Lisinopril - dab tsi yog cov tshuaj no los ntawm? Cov lus qhia rau kev siv, analogues, tshuaj xyuas

Cov lus qhia rau kev siv:

Cov nqi hauv cov khw muag tshuaj hauv online:

Lisinopril yog ib qho kev txhim kho angiotensin hloov kho enzyme (ACE) inhibitor uas txo cov tsim cov tshuaj angiotensin II los ntawm angiotensin Kuv.

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Dosage daim ntawv ntawm Lisinopril - ntsiav tshuaj: tiaj, puag ncig, nrog cov ntug beveled, muaj kev pheej hmoo ntawm ib sab (10 pcs. Hauv cov hlwv, hauv ib pob ntawv qhwv 2, 3, 4, 5 lossis 6 pob, 14 pcs. Hauv cov hlwv xov tooj ntawm tes, hauv pob ntawv thawv ntawm 1, 2, 3 lossis 4 ntim).

Cov tshuaj nquag ua haujlwm ntawm cov tshuaj yog lisinopril nyob rau hauv daim ntawv ntawm lub cev qhuav dej. Nws cov ntsiab lus hauv cov ntsiav tshuaj, nyob ntawm qhov xim:

• Tsaus txiv kab ntxwv 2.5 mg
• Txiv kab ntxwv 5 mg
• Paj yeeb - 10 mg
• Dawb lossis yuav luag dawb - 20 mg.

Ntu cov khoom siv: lactose monohydrate, pob kws hmoov txhuv nplej siab, methylene chloride, povidone, magnesium stearate. Hauv cov ntsiav tshuaj ntawm 2.5 thiab 5 mg, ntxiv rau, lub hnub poob hnub poob daj zas yog muaj, hauv cov ntsiav tshuaj 10 mg - zas azorubine, hauv cov ntsiav tshuaj 20 mg - titanium dioxide.

Kev ntsuas rau siv

• Thaum ntxov (hauv thawj 24 teev) kev kho mob ntawm myocardial infarction nyob rau hauv cov neeg mob uas muaj cov hemodynamic ruaj khov (ua ib feem ntawm txoj kev kho kom sib xyaw thiaj li tswj tau cov ntsuas no thiab tiv thaiv lub plawv tsis ua thiab ua rau lub plab tsis ua haujlwm)
• Mob plawv tsis ua hauj lwm (ib feem ntawm cov kev kho mob nyuaj),
• Renovascular thiab cov hlab ntsha tseem ceeb ntawm cov hlab ntsha (raws li ib yam tshuaj los yog hauv kev sib xyaw nrog lwm cov tshuaj tiv thaiv antihypertensive),
• Mob ntshav qab zib nephropathy (kom txo tau albuminuria hauv cov neeg mob uas muaj ntshav qab zib hom I uas muaj ntshav siab thiab cov neeg mob ntshav qab zib hom II mob ntshav qab zib).

Cov Yuav Tsum Tau Ua

• Kab mob tib neeg idiopathic edema lossis Quincke angioedema,
• Keeb kwm ntawm kev mob hlwb, suav nrog raws li qhov txiaj ntsig ntawm kev siv ACE inhibitors,
• Cov mob tsis haum ntshav qabzib, qabzib-galactose malabsorption, lactase tsis txaus,
• Tsis txog 18 xyoo
• Cev xeeb tub
• Kab Mob Siab
• Cov tshuaj tiv thaiv tsis haum rau cov tshuaj ntawm cov tshuaj lossis lwm yam ACE inhibitors.

Tus txheeb ze (xav tau kev saib xyuas ntxiv):

• Laus lub caij nyoog
• Hypertrophic obstructive cardiomyopathy,
• Stenosis ntawm aortic orifice,
• Cov leeg ntshav siab,
• Mob plawv dhia qeeb,
• Coronary mob plawv
• Cerebrovascular kab mob (suav nrog cerebrovascular tsis txaus),
• Kev txwv tsis pub mob hlwb pob txha hematopoiesis,
• Thawj Hyperaldosteronism,
• Mob ntshav qab zib mellitus
• Cov kab mob ntawm cov kab mob sib txuas (nrog rau cov scleroderma thiab cov kab mob lupus erythematosus),
• Hyperkalemia
• Ntshav Qab Zib,
• Hypovolemic tej yam kev mob (suav nrog raws plab thiab ntuav),
• Ob leeg lub raum leeg mob stenosis los yog ua rau lub raum txoj raum ntshav, lub raum khiav tsis zoo (qhov muaj peev xwm ua kom tsis muaj ntshav tsawg dua 30 ml / min), mob tom qab hloov raum,
• Hemodialysis, uas siv high-flow dialysis membranes (AN69).

Tsuas tshuaj thiab tswj hwm

Lisinopril yuav tsum noj qhov ncauj 1 zaug nyob rau ib hnub, tsis hais noj zaub mov, tab sis nyiam dua nyob rau tib lub sijhawm ntawm ib hnub.

Kev kho mob ntawm qhov kub siab tseem ceeb pib nrog kev noj tshuaj txhua hnub ntawm 10 mg. Cov koob tshuaj saib xyuas yog 20 mg, qhov siab tshaj ib hnub yog 40 mg. Nrog rau kev nce ntxiv hauv koob tshuaj, nws yog ib qho tseem ceeb uas yuav tsum xav txog tias qhov kev tiv thaiv hypotensive ruaj khov muaj kev txhim kho tom qab 1-2 lub hlis ntawm kev kho. Yog tias thaum noj qhov ntau tshaj ib hnub twg ntawm qhov ua kom cov tshuaj kho mob tsis txaus, lwm cov tshuaj ntxiv los ntawm lwm cov tshuaj tiv thaiv kab mob kuj ua tau. Cov neeg mob uas tau txais diuretics yav dhau los, 2-3 hnub ua ntej teem caij rau cov tshuaj no, lawv yuav tsum raug tshem tawm. Yog tias qhov no ua tsis tau, ces thawj zaug ntawm Lisinopril yuav tsum tsis pub tshaj 5 mg rau ib hnub.

Thawj koob tshuaj rau kev kho lub plawv tawg thiab lwm yam mob nrog rau kev ua si ntau ntxiv ntawm renin-angiotensin-aldosterone system yog 2.5-5 mg ib hnub. Txoj kev kho yog ua tiav los ntawm kev tswj hwm lub raum, ntshav siab (BP), ntshiab poov tshuaj. Tus kws kho mob txiav txim siab saib xyuas txij nkawm li cas ntawm cov ntshav siab. Hauv kev kho mob raum tsis ua haujlwm, qhov tshuaj txhua hnub tau txiav txim siab nyob ntawm kev tshem tawm creatinine (CC): nrog CC 30-70 ml / min - 5-10 mg, nrog CC 10-30 ml / min - 2.5-5 mg, nrog CC tsawg dua 10 ml / feeb thiab cov neeg mob tau mob hemodialysis - 2.5 mg. Cov kev saib xyuas txij nkawm yog nyob ntawm cov ntshav siab.

Kev kho mob ntawm lub plawv tsis ua haujlwm ntev pib nrog kev noj tshuaj 2.5 mg ib hnub twg (ib txhij nrog mob glycosides thiab / lossis diuretics). Nyob rau ntawm ntu ntawm 3-5 hnub, nws yog maj mam nce - los ntawm 2.5 mg - txog thaum txij nkawm txij nkawm ntawm 5-10 mg ib hnub twg tau mus txog. Qhov siab tshaj plaws tau tso cai rau noj txhua hnub yog 20 mg. Yog tias ua tau, cov koob tshuaj diuretic yuav tsum tau txo ua ntej noj Lisinopril.

Hauv cov neeg laus dua, tshaj tawm lub ntsej muag ntev tshaj plaws hypotensive nyhuv yog feem ntau sau tseg, yog li kev kho mob pom zoo kom pib nrog lub koob tshuaj txhua hnub ntawm 2.5 mg. Hauv cov mob myocardial infarction, 5 mg tau sau nyob rau hauv thawj 24 teev, 5 mg hauv ib hnub, 10 mg hauv ob hnub ntxiv thiab tom qab ntawd 10 mg ib hnub ib zaug, qhov kev kawm tsawg kawg yog 6 lub lis piam. Nyob rau hauv rooj plaub ntawm ib qho kev txo qis hauv systolic siab mus rau 100 hli RT. Kos duab. thiab qis dua koob tshuaj yog txo kom 2.5 mg. Nrog rau lub caij nyoog (ntau dua 1 teev) tshaj tawm txo hauv systolic siab hauv qab 90 hli RT. Kos duab. cov tshuaj raug muab tso tseg. Rau cov neeg mob uas tsis tshua muaj systolic siab (120 mmHg. Daim Duab. Thiab hauv qab), 2.5 mg yog tau sau tseg hauv thawj 3 hnub tom qab mob myocardial infarction lossis thaum pib kho.

Thawj koob tshuaj rau cov ntshav qab zib mob nephropathy yog 10 mg rau ib hnub. Yog tias tsim nyog, nws tau nce ntxiv txog 20 mg: txhawm rau cov neeg mob ntshav qab zib hom ntshav qab zib kom nce mus txog qhov ntsuas ntawm diastolic siab qis dua 75 hli Hg. Art., Thiab hauv cov neeg mob uas muaj mob ntshav qab zib hom II - hauv qab 90 hli RT. Kos duab. (siab ntsuas yog ntsuas hauv qhov chaw zaum).

Sab sij huam

Cov kev mob tshwm sim feem ntau: nkees, mob taub hau, kiv taub hau, xeev siab, raws plab, hnoos qhuav.

• Kab mob hlab ntsha hauv plawv: cim txo qis hauv cov ntshav siab, ntshav txha caj qaum, tachycardia, mob hauv lub siab, mob hauv siab, cuam tshuam ntawm atrioventricular conduction, qhov pib lossis qhov tsis zoo ntawm cov tsos mob ntawm lub plawv tsis ua haujlwm, orthostatic hypotension, myocardial infarction,
• Lub hauv nruab nrab hauv lub paj hlwb: qhov tawv ncauj ntxig ntawm daim di ncauj thiab cov leeg ntawm qhov mob siab, mob pob txha, mob pob txha caj qaum, tsis nco qab, ua rau lub cev tsis muaj zog, lub siab ua haujlwm, qaug zog, tsis meej pem,
• Lub plab zom mov: hloov pauv, qhuav lub qhov ncauj mucosa, mob plab, dyspepsia, anorexia, daj ntseg (cholestatic lossis hepatocellular), kab mob pancreatitis, mob siab,
• Genitourinary system: anuria, oliguria, proteinuria, uremia, lub raum tsis ua haujlwm, mob raum tsis ua haujlwm, txo qis potency,
• Cov kab mob ua pa: qhuav hnoos, dyspnea, bronchospasm,
• Hematopoietic system: agranulocytosis, neutropenia, thrombocytopenia, leukopenia, ntshav liab (erythropenia, hemoglobin concentration, hematocrit),
• Daim tawv nqaij: photosensitivity, alopecia, nce tawm hws, khaus,
• Kev tsis haum tshuaj: kev mob hlwb ntawm qhov tsis sib xws, lub ntsej muag, daim di ncauj, tus nplaig, epiglottis thiab / lossis lub suab nrov, tawv nqaij ua pob, urticaria, nce ESR, ua npaws, eosinophilia, kuaj pom muaj txiaj ntsig rau cov tshuaj tiv thaiv kev tiv thaiv kab mob, leukocytosis, mob hnyuv angioedema,
• Lwm yam: arthralgia / mob caj dab, myalgia, vasculitis,
• Qhov ntsuas pom: kev ua haujlwm ntawm hepatic transaminases, hyperbilirubinemia, hyponatremia, hypercreatininemia, hyperkalemia, muaj zog urea concentration.

Nrog rau kev siv kub ib txhij (sodium aurothiomalate) tso ntshav nrog tshuaj ACE inhibitor, cov tsos mob nyuaj piav qhia, suav nrog xeev ntuav thiab ntuav, tawm ntsej muag, ntshav hypotension.

Cov lus qhia tshwj xeeb

Lisinopril yog contraindicated hauv cardiogenic poob siab thiab mob myocardial infarction, yog tias vasodilator tuaj yeem ua rau cov ntshav tsis txaus hemodynamic, piv txwv li, thaum systolic ntshav siab tsis yog ntau dua 100 hli Hg. Kos duab.

Kev txo qis hauv cov ntshav siab thaum noj cov tshuaj feem ntau tshwm sim thaum muaj kev txo qis hauv lub cev ntawm cov ntshav hauv lub cev (BCC) tshwm sim los ntawm kev siv cov diuretics, raws plab lossis ntuav, hemodialysis, thiab txo qis ntsev hauv zaub mov. Cov neeg mob uas muaj lub plawv tsis ua hauj lwm ntev kuj tseem muaj qhov pheej hmoo tias yuav txo cov ntshav siab. Ntau zaus nws pom nyob rau hauv cov neeg mob uas muaj kev mob loj heev ntawm lub plawv tsis ua haujlwm los ntawm hyponatremia, lub raum tsis ua haujlwm lossis noj cov tshuaj diuretics hauv siab. Cov kev piav qhia ntawm cov neeg mob thaum pib kho yuav tsum tau ua raws li kev saib xyuas mob nkeeg, kev xaiv ntawm Lisinopril thiab diuretics yuav tsum tau ua nrog ceev faj. Cov kev cai zoo ib yam yuav tsum tau ua thaum coj cov tshuaj rau cov neeg mob plawv thiab lub plawv tsis txaus, uas kev txo cov ntshav siab tuaj yeem ua rau mob stroke lossis myocardial infarction. Ua ntej pib txoj kev kho mob, nws pom zoo kom ib txwm ua kom cov dej qab ntsev ntawm cov ntshav thiab / lossis ntxiv rau cov bcc, tom qab ntawd ua tib zoo saib xyuas cov nyhuv ntawm thawj zaug tshuaj.

Hauv kev kho mob ntawm cov tsos mob arterial hypotension, kev pw tsaug zog yuav tsum tau muab, yog tias tsim nyog, kev tso dej tswj dej ntawm cov kua (qab ntsev) yog tshuaj. Transient arterial hypotension tsis yog qhov sib cuam tshuam rau Lisinopril, tab sis tej zaum yuav tsum txo koob tshuaj lossis txiav txuas ntxiv ntawm cov tshuaj.

Txo lub raum kev ua haujlwm (ntshav creatinine concentration ntau dua 177 μmol / L thiab / lossis proteinuria ntau dua 500 mg / 24 teev) hauv cov neeg mob uas muaj myocardial infarction yog qhov sib txuam rau kev siv Lisinopril. Nrog rau kev txhim kho lub raum tsis ua haujlwm (ntshav creatinine concentration ntau dua 265 μmol / L lossis 2 zaug siab dua qib pib) thaum kho nrog cov tshuaj no, tus kws kho mob txiav txim siab tias yuav tsum tsis kho.

Mob Angioedema ntawm qhov mob siab heev, ntsej muag, nplaig, daim di ncauj, mob epiglottis thiab / lossis lub suab nrov yog tsis tshua muaj, tab sis tuaj yeem tshwm sim tau txhua lub sijhawm thaum kho. Hauv qhov no, txoj kev kho yuav tsum nres tam sim ntawd thiab ua tib zoo saib xyuas tus neeg mob yuav tsum tau tsim kom txog thaum cov tsos mob rov qab ua tiav. Laryngeal edema tuaj yeem ua rau neeg tuag taus. Yog tias qhov mob ntawm lub ntsws ua pa, mob ntsej muag lossis tus nplaig npog, thaiv kev ua pa yog ua tau, yog li, kev kho mob sai thiab / lossis ntsuas kom ua tau pa hauv tsev yog qhov tsim nyog.

Thaum kho nrog ACE inhibitors, muaj kev pheej hmoo ntawm kev mob agranulocytosis, yog li nws tsim nyog los tswj cov ntshav ntshav.

Yog tias muaj kev ua haujlwm ntau ntawm hepatic transaminases lossis qhov tshwm sim ntawm cov tsos mob cholestasis, cov tshuaj yuav tsum raug txiav, vim tias muaj qhov pheej hmoo ntawm kev txhim kho cholestatic jaundice, nce mus rau fulminant daim siab necrosis.

Txhua lub sijhawm ntawm txoj kev kho yuav tsum yauv tsum tsis haus dej haus cawv, thiab tseem ceev faj rau huab cua kub thiab thaum ua lub cev tawm dag zog, raws li lub cev qhuav dej thiab txo qis hauv cov ntshav siab yog qhov ua tau.

Raws li kev tshawb fawb txog kev sib kis, kev siv ACE inhibitors nrog rau cov tshuaj insulin lossis tshuaj ntawm qhov ncauj hypoglycemic tuaj yeem ua rau kev txhim kho ntawm hypoglycemia, tshwj xeeb tshaj yog nyob rau thawj lub lim tiam ntawm kev sib xyaw, nrog rau cov neeg mob uas lub raum tsis ua haujlwm. Vim li no, cov neeg mob ntshav qab zib yuav tsum ua tib zoo saib glycemia, tshwj xeeb tshaj yog thawj lub hlis uas siv Lisinopril.

Yog tias muaj kev mob tshwm sim los ntawm lub hauv nruab nrab hauv lub siab, nws raug nquahu kom tsis txhob tsav tsheb thiab ua cov haujlwm txaus ntshai.

Yeeb tshuaj sib cuam tshuam

Beta-blockers, diuretics, qeeb calcium calcium blockers thiab lwm yam tshuaj tiv thaiv kabmob tuaj yeem txhim kho cov nyhuv hypotensive ntawm Lisinopril.

Nrog rau kev siv txuas ntxiv ntawm cov tshuaj potassium, cov ntsev hloov pauv muaj cov poov tshuaj los yog potassium-sparing diuretics (amiloride, triamterene, spironolactone), txoj 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. Vim li no, tsuas yog ib tus kws kho mob yuav tsum tau sau ntawv cia ua ke, thiab kev kho yuav tsum tau ua nyob rau hauv kev soj ntsuam tas li ntawm lub raum kev ua haujlwm thiab cov poov tshuaj poom tshuaj concentration.

Nrog tib lub sijhawm siv vasodilators, barbiturates, tricyclic antidepressants, phenothiazine thiab ethanol, cov nyhuv antihypertensive ntawm Lisinopril yog kho kom zoo. Antacids thiab colestyramine txo nws txoj kev nqus tawm ntawm txoj hnyuv huam.

Cov tshuaj nonsteroidal anti-inflammatory (nrog rau xaiv cyclooxygenase-2 inhibitors), adrenostimulants thiab estrogens txo cov nyhuv hypotensive ntawm cov tshuaj.

Nrog rau kev siv lisinopril tib lub sijhawm, nws maj mam txo qis kev pom ntawm lithium los ntawm lub cev, vim tias nws cov teebmeem cardiotoxic thiab neurotoxic zoo tuaj.

Kev siv sib xyaw nrog methyldopa tuaj yeem ua rau kev txhim kho hemolysis, nrog rau kev xaiv serotonin reuptake inhibitors - kom mob hyponatremia, nrog cytostatics, procainamide, allopurinol - rau leukopenia.

Lisinopril ua kom zoo rau kev ua haujlwm ntawm peripheral leeg lub zog, txo kev ua haujlwm ntawm qhov ncauj tsis haum, txo qis quinidine, ua rau cov tshuaj neurotoxicity ntawm salicylates, tsis muaj zog ntawm cov tshuaj tiv thaiv kab mob hauv lub qhov ncauj, epinephrine (adrenaline), norepinephrine (norepinephrine) thiab cov tshuaj tiv thaiv gout ntau ntxiv Cov.

Nrog rau kev siv ntawm Lisinopril nrog rau kev npaj kub, nws yog ib qho ua tau los txhim kho ntsej muag hyperemia, xeev siab thiab ntuav, thiab ntshav liab hypotension.

Teeb meem tshwm sim tuaj

Nyob rau hauv txhua rooj plaub, nws tsim nyog noj Lisinopril ntsiav tshuaj kom zoo zoo. Cov kev qhia qhia pom qhov tshwm sim ntawm cov kev mob tshwm sim:

• mob taub hau, kiv taub hau,
• xeev siab, raws plab,
• qaug zog,
• hnoos qhuav.

Tsis tshua pom muaj phiv los sis tshuaj:

1. Kev nkees nkees, tsis meej pem.
2. Kev mob hauv siab, txog siav, ua pa bronchospasm.
3. Lub Neej Bradycardia
4. Ib qho ntshav poob siab.
5. Muaj hws ntau.
6. Mob leeg, tshee, cramps.
7. Ntau cov plaub hau hle.
8. Kev tsis haum rau ultraviolet hluav taws xob.
9. Kev ua xua tsis haum.
10. Hloov ntshav kev suav.

Ua ntej siv cov tshuaj, sab laj rau koj tus kws kho mob. Nws yuav xaiv qhov yog rau koj. Qhov no yuav pab txo qis kev phom sij.

Pharmacological kev txiav txim

Lisinopril nce lub suab nrov ntawm cov hlab ntsha peripheral thiab txhawb nqa adrenal secretion ntawm aldosterone. Ua tsaug rau kev siv cov ntsiav tshuaj, vasoconstrictor nyhuv ntawm cov tshuaj hormone angiotensin raug txo kom tsawg, thaum nyob hauv cov ntshav ntshav muaj kev txo qis hauv aldosterone.

Kev noj tshuaj pab txo qis ntshav siab, thiab tsis hais tus lej ntawm lub cev (sawv, dag). Lisinopril tshem tawm qhov tshwm sim ntawm reflex tachycardia (nce siab hauv lub plawv).

Kev poob tawm hauv cov ntshav siab thaum tswj hwm kev noj tshuaj muaj tshwm sim txawm tias muaj cov ntsiab lus tsawg ntawm renin hauv cov ntshav ntshav (ib yam tshuaj tsim nyob hauv lub raum).

Tshuaj muaj yees

Cov nyhuv ntawm cov tshuaj no tau pom tau hauv ib teev tom qab nws txoj kev tswj hwm qhov ncauj.Qhov siab tshaj plaws ntawm Lisinopril pom zoo 6 teev tom qab kev tswj hwm, thaum cov nyhuv no txuas ntxiv mus tas hnub.

Kev txiav qhov muag tsis meej ntawm cov tshuaj no tsis ua rau nce ntshav siab sai, qhov kev nce ntxiv yuav tsis tseem ceeb piv rau qib uas tau muaj ua ntej kev kho mob.

Yog tias Lisinopril siv los ntawm cov neeg mob kev mob plawv, nrog rau kev kho mob digitalis thiab diuretic, nws muaj cov nyhuv hauv qab no: nws txo qhov kev tawm tsam ntawm cov hlab ntsha ntu, nce ntshav tawm thiab cov ntshav ntim ntau npaum li cas (tsis tas nce lub plawv), txo lub nra ntawm lub plawv, thiab ua rau lub cev muaj zog tiv thaiv kev ntxhov siab ntawm lub cev Cov.

Cov tshuaj cuam tshuam txhim kho intrarenal puab. Qhov nqus ntawm cov tshuaj no tshwm sim los ntawm kev mob plab, thaum nws cov siab tshaj plaws hauv cov ntshav tau pom nyob hauv thaj tsam li 6 mus rau 8 teev tom qab kev tswj hwm.

Cov lus qhia rau kev siv

Lisinopril (kev qhia hais tias kom noj ntau yam tshuaj) muaj nyob rau hauv cov ntsiav tshuaj muaj 2.5 mg, 5 mg, 10 mg thiab 20 mg ntawm cov tshuaj nquag. Siv Lisinopril cov lus qhia ib hnub ib zaug, nyiam dua tib lub sijhawm.

Kev siv cov tshuaj rau qhov kub siab tseem ceeb yuav tsum pib nrog 10 mg rau ib hnub, tom qab ntawd hloov mus rau qhov kev saib xyuas txij nkawm ntawm 20 mg rau ib hnub, thaum muaj mob hnyav, qhov siab tshaj plaws niaj hnub noj 40 mg tau tso cai.

Kev txheeb xyuas txog lisinopril qhia tau hais tias tag nrho kev kho mob ntawm cov tshuaj tuaj yeem txhim kho 2-4 lub lis piam tom qab pib kho. Yog tias tom qab siv tshuaj ntau tshaj plaws ntawm cov tshuaj xav tau cov txiaj ntsig tsis tiav, kev pom zoo ntxiv los ntawm lwm cov tshuaj tiv thaiv antihypertensive raug pom zoo.

Cov neeg mob noj tshuaj diuretics, 2-3 hnub ua ntej pib siv ntawm Lisinopril, koj yuav tsum tsum tsis txhob noj lawv. Yog tias vim li cas qee zaum tshem tawm cov tshuaj diuretics tsis yooj yim sua, cov koob tshuaj txhua hnub ntawm lisinopril yuav tsum txo kom tsawg 5 mg.

Nyob rau hauv cov xwm txheej nrog nce kev ua si ntawm renin-angiotensin-aldosterone system uas tswj cov ntshav thiab ntshav siab, Lisinopril pom zoo kom siv cov tshuaj rau txhua hnub ntawm 2.5-5 mg. Cov kev saib xyuas cov tshuaj ntawm cov tshuaj rau cov kabmob zoo li no yog tsim tshwj xeeb nyob ntawm seb muaj nuj nqis ntawm cov ntshav siab.

Yuav ua li cas coj nrog kab mob

Hauv raum tsis ua haujlwm, qhov tshuaj txhua hnub ntawm lisinopril nyob ntawm creatinine tshem tawm thiab tuaj yeem sib txawv ntawm 2.5 txog 10 mg rau ib hnub.

Kev mob ntshav siab ntawm lub cev ntev li no yuav tsum tau noj li 10-15 mg ib hnub rau ib lub sijhawm ntev.

Kev noj tshuaj rau cov mob plawv tsis ua hauj lwm pib nrog 2.5 mg ib hnub twg, thiab tom qab 3-5 hnub nws tau nce mus rau 5 mg. Koob saib xyuas cov kabmob no yog 5-20 mg ib hnub twg.

Txog cov mob ntshav qab zib nephropathy, Lisinopril pom zoo kom noj 10 mg rau 20 mg rau ib hnub.

Kev siv cov mob myocardial infarction koom nrog kev kho mob nyuaj thiab tau ua raws li cov txheej txheem hauv qab no: ntawm thawj hnub - 5 mg, tom qab ntawd tib lub tshuaj ib hnub ib zaug, tom qab ntawd cov tshuaj ntau npaum li cas ob npaug thiab noj ib zaug txhua ob hnub, theem kawg yog 10 mg ib hnub. Lisinopril, kev qhia txiav txim siab lub sijhawm kho, rau mob myocardial infarction siv sijhawm tsawg kawg 6 lub lis piam.

Tsuas tshuaj thiab tswj hwm

Sab hauv. Ib hnub ib zaug, tsis hais txog ntawm kev ua zaub mov. Yog tias mob ntshav dhau los ntawm cov leeg ntshav, cov neeg mob tsis tau txais lwm cov tshuaj tiv thaiv kev tiv thaiv kabmob 5 yam tshuaj ib hnub ib zaug, kev saib xyuas txij nkawm yog 20 mg / hnub. Qhov nyiaj pab ntau tshaj txhua hnub yog 40 mg. Tag nrho cov txiaj ntsig feem ntau pib tom qab 2 txog 4 lub lim tiam los ntawm kev pib kho. Nrog cov kab mob tsis txaus ntseeg, kev sib txuam ntawm cov tshuaj nrog lwm cov tshuaj tiv thaiv kabmob muaj peev xwm ua tau.

Yog tias tus neeg mob tau txais kev kho mob ua ntej nrog diuretics, tom qab ntawd qhov kev haus tshuaj ntawm cov tshuaj yuav tsum nres 2-3 hnub ua ntej pib ntawm Lisinopril. Yog tias qhov no ua tsis tau, tom qab ntawd thawj koob tshuaj yuav tsum tsis pub tshaj 5 mg 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 ua tiav tau tom qab kwv yees li 6 teev), txij li pom qhov txo qis hauv ntshav siab tuaj yeem tshwm sim.

Hauv kev mob plawv tsis ua haujlwm ntev - pib nrog 2.5 mg ib zaug, tom qab ntawd koob tshuaj nce siab dua 2.5 mg tom qab 3 txog 5 hnub. Qhov siab tshuaj ntau tshaj txhua hnub yog 20 mg.

Mob myocardial infarction (raws li ib feem ntawm kev sib xyaw ua ke hauv thawj 24 teev nrog hemodynamics ruaj khov): hauv thawj 24 teev - 5 mg, tom qab ntawd 5 mg tom qab 1 hnub, 10 mg tom qab ob hnub thiab tom qab ntawd 10 mg ib hnub ib hnub. Lub sij hawm ntawm kev kho mob yog tsawg kawg 6 lub lis piam.

Hauv cov neeg laus, ib qho kev tshaj tawm ntev dua uas muaj kev tiv thaiv hypotensive feem ntau yog pom, uas cuam tshuam nrog kev txo qis ntawm lisinopril kev tshem tawm (nws raug pom zoo kom pib kho nrog 2.5 mg / hnub).

Ntawm cov neeg mob uas lub raum tsis ua haujlwm koob tshuaj yog teem raws li qhov tseem ceeb ntawm QC.

70 - 31 (ml / min) (ntshiab si

Sab sij huam

Los ntawm cov kab mob plawv: txo qis ntshav siab, arrhythmias, mob hauv siab, tsis tshua - orthostatic hypotension, tachycardia.

Los ntawm lub paj hlwb: kiv taub hau, mob taub hau, qaug zog, tsaug zog, sib tw ntawm cov leeg ntawm cov leeg thiab daim di ncauj, tsis tshua - asthenia, kev nyuaj siab, tsis meej pem, pw tsaug zog, ntuav.

Los ntawm lub plab zom mov: xeev siab, ntuav, raws plab, dyspepsia, tsis qab los, hloov pauv, mob plab, qhov ncauj qhuav.

Kev tsis haum tshuaj: angioedema (thaj chaw hauv daim tawv nqaij, nqaij mos thiab / los yog cov nqaij mos ua ke nrog urticaria lossis tsis muaj nws), tawv nqaij ua pob khaus, khaus.

Lwm yam: "Qhuav" hnoos, txo hwj chim ntxiv, tsis tshua muaj - kub taub hau, o (nplaig, daim di ncauj, nqaj).

Noj ntau dhau

Cov ntaub ntawv hais txog kev soj ntsuam ntawm kev siv tshuaj ntau dhau ntawm lisinopril hauv tib neeg tsis muaj.

Cov tsos mob ua tau: arterial hypotension.

Kev Kho Mob: tus neeg mob yuav tsum muab txoj hauj lwm tav toj nrog sawv ceg tsa ceg, yog tias tsim nyog, saline yog txhaj rau txoj hlab ntshav, txoj haujlwm hemodialysis tau ua.

Kev cuam tshuam nrog lwm yam tshuaj

Cawv, diuretics thiab lwm cov tshuaj tiv thaiv kev tiv thaiv (blockers ntawm α- thiab β-adrenergic receptors, calcium antagonists, thiab lwm yam) potentiate hypotensive nyhuv ntawm lisinopril.

Nonsteroidal anti-inflammatory tshuaj, estrogens, adrenostimulants txo cov nyhuv hypotensive ntawm cov tshuaj.

Nrog rau kev siv thooj txhij nrog diuretics, txo qis hauv kev nthuav tawm ntawm cov poov tshuaj.

Thaum siv cov tshuaj uas muaj cov tshuaj lithium, nws yog ib qho ua tau kom ncua kev tshem tawm ntawm cov roj ntsha lithium tawm hauv lub cev thiab, raws li, muaj kev pheej hmoo ntawm nws cov nyhuv ua kom mob siab. Nws yog ib qho tsim nyog yuav tsum soj ntsuam qib theem ntawm cov roj ntsha lithium hauv cov ntshav.

Kev siv ua ke nrog beta-blockers, qeeb calcium calcium blockers, diuretics thiab lwm yam tshuaj tiv thaiv kab mob txhim kho qhov hnyav ntawm cov nyhuv hypotensive.

Antacids thiab colestyramine txo qis kev nqus ntawm lisinopril nyob rau hauv lub plab zom mov.

Daim ntawv thov nta

Nrog kev ceev faj, Lisinopril yuav tsum siv rau hauv cov neeg mob uas muaj mob rau cov hlab ntshav hlab ntshav lossis cov kab mob cerebrovascular kom tsis txhob muaj lub ntsej muag ntshav siab ntau hauv cov neeg mob no.

Nrog kev ceev faj, Lisinopril yog tshuaj rau cov neeg mob uas lub raum tsis ua haujlwm, tom qab lub raum hloov pauv, nrog ob leeg lub raum artery stenosis lossis stenosis ntawm ib lub raum artery, arterial hypotension, tsis txaus lub hlwb kev khiav haujlwm, autoimmune systemic kab mob, thiab lwm tus.

Kev hloov pauv ntawm cov hlab ntsha tsis yog qhov sib txuam rau txoj kev siv tshuaj ntxiv tom qab ua kom ntshav khov. Nrog rau qhov txo qis hauv cov ntshav siab, nws yog qhov tsim nyog los txo cov koob tshuaj lossis tsum tsis txhob noj Lisinopril lossis diuretic.

Hauv cov neeg mob uas muaj lub plawv tsis ua hauj lwm hnyav, kev siv ACE inhibitors tuaj yeem ua rau lub raum rov qab. Hauv qee tus neeg mob nrog kev mob ntshav siab, ua ke nrog kev sib koom ua ke ntawm lub raum ob leeg lub raum lossis qhov txhab ntshav ntawm ib lub raum, ntshav ntau ntawm urea nitrogen thiab creatinine yuav nce ntxiv.

Hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev nrog cov ntshav siab lossis qis, noj Lisinopril yuav ua rau txo ntshav siab ntau ntxiv, tab sis qhov no tsis yog lub laj thawj rau kev kho mob.

Thaum lub sijhawm phais mob siv cov tshuaj nrog hypotensive nyhuv rau tshuaj loog, kev tso tawm kev txwv ntawm renin yog ua tau. Arterial hypotension vim qhov tshuab no yog tshem tawm los ntawm kev nce ntxiv hauv qhov ntim ntawm cov ntshav ncig.

Cov kev loj hlob ntawm hyperkalemia nyob rau hauv cov neeg mob raum tsis ua haujlwm, mob ntshav qab zib mellitus, concomitant kev kho mob nrog cov poov tshuaj-sparing diuretics (spironolactone, triamteren, amiloride) thiab ntsev ntsev. Nrog kev siv sib xyaw ua ke ntawm lisinopril nrog cov tshuaj saum toj no, kev soj ntsuam ntau dhau ntawm kev saib xyuas cov poov tshuaj hauv cov ntshav cov ntshav yog tsim nyog.

Nrog rau qhov tsis muaj teeb meem sai sai ntawm kev noj Lisinopril, tsis muaj ntshav lossis ntshav nce siab sai sai piv nrog nws qib ua ntej noj cov tshuaj no.

Kev ua tau zoo thiab kev nyab xeeb ntawm Lisinopril yog ywj siab ntawm cov neeg mob lub hnub nyoog.

Cev xeeb tub thiab lactation

Lisinopril yog contraindicated nyob rau hauv cev xeeb tub thiab lactation (pub niam mis).

Kev siv cov tshuaj hauv lub sijhawm II thiab III ntawm lub sijhawm cev xeeb tub tuaj yeem ua rau txo qis ntawm cov kua dej tsis haum, tshwm sim ntawm anuria, arterial hypotension thiab ua rau lub cev tsis muaj pob txha pob txha pob txha taub hau.

Cawv rau ntawm kev muaj peev xwm tsav lub tsheb thiab ua haujlwm nrog cov tshuab.

Thaum kho, ib tug yuav tsum tsis txhob tsav tsheb thiab ua cov haujlwm muaj kev phom sij uas yuav tsum muaj kev xav zoo thiab nce ceev ntawm lub hlwb kev xav, vim tias kiv taub hau yog ua tau, tshwj xeeb tshaj yog thaum pib kho.