Presartan N

Magunguna tare da sakamako na antihypertensive, yana nufin magunguna, waɗanda keɓaɓɓen shinge. karafarin masu karɓa (nau'in AT1) Ba ya hana enzyme (kinase II) cewa yana lalata bradykinin. Presartan ya rage maida hankali jini aldosterone da basamara, OPSS, BOKA, yana rage bayan fitarwa, matsin lamba a cikin “karamin” kewayawar zagayawa na jini, yana da tasirin diuretic. Yana hana ci gaban myocardial hauhawar jini. A cikin marasa lafiya tare da CHF yana ƙaruwa juriya ga aiki na jiki.

Bayan kashi ɗaya na Presartan, tasirin antihypertensive ya isa matsakaicin darajar shi bayan sa'o'i 6, kuma a hankali yana ragewa gobe. Ana nuna tasirin sakamako mai ƙima a matsakaicin wata ɗaya bayan fara magani tare da miyagun ƙwayoyi.

Presartan, umarnin don amfani (Hanyar da sashi)

An dauki Presartan ba tare da la'akari da cin abinci ba, sau 1 a rana. A cikin jiyya hauhawar jini shawarar da aka bayar ta yau da kullun na 50 MG, wanda, idan ya cancanta, ana iya ƙara zuwa 100 MG. Idan mai haƙuri ya ɗauki allurai da yawa na diuretics, ya kamata a rage sashi zuwa 25 MG kowace rana.

Don neman magani CHF kashi na farko na yau da kullun shine 12.5 MG, an ɗauka a lokaci guda, to, tare da tazara ta mako, ana ƙaruwa da kashi sau 2 (12.5, 25, 50 mg). Adadin kulawa shine 50 MG kowace rana. Don haɓaka sakamako mai ban tsoro, ana bada shawara don yin magani Presartan N (Losartan tare da wakili na antihypertensive).

Haɗa kai

Amfani da ƙwayoyi tare da kwayoyi dauke da potassium (shirye-shiryen potassium, potassium-sparing diuretics) kara hadarin ci gaba hyperkalemia. Haɗarin shan miyagun ƙwayoyi tare da diuretics na iya haifar da raguwa mai kaifi BOKA. Hadin gwiwa tsakanin Shugaba da NSAIDs yana taimaka wajen rage tasirin maganin. Tare da gudanar da sabis na lokaci guda tare da wasu magungunan antihypertensive, juna sakamako mai ban tsoro.

Formaddamar da tsari da abun da ke ciki

Nau'in magani na Presartan shine allunan da aka sanya a fim: a allurai 25 da 50 mg - zagaye biconvex, ruwan hoda, allunan 25m tare da layin rarrabuwa a gefe daya, a kashi 100 na digo - digo-mai-kamar, biconvex, farar fata ko kusan farin tare da zane-zanen hoto " 100 ”a gefe guda kuma“ BL ”a daya gefen (inji mai kwakwalwa guda 10.) A cikin alkuki mai haske, murjiyoyi 3 a cikin kwali mai kwali, guda 14. A cikin laushi, firji 2 a cikin kwali.

Abun ciki 1 kwamfutar hannu 25/50 mg:

• abu mai aiki: potassium losartan - 25/50 mg,
• abubuwan taimako: sitaci sitiri, microcrystalline cellulose, tsabtace talc, colloidal silicon dioxide, sittin glycolate, magnesium stearate, isopropyl barasa, methylene chloride, opadry OY-55030, daskararre ja ja.

Abinda ke ciki 1 kwamfutar hannu 100 MG:

• abu mai aiki: potassium losartan - 100 MG,
• abubuwan taimako: sitaci sitaci, sitaci, microcrystalline cellulose, talc, colloidal silicon dioxide, sitaci carboxymethyl sitaci, magnesium stearate, hypromellose, titanium dioxide, talc, macrogol.

Pharmacokinetics

Presartan yana dafe da sauri daga cututtukan ciki (GIT). Metabolized ta hanyar wucewa ta hanta. Matsakaicin ɗaukar nauyin sunadaran plasma na losartan da metabolites shine kashi 92-99. Bioavailability - 33% (abincin abinci ba shi da wani tasiri). Magungunan a zahiri ba ya ratsa bakin jini-kwakwalwa. Ba ya tarawa cikin jiki, an dauki nauyin motsa jiki tare da fitsari da bile. Rabin rayuwar losartan shine 2 hours.

Alamu don amfani

• hauhawar jini da jijiyoyin jini na hagu (don rage haɗarin ciwan cututtukan zuciya da mace-mace),
• nau'in ciwon sukari na II na sukari da proteinuria (don rage haɗarin proteinuria da hypercreatininemia),
• ana amfani da kasalar zuciya kamar yadda wani ɓangare na maganin haɗuwa lokacin da ba zai yiwu a yi amfani da angiotensin da ke juya masu hana enzyme (ACE) ba.

Contraindications

• matsanancin hanta ˃ maki 9 akan sikelin-Yara (na allunan 100 MG),
• ciki da lactation,
• shekaru zuwa shekaru 18
• karuwa da hankali ga abubuwan Presril.

Kudin contraindications (na allunan 100 MG):

• gout
• hawan jini
• rashin lafiyan halayen yayin aikin da ya gabata tare da masu hana ACE ko wasu kwayoyi,
• asma,
• cututtuka na jini
• rage jini saukar jini (BCC),
• jijiyoyin jini,
• hadin gwiwa tare da magungunan anti-inflammatory marasa amfani (NSAIDs),
• cututtukan zuciya da jijiyoyin jini
• tsufa.

Umarnin don amfani da Presartan: hanyar da sashi

Ana ɗaukar allunan allunan ta baki sau 1 a rana sau ɗaya, ba tare da la'akari da cin abinci ba.

An nuna sashi:

• hauhawar jini: jijiyoyin farko da aka ba da shawarar su ne 25 MG / rana, matsakaicin kashi shine 50 MG / rana, idan ya cancanta, ana iya haɓaka shi zuwa 100 MG / rana, yayin shan magani sau 2 a rana an yarda,
• kashin zuciya: maganin da aka bada shawarar farko shine 12.5 mg / day, ana aiwatar da tititin kashi tare tazara ta mako. Matsakaicin goyon baya shine 50 MG / rana,
• rigakafin cututtukan zuciya da mace-mace a cikin marasa lafiya da hauhawar jini da jijiyoyin jini na hagu: wanda aka ba da shawarar farko shine 50 MG / rana, sannan an ƙaru zuwa 100 MG / rana, ko kuma an sanya allunan haɗarin hydrochlorothiazide,
• nau'in ciwon sukari na II na sukari tare da proteinuria: maganin da aka ba da shawarar farko shine 50 MG / rana, to an ƙara zuwa 100 MG / rana.

Ungiyoyin haƙuri na musamman:

• gazawar hanta (points maki 9 akan sikelin Yara-Pugh), ɗaukar allurai na diuretics, hemodialysis, shekaru sama da shekaru 75: matakin farko na maganin bai wuce 25 MG / rana ba,
• aikin hanta mai rauni: ƙananan allurai na miyagun ƙwayoyi ya kamata a yi amfani dasu.

Side effects

Presartan a cikin sashi na 25 da 50 mg shine mafi yawanci ana jure shi. Abubuwan da ke tattare da gefen zasu iya faruwa a cikin nau'in gudawa, dyspepsia, ciwon tsoka, kumburi, ciwon kai, farin ciki, damuwa, bacci, damuwa (bacci a jiki 5.5 meq / l), a lokuta masu wuya, tari, gazawar numfashi, tachycardia, angioedema ( lebe, fuska, pharynx da / ko harshe), urticaria, haɓaka ayyukan hanta enzymes hanta, matakin serir bilirubin.

Sakamakon sakamako masu illa yayin ɗaukar allunan Presartan a sashi na 100 MG:

• tsarin zuciya: tachycardia, palpitations, hanci hanci, maganin orthostatic hypotension, arrhythmias, bradycardia, vasculitis, angina pectoris, infarction na myocardial,
• tsarin narkewa: zawo, ciwon ciki, tashin zuciya, dyspepsia, busasshiyar roba, anorexia, amai, ciwon hakori, maƙarƙashiya, ciwon zuciya, ƙwanƙwasa, hepatitis, aikin hanta mai rauni,
• tsarin musculoskeletal: spasms na maraƙin ƙwayar maraƙin, ciwon baya da ƙafa na ciwo, arthralgia, arthritis, jin zafi a kafada, gwiwa, fibromyalgia,
• fata: erythema, bushe fata, ecchymosis, daukar hoto, alopecia, ƙara sweating,
• halayen rashin lafiyan: fatar fata, itching, urticaria, angioedema (gami da edey na maƙogwaron, harshe),
• bashinpoiesis: thrombocytopenia, eosinophilia, tsarkakakke na Schoenlein - Genoch, dan kadan raguwar haemoglobin da bashin jini,
• tsarin juyayi: ciwon kai, farin ciki, rashin bacci, damuwa, damuwa, bacci, damuwa, bacci, rashin damuwa, damuwa, damuwa, damuwa, damuwa, damuwa, damuwa, bacci, damuwa, bacci, damuwa, damuwa, bacci, damuwa, bacci, damuwa.
• tsarin numfashi: tari, cututtukan hanji, mashako, hanci, ambaliya, ciwon hanji na sama,
• tsarin halittar jini: urinary fili cututtuka, peremptory urination, naƙasa aikin na renal, rage libido, rashin ƙarfi,
• sauran: asma, zafin kirji, gajiya, gurguwar waje, wuce gona da iri kan al'amuran gout,
• sigogi na dakin gwaje-gwaje: hyperuricemia, karuwa a cikin maida hankali ne urea, saura saura da creatinine a cikin jini, karuwa a cikin ayyukan hepatic transaminases (matsakaici), hyperbilirubinemia.

Umarni na musamman

Ee, lokacin da kuka fara shan Presartan, yakamata ku gyara fitsarin da ya haifar, alal misali, ta hanyar daukar diuretics a allurai, idan babu damar daidaita BCC, magani ya kamata ya fara da karancin maganin.

Magunguna waɗanda ke shafar RAAS (tsarin renin-angiotensin-aldosterone) sun sami damar haɓakar urea a cikin jini da serum creatinine a cikin marasa lafiya da keɓaɓɓiyar ƙwayar ƙwayar koda na jijiya ko ƙwarƙwarar ƙwayar koda.

Tasiri a kan ikon tuka motoci da abubuwa masu rikitarwa

Ba a gudanar da bincike na musamman kan tasirin Presartan kan iya tuka motoci da sauran hanyoyin da ake fama da su ba. Koyaya, yakamata ayi la'akari da haɓaka sakamako masu illa, irin su nutsuwa da farin ciki, suna buƙatar karɓar taka tsantsan yayin yin ayyukan haɗari.

Hulɗa da ƙwayoyi

• potassium-spure diuretics, shirye-shiryen potassium: hadarin haɓakar hyperkalemia,
• diuretics: haɗarin raguwar hauhawar haɓakar haɓakar jini,
• beta-blockers da tausayawa: haɓaka tasirin su,
• rifampicin, flucanazole: rage taro na aiki metabolite na losartan a cikin jini,
• lithium: haɓaka cikin haɗuwa cikin jini yana yiwuwa,
• NSAIDs: ana rage tasirin magungunan,
• sauran magungunan antihypertensive: haɓaka haɗakar juna na inganta.

Misalai na Prezartan su ne Brozaar, Blocktran, Vazotens, Zisakar, Kozaar, Lozap, Cardomin-Sanovel, Losartan, Renicard, Lakea, Vero-Lozartan, Lorista.

Yadda ake amfani: sashi da hanya na jiyya

Ana ɗaukar allunan Presartan N ta baki, ba tare da la'akari da cin abinci ba.

Matsayi na farko da tabbatarwa shine 1 kwamfutar hannu 12.5 mg + 50 mg 1 lokaci a rana. Ana samun tasirin antihypertensive matsakaici a cikin makonni uku na ilmin likita. Don cimma sakamako mafi ma'ana, yana yiwuwa a ƙara yawan maganin a cikin allunan 2 a allurai na 12.5 MG + 50 MG sau ɗaya a rana. Matsakaicin adadin yau da kullun shine allunan 2 na Presartan N.

A cikin marasa lafiya tare da rage yawan ƙwayar jini (alal misali, yayin ɗaukar manyan magungunan diuretics), shawarar da aka fara amfani da ita na losartan a cikin marasa lafiya tare da hypovolemia shine 25 mg sau ɗaya a rana. Dangane da wannan, magani tare da Presartan N dole ne a fara shi bayan shafe abubuwan hana haihuwa da kuma gyaran hypovolemia.

A cikin tsofaffi marasa lafiya da marasa lafiya tare da gazawar na yara, ciki har da waɗanda ke kan dialysis, ba a buƙatar daidaita sigar farko.

Rage haɗarin cututtukan zuciya da mace-mace a cikin marasa lafiya da hauhawar jini da jijiyoyin jini na hagu

Ainihin matakin farko na losartan shine 50 MG 1 lokaci ɗaya kowace rana. Marasa lafiya waɗanda suka kasa cimma ƙarfin jini yayin shan losartan 50 mg / rana suna buƙatar magani tare da haɗuwa da losartan tare da ƙananan allurai na hydrochlorothiazide (12.5 mg), kuma idan ya cancanta, ƙara yawan losartan zuwa 100 MG a hade tare da hydrochlorothiazide a kashi na 12.5 mg / rana, a nan gaba - haɓaka zuwa Allunan 2 na miyagun ƙwayoyi a kashi 50 / 12.5 a cikin duka (100 MG na losartan da 25 MG na hydrochlorothiazide kowace rana sau ɗaya).

Aikin magunguna

Presartan H ya ƙunshi haɗuwa na losartan da hydrochlorothiazide, dukkanin abubuwan biyu suna da tasirin antihypertensive mai ƙarfi, rage karfin jini (BP) zuwa mafi girma fiye da kowane kayan haɗin daban.

Losartan takamaiman mai karɓar angiotensin II mai karɓar antagonist (ƙananan nau'ikan AT1) don gudanarwa na baka. Losartan da magungunan ƙwayar cuta ta aiki (E 3174) duka a cikin in vitro kuma a cikin vivo sun toshe duk sakamakon ilimin halittar jiki na angiotensin II, ba tare da la'akari da tushen ko hanyar aikin ba. Losartan zaɓi yana ɗaure wa masu karɓa na AT1 kuma ba ya ɗaure ko toshe masu karɓar wasu kwayoyin hormones da tashoshin ion, waɗanda ke taka muhimmiyar rawa a cikin tunanin aikin tsarin jijiyoyin jini. Bugu da kari, losartan baya hana sinadarin angiotensin-mai canza ruwa (ACE) - kininase II, kuma, gwargwadon hakan, baya hana lalacewar bradykinin, sabili da haka sakamako masu illa na kai tsaye suna da alaƙa da bradykinin (alal misali, angioedema) ba kasafai ake samu ba.

Lokacin amfani da losartan, rashi rinjayar mummunan ra'ayi akan renin ɓoye yana haifar da karuwa a cikin aikin renin plasma. Ara yawan aikin renin yana haifar da ƙaruwa a cikin angiotensin II a cikin jini. Koyaya, aikin antihypertensive da raguwa a cikin taro na aldosterone a cikin jini na jini ya ci gaba, wanda ke nuna ingantaccen shinge na masu karɓar angiotensin II. Losartan da metabolite mai aiki suna da kusanci sosai don masu karɓar angiotensin Ina karɓar angiotensin P. Masu amfani da metabolite mai aiki sau 1040 ne fiye da losartan.

Bayan gudanar da maganin baka guda ɗaya, tasirin antihypertensive (raguwa a cikin systolic da daskarar jini na jini) ya kai matsakaici bayan sa'o'i 6, sannan a hankali ya ragu a cikin sa'o'i 24. Matsakaicin tasirin antihypertensive yana haɓaka makonni 3-6 bayan farawar miyagun ƙwayoyi.

Hydrochlorothiazide - mai diuretic thiazide, yana rushe sake farfadowa daga sodium, chlorine, potassium, ion magnesium a cikin distal nephron, yana jinkirta fitowar alli, uric acid. Increaseara yawan haɓakar haɓakar waɗannan ion yana hade da haɓaka da adadin fitsari (saboda ruwa na osmotic). Yana rage ƙwayar jini na jini, yana ƙara yawan ƙwayar renin plasma da ɓoyewar aldosterone. Lokacin da aka ɗauka da babban allurai, hydrochlorothiazide yana ƙara haɓakar bicarbonates, yayin da amfani na lokaci mai tsawo yana rage haɗarin alli.

Tasirin antihypertensive yana haɓakawa saboda raguwar ƙwayar jini (BCC), canje-canje a cikin sake kunnawar bango na jijiyoyin bugun jini, raguwa a cikin tasirin tasirin vasoconstrictor amines (adrenaline, norepinephrine) da haɓaka sakamako mai banƙyama a cikin ganglia. Ba ya shafar matsin lamba na jini. Ana lura da sakamako na diuretic bayan sa'o'i 1-2, ya kai matsakaici bayan sa'o'i 4 kuma yana ɗaukar awanni 6-12. Tasirin antihypertensive yana faruwa a cikin kwanaki 3-4, amma ana buƙatar makonni 3-4 don cimma sakamako mafi kyau na warkewa.

Tambayoyi, amsoshi, sake dubawa kan magunguna Presartan N

Bayanin da aka bayar an yi shi ne don ƙwararrun likitoci da magunguna. Cikakken bayani game da magani yana kunshe ne a cikin umarnin da aka haɗe zuwa marufin da mai masana'anta. Babu wani bayani da aka sanya akan wannan ko wani shafin yanar gizon mu wanda zai iya canza matsayin roko na musamman ga kwararrun.

Sanarwa da aka saki, marufi da abun da ke ciki Presartan N

Allunan, masu launin rawaya mai hoto, sune biconvex mai kyau, a cikin ɓangaren giciye: ainihin shine daga fari zuwa kusan fari.

Fitowa: lactose monohydrate 111.50 mg, microcrystalline cellulose 58 MG, pregelatinized sitaci 3 mg, sitaci masara 12 mg, colloidal silicon dioxide 1 mg, magnesium stearate 2 mg.

Harsashi abun da ke ciki:
hypromellose 2.441 g, titanium dioxide 0.60 MG, talc 1.50 mg, macrogol-6000 0.40 mg, narkewar launin ruwan kwaro 0.058 mg.

Guda 14. - fakiti mai bakin ciki (2) - fakitoci na kwali.

Sashi da gudanarwa

Tare da hauhawar jini na jijiya, kashi na farko na yau da kullun shine 25 MG, matsakaita na yau da kullun shine 50 MG, yawan gudanarwa shine lokaci 1 / rana.

Matsakaicin sakamako mai lalacewa yana tasowa makonni 3-6 bayan fara maganin. Idan ya cancanta, ana iya ƙaruwa da adadin ƙwayar zuwa 1 00 MG kowace rana. A wannan yanayin, yana yiwuwa a sha miyagun ƙwayoyi sau 2 a rana.

Matsayi na farko ga marasa lafiya da raunin zuciya shine 12.5 MG 1 lokaci / rana. Yawanci, ana ba da lambar gwargwado a lokutan mako (i.e. 12.5 mg / rana, 25 mg / rana. 50 mg / day) zuwa matsakaiciyar kiyayewa na 50 mg 1 lokaci / rana, gwargwadon haƙuri da haƙuri ga miyagun ƙwayoyi.

Lokacin da aka tsara magunguna ga marasa lafiya da ke karɓar ƙwayoyin maganin diuretics masu yawa, kashi na farko ya kamata a rage zuwa 25 MG 1 lokaci / rana.

Ya kamata a ba marasa lafiya da ke fama da aikin hanta ƙananan ƙwayoyi na losartan,

A cikin marasa lafiya tsofaffi, har ma da marasa lafiya da ke fama da rauni na aikin koda, ciki har da marasa lafiya akan hemodialysis, babu buƙatar daidaita sashin farko na maganin.

Za'a iya yin amfani da Presartan tare da haɗuwa tare da sauran magungunan antihypertensive. Ana iya amfani da Losartan ba tare da la'akari da yawan abinci ba.

Side sakamako

Kullum ana iya jurewa da hawan jini. Ana iya lura da shi: zawo, dyspepsia, ciwon tsoka, kumburi, tsananin farin ciki, tashin hankali, ciwon kai, hyperkalemia (potassium a cikin jini sama da 5.5 meq / l). A cikin lokuta mafi sauƙi, za'a iya samun tari, gazawar numfashi, tachycardia, angioedema (wanda ya hada da kumburin fuska, lebe, pharynx da / ko harshe), cututtukan ciki, ƙaruwar ƙwayar cuta, hanta na hanta, bilirubin a cikin jini.

Siffofin aikace-aikace

A cikin marasa lafiya masu fama da rashin ruwa (alal misali, karbar magani tare da allurai da yawa na diuretics), hypotension na hypotension na iya faruwa a farkon jiyya tare da Presartan. Wajibi ne a gyara bushewar ruwa kafin a fara ko kuma a fara jiyya tare da karancin magani.

Bayanai na magunguna sun nuna cewa yawan losartan a cikin plasma a matakan marasa lafiya da ke fama da cutar cirrhosis yana ƙaruwa sosai, sabili da haka, marasa lafiya waɗanda ke da tarihin cutar hanta ya kamata a tsara su da ƙananan magunguna.

Wasu kwayoyi waɗanda ke shafar tsarin kipinapgiotensin na iya haɓaka urea jini da serum creatinine a cikin marasa lafiya da ke fama da rauni na aiki.

Ba a san ko losartan ya keɓance cikin madara ba. Lokacin da aka wajabta allurar lokacin shayarwa, ya kamata a yanke shawara ko dai a daina shayarwa, ko kuma a daina magani da kwayoyi.