"Kardosal": umyalelo manual, ncomo, iinkcazelo, analogs

"Kardosal" (igama ngamazwe - "olmesartan medoxomil") yindlela ochasene of angiotensin II receptor (uhlobo AT1) - prayimari vasoactive RAAS ihomoni eziphathelele kuphuhliso wegazi kubalulekile.

Ngohlobo ukukhulula ichiza, iincindi zalo

Ichiza ifumaneka emacwecweni ezihlawulelwayo esingxotyeni salo. into Basic, apho medicament ye olmesartan medoxomil ezisetyenziswa amacwecwe ziquka ukusuka-10 ukuya kuma-40 mg ( "Kardosal 10"; "20 Kardosal", "Kardosal 40").

Ngaphezu koko, eli chiza safakwa wemagniziyam stearate, microcrystalline kwincindi, monohydrate lactose. Kwakhona, njengokuba abangabancedani koponentov giproloza ezisetyenzisiweyo giproloza ephantsi endaweni. Iqokobhe idaliwe ukusuka titanium dioxide kunye talc esongezwa hypromellose.

imiphumela kwemithi

Kuthathwa ukuba ichiza "Kardosal" ebambeleyo ekhankanyiweyo ephilayo, inegalelo uvimba ifuthe angiotensin II, _AT1 receptor zacaciswa. Xa lwegazi medicament kwandisa uxinzelelo esimbaxa, le isiphumo ihlala ixesha elide. Akukho data engqina kokuvela hypotension emva kokuba ukusetyenziswa yokuqala idosi sokuqala isiyobisi kunye tachycardia ngenxa kunyango ixesha elide ( "Kardosal 20", "Kardosal 40"), imbonakalo zokurhoxa kunye nokwanda okukhulu uxinzelelo lwegazi.

Ukusetyenziswa kweziyobisi kanye iziphumo imini ukuhla okuphakathi zalathisi uxinzelelo lwegazi. Yifuna iphuhlisa ngaphezu kweeyure ezingama-24. Ngokuqhelekileyo, umphumo iqinile ifunyanwa ngomhla weshumi elinesine unyango, iziphumo ezingcono waphawula emva konyango lwe malunga neenyanga ezimbini.

Pharmacokinetics

Kukufakwa ichiza, ukwabiwa

tablet enxilile kuthatha ngokukhawuleza ngokohlobo metabolite pharmacologically esebenzayo ethunjini (ngenxa yesenzo ezwi enqanda) kunye negazi portal (ngexesha kukufakwa ukusuka phecana zesisu).

Ngexesha therapeutic nokwakhiwa plasma yegazi lo uchonge izinto esebenzayo ingatshintshanga. Umyinge bioavailability imalunga-26%. Inqanaba eliphezulu beziyobisi afumaneka kwi-avareji iiyure ezimbini emva kokuba yamkelwa, kunye ukwandisa idosi (idosi enye - 80 mg) kuwo kwandisa.

"Kardosal 40", kwakunye iimveliso idosi ezahlukeneyo isithako esebenzayo, ingahoywa ngaphandle ugxininisa ekusetyenzisweni isidlo. Ukutya phantse akukho nafuthe bioavailability.

Udibaniso ne kwiproteni plasma phantse ngokupheleleyo, elungelelene 99,7%. Nangona kunjalo, ukusetyenziswa ngaxeshanye "Kardosala" vysokosvyazyvayuschimisya kunye nezinye iziyobisi kokuba lincipha kakhulu.

Drug ukutya uze zinomgutyulo wayo emzimbeni

isibindi Ngokomthetho drug efunyenwe (60%), bonke (40%) - nezintso. ejikeleza Intrahepatic osisiqu esebenzayo babambanayo mncinci kakhulu. Ekubeni kukhuthaza iveliswa ikakhulu sisibindi, unyango kunye arhente "Kardosal dibanisa 'ukuba akuvumelekanga ukuba ogulayo biliary phecana kokuphazanyiswa. ukusetyenziswa Emva ngokuphindaphindiweyo iyeza ngokuyinxenye ziboniswe kwi-avareji iiyure ezili-12. ukusebenza Good liyasetyenziswa ekubeni efumene umthamo ichiza, okuhambelana ngeedosi ezininzi "Kardosala". A ukusebenza okubonakalayo ukho yaye emva kweentsuku ezilishumi elinesine unyango, apha olwenzeka lungenzeki. Kweli nani, njengoko kugqitywe sezintso alichatshazelwa umthamo iziyobisi ezahlukeneyo, oko ku ezahlukene ukususela 0.5 ukuya 0.7 L / h (malunga).

Kwiimeko ezizodwa clinical

Abo izigulane abafunyanwa nokunyhashwa umsebenzi kwezintso (inobulali, alungise, kakhulu), AUC inyuke nge-62, 82 ne 179%, xa imeko uzinzile.

Xa iingxaki kwesibindi, ichazwe kancinane kwaye abangaxhalabisiyo, single AUC idosi ukwandisa iindlela inceda ku-6 no-65%.

ubungqina

Ukwalathelwa lithetha "Kardosal" umyalelo kwi isicelo yenza ekufumanekeni wegazi kubalulekile.

Ezinyangiweyo "Kardosalom" xa ukhulelwe ayamkelekanga. Ukuba ukukhulelwa kukuba kule nkqubo yonyango, kuyimfuneko ukwenza ukupheliswa ichiza.

Ngenxa yokungabikho kweenkcukacha oluxhasa ukhuseleko yonyango ukuncancisa ngexesha ukhozo unyango lokuncancisa.

Ukuze sibe nako ukuthenga "Kardosal" kwaye baqale ukuphathwa ngayo, ugqirha kufuneka ubhale kagqirha.

Izimo

Izimo ziquka hypersensitivity kwabo izinto ezifakwe kwi ekuqulunqeni, ungumntwana (ongaphantsi kweminyaka eli-18), ukukhulelwa, ibele-lwebele. Ukongeza, ipilisi ungamiselwanga kwezi meko zilandelayo:

• ekuphazamiseni nesiqephu biliary;
• ubukho malabsorption syndrome, galactosemia;
• ukungabikho yelactose;
• ixesha emva kokuba esinye kidney;
• ukusilela kwezintso kwi QC ephantsi (ml ngaphantsi kwe-20 / min).

"Kardosal" - ichiza nolawulwa ngononophelo kakhulu ukuba izigulane kunye nemiqathango:

• kwemithambo;
• hyperaldosteronism (primary);
• ukuphazamiseka kwesibindi;
• ukusilela kwezintso, apho KK i ml mkhulu kuno-20 / min;
• stenosis, sisilonda esidumbileyoesingaphakathi ekhatshwa mitral okanye umba aortic;
• flow senhliziyo ezingapheliyo;
• isifo cerebrovascular;
• ukudla ephelekwa limited sodium otyiwa;
• hyponatremia, hyperkalemia (kukho umngcipheko insufficiency kwezintso, hypotension okanye emzimbeni);
• karhulumente xa BCC unciphisa kubonakala ukugabha, urhudo;
• stenosis, ibetha i Umthambo kwezintso kuphela, stenosis amabini, apho kwemithambo sezintso achaphazelekayo;
• cardiomyopathy obstructive hypertrophic;
• ubudala kwiminyaka engama-65;
• imfuneko yokuba womchamo.

Besebenzisa "Kardosala"

"Kardosal" umyalelo ncwadi incoma usebenzisa-10 mg, okuhambelana idosi sokuqala. Xa ukuzinza elingonelanga uxinzelelo lwegazi ziphele ngosuku ukuya mg 20 iziyobisi. yedosi engange-40 iziyobisi mg ngosuku ayamkelekanga. amayeza Daily kufuneka asele ngexesha elinye, kwelinye kunye nexesha elifanayo. Kuba izigulane ezineengxaki zezintso kutyhilwa ngobulali ukumodareyitha elihlabayo, xa imvume kwi ezahlukeneyo ukususela ml-20 ukuya kuma-60 / min, idosi iphezulu "Kardosala" ayikwazi ibe ngaphezu kwama-20 mg. Kwiimeko apho kukho imfuneko yokomeleza isiphumo nto iveliswa unyango esimbaxa (ngaphandle "Kardosala" isicelo "Hydrochlorothiazide").

imiphumela emibi

Ekunyangeni iziyobisi "Kardosal" yemiyalezo kuvumela iziphene ezifana:

• Ukusabela okunge- ukususela kwiinkqubo bokuphefumla yokucola ukutya, imbonakalo yokuphazamiseka kwenkqubo musculoskeletal, womchamo kunye nezintso, ukutshintsha ezinye parameters elebhu, uphuhliso ukuphazamiseka umlinganiswa jikelele (iziphene ezifana kwenzeka rhoqo);
• uphuhliso angina, imbonakalo ukuphazamiseka ezichaphazela luvo (ngamanye amaxesha avele);
• utshintsho kwinkqubo sentliziyo, uphuhliso hyperkalemia (uyibone).

side effects ezivela kunqabile kakhulu emva kokufumana "Kardosal" imiyalelo medicament ukusetyenziswa ziquka:

• yokuphazamiseka kwinkqubo hematopoietic;
• ukukhohlela;
• uhlobo nokoyika ukusilela kwezintso;
• iingxaki esikhumbeni;
• syndrome asthenic;
• intloko ebuhlungu, imbonakalo nesiyezi;
• myalgia;
• isimo convulsive;
• isicaphucaphu kunye nokugabha, iintlungu esiswini;
• ukwanda urea, creatinine egazini;
• utshintsho esibindini - Ukunyuka kumsebenzi enqanda yayo.

libanda

Libanda kunokwenzeka, ukuthi kuziveza unciphiso okuphawulekayo kwezalathisi uxinzelelo lwegazi. Kwimeko yoko ngolo unyango kufuna esweni rhoqo kwizigulane. Ukuphelisa iimpawu eziyelelene libanda, lithetha "Kardosal", oogqirha bacebisa ukuba enze ncomo unyango kwangumqondiso kwaye unyango noncedo bunjani uxinzelelo lwegazi. Kwimeko libanda, isigulane elele ngomqolo aniphakamisele imilenze yakhe. Ukongeza, xa usebenzisa idosi elikhulu ichiza Kucetyiswa ukuba enze lavage esiswini, anike umntu carbon iyasebenza. Kukho imfuneko yokuba umthamo replacement, ukupheliswa emzimbeni kunye nokubuyiselwa kwityala lamanzi-ityuwa. Ulwazi malunga namathuba kukhuthaza izinto olmesartan medoxomil yi dialysis apho.

oyi

Xa kwizigulane phambi kokuba unyango ngokunzima baphathwe kunye womchamo kwaye zilandelwe ukudla ayibandakanyi ukuselwa ityuwa, kunokubangela hypotension ngenxa yokusetyenziswa yokuqala ithamo beziyobisi. Isiphumo efanayo ibonakala kwizigulane abaye kwenzeka ukugabha okanye ukurhuda. Isizathu soku abasabela ngayo umzimba - ekunciphiseni BCC. isiganeko esibi elolu hlobo kufuneka kuthintelwa. Umngcipheko livela kufuneka ziqwalaselwe phambi kokuqala unyango.

Ukuba umntu uwaphule nezintso, kubalulekile ukujonga njalo ezi zibalo serum njengoko creatinine, potassium. Ukusetyenziswa kwe -ACE inhibitors zizigulane abaye kokufunyaniswa hyperaldosteronism (zaseprayimari), elingenantsingiselo, ngoko musa ukumisela kuthetha "Kardosal" (ratings kubonisa akukho mpendulo ACE inhibitors).

Khumbula ukuba ukuhla kakhulu kuxinzelelo igazi izigulane yegazi, nto leyo echaphazela izitya zobuchopho, okanye isifo kwemithambo kunokubangela uphuhliso kweemeko eziyingozi ezifana stroke kobuchopho kwaye iposi engabalulekanga.

Ukuba umntu ukuba enze nokugcinwa oomatshini ngendlela entsonkothileyo okanye ukuqhuba isithuthi, kubalulekile ukwazi ukuba ukuthatha "Kardosala" kunokubangela ukonakala kweendlela zempilo (ukudinwa, ubuthathaka, isiyezi), nangona oku kuyenzeka kunqabile.

Ngenxa isiqulatho lactose kwi ichiza ziwuthimbe esalelweyo ukuba izigulane ungenxa galactose ukunganyamezelani umlinganiswa. Kukwasebenza kwanjalo kwizigulane kunye malabsorption syndrome galactose kunye iswekile, yelactose ukunqongophala emzimbeni.

Intsebenziswano kunye namanye amachiza

Ugqirha kufuneka ubhale i amayeza uze ufumanise ukuba isigulane iphathwa ngezinye iindlela ukuthintela ngayo okungeyomfuneko. Akuyi Kucetyiswa ukuba basebenzise zombini "Kardosalom" kunye ntlobo zilandelayo kwamachiza:

• kuthetha equlethe potassium;
• ababambeleyo ityuwa, ezibandakanya abo potassium ekhona;
• Potassium-engashiyi womchamo;
• amayeza ezichaphazela amanqanaba potassium kwi serum egazini (ukwandisa eli nani).

Umzekelo iindlela ezinjalo i "lweeHedfowuni". Oku uyakwazi ukuphembelela isiqulatho potassium egazini. Xa ukungakwazi unyango "Kardosal" analogue zinika ithuba lokwenza indawo yayo.

Ukomeleza lo umfutho liyasetyenziswa xa unyango lwe namanye amachiza umfutho kunye NSAIDs, okt ukuphunyezwa unyango ezibanzi. Therapy nenkqubo ehlanganisiweyo ibandakanya ukusetyenziswa inhibitors Cox-2, acetylsalicylic acid (idosi yemihla ngemihla - ngaphezulu kwe-3 g). Isenzo angiotensin II bachasene receptor kunokuba synergistically eziphembelela ukuhluza glomerular yi ukuncitshiswa yayo.

Nokusebenzisa ngaxeshanye imithi ezifana angiotensin II bachasene receptor, kunye NSAIDs, kukho amathuba ahlekise sezintso shape ukungaphumeleli yesigulane. Ngenxa yesi sizathu, iliso ubume sezintso kwi lokuqala unyango kufuneka kwenziwe rhoqo. unyango olunjalo kufuneka ngokuqinisekileyo asele izinto ezibumanzi ngokwaneleyo. Noko ke, ukwehla kunokwenzeka ubungqongqo amanyathelo umfutho, apho ukonakala elifana neli rhoqo ukusebenza unyango.

Ukuba 'Kardosal "lisetyenziswa kwi asidi zonyango, ezizezi hayidroksayidi aluminiyam nezinki, kukho ukwehla ubungozi bioavailability ukwimo esebenzayo (phakathi).

Kubikwe ingathityazwa amanqanaba ukunyuka lithium kwi serum igazi ukubonisa iipropati ityhefu ngenxa yokwabelana inhibitors ACE, angiotensin II abamelene receptor kunye neziyobisi Lithium. Malunga nalo udityaniso therapy umyalezo "Kardosalom" kunye neziyobisi, enye enkulu ukuba ngawaphi amacandelo - Lithium, ayikhuthazwa. Nangona kunjalo, ukuba kukho imfuneko enjalo, ulawulo yegazi kufuneka rhoqo.

Iindleko iziyobisi, analogs, ncomo

Xa kunikwa "Kardosal" amacwecwe ezifana ixabiso ayikho zonke izigulane, ngoko ke abanomdla ubukho unyango kunye ukusetyenziswa kwezinye, indlela ephumelelayo ngakumbi. "Kardosal" ikhontenti-10 mg eyona nto asebenzayo kuthengelwa miri 610, ichiza apho ubume has 20 mg esisebenza -. Kwama-756 bagcobe. "Kardosal", ogama ixabiso imalunga 860 engange., Liqulathe 40 mg ingxenye enkulu.

Njengoko isifaniso, xa kufuneka ukhethe enye indlela wokuphunyezwa unyango, endaweni "Kardosala" uyakwazi ukusebenzisa amayeza "Olimestra" okanye ukuvelisa kwanonyango zidityaniswe ngokusekelwe ekusetyenzisweni "hydrochlorothiazide", "medoxomil olmesartan". Ungathatha ingqalelo iintanga ezifana "Lozarel 'okanye' Cozaar '. Ukongeza, kuba ukutshintshwa kwamachiza abafanelekileyo "Nortivan" "Valsartan Zentiva".

Bazi ngezakhiwo ezifana "Olmesar", "Plaunak". Ngokuqhelekileyo substitutes yahluka-mali yokuqala, omnye umahluko kukuba ixabiso elifanelekileyo wayicola parameters bioavailability, ngoko ke ucango, nangona ukumelana nomsebenzi.

Analogs zisoloko akunakusetyenziswa phantsi kweliso lomgadi oyingcali, kuyimfuneko ukuhlola rhoqo uxinzelelo lwegazi. Ukuba ufuna ukukhetha up analogu kwiziko "Kardosal" kunokuba indawo eli chiza, ugqirha isigqibo, kuthathelwa ingqalelo ezi zihlandlo ezahlukeneyo. Xa efumanise iziganeko ezibi ngethuba unyango lo analogu kufuneka ukuba enze izenzo kuyimfuneko ngendlela ngexesha ezijoliswe ekupheliseni zabo. Ngexesha unyango kuyimfuneko ukuhlola ifuthe emzimbeni.

Xa original ngaphandle izixhobo ukutshintsha ayikwazi ukukwenza, ukuba umnike kukhethwa leziyobisi iveliswayo ziinkampani yaseYurophu kuvavanywa. Xa uceba endaweni "Kardosal" macwecwe analogue kufuneka nje ukuba ukhethe umgangatho uphezulu.

Izimvo yashiywa iiforam ugqirha-nomonde, kubonisa ukuba ichiza "Kardosal" ngexesha unyango sisoloko sisenza reactions ezibi, yeyona ixhaphakileyo apho - intlungu esifubeni nokudinwa rhoqo. Kodwa nangona ezi zihlandlo ekhathazayo, isiphumo iqinile isoloko kakhulu. Ukubonakala iziphumo ezibi ifuna ukuthunyelwa oyingcaphephe icebiso, kwaye ukutshintsha irejimeni yonyango.

Xa unyango kwezigulane umfutho wegazi phendla, kubalulekile ukuba ulawulo yesigulane osisigxina. Ukuphunyezwa unyango, ngaloo ndlela uya kunika ifuthe elifunekayo, uze ulandele imeko ephilayo, kwaye kwimeko zokuphula - ukulungisa kubo kwexesha. Kubalulekile indlela edibeneyo, kodwa unyango ngamachiza akwanelanga, kufuneka ukhethe isidlo esikhethekileyo. Phakathi kwezi meko unyango efunekayo - nokuhambelana imo gentle umsebenzi, ukubatshabalalisa imikhwa emibi, ukunciphisa yomzimba kunye nokuhambelana kunye namanye amabhunga ukuba okuphakanyiswe ngenxa ugqirha iziphumo ezingcono zonyango.