ʻO Hartil Amlo: nā ʻōlelo aʻoaʻo no ka hoʻohana

Nā ʻatikā ʻO 5 mg + 5 mg, paʻakikī, gelatin, CONI-SNAP 3, ʻaʻole i hoʻohālikelike ʻia, pani pono ʻia, me kahi waihona ʻokaʻake ma ke kukui burgundy a me ka uhi uhi opaque i burgundy māmā.

PRING crospovidone (E-1202), hypromellose (E-464), cellulose microcrystalline (E-460), glycerol dibehenate.

ʻO ka hoʻonohonohoʻana o ka kapsul CONI-SNAP 3: ʻulaʻulaʻula (E-133), ʻulaʻulaʻula (E-129), titanium dioxide (E-171), gelatin.

7 pcs - nā laka i hana ʻia mai o PVC / Polyamide / Aluminum (4) - nā kīʻaha pepa.
7 pcs - nā laka i hana ʻia mai o PVC / Polyamide / Aluminum (8) - nā kīʻaha pepa.
10 kamepiula - nā laka i hana ʻia mai o PVC / Polyamide / Aluminum (3) - nā kīʻaha pepa.
10 kamepiula - nā laka i hana ʻia mai o PVC / Polyamide / Aluminum (9) - nā kīʻaha pepa.

Ka hana lāʻau lapaʻau

Ka hana o ka hana o ka ramipril

ʻO Ramiprilat, kahi metabolite ikaika o ka prodrug ramipril, ke kāohi nei i ka enzyme dipeptidyl carboxypeptidase I (ʻonymsninoa: angiotensin-hoʻohuli i ka enzyme, kininase II). I loko o ka plasma a me nā ʻili, hoʻokomo kēia enzyme i ka hoʻololi ʻana o ka angiotensin I i kahi ʻano vasoconstrictor ikaika - angiotensin II, a hāʻawi pū hoʻi i ka hōʻino o ka waiwai vasodilator ikaika - bradykinin. ʻO ka hōʻemi i ka hoʻokumuʻana o ka angiotensin II a ke kāohi nei i ka hōʻino o ka bradykinin e alakaʻi i ka vasodilation.

Mai ka hoʻoulu ʻana o ka angiotensin II i ka hoʻokuʻu ʻana o ald testosterone, hōʻemi ka ramiprilat i ka huna ʻana o ka aldosterone. ʻO ka pane iki i ka monotherapy me kahi ACE inhibitor ma lalo i ka heluna o nā poʻe maʻi ʻeleʻele (Afro-Caribbean) me nā maʻi hypertension (he poʻe nui o nā mea maʻi me ka hypertension a, ma ke ʻano he laʻana, me ka haʻahaʻa renin haʻahaʻa) ma mua o nā mea maʻi me nā ʻāpana ʻokoʻa.

Hoʻohana ʻia ka hoʻohana ʻana me ka ramipril i kahi hoʻokaʻawale i hōʻailona ʻia i ka hoʻihoʻi ʻana i ka hana kuahi peripheral. Ma ke kānāwai, ʻaʻole i loli nui ka lāʻau lapaʻau i ke kahe koko a me ka hopena filtration glomerular. Hoʻohana ʻia ka hoʻohana ʻana ʻo ramipril e kahi hopena antihypertensive, ʻelua i ke kū i ke kūlana o ka mea maʻi a me ka noho hoʻopunipuni, a ʻaʻole ka hopena o ka lāʻau lapaʻau i ka tachycardia compensatory.

Ma hope o ka lawelawe waha hoʻokahi o ka ramipril, ʻike ʻia kona hopena antihypertensive i loko o 1-2 mau hola, hiki loa i ka lōʻihi ma hope o 3-6 mau hola a lōʻihi no nā hola 24. Me kahi lā o ka ramipril, e hoʻonui mālie kona hopena antihypertensive ma luna o 3-4 mau pule a hoʻomau me ka holomua lōʻihi.

ʻO ka wehe koke ʻana o ka ramipril ʻaʻole i ukali ʻia e ka piʻi wikiwiki o ka kahe koko.

Ke hana o ka hana a amlodipine

Hoʻopili ʻia ʻo Amlodipine i ka hoʻopili ʻana o ka ion o ka calcium i ka cardiomyocytes a me nā pakanui palupalu vascular (a "lohi" aanini ke kīwī, a me ka calcium antagonist pū kekahi).

ʻO ka hoʻokūkū o kona hopena antihypertensive ma muli o kahi hopena hoʻomaha hoʻomaha i ka neʻe o nā io o nā moku koko, e hōʻemi ana i ka pale a vipula peripheral.

ʻO ka wehewehe kikoʻī e pili ana i ka kaomi e hoʻomaʻamaʻa ʻia ai ke ʻano o ka angina pectoris ʻaʻole i paʻa, akā hiki i kēia hana ke hana i nā ʻaoʻao ʻelua:

1) ka hoʻonui ʻana o ka uhaia peripheral, a, no laila, ke kahe nei o ka huakaʻi pale āiwaʻi peripheral (afterload).

ʻOiai ka mea ʻaʻole ka kumu o ka lāʻau e hoʻoneʻe i ka tachycardia reflex, e emi ka nui o ka nui o ka myocardium a me nā mea e pono ai ke kanu o ka oxygen.

2) ka hoʻonui ʻana o ka lāʻau nui coronary a me nā arterioles coronary, ʻelua i hoʻololi ʻia a ma nā ʻehā ischemic o ka puʻuwai puʻuwai, hoʻonui i ka kahe o ka oxygen i ka myocardium.

Hoʻonui ka mīkini i ka lako o ka oxygenocococial myocardial ka nui o nā spasms o ka coronary arteries (variant angina a me Prinzmetal angina).

I nā mea maʻi me ka haehae maʻi, hoʻokahi ʻāpana o kēlā me kēia lā ʻo amlodipine e hāʻawi i kahi nui o ka nui o ka nui o ke kahe koko i loko o kahi mau hola 24 (i ka "noho" maʻi a me ka "kū" kūlana). Ma muli o ka hōʻike lohi ʻana i ka hana a me ka hopena lōʻihi, ʻaʻole i hoʻonā ka lāʻau i ka maʻi hypotension.

I ka poʻe maʻi me ka angina pectoris, hoʻokahi pākahi hāmeʻa i kēlā me kēia lā e hoʻonui i ka hoʻomanawanui, hoʻopau i ka hoʻomohala hou ʻana o ka hoʻouka ʻana i ka angina pectoris a me ka "ischemic" hōʻeha o ka māhele ST, a e hōʻemi ana i ka huina o ka hoʻouka ʻana a angina a me ka hoʻohanaʻana i ka nitroglycerin. ʻAʻole make ka hopena i ka hopena metabolic i ka hopena: ʻaʻole i pili i ka lipids plasma, ke kō o ke koko a me ka waikū serum uric a hiki ke kuhikuhi i nā poʻe maʻi me ka hānō.

Nā ʻIkepili Pono preclinical

E pili ana i ramipril:

Me ka hoʻokolima waha o ka hipa ramipril i ka rodents a me nā ʻīlio, ua ʻike ʻia ka lāʻau lapaʻau ʻaʻole e hoʻopili i ka nui o ka make i nā holoholona. ʻO nā haʻawina e hoʻohana ana i ka hoʻokele waha paʻa ʻana o ka lāʻau i mālama ʻia i nā lālau, ʻīlio, a me nā mea nui. I nā holoholona ʻekolu o nā holoholona holoʻokoʻa, ua hoʻololi ʻia nā loli i loko o ka paʻa ʻana o nā electrolytes plasma a me nā loli i ke kiʻi koko.

I ka hōʻike ʻana o ka hana pharmacodynamic o ramipril, ua nānā ʻia ka hoʻomohala ʻana o ka juxtaglomerular complex hypertrophy i loko o nā ʻīlio a me nā mau lekioma i hoʻokahi lā o 250 mg / kg / lā. ʻOi ka male, nā ʻīlio, a me nā mea nui i hoʻomanawanui i ka lā i nā lā 2, 2.5, a me 8 mg / kg (koʻikoʻi ke kino) / lā, kēlā me kēia, me ka hopena ʻole.

Nā haʻawina o nā hopena o ka hopena o ka lāʻau lapaʻau ma ka wahi e hoʻohālikelike ai i nā mea lālani, nā pōpoki a me nā mea nui nā mea i hōʻike ʻole i kekahi hopena teratogenic o ramipril. ʻAʻole hōʻike nā kāne a me nā luahine wahine i loli i ka loli.

ʻO ka hoʻopuka ʻana i ka ramipril i nā kiʻi wahine i ka wā o ka wā fetal a i ka manawa o ka lactation i loko o kahi lā i kēlā me kēia lā he 50 mg / kg paona kino (a ʻoi aku paha) i hele pū ʻia e nā pōʻino i hiki ʻole i ka lolo (hoʻonui i ka pelalela) o ka maʻi wahine.

Ma nā noi nui nui e hoʻohana ana i nā ʻōnaehana ho'āʻo nui, ʻaʻohe mau hōʻailona o ka mutagenicity a i ʻole genotoxicity o ka ramipril.

E pili ana i ka amlodipine:

I nā kiʻī a me nā kiʻekiʻi i hoʻohui ʻia me ka male amlodipine i loko o nā kukū ʻai ʻana a hiki i ʻelua mau makahiki i nā kukuna e pili ana i nā kiʻekiʻe o nā lā he 0.5, 1.25 a me 2.5 mg o ka amlodipine / kg (kaumaha o ke kino) / lā, ʻaʻole i ʻike ʻia ka hopena carcinogenic. ʻO ka hopena kiʻekiʻe loa ma nā kiole (ma nā ʻōlelo o mg / m 2) i hoʻohālikelike ʻia me ka nui o ke kanaka i koho ʻia (MHD) o 10 mg amlodipine i kēlā me kēia lā. ʻO ka hopena kiʻekiʻe loa ma nā kiʻi (ma ka ʻōlelo o mg / m 2) ka mea i kokoke i ʻelua mau manawa ma mua o ka MPD.

I loko o nā haʻawina o ka amlodipine maleate, ʻaʻohe hōʻailona o ka mutagenicity i kumu o ka hoʻohana ʻia ʻana o ka lāʻau lapaʻau, ʻelua ma nā pae gen a i ka pae o nā chromosomes.

ʻO ka palupalu i nā mauʻaoʻao i hāʻawi ʻia i ka male amlodipine oralally ma kahi o ka piʻi a hiki i 10 mg / kg (ka nui o ke kino) / lā (i, ma ke ʻano o ka mg / m 2, he 8 mau manawa ke kiʻekiʻe o ka MPD o 10 mg / lā) ʻaʻole i hoʻopiʻi.

Hoʻohui nūhou

E pili ana i ramipril:

Nā hana Extracorporeal e pili ana i ka hoʻopili ʻana i ke koko me nā papa hewa hoʻopiʻi hewa ʻole, e like me ka hemodialysis ma o nā membranes ākea (e.g. membranes i haku ʻia mai nā pūhui polyacrylonitrile), hemofiltration a apheresis o lipoproteins haʻahaʻa haʻahaʻa me ka hoʻohana ʻana i dextran sulfate, no ka hoʻonui nui o ka hoʻomohala ʻana i ka anaphylactic a i ʻole anaphylactoid. Inā pono e mālama ʻia ia ʻano hoʻomaikaʻi, a laila pono e noʻonoʻo ʻia ka hoʻohana ʻana o kēlā me kēia ʻano o ka membrane no ka dialysis a i ʻole nā ​​lāʻau antihypertensive o kahi ʻano ʻokoʻa ʻē aʻe.

Hoʻomaʻamaʻa no ka hoʻohana

Me ka hoʻokolohua mau ʻana me ka mākaukau potasi, hiki i ka capi-mālama mālama i nā diuretics a me nā mea ikaika e hoʻonui ai i nā pae pākela plasma (me ka neʻe ana ʻo kaiotropin II receptor antagonists, trimethoprim, tacrolimus, cyclosporine): hiki i ka hoʻomohala ʻana o ka hyperkalemia, no laila e pono e nānā pono i ka pae o ka paʻakai i ka sima o ke koko.

ʻO nā lāʻau antihypertensive (e. G., Diuretics) a me nā mea waiwai e hiki ke hoʻohaʻahaʻa i ke kahe koko (e.g., nitrates, tricyclic antidepressants, painkillers, alkohol, baclofen, alfuzosin, doxazosin, prazosin, tamsulosin, terazosin): e lilo paha ka hopena o ka hypotension.

ʻO ka Vasopressor sympathomimetics a me nā mea waiwai ʻē aʻe (no ka laʻana, isoproterenol, dobutamine, dopamine, adrenaline) hiki ke hōʻemi i ka hopena antihypertensive o ramipril: ua mālama ʻia ka nānā ʻana i ke koko.

Allopurinol, immunosuppressants, corticosteroids, procainamide, cytostatics a me nā lāʻau ʻē aʻe e hiki ai ke hoʻololi i ka nui o nā pili koko: he nui ka hopena o ka hoʻomohala ʻana i nā hopena hematological.

ʻO ka paʻakai Lithium: ʻoiai e lawe ana i nā inhibitor ACE me ka mākaukau lithium, hiki ke hoʻēmi i kāna excretion a, ma laila, e hoʻonui ai i ka ʻike o ka lithium i loko o ke koko me kahi piʻi aʻe ma hope o kāna mau hana hoʻonā. Pono ka nānā ʻana i nā pae lithium.

ʻO nā hui antidiabetic, me ka insulin: e ulu paha nā hopena hypoglycemic. Kuhi ʻia aku nei e kāohi i ka pae o ka glucose i ke koko.

ʻO nā lāʻau anti-inflammatory nonsteroidal a me ka acetylsalicylic acid: kahi hōʻemi i ka hopena antihypertensive o ka ramipril. Eia kekahi, ʻo ka hoʻohana pū ʻana o ka ACE inhibitors a me NSAIDs hiki i ka hoʻomohala ʻana i ka hyperkalemia a hoʻonui i ka hopena o ka hana renal impaired.

E pili ana i ka amlodipine:

Hōʻoluʻolu ka lāʻau lapaʻau me ka diuret thiazide, beta-blockers, lōʻihi nitrates, sublingual dosage form of nitroglycerin, non-steroidal anti-inflammatory drug, antibiotics and oral hypoglycemic drug.

Ka hopena o nā lāʻau ʻē aʻe ma ka amlodipine

- Nā mākaʻikaʻi CYP3A4: i ka wā e hoʻohana ai ka lāʻau me ka CYP3A4 inhibitor, erythromycin i nā poʻe ʻōpio a me ka diltiazem i nā maʻi maʻi maʻi, ma kēlā me kēia, ke kaila o ka plasma o nā amlodipine e hoʻonui, ma kēlā me kēia, ma ka 22% a me 50%. Eia nō naʻe, ʻaʻole maopopo ka ʻike koʻikoʻi e pili ana i kēia kūlana. ʻAʻole hiki ke hoʻokaʻawale ʻia kēlā me nā mea paʻa CYP3A4 ikaika (no ka laʻana, ka ketoconazole, itraconazole, ritonavir) hiki ke hoʻonui i ka kukuna plasma o ka amlodipine i kahi nui aʻe ma mua o diltiazem. Pono e hoʻohana ʻia ʻo Amlodipine me ka akahele me ka wā e hoʻokūkū pū ʻia me nā mea hoʻopaʻa CYP3A4. Eia naʻe, ʻaʻohe mea i hōʻike i kekahi mau hopena pili i pili pū i kēia pili.

- inducers CYP3A4: ʻaʻohe mea e hōʻike i ka hopena o nā lawelawe manuahi CYP3A4 ma amlodipine. ʻO ka hoʻohana pū ʻana o ka lāʻau me ka CYP3A4 inducers (no ka laʻana, he rifampicin a i ʻole wort St. John) hiki ke hoʻohaʻahaʻa i ka plasma o ka amlodipine. Pono e hoʻohana ʻia ʻo Amlodipine me ka akahele i ka wā i hoʻohana pū ʻia me CYP3A4 inducers.

I nā haʻawina haʻalulu o nā lau o nā lāʻau, ʻaʻole i hoʻopili ʻia ka hoʻohana ʻana o ka amlodipine me ka wai huapuni, cimetidine, alumini / magnesium (antacids) a me ka sildenafil, ʻaʻole i pili i ka pharmacokinetics o amlodipine.

ʻO ka hopena o ka amlodipine ma luna o nā lāʻauʻokoʻa

Hoʻohui ʻia ka hoʻohana ʻana o ka amlodipine me nā lawena antihypertensive e hoʻomaikaʻi ana i kā lākou therapeutic efficacy.

Ma nā haʻawina loiloi o ka hoʻopili ʻana i ka lāʻau, ʻaʻole i pili ka amlodipine i ka pharmacokinetics o atorvastatin, digoxin, ethanol (ethanol), warfarin, a i ʻole cyclosporine.

ʻAʻohe hopena o ka amlodipine ma nā loli i loko o nā hoʻokolohua hōʻoia.

Ka hoʻoponopono ʻia ʻana

ʻO ka papa i ʻōlelo ʻia i kēlā lā i kēia lā he 1 mau kō me kahi laʻau i kuhikuhi ʻia. E lawe ʻia ʻo Hartil ® Amlo i kēlā me kēia lā, ma ka manawa like, ma mua o ke kīʻaha ʻana. ʻAʻole ʻoki ʻia a ʻōmaʻomaʻo paha nā kapikala.

ʻAʻole kūpono ia kahi lāʻau lapaʻau paʻa paʻa no ka hoʻomaka mua o ka lāʻau. Inā aia kekahi no ka hoʻoponopono ʻana o ka dosage, a laila e lawe wale ʻia ia me ke kōkua o monocomponents a wale nō ma hope o ke kū ʻia ʻana o kēlā hāmeʻa hiki iā mākou ke hoʻololi i kahi ʻano hou o ka lāʻau me kahi ʻākana i ʻōlelo ʻia ai ka lāʻau Hartil ® Amlo.

Nā pāʻelemakule: pono ʻo ia e kuhikuhi i ka lāʻau lapaʻau me ka mālama ʻana i nā poʻe maʻi e lawe ana i ka diuretics, ʻoiai ʻo kēia mau mea maʻi e hoʻokuʻi ʻia ka pae wai-electrolyte. Pono e hoʻopaʻa i ka hana renal a hoʻoholo i ke ʻano o ka paʻakai i ka serum koko.

I ka poʻe maʻi me ka hana o ka puʻuwai maʻi, hiki i ka lōʻihi ke hoʻopau i ka amlodipine. ʻAʻole i hoʻoholo ʻia nā ʻōlelo hōʻike e pili ana i ka make ʻana o ka amlodipine, akā pono e kuhikuhi ʻia ka lāʻau lapaʻau i kēia mau mea maʻi me ka akahele loa. I ka poʻe maʻi me ka hana maʻi lēwa, pono e hoʻomaka ʻia ka lāʻau ramipril ma lalo o ka mākaʻi ʻana o ka lāʻau lapaʻau, a ʻo ka nui ʻana o ka nui o kēlā me kēia lā e 2.5 mg o ramipril.

Manaʻo ʻia e kuhikuhi ʻia ʻo Khartil ® Amlo i kēlā mau mea maʻi i hoʻolaʻa ʻia i ka 2.5 mg o ramipril aʻoi aku ka maikaʻi o ka mālama pono ʻana ke koho ʻana i ka nui o ka ramipril.

I mea e hoʻoholo ai i ka hui like ʻana o nā pali a me ka mālama mālama pono ʻana i ka poʻe maʻi me ka hana pūpū maʻi ʻole, pono ke koho pono ʻia ka nui o ka lāʻau lapaʻau ma o ka hoʻoholo ʻana i nā hala o ka ramipril a me amlodipine.

ʻAʻohe pono e hoʻoponopono i ka hōʻike ʻana o ka amlodipine i nā mea maʻi me ka hana ʻoi aku ka maʻi lēwa.

ʻAʻole i hoʻopili ʻia ʻo Amlodipine i ka wā o ka dialysis. ʻO ka poʻe maʻi e kau ana i ka dialysis, pono e kuhikuhi ʻia ka amlodipine me ka makaʻala loa.

Pono e hoʻolako ʻia ka pākaʻi o kēlā me kēia lā i ka poʻe maʻi me ka hala ʻole o ka hana ʻana i ka hana me ka hoʻomaʻemaʻe kuhi.

- Inā ʻo cleince clearance he ≥60 ml / min, a laila ʻaʻole pono ke hoʻoponopono mua ʻia, ʻo ka nui loa ma mua o kēlā me kēia lā he 10 mg.

- Inā ʻo cleince clearance is ® Amlo, pono e kuhikuhi wale aku inā ua hoʻohuli ʻia ka mea maʻi i ka ramipril dosing regimen o 2.5 mg a i ʻole 5 mg ʻo ia ka pae mālama mālama maikaʻi loa (i hoʻokumu ʻia i ka wā ramipril). Pono nā mea maʻi e kau ana i ka hemodialysis i ka lāʻau lapaʻau i kekahi mau hola ma hope o ka hemodialysis.

Ma ke kaʻina hana i mālama ʻia me ka lāʻau ʻo Hartil ® Amlo, pono ke hana pono o nā pūpū a me ka ʻikepili i loko o ka serum koko. Ma kahi e hōʻemi ai i ka hana haki, pono e hoʻokaʻawale ʻia ka hoʻohana ʻana i ka lāʻau ponoililililil ʻAillo, a pono e kuhikuhi ʻia kāna mau ʻāpana i nā dosis i hoʻoponopono ʻia ma kahi kūpono.

Hiki i nā maʻi ʻōpiopio ke lawe i nā ʻōhua maʻamau o ka amlodipine, akā naʻe, pono e mālama ʻia e hoʻonui i ka nui o ka lāʻau.

Pono e hoʻohaʻahaʻa ʻia ka mua o ka ramipril ma mua o ka mea maʻamau, a ʻoi aku ka palupalu ma mua o ke ʻano loiloi, ma muli o ka nui o ka hopena ʻoi aku ka hopena.

ʻAʻole ia e kuhikuhi i koho iā Hartil ® Amlo i nā mea maʻi kahiko a nāwaliwali.

ʻAʻole ia e kuhikuhi i kuhikuhi i a Hartil ® Amlo no nā keiki a me nā ʻōpio ma lalo o ka makahiki 18, ʻoiai, ʻaʻole i hoʻoholo ʻia ka palekana a me ka hana o ka lāʻau lapaʻau ma kēia pūʻulu o nā mea maʻi.

Nā hōʻailona no ka hāpai ʻana

E pili ana i ramipril

ʻAʻohe mea e hoʻolōʻihi ʻia ka hoʻohana ʻana o nā IPF inhibitor i ka manawa o ka mākō mua o ka hapai ʻana, a i ka wā o ka trimesters lua a me ke kolu o ka hapai ʻana, ua contraindicated ka hoʻohana ʻana o nā IPF inhibitors.

ʻO ka hōʻike epidemiological o ka hopena o ka teratogenicity ma hope o ka hoʻolaha ʻana i nā inhibitor ACE i ka manawa mua o ka maʻa o ka wā ʻo ka hoʻomaka ʻana o ka hapai, ʻaʻole ia he hōʻoiaʻiʻo, akā he liʻiliʻi iki i ka hopena ʻole. Inā aia kahi e hoʻomau i ka hana me ka hoʻohana ʻana o ka inhibitions ACE / APAT II, ​​a laila pono nā mea maʻi e hoʻolālā nei i ka hapai e hoʻololi i kā lākou therapeutic hoʻoponopono i kahi ʻano antihypertensive hou e kū nei i nā koi palekana no kona hoʻohana ʻana i ka wā hāpai. I ka wā e hoʻopaʻa ʻia ai ka male ʻana, pono e hoʻokuʻu koke ʻia ka mālama ʻana me ka ACE inhibitors a, inā pono, pono e hoʻomaka ʻia nā lāʻau aʻoaʻo hou.

Hōʻike i ka hoʻonaʻauao ACE i ka wā o ka trimesters lua a me ke kolu ua ʻike ʻia i ka hoʻomaka ʻana o ka fetotoxicity i nā kānaka (ke kīnā ʻana i hoʻomohala ʻia o ka ʻōpū o ka pēpē, oligohydramnios, ka hoʻolohi ʻana i ka ossification o ka ʻuā) a me nā mea momona (neonatal failed, hypotension, hyperkalemia). Inā hele ka ʻike i nā mea pale o ACE i ka wā o ka hapalua o ka hāpai ʻana, e pono ʻia e hana i kahi ultrasound o ka hana o ke keiki a me ka hoʻomohala ʻana i nā iwi ʻōpala. ʻO nā pēpē i hāpai ʻia e ko lākou mau māmā i ka ACE inhibitors no ka hoʻomohala pono ʻana o ka hypotension, oliguria a me hyperkalemia.

E pili ana i ka amlodipine

ʻAʻole paʻa nā palekana o ka amlodipine i ka wā hāpai o ka wahine. Hōʻike nā haʻawina o ka hana hoʻohua i nā lāliiki i ka loaʻa ʻole o nā hōʻailona o nā palaka, me ka hoʻokaʻawale ʻana o ka hana ma hope aku a me ka lōʻihi lōʻihi, me 50 mau manawa ʻoi i ka nui o ke kō i mālama ʻia no nā kānaka. Hoʻohana ʻia ka hoʻohana ʻana i ka lāʻau lapaʻau i ka wā ʻo ka hapai i ka lilo ʻole o nā ala palekana palekana ai ka wā i hopohopo ʻia ai kahi maʻi koʻikoʻi i ka makuahine a me ka maʻi hānau.

E pili ana i ramipril

No ka mea, ʻaʻole i lawa ka ʻike e pili ana i ka hoʻohana ʻana o ka ramipril i ka wā e hānai ʻia ai, ʻaʻole ʻōlelo ʻia ka hoʻohana ʻana o ka ramipril i kēia manawa, ʻoi aku ka maikaʻi o ke koho ʻana i nā ʻano hana olakino e pili ana i ka hānai ʻana i nā mea palekana i ka wā o ka umauma, ʻo ia hoʻi no ka hānai ʻana i nā pēpē hou a me nā pēpē.

E pili ana i ka amlodipine

ʻAʻohe ʻikepili ma ka alakiʻi ʻana o ka amlodipine me ka waiū waiū. ʻO ka hoʻoholo e hoʻomau / pani i ka pale umauma a i ʻole e hoʻomau / hoʻopau i ka ʻoihana me ka amlodipine e pono e noʻonoʻo pono i nā pono o ka hana umauma o ka pēpē a me nā pono o ka lāʻau amlodipine no ka makuahine.

Nā ʻōlelo kikoʻī

E pili ana i ramipril:

Nā hui kelepona kūikawā

ʻAʻole i ʻae ʻia ka ACE inhibitors i ka wā hāpai. Inā aia kahi e hoʻomau i ka hana me ka hoʻohana ʻana i ka inhibitions ACE, a laila hoʻololi nā mea maʻi e hāpai i ka hapai e hoʻololi i ka hoʻoponopono hou ʻana i ke ʻano antihypertensive hou, ʻo ia ka hoʻokō i nā koi palekana no ka hoʻohana ʻana i ka wā hapai. I ka manawa e hōʻoia ʻia ka hopena o ka hapai, e hoʻopau koke ʻia ka lāʻau me ka hoʻohana ʻana i nā pale o ACE, a inā pono, pono e hoʻomaka ʻia ka hoʻohana ʻana i nā ʻano aʻoaʻo.

ʻO nā maʻi me ka piʻi nui o ka maʻi hypotension:

- Nā mea maʻi me ka renin-angiotensin-aldosterone ka pauna kālā:
nā mea maʻi me ka renin-angiotensin-aldosterone ka pauna nui e pili ana i ka hopena nui o ka hina o ke kahe o ke koko a me ka hana ʻana i nā mea hana luhi ma muli o ke neʻe ʻana o ka ACE, ka mea nui i ka wā o nā ACE inhibitors a i ʻole e hana i ka diuretics e hoʻohālikelike ʻia i ka manawa mua a i hoʻōla ʻia ko lākou dosage no ka manawa mua.

Inā ʻike ka ʻike o ka hyperactivation o ka ʻōnaehana renin-angiotensin-aldosterone, a laila inā pono, e hoʻonohonoho i nā mālama olakino, me ka mālama ʻana i ke kaomi o ke koko:

- i nā mea maʻi me ka maʻi hypertension kiʻekiʻe,

- i nā mea maʻi me ka puʻuwai naʻau decompensated,

- i nā mea maʻi me ka hemodynamically i hōʻike i ka hūnā hala a i waho paha mai ka ventricle hema (no ka laʻana, ka stenosis o ka aorta a i ʻole mitral valve).

- i nā mea maʻi me ka stenosis unilateral o ka aralopa ʻaʻa me kahi lua o ka hana,

- i nā mea maʻi me nā mea ʻeha a loaʻa ʻole (a i ʻole nā ​​hanana paha) i ka pae wai-electrolyte (me nā mea maʻi e lawe ana i nā diuretics),

- i nā mea maʻi me ka cirrhosis a me / a i nā ascites paha.

- i nā mea maʻi i hana i ka hana ʻoki loa, a i ʻole ia e hana i ka anesthesia me ka hoʻohana ʻana i nā lāʻau lapaʻau e hoʻokau nei i ka hypotension,

Ma kahi ākea, ua manaʻo ʻia e hoʻoponopono ʻia nā dehydration, hypovolemia, a i ʻole hemahema ka paʻakai ma mua o ka hoʻōmi ʻia (ma nā mea maʻi me ka puʻuwai puʻuwai, akā naʻe, pono ke kaupaona ʻia nā mea hoʻomaikaʻi a me nā mea ʻē aʻe o ia mau ʻano.

- i nā mea maʻi me ka transient (transient) a i ʻole ka mauʻu naʻau paʻa ma hope o MI,

- i nā mea maʻi e hōʻemi ana i ka hoʻomohalaʻana i ka ischemia cardiac a i ʻole cerebral paha i nā hihia o ka hypotension koʻikoʻi.

I ka hoʻomaka mua o ka mālama ʻana, pono ke nānā ʻia o ka maʻi lapaʻau kūikawā.

Manaʻo ʻia e hoʻōki i ka hoʻohana ʻana i ka angiotensin-hoʻohuli i ka inhibitor enzyme, e like me ka ramipril, i hoʻokahi lā ma mua o ka hana ʻana, inā hiki.

ʻO ka nānā ʻana me ka nānā ʻana i nā pēpē

Pono ke ʻano o ka hana a Renal ma mua o ka wā o ka mālama ʻana, a hoʻoponopono ʻia ka nui o nā lāʻau, ʻoi aku hoʻi i nā hebedoma mua o ka mālama ʻana. No ka poʻe maʻi me ka pono kīkino, pono pono e nānā pono. Aia kahi hopena o ka hana renal impaired, ʻoi aku i nā mea maʻi me ka puʻuwai naʻau congestive a i ʻole ma hope o ke hoʻololi ʻana i ka maʻi.

ʻO ka hopena o ka angioedema i nā maʻi e lawe ana i ka inhibitor ACE, me ka ramipril, ua hōʻike ʻia.

Inā hele mai ka angioedema, pono e hoʻokuʻu ʻia ka ramipril. Ua kuhikuhi koke ʻia nā wahi a me nā ʻano o ka maʻi hoʻokele. Pono ka nānā ʻana o ka mea maʻi no ka liʻiliʻi o 12-24 mau hola, a hoʻokuʻu i ka hoʻokele ʻana ma hope o ka hopena o nā hopena.

ʻO ka hōʻea ʻana o ka angioedema intestinal ua hōʻike ʻia i nā mea maʻi e lawe ana i ka inhibce ACE, me ka ramipril.

Ua hoʻopiʻi kēia mau mea maʻi me ka hōʻeha o ka ʻōpū (me a ʻole paha nā hōʻailona o ka nausea a i ʻole ka luaʻi).

ʻO ka hoʻohana ʻana o ka inhibce ACE e hoʻonui i ka hiki i ka anaphylactic a me ke ʻano anaphylactoid (a me ko lākou koʻikoʻi) i nā mea make pika a me nā mea like ʻole. A pau ka desensitization, pono e hāʻawi ʻia ka noʻonoʻo ʻana no ka hoʻokuʻu ʻana i kahi manawa ramipril.

Ua nānā ʻia ʻo Hyperkalemia i kekahi mau mea maʻi e lawe ana i ka inhibitor ACE, me ka ramipril. ʻO ka hui o nā mea maʻi me ka nui o ka pilikia o ka hyperkalemia e pili ana i nā mea maʻi me ka hōʻino ʻole o ka maʻi, nā mea maʻi ma waena o nā makahiki 70 (ʻoi aku ka 70 mau makahiki he nui), nā mea maʻi me ka diabetes mellitus ʻaʻole i kiaʻi ʻia, a i nā mea maʻi e lawe nei i ka paʻakai pālolo, pākuhi āpau pākuhi a me nā mea hana ikaika e hoʻonui ai i ka pae o ka paʻakai plasma ke koko, me nā mea maʻi me nā kūlana e like me ka dehydration, ka huhū o ka puʻuwai, a i ʻole metabolic acidosis. Inā noʻonoʻo ʻia ka hoʻohana pinepine ʻana o nā lāʻau lapaʻau ma luna, e pono ke nānā pono i ka nānā pinepine ʻana i ka pae o ka pāhana ma loko o ka serum koko.

Aia he hōʻike laha maʻamau o nā hihia o ka neutropenia / agranulocytosis, thrombocytopenia a me ka anemia, pū ka pu me ka momona o ka iwi. No ka ʻike mua loa i ka leukopenia, ʻike ʻia e kāohi i ka helu leukocytes. Hoʻomaopopo pinepine ʻia ka mālama ʻana i ka laʻi mua o ka mālama ʻana i waena o nā poʻe maʻi me ka hana pūpū o ka maʻi haki, a me nā mea maʻi me nā kolone concomitant (no ka laʻana, lupus erythematosus a scleroderma), a i nā mea maʻi āpau e lawe ana i nā lāʻau lapaʻau ʻē aʻe e hiki ai ke hoʻololi i ke kiʻi o ke koko.

Hoʻonui ka ACE inhibitors i ka ulu ʻana o ka angioedema i nā maʻi ʻeleʻele i hoʻohālikelike ʻia me nā mea maʻi me nā ʻāpana ʻokoʻa.

E like me nā inhibitions ACE ʻē aʻe, ʻoi aku ka liʻiliʻi o ka ramipril ma ka hoʻohaʻahaʻa ʻana i ke koko koko i nā maʻi ʻeleʻele i hoʻohālikelike ʻia i nā mea maʻi me nā ʻili ʻokoʻa. ʻO kēia paha ma muli o ka ulu nui o ka hypertension arterial me ka haʻahaʻa o renin i ka nui o nā poʻe maʻi ʻeleʻele e loaʻa ana ka maʻi hypertension.

Aia nā hōʻike e pili ana i ka mare ʻana ma hope o ka lawe ʻana i nā pale o ACE. ʻO kahi hiʻohiʻona hiʻohiʻona o ka ʻōpala ʻo kona maloʻo a hoʻomau hoʻi, me ka nalo o kona mau hōʻike ma hope o ka hoʻokuʻu ʻana o ka mālama maʻi. ʻO ka ʻōpū ma muli o ke lawe ʻana i ka ACE inhibitors e pono ke noʻonoʻo ʻia he ʻāpana o ke ʻano maʻi o ka ʻōpū.

E pili ana i ka amlodipine:

ʻAʻole paʻa i ka palekana a me ka hana pono o ka amlodipine ma ka pilikia hypertensive.

Hoʻohana i ka poʻe maʻi me ka nele o ka naʻau

Pono e mālama me ka akahele ma nā maʻi me nā puʻuwai naʻau. Ma kahi haʻawina lōʻihi i hoʻomohala ʻia i ka papa maʻi e pili ana i nā mea maʻi me ka hōʻeha o ka naʻau (ʻo NYHA kahi III a me ka papa hana IV), ua hoʻopaʻa ʻia nā hihia o ka edema pulmonary, ʻo ke ʻano o ka nui o ka hui me ka amlodipine, i hoʻohālikelike ʻia me ka hui pletebo, akā ʻaʻole kēia. i hele pū me ka paʻa ʻole o ka puʻuwai kaumaha.

Hoʻohana i ka mea maʻi me ka hana aho lēwa

I ka poʻe maʻi me ka pīhoihoi hana pōmaikaʻi, hoʻonui ʻia ka hapalua o ke ola o ka amlodipine, ʻaʻohe ʻano kumu e hoʻololi ai i ka dosage. Pono nā mea maʻi ma kēia hui āpau e lawe i ka amlodipine me ka akahele.

Hoʻohana i nā mea maʻi maʻi

Pono nā poʻe maʻi e lawe aku i ka amlodipine me ka akahele.

Hoʻohana i ka mea maʻi me ka hana renal impaired

ʻO nā mea maʻi me ka hana renal impaired e lawe i ka amlodipine i nā poli maʻamau. ʻAʻole hoʻoponopono i nā hoʻololi i loko o ke kaila o ka amlodipine i ke kūkaʻi o ka maikaʻi o ka renal. ʻAʻole i hoʻopili ʻia ʻo Amlodipine i ka wā o ka dialysis.

I loko o nā pulupulu capsule 5 mg / 5 mg a me 10 mg / 5 mg he nani i ka ʻulaʻula (allura red AC-FD & C Red 40 E-129, a i loko o nā pulupulu pale 5 mg / 10 mg a me 10 mg / 10 mg laila loaʻa ka azorubine (carmuazine) (( E-122) Hiki i kēia mau leʻa ke hana i nā hopena kūlohelohe.

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

ʻO kekahi mau hopena kūpono (no ka laʻana, ka hōʻailona o ka hoʻohaʻahaʻa i ke koko, e like me ka dizziness) hiki ke hōʻeha i ka mea hiki i ka mea maʻi e hoʻokūkī a pane koke, a no laila e hoʻonui i ka pilikia i nā kūlana e koʻikoʻi ai kēia mau mākaukau (no ka laʻana, ʻoiai ke kaʻa a lawelawe paha. mīkini a me nā mīkini hana.

Ma keʻano kūikawā, hiki ke tupu kēia i ka hoʻomaka o ke ʻano a i ka wā e hoʻololi ana i nā lāʻau lapaʻau ʻē aʻe. Ma hope o ka lawe ʻana i ka hopena mua o ka lāʻau a i ʻole ka manawa i hoʻonui ʻia i loko o kona nui, ʻaʻole ʻia ke kāhea i nā kaʻa a mālama paha i nā mīkini a me nā mīkini no nā mau hola.

Lapaʻau lāʻau

Hoʻomoe a me ka hoʻolele

Ma hope o ka lawelawe waha, ua hopu koke ʻia ka ramipril mai ka hana kūwili ʻana. C_max Loaʻa ka hipa ramipril i ka plasma i loko o kahi hola 1. Ma ke noʻonoʻo i ka nui o ka urine, aia ka pae ma ka liʻiliʻi o 56% a ʻaʻole i hilinaʻi ma ka kaʻai ʻai. ʻO ka bioavailability o ka metabolite ikaika o ramiprilat ma hope o ke alakaʻi waha ʻana o 2.5 mg a me 5 mg o ka ramipril he 45%.

C_max ʻO ramiprilat, ke ʻano nui o ka manawa maoli o ka hipa ramipril, ua hiki i 2-4 mau hola ma hope o ka lawe ʻana i ka ramipril. C_{ai ʻo ss} ua hiki aku ke ramiprilat plasma pau i ka pili, e pili ana, i ka lā 4 o ka lawe i ka ramipril i loko o kahi hopena lapaʻau. ʻO ka paʻa ʻana o ka ramipril i nā ʻōmū serum ma kahi o 73%, a ʻo ka ramiprilat he 56%.

Metabolism a me ka hoʻopā ʻana

Ua aneane a ua hoʻohālikelike ʻia ʻo Ramipril me ka ramiprilat a me ka diketopiperazinovy ​​eter, ke kumetopiperazinovy ​​acid a no ka ramipril a me ramiprilat glucuronides. Lawe ʻia ka excretion o nā metabolites i ʻoi aku ma o nā keiki. Hoʻemi ka hoʻoliʻi i ka plasma o ka ramiprilat i ke ʻano polyphase. Ma muli o kona kaita ʻana i ka ACE a me ka nāwaliwali nāwaliwali me ka hoʻoulu ʻana o ka enzyme, hōʻike ʻo ramiprilat i kahi kaʻina hope o ka hemo ʻana ma ka liʻiliʻi haʻahaʻa o ka lāʻau i ka plasma. Ma hope o ka hoʻomau ʻana o ka lawelawe ramipril i hoʻokahi pākahi 1 mau manawa /, kūpono ʻo T_1/2 ʻO ramiprilat he 13-17 mau hola (ma kahi o ka 5-10 mg), a ma hope o ka hōʻemi ʻana i ka hopena i ka 1.25-2.5 mg T_1/2 l lōʻihi. ʻO kēia kaʻina ma muli o ka hiki i ka saturating kaomi o ka enzyme, kahi e paʻa ai i ramiprilat.

Ma hope o hoʻokahi mau kiko o ka hipa ramipril, ʻaʻohe hōʻailona o ka ramipril a me kāna mau metabolites ma ka waiū umauma. Eia nō naʻe, ʻo ka hoʻopā ʻana i ka hipa ramipril me ka umauma o ka waiū me ka hoʻohana pinepine ʻana i ka lāʻau i ʻole e maopopo.

ʻO ka pharmacokinetics i nā hihia lapaʻau kūikawā

Ua hōʻemi ʻia ʻo Ramiprilat renal excretion i nā maʻi me nā paʻa inoa ʻole, a me ke wehe kīleʻa o ramiprilat i hilinaʻi nui ʻia ma QC. Ke alakaʻi kēia i kahi hoʻonui i nā kukuna plasma o ramiprilat, e hoʻohaʻahaʻa me ka wikiwiki o nā maʻi i nā maʻi me ka hana maʻamau maʻamau.

I nā maʻi me ka hana paʻa ʻaʻe, ka hoʻololi o ka metabolic o ramipril i ramiprilat i lalo me ka emi o ka hana o ka hepatic esterases, a me nā pae o ka ramipril i hoʻonui i kēia mau maʻi. C_max ramiprilata i kēia mau maʻi, eia naʻe, ʻaʻole i ʻokoʻa mai ka poʻe i nā mea maʻi me ka hana neʻe maʻamau.

Hoʻomoe a me ka hoʻolele

Ma hope o ka lawelawe waha, ua hoʻohemo mālie ʻia ka amlodipine mai ka ʻōpala ʻana. C_max i loko o ka serum ua nānā ma hope o nā hola 6-12. ʻAʻole i pili ka ʻai i ka bioavailability o amlodipine. ʻO ka bioavailability kūpono pololei loa 64-80%.

V_{e d} hana 21 l / kg ia kaupaona o ke kino. C_{ai ʻo ss} i loko o ke koko koko (5-15 ng / ml) i loaʻa ma hope o 7-8 mau lā o ka hoʻohana ʻana i ka lāʻau. Ua hōʻike ʻia nā haʻawina a vitro i ka 93-100% o ka amlodipine e kahe ana i ke kahe koko e hoʻopaʻa ai i nā protein plasma.

Metabolism a me ka hoʻopā ʻana

Hoʻopili koke ʻia ʻo Amlodipine (e like me 90%) i ka puʻuwai e hana i nā metabolites inactive.

Ma kahi o 10% o ka pūmaka hoʻomaka a me 60% o nā metabolite ʻaʻole i hana i ka excreted i loko o ka urine, 20-25% me nā feces. ʻO ka emi ʻana o ke kaila plasma he biphasic. Hoʻopau hope loa T_1/2 mai ka pelekela koko ma kahi o 35-50 mau hola i ka wā i lawe ai i ka manawa 1 / ʻO ka huina piha he 7 ml / min / kg (me ke kaumaha o ke kanaka maʻi o 60 kg - 25 l / h).

ʻO ka pharmacokinetics i nā hihia lapaʻau kūikawā

ʻAʻole mahele i nā loli koʻikoʻi ko ka pharmacokinetics o amlodipine a me ka hoʻonui ʻana o ka nui o nā mea maʻi.

He manawa e hiki ai i C_max ʻO amlodipine i ka plasma i loko o nā ʻōpio a me nā maʻi ʻōpio, like like ia. I nā maʻi maʻi maʻi ʻO ka huina piha o amlodipine he 19 l / h. Hoʻopau maʻa mau ka hoʻomaʻemaʻe Amlodipine me ka hoʻonui ʻana i ka AUC a me T_1/2i nā maʻi maʻi maʻi.

Ka hoʻonui nui AUC a me T_1/2 i ka poʻe maʻi me ka puʻuwai naʻau neʻe like loa me nā mea maʻi maʻi.

ʻO Amlodipine ka nui o ka metabolized e hana i nā metabolite hana ʻole. ʻO 10% o ka hoʻohui hoʻomaka i hoʻololi ʻia i loko o ka urine. ʻAʻole pili nā loli i ka plasma o ka amlodipine ma ka pae nā mālamalama maikaʻi ʻole. ^ E Ha yM. I kēlā mau maʻi e lawe i nā maʻi maʻamau o ka amlodipine. ʻO nā kāhea o ka amlodipine hiki ole.

T_1/2 amlodipine i nā maʻi me ka hana paʻa ʻaʻe lohi.

Nā Hoʻohui

ka hele ana o ka mōʻaukala o ka angioedema (ka hoʻoilina, ka idiopathic, a i ʻole ka angioedema i hala ma mua o ka hoʻohana ʻana o ka ACE inhibitors a i ʻole na angiotensin II receptor antagonist).

- ka hana maʻi extracorporeal, i hui pū ʻia me ka hoʻopili ʻana i ke koko me nā papa hewa hewa i hoʻopiʻi ʻia,

- i'ōlelo ʻia i ka stenosis renal renal stenosis a i ʻole ka stenosis renal o ke keiki wale nō ka mākaukau,

- hypotension a hemodynamically unstable state (ramipril ʻaʻole i kuhikuhi ʻia),

- kahi hopena koʻikoʻi o ka hypotension,

- kūwili (me ka hoʻohui o ke ʻano a me nā kūloko).

- kaʻili ʻana o nā kahe koko, ke pale ʻana i ka kahe o ke koko mai ka palena hema o ka hema (no ka laʻana, he stortosis aortic koʻikoʻi),

- ka hewa ʻole naʻau hemodynamically a pau ma hope o ka maʻi myocardial infarction,

- Hypersensitivity i ramipril (a i ʻole ACE inhibitors), amlodipine, dihydropyridine derivatives, a / a i ʻole kekahi o nā mea o ka poʻe o ka lāʻau lapaʻau.

ʻŌpū a me ka lactation

ʻO nā hōʻike Epidemiological e hōʻike ana i ka hopena o ka teratogenicity ma hope o ka hoʻolaha ʻana i nā inhibitor ACE i ka manawa mua o ka maʻa o ka wā hapai o ka hāpai ʻana ʻaʻole ia he hōʻoiaʻiʻo, akā he liʻiliʻi iki i ka hopena ʻole.

ʻO ka ʻike ma ke ākea ACE i ka wā o ka wā o ka hana o ka hapalua a me ke kolu o ka hapai i ʻike ʻia e hoʻolilo i ka fetotoxicity i nā kānaka (ke kīnā ʻana i hoʻomohala i nā ʻōpū o ka pēpē, oligohydramnios, lohi i ka pīpī) a me nā mea huʻihui neonatal (renal failed, hypotension, hyperkalemia). Inā hele ka ʻike i nā mea pale o ACE i ka lua o ka hapalua o ka hapai ʻana, e ʻōlelo ʻia e hana i kahi ultrasound o ka hana o ke keiki a me ka hoʻomohala ʻana i nā iwi o ka iwi. ʻO nā pēpē i hāpai ʻia e ko lākou mau māmā i ka ACE inhibitors no ka hoʻomohala pono ʻana o ka hypotension, oliguria a me hyperkalemia.

No ka mea ʻaʻole lawa ka ʻike e pili ana i ka hoʻohana ʻana o ka ramipril a me ka amlodipine i ka wā lactation, ua hoʻohana aku kā lākou hoʻohana ʻana i kēia manawa a ʻoi aku ka maikaʻi o ke koho ʻana i nā ʻano hana ʻē aʻe o ka mālama ʻana me nā mea palekana palekana pilikino, ʻano nui i ka wā lactation.

ʻLoe a me ke kākele

Pono e hoʻohana ʻia ka lāʻau lapaʻau e like me ka mea i kuhikuhi ʻia e ke kauka.

Pono ʻia ka Hartil ® Amlo i ka manawa like o ka lā, i kēlā me kēia lā i ka wā e mālama ai, ma mua a ma hope o ka ʻai. ʻAʻole ʻoe e lau a humu paha i nā pale.

ʻO ka laʻana i kēlā lā i kēia lā he 1 mau kapeke o kekahi nui.

ʻAʻole kūpono ia me kahi lāʻau lapaʻau me kekahi dosage no ka hoʻomaka mua o ka maʻi.

Inā loaʻa kekahi pilikia no ka hoʻoponopono ʻana o ka make, hiki ke hoʻololi ʻia ka hopena o ka lāʻau Hartil ® Amlo a hiki ke hoʻoponopono ʻia nā haʻuki o nā māhele o kēlā me kēia me kā lākou hui pū ʻole.

A hōʻike ʻia e kuhikuhi i ka lāʻau lapaʻau me ka makaʻala. nā mea maʻi e lawe ana i nā diuretics, no ka mea, i kēia mau mea maʻi, he mea ʻole ke kūʻelima i ka pae wai-electrolyte. Pono e hoʻopaʻa i ka hana renal a hoʻoholo i ke ʻano o ka paʻakai i ka serum koko.

Hoʻohana nā mea maʻi me ka hana aho lēwa

I ka hoʻomanawanui me ka hana o ka puʻuwai hemahema, mālama ramipril ʻo ka hoʻomaka ʻana ma lalo o ka mālama ʻana i ka lāʻau lapaʻau, me ka nui o kēlā me kēia lā ma kahi o 2.5 mg ramipril.

ʻO nā papa ʻo Hartil ® Amlo e loaʻa ai ka 2.5 mg o ka ramipril + 2.5 mg o ka amlodipine ua noi ʻia no nā mea maʻi i hoʻihoʻi i ka nui o ka nui o ka 2.5 mg o ka ramipril, ma ke ʻano he nui e mālama ana i ka wā e koho ai i ka nui o ka ramipril.

I ka hihia o ka palaleka o ka ate, ka wā hoopau amlodipine mahuahua. ʻAʻohe ʻōlelo kūpono e pili ana i ka doses e pili ana i ka amlodipine, no laila, pono ke kauoha ʻia ka lāʻau i loko o kēia mau mea maʻi me ka akahele.

Hoʻohana nā mea maʻi me ka hana pūnāwai paʻa ʻole

No ka hoʻoholo ʻana i ka hui like ʻana o nā pā mua a me ka mālama mālama ʻia i nā mea maʻi me ka hana ʻole kīnā ʻole, koho ʻia ka nui o ka lāʻau i kēlā me kēia kanaka e hoʻoholo i nā hala o ka ramipril a me amlodipine.

Pāʻeha ʻaina i kēlā me kēia lā ramipril i ka poʻe maʻi me ka pilikia ʻole, pono e hoʻokumu ʻia me ka mālama ʻana i ka QC:

- i nā mea maʻi me CC ≥ 60 ml / min, ʻaʻole pono ka hoʻoponopono ʻana i ka pualikoa mua loa, ʻo ka nui loa ma ke ʻano he 10 mg,

- i nā mea maʻi me KK ® Amlo, ua ʻōlelo ʻia e hoʻopuka wale nō inā ua lawe ʻia ka mea maʻi i ka regimen dosis ramipril o 2.5 mg a i ʻole 5 mg ʻo ka lilo ʻana o ka mālama mālama pono (ua paʻa i ka wā ramipril dosing). Pono nā mea maʻi e kau ana i ka hemodialysis i ka lāʻau lapaʻau i kekahi mau hola ma hope o ka hemodialysis.

ʻAʻohe hoʻoponopono hoʻoponopono ʻia e pono ai amlodipine nā mea maʻi me ka hana pūnāwai paʻa ʻole.

ʻAʻole i hoʻopili ʻia ʻo Amlodipine i ka wā o ka dialysis. ʻO ka poʻe maʻi e kau ana i ka dialysis, pono e kuhikuhi ʻia ka amlodipine me ka makaʻala loa.

I ka wā o ka mālamaʻana me Hartil ® Amlo, ka kaohi o ka hiki ke hana o nā pēpē a me nā ʻikepili i loko o ka serum koko. Ma kahi e hōʻemi ai i ka hana haki, pono e hoʻokaʻawale ʻia ka hoʻohana ʻana i ka lāʻau ponoililililil ʻAillo, a pono e kuhikuhi ʻia kāna mau ʻāpana i nā dosis i hoʻoponopono ʻia ma kahi kūpono.

Hoʻohana nā maʻi maʻi maʻi

Pono e hoʻohaʻahaʻa ʻia ka mua o ka ramipril ma mua o ka mea maʻamau, a ʻoi aku ka ʻōmaʻomaʻi o ka hopena ma hope o ke ʻano o ka hopena o ka hopena. ʻAʻole ia e kuhikuhi i koho iā Hartil ® Amlo i nā mea maʻi kahiko a nāwaliwali.

Hiki i nā maʻi ʻōpiopio ke lawe i nā ʻōhua maʻamau o ka amlodipine, akā naʻe, pono e mālama ʻia e hoʻonui i ka nui o ka lāʻau.

Hoʻohana keiki a me na opio malalo o na makahiki 18

ʻAʻole ia e kuhikuhi i kuhikuhi i a Hartil ® Amlo no nā keiki a me nā ʻōpio ma lalo o ka makahiki 18, ʻoiai, ʻaʻole i hoʻokumu ʻia ka palekana a me ka hana o ka lāʻau lapaʻau ma kēia pūʻulu o nā mea maʻi.

Ke keu

Nā Hoʻomaka nā kūlana i ka palena o ka overdose, nui i ka vasodilation peripheral (me ka maʻi hypotension koʻikoʻi a me ke kiʻi pīhoihoi), bradycardia, ʻokoʻa ka hoʻoneʻeʻana o ka electrolyte a me ka hana ʻole ʻana.

Lāʻau: Pono mālama ʻia nā kūlana o ka mea maʻi, a ʻo ka lāʻau i ʻōlelo ʻia me ka maʻi a me ke kākoʻo. ʻO nā hana i hoʻolālā ʻia ka komo ʻana o ka detoxification (gastage lavage, adsorbent intake) a me nā ʻōnaʻi e hoʻihoʻi hou i ka kūpaʻa o nā ʻāpana hemodynamic, ʻo ia hoʻi alpha hoʻolana₁-adrenomimetics a i ʻole angiotensin II (angiotensinamide). Hoʻokuʻu maikaʻi ʻia ʻo Ramiprilat e nā hemodialysis mai ke kahawai nui. Me ka hypotension i haʻi ʻia e ka overdose o ka amlodipine, pono e hāʻawi ʻia i ka mea maʻi i kahi kūlana kiʻekiʻe me ka kūlana kiʻekiʻe o nā wāwae a lawe i nā hana hoʻoikaika e mālama ai i ka hana o nā ʻōnaehana cardiovascular, me ka mālama pinepine ʻana i nā hana o ka naʻau a me ka papa hana hanu, BCC a me ka nui o ka urine i hoʻopā ʻia. Ma ka haʻalele ʻana o nā contraindications, hiki ke hoʻohana (me ka akahele) me nā vasoconstrictors e hoʻihoʻi i ka leo vascular a me ke koko. I / i ka hoʻomaka ʻana o ka calcium gluconate hiki ke mālama pono i ka hoʻopau ʻana i kahi pānaʻi o nā kaila calcium. I kekahi mau hihia, pōmaikaʻi ka gastage lavage. Ma kahi noiʻi e pili ana i nā mea hana olakino olakino, ua hōʻike ʻia ʻo ka hoʻohana ʻana o ka carbon activated i loko o 2 mau hola ma hope o ka lawe ʻana he 10 mg o ka amlodipine i hoʻohaʻahaʻa nui ʻia kona komo ʻana. No ka mea pili pili ka amlodipine me nā protein, ʻaʻohe pono o hemodialysis.

Hoʻopili pū me nā lāʻau ʻē aʻe

ʻAʻole pono ke hui pū ʻia ʻo Hartil ® Amlo me nā hana extracorporeal e pili ana i ka hoʻopili ʻana i ke koko me nā wahi hewa i hoʻopiha ʻia, e like me ka hemodialysis ma o nā membranes nui (no ka laʻana, nā membran e hana ʻia mai nā pūhui polyacrylonitrile), hemofiltration a i ʻole apheresis o nā lipoproteins haʻahaʻa haʻahaʻa me ka dextran sulfate, ma muli o ka hoʻonui ka hopena o ka hoʻomohalaʻana i ka hopena anaphylactic a i ʻole anaphylactoid hopena. Inā pono e mālama ʻia ia ʻano hoʻomaikaʻi, a laila pono e noʻonoʻo ʻia ka hoʻohana ʻana o kēlā me kēia ʻano o ka membrane no ka dialysis a i ʻole nā ​​lāʻau antihypertensive o kahi ʻano ʻokoʻa ʻē aʻe.

Me ka hui pū ʻana me ka hoʻomākaukau ʻana i ka paʻakai, e hoʻomohala ana ka diuretics pākika a me nā mea ʻano ʻē aʻe e hoʻonui ana i ka pae o ka potassium potassium (e hui pū ana me ka angiotensin II receptor antagonists, trimethoprim, tacrolimus, cyclosporine), hiki i ka hyperkalemia ke kūkulu, no laila, pono pono e nānā pono i ka pae o ka sima potassium.

Ke lawe like ʻia me ka lāʻau antihypertensive (e. G., Diuretics) a me nā mea waiwai ʻē aʻe e hiki ke hoʻemi i ke koko (e.

Me ka hoʻokolohua ʻōpiopio me ka vasopressor sympathomimetics a me nā mea ola ʻē aʻe (no ka laʻana, isoproterenol, dobutamine, dopamine, adrenaline), e emi iho ana ka hopena antihypertensive o ka ramipril, no laila e ʻōlelo ʻia ke nānā aku i ke ʻano o ke koko.

Me ka hoʻokolohua ʻōwili me allopurinol, immunosuppressants, corticosteroids, procainamide, cytostatics a me nā lāʻau lapaʻau ʻē aʻe hiki ke hoʻololi i ka nui o nā pili o ke koko, ka ulu ʻana o ka ulu ʻana o ka hopena hematological.

Me ka hoʻokūkū like ʻana o nā inhibitor ACE me ka hoʻomākaukau ʻana lithium, hiki ke hoʻēmi i kāna excretion a, a laila, e hoʻonui i ka ʻike ʻana i ka lithium i loko o ke koko me kahi piʻi aʻe o kāna hana kūlohelohe. Pono ka nānā ʻana i nā pae lithium.

ʻOiai e lawe ana me antidiabetic agents (me ka insulin) e hoʻomohala i nā hopena hypoglycemic. Kuhi ʻia aku nei e kāohi i ka pae o ka glucose i ke koko.

ʻOiai e lawe pū ana me Nā NSAID (e komo pū ana me ka acetylsalicylic acid) e hōʻemi i ka hopena antihypertensive o ramipril. Eia kekahi, ʻo ka hoʻohana pū ʻana o ka ACE inhibitors a me NSAIDs hiki i ka hoʻomohala ʻana i ka hyperkalemia a hoʻonui i ka hopena o ka hana renal impaired.

Hōʻoluʻolu ka lāʻau lapaʻau me ka diuret thiazide, beta-blockers, ka lōʻihi o ka hoʻokuʻu ʻana, nitrates, sublingual dosages form of nitroglycerin, NSAIDs, antibiotics, a me nā lāʻau hypoglycemic waha.

ʻOiai e lawe ana i ka lāʻau lapaʻau me kahi CYP3A4 inhibitor erythromycin i nā maʻi ʻōpio a diltiazem i nā poʻe maʻi maʻi, no kēlā me kēia, ke piʻi ʻana o ka plasma o ka amlodipine e hoʻonui i ka 22% a me 50%. Eia nō naʻe, ʻaʻole maopopo ka ʻike koʻikoʻi e pili ana i kēia kūlana. ʻAʻole hiki ke hoʻokaʻawale ʻia kēlā me nā mea paʻa CYP3A4 ikaika (no ka laʻana, ka ketoconazole, itraconazole, ritonavir) hiki ke hoʻonui i ka kukuna plasma o ka amlodipine i kahi nui aʻe ma mua o diltiazem. Pono e hoʻohana ʻia ʻo Amlodipine me ka akahele me ka wā e hoʻokūkū pū ʻia me nā mea hoʻopaʻa CYP3A4. Eia naʻe, ʻaʻohe mea i hōʻike i kekahi mau hopena pili i pili pū i kēia pili.

Hoʻokomo ʻia CYP3A4: ʻaʻole ʻike nā ʻikepili ma ka hopena o nā lawelawe manuahi CYP3A4 ma amlodipine. ʻO ka hoʻohana pū ʻana o ka lāʻau lapaʻau me nā inducers o CYP3A4 (no ka laʻana, he rifampicin a i ʻole welo a make ʻole ʻo St. John) e hoʻohaʻahaʻa i ka plasma plasma o ka amlodipine. Pono e hoʻohana ʻia ʻo Amlodipine me ka akahele i ka wā i hoʻohana pū ʻia me CYP3A4 inducers.

I nā haʻawina ʻoihana pili o ka launa pūloko, ʻo ka hoʻohana like ʻana o ka amlodipine me ka wai huapuni, cimetidine, alumini / magnesium (antacids) a me ka sildenafil, ʻaʻole i hoʻopilikia i ka pharmacokinetics o amlodipine.

Hoʻohana pū ka hoʻohana ʻana i ka amlodipine me nā mea āpau antihypertensive e hoʻomaikaʻi ana i kā lākou therapeutic efficacy.

Ma nā haʻawina loiloi o ka hoʻopili ʻana i ka lāʻau lapaʻau, ʻaʻole i hoʻopilikia ka amlodipine i ka pharmacokinetics o vvastatin, digoxin, ethanol (ethanol), warfarin, a i ʻole cyclosporine.

ʻAʻole paʻa i ka hopena o ka amlodipine ma nā loli i loko o nā hoʻokolohua hōkele.

E hoʻokuʻu i ke ʻano a me ka ʻano

Loaʻa ka lāʻau lapail i ka hua i nā papa no ke alakaʻi waha ʻana i nā kukui ʻulaʻula, oval, ʻolo. Hoʻopili ʻia nā papa i nā palaka o nā ʻāpana he 7 (1-4) i kahi pahu pepa, nā ʻōlelo kuhikuhi a me ka wehewehe e pili ana i ka lāʻau lapaʻau.

Aia kēlā me kēia papa i ka 5 mg a i ʻole 10 mg o ka pakanui a me Ramipril, a me kekahi o nā mea kōkua, e komo pū ana ka lactose monohydrate.

Hoʻololi hou i nā papa he 2,5 mg + 12.5 mg, 5 mg + 25 mg Hartil D me ka diuretic hydrochlorothiazide. ʻO ka hui pū kau ka ramipril, hydrochlorothiazide a me nā mea hanohano (Hartil D).

E hoʻokuʻu i nā palapala a me ka ʻano

Loaʻa ka lāʻau lāʻau i ke ʻano o nā capsula gelatin o 5 mg a me 10 mg o ka mea hana ikaika. ʻO ka waiwai waiwai ʻo ramipril (Ramiprilum). He wahi basa palupalu ia kahi keʻokeʻo keʻokeʻo i hoʻōla ʻia i nā hopena buffer a me nā solvents organika. Nā mea kū'ē - amlodipine, microcellulose, crospovidone, hypromellose.

Nā hōʻailona no ka hoʻohana ʻana

He pālahalaha nui nā capsules i ka hana ʻo ramipril a ua kuhikuhi ʻia e like me kēia mau hōʻike ʻana:

• hypertension arterial - kahi kūlana o ke koko kiʻekiʻe ke kiʻekiʻe,
• prolaps mitral
• hoʻohanaʻia no ka hyperthermia hewa e hōʻoluʻolu i ke kūlana,
• pilikia ʻole, kahi i hana ʻia ai ka hana o ke kino holoʻokoʻa ma muli o ka lawa ʻole o ke kahe ʻana o ke koko a me ka saturation o nā kino o nā io a me nā ʻōnaehana,
• angina pectoris, ischemia,
• kahi hopena o ka halaʻi myocardial, i mea e pale ai i ka lua lua a hōʻemi ʻana i ke kaumaha ma ka puʻuwai naʻau,
• ka pale ʻana i ka maʻi hōʻeha ma ka maʻi naʻau coronary.

ʻŌpala Gastrointestinal

ʻO Stomatitis, nilo, hoʻopuka, ka ʻōpū o ka naʻau, pancreatitis, edema o ka ʻōpū, ʻeha, ʻeha ʻana i loko o nā ʻāpana a me nā pancreas, i hoʻemi ʻia ka makemake.

Mai ka wahi gastrointestinal, hiki iā Hartil ke hoʻomālamalama.

Hoʻopilikia i ka hiki ke mālama i nā mīkini

Hiki i ka lāʻau lapaʻau ke hoʻopilikia i ka ʻōnaehana o ka pokela, ma kahi o ka hiamoe, e hōʻemi i ka luhi. I kēia mea, pono ʻoe e haʻalele i nā hana ma nā mīkini ʻimi ʻole a i ʻole hoʻi i ke kaʻa.

ʻO Hartil Amlo e pili pono i kou hiki ke alakaʻi i kahi kaʻa.

Hoʻohana i ka wā hāpai a me ka lactation

I ka mākia II a me III, ua pāpā ʻia kēia lāʻau lapaʻau e lawe. I ka wā i hoʻokama mua ʻia, hiki iā ʻoe ke hoʻohana iā Hartil wale nō ma ka hihia o kahi ulia pōpilikia. Ke mālama nei i ka wā lactation, ʻoi aku ia e hoʻololi i ka kīloi kūlohelohe.

No nā keiki ma lalo o 15 mau makahiki o ka lawe ʻana i ka lāʻau, ua ā paʻa loa ʻia, no ka mea ʻaʻole i hoʻokō ʻia nā haʻawina.

Hoʻopili pū me nā lāʻau ʻē aʻe

Me ka hoʻokolohua hoʻohālikelike me nā diuretics a me nā lāʻau maʻi hypertensive ʻē aʻe, hiki ke loaʻa ka hopena haʻahaʻa i ka nui o ke koko.

Inā ʻoe e hoʻohui i nā lāʻau lapaʻau antihypertensive me nā lāʻau lapaʻau anti-inflammatory non-steroidal, e hoʻemi ʻia ka hopena, a ʻaʻohe mea i loaʻa ke kōkua mai ka lāʻau lapaʻau.

Ke lawe nei i nā lāʻau laikui lithium i hui pū me Hartil, hoʻonui ka lithium i ke koko.

ʻAʻole ia e kuhikuhi pū i ka hoʻohana ʻana me nā kālā i loaʻa ka pākeke i ka mana, no laila ʻaʻole iʻoi aʻe i ka nui o ka pāhare pālolo ma ke kino.

Inā no kekahi kumu ke hiki ʻole ke lawe ʻia nā kapala, hiki iā ʻoe ke kahakaha iā lākou me ka lāʻau Hungarian, ʻAmelika a me Lūkini paha no kahi hopena like:

• ka nohona ʻo ramipril lāua ʻo amlodipine: capsules Bi-Ramag, Sumilar, Tritace-A,
• ke pili ana i ka amlodipine a me ka lisinopril: ʻAlau Aml-L, Amlipin, Equator,
• kaukaʻi ʻia ma perindopril: Amlessa, Bi-Prestarium, Viacoram,
• e pili ana i ka lercanidipine a me enalapril: Coriprene, Lerkamen, Enap L Combi.

ʻO kā ka hoʻohālikelike o ka lāʻau Harty Amlo ʻo Amlessa. ʻO kā ka mea hoʻohālikelike o ka lāʻau Hartil Amlo ʻo Coripren.ʻO ka hoʻohālikelike o ka lāʻau Meaililillo ʻo Lerkamen.

ʻAʻole ʻōlelo nā loea i ka hoʻololi ʻana i nā lāʻau lapaʻau ponoʻī iā lākou iho, no laila, ʻaʻole e hōʻino i ka olakino. Ma mua o ke kauʻana he pono ke kūkā i kahi kauka.

Cardiologists

Alexander Ivanovich, Moscow

ʻO ka lāʻau lapaʻau kekahi o nā mea e pono loa no ka mālama a me ka pale ʻana i ka maʻi naʻau a me ka hoʻihoʻi ʻana o ke koko. Inā ʻaʻohe contraindications, ua kuhikuhi pinepine wau iā ia e pale aku i ka myocardial infarction a me ka hahau ʻana.

ʻO nā ʻōkuhi no ka hoʻohana ʻana iā Hartil-Amlo ʻO nā penina no ke kaomi ka maikaʻi loa

Tamara Nikolaevna, 70 makahiki, Krasnodar

Ua pilikia māua kaʻu kāne a me ka hōʻeha ʻole o ka naʻau. I kekahi mau makahiki, ua inu mākou i ka papa ʻana o Hartil ʻelua i ka makahiki hoʻokahi. Ka maikaʻi ka lāʻau lapaʻau, ʻaʻole ia ka hopena i ka hopena, hoʻohaʻahaʻa i ke koko, hoʻohemo i ke poʻo, ka meʻe. Hana ka naʻau me ke ʻole keʻakeʻa, manaʻo mākou i 20 mau makahiki ʻōpio.

Nā Pāʻani Hartil

Lawe ʻia ia me ka haki ʻole, ka holoi ʻia ʻana me ka nui o ka wai (ma kahi o 1 aniani), ʻo ko ke ʻano o ka manawa ʻaina.

Pono ka hoʻonā ʻia o ka dosage no kēlā me kēia mea maʻi pākahi, me ka noʻonoʻo ʻana i ka hopena therapeutic a me ka hoʻomanawanui. Hiki ke hoʻokaʻawale i nā papa i ka hapalua, e uhaʻi ana i ka hopena.

• Hoʻopau ʻole nā ​​puʻuwai naʻau. ʻO ka papa hoʻomaka ʻia ʻo 1.25 mg hoʻokahi i kēlā me kēia lā (1/2 papa o Hartil 2.5 mg i kēlā me kēia lā). ʻO ka hopena o ka hopena therapeutic, hiki ke hoʻonui ʻia i ka hopena ma o ka kānalua ʻana i ka lā i kēlā me kēia 2-3 mau pule. Inā pono ʻoe e lawe hou aku ma mua o 2,5 mg o ka lāʻau lapaʻau, hiki ke hoʻokaʻawale ʻia kēia mahele a hoʻokaʻawale paha i 2 mau pona. Pono e hoʻonui ka nui o ka lā ma mua o 10 mg.
• He maʻi haole. ʻO ka paena hoʻomaka hoʻomaka ʻia he 2.5 mg hoʻokahi i kēlā me kēia lā (1 papa o Hartil 2.5 mg i kēlā me kēia lā). ʻO ka hopena o ka hopena therapeutic, hiki ke hoʻonui ʻia i ka hopena ma o ka kānalua ʻana i ka lā i kēlā me kēia 2-3 mau pule. ʻO ka papa mālama mālama maʻamau ka 2.5-5 mg i kēlā me kēia lā (1 papa o Hartil 2.5 mg a i ʻole 1 papa o 5 mg). Pono e hoʻonui ka nui o ka lā ma mua o 10 mg.
• Kākoʻo o ka myocardial infarction, hōʻeha, a i make paha mai nā maʻi cardiovascular. ʻO ka paena hoʻomaka hoʻomaka ʻia he 2.5 mg hoʻokahi i kēlā me kēia lā. Mamuli o ka hoʻomanawanui o ka lāʻau lapaʻau, ma hope o 1 hebedoma hoʻokele, pono e pāpālua ʻia ka nui e hoʻohālikelike ʻia i ka mea mua. E pāpālua ʻia kēia paona ma hope o nā hebedoma 3 o ka hoʻokele ʻana. ʻO ka papa hana mālama ʻia e 10 mg hoʻokahi i kēlā me kēia lā.
• ʻO nā maʻi ʻole o ka maʻi maʻi a i ʻole ka maʻi diabetes. ʻO ka laʻana i ʻōlelo mua ʻia ʻo 1.25 mg hoʻokahi mau lā (1/2 papa o Hartil 2.5 mg i kēlā me kēia lā). ʻO ka hopena o ka hopena therapeutic, hiki ke hoʻonui ʻia i ka hopena ma o ka kānalua ʻana i ka lā i kēlā me kēia 2-3 mau pule. Inā pono ʻoe e lawe hou aku ma mua o 2,5 mg o ka lāʻau lapaʻau, hiki ke hoʻokaʻawale ʻia kēia mahele a hoʻokaʻawale paha i ʻelua papa. ʻO ka paona ʻana i kēlā lā i kēia lā he 5 mg.
• Ma hope o ka hoʻonā ʻana i ka myocardial infarction. Hoʻomaopopo ʻia e hoʻomaka i ka lawe ʻana i ka lāʻau lāʻau ma ka lā 3-10th ma hope o ka maʻi myocardial maʻi. ʻO ka dosis kaukau mua ʻia, kau ʻia ma ke ʻano o ka mea maʻi a ua hala ka manawa ma hope o ka maʻi myocardial infarction, ʻo 2.5 mg mau manawa 2 i ka lā (1 papa o Hartil 2.5 mg 2 mau manawa i ka lā). Aia i ka hopena therapeutic, hiki ke pāpālua ʻia ka nui o ka hopena ma mua o 5 mg (2 papa o Hartil 2.5 mg a i ʻole 1 papa o Hartil 5 mg) mau manawa i ka lā. Pono e hoʻonui ka nui o ka lā ma mua o 10 mg. Me ka hoʻomau ʻole ʻana i ka lāʻau lapaʻau, pono e hōʻemi ʻia ka ʻona.

Nā hui ahonui kūikawā

ʻO nā maʻi maʻi. ʻO ka hoʻohana ʻana i ka ramipril i nā maʻi maʻi makua e lawe ana i ka diuretics a me / a me ka ʻole o ka naʻau, a me ke ʻano o ka maʻi ʻaʻomaʻi a me nā hana paha, pono i kahi mālama kūikawā. Pono e hoʻokumu ʻia nā Dosis e ke koho ponoʻī o nā pona ma muli o ka hopena o ka lāʻau lapaʻau.

Hōʻeha ka naʻau ʻili. Ma ke ʻano o ka hana maʻi ʻehaʻeha, hōʻemi a hoʻonui ʻia paha i ka hoʻohana ʻana i ka lāʻau lapaʻau hiki ke mālama pinepine ʻia, ʻo ia hoʻi, i nā manawa mua o ka mālama ʻana, ʻo nā mea maʻi me ka hana aho maʻemaʻe e pono ai ka mālama mālama maʻi. ʻAʻole pono ka dosis nui o kēlā me kēia lā i kēlā me kēia lā.

I ka poʻe maʻi e loaʻa ana i ka terapi diuretic, ma muli o ke kaila o ka hoʻemi nui ʻana i ke kahe o ke koko, hiki i ka manawa ke hoʻokaʻawale ʻana i ke kaʻa a i ʻole ka liʻiliʻi ʻana i ka hopena o ka diuretics e pono e noʻonoʻo pono i nā lā 2-3 (a i ʻole e lōʻihi, e pili ana i ka lōʻihi o ka hana o ka diuretics) ma mua o ka lawe ʻana i ka lāʻau Hartil. No nā mea maʻi i mālama mua ʻia me ka diuretics, ma mua o ka hopena mua loa he 1.25 mg.

Nā hopena hopena

Hoʻomaopopo nā hōʻike lapaʻau o Hartil i ka hopena o nā hopena ʻaoʻao. ʻO kā lākou papa inoa he ākea loa a koi ʻia kahi noi kikoʻī. Kēia ʻia ʻoe e familiarize iā ʻoe iho me nā hopena like loa ma mua o ka lawe ʻana i ka lāʻau lapaʻau.

• urticaria, ʻeha, ʻohiʻeha o ka ʻili, conjunctivitis,
• ka hoʻohaʻahaʻa ʻana i ka momona, nausea, constipation / diarrhea, pancreatitis, maloʻo maloʻo, luaʻi,
• rula, hyperthermia, alopecia, loulou,
• hyperkalemia, hypercreatininemia, hoʻonui hana i ka transaminases hepatic a me ka pae urea nitrogen, hyponatremia,
• he thrombocytopenia, anemia, hematocrit haʻahaʻa a me ka nānā ʻana hemoglobin, thrombocytopenia, neutropenia, leukocytopenia, agranulocytosis, hemolytic anemia, pancytopenia,
• nāwaliwali, nā māhā, nā kahe, nā huhū a me ka huhū, ka hooweliweli, ka maʻi hopohopo, nā hopohopo, ka hōʻāwīwī ʻana o ka naʻau, nā pilikia i ka hoʻomaopopo ʻana (ʻono, lohe, ʻono, ʻike) a me nā pilikia vestibular,
• mahuahua proteinuria, renal maikaʻi ʻole, hoʻemi i ka libido, hoʻemi i ka nui o ka urine,
• orthostatic hypotension, hōʻemi i ke koko. I nā hanana lohi - arrhythmia, ke nānā mai o nā pilikia o ke ola i nā kino, ischemia myocardial a me ka lolo,
• he pōkole o ka hanu, bronchospasm, rhinorrhea, sinusitis, rhinitis, bronchitis, ʻōpala maloʻo.

ʻO ka hoʻohana ʻana o Hartil i ka wā hapai hiki ke alakaʻi i ka hopena i ka ʻōpū o ka pūpū: nā hōʻino like ʻole o ka hoʻomohala ʻana a me ka hana ʻana o nā palupalu, i hoʻokahe ʻia ke koko ma ke keiki, a hypoplasia o nā ʻōpū a me ka ʻuʻuku, kirimana o nā limahana, a me ka hoʻololi ʻana o ke ʻūhā.

ʻO nā hua'ōlelo hoʻomaha a me ke kumukūʻai

ʻO ke kumukūʻai kūpono o Hartil (5 mau papa, 28 mau ʻāpana) ma Moscow he 400 mau rubles. Hoʻokuʻu ʻia ka lāʻau lapaʻau mai nā lāʻau lapaʻau ma o ka lāʻau lapaʻau.

ʻO ka mahana kiʻekiʻe o ka mālama ʻana o ka lāʻau lapaʻau he 25 tikelika. Ua hōʻike ʻia ka ola o nā papa o ka papa ma ka pākaukau a ʻo 4 mau makahiki mai ka lā o ka hana. Hōʻike ʻo Hartil i ka hoʻohana ʻana i nā papa e mālama ai i kahi wahi i hiki ʻole ai i nā keiki, kahi mamao loa mai ka lā pono.

Ka hoʻonohonoho ʻana a me ke ʻano o ka hoʻokuʻu ʻana

Loaʻa kahi Hartil i ka papa pākau. Hoʻopili ʻia ka lāʻau lapaʻau i nā palaka no nā papa he 7. Aia ka pahu pepa paha i ka 14 a me 28 mau paena o kahi palapala hoʻohālikelike.

ʻO ka mea waiwai he ramipril.

Nā Papa 1.25 mg, 2.5 mg, 5 mg a me 10 mg (Hartil).

Nā papa ʻaina 5 mg: nā mālamalama kukui me kahi kala melemele, oval, me ke kaula hoʻokaʻawale, chamfer a me ke kahakaha "R3" ma kahi ʻaoʻao.

Nā papa ʻaina 10 mg: keokeo a i ʻole paha he keʻokeʻo keʻokeʻo, ʻūpū me ka laina hoʻokaʻawale, chamfer a me nā kiʻi "R4" ma kahi ʻaoʻao.

• Nā ʻōlela Hartil D me ka diuretic hydrochlorothiazide 2.5 mg + 12.5 mg, 5 mg + 25 mg.
• Hartil Amlo Ramipril. E hoʻohui i ka amlodipine hou. Hōʻai me ka hoʻonui o ke koko i ka wā e lawe i nā mea hana ikaika (ʻokoʻa a ʻokoʻa paha) e hāʻawi i ka hopena maikaʻi.

He aha ka mea e kōkua ai iā Hartil?

ʻO nā ʻōkuhi no ka hoʻohana ʻana i kēia hāmeʻa penei:

• ʻO ka pohō o ka naʻau ma hope o ka maʻi myocardial infarction me ka hemodynamics paʻa,
• nāwaliwali o ka puʻuwai
• haehae maʻi
• maʻi maʻamau nephropathy,
• maʻi hōʻano ʻē
• ka pono e hoʻemi i ka pilikia o myocardial infarction, "coronary death" i nā poʻe me ka maʻi coronary artery,
• ka pono e hoʻemi i ka pilikia o ka pilikia i ka poʻe me ka maʻi coronary artery.

Me ka hypertension arterial, hiki nō ke hoʻohana ʻia ʻo Hartil Amlo, inā ma mua o ke hoʻololi ʻana i kēia lāʻau lapaʻau, mālama ʻia ke kahe koko i ka manawa like me ka ramipril a me ka amlodipine i loko o nā ʻano like ʻole e like me ka lāʻau lapaʻau.

Nui! Pono ke kauka e hoʻoholo i ka pono o kahi papa lāʻau lapaʻau. Loaʻa ʻole ʻia ka lāʻau lapaʻau kūʻokoʻa.

Nā ʻōkuhi no ka hoʻohana

Hoʻonohonoho ʻia ka hopena o ka lāʻau ʻo Hartil e ke kauka kūʻokoʻa. Hoʻomaka ka mālamaʻana o ka hypertension arterial me ka liʻiliʻi liʻiliʻi ma ka laʻana - 2,5 mg hoʻokahi i ka lā.

Me ka hikiʻole o ka hopena therapeutic a i ʻole nele o ka hopena, hiki ke hoʻonui ʻia ka nui o ka nui ma mua o ka manawa 1 i ka hebedoma e 2.5 mg, ka nui o ka nui o kēlā me kēia lā no ka mea maʻi maʻi he 10 mg. ʻAʻole lawa kēia mau maʻa i ka hoʻohaʻahaʻa ʻana i ke koko i nā kumu maʻamau, a laila ua kuhikuhi ʻia nā papa ʻo Hartil ma ke ʻano o ka paʻakikī paʻakikī me nā mea hana antihypertensive.

Inā kūpono, pono e hāʻawi ʻia nā mea maʻi i kahi mālama mālama o 2.5-5 mg o Hartil i kēlā me kēia lā.

Pono e mālama ʻia ka mālama ʻia ʻana o nā hōʻeha ma hope o ka hōʻā ʻana o ka puʻuwai maʻa no 3 mau lā, ʻo ka hoʻomaka mua ʻana o ka lāʻau ʻo 2.5 mg, lawe ʻia ka lāʻau i ʻelua manawa i ka lā, ʻo ke ʻano nui o kēlā me kēia lā no ka maʻi pākeke ʻo 10 mg.

No ka mālamaʻana i ka nephropathy maʻi o ka maʻi maʻi a ʻole paha, i kuhikuhi ʻia ka lāʻau ʻai ʻo Hartil i loko o kahi waihona o 1.25 mg hoʻokahi i ka lā. ʻO 3 mau lōʻihi ka lōʻihi o ka mālamaʻana.

I mea e pale ai i ka hoʻomohala ʻana o ka infococote myocardial, ʻo ka mea maʻi me ka angina pectoris a me ka maʻi maʻi i loko o nā moku i kuhikuhi ʻia i ka lāʻau ʻo Hartil ma kahi he 2.5 mg pākahi i hoʻokahi lā no nā hebedoma 3, ma hope o ka hoʻonui ʻia ʻana o ka pā i 5 mg i kēlā me kēia lā a hoʻomau hoʻi i ka lāʻau lapaʻau no 3 mau pule.

ʻO nā mea maʻi me nā maʻi pūpū a i ʻole ka naʻau puʻuwai e pono e koho i kahi ʻano hoʻokahi, e hoʻolaʻa ʻia me ka hana ʻo Hartil mai kahi mahele o 1.25 mg i kēlā me kēia lā, inā pono a me ka hoʻomanawanui maʻamau, e hoʻonui iki ʻia.

Nā hopena lāʻau lapaʻau

ʻO ka hoʻopaʻa ʻana i ka lāʻau lapaʻau i ka hoʻokumu ʻana o ACE, ʻo ka mea nui loa ka nānā ʻana he hypotension, ʻo ia hoʻi, he kahe o ke kaomi ma mua o 20% o ka waiwai mua. I kēia hihia, hoʻohāʻau ka pulse i mua o ka hoʻokipa ʻana, me ka uku ʻole ʻia no ka nalowale.

No ka mea ke poloka ia angiotensin, hoʻemi ʻia ka hana o ald testosterone, a me ka hoʻonui ʻana o ka hana i loko o ke plasma o renin. Hoʻopau ka hopena o ka lāʻau i ka ACE ʻaʻole i ke kahe koko, akā, i ka mea i hana ʻia i ka pā vascular a me nā kiko pilin ʻē aʻe.

ʻO nā huahana farmacodynamic ʻē aʻe:

• Inhibition o nā hana mōʻaukala i pili me ka moku maʻi maʻi i haʻi ʻia - microalbuminuria, no ka laʻana.
• Ke lohi nei i ka proteinuria a me ka hoʻonui ʻana i nā pae o ka creatinine, e hoʻonāukiuki i ka holomua o ka hiki ʻole o ka hana renal.
• ʻO ka hōʻemi o ka puʻuwai naʻau hypertrophied, kōkua me ka hypertension arterial.
• ʻO ka weheʻana o ka bradykinin, e hana ana i nā kīʻaha koko, e hoʻokuʻu i ka prostacyclin a me ka divicent nitric oxide i loko o ke koko.
• Ke kaomi nei i ka hoʻemi ʻana ma ka vein portal inā ʻike ʻia ka hypertension.
• ʻO ka hōʻemi i ka pinepine o ka hiki ʻana mai o ka arrhythmia inā he mea hoʻopiʻi ka mea maʻi i ka myocardial reperfusion, ua pale ʻia ka pilikia o ka hoʻomohala hou ʻana o ka ʻeha puʻuwai, ua hoʻihoʻi ʻia ka hoʻokahe koko maʻamau.

Nā kūlana kūikawā

Hoʻolaha ʻia ka hana ma lalo o ka mālama mālama olakino maʻamau.

Ma hope o ka lawe ʻana i ka ʻōlelo mua o Hartil, pono ia ma lalo o ka mākaʻikaʻi ʻana o kahi kauka i pale ai i kahi ʻano hypotensive i kāohi ʻole ʻia. Pono ʻia ke ʻano neʻe koko nui.

ʻAʻole pono ke kuhikuhi ʻia ʻo Ramipril a hiki i nā hana i hoʻopaʻa ʻia e pale ai i ka pohō nui o ke koko a me ka hana like ʻole. Inā hiki, ka hoʻoponopono ʻana i ka dehydration, hypovolemia, kahi hoʻohaʻahaʻa i ka nui o nā ʻāpana ololi i waho ʻia ma mua o ka lawe ʻana i ka lāʻau. Inā he koʻikoʻi kēia mau maʻi, pono e hoʻomaha.

ʻO ka poʻe maʻi me ka hōʻino o ka maʻi valinal, hoʻopōmaʻa ʻia o ka hana haki, he hōʻemi i hōʻailona ʻia i ke koko, a me nā mea maʻi me ka puʻuwai o ka naʻau a ma hope o ka hoʻololi ʻana o ka maʻi, pono e nānā pono.

E kū'ē i ke kāʻei o ka lawe ʻana i ka lāʻau, hōʻemi ka nui o ka sodium a me ka hoʻonui ʻana ma ke kau o ka paʻakai ka mea hiki, ʻoi aku ka maʻamau o ka hana renal impaired a i ʻole ke lawe ʻana me ka diuretics potassium-sparing.

Inā lawe ʻoe i ka lāʻau lapaʻau e hōʻemi i ka nui o ke kaomi, pono e kau ʻia ka mea maʻi ma kahi kūlana me nā wāwae i hāpai ʻia, ke ʻano hōʻailona maʻi, me ka hoʻopuka ʻana o ka wai, pono paha.

I ka hihia o ka hana renal maʻi a me nā maʻi o ka hoʻopili ʻana, i ka wā e lawe ai i nā lāʻau ʻē aʻe e pili ana i ka hematopoietic a me nā ʻōnaehana pale, ka hopena o ka hoʻololi ʻana o ke koko.

Me ka lawelawe like o ka diuretics, ka mālama pinepine ʻana i ka pae o ka sodium i loko o ka serum koko, a me ka helu o nā leukocytes, pono.

I nā mea maʻi ma ka hemodialysis e hoʻohana ana i nā membrane me nā wai hoʻokele hydraulic kiʻekiʻe me ka hoʻokūkū ʻana o nā inhibitor ACE, hiki i nā hanana hoʻoweliweli hoʻoweliweli. Ua nānā ʻia nā kūlana like i loko o nā poʻe maʻi e lawe ana i ka apheresis LDL me ka loaʻa ʻana o ka dextran sulfate.

ʻAʻole pono e hāʻawi ʻia nā pale o ACE i ka poʻe maʻi e loaʻa ana i ka desensitizing therapy ma muli o ka pilikia o ka hoʻomohala ʻana i nā hopena anaphylactoid koʻikoʻi.

Pono e noʻonoʻo i nā papa Hartil me nā waihona kiko o ka 5 mg e komo me ka 96.47 mg o ka lactose, 10 mg - 193.2 mg.

Loaʻa ka ʻike me ka ramipril i nā keiki me ka ikaika ʻole o ka renal a i ka wā dialysis.

Hoʻokumu ia i ka emi o ke kahe o ke koko, e hopena i ka hiki ke hoʻokō. I kēia mea, ʻaʻole ʻōlelo ʻia ke alakaʻi a me ke komo ʻana i nā hana e pili ʻole ʻia.