Har'a litlhare tsa kalafo ea khatello e phahameng ea mali (BP), Pyramil e hlahelletse. Moriana o thibela ts'ebetso ea enzymatic phetohong ea angiotensin I. Litlamorao tsa phello ea methapo le phello ea pelo li bonahala. Ka lebaka la ts'ebetso e kopaneng ea likhomphutha tsena ka bobeli, ho ile ha khonahala ho fokotsa kotsi ea ho ba le myocardial infarction, stroke le ho eketsa sekhahla sa ntlafatso ea bakuli ba nang le liso tsa methapo ea methapo.
Lebitso la Machaba le sa Tšoanelehang
Ramipril
Har'a litlhare tsa kalafo ea khatello e phahameng ea mali (BP), Pyramil e hlahelletse.
ATX
C09AA05
Lokolla liforomo le sebopeho
Setlhare se fumaneha ka foromo ea lipilisi. Matlapa a Oblong biconvex a na le 5 kapa 10 mg ea ntho e sebetsang ea ramipril. Ha ho sebelisoa likarolo tse thusang tlhahisong ena:
- colloidal silicon dioxide;
- glyceryl dibehenate;
- cellcose ea microcrystalline;
- glycine hydrochloride;
- setlolo sa pregelatinized.
Matlapa a 5 mg a pinki e bobebe ka lebaka la tlatsetso ea dae e khubelu e thehiloeng holim'a tšepe. Kotsi e fumaneha feela ka lehlakoreng le ka pele.
Microcrystalline cellulose e sebelisoa e le likarolo tse thusang tlhahisong ea Pyramil.
Ketso ea pharmacological
Setlhare ke sa ACE inhibitors (angiotensin-converting enzyme). Ha e kena ka har'a sebete, hydrolyzes e sebetsang ea lik'hemik'hale ho etsa sehlahisoa se sebetsang - ramiprilat, e fokotsang phello ea ACE (angiotensin-converting enzyme e potlakisa phetoho ea angiotensin I ho angiotensin II ka karabelo ea lik'hemik'hale).
Ramipril e thibela bongata ba plasma ea angiotensin II, e fokotsa sekhahla sa aldosterone mme ka nako e ts'oanang e ntlafatsa phello ea renin. Tabeng ena, kinase II blockade e etsahala, tlhahiso ea prostaglandin e eketseha mme bradycardin ha e robehe. Ka lebaka la ts'ebetso ea ntho e sebetsang, khatello ea methapo ea pelo (OPSS) e fokotseha, ka lebaka la eona ba atoloha.
Mofumahali
Ha ho fanoa ka molomo, moriana o kenella ka potlako ka mpeng e nyane, ho sa tsotelehe lijo. Tlas'a tšusumetso ea esterase, hepatocytes e fetoha phetoho ea ramipril ho ramiprilat. Sehlahisoa se bolileng se thibela angiotensin-converting enzyme makhetlo a 6 le matla ho feta ramipril. Setlhare se fihla sehlohlolong se phahameng sa plasma nakong ea hora kamora ts'ebetso, ha tekanyo e phahameng ea ramiprilat e fumanoa kamora lihora tse 2-4.
Ha e kenella maling, karolo e sebetsang e tlama liprotheine tsa plasma ka 56-73% mme e qala ho ajoa liseleng tsohle. Bophelo ba halofo ea lithethefatsi ka ts'ebeliso e le 'ngoe ke lihora tse 13-17. Ramipril le metabolite e sebetsang li epuoa ho tsoa ka liphio ka 40-60%.
Ramipril le metabolite e sebetsang li epuoa ho tsoa ka liphio ka 40-60%.
Matšoao a ho sebelisoa
Moriana o laetsoe kalafo le thibelo ea mafu a latelang:
- nephropathy ea mofuta oa lefu la tsoekere le e se nang lefu la tsoekere maemong a preclinical kapa sepetlele, e tsamaeang le khatello ea mali ea methapo, proteinuria le tokollo ea albin ka moroto;
- lefu la tsoekere la mellitus le rarahaneng ke mabaka a eketsehileng a kotsi ka tsela ea khatello ea mali, ho eketseha kapa ho fokotseha ha cholesterol le lipoprotein tse fokolang, litloaelo tse mpe;
- khatello e phahameng ea mali ka har'a lijana tse ka sehloohong;
- lefu la pelo le matla, le ileng la hlaha matsatsing a 2-9 kamora ho hlaseloa ke lefu la pelo.
Setlhare sena se thusa ho fokotsa kotsi ea ho ts'oaroa hape ke ts'ebeliso ea batho ba fetileng likopanong tsa methapo ea mokokotlo kapa lefu la pelo, ho nyekeloa ke pelo, angioplasty ea methapo ea mokokotlo. Motsoako ke karolo ea phekolo e amanang le ho hloleha ha pelo ho sa foleng.
Contraindication
Maemong a mang, moriana ha o khothalletsoe kapa oa thibeloa hore o sebelisoe:
- ho ruruha ho matla ha renal kapa hepatic;
- lefu la pelo le pelo;
- khatello e tlase ea mali haeba khatello ea systolic e ka tlase ho 90 mm Hg. st .;
- hyperaldosteronism;
- stenosis ea mitral valve, aorta, methapo ea kutlo;
- cardiomyopathy e thibelang;
- ho ima le ho nyekeloa ke mpa;
- bana ba ka tlase ho lilemo tse 18;
- eketseha habonolo ea lisele tsa mmele ho likarolo tsa moriana.
Ho hlokomelisoa ha ho etsoa li-immunosuppressants, diuretics, saluretics.
Mokhoa oa ho nka Pyramil
Setlhare se etselitsoe tsamaiso ea molomo. Karolo ea letsatsi le letsatsi ea kalafo e khethoa ke ngaka e thehiloeng ho litšobotsi tsa mokuli, nalane ea bongaka le liteko tsa laboratori. Karolo ea bohlokoa ea ho khetholla mofuta oa kalafo e bapaloa ke ho teba le mofuta oa lefu lena.
| Boloetse | Mohlala oa phekolo |
| Phaello ea mali | Ha ho sa sebetse pelo, tloaelo ea letsatsi le letsatsi e fihla ho 2,5 mg. Tekanyetso e nyoloha ka mor'a libeke tse ling le tse ling tse 2-3 ho latela mamello. Ha ho na le phello ea kalafo e nang le takatso ea ka mehla ea 10 mg ea moriana, ho hlokahala hore o buisane le ngaka ea hau ka khetho ea kalafo e felletseng. Sekhahla se phahameng se lumelletsoeng ke 10 mg ka letsatsi. |
| Ho nyekeloa ke pelo ho sa feleng | 1,25 mg ka letsatsi hang. Litekanyetso li eketsoa libeke tse ling le tse ling tse 1-2 ho latela boemo ba mokuli. Litefiso tsa letsatsi le letsatsi ho tloha ho 2,5 mg le kaholimo li khothalletsoa ho aroloa ka litekanyetso tsa 1-2. |
| Fokotsa kotsi ea ho tšoaroa ke lefu la stroke | Tekanyetso e le 'ngoe ea letsatsi le letsatsi ke 2,5 mg. Libekeng tse 3 tse tlang, ho na le palo ea litekanyetso tse eketsang (matsatsi a mang le a mang a 7). |
| Ho nyekeloa ke pelo kamora ho hlaseloa ke pelo | Phekolo e qala matsatsi a 3-10 kamora ho hlaseloa ke lefu la pelo. Tekanyetso ea pele ke 5 mg ka letsatsi, e arotsoe ka litekanyetso tse peli (hoseng le pele u robala). Kamora matsatsi a 2, tloaelo ea letsatsi le letsatsi e nyoloha ho 10 mg. Ka mamello e tlase ho litekanyetso tsa pele bakeng sa matsatsi a 2, sekhahla sa letsatsi se fokotsoa ho 1,25 mg ka letsatsi. |
| Nephropathy ea lefu la tsoekere le e se nang lefu la tsoekere | 1,25 mg bakeng sa ts'ebeliso e le 'ngoe, e lateloang ke keketseho ho 5 mg. |
Le lefu la tsoekere
Boemong ba pele ba kalafo ea lithethefatsi, ho khothalletsoa ho nka halofo ea letlapa la 5 mg ka letsatsi hang. Ho ipapisitsoe le boemo bo eketsehileng ba bophelo bo botle, tloaelo ea letsatsi le letsatsi e ka phetoa habeli ho ea tekanyetso e kholo ea 5 mg e nang le tšitiso ea libeke tse 2-3.
Litla-morao Pyramil
Litlamorao tse mpe tsa ho nwa moriana o bonahala ho latela karabelo ea motho ka mong ea metsoako ea lik'hemik'hale ea ntho e sebetsang.
Karolong ea setho sa pono
Acuity e bonoang ea fokotseha, ho ea pele ebile hoa fifala. Maemong a sa tloaelehang, ho ba le conjunctivitis.
Ho tsoa ho lisele tsa musculoskeletal le tse sebetsang
Sisteme ea musculoskeletal e kopana ka makhetlo le mesifa ea mesifa le bohloko ba manonyeletso.
Phekolo ea ka mpeng
Boitšoaro bo fosahetseng ba tsamaiso ea tšilo ea lijo nakong ea ts'ebeliso e mpe ea lithethefatsi bo iponahatsa ka sebopeho sa:
- bohloko le ho hloka botsitso sebakeng sa epigastric;
- lets'ollo, ho tlatlapa, ho sokela;
- ho hlatsa, ho nyekeloa le pelo;
- dyspepsia;
- molomo o omileng
- ho fokotse takatso ea lijo ho fihlela nts'etsopele ea ho ipolaisa tlala;
- pancreatitis e nang le monyetla o fokolang oa lefu.
Mohlomong keketseho ea ts'ebetso ea li-aminotransferase ho hepatocytes, li-amana tsa hepatocellular. Ho na le secretion e eketsehileng ea lero la pancreatic, keketseho ea plasma ea mahlaseli a bilirubin maling, ka lebaka la eona choleundatic jaundice e hlaha.
Hematopoietic litho tsa ka hare
Khahlano le semelo sa kalafo ea lithethefatsi, ho na le monyetla oa ho fetoha ka mokhoa o ipheta-phetisetso oa agranulocytosis le neutropenia, ho fokotseha hoa palo ea lisele tsa mali le boemo ba hemoglobin.
Tsamaiso ea methapo e bohareng
Litla-morao tse ka hare ho tsamaiso ea methapo ea kutlo le pherekano li hlahisoa e le:
- ho tsekela le ho tšoaroa ke hlooho;
- tahlehelo ea maikutlo;
- parosmia;
- maikutlo a tukang;
- ho lahleheloa ke botsitso;
- ho thothomela ha maoto le matsoho.
Tlas'a tekano ea kelello, ho tšoenyeha, ho tšoenyeha, ho tšoenyeha ha boroko hoa hlokomeloa.
Ho tsoa ts'ebetsong ea moroto
Ho na le keketseho ea pherekano ea ho hlohlona ha glomerular, ka lebaka la hore protheine e fumaneha ka har'a moroto, mme boemo ba creatinine le urea maling bo nyoloha.
Ho na le keketseho ea pherekano ea ho hlohlona ha glomerular, ka lebaka la hore protheine e fumaneha ka har'a moroto, mme boemo ba creatinine le urea maling bo nyoloha.
Ho tsoa tsamaisong ea phefumoloho
Litlamorao tse mpe tsamaisong ea phefumoloho li bonahala ka mokhoa oa bronchitis, ho khohlela khafetsa ho omileng, ho hema ka thata, sinusitis.
Karolong ea letlalo
Bakuli ba nang le tloaelo ea ho bonahatsa ho kulisoa ke mefuta ea lintho tsohle tse ling ba na le kotsi ea ho ba le dermatitis ea letlalo, urticaria le hyperhidrosis. Photosensitization ha e na seoelo - maikutlo a khanya, alopecia, matšoao a mpefatsang a psoriasis, onycholysis.
Ho tsoa ts'ebetsong ea genitourinary
Ho banna, nakong ea phekolo ea lithethefatsi, ho fokotseha ha potency ho ka etsahala ho fihlela nts'etsopele ea erectile dysfunction (impotence) le gynecomastia.
Ho tsoa ho tsamaiso ea methapo ea pelo
Litla-morao tsa lithethefatsi tsamaisong ea potoloho li bonahala ka maemo a latelang:
- orthostatic hypotension;
- arrhythmia, tachycardia;
- vasculitis, lefu la Raynaud;
- peripheral puffiness;
- ho fufuleloa ha sefahleho.
Khahlano le semelo sa stenosis sa likepe tsa methapo, nts'etsopele ea maloetse a potoloha ho ka etsahala.
Sistimi ea Endocrine
Ka theoret, ponahalo ea tlhahiso e sa laoleheng ea li-hormone tsa antidiuretic e ka khonahala.
Karolong ea sebete le tsamaiso ea biliary
Kotsi ea ho ba le hepatitis le cholecystitis e eketseha.
Ho tloha ka lehlakoreng la metabolism
Litaba tsa potasiamo maling li eketseha.
Allergie
Boteng ba hypersensitivity ho ramipril le likarolo tse thusang tsa Pyramil, ho ka ba le karabelo e latelang e latelang:
- angioedema;
- Lefu la Stevens-Johnson;
- lekhopho, ho hlohlona, erythema;
- alopecia;
- anaphylactic makala.
Tšusumetso ho bokhoni ba taolo ea methapo
Nakong ea phekolo ea lithethefatsi, ho khothalletsoa ho hana ho khanna, ho sebelisana le mekhoa e rarahaneng, le liketsahalong tse ling tse hlokang ho tsepamisa maikutlo le ho arabela ka potlako.
Nakong ea phekolo ea lithethefatsi, ho khothalletsoa ho hana ho khanna.
Litaelo tse khethehileng
Pele u qala kalafo ea lithethefatsi, ho hlokahala hore u tlatse bofokoli ba sodium le ho felisa hypovolemia. Kamora ho nka tekanyetso ea pele, bakuli ba lokela ho ba tlhokomelong ea bongaka bakeng sa lihora tse 8, kaha ho na le kotsi ea ho ba le hypotension ea orthostatic.
Ka boteng ba jaundice ea cholestatic, nalane ea edema, ho bohlokoa ho emisa ho sebelisa moriana. Nakong ea ts'ebetso ea boipheliso kamora ho ts'ebetso tlasa ts'oaetso e akaretsang, ho theoha ha khatello ea mali hoa khoneha, ka hona, moriana o lokela ho hlakoloa lihora tse 24 pele o buuoa.
Sebelisa botsofaling
Ho hlokahala hore motho a hlokomeloe ha a nkuoa ke batho ba lilemo tse fetang 65 ka lebaka la menyetla ea ho ba le bothata ba ho ruruha ha pelo le pelo.
Mosebetsi ho bana
E thibetsoe ho sebelisa ho fihlela lilemo tse 18.
Sebelisa nakong ea bokhachane le pelehi
Setlhare sena se na le phello e kholo holima kholo ea "" "" "" "" "" "" "" "" "" "" ho nka Pyramil nakong ea kemiso kapa moimana ho thibetsoe.
Nakong ea phekolo ea lithethefatsi, ho khothalletsoa ho emisa lactation.
Kopo ea ts'ebetso ea renal e senyehileng
Lithethefatsi ha lia lokela ho nkuoa ka tumello ea creatinine ka tlase ho 20 ml / min. Ho hlokahala hore ho hlokomeloe bakuli ka mor'a ho fetisoa ha meno.
Sebelisa bakeng sa ts'ebetso ea sebete e sa sebetseng
Ho lokela hore ho sebelisoe tlhokomeliso ha sebete se sa sebetse hantle. Ka tlolo e mpe, kamohelo ea Pyramil e tlameha ho hlakoloa.
Piramiti ea overdose
Ka tšebeliso e mpe ea lithethefatsi, lipontšo tsa overdose li bonoa:
- pherekano le ho lahleheloa ke kelello;
- stupor;
- ho hloleha ha rems;
- ho thothomela
- tlolo ea tekanyo ea letsoai le metsi 'meleng;
- ho theoha ha khatello ea mali;
- bradycardia.
Haeba ho se ho fetile lihora tse 'ne ka mor'a ho nka tekanyetso e kholo, ho hlokahala hore motho ea hlasetsoeng a hlatse, a hlatsoe mpa,' me a fane ka adsorbent. Ho tahoa e matla, kalafo e reretsoe ho khutlisa li-electrolyte le khatello ea mali
Ho sebelisana le lithethefatsi tse ling
Ka tsamaiso e le 'ngoe ea Pyramil le meriana e meng, ho latela maikutlo a latelang:
- Lithethefatsi tse nang le letsoai la potasiamo kapa tse eketsang mohopolo oa serum potasiamo le heparin li baka hyperkalemia.
- Ho theoha haholo ha khatello ho ka etsahala hammoho le lipilisi tsa ho robala, li-analgesics le lithethefatsi tsa narcotic.
- Kotsi ea ho ba leukopenia hammoho le ramipril le allopurinol, corticosteroids, procainamide e eketsehile.
- Lithethefatsi tse seng khahlanong le ho ruruha li fokolisa phello ea Pyramil 'me li eketsa monyetla oa ho se sebetse ha liphio.
- Ramipril o eketsa menyetla ea ho makala ha anaphylactic nakong ea ho luma ha kokoanyana.
Ho se lumellane ho bonoa hammoho le lithethefatsi tse nang le aliskiren, le li-antagonists tsa angiotensin II, li-stabilizer tsa membrane ea lisele.
Tekanyo ea joala
Ha u nka joala ba ethyl, ho ka etsahala ho ntlafatsa setšoantšo sa kliniki ea vasodilation. Ramipril o ntlafatsa phello e kotsi ea ethanol sebeteng, ka hona, ha o nka Pyramil, o hana ho noa joala.
Li-analog
Papiso ea Pyramil e kenyeletsa:
- Amprilan;
- Matlapa a eketsehileng a Pyramil;
- Tritace;
- Dilaprel.
Ho fetohela moriana o mong ho etsoa kamora ho buisana le ngaka.
Lipehelo tsa khefu ea khemisi
Setlhare se rekisoa ka taelo ea ngaka.
A na nka reka ntle le lengolo la ngaka?
Ka lebaka la kotsi e eketsehileng ea ho ba le maikutlo a mabe a 'mele, thekiso ea mahala ea Pyramil e thibetsoe.
Theko ea phiramiti
Theko e tloaelehileng ea lithethefatsi e fapana ho tloha ho 193 ho isa ho li-ruble tse 300.
Maemo a polokelo ea moriana
Ho khothalletsoa ho boloka moriana o le sebakeng se omileng, se sirelelitsoeng ke khanya ea letsatsi, ka lithemparetjha ho fihlela + 25 ° C.
Letsatsi la ho felloa ke nako
Lilemo tse 2
Moqapi
Sandoz, Slovenia.
Litlhahlobo tsa phirame
Tatyana Nikova, ea lilemo li 37, Kazan
Ngaka e ngotse matlapa a Pyramil hobane ke na le khatello ea mali e sa foleng. Likhatello tse matla mantsiboea li se li lebetsoe lilemo tse peli. Empa u hloka ho sebelisa lithethefatsi khafetsa. Matla ha a bolokehe. Ke rata boleng bo botle ba chelete. Ka litla-morao, ke khona ho khetholla khohlela e omileng.
Maria Sherchenko, ea lilemo li 55, Ufa
Ke nooa lipilisi ho fokotsa khatello kamora ho otloa ke stroke. Ba bangata ha baa ka ba thusa, empa ba kopana le Pyramil. Qalong, ho ne ho se na phello ka lebaka la litekanyetso tse nyane, empa kamora libeke tse 2 lethal dose le eketsehile, khatello ea qala ho fokotseha. Ke ikutloa ke le betere, empa ke tobane le ho se lumellane ha lipilisi tse nang le lithethefatsi tse 'maloa. Ho fumana motsoako o nepahetseng ho thata.
