj no yog cov tshuaj analogues (cov tshuaj muaj cov tshuaj yeeb dej caw sib txawv, tab sis tib qho taw qhia), nws yog qhov raug hu rau lawv cov generics (tib yam tshuaj, cov npe sib txawv).

Feem ntau, qhov sib txawv ntawm cov tshuaj muaj nyob hauv contraindications. Lisinopril yuav tsum tsis txhob raug rau cov neeg uas mob tsis haum mis nyuj. Nyeg, Diroton yog txwv rau cov neeg uas muaj caj ces ntawm Quincke's edema.

Lisinopril yog tsim los ntawm cov tuam txhab Lavxias, thiab Diroton yog tsim nyob rau hauv Hungary, thiab yog li ntawd, nws tus nqi yog ntau dua. Tab sis qhov no tsis cuam tshuam rau kev ua tau zoo.

Lisinopril lossis Diroton - uas zoo dua? Xyuas

Raws li kev tshuaj xyuas txog cov tshuaj no, koj tuaj yeem tau txais kwv yees daim duab uas cov tshuaj zoo dua.

• Tus nqi qis
• Kev ceev ntawm cov nyhuv kho.

• Tsis haum rau cov neeg uas mob tsis haum mis nyuj.

• Tsawg contraindications
• High efficiency.

Qhov ua tau zoo ntawm daim ntawv tso cai kho mob thiab cov tshuaj feem ntau lisinopril hauv kev kho tshuaj thiab ua ke nrog hydrochlorothiazide ntawm cov neeg mob ntshav siab

A.A. Abdullaev, Z. J. Shahbieva, U. A. Islamova, R. M. Gafurova
Dagestan lub xeev cov tsev kho mob kho mob, Makhachkala, Russia

Ntsiab lus
Lub Hom Phiaj: los piv qhov ua tau zoo, kev nyab xeeb thiab chaw muag tshuaj-kev khwv nyiaj txiag ntawm kev kho mob nrog cov ntawv tso cai thiab cov tshuaj ACE inhibitors lisinopril (Irumed (Belupo) thiab Diroton (Gideon Richter) hauv kev kho mob monotherapy thiab hauv kev sib xyaw nrog hydrochlorothiazide hauv cov neeg mob uas muaj qib 1-2 txhaws los ntshav.
Cov ntaub ntawv thiab cov hau kev: 50 cov neeg mob uas mob AH ntawm 1-2 tbsp tau suav nrog kev tshawb fawb raws qib kev xav tom ntej. (22 tus txiv neej thiab 28 tus poj niam) 35-75 xyoo, nrog rau nruab nrab ntev ntawm kev kub siab ntawm 7.1 ± 3.3 xyoo. Rau tus neeg mob tawm ntawm txoj kev tshawb no: 2 ntawm keeb kwm ntawm kev kho mob nrog Irumed thiab 4 ntawm keeb kwm ntawm kev kho nrog Diroton. Kev soj ntsuam txhua hnub ntawm cov ntshav siab (BPM) tau ua tiav siv cov twj SL90207 thiab 90202 (SpaceLabsMedical, USA).
Ntsiab: kev kho mob nrog Iramed ua rau txo qis ntshav siab ntau dua (-27.8 ± 8.6 / -15.1 ± 6.9 hli RT.Kos duab.) Piv nrog Diroton (-21.1 ± 6.9 / -9.0 ± 5.9 hli Hg), pXaus: Kev kho mob nrog Irumed hauv cov neeg mob AH ntawm 1-2 mob hnyav yog tus yam ntxwv zoo tshaj plaws antihypertensive thiab yog cov kws muag tshuaj ntau dua li Diroton kho.
Cov ntsiab lus: arterial kub siab, lisinopril, Irumed, Diroton.

Aim: los sib piv cov kev ua tau zoo thiab kev pom zoo ntawm kev tso cai kho mob thiab cov tshuaj ACE inhibitor lisinopril (Irumed, Belupo thiab Diroton, Gedeon Richter) hauv kev kho tshuaj thiab sib xyaw nrog hydrochlorothiazide ntawm cov neeg mob ntshav siab (AH).
Cov ntaub ntawv thiab cov hau kev: kev sib tham qhib kev tshawb nrhiav tshiab muaj 50 tus neeg mob AH (22 tus txiv neej thiab 28 tus pojniam hnub nyoog 35-75 xyoo) txhais tau ntev li 7.1 ± 3.3 xyoo. 6 tus neeg mob tau tawm hauv kev kawm (Irumed -2 ​​thiab Diroton - 4). Ntshav siab (BP) tau saib xyuas 24 xuab moos nrog lub twj SL 90207 thiab 90202 (Chaw Kho Mob Hauv Tsev, Tebchaws Asmeskas).
Ntsiab: Irumed ntau qhov txo qis hauv tsev kuaj mob BP (-27.8 ± 8.6 / -15.1 ± 6.9 hli Hg) dua li Diroton (-21.1 ± 6.9 / -9.0 ± 5.9 hli Hg ), pXaus: Txoj kev kho Irumed pom qhov ua tau zoo tshaj plaws thiab kev siv nyiaj tsawg dua li kev kho mob Diroton hauv cov neeg mob qib 1-2 txhaws tawm ntshav.
Ntsiab lus: Rauv arterial kub siab, lisinopril, Irumed, Diroton

Cov ntaub ntawv hais txog cov neeg sau ntawv
Abdullaev Aligadzhi Abdullaevich - Dr. med. kawm xaiv kawm, hau. Department ntawm Sab Nraum Kho, Kev Kho Kab Mob Hlawv thiab Kev Kho Mob General
GOU VPO Dagestan State Medical Academy
Shakhbieva Zarema Yusupovna - kawm tiav tub ntxhais kawm ntawm tib lub department
Islamova Ummet Abdulhakimovna - Cand. zib ntab xaiv kawm txuj ci, tus pab cuam ntawm tib lub department. 367030, RD, Makhachkala, I. Shamily Ave., 41, apt. 94.
Gafurova Raziyat Magomedtagirovna - Cand. zib ntab xaiv kawm txuj ci, tus pab cuam ntawm tib lub department. 367010, RD, lub nroog Makhachkala, ul. Mendeleev, d.12.

Taw qhia
Kev kho mob rau cov neeg mob ntshav siab (AH) tam sim no yog ib qho haujlwm tseem ceeb, vim nws txoj kev pab rau kev mob plawv (SS) cov neeg tuag txog 40%, thiab nrog kev kho kom zoo thiab muaj kev nyab xeeb, nws hais txog kev hloov phom sij rau kev txhim kho cov hlab plawv ( IHD) thiab lwm yam kab mob SS. Cov txiaj ntsig ntawm ntau cov kev tshawb fawb tau ua pov thawj tias monotherapy ua tau zoo tsuas yog muaj qee qhov me me (txog 30%) ntawm cov neeg mob ntshav siab 2, 3. Kev siv tshuaj ntawm ob lub tshuaj tuaj yeem ua tiav lub hom phiaj ntawm cov ntshav siab (Tom qab tas sijhawm ntawm lub sijhawm tiv thaiv patent, ib lub tuam txhab tshuaj muaj peev xwm tsim thiab muag cov tshuaj. Yog li ntawd, tib cov tshuaj los ntawm ntau lub tuam txhab tuaj yeem muag hauv cov khw muag tshuaj, thiab cov tshuaj no muaj peev xwm sib txawv heev nyob rau hauv kev ua tau zoo thiab kev nyab xeeb. cov khoom ntiag tug ntawm cov tshuaj, muaj pov thawj hauv cov loj hauv kev soj ntsuam hauv kev soj ntsuam, xa mus rau cov thawj cov tshuaj thiab cov tshuaj uas tsim nyob hauv cov ntawv tso cai.Qhov cov tshuaj feem ntau yuav tsum muaj pov thawj piv rau kev ua tau zoo hauv kev sim tshuaj los ntawm kev sib piv ncaj qha nrog cov thawj.Peb qhov no, peb tuaj yeem hais tias cov tshuaj feem ntau kuj tseem muaj txiaj ntsig thiab nws muaj kev nyab xeeb, zoo li qhov qub, thiab koj tuaj yeem faib cov ntaub ntawv tau ntawm cov tshuaj qub rau nws. Hmoov tsis zoo, tsuas muaj tsawg ntawm cov tshuaj feem ntau, cov kev tshawb fawb zoo sib xws tau ua.

Nyob rau hauv xyoo tas los no, muaj kev txaus siab tseem ceeb ntawm nyiaj txiag ntawm kev kho mob tshuaj. Qhov no raug thawb los ntawm kev tau txais nyiaj tsawg ntawm cov chaw kho mob thiab, feem ntau, cov khoom siv los ntawm tus neeg mob nws tus kheej. Txhawm rau daws cov teeb meem no hauv qhov xwm txheej tam sim no, nws yuav tsum tau txiav txim siab tsis yog qhov chaw kuaj mob siv tau thiab muaj kev nyab xeeb ntawm ib qho tshuaj, tab sis kuj tseem cuam tshuam txog kev lag luam rau tus neeg mob thiab rau kev kho mob. Rational pharmacotherapy kev kho mob ntawm ib yam kab mob yuav tsum ua raws ntawm pharmacoeconomics 7, 8.

Tshawb nrhiav lub hom phiaj - sib piv cov kev ua tau zoo, kev nyab xeeb thiab pharmacoeconomic ua pov thawj ntawm kev kho mob nrog cov ntawv tso cai thiab cov tshuaj ACE inhibitors lisinopril (Irumed (Belupo) thiab Diroton (Gideon Richter) hauv kev kho mob monotherapy thiab hauv kev sib xyaw nrog hydrochlorothiazide nyob rau hauv cov neeg mob uas muaj qib 1-2 txhaws ntshav.

Cov khoom thiab txoj kev: txoj kev tshawb no suav nrog 50 cov neeg mob uas mob ntshav siab ntawm 1-2 qhov hnyav, ntawm 6 leej neeg mob tawm thaum lub sijhawm rov qab soj ntsuam: 2 thaum kho mob Irumed thiab 4 thaum kho nrog Diroton. Tag nrho ntawm 44 tus neeg mob ua tiav txoj kev tshawb no. Thaum pib, pawg tsis muaj qhov sib txawv ntawm lub hnub nyoog, poj niam txiv neej, thiab lwm yam ntxwv (Cov Lus 1).Txoj kev tshawb no suav nrog cov neeg mob hnub nyoog 18-75 xyoo uas nyuam qhuav tawm tsam tshiab lossis tus uas tsis nquag noj tshuaj tiv thaiv kabmob thaum lub hli dhau los. Nyob rau lub sijhawm suav nrog, pab pawg nruab nrab systolic ntshav siab (SBP) chaw kuaj mob (chav kawm) yog 158.5 ± 7.5 hli Hg. Daim duab., Diastolic ntshav siab (DBP) C. 97.5 ± 5.0 mmHg. Art., Lub plawv dhia 74.7 ± 8.8 neeg ntaus / min. Qhov tsis suav cov ntsiab lus yog: cov ntawv ntxiv ntawm kev kub siab, mob ntshav qab zib cerebrovascular, mob myocardial infarction nyob rau 6 lub hlis dhau los, angina pectoris II-III FC, lub plawv tsis ua haujlwm, mob plawv dhia tsis ua hauj lwm, lub siab thiab lub raum kev ua haujlwm.

Rooj ntawv 1. Thawj qhov kev soj ntsuam thiab kev ua neeg thiab kev ntsuas ntawm cov pab pawg

Tus Qauv Kawm: qhov kev tshawb fawb yog kev xaiv, qhib-xaus, yav tom ntej, thiab tau ua hauv GCP cov cai (Zoo Cov Kev Ntsuas Ua Zoo) thiab 2000 Helsinki Kev Tshaj Tawm. Lub sijhawm saib xyuas yog 24-25 lub lis piam. Ua ntej kev koom rau hauv txoj kev tshawb fawb, keeb kwm kev kho mob tiav tau sau hauv txhua tus neeg mob, kev tshuaj xyuas lub cev tau ua tiav, ntshav siab tau ntsuas los ntawm Korotkov txoj kev, tom qab ntawd cov neeg mob uas tau ua raws li cov txheej txheem suav nrog thiab tsis muaj qhov tshwj xeeb cais tau cia li muab yuam kev rau 2 pawg sib luag, thawj zaug pib kho mob nrog Iramed thiab lub thib ob nrog Diroton ntawm koob tshuaj 10 mg / hnub. Tom qab 2 lub lis piam, thaum lub hom phiaj ntawm cov ntshav siab tsis tiav (kev soj ntsuam ntshav siab tau txhais tias qhov nruab nrab ntawm 3 ntsuas kev ntsuas ntshav nrog phau ntawv sphygmomanometer nyob rau hauv qhov chaw zaum tom qab 10-15 feeb ntawm so, thiab tseem sawv ntsug, 1 feeb ua ntej noj tshuaj rau hnub mus ntsib. Rau cov qauv tshuaj rau qhov muaj txiaj ntsig ntawm kev tiv thaiv kabmob ntshav rau AD cov qe ntshav, lawv tau txo qis hauv DBP cov hlwb li 10% lossis 10 hli Hg thiab GARDEN hlwb li 15 hli Hg los ntawm theem pib. software pob Statistiсa 6.0 (Statsof t, Tebchaws USA), muab rau qhov ua tau ntawm parametric thiab nonparametric tsom xam.Qhov qhov sib txawv tau txiav txim siab tseem ceeb ntawm pCov txiaj ntsig thiab kev sib tham

Ob qho tib si kawm txog tshuaj muaj qhov ua tau zoo antihypertensive, ua kom nrov nrov ntxiv rau kev hloov pauv ntawm cov neeg mob mus rau kev kho ua ke. Irumed txo qis ntshav siab xws li tom cl. HELL, thiab raws li luag. Tom qab 2 lub lis piam ntawm kev noj tshuaj lisinopril ntawm ib koob ntawm 10 mg / hnub hauv pawg Irumed, cov ntshav siab poob qis los ntawm 158.4 ± 7.4 / 98.2 ± 4.4 hli Hg. Kos duab. mus txog 146.1 ± 9.1 / 93.1 ± 6.1 mmHg. Kos duab. (p. 6)Rooj 2. Lub zog ntawm cov ntshav siab. thaum kho nrog Irumed thiab Diroton.