Nā ʻōkuhi o Tritace no ka hoʻohana, contraindications, nā hopena ʻaoʻao, nā loiloi

ʻO ka lāʻau Antihypertensive, inhibitor ACE
Keʻano: TRITACE
ʻO ka mea ikaika o ka lāʻau lapaʻau: ramipril
ATX Encoding: C09AA05
KFG: inhibitor ACE
Reg. helu: P No. 016132/01
Ka lā hoʻopaʻa inoa: 12.29.04
Mea ʻai reg. acc .: AVENTIS PHARMA Deutschland GmbH

E hoʻokuʻu i ke ʻano Tritace, kāohi lāʻau a me ka hoʻonohonoho.

Kūpaʻa nā papa, aniani ke aniani i ke kala me ka hōʻailona hoʻokaʻawale ma nā ʻaoʻao ʻelua a kahakaha ʻia me "2.5 / stylized kiʻi o ka leka h" a me "2.5 / HMR" ma ka ʻaoʻao.
1 kōpō
ramipril
2,5 mg

Nā mea kūʻokoʻa: hypromellose, ke kōkau pregelatinized, cellulose microcrystalline, sodium stearyl fumarate, ʻele hao melemele.

14 ʻōpō. - nā ʻili uila (2) - nā ʻeke pepa.

Hoʻonaninani nā papa, a ʻulaʻula kukui i ke kala me ka hoʻokaʻawale ʻana i nā hōʻailona ma nā ʻaoʻao ʻelua a kahakaha ʻia me "5 / stylized image o ka leka h" a me "5 / HMR" ma ka ʻaoʻao.

1 kōpō
ramipril
5 mg

Nā mea kūʻokoʻa: hypromellose, ke kōkau pregelatinized, cellulose microcrystalline, sodium stearyl fumarate, hao dye red oxide.

14 ʻōpō. - nā ʻili uila (2) - nā ʻeke pepa.

Kahi ʻia ka wehewehe ʻana o ka lāʻau lapaʻau ma luna o nā kuhikuhi i pili i ka hoʻohana.

ʻO ka hana lāʻau lapaʻau Tritace

ʻO ka lāʻau Antihypertensive, inhibitor ACE. ʻO Ramiprilat, kahi metabolite ikaika o ramipril, he mea pale lōʻihi ACE. I loko o ka plasma a me nā ʻili, e hoʻopili kēia kaomi i ka hoʻololi ʻana o ka angiotensin I ke angiotensin II (kahi vasoconstrictor e neʻe) a me ka uhaʻi ʻana o ka bradykinin vasodilator ikaika. ʻO ka hōʻemi i ka hoʻokumuʻana o ka angiotensin II a me ka hoʻonui ʻana i ka hana o ka bradykinin alakaʻi i ka vasodilation a hāʻawi i ka cardioprotective a me ka endothelioprotective hopena o ka ramipril.

Hoʻoulu ʻo Angiotensin II i ka hoʻokuʻu i ka ald testosterone, i kēia ʻike, ʻo ramipril ka mea e hōʻemi ai i ka hilo ʻana o aldosterone.

ʻO ka lawe ʻana i ka ramipril e alakaʻi i ka emi nui o OPSS, ma ka maʻamau me ka ʻole o ka loli ʻana i ka kahe koko a me ka hopena filomation glomerular. ʻO ka lawe ʻana i ka ramipril e hōʻemi i kahi kahe o ke koko i loko o ka nui a me ke kūlana kū me ka hoʻonui ʻole ʻana i ka uku o ka puʻuwai. Hoʻomaka ka hopena antihypertensive 1-2 mau hola ma hope o ka inu ʻana i kahi pākahi hoʻokahi o ka lālani a hoʻomau mau no nā hola 24. ʻO ke kiʻekiʻe antihypertensive hopena e ulu nei maʻamau ma o nā hebedoma 3-4 o ka hoʻomau mau ʻana i ka lāʻau a mālama ʻia no ka manawa lōʻihi. ʻAʻole ka hopena o ka hoʻopau ʻana i ka lāʻau lapaʻau i ka piʻi wikiwiki a me ka nui o ka neʻe ʻana o ke koko.

ʻO ka hoʻohana ʻana i ka lāʻau lapaʻau e hōʻemi i ka make ma mua (me ka make koke ʻana i ka make), ʻo ka hōʻeha o ka hōʻeha ʻana o ka naʻau puʻukui, e hōʻemi ana i ka nui o nā halemai o nā poʻe maʻi me nā hōʻailona maʻi o ka hōʻeha naʻau ma hope o ka maʻi myocardial infarction

I nā mea maʻi me ka maʻi maʻi maʻi nondiabetic i hoʻohiki ʻia i ka nephropathy, ua hōʻemi ʻia ka lāʻau lapaʻau i ka nui o ka holomua o ka hiki ʻole o ka renal, a ma ka manawa mua o ka maʻi maʻi a me ka nephropathy nondiabetic, ʻo ka ramipril e hōʻemi ana i ka albuminuria.

Hoʻomaʻamaʻa maikaʻi ka lāʻau lapaʻau i ka hoʻoliʻiliʻi a me nā ʻike lipid, e hōʻemi ai i ka hypocrial myocardial koʻikoʻi a me ka pā vascular.

ʻO ka Pharmacokinetics o ka lāʻau.

Ma hope o ka lawelawe waha, ua hoʻoiho koke ʻia mai ka gastrointestinal tract (50-60%). ʻAʻole hōʻeha ka meaʻai i ka piha o ka hoʻopili ʻana, akā e hoʻolohi i ka hee ʻana.

Cmax o ka ramipril a me ramiprilat i hele i loko o ke koko koko ma hope o 1 a me 3 mau hola, kēlā.

ʻO ka wahī a me ka metabolism

Ke lilo nei i mea kūʻai, ua nui ka ramipril i kahi metabolism presystemic intensive (ka mea nui i ka ate ma ka hydrolysis), ma muli o kāna ʻano hana metabolite wale nō, ʻo ramiprilat. Ma ka hoʻohui i kēia metabolite ikaika, glucuronidation o ramipril a me ramiprilat i hoʻohālikelike mau ʻole i nā metabolites - ramipril diketopiperazine a me ka rameprilat diketopiperazine. ʻO Ramiprilat ma kahi o 6 mau manawa e ʻoi aku ka ikaika ma ka pale ʻana i ka ACE ma mua o ka ramipril.

ʻO ka paʻa ʻana o ka ramipril i nā protein plasma he 73%, ramiprilata - 56%.

ʻO ka Vd o ka ramipril a me ka ramiprilat he 90 mau mele a 500 mau lita.

Ma hope o kēlā me kēia lā, ʻo ka wā hoʻokahi-ka hoʻokele o ka lā hana i ka wai ma loko o kahi 5 mg Css i ka plasma, ua hōʻea ʻia i ka lā 4. ʻO ka hoʻoliʻi ka plasma o nā ramiprilate e emi i loko o kekahi mau manawa: ʻo ka hoʻoili mua a me ka hana excretion o ramiprilat me T1 / 2 ma kahi o 3 mau hola, a laila he kikowaena waena me ka ramiprilat T1 / 2 ka wā ma kahi o 15 mau hola a me ka hopena hope loa me ka minamina nui loa o ka ramiprilat i plasma a me T1 / 2 ramiprilata ma kahi o 4-5 mau lā. Hoʻopili ʻia kēia hāpana hope loa me ka hoʻoneʻe lemu ʻana o ramiprilat ma muli o ka hui me nā ʻae ACE. ʻOiai ka lōʻihi o ka manawa hope loa me kahi pākahi hoʻokahi ramipril ma kahi hoʻokahi o 2.5 mg a i ʻole Css, ʻoi ka ʻike o ke ramiprilat i ka plasma ma hope o ka 4 lā o ka mālama ʻana.

Me ka papa o ka lāʻau lapaʻau T1 / 2 he 13-17 mau hola.

Ke nānā ʻia, ma kahi o 60% o ka hana ikaika e hoʻopau ʻia i loko o ka pāʻai a ma kahi o 40% me ka bile, me ka hapa iki o 2% i hoʻololi i kahi loli.

E hoʻokuʻu i ke ʻano a me ka ʻano

Loaʻa ka Tritace i ka puka pā:

2.5 mau papa ʻāpana: kukui aniani, oblong, ma nā ʻaoʻao ʻelua me kahi māka a me ke kahakaha (ma ka ʻaoʻao hoʻokahi - "2.5" a me ka leka stylized h, ma ka ʻaoʻao ʻē aʻe - "2.5" a me HMR) (14 ʻāpana i kēlā me kēia) .Kīlani, ma ke kāleka paena ʻelua kīpē),
Nā papa ʻaina 5 mg: nā mālamalama kukui i ke kala me nā kukui a i ʻole nā ʻāpana pōkole, oblong, ma nā ʻaoʻao ʻelua me kahi māka a me ke kahakaha (ma kēlā ʻaoʻao - "5" a me ka leka stylized h, ma ka ʻaoʻao - "5" a me HMR) (14 kēlā me kēia) nā pcs i loko o kaʻaila, ma kahi pahu kāoʻa ʻelua mau palaka),
Nā papa ʻaina 10 mg: aneane keʻokeʻo a keʻokeʻo paha keʻokeʻo, ʻehā, ma nā ʻaoʻao ʻelua me kahi kīʻaha a me nā "constriction" ma nā ʻaoʻao ma ka ʻaoʻao o ke kūlana, i kahakaha ʻia ma kekahi ʻaoʻao (HMO / HMO) (14 pcs i ka blisters, a i ke kāwena. huaka).

Helu 1 papa:

mea waiwai: ramipril - 2.5, 5 a 10 mg,
Nā haʻawina kōkua: microcrystalline cellulose, hypromellose, sodium stearyl fumarate, prarchelatinized starch, yellow iron oxide dye (2.5 mg tablet), ulaula pōpilikia hao pōpele (5 mg tablet).

Nā hōʻailona no ka hoʻohana ʻana

CHF (pilikia hōʻeha o ka puʻuwai) - i ka hoʻomaʻamaʻa paʻakikī, me ka hoʻohui pū me ka diuretics,
puʻuwai naʻau i ulu ʻia mai 2 a 9 mau lā ma hope o ke kīleʻa myocardial maha ʻole,
pono hypertension pono,
hoʻonui mahuahua kolohe cardiovascular (nā maʻi me ka mōʻaukala o ka uʻi, me ka maʻi ʻeha coronary paʻa a me ka mōʻaukala o myocardial infarction, me nā maʻi peripheral arterial lesi, me ka maʻi mellitus maʻi mika a ma kahi liʻiliʻi he kumu koʻikoʻi keu) - e hōʻemi ai i ka make cardiovascular ka hopena i ka hoʻoulu ʻana i kahi hōʻeha a i ʻole ka myocardial infarction,
nephropathy (ʻeha a maʻi ʻole paha (diabetes), me ka proteinuria koʻikoʻi.

Nā Hoʻohui

kahe koko haʻahaʻa (systolic blood pressure emi a 90 mm Hg), a me nā kūlana me ka palena ʻole hemodynamic unstable.
ʻO ka CHF i ke kūlana o ka decompensation (no ka mea ʻaʻole i lawa ka ʻike i ka hoʻohana ʻana ma ka hana i ka hana lapaʻau).
hypertrophic obstructive cardiomyopathy a i ʻole ka nui o ka stenosis koʻikoʻi o ka pā mitral a i aicic,
unilateral (me kahi'āpana hoʻokahi) aiʻole bilateral hemodynamically koʻikoʻi renal artery stenosis,
nephropathy (i ka mālama ʻana i nā immunomodulators, nā mea hoʻohana ʻole i ke kinipoki anti-inflammatory, glucocorticosteroids a / a i ʻole nā lāʻau lapaʻau cytotoxic ʻē aʻe, no ka mea ʻaʻole i lawa nā hōʻike olakino).
hemodialysis (ma muli o ka nele o ka ʻike lapaʻau).
pilikia hōʻeha loa,
hemofiltration a i ʻole hemodialysis e hoʻohana ana i nā membra polyacrylonitrile kiʻekiʻe (ma muli o ke kaʻe o ka hopena hypersensitivity),
ka moolelo o ke angioedema,
hyposensitizing treatment no hypersensitivity kūloko i wasp a me nā pi bee,
apheresis o LDL (nā lipoproteins haʻahaʻa haʻahaʻa), ka mea e hoʻohana ana i ka dextran sulfate (ma muli o ke ʻano o ka hopena o ka hopena hypersensitivity),
hyperaldosteron's,
nā keiki a me nā ʻōpio i lalo o 18 mau makahiki (ma muli o ka ʻike o ka maʻi lapaʻau).
ka wā hapai a me ka umauma.
hypersensitivity i kekahi o ka lāʻau o ka lāʻau lapaʻau a i ʻole kekahi mea ʻē aʻe ACE inhibitors.

I ke kaola nui o ka myocardial infarction, ua mālama pū ʻia ʻo Tritace i kēia mau kūlana:

pulmonary puuwai
ka lani panghina,
hōʻeha paʻa ka naʻau
life-hoʻoweliweli life arrhythmias.

Hoʻohana ʻia (Tritace me ka mālama):

hana ʻaihā lewa (e nawaliwali paha a e hoʻonui ai i ka hana ʻo ramipril),
pilikia hana ʻole i ka lolo a me ka hōʻino
postoperative wā ma hope o ka hoʻololi ʻana i ka huehue,
maʻi mellitus maʻiʻi
hyperkalemia
cirrhosis o ka ate me ka edema a me ka ascites,
ka hopena o ka hopena o ke kahe o ke koko i pili i ka piʻi nui ʻana (no ka laʻana, me ka lesi atherosclerotic o ka cerebral a me nā coronary artery).
nā maʻi ʻōnaehana o ka kikoʻelima kikoʻī (scleroderma, systemic lupus erythematosus, me ka hoʻopiʻi ʻana i nā mea lapaʻau me nā mea kanu e hiki ai i nā loli ke kiʻi koko koko peripheral).
nā kūlana i hoʻonui ʻia ai ka hana o ka ʻoihana RAAS (renin-angiotensin-aldosterone system), a i ka wā e hoʻokaʻawale ʻia ai ka ACE, he hopena nui o ka hoʻēmi ʻana o ke kahe koko a me ka hana ʻole ʻana i waho (ʻeha puʻuwai puʻuwai, ikaika hypertension arterial, hoʻōla wai-electrolyte hoʻōla, mua ka hoʻohana ʻana i nā lāʻau diuretic, etc. .),
holomua ʻoi aku (ma muli o ka nui o ka pilikia o ka hopena hypotensive hopena).

ʻLoe a me ke kākele

Lawe ʻia nā papa Tritace me ka waha ʻole me ka ʻaʻa ʻole ʻana a inu i ka wai nui. ʻO ka lawe ʻana i ka lāʻau lapaʻau, ʻaʻole hilinai i ka manawa ʻai. Koho ʻia ka ʻ individuallykene i ka lawe ʻia ʻana o ka maʻi me ka hopena therapeutic hopena. ʻO ka maʻamau ka lōʻihi o ka mālama ʻana, a e hoʻoholo ʻia ka lōʻihi e kona kauka.

Ka hānai i nā regimens o Tritace me ka hana maʻamau a me ka hana o ka pēpē:

CHF: ʻo ka 1.25 mg i hoʻokahi manawa i ka lā, i ka wā e hiki mai ana, i ka noʻonoʻo ʻana i ka hoʻomanawanui o ka lāʻau lapaʻau, hiki ke hōʻea i ka pāpālua i kēlā me kēia 1-2 mau pule, e loaʻa ana i ka lā i kēlā me kēia lā, inā ʻoi aku ka nui o ka 2.5 mg, hiki ke hoʻokaʻawale i ʻelua dosis, ʻo ka loa ma ke ʻano he 10 mg i ka lā.
ka hopena ʻole o ka naʻau i ulu i loko o kekahi mau lā ma hope o ka hala ʻana o myocardial: ka hoʻomaka muaʻana - 5 mg i kēlā me kēia lā i ʻelua mau puʻupaʻa mahele (kakahiaka a me ke ahiahi), me ka hoʻomau ʻole i ka dosis mua (hōʻemi nui i ke kahe koko), ua makemake ʻia e hōʻemi a hāʻawi i ka mea maʻi i nā lā 2 , 5 mg o ka lāʻau lapaʻau i kēlā me kēia lā i ʻelua mau puʻupaʻa māhele. I ka wā e hiki mai ana, i hāʻawi ʻia i ka pane o ka mea maʻi, hiki iā ʻoe ke hoʻonui i ka nui ma o ka pālua ʻia i kēlā me kēia lā 1-3, ʻo ka nui loa ka 10 mg i kēlā me kēia lā.
pono o ka hypertension pono waiwai: ʻo ka mua ka ʻōlelo he 2.5 mg hoʻokahi i ka lā (i ke kakahiaka), inā i loko o 3 a i hoʻokahi mau pule paha e hoʻōla ai i ka hopena o ka hoʻomaʻamaʻa ʻana i ke kahe o ke koko, ʻaʻole i loaʻa, hiki ke hoʻonui i ka maʻi i 5 mg i kēlā me kēia lā, ma hope o kekahi 2-3 he mau pule o ka wiki, inā he lawa ʻole ka hana o nā lā a pau i kēlā me kēia lā he 5 mg, e pālua ʻia ka nui o Tritace i ka nui i ʻōlelo ʻia ʻia, ʻo ia ka 10 mg i kēlā me kēia lā, a waiho ʻia i ia mau mea like ʻole, akā hoʻohui ʻia nā mea hana antihypertensive e pili ana i ka lāʻau lapaʻau.
ka hoʻemi ʻana o ka maʻi cardiovascular a me ka hōʻeha o ka hōʻeha a i ʻole ka myocardial infarction i nā mea maʻi me ka hoʻonui ʻia o ka puʻuwai cardiovascular: 2.5 mg hoʻokahi manawa i ka lā ma ka hoʻomaka ʻana o ka hoʻomohala ʻana, e ukali ʻia ana me ka hoʻonui nui ʻana o ka wai, me ka noʻonoʻo ʻana i ka hoʻomanawanui i ka lāʻau, ʻelua i ka nui ma hope o 1 hebedoma, a i nā 3 mau hebedoma e hiki mai ana, e lawe mai i ka wai mālama mālama maʻamau, ʻo ia ka 10 mg i kēlā me kēia lā ma kahi hoʻokahi.
ʻO ka maʻi nephropathy ka maʻi a i ʻole nondiabetic: ʻo ka hopena mua loa he 1,25 mg hoʻokahi i ka lā, i ka wā e hiki mai ana ke hoʻonui i ka pāʻai i 5 mg hoʻokahi manawa i ka lā, ʻaʻole i ʻike ʻia ka hoʻohana ʻana o Tritace i nā haʻahaʻa kiʻekiʻe i kēia mau kūlana.

Ma kahi o ka hana renal impaired (cleanine clearance o 50-20 ml / min) a me ka ate, i nā mea maʻi me ka hoʻomaʻamaʻa ʻana i mua me ka diuretics, nā maʻi maʻi maʻi, nā mea maʻi me nā haʻahaʻi a me nā kuʻuna, ʻaʻole i hoʻoponopono ʻia e ka nalowale o nā electrolytes a me nā pilala, me ka poʻe no laila ka hopena nui loa. ka hopena i ke koko ke kumu o kekahi mau pilikia, ʻaʻole ʻoi aku ka nui o ka ma mua o Tritace i ka 1.25 mg i kēlā me kēia lā.

I ka hihia o ka hana renal maʻi, nui ka nui o ka nui o kēlā me kēia lā ʻaʻole iʻoi aku ma mua o 5 mg, a no ka hoʻoulu ʻana i ka ate ate - ʻaʻole iʻoi aku ma mua o 2.5 mg.

Nā hopena hopena

hoʻoweliweli ʻāwīwī: pinepine - ʻeha o ka huehue, hōʻeha, ka luaʻi ʻana, hoʻowahāwahā i loko o ka ʻōpū, ke ʻano hoʻonaninani i ka ʻōpū a me ka ʻōpū, ka ʻōpū ʻana, nā dyspepsia, i kekahi manawa - mucosa o ka waha, pancreatitis, gastritis, ʻeha ʻeha, constipation, ka ʻōpū o ka ʻōpū, hoʻonui ʻia na hana maʻi o ka pancreatic, ʻokoʻa - ka huhū o ka alelo, ʻike pinepine ʻole - aphthous stomatitis,
systemovio cardiovascular: pinepine - hypotension orthostatic, ka hoʻemi nui ʻana i ke kahe o ke koko, nā nāwaliwali, i kekahi manawa - ʻaʻole ke ʻano a i ʻole ka nānā ʻana i ka arrhythmias, nā edema peripheral, ischemia myocardial, palpitations, flushing o ka maka, tachycardia, līkuhi - vasculitis, piipuni lele, ʻike pinepine ʻole. ʻO ka maʻi o Raynaud
ʻōpū o ka hanu: pinepine - ka manawa pokole o ka hanu, bronchitis, pāhulu maloʻo, sinusitis, i kekahi manawa - ʻoiʻi ka ihu, bronchospasm (me ka hoʻopiʻi ʻana o ka hānō bronchial),
kaila o ka lae kikowaena: pinepine - ka ʻoluʻolu o ke poʻo, ke poʻo, ka manawa - ke ʻōpio a ʻole ka hoʻolilo ʻana i ka naʻau o ka naʻau, hoʻomaʻamaʻa moe, hoʻonaninani, ʻano hopohopo, puʻupuʻu, hopohopo, hopohopo, hopohopo, hoʻāhewa - hōʻeuʻeu, ʻike ʻole, hopohopo, pinepine ʻike ʻole - ʻike maka ʻole ʻia o nā mea ʻono, paresthesia, hoʻonaninani ʻia a me nā hopena psychomotor, ischemia cerebral,
ka nānā ʻana o ka ʻike a me ka hoʻolohe ʻana: i kekahi manawa - nā hana ʻino, a me nā kiʻi hiʻona, līpoki - tinnitus, hoʻopiʻi ka lohe, conjunctivitis,
musculoskeletal ʻōnaehana: pinepine - ʻehaʻeha o ka naʻau, nā ʻāʻī o ka naʻau, i kekahi manawa - ʻeha pūpili,
ʻōnaehana hānai a me nā momona mummary: i kekahi manawa - hoʻemi i ka libido, ka hala ʻole, ʻike ʻike ʻole - gynecomastia,
ʻōnaehana urinary: i kekahi manawa - polyuria, hoʻonui proteinuria, hana i ʻole ke kaulike, hoʻonui i ʻike ʻia o ka creatinine a me urea i ke koko,
hepatobiliary ʻōnaehana: i kekahi manawa - i hoʻonui ʻia ka hana o nā huina o nā huina o ka huina, līpoki - nā pāpale hepatocellular, pāniki cholestatic, ʻike pinepine ʻole ʻia - cytolytic a hepatestitis hepatitis, hoʻōho ʻole o ka ate
hematopoietic ʻōnaehana: i kekahi manawa - eosinophilia, jarang - thrombocytopenia, leukopenia, kahi hoʻokaʻawale i ka hoʻolilo ʻana o ka hemoglobin, he hōʻemi i nā helu o nā ʻoliʻula ʻulaʻula, ʻaʻole maopopo ka ʻike i ke alapine - pancytopenia, hoʻōla i ka hematopoiesis
ka pāhana a me ka helu ʻolima: pinepine - i ka nui o ka neʻe o ka paʻakai i loko o ke koko, i kekahi manawa - ke hoʻemi ʻana o ka momona, ka anorexia, ʻike pinepine ʻole ʻia - he ʻemi o ka neʻe o ka sodium,
kalima: ke kumu ʻike ʻole - anaphylactoid a i ʻole ka anaphylactic ʻano, hoʻonui i ke kūpaʻa o nā antinuclear antibodies,
ʻO ka ʻili a me ka membrē mucous: pinepine - i ka ʻūhā i ka ʻili, i kekahi manawa - gane, edema Quincke, hyperhidrosis, i ʻole - urticaria, exfoliative dermatitis, exfoliation o ka pā paku, aneane loa - ke ʻano o ka photosensitivity, ʻike pinepine ʻole - erythema multiforme, dermatitis like psoriasis, hoʻōkuhi ʻo epidermal , pemphigus, alopecia, Stevens-Johnson syndrome, lichen-like or pemphigoid rash, worsening of psoriasis,
nā hopena maʻamau: pinepine - kahi manaʻo o ka luhi, ka umauma ʻeha, i kekahi manawa - ke kuni, ka liʻiliʻi - nā maʻi asedeic.

Nā ʻōlelo kikoʻī

Ma mua o ka hoʻohana ʻana iā Tritace, hypovolemia a me hyponatremia e pono e hoʻopau ʻia. Inā lawe ka mea maʻi i ka diuretics, pono lākou e hoʻopau a i hōʻemi ʻia ka nui o nā lā 2-3 mau lā ma mua o ka hoʻomaka ʻana o ka ʻoihana ramipril.

Ma hope o ka lawe ʻana i ka pā mua o Tritace a me kēlā me kēia hoʻonui i kona nui a me / a i ʻole ka hoʻohālikelike i ka diuretika i ka manawa like, pono e mālama pono ʻia ka mālama ʻana i ka maʻi ma ka liʻiliʻi loa 8 mau hola, no laila inā he nui ka hoʻohaʻahaʻa nui ʻana i ke koko, ua lawe ʻia nā hana kūpono manawa.

Me ke koko kiʻekiʻe nui a me ka hāʻule ʻole o ka puʻuwai, ʻoi aku me ka maʻa myocardial infarction, ʻoi aku ka mālama me ramipril e hoʻomaka wale i kahi lāʻau lapaʻau kūikawā.

I nā maʻi me ka puʻuwai pu ʻole, lawe i ka Tritace hiki ke alakaʻi i ka nui o ke kahe koko, i kekahi manawa i hele ʻia me ka azotemia a i ʻole oliguria, a i nā hihia loaʻa ʻole, ka hopena o ka renal ka hopena.

I ka lā wela a / a i ka wā o ka hoʻāliʻi kino, hiki i ka nui o ka hōʻuki a me ka nui o ka ea, hiki iā ia ke hōʻemi i ka nui o ka sodium i loko o ke koko a me ka hoʻokaʻawale ʻana i ka nui o ke koko pīpī, a, ʻo ia hoʻi, i ka hoʻomohala ʻana o ka hypotension arterial.

I ka wā mālama, ʻaʻole pono e inu i nā mea inu ʻona.

I ka hoʻomaka ʻana o ka hoʻomohala o ka angioedema, i hoʻopaʻa ʻia i ka larynx, pharynx a me ka ʻōlelo, lawe aku iā Tritace e hoʻopau koke a hana i nā hana wikiwiki e pani i ka ʻāʻī.

Ma mua o nā kāhuna, me ke komo ʻana o nā niho dental, pono ia e ʻike i nā kauka e pili ana i ka hoʻohana ʻana o nā inhibce ACE.

ʻO nā pēpē i hōʻike ʻia i ka hoʻolaha intrauterine i ramipril e pono ka nānā pono ʻia e ʻike i ka oliguria, ka hyperkalemia, a me ka hypotension arterial.

I nā lā 3-6 mau mākena mua o ka mālama ʻana me Tritace, pono e kiaʻi pinepine i ka hana renal, i ke ʻano o ka electrolyte, nā ʻāpana hematological, nā hana enima a me nā ʻano o ka bilirubin i ke koko.

I ka wā o ka mālama ʻana me ka lāʻau lapaʻau, pono e pale kekahi i ke kaʻa a me ka hana i nā hana ʻē aʻe paha, ʻoiai hoʻowalewale, nānā ʻole, a me ka wikiwiki o ka hopena psychomotor hiki mai i ka wā e lawe ana iā Tritace.

Hoʻohui nūhou

ʻAʻole kuhikuhi ʻia ka lāʻau lapaʻau e lawe pū ʻia i ka diuretics potassium-sparing a me nā paʻakai pālolo.

Ke hui pū me nā lāʻau lapaʻau e hoʻohaʻahaʻa i ke koko (tricyclic antidepressants, diuretics, nitrates, etc.), kahi mākaʻikaʻi o kahi o ka hopena hypotensive.

ʻO ka Narcotic, painkillers a me nā lāʻau hiamoe, hiki ke alakaʻi i kahi kahe nui ʻana o ke kahe o ke koko.

ʻO ka Vasopressor sympathomimetics e hōʻemi i ka hopena hypotensive o Tritace.

ʻO ka immunosuppressants, cytostatics, glucocorticosteroids systemic, procainamide, allopurinol a me nā lāʻau āpau e hoʻopilikia ana i nā ʻōhua hematological e hoʻonui i ka hiki ke hoʻomohala ʻana i ka leukopenia.

Me ka hana like me ka insulin a me ka waha hypoglycemic agents, hiki ke hoʻonui i ka hopena hypoglycemic o kēia mau lāʻau.

ʻO ka hui pū me nā paʻakai lithium e alakaʻi i ka hoʻonuiʻana i ka hoʻolilo lithium serum a hoʻonui i ka hopena o ka neurotoxic a me ka cardiotoxic hopena o ka lithium.

Hiki i nā lāʻau anti-inflammatory nonsteroidal e hoʻonāwaliwali i ka hopena o Tritace, a me ka hoʻonui ʻana i ka serum konsentrate o ka paʻakai a hoʻonui i ka hopena o ka hana renal impaired.

Me ka hoʻohana like pū me ka ethanol, hoʻonui ʻia ka vasodilation a me ka hopena maikaʻi o ka étanol ma ke kino.

ʻO ka estrogens a me ka sodium chloride hoʻonāwaliwali i ka hopena hypotensive o ka ramipril.

Hiki i ka hui pū me ka heparin ke alakaʻi i ka piʻiʻana o ka paʻakai potassium serum.

ʻO nā hui o Tritace: Amprilan, Dilaprel, Ramipril, Ramipril-SZ, Pyramil, Khartil.

ʻO ka dosis a me ke ala o ka hoʻokele lāʻau.

Lawe ʻia ka lāʻau lapaʻau. E hoʻopau ʻia nā papa āpau (me ka ʻole o ka hoka) ma mua o ka manawa a ma hope o ka ʻai a holoi ʻia hoʻi me kahi waiwai (1/2 kīʻaha) o ka wai. Hoʻohālikelike ʻia ka hopena ma muli o ka hopena therapeutic manaʻolana a me ka hoʻomanawanui o ka lāʻau lapaʻau i nā mea maʻi ma kēlā me kēia hihia.

Inā loaʻa ka mea maʻi i ka diuretics, a laila e pono ke hoʻopau ʻia i nā lā 2-3 (e pili ana i ka lōʻihi o ka hana o ka diuretics) ma mua o ka hoʻomaka ʻana me ka Tritace, a i ʻole ka hoʻemi ʻana i ka hopena o nā diuretics i lawe ʻia.

I ka hihia o ka hana renal impaired (CC 50-20 ml / min / 1.73 m2 o ka nui o ke kino), ʻo ka hana mua ka 1,25 mg. ʻO ka palena kiʻekiʻe loa o kēlā me kēia lā he 5 mg.

I ka hihia o ka hana maʻi pehu, ʻo ka nui o kēlā me kēia lā he 2.5 mg.

I ka hoʻomanawanui ma mua e lawe ana i ka diuretics, ʻo ka helu mua ma laila 1.25 mg.

Inā hiki ʻole ke hoʻokaʻawale loa i ka palaki ʻana o ka hoʻokaʻina o ka wai-electrolyte ma nā hihia o ka nui o ka hypertension arterial, a me ka maʻi i loko o nā maʻi a ka maʻi hypotensive e hana i kahi pila (no ka laʻana, me ka hoʻokaʻa ʻana o ke kahe koko ma muli o ka hoʻopulapula o nā wahī o ka coronary o nā naʻau a me nā kīʻaha).

Hiki ke helu ʻia ke hoʻohana ʻia ʻo CC me ka hoʻohana ʻana i nā mea hoʻohālike o ka serum creatinine e like me kēia ʻano ma lalo iho (ʻo ke ʻano ʻo Cockcroft):

Kauka kino (kg) x (140 - makahiki)

72 x serum hana (mg / dl)

no nā wahine: hoʻonui i ka hopena i loaʻa i ka hoʻohālikelike luna aʻe na 0.85.

Hoʻohana maʻamau ka maʻi Tritace a ʻoi loa ka lōʻihi o kēlā me kēia hihia i kēlā me kēia kauka.

Ma ka mālama ʻana i ka maʻi hypertension, ua hoʻomaopopo ʻia ka lāʻau ʻai i ka manawa 1 / lā, ʻo ka hopena mua loa he 2,5 mg, inā pono, e pālua ʻia ka pākaukau ma hope o nā hebedoma 2-3, e pili ana i ka pane a ka mea maʻi i ka hopena, ʻo ka mālama mālama ʻia o kēlā me kēia lā he 2.5-5 mg, a ʻo ka nui loa i kēlā me kēia lā he 10 mg

I ka mālamaʻana i ka palaka o ka puʻuwai pale, ka nui o ka laina i kēlā me kēia lā he -1.25 mg 1 manawa / lā. Aia ma muli o ka pane a ka mea maʻi, hiki ke hoʻonui ʻia ka hopena. Manaʻo ʻia e pāpālua i ka nui i nā manawa o 1-2 mau pule. Pono nā kumumanaʻo mai he 2,5 mg a i ʻole e lawe ʻia a hoʻohele ʻia i 2 mau pāheona. ʻO ka palena loa ʻo kēlā me kēia lā he 10 mg.

I ka hoʻomau ʻana o ka pilikia o ka puʻuwai paʻakikī ma hope o ka myocardial infarction, ʻo ka nui o ka mahele mua he 5 mg ma 2 mau kīnā - 2.5 mg i ke kakahiaka a me ke ahiahi Inā he kūpaʻa kēia dosis, e hoʻemi ʻia i 1.25 mg 2 mau lā / lā no 2 mau lā. I ka hoʻonuiʻana i kēia maʻi, pono ia e hoʻokaʻawale iā ia i 2 mau dosis i ka lā 3 mau lā. Ma hope aku, ʻo ka huina o kēlā me kēia lā, i hoʻokaʻawale ʻia i loko o 2 mau ineka, hiki ke lawe ʻia i hoʻokahi wai lāʻau hoʻokahi. ʻO ka palena loa ʻo kēlā me kēia lā he 10 mg.

I loko o ka pilikia nui o ka puʻuwai kūpilikiʻi (ʻoi aku ka IV ma muli o ka helu NYHA) ma hope o ka infococion myocardial, ua kuhikuhi ʻia ka lāʻau lapaʻau ma kahi pākana o 1.25 mg 1 mau manawa / lā. I kēia māhele o nā mea maʻi, e hoʻonui ʻana i ka nui o ka dosis me ka makaʻala nui loa.

I ka mālamaʻana i ka maʻi nephropathy diabetes a me ka mea ʻole, ʻo ka hopena mua loa he 1.25 mg 1 manawa / lā. ʻO ka papa mālama mālama he 2.5 mg. Me ka hoʻonui ʻana o ka waiū, pono e pāpālua ia me ka wā o nā hebedoma 2-3. ʻO ka palena kiʻekiʻe loa o kēlā me kēia lā he 5 mg.

I mea e pale ai i ka myocardial infarction, stroke a me ka "coronary death", ʻo ka mua ka dosis ma kahi o 2.5 mg 1 mau lā / lā. Pono e hoʻonui ʻia ka nui ma ka hoʻopalua ma hope o ka 1 pule o ka mālama ʻana. Ma hope o 3 hebedoma, hiki ke hoʻonui ʻia ke kaumaha ma ka 2 mau manawa, ʻo ka nui o ka nui he 10 mg.

Nā hopena ʻaoʻao o Tritace:

Mai ka pūnaehana urinary: hoʻonui i ka serum urea, hypercreatininemia (ʻoiai me ka manawa like o ka diuretics), hana i ʻole ke kauā ʻana, hana i ʻole ke āpau, ʻaʻole i loaʻa - hyperkalemia, proteinuria, hyponatremia, hoʻonui i ka proteinuria a i loaʻa paha ka nui o ka urine.

Ma ka ʻāpana o ka ʻōnaehana cardiovascular: maʻa - kahi i hoʻokaʻawale ʻia i loko o ke kahe o ke koko, hypotension postural, myocardial a cerebral ischemia, myocardial infarction, arrhythmia, syncope, ischemic stroke, palima iseo o cerebral, tachycardia, peripheral edema (i loko o nā kuʻekuʻe wāwae.

He hopena alikaʻi: angioedema o ka maka, nā lehelehe, ka ihu, lehelehe, glottis a me / a larynx, ʻulaʻula hoʻi o ka ʻili, ʻāwīwīwīwīwīwīwīwīwīwī, conjunctivitis, itching, urticaria, ʻokoʻa rashes ma ka ʻili a i ka membous mucous (maculopapular exanthema a enanthema, erythema multiforme (komo i ke ala o Stevens-Johnson), pemphigus (pemphigus), serositis, exacerbation o psoriasis, nā nekrolysis epidermal poʻomanaʻo (Lyell syndrome), onycholysis, photosensitivity, kekahi mau alopecia, hoʻomohala ʻana i ka maʻi Raynaud, hoʻonui i ka ʻāpana o nā antinuclear antibodies , eosinophilia, vasculitis, myalgia, arthralgia, ʻĀlelo kele.

Mai ka pūnaehana hanu: pinepine - he uukū reflex maloʻo, ʻoi aku ka pō i ka wā o ka mea maʻi i ke kūlana, ʻo ka mea pinepine ia i loko o nā wahine a me nā mea ʻole palu (ma kekahi mau hihia, e hoʻohuli ana i kahi inhibitor ACE ka maikaʻi). I ka hihia o ka hoʻomau ʻana, pono ke hoʻokaʻawale i ka lāʻau. Hiki - catarrhal rhinitis, sinusitis, bronchitis, bronchospasm, dyspnea.

Mai ka pūnaehana ʻana: ka nausea, ka ʻeha o ka epigastric, ka nui o ka hana o nā ʻalā a me nā pancreas enzymes, bilirubin, loa pinepine nā kolestatic jaundice, ʻāwīwīwīwī hele, hele mai ka maʻi, ʻaʻai, constipation a me ka nalowale o ka makemake, hoʻololi i ke ʻano ("metallic" ʻono), hoʻemi ʻono ʻōpala a me kekahi manawa ke lilo ʻana o ka ʻono, ka malo maloʻo, stomatitis, glossitis, pancreatitis, i ʻole nāwaliwali o ka maʻi o ka mucosa gastrointestinal, ʻōpū o ka ʻōpū, hana i ka hana heʻumi, me ka hiki ke hoʻomohala ʻana i ka hina o ka ate ma ka palaualelo. ochnosti.

Mai ka pūnaehana hemopoietic: luhi - ka emi ʻana o ka nui o nā sela koko ʻula a me ka hoʻohaʻahaʻa ʻana i ka hemoglobin mai i ke aniani i ka hopena nui, thrombocytopenia a me leukopenia, i kekahi manawa neutropenia, agranulocytosis, pancytopenia, hemolytic anemia.

Mai ka ʻaoʻao o ka pūnaehana hoʻonāukiuki a me ka ʻōnaehana o peripheral: imbalance, hōʻeha, ka puʻuwai, nā wīwī, nā lūlū hiamoe, nāwaliwali, ka haunaele, ka hopohopo, nā hopohopo, paresthesia, nā mānoʻamanui kūwili.

Mai nā naʻau sensory: nā maʻi vestibular, nā mea hoʻonaninani, ka ʻono, ka hoʻolohe ʻana a me ka ʻike, tinnitus.

Nā mea'ē aʻe: i hōʻemi ʻia ke kūkulu ʻana a me ke kaʻa ʻana, ka ʻala.

Hoʻohana i ka wā hāpai a me ka lactation.

ʻO ka lāʻau Tritace ka contraindicated ma ka wā hāpai. No laila, ma mua o ka hoʻomaka ʻana i ka mālama ʻana, e hōʻoiaʻiʻo ʻaʻole i hapai.

Inā lilo ka mea maʻi i ka wā o ka mālama ʻana, pono ia e hoʻololi i Tritace me kekahi lāʻau lapaʻau hou e hiki koke ai. Inā ʻaʻole, loaʻa kahi pilikia o ka hōʻino o ka wā hānau, ma mua o ka wā mua o ka wā o ka hapai. Ua ʻike ʻia ka hopena o ka lāʻau i ka holo ʻana o nā pōpoki o ka pūpū, hoʻemi i ke koko o ka pēpē a me nā keiki hou, i ʻole hana renal functioning, hyperkalemia, skop hypoplasia, oligohydramnios, limb contracture, skull deform, lung hypoplasia.

No nā pēpē hou i hōʻike ʻia i ka hoʻolaha intrauterine i nā mea hōʻiliʻili o ACE, ʻoi ʻia ka mea e nānā pono ai i ka huli ʻana o ka hypotension arterial, oliguria a me hyperkalemia. I oliguria, pono ia e mālama i ke kahe o ke koko a me ka hoʻoliʻi ʻana i ke kīpine ma ka hoʻopuka ʻana i nā wai kūpono a me nā vasoconstrictors. I nā pēpē a me nā pēpē, loaʻa he pilikia o ka oliguria a me nā maʻi neurological, e hiki paha ma muli o ka emi ʻana o ke kahe a me ka koko cerebral ma muli o ka emi ʻana o ke kahe o ke koko i hoʻāla ʻia e ACE inhibitors (loaʻa e nā wahine hāpai a ma hope o ka hānau keiki). Hoʻomaopopo ʻia ka nānā ʻana.

Inā pono e kuhikuhi i Tritace i ka wā o ka lactation, pono keʻakeʻa i ka hōʻuluʻulu ʻana o nā kāne.

ʻO nā ʻōlelo kūikawā no ka hoʻohana ʻana o Tritace.

ʻO ka lōʻihi ka hana o Tritace, ka lōʻihi i kēlā me kēia hihia i hoʻoholo ʻia e ke kauka. Pono ia i nā mākau mālama olakino maʻamau, i ka maʻi ma nā mea maʻi me ka hana aho a me ka hana ʻana o ka pūpū. A ʻōlelo ʻia ua hoʻoponopono ʻia nā dehydration, hypovolemia, a i ʻole hemahema ʻia ka paʻakai ma mua o ka mālama ʻana.

Ma ka pilikia o ka pilikia, hiki ke hoʻomaka ʻia ke mālama ʻia me ka lāʻau lapaʻau inā neʻe wale paha ke mālama pono ʻia i ka manawa like i mea e pale ai i ka hoʻemi ʻana o ke koko nui a me ka hana renal impaired.

Pono e kāohi i ka hana renal, maʻa mau loa i nā pule mua o ka mālama ʻana. I nā mea maʻi me ka maʻi valula o ka maʻi (no ka laʻana, me ka stenosis renal hāleʻa ʻaʻole koʻikoʻi koʻikoʻi, a i ʻole unilateral hemodynamically koʻikoʻi renal artery stenosis) i nā hihia i hana ʻole ai iā ia ka hana, a me nā mea maʻi e hana nei i kahi maʻi kidney, e nānā pono ka nānā ʻana.

ʻO ka paʻakai kikowaena a me ka paʻakai e pono e mālama pono ʻia. I ka poʻe maʻi me ka hana renal impaired, koi ʻia ka nānā pinepine ʻana i kēia mau hōʻailona.

Pono e kāohi i ka nui o leukocytes (maʻi o ka leukopenia). Hōʻike ʻia ka kiaʻi pinepine ʻana i ka hoʻomaka ʻana o ka mālama ʻana, a me ka poʻe maʻi ma ka hopena o ka hōʻemi - a hiki i ka manawa 1 i kēlā me kēia mahina i ka 3-6 mau mahina o ka mālama ʻana i nā maʻi i nā maʻi me ka hoʻonui nui aʻe o ka hana neutropenia - me ka hana ʻole o ka maʻi hakahaka, nā ʻōnaehana maʻi o ka kiko o ke kohu a loaʻa paha nā dosis kiʻekiʻe. diuretics, a me ma nā hōʻailona mua o ka maʻi.

Ma ka hōʻoia ʻana o ka neutropenia (helu neutrophil e emi iho ma mua o 2000 / μl), pono ke oki i ke ʻano o ka inhibitor o ACE.

Inā aia nā hōʻailona o ka pale ʻole i ka maʻi ma muli o ka leukopenia (no ka laʻana, ke ʻano, ke ala ʻana, ka ʻāʻī lymph node, tonsillitis), ka nānā pono ʻana o ka kiʻi koko o peripheral. I ka loaʻa ʻana o nā hōʻailona o ke kahe (ʻo ka petechiae liʻiliʻi, ʻili red-brown ma ka ʻili a me nā membuses mucous) pono hoʻi e kāohi i ka nui o nā platelets i ke koko peripheral.

Ma mua a i ka wā o ka mālama ʻana, kaohi o ke kahe o ke koko, hana o ka pēpē, pae hemoglobin i loko o ke koko peripheral, creatinine, urea, ka hoʻokūkūʻana o ka electrolyte a me ka hana o nā huʻina o ka huina o ke koko e pono ai.

Pono e hoʻomaʻemaʻe ʻia i ka wā e kau ana i ka lāʻau lapaʻau i nā mea maʻi ma ka lāʻau paʻakai a ʻole paʻakai paʻakai (hoʻonui i ka nui o ka ulu ʻana o ka hypotension). I nā mea maʻi me ka hoʻēmi ʻia BCC (ma muli o ka diuretic therapy) ʻoiai ke kaupalena ʻana i ka sodium intake, ka maʻi ʻana a me ka luaʻi, e hoʻomohala ʻia a hypotension hypertension arterial.

ʻO ka hypotension arential, ʻaʻole ia he contraindication no ka hoʻomau ʻia o ka mālama ʻana ma hope o ka hoʻomau ʻana o ke koko. Ma ka hihia o ka hana pinepine o ka hypotension arterial nui, pono e hoʻemi ʻia ka nui o nā lāʻau a haʻalele paha i ka lāʻau.

Inā hōʻike nā moʻolelo i ka hoʻomohala ʻana o ka angioedema i pili ʻole me ka hoʻohana ʻana o nā inhibitor ACE, a laila loaʻa nō ke ʻano o nā mea maʻi i kona hoʻomohala ʻana i ka wā e lawe ai iā Tritace.

Pono e mālama ʻia ka mālama ʻana i ka wā e hana ai i ka hoʻomaʻamaʻa kino ʻana a me / a i ʻole ka mahana wela ma muli o ka hopena o ka maʻi dehydration a me ka hypotension arterial ma muli o kahi emi o ke kahe o ka wai.

ʻAʻole kuhikuhi ʻia ka inu ʻawa.

Ma mua o kahi hoʻomaʻamaʻa (me nā mea pūlima), pono e ao aku i ka luna lapaʻau / anesthetist e pili ana i ka hoʻohana ʻana o ka inhibce ACE.

Inā hele ka edema, no ka laʻana ma ka maka (lip, eyelids) a i ʻole alana, a inā i ʻole kai a i ʻole ka hanu ʻana, pono i ka mea maʻi e hoʻōki i ka lawe ʻana i ka lāʻau. ʻO Angioedema ma kahi o ka ʻōlelo, pharynx, a i ʻole larynx (hiki i kahi hōʻailona ke hoʻopau i ka neʻe ʻana a i ʻole ka hanu) hiki ke hoʻoweliweli a ola i ke ʻano o ka mālama mālama.

ʻO ka ʻike ma ka hoʻohana ʻana iā Tritace i nā keiki, i loko o nā mea maʻi me ka maʻi koʻikoʻi o ka renal (CC ma lalo o 20 ml / min me kahi kino kino o 1,73 m2), me nā mea maʻi e loaʻa ana ka maʻi hemodialysis, ʻaʻole lawa.

Ma hope o ka lawe ʻana i ka hapa mua, me ka hoʻonui ʻana i ka nui o ka diuretic a me / a ramipril paha, pono nā mea maʻi ma lalo o ka mālama ʻana i nā maʻi no 8 mau hola e pale ai i ka hoʻomohala ʻana i kahi ʻano hypotensive kuʻuna. I ka poʻe maʻi me ka puʻuwai puʻuwai hemahema, lawe i ka lāʻau lapaʻau hiki ke alakaʻi i ka hoʻomohala ʻana o ka maʻi hypertension arterial, i loko o kekahi mau hihia me ka oliguria a i ʻole azotemia, a me kaʻole loa, ka hoʻomohala ʻana o ka hiki ʻole o ka hana renal.

ʻO nā maʻi me ka hypertension arterial malignant a i ʻole e hoʻopili i ka puʻuwai naʻau nui e hoʻomaka i ka mālama ʻana i loko o kahi haukapila.

I nā mea maʻi e loaʻa ana i ka ACE, e pili ana i ke ola, e hoʻomohala koke i ka hoʻihoʻi anaphylactoid i kekahi manawa, i ke ʻano o ka hoʻoulu ʻana o ka pīhoihoi, i ka wā e hemodialysis e hoʻohana ana i kekahi membranes nui (no ka laʻana, polyacrylonitrile). E kūʻē i ke kūleʻa o ka mālama ʻana me Tritace, pono e pale ʻia ka hoʻohana ʻana o nā membrane like i ka laʻana, no ka laʻana, no ka hemodialysis wikiwiki a i ʻole hemofiltration. Inā pono e hoʻokō i kēia mau kaʻina hana, ʻoi aku ka maikaʻi o ka hoʻohana ʻana i nā membranes a hōʻea paha i ka lāʻau lapaʻau. Ua nānā ʻia nā ʻano like like me LDL apheresis e hoʻohana ana i ka dextran sulfate. No laila, ʻaʻole pono kēia ala o nā hana i nā maʻi e loaʻa i kahi inhibce ACE.

Hoʻohana ʻo Pediatric

ʻAʻole paʻa ma ka palekana a me ka hana o ka lāʻau lapaʻau i nā keiki a me nā ʻōpio ma lalo o ka makahiki 18, no laila, ua hoʻohālikelike ka koho.

Hoʻokomo i ka hiki ke lawe i nā kaʻa a kāohi i nā mīkini

I ka wā o ka mālama ʻana, pono ka mea maʻi e pale i ka hana ʻana i nā hana pōpilikia e pono ai ka piʻi ʻana o ka neʻe ʻana a me ka wikiwiki o ka hopena psychomotor, e like me hiki paha ke hoʻomanawanui, ʻoi aku paha ma hope o ka hopena o ka Tritace i ka hihia no ka lawe ʻana i ka diuretics.

ʻO ka pane ʻana o ka lāʻau.

Nā hōʻailona: kahi hōʻailona i hoʻemi i ke kahe o ke koko, pīhoihoi, bradycardia koʻikoʻi, nā haunaele i ka pae wai-electrolyte, kūleʻa renal failed, stupor.

Hanaʻi: lavage gastric, koma o adsorbents, sodium sulfate (inā hiki i loko o nā minuke 30 mua). I ka hanana o ka hoʻomohala o ka hypotension arterial, hoʻopuka ka alpha1-adrenostimulants (norepinephrine, dopamine) a me ka angiotensin II (angiotensinamide) hiki ke hoʻohui ʻia i ka lāʻau i hoʻohou hou i ka bcc a hoʻihoʻi i ke kūpaʻa paʻakai.

Hoʻohui ʻana o Tritace me nā lāʻau lapaʻau ʻē aʻe.

Me ka hoʻohana like ʻana o ka paʻakai pālolo, mālama diuretics pākileka (no ka laʻana, amiloride, triamteren, spironolactone) me Tritace, hyperkalemia e nānā (pono pono ka nānā ʻana i ka ʻōmato potassium.

ʻO ka hoʻohana like ʻana o Tritace me nā antihypertensive agents (ma ka helu, me ka diuretics) a me nā lāʻau ʻē aʻe e hoʻemi ana i ke kahe koko, ke alakaʻi nei i ka hopena o ka ramipril.

Me ka hoʻohana like ʻana me ka hypnotics, opioids a me analgesics, hiki ke loaʻa kahi hoʻolilo nui i ke koko.

Hiki i nā lāʻau Vasopressor sympathomimetic (epinephrine) a me nā estrogens ke hoʻonāwaliwali i ka ramipril.

Me ka hoʻohana pū ʻana o Tritace me allopurinol, procainamide, nā lāʻau lapaʻau cytotoxic, immunosuppressants, corticosteroids systemic a me nā lāʻau lapaʻau ʻē aʻe hiki ke hoʻololi i ke kiʻi koko, kahi hōʻemi o ka nui o nā puna keʻokeʻo i ke koko hiki.

Me ka hoʻohana like ʻana me ka hoʻomākaukau lithium, hiki i ka nui o ke neʻe o ka lithium ma ka plasma, kahi e hiki ai ke hoʻonui i nā cardio- a me ka hopena neurotic o ka lithium.

Me ka hana like o Tritace me nā māmala hypoglycemic waha (sulfonylureas, biguanides), insulin, hypoglycemia hoʻonui ʻia.

Nā NSAIDs (indomethacin, acetylsalicylic acid) e hoʻemi i ka hopena o ramipril.

Me ka hoʻohana pū ʻana me ka heparin, hiki i ka nui o ke neʻe o ka paʻakai ma ka serum koko.

ʻO ka paʻakai e hōʻemi ana i ka hopena o ka ramipril.

Hoʻonui ka Ethanol i ka hopena hypotensive o ka ramipril.

Koi nui ʻia

ʻO 2 mau maʻa mau ke ʻano maʻamau ma kahi o 2.5 mau manawa i kēlā me kēia lā i ke kakahiaka (½ 5 mg nā ʻānela e ʻae ʻia). Inā hoʻohana ʻia ka lāʻau lapaʻau no 3 hebedoma i kahi wai i hāʻawi ʻia a ʻaʻole hoʻi i hoʻihoʻi ʻia ke koko, i maʻamau, hoʻonui ʻia ka nui o kēlā me kēia lā i 5 mg. Me ka lawaʻole o ka maikaʻi ma hope o nā hebedoma 2-3, hiki ke hoʻonui ʻia ka nui o kēlā me kēia lā i 10 mg.

ʻO kahi hoʻoponopono hoʻoponopono hou aku me ka lawa o antihypertensive hopena o ka lāʻau i ka hoʻohui pū ʻana o nā pono e hoʻohana ʻia nā lāʻau antihypertensive (no ka laʻana, lohi ka mīkini palaka a i ʻole diuretics).

Pākuʻi helu

5 mg a me nā papa he 10 mg

Hoʻokahi i ka papaʻa 5 mg

mea waiwai - ramipril 5 mg

nā mea hoʻohālikelike: hypromellose, ke kō kōpaʻa pregelatinized, cellulose microcrystalline, ʻulaʻula ka hao (E 172), sodium stearyl fumarate

Hoʻokahi ka papa lāʻau 10 mg

mea waiwai - hipa kāne 10 mg

nā mea hoʻohālikelike: hypromellose, ke kō kōpaʻa pregelatinized, cellulose microcrystalline, sodium stearyl fumarate

ʻO nā papa ʻōpiopio ʻulaʻula ulaula, me ka pilikia o ka uhai ʻana i nā ʻaoʻao ʻelua o ka papa ʻaina, i kahakaha me ka "5 / logo huikala" ma kekahi ʻaoʻao a me "5 / HMP" ma ka ʻaoʻao

ʻO nā papa ʻalani o ke keʻokeʻo a i ʻole keʻokeʻo paha ke keʻokeʻo, me ke kīpē no ka uhai ʻana i nā ʻaoʻao ʻelua o ka papaʻaina, me ke kahakaha "HMO / HMO" ma kahi ʻaoʻao.

Hoʻopau ʻole nā naʻau paʻakikī

Ma 1.25 mg hoʻokahi manawa i ka lā (e hoʻohana i nā pahu ½ o 2.5 mg). Wahi a ka hopena e pili ana i ka mālama ʻana, ʻae ʻia kahi piʻi o ka ʻōlelo. E papalua ʻia ka ʻōlelo, e mālama ana i ka wā o 1-2 mau pule. Inā loaʻa ka dosis i kēlā me kēia lā he 2.5 mg a ʻoi aku paha, hiki ke lawe ʻia i hoʻokahi manawa a ʻoka ʻia paha i 2 mau papa. ʻAʻole ia e hāʻawi ʻia iʻoi aku o ka nui o ka lā maʻamau o 10 mg.

ʻO ka hōʻemi ʻana i ka hopena o ka make cardiovascular, stroke, a me ka myocardial infarction i nā mea maʻi me ka pono o ka maʻi cardiovascular

Hoʻomaka ka Therapy i ka 2.5 mg hoʻokahi i ka lā (1 papa 2.5 mg a i ʻole ʻehā tablet 5 mg). Aia ma muli o ka hopena o ke kino i ka lāʻau lapaʻau, ʻae ʻia ka piʻi ʻana ma ke ʻano o ka lā i kēlā me kēia lā. Ma hope o hoʻokahi hebedoma no ka lapaʻau ʻia, e hoʻolako ʻia e pāpālua i ka nui, a ma luna o 3 mau hebedoma e hiki mai ana, e hoʻonui iā ia i ka mālama maʻamau maʻamau i kēlā me kēia lā he 10 mg, kahi i lawe ʻia hoʻokahi

ʻO ka hoʻohana ʻana i ka lāʻau lapaʻau i loko o kahi hopena ma mua o 10 mg, a ma nā mea maʻi me CC ma lalo o 0.6 ml / min, ʻaʻole lawa.

Hoʻokumu ka puʻuwai naʻau mai ka lā 2 a i ka lā 9 ma hope o ka hoʻonāukiuki myocardial infarction

Hoʻomaka ka hoʻomaʻamaʻa i kēlā me kēia lā i kēlā me kēia lā o 5 mg, hoʻokaʻawale ʻia i ʻelua mau minamina o 2.5 mg, ka mea i lawe ʻia i ke kakahiaka a me ke ahiahi (2.5 mg papa ʻaina a ½ 5 mg papan). Me kahi hoʻoluhi nui o ke koko i loko o ka mea maʻi i nā lā 2, ʻo Tritace e kuhikuhi i ka 1.25 mg 2 mau manawa i ka lā (½ papa 2.5 mg). A laila, ma lalo o ka mākaʻi o ke kauka, hoʻonaninani ka piʻi ʻana, e pāpālua i kēlā me kēia 1-3 mau lā. Ma hope mai, hiki ke hāʻawi ʻia i ka hoʻokahi o ka lā i kēlā me kēia lā, i hoʻokaʻawale ʻia i nā inikua ʻelua. ʻAʻole ia e hāʻawi ʻia iʻoi aku o ka nui o ka lā maʻamau o 10 mg.

ʻO ka hoʻohana ʻole ʻana o Tritace no ka mālamaʻana i nā maʻi me nā maʻi koʻikoʻi o ka puʻuwai hōʻeha (III - IV hana like e like me ka helu ʻana o NYHA), ʻaʻole i ʻike maopopo ʻia, no laila, i ka mālama ʻana i nā maʻi like, ua hoʻokaʻawale ʻia nā kaha kikoʻī: 1.25 mg hoʻokahi i kēlā lā (½ papa 2.5 mg). E hoʻonui i nā maʻi me ka akahele nui.

Hoʻohana i ka mea maʻi me ka renal dysfunction

Me CC mai 50 a 20 ml / min, ua kau ʻia ʻo Tritace i kahi ma mua i kēlā me kēia lā maʻamau o 1.25 mg (½ papa 2.5 mg). ʻO ka ʻōmapa i ʻōlelo ʻia i kēlā lā i kēia lā he 5 mg. Hoʻohana ʻia ka regimen lapaʻau like ʻole i nā mea maʻi me ka hypertension arterial koʻikoʻi, ʻaʻole hiki ke ʻae ʻia e ka nalowale o nā electrolytes a me ka hiʻona, a me nā mea maʻi a nā mea nui o ke kaʻe o ke koko e piha me nā hopena koʻikoʻi (no ka laʻana, me nā hōʻeha o ka atherosclerotic o ka lolo a me nā lāʻau coronary).

Hoʻohana i ka mea maʻi me ka mālama diuretic ma mua

ʻO 2-3 lā ma mua o ka hoʻomaka ʻana o ka mālama ʻana me Tritace, e pili ana i ka hoʻolaha ʻana o ka lōʻihi i ka diuretics, pono ia e hooki i ka lawe ʻana i kēia mau lāʻau a hōʻemi paha i kā lākou dosis. Hōʻike ʻia kēlā mau mea maʻi e hoʻomaka i ka mālama ʻana me ka haʻahaʻa loa ʻo ia i ka 1.25 mg (½ papa o 2.5 mg), ka mea i loaʻa i ka manawa i kēlā me kēia lā i ke kakahiaka. Ma hope o ka lawe ʻana i ka hopena mua, hoʻonui i ka nui o Tritace a me / a i ʻole diuretics loop-type, noho mau nā mea maʻi ma lalo o ka mākaʻi ʻana ma lalo o 8 mau hola e pale ai i kahi ʻano hypotensive kuʻuna.

Hoʻohana i ka mea maʻi me ka maʻi aho

Ma kēia pūʻulu o nā mea maʻi, lawe i ka lāʻau lapaʻau hiki ke hoʻoulu i ka nui o ka hoʻonui a me ka hoʻohaʻahaʻa i ke koko. No laila, pono ke hoʻokipa ʻia ʻo Tritace ma lalo o ka mākaʻikaʻi koʻikoʻi o kahi kauka. Hoʻoholo ʻia ʻaʻole e hoʻonui i kēlā me kēia lā he 2,5 mg (1 papa 2.5 mg a i ½ papa 5 mg).

ʻO nā ʻōmaʻomaʻo o ka overdose ka hopena o ka renal ka pau ʻole, ka nui o ka vasodilation peripheral me ka loaʻa ʻana o ka pīhoihoi a me ka hoʻokaʻawale ʻana i ke kahe o ke koko, nā pilikia o ka hoʻonaninua wai-electrolyte, bradycardia, stupor. I kēia hihia, holoi ʻia ka ʻōpū a ʻōlelo ʻia ka sodium sulfate (inā pono, pono ia e lawe i ka 30 mau minuke mua ma hope o ka lawe nui ʻana i ka nui o ka lāʻau lapaʻau) a me nā adsorbents. Me ka hoʻohaʻahaʻa pane ʻana i ke koko, ua mālama ʻia ka angiotensinamide (angiotensin II) a me nā alpha₁agonist -adrenergic (dopamine, norepinephrine). Ma ka hihia o ka bradycardia refractory i ka lāʻau lapaʻau lāʻau, ke hoʻolako ʻia kahi pacemaker hana i kekahi manawa. Ma ka hihia o ka overdose, ʻae ʻia ka nānā ʻana i nā manawa maʻamau o nā ʻike serum o nā electrolytes a me ka creatinine.

ʻO nā waiwai Pharmacological

Lapaʻau lāʻau

Ma hope o ka lawelawe waha, ua mālama koke ʻia ka ramipril mai ka ʻeha o ka gastrointestinal: ʻike ʻia ka pihi plasma kiʻekiʻe o ka ramipril i loko o hoʻokahi hola. ʻO ka maʻa o ke kīpēpē he hapa loa o ka 56% o ka nui i lawe ʻia a kūʻokoʻa ʻole i ka ʻaina o ka meaʻai. Kokoke pau loa ia e ka hoʻonaninani (ʻo ka hapanui o ka ate) me ka hoʻokumu ʻana o ka metabolite ikaika - ramiprilat (ʻo ia ka 6 mau manawa i ka papa o ka ACE-angiotensin-hoʻohuli i ka enzyme ma mua o ramipril). ʻO ka bioavailability o ka ramiprilat he 45%.

Loaʻa ka lōʻihi loa o ka ramiprilat i ka plasma ma hope o nā hola 2-4. Ka palekana o ka plasma paʻa o ka ramiprilat ma hope o hoʻokahi kaʻe o ka nui o ka nui o ka ramipril ua hele ma ka lā 4 o ka lā.

ʻO ka pilina o ka protein plasma e pili ana i ka 73% no ka ramipril a me 56% no ka ramiprilat.

Ua aneane piha ka Ramipril i ka ramiprilat, diketopiperazinovy ester, diketopiperazinovy acid a me nā glucuronides o ka ramipril a me ramiprilat.

Hoʻopau ka hana o nā metabolites ma o nā keiki maʻi. ʻO ka hoʻoneʻeʻana o ka plasma o ka ramiprilat e hoʻemi nei i ka polyphase. Ma muli o kona hiki i ke kūpaʻa saturated i ka ACE a me ka neʻe wikiwiki ʻana mai ka enzyme, hōʻike ʻo ramiprilat i kahi lōʻihi elimination hapa loa i nā hoʻokaʻawale plasma. ʻO ka hapalua ola maikaʻi o ka ramiprilat mai 13 a 17 mau hola no nā dute o 5 a me 10 mg.

Hoʻomaka ka hopena antihypertensive 1-2 mau hola ma hope o ka hoʻokomo ʻana i kahi pākahi hoʻokahi o ka lālani, hoʻomohala ʻia ka hopena kiʻekiʻe 3-6 mau hola ma hope o ka hoʻokō ʻana a lōʻihi no 24 mau hola. Me ka hoʻohana o kēlā me kēia lā, hoʻonui pinepine ka hana antihypertensive ma luna o 3-4 mau pule.

Ua hōʻike ʻia i ka hopena antihypertensive 2 mau makahiki me ka lōʻihi o ka hoʻopaʻa ʻana. ʻO kahi haki nui i ka lawe ʻana i ka ramipril ʻaʻole alakaʻi i ka hoʻonui nui o ke kahe koko ("rebound").

Nā hui ahonui kūikawā

I ka poʻe maʻi me ka hana renal impaired hoʻemi ʻia ka renal excretion o ramiprilat, hoʻomaʻemaʻe i ke kūlohelohe o ka ramiprilat kū pololei i ka cleince clearance. Ke alakaʻi kēia i ka hoʻonui i ka neʻe o ka plasma ramiprilat, e hoʻohaʻahaʻa me ka mea lohi ma mua o nā kumuhana me ka hana maʻamau maʻamau.

I ka poʻe maʻi me ka hana aho lēwa ramipril metabolism i ramiprilat lohi i ka neʻe o ka hana i ka esterases hepatic. Hōʻike kēia mau mea maʻi i nā kiʻekiʻe ramipril kiʻekiʻe. Eia nō naʻe, ua like ka pae ʻana o ka plasma ramiprilat i nā mea i nā mea maʻi me ka hana neʻe maʻamau.

Ma hope o ka loaʻa ʻana o kahi pā hoʻokahi o ka ramipril i lawe waha ʻia, ʻaʻole i ʻike ʻia ka lāʻau lapaʻau a me kāna metabolite i ka waiū umauma. Eia naʻe, ʻaʻole ʻike ʻia ka hopena o nā hōkū he nui.

Lapaʻau lāʻau

Ua hoʻokumu ʻia ka angiotensin-hoʻohuli o ka enzyme ACE, i ʻike ʻia ʻo dipeptidyl carboxypeptidase I), kahi e hoʻopili ai ka huli ʻana o ka angiotensin I ke angiotensin II, he vasoconstrictor ikaika, a he kumu no hoʻi ka wāwahi o bradykinin, he vasodilator, he kumu koʻikoʻi o ka hoʻomohala ʻana i ke ʻano o ka hypertension.

ʻO Ramiprilat, kahi metabolite ikaika o Tritace®hoʻomaloka ʻana i ke ACE i ka plasma a me nā ʻili, incl. ka pale aku i ka paia vascular, pale i ka hoʻokumu ʻana o ka angiotensin II a me ka kaʻa o ka bradykinin, e alakaʻi ana i ka vasodilation a me ke kahe koko.

Me ka hoʻohaʻahaʻa ʻana i ka kao o ka angiotensin II i loko o ke koko, ua hoʻopau ʻia kāna hopena pale i ka mea huna o ka renin e ke ʻano o ka hōʻike maikaʻi ʻole, ka mea i hāpai i ka hoʻonui i ka hana o ka renin plasma.

ʻO ka hoʻonui nui aʻe o ka hana o ka papa kallikrein-kinin i loko o ke koko a me nā kao e hoʻoholo ai i ka cardioprotective a me ka endothelioprotective hopena o ka ramipril ma muli o ka hana hou ʻana o ka ʻōnaehana prostaglandin a, ma muli, i ka hoʻonui ʻia ʻana o ka synthesis o ka prostaglandins, e hōʻeuʻeu i ka hoʻokumu ʻana o ka nitric oxide (NO) i ka endotheliocytes.

Hoʻolāla ʻo Angiotensin II i ka hana o ald testosterone, no laila lawe ka Tritace® alakaʻi i kahi emi i ka huni o ka ald testosterone a me ka hoʻonui ʻana i ka hana serum i nā paʻakai pālolo.

I nā maʻime ka ha o ka hypertension ʻĀina Tritace® alakaʻi i kahi emi o ke koko i ka wā e waiho ana a kū ana, me ka uku ʻole o ka uku i loko o ka puʻuwai naʻau (HR). Triteke® ka hoʻēmi nui ʻana i ka huakaʻi pale kipi peripheral (OPSS), ma ka hoʻomaʻamaʻa ʻole ʻana i ka loli o ke kahe koko a me ka hopena filomation glomerular.

I ka poʻe maʻi me ka hypertension arterial, lohi ʻo ramipril i ka hoʻomohala ʻana a me ka holomua o ka myocardial hypertrophy a me ka pā vascular.

I ka hui pū me nā diuretics a me glycosides cardiac (e like me ka mea e alakaʻi ai e ke kauka) Tritace® ka mea maʻi ma ka mea maʻi me nā puʻuwai naʻau pahu II-IV e like me ka papa hana ʻana o NYHA (New York Cardiology Association).

Triteke® ua loaʻa ka hopena maikaʻi i ka hemodynamics o ka puʻuwai - e hōʻemi ana ia i ka OPSS (hoʻemi i ka hoʻokahe ma hope o ka naʻau), hoʻemi i ka hōʻemi piha ʻana o ka hema a me ka ʻaha kūpono, hoʻonui i ka huina cardiac, a hoʻomaikaʻi i ka index cardiac.

Me ka maʻi diabetes maʻi a me ka maʻi ʻole ʻĀina Tritace® ka hoʻolohi ana i ka pae o ka holomua o ka renal ka maikaʻi a me ka hoʻomaka ʻana o ka papa hana o ka hōʻaʻole o ka renal a, ma laila, e hōʻemi ai i ka pono o hemodialysis a i ʻole hoʻololi i ka kidney. No ka maʻi maʻi maʻi diabetes a i ʻole ka lolo ʻole® hoʻemi i ka ʻōpū o ka proteinuria.

I ka poʻe maʻi e pilikia nui ana no ka hoʻomohala ʻana i ka maʻi cardiovascular ma muli o ke kauā maʻi vascular (maʻi ʻeha o ka coronary, ka mōʻaukala o ka maʻi pāpaʻi o ka maʻi pā, ka mōʻaukala o ka stroke), a i ʻole ka maʻi mellitus me ka liʻiliʻi loa o ka mea hou aku (microalbuminuria, hypertension arterial, hoʻonui i ka ʻike o ka kolamu o ka kolamu OX.-KĀLLL, ka ulaula), lawe ana i ka ramipril i hui pū me ka maʻi maʻamau a i ʻole ka monotherapy e hōʻemi pono i ka ulu ʻana o myocardial infarction, ka pehu, a me ka make ma ke kumu o ka cardiovascular. Eia kekahi, Tritace® hōʻemi iki i nā helu make kino, a me ka pono o ke kaʻina hana houʻokiʻoki, a me ka hōʻai ʻana i ka hoʻomaka a hoʻomaikaʻi ʻole paha i ka ulu ʻana o ka naʻau puʻuwai.

I ka poʻe maʻi me ka puʻuwai naʻau i ulu ʻia i ka wā mua o ka nui o ka myocardial infarction (2-9 lā), ke lawe me Tritace®Hoʻomaka mai ka lā 3 a i ka lā 10 o ka hala o myocardial infarction, ʻoi loa ka hopena o ka make ma ka 5.7%, ʻo ka hopohopo pili i ka 27%.

Ma ka nui o ka poʻe maʻi ma ka maʻi, a me ka poʻe no ka maʻi me ka mellitus o ka maʻi mole, ka mea me ka haole hypertension a me ka hoʻokaʻina koko. Triteke® ka hoʻemi nui ʻana i ka hopena o ka nephropathy a me ka hōʻea o ka microalbuminuria.

ʻLoe a me ke kākele

No ka lawelawe waha.

ʻAno ʻia ʻo Tritace® kēlā me kēia lā i ka manawa like.

Triteke® hiki ke lawe ʻia a ʻole ʻole ka ʻai, me ka mea kūʻokoʻa ʻole ka bioavailability o ka ʻaʻa meaʻai. Triteke® pono e lawe me ka nui o ka wai. ʻAʻole hiki iā ʻoe ke ʻoki a haki paha i ka papaʻaina.

Loaʻa nā poʻe maʻi i ka mālama Diuretic

I ka hoʻomaka ʻana o ke aʻaau me Tritace® Hiki paha i ka hypotension, ʻoi aku ka hopena o nā hopena i nā mea maʻi e loaʻa ana i nā diuretics. I kēia hihia, pono e hoʻomaʻamaʻa, no ka mea i hiki i nā mea maʻi ke nalowale i nā pilau a i ʻole nā paʻakai.

Inā hiki, pono ke hoʻopau ʻia i ka diuretics 2 a i ʻole 3 lā ma mua o ka hoʻomaka ʻana o Tritace therapy.®.

I ka poʻe maʻi me ka hypertension me ka pani ʻole ʻana o ka diuretics, mālama ʻia me Tritace® pono e hoʻomaka me kahi pae o 1.25 mg. Pono e kāohi i ka pae serum potassium a me diuresis. Nā hopena hopena o Tritace® Hiki ke hoʻoponopono ʻia e like me ka pae koko o ka hopena.

He maʻi haole

Koho ʻia ka ʻōkuhi o kēlā me kēia e like me ka kōkuhi a me ke pae o ke koko. Triteke® hiki ke hoʻohanaʻia e monotherapy a i hui pū ai me nā mea hana antihypertensive.

Tritace Therapy® pono nā hoʻomaka ma nā pae. ʻO ka dosage hoʻomaka e hoʻomaka ʻia ʻo 2.5 mg i kēlā me kēia lā.

I ka poʻe maʻi me ka hoonui o ka hana o ka ʻōnaehana renin-angiotensin-ald testosterone, hiki ke hōʻemi nui ke kahe ʻana ma hope o ka lawe ʻana i ka ʻaina mua. No kēlā mau maʻi maʻi, ʻo ka dosage hoʻomaka ʻia ʻana ʻo ka 1.25 mg. Hoʻomaka ka hoʻomaʻamaʻa ma lalo o ka nānā o kekahi kauka.

Dosis titration a me ka hoʻomalaha dosage

Inā makemake ʻia, hiki ke pālua ʻia ka nui o nā make ma nā manawa ʻelua a ʻehā paha pule, i hiki ke loaʻa i ka hopena o ka neʻe. Kōkuhi Uwau Kiʻo Kūhi® ʻo 10 mg i kēlā me kēia lā. Lawe ʻia ka lāʻau i hoʻokahi manawa i ka lā.

Kāohi pilikia Cardiovascular

ʻO ka papa helu hoʻomaka ʻia ʻo 2.5 mg Tritace® i ka maka? i.

Dosis titration a me ka hoʻomalaha dosage

Aia i ka hoʻomanawanuiʻana o ka waihona ikaika, hoʻonui pinepine ʻia ka dosage. Nohea ʻia e pāpālua i ka maʻi ma 1-2 mau pule ma hope o ka hoʻomaka ʻana o ka lāʻau lapaʻau a laila ma 2-3 mau wiki e hoʻonui ai i ka mālama mālama ʻia o 10 mg Tritace® i ka la.

E ʻike pū i nā doses i nā maʻi e lawe ana i nā diuretics.

ʻO ka maʻi maʻi oʻe

ʻO nā mea maʻi me ka maʻi maʻi a me ka microalbuminuria

ʻO ka papa hoʻomaka ʻana he 1.25 mg Tritace i kēlā me kēia lā.

Dosis titration a me ka hoʻomalaha dosage.

Wahi a ka hoʻomaloli ʻana i ka lāʻau lapaʻau, e hoʻonui mālie ka nui. Hoʻololi i ka nui o ka dosage i 2.5 mg i kēlā me kēia lā ma hope o ʻelua mau pule a laila e 5 mg i kēlā me kēia lā ma hope o ʻelua mau pule he nui.

ʻO nā maʻi me ke kōmaʻi ma ka liʻiliʻi loahoʻokahi hou aku hiʻona

ʻO ka papa helu hoʻomaka ʻia ʻo 2.5 mg Tritace® i ka la.

Dosis titration a me ka hoʻomalaha dosage

Aia i ka hoʻomanawanuiʻana o ka waihona ikaika, hoʻonui pinepine ʻia ka dosage. Hoʻolako ʻia e pāpālua i ka pāpapa i 5 mg i kēlā me kēia lā ma hope o hoʻokahi a ʻelua mau pule a laila e 10 mg i kēlā me kēia lā ma hope o ʻelua a ʻekolu mau pule. ʻO ka nui maʻa ʻia i kēlā me kēia lā he 10 mg i kēlā me kēia lā.

ʻO nā mea maʻi me ka nephropathy non-diabetes / macroproteinuria ma luna o 3 g / lā

ʻO ka papa helu hoʻomaka ʻia ʻo 1.25 mg Tritace® i ka la.

Dosis titration a me ka hoʻomalaha dosage

Aia i ka hoʻomanawanuiʻana o ka waihona ikaika, hoʻonui pinepine ʻia ka dosage. Hoʻolako ʻia e pāpālua i ka nui o ka make i ka 2.5 mg i kēlā me kēia lā ma hope o ʻelua mau pule o ka lāʻau a laila i 5 mg i kēlā me kēia lā ma hope o ʻelua mau pule.

ʻO ka hikiʻole o ka puʻuwai naʻau

No ka poʻe maʻi me ka terapi diuretic ma mua, ʻo ke ʻano i hoʻomaka ʻia ka dosis ʻo 1.25 mg Tritace® i ka la.

Dosis titration a me ka hoʻomalaha dosage

Pono e hana i ka Titration ma ke kānalua i ka nui o Tritace® i kēlā me kēia pule a i ʻelua paha i kahi kiʻekiʻe o kēlā me kēia lā he 10 mg. Wehe ʻia ka hoʻokaʻawale ʻana i nā pāʻālua i ʻelua mau lā i kēlā me kēia lā.

ʻO ka prophylaxis ka lua ma hope o ka hoʻonā ʻana i ka maʻi myocardial koʻikoʻi me ka puʻuwai pu ʻole

ʻO ka inika kumu mua he 2.5 mg pālua i kēlā me kēia lā no 3 mau lā, a hoʻomaka e kau ʻia 48 mau hola ma hope o ka hoʻohālikelike myocardial i nā maʻi maʻi lapaʻau a me ka hemodynamically paʻa. Inā hōʻole iki ka make ʻana o ka 2,5 mg, a laila hoʻokaʻawale ʻia ka lāʻau i ʻelua inika o 1.25 mg no 2 mau lā a hiki i ka nui o ka dosage ke 2.5 mg a me 5 mg pālua i ka lā. Inā ʻaʻole hiki ke hoʻonui ʻia i kēia manawa a 2.5 mg pālua i kēlā lā i kēia lā, pono e hoʻokuʻu ʻia ka lāʻau.

E ʻike pū i ka dosage ma luna no nā mea maʻi e lawe ana i nā diuretics.

Dosis titration a me ka hoʻomalaha dosage

Hoʻonui pinepine ʻia ka nui o kēlā me kēia lā ma ke kānalua ʻana i ka nui ma waena o 1 a hiki i 3 mau lā i ka paʻahana i kēlā me kēia lā o 5 mg ʻelua i kēlā me kēia lā. Inā hiki, pono e hoʻokaʻawale ʻia ka papa mālama mālama ʻia i ʻelua iniha.

Inā ʻaʻole hiki ke hoʻonui ʻia i kēia manawa a 2.5 mg pālua i kēlā lā i kēia lā, pono e hoʻokuʻu ʻia ka lāʻau. Ma ka noʻonoʻo i ka mālamaʻana o nā maʻi me ka puʻuwai puʻuwai hōʻeha nui (NYHA papa IV) ma hope koke o ka myocardial infarction, ua palena wale nō ka ʻike. Inā hoʻoholo ia e pili ana i ka mālama ʻana i nā mea maʻi, e pono e hoʻomaka me ka nui o ka 1.25 mg i hoʻokahi lā i ka lā, a hoʻomaʻamaʻa nui ʻia me ka hoʻonui nui ʻana.

Nā Pūnaewele Pōkoki kūikawā

ʻO ka maʻi me ka hana renal impaired

Pono ka hoʻoholo ʻana o ka helu i kēlā me kēia lā i nā maʻi me ka hana renal impaired e pili ana i ka hana ʻana o ka creatinine:

- inā he kuhi creinine ≥ 60 ml / min, ʻaʻole pono i ke hoʻololi ʻana i ka wai ma mua (2.5 mg / lā), ʻoi loa ka nui o kēlā me kēia lā he 10 mg.

- inā ka clearance creatinine ma waena o 30-60 ml / min, ʻaʻole i hoʻololi ʻia ka dosage mua (2.5 mg / lā), ʻo ka nui loa ka nui o kēlā me kēia lā he 5 mg.

- inā ka clearance creince ma waena o 10-30 ml / min, ʻo ka nui o ka maʻa he 1.25 mg / lā, ʻo ka nui loa o ka lā ma kēlā me 5 mg.

- nā mea maʻi me ka maʻi hypertension e hana ana i ka hemodialysis: ke kāʻili maikaʻi ʻole ʻo ramipril e ka dialysis, ʻo ka nui o ka nui o ka helu 1.25 mg / lā, ʻo ka nui loa o ka lā helu nui he 5 mg. Pono e lawe ʻia ka lāʻau i kekahi mau hola ma hope o ka pau ʻana o ke kaʻina dialysis.

ʻO nā mea maʻi me ka hana pūlima hemahema

I ka poʻe maʻi me ka hana aho lēwa, ʻo ka Tritace therapy® ʻo ka hoʻomaka ʻana ma lalo o ka mālama ʻana i nā kauka olakino, ʻo ka nui loa o ka lā maʻamau o Tritace® he 2.5 mg.

ʻO ka dosis ma mua o kēia ʻōpū o nā maʻi e pono loa me ka haʻahaʻa, a me ka hoʻomohala o ka nui ma mua o ka nui ma mua o ka nui, no ka mea he nui ka hopena o nā hopena hopena i nā mea maʻi a me nā mea maʻi. ʻO ka helu haʻahaʻa haʻahaʻa haʻahaʻa o 1.25 mg o ramipril e pono e noʻonoʻo pono.

Triteke® ʻaʻole i hōʻike ʻia no ka hoʻohana ʻana i nā keiki a me nā ʻōpio ma lalo o 18 makahiki o ka makahiki ma muli o ka ʻike ʻole o ka ʻike i ka palekana a me ka hiki. Nui wale ke ʻike ʻana i ka ramipril i nā keiki.

E hoʻokuʻu i nā palapala a me ka ʻano

Oe ke kuai i ka lāʻau lapaʻau i ka form solid. ʻO ka mea nui i ka hoʻopili waiwai ʻo ramipril. I ka papa 1, loaʻa ka waihona i kahi paʻa o 2.5 mg. Aia nā koho ʻē aʻe no ka lāʻau lapaʻau: 5 a 10 mg. Ma nā kiko āpau, like nā ʻāpana liʻiliʻi. ʻAʻole ia e hōʻike i kēia mau mea i ka hana antihypertensive. E pili ana kēia:

haniailahion,
ke kumu pregelatinized
mikuleka
sodium stearyl fumarate,
nā vali.

I ka papa 1, loaʻa ka waihona i kahi paʻa o 2.5 mg.

Hiki iā ʻoe ke kūʻai i ka lāʻau i loko o nā pūpū he 2 mau blisters, ma kēlā me kēia 14 papa.

Mea i kuhikuhi ʻia

ʻO kekahi mau hōʻailona no ka hoʻohana ʻana i ka lāʻau lapaʻau:

hypertension aʻai (kū a me ke koʻikoʻi),
ka ole naʻau, ma kēia hihia, ua kuhikuhi ʻia ka lāʻau lapaʻau wale nō he ʻāpana o ka lāʻau paʻakikī,
system renal impaired i kumu o ka maʻi maʻi,
ka pale ʻana o nā kulekele o ka ʻōnaehana cardiovascular (stroke, myocardial infarction, etc.) i nā mea maʻi me ka ʻehaʻeha o kēlā ʻano pilikia,
ischemia cardiac, inā naʻe, pono ka lāʻau no nā poʻe i loaʻa i ka wā i hala a myocardial infarction, coronary artery bypass grafting, a i ka anioplasty arterial,
hoʻonāukiuki nā kūlana no nā hoʻololi i ke kūkulu ʻana o nā pā o nā paia o nā māla peripheral.

ʻO ka hōʻailona nui no ka lawe ʻana i ka lāʻau ka maʻi hypertension arterial.
Hoʻomaʻamaʻa ʻia ʻo Tritace no ka mau hewaʻole o ka ʻōnaehana, i hoʻonāukiuki ʻia e ka maʻi mellitus.
Ua kuhikuhi ʻia aku nei ʻo Tritace no ka neʻe ʻana i kaʻu ʻoihana.

Me ka mālama pono

Kēia mau helu pili contraindications:

hoʻololi i ka atherosclerotic i loko o nā paia o nā lāʻau,
nāwaliwali o ka puʻuwai
malignant hypertension,
hinake i ka lumen o nā kinela o nā keiki i loko o ka dinamics, i hoʻolako ʻia i kēia kaʻina hana wale nō ma kahi ʻaoʻao.
hoʻohana maʻalahi diuretic
ka nele o ke kahe i loko o ke kino e pale ai i ka hoʻopiʻi, ke nānā ʻana a me nā kūlana pathological ʻē aʻe,
hyperkalemia
maʻi mellitus maʻiʻi.

ʻAʻole kuhikuhi ʻia ka lāʻau lapaʻau no ka paʻakikī o ke ake a me ka pohō.
Ua hoʻohālikelike ʻia kēia lāʻau lapaʻau i ka hiki ʻole o ka pilikia.
Me ka mālama aka, hoʻohana ʻia ka lāʻau lapaʻau me ka loaʻaʻole o nā wai i loko o ke kino e kū'ē i ka luaʻi.

Pehea e lawe ai iā Tritace

ʻAʻole pono nā papa Chew. Koho ʻia ka lahui mālama lapaʻau me ka mālama ʻana i ke ʻano o ka pathological. I ka nui o nā hihia, e hoʻonui pinepine ʻia ka nui o ka hoʻolaʻa ikaika. Hoʻomaʻama pinepine ʻia a 1.25-2.5 mg o kēia māhele 1 ka manawa i kēlā me kēia lā. Ma hope o kekahi manawa, hoʻonui ka nui o ka lāʻau lapaʻau. I kēia hihia, ua hoʻoholo ʻia ka hopena i ka maʻi pākahi no kēlā me kēia maʻi, e noʻonoʻo ana i ka dinamika o ka maʻi. ʻO ka manawa pinepine, hoʻomaka lākou i kahi papa o ka mālamaʻana me ka 5 mg o ka lāʻau.

Me ka maʻi diabetes

Hoʻohana ka mea hana i kahi nui ʻaʻole iʻoi aku i ka 1.25 mg i kēlā me kēia lā. Inā kūpono, hoʻonui ʻia kēia dosis. Eia naʻe, hoʻoholo hou ʻia ka lāʻau i nā hebedoma ma hope o ka hoʻomaka ʻana o ka hoʻokele.

Me ka maʻi diabetes, e hoʻohana ʻia ka lāʻau lapaʻau ma ka nui ʻaʻole iʻoi aku i ka 1.25 mg i kēlā me kēia lā.

Pūnaehana pīhoihoi waena

ʻO nā poʻo, ka hōʻemi, ka haʻalulu o nā mea hoʻonui, hoʻemi i ka hoʻonaninani, ka nalowale o ke kaulike ma kahi kūlana kūpono, ka maʻi arterio coronary, i hele pū me ka pilikia o ke alapine.

Mai ka ʻaoʻao o ka pūnaehana pīhoihoi koʻikoʻi, aia paha nā poʻo ma hope o ka lawe ʻana iā Tritace.

ʻŌnaehana Endocrine

Hōʻino i nā hana biochemical: aia kahi a hōʻemi a hoʻonui paha i ka hoʻoweliweli ʻana o nā ʻano mea like ʻole (sodium, potassium, magnesium, calcium).

Mai ka ʻōnaehana musculoskeletal, hiki paha i nā ʻūpiki lāiwi ma hope o ka lawe ʻana iā Tritace.

Mai ka pānaʻi

Hoʻonui ka ʻike o nā antibiola antinuclear, ulu ke ʻano anaphylactoid.

ʻAʻole ia e kuhikuhi ʻia e hoʻokau i kahi kaʻa ma muli o ke kiʻekiʻe kiʻekiʻe o nā hopena maikaʻiʻole.

ʻO Urticaria, ka hele pū ʻana me ka minamina, ʻūnū, ʻulaʻula o kekahi mau ʻāpana o ka integument o ka waho a me ke ʻano nui.

Ke noi no ka hana renal haukapole

ʻO nā contraindications nā maʻi koʻikoʻi o kēia ʻōpū. ʻAʻole kuhikuhi ʻia ka lāʻau lapaʻau me ka hoʻohaʻahaʻa ʻana i ka cleince creatinine i 20 ml / min.

I ka ʻelemakule, pono e hana ʻia ka akahele, no ka mea aia nō he pilikia o ka hoʻemi ʻana o ke kaomi.

Hoʻopili pū me nā lāʻau ʻē aʻe

Hāʻawi i ka hopena o ka lāʻau lapaʻau i ka nīnau ʻana, pono e mālama ʻia i ka wā e koho ana i ka lāʻau lapaʻau no ka ʻoihana paʻakikī.

I ka hihia o kahi overdose, hoʻomohala paha nā abnormalities cardiac.

ʻO nā hui e koi ana i ka mālama

Kēia pū me kēia hui nā hua lāʻau e alakaʻi i ka emi ʻana o ke kaomi. Pono e nānā i ka pane o ke kino i ka wā e hoʻohana ai i ka heparin, ethanol a me ka sodium chloride.

ʻO ka inu ʻana i ka ʻawaʻawa ʻawaʻawa me ka huahana e nīnau ʻia ana, ʻaʻole ʻōlelo ʻia.

Hoʻolaha ka waipuna

ʻO ka inu ʻana i ka ʻawaʻawa ʻawaʻawa me ka huahana e nīnau ʻia ana, ʻaʻole ʻōlelo ʻia.

Pono e koho i nā lāʻau lapaʻau i hōʻike ʻia e nā wahi liʻiliʻi liʻiliʻi, akā i ka manawa like ia e hāʻawi i ka maʻamau maʻamau o ka hypertension a alakaʻi i ka lōkuhi o ka hypertrophy hypertrophy cardiac.

Hōʻikeʻike e pili ana iā Tritac

Kūkia ʻia ʻoe e loaʻa i ka ʻike he nui e like me ka hiki o ka pono o ka lāʻau lapaʻau. Kōkua kēia i ka loiloi o nā mea kūʻai aku a me nā ʻoihana.

Zafiraki V.K., cardiologist, 39 makahiki, Krasnodar

Me nā ala poloka o ka ʻōnaehana cardiovascular, hoʻohana pono kēia lāʻau lapaʻau: hoʻomaʻamaʻa ʻia ia i ke kahe koko a ʻaʻole i hoʻonāukiuki i nā hopena ʻaoʻao. Eia nō naʻe, i ka hapa nui o nā mea maʻi, ua hāliʻi ʻia nā maʻi concomitant, no ka mea he pilikia pilikia e kuhikuhi i kahi lāʻau lapaʻau - pono ka mālama pono ʻana i ke ʻano o ke kino.

Alanina E. G., lapaʻau, 43 makahiki, Kolomna

Pono e lawe ʻia kēia lāʻau lapaʻau, ʻaʻole hiki iā ʻoe ke hoʻonui i ka nui o kēlā me kēia lā, pono ʻoe e nānā i kou olakino. I ka manawa e kū mua mai ai nā hōʻailona maikaʻi ʻole, ua hoʻopau ʻia ke ala o ka mālama ʻana. ʻAʻole wau e hoʻopaʻapaʻa i ka hopena o ka lāʻau lapaʻau, akā hoʻāʻo wau e kākau i ka liʻiliʻi iki, no ka mea, he nui loa ka paʻakikī o ka hoʻouluʻana i nā hoʻonāukiuki koʻikoʻi.

Maxim, 35 makahiki, Pskov

I kekahi manawa ke lawe nei au i ka lāʻau lapaʻau, no ka mea ua lōʻihi koʻu maʻi. Hana koke ʻo ia. Ua kuhikuhi aku ke kauka i kahi puʻupuʻu liʻiliʻi, no ka mea, ʻaʻohe pilikia koʻikoʻi au. No kēia kumu, ʻaʻole i hopena ka hopena.

Veronika, 41 makahiki, Vladivostok

Ma muli o nā pilikia me nā moku, lele kaomi pinepine. Hoʻololi pinepine wau i ka lāʻau antihypertensive ma ke kau ʻana o ke kauka. Ua hoʻāʻo wau e lawe i nā lāʻau like ʻole. He kūpono loa ka lāʻau lapaʻau i ka nīnau, no ka mea ke ʻike koke ʻia ka hopena. Akā, he mea hoʻoikaika kolohe kēia. Hoʻohana pinepine wau iā ia ma mua o nā analogue.