I ka nāwaliwali o ka puʻuwai maʻi, hiki ke hoʻohana i ka lisinopril i ka manawa like me ka diuretics a me / a i ʻole glycosides cardiac. Inā hiki, pono e hoʻemi ʻia ka nui o ka diuretic ma mua o ka lawe ʻana i ka lisinopril. ʻO ka inumele mua he 2.5 mg 1 mau manawa / lā, i ka wā e hiki mai ana ka hoʻonui iki ʻana (e ka 2.5 mg i ka lā 3-5) i ka 5-10 mg / lā. ʻO ka maʻa loa he 20 mg / lā.
In myocardial infarction (ma ke ʻano o ka hoʻohui ʻana i nā lāʻau lapaʻau i nā hola 24 mua, ʻo nā mea maʻi me nā neʻe hemodynamic mau) e kuhikuhi ʻia he 5 mg i loko o nā hola 24 mua, a laila 5 mg i kēlā me kēia lā, 10 mg ma hope o ʻelua mau lā a laila 10 mg hoʻokahi i ka lā. I ka poʻe maʻi me ka maʻi myocardial infarction, hoʻohana ʻia ka lāʻau lapaʻau no 6 mau pule. I ka hoʻomaka ʻana o ka hoʻōla a i ka wā mau lā 3 a pau ma hope o ka maʻi myocardial acute, nā mea maʻi me ka haʻalulu haʻalulu haʻahaʻa haʻahaʻa (120 mm Hg a i ʻole kahi haʻahaʻa) e kuhikuhi ʻia ana he dosis o 2.5 mg. Ma ka hanana o ka hypotension arterial (kahe koko systolic ma lalo a i ʻole like me 100 mm Hg), hiki i ke ʻano o kēlā me kēia lā o 5 mg hiki ke hoʻemi iki ʻia i ka manawa iki i 2.5 mg. Ma ka hihia o ka lōʻihi o ka hoʻokūkū arterial (kahe koko systolic ma lalo o 90 mm Hg no ka nui aʻe o ka hola 1), pono e hōʻoki ʻia ʻo Irumed.
I ka nephropathy maʻi kamika i nā maʻi me ka maʻi diabetes mellitus type 1 (kū i ka insulin), ua kuhikuhi ʻia ʻo Iramed ® ma kahi pākana o 10 mg 1 manawa / lā. Inā pono, hiki ke hoʻonui ʻia i kēia maʻa i 20 mg / lā i mea e hoʻokō ai i nā helu koko koko diastolic ma lalo o 75 mm Hg. i kahi noho. I nā maʻi me ka maʻi diabetes mellitus type 2 (non-insulin-dependant), he like ka nui o ka lāʻau no ka hoʻokō ʻana i nā koina koko diastolic ma lalo o 90 mm Hg. i kahi noho.
Kaulana ka hopena
ʻO ka manawa pinepine: ka manawa, ka ʻeha, ka luhi, ka ʻeha o ka maʻi, ke kō maloʻo.
Mai ka pūnaehana cardiovascular: he hōʻailona i ka emi ʻana o ke koko, ke ʻeha ʻeha, ʻemi - hypotension orthostatic, tachycardia, bradycardia, ke ʻano o nā ʻōpū o ka hōʻoki ʻana i ka puʻuwai, ka hoʻopiʻi ʻana o AV, ka myocardial infarction.
Mai ka ʻaoʻao o ka pūnaehana nīkini waena a me nā ʻōnaehana hoʻoneʻe peripheral: ka uea hanahana, ka haunaele, ka paresthesia, ka nalowale, me ka puʻuli hoʻonaninani o nā ʻūhā o ka umauma a me nā lehelehe, ʻaʻole ka maʻi - asthenic syndrome.
Mai ka pūnaehana ʻana: ka waha maloʻo, anorexia, dyspepsia, hoʻololi i ka ʻeha, ʻeha o ka ʻōpū, ka pancreatitis, hepatocellular a i ʻole cholestatic, jaundice, hepatitis, hoʻonui i ka hana o ka transaminases hepatic, hyperbilirubinemia.
Mai ka papa hana hanu: dyspnea, bronchospasm.
ʻO nā hopena dermatological: hoʻonui nui loa, nāu ʻili, alopecia, photosensitivity.
Mai nā lālā hemopoietic: leukopenia, thrombocytopenia, neutropenia, agranulocytosis, anemia (hoʻemi i ka hematocrit, hemoglobin, erythrocytopenia).
Mai ka ʻaoʻao o ka hana metabolism: hyperkalemia, hyponatremia, hyperuricemia, hoʻonui i hana me ka creatinine i loko o ke koko.
Mai ka urinary system: impalired renal function, oliguria, anuria, uremia, proteinemia.
Nā ʻano maʻi: urticaria, angioedema o ka maka, nā wāwae, nā lehelehe, ka alelo, ka epiglottis a me / a i ka larynx, ke ʻano o ka ʻeha, ka ʻeha, ka mai, nā hopena hoʻonaninani a me ka huakaʻi antiinuclear, hoʻonui i ka ESR, eosinophilia, leukocytosis, i kekahi mau hihia - interstitial angioeurotic.
Nā mea'ē aʻe: arthralgia / arthritis, myalgia, vasculitis, hōʻemi i ka potency.
Nā hōʻailona: hōʻailona hōʻailona i ka hoʻokahe nui o ke koko, ka malo maloʻo, ka lūlū, ka mālama ʻana i ka urinary, constipation, hopohopo, hoʻonui i ka huhū.
Hoʻomaʻamaʻa: hōʻailona symptomatic, intravenous hoʻokele o ka paʻakai a, inā pono, ka hoʻohana ʻana i nā lāʻau vasopressor ma lalo o ke kaʻi o ke koko a me ke kaulike wai-electrolyte. Mahalo paha ka hoʻohana ʻana o hemodialysis.
Me ka hoʻohana like ʻana o Irumed me ka diuretics potassium-sparing (spironolactone, triamteren, amiloride), mākaukau potassium, nā paʻakai paʻakai e pili ana i ka potassium, nā piʻi aʻe o ka hyperkalemia hoʻonui, ʻoi aku hoʻi i nā mea maʻi me ka hana renal impaired.
Me ka hana like o Irumed me ka diuretics, kahi mākau i ʻike nui ʻia i ka hoʻokahe koko.
Me ka hoʻohana like ʻana o Irumed me nā lāʻau lapaʻau antihypertensive hou, ua ʻike ʻia kahi hopena hoʻohui.
Me ka hoʻohana pū ʻana o Irumed me NSAIDs, estrogens, adrenostimulants, hoʻemi ʻia ka hopena antihypertensive o ka lisinopril.
Me ka hana like o Irumed me ka lithium, lithium excretion mai ke kino ke iho nei i lalo.
Me ka hana like o Irumed me nā antacids a me colestyramine, ua pau ke komo ʻana o ka lisinopril mai ka gastrointestinal tract.
Hoʻonui nā Ethanol i ka hopena o ka lāʻau.
Pono e noʻonoʻo i ka emi ʻana o ke kahe o ke koko me ka hoʻohaʻahaʻa ʻana i ka nui o ka wai i hoʻihoʻi ʻia e ka diuretic therapy, me ke kahe ʻana o ka paʻakai i ka meaʻai, i ka wā o ka dialysis a i nā mea maʻi me ka maʻi a i ʻole ka luaʻi. I loko o nā mea maʻi me ka paʻa ʻole o ka puʻuwai me ka ʻole o ka renal i ʻole ka ulu ʻana, e ulu paha ka hōʻailona hypotension, ka mea i ʻike pinepine ʻia i nā mea maʻi me ka puʻuwai puʻuwai, ma muli o ka hoʻohana i nā nui o ka diuretic, hyponatremia, a me ka hana ʻole i ke ake ʻole. I kēlā mau mea maʻi, pono e hoʻomaka ʻia ka mālama ʻana ma lalo o ka mālama pono ʻana o ke kauka (me ka makaʻala, koho i kahi iki o ka lāʻau a me ka diuretics). Pono ka hana e like me ke koho ʻana iā Irumed i ka poʻe maʻi me ka maʻi ʻalihi coronary, hiki ʻole i ka cerebrovascular, ma kahi hōʻemi o ke kaʻe koko ke alakaʻi i ka myocardial infarction a i ʻole ka hahau ʻana.
I ka hihia o ka hoʻomohalaʻana o kahi hōʻemi i ke koko, pono e hāʻawi ʻia ka mea maʻi i kahi kūlana, a inā pono, iv 0.9% sodium chloride hoʻonā. ʻO kahi pane transit hypotensive ʻaʻole kahi contraindication no ka lawe ʻana i ka hopena hou o ka lāʻau.
Ke hoʻohana nei ʻo Irumed i kekahi mau mea maʻi me ka puʻuwai puʻuwai o ka puʻuwai, akā me ka hoʻohaʻahaʻa maʻamau a haʻahaʻa paha, hiki ke emi mai ke kahe o ke koko, ka mea maʻamau ʻaʻole ia he kumu no ka hoʻokuʻu ʻana i ka mālama ʻana. I ka hihia arthial hypotension e lilo i hōʻailona, pono ia e hōʻemi i ka nui o ka lāʻau no ka lāʻau a kāpae paha i ka mālama ʻana me Irumed.
Ma ka huaola myocardial infarction, ua hōʻike ʻia ke hoʻohana ʻana o ka lāʻau maʻamau (thrombolytics, acetylsalicylic acid, nā beta-blockers). Hiki ke hoʻohana 'ia' o Irumed ® e pili i ka / i ka hoʻokomo a me ka hoʻohana 'ana i nā pahuhopu transdermal o ka nitroglycerin.
ʻAʻole e kuhikuhi ʻia ʻo Iramed ® i ka poʻe maʻi me ka maʻi myocardial acute, ka mea e ola nei i ka hoʻopiʻi hou ʻia i ka ʻōpū o ka hemodynamics ma hope o ka hoʻohana ʻana o nā vasodilators: no nā mea maʻi me ke koko o ke systolic o 100 mm Hg. a i lalo, a i ʻole me ka haʻalulu cardiogenic.
I ka poʻe maʻi me ka puʻuwai puʻuwai hōʻeha, kahi māka i hōʻemi ʻia i ke koko ma hope o ka hoʻomaka ʻana o ka mālama ʻana me ka ACE inhibitors hiki ke alakaʻi hou i ka palaualohi o ka hana māka. Kuhi ʻia nā ala o ka hoʻomohala ʻana i nā pilikia ʻoi aku ka hemahema. I ka maʻi me ka bilateral renal stenosis stenosis a me ka stenosis kūloko o kahi keiki hoʻokahi i mālama ʻia me nā mea hoʻopaʻa ACE, loaʻa i ka nui o ka urea serum a me ka creatinine, ma muli o ka hoʻohemo ʻana o ka hana (ʻoi aku ka maʻamau i nā mea maʻi me ka hana ʻole ʻole).
ʻAʻole i hāʻawi ʻia ʻo Lisinopril no ka maʻi myocardial infarction i ka poʻe maʻi me ka maʻi koʻikoʻi o ka renal me ka ʻike serum creatinine ma mua o 177 mmol / l a me ka proteinuria o ka 500 mg / lā. Inā ulu ka ulia pōpilikia me ka hoʻohana ʻana i ka lāʻau lapaʻau (ʻo nā kiko o ka serum creatinine e ʻoi aku ma mua o 265 mmol / l a i kahi hoʻonui ʻana 2-hoʻohālikelike ʻia me ka hōʻailona ma mua o ka mālama ʻana), pono e nānā ʻia ka pono no ka mālama ʻana me Iramed ®.
ʻO nā mea maʻi e hopu ana i ka ACE inhibitors, me ka lisinopril, pinepine i hoʻomohala i ka angioedema o ka maka, nā wāwae, nā lehelehe, ka alinaline, ka epiglottis a me / a i ʻole larynx, a hiki i kona hoʻomohala i kēlā me kēia manawa i ka mālama ʻana. I kēia hihia, pono e hoʻōki ka lāʻau me Irumed i ka hiki koke a nānā pono ka mea maʻi a hiki i ka hōʻeha ʻana i nā hōʻailona holoʻokoʻa. Eia nō naʻe, i nā hihia i hele mai ai ka edema wale nō ma ka maka a me nā lehelehe a me ke ʻano maʻamau ke ʻano o ka mālama ʻole, antihistamines e kuhikuhi ʻia.
Me ka hoʻomalaha ʻana o ka angioedema i ka alelo, ka epiglottis a i ʻole larynx, e hiki ai i ka ala ʻana i ke ala. Lele, no laila, e lawe koke ʻia ka lāʻau kūpono (0.3-0.5 ml 1: 1000 epinephrine solution s / c) a / a i ʻole nā mea e hōʻoia ai i ka ala airway. Ua hōʻike ʻia ma nā mea maʻi o ka lāhui Negroid e lawe ana i ka ACE inhibitors, ua hoʻomohala pinepine i ka angededema ma mua o nā poʻe maʻi o nā lāhui ʻē aʻe. I ka poʻe maʻi me ka mōʻaukala o ka angioedema i hoʻopili ʻole ʻia me ka mālama mua ʻana me ka ACE inhibitors, e hoʻonui ʻia ka nui o kona hoʻomohala ma ka wā o ka mālama ʻana me Iramed.
I nā mea maʻi e lawe ana i ka inhibitor ACE, i ka wā e hoʻokaʻawale ai i ka venmen hymenoptera (nā manu, nā pi, nā ʻōpio), kahi hopena o ka anaphylactoid hiki pinepine i kahi ulu. Hiki ke pale i kēia e hoʻokaʻawale i ka wā loea me ka hoʻokaʻawale ʻana o ACE ma mua o desensitization.
Pono e noʻonoʻo e i nā mea maʻi e lawe ana i ka ACE inhibitors a me ka hana ʻana i ka hemodialysis me ka hoʻohana ʻana i nā membaly dialysis kiʻekiʻe (no ka laʻana, AN69), he hanana anaphylactic e ulu. I ia mau hihia, pono e noʻonoʻo i ka hoʻohana ʻana o ke ʻano like ʻole o ka membrane no ka dialysis a i ʻole nā lāʻau antihypertensive.
Ke hoʻohana nei i ka inhibitor ACE, ʻike ʻia ka pākaukau (maloʻo, lōʻihi, e nalo ana ma hope o ka pau ʻana o ka mālama ʻana me kahi inhibitor ACE). I ka hopena o ka maʻi maʻamau o ka maʻi pākahi, pono ka noʻonoʻo ʻana ma muli o ka hoʻohana ʻana o kahi inhibce ACE.
Ke hoʻohana nei i nā lāʻau lapaʻau e hoʻohaʻahaʻa i ke koko i nā mea maʻi me ka nui o ka hōʻeha ʻana a i ka wā nui o ka anesthesia, hiki i ka lisinopril ke kāohi i ka hoʻokumu ʻana o ka angiotensin II, ka lua o ka pili i ka hoʻopiʻi ʻana i ka renin excretion. ʻO ka emi ʻana o ke kahe o ke koko, ʻike ʻia kahi hopena o kēia hana, hiki ke hoʻopau ʻia e ka piʻi ʻana o ka bcc. Ma mua o ka wehe ʻana (e komo pū ana me nā hana niho dental), pono e hoʻomaopopo ʻia ka lāʻau lapaʻau / anesthetist e pili ana i ka hoʻohana ʻana o ka inhibitor ACE.
I kekahi mau hihia, ua hoʻomaopopo ʻia ka hyperkalemia. ʻO nā mea pilikia i ka hoʻomohala ʻana o ka hyperkalemia e pili ana i ka hiki ʻole o ka renal, ka maʻi diabetes mellitus a me ka hoʻohana pū ʻana o ka diuretics potassium-sparing (spironolactone, triamteren a amiloride), mākaukau pākaha a i ʻole nā mea paʻakai e loaʻa ana i ka pāhare, ka mea nui i nā poʻe maʻi me ka hana renal impaired. Inā pono, e hoʻohana pono ka hoʻohana ʻana o kēia mau hui i ka pae o ka paʻakai ma ka serum koko.
I nā mea maʻi e pilikia ana i ka hoʻomohala ʻana i ka hypotension symptomatic (ma ka paʻakai a i ʻole ka paʻakai ʻole) me ka / me ke ʻano hyponatremia, me nā mea maʻi a loaʻa nā wai nui o ka diuretics, pono ke uku ʻia nā kūlana i luna ma mua o ka hoʻolilo ʻana (i ka lilo ʻana o ka wai a me nā paʻakai). Pono e kāohi i ka hopena o ka hopena mua o ka lāʻau Iromed ® ma ke kumu o ke koko.
Hoʻokomo i ka hiki ke lawe i nā kaʻa a kāohi i nā mīkini
ʻAʻohe ʻikepili i ka hopena o Irumed, hoʻohana ʻia ma nā lāʻau therapeutic, ma ke hiki ke lawe i nā kaʻa a me nā hana hoʻokō, akā naʻe pono e noʻonoʻo ʻia ka hiki ʻana ke dizziness. No laila, i ka wā o ka mea mālama, pono e mālama nā mea maʻi i ka wā e holo ana i nā kaʻa a me nā hana e koi ana i ka piʻi nui o ka nānā a me ka wikiwiki o ka hopena psychomotor.
Hoʻokuʻu i ka palapala Iruming, hoʻopihapiha lāʻau a me ka hoʻonohonoho ʻana.
Ke keʻokeʻo nā papa papa, ʻūlū, biconvex, me kahi kāki ma kekahi ʻaoʻao.
1 kōpō
lisinopril (ma ke ʻano o kahi dihydrate)
5 mg
Nā mea kūʻokoʻa: mannitol, calcium phosphate dihydrate, mau māka palaoa, pregelatinized kāka palaoa, colloidal silicon dioxide, magnesium stearate.
30 kiʻi - nā kāmele (1) - nā ʻeke pepa.
Ke keʻokeʻo nā papa papaʻa, puni, pōpoki, a me kahi pali ma kekahi ʻaoʻao.
1 kōpō
lisinopril (ma ke ʻano o kahi dihydrate)
5 mg
Nā mea kūʻokoʻa: mannitol, calcium phosphate dihydrate, mau māka palaoa, pregelatinized kāka palaoa, colloidal silicon dioxide, magnesium stearate.
30 kiʻi - nā kāmele (1) - nā ʻeke pepa.
ʻĀmaʻomaʻo nā papa i ka waihoʻoluʻu ona, polu, pulupulu-cylindrical, me ka loaʻa ʻana o ka ʻaoʻao ma ka ʻaoʻao.
1 kōpō
lisinopril (ma ke ʻano o kahi dihydrate)
10 mg
Nā mea kūʻokoʻa: mannitol, kaleka he phosphate dihydrate, mau māka palaoa, pregelatinized mais starch, yellow iron oxide dye (E172), colloidal silicon dioxide, magnesium stearate.
30 kiʻi - nā kāmele (1) - nā ʻeke pepa.
ʻO nā papa ʻula like Peach, poepoe, papaʻi-cylindrical, me ka pilikia o kekahi ʻaoʻao.
1 kōpō
lisinopril (ma ke ʻano o kahi dihydrate)
20 mg
Nā mea kūʻokoʻa: mannitol, kaleka he phosphate dihydrate, kaʻai palaoa, pregelatinized kaʻa māka ʻeleʻele, ka melemele hao melemele (E172), ka pakanā uila ʻulaʻula (E172), kolo silloid dioxide, magnesium stearate.
30 kiʻi - nā kāmele (1) - nā ʻeke pepa.
Kahi ʻia ka wehewehe ʻana o ka lāʻau lapaʻau ma luna o nā kuhikuhi i pili i ka hoʻohana.
Ua hana ʻia ka hana lapaʻau
ACE paleʻai. ʻO ka lāʻau antihypertensive. Hoʻohui ka hana o ka hana me ka pale ʻana i ka hana ACE, ka mea e alakaʻi ai i ka pani ʻana o ka hoʻokumu ʻana o ka angiotensin II mai ka angiotensin I a me kahi hoʻokaʻawale koke i ka hoʻokuʻu ʻana o ka ald testosterone. Hoʻemi i ka hōʻemi o ka bradykinin a hoʻonui i ke ʻano o ka prostaglandins.
Hoʻemi ia i OPSS, ke koko, preload, kaomi i ka pulillary pulmonary, e hōʻemi i ka nui o ke koko koko a me ka hoʻonui ʻana i ke ahonui i ka maʻi i nā mea maʻi me ka hoʻopiʻeha naʻau. Loaʻa iā Lisinopril ka hopena vasodilating, ʻoiai ke hoʻonui nei i nā kīhaka i kahi nui aʻe ma mua o nā veins. Ua wehewehe ʻia kekahi mau hopena e ka hopena ma ka ʻimi renin-angiotensin. Hoʻomaikaʻi i ka hāʻawi ʻana i ke koko i ka myocardium ischemic. Me ka hoʻohana ʻana i ka lōʻihi, ua emi nā hypertrophy o ka myocardium a me nā paia o nā ʻāpana o ke ʻano o ka mea pale.
ʻO ka hoʻohana ʻana o nā inhibitor ACE i nā poʻe maʻi me ka loaʻa ʻole o ka puʻuwai puʻuwai e alakaʻi i ka hoʻonui i ke kali ʻana i ke ola, i nā poʻe maʻi i loaʻa i ka myocardial infarction, me nā hōʻike ʻole o ka pale o ka puʻuwai hemahema, i kahi holomua o ka hala o ka ventricular dysfunction.
Hoʻomaka ka hoʻomaka ʻana o ka hana i ka hola 1 ma hope o ka lawe ʻana i ka lāʻau lapaʻau, ʻike ʻia ka hopena loa ma hope o 6-7 mau hola, ʻoi aku ka lōʻihi o ka hana 24 mau hola. Me ke hypertension, ʻike ʻia ka hopena ma nā lā mua ma hope o ka hoʻomaka ʻana o ka mālama ʻana, hoʻomau kahi hopena paʻa ma hope o 1-2 mau mahina.
Me kahi haʻaleleʻokiʻoki i ka lāʻau, ʻaʻole i ʻike ʻia kahi hoʻonui nui i ke koko. I ka hoʻohui i ke koko, hiki i ka lisinopril ke hōʻemi i ka albuminuria. I ka poʻe maʻi me ka hyperglycemia, kōkua ia i ka hoʻohālikelike i nā hana o ka endothelium glomerular iʻino. ʻAʻole i pili ʻo Lisinopril i ka ʻike o ka glucose i ka plasma koko i nā mea maʻi me ka maʻi mellitus a ʻaʻole i alakaʻi i ka piʻi o nā hihia o ka hypoglycemia.
ʻO ka Pharmacokinetics o ka lāʻau.
Ma hope o ka lawe ʻana i ka lāʻau lapaʻau i loko, e pili ana i 25% o ka lisinopril mai ke kāpili ʻana. ʻAʻole ʻai i ka ʻai i ka hoʻopili ʻana o ka lisinopril. ʻO ka Absorption kahi awelika o 30%. ʻO Bioavailability ʻo 29%. Loaʻa ka Cmax i ka plasma ma hope o ka like o 6-8 hola.
Hoʻopili paʻa i nā protein plasma. Ua komo liʻiliʻi ʻo Lisinopril i ka BBB, ma o ka paʻu placental.
Nā T1 / 2 - he mau hola 12. ʻAʻole i hoʻohuli ʻia ʻo Lisinopril a hoʻololi ʻia i loko o ka urine.
Nā hōʻailona no ka hoʻohana ʻana:
- hypertension arterial (ma ke ʻano o ka monotherapy a i hui pū ʻia me nā lāʻau antihypertensive),
- ka huhū puʻuwai kūpilikiʻi (ma ke ʻano he hui hoʻohui no ka mālama ʻana i nā mea maʻi e lawe ana i ka digitalis a / a i ʻole diuretics),
- ka mālama mua ʻana i ka maʻi myocardial infarction (ma ke ʻano o ka hoʻohui ʻana i nā hōʻola i nā hola 24 mua i nā mea maʻi me nā ʻōhua hemodynamic mau, e mālama i kēia mau ʻōuli a pale i ka pale o ka ventricular hema a me ka palaualelo o ka naʻau).
- nephropathy diabala (e hōʻemi i ka albuminuria i nā mea maʻi e pili ana i ka insulin me nā maʻi koko maʻamau a me nā mea maʻi non-insulin-hilinaʻi me ka hypertension arterial).
ʻO ka dosis a me ke ala o ka hoʻokele lāʻau.
Ua kuhikuhi ʻia ka lāʻau lapaʻau. ʻAi ʻole ka ʻai ʻana i ke kīpona, no laila e hiki ke kiʻi ʻia i ka lāʻau i mua o ka wā o ka ʻai ʻana. ʻO ka pinepine o ka hoʻokele he 1 manawa / lā (ma kahi o ka manawa like).
I ka mālamaʻana i ka hypertension koʻikoʻi, ua hāʻawi ʻia e kuhikuhi i kahi hoʻomaka o 10 mg. ʻO ka papa mālama mālama he 20 mg / lā. ʻO ka pae ʻauʻau nui loa ʻo kēlā me kēia lā he 40 mg. No ka hoʻomohala piha ʻana o ka hopena, pono ke ʻano o ka papa hebedoma he 2 mau hebedoma me ka lāʻau lapaʻau (pono pono kēia hana i ka wā e hoʻonui ai i ka ʻokoʻa). Inā ʻaʻole make ka hoʻohana ʻana i ka lāʻau i loko o ka nui loa i ka hopena therapeutic kūpono, a laila hiki i ke ʻano o kahi lāʻau hou aʻe o nā mea antihypertensive.
No ka poʻe maʻi e lawe ana i ka diuretics, pono e hoʻokaʻawale ke mālama me ka diuret 2-3 i nā lā 2-3 ma mua o ka hoʻomaka ʻana o ka mālama ʻana me Irumed. No ka poʻe maʻi i hikiʻole ke ho'ōki i ka mālama ʻana me ka diuretics, ua kuhikuhi ʻia ʻo Iramed i kahi ma mua o ka 5 mg / lā.
Ma ka hihia o ka renovascular hypertension a i ʻole nā kūlana ʻē aʻe me ka hana nui o ka ʻōnaehana renin-angiotensin-aldosterone, ua kauoha ʻia ʻo Irumed i kahi kinapo o ka lā 2.5-5 mg / lā ma lalo o ka kaohi o ke koko, ka hana ʻeha, ka paʻū o ka paʻakai i ka serum o ke koko. Hoʻomoe ʻia ka mālama mālama 'ana ma o ke koko.
I ka poʻe maʻi me ka maikaʻi ʻole o nā maʻi a me nā maʻi ma ka hemodialysis, e kau ʻia ka nui o ka pākaʻi ma ka QC Hoʻoholo ʻia ka mālama mālama ʻia e pili ana i ke kahe o ke koko (ma lalo o ka mālamalama o ka hana renal, potassium a me ka paʻakai o ka paʻakai ma ke koko).
QC
Initial i kēlā me kēia lā
30-70 ml / min
5-10 mg
10-30 ml / min
2.5-5 mg
2013-03-20
Nā ʻaina Hoʻolāʻau
- ka mōʻaukala o ka angioedema (me ka hoʻohana ʻana o ʻAi inhibitors),
- edema kahe ma Quincke,
- a hiki i 18 makahiki (ʻaʻole i hoʻokumu ʻia ka pono a me ka palekana),
- hapai
- hypersensitivity a lisinopril a me nā mea ʻē aʻe ACE,
Me ka akahele pono ke kauka ʻana i ka lāʻau no ka stenosis aortic, hypertrophic cardiomyopathy, bilateral renal aren stenosis, hoʻokahi ʻoki palani stenosis me ka azotemia holomua, ma ke kūlana ma hope o ka hoʻololi ʻana i ka pēpē, hyperaldosteronism primer, hypotension arterial, hypoplasia baloka, nā hyponatremia i nā poʻe maʻi me ka hoʻonui nui o ka ulu ʻana. ma kahi pākahi-paʻakai a i ʻole ka paʻakai ka paʻakai), hyperkalemia, nā kūlana i hui ʻia me ka hoʻemi ʻana o ka nui o ke koko e kahe mau ana (me nā maʻi ʻaʻa, luaʻi), nā maʻi ʻokoʻa hoʻohui (me ka systemus lupus erythematosus, scleroderma), ka maʻi mellitus, ka momona, hyperuricemia, IHD, cerebrovascular insufficiency, nā maʻi maʻi.
Nā manaʻo e hoʻohana
Ua kuhikuhi ʻia ka lāʻau lapaʻau. ʻAi ʻole ka ʻai ʻana i ke kīpona, no laila e hiki ke kiʻi ʻia i ka lāʻau i mua o ka wā o ka ʻai ʻana. Hoʻomoʻa ʻana i ka hoʻonui ʻia ʻana i ka manawa 1 i kēlā me kēia lā (kahi like i ka manawa like).
I ka mālama ʻia ʻana o ka hypertension koʻikoʻi Hoʻomaopopo ʻia kahi ma mua o 10 mg. ʻO ka awelika mālama mālama kūpono he 20-40 mg i kēlā me kēia lā. ʻO ka palena kiʻekiʻe loa o kēlā me kēia lā he 80 mg.
No ka poʻe maʻi e lawe ana i ka diuretics, ke koho pono ʻia ka pākēkē, i hāʻawi ʻia i kēlā mau mea maʻi e loaʻa ka hyponatremia a he hōʻemi paha ka nui o ke koko lele, hiki iā ia ke hana i ka hoʻomohala ʻana o ka maʻi hypaticension. Pono e hoʻoneʻe ʻia ka lāʻau lapaʻau me ka diuretika i nā lā 2-3 ma mua o ka hoʻomaka ʻana o ka mālama ʻana me Irumed a, inā pono, hoʻomau ʻia ma hope o ke koho ʻana i kahi ʻano o Irumed, e pili ana i ke ʻano lāʻau. No ka poʻe maʻi i hiki ʻole ke pani i ka mālama ʻana me ka diuretics, ua ʻōlelo ʻia ʻo Iramed i kahi ma mua o ka 5 mg / lā, e hoʻonui hou ʻia ana i ka hopena therapeutic a me ka hoʻomanawanui o ka lāʻau. Inā kūpono, hiki ke hoʻomau ʻia ka mālama ʻana me ka diuretics.
Ka hoʻohana ʻana o Irumed i ka wā hāpai a me ka lactation
Hoʻohana ʻia ka hoʻohana ʻana o Irumed i ka wā hapai. Hiki ʻo Lisinopril i ke kālai placental.
Inā pili ka hānau ʻana, e hoʻokaʻawale koke ka lāʻau me Iromed, inā ʻaʻole ʻoi aku ka pōmaikaʻi o ka makuahine i ka nui o ka maʻi o ka ʻōpū o ka maʻi (pono e hoʻomaopopo ʻia ka mea maʻi i ka hopena o ke kīpē). ʻO ka hoʻomaopopo ʻana o nā inhibce ACE i II a me III trimesters o ka hapaha hiki ke make i ka wī a me ka pēpē. I nā pēpē hou, ʻōpiopio hipoplasia, oligohamoamnios, deformation o nā iwi o ka ʻōpala a me ke alo, nā hypoplasia o nā māmā, a me ka hoʻomohala ʻana o ka pūlohi e ulu ai. No nā pēpē a me nā pēpē i lawe ʻia ko lākou mau makuahine e nā mea paʻa o ka ACE i ka wā hāpai ʻia, e manaʻo ʻia e mālama ʻia ka mālama pono ʻana i ka hopena o ka hopena o ke kahe koko, oliguria, hyperkalemia.
ʻAʻohe ʻikepili i ka pā ʻana o ka lisinopril i ka waiū umauma. I ka wā mālama me Irumed, pono ia e hoʻopau i ka umauma.
ʻO Irumed kahi mea pale paʻa ACE. ʻO ka lāʻau antihypertensive. Hoʻohui ka hana o ka hana me ka pale ʻana i ka hana ACE, ka mea e alakaʻi ai i ka pani ʻana o ka hoʻokumu ʻana o ka angiotensin II mai ka angiotensin I a me kahi hoʻokaʻawale koke i ka hoʻokuʻu ʻana o ka ald testosterone. Hoʻemi i ka hōʻemi o ka bradykinin a hoʻonui i ke ʻano o ka prostaglandins.
Hoʻemi ia i OPSS, ke koko, preload, kaomi i ka pulillary pulmonary, e hōʻemi i ka nui o ke koko koko a me ka hoʻonui ʻana i ke ahonui i ka maʻi i nā mea maʻi me ka hoʻopiʻeha naʻau. Loaʻa iā Lisinopril ka hopena vasodilating, ʻoiai ke hoʻonui nei i nā kīhaka i kahi nui aʻe ma mua o nā veins. Ua wehewehe ʻia kekahi mau hopena e ka hopena ma ka ʻimi renin-angiotensin. Hoʻomaikaʻi i ka hāʻawi ʻana i ke koko i ka myocardium ischemic. Me ka hoʻohana ʻana i ka lōʻihi, ua emi nā hypertrophy o ka myocardium a me nā paia o nā ʻāpana o ke ʻano o ka mea pale.
ʻO ka hoʻohana ʻana o nā inhibitor ACE i nā maʻi me ka hōʻeha ʻole o ka naʻau e alakaʻi i ka hoʻonui ʻana i ke ola, i loko o nā poʻe maʻi i loaʻa i ka myocardial infarction, me nā hōʻike ʻole o ka pale o ka puʻuwai hemahema, i kahi holomua o ka hala o ka ventricular dysfunction.
Hoʻomaka ka hoʻomaka ʻana o ka hana i ka hola 1 ma hope o ka lawe ʻana i ka lāʻau lapaʻau, ʻike ʻia ka hopena kiʻekiʻe ma hope o 6-7 hola, ʻoi aku ka lōʻihi o ka hana 24 mau hola. Me ka haehae maʻi maʻi, ʻike ʻia ka hopena i nā lā mua ma hope o ka hoʻomaka ʻana o ka mālama ʻana, hoʻomohala kahi hopena ma hope o 1-2 mau mahina.
Nā hopena ʻaoʻao
Mai ka pūnaehana cardiovascular: hōʻailona hōʻemi i ke koko, ʻeha ʻeha, hypotension orthostatic, tachycardia, bradycardia, nā ʻōuliuli o ka puʻuwai puʻuwai, pōkole AV kaʻai ʻana, ka myocardial infarction.
Mai ka pūnaehana hana ʻana: ʻeha ka ʻōpū, malo nui, dyspepsia, anorexia, hoʻololi ʻono, pancreatitis, hepatocellular a cholestatic hepatitis, jaundice, hoʻonui i ka hana o ka transaminases hepatic, hyperbilirubinemia.
Mai ka ʻaoʻao o ka pīkī laha waena: lability o ka moʻo, haunaele, paresthesia, ʻūlio, puʻupuʻu hōʻoia ʻana e hiki ai ke kani ʻana o nā umauma o nā manamana lima a me nā lehelehe, nā maʻi asomiaic, nā mea hilahila.
Mai ka papa hana hanu: dyspnea, bronchospasm, ʻnealelo.
Ma ka ʻāpana o ka ʻili. urticaria, lulu, lauoho lauoho, photosensitivity.
Mai nā ʻekopa hemopoietic: leukopenia, thrombocytopenia, neutropenia, agranulocytosis, anemia (hoʻoneʻe hematocrit, erythrocytopenia).
Mai ka pae genitourinary: uremia, oliguria / anuria, hana hana ʻole ʻia o ka maʻi kaulike, hoʻonāukiuki ʻana i ka hana renal, hōʻemi i ka potency.
Nā maʻi kūwaha: angioedema o ka helehelena, nā wāwae, nā lehelehe, ka alelo, ka epiglottis a me / a i ʻole ka larynx, ke ʻāwili o ka ʻeha, ka ʻeha, ka maʻi, nā hopena hoʻonaninani antinuclear maikaʻi, hoʻonui i ka ESR, eosinophilia, leukocytosis.
Nā ʻili: hyperkalemia, hyponatremia, hyperuricemia, arthralgia, myalgia.
I ka hapa nui o nā maʻi, ʻo nā hopena ʻokoʻa a me ke ʻano hele ʻole.
Pono e noʻonoʻo i ka emi ʻana o ke kahe o ke koko me ka hoʻohaʻahaʻa ʻana i ka nui o ka wai i hoʻihoʻi ʻia e ka diuretic therapy, me ke kahe ʻana o ka paʻakai i ka meaʻai, i ka wā o ka dialysis a i nā mea maʻi me ka maʻi a i ʻole ka luaʻi. I loko o nā mea maʻi me ka paʻa ʻole o ka puʻuwai me ka ʻole o ka renal i ʻole ka ulu ʻana, e ulu paha ka hōʻailona hypotension, ka mea i ʻike pinepine ʻia i nā mea maʻi me ka puʻuwai puʻuwai, ma muli o ka hoʻohana i nā nui o ka diuretic, hyponatremia, a me ka hana ʻole i ke ake ʻole. I kēlā mau mea maʻi, pono e hoʻomaka ʻia ka mālama ʻana ma lalo o ka mālama pono ʻana o ke kauka (me ka makaʻala, koho i kahi iki o ka lāʻau a me ka diuretics). Pono ka hana e like me ke koho ʻana iā Irumed i ka poʻe maʻi me ka maʻi ʻalihi coronary, hiki ʻole i ka cerebrovascular, ma kahi hōʻemi o ke kaʻe koko ke alakaʻi i ka myocardial infarction a i ʻole ka hahau ʻana.
I ka hihia o ka hoʻomohalaʻana o kahi hōʻemi i ke koko, pono e hāʻawi ʻia ka mea maʻi i kahi kūlana, a inā pono, iv 0.9% sodium chloride hoʻonā. ʻO kahi pane transit hypotensive ʻaʻole kahi contraindication no ka lawe ʻana i ka hopena hou o ka lāʻau.
Ke hoʻohana nei ʻo Irumed i kekahi mau mea maʻi me ka puʻuwai puʻuwai o ka puʻuwai, akā me ka hoʻohaʻahaʻa maʻamau a haʻahaʻa paha, hiki ke emi mai ke kahe o ke koko, ka mea maʻamau ʻaʻole ia he kumu no ka hoʻokuʻu ʻana i ka mālama ʻana. I ka hihia arthial hypotension e lilo i hōʻailona, pono ia e hōʻemi i ka nui o ka lāʻau no ka lāʻau a kāpae paha i ka mālama ʻana me Irumed.
Ma ka huaola myocardial infarction, ua hōʻike ʻia ke hoʻohana ʻana o ka lāʻau maʻamau (thrombolytics, acetylsalicylic acid, nā beta-blockers). Hiki ke hoʻohana ʻia i Iramed e hui pū me ka hoʻokele intravenous a i ʻole me ka hoʻohana ʻana o nā ʻōnaehana nitroglycerin transdermal.
I ka poʻe maʻi me ka puʻuwai puʻuwai hōʻeha, kahi māka i hōʻemi ʻia i ke koko ma hope o ka hoʻomaka ʻana o ka mālama ʻana me ka ACE inhibitors hiki ke alakaʻi hou i ka palaualohi o ka hana māka. Ua hōʻike ʻia nā hihia o ka hoʻomohala ʻana i ka hana ʻoi aku ka nānā ʻana i ka wā e lawe ana i ka inhibitions ACE. I ka poʻe maʻi me ka stenosis renalal renal stenosis a i ʻole ka lāʻau o ka stenosis o ke keiki hoʻokahi i mālama ʻia me ka inhibitions ACE, i loaʻa ka hoʻonui ʻana i ka uea serum a me ka creatinine, ma muli o ka hoʻohemo ʻana o ka hana (ʻoi aku ka maʻamau i nā mea maʻi me ka hana ʻole ʻole).
ʻO nā mea maʻi e hopu ana i ka ACE inhibitors, me ka lisinopril, pinepine i hoʻomohala i ka angioedema o ka maka, nā wāwae, nā lehelehe, ka alinaline, ka epiglottis a me / a i ʻole larynx, a hiki i kona hoʻomohala i kēlā me kēia manawa i ka mālama ʻana. I kēia hihia, pono e hoʻōki ka lāʻau me Irumed i ka hiki koke a nānā pono ka mea maʻi a hiki i ka hōʻeha ʻana i nā hōʻailona holoʻokoʻa. Eia nō naʻe, i nā hihia i hele mai ai ka edema wale nō ma ka maka a me nā lehelehe a me ke ʻano maʻamau ke ʻano o ka mālama ʻole, antihistamines e kuhikuhi ʻia.
Me ka hoʻolalelale ʻana o ka angioedema i ka alelo, epiglottis a i ʻole larynx, hiki i ka ahulau kūlima ala, no laila, pono e hoʻoholo ʻia nā lāʻau kūpono a me / a i ʻole nā hana e hoʻopaʻa ai e hoʻopaʻa i ka ala. Ua hōʻike ʻia ma nā mea maʻi o ka lāhui Negroid e lawe ana i ka ACE inhibitors, ua hoʻomohala pinepine i ka angededema ma mua o nā poʻe maʻi o nā lāhui ʻē aʻe. I ka poʻe maʻi me ka mōʻaukala o ka angioedema i hoʻopili ʻole ʻia me ka mālama mua ʻana me ka ACE inhibitors, e hoʻonui ʻia ka nui o kona hoʻomohala ma ka wā o ka mālama ʻana me Iramed.
I nā mea maʻi e lawe ana i ka inhibitor ACE, i ka wā e hoʻokaʻawale ana i kahi hymenopter (wasps, pi, bubu, a me nā hymenoptera ʻē aʻe), hiki i kahi hanana anaphylactoid ke ʻano paʻakikī. Hiki ke pale i kēia e hoʻokaʻawale i ka wā loea me ka hoʻokaʻawale ʻana o ACE ma mua o desensitization.
Pono e noʻonoʻo e ma nā mea maʻi e lawe ana i ka inhibitors ACE a me ka hoʻomaikaʻi ʻana i ka hemodialysis e hoʻohana ana i nā membranes dime high-permeability, kahi hopena anaphylactic e ulu. I ia mau hihia, pono e noʻonoʻo i ka hoʻohana ʻana o ke ʻano like ʻole o ka membrane no ka dialysis a i ʻole nā lāʻau antihypertensive.
Ke hoʻohana nei i ka inhibitor ACE, ʻike ʻia ka pākaukau (maloʻo, lōʻihi, e nalo ana ma hope o ka pau ʻana o ka mālama ʻana me kahi inhibitor ACE). I ka hopena o ka maʻi maʻamau o ka maʻi pākahi, pono ka noʻonoʻo ʻana ma muli o ka hoʻohana ʻana o kahi inhibce ACE.
Ke hoʻohana nei i nā lāʻau lapaʻau e hoʻohaʻahaʻa i ke koko i nā mea maʻi me ka nui o ka hōʻeha ʻana a i ka wā nui o ka anesthesia, hiki i ka lisinopril ke kāohi i ka hoʻokumu ʻana o ka angiotensin II, ka lua o ka pili i ka hoʻopiʻi ʻana i ka renin excretion. ʻO ka emi ʻana o ke kahe o ke koko, ka mea i ʻike ʻia he hopena o kēia hana, hiki ke hoʻopau ʻia e ka piʻi ʻana o ka nui o ke koko kahe.
I kekahi mau hihia, ua hoʻomaopopo ʻia ka hyperkalemia. ʻO nā mea pilikia i ka hoʻomohala ʻana o ka hyperkalemia e pili ana i ka hiki ʻole o ka renal, ka maʻi diabetes mellitus a me ka hoʻohana pū ʻana o ka diuretics potassium-sparing (spironolactone, triamteren a amiloride), mākaukau pākaha a i ʻole nā mea paʻakai e loaʻa ana i ka pāhare, ka mea nui i nā poʻe maʻi me ka hana renal impaired. Inā pono, e hoʻohana pono ka hoʻohana ʻana o kēia mau hui i ka pae o ka paʻakai ma ka serum koko.
I nā mea maʻi me ka pilikia o ka hoʻomohala ʻana i ka hypotension symptomatic (ma ka paʻakai a i ʻole ka paʻakai ʻole) me ka ʻole a i ʻole hyponatremia, a me nā mea maʻi i loaʻa nā wai kiʻekiʻe o ka diuretics, pono nā uku ma luna aʻe e uku ʻia ma mua o ka hoʻolilo (i ka lilo ʻana o ka wai a me nā paʻakai).
Hoʻokomo i ka hiki ke lawe i nā kaʻa a kāohi i nā mīkini
ʻAʻohe ʻikepili e pili ana i ka hopena o Irumed, i hoʻopili ʻia ma nā dosis therapeutic, ma ke hiki ke lawe i nā kaʻa a me nā hana hoʻokō, akā naʻe pono e noʻonoʻo ʻia ka hiki ʻana ke huki.
Nā Hoʻomaka hōʻailona hōʻemi i ke koko.
Lāʻau: pono e hoʻonāukiuki i ka hoʻopuka a me / a holoi paha i ka ʻōpū, i ka wā e hiki mai ana, ua hoʻokō ʻia ke ʻano maʻi maʻi kuhikuhi e pili ana i ka hoʻoponopono ʻana i ka hoʻoheheʻe ʻia a me nā haunaele. Me ka hypotension arterial, pono e lawelawe ʻia kahi hopena isotonic, ua kuhikuhi ʻia nā vasopressors. Mahalo paha ka hoʻohana ʻana o hemodialysis.Nā Hoʻomaka hōʻailona hōʻemi i ke koko.
Lāʻau: pono e hoʻonāukiuki i ka hoʻopuka a me / a holoi paha i ka ʻōpū, i ka wā e hiki mai ana, ua hoʻokō ʻia ke ʻano maʻi maʻi kuhikuhi e pili ana i ka hoʻoponopono ʻana i ka hoʻoheheʻe ʻia a me nā haunaele. Me ka hypotension arterial, pono e lawelawe ʻia kahi hopena isotonic, ua kuhikuhi ʻia nā vasopressors. Mahalo paha ka hoʻohana ʻana o hemodialysis.
Me ka hoʻohana like ʻana o Irumed me ka diuretics potassium-sparing (spironolactone, triamteren, amiloride), mākaukau potassium, nā paʻakai paʻakai e pili ana i ka potassium, nā piʻi aʻe o ka hyperkalemia hoʻonui, ʻoi aku hoʻi i nā mea maʻi me ka hana renal impaired.
Me ka hana like o Irumed me ka diuretics, kahi mākau i ʻike nui ʻia i ka hoʻokahe koko.
Me ka hoʻohana like ʻana o Irumed me nā lāʻau lapaʻau antihypertensive hou, ua ʻike ʻia kahi hopena hoʻohui.
Me ka hana like o Irumed me NSAIDs, estrogens, ua pau ka hopena antihypertensive o ka lisinopril.
Me ka hana like o Irumed me ka lithium, lithium excretion mai ke kino ke iho nei i lalo.
Me ka hoʻohana like ʻana o Irumed me nā antacids a me colestyramine, ua hoʻemi ʻia ka pale ʻana o ka lisinopril ma ke ʻano o ka digestive tract.
ʻAʻole i loaʻa kahi kamaʻilio pharmacokinetic koʻikoʻi i nā hihia kahi i hoʻohana ai ka lisinopril me ka propranolol, digoxin, a i ʻole hydrochlorothiazide.
Pono e mālama i ka lāʻau ma nā mahana a hiki i 25 ° C. ʻO ka lā kau: 3 mau makahiki.
Keʻena lāʻau lapaʻau: nā kauoha no ka hoʻohana ʻana
ʻO Irumed he mākuhi hypotensive i hoʻohana ʻia i ka mālama ʻana i ka maʻi hypertension a me nā ala ʻē aʻe o ka puʻuwai a me nā kahe koko e pili ana i ka piʻi nui o nā kīʻaha. Inā hoʻohana hewa pololei, hiki iā ia ke alakaʻi i nā hopena hoʻowalewale i ke ola, no laila hiki iā ʻoe ke hoʻomaka e lawe i ka lāʻau lapaʻau wale nō me ka ʻae ʻia o ke kauka.
Inoa Kūʻai ʻole honua
Lisinopril - ka inoa o ke ʻano ikaika o ka lāʻau.
ʻO Irumed kahi lāʻau lapaʻau hypotensive i hoʻohana ʻia i ka mālama ʻana i ka maʻi hypertension a me nā ala ʻē aʻe o ka puʻuwai a me nā kīʻaha koko.
С09АА03 - pāʻālua no ka hoʻonaninani ʻano anti-therapeutic-chemical.
E hoʻokuʻu i nā palapala a me ka ʻano
Ke loaʻa nei ka lāʻau lapaʻau i kahi papa papa o ka hoʻokuʻu. ʻO ka hoʻonohonoho ʻana o kēlā me kēia papa pākaukau:
- lisinopril dihydrate (10 a 20 mg),
- mannitol
- kalaka kākāʻau
- kaleka?
- ise kaomi lepo
- silika ʻakomi
- ka huehue a pregelatinized
- paʻahau magnesium.
Hāʻawi ʻia nā papa i nā cell polimika 30-cell, kahi i waiho ʻia ma ka pepa pepa me nā ʻōlelo aʻoaʻo.
Mea i kuhikuhi ʻia
ʻO ka manaʻo no ke koho ʻana iā Irumed nā:
- hypertension (ʻo ia wale nō ka loea lapaʻau a i ʻole me ka hui pū me nā lāʻau lapaʻau ʻē aʻe).
- ka paʻa ʻole o ka puʻuwai (i hui pū me ka diuretics a i ʻole glycosides cardiac),
- ke kāohi a me ka mālama ʻana i ka infarction myocardial (ma ka lā mua i hoʻōla ʻia ka lāʻau lapaʻau e mālama i nā ʻāpana hemodynamic a i ka pale ʻana o ka pīhoihoi cardiogenic)
- hanaʻino o ka maʻi diabetes (e hoʻemi i ka nui o ka albumin i hoʻopuka i loko o ka pā i ka poʻe me ka maʻi type a me ke ʻano type 2.
Nosological ʻano papa (ICD-10)
| Nā Palaki | 1 kōpō. |
| mea ikaika: |
| lisinopril dihydrate (ma kahi o ka lisinopril anhydrous) | 10/20 mg |
| nā koho (10 mg): mannitol, kalsium phosphate dihydrate, starch palaoa, pregelatinized mais starch, yellow iron oxide dye (E172), colloidal silicon dioxide, magnesium stearate |
| nā koho (20 mg): mannitol, kalsium phosphate dihydrate, starch corn, pregelatinized mais starch, yellow iron oxide dye (E172), poulika kahe ʻona okana (E172), colloidal silicon dioxide, magnesium stearate |
ʻLoe a me ke kākele
I loko ma mua o a ma hope o ka ʻai, 1 ka manawa no kēlā me kēia lā, ʻoluʻolu ʻo i ka manawa like.
Koi nui ʻia. ʻO ka dosis mua he 10 mg hoʻokahi i ka lā, ʻo ka mālama mālamaʻana he 20 mg / lā, a ʻo ka nui ka 40 mg / lā.
No ka hoʻomohala piha ʻana o ka hopena, pono ke ʻano o ke ʻano o ka lāʻau lapaʻau he 2-4-pule (pono pono ʻia kēia ʻano i ka wā e hoʻonui ai i ka ʻōpū). Inā ʻaʻole make ka hoʻohana ʻana i ka lāʻau i loko o ka nui loa i ka hopena therapeutic kūpono, a laila hiki i ke ʻano o kahi lāʻau hou aʻe o nā mea antihypertensive.
I nā maʻi nā mea i loaʻa i mua diuretics, pono ia e hoʻopau iā lākou i nā lā 2-3 ma mua o ka hoʻomaka ʻana o ka lāʻau. Inā hiki ʻole ke kāpae i ka diuretics, ʻaʻole pono ʻoi aku ka helu mua o ka lisinopril ma mua o 5 mg / lā.
I ka hihia o ka renovascular hypertension a i ʻole nā kūlana me ka hoʻonui ʻana i ka hana RAAS. ʻO ka lāʻau Iramed ® ka mea i kuhikuhi ʻia i loko o kahi hoʻomaka mua o 2.5-5 mg / lā ma lalo o ka kaohi o ke kahe koko, hana o ka maʻi, kāʻai paʻakai i ka serum o ke koko.
Hoʻomoe ʻia ka mālama mālama 'ana ma o ke koko.
I nā maʻi me ka pilikia ʻole a me nā mea maʻi ma hemodialysis, ua kau ʻia ka pākaukau mua ma muli o ke kiʻekiʻe Cl o ka kaihanga. Hoʻoholo ʻia ka mālama mālama ʻia e pili ana i ke kahe o ke koko (ma lalo o ka mālamalama o ka hana renal, potassium a me ka kō o ka sodium i loko o ke koko).
ʻO nā hala no ka hala ʻole ʻana. Hoʻoholo ʻia nā hala ma muli o ka waiwai nui o ka Cl Clinine, e like me ka hōʻike ʻana i ka papa.
| Cl Mea hana, ml / min | Initial dosis, mg / lā |
| 30–70 | 5–10 |
| 10–30 | 2,5–5 |
| pule |
I ka hoʻomaka ʻana o ka hoʻōla a i ka wā o nā lā 3 mau loa ma hope o ka maʻi myocardial infarction i loko o nā mea maʻi me ke koko haʻahaʻa haʻahaʻa (120 mmHg a i ʻole a lalo), kahi papa haʻahaʻa o 2.5 mg e pono e kuhikuhi. I ka loaʻa ʻana o ke kahe o ke koko (SBP ≤100 mm Hg), kahi lāʻau i kēlā me kēia lā o 5 mg hiki, inā pono, e hōʻemi iki ʻia i ka 2.5 mg. Ma ka hihia o ka lohi i hoʻokahe nui i ke koko (CAD mmHg ma mua o 1 hola), pono e hoʻokuʻu ʻia ka lāʻau lapaʻau.
ʻO ka nephropathy Diabetic. I ka poʻe maʻi me ka diabetes mellitus-non-insulin mellitus, hoʻohana ʻia he 10 mg o ka lisinopril i hoʻokahi lā. Inā pono, hiki ke hoʻonui ʻia i kēia maʻa i 20 mg hoʻokahi manawa i ka lā e hiki ai ke hoʻokō i nā waiwai DAD ma lalo o 75 mm Hg. i kahi noho.
I ka poʻe maʻi me ka diabetes mellitus-hilinaʻi kūʻokoʻa - hoʻohana ʻia ʻo ia ka dosage e hoʻokō ai i nā waiwai dAD ma lalo o 90 mm Hg. i kahi noho.
Mea hana
BELUPO, lāʻau lapaʻau a me nā mea hoʻokomo dd, Nā Repubalika o Kroasia. 48000, Koprivnitsa, st. Danica, 5.
ʻOihana keʻena o BELUPO, nā lāʻau lapaʻau a me nā mea kū pono o ka dd, ka Repubalika o Kroasia i Lūkia (alamat no nā hoʻopiʻi): 119330, Moscow, 38 Lomonosovsky pr-t, ʻtpole. 71–72.
Tel .: (495) 933-72-13, fax: (495) 933-72-15.
