Yuav bisoprolol thiab lisinopril tuaj yeem siv ua ke?

Yuav ua li cas yog hom tshuaj zoo tshaj plaws rau cov mob plawv thiab vascular - Concor? Nws qhov tshwj xeeb txawv thiab kev sib piv nrog analogues, txhua qhov no koj yuav kawm los ntawm cov ntawv no.

Tus Concor muaj cov tshuaj nquag bisoprolol. Qhov no yog β1-blocker uas tiv thaiv qhov kev ua ntawm adrenaline (homon) ntawm lub siab nqaij.

Lub ntsiab zoo ntawm Concor muaj xws li:

• Txo cov kev tsis txaus ntseeg ntawm lub siab nqaij pob txha - txhav ntxiv (ntxiv tshwj xeeb ntawm lub siab) ploj thiab lub plawv dhia (HR) qeeb qeeb,
• Lub zog ntawm kev tawm tsam yog txo, uas ua rau:
  • Tsawg cov ntshav siab (BP),
  • Txo myocardial oxygen thov,
  • Mob Angina tawm tsam (mob hauv lub siab thaum tawm dag zog lub cev) tsis tshua muaj zog thiab tsis tshua hais lus,
  • Nrog rau siv ntev, qhov loj me ntawm cov leeg mob hauv lub plawv txo, uas txhim kho kev kwv yees ntawm kev muaj sia nyob thiab txo qhov kev pheej hmoo ntawm cov mob plawv.

Cov tshuaj muaj txiaj ntsig zoo thawm hnub thiab noj ib hnub ib zaug. Concor yog siv rau cov ntsuas hauv qab no:

• Arterial hypertension (ntshav siab dua 140/90 hli Hg) - txo qis siab,
• Kab mob plawv (CHD) (kev tsis sib xws ntawm qhov xav tau thiab xa oxygen mus rau myocardium) - txo qhov xav tau myocardium hauv oxygen,
• Tachycardia (lub plawv hla 90 lub zog / min) - lub plawv dhia qeeb,
• Extrasystole thiab txhua lub plawv kev ntxhov siab tsis zoo (tsis tuaj yeem) - tiv thaiv kev txhim kho,
• Lub plawv tsis ua haujlwm (edema thiab ua tsis taus pa vim lub cev tawm ntawm kev tawm dag zog) hauv kev tshem tawm - ua kom lub siab ua haujlwm, ua kom qeeb ntawm kev muaj mob, txhim kho kev kwv yees.

Concor tuaj yeem ua rau txo qis ntau dhau ntawm lub plawv dhia, kev txhim kho ntawm conduction blockade (ua txhaum ntawm qhov ib txwm kawm ntawm cov hluav taws xob los ntawm lub plawv).

Dab tsi yog ACE inhibitors thiab sartans

Ntxiv rau β-blockers, muaj ntau chav kawm ntawm cov tshuaj uas txo cov ntshav siab. Ib ntawm lawv cuam tshuam qhov thiaj li hu ua renin-angiotensin-aldosterone system (RAAS) thiab nws suav nrog angiotensin-hloov mus rau enzyme inhibitors (ACE inhibitors) thiab angiotensin II receptor blockers (sartans).

RAAS yog qhov tsis tshua muaj tshuaj lom ntawm biochemical. Nws pib nyob rau hauv lub raum, thaum cov neeg tshwj xeeb hauv cov plab hnyuv siab raum txiav txim siab txo qis ntshav siab hauv qab ib txwm muaj, uas ua rau muaj qhov tso zis tawm ntxiv. Muaj qee yam kabmob (nqaim ntawm cov hlab ntsha raum, mob raum ntev), cov kab mob no tau ua haujlwm, uas ua rau muaj kev txhim kho ntawm cov kev mob tshwm sim.

Cov tshuaj noj los ntawm ACE inhibitor thiab sartans pawg yog siv los txo qhov haujlwm ntawm RAAS thiab txo cov ntshav siab. Lub ntsiab contraindication ntawm cov tshuaj no yog qhov nqaim ntawm cov hlab ntsha hauv raum. Tus txheej txheem ntawm kev ua ntawm ACE inhibitors yog ua raws li kev tiv thaiv ntawm kev tsim ntawm angiotensin, muaj zog vasoconstrictor. Sartans tiv thaiv qhov kev txiav txim ntawm tib lub angiotensin los ntawm kev thaiv cov receptors nkag rau nws.

Ntxiv nrog rau txo qis ntshav siab, cov txiaj ntsig ntawm ACE inhibitors muaj xws li:

• Txhim kho cov mob ntawm ob lub raum mob ntshav qab zib, mob raum,
• Txo txoj kev pheej hmoo ntawm kev txhim kho myocardial infarction, txhim kho lub neej muaj kev pheej hmoo rau mob plawv mob plawv,
• Qeeb ua qhov nce zuj zus ntawm lub plawv tsis ua.

Qhov kev cuam tshuam tseem ceeb ntawm ACE inhibitors yog lawv lub peev xwm ua rau hnoos qhuav. Hauv qee kis, nws ua rau tshem tawm cov tshuaj no.

Sartans muaj cov yam ntxwv li nram no:

• Txhim kho cov mob ntawm ob lub raum hauv cov xwm txheej zoo sib xws,
• Tsis ua rau hnoos qhuav,
• Pab txhawb rau chav kawm ntawm gout (deposition ntawm uric acid ntsev rau hauv cov nqaij mos),
• Txhim khu cov txheej txheem kho,
• Tsis txhob txo txoj kev pheej hmoo ntawm lub plawv nres thiab tsis txhim kho qhov kwv yees ntawm kev mob plawv,
• Tsis txhob qeeb tus txheej txheem ntawm lub plawv nres.

Qhov no tseem ceeb heev!
Txhua ACE cov tshuaj tiv thaiv thiab cov kab noj hniav muaj cov teratogenic uas muaj zog heev (ua rau lub plab hauv plab) cuam tshuam. Txawm li cas los xij yuav tsum tsis txhob siv cov tshuaj no rau cov poj niam thaum cev xeeb tub, vim lawv tau lees tias yuav ua rau muaj kev txhim kho hauv kev tsis ua haujlwm hauv tus me nyuam hauv plab.

Txawv Kaptoena

Cov khoom xyaw nquag hauv Kapoten yog captopril - ACE inhibitor ntawm thawj tiam. Nws qhov tshwj xeeb yog qhov ceev ntawm cov ntshav siab, tshwj xeeb tshaj yog thaum noj hauv qab tus nplaig, thiab lub sijhawm luv luv ntawm kev ua (txog li 6 - 8 teev). Cov nta no ua rau Kapoten indispensable hauv kev pab thaum lub siab kub ntxhov. Rau kev siv tas li, cov tshuaj tsis xis nyob vim qhov xav tau noj 3 zaug ib hnub.

Enalapril thiab Enap - nta

Cov tshuaj yeeb dej caw hauv Enap yog Enalapril. Tib lub sijhawm, nyob rau hauv lub npe "Enalapril" kuj tau tsim ntau cov tshuaj los ntawm ntau lub tuam txhab tshuaj. Enalapril belongs rau lub cim thib ob ntawm ACE inhibitors thiab tau ua haujlwm nyob rau 12 teev, uas ua rau nws siv tau yooj yim - noj 2 zaug ib hnub nyob rau tib lub sijhawm (piv txwv li 7 teev sawv ntxov thiab 7 teev tsaus ntuj lossis 9 teev sawv ntxov thiab 9 teev tsaus ntuj, thiab lwm yam).

Qhov thib ob pom qhov txawv ntawm enalapril yog nws cov lipophilicity - siab sib raug zoo rau cov nqaij mos adipose. Cov cuab yeej no ua rau Enap cov tshuaj ntawm kev xaiv rau kev kho mob ntshav siab hauv cov neeg rog dhau.

Enap lossis Concor - uas zoo dua?

Enap yog qhov yuav tsum tau siv rau cov neeg mob lub raum, rog dhau, thiab ntshav qab zib. Concor zoo dua rau cov neeg mob uas muaj kev cuam tshuam nrog kev sib dhos, tachycardia, muaj kev tawm tsam ntawm angina pectoris ntau zaus. Yog hais tias ib tus neeg muaj lub plawv dhia so tsis pub dhau 50-60 neeg ntaus / min, muaj cov conduction blockade, ces Enap yuav tsum tau nyiam, vim tias Concor tsuas yuav ua kom cov mob no dua.

Concor thiab Enalapril - Tshaj

Kev siv tshuaj sib xyaw ntawm β1-blocker thiab ACE inhibitor yog qhov sib xyaw ua ke kom zoo tshaj plaws ntawm cov tshuaj tiv thaiv kev mob ntshav siab. Ob leeg Concor thiab Enalapril yog ib qho zoo tshaj plaws ntawm cov neeg sawv cev ntawm lawv cov pawg muag tshuaj. Kev siv ua ke ntawm cov tshuaj no tso cai rau koj ua tiav cov teebmeem no:

• Txo cov ntshav siab ntau dua (dhau 180/110 hli Hg),
• Qeeb ua qhov tsis zoo ntawm cov mob plawv thiab raum,
• Qeeb ua qhov nce zuj zus ntawm lub plawv tsis ua.

Txawv Lisinopril

Lisinopril kuj tseem yog rau tiam ob ntawm ACE inhibitors, tab sis txawv ntawm enalapril. Ua ntej, cov tshuaj no ua haujlwm 24 teev, uas tso cai rau koj noj ib hnub ib zaug. Thib ob, Lisinopril hais txog hydrophilic tebchaw, uas ua rau nws tsis tshua muaj txiaj ntsig hauv cov neeg mob uas muaj lub cev nyhav dhau los. Vim tias nws tus nqi pheej yig, muaj cov txiaj ntsig zoo rau hauv chav kawm ntawm txoj kev mob ntshav siab, txhim kho kev mob ntshav qab zib, mob raum thiab lub plawv tsis ua haujlwm, Lisinopril thiab enalapril yog cov tshuaj ACE nrov tshaj plaws.

Lisinopril thiab Concor - nws puas tuaj yeem coj ua ke?

Kev siv ua ke ntawm Concor β1-blocker thiab ACE inhibitor Lisinopril yog qhov kev hloov pauv zoo rau kev sib xyaw ntawm Concor + Enalapril: ob qho tshuaj no ib hnub ib zaug, thiab cov txiaj ntsig ntawm qhov no tsis txo qis. Qhov kev zam yog cov neeg rog nyob rau hauv uas Lisinopril tej zaum yuav tsis ua rau txo cov ntshav siab txaus.

Cov yam ntxwv ntawm Prestarium

Lub Prestarium suav nrog ib qho ntawm ACE kawg tshuaj tiv thaiv perindopril. Cov tshuaj no muaj cov nyhuv hauv 24-teev thiab noj ib hnub ib zaug. Prestarium, zoo li Enalapril, hais txog lipophilic tebchaw, vim tias nws ua tau zoo dua rau cov neeg mob rog. Qhov tsis zoo ntawm cov tshuaj yog nws tus nqi siab (2 txog 3 zaug ntau dua hauv kev sib piv nrog Lisinopril thiab Enalapril).

Thaum pib, Prestarium tau nce siab ua tus ACE inhibitor, muaj peev xwm tiv thaiv cov hlab ntsha txuas ntawm qhov tso ntawm cov plahaum cov plahaum. Txawm li cas los xij, kev tshawb fawb loj tau refuted zoo xws li cov tshuaj.

Prestarium thiab Concor - Tshaj

Zoo li txhua lwm ACE inhibitors, Prestarium txuas txig nrog lub Concor -1-blocker. Cov tshuaj ua kom sib txuam zoo, txhim kho kev soj ntsuam ntawm kev muaj sia nyob thiab txo qhov pheej hmoo ua rau cov neeg mob plawv tsis ua haujlwm, rog, mob ntshav qab zib, thiab mob raum.

Yuav ua li cas noj Concor thiab Prestarium ua ke?

Kev xaiv tshuaj ntawm cov tshuaj thaum ua ke nrog Concor thiab Prestarium, zoo li lwm ACE inhibitor nrog β1-blocker, yog nqa tawm raws li hauv qab no. Yog tias ib qho ntawm cov tshuaj tau noj ua ntej lawm, ces nws cov tshuaj noj yuav zoo li qub. Cov tshuaj, uas tau sau tseg rau thawj zaug, yog pib siv tsawg kawg nkaus (rau Concor nws yog 2.5 mg, rau Prestarium - 2 mg). Lub sijhawm 2 - 3 hnub tom qab noj tshuaj sib xyaw, ntshav siab yog ruaj khov. Yog tias nws txo qis hauv kev teb rau kev kho mob, tom qab ntawd qhov kev nce ntxiv hauv koob tshuaj yuav tsum tau nqa tawm tom qab 1 txog 2 hlis, kom txog thaum ntsuas pom qhov cim qis dua 140/90 hli Hg. Yog tias, dhau 2 mus rau 3 hnub, ntshav siab tsis txo lossis poob qis dua qis dua 20% ntawm thawj zaug, tom qab ntawd cov tshuaj ntawm cov tshuaj tau nce ntxiv kom txog thaum lawv mus txog qhov siab tshaj (20 mg rau Concor thiab 8 mg rau Perindopril) lossis kom txog thaum muaj kev cuam tshuam tshwm sim.

Lorista thiab nws tus yam ntxwv

Lorista suav nrog valsartan, cov tshuaj nyob rau hauv pab pawg ntawm sartans. Feem ntau, Lorista thiab nws cov tshuaj zoo sib xws yog tsim rau kev txhim kho hnoos qhuav vim ACE inhibitors. Tsis zoo li tom kawg, Sartan tsis muaj peev xwm txhim kho qhov kev txiav txim siab ntawm lub plawv tsis ua haujlwm thiab tsis txo qis kev pheej hmoo ntawm kev pheej hmoo txoj sia ntawm cov kab mob plawv.

Ntxiv rau kev tsis kam rau ACE inhibitors, Lorista tuaj yeem siv rau hauv cov neeg mob ntshav siab tom qab kev phais. Qhov no yog vim muaj peev xwm ntawm txhua qhov sartans los txhim kho cov txheej txheem kho nqaij. Ib qho kev zam yog stenting (txhim kho qhov tshwj xeeb "caij nplooj ntoos hlav" uas ua kom dav lumen ntawm cov leeg ntshav) - ntawm no Lorista yuav ua rau kom lub nkoj nqaim dua.

Concor lossis Lorista - uas zoo dua?

Yog tias peb txiav txim siab Concor thiab Lorista yog qhov txhais tau tias kev kho mob ntawm txoj hlab ntaws sib cais, tom qab ntawd the1-adrenergic blocker zoo li meej meej dua: nws cuam tshuam tsis tsuas yog theem ntawm cov ntshav siab, tab sis kuj tiv thaiv kev txhim kho ntawm ntau yam teeb meem, txhim kho cov mob ntawm cov leeg plawv.

Tsis tsuas yog Lorista, tab sis txhua daim sartans siv rau hauv kev kho mob ntshav siab tshwj xeeb nrog kev sib xyaw nrog lwm cov tshuaj, feem ntau feem ntau nrog β1-blockers.

Concor thiab Lorista - Kev sib raug zoo

Yog lawm, kev sib xyaw ntawm Concor thiab Lorista ua tsis tau zoo rau kev sib xyaw ntawm Concor thiab lwm yam tshuaj tiv thaiv ACE vim tias tsis tshua muaj kev cuam tshuam hauv chav kawm ntawm lub plawv tsis ua hauj lwm thiab kev pheej hmoo ntawm myocardial infarction. Txawm li cas los xij, qhov kev sib txuam ntawm cov tshuaj no tej zaum yuav raug yuam vim muaj kev txhim kho hnoos qhuav hauv kev teb rau kev noj tshuaj ACE inhibitor. Hais txog cov txiaj ntsig ntawm kev mob ntawm ob lub raum thiab chav kawm mob ntshav qab zib, Sartan Lorista tsis qis qis rau ACE inhibitors.

Cov yam ntxwv ntawm Bisoprolol

Bisoprolol yog ib qho nrov npe beta-blockers, nws muaj lwm lub npe txawv - Concor.

Nws muaj ntsis hypotensive thiab antianginal (anti-ischemic) nyhuv. Lub cuab yeej pab txo qis lub plawv thaum so thiab thaum qoj ib ce.

Nws yog tshuaj ua ib qho yeeb tshuaj, thiab ua ib feem ntawm txoj kev kho mob nyuaj rau ntau yam kab mob ntawm cov hlab plawv.

Li cas lisinopril

Lisinopril yog ib tug thawj coj ntawm ACE inhibitors (angiotensin-hloov enzyme), uas yog siv los kho kev mob ntshav siab. Ua tsaug rau cov tshuaj no, nws muaj peev xwm:

• nrog kev siv tsis tu ncua, ua tiav qhov txo qis ntshav siab mus rau theem ib txwm,
• txo qhov kev pheej hmoo ntawm sab laug ventricular hypertrophy thiab qeeb nws txoj kev loj hlob,
• txhim kho lub zog ua haujlwm ntawm lub plawv,
• txo qhov ntxim nyiam ntawm myocardial infarction,
• Txo kev tshwm sim ntawm lub plawv mob qog nqaij tawv.

Thaum noj, qhov nqus mus rau hauv cov ntshav tshwm sim thaum thawj teev, nce mus rau qhov siab kawg hauv 6 teev. Cov kev ua ntawm cov tshuaj nquag muaj ntxiv rau lwm lub sijhawm 16-17 teev.

Cov nyhuv antihypertensive nce thiab mus txog qhov siab tshaj plaws tom qab 1-2 hlis. Yog li, cov tshuaj tsis yog txhais tau tias txo qis siab.

Cov nyhuv sib xyaw ua ke ntawm bisoprolol thiab lisinopril

Nws yog qhov tseeb tias kev siv ua ke ntawm cov tshuaj no muaj lub zog antihypertensive zoo. Txawm hais tias qhov tseeb tias lawv tsis muaj qhov cuam tshuam ceev ntawm lub siab, nws txoj kev siv lub sijhawm ntev normalizes nws qhov kev ua tau zoo.

Tsis tas li ntawd, tawm tsam cov keeb kwm yav dhau los ntawm kev txo ntshav siab, lub plawv dhia rov qab zoo li qub, lub plawv dhia qis, tachycardia thiab ventricular fibrillation ploj.

Ntxiv Bisoprolol nrog cov tshuaj Lisinopril tiv thaiv keeb kwm ntawm qhov txo qis hauv cov ntshav siab, lub plawv dhia rov qab zoo li qub, lub plawv hloov qis, tachycardia ploj.

Kev ntsuas rau siv tib txhij

Ua ke, ob qho tshuaj yog tsim nyog rau kev ua hauv qab no:

• arterial kub siab nyob rau txhua theem ntawm kev loj hlob,
• mob plawv tsis ua hauj lwm
• angina pectoris
• atrial fibrillation,
• post-infarction mob
• ricochet leeg ntshav siab,
• tachycardia
• mob plawv plawv.

Yuav ua li cas noj bisoprolol thiab lisinopril

Txij li thaum cov txiaj ntsig zoo ntawm cov ntsiav tshuaj ntawm lub siab tshwm sim tsuas yog siv sijhawm ntev, lawv yuav tsum yog tus kws kho plawv lossis kws kho mob tawm los. Kev noj tshuaj rau tus kheej yog qhov tsis txaus ntseeg.

Siv yeeb tshuaj 1 zaug ib hnub twg. Koj tuaj yeem haus tshuaj ntsiav thaum sawv ntxov nyob rau txhua lub sijhawm. Txawm li cas los xij, qee cov kws tshaj lij nyiam ntseeg tias nws yog qhov zoo dua rau noj tshuaj thaum hmo ntuj, txij li thaum lub sijhawm so hmo ntuj, qhov yuav ua rau myocardial infarction nce ntxiv.

Nyob ntawm seb mob hnyav npaum li cas, tus kws kho mob tuaj yeem sau 5-10 mg ntawm Lisinopril thiab 5 mg ntawm Bisoprolol ib hnub ib zaug thaum pib kho. Ua raws li qhov muaj zog ntawm kev hloov siab, tus kws kho mob tshwj xeeb yuav nce lossis txo cov tshuaj ntau npaum li cas.

Koj yuav tsum noj cov tshuaj nyob sab hauv, tsis hais noj mov, muaj dej txaus.

Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias koj yuav tsum haus tshuaj muaj zog tsis tu ncua, tas koj lub neej, tshwj xeeb yog tom qab ncav cuag ib nrab hnub nyoog thiab xyoo tom ntej. Nrog kev kho mob phaum, yuav tsis muaj qhov tshwm sim. Ib qho kev dhia hauv siab yuav ua rau lub plawv nres lossis mob stroke, suav nrog kev tuag.

Bisoprolol yuav tsum noj qhov ncauj, tsis hais noj zaub mov, muaj dej txaus.

Sab sij huam

Nrog kev siv lub sijhawm ntev ntawm Lisinopril, qee kis, cov tsos mob ntawm hnoos qhuav qhuav yog tau. Hauv qhov no, koj yuav tsum tau sab laj nrog kws kho mob.

Kev siv cov tshuaj no tuaj yeem ua rau qaug zog ntau dua, txhav txhav, kiv taub hau, qaug zog, poob siab ntau, nyob rau hauv cov xwm txheej tsis tshua muaj dyspeptic tshwm sim - xeev siab, ntuav, raws plab.

Lub tswv yim ntawm cov kws kho mob

Oleg, kws kho plawv: "Kuv xav txog qhov sib xyaw ua ke ntawm ACE inhibitor thiab beta-blocker zoo rau kev kho mob ntshav liab. Nrog lub sijhawm siv ntev, lawv tsim cov kev cuam tshuam thiab muaj kev ntseeg siab txo qis. "

Anastasia, kws kho mob: “Bisoprolol-Lisinopril complex tau ua pov thawj nws tus kheej txawm tias nyob rau hauv kev kho mob ntawm cov hom mob ntshav siab. Nws ua tau zoo zam txim, suav nrog cov neeg laus laus, thiab nws yooj yim rau coj nws - tsuas yog 1 zaug ib hnub. Ib qho ntxiv, cov tshuaj muaj tsim pheej yig tus nqi, uas tso cai rau lawv los tsa cov nyiaj laus. ”

Kev Ntsuam Xyuas Rau Neeg Mob

Alexander, 68 xyoo, Vladivostok: “Thaum kws kho mob kuaj mob ntshav siab thiab pib xaiv tshuaj, uas lawv tsis tau sim. Qee yam tau pab ib ntus, thiab qee yam tsis muaj qab hau. Thaum lawv sim Lisinopril, maj mam pib txo kom lub siab. Thaum bisoprolol ntxiv, qhov txheej txheem ua kom nrawm. Tam sim no kuv noj 1 lub tshuaj ntawm ib qho thiab lwm yam tshuaj kho mob thaum hmo ntuj thiab lub siab yog qhov ib txwm ua. "

Tatyana, hnub nyoog 44 xyoo, Khabarovsk: “Lisinopril tau raug tshuaj tam sim ntawd, raws li paub tias kev mob ntshav siab thib ob lawm. Lub siab maj mam rov qab los piv rau tus txheeb ze, tab sis muaj zog tachycardia tshwm sim. Thaum noj Bisoprolol txhua hnub tau ntxiv, cov mem tes tsis tsawg zuj zus, thiab kuv kev noj qab haus huv zoo dua qub. "

Cov Lus Cog Tseg rau Bisoprolol thiab Lisinopril

Nws yog contraindicated hauv kev pib kho rau qee yam kab mob thiab mob, suav nrog:

• cev xeeb tub
• lub sij hawm pub niam mis,
• Tshwm sim angina pectoris,
• nce nyob rau theem ntawm cov thyroid hormones hauv cov ntshav,
• metabolic acidosis
• kev tsis haum rau tshuaj Cheebtsam,
• txo qis siab
• post-infarction mob
• muaj pheochromocytoma,
• Raynaud tus kab mob hauv ib theem lig,
• ricochet leeg ntshav siab,
• mob ntsws asthma ntau heev,
• txo lub plawv dhia,
• ua txhaum ntawm kev tsim lossis lub zog ntawm cov mem tes hauv qhov ntswg ntshav,
• cardiogenic poob siab
• mob plawv sai
• keeb kwm ntawm Quincke tus edema,
• hypertrophic cardiomyopathy nrog lub cev tsis muaj zog hauv cov hlab ntsha,
• nqaim ntawm qhib ntawm aorta, lub raum hlab ntsha los yog mitral valve,
• ntau dhau ntawm kev faib tawm ntawm aldosterone,
• cov me nyuam tsis tau muaj 18 xyoo,
• siv nrog tshuaj uas muaj Aliskiren,
• lub raum khiav tsis zoo nrog lub siab tus yam ntxwv qis dua 220 μmol / l,
• tsis kam lees rau galactose,
• lactase tsis muaj peev xwm.

Thaum kho txoj kev kho mob, hemodialysis siv high-flow membranes yog txwv tsis pub.

Amlodipine thiab cawv sib xyaw cov kev mob tshwm sim

• Lub ntsiab lus tseem ceeb ntawm kev siv tshuaj
• Ntau tshaj thiab cuam tshuam
• Cawv siv tom qab amlodipine

Amlodipine yog ib qho tshuaj heterogeneous tsom mus rau kev thaiv cov tshuaj calcium calcium uas nyob hauv hom L. Feem ntau nws tau muab tshuaj kho mob ntshav siab rau qee zaus, qee zaum nws siv nyob rau hauv tandem nrog lwm cov tshuaj, ua ib qho cuab yeej ntxiv. Yog li, koj yuav tsum xav txog qhov twg Amlodipine yog thiab dab tsi yog nws qhov ua tau zoo nrog haus cawv.

Amlodipine muaj cov yam ntxwv li nram no:

Nws muaj peev xwm zwm cov hlab ntsha, i.e., lub suab nrov ntawm lawv cov phab ntsa poob, thiab, yog li ntawd, cov lumen nce ntxiv. Cov nyhuv antihypertensive - cov nyhuv ntawm lub hauv nruab nrab lub paj hlwb ntawm tib neeg lub cev. Cov nyhuv antianginal, i.e., cov tshuaj muaj peev xwm tshem tawm txhua yam ntawm kev tshwm sim ntawm tus kabmob uas cuam tshuam rau cov hlab ntsha ntawm lub plawv. Nws ua raws li tus antispasmodic, nws yuav yooj yim dua hais, nqaij leeg kuj txo qis.

Raws li qhov kev hloov pauv ntawm cov tshuaj los ntawm ib txoj haujlwm mus rau lwm qhov, cov hlab ntsha nthuav dav, vim li ntawd, lub siab yuav pib ntaus tsis yog li feem ntau. Qhov tshwm sim ntawm kev noj tshuaj yog qhov txo qis hauv cov txiaj ntsig ntawm lub siab nqaij thiab qhov txo qis hauv oxygen noj los ntawm myocardium.

Raws li cov lus qhia, cov cim tseem ceeb rau kev siv:

Nws yog siv nyob rau ntawm qhov chaw siab ceev. Qee zaum nws ua raws li mono-tus neeg sawv cev rau kev mob ntshav siab, thiab qee zaum Amlodipine raug tso cai siv hauv tandem nrog theazadnes, inhibitors thiab, a, β - adreno blockers. Cov cuab yeej tshem tawm qhov xav tau rau myocardial revascularization thiab kev kho mob hauv tsev kho mob vim yog IHD lossis angina pectoris. Yog tias kuaj pom tus mob angina, ces Amlodipine raug suav tias yog qhov khoom tseem ceeb. Tsis tas li ntawd, nws yog thawj qhov kev siv tshuaj thaum cuam tshuam rau myocardial ischemia, uas yog tshwm sim los ntawm kev hnoos qeev lossis deformation ntawm cov hlab ntshav ntawm lub plawv lossis lawv cov nqaij tawv. Nws yog tshuaj kom txo txoj kev pheej hmoo ntawm kev tuag ua ke ntawm ischemia ntawm lub plawv mob, tshwj xeeb tshaj yog mob stroke thiab lub plawv nres. Yog tias tus kws kho mob kho cov mob neoplasms ntawm cov phab ntsa ntawm cov hlab ntsha vim tias tus neeg txhav lossis txoj kev nqaim ntawm lub lumen ntawm cov hlab ntshav, tab sis kev kuaj mob tsis tau ua kom meej, ces kev siv tshuaj yeeb raug tso cai. Nws tuaj yeem siv los ua kev kho mob monotherapy, thiab qee zaum ua ib qho ntxiv tau txuas ntxiv nrog rau cov tshuaj antianginal.

Qhov tshuaj tsuas tsim los ntawm kev qhia:

Yog tias angina pectoris twb mob ntev, ces Amlodipine yuav tsum noj 1 zaug hauv 24 teev, ib ntsiav tshuaj (noj mus rau hauv tus lej tias nws muaj 5 mg), saib tus neeg mob cov tshuaj tiv thaiv. Cov koob tshuaj tuaj yeem nce ntxiv, nce txog 10 ml, kuj 1 zaug hauv ib hnub, tab sis tsis pub dhau 14 hnub. Yog hais tias kuaj pom kab mob ntsws, ces cov koob tshuaj yuav tsum tsis pub tshaj 5-10 mg, ib zaug txhua 24 teev.

Koj yuav tsum nco ntsoov tias txawm tias cov tshuaj ua raws li kev tivthaiv ntxiv, tom qab ntawd cov tshuaj yuav tsum tsis raug txo kom tsawg.

Nws tseem yog ib qho tseem ceeb uas yuav tsum xav txog tias qhov kev txais tos yuav tsum tau nqa tawm ntawm cov sij hawm nruj me ntsis, i.e., raws nraim 24 teev yuav tsum dhau ntawm lub sijhawm ntawm thawj txais tos, tsis muaj ntxiv.

Muaj qhov tshwm sim siab ntawm kev overdose.

Cov kev rau txim sau tseg yog:

• Txo qis dua hauv cov roj ntsha cov cim qhia ntawm txhua qhov system ntawm tib neeg lub cev,
• Lub plawv palpitations
• Cov kev ua kom cov ntshav khov kho tau zoo, tau nthuav tawm hauv lawv qhov nthuav dav, vim li ntawd, cov ntshav siab txo qis.

Yog tias tus kws kho mob pom tias kev noj tshuaj ntau dhau, lossis tus neeg nws tus kheej tau sau tseg cov tsos mob tau piav saum toj saud, tom qab ntawv yuav tsum tau muab kev pabcuam sai sai:

• Thawj yam tsim nyog yog yaug lub plab, los yog ntxias dag ntxias kom ntuav, lossis tso ib qho tshuaj ntxuav kom huv,
• Tom ntej no, koj yuav tsum tau haus dej haus cawv, uas yuav pab ntxuav lub plab thiab tshem tawm cov khoom seem,
• Pw hauv txaj lossis rooj zaum, thiab muab ob peb tog hauv ncoo tso rau hauv qab koj txhais taw,
• Saib xyuas koj tus kheej lub plawv dhia thiab ua pa, ua haujlwm ntawm lub zais zis thiab ntshav ncig,
• Tus kws kho mob yuav tsum sau cov tshuaj rau cov leeg nrog dopamine, mesatone thiab gluconate,
• Hemodialysis hauv qhov xwm txheej no yuav tsis ua haujlwm.

Raws li cov lus qhia, lub ntsiab contraindications rau kev siv Amlodipine yog:

Yog hais tias ib tug neeg tau txheeb nrog tus neeg tsis kam mus rau tag nrho cov tshuaj lossis nws cov khoom siv tshwj xeeb. Thaum kuaj mob angina pectoris, uas muaj qhov tsis khov. Ib qho kev zam yog Prinzmetal lub angina pectoris. Yog hais tias kev kawm siab heev ntawm cov laug ventricular tsis ua haujlwm, lossis ua lwm yam lus, cardiogenic shock, yog kaw. Yog tias tus kws kho mob tau txiav txim siab txog thaj chaw mob tseem ceeb thiab mob aortic stenosis. Nws yog txwv tsis pub noj cov tshuaj rau lub sijhawm thaum coj tus menyuam, vim nws nyhav rau hauv lub tsho me nyuam. Tsis tas li, nws tsis raug tso cai muab tshuaj rau noj yog tias tus poj niam pub mis rau nws tus menyuam. Cov menyuam hluas yog qhov txwv tsis pub noj cov tshuaj no.

Nws yog ib qho tseem ceeb kom nkag siab tias tom qab noj tshuaj Amlodipine, kev tawm tsam siab thiab lwm cov kev mob tshwm sim yuav tshwm sim, uas yog vim li cas cov kws kho mob tsis pom zoo tsis tsav tsheb mus ib ntus thiab tawm kev ua haujlwm uas yuav tsum muaj lub siab xav lossis los ntawm cov cuab yeej muaj kev phom sij. Ib qho ntxiv, tus kws kho mob uas koom nrog yuav tsum hais tias qhov ua tau zoo ntawm kev kho mob tsis yog nyob ntawm cov tshuaj xwb, tab sis kuj ua raws li kev ua raws li kev noj haus kho mob. Nws lub hom phiaj tseem ceeb yog txo qis ntsev noj los ntawm tib neeg.

Raws li txhua qhov kev tshuaj xyuas thiab kev kho mob, daim ntawv teev cov kev mob tshwm sim lub ntsiab los ntawm kev siv tshuaj yeeb raug suav sau.

Cov teeb meem nrog cov hlab plawv:

• Kev o ntawm pob luj taws, luj taws thiab luj taws,
• Mob tachycardia,
• Ib qho dhia dhia hauv siab, nws poob rau qib siab,
• Kev raug mob ntawm txhua yam ntawm cov nkoj,
• Kev ua txhaum ntawm lub siab, tshwj xeeb hauv zaus ntawm cov cwj nrag,
• Kev nco tsis nco dheev, tus yam ntxwv los ntawm lub xeev syncopal.

Cov teeb meem hauv lub hauv nruab nrab cov hlab hlwb:

• Dhia hauv tib neeg lub cev kub
• Tso dej tawm ntawm lub ntsej muag thiab lub cev,
• Qaug zog yog tsau,
• Mob taub hau heev
• Feem ntau kiv taub hau,
• Hyperhidrosis,
• Qaug zog thiab tas li nkees nkees,
• Nyob rau hauv dav dav, ib tug neeg xav tias phem,
• Lub zeem muag poob
• Tawv pob ntseg, suab nrov tau hnov
• Kev saj ntawm cov zaub mov ploj zuj zus mus,
• Ua rau txhua tus nqua ntshav.

Qhov tsis xis nyob ntawm tus kheej genitourinary system:

• Qhov tsis tu ncua thiab tsis xav tau qhov xav mus "me ntsis los ntawm"
• Tsis kaj siab ncus thaum mus siv chav dej,
• Groin tsis xis nyob thaum taug kev.

Cov teeb meem zom:

• Kev mob hnyav rau cov mob peritoneum,
• Ntuav thiab xeev siab
• Dyspeptic mob
• Dryness ntawm tib neeg mucous daim nyias nyias,
• Cov pos hniav loj hlob,
• Lub plab hnyuv mob
• Tsawg tsawg zaus, pom tias muaj kab mob siab.

Lub cev cov leeg txheej txheem mob hlwb:

• Qhov tsis xis nyob, tig mus ua cov neeg ntse ntse hla thoob plaws ntawm tus txha nqaj qaum,
• Mob leeg
• Cov leeg nqaij yog ib txwm nyob hauv nro.

Tus kabmob no tseem siv rau cov ntshav ncig, tab sis hauv qhov no, kev coj ua tsis tau teev cia. Txawm li cas los xij, muaj qhov ua tau tias ib tus neeg yuav kis mob los ntawm huab cua sov purpura, nws yuav sau cia qis qis hauv qib ntawm leukocytes hauv cov ntshav, nrog rau qhov ntim ntawm platelets.

Ntawm ib feem ntawm cov txheej txheem ua pa, kuj tseem muaj kev mob tshwm sim:

• Thaum khiav thiab taug kev, tus neeg ceeb toom txog kev ua pa luv,
• Lub qhov ntswg los ntswg
• Kev hnoos yog qhov uas tsis muaj lub laj thawj.

Cov tawv nqaij tseem muaj kev txom nyem - khaus, liab thiab tawm pob. Pigmentation yog tsis tshua muaj kev kuaj pom.

Nyob rau hauv lub ntsiab lus physiological - lub cev hnyav dua, txo qis ntse, tom qab ntawd ces lub cev qhov hnyav.

Ib qho ntawm cov lus nug feem ntau ntawm cov neeg mob noj cov tshuaj no yog "nws puas tuaj yeem siv cov tshuaj yeeb yam muaj txiaj ntsig thiab yuav muaj dab tsi tshwm sim?".

Txhua tus kws kho mob, txawm hais tias tsis tau xav txog, yuav hais tias kev haus cawv thiab siv tshuaj yog qhov tsis zoo. Tsis ntseeg, muaj ntau ntau pab pawg, qee yam txwv tsis pub lub koomhaum pab neeg, lwm tus tso cai, tab sis hauv cov khoom muaj tsawg tsawg, tseem muaj lwm tus neeg tso cai nrog txhua yam cawv. Qhov yog, ethanol yog ib hom tshuaj lom uas ua rau lub nruab nrab hauv lub paj hlwb, thiab raws li peb pom los ntawm cov npe ntawm cov kev mob tshwm sim, Amlodipine kuj cuam tshuam rau nws.

Tsis tas li ntawd, Amlodipine nkag rau hauv lub siab, rau kev ua mus ntxiv, haus cawv tau tawm hauv tib txoj kev, uas txhais tau tias thaum cov tshuaj nkag mus rau hauv lub cev, nws pib ua haujlwm rau qhov txwv. Raws li qhov kev tawm tsam no, lub siab ua rau lub siab tsis muaj zog, thiab lub txim ntawm qhov no tuaj yeem ua rau tuag taus.

Raws li cov lus qhia, Amlodipine thiab cawv tuaj yeem noj nyob rau hauv tandem, tab sis tseem tsis tsim nyog nws. Cov cheebtsam uas yog ib feem ntawm cov lus qhia yuav pib tsis zoo los ntawm cov ntshav nyob rau hauv cov cawv, tom qab ntawd cov kev kho no tuaj yeem hu ua khoob.

Kev sib xyaw ua ke yog qhov tsim nyog, tab sis lo lus nug yog ripening, vim li cas kho siab yog tias koj xav ua kom koj lub cev thiab ua rau lub siab poob siab rau lub hauv nruab nrog cawv?

Nws tsim nyog sau cia tias haus cawv, tsuas yog nkag mus rau hauv lub cev, zoo li Amlodipine dilates cov hlab ntshav, txo lawv lub suab, thiab qhov no ua rau txo qis hauv lub siab. Thaum lub sijhawm dhau los, nrog ntau npaum li cas, lub siab tsis yog rov qab los rau nws txoj haujlwm dhau los, nws dhia rau exorbitant qhov tseem ceeb. Nws hloov tawm tias ob qho yeeb tshuaj tsom rau ib qho txiaj ntsig sib txawv.

Thaum ib tug neeg tab tom kho mob nrog rau yeeb tshuaj, nws zoo dua rau kev tso tseg txoj kev haus dej kom tsis txhob raug lub txim ntawm qhov xwm txheej ntawd. Xws li lub union tsis ua rau muaj ib yam dab tsi zoo; koj tsuas yog ua kom muaj tshuaj lom ntxiv rau hauv tag nrho koj cov kab ke.

Amlodipine yog tshuaj uas cuam tshuam rau txhua tus neeg sib txawv, thiab kev sib xyaw nrog cawv, nws tuaj yeem ua rau muaj kev tsis haum. Nrog txhua txoj kev xav, koj yuav tsum tsis kam lees ob lub lim tiam no ntawm kev kho dej cawv, kom tom qab koj tau kawm tiav kev noj qab haus huv.

Qhov tsim txom tsawg kawg nkaus uas koj tuaj yeem nqa tuaj rau koj lub cev los ntawm haus dej haus cawv nrog tshuaj yog qhov poob ntawm cov txiaj ntsig ntawm kev noj tshuaj. Qhov tshwm sim phem tshaj plaws yog daim siab ua kom lub siab thiab ua rau lub nruab nrab ntawm cov leeg hlwb. Tsis txhob tsis saib xyuas koj li kev noj qab haus huv, nws yooj yim rau kev saib xyuas nws hnub no dua li txuag dua tag kis.

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

Bisoprolol - xaiv beta-blocker yam tsis muaj nws tus kheej sympathomimetic cov haujlwm, muaj antihypertensive, antiarrhythmic thiab antianginal teebmeem. Los ntawm kev thaiv beta1-adrenergic receptors lub plawv hauv cov koob tshuaj qis, nws txo qhov tsim muaj ntawm cyclic adenosine monophosphate (cAMP) tsa los ntawm catecholamines los ntawm adenosine triphosphate (ATP), txo cov dej ntws tsis txaus ntawm calcium ions (Ca2 +), muaj qhov tsis zoo chrono-, dromo-, batmo- thiab teotrop mob plab, inhibits conduction thiab excitability, txo myocardial contractility).

Nrog rau qhov nce ntxiv hauv koob tshuaj, nws muaj beta2-adrenergic thaiv cov nyhuv.

Tag nrho cov kev tawm tsam ntawm cov leeg thaum pib ntawm kev siv cov beta-blockers, hauv thawj 24 teev, nce (vim tias qhov kev pab cuam rov qab los ntawm kev ua haujlwm ntawm alpha-adrenergic receptors thiab tshem tawm ntawm beta2-adrenoreceptor stimulation), uas rov qab mus rau nws lub xeev qub tom qab 1-3 hnub, thiab txo qis nrog kev tswj hwm ntev.

Cov nyhuv antihypertensive cuam tshuam nrog kev poob qis hauv cov ntshav tsawg feeb, txhawb kev ua kom zoo dua ntawm cov hlab ntsha, ib qho kev txo qis ntawm kev ua si ntawm renin-angiotensin-aldosterone system (tseem ceeb dua rau cov neeg mob nrog kev txo qis ntawm renin), rov qab los ntawm qhov rhiab ntawm aortic arch baroreceptors ) thiab cov cuam tshuam rau lub hauv nruab nrab lub paj hlwb. Nrog rau cov hlab ntsha o, cov nyhuv tshwm sim tom qab 2-5 hnub, cov nyhuv ruaj khov - tom qab 1-2 hlis.

Qhov ua tiav antianginal yog vim muaj qhov txo qis ntawm myocardial oxygen xav tau vim qhov txo qis ntawm lub plawv thiab qhov txo qis ntawm daim ntawv cog lus, lengthening ntawm diastole, thiab kev txhim kho ntawm myocardial perfusion. Los ntawm kev ua kom tiav qhov kawg diastolic siab nyob rau sab laug ventricle thiab nce ntxiv ntawm kev ncab ntawm cov leeg ntawm cov hlab ntsha, nws tuaj yeem ua kom muaj myocardial oxygen xav tau, tshwj xeeb tshaj yog nyob rau cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev (CHF).

Hauv kev sib piv rau cov tsis xaiv tshuaj beta-blockers, thaum muab rau hauv cov tshuaj nruab nrab, nws muaj qhov tsis tshua muaj txiaj ntsig rau cov kabmob uas muaj beta2-adrenergic receptors (txiav, pob txha pob txha, cov leeg ntawm cov hlab ntsha, bronchi thiab uterus) thiab tsis ua rau sodium ion los khaws cia (Na +) hauv lub cev. Thaum siv nyob rau hauv cov koob tshuaj loj, nws muaj qhov cuam tshuam ntawm ob txoj kev sib piv ntawm beta-adrenergic receptors.

Muaj pes tsawg leeg

Bisoprolol fumarate + tus tshaj tawm.

Cov Tshuaj Pharmacokinetics

Bisoprolol yog yuav luag nqus los ntawm txoj hnyuv hauv plab (80-90%). Noj mov tsis cuam tshuam rau kev nqus ntawm cov tshuaj. Kev tso cai hla dhau ntawm cov ntshav-hlwb teeb meem thiab qhov chaw teeb meem yog qhov tsawg, qhov zais ntshis nrog niam mis yog tsawg. Cov tshuaj txiav tawm hauv daim siab. Nws yog tawm los ntawm lub raum - 50% tsis pauv, tsawg dua 2% - dhau los ntawm txoj hnyuv.

Cov Khoom Qhia

• Arterial kub siab,
• Coronary heart disease (CHD): tiv thaiv ntawm kev tawm tsam ntawm tus mob angina pectoris ruaj khov.

Tso Tawm Cov Ntawv

Cov ntsiav tshuaj 2.5 mg, 5 mg thiab 10 mg.

Cov lus qhia rau kev siv thiab ntau npaum li cas

Sab hauv, thaum sawv ntxov nyob rau ntawm lub plab khoob, tsis tas yuav zom, nrog me me ntawm kua.

Nrog rau kev mob ntshav hauv lub plawv thiab kev mob plawv (tiv thaiv kev tawm tsam ntawm lub ntsws angina pectoris), nws raug nquahu kom noj 5 mg ib zaug. Yog tias tsim nyog, nce qhov koob tshuaj rau 10 mg ib hnub ib zaug. Qhov siab tshuaj ntau tshaj txhua hnub yog 20 mg.

Hauv cov neeg mob uas lub raum lub raum tsis ua haujlwm (kev tsim muaj peev xwm tshem tau tsawg dua 20 ml / min) lossis nrog lub siab tsis ua haujlwm siab, qhov siab tshaj plaws txhua hnub yog 10 mg.

Koob tshuaj hloov kho hauv cov neeg mob laus tsis tas yuav.

Sab sij huam

• Mob taub hau
• Kiv taub hau
• Insomnia
• Ntxoov Huaj
• Kev Nyuaj Siab
• Kev nkees nkees
• Qaug zog,
• Tsis nco qab
• Kev Ua Si
• Npau suav “Npau suav phem”,
• Cramps
• Tsis meej pem lossis luv qhov nco tsis tau
• Pom kev tsis pom kev
• Tsis ua rau kua muag tsis pom,
• Qhuav thiab mob qhov muag
• Hnov hnov ​​lus tsis zoo
• Kab mob ntsws
• Sinus bradycardia,
• Cim txo hauv ntshav siab,
• Ua txhaum ntawm AV conduction,
• Orthostatic hypotension,
• Decompensation ntawm CHF,
• Sab Nraud Nruab Nruab,
• Cov kev sim ntawm angiospasm (nce puas ntawm peripheral ncig, txias ntawm qis qis, Raynaud's syndrome, paresthesia),
• Kev mob hauv siab
• Zawv plab
• Xeev siab, ntuav,
• Cov qhov ncauj qhuav qws,
• Cem quav
• Nasal congestion
• Ua pa nyuaj thaum kws kho mob siab (poob zoo xaiv),
• Hauv cov neeg mob predisposed - laryngo - thiab bronchospasm,
• Hyperglycemia (hom 2 mob ntshav qab zib mellitus),
• Kev Mob Ntshav Qab Zib (hom 1 mob ntshav qab zib mellitus),
• Cov tawv nqaij khaus
• Pob pob
• Urticaria,
• Kev ua xua rau rhinitis
• Txhim kho li qub,
• Hyperemia ntawm daim tawv nqaij,
• Exacerbation ntawm cov tsos mob psoriasis,
• Alopecia
• Nqaij tsis muaj zog
• Cramps hauv plab hlaub nqaij
• Arthralgia,
• Thrombocytopenia, agranulocytosis,
• Impaired potency,
• Cov tsos mob "tshem tawm" (muaj kev tawm tsam ntxiv ntawm angina pectoris, nce ntshav siab).

Cov Yuav Tsum Muaj

• Mob plawv tsis ua hauj lwm lossis mob plawv tsis ua hauj lwm hauv qib sai (yuav tsum tau kho inotropic),
• Cardiogenic poob siab,
• Atrioventricular thaiv 2 thiab 3 qib, yam tsis tas yuav txav nrawm,
• Sinoatrial thaiv
• Mob sinus syndrome
• Bradycardia (lub plawv dhia qis dua 60 rab phom / min),
• Cardiomegaly (tsis muaj cov cim ntawm lub plawv tsis ua haujlwm),
• Arterial hypotension (systolic siab qis dua 100 hli Hg)
• Cov ntaub ntawv mob ntsws asthma thiab mob ntsws,
• Kev mob loj rau mob hnoos qeev, Raynaud tus mob,
• Lactation
• Hloov siv MAO inhibitors tshwj tsis yog MAO-B,
• Cov kab mob tsis haum rau lactose, lactase deficiency, glucose-galactose malabsorption syndrome,
• Pheochromocytoma (tsis muaj tib lub sijhawm siv alpha-blockers),
• Kev mob acidosis,
• Siv cov flactaphenin, suloprid yooj yim,
• Yooj yim tswj cov leeg ntawm verapamil, diltiazem,
• Muaj hnub nyoog txog 18 xyoo (qhov ua tau zoo thiab kev nyab xeeb tsis pom zoo),
• Hypersensitivity rau bisoprolol, lub Cheebtsam ntawm cov tshuaj thiab mus rau lwm qhov beta-blockers.

Cev xeeb tub thiab lactation

Siv thaum cev xeeb tub yog ua tau yog tias cov txiaj ntsig rau leej niam outweighs qhov kev pheej hmoo ntawm cov kev mob tshwm sim hauv tus me nyuam hauv plab.

Cuam tshuam rau tus me nyuam hauv plab: mob hlab ntsha tawg sai sai, mob ntshav qab zib tsawg, ua kom hlwb, ua pa nyuaj (neonatal asphyxia) hauv cov menyuam mos yug los kuj muaj peev xwm ua tau.

Yog tias nws yuav tsum siv Bisoprolol thaum lactation, yuav tsum pub mis rau menyuam noj, vim Bisoprolol ua haujlwm tawm hauv niam cov kua mis.

Siv rau menyuam yaus

Contraindicated rau cov menyuam yaus hnub nyoog qis dua 18 xyoo (qhov ua tau zoo thiab kev nyab xeeb tsis tau).

Cov lus qhia tshwj xeeb

Kev tshuaj xyuas cov neeg mob noj Bisoprolol yuav tsum suav nrog kev saib xyuas lub plawv dhia thiab ntshav siab (thaum pib kho txhua hnub, tom qab ntawd ib zaug txhua 3-4 lub hlis), ib qho tshuaj electrocardiogram (ECG), ntshav qabzib hauv cov neeg mob ntshav qab zib mellitus (1 lub sijhawm hauv 4-5 lub hlis). Hauv cov neeg mob laus, nws raug nquahu kom soj ntsuam lub raum (1 lub sijhawm hauv 4-5 lub hlis).

Cov neeg mob yuav tsum tau kawm nyob rau hauv txoj hauv kev ntawm suav lub plawv dhia siab thiab qhia txog kev xav tau kev qhia kho mob rau lub plawv tsawg dua 50 rab koob / min.

Ua ntej pib kev kho mob, nws raug nquahu kom kawm txoj haujlwm ntawm kev ua pa sab nraud rau hauv cov neeg mob uas muaj keeb kwm tiv thaiv kab mob bronchopulmonary.

Hauv kwv yees li 20% ntawm cov neeg mob angina pectoris, beta-blockers tsis muaj txiaj ntsig.Lub hauv paus ntsiab lus tseem ceeb yog mob rau cov hlab ntsha atherosclerosis nrog kev qis qis ntawm ischemia (lub plawv tsawg dua 100 neeg ntaus / min) thiab nce ntxiv rau qhov kawg diastolic ntim ntawm sab laug ventricle, uas ua txhaum lub subendocardial ntshav txaus. Hauv "neeg haus luam yeeb" qhov ua tau zoo ntawm beta-blockers yog qhov qis dua.

Cov neeg mob siv tsom iav yuav tsum tau coj mus rau hauv tus account tias, tawm tsam keeb kwm ntawm kev kho mob, qhov txo qis hauv kev tsim cov kua muag ntawm lub kua muag yog ua tau.

Thaum siv hauv cov neeg mob pheochromocytoma, muaj kev pheej hmoo ntawm kev tsim paradoxical hlab ntsha tawg (yog tias alpha-adrenoblockade tsis tau ua tiav yav dhau los).

Nrog thyrotoxicosis, Bisoprolol tuaj yeem npog qee qhov kev kho mob ntawm thyrotoxicosis (piv txwv, tachycardia). Kev tshem tawm sai sai hauv cov neeg mob thyrotoxicosis yog contraindicated, vim nws tuaj yeem txhim kho cov tsos mob.

Ntawm cov ntshav qab zib, nws tuaj yeem npog tachycardia tshwm sim los ntawm cov qog ntshav qab zib. Hauv kev sib piv rau cov tsis raug xaiv cov beta-blockers, nws xyaum tsis txhim kho cov roj ntsha insulin thiab tsis ncua sij hawm kho cov ntshav qabzib concentration mus rau qhov tseem ceeb.

Nrog rau kev sib xyaw ua ke ntawm clonidine, nws txoj kev tswj hwm tuaj yeem nres tsuas yog ob peb hnub tom qab tshem tawm ntawm bisoprolol.

Nws muaj peev xwm nce ntxiv qhov hnyav ntawm qhov tshwm sim tsis haum thiab tsis muaj txiaj ntsig ntawm kev siv tshuaj ntawm epinephrine (adrenaline) ntau dhau los tiv thaiv keeb kwm ntawm keeb kwm kev tiv thaiv kev mob tshwm sim.

Yog tias nws yuav tsum tau ua tiav txoj kev npaj phais mob, kev tshem tawm tshuaj yeeb tshuaj yog kwv yees 48 teev ua ntej pib kev tso tshuaj kom tsaug zog. Yog tias tus neeg mob tau siv tshuaj ua ntej kev phais mob, nws yuav tsum xaiv cov tshuaj rau cov tshuaj loog tshwj xeeb nrog qhov tsis pom qhov tsis zoo.

Kev ua kom rov qab ua kom zoo dua ntawm qhov chaw mos ntawm lub paum tau tuaj yeem tshem tawm los ntawm kev tswj hwm ntawm atropine (1-2 mg).

Cov tshuaj noj uas txo cov catecholamine khw muag khoom (piv txwv li, reserpine) tuaj yeem txhim kho cov txiaj ntsig ntawm beta-blockers, yog li cov neeg mob noj cov tshuaj sib xyaw no yuav tsum nyob hauv kev saib xyuas tas li los ntawm kws kho mob txhawm rau txhawm rau kuaj ntshav hypotension lossis bradycardia.

Cardioselective adrenoblockers tej zaum yuav raug muab tshuaj rau cov neeg mob uas muaj kab mob bronchospastic thaum tsis ua haujlwm thiab / lossis tsis muaj txiaj ntsig ntawm lwm cov tshuaj tiv thaiv kab mob, tab sis ntau npaum li cas yuav tsum tau soj ntsuam nruj me ntsis. Ib qho kev tshaj tawm yog qhov txaus ntshai rau kev loj hlob ntawm txoj kev mob bronchospasm.

Xws li cov neeg mob laus uas muaj kev sib koom tes ntau dua bradycardia (tsawg dua 50 beats / min), txoj hlab ntshav hauv ntshav (ntshav siab qis dua 100 hli Hg), AV block, bronchospasm, ventricular arrhythmias, mob siab rau lub siab thiab lub raum tsis ua haujlwm, nws yog qhov tsim nyog los txo qhov koob lossis nres. kev kho mob. Nws raug nquahu kom tsum tsis txhob muaj kev kho mob nrog kev txhim kho kev nyuaj siab tshwm sim los ntawm kev noj cov beta-blockers.

Koj tsis tuaj yeem cuam tshuam nrog kev kho mob sai sai vim tias qhov kev phom sij ntawm kev loj hlob tsis meej thiab myocardial infarction. Kev tshem tawm yog nqa tawm maj, txo cov koob tshuaj rau 2 lub lis piam lossis ntau dua (txo qhov koob tshuaj 25% hauv 3-4 hnub).

Nws yuav tsum raug tshem tawm ua ntej kev kawm txog cov ntsiab lus hauv cov ntshav thiab zis ntawm catecholamines, normetanephrine thiab vanillyl mandelic acid, tshuaj tiv thaiv kab mob sib kis.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab

Thaum lub sijhawm kho mob, yuav tsum tau saib xyuas thaum tsav tsheb thiab koom nrog lwm yam kev phom sij uas yuav tsum muaj kev ntseeg ntau ntxiv thiab ceev ntawm cov kev tiv thaiv psychomotor.

Yeeb tshuaj sib cuam tshuam

Kev ua xua uas siv rau kev txhaj tshuaj tiv thaiv kab mob los yog ua xua rau kev kuaj tawv nqaij ua rau muaj kev phom sij ntau dua lossis ua kom tsis haum rau cov neeg mob uas tau txais bisoprolol.

Phenytoin thaum muab cov tshuaj tso ntshav, tshuaj rau inhalation general anesthesia (hydrocarbon derivatives) nce qhov hnyav ntawm cardiodepressive kev txiav txim siab thiab qhov ntxim nyiam ntawm kev txo ntshav siab.

Iodine-muaj radiopaque kev kuaj mob tus neeg sawv cev rau kev tswj hwm kev quav dej num nce qhov kev pheej hmoo ntawm kev phiv tshuaj.

Bisoprolol hloov qhov ua tau zoo ntawm insulin thiab hypoglycemic tus neeg sawv cev rau kev tswj hwm ntawm qhov ncauj, ua lub ntsej muag cov tsos mob ntawm kev txhim kho hypoglycemia (tachycardia, nce ntshav siab).

Cov nyhuv tshuaj tiv thaiv yog qhov ua kom tsis muaj zog los ntawm cov tshuaj tsis muaj tshuaj steroidal (sodium ion retention thiab prostaglandin synthesis blockade los ntawm ob lub raum), glucocorticosteroids thiab estrogens (sodium ion retention).

Mob glycosides, methyldopa, reserpine, thiab guanfacine ntau qhov kev pheej hmoo ntawm kev txhim kho lossis kev ua kom pheej hmoo rau mob bradycardia, atrioventricular block, plawv nres, thiab lub plawv tsis ua haujlwm.

Kev sib xyaw ntawm Bisoprolol nrog calcium antagonists (verapamil, diltiazem, bepridil) tsis pom zoo thaum muab cov tshuaj ua kom zoo, vim muaj qhov tshwm sim tsis zoo ntawm kev ua haujlwm inotropic ntawm myocardium, AV conductivity thiab ntshav siab.

Kev siv ua ke ntawm nifedipine thiab bisoprolol tuaj yeem ua rau txo qis ntshav siab.

Nrog rau kev siv Bisoprolol thiab chav kawm ua ke 1 tshuaj antiarrhythmic (disopyramide, quinidine, hydroquinidine), atrial ventricular conduction thiab ib qho tsis zoo inotropic yuav cuam tshuam (kev soj ntsuam thiab tshuaj hluav taws xob yog qhov tsim nyog).

Nrog tib lub sijhawm siv bisoprolol thiab chav kawm 3 tshuaj thuv rov qab (piv txwv li, amiodarone), atrial conduction yuav ua kom paug.

Nrog tib lub sijhawm siv cov tshuaj Bisoprolol thiab lwm yam beta-blockers, suav nrog cov uas muaj nyob hauv qhov muag tee, muaj kev sib txuam ntawm kev ua tau.

Siv tib lub sijhawm Bisoprolol nrog beta-adrenergic agonists (piv txwv li isoprenaline, dobunamine) tuaj yeem ua rau txo qis hauv cov nyhuv ntawm ob lub tshuaj yeeb tshuaj.

Kev sib xyaw ntawm Bisoprolol nrog beta - thiab alpha-adrenergic agonists (piv txwv li, iorepinephrine, epinephrine) tuaj yeem txhim kho vasoconstrictor cuam tshuam los ntawm cov neeg sawv cev uas tshwm sim nrog kev koom nrog alpha-adrenergic receptors, uas ua rau muaj kev nce ntshav ntxiv.

Diuretics, clonidine, sympatholytics, hydralazine thiab lwm yam tshuaj tiv thaiv kabmob tuaj yeem ua rau txo cov ntshav siab ntau dhau.

Nrog tib lub sijhawm siv bisoprolol thiab mefloquine, kev pheej hmoo ntawm bradycardia nce.

Txheeb xyuas qhov siv bisoprolol nrog flactaphenin thiab sultopride yog contraindicated.

Qhov kev ua ntawm tsis ua rau cov leeg ua kom cov leeg ua si thiab cov tshuaj tiv thaiv uas ua kom zoo ntawm cov tshuaj pleev ib ce thaum kho nrog Bisoprolol tej zaum yuav ua rau lub sijhawm ntev.

Peb - thiab tetracyclic cov tshuaj tiv thaiv kev ntxhov siab, tshuaj tiv thaiv kab mob (tshuaj tiv thaiv kab mob), ethanol (cawv), cov tshuaj loog thiab cov tshuaj tiv thaiv hypnotic nce hauv nruab nrab cov hlab ntsha hauv lub siab. Kev siv tib lub sij hawm Bisoprolol nrog MAO inhibitors (tshwj tsis yog MAO-B) tsis pom zoo vim muaj kev cuam tshuam ntau ntxiv hauv cov nyhuv hypotensive. Kev so ntawm kev kho mob ntawm kev noj MAO inhibitors thiab Bisoprolol yuav tsum yog tsawg kawg 14 hnub.

Nws txo qhov kev tshem tawm ntawm cov tshuaj lidocaine thiab xanthines (tshwj tsis yog diprofillin) thiab ua rau lawv cov ntshav plasma ntau ntxiv, tshwj xeeb tshaj yog nyob rau cov neeg mob thaum pib muaj kev tshem tawm ntawm theophylline nyob rau hauv kev haus luam yeeb.

Sulfasalazine tsub kom lub siab ntawm bisoprolol hauv ntshav ntshav.

Rifampicin shortens qhov kev tshem tawm ib nrab-lub neej ntawm bisoprolol.

Analogues ntawm cov tshuaj Bisoprolol

Cov qauv ntawm cov qauv ua haujlwm:

• Arithel
• Aritel Cor
• Bidop
• Biol
• Biprol
• Bisogamma
• Txhab Nyiaj
• Bisomor,
• Bisoprolol OBL,
• Bisoprolol Tiaj Nyom,
• Bisoprolol Prana,
• Bisoprolol ratiopharm,
• Bisoprolol Sandoz
• Bisoprolol Teva,
• Bisoprolol hemifumarate,
• Bisoprolol fumarate,
• Bisoprolol Fumarate Pharmaplant,
• Tsoo
• Tus Kheej Cor,
• Corbis
• Cordinorm
• Coronal
• Hypertin
• Tyrez.

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

Lisinopril - ACE inhibitor, txo qhov tsim ntawm angiotensin 2 los ntawm angiotensin 1. Txo cov ntsiab lus ntawm angiotensin 2 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. Txo tag nrho peripheral vascular tsis kam, ntshav siab (BP), preload, siab nyob rau hauv cov hlab ntsws capillaries, ua rau kev nce ntshav feeb thiab nce myocardial zam rau kev ntxhov siab hauv cov neeg mob uas mob plawv tsis ua haujlwm. 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. Cov nyhuv antihypertensive pib tom qab li 6 teev thiab kav rau 24 teev. Lub sijhawm ntawm cov nyhuv kuj nyob ntawm qhov koob tshuaj. Qhov pib ntawm kev ua yog tom qab 1 teev. Qhov siab tshaj plaws txiav txim siab tau txiav txim siab tom qab 6-7 teev. Nrog rau kev kub siab, qhov tshwm sim pom nyob hauv thawj hnub tom qab pib kho, qhov ua haujlwm 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.

Ntxiv rau qhov txo qis ntshav siab, lisinopril txo cov albuminuria. Hauv cov neeg mob hyperglycemia, nws pab ua kom lub cev ua haujlwm ntawm glomerular endothelium tsis ua haujlwm.

Lisinopril 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 hypoglycemia.

Muaj pes tsawg leeg

Lisinopril (nyob rau hauv daim ntawv ntawm dihydrate) + excipients.

Cov Tshuaj Pharmacokinetics

Tom qab noj cov tshuaj hauv, kwv yees li 25% ntawm lisinopril yog nqus los ntawm cov hnyuv plab. Noj mov tsis cuam tshuam rau kev nqus ntawm cov tshuaj. Yuav luag tsis khi rau cov plasma protein. Kev tso cai hla ntawm cov ntshav-hlwb thiab thaj chaw teeb meem yog tsawg. Lisinopril tsis muaj biotransformed hauv lub cev. Nws yog tawm los ntawm lub raum tsis hloov pauv.

Cov Khoom Qhia

• Arterial hypertension (hauv kev kho mob hlwb lossis hauv kev sib xyaw nrog lwm cov tshuaj antihypertensive),
• Mob plawv tsis ua hauj lwm (raws li ib feem ntawm kev sib koom ua ke kho kev kho mob ntawm cov neeg mob noj digitalis thiab / lossis diuretics)
• Kev kho thaum ntxov ntawm mob myocardial infarction (hauv thawj 24 teev nrog cov hemodynamics ruaj khov los tswj cov ntsuas no thiab tiv thaiv sab laug ventricular kawg thiab lub plawv tsis ua haujlwm),
• Mob ntshav qab zib nephropathy (poob albuminuria hauv cov neeg mob insulin-uas muaj ntshav siab thiab cov neeg mob tsis haum tshuaj muaj kev mob ntshav siab).

Tso Tawm Cov Ntawv

Cov ntsiav tshuaj 2.5 mg, 5 mg, 10 mg, 20 mg.

Cov lus qhia rau kev siv thiab ntau npaum li cas

Sab hauv, tsis hais txog pluas noj. Nrog rau cov hlab ntsha o, cov neeg mob tsis tau txais lwm cov tshuaj tiv thaiv kev tiv thaiv kabmob 5 yam tshuaj ib hnub ib zaug Yog tias tsis muaj kev cuam tshuam, qhov koob tshuaj tau nce ntxiv txhua 2-3 hnub los ntawm 5 mg rau qhov nruab nrab cov tshuaj kho 20-40 mg ib hnub (nce ntau dua koob thawj 40 mg ib hnub feem ntau tsis ua rau txo qis ntshav siab). 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 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 zaug ntawm Lisinopril 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 ua tiav tau tom qab kwv yees li 6 teev), txij li pom qhov txo qis hauv ntshav siab tuaj yeem tshwm sim.

Nyob rau hauv kev tshwm sim ntawm kev kho lub plawv tawg lossis lwm yam kev mob nrog kev ua si ntau ntxiv ntawm renin-angiotensin-aldosterone system, nws tseem yuav tsum tau tshaj tawm cov koob tshuaj qis ntawm 2.5-5 mg ib hnub, nyob rau hauv kev saib xyuas kev kho mob (tswj ntshav siab, raum kev ua haujlwm, poov tshuaj concentration hauv cov ntshav). Kev saib xyuas cov koob tshuaj, txuas ntxiv kev tswj hwm kev kho mob nruj, yuav tsum txiav txim siab nyob ntawm qhov kev hloov pauv ntawm cov ntshav siab.

Nrog cov kev pheej hmoo ntawm cov leeg ntshav, kev kho lub sij hawm ntev ntawm 10-15 mg ib hnub yog qhia.

Hauv kev mob plawv tsis ua hauj lwm ntev - pib nrog 2.5 mg 1 zaug nyob rau ib hnub, tom qab ntawd koob tshuaj nce 2.5 mg nyob rau hauv 3-5 hnub rau ib txwm, txhawb kev noj tshuaj txhua hnub ntawm 5-20 mg. Qhov tshuaj yuav tsum tsis pub tshaj 20 mg ib hnub twg.

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 excretion (nws tau pom zoo kom pib kho nrog 2.5 mg ib hnub).

Mob myocardial infarction (raws li ib feem ntawm txoj kev kho ua ke)

Thawj hnub - 5 mg hais lus, tom qab ntawd 5 mg txhua lwm hnub, 10 mg txhua ob hnub thiab tom qab ntawd 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. Thaum pib kho lossis thaum thawj 3 hnub tom qab muaj mob myocardial ntau nyob rau hauv cov neeg mob uas muaj ntshav tsawg systolic (120 mmHg lossis tsawg dua), ib koob tshuaj qis yuav tsum raug kho - 2.5 mg. Xws li poob qis hauv ntshav siab (systolic ntshav siab hauv qab lossis sib npaug li 100 mm Hg), qhov tshuaj txhua hnub ntawm 5 mg tuaj yeem, yog tias tsim nyog, yuav raug txo ib ntus rau 2.5 mg. Thaum lub cim ntev dhau txo cov ntshav siab (systolic ntshav qis dua 90 hli Hg. Daim duab. Ntau dua 1 teev), kev kho mob nrog Lisinopril yuav tsum tsis ua haujlwm ntxiv.

Hauv cov neeg mob uas tsis mob ntshav qab zib tsis yog insulin, 10 mg ntawm Lisinopril yog siv ib hnub ib zaug. Qhov koob tshuaj yuav yog, yog tias tsim nyog, nce ntxiv rau 20 mg ib hnub ib zaug txhawm rau kom ua tiav diastolic ntshav siab qis dua 75 hli Hg. Kos duab. hauv ib txoj hauj lwm zaum. Hauv cov neeg mob uas muaj ntshav qab zib insulin-tiv thaiv kab mob ntshav qab zib, qhov ntau npaum qhov qub, thiaj li ua tiav diastolic ntshav siab qis dua 90 hli Hg. Kos duab. hauv ib txoj hauj lwm zaum.

Sab sij huam

• Kiv taub hau
• Mob taub hau
• Neeg tsis muaj zog
• Zawv plab
• Qhuav hnoos
• Xeev siab, ntuav,
• Cov tawv nqaij ua pob
• Kev mob hauv siab
• Angioneurotic edema (lub ntsej muag, daim di ncauj, tus nplaig, lub suab ntawm lub ntsej muag lossis mob epiglottis, sab saud thiab sab hauv)
• Cim txo hauv ntshav siab,
• Orthostatic hypotension,
• Mob raum tsis zoo,
• Lub plawv tuaj ntxhov sab xis
• Lub plawv palpitations
• Qaug zog,
• Kev nkees nkees
• Xaus khov kho cov leeg ntawm nqaj thiab daim di ncauj,
• Leukopenia, neutropenia, agranulocytosis, thrombocytopenia,
• Lub plawv dhia
• Tachycardia
• Myocardial infarction
• Cerebrovascular mob stroke hauv cov neeg mob uas muaj kev pheej hmoo ntawm tus kab mob, vim tshaj tawm hauv cov ntshav siab,
• Lub qhov ncauj qhuav
• Kev Mob Nkeeg
• Yeeb Ncuab
• Saj pauv
• Mob plab
• Urticaria,
• Muaj hws ntau
• Cov tawv nqaij khaus
• Alopecia
• Mob raum tsis zoo,
• Oliguria
• Kev Mob Nkeeg
• Mob raum tsis ua hauj lwm
• Cov tsos mob Asthenic
• Ua tau txaus siab kawg
• Tsis meej pem,
• Tsawg dua potency
• Neej Hmoob
• Ua npaws
• Kev ua tsis tau zoo ntawm kev txhim kho me nyuam hauv plab.

Cov Yuav Tsum Muaj

• Keeb kwm ntawm tus kab mob angioedema, suav nrog los ntawm kev siv ACE inhibitors,
• Quincke cov keeb kwm muaj keeb,
• Muaj hnub nyoog txog 18 xyoo (qhov ua tau zoo thiab kev nyab xeeb tsis pom zoo),
• Kev ua haujlwm siab rau lisinopril lossis lwm yam ACE inhibitors.

Cev xeeb tub thiab lactation

Kev siv cov lisinopril thaum cev xeeb tub yog contraindicated. Thaum xeeb tub yog tsim muaj, cov tshuaj yuav tsum tau txiav kom sai li sai tau. Kev lees txais ntawm ACE inhibitors nyob rau lub sijhawm 2 thiab 3 lub hlis ntawm cev xeeb tub muaj qhov tshwm sim tsis zoo ntawm tus menyuam hauv plab (qhov tshaj tawm hauv cov ntshav siab, lub raum tsis ua haujlwm, hyperkalemia, cranial hypoplasia, thiab kev tuag rau hauv plab yog muaj peev xwm ua tau). Tsis muaj cov ntaub ntawv qhia txog cov tshuaj tsis zoo ntawm cov tshuaj ntawm tus me nyuam yog siv thaum thawj thawj lub hlis. Rau cov menyuam mos thiab cov menyuam mos uas muaj kev kis mob rau ACE inhibitors, nws raug nquahu kom ua tib zoo saib xyuas kom ncav sijhawm kom paub tseeb tias yuav txo cov ntshav siab, oliguria, hyperkalemia.

Lisinopril hla lub tsho me me. Tsis muaj ntaub ntawv qhia txog kev nkag mus ntawm lisinopril rau hauv niam mis. Rau lub sijhawm ntawm kev kho mob nrog tshuaj, nws yog ib qho tsim nyog kom thim tsis pub niam mis.

Cov lus qhia tshwj xeeb

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 cov neeg mob uas muaj lub plawv mob tsis ua hauj lwm nrog lub raum tsis ua haujlwm zoo los yog tsis muaj nws, qhov cim tseg yuav txo qis ntshav siab yog tau. Nws pom ntau nyob hauv cov neeg mob uas muaj lub plawv tsis ua hauj lwm ntev, vim kev siv cov tshuaj ntau dhau ntawm diuretics, hyponatremia, lossis ua rau lub raum tsis ua haujlwm. Hauv cov neeg mob zoo li no, kev kho mob nrog Lisinopril yuav tsum tau pib los ntawm kev saib xyuas 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 kho mob rau cov neeg mob plawv, mob ntshav hlab hlwb tsis txaus, uas kev txo cov 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.

Thaum siv Lisinopril hauv qee cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev, tab sis nrog ntshav siab lossis ntshav qis, kev txo qis hauv ntshav yuav tshwm sim, uas feem ntau tsis yog lub laj thawj rau kev kho mob.

Ua ntej pib txoj kev kho mob nrog Lisinopril, yog tias ua tau, ua kom lub cev tsis zoo ntawm sodium thiab / lossis ua rau kom ploj ntawm cov dej ntawm cov kua dej, ua tib zoo saib xyuas cov nyhuv ntawm thawj zaug ntawm Lisinopril ntawm tus neeg mob.

Thaum muaj mob rau lub raum mob hlwb (tshwj xeeb tshaj yog nrog ob tog sib tshooj, lossis nyob rau ntawm lub raum leeg mob raum), ua rau lub plawv khiav tsis zoo vim tsis muaj sodium thiab / los yog kua, kev siv Lisinopril kuj tseem tuaj yeem ua rau lub raum tsis zoo, mob raum tsis ua haujlwm, uas feem ntau Nws hloov tawm tsis ua haujlwm tom qab tsis ua tiav ntawm cov tshuaj.

Hauv cov kab mob myocardial infarction

Kev siv cov qauv kev kho mob (thrombolytics, acetylsalicylic acid, beta-blockers) yog qhia. Lisinopril tuaj yeem siv rau hauv kev txuas nrog kev tswj hwm los yog nrog kev siv tshuaj kho kab mob ntawm nitroglycerin.

Kev phais / General Ua Tshuaj loog

Nrog kev phais mob ntxiv, nrog rau kev siv lwm yam tshuaj uas ua rau txo cov ntshav siab, lisinopril, thaiv kev tsim cov tshuaj angiotensin 2, tuaj yeem ua rau tsis pom tseeb tias yuav txo cov ntshav siab.

Hauv cov neeg mob laus, cov koob tshuaj ib zaug ua rau muaj kev nkag siab ntau dua ntawm cov tshuaj hauv cov ntshav, yog li, tshwj xeeb yuav tsum tau saib xyuas thaum txiav txim qhov koob.

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 siv cov tshuaj nyob rau hauv lub raws lim ntshav nrog polyacryl-nitrile membrane, anaphylactic kev poob siab tuaj yeem tshwm sim, yog li ntawd, nws raug nquahu tias ib yam txawv ntawm daim nyias nyias rau kev lim ntshav, lossis kev teem sijhawm ntawm lwm tus neeg sawv cev antihypertensive.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tshuab

Tsis muaj cov ntaub ntawv hais txog cov nyhuv ntawm lisinopril ntawm kev muaj peev xwm tsav tsheb thiab cov tshuab siv hauv kev siv tshuaj, tab sis nws yuav tsum tau yug los rau hauv lub siab tias kiv taub hau yog ua tau, yog li ntawd ceev faj yuav tsum siv.

Yeeb tshuaj sib cuam tshuam

Lisinopril txo qis excretion ntawm poov tshuaj los ntawm lub cev thaum kho nrog diuretics.

Yuav tsum tau saib xyuas tshwj xeeb thaum siv cov tshuaj nrog:

• Potassium-sparing diuretics (spironolactone, triamteren, amiloride), poov tshuaj, poov tshuaj ntsev hloov pauv (muaj kev pheej hmoo ntawm kev txhim kho hyperkalemia, tshwj xeeb nrog kev ua haujlwm tsis zoo hauv lub raum), yog li lawv tuaj yeem tsuas muab tshuaj ua ke ntawm lub hauv paus ntawm tus kws kho mob qhov kev txiav txim siab nrog kev soj ntsuam cov kua poov tshuaj ntau ntau ntshav thiab lub raum muaj nuj nqi.

Siv nrog kev ceev faj ua ke:

• Nrog diuretics: nrog rau kev tswj hwm ntxiv ntawm diuretic rau tus neeg mob noj Lisinopril, raws li txoj cai, ib qho kev tiv thaiv kab mob ntxiv tshwm sim - ib qho kev pheej hmoo ntawm cov lus txo qis hauv cov ntshav siab,
• Nrog rau lwm cov tshuaj tiv thaiv kabmob (ntxiv cov nyhuv ntxiv),
• Nrog rau cov tshuaj tsis-steroidal anti-inflammatory (NSAIDs) (indomethacin, thiab lwm yam), estrogens, thiab kuj adrenostimulants - ib qho kev txo qis ntawm cov nyhuv tshuaj tiv thaiv lisinopril,
• Nrog lithium (lithium tso tawm qis dua, yog li ntawd, cov dej lithium concentration yuav tsum tau saib xyuas tsis tu ncua),
• Nrog antacids thiab colestyramine - txo qhov nqus nyob rau hauv cov hnyuv.

Cawv ua kom qhov zoo ntawm cov tshuaj.

Analogues ntawm cov tshuaj Lisinopril

Cov qauv ntawm cov qauv ua haujlwm:

• Dapril
• Diropress
• Diroton
• Irumed
• Lysacard
• Lysigamma
• Lisinopril Grindeks,
• Lisinopril Organics,
• Lisinopril Pfizer,
• Lisinopril Stada,
• Lisinopril OBL,
• Lisinopril Teva,
• Lisinopril dihydrate,
• Lysinotone
• Mob nqeeb,
• Lysoryl
• Lister,
• Liten,
• Kev txais
• Rileis Sanovel,
• Sinopril.

Nrog hydrochlorothiazide:

• Zoniksem ND,
• Zonixem NL,
• Iruzid,
• Co Diroton
• Lisinopril N,
• Lysinotone H,
• Lysoretic
• Lister Ntxiv,
• Liten N,
• Rileys Sanovel plus,
• Scopril ntxiv rau.

Nrog amlodipine:

Lub taub hau ntawm Lub Tsev Haujlwm Saib Xyuas Kev Mob Nkeeg Tshaj Lij Choj, Tus Neeg Xaiv Tsa ntawm Kev Tshawb Fawb Kev Kho Mob, Kws Kho Mob ntawm qib siab tshaj plaws (GCP). Tus Tswv Cuab ntawm Lavxias thiab European Society of Cardiology (RKO, ESC), Lub Koom Haum Hauv Tebchaws ntawm Cov Ntawv Pov Thawj Kho Mob Kev Pom Zoo. Nws tshwj xeeb hauv kev txheeb xyuas thiab kev kho mob ntawm cov mob hnyav ntawm kev mob ntshav siab, mob plawv, mob plawv, tsis ua haujlwm, mob plawv dhia tsis zoo, thiab ntxiv rau kev tiv thaiv cov kab mob plawv thiab lawv cov teeb meem.

Bisoprolol - cov lus qhia rau kev siv, analogues, tshuaj xyuas ...

Bisoprolol belongs rau cov pab pawg xaiv cov beta-blockers uas ua rau cov hlwb leeg ntawm cov ntshav plawv thiab cov hlab ntsha. Cov tshuaj txwv cov beta-adrenergic receptors, uas tau txais impulses los ntawm lub paj hlwb, uas ua rau lub plawv dhia qeeb. Cov ntshav siab poob qis, nws yooj yim dua rau lub plawv los tso ntshav.

Kev tshuaj ntsuam xyuas kev sib cuam tshuam ntawm yeeb tshuaj uas koj xaiv rau ...

Bisoprolol yog ib qho tshuaj zoo rau kev kho mob ntawm lub plawv: txoj hlab ntshav siab, angina pectoris thiab lwm tus. Qhov sib xyaw tshwj xeeb no muaj cov nyhuv antihypertensive zoo heev, yog li nws sai txo cov ntshav siab.

Bisoprolol diuretic los yog tsis: cim, siv

Angiotensin hloov mus rau enzyme inhibitors (ACE inhibitors) Angiotensin receptor antagonists (blockers lossis ARA lossis ARB) Direct renin inhibitors (PIR) Beta blockers (BB) Calcium antagonists (AK) nyob rau hauv ob qho - pulsating (AKP) thiab dihydropyridine (ACP) thiab dihydropyridine central action Diuretics Kev siv tshuaj sib xyaw ua ke zoo?

Bisoprolol: cov lus qhia rau kev siv, thaum twg lub siab

1 Cov lus piav qhia 1.1 Cov lus sib xyaw thiab daim ntawv tso tawm 1.2 Tshuaj Tso Cai Ua Si 1.3 Kev Qhia thiab contraindications rau siv2 Cov lus qhia rau kev siv 2.1 Cov lus pom zoo ntawm cov kws kho mob 2.2 Cov kev phiv uas yuav ua tau 2.3 Noj 3 Kev cuam tshuam nrog lwm cov tshuaj thiab tshuaj 4 Lisinopril hauv chaw muag tshuaj 5 Qhov Kawg Noj Lisinopril siab pom zoo cov kws tshaj lij. Ua ke nrog cov tshuaj tiv thaiv analogues, cov tshuaj no muab qhov txo qis hauv cov ntshav hauv cov hlab ntshav, nrog rau txo qis lawv qhov kev tawm tsam.

Cov tshuaj sib xyaw rau kev kub siab. Txog ntawm kev kho mob ...

1 Qhov cuam tshuam tseem ceeb2 Pharmacokinetics3 Kev Qhia thiab txoj kev siv4 Cov Lus Qhia rau siv 5 Qhov tsis xav ua 6 Kev sib cuam tshuam nrog tshuaj ntawm lwm pab pawg 7 Daim ntawv tso tawm thiab cov qauv sib txig Hauv kev kho plawv, xws li B-blocker li bisoprolol yog siv dav. Cov lus qhia rau kev siv yuav pab kom nkag siab qhov tshuaj ua haujlwm zoo li cas, thaum nws siv tau, yuav ua li cas ua kom raug, qhov kev mob tshwm sim tuaj yeem xav qhov twg. Tab sis txawm li cas los xij koj yuav tsum noj cov tshuaj no yam tsis muaj kws kho mob pom zoo, txwv tsis pub koj tuaj yeem tsim kev puas tsuaj rau koj tus kheej kev noj qab haus huv.

Bisoprolol (Concor) | Tshuaj | Tswv yim | Bisoprolol ...

Thiv hauv. Cov cheebtsam tsis muaj cov pab pawg ua haujlwm uas yuav ua rau muaj qhov tsis xws lossis nag lossis daus. Tsis ntxim rau kev nqus. Cov tshuaj tsis hloov pH ntawm lub plab kua txiv, microflora li qub, lub plab zom mov, kev ua haujlwm glycoprotein P (ATP-muaj cov cab kuj muaj protein ntau) thiab ua rau lub plab hnyuv puas.

Lisinopril: cov lus qhia rau kev siv, thaum twg siab, xyuas, analogues

Qhov tseeb ntshav siab (BP) tau ib txwm yog ib tus thawj coj ntawm cov kab mob uas muaj hnub nyoog nce. Txog li 50% ntawm cov pej xeem muaj kev tiv thaiv kab mob ntshav liab (AH), thiab hauv cov pab pawg neeg laus qhov ntsuas no yog 80% lossis ntau dua. Kev kho ntshav siab yog nqa nrog ntau yam tshuaj. Ib qho ntawm kev siv feem ntau yog dipeptidyl carboxypeptidase inhibitors, uas tseem hu ua angiotensin hloov enzyme (ACE). Ntawm ACE inhibitors, qhov chaw tshwj xeeb yog coj los ntawm cov tshuaj Lisinopril.

Bisoprolol: kev tshuaj xyuas ntawm cov kws kho mob thiab cov tshuaj ntawm cov tshuaj :: SYL.ru

Cov tshuaj uas pheej yig, siv rau hauv cov tshuaj niaj hnub, hu ua "Bisoprolol". Cov tshuaj no zoo li cas los ntawm? Qhov lus teb tau zoo tshaj plaws rau lo lus nug no yog muab los ntawm cov lus qhia rau kev siv tshuaj, uas yog qhov tsim nyog nyob hauv pob. Txawm li cas los xij, yog tias muaj lub siab xav nrog cov ntaub ntawv no yam tsis tau txais tshuaj, ces cov khoom siv no yog nyob ntawm koj qhov kev pabcuam.

Kev kho ntshav siab, tshuaj, tshuaj xyuas, plawv plawv

Cov kab mob ntawm cov hlab plawv yog pom hauv txhua tus neeg niaj hnub. Lawv tau nrog los ntawm kev dhia mus ntxiv hauv kev ntsuas ntshav. Yog li, txhua tus neeg uas muaj tus mob no tab tom nrhiav txoj hauv kev zoo los ua kom lub siab ceev. Txij li cov mob no cuam tshuam nrog lub neej zoo. Ib qho ntawm cov tshuaj zoo tshaj plaws yog Bisoprolol, cov lus qhia rau kev siv yuav tsum tau kawm kom paub meej, thiab tseem xav txog thaum lub siab siv nws.

Kuv yuav tau noj Bisoprolol ntev npaum li cas yam tsis muaj kev so thiab li cas ...

Feem ntau cov neeg mob ntshav siab, txhawm rau txo cov ntshav siab rau cov lej nyab xeeb, koj yuav tsum noj 2-3 hom tshuaj tib lub sijhawm. Ib qho tshuaj ib leeg zoo txo ​​qis ntshav siab tsis pub dhau 20-30% ntawm cov neeg mob ntshav siab. Qhov seem 70-80% ntawm cov neeg mob xav tau kev kho mob sib xyaw, uas yog, ntau yam tshuaj siv tib lub sijhawm. Cov tshuaj sib xyaw rau cov ntshav siab - cov uas muaj 2-3 cov tshuaj nyob hauv ib ntsiav tshuaj. Peb yuav tham nrog lawv hauv qab no.

Bisoprolol: kev tshuaj xyuas ntawm cov kws kho mob thiab cov tshuaj ntawm cov tshuaj :: SYL.ru

Cov ntsiab lus rau siv Kab mob Tiv Thaiv Yuav siv li cas bisoprolol yog Siv Ntau Tshaj Phiv Phom Sij bisoprolol Cov poj niam cev xeeb tub tuaj yeem siv bisoprolol Qhov sib xyaw ntawm bisoprolol thiab cawv Yuav ua li cas hloov bisoprolol

Kev ua tau zoo ntawm bisoprolol thiab lisinopril hauv kev kho mob ntawm ...

Bisoprolol yog ib qho txiaj ntsig zoo tshaj plaws-beta-blockers. Qhov zoo ntawm kev siv bisoprolol rau kev mob ntshav ntawm lub plawv, nws txoj kev siv ntau hom kev mob plawv thiab xaiv cov tshuaj muaj txiaj ntsig zoo yog xam.

Hauv kev soj ntsuam mob tiag tiag, beta-blockers (BAB) yog ib qho tshuaj uas feem ntau siv hauv kev kho mob plawv (CVD). Cov teeb meem xaiv BAB tseem muaj feem xyuam.

Tsev »Kev Kho Mob» ACE inhibitors »Cov lus qhia ntxaws ntxiv rau kev siv Lisinopril ntsiav tshuaj: ntawm kev siv siab li cas, xyuas cov neeg mob

Qhov tseeb ntshav siab (BP) tau ib txwm yog ib tus thawj coj ntawm cov kab mob uas muaj hnub nyoog nce. Txog li 50% ntawm cov pej xeem muaj kev tiv thaiv kab mob ntshav liab (AH), thiab hauv cov pab pawg neeg laus qhov ntsuas no yog 80% lossis ntau dua.

Kev kho ntshav siab yog nqa nrog ntau yam tshuaj. Ib qho ntawm kev siv feem ntau yog dipeptidyl carboxypeptidase inhibitors, uas tseem hu ua angiotensin hloov enzyme (ACE). Ntawm ACE inhibitors, qhov chaw tshwj xeeb yog coj los ntawm cov tshuaj Lisinopril.

Cov lus qhia rau kev siv cov tshuaj no yog lub luag haujlwm ntawm cov ntawv no. Txog rau qhov no, cov lus nug yuav tau kawm txog yuav ua li cas noj Lisinopril los ntawm qhov siab, lub sijhawm twg hnub zoo dua rau kev ua, ntxiv rau contraindications, phiv thiab lwm yam.

Lisinopril (hauv Latin - Lisinoprilum) muaj nyob hauv ntsiav tshuaj daim ntawv, uas tej zaum yuav muaj li ntawm 2.5 txog 40 mg ntawm tib yam tshuaj muaj yees (ib yam tshuaj). Yog li, piv txwv li, 10 mg Lisinopril ntsiav tshuaj muaj 10.89 mg ntawm lisinopril dihydrate, uas, raws li sau tseg hauv cov lus qhia rau kev siv, nws yog sib npaug rau 10 mg ntawm lisinopril.

Cov tshuaj muaj pes tsawg leeg, ntxiv rau cov tshuaj nquag - ACE inhibitor, yog sawv cev los ntawm cov khoom siv pabcuam uas tsis muaj cov tshuaj ua kom zoo: ntau yam ntsev, hmoov txhuv nplej siab, dyes, thiab lwm yam.

HYPERTENSION - NCO HAUV LUB MAS!

Ib qho mob plawv nrog mob stroke yog qhov ua rau yuav luag 70% ntawm tag nrho cov neeg tuag hauv ntiaj teb. Xya tawm ntawm kaum tus neeg tuag vim kev txhaws ntawm cov hlab ntsha ntawm lub plawv lossis paj hlwb. Yuav luag txhua qhov teeb meem, qhov laj thawj rau qhov txaus ntshai kawg no yog qhov qub - lub siab surges vim kub siab ...

HYPERTENSION - NCO HAUV LUB MAS!

Ib qho mob plawv nrog mob stroke yog qhov ua rau yuav luag 70% ntawm tag nrho cov neeg tuag hauv ntiaj teb. Xya tawm ntawm kaum tus neeg tuag vim kev txhaws ntawm cov hlab ntsha ntawm lub plawv lossis paj hlwb. Yuav luag txhua qhov teeb meem, qhov laj thawj rau qhov txaus ntshai kawg yog qhov zoo ib yam - lub siab surges vim kub siab. Tus "neeg tua neeg ntsiag to," raws li kws kho plawv hu nws, txhua xyoo siv ntau lab ntawm lub neej.

Mechanism ntawm kev ua

Cov nyhuv pharmacological ntawm cov tshuaj tau piav qhia los ntawm cov nyhuv inhibitory ntawm lisinopril hauv kev sib raug zoo nrog kev ua si ntawm dipeptidyl carboxypeptidase. Qhov no enzyme catalyzes hloov kev nyob rau hauv ob kab:

Hauv cov txheej txheem renin-angiotensin, dipeptidyl carboxypeptidase txhawb kev hloov pauv ntawm angiotensin los ntawm thawj daim ntawv mus rau qhov thib ob, uas ua rau vascular phab ntsa kom nrov, thiaj li ua rau ntshav nce siab. Hauv cov txheej txheem kallikrein-kinin, qhov enzyme no txhawb lub cleavage ntawm bradykinin, peptide uas muaj cov nyhuv vasodilating.

Cov lus qhia rau kev siv sau tseg tias cov tshuaj Lisinopril, cov tshuaj nquag muaj uas yog lisinopril dihydrate, inhibits cov txheej txheem hauv ob lub kab ke, uas yog:

• tiv thaiv kev hloov pauv ntawm angiotensin,
• txo tus nqi ntawm cleavage ntawm bradykinin.

Vim qhov no, muaj kev cuam tshuam vasodilating, ua kom ntshav siab, tau tiav.

Tsis tas li ntawd, cov tshuaj nquag muaj feem cuam tshuam rau cov metabolism hauv lwm cov kev lom tsiaj txhu hauv lub cev. Nws yog nrog qhov no tias ntau cov kev mob tshwm sim ntawm cov tshuaj Lisinopril cuam tshuam, lub ntsiab ntawm yog hnoos.

Cov txheej txheem ntawm kev ua tau piav qhia hauv kab lus yav dhau los muab kev nkag siab ntawm cov cim qhia rau kev siv tshuaj Lisinopril. Dab tsi cov ntsiav tshuaj no los ntawm kev txiav txim siab los ntawm kev muaj peev xwm ntawm cov tshuaj nquag los thaiv kev hloov ntawm angiotensin thiab bradykinin, uas ua rau muaj ntshav nce siab.

Tsis tas li ntawd, Lisinopril, raws li qhia hauv cov lus qhia rau kev siv, muaj cov teebmeem li nram no:

• txo qis laug ventricular hypertrophy,
• txhim kho kev ua haujlwm hauv lub siab,
• nce raum ntshav txaus,
• txhim kho lub raum kev ua haujlwm,
• muaj cov nyhuv nephroprotective.

Vim tias cov txiaj ntsig tsis yooj yim, kev taw qhia rau kev siv Lisinopril ntsiav tshuaj, raws li cov lus qhia rau kev siv, suav nrog tsis tsuas yog mob ntshav siab, tab sis kuj mob plawv tsis ua hauj lwm (ua ib feem ntawm cov kev ntsuas hnyav), myocardial infarction, lub plawv tsis ua haujlwm lub plawv muaj ntshav qab zib mellitus.

Cov tib neeg kev txom nyem los ntawm ntshav siab yuav tsum paub tias kev kho mob ntshav siab koom nrog kev siv cov tshuaj uas tsim nyog, tsis hais txog qib ntshav siab tam sim no. Qhov no yog pov thawj ncaj qha los ntawm cov lus qhia rau kev siv nrog Lisinopril: lub siab ntawm kev siv tshuaj uas tsis yog tsis tau sau tseg rau hauv nqe lus.

Ntxiv mus, qhov tshwm sim ntawm kev tshawb fawb soj ntsuam, nws tau pom tias kev siv tshuaj kho mob, tshwj xeeb tshaj yog regression ntawm sab laug ventricular hypertrophy, manifests nws tus kheej tsuas yog thaum lub sijhawm siv ntev.

Lisinopril, yog ib yam khoom uas nquag, yog ib feem ntawm kaum ob ntawm mono thiab cov tshuaj siv tshuaj. Coob tus ntawm lawv hu ua Lisinopril. Cov chaw tsim khoom yog ob qho tib si cov teb chaws thiab thoob ntiaj teb kev lag luam kws tshuaj.

Cov tshuaj Lisinopril los ntawm Lavxias lub tuam txhab Organika yog qhov kev xaiv nyiaj rau cov tshuaj niaj hnub no. Vim li no, feem ntau nws xaiv los ntawm cov neeg mob uas tsis tuaj yeem them taus cov khoom sib txawv ntawm cov tshuaj tua kab mob lisinopril. Cov tshuaj no tau txais cov tshuaj xyuas zoo.

Cov tshuaj Lisinopril yog tsim tawm los ntawm Lavxias Nizhny Novgorod kev lag luam tuav, nrog rau cov tuam txhab tsis yog Lavxias uas yog cov tswv cuab ntawm qhov kev txhawj xeeb thoob ntiaj teb Stada AG. Ntau tus neeg mob xaiv cov tshuaj los ntawm cov tsim khoom no, txawm hais tias nws yog 2 zaug kim dua Organics.

Ntawm ntau pua cov tshuaj tsim los ntawm cov kws muaj npe nrov German tuav, tseem muaj Lisinopril. Nws siv yog zoo ib yam li txhua lwm yam tshuaj nrog cov tshuaj yeeb dej caw no. Qhov txawv yuav yog qhov tseem ceeb rau qee cov neeg mob: Ratiopharm, thiab qhov no tau qhia hauv cov lus qhia rau kev siv, ua rau cov tshuaj lactose-tsis pub.

Lub Ukrainian tshuaj Hoobkas Astrapharm muaj ib qho ntawm feem ntau cov kev xaiv nyiaj txiag yeeb tshuaj Lisinopril. Kev tshuaj xyuas tus neeg mob txog nws feem ntau yog qhov zoo, uas yog txiav txim los ntawm tus nqi ntsuas, nrog rau qhov uas tsis muaj lactose hauv tshuaj muaj pes tsawg leeg.

Los ntawm kev txhawj xeeb thoob ntiaj teb Teva, Lisinopril mus rau Sab Hnub Tuaj Tebchaws Europe ua lag luam yog tsim los ntawm lub chaw muag tshuaj Hungarian. Yog li, cov tshuaj no, raws li kev kho mob txawv teb, nws kim dua tus uas tau hais los saud.

Qhov no tsis yog tag nrho cov kev hloov pauv ntawm cov tshuaj nyob hauv tib lub npe: lawv yuav raug ntaus tsawg kawg yog ob kaum ob.

Raws li txoj cai, thaum xaiv Lisinopril, qhov tshwj xeeb uas lub chaw tsim khoom zoo dua, cov neeg siv khoom ntseeg ntau dua ntawm tus nqi ntsuas. Txawm li cas los xij, cov neeg mob yuav tsum nco ntsoov tias cov tshuaj ntxiv uas kim dua tuaj yeem tiv taus zoo dua thiab muaj qhov tshwm sim tsawg dua (qhov no tsis siv rau kev hnoos).

Qib mob ntshav siab

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Kev siab siab thiab ntshav siab tshwm sim los ntawm nws - nyob rau hauv 89% ntawm cov neeg mob, lawv tua tus neeg mob lub plawv lossis mob stroke! Yuav ua li cas tiv nrog lub siab thiab txuag koj lub neej - kev sib tham nrog lub taub hau ntawm lub koom haum ntawm Cardiology ntawm Red Cross ntawm Russia ...

Pharmacological kev txiav txim

Lisinopril, cov lus qhia rau kev siv ua pov thawj qhov no, ua rau lub suab ntawm cov hlab ntsha txuas ntxiv mus thiab txhawb kev ua qog adrenal tso cai 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).

Cov tshuaj muaj nqi

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

Zoo li txhua yam tshuaj, Lisinopril yuav tsum tsuas yog siv tom qab tus kws kho mob tau sau nws. Raws li tau piav qhia saum toj no, cov tshuaj nquag muaj cov nyom ua rau lub cev hloov pauv, kho kho qhov concentration ntawm cov roj ntsha enzymes. Txawm hais tias qhov tseeb hais tias kev piav qhia ntawm lisinopril tau muab rau hauv cov lus qhia rau kev siv yog ua tiav, cov lus qhia tshwj xeeb yog qhov tsim nyog ua ntej pib siv.

Txhua tus neeg uas tau nyeem cov lus qhia rau kev siv, yuav pom cov ntaub ntawv qhia txog kev siv tshuaj los ntawm cov tshuaj Lisinopril. Peb twb tau sib tham txog lo lus nug ntawm dab tsi siab kuv yuav tsum noj ib ntsiav tshuaj. Ib zaug ntxiv, peb nco ntsoov tias qhov no yuav tsum tau ua txhua hnub, tsis hais txog qhov ntsuas tam sim no ntawm lub tshuab ntsuas kub.

Nws tsis muaj dab tsi nyuaj rau kev noj Lisinopril. Qhov no yuav tsum tau ua ib hnub ib zaug, nqos tag nrho cov ntsiav tshuaj thiab haus nrog qhov tsim nyog ntawm cov dej. Zoo li ntau lwm cov ntsiav tshuaj, koj yuav tsum haus Lisinopril tib lub sijhawm: qhov no yuav ua rau koj tau txais txiaj ntsig ntau tshaj plaws los ntawm cov tshuaj.

Lwm lo lus nug uas cov neeg mob ntshav siab feem ntau nug thaum pib kho mob nrog Lisinopril yog ntev npaum li cas Kuv tuaj yeem noj cov tshuaj no. Nrog kev thev taus zoo, Kev kho AH tuaj yeem siv sijhawm ntev: kom txog thaum nws muaj cov nyhuv xav tau. Qee lub sijhawm siv sijhawm, piv txwv li, tom qab myocardial infarction, lub sijhawm tswj xyuas tau txiav txim siab ib tus zuj zus.

Cov lus qhia rau kev siv tsis muaj qhov tseem ceeb piav qhia meej txog yuav ua li cas noj Lisinopril kom raug - thaum sawv ntxov lossis yav tsaus ntuj. Txawm li cas los xij, txoj kev kho mob pom tias kev nkag thaum sawv ntxov yog qhov zoo dua.

Cov ntsiav tshuaj tau nqus rau hauv lub plab zom mov, thiab ua raws li cov lus qhia rau kev siv, cov ntsiab lus ntawm cov zom zaub mov tsis cuam tshuam rau qhov nqus ntawm cov lisinopril. Yuav noj nws li cas - ua ntej lossis tom qab noj mov - nrog kev kho tas li tsis muaj teeb meem.

Lisinopril tsis yog ib txoj “ceev” ACE inhibitor.Nws cov txiaj ntsig, raws li tau sau tseg hauv cov lus qhia rau kev siv, txhim kho maj mam los ntawm qhov kawg ntawm thawj teev tom qab kev tswj hwm, tom qab ntawd maj mam nce rau 6 teev thiab kav mus rau lwm 15-17 teev.

Vim li no, nws tsis muaj teeb meem rau cov neeg mob ntev npaum li cas cov tshuaj yuav pab tau. Lisinopril tsis yog kev pab thaum muaj xwm ceev thiab yuav tsum tsis txhob siv los ua ntsiav tshuaj kom txo qis ntshav siab sai sai.

Cov txheej txheem kev kho mob, ib yam li lwm ACE inhibitors, koom nrog kev pib kho nrog qhov tsawg kawg, uas tuaj yeem ntxiv tom qab yog tias tsim nyog. Hauv cov khw muag tshuaj, koj tuaj yeem nrhiav cov tshuaj Lisinopril nrog cov tshuaj muaj txiaj ntsig ntawm 2.5 txog 40 mg, uas yooj yim rau kev kho mob ntawm txhua qhov kev mob siab.

Ua raws li qhov mob hnyav ntawm cov ntshav siab thiab cov tshuaj uas tau txais, kev pib ntawm lisinopril, raws li cov lus qhia rau kev siv, yog 2.5 lossis 5 mg. Yog tias kev kho mob ntawm koob tshuaj 2.5 mg pom tias nws cov hauj lwm zoo, ces kev noj cov tshuaj yuav tsum tsis txhob nce ntxiv.

Lub sijhawm tiv thaiv ntawm qhov kev kho kom zoo yog nyob ntawm qhov ntau npaum li cas.

Cov lus qhia rau kev siv nrog lisinopril 5 mg qhia meej tias feem ntau, qhov kev siv tshuaj no yog tus qauv thiab txaus rau kev kho mob los ntawm kev mob siab me thiab mob nyhav. Yog tias qhov ua kom tshwm sim tsis tshwm sim, qhov ntau npaum li cas ntawm cov tshuaj tau tuaj yeem nce ntxiv 5 mg txhua 3 hnub. Nrog rau qhov nce ntxiv hauv cov koob tshuaj yuav tsum tau coj, cov yam ntxwv hauv qab ntawm cov nyhuv los tiv thaiv kev lisinopril yuav tsum tau yug los hauv lub siab:

• qhov kev poob qis hauv siab tau ceeb toom nyob hauv thawj hnub ntawm kev tuaj kawm,
• cov nyhuv antihypertensive nce thiab nce mus txog qhov siab kawg nkaus tsis pub dhau 1-2 lub hlis ntawm kev kho mob.

Nce qhov ntau ntawm cov tshuaj raws li cov lus qhia rau kev siv yog muaj txog 20 mg rau ib hnub (feem ntau) lossis txog 40 mg ib hnub (ntau kawg). Ib qho kev nce ntxiv hauv cov tshuaj (ntau dua 40 mg) tsis txhim kho cov nyhuv kho.

Lisinopril kuj tseem raug suav tias yog ib feem ntawm cov tshuaj hauv kev kho mob lub plawv tsis ua haujlwm, nyob rau tom qab lub sijhawm dhau los, nrog cov ntshav qab zib mob nephropathy. Qhov ntau npaum cov hauv cov kis no tau teeb tsa ua ib tus zuj zus, tab sis raws li cov ntsiab lus dav dav, algorithm rau nws txoj kev teem caij sib haum rau cov txheej txheem saum toj no.

Ua raws li cov tshuaj noj yog qhov tsim nyog rau kev kho mob nrog cov tshuaj Lisinopril. Kev siv ntau tshaj yog ua tau: hauv cov lus qhia rau kev siv, nws raug sau tseg tias, feem ntau, nws tau hais tawm hauv kev txo qis hauv cov ntshav siab thiab cov tsos mob ntawm cov tsos mob cuam tshuam nrog tus mob no:

• tsaug zog
• apathy
• kiv taub hau
• orthostatic hypotension,
• xeev siab

Kev txo tawm hauv cov ntshav siab ntev dua yog qhov ua tau nrog me ntsis ntawm cov tshuaj tsis tu ncua. Yog li, cov neeg mob yuav tsum ceev faj, kawm cov lus qhia rau kev siv thiab ib txwm ua raws li kev coj noj coj ua los ntawm kws kho mob.

Saum toj no, peb tau sau tseg tias cov tshuaj nquag ntawm cov tshuaj cuam tshuam rau ntau yam tshuaj lom hauv lub cev. Qee qhov cuam tshuam tseem tsis tau muaj kev kawm txaus, tab sis nws yog lawv uas ua rau muaj kev cuam tshuam, uas feem ntau hu ua cov kev mob tshwm sim.

Ntawm lawv, hauv cov lus qhia rau kev siv, ua ntej txhua yam, hnoos qhuav yog sau tseg, uas raws li cov ntaub ntawv muaj nrog txhua tus neeg mob thib kaum noj Lisinopril. Cov kev mob tshwm sim, ntxiv rau, feem ntau tuaj yeem tshwm sim hauv daim ntawv ntawm:

• mob taub hau
• kiv taub hau
• ntev li ntawm txo nyob rau hauv cov ntshav siab,
• apathy, tsaug zog thiab nkees,
• xeev siab thiab raws plab.

Cov lus qhia rau kev siv muaj ib daim ntawv teev dav heev ntawm cov kev mob tshwm sim. Txawm li cas los xij, txhua tus ntawm lawv yog nrog pov tseg "tsis tshua muaj".

Raws li kev mob tshwm sim, contraindications rau lisinopril yog tus qauv rau txhua ACE inhibitors:

• tsis mob siab rau lisinopril lossis lwm yam tshuaj ntawm pawg ACE, nrog rau cov khoom ntu hauv cov lus muaj pes tsawg leeg,
• cev xeeb tub, lactation,
• hnub nyoog txog 18 xyoo
• predisposition rau kev tsis haum edema.

Kev siv cov tshuaj muaj cov npe zoo kawg nkaus ntawm kev txwv uas yuav tsum tau ceev faj hauv kev kho qee pab pawg ntawm cov neeg mob.Ntau cov ntaub ntawv ntawm cov ntaub ntawv no tuaj yeem pom nyob rau hauv cov lus qhia raug cai rau kev siv.

Cov lus qhia rau kev siv tsis muaj cov lus qhia txog seb cov ntsiav tshuaj daws lub siab ntawm lisinopril ntawm kev ua haujlwm erectile. Hauv cov kev tshawb fawb ua rau ntawm cov ncauj lus no, qhov nce ntawm cov ntshav ntawm testosterone dawb thiab dehydroepiandrosterone sulfate tau sau tseg thaum kho nrog ACE inhibitors. Qhov no tso cai rau koj los teb cov lus nug seb puas yog Lisinopril cuam tshuam potency, tsis zoo.

Txawm li cas los xij, cov neeg mob ntshav siab yuav tsum nkag siab tias kev mob ntshav siab thiab kev ua haujlwm hauv lub cev ua haujlwm kuj muaj cov kab mob tseem ceeb, uas yog kev ua txhaum vascular, nrog rau cov neeg ua lub luag haujlwm tsim kev txhim kho erection. Cov txiv neej ntsib teeb meem nrog potency ntawm cov keeb kwm yav dhau los ntawm kev kub siab yuav tsum tau txais kev kho mob antihypertensive nrog ACE inhibitors (thaum tsis muaj contraindications).

Raws li tau pom meej los ntawm cov lus qhia rau kev siv, Lisinopril ua rau txo qis vascular thiab lub cev tsis ua haujlwm ntawm cov ntshav siab, uas cov tshuaj no tau sau tseg. Cawv kuj tseem muaj cov vasodilating effect, uas, thaum noj ib txhij nrog tus neeg sawv cev hypotensive, ua rau muaj kev pheej hmoo ntawm cov kev mob tshwm sim tom qab: kev txo ntshav siab ntau, mob taub hau, qaug zog thiab lwm yam.

Cov kws kho mob tsis pom zoo kom noj cov tshuaj lisinopril thiab dej cawv tib lub sijhawm. Lawv kev sib raug zoo yog qhov tseeb heev, tshwj xeeb, ntau tus neeg mob ntshav siab nco ntsoov tias kev sib txuam no tsis coj yam tshwm sim thiab tsis ua rau tus mob. Txawm li cas los xij, cov neeg nyeem yuav tsum nkag siab tias haus dej cawv, ua tus kab mob cardio- thiab vasotoxic tus neeg sawv cev, lom zem ntau tshem tawm cov kev kho mob uas tau txais thiab cuam tshuam cov kev mob mus ntev rau tus neeg mob nrog kub siab.

Txog kev kho mob ntshav siab, ACE inhibitors feem ntau yog tshuaj ua ib qho ntawm cov tshuaj muaj txiaj ntsig zoo, suav nrog tshuaj Lisinopril. Kev tshuaj xyuas ntawm cov neeg mob noj cov tshuaj, vim li no, muaj ntau heev. Feem coob ntawm lawv yog cov zoo.

Cov tib neeg nco qab cov yam ntxwv tseem ceeb ntawm cov tshuaj no:

• "Tuav siab zoo"
• yuav tsum tau noj ib hnub ib zaug,
• pheej yig.

Qee qhov xwm txheej, cov neeg mob tau sau tseg txog qhov ntshav nce qis, qhov tshwm sim tsis muaj zog, lub xeev tsis pom zoo - cov cim ntawm kev noj tshuaj ntau dhau, qhia tias koob tshuaj tsis raug xaiv.

Muaj cov kev tshuaj xyuas uas tus neeg muag cov tshuaj cuav raws lub npe Lisinopril hauv cov chaw muag tshuaj tau sau cia. Cov neeg tau txais kev pab yuav tsum ua tib zoo saib thiab yuav cov tshuaj hauv pob ntawv uas paub, los ntawm cov khw muag khoom muaj txiaj ntsig thiab ntawm tus nqi ib txwm muaj.

Xyuas cov kws kho plawv txog cov tshuaj

Cov lus qhia rau kev siv ceeb toom xws li tus cwj pwm tseem ceeb ntawm cov tshuaj Lisinopril, li tsis yog biotransformability hauv lub cev. Kev tshuaj xyuas cov kws kho plawv kuj tsom mus rau qhov tseeb tias cov tshuaj ua kom nquag plias tsis tau tshawb nrhiav hauv lub siab, tab sis raug hloov pauv tsis hloov. Qhov no txawv cov lisinopril los ntawm lwm cov dipeptidyl carboxypeptidase inhibiting tshuaj.

Ntawm qhov tod tes, qhov no yuav tsum tau ua tib zoo saib xyuas lub raum, hauv cov qib creatinine tshwj xeeb, raws li sau tseg hauv cov lus qhia rau kev siv. Nrog ib qho kev txo qis ntawm glomerular pom kev sib kis, qib ntawm lisinopril hauv cov ntshav nce siab, uas ua rau muaj kev pheej hmoo ntawm cov tsos mob overdose.

Feem ntau, cov kws kho plawv tau teb zoo rau Lisinopril, nws tus cwj pwm yog qhov zoo rau txo cov ntshav siab, uas muaj cov nyhuv ntev ntev. Nws yog cov tshuaj ntawm kev xaiv rau cov neeg mob uas lub siab tsis ua haujlwm, mob siab rau daim siab, mob ntsws.

Yog tias peb tham txog xws li kev sib xyaw li Lisinopril thiab cawv, tom qab ntawd cov kev xav ntawm kws kho plawv ntawm qhov teeb meem no sib txawv hauv qib sib txawv ntawm kev sib txawv. Rau cov neeg uas quav cawv lossis haus dej haus ntau, qhov tsis lees txais nws tuaj yeem pab txhawb kev txhim kho vascular kev puas tsuaj nrog lub txiaj ntsig tuag tau.Nws raug nquahu rau cov neeg uas haus cawv ib zaug ("rau hnub so") kom tsis txhob noj nws kiag li, vim tias qhov kev pheej hmoo ntawm cov kev mob tshwm sim thaum kho nrog Lisinopril muaj ntau tshaj li lwm qhov txaus ntshai.

Latin Qhia

Niaj hnub no, ntau thiab ntau tus kws kho mob, txawm tias muaj peev xwm tshaj lij, sau cov tshuaj tsis yog Latin. Tau txais tshuaj rau qhov yuav tshuaj hauv koj hom lus, tsis txhob poob siab. Rau cov neeg uas nyob ntawm cov neeg muaj hmoo uas tau txais tshuaj rau Lisinopril hauv Latin, ntawm no yog nws daim ntawv dav dav:

Rp.: Tabulettae Lisinoprili (qhia kev noj tshuaj, piv txwv, 5 mg lossis 0.005 g).

S. 1 ntsiav tshuaj sab hauv 1 r / d.

Kev kho mob ntshav siab, mob plawv tsis ua haujlwm, tom qab tus mob tsis sib haum hauv ntau tus neeg mob yog siv ntau cov tshuaj los ntawm ntau pawg pharmacological. Qhov no muaj tseeb rau Lisinopril.

Qhov sib xyaw ua ke ntawm cov tshuaj muaj zog yog ib qho zoo tshaj plaws hauv kev kho mob ntawm ntau cov kab mob plawv, nrog rau kev kub siab thiab cov txheej txheem loj atherosclerotic.

Kev sib xyaw ntawm amlodipine, lisinopril thiab rosuvastatin, thaum tsis muaj contraindications rau txhua ntawm lawv, tuaj yeem kho rau:

• AH
• mob vwm mob hlwb
• lub plawv tsis ua hauj lwm
• atrial fibrillation.

Kev npaj ua ke tag nrho muaj peb ntu yog tsim los ntawm lub tuam txhab Hungarian Hungarian Gideon Richter nyob hauv kev lag luam npe Ekwamer.

Kev sib xyaw ntawm tshuaj ACE inhibitor thiab tshuaj diuretic yog qhov ntau tshaj plaws hauv kev kho mob ntshav siab. Lisinopril thiab hydrochlorothiazide tuaj yeem ua tiav zoo dua tswj kev ua haujlwm siab thaum qhov kev xav ua tsis tiav los ntawm kev noj ib hom tshuaj no. Hauv cov khw muag tshuaj, koj tuaj yeem pom ntau cov tshuaj muaj ob yam tshuaj (ntawm kev noj tshuaj 10 lossis 20 mg ntawm lisinopril thiab 12.5 mg ntawm hydrochlorothiazide):

• Iruzid,
• Co Diroton
• Lysinotone H,
• Lysoretic
• Rileys-Sanovel ntxiv rau.

Cov kws kho mob tsis tau sau ntawv lisinopril nrog indapamide, hloov rau tom kawg nrog hydrochlorothiazide. Tsis muaj kev sib txuas ua ke nrog cov muaj pes tsawg leeg. Yog li ntawd, yog tias koj txaus siab rau lo lus nug ntawm seb Indapamide thiab Lisinopril tuaj yeem nqa tib lub sijhawm, tom qab ntawd koj yuav tsum caiv qhov kev sib txuam no. Indapamide, raws li txoj cai, yog ua ke nrog cov lus sib piv ntawm Lisinopril - Enalapril.

Cov chaw muag tshuaj rau pawg uas Lisinopril belongs (cov tshuaj tiv thaiv dipeptidyl carboxypeptidase) yog sawv cev los ntawm ntau cov tshuaj yeeb tshuaj. Tsis tas li ntawd, muaj cov tshuaj los ntawm lwm pab pawg:

• angiotensin receptor blockers (ARBs),
• qeeb calcium channel blockers (BMKK),
• beta-blockers (BAB), -

- tag nrho lawv muaj cov nyhuv antihypertensive thiab, hauv qee qhov xwm txheej, tuaj yeem ua raws li cov tshuaj analogue thiab hloov chaw ntawm cov tshuaj Lisinopril.

Enalapril-based tshuaj muaj txiaj ntsig ib txwm siv rau kev kho mob ntshav siab thiab lwm yam kab mob plawv.

Lawv tsis muaj qhov zoo tshaj lisinopril. Raws li txoj cai, lawv xav tau lub sijhawm teem 2 zaug nyob rau ib hnub.

Cov tshuaj Berlipril yog ua raws li cov enalapril saum toj no. Yog tias peb tham txog qhov twg zoo dua, ces Lisinopril rau ntau tus neeg mob yog qhov kev xaiv zoo dua.

Xaiv Lisinopril lossis Prestarium, nws yog qhov zoo dua rau kev kub siab, nws yuav tsum raug sau tseg tias perindopril, uas yog ib feem ntawm Prestarium, yog cov metabolized hauv lub siab, uas yuav yog qhov tseem ceeb rau cov neeg mob plawv thiab mob siab. Tsis tas li ntawd, perindopril ua rau pom nws cov nyhuv ntau dua sai dua (tom qab 3 teev), tab sis nws yuav tsum haus cawv kom nruj ua ntej noj mov, vim tias muaj cov zaub mov txo nws txoj kev nqus.

Txhais ntawm cov tshuaj Lisinopril muaj ntau. Ib qho uas kim tshaj plaws yog cov tshuaj tsim los ntawm Hungarian Gideon Richter, Diroton. Nws suav hais tias yog ib qho zoo dua qub, uas yog xav txog hauv kev txheeb xyuas ntawm cov ncauj lus, uas yog qhov zoo dua - Lisinopril lossis Diroton. Cov neeg mob uas tsis muaj kev cuam tshuam txog nyiaj txiag, xaiv rau tom kawg.

Captopril-based cov tshuaj ua tau sai dua (hauv ib nrab ntawm ib teev), tab sis cov nyhuv tsis kav ntev, uas yog vim li cas lawv xav tau 3 zaug hauv ib hnub. Vim tias qhov no, kev siv tshuaj captopril tsis haum rau kev kho mob tas li: nws tau ua pov thawj tias tsuas yog ib feem me me ntawm cov neeg mob tau tuaj yeem ua raws li cov kev cai ntau rau lub sijhawm ntev. Qhov no yuav tsum tau muab qhia hauv siab thaum xaiv Lisinopril lossis Captopril, uas yog qhov zoo tshaj plaws.

Ntawm cov dipeptidyl carboxypeptidase inhibitors, ramipril yog ib qho ntawm tsib kev uas, thaum kev kuaj mob loj, nws tau ua pov thawj tias lawv siv hauv cov neeg mob ntshav siab txo kev tuag.

Hauv qhov kev txiav txim siab no, kev xaiv ntawm Ramipril lossis Lisinopril cov tshuaj, uas zoo dua los ntawm lawv, tsis tuaj yeem ua rau ntawm lub hom phiaj cov ntaub ntawv. Txawm li cas los xij, nws muaj peev xwm hais tias tus neeg mob siab rau ib hom tshuaj yuav txawv.

Yog tias hnoos yog los ntawm Lisinopril, ces lo lus nug ntawm yuav ua li cas los hloov nws yog qhov tshwj xeeb. Ib qho kev xaiv tej zaum yuav yog Lorista.

Cov tshuaj nquag - losartan poov tshuaj - muaj lub zog sib txawv ntawm kev txiav txim thiab yog li tsis ua rau hnoos. Txawm li cas los xij, thaum txiav txim siab tias Lisinopril lossis Lorista zoo dua, nws yuav tsum tau yug los rau hauv lub siab tias cov tshuaj tom kawg txo qhov siab tsis tshua muaj txiaj ntsig (los ntawm 8 hli Hg tiv thaiv 20 hli Hg hauv lisinopril, raws li kev tshawb fawb soj ntsuam). Ntxiv rau, Lorista yuav tsum haus cawv 2 zaug hauv ib hnub, thiab nws kuj muaj cov npe zoo tshaj plaws txog kev phiv thiab contraindications, raws li tau hais tseg hauv cov lus qhia rau kev siv.

Cov tshuaj Valz (cov tshuaj nquag yog valsartan) nyob nrog tib pab pawg tshuaj xws li Lorista, txawm li cas los xij, piv nrog tom kawg, nws muaj qhov tseem ceeb tseem ceeb - lub sijhawm ntawm cov nyhuv, uas tso cai rau koj noj nws ib hnub ib zaug. Zoo li lwm cov tshuaj ARB, valsartan feem ntau yog ua ke nrog lwm cov tshuaj. Yog tias peb tham txog kev kho mob monotherapy, tom qab ntawd Lisinopril tuaj yeem suav tias yog qhov zoo dua thiab ua haujlwm tau zoo.

Bisoprolol-based tshuaj thaiv cov adrenergic receptors ntawm lub plawv thiab aorta, yog li txo lub plawv dhia thiab feeb cov ntshav ntim, txo qis qis dua. Nws yuav tsum raug sau tseg tias kev siv tshuab ntawm kev txo qis siab hauv cov tshuaj ntawm BAB pawg tsis meej kiag li, raws li tau sau tseg hauv cov lus qhia rau kev siv. Xaiv lisinopril lossis bisoprolol, nws yog qhov zoo tshaj rau tus neeg mob, tus kws kho mob yuav suav nrog ntau yam thiab ua rau kev teem caij uas tsim nyog tshaj plaws.

Koj tuaj yeem kawm paub ntau ntxiv txog kev kub siab los ntawm cov yeeb yaj kiab no:

Ua ke nrog cov kab lus no lawv nyeem:

Cov cai atx: c07ab07 Pharmacological pawg: Beta-blockers

Bisoprolol tsis muaj nws tus kheej sympathomimetic kev ua si thiab membrane-stabilizing nyhuv. Vim tias nws cov lipophilic muaj zog, cov tshuaj cuam tshuam sai sai los ntawm txoj hnyuv hauv lub plab. Vim tias ib nrab-lub neej ntev (10-12 teev), bisoprolol raug kho 1 zaug nyob rau ib hnub. Kev ua haujlwm siab tshaj plaws ntawm bisoprolol yog 2-4 teev tom qab kev tswj hwm, lub sijhawm ntawm cov nyhuv yog 24 teev. Bisoprolol tsis cuam tshuam nrog lwm cov tshuaj siv los kho cov kab mob plawv. Noj mov tsis muaj kev cuam tshuam cov pharmacokinetics ntawm bisoprolol. Lub raum khiav tsis zoo yuav luag tsis muaj dab tsi cuam tshuam cov tshuaj nyob rau hauv cov ntshav, tsuas yog mob raum tsis ua haujlwm yuav tsum txhaj tshuaj ntau heev.

Cov koob tshuaj uas muaj ntau yam tshuaj ntawm bisoprolol yog kab, nws cov neeg thiab kev hloov pauv me me yog qhov me me, uas ua kom muaj kev cuam tshuam tas mus li thiab paub tseeb txog kev kho mob ntawm cov tshuaj.

Cov yam ntxwv ntawm bisoprolol metabolism txiav txim siab txog nws qhov kev soj ntsuam zoo: qhov tseem ceeb ntawm kev noj nws ib hnub ib zaug, qhov tsis muaj qhov xav tau koob tshuaj hloov kho rau daim siab thiab lub raum pathologies hauv cov neeg laus, thaum siv ua ke nrog lwm cov tshuaj, thiab kev nyab xeeb siab ntawm kev kho cov neeg mob uas muaj kab mob xws li qab zib mob ntshav qab zib, mob ntsws tsis tu ncua, mob hlab ntsha hlwb.

Ischemic (mob leeg) mob plawv.BAB yog cov tshuaj tseem ceeb nyob rau hauv kev kho mob ntawm ruaj ntseg angina pectoris. Lawv cov nyhuv antianginal yog vim muaj qhov tsis zoo inotropic thiab chronotropic, uas ua rau txo qis ntawm myocardial oxygen thov, thiab vim yog qhov ntev ntawm lub diastole, rau lub sijhawm ntawm perfusion ntawm lub plawv mob. Tsis tas li ntawd, kev nce siab ntawm lub sijhawm ntawm myocardial perfusion mus rau diastole yog qhov txiaj ntsig ntawm lub plawv txo qis pab txhawb kev txhim kho oxygen xa mus rau myocardium. Yog tias muaj kev xaiv ntau dua ntawm cov tshuaj niaj hnub ntawm BAB pawg, qee cov kws kho mob tau sau ntawv siv tshuaj tsis muaj txiaj ntsig zoo hauv kev siv tshuaj tsawg kawg nkaus.

Thaum twg koj yuav tsum tau muab qhov kev nyiam ua rau kev kho mob BAB: 1) yog tias muaj kev sib txuas meej ntawm kev txhim kho ntawm kev nres ntawm angina thiab kev ua haujlwm ntawm lub cev, 2) nrog kev mob ntshav siab, 3) muaj cov plawv dhia tsis ua haujlwm (supraventricular lossis ventricular arrhythmia), 4) nrog myocardial infarction.

Xws li koob tshuaj ntawm BAB yog suav tias yog sib npaug, uas ua rau tib yam kev txo qis hauv lub plawv dhia thaum qoj ib ce (propranolol 100 mg, atenolol 100 mg, metoprolol 100 mg, bisoprolol 10 mg).

Raws li cov txiaj ntsig ntawm ATP-daim ntawv tshuaj ntsuam (Angina Kev Kho Mob Txawv) *, thaum xaiv cov tshuaj antianginal nrog hemodynamic mechanism ntawm kev ua hauv kev tswj hwm monotherapy, nitrates (11.9%) yog nyiam nyob hauv Russia, tom qab ntawd BAB (7.8%) thiab calcium antagonists (2 , 7%). Txawm li cas los xij, nrog kev kho mob sib xyaw ua ke ntawm BAB (feem ntau yog sib xyaw nrog cov organic nitrates) yog cov kev kho mob ntau zaus ntau - hauv 75% ntawm cov neeg mob.

Kev tsom xam cov kev tshawb fawb ntawm ntau qhov kev tshawb fawb pom tau hais tias lub plawv pa nyhuv ntawm BAB tsis nyob ntawm seb puas muaj los yog tsis muaj β-tshuaj xeb, tab sis meej meej nyob ntawm cov khoom ntxiv xws li sab hauv sympathomimetic kev ua si (ICA) thiab lipophilicity.

Hauv cov neeg mob nrog myocardial infarction, tshaj tawm cov nyhuv cardioprotective yog sib zog los ntawm cov tshuaj lipophilic (txo cov neeg tuag los ntawm qhov nruab nrab ntawm 30%): betaxolol, carvedilol, metoprolol, propranolol, timolol, thiab lwm yam thiab BAB tsis muaj ICA (qhov nruab nrab ntawm 28%), uas yog metoprolol, propranolol thiab timolol. Tib lub sijhawm, tsis yog BAB nrog ICA (alprenolol, oxprenolol thiab pindolol), tsis pub siv cov tshuaj hydrophilic (atenolol thiab sotalol) nrog kev siv ntev tsis tiv thaiv kev tuag nyob hauv pawg neeg mob no. Ntawm BAB nyob rau hauv cov neeg mob uas muaj mob ua rau mob hlab ntsha hlwb, bisoprolol (5-20 mg / hnub), atenolol (25-100 mg / hnub), metoprolol (50-200 mg / hnub), carvedilol (25-50 mg / hnub), nebivolol (5 mg / hnub). Cov tshuaj nrog cardioselectivity (bisoprolol, atenolol, metoprolol, betaxolol) muaj feem ntau thaiv cov nyhuv rau β-adrenoreceptors, thiab nrog kev kho kom ntev, lawv txoj kev zam tau zoo tshaj yog tsis muaj qhov tseem ceeb me.

Cov ntaub ntawv ntawm cov kev tshawb fawb pom tias kev siv bisoprolol, carvedilol tsis yog tsuas yog txo qhov hnyav ntawm cov tsos mob, tab sis kuj tseem txhim kho qhov kev tshawb nrhiav. Hauv cov neeg mob nrog angina pectoris, tus lej thiab lub sijhawm ntawm lub sijhawm hloov mus ntawm ischemia tuaj yeem txo qis. Tsis tas li ntawd, kev kho mob yog nrog pov tseg txo qis hauv qhov ntsuas xws li kev tuag thiab kev mob hlwb, thiab kev txhim kho ntawm cov neeg mob.

Bisoprolol pab ua kom ib ce muaj zog ua kom ntau dua qhov kev siv ntawm atenolol thiab metoprolol, nws ua rau muaj kev qoj ib ce tseem ceeb thiab ua kom siv tshuaj tiv thaiv kev tawm dag zog. Nws tau qhia tias bisoprolol ua rau ntau dua li ntawm atenolol thiab metoprolol txhim kho lub neej zoo ntawm cov neeg mob thiab txo kev ntxhov siab, qaug zog. Nws yog ib qho tseem ceeb heev uas bisoprolol txo qis kev mob plawv thiab muaj kev pheej hmoo ntawm kev tsim kev tuag lub cev myocardial infarction hauv cov neeg mob uas muaj kev pheej hmoo siab uas yuav raug phais plawv.

Kev kawm TIBBS tau soj ntsuam cov txiaj ntsig ntawm bisoprolol piv nrog nifedipine ntawm hloov ischemia hauv 330 cov neeg mob uas muaj lub hlwb angina pectoris nrog myocardial ischemia tshawb xyuas qhov tseeb los ntawm electrocardiography thiab ECG, kuaj xyuas los ntawm kev ntsuas treadmill thiab Holter tshuaj xyuas.Tom qab 4 lub lim piam ntawm kev kho mob hauv pab pawg bisoprolol (20 mg / hnub), tus lej ntawm myocardial ischemia poob qis (los ntawm 8.1 ± 0.6 rau 3.2 ± 0.4), tag nrho lub sijhawm ntawm myocardial ischemia poob qis (los ntawm 99.3 10.1 rau 31.2 ± 5.5 min), cov lej ntawm ischemic tawm tsam thaum sawv ntxov tseem ceeb. Cov neeg mob uas tshem tawm qhov hloov pauv myocardial ischemia tiav los ntawm kev kho tau muaj kev pheej hmoo tsawg dua los ntawm kev tuag piv nrog cov neeg mob uas txuas rau hauv ischemic phaum ntu. Cov kws sau ntawv kuj tau sau tseg txog kev nce siab hauv lub plawv hloov pauv thaum kho nrog bisoprolol. Nyob rau tib lub sijhawm, qhaj ntawv ntawm cov nyhuv ntawm retard daim ntawv ntawm nifedipine (40 mg / hnub) ntawm qhov ntsuas ntsuas tseem ceeb no tau qhia.

Lwm qhov kev tshawb nrhiav tau sau tseg muaj kev mob tshwm sim tsawg dua, kev ua tau zoo ntawm bisoprolol piv rau nifedipine, thiab kev sib txig sib luag thiab kev zam zoo dua thaum piv nrog amlodipine. Nws tau pom tias qhov sib ntxiv ntawm cov calcium uas thaiv cov kab mob rau bisoprolol tsis muaj txiaj ntsig zoo hauv kev kho mob ntawm cov neeg mob uas muaj tus mob angina pectoris ruaj khov. Antianginal thiab anti-ischemic kev ua tau zoo ntawm bisoprolol tau pom tias hauv MIRSA txoj kev tshawb nrhiav, nyob rau hauv uas bisoprolol txo tag nrho ischemia thaum qoj ib ce thiab txhim kho kev kwv yees ntawm cov neeg mob uas muaj mob ua mob rau cov hlab ntshav txhaws. Teeb meem tsis zoo ntawm BAB txuam nrog β thaivreceptors nyob hauv lub kaw lus bronchopulmonary. Qhov yuav tsum tau los tswj kev teem sijhawm β-blockers thiab cov kev mob tshwm sim (bradycardia, hypotension, bronchospasm, ntau cov cim ntawm lub plawv tsis ua hauj lwm, lub plawv txhaws, pob txha ntshav ntawm lub cev tsis muaj zog, nkees, insomnia) ua rau tus kws kho mob tsis tas siv cov tshuaj muaj txiaj ntsig no. Txawm li cas los xij, hauv kev xaiv BAB Cov xwm txheej no raug sau tseg ntau tsawg. Cov kev kho mob tseem ceeb hauv kev sau tshuaj BAB rau cov neeg mob plawv yog siv cov tshuaj me me, lawv kev tswj hwm tsawg dua li qhov tsim nyog, thiab kev tshem tawm yeeb tshuaj thaum muaj tshwm sim ntawm lub plawv dhia ntawm tsawg dua 60 bpm Nws kuj tseem yuav tsum tau yug los hauv lub siab qhov tseem ntawm kev txhim kho ntawm kev tshem tawm cov tsos mob, yog li ntawd, BAB yuav tsum tau muab tshem tawm maj mam. Yog li, BAB tau suav hais tias yog qhov tseem ceeb ntawm kev kho mob ntawm txhua daim ntawv ntawm cov kab mob plawv, raws li lawv cov txiaj ntsig hauv cov neeg mob tom qab myocardial infarction. Ib qho kev txo qis 25% ntawm kev mob ntsig txog myocardial infarction thiab kev ploj tuag tau pom tias hauv cov neeg mob uas muaj mob rau txoj hlab ntshav hlab ntsha thaum kho nrog BAB. Cov tshuaj ntawm cov pab pawg no yog qhov kev xaiv thawj zaug rau kev kho mob ntawm cov neeg mob angina pectoris, tshwj xeeb tshaj yog nyob rau cov neeg mob tom qab myocardial infarction, vim lawv ua rau muaj pov thawj txo qis hauv kev tuag thiab qhov zaus ntawm myocardial recurrence.

Bisoprolol hauv kev sib piv nrog atenolol thiab metoprolol muaj ntau qhov ua kom pom kev mob siab (hauv kev kho mob ua rau nws tsuas yog β-adrenoreceptors) thiab lub sijhawm ua haujlwm ntev dua. Nws siv rau IHD ib hnub ib zaug, nyob ntawm cov chav kawm ua haujlwm ntawm angina pectoris ntawm koob tshuaj 2.5-20 mg. Yog tias BAB monotherapy yog qhov tsis txaus, tom qab ntawd yog nitrates lossis calcium antagonists los ntawm cov pawg dihydropyridine ntxiv rau kev kho mob (GFCF, 2008). Saib xyuas cov xwm txheej ntawm cov neeg mob noj bisoprolol yuav tsum muaj: ntsuas ntsuas lub plawv thiab ntshav siab (thaum pib kho txhua hnub, tom qab ntawd 1 zaug txhua 3-4 lub hlis), ECG, txiav txim xyuas ntshav qabzib hauv cov neeg mob ntshav qab zib mellitus (1 lub sijhawm txhua 4-5 lub hlis ) Hauv cov neeg mob laus, nws raug nquahu kom soj ntsuam lub raum (1 lub sijhawm hauv 4-5 lub hlis). Nrog kev mob raum tsis zoo (cov neeg tsim muaj peev xwm tshem tau tsawg dua 20 ml / min) thiab hauv cov neeg mob uas muaj kab mob siab ntau, qhov siab tshaj plaws txhua hnub yog 10 mg.

Arterial tawg. Kev ua rau lub ntsej muag ntawm bisoprolol cuam tshuam nrog kev poob qis hauv cov ntshav tsawg feeb, lub plawv dhia, kev txhawb lub zog ntawm cov hlab ntsha, txo qis rau kev ua haujlwm ntawm renin-angiotensin system (ntawm qhov tseem ceeb rau cov neeg mob thaum pib hypersecretion ntawm renin), rov qab los ntawm kev nkag siab hauv cov lus teb rau qhov txo qis ntshav siab thiab cuam tshuam rau hauv nruab nrab lub paj hlwb nyob rau vasomotor chaw zov me nyuam).Nrog rau kev kub siab, cov nyhuv tshwm sim tom qab 2-5 hnub, qhov ua haujlwm ruaj khov - tom qab 1-2 hlis. Yog li, cov nyhuv ntawm cov tshuaj yog raws li txo qis hauv kev tawm tswv yim, txo lub plawv dhia, txo qis kev tso pa tawm thiab kev txiav txim siab ntawm renin hauv ntshav, thiab inhibition ntawm cov teebmeem ntawm cov vasomotor chaw. Kev kho Bisoprolol yuav tsum tsis txhob cuam tshuam tam sim ntawd, tshwj xeeb tshaj yog nyob rau cov neeg mob uas muaj mob rau txoj hlab ntshav ntawm lub cev. Yog tias tsis ua tiav ntawm kev kho yog qhov tsim nyog, tom qab ntawd cov tshuaj ntawm cov tshuaj yuav tsum tau maj mam txo.

Qhov ua tau zoo ntawm bisoprolol hauv kev kub siab tau pom tias muaj ntau qhov kev tshawb fawb soj ntsuam. Kev siv tshuaj zoo txhua hnub nyob rau thaj tsam li ntawm 5 txog 10 mg, txawm hais tias qee qhov kev tshawb nrhiav siv koob tshuaj 20 mg. Nws tau pom tias lub sijhawm ntev ntawm kev ua haujlwm siab tshaj ntawm bisoprolol yog tsawg kawg 24 teev, thiab thaum piv cov nyhuv nrog BAB, xws li atenolol thiab metoprolol, nws tsis qis dua rau lawv hauv txhua yam.

Hauv kev tshawb nrhiav ob zaug dig muag ntawm BISOMET hauv 87 cov neeg mob ntshav siab, tau pom tias bisoprolol (n = 44) ntawm 10 koob / hnub piv rau metoprolol (n = 43) ntawm koob tshuaj 100 mg / hnub raws li qhov ntsuas ntshav txo ntshav siab thaum so, tab sis ho surpasses nws nyob rau hauv nws cov nyhuv rau theem ntawm systolic ntshav siab thiab lub plawv dhia thaum qoj ib ce (24 teev tom qab kawg koob bisoprolol, systolic ntshav siab ntawm lub luag haujlwm ntawm 100 watts tseem txo mus rau 86% ntawm qhov siab tshaj plaws 3 teev ntawm cov tshuaj, thiab tsuas yog 63% hauv pawg metoprolol (p = 0.02) Yog li, bisoprolol tau pom tias yog qhov zoo dua flax metoprolol nyob rau hauv cov kev kho mob ntawm kub siab, tshwj xeeb tshaj yog nyob rau hauv cov neeg mob uas hypersympathicotonia.

Kev tshawb nrhiav BIMS piv rau kev tiv thaiv kev cuam tshuam ntawm bisoprolol thiab atenolol hauv cov neeg haus luam yeeb. Bisoprolol thiab atenolol ua tau zoo hauv 80 thiab 52% ntawm tus neeg mob, feem.

Cov nyhuv ntxim nyiam ntawm bisoprolol tsis yog qhov qis dua li cov calcium calcium antagonists (nifedipine) thiab angiotensin-converting enzyme inhibitors (ACE inhibitors, enalapril). Hauv kev sib piv 6 lub hlis kev tshawb nrhiav, bisoprolol ntawm ib koob ntawm 10-20 mg / hnub ua rau muaj qhov txo qis ntawm sab laug ventricular myocardial loj index los ntawm 11%, uas piv rau cov nyhuv ntawm enalapril ntawm ib koob ntawm 20-40 mg / hnub.

Hauv cov neeg mob uas tsis tshua mob mus txog qhov kub ntxhov nrog ib koob tshuaj ib hnub, bisoprolol txo cov ntshav siab los ntawm 15-20%. Hauv kev tshawb fawb nrog kev rov saib xyuas cov ntshav siab hauv tsev kho mob raws li cov qauv kev xaiv lub cev muaj zog xaiv rau txhua tus neeg mob, bisoprolol ntawm koob tshuaj 10 mg ib hnub ib zaug muaj feem ntau "du" antihypertensive nyhuv thaum nruab hnub piv nrog cov txiaj ntsig ntawm metoprolol lossis propranolol, uas tau raug kho 2 ib hnub. Raws li rau qhov muaj zog ntawm diastolic cov ntshav siab, qhov piv ntawm cov nyhuv kawg mus rau qhov kawg yog 91.2% rau bisoprolol. Nws ntseeg tau tias tus nqi yam tsawg kawg ntawm qhov ntsuas no kom ntseeg tau tias "kev siv" tiv thaiv kabmob thaum hnub ib hnub yog 50%.

Hauv ib txoj kev tshawb nrhiav, qhov kev ua tau zoo ntawm kev sib xyaw ua ke siv bisoprolol thiab hydrochlorothiazide hauv 512 cov neeg mob uas mob me txog rau qib nrab tau kawm, thiab txhua cov tshuaj tau raug muab tshuaj hauv ntau cov koob tshuaj (bisoprolol los ntawm 2.5 txog 20 mg, hydrochlorothiazide los ntawm 6.25 txog 25 mg). Nws tau pom tias kev siv ua ke ntawm cov tshuaj no hauv kev txhaj tshuaj tsawg kawg yog zam zoo los ntawm cov neeg mob, thaum muaj ib qho kev txo qis ntawm cov ntshav hauv cov ntshav siab txog 90 mm RT. Kos duab. thiab qis dua hauv 61% ntawm cov neeg mob.

Kev siv ntev ntev ntawm bisoprolol hauv cov neeg mob ntshav siab tuaj yeem ua rau thim rov qab ntawm sab laug ventricular hypertrophy. Txij li thaum kho cov tshuaj yuav tsum tau nqa tawm tsis tu ncua thiab ntev, tshuaj kho mob rau lub hom phiaj no yuav tsum yooj yim siv thiab zam zoo los ntawm cov neeg mob. Hauv kev kho mob ntshav siab, cov kev txwv tseem ceeb thaum siv BAB cuam tshuam nrog kev ntshai ntawm kev tsim cov teeb meem hauv lub cev tsis zoo (nce insulin tsis kam, kev hloov pauv nyob rau hauv cov ntshav lipid spectrum) thiab kev cuam tshuam ntawm cov chav kawm ua kom muaj kab mob ntsig ua mob ntsws (COPD) lossis peripheral arterial kab mob.

Lub plawv tuaj ntxhov sab xis. Nyob rau ntawm lub koom haum txog chaw kho mob Cardiology.AL Myasnikov nqa tawm ntawm kev ua haujlwm ntawm kev sib piv ntawm bisoprolol thiab amiodarone hauv kev kho mob ntawm ventricular extrasystole (PVC) hauv cov neeg mob uas muaj kev puas siab ntsws metabolic. Hauv 52 cov neeg mob uas muaj mob metabolic syndrome raug mob ZhE, amiodarone 200 mg ib hnub ib zaug, 5 hnub hauv ib lub lis piam tau siv tshuaj tiv thaiv kab mob, 55 cov neeg mob noj 10 mg bisoprolol txhua hnub nyob rau yav tsaus ntuj. Kev ua tau zoo tau raug ntsuas siv txhua hnub ECG soj ntsuam tom qab 1, 3, 6, 9, thiab 12 lub hlis. Qhov kawg ntawm kev soj ntsuam, qhov muaj txiaj ntsig tseem ceeb ntawm bisoprolol piv nrog amiodarone tau pom tias muaj txiaj ntsig (50% ntawm cov neeg mob tau txais kev kho zoo piv rau 17.3%, p = 0.02). Lawv tsum tsis noj cov tshuaj vim qhov ua ploj nyhuv, feem, 20% tiv thaiv 46.1% (p = 0.004). Tus naj npawb ntawm cov neeg mob uas tsis kam lees kho vim muaj kev phiv los ntawm ob pawg neeg tau sib piv.

Hauv kev tshawb fawb los ntawm A.Plewan li al. Kev ua tau zoo ntawm bisoprolol ntawm ib koob ntawm 5 mg thiab sotalol ntawm ib koob tshuaj 160 mg hauv kev tiv thaiv ntawm paroxysms ntawm atrial fibrillation hauv cov neeg mob tom qab cardioversion tau qhia. Tib lub sijhawm, bisoprolol ua rau muaj kev mob tshwm sim tsawg dua li sotalol. Bisoprolol tsis tau qis dua los ntawm amiodarone hauv kev tiv thaiv atrial fibrillation hauv cov neeg mob uas muaj mob rau cov hlab ntsha txoj hlab ntshav tom qab cov hlab ntshav txoj hlab ntshav hla kev hla pob txha. Qhov kev ua tau zoo ntawm bisoprolol yog cov tshuaj ua kom yuag-txo qis hauv kev kho mob ntawm ventricular thiab supraventricular extrasystoles nrog ib daim ntawv txuas ntawm atrial fibrillation kuj tau pom. Lub peev xwm ntawm β-blockers, suav nrog bisoprolol, los tiv thaiv kev txhim kho ntawm lub neej phom sij ventricular arrhythmias hauv pab pawg ntawm cov neeg mob uas muaj kev pheej hmoo ntawm kev tuag sai yog qhov tseem ceeb heev.

Lwm yam qhia rau kev teem caij bisoprolol. Bisoprolol ua tau zoo thiab muaj kev nyab xeeb rau cov ntshav qab zib, cov tshuaj tsis cuam tshuam rau cov ntshav qabzib hauv cov neeg mob ntshav qab zib mellitus, tsis tas yuav tsum kho cov tshuaj ntawm cov tshuaj tiv thaiv kab mob hauv lub qhov ncauj. Bisoprolol tsis cuam tshuam rau theem ntawm cov thyroid hormones hauv hyperthyroid xeev, tsis ua rau hypokalemia. Cov ntaub ntawv cov ntaub ntawv qhia tias tsis muaj dab tsi cuam tshuam rau lipid spectrum hauv cov neeg mob noj bisoprolol ntev.

Kev teem sijhawm ntawm BAB tuaj yeem txhim kho qhov kev pom ntawm lub neej ntawm cov neeg mob uas tau ua qee yam haujlwm hauv lub plawv thiab cov hlab ntsha. Yog li, nws tau qhia tias kev teem sijhawm bisoprolol thaum thiab tom qab cov haujlwm no txo ​​qis kev pheej hmoo ntawm kev tuag los ntawm ib qho laj thawj thiab qhov muaj feem ua rau tsis mob ntshav siab myocardial infarction hauv cov neeg mob uas muaj kev pheej hmoo siab heev ntawm cov kab mob plawv.

Dab tsi pab lisinopril?

Kev qhia rau kev siv tshuaj muaj xws li:

• mob ntshav qab zib nephropathy (txo qis ntawm albuminuria hauv kev tiv thaiv cov kab mob insulin-cov neeg mob ntshav siab thiab cov neeg mob tsis haum tshuaj muaj kev mob ntshav siab),
• mob plawv tsis ua hauj lwm (raws li ib feem ntawm txoj kev kho ua ke rau kev kho mob ntawm cov neeg mob noj digitalis thiab / lossis diuretics),
• arterial hypertension (hauv monotherapy lossis hauv kev sib xyaw nrog lwm cov tshuaj antihypertensive),
• kev kho thaum ntxov ntawm mob myocardial infarction (hauv thawj 24 teev nrog cov hemodynamic ruaj khov los tswj cov ntsuas no thiab tiv thaiv sab laug ventricular kawg thiab lub plawv tsis ua haujlwm).

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.

Cov lus qhia tshwj xeeb

Hauv cov mob myocardial infarction, cov tshuaj siv los tiv thaiv keeb kwm ntawm kev kho mob nyuaj nrog kev siv cov tshuaj thrombolytics, beta-blockers thiab acetylsalicylic acid.

Ua ntej kev phais mob, kws kho mob yuav tsum tau ceeb toom txog kev noj Lisinopril. Cov neeg muaj ntshav qab zib yuav tsum tau soj ntsuam lawv cov piam thaj kom xwm yeem.

Yeeb tshuaj sib cuam tshuam

Hauv kev sib xyaw nrog kev npaj muaj lithium, tom kawg yog tas los ntawm lub cev. Nrog rau kev sib xyaw no, kev soj ntsuam tas li ntawm kev saib xyuas ntawm cov roj ntsha lithium hauv cov ntshav yuav tsum ua tiav.

Lisinopril txhim kho kev txiav txim siab ntawm ethanol. Cov tshuaj nonsteroidal anti-inflammatory, estrogens thiab acetylsalicylic acid txo cov nyhuv antihypertensive ntawm cov tshuaj.

Analogues ntawm cov tshuaj Lisinopril

Tus qauv txiav txim siab pom cov qauv analogues:

1. Liten.
2. Lysinotone.
3. Kev txais.
4. Lizonorm.
5. Sinopril.
6. Lisinopril dihydrate.
7. Dapril.
8. Lysigamma.
9. Lisinopril Grindeks (Stada, Pfizer, Teva, OBL, Organics).
10. Laub.
11. Irumed.
12. Lizoril.
13. Rileis Sanovel.
14. Diroton.
15. Lysacard.
16. Diropress.

Nrog hydrochlorothiazide:

1. Scopril ntxiv rau.
2. Liten N. Hmoob.
3. Lister Ntxiv.
4. Iruzid.
5. Rileys Sanovel ntxiv rau.
6. Co-Diroton.
7. Lysoretic.
8. Lisinopril N.
9. Zoniksem ND.
10. Lysinoton N.
11. Zonixem NL.

Nrog amlodipine:

Cov lus so thiab nqe

Tus nqi nruab nrab ntawm Lisinopril (10 mg ntsiav tshuaj No. 30) hauv Moscow yog 44 rubles. Hauv Kiev, koj tuaj yeem yuav tshuaj rau 45 hryvnias, hauv Kazakhstan - rau 1498 tenge. Hauv Minsk, cov khw muag tshuaj muaj tshuaj rau 2-3 bel. txhuam. Muaj los ntawm cov khw muag tshuaj nrog cov tshuaj noj.

Cov tshuaj uas pheej yig, siv rau hauv kev kho mob niaj hnub, hu ua "Bisoprolol." Cov tshuaj no zoo li cas los ntawm? Qhov lus teb tau zoo tshaj plaws rau lo lus nug no yog muab los ntawm cov lus qhia rau kev siv tshuaj, uas yog qhov tsim nyog nyob hauv pob. Txawm li cas los xij, yog tias muaj lub siab xav nrog cov ntaub ntawv no yam tsis tau txais tshuaj, ces cov khoom siv no yog nyob ntawm koj qhov kev pabcuam.

"Bisoprolol": cov tshuaj no yog los ntawm dab tsi?

Cov tshuaj no tau tsim los siv rau hauv kev mob ntshav hauv lub plawv thiab mob plawv, nws kuj tseem muaj kev pabcuam tseem ceeb rau kev mob plawv mob ntshav plawv, mob plawv tsis xwm yeem (CHF), mob angina pectoris, mob plawv tom qab mob caj pas. Raws li txoj cai, nws yog kws kho yog mob plawv arrhythmias pom nrog extrasystoles, arrhythmias, thyrotoxicosis.

Cov cim qhia ntawm "Bisoprolol" ntawm kev muag khoom tau nthuav tawm hauv ntau yam. Kev npaj nrog tib lub npe, tab sis los ntawm cov tuam ntxhab sib txawv txawv hauv nqe. Kev tsim qauv ntawm cov neeg tsim khoom yuav raug ntxiv rau lub npe: "Teva", "Vertex", "North Star". Nyob ntawm seb muaj pes tsawg ntawm cov ntsiav tshuaj hauv pob, cov yam ntxwv ntawm cov muaj pes tsawg leeg, cov khoom tsim khoom, ib pob nqi los ntawm 20 txog 200 rubles.

Nws puas tuaj yeem hloov cov tshuaj nrog tshuaj tiv thaiv?

Cov cim ntawm "Bisoprolol" rau muag yog sawv cev los ntawm cov khoom hauv qab no:

Qee qhov ntawm lawv muaj nyob ntawm tus nqi pheej yig, xws li cov tshuaj hauv nqe lus nug, lwm tus kuj kim dua. Yog tias tus kws kho mob qhia kom siv Bisoprolol, cov nyhuv ntawm cov tshuaj no yuav loj dua li ntawm cov tshuaj tiv thaiv kab mob. Hloov cov tshuaj nrog cov tshuaj (generics) yog ua tau tsuas yog kev pom zoo ntawm tus kws kho mob koom nrog. Kev hloov tus kheej ntawm ib cov tshuaj nrog lwm tus yog categorically tsis pom zoo, txhua qhov ntau dua li ntawd los ntawm cov peev txheej pom tsis muaj txiaj ntsig, thiab Bisoprolol thev taus zoo dua li ntau yam analogues.

Yuav siv li cas?

Bisoprolol belongs rau cov pab pawg xaiv beta1-blockers. Cov khoom muaj nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, txhua tus muaj plhaub - nyias zaj duab xis uas tswj kev tswj hwm.

Yuav noj li cas "Bisoprolol" tau piav qhia txhua yam hauv cov lus qhia uas txuas nrog rau cov tshuaj. Feem ntau lawv haus nws thaum sawv ntxov ua ntej noj tshais ntawm lub plab khoob. Tag nrho cov tshuaj txhua hnub yog siv nyob rau hauv ib lub sij hawm, nqos tam sim ntawd, tsis tas yuav zom. Raws li txoj cai, los ntawm 5 txog 10 mg yog tsim nyob rau ib hnub. Cov tshuaj txhua hnub ntawm Bisoprolol rau cov neeg laus yuav tsum tsis pub ntau tshaj 20 mg. Cov xwm txheej tshwj xeeb ntawm kev txais neeg mob yog tsim los rau cov neeg uas kuaj mob raum thiab / lossis teeb meem rau daim siab ua haujlwm (qhov kev siv tshuaj txhua hnub ntau tshaj yog halved txog 10 mg).

Daim ntawv thov nta

Raws li cov lus qhia, "Bisoprolol" raug pom zoo kom noj los ntawm kev noj tshuaj ntawm 1.25 mg ib hnub (rau kev kho mob ntawm lub plawv tsis ua haujlwm). Nws yog tswj thoob plaws thawj lub lim tiam ntawm kev kho mob. Hauv lub lim tiam thib ob, qhov kev xav tau nce mus rau 2.5 mg, tom qab lwm lub lis piam lawv nce ntxiv, thiab cov koob tshuaj txhua hnub nce mus txog 3.75 mg. Tom qab ntawd, rau ob peb lub lis piam (los ntawm plaub mus txog lub thib yim), 5 mg tau noj txhua txhua hnub thaum sawv ntxov, thiab txij lub cuaj mus txog kaum ob, 7,5 mg. Cov kauj ruam tom ntej yog 10 mg hauv 24 teev. Cov koob tshuaj no tau tswj hwm kom txog thaum tus kws kho mob pom zoo kom ua tiav qhov kev kho mob. Cov cuab yeej yog tsim kho ntev, feem ntau siv rau xyoo, qee zaum nws yog tshuaj rau lub neej ntev.

Yog tias thaum kho nrog Bisoprolol (raws li cov lus qhia) tus neeg mob tau pom tias muaj kev txhim kho, chav kawm yuav tsum tsis txhob cuam tshuam nrog yam tsis tau txais kev pom zoo los ntawm tus kws kho mob. Koj tuaj yeem tshawb xyuas nrog koj tus kws kho mob seb nws puas muaj tiag los kho kev kho mob, tab sis tsis muaj kev pom zoo los ntawm cov kws tshaj lij, nws yog txwv tsis pub noj. Tus mob tuaj yeem ua tsis tau tsuas yog rov qab rau qhov uas tau ua ntej pib kho, tab sis kuj dhau los ua neeg ceeb toom pom ntau dua.

Kev kuaj mob: thaum tsis sau daim ntawv "Bisoprolol"?

Cov kev txwv tsis pub siv "Bisoprolol" suav nrog cov kab hauv qab no:

• bradycardia
• Mob Hlwb Mob Hlwb Ntev (COPD),
• cardiomegaly
• hypotension
• cardiogenic poob siab
• mob hnyav daim ntawv peripheral kev tsis txaus ntseeg.

Tsis tas li, cov tshuaj tsis siv rau lub sijhawm pub mis thiab thaum siv cov tshuaj monoamine oxidase inhibitors (MAOs), yog tias lawv tsis zwm rau MAO-B pawg.

Nws ua haujlwm li cas?

Raws li hauv qab no los ntawm cov lus qhia ntawm "Bisoprolol" (kev txheeb xyuas pom tseeb qhov no), cov tshuaj muaj cov nyhuv hypotensive muaj zog, pab tua cov neeg tsis tuaj yeem. Cov tshuaj ua yeeb yaj kiab xaiv thiab nyob rau hauv chav kawm ntawm beta1-blockers. Nws cuam tshuam beta1 receptors nyob rau hauv lub plawv mob, tab sis ntawm qhov tsis tshua muaj koob, vim tias qhov kev ua si ntawm catecholamines yog inhibited, tiam ntawm ATP, cAMP poob qis, thiab calcium metabolism qeeb. Cov cuab yeej ua haujlwm qeeb qis hauv lub plawv vim yog inhibition ntawm kev tsis txaus siab thiab lub peev xwm ntawm myocardium los cog lus.

Cov yam ntxwv ua tau zoo: lwm qhov tseem ceeb?

Paub meej tias qhov ua tau zoo ntawm kev kho mob ntshav siab "Bisoprolol" kev txheeb xyuas, uas tau tshaj tawm hauv cov lej coob ntawm World Wide Web. Raws li cov kws tsim tawm piav qhia, qhov muaj txiaj ntsig zoo yog vim muaj qhov txo qis ntawm cov feeb ntawm cov ntshav ncig. Ntxiv rau, cov tshuaj nquag ua haujlwm ntawm cov tshuaj stimulates peripheral hlab ntsha, lub renin-angiotensin-aldosterone system raug txwv. Baroreceptors nyob rau hauv tus ntawm "Bisoprolol" ua ntau rhiab. Nrog rau kev kub siab, cov thawj cov nyhuv tuaj yeem pom ob peb hnub tom qab pib kev tswj hwm (tab sis tsis pub dhau tsib), thiab kev ruaj khov ntawm tus neeg mob tus mob tau pom ib lossis ob hlis tom qab pib kho.

Cov nyhuv uas tshem tawm cov teeb meem nyuaj rau ntawm lub siab tom qab mob caj pas kuj tseem paub tseeb los ntawm kev txheeb xyuas ntawm Bisoprolol. Raws li cov chaw tsim khoom piav qhia, qhov kev ua haujlwm tau lees paub los ntawm qhov tseeb tias nyob rau hauv kev cuam tshuam ntawm cov nquag muaj txheej txheem myocardium tau txais qhov tsim nyog ntawm cov pa oxygen, txij li lub plawv txo, diastole ntev dua, myocardial perfusion zoo dua. Diastolic siab nce, cov leeg nqaij hauv cov hlab ntsha ntawm lub plawv zoo dua ncab.

"Bisoprolol" rau arrhythmias: qhov ua pov thawj ua haujlwm

Txheeb xyuas cov lus pov thawj ntawm "Bisoprolol", ib qho tsis tuaj yeem tsis pom txog qhov tsis ua haujlwm.Cov hauj lwm zoo ntawm kev noj tshuaj nyob rau hauv cov neeg mob uas muaj qhov tsis txaus ntseeg no tau ua kom paub tseeb vim yog kev txwv tsis pub cuam tshuam ntawm cov xwm txheej uas ua rau lub xeev raug mob. Spontaneous arousal yuav luag ua tsis tau.

Cov tshuaj sawv tawm tsam ntawm keeb kwm ntawm cov tsis xaiv tshuaj beta-adrenergic thaiv cov tshuaj, vim tias cov kev phiv ntawm Bisoprolol rau lwm yam kabmob muaj ntau dua nrog kev ntsuas tshuaj nruab nrab. Ua ntej tshaj, qhov no siv rau cov kab ke uas muaj beta2-adrenergic receptors. Cov txiaj ntsig tsis zoo ntawm cov pa roj carbon thiab sodium metabolism kuj raug txo (tom kawg tsis ntau ntxiv hauv lub cev).

Qhov tshwm sim cuam tshuam ntawm "Bisoprolol"

Kev phiv tshuaj muaj tsawg tsawg (hauv ib ntawm ib puas tus neeg mob). Raws li hauv qab no los ntawm kev tshuaj xyuas cov tshuaj, cov neeg mob ntsib cov teeb meem zoo sib xws, ntawm qhov nruab nrab, kev ua siab ntev rau tshuaj yog qhov zoo. Nyob rau tib lub sijhawm, koj yuav tsum tau npaj kom txhij rau kev phiv thiab, thaum thawj qhov tshwm sim ntawm qhov mob nyhav, koj yuav tsum sab laj nrog koj tus kws kho mob tam sim ntawd.

Hauv qee tus neeg mob, thaum siv Bisoprolol, qaug zog nce, pw tsaug zog, tsis pom kev, thiab qhov muag pom tshwm. Tej zaum qhov kev loj hlob ntawm qhov ntswg bradycardia, txo qis siab. Tus neeg nquag, koj tuaj yeem hnov ​​cov lus tsis txaus siab txog qhov dryness ntawm qhov ncauj ntawm qhov ncauj thiab teeb meem nrog quav. Yog tias cov tshuaj siv rau hauv cov tshuaj loj heev, muaj qhov phom sij ntawm txoj kev ua pa nyuaj. Nrog rau cov ntshav qab zib, qhov ntxim nyiam ntawm hyperglycemia, hypoglycemia (nyob ntawm seb hom mob) nce. Tsis tshua muaj, muaj kev tsis haum tshuaj yog pom, muaj tsos ntawm urticaria lossis tawv nqaij khaus, qhov zoo li pob khaus yog ua tau. Thaum siv cov khoom lag luam thaum cev xeeb tub, muaj qhov pheej muaj qhov mob tshwm sim qeeb ntawm kev yug menyuam. Muaj qee kis, qhov mob ntsig txog kev thim rov qab mob tau kuaj pom thaum, ntawm qhov kawg ntawm txoj kev kho mob, mob angina pectoris zuj zus. Tsis tas li ntawd nyob rau hauv tsawg zaus, ib tug txo nyob rau hauv potency tau sau tseg.

Daim ntawv thov kev tshwj xeeb

Thaum xaiv "Bisoprolol" nws yog qhov yuav tsum tau soj ntsuam kom tsis tu ncua ntawm tus neeg mob. Nws yog ib qho tseem ceeb los teev cia lub plawv dhia, siab. Thaum pib ntawm kev siv "Bisoprolol", cov ntsuas tau kuaj txhua txhua hnub, nrog kev zam zoo, tus neeg mob tuaj yeem saib xyuas txhua 3-4 lub hlis. Nws raug nquahu kom tsis tu ncua mus rau ECG, nrog kev kuaj mob ntshav qab zib, pub ntshav rau cov piam thaj tsawg kawg ib zaug txhua 4 lub hlis. Thaum siv Bisoprolol txoj kev kho nyob rau hauv lub hnub nyoog laus, nws raug nquahu kom soj ntsuam lub raum kev ua haujlwm, kev txheeb xyuas qhov tseeb yog muab peb zaug ib xyoos. Yog tias cov tshuaj siv los kho lub plawv tsis ua hauj lwm nrog kev pib ntawm 1.25 mg, lub cev yuav tsum noj rau thawj plaub teev. Cov chaw tsim khoom lag luam pom zoo soj ntsuam lub siab, lub plawv dhia, thiab coj kev nyeem ntawv ECG.

Txog kev tswj hwm nws tus mob muaj txiaj ntsig zoo, tus neeg mob kho nrog Bisoprolol yuav tsum tuaj yeem xam lub plawv dhia los ntawm nws tus kheej. Yog tias tus nqi tsawg dua 50 rab koob hauv ib feeb, koj yuav tsum tau sab laj nrog koj tus kws kho mob tam sim ntawd.

Dab tsi ntxiv rau saib?

Txawm hais tias kev qhia ntawm "Bisoprolol", qee qhov mob nrog angina pectoris, qhov kev kho mob tsis muaj qhov ua tau zoo. Qhov no yog vim qhov tshwj xeeb ntawm tus kabmob: nws tau paub tias txhua yam tshuaj los ntawm pawg ntawm cov beta-blockers tsis muab txiaj ntsig rau kwv yees li txhua tus neeg mob thib tsib. Raws li txoj cai, qhov no yog vim mob rau cov hlab ntshav atherosclerosis, nyob rau hauv uas muaj qhov qis ischemic tsawg dua. Cov txiaj ntsig ntawm cov tshuaj txo qis dua yog tias ib tus neeg haus luam yeeb ntev, nrog rau qhov uas ua rau cov ntshav khiav tsis zoo.

Ua ntej sau ntawv rau Bisoprolol, tus kws kho mob kuaj xyuas lub luag haujlwm ntawm kev ua pa sab nraud rau hauv cov neeg mob uas muaj keeb kwm ntawm lub ntsws bronchopulmonary. Yog hais tias tus neeg mob siv lub khob tsom qhov muag, nws yuav tsum nco ntsoov tias kev siv "Bisoprolol" hauv qee qhov teeb meem ua rau muaj kev txo qis ntawm cov kua zais ntawm lacrimal. Nrog tsim pheochromocytoma, muaj qhov ntxim nyiam ntawm daim ntawv tshwj xeeb ntawm kev kub siab, yog tias nws tsis muaj peev xwm ua tiav qhov tshwm sim alpha-adrenoblock. Thaum xaiv Bisoprolol rau kev kho mob ntawm cov neeg mob uas thyrotoxicosis, nws yuav tsum nco ntsoov tias cov tshuaj tsis tuaj yeem tshem tawm sai sai.

Sib xyaw nrog lwm yam tshuaj

Nws tau paub tias kev sib raug zoo ntawm Bisoprolol thiab cov neeg sawv cev uas muaj cov clonidine tso cai siv cov tshuaj no tib lub sijhawm, tab sis nws tsis tuaj yeem lees tshem ob yam tshuaj tib lub sijhawm. Ua ntej tshaj plaws noj ib qho tshuaj, thiab tom qab ob peb hnub - zaum ob. Nrog rau kev siv tshuaj, nyob rau hauv txoj hauv kev uas qhov ntim ntawm catecholamines yuav txo qis, qhov ua tau zoo ntawm beta-blockers tuaj yeem nce ntxiv. Nws yog qhov yuav tsum tau qhia rau tus kws kho mob txog txhua yam tshuaj kho mob los ntawm lwm tus kws tshaj lij. Tus kws kho mob yuav tsum ua ntu zus los saib xyuas tus neeg mob lub sijhawm, txwv tsis pub lub siab luv ntawm kev ua kom siab, bradycardia nce.

Cov cuab yeej tuaj yeem siv rau mob ntshav qab zib. Cov tshuaj tsis cuam tshuam rau hypoglycemia nyob rau hauv Feem ntau, tab sis nrog kev txhim kho ntawm tachycardia provoked los ntawm cov ntsiab lus no, kev siv "Bisoprolol" tuaj yeem npog cov tsos mob tshwm sim. Cov tshuaj hauv cov lus nug tsis cuam tshuam rau kev rov qab ua kom ntshav qab zib hauv cov ntshav mus rau qib ib txwm.

Xyuas: cov neeg mob hais li cas?

Hauv Is Taws Nem muaj cov lus teb zoo tshaj plaws txog Bisoprolol. Cov tshuaj yog qhov pheej yig thiab pab tswj kev mob ntawm tus neeg mob tab txawm tias muaj mob hnyav, yog tias siv los ntawm tus kws kho mob koom nrog thiab nrog soj ntsuam tus mob kom zoo. Feem ntau cov lus teb tsis zoo yog tshwm sim los ntawm kev tswj hwm tus kheej ntawm cov tshuaj tsis muaj kev pab los ntawm cov kws tshaj lij, lossis los ntawm kev tsis txaus siab rau lub cev txuam nrog tus neeg tus yam ntxwv. Tsis tas li, qee cov neeg mob tau sau tseg txog qhov nyuaj ntawm kev sib txuas ntawm cov tshuaj sib txuam ntawm Bisoprolol nrog cov tshuaj uas muaj nyob hauv lwm cov tshuaj. Qhov kev sib cuam tshuam no ua rau nws yuav tsum tau siv cov tshuaj tsuas yog tias muaj lus pom zoo los ntawm cov kws kho mob uas tuaj kawm paub txog cov tshuaj twg uas nws tus neeg mob tau noj.

Nyob rau tib lub sijhawm, muaj kev txheeb xyuas txog Bisoprolol, uas tau hais tias cov tshuaj no ua tsis muaj txiaj ntsig hauv ib kis tshwj xeeb. Raws li lub tuam txhab kev tsim ntawv cim tseg, qhov no ua tau nyob rau hauv txhua tsib qhov xwm txheej thiab yog vim muaj lwm yam teeb meem kev noj qab haus huv lossis tus yam ntxwv. Koj yuav tsum npaj kom zoo rau cov xwm txheej zoo li no.

Lisinopril thiab metoprolol yog ob qho tshuaj uas kho ntshav siab. Qhov sib txawv tseem ceeb ntawm lisinopril thiab metoprolol yog tias lisinopril yog ib qho angiotensin hloov enzyme (ACE) inhibitor, thaum metoprolol yog beta blocker. Vim tias lawv muaj ob yam tshuaj sib txawv, lisinopril thiab metoprolol pab tswj cov ntshav siab nyob rau ntau txoj hau kev. Lwm qhov sib txawv ntawm lisinopril thiab metoprolol suav nrog ntau npaum li cas, kev kho mob ntxiv uas lawv tau kho, thiab kev txhawj xeeb txog kev nyab xeeb rau cov poj niam cev xeeb tub lossis lactating.
Ntshav siab yog qhov mob uas ua rau lub plawv tso ntshav tawm nrog lub zog ntau dhau los ntawm cov hlab ntsha. Qhov ACE inhibitor txo qis ntshav siab, tiv thaiv qhov tsim ntawm ib yam mob hu ua angiotensin II hauv lub cev. Angiotensin II ua rau lub siab ua haujlwm thiab ua rau cov ntshav siab vim nws txwv cov hlab ntsha. Ntawm qhov beta blocker, ntawm qhov kev txiav txim siab, txo qis ntshav siab los ntawm qhov thaiv cov teebmeem uas adrenaline muaj rau lub cev. Los ntawm kev thaiv cov adrenaline, cov beta blocker tso cai rau lub siab ntaus ntawm tus nqi qeeb thiab tsis tshua muaj zog.

Lisinopril yog muab rau hauv cov ntsiav tshuaj sau, thiab cov tshuaj niaj zaus yuav tsum noj ib zaug ib hnub. Ntxiv rau cov ntshav siab, lisinopril kuj tseem ceeb rau kev kho mob plawv tsis ua hauj lwm zoo, suav nrog lwm cov tshuaj. Metoprolol kuj tseem tuaj txog hauv cov ntsiav tshuaj, nrog rau cov ntsiav tshuaj tso tawm ntev dua, cov tshuaj ib txwm ua rau cov ntsiav tshuaj ib zaug lossis ob zaug ib hnub, thiab ncua kev tso tshuaj ntsiav ib hnub ib zaug. Kev siv tshuaj txuas ntxiv yog xav kom tso tawm cov tshuaj maj mam tso rau hauv lub cev ntev mus, yog li cov tshuaj nyob rau hauv lub cev ntev dua.Tsis zoo li lisinopril, metoprolol yuav tsum nrog lossis ua raws cov zaub mov. Lwm yam mob uas pab metoprolol suav nrog mob hauv siab, mob plawv tsis ua hauj lwm, thiab lub plawv dhia tsis xwm yeem.

Cov pojniam cev xeeb tub lossis lactating yuav tsum tsis txhob siv lisinopril. Hauv cov poj niam cev xeeb tub, lisinopril tuaj yeem ua rau muaj kev xeeb me nyuam hauv cov menyuam. Kuj tsis paub meej tias lisinopril puas muaj nyob hauv leej niam cov kua mis, tab sis vim tias cov poj niam cev xeeb tub yuav tsum tsis txhob noj tshuaj, nws yog ib qho kev pom zoo uas cov poj niam laus tsis txhob noj cov tshuaj no. Txog metoprolol, poj niam cev xeeb tub lossis pub niam mis rau menyuam noj yuav tsum noj tshuaj yog tias lawv tus kws kho mob pom zoo. Nws yuav vam khom lawv tus mob, thiab yog tias nws yuav muaj txiaj ntsig zoo rau leej niam. Qhov no vim nws tsis paub meej tias metoprolol puas muaj qhov tsis zoo rau tus menyuam yaus hauv plab.

Cov poj niam yuav tsum tsis txhob siv lisinopril thaum pub niam mis.

Tus poj niam cev xeeb tub yuav tsum sab laj nrog nws tus kws kho mob yug menyuam ua ntej noj cov tshuaj metoprolol lossis lwm yam tshuaj.

Lisinopril yog ib yam tshuaj uas thaiv qee cov enzymes hauv lub cev uas ua lub luag haujlwm kom txoj hlab ntshav nqaim.

Hauv kev soj ntsuam mob tiag tiag, beta-blockers (BAB) yog ib qho tshuaj uas feem ntau siv hauv kev kho mob plawv (CVD). Cov teeb meem xaiv BAB tseem muaj feem xyuam.

Nws paub tias beta-1-xaiv ABs zoo dua rau cov tsis muaj kev xaiv: lawv nce peripheral vascular tsis kam, txo qhov mob ntawm cov vasoconstrictor teb rau catecholamines thiab, yog li ntawd, muaj txiaj ntsig zoo dua rau cov neeg haus luam yeeb, tsawg dua ua rau hypoglycemia hauv cov neeg mob ntshav qab zib mellitus (DM), tsawg dua ua rau kom muaj kev tshem tawm cov leeg mob. Beta-1-xaiv AB tuaj yeem siv rau hauv cov neeg mob uas muaj kev mob ntsws, los ntawm kev hloov qis qis dua qhov kev hloov kho lipid cov ntshav.

Bisoprolol (Bidop) yog ib qho ntawm kev ua tau zoo tshaj plaws BAB. Qhov kev cuam tshuam ntawm bisoprolol rau beta-1-adrenergic receptors yog 75 npaug ntau dua rau beta-2-adrenergic receptors. Hauv cov txheej txheem ib txwm muaj, cov tshuaj muaj yuav luag tsis muaj qhov cuam tshuam ntawm beta-2-adrenergic receptors thiab yog li yog li tsis muaj ntau yam kev cuam tshuam tsis zoo. Bisoprolol hauv kev kho mob ntau npaum li cas (2.5-10.0 mg / hnub) tsis ua rau mob bronchospasm thiab tsis cuam tshuam txoj hlab ntsws ua haujlwm rau cov neeg uas muaj mob txhaws mob ntsws (COPD). Ntxiv rau, bisoprolol tsis cuam tshuam rau lub raum kev ua haujlwm thiab mob ntshav ntawm lub plab, tsis cuam tshuam txog cov khoom noj carbohydrate, thiab tsis nce ntshav plasma cholesterol thiab lipoproteins.

Cov khoom no txiav txim siab siv bisoprolol ntau yam CVDs, feem ntau hauv txoj hlab ntshav siab (AH) thiab mob plawv (CHD).

Cov txiaj ntsig ntawm Bisoprolol hauv kev kub siab

Cov cim tseem ceeb rau kev siv BAB rau cov neeg mob ntshav siab yog: mob plawv, keeb kwm ntawm myocardial infarction, mob plawv tsis ua hauj lwm (CHF), tachyarrhythmia, glaucoma.

Bisoprolol tsis yog qhov qis dua rau lwm BAB hauv kev ua haujlwm tiv thaiv kev tsis txaus siab thiab dhau lawv nyob hauv ntau qhov ntsuas. Ob qhov muag dig, randomized BISOMET txoj kev tshawb nrhiav pom tias bisoprolol, zoo li metoprolol, txo qis ntshav siab (BP) thaum so, tab sis tseem ceeb tshaj metoprolol nyob rau hauv cov nqe lus ntawm nws cov nyhuv systolic ntshav siab thiab lub plawv dhia (HR) thaum lub sijhawm ua exercise. Cov lus tshaj tawm ntawm bisoprolol hauv cov neeg mob coj kev ua lub neej zoo, txhawb kev muab tshuaj rau cov neeg hluas uas muaj ntshav siab.

Hauv qhov no, nws tsim nyog nco qab cov tswvyim hais ua dabneeg hais txog cawv ntawm BAB rau kev ua haujlwm erectile. Feem ntau, noj BAB yog txuam nrog kev muaj peev xwm ntawm kev sib deev tsis txaus ntseeg. Nrog kev hwm txog bisoprolol, qhov tsis muaj qhov tsis zoo ntawm kev ua haujlwm ntawm kev sib deev hauv cov txiv neej tau raug pov thawj pom tseeb. Cov cuab yeej no ntawm bisoprolol nce ntxiv kev ua raws li kev kho mob ntawm cov txiv neej hluas txiv neej uas pib mob ntshav siab hauv xyoo kev ua haujlwm hauv lub neej. Hauv kev kawm txog L. M. Prisant li al.Nws tau pom tias qhov ntau zaus ntawm kev sib daj sib deev nrog bisoprolol tsis txawv ntawm qhov ntawd nrog placebo.

Thaum piv bisoprolol nrog calcium antagonists (nifedipine) thiab angiotensin hloov enzyme inhibitors (ACE inhibitors) (enalapril), nws tau muab tawm tias nws tsis muaj tsawg dua antihypertensive kev ua si. Ntxiv mus, nyob rau hauv kev sib piv ntawm kev tshawb nrhiav, bisoprolol (10-20 mg / hnub) ua rau muaj qhov txo qis ntawm sab laug ventricular myocardial loj index (LVML) los ntawm 11%, uas zoo ib yam rau ACE inhibitor nyhuv (enalapril, 20-40 mg / hnub).

Lwm qhov kev tshawb nrhiav tau soj ntsuam qhov ua tau zoo ntawm bisoprolol hauv koob tshuaj 5-10 mg rau cov neeg mob ntshav siab thiab sab laug ventricular myocardial hypertrophy (LVH). Tom qab 6 lub hlis, MMVL qhov ntsuas qis tau poob qis los ntawm 14.6%, qhov tuab ntawm myocardium ntawm lub posterior phab ntsa ntawm sab laug ventricle (LV) thiab interventricular septum los ntawm 8% thiab 9%, feem, thiab qhov ntim ntawm cov kab noj hniav thiab cov feem ntawm lub cev tsis sib hloov ntawm LV tsis hloov. Nyob rau tib lub sijhawm, qhov regression ntawm LV hypertrophy tsis tuaj yeem piav qhia los ntawm kev ua haujlwm hypotensive ib leeg; hauv 5 cov neeg mob uas tsis ncav cov nuj nqis ntshav siab, qhov txo qis ntawm LVM index kuj tseem raug sau tseg.

Kev soj ntsuam ntawm cov yam ntxwv organoprotective, suav nrog cov nyhuv ntawm ntau yam tshuaj tiv thaiv kev tiv thaiv ntawm txoj kev txhav ntawm phab ntsa arterial, tam sim no yog qhov kev kawm ntawm kev kawm thiab sib tham. Muab cov kev tshawb pom ntawm cov cim tshiab ntawm cov kab mob plawv, peb nthuav qhia cov ntaub ntawv ntawm cov nyhuv ntawm bisoprolol ntawm lub hauv siab, cov mem tes siab, thiab nruj ntawm cov vascular phab ntsa. Lub nruj ntawm lub vascular phab ntsa yog ib qho tseem ceeb ntawm kev txiav txim siab cov ntshav plawv ntshav. Ob leeg vascular phab ntsa txhav thiab cov mem tes siab yog ze ze rau cov kev xaus xws li lub plawv kev tuag, myocardial infarction, thiab mob stroke. Ib qho kev sib raug zoo dua ntawm lub plawv kev pheej hmoo yog nruab nrab, lossis aortic, mem tes ntshav siab.

Bisoprolol ntawm kev noj tshuaj ntawm 10 mg rau cov neeg mob ntshav siab tau ua rau muaj qhov txo qis ntawm cov mem tes yoj voos nrawm dua, nrog rau kev txhim kho qhov elasticity ntawm cov leeg ntshav caj npab.

ADLIB txoj kev tshawb fawb tau soj ntsuam qhov tshwm sim ntawm ntau cov chav kawm ntawm cov tshuaj tiv thaiv kabmob (amlodipine 5 mg, doxazosin 4 mg, lisinopril 10 mg, bisoprolol 5 mg thiab bendroflumethiazide 2.5 mg) ntawm vascular phab ntsa txhav qhov muag taw qhia - nruab nrab siab, ntsuas yoj thiab augmentation index. Cov ntsiab lus nrov tshaj plaws nyob rau hauv cov ntshav siab hauv cov ntshav ntawm cov nqaij ntshiv brachial yog tshwm sim los ntawm lisinopril thiab bisoprolol. Bisoprolol nrog rau lisinopril thiab amlodipine txo cov ntshav siab. Nyob rau tib lub sijhawm, bisoprolol muaj qhov sib txawv ntawm cov txiaj ntsig augmentation index thiab yoj rov qab yoj: qhov augmentation Performance index tau siab dua nrog lwm cov tshuaj, thiab cov tshuaj yoj nthwv dej tau siab tshaj plaws thaum kho bisoprolol.

Peb tsis tuaj yeem nres ntawm kev kho mob los ntawm kev mob ntshav siab hauv cov neeg mob rog. AH kuaj tau rau 88% ntawm cov neeg mob lub plab ua rog rog.

Dua li ntawm qhov tseeb tias BAB yog rau cov chav kawm tseem ceeb ntawm cov tshuaj hauv kev kho kev mob ntshav siab, kev rog rog thiab mob ntshav qab zib tsis ua lub hom phiaj tseem ceeb rau lawv kev tswj hwm, txawm hais tias kev siv BAB nyob rau hauv cov neeg mob rog muaj qhov ua rau pathogenetic, muab lub luag haujlwm tseem ceeb ntawm kev ua haujlwm ntawm lub cev tsis txaus siab hauv kev txhim kho ntshav siab hauv kev rog.

Kev ntshai los ntawm kev muab tshuaj BAB rau tus neeg mob uas muaj tus mob metabolic yog vim kev ntshai tsam ntshav qab zib ntau zuj zus. BAB muaj qhov sib txawv prodiabetogenic. Yog li, thaum noj bisoprolol thiab nebivolol rau cov neeg mob ntshav siab thiab ntshav qab zib, tsis muaj kev hloov pauv hauv cov ntshav ntshav, thaum kho nrog atenolol ua rau muaj kev nce siab hauv nws qib. Nws tau pom tias bisoprolol tsis hloov pauv cov ntshav qabzib hauv cov neeg mob ntshav qab zib, thiab kev hloov kho tshuaj hypoglycemic yog tsis tas yuav tsum tau ua, uas qhia tau tias nws qhov kev txiav txim siab tsis txaus.

Cov kev tshawb fawb txog cov neeg mob ntshav qab zib ua nrog bisoprolol tau qhia tias, vim nws qhov kev xaiv ntau dhau los, cov tshuaj tsis cuam tshuam loj rau cov carbohydrate thiab lipid metabolism thiab tuaj yeem siv rau hauv cov neeg mob ntshav qab zib.

Ib qho khoom muaj txiaj ntsig zoo ntawm bisoprolol rau kev tswj hwm rau cov neeg mob rog rog nrog ntshav siab yog nws lub peev xwm yaj tag nrho hauv cov rog thiab hauv dej (amphiphilicity). Bisoprolol vim yog amphiphilic lub zog yog 50% biotransformed hauv daim siab, qhov seem yog tawm los ntawm lub raum tsis hloov. Raws li pom muaj ntau zaus hauv cov neeg mob uas muaj lub siab lub cev "kev nyuaj siab" hauv daim ntawv ntawm lub siab tsis rog cawv lub siab, kev siv bisoprolol yog tsim nyog rau kev kho mob ntshav siab hauv pawg neeg mob no. Amphiphilicity ua rau kom muaj kev sib txig sib luag ntawm bisoprolol, uas piav qhia qhov muaj peev xwm tsawg ntawm nws cov kev cuam tshuam nrog lwm cov tshuaj thiab muaj kev nyab xeeb ntau dua thaum siv hauv cov neeg mob uas muaj mob me lossis mob raum.

Cov kev coj ua thiab qhov muaj COPD thiab CVD hauv ib tus neeg mob tib lub sijhawm ua rau nws tsim nyog ua tib zoo xaiv BAB. Nws tau pom tias kev tswj hwm ntawm BAB rau cov neeg mob COPD uas muaj myocardial infarction txo txoj kev pheej hmoo ntawm kev tuag los ntawm 40% (piv nrog pab pawg neeg zoo sib xws uas tsis muaj BAB). Raws li S. Chatterjece, nyob rau hauv cov neeg mob bronchial hawb pob, kev hloov pauv ntawm bronchial patency nrog 10 thiab 20 mg ntawm bisoprolol tsis tshua muaj qhov txawv ntawm cov uas muaj cov placebo.

Cardioselective BAB bisoprolol nyob rau hauv cov neeg mob CVD thiab concomitant COPD tsis ua rau muaj kev cuam tshuam zoo rau bronchial patency thiab txhim kho lub neej zoo ntawm cov neeg mob, thaum xaiv tsawg dua atenolol thiab metoprolol tsis zoo txog kev ua pa rau lub cev ntawm cov neeg mob no.

Kev siv bisoprolol nyob rau hauv ntau yam mob ntawm ischemic mob plawv

Cov lus pom zoo hauv tsev rau kev kuaj mob thiab kev kho mob rau cov mob plawv ua rau xav txog BAB yog thawj cov tshuaj rau kev kho mob ntawm ntau yam mob ntawm cov hlab ntsha txhaws, suav nrog ua lub luag haujlwm tseem ceeb ntawm kev kho mob rau cov neeg mob uas muaj keeb kwm ntawm myocardial infarction thiab mob plawv tsis ua haujlwm ntev. Nws yog nyob rau hauv cov kev kuaj mob no uas BABs tuaj yeem txhim kho qhov kwv yees ntawm cov neeg mob.

Antianginal cov khoom muaj peev xwm tso cai sau bisoprolol rau kev tiv thaiv ntawm cov mob angular rau cov neeg mob uas mob angina pectoris ruaj khov. Hauv qhov chaw kuaj mob ua haujlwm ntau TIBBS (Kev Kawm Tag Nrho Ischemic Burden Bisoprolol Txoj Kev Tshawb Fawb), nws tau pom tias bisoprolol tshem tawm zoo ntu ntawm kev hloov pauv myocardial ischemia rau cov neeg mob uas muaj lub siab angina thiab ua rau lub plawv hloov pauv. Txoj kev tshawb no tseem qhia txog cov ntxim rau kev txhim kho cov kev ntsuas ntawm tus mob plawv nrog bisoprolol. Nws tau raug pov thawj tias qhov ntau zaus ntawm cov kev mob plawv ntshav nrog kev kho bisoprolol yog qhov qis dua nrog nifedipine thiab placebo.

Nws kuj tau pom tias hais txog kev ua haujlwm antianginal, bisoprolol yog piv rau atenolol, betaxolol, verapamil thiab amlodipine. Lwm cov kev tshawb fawb pom tau tias bisoprolol tiv thaiv zoo dua qhov tshwm sim ntawm angular tawm tsam thiab ua rau muaj kev ntxhov siab ntau ntxiv dua li isosorbide dinitrate (siv raws li kev kho mob monotherapy) thiab nifedipine. Hauv cov neeg mob uas muaj angina ruaj khov, bisoprolol tuaj yeem siv ua ke nrog lwm cov kab mob antianginal (tshwj xeeb, nrog nitrates thiab calcium antagonists).

Nws tau pom tias bisoprolol ua rau txo qis kev pheej hmoo ntawm myocardial infarction thiab lub plawv kev tuag ntawm cov neeg mob raug phais ntawm cov hlab ntsha loj. Raws li txhais tau tias ntawm kev tiv thaiv theem nrab ntawm myocardial infarction, kev siv bisoprolol hauv cov neeg mob ruaj khov uas tau muaj myocardial infarction (pib ntawm 5-7 hnub ntawm kev mob) yog qhov tsim nyog.

Kev xaiv ntawm bisoprolol

Muab cov tshuaj ntau ntawm cov khw muag khoom hauv Lavxias thiab xav tau cov kev xaiv uas tsim nyog, qhov teeb meem ntawm kev sib hloov ntawm cov tshuaj qub rau cov tshuaj feem ntau rau cov laj thawj nyiaj txiag muaj feem cuam tshuam. Qhov kev txwv qhov tseem ceeb hauv kev siv dav dav ntawm cov tshuaj qub yog lawv cov nqi siab. Ntawm qhov tod tes, qhov tseeb ntawm cov txiaj ntsig zoo ntawm cov tshuaj qub yog qhov paub zoo. Thaum xaiv cov tshuaj feem ntau, nws yog ib qho tsim nyog yuav tsum muaj cov ntaub ntawv hais txog kev kho kom zoo sib xws ntawm thawj cov tshuaj.Los ua pov thawj kho kev sib npaug, kev tshawb fawb ntawm cov tshuaj ib txwm muaj nrog kev sib piv soj ntsuam nrog cov tshuaj qub thiaj li kawm nws qhov ua tau zoo thiab kev nyab xeeb.

Peb yuav nyob hauv kev qhia ntxiv ntawm cov ntaub ntawv ntawm kev tshawb fawb soj ntsuam koom nrog cov neeg mob Lavxias uas mob ntshav siab thiab mob plawv raws li kev ua haujlwm ntawm cov tshuaj Bidop (bisoprolol).

Hauv 2012, K.V. Protasov li al. Cov chaw soj ntsuam kev ua tau zoo thiab kev nyab xeeb ntawm cov thawj thiab cov kev npaj bisoprolol npaj rau cov neeg mob ntshav siab thiab cov neeg mob taub hau tsis tshua zoo sib piv. Peb tau kuaj mob 30 tus neeg mob siab txog AH ntawm 1-2 qib (lub hnub nyoog nruab nrab - 47 xyoo). Cov neeg mob tau randomized rau cov thawj bisoprolol thiab Bidop pawg, uas tau raug txiav txim ntawm kev pib siv 5 mg / hnub. Tom qab 6 lub hlis ntawm kev kho mob thiab 2 lub lim tiam ntawm lub sijhawm ntxuav, cov tshuaj tau hloov nrog lwm txoj haujlwm, tom qab ntawd cov kev kho mob txuas ntxiv mus txog 6 lub lis piam. Cov qauv tshawb nrhiav tau nthuav tawm hauv Daim Duab.

Thaum pib, thaum lub sijhawm 2 thiab 6 lub lim tiam ntawm kev kho, ntshav siab, lub plawv dhia, qhov tsis xav tau sab raug kaw, thiab cov txiaj ntsig ntawm kev ntsuas tus kheej ntsuas ntshav siab (SCAD) tau raug txheeb xyuas. Ntawm qhov pib thiab ntawm 6 lub lim tiam, kev soj ntsuam ntshav txhua hnub (BPM) tau ua tiav. Thaum 6 lub lim tiam ntawm kev kho mob, chaw ua haujlwm cov ntshav siab poob qis hauv thawj pawg bisoprolol los ntawm 23.0 / 10.5 hli Hg. Art., Nyob hauv pawg pab pawg - los ntawm 21.2 / 10.0 hli RT. Kos duab., Qhov sib txawv ntawm pawg tsis sib haum. Hom phiaj ntshav siab (Metoprolol: cov lus qhia rau kev siv

Pharmacological kev txiav txim	Xaiv beta1-blocker. Nws txo cov nyhuv stimulating uas adrenaline thiab lwm cov tshuaj hormones catecholamine muaj ntawm kev ua haujlwm hauv lub plawv. Yog li, cov tshuaj tiv thaiv kev nce siab hauv lub plawv, feeb ntau thiab nce daim ntawv cog lus ntawm lub siab. Nrog rau kev ntxhov siab thiab kev tawm dag zog ntawm lub cev, ib qho kev tso tawm sai sai ntawm cov catecholamines tshwm sim, tab sis ntshav siab tsis nce ntau.
Cov Tshuaj Pharmacokinetics	Metoprolol nrawm thiab nrawm. Txais tos tib lub sijhawm cov zaub mov tuaj yeem nce nws txoj kev lom zem los ntawm 30-40%. Cov ntsiav tshuaj uas ua haujlwm ntev ntev muaj cov tshuaj microgranules los ntawm qhov uas cov tshuaj nquag, metoprolol succinate, maj mam tso tawm. Kev ua rau kev kho mob ntev tshaj li 24 teev. Cov ntsiav tshuaj ceev ceev metoprolol tartrate tsum ua yeeb yam tsis pub dhau 10-12 teev. Cov tshuaj no ua rau cov kab mob oxidative metabolism hauv lub siab, tab sis kwv yees li 95% ntawm kev siv tshuaj yog raug tso tawm los ntawm lub raum.
Kev ntsuas rau siv	leeg ntshav siab angina pectoris lub siab ua kom lub plawv tsis ua haujlwm sai nrog cov chaw kuaj mob (IIHA - IV cov chav haujlwm ua haujlwm raws li NYHA kev faib tawm) thiab lub luag haujlwm tsis ua haujlwm ntawm sab laug ventricle ua cov tshuaj kho rau cov kev kho mob tseem ceeb, txo qis kev tuag thiab kev rov mob plawv tom qab mob theem myocardial infarction, lub siab ua kom muaj kev ntxhov siab, suav nrog tachycardia supraventricular, qhov txo qis ntawm zaus ntawm ventricular contraction thaum atrial fibrillation thiab ventricular extrasystoles, kev ua haujlwm ntawm lub plawv tsis ua hauj lwm, nrog los ntawm tachycardia, kev tiv thaiv ntawm mob taub hau tuaj.

Tseem Ceeb! Lub plawv tsis ua hauj lwm, qhov txo qis kev tuag thiab qhov rov ua mob plawv dua yog qhia tsuas yog rau cov metoprolol succinate, ua cov ntsiav tshuaj tawm mus ntev. Kev siv tshuaj metoprolol ua kom sai li sai tau rau lub plawv tsis ua hauj lwm thiab tom qab lub plawv nres yuav tsum tsis txhob kho.

Kuj tseem muaj ib qhov vis dis aus hais txog kev kho mob plawv thiab mob angina pectoris

Tsuas tshuaj	Nyeem ntxiv txog ntau npaum li cas ntawm metoprolol succinate thiab tartrate hauv cov neeg mob ntshav siab, mob taub hau ntawm lub plawv, mob plawv tsis ua hauj lwm - nyeem ntawm no. Cov ntsiav tshuaj tuaj yeem muab faib ua ib nrab, tab sis tsis tuaj yeem ntxo lossis zom. Nws tuaj yeem noj nrog zaub mov lossis hauv plab khoob, yooj yim. Cov koob tshuaj yuav tsum tau xaiv ib tus zuj zus rau txhua tus neeg mob thiab nce qeeb qeeb thiaj li tias bradycardia tsis loj hlob - cov mem tes yog qis dua 45-55 neeg ntaus ib feeb.
Sab sij huam	Cov kev mob tshwm sim: bradycardia - cov mem tes poob rau 45-55 neeg ntaus ib feeb, orthostatic hypotension, limb txias txog siav siav uas siv dag zog, qaug zog, mob taub hau, kiv taub hau, tsaug zog lossis pw tsaug zog, npau suav phem, xeev siab, mob plab, cem quav lossis zawv plab, Tsis tshua muaj: o ntawm ob txhais ceg mob lub plawv kev nyuaj siab lossis ntxhov siab, daim tawv nqaij ua pob bronchospasm pom qhov muag tsis zoo, dryness lossis voos ntawm lub qhov muag, hnyav. Rau qee yam kev phiv uas tsis tshua pom muaj lossis mob hnyav, sab laj nrog kws kho mob tam sim ntawd!
Cov Yuav Tsum Muaj	cov tshuaj tiv thaiv tsis haum rau metoprolol, ua xua rau beta-blockers lossis ntu ntawm cov ntsiav tshuaj, xav tias tsam myocardial infarction, hnub nyoog txog 18 xyoo (qhov ua tau zoo thiab kev nyab xeeb tsis tau tsim tsa), ntau cov hlab plawv contraindications (sib tham nrog koj tus kws kho mob!).
Cev xeeb tub thiab pub niam mis	Kev siv cov ntsiav tshuaj sai lossis "qeeb" metoprolol thaum cev xeeb tub yog ua tau yog tias muaj txiaj ntsig rau leej niam tshaj qhov ua rau muaj kev pheej hmoo rau menyuam hauv plab. Zoo ib yam li lwm cov beta-blockers, metoprolol tuaj yeem ua rau cov kev mob tshwm sim - bradycardia hauv tus me nyuam hauv plab lossis menyuam mos. Ib qho me me ntawm cov tshuaj tau tawm hauv niam cov kua mis. Thaum sau ntawv yuav siv cov tshuaj nruab nrab, qhov kev pheej hmoo ntawm kev phiv rau tus menyuam yog tsis siab. Txawm li cas los xij, ib qho yuav tsum ua tib zoo saib xyuas qhov tshwm sim muaj tshwm sim ntawm cov paib-adrenoreceptor blockade hauv menyuam yaus.
Yeeb tshuaj sib cuam tshuam	Nonsteroidal anti-inflammatory tshuaj tsis muaj zog tiv thaiv cov nyhuv ntawm metoprolol hauv kev txo cov ntshav siab. Lwm yam tshuaj rau kev kub siab - ntawm qhov tsis tooj, ntxiv dag zog rau nws. Tsis txhob noj cov tshuaj no tib lub sij hawm verapamil lossis diltiazem. Cov npe ntawm cov tshuaj sib cuam tshuam ntawm metoprolol tsis tiav. Qhia rau koj tus kws kho mob txog txhua yam tshuaj, tshuaj noj, thiab tshuaj ntsuab uas koj tau noj ua ntej koj tau noj tshuaj rau cov kab mob ntshav siab thiab mob plawv.
Noj ntau dhau	Cov tsos mob - lub plawv dhia qis thiab lwm yam teeb meem plawv. Tsis tas li, kev tsim txom ntawm lub ntsws tsis ua haujlwm, tsis nco qab zoo, muaj peev xwm tswj tsis tshee tshee, mob plab, nce hws, xeev siab, ntuav, hloov ntshav qab zib. Txoj kev kho yog, ua ntej txhua yam, noj cov tshuab hluav ncaig thiab ntxuav lub plab. Tom ntej no - resuscitation nyob rau hauv chav kho mob hnyav.
Daim ntawv tso tawm	25 mg, 50 mg, 100 mg, 200 mg zaj duab xis-cov ntsiav tshuaj.
Cov lus thiab cov xwm txheej ntawm kev cia	Khaws ntawm qhov kub tsis tshaj li 30 ° C, txee lub neej - 3 xyoos. Tsis txhob siv tom qab hnub tas sij hawm qhia ntawm pob.
Muaj pes tsawg leeg	Cov tshuaj phiv yog metoprolol succinate lossis tartrate. Cov muaj mob: methyl cellulose, glycerol, pob kws hmoov txhuv, ethyl cellulose, magnesium stearate. Cov hnab riam zaj duab xis: hypromellose, stearic acid, titanium dioxide (E171).

Yuav noj cov tshuaj metoprolol li cas

Ua ntej tshaj plaws, nco ntsoov tias koj yog kws kho tshuaj uas nws cov tshuaj muaj yees metoprolol succinate. Txog hnub tim, tsis muaj laj thawj siv cov ntsiav tshuaj uas tsis muaj lawm uas muaj cov tshuaj metoprolol tartrate. Lawv yuav tsum tau noj ob peb zaug hauv ib hnub, uas yog qhov tsis yooj yim rau cov neeg mob. Lawv ua rau mob ntshav siab. Nws ua mob rau cov hlab ntshav. Noj Betalok ZOK lossis Egilok C ntawm kev muab tshuaj uas tus kws kho mob qhia, thiab kom ntev npaum li kws kho mob pom zoo. Cov tshuaj no yuav tsum tau coj mus ntev - ntau xyoo, lossis tseem muaj sia nyob. Lawv yuav tsis haum rau tej qhov xwm txheej koj xav tau ceev nrawm los ntshav lossis txo qhov mob ntawm lub hauv siab.

Kuv yuav tau haus ntev npaum li cas metoprolol?

Metoprolol yuav tsum noj ntev npaum li kws kho mob hais. Mus ntsib koj tus kws kho mob tsis tu ncua txhawm rau soj qab xyuas thiab sab laj. Koj tuaj yeem tsis tuaj yeem cia siab rau tawg, tso tseg cov tshuaj lossis txo nws cov ntau npaum. Noj cov beta blocker thiab lwm yam tshuaj noj uas tau tsim rau koj ua lub neej noj qab nyob zoo. Nov yog kev kho mob siab rau kev kub siab thiab mob plawv. Yog tias koj tsis ua raws li cov lus pom zoo rau kev ua neej noj qab haus huv, tom qab ntawd ntev mus txawm tias cov ntsiav tshuaj uas kim tshaj plaws yuav nres pab.

Yuav noj cov tshuaj metoprolol li cas: ua ntej noj mov lossis tom qab?

Cov lus qhia raug cai tsis qhia txog yuav tsum noj metoprolol li cas - ua ntej noj mov lossis tom qab.Qhov sau ua lus Askiv lub chaw muaj ntaub ntawv (http://www.drugs.com/food-interactions/metoprolol,metoprolol-succinate-er.html) hais tias cov tshuaj muaj metoprolol succinate thiab ua kom tawv ncauj yuav tsum noj nrog zaub mov noj. Khoom noj khoom haus txhim kho cov nyhuv ntawm cov tshuaj, piv nrog kev yoo mov. Tshawb nrhiav seb kev noj haus cov zaub mov muaj piam thaj tsawg yog li cas thiab nws pab tau npaum li cas rau kev kub siab thiab kab mob plawv. Tham nrog koj tus kws kho mob txog seb koj tuaj yeem ua raws nws.

Puas yog metoprolol thiab haus cawv sib txuam tau?

Cov ntsiav tshuaj uas muaj metoprolol tartrate muaj qhov ua tsis tau zoo, thiab kev haus cawv ntxiv ntxiv rau lawv cov kev mob tshwm sim. Hypotension yuav tshwm sim - ntshav siab yuav poob ntau. Cov tsos mob ntawm hypotension: kiv taub hau, qaug zog, txawm tias tsis nco qab. Cov tshuaj uas nws haus tshuaj zoo yog metoprolol succinate yog siv tau nrog kev haus cawv kom tsim nyog. Koj muaj peev xwm haus dej haus cawv tsuas yog tias koj muaj peev xwm tswj kev tiv thaiv cawv. Kev haus cawv nrog beta blockers yog txaus ntshai. Nws raug nquahu kom tsis txhob haus cawv rau thawj 1-2 lub lis piam los ntawm kev pib kho nrog metoprolol, ntxiv rau tom qab nce qhov ntau ntawm cov tshuaj. Nyob rau lub sijhawm hloov pauv no, cov tsheb thiab cov khoom siv phom sij yuav tsum tsis txhob tsav.

Cov nqi rau cov tshuaj uas cov tshuaj nquag yog metoprolol succinate

Cov nqi rau cov tshuaj uas qhov tshuaj nquag yog metoprolol tartrate

Kev siv cov metoprolol

Metoprolol yog cov tshuaj muaj npe nrov thoob ntiaj teb rau kev mob ntshav siab, mob plawv, thiab kho lub siab. Txij li xyoo 2000, cov cim qhia ntxiv rau kev siv tau tshwm sim. Nws kuj tau raug tshuaj rau lub plawv tsis ua haujlwm ntev ntev, nrog rau cov tshuaj ib txwm muaj - ACE inhibitors, tshuaj tua kab mob thiab lwm yam. Cia peb pom yuav ua li cas metoprolol ua haujlwm, nws cov ntawv ntau npaum li cas nyob thiab lawv sib txawv li cas.

• Txoj kev zoo tshaj plaws los kho kev kub siab (ceev, yooj yim, zoo rau kev noj qab haus huv, yam tsis muaj "tshuaj lom" tshuaj noj thiab noj tshuaj pab rau qhov muag)
• Tawg yog txoj hauv kev los ntawm nws rov qab los ntawm theem 1 thiab 2
• Ua rau muaj kub siab thiab yuav ua li cas tshem tawm lawv. Kev ntsuas ntshav siab
• Kho tau zoo ntawm kub siab tsis muaj tshuaj

Adrenaline thiab lwm cov tshuaj hormones uas yog catecholamines ua rau mob siab rau lub siab nqaij. Raws li qhov txiaj ntsig ntawm qhov no, cov mem tes thiab tus nqi ntawm cov ntshav lub plawv nqus nrog txhua tus yeej nce. Ua ntshav nce siab. Beta-blockers, suav nrog metoprolol, ua kom tsis muaj zog (thaiv) cov nyhuv catecholamines ntawm lub siab. Vim qhov no, ua rau cov ntshav siab thiab cov mem tes poob qis. Tus load ntawm lub siab yog txo qis. Txoj kev pheej hmoo ntawm thawj lub plawv thiab thib ob yog txo qis. Lub neej cia siab ntawm cov neeg uas tau txhim kho mob plawv hlab ntsha plawv lossis mob plawv tsis muaj nce zuj zus.

Dosage cov ntaub ntawv ntawm metoprolol: tartrate thiab succinate

Hauv cov ntsiav tshuaj, metoprolol muaj nyob rau hauv daim ntawv ntawm ntsev - tartrate lossis succinate. Kev lig kev cai, metoprolol tartrate tau siv los tso tawm ntsiav tshuaj sai, ntawm cov tshuaj tam sim ntawd nkag rau hauv cov ntshav. Succinate yog rau kev pab txhawb nqa kev tso cov ntaub ntawv ntau npaum li cas. Long-acting metoprolol succinate ntsiav tshuaj yog tsim siv CR / XL (Tswj Tso Tawm / Tso Tawm Tshaj Tawm) lossis ZOK (xoom-xaj-txiav txim-Kinetics) thev naus laus zis. Kev ceev nrawm metoprolol tartrate muaj cov kev cuam tshuam loj. Nws yog qis dua nyob rau hauv kev ua tau zoo rau cov tshiab beta-blockers thiab yog qhov ua kom tsis zoo.

Pes tsawg zaus ib hnub twg noj2-4 zaug ib hnubNws txaus kom noj 1 zaug nyob rau ib hnub. Ib koob tshuaj twg siv tau ntev txog 24 teev. Qhov tso siab ruaj khov ntawm cov tshuaj nquag hauv cov ntshavTsis yogYog lawm Txoj kev loj hlob qeeb ntawm atherosclerosisTsis yogYog lawm, me ntsis txhim kho cov nyhuv ntawm statin tshuaj Kam taus, ntau zaus ntawm cov kev mob tshwm simTolerated mob heev ntxiv dua li tso tawm cov tshuaj metoprololKev tiv thaiv zoo, phiv - tsis tshua muaj Qhov Ua Tau Zoo Hauv Lub Plawv Tsis PlojTsis muaj zogYog lawm, piv rau lwm cov beta blockers niaj hnub no

Feem ntau cov kev tshawb fawb uas tau ua pov thawj kev ua tau zoo ntawm metoprolol rau cov kab mob plawv tau siv cov kev tso tawm cov qauv uas muaj succinate. Cov neeg tsim cov tshuaj metoprolol tartrate tsis tuaj yeem saib tsis tau qhov no thiab coj kev ua pauj. Nyob rau lub sijhawm xyoo 2000, "qeeb-qeeb" tartrate hu ua Egilok retard pib tau muag hauv cov tebchaws Lavxias.

Ib nthwv dej ntawm cov khoom tau luam tawm nyob rau hauv kev kho mob txhua hnub ua pov thawj tias nws pab tsis muaj qhov ua tsis zoo dua li cov metoprolol succinate, tshwj xeeb, cov tshuaj qub Betalok ZOK. Txawm li cas los xij, cov kab lus no tsis lees paub. Vim tias lawv tau pom meej meej los ntawm cov kws tsim tshuaj ntsiav Egiloc Retard. Hauv cov xwm txheej zoo li no, nws tsis yooj yim sua kom ua lub hom phiaj sib piv kev tshawb fawb ntawm cov tshuaj. Hauv cov ntawv Askiv, nws tsis tuaj yeem nrhiav pom ib qho ntaub ntawv ntawm kev npaj ntawm metoprolol tartrate li kev tso tawm.

Cov chaw tshawb fawb

Metoprolol ntsiav tshuaj tau raug muab rau cov neeg mob ntshav siab thiab mob plawv txij li xyoo 1980 los. Kaum ob ntawm cov kev tshawb fawb loj ntawm cov beta-blocker no tau ua tiav, koom nrog ntau txhiab tus neeg mob. Lawv cov txiaj ntsig tau luam tawm hauv cov ntawv kho mob muaj suab npe.

Hjalmarson A., Goldstein S., Fagerberg B. et al. Qhov cuam tshuam ntawm kev tswj cov tshuaj metoprolol rau tag nrho cov neeg tuag, mus pw hauv tsev kho mob, thiab kev noj qab nyob zoo hauv cov neeg mob lub plawv tsis ua hauj lwm: metoprolol CR / XL muaj kev tiv thaiv kev sim hauv qhov tsis txaus siab lub plawv (MERIT-HF). JAMA 2000,283: 1295-1302.Cov nyhuv ntawm metoprolol hauv kev qhia tawm cov tshuaj rau tag nrho cov neeg tuag, tsev kho mob tus nqi thiab lub neej zoo hauv cov neeg mob mob plawv tsis ua hauj lwmMetoprolol succinate nyob rau hauv daim ntawv tso tawm ntev yog qhov zoo ntawm lub plawv tsis ua haujlwm. Txawm li cas los xij, hauv txoj kev tshawb fawb no, nws tsis raug piv nrog rau lwm cov beta blockers. Deedwania PC, Giles TD, Klibaner M, Ghali JK, Herlitz J, Hildebrandt P, Kjekshus J, Spinar J, Vitovec J, Stanbrook H, Wikstrand J. Cov txiaj ntsig, kev nyab xeeb thiab tiv taus cov tshuaj metoprolol CR / XL hauv cov neeg mob ntshav qab zib thiab mob plawv ntev. tsis ua haujlwm: kev paub los ntawm MERIT-HF. American Heart Journal 2005, 149 (1): 159-167.Qhov ua tau zoo, kev nyab xeeb, thiab kev tiv taus ntawm metoprolol ua rau cov neeg mob ntshav qab zib thiab mob plawv tsis ua haujlwm ntev. Cov ntaub ntawv tshawb MERIT-HF.Cov neeg mob ntshav qab zib hom 2 zam lub metoprolol succinate, uas lawv tau kho rau kev kho mob plawv tsis ua haujlwm ntev. Cov tshuaj txhim kho txoj kev muaj sia nyob thiab txo qis dua zaus mus pw hauv tsev kho mob. Txawm li cas los xij, nws tsis nce ntshav qab zib. Wiklund O., Hulthe J., Wikstrand J. li al. Kev cuam tshuam ntawm kev tswj hwm tso tawm / tso tawm cov tshuaj metoprolol ntawm cov carotid intima-media tuab hauv cov neeg mob hypercholesterolemia: kev tshawb nrhiav 3-xyoos. Stroke 2002.33: 572-577.Cov nyhuv ntawm metoprolol hauv kev pab txhawb cov ntsiav tshuaj tso tawm ntawm cov tuab ntawm intima-media complex ntawm cov carotid leeg nyob rau hauv cov neeg mob ntshav siab. Cov ntaub ntawv los ntawm kev tshawb fawb 3-xyoos, sib piv nrog cov placebo.Metoprolol nyob rau hauv cov ntsiav tshuaj tso tawm (succinate) inhibits kev loj hlob ntawm atherosclerosis, yog tias kho rau cov neeg mob ntxiv nrog rau statins. Heffernan KS, Suryadevara R, Patvardhan EA, Mooney P, Karas RH, Kuvin JT. Ntxim ntawm atenolol vs metoprolol succinate ntawm txoj hlab ntshav ua haujlwm rau cov neeg mob ntshav siab. Clin Cardiol. Xyoo 2011, 34 (1): 39-44.Kev sib piv ntawm kev cuam tshuam ntawm atenolol thiab metoprolol succinate ntawm txoj hlab ntshav ua haujlwm hauv cov neeg mob ntshav siab.Atenolol thiab metoprolol succinate cov ntshav siab sib npaug. Hauv qhov no, metoprolol tiv thaiv cov hlab ntsha zoo dua. Cocco G. Erectile kawg ua haujlwm tom qab kho nrog metoprolol: hawthorne effect. Cardiology 2009, 112 (3): 174-177.Erectile kawg ua haujlwm thaum noj cov tshuaj metoprolol.Kev qaug zog ntawm potency rau cov txiv neej nrog kev siv cov tshuaj metoprolol succinate hauv tsawg kawg 75% ntawm cov neeg mob tshwm sim los ntawm kev xav ntawm lub hlwb, thiab tsis yog los ntawm cov nyhuv tshuaj tiag. Ib cov placebo txum tim potency tsis muaj qhov phem dua li tadalafil (cialis).

Peb taw qhia tias tsuas yog metoprolol succinate muaj cov ntaub ntawv pov thawj zoo. Nws pab tau zoo, tshwj xeeb tshaj yog ua ke nrog lwm cov tshuaj, thiab tsis tshua muaj kev phiv tshuaj. Hauv tshwj xeeb, qhov beta blocker tsis cuam tshuam txog txiv neej potency. Metoprolol tartrate tsis tuaj yeem khav tau ib qho txiaj ntsig tshwj xeeb. Txog rau hnub tim, nws tsis pom zoo siv nws, txawm tias tus nqi tsawg.

Piv nrog rau lwm cov beta blockers

Rov qab hais tias metoprolol tau siv rau hauv kev kho mob txij thaum 1980s. Txawm tias metoprolol txhawb kev tso tawm cov ntsiav tshuaj nrog cov yam ntxwv zoo dua qub tsis muaj ntxiv lawm. Qhov beta blocker occupies ntau qhov sib txawv ntawm lub khw muag tshuaj. Cov kws kho mob paub nws zoo thiab zoo siab hlo tshuaj rau lawv cov neeg mob. Txawm li cas los xij, lwm yam tshuaj nrhiav kev thawb nws.

Beta-blockers - cov neeg sib tw ntawm metoprolol:

Espinola-Klein C, Weisser G, Jagodzinski A, Savvidis S, Warnholtz A, Ostad MA, Gori T, Munzel T. Beta-Blockers hauv cov neeg mob cuam tshuam claudication thiab mob ntshav siab: cov txiaj ntsig los ntawm kev txiav txim siab los ntawm nebivolol lossis metoprolol nyob rau hauv kev mob ntshav los ntawm txoj kev sim. Kub Siab 2011, 58 (2): 148-54Qhov ua haujlwm ntawm beta-blockers rau cov neeg mob sib quas ntus claudication thiab ntshav siab. Cov txiaj ntsig ntawm kev sib piv ntawm kev tshawb nrhiav ntawm nebivolol thiab metoprolol rau cov kev mob hlwb hauv cov hlab ntsha peripheral.Metoprolol thiab nebivolol sib npaug zoo pab cov neeg mob uas muaj mob rau hauv lawv cov ceg. Tsis muaj qhov sib txawv hauv kev ua tau zoo ntawm cov tshuaj. Kampus P, Serg M, Kals J, Zagura M, Muda P, Karu K, Zilmer M, Eha J. Cov teebmeem sib txawv ntawm nebivolol thiab metoprolol ntawm lub hauv paus aortic siab thiab sab laug phab ntsa ventricular tuab. Qhov Ntshav Dhau Xyoo 2011, 57 (6): 1122-8.Qhov sib txawv hauv cov nyhuv ntawm nebivolol thiab metoprolol ntawm lub hauv nruab siab hauv aorta thiab phab ntsa tuab ntawm cov leeg ventricle ntawm lub plawv.Nebivolol thiab metoprolol sib npaug txo qis lub plawv thiab ntshav ntshav nruab nrab. Txawm li cas los xij, tsuas yog nebivolol qhov teeb meem tseem ceeb rau hauv nruab nrab ntawm SBP, DBP, nruab nrab lub zog mem tes thiab phab ntsa tuab ntawm sab laug ventricle ntawm lub plawv.

Phillips RA, Fonseca V, Katholi RE, McGill JB, Messerli FH, Tswb DS, Raskin P, Wright JT Jr, Iyengar M, Anderson KM, Lukas MA, Bakris GL. Kev sojntsuam cov pej xeem ntawm cov teebmeem ntawm carvedilol vs metoprolol ntawm kev tswj glycemic thiab insulin rhiab heev rau cov neeg mob uas muaj ntshav qab zib hom 2 thiab ntshav siab nyob rau hauv Glycemic Cov Kev Ntshav Qab Zib Mellitus: Carvedilol-Metoprolol Sib Piv hauv hypertensives (GEMINI) kev kawm. Phau ntawv Journal ntawm CardioMetabolic Syndrome 10/2008, 3 (4): 211-217.	Kev soj ntsuam thaj tsam ntawm cov teebmeem ntawm carvedilol thiab metoprolol ntawm glycemic tswj thiab insulin rhiab heev hauv cov neeg mob uas muaj ntshav qab zib hom 2 thiab ntshav siab. GEMINI kawm cov ntaub ntawv.	Hauv cov neeg mob uas muaj ntshav qab zib hom 2, carvedilol muaj cov txiaj ntsig zoo dua rau kev zom zaub mov dua li metoprolol. Txawm li cas los xij, metoprolol tartrate tau siv rau hauv kev kawm, tsis yog succinate.
Acikel S, Bozbas H, Gultekin B, Aydinalp A, Saritas B, Bal U, Yildirir A, Muderrisoglu H, Sezgin A, Ozin B. Kev sib piv ntawm kev ua tau zoo ntawm metoprolol thiab carvedilol rau kev tiv thaiv atrial fibrillation tom qab kev kho mob ntawm txoj hlab ntshav. Phau Ntawv Xov Xwm Thoob Ntiaj Teb ntawm Cardiology 2008, 126 (1): 108-113.	Kev sib piv ntawm kev ua tau zoo ntawm metoprolol thiab carvedilol hauv kev tiv thaiv kev mob arterial fibrillation tom qab kev mob plawv rau txoj hlab ntshav bypass phais.	Hauv cov neeg mob uas kho mob raws txoj kev phais ntshav, carvedilol zoo dua tiv thaiv atrial fibrillation dua li metoprolol succinate.
Remme WJ, Cleland JG, Erhardt L, Spark P, Torp-Pedersen C, Metra M, Komajda M, Moullet C, Lukas MA, Poole-Wilson P, Di Lenarda A, Swedberg K. Ntxim li ntawm carvedilol thiab metoprolol ntawm hom kev kev tuag rau cov neeg mob lub plawv tsis ua haujlwm. European Journal of Heart Poob tsis tau 2007, 9 (11): 1128-1135.	Cov nyhuv ntawm carvedilol thiab metoprolol ntawm cov ua rau kev tuag nyob hauv cov neeg mob plawv.	Hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm, carvedilol zoo dua txo cov neeg tuag los ntawm txhua qhov laj thawj tshaj metoprolol tartrate, thiab tshwj xeeb tshaj yog kev tuag ntawm cov cwj nrag.

Kev sib tw beta-blockers tej zaum yuav zoo dua rau metoprolol hauv kev ua tau zoo. Txawm li cas los xij, metoprolol succinate ntsiav tshuaj ncua kev tso tawm kuj pab tau. Thiab cov kws kho mob tau txhag cia. Lawv tsis nrawm los hloov cov tshuaj uas tau ntev dhau los ua haujlwm rau cov neeg mob, rau lwm tus. Ntxiv mus, metoprolol npaj muaj tus nqi pheej yig. Hauv cov chaw muag tshuaj, qhov kev thov rau Betalok ZOK, Egilok S, Metoprolol-Ratiopharm ntsiav tshuaj poob, yog tias maj mam, lossis tseem nyob qis qis.

Metoprolol ntau npaum rau ntau yam kab mob

Metoprolol muaj nyob rau hauv cov ntsiav tshuaj nyob rau hauv daim ntawv ntawm ib qho ntawm ob qho ntsev - tartrate lossis succinate. Lawv coj tus cwj pwm sib txawv, muab cov nqi sib txawv ntawm kev nkag mus ntawm cov tshuaj nquag rau hauv cov ntshav. Yog li no, rau cov ntsiav tshuaj kub ceev ntawm metoprolol tartrate, ib qho tshuaj rau noj yog siv, thiab rau "qeeb" metoprolol succinate, lwm qhov. Thov nco ntsoov tias metoprolol tartrate tsis yog qhia rau lub plawv tsis ua haujlwm.

Metoprolol Succinate: Ncua Sijhawm Tshaj Tawm

Metoprolol tartrate: cov ntsiav tshuaj ua haujlwm ceev

Arterial tawg50-100 mg ib hnub ib zaug. Yog tias tsim nyog, cov koob tshuaj tuaj yeem raug nce ntxiv rau 200 mg ib hnub, tab sis nws zoo dua los ntxiv lwm cov tshuaj tiv thaiv kev tiv thaiv kab mob - diuretic, calcium antagonist, ACE inhibitor.25-50 mg ob zaug ib hnub twg, sawv ntxov thiab yav tsaus ntuj. Yog tias tsim nyog, cov koob tshuaj yuav raug nce mus rau 100-200 mg ib hnub lossis ntxiv lwm yam tshuaj uas txo cov ntshav siabAngina pectoris100-200 mg ib hnub ib zaug. Yog tias tsim nyog, lwm cov tshuaj antianginal yuav ntxiv rau txoj kev kho.Thawj koob tshuaj yog 25-50 mg, noj 2-3 zaug ib hnub. Nyob ntawm cov txiaj ntsig, qhov tshuaj no tuaj yeem hloov maj mam nce mus rau 200 mg ib hnub lossis ntxiv ib hom tshuaj ntxiv rau angina pectoris.Lub plawv dhia tsis ua hauj lwm hauv chav kawm IIQhov pom zoo kom pib noj yog 25 mg ib hnub ib zaug. Tom qab ob lub lim tiam ntawm kev kho mob, qhov tshuaj yuav raug nce ntxiv rau 50 mg ib hnub ib zaug. Txuas ntxiv mus yog ob zaug txhua ob lub lis piam. Cov koob tshuaj txij nkawm rau kev kho mob ntev yog 200 mg ib hnub ib zaug.Tsis muaj

• Cov mob tshwm sim, cov tsos mob, kuaj mob, tshuaj thiab cov tshuaj kho mob rau lub plawv nres
• Diuretic tshuaj rau edema hauv plawv nres: cov ncauj lus kom ntxaws
• Cov lus teb rau cov lus nug uas nquag muaj txog lub plawv tsis ua hauj lwm - kev txwv dej thiab ntsev, ua pa tsis txaus, noj zaub mov, cawv, xiam oob qhab
• Lub plawv tsis ua hauj lwm hauv cov neeg laus: cov yam ntxwv kho

Saib ntawm daim vis dis aus ntawd thiab:

Lub plawv tsis ua haujlwm ntev III-IV ua haujlwm chav kawm	Nws raug nquahu kom pib nrog ib koob tshuaj 12,5 mg (1/2 ntsiav tshuaj ntawm 25 mg) ib hnub ib zaug rau thawj ob lub lis piam. Cov koob tshuaj yog xaiv tau ib tus zuj zus. Tom qab 1-2 lub lis piam los ntawm kev pib ntawm kev kho mob, lub koob tshuaj yuav raug nce mus rau 25 mg ib hnub ib zaug. Tom qab ntawd, tom qab lwm 2 lub lis piam, cov koob tshuaj yuav tau nce ntxiv rau 50 mg ib hnub ib zaug. Nkaujhnubqub los ib yam. Cov neeg mob uas zam lub beta-blocker zoo yuav muab ob npaug rau koob tshuaj txhua 2 lub lis piam kom txog thaum siv ntau kawg - 200 mg ib hnub ib zaug.	Tsis muaj
Kev mob siab ntawm lub plawv	100-200 mg ib hnub ib zaug.	Thawj koob tshuaj yog 2-3 zaug hauv ib hnub rau 25-50 mg. Yog tias tsim nyog, qhov tshuaj txhua hnub tuaj yeem hloov maj mam nce mus rau 200 mg / hnub lossis ntxiv lwm yam cuab yeej uas ua haujlwm rau lub plawv dhia.
Kev pab txhawb nqa tau zoo tom qab myocardial infarction	Lub hom phiaj koob tshuaj yog 100-200 mg rau ib hnub, hauv ib lossis ob koob.	Qhov niaj hnub niaj hnub noj tshuaj yog 100-200 mg, muab faib ua ob zaug, thaum sawv ntxov thiab yav tsaus ntuj.
Muaj nuj nqi ntawm lub siab, los ntawm tachycardia	100 mg ib hnub ib zaug. Yog tias tsim nyog, koob tshuaj yuav raug nce rau 200 mg ib hnub twg.	Kev noj tshuaj ib txwm ib hnub yog 2 zaug hauv ib hnub, 50 mg, sawv ntxov thiab yav tsaus ntuj. Yog tias tsim nyog, nws muaj peev xwm nce ntxiv txog 2 zaug 100 mg.
Kev tiv thaiv ntawm mob taub hau tawm tsam (mob taub hau)	100-200 mg ib hnub ib zaug	Qhov niaj hnub niaj hnub noj tshuaj yog 100 mg, faib ua ob zaug, noj thaum sawv ntxov thiab yav tsaus ntuj. Yog tias tsim nyog, nws tuaj yeem raug nce txog 200 mg / hnub, tseem muab faib ua 2 koob.

Nco ntsoov txog kev noj cov tshuaj metoprolol hauv lub plawv tsis ua haujlwm. Yog tias tus neeg mob tsim kho bradycardia, uas yog, cov mem tes poob qis dua 45-55 neeg ntaus ib feeb, lossis "ntshav siab" sab saud qis dua 100 mmHg. Txuj ci., Tej zaum koj yuav xav tau txo ib ntus ntawm cov tshuaj. Thaum pib kho mob, tej zaum yuav muaj kev mob ntshav ncig (hypotension). Txawm li cas los xij, tom qab qee lub sijhawm, nyob rau ntau tus neeg mob, lub cev yoog, thiab lawv ib txwm zam rau kev kho mob ntawm cov tshuaj. Kev haus dej cawv ua rau kom muaj kev phiv zoo ntawm cov tshuaj metoprolol, yog li nws zoo dua rau qhov tsis haus cawv.

Yuav hloov mus rau bisoprolol lossis carvedilol li cas

Nws yuav tshwm sim uas tus neeg mob yuav tsum tau hloov pauv ntawm metoprolol rau bisoprolol (Concor, Biprol lossis lwm tus) lossis carvedilol. Cov laj thawj yuav txawv. Raws li txoj kev xav, hloov ib beta blocker nrog lwm tus tsis muab cov txiaj ntsig zoo. Hauv kev xyaum, kev loj hlob tuaj yeem tshwm sim. Vim tias qhov ua tau zoo thiab kev tiv taus ntawm cov tshuaj rau txhua tus neeg yog tus neeg. Los yog cov ntsiav tshuaj metoprolol li ib txwm yuav ploj ntawm kev muag, thiab lawv yuav tsum tau hloov nrog lwm cov tshuaj. Cov lus hauv qab no tej zaum yuav pab tau koj.

Tau qhov twg los - DiLenarda A, Remme WJ, Charlesworth A. Txauv ntawm cov beta-blockers hauv cov neeg mob plawv tsis ua haujlwm. Cov kev paub rau qib tom qab post ntawm COMET (Carvedilol lossis Metoprolol European Trial). European Journal of Heart Poob tsis tiav 2005, 7: 640-9.

Lub rooj qhia metoprolol succinate. Txog metoprolol tartrate nyob hauv cov ntsiav tshuaj tso tawm sai, qhov sib npaug tag nrho txhua hnub yog kwv yees 2 zaug siab dua. Bisoprolol noj 1 zaug nyob rau ib hnub, carvedilol - 1-2 zaug ib hnub.

Cov Lus Nquag Nug thiab Cov Lus Teb

Hauv qab no yog cov lus teb rau cov lus nug uas feem ntau tshwm sim hauv cov neeg mob noj metoprolol rau cov ntshav siab thiab cov kab mob plawv.

Metoprolol lossis Betalok ZOK: uas yog ib qho zoo dua?

Betalok ZOK yog lub npe lag luam tawm rau cov tshuaj uas nws muaj tshuaj yog metoprolol succinate. Qhov no tsis yog hais tias metoprolol tau zoo dua ntawm Betalok ZOK, lossis rov qab ua ke, vim nws yog ib qho thiab zoo ib yam. Betalok ZOK zoo dua li lwm cov ntsiav tshuaj uas muaj metoprolol tartrate. Cov laj thawj rau qhov no tau piav qhia txhua yam saum toj no. Niaj hnub no metoprolol tartrate tuaj yeem suav hais tias yog ib yam tshuaj uas tsis siv lawm.

Metoprolol lossis Concor: nws yog qhov zoo dua?

Thaum ib nrab xyoo 2015, ib qho kev tshawb fawb tau ua tiav uas piv rau qhov ua tau ntawm metoprolol succinate thiab concor (bisoprolol) hauv kev kho kev mob ntshav siab.Nws muab tawm tias ob qho tshuaj ua rau txo cov ntshav siab sib npaug thiab muaj kev tiv thaiv zoo. Hmoov tsis zoo, tsis muaj cov ntaub ntawv ntseeg tau uas cov tshuaj no zoo tshaj rau cov neeg mob plawv tsis ua haujlwm, mob plawv thiab mob paj hlwb. Qhov twg yog qhov zoo dua: Concor, Betalok ZOK lossis Egilok C? Tseg qhov kev txiav txim siab rau qhov teeb meem no raws kev pom zoo ntawm koj tus kws kho mob. Txawm li cas los xij, koj yuav tsum tsis txhob noj cov ntsiav tshuaj uas nws nquag ua yog metoprolol tartrate. Lawv yog cov muaj tseeb ntau dua li cov tshuaj teev tseg saum toj no.

Puas yog metoprolol pab txhawb siab?

Metoprolol succinate pab nrog qhov siab tsis muaj qhov phem dua li lwm cov niaj hnub beta-blockers - bisoprolol, nebivolol, carvedilol. Tsis muaj cov ntaub ntawv ntseeg tau uas cov tshuaj no zoo dua li lwm tus. Txawm li cas los xij, nws paub zoo tias metoprolol tartrate yog ib qho tshuaj kho qhov muag uas tsis muaj qhov zoo tshaj plaws. Cov tshuaj no yuav tsum tau noj ob peb zaug hauv ib hnub, uas nws tsis yooj yim rau cov neeg mob. Lawv ua rau muaj ntshav siab khiav ceev. Nws ua mob rau cov hlab ntshav. Metoprolol tartrate tsis txaus txo cov kev pheej hmoo ntawm lub plawv thiab lwm yam kev cuam tshuam ntawm kub siab.

Yog tias tus kws kho mob tau sau tshuaj metoprolol rau lub siab, tom qab ntawd coj Betalok ZOK lossis Egilok S. Noj ob peb koob tshuaj qis dua yog qhov zoo dua li qhov siv tshuaj ntau dua. Nco ntsoov tias kev kho mob ntshav siab yog lub neej noj qab nyob zoo. Yog tias koj tsis ua raws li cov lus pom zoo ntawm khoom noj khoom haus, kev tawm dag zog thiab kev tswj hwm kev ntxhov siab, tom qab ntawd tsis ntev txawm tias cov ntsiav tshuaj uas kim tshaj plaws yuav nres pab.

Kuv puas tuaj yeem nqa tus beta blocker thiab lisinopril ua ke?

Yog lawm, metoprolol thiab lisinopril tuaj yeem noj ua ke raws li koj tus kws kho mob hais. Cov no yog cov tshuaj siv tau. Tsis txhob noj ib qho tshuaj twg nyob hauv kab lus no ntawm koj tus kheej kev pib. Nrhiav tus kws kho mob uas paub txog dhau los nrhiav cov tshuaj zoo tshaj plaws rau koj cov ntshav siab. Ua ntej koj yuav tau noj tshuaj, koj yuav tsum tau xeem ntawv thiab yuav tsum ua qhov kev kuaj mob. Rov mus ntsib kws kho mob tsawg kawg ib hlis ob zaug los kho cov tshuaj kho raws li kev soj ntsuam dhau sijhawm dhau los.

Kuv tau sau ntawv tawm cov tshuaj metoprolol (Egiloc C) rau siab. Kuv tau pib noj nws - kuv qhov muag pom kev poob thiab kuv tau nce ntau hauv chav dej thaum hmo ntuj. Tsis tas li, mob txhab rau ntawm ob txhais ceg, kho tsis zoo. Cov no puas yog cov kev mob tshwm sim ntawm cov ntsiav tshuaj?

Tsis yog, Egilok ntsiav tshuaj tsis muaj dab tsi ua rau nws. Theej, koj muaj teeb meem ntawm cov ntshav qab zib hom 2. Kawm kab lus "Cov tsos mob ntshav qab zib hauv cov neeg laus," ces mus rau chav kuaj ntshav qab zib. Yog paub kuaj ntshav qab zib, kho nws.

Cov ntshav siab poob sai npaum li cas tom qab siv cov tshuaj metoprolol?

Cov ntsiav tshuaj, cov tshuaj nquag ntawm uas yog metoprolol succinate, ua kom ntseeg nkaws. Lawv tsis haum yog tias koj xav tau kom nrawm nrawm nrog qhov teeb meem kub siab. Cov tshuaj uas muaj cov tshuaj metoprolol tartrate pib txo qis dua tom qab 15 feeb. Tag nrho cov txiaj ntsig tsim tawm tom qab 1.5-2 teev thiab kav ntev li 6 teev. Yog tias koj xav tau kev kho sai sai, tom qab ntawd nyeem kab lus "Yuav ua li cas muab kev saib xyuas kub ntxhov rau kev kub ntxhov."

Puas yog metoprolol siv tau rau ... xws li thiab cov tshuaj no?

Nyeem cov lus qhia rau cov tshuaj uas koj nyiam. Nrhiav pawg twg nws yog pawg. Nws tuaj yeem yog cov diuretic (diuretic), ACE inhibitor, tus mob angiotensin-II receptor blocker, calcium antagonist (calcium channel blocker). Nrog rau tag nrho cov pawg teev tseg ntawm cov tshuaj rau kub siab, metoprolol tuaj yeem sib xws. Piv txwv li, koj txaus siab rau Prestarium. Hauv cov lus qhia, pom tias nws yog ACE inhibitor. Metoprolol tau tshaj nws. Indapamide yog cov diuretic. Ua ke nrog nws, koj kuj tuaj yeem nqa. Nkaujhnubqub los ib yam. Feem ntau, cov neeg mob tau sau tseg 2-3 cov tshuaj nyob rau ib lub sijhawm ntawm lub siab.Nyeem ntxiv hauv kab lus “Cov tshuaj kho mob ntshav siab yog cov muaj zog tshaj plaws.”

Metoprolol yog beta blocker. Koj tsis tuaj yeem siv ob lub beta blockers tib lub sijhawm. Yog li, tsis txhob noj nws ua ke nrog bisoprolol (Concon, Biprol, Bisogamma), nebivolol (Nebilet, Binelol), carvedilol, atenolol, anaprilin, thiab lwm yam, feem ntau, ob yam tshuaj rau ntshav siab, uas koom nrog tib pawg, tsis tuaj yeem noj nyob rau tib lub sijhawm.

Yuav muaj kev pheej hmoo siab npaum li cas uas tus mob psoriasis yuav tsis zoo los ntawm kev noj Egiloc C lossis Betalok ZOK?

Tsis siab dua lwm cov niaj hnub beta blockers. Tsis muaj cov ntaub ntawv qhia meej hauv cov ntaub ntawv.

Kuv muaj kub siab vim yog poob haujlwm ua haujlwm, ntau qhov xwm txheej. Tus kws kho mob tau hais kom noj cov tshuaj metoprolol. Kuv nyeem tias kev nyuab siab yog ib qho mob tshwm sim. Thiab kuv yog txhua qhov qab haus huv. Kuv puas yuav tsum noj cov tshuaj no?

Kev ntxhov siab thiab kev ntxhov siab ntxhov siab yog tawm tsam. Kev ntxhov siab yog impotence, apathy, ntev. Kev txiav txim los ntawm cov ntawv sau ntawm cov lus nug, koj muaj kev coj txawv txawv. Tej zaum noj cov tshuaj metoprolol yuav muaj cov nyhuv sedative, thiab nws yuav muaj txiaj ntsig rau koj.

Metoprolol txo qis ntshav siab, tab sis txhais tes thiab ceg pib txias. Puas yog qhov no hauv qhov ntau lossis kuv yuav tsum tsis txhob noj nws?

Tes thiab txhais taw los ua txias dua - qhov no yog ib qho kev phiv los ntawm beta-blockers, suav nrog metoprolol. Yog tias koj xav hais tias cov txiaj ntsig ntawm kev noj tshuaj yog ntau dua qhov kev phom sij ntawm nws cov kev mob tshwm sim, ces txuas ntxiv mus noj. Yog koj tsis xis nyob - thov kws kho mob khaws lwm yam tshuaj rau koj. Nco ntsoov tias los ntawm kev siv cov beta-blockers hauv thawj lub lim tiam, koj txoj kev noj qab haus huv tej zaum yuav phem dua, tab sis tom qab ntawd lub cev yoog. Yog li nws tsim nyog qee lub sijhawm los tos yog tias "sab saud" siab tshaj 100 mmHg. Kos duab. thiab cov mem tes tsis poob qis dua 55 yeej ib feeb.

Tus kws kho mob qhia kom hloov cov tshuaj rau kub siab Metoprolol-Ratiopharm nrog rau kim dua Betalok ZOK. Puas tsim nyog nws?

Yog, nws yog. Cov tshuaj nquag ntawm kev npaj ntawm lub tuam txhab Ratiopharm yog metoprolol tartrate, thiab Betalok ZOK yog succinate. Qhov sib txawv ntawm lawv tau piav qhia txhua yam saum toj no. Koj yuav tsis muaj kev xav tias ntau npaum li cas cov tshuaj tshiab tiv thaiv koj los ntawm lub plawv nres. Tab sis koj yuav pom zoo li ntawd tam sim no cov ntsiav tshuaj tuaj yeem noj 1 zaug ib hnub. Koj cov ntshav siab yuav los ze zog li qub, nws cov qog yuav poob qis thaum nruab hnub.

Metoprolol - tshuaj noj nrov thoob plaws ntiaj teb rau cov ntshav siab, mob plawv (angina pectoris), lub plawv tsis ua haujlwm, thiab kev tsis ua haujlwm. Cov ntawv sau tag nrho cov lus qhia txog cov tshuaj no uas cov kws kho mob thiab cov neeg mob xav tau. Txuas nrog kuj muab rau cov hauv paus tseem ceeb - kev tshwm sim los ntawm kev tshawb fawb hauv chav kho mob, rau kev kawm kom tob.

Txog rau hnub tim, nws raug nquahu kom siv cov tshuaj metoprolol succinate nkaus xwb - tso tawm cov ntsiav tshuaj tas mus li. Cov cuab yeej no txaus siv sijhawm 1 hauv ib hnub. Cov tshuaj uas nws cov tshuaj muaj yees metoprolol tartrate yuav tsum noj 2-4 zaug ib hnub. Lawv yog cov ua tsis tau zoo nyob rau hauv kev ua tau zoo rau lwm cov beta-blockers thiab muaj qhov tsis zoo. Yog tias koj noj lawv, ces tham nrog koj tus kws kho mob yog tias koj yuav tsum hloov nws nrog qee yam tshuaj ntxiv.

Tej zaum bisoprolol, carvedilol thiab nebivolol pab cov neeg mob zoo dua li cov metoprolol succinate thiab tshwj xeeb yog cov ua kom yaj. Qhov no tau raug pov thawj los ntawm ntau cov ntawv sau uas tau tshwm sim hauv cov ntawv kho mob txij li ib nrab ntawm 2000s. Txawm li cas los xij, Betalok ZOK thiab Egilok S ntsiav tshuaj tsis nrawm muab lawv txoj kev lag luam rau cov neeg sib tw. Vim tias cov kws kho mob tau sau cov tshuaj no rau lub sijhawm ntev, lawv paub txog lawv cov txiaj ntsig zoo thiab tsis nrawm rau tsis kam lawv. Ntxiv mus, metoprolol kev npaj muaj nqi dua kom zoo dua piv rau lwm yam beta-blockers.

• Beta blockers: cov ntaub ntawv xov xwm
• Cov tshuaj diuretic
• Tawg ntshav Mob rau cov laus

1. Angiotensin Hloov Kev Tso Cai Enzyme (ACE)
2. Angiotensin II Tus Txais Txais Khoom (ARBs)

Calcium Channel Blockers (Cov Hluav Taws Xob calcium Antagonists)

Cov tshuaj tiv thaiv (diuretics)

Ntxiv cov tshuaj tiv thaiv kabmob ntshav

Imidazoline receptor agonists

Methyldopa (Dopegit, Aldomet)

Clonidine (Clonidine)

Direct renin inhibitor

Alpha blockers

Nyiaj txiag tag

Thaum tsis xav tau cov tshuaj kom hnyav

Xaus

Thaum pom muaj kev ntsuas siab ntau dhau, cov lus nug feem ntau tshwm sim ntawm kev kho mob siab tshuaj. Cov tshuaj rau ntshav siab yog xaiv tshwj xeeb los ntawm kws kho mob. Kev sim siv cov tshuaj ntawm koj tus kheej yog qhov txaus ntshai. Txhua cov tshuaj muaj cov cim qhia meej thiab sib kis. Yog tias tsis muaj kev paub tshwj xeeb, nws yog qhov nyuaj rau kev txiav txim siab txhua tus nuances thiab tuaj yeem ua rau muaj kev phom sij xwb.

Tam sim no, muaj 5 lub ntsiab pab pawg ntawm cov tshuaj tiv thaiv antihypertensive. Lawv tau siv ob qho tib si ntawm kev ywj pheej thiab kev sib xyaw ua ke. Tab sis tseem muaj cov tshuaj ntxiv uas tau siv nyob rau hauv kev sib txuas ua ke kom txhim kho cov nyhuv.

Angiotensin Hloov Kev Tso Cai Enzyme (ACE)

Qhov no yog pab pawg coob tshaj plaws ntawm txoj kev txo qis. ACE inhibitors feem ntau siv rau hauv kev kho mob hlwb. Ntxiv nrog rau kev ua tseem ceeb, lawv ntxiv kev tiv thaiv cov kab mob hauv lub cev thiab tsis ua rau tshem tawm cov leeg mob. Cov kev kho mob ib txwm pib nrog ib qho me me, maj mam nqa mus rau qhov zoo tshaj plaws. Yuav kom tau txais txiaj ntsig zoo, 2 txog 4 lub lim tiam ntawm kev kho mob tas li yuav tsum muaj. Txawm li cas los xij, cov tshuaj no muaj lawv lub zoo:

1. Kev txhim kho ntawm cov tsos mob ntawm "kev khiav tawm" cov nyhuv hypotensive. Hauv qhov no, tawm tsam tom qab ntawm txoj kev kho, nws tsis tuaj yeem tswj hwm qhov ntsuas siab ntawm qib kom tsim nyog.
2. Cov tsos ntawm hnoos qhuav, xav tau kev tsis ua tiav ntawm kev kho.
3. Cov npe tseem ceeb txog cov kev mob tshwm sim loj heev, suav nrog Quincke's edema.
4. Kev sib koom tes nrog cov tshuaj tiv thaiv tsis muaj tshuaj steroidal (NSAIDs) ua rau txo qis hauv cov nyhuv hypotensive.
5. Nws ua rau kev ncua sijhawm ntawm cov poov tshuaj hauv lub cev, uas yuav tsum tau txiav txim siab thaum siv, piv txwv li, potassium-sparing diuretics.

Feem ntau ACE inhibitors tsis muaj kev tiv thaiv. Kev txo qhov siab txo tau zoo yog muab los ntawm cov nquag metabolite (prilat), uas yog tsim nyob rau hauv daim siab lossis cov qog ua pa ntawm lub plab zom mov vim cov txheej txheem biotransformation. Tias yog vim li cas nrog kev ua txhaum ntawm lub plab zom mov, muaj ntau zaus tsis muaj qhov tshwm sim zoo thaum kho. Qhov tshwj tsis yog 2 tshuaj: captopril thiab lisinopril.

ACE inhibitors tau noj ib hnub ib zaug, tsis hais txog ntawm kev noj zaub mov, nrog kev zam tsawg. Cov nyhuv feem ntau muaj peev xwm tsim tawm ib teev tom qab kev tswj hwm, nce mus txog qhov siab kawg tom qab 6 teev thiab kav mus txog ib hnub. Nquag thiab siv lub zog ua kom lub cev tsis ua tiav yog feem ntau los ntawm lub raum. Qhov no yuav tsum tau txiav txim siab yog tias muaj lub raum tsis ua haujlwm. Tab sis muaj ACE inhibitors uas muaj ob txoj hauv kev ntawm kev zam: los ntawm ob lub raum thiab txoj hnyuv. Lawv muaj kev nyab xeeb dua, yog li tsis tas yuav tsum tau yoog hloov kho.

1. Enalapril. Renitec yog thawj tus tsim, tom qab ntawd nws cov qauv pom tshwm sim: Burlipril, Renipril, Enapharm, Invoril, Enam, Enap. Enalapril muaj lub sijhawm ncua sijhawm nruab nrab, yog li nws pom zoo kom coj nws thaum sawv ntxov thiab yav tsaus ntuj.
2. Lisinopril - Diroton, Diropress, Lysigamma, Lisinoton, Lysoril, Lister. Original lisinopril tsis tau cuv npe hauv tebchaws Russia. Nws muaj qhov zoo hauv daim siab pathology.
3. Perindopril. Tus qub yog A. Generiki Prestarium: Perineva, Parnawel. Nws muaj qhov tsawg tshaj plaws ntawm kev phiv thiab tshaj tawm cov nyhuv organoprotective. Daim foos tsis zoo tawm ntawm cov ntsiav tshuaj tau tsim uas tsis tas yuav tsum tau ntxuav nrog dej. Nws tau noj rau hauv plab khoob.
4. Ramipril. Tritace yog thawj zaug. Ib me ntsis tom qab, nws qhov chaw raug coj los ntawm kev siv tau ntau yam ntxiv: Amprilan, Dilaprel, Wazolong, Priramil, Hartil. Nws muaj ob txoj kev nthuav dav: los ntawm ob lub raum thiab daim siab. Feem ntau kho rau lub plawv tsis ua haujlwm thiab tom qab myocardial infarction.
5. Fosinopril - Monopril (qub), Fosicard, Fosinap, Fizinotek. Nws yog tawm los ntawm daim siab thiab lub raum.
6. Zofenopril - Zokardis. Nws muaj qhov zoo hauv cov kab mob myocardial infarction.
7. Moexipril - Moex. Pab txo qis kev ua haujlwm ntawm osteoclasts, uas txwv tsis pub rhuav tshem cov ntaub so ntswg. Qhov no yog qhov tseem ceeb rau kev tiv thaiv txha caj qaum hauv poj niam postmenopausal. Nws muaj ob txoj hauv kev zam.
8. Tsilazapril - Inhibeys. Nws yog kim. Nws yuav tsum noj rau ntawm lub plab khoob.
9. Thrandolapril - Gopten. Siv tau ntev txog 24-36 teev. Tab sis nrhiav nws hauv cov khw muag tshuaj yog qhov nyuaj heev. Txoj kev tshem tawm yog ob npaug.
10. Spirapril - Quadropril. Nws raug tawm los ntawm lub raum thiab cov hnyuv.
11. Hinapril - Akkupro. Nws tsis muaj qhov zoo tshwj xeeb.

Txog tam sim no, cov tshuaj ntawm 1st tiam - captopril (Kapoten) tsis tau poob nws qhov tseeb. Nws tsis tsim nyog rau kev kho mob tsis tu ncua, tab sis raws li lub tsheb tos neeg mob nws pom zoo kom muaj nws ntawm tes. Tom qab kev tswj hwm ntawm qhov ncauj, cov nyhuv tshwm sim tom qab 15-60 feeb, yog tias koj muab cov ntsiav tshuaj tso rau hauv tus nplaig - tom qab 5 feeb. Nws tuaj yeem siv rau ntsoog. Muaj nyob rau hauv cov koob tshuaj 25 thiab 50 mg.

Angiotensin II Tus Txais Txais Khoom (ARBs)

Pab pawg no ua zoo ib yam li ACE inhibitors. Tab sis ua tsaug rau cov txheej txheem sib txawv me ntsis ntawm kev nqis tes, qhov hnoos qhuav tsis tshua muaj tshwm sim thiab tsis muaj qhov "ploj zuj zus". Yog li, ARBs yog qhov zoo tshaj plaws rau ACE inhibitors. Cov tshuaj thaiv thiab phiv yog zoo heev. Kev txais tos yog nqa tawm ib hnub ib zaug, tsis hais noj zaub mov. Cov nyhuv kav ntev li ntawm 24 teev.

1. Lozartan - Cozaar (thawj), Blocktran, Vazotens, Lozap, Lozarel, Lorista, Presartan. Nws txo cov ntshav ntawm uric acid, uas tso cai rau nws pom zoo rau cov neeg uas raug mob gout.
2. Valsartan yog Ameslikas hu ua "Diovan", tom qab ntawd Valz, Valsacor, Nortian, Sartavel tshwm sim. Nws muaj suab tshaj tawm kev tiv thaiv. Nws muaj ob peb phiv.
3. Candesartan. Tus qub yog Atakand. Generics - Hyposart, Candecor, Xarten. Nws muaj cov nyhuv koob tshuaj-siv tsis tau.
4. Irbesartan. Thawj tus sawv cev - Aprovel, analogues - Ibertan, Irsar, Chaw ruaj khov. Muab kev tswj siab thaum nruab hnub.
5. Olmesartan Medoxomil - Cardosal (thawj), Olimestra. Nws ua haujlwm zoo, tab sis ntau dua 24 teev.
6. Telmisartan. Ua ntej yog thawj zaug, tab sis nyob hauv Russia Mikardis tau muab hauv paus ntxiv. Qhov siab tshaj plaws hauv cov ntshav tau mus txog tom qab ib teev, thiab kev ua haujlwm siab hypotensive tom qab 3 teev thiab kav ntev dua ib hnub.
7. Eprosartan - Teveten (thawj), Naviten. Nws yog qhov ua tau zoo, vim tias nws muaj qhov tsawg kawg ntawm kev phiv. Nws muaj cov nyhuv sympatholytic.
8. Azilsartan Medoxomil - Edarby. Nws muaj cov nyhuv antihypertensive zoo. Nws muaj ob txoj hauv kev zam.

Cov pab pawg no muaj cov nyeem pom tseeb. Cov pab pawg tseem ceeb yog qhov txo qis ntawm lub plawv dhia. Yog hais tias mem tes yog tsis tshua muaj thawj zaug, tom qab ntawd noj cov tshuaj zoo li no tuaj yeem ua rau muaj kev txhawm rau mob hlwb thiab txawm tias lub plawv nres. Qhov qhia tau rau kev teem caij yog txoj hlab ntshav txhaws tiv thaiv keeb kwm ntawm tachycardia, ischemic mob plawv, hyperthyroidism.

Txoj kev kho mob pib nrog cov koob tshuaj tsawg kawg, uas nce siab zuj zus. Hauv cov neeg mob laus, qhov no tau ua tib zoo saib, tsis ntau tshaj ib zaug txhua 2 asthiv. Nws yog ib qho tsim nyog yuav tsum tau soj ntsuam tas li tsis yog lub siab, tab sis kuj tseem muaj rau cov mem tes. Yog tias lub siab loj dua, thiab cov mem tes nce txog 55-60 ib feeb, tom qab ntawd nce cov koob tshuaj yog nruj me ntsis txwv. Tab sis yog tias nws tsim nyog yuav tsum tau tso tseg kev kho mob, ces qhov no yuav tsum tau ua kom maj mam, txij li nws ua tau kom muaj kev tshem tawm tus mob tawm.

Pab pawg no yuav tsum tau siv kom zoo zoo rau cov neeg mob uas tau mob COPD nrog mob hawb pob, vim tias tseem muaj peev xwm tsim cov mob bronchospasm. B-blockers muaj cov txiaj ntsig rau kev ua kom yuag plab rog, uas yuav tsum tau txiav txim siab nyob rau hauv muaj ntshav qab zib mellitus. Thaum kho, yuag nce ceeb toom.

• Metaprolol tartrate. Betalok yog thawj, cov lus piv qhia yog Vazokardin, Corvitol, Metokard, Serdol, Egilok.Lub sijhawm ua haujlwm ntev - Egilok retard. Cov ntsiav tshuaj tau sau tawm 2 zaug hauv ib hnub, tsis hais txog kev noj zaub mov. Egilok retard tau noj thaum sawv ntxov. Cov ntsiav tshuaj muaj peev xwm muab faib tau yog qhov xav tau.
• Metaprolol Succinate - Betalok ZOK, Egilok C, Metozok. Nov yog cov tshuaj siv ntev. Koj tsis tuaj yeem sib faib cov ntsiav tshuaj. Nqos lawv tag nrho yam tsis ntxo. Qhov kev txiav txim kav ntev dua 24 teev. Qhov no yog lub ntsiab zoo ntawm succinates.
• Bisoprolol - Kokor (qub), Bidop, Coronal, Niperten, Cordinorm, Aritel, Biol, Bisogamma, Biprol. Cov ntsiav tshuaj nyias txawv nyias. Yog li, Concor muaj cov duab ntawm lub siab, Cordinorm yog hom kab npauj npaim uas muaj kev pheej hmoo txaus. Biol muaj 2 qhov txaus ntshai uas tso cai rau koj los faib cov ntsiav tshuaj ua 4 ntu nrog ib tus ntiv tes. Nws yog qhov yooj yim los siv thaum xaiv koob tshuaj. Nws noj ib hnub ib zaug.
• Carvedilol. Thaum xub thawj, Dilatrend tau siv, tom qab ntawd nws pib hloov los ntawm Acridilol, Carvitrend, Coriol, Kardivas, Carvedigamm. Nws tsis tshua muaj los kho. Nws txawv ntawm lwm yam B-blockers hauv qhov ntawd nws ntxiv thaiv alpha1-adrenergic receptors. Thiab qhov no muab cov nyhuv vasodilator ntxiv. Nws muaj cov txiaj ntsig zoo ntawm cov rog metabolism, txo cov ntsiab lus ntawm cov teeb meem roj cholesterol thiab nce ntxiv muaj txiaj ntsig zoo. Nws feem ntau yog noj ob zaug ib hnub tom qab noj mov.
• Betaxolol - Lokren (qub), Betoptik, Betak, Betoftan, Xonef, Optibetol. Nws tsis tshua muaj mob bronchospasm, yog li nws yog qhov zoo los siv rau hauv cov neeg mob hawb pob lossis mob COPD. Cov ntsiav tshuaj muaj peev xwm tuaj yeem faib ua ke. Nws tau coj thaum sawv ntxov, siv tau rau ib hnub.
• Nebivolol. Tau ntev, tsuas yog Nebilet tau qhia rau lub khw tshuaj. Tam sim no ntau tus neeg pheej yig ntxiv tau tsim: Bivotens, Nebilong, Binelol, Nebilan. Txhawb nqa qhov kev tso tawm ntawm nitric oxide los ntawm endothelium ntawm lub ntsa ntsa. Qhov no ua rau vasodilation me me. Cov tshuaj raug noj 1 zaug nyob rau ib hnub, tsis hais txog kev ua zaub mov. Siv tau 24 teev.

Muaj lwm yam B-blockers uas yav dhau los siv nquag, tab sis hnub no lawv tau siv tsawg, vim tias muaj ntau hom tshuaj niaj hnub no. Qhov no yog feem ntau Atenolol, uas tau pom zoo kom noj 1-2 zaug ib hnub ua ntej noj mov.

Lwm tus neeg sawv cev ntawm 1st tiam B-blockers yog propranolol (Anaprilin). Vim yog qhov cuam tshuam txog qhov tsis zoo, tsis yog tsuas yog qhov xav tau B1 receptors, tab sis kuj rau B2 receptors, qhov ntxim nyiam ntawm kev tsim cov kev mob tshwm sim tsawg. Rau kev kho mob ntshav siab tsis yog siv. Nws tuaj yeem muaj txiaj ntsig tsuas yog rau kev txiav tawm kev kub siab ntawm cov teeb meem nrog tachycardia.

Calcium Channel Blockers (Cov Hluav Taws Xob calcium Antagonists)

Cov nyhuv antihypertensive yog vim muaj vasodilation, uas ua rau txo qis kev tawm tsam tag nrho cov hlab ntsha tiv thaiv teeb meem. Cov calcium calcium blockers tsis cuam tshuam rau cov txheej txheem metabolic, tiv thaiv thrombosis, thiab qeeb ntawm cov mob atherosclerosis. Qhov tshwj xeeb tshaj yog siv rau cov neeg laus.

Ntawm cov calcium antagonists, nyob ntawm tus qauv tshuaj, 3 pawg tau txawv: dihydropyridines, phenylalkylamines thiab benzodiazepines. Ib pawg ntawm dihydropyridines feem ntau yog siv rau kev kho mob ntawm txoj hlab ntaws: nifedipine, amlodipine, thiab lwm yam. Cov kev mob tshwm sim Feem ntau vim qhov kev kho mob twg thiaj li yuav tsum tau muab tso tseg yog mob taub hau thiab mob peripheral edema. Muaj peev xwm tachycardia thiab liab ntawm lub ntsej muag.

1. Nifedipine - Adalat (thawj), Phenigidin, Nifecard, Corinfar, Cordipine, Cordaflex. Calcium antagonist ntawm 1 tiam. Nws ua sai sai: thaum nqos, cov nyhuv tshwm sim tom qab 30-60 feeb, yog tias muab tso rau hauv qab nplaig - tom qab 5-10 feeb. Cov nyhuv antihypertensive kav ntev txog 3-4 teev, yog li nifedipine tsis haum rau kev kho mob tas mus li. Nws tsuas yog siv los txo cov ntshav siab ceev lossis thaum muaj teeb meem tsis hnyav tachycardia.
2. Kev ua yeeb yam ntev ntev nifedipine - Calcigard retard, Cordipin retard, Corinfar retard.Cov ntsiav tshuaj tau noj 2 zaug hauv ib hnub tom qab noj mov. Cordaflex RD, Cordipin HL, Corinfar UNO, zoo li Nifecard HL muab cov tswj kev tswj siab 24 teev nyob rau ib hnub. Txais txais 1 zaug nyob rau ib hnub. Cov ntsiav tshuaj tsis tuaj yeem faib.
3. Amlodipine. Norvask yog thawj zaug thiab feem ntau kawm, tab sis kim. Ntau cov generics tau tsim: Amlothop, Kulchek, Normodipin, Stamlo, Tenoks. Cov nyhuv antihypertensive tuaj yeem pom 1-2 teev tom qab kev coj noj coj ua. Nws mob tsawv rau ib hnub. Amlodipine hnyav dua li nifedipine. Tsim levorotatory isomer ntawm amlodipine - EsCordi Cor. Zoo tsis muaj qhov o. Koob tshuaj yuav tsum txhaj 2 zaug tsawg dua.
4. Felodipine yog thawj Felodip thiab Plendil. Muab piv nrog cov calcium antagonists yav dhau los, nws ua rau cov nqaij ntshiv qis dua. Nws noj ib hnub ib zaug.
5. Lercanidipine. Zanidip yog thawj zaug, tom qab ntawd Lerkamen raug tso tawm. Nws tau noj ua ntej noj mov. Edema tsis tshua muaj.
6. Isradipine - Lomir. Siv tau ntev li 12 teev. Siv cov ntsiav tshuaj 2 zaug hauv ib hnub. Kuj tseem muaj lub sijhawm ntev-kev ua haujlwm tsiav tshuaj.

Verapamil belongs rau phenylalkylamines. Nws tseem muaj nyob hauv qab lub npe Isoptin thiab Finoptin. Ua haujlwm zoo li B-blockers. Cov lus qhia thiab contraindications yog qhov zoo sib xws. Tab sis kev nyiam txais yog muab rau cov tshuaj no, piv txwv li, yog tias tus neeg mob muaj mob ntsws asthma thiab lwm yam mob ntsws.

Benzodiazepines, uas suav nrog diltiazem, kev xyaum tsis tau siv tam sim no los kho ntshav siab.

Cov tshuaj tiv thaiv (diuretics)

Chav kawm ntawm antihypertensive tshuaj feem ntau yog siv hauv kev kho ua ke. Diuretics txo cov ntshav siab los ntawm kev tshem tawm cov dej ntau thiab sodium hauv lub cev. Lawv rov los thaum sawv ntxov. Lawv muaj lub txiaj ntsig tsis zoo ntawm qhov muaj peev xwm.

1. Hydrochlorothiazide (hypothiazide). Rau kev kho mob kub siab, 25 mg ntsiav tshuaj yog siv, uas raug pom zoo kom muab faib ua ib nrab. Cov koob tshuaj no yog txaus kom ua tiav qhov kev xav tau. Tib lub sijhawm, qhov ntxim nyiam ntawm cov kev mob tshwm sim yog qhov tsawg dua. Ntawm kev ceeb toom tshwj xeeb yog qhov cuam tshuam tsis zoo ntawm no diuretic rau cov metabolism: ib qho kev nce hauv qab zib, qib ntawm uric acid thiab cov roj cholesterol hauv cov ntshav, thaum cov poov tshuaj ploj.
2. Indapamide - Arifon (thawj), Indap. Cov ntsiav tshuaj muaj 2.5 mg ntawm cov nquag xyaw. Cov nyhuv mob tsawv rau 24 teev. Muaj cov foos tshwj xeeb: Arifon retard, Ravel-SR thiab Indapamide retard. Lawv txawv nyob rau hauv ib koob tshuaj ntawm 1.5 mg. Cov tshuaj no yog qhov zoo dua, vim tias lawv coj ncaj ncees thawm hnub. Indapamide cuam tshuam rau cov metabolism, tab sis rau qee yam tsawg dua.
3. Spironolactone - Aldactone (qub), Veroshpiron, Veroshpilakton. Nws txawv ntawm lwm cov diuretics nyob rau hauv uas nws khaws cov poov tshuaj thiab muaj cov nyhuv antialdosterone. Kev qhia rau kev siv yog refractory arterial hypertension lossis edematous syndrome. Nrog lub caij nyoog siv hauv cov txiv neej, ib qho kev nce hauv cov qog mammary yog ua tau - gynecomastia.
4. Torasemide - Diuver, Britomar, Trigrim. Cov tshuaj thawj tsis tau sau npe nyob rau hauv Russia. Nws muaj cov ntsiab lus antialdosterone. Cov theem poov tshuaj yog suab tsis cuam tshuam. Cov nyhuv tshuaj diuretic tsuas kav ntev txog 18 teev, tab sis tso zis tawm maj tuaj thoob plaws hnub.

Muaj cov yeeb tshuaj zoo li furosemide (Lasix). Nws muaj lub zog diuretic muaj txiaj ntsig, tab sis muaj qhov tsis zoo ntawm cov metabolism. Rau kev siv tas mus li tsis siv. Tsawg zaus, nws tuaj yeem siv los daws kev kub siab thaum muaj kev kub ntxhov.

Muaj lwm lub diuretic - chlortalidone. Ntau zaus muaj nyob rau hauv kev npaj ua ke los txhim kho cov nyhuv hypotensive.

Imidazoline receptor agonists

Tshwj xeeb I2-imidazoline receptors nyob hauv qhov medulla oblongata yog tsa. Vim li ntawd, cov nyhuv ntawm lub zog sympathetic rau ntawm lub plawv thiab cov hlab ntshav yog txo.Lawv muaj cov txiaj ntsig zoo ntawm cov txheej txheem hauv lub cev hauv lub cev, yog li cov tshuaj no tau pom zoo rau cov neeg muaj kev rog thiab mob ntshav qab zib. Pawg no suav nrog:

1. Moxonidine - Physiotens (yog thawj zaug), Moxarel, Moxonitex, Tenzotran. Muaj nyob rau hauv koob tshuaj ntawm 0.2 thiab 0.4 mg. Nws tuaj yeem siv tau ob qho tib si rau kev txais tos tsis tu ncua thiab rau cov teeb meem nres.
2. Rilmenidine - Albarel. Cov ntsiav tshuaj muaj 1 mg ntawm cov tshuaj nquag.

Direct renin inhibitor

Txog tam sim no, qhov no suav nrog tib tus sawv cev - Aliskiren (Rixila, Rasilez). Pib hauv theem pib ntawm kev pib ntawm RAAS. Tiv thaiv lub plawv thiab lub raum, qeeb qeeb ntawm cov mob ntawm atherosclerosis. Nws tau thov ib hnub ib zaug. Nws ceev lub siab rau ib hnub, thaiv thaum sawv ntxov ntxov, thaum feem ntau ntawm kev mob vascular tshwm sim.

Alpha blockers

Cov sawv cev tseem ceeb yog: doxazosin (Kardura, Kamiren) thiab prazosin. Cov tshuaj hauv cov pab pawg no muaj cov txiaj ntsig zoo ntawm cov txheej txheem metabolism thiab txo qis cov cholesterol. Kev siv cov alpha-adrenergic blockers nyob rau hauv cov txiv neej uas muaj, ntxiv rau kev mob ntshav ntawm cov ntshav, prostate adenoma tsuas yog hais txog. Doxazosin noj 1 zaug nyob rau ib hnub, thiab prazosin raug pom zoo kom siv 2-3 zaug hauv ib hnub.

Nyiaj txiag tag

Qhov no suav nrog tshuaj rau ntshav siab, muaj 2, lossis txawm tias muaj tshuaj 3 yam nyob hauv ib ntsiav tshuaj. Qhov no yooj yim, vim cov lej ntawm cov tshuaj noj thaum nruab hnub yuav raug txo kom tsawg.

Feem ntau, ACE inhibitors thiab diuretics raug sib xyaw:

• enalapril + hydrochlorothiazide - Co-Renitec, Enap N, Berlipril ntxiv, Renipril GT,
• lisinopril + hydrochlorothiazide - Co-Diroton, Iruzide, Lysoretic,
• ramipril + hydrochlorothiazide - Tritace ntxiv, Wazolong N, Hartil D, Amprilan NL,
• fosinopril + hydrochlorothiazide - Fosicard N, Fosinotek N,
• zofenopril + hydrochlorothiazide - Zokardis ntxiv,
• hinapril + hydrochlorothiazide - Akkuzid,
• perindopril + indapamide - Noliprel, Noliprel forte, Ko-Perineva, Ko-Parnavel.

Kev sib xyaw ntawm ARBs thiab diuretics zoo siv:

• losartan + hydrochlorothiazide - Gizaar, Blocktran GT, Vazotens N, Lozap ntxiv, Lorista N,
• valsartan + hydrochlorothiazide - Co-Diovan, Duopress, Valz N, Valsacor N,
• irbesartan + hydrochlorothiazide - Coaprovel, Firmasta N, Ibertan Ntxiv,
• telmisartan + hydrochlorothiazide - MikardisPlus,
• eprosartan + hydrochlorothiazide - Teveten Ntxiv,
• candesartan + hydrochlorothiazide - Atacand Ntxiv, Candecor N,
• Olmesartan Medoxomil - Cardosal Ntxiv,
• azilsartan medoxomil + chlortalidone - Edarby Clough.

Nrog rau diuretics, B-blockers tseem tuaj yeem ua ke:

• bisoprolol + hydrochlorothiazide - Lodose, Bisangil, Biprol ntxiv thiab Aritel Plus,
• nebivolol + hydrochlorothiazide - Nebilong N,
• atenolol + chlortalidone - Tenorik, Tenoretik.

Hauv nruab nrab mus txog rau mob ntshav siab, kev sib xyaw ntawm ACE inhibitors, ARBs, thiab B-blockers nrog calcium antagonists feem ntau tau sau tseg:

• ramipril + amlodipine - Egipres,
• perindopril + amlodipine - Prestans, Parnavel Amlo, Dalneva,
• lisinopril + amlodipine - Ua Yeeb Yam, Equacard,
• enalapril + lercanidipine - Coriprene,
• losartan + amlodipine - Amzaar, Lortenza, Amozartan,
• valsartan + amlodipine - Exforge, Vamloset,
• irbesartan + amlodipine - Aprovask,
• bisoprolol + amlodipine - Concor AM,
• nebivolol + amlodipine - Nebilong AM,
• atenolol + amlodipine - Tenochok,
• metoprolol + felodipine - Logimax.

Txog rau hnub tim, tsuas muaj ib qho sib xyaw peb zaug xwb, suav nrog indapamide, perindopril thiab amlodipine - Ko-Dalnev.

Thaum tsis xav tau cov tshuaj kom hnyav

Yog tias cov ntshav siab cov nuj nqis tsis siab heev thiab kev noj tshuaj tas mus li tsis tas yuav tsum muaj, tom qab ntawd cov tshuaj tiv thaiv kev tiv thaiv ntshav me me tau txais kev pab txo tus mob:

• Dibazole - ua zoo li calcium channel blockers, txhawb kev vasodilation. Cov tshuaj ntim tshuaj muaj 20 mg ntawm cov nquag xyaw. Nws tuaj yeem siv 2-3 zaug hauv ib hnub nyob rau hauv kev kawm luv luv lossis thaj chaw.
• Papaverine - tseem ua kom txoj hlab ntshav, vim tias nws yog myotropic antispasmodic. Muaj nyob hauv 40 mg ntsiav tshuaj. Nws yog kho 3-4 zaug hauv ib hnub lossis siv rau kev tsis zoo ntawm lub dag zog.
• Andipal - muaj dibazole, papaverine, phenobarbital, metamizole sodium. Vim tias thawj zaug muaj ob feem, cov tshuaj pab kom txo qis. Phenobarbital calms, thiab metamizole sodium pab daws kev mob taub hau. Nws tau noj rau lub ntsiav tshuaj nrog qhov nce siab me ntsis. Tom qab ib nrab ib teev nyob rau hauv qhov tsis muaj tshwm sim, txoj kev tuaj yeem rov ua dua.

Xaus

Qhov kev xaiv ntawm cov tshuaj yog loj heev. Txhua tus neeg tuaj yeem xaiv txoj kev kho tus kheej. Tab sis tshuaj noj los ntawm ntshav siab tuaj yeem xaiv kom raug yog los ntawm kws kho mob. Qhov no tsis tas ua haujlwm thawj zaug, qee zaus koj yuav tsum txheeb los ntawm ntau yam kev xaiv thiab kev sib txuas. Nws siv sijhawm thiab ua siab ntev. Tab sis yog tias koj ncaj qha ua raws li cov lus pom zoo, noj cov tshuaj tsis tu ncua, ces cov txiaj ntsig yuav tshwm sim.