"Ramipril": kufanana, kuongorora uye mirayiridzo. Ramipril-C3

Pakati pezvirwere zvinogona kuderedza zvakanyanya mararamiro ehupenyu uye hunochinja hutano hwahwo, hutachiona hwehutachiona huga hunosiyana. Inokura zvishoma nezvishoma uye zvishoma nezvishoma inotakura midziyo, uropi, itsvo uye myocardium. Pazvikamu zvekutanga murwere zvakaoma kuziva chirwere ichi, nokuti chinoratidzika pachedu pasina zvikwangwani.

Gare gare vanooneka, uye murwere anotaura kuti ropa rake rinokunda zvakanyanya kudarika zvinowanzoitika. Izvi zvinoda kutanga kwemishonga yekurapa, izvo zvinogoneka nekushandiswa kwemakirasi mashanu emishonga. Uye "Ramipril" ndiyo yakanakisisa kwavari, ichivimbisa chigumisiro ne monotherapy kana sechikamu chekubatanidza mishonga yakawanda.

Shanduro yemamiriro ekugadzirira

"Ramipril", zvakafanana nemishonga, uyewo zvinodhaka zvinodhaka zvinodhaka zvinodhaka. Ramipril pachayo chinhu chinoshanda chinowanikwa mumishonga yakawanda. Iyo iACE inhibitor inogona kudzivirira enzyme uye kuderedza ropa. Iyo inobvumira kunyatsovandudza kufungidzira kwechikoro chechirwere kune vakwegura.

Mune zvidzidzo zvekliniki, yakaratidza kuti ramiprilate, iyo inoshandiswa metabolite yaRamipril, inhibits the enzyme angiotensin-kutendeuka zvakanyanya. Nemhaka yeizvi, "Ramipril", mifananidzo yakaenzana uye yakagadzirirwa zvakagadzirirwa ndiyo nzira yekusarudzwa kwekuoma kwehutano hwehutano.

Analogues

Sezvo mushonga wacho unogona kudzivirira zvakasimba ACE uye inobatsira kudzora kukwirira kweropa, Ramipril ine dzakawanda zvakafanana. Zvose zviri kubudirira kushandiswa mukurapwa kwehutachiona. Uye iyo ramipril yekutanga ndiyo chirwere cheTritace. Mamwe ose - ma generical, kubudirira kwahwo kunofanira kuenzaniswa naye. Kubvuma kutengeswa kunofanira kusimbiswa ne bioequivalence kumutambo Tritace.

Panguva iyo runyorwa rwemashoko anotevera: Amprilan, Vazolong, Dilaprel, Korpil, Piramil, Rampepress, Ramigamma, Ramikardia, Tritats, Hartil. Ramipril inobudiswawo nekambani dzeRussia TatkhimParmPreparaty, Biokom uye Severnaya Zvezda. Kuitwa kwechipiri kunonzi "Ramipril SZ".

Nhamba yepamusoro uye maitiro akaoma

Mishonga inopesana nehutachiona "Ramipril" iri nyore kutora uye inotora. Basa rayo rinotibvumira kuti tisiyanise mitero mitatu yemishonga yemishonga. Izvi zvinokwana 2.5 mg, 10 uye 5 mg. Matafura ehuwandu hwakadaro anotorwa kaviri pazuva. Kunewo mishonga yakakomba ine ramipril uye hydrochlorothiazide: Amprilan ND, Amprilan NL, Vazolong N, Remazid, Triapin, Tritace Plus, Hartil D, Egypt. Pano, chiyero che ramipril chinokwira kubva pa2,5 mg kusvika kune gumi, uye muyero wehydrochlorothiazide kubva kune 12.5 kusvika ku25 mg mune imwe piritsi.

Chikamu chechipiri chekugadzirisa zvakakosha ndechekusanganiswa kwaRamipril uye muvengi we calcium - Amlodipine. Muenzaniso wemishonga ndeye "Egipress", iyo inowanikwa muzvidimbu zviviri zvinodiwa: 10 mg ramipril uye 5 mg ye amlodipine, uyewo pane imwe ye 10/10 mg. Mukuwedzera kune uku kusanganiswa, kune rumwe rudzi rwechirwere chinosanganisira ACE inhibitor Ramipril uye calcium antiagonist Felodipine. Iyi "Triapin", ine 2.5 mg ramipril uye 2.5 mg ye felodipine.

Mirairo yekushandiswa

Mukuwedzera kune zvinorayirwa nachiremba, murwere anofanirwa kufungisisa mirairo yekushandiswa. Iine ruzivo pamusoro pezviratidzo, migumisiro, masero uye kugamuchirwa kwemasvondo, zvinopesana nezvinyorwa uye zvinodzivirira. Uyewo yakabatanidzwa pakugadzirira "Ramipril" mirayiridzo yekushandisa inotsanangura kudikanwa kwekurega kunwa doro mukurapa kwehuwandu hwehutano.

Zviratidzo

"Ramipril", zvakafanana nemishonga uye zvinowanzoita "Tritace" zvinoratidzwa apo:

• Essential hypertension ;
• Mumukoko wakaoma we-multiclass therapy wekusingaperi moyo kusakatika;
• Chirwere cheshuga nedzimwe nhephropathy pamakiriniki kana mumagariro echechi, asingabatanidzwi ne stenosis yemakumbo emarara ;
• Zvine zviratidzo zvinokonzerwa nehutano hwepfungwa;
• Nekudzivirira myocardial infarction, kuderedza kufa kwevarwere vane zvirwere zvepfungwa, pamwe nekurapwa kwehutano hwepfungwa nehuwandu hwehutano hwemwoyo.

Icho chinonyanya kuratidza chirwere cheupfungwa. Ichi ndicho chirwere chinowanzoonekwa chepakati nepakati pekare, zvinoda kururamiswa. Uyewo, mushonga we "Ramipril" kana imwe ACE inhibitor inofanira kupiwa kuvarwere mumazuva ekutanga 2-9 kubva panguva yakaoma ye myocardial infarction. Chirwere chechirwere chinofanira kunge chakarerukirwa sezvinobvira, kunyange kana murwere asina kuwandisa. Izvi zvinokonzerwa nehutano hwemhepo hunokonzerwa neACE inhibitors.

Contraindications

Mushonga we "Ramipril SZ" haufaniri kushandiswa pakuvapo kwenhoroondo ye angioedema mune chero mifananidzo yezvinodhaka, pamwe chete nechinangwa chipi nechipi chinogadziriswa pakugamuchirwa kwayo. Contraindicated kusarudzwa muhupo hwehupenyu hunokosha hwe stenosis ye mitsetse kumativi ose maviri. Kana iyo stenosis isingabatanidzi uye murwere anowanzova nehvo mbiri dzakashanda, saka kusarudzwa kunobvumirwa nekuchenjerera uye pasi pekutungamirirwa kweGFR.

Mishonga "Ramipril" (5 mg kana kuti inotaurwa mune imwe mimwe miyo) haisati yashandiswa nehutachiona hypotension pasi pe 90 mm Hg. Art. Uyewo, mushonga wacho haufaniri kushandiswa kwehutodynamically inokosha stenosis ye-aortic kana mitral valve, ine obstructive hypertrophic cardiomyopathy, primary hyperaldosteronism, kusagadzikana kwechirwere chechirwere nechisimba chekusika (GFR) pasi pe 20 ml / min.

Yakabatanidzwa pakugadzirira "Ramipril" mirayiridzo yekushandiswa (zvakafanana nemagwaro aya haisipo) ine chiratidzo chekusagona kushandiswa kwechirwere muhutumbi nekudzivirira. Izvo hazvibvumirwiwo kushandisa mushonga wevana. Pasi pezera remakore gumi nemasere, ruzivo rwekushandisa kliniki harina kukwana uye harigoni kusimbisa kuchengetedzwa.

Kusarudza Maitiro

Iyo inonyanya kushandiswa kwemishonga yemishonga "Ramipril" mapiritsi. Muchifukutu, hazvisi zvishoma. Chirongwa chekutanga chekutanga chinonzi 1.25 mg. Nhamba duku kudarika yemishonga ndeye 2.5 mg, iyo inoita kuti zvidikanwe kuzviparadzanisa muviri. Kuva netambo pahwendefa kunoita kuti zvive nyore.

Mune imwe yehutachiona hwehuwandu hwehutachiona, chirwere chekutanga chinokwana 1.25 mg kamwe kamwe. Zvadaro, nekurerukirwa zvakanaka, chirwere chacho chinowedzera kaviri. Kunyorwa kwechirwere ichi kunoitwa kusvika panguva iyo ropa rekuyeresa rinotsigira. Mutsara wekurapa kwehuwandu hwehutachiona ndeweBP nguva dzose, iyo inowanzosimuka pakuzorora.

Precautions

Chirwere ichi chinofanira kutorwa pasi pesimba rekudzivirira, kunyanya nechinangwa chikuru. Zvakakosha kuti systolic yeropa rega inofanirwa kuisa pasi pe 90 mm. Gt; Art. Kana BP inowira pasi peyero iyi, zvinokurudzirwa kuti utsvake rubatsiro kubva kuvarapi. Kuti udzivirire BP inowira, haikwanisi kushandisa Ramipril pamwe ne nitrate, kirasi I antiarrhythmics (Procainamide) uye alpha-1 blockers (Alfuzosin, Tamsulosin).

Mushonga unofanirwa kutorwa nguva dzose uye zvichida panguva imwe chete. Izvi zvinokubvumira kuti uenzanise renin-angiotensin-aldosterone system, iyo inodzora kuwedzera kweropa. Usasvetuka mishonga, iyo inogona kuratidzirwa nematambudziko makuru ehutachiona. Kunyatsoramba kubvuma kunogona kukonzera marwadzo, njodzi dzekuitika dzinowedzera munguva ino.

Mhinduro dzevarwere pamusoro pemishonga

Tritace uye generic yayo ndeyemishonga inoderedza kuvhara ropa zvakanaka. Kusvika iye zvino, ichi chirwere ndicho chirwere chakasimba zvikuru chinopesana nemishonga. Pamusana peizvi, mhinduro dzevarwere pamusoro pake dzinowanikwa zvakanaka. Vanoratidzika sechirwere chakavimbika uye chakasimba chinodzora BP zvakanaka. Kunyanya kukosha ndeyekuongororwa kwevaya vagara vaitora mamwe mishonga yeboka iri.

Varwere vakacherechedza nhamba shomanana yekushungurudzwa kwakashata kunobatanidza nehupfu. Nhamba yakakura yehukama hweACE, pamwe nehana shoma yehutachiona huwandu hwehuwandu hwemigumisiro yemagetsi, zvingave zvisingadiwi nekugara uchishandiswa. Zvakakosha kuti nhamba yezvinetso zvinopesana nechekuita kwekushandisa kushandiswa kwe "Ramipril" yakanyanya kuderedzwa. Zvisinei, kubviswa kwavo kwakakwana hazvibviri ne monotherapy.

Kuongorora kwechiremba nezvemishonga

Nhamba dzehuwandu hwehutano hwepfungwa dzinoodza mwoyo. Icho chinosimbisa kukosha kwechirwere ichi kune mushonga wemazuva ano. Zvakakoshawo kuti hutachiona hunoita kuti zvishoma nezvishoma zvivepo. Hypertension inokura nekuda kwehuwandu hwehupfumi hwemhuka, iyo inowedzera huwandu hwengiotensin yeropa. Kuvhiringidzika kwe enzyme iyi kunounza kuderera kwekumanikidza. Izvi zvakakosha kudzivirira kupera kwemukati wehuta uye kuonekwa kwezvinetso zvinotyisa zvehutachiona.

Sokudzoka kwekuongorora zvipatara zvinoratidzira, huwandu hwehutachiona hwehutachiona uye hutachiwana hwechirwere chemoyo hunokura mushure mokunge murwere ave nehutachiona kwechinguva. Saka kukosha kwekurapa kwake kwakakura. Uye zvinotonyanya kukosha, ndiko kuwana kwemukana wokubvisa urwere nekuda kwekugadzirira boka reACEI. Pakati pavo, "Ramipril" ichiri chine simba uye chinoshanda kwazvo.

Zviratidzo zvechiremba pamusoro pake zvinoratidza zvipo zvaro. Chirwere chacho chinonyanya kushandiswa, chine maitiro mashomanana akaoma uye inoshanda chaizvo. Zvisinei, pasinei nehuhu hunhu, hungave husina kukwana kubata chirwere chepfungwa chakanyanya. Iyi inenge 40-50% yemakiriniki.

Nokurapa kwavo, regimen yakabatana inosanganisira ACE inhibitors, adiuretic, anopikisa calcium, uye dzimwe nguva beta-blocker inodiwa. Sezvo inhibitor ye-angiotensin-inoshandura enzyme, "Ramipril" yakakodzera zvakakodzera. Nokudaro, anokwanisa nguva dzose kutora nzvimbo yake mukurapa kwehuwandu hwehutachiona, chero nguva izvi zvichibvumirwa. Kunyange zvazvo varwere vakawanda vanozviwana zvichivhiringidza nokuda kwezvakawanda zvakanyanya mari.