Lozarel pab ua kom ntshav nce siab

Cov tshuaj Lozarel yog siv rau hauv kev kho plawv, endocrinology thiab nephrology. Cov lus qhia rau kev siv muaj cov lus pom zoo rau kev siv kom tsim nyog ntawm cov khoom, nyob ntawm seb puas yog cov cim kuaj mob.

Lub hauv paus ntawm cov tshuaj yog losartan poov tshuaj nyob rau hauv ib qho nyiaj ntawm 50 mg. Cov khoom siv ntxiv suav nrog silicon dioxide, magnesium stearate, lactose, hmoov txhuv nplej siab. Cov nkauj tseem muaj microcrystalline cellulose.

Daim ntawv tso tawm

Cov tshuaj yuav tuaj yeem yuav hauv cov ntsiav tshuaj, uas tau ntim hauv ib lub hlwv ntawm 10 ntsiav tshuaj. Hauv ib pob muaj 3 lub hlwv.

Cov ntsiav tshuaj muaj cov xim dawb (tsawg dua nrog daj ua zas daj) thiab puag ncig puab. Ntawm ib sab yog cov pheej hmoo. Qhov saum npoo ntawm lub ntsiav tshuaj yog zaj duab xis coated.

Kho kev nqis tes ua

Angiotensin 2 yog ib qho enzyme uas, los ntawm kev khi rau cov receptors hauv lub plawv, ob lub raum thiab qog adrenal, ua rau txoj kev nqaim ntawm lumen ntawm lawv cov hlab ntsha. Nws kuj tseem cuam tshuam rau kev tso tawm aldosterone. Tag nrho cov teebmeem no ua rau nce ntshav siab.

Losartan txwv qhov kev txiav txim ntawm angiotensin 2, tsis hais tus txheej txheem ntawm nws tsim. Vim qhov no, cov kev hloov hauv qab no tshwm sim hauv lub cev:

• txo tag nrho peripheral leeg tshav kuj,
• ntshav aldosterone ntau ntau
• ntshav siab poob qis
• cov qib siab nyob rau hauv cov ntsws ntsig kev txo qis.

Ntshav siab poob qis vim qhov me me diuretic nyhuv ntawm cov tshuaj. Nrog rau kev txais neeg tsis tu ncua, qhov kev pheej hmoo ntawm lub plawv cov ntshav ntshav yog txo, qoj ib ce rau hauv cov neeg uas twb muaj myocardial tsis muaj peev xwm txhim kho.

Qhov siab tshaj tawm tshwm sim 21 hnub tom qab pib ua thawj coj. Cov nyhuv antihypertensive yog pom tau hais hauv ib hnub.

Lozarel yog tsim rau kev kho plawv, lub raum ntshav thiab kev ua kom cov metabolism hauv lub cev tsis zoo. Cov tshuaj yog qhia rau kev nce ntxiv hauv cov ntshav siab vim yog tus kab mob hauv qab, los yog kub siab ntawm qhov tsis paub meej.

Cov tshuaj yog qhia rau lub plawv tsis ua haujlwm (lub plawv tsis ua haujlwm), uas tsis yog tshem tawm los ntawm angiotensin-hloov enzyme inhibitors. Nrog kev sib xyaw ua ke ntawm cov ntshav siab, muaj hnub nyoog siab, sab laug ventricular hypertrophy thiab lwm yam, nws yog siv los txo kev tuag thiab kev muaj peev xwm ntawm vascular raug mob (lub plawv nres, mob hlab ntsha tawg).

Cov tshuaj yog siv rau qhov muaj teeb meem ntawm hom 2 mob ntshav qab zib mellitus - nephropathy, vim nws txo qhov muaj peev xwm ntawm kev muaj mob.

Cov lus qhia rau kev siv

Losartan noj 1 zaug nyob rau ib hnub. Ib koob tshuaj 50 mg yog siv los kho kub siab. Yog tias lwm pawg ntawm cov tshuaj tiv thaiv kev tiv thaiv tsis zoo, tau pib nrog ib nrab ntawm cov ntsiav tshuaj. Yog tias tsim nyog, nce qhov koob ntxiv rau 100 mg, uas tuaj yeem noj ib zaug lossis faib ua 2 koob.

Hauv kev kho mob plawv tsis ua hauj lwm, kev txhaj tshuaj tsawg kawg yog 12.5 mg yog tau kho. Txhua 7 hnub nws yog ob npaug, maj mam nce mus rau 50 mg. Hauv qhov no, lawv tsom rau kev tsiv ntawm cov tshuaj. Nrog rau ib nrab koob (25 mg), yog tias tus neeg mob lub raum lossis lub siab tsis ua haujlwm, nws nyob rau ntawm tus mob hemodialysis.

Txhawm rau kho cov proteinuria hauv ntshav qab zib, cov tshuaj yog tawm ntawm ib koob tshuaj 50 mg / hnub. Qhov siab tshaj plaws niaj hnub noj rau cov kab mob no yog 100 mg.

Kev txais tos tsis nyob ntawm cov khoom noj thiab yuav tsum tau nyob rau txhua hnub thaum tib lub sijhawm.

Cov Yuav Tsum Tau Ua

Losartan poov tshuaj tsis yog kws kho rau cov neeg mob ntawd:

• nrog kev tsis haum ntawm cov piam thaj lossis galactose,
• piam thaj intolerance,
• galactosemia
• tsis tau muaj 18 xyoo
• xeeb tub
• mis txiag
• cov neeg nrog intolerance mus rau lub Cheebtsam ntawm cov tshuaj.

Kev tswj xyuas tus mob yuav tsum tau teem caij rau txoj kev kho mob rau lub raum lossis mob siab raum, lub plawv mob rau lub raum (2 sab lossis ib tus neeg lub raum), thiab cov neeg ntim ntshav tsawg zuj zus. Nrog kev ceev faj, Lozarel siv rau electrolyte tsis txaus.

Kev ntsuas rau siv

Cov tshuaj Lozarel tau sau tseg yog tias muaj:

1. Pom cov cim ntawm kub siab.
2. Txo txoj kev pheej hmoo ntawm cuam tshuam txog kev mob plawv hauv cov neeg muaj kev txom nyem los ntawm cov hlab ntsha txhaws los yog sab laug ventricular hypertrophy, uas tau tshwm sim los ntawm kev txo qis hauv cov zaus ntawm cov kab mob plawv tuag, mob hlab ntsha tawg thiab myocardial infarction.
3. Muab kev tiv thaiv raum hauv cov neeg mob ntshav qab zib hom 2.
4. Qhov xav tau kom txo cov proteinuria.
5. Mob plawv tsis ua hauj lwm nrog kev kho mob tsis ua hauj lwm los ntawm ACE inhibitors.

Sab sij huam

Kev lees txais cov tshuaj tuaj yeem nrog kev phiv tshuaj, uas tsis muaj zog thiab tsis tas yuav tsum tau txiav nws txoj kev tswj hwm. Lawv muab nthuav qhia hauv qhov rooj.

Cov kev tsis zoo uas tsis koom nrog ib pawg twg suav nrog gout.

Tshaj tsos mob

Kev overdose muaj qhov tshwm sim: lub plawv dhia ceev ceev, lub ntsej muag ntshav siab, lub plawv dhia tsis tshua muaj thaum txhawb qhov chaw mos.

Diuretics thiab cov tsos mob siv tau los kho tus mob. Tus txheej txheem ua rau hemodialysis tsis muaj kev cuam tshuam, vim losartan tsis raug tshem tawm ntawm kev tshaj lij roj ntsha hauv txoj hauv kev no.

Yeeb tshuaj sib cuam tshuam

Kev sib xyaw nrog kev siv tshuaj diuretics los ntawm cov pab pawg ntawm cov potassium-sparing, thiab cov kev npaj muaj poov tshuaj lossis nws cov ntsev nce, muaj kev pheej hmoo ntawm hyperkalemia. Ceev faj Lozarel yog kho nrog cov roj ntsha lithium, vim tias cov concentration ntawm lithium hauv cov ntshav yuav nce ntxiv.

Kev siv cov tshuaj ua ke nrog fluconazole lossis rifampicin tuaj yeem txo qhov kev cia siab ntawm cov nquag metabolite hauv cov ntshav. Kev txo qis ntawm qhov ua tau zoo ntawm cov tshuaj tshwm sim thaum kev sib koom tes nrog cov tshuaj uas tsis yog tshuaj steroidal hauv ib qhov tshuaj siab ntau dua 3 g.

Losartan tsis cuam tshuam nrog tej yam muaj tshuaj:

• warfarin
• hydrochlorothiazide,
• digoxin
• phenobarbital,
• cimetidine
• erythromycin,
• ketoconazole.

Cov tshuaj pab kho cov teebmeem ntawm β-blockers, diuretics thiab lwm yam tshuaj uas txo cov ntshav siab.

Cov lus qhia tshwj xeeb

Losartan tsis cuam tshuam rau txoj kev xav, yog li tom qab coj nws koj tuaj yeem tsav lub tsheb thiab ua haujlwm nrog cov txheej txheem. Hauv qhov xwm txheej tsis nco qab qhov tshuaj ntawm cov tshuaj, cov ntsiav tshuaj tom ntej yuav qaug thaum lub sijhawm tshwm sim. Yog tias txog sijhawm siv lwm lub tshuaj ntxiv, lawv haus nws ib yam li - 1 ntsiav tshuaj (noj 2 ntsiav tshuaj tsis pom zoo).

Nrog kev siv sijhawm ntev ntawm cov tshuaj, plasma K qib raug saib xyuas. Yog tias cov tshuaj siv tawm tsam tom qab ntawm cov tshuaj loj ntawm diuretics, muaj kev pheej hmoo ntawm hypotension. Lozarel tsub kom txog qib ntawm creatinine thiab urea thaum muaj mob hlab ntsha lub raum stenosis ntawm ib lub raum, zoo li ntawm ob sab sib luag ntawm cov hlab ntsha.

Analogs: Presartan, Lozap, Cozaar, Blocktran, Lorista, Cardomin-Sanovel.

Pheej pheej yig analogues: Vazotens, Losartan.

Raws li kev txheeb xyuas ntau, Lozarel tau pom zoo zoo nrog kev siv mus sij hawm ntev, tswj lub siab thaum nruab hnub. Nws yog nrov ntawm cov neeg mob, thiab nws feem ntau yog kws kho mob tshwj xeeb - kws kho mob, kws kho plawv, tsev neeg cov kws kho mob. Qee qhov kev txheeb xyuas muaj qhov qhia tau tias muaj kev phiv tshuaj.

Cia thiab txee lub neej

Cov tshuaj yeeb tshuaj no tuaj yeem siv tsis pub dhau 2 xyoos txij li hnub tawm. Nws yog cia rau hauv chav tsev uas qhov kub tsis tshaj 25 °.

Cov tshuaj pom zoo kom noj tsuas yog tom qab kuaj, sim, kuaj cuab yeej, kev txheeb xyuas tus kab mob concomitant pathology. Kev siv tus kheej ntawm Lozarel tuaj yeem ua rau muaj teeb meem.

Sab sij huam

Thaum kho nrog Losarel, cov kev mob tshwm sim tsis tshua muaj qhia, thiab tsis tas yuav tsum tau kho txoj kev kho.

Hauv cov neeg muaj teeb meem hauv cov hlab plawv, cov kev tsis ncaj ncees hauv qab no qee zaum tshwm sim:

Nrog kev ua txhaum ntawm txoj hnyuv, xeev siab, mob plab, cem quav, mob hniav, mob siab, mob plab, thiab saj tsis zoo kuj pom tshwm sim ntau. Cov tsos mob no tsis pom tshwm sim thaum tseem hluas.

Raws li kev kho mob dermatology, tso ntshav txhaws, nqaij tawv qhuav, thiab tawm hws kom ntau.

Ntawm ib feem ntawm kev fab tshuaj, khaus, tawm pob rau ntawm daim tawv nqaij, thiab ua xua tshwm sim.

Los ntawm ib sab ntawm cov leeg txheej txheem mus ib ntus feem ntau muaj mob hauv qab, ceg, hauv siab, mob caj dab, mob plab.

Nrog kev ua txhaum ntawm tus txheej txheem ua pa, hnoos, mob ntswg, txhaws ntswg, mob ntsws pharyngitis.

Hauv cov kab mob txeeb zig - mob raum tsis ua haujlwm, mob txeeb zig.

Tsuas tshuaj thiab tswj hwm

Nws yog ib qho tsim nyog yuav tsum noj cov ntsiav tshuaj sab hauv ib zaug ib hnub, tsis hais noj mov li cas.

Nrog rau cov hlab ntsha o kev pib thiab kev tswj hwm qhov kev noj tshuaj feem ntau 50 mg ib hnub ib zaug. Yog tias tsim nyog, nws tuaj yeem nqa txog 100 mg.

Rau cov neeg mob nrog mob plawv tsis ua hauj lwm khaws qhov pib ua ntej ntawm 12.5 mg, thiab tom qab ntawd ob zaug ib asthiv, nqa mus rau 50 mg rau ib hnub.

Nrog ntshav qab zib hom 2, uas nrog cov proteinuria, cov lus pom zoo thawj zaug yuav tsum yog 50 mg ib hnub ib zaug.

Thaum nqa tawm txoj kev kho, nyob ntawm tus neeg mob ntshav siab, nws raug tso cai kom nce cov tshuaj ib hnub ib zaug txog rau 100 mg.

Rau txo txoj kev pheej hmoo ntawm kev tsim mob plawv muaj teeb meem hauv cov neeg muaj mob ntshav lub plawv, nrog rau sab laug ventricular hypertrophy, qhov pib koob tshuaj 50 mg ib hnub ib zaug tau xaiv. Hauv qhov no, kev noj tshuaj ntxiv tuaj yeem raug nce ntxiv kom 100 mg ib hnub twg.

Cov lus thiab cov xwm txheej ntawm kev cia

Khaws ntawm qhov kub thiab txias tsis tshaj 25 ° C. Khaws cov tshuaj tawm kom ncav cuag cov me nyuam yaus me.

Hnub tas sij hawm Cov tshuaj yog 2 xyoos.

Tsis txhob siv cov tshuaj tom qab hnub tas sij hawm.

Tus nqi ntawm cov tshuaj Lazorel sib txawv raws li qhov chaw tsim khoom thiab lub network ntawm cov chaw muag tshuaj, hauv Lavxias ntawm qhov nruab nrab nws raug nqi los ntawm 200 rubles.

Nyob rau hauv Ukraine cov tshuaj tsis nrov thoob plaws thiab raug nqi txog 200 UAH.

Yog tias tsim nyog, koj tuaj yeem hloov "Lozarel" nrog ib qho ntawm cov tshuaj no:

• Brozaar
• Blocktran
• Vero-Losartan
• Vazotens
• Cardomin-Sanovel
• Zisakar
• Cozaar
• Karzartan
• Lozap,
• Lakea
• Losartan A,
• Losartan Canon
• "Losartan poov tshuaj",
• Losartan Richter,
• Losartan MacLeods,
• Losartan Teva
• "Lozartan-TAD",
• Losacor
• Lorista
• TubhmoovTiam
• Lotor
• "Renicard."

Kev siv cov analogues rau kev kho mob yog qhov tshwj xeeb tshaj yog nyob rau hauv cov mob uas tus neeg mob muaj qee leej tsis kam lees rau cov tshuaj ntawm cov tshuaj. Txawm li cas los xij, tsuas yog ib tus kws kho mob tuaj yeem sau ntawv noj tshuaj.

Piv txwv li tshuaj xyuas cov tshuaj muaj nyob hauv Is Taws Nem, piv txwv li, Anastasia sau hais tias: “Kuv cov ntshav qab zib ua rau mob hnyav. Sai sai no, Kuv tau ntsib nrog kev paub tshiab ntawm tus kab mob no. Kuv kuj tau kuaj nrog nephropathy. Tus kws kho mob tau sau ntau cov tshuaj sib txawv, suav nrog Lozarel. Nws yog nws leej twg pab rau sai sai thiab ua rau rov qab ua haujlwm ntawm ob lub raum. Cov ceg o tau ploj mus. "

Lwm qhov kev txheeb xyuas tuaj yeem pom tom qab kawg ntawm tsab xov xwm no.

Cov tshuaj Lozarel raug lees paub tias yog cov tshuaj zoo hauv kev kho mob siab thiab lub plawv tsis ua haujlwm. Nws tau nthuav tawm cov kab ke ntxiv nrog cov khoom sib txuam zoo sib xws, nws tsis pom zoo rau cov teeb meem ntawm daim siab thiab lub raum, zoo li thaum lub cev xeeb tub thiab qis dua 18 xyoo. Txhawm rau kom tsis txhob tshwm sim tshwm sim, nws pom zoo kom noj cov tshuaj kom nruj raws li kws kho mob tau hais tseg.

Dosage daim ntawv

Cov ntsiav tshuaj zaj duab xis-12,5 mg, 25 mg, 50 mg, 75 mg, 100 mg

Muaj ib txheej ntim yeeb yaj kiab-ntim

cov tshuaj nquag ua haujlwm - losartan poov tshuaj 12,5 mg lossis 25 mg lossis 50 mg lossis 75 mg lossis 100 mg

kev zam: microcrystalline cellulose, povidone, sodium starch glycolate (hom A), silicon dioxide colloidal anhydrous, magnesium stearate,

zaj duab xis txheej muaj pes tsawg leeg: dawb opadray (OY-L-28900), lactose monohydrate, hypromellose, titanium dioxide (E 171), macrogol, indigo carmine (E 132) txhuas cov kua roj vanish (rau kev noj tshuaj 12,5 mg).

Cov ntsiav tshuaj zaj duab xis, oval, xiav, sau nrog "1" ntawm ib sab (rau ntau npaum 12,5 mg).

Cov xaum thaij yeeb yaj kiab yog oval, dawb hauv cov xim, nrog ib qho nqis siab rau ntawm ib sab thiab tus txaug "2" ntawm ib sab (rau ntau npaum li 25 mg).

Cov yeeb yaj kiab-cov xim xau dawb yog oval, dawb xim, nrog ib qho thais ntawm ib sab thiab ib qho "3" ntawm ib sab (rau kev siv tshuaj ntawm 50 mg).

Tshuaj tua kab mob, zaj duab xis-coated, oblong, dawb, nrog ob qho kev pheej hmoo ntawm ib sab thiab sau "4" ntawm ib sab (rau ntau npaum ntawm 75 mg).

Tshuaj, zaj duab xis-txheej, oblong, dawb, nrog peb qhov phom sij ntawm ib sab thiab kos "5" ntawm ib sab (rau qhov tshuaj ntau npaum li 100 mg).

Pharmacological kev txiav txim

Tom qab kev tswj hwm ntawm qhov ncauj, losartan yog qhov zoo thiab yauv ua rau lub cev presystemic metabolism nrog kev tsim cov metabolite ntawm carboxylic acid, nrog rau lwm qhov ua kom lub cev tsis muaj zog. Cov kab ke ua haujlwm ntawm lub cev ntawm cov kabmob losartan hauv cov qauv tshuaj yog kwv yees li 33%. Qhov nruab nrab ntau ntau ntawm losartan thiab nws cov metabolite nquag tau mus txog tom qab 1 teev thiab tom qab 3-4 teev, feem.

Losartan thiab nws cov metabolite yog ≥ 99% ua txhua yam rau cov ntshav plasma protein, feem ntau rau albumin. Qhov ntim ntawm kev faib tawm ntawm losartan yog 34 litres.

Li ntawm 14% ntawm kev noj tshuaj ntawm losartan, thaum muab tshuaj rau pob ntseg los yog thaum noj ntawm qhov ncauj, hloov mus rau nws cov nquag metabolite. Tom qab kev tswj hwm ntawm cov nqaij ntshiv lossis kev siv 14C-daim paib potassium losartan, lub xov tooj cua ntawm cov ntshav khov yog feem ntau los ntawm losartan thiab nws cov metabolite. Kev hloov tsawg kawg nkaus ntawm losartan rau nws cov nquag metabolite tau pom nyob hauv kwv yees li 1% ntawm cov neeg mob hauv txoj kev tshawb fawb. Ntxiv nrog rau lub cev zom cov khoom noj tshwj xeeb, cov pib ua kom lub cev ntaj ntsug kuj tseem raug tsim.

Lub plasma tshem ntawm losartan thiab nws cov metabolite yog kwv yees li 600 ml / feeb thiab 50 ml / feeb, feem. Lub raum tshem tawm ntawm losartan thiab nws cov metabolite nquag muaj kwv yees li ntawm 74 ml / feeb thiab 26 ml / feeb, feem. Thaum noj cov tshuaj losartan, li ntawm 4% ntawm cov koob tshuaj tsis pom zoo tsis hloov pauv hauv cov zis thiab li 6% ntawm cov koob tshuaj tau tawm hauv cov zis ua cov tshuaj tiv thaiv kab mob. Cov kws tshuaj ntawm losartan thiab nws cov tshuaj tiv thaiv metabolite yog tawm thaum noj cov tshuaj losartan potassium hauv cov koob tshuaj ntau txog 200 mg.

Tom qab kev tswj hwm ntawm qhov ncauj, qhov ntau ntawm losartan thiab nws cov metabolite hauv ntshav plasma txo qis tshaj tawm, qhov kawg ib nrab-lub neej yog kwv yees 2 teev thiab 6-9 teev, feem.

Losartan thiab nws cov metabolite nquag tsis txuam nrog tseem ceeb hauv cov ntshav ntshav thaum ib koob 100 mg siv ib hnub ib zaug.

Losartan thiab nws cov metabolite nquag ua rau cov kua tsib thiab tso zis. Tom qab cov neeg siv qhov ncauj, kwv yees li 35% thiab 43% yog cov zis tawm, thiab 58% thiab 50% nrog quav, feem.

Pharmacokinetics ntawm cov neeg mob ib leeg

Hauv cov neeg mob laus uas muaj kev mob ntshav siab, cov ntsiab lus ntawm losartan thiab nws cov metabolite hauv cov ntshav ntshav tsis txawv ntawm cov uas pom muaj hauv cov neeg mob hluas uas mob ntshav liab.

Hauv cov neeg mob nrog poj niam txoj hlab ntshav siab, qhov theem ntawm losartan hauv ntshav ntshav yog ob zaug ntau dua hauv cov neeg mob txiv neej arterial hypertension, thaum qib ntawm cov nquag metabolite hauv ntshav ntshav tsis txawv hauv txiv neej thiab poj niam.

Hauv cov neeg mob uas mob sib khuav xws li cawv me ntsis mus rau lub siab, cov ntshav ntawm losartan thiab cov tshuaj tiv thaiv hauv cov ntshav ntshav tom qab kev tswj hwm ntawm qhov ncauj tau 5 thiab 1.7 npaug, feem ntau, ntau dua li cov txiv neej hluas.

Hauv cov neeg mob nrog creatinine tshem tawm saum toj 10 ml / min, ntshav ntau ntawm losartan tsis hloov. Piv nrog cov neeg mob uas lub raum zoo li qub, hauv cov neeg mob ntawm hemodialysis, qhov chaw AUC (thaj chaw nyob hauv qhov chaw cia khoom thaum lub caij nplooj zeeg) rau losartan yog kwv yees li 2 zaug siab dua.

Hauv cov neeg mob uas lub raum tsis ua haujlwm lossis hauv cov neeg mob ntawm hemodialysis, cov ntshav plasma qhov ntau ntawm cov nquag metabolite yog tib yam.

Losartan thiab nws cov metabolite nquag tsis raug tshem tawm los ntawm hemodialysis.

Losartan yog hluavtaws angiotensin II receptor antagonist (hom AT1) rau kev siv lub qhov ncauj. Angiotensin II - muaj zog vasoconstrictor - yog ib yam tshuaj lom ntawm lub cev renin-angiotensin thiab yog ib qho tseem ceeb tshaj plaws hauv pathophysiology ntawm kev mob ntshav siab. Angiotensin II khi rau AT1 receptors, uas pom nyob rau hauv ntau cov ntaub so ntswg (piv txwv li, hauv cov leeg ntawm cov leeg ntshav, cov qog adrenal, lub raum thiab lub siab), txiav txim siab txog ntau cov teebmeem kev mob siab, nrog rau vasoconstriction thiab aldosterone tso tawm.

Angiotensin II tseem muaj kev cuam tshuam cov kev loj hlob ntawm cov leeg hlwb muaj zog.

Losartan xaiv cov nplov AT1 receptors. Losartan thiab nws cov pharmacologically nquag metabolite - carboxylic acid (E-3174) - thaiv tag nrho cov kev mob ntawm lub cev mob siab ntawm angiotensin II, tsis hais qhov twg los ntawm txoj kev los ntawm kev coj los ua ke.

Losartan tsis muaj qhov cuam tshuam thiab tsis thaiv lwm yam tshuaj receptors lossis ion channels uas tau koom nrog kev tswj hwm ntawm cov kab mob plawv. Ntxiv mus, losartan tsis inhibit ACE (kininase II), ib qho enzyme uas txhawb txoj kev puas tsuaj ntawm bradykinin. Raws li qhov tshwm sim, tsis muaj kev nce ntxiv hauv kev tshwm sim ntawm cov kev mob tshwm sim los ntawm kev sib kho los ntawm bradykinin.

Thaum lub sij hawm siv cov tshuaj Lozarel tshem tawm ntawm qhov tsis zoo rov qab ua txhaum ntawm angiotensin II rau kev tso tseg zais cia ua rau muaj kev nce ntxiv ntawm ntshav plasma renin kev ua si (ARP). Xws li kev nce qib hauv kev ua si ua rau kev nce qib ntawm angiotensin II hauv ntshav ntshav. Dua li ntawm qhov nce no, kev ua haujlwm ntawm antihypertensive thiab txo qis hauv kev mloog zoo ntawm aldosterone hauv cov ntshav plasma mob siab, uas qhia tau tias muaj kev cuam tshuam zoo ntawm cov tshuaj angiotensin II. Tom qab kev txiav tsis ua losartan, plasma renin kev ua si thiab qib angiotensin II rau 3 hnub rov qab mus rau qhov pib.

Ob leeg losartan thiab nws cov metabolite tseem ceeb muaj qhov zoo dua rau AT1 receptors dua li AT2. Lub cev nquag metabolite yog 10 txog 40 zaug ntau dua li losartan (thaum hloov ua huab hwm coj).

Ib koob tshuaj ntawm losartan hauv cov neeg mob uas mob sib khuav ntawm cov mob ntshav liab los ntawm cov leeg ntshav siab qhia pom kev txo qis systolic thiab diastolic ntshav siab. Qhov siab tshaj plaws ntawm losartan nthuav dav li 5-6 teev tom qab kev tswj hwm, cov nyhuv tshuaj kho tau 24 teev, yog li nws txaus noj nws ib hnub ib zaug.

Pharmacodynamics thiab pharmacokinetics

Losartan yog qhov tshwj xeeb receptor angiotensin II (hom AT1) antagonist.

• khi rau AT1 receptors, uas yog nyob hauv thaj nqaij leeg ntawm cov hlab ntshav, lub siab, lub raum, thiab hauv cov qog adrenal,
• muaj cov nyhuv vasoconstrictive, tso tawm aldosterone,
• zoo thaiv angiotensin II,
• tsis ua rau kev tsuj tawm ntawm kinase II - cov enzyme uas rhuav tshem bradykinin.

"Lozarel," raws li muaj pov thawj los ntawm kev piav qhia ntawm cov tshuaj, pib ua tam sim ntawd. Tom qab ib teev, qhov siab ntawm lazortan ncav cuag nws qhov siab tshaj plaws, cov nyhuv ua tau ntev li 24 teev. Xav tias, lub siab poob qis dua 6 teev tom qab noj tshuaj ntsiav. Cov txiaj ntsig zoo antihypertensive raug pom tom qab 3-6 lub lis piam. Losartan khi rau cov seem ntawm albumin los ntawm 99%, raug tawm los ntawm lub raum thiab dhau los ntawm cov hnyuv.

Noj ntau dhau

Cov tsos mob: Tsis muaj ntaub ntawv hais txog kev haus tshuaj ntau dhau. Cov tsos mob feem ntau ntawm kev noj haus ntau dhau yuav yog txoj hlab ntshav hypotension, tachycardia, bradycardia yuav tshwm sim vim kev xav parasympathetic (paum).

Kev Kho Mob: Thaum pom tus tsos mob hypotension tshwm sim, kev txhawb nqa yuav tsum tau txais. Kev kho mob yog nyob ntawm lub sijhawm ntev li cas tom qab noj Lozarel, ntxiv rau qhov xwm thiab qhov mob ntawm cov tsos mob. Ntawm qhov tseem ceeb tshaj plaws yuav tsum tau muab rau lub zog ntawm lub plawv. Lub hom phiaj ntawm cov roj carbon activated. Saib xyuas cov haujlwm tseem ceeb heev. Hemodialysis yog qhov ua tsis tau zoo, vim tias tsis yog ib qho losartan lossis nws lub zog metabolite raug nthuav tawm thaum mob hemodialysis.

Cov Tshuaj Pharmacokinetics

Tom qab lub qhov ncauj tswj hwm, losartan yog qhov zoo nqus tau ntawm txoj hnyuv. Ntawm thawj txoj kev dhau los ntawm daim siab, nws hla cov metabolism hauv los ntawm carboxylation nrog kev koom tes ntawm CYP2C9 isoenzyme thiab kev tsim cov metabolite nquag. Cov txheej txheem ib puag ncig ntawm lub cev ntawm losartan yog kwv yees li 33%. Kev siab tshaj plaws (C_max) ntawm cov tshuaj nquag Lozarel hauv cov ntshav cov ntshav tau mus txog tom qab kwv yees li 1 teev, thiab nws cov nquag metabolite tom qab 3-4 teev. Kev noj zaub mov zoo ib txhij tsis cuam tshuam rau kev nyab xeeb ntawm losartan. Hauv ib qho koob tshuaj ntawm nce txog 200 mg, losartan tswj cov tshuaj pharmacokinetics tawm.

Kev khi rau cov ntshav plasma protein (feem ntau nrog albumin) - ntau dua 99%.

V_d (xa tawm ntim) yog 34 litres.

Yuav luag tsis tuaj yeem nkag mus rau cov ntshav-lub hlwb teeb meem.

Txog li 14% ntawm qhov ncauj ntawm losartan tau hloov pauv mus rau hauv qhov chaw metabolite.

Lub plasma tshem ntawm losartan yog 600 ml / min, lub raum tshem yog 74 ml / min, nws cov metabolite yog 50 ml / min thiab 26 ml / min, feem.

Li ntawm 4% yog tawm los ntawm lub raum tsis hloov, nce txog li 6% ntawm qhov kev lees txais uas tau lees paub hauv kev txiav tawm ntawm cov tshuaj metabolite. Qhov seem yog tawm los ntawm txoj hnyuv.

Ib nrab hnub kawg ntawm lub neej ntawm cov tshuaj yeeb dej cawv uas tsis tu ncua yog li 2 teev, nws cov tshuaj tiv thaiv metabolite - txog 9 teev.

Tawm tsam keeb kwm yav dhau los ntawm kev siv Lozarel nyob rau hauv ib koob tshuaj txhua hnub ntawm 100 mg, qhov hnyav me ntsis ntawm losartan thiab nws cov nquag metabolite hauv cov ntshav ntshav tau pom.

Nrog cov mob me mus rau mob hnyav ntawm lub siab ua rau lub siab ua pa, lub siab ntawm losartan nce 5 zaug, thiab cov nquag metabolite - 1.7 npaug, piv nrog cov neeg mob uas tsis muaj cov kab mob.

Qhov siab ntawm losartan nyob rau hauv cov ntshav ntshav hauv cov neeg mob nrog creatinine tshem tawm (CC) saum toj no 10 ml / min zoo ib yam li ntawd hauv cov neeg mob uas lub raum tsis ua haujlwm. Nrog CC tsawg dua 10 ml / min, tus nqi ntawm tag nrho cov tshuaj (AUC) hauv cov ntshav ntshav nce ntxiv li 2 zaug.

Nrog hemodialysis, losartan thiab nws cov metabolite nquag tsis tau tawm ntawm lub cev.

Hauv cov txiv neej nrog kev mob ntshav siab hauv lub hnub nyoog laus, cov theem ntawm cov tshuaj lom neeg hauv cov ntshav tsis sib txawv ntawm qhov tsis zoo sib xws hauv cov txiv neej hluas.

Nrog kev mob ntshav liab rau cov poj niam, qhov ntshav plasma concentration ntawm losartan yog 2 npaug ntau dua li txiv neej. Cov ntsiab lus ntawm cov nquag metabolite yog qhov zoo sib xws. Qhov sib txawv ntawm lub khw muag tshuaj sib txawv tsis muaj qhov tseem ceeb hauv lub chaw kho mob.

Yuav ua li cas noj thiab nyob li cas siab, noj ntau npaum li cas

"Lozarel", cov lus qhia rau kev siv uas piav qhia txog kev noj tshuaj zoo rau ntau tus kabmob, yog siv tsis hais zaub mov. Cov ntsiav tshuaj yog qaug dej qaug cawv tib lub sijhawm ib hnub ib zaug hauv kev muab tshuaj uas tus kws kho mob pom zoo.

Nrog rau kev kub siab (ntshav siab nce siab tshaj 140/90 hli Hg), qhov kev siv tshuaj yog noj 50 mg ib hnub twg. Raws li kev ntsuas, qhov ntau npaum li cas tau nce txog qhov siab tshaj ntawm 100 mg. Nrog rau kev txo BCC, kho cov ntshav siab pib nrog 25 mg. Ntawm dab tsi ntshav siab cov tshuaj tau qhia, hauv txhua kis tus kws kho mob txiav txim siab.

Lub plawv tsis ua haujlwm raug kho raws li qee txoj kev ua. Kev kho mob pib nrog 12,5 mg ntawm kev siv tshuaj ib hnub. Txhua lub lis piam, cov koob tshuaj muaj ob npaug: 25, 50, 100 mg. Yog tias tsim nyog, koj tuaj yeem tau txais 150 mg "Lozarel" ib hnub.

Nrog nephropathy nrog hom II mob ntshav qab zib, cov neeg mob noj 50 mg ntawm cov tshuaj ib hnub. Nws yog qhov peev xwm nce qhov kev noj tshuaj kom ntau tshaj 100 mg. Cov txheej txheem qub yog cuam tshuam rau cov neeg mob sab laug ventricular hypertrophy.

Tseem Ceeb! Rau cov neeg mob laus (laus dua 75 xyoo), cov neeg mob uas muaj ntau yam kab mob hauv lub siab lossis ob lub raum, cov tshuaj kho tau kho los ntawm tus kws kho mob hauv kev coj ua txo cov tshuaj rau niaj hnub.

Kev sib txuam

Kev sib xyaw ntawm "Lozarel" nrog NSAIDs tuaj yeem ua rau lub raum tsis ua haujlwm. Cov hauj lwm ntawm antihypertensive tshuaj yog txo txo.

Qhov ua ke nrog cov tshuaj uas muaj cov roj ntsha lithium ua rau muaj kev nce ntxiv ntawm cov ntshav lithium.

Poov tshuaj-sparing diuretics hauv tandem nrog "Lozarel" tuaj yeem ua rau tshwm sim ntawm hyperkalemia.

Cov tshuaj no txhim kho cov nyhuv hauv lub cev ntawm cov tshuaj antihypertensive. Thaum sau tshuaj "Lozarel" ua ke nrog ATP inhibitors, nws yog ib qho tsim nyog yuav tsum soj ntsuam qhov xwm txheej ntawm ob lub raum, txij li kev muaj peev xwm tshwm sim tsis zoo nce siab.

"Lozarel" tuaj yeem hloov nrog lwm cov tshuaj uas muaj cov nyhuv zoo sib xws. Piv txwv:

Cov tshuaj sib txawv hauv cov nqi thiab chaw tsim khoom. Tab sis koj yuav tsum tsis txhob hloov nws tus kheej ntawm Lozarel uas cov kws kho mob tau siv rau lwm txoj hauv kev. Ib qho tshuaj noj yuav tsum raug xaiv los ntawm cov kws tshaj lij uas ntsuas qhov mob ntawm tus neeg mob thiab qhov ntsuas ntawm kev siv tshuaj hauv txhua kis.

Lozarel, cov lus qhia rau kev siv: txoj kev thiab ntau npaum li cas

Lozarel ntsiav tshuaj noj ntawm qhov ncauj, tsis hais noj mov dabtsi.

• arterial hypertension: thaum pib thiab txij nkawm koob tshuaj - 50 mg ib hnub ib zaug. Thaum tsis muaj kev pabcuam hauv chaw khomob txaus rau qee tus neeg mob, kev nce ntxiv txog li 100 mg yog tso cai, hauv cov tshuaj no yuav tsum noj 1 lossis 2 zaug ib hnub. Nrog rau kev kho nrog concomitant nrog kev txhaj tshuaj zoo ntawm diuretics, kev siv Lozarel yuav tsum tau pib nrog 25 mg (1/2 ntsiav tshuaj) ib zaug ib hnub,
• mob plawv tsis ua hauj lwm: thawj koob tshuaj yog 12,5 mg (1/4 ntsiav tshuaj) 1 zaug hauv ib hnub, txhua 7 hnub koob tshuaj tau nce 2 zaug, maj mam nce nws mus rau 50 mg ib hnub twg, muab cov tshuaj tiv thaiv,
• yam 2 mob ntshav qab zib mellitus nrog proteinuria (kom txo qis kev pheej hmoo ntawm kev mob hypercreatininemia thiab proteinuria): qhov kev xav pib yog 50 mg ib hnub ib zaug. Nyob ntawm cov ntsuas ntawm cov ntshav siab thaum kho, cov koob tshuaj tuaj yeem nce ntxiv txog 100 mg hauv 1 lossis 2 koob tshuaj,
• arterial hypertension nyob rau hauv cov neeg mob laug laug ventricular hypertrophy (txo qis kev pheej hmoo ntawm kev tsim mob plawv thiab cov neeg tuag): thawj koob tshuaj yog 50 mg ib hnub ib zaug, yog tias tsim nyog, nws tuaj yeem nce ntxiv txog 100 mg.

Rau cov neeg mob uas lub raum tsis ua haujlwm (CC tsawg dua 20 ml / min), keeb kwm muaj kab mob siab, ua kom lub cev qhuav dej, muaj hnub nyoog tshaj 75 xyoos lossis rau lub caij lim ntshav, qhov pib siv ib zaug ntawm Lozarel yuav tsum tau noj nyob rau hauv tus nqi 25 mg (1/2 ntsiav tshuaj).

Thaum tsis ua haujlwm lub raum

Ceev faj yuav tsum tau siv rau hauv kev kho mob ntawm cov neeg mob lub raum tsis ua haujlwm, ob tog raum mob ntshav ntawm lub raum, thiab stenosis ntawm ib lub raum leeg.

Cov tshuaj pom zoo kom noj tshuaj rau lub raum khiav tsis zoo (CC tsawg dua 20 ml / min): thawj koob - 25 mg (1/2 ntsiav tshuaj) 1 zaug hauv ib hnub.

Kev txheeb xyuas ntawm Lozarel

Kev tshuaj xyuas txog Lozarel cov neeg mob thiab cov kws tshaj lij yog qhov zoo. Cov kws kho mob nco ntsoov tias cov tshuaj, ntxiv rau los tiv thaiv kev ua kom tsis haum, muaj cov nyhuv ntxiv diuretic. Txais Lozarel so lub nra thiab tiv thaiv qhov pib thiab kev loj hlob ntawm myocardial hypertrophy. Hauv kev mob plawv tsis ua hauj lwm, kev muaj peev xwm tiv taus lub cev kev ua si nce.

Hauv cov neeg mob ntshav qab zib mellitus thiab nephropathy, noj Lozarel ua kom ntseeg tau tias kev tshem tawm ntawm edema.