A wane irin matsin lamba ne aka rubuta Enap da umarnin magani

Hauhawar jini a jijiya wata cuta ce da ke alakantuwa da hauhawar matsin lamba da lalacewar gabobin masu hankali. Ba a fayyace ainihin dalilin cutar ba, sabili da haka, a cikin aikin asibiti, ana amfani da magunguna waɗanda ke da niyyar fasa haɗin hanyoyin pathogenesis. Enap magani ne na farko na yau da kullun wanda yawancin marasa lafiya ke amfani dashi saboda aminci, inganci da kwanciyar hankali.

Umarnin don amfani da miyagun ƙwayoyi

"Enap" shine sunan jami'in magani, mai aiki wanda shine maganin enalapril - asalin asalin acid din. Kayan aiki yana cikin rukunin masu hanawa (rage gudu) angiotensin-mai canza enzyme (ACE inhibitor), tsarin aikin wanda aka gabatar a cikin tebur.

Bugu da kari, sinadarin yana da tasirin antifibrillatory kuma yana hana gyaran myocardial (sake fasalin) bayan bugun zuciya, tare da nakasa ko kuma rashin ingancin valvular.

Akwai "Enap" a cikin kwamfutar hannu tare da sashi daban-daban na kayan aiki da haɗi tare da wasu hanyoyi don amfani mai dacewa, don cimma burin warkewa.

Inungiyar inhibitor ACE tana cikin layin farko na magunguna don maganin hauhawar jini. "Enap" wakili ne na aji na biyu tare da tsawan sakamako (sama da awanni 24) kuma ana wajabta shi sau ɗaya a rana.

Ana amfani da kayan aiki a far:

• mahimmancin hauhawar jini - ci gaba da karuwa a cikin alamu masu matsa lamba ba ga wani dalili na fili ba (kawai ana sanya abubuwan haɗari),
• Ciwo na Cohn da hyperaldosteronism na farko - cututtukan endocrine waɗanda ke tattare da haɓaka ƙirar aldosterone,
• mai ciwon sukari nephropathy - take hakkin iko a cikin filtration na cututtukan cututtukan metabolism na metabolism,
• naƙasasshen zuciya - ƙwaƙwalwar tana ƙaruwa da ƙarfin ƙwayar jini ba tare da shafi mita ba,
• hawan jini na jijiya tare da lahani mara nauyi,
• cututtukan koda na koda shine rukuni na cututtukan cututtukan da ke tattare da hanya mai zurfi na ci gaba da raguwa a cikin ƙirar tacewa ta duniya.

"Enap" - wata hanya don sarrafa hauhawar jini, wanda ke fara aiki 1 sa'a bayan gudanarwa. Ba'a yi amfani da maganin don dakatar da rikice-rikice masu hauhawar jini ba.

Sashi da gudanarwa

Ana samun magungunan a cikin nau'ikan allunan tare da nau'ikan abubuwa daban-daban na abu mai aiki - Enalaprilat (2.5-5-10-20 mg). Abubuwa masu taimako: magnesium stearate, sitaci masara, sittin bicarbonate, rawaya da jan karfe baƙin ƙarfe (fenti don allunan 20 mg), talc da lactose monohydrate.

Magungunan an yi shi ne don gudanar da maganin baka sau ɗaya a rana ba tare da an ɗaura shi da kayan abinci ba. Zabi na kashi da regimen an yarda da likita mai halartar.

Enap - 5mg Allunan suna da lebur, zagaye a cikin siffa tare da yatsar baki. Launi - fari, ba tare da ƙarin ƙazantawa ba, a gefe ɗaya - rarraba tsiri.

Ana amfani da miyagun ƙwayoyi a cikin kwalin kwali: Allunan 20 a cikin blis of 10 guda.

An gabatar da jigilar magunguna a cikin tebur.

Matsakaicin maganin warkewa na 40 MG shine allunan 8, ƙarancin abin da ke tattare da alamomin zubar da jini (hyperkalemia, orthostatic hypotension, da sauransu).

Kashi 10 MG

Allunan tare da kashi na enalaprilat 10 MG - zagaye-mai launin ruwan kasa tare da fitowar sha'awa cikin waje a cikin kauri na samfurin. An yanke gefuna na shirye-shiryen, a gefe ɗaya daga farfajiya akwai ƙira mai rarraba.

An gabatar da manufar Enap 10 MG don cututtuka daban-daban a cikin tebur.

Boye HL da H

Kulawa da hauhawar jini a matsakaici ya ƙunshi zaɓi na haɗakar magunguna. Ana amfani da haɓaka mafi inganci na inhibitors na ACE da diuretics.

KRKA yana samar da Enap N da Enap HL, waɗanda ke ɗauke da maganin da aka ƙayyade na enalaprilat da hydrochlorothiazide (nau'in magungunan thiazide daga ƙungiyar diuretics).

An gabatar da fom ɗin saki a cikin tebur.

Kirkirar tsari na shigowa ya danganta da tsananin cutarwar da kasancewar cututtuka masu haɗuwa. Matsakaicin warkewa shine 1 kwamfutar hannu kowace rana.

Haɗin maganin inhibitors na ACE tare da diuretics ana ɗauka mafi inganci a cikin maganin hauhawar jijiya a cikin tsofaffi.

Contraindications

"Enap" yana nufin ƙungiyar masu hana ACE waɗanda ke aiki akan masu karɓa waɗanda suke cikin tasoshin jikin duka. Amfani da miyagun ƙwayoyi yana da iyakance a cikin marasa lafiya da:

• rashin lafiyan halayen ga aiki da kayan taimako na miyagun ƙwayoyi (gami da sauran wakilan ƙungiyar),
• tarihin girgiza anaphylactic gigicewa ko burar anginaede Quincke,
• mai ciwon sukari mai ciwon sukari (CKD 3 kuma mafi matakai),
• ciki (aiki metabolites magani shiga cikin jini shinge da kuma hana tashin jini tsakanin uwa da yaro),
• yara a ƙarƙashin shekaru 6
• gazawar hanta
• hyperkalemia sakamakon lalacewa ta hanyar rhabdomyolysis, CKD, rauni na ƙonewa ko ciwo mai rauni.

Shirye-shirye tare da haɗuwa da hydrochlorothiazide ya rushe metabolism, sabili da haka, an contraindicated a cikin marasa lafiya tare da ciwon sukari mellitus.

Side effects

Sakamakon da ba a so ɗauka game da shan ƙwayoyi suna faruwa ne sakamakon tasirin tasirin glucose, Potassium, faɗuwar jini da hauhawar gurɓataccen ƙwayar bradykinin.

Yawancin sakamako masu illa tare da alƙawarin "Enap" an gabatar dasu a cikin tebur.

Alamomin gama gari sun haɗa da rauni, farin ciki, raɗaɗin tsoka, da tashin hankali na bacci. Sakamakon sakamako yana da wuya (ban da tari) kuma ana kashe su ta hanyar daidaitawa da zaɓi na musanyawa.

Marasa lafiya da keɓaɓɓen narkewa na buƙatar saka idanu sosai game da matakan potassium saboda babban haɗarin maye da bugun zuciya a cikin diastole.

Analogs ana samarwa a kasuwar Rasha

Enalapril sanannen abu ne mai aiki wanda aka yi amfani dashi wajen maganin hauhawar jini kuma ana samunsa a ƙarƙashin sunayen kasuwanci daban-daban.

Shirye-shirye tare da irin wannan abun da ke ciki rajista a Rasha:

• Burlipril (Jamus),
• Ednit (Harshen Hungary),
• "Sabuntawa" magani ne na asali,
• Enam (India),
• Brumipril (Belgium) yana samuwa a cikin capsules,
• Enalapril Hexal (Jamus),
• Enapharm (Rasha).

Zaɓin kayan aiki ya dogara da hankalin mutum da ikon mai haƙuri. Game da rashin inganci na miyagun ƙwayoyi, ana bada shawarar zaɓin maye gurbin daga ƙungiyar inhibitor ACE ko wasu magunguna na farko na rigakafin ƙwayar cuta.

Kulawa da hauhawar jini shine wata tambaya a buɗe wacce zaban wakili ya dogara da shekarun mai haƙuri, tsawon lokacin da ake magana da cutar tare da kasancewar cututtukan haɗin gwiwa Enap shine ɗayan magungunan da aka tsara waɗanda ake amfani dasu a cikin warkewa. Amfani mai dacewa, tsawon lokacin aiki, tasiri da aminci sune manyan fa'idodin maganin. Wa'adin regimen da sashi na maganin yana gudana ne ta hanyar likitan halartar tare da gyara mai zuwa bayan kwana 10-12.

An yi amfani da hanyoyin bayanan da ke gaba don shirya kayan.

Fom ɗin saki

Ana yin allunan Enap dauke da abubuwa iri-iri na aiki mai aiki.

• Yana nufin Guji 2.5 MG - Waɗannan fararen ko farin farin allunan, biconvex, zagaye, tare da bevel. Kunsasshen a blisters na 10 inji mai kwakwalwa.
• Yana nufin Nuna 5 MG - Waɗannan fararen ko fararen allunan fari ne, ɗakunan silima, tare da chamfer da haɗari. Kunsasshen a blisters na 10 inji mai kwakwalwa.
• Yana nufin Ciniki 10 MG - Waɗannan sune allunan launin ruwan kasa-launin shuɗi, silsila-silin, tare da bevel da daraja. Zai iya kasancewa farin fararen burgina a ciki da saman kwamfutar hannu. Kunsasshen a blisters na 10 inji mai kwakwalwa.
• Yana nufin Nuna 20 MG - Waɗannan sune allunan hasken-Orange, Silinda-ɗakin kwana, tare da chamfer da haɗari. Wataƙila farat ɗaya launin fari da launin ruwan kasa-burgundy a ciki da saman tebur ɗin. Kunsasshen a blisters na 10 inji mai kwakwalwa.

A cikin fakitoci na kwali - 2, 3, 6 blisters.

Aikin magunguna

Enap magani ne mai rashin hankali. Hanyar aiwatar da aiki na enalapril ya dogara da hana ayyukan ACE, yana haifar da raguwar samarwa na angiotensin II.

Kwayar halittar enalapril itace asalin amino acid ce: L-Alanine da L-proline. Bayan an sha maganin a baki, ana sanya shi cikin ruwa zuwa enalaprilat, mai hanawa ACE. A ƙarƙashin tasirinsa, samar da angiotensin I angiotensin II yana raguwa, saboda raguwa a cikin matakin plasma, an lura da karuwa a cikin aikin renon plasma da raguwa a cikin ɓoyewar aldosterone. Tunda ACE daidai yake da kininase II, enalapril yana da ikon toshe halakar bradykinin (wannan peptide ne wanda ke haifar da tasirin vasopressor). A yanzu, ba a san menene mahimmancin wannan tasirin ba a cikin hanyar aiwatar da aiki na abu mai guba.

Tasirin antihypertensive na abu mai aiki yana da alaƙa da farko tare da hana ayyukan RAAS, wanda ke taka muhimmiyar rawa a cikin tsarin aiwatarwa hawan jini. Amma ko da a cikin mutane masu cutar hawan jini da ƙananan maida hankali, an lura da tasirin rigakafin cutar enalapril.

Bayan amfani da wannan magani, hawan jini yana raguwa ba tare da la’akari da matsayin da jikin ɗan adam yake ba, yayin da ƙwarjin zuciya baya ƙaruwa sosai.

Ci gaba bayyanar cututtukan orthostatic yakan faru ne kawai a cikin lambobin da ba a sani ba Wani lokaci, don cimma matsa lamba da aka ambata, zai ɗauki makonni da yawa don ɗaukar maganin. Tare da katsewar maganin, babu hauhawar jini.

Mai tsananin hana aikin ACE, a matsayin mai mulkin, an lura yana awanni 2-4 bayan fitowar kwamfutar. Sakamakon antihypertensive yawanci ana jin sa'a 1 bayan shan miyagun ƙwayoyi a ciki, matsakaicin sakamako yana faruwa bayan sa'o'i 4-6. Tsawon lokacin aikin ya dogara da yawan ƙwayoyi. Idan mai haƙuri ya ɗauki allurai na Enap wanda likita ya ba da shawarar, za a kula da sakamako na hemodynamic da antihypertensive don aƙalla 24 hours.

A cikin mutanen da ba su da lafiya mahimmancin hauhawar jini, tare da raguwa a cikin karfin jini, raguwa a cikin jijiyoyin bugun jini da karuwar fitowar zuciya. Koyaya, babu wani canji mai mahimmanci a cikin bugun zuciya. Yawan hauhawar jini yana karuwa, ba a lura da canje-canje a matakan tsagewar duniya. Amma akwai karuwa a cikin wannan alamar a cikin mutanen da ke da ƙarancin tace ƙimar ƙasa.

A cikin mutane suna wahala mai ciwon sukari nephropathy da marasa ciwon sukari, yayin shan enalapril rage albuminuria /furotinururia da kuma kawar da IgG ta hanta.

Marasa lafiya da ke fama da rauni a zuciya yayin jiyya tare da diuretics da cardiac glycosides da kuma yin amfani da enalapril suna da raguwa a cikin karfin jini, bugun zuciya, haɓakar fitowar zuciya, da raguwa a cikin zuciya (a matsayin mai mulkin, a cikin mutanen da ke fama da rauni na zuciya wannan mai nuna yana ƙaruwa).

Akwai raguwa cikin yawan ƙwaƙwalwar ƙwayar hanji. Tare da tsawaita amfani da allunan, enalapril yana ƙaruwa da haƙuri ga kayan jiki, rage tsananin bayyanuwar bugun zuciya. A cikin mutane tare da CHF a cikin sauƙi zuwa matsakaici na matsakaici, ƙwayar tana rage jinkirin ci gaba da cutar, har ila yau yana rage ƙimar ci gaban dilaation na hagu ventricle

A cikin mutanen da ke da matsalar lalacewar ventricular, Enap yana rage yiwuwar manyan sakamako na ischemic (yawan bayyanuwar abubuwa yana raguwa infarction na zuciyayana rage yawan asibiti saboda angina pectoris).

Pharmacokinetics da kuma kantin magunguna

Bayan shan enalapril an lura da saurin ɗaukar nauyi - matakin digiri ne na kusan kashi 60%. Ana lura da mafi girman taro na enalapril a cikin jini 1 awa bayan aikace-aikacen, yayin cin abinci baya tasiri sha. Abun yana aiki da ruwa sosai, wanda aka gina enalaprilat, ACE inhibitor. Mafi girman maida hankali na enalaprilat an gyara shi 3-4 sa'o'i bayan maganin baka. Tare da sake maimaita amfani da maganin enalapril, cirewar rabin rayuwa shine awanni 11.

Enalapril ba shi da mahimmanci biotransformed a cikin jiki, ban da juyawa daga cikin abu zuwa enalaprilat.

M kodan ya fice daga hanta. A cikin fitsari, enalaprilat a kashi 40% kuma enalapril da baya canzawa a kashi 20% an ƙaddara.

Alamu don amfanin Enap

Alamun masu zuwa don amfani da Enap an ƙaddara:

• mahimmancin hauhawar jini,
• CHF (a hade magani)
• domin hana bayyanar da tsananin raunin zuciya a cikin wadancan marasa lafiya da suka kamu da cutar asymptomatic hagu ventricular tabarbarewa (a hade magani)
• don rage yawan bayyanuwar infarction na zuciya,
• domin rage yawan asibitocin mutane da m angina.

Daga abin da Allunan Enap, kuma ko yana da ƙimar amfani da su a kowane yanayi, mai haƙuri ya kamata ya nemi likita.

Side effects

A lokacin jiyya, ana iya lura da irin wannan sakamako masu illa (mummunan tasirin da ke cikin kowane rukuni an tsara shi daga mafi yawan lokuta zuwa mafi wuya):

• bashin: anemia, neutropeniaraguwa a cikin hematocrit kuma hawan jini, agranulocytosis, thrombocytopeniahaemopoiesis inhibition, pancytopenia, cututtukan autoimmune, bashin,
• metabolism: yawan haila,
• tsarin juyayi: bacin raiciwon kai, tabin hankali, nutsuwa, rashin bacci, paresthesia, babbar damuwa, vertigo, hargitsin bacci,
• zuciya da jijiyoyin jini: farin ciki, raguwar alama a cikin karfin jini, ciwon kirji, angina pectoris, bugun zuciya, bugun zuciya, bugun jiniko infarction na zuciya, cutar ta Raynaud,
• azanci gabobin: canji mai ɗanɗano, jin daɗin tinnitus, hangen nesa,
• narkewa: zawo, tashin zuciya, rashin tsoro, ciwon ciki, tashin zuciya, maƙarƙashiya, amai, maganin ciwon huhu, dyspepsia, anorexiabushe mucosa bakin, peptic ulcer, gurguntar bile tsare da hanta aiki, hepatitis, hepatic necrosis, maƙarƙashiyacholestasis stomatitisrauni na aphthous
• tsarin numfashi: tari, ciwon makogwaro, rhinorrhea, tsananin zafin rana, bronchospasm, karancin numfashi, rashin lafiyan alveolitishuhun huhun kwayar cutar huhu, rhinitis,
• fata fata: kurji, bayyanuwar cututtukan zuciya, angioedema, tsananin ɗaci, itching, alopecia, cututtukan mahaifaerythema multiforme, erythroderma, exfoliative dermatitis, epidermal mai guba necrolysis, pemphigus,
• tsarin kula da dabbobi: lalacewa aiki na koda, proteinuria, gazawar renal, rashin ƙarfi, gynecomastiaoliguria
• tsarin musculoskeletal: jijiyar wuya,
• alamomin bincike na dakin gwaje-gwaje: hyperkalemia, karuwa a cikin kwayoyin halittar creatinine, hyponatremia, karuwa a cikin taro na urea a cikin jini, ayyukan enzymes na hanta, matakin bilirubin a cikin jini,
• wasu abubuwan bayyanai: cutar rashin isasshen bayanin cutar ADH, zazzabimyalgia, myositis, arthritis, vasculitis, serositis, leukocytosis, Karuwar ESR, halayen daukar hoto.

Enap allunan, umarnin don amfani (hanya da sashi)

Umarni na hukuma game da amfani da Enap yana ba marasa lafiya damar shan magani a baki, ba tare da la'akari da cin abincin ba. An bada shawara a sha maganin a lokaci guda na rana tare da karamin adadin ruwa.

A hauhawar jini Da farko, ana sanya magani a cikin kashi 5 zuwa 20 MG sau ɗaya a rana, sashi yana dogara da tsananin hauhawar jini. Game da hauhawar jini, ana ba da shawarar kashi 5 MG ko 10 MG kowace rana zuwa digiri mai sauƙi.

A cikin mutane tare da mummunan aiki na RAAS, hawan jini na iya raguwa da yawa. A wannan yanayin, ana ba da shawarar yin amfani da ƙananan allurai na maganin - 5 MG kowace rana, gudanar da magani a ƙarƙashin kulawar kwararrun.

Kafin shan maganin, kuna buƙatar yin la'akari da cewa magani na baya tare da manyan magunguna na diuretic na iya haifar da rashin ruwa da haɓaka haɗarin jijiyoyin jini a farkon farkon magani. A wannan yanayin, an ba da shawarar yin amfani da kashi wanda bai wuce 5 MG kowace rana ba. Wajibi ne a dakatar da yawan shan diurelin kwanaki 2-34 kafin a fara Enap. A kan aiwatar da magani, yana da muhimmanci a kula da yanayin kodan, tantance abubuwan da ke cikin potassium a cikin jini.

Adadin kulawa shine kashi 20 a kowace rana. Idan akwai irin wannan buƙatar, to, ana ƙaruwa da kullun zuwa 40 MG, an ƙaddara sashi daban-daban.

Tare da CHF, kamar yadda tare da barkewar ventricular hagu, kashi na farko shine 2.5 MG na miyagun ƙwayoyi kowace rana. Wasu lokuta, diuretics, beta-blockers, da cardiac glycosides ana rubutasu lokaci guda don maganin rashin lafiyar zuciya.

Bayan gyara hauhawar jini ana iya ƙara yawan kashi a hankali - by 2.5-5 MG kowane kwanaki 3-4, kawo shi zuwa matakin tabbatarwa - 20 MG kowace rana. Mafi girman magani shine 40 MG kowace rana.

Tunda kan aiwatar da jiyya akwai yiwuwar haɓakar rashin lafiyar koda da jijiyoyin jini, ya zama dole a sa ido a hankali kan alamomin matsin lamba da aikin na koda. Babu buƙatar sake warware miyagun ƙwayoyi idan hypotension ya bunkasa bayan amfani da kashi na farko.

Mutanen da ke da cutar koda suna buƙatar haɓaka tazara tsakanin amfani da allunan ko rage yawan maganin.

An shawarci tsofaffi mutane suyi amfani da kashi na farko na 1.25 MG na Enap, tunda an rage saurin fitarwar enalapril.

Yawan abin sama da ya kamata

Idan yawan abin sama da ya kamata ya faru, to bayan kimanin awa 6, an lura da raguwar alama cikin karfin jini. Haɗin gwiwa na iya haɓaka, daidaituwar ruwa na lantarki zai iya rikicewa, tare da yawan damuwa, hauhawar jini, gazawar renal, bradycardia ya bayyana farin ciki, samarin, katsewa, palpitations.

Game da yawan abin sama da ya kamata, kuna buƙatar sanya mutumin a wuri na kwance, yayin da kai ya kamata ya kasance a matakin jiki. Idan yawan abin sama da ya kamata ya kasance mai laushi, kuna buƙatar kurkura ciki, ku bayar carbon kunnawa. Ana amfani da shi a cikin manyan lokuta na yawan haɗuwa da Enap a / a cikin gabatarwar maganin 0.9% sinadarin sodium, kuma ana iya aiwatar da shan madadin bugun jini, catecholamines.

Enalaprilat za'a iya cire shi daga jiki ta hanyar hemodialysis, yawan fitarwar shine 62 ml a minti daya.

Mutanen da ke da bradycardia amintattu ne na na'urar bugun zuciya. Game da yawan abin sama da ya kamata, saka idanu a hankali na magani electrolyte abun ciki da taro creatinine.

Haɗa kai

Tare da dakatarwa guda biyu na RAAS, wannan shine, a cikin yanayin gudanarwa na lokaci daya na masu hana ACE, masu adawa da karɓar angiotensin II ko aliskiren, haɗarin yana ƙaruwa jijiyoyin jini. Idan ya cancanta, irin wannan haɗin dole ne a hankali saka idanu a kan aikin kodan, ma'aunin ruwa da lantarki, hauhawar jini.

An ba da izini don haɗu da enalapril da aliskiren mutane masu ciwon sukari da cutar koda.

ACE inhibitors rage asarar potassium a ƙarƙashin rinjayar diuretics. Ta hanyar amfani da sinadarin enalapril da potassium-sparing diuretics, samfuran da ke dauke da sinadarin potassium, da kuma wasu abubuwan da ke dauke da potassium, hyperkalemia na iya haɓaka. Tare da wannan haɗin, yana da mahimmanci don sarrafa potassium mai

Tare da maganin cututtukan juji na baya, BCC na iya raguwa kuma da yiwuwar yanayin jijiya a cikin ɗaukar enalapril na iya ƙaruwa. Za'a iya rage irin wannan tasirin ta hanyar kawar da abubuwan diuretics, daɗa yawan shan ruwa da gishirin yau da kullun, da rage yawan maganin enalapril.

Tare da yin amfani da lokaci-lokaci na enalapril alpha-blockers, beta-blockers, methyldopa, BKK, jami'ai tarewa, nitroglycerin ko wasu nitrates, ana iya samun ƙarin raguwa a hawan jini.

Lokacin da aka ɗauka a layi daya tare da shirye-shiryen lithium, an lura da haɓaka tazara a cikin taro na lithium, kamar kuma yawan maye na lithium. Lokacin ɗaukar diuretics na thiazide, karuwa a cikin taro na lithium yana yiwuwa. Ba a yaba wa irin waɗannan haɗuwa ba, idan ya cancanta, a mai da hankali sosai kan kula da ƙwayoyin lithium mai mahimmanci.

Lokacin da aka ɗauka lokaci guda tare da enalapril, adadin maganin hana daukar ciki, maganin ƙwayoyin cuta, magungunan maganin tricyclic na iya kara rage haɓakar jini.

Lokacin ɗauka lokaci guda tare da Enap NSAIDs, tasirin antihypertensive na iya raguwa. Hakanan za'a iya lura da raunin aikin fitsari, musamman ma a cikin waɗanda ke fama da cutar koda. Sakamakon yana juyawa.

Lokacin ɗauka lokaci guda tare da Enap maharan hypoglycemic da insulin Za a iya kunna tasirin hypoglycemic kuma haɗarin haɗarin hypoglycemia yana ƙaruwa.

Tasirin antihypertensive na miyagun ƙwayoyi yana inganta ethanol.

Sympathomimetics yana rage tasirin antihypertensive na hanawar ACE.

Enalapril yana rage tasirin kwayoyi, waɗanda suka haɗa akarijin.

Lokacin da aka ɗauka lokaci guda tare da enap immunosuppressants, cytostatics, allopurinol da alama na leukopenia yana ƙaruwa. A cikin mutanen da ke fama da rauni na aiki lokacin ɗauka allopurinol kuma masu hana ACE kara haɗarin rashin lafiyan mutum.

Shan enalapril da cyclosporine a lokaci guda yana haifar da karuwa a cikin yiwuwar hyperkalemia.

Lokacin shan antacids, bioavailability na masu hana ACE ragewa yana raguwa.

Umarni na musamman

Bayan farawar magungunan Enap na farko, toshewar jijiya na iya haɓaka. Tare da mummunan hypotension, ya kamata a dage haƙuri a kwance, idan ya cancanta, gabatar da maganin 0.9% Sodium chloride.

Bayan yanayin mai haƙuri ya daidaita, ana iya ci gaba da jiyya.

Ba a bada shawarar yin amfani da Enap ga mutanen da suka kamu da cutar koda.

Da wuya, wata cuta ta fara Jazzice cholestatic da hepatitisdaga baya ya ci gaba zuwa hanta na hanta. Idan mai haƙuri ya bunkasa jaundice, dakatar da magani nan da nan kuma tuntuɓi ƙwararre.

Akwai kwatancen lokuta na neutropenia ko agranulocytosis a cikin mutanen da ke amfani da inhibitors na ACE.

A hankali sosai, kuna buƙatar yin amfani da wannan magani ga mutanen da ke da cututtukan nama na haɗin gwiwa, idan har sun sha maganin immunosuppressive, suna ɗauka procainamide, allopurinol. A wannan halin, mummunan cututtuka da ba za a iya bi da su ba na iya haɓaka. maganin rigakafi. Lokacin da masu wannan cutar suke ɗaukar cutar, lura da lokaci-lokaci game da matakin leukocytes a cikin jini ya zama dole.

Akwai damar cutar angioedema a cikin mutanen da suke karɓar haɓaka. A alamun farko na wannan yanayin, ana buƙatar cire magunguna da gaggawa kuma ziyarar likita. An lura da haɗarin haɗarin bunkasa wannan yanayin a cikin marasa lafiya tare da tarihin ciwon angioedema.

A kan aiwatar da shan miyagun ƙwayoyi a cikin lokuta masu wuya, ci gaban halayen anaphylactoid a cikin mutanen da suka shiga halin rashin walwala tare da hymenoptera venom.

A yayin aiwatar da shan maganin, marasa lafiya na iya haɓaka marasa amfani bushe taribacewar bayan sokewar enalapril.

Ya kamata a yi gargaɗi ga ƙwararrun likitan cewa mai haƙuri yana ɗaukar Enap kafin yin ayyukan tiyata tare da janar maganin ciwan jiki.

Yana da mahimmanci tuƙi a hankali kuma yin wasu nau'ikan ayyukan da ke buƙatar mai da hankali yayin jiyya tare da Enap.

Cire analogs

Ana siyar da magungunan ƙwallon ƙafa - ana amfani da magunguna Haske R, Burlipril, Bagopril, Vazolapril, Renipril, Invoril, Ednit, Enalapril da sauransu

Enalapril ko Enap - Wanne ya fi kyau?

Masu amfani da aka rubuta magunguna tare da maganin enalapril mai aiki suna yawanci sha'awar ko enalapril da enap allunan abu daya ne, menene banbanci tsakanin su? A zahiri, kayan aiki mai aiki a cikin magungunan guda biyu suna kama. Dangane da haka, suna haifar da sakamako iri ɗaya akan jiki. Bambancin kawai shine ƙasar asalin.

Yayin ciki da lactation

Ba za ku iya sha Enap ba a cikin mata masu juna biyu a cikin farkon farkon, kuma a cikin watanni masu zuwa na ciki. A yau, haɗarin ci gaban tasirin teratogenic ba shi yanke hukunci ba. Idan an tabbatar da daukar ciki, a wannan yanayin, dole ne a soke maganin nan da nan.

Idan mace ta dauki allurar ACE yayin daukar ciki, to ya zama dole a lokaci-lokaci a yi gwajin gwaje-gwaje don tantance matakin motsin mara-lafiya, na'urar duban dan tayi daga kasusuwa kwanyar da kodan tayin. An ƙaddara abu mai aiki a cikin madara, sabili da haka, lactation lokacin jiyya ya kamata a dakatar.

Enap sake dubawa

Kimantawa na Enap, sake duba likitoci game da ingancinsu galibi tabbatacce ne. Masana sun yarda cewa tare da ingantaccen amfani da wannan magani, mai haƙuri na iya inganta ingancin rayuwa. Haka kuma, yayin aikin jiyya, ana haifar da sakamako iri daban-daban sau da yawa. Masu amfani sau da yawa suna ambaton cewa suna damuwa da bushe tari, da sauransu Yana da mahimmanci a tuna cewa idan yanayin ya tsananta, ya kamata ka tuntuɓi likita nan da nan wanda zai daidaita sashi ko kuma ya samar da wani magani.

Hanyar aikin

Ofaya daga cikin manyan fa'idodin Enap shine saurin tasirinsa akan jikin mai haƙuri. Kusan nan da nan bayan shan maganin, yana farawa da tasiri a jiki.

Da farko, miyagun ƙwayoyi suna kunna tsarin angiotensin, ta haka yana ƙaruwa da ƙimar renin. Hakanan yana taimakawa rage aldosterone, wanda zai haifar da alamun hauhawar jini.

Hakanan, sakamakon yawan cin abinci na yau da kullun na Enap, samar da irin wannan sashin kamar bradykinin yana aiki. Wannan bangaren yana daidaita yanayin zuciya kuma yana taimakawa rage karfin jini ta hanyar fadada ganuwar bututun jini.

Yawancin likitoci suna ba da shawarar yin amfani da Enap ga marasa lafiya waɗanda ke fama da babban nau'in hauhawar jini. A wannan yanayin, shan kwamfutoci zai kara haɓaka tasoshin jini kuma yana ƙaruwa da sauri na yin hawan jini zuwa zuciya.

A cikin mafi yawan marasa lafiya, Enap ya fara aiki a cikin awa daya bayan shan maganin. Koyaya, mafi girman tasirin sakamako zai zama sananne ne kawai bayan sa'o'i 5-6.

A wani matsin lamba ne zan sha maganin?

Don farawa, ya kamata ka yanke shawara a kan menene alamun alamun jini yana da kyau a yi amfani da allunan. Masana sun ba da shawarar tsofaffi waɗanda ke so su saukar da hawan jini su sha maganin. A karancin jini, ba za ku iya sha "Enap" ba, saboda wannan zai kara dagula lafiyarku.

Don haɓaka tasiri na miyagun ƙwayoyi, wajibi ne don barin kyawawan halaye. Saboda haka, a duk tsawon jiyya, za ku daina shan sigari da shan giya.

Har yaushe zan iya ɗauka?

Dogon likitan ya ƙaddara tsawon lokacin da ake bi da shi don yin maganin hauhawar jini. Mafi yawan lokuta, ana amfani da allunan sama da mako guda don kawar da alamun cutar hawan jini. Idan a wannan lokacin cutar bata bace, an tsawaita hanya zuwa wani sauran kwana biyar.

Analogs da wasu abubuwa

Mutanen da bai kamata suyi amfani da Enap ba wajen maganin hawan jini ana shawarce su da su sha madadin wannan magani.

Daga cikin mafi ingancin analogues sune:

• Burlipril. Wannan kayan aiki ana ɗaukar magani mai inganci wanda zai iya kawar da alamun hauhawar jini. Abun da ke cikin Berlipril ya ƙunshi tsarin enalaprilat, wanda ke haɓaka samar da bradykinin kuma yana daidaita ganuwar jijiyoyin jini. A cikin fewan kwanakin farko, ba a ɗauki fiye da 5 MG na miyagun ƙwayoyi kowace rana. Fiye da kwanaki 10, da sannu sannu-sannu ƙara zuwa 30 MG.
• Renetek. An ƙera shi daga malena, wanda ke haɓaka wurare dabam dabam na jini da aikin tsarin jijiyoyin jini. Yin amfani da "Renitek" a cikin mako zai taimaka wajen rage karfin jini zuwa matakan al'ada. Don kawar da alamun hauhawar jini, aƙalla 10 MG na miyagun ƙwayoyi suna bugu kowace rana.
• "Renipril." An wajabta maganin don mayar da numfashi, inganta wurare dabam dabam na jini, datse hanyoyin jini da rage kaya a zuciya. "Renipril" yana bugu kowace rana a 15 MG kowace rana.

Kammalawa

Tashin hankali na hawan jini yana tare da alamu mara kyau da kake son kawar da sauri. Sau da yawa suna amfani da Enap da sauran magunguna masu kama don wannan.Kafin amfani da irin wannan kwayoyin, kana buƙatar sanin kanka tare da abun da ke ciki, tsarin aikin akan jikin, contraindications da fasalin amfani a cikin jiyya na hauhawar jini.

Dokoki don rage matsin lamba ba tare da kwayoyin magani ba: bidiyo

Masana sun ba da shawarar a magance hawan jini a jika. Idan a farkon matakan za a iya daidaita karfin jini ta hanyoyin gargajiya na magani, to tare da hauhawar jini na digiri na biyu da na 3 zai zama kari mai ban mamaki wanda ke inganta tasirin magunguna. Tabbas, sakamakon irin wannan ilimin yana yawanci mutum ne, amma sake duba masana game da maganin gargajiya da kuma masu tallafawa madadin magani ya nuna cewa lura da kyaututtukan yanayi yana kara saurin inganta yanayin hauhawar jini.

Wanene aka wajabta maganin?

Hawan jini shine matsalar gama gari na masu kwantar da hankali, likitocin zuciya, endocrinologists, da kuma nephrologists. Hawan jini shine babban abokin da yake yawan kamu da ciwon sikila, mafi mahimmancin al'amari ga abin da ya faru na cututtukan zuciya da jijiyoyin jini. Ko da ƙaramin matsin lamba a sama da matakin ƙima yana da haɗari, musamman ga marasa lafiya da ke da yiwuwar rikicewar cututtukan zuciya. A matsin lamba a sama da 180/110, haɗarin lalacewar zuciya, kwakwalwa, da kodan yana ƙaruwa sau goma.

Hawan jini wani yanayi ne na kullum, don haka yakamata masu haƙuri su riƙi magani kowace rana a rayuwarsu. A wane matsa lamba ne don fara allunan shan giya ya dogara da cututtukan concomitant. Ga yawancin mutane, ana daukar 140/90 matsayin tsattsauran ra'ayi ne. Ga masu fama da cutar sankara, yana da ƙananan ƙananan - 130/80, wanda ke ba ku damar kare ɗayan mafi kyawun gabobin cikin waɗannan marasa lafiya - kodan. A cikin gazawar renal, yana da kyau a kiyaye matsin dan kadan ƙasa, don haka allunan sun fara sha, suna farawa daga matakin 125/75.

A matsayinka na doka, ana ba da allunan Enap a farkon cutar, kai tsaye bayan gano cutar hawan jini. Magungunan yana ba ku damar rage matakin babba, systolic, matsin lamba ta 20, da ƙananan, diastolic, ta raka'a 10. Wannan raguwa yana sa ya yiwu a daidaita matsin lamba a cikin kashi 47 na marasa lafiya. Tabbas, muna magana ne game da alamomin ƙididdiga. Ga waɗancan marasa lafiya waɗanda ba su kai matakin manufa ba, ana yin ƙarin ƙarin ƙarin magungunan antihypertensive 1-2.

Dangane da umarnin, ana amfani da allunan Enap a cikin waɗannan lambobin:

1. Babban abin nuni ga amfanin Enap shine hauhawar jini, shine matsin lamba a hankali. Enalapril ana ɗauka ɗayan maganin gargajiya don magance hauhawar jini, sabili da haka, a cikin gwaji na asibiti da yawa, ana gwada sababbin magunguna cikin sharuddan tasiri tare da shi. An gano cewa matakin rage karfin matsin lamba yayin jiyya tare da Enap daidai yake da lokacin ɗaukar sauran magungunan antihypertensive guda ɗaya, gami da na zamani. A yanzu, babu ɗayan magungunan da suka fi ƙarfin wasu. Likitocin, suna zaɓar wasu magungunan kwayoyi don matsin lamba, akasarinsu suna jagorantar su da ƙarin kayan aikinsu da matakin aminci ga wani haƙuri.
2. Enap yana da tasirin cutar zuciya, sabili da haka, an wajabta shi don cututtukan zuciya: an riga an gano gazawar zuciya, babban haɗarin gazawar marasa lafiya tare da hauhawar jini na ventricular hagu. A cewar masana kimiyyar cututtukan zuciya, yin amfani da Enap da likitocin sa ana amfani da su a cikin irin wannan mara lafiyar na iya rage mace-mace, rage yawan asibitoci, rage jinkirin ci gaba da cutar, sannan a wasu yanayin inganta halayyar motsa jiki da rage tsananin bayyanar cututtuka. Hadarin mutuwa a cikin marasa lafiya waɗanda ke rage matsa lamba ta hanyar Enap ko haɗakar Enap tare da diuretics shine 11% ƙasa da waɗanda ke amfani da diuretics kawai don magance hauhawar jini. A cikin rauni na zuciya, ana ba da umarnin sau da yawa a cikin allurai masu yawa, ƙasa da kullun a matsakaici.
3. Enap yana da kayan anti-atherosclerotic, sabili da haka an ba da shawarar don ischemia na jijiyoyin jini. Amfani da shi a cikin cututtukan zuciya na zuciya yana ba da damar rage 30% cikin haɗarin bugun jini, da kuma haɗarin mutuwa na 21%.

Yaya maganin yake aiki?

Aiki mai aiki na allunan Enap shine enalapril maleate. A cikin asalin sa, ba shi da tasirin magani, sabili da haka, yana nufin prodrugs. Enalapril yana shiga cikin jini kuma yana canzawa zuwa hanta tare da shi, inda aka canza shi zuwa enalaprilat, wani abu wanda ke da ƙayyadaddun magungunan antihypertensive. Kusan 65% na enalapril yana shiga cikin jini, 60% daga ciki wanda ya shiga hanta ya juya zuwa enalaprilat. Saboda haka, jimlar bioavailability na miyagun ƙwayoyi ya kusan 40%. Wannan kyakkyawan sakamako ne mai kyau. Misali, a cikin lisinopril, wanda har yanzu yake aiki a cikin kwamfutar hannu kuma baya buƙatar sa hanta, wannan adadi shine 25%.

Matsakaici da yawan sha enalapril da jujjuyawar shi zuwa enalaprilat ba ya dogara da cikar ƙwayar gastrointestinal ba, don haka ba za ku iya damuwa ba, shan wannan magani kafin abinci ko bayan. A cikin abubuwan biyu, mafi girman matakin aiki a cikin jini zai kasance bayan awa 4 daga lokacin gudanarwa.

Enap ba magani ne mai saurin motsa jiki ba, ba a so a dauke shi don dakatar da hauhawar jini. Amma tare da shigarwar yau da kullun, yana nuna sakamako tabbatacce. Dangane da sake dubawa game da marasa lafiya da ke shan maganin, matsa lamba kan Enap ba wuya. Domin magungunan suyi aiki da karfi, dole ne a bugu dasu akalla kwanaki 3 ba tare da tsangwama ba a kusan lokaci guda.

Kimanin 2/3 na enalapril yana fita a cikin fitsari, 1/3 - tare da feces. Tare da gazawar koda, exclation zai iya zama da wahala, maida hankali akan enalapril a cikin jini yana ƙaruwa, don haka marasa lafiya na iya buƙatar rage sashi a ƙasa daga matsayin.

Dangane da haɗin gwiwar kungiyar likitancin, kungiyar enalapril tana cikin masu hana ACE. An ƙirƙira shi a cikin 1980 kuma ya zama na biyu a cikin rukuninta bayan captopril. An bayyana aikin Enap daki-daki a cikin umarnin don amfani. An yi niyya don murƙushe tsarin tsarin matsin lamba - RAAS. Magungunan yana toshe sinadarin angiotensin-wanda yake juya enzyme, wanda yake wajibi ne don samuwar angiotensin II - wani sinadari wanda yake gundarin jijiyoyin jini. Katange na ACE yana haifar da shakatawa na tsokoki na jijiyoyin gefe da raguwa cikin matsin lamba. Bugu da ƙari da tasirin hypotensive, Enap yana shafar kira na aldosterone, hormone antidiuretic, adrenaline, potassium da renin a cikin jini, sabili da haka, maganin yana da kaddarorin da yawa waɗanda suke da amfani ga marasa lafiya masu hauhawar jini, ba kirga raguwar matsin lamba ba:

1. Hawan jini yana tilasta ventricle hagu (babban ɗakin zuciya) yayi aiki sosai, wanda yawanci yakan haifar da faɗaɗawa. Thatuwar farin ciki, ɓarna da heartarfin bango na zuciya yana kara yiwuwar arrhythmia da gazawar zuciya sau 5, bugun zuciya sau 3. Allunan magungunan Enap ba zasu iya hana kara hauhawar jini a cikin hagu ba, har ma suna haifar da tashin hankali, kuma ana lura da wannan sakamako har ma a cikin tsofaffi marasa lafiyar.
2. A cikin duk rukuni na kwayoyi don matsa lamba, Enap da sauran masu hana ACE suna da tasirin nephroprotective da aka fi sani. Tare da glomerulonephritis, nephropathy na ciwon sukari a kowane mataki, miyagun ƙwayoyi suna jinkirta ci gaban lalacewar koda. Dogon lokaci (lura ya wuce shekaru 15) maganin enalapril yana hana nephropathy a cikin masu ciwon sukari tare da microalbuminuria.
3. Hanyoyi guda ɗaya kamar na ventricle na hagu (shakatawa, rage kaya), lokacin da aka yi amfani da Enap, yana faruwa a cikin dukkanin tasoshin. Sabili da haka, ayyukan endothelium suna dawo da hankali, tasoshin suna da ƙarfi kuma suna naɗa.
4. Menopauseuse a cikin mata yakan haifar da bayyanar hauhawar jini ko kuma ƙaruwa da tsananin cutar data kasance. Dalilin wannan shine rashi estrogen, wanda ke haifar da karuwa a cikin ayyukan ACE. ACE inhibitors suna da irin wannan sakamako ga estrogen akan RAAS, sabili da haka, ana amfani da shi sosai a cikin mata masu postmenopausal. Dangane da sake dubawa, allunan Enap a cikin wannan rukuni na marasa lafiya ba kawai rage karfin jini ba kuma ana iya jurewa cikin sauƙi, amma kuma suna rage ƙarfin haihuwa: suna rage gajiya da farin ciki, daɗa yawan libido, inganta yanayi, cire fitilun zafi da kuma ɗumi.
5. Cututtukan huhu na yau da kullun na iya haifar da hauhawar huhu. Boye a cikin irin wannan marasa lafiya na iya rage yawan kumburin huhu, kara juriya, da kuma hana kasala ga zuciya. Sama da makonni 8 na gudanarwa, matsakaicin raguwar matsin lamba shine raka'a 6 (daga 40.6 zuwa 34.7).

Yadda ake ɗauka

Umarnin amfani da Enap bai nuna lokacin da yakamata ayi: safe ko yamma, waɗannan allunan. Likitoci yawanci suna bayar da magani na safiya don likitan ya sami nasarar ramawa game da ayyukan jiki, damuwa da sauran damuwa. Koyaya, akwai hujja cewa ƙarshen ƙarshen sakamakon enalapril yana ƙaruwa. Duk da gaskiyar cewa raguwar tasirin yana dauke da mahimmanci (mafi girman 20%), wasu marasa lafiya na iya ƙara matsa lamba a cikin safiya.

Duba kanka: auna matsa lamba da safe kafin shan kwayoyin. Idan yana saman matakin manufa, lallai ne sai an gyara jiyya, saboda hauhawar jini a cikin safiya safe shine mafi haɗari dangane da haɓakar rikice-rikice a cikin tasoshin da zuciya. A wannan halin, ya kamata a sake shirya liyafar Enap don maraice ko yamma. Zabi na biyu shine canzawa daga Enap zuwa Enap-N.

Tsarin magani yana da mahimmanci don magance hauhawar jini. Enap yana bugu kullun, yana gujewa tsangwama. Magungunan yana tarawa a cikin jiki na kwanaki da yawa kafin tasirin sa ya zama mai iyaka. Sabili da haka, har ma da izinin tafiya guda ɗaya na iya tsokana mai tsawo (har zuwa kwanaki 3), amma yawanci ƙaramin ƙaruwa ne a cikin matsi. Ba wai kawai al'amura na yau da kullun ba ne kawai, har ma lokaci guda na shigarwa. Dangane da bincike, Enap yana ba da kyakkyawan sakamako a cikin marasa lafiya waɗanda suka ɗauki magunguna a agogo ƙararrawa, suna gujewa karkacewa daga jadawalin fiye da awa 1.

Dangane da umarnin, gudanarwar Enap yana farawa tare da farawa na farko, wanda likita ya ƙaddara ta la'akari da matakin matsin lamba da kasancewar wasu cututtuka. Mafi yawan lokuta, ana daukar 5 ko 10 mg azaman kashi na farko. Bayan kwamfutar hannu ta farko, ana auna karfin jini sau da yawa a rana, kuma ana rubuta sakamakon. Idan ba'a cimma matsa lamba kan matsa lamba (140/90 ko ƙasa ba) ko kuma akwai ƙarfin juzu'i, ana samun ƙara girman sashi bayan kwana 4. Yawancin lokaci yana ɗaukar kusan wata guda don zaɓin kashi. Enap yana da fadi da zaɓi na sashi. Bugu da kari, duk allunan, farawa daga 5 MG, an sanye su da daraja, wato, ana iya raba su rabi. Godiya ga wannan kashi, zaku iya zaɓar gwargwadon iko.

Ga yawancin marasa lafiya, farashin kula da hauhawar jini yana da mahimmanci, kuma wani lokacin yanke hukunci. Enap yana nufin magunguna masu araha, koda za'ayi amfani da shi azaman sashi. Matsakaicin matsakaiciyar farashin kowane wata bisa la toakari da sake dubawar haƙuri shine 180 rubles. Sauran masu hana ACE ba su da tsada sosai, alal misali, perindopril na masana'anta guda ɗaya (Perinev) zai biya 270 rubles.

Nawa ne kudin Enap:

M sakamako masu illa

Dangane da sakamakon bincike na asibiti, masana kimiyya suna kimanta haƙuri na Enap da kyau. Ko yaya, tasirin maganin yana haifar da bayyanar wasu sakamako masu illa, don haka ya kamata a fara kulawa da matsanancin hankali. Bai kamata a ɗauki allunan farko ba idan jikin yana bushewa sakamakon zawo, amai, isasshen ruwan da gishiri. A cikin sati, yawan lodi, wuce gona da iri, tuki mota, aiki da tsayi ba da shawarar ba.

Side effects na Enap bisa ga umarnin:

Kwatantawa da irin kwayoyi

Tsarin sunadarai na masu hana ACE abubuwa ba su da yawa. Abin mamaki, sakamakon wadannan abubuwan a jikin mutum kusan iri daya ne. Hanyar aikin, jerin abubuwan da ba a son su har ma da contraindications suna da kusanci da su. An kuma kimanta ingancin magungunan kwayoyi kamar guda.

Koyaya, wasu bambance-bambance a cikin masu hana ACE akwai har yanzu:

1. Da farko dai, sashi ya bambanta. Lokacin canzawa daga Enap zuwa analog na rukuni, ana buƙatar zaɓin kashi sabo, fara daga ƙarami.
2. Ya kamata a bugu da ƙwaƙwalwa a kan komai a ciki, da sauran kwayoyi daga ƙungiyar - ba tare da la'akari da lokacin cin abinci ba.
3. Mafi mashahuri enalapril, captopril, lisinopril, perindopril ana keɓe su ne musamman ta hanyar kodan, sabili da haka, tare da gazawar renal, akwai babban haɗarin yawan zubar jini. A cikin kewayon trandolapril da ramipril, kodan suna shiga cikin ƙarancin yanayi, har zuwa 67% na abu yana cikin metabolized a cikin hanta.
4. Yawancin inhibitors na ACE, gami da enalapril, sune prodrugs. Suna aiki mafi muni a cikin cututtukan hanta da na hanji. Captopril da lisinopril suna fara aiki, tasirin su baya dogaro da yanayin tsarin narkewa.

Zaɓin takamaiman magani, likita yayi la'akari ba kawai waɗannan nuances ba, har ma da kasancewar maganin. Idan an tsara Enap a gare ku kuma an yarda da shi sosai, ba da shawarar canza shi zuwa wasu allunan. Idan Enap bai samar da tsayayyen kulawar matsin lamba ba, ana ƙara wani wakili na rigakafi zuwa tsarin kulawa.

Me yasa hawan jini yana da hadari?

Tare da haɓakar hawan jini, zuciya tana aiki sama da al'ada, kuma sakamakon ƙoƙari mai yawa, ƙwayar tsoka tayi girma. Kayan tsokoki na jiki suna girma kamar guda a ƙarƙashin kullun kaya. A cikin zuciyar da ke fadadawa a matsanancin matsin lamba, zauren ya kara fadada da kuma sauke nauyin ventricle na hagu, sakamakon wanda mutuwar myocardial cell, mutuwar myocardial.

Ayyukan kwayoyi game da matsin lamba yana sa kwantar da hankali, yana ba da gudummawar jini kyauta ta cikin jijiya, wanda ke saukar da ventricle hagu kuma yana inganta jini a cikin zuciya.Sabili da haka, metabolism yana inganta, babu yanayi don arrhythmias, kuma ƙwayoyin myocardial ba su wahala.

Don haka magani don matsa lamba na Enap a jiki. An kafa wurare dabam dabam na jini ba kawai a yankin zuciya ba, amma a cikin dukkanin gabobin jiki da tsare-tsarensu. Tare da yin amfani da miyagun ƙwayoyi na yau da kullun, hawan jini yakan zama daidai, kuma lafiyar mutanen da ke fama da cututtukan zuciya da jijiyoyin jini suna inganta.

Ana ɗaukar allunan a baki da ruwa. Aikin yana kwana daya. Babu wani sakamako mai maye, don haka babu matsaloli daga sokewar Enap na bazata. Ana yin Enap a cikin allunan na 2.5 MG (fari, biconvex, zagaye), 5 MG (farin, lebur-silili), 10 MG (ja-kasa-kasa, lebur-Silinda), 20 MG (orange mai haske, lebur-silili). Allunan an cika su cikin guda 10. a cikin taushi, fakitin kwali na dauke da alluna 2-6. Babban sinadari mai aiki shine enalapril, ƙarin abubuwa sune sitaci na masara, lactose monohydrate, carbon hydrogen carbonate, magnesium stearate, talc, hyprolase, da fenti.

Yaushe za ayi maganin sauro?

Ana nuna allunan matsi a waɗannan yanayi:

• a hade far don rashin cin nasara a zuciyar mutum,
• da hawan jini,
• don rage haɗarin infarction na zuciya na zuciya,
• don inganta yanayin marasa lafiya da rashin tsawan angina pectoris, wanda ke ba da jinkiri ga asibiti,
• a hade jiyya don asymptomatic bar ventricular tabarbarewa don hana mai rauni zuciya.

Lokacin da bazaka iya ɗaukar Enap ba

Cikakken bayani game da shirye-shiryen E yana kunshe cikin umarnin don amfani da wane irin matsin lamba, tsawon lokacin, akan me sashi, da sauransu. Duk da haka, mai haƙuri ba ya buƙatar karanta umarnin - likitan likita ba zai ba da magani ba idan akwai abubuwan da ke tafe:

• hypersensitivity ga enalapril da sauran abubuwan haɗin jikin Allunan,
• karamin shekaru
• ciki da hepatitis B,
• porfria
• angioedema,
• rashin daidaituwa na lactose,
• shan aliskiren tare da cutar koda ko cutar sankara.

Tare da taka tsantsan, allunan daga matsa lamba na Enap an tsara:

• marasa lafiya da hyperkalemia, cutar sankarar mahaifa, Stenosis na koda,
• tare da cututtukan ischemic, gazawar koda, cututtukan cututtukan nama,
• bayan jujjuyawar koda,
• tare da cututtukan hematopoiesis wanda aka zalunta, cutar cerebrovascular.

Likita na iya ba da shawarar magungunan ga mutanen da ke fama da cutar sankara, suna ɗauke da immunosuppressants da diuretics, suna bin abincin da ba gishiri ba, idan an nuna.

Yadda ake shan kwayoyin hana daukar ciki

Enap an wajabta shi a cikin matsin lamba a cikin matakan daban-daban, la'akari da yanayin yanayin mai haƙuri, shekarun, cututtukan haɗuwa. Farfado da hauhawar hauhawar jini yana farawa ne ta hanyar 5-10 MG na maganin a kowace rana.

Ana kula da hauhawar jini ta atomatik tare da allurai na 5-20 MG. Ya kamata a ɗauka a cikin zuciya cewa a cikin wasu marasa lafiya matsa lamba na iya raguwa da yawa, suna buƙatar fara da ƙananan allurai na maganin - 5 MG kowace rana. Dole ne likitan da ke halartar ya lura da yanayin mai haƙuri.

Kafin shan kwaya, kuna buƙatar yin la'akari da cewa idan an ɗauki diuretics a cikin manyan allurai a baya, wannan na iya haifar da bushewa da haɓaka ƙaran shinkafa a farkon farawa ta amfani da Enap. A cikin wannan halin, fara magani tare da mafi ƙarancin 5 MG kowace rana. L

Idan an soke diuretics kwanaki 2-3 kafin farawar Enap. Yayin aikin jiyya, kuna buƙatar bincika lokaci zuwa lokaci yadda ƙodan ke aiki, kazalika da ɗaukar gwaje-gwaje don abubuwan da ke cikin potassium a cikin jini. Matsakaicin ma'aunin kulawa shine 20m Enapa kowace rana, idan ya cancanta, za a iya ƙaruwa sashi ta likita, la'akari da yanayin mai haƙuri.

A cikin marasa lafiya da rauni na zuciya, kamar yadda a gaban raguwar ventricular dysfunction, ana wajabta allunan don hawan jini a kashi na 2.5 a kowace rana. Wasu lokuta, yayin lura da raunin zuciya, cututtukan bugun zuciya, cututtukan zuciya da beta-blockers an tsara su a layi daya.

Lokacin da aka tsayar da yanayin matsin lamba, ana iya ƙara yawan ƙwayar cutar - kowane kwanaki 3-4 ta 2.5-5 MG, har sai ya isa daidaitaccen tabbatarwa (20 MG). Matsakaicin adadin enalapril kowace rana shine 40 MG.

Likitoci suna yin la’akari da cewa yayin aikin jiyya akwai haɗarin faduwar cutar koda da kuma raguwa cikin matsin lamba, don haka suna sa ido sosai a kan matsin lambar mai haƙuri da aikin koda yayin jiyya.

Idan matsi ya ragu sosai bayan cinikin Enap na farko, ba lallai ba ne a soke maganin, sakamako na gaba zai wuce. Marasa lafiya da cututtukan koda suna buƙatar rage sashi ko ƙara tazara tsakanin allunan. An tsara mutanen Elap na Enap a 1.25 MG a farko, tunda cirewar Enalapril daga jiki a cikinsu yana da hankali sosai.

Enap da nasa sakamako

Kamar sauran magungunan antihypertensive, Enap na iya haifar da mummunan sakamako a cikin mutane. Wadannan abubuwan sune sakamakon da zaku iya samu yayin hawa zuwa tsari:

• daga tsarin hematopoietic: raguwar haemoglobin da anemia a kan asalinsa, neutropenia, agranulocytosis, hanawar aikin hematopoietic, lymphadenopathy, bayyanar cututtuka na cututtukan zuciya, thrombocytopenia,
• daga gefen metabolism: hypoglycemia,
• a cikin aikin mai juyayi: ciwon kai, rikicewa, damuwa, rudewa yayin rana da matsaloli tare da baccin dare, tsananin wuce gona da iri,
• a cikin yanayin zuciya da jijiyoyin jini: raguwa mai yawa a cikin karfin jini, farin ciki, raɗaɗin sternum, angina pectoris, bugun zuciya, rashin lafiyar Raynaud, haɗarin bugun jini ko taɓin hankali na zuciya,
• daga gabobin azanci: tinnitus, wahayin gani, canji a dandano,
• a cikin narkewa kamar ciki: tashin zuciya da ciki na ciki kafin amai, flatulence da zawo, hanji hanji da maƙarƙashiya, dyspepsia, pancreatitis, peptic miki, hepatitis, bushe mucous membrane na bakin, malfunction na hanta, glossitis, cholestasis, hepatic necrosis, aphthous ulcers, stomatitis
• a cikin tsarin numfashi: ciwon makogwaro da tari, matsanancin ciki, rhinorrhea, gazawar numfashi da matsewa a cikin hanji, ciwon huhu, rhinitis,
• a kan fata: hypersensitivity, fitsari, angioedema, gumi mai yawa, urticaria, asarar gashi, erythroderma, pemphigus, necrolysis mai guba,
• daga tsarin halittar jini: gazawar koda, rashin karfin jiki, oliguria, gazawar koda, gynecomastia,
• a cikin tsarin jijiyoyin wuya: murƙushewar tsoka,
• a cikin gwaje-gwaje na gwaje-gwaje: karuwar taro na potassium, sodium da creatinine a cikin jini, ƙara yawan aiki na enzymes hanta, ƙara yawan bilirubin da urea a cikin jini, ƙara yawan ESR,
• sauran bayyanai sune: leukocytosis, amosanin gabbai, vasculitis, zazzabi, serositis, myalgia, photoensitivity, myositis.

Enap karfin gwiwa tare da wasu magunguna

Kafin sanya likitan Enap ga mai haƙuri, tilas ne likita ya gano magungunan da mutumin yake ɗaukar don kada ya haifar da sakamako, saboda ba duk magunguna bane ke haɗuwa da enalapril.

An san cewa a cikin batun kulawa na lokaci daya na masu hana ACE, masu adawa da angiotensin II, toshewar RAAS sau biyu, wanda ke iya haifar da mummunan tashin hankali (matsanancin raguwa). Idan irin wannan ilimin ya zama tilas a wurin likita, kuna buƙatar sarrafa aikin koda, hawan jini, ma'aunin ruwa-electrolyte a jiki.

Haramun ne a dauki enalapril da aliskiren a lokaci guda ga marasa lafiya da ke fama da cututtukan koda, masu ciwon suga.

A ƙarƙashin rinjayar masu hana ACE, asarar potassium saboda shan diuretics an rage su. Lokacin da aka magance su da maganin enalapril da potassium-sparing diuretics, waɗanda suke maye gurbin potassium akwai haɗarin haɓakar hyperkalemia. A irin wannan farjin, yana da mahimmanci don sarrafa matakin potassium a cikin jini.

Idan an yi maganin diuretic kafin a fara maganin Enap, to akwai haɗarin raguwa mai ƙarfi cikin ƙarfi. Za'a iya daidaituwa idan an soke diuretics kwana biyu kafin a ɗauki Enap, ƙari da amfani da ruwa yau da kullun tare da gishiri, da ɗan rage shawarar da aka bayar da shawarar allunan daga matsa lamba (Enalapril).

Yana da mahimmanci a la'akari da cewa gudanarwar na Enap da Adrenergic tarewa na dindindin, BKK, nitroglycerin, jami'ai masu toshe ganglion, nitrates na iya haifar da raguwa mai ƙarfi a cikin karfin jini. Saboda haka, yana da kyau a sake duba tsarin kula da magani, sashi da kuma yadda za a sha magungunan.

Idan an dauki Enap a bangon shirye-shiryen lithium, ana iya samun karuwar yawan lithium a cikin jini, yin maye yana iya yiwuwa. Thiazide diuretics shima yana kara yawan matakan lithium. Saboda haka, ba a ba da shawarar yin amfani da irin waɗannan magungunan ba, kuma idan ya zama tilas, dole ne ku mallaki taro a cikin taro na jini.

Idan anesthetics, maganin anticeplicsants, magungunan rigakafin ƙwayoyi suna ɗauka akan asalin Enap, wannan na iya rage yawan jini. Idan an dauki Enap a kan asalin NSAIDs, ba zai nuna cikakken sakamako ba, a ƙari, kodan na wahala. Bayan an gyara tsarin kulawa, yanayin zai koma daidai.