Sakamakon ciwon sukari na Captopril 25

Hanya na gargajiya don lura da marasa lafiya tare da hauhawar jini shine farkon farawa na monotherapy tare da magungunan antihypertensive tare da lambar ƙaddamarwa zuwa mafi girman tasiri, sannan an kara magunguna na biyu da na uku. Koyaya, wannan tsarin yana da tsayi kuma ba koyaushe yake tasiri ba. A yayin aiwatar da ƙwarewar asibiti a cikin lura da hauhawar jini, ya zama a fili cewa monotherapy yana da tasiri kawai a cikin 50% na marasa lafiya kuma kawai tare da ƙara haɓaka matsakaici a cikin karfin jini. Sau da yawa, hanyoyin dabaru daban-daban suna kwance ne a cikin haɓakar hauhawar jini, sabili da haka monotherapy bazai iya tasiri duk abubuwan da ke haifar da haɓakar hawan jini a cikin kowane haƙuri

Bugu da kari, cimma nasarar manufofin makasudin karfin jini (140/90 mm RT. Art. "W />
Tsarin aikin rigakafin ƙwayar cuta a cikin marasa lafiya da masu ciwon sukari tare da hawan jini> 140/90 mm RT. Art.

Gwaje-gwaje na kwastomomi na asibiti da yawa sun nuna cewa ana buƙatar magunguna 2 zuwa 4 na ƙungiyoyi daban-daban don cimma burin maƙasudin jini.

Fa'idodin haɗuwa da illar hawan jini kafin tashin zuciya shine bayyananne:
• Haɗa magani yana ba ku damar yin aiki akan hanyoyin da yawa na haɓaka hauhawar jini, wanda ke sa ya fi tasiri,
• haɗuwa da warhaƙi yana ba da damar yin amfani da ƙananan allurai na magunguna ba tare da yin lahani ba,
• wasu haɗuwa na kwayoyi suna kawar da (ko raunana) sakamakon sakamako na abubuwan haɗin mutum.

Dangane da shawarwari daga 2003 na Kwamitin Hadin gwiwar Amurka na VII don Yin rigakafi da Jiyya na Ciwon jijiyoyin jini (JNC 7), ya kamata a tsara maganin haɗin gwiwa ga kowane mara lafiya wanda karfin jini ya wuce 20/10 mmHg. Art. makasudin manufa, i.e. 140/90 mmHg. Art. a cikin marasa lafiya ba tare da ciwon sukari ba kuma 130/80 mm RT. Art. a cikin marasa lafiya da ciwon sukari.

An gabatar da dabarun zaɓin maganin rigakafin ƙwayar cuta ga marasa lafiya da masu ciwon sukari.

Dabarar maganin rigakafin cutar kansa

Monotherapy mai yiwuwa ne kawai tare da haɓaka matsakaici a cikin karfin jini> 130/80 mm RT. Art., Amma

Babban maƙasudi a cikin lura da marasa lafiya da ciwon sukari shine rigakafin yiwuwar haɓaka ko saurin ci gaba na rikicewar jijiyoyin bugun ƙwayar wannan cuta (DN, DR, lalacewar tasoshin zuciya, kwakwalwa, da sauran manyan jijiyoyin hannu). Ba za a iya shakkar cewa an nuna sanadin haddasawa ba.

Adducins sune sunadarai na cytoskeleton na sel. Ana zaton cewa, a gefe guda, adduoins suna yada siginar sakonni a cikin kwayar, kuma a gefe guda, yayin hulɗa tare da sauran sunadaran cytoskeletal, suna jigilar ion ta cikin membrane sel. A cikin mutane, dukkanin aducins sun kasance sau biyu.

Saki siffofin da abun da ke ciki

Allunan suna da fararen launi, ƙamshi na musamman, siffar-ɗakin silima. Daga cikin masu toshe, magungunan sun shahara ga iyawarta don rage juriya da bugun jini a jikin ganuwar jijiya.

Abubuwan da ke aiki suna ƙunshe cikin adadin 25 MG.

Siffar saki - Allunan, 25 MG, 10 inji mai kwakwalwa. Kunshin kwano, tantanin halitta, sanye take da umarni don amfani. Guda 20. Allunan an tattara su a cikin tukunyar da aka sanya a cikin kwali.

Ana samar da miyagun ƙwayoyi a kashi 12.5 MG da 50 MG. Magungunan ya ƙunshi ƙungiyar sulfhydryl wanda ke hana lalacewar myocardium.

Magungunan ya ƙunshi ƙungiyar sulfhydryl wanda ke hana lalacewar myocardium.

Aikin magunguna

Magungunan yana kawar da ayyukan ACE, a sakamakon haka, ƙimar canjin enzyme I zuwa angiotensin II, wanda ke da tasirin vasoconstrictor, yana raguwa.

A cikin adrtal bawo, samar da aldosterone yana ƙaruwa. Magungunan yana shafar tsarin kinin-kallikrein, yana kiyaye bradykinin.

Pharmacokinetics

Bayan amfani da kashi ɗaya na wakili mai guba, an cire kashi 75% na maganin daga ƙwayar narkewar abinci. Cin abinci yana shafar shaye shayen, rage tasirinsa da 40%.

A cikin jini (plasma) na jini, maganin yana danganta ga sunadarai (albumin) kuma an kebe shi a cikin madara.

Bayan amfani da kashi ɗaya na wakili mai guba, an cire kashi 75% na maganin daga ƙwayar narkewar abinci.A cikin jini (plasma) na jini, maganin yana ɗaure wa sunadarai (albumin).
Magungunan ya karye cikin sel hanta.

Magungunan yana rushewa a cikin hanta hanta, yana samar da wadannan mahadi:

• hallakar dimer na aiki abu,
• cysteine ​​disulfide.

Abubuwan da aka lalata ba su da aiki. Rabin rayuwar miyagun ƙwayoyi bai wuce awanni 3 ba. Tare da gazawar koda, ƙwayar magani ta tara a jikin mutum, a sakamakon haka, haɗuwar urea da creatinine a cikin ƙwayar jini yana ƙaruwa.

Abinda Captopril ya taimaka 25

Ana nuna wakilin sinadarai ga cututtuka irin su:

• hauhawar jini (a matsayin wani ɓangare na haɗakar magani),
• canji a cikin aikin ventricle na hagu saboda rashin ƙarfi na mama,
• mai ciwon sukari nephropathy,
• bugun zuciya.

Umarnin don yin amfani da wakili na warkewa yana nuna rashin ischemic, sakamakon jijiyoyin bugun. Ana amfani da miyagun ƙwayoyi don ba da kulawa ta gaggawa don kara karfin jini a matakin prehospital.

Ana amfani da miyagun ƙwayoyi don ba da kulawa ta gaggawa don kara karfin jini a matakin prehospital.

Nawa ne matsa lamba ke raguwa

ACE inhibitors har zuwa 150 MG kowace rana, wanda aka yi amfani dashi a cikin maganin gargajiya tare da glycosides na zuciya da diuretic, rage haɗarin mutuwa da 40%.

Yawan farawa na 6.25 MG sannu-sannu yakan tashi zuwa 25 MG sau 2-3 a rana. Don hana raguwa a cikin karfin jini, haɓaka yawan adadin miyagun ƙwayoyi da aka ɗauka ana yin su na kwanaki da yawa (ana iya yin amfani da kashi biyu cikin haɓaka tare da karfin jini na systolic sama da Hg 90 mm Hg kuma ba fiye da 1 lokaci a mako)

Manyan sassan miyagun ƙwayoyi da sauri suna rage karfin jini, amma suna haifar da haɓaka sakamako masu illa, har zuwa lalatawar jini ko bugun jini.

Contraindications

Ba a sanya magani ba idan bayanai kan cututtuka irin su:

• anaphylactic shock (Tarihi),
• mai aiki mai ɗaukar hoto,
• hawan jini
• kamuwa da cutar koda
• kunkuntar daga aortic orifice,
• mitral bawul stenosis,
• hepatitis
• cirrhosis na hanta
• jijiyoyin jini,
• cardiogenic rawar da myocardial infarction.

Ba a ba da magani ba idan bayani game da nakasa aikin aikin renal ya nuna a tarihin likita.

Hypotension da bayyanuwar farko na rashin lafiyar koda ne cikakkiyar contraindications don alƙawarin da miyagun ƙwayoyi.

Tare da infarction myocardial

An tsara miyagun ƙwayoyi a farkon matakan, yana da sakamako masu zuwa:

• yana rage nauyi a zuciya,
• yana rage hadarin cututtukan fata,
• normalizes endothelial aiki,
• yana kunna masu karɓar peptide wanda ke lalata tasoshin jini.

Magungunan sun bugu a ƙarƙashin kulawar karfin jini na makonni 5. Bayan ɗaukar magunguna, ana lura da ganiya na antihypertensive bayan sa'o'i 3-5.

Maganin farko na maganin shine 6.25 MG.

An wajabta magungunan don kwanaki 3-16 bayan tsananin infarction myocardial m. Bayan sa'o'i 2, ana kara yawan adadin inhibitors na ACE zuwa 12.5 MG kuma ana shan shi sau 3 a rana.

Jiyya yana da tsayi, ana aiwatar da shi a ƙarƙashin ikon hawan jini (matsi na systolic haƙuri bai kamata ya faɗi ƙasa da 100 mm Hg ba. Art.).

Captopril, wanda aka ba da wuri, yana taimakawa rage yawan tashin zuciya.

A karkashin matsin lamba

Kashi na farko na maganin shine 25 MG 2 sau a rana. Idan buƙatar ta tashi, an ƙara adadin ƙwayar don kwanaki 14-28 har sai an sami sakamako na asibiti.

Tare da hauhawar jini na digiri na I-II, ana gudanar da jiyya ta amfani da inhibitors na ACE a ƙimar 25 mg 2 sau a rana. Matsakaicin adadin maganin yau da kullum shine 100 MG.

A cikin hauhawar jini, ana ba da izini na 30 MG sau 3 a rana. Lokacin da yake rubuta magani, haɗarin raguwa cikin hawan jini yana ƙaruwa idan mara lafiya yana fama da matsanancin rauni na zuciya, yana da ƙarancin jini.

A cikin raunin zuciya

Don lura da raunin zuciya, ana bada shawarar magani idan magani tare da diuretics bashi da tasiri a asibiti. Maganin farko shine 6.25 mg sau 3 a rana.

Yawan kiyayewar maganin ba ya wuce 25 MG sau 3 a rana.

Matsakaicin adadin mai toshe shine 150 MG kowace rana.

Tare da ciwon sukari nephropathy

Game da aiki na nakasa mai rauni, wanda aka haɓaka a cikin haƙuri tare da ciwon sukari mellitus, tare da keɓancewar creatinine na 30 ml / min, an wajabta maganin a kashi 75-100 mg / rana.

Magungunan sun bugu a matsanancin matsin lamba 1 sa'a kafin cin abinci.

Har yaushe ze dauka?

Matsin lamba yana raguwa sa'o'i 1-1.5 bayan amfani da kashi ɗaya na miyagun ƙwayoyi. Sakamakon magani mai zurfi yana faruwa makonni 8 bayan gudanarwa na yau da kullun na magungunan antihypertensive.

A tsarin likita na Captopril 25 likita ne ya ƙaddara shi.

Gastrointestinal fili

Lokacin amfani da maganin, zaku iya haɗuwa da irin waɗannan bayyanannun bayyanannun abubuwa kamar:

• tashin zuciya
• rashin ci
• canjin dandano
• zafin epigastric
• maƙarƙashiya
• hepatitis
• kumburi,
• take hakkin da samar da bile,
• fata ƙaiƙayi
• tashin hankali a cikin madaidaiciyar hypochondrium.

Hematopoietic gabobin

Abubuwa na yau da kullun bayan amfani da miyagun ƙwayoyi ana ɗauka su zama:

• anemia
• raguwar platelet,
• ƙananan matakan neutrophils a cikin jini.

Matsakaicin maganin a cikin mutane sama da 65 yana haifar da raguwa a cikin adadin ƙwayar farin jini, haɓaka mai saurin kamuwa da cututtukan fungal, wanda ke da haɗari musamman ga marasa lafiya da cututtukan autoimmune.

Tsarin juyayi na tsakiya

A lokacin jiyya, bayyanar irin wannan halayen mara kyau kamar:

• tsananin farin ciki
• gajiya
• take hakkin daidaituwa
• canza canjin yanayin fata.

A cikin marasa lafiya tsofaffi, raunin gani, barci, ciwon kai, raunin hankali, rushewar orthostatic mai yiwuwa ne.

A lokacin jiyya, an lura da wahala.

Daga tsarin urinary

Rashin amsa halayen jiki sun bayyana kamar:

• mai aiki mai ɗaukar hoto,
• polyuria
• karuwa da yawan furotin a cikin fitsari,
• ƙara yawan ƙwayoyin cuta a cikin kasusuwa na ƙwayar urinary.

A cikin marasa lafiya da rauni na koda, hadarin haɓakar microalbuminuria yana ƙaruwa, adadin creatinine yana ƙaruwa da fiye da 30% daga matakin farko. A cikin wasu marasa lafiya, aikin jijiyoyin jijiyoyi suna ƙaruwa, ischemic nephropathy yana haɓaka.

Daga tsarin numfashi

A lokacin jiyya, bayyanar irin wannan halayen mara kyau kamar:

• karin ƙarfe,
• bushe zafi tari,
• hoarseness da tsananin murya,
• ciwon makogwaro
• karancin numfashi yayin da yake kwance.
• laryngeal stenosis,
• huhun ciki.

Sabuwar jarirai suna haɓaka oliguria da rikicewar jijiyoyin jini.

Captopril na iya haifar da bushe, tari mai zafi.

A ɓangaren fata

Lokacin amfani da inhibitor na ACE, mai haƙuri na iya haɗuwa da irin waɗannan bayyanannun bayyanannun abubuwa kamar:

• infiltrated m papules,
• ƙuna mai zafi
• kodadde ruwan hoda blisters.

Bayyanar fata yana faruwa 'yan mintoci kaɗan bayan shan maganin, alamomin sun sake farawa bayan ɗaukar kashi na gaba na magani.

Tashin hankali yana faruwa ne daga asalin dunƙulewar hannu, zazzabi ya bayyana, fatar jiki tayi nauyi, wanda yayi rauni sosai, fossa baya yin madaidaiciya na dogon lokaci ta latsa tare da yatsa.

Daga tsarin kare jini

Magunguna bayan an yi amfani da tsawan lokaci na iya haifar da rashin ƙarfi, aikin nahaifa.

Bayanan mutum ɗaya bayan shan miyagun ƙwayoyi an kwatanta shi da jijiyoyin bugun gini na ciki da na urticaria. Haɓakar halayen anaphylactoid yana haɗuwa tare da bayyanar da ƙaiƙayi na ƙashin kansa a saman babba da ƙananan baya, fuska, bakin ciki, ɓangaren ƙananan ɓangaren hanji na hanji da na hanji.

Bayanan mutum ɗaya bayan ɗaukar miyagun ƙwayoyi suna bayyanar da bayyanar shaƙa.

Mai haƙuri yana da alamu masu zuwa:

• aphonia,
• mai jan numfashi
• choking
• m sakamako.

Pharmacodynamics

Captopril wani abu ne wanda ke hana juyar da sinadarai ta hanyar sinadarai (ACE) wanda ke hana sauyawar halittar angiotensin I zuwa angiotensin II, wanda hakan ke haifar da raguwar sakin aldosterone. Wannan tasirin yana haifar da raguwa a cikin matsin lamba na jijiyoyin bugun jini, karfin jini (BP), aikawa - da kuma girkewar zuciya.

Aikin renin plasma baya tasiri mai tasirin gaske. Ragewar saukar karfin jini yana faruwa duka a matakin al'ada da ƙananan matakan, wanda aka bayyana shi ta hanyar tasirin tsarin renin-angiotensin.

Amfani da kullun na captopril yana rage zafin hauhawar jini, da kuma ganuwar jijiyoyin jijiyoyi.

Hakanan, ƙwayar tana da tasirin waɗannan abubuwa akan jikin:

• Yana haɓaka hawan jini da na jijiyoyin jini,
• rage tari platelet,
• yana kara samarda jini ga ischemic myocardium,
• yana taimakawa rage yawan ions sodium ion a cikin marasa lafiya da raunin zuciya,
• yana rage lalacewar bradykinin kuma yana ƙaruwa da aiki na prostaglandin.

Captopril yana fassara mahimmancin jijiyoyin jini fiye da jijiya.

Ya bambanta da yin amfani da vasodilators kai tsaye (minoxidil, hydrazine, da dai sauransu), raguwa a cikin karfin jini bayan shan captopril ba ya haifar da bayyanar da tachycardia reflex da kuma rage buƙatar myocardium a cikin wadatar oxygen. A cikin raunin zuciya, isasshen ƙwayar magani ba ya shafar adadin hawan jini.

Bayan gudanarwar baka, ana lura da mafi girman raguwar hauhawar jini bayan awanni 1-1.5. Tsawon lokacin tasirin sakamako mai dorewa ne kuma ya sami ƙimar mafi kyau akan makwanni da yawa.

Umarnin don amfani da Captopril: hanya da sashi

Ana ɗaukar kwamfutocin Captopril a baki sau 1 kafin cin abinci.

Likita ya tsara maganin yau da kullun daban-daban dangane da alamun asibiti.

Tsarin shawarar da aka bayar da shawarar don gazawar zuciya (tare da raunin magani), in babu ingantaccen sakamako daga amfani da diuretics: kashi na farko na 6.25 MG sau 2-3 a rana. Ana daidaita sashi zuwa matsakaiciyar goyon baya - 25 mg sau 2-3 a rana a hankali, tare da tazara tsakanin makonni 2 ko fiye. Idan ya cancanta, ƙara yawan kashi, karuwa ana yin 1 lokaci cikin makonni biyu,

Shawarwarin allurai na allurar da ke nunawa don matsa lamba tare da hauhawar jini: Aikin farko na 25 mg 2 sau a rana. Idan tasirin warkewa bai isa ba, ana bayar da shawarar rage ƙwayar a hankali, lokaci 1 cikin makonni 2-4. Matsakaicin kulawa don matsakaicin nau'i na hauhawar jini shine 25 MG 2 sau a rana, amma ba fiye da 50 MG ba, don mummunan tsari - 50 mg sau 3 a rana.

Matsakaicin adadin yau da kullun shine 150 MG.

Ana ba da shawarar sashi na yau da kullun na miyagun ƙwayoyi ga marasa lafiya da ke fama da rauni na aikin ƙira: don matsakaici matsakaici (ƙararrawa na creatinine (CC) na aƙalla 30 ml / min / 1.73 m 2) - 75-100 mg, tare da ƙetaren magana (CC a ƙasa 30 ml / min / 1.73 m 2) - farkon kashi na 12.5-25 mg kowace rana. Idan ya cancanta, ana yin haɓaka na dogon lokaci, amma ana amfani da magani koyaushe a cikin adadin yau da kullun ƙasa da yadda aka saba.

Ga tsofaffi marasa lafiya, an zaɓi kashi a tsanaki daban-daban, ana ba da shawarar farawa tare da 6.25 mg sau 2 a rana kuma kuyi ƙoƙarin kula da kashi a wannan matakin.

Idan ya cancanta, ƙarin takaddar maganin diuretics, an wajabta amfani da madaidaiciyar diuretic maimakon jerin thiazide.

Side effects

Amfani da captopril na iya haifar da sakamako masu illa:

• Daga tsarin jijiyoyin jini: raguwa mai yawa a cikin karfin jini, hauhawar jini na orthostatic, edema, tachycardia,
• Daga gastrointestinal fili, pancreas, hanta: bushe baki, dandano mai rauni, asarar ci, tashin zuciya, stomatitis, da wuya - ciwon ciki, zawo, hyperbilirubinemia, ƙara yawan aiki na hanta enzymes hanta, hepatitis,
• Daga tsarin urinary: lalacewar aikin renal (ƙarancin matakan creatinine da urea cikin jini), proteinuria,
• Daga tsarin mai juyayi: rashin bacci, tsananin farin ciki, jin gajiya, ciwon kai, paresthesia, ataxia, asthenia, wahalar gani,
• Daga tsarin haemopoietic: da wuya - anemia, neutropenia, agranulocytosis, thrombocytopenia,
• Daga tsarin numfashi: bronchospasm, busassun tari (na lokaci), huhun huhun,
• Manuniyar dakin gwaje-gwaje: hyponatremia, hyperkalemia, acidosis, a cikin marasa lafiya tare da ciwon sukari na mellitus - hypoglycemia (tare da wakilai na bakin jini hypoglycemic da insulin)
• Abubuwan da ke tattare da cututtukan cututtukan cututtukan fata: ƙara yawan hotunan hoto, ƙaiƙayi, fatar fata, yawanci maculopapular, ƙasa da yawan fitina ko vesicular,
• Allergic da immunopathological halayen: angioedema na mucous membranes na bakin, harshe, maƙogwaro da fatywa, lebe, fuska da wata gabar jiki, da wuya - hanji hanji, lymphadenopathy, cutar serum, a lokuta mafi wuya, kasancewar maganin antinuclear a cikin jini,
• Sauran: paresthesia.

Umarni na musamman

Tare da alƙawura kuma a kai a kai kan aiwatar da shan ƙwayar, ya zama dole don saka idanu akan aikin renal.

Ya kamata a gudanar da lura da marasa lafiya da raunin zuciya yayin kulawa ta kusa da likita.

Tare da taka tsantsan, musamman a kan asalin aikin nakasa mai aiki, ana tsara Captopril a hade tare da immunosuppressants (ciki har da cyclophosphamide, azathioprine), allopurinol ko procainamide, marasa lafiya tare da vasculitis na tsarin ko rarraba hanyoyin haɗin kai. Don hana rikice rikice, kafin farkon amfani, a cikin farkon watanni 3 na farko (1 lokaci a cikin makonni 2) da kuma lokaci-lokaci yayin duk lokacin amfani da miyagun ƙwayoyi, ya zama dole don sarrafa hoto na tsinkaye na jini.

A cikin marasa lafiya waɗanda ke da tarihin cutar koda, captopril yana ƙaruwa da yiwuwar haɓakar furotin, saboda haka, a cikin wannan rukuni na marasa lafiya, ya kamata a kula da matakin furotin a cikin fitsari a cikin watanni 9 na farko (1 lokaci a cikin makonni 4), kuma idan ya wuce al'ada, batun cire magunguna ya kamata a magance shi. .

Hadarin haɓakar ƙoshin dan adam ya wanzu a cikin marasa lafiya da ke fama da cutar sankarar ƙwayar ƙwayar cuta ta renal, tare da haɓaka matakin creatinine ko urea a cikin jini, wajibi ne don rage kashi ko soke shi.

Don hana haɓakar halayen anaphylactoid a cikin marasa lafiya suna ɗaukar Captopril, ana bada shawarar kada a yi amfani da membranes dialysis me permeability (gami da AN69) don maganin hemodialysis.

Za a iya rage haɗarin haɓaka ƙwayar jijiya daga amfani da miyagun ƙwayoyi idan, kafin a fara jiyya (kwanaki 4-7), an rage yawan ƙwayar ko an dakatar da amfani da diuretics.

Idan alamar ƙwayar jijiya ta bayyana yayin ɗaukar ƙwayar, ana bada shawarar mai haƙuri don ɗaukar matsayi a kwance kuma ya ɗaga ƙafafunsa.

Tare da matsanancin ƙwayar jijiya, mai haƙuri dole ne ya sarrafa cikin maganin isotonic sodium chloride.

Tare da haɓakar angioedema, ya kamata a dakatar da miyagun ƙwayoyi kuma ya kamata a nemi shawarar likita cikin gaggawa. Don edema tare da bayyanawa a kan fuska, yawanci, ba a buƙatar magani na musamman, sai dai shan magungunan antihistamines don rage tsananin bayyanar cututtuka. Idan akwai haɗarin haɓakarwar hanyar iska (kumburi da harshe, pharynx ko maƙogwaro), epinephrine 0.5 ml (adrenaline) dole ne a gudanar da subcutaneously a cikin rabo na 1: 1000.

Yin amfani da captopril na iya haifar da jin daɗi, musamman a farkon jiyya, don haka an shawarci marasa lafiya su guji tuki motoci da hanyoyin, ka'idodin haɗari masu haɗari waɗanda ke buƙatar taro da babban saurin halayen psychomotor.

Hulɗa da ƙwayoyi

Ayyukan antihypertensive na captopril an inganta shi ta hanyar vasodilators (minoxidil) da diuretics.

Haɗuwa tare da clonidine, estrogens, indomethacin da sauran magungunan anti-mai kumburi marasa amfani na steroid suna taimakawa rage girman tasirin maganin.

Tare da amfani da lokaci guda na allon

• Tsarin potassium-sparing diuretics da kuma shirye-shiryen potassium zasu iya haifar da hyperkalemia,
• Shirye-shiryen zinari (sodium aurothiomalate) da kuma hanawar enzyme mai juyawar angiotensin-suna haifar da hadaddun alamu, ciki har da tashin zuciya, amai, fuska, zubar jini,
• Procainamide da allopurinol suna ba da gudummawa ga haɗarin haɓakar ciwo na Stevens-Johnson da / ko neutropenia,
• Salts na lithium yana haɓaka ƙwaƙwalwar lithium,
• Cyclophosphacin, azathioprine da sauran immunosuppressants suna kara yiwuwar cututtukan cututtukan zuciya,
• Ma'aikatan insulin da na bakin hypoglycemic jami'ai suna kara hadarin yawan haila.

Ana amfani da Capelril analogues sun hada da: Capoten, Captopril-STI, Captopril-AKOS, Captopril Sandoz, Captopres, Alkadil.

Yi amfani da lokacin daukar ciki da lactation

A cikin mahaifiyar da zata zo nan gaba, ana yin magani ta hauhawar jijiya ta amfani da magani Methyldopa.

Ba a tsara mai katange ba, saboda yana kira:

• gazawar na yara a jariri,
• kwancen hannu da nakasar kwanyar,
• rashin ci gaba na huhu,
• mutuwar tayin.

Magunguna a cikin madarar nono yana da mummunar tasiri akan lafiyar yarinyar.

Abun dacewa

Ba za a iya sha miyagun ƙwayoyi lokaci guda tare da abubuwan sha waɗanda ke ɗauke da ethyl barasa ba, don guje wa ci gaban sakamako.

Game da guba na Captopril, mai haƙuri yana haɓaka raunin gani.

Yawan abin sama da ya kamata

Game da guba da mai hana ACE, mara lafiya ya ci gaba:

• tashin hankali
• infarction na zuciya
• bugun jini
• thromboembolism
• na gazawar
• karancin gani.

Don magani, ana bada shawara don tsabtace hanji, sanya allurar rigakafin magungunan vasoconstrictor. Don magani, ana amfani da maganin colloidal, kwayoyi Dopamine da Norepinephril.

Yin hulɗa tare da wasu kwayoyi

Haɗin magunguna tare da vasodilator yana haifar da haɓaka sakamako mai illa.

Yin amfani da inhibitor na ACE tare da magungunan anti-inflammatory marasa steroidal ko Clonidine yana haifar da raguwar tasirin maganin.

Yin amfani da miyagun ƙwayoyi tare da diuretic yana haifar da yawan adadin ions na potassium.

Yakamata a yi taka tsantsan tare da yin amfani da salts na lilin tare da wakili mai narkewa, tunda maida hankali a cikin inorganic fili a cikin jijiyar jini yana ƙaruwa.

Yin amfani da captopril tare da magungunan anti-inflammatory marasa steroidal yana haifar da raguwa a cikin tasirin maganin.

Marasa lafiya suna ɗaukar Allopurinol da ACN inhibitor suna cikin haɗarin haɓaka alamar Stevens-Johnson.

Azaman madadin wakili mai guba, yi amfani da:

Mai hana kamfanin Sandoz (Jamus) ya ƙunshi 6.25 MG na kayan mai aiki a cikin kwamfutar hannu 1. Ana amfani da maganin don warkar da hauhawar jini, tashin zuciya, bugun jini mai nau'in ciwon sukari na 1.

Alkadil na iya zama madadin magani kuma magani ne mai tasiri. An wajabta magunguna don gazawar daidaitaccen ilimin warkarwa.

Angiopril yana da irin wannan sakamako tare da mai hana ACE. An wajabta maganin don maganin LV mai rauni na zuciya, bayan infarction na zuciya, tare da albuminuria ba fiye da 30 mg / rana.

Umarnin KyaftinKa umarnin umarninBaitaccen bayanin

Kuna iya maye gurbin maganin ta hanyar magani kamar Kapoten. Ana ɗaukar maganin kamar yadda likita ya umarta 1 hour kafin abinci.

Neman bita don Captopril 25

Vasily, shekara 67, Voronezh

Ina fama da cutar hawan jini. A bara, an sami matsalar hauhawar jini sau biyu. Ba a rasa matsin lambar komai ba, koda bayan allura a asibiti bai zama da sauƙi ba. Na tuna da miyagun ƙwayoyi, sanya kwamfutar hannu na 25 MG a karkashin harshe na, kuma bayan minti 30 matsin lamba ya ragu. Naku koyaushe a cikin magani a cikin majalisa.

Margarita, shekara 55, Cheboksary

A cikin dare, matsin lamba ya kasance 230 zuwa 115. Na sa allunan 2 na miyagun ƙwayoyi a ƙarƙashin harshe na, sannan da dare wani 2. Da safe, matsanancin ya ragu zuwa 160 cikin 100. Likita ya allurar da diuretic kuma matsin ya dawo daidai. Na yi imani cewa ya fi kyau amfani da Kapoten na farko don magani.

Tamara, shekara 57, Derbent

Ina ɗaukar inhibitor ACE na tsawon shekaru 15, 1 kwamfutar hannu 0.25 MG sau ɗaya a rana. Ayyukan yau da kullun sun canza, ayyukan motsi ya ragu, don haka ina sha Allunan 2 na miyagun ƙwayoyi kowace rana. Babu sakamako masu illa. Magungunan suna da tasiri.

Form sashi

Tabletaya daga cikin kwamfutar hannu ya ƙunshi

abu mai aiki - kwalliya 25 MG

magabata: lactose monohydrate, microcrystalline cellulose, magnesium ko alli stearate, silicon dioxide, colloidal anhydrous

Allunan suna fararen launi, silin-silili, tare da chamfer a kowane ɓangaren, tare da ƙirar giciye a gefe ɗaya da kuma zane "G" a ɗayan.

Kayan magunguna

Pharmacokinetics

Bayan gudanar da baki, yana da sauri kuma yana ɗauka gaba ɗaya daga cikin ƙwayar gastrointestinal. Cin abinci lokaci guda yana rage sha da kashi 30-55%. Matsakaicin maida hankali (Cmax) a cikin jini yana gudana bayan minti 30-90. A cikin plasma, yana ɗaure wa furotin ta hanyar 25-30%. An rarraba shi cikin ɗaukacin gabobin jiki da kyallen takarda, ya haɗu cikin mahaifa, zuwa cikin madara, kuma shinge na kwakwalwa-jini baya wucewa. Yana cikin metabolized a cikin hanta tare da kirkirar dimpleril disulfide dimer da kuma cututtukan ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa. Cire rabin rayuwar sa yayi sa'o'i 2-3. 40-50% an cire shi ta hanyar kodan ba canzawa, sauran a cikin hanyar metabolites.

Pharmacodynamics

Captopril yana da hypotensive, vasodilating, sakamako na cardioprotective. Yana hana ayyukan toshewar enzyme na angiotensin, wanda ke haifar da raguwa a cikin sauyawa na sauyin angiotensin I zuwa angiotensin II (yana da tasirin vasoconstrictor, yana inganta ƙaddamar da aldosterone) kuma yana hana shigo da iska na kwandishan mara ƙarfi - bradykinin da prostoglandin E2. Yana haɓaka ayyukan tsarin kallikrein-kinin, yana ƙara ƙaddamar da abubuwa masu aiki da keɓaɓɓe waɗanda ke da tasirin natriuretic da jijiyoyin bugun jini, da haɓaka kwararar jini na koda. Yana rage juriya na jijiyoyin jiki, pre-da bayan saiti a kan zuciya, matsin lamba a cikin karamin da'irar kuma a cikin hanji, yana kara karfin zuciya.

Alamu don amfani

hauhawar jini (tsoka-da magani)

rauni na zuciya (na zaman hadewa)

dysfunction na ventricle hagu lokacin da barga cikin

marasa lafiya bayan infarction na fitsari

mai ciwon sukari nephropathy tare da nau'in ciwon sukari na mellitus I

Sashi da gudanarwa

Ana shan maganin a baka, ba tare da la'akari da abincin ba.

Kashi na farko na 25-50 mg sau 2 a rana, idan ya cancanta, ana kara rage guda zuwa 100-150 mg sau 2 a rana, tare da tazara tsakanin makonni 2-4. Adadin magani na 25 mg sau 2-3 a rana. Matsakaicin adadin yau da kullun shine 150 MG.

Rashin lafiyar zuciya

Kashi na farko na 6.25 -12.5 mg 2-3 sau a rana, wanda ke biye da karuwa kowane mako 2-3, zuwa kashi na kulawa na 25 mg sau 2-3 a rana ko har zuwa 50 mg sau 3 a rana. Matsakaicin adadin yau da kullun shine 150 MG.

Hagu na ventricular dysfunction

Jiyya yana farawa ne tazara tsakanin ta 3 zuwa rana ta 16 bayan saukar myocardial infarction. Ainihin kashi na captopril shine 6.25 mg / rana a ranar farko. Sannan, washegari, yana ƙaruwa zuwa 12.5 MG sau uku a rana don kwana biyu tare da haɓakar hankali zuwa 25-50 MG na captopril sau uku a rana. Ana samun wannan maganin a hankali akan makonni da yawa. Idan akwai matsalar hypotension, kamar yadda yake cikin gazawar zuciya, za a iya rage yawan diuretics da / ko sauran masu maye gurbin kwastomomi domin cimma daidaitaccen yanayin aiki na maganin kwakwalwa.

Matsakaicin adadin yau da kullun shine 150 MG.

Nephropathy na ciwon sukari tare da mellitus na sukari-dogara da insulin

Maganin farko shine 6.25 MG / rana. Idan ya cancanta, ƙara kashi zuwa 75-100 mg / rana (a cikin allurai 2-3). Game da ciwon sukari mai dogaro da insulin tare da microalbuminuria (sakin albumin 30-300 mg kowace rana), kashi shine 50 MG sau biyu a rana. Tare da cikakken ƙwayar furotin fiye da 500 a kowace rana, ƙwayar tana da inganci a kashi 25 na MG sau uku a rana.

Game da illa mai aiki na renal

Maganin farko na 6.25 MG sau 2-3 a rana, tare da ƙaruwa. Matsakaicin adadin ya dogara da keɓantaccen ɗaukar hoto.