"Cardosal": bhuku rekudzidzisa, kuongorora, kutsanangura, zvinyorwa

"Cardosal" (munyika yose inozivikanwa se "Olmesartan medoxomil") inopesana neangiotensin II receptor (inonzi AT1), iyo inonzi primary hormone hormone RAAS, iyo inobatana nekukura kwehuwandu hwehutano hwepamusoro.

Maitiro ekubudiswa kwechirwere, zvikamu zvayo

Mishonga iyi inowanikwa mumapiritsi, ayo akavharwa. Iyo chinhu chikuru, iyo inoshandiswa mumushonga ndeye medoxomil olmesartana, tablet iri ine 10 kusvika 40 mg (Cardosal 10, Cardosal 20, Cardosal 40).

Uyezve, magnesium stearate, microcrystalline cellulose, lactose monohydrate yakawedzerwa pakuumbwa. Uyewo, sezvibatsiro zvekubatsira, giprolose uye giprolose yakasimudza-pasi inoshandiswa. Iko shell yakagadzirwa ne titanium dioxide pamwe nekuwedzera kwetelc uye hypromellose.

Pharmacological action

Zvinofungidzirwa kuti mushonga we "Cardosal", unoshanda pamuviri, unobatsira kudzivirira matambudziko eAngiotensin II, anopindirana neAt ₁ -zvibvumirano. Kana huwandu hwehutachiona hunoderedza kushanda kwepfungwa, izvi zvinopfuurira kwenguva yakareba. Izvo hazvina ruzivo rwekusimudzira kuitika kwe hypotension mushure mekushandiswa kwekutanga kwemurairo wekutanga wemishonga uye tachycardia nekuda kwechirwere chenguva refu (Cardosal 20, Cardosal 40), kutaridzika kwehutachiona hwehutachiona, pamwe chete nekuwedzera kwakanyanya muropa.

Kushandiswa kwemishonga kamwechete pazuva kunotungamirira kunonoka kuderera muropa. Izvo zvinodiwa zvinowedzera mukati maawa makumi maviri nemaviri. Kazhinji, mhirizhonga inopera yakawanikwa pazuva regumi nemana rerapi, chikwata chikuru chinowanikwa mushure mekurapwa kwemaawa maviri.

Pharmacokinetics

Kubviswa kwegadziriro, kugoverwa kwayo

Purogiramu inogadziriswa inokurumidza kutora maitiro e pharmacologically anobata metabolite mumatumbo (nekuda kwechiito chinoshandiswa nema enzymes) uye muhutachipa ropa (panguva yekunyanya kubva pamagetsi).

Panguva yekurapa, chinhu chinoshanda chinoramba chisina kuchinjwa mu plasma yeropa . Avhareji bioavailability inenge 26%. Nhamba yepamusoro yemishonga inowanika pamwero wemaawa maviri mushure mekubvumwa kwayo, uye kuwedzerwa kweroji (imwe nhengo ye 80 mg), inowedzera.

"Cardosal 40", kufanana nekugadzirira nemutero wakasiyana wezvigadzirwa zvinoshanda, zvinogona kutorwa, pasina kutungamirirwa nenguva yekudya. Zvokudya zvinenge zvisingabatsiri pane bioavailability.

Kubatana kweplasma mapuroteni kunenge kwakakwana uye kunokwana 99.7%. Zvisinei, nekushandiswa kamwechete kweKadhiosal nemimwe mishonga yakanyanyobatanidzwa zvikuru, yakanyanya kuderedzwa.

Metabolism yemishonga, iyo yakabuda kubva mumuviri

Chaizvoizvo, mishonga yacho yakanyanyiswa nechiropa (60%), iyo yose (40%) neitsvo. Intrahepatic circulation yezvinhu zvinoshanda hazvikoshi. Sezvo excretion ichiitwa zvikuru neechiropa, kurapwa neKardosal Plus kunorambidzwa kana murwere akavhara bile ducts. Mushure mekushandisa zvakare, mushonga wacho unokonzerwa zvishoma pamusana peawa gumi nemaviri. Kubudirira kunobatanidzwa mushure mokutora mishonga muyero, iyo inofananidzwa nemaitiro akawanda e "Cardosal". Chiitiko chakakosha chiripo mushure memazuva ane gumi nemana ekurapa, humwe cumulation haisi kuitika. Pachiyero chakadai sekuregererwa kwechirwere, hazviiti maitiro akasiyana emishonga, iyo iri pakati kubva ku 0.5 kusvika ku7 l / h (inenge).

Special clinic cases

Mune ivavo varwere vakawanikwa vakaremara ruchiita basa (runyoro, kuenzanisa, rakaoma), AUC inowedzera ne 62, 82 uye 179% apo mamiriro acho akaoma.

Muhutano hwechiropa, inoratidzirwa zvishoma nezvishoma, muzana mumwe chete wemushonga unobatsira kuwedzera AUC ne6 ne65%.

Zviratidzo

Chinangwa che "Cardosal" chinoreva murairo wekushandisa unoita kuti zviboneke kubudisa kana kune huwandu hwehutano hunokosha.

Kuchengetedzwa "Cardosal" panguva yekuzvitakura hazvigamuchirwi. Kana kubata kwaitika panguva yekurapa, zvakakosha kubvisa chirwere ichi.

Nokuda kwekushaikwa kwemashoko anosimbisa kuchengetedzwa kwemishonga munguva yekuyamwisa, panguva yekurapa, kunwisa kunomiswa.

Kuzokwanisa kutenga "Cardosal" uye kutanga kutarisirwa nayo, chiremba anofanira kupa mutemo.

Contraindications

Kupindirana kwechipiri kunosanganisira hypersensitivity kune izvo zvinhu zvinosanganiswa mumishonga, vana vezera remakore (pasi pemakore gumi nemasere), pamuviri, nekuyamwisa. Mukuwedzera, mahwendefa haatauri munyaya dzinotevera:

• Kuvhiringidzwa kwebazi rebhaariary;
• Kuvapo kwe malabsorption syndrome, galactosemia;
• Lactase kukwana;
• Nguva inotevera mushure meyipi yekupora kupinza basa;
• Renal kukundikana neAcc QC (pasi pe 20 ml / min).

"Cardosal" mushonga unorayirwa neuchenjeri chaiyo kune varwere vane mamiriro ezvinhu akadaro:

• IHD;
• Aldosteronism (primary);
• Kushungurudzika muropa kunoshanda;
• Renal kusakundikana, umo CK inopfuura 20 ml / min;
• Stenosis, inosanganisira mitral valve kana aortic valve;
• Mwoyo kukanganisa kwemamiriro asingagumi;
• Zvirwere zvipembenene;
• Zvokudya zvinopedzerwa nekudya kwakanyanya kwe sodium;
• Hyponatremia, hyperkalemia (kune ngozi yekusakundikana kwechirwere, kukura kwehutachiona kana kupera mvura);
• Mamiriro apo bcc inoderera, kurutsa, chirwere;
• Stenosis, inokonzera mitsetse yeinye imwe, stateral stenosis, umo maitiro emvura anonyangadza anokanganisa;
• Kuvhiringidza cardiomyopathy hypertrophic;
• Anopfuura makore makumi matanhatu nemashanu;
• Izvo zvekushandiswa kwe diuretics.

Kushandisa "Cardosal"

"Kadhiosi" kurayirirwa kwekushandisa inokurudzira kushandisa 10 mg, iyo inofanana neyero yekutanga. Kana paine kushaya kukwana kwemaitiro eropa zuva nezuva, unofanira kutora 20 mg yemishonga. Kupfuudza chirwere che 40 mg yemishonga zuva nezuva hazvigamuchirwi. Zuva rimwe nerimwe mishonga inofanira kudhakwa kamwechete, panguva imwe chete. Kune varwere vane zvinetso zvinyoro kana zvisinganzwisisiki zvepfungwa, apo kusununguka kuri pakati pe20 uye 60 ml / min, mukana wepamusoro weCardosal haugoni kuva kupfuura 20 mg. Mumamiriro ezvinhu apo pane chido chekusimbisa chiitiko chakawanikwa, kushandiswa kwakaoma kunoitwa (kunze kwe "Cardosal", "Hydrochlorothiazide" inoshandiswa).

Zviitiko zvakashata

Mukurapa nemishonga "Cardosal" murayiridzo wekushandisa unobvumira migumisiro yakadaro:

• Kukanganisa kwakashata kubva pamapfupa ekufema uye kudya, kuratidzika kwevhiringidzi mu musculoskeletal system, urinary tract uye itsvo, kuchinja kweimwe zviratidzo zve laboratori, kukura kwehutano huzhinji (zvakadai zvinowanzoitika nguva dzose);
• Kutanga kwe angina pectoris, kuonekwa kwekusawirirana kunokonzera hurongwa hwemagetsi (kuonekwa dzimwe nguva);
• Kuchinja mubasa remwoyo yematambudziko, kusimbiswa kwe hyperkalemia (kazhinji isingatariswi).

Kune migumisiro yechirwere, iyo inowanzoitika kakawanda mushure mekutora mishonga "Cardosal", murayiridzo wekushandisa unosanganisira:

• Matambudziko mu hematopoiesis system;
• Cough;
• Kurwisa kwakanyanya kwemainal;
• Zvinetso zveganda;
• Asthenic syndrome;
• Musoro, chizivo;
• Myalgia;
• Kushungurudza mamiriro;
• Nausea, pamwe chete nekurutsira, kurwadziwa mumimba;
• Kuwedzera mu urea, creatinine muropa;
• Kuchinja mune chiropa - kuwedzerwa kwemabasa emuviri wayo.

Overdose

Kuwedzerwa kwepamusoro kunobvira, kunoratidzwa nekuderera kwechirwere muropa. Mune mhaka yemugumisiro wakadaro wokurapa, kugara uchicherechedza murwere kunodiwa. Kuti abvise zviratidzo zvinowedzerwa nekudarika kwekare neKadhiosal, mazano echiremba anokurudzira kuita zviratidzo zvechirwere, uyewo kugadzirisa kurapwa kunowedzera kuisa ropa. Kana kudarika, murwere anoiswa pamusana wake ndokusimudza makumbo ake. Mukuwedzera, paunenge uchitakura dhiragi guru remishonga, rinokurudzirwa kushambidza mudumbu, kupa munhu akaitwa charcoal. Pane chido chekudzorerwa kweBBCC, kubviswa kwemvura uye kudzorerwa kwemvura-munyu. Dhiyabhorosi pamusoro pemubhedha wekubvisa chiremera olmesartan medoxomil kubva mumuviri ne dialysis haisipo.

Special instructions

Varwere vakanga vakanyatsorapwa vachirapa vasati vatanga kurapwa uye vachitevera kudya kunosanganisira kusadya munyu kunogona kuve nehutachiona nekuda kwekushandiswa kwekutanga kwechirwere. Chigumisiro chimwe chete chinogona kuonekwa muvarwere vane ruzivo rwokurutsa kana chirwere. Chikonzero chekuita kwechimiro chakadaro ndechekuderera mu bcc. Chimwe chikamu chekuita kwechimiro ichi chinofanira kudziviswa. Ngozi yekuonekwa kwayo inofanira kuongororwa musati watanga kurapa.

Kana munhu asina simba rekuita basa, zvinokosha nguva nenguva kuongorora seramu yeropa zviratidzo zvakadai sezinga re creatinine, potasium. Kushandiswa kweACE inhibitors kune varwere avo vakaonekwa kuti vane hyperaldosteronism (primary) haina zvazvinobatsira, saka havatauri yeKardosal (kuongororwa hakuratidzi mhinduro kune ACE inhibitors).

Izvo zvinofanira kufungwa mupfungwa kuti kupera kwakasimba kweropa mukati mevarwere vane atherosclerosis, iyo inokanganisa midziyo yeperebral, kana neHD, inogona kutungamirira kukurudzirwa kwemamiriro ezvinhu akaipisisa sezvinonzi ischemic stroke kana myocardial infarction.

Kana munhu achizoita kugadziriswa kwemaitiro akaoma zvakaoma kana kutyaira motokari, zvinokosha kuziva kuti kutenga Cardosal kunogona kukonzera kuora kwehupenyu (kukurumidza kuneta, kushaya simba, chirungu), kunyange izvi zvichiitika kazhinji.

Nokuda kwezvakanyorwa zve lactose mumishonga, hutungamiri hwahwo hunorambidzwa kune varwere vasingagwirirani kune galactose yehupenyu. Izvo zvinoshandawo kuvarwere vane chirwere chema malabsorption che galactose uye glucose, kushayikwa mumuviri we lactase.

Kuwirirana nedzimwe nzira

Chiremba anofanira kuraira chiremba uye aone kana murwere ari kurapwa nedzimwe nzira kudzivirira kutendeuka kusingadi kwomuviri. Hazvikurudzirwi panguva imwe chete kushandisa Cardosal uye mhando dzinotevera dzemishonga:

• Mishonga ine potassium;
• Zvikamu zvehuyu umo potasium iripo;
• Potassium-sparing diuretics;
• Zvinodhaka zvinokanganisa zero re potassium muropa serum (kuwedzera ichi chiyero).

Muenzaniso wezvinhu zvakadaro ndi "Heparin". Inokwanisa kukanganisa zvinyorwa zve potassium muropa. Kana zvisingabviri kurapa chiremba "Cardosal", zvakafanana zvinopiwa mukana wokuti uchinatsire.

Kusimbisa kusagadzirisa mafungiro emvura kunowanikwa paunosanganisira mamwe madhiragi anonyanyisa uye NSAID mukurapa, ndiko kuti, pakushandisa kurapa kwakaoma. Utachiona nenzira yakakomba inosanganisira kushandiswa kwe inhibitors ye COX-2, acetylsalicylic acid (zuva rega rega - rinopfuura 3 g). Chiito chevangiotensin II chinotarisana nevatambi vanogona kuitika synergistically, chinokonzera glomerular filtration nekuchideredza.

Nekushandisa panguva imwe chete yemishonga yakadaro seangiotensin II inopikisana nevatori veNSAID, kune chiitiko chemu murwere anowedzera kukanganisika kwekushaya ropa. Nokuda kwechikonzero ichi, kutarisa mamiriro eensoo pachikwata chekutanga cherapi inofanira kuitwa nguva dzose. Nekurapa uku, iwe unofanira kugara uchitora mvura yakakwana. Zvisinei, zvinoita kuti kuderedza kusimba kwechiito chekushaya simba, sechikonzero chekuti kune kuwedzera kuora kwekubudirira kwerapi.

Kana "Cardosal" inoshandiswa panguva yekurapa neine antacids, iyo inonzi aluminium hydroxide uye magnesium hydroxide, kune ngozi yekuderedza bioavaidhi yemuviri unoshanda (kuenzanisa).

Yakave ichitaurirwa kuti nhamba ye lithiamu muropa serum inokurudzirwa zvakanyanya uye iyo inotyisa inoratidzwa semugumisiro wokushandiswa kweACE inhibitors, angiotensin II zvinopesana nevatori uye vamiririri vane lithium. Nezvemashoko akadaro, kubatana pamwe chete kweKardosal uye kugadzirira, chimwe chezvinhu zvinonzi lithium, hazvikurudzirwi. Zvisinei, kana kuda kwakadaro kuriko, kutonga kweropa rakagadzirwa kunofanirwa kuva nguva dzose.

Mari inoshandiswa pakurapa, mifananidzo, maitiro

Paunogadzira mahwendefa e "Cardosal", mutengo haufananidzi varwere vose, saka vanofarira mukana wekurapwa nekushandiswa kweimwe, iyo inobatsira zvikuru. "Cardosal" ine 10 mg yezvigadzirwa zvinoshandiswa zvinogona kutengwa nemabhiri 610. Mishonga, iyo ine 20 mg yezvigadzirwa zvinoshandiswa, 756 rubles. "Cardosal", mutengo waro unenge 860 rubles, une 40 mg yeiyo huru.

Sekufananidzira, apo iwe unoda kusarudza imwe nzira yekuzadzikisa kurapwa, panzvimbo ye "Cardosal" unogona kushandisa mushonga "Olimestra" kana kuita sangano rinosanganiswa maererano nekushandiswa kwe "Hydrochlorothiazide", "Medoxomil Olmesartana". Unogona kushandisa mifananidzo yakadai se "Lozare" kana "Cosaar". Mukuwedzera, maRirtivan, mishonga yeValsartan Zentiva inokodzera kugadziriswa.

Inonyatsozivikanwa nezvekugadzirira kwakadaro se "Olmesar", "Plaunak". Kazhinji, vatsigiri vanosiyana nenzira yepakutanga, imwe yezvakasiyana ndiyo mutengo unodhura uye inoderedza bioavailability, saka vanoonekwa sevasina kubudirira, kunyange zvazvo vanogona kukunda basa ravo.

Nhoroondo dzinoshandiswa nguva dzose pasi pekutarisirwa kwechiremba wezvenyanzvi, zvinodikamwa kugara uchitarisa ropa. Kana iwe uchida kusarudza analogu kune "Cardosal", pane kutora nzvimbo iyi ichi chiremba, chiremba anosarudza, achifungisisa nguva dzakasiyana-siyana. Kana kune mimwe migumisiro mune nguva yekurapa, analogo inofanira kutorwa munguva yekutora matanho anodikanwa ane chinangwa pakubviswa kwavo. Panguva yekurapa, zvakakosha kutarisa zvinoitika pamuviri.

Apo kushandiswa kwemavambo ekutanga kunokosha, zvakakosha kupa kupa kune mishonga inogadzirwa nekambani dzakaratidzwa dzeEurope. Mukugadzirisa kudzorera mahwendefa "Cardosal", zvakafanana zvinofanira kusarudzwa chete zvakanakisisa.

Mhinduro dzakasara pamisasa navanachiremba nevarwere zvinoratidza kuti chirwere "Cardosal" panguva yekurapa kazhinji chinokonzera kusagadzikana kwemuviri, iyo inonyanya kukosha ndeyo kurwadziwa kwepfuva uye kusava nekusingaperi. Asi pasinei nenguva idzi dzisingafadzi, chiito che hypotensive chinogara chiri nani. Kuonekwa kwemigumisiro inoda kuti nyanzvi inotsvaka mazano uye, zvichida, kuchinja mumutambo wemishonga.

Mukurapa kwevarwere avo vakaonekwa kuti vane hypertension, zvakakosha kupa murwere nguva dzose kutarisa. Kubudirira kwehutano, saizvozvo, huchabvumira kuwana mamiriro anodiwa uye kutarisa mamiriro ehupenyu, uye kana zvichionekwa nekuputsa - munguva yekudziparadza. Nzira inobatanidza inokosha inokosha, chete kurapwa kwemishonga hakukwani, isu tichiri kudiwa kusarudza kudya kunokosha. Pakati pemamiriro ezvinhu anodiwa ekurapwa ndeyekuchengetedza kushandiswa kwebasa rekushanda, kubvisa tsika dzakaipa, kukanganisa kushanda kwemuviri nekucherechedza mamwe mazano ayo chiremba akarayira kuti mugumisiro wakanaka wekurapa.