"Fosinopril": imiyalelo ukusetyenziswa. "Fosinopril": ezibonisa ukusetyenziswa, nabalingani real

"Fosinopril" yi inhibitor of angiotensin ukuguqula enzyme. Eli chiza liye inyathelo iqinile, oku kusetyenziswa uxinzelelo oluphezulu lwegazi, yedwa kunye nonyango entsonkothileyo. Ngaphezu koko, lo medicament unamandla natriuretic, vasodilating kunye inyathelo cardioprotective, oku kusetyenziswa xa zidityaniswe kunye namanye amachiza ngexesha unyango ukusilela kwentliziyo.

iipropati amayeza "fosinopril"

Ukulungiselela "Fosinopril" emzimbeni kuthatha uhlobo le metabolite esebenzayo ukuba xi ukusebenza ngomhla angiotensin ukuguqula enzyme. Ichiza kunciphisa izinga ukuyilwa angiotensin 2, normalizes uxinzelelo lwegazi zenkqubo, nemiphumo emihle imithambo yegazi.

Angiotensin ukuguqula umsebenzi enzyme usebenzisa 10, 20 no-40 mg ichiza lincipha kakhulu kwi-avareji iiyure-7 (akukho ngokukhawuleza ngaphezu kweeyure ezi-2, kodwa kweeyure ezingama-12 emva kokuba ukuthatha amayeza). Emini oko kuncitshiswa 7-15%.

"Fosinopril" Amacwecwe kuvumela ukwahlula hypertrophy engabalulekanga kunye komlomo le ventricle ngasekhohlo, phambi meko igalelo emzimbeni zabo. Ichiza abangaphangeliyo akuseko aldosterone oluqhutywa kwi adrenal, kwandisa umsebenzi inkqubo kallikrein-kinin, uzinzise isiqulatho bradykinin zomzimba kunye negazi. unyango ngenxa ngokusekelwe ekusetyenzisweni "fosinopril" izinto kwandisa liberatiou leyo ukuphucula unikezelo igazi nezintso, yiba natriuretic, inyathelo vasorelaxant. Le medicament kunciphisa imveliso vasopressin arginine kunye endothelin-1, apho inyathelo vasoconstrictor.

Ngokuthi kuncitshiswe uxinzelelo (ukuzala, iSystolic) musa ukuphuhlisa, kunye postural intolerance tachycardia reaction akatshintshi BCC. Akukho tshintsho kumsebenzi reflex le myocardium, kwezintso kunye ithombo legazi lobuchopho. kungabangakho kwaphulwa igazi ubonelelo eluswini, enyama yangaphakathi, skeletal izicwili kwezihlunu.

Njengoko yesikhokelo, "Fosinopril" lisetyenziswa idosi enye, na isenzo iqinile leyo libizwa kakhulu emva ezintlanu iiyure. Le nguqu ngenxa lugciniwe ngosuku, nto leyo ekuvumela ukuba ugcine i parameters uxinzelelo lwegazi eqhelekileyo. Ukuze ukubonisa kangangoko kunokwenzeka kufuneka ukuba kudlule iiveki ezimbalwa.

Ngexesha unyango "fosinopril" lwegazi unako ukuphucula impendulo umzimba ukuba nokuncipha okukhawulezileyo uxinzelelo lwegazi zenkqubo. Xa therapy kudityaniswe thiazides kunye "Fosinopril" lithetha livela umsebenzi zicaca umfutho. Ukuba kuyimfuneko, rhoxisa i "fosinopril" akazange Ukuphuhlisa syndrome, ayikho nkqu kwimeko xa ukurhoxiswa yenziwa ngesiquphe. Ukulungiselela kuphucula isigulane xa eliqukuqela nzima ifomu ukusilela intliziyo ezingapheliyo, kwakunye impendulo umzimba ukuba ntshikilelo emzimbeni.

Ngokuphathelele umboniso mutagenic kwaye ezinetyhefu kwithuba unyango "Fosinopril" guide iyeza ibonisa ukungabikho kwabo. Nangona kunjalo, ukusetyenziswa amathamo cytotoxic kukhokelela ezithile kwizigulo ezinxulumene aberrations chromosomal. Studies zabanjwa iimpuku kunye neempuku wabonisa ukuba idosi yemihla ngemihla esingadlulanga 400 mg / kg akubangeli iimpawu carcinogenicity. Ngenxa ngeedosi eziphezulu kumabuzi iinkunzi Akunakuba lipomas rhoqo wabonakala. ngeedosi imihla ichiza ukuya kuma-60 mg / kg kumabuzi akazange abangele ukuphazamiseka ezinxulumene ukuphunyezwa umsebenzi okuzala. Xa ufakwe medicament amabuzi abakhulelweyo (yonke imihla umthamo ukuya ku 400 mg / kg ngosuku) nemivundla (yonke imihla ithamo-40 mg / kg) yenzekile ukunxila, iziyobisi ichaphazele ikhondo yokukhulelwa.

Sokufunxa lithetha "Fosinopril" Umsebenzisi Application kwachazwa ngokuthi kade, ngenxa yokwehla ukutya ngaphezulu. Ngenxa lokuqala-pass yokucolwa bioavailability kancinane (36%). "Fosinopril" hydrolyzed, le nkqubo lwenzeka egazini, isibindi kunye shell zesisu ngenxa ukuphunyezwa kwayo fozinoprilat kuyilwa, nto leyo metabolite esebenzayo. Inqanaba eliphezulu amayeza emzimbeni ifumaneka kwi-avareji iiyure ezintathu emva kokuba isicelo sayo. Half-ubomi lwenzeka iiyure 12-15. Unxibelelwano kunye plasma phantse epheleleyo - ukuya kutsho kuma-98%, umthamo unikezelo lincinane.

Amayeza ingangqubani imiqobo umda placental negazi-ingqondo, ixesha unyango ekhona ngobisi lwebele. Xa kwesibindi (ezinxilisayo, biliary) yehle ukucoca, haydrolisis uyaqhubeka kancinci. Xa insufficiency sezintso kwenzeka uphazamiseko diatsidnyh metabolites esebenzayo zinomgutyulo, iziyobisi bangaqokelela emzimbeni. Ukusetyenziswa dialysis ukususa ichiza ukusuka eziphilayo "Fosinopril" ibonisa yemiyalezo njengento intshukumo engeyoyangeli ukuvelisa isiphumo oyifunayo.

Iimpawu "Fosinopril" ukulungiselela

"Fosinopril" ezimiselweyo sisifo sentliziyo kunye noxinzelelo lwegazi. Kwimeko yokuqala, ichiza sisiseko unyango ezongezelelweyo, kwi sakhiwo yesibini kusetyenziswa unyango kunye monotherapy.

Unyango with "Fosinopril"

Ngokuqhelekileyo, tablets abasela amaxesha enye okanye ezimbini ngosuku ngexesha elifanayo. Xa unyango nomfutho kucetyiswa zokuqala-10 mg beziyobisi, kwaye kamva - 20-40 mg. Kulo unyango zidityanisiwe, ngaphandle xa "fosinopril" lisetyenziswa umchamo, ukuthatha-10 mg iziyobisi. Kulo mzekelo, ukubekwa esweni okokoko uxinzelelo lwegazi, idosi iphezulu kangangoko ichiza 80 mg ngosuku. Ukuba ichiza, elinye ithamo akuthethi kabini kwaba Idlule. amathamo Treatment yakho usebenzisa izixhobo ekucetyiswa ngugqirha asikwazi ukuthatha isixa-mali esikhudlwana okanye ezincinane beziyobisi kunye nokwandisa rhoqo kwayo ukusetyenziswa, kwaye unokwenza le ukurhoxiswa "fosinopril" ngaphandle kokubonisana gqirha.

Phambi ukuthatha amayeza "Fosinopril" manual Kucetyiswa ukuba ukuvavanya iqondo ukunyuka koxinzelelo lwegazi. Ekuqeshweni unyango ithatha ingqalelo iimeko ezahlukeneyo lwezonyango, ugqirha kufuneka esweni rhoqo imeko yomguli.

Ukunciphisa ubungozi yophuhliso lwegazi sesekondari, igcuntswana leyeza kucetyiswa ebusuku. unyango umfutho rhoxisa iintsuku ezisixhenxe phambi lokwaluka unyango, "fosinopril". Ukuba ngaphambili wenza unyango umchamo kukunciphisa umngcipheko hypotension kwangumqondiso, elungisa ibhalansi ulwelo kunye electrolyte, umchamo nciphisa ngokubaluleka idosi, kwezinye iimeko, ayeke ezithatha ichiza ngokupheleleyo (iintsuku 4-7 phambi kwedosi yokuqala "fosinopril").

Emva therapy iposi engabalulekanga lithetha "Fosinopril" umyalelo kwi isicelo ikuvumela ukuba uqale kwiintsuku ezintathu kamva. Ngexesha unyango ifuna ukujongwa rhoqo uxinzelelo lwegazi kunye neendlela lihlole igazi yoluvo (zihlolwe phambi kokuba unyango, ulawulo zingaphelanga iinyanga 3-6 unyango kwi esiku elizayo lwenziwa ngonyaka, esweni rhoqo kakhulu lunokuba yimfuneko xa amathuba aphezulu isahlakalo neutropenia). Ngaphezu koko, kuyimfuneko ukulawula ubunzima bomzimba, khangela ubume izintso kunye namanqanaba creatinine, potassium ekwakhiweni plasma protein, urea igazi nitrogen. Ngexesha unyango kufuneka ulandele ukutya.

Izigulane lwegazi lakhe abuhlungu onesimilo amayeza idosi ngokuthe ukwanda (qho ebusuku), kokuqwalasela utshintsho uxinzelelo lwegazi, lo gama umphumo iya kuba nkulu.

Izimo ekufumaneni "Fosinopril" iziyobisi

Xa kunikwa iipilisi "Fosinopril" ezibonisa zokusetyenziswa ziqwalaselwa ngaxeshanye kunye Izimo. Ichiza alisetyenziswa kwimeko hypersensitivity amacandelo zalo kunye namanye amachiza afanayo. Amayeza engamiswanga kwizigulana abaneminyaka engaphantsi kwe-18 ubudala kunye nabasetyhini abakhulelweyo, uncancisa abafazi. Contraindication ingcole elibaleka ukusilela kwezintso. Izimo ziquka angioedema (idiopathic, amafa) njenge akhoyo ngelo xesha kokutyunjwa ichiza, kwakunye nabo zinembali wavakalisa hyperkalemia, hypotension.

ukukhulelwa

Tablets "Fosinopril" yemiyalezo lithintela ukusetyenziswa ngethuba lokukhulelwa, ngenxa yokuba iziyobisi yolu hlobo kunokukhokelela iingxaki zophuhliso kunye nokufa ezingekazalwa.

Ukuba ekhulelwe ixesha ukuphunyezwa unyango kufuna ukubhangiswa ngokukhawuleza ichiza. Kwiimeko ezinjalo, uphando ultrasound ukuchonga benzakalise olungekazalwa.

Usana onina waphathwa ngexesha lokukhulelwa "fosinopril", inokufumaneka hyperkalemia, hypotension, oliguria. Xa kuphuhliswa oliguria, kubalulekile ukubonelela inkxaso perfusion kwezintso kunye noxinzelelo lwegazi zitshekishwe qho. Ukuba imisebenzi sezintso ukwenzela ukulungisa uxinzelelo lwegazi mogzhet kwenziwa igazi okanye dialysis.

Imida kusetyenziso yokulungiselela "Fosinopril"

E ngenkankulu kuqhubeka zifo samathambo kufuneka athathe ingqalelo umlinganiselo iinzuzo kunye nobungozi yonyango lithetha "Fosinopril". Imiyalelo yokusebenzisa, iimpendulo lubonisa imfuneko ukuqwalasela umngcipheko kunye neenzuzo kwezi meko zilandelayo:

• kwemithambo;
• phambi umguli zilinywe kidney;
• sifo;
• diabetes;
• imbali angioedema;
• iintlobo ezingapheliyo sisifo kwemiphunga;
• hyperkalemia ne index ngaphezu 5.5 mmol / l;
• iminjunju;
• ukuqina;
• utshintsho obstructive, ekhatshwa lokuphuma igazi kakuhle ngokusuka entliziyweni (stenosis aortic, mitral);
• Ukungaphumeleli senhliziyo esibi;
• ukudla, ngokubonelela inani eliqingqiweyo yomxholo ityuwa okanye isixa ubuncinane sodium ukutya aphele;
• hyponatremia;
• leukopenia, thrombocytopenia;
• kwezinye iinkqubo (dialysis, zomzimba) ukusebenza;
• yegazi, ethi ichaphazele nemilenze;
• emzimbeni;
• sezintso Ukungaphumeleli creatinine ngasentla 300 pmol / L;
• ebudaleni;
• hepatitis;
• iingxaki zobuchopho kwaye ithombo legazi semithambo;
• stenosis;
• iimeko apho nokuncipha BCC.

ziziphumo ebezingalindelekanga ezivela "Fosinopril" iziyobisi

Ifumaneka kwi medicament "Fosinopril" uhlolo kunye nesikhokelo ibonisa amathuba yokuphuhlisa iziphumo ebezingalindelekanga ethile. Kungenzeka ukuphazamiseka benkqubo hematopoiesis kunye nemithambo yegazi. utshintsho anokwenzeka e-nervous system, inkqubo yokucola ukutya, uphuhliso eziyi zokusebenza. Ezinye izigulane waba utshintsho parameters elebhu kunye neziganeko ezibi, ngokubonakala yesikhumba ochaphazelekayo, inkqubo musculoskeletal. Kungenzeka yokuphazamiseka isixokelelwano sokuphefumla kunye enzala. Phakathi kwezinye reactions umzimba ezibi - hyperhidrosis, ukwehla kobunzima, ukugabha, ifiva, nokudumba angioneurotic, uphuhliso lomzimba kwiinkqubo esosulelayo okanye iinkqubo ukudumba kwiindawo nkovu, lymphadenopathy, zisiba of sifo. Naziphi na iingxaki ngexesha unyango kufuneka kuxelwe kugqirha wakho. nengozi ephezulu iziganeko ezibi ezinxulumene gwenxa kweziyobisi.

Libanda, "Fosinopril" iziyobisi

Xa unyango iziyobisi, "Fosinopril" iimpendulo zibonisa ubukho amathuba i libanda, ngenxa yokudlula idosi ekhuthazwayo. Libanda, ihamba ekubonakalisweni nokoyika hypotension, ukusilela kwezintso, badengeka, ukothuka, bradycardia, ukuphazamiseka kwamanzi kunye electrolyte imali eseleyo.

Khupha unciphiso idosi okanye ukuphelisa i medicament wahlamba isisu kwaye anike isigulane sisele sorbent. Kubalulekile ukuba abantu bathathe indawo tyaba, kubalulekile ukuphumeza amanyathelo ejoliswe ukwandisa BCC. Kwakhona kufuna unyango nomqondiso. Ihaemodialysis kule meko ayiniki yifuna.

Drug intsebenziswano "Fosinopril" ukulungiselela

Amathuba isahlakalo hyperkalemia kakhulu xa usebenzisa iziyobisi, nto leyo ubunjwe ababambeleyo potassium ityuwa, cyclosporine, nokongezwa ne potassium, womchamo potassium-ndiconga.

Ifuthe ichiza luthe kucaciswe ngakumbi ukusetyenziswa kwezinye iindlela, ibe nafuthe iqinile, kunye notywala. A isiphumo ithambile kulindeleke ekhoyo ngenxa yokusetyenziswa kweziyobisi ukuba isebenze inkqubo renin-angiotensin-aldosterone, estrogen, NSAIDS kunye sympathomimetics. Kwiimeko ezinjalo kuyimfuneko ukuba ukwala ukwamkela ezi mali okanye indawo "Fosinopril". Analogs zikhethwa gqirha khona. Ngomhla ithuba yokudibanisa ichiza kunye nezinye iziyobisi zingafunyanwa yincutshe.

Analogs, "Fosinopril" izithethantonye iziyobisi

"Fosinopril" uye ntonye kunye analogue. Kuba ntonye 'elethu Fosinopril-Teva "," Monopril. " Ukususela eli qela iziyobisi wavelisa "Fosinopril-OBL», «Fozikard". Of izithetha-ntonye uyakwazi ukukhetha "Fozinal", "Fozinotek".

Xa unyango akaphazanyiswa lithetha "Fosinopril" imiyalelo ukusetyenziswa, izithetha-ntonye okanye analogs amisiweyo lweengcali ukuze unyango. Analogs "Berliprilom ',' Renitec '" ramipril "," Moeksom "," lisinopril ". analogs Ezaziwayo Uphinde "Prestarium", "Enap" yaye "enalapril". Of analogue linokukwenziwa "Tritatse", "Akkupro", "captopril". unyango kunokwenzeka usebenzisa i "Charter" okanye "Prenessa".

Ukuba sinqanda ukusebenzisa "Fosinopril" imiyalelo amayeza ukusetyenziswa, analogs okanye ntonye bakhetha isigqibo specialist.

Izimvo elungiswa "Fosinopril"

Kubalulekile ukukhetha ilungelo amayeza anti-unesifo kwisigulana, kuthathelwa ingqalelo izinto awohluke yomzimba wakhe. Ukuba "Fosinopril" umntu ofanelekileyo iziyobisi, xi lifinyele ngempumelelo, kunye neziphumo ebezingalindelekanga musa zenzeke. Njengoko ncomo, kukho nokuzinziswa soxinzelelo lwegazi, ngcono impilo jikelele. Ukuba ngayo ezibi lomzimba kuyagcinwa, ukuba abanomoya, ubukhulu becala kungcamla ukuphazamiseka, ukuba nesifuthufuthu, ukhohlokhohlo.

uxinzelelo lwegazi oluphezulu kunokubangela iingxaki ezinkulu yanxulunyaniswa nomonakalo amalungu omzimba abalulekileyo, ngoko ke kufuneka ixesha ukuze uthomalaliso eyimfuneko funda inkcazo amayeza "Fosinopril" analogue, ukuze simazi kunye nenye ingcaciso eluncedo.