Dapril 20 MG: umarnin don amfani

Ana samun Dapril a cikin nau'ikan allunan (guda 10 kowannensu a cikin fakitoci masu laushi, a cikin kwali na kwali: 5 MG da 10 MG kowane - fakitoci 3, 20 MG kowane - 2 fakitoci).

Kwamfutar hannu 1 ya ƙunshi:

• abu mai aiki: lisinopril - 5 MG, 10 MG ko 20 MG,
• karin abubuwan taimako: alli hydrogen phosphate, mannitol, iron iron (E172), magnesium stearate, sitaci gelatinized, sitaci.

Contraindications

• tarihin cutar ta malalatawa,
• na farko hyperaldosteronism,
• matsanancin cutar na koda,
• biyu-na yara koda Stenosis ko artery stenosis na wani koda tare da ci gaban azotemia,
• azotemia
• yanayi bayan kamuwa da koda,
• hyperkalemia
• stenosis na aortic orifice da kuma irin wannan yanayin damuwa,
• shekarun yara
• Tsarin ciki na II da III na lokacin daukar ciki,
• nono
• hypersensitivity ga ACE inhibitors da abubuwan magunguna.

Sashi da gudanarwa

Ana ɗaukar allunan a baka.

Likita ya tsara adadin magungunan daban-daban bisa ga alamu na asibiti da bukatun mutum don cimma sakamako mai dorewa.

• hauhawar jijiyoyi: kashi na farko - 10 MG 1 sau ɗaya a rana. Na gaba, an zaɓi kashi ɗaya daban-daban, yin la'akari da matakin matsin lamba na jini (BP) na mai haƙuri, kashi na kulawa da aka saba shine 20 MG sau ɗaya a rana, cikin rashin isasshen sakamako na warkewa bayan kwanaki 7 na maganin, ana iya ƙara zuwa 40 MG. Matsakaicin adadin yau da kullun shine 80 MG,
• rauni na zuciya: kashi na farko shine 2.5 MG kowace rana, maganin kiyayewa shine 5 mg a rana.

Game da aiki mai rauni na koda, ana kafa kullun da aka fara la'akari da keɓancewar kerawa (CC):

• QC mafi girma daga 30 ml / min: 10 mg,
• KK 10-30 ml / min: 5 mg,
• CC kasa da 10 ml / min: 2.5 mg.

Side effects

• daga tsarin zuciya: mafi wuya - tachycardia, orthostatic hypotension,
• daga tsarin mai juyayi: jin jiki na kasala, ciwon kai, farin ciki, wani lokacin - rikicewa, rashin daidaiton yanayi,
• daga cutar haemopoietic: agranulocytosis, neutropenia, ƙananan matakan haemoglobin, raguwa a cikin adadin ƙwayoyin jan jini,
• daga narkewar abinci: tashin zuciya, da wuya - bushe bakin, ciwon ciki, zawo, wani lokacin - karuwar ayyukan hanta enzymes, kara matakan bilirubin a cikin jini,
• halayen rashin lafiyan: da wuya - fatar fata, wani lokacin - Quincke's edema,
• daga tsarin numfashi: bushe tari,
• wasu: wani lokaci - hyperkalemia, lalacewa aiki na renal.

Umarni na musamman

Yin amfani da inhibitors na ACE na iya haifar da sakamako mai illa a cikin hanyar bushe tari, wanda ya ɓace bayan cire magunguna. Wannan yakamata ayi la'akari dashi a cikin bambance banbancen tari na tari a cikin mara lafiya shan Dapril.

Dalilin raguwar hauhawar jini shine raguwa a cikin yawan motsawar jikin mutum wanda yake haifar da zawo ko amai, yawan amfani da diuretics, raguwar ci abinci mai gishiri, ko dialysis. Sabili da haka, ana bada shawara don fara magani a ƙarƙashin tsananin kulawa na likita kuma tare da taka tsantsan yawan ƙwayoyi.

Lokacin da zazzabi ta hanyar amfani da membranes tare da babbar matsala, akwai haɗarin cutar rashin lafiyar anaphylactic. Sabili da haka, don dialysis, yana da buƙatar amfani da membranes kawai na wani nau'in ko don maye gurbin miyagun ƙwayoyi tare da wani wakili na antihypertensive.

Hulɗa da ƙwayoyi

Tare da amfani da Dapril lokaci guda:

• potassium-sparing diuretics (triamteren, spironolactone, amiloride), samfuran da ke dauke da potassium wanda ke dauke da abubuwan maye gurbin potassium gishiri - suna kara hadarin cutar hyperkalemia, musamman tare da aiki na nakasa,
• diuretics, maganin cututtukan jini - suna haifar da raguwar raguwar hauhawar jini,
• magungunan anti-mai kumburi-marasa steroidal - rage tasirin antihypertensive na miyagun ƙwayoyi,
• shirye-shiryen lithium - rage rage yawan fitowar su daga jiki,
• ethanol - yana haɓaka sakamakon maganin.

Anafani da maganin Dapril sune: Allunan - Diroton, Lisinopril, Lisinopril-Teva, Lisinoton.

Aikin magunguna

Dapril magani ne na rigakafi daga rukunin angiotensin-inhibiting enzyme (ACE) yana hana sakamako mai tsawo. Lisinopril mai aiki abu ne na metabolite na enalapril (enalaprilat). Lisinopril, yana hana ACE, yana hana samuwar angiotensin II daga angiotensin I. A sakamakon haka, an kawar da tasirin vasoconstrictor na angiotensin II. samuwar angiotensin III, wanda ke da tasirin gaske na inotropic, yana raguwa, sakin norepinephrine daga ƙwaƙwalwar ƙwaƙwalwar ƙwaƙwalwa mai juyayi yana raguwa, ɓoyewar aldosterone a cikin yanki mai narkewa na adrenal cortex da hypokalemia wanda ke haifar dashi kuma riƙewar sodium da ruwa yana raguwa. Bugu da kari, akwai tarin bradykinin da prostaglandins wadanda suke haifar da vasodilation. Duk wannan yana haifar da raguwa a cikin karfin jini, sannu a hankali kuma mafi ƙarancin hankali fiye da yin alƙawarin captopril gajere. Saboda haka, karuwa a cikin zuciya ba ya faruwa. Lisinopril yana rage juriya na jijiyoyin bugun jini (OPSS) da kuma fitowar kaya, wanda ke haifar da hauhawar fitowar zuciya, fitowar zuciya, da hauhawar jini. Bugu da kari, da ikon venous yana ƙaruwa, preload, matsa lamba a dama atrium, na huhu jijiyoyin jini da kuma veins rage, i.e. a cikin jijiyoyin bugun jini, matsanancin bugun jini a cikin ventricle hagu yana raguwa, diuresis yana ƙaruwa. Matsi na tacewa a cikin majallan dunkulalliya ya ragu, proteinuria yana raguwa kuma ci gaban glomerulosclerosis yana raguwa. Sakamakon yana faruwa awanni 2 bayan shan maganin. Matsakaicin sakamako yana tasowa bayan sa'o'i 4-6 kuma yana aƙalla awanni 24.

Sashi da gudanarwa

A cikin lura da hauhawar jini, kashi na farko na 5 MG 1 lokaci ɗaya kowace rana. Adadin kulawa har zuwa 20 MG sau ɗaya kowace rana. Tare da jiyya na mako-mako, ingantaccen kashi yana ƙaruwa zuwa 20-40 MG kowace rana. Ana yin zaɓin sashi daban-daban gwargwadon alamun alamun jini. Matsakaicin adadin shine 80 MG kowace rana.

A cikin rauni na zuciya, kashi na farko na 2.5 MG kowace rana. Matsayin da aka saba dashi shine 5 zuwa 20 MG kowace rana.

Idan akwai matsala game da aiki na keɓaɓɓiyar aiki, an saita kashi gwargwadon aikin sharewar halitta (QC). Tare da CC fiye da 30 ml / min, maganin da aka ba da shawarar shi ne 10 mg / rana. Tare da CC daga 30 zuwa 10 ml / min, kashi shine 5 MG sau ɗaya a rana. Tare da CC kasa da 10 ml / min 2.5 mg.

Alamu don amfani

Ana amfani da Dapril don magance:

• hauhawar jijiyoyin jini (ciki har da farfadowa) - za a iya amfani da maganin a hade tare da wasu magungunan antihypertensive ko a cikin hanyar monotherapy,
• rauni na zuciya (na kula da marasa lafiya da ke shan diuretics da / ko shirye-shiryen Digitalis a matsayin wani ɓangare na maganin haɗuwa).

Nau'i na saki, abun da ke ciki

Ana samun Dapril a cikin nau'ikan allunan zagaye masu ruwan hoda na ruwan hoda. Orarancin abubuwan inclusions da marbling Allunan an sanya su cikin faranti na bakin ciki, sannan kuma a cikin fakitoci na kwali.

Kowane kwamfutar hannu ya ƙunshi lisinopril (sashi mai aiki mai aiki), da abubuwa masu taimako - mannitol, E172, alli hydrogen phosphate, sitaci gelatinized, sitaci, stenes magnesium.

Yin hulɗa tare da wasu kwayoyi

Yin amfani da Dapril a lokaci guda tare da kayan abinci na potassium, salts na potassium, daskararren maganin potassium (amiloride, triamteren, spironolactone) yana ƙara haɗarin hyperkalemia (musamman a cikin marasa lafiya da ke fama da rauni na aikin ƙirar), tare da NSAIDs, yana yiwuwa a raunana tasirin lisinopril, tare da maganin antidepressants da salure mummunan tashin hankali, tare da shirye-shiryen lithium - jinkirta cire lithium daga jiki.

Amfani da barasa yana inganta tasirin mai aiki mai ƙarfi.

A lokacin daukar ciki

Maƙerin ya mai da hankali ga rashin yiwuwar amfani da lisinopril yayin lokacin gestation. Da zaran an tabbatar da gaskiyar daukar ciki, yakamata a dakatar da maganin nan da nan.

Yana da mahimmanci a tuna cewa magani tare da masu hana ACE a cikin 3 da na 2 yana da mummunar tasiri a tayin (rikice-rikice masu yiwuwa sun haɗa da hyperkalemia, mutuwar intrauterine, raguwar alama a cikin karfin jini, hypoplasia na kwanciyar hankali, gazawar renal).

A lokaci guda, babu wani tabbacin mummunan sakamako na miyagun ƙwayoyi akan tayin a cikin farkon farkon.

Idan jariri ko jariri ya fallasa su ACE inhibitors a cikin mahaifar, ya zama dole a lura da yanayin sa a hankali. Wannan ya zama dole don ganowar hyperkalemia, oliguria, raguwar hauhawar jini.

A fili yake cewa lisinopril yana iya shiga cikin mahaifa, amma har yanzu babu wani bayani game da shigar azzakarin cikin nono.

A matsayin kiyayewa, an bada shawarar barin shayar da jarirai har tsawon lokacin kulawa da Dapril.

Sharuɗɗan da yanayin ajiya

Wanda ya kirkiro Dapril ya shawo kan masu sayen kayayyaki game da bukatar zabi wani wuri mai bushe, duhu da zai adana maganin.

A wannan yanayin, yawan zafin jiki na cikin dakin kada ya wuce digiri 25. Idan kawai an cika yanayin da ke sama, ana iya adana samfurin don rayuwar rayuwar shiryayye na shekaru 4.

A matsakaici, fakitin Dapril ɗaya ga ɗan ƙasa na Federationasar Rasha 150 rubles.

Mai haƙuri yana zaune a cikin Ukraine, na iya siyan fakitin maganin a matsakaita na 40 hryvnia.

Ana amfani da magungunan Dipril sun hada da kwayoyi kamar Diroton, Diropress, Iramed, Zoniksem, Lizigamma, Lizakard, Lisinopril, Lisinoton, Lisinopril dihydrate, Lisinopril granilli, Rileys-Sanovel, Lizoril, Liziprex, Lizonlir, Cinnopril, Cinnopril

Gabaɗaya, sake dubawa na masu amfani da yanar gizo game da Dapril na miyagun ƙwayoyi suna da inganci.

Marasa lafiya da likitoci suna ba da amsa ga maganin sosai, suna mai da hankali kan inganci da saurin aiwatarwa.

Ma'aikatan kiwon lafiya sun mayar da hankali kan abubuwan da ke zuwa: duk da yawan adadin sakamako masu illa da aka nuna a cikin umarnin, suna da matuƙar wuya (yawan aukuwar abubuwan da mutane da ba a so su ke cikin kewayon daga 0.01 zuwa 1%).

Kuna iya karanta sake dubawa na masu haƙuri na ainihi game da miyagun ƙwayoyi a ƙarshen labarin.

Don haka, An sanya Dapril a matsayin ingantaccen ƙwayar magunguna.

Magungunan yana cikin buƙata, saboda kasancewarsa, ƙanƙantar farashi mai sauƙi.

Don sayan magani a kantin magani, dole ne a gabatar da takardar likita.

Yadda ake amfani: sashi da hanya na jiyya

A ciki, tare da hauhawar jini - 5 MG sau ɗaya a rana. A cikin rashin sakamako, ana kara yawan kashi a kowane kwana 2-3 ta 5 MG zuwa matsakaiciyar warkewa na 20-40 mg / rana (kara yawan kwayar da ke sama da 20 mg / rana yawanci baya haifar da raguwar hauhawar jini). Matsakaicin adadin yau da kullun shine 80 MG.

Tare da HF - fara da 2.5 MG sau ɗaya, biye da karuwar kashi na 2.5 mg bayan kwanaki 3-5.

A cikin tsofaffi, ana lura da mafi yawan tasirin sakamako mai lalacewa, wanda ke da alaƙa da raguwa cikin ragin lisinopril excretion (ana ba da shawarar fara magani tare da 2.5 MG / rana).

A cikin gazawar koda na kullum, tarawa yana faruwa tare da raguwa cikin tacewa kasa da 50 ml / min (yakamata a rage kashi 2 sau biyu, tare da CC ƙasa da 10 ml / min, dole ne a rage kashi ta 75%).

Tare da ci gaba da hauhawar jijiya, ana nuna magani na tsawon lokaci a 10-15 mg / rana, tare da raunin zuciya - a 7.5-10 mg / rana.

Pharmacodynamics

Dapril ya toshe halittar oligopeptide hormone, wanda ke da tasirin vasoconstrictor. Hakanan akwai raguwa a cikin jijiyoyin bugun koda na ciki, da bayan-saiti da kan zuciya, kusan babu wani tasiri a cikin bugun zuciya da karfin jini.

Bugu da kari, juriya daga tasoshin din koda yana ragewa kuma yana gudana cikin jini a jikin mutum yana inganta. A mafi yawancin lokuta, an lura da raguwar matsin lamba bayan shan magungunan bayan awa 1-2 (mafi yawa bayan awanni 6 zuwa 9).

Ana lura da sakamako mai warkewa bayan makonni 3-4 daga farkon jiyya. Cutar shan magani ba ta inganta ba.

A lokacin jiyya, akwai karuwa a ragewa zuwa aikin jiki, yayin da a cikin marasa lafiya da ke fama da hawan jini akwai raguwar matsin lamba ba tare da haɓaka tachycardia ba.

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Pharmacokinetics

Dapril yana tunawa da kusan 25-50%. Matsayin sha na miyagun ƙwayoyi bai shafe shi ta hanyar abinci ba.

A cikin jini na plasma, miyagun ƙwayoyi sun isa mafi girman maida hankali bayan sa'oin 6-8.

Babu daurewa magungunan don sunadarai da tsarin metabolization, kodan ya cire maganin.

Idan akwai rauni na aiki na keɓaɓɓiyar aiki, lokacin kawar da miyagun ƙwayoyi yana ƙaruwa daidai da yanayin raunin aikin.

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Amfani da dapril lokacin daukar ciki

Babban sinadarin Dapril shine lisinopril, wanda ke da ikon shiga katangar mahaifa, don haka shan maganin yana contraindicated ga mata masu juna biyu. Shan Dapril lokacin daukar ciki na iya cutar da tayin da tayi. Samun maganin a farkon watanni na farko da na biyu na iya haifar da mutuwar mahaifa, kwanyar kwanciyar hankali, gazawar koda da sauran rikice-rikice.

Yawan abin sama da ya kamata

Lokacin da aka ɗauke shi fiye da adadin shawarar da aka ba da shawarar, dapril yana haifar da raguwa mai yawa a cikin karfin jini, overdrying na bakin mucosa, ƙarancin koda, ƙarancin zuciya da numfashi, farin ciki, damuwa na ruwa-electrolyte balance, tashin hankali, damuwa, nutsuwa.

Game da yawan ƙwayar maganin ƙwayar cuta, ana ba da shawarar yin amfani da maganin kashe kumburi da gudanar da sinadaran enterosorbents.

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Haɗi tare da wasu kwayoyi

Tare da gudanarwa na Dapril na lokaci guda tare da wasu kwayoyi waɗanda ke rage karfin jini (musamman tare da diuretics), ana lura da ƙara tasirin sakamako.

Magungunan Nonsteroidal tare da tasirin anti-mai kumburi (acetylsalicylic acid, ibuprofen, da sauransu), sinadarin sodium tare da Dapril yana rage tasirin warkewar ƙarshen.

Gudanar da magunguna a lokaci guda tare da potassium ko lithium yana haifar da hauhawar matakan waɗannan abubuwan a cikin jini.

Magungunan Immunosuppressive, magungunan antitumor, alopurinol, hormones steroid, procainamide a hade tare da Dapril suna haifar da raguwa a cikin matakin leukocytes.

Dapril yana kara bayyanar dafin giya.

Magunguna masu narkewa, magunguna masu kwantar da hankali suna inganta tasirin warkewar Dapril.

Tare da tsarkakewar jini na mutum, ana iya halayen anaphylactic.

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