Ta yaya kuma ya kamata in ɗauki allunan Hartil?

Hartil-D ne maganin rigakafi magani ne wanda shima yake bayarwa diuretic aiki. Abzakarwa aikin abubuwa masu amfani na miyagun ƙwayoyi sun kasance masu dacewa, yayin da shamir ragewa hypokalemic sakamakohydrochlorothiazide.

Magunguna da magunguna

Ana amfani da abubuwa masu aiki na wannan kayan aiki don hawan jini.

Ramiprilat (aiki metabolites karami) bacin rai ACE. Bugu da kari, yana rage hayaki. aldosterone. Ramipril kuma yana haifar da raguwa na gefe na jijiyoyin bugun jini.

A mafi yawan lokuta maganin rigakafi ana iya ganin aikin bayan awa 1-2. Ya ci gaba har kwana guda. Matsakaicin mafi girman tsananin mataki ana samun sa ne bayan sa'o'i 3-6. Tare da tsawan magani, matsakaicin sakamako yawanci ana iya ganin bayan sati 3. Tare da tsawon lokaci na jiyya, ana kula da shi na shekaru 2.

Hydrochlorothiazide dokoki ne thiazide diuretic. Yiwuwar yanayin shi maganin rigakafi Ayyuka sun haɗa da canza daidaituwar sodium da juriya na tasoshin koda, tare da rage matakin ƙwayar extracellular, plasma, da halayen karafarirani II da basamara.

Matsakaicin sakamako ana iya ganin bayan sa'o'i 3-6 kuma yana ɗaukar tsawon sa'o'i 12. Abzakarwa Ana samun sakamako bayan kwanaki 3-4 na farji kuma yana ɗaukar mako guda bayan kammala karatun. Tare da tsawan magani, raguwa hawan jini ana samunsa ta amfani da ƙarami kaɗan fiye da tilas don diuretic sakamako. Rage hawan jini akwai kadan karuwa cikin sauri filirƙirarin dunƙuleaiki renin a cikin jini plasma kuma na jijiyoyin bugun gini na gado na koda. Lokacin amfani hydrochlorothiazide a cikin manyan sigogi, an rage ƙarancin plasma da saurin filarfafa ɗaukar hoto, yana nufin hawan jini da kuma na koda jini ya kwarara. Tare da tsawan magani a kananan allurai, yawan jini, na tsarin jijiyoyin bugun jini da yana nufin hawan jini kasance da kasa sosai a lokaci guda filirƙirarin dunƙule da dawowar girma minti daya zuwa ga alamomin da suka gabata.

Contraindications

Ba a bada shawarar wannan kayan aikin don amfani da:

• cholestasis,
• Harshen Quincke's edema a ciki tarihikazalika da gado / idiopathic,
• manyan matsaloli tare da aikin koda,
• rashin lafiya,
• firamaren farko,
• maganin hemodialysis,
• rashin haƙuri galactose,
• rashi na gado lactases ko da zazzabin cizon sauro glucose galactose,
• nono,
• ciki,
• yara
• mahimmancin abubuwa marasa kyau a cikin hanta,
• jijiyoyin jini,
• yanayi bayan kamuwa da koda,
• rashin jituwa ga abubuwan da ke cikin magani.

Tare da taka tsantsan, an wajabta Hartil-D don aortic da mitral stenosis, cututtukan cututtukan cututtukan jijiyoyin jiki, rauni mai rauni na jijiyoyin zuciya da jijiyoyin wuya, sun tarwatsa "cututtukan hanji", mummunan yanayin ventricular arrhythmias, hanawa ciwan jini guda ɗaya, biyuna asali artery stenosis, gout, hyponatremia, hawan jini, na gazawar, cirrhosis na hantam angina pectorisna kullum bugun zuciya (mataki na hudu), raguwa Bcc, ciwon sukaritsufa tsoratarwar zuciya, hyperkalemia, guda daya na jijiya fatar jiki, hypokalemia, Ciwon zuciya na Ischemic, gazawar hanta.

Side effects

Lokacin amfani da miyagun ƙwayoyi a farkon farfajiya da kuma bayan ƙara yawan magunguna, yana faɗi jijiyoyin jini. Kwayar cutar za ta iya haɗawa tsananin farin cikiwahayin gani, rauni gaba ɗaya, santsi. Bugu da kari, mutum lokuta na firgita cerebrovascular hadari da aka ruwaito, samarin, arrhythmias, infarction na zuciyapalpitations bayyanahauhawar jini, angina pectoris da rawar jiki. Yayin amfani ACE masu hanawa a jijiyoyin jini mai yiwuwa zubar da jini a cikin kwakwalwa da ischemic bugun jini.

Hakanan akwai yiwuwar halayen masu zuwa kamar haka:

• metabolism - hawan jiniƙara matakan acid hypokalemia, gout, hyperkalemia, hypomagnesemia, hawan jini, hyponatremia, bashin,
• tsarin juyayi - rashin kulawajuyayi ciwon kaigajiya, jin rauni, nutsuwa,
• gabobin hangen nesa - alaƙa, maganin cututtukan jini,
• Tsarin zuciya - raguwa mai mahimmanci hawan jini, kumburi ankles
• tsarin numfashi - bayyanar da bushe tari, mashako,
• tsarin narkewa - tashin zuciya, amai, ciwon mara, dyspepsiararrafe a cikin yankin epigastric, maƙarƙashiyadamling ci, ƙishirwa, zawo,
• fata fata - cututtukan mahaifa, daukar hoto, itching,
• tsarin urinary - proteinuria,
• Tsarin haihuwa - rage libido.

A cikin halayen da ba kasafai ba, masu yiwuwa ne:

• Tsarin wurare dabam dabam da kuma ganyayyaki - raguwa cikin abun ciki bashin da hawan jini, thrombocytopenia, eosinophilia, leukopenia, kwankwantin, agranulocytosis,hemolytic anemia (idan akwai karanci glucose-6-phosphate dehydrogenase),
• metabolism da abinci mai gina jiki - ba daidai ba ruwa-electrolyte ma'auni, na zuciya alkalosis, hypochloremiakara abun ciki triglycerides a cikin magani da kuma magani amylases, hypercholesterolemiafitina ciwon sukari mellitus,
• tsarin juyayi - damuwa, rashin daidaituwa, kamshi, paresthesia,
• gabobin hangen nesa - myopia na lokaci,
• ji gabobin - kunne a cikin kunnuwa,
• tsarin zuciya da jijiyoyin jini - rikice rikicewar ƙwayar cuta na zuciya, suma, rikicewar thromboembolic, vasculitis, thrombosistashin hankali Cutar Raynaudcututtukan jijiyoyi embolism,
• tsarin numfashi - karancin numfashi, rhinitis, maƙarƙashiyarashin lafiyan mutum ciwon huhun ciki, sinusitis, pharyngitis, karin ƙarfe, Harshen Quincke's edemahuhun ciki
• narkewa kamar gabobin - toshe hanji, busasshen bakin, dandano, sialadenitisamai, kumburi da mucous membranes, cututtukan zuciya na basur,
• hanta - haɓaka aiki bilirubin hanta enzymes, Jazzice cholestatic, cholecystitis, hepatitis, necrosis hanta
• fata fata - tsari lupus erythematosus, erythema multiforme, fitar da fuska, gefen farji, haɓaka zagi, Ciwon Lyelltashin hankali psoriasis, Stevens-Johnson ciwo, halayen rashin lafiyan halayen, alopecia, onycholysis,
• tsarin musculoskeletal da tsoka mai haɗawa - spasm tsoka, arthralgia, amosanin gabbai, myalgiarauni na tsoka inna,
• tsarin urinary - lalacewa aiki na renal, bushewar ruwa, ƙaruwar matakan nitrogen saura magani creatinine, nephrotic syndromem na gazawar, oliguria, interstitial nephritis,
• tsarin haihuwa - rashin ƙarfi,
• wasu - anaphylactic halayen.

Harshen Quincke's edema a mafi yawan lokuta yana bayyana a cikin marasa lafiya na tseren Negroid. Bugu da kari, karamin rukuni yana da angioedema fuskoki da amsammar yankuna saboda amfani ACE masu hanawa.

Tare da tasirin sakamako masu illa daga fata, kuna buƙatar tuntuɓi ƙwararre.

Ana lura da lura da likita lokacin da jaundice da haɓaka aiki enzymes hanta.

Umarnin don amfani da Hartil-D (hanya da sashi)

Magunguna an yi shi ne don amfani guda ɗaya da safe tare da isasshen adadin ruwa. Umarnin don amfani da rahoton Hartil-D ya ce cin abinci ba ya tasiri tasirinsa. Allunan ba za a iya raba su zuwa sassa ba.

Thisauki wannan kayan aikin kawai bayan likitan likita ya zaɓi sashi da tsari. A matsayinka na mai mulkin, an tsara 2.5 MG don fara hanya shamirda 12.5 MG hydrochlorothiazide. Siyarwar tabbatarwa iri daya ce ko kuma ninki biyu, babba da kowane abu mai aiki. Yawan yana ƙaruwa idan ya cancanta tare da mafi ƙarancin tazara na makonni 3. Shawarar mafi yawan sati daya a rana shine 5 MG. shamir da 25 MG hydrochlorothiazide.

Ga mutanen da ke cikin tsufa, har ma da waɗanda ke da rauni na kodan da hanta, ana zaɓan sashin kowane ɗayan daban-daban kafin canzawa zuwa hada magungunan Khartil-D. Ya kamata ya zama kadan.

Yawan abin sama da ya kamata

Lokacin amfani da wannan magani a cikin sigogin sama da na yau da kullun, masu zuwa zasu yiwu: riƙewar urinary, raguwa mai mahimmanci hawan jinikatsewa arrhythmia, yanayin rawar jiki, tashin hankali na hanji, rashin daidaituwa na lantarki, coma, paresis, bradycardia, na gazawar.

Ana ɗaukar tsarin kulawa ne akayi daban-daban. Kamar yadda aka yi amfani da janar, za a iya yin amfani da maganin kashe kumburi, sodium sulfate da gawayi da keɓaɓɓu. Bugu da kari, ana amfani da warkarwa mai tallafawa.

Ramipril cire daga jiki ta dialysis.

Tare da raguwa mai mahimmanci hawan jini ruwa mai narkewa ana mayar da su ta hanyar kimiyyar lissafi. Idan wannan bai haifar da sakamakon da ake so ba, gudanar da jiyya na iya yiwuwa. karafarirani II, catecholamines. Yana da matukar muhimmanci a kiyaye Bcc, KShchS, diuresis, matakin electrolytes da glucose a cikin jini. Tare da mai tsanani bradycardia an sanya na'urar bugun zuciya. A hypokalemia Ya kamata a dawo da matakan potassium na yau da kullun.

Barazanar rayuwa angioedema Wadannan matakan suna aiki:

• subcutaneous management har zuwa 0.5 MG epinephrine ko jinkirin gudanarwa na ciki adrenaline tare da sarrafawaECG da hawan jini,
• gabatarwa maganin antihistamines kwayoyi
• gudanarwar ciki ko gudanarwar cikin jijiya glucocorticoids,
• adrenaline za a iya ƙarawa C₁ mai kunnawaidan mara lafiyar yana da rashi.

Haɗa kai

Hadawa shamir da kamuwa da cuta na iya karuwa maganin rigakafi sakamako. Bugu da kari, za a iya rage raguwa mai yawa. hawan jini. Don haka yana da kyau a guji haɗuwa irin wannan.

Abzakarwa Ana iya inganta tasirin lokacin ɗauka shamir lokaci guda tare da nitrates na Organic ko vasodilators. Bugu da kari, yana raunana lokacin da aka cinye shi. NSAIDs. Wadannan kudaden zasu iya haifar da hade tare da shamir ga mai illa aiki na koda. A lokuta da wuya, an lura na gazawar. Hadarin ci gabanta yana ƙaruwa yayin ɗaukar Hartil-D tare da Allopurinol (kuma na iya bayyana leukopenia) da Sankarini. Matsayi na ƙarshe kuma Lovastatinda datakantarwa zai iya haifar da hyperkalemia. Leukopenia kuma yana haɓaka lokacin da aka haɗu da Hartil-D Procainamide, immunosuppressants da cytostatics.

Haɗa kai shamir tare da shirye-shiryen lithium yana haifar da karuwa a cikin matakan lithium, haɓakar illa mai guba yana yiwuwa. Ba a bayar da shawarar wannan haɗin ba, amma idan ba makawa, ana buƙatar saka idanu akan yanayin haƙuri. Yin maye na Lithium yana iya ƙaruwa tare dathiazide diuretics.

Ciwon jijiyoyin jini fadada ta hanyar hulda shamir tare da wasu m, maganin tari yana nufin kuma maganin tricyclic maganin alada.

Hakanan za'a kula da yanayin mai haƙuri lokacin da aka haɗa Hartil-D tausayawa. Kuma lokacin hulɗa tare hypoglycemic hakan na iya kara tasirinsu har zuwa lokacin bayyanar yawan haila. Wannan zai yiwu musamman a farkon farfajiya kuma tare da nakasa aikin aikin koda.

Hadawa dialysis tare da ACE masu hanawa contraindicated, saboda wannan na iya haifar da anaphylactoid halayen.

Hydrochlorothiazide lokacin hulɗa da Amphotericin B, GKSlaxatives Carbenoxoloneko Corticotropin na iya haifar da rashin daidaituwa na lantarki. Kuma idan aka haɗu tare da salts na kalis, bayyanar hawan jinida zuciya glycosides – buguwa ta dijital da hypokalemiatare da Sotalolom – arrhythmiatare da salicylates - increasedara tasirin cututtukan da ke tattare da su a kan ƙwayar jijiya ta tsakiya.

Damuwa hydrochlorothiazide rage-rage ta cholesterol ya sake kasancewa da Colestipol. Sabili da haka, tsakanin shigar dasu ya zama dole don yin rata na ɗaya zuwa awoyi da yawa.

Wannan sinadaran mai aiki Hartil-D shima yana haɓaka sakamako. rashin depolarizing shakatawa na tsoka.

Hakanan maganin rigakafi sakamakon cutar yana raguwa idan aka haɗu da sodium chloride.

Ra'ayoyi game da Hartil-D

Binciken Hartil-D ya nuna ingancin wannan magani. Ana iya ganin tasirin sa daga farkon hanyar. Wasu marasa lafiya, duk da haka, suna buƙatar daidaita sashi, tun da raguwar wuce kima a cikin hawan jini yana yiwuwa. Wannan shine dalilin da ya sa yakamata a yi amfani da wannan kayan aiki a ƙarƙashin kulawar ƙwararrun masani. Idan ana ɗauka daidai da shawarar likita, yana taimakawa sosai hauhawar jini.

Farashi, inda zaka siya

Kudin wannan kayan aiki a cikin Allunan na 2.5 MGshamir da kuma 12.5 MG hydrochlorothiazide - kusan 300 rubles. Farashin Allunan wanda 5 MG shamir da 25 MG hydrochlorothiazide - kusan 400 rubles.

Abun ciki da tsarin aiwatarwa

Tabletaya daga cikin kwamfutar hannu yana da a cikin kayan abu mai aikikamar yadda ramipril a cikin adadin 5 MG ko 10 MG. Biyan kuɗiabubuwan da aka gyara wuraren kiwon lafiya sune:

• sodium bicarbonate,
• makarin sodium,
• sodium kararayi fumarate,
• pregelatinized sitaci
• lactose monohydrate,
• baƙin ƙarfe baƙin ƙarfe ja,
• baƙin ƙarfe oxide rawaya.

A miyagun ƙwayoyi zai iya samun cardioprotective da angioprotective illa. Hakanan, ƙwayar na iya kunna ayyukan resorption na ƙwanƙwasa jini wanda ke jikin bangon tasoshin jini, yana lalata filayen cholesterol, ƙara adadin fibrinogen da rage aiwatar da ƙwayoyin gluing tare, wato, haɗakar platelet.

Tasirin sakamako mai kyau na ɗaukar allunan Hartil ya fara zama sananne bayan sa'o'i 1-2. Ingancin magungunan ya ci gaba na tsawon awanni 24. Abubuwan da ke cikin magungunan rigakafin ƙwayoyi ba su dogara da jinsi, nauyi da shekarun mai haƙuri da yake karɓa ba.

Kuma a cikin ƙarin daki-daki game da ramipril da kayanta na magunguna za a iya samo ta hanyar kallon bidiyo na gaba.

Fom ɗin saki

Magungunan yana cikin nau'in kwamfutar hannu. A cikin kantin magunguna zaku iya siyan kwalin kwali, wanda ya hada da alluna bakwai na ruwan hoda mai haske ko launin ruwan hoda-ruwan hoda a cikin blisters.

Allunan suna da sihiri mai faɗi, akan farfajiya zaku iya ganin zane "R3". Wannan magani ya ƙunshi 5 MG na babban abu mai aiki - ramipril.

Hakanan a cikin kantin magunguna zaka iya siyan fakitin fararen alluna bakwai na launi iri iri, amma tare da "Z44" wanda ke nuna cewa shirin ya ƙunshi 10 mg na babban sinadaran aiki.

A waɗanne lokuta ake ɗaukar allunan Hartil?

Likitoci suna ba da magani ga marasa lafiya da cututtuka kamar:

• hauhawar jini
• na kullum zuciya
• mai ciwon sukari nephropathy,
• bugun zuciya sakamakon tashin zuciya.

Likitocin zuciya sun lura cewa shan kwayoyin na rage hadarin kamuwa da bugun zuciya, ko da a cikin majinyacin da aka yiwa tiyata.

Haihuwa da lactation

Magungunan Hartil-D yana contraindicated lokacin daukar ciki, don haka ya kamata a cire gaban ciki kafin a fara shi. Idan mai haƙuri ya yi shirin yin juna biyu, ya kamata ta daina shan magungunan ACE da hydrochlorothiazide kuma ta maye gurbinsu da wasu magungunan antihypertensive. Idan ciki ya faru yayin ɗaukar miyagun ƙwayoyi Hartil-D, to ya kamata a maye gurbin shi da wuri-wuri (a kowane hali, kafin ƙarshen farkon watanni uku) tare da ƙwayar da ba ta da mai hanawa ta ACE don guje wa haɗarin lalata tayin.

Tunda ramipril da hydrochlorothiazide sun kebe cikin madara, ba a yarda da ciyar da nono yayin jiyya tare da Hartil-D ba.

Sashi da gudanarwa

Hartil-D dole ne a dauki kullun sau ɗaya a rana da safe. Ya kamata a hadiye allunan ba tare da taunawa ba kuma shan ruwa mai yawa (aƙalla rabin gilashin). Ana iya ɗaukar allunan Hartil-D ba tare da la'akari da abincin ba: ana iya ɗaukar su a kan komai a ciki, lokacin ko bayan abincin. Allunan za'a iya raba su a rabi, kuma a kakkarya cikin hadari.

Hartauki Hartil-D, tsayayye don lura da takardar sayen magani na likita. Yawan farawa na yau da kullun don manya shine 2.5 mg na ramipril da 12.5 mg na hydrochlorothiazide. Za'a iya ƙara adadin tare da tazara tsakanin aƙalla makonni 3. Yankin tabbatarwa na yau da kullum shine 2.5 MG na ramipril da 12.5 MG na hydrochlorothiazide ko 5 MG na ramipril da 25 MG na hydrochlorothiazide. Matsakaicin maganin yau da kullun shine 10 mg ramipril da 50 mg hydrochlorothiazide. Tsawon likitan yana ƙaddara tsawon lokacin da ake bi da shi.

Allura ga tsofaffi marassa lafiya da marasa lafiya da ke fama da hanta ko aikin koda galibi suna ƙasa da yadda aka saba kuma ya kamata a zaɓa daban daban ta likita, yin la'akari da yanayin aikin ƙodan da hanta.

Side sakamako

A shawarar allurai, yawanci ana amincewa da maganin. A wasu halaye, bayyanar halayen da ba a so, mai yiwuwa ne, wanda yawanci baya buƙatar dakatar da maganin. Idan kun sha wahala ko mummunan sakamako ko rashin amfani da aka ambata a cikin wannan jagorar, nemi likita ko mai harhada magunguna.

A farkon hanyar kulawa kuma bayan kara yawan kashi, raguwar wuce kima cikin karfin jini na iya faruwa - haɓaka tashin hankalibayyanar cututtuka ta hanyar damuwa kamar rauni, gaba ɗaya rauni, hangen nesa, wani lokacin tare da kasala ko asarar sani. Yiwuwar samun hauhawar jini ya fi girma a cikin marasa lafiya da ke fama da gurbataccen ruwa - ma'aunin lantarki, tare da raunin zuciya, da gazawar aikin koda. Tare da haɓakar hypotension, dole ne a mai haƙuri zuwa matsayi na kwance, idan ya cancanta, yi jiko na ciki don haɓaka ƙarar jini yana yaduwa. Lokaci na ba da magani ba rikice-rikice ba ne don tsarin magani na gaba. Tare da tsananin raɗaɗi da tsawaita jini, za a buƙaci raguwa a cikin adadin ƙwayoyi ko dakatarwar magani.

An sani cewa shan ACE inhibitors yana iya kasancewa tare da shi bushe tari, wanda ke ƙaruwa da daddare kuma a cikin matsanancin matsayi, ya fi yawa ga mata da masu shan sigari. Wannan tari koda yaushe yana tafiya ba da jimawa ba bayan katse maganin. Wani lokacin tari na iya tsayawa lokacin da aka tura mai haƙuri zuwa wani inhibitor na ACE.

Sauran sune sauran tasirin sakamako na yau da kullun da aka bayar da rahoto yayin gwaji na asibiti da kuma amfani da inhibitors na ACE, gami da ramipril a hade tare da hydrochlorothiazide.

Rashin lafiyar metabolism: babban raguwa a matakin potassium a cikin jini, a cikin mawuyacin hali mai rauni tare da rauni ko rauni na tsoka, haɓaka matakin urea da creatinine a cikin jini, gout, haɓaka matakin glucose a cikin jini, da wuya ƙara yawan matakin potassium a cikin jini.

Rashin damuwa daga tsarin juyayi: farin ciki, gajiya, ciwon kai, rauni, gajiya.

Rashin tsari daga tsarin zuciya: jijiyoyin jijiyoyin jini, rauni na gwiwa.

Rashin narkewa: tashin zuciya, ciwon ciki, raunin narkewa, huhun ciki, ƙishirwa, maƙarƙashiya, zawo, rashin ci.

Rashin lafiyar numfashi: tari, mashako, rhinitis, sinusitis.

Paarancin aiki na renal: lalacewa aiki, na ƙara matakan urea a cikin jini da jini creatinine, rashin ruwa.

Rashin ƙarfin jijiya: conjunctivitis, cututtukan jini, rashin gani na gani, tinnitus.

Gaba daya halayen jiki, halayen rashin lafiyan jiki, raunin fata: rashin lafiyan halayen, mafi sau da yawa a cikin nau'i na fata na yau da kullun, m sau da yawa - urticaria, rashes fata tare da itching, bayyanar vesicles ko flaking yankunan, kumburi fata da mucous membranes, photoensitivity, wuce kima sweating, hadin gwiwa zafi, exacerbation na psoriasis, systemic lupus erythematosus, vascitis.

Siffofin aikace-aikace

Yayin jiyya tare da Hartil-D kulawa ta yau da kullun. Baya ga cutar hawan jini, aikin koda, yawan jini da kuma sigogin biochemical ya kamata a sa ido akai-akai. Ya kamata a kawar da cin zarafin ruwa - ma'aunin electrolyte kafin shan magani.

Hartil-D na iya haifar matsanancin raguwar hauhawar jini, musamman bayan kashi na farko ko bayan shan maganin farko. Yiwuwar samun hauhawar jini ya fi girma tare da raguwa da yawaitar yaduwar jini sakamakon asarar ruwa da salma, kuma a cikin marassa lafiyar da ke fama da rauni na zuciya waɗanda ke da karfin jini ko ƙarancin jini. Tare da haɓakar hypotension, dole ne a tura mai haƙuri zuwa matsayi na kwance kuma, idan ya cancanta, jiko na ciki na saline ya zama dole don ƙara yawan ƙwayar jini. Lokaci na wucin gadi ba shine contraindication ba don tsarin magani na gaba. Tare da tsawanta da asibiti mai ƙarfi mai zurfi, yana iya zama dole don rage yawan maganin ko dakatar da magani da shi.

A cikin lamuran da ke gaba, ya kamata a kula da kulawa ta musamman lokacin amfani da miyagun ƙwayoyi Hartil-D:

- a cikin marasa lafiya tare da bushewaa cikin cututtukan gudawa da amai,
- a cikin marasa lafiya shan kamuwa da cuta,
- a cikin marasa lafiya da karuwar shakatawa kwayoyin adrenal bawo (Ciwon Conn)
- a cikin mutane ta amfani karancin abinci mai gishirishan kayan abinci masu gina jiki na gina jiki kopotassium kwayoyi
- a cikin marasa lafiya fama na kodanauyi bugun zuciya, ciwon zuciya,
- a cikin marasa lafiya tare da ciwon sukariwaɗanda suke buƙatar saka idanu a kai a kai matakin ƙwayar cutar glycemia. Yana iya zama dole a kowane ɗayan zaɓi na magunguna masu rage sukari ko canzawa daga shirye-shiryen kwamfutar hannu zuwa insulin,
- a cikin marasa lafiya tare da tsari lupus erythematosus ko psoriasis haɓaka cutar tana yiwuwa.

Yakamata a kauce masa maganin hemodialysis a kan asalin magani tare da miyagun ƙwayoyi Hartil-D. Idan dialysis yana da mahimmanci, ya kamata ku canza zuwa shan wani maganin rigakafin ƙwayar cuta wanda ba mai hanawa bane na ACE.

Wajibi ne a sanar da likita game da shan maganin Hartil-D kafin aikin tiyata da maganin ciwan jiki, haɗe tare da maganin sa barci na hanyoyin hakori.

Kulawar Hartil-D na iya haifar bushe tariwanda koyaushe yakan ɓace bayan dakatarwar magani.

Hartil-D ya ƙunshi lactose monohydrate. Wannan yakamata ayi la'akari dashi wajen lura da marasa lafiya da rashi lactase da sauran cututtukan da suka saba samu (galactosemia ko cutar glucose / galactose malabsorption syndrome).

Idan kun manta ku ɗauki Hartil-D akan lokaci, ɗauki maganin da aka rasa da wuri-wuri, sannan ka ɗauki magani kamar yadda likitanka ya umurce ka. Idan kashi na gaba ya rage awanni ko kuma lokaci yayi da za a ɗauka na gaba bayan kashi da aka rasa, kar a ɗauki kashi biyu na Hartil-D don rama adadin da aka rasa. A wannan yanayin, gabaɗaya adadin da ba'a ɗauka akan lokaci kuma ci gaba da shan magani bisa ga tsarin da aka saba.

Kada ku katse ko dakatar da ɗaukar Hartil-D akan kanku! Cutar da shigowa Hartil-D ko kashi canji yakamata a gudanar dashi kamar yadda aka tsara da kuma sanya ido likita.

Kariya da aminci

Tasiri kan rashin iya tuƙi motoci ko kayan aikin masu haɗari

Hartil-D, ya danganta da matsayin mutum game da shan miyagun ƙwayoyi, na iya samun mummunar tasiri akan iyawar yin aikin da ke buƙatar ƙara yawan kulawa. A farkon jiyya tare da Hartil-D kuma bayan an kara yawan ƙwayar cuta, ba a ba da shawarar fitar da motoci ko yin wasu aikin da ke buƙatar ƙara kulawa da saurin halayen psychomotor ba. A nan gaba, ikon aiwatar da aikin da ke sama da ƙayyadadden matakan tsaro yana gudana ne daban-daban daga likita.

Yadda za a ɗauka?

Allunan Hartil zasu iya bugu lokacin da ya dace, wannan ba lallai bane kafin abinci, bayan ko lokacin cin abincin. Ba za a iya shayar da ƙwayar ba, ya kamata ka haɗu da magungunan tare da adadin ruwan tsabta na al'ada.

Wahalar haƙuri hauhawar jini, likitan zuciya zai ba da shawarar shan 2.5 mg na miyagun ƙwayoyi sau ɗaya a rana. Idan ya cancanta, to yawan maganin da aka sha zai iya ƙaruwa a hankali. Yana da kyau a san cewa yawan adadin Hartil da aka ɗauka a rana kada su zarce 10 MG.

Wahalar haƙuri bugun zuciya a cikin tsari na kullum, likita ya ba da izinin sha allunan 1.25 MG kowace rana. Idan ya cancanta, likitan zuciya ya kara yawan maganin. Yawan adadin magungunan da suka bugu a rana shima bai kamata ya zarce 10 MG ba.

Mutumin da ya wahala bugun zuciya, an wajabta magunguna don kwanaki 2-9. Mai haƙuri ya kamata ya sha 2.5 mg na miyagun ƙwayoyi sau biyu a rana. Idan ya cancanta, likitan zuciya na iya ba da shawarar kashi biyu na Hartil.

Wadanda basu da lafiya nephropathy, dole ne ku sha 1.25 MG na miyagun ƙwayoyi kowace rana. A cikin lokuta mafi wuya tare da wannan cuta, ana daidaita sashi zuwa 5 MG kowace rana.

A matsayin rigakafin bugun zuciya ko bugun jini da bugun zuciya likita na iya ba da haƙuri ga shan Hartil a cikin adadin 2.5 MG a rana. Hakanan sashi yana iya ƙaruwa kuma sannu a hankali ya kai 10 MG.

Amfani da Hartil a cikin yara, yayin daukar ciki da lactation

An hana shan magani a lokacin haihuwar yaro da shayarwa. Hartil ya sami damar tsokanar faruwar lamarin a cikin samuwar kodan da ba a haifa ba, a rage karfin jininsa. Hakanan, ƙwayar tana da haɗari a cikin hakan na iya ba da gudummawa ga ci gaban hyperkalemia a cikin tayin, hypoplasia na kwanciyar hankali da kuma nakasar ta, hypoplasia huhun, yanayin cututtukan ƙafafun ƙafa.

Tsaro na ɗaukar Hartil da ingantaccen aikinsa ƙarƙashin shekara 18 ba a kafa shi ba. A wannan batun, ba za ku iya ɗauka ba.

Mai yiwuwa contraindications da sakamako masu illa

Bai kamata a dauki Hartil a cikin waɗannan lamuran ba:

• tarihin cutar malakka,
• rashin hankali ga abubuwan da ke kunshe a cikin magani,
• ciki a kowane lokaci
• lactation
• na asali artery,
• na farko hyperaldosteronism,
• sasantawa biyu na koda
• na gazawar
• m hemodynamics.

Bugu da kari, wannan magani na iya haifar korau halayen kwayoyin yayin da aka dauka, wanda zai iya hadawa da:

• rage karfin jini
• arrhythmia
• thrombocytopenia
• orthostatic hypotension,
• karin furotin,
• bushe tari
• rikicewar yanayi
• hargitsi a cikin tsarin wurare dabam dabam,
• ta ƙara rashin nasara na koda
• rawar jiki
• rhinorrhea
• ischemia na zuciya da kuma kwakwalwa
• rage libido
• bayyanar rauni
• nutsuwa
• juyayi rashin hankali
• tsinkaye mara kyau ta ji, kamshi, dandano da hangen nesa,
• katsewa
• karin ƙarfe
• alopecia
• rikicewar vestibular
• rage taro na haemoglobin da bashin jini,
• rhinitis, sinusitis,
• mashako
• jijiyar wuya
• hyponatremia,
• rage cin abinci
• alaƙa
• tashin zuciya, zawo, ko maƙarƙashiya
• kasawa numfashi, bushe baki,
• hemolytic anemia
• rashes, fata itching.

Saboda yawan halayen masu illa da ake samu yayin ɗaukar allunan, kuna buƙatar sha su, lura da matakan tsaro. Yana da mahimmanci a fahimci cewa yayin jiyya tare da Hartil, ana buƙatar sarrafawa ta likita. Wannan ya zama dole musamman a cikin lokaci na gaba lokacin sashi na magani yana ƙaruwa. A cikin sa'o'i takwas bayan ɗaukar Hartil a cikin ƙara yawan ƙwayar cuta, sau da yawa kuna buƙatar auna hawan jini da saka idanu kan halaye a cikin alamun.

Hakanan, ana buƙatar kulawa da likita koyaushe ta hanyar marasa lafiya tare da cututtukan na koda na jijiyoyin jiki, tabarbarewa koda, wanda ya ci gaba da juyawa koda.

Ayyuka daban-daban waɗanda ke buƙatar haɓakar maida hankali sosai ya kamata a watsar da su tsawon lokacin kulawa tare da waɗannan kwayoyin.

Yarda da Hartil tare da wasu kwayoyi da barasa

Gudanar da haɗin gwiwar Allunan tare da magunguna daban-daban mai yiwuwa ne saboda dalilai na likita. Amma yana da daraja la'akari da cewa amfani da wannan magunguna da magunguna na rukuni-rukuni irin na cytostatics da corticosteroids, yana ba da gudummawa ga bayyanar canje-canje a cikin abubuwan da ke cikin jini kuma yana iya haifar da rikice-rikice iri-iri a cikin tsarin kewaya.

Hakanan yana da matukar haɗari don haɗaka amfani da wannan magani tare da insulin da sauran magunguna don magance ciwon sukari, kamar yadda a wannan yanayin akwai raguwa mai yawa a cikin sukari na jini, wanda zai iya zama haɗari.

Likitocin zuciya sun bada shawarar a daina shan giya yayin magani tare da wadannan kwayoyin, tunda suna taimakawa wajen kara tasirin abubuwan da ke tattare da giya.

Wannan magani a cikin nau'in sakin da ya dace ana sayar dashi a kusan dukkanin kantin magunguna. Hakanan zaka iya sayan maganin a cikin kantin magani na kan layi. Lokacin sayen magani, ana buƙatar takardar sayan magani daga likita mai halartar.

Matsakaicin farashin magani yana farawa daga 370 rubles a cikin kantin magunguna a Moscow. A cikin kantin magunguna na kan layi zaka iya siyar da magani kaɗan mai rahusa - farashin magunguna yana farawa daga 297 rubles.

Magunguna iri daya da tsadar su

Ana iya danganta magungunan masu zuwa ga analog na wannan magani:

• Amprilan - daga 220 rubles,
• Pyramil - daga 202 rubles,
• Tritace - daga 996 rubles,
• Dilaprel - daga 115 rubles,
• Ramimed - daga 280 rubles.

Kafin sayen magungunan analogues na miyagun ƙwayoyi, dole ne a bincika tare da likitanka idan sun sami damar maye gurbin wannan magani gaba ɗaya ko a'a.

Hartil magani ne mai ƙarfin gaske, sabili da haka, ya zama dole a sha shi kawai tare da alƙawarin likita tare da tsayar da rubabbun magunguna. In ba haka ba, zaku iya samun haɓakar halayen masu illa.

Abun ciki da aiki

Annotation din ya fada cewa Hartil ya kasance na rukuni na masu hana ACE. Abunda yake aiki a cikin kayan shine ramipiril. Sakamakon toshe enzyme na angiotensin-mai canzawa, wakili yana da tasiri mai tasirin gaske.

Kula! Magungunan yana fara rage matsin lamba a cikin awanni 1.5-2 bayan gudanarwa. Effectwarin tasirin asibiti yana tasowa bayan 3.5-6 kuma yana ɗaukar tsawon awanni 24. Hartil yana buƙatar amfani na yau da kullun da na dogon lokaci, ba shi yiwuwa a sha Allunan daga harka harka.

Bugu da kari, ramipyril:

• yana haɓaka haɓakar juji da haɓakar ƙwayar zuciya (tare da tsawan lokaci),
• inganta hawan jini a cikin myocardium,
• Yana rage mita arrhythmias,
• normalizes da matsa lamba a cikin portal jijiya tare da Portal hauhawar jini,
• yana hana lalacewar aikin na yara a cikin masu ciwon sukari.

Alamu don amfani

Bayan mun fahimci hanyar aiwatar da miyagun ƙwayoyi, zamu tattauna abubuwan da ke nuna amfanin yin amfani da shi.

• hauhawar jini
• CHF,
• m infayction na wucin gadi, tarihin bugun jini a cikin tarihi (don rage haɗarin maimaita rikicewar jijiyoyin jini),
• nephropathy, gami da ciwon sukari.

Sakin Fom

Kamfanin masana'antar sarrafa magunguna ta kasar Hungary EGIS Pharmaceuticals PLC ne ya kera Hartil. Hanya guda ɗaya da aka kwato shine Allunan tare da sashi na 5 ko 10 MG. A cikin kunshin kwali, ban da 28 ruwan hoda mai haske ko allunan farin, akwai cikakkun umarnin umarnin amfani. Matsakaicin farashin akwatin shine 410 p. don sashi na 5 MG da 460 r na 10 MG.

Kula! Ya fi riba a sayi allunan milligram 10. Kowane ɗayansu za'a iya rarrabashi a rabi, watse cikin haɗari.

Bugu da ƙari, jeri na masana'antun ya ƙunshi magungunan haɗin gwiwa dangane da ramipiril da sauran magungunan antihypertensive:

• Hartil Amlo (AM) (ramipiril + amlodipine) 5 mg + 5 mg, 10 mg + 10 mg,
• Hartil D (ramipiril + hydrochlorothiazide) 2.5 MG + 12.5 MG, 5 MG + 25 MG.

Hanyar amfani

An dauki Hartil a baki ba tare da tauna ba, an wanke shi da ruwa (adadi mai yawa, kusan 200-250 ml) na ruwa. Kuna buƙatar shan maganin a kowace rana, kowane awa 24.

Likita ya saita sashi da tsawon lokacin jiyya daban daban ga kowane mara lafiya. Ana ba da daidaitattun shawarwari a cikin tebur da ke ƙasa.

Tebur 1: Shawarwarin daidaitaka don zaɓin Sashin Hartil:

Mahimmanci! Ana buƙatar kulawa ta musamman don zaɓar sashi na Hartil don tsofaffi marasa lafiya waɗanda ke shan maganin ciwon kai da wahala daga cututtukan haɗin gwiwa (gazawar zuciya, rashin aiki na gabobin somatic).

Jiyya na hauhawar jini a cikin masu ciwon sukari

Shin Hartil ya dace da maganin hauhawar jini a cikin tsofaffi marasa lafiya da ke fama da ciwon sukari na 2?

Sannu Gaba ɗaya, Ee: miyagun ƙwayoyi suna da tasirin gaske akan hanyar macroangiopathy na ciwon sukari da nephropathy. Koyaya, ga kowane mai haƙuri, yakamata a zaɓi magani mai ƙwarin gwiwa daban-daban.

Kari akan haka, yin amfani da Hartil tare da raguwar cututtukan cututtukan cututtukan jini suna haifar da raguwa sosai a matakan glucose na jini. Sabili da haka, wani lokacin, a kan asalin maganin magani, yana da mahimmanci don daidaita sashin insulin.

Pharmacokinetics na miyagun ƙwayoyi.

Ramipril
Damuwa
Bayan gudanar da baki, ramipril yana sha da sauri. Yin hukunci da aikin rediyo da aka gano a cikin fitsari bayan da aka sa masa alama ta ramipril (excretion da kodan yana daya daga cikin hanyoyi da yawa), aƙalla 56% na maganin yana shan. Cin abinci lokaci guda baya shafar sha.
Ramipril wani prodrug ne, yana yin aiki da metabolism yayin "sashin farko" ta hanyar hanta, sakamakon abin da kawai raminprilat mai aiki ne wanda aka kafa (saboda hydrolysis, galibi a hanta). Bugu da ƙari ga zama mai aiki na ƙwayar ramiprilat, ramipril conjugates tare da glucuronic acid kuma ya juya zuwa cikin ester diketopiperazine na ramipril. Hakanan ana amfani da Ramiprilat tare da glucuronic acid kuma an canza shi zuwa diketopiperazine-ramiprilat (acid). Sakamakon kunnawa / metabolism na ramipril, bioavailability bayan kulawar baka shine kusan 20%.
Cmax na ramipril a cikin plasma an kai shi cikin awa 1 bayan gudanarwar baka. Cmax na ramiprilat a cikin plasma an kai shi a cikin sa'o'i 2-4 bayan fitowar ramipril.
Rarraba
Doka ga ƙwayoyin plasma don ramipril da ramiprilat kusan 73% da 56%, bi da bi.
A cikin binciken gwaji, an gano cewa ramipril an cire shi a cikin madara.
Kiwo
T1 / 2 na ramipril shine kimanin awa 1. Rage yawan haɗarin ramiprilat a cikin ƙwayar jini shine multiphase a cikin yanayi. Rarrabawar farko da kawarwa ana nuna shi ta hanyar T1 / 2 daidai da kusan awanni 3. Sannan lokacin tsaka-tsaki (T1 / 2 kimanin sa'o'i 15) da kuma lokacin ƙarshe, lokacin da ramiprilat maida hankali a cikin jini yana da ƙasa sosai (T1 / 2 - kwanaki 4-5), bi. ) Wannan matakin na ƙarshe yana faruwa ne saboda jinkirin rarrabuwar ramiprilat daga ƙaƙƙarfan amma babban hadaddun tsarin ACE. Duk da tsawon lokacin kawarwa, ana samun Css of ramipril a cikin kwanaki 4 tare da cin abincin yau da kullum na 2.5 MG ko fiye na ramipril. Ingantaccen T1 / 2 (sigogi masu alaƙa da zaɓin kashi) shine 13-17 awanni bayan shan allurai da yawa.
Bayan sarrafawar giyar 10 mg na ramipril mai alama, kusan 40% na aikin rediyo yana fallasa ta cikin hanjin kuma kashi 60% na kodan. A cikin sa'o'i 24 bayan shigar 5 mg na ramipril ta marasa lafiya tare da catheter wanda ke nuna sakamakon bile, daidai ƙarancin hutu na ramipril da metabolites ta ta kodan da bile aka samo. Kimanin kashi 80-90% na metabolites da ke tattare da kodan da bile suka wakilta ta ramiprilat da kwayoyi don kara karfin sa. Glucuronide da diketopiperazine wanda aka samo daga ramipril sunyi lissafin kusan 10-20%, kuma ramipril wanda ba a iya jurewa ba sun lissafa kimanin 2% na jimlar ramipril.

Sashi da hanyar gudanar da magani.

Allunan yakamata a sha 1 lokaci / rana kowace rana da safe, shan ruwa mai yawa. Ana iya ɗaukar magani ba tare da la'akari da abincin ba. Allunan ba a yi nufin su kasu kashi biyu ba.
Ga manya, an bada shawarar amfani da maganin Hartil-D bayan an zaɓi zaɓin kowane ɗayan abubuwan. Za'a iya ƙara adadin tare da tazara tsakanin aƙalla makonni 3. Matsayi na yau da kullun shine 2.5 MG na ramipril da 12.5 MG na hydrochlorothiazide. Yankin tabbatarwa na yau da kullun shine 2.5 mg na ramipril da 12.5 mg na hydrochlorothiazide ko 5 MG na ramipril da 25 MG na hydrochlorothiazide. Mafi girman shawarar yau da kullun shine 5 MG na ramipril da 25 MG na hydrochlorothiazide.
Don tsofaffi marasa lafiya da marasa lafiya tare da CC daga 30 zuwa 60 ml / min, dole ne a zaɓi kowane sigogin kowane ɗayan abubuwan da aka haɗa (ramipril da hydrochlorothiazide) kafin canzawa zuwa hada magungunan Hartil-D.
Yawan maganin Hartil-D ya kamata ya zama gwargwadon iko. Mafi girman shawarar yau da kullun shine 5 MG na ramipril da 25 MG na hydrochlorothiazide.
Hartil-D yana cikin ƙwaƙƙwaran ƙwayoyi a cikin marasa lafiya da ke fama da rauni na aikin haya (CC ƙasa da 30 ml / min / 1.73 m2).
Kafin canzawa zuwa Hartil-D, marasa lafiya da ke da rauni ko matsakaita masu rauni na aikin hanji ya kamata a basu kashi na ramipril.
Ba a ba shi damar ɗaukar ƙwayar Hartil-D a cikin marasa lafiya da mummunan rauni na aikin hanta da / ko cholestasis.
Ba'a ba da shawarar Hartil-D ga yara da matasa (a ƙarƙashin shekara 18) saboda ƙarancin aminci da ingantaccen bayanan ƙungiyar wannan shekarun.