Pyramil mmezi: ntuziaka maka ojiji

Akwụkwọ ntuziaka
maka iji ọgwụ eji eme ihe maka ọgwụ

Gụọ ntuziaka ndị a nke ọma tupu ịmalite ị /ụ ọgwụ / ọgwụ.
• Chekwaa akwụkwọ ntuziaka ahụ; enwere ike ịchọrọ ya ọzọ.
• Ọ bụrụ na ị nwere ajụjụ ọ bụla, jụọ dọkịta gị.
• Edinyere ọgwụ a n’onwe gị na ekwesighi isoro ndị ọzọ kerịta ya, n’ihi na ọ nwere ike imerụ ha ahụ ọbụlagodi n’inwe otu ụdị mgbaàmà gị.

Usoro onunu ogwu:

ihe eji eme ihe: ramipril - 2.50 / 5.00 / 10.00 mg, ndị na-ebu ụzọ: microcrystalline cellulose - 296.10 / 293.60 / 289.00 mg, pregelatinized stachi - 18.00 / 18.00 / 18.00 mg, silicon dioxide nke nwere mmiri - 32,00 / 32,00 / 32,00 mg, glycine hydrochloride - 3.00 / 3.00 / 3.00 mg, gbeceryl dibehenate - 8.00 / 8.00 / 8.00 mg, iron dye oxide odo (E-172) 0.40 / - / - mg, dai iron oxide uhie (E-172) - / 0.40 / - mg.

Nkọwa:

Mbadamba 2.5 mg: mbadamba nkume plong, biconvex nke agba odo na-acha odo odo nwere oke ihe isi ike, ya na udiri oria di iche iche na agba di njo ma obu ihe egwu.
Mbadamba mbadamba 5.0 mg: mbadamba nkume plong, biconvex nke agba pink na nwere ihu siri ike, na obere patị nke agba gbara ọchịchịrị na ihe egwu dị n'otu akụkụ.
10,5 mg mbadamba: oblong, biconvex mbadamba ọcha ma ọ bụ ihe fọrọ nke nta ka ọ bụrụ ụcha na agba nwere akụkụ siri ike na ihe egwu n'akụkụ ya.

Ngwongwo ogwu

Mlọ ọgwụ
Ramipril na-abanye ngwa ngwa eriri afọ ma na-enyocha hydrolysis na imeju iji mepụta metabolite na-arụ ọrụ nke ramiprilat. Ramiprilat bụ onye na - arụ ọrụ ogologo oge ACE inhibitor, enzyme nke na - egbochi ntụgharị nke angiotensin I na angiotensin II.
Ramipril na-ebute mbelata ọkwa nke angiotensin II na plasma ọbara, mmụba nke ọrụ renin yana mbelata ntọhapụ nke aldosterone.
Na-egbochi ọkwa kininase II, na-egbochi mmebi nke bradykinin, na-eme ka njikọ nke prostaglandins dịkwuo mma. N'okpuru mmetụta nke ramipril, arịa ndị dị n'akụkụ na-agbasa ma ngụkọta ngụkọta akwara na-agbada (OPSS) na-ebelata.
Ọbara ọbara
Ọ nwere mmetụta dị ebube n'ọnọdụ onye ọrịa “dina” na “guzo”.
Ọ na - ebelata OPSS (mgbe ebesịrị ya), nrụgide na - akụ mmụọ n'ime mkpụrụ ndụ akwara na - enweghị mmụba ọnụego obi (HR).
Na-eme ka ọbara na -akpata ọbara na ọbara gbasara akwara na-enweghị mmetụ mmụba nke ọchịchị ụwa.
Mmalite nke usoro hypotensive n'ime 1-2 awa mgbe ịbasịchara, mmetụta kachasị na-etolite 3-6 awa mgbe nchịkwa. Omume ahụ dịkarịa ala elekere 24.
Ọrịa obi na-adịghị ala ala na nkụda obi n'ihi nnukwu myocardial infarction
Ramipril belatara OPSS na, n'ikpeazụ, ọbara mgbali.
Na-abawanye mmeputa obi na ndidi. Site na iji ogologo oge, ọ na-enye aka na mmepe nke myocardial hypertrophy na ndị ọrịa nwere nkụda obi nke klas arụ ọrụ nke I na nke II dịka nhazi NYHA, na-eme ka inye ọbara dị mma na ischemic myocardium.
Ramipril na-abawanye lanarị ndị ọrịa nwere ihe mgbaàmà nke mgbanwụ ahụ ma ọ bụ nkụchi obi na-adịghị ala ala mgbe mịkasịial infarction. O nwere mmetụta cardioprotective, na-egbochi ọgbụgba akwara ụbụrụ, na-ebelata ohere ịbelata infarction myocardial ma belata oge ịnọ n'ụlọ ọgwụ.
Ọrịa mamịrị na-arịa ọrịa mamịrị na-arịa ọrịa mamịrị
N'ime ndị ọrịa nwere ọrịa shuga na ọrịa nephropathy, ị raụ ramipril na-agbadata ọnụego nke ngụgụ nke ọdịda akụrụ na mmalite nke akwara gbasara njedebe akụrụngwa na, yabụ, na-ebelata mkpa ịba ọria ma ọ bụ mmịnye akụrụ. N'ime mmalite nke ọrịa mamịrị ma ọ bụ nephropathy, ọrịa ramipril na-ebelata ogo albuminuria.
Ndị ọrịa nọ n'ihe egwu dị elu nke Ọrịa obi
n'ihi vaskụla ọnya (ọrịa obi na-arịa ọrịa obi na-arịa (CHD), na-arịa ọrịa akwara ma ọ bụ akụkọ banyere ọrịa strok), ọrịa shuga na-arịa otu ihe ize ndụ ndị ọzọ (microalbuminuria, ọbara mgbali elu, ịba ụba mkpo plasma nke mkpokọta cholesterol (OX), belatara mkpo plasma njupụta nke lipoprotein cholesterol (HDL-C), ị smokingụ sịga) mgbakwunye nke ramipril na usoro ọkọlọtọ na-ebelata mbelata nke infarction myocardial, ins lta na ọnwụ site obi na-akpata.
Mlọ ọgwụ
Ramipril na-abanye ngwa ngwa na eriri afọ mgbe nchịkwa ọnụ. Anakpo nnwere onwe n’enweta nri.
Mgbe a gbasasịrị, ramipril ngwa ngwa ọ fọrọ nke nta ka ọ bụrụ ọrụ metabolite na-arụ ọrụ nke ramiprilat n'okpuru ọrụ nke umeji esterase enzyme. Ramiprilat dị ihe dị ka ugboro isii karịa ike igbochi ACE karịa ramipril. Achọpụtakwala metabolites ndị ọzọ na-adịghị arụ ọrụ.
N'ime ndị ọrịa nwere ọrụ akwara nwere nsogbu, mgbanwe nke ramipril n'ime ramiprilat na-adalata n'ihi ntakịrị oge esterase, ya mere, ọkwa nke ramipril na plasma ọbara dị na ndị ọrịa a na-abawanye.
A na-enweta ntinye uche kachasị nke ramipril na plasma n'ime otu elekere mgbe nchịkwa, ramiprilat - n'ime awa 2-4 mgbe ị takingụ ọgwụ ahụ.
Bioavailability ramipril bụ 60%. Nkwukọrịta na protein plasma ruru 73% maka ramipril na 56% maka ramiprilat. Mgbe ị mechara 5 mg, mwepụ nke akụrụngwa nke ramipril bụ 10-55 ml / min, mwepu nke extrarenal ruru 750 ml / min. Maka ramiprilat, ụkpụrụ ndị a bụ 70-120 ml / min na ihe dịka 140 ml / min, n'otu n'otu. Ramipril na ramiprilat bụ ndị kachasị wepụtara site na akụrụ (40-60%). N'ịrụ ọrụ mgbazinye nsogbu, mkpochapu ha na-adalata.
Ọkara ọkara nke ramiprilat na iji ogologo oge na 5-10 mg otu ugboro n'ụbọchị bụ 13-17 awa.

Ihe ngosi maka ojiji

• ọbara mgbali elu,
• nkụda obi na-adịghị ala ala (dịka akụkụ nke ọgwụgwọ njikọta),
• ọrịa mamịrị na-arịa ọrịa shuga ma ọ bụ ọrịa mamịrị, na-ekwupụta ọnọdụ ya, na-adakarị, gụnyere ya proteinuria siri ike, ọkachasị mgbe ejikọtara ya na ọbara mgbali elu yana ọnụnọ microalbuminuria,
• belata ihe dị na infarction myocardial, ọrịa strok, ma ọ bụ ọnwụ obi na ndị ọrịa nwere nnukwu ọrịa ọrịa obi:
- n'ime ndị ọrịa ekwenyela na ọrịa akwara ọbara, ọrịa infarction na myocardial infarction ma ọ bụ na-enweghị akụkọ ntolite nke ndị ọrịa, gụnyere ndị ọrịa na-agafekwa ọbara na-agafe agafe na ọrịa angioplasty, akwara nje akwara na-agagharị agagharị,
- n'ime ndị ọrịa nwere ọrịa strok,
- n'ime ndị ọrịa nwere ọnya ọrịa anya nke akwara,
- n'ime ndị ọrịa nwere ọrịa shuga nwere opekempe ihe egwu ọzọ (microalbuminuria, ọbara mgbali elu, ịba ụba plasma nke OX, belata plasma nke HDL-C, ịse anwụrụ),
• nkụda obi nke toro n'ime ụbọchị ole na ole mbụ (site na ụbọchị abụọ ruo ụbọchị 9) mgbe nnukwu ọgbụgba myocardial dị ukwuu.

Ihe ngbanwe

• hypersensitivity na ramipril, ndị ọzọ ACE inhibitors ma ọ bụ ihe inyeaka nke ọgwụ ahụ,
• ọrịa ụbụrụ ma ọ bụ idiopathic angioedema Quincke (gụnyere ị ACụ ACE inhibitors na akụkọ ntolite),
• ihe akwara dị na akwara ukwu (akwara abụọ ma ọ bụ otu agụrụ),
• akpata oyi n'ahụ,
• hyperaldosteronism nke mbụ,
• ọbara ọgbụgba siri ike (mgbali ọbara systolic na-erughị 90 mm Hg) ma ọ bụ ọnọdụ nwere hemodynamics kwụsiri ike,
• ịtụrụ ime
• oge ị breastụ ara,
• ruo afọ 18 (amụbeghị banyere ịdị mma na nchekwa nke iji),
• odida nnukwu akụrụngwa (mwepụta creatinine (CC) erughị 20 ml / min / 1.73 m²),
• nnukwu ọrịa imeju (enweghi ahụike ọria),
• ọrịa ịba ọcha n'anya ma ọ bụ ịba ọcha n'anya na-eji ụfọdụ membranes nwere oke na-adịghị mma ebubo (oke ọnya polyacrylonitrile dị elu (ihe ize ndụ nke ịmalite mmeghachi omume hypersensitivity)),
• oge nke lipoproteins dị ntakịrị nke na-eji sulfate dextran (ihe egwu nke ịmalite mmeghachi omume hypersensitivity),
• iji mee ihe na nnukwu ọrịa myocardial infarction: nnukwu obi nkụchi (CHF) (klaasị NYHA klas arụ ọrụ), angina na-ejideghi, ihe egwu obi na - egbu obi, ihe na - egbu obi.
Dị ka ọ dị ndị ọzọ na - egbochi ACE, ojiji nke ramipril na ọgwụ nwere aliskiren bụ contraindicated na ndị ọrịa nwere ọrịa mellitus ma ọ bụ agafeghị oke ma ọ bụ ọdịda na-adịghị mma (CC erughị 60 ml / min / 1.73 m²),
• n'otu oge nke angiotensin II receagonor antagonists na ndị ọrịa na-arịa ọrịa mamịrị nephropathy,
• nephropathy, nke a na-agwọ ya na glucocorticosteroids, ọgwụ mgbochi mkpali na-abụghị steroidal (NSAIDs), immunomodulators na / ma ọ bụ ọgwụ cytotoxic ndị ọzọ (Ahụmahụ ụlọ ọgwụ ezughi ezu),
• akwara maaticis ma ọ bụ mitral stenosis (ihe ọghọm nke mbelata ọbara mgbali elu sochiri ọrụ na-arụ ọrụ na-arụ ọrụ nke ukwuu (CC karịa 20 ml / min / 1.73 m²), hyprorophic obstructive cardiomyopathy.

Jiri nlezianya

Ojiji nke oge a na ọgwụ nwere aliskiren, ma ọ bụ ya na angiotensin II antagonist antagonist, na-eduga na mgbochi abụọ nke usoro renin-angiotensin-aldosterone (RAAS), hyperkalemia, hyponatremia (gụnyere megide ndabere nke nri afọ na nri nwere mgbochi nnu). ọrịa shuga mellitus (ihe ize ndụ nke hyperkalemia), nkụda obi na-adịghị ala ala, nke ka njọ ma ọ bụ maka ọgwụ ndị ọzọ nwere mmetụta antihypertensive, ọrịa akwara na ọnya ụbụrụ. akwara akwara (onwu osiso na obara nke obara), otutu ihe ana - eme ka akuko gi puta (onodu nke akuko), onodu tinyere osighari olu nke inye obara (tinyere oria, uchu), n’otu oge eji eme oriri lithium, immunosuppressants na saluretics, ọrịa anụ ahụ jikọrọ ọnụ (gụnyere sistemu lupus erythematosus, scleroderma - intanitenia abawanye nke neutropenia ma ọ bụ agranulocytosis), desensitizing ọgwụ, afọ dị elu (karịa afọ 65) (mụbara nsogbu nke concoitant dysfunction nke imeju na / ma ọ bụ akụrụ na obi nkụchi), ọnọdụ mgbe ntụgharị akụrụ, ọdịda imeju.

Jiri n’oge ime na n’oge a na-enye nwa ara

Eji ọgwụ ogwu Pyramil pregnancy n’oge ime na inye nwa ara, n’ihi iji ramipril nwere ike na-enwe mmetụta dị njọ na nwa ebu n’afọ: mmebi nke akụrụ nwa ebu n’afọ, mbelata ọbara mgbali n’ute nwa na nwa amụrụ ọhụrụ, ọrụ akụrụngwa, hyperkalemia, hypoplasia nke ọkpụkpụ nke okpokoro isi, hypoplasia nke ngụgụ. Achọghị Pyramil for maka ụmụ nwanyị na-eme atụmatụ ịtụrụ ime. Maka oge ịtụrụ ime n'oge ọgwụgwọ Pyramil drug, ị ga-akwụsị ị takingụ ọgwụ ozugbo o kwere omume wee lelee mmepe nwa ebu n’afọ.
Womenmụ nwanyị nke afọ omumu na-anata ọgwụgwọ na ndị na-egbochi ACE kwesịrị iji ọgwụ mgbochi dị irè.
Ọ bụrụ na ụmụ nwanyị toro afọ na-arịa ọbara mgbali elu na - ewere ndị na - egbochi ACE, mgbe ahụ ekwesịrị icheta na n'oge ime ime, nyefee onye ọrịa ahụ ka ọ takingụọ ọgwụ hypotensive site na otu ọzọ. N'okwu niile, ọ dị mkpa ilezi anya maka nlekọta ahụike.
Onweghi ihe akaebe banyere ma ramipril puru na mmiri ara ara.
Nnyocha ụmụ anụmanụ egosila na arara ramipril na mmiri ara ehi. A contraụ ọgwụ iji Pyramil ® n’oge a na-enye nwa ara. Ọ bụrụ na ọ dị mkpa ịnye onye Pyramil ọgwụ ọgwụ a na-elekọta nwa, a ga-ekpebi okwu banyere ịkwụsị inye ya ara.

Usoro onunu ogwu na nhazi

N'ime, n'agbanyeghị nri nri, na-enweghị ịta ata, ị drinkingụ nnukwu mmiri (iko 1-2).
A na-ahọrọ dose ahụ dabere na ọgwụgwọ ọgwụgwọ na ndidi na ndidi maka ọgwụ.
Ọbara ọbara
Usoro akwadoro ịmalite Pyramil ® maka ndị ọrịa na-enweghị nkụda obi na-anaghị a diụ ọgwụ bụ 2.5 mg kwa ụbọchị. Enwere ike ịbawanye dose ahụ kwa izu 2-3 dabere na nsonaazụ na nnagide. Oke kacha bụ 10 mg otu ugboro n'ụbọchị.
Dị ka ọ dị, ọ̀rụ nchekwa bụ 2.5-5 mg otu ugboro kwa ụbọchị.
Enweghị mmetụta ọgwụgwọ na-eju afọ mgbe ị na-ewere 10 mg kwa ụbọchị nke Pyramil ®, a na-atụ aro ịhọpụta ọgwụ ndị jikọrọ ọnụ.
Ọ bụrụ na onye ọrịa ahụ na-a diụ ọgwụ akwara, ha kwesịrị ịkwụsị ị themụ ya ma ọ bụ belata ọgwụ ha ruo ụbọchị 2-3 tupu mmalite nke Pyramil ®. Maka ndị ọrịa dị otú a, ụdị ọgwụ a tụrụ aro ya bụ 1.25 mg (1/2 mbadamba 2.5 mg) otu ugboro n’ụbọchị.
Ọrịa obi na-adịghị ala ala
Ngosipụta mbụ Pyramil ® bụ 1.25 mg (1/2 mbadamba 2.5 mg) otu ugboro n’ụbọchị.
Enwere ike ịbawanye ogwu ahụ nwayọ dabere na nsonaazụ ya na ntachi obi, na-agbagha ya kwa izu 1-2. A pụrụ ịụ ya 2,5 mg kwa ụbọchị ma nke ka elu n’otu ụzọ abụọ.
Oke kacha bụ 10 mg otu ugboro n'ụbọchị.
Maka ndị ọrịa na-a ofụ ọgwụ mgbatị dị elu, a ga-ebelata ọgwụ ha tupu ịmalite ọgwụgwọ na Pyramil order iji belata ihe ize ndụ nke ịmalite ịmịnye ọbara ọgbụgba.
Iji belata ihe ize ndụ nke infarction myocardial, ọrịa strok, ma ọ bụ ọnwụ obi na ndị ọrịa nwere nnukwu ọrịa obi.
Usoro akwadoro ịmalite: 2.5 mg otu ugboro kwa ụbọchị. Dabere na ntachi obi, enwere ike okpukpu abụọ nke ọgwụ ahụ ka izu 1 nke ọgwụgwọ gasịrị, na izu 3 nke ọgwụgwọ na-esote, mụbaa ya na usoro mmezi nke 10 mg otu ugboro n'ụbọchị.
Ọkpụkpụ obi n'ihi nnukwu ọrịa myocardial infarction
Ọgwụgwọ na-amalite ụbọchị 3-10 mgbe nnukwu ọrịa myocardial infarction.
Mkpụrụ mbụ nke Pyramil ® bụ 5 mg kwa ụbọchị (2.5 mg ugboro abụọ n'ụtụtụ na ná mgbede), mgbe ụbọchị abụọ ahụ na-amụba dose ahụ ruo 5 mg ugboro abụọ n'ụbọchị.
Site na ntachi obi na ọkwa mbụ nke 2.5 mg ugboro abụọ n'ụbọchị, a ga-edenye ọgwụ nke 1.25 mg (1/2 mbadamba 2.5 mg) ugboro abụọ kwa ụbọchị, emesịa ịbawanye ọgwụ ahụ gaa na 2.5 mg na 5 mg ugboro abụọ kwa ụbọchị. Ọgwụ nchekwa Pyramil ® bụ 2.5-5 mg ugboro abụọ n'ụbọchị. Ogo kachasị kwa ụbọchị bụ 10 mg.
Ọrịa mamịrị na-arịa ọrịa mamịrị na-arịa ọrịa mamịrị
Usoro akwadoro nke Pyramil ® bụ 1.25 mg (1/2 mbadamba 2.5 mg) otu ugboro n’ụbọchị.
Dabere na ntachi obi, enwere ike ịgbanye okpukpu abụọ na etiti oge izu abụọ ruo na nke kacha nke 5 mg kwa ụbọchị.
Ọ bụrụ na onye ọrịa ahụ na-a diụ ọgwụ akwara, ha kwesịrị ịkwụsị ị themụ ya ma ọ bụ belata ọgwụ ahụ ụbọchị 2-3 tupu mmalite nke Pyramil ®, na nke a, usoro ọgwụgwọ atụtara Pyramil recommended dị mbụ bụ 1.25 mg (1/2 mbadamba 2.5 nke mg mg) otu ugboro n'ụbọchị.
Ndị ọrịa nwere ọrụ mgbazinye nsogbu
Maka ndị ọrịa nwere nsogbu akụrụngwa ezighi ezi (mwepụta creatinine (CC) 20-50 ml / min / 1.73 m²), usoro ọgwụgwọ akwadoro nke Pyramil ® bụ 1.25 mg (1/2 mbadamba 2.5 nke mg mg) otu ugboro kwa ụbọchị. , na ọgwụ kachasị ekwesighi gafere 5 mg kwa ụbọchị. Na ọdịda akụrụngwa siri ike (CC n'okpuru 20 ml / min / 1.73 m²), usoro akwadoro nke Pyramil ® bụ 1.25 mg (1/2 mbadamba 2.5 mg) otu ugboro n'ụbọchị, ọ bụrụ na ọ dị mkpa, enwere ike ịbawanye dose ahụ. ihe ruru 2.5 mg kwa ụbọchị.
Ndị ọrịa nwere ọria imeju
N'ime ndị ọrịa nwere ọrụ imeju na-arịa ọrịa, enwere ike ịhụ mmụba ma na-akụda mmụọ ọgwụgwọ Pyramil ®. Ekwesịrị ịmalite ọgwụgwọ n'okpuru nlekọta dọkịta na-eji ọgwụ nke 1.25 mg (1/2 mbadamba 2.5 mg). Ogwu kachasị elu ekwesịghị ịfe 2.5 mg kwa ụbọchị.
Ndị okenye (ndị okenye karịrị afọ 65)
Ekwesịrị ịkpachara anya mgbe a na-edegara ndị Pyramil ọgwụ ọgwụ Pyram an ma ọ bụrụ na ha nwere akụrụ ma ọ bụ imeju, yana nkụchi obi na / ma ọ bụ ojiji ọnya ọnya.
Ekwesịrị ịhọrọ dose ahụ n'otu n'otu dabere na ọkwa ọbara mgbali elu. A na-ebelata ọgwụ izizi na 1.25 mg kwa ụbọchị.

Mmetụta akụkụ

Dị ka Healthtù Ahụ Ike (wa (WHO) si kwuo, a na-ekewa mmetụta ndị na-achọghị dịka oge ha nke mmepe dị ka ndị a: ọtụtụ mgbe (≥ 1/10), ọtụtụ mgbe (≥1 / 100), site na usoro akwara obi.
mgbe: akara mbelata ọbara mgbali elu, na-emebi orthostatic usoro nke olu vaskụla (orthostatic hypotension), syncope,
ugboro ugboro: orthostatic ida, myocardial ischemia, tinyere mmepe nke ọgụ nke angina pectoris ma ọ bụ myocardial infarction, ihe mberede cerebrovascular (n'ihi oke ọbara ọgbụgba na ndị ọrịa n'ihe ize ndụ), tachycardia, arrhythmia, peripheral edema, palpitation, ọbara ọgbụgba na akpụkpọ nke ihu,
adịkarịghị: ihe omume ma ọ bụ mmebi nke ọrịa mgbasa na nzụlite ọnya ọnya afọ, vasculitis,
amaghi ugboro: Ọrịa Raynaud.
Site na akụkụ ahụ dị na hemopoietic
ugboro ugboro: eosinophilia
adịkarịghị: leukopenia, gụnyere neutropenia na agranulocytosis (neutropenia na agranulocytosis na - atụgharị ma na - apụ n'anya mgbe a kagbuo ndị na - egbochi ACE), anaemia, thrombocytopenia, lymphadenopathy, mbelata hemoglobin,
amaghi ugboro: mgbochi nke ụmị ọkpụkpụ, pancytopenia, anaemia hemolytic.
Site na sistemụ ụjọ
mgbe: ike ọgwụgwụ, isi ọwụwa,
ugboro ugboro: Ike ọgwụgwụ, nchekasị, ahụ́ ịma jijiji, paresthesia, iribiga nri, nsogbu ihi ụra, nsogbu ehighị ụra, nchegbu ụjọ,
adịkarịghị: ịma jijiji, enweghị atụ, ọgba aghara,
amaghi ugboro: ischemia nke ụbụrụ, gụnyere ọrịa strok na obere nsogbu nke ụbụrụ ụbụrụ, parosmia (echiche na-esi isi ike), mmeghachi omume psychomotor, nsogbu ịta ahụhụ.
Site na anụ ahụ anụ ahụ
ugboro ugboro: nsogbu ndị a na-ahụ anya, gụnyere onyunyo na-acha nkọ, nsogbu na-atọ ụtọ,
adịkarịghị: conjunctivitis, nkwarụ ntị, tinnitus (mmetụta nke ịda ụda, tinnitus).
Site na sistem iku ume
mgbe: Ikwu "akpọnwụ", ọnya afọ, sinusitis, mkpụmkpụ ume,
ugboro ugboro: bronchospasm, tinyere mkpachapụ anya na umeji ụkwara umeji, imi mkpọchi.
Site na nri diges
mgbe: mmeghachi omume mgbu na afọ na eriri afọ, mgbari nri, ahụ erughị ala afọ, dyspepsia, afọ ọsịsa, ọgbụgbọ, ọgbụgbọ,
ugboro ugboro: pancreatitis, ịba ụba nke “imeju” transaminases na plasma conjugated bilirubin ịba ụba, ịba ụba pancreatic enzyme ọrụ, angioedema eriri afọ, mgbu afọ, gastritis, afọ ntachi, ọnụ akọrọ,
adịkarịghị: glossitis, cholestatic jaundice, ọnya hepatocellular,
amaghi ugboro: aphthous stomatitis (mmeghachi omume mbufụt nke mucosa onu), oke imeju na-ada, cholestatic ma ọ bụ cytolytic ịba ọcha n'anya, gụnyere egbu egbu.
Site na urinary tract
adịkarịghị: arụmọrụ gbasara akụrụ, gụnyere mmepe nke akwara oke, mmụba mmamịrị, ịba ụba proteinuria, nwee ịba ụba urea na creatinine n'ime ọbara.
Na akụkụ anụ ahụ na akpụkpọ ahụ mucous
mgbe: akpụkpọ ahụ na-eme ngwa ngwa, ọkachasị maculopapular,
ugboro ugboro: angioedema, gụnyere egbu egbu (edema laryngeal nwere ike ibute mgbochi ikuku na-eduga na ọnwụ), itching skin, hyperhidrosis (sweating pressure),
adịkarịghị: dermatitis exfoliative, urticaria, onycholysis (exfoliation nke ntu site na anụ ahụ dị nro nke mkpịsị aka),
adịkarịghị: mmeghachi omume nbelata
amaghi ugboro: necrolysis na-egbu egbu, Stevens-Johnson syndrome, erythema multiforme, pemphigus (cystic rash), na-akawanye njọ nke psoriasis, psoriasis-like dermatitis, pemphigoid ma ọ bụ lichenoid exanthema ma ọ bụ enanthema, alopecia.
Site na usoro akwara
mgbe: mgbo, akwara,
ugboro ugboro: arthralgia.
Site n'akụkụ nke metabolism
mgbe: na-abawanye potassium na ọbara,
ugboro ugboro: anorexia, agụụ belatara,
amaghi ugboro: ibelata sodium n’ime ọbara.
Site na usoro ahụ ji alụso ọrịa ọgụ
amaghi ugboro: mmeghachi omume anaphylactic ma ọ bụ mmeghachi omume anaphylactoid, ụba titer nke ọgwụ antiinuclear.
Usoro endocrine
amaghi ugboro: ọrịa nke ezughị oke nke homonụ antidiuretic (SNA ADH).
Site na usoro ọmụmụ
ugboro ugboro: enweghi ike ọgwụgwụ n'ihi ụkọ ọgbụgba, mbelata libido,
amaghi ugboro: gynecomastia.
Ọrịa na nkwarụ izugbe na saịtị ịgba ahụ
mgbe: obi mgbu, ike ọgwụgwụ,
ugboro ugboro: ahụ ọkụ
adịkarịghị: asthenia.

Dodoụbiga ya ókè

Ọrịa oke vasodilation oke na mmepe nke mbelata ọbara mgbali elu (BP), ujo, bradycardia, nrụgide mmiri-electrolyte, ujo, ọdịda akụrụ oke, nzuzu.
Ọgwụgwọ: N'okwu dị nro nke ịdoụbiga mmanya ókè: lavage gastric, nchịkwa nke adsorbents, sodium sulfate (ọkacha mma n'ime nkeji iri atọ mbụ ka nchịkwa gasịrị). Ekwesịrị inyocha ọrụ nke akụkụ ahụ dị mkpa. N'okwu ndị siri ike karị, usoro nke ịkwụdo ọbara mgbali ọgụ: nchịkwa intravenous nke 0.9% nke sodium chloride, ntụgharị plasma, ntinye nke pacemaker anụ ahụ nwa oge na bradycardia na-eguzogide ọgwụ, hemodialysis. Site na mbelata ọbara mgbali elu, enwere ike itinye mgbakwunye nke ag-adrenergic agonists (norepinephrine, dopamine) na ọgwụgwọ iji mejupụta olu nke mgbasa ọbara ma weghachite nguzo mmiri-electrolyte. N'ihe banyere bradycardia, a na-atụ aro ịhọpụta atropine ma ọ bụ itinye ya n'ọrụ pacemaker nwa oge.
Ọ dị mkpa iji nlezianya nyochaa ọbara mgbali, ọrụ akụrụ yana electrolytes serum.
Enweghị ahụmịhe n'iji diureis a na-amanye, mgbanwe mgbanwe pH, mmamịrị ma ọ bụ ọgwụgwọ iji mee ka mwepụ nke ramipril ahụ dị ngwa. A na-egosipụta hemodialysis n'ọnọdụ mmepe nke akwara ituli.

Mmekọrịta na ọgwụ ndị ọzọ

Ngwakọta ndị amachibidoro
Ojiji nke ụfọdụ membranes dị elu nwere oke na-adịghị mma (dịka ọmụmaatụ, polyacryl-nitrile membranes) n'oge hemodialysis ma ọ bụ mmịpụta, ojiji nke dextran sulfate n'oge oge nke lipoproteins dị ala nwere ike ibute ihe egwu anaphylactic mmeghachi omume, ma ọ bụrụ na onye ọrịa ahụ chọrọ ịrụ usoro ndị a, ụdị ọzọ memb (n'ihe banyere plasmapheresis na hemofiltration) ma ọ bụ bufee onye ọrịa ahụ ka ọ takingụọ ọgwụ ndị ọzọ na-egbochi ya.
Dị ka ndị ọzọ ACE inhibitors, ojiji jikọtara ramipril na aliskiren na ọgwụ aliskiren nwere ndị ọrịa nwere ọrịa mellitus ma ọ bụ ọdịda na-adịghị ala ala (CC na-erughị 60 ml / min / 1.73 m²).
Iji ya na ndị ọzọ na - egbochi ACE na - ebuso ndị ọzọ nsogbu na - ebulite nsogbu nke ọdịda akwara (gụnyere nnukwu ọrịa gbasara akụrụ), hyperkalemia.
Ojiji nke ọgwụ nje na angiotensin II antagonist na ndị ọrịa nwere ọrịa nephropathy na-adịkarị n'etiti ndị ọrịa.
Ejikọtara ọnụ iji kpachara anya
Jiri ya mee ihe potassium salts, potassium na-eme ka ọnụọgụ dị iche iche (dịka ọmụmaatụ, amiloride, triamteren, spironolactone), yana ọgwụ, na-enye aka na mmụba na potassium protein (gụnyere trimethoprim, tacrolimus, cyclosporine, antiotensin II receptor antagonists) nwere ike iduga ụba protein serum (chọrọ nlebara anya mgbe niile nke ọkwa potassium).
Ọgwụ antihypertensive (alfuzosin, doxazosin, prazosin, tamsulosin, terazosin), baclofen, diuretics, nitrates, tricyclic antidepressants, antipsychotics, ọgwụ ịrahụ ụra, ọgwụ narcotic, ndị nnọchi anya izugbe na ọgwụ mgbatị mpaghara. welie mmetụta antihypertensive nke ramipril.
Vasopressor sympathomimetics yana ọgwụ ndị ọzọ na - akpata mmetụta antihypertensive (dịka ọmụmaatụ, isoproterenol, dobutamine, dopamine, epinephrine) belata mmetụta antihypertensive nke ramipril, ma achọrọ ileba ọbara mgbe niile.
Jiri ya mee ihe allopurinol, procainamide, cytostatics, immunosuppressants, corticosteroids (glucocorticosteroids na mineralocorticosteroids) na ụzọ ndị ọzọ nwere ike isi metụta usoro hematological, na-eme ka ohere nke mmepe leukopenia dịkwuo elu.
Agaghị atụ aro iji ramipril na corticosteroids n'otu oge.
Nnu nke lithium na-ebute mmụba nke mkpokọta lithium na ọbara ọbara yana mmụba na akwara obi na mmetụta neurotoxic nke lithium.
Ramipril na-akwalite mmetụta hypoglycemic ndị ọrịa hypoglycemic (insulin, ndị na-ahụ maka hypoglycemic maka nchịkwa ọnụ (usoro sulfonylurea)) ruo mmepe nke hypoglycemia. Achọrọ glucose njikwa.
Vildagliptin eduga na mmụba nke ọrịa angioedema.
Na-ejikọ ọnụ iji ramipril na mTOR (mammalian Target nke Rapamycin - lekwasịrị rapamycin na sel mammalian), dịka ọmụmaatụ, na temsirolimus, nwere ike ibute mmụba nke angioedema.
Njikọ iji tụlee
Ọgwụ ndị na-alụso ọrịa ọgụ ọgụ (NSAIDs) (dịka ọmụmaatụ, acetylsalicylic acid (karịa 3 g / ụbọchị), cyclooxygenase-2 inhibitors (COX2) nwere ike ibelata mmetụta antihypertensive nke ramipril, yana ịkpata arụmọrụ ezinaụlọ, mgbe ụfọdụ na-eduga na mmepe nke ọdịda akwara. Heparin nwere ike ịba ụba potassium.
Sodium Chloride nwere ike ibelata mmetụta nke ramipril.
Ekwesighi iwesa ya ethanol n'oge ọgwụgwọ na ramipril (a na-eme ka mmetụta ethanol dị na usoro ụjọ ahụ (CNS) dịkwuo mma).
Estrogens emebi mmetụta antihypertensive (njigide mmiri).
Ahụ́ ọkụ ọgbụgba ọsịsọ na oke ọmụrụ nwa na nsị ahụhụ. Ndị na-egbochi ACE, gụnyere ramipril, na-amụba ohere nke ịmalite ịrịa ọrịa anaphylactic siri ike ma ọ bụ mmeghachi omume anaphylactoid na nsí ụmụ ahụhụ.

Ntụziaka pụrụ iche

Tupu ịmalite ọgwụgwọ Pyramil ®, ọ dị mkpa iji kpochapụ hyponatremia na hypovolemia. N'ime ndị ọrịa burula ọgwụ ịba ọcha n'anya, ọ dị mkpa ịkagbu ma ọ bụ belata ọgwụ ha 2-3 ụbọchị tupu ịmalite ị Pyụ ọgwụ Pyramil ®. N'okwu a, a ga-eji nlezianya nyochaa ọnọdụ ndị ọrịa nwere ọrịa obi na-esighị ike n'ihi ohere nke ibute nkwarụ na ndị ọrịa nwere oke ọbara.
Mgbe ha takingụsịrị ọgwụ nke mbụ, yana ịbawanye ọnya nke diuretic na / ma ọ bụ Pyramil ®, ndị ọrịa kwesịrị ịnọ n'okpuru nlekọta ahụike maka elekere 8 n'ihi ohere nke ịmalite ịmịnye hypolatet orthostatic.
Ọrịa ọbara ọgbụgba dị ala abụghị ihe mgbochi maka ịkawanye ọgwụgwọ Pyramil ®, ebe ọ bụ na mgbe ị na-eweghachi olu nke inye ọbara na inye ọbara ọgbụgba, ị takingụ ọgwụ ndị ọzọ na -emekarị anaghị ebute hypotension arterial hypotension.
N'ihe banyere ugboro ugboro na oke ọgbụgba ọbara, a ga-belata dose ahụ ma ọ bụ kwụsị ọgwụ ahụ. Ndị ọrịa nwere oke ume ọbara mgbali elu ma ọ bụ obi nkụchi obi, ọkachasị mgbe ọ dị nnukwu nke myocardial infarction, kwesịrị ịmalite ọgwụgwọ. naanị n'ụlọ ọgwụ.
N'ime ndị ọrịa nwere ọrịa obi na-adịghị ala ala, iwere Pyramil ® nwere ike ibute mbelata ọbara mgbali elu, bụ nke n'ọnọdụ ụfọdụ na-esonyere oliguria ma ọ bụ azotemia na adịkarịghị mmepe nke nnukwu nsogbu gbasara akwara.
Ndị ọrịa nwere ọrụ RAAS ịba ụba nke na-a theụ ọgwụ ahụ maka oge mbụ ma ọ bụ na ọnụọgụ dị ukwuu kwesịrị ilebara mgbali ọbara anya na ọrụ akụrụ, ọkachasị na mbido ọgwụgwọ, ebe ndị ọrịa a nwere ohere dị ukwuu nke mbelata ọbara mgbali elu na ọrụ ezigharị na-akpata n'ihi mgbachi nke ACE.
Ekwesịrị iji nlezianya na-emeso ndị ọrịa agadi, n'ihi na ha nwere ike ịmatacha ndị na-egbochi ACE.
Ekwesịrị iji nlezianya mee ihe n'oge mgbatị anụ ahụ na / ma ọ bụ ihu igwe na-ekpo ọkụ n'ihi ihe ize ndụ nke ọsụsọ na mmiri mmiri na -echekarị site na mmepe nke hypotension n'ihi mbelata olu nke mgbasa ọbara yana mbelata nke ọdịnaya sodium n'ime ọbara.
Tupu na mgbe ọ na-eme Pyramil ®, ọ dị mkpa ileba anya na ọrụ gbasara akụrụngwa (creatinine, urea), potassium plasma, ọnụọgụ ọbara, ọbara haemoglobin na umeji.
Site na mmepe nke ọrịa cholestatic jaundice ma ọ bụ mmụba dị ukwuu na ọrụ nke "akwara" transaminases, ị kwesịrị ịkwụsị ị takingụ ọgwụ mgbochi ACE.
Ndi otu nsogbu a bu hyperkalemia bu ndi oria na nsogbu akwara ha, oria di mellitus, tinyere ndi n’enye ogwu, udiri nri nke potassium ma obu mmanu ndi nwere mmanu ndi mmadu na aru ike (nke ima bu heparin).
N'ime ndị ọrịa nwere oke ihe ize ndụ nke neutropenia (yana ọrụ akwara nwere nsogbu, ọrịa systemic nke anụ ahụ na - ejikọta ya), mgbe ị na-a Pyụ ọgwụ Pyramil ®, a ga-enyocha ule ọbara n'obara otu ugboro kwa ọnwa n'ime ọnwa 3-6 mbụ nke ọgwụgwọ, yana na akara mbụ nke ọrịa. Ọ bụrụ na achọpụtara na neutropenia (ọnụọgụ nke neutrophils erughị 2000 / μl), a ga-akwụsị ịgwọ ndị na-egbochi ACE.
N'ọnọdụ ndị a na-adịghị ahụkebe, mgbe ejiri ya na ndị mgbochi ACE, gụnyere ramipril, angioedema nke ihu, aka, egbugbere ọnụ, ire, larynx na / ma ọ bụ pharynx. Ọ bụrụ na edema nwere ike itolite na mberede n'oge ọgwụgwọ ọ bụla, ịkwesịrị ịkwụsị ị theụ ọgwụ ahụ ozugbo, lekọta ahụike mberede ma hụ na iji nlezianya nyochaa onye ọrịa ahụ ruo mgbe mgbaàmà ahụ ga-akwụsị kpamkpam na kpamkpam.
N'ime ndị ọrịa na-anata ndị na-egbochi ACE, a hụrụ oge ọrịa angioedema nke akụkụ eriri afọ, nke emere site na mgbu azụ na ya ma ọ bụ na-enweghị ọgbụgbọ na ọgbụgbọ, mgbe ụfọdụ, a na-ahụ ihu ihu ihu n'otu oge. Ọ bụrụ na onye ọrịa ebulite mgbaama ndị a dị n'elu na ọgwụgwọ nke ndị na - egbochi ACE, nchọpụta ọdịiche dị iche iche kwesịkwara ịtụle ohere nke ịmalite ịmịnye afọ n'ime ha.
Ojiji nke ACE inhibitors, gụnyere ramipril, n'ime ndị ọrịa a na-awa ahụ site na iji ọgwụ na-akụnwụ ahụ, nwere ike iduga mmepe nke hypotension art art.
Ọ na-atụ aro ịkwụsị ị Pyụ ọgwụ Pyramil ® otu ụbọchị tupu ịwa ahụ.
Ekwesiri iji ụfọdụ membranes dị elu nwere oke ebubo (dịka ọmụmaatụ, polyacrylonitrile membranes), dịka ọmụmaatụ, maka ọgwụgwọ hemodialysis ngwa ngwa ma ọ bụ mmịkọ na njikọta ACE (n'ihi ohere nke mmeghachi omume anaphylactoid na ndị ọrịa). N'ọnọdụ ndị a na-adịghị ahụkebe, yana apheresis nke lipoproteins dị ntakịrị (LDL) na dextran sulfate na nchịkwa nke oge nke ndị na-egbochi ACE, mmeghachi omume anaphylactoid nwere ike ịmalite.
Ya mere, ekwesighi iji usoro a mee ihe na ndị ọrịa na-anata ndị na-egbochi ACE.
Ndị na - egbochi ọgwụ mgbochi na - egbochi RAAS anaghị adịkarị mma n'ịgwọ ndị ọrịa nwere hyperaldosteronism nke mbụ, yabụ na - atụ aro iji ramipril n'ọnọdụ ndị dị otú ahụ.
Dị ka ndị ọzọ ACE inhibitors, ojiji jikọtara ramipril na aliskiren na ọgwụ aliskiren nwere ndị ọrịa nwere ọrịa mellitus ma ọ bụ ọdịda na-adịghị ala ala (CC na-erughị 60 ml / min / 1.73 m²).
Iji otu oge ahụ ọgwụ ọjọọ eme ihe nwere aliskiren, ma ọ bụ ya na antiotensin II receptor antagonists, na-eduga na mgbochi abụọ RAAS, anaghị atụ aro ya n'ihi ohere nke mbelata ọbara mgbali elu, mmepe nke hyperkalemia na arụ ọrụ na-arụ ọrụ na-arụ ọrụ ma e jiri ya tụnyere monotherapy.
Inwe oge nke angiotensin II receagonor antagonists na ndị ọrịa na-arịa nephropathy na-arịa ọrịa contraindicated (lee mpaghara "Contraindications").

Mmetụta ikike ịkwọ ụgbọala, usoro

Enweghị data na mmetụta ọjọọ nke nkwadebe Pyramil in na usoro ọnụọgụ ndị a tụrụ aro maka ike ịkwọ ụgbọala ma ọ bụ jiri usoro rụọ ọrụ. Agbanyeghị, n'ihi ohere ndị ọ na-akpata, dị ka iwetulata ọbara ọgbụgba na ụra ụra, a na-atụ aro ka ịghara itinye aka n'ihe omume ndị dị ize ndụ nke chọrọ ntinye uche dị ukwuu na ọsọ nke mmeghachi omume psychomotor, gụnyere ịkwọ ụgbọala, ọkachasị mgbe ị doseụsịrị ọgwụ mbụ, ịgbanye ọgwụ ọzọ. mgbe ị na-a diụ mmanya na-aba n’anya.

Nchedo nchekwa

A na-adụ ntị na ndị ọrịa na-anata ọgwụgwọ diuretic, n'ihi ụkọ mmiri na (ma ọ bụ) electrolytes n'ime ahụ, yana ileba anya na ọrụ akụrụngwa na ọkwa potassium na ọbara.

Ozi na ramipril
Ihe nnochi abuo nke renin-angiotensin-aldosterone system (RAAS)
Agaghị atụkọta ngwakọta nke Pyramil® na aliskiren n'ihi ụba nke hypotension, hyperkalemia, na mgbanwe na ọrụ gbasara aha. Ojiji Pyramil® na njikọ ya na aliskiren bụ contraindicated na ndị ọrịa nwere ọrịa mellitus ma ọ bụ ọdịda akụrụ (GFR 2) (lee “Mmekọrịta na ọgwụ ndị ọzọ”).
Ndị ọrịa nọ n'ihe ọghọm nke hypotension
Ndị ọrịa na-agbasi mbọ ike nke sistemụ renin-angiotensin-aldosterone
Ndị ọrịa nwere nnukwu ọrụ RAAS nọ n'ihe ize ndụ dị ukwuu nke mbelata ọbara mgbali elu na arụ ọrụ ezigharị n'ihi mmachi ACE, ọkachasị na nchịkwa mbụ nke ACE inhibitor (ma ọ bụ diuretic diuretic) ma ọ bụ mmụba na dose.
Nkwupụta nke RAAS kwupụtara, chọrọ ndị ọrụ ahụike njikwa, gụnyere nlebara anya ọbara ọgbụgba, na-atụ anya na otu ndị a:
- ndị ọrịa nwere nnukwu ọbara ọgbụgba,
- ọrịa nwere decompensated ọrịa obi ọrịa,
- ndị ọrịa nwere nnukwu nsogbu metụtara oke ọbara ma ọ bụ agbapụta ọbara site na aka ekpe ventricle (dịka ọmụmaatụ, stenosis nke aortic ma ọ bụ mitral valve),
- ndị ọrịa nwere akwara akwara akwara ozi siri ike na akụrụngwa nke abụọ na-arụ ọrụ,
- ndị ọrịa nwere ma ọ bụ zụlite erughi nke mmiri mmiri na (ma ọ bụ) electrolytes (gụnyere ndị ọrịa na-a diụ ọgwụ isi),
- ndị ọrịa na - arịa ọrịa cirrhosis na (ma ọ bụ) ascites,
- Ọrịa ịwa ahụ na-eme ka ọgbụgba na -eme ka ndị ọrịa nwee nsogbu.
Tupu ịmalite ọgwụgwọ, a na-atụ aro ka a dozie nkụda mmụọ, hypovolemia, ma ọ bụ electrolyte erughi (n'agbanyeghị, na ndị ọrịa nwere nkụda mmụọ obi na uru niile na atụmatụ nke usoro ndị a ga-elezi anya nke ọma, 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 ọrịa ma ọ bụ ọrịa hypotension.
Na mmalite ọgwụgwọ, a chọrọ nlekọta ahụike pụrụ iche.
Ndị okenye na-arịa ọrịa
Usoro mmịpụta nke ramipril kwesịrị ịdị obere, yana mmụba nlezianya na-esote ya, n'ihi ohere dị ukwuu nke mmetụta na-adịghị mma. A naghị akwado amlodipine / ramipril na agadi ndị ọrịa na-arịa ọrịa.
Gerywa ahụ
Ọ bụrụ na ọ ga - ekwe omume, a na - atụ aro ka ịkagbu ndị na - egbochi ACE otu ụbọchị tupu ịwa ahụ.
Nyochaa akụrụ
Ekwesịrị ịtụle ọrụ ntaramahụhụ tupu yana n'oge ọgwụgwọ yana ịkwesịrị ịhazigharị ọgwụ, karịsịa n'izu ndị mbụ nke ọgwụgwọ. Ọ dị mkpa nlezianya nlebara anya dị mkpa na ndị ọrịa nwere ọrụ ezumike ọrụ na-arụ ọrụ. E nwere ihe ọghọm nke ọrụ akụrụ na-arụ ọrụ, ọkachasị ndị ọrịa nwere nkụchi obi ma ọ bụ mgbe akụrụ gbasara akụrụ.
N'ime ndị ọrịa nwere nnukwu ọdịda gbasara akụrụ (GFR)

Usoro onunu ogwu na nhazi

Doses
Ekwesighi iji Pyramil® eme ihe maka ịmalite ọgwụgwọ nke ọbara mgbali elu. Ekwesịrị ịhọrọ usoro nke usoro ọ bụla n'otu n'otu dabere na profaịlụ onye ọrịa na ọkwa nke njikwa ọbara mgbali enwetara.
Ọ bụrụ na ọ dị mkpa ịgbanwe dose ahụ, a na-ahọrọ usoro onunu ogwu ọ bụla maka ọgwụ ọ bụla iche - ramipril na amlodipine, ma naanị mgbe ikpebila usoro dị mkpa, a ga-eji dochie nchịkwa nke otu onye ahụ site na nchịkwa nke ọgwụ Pyramil® extra.
Ka akwadoro dose: otu Capsule kwa ụbọchị. Ikike dịkarịa ala kwa ụbọchị: otu capsule nke 10 mg / 10 mg.
Ndị otu ọrịa pụrụ iche
Ndị ọrịa nwere nsogbu gbasara akụrụngwa: a na-ekpebi akara kachasị mma na usoro mmezi n'otu n'otu site na itinye otu akụkụ ọgwụ ahụ (amlodipine na ramipril) iche.
Apụrụ mwepu nke Ramipril n'oge usoro ọgwụgwọ, yabụ, a ga-ewere ọgwụ ahụ ọtụtụ awa mgbe ọ gbasịrị hemodialysis.
Amlodipine anaghị agwọ ọrịa. Maka ndị ọrịa n’usoro nyocha, ọ na -echebe ya oke oke.
N'oge ọgwụgwọ Pyramil®, ana-enyocha ọrụ akụrụ yana ọkwa potassium n'ime ọbara. Ọ bụrụ na arụ ọrụ ezumike mkpirisi, a ga-akwụsị Pyramil® Mgbakwunye ma dochie ya site na iwere usoro dị iche iche ahọpụtara nke ọma na iche iche.
Ndị ọrịa nwere ọria imeju: dose kachasị nke ramipril kwa ụbọchị bụ 2.5 mg. Ọgwụ Pyramil® Mgbakwunye na ndị ọrịa nwere ọrụ imeju na-adịghị mma.
Ndị agadi: A na-atụ aro ịmalite ọgwụgwọ site na iji usoro mmalite nke ala dị ala, na-esochi mmụba nlezianya.
Childrenmụaka na ndị nọ n’oge uto: nchekwa na ịdị irè nke Pyramil® Mgbakwunye n'ime ụmụaka emebeghị. Ọ gaghị ekwe omume ịnye ndụmọdụ usoro ọgwụgwọ.

Ofzọ nke ngwa
Maka nchịkwa ọnụ. Were otu oge n’ụbọchị, agbanyeghị iri nri.

Nhazi ọkwa nosological (ICD-10)

Nkọwa nke ụdị usoro onunu ogwu

5 mg mbadamba: oblong, biconvex, pink dị na agba na agba nwere ihu siri ike, yana obere ụdị agba gbara ọchịchịrị na ọfụma n'otu akụkụ.

Mbadamba ụrọ, 10 mg: oblong, biconvex, na-acha ọcha ma ọ bụ ihe fọrọ nke nta ka ọ bụrụ na-acha ọcha na agba nwere ihu siri ike ma ọ bụghị n'otu akụkụ.

Mlọ ọgwụ

Ramipril na-abanye ngwa ngwa na ngwangwa ahụ ma na-enyocha hydrolysis na imeju site na nguzobe nke metabolite na-arụ ọrụ nke ramiprilat. Ramiprilat bụ onye na - arụ ọrụ ogologo oge ACE inhibitor, enzyme nke na - egbochi ntụgharị nke angiotensin I na angiotensin II.

Ramipril na-ebute mbelata ọkwa nke angiotensin II na plasma ọbara, mmụba nke ọrụ renin yana mbelata ntọhapụ nke aldosterone. Na-egbochi ọkwa nke kinase II, na-egbochi nkwụsịtụ nke bradykinin, na-eme ka njikọ nke PG dịkwuo elu. N'okpuru omume nke ramipril, arịa ndị dị n'akụkụ na-agbasa ma OPSS na-ebelata.

Ọ nwere mmetụta dị ala mgbe onye ọrịa dina ma guzoro ọtọ. Na -ebelata OPSS (mgbe ebesịrị), nrụgide mbido na okpu pulmonary na-enweghị mmụba na ọnụego obi. Na-eme ka ọbara na -akpata ọbara na akwara gbasara ọbara na-enweghị emetụta GFR.

Mmalite nke mmetụta hypot bụ 1-2 awa mgbe ịghasịrị, mmetụta kachasị na-etolite 3-6 awa mgbe mmesịrị. Omume ahụ dịkarịa ala elekere 24.

Ọkpụkpụ obi na nkụchi obi n'ihi oke myocardial infarction

Ramipril belatara OPSS ma mesịa nwee ọbara mgbali. Na-abawanye mmeputa obi na ndidi. Site na iji ogologo oge, ọ na-enye aka na mgbanwe nke myocardial hypertrophy na ndị ọrịa nwere nkụda obi nke klas arụ ọrụ nke Mbụ na nke II dị ka nhazi ọkwa NYHA, na - eme ka ọkpụkpụ ọbara nye ischemic myocardium.

Ramipril na-abawanye nlanarị nke ndị ọrịa nwere ihe mgbaàmà nke oge ezumike ma ọ bụ CHF mgbe mmerụ myocardial. O nwere mmetụta cardioprotective, na-egbochi ọgbụgba akwara ụbụrụ, na-ebelata ohere ịbelata infarction myocardial ma belata oge ịnọ n'ụlọ ọgwụ.

Ọrịa mamịrị na-arịa ọrịa mamịrị na-arịa ọrịa mamịrị

N'ime ndị ọrịa nwere ọrịa shuga na-arịa ọrịa mamịrị na-arịa ọrịa mamịrị, ramipril na-agbadata ọnụego ọganihu nke ọdịda akụrụngwa yana mmalite ọdịda gbasara akụrụngwa ọdịda, ya mere na-ebelata mkpa ịba ama ma ọ bụ mmịnye akụrụ. N'ime mmalite nke ọrịa mamịrị ma ọ bụ nephropathy, ọrịa ramipril na-ebelata ogo albuminuria.

N'ime ndị ọrịa nwere nnukwu ihe ọria ọrịa obi n'ihi ọnya akwara (na-arịa ọrịa akwara akwara, na-arịa ọrịa akwara ma ọ bụ akụkọ banyere ọrịa strok), ọrịa shuga na-arịa ma ọ dịkarịa ala otu ihe ize ndụ ọzọ (microalbuminuria, ọbara mgbali elu, ịba ụba ọkwa plasma nke mkpokọta cholesterol, belata plasma na-ebelata. ịta nke HDL-C, ise anwụrụ) mgbakwunye nke ramipril na usoro ọkọlọtọ na-ebelata oke mpecardial infarction, ọrịa strok na ọnwụ obi. vaskụla na-akpata.

Mlọ ọgwụ

Ramipril na-abanye ngwa ngwa na eriri afọ mgbe nchịkwa ọnụ. Anakpo nnwere onwe n’enweta nri.

Mgbe a gbasasịrị, ramipril ngwa ngwa ọ fọrọ nke nta ka ọ bụrụ ọrụ metabolite nke ramiprilat dị n'okpuru nduzi nke esterase enzyme na imeju. Ramiprilat dị ihe dị ka ugboro isii karịa ike igbochi ACE karịa ramipril. A chọpụtawokwa ọgwụ metabolites ndị ọzọ na-adịghị arụ ọrụ.

N'ime ndị ọrịa nwere ọrụ akwara nwere nsogbu, mgbanwe nke ramipril n'ime ramiprilat na-adalata n'ihi ntakịrị oge esterase, ya mere, ọkwa nke ramipril na plasma ọbara dị na ndị ọrịa a na-abawanye.

C_max A na-enweta ramipril na plasma n'ime otu awa mgbe nchịkwa, ramiprilata - n'ime awa 2-4 mgbe ị theụsịrị ọgwụ ahụ. Bioavailability ramipril bụ 60%. Njikọ protein na Plasma ruru 73% maka ramipril na 56% maka ramiprilat. Mgbe i mechara 5 mg, mwepụ nke akụrụngwa nke ramipril bụ 10-55 ml / min, mwepu nke extrarenal ruru 750 ml / min. Maka ramiprilat, ụkpụrụ ndị a bụ 70-120 ml / min na ihe dịka 140 ml / min, n'otu n'otu. Ramipril na ramiprilat bụ ndị akụrụ wepụtara kachasị (40-60%). N'ịrụ ọrụ mgbazinye nsogbu, mkpochapu ha na-adalata.

Ndi_1/2 ramiprilata na iji oge ogologo oge na 5-10 mg 1 oge kwa ụbọchị bụ awa 13-17.

Ihe ngosi nke ogwu Pyramil ®

ọrịa obi na-adịghị ala ala (dị ka akụkụ nke ọgwụgwọ njikọta),

ọrịa shuga na-arịa ọrịa mamịrị na-arịa ọrịa shuga na-arịa ọrịa shuga na-enweghị atụ, usoro ọgwụgwọ na-ekwupụta ọnọdụ, gụnyere ya na proteinuria siri ike, ọkachasị mgbe ejikọtara ya na ọbara mgbali elu yana ọnụnọ microalbuminuria,

ọghọm nke ọrịa myocardial infarction, ọrịa strok, ma ọ bụ ọnwụ obi na ndị ọrịa nwere nnukwu ihe ọria ọrịa obi (ndị ọrịa nwere ọnya akwara na-arịa ọrịa akwara, akụkọ ihe mere eme nke myocardial infarction ma ọ bụ na-enweghị ya, gụnyere ndị ọrịa nwere ajọ akụkụ akwara na-agafe agafe, ọrịa obi). nsogbu ọnya ọgbụgba, ọrịa mellitus nwere opekempe ihe egwu ọzọ (microalbuminuria, ọbara mgbali elu, ịba ụba plasma x ngụkọta cholesterol kasịnụ, ebelata plasma kasịnụ nke LDL-HDL cholesterol, ise)

nkụda obi nke toro n’ime ụbọchị ole na ole mbụ (site na ụbọchị abụọ ruo ụbọchị 9) mgbe nnukwu ụbụrụ myocardial dị ukwuu.

Ime na lactation

Eji ọgwụ ogwu Pyramil pregnancy n’oge ime na inye nwa ara, n’ihi nwere ike bụrụ ihe ọjọọ na nwa ebu n’afọ: na -emepụta mmepe nke akụrụ nwa ebu n’afọ, mgbali ọbara nke nwa ebu n’afọ na ụmụ amụrụ ọhụrụ, ọrụ akụrụ arụ, hyperkalemia, hypoplasia nke ọkpụkpụ nke skull, hypoplasia nke ngụgụ. Achọghị Pyramil for maka ụmụ nwanyị na-eme atụmatụ ịtụrụ ime. Maka oge ịtụrụ ime n'oge ọgwụgwọ Pyramil drug, ị ga-akwụsị ị takingụ ọgwụ ozugbo o kwere omume wee lelee mmepe nwa ebu n’afọ.

Womenmụ nwanyị nke afọ omumu na-anata ọgwụgwọ na ndị na-egbochi ACE kwesịrị iji ọgwụ mgbochi dị irè. Ọ bụrụ na ụmụ nwanyị toro afọ na-arịa ọbara mgbali elu na-ewere ndị na - egbochi ACE, mgbe ahụ ekwesịrị icheta na n'oge ime ime, nyefee onye ọrịa ahụ ka ọ takingụọ otu ọgwụ hypotensive site na otu ọzọ. N'okwu niile, ọ dị mkpa ilezi anya maka nlekọta ahụike.

Onweghi ihe akaebe banyere ma ramipril puru na mmiri ara ara.

Nnyocha ụmụ anụmanụ egosila na arara ramipril na mmiri ara ehi. A contraụ ọgwụ iji Pyramil ® n’oge a na-enye nwa ara. Ọ bụrụ na ọ dị mkpa ịnye onye Pyramil ọgwụ ọgwụ a na-elekọta nwa, a ga-ekpebi okwu banyere ịkwụsị inye ya ara.

Nsonaazụ

A na-enye mmetụta ndị achọghị ka ekwenyero na nhazi ọkwa WHO dịka ọnụego mmepe ha dị ka ndị a: ọtụtụ mgbe (> 1/100), ọtụtụ mgbe (> 1/100, 1/1000, 1/10000, ọbara mgbali, usoro orthostatic na-emebi ụda olu vaskụla (orthostatic hypotension) , ọnọdụ syncopal, ugboro ugboro - orthostatic ida, myocardial ischemia, tinyere mmepe nke mwakpo nke angina pectoris ma ọ bụ myocardial infarction, ọrịa mberede ụbụrụ (n'ihi oke ọgbụgba ọbara n'ọbara na ndị ọrịa n'ihe ize ndụ), tachycardia, arrhythmia, oke mbibi, palpitation, flushing to akpụkpọ ahụ ihu, adịkarịghị - ihe omume ma ọ bụ nbawanye ike nke mgbasa ọbara na nzụlite stenotic vaskụla ọnya, vasculitis, ugboro ole amabeghị - ọrịa Raynaud.

Site na akụkụ ahụ dị na hemopoietic: ugboro ugboro - eosinophilia, adịkarịghị - leukopenia, gụnyere neutropenia na agranulocytosis (neutropenia na agranulocytosis na - atụgharị ma na - apụ n'anya mgbe a kagbuo ACE inhibitors), anaemia, thrombocytopenia, lymphadenopathy, hemoglobin, ugboro ole a na - amaghị - suppression of hemorrhabraia hemorria

Si ụjọ usoro: ọtụtụ mgbe - adịghị ike, isi ọwụwa, ugboro ugboro - lability ọnọdụ, nchegbu, ụjọ, paresthesia, ọgbụgba, ọgba aghara ụra, ehighị ụra nke ukwuu, ụjọ moto, adịkarịghị - jijiji, enweghị isi, ọgba aghara, ugboro ole a na - amaghị - ọrịa ụbụrụ, gụnyere ọgbụgbọ na ọgba aghara na - adịghị ala ala. mgbasa ụbụrụ, parosmia (nghọta nke isi), nsogbu psychomotor na-akpata, ịta ahụhụ.

Si uche: ugboro ugboro - esemokwu na-ahụ anya, gụnyere onyonyo na-acha ọkụ, na-emebi mmetụta dị ụtọ, adịkarịghị - conjunctivitis, nkwarụ ntị, tinnitus (mmetụta nke ịda ụda, tinnitus).

Site na usoro iku ume: ọtụtụ mgbe - akọrọ ụkwara, bronchitis, sinusitis, mkpụmkpụ nke iku ume, ugboro ugboro - bronchospasm, gụnyere njupụta nke ụkwara ume ọkụ, imi mkpọchi.

Site na nri digestive: mgbe - mmeghachi omume mbufụt na afọ na eriri afọ, mgbakasị nri, ahụ erughị ala afọ, dyspepsia, afọ ọsịsa, ọgbụgbọ, ọgbụgbọ, ure - pancreatitis, mụbara ọrụ nke ịba ọcha n'anya na ịta nke bilirubin bilirubin na plasma ọbara, ọrụ na-abawanye nke pancreatic enzymes, eriri afọ akwara ọzịza, ọnya afọ, eriri afọ, afọ ntachi, ọnụ akpọnwụ, ọ na-adịkarịke glossitis, cholestatic jaundice, hepatocellular ọnya, ugboro amaghị ama - af ozny stomatitis (mkpali mmeghachi omume nke onu mucosa), nnukwu imeju ọdịda, ma ọ bụ cytolytic na cholestatic ịba ọcha n'anya, gụnyere egbu egbu.

Site na urinary tract: ọ na - adịkarịghị - arụ ọrụ akụrụ, gụnyere mmepe nke mmụba akwara, mmụba nke mmamịrị, mmụba nke proteinuria dị adị, mmụba nke mkpo urea na creatinine n'ime ọbara.

Site na anụ ahụ na akpụkpọ anụ mucous: ọtụtụ mgbe - ọnya anụ ahụ, ọkachasị maculopapular, ugboro ugboro - angioneurotic edema, gụnyere egbu egbu (laryngeal edema nwere ike ibute ihe mgbochi ikuku na-eduga na ọnwụ), itching skin, hyperhidrosis (sweating pressure), adịkarịghị - exfoliative dermatitis, urticaria, onycholysis (peeling the ntu from the soft soft the finger of the finger), adịkarịghị - photoensitivity reactions, ugboro amaghi - necrolysis na-egbu egbu, Stevens-Johnson syndrome, erythema multiforme, pemphigus (cystic rash), na-akawanye njọ nke psoriasis, psoriasis-like dermatitis, pemphigoid ma ọ bụ lichenoid exanthema ma ọ bụ ena isiokwu, alopecia.

Site na usoro mọzụlụ: ọtụtụ mgbe - nkwonkwo akwara, myalgia, ugboro ugboro - arthralgia.

Site n'akụkụ nke metabolism: ọtụtụ mgbe - ịba ụba potassium n'ime ọbara, ugboro ugboro - anorexia, agụụ belatara, ugboro ole amabeghị - sodium dị n'ọbara.

Si dịghịzi usoro: ugboro-amaghị ama - anaphylactic ma ọ bụ mmeghachi omume anaphylactoid, ụba titer nke mgbochi antinuclear.

Site na usoro endocrine: ugboro-amaghị - ADHD nzuzo syndrome.

Site na usoro omumu: ugboro ugboro - adịghị ike nke oge n'ihi dysfunction erectile, belata libido, ugboro ole amaghi - gynecomastia.

Ọrịa na nkwarụ izugbe na saịtị ịgba ahụ: ọtụtụ mgbe - mgbu obi, ike ọgwụgwụ, ugboro ugboro - ahụ ọkụ, adịkarịghị - asthenia.

Mmekorita

Ojiji nke ụfọdụ membranes dị elu nke nwere ihu na-adịghị mma (dịka ọmụmaatụ, polyacrylonitrile membranes) n'oge hemodialysis ma ọ bụ hemofiltration, ojiji nke dextran sulfate n'oge LDL apheresis nwere ike ibute nsogbu nke anaphylactic mmeghachi omume, ma ọ bụrụ na onye ọrịa ahụ chọrọ usoro ndị a, ekwesịrị iji ụdị membranes ndị ọzọ (n'ọnọdụ nke plaisis) na ịba ọcha n'anya) ma ọ bụ bufee onye ọrịa ahụ ọgwụ ndị ọzọ.

Dị ka ndị ọzọ ACE inhibitors, ojiji jikọtara ramipril na aliskiren na ọgwụ aliskiren nwere ndị ọrịa nwere ọrịa mellitus ma ọ bụ ọdịda na-adịghị ala ala (Cl creatinine 2).

Iji ya na ndị ọzọ na-egbochi ACE na-eme ka ohere nke ịmalite ịkụda akwara ghara ịdị (gụnyere nnukwu), hyperkalemia. Otu ọgwụ a na-eme n'otu oge yana ARA II n'ime ndị ọrịa nwere ọrịa nephropathy bụ contraindicated ma atụghị ya na ndị ọrịa ndị ọzọ.

Ejikọtara ọnụ iji kpachara anya

Ojiji ndị ahụ na-eme ka mmiri dị n’etiti salts, ọgwụ na-egbu potassium (dịka ọmụmaatụ, amiloride, triamteren, spironolactone), yana ọgwụ ndị na-abawanye ọkwa nke potassium n’ime ọbara ọbara (gụnyere trimethoprim, tacrolimus, cyclosporine, ARA II) nwere ike ibute mmụba na ọkwa nke potassium na ọbara ọbara (achọrọ). nleba anya mgbe nile nke potassium n’obara ọbara).

Ọgwụ antihypertensive (alfuzosin, doxazosin, prazosin, tamsulosin, terazosin), baclofen, diuretics, nitrates, tricyclic antidepressants, antipsychotics, hypnotics, narcotic analgesics, ndị nnọchi anya izugbe na ọgwụ na-akụnwụ ahụ na-ebuli mmetụta antihypertensive nke ramipri.

Vasopressor sympathomimetics na ọgwụ ndị ọzọ na-akpata mmetụta antihypertensive (dịka ọmụmaatụ isoproterenol, dobutamine, dopamine, epinephrine) belata mmetụta antihypertensive nke ramipril, yana ịchọrọ ilegide ọbara mgbe niile.

Ojiji nke allopurinol, procainamide, cytostatics, immunosuppressants, corticosteroids (GCS na mineralocorticosteroids) na ọgwụ ndị ọzọ nwere ike imetụta oke ọgbụgba ọbara na-amụba ohere nke ịmalite leukopenia. Agaghị atụ aro iji ramipril na corticosteroids n'otu oge.

Ngwunye lithium na-eduga n'ịba ụba nke mkpo lithium na mmụba nke kadio- yana neurotoxic nke lithium.

Ramipril na-eme ka mmetụta nke ndị na - ahụ ike hypoglycemic (insulin, ndị na - ahụ maka hypoglycemic) maka nchịkwa ọnụ (ihe dị n'ụkpụrụ sulfonylurea) ruo mmepe nke hypoglycemia. Ọ dị mkpa iji chịkwaa glucose.

Vildagliptin na-ebute mmụba nke angioedema.

Na nkwekorita ojiji nke ramipril na mTOR inhibitors (mammalian lekwasịrị anya nke rapamycin - ebumnuche nke rapamycin na sel mammalian) kinases, dịka ọmụmaatụ ya na temsirolimus, nwere ike ibute mmụba ugboro ugboro na mmepe nke angioedema.

Njikọ iji tụlee

NSAIDs (dịka acetylsalicylic acid (karịa 3 g / ụbọchị), ndị na-egbochi COX2) nwere ike ibelata mmetụta antihypertensive nke ramipril, yana ịkpata ọrụ mgbazinye, mgbe ụfọdụ na-eduga na mmepe nke ọdịda renal.

Heparin nwere ike ime ka potassium mmanụ hie nne.

Sodium chloride nwere ike ịkụda nsonaazụ ramipril.

Ekwesighi iji nri ethanol n'oge ọgwụgwọ ya na ramipril (a na-eme ka mmetụta ethanol dị na usoro ụjọ nke etiti ahụ dịkwuo elu). Estrogens na-akụda mmetụta antihypertensive (njigide mmiri).

Ọgwụgwọ ọrịa uche nke na-egbochi nsị ahụhụ

Ndị na-egbochi ACE, gụnyere ramipril, na-amụba ohere nke ịmalite ịrịa ọrịa anaphylactic siri ike ma ọ bụ mmeghachi omume anaphylactoid na nsí ụmụ ahụhụ.

Omume ọgwụ

Mgbe nchịkwa ọnụ gasịrị, ramipril na-abanye ngwa ngwa site na eriri afọ: a na-abanye n'ọtụtụ plasma nke ramipril n'ime otu awa. Ogo ogo mmuta di ihe ruru pacenti iri isii na isii nke ogwu a ewere na o nweghi onwe ya n’inye nri. Ihe bioavailability nke metabolite na-arụsi ọrụ ike nke ramiprilat mgbe nchịkwa ọnụ nke 2.5 mg na 5 mg bụ 45%, a na-enweta oge kachasị elu awa 2 ruo 4 mgbe nchịkwa gasịrị.

Mkpokọta plasma nke ramiprilat na-ejigide mgbe otu mkpụrụ ọgwụ ramipril na-adịkarị bụ ụbọchị anọ.

Njikọ protein protein Plasma dị ihe dị ka 73% maka ramipril na 56% maka ramiprilat.

Ramipril fọrọ nke nta ka ọ bụrụ metabolized ka ramiprilat, diketopiperazinovy ​​ester, diketopiperazinovy ​​acid na glucuronides nke ramipril na ramiprilat.

Mwepu nke metabolites, tumadi site na akụrụ. Ihe ndọta Plasma nke ramiprilat na-ewepu polyphase. N'ihi ikike siri ike ọ na-ejikọ ACE na nkewapụ ngwa ngwa site na enzyme ahụ, ramiprilat na-egosipụta usoro mkpocha ogologo oge na nnukwu ọkwa plasma dị ala. Mgbe ị takingụchara ọgwụ ramipril kwa ụbọchị ugboro ugboro, ịdị ndụ ọkara nke ramiprilat na-emetụta bụ 13-17 awa maka 5-10 mg na ogologo maka obere doses nke 1.25-2.5 mg. Ihe dị iche bụ n'ihi na ike nke enzyme dabere na njikọ nke ramiprilat.

Otu ọgwụ a na-a ofụ nke 10 mg nke ramipril edugaghị n'ịchọta ramipril ma ọ bụ metabolit na mmiri ara. Agbanyeghị, amabeghị nsonaazụ nke otutu doses.

N'ime ndị ọrịa nwere ezughi oke gbasara akụrụ, a na-ebelata mwepu nke ramiprilat, ebe ọ bụ na mwepụ nke renti ramiprilat nwere njikọ chiri anya na nsụkọta nke creatinine. Nke a na-ebute mmụba na ịta plasma ramiprilat, nke na-agbada nwayọ karịa ihe ndị nwere ọrụ ezumike nkịtị.

N'ime ndị ọrịa nwere ọrịa ịba ọcha n'anya, a na-egbu oge ịgbalite ramipril na ramiprilat n'ihi ọrụ belata hepatic esterases. Ndị ọrịa dị otú a na-egosipụta ọkwa ramipril dị elu. Agbanyeghị, ọnụ ọgụgụ plasma ramiprilat dị elu bụ nke ndị nọ na ndị ọrịa nwere ọrụ imeju nkịtị.

Ramiprilat bụ metabolism nke ramipril, na-egbochi enzyme dipeptidyl carboxypeptidase I (nke a makwaara dị ka angiotensin-enzyme ma ọ bụ kininase II). Na plasma na anụ ahụ, enzyme a na - eme ka ntụgharị nke angiotensin nke m gbanwee bụrụ ihe na - arụ ọrụ nke vasoconstrictor (vasoconstrictor) angiotensin II, yana ndakpọ nke vasodilator bradykinin. Mbelata okike nke angiotensin II na igbochi ndakpọ nke bradykinin na-eduga n'ịbawanye akwara nke ọbara. Ebe ọ bụ na angiotensin nke abụọ na - akpalite mwepụta nke aldosterone, a na - ebelata nzuzo nke aldosterone n'ihi ramiprilat. Nzaghachi nkezi nke monotherapy nwere onye na - egbochi ACE na ndị ọrịa agbụrụ Negroid (nke na - abụkarị ọnụ ọgụgụ nwere ọbara mgbali elu na obere itinye renin) dị ala ma e jiri ya tụnyere ndị nnọchi nke agbụrụ ndị ọzọ.

Ramipril na-ebelata mkpụkọ akwara obi (OPSS) mkpokọta, na-emeghị mgbanwe na ọbara ọgbụgba akwara na ọnụego nnweta.

N'ime ndị ọrịa nwere ọbara mgbali elu, ị Pyụ Pyramil® na-eduga n'ịbelata ọbara mgbali mgbe ị na-edina ma na-akwụ ọtọ, na-enweghị mmụba na ọnụego obi (HR). N’ọtụtụ ndị ọrịa, ọgwụ antihypertensive mgbe a jisịrị ọnụ nke nchịkwa otu na-apụta mgbe awa 1-2. Mmetụta dịkarịsịrị otu ụzọ na-adịkarị mgbe awa 3-6 na-abụkarị awa 24.

Mmetụta antihypertensive kachasị na iji ramipril ogologo oge ka ahuru ka izu ụka 3-4 gachara. Site na usoro ọgwụgwọ ogologo oge, ọ na-adịgide ruo afọ 2.

Esskwụsị nkwụsị nke ramipril anaghị ebute mmụba ọbara ngwa ngwa.

Na mgbakwunye na usoro ọgwụgwọ na diuretics na cardiac glycosides (dịka dọkịta nyere ya), Pyramil dị irè na ndị ọrịa nwere ọkwa ọdịda II-IV dabere na nhazi ọkwa nke NYHA (New York Cardiology Association).

Pyramil na-ebelata OPSS (Mbelata nke ibu na-ebugharị n'obi), na-eme ka ikike nke ọwara sikwuo ike ma belata mgbali nke ventricle ekpe, nke, n'ihi ya, na-eduga n'ịbelata mbubata obi na obi. Mgbe ị na-ewere ramipril, enwere mmụba na mmepụta obi, nkebi irighiri akwara na mmụba na nnagide mmega ahụ na mmụba na usoro gbasara obi. Ramipril na-ebelata olu neuroendocrine.

Ngwakọta nke mbadamba nkume Pyramil

A na-emepụta ọgwụ ahụ site na ụlọ ọrụ ndị si Poland na Switzerland. Ọ dị n'ụdị mbadamba.

Tebụl 1. Nhazi nke pyramil ahụ.

Usoro nke ime ihe

Mmetụta Pyramil bụ n'ihi ihe dị n'ọrụ - ramipril. Ọ na - enye aka:

1. Na-agbatị usoro njikọ nke angiotensin n'ime ọbara na anụ ahụ. Ọ bụ homonụ a nwere mmetụta vasoconstrictor ma na-ebute mmụba nke nrụgide.
2. Ọ na - enyere aka igbochi sistemụ ahụ mmadụ na - ahụ maka ịba ụba ọbara mgbali anụ ahụ na arịa.
3. Na-akụda mwepụta nke norepinephrine, nke na - eso akpata mmụba obi. Na mgbakwunye, ihe ahụ nwere vasoconstrictor utịp ma belata mmetụta pressor.
4. Na-ebelata mmepụta aldosterone. Hormone a na-akpọ Mineralocorticoid na-amụba ọ̀tụ̀tụ̀ ọbara na-ekesa.
5. Na-eme ka nguzogide nke bradykinin na-emebi emebi. Ihe ahụ nwere mmetụta antihypertensive (na-ebelata nrụgide).
6. Na-akwalite mgbasawanye nke akwara ọbara n'ime akụrụ.
7. Ọ nwere mmetụta mweghachi dị mma na ventricle aka ekpe na usoro akwara obi n'ozuzu ya.
8. Na-eweghachi anụ ahụ myocardial site na-akpali njikọ nke nitric oxide.
9. Na-ebelata mkpokọta akwara vaskụla na akwara na akụkụ ahụ.
10. Ọ na - eme ka ahụ mmadụ na - eme ka ọbara na - arụ ọrụ nke ọma.
11. Na-akwalite ahụ efe nke ọbara ọgbụgba.

Ntụziaka maka ojiji

Ihe ngwugwu Pyramil ọ bụla nwere ozi nnabata.Tupu ojiji, ọ dị oke mkpa iji aka gị mara ntụziaka nke onye nrụpụta.

Karịsịa, Pyramil, ntuziaka maka ojiji nke nwere ndepụta zuru ezu na-egosi, dị irè maka:

1. Ọbara mgbali elu.
2. Ọrịa obi na-adịghị ala ala.
3. Ọrịa mamịrị / na-arịa ọrịa mamịrị / ọrịa mamịrị.
4. Iji gbochie ihe ize ndụ nke ịrịa ọrịa myocardial infarction ma ọ bụ ọrịa ndị ọzọ nwere ike ibute ọnwụ.
5. Na akwara obi ọrịa obi, gụnyere mgbe ogwugwo nke ọrịa obi.
6. Site na ọrịa strok.
7. Mgbe ọgbaghara ma ọ bụ mechie nnukwu arịa ọbara.
8. Na ọrịa shuga gbagwojuru anya site n’ihe dị iche iche.
9. Dị ka usoro ọgwụgwọ mgbe infarction myocardial mere na ihe ọghọm nke nkụda obi.

Mbadamba Pyramil nwere ọdịdị biconvex. On otu akụkụ bụ notch - n'ihe ize ndụ. Mbadamba nkume ndị ahụ siri ike na mmetụ, a na-ahapụ ka agba ọchịchịrị na shei ahụ. Pyramil dị na usoro ndị a:

1. 2,5 mg Ekpuchi na a heterogeneous lemon odo shei shei transverspersed.
2. 5 mg Ha nwere shei pinkish dị mfe.
3. 10 mg Ha na-ese na-acha ọcha ma ọ bụ ihe fọrọ nke nta ka ọ bụrụ ọcha na-enweghị ncha.

Usoro Pyramil dabere na ngosipụta maka ojiji na ndidi n'otu onye ọrịa.

Ọgbaghara sitere na ọbara mgbali elu

Tebụl 2. Usoro onunu ogwu ma ghazie Pyramil.

Pyramid enweghị ike ịta ata ma a ga-eji mmiri kwụọ ya mmiri (opekata mpe - 100 ml).

Atụmatụ eji

Ejiri Pyramid, nkuzi nke nwere ọtụtụ ihe mgbochi, ejiri ya kpachara anya na oge ụfọdụ. Enwere ọtụtụ ntuziaka pụrụ iche, n'etiti ha:

1. Jiri nlezianya bara uru ijikọta Pyramils ​​ya na ihe ọureụ. A na-atụ aro ka ibelata ọgwụ ma ọ bụ jụ kpamkpam ị theụ ọgwụ ahụ.
2. Oge mbụ eji Pyramil kwesịrị ịmalite n’okpuru nlekọta nke otu ọkachamara. Oge nlele kacha nta bụ elekere asatọ.
3. Na nkụda obi na-adịghị ala ala, Pyramylls nwere ike ibute mbelata ọbara mgbali elu.
4. Site n'ịrụ ọrụ dị elu nke sistemụ renin-angiotensin, a na-atụ aro ka ilegide ọbara mgbali elu na ọrụ akụrụ.
5. Site na ịba ụba nke mmega ahụ ma ọ bụ oke ikuku ikuku, ọ dị mkpa iji gbochie akpịrị ịkpọ nkụ. Na Pyramil, ọ nwere ike ime ka nrụgide dị ukwuu.
6. Tupu ịwa ahụ, Pyramil wepụrụ awa 24 tupu oge, wdg.

Dabere na data dịnụ, Pyramil enweghị mmetụta na-adịghị mma na ike ịkwọ ụgbọala. Agbanyeghị, nsonaazụ ndị ọzọ dịka adịghị ike na ida ụra nwere ike imetụta nchekwa ịnya ụgbọ ala.

N'ime oge ịtụrụ ime ma ọ bụ na-a breastụ ara, amachibidoro Pyramil. Nke a nwere ike ibute mmepe nwa ebu n’afọ ma ọ bụ ntoputa nke ọtụtụ ọrịa. Mgbe ị na-eme atụmatụ ịtụrụ ime, ịkwesịrị ịjụ ị theụ ọgwụ ahụ tupu oge eruo.

Amachibidoro Pyramid:

• Ndị mmadụ na-erubeghị afọ 18
• ya na uda Quincke,
• gbasara akụrụ / ọdịda
• hypersensitivity nke mmiri ọgwụ,
• yana glucose steroid ma ọ bụ ọgwụ na-abụghị steroid,
• na nsogbu nke mbelata ọbara mgbali elu na onye ọrịa (ọkachasị na ndị ọrịa enweghị obi),
• ya na cardiogenic ujo, wdg.

Analogs na mmekorita

Enwere otutu ogwu dochie anya Pyramil, nke enwere ike ekewa abuo abuo:

1. Mmekorita nke Pyramil. Pụtara inwe otu ụdị ihe na-arụ ọrụ na mejupụtara ahụ, mana dị iche na aha ahia.
2. Pyramil Analogs. Nkwadebe nke di iche na mejuputara, ma nwee udiri ọgwụgwọ ahu.

Pyramil, nke enwere ike inweta ihe omuma ya na ọgwụ, yiri ya na otu a:

Pyramil, ihe analogues nke nwere otu mmetụta, nwere ike dochie ya: