"Kardosal": malangizo Buku, ndemanga, mafotokozedwe, analogs

"Kardosal" (dzina mayiko - "olmesartan medoxomil") ndi antagonist wa angiotensin II cholandilira (mtundu AT1) - pulayimale vasoactive timadzi RAAS zokhudza chitukuko cha matenda oopsa n'kofunika.

Fomu kumasula mankhwala, zigawo zake

Mankhwala akupezeka mu magome amene ataphimbidwa ndi m'chimake a. Kuweta zoona, chifukwa chimene medicament wa olmesartan medoxomil ntchito mapiritsi ndi monga 10 40 mg ( "Kardosal 10", "20 Kardosal", "Kardosal 40").

Komanso, mankhwala Chinawonjezeka mankhwala enaake a stearate, microcrystalline mapadi, lactose monohydrate. Komanso, monga wothandiza koponentov ntchito giproloza ndi otsika mmalo giproloza. mthunzi analengedwa kuchokera titaniyamu woipa ndi talc adawonjeza hypromellose.

zotsatira pharmacological

Amaganiza kuti mankhwala "Kardosal" kuchita chamoyo, zimathandiza kuti kutsekereza zotsatira za angiotensin II, _AT1 cholandilira nkhoswe. Mu matenda oopsa medicament Sachita wolumikizira kuthamanga, amenewa kumatenga nthawi yaitali. Palibe deta natsimikiza zosayembekezereka wa hypotension pambuyo ntchito loyamba mlingo woyambilira wa mankhwala ndi tachycardia chifukwa mankhwala yaitali ( "Kardosal 20", "Kardosal 40"), maonekedwe a achire limodzi ndi kuwonjezeka lakuthwa magazi.

Kugwiritsa ntchito mankhwala kamodzi zotsatira tsiku kuchepa wofatsa mu zizindikiro magazi. Zotsatira anakhumba zimatenga maola 24. Childs, zotsatira hypotensive zimatheka pa tsiku lakhumi la mankhwala, zotsatira zabwino anati mankhwala pafupifupi miyezi iwiri.

Pharmacokinetics

Mayamwidwe wa mankhwala, kugawa ake

Ataledzera piritsi mofulumira akutenga mawonekedwe a metabolite pharmacologically mwakhama intestine ndi (chifukwa kanthu ankachititsa ndi michere) ndi magazi zipata (pa mayamwidwe kwa mundawo m'mimba).

Pa achire zikuchokera kwa madzi a m'magazi si wapezeka yogwira mankhwala sichinasinthe. Avereji bioavailability ndi za 26%. Mlingo pazipita mankhwala opezeka maola awiri pambuyo cholanda, ndi kuwonjezeka mlingo (osakwatira mlingo - 80 mg) wa zolemera.

"Kardosal 40", komanso mankhwala ndi mlingo wosiyana wa pophika yogwira, akhoza kumwedwa popanda kuika mtima pa mowa ndi chakudya. Kudya pafupifupi ziribe mphamvu pa bioavailability.

Mogwirizana ndi mapuloteni plasma ndi pafupifupi onse, ndipo limafanana ndi 99,7%. Komabe, munthawi yomweyo kugwiritsa ntchito "Kardosala" vysokosvyazyvayuschimisya ndi mankhwala ena ndi zayamba yafupika.

kagayidwe mankhwala ndi excretion ake m'thupi

Kwenikweni mankhwala anachokera chiwindi (60%), ena (40%) - impso. Intrahepatic kufalitsidwa kwa mankhwala yogwira ndi zonyozeka. Popeza excretion amapangidwa makamaka ndi chiwindi, mankhwala ndi wothandizila "Kardosal kuphatikiza" izo ndikoletsedwa ngati wodwalayo biliary thirakiti kutsekeka. ntchito pambuyo mobwerezabwereza mankhwala pang'ono anasonyeza pafupifupi maola 12. umapangitsa zimawonedwa atalandira mlingo wa mankhwala womwe ndi Mlingo zingapo "Kardosala". A zotsatira kwambiri alipo ndipo atapita masiku khumi ndi anai a chithandizo, hereinafter kudzikundikira zimachokeradi. Mu chithunzi ichi, monga chilolezo aimpso si bwanji ndi mlingo wosiyana mankhwala, ndi mu osiyanasiyana kuchokera 0,5 kuti 0,7 L / h (pafupifupi).

Special milandu matenda

Odwala amene anapezeka kuphwanya ntchito aimpso (ofatsa, odziletsa, aakulu), AUC chinawonjezeka ndi 62, 82 ndi 179%, pamene chikhalidwe ndi wolimba.

Pamene vuto la chiwindi, pang'ono ndi amtengo umaonetseredwa, mlingo umodzi AUC kuwonjezeka njira kumathandiza 6 ndi 65%.

umboni

Kusankhidwa amatanthauza "Kardosal" malangizo ntchito chimathandiza kudziwika oopsa n'kofunika.

Ankachitira "Kardosalom" pa mimba ndi zosayenela. Ngati mimba ali mu ndondomeko chithandizo, m'pofunika kuti chiyembekezo chakuti mankhwala.

Chifukwa cha kusowa deta kuchirikiza chitetezo cha mankhwala a kuyamwitsa pa nthawi yolandira chithandizo asiye yoyamwitsa.

Kuti athe kugula "Kardosal" ndi kuyamba kusonyezedwa izo, dokotala ayenera kulemba mankhwala.

contraindications

Contraindications monga hypersensitivity anthu zinthu zimene m'gulu chiphunzitso, mwana (pansi zaka 18), mimba, kuyamwitsa. Komanso, mankhwala si zinafotokozedwa milandu zotsatirazi:

• kutsekeka kwa mundawo biliary;
• pamaso pa malabsorption syndrome, galactosemia;
• kusowa lactase;
• nthawi pambuyo kumuika impso;
• kulephera aimpso pa otsika QC (zosakwana 20 ml ya / Mph).

"Kardosal" - mankhwala kutumikiridwa ndi kusamala kwambiri odwala zinthu:

• inatsekeratu mtsempha wamagazi matenda;
• hyperaldosteronism (chachikulu);
• matenda a chiwindi;
• aimpso kulephera, imene KK ndi wamkulu kuposa 20 ml ya / Mph;
• stenosis, chotupa limodzi ndi mitral kapena vavu kung'ambika;
• aakulu mtima kulephera otaya;
• cerebrovascular matenda;
• zakudya limodzi ndi kudya zochepa ndi sodium;
• hyponatremia, hyperkalemia (pali chiopsezo insufficiency aimpso, hypotension kapena kuchepa madzi);
• boma pamene Bcc amachepetsa kuoneka kusanza, kutsekula m'mimba;
• stenosis, kumenya mtsempha wamagazi yekha impso, amgwirizano stenosis, imene mtsempha wamagazi akhudzidwa aimpso;
• hypertrophic obstructive cardiomyopathy;
• zaka zaka 65;
• kufunika okodzetsa.

Kugwiritsa "Kardosala"

"Kardosal" malangizo Buku akuonetsa ntchito 10 mg womwe ndi mlingo woyambilira. Pamene osakwanira normalization wa magazi ayenera kudyedwa pa tsiku 20 mg wa mankhwala. Owonjezera mlingo wa 40 mg wa mankhwala pa tsiku liri losayenera. mankhwala Daily ayenera kumwa nthawi imodzi, nthawi imodzi ndipo nthawi yomweyo. Kwa odwala ndi vuto la impso anaulula wofatsa chowongolera mwamphamvu, pamene chilolezo ndi mu osiyanasiyana kuchokera ml ya 20 60 / Mph, mlingo pazipita "Kardosala" sangakhale oposa 20 mg. Pa nthawi imene pakufunika kulimbikitsa zotsatira chifukwa amapangidwa chithandizo zovuta (kupatula "Kardosala" ntchito "Hydrochlorothiazide").

zotsatira zoyipazi

Pochiza mankhwala "Kardosal" malangizo Buku kulola zotsatira ngati mbali:

• zoipa zimachititsa machitidwe kupuma ndi m'mimba, maonekedwe a chisokonezo dongosolo minofu ndi mafupa, mkodzo thirakiti impso, kusintha zina magawo choyezera, pakhale matenda ambiri khalidwe (zotsatira ngati mbali nthawi zambiri);
• chitukuko cha angina, maonekedwe a matenda zokhudza wamanjenje dongosolo (nthawi zina amaoneka);
• kusintha mu dongosolo mtima, chitukuko cha hyperkalemia (kawirikawiri anawona).

Mankhwalawo kuti uka kwambiri kawirikawiri atalandira medicament "Kardosal" malangizo ntchito monga:

• chisokonezo dongosolo hematopoietic;
• kutsokomola;
• pachimake mawonekedwe kulephera aimpso;
• mavuto khungu;
• asthenic syndrome;
• mutu, chizungulire maonekedwe;
• myalgia;
• convulsive boma;
• nseru limodzi ndi kusanza, kupweteka m'mimba;
• kuenjezera urea, creatinine m'mwazi;
• kusintha chiwindi - kuwonjezeka ntchito michere ake.

ambiri osokoneza

Ambiri osokoneza ndi n'kotheka, umakhala ndi kuchepetsa Amowabu zizindikiro magazi. Pankhani imeneyi chifukwa cha mankhwala amafuna polojekiti zonse odwala. Kuthetsa zizindikiro zimene zigwirizana pamodzi ndi ambiri osokoneza amatanthauza "Kardosal" Madokotala amalangiza kuti inu mumachita ndemanga mankhwala symptomatic ndi mankhwala wothandiza matenda a kuthamanga magazi. Pankhaniyi cha mankhwala osokoneza bongo wodwala kugona pa nsana wake ndi kukweza miyendo yake. Komanso, pamene ntchito mlingo waukulu wa mankhwala tikulimbikitsidwa kuchita chapamimba lavage, kupereka munthu adamulowetsa mpweya. Pali kufunika m'malo buku, Kupha madzi m'thupi ndi kukonzanso bwino madzi amchere. Information zokhuza kuthekera excretion zinthu olmesartan medoxomil ndi dialysis kumeneko.

Kusamala

Odwala amene pamaso pa mankhwala intensively mankhwala okodzetsa ndi Pamilunguyo zakudya kuti amakonda kumwa mchere, zikhoza hypotension chifukwa cha ntchito mlingo woyamba wa mankhwala. The chifukwa yomweyo zingaoneke odwala amene zachitika kusanza kapena kutsekula m'mimba. Chifukwa anachita ichi cha thupi - kuchepetsa Bcc. Kulanga mwambo chikhalidwe ichi ayenera kupewedwa. Chiopsezo pakuwonekera kwake tiyenera kuziganizira musanayambe mankhwala.

Ngati munthu wathyola impso, n'kofunika nthawi onani Chiwerengerochi anali seramu monga creatinine, potaziyamu. Ntchito Ace zoletsa ndi odwala amene anawapeza hyperaldosteronism (chachikulu), chopanda tanthauzo, kotero iwo alibe mankhwala amatanthauza "Kardosal" (mavoti alibe poyankha Ace zoletsa).

Kumbukirani kuti kufooka amphamvu magazi odwala ndi atherosclerosis, kumene kumakhudza ziwiya ubongo, kapena matenda mtsempha wamagazi angachititse chitukuko cha zinthu zoopsa monga sitiroko ischemic ndi m'mnyewa wamtima infarction.

Ngati munthu akufuna kuchita yokonza makina mwaluso kapena kuyendetsa galimoto, ndikofunika kudziwa kuti kumwa "Kardosala" zingachititse kuwonongeka kwa thanzi (kutopa, kufooka, chizungulire), ngakhale kuti kawirikawiri zimachitika.

Chifukwa okhutira lactose mu mankhwala cholanda choletsedwa odwala cholowa khalidwe galactose tsankho. N'chimodzimodzinso odwala malabsorption syndrome galactose ndi shuga, lactase akusowa mu thupi.

Mogwirizana ndi mankhwala ena

dokotala ayenera kulemba mankhwala ndi kupeza ngati mtima wa mankhwala kudzera zina zopewera zochita osafunika. Iwo ali osavomerezeka ntchito zonse "Kardosalom" mitundu zotsatirazi mankhwala:

• zikutanthauza munali potaziyamu;
• mchere mmalo, monga anthu a potaziyamu alipo;
• Potaziyamu-yosalekerera okodzetsa;
• mankhwala amene amakhudza milingo potaziyamu mu seramu magazi (kuwonjezeka chithunzi ichi).

Chitsanzo cha njira imeneyi ndi "Heparin". Ndi chokhoza kusonkhezera zili potaziyamu mu magazi. Pa ndikosatheka chithandizo "Kardosal" analogues mpata kuti m'malo ake.

Kulimbikitsa zotsatira antihypertensive zimawonedwa pamene chithandizo cha mankhwala ena antihypertensive ndi NSAIDs, mwachitsanzo kukhazikitsa chithandizo mabuku. Therapy ndi njira Integrated zimaphatikizapo kugwiritsa ntchito zoletsa Cox-2, asidi acetylsalicylic (tsiku mlingo - oposa 3 g). Zimene angiotensin II cholandilira muzikangana kungakhale synergistically kulimbikitsa kusefera glomerular ndi kuchepetsa ake.

Ndi ntchito munthawi yomweyo medicaments monga angiotensin II cholandilira muzikangana, ndi NSAIDs, pali imabwera pachimake aimpso kulephera mawonekedwe wodwalayo. Pachifukwa ichi, kuwunika udindo aimpso pa siteji koyamba mankhwala ayenera kuchitidwa nthawi zonse. chithandizo ayenera ndithudi kumwa madzi okwanira. Komabe, n'zotheka kuchepetsa zovuta kanthu antihypertensive, umene kuwonongeka zimawonedwa pafupipafupi mphamvu ya mankhwala.

Ngati "Kardosal" ntchito Mankhwalawa ayenera kumwedwa chithandizo nthawi, ndicho zotayidwa hydroxide ndi magnesium, pali kuchepetsa chiopsezo ku bioavailability wa chinthu yogwira (zolimbitsa).

Iwo lipoti kusintha ukuwonjezeka lifiyamu misinkhu mu seramu magazi ndi kusonyeza katundu poizoni chifukwa kugawana Ace zoletsa, angiotensin II cholandilira muzikangana ndi mankhwala okhala lifiyamu. Mogwirizana ndi amenewa kuphatikiza mankhwala mauthenga "Kardosalom" ndi mankhwala, mmodzi amene zigawo zikuluzikulu - lifiyamu, osavomerezeka. Komabe, ngati pakufunika alipo, ulamuliro wa magazi ayenera nthawi zonse.

Mtengo wa mankhwala, analogs, ndemanga

Pamene kugawa "Kardosal" mapiritsi ngati mtengo si odwala onse, kotero iwo ndi chidwi ndi kuthekera kwa mankhwala ndi ntchito zina, njira zambiri. "Kardosal" ndi nkhani ya 10 mg wa pophika yogwira zikhoza kugulidwa kwa opaka 610, mankhwala kumene zikuchokera ali 20 mg wa yogwira pophika -. Pa 756 pakani. "Kardosal", amene mtengo uli pafupi 860 rubles., Muli 40 mg wa mbali yaikulu.

Monga kufanizira ndi, pamene inu kusankha njira inanso kukhazikitsa chithandizocho, mmalo mwa "Kardosala" mungagwiritse ntchito mankhwala "Olimestra" kapena kubala osakaniza mankhwala zochokera ntchito "hydrochlorothiazide", "olmesartan medoxomil". Inu tingalandire anzawo monga "Lozarel 'kapena' Cozaar. Komanso, m'malo a mankhwala abwino "Nortivan" "Valsartan Zentiva".

Pozindikira formulations monga "Olmesar", "Plaunak". Kawirikawiri mmalo amasiyana ndalama ija, munthu kusiyana ndi mtengo wololera ndi kuchepetsedwa magawo bioavailability, kotero iwo sakhala ogwira, ngakhale kuti akhoza kuthana ndi ntchitoyo.

Analogs nthawi zonse ntchito kuyang'aniridwa zonse katswiri, m'pofunika kumaona magazi. Ngati mukufuna kukatenga analogue ku chipatala "Kardosal" kuposa m'malo mankhwala, dokotala n'kusankha nkhani ya mphindi osiyana. Pa kudziwika zochitika chowawa nthawi mankhwala ndi analogue ayenera kuti kuchita zinthu zogwirizana m'njira yake umalimbana Kupha kwawo. Pa mankhwala m'pofunika kufufuza zotsatira pa thupi.

Pamene pachiyambi popanda kusintha zipangizo sangachite ayenera mmalo mankhwala chopangidwa ndi makampani European kuyesedwa. Pamene akukonzekera m'malo "Kardosal" mapiritsi analogues umafunika kusankha wapamwamba.

Comments anachoka pa maonekedwe madokotala ndi odwala, kusonyeza kuti mankhwala "Kardosal" pa mankhwala zimayambitsa zochita zoipa, ambiri amene - kupweteka m'chifuwa ndi kutopa nthawi zonse. Koma ngakhale mphindi izi zosasangalatsa, zotsatira hypotensive ndi nthawi yabwino. Maonekedwe a mavuto amafuna kungapezeke kuti katswiri nzeru, ndipo akhoza kusintha chithandizo chakudya.

Mankhwalawa odwala wolumikizira oopsa Zavumbulutsidwa, nkofunika kuti ulamuliro wodwalayo okhazikika. Kukhazikitsa mankhwala, tikatero adzapereka zotsatira anakhumba, ndi kutsatira mkhalidwe lake, ndi vuto la kuyan'anila - kukonza iwo mu nthawi. Zofunika Integrated njira, koma mankhwala si kokwanira, tiyenera kusankha chakudya chapadera. Pakati chofunika zinthu mankhwala - kugwilizana ndi wofatsa akafuna ntchito, ndiyotani pakuchotsa zizolowezi zoipa, chepetsani zinthu zakuthupi ndi kugwilizana ndi mabungwe ena amene akhala akufuna kuti dokotala bwino chithandizo.