"Enalapril": imiyalelo ukusetyenziswa kunye nengxelo. Analogs "Enalapril"

Ukuba uneengxaki uxinzelelo lwegazi, abaninzi bafumana koogqirha iingcebiso ukuba ichiza "enalapril" (tablets). Ukusuka into emncedayo ukulahla yeza? Ukususela iziphumo zesi sifo (ie; ngqo kwi uxinzelelo oluphezulu lwegazi), okanye lowo yena ulibambela fronts eziliqela, abuyisele umsebenzi eqhelekileyo nemithambo yegazi, ebangela igazi xi returns eqhelekileyo? Ukuze siqonde indlela iipilisi na "Enalapril" uxinzelelo eziyimfuneko ukuze aqhelane isikhokelo ezisemthethweni malunga nokusetyenziswa kwale iyeza. Ukongeza, siqwalasela eziliqela analogs kweli chiza ngu esisebenza kwaye isiphumo.

Inkcazelo yokulungiselela, ifomu ukukhululwa, ngakumbi ukugcinwa kunye neemeko nokupha of Pharmacy

Iipilisi "Enalapril" ingcinezelo enziwe kwakhona ziinkampani ezininzi zamachiza ehlabathini lonke. Eyona nto iphambili ebonakalayo ichiza enalapril maleate, leyo yi eliphi iqela yayo libhekisela ACE-blocker. Okwangoku, kukho iipilisi kunye isiqulatho isithako esisebenzayo of mg-5, 10 no-20. Ngenxa yokuba lokulungiselela "Enalapril" xi kuchaphazela ngqo ukusebenza CCC kunye nenani nezinye iinkqubo emzimbeni, kokukhululwa kwakhe ezikhemesti yenziwe yi kagqirha.

Ixesha ukuqalisa kunye nokusetyenziswa kwalo iziyobisi iminyaka engama-3 ukusuka kumhla imveliso yawo. Ngaloo tablets ungalahli iipropati zabo zonyango xa agcinwe imithetho. Abavelisi Sicebisa ukugcina medicament kwindawo eyomileyo, ekhuselweyo elangeni ngqo, kubushushu ongekho ngaphantsi kwe-15 kwaye hayi ngaphezu kweqondo lama-25.

Analogs "Enalapril 'abe iimpawu ezifanayo, ngoko iingcebiso esebenzayo ichiza, kwaye bagcine ngexesha yokugcina yabo.

Pharmacodynamics medicament

Enalapril maleate (tablets esisebenza) ngokwalo aluchaphazeli lenkqubo kwiinkqubo emzimbeni womntu. Isibakala sokuba eli compound kuthathwa ukuba lolunye uhlobo 'prodrug "oko kukuthi ngenxa yokuba inani elincinane reactions haydrolisis zokubumba i into entsha ngokupheleleyo - enalaprilat.

It is a isiphumo ngxelo imbi kwi umsebenzi ACE kunokuba bamqumbise ukuhla okubonakalayo umlinganiselo aldosterone emzimbeni womntu. Ngokufutshane, isiphumo "Enalapril" sikuko ukuthoba uxinzelelo lwegazi (zombini ukuzala kunye iSystolic) kunye nokunciphisa umthwalo entliziyweni kwezihlunu (myocardium).

Ngenxa yoko, ukuqwalasela ixesha elide siye safumanisa ukuba, nangona ukuncipha uxinzelelo lwegazi emva ezithatha ichiza "enalapril" izigulane ziye kungasweleke kwinqanaba ejikeleza igazi ebuchotsheni. Ngaphezu koko, amacwecwe yokwamkela kwaphucula ukuhamba kwegazi kwezintso kunye sentliziyo.

ukusetyenziswa lwexesha elide ichiza wabonisa ukusebenza aphezulu izihlunu hypertrophic, yenzelwe ukuba ventricle lasekhohlo izihlunu intliziyo, kunokuba uncedo ukuthintela inkqubela ukusilela kwentliziyo. Ukongeza, uthomalaliso "enalapril" iinyanga ezi-6 ukuya ukuphucula imeko kwezigulane dilatation ventricular yasekhohlo kunye nokuhamba kwegazi kwi myocardium, ezibangwa ischemia.

I engekho mthethweni esebenzayo ifumaneka plasma igazi emva iyure e-1 emva kokuba ulwamkelo iipilisi yaye ifikelela iphezulu emva kweeyure 4-6. Isiphumo iqinile ithatha iiyure ukuya ku-24.

Mihlaba amayeza efanayo yaye ilifa analogs "Enalapril" yomenzeli esebenzayo.

Pharmacokinetics

Njengoko kuchaziwe ngentla, kukufakwa iziyobisi iziyobisi esebenzayo kwenzeka ngokwaneleyo ngokukhawuleza. Sathatha% 60 kuphela enalapril maleate, umthamo kakhulu yonke sibophelela kwiiproteni plasma. Iingcali kukhe kuqwalaselwe abathengi 'inyaniso yokuba kukufakwa umchiza akaxhomekekanga ekudleni.

Izinga eliphezulu kwii-enalapril imiqobo nge-GHB ngenxa isakhiwo molecule ye isithako esebenzayo. Kwakhona iyakwazi onokuwoyisa ngayo umqobo placental kwaye lufumaneka inyama yedini lokutshangatshangisa, kunye nobisi lwebele amabhinqa phindeke.

Kukhuthaza ichiza ikhutshwa phandle isikakhulu izintso (60%). output Ngaloo kutshintsha ye malunga ne-20% ne-40% - njenge metabolite. Uhlala into esebenzayo ngaphandle nge amathumbu, apho umlinganiselo enalapril / enalaprilat uye izalathi 6-8% / 25-27%.

Iimpawu kunye Izimo

Le zibonisa ukuba ukusetyenziswa kwe-medicament "Enalapril" na ukunyuka ziqhubeke uxinzelelo lwegazi ezibangelwa zizifo ezifana scleroderma kunye CHF. Ukongeza, ichiza isoloko isetyenziswa kunyango umbala kwizigulane kunye kwafunyaniswa ischemia coronary, ngasekhohlo kwekhono ventricular (kuquka nazimpawu). Ukuba injalo "enalapril" Kubonakala iziyobisi ukusetyenziswa, kodwa self-medicate kuyo nayiphi na imeko ayikhuthazwa. oyingcaphephe kuphela ukwenza irejimeni echanekileyo unyango kunye ukugqiba idosi.

Ngexesha leemviwo, ugqirha wakho uya kuba nako ukumisa ubukho okanye ukungabikho Izimo kunokwenzeka. Ezi ziquka izifo ukugula lokusebenza kwamalungu:

1. Ukwanda uvakalelo isithako esebenzayo beziyobisi (esifanayo "Enalapril" ngaxeshanye nabo bafuna ukurhoxisa, njengoko kwiimeko ezininzi ezifanayo kule ekuqulunqeni iziyobisi).
2. Pregnancy, lokwaphusa kunye nabantwana abangaphantsi kweminyaka eli-18.
3. Previous case angioedema ngexesha amalungiselelo nyango kwiqela ACE-inhibitor.
4. insufficiency Cerebrovascular, kunye nezinye izifo cerebrovascular.
5. hematopoiesis Cerebrovascular.
6. izifo kwezintso, kuquka sezintso kwimithambo stenosis (unilateral okanye amabini), ukusilela kwezintso, ubukho organ zilinywe.
7. isifo sesibindi.
8. Izifo iphecana zesisu, ekhatshwa sorhudo kunye nokugabha.
9. Scleroderma kunye nezinye izifo samathambo echaphazela kwizihlunu nokuqina.
10. Ukophulwa kweenkqubo pathways emzimbeni, kuquka hyperkalemia.
11. Diabetes osegazini.

Ukwamkelwa "Enalapril" kuzo zonke iimeko ezichazwe ngasentla kufuneka iyarhoxiswa, okanye unyango lwenziwa phantsi kweliso lomgadi ziingcali.

Ichiza "enalapril": uluhlu yeziphumo ebezingalindelekanga

Nangona kukho iinzuzo ezinkulu ichiza, xa ulwamkelo izigulane zifumana ngeentlobo iziphumo ebezingalindelekanga ezichaphazela phantse zonke iinkqubo omzimba. Ulwazi iziganeko egwenxa eziqulathwe kule theyibhile ingezantsi.

Ubukhulu becala la ukumqumbisa yi impembelelo ngqo kwi umzimba omkhulu kweziyobisi iziyobisi esebenzayo "Enalapril". Analogs (imiyalelo ukusetyenziswa kwabo iqulathe ulwazi oluneenkcukacha kwisifundo) nako kunokubangela iingxaki ezifanayo. Ugqirha wakhe nomonde kwaye kubalulekile ukuqaphela imiqondiso ziziphumo ebezingalindelekanga, njengoko ngoyaba kubo kunokukhokelela uqhushululu kakhulu ekusebenzeni umzimba.

Indlela ukuthatha iipilisi "enalapril": iindlela kunye balawule

Ukuba kuzinziswe iingcali uxinzelelo lwegazi bacebisa ukusetyenziswa ixesha elide ichiza (kubandakanywa analogue yayo, umzekelo, "hexane Enalapril" iziyobisi). Xa lokuqala unyango nomfutho kucetyiswa ukuba ukuthatha amachiza umthamo we-5 mg ngosuku. Ukwanda yokuphatha wegazi phakathi kweeveki ezimbini unyango idosi linyuke 5 mg. Kubalulekile ukuphawula ukuba iiyure zokuqala 2-3 emva kokuqalisa unyango, isigulane kufuneka abe phantsi kweliso elibukhali likagqirha. Oku kunceda ukuchonga iziphumo ebezingalindelekanga ekuqaleni kuphuhliso lwabo. Ithamo nobuninzi ngaphezu-40 mg ngemini, kodwa ukusetyenziswa kwe-mali ye ichiza kunokwenzeka kuphela xa tolerability kuyimfuneko enkulu kwaye olwanelisayo medicament.

Emva kweeveki 2-3 emva kokuqalisa monotherapy "Enalapril" iziyobisi, izigulane zigqithiselwe ekuxhaseni imo reception iziyobisi. Ngeli xesha, idosi yemihla ngemihla yi 10-40 mg iziyobisi. Iipilisi kufuneka asele amaxesha 1-2 ngosuku. Ezicetyiswayo ngexesha unyango umlinganiselo uxinzelelo lwegazi rhoqo.

Iingcebiso ngasentla AWUSEBENZI kwabo izigulane musa sigula zizigulo ezihamba ezifana hyponatremia kunye noxinzelelo lwegazi renovascular. Ziziphi avumelekile ukuba kufuneka uthathe iziyobisi? Njengomgaqo, kuxhomekeke iimpawu ngamnye yomguli kunye nobungakanani sifo. Ithamo wokuqala kuyo nayiphi na imeko ukuba ibalwe kuphela ngugqirha khona.

Ubude yokwamkela medicament kuxhomekeke kwizinto ezininzi, eziquka imeko yomguli kunye neziphumo zeemvavanyo elebhu. Iingcali qaphela ukuba ukurhoxiswa ngokukhawuleza beziyobisi kunokukhokelela emibi. Ngoko ke, nokuba ngokugqithisileyo ukwehlisa wegazi izigulana ekufumaneni ichiza "enalapril" ngokuthe ngcembe kufuneka ukunciphisa izinga.

Iimpawu kunye nonyango lwe libanda, iziyobisi

Ngoko ke, siye wajonga iimpawu ezingundoqo ze ichiza "enalapril" (amacwecwe), ukusuka apho uncedo kunye neziphumo yokwamkela zabo ekugqibeleni. Lifikile ixesha lokuba ugqithele iingxoxo ngalo mbandela, i libanda kweli chiza. Kaninzi izigulane zidla ukuthatha ngeedosi ezinkulu iziyobisi benethemba ukuphelisa ezi mpawu ezingemnandi. Xa kunjalo, ukuba oko kuyenzeka ukuba uthathe amayeza "Enalapril" umntu, imiphumo inokuba emibi kakhulu. Ngenxa ukuncitshiswa ekuweni kwegazi kunokwenzeka kwizigulane kaninzi ekhokelela iqhosha kakhulu engabalulekanga okanye ukuphazamiseka ejikeleza lobuchopho.

Ngokuqhelekileyo, iimpawu yokuqala libanda, kukho ilahleko osezingqondweni, imo wobuthongo okanye imbonakalo ukuxhuzula. Kwakhona, kusenokubakho neminye imiqondiso ye sisilonda esidumbileyoesingaphakathi uhuhamba igazi ebuchotsheni nabanezinto ezingaqhelekanga kwentliziyo: lipholi ulusu, yintloko ebuhlungu, iintlungu emva breastbone.

Unyango lwe isigulane kunye libanda of "Enalapril" iziyobisi nomqondiso. Ukonakalisa onobulali kuboniswa abafumana saline kunye lavage esiswini. Kwiimeko ezininzi kakhulu kusenokufuna inaliti efakwa ye-saline kunye plasma ootitshala ababambeleyo, ngokunjalo olugqitha esikhumbeni.

imithi

Tablets "Enalapril" bakwazi ukwenza atypically, ngoxa ulwamkelo kunye namanye amayeza. amachiza Nonsteroidal anti-ukudumba ( "Ibuprofin" kunye m. P.) Yaye iziyobisi estrogensoderzhashie ikakhulu ukunciphisa wesenzo iqinile. Blocker, iziyobisi nitratsoderzhaschie, iintlungu kunye ethanol kwandisa isiphumo ichiza "enalapril". Amachiza umchamo zithathwa kunye iipilisi ukuthoba uxinzelelo, kunokubangela uphuhliso hyperkalemia. Ngononophelo kakhulu kufuneka kuthathwe iziyobisi iqela immunosuppressants, ngenxa yokuba kwi ulwamkelo kunye namayeza eziqulathe enalapril kwandisa ngokubalulekileyo haematotoxicity yayo.

Reviews imithi

Ukuza kuthi ga ngoku malunga ichiza unokuviwa zombini ingxelo akhabayo kunye navumelanayo. I inzuzo enkulu yokuqala ka "Enalapril" tablets - Ixabiso (20-25 engange pack nganye), apho akukho sezandleni ukuya phezulu. Ukongeza, bawazisa kumalungiselelo kunye nokusebenza kwayo. Indima kubakho iingxaki eziphambili ke reactions kwicala ezininzi kunye nengozi ephezulu yeengxaki phambi izifo ezihamba.

Uninzi izigulane iipilisi 'Enalapril' yanceda kukuphelisa yokunyuka yenkqubo wegazi. Eyabasebenzisi iziqinisekiso zabo iye yabangela yokuphazamiseka ekusebenzeni amasebe awohlukeneyo, kufuneka anikezele nje kuphela ichiza, kodwa analogue zalo, njengoko kwiimeko ezininzi, aqulathe into efanayo esebenzayo okanye enalapril indapamide like. Yiyo loo nto iingcali ayikhuthazwa ukuthatha amayeza ezininzi ukuthoba uxinzelelo lwegazi.

Analogs "Enalapril": umahluko, eziluncedo nezingeloncedo

On kukho ezininzi amachiza afanayo ichiza "enalapril" imarike zoxubo ehlabathini. Kakhulu, bona babe iindleko eziphezulu, nto leyo ayisoloko akuqinisekisi kukungabikho reactions ezibi okanye ngempumelelo iziyobisi ngaphezulu. Qwalasela uluhlu iziyobisi iqanjwa into esebenzayo, efana noko kuqulathwe kwi "Enalapril" iipilisi. Ngokuqhelekileyo, iilebhu zoxubo kumazwe Western isetyenziswa njengecandelo ephambili amplodipin enalapril, eyahluke ukusuka maleate enalapril kuphela kubume molecule. Kungenjalo neneempawu ezifanayo kunye neepropati.

Kwimarike zoxubo Russian kukho analogs zilandelayo "Enalapril":

1. Iipilisi kunye njengezingxobo for injectable "Enap" inkampani Slovenian KRKA. ixabiso labo iqala ngentsimbi 280 wenyuka waya ku engange 4000 ukuze diphu amacwecwe, kwaye engange 500 for ezineengqayi-10 kunye nesisombululo. Njengoko kubonakala, xa lithelekiswa 'Enalapril "ichiza, ixabiso kakhulu ophezulu, nto leyo eyenza iimveliso kule brand ingafikeleleki ekubeni kubekho inani elikhulu labathengi. Kwangaxeshanye, iingcali uqaphele umgangatho ophezulu analog.
2. Tablets "Enalapril hexane" evela kumenzi German SANDOZ. iziyobisi Domestic nesinokusebenziseka ayikho ngaphantsi a medicament elinikiweyo. Iindleko analogu ngaloo engaphezulwana nje kancinane kune ixabiso "Enalapril" kwaye imalunga 78-100 engange pack nganye.
3. Tablets "Berlipril" eziveliswa inkampani yaseJamani zamachiza, "eBerlin-Chemie". Eyona nto iphambili ebonakalayo ichiza amlodipine, enalapril. Ngenxa yokuba ukuba irisithi le khompawundi eziyintsinda ngakumbi yaye kuziindleko, amacwecwe iindleko imalunga 140-180 engange pack nganye.
4. Tablets "Renitek" kwi-Merck, ixabiso nto leyo yee-uluhlu yaye engange 80-150 pack nganye.

Kwakhona Pharmacy uyakwazi ukufumana ezifana kubume kunye nezenzo kwi analogue iziyobisi "Enalapril" ngokuthi "Kalpiren", "Miopril", "Envas", "Vazopren" yaye "Miopril". Iingcali, Noko ke, bathi iziyobisi akusoloko ngabo zingasetyenziswa njenge ezitshintshwayo anisondelanga isigulane, ngenxa yaso nasiphi na isizathu, siyobisi zasekhaya. Inyaniso kukuba kumafa yalo ngokoqobo ukuphinda "Enalapril" yethu, nto leyo ethetha ukuba inokubangela ezininzi iingxaki. Kwakhona, oogqirha bacetyiswa ukuba anikele ingqalelo ubume wavelisa kwamanye amayeza. Amplodipin enalapril, eyahluke ukusuka maleate enalapril lincinane, lingakwazi ukwenza ngokungalunganga emzimbeni. Xa kunjalo, phambi kokuba usebenzise njengoko ichiza ephambili nayiphi na analogs ngentla, kubalulekile ukuba ubonane nogqirha.