Hartil Amlo: ntụziaka maka iji

Capsules 5 mg + 5 mg, ihe siri ike, gelatin, CONI-SNAP 3, enweghị mpempe akwụkwọ, na-emechi onwe ya, yana ntọala opaque na burgundy na mkpuchi opaque na burgundy light.

PRING crospovidone (E-1202), hypromellose (E-464), microcrystalline cellulose (E-460), glycerol dibehenate.

Ngwakọta nke Capsule CONI-SNAP 3: acha anụnụ anụnụ (E-133), acha ọbara ọbara (E-129), titanium dioxide (E-171), gelatin.

7 pcs - blisters mere nke PVC / Polyamide / Aluminom (4) - ngwugwu nke kaadiboodu.
7 pcs - blisters mere nke PVC / Polyamide / Aluminom (8) - ngwugwu nke kaadiboodu.
10 PC. - blisters mere nke PVC / Polyamide / Aluminom (3) - ngwugwu nke kaadiboodu.
10 PC. - blisters mere nke PVC / Polyamide / Aluminom (9) - ngwugwu nke kaadiboodu.

Omume ọgwụ

Usoro nke ihe ramipril

Ramiprilat, metabolite na-arụsi ọrụ ike nke ramipril prodrug, na-egbochi enzyme dipeptidyl carboxypeptidase I (okwu: angiotensin-enzyme converting, kininase II). Na plasma na anụ ahụ, enzyme a na - ejighari ntụgharị nke angiotensin nke m n'ime ihe vasoconstrictor na - arụ ọrụ - angiotensin II, na - enyekwa aka na nbibi nke ihe vasodilator na - arụ ọrụ - bradykinin. Mbelata nguzobe nke angiotensin II na igbochi mmebi nke bradykinin na-eduga na vasodilation.

Ebe ọ bụ na angiotensin nke abụọ na-akpalite mwepụta nke aldosterone, ramiprilat belatara nzuzo nke aldosterone. Nzaghachi ndị na-emetụta monotherapy na ACE inhibitor dị ntakịrị na ndị ọrịa ojii (Afro-Caribbean) nwere ọbara mgbali elu (ọnụ ọgụgụ ndị ọrịa nwere ọbara mgbali elu na, dịka iwu, nwere obere ọdịnaya renin) karịa na ndị ọrịa nwere ụcha akpụkpọ ahụ dị iche.

Ojiji nke ramipril na-agbadata ọnụ na-enweghị atụ na mgbochi ọgụ ike n'akụkụ akwara. Dịka iwu, ọgwụ a agbanweghị oke akwara ọbara ọbara na ọnụego nnweta. Ojiji nke ramipril na-enwe mmetụta dị larịị, ma na nguzo ọnọdụ onye ọrịa yana ọnọdụ ụgha, ọgwụ ahụ anaghịkwa akpata tachycardia akwụ ụgwọ.

Mgbe otu nchịkwa nke ramipril na-ekwu okwu, a na-ahụ na ọ na-ahụ ihe antihypertensive n'ime awa 1-2, na-erute mgbe awa 3-6 na-adịgide ruo awa 24. Site n'iji ramipril kwa ụbọchị, mmetụta antihypertensive ya na-eji nwayọọ nwayọọ na-abawanye n'ime izu 3-4 wee na-adịgide. site na ọgwụgwọ ogologo oge.

Nkagbu mberede nke ramipril esoghi mmụba nke ọbara mgbali ọsọ.

Usoro nke amlodipine

Amlodipine na-egbochi ike inweta kalsel na ihe ndị dị na cardiomyocytes na sel anụ ahụ na-eme ka akwara ike (nke a na-egbochi ma ọ bụrụ na a na-egbochi calcium ion antagonist).

Ofzọ nke mmetụta mbufụtara ya bụ n'ihi nsonaazụ zuru oke na akwara olu nke arịa ọbara, na -ebelata mbelata ogwe akwara na -akpata.

Nkọwa zuru ezu banyere sistemu nke ọ na-eme ka usoro angina pectoris bụrụ nke akwadobeghị, ma usoro a nwere ike ịrụ ọrụ ụzọ abụọ:

1) mmụba nke akwara arterioles, ma, yabụ, mbelata ngwekọta akwara na - agbasa (mgbe ebesịrị).

Ebe ọgwụ a anaghị eme ka reflex tachycardia reflex, ike ike nke myocardium na mkpa ya maka ọkọnọ oxygen ga-ebelata.

2) mmụba nke nnukwu akwara akwara akwara na akwara arterioles, ma na-agbanweghi agbanwe yana mpaghara mpaghara ischemic nke akwara obi, na-abawanye mgbasa nke oxygen n’ime myocardium.

Usoro a kọwara n’elu na-eme ka inye akwara oxygen myocardial ike na-agbanye ya n’arịa akwara ụbụrụ (angina ma ọ bụ Prinzmetal angina).

N'ime ndị ọrịa nwere ọbara mgbali elu, otu ọgwụ kwa ụbọchị amlodipine na-ebute mbelata nke ukwuu na mgbali ọbara n'ọtụtụ awa 24 (n'ọnọdụ “onye dina” na “ọnọdụ”) onye ọrịa. N'ihi ngosipụta nwayọ nke ihe ahụ na nsonaazụ ogologo oge, ọgwụ ahụ anaghị akpata hypotension.

N'ime ndị ọrịa nwere angina pectoris, otu mkpụrụ ọgwụ kwa ụbọchị na-abawanye nnabata mmega ahụ, na-egbu oge mmepe nke mwakpo angina pectoris na "ischemic" nke akụkụ ST, ma belata ugboro ugboro ọgụ angina na oriri nke nitroglycerin. Ọgwụ anaghị akpata mmetụta metabolic ọ bụla: ọ naghị emetụta plasma lipids, shuga ọbara na serum uric acid ma enwere ike inye ya ndị ọrịa nwere ashma.

Ọmụmụ Nche Ọrịa

Banyere ramipril:

Site na nchịkwa ọnụ nke ramipril ka akwara na nkịta, a chọpụtara na ọgwụ ahụ anaghị akpata oke egbu egbu na anụmanụ. Emere nnyocha site na iji ọgwụ ọnụ na-adịgide adịgide nke ọgwụ ahụ na oke, nkịta, na enwe. N'ime ụdị anụmanụ atọ niile, e depụtara mgbanwe na mkpokọta plasma electrolytes na mgbanwe na foto ọbara.

Dị ka ihe akaebe nke ọrụ ọgwụ ọgwụ ramipril, a hụrụ mmepe nke renal juxtaglomerular complex hypertrophy na nkịta na enwe na ọgwụ kwa ụbọchị nke 250 mg / kg / ụbọchị. Oke, nkịta, na enwe anabataghị usoro ọgwụ kwa ụbọchị nke 2, 2.5, na 8 mg / kg (ịdị arọ) / ụbọchị, n'otu n'otu, na-enweghị mmetụta ọjọọ.

Ihe omumu banyere ogwu ojoo ogwu ojoo na oke, oke bekee na anaghi ekpughe ihe omuma a nke ramipril. Ma ụmụ nwoke ma oke oke anaghị egosi mgbanwe ọmụmụ.

Mmeghe nke ramipril nye oke ụmụ nwanyị n’oge nwa ebu n’afọ na n’oge a na-enye nwa ara kwa 50 mg / n'arọ ibu (ma ọ bụ karịa) sochiri mmebi ahụ n’akwara nwa ebu n’afọ.

N'ime omumu ọmụmụ buru ibu site na iji ọtụtụ usoro nnwale, ọ nweghị ihe ịrịba ama nke mutagenicity ma ọ bụ mkpụrụ ndụ ihe ọkụ nke ramipril.

Na njikọ amlodipine:

Na oke na ụmụ oke na agbakwunye amlodipine maleate na mkpokọta ruo afọ abụọ na mkpokọta kwekọrọ na ọkwa dosing kwa ụbọchị nke 0,5, 1.25 na 2,5 mg nke amlodipine / n'arọ (ahụ dị arọ) / ụbọchị, ọ nweghị mmetụta ọrịa carcinogenic hụrụ. Ogwu kachasị elu na ụmụ oke (n'ihe dịka mg / m 2) dị ka nke a kacha atụ aro mmadụ (MHD) nke 10 mg amlodipine kwa ụbọchị. Oke kachasị na oke oke (n'ihe dịka mg / m 2) ruru ihe dị ka okpukpu abụọ karịa nke MPD.

N'ime usoro ọmụmụ nke amlodipine maleate, enweghị akara nke mutagenicity kpatara site na iji ọgwụ ahụ, ma na ọkwa mkpụrụ ndụ ma na ọkwa chromosomes.

Ọdịdị dịịrị oke nyere ọgwụ amlodipine nke ọnụ na-ewe ihe ruru 10 mg / kg (ịdị arọ) / ụbọchị (nke, na usoro mg / m 2, ji okpukpu 8 karịa nke MPD nke 10 mg / ụbọchị) adịghị arụ ọrụ.

Mkparịta ụka ọgwụ ọjọọ

Banyere ramipril:

Usoro extraracorporeal metụtara kọntaktị ọbara na ala ndị na-adịghị mma ebubo, dị ka hemodialysis site na membranes nke ukwuu (dịka membranes nke sitere na polyacrylonitrile compound), hemofiltration ma ọ bụ apheresis nke obere npoproteins dị ala site na iji dextran sulfate, n'ihi ohere dị ukwuu nke ịbawanye mgbochi anaphylactic ma ọ bụ anaphylaid. Ọ bụrụ na ụdị ọgwụgwọ ahụ dị mkpa, mgbe ahụ, a ga-atụle ojiji nke ụdị akpụkpọ ahụ dị iche iche maka dialysis ma ọ bụ ọgwụ antihypertensive nke otu dị iche.

Kpachara anya maka iji ya

Site na nhazi nke oge a na nkwado potassium, ihe nchekwa capi-echebe diuretics na ihe ndị ọzọ na-arụ ọrụ na-eme ka ọnụọgụ potassium na-abawanye (gụnyere ya na angiotensin II receptor antagonists, trimethoprim, tacrolimus, cyclosporine): mmepe nke hyperkalemia ga-ekwe omume, ya mere ọ dị mkpa iji nlezianya nyochaa ọkwa nke potassium na ọbara ọbara.

Ọgwụ antihypertensive (dịka ọmụmaatụ, diuretics) na ihe ndị ọzọ nwere ike belata ọbara mgbali (dịka ọmụmaatụ, nitrates, tricyclic antidepressants, painkillers, mmanya, baclofen, alfuzosin, doxazosin, prazosin, tamsulosin, terazosin): a nwere ike belata hypotension.

Vasopressor sympathomimetics na ihe ndị ọzọ (dịka ọmụmaatụ, isoproterenol, dobutamine, dopamine, adrenaline) nke nwere ike belata mmetụta antihypertensive nke ramipril: a na-atụ aro ka ịdebe ọbara mgbali elu.

Allopurinol, immunosuppressants, corticosteroids, procainamide, cytostatics na ọgwụ ndị ọzọ nwere ike ịgbanwe ọnụ ọgụgụ mkpụrụ ndụ ọbara: ohere dị elu nke mmeghachi omume hematological.

Ngwakọta nke lithium: ka ị na-ewere ọgwụ mgbochi lithium ACE na-egbochi ya, ọ nwere ike belata ntụpọ ya ma, n'ihi ya, na-abawanye mkpokọta nke lithium n'ọbara site na mmụba ya na-esochi ya. Ichoro nlezi anya nke ọkwa lithium.

Ndị ọrụ Antidiedi, gụnyere insulin: mmeghachi omume hypoglycemic nwere ike ịmalite. A na-atụ aro ka ịchịkwa ogo nke glucose dị n'ọbara.

Ọgwụ mgbochi mkpali na ọgwụ acethlsalicylic acid: mbelata mmetụta antihypertensive nke ramipril ga-ekwe omume. Na mgbakwunye, iji njikọta ACE na ihe mgbochi NSAID nwere ike ibute mmepe nke hyperkalemia ma bulie ohere nke ọrụ mgbazinye nsogbu.

Na njikọ amlodipine:

Ọgwụ ahụ ekwekọrịtara na ọgwụ thiazide diuretics, beta-blockers, nitrates na-agbatị ogologo oge, ụdị ọgwụ nitroglycerin, ọgwụ mgbochi na - abụghị steroidal, ọgwụ nje na ọgwụ hypoglycemic ọgwụ.

Nsonaazụ nke ọgwụ ndị ọzọ na amlodipine

- Ndị na - egbochi CYP3A4: mgbe ejiri ọgwụ mgbochi CYP3A4 mee ọgwụ ahụ, erythromycin n'ime ndị ọrịa na - eto eto na diltiazem na ndị ọrịa agadi, karị, plasma ịta nke amlodipine na - abawanye, n'otu n'otu, site na 22% na 50%. Agbanyeghị, ebumnuche banyere ọnọdụ a ka amabeghị. Enweghị ike ịwepụ ya na ndị na-egbochi CYP3A4 dị ike (dịka ọmụmaatụ, ketoconazole, itraconazole, ritonavir) nwere ike ịba ụba plasma nke amlodipine ka ukwuu karịa diltiazem. Ekwesịrị iji amlodipine jiri nlezianya mee ihe mgbe a na-ejikọ ya na ndị na-egbochi CYP3A4. Agbanyeghị, enwebeghị akụkọ banyere nsonaazụ ọ bụla metụtara njikọ a.

- Ndị na - eme CYP3A4: enweghị ihe akaebe banyere mmetụta ndị inducers CYP3A4 na amlodipine. Njikọ ọgwụ a na CYP3A4 inducers (dịka ọmụmaatụ, rifampicin ma ọ bụ St John's wort) nwere ike belata nsị plasma nke amlodipine. Ekwesịrị iji amlodipine kpachara anya mgbe ejiri ya na CUP3A4 inducers.

N'ime omumu ihe omumu banyere nmekorita ọgwụ, ijiri amlodipine na mmiri nkpuru osisi, cimetidine, aluminom / magnesium (antacids) na sildenafil emetutaghi ọgwụ pharmokokinetics nke amlodipine.

Nsonaazụ nke amlodipine na ọgwụ ndị ọzọ

Ihe jikọtara amlodipine na ndị ọzọ na - alụ ọgụ maka ọgwụ na - akwalite arụmọrụ ọgwụgwọ ha.

N'ime ọmụmụ ụlọ ọgwụ banyere mmekọrịta dị n'etiti ọgwụ, amlodipine emetụtaghị ọgwụ ọgwụ nke atorvastatin, digoxin, ethanol (ethanol), warfarin, ma ọ bụ cyclosporine.

Enweghị mmetụta amlodipine na mgbanwe nke nnwale ụlọ nyocha egosiwo.

Usoro usoro onunu ogwu

Usoro a na-atụ aro kwa ụbọchị bụ 1 capsule na ọgwụ enyere. A ga-akpọ Hartil daily Amlo kwa ụbọchị, n'otu oge n'ụbọchị, tupu nri ma ọ bụ mgbe nri ahụ gasịrị. Ekwesighi etipiapi ahihia ma ọ bụ ghọ ata.

Ọgwụ ọgwụ agwakọtara ọgwụ adịghị edozi maka adabaghị maka usoro ọgwụgwọ mbụ. Ọ bụrụ na ọ dị mkpa maka idozi usoro onunu ogwu, mgbe ahụ ekwesịrị ime ya naanị site na enyemaka nke ndị mmebe ego na naanị mgbe ịmalite ụdị ọgwụ zuru oke ka anyị ga-agbanye na ụdị ọgwụ ọhụrụ ahụ na oke ọgwụ ọgwụ Hartil cribed Amlo.

Ndị okenye: a na-atụ aro iji ọgwụ dọọ ndị ọrịa na-a drugụ ọgwụ ahụ ọgwụ, n'ihi na n'ime ndị ọrịa a, imebi nguzo mmiri-electrolyte nwere ike ime. Ọ dị mkpa ịmụ banyere ọrụ gbasara akụrụ ma chọpụta ọkwa nke potassium n'ime ọbara ọbara.

N'ime ndị ọrịa nwere ọrụ imeju na-egbu egbu, iwepụ amlodipine nwere ike ịgbatịkwu oge. Ekpebisila ike ikwu maka etu amlodipine sirila, mana ekwesịrị ịnye ndị ọrịa ọgwụ a oke oke oke. N'ime ndị ọrịa nwere ọrụ imeju na-adịghị mma, ọgwụgwọ ramipril kwesịrị ịmalite naanị n'okpuru nlekọta ahụike dị nso, yana oke kachasị kwa ụbọchị kwesịrị ịbụ 2.5 mg nke ramipril.

A na-atụ aro ka enye ndị Khartil ® Amlo ọgwụ naanị maka ndị ọrịa ahụ a kpọfere 2.5 mg nke ramipril dị ka ezigbo mmezi ahụ mgbe ị na-ahọrọ usoro nke ramipril.

Iji chọpụta ezigbo njikọta nke usoro mmalite na mmezi ya na ndị ọrịa nwere ọrụ mkpo ya, a ga-ahọpụta usoro ọgwụ iji aka ya wee chọpụta nha nke ramipril na amlodipine.

Ọ baghị uru idozi usoro nke amlodipine dị na ndị ọrịa nwere ọrụ mgbazinye nsogbu.

Amlodipine apụtaghị onwe ya n'oge a na-ahụ ya. Ọrịa kwesịrị ịgwọ ndị ọrịa ọrịa ọgwụ, amlodipine.

Kwa ụbọchị nke ramipril na ndị ọrịa na akụrụ odida ga-ike ibido iburu n'uche nwebi ikike.

- Ọ bụrụ na mwepụ creatinine bụ ml60 ml / min, mgbe ahụ usoro ọgwụgwọ mbụ ekwesighi idozigharị, oke kachasị kwa ụbọchị bụ 10 mg.

- Ọ bụrụ na nwechara njiri mara bụ lo Amlo, a na-atụ aro ka ọ jupụta naanị ma ọ bụrụ na onye ọrịa agbanweela ka usoro ọgwụ ramipril 2,5 mg ma ọ bụ 5 mg dị ka ọgwụ mmezi kachasị (guzobere n'oge domipril dosing). Ndị ọrịa na-anwale hemodialysis kwesịrị ị theụ ọgwụ ahụ ruo ọtụtụ awa mgbe ọ gbasịrị hemodialysis.

N'ime usoro ọgwụgwọ ya na ọgwụ ọgwụ Hartil ® Amlo, ike arụmọrụ akụrụ na ọdịnaya potassium na ọbara ọbara kwesịrị ịchịkwa. Ọ bụrụ n'ihe gbasara ọrụ akụrụngwa na-emebi emebi, a ga-akwụsị ịcontụ ọgwụ Hartil ® Amlo, etinyere ya ọgwụ ndị a na usoro onyonyo ọfụma.

Ndị ọrịa agadi nwere ike ịnwe ọgwụ amlodipine nkịtị, agbanyeghị, ekwesịrị ịkpachara anya iji mee ka ọgwụ a dịkwuo elu.

Usoro mbụ nke ramipril kwesịrị ịdị ala karịa ka ọ dị na mbụ, imeghari usoro ọgwụgwọ nke sochirinụ kwesịrị ịdị nro, n'ihi nnukwu ihe egwu nke nsonaazụ na-adịghị mma.

A naghị atụ aro ịhọpụta Hartil ® Amlo maka ndị ọrịa agadi na ndị adịghị ike.

A naghị atụ aro ịkọ ya Hartil ® Amlo maka ụmụaka na ndị nọ n’agbata afọ 18, ebe ọ bụ na ekpebibeghị nchekwa na ịdị mma nke ọgwụ n’ìgwè ndị ọrịa a.

Ihe ngosi maka ime di

Banyere ramipril

Agaghị akwado ihe ndị IPF inhibitors n'oge ọnwa atọ nke ịtụrụ ime, yana oge nke abụọ na nke atọ nke afọ ime, a na-egbochi mgbochi nke IPF inhibitors.

Ihe akaebe nke oria ojoo nke ihe egwu teratogenicity mgbe ekpughere ndị na - egbochi ACE n'oge ọnwa atọ nke afọ ime anaghị ekwenye ekwenye, mana ntakịrị mmụba n'ihe ize ndụ a enweghị ike ịkwụsị. Ọ bụrụ na ọ dị mkpa ka a gaa n'ihu iji ọgwụ ndị ACE / ARAT II na-egbochi ya, mgbe ahụ ndị ọrịa na-eme atụmatụ ịtụrụ ime kwesịrị ịgbanwe usoro ọgwụgwọ ha na usoro ọgwụgwọ ọzọ na-egbo mkpa nchekwa maka iji ya n'oge ime. Mgbe egosipụtara afọ ime, a ga-akwụsị ọgwụgwọ ya na ndị na - egbochi ACE ozugbo, ma ọ bụrụ na ọ dị mkpa, ekwesịrị ịmalite usoro ọgwụgwọ ọzọ.

Nkpughepu nye ndị na - egbochi ACE n’oge nke abụọ na nke atọ bụ ihe a na - akpata fetotoxicity n’etiti mmadụ (nzụlite akụrụ nke nwa ebu n’afọ, oligohydramnios, na - egbu oke mkpofu nke okpokoro isi) na nsonye obi na - egbu egbu (akwara na - akpata mkparị, hypotension, hyperkalemia). Ọ bụrụ na ikpughe nye ndị na-egbochi ACE na-eme n’oge ọnwa nke abụọ nke ime, a na-atụ aro ka ọ rụọ ọrụ nyocha nke akụrụ na mmepe nke ọkpụkpụ okpokoro isi. Ekwesịrị ileba anya ụmụ amụrụ ọhụrụ nke nne ya buru ihe ndị na - egbochi ACE maka mmepe nke hypotension, oliguria na hyperkalemia.

Na njikọ amlodipine

Emebeghi nchekwa nke amlodipine n'oge ime ụmụ nwanyị. Ihe omumu banyere oke omumu na oke gosiputara na enweghi ihe iri ama ma obu oria ma emegharia ya na oge ogologo oge, ya na onwa iri ise kariri mmadu. A na-atụ aro iji ọgwụ ahụ n'oge afọ ime naanị mgbe enweghị usoro ọzọ dị nchebe yana ọrịa ahụ butere nne na nwa ebu n'afọ nnukwu ihe.

Banyere ramipril

Ebe ọ bụ na enweghi ozi zuru ezu gbasara iji ramipril n'oge a na-a breastụ ara, a dịghị atụ aro iji ramipril n'oge a, ọ ka mma ịhọrọ usoro ọgwụgwọ ọzọ nwere profaịlụ nchekwa akọwapụtara karị mgbe ị na-enye nwa ara, ọkachasị mgbe ị na-enye ụmụ amụrụ ọhụrụ na ụmụ ọ ga-amụ amụ.

Na njikọ amlodipine

Enweghị data dị na oke nke amlodipine na mmiri ara. Ekwesịrị ime mkpebi nke ịnọgide na-a /ụ ara ma ọ bụ ka ọ kwụsị ịhapụ ịgwọ ọrịa ara na amlodipine na-elele uru ịfeụ nwa ga-abara nwa na uru amlodipine na-arụrụ nne ya.

Ntụziaka pụrụ iche

Banyere ramipril:

Otu Penti Pụrụ Iche

Ekwesighi ị inụ ihe mgbochi ACE n'oge afọ ime. Ọ bụrụ na ọ dị mkpa ịga n'ihu na iji ọgwụ ACE eme ihe, mgbe ahụ ndị ọrịa na-eme atụmatụ ịtụrụ ime kwesịrị ịgbanwe usoro ọgwụgwọ ka ọ bụrụ usoro ọgwụgwọ ọzọ, nke na-emezu ihe nchekwa nchekwa maka iji ya n'oge ime. Mgbe emere nkwenye nke afọ ime, a ga-akwụsị iji ọgwụ ndị na - egbochi ACE kwụsị ya, ọ bụrụ na ọ dị mkpa, ekwesịrị ịmalite usoro ọgwụgwọ ọzọ.

Ọrịa nwere ike dị elu nke hypotension:

- Ndị ọrịa nwere oke renin-angiotensin-aldosterone sistem:
ndị ọrịa nwere oke renin-angiotensin-aldosterone sistemụ nwere oke ihe egwu nke ọrịa ọgbụgba ọbara na ọrụ mkpịsị aka na-adịghị mma n'ihi mgbochi ACE, karịchaa mgbe etinyere ACE inhibitors ma ọ bụ concoitant diuretics maka oge mbụ ma ọ bụ bulie ọgwụ ha maka oge mbụ.

Ọ bụrụ na ngosipụta nke hyperactivation nke sistemụ renin-angiotensin-aldosterone yiri ka ọ ga-ekwe omume, mgbe ahụ, ọ bụrụ na ọ dị mkpa, hazie nlekọta ahụike, gụnyere nlegide ọbara mgbali:

- n'ime ndị ọrịa nwere nnukwu ọbara mgbali,

- n'ime ndị ọrịa nwere decompensated ọrịa obi ọrịa,

- n'ime ndị ọrịa nwere nnukwu ihe ngosipụta ma ọ bụ na - apụta site na aka ekpe ventricle (dịka ọmụmaatụ, stenosis nke aorta ma ọ bụ mitali valve),

- n'ime ndị ọrịa nwere obere akwara nke akwara akwara nwere akụrụngwa nke abụọ,

- n'ime ndị ọrịa nwere nsogbu ma ọ bụ ma ọ bụ kwe omume na mmiri elektrọnte (gụnyere ndị ọrịa na-a diụ ọgwụ).

- n'ime ndị ọrịa na - arịa ọrịa cirrhosis na / ma ọ bụ ascites,

- n'ime ndị ọrịa a wara ụdị ịwa ahụ dị mgbagwoju anya, ma ọ bụ nke na-agwọ ọgwụ ọgwụ na-akpata hypotension,

Na mkpokọta, a na-atụ aro ka akpachapụ akpịrị, hypovolemia, ma ọ bụ nnu nnu mezie tupu ọgwụgwọ (na ndị ọrịa nwere nkụchi obi, na agbanyeghị, a ga-eji nlezianya na uru niile nke usoro ndị dị otú ahụ dị, na-eburu n'uche ihe ize ndụ nke oke ibu).

- n'ime ndị ọrịa nwere obere oge ma ọ bụ nkụda obi na-adịgide adịgide mgbe MI gasịrị,

- n'ime ndị ọrịa nọ n'ihe ize ndụ nke ịmalite ịrịa ọrịa obi ma ọ bụ ischemia ma ọ bụ ọrịa hypotension.

Na mmalite ọgwụgwọ, a chọrọ nlekọta ahụike pụrụ iche.

A na-atụ aro ka ịkwụsị iji angiotensin-na-agbanwe enzyme inhibitors, dị ka ramipril, otu ụbọchị tupu ịwa ahụ, ma ọ bụrụ na ọ ga-ekwe omume.

Nyochaa akụrụ

Ekwesịrị ịtụle ọrụ ntaramahụhụ tupu yana n'oge ọgwụgwọ, a na-edozi usoro ị doụ ọgwụ ahụ si dị, karịsịa n'izu ndị mbụ nke ọgwụgwọ. Maka ndị ọrịa nwere ezughi oke gbasara akụrụ, ilebara anya nke ọma dị mkpa. E nwere ihe ọghọm nke ọrụ akụrụ na-arụ ọrụ, ọkachasị ndị ọrịa nwere nkụchi obi ma ọ bụ mgbe akụrụ gbasara akụrụ.

A na-akọpụta nrịgo angioedema na ndị ọrịa na-ewere ihe mgbochi ACE, gụnyere ramipril.

Ọ bụrụ na ọrịa angioedema mere, a ga-akwụsị ịkpọ Ramipril. A na - atụzi usoro nke usoro ọgwụgwọ ọrịa mberede ka ọ bụrụ ihe ọ bụla. Ekwesịrị ilebara onye ọrịa ahụ anya ma ọ dịkarịa ala awa iri na abụọ ruo iri abụọ na abụọ, iri atọ na atọ site na nchịkwa ya naanị mgbe mgbaàmà ahụ kwụsịchara

A kọrọ banyere ọrịa angioedema nke ọrịa afọ na ndị ọrịa na-ewere ndị na-egbochi ACE, gụnyere ramipril.

Ndị ọrịa a mere mkpesa maka mgbu afọ (yana ma ọ bụ enweghị ihe mgbaàmà nke ọgbụgbọ ma ọ bụ vomiting).

Ojiji nke ACE na-eme ka ohere nke anaphylactic na mmeghachi omume anaphylactoid (yana ogo ha) na nsị ahụhụ na ihe nfụkasị ndị ọzọ. Ruo mgbe enweghị nchegharị ga-ezu, ekwesịrị ịtụle iji kwụsịtụ ramipril nwa oge.

A hụrụ Hyperkalemia na ụfọdụ ndị ọrịa na-ewere ọgwụ mgbochi ACE, gụnyere ramipril. Ndi otu ndi oria nwere nsogbu nke hyperkalemia gunyere ndi oria nwere nsogbu gbasara akwara, ndi agadi (kari iri asaa n’abuo), ndi oria nwere oria di mellitus na anaghi ajuju, ma obu ndi oria na - a potassiumụ ihe ndi ozo. ọbara, yana ndị ọrịa nwere ọnọdụ dịka akpịrị ịkpọ nkụ, nkụchi obi na-adịghị ala ala, ma ọ bụ metabolic acidosis. Y’oburu na ewere ya n’otu oge eji ogwu eme ihe n’elu ekwesiri ekwesiri, ekwesiri ka nleba anya mgbe nile banyere onodu potassium n’etiti obara.

Enwetụbeghị akụkọ banyere ikpe nke neutropenia / agranulocytosis, thrombocytopenia na anaemia, yana ịda mbà n'obi. Maka nchọpụta izizi nke leukopenia, a na-atụ aro ijikwa ọnụ ọgụgụ leukocytes. A na-atụ aro ka enwekwu nleba anya na ọkwa mbụ nke ọgwụgwọ n'etiti ndị ọrịa nwere ọrụ gbasara akụrụma, yana ndị ọrịa nwere congenitant collagenoses (dịka ọmụmaatụ, lupus erythematosus ma ọ bụ scleroderma), yana na ndị ọrịa niile na-a drugsụ ọgwụ ndị ọzọ nwere ike ibute mgbanwe na foto ọbara.

Ndị na-egbochi ACE na-abawanye ọrịa angioedema na ndị ọrịa ojii ma e jiri ya tụnyere ndị ọrịa nwere agba akpụkpọ dị iche.

Dịka ndị ọzọ na - egbochi ACE, ramipril nwere ike ghara ịdị nfe na-ebelata ọbara mgbali na ndị ọrịa ojii ma e jiri ya tụnyere ndị ọrịa nwere agba dị iche. Ikekwe nke a bụ n'ihi oke ọbara ọgbụgba akwara na-enwe oke ala nke renin na ndị ọrịa ojii na-arịa ọbara mgbali elu.

Enwere akụkọ banyere ụkwara mgbe ị gacịrị ndị na-egbochi ACE. Otu njiri mara njiri ụkwara bụ akpọnwụ ya na nnọgidesi ike ya, yana mwepu nke ngosipụta ya mgbe ịkwụsị ọgwụgwọ. Ugboro site na ị takingụ ihe mgbochi ACE kwesịrị ịtụle dị ka akụkụ nke nchọpụta ọdịiche nke ụkwara.

Na njikọ amlodipine:

Achọpụtaghị nchekwa na arụmọrụ nke amlodipine na nsogbu ọbara ọgbụgba.

Jiri na ndị ọrịa nwere nkụda obi

Ekwesịrị iji ya kpachara anya na ndị ọrịa nwere nkụda obi. N'ime ọmụmụ ihe a na - achịkwa ogologo oge metụtara ndị ọrịa nwere nkụda mmụọ nke ukwuu (NYHA klas nke III na klas arụ ọrụ), edepụtara okwu gbasara ọrịa n’akwara umere, ihe kpatara nke ahụ dị elu na otu ahụ na amlodipine, ma e jiri ya tụnyere ìgwè placebo, mana nke a abụghị sochi obi obi daa.

Jiri na ndị ọrịa nwere ọrụ imeju na-arụ ọrụ

N'ime ndị ọrịa nwere ọrụ imeju na-arụ ọrụ, ọkara nke amlodipine na-agbatịkwu agbatị, enweghị ndụmọdụ ọ bụla maka ịgbanwe usoro onunu ogwu. Ndị ọrịa nọ n’òtù a kwesịrị iji nlezianya na-amlodipine.

Jiri ndị ọrịa agadi

Ndị ọrịa merela agadi kwesịrị iji nlezianya na-amlodipine.

Jiri na ndị ọrịa nwere ezigbo ọrụ gbasara akụrụngwa

Ndị ọrịa nwere nsogbu gbasara akụrụngwa nwere ike ịnwe amlodipine na usoro ịha ọ bụla. Mgbanwe nke mkpokọta plasma nke ndọta amlodipine adabaghị na ogo ọdịda akụrụ. Amlodipine apụtaghị onwe ya n'oge a na-ahụ ya.

N ’ikpu isi mkpuchi 5 mg / 5 mg na 10 mg / 5 mg na-acha ọbara ọbara (allura red AC-FD & C Red 40 E-129, na chasule shei 5 mg / 10 mg na 10 mg / 10 mg nwere azorubine (carmuazine) ( E-122) .Ihe ndia nwere ike ibute mmeghachi omume nfụkasị.

Mmetụta ikike ịkwọ ụgbọ ala na usoro nchịkwa

Effectsfọdụ nsonaazụ ndị ọzọ (dịka ọmụmaatụ, mgbaàmà nke mbelata ọbara mgbali, dị ka ọgbụgbọ) nwere ike imebi ikike onye ọrịa itinye uche na ịzaghachi ngwa ngwa, yabụ nwekwuo ihe ọghọm n'ọnọdụ ebe ikike ndị a dị mkpa (dịka ọmụmaatụ, mgbe ị na-anya ụgbọala ma ọ bụ na-eje ozi) igwe na usoro).

Karịsịa, nke a nwere ike ime na mmalite ọgwụgwọ ma ọ bụ mgbe ị na-edochi ọgwụ ndị ọzọ. Mgbe ị takingụchara ọgwụ mbụ ahụ ma ọ bụ nwee mmụba na-a subsequụ ya, a gaghị atụ aro ịkwọ ụgbọala ma ọ bụ jigide igwe na usoro ruo ọtụtụ awa.

Mlọ ọgwụ

Mgbu na nkesa

Mgbe nchịkwa ọnụ gasịrị, ramipril na-abanye ngwa ngwa na ngwara nri. C_max ramipril na plasma ruru n'ime elekere 1. N’ịbanye na mmamịrị mmamịrị, ọkwa nke iwere dịkarịa ala 56% anaghị esite na nri oriri. Bioavailability nke metabolite na-arụ ọrụ nke ramiprilat mgbe nchịkwa ọnụ nke 2.5 mg na 5 mg nke ramipril bụ 45%.

C_max ramiprilat, bụ naanị metabolite ọrụ nke ramipril, na-eru awa 2-4 mgbe ị nwesịrị ramipril. C_ss Ramiprilat plasma ịta ahụ eruola, odika, n’ụbọchị nke anọ nke ịra ramipril na usoro ọgwụgwọ. Ijikọ ramipril na protein protein dị ihe dịka 73%, ramiprilat dịkwa ihe dị ka 56%.

Metabolism na ntụpọ

Ramipril fọrọ nke nta ka ọ bụrụ ihe a na-ahụ anya na ramiprilat na diketopiperazinovy ​​ether, diketopiperazinovy ​​acid na ramipril na ramiprilat glucuronides. A na - eme ntụgharị nke metabolites tumadi site na akụrụ. A na-ebelata plasma nke ramiprilat na ọnọdụ polyphase. N'ihi nguzo ya na ACE na adịghị ike nke enzyme ahụ, ramiprilat gosipụtara usoro ikpeazụ nke iwepụ ogologo oge na ọgwụ ịba na plasma dị ala. Mgbe nchịkwa ramipril ugboro ugboro na otu usoro 1 oge /, T nke dị irè_1/2 ramiprilat bụ awa 13-17 (na ọgwụ nke 5-10 mg), na mgbe iwesachara ya ahụ ruo 1.25-2.5 mg T_1/2 toro ogologo. Ọdịiche a bụ n'ihi enzyme, nke jikọtara ramiprilat.

Mgbe otu ugboro ramipril, enweghị akara nke ramipril na metabolites ya na mmiri ara. Agbanyeghị, mịrị amị nke ramipril na mmiri ara ara na inye ọgwụ ọgwụ ugboro ugboro ka amabeghị.

Pharmacokinetics n'ihe gbasara ọrịa

Ramiprilat renal excretion na ndị ọrịa nwere arụ ọrụ ezumike, na mkpochapụ nke ramiprilat dabere na QC. Nke a na-ebute mmụba n'ọbara plasma nke ramiprilat, nke na-agbada nwayọ karịa ndị ọrịa nwere ọrụ ezumike nkịtị.

Na ndị ọrịa na- arụ ọrụ imeju, ntụgharị metabolism nke ramipril gaa ramiprilat na-adalata n'ihi mbelata nke ọrụ hepatic esterases, na ọkwa plasma nke ramipril na ndị ọrịa a na-abawanye. C_max ramiprilata n'ime ndị ọrịa a, Otú ọ dị, adịghị iche na ndị nọ na ndị ọrịa nwere ọrụ imeju nkịtị.

Mgbu na nkesa

Mgbe nchịkwa ọnụ gachara, amlodipine na-ewere nwayọ nwayọ site na nri diges. C_max A na-ahụkwa ya n'ọbara ka ọ gachara awa 6-12. Nri anaghị emetụta bioav adị nke amlodipine. Ezigbo bioavailability bụ 64-80%.

Ise_d mee 21 l / n'arọ nke aru. C_ss na plasma ọbara (5-15 ng / ml) na-enweta mgbe ụbọchị asaa gachara maka ọgwụ 7-8. Na nyocha nke vitro egosiwo na 93-99% nke amlodipine na-agbagharị n'ọbara dị na protein nke plasma.

Metabolism na ntụpọ

Amlodipine na-agbakọ ngwa ngwa (ihe dị ka 90%) na imeju iji mepụta metabolites na-adịghị arụ ọrụ.

Ihe dị ka 10% nke ihe amalite na 60% nke metabolites na-adịghị arụ ọrụ na-apụtakarị na mmamịrị, 20-25% na feces. Mbelata nke ịta plasma bụ biphasic. Iwepu ikpe azu T_1/2 site na plasma ọbara dị ihe dị ka awa iri atọ na ise ruo iri atọ na ise ka iri wee were oge 1 / Nwepu ya zuru oke bụ 7 ml / min / n'arọ (ya na ịdị arọ nke onye ọrịa dị ka 60 n'arọ - 25 l / h).

Pharmacokinetics n'ihe gbasara ọrịa

Aclọ ọgwụ ọgwụ amlodipine anaghị enwe nnukwu mgbanwe na ọdịda akụrụngwa yana afọ ndị ọrịa na-arịwanye elu.

Oge iru C_max amlodipine na plasma na ndị agadi na ndị ọrịa na-eto eto bụ otu. Na ndị ọrịa agadi mkpokọta amlodipine bụ 19 l / h. Mwepu amlodipine na-agbadakarị site na ịbawanye ụba AUC na T_1/2n'ime ndị ọrịa agadi.

AUC na T na-abawanye_1/2 na ndị ọrịa nwere ọrịa obi mgbada bụ otu ihe ahụ n'ebe ndị ọrịa agadi nọ.

Amlodipine nwere ọtụtụ metabolized iji mepụta metabolites na-adịghị arụ ọrụ. 10% nke ihe na-amalite amalite dị na mmamịrị. Mgbanwe nke plasma nke amlodipine enweghị njikọ na ogo gbasara akwara. Ndị ọrịa dị otú a nwere ike ị doụ ọgwụ amlodipine mgbe niile. Nchọpụta nke amlodipine enweghị arụ ọrụ.

Ndi_1/2 amlodipine dị na ndị ọrịa nwere arụ ọrụ imeju toro ogologo.

Ihe ngbanwe

akụkọ banyere ọrịa angioedema (ihe nketa, idiopathic, ma ọ bụ angioedema gara aga nke kpatara ACE inhibitors ma ọ bụ ndị na-anabata angiotensin II antagonist),

- extracorporeal ọgwụgwọ, soro na kọntaktị ọbara na-ebupụta n'ụzọ ndị na-adịghị mma,

- stenosis akpọ klaasị akwara azụ ma ọ bụ akwara akwara nke akụrụngwa na-arụ ọrụ,

- hypotension ma ọ bụ hemodynamically steetị steetị (ramipril ekwenyeghi ya),

- udiri nzuzu,

- ujo (tinyere cardiogenic),

- imechi arịa ọbara, na - egbochi ọbara ọgbụgba site na ventricle ekpe (dịka ọmụmaatụ, nnukwu ọgbụgba stitosis),

- akwara obi na-esighi ike mgbe oburu na myocardial infarction,

- Hypersensitivity na ramipril (ma ọ bụ ndị na-egbochi ACE), amlodipine, ọgwụ dihydropyridine, na / ma ọ bụ nke ọ bụla na ọgwụ ọgwụ.

Ime na lactation

Ihe ndekọ oria na - egosi ihe egwu nke teratogenicity mgbe ekpughere ndị na - egbochi ACE n'oge ọnwa atọ nke afọ ime anaghị ekwenye ekwenye, mana ntakịrị mmụba n'ihe ize ndụ a enweghị ike ịkwụsị.

Nkpughepu nye ndị na - egbochi ACE n'oge ọnwa nke abụọ na nke atọ nke afọ ime ka apụtara fetotoxicity na mmadụ (mmetọ nke akụrụ nke nwa ebu n’afọ, oligohydramnios, ossification of the skull) and aonatal toxicity (renal failure, hypotension, hyperkalemia). Ọ bụrụ na ikpughe nye ndị na-egbochi ACE na-eme n'oge ọnwa nke abụọ nke afọ ime, a na-atụ aro ka ọ rụọ ọrụ nyocha nke ọrụ akụrụ na mmepe nke ọkpụkpụ nke isi. Ekwesịrị ileba anya ụmụ amụrụ ọhụrụ nke nne ya buru ihe ndị na - egbochi ACE maka mmepe nke hypotension, oliguria na hyperkalemia.

Ebe ọ bụ na enweghi ozi ezughi oke banyere ojiji nke ramipril na amlodipine n'oge a na-enye nwa ara, a na - egbochi ojiji ha n'oge a, ọ ka mma ịhọrọ usoro ọgwụgwọ ọzọ na profaịlụ nchekwa akọwapụtara akọwapụtara, karịsịa n'oge a na-enye nwa ara.

Usoro onunu ogwu na nhazi

Ekwesịrị ị Theụ ọgwụ a oke dị ka dọkịta si kwuo.

A ga-akpọ Hartil ® Amlo n'otu oge nke ụbọchị, kwa ụbọchị n'oge ọgwụgwọ, ma tupu nri ma mgbe nri gasịrị. Azọpia ya ma ọ bụ tazu ahihia.

Usoro a na-atụ aro kwa ụbọchị bụ 1 capsule nke ụfọdụ usoro onunu ogwu.

Ngwakọta ngwakọta na usoro ọgwụgwọ ụfọdụ adịghị adabara ọkwa ọgwụgwọ mbụ.

Ọ bụrụ na ọ dị mkpa maka ịmegharị dose, a ga-agbanwe ọgwụ nke Hartil ® Amlo ma ọ bụ na enwere ike ịgbanwegharị usoro nke otu na ngwakọta ha n'efu.

A na-atụ aro ka iji ọgwụ kpachara ọgwụ ahụ. ndị ọrịa na-a diụ mkpụrụ ọgwụ, ebe ọ bụ na n'ime ndị ọrịa a imebi nguzo mmiri-electrolyte nwere ike ime. Ọ dị mkpa ịmụ banyere ọrụ gbasara akụrụ ma chọpụta ọkwa nke potassium n'ime ọbara ọbara.

Jiri na ndị ọrịa nwere ọrụ imeju

N'ime ndị ọrịa nwere ọrụ imeju adịghị mma, ọgwụgwọ ramipril ekwesịrị ịmalite ya n'okpuru nlekọta ahụike dị nso, yana oke ọgwụ kwa ụbọchị nke 2.5 mg ramipril.

A na-atụ aro mbadamba ihe Hartil ® Amlo nwere 2.5 mg ramipril + 2.5 mg amlodipine maka ndị ọrịa ebugharị na 2,5 mg nke ramipril, dị ka oke mmezi kachasị mma mgbe ị na-ahọrọ usoro nke ramipril.

N'ihe banyere ọrịa imeju, mkpochapu oge amlodipine nwere ike ịba ụba. Enweghị ndụmọdụ ọ bụla maka dosing banyere amlodipine, yabụ, ekwesịrị iji ọgwụ nke ndị ọrịa ahụ wee kpachara anya.

Jiri na ndị ọrịa nwere ọrụ ezughi oke ọrụ

Iji kọwaa nchikota kachasị mma nke usoro mbụ na mmezi ya na ndị ọrịa nwere ọrụ mkpo ya, a na-ahọpụta usoro ọgwụ site n'otu n'otu na-ekpebi usoro nke ramipril na amlodipine.

Kwa ụbọchị ramipril n'ebe ndị ọrịa nwere nsogbu gbasara akụrụ, ekwesịrị idobe ya na-eburu n'uche QC:

- n'ime ndị ọrịa nwere CC ≥ 60 ml / min, a naghị achọ mgbazi nke izizi, ọgwụ kachasị kwa ụbọchị bụ 10 mg,

- n'ime ndị ọrịa nwere KK ® Amlo, a na-atụ aro ka ọ jupụta naanị ma ọ bụrụ na ebugharị onye ọrịa ahụ na usoro ramipril dosing nke 2.5 mg ma ọ bụ 5 mg dị ka ọgwụ mmezi kachasị (guzobere n'oge domi raril). Ndị ọrịa na-anwale hemodialysis kwesịrị ị theụ ọgwụ ahụ ruo ọtụtụ awa mgbe ọ gbasịrị hemodialysis.

Onweghi mmezi usoro onunu ogwu achoro amlodipine ndị ọrịa nwere ọrụ ezughi oke ọrụ.

Amlodipine apụtaghị onwe ya n'oge a na-ahụ ya. Ọrịa kwesịrị ịgwọ ndị ọrịa ọrịa ọgwụ, amlodipine.

N'oge ọgwụgwọ nke Hartil ® Amlo, achọrọ ike nke akụrụ na ike ọdịnaya nke ọbara n'ọbara. Ọ bụrụ n'ihe gbasara ọrụ akụrụngwa na-emebi emebi, a ga-akwụsị ịcontụ ọgwụ Hartil ® Amlo, etinyere ya ọgwụ ndị a na usoro onyonyo ọfụma.

Jiri na ndị ọrịa agadi

Ọbara mbụ nke ramipril kwesịrị ịdị ala karịa ka ọ dị na mbụ, imeghari usoro ọgwụgwọ nke sochirinụ ga-adịwanye ala, n'ihi nnukwu ihe egwu dị na nsonaazụ ya. A naghị atụ aro ịhọpụta Hartil ® Amlo maka ndị ọrịa agadi na ndị adịghị ike.

Ndị ọrịa agadi nwere ike ịnwe ọgwụ amlodipine nkịtị, agbanyeghị, ekwesịrị ịkpachara anya iji mee ka ọgwụ a dịkwuo elu.

Jiri na ụmụaka na ndị ntorobịa erubeghị afọ 18

Achọpụtaghị ya ịkọwa Hartil ® Amlo maka ụmụaka na ndị ntorobịa na-erubeghị afọ 18, ebe ọ bụ na e guzobebeghị nchekwa na ịdị mma nke ọgwụ na otu ndị ọrịa a.

Dodoụbiga ya ókè

Ọrịa dabere na ogo nke ịdoụbiga mmanya ókè, oke ịba ọcha n'anya (ya na hypotension na foto ujo), bradycardia, elektrọnte elektrik, na ọdịda akụrụ nwere ike ime.

Ọgwụgwọ: Ekwesịrị inyocha ọnọdụ onye ọrịa ahụ oge niile, yana usoro ọgwụgwọ edepụtara kwesịrị ịbụ ihe mgbaàmà ma kwado ya. Ihe ndi eweputara bu ntinye mmiri (gastric lavage, adsorbent intine) na usoro iji weghachite nkwụsi ike nke onodu hemodynamic, tinyere ọrụ alfa₁-adrenomimetik ma ọ bụ angiotensin II (angiotensinamide). Ramiprilat bụ nke ọrịa akụrụngwa na-ewepụ ọbara nke ọma. N'ihe banyere hypotension ụlọ ọgwụ kpatara oke amlodipine, a ga-enye onye ọrịa ọnọdụ dị obosara yana ụkwụ dị elu ma were usoro dị mma iji lekọta ọrụ usoro obi, gụnyere ileba anya na ọrụ nke obi na iku ume iku ume, BCC yana oke mmamịrị ahụ. Na enweghị contraindications, ọ ga-ekwe omume iji (jiri nlezianya) vasoconstrictors weghachite ụda vaskụla na ọbara mgbali. Na / na ntinye nke glucose glucose nwere ike ịdị irè na iwepu ihe mgbochi nke ọwa calcium. N'ọnọdụ ụfọdụ, lavage gastric nwere ike inyere gị aka. N'ime ọmụmụ metụtara ndị ọrụ afọ ofufo siri ike, egosiri na ojiji nke carbon na-arụ ọrụ n'ime awa 2 mgbe ị takingụchara ọgwụ 10 amlodipine belatara mmịpụta ya. Ebe ọ bụ na amlodipine nwere njikọ chiri anya, protein na-adịghị ala ala adịghị arụ ọrụ.

Mmekọrịta na ọgwụ ndị ọzọ

Hartil ® Amlo ekwesịghị ịgụnye ya na usoro extracorporeal metụtara ọbara metụtara ihe ndị ọzọ na-adịghị mma, dị ka hemodialysis site na membranes nke ukwuu (dịka ọmụmaatụ, membranes mere site na polyacrylonitrile ogige), hemofiltration ma ọ bụ apheresis nke lipoproteins dị ala site na iji dextran sulfate, n'ihi ụba abawanye. ihe egwu nke ịba n’ihu anaphylactic ma ọ bụ mmeghachi omume anaphylactoid. Ọ bụrụ na ụdị ọgwụgwọ ahụ dị mkpa, mgbe ahụ, a ga-atụle ojiji nke ụdị akpụkpọ ahụ dị iche iche maka dialysis ma ọ bụ ọgwụ antihypertensive nke otu dị iche.

Site na nchịkwa nke imekotaotu oge na nhazi nke potassium, ihe ndị na - eme ka potassium na ihe ndị ọzọ na - arụ ọrụ na - eme ka ọnụọgụ potassium na - abawanye (gụnyere ya na angiotensin II receptor antagonists, trimethoprim, tacrolimus, cyclosporine), hyperkalemia nwere ike ịmalite, ya mere, ọ dị mkpa iji nlezianya nyochaa ọkwa nke potassium potassium.

Mgbe ejiri ọgwụ antihypertensive (dịka ọmụmaatụ, diuretics) na ihe ndị ọzọ nwere ike ibelata ọbara mgbali (dịka ọmụmaatụ, nitrates, tricyclic antidepressants, analgesics, ethanol, baclofen, alfuzosin, doxazosin, prazosin, tamsulosin, n'ihe ize ndụ terazosin), ọ ga-ekwe omume.

Site na nchịkwa nke oge a na vasopressor sympathomimetics na ọgwụ ndị ọzọ (dịka ọmụmaatụ, isoproterenol, dobutamine, dopamine, adrenaline), mmetụta antihypertensive nke ramipril nwere ike ibelata, ya mere, a na-atụ aro maka nlebara ọbara mgbali elu.

Site na nchịkwa nke oge a na allopurinol, immunosuppressants, corticosteroids, procainamide, cytostatics na ọgwụ ndị ọzọ nwere ike ịgbanwe ọnụ ọgụgụ ọbara, ohere nke ịmalite ịmịnye mmeghachi omume ọbara.

Site n'otu oge nke ACE inhibitors na egbochi lithium, ọ ga-ekwe omume ibelata ntụgharị uche ya, ma, yabụ, nwekwuo oriri nke lithium n'ọbara yana mmụba na-esochi nsí ya. Ichoro nlezi anya nke ọkwa lithium.

Mgbe na-ewere ya na ihe ndị na - egbochi ọgwụ mgbochi (gụnyere insulin) nwere ike ịmalite mmeghachi omume hypoglycemic. A na-atụ aro ka ịchịkwa ogo nke glucose dị n'ọbara.

Mgbe na-na Ndị NSAID (gụnyere acetylsalicylic acid) nwere ike ibelata mmetụta antihypertensive nke ramipril. Na mgbakwunye, iji njikọta ACE na ihe mgbochi NSAID nwere ike ibute mmepe nke hyperkalemia ma bulie ohere nke ọrụ mgbazinye nsogbu.

Ọgwụ ahụ ekwekọrịtara na ọgwụ thiazide diuretics, beta-blockers, nitrates nyaka-oge, ụdị ọgwụ nitroglycerin, NSAIDs, ọgwụ mgbochi, na ọgwụ hypoglycemic ọgwụ.

Mgbe ị na-a theụ ọgwụ ahụ na onye CYP3A4 inhibitor erythromycin n'ime ndị ọrịa na-eto eto na diltiazem n'ime ndị ọrịa agadi, karị, ọkwa nke amlodipine na-abawanye site na 22% na 50%, n'otu n'otu. Agbanyeghị, ebumnuche banyere ọnọdụ a ka amabeghị. Enweghị ike ịwepụ ya na ndị na-egbochi CYP3A4 dị ike (dịka ọmụmaatụ, ketoconazole, itraconazole, ritonavir) nwere ike ịba ụba plasma nke amlodipine ka ukwuu karịa diltiazem. Ekwesịrị iji amlodipine jiri nlezianya mee ihe mgbe a na-ejikọ ya na ndị na-egbochi CYP3A4. Agbanyeghị, enwebeghị akụkọ banyere nsonaazụ ọ bụla metụtara njikọ a.

Inductor CYP3A4: data na mmetụta nke inducers CYP3A4 na amlodipine adịghị. Njikọ ọgwụ a na CYP3A4 inducers (dịka ọmụmaatụ, rifampicin ma ọ bụ St John's wort perforated) nwere ike belata nsị plasma nke amlodipine. Ekwesịrị iji amlodipine kpachara anya mgbe ejiri ya na CUP3A4 inducers.

N'ime ọmụmụ ụlọ ọgwụ banyere mmekọrịta dị n'etiti ọgwụ ọgwụ, ojiji nke oge amlodipine na mmiri mkpụrụ osisi grapefine, cimetidine, aluminom / magnesium (antacids) na sildenafil emetụtaghị ọgwụ ọgwụ nke amlodipine.

Ojiji nke amlodipine na ndị ọzọ na - eme ihe mgbochi na - akwalite arụmọrụ ọgwụgwọ ha.

N'ime nyocha ụlọ ọgwụ gbasara mmekọrịta dị n'etiti ọgwụ ọgwụ, amlodipine emetụtaghị ọgwụ ọgwụ nke anatin, digoxin, ethanol (ethanol), warfarin, ma ọ bụ cyclosporine.

Egobeghi ihe amlodipine na ngbanwe nke ule ụlọ nyocha.

Mwepụta wepụtara ya na ihe mejupụtara

Hartil ọgwụ ahụ dị n'ụdị mbadamba nkume maka nchịkwa ọnụ nke oroma dị mma, oval, ewepụghị. Makọtara mbadamba na blisters nke 7 iberibe (1-4) na kaadiboodu, ntuziaka zuru ezu na nkọwa nwere njikọ na ọgwụ ahụ.

Mbadamba ụrọ nke ọ bụla nwere 5 mg ma ọ bụ 10 mg nke Ramipril na-arụ ọrụ, yana ọtụtụ ihe inyeaka, gụnyere lactose monohydrate.

N'agbanyeghị arụpụta mbadamba nkume 2.5 mg + 12.5 mg, 5 mg + 25 mg Hartil D na diuretic hydrochlorothiazide. Ihe mejupụtara ya gụnyere ramipril, hydrochlorothiazide na excipients (Hartil D).

Weputara udi ya na ihe mebere ya

Ọgwụ dị n'ụdị gelatin capsules nke 5 mg na 10 mg nke ihe ndị na-arụ ọrụ ike. Ihe na-arụ ọrụ bụ ramipril (Ramiprilum). Nke a bụ chemical kemịkalụ nke na-acha ọcha ntụ ntụ soluble na ihe ndozi na ihe mgbaze organic. Ndị ọkachamara - amlodipine, microcellulose, crospovidone, hypromellose.

Ihe ngosi maka ojiji

Capsules nwere ụdị ọrụ dị iche iche nke ramipril ma dozie ha dịka ihe ngosi ndị a:

• ọbara mgbali ọbara - ọnọdụ ọbara mgbali elu na-adịghị ala ala,
• proralta ikuku
• nke a na-eji oke ịba ọcha n'anya mee ka ọnọdụ ahụ belata,
• nkụchi obi, nke na arụ ọrụ nke ahụ dum na - agbagha n'ihi oke obubata ọbara na okirikiri oxygen nke akụkụ ahụ na sistem,
• angina pectoris, ischemia,
• N'ihi nsị nke myocardial, iji gbochie mwakpo nke abụọ ma belata ibu ahụ na akwara obi,
• mgbochi nke ọrịa strok na akwara obi.

Ọkpụkpụ afọ

Stomatitis, ọgbụgbọ, vomiting, obi mgbawa, pancreatitis, edema afọ, afọ ọsịsa, mgbu na eriri afọ na pancreas, belatara agụụ.

Site na eriri afọ, Hartil nwere ike ibute ọgbụgbọ.

Mmetụta ikike ịchịkwa usoro

Ọgwụ nwere ike imetụta sistemụ etiti, na-akpata ụra, belata ịta. N'akụkụ a, ị ga-ahapụ ọrụ na akụrụngwa akpaka ma ọ bụ na-anya ụgbọala.

Hartil Amlo nwere ike imetụta ike gị ịnya ụgbọ.

Jiri n'oge ime na lactation

N’ime usoro nke abụọ na nke III, amachie ọgwụ a. N'ime oge ọkara nke mbụ, ịnwere ike iji Hartil naanị ma enwere ọnọdụ mberede. Mgbe ị na-agwọ ọrịa n'oge a na-enye nwa ara, a na-atụ aro ka ọ gbanwee gaa na nri anụ.

Maka ụmụaka gbara afọ 15, ị prohibitedụ ọgwụ a ka amachibidoro, ebe ọ bụ na emebeghị nnyocha.

Mmekọrịta na ọgwụ ndị ọzọ

Site na nchịkwa nke oge a na diuretics na ọgwụ ndị ọzọ na-arịa hypertensive, mbelata ọbara mgbali elu ga-ekwe omume.

Ọ bụrụ na ijikọ ọgwụ ndị na - egbochi ọgwụ mgbochi na - abụghị steroidal anti-inflammatory ọgwụ, a na - ebelata nsonaazụ ya, ma ọ fọdụkwa na - agaghị enweta uru ọ bụla na ọgwụ ahụ.

Mgbe ị na-a drugsụ ọgwụ ndị nwere lithium na Hartil, itinye uche nke lithium na ọbara na-abawanye.

A naghị akwado ya ka iji ya na ngwaahịa nwere potassium na ihe mejupụtara ka ọ ghara ịgafe ọkwa nke potassium ahụ.

Ọ bụrụ na n'ihi ihe ụfọdụ enweghị ike ịhapụ capsules, ị nwere ike dochie ha na ọgwụ Hungarian, American ma ọ bụ ọgwụ Russia nke nwere otu mmetụta:

• dabere na ramipril na amlodipine: capsules Bi-Ramag, Sumilar, Tritace-A,
• dabere na amlodipine na lisinopril: Mbadamba Amapil-L, Amlipin, Equator,
• dabere na perindopril: Amlessa, Bi-Prestarium, Viacoram,
• dabere na lercanidipine na enalapril: Cori Loose, Lerkamen, Enap L Combi.

Ihe atụ nke ọgwụ Harty Amlo bụ Amlessa. Ihe atụ nke ọgwụ Hartil Amlo bụ Coripren.Ihe atụ nke ọgwụ Hartil Amlo bụ Lerkamen.

Ndị ọkachamara anaghị atụ aro ịgbanwe ọgwụ ndị ahụ n'onwe ha, ka ha ghara imerụ ahụike. Tupu i dochie ya, ọ dị mkpa ịga hụ dọkịta.

Ndi Okacha Cardio

Alexander Ivanovich, Moscow

Ọgwụ bụ otu n'ime ụzọ kachasị dị irè maka ọgwụgwọ na mgbochi nke ọrịa obi na mweghachi ọbara mgbali elu. Ọ bụrụ na enweghi contraindications, ana m ede ya oge niile iji gbochie infarction myocardial ugboro ugboro.

Ntụziaka maka iji Hartil-Amlo Kedu ọgwụ maka nrụgide kachasị mma

Tamara Nikolaevna, afọ 70, Krasnodar

Mụ na di m na-arịa ọrịa obi. Ruo ọtụtụ afọ, anyị anọwo na-a drinkingụ ihe omume Hartil ugboro abụọ n'afọ. Ọgwụ dị irè, anaghị akpata nsonaazụ, na-ebelata ọbara mgbali ngwa ngwa, belata isi ọwụwa, ọzịza. Obi na-arụ ọrụ n’akwụsịghị akwụsị, ọ dị anyị ka ọ dị afọ iri abụọ.

Ọgwụ Hartil

A na-ewere ya ọnụ n’etinyeghị ọnụ, a washedụrụ ya nnukwu mmiri mmiri (ihe dịka iko 1), n’agbanyeghi oge nri.

Ekwesịrị ịhazi usoro onunu ogwu a maka onye ọrịa ọ bụla iche iche, na-eburu n'uche ọgwụgwọ na ndidi. Mbadamba nwere ike ikewa nkera abụọ, gbarie n'ihe ize ndụ.

• Ọrịa obi na-adịghị ala ala. Usoro akwadoro ịmalite bụ 1.25 mg otu ugboro kwa ụbọchị (1/2 mbadamba nke Hartil 2.5 mg kwa ụbọchị). Dabere na ọgwụgwọ ọgwụgwọ, enwere ike ịbawanye dose ahụ site na ị na-agbagha ugboro ole kwa ụbọchị kwa izu 2-3 ọ bụla. Ọ bụrụ na ịchọrọ ị thanụ ihe karịrị 2.5 mg nke ọgwụ, enwere ike ị doseụ ọgwụ a ozugbo ma ọ bụ ekewa abụọ. Maximumbọchị a na-agbaso kwa ụbọchị ekwesịghị ịkarị 10 mg.
• Ọbara ọbara. Usoro akwadoro ịmalite bụ 2.5 mg otu ugboro kwa ụbọchị (1 mbadamba Hartil 2.5 mg kwa ụbọchị). Dabere na ọgwụgwọ ọgwụgwọ, enwere ike ịbawanye dose ahụ site na ị na-agbagha ugboro ole kwa ụbọchị kwa izu 2-3 ọ bụla. Ọgwụ mmezi a na-eme bụ 2.5-5 mg kwa ụbọchị (1 mbadamba ihe Hartil 2.5 mg ma ọ bụ mbadamba 1 nke 5 mg). Maximumbọchị a na-agbaso kwa ụbọchị ekwesịghị ịkarị 10 mg.
• Mgbochi nke ịrịa ọrịa myocardial, ọrịa strok, ma ọ bụ ọnwụ site na nkwarụ obi. Usoro akwadoro ịmalite bụ 2.5 mg otu ugboro kwa ụbọchị. Dabere na ntachi obi nke ọgwụ ahụ, mgbe izu ụka 1 gasịrị, nchịkwa kwesịrị ka okpukpu abụọ karịa nke mbụ. O kwesiri igba okpukpu a ka okpukpu abuo mgbe ochichi izu ato gachara. Ọgwụ a na-akwadoro bụ 10 mg otu ugboro kwa ụbọchị.
• Ọrịa mamịrị na-arịa ọrịa mamịrị ma ọ bụ ọrịa mamịrị. Ọgwụ akwadoro ka akwadoro bụ 1.25 mg otu ugboro kwa ụbọchị (1/2 mbadamba Hartil 2.5 mg kwa ụbọchị). Dabere na ọgwụgwọ ọgwụgwọ, enwere ike ịbawanye dose ahụ site na ị na-agbagha ugboro ole kwa ụbọchị kwa izu 2-3 ọ bụla. Ọ bụrụ na ịchọrọ ị thanụ ihe karịrị 2.5 mg nke ọgwụ, enwere ike ị doseụ ọgwụ a ozugbo ma ọ bụ ekewa abụọ. Ọgwụ kachasị akwadoro kwa ụbọchị bụ 5 mg.
• Ọgwụgwọ mgbe infarction myocardial. Ọ na-atụ aro ka ịmalite ị theụ ọgwụ ahụ n’ụbọchị nke 3-nke 10 mgbe nnukwu ọgbụgba myocardial infarction. Usoro akwadoro nke mbụ akwadoro, dabere n'ọnọdụ onye ọrịa yana oge gafechara na nnukwu myocardial infarction, bụ 2.5 mg ugboro abụọ kwa ụbọchị (1 mbadamba ihe Hartil 2.5 mg ugboro abụọ n'ụbọchị). Dabere na ọgwụgwọ ọgwụgwọ, enwere ike ịgbatị okpukpu abụọ ruo 5 mg (mbadamba abụọ nke Hartil 2.5 mg ma ọ bụ mbadamba 1 nke Hartil 5 mg) ugboro 2 n'ụbọchị. Maximumbọchị a na-agbaso kwa ụbọchị ekwesịghị ịkarị 10 mg. Na anabataghị ọgwụ ahụ, ekwesịrị ibelata dose ahụ.

Ndị otu ọrịa pụrụ iche

Ndị okenye na-arịa ọrịa. Ojiji nke ramipril na ndị agadi agadi na-a diụ diuretics na / ma ọ bụ na nkụchi obi, yana imeju ma ọ bụ ọrụ akụrụ, chọrọ nlebara anya pụrụ iche. Usoro onunu ogwu aghaghi ibido n’otu n’otu n’eseputa usoro ogwu ihe dabere n’emeghachi omume nye ogwu.

Ọrụ imeju na-arụ ọrụ. N'ihe banyere ọrụ imeju na-arịa ya, belata ma ọ bụ nwekwuo mmetụta na ị Hartụ ọgwụ Hartil nwere ike ịchekwa oge mgbe niile, yabụ, na mmalite nke ọgwụgwọ, ndị ọrịa nwere nsogbu imeju na-achọ nlekọta nlekọta ahụike. Oke kachasị kwa ụbọchị na ụdị ndị ahụ agaghị agafe 2.5 mg.

N'ime ndị ọrịa na-anata ọgwụgwọ ọrịa diuretic, n'ihi ihe ọghọm nke mbelata ọbara mgbali elu, enwere ike ịtụle ohere nke ịbelata nwa oge ma ọ bụ opekata mpe ka ọnụọgụ nke ọnya dịkarịa ala ụbọchị 2-3 (ma ọ bụ ogologo oge, dabere na oge nke ihe nke diuretics) tupu ị takingụ ọgwụ ahụ. Hartil. Maka ndị ọrịa na mbụ agwọ ọrịa diuretics, oge mbụ usoro ọgwụgwọ bụ 1.25 mg.

Nsonaazụ

Nyocha ahụike nke Hartil na-ahụ ma enwere ike ọghọm ya. Ndepụta ha buru oke ibu ma choro ihe omimi zuru oke. A na-atụ aro ka ịmara mmetụta ndị kachasị emetụta tupu ị takingụọ ọgwụ:

• urticaria, itching, akpukpo ahu, conjunctivitis,
• afọ, agụụ, afọ ntachi / afọ ọsịsa, pancreatitis, akpịrị ịkpọ nkụ, ọgbụgbọ,
• mbufụt, ọbara mgbali, alopecia, sweating,
• hyperkalemia, hypercreatininemia, ịba ụba nke ọrụ hepatic transaminases na ọkwa urea nitrogen, hyponatremia,
• thrombocytopenia, anaemia, obere hematocrit na oke ịba ọcha n'anya, thrombocytopenia, neutropenia, leukocytopenia, agranulocytosis, hemolytic anaemia, pancytopenia,
• adịghị ike, isi ọwụwa, iro ụra, ahụ erughị ala, oke ụjọ, ọgba aghara ọnọdụ, nchekasị, spasm muscle, ọgba aghara na nghọta (isi, ịnụ ihe, ụtọ, ọhụụ) na mgbagha vestibular,
• ụba proteinuria, ọdịda akụrụ, mbelata libido, belata mmamịrị na-abawanye,
• orthostatic hypotension, mbelata ọbara mgbali. N'ọnọdụ ndị a na - adịghị ahụkebe - arrhythmia, ọdịdị nke nsogbu nke akụkụ ahụ, ischemia myocardial na ụbụrụ,
• mkpụmkpụ ume, bronchospasm, rhinorrhea, sinusitis, rhinitis, bronchitis, akọrọ ụkwara.

Ojiji Hartil n’oge ime nwere ike ibute nsonaazụ n’akuku nwa ebu n’afọ: mmebi dị iche iche nke mmepe na arụ ọrụ nke akụrụ, mbelata ọbara mgbali n’ime nwatakịrị, hypoplasia nke ngụgụ na okpokoro isi, nsị nke aka na ụkwụ, na imebi okpokoro isi.

Usoro ezumike na ọnụahịa

Ọnụ ego nke Hartil (mbadamba 5 mg, mbadamba 28) na Moscow bụ 400 rubles. A na-enye ọgwụ ọgwụ n'ụlọ ọgwụ.

Temperaturedị nchekwa kachasị mma nke ọgwụ ahụ bụ ogo 25. Ndụ nchekwa nke mbadamba nkume ahụ ka egosiri na ngwugwu ahụ yana afọ 4 site na ụbọchị emepụtara. Hartil na-atụ aro ka iji mbadamba ihe ka echekwaa n’ebe ụmụaka agaghị enweta ya, na-anabataghị ìhè anyanwụ.

Ngwakọta na ụdị ntọhapụ

Hartil dị n'ụdị mbadamba. A gwakọ ọgwụ a na blisters maka mbadamba 7. Mpempe kaadiboodu nwere ike ịnwe nkeji iri na anọ na iri abụọ na asaa.

Ihe na-arụ ọrụ bụ ramipril.

Mbadamba ụrọ 1,25 mg, 2,5 mg, 5 mg na 10 mg (Hartil).

Mbadamba mbadamba 5: pink dị ọcha na oroma, oval, dị larịị nke nwere ahịrị, chamfer na ihe osise "R3" n'otu akụkụ.

Mbadamba 10 mg: ọcha ma ọ bụ ihe fọrọ nke nta ka ọ bụrụ nke ọcha, larịị nke nwere ahịrị na-ekewa, chamfer na osise "R4" n'otu akụkụ.

• Mbadamba mkpụrụ osisi Hartil D nwere diuretic hydrochlorothiazide 2.5 mg + 12.5 mg, 5 mg + 25 mg.
• Hartil Amlo Ramipril. Gụnyere amlodipine ndị ọzọ. Nyere site na mmụba ọbara mgbali elu ma ọ bụrụ na ịnwe ihe ndị na-arụ ọrụ (n'otu n'otu ma ọ bụ ọnụ) na-enye nsonaazụ dị mma.

Gịnị na-enyere Hartil aka?

Ihe ngosiputa maka ihe eji eme ihe bu ihe ndi a:

• nkụchi obi na-akpata nnukwu ọrịa myocardial infarction na ezigbo ọrịa metụtara Hemodynamics,
• ike ọgwụgwụ nke obi
• ọbara mgbali ike
• ọrịa shuga,
• ọrịa akụrụ na-adịghị ala ala,
• mkpa iji belata ihe dị na infarction myocardial, "ọnwụ na-egbu egbu" n'ime ndị mmadụ na-arịa ọrịa akwara ọbara.
• mkpa iji belata ohere ọrịa strok n’arụ ndị na-arịa akwara ọbara.

Site na ọbara mgbali elu, a pụkwara iji Hartil Amlo mee ihe, ọ bụrụ na tupu ịbanye na ọgwụ a, a na-ejikwa ọbara mkpịsị ọbara na amlodipine n'otu oge ị controlledụ ọgwụ otu ihe.

Dị Mkpa! Dọkịta ga-ekpebi na ọ ga-achọ ka e nye ya ọgwụ ọgwụ. Onweghi ogwu zuru oke.

Ntụziaka maka ojiji

Ọ bụ dibịa ọgwụ ahụ Hartil debere n’otu n’otu n’otu. Ọgwụ nke ọbara mgbali elu bidoro na obere opekempe - 2.5 mg otu ugboro kwa ụbọchị.

Site na ọgwụgwọ ọgwụgwọ ezughi ezu ma ọ bụ enweghị mmetụta, enwere ike ịbawanye dose ahụ karịa oge 1 kwa izu site na 2.5 mg, ọgwụ kachasị maka onye ọrịa toro eto bụ 10 mg. Ọ bụrụ na usoro ọgwụgwọ a ezughi iji wedata ọbara mgbali elu na ụkpụrụ a na-ahụkarị, a ga-enye mbadamba mkpụrụ osisi Hartil dịka akụkụ nke usoro ọgwụgwọ dị mgbagwoju anya na ndị ọzọ na-emegide ọgwụ.

Ọ bụrụ na ọ dị mkpa, a ga-enye ndị ọrịa ọgwụ mgbochi ihe dịka 2.5-5 mg nke Hartil kwa ụbọchị.

Ekwesịrị ịgwọ ọgwụ maka nsogbu a mgbe ọrịa obi na-egbu oge maka ụbọchị 3, ọgwụ mbụ bụ 2.5 mg, a na-a drugụ ọgwụ ahụ ugboro abụọ kwa ụbọchị, oke ọgwụ kwa ụbọchị maka onye ọrịa okenye bụ 10 mg.

Maka ọgwụgwọ nke ọrịa mamịrị ma ọ bụ nephropathy na-arịa ọrịa shuga, a na-enye ọgwụ ahụ Hartil na usoro onunu ogwu nke 1.25 mg otu ugboro n'ụbọchị. Ogologo oge ọgwụgwọ bụ izu 3.

Iji gbochie mmepe nke infarction myocardial, ndị ọrịa nwere angina pectoris na nsogbu ọbara na arịa ka a na-edebere ọgwụ Hartil na ọgwụ nke 2.5 mg otu ugboro kwa ụbọchị maka izu 3, mgbe nke a na-abawanye ọgwụ ahụ ruo 5 mg kwa ụbọchị ma nọgide na-a continueụ ọgwụ ahụ maka izu 3.

Ndị ọrịa nwere ọrịa akụrụ ma ọ bụ obi na-adịghị ala ala kwesịrị ịhọrọ ọgwụ n’otu n’otu, a na-enye ọgwụgwọ ịdebere Hartil site na nha nke 1,25 mg kwa ụbọchị, ma ọ bụrụ na ọ dị mkpa na iji ndidi na-anabata ya, jiri nwayọ na-abawanye ya.

Mmetụta ọgwụ

Ebe ọgwụ a na - egbochi mmepụta nke ACE, mmetụta ya kachasị achọpụta ga - abụ hypotension, ya bụ, mbelata nrụgide site na ihe karịrị 20% nke uru mbụ. N'okwu a, usu ga-abụ otu n'usoro dịka a na-anabata oriri nnabata, na-akwụghị ụgwọ ihe ndị funahụrụ ya.

Ebe ọ bụ na ọ na-egbochi angiotensin, a na-ebelata mmepụta nke aldosterone, yana ịba ụba ọrụ na plasma nke renin. Mmetụta ọgwụ ahụ na-erite ọ bụghị naanị na ACE dị n'ọbara ọbara, kamakwa na nke ahụ nke emepụtara na mgbidi vaskụla na anụ ahụ ndị ọzọ dị n'akụkụ.

Njirimara ọgwụ ndị ọzọ:

• Mgbochi nke usoro akụrụngwa metụtara steeti akpọ ọrịa shuga - microalbuminuria, dịka ọmụmaatụ.
• Na-eme ka proteinuria na-agbasa ma na-amụba ọkwa nke creatinine, nke na-akpalite n'ihu mmepe nke ọdịda akụrụ.
• Mbelata akwara obi mgbali elu, nyere aka na mgbali elu.
• Ndakpọ nke bradykinin, nke na-arụ ọrụ na arịa ọbara, na-ahapụ prostacyclin na nitric oxide n'ime ọbara.
• Mbelata nrụgide na akwara Portal ma ọ bụrụ na a hụrụ ọbara mgbali elu.
• Mbelata ugboro ole ihe mere na ọ bụrụ na onye ọrịa ahụ emee ihe mgbapụta myocardial, a na-egbochi ohere nke inwekwu nkụchi obi, weghachi ọbara dị mma.

Ọnọdụ pụrụ iche

A na-eme ọgwụgwọ n'okpuru nlekọta ahụike mgbe niile.

Mgbe ọ takingụsịrị ọgwụ mbụ nke Hartil, onye ọrịa ahụ kwesịrị ịnọ n'okpuru nlekọta dọkịta iji zere mmeghachi omume hypotensive a na-achịkwaghị achịkwa. Icho oru obara ugboro ugboro.

Ekwesighi ịkọwa Ramipril ruo mgbe eburu usoro iji gbochie ọnụ ọgụgụ ọbara mgbali elu na arụ ọrụ ezumike. Ọ bụrụ na enwere ike, mgbazi nke akpịrị mmiri, hypovolemia, mbelata ọnụ ọgụgụ sel ọbara ọbara na-ebu tupu ị takingụ ọgwụ. Ọ bụrụ na nsogbu ndị a siri ike, ramipril kwesịrị igbu oge.

Ndị ọrịa nwere akwara vaskụla, ọrụ akwara nwere nsogbu, mbelata ọbara mgbali elu, yana ndị ọrịa nwere nkụda obi na mgbe akụrụ gbasasịrị, chọrọ nlezianya nyocha.

Na-emegide usoro ị theụ ọgwụ ahụ, mbelata ọkwa nke sodium na mmụba nke ọkwa potassium ga-esi kwe omume, nke bụ ihe a na-ahụkarị na ọrụ ezigharị arụ ma ọ bụ mgbe ị na-eji ọgwụ mkparị na-enye ya ọgwụ.

Ọ bụrụ na ị theụ ọgwụ ahụ na-ebute oke mgbali elu, a ga-atụnye onye ọrịa n'ọnọdụ ya na ụkwụ etolite, usoro ọgwụgwọ ọrịa, gụnyere iwebata mmiri, nwere ike ịdị mkpa.

Ọ bụrụ na arụ ọrụ ezumike n’akwara ezumike yana ọrịa ndị na - akpata ọnya anụ ahụ, mgbe ị na - a drugsụ ọgwụ ndị ọzọ na - emetụta usoro hematopoietic na usoro mgbochi, enwere ike ịgbanwe mgbanwe ọbara.

Site na nhazi oge nke ụkwara ume ọkụ, ilele ọkwa nke sodium n'ọbara ọbara yana ọnụọgụ leukocytes.

N'ime ndị ọrịa nọ n'ọrịa na-agwọ ọrịa na-eji membranes nke nwere ikike hydraulic dị elu na njikwa oge nke ndị na-egbochi ACE, mmeghachi omume ndụ anaphylactoid ga-ekwe omume. Otu ọnọdụ ahụ ka a hụrụ na ndị ọrịa na-arịa ọrịa LDL na nnabata nke sulfate dextran.

E kwesịghị inye ndị na-egbochi ACE ndị ọrịa na-anabataghị ọgwụ n'ihi ihe egwu nke ịmalite mmeghachi omume anaphylactoid.

Okwesiri iburu n’uche na mbadamba ihe omume Hartil nke nwere ihe mejuputara ihe nke 5 mg gunyere 96.47 mg nke lactose, 10 mg - 193.2 mg.

Ahụmịhe na ramipril na ụmụaka nwere nnukwu akụrụ akwara na n’oge ịrịa ọnụọgụ dị oke.

Na-eme ka mbelata ọbara mgbali, nke nwere ike imetụta ikike itinye uche. N'akụkụ a, ịnyaghị ịnya ụgbọ ala na itinye aka n'ihe omume ndị dị ize ndụ.