Pehea e hoʻohana ai i ka lāʻau lapaʻau Tritace?

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.