Ọgwụ> Lisinopril - ratiopharm (mbadamba)

Lisinopril ratiopharm bụ ọgwụ iji belata ọbara mgbali elu akwara ma gwọọ obi na akụrụ. Dịka ọgwụgwọ oge dị mkpirikpi, a ga-eji ọgwụ ahụ mee ihe maka nnukwu infarction myocardial (ọ karịghị izu isii, dabere na nkwụsi ike nke hemodynamic). Mbelata ọbara ọgbụgba na-apụta n'ime otu awa na ọkara mgbe ị theụsịrị ọgwụ wee rute oke kachasị mgbe elekere isii na itoolu gasịrị.

N'ime ọgwụgwọ ọbara mgbali elu, usoro izizi nke lisinopril ratiopharm bụ 10 mg. A na-a medicineụ ọgwụ ahụ kwa ụbọchị, otu oge, na - ejikwa aka nri nri. Ọzọkwa, a na-edozi ọgwụ ahụ otu ugboro kwa izu abụọ ma ọ bụ anọ na usoro usoro onunu ogwu nke 5-10 mg.

N'ime ọgwụgwọ nke nnukwu myocardial infarction, a na-enye ọgwụ ahụ ka elekere mbụ nke 24-72 mgbe nyocha nke akara, ma ọ bụrụ na ihe ngosipụta ọbara ọbara systolic erughị 100 mm Hg. Usoro izizi bụ 5 mg na mmụba na 10 mg n'ụbọchị nke nchịkwa.

Na ọdịda akụrụngwa, a na-ahọpụta usoro ọgwụ ka dabere na njiri nwepụta okike.

Ihe mgbochi zuru oke maka iji ọgwụ a bụ nwata, ịtụrụ ime, angioedema na edema nke Quincke. A naghị atụ aro itinye oge n'oge ịra ahụ. Ka ị na-a diụ ọgwụ ụkwara, ị takingụ ọgwụ ahụ nwere ike ịgbakwunye oke mbelata ọbara ọgbụgba, yana ijikọta ya na ọgwụ antidiabetic nwere ike ibute mbelata nke ọkwa glucose na mmepe nke hypoglycemic ujo.

Ndepụta nke nsonaazụ mgbe ị na-ewere Lisinopril buru ibu. N'akụkụ usoro sisitemu hematopoietic, enwere ike ịba ụba na haemoglobin na hematocrit, n'akụkụ akụkụ akwara - isi ọwụwa, ọgbụgbọ, ọgba aghara ụra, asthenia, ike ọgwụgwụ, na akụkụ nke sistem obi - hypotension na mmetụta orthostatic ndị ọzọ. Bụrụ na ịchọpụta nsonaazụ ndị edepụtara, achọrọ ọbara mgbali mgbe niile, yana ileba anya na ọkwa creatinine na plasma electrolyte.

Ngwá ọgwụ ọgwụ nke Lisinopril-ratiopharm

Lisinopril (N-N- (15) -1-carboxy-3-phenylpropyl-L-lysyl-L-proline) bụ ihe mgbochi ACE. Ọ na - egbochi guzobe angiotensin II, nke nwere mmetụta vasoconstrictor. Na-ebelata akwara nke systolic arterial na ọbara ọgbụgba, akwara vaskụla akwara ma na-eme ka ọbara na-ekesa akụrụ. Na ọtụtụ ndị ọrịa, antihypertensive mmetụta ayarade onwe 1-2 awa mgbe onu nchịkwa nke ọgwụ, kacha - odika awa isii 9. A na-ahụta Stabilisation nke ọgwụgwọ ọgwụgwọ mgbe izu 3-4 gachara. Mwepu onwe ya ọrịa anaghị etolite.
Ntinye ọgwụ ahụ mgbe nchịkwa ọnụ gasịrị ihe dị ka 25-50%. Iri nri otu oge anaghị emetụta ịmịkọrọ. Ntinye uche kachasị na plasma ọbara na-erute mgbe ihe dị ka awa 6-7. Lisinopril dị obere na-ejikọ na protein plasma. Ọ bụ metabolized, na-ete ya na mmamịrị na-agbanweghi. Oge iwepu ọkara ndụ bụ awa 12. N'ọnọdụ arụ ọrụ ezumike, a na-ebelata mwepu nke lisinopril na ogo nke oke arụ ọrụ. N'ime ndị ọrịa agadi (ihe karịrị afọ 65), yana nkụchi obi, a na-ebelata mkpochapu nke lisinopril.
A na-ewepụ ọgwụ ahụ n'oge ịba ọcha n'anya.

Ojiji nke ogwu lisinopril-ratiopharm

AH (ọbara mgbali akwara)
Dịka iwu, usoro izizi na ọgwụgwọ ọbara mgbali elu (hypertension) bụ 5 mg / ụbọchị na otu ọgwụ (n'ụtụtụ). Ọ bụrụ na n’otu oge ọbara ọgbụgba anaghị akpacha, ọgwụ a na-abawanye ruo 10-20 mg (dabere na nzaghachi ndị ọrịa) otu ugboro n’ụtụtụ. Usoro a tụrụ aro na-abụkarị 10-20 mg, yana nke kachasị bụ 40 mg / ụbọchị.
Ọrịa obi na-adịghị ala ala
Ọgwụ nke mbụ bụ 2.5 mg (1/2 t nke mbadamba 5 mg). A na-eji nwayọọ nwayọọ na-abawanye ọgwụ a dabere na mmeghachi omume onwe onye. Ọgwụ a na-atụ aro na ọgwụgwọ ọgwụgwọ bụ 20 mg / ụbọchị na otu usoro.
Jiri mkpachara anya na ndị ọrịa na-a takeụ ọgwụ ọ haveụ /ụ / na-a haveụ ọgwụ. Ọ bụrụ na ọ gaghị ekwe omume ịkwụsị ị ofụ ihe ọ inụ inụ tupu oge eruo, a na-atụ aro ka ewere lisinopril na obere ọgwụ n'okpuru njikwa ọbara mgbali na ọrụ akụrụ.
Nnukwu myocardial infarction na ngalaba nke ST
Ekwesịrị ịmalite ọgwụgwọ na awa 24 mbụ site na mmalite nke ihe mgbaàmà nke infarction myocardial (na enweghị ụbụrụ ike). Ọgwụ izizi bụ 5 mg / ụbọchị, ọgwụ a zubepụtara bụ 10 mg / ụbọchị na otu usoro. Ndị ọrịa nwere nrụgide systolic adịghị elu karịa 120 mm RT. Art. Tupu na n'oge ọgwụgwọ, n'ime ụbọchị atọ mbụ mgbe ọ gbasịrị infarction myocardial, a na-amalite usoro ọgwụgwọ n'ọtụtụ 2.5 mg. Site n'ọkwa mgbali ọbara systolic n'okpuru 100 mm RT. Art. ọgwụgwọ ọgwụgwọ ekwesịghị ịgafe 5 mg kwa ụbọchị (enwere ike belata 2.5 mg).
Ọ bụrụ na mgbe ị lụchara lisinopril na 2,5 mg, ọkwa ọbara mgbali systolic dị n'okpuru 90 mm Hg. Art., A gha ịkagbu ọgwụ ahụ. Oge a tụrụ aro ka iji maka infarction myocardial bụ izu isii.
Nephropathy (ogbo nke mbụ) na ndị ọrịa nwere ụdị ọrịa shuga II nke ọrịa mellitus
Ọgwụ izizi bụ 10 mg 1 oge kwa ụbọchị, dose kachasị bụ 20 mg 1 oge kwa ụbọchị.
N'ihe banyere ọrịa shuga na-akpata insulin (n'ihi ohere nke ịmalite hyperkalemia), ekwesịrị ịmalite ọgwụgwọ na lisinipril na obere usoro dabere na tebụl ma rụọ ọrụ n'okpuru nlekọta dọkịta.
Ọdịda ntaramahụhụ na mwepụ nke mkpụrụ osisi 30-80 ml / min: Ọgwụ izizi bụ 2.5 mg otu ugboro kwa ụbọchị n'ụtụtụ. Ọgwụgwọ (5-10 mg kwa ụbọchị) dabere na nzaghachi onye ọrịa. Agaferela oke nke ubochi kachasị nke 20 mg.
Mkpuchi ntaramahụhụ na mwepụ nke creatinine erughị 30 ml / min: Usoro akwadoro ịmalite bụ 2.5 mg. A na-ekpebi ọgwụ a na-eme kwa ụbọchị n’otu n’otu, dabere na nghọta ahụ, ọ dị mma ịbawanye oge n’etiti usoro ọgwụ a (1 oge n’ime ụbọchị 2).

Ihe mgbochi iji ọgwụ Lisinopril-ratiopharm

Hypersensitivity na lisinopril ma ọ bụ ihe ndị ọzọ nke ọgwụ ahụ, angioedema, gụnyere jikọtara ya na ojiji nke ACE inhibitors na akụkọ ntolite, idiopathic na heintementin Quincke edema, ụzụ obi, oke myocardial infarction na ọnụnọ nke nnukwu ọgbụgba ọbara (mgbali ọbara systolic n'okpuru 90 mm Hg). , oge ime na lactation, afọ ruo afọ iri na abụọ.

Nsonaazụ nke ọgwụ lisinopril-ratiopharm

sisitemu obi: ọbara ọgbụgba (karịsịa mgbe ị ofụ ọgwụ mbụ nke ọgwụ site n'aka ndị ọrịa nwere sodium erughị ala, akpịrị ịkpọ nkụ, nkụda obi), mmeghachi omume orthostatic, gụnyere ọgbụgbọ, adịghị ike, ọhụhụ isi, enweghị mmụọ. Enwere akụkọ dị iche iche banyere mmepe nke tachycardia, cardiac arrhythmias, ihe mgbu na sternum, na ọnya ọnya.
Usoro nke Hematopoietic na lymphatic: adịkarịghị - thrombocytopenia, leukopenia, neutropenia, agranulocytosis, hemolytic anaemia, lymphadenopathy, ọrịa autoimmune.
Usoro ịtụgharị uche: arụrụ ọrụ na-arụ ọrụ na arụ ọrụ, n'ọnọdụ ụfọdụ - nnukwu nsogbu gbasara akụrụ. Na ndị ọrịa nwere akwara akwara stenosis na ndị ọrịa n’otu oge na-anata diuretics, enwere ike ịhụbawanye ọnụọgụ serin creatinine na urea nitrogen n’ime ọbara ahụ, enwere akụkọ dịpụrụ adịpụ nke uremia, oliguria, anuria, adịkarịghị - enweghi ike, gynecomastia.
Usoro okuku ume: ụkwara akọrọ na ụkwara akwara, mgbe ụfọdụ sinusitis, rhinitis, bronchospasm, glossitis na ọnụ akọrọ, enwere akụkọ dị iche iche nke mmiri ara na eosinophilic.
GIT: ọgbụgbọ, ọgbụgbọ, mgbu mgbu na dyspepsia, anorexia, dysgeusia, afọ ntachi, afọ ọsịsa. N'ọnọdụ ndị dịpụrụ adịpụ - cholestasis, ịba ụba ọrụ nke transpeases hepatic na ọdịnaya bilirubin n'ihi ọrụ imeju na-arụ ọrụ na mmebi na necrosis nke hepatocytes. Enwere akụkọ banyere ọrịa pancreatitis, ịba ọcha n'anya (hepatocellular ma ọ bụ cholestatic).
Akpụkpọ ahụ, nfụkasị ahụ na mmeghachi omume immunopathological: mmetụta nke okpomoku, ịchapu nke anụ ahụ, itching, n'ọnọdụ ụfọdụ - angioedema nke egbugbere ọnụ, ihu na / ma ọ bụ aka, ịsụsọ oke, nrịba epidermal necrolysis, Stevens-Jones syndrome, polymorphic alopecia. Enwere ike ibute mmeghachi omume anụ ahụ site na ahụ ọkụ, myalgia, ogbu na nkwonkwo / ọrịa ogbu na nkwonkwo, vasculitis, ihe dị mma na-akpata antinuclear, ịba ụba ESR, eosinophilia, leukocytosis, fotophobia.
CNS: isi ọwụwa, ike ọgwụgwụ, nkụchi, obi erughị ala, ọgba aghara ụra, paresthesia, enweghị ike, disorition, ọgba aghara, tinnitus na belata visual visual, asthenia.
Ihe ngosi ulo oru: ụba ọbara serin creatinine na urea nitrogen, hyperkalemia, mgbe ụfọdụ, mmụba na ịta ahụhụ bilirubin, hyponatremia.

Ntụziaka pụrụ iche maka iji ọgwụ Lisinopril-ratiopharm

Na nnukwu myocardial infarction yana mpaghara elu ST Enwere ike inye lisinopril ndị ọrịa niile na enweghị contraindications, ọkachasị ndị ọrịa nwere nkụda obi na mmalite nke ọrịa ahụ, yana mbelata ọbara mgbali nke ventricle aka ekpe, yana ọbara mgbali elu (ọbara mgbali akwara), yana ọrịa shuga mellitus.
N'ime ndị ọrịa nwere hypovolemia, ụkọ sodium n'ihi ojiji nke diuretics, nri na-enweghị nnu, n'ihi vomiting, afọ ọsịsa, mgbe ọ gachara, mmepe nke hypotension mberede, ọdịda akụrụ oke. N'ọnọdụ ndị a, ọ ga-adị mma ka ị kwụọ ụgwọ maka mmiri mmiri na nnu na-efu tupu ịgwọ lisinopril ma nye nlekọta nlekọta ahụike zuru oke.
N'iji nlezianya (na-eburu n'uche uru / ọghọm ruru), a na-enye ọgwụ ahụ maka ndị ọrịa nwere obere akwara akwara stenosis ma ọ bụ otu akụrụ renal artery stenosis, yana maka ndị ọrịa nwere nsogbu gbasara akụrụ isi, imeju, hematopoiesis, ọrịa autoimmune, nnukwu aortic, mitral stenosis, hyphorophic cardiomyopathy. Ọnọdụ ndị a niile na-achọ nlekọta nlekọta ahụike mgbe niile na nlekota paramita ụlọ nyocha.
Enwere akụkọ nke ọrịa cholestatic jaundice na-aga n'ihu na necrosis zuru ezu. Ọ bụrụ na onye ọrịa ebido jaundice ma ọ bụ mmụba dị ukwuu na enzymes imeju, a ga-akwụsị ị useụ ọgwụ ahụ.
Na isi aldosteronism, n'oge ọgwụgwọ nke ọnọdụ nfụkasị, a naghị atụ aro iji ọgwụ mgbochi ACE.
N'ime ndị ọrịa mere agadi, enwere ike ịhụwanye ịdị ọcha nke lisinopril site n'iji ọgwụ ị usualụ ọgwụ ọ na-emebu.
N'iji nlezianya mee, a na-enye lisinopril ka ndị ọrịa nwee ọ̀kwù nke creatinine n'ọbara (ihe ruru 150-180 micromol / l).
Ebe ọ bụ na lisinopril-ratiopharm abụghị biotransformform na imeju, ọ nwere ike ịbụ ọgwụ ịhọrọ n'etiti ndị ọzọ na - egbochi ACE maka ndị ọrịa nwere nsogbu imeju.
Oge nke ime na lactation. Ihe ogwu riri nne na oge ato nke ime. N’ime okpukpu nke abụọ na nke III, anaghị atụ aro ọgwụgwọ na lisinopril (ọ bụrụ na iji ọgwụ ahụ eme ihe dị ezigbo mkpa na II trimester, a na-atụ aro ka a na-achọpụta ultrasound nke ndị na-egosi arụmọrụ). A ga-enyocha ụmụ amụrụ ọhụrụ nke nne ya lisinopril maka mmepe nke hypotension, oliguria, hyperkalemia. A naghị atụ aro iji ọgwụ ahụ eme ihe n'oge ịra akwa.
Mmetụta ikike ịkwọ ụgbọ ala ma jiri usoro rụọ ọrụ. Na nmalite ọgwụgwọ, enwere ike ịmalite ịmịnye ọbara, nke nwere ike imetụta ikike ịkwọ ụgbọala ma rụọ ọrụ nwere ike dị egwu.

Mkparịta ụka ọgwụ ọjọọ Lisinopril-ratiopharm

Mmanya na-egbu egbu, ihe ndị na-egbu egbu na ihe ndị ọzọ na-egbochi ọgwụ (ndị na-egbochi α- na β-adrenergic ndị na-anabata ya, ndị na-emegide calcium, wdg) na-eme ka mmetụta nke lisinopril pụta.
N'iji ọgwụ ndị na - eme ka ọnụnọ potassium dị mkpirikpi (spironolactone, amiloride, triamteren), hyperkalemia nwere ike ịmalite, yabụ, mgbe ị na-eji ọgwụ ndị a, ọ dị mkpa iji chịkwaa mkpokọta nke potassium na plasma ọbara. Hyperkalemia nwekwara ike iji nke cyclosporine mee ihe, nkwado potassium, nri nri nwere potassium, nke bụ ihe dị mkpa na ọrịa shuga mellitus, ọdịda akụrụ.
NSAIDs (karịsịa indomethacin), sodium chloride belata mmetụta antihypertensive nke lisinopril.
Mgbe eji eji lithium mee ihe, enwere ike igbu oge iwepu lithium n’ahụ ma, n’ihi ya, mee ka ohere nke nsonaazụ ya dịkwuo elu. Ọ dị mkpa ịdị na-enyocha ọkwa lithium dị n'ọbara.
Ọkpụkpụ ụmị, yana lisinopril, na-abawanye ihe ize ndụ nke neutropenia na / ma ọ bụ agranulocytosis.
Allopurinol, cytostatics, immunosuppressants, corticosteroids, procainamide na ojiji nke oge a na lisinopril nwere ike ibute mmepe nke leukopenia.
Estrogens, sympathomimetiks belata antihypertensive irè nke lisinopril.
Enwere ike iji Lisinopril-ratiopharm mee ihe n'otu oge na glyceryl trinitrate, nke a na-eduzi iv ma ọ bụ transdermally.
Edebere ịdọ aka na ntị maka ndị ọrịa nwere nnukwu myocardial infarction maka awa 6-12 mgbe nchịkwa streptokinase (ihe egwu nke hypotension).
Lisinopril-ratiopharm na-eme ka ngosipụta nke mmanya na-egbu egbu pụta ìhè.
Ọgwụ, ọgwụ na-akụnwụ ahụ, hypnotics, antioxide ọgwụ tricyclic na-eme ka mmetụta hypotensive dị.
N’oge ọgbụgba na ọgwụgwọ lisinopril, enwere ihe ọghọm nke mmeghachi omume anaphylactic ma ọ bụrụ na ejiri polịcrylonitrile metal nke sulfonate dị elu membranes (dịka ọmụmaatụ, AN69).
Hypoglycemic oral ዝግጅት (ọmụmaatụ, urea sulfonyleri - metformin, biguanides - glibenclamide) na insulin mgbe ejiri ya na ndị na - egbochi ACE nwere ike ịkwalite mmetụta hypotensive, karịsịa na mmalite ọgwụgwọ.
Antnweta ọgwụ antacids nwere ike belata mmetụta antihypertensive.

Doụ ọgwụ ogwu Lisinopril-ratiopharm, nrịanrịa na ọgwụgwọ

Mbelata nke ọbara mgbali elu na nsị isi nke akụkụ ndị dị mkpa, ujo, ahaghị n ’ọbara electrolytes, nnukwu akwara ọdịda, tachycardia, bradycardia, dizziness, nchegbu na ụkwara. Ọ dị mkpa ịkwụsị ị theụ ọgwụ. Maka ịxụ mmanya, a na-atụ aro lavage gastric. Site na nkwonkwo ọbara, a ga-etinye onye ọrịa ahụ n'apata ụkwụ ka o buliri elu. Maka ndozi nke ọbara mgbali, a na-egosipụta nchịkwa intravenal nke ọgwụgwọ anụ ahụ na / ma ọ bụ nnọchi plasma. Ọ bụrụ na ọ dị mkpa, a na-ahụ maka iv angiotensin. Enwere ike ịkọwa Lisinopril site na hemodialysis (polyacrylonitrile metal sulfonate membranes-elu-elu dịka AN69 enweghị ike). N'ihe banyere angioedema na-egbu ndụ, iji ọgwụ mgbochi eme ihe dị mkpa. Ọ bụrụ na ọnọdụ adọkpụọnụ ahụ na-esochi ọzịza nke ire, glottis, na larynx, ọ dị mkpa ịmalite ngwa ngwa site na nchịkwa s / c nke 0.3-0.5 ml nke epinephrine solution (1: 1000), a na-egosi intubation ma ọ bụ laryngotomy iji hụ na patway patway . Mgbe bradycardia na-aga n'ihu mgbe usoro ọgwụgwọ gasịrị, ọ dị mkpa iji duzie mkpali eletrik. Ọ dị mkpa iji nyochaa mgbe niile ihe ndị na-egosi ọrụ dị mkpa, ịta nke serum electrolytes na creatinine.

Mpempe usoro onunu ogwu

Njirimara nke anụ ahụ na kemịkal:

Mkpokọta 5 mg na-acha ọcha gburugburu biconvex mbadamba, na ntinye maka ịgbasa n'otu akụkụ,

10 mg mbadamba: pink dị larịị, nke na-enweghị otu, dotted, biconvex gbara okirikiri, ọ bụrụkwa nke na-agbaji otu akụkụ,

Mpempe 20 mg nke acha ọbara ọbara na-acha uhie uhie na-enweghị otu, dotted, biconvex gbara okirikiri, na ntuli aka maka ịgbasa n'otu akụkụ.

Ngwongwo ogwu

Lisinopril bụ peptidyl dipeptidase inhibitor. Ọ na - egbochi ACE (ACE), nke bụ ihe na - eweta mgbanwe maka angiotensin nke m n'ime peptide vasoconstrictive, angiotensin II, na - akpali nzuzo nke aldosterone site na cortex adrenal. Mkpesa ACE na-eduga n'ịbelata mkpo uche nke angiotensin II, nke na-eduga n'ịbelata ọrụ vasoconstrictor na secretion nke aldosterone. Mbelata aldosterone zoro ezo nwere ike ibute ụba ọnụọgụ potassium. Lisinopril na-ebelata ọbara mgbali elu bụ isi n'ihi mgbochi nke renin-angiotensin-. Agbanyeghị, lisinopril nwere mmetụta antihypertensive ọbụna na ndị ọrịa nwere ọkwa renin dị ala. ACE bụ otu ihe ahụ ka kinase II, enzyme nke na-akwalite mbibi nke bradykinin.

Na-emegide usoro ọrụ nke ọgwụ ahụ, mbelata na akwara systolic art na nrụgide diastolic.

E gosiputara ya na profaịlụ niile nke mmeghachi omume ọjọọ na ndị ọrịa natara lisinopril dị elu ma ọ bụ nke dị ala yiri nke ahụ na ọdịdị na ugboro.

A kọrọ na n'ime ndị ọrịa na-anata lisinopril, enwere mbelata dị ukwuu na mbelata nke albumin na mmamịrị, na-egosi na mmetụta ACE nke lisinopril dugara na mbelata microalbuminuria site na imetụta anụ akwara na-emetụta kpọmkwem na mgbakwunye ikike ya belata ọbara mgbali elu.

Usoro ọgwụgwọ nke nwere lisinopril emetụtaghị nchịkwa nke glucose ọbara, dị ka e gosipụtara site na mmetụta ya na-enweghị atụ na ọkwa nke glycosylated haemoglobin (HbA) ₁ c)

E guzobere ya na lisinopril na-arụ ọrụ dị mma na iweghachi ọrụ nke endothelium mebiri emebi na ndị ọrịa nwere hyperglycemia.

Lisinopril bụ ihe mgbochi ACE na-egbochi ọnụ nke na-enweghị sulfhydryl.

Mgbe ị nwusịrị lisinopril, a na-abanye n'ọtụtụ ọbara n'ọtụtụ ọbara mgbe elekere asaa nke elekere asaa, ọ bụ ezie na n'ime ndị ọrịa nwere nnukwu myocardial infarction, a na-enwekarị ntakịrị oge ịbịaru ọkwa ndị kachasị elu. Dabere na ntụgharị mmamịrị na mmamịrị, nkezi ogo nke lisinopril na nso a bụ ihe dị ka 25% nke mgbanwe dị iche iche na ndị ọrịa dị iche iche na 6-60% nke usoro ọnụọgụ niile a mụrụ (5-80 mg). N'ime ndị ọrịa nwere nkụda mmụọ, a na-ebelata bioav adị ihe dịka 16%.

Iri nri anaghị emetụta nnabata nke ọgwụ

Lisinopril anaghị ejikọ protein ndị dị na plasma, belụsọ maka angiotensin na - ekesa enzyme (ACE).

Lisinopril adịghị metabolized ma wepu ya na-agbanweghi na mmamịrị ya. Iwepu ọkara ndụ n’ime ndị ọrịa na-a multipleụ ọtụtụ ọgwụ bụ elekere 12.6. Nwepu nke lisinopril n’otu n’ime ndị ahụ siri ike bụ 50 ml / min. Ọ bụrụ na arụ ọrụ ezumike mkpirisi, a na-ebelata mwepu nke lisinopril na ogo nke arụ ọrụ arụ ọrụ. Mbelata nke uche ọbara na-egosipụta usoro ogologo oge ọ nweghị ihe ọ bụla metụtara nchịkọta ọgwụ. Oge ikpeazụ a nwere ike igosi oke njikọ aka na ACE ma ọ naghị atụ aro ya.

Ndị ọrịa nwere ọria imeju

N'ime ndị ọrịa nwere ọrịa cirrhosis, ọrụ imeju na-arụ ọrụ na-eduga na mbelata lisinopril (ihe dị ka 30% mgbe mkpebi nke mmamịrị), yana mmụba na mkpughe (ihe dị ka 50%) ma e jiri ya tụnyere ndị ọrụ afọ ofufo dị mma n'ihi mbelata nke mwepu.

Renrụ ọrụ na-arụ ọrụ na ụlọ

Ọrụ akụrụ na-eme ka ọ dị mma na-ebelata mkpochapu nke lisinopril, nke akụrụ na-ewepụ ya, mana mbelata a dị mkpa maka ọgwụgwọ naanị mgbe mmiri mmụba dị ala karịa 30 ml / min. Site na nkezi ogo dị nwayọ maka mmebi akụrụ (mwepu nke 30-80 ml / min), nkezi AUC na-abawanye nanị 13%, ebe enwere oke mmebi akụrụ (mwepụta creatinine nke 5-30 ml / min), nkezi AUC nke 4 5 ugboro. Enwere ike iwepụ Lisinopril site na usoro ọgwụgwọ. N'oge ọgbụgba akwara, oge nke bụ elekere anọ nke elekere anọ, ntinye uche nke lisinopril na plasma na-agbadata na nkezi sitena 60% site na mmachaa ọria di n'etiti 40 na 55 ml / min.

Ndị ọrịa nwere nkụchi obi nwere ngosipụta dị elu na lisinopril ma e jiri ya tụnyere ndị ọrụ afọ ofufo nwere ahụ ike (nkezi nke ụbara AUC nke 125%), mana dabere na ọnụego nke lisinopril hụrụ na mmamịrị, enwere mbelata ihe mkpokọta ihe dịka 16% ma e jiri ya tụnyere ndị ọrụ afọ ofufo ahụike.

Ndị okenye na-arịa ọrịa

Ndị ọrịa agadi nwere ọkwa ọgwụ dị elu n'ọbara yana usoro ịta ahụhụ / elekere dị elu (mmụba nke ihe dịka 60%) ma e jiri ya tụnyere ndị ọrịa na-eto eto.

A na-amụ profaịlị nke ọgwụ lisinopril na ụmụaka 29 nwere ọbara mgbali elu site na afọ isii ruo afọ iri na isii, na GFR dị elu karịa 30 ml / min / 1.73 m 2. Mgbe etinyere lisinopril na 0.1-0.2 mg / n'arọ, ekwesara ịta ahụhụ na plasma ọbara n'ime elekere isii nke elekere, ogo ogosi mwepụ na isi ahụ wepụrụ na mmamịrị bụ 28%. Ihe omuma ndi a yiri ihe ndi okenye kwuru.

Ihe ngosi AUC na C _max n'ime ụmụaka yiri ndị ahụ a hụrụ n’ebe ndị okenye nọ.

Obi dara ada (oria Symptomatic).

Nnukwu myocardial infarction (obere oge ọgwụgwọ (izu isii) maka ndị ọrịa hemodynamically kwụsiri ike ka awa 24 gachara nnukwu ọrịa myocardial infarction).

Nsogbu nke akụrụ na ọrịa shuga mellitus (ọgwụgwọ ọrịa akụrụ na ndị ọrịa nwere oke ume, nwere ụdị ọrịa shuga mellitus nke mbụ na nephropathy).

Ihe ngbanwe

Hypersensitivity na lisinopril, ihe ndị ọzọ nke ọgwụ ahụ, ma ọ bụ ndị ọzọ na-egbochi ACE.
Akụkọ banyere angioedema (gụnyere mgbe ejiri ACE inhibitors, idiopathic na heinji akụkụ Quincke).
Aortic ma ọ bụ mitral stenosis ma ọ bụ cardioyopathy hypertrophic nwere nsogbu ọgba aghara dị ukwuu.
Stenosis biliary na akwara ma ọ bụ stenosis nke akụrụ.
Nnukwu nrịba nke myocardial nwere hemodynamics na-ejighị n'aka.
Cardiogenic ujo.
Ọrịa nwere ọghọm creatinine ≥ 220 μmol / L.
N’otu oge iji ọgwụ ahụ na membranes membranes nke dị elu polyacrylonitrile sodium-2-methylosulfonate (dịka ọmụmaatụ AN 69) n’oge a na-eme ya.
Ojiji nke aliskiren nwere ọgwụ n’otu oge n’ime ndị ọrịa nwere ọrịa mellitus ma ọ bụ ịrụ ọrụ na-arụ ọrụ n’ịrụ ọrụ (GFR 2).
Isi hyperaldosteronism.
Womenmụ nwanyị dị ime ma ọ bụ ụmụ nwanyị dị ime na-eme atụmatụ ịtụrụ ime (lee “Jiri n’oge ime ma ọ bụ n’ịra”).

Mmekọrịta na ọgwụ ndị ọzọ na ụdị mmekọrịta ndị ọzọ

Diuretics. N'iji oge a na-ahụ maka ọrịa diuretics na ndị ọrịa, a na-ewerezi lisinopril - mmetụta antihypertensive na-abụkarị okpukpu abụọ. Na nmalite njikọta nke lisinopril na diuretics, ndị ọrịa nwere ike ịnwe mbelata ọbara mgbali elu na lisinopril. Enwere ike belata hypotension artpotomatic artpot hypotension na lisinopril ma ọ bụrụ na a kwụsịrị mmịkọ tupu ịmalite ọgwụgwọ lisinopril na mmụba nke mmiri ma ọ bụ olu nnu, yana ịgwọ obere ala nke ndị na-egbochi ACE na mbido.

Ihe mgbakwunye nri nri na-enye potassium, ihe na-enye potassium, ma ọ bụ potassium nwere ya. Patientsfọdụ ndị ọrịa nwere ike ịmalite hyperkalemia. Ihe ndị na-abawanye n'ihe ize ndụ nke hyperkalemia gụnyere ọdịda akụrụ, ọrịa shuga shuga, ojiji nke potassium-sparing diuretics (dị ka spironolactone, triamteren, amiloride), ihe mgbakwunye nri nri na-enye potassium, na iji nnu dochie ya na potassium. Iji ihe mgbakwunye nri nri na-enye potassium, ọgwụ na-egbu potassium ma ọ bụ iji nnu dochie potassium nwere ike ibute oke mmụba na ọkwa potassium, karịchaa ndị ọrịa nwere ọrụ ezumike nri.

N'akụkụ a, ọgwụ ga-edenye naanị na iji nlezianya nlezianya nke dọkịta na-elele ma na-elele ọkwa potassium kwa oge yana ọrụ akụrụ.

Ọ bụ ezie na ị na-ewere lisinopril megide ọgwụ potassium dị ka diuretics, hypokalemia kpatara oke nri ha nwere ike belata.

Nkwadebe Lithium. Enweela mmụba nke nnochi anya ọbara lithium na mmeghachi omume nsi na ojiji nke lithium na ndị na - egbochi ACE. Ojiji nke thiazide diuretics n’otu oge ahụ nwere ike ime ka ihe a ofụ bekee dịkwuo njọ belata nke mmanya na-egbu egbu. Ekwesighi iji lisinopril na lithium n'otu oge, agbanyeghị, ọ bụrụ na ngwakọta dị otu ahụ dị mkpa, a ga-akpachapụ anya nyocha ọkwa nke lithium n'ọbara ọbara.

Ọgwụ antisteroidal anti-inflammatory (NSAIDs), tinyere acetylsalicylic acid ≥ 3 g / day.

Ọgwụ ndị ọzọ na - egbochi mkpali (beta-blockers, alfa-blockers, calcium antagonists). Oge a ọgwụ ndị a n’otu oge nwere ike iwelie mmetụta ebughi oke ibu nke lisinopril. Iji ọgwụ nitroglycerin, nitrates ndị ọzọ ma ọ bụ vasodilators ndị ọzọ na-emekọrịta ihe nwere ike belata ọbara mgbali elu.

Tricyclic antidepressants / antipsychotic / izizi. Ojiji nke ọgwụ anesthetics, tricyclic antidepressants na ọgwụ antipsychotic na ndị na - egbochi ACE nwere ike ibute mmụba nke mmetụta nke ikpeazụ.

Ọgwụ Sympathomimetic. Ọgwụ Sympathomimetic nwere ike belata mmetụta antihypertensive nke ACE inhibitors. Maka nke a, ọ dị mkpa ileba anya nke ọma n'ọbara ọbara onye ọrịa ahụ iji chọpụta ma ọ̀ nwudela ọgwụgwọ ọgwụgwọ achọrọ.

Ọgwụ Antidiabetic. Ojiji nke ACE inhibitors na ọgwụ mgbochi (insulin, onodu hypoglycemic na-elekọta mmadụ) nwere ike ịkwalite mmetụta nke iwetulata ọbara dị ala n'ihe egwu nke hypoglycemia. Mmetụta a na - abụkarị n'ime izu ndị mbụ nke ọgwụgwọ njikọta na ndị ọrịa nwere ọdịda akwara.

Acetylsalicylic acid, ọgwụ thrombolytic, beta-blockers, nitrates. Enwere ike iji Lisinopril mee ihe n'otu oge na acetylsalicylic acid (na usoro onyunyo), ọgwụ thrombolytic, beta-blockers na / ma ọ bụ nitrates n'okpuru nlekọta nke dọkịta.

Nkwadebe nke ọla edo. Nitritoid mmeghachi omume (mgbaàmà nke vasodilation, gụnyere ọkụ ọkụ, ọgbụgbọ, ọgbụgbọ, na hypotension, nke nwere ike ịba oke ike) mgbe agbachasị usoro edo edo (dịka, sodium otu oge) bụ ihe a na-ahụkarị na ndị ọrịa e mesoro ndị na-egbochi ACE.

Ihe ngbochi abuo nke renin-angiotensin-. Emegosiputara ya na mgbochi abuo nke renin-angiotensin- RAAS tinyere ya na ihe ndi ACE inhibitors, angiotensin II receptor antagonists or aliskiren bu ihe ngosi di elu nke mmeghari akwara dika akwara hypotension, hyperkalemia, nsogbu ndi mmadu nwere aha mkpuru akwara (tinyere akwara akwara odida) atụnyere ihe eji eme monotherapy.

Allopurinol, cytostatics, immunosuppressants, corticosteroids, procainamide. N'iji ya mee ya na lisinopril, leukopenia nwere ike iduga.

Ọgwụ na-ebelata ụmị ọkpụkpụ. N'iji ya na lisinopril na-eme n'otu oge, ha na-abawanye ihe ize ndụ nke neutropenia na / ma ọ bụ agranulocytosis.

Estrogens. Site na oge a, enwere ike belata mmetụta hyisensive nke lisinopril n'ihi njigide mmiri dị n'ime ahụ.

Ekwesịrị iji Lisinopril jiri nlezianya mee ihe na ndị ọrịa nwere nnukwu myocardial infarction n'ime 6-12 awa mgbe nchịkwa nke streptokinase (ihe ize ndụ nke ịmalite hypotension artpot).

Ọgwụ, ọgwụ na-egbu egbu, ihe ọ alcoụ alcoụ na-egbu egbu, ọgwụ ihi ụra yana lisinopril na-akpata mmụba na mmetụta hypotensive.

Njirimara ngwa

Sympotomatic artpot hypotension adịkarịghị hụrụ ndị ọrịa nwere ọbara mgbali elu na-enweghị mgbagha. N'ime ndị ọrịa nwere nkụda mmụọ, ma ọ bụ na-enweghị akụrụ gbasara akwara, a chọpụtara hypotension arterial hypotension.

Ikekwe ịmalite hypotension dị elu na ndị ọrịa nwere nnukwu nkụchi obi na-asesụ nnukwu ọgwụ nke loop diuretics, nwere hyponatremia ma ọ bụ ọrụ ezigharị nke ọdịdị arụ ọrụ, n'oge ọgbụgba, afọ ọsịsa ma ọ bụ vomiting, yana n'ụdị siri ike nke ọbara ọgbụgba akwara azụ.

Mgbe akwara hypotension mere, a ga-etinye onye ọrịa ahụ n'azụ ya, ọ bụrụ na ọ dị mkpa, ọ dị mkpa itinye nnu iji mee mkpo mmiri.

Ọgwụ hypotension dị obere abụghị ihe mgbochi megide ị theụ ọgwụ ọzọ, ana - ejikwa ya ngwa ngwa mgbe ọbara mgbali elu gbagochara oke mmụkọta ahụ.

N'ime ụfọdụ ndị ọrịa nwere nkụda mmụọ, nwee ọbara mgbali nkịtị ma ọ bụ nke dị ala, mbelata mgbakwunye ọbara mgbali usoro nwere ike ịmalite n'oge ọgwụgwọ na lisinopril. Mmetụta a bụ nke a na - ebu amụma ma, dịka iwu, ọ chọghị ịkwụsị ọgwụgwọ lisinopril. Ọ bụrụ na hypotension akwara ghọrọ Symptomatic, ọ nwere ike ịdị mkpa belata dose ma ọ bụ kwụsị ị lụ lisinopril.

Nnukwu ọgbụgba akwara na nnukwu ọrịa myocardial infarction. Na nnukwu myocardial infarction na ndị ọrịa nwere hemodynamics kwụsiri ike, a ga-eme ọgwụgwọ na lisinopril na awa 24 mbụ iji gbochie mmerụ ahụ nke ụlọ aka ekpe na nkụda mmụọ, yana iji belata ọnwụ. Na nnukwu myocardial infarction, agaghị enwe ike ịmalite ịgwọ ọrịa na lisinopril ma ọ bụrụ na enwere ihe ọghọm dị na nhụsianya ọria ga-ebilite ma a gwọchaa vasodilators. Nke a metụtara ndị ọrịa nwere ọbara mgbali systolic nke 100 mm RT. Art. ma ọ bụ ole na ole, ma ọ bụ ndị ọrịa buterela ujo mgbali. N'ime ụbọchị 3 mbụ nke ọrịa myocardial infarction, a ga-ebelata dose ahụ ma ọ bụrụ na nrụgide systolic agafeghị 120 mm Hg. Art. Ọ bụrụ na mgbali ọbara systolic hà ma ọ bụ ihe na-erughị Hg.

Na ndị ọrịa nwere hypovolemia, ụkọ sodium n'ihe metụtara ị diụ ọnya, nri na-enweghị nnu, site na ọgbụgbọ, afọ ọsịsa, mgbe achara ọsịsa, mmepe nke nnukwu akwara ike, ọgbụgba akwara na-ada ada. N'ọnọdụ ndị dị otú a, ọ ga-adị mma ka ịkwụghachi ụgwọ mmiri na mmiri na-efu tupu ịgwọ lisinopril ma nye nlekọta nlekọta ahụike. Na oke ịkpachapụ anya (na-eburu n'uche uru / ohere ịgbanye), a ga-enye ndị ọrịa ọgwụ ọgwụ mgbe ọ gbasịrị akụrụ, yana ndị ọrịa arụ ọrụ ezumike, imeju, hematopoiesis ọrịa, ọrịa autoimmune. Ọnọdụ pathologies edepụtara niile mgbe ị na-eji lisinopril chọrọ nlekọta nlekọta ahụike yana nlele ụlọ nyocha.

Aortic na mitral valve stenosis / hypertrophic cardiomyopathy. Dịka ndị ọzọ na - egbochi ACE, a naghị akwado lisinopril maka ndị ọrịa nwere mitral stenosis ma ọ bụ ihe isi ike na njikwa ọbara site na ventricle ekpe (ya na aortic stenosis ma ọ bụ cardioyopathy hypertrophic).

Alrụ ọrụ na-arụ ọrụ na ụlọ. N'ime ndị ọrịa nwere nsogbu gbasara akụrụngwa (nwechara ya

Na ndị ọrịa na- obi obara ọbara ọgbụgba, na - ebido na mmalite ọgwụgwọ nke ndị na - egbochi ACE, nwere ike ibute ọrụ ndị na-arụ ọrụ na-arụ ọrụ. N'ọnọdụ ndị dị otú a, a kọọrọ mmepe nke nnukwu akwara oke, nke a na-atụgharịkarị.

Somefọdụ ndị ọrịa nwere Stenosis biyun nke otu akụrụngwa akwara ma ọ bụ akụrụ obere akwara akwara Stenosis Ndị na-egbochi ACE na-abawanye ọkwa urea na serum creatinine, dịka iwu, mmetụta ndị a na-apụ mgbe ha kwụsịrị ọgwụ ahụ. Ohere nwere ike ịdị otú ahụ dịkarịsịrị elu na ndị ọrịa nwere ọdịda akwara.

Ọnụnọ nke ọbara mgbali ọgbụgba na-abawanye ihe ọghọm nke hypotension akwara na ọdịda akwara.

Na ụfọdụ ndị ọrịa Ag na-enweghị ọrịa akwara doro anya gbasara akụrụngwa, ojiji nke lisinopril, ọkachasị mgbe ị na-a diụ mkpụrụ ndụ akwara, na-eduga n'ịba ụba nke urea n'ọbara na creatinine n'ọbara ọbara, mgbanwe ndị a, dị ka iwu, enweghị ihe ọ bụla. Ohere ha nwere ike dị elu na ndị ọrịa nwere nsogbu ezumike nkè. N'ụdị ndị ahụ, ọ nwere ike ịdị mkpa iji belata dose na / ma ọ bụ kwụsị ị diụ ọgwụ na / ma ọ bụ lisinopril.

Na nnukwu myocardial infarction a machibidoro iwu iji lisinopril mee ndị ọrịa nwere ezigbo ọrụ ịgbazi (serum creatinine> 177 μmol / L na proteinuria> 500 mg / 24 h). Ọ bụrụ na ọrụ akụrụ na-arụ ọrụ nke ọma amalite n'oge ọgwụgwọ na lisinopril (serum creatinine> 265 μmol / L ma ọ bụ okpukpu abụọ ma e jiri ya tụnyere ọkwa mbụ), ekwesịrị ịhapụ ịkwụsị iji ya.

Hypersensitivity / angioedema. Ọ na-esikarị ike ịkọ nkọ nke ihu, aka, egbugbere ọnụ, ire, glottis na / ma ọ bụ larynx na ndị ọrịa mesoro ndị na - egbochi ACE, gụnyere lisinopril. Ọrịa Angioneurotic nwere ike ime n'oge ọ bụla n'oge ọgwụgwọ. N'ọnọdụ ndị dị otú a, ekwesịrị ịkwụsị ọgwụ ahụ ozugbo, ekwesịrị ịmalite ọgwụgwọ kwesịrị ekwesị na ịkwesịrị nlezianya nyocha ndị ọrịa iji hụ na mgbaàmà ahụ kpamkpam. N'ọnọdụ ebe edepụtara edegharị na mpaghara ire, anaghị eduga na iku ume iku ume, onye ọrịa ahụ nwere ike ịchọ nlele ogologo oge, ebe ọ bụ na ọgwụgwọ na antihistamines na corticosteroids nwere ike ezughi oke.

Achọpụtala ọnọdụ dị njọ n'ihi ọrịa anakpo nke ogwooro ma ọ bụ ire.

N'ime ndị ọrịa nwere akụkọ banyere ọrịa angioedema nke na-ejikọghị ya na iji ọgwụ mgbochi ACE, enwere ike ịbawanye n'ihe ize ndụ nke ịmalite ọrịa angioedema na mmeghachi omume nke ọgwụ a otu.

Ndị na - egbochi ACE nwere ike ibute ọrịa angioedema karịa na ndị ọrịa agbụrụ Negroid karịa ndị ọrịa nke agbụrụ Caucasian.

Mmeghachi omume anaphylactoid na ndị ọrịa na-enyocha hemodialysis. A na-akọ na mmeghachi omume anaphylactoid na ndị ọrịa na-eme n'ọbara dị (dịka ọmụmaatụ AN 69) ma mesoo ndị na - egbochi ACE n'otu oge. Ekwesịrị ịrịọ ndị ọrịa a ka ha gbanwee membranes membranes gaa membranes nke ụdị ọzọ ma ọ bụ ka ha jiri ọgwụ antihypertensive nke klaasị ọzọ.

Ọpụpụ. Ndị ọrịa na - a inụ ọgwụ mgbochi ACE n'oge ọgwụgwọ desensitization (dịka ọmụmaatụ, nsị Hymenoptera) na - azụlite mmeghachi anaphylactoid kwụsiri ike. A na-ezere mmeghachi omume ndị a na otu ndị ọrịa ahụ site na ịkwụsị oge ụfọdụ nke ndị na - egbochi ACE, mana mgbe ejiri ọgwụ ahụ na - akpachapụghị anya, e weghachiri mmeghachi omume ahụ.

Imeju imeju. O yikarịrị ka a na - ejikọta ndị na - egbochi ACE na ọrịa na - amalite site na ọrịa cholestatic jaundice ma na - aga n'ihu ngwa ngwa na necrosis na (mgbe ụfọdụ) ọnwụ. Achọpụtaghị usoro nke ọrịa a. Ndị ọrịa emeela jaundice n'oge nchịkwa nke lisinopril ma ọ bụ chọpụtawo mmụba dị ukwuu na enzymes imeju kwesịrị ịkwụsị ị theụ ọgwụ ahụ ma nye nlekọta ahụike kwesịrị ekwesị.

Neutropenia / agranulocytosis. A kọwo na ọrịa neutropenia / agranulocytosis, thrombocytopenia, na anaemia n'ime ndị ọrịa natara ndị na-egbochi ACE. N'ime ndị ọrịa nwere ọrụ ezumike nkịtị na enweghị ihe ndị ọzọ na-agbagha, neutropenia adịkarịghị. Mgbe ịkwụsị ACE inhibitor, a na-atụgharị ndọghachi ọbara na neutranencytosis na agranulocytosis. Ọ dị mkpa iji dozie lisinopril nwere oke ịkpachapụ anya nye ndị ọrịa nwere collagenosis, yana mgbe ndị ọrịa na-anata ọgwụgwọ immunosuppressive, mgbe a na-agwọ ya na allopurinol ma ọ bụ procainamide, ma ọ bụ na njikọ nke ihe ndị a gbagwojuru anya, karịsịa megide ndabere nke ọrụ ezumike ezughị ezu. Offọdụ n'ime ndị ọrịa a na-ebute ọrịa dị egwu nke na-adịghị agbakarị ọgwụ mgbochi ọgwụ siri ike. Mgbe ị na-eji ọgwụ ahụ eme ihe na ndị ọrịa dị otú a, a na-atụ aro ka inyocha ọnụ ọgụgụ nke leukocytes n'ọbara ma nye ndị ọrịa ịkọ akụkọ ọ bụla nke ọrịa.

Ughhapụ nsị. Mgbe ị usingachara ndị na - egbochi ACE, ụkwara nwere ike ịda. Abụkarị ụkwara anaghị amịpụta mkpụrụ ma kwụsị mgbe ọ kwụsịrị ọgwụgwọ. A ga-atụle ụkwara nke ndị na-egbochi ACE na nchọpụta ọdịiche dị na ụkwara dị ka otu nhọrọ enwere ike.

Gerywa Ahụ / Ahụhụ N'ime ndị ọrịa a na-awa ahụ ma ọ bụ ọgwụ na - eme ka hypotension, lisinopril nwere ike igbochi nguzobe nke angiotensin II mgbe mmesiri iweghachite nke renin. Ọ bụrụ na ahụrụ hypotension n'ihi usoro a, ọ dị mkpa iweghachi olu nke ọbara na-ekesa.

Hyperkalemia Otutu ikpe banyere ubara ogwu ndi ozo na ndi oria nke ejiri ogwu mgbochi ACE gwọọ ha, tinyere lisinopril. Ndị ọrịa nọ n'ihe egwu dị elu nke ịrịa hyperkalemia bụ ndị nwere ọrịa akụrụ, ọrịa shuga, ma ọ bụ ndị na-eji mgbakwunye potassium, ọgwụ mkpụrụ osisi potassium, ma ọ bụ ndị nọchiri nnu nnu, ma ọ bụ ndị na-a drugsụ ọgwụ ndị ọzọ na-abawanye ọgwụ potassium. (dịka ọmụmaatụ heparin).

Ndị ọrịa nwere ọrịa shuga. N'ime ndị ọrịa na-arịa ọrịa shuga na-a drugsụ ọgwụ mgbochi antidiabetic ma ọ bụ insulin, ekwesịrị ịkpachara anya na-achịkwa glycemic n'oge ọnwa mbụ nke ọgwụgwọ na ndị na-egbochi ACE.

Mmeghachi omume anaphylactoid na-eme n'oge apheresis nke lipoproteins dị ntakịrị (LDL). Na apheresis nwere dextrin sulfate, iji ACE inhibitors nwere ike ibute mmeghachi omume anaphylactic nke nwere ike igbu mmadụ. Enwere ike izere mgbaàmà ndị a site na ịkwụsị usoro ọgwụgwọ na ndị na - egbochi ACE tupu apheresis ọ bụla ma ọ bụ site na iji ọgwụ ọgwụ ndị ọzọ dochie ACE.

Njikọ agbụrụ. Ndị na - egbochi ACE nwere ike ibute ọrịa angioedema karịa na ndị ọrịa nwere agba gbara ọchịchịrị (agbụrụ Negroid) karịa ndị ọrịa agbụrụ Caucasian. Ọzọkwa, n'ime ìgwè ndị ọrịa a, mmetụta dị ala nke lisinopril apụtaghị n'ihi oke nke ụmụ irighiri ihe ndị dị ala.

Lithium. Na mkpokọta, akwadoghị ka ịme lithium na lisinopril n'otu oge.

Ihe ngbochi abuo nke renin-angiotensin- (RAAS). A kọrọ na iji otu oge ACE inhibitors, angiotensin II na-egbochi ndị na-egbochi ma ọ bụ aliskiren na-abawanye ihe ize ndụ nke hypotension, hyperkalemia, na-arụ ọrụ na-arụ ọrụ na-arụ ọrụ na-arụ ọrụ ogologo oge (gụnyere nnukwu gbasara akụrụ. Ya mere, mgbochi nke RAAS okpukpu abụọ site na iji jikọtara ACE inhibitors, ndị na-anabata nnabata angiotensin II, ma ọ bụ aliskiren akwadoghị.

N'ọnọdụ dị mkpa maka iji ọgwụ mgbochi abụọ, ọ ga-arụ ọrụ n'okpuru nlekọta nke ọkachamara ma lelee ọrụ akụrụ, ọkwa electrolyte na ọbara mgbali elu. A naghị atụ aro ka ndị ọrịa nwere ọrịa nephropathy jiri ọgwụ mgbochi ACE na mgbochi ndị nnabata angiotensin II n'otu oge.

Proteinuria A kọọrọ ihe ndị metụtara ichepụta mmepe nke protinuria na ndị ọrịa, ọkachasị na obere ọrụ gbasara akụrụngwa ma ọ bụ mgbe ọ gachara oke lisinopril. N'ihe banyere proteinuria dị mkpa na ụlọ ọgwụ (karịa 1 g / ụbọchị), ekwesịrị iji lisinopril naanị mgbe ọ tụlechara ọgwụgwọ ọgwụgwọ na ihe ọghọm yana yana ileba anya mgbe niile na parameters na biochemical.

Jiri n'oge ime na lactation

Ime A machibidoro ọgwụ a na ụmụ nwanyị dị ime ma ọ bụ ụmụ nwanyị na-eme atụmatụ ime. Ọ bụrụ n’inyocha afọ ime n’oge ọgwụ a, iji ọgwụ ahụ mee ya, ekwesịrị ịkwụsị ya ma ọ bụrụ na ọ dị mkpa, were ọgwụ ọzọ akwadoro maka iji ụmụ nwanyị ime.

A maara na ịdị ogologo oge ikpughere ndị na-egbochi ACE n'oge ọnwa nke abụọ na nke atọ nke afọ ime na-akpali ọdịdị nke fetotoxicity (ọrụ mbelata akwara, oligohydramnios, ossification of the skull) and aonatal toxicity (renal kelinal, arterial hypotension, hyperkalemia). N'ihe banyere kpughere ndị na - egbochi ACE n'oge ọnwa nke abụọ nke ịtụrụ ime, a na - atụ aro ka ileba anya na ọrụ ọkpụkpụ na cranial iji ultrasound.

Ekwesịrị ilebara ụmụ ọhụrụ nne ha buru lisinopril anya maka ọbara ọgbụgba, oliguria, na hyperkalemia.

Ara. Ebe o nweghi ihe omuma banyere ike iji lisinopril n’oge inye ara ara, a ka akwadoro ka icho lisinopril n’oge inye ara. N'ime oge a, ọ dị mma iji usoro ọgwụgwọ ọzọ, profaịlụ nchekwa nke a na-amụ nke ọma, ọkachasị ma ọ bụrụ na a na-enye nwa amụrụ ọhụrụ.

Usoro onunu ogwu na nhazi

A ga-ederịrị Lisinopril ugboro 1 kwa ụbọchị. Dịka ọgwụ ndị ọzọ a ga-a onceụ otu ugboro n'ụbọchị, a ga-ewere lisinopril kwa ụbọchị n'otu oge. Iri nri anaghị emetụta nnabata nke mbadamba ụdọ lisinopril. A ga-ekpebi dose ahụ n'otu n'otu dabere na data nyocha nke ọrịa na ndị na-egosi ọbara mgbali.

Enwere ike iji Lisinopril mee ihe dịka monotherapy yana yana klas ndị ọzọ nke ọgwụ mgbochi.

Usoro izizi maka ndị ọrịa nwere ọbara mgbali bụ 10 mg. Ndị ọrịa nwere usoro renin-angiotensin-aldosterone na-arụ ọrụ (ọkachasị, na mgbali umegharị renovascular, ịba ụba nke nnu (sodium chloride) site na ahụ na / ma ọ bụ belata olu mmiri intercellular, nkụchi obi ma ọ bụ ọbara mgbali elu) nwere ike ịnweta mbelata ọbara mgbali elu mgbe ị nwesịrị mbụ. doses. Maka ndị ọrịa dị otú a, ọgwụ a tụrụ aro bụ 2.5-5 mg, mmalite nke ọgwụgwọ kwesịrị ịmalite n'okpuru nlekọta dọkịta. Ibelata usoro izizi a ka akwadoro n’ihu ọdịda akwara (lee Isiokwu 1 dị n'okpuru).

Ọgwụ a na-atụ aro ka ọ bụrụ ọgwụ a na-atụ aro bụ 20 mg otu ugboro n'ụbọchị. Ọ bụrụ na nhọpụta nke ọgwụ a anaghị enye ọgwụgwọ zuru oke n'ime izu 2-4 mgbe ị theụ ọgwụ ahụ na usoro usoro akọwapụtara, enwere ike ịba ụba. Oke kachasị eji na nnwale ụlọ ọgwụ na-achịkwa ogologo oge bụ 80 mg kwa ụbọchị.

Ndị ọrịa na-a diụ ọgwụ.

Sympotomatic artpot hypotension nwere ike ime mgbe ebidochara ọgwụgwọ na lisinopril. O yikarịrị ka nke a maka ndị ọrịa na-a diụ ọgwụ dijitalụ mgbe ejiri lisinopril gwọọ ya.

Nhọrọ ịchọrọ maka ndị ọrịa nwere ọdịda akụrụ.

Usoro ọgwụgwọ maka ndị ọrịa nwere akụrụ gbasara akwara kwesịrị ịdabere na QC, usoro nlekọta ahụ na-adabere na nzaghachi ụlọ ọgwụ ma ahọpụtara ya site na iji akara oge niile na-egosi ọrụ akụrụ, ịta ụta nke potassium na sodium n'ọbara, dị ka egosiri na tebụl dị n'okpuru. 1.

Tebụl 1. Nhọrọ nke usoro maka ndị ọrịa nwere ọdịda akwara.