N'ime nkụda obi na-adịghị ala ala, ọ ga-ekwe omume iji lisinopril na-eme ya oge na diuretics na / ma ọ bụ cardiac glycosides. Ọ bụrụ na ọ ga-ekwe omume, ekwesịrị belata dose nke diuretic tupu iwere lisinopril. Ọgwụ nke mbụ bụ 2.5 mg 1 oge / ụbọchị, n’ọdịnihu ọ ga-eji nwayọ nwayọ (site na 2.5 mg na ụbọchị 3-5) gaa na 5-10 mg / ụbọchị. Oke kachasị bụ 20 mg / ụbọchị.
Na nnukwu myocardial infarction (dị ka akụkụ nke ọgwụgwọ njikọta n'ime awa 24 mbụ, a na-enye ndị ọrịa nwere paradaịs hemodynamic kwụsie ike) 5 mg na awa 24 mbụ, mgbe ahụ 5 mg kwa ụbọchị, 10 mg mgbe ụbọchị abụọ gachara 10 mg otu ugboro kwa ụbọchị. N'ime ndị ọrịa nwere nnukwu myocardial infarction, a na-eji ọgwụ ahụ eme ihe maka izu isii. Na nmalite ọgwụgwọ ma ọ bụ n'ime ụbọchị 3 mbụ mgbe ọ rịsịrị nnukwu ọrịa myocardial infarction, a na-enye ndị ọrịa nwere ọbara mgbali systolic dị ala (120 mm Hg ma ọ bụ nke dị ala) ka 2.5 mg. N'ọnọdụ mmewere ọgbụgba akwara (mgbali ọbara systolic dị n'okpuru ma ọ bụ nha 100 mm Hg), enwere ike belata ọgwụ 5 kwa ụbọchị na 2.5 mg. Ọ bụrụ na ọbara ọgbụgba akwara na-adị ogologo oge (ọbara mgbali systolic dị n'okpuru 90 mm Hg maka ihe karịrị elekere 1), ekwesịrị ịkwụsị.
Na nephropathy na-arịa ọrịa shuga na ndị ọrịa nwere ụdị ọrịa shuga mellitus 1 (insulin-based), a na-edenye Iramed at na ọgwụ nke 10 mg 1 oge / ụbọchị. Ọ bụrụ na ọ dị mkpa, enwere ike ịbawanye dose ahụ gaa na 20 mg / ụbọchị iji mezuo ụkpụrụ ọbara mgbali ọbara n'okpuru 75 mm Hg. nọdụ ọdụ. N'ime ndị ọrịa nwere ụdị ọrịa shuga mellitus nke 2 (nke na-abụghị insulin), ọgwụ a bụ otu iji mezuo ụkpụrụ mgbali ọbara ọbara n'okpuru 90 mm Hg. nọdụ ọdụ.
Mmetụta dị n'akụkụ Irumed
Ọtụtụ mgbe: ọgbụgbọ, isi ọwụwa, ike ọgwụgwụ, afọ ọsịsa, ụkwara akọrọ, ọgbụgbọ.
Site na usoro obi: mbelata ọbara mgbali elu, mgbu obi, ọ na - adịkarị obere - orthostatic hypotension, tachycardia, bradycardia, ihe na - akawanye njọ nke nkụchi obi, na - ebugharị AV conduction, infarction myocardial.
Site n'akụkụ akụkụ akwara dị n’etiti akụkụ ahụ na - emetụta akwara: mgbatị mmụọ, ọgba aghara, paresthesia, iro ụra, na -eme ka uru ahụ nke aka na egbugbere ọnụ ya dịkarịsịrị ala - ọrịa asthenic.
Site na usoro nri: akpọnwụ akpịrị, anorexia, dyspepsia, mgbanwe uto, mgbu nke afọ, pancreatitis, hepatocellular ma ọ bụ cholestatic, jaundice, ịba ọcha n'anya, ụba ọrụ nke ọrịa hepatic transaminases, hyperbilirubinemia.
Site na sistem iku ume: dyspnea, bronchospasm.
Ihe mmeghachi omume oria: ọsụsọ bara ụba, itching skin, alopecia, photoensitivity.
Site na akụkụ ahụ haemopoietic: leukopenia, thrombocytopenia, neutropenia, agranulocytosis, anaemia (mbelata ọbara ọbara, haemoglobin, erythrocytopenia).
Site n'akụkụ nke metabolism: hyperkalemia, hyponatremia, hyperuricemia, mụbara creatinine na ọbara.
Site na sistemụ urinary: arụ ọrụ ezughi oke ọrụ, oliguria, anuria, uremia, proteinine.
Mmeghachi omume Allergic: urticaria, angioedema nke ihu, aka, egbugbere ọnụ, ire, epiglottis na / ma ọ bụ akwara, ọnya ọnya, ahụ ọkụ, ezigbo antinuclear antibody test results, mụbara ESR, eosinophilia, leukocytosis, n'ọnọdụ ụfọdụ - interstitial angioeurotic.
Ndị ọzọ: ogbu na nkwonkwo / ọrịa ogbu na nkwonkwo, myalgia, vasculitis, belatara ikike.
Mgbaàmà: akara akara mgbali ọbara, ọnụ akọrọ, iro ụra, njide urinary, afọ ntachi, nchekasị, oke iwe.
Ọgwụ: usoro ọgwụgwọ syndrome, usoro nchịkwa nke nnu si, ọ bụrụ na ọ dị mkpa, iji ọgwụ vasopressor n’okpuru nchịkwa ọbara na nguzo mmiri-electrolyte. Ikekwe, iji ọgwụ eji agwọ ọrịa.
N'iji oge nke Irumed na mkpụrụ osisi na-eme ka ihe na-egbu egbu (spironolactone, triamteren, amiloride), nkwado potassium, nnọchi nnu nwere potassium, ihe ize ndụ nke hyperkalemia na-abawanye, ọkachasị ndị ọrịa nwere ọrụ mgbazinye nsogbu.
N'iji oge emegharị Iureed na diuretics, achọpụtala mbelata ọbara mgbali elu.
N'iji oge nke Irumed na ọgwụ ọgwụ ndị ọzọ na - egbochi mkpali, a na-achọpụta mmetụta mmelite.
Site na ojiji nke Irumed na NSAIDs n'otu oge, estrogens, adrenostimulants, belata antihypertensive mmetụta nke lisinopril.
N'iji oge nke Irumed na lithium eme ihe, lithium excrement sitere n'ahụ gi na-adalata.
N'iji oge nke Irumed na antacids na colestyramine, ntinye nke lisinopril si eriri afọ na-ebelata.
Ethanol na-eme ka mmetụta ọgwụ ahụ dịkwuo mma.
Ekwesịrị iburu n’uche na mbelata ọbara mgbali elu pụtara na mbelata nke olu na-ebute ọgwụgwọ diuretic, belata nnu n’ime nri, n’oge ọgbụgba na ndị ọrịa nwere ọria afọ ma ọ bụ vomiting. N'ime ndị ọrịa nwere ọrịa obi na-adịghị ala ala nke nwere akwara akwara ma ọ bụ na-enweghị ya, hypotension hypotension nwere ike ịmalite, bụ nke a na-ahụkarị n'etiti ndị ọrịa nwere nnukwu obi nkụchi, n'ihi ojiji nke nnukwu usoro nke diuretic, hyponatremia, ma ọ bụ ọrụ na-arụ ọrụ na-arụ ọrụ nke ukwuu. N'ime ndị ọrịa dị otú ahụ, ekwesịrị ịmalite ọgwụgwọ n'okpuru nlezianya nke dibịa (jiri nlezianya họrọ nhọrọ nke ọgwụ na diuretics). A ga-esokwa usoro yiri ya mgbe ị na-ahọpụta ndị ọrịa nwere ọrịa akwara ọbara, ụkọ akwara, nke oke mbelata ọbara mgbali elu nwere ike ibute ọrịa myocardial infarction ma ọ bụ ọrịa strok.
N'ihe banyere mmepe nke mbelata ọbara pụtara, ekwesịrị inye onye ọrịa ọnọdụ kwụ ọtọ ma, ọ bụrụ na ọ dị mkpa, iv 0.9% sodium chloride solution. Mmeghachi azụ hypotensive abụghị ọgwụ mgbochi maka ị theụ ọgwụ ọzọ.
Mgbe ị na-eji ntamu na ụfọdụ ndị ọrịa nwere nkụda mmụọ na-adịghị ala ala, mana iji ọbara mgbali nkịtị ma ọ bụ nke dị ala, mbelata ọbara mgbali nwere ike ime, nke na-abụkarị ihe kpatara ịkwụsị ọgwụgwọ. Ọ bụrụ na hypotension arterial bịara bụrụ ihe nnọchianya, ọ dị mkpa iji belata ọgwụ ahụ ma ọ bụ kwụsị ịgwọ ya.
Na nnukwu myocardial infarction, eji usoro ọgwụgwọ (thrombolytics, acetylsalicylic acid, beta-blockers) gosipụtara. Enwere ike iji Mgbuma ® na njikọ ya na mmeghe ma ọ bụ iji usoro transdermal nke nitroglycerin.
Ekwesighi inye ndị ọrịa nwere nnukwu nsogbu myocardial infarction, ndị nọ n'ihe ize ndụ nke ịkwupụta njọ na hemodynamics mgbe ndị vasodilalis ji: maka ndị ọrịa nwere ọbara mgbali nke 100 mm Hg. ma ọ bụ wedata ala, ma ọ bụ jiri ujo kadiogenic.
N'ime ndị ọrịa nwere ọrịa obi na-adịghị ala ala, mbelata ọbara mgbali elu mgbe ịmalitere ya na ndị na - egbochi ACE nwere ike iduga n'ịdịwanye njọ nke ọrụ akụrụ. Ekwuru okwu banyere mmepe nke akụrụngwa nke nnukwu akwara. N'ime ndị ọrịa nwere akwara mkpụrụ ndụ akwara stenosis ma ọ bụ stenosis akwara nke otu akụrụ mesoro ndị na - egbochi ACE, enwere mmụba na seria urea na creatinine, na - abụkarị nlọghachi azụ mgbe akwụsịrị ọgwụgwọ (nke a na - ahụkarị na ndị ọrịa nwere akwara gbasara akwara).
Achọpụtaghị Lisinopril maka nnukwu ọrịa myocardial infarction na ndị ọrịa nwere nnukwu akụrụ na-enwe nsogbu nwere nri mkpụrụ nke ihe karịrị 177 mmol / l ma ọ bụ nwere proteinuria karịa 500 mg / ụbọchị. Ọ bụrụ na ọgwụ gbasara akụrụ na-etolite site n'iji ọgwụ eme ihe (ọdịnaya nke serin creatinine karịrị 265 mmol / l ma ọ bụ mmụba okpukpu abụọ ma e jiri ya gosipụta ya tupu a gwọọ ya), ekwesịrị ịtụle mkpa maka ọgwụgwọ ya na Iramed ®.
Ndị ọrịa na - a inụ ọgwụ mgbochi ACE, gụnyere lisinopril, na - enwekarị ọwụwa angioedema nke ihu, aka, egbugbere ọnụ, ire, epiglottis na / ma ọ bụ ogwooro, na mmepe ya ga - ekwe omume n'oge ọ bụla n'oge ọgwụgwọ. N'okwu a, a ga-akwụsị ọgwụgwọ na-arịa Irumed ngwa ngwa o kwere omume na a ga-enyocha onye ọrịa ruo mgbe mgbaàmà ya na-amalite kpamkpam. Agbanyeghị, n'ọnọdụ ebe edema na-eme naanị na ihu na egbugbere ọnụ yana ọnọdụ a na-ahụkarị na-enweghị ọgwụgwọ, enwere ike ịkọ ọgwụ antihistamines.
Site na mgbasa nke angioedema na ire, epiglottis ma ọ bụ larynx, mgbochi ikuku na-egbu egbu nwere ike ime, yabụ, ekwesịrị ịgwọ ọrịa kwesịrị ekwesị ozugbo (0.3-0.5 ml 1: 1000 epinephrine solution s / c) na / ma ọ bụ usoro iji hụ na patway airway. Achọpụtara ya na ndị ọrịa nke agbụrụ Negroid na-ewere ndị na-egbochi ACE, ọrịa angioedema na-etolite karịa oge ụfọdụ na ndị ọrịa nke agbụrụ ndị ọzọ. N'ime ndị ọrịa nwere akụkọ banyere ọrịa angioedema nke na-ejikọghị na usoro ọgwụgwọ mbụ ya na ndị na - egbochi ACE, ihe ize ndụ nke mmepe ya n'oge ọgwụgwọ ya na Iramed nwere ike ịba ụba.
N'ime ndị ọrịa na-a ACụ ọgwụ ACE, n'oge mkpaghasị nke hymenoptera venom (beps, a beesụ, ndanda), mmeghachi omume anaphylactoid nwere ike na-enweghị ike ịmalite ngwa ngwa. Enwere ike ịhapụ nke a site na ịkwụsịtụ ya na onye na - egbochi ACE tupu nkụda mmụọ ọ bụla.
Ekwesiri iburu n'uche na n'ime ndị ọrịa na-ewere ọgwụ mgbochi ACE ma na-arịa hemodialysis site na membranes dialysis di elu (dịka ọmụmaatụ, AN69), mmeghachi omume anaphylactic nwere ike ịmalite. N'ụdị ndị a, ọ dị mkpa ịtụle iji ụdị akpụkpọ ahụ dị iche iche maka dialysis ma ọ bụ ọgwụ ọzọ antihypertensive.
Mgbe ị na-eji ndị na-egbochi ACE, a na-ama ụkwara (akọrọ, na-adịte aka, nke na-apụ n'anya mgbe ọ kwụsịrị ọgwụgwọ na onye na - egbochi ACE). Na nchọpụta ọdịiche nke ụkwara, a ga-echebara ụkwara nke a na-eji ihe mgbochi ACE.
Mgbe ị na-eji ọgwụ ndị na-eme ka ọbara mgbali dị ala na ndị ọrịa nwere nnukwu ịwa ahụ ma ọ bụ n'oge mgbatị akwara, lisinopril nwere ike igbochi guzobe angiotensin nke abụọ, nke abụọ dabere na nkwụghachi ụgwọ nke renin. Mbelata ọbara mgbali elu, nke a na-eche na nsonaazụ nke usoro a nwere ike iwepụ mgbakwunye bcc. Tupu ịwa ahụ (gụnyere ịwa ahụ eze), a ga-eme ka dọkịta na-awa ahụ / ọgwụ na-agwọ ọrịa banyere iji ọgwụ mgbochi ACE mee ihe.
N'ọnọdụ ụfọdụ, a chọpụtara hyperkalemia. Ihe ndị dị ize ndụ maka mmepe nke hyperkalemia gụnyere ọdịda akụrụ, ọrịa shuga mellitus na ojiji nke potassium-sparing diuretics (spironolactone, triamteren ma ọ bụ amiloride), nkwado potassium ma ọ bụ nnọchi nnu nwere mmanụ potassium, ọkachasị ndị ọrịa nwere ọrụ akụrụ ya na-arụ ọrụ ọfụma. Ọ bụrụ na ọ dị mkpa, ojiji nke ijikọtara ndị a kwesịrị ịdị na-enyocha ọkwa nke potassium na ọbara.
N'ime ndị ọrịa nọ n'ihe ize ndụ nke ịmalite ọrịa hypotension (na obere nnu ma ọ bụ nnu na-enweghị nri) na / na-enweghị hyponatremia, yana na ndị ọrịa natara ọgwụ ọnya dị elu, a ga-akwụ ụgwọ ọnọdụ ndị dị n'elu tupu ọgwụgwọ (enweghị mmiri na nnu). Ọ dị mkpa ịchịkwa nsonaazụ mbụ nke ọgwụ Iromed drug na uru ọbara mgbali bara.
Mmetụta ikike ịkwọ ụgbọ ala na usoro nchịkwa
Enweghị data na nsonaazụ nke Mgbu, ejiri mee ihe na usoro ọgwụgwọ, na ikike ịkwọ ụgbọala na usoro, mana ekwesịrị iburu n'uche na ọgbụgba ga-ekwe omume. Ya mere, n'oge ọgwụgwọ, ndị ọrịa kwesịrị ịkpachara anya mgbe ha na-anya ụgbọ ala na ọrụ ha chọrọ ịbawanye ụba nke nlebara anya na ọsọ nke mmeghachi omume psychomotor.
Mwepụta ewepụtara dị njọ, nchịkọta ọgwụ na ihe mejupụtara.
Mbadamba nkume ndị ahụ na-acha ọcha, gburugburu, biconvex, nwee mkpọchighị ọnụ n'otu akụkụ.
Taabụ 1
lisinopril (n'ụdị nke mmiri mmiri ara)
5 mg
Ndị pụrụ iche: mannitol, calcium phosphate dihydrate, stachi ọka, pregelatinized ọka stachi, colloidal silicon dioxide, magnesium stearate.
30 PC - blisters (1) - ngwugwu nke kaadiboodu.
Mbadamba ahụ dị ọcha, gburugburu, dị gburugburu cylindrical, na-enweghị ọkwa n'otu akụkụ.
Taabụ 1
lisinopril (n'ụdị nke mmiri mmiri ara)
5 mg
Ndị pụrụ iche: mannitol, calcium phosphate dihydrate, stachi ọka, pregelatinized ọka stachi, colloidal silicon dioxide, magnesium stearate.
30 PC - blisters (1) - ngwugwu nke kaadiboodu.
Mbadamba nkume ndị ahụ bụ odo edo edo na agba, okirikiri, cylindrical, nwere ihe egwu dị n'otu akụkụ.
Taabụ 1
lisinopril (n'ụdị nke mmiri mmiri ara)
10 mg
Ndị pụrụ iche: mannitol, calcium phosphate dihydrate, stachi ọka, pregelatinized ọka stachi, odo iron oxide odo (E172), colloidal silicon dioxide, magnesium stearate.
30 PC - blisters (1) - ngwugwu nke kaadiboodu.
Mbadamba mbadamba peach, nwere okirikiri, nwere oghere dị n'otu akụkụ.
Taabụ 1
lisinopril (n'ụdị nke mmiri mmiri ara)
20 mg
Ihe ndị pụrụ iche: mannitol, calcium phosphate dihydrate, stachi ọka, pregelatinized ọka stachi, ihe eji acha edo edo edo (E172), ihe nchara na-acha ọbara ọbara (E172), silloon silikon dioxide, magnesium stearate.
30 PC - blisters (1) - ngwugwu nke kaadiboodu.
Nkọwa ọgwụ a sitere na ntuziaka masịrị iwu maka iji ya eme ihe.
Emere ọgwụ ọgwụ
Ihe mgbochi ACE. Ọgwụ antihypertensive. Usoro metụtara ihe a metụtara na igbochi ọrụ ACE, nke na-eduga na mbelata nguzobe nke angiotensin II site na angiotensin I ma belata mbelata nke ntọhapụ nke aldosterone. Na-ebelata mmebi nke bradykinin ma mee ka njikọ nke prostaglandins dịkwuo elu.
Na-ebelata OPSS, ọbara mgbali elu, ibubata ihe, nrụgide na mkpụrụ ndụ akwara, na-eme ka mmụba olu olu nkeji na mmụba mmega ahụ na ndị ọrịa nwere nkụda mmụọ obi na-adịghị ala ala. Lisinopril nwere mmetụta vasodilating, ebe ọ na-agbasa akwara ndị ahụ ruo na ọnya dị ukwuu karịa veins. A na-akọwapụta ụfọdụ nsonaazụ site na nsonaazụ sistemụ renin-angiotensin. Ọ na - eme ka ọkpụkpụ ọbara na ischemic myocardium dị mma. Site n'iji ogologo oge, hypertrophy nke myocardium na mgbidi nke akwara ndị dị n'ụdị resistive na-ebelata.
Ojiji nke ndị na - egbochi ACE na ndị ọrịa nwere nkụda mmụọ na-adịghị ala ala na-eduga n'ịba ụba nke ndụ, na ndị ọrịa nwere obere myocardial infarction, na-enweghị ngosipụta ụlọ nyocha nke nkụda obi, na-eji nwayọ nwayọ nke ịhapụ ventricular dysfunction.
A na - ahụta mmalite nke ihe a na - ewe elekere 1 mgbe ị takingụ ọgwụ ahụ, a na - ahụkarị mmetụta kachasị mgbe awa 6-7 gachara, ogologo oge a na - eme ya bụ awa 24. Site na mgbali ọbara, a na - ahụ mmetụta ahụ n’ụbọchị ndị mbụ mgbe ebidochara ọgwụgwọ, mmetụta kwụsiri ike na - amalite mgbe ọnwa 1-2 gachara.
Site na ịkwụsị ọgwụ ọgwụ ike, achọpụtaghị mmụba dị elu nke ọbara mgbali. Na mgbakwunye na iweda ọbara mgbali elu, lisinopril na-ebelata albuminuria. N'ime ndị ọrịa nwere hyperglycemia, ọ na-enyere aka ịdịzie aka ọrụ nke endothelium glomerular mebiri emebi. Lisinopril anaghị emetụta mkpokọ glucose plasma na ndị ọrịa nwere ọrịa mellitus ma ọ dịghị ebute mmụba na ọnọdụ hypoglycemia.
Pharmacokinetics nke ọgwụ.
Mgbe ị takingụsịrị ọgwụ ahụ n'ime, ihe dị ka 25% nke lisinopril na-abanye na ngọngọ nri. Iri nri anaghị emetụta nnabata nke lisinopril. Orhapụ iwe bụ nkezi nke 30%. Bioavailability bụ 29%. Cmax na plasma ruru mgbe ihe dị ka elekere 6-8 gachara.
N'akụkụ ike siri ike na protein protein. Lisinopril batara na BBB ntakịrị, site na ihe mgbochi placental.
T1 / 2 - awa 12. Lisinopril adịghị metabolized ma wepụta na agbanweghi na mmamịrị ya.
Ihe ngosi maka ojiji:
- ọbara mgbali ọbara (n'ụdị monotherapy ma ọ bụ yana ọgwụ ndị ọzọ antihypertensive),
- nkụda obi na-adịghị ala ala (dịka akụkụ nke ọgwụgwọ njikọ maka ọgwụgwọ nke ndị ọrịa na - a takingụ digitalis na / ma ọ bụ diuretics),
- n'oge ọgwụgwọ nke nnukwu myocardial infarction (dị ka akụkụ nke usoro ọgwụgwọ na awa 24 mbụ na ndị ọrịa nwere usoro nguzosi ike dị mma, iji nọgide na-egosi ndị a ma gbochie nkụda mmụọ na nkụda mmụọ.
- nephropathy na-arịa ọrịa shuga (iji belata albuminuria na ndị ọrịa insulin na-enwe nsogbu ọbara nkịtị na ndị ọrịa na-abụghị insulin nwere ọbara mgbali elu).
Usoro onunu ogwu na uzo icho ogwu a.
Edere ọgwụ a n'ọnụ. Iri nri anaghị emetụta mmịpụta, yabụ, enwere ike ị takenụ ọgwụ tupu, n'oge ma ọ bụ mgbe nri ahụ gasịrị. Ogologo oge nchịkwa bụ 1 oge / ụbọchị (ihe dị ka n'otu oge ahụ).
Na ọgwụgwọ nke ọbara mgbali elu dị mkpa, a na-atụ aro ịkọ ọgwụ mbụ nke 10 mg. Ulo mmezi bu 20 mg / ubochi. Oke kachasị kwa ụbọchị bụ 40 mg. Maka mmepe zuru oke nke nsonaazụ ahụ, enwere ike ịchọ usoro ọgwụgwọ nke izu 2-4 na ọgwụ ahụ (ekwesịrị iburu n'uche nke a mgbe ị na-abawanye dose). Ọ bụrụ na iji ọgwụ ahụ na ọnụọgụ ọgwụ kachasị oke anaghị akpata nsonaazụ ọgwụgwọ zuru oke, mgbe ahụ itinye ọgwụ ọzọ maka ọgwụ antihypertensive ọzọ ga-ekwe omume.
Maka ndị ọrịa na-a diụ mkpụrụ ọgwụ, a ga-akwụsị ịgwọ ọrịa ya n’ọrịa ọnụọgụ ụbọchị abụọ tupu mmalite nke Irumed. Maka ndị ọrịa na-agaghị ekwe omume ịkwụsị ọgwụgwọ na ọrịa akwara, a na-edenye Iramed ọgwụ dị ka 5 mg / ụbọchị.
N'ihe banyere ọbara ọgbụgba mgbagha ma ọ bụ ọnọdụ ndị ọzọ na-arụ ọrụ nke sistemụ renin-angiotensin-aldosterone, etinyere Irumed na usoro mbu nke 2.5-5 mg / ụbọchị n'okpuru njikwa ọbara mgbali, ọrụ akụrụ, itinye uche potassium na ọbara ọbara. E dobere usoro mmezi dabere na ọbara mgbali elu.
N'ime ndị ọrịa nwere ọdịda akụrụngwa na ndị ọrịa na hemodialysis, a na-etinye usoro izizi dabere na QC. A na-ekpebi ihe mmezi dabere na ọbara ọgbụgba (n'okpuru nchịkwa ọrụ akụrụ, potassium na sodium ọkwa n'ọbara).
QC
Dose doseụ ọgwụ kwa ụbọchị
30-70 ml / min
5-10 mg
10-30 ml / min
2,5-5 mg
2013-03-20
Mkpochapu Contraindications
- akụkọ banyere anakede (gụnyere iji ACI inhibitors),
- isi nkọlọ nke Quincke,
- afọ ruo afọ 18 (arụpụtaghị na ịdị adị na nchekwa),
- ime
- hypersensitivity na lisinopril na ndị ọzọ na-egbochi ACE,
Na ịkpachara anya ogwu kwesiri ka edee ogwu n'ihi ogwu akwara, hypertrophic cardiomyopathy, akuko abuo akuko artenia stenosis, otu akuko akwara stenosis na azotemia na - aga n’ihu, na onodu mgbe akpogharia akụrụ, hyperaldosteronism nke mbu, akwara obara, hypoplasia akwara, hyponatremia na ndi oria nwere nsogbu nke ibute. obere nnu ma ọ bụ nnu nnu), hyperkalemia, ọnọdụ tinyere mbelata nke olu na-ekesa ọbara (gụnyere afọ ọsịsa, vomiting), ọrịa anụ ahụ jikọrọ ọnụ (gụnyere systemic lupus erythematosus, scleroderma), ọrịa shuga mellitus, gout, hyperuricemia, IHD, ụkọ nri ụbụrụ, ọrịa ndị agadi.
Ndụmọdụ maka iji ya
Edere ọgwụ a n'ọnụ. Iri nri anaghị emetụta mmịpụta, yabụ, enwere ike ị takenụ ọgwụ tupu, n'oge ma ọ bụ mgbe nri ahụ gasịrị. Otutu maka nnabata 1 oge kwa ụbọchị (ihe dịka n'otu oge).
Na ọgwụgwọ nke ọbara mgbali elu dị mkpa A na-atụ aro ịnweta ọgwụ mbụ 10 mg. Ọkara mmezi ahụ bụ 20-40 mg kwa ụbọchị. Oke kachasị kwa ụbọchị bụ 80 mg.
Ndị ọrịa na-a diụ mkpụrụ ọgwụ, ana-ahọrọ dose ahụ n’otu n’otu, nye na ndị ọrịa dị otú ahụ nwere ike ịnwe hyponatremia ma ọ bụ belata olu ọbara, nke nwere ike iduga mmepe nke hypotension. A ga-akwụsị ịgwọ ọrịa n’ịrịa ọnya afọ 2-3 tupu mmalite nke Mkpesa ya na, ọ bụrụ na ọ dị mkpa, bidoghachi mgbe ịhọrọ ntụtụ nke Mgbu Ahụ, dabere n’ọnọdụ ụlọọgwụ. Maka ndị ọrịa na-agaghị ekwe omume ịkwụsị ọgwụgwọ na diuretics, a na-edenye Iramed ụzọ oge mbụ nke 5 mg / ụbọchị, na-amụba ya na-adabere na ọgwụgwọ na ịnagide ọgwụ ahụ. Ọ bụrụ na ọ dị mkpa, enwere ike ịmaliteghachi ọgwụgwọ na ọgwụ diuretics.
Ihe ejiri ilu n’itolite n’oge a na-ete nwa
Irumed n'oge ime dị ime. Lisinopril na-agafe ihe mgbochi placental.
Ọ bụrụ na ịtụrụ ime, a ga-akwụsị ịgwọ ọrịa na Iromed ozugbo, ọ gwụla ma uru nne ya karịrị ihe ọ bụla nwere ike ibute nwa ebu n’afọ (a ga-eme ka onye ọrịa mara ihe o nwere ike ime nwa ebu n’afọ). Nnabata nke ndị na - egbochi ACE na ngụkọ oge nke II na III nke afọ ime nwere ike ibute ọnwụ nwa ebu n’afọ na nwa amụrụ ọhụrụ. N'ime ụmụ amụrụ ọhụrụ, hypoplasia skull, oligohydramnios, mmebi nke ọkpụkpụ nke isi na ihu, hypoplasia nke ngụgụ, yana akụrụ na-enwe ọria. Maka ụmụ amụrụ ọhụrụ na ụmụ ọhụrụ ndị ACE na-egbochi nne n'oge ọmụmụ ha, a na-atụ aro ka a na-elezi anya iji chọpụta oge mbelata ọbara mgbali elu, oliguria, hyperkalemia.
Enweghị data na ntopute nke lisinopril n'ime mmiri ara. N'oge ọgwụgwọ Irumed, ọ dị mkpa ịkagbu ara.
Igwe mmiri bụ ihe mgbochi ACE. Ọgwụ antihypertensive. Usoro metụtara ihe a metụtara na igbochi ọrụ ACE, nke na-eduga na mbelata nguzobe nke angiotensin II site na angiotensin I ma belata mbelata nke ntọhapụ nke aldosterone. Na-ebelata mmebi nke bradykinin ma mee ka njikọ nke prostaglandins dịkwuo elu.
Na-ebelata OPSS, ọbara mgbali elu, ibubata ihe, nrụgide na mkpụrụ ndụ akwara, na-eme ka mmụba olu olu nkeji na mmụba mmega ahụ na ndị ọrịa nwere nkụda mmụọ obi na-adịghị ala ala. Lisinopril nwere mmetụta vasodilating, ebe ọ na-agbasa akwara ndị ahụ ruo na ọnya dị ukwuu karịa veins. A na-akọwapụta ụfọdụ nsonaazụ site na nsonaazụ sistemụ renin-angiotensin. Ọ na - eme ka ọkpụkpụ ọbara na ischemic myocardium dị mma. Site n'iji ogologo oge, hypertrophy nke myocardium na mgbidi nke akwara ndị dị n'ụdị resistive na-ebelata.
Ojiji nke ndị na - egbochi ACE na ndị ọrịa nwere nkụchi obi na-eduga n'ịba ụba nke ndụ, na ndị ọrịa mgbe ebịchara myocardial infarction, na-enweghị ngosipụta akparamaagwa nke nkụda obi, na-eji nwayọ nwayọ nke ọnụnọ ventricular dysfunction.
A na - ahụta mmalite nke ihe a na - ewe elekere 1 mgbe ị takingụ ọgwụ ahụ, a na - ahụkarị mmetụta kachasị mgbe awa 6-7 gachara, oge a ga - eme ya bụ awa 24. Site na mgbali elu, a na - achọpụta mmetụta ahụ n’ụbọchị mbụ mgbe mmalite ọgwụgwọ, mmetụta kwụsiri ike na - amalite mgbe ọnwa 1-2 gachara.
Mmetụta dị n'akụkụ Irumed
Si usoro obi: akara akara mgbali ọbara, mgbu obi, hyperension orthostatic, tachycardia, bradycardia, ihe na - akawanye njọ nke nkụchi obi, ọrịa AV na - ebugharị, infarction myocardial.
Site na nri digestive: mgbu afọ, akpọnwụ akpọnwụ, dyspepsia, anorexia, mgbanwe uto, pancreatitis, hepatocellular ma ọ bụ cholestatic ịba ọcha n'anya, jaundice, ụba ọrụ nke hepatic transaminases, hyperbilirubinemia.
Site n'akụkụ nke usoro ụjọ ahụ: otiti nke onodu ojoo, ọgba aghara, ahu nkpagbu, ura, nkpudo nke ukwu aka na egbugbere onu, oria asthenic, ọgba aghara.
Site na usoro iku ume: dyspnea, bronchospasm, apnea.
Na akpukpo ahu: urticaria, sweating, ntutu isi, photosensitivity.
Site na akụkụ ahụ dị na hemopoietic: leukopenia, thrombocytopenia, neutropenia, agranulocytosis, anaemia (mbelata hematocrit, erythrocytopenia).
Site na usoro mkpụrụ ndụ: uremia, oliguria / anuria, ọrụ ezughi oke ọrụ, nnukwu gbasara akụrụ, ọdịda ada ada.
Mmeghachi omume nfụkasị ahụ: ihu ihu, aka, egbugbere ọnụ, ire, epiglottis na / ma ọ bụ larynx, ọnya ọnya, itching, ahụ ọkụ, ezigbo antinuclear antibody test results, mụbara ESR, eosinophilia, leukocytosis.
Ndị ọzọ: hyperkalemia, hyponatremia, hyperuricemia, arthralgia, myalgia.
Imirikiti ndị ọrịa, nsonaazụ ya na-adị nwayọọ ma na-adịte aka.
Ekwesịrị iburu n’uche na mbelata ọbara mgbali elu pụtara na mbelata nke olu na-ebute ọgwụgwọ diuretic, belata nnu n’ime nri, n’oge ọgbụgba na ndị ọrịa nwere ọria afọ ma ọ bụ vomiting. N'ime ndị ọrịa nwere ọrịa obi na-adịghị ala ala nke nwere akwara akwara ma ọ bụ na-enweghị ya, hypotension hypotension nwere ike ịmalite, bụ nke a na-ahụkarị n'etiti ndị ọrịa nwere nnukwu obi nkụchi, n'ihi ojiji nke nnukwu usoro nke diuretic, hyponatremia, ma ọ bụ ọrụ na-arụ ọrụ na-arụ ọrụ nke ukwuu. N'ime ndị ọrịa dị otú ahụ, ekwesịrị ịmalite ọgwụgwọ n'okpuru nlezianya nke dibịa (jiri nlezianya họrọ nhọrọ nke ọgwụ na diuretics). A ga-esokwa usoro yiri ya mgbe ị na-ahọpụta ndị ọrịa nwere ọrịa akwara ọbara, ụkọ akwara, nke oke mbelata ọbara mgbali elu nwere ike ibute ọrịa myocardial infarction ma ọ bụ ọrịa strok.
N'ihe banyere mmepe nke mbelata ọbara pụtara, ekwesịrị inye onye ọrịa ọnọdụ kwụ ọtọ ma, ọ bụrụ na ọ dị mkpa, iv 0.9% sodium chloride solution. Mmeghachi azụ hypotensive abụghị ọgwụ mgbochi maka ị theụ ọgwụ ọzọ.
Mgbe ị na-eji ntamu na ụfọdụ ndị ọrịa nwere nkụda mmụọ na-adịghị ala ala, mana iji ọbara mgbali nkịtị ma ọ bụ nke dị ala, mbelata ọbara mgbali nwere ike ime, nke na-abụkarị ihe kpatara ịkwụsị ọgwụgwọ. Ọ bụrụ na hypotension arterial bịara bụrụ ihe nnọchianya, ọ dị mkpa iji belata ọgwụ ahụ ma ọ bụ kwụsị ịgwọ ya.
Na nnukwu myocardial infarction, eji usoro ọgwụgwọ (thrombolytics, acetylsalicylic acid, beta-blockers) gosipụtara. Enwere ike iji Iramed mee ihe na njikọta ma ọ bụ iji sistemụ nitroglycerin transdermal.
N'ime ndị ọrịa nwere ọrịa obi na-adịghị ala ala, mbelata ọbara mgbali elu mgbe ịmalitere ya na ndị na - egbochi ACE nwere ike iduga n'ịdịwanye njọ nke ọrụ akụrụ. A chọpụtala okwu banyere mmepe nke oke akụrụ oke mgbe ị na-ewere ndị na - egbochi ACE. N'ime ndị ọrịa nwere akwara mkpụrụ ndụ akwara stenosis ma ọ bụ stenosis akwara nke otu akụrụ mesoro ndị na - egbochi ACE, enwere mmụba na seria urea na creatinine, a na - atụgharịkarị mgbe a kwụsịrị ọgwụgwọ (nke a na - ahụkarị na ndị ọrịa nwere akụrụ gbasara akwara).
Ndị ọrịa na - a inụ ọgwụ mgbochi ACE, gụnyere lisinopril, na - enwekarị ọwụwa angioedema nke ihu, aka, egbugbere ọnụ, ire, epiglottis na / ma ọ bụ ogwooro, na mmepe ya ga - ekwe omume n'oge ọ bụla n'oge ọgwụgwọ. N'okwu a, a ga-akwụsị ọgwụgwọ na-arịa Irumed ngwa ngwa o kwere omume na a ga-enyocha onye ọrịa ruo mgbe mgbaàmà ya na-amalite kpamkpam. Agbanyeghị, n'ọnọdụ ebe edema na-eme naanị na ihu na egbugbere ọnụ yana ọnọdụ a na-ahụkarị na-enweghị ọgwụgwọ, enwere ike ịkọ ọgwụ antihistamines.
Site na mgbasa nke angioedema na ire, epiglottis ma ọ bụ larynx, enwere ike ịmachi ikuku, yabụ, ekwesịrị ịgwọ ọrịa kwesịrị ekwesị na / ma ọ bụ usoro iji hụ na mgbochi ikuku. Achọpụtara ya na ndị ọrịa nke agbụrụ Negroid na-ewere ndị na-egbochi ACE, ọrịa angioedema na-etolite karịa oge ụfọdụ na ndị ọrịa nke agbụrụ ndị ọzọ. N'ime ndị ọrịa nwere akụkọ banyere ọrịa angioedema nke na-ejikọghị na usoro ọgwụgwọ mbụ ya na ndị na - egbochi ACE, ihe ize ndụ nke mmepe ya n'oge ọgwụgwọ ya na Iramed nwere ike ịba ụba.
N'ime ndị ọrịa na-ewere ọgwụ mgbochi ACE, n'oge enweghị ikike nchegharị (beps, a beesụ, ndanda na hymenoptera), mmeghachi omume anaphylactoid nwere ike na-enweghị ike ịmalite ngwa ngwa. Enwere ike ịhapụ nke a site na ịkwụsịtụ ya na onye na - egbochi ACE tupu nkụda mmụọ ọ bụla.
Okwesiri iburu n’uche na n’ime ndi oria na-a inara ihe mgbochi ACE ma na-anagide onodu okuko site na iji mebiri emebi ihe di elu, ihe anafilactic nwere ike itolite. N'ụdị ndị a, ọ dị mkpa ịtụle iji ụdị akpụkpọ ahụ dị iche iche maka dialysis ma ọ bụ ọgwụ ọzọ antihypertensive.
Mgbe ị na-eji ndị na-egbochi ACE, a na-ama ụkwara (akọrọ, na-adịte aka, nke na-apụ n'anya mgbe ọ kwụsịrị ọgwụgwọ na onye na - egbochi ACE). Na nchọpụta ọdịiche nke ụkwara, a ga-echebara ụkwara nke a na-eji ihe mgbochi ACE.
Mgbe ị na-eji ọgwụ ndị na-eme ka ọbara mgbali dị ala na ndị ọrịa nwere nnukwu ịwa ahụ ma ọ bụ n'oge mgbatị akwara, lisinopril nwere ike igbochi guzobe angiotensin nke abụọ, nke abụọ dabere na nkwụghachi ụgwọ nke renin. Mbelata ọbara mgbali elu, nke a na-eche na nsonaazụ nke usoro a, nwere ike iwepụ mmụba nke ọbara na - ekesa.
N'ọnọdụ ụfọdụ, a chọpụtara hyperkalemia. Ihe ndị dị ize ndụ maka mmepe nke hyperkalemia gụnyere ọdịda akụrụ, ọrịa shuga mellitus na ojiji nke potassium-sparing diuretics (spironolactone, triamteren ma ọ bụ amiloride), nkwado potassium ma ọ bụ nnọchi nnu nwere mmanụ potassium, ọkachasị ndị ọrịa nwere ọrụ akụrụ ya na-arụ ọrụ ọfụma. Ọ bụrụ na ọ dị mkpa, ojiji nke ijikọtara ndị a kwesịrị ịdị na-enyocha ọkwa nke potassium na ọbara.
N'ime ndị ọrịa nọ n'ihe ize ndụ nke ịmalite hypotension ọrịa (na obere nnu ma ọ bụ nnu na-enweghị nri) na ma ọ bụ na-enweghị hyponatremia, yana na ndị ọrịa natara ọgwụ ọnya dị elu, a ga-akwụ ụgwọ ọnọdụ ndị dị n'elu tupu ọgwụgwọ (ọnwụ nke mmiri na nnu).
Mmetụta ikike ịkwọ ụgbọ ala na usoro nchịkwa
Enweghị data na nsonaazụ nke Mgbu, etinyere na usoro ọgwụgwọ, na ikike ịkwọ ụgbọala na usoro, mana ekwesịrị iburu n'uche na ọgbụgba ga-ekwe omume.
Ọrịa akara mbelata ọbara mgbali elu.
Ọgwụgwọ: Ọ dị mkpa iji mee ka ọ b ụ ọfụma na / ma ọ bụ hichaa afọ, n'ọdịniihu, a na-eme ọgwụgwọ symptomatic iji dozie akpịrị ịkpọ nkụ na ọgba aghara na nguzo mmiri. Site na hypotension art art, a ga-achịkwa azịza isotonic, a na-enye ndị vasopressors iwu. Ikekwe, iji ọgwụ eji agwọ ọrịa.Ọrịa akara mbelata ọbara mgbali elu.
Ọgwụgwọ: Ọ dị mkpa iji mee ka ọ b ụ ọfụma na / ma ọ bụ hichaa afọ, n'ọdịniihu, a na-eme ọgwụgwọ symptomatic iji dozie akpịrị ịkpọ nkụ na ọgba aghara na nguzo mmiri. Site na hypotension art art, a ga-achịkwa azịza isotonic, a na-enye ndị vasopressors iwu. Ikekwe, iji ọgwụ eji agwọ ọrịa.
N'iji oge nke Irumed na mkpụrụ osisi na-eme ka ihe na-egbu egbu (spironolactone, triamteren, amiloride), nkwado potassium, nnọchi nnu nwere potassium, ihe ize ndụ nke hyperkalemia na-abawanye, ọkachasị ndị ọrịa nwere ọrụ mgbazinye nsogbu.
N'iji oge emegharị Iureed na diuretics, achọpụtala mbelata ọbara mgbali elu.
N'iji oge nke Irumed na ọgwụ ọgwụ ndị ọzọ na - egbochi mkpali, a na-achọpụta mmetụta mmelite.
N'iji oge nke Irumed na NSAIDs, estrogens, belata antihypertensive mmetụta nke lisinopril.
N'iji oge nke Irumed na lithium eme ihe, lithium excrement sitere n'ahụ gi na-adalata.
N'iji oge nke Irumed na antacids na colestyramine mee ihe, a na-ebelata nnabata nke lisinopril na ngha.
Enweghi mmekorita ogwu nke di egwu banyere ebe eji lisinopril jiri propranolol, digoxin, ma obu hydrochlorothiazide.
Ekwesịrị ịchekwa ọgwụ a na okpomọkụ ruo 25 Celsius. Bọchị mmebi: afọ 3.
Ọgwụ Irmed: ntuziaka maka ojiji
Mgbu bụ onye ejiri ọgwụ hypotensive mee ihe na ọgwụgwọ nke ọbara mgbali elu na ọrịa ndị ọzọ nke obi na akwara ọbara metụtara mgbali elu na akwara. Ọ bụrụ na-ejighi ya, ọ nwere ike ibute nsonaazụ ndị na-egbu ndụ, yabụ ị nwere ike ịmalite ị takingụ ọgwụ naanị site n'ikike nke dọkịta.
International Nonproprietary Aha
Lisinopril - aha nke ọgwụ na-arụ ọrụ.
Irumed bụ ọgwụ eji egbochi hypotensive nke ejiri ọgwụgwọ ọgwụgwọ ọbara mgbali elu na ọrịa ndị ọzọ nke obi na arịa ọbara.
С09АА03 - koodu maka anatomical-ọgwụgwọ-kemịkalị kemịkalụ.
Weputara udi ya na ihe mebere ya
Ọgwụ nwere ụdị mwepụta mbadamba. Nhazi nke mbadamba ihe ọ bụla gụnyere:
- lisinopril dihydrate (10 ma ọ bụ 20 mg),
- mannitol
- nduku nduku
- calcium phosphate akpọnwụwo,
- iron oxide edo edo,
- sịlịkọn na-enye mmiri ikuku,
- pregelatinized nduku stachi
- stereta magnesium.
A na-enye mbadamba n’ime sel polymer 30, nke edobere n’ime kaadiboodu tinyere ntuziaka.
Ihe enyere n'iwu
Ihe ngosi maka nhọpụta nke Mkpesa bụ:
- ọbara mgbali elu (dịka naanị onye na - agwọ ọrịa ma ọ bụ yana ọgwụ ndị ọzọ).
- ọrịa obi na-adịghị ala ala (yana mgbakwunye na diuretics ma ọ bụ cardiac glycosides),
- mgbochi na ọgwụgwọ nke infarction myocardial (n’ụbọchị mbụ a na-a drugụ ọgwụ ahụ ka ọ na-elekọta paradaịs hemodynamic na mgbochi nke ujo cardiogenic),
- mmebi akụrụ (iji belata ego nke albumin dị na mmamịrị n’ime ndị nwere ụdị 1 na ụdị 2 nke ọrịa shuga).
Nhazi ọkwa nosological (ICD-10)
| Ọgwụ | Taabụ 1. |
| ike ọrụ: |
| lisinopril dihydrate (na usoro nke lisinopril anhydrous) | 10/20 mg |
| ndị na-ebu ụzọ (10 mg): mannitol, calcium phosphate dihydrate, ọka ọka, pregelatinized ọka stachi, odo iron oxide odo (E172), silloon silikon dioxide, magnesium stearate |
| ndị na-ebu ụzọ (20 mg): mannitol, calcium phosphate dihydrate, stachi ọka, pregelatinized ọka stachi, odo iron oxide dye (E172), uhie iron oxide dye (E172), silloon silikon dioxide, magnesium stearate |
Usoro onunu ogwu na nhazi
N'ime tupu ma ọ bụ mgbe nri gachara, otu oge kwa ụbọchị, ọkacha mma n'otu oge.
Ọbara mgbali dị mkpa. Usoro izizi bụ 10 mg otu ugboro kwa ụbọchị, usoro nlekọta ahụ bụ 20 mg / ụbọchị, nke kachasị bụ 40 mg / ụbọchị.
Maka mmepe zuru oke nke nsonaazụ, enwere ike ịchọ usoro ọgwụgwọ nke izu 2-4 site na ọgwụ ahụ (a ga-elebara nke a anya mgbe ị na-abawanye dose ahụ). Ọ bụrụ na iji ọgwụ ahụ na ọnụọgụ ọgwụ kachasị oke anaghị akpata nsonaazụ ọgwụgwọ zuru oke, mgbe ahụ itinye ọgwụ ọzọ maka ọgwụ antihypertensive ọzọ ga-ekwe omume.
N'ime ndị ọrịa nwetagoro ọgwụ diuretics, ọ dị mkpa ịkagbu ha ụbọchị 2-3 tupu mmalite ọgwụ. Ọ bụrụ na ọ gaghị ekwe omume ịkagbu nsị, mkpụrụ ọgwụ mbụ nke lisinopril ekwesịghị ịbụ ihe karịrị 5 mg / ụbọchị.
N'ọnọdụ ọgbụgba mgbagha ọbara ma ọ bụ ọnọdụ ndị ọzọ na-arụ ọrụ RAAS. A na-enye ọgwụ ahụ ọgwụ ọgwụ Iramed med na usoro ọgwụ mbụ nke 2.5-5 mg / ụbọchị n'okpuru nchịkwa nke ọbara mgbali, ọrụ akụrụ, ihe mgbakwunye potassium na ọbara ọbara.
E dobere usoro mmezi dabere na ọbara mgbali elu.
N'ime ndị ọrịa nwere ọdịda akụrụngwa na ndị ọrịa na-arịa hemodialysis, atọrọ ọgwụ mbu dabere na ọkwa Cl nke creatinine. A na-ekpebi ụgwọ mmezi dabere na ọbara mgbali (n'okpuru nchịkwa ọrụ akụrụ, potassium na sodium ọkwa n'ọbara).
Usoro onunu ogwu maka akwara okpu. A na-ekpebi usoro ọgwụgwọ dabere na uru Cl nke creatinine, dị ka egosiri na tebụl.
| Cl creatinine, ml / min | Mkpụrụ mbụ, mg / ụbọchị |
| 30–70 | 5–10 |
| 10–30 | 2,5–5 |
| izu |
Na nmalite ọgwụgwọ ma ọ bụ ụbọchị atọ mbụ ka ọ gbasasịrị nnukwu ọrịa myocardial infarction na ndị ọrịa nwere SBP dị ala (120 mm Hg ma ọ bụ nke dị ala), a ga-edenye obere ọgwụ nke 2.5 mg. N'ihe banyere mbelata ọbara mgbali (SBP ≤100 mm Hg), kwa ụbọchị nke 5 mg nwere ike, ma ọ bụrụ na ọ dị mkpa, belata obere oge ruo 2.5 mg. N'ihe banyere mbelata ọbara mgbali elu ogologo oge (CAD mmHg karịa elekere 1), a ga-akwụsị ị treatmentụ ọgwụ.
Ọrịa mamịrị na-arịa ọrịa mamịrị. N'ime ndị ọrịa nwere ọrịa mellitus na-abụghị insulin, a na-eji 10 mg nke lisinopril otu ugboro n'ụbọchị. Ọ bụrụ na ọ dị mkpa, enwere ike ịbawanye dose ahụ gaa na 20 mg otu ugboro kwa ụbọchị iji mezuo ụkpụrụ DAD n'okpuru 75 mm Hg. nọdụ ọdụ.
N'ime ndị ọrịa nwere mellitus na-arịa ọrịa shuga - a na-eji otu usoro iji nweta ogo DAD n'okpuru 90 mm Hg. nọdụ ọdụ.
Emeputa
BELUPO, ọgwụ na ịchọ mma dd, Republic of Croatia. 48000, Koprivnitsa, St. Danica, 5.
Lọ ọrụ nnọchiteanya nke BELUPO, ọgwụ na ịchọ mma dd, Republic of Croatia na Russia (okwu maka mkpesa): 119330, Moscow, 38 Lomonosovsky Prospect, dabara. 71–72.
Tẹ.: (495) 933-72-13, faksị: (495) 933-72-15.
