"Fosinopril": mirayiridzo kushandiswa. "Fosinopril": zvairatidza kuti kushandiswa, dzomuzana chaiwo

"Fosinopril" ane inhibitor kuti angiotensin rokutendeutsa enzayemu. The mushonga hypotensive chiito, rinogona kushandiswa cheBP, oga uye kunzwisisa kurapa. Uyezve, medicament rine natriuretic, vasodilating uye cardioprotective chiito, rinoshandiswa akabatana nevamwe zvinodhaka panguva kurapwa nomwoyo kukundikana.

Pharmacological ehupfumi "fosinopril"

Kugadzirira "Fosinopril" mumuviri anotora chimiro yezviri metabolite kuti mwoyo zvazvinoita angiotensin rokutendeutsa enzayemu. The mushonga akazoita mwero paumbwe angiotensin 2, normalizes ari systemic BP, kunobatsirawo midziyo ropa.

Angiotensin rokutendeutsa enzayemu basa uchishandisa 10, 20 uye 40 MG zvinodhaka riri substantially wakaderedzwa Paavhareji kwemaawa 7 (hapana kudarika 2 maawa, asi kwete papera pane 12 maawa pashure pokutora mishonga). Masikati nayo ipfupi nokuda 7-15%.

"Fosinopril" Mahwendefa kubvumira kuti asava myocardial hypertrophy uye dilation kuti ventricle kuruboshwe, pamberi ezvinhu akadaro dzinobatsira kubviswa kwavo. The mushonga kuchititadzisa paumbwe aldosterone iyo rinoitwa munyika adrenal omumuviri, anowedzera basa rimwe kallikrein-kinin hurongwa, kudzikamisa bradykinin kugutsikana mune nyama uye ropa. kurapa Nokuda kwakavakirwa kushandiswa "fosinopril" kunowedzera liberatiou zvinhu izvo kuvandudza ropa wedzerai itsvo, vane natriuretic, vasorelaxant chiito. The medicament kunoderedza kugadzirwa arginine vasopressin uye endothelin-1, izvo chiito vasoconstrictor.

Akaroromesawo kumanikidzwa (diastolic, systolic) regai kuva, uye postural orthostatic tachycardia maitiro haachinji Nyorera mumwe zvisingaoneke. Hapana kuchinja dzepanguva basa myocardium, renal uye ropa riyerere chepfungwa. Hakuna kumbova kutyora ropa wedzerai ganda, nhengo dzomukati, skeletal tsandanyama tishu.

Sezvo murayiridzo manual, "Fosinopril" kushandiswa chete dose, ane hypotensive chiito icho chinonyanya iziviswe pashure maawa anenge mashanu. The zvichiguma kushanda ari kuramba pazuva, izvo zvinoita kuti tirambe hwandaiva BP parameters. Kuratidza kufadza zvinoita zvazvinoita kunodiwa kuti vakapfuura shomanana.

Panguva kurapwa "fosinopril" neBP anogona kunatsiridza muviri achipindura nokukurumidza kuderera systemic BP. Kana zvabatanidzwa kurapa ne thiazides uye "Fosinopril" kunoreva rinowanika zvakawanda raidudzwa antihypertensive basa. Kana zvakakodzera, kubvisa "fosinopril" haana kutanga urwere, hazvisi kunyange panyaya kana kukanzura akaita zvinoshamisa. Kugadzirira kunobatsira murwere kana zvakaoma inoyerera chimiro chisingaperi mwoyo kukundikana, uyewo muviri apindura mumuviri kushushikana.

Nezveshoko kuratidzwa mutagenic uye genotoxic zvivako munguva kurapwa "Fosinopril" mishonga gwaro anoratidza dzavo vasipo. Zvisinei, kushandisa cytotoxic mishonga kunotungamirira zvimwe zvirwere chokuita chromosomal aberrations. Studies yaiitwa muna makonzo uye makonzo akaratidza kuti nezuva dose isingadariki 400 MG / makirogiramu haakonzeri zviratidzo carcinogenicity. Nokuda dzakakwirira mishonga mukono makonzo stuffing kazhinji akazviratidza lipomas. Daily mishonga yacho mushonga kusvika 60 MG / makirogiramu mu makonzo haana kukonzera zvinetso chokuita Implementation pakati rokubereka ushande. Kana achiita makonzo pamuviri medicament (daily dose kusvika 400 MG / makirogiramu pazuva) netsuro (daily dose 40 MG / kg) chakaitika kudhaka, zvinodhaka kukanganisa nzira pamuviri.

Kubvisa rinoreva "Fosinopril" User Application inozivikanwa se kunonoka, nokuda kuderera kupfuura zvokudya. Nokuda vomuzana vanopfuura muviri bioavailability zvishoma (36%). "Fosinopril" hydrolyzed, izvi rinowanikwa muropa, chiropa uye gastrointestinal goko nokuda Implementation ayo fozinoprilat kuumbwa, inova kushingaira metabolite. The kunonyanyisa pamwero kurapwa mumuviri akawanikwa Paavhareji maawa matatu pashure kushandiswa kwayo. Hafu-upenyu kunoitika maawa 12-15. Kutaura plasma iri rinenge wakakwana - kusvika 98%, bhuku nokuparadzirwa iri duku.

Mishonga hakupesani miganhu placental uye ropa-pfungwa zvipingamupinyi, nguva kurapwa aripo ari mukaka. In cirrhosis (chidhakwa, biliary) ungaderedza Clearance, hydrolysis anoenderera zvishoma nezvishoma. In renal insufficiency kunoitika Kuvhiringidza diatsidnyh vanoshingaira metabolites excretion, mushonga anogona -wedzera mumuviri. Kushandiswa dialysis kubvisa mushonga kubva muviri "Fosinopril" mirayiridzo Chinyorwa kuratidzirana sezvo chiito usingabereki zvibereko zvinodiwa mugumisiro.

Zvairatidza "Fosinopril" gadziriro

"Fosinopril" nachiremba mwoyo nokukundikana uye BP. Muchiitiko chokutanga, mushonga ndiyo hwaro mamwe kurapa, yechipiri kunzwisisa inoshandiswa nokuda mushonga uye monotherapy.

Treatment ne "Fosinopril"

Kazhinji, mahwendefa vari kunwa mumwe kana kaviri pazuva iyoyo. 20-40 MG - pakurapa neBP rokutanga 10 MG zvinodhaka, uye gare gare inokurudzirwa. In kurapwa zvabatanidzwa kunze apo "fosinopril" rinoshandiswa diuretic, achitora 10 MG zvinodhaka. Muchiitiko chino, chichiitwa richiona nezvezvabuda BP, kufadza zvinokwanisika dose zvinodhaka riri 80 MG pazuva. Kana mushonga, mumwe dose hakuiti kaviri akanga akapembera. Treatment mishonga anobudiswa kushandisa maturusi ndakarumbidzwa chiremba haagoni kutora yakakura kana duku chitsama zvinodhaka uye kuwedzera ayo kakawanda kushandiswa, kana unogona kuita kukanzura "fosinopril" pasina kubvunza chiremba.

Asati kutora mishonga "Fosinopril" Chinyorwa akatikurudzira kuti iwe kuidza dhigirii zvezvibereko BP. In kugadzwa kurapwa anofunga zvekuchipatara siyana ezvinhu, chiremba vanofanira kugara kuongorora ezvinhu omurwere.

Kurerutsa ngozi kukura neBP yechipiri, boka duku dose inokurudzirwa panguva yokurara. Antihypertensive kurapwa kukanzura mazuva manomwe asati mharuro yokurapa, "fosinopril". Kana kare akaita diuretic kurapa ndiko yekuzvidzivirira symptomatic hypotension, kutsiura Urume uye electrolyte dzakagadzikana diuretic kuderedza ari dose, mune zvimwe zviitiko, kumisa achitora mushonga zvachose (kwemazuva 4-7 asati wokutanga dose "fosinopril").

Pashure myocardial infarction kurapa rinoreva "Fosinopril" mirayiridzo iri kushanda kunoita iwe kutanga mazuva matatu gare gare. Panguva kurapwa kunoda nguva nokuyerwa BP uye cheki mifananidzo peripheral ropa (achiongorora pamberi yokurapa, chidhiraivho mukati 3-6 mwedzi yokurapa mune ramangwana ongororo rinoitwa gore negore, kakawanda zvichiongororwa zvingava zvakakodzera kana refu ndingangokuvara panowanikwa neutropenia). Uyezve, zvinokosha kudzora muviri uremu, tarisa mamiriro itsvo creatinine yomuropa, potassium ari Kuronga yeplasma, ropa urea senitrogen. Panguva kurapwa unofanira kutevera zvokudya.

Varwere vane akaipa neBP ane unhu mishonga dose zvishoma nezvishoma akawedzera (ose usiku), kufunga kuchinja BP, ukuwo mugumisiro zvichabviswa maximized.

Contraindications kugamuchira "Fosinopril" chinodhaka

Kana rakavapa Mahwendefa "Fosinopril" zvairatidza yokushandisa vanoonekwa panguva imwe chete contraindications. The mushonga harishandiswi pakuparwa hypersensitivity kuti yenhengo dzayo uye zvimwe zvinodhaka zvakafanana. Mishonga haungopiwi varwere vakwegura kwemakore asingasviki 18 okukura nevakadzi vane pamuviri, pamukaka vakadzi. Contraindication ari chaizvo inoyerera renal kukundikana. Contraindications zvinosanganisira angioedema (idiopathic, enhaka) sechipo nenguva kugadzwa chinodhaka, uyewo vaya vane nhoroondo akaratidza hyperkalemia, hypotension.

pamuviri

Mahwendefa "Fosinopril" mirayiridzo Chinyorwa unorambidza kushandiswa panguva pamuviri, nekuti zvinodhaka izvi mhando kungaita kuti zvokukura zvirwere uye fetus rufu.

Kana pamuviri ndiyo nguva Implementation of mishonga inoda nokukurumidza abolition zvinodhaka. Muzviitiko zvakadaro, Ultrasound kudzidza kuziva zvakaipa azvarwa.

A achangoberekwa ane mai aiitirwa panguva pamuviri "fosinopril", anogona kuwanikwa hyperkalemia, hypotension, oliguria. Kana dzakabudirira oliguria, zvakakosha kuti anotsigira renal perfusion uye BP ndakaongorora dzose. Kana itsvo mabasa uye kuti normalize BP mogzhet kuitwa ropa kana dialysis.

Nokuremara pakushandisa "Fosinopril" gadziriro

At kashoma rwuchibuda autoimmune zvirwere vanofanira kufungawo nhamba kubatsirwa uye zvinogona ngozi kurapa zvinoreva "Fosinopril". Mirayiridzo yokushandisa, mhinduro anoratidza kudikanwa kufunga ngozi uye kubatsirwa mune zvinotevera nyaya:

• coronary tsinga chirwere;
• kuvapo murwere wakasimwa itsvo;
• gout;
• chirwere cheshuga;
• angioedema nhoroondo;
• chisingaperi siyana obstructive bapu chirwere;
• hyperkalemia pamwe indekisi kupfuura 5,5 mmol / L;
• desensitization;
• cirrhosis;
• obstructive kuchinja, achiperekedzwa havachanyatsogoni ropa water drainage kubva pamwoyo (kutsemuka stenosis, mitral);
• zvikuru mwoyo kutadza;
• zvokudya, ichipa shoma yaunodya yomunyu tigutsikane kana shoma uwandu yavaibvisa zvokudya vapera;
• hyponatremia;
• leukopenia, thrombocytopenia;
• dzimwe nzira (dialysis, yokutindivadza) oparesheni;
• atherosclerosis, hunobata maoko nemakumbo rezasi;
• kupera muviri;
• renal kukundikana creatinine kupfuura 300 pmol / L;
• kukwegura;
• chiropa;
• nezvinetso uropi uye ropa riyerere coronary;
• stenosis;
• mamiriro ayo kudzikira Nyorera mumwe zvisingaoneke.

Side migumisiro kubva "Fosinopril" chinodhaka

Available kuti medicament "Fosinopril" wongororo uye muperekedzi hunoratidza mukana wokuti nekukudziridza zvimwe nemishonga. Zvingaitika mune kusagadzikana hematopoiesis maitiro uye kumwoyo. Possible rokuchinja tsinga, zvomudumbu hurongwa, pave woshanda pfungwa. Vamwe varwere vaiva kuchinja murabhoritari parameters uye yaivhuvhuta zviitiko, kuratidzwa sei ganda, zvetsandanyama nemapfupa hurongwa. Zvingaitika kuvhiringidzika kufema uye urogenital hurongwa. Zvimwewo siyana rwakashata muviri - hyperhidrosis, uremu, kurutsa, fivha, angioneurotic edema, muviri kukura mune zvirwere pezvakaitwa kana anogumbura pezvakaitwa mu node nodes, lymphadenopathy, kuwedzera pamusoro gout. matambudziko Chero panguva kurapwa anofanira vakaudza chiremba wako. Higher mukana yaivhuvhuta zviitiko chokuita kushandisa zvinodhaka.

Ovhadhozi "Fosinopril" chinodhaka

In kurapika, "Fosinopril" mhinduro anoratidza nokuvapo mukana ane ovhadhozi semubairo kwazvo zvavakabvumirana dose. Ovhadhozi achabatsirwa chakasimba kuratidzirwa hypotension, renal kukundikana, ndivete, kuvhunduka, bradycardia, kunetswa nemvura uye electrolyte mwero.

Kubereka dose rutapudzo kana kubviswa munhu medicament kushambidzwa dumbu uye kupa murwere kunwa sorbent. Zvinokosha kuti vanhu vanotora chinjikira nzvimbo, zvakakosha kushandisa matanho zvainanga kuwedzera Nyorera mumwe zvisingaoneke. Zvinodawo symptomatic kurapa. Hemodialysis muchiitiko ichi haapi zvinozoita.

Drug kudyidzana "Fosinopril" gadziriro

The ndingangokuvara panowanikwa hyperkalemia chemhando kana kushandisa zvinodhaka, iro rinoumbwa potassium munyu Sevamiririri, cyclosporine, supplementation pamwe potassium, potassium-anorura diuretics.

Kubata zvinodhaka inofambidzana akaratidza zvakajeka kushandisa dzimwe nzira, ane hypotensive mugumisiro, uye doro. A zvazviri simba pane kutarisirwa aripo pamusana kushandisa zvinhu kuti Activate yacho renin-angiotensin-aldosterone hurongwa, estrogen, NSAIDS uye sympathomimetics. Muzviitiko zvakadaro zvakafanira kuramba kugamuchira mari idzi kana kutsiva "Fosinopril". Analogs vanosarudzwa nokuda kupinda chiremba. On zvaiita kubatanidza mushonga nedzimwe zvinodhaka kunogona kuwanikwa kubva nyanzvi.

Analogs, "Fosinopril" anoreva zvakafanana chinodhaka

"Fosinopril" rine anoreva zvakafanana uye analogues. Nokuti anoreva zvakafanana ndezvaJehovha "Fosinopril-din email", "Monopril." Kubva boka iri zvinodhaka anobudiswa "Fosinopril-OBL», «Fozikard". Pakati anoreva zvakafanana unogona kusarudza "Fozinal", "Fozinotek".

Kana marapirwo haabvumiri rinoreva "Fosinopril" mirayiridzo kushandiswa, anoreva zvakafanana kana analogs yakatarwa nyanzvi kuti anorapwa. Analogs "Berliprilom ',' Renitec '" ramipril "," Moeksom "," lisinopril ". Anozivikanwa analogs zvakare muridzi "Prestarium", "Enap" uye "enalapril". Of analogues anogona kupiwa "Tritatse", "Akkupro", "captopril". Possible kurapwa achishandisa "Charter" kana "Prenessa".

Kana unorambidza kushandisa mishonga "Fosinopril" mirayiridzo kushandiswa, analogs kana anoreva zvakafanana kusarudza anosarudza nyanzvi.

Reviews kugadzirira "Fosinopril"

Zvakakosha kusarudza zvakanaka Anti-vane chirwere cheBP nemishonga kuti murwere, kufungisisa peculiarities muviri wake. Kana "Fosinopril" chinodhaka yakakodzera munhu, kumanikidza ipfupi zvinobudirira, uye kurutivi migumisiro regai kuitika. Sezvo ongororo, pane Kudzikamiswa ropa kumanikidzwa, anovandudza kunopindirana utano. Kana nenjodzi mumuviri uye zvinochengetwa, ivo munyoro, zvikurukuru kuravidza chinovanetsa, Flushing, chikosoro.

BP zvinogona kukonzera zvinetso zvakakomba chokuita kukuvara chinokosha zvomukati, saka unofanira nguva kuti zvakafanira kurapa uye verenga tsanangudzo mishonga "Fosinopril" analogues, kuzivana nevamwe mashoko anobatsira.