"Fosinopril": yokusetshenziswa. "Fosinopril": izinkomba ukusetshenziswa, nozakwabo yangempela

"Fosinopril" kuyinto inhibitor ka angiotensin ukuguqulela enzyme. Umuthi uye isinyathelo hypotensive, ingasetshenziswa i-high blood pressure, wedwa futhi therapy eziyinkimbinkimbi. Ngaphezu kwalokho, i-nomuthi uzabalaza natriuretic, vasodilating futhi isenzo cardioprotective, isetshenziswa lihambisana namanye izidakamizwa ngesikhathi ukwelashwa ephethwe yisifo senhliziyo.

izakhiwo kwemithi "fosinopril"

Ukulungiselela "Fosinopril" emzimbeni kuthatha isimo metabolite asebenzayo ukuthi ezicindezelayo nomthelela angiotensin ukuguqulela enzyme. Umuthi kunciphisa izinga kumiswa angiotensin 2, normalizes le letindzala blood pressure, nethonya elihle imithambo yegazi.

Angiotensin ukuguqulela enzyme umsebenzi usebenzisa 10, 20 no-40 mg isidakamizwa kakhulu encishisiwe ngokwesilinganiso amahora 7 (akukho ngokushesha kunokuba 2 amahora, kodwa amahora kungakadluli 12 ngemuva kokuthatha imithi). Emini ke kuyehla 7-15%.

"Fosinopril" Tablets avumele ukuba ngakususi hypertrophy esivimba amanzi futhi Ukuvuleka komlomo i-ventricle engakwesobunxele, ebukhoneni izimo ezinjalo neqhaza ziqedwe yabo. Umuthi kuvimbela ukwakheka aldosterone owenziwa e nezindlala adrenal, kwandisa umsebenzi uhlelo kallikrein-kinin, usimamise okuqukethwe bradykinin ezicutshini futhi igazi. ukwelashwa Ngenxa esekelwe ukusetshenziswa "fosinopril" inyuka liberatiou izinto okuyinto ngcono igazi eligciniwe ezinsweni, babe natriuretic, isenzo vasorelaxant. I nomuthi kunciphisa ukukhiqizwa vasopressin arginine futhi endothelin-1, okuyinto isenzo vasoconstrictor.

Ngokunciphisa ingcindezi (diastolic, systole) musa ukuthuthukisa, kanye postural orthostatic tachycardia ukuphendula ayishintshi BCC. Azikho izinguquko umsebenzi reflex we myocardium, kwezinso futhi cerebral ukugeleza kwegazi. Sekube kungekho ukuphulwa supply igazi isikhumba, izitho zangaphakathi lwamathambo kwemisipha izicubu.

Njengoba bhukwana imfundo, "Fosinopril" lisetshenziswe umthamo owodwa, has a action hypotensive okuyinto iningi liphinyiselwe ngemva amahora angaba mahlanu. Umthelela okuholela lugcinwa ngosuku, okuyinto ikuvumela ukuba ugcine evamile blood pressure nemingcele. Ukuze sibonise umphumela esiphezulu kungenzeka iyadingeka Sekudlule amasonto ambalwa.

Phakathi ukwelashwa "fosinopril" umfutho wegazi ophakeme angathuthukisa ukusabela komzimba kuya ukwehla ngokushesha letindzala blood pressure. Lapho ukwelashwa kuhlangene thiazides futhi "Fosinopril" izindlela livela umsebenzi evelele antihypertensive. Uma kudingeka, ukukhansela "fosinopril" akazange ukuthuthukisa lesi sifo, akusiyo ngisho esimweni lapho ukwesula senziwa kakhulu. Ukulungiselela ngcono nesineke lapho kanzima egeleza ifomu inhliziyo ezingamahlalakhona ukwehluleka, kanye ukusabela komzimba ukuze ukucindezeleka ngokomzimba.

Ngokuphathelene ngesibonakaliso izakhiwo mutagenic futhi genotoxic esikhathini ukwelashwa "Fosinopril" imithi Umhlahlandlela ubonisa ukungabikho yabo. Nokho, ukusetshenziswa ngemithamo cytotoxic kuholela ezinye iziyaluyalu elihlobene ne chromosomal aberrations. Izifundo yayiqhutshelwa amagundane kanye amagundane wabonisa ukuthi umthamo wansuku zonke esingeqile 400 mg / kg akakubangeli izimpawu of carcinogenicity. Ngenxa ngemithamo ephakeme e amagundane angamaduna ukugxusha lipomas wavela kaningi. Ukweqiwa Daily zomuthi-60 mg / kg amagundane akuzange kumenze iziyaluyalu elihlobene ne ukuqaliswa umsebenzi zokuzala. Lapho iqondiswa nomuthi amagundane abakhulelwe (nsuku zonke ulapha kuze kufinyelele 400 mg / kg ngelilanga) kanye onogwaja (nsuku zonke umthamo 40 mg / kg) iphutha ukudakwa, izidakamizwa zibulale Yiqiniso yokukhulelwa.

Ukuncela kusho "Fosinopril" Umsebenzisi Isicelo kwachazwa ngokuthi kancane, ngenxa ekunqabeni ukudla okwengeziwe. Ngenxa lokuqala pass umzimba bioavailability kancane (36%). "Fosinopril" hydrolyzed, le nqubo kwenzeka egazini, isibindi kanye igobolondo emathunjini ngenxa nokuqaliswa kwalo fozinoprilat kwakhiwa, okuyinto kuyinto metabolite asebenzayo. Izinga esiphezulu imithi emzimbeni itholakala amahora amathathu emva uhlelo lwayo lokusebenza. Isigamu-ukuphila kwenzeka amahora 12-15. Ukuxhumana ne-plasma sekuyaphela - kuze kufinyelele 98%, ivolumu yokusabalalisa incane.

Imithi akwephuli imikhawulo esinomhlapho futhi gazi ebuchosheni izithiyo, isikhathi sokwelashwa elikhona obisini lwebele. Ngo isifo sokusha (oludakayo, biliary) kwehle imvume, hydrolysis okuphuma kancane. Ngo esingamahlalakhona kwezinso kwenzeka ukuphazamiseka diatsidnyh metabolites asebenzayo excretion, izidakamizwa angase buthelela emzimbeni. Ukusetshenziswa zelashwe ukususa izidakamizwa kusukela umzimba "Fosinopril" imfundo manual ekhombisa njengoba isenzo okungadingi nemiphumela ebesiyilindele.

Izinkomba "Fosinopril" ukulungiselela

"Fosinopril" okunqunyiwe ngokwehluleka senhliziyo nomfutho wegazi ophezulu. Esimweni sokuqala, umuthi luyisisekelo yokwelapha ezengeziwe, in the eziyinkimbinkimbi yesibili isetshenziselwa yokwelapha kanye monotherapy.

Ukwelashwa nge "Fosinopril"

Ngokuvamile, amaphilisi ephuza elilodwa noma amabili izikhathi ngosuku ngesikhathi esifanayo. Ekwelapheni nomfutho wegazi ophezulu Kunconywa lokuqala 10 mg zomuthi, futhi kamuva - 20-40 mg. In the ukwelashwa kuhlangene, ngaphandle uma "fosinopril" lisetshenziswa isisu, ukuthatha 10 mg izidakamizwa. Kulokhu, ukuqapha okuqhubekayo wegazi, esiphezulu umthamo okungenzeka umuthi 80 mg ngosuku. Uma izidakamizwa, omunye umthamo akusho kabili seqiwe. Ukwelashwa ngemithamo kusetshenziswa amathuluzi ezinconywe udokotela awukwazi ukuthatha imali ezinkulu noma ezincane zomuthi futhi ukwandisa imvamisa yayo ukusetshenziswa, futhi ongenza ukwesula "fosinopril" ngaphandle kokukhuluma nodokotela.

Ngaphambi kokuthatha imithi "Fosinopril" manual Kuyanconywa ukuthi ukuhlola degree of ukwanda wegazi. Ekumisweni ukwelashwa uyakucabangela izimo zokwelapha ezahlukene, udokotela kufanele ukuqapha njalo ngezimo zesiguli.

Ukuze unciphise ingozi ukuthuthukiswa nomfutho wegazi ophezulu yesibili, umthamo encane Kunconywa ngesikhathi sokulala. ukuphathwa Antihypertensive khansela izinsuku eziyisikhombisa ngaphambi Ukuqalwa okwelashwa, "fosinopril". Uma uke kwenziwa yokwelapha isisu ukunciphisa ingozi hypotension lingaze, elungisa ibhalansi uketshezi electrolyte, isisu kakhulu ukunciphisa umthamo, kwezinye izimo, uyeka ukuphuza umuthi ngokuphelele (izinsuku 4-7 ngaphambi komthamo wokuqala "fosinopril").

Ngemva esivimba amanzi therapy infarction kusho "Fosinopril" imfundo on isicelo ikuvumela ukuba uqale ngemva kwezinsuku ezintathu. Phakathi ukwelashwa kudinga nesilinganiso njalo of wegazi kanye isheke amaphethini igazi neuropathy (ihlolwe ngaphambi kokwelashwa, zokulawula ngaphakathi izinyanga 3-6 yokwelapha ku yokuqinisekisa ikusasa wenziwa minyaka yonke, ukuqapha njalo kungase kudingeke lapho awokuthi okuvela neutropenia). Ngaphezu kwalokho, kubalulekile ukulawula isisindo somzimba, hlola isimo izinso kanye namazinga creatinine, potassium yokwakheka plasma amaprotheni, igazi urea nitrogen. Phakathi ukwelashwa udinga ukulandela ukudla.

Iziguli nomfutho wegazi ophezulu kabani abulalayo has imithi uhlamvu umthamo ukwanda kancane kancane (njalo ebusuku), ucabangela izinguquko wegazi, kuyilapho umphumela uzobe laba likhulu.

Izimo ethola "Fosinopril" izidakamizwa

Lapho ukwabela amaphilisi "Fosinopril" izinkomba ukusetshenziswa ezibhekwa kanyekanye ne Izimo. Umuthi alisetshenziswa uma hypersensitivity kuya izingxenye zalo kanye nezinye izidakamizwa ezifanayo. Imithi engamiswanga iziguli abaneminyaka engu esingaphansi 18 ubudala kanye nabesifazane abakhulelwe, ibele abesifazane. Contraindication is kakhulu ogeleza ukwehluleka kwezinso. Izimo zihlanganisa angioedema (idiopathic, lezinceku) njengoba abakhona ngesikhathi ukuqokwa izidakamizwa, kanye nalabo abanomlando uzwakalise hyperkalemia, hypotension.

sokukhulelwa

Tablets "Fosinopril" imfundo manual sivimbela ukusetshenziswa ngesikhathi sokukhulelwa, ngoba izidakamizwa yalolu hlobo kungaholela ekuphazamisekeni kwemikhuba zentuthuko kanye nokufa fetus.

Uma ekhulelwe kwesikhathi ukuqaliswa yokwelapha kudinga ukuqedwa okusheshayo zomuthi. Ezimweni ezinjalo, ocwaningweni ultrasound ukuhlonza umonakalo ezingenzeka embungwini.

Usana enomama welashelwa ngesikhathi sokukhulelwa "fosinopril", kungatholakala hyperkalemia, hypotension, oliguria. Uma athuthukile oliguria, kubalulekile basekelwe perfusion kwezinso nomfutho wegazi bahlolwe njalo. Uma izinso imisebenzi futhi ukuze kulesetayelekile blood pressure mogzhet kwenziwe ukumpontshelwa noma isebenzisa umshini wezinso.

Ukulinganiselwa ukuba ukusetshenziswa "Fosinopril" ukulungiselela

Ngezinye kokuqhubeka izifo sokuhlasela kwamasosha omzimba neze kufanele acabangele ratio izinzuzo nezingozi ezingase zibe khona ezibangelwa ukwelashwa kusho "Fosinopril". Yokusetshenziswa, izimpendulo kubonise isidingo sokucabangela izingozi nezinzuzo kulezi zimo ezilandelayo:

• yenhliziyo isifo Umthambo;
• khona isiguli utshalwe izinso;
• sifo;
• sikashukela;
• umlando angioedema;
• amafomu njalo obstructive wamaphaphu nesifo;
• hyperkalemia onenkomba mkhulu kunezinhliziyo 5.5 mmol / l;
• ebulala;
• isifo sokusha;
• izinguquko obstructive, ephelezelwa kahle igazi outflow ngokusuka enhliziyweni (stenosis yomthambo i-aorta, mitral);
• ukuhluleka kwenhliziyo okukhulu;
• Ukudla, ukuhlinzeka engayitholi elilinganiselwe angaphezulu aqukethe usawoti ongaba noma inani lemali elincane sodium e ukudla yokuqothulwa;
• hyponatremia;
• leukopenia, thrombocytopenia;
• ezinye izinqubo (dialysis, izinzwa) ukusebenza;
• isifo sokuqina kwemithambo yegazi, esithinta nasemilenzeni aphansi;
• amanzi emzimbeni;
• kwezinso ukwehluleka creatinine ngenhla 300 pmol / L;
• sokuguga;
• ukusha kwesibindi kohlobo;
• izinkinga zobuchopho futhi yenhliziyo ukugeleza kwegazi;
• stenosis;
• izimo lapho lehla BCC.

Imiphumela engemihle evela "Fosinopril" izidakamizwa

Iyatholakala kuze nomuthi "Fosinopril" ukubuyekezwa kanye Umhlahlandlela kubonise amathuba wokuthuthukisa side effects ezithile. Kungenzeka ku iziyaluyalu hematopoiesis uhlelo kanye uhlelo senhliziyo nemithambo yegazi. izinguquko ezingenzeka isimiso sezinzwa, isimiso sokugaya ukudla bungene, ukuthuthukiswa izinzwa tekusebenta. Ezinye iziguli kwakufanele izinguquko imingcele laboratory kanye izigameko ezingezinhle ezavela, kube yikwembulwa isikhumba abathintekayo, uhlelo zemisipha. Kungenzeka yokuphazamiseka umgudu wokuphefumula futhi urogenital. Phakathi kwezinye ukusabela komzimba enqabayo - hyperhidrosis, ukuncipha emzibeni, ukuhlanza, imfiva, edema angioneurotic, ukuthuthukiswa umzimba izinqubo ezithathelwanayo noma izinqubo ukuvuvukala kule lymph node, lymphadenopathy, eziya ziba zimbi ka sifo. Izinkinga phakathi ukwelashwa kufanele kubikwe kudokotela wakho. nengozi izigigaba ezingezinhle elihlobene ne-ukusebenzisa kabi izidakamizwa.

Overdose "Fosinopril" izidakamizwa

Ngo ukwelashwa izidakamizwa, "Fosinopril" izimpendulo ukhombise okungenzeka khona ngokweqile ngenxa yokudlula umthamo watusa. Overdose kuhambisana ukubonakaliswa okukhulu hypotension, ukwehluleka kwezinso, stupor, ukushaqeka, bradycardia, ukuphazamiseka kwamanzi kanye electrolyte ibhalansi.

Khiqiza ukuncipha umthamo noma ukuqedwa a nomuthi wageza isisu ukunikeza isiguli ukuthi uphuze sorbent. Kusemqoka ukuthi abantu bathathe evundlile, kubalulekile ukwenza amagadango okuhloswe ngazo okwandisa BCC. Lo mbono uphinde udinge ukwelashwa lingaze. Hemodialysis kulokhu akukwenzi umphumela oyifunayo.

Izidakamizwa ukuxhumana "Fosinopril" ukulungiselela

Amathuba okuvela hyperkalemia eliphakeme uma usebenzisa izidakamizwa, okuyinto yakhiwa potassium usawoti esikhundleni, cyclosporine ukuze lezi zinsiza zisebenze ne-potassium, isisu potassium-ungahawukelanga.

Umthelela izidakamizwa kuba eshiwo ngokucacile ngaphezulu ukusetshenziswa kwezinye izindlela, kunomphumela hypotensive, kanye notshwala. A nomphumela buthaka kunokulindelekile likhona ngenxa ukusetshenziswa izinto kusebenze uhlelo renin-angiotensin-aldosterone, i-estrogen, ama-NSAID futhi sympathomimetics. Ezimweni ezinjalo kubalulekile bayenqaba ukwamukela lezi zimali noma esikhundleni "Fosinopril". Analogs akhethiwe nge udokotela ukuba khona. On kungenzeka ngokuhlanganisa izidakamizwa nezinye izidakamizwa ingatholakala onguchwepheshe.

Analogs, "Fosinopril" omqondofana izidakamizwa

"Fosinopril" has bomcondvofana kanye analogue. Ukuze omqondofana eyakhe "Fosinopril-Teva", "Monopril." Kusukela leli qembu izidakamizwa kwaveza "Fosinopril-OBL», «Fozikard". Kulaba omqondofana ungakhetha "Fozinal", "Fozinotek".

Lapho ukwelashwa sekudlulile ayivumeli kusho "Fosinopril" yokusetshenziswa, omqondofana noma analogs esimisiwe kuchwepheshe ukuze bayothola ukwelashwa. Analogs "Berliprilom ',' Renitec '" ramipril "," Moeksom "," lisinopril ". analogs Akwaziwa naye onesitolo "Prestarium", "Enap" futhi "enalapril". Of analogue angabelwa "Tritatse", "Akkupro", "captopril". ukwelashwa kunokwenzeka usebenzisa "Charter" noma "Prenessa".

Uma unqabela ukusetshenziswa imithi "Fosinopril" yokusetshenziswa, analogs noma omqondofana ukhethe enquma onguchwepheshe.

Izibuyekezo sokulungiselela "Fosinopril"

Kubalulekile ukukhetha nomuthi ofanele-anti-abanomfutho wegazi ophakeme isiguli, ikhumbula izici lomzimba wakhe. Uma "Fosinopril" izidakamizwa umuntu ofanele, ingcindezi kuyehla ngempumelelo, futhi imiphumela emibi azisenzeki. Njengoba nokubuyekezwa, kukhona sinjalo wegazi, kuthuthukisa impilo jikelele. Uma ukusabela ezingezinhle lomzimba kuyagcinwa, zingabantu oluncane, ikakhulukazi ukunambitha nasiphazamiso, kodwa ngamanzi, ukukhwehlela.

High blood pressure kungaholela ezinkingeni ezingathi sína elihlobene ne ukulimala kwezitho ezibalulekile, ngakho udinga isikhathi ukuze wenze indlela yokwelapha edingekayo futhi ufunde incazelo imithi "Fosinopril" analogue, ngijwayele neminye imininingwane ewusizo.