Amprilan® (Amprilan)

Ke hoʻokaʻawale nei ke ACE hoʻopiha-2, hoʻonui i ka hana renin, hoʻonui ʻia ka hana bradykininhoʻonui ka hana aldosterone. ^ E Ha yM. Hoʻohana ʻia ka Hemodynamic a me nā antihypertensive o ka lāʻau ma ka hoʻonui ʻana i ka lumen o ka moku, e hōʻemi ana i ka OPSS. ʻAʻole pili ka lāʻau lapaʻaupuʻuwai puʻuwai. ^ E Ha yM. Hiki i ka mālama wā lōʻihi ke alakaʻi i ka lūlū o ka hypertrophy o ka ventricular hema haehae maʻi. ^ E Ha yM. Hoʻolaha he pili koko hoʻopaʻa ʻia 1-2 mau hola ma hope o ka lawe ʻana i ka lāʻau, hoʻomau ka hopena antihypertensive no hoʻokahi lā.

I nā maʻi me puʻuwai paʻakikī hoʻemi ʻia ka pilikia puʻuwai puʻu, make like, make disease, the number of emergency hospitalizations and the number of ʻōhumu hypertensive. ^ E Ha yM. I nā maʻi me maʻi maʻi aia ka emi microalbuminuriahoʻemi i ka pilikia nephropathy. ^ E Ha yM. Hoʻopilikia kēia mau hopena ma kahi o ke kiʻekiʻe o ke koko.

Nā ʻĀina Amprilana

• puʻuwai paʻakikī (ke kēnā)
• haʻi maʻi,
• maʻi maʻi coronary arterymau naʻau.

Nā hōʻailona no ka hoʻohana ʻana ma nā maʻi me maʻi maʻi: nephropathy.

Nā Hoʻohui

• haaheo i nā ʻāpana
• puʻuwai naʻau (mitral, aortic, hui pū)
• hana waiū,
• huahua,
• ʻōnaehana ʻōnaehana,
• ʻano pālahalaha,
• hapai,
• makahiki i 18 makahiki.

Nā hopena hopena

I ka hapanui pinepine, ua kākau ʻia kahi hiʻi o ke koko pika.kelauʻi, migraine-like headache, maloʻo maloʻo, Hōʻoiaʻiʻo bronchospasmʻāʻī ʻili, hoʻomaʻamaʻa gaugitis a lōkohu me ka hoʻonui ʻana o ka hoʻouka ʻana o nā hoʻouka, ʻeha ʻana i nā ʻāpana a me nā naʻau.

ʻOi aku ka maʻamau arriraliapuʻuwai puʻuwai ʻinalelo angina pectorispaʻakikī e ka myocardial infarction, ʻO ka maʻi o Raynaud, vasculitis, astheno-depressive syndrome me ka hōʻeha hiamoe, ka lele ischemic attack a me he poho, huakai, ʻenehana renal system me ka hoʻonui ʻana i ka ʻike mea hana a urea i loko o ka urine nā hopena kūloheloheka hoʻololi i ka ʻokoʻa ma ka hana ʻana i ke ʻano o ka neutropenia, erythropenia.

Me ka holoʻana o ka paʻakikī o ka hopena maikaʻiʻole, ua manaʻo e kūkākūkā i ke kauka a hoʻomaha iki i ka lawe ʻana i ka lāʻau lapaʻau Amprilan.

E hoʻokuʻu i ke ʻano a me ka ʻano

ʻO ka mea hana nui a Amprilan ʻo Ramipril.

ʻO nā mea kōkua i loaʻa i loko o nā papa: ka sodium croscarmellose, ke kō pregelatinized, sodium stearyl fumarate, sodium bicarbonate, lactose monohydrate, ʻele.

Loaʻa nā dosages: 1.25 mg, 2.5 mg, 5 mg a me 10 mg o ka ramipril i hoʻokahi papa.

Hana ʻia ʻo Amprilan i nā papa (7 a i ʻole 10 mau papa i loko o kahi blister) oval me kahi ʻāpana papa a me kahi bevel. Kūlike ka ʻāpana o nā papa ma muli o ke ʻano o ka lāʻau lapaʻau: keʻokeʻo a ʻokoʻa paha ke keʻokeʻo (1.25 mg a me 10 mg pākahi), kukui kukui (2,5 mg pākahi), pink interspersed (5 mg kēlā)

Ka hana lāʻau lapaʻau

Lapaʻau lāʻau ʻO Amprilan kahi mea paʻa i ka ACE lohi. Hoʻololi ʻo Angiotensin-hoʻololi i ka hoʻololi ʻana o ka angiotensin II mai ka angiotensin I, he ʻano like me ka kinase - he enzyme e hoʻoulu ai i ka ʻimi ʻana o ka bradykinin. I ke hopena o ka blockade o ACE e Amprilan, ua emi iho ka ʻike ʻana o ka angiotensin II, ke ʻano o ka hana ʻana o renin i loko o ke kaila plasma, ka hana a bradykinin a me ka ulu ʻana o ka hoʻonui aldosterone, e alakaʻi ana i ka piʻi o ka waihona potassium i loko o ke koko.

Loaʻa i ka Amprilan nā hopena antihypertensive a me hemodynamic ma muli o ka hiki i ke kīʻaha koko a me ka hōʻemi o kā lākou huakaʻi pale peripheral āpau. I kēia hihia, ʻaʻole loli ka manaʻo o ka puʻuwai. ʻO ka emi ʻana o ke kaomi ma hope o hoʻokahi awelika o Amprilan i nānā ʻia ma hope o 1-2 mau hola, ma hope o 3-6 mau hola o ka hopena therapeutic i hōʻea i kahi lōʻihi a lōʻihi mau 24 hola.

Me ka lōʻihi o ka mālama ʻana me ka lāʻau lapaʻau, e haʻalele ana i ka hypertrophy ventricular, a ʻoiai ʻaʻohe hopena maikaʻi o ka hana o ka naʻau.

Lapaʻau lāʻau

Hoʻopili koke ʻia ka mea hana mai ka digestive tract (ʻaʻole hilinaʻi ka wikiwiki i ka intake meaʻai). Hoʻokahi hola ma hope o ka noi, ua hoʻokō ka nui o ka waiwai o ka waiwai i loko o ke koko. A hiki i 73% o ka ramipril pili i nā protein plasma.

Holo ka lāʻau i ka palupaleka, hana i ka ramiprilat metabolite ikaika (ʻo ka hana o ka mea hope loa he 6 mau manawa i luna o ka hana o ramipril iho) a me ka hāmeʻa diketopiperazine hana ʻole. Kuhi ka nui o ka ramiprilat i loko o ke koko ka ʻike mau hola he 2 ma hope o ka hoʻohana ʻana i ka lāʻau, he paʻa e paʻa ana i ka ʻano lā ma ka lā 4 o ka hoʻomaʻamaʻa. Ma kahi o 56% o ramiprilat e nakiki i nā protein plasma.

I luna o 60% o ramipril a me ramiprilat e hoʻopili ʻia ana e nā ʻōpū i loko o nā ʻano o nā metabolites, ʻoi aku ma mua o 2% o ka ramipril ua wehe ʻia mai ke kino i loli ʻole. ʻO ka hapalua o nā ola o ka ramiprilat mai 13 a 17 mau hola, ramipril - 5 mau hola.

Me ka hana pūnāwai paʻa ʻole, ua emi ka nui o ka hoʻonui ʻana o ka ramipril a me nā metabolites. I ka poʻe maʻi me ka maʻi hepatic, ua lohi ka loli o ka ramipril i ramiprilat, e hoʻonui ʻia ka ʻike o ka ramipril i loko o ka serum koko.

ʻLoe a me ke kākele

Lawe ʻia nā papa manawaleʻa, me ko ke ʻano o ka ʻai ʻana, mai kipi, inu i nā ʻano he nui.

Koho ʻia ka nui o ka lāʻau lapaʻau e ke kauka ponoʻī no kēlā me kēia maʻi, e noʻonoʻo ana i nā hōʻike, ka hoʻomanawanui o ka lāʻau, nā maʻi concomitant a me ka wā o ka mea maʻi. Ke koho ʻana i kahi mahele, pono e noʻonoʻo ʻia ke ʻano o ke koko. ʻO ka palena kiʻekiʻe loa o ka lāʻau no nā ʻano kīwī he 10 mg i kēlā me kēia lā. ʻO ka lōʻihi ka papa o ka lāʻau lapaʻau, hoʻonohonoho pū ʻia e ke kauka.

Me ka haina o ka hypertension ʻO ka dosage aʻoi mua ʻia he 2.5 mg hoʻokahi i kēlā me kēia lā. Inā kūpono, hiki ke pāpālua i ka make ma nā lā 7-14.

I loko o nā pūpū puʻuwai hema ʻo ka ʻōlelo mua o ka lāʻau lapaʻau ʻo 1.25 mg (hiki ke pāpālua ʻia ma hope o 1-2 mau pule).

Me ka pohō ʻole o ka naʻau, aia nō i ka lā 2-9 mau lā ma hope o ka hua kī ʻia ʻana o ka myocardial, ʻoi ʻia e lawe i ka nui o 5 mg o Amprilan i kēlā me kēia lā - 2,5 mg i ke kakahiaka a me ke ahiahi. Inā i ka wā e hoʻomaʻamaʻa nui ana ke koʻokoʻo, ua hoʻokaʻawale ʻia ka nui (1.25 mg ʻelua i kēlā me kēia lā). Ma hope o 3 mau lā, e piʻi hou ka lāʻau. Inā lawe ʻoe i ka lāʻau lapaʻau ma loko o kahi wai o 2.5 mg ʻelua mau manawa i kahi lā hou a ʻoluʻolu hou ʻia e ka mea maʻi, pono e hōʻoki ʻia ka hoʻomaʻemaʻe ʻana me Amprilan.

ʻO Nepropathy (me nā ala ākea o nā pēpē a me ka maʻi maʻi).ʻO ka paena hoʻomaka ʻana ʻo 1.25 mg i kēlā me kēia lā. I kēlā me kēia 14 lā, e pāpālua ʻia ka nui o ke ana a hiki i kahi mālama mālama ʻia o 5 mg i kēlā me kēia lā.

Ke kāohi nei i ka hana o ka naʻau ma hope o ka infococose myocardial. I ka hoʻomaka mua ʻana o ke papa lāʻau, ʻo ia ʻo Amprilan 2,5 mg i kuhikuhi ʻia i kēlā me kēia papa i kēlā me kēia lā. Ma hope o hoʻokahi pule, ua hoʻonui ʻia ka dosage i ka 5 mg no ka lā, ma hope o kekahi mau hebedoma 2-3 - i kahi maʻi mālama mālama o 10 mg hoʻokahi i ka lā.

Me ka ae ʻana i ka arterial a ma hope o ka maʻi bypass coronary Lawe ʻia ʻo Amprilan he 2.5 mg hoʻokahi i ka lā no 7 lā. A laila, no 2-3 mau hebedoma, lawe ʻia ka lāʻau lapaʻau ma 5 mg i kēlā me kēia lā, ma hope o ka hoʻonui ʻia ʻana o kāna inikua ʻelua mau manawa hou - hiki i 10 mg i kēlā me kēia lā.

Nā ʻōlelo kikoʻī

1. No ka poʻe maʻi me ka hana hoʻopiʻi hana o nā hana pēpē, ʻo ka hoʻomaka mua ʻana o Amprilan he 1.25 mg, a me ka nui o ka nui o kēlā me kēia lā e 5 mg.
2. No ka poʻe maʻi me ka hemahema o ka ate, ʻo ka nui o ka ma mua o 1.25 mg, ka nui o ka nui o kēlā me kēia lā he 2.5 mg.
3. Inā ʻōlelo ʻia ʻo Amprilan i nā maʻi e lawe ana i nā diuretics, hiki ke hoʻopau ʻia a hōʻemi paha i ka make o ka diuretics. Mālama pū kekahi kia mālama mau i ke kūlana o kēlā mau maʻi, ʻoi aku nā mea maʻi maʻi (ma mua o 65 mau makahiki).
4. Lawe ʻia ʻo Amprilan me ka akahele i nā mea maʻi me nā maʻi ʻōnaehana o ka maʻa hoonanea, ka maʻi diabetes mellitus, ka pectoris kaomi paʻa.
5. He hopena maikaʻi ka hopena i ka pūpū (hypoplasia o nā pūpū a me nā iwi o kahi ʻōpala, hyperkalemia, hana o ka renal) a hoʻohālikelike ʻia i nā wahine hāpai. Ma mua o ka haʻalele ʻana iā Amprilan, he mea nui no na wahine wahine o ka hānau keiki ʻana e haʻalele i ka male ʻana.
6. I ka wā e lawe ai iā Amprilan i ka wā lactation, pono ke hoʻopau ʻia ka umauma.

Nā kuleana a me nā kūlana e waiho ai

E mālama i ka lāʻau lapaʻau i kahi mahana ʻaʻole iʻoi aku ma mua o 25 ° C, ma kahi wahi i pale ʻia mai ka lepo a me ka lā, ʻaʻole hiki ke loaʻa i nā keiki. ʻO 3 mau makahiki kahi e noho ai ke ola o nā papa Amprilan. Ma hope o ka lā i hōʻike ʻia i ka pā, ʻaʻole hiki ke lawe ʻia ka lāʻau lapaʻau.

Nā mea hoʻohālikelike'ōmaʻomaʻo o Amprilan (nā mea kanu me nā mea hana like like):

Nā kiʻi 3D

ʻLoe a me ke kākele

I loko no ka manawa o ka ʻai ʻana (hiki ke lawe ʻia nā papa ʻaina i mua a i ka manawa a ma hope o ka ʻai ʻana), inu i ka wai nui (1/2 kīʻaha). Mai hamo a ʻānai paha i nā papa ma mua o ka lawe ʻana.

Koho ʻia ka lā ma ka mea e hopena ai ka hopena a me ke ahonui i ka lāʻau lapaʻau.

ʻO ka maʻi me ka Amprilan ® ka maʻamau o ka lōʻihi, a ʻo ka manawa ke loaʻa i kēlā me kēia hihia e ke kauka.

Inā ʻaʻole i hōʻike ʻia, a laila me ka hana maʻamau a me ka hana hepatic, ʻae ʻia nā hoʻoponopono hoʻoponopono i lalo.

ʻO ka maʻa mau nā hoʻomaka hoʻomaka ʻana he 2.5 mg / lā i ke kakahiaka. Inā lawe ʻoe iā Amprilan ® i kēia ʻauʻau no 3 mau hola a keu paha, ʻaʻole hiki ke hiki i ke ʻano o ke koko, a laila hiki ke hoʻonui ʻia ke ʻano i ka 5 mg / lā. Inā ʻaʻole pono ka nui o ka nui o ka 5 mg, ma hope o 2-3 mau pule e hiki nō ke pāpālua ia i ka nui o ka lā i hāpai ʻia ʻia o 10 mg.

ʻO ke ala hou e hoʻonui ai i ka pāoʻi i ka 10 mg / lā me ka lawa o ka pono antihypertensive o kahi lā i kēlā me kēia lā no 5 mg, hiki iā ia ke hoʻohui i nā lawena antihypertensive e mālama ai, ma ka diuretics a i ʻole BKK.

ʻO ka lā helu hoʻomaka ʻia ʻo 1.25 mg / lā. Ma muli o ka pane a ka mea maʻi i ka lāʻau, hiki i ka lāʻau ke hoʻonui.

Hoʻonohonoho ʻia e pāpālua i ka pālua me kahi anawa o 1-2 pule. Inā makemake ʻoe e lawe i kēlā me kēia lā he 2,5 mg a ʻoi aku paha, hiki ke hoʻohana ʻia i hoʻokahi manawa i ka lā, a i ʻoka ʻia i ʻelua pūhaka.

ʻO ka nui loa i ʻōlelo ʻia i kēlā me kēia lā he 10 mg.

ʻO ka maʻi nephropathy maʻi ʻole

ʻO ka lā helu hoʻomaka ʻia ʻo 1.25 mg / lā. Hiki ke hoʻonui ʻia ka nui i ka 5 mg / lā. Me kēia mau kūlana, ʻaʻole i aʻo pono nā wana i luna ma mua o 5 mg / lā i nā hoʻokolohua lapaʻau i hoʻopaʻa ʻia.

ʻO ka hōʻemi ʻana i ka hopena o ka hoʻomohala ʻana i ka infarction myocardial, stroke, a i ʻole ka make cardiovascular i nā maʻi me nā maʻi o ka puʻuwai kiʻekiʻe.

ʻO ka paena hoʻomaka hoʻomaka ʻia he 2.5 mg / lā.

Ma muli o ka hoʻomanawanui o ka mea maʻi iā Amprilan ®, hiki ke hoʻonui mālie ʻia ka hopena.

Manaʻo ʻia e pāpālua i ka pāʻai ma hope o 1 hebedoma lapaʻau, a ma mua o 3 mau pule, e hoʻonui iā ia i ka maʻi mālama maʻamau maʻamau o 10 mg / lā.

ʻO ke hoʻohana ʻana i kahi lāʻau ma mua o 10 mg / lā i nā hoʻokolohua lapaʻau i hoʻopaʻa ʻia ʻaʻole lawa. ʻAʻole maopopo ka hoʻohana ʻana i ka lāʻau lapaʻau i nā mea maʻi me ka Cl creatinine ma lalo o 0.6 ml / sec.

Hoʻokele ʻia ka puʻuwai naʻau i ulu ʻia ma nā lā mua i hala (mai 2 a 9 mau lā) ma hope o ka maʻi myocardial hoʻonā

ʻO ka paena mua i ʻōlelo ʻia ʻo 5 mg / lā, hoʻokaʻawale iā 2 mau papa hoʻokahi o ka 2.5 mg (lawe ʻia i ke kakahiaka a me ke ahiahi). Inā 'aʻole ka mea hoʻomanawanui i kēia mahele mua (kahi nui o ka emi nui o ke koko e mālama' ia), a laila ua ʻōlelo ʻia e lawe i ka 1.25 mg 2 mau manawa i ka lā no 2 lā.

A laila, hilinaʻi i ka hopena o ka mea maʻi, hiki ke hoʻonui ʻia ke ʻano. Ke kauoha ʻia nei e hoʻolōʻihi ʻia ka maʻi me ka piʻi o ka papalua me kahi manawa o 1-3 mau lā. Eia kekahi, ʻo ka huina o kēlā me kēia lā, kahi i hoʻokaʻawale ʻia me 2 mau dosis, hiki i kahi hoʻokahi.

ʻO ka nui ʻāpopo i hōʻike ʻia ʻo 10 mg.

I kēia manawa, ʻike i ka mālamaʻana i nā poʻe maʻi me ka hōʻeha puʻuwai hōʻeha (III - IV papa hana e like me ka helu ʻana NYHA) i ka manawa koke mai nei ma hope o ka pono o ka infarococococococare maʻa. Inā hoʻoholo nā mea maʻi e hana i ka hoʻomaʻamaʻa ʻia me Amprilan ®, ʻo ke ala ʻia e hoʻomaka ʻia ka mālama ʻana me ka haʻahaʻa haʻahaʻa haʻahaʻa - 1.25 mg / lā, a pono e mālama ʻia me kēlā me kēia piʻi ʻana o ka waiola.

Nā hui ahonui kūikawā

Hola paʻa kino hana. Me ka hoʻokumuʻana Cl mai 50 a 20 ml / min / 1.73 m 2, ʻo ka nui o ka laʻana o kēlā me kēia lā he 1.25 mg. ʻO ka pae helu ʻokoʻa loa i kēlā me kēia lā he 5 mg.

I ke kala ʻana i ka wai o ka puna a me nā electrolytes, hōʻemi loa i ka hypertension nui, a inā hoʻi inā he nui ka kahe o ke kahe o ke koko e hōʻike ana i kekahi mau hopena (no ka laʻana, me nā poho o ka atherosclerotic o ka coronary a me ka cerebral arteri). Hoʻemi ʻia ka lāʻau mua ma 1.25 mg / lā.

ʻO ka maʻi diuretic o mua. Inā hiki, hiki ke hoʻopau ʻia nā diuretics i nā lā 2-3 (e pili ana i ka lōʻihi o ka hana o ka diuretics) ma mua o ka hoʻomaka ʻana i ka mālama ʻana me Amprilan ® a i ʻole e hōʻemi ʻia i ka hopena o ka diuretics i lawe ʻia. Hoʻomaka ka mālama ʻana i nā mea maʻi e like me ka haʻahaʻa loa o Amprilan ® - 1.25 mg / lā i ke kakahiaka. Ma hope o ka lawe ʻana i ka hapa mua a me kēlā me kēia manawa ma hope o ka hoʻonui ʻana i ka nui o ka make ʻana o ka Amprilan ® a me / a diuretics loop, pono ma lalo o ke kahu maʻi o nā maʻi no ka liʻiliʻi 8 mau hola e pale ai i kahi ʻano hypotensive kuʻuna.

He 65 makahiki. Hoʻemi ʻia ka lāʻau mua ma 1.25 mg / lā.

Hōʻeha ka hana ʻoluʻolu. ʻO ka hopena o ke kahe o ke koko i ka lawe ʻana iā Amprilan ® hiki ke hoʻonui ʻia (ma ka hoʻolalelima ʻana o ka excretion ramiprilat) a i ʻole e nāwaliwali ʻia (no ka hoʻolohi lohi ʻana o ka loli o ka ramipril ka hana i ka ramiprilat ikaika). No laila, i ka hoʻomaka o ka mālama ʻana, pono ka makaʻala mālama olakino. ʻO ka helu ʻeha loa i kēlā me kēia lā he 2.5 mg.

Mea hana

JSC "Krka, dd, Novo mesto". Šmarješka cesta 6, 8501 Novo mesto, Slovenia.

Ke kīleʻa ʻana a me / a i ʻole a i ʻole ka pauku i ka hui ʻo Lūkini, pono e hōʻike ʻia: "KRKA-RUS" LLC. 143500, Lūkia, Moscow Wilayah, Istra, ul. Moscow, 50.

Tel .: (495) 994-70-70, fax: (495) 994-70-78.

ʻOihana keʻena o Krka, dd, Novo mesto JSC i ka Lūkini Russian / hui i ʻae aku i nā hoʻopiʻi ʻana i nā mea kūʻai aku: 125212, Moscow, Golovinskoye sh., 5, bldg. 1, papahele 22.

Tel .: (495) 981-10-95, fax (495) 981-10-91.

Lapaʻau lāʻau

Ma hope o ka mālama waha ʻana i ka hipa ramipril, wikiwiki koke ʻo Amprilan mai ka ʻeha o ka gastrointestinal (gastrointestinal tract) ma kahi pae o 50-60%. Hoʻololi i ka hoʻokeo ʻana me ka meaʻai i kāna hoʻopili ʻana, akā ʻaʻole i hoʻopilikia i ka nui o nā mea i komo i ke kahe koko. I loko o ka hopena o ka biotransformation / hoʻonāukiuki o ka ramipril, ka mea nui i ka ate ma ka hydrolysis, ramiprilat (kahi metabolite ikaika, 6 mau manawa hou aku ka ikaika ma mua o ka ramipril e pili ana i ka pale o ACE) a me ka diketopiperazine (kahi hana metabolite ka mea ʻaʻole i hana i ka hana pharmacological). Eia kekahi, ua hui pū ʻia ka diketopiperazine me ka waikawa glucuronic, a ʻo ka ramiprilat ka glucuronated a me ka hoʻoneʻe i ke kumetopiperazinic acid.

Hoʻokomo ka bioavailability o ramipril i ka waha o ka waha a ʻokoʻa mai ka 15% (no ka 2.5 mg) a i ka 28% (no ka 5 mg).ʻO ka bioavailability o ramiprilat ma hope o ke alakaʻi waha ʻana o 2.5 mg a me 5 mg o ka ramipril

ʻO 45% o kēia hōʻailona i loaʻa ma hope o ke kākā ʻana o ka paʻina o nā pā like ʻole.

Ma hope o ka lawe ʻana iā Amprilan i loko, ua loaʻa ka pae kiʻekiʻe o ka plasma ramipril ma hope o 1 h, ʻo ramiprilat - ma hope o nā hola 2-4. ʻO ka make ʻana o ka pae o ka ramiprilat i ka plasma ka mea i loaʻa i kekahi mau manawa: ka pae nui o ka hoʻoili a me ke kina ʻana me T_1/2 (hapa hapalua)

3 h, waena kūwae waena me T_1/2

15 h a me ka pae hope loa me ka haʻahaʻa haʻahaʻa haʻahaʻa o ka ramiprilat i plasma a me T_1/2

ʻO 4-5 mau lā, ma muli o ka hoʻokuʻu lohi ʻana o ramiprilat mai kahi paʻa paʻa me nā mea hoʻokae ACE. ʻOiai kēia manawa o ka hopena hope loa, ka lawe mau ʻana i ka ramipril ma mua o 2.5 mg a i hoʻokahi manawa hou aʻe i hoʻokahi lā i loko o ka mea hiki ke hoʻokō i ka hoʻokaʻoliʻu plasma o ka hoʻoneʻe ʻana o ka ramiprilat ma hope o 4 lā o ka lawe ʻana i ka lāʻau. Ma ke ʻano ʻo ka hoʻokele ʻana ʻo Amprilan i ka T_1/2 kūlike ma ka ʻona a ʻokoʻa mai 13 a 17 mau hola

Hoʻopili ʻo Ramipril i nā protein protein ma kahi o 73%, ramiprilat - 56%.

Ma hope o ka mālama waha ʻana i ka ramipril, i kāʻei ʻia me ka isotope radioaktif, i loko o kahi pali o 10 mg, a hiki i 39% o ka radioactivity ka mea i lawehala ma waena o nā ʻōpū, kahi e pili ana ia 60% i nā aʻalopele. I ka poʻe maʻi me ka wai o ka hue wai me ka wai ma muli o ka lawe ʻana i ka 5 mg o ka ramipril i loko o kaʻeha a ma waena o nā ʻāpana, kokoke i ka nui o ka like me ka ramipril a me kāna mau metabolites i hoʻokuʻu ʻia ma nā hola 24 mua ma hope o ka hoʻokele ʻana.

Ma kahi o 80-90% o nā waiwai i lawe ʻia i ka urine a me ka bile i ʻike ʻia he ramiprilat a me nā metabolites. Hoʻolālā ʻo Ramipril glucuronide a me diketopiperazine

10-20% o ka huina o nā huina a me nā unababolized ramipril -

Ma nā haʻawina preclinical i nā holoholona, ​​ua ʻike ʻia ua hala ka ramipril i ka waiū umauma.

I nā mea maʻi me ka hana renal impaired, ʻo ka clearance clearance (CC) no kahi o 60 ml / min a hoʻopau i ka ramiprilat a me nā metabolites. Ke alakaʻi nei kēia i ka hoʻonui i kā lākou neʻe plasma a me kahi hoʻohaʻahaʻa i ka hoʻohālikelike ʻana me nā mea maʻi me ka hana maʻamau maʻamau.

ʻO ka lawe ʻana i nā dosis kiʻekiʻe o ka ramipril (10 mg) ma ka hihia o ka hana hōʻehaʻeha o ke akea e alakaʻi i kahi kaho o ka presystemic metabolism o ramipril a me kahi wikiwiki o ka metabolite kūlohelohe.

I nā mea hana olakino olakino a me nā poʻe maʻi me ka hypertension arterial, ʻaʻohe klinikola kumulamu koʻikoʻi o ka ramipril a me ramiprilat i nānā ʻia ma muli o kahi hopena ʻelua pule me Amprilan ma kahi o 5 mg pākahi. Ma hope o ka papa ʻelua mau pule like ʻelua, nā mea maʻi me ka puʻuwai puʻuwai ua loaʻa i kahi hoʻonui 1.5-1-1 ka nui o ka nui o ka ramiprilat i loko o ke koko koko a me ka wahi ma lalo o ka pīpī i ka manawa o ka manaʻo (AUC).

ʻO nā hiʻohiʻona pharmacokinetic o ramipril a me ramiprilat i nā limahana olakino olakino e 65-75 mau makahiki ʻaʻole i ʻokoʻa nui mai kēlā mau poʻe ʻōpio olakino maikaʻi.

ʻO nā waiwai Pharmacological

Lapaʻau lāʻau

ʻO ka metabolite ikaika o ramipril, i hoʻomohala ʻia e ka hana a nā “enzyme” enzymes, ʻo ramiprilat he mea hoʻomalu i ka ACE huna (synonyms o ACE: kininase II, dipeptidyl carboxy dipeptidase I). ACE i loko o ka plasma a me nā kikoo catalyzes i ka huli ʻana o ka angiotensin I ka angiotensin II, kahi hopena vasoconstrictor, a me ka haʻihaʻi o ka bradykinin, he hopena vasodilating. No laila, i ka wā e lawe ai i ka ramipril i loko, e hoʻoneʻe ana ka hoʻokumu ʻana o ka angiotensin II a hōʻiliʻili ka bradykinin, kahi e hiki ai i ka vasodilation a me ka hoʻolilo o ke koko (BP). Ka hoʻonui ʻana o Ramipril i ka hana o ka ʻōnaehana kallikrein-kinin i loko o ke koko koko a me nā ʻili me ka hoʻōla ʻana o ka ʻōnaehana prostaglandin a me ka hoʻonui ʻana aʻe i ka synthesis o prostaglandins, e hoʻoulu ana i ka hana o ka nitric oxide (N0) i ka endotheliocytes, e kumu ai ka hopena cardioprotective.

Hoʻomoe ʻo Angiotensin II i ka hana o aldosterone, no laila, ʻo ka lawe ʻana i ka ramipril e alakaʻi i ka hōʻemi o ka huna ʻana o ka ald testosterone a me ka hoʻonui ʻana o ka pā o ka potassium ma ka serum koko.

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

Ua manaʻo ʻia aia ka hoʻomohala ʻana i kekahi mau hopena pōʻino (ʻo ia hoʻi, ka umauma "maloo") pili me ka nui o ka hana o ka bradykinin.

I nā maʻi me ka hypertension arterial ka lawe ʻana i ka ramipril pili i ka emi ʻana o ke koko i loko o nā kūlana "hoʻopunipuni" a me ka "kū" i ʻole ka hoʻonui ʻia ʻana o ka puʻuwai naʻau (HR). Ua hōʻemi nui ʻo Ramipril i ka pale kūʻokoʻa o kēlā me kēia kūleʻa peripheral (OPSS), ma ka hoʻomaʻamaʻa ʻole i ka hoʻololi ʻana i ke kahe koko o ka renal a me ka huina filtration glomerular. Hoʻomaka ka hopena antihypertensive e hele i ka 1 i ka 2 mau hola ma hope o ka hoʻokomo ʻana i hoʻokahi dosis o ka lāʻau, hōʻea i kona waiwai kiʻekiʻe ma hope o nā hola 3-6, a mau no 24 mau hola. Me ke papa o ka lawe ʻana iā Amprilan, hiki ke hoʻonui ikaika ka hopena antihypertensive, maʻamau e hōʻalo ʻia e ka 3-4 mau wiki o ka hoʻohana maʻamau a hoʻomau i ka wā lōʻihi. Hōʻalo ka hiki ʻana o ka lāʻau lapaʻau ʻaʻole alakaʻi i ka piʻi wikiwiki a nui i ke kaʻe o ke koko (nele o ka "withdrawal" syndrome).

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 poʻe maʻi me ka puʻuwai naʻau paʻakikī (CHF) Hōʻemi ka ramipril i ka OPSS (hoʻemi i ka hoʻoulu ʻana ma ka puʻuwai), hoʻonui i ka hiki ke o ka channel venous a hōʻemi i ke kaomi piha o ka ventricle hema (LV), kahi, e alakaʻi ai i ka hoʻemi o ka preload ma ka puʻuwai. I kēia mau maʻi āpau, i ka wā e lawe ai i ka ramipril, he nui ka hopena o ka hopena o ka cardiac, LV ejection hapa (LVEF) a me ka hoʻomaikaʻi ʻana i ka hoʻokau ʻana.

Me ka maʻi diabetes maʻi a me ka maʻi ʻole lawe aku i ka hipa o ka ramipril i hoʻomoe i ka pae o ka holomua o ka renal ka maikaʻi a me ka hoʻomaka ʻana o ka hopena o ke kau ʻana i ka hopena o ka hana a, a, ma laila, e hōʻemi ana i ka pono hemodialysis a i ʻole hoʻololi i ka maʻi. I nā hoʻomaka mua o ka maʻi diabetes a nondiabetic nephropathy, hoʻemi ka ramipril i ka hōʻeha o ka albuminuria.

I ka poʻe maʻi me ka pilikia nui o ka hoʻomohala ʻana i nā maʻi cardiovascular ma muli o nā maʻi vascular (maʻi coronary heart disease, ka mōʻaukala o kēlā me nā mea pono e pili ana i ka maʻi, ka mōʻaukala o ke kuhi) a i ʻole ka maʻi mellitus me ka liʻiliʻi loa ma kahi o nā mea e pili ana i ka maʻi (microalbuminuria, hypertension arterial, he hoʻonui i ka neʻe ʻana o ka nui Ka kolamu (OXc), e hoʻohiolo ana i ka manaʻo o ka cholesterol lipoprotein kiʻekiʻe-density (HDL-C), ulaula) i ka hoʻohui ʻana o ka ramipril i ka hana maʻamau e hōʻemi Hōʻike ia i ka loaʻa ʻana o ka myocardial infarction, stroke, a me ka make cardiovascular. Eia kekahi, hoʻemi ʻo ramipril i ka nui o ka make me ka nui o ka make, a me ka pono o ka hana hou revascularization a e hoʻolohi i ka hoʻomaka a i ʻole ka holomua o ka puʻuwai naʻau.

I nā mea maʻi me ka hōʻeha o ka naʻau me nā hōʻike lapaʻau i ulu ai i nā lā mua o ka nui o ka maʻi myocardial infarction (2-9 mau lā), ka hoʻohana ʻana iā ramipril, hoʻomaka ʻia mai ka lā 3 a i ka lā 10 o ka maʻi myocardial acute, hōʻemi i ka make (ma ka 27%) ka make (ma ka 30%), ka hōʻeha o ka hōʻeha nui o ka naʻau e holomua ana i kahi pae koʻikoʻi (III-IV papa hana e like me ka palapala ʻo NYHA) / pale-therapy (e 23%), ka hopena o ka hoʻoliʻi ma hope o ka hoʻomohala ʻana o ka hōʻeha o ka naʻau (e 26%).

Ma ka nui o ka poʻe maʻi ma ka maʻi, a me ka poʻe maʻi me ka maʻi mellitus o ka maʻi mole, ka mea me ka hypertension arterial a me ka hoʻokaʻina koko, ke hoʻokaʻawale nei ʻo ramipril i ka hopena o ka nephropathy a me ka hanana o microalbuminuria.

Lapaʻau lāʻau

Ma hope o ka lawelawe waha, ua hopu koke ʻia ka ramipril mai ka ʻeha o ka gastrointestinal (50-60%). Hoʻololi ka ʻai i kona ʻuʻina ʻana, akā ʻaʻole i pili i ka hoʻopiha piha ʻana.

Lā ʻo Ramipril i kahi hanahana presystemic intensial / hana (nui i loko o ka ate ma ka hydrolysis), ka hopena o kāna metabolite wale nō, ʻo ramiprilat, nona ka hana me ka pale ʻana i ka ACE pili ma kahi o 6 mau manawa o ka ramipril. Eia kekahi, ma muli o ka metabolism ramipril, diketopiperazine, ʻaʻole ia o ka hana pharmacological, i hoʻokumu ʻia, kahi i hui pū ʻia me ka acid glucuronic, ʻo Ramiprilat hoʻi he glucuronated a hoʻoneʻeneʻe i ka meletopiperazinic acid.

ʻO ka bioavailability o ramipril ma hope o ke alakaʻi waha ʻana ma waena o 15% (no kahi momona o 2.5 mg) a i ka 28% (no kahi dosis o 5 mg). ʻO ka bioavailability o ka metabolite ikaika, ramiprilat, ma hope o ka nānāʻana o 2.5 mg a me 5 mg o ka ramipril he 45% ka hoʻohālikelike ʻia (hoʻohālikelike ʻia me kona bioavailability ma hope o ka hoʻokō intravenous ma nā kī like).

Ma hope o ka lawe ʻana i ka ramipril i loko, ʻoi ka ʻike nui loa o ka plasma nui a ka ramipril a me ka ramiprilat ma hope o ka 1 a me 2 a hiki i ka 4 mau hola, kēlā. ʻO ka emi ʻana o ka neʻe o ka plasma o ramiprilat i loaʻa i kekahi mau manawa: ka hoʻoili a me ka hana excretion me ka hapalua ola (T1 / 2) o ramiprilat o kahi o 3 mau hola, a laila ʻo ka manawa waena me ka T1 / 2 ramiprilat, aneane 15 mau hola, a me ka hopena hope loa me ka haʻahaʻa haʻahaʻa loa o ka ramiprilat i ka plasma a me ka ramepa T1 / 2 ramiprilat, ma kahi o 4-5 mau lā. ʻO kēia hana ma muli o ka hoʻokuʻu lohi o ramiprilat mai kahi paʻa paʻa me nā mea hoʻokae ACE. ʻOiai ka lōʻihi o ka manawa hope loa me kahi pākuʻi waha hoʻokahi o ka ramipril i ʻōlelo iki ʻia ma kahi o 2.5 mg a i ʻole ka nui, ʻike ʻia ka pāpaʻi plasma o ka waiwai o ka ramiprilat ma hope o ka mau lā 4 o ka mālama ʻana. Me ka hoʻohanaʻana i ka lāʻau "hopena" T1 / 2 nā kumu hoʻohālikelike i nā hola 13-17.

ʻO ke kamaʻilio me nā protein plasma koko e like me 73% no ka ramipril, a ʻo 56% no ka ramiprilat.

Ma hope o ka hoʻopuka ʻana i ka paʻakai, ʻo ka laha o ka hoʻolaha ʻana o ka ramipril a me ramiprilat he 90 mau ʻo L a me kahi o 500 L, kēlā.

Ma hope o ka nānā ʻana i ka ramipril (10 mg) i kāʻei ʻia me ka isotope radioaktif, 39% o ka radioactivity ka mea i kāpae ʻia ma o nā ʻōpū a ma kahi o 60% e nā keiki. Ma hope o ka hoʻokele ʻana i ka maʻi ramipril, ʻike ʻia ka nui o 50-60% i loko o ka urine i ka nui o ka ramipril a me kāna metabolites. Ma hope o ka hoʻokele ʻana o ramiprilat, ma kahi o 70% o ka nui i loaʻa i loko o ka urine ma ke ʻano o ka ramiprilat a me nā metabolites, ma nā ʻōlelo ʻē aʻe, me ka keʻe ʻana o ka lawelawe ramipril a me ramiprilat, kahi ʻāpana koʻikoʻi o ka dosis e hoʻopili ʻia ma loko o nā ʻāpana me ka huahele, ma ke ala ʻana i nā pōpoki (50% a 30%, like). Ma hope o ka hoʻoponopono waha ʻana o 5 mg o ka ramipril i nā mea maʻi me ka hoʻokahe wai o ka bile, aneane like ka nui o ka hipa ramipril a me kāna mau metabolites i hoʻopaku ʻia e nā keiki a ma o nā ʻāpana i loko o nā hola 24 mua ma hope o ka hoʻokele ʻana.

Ma kahi o 80 - 90% o nā metabolites i loko o ka urine a me ka bile i ʻike ʻia he ramiprilat a me nā metabolits ramiprilat. ʻO ka helu meloka Ramipril glucuronide a me ka ramepril kumetopiperazine account ma kahi o 10-20% o ka nui o ka huina, a me ka kikoʻī o ka ramipril unmetabolized i loko o ka urine e like me 2%. Ua hōʻike ʻia nā haʻawina holoholona me nā hipa ʻokripril i ka umauma waiū.

I ka hihia o ka hana renal maʻi ʻole me ka creatinine clearance (CC) no kahi o 60 ml / min, e hoʻopiha ʻia nā excretion o ramiprilat a me nā metabolites i nā ʻōpū. Ke alakaʻi nei kēia i ka hoʻonui i ka neʻe o ka plasma o ka ramiprilat, e hoʻohaʻahaʻa i ka mea lohi ma mua o nā mea maʻi me ka hana maʻamau maʻamau.

Ke lawe nei i ka ramipril ma nā wai haʻahaʻa (10 mg), hana ka hopena o ka puʻuwai maʻi i ka hōʻemi i ka presystemic metabolism o ramipril i ka ramiprilat ikaika a me kahi hōʻano wikiwiki i ka ramiprilat. I nā limahana olakino a me nā mea maʻi me ka hypertension arterial, ma hope o ka mālama ʻia o hoʻokahi pule ʻelua me ka ramipril i kēlā me kēia lā o 5 mg, ʻaʻohe ʻano nui o ka hōʻuluʻulu ʻo ramipril a me ramiprilat. I ka poʻe maʻi me ka puʻuwai naʻau, ma hope o nā hebedoma ʻelua o ka mālama ʻana me ka ramipril i loko o kahi pānaʻi o kēlā me kēia lā he 5 mg, he hoʻonui ʻia 1.5-1.8-nui i ka hoʻoliʻi ʻana o ka plasma o ramiprilat a me kahi i ka lalo o ka pālohi ʻana i ka manawa (AUC).

I nā limahana olakino olakino (65-75 mau makahiki), ʻaʻole nui ka like i ka pharmacokinetics o ramipril a me ramiprilat i nā poʻe olakino olakino.

Hoʻohana i ka wā hāpai a i ka wā o ka umauma

Ua hoʻohālikelike ʻia ʻo Amprilan i ka wā hāpai ʻana, no ka mea hiki ke loaʻa kahi hopena i ka pūpū: hoʻonui i ka hanana ʻana o nā keiki o ka pēpē, a hoʻemi ʻia ke koko o ka ʻōpiopio a me nā keiki hou, nā māla o ka maʻi papaha, hyperkalemia, hypoplasia o nā iwi o ka ʻōpala, hypoplasia o ka ʻōpū.

No laila, ma mua o ka lawe ʻana i ka lāʻau i nā wahine o ka wā hānau keiki, pono ke haʻalele ʻia ka wahine hānau.

Inā hoʻolālā kahi wahine i ka hapai, a laila e hoʻokuʻu ʻia ka mālama ʻana me ka inhibitor ACE.

Ma ka wā hapai i ka wā mālama me Amprilan, pono ʻoe e kāpae e lawe iā ia i ka wā hiki loa a hoʻoneʻe i ka mea maʻi i lawe i nā lāʻau ʻē aʻe, me ka hoʻohana ʻana o ia mau pilikia i ke keiki i liʻiliʻi.

Inā makemake ʻia ka mālama ʻana iā Amprilan i ka wā o ka hoʻoulu ʻana, e ʻoki ʻia nā umauma.

Amprilan, nā ʻōkuhi no ka hoʻohana (Paʻa a me ke ʻano)

Ua kuhikuhi ʻia ʻo Ramipril i loko o ke kūʻokoʻa o ka ʻono ʻana i ka meaʻai. Hoʻomaopopo ʻia nā papa no ka inu ʻana i nā ʻano wai he nui. Ke hōʻike ʻia nei ka lāʻau lapaʻau e kekahi kauka i koho i kahi kao kūpono e noʻonoʻo ai i ke kūlana o ka mea maʻi a hoʻomanawanui i nā ʻāpana o ka lāʻau. Hoʻomaopopo ʻia e hoʻomaka i ka lawe ʻana iā Amprilan me nā liʻiliʻi liʻiliʻi o ka 2.5 mg, me ka piʻi aʻe o ka piʻi i nā helu he nui - 10 mg. Hoʻoholo ʻia ka lōʻihi o ka lāʻau lapaʻau e ke kauka e hilinaʻi ana i nā hoʻopiʻi a me ka ʻikepili, kahi mōʻaukala olakino maikaʻi ʻia.

Nā ʻōkuhi no ka hoʻohana ʻana iā Amprilan ND a me NL: papa pākahi i kēlā me kēia lā. Hiki i ka hoʻoponopono hoʻoponopono ʻia i ka wā o ka mālama ʻana. ʻAʻole palena ka lōʻihi o ka lāʻau lapaʻau.

Pākuʻi helu

Nā Papa 1.25 mg, 2,5 mg, 5 mg a me 10 mg

Aia ma ka papa papa

mea waiwai - ramipril 1.25 mg, 2.5 mg, 5 mg, 10 mg,

nā mea hoʻowalewale: sodium bicarbonate, lactose monohala, croscarmellose sodium, pregelatinized starch (starch 1500), sodium stearyl fumarate (nā mea ʻai no 1.25 mg, 2.5 mg, 5 mg a me 10 mg),

no ka helu 2.5 mg: pigment mix PB22886 melemele (lactose monohydrate, iron oxide yellow (E 172)),

no ka ana no ka 5 mg: pigment mix PB24899 ʻulaʻula (lactose monxidate, iron oxide red (E 172), iron oxide yellow (E 172)

Flat oval tablet, mai keʻokeʻo a hiki i keʻokeʻo,

chamfered (no nā papa o 1.25 mg a me 10 mg)

Flat oval tablet, kukui aniani, chamfered (no ka laʻana o 2.5 mg)

Nā papa pala o kahi ʻano oval, ʻulaʻula, me kahi makika a ʻike ʻia ʻole (me ke ʻano he 5 mg)

Ke keu

ʻO nā hōʻailona o kahi overdose o ka lāʻau lapaʻau brieociaia (langka pulse), he hapalua o ka neʻe koko, kāʻā haʻalulu me ka pani ʻole o ka pilikia. Hoʻokomo ʻia nā ʻōnaʻi ulia no ka overdose hihā a me nā palapala noihoʻohui, a me ka hoʻoweliweli o ka haʻalulu, ka hoʻomaka ʻana o nā lāʻau lapaʻau e hoʻonui ai i ke koko.

Hoʻohui

Kāleka haluluHalakalaha, he hui o nā lāʻau lapaʻau anti-inflammatory, ʻo ka hormon corticosteroid e hiki ke hōʻemi i ka nui o ka hopena hypotensive raminipril. ^ E Ha yM. Hoʻonui i ka hopena hypotensive o nā lāʻau antipsychotics, nā lāʻau antidepressant. ʻO ka hui pū ʻana o Amprilan me nā lāʻau lapaʻau o ka hui lithium, gula, potassium-sparing diuretics, hypoglycemic agents, cytostatics, potassium hoʻomākaukau, immunosuppressants, ʻaʻole i ʻōlelo ʻia.

E hoʻokuʻu i ke ʻano a me ka pale

Ua hoʻonoho ʻia a he 10 paha nā papa i loko o kahi kīʻaha blister o kahi kiʻi o ka polyamide laminated / alumini / polyvinyl chloride a me ka alumini foil.

Hōʻike ʻia ka ʻatikena blister me 7 mau papa i nā ʻano ʻelua, ʻokoʻa i ka hoʻonohonoho ʻana o nā papa i ka pākau.

4, 12 a ʻehā paha (7 mau papa i kēlā) a i ʻole, 2, 3 a i ʻole (5 mau papa i kēlā me kēia) mau pūʻulu blister me nā ʻōlelo no ka hoʻohana ʻana i ke olakino ma ka mokuʻāina a me nā ʻōlelo Lūkini e kau ʻia ana i loko o kahi kīpē