"Enalapril": yokusetshenziswa nempendulo. Analogs "Enalapril"

Uma unezinkinga blood pressure, abaningi kodokotela izincomo ukuthatha izidakamizwa "enalapril" (amaphilisi). Kusukela lokho kusiza ukuqeda lokhu imithi? Kusukela yemiphumela yokugula (ie, ngokuqondile-high blood pressure), noma-ke lenza nezimpi eziningana, ekubuyiseleni yokwenza evamile esimiso senhliziyo nemithambo yegazi, okubangela wegazi ubuyela evamile? Ukuze uqonde ukuthi amaphilisi "Enalapril" ingcindezi kunesidingo sokuba bajwayelane isiqondiso asemthethweni ukusetshenziswa kwalesi imithi. Ngaphezu kwalokho, sibheka eziningi analogs yalesi izidakamizwa by isithako futhi ine umphumela.

Incazelo lokulungisela ifomu ukukhululwa, ikakhulukazi isitoreji nemibandela tekukhipha Pharmacy

Amaphilisi "Enalapril" ingcindezi ezivezwa izinkampani eziningi zokwenza imithi emhlabeni jikelele. The main isithako zomuthi kuyinto enalapril maleate, okuyinto iqembu sokusebenzisana yayo libhekisela ACE-blocker. Okwamanje, kunezinhlobo amaphilisi nge isithako okuqukethwe okusebenzayo 5, 10 no-20 mg. Ngenxa yokuthi ukulungiswa "Enalapril" ingcindezi oluthinta ngqo ukusebenza CCC futhi eziningi nezinye izinhlelo emzimbeni, kokudedelwa Pharmacy kwenziwa kadokotela.

Timing ukuqaliswa kanye nokusetshenziswa kwale izidakamizwa anqunyelwe engu-3 kusukela ngosuku ukukhiqizwa yayo. Ngakho amaphilisi qinani izakhiwo zabo zokwelapha lapho egcinwe imithetho. Abakhiqizi Sisikisela ngokugcina nomuthi e eyomile, bavikeleke elangeni, ezingeni lokushisa hhayi ngaphansi kuka-15 no-hhayi degrees ezingaphezu kwezingu-25.

Analogs "Enalapril" babe ezifanayo kodwa ngesikhathi esifanayo, ngakho izincomo esebenzayo emuthini, futhi ungakwazi bagcine ngesikhatsi isitoreji yabo.

Pharmacodynamics nomuthi

Enalapril maleate (amaphilisi isithako) ngokwalo akuphazamisi uqhubeke e umzimba womuntu izinqubo. Iqiniso lokuthi leli kwakwakhe ubhekwa uhlobo "prodrug" okungukuthi ngenxa inombolo encane hydrolysis ukusabela azakhele into entsha ngokuphelele - enalaprilat.

Kuyinto umphumela ezicindezelayo kumsebenzi ACE kuka avuse ukwehla okukhulu inani aldosterone emzimbeni womuntu. Kafushane, umphumela "Enalapril" liqukethe ukwehlisa komfutho wegazi (kokubili diastolic futhi systole) kanye nokuncipha umthwalo imisipha yenhliziyo (myocardium).

Ngenxa yalokho, yesikhathi eside kokuma sithole ukuthi, naphezu ukunciphisa umfutho wabo wegazi ngemva kokuthatha lesi sidakamizwa "enalapril" iziguli sibe khona yokuntuleka ezingeni kwegazi ebuchosheni. Ngaphezu kwalokho, amaphilisi reception ngcono kwezinso futhi yenhliziyo ukugeleza kwegazi.

ukusetshenziswa eside zomuthi yabonisa kusebenta okusezingeni eliphezulu kwezicubu hypertrophic, isebenze i-ventricle engakwesobunxele we imisipha yenhliziyo, kuka usizo ukuvimbela intuthuko ephethwe yisifo senhliziyo. Ngaphezu kwalokho, indlela yokwelapha "enalapril" izinyanga ezingu-6 ukuze ngithuthukise isimo sakhe kweziguli kwesokunxele ventricular dilatation kwegazi e myocardium, okubangelwa ischemia.

I asebenzayo izidakamizwa izidakamizwa itholakala plasma yegazi ngemuva 1 ihora ngemuva yokwamukela amaphilisi kanye ifinyelela esiphezulu yayo ngemuva kwamahora 4-6. Umthelela hypotensive kuthathe amahora afika ku-24.

esifanayo izakhiwo kwemithi nilidle analogs "Enalapril" ye-ejenti asebenzayo.

Pharmacokinetics

Njengoba kushiwo ngenhla, ukumuncwa esebenzayo izidakamizwa izidakamizwa senzeka ngokwanele ngokushesha. Ugxile mayelana 60% kuphela enalapril maleate, lo kakhulu wonke lo mqulu sibopha ukuthi plasma amaprotheni. Ochwepheshe ukuziqhakambisa abathengi 'yokuthi ukumuncwa enkompolo akuxhomekile ukudla.

I okusezingeni eliphezulu Ukungena ngesilinganiso enalapril ngokusebenzisa-GHB izithiyo ngenxa ukwakheka kwama-molecule isithako esebenzayo. Futhi-ke uyakwazi yokunqoba isithiyo esibangwa esinomhlapho futhi itholakala webele kwezicubu ubisi wamabele kwabesifazane lactating.

Excretion zomuthi wenziwa ngokuyinhloko izinso (60%). okukhipha Ngakho angashintshiwe labangaba ngu-20% no-40% - njengendlela metabolite. Izinsalela izidakamizwa esebenzayo ngokusebenzisa amathumbu, lapho isilinganiso enalapril / enalaprilat has izinkomba 6-8% / 25-27%.

Izinkomba kanye contraindications

I izinkomba for ukusetshenziswa nomuthi "Enalapril" kuwukwanda ziphikelele blood pressure kubangelwa izifo ezifana scleroderma futhi CHF. Ngaphezu kwalokho, izidakamizwa ngokuvamile sisetshenziswa yokwelapha prophylactic in iziguli kutholakala ukuthi uphethwe yini ischemia yenhliziyo, washiya ukungasebenzi ventricular (kuhlanganise asymptomatic). Lokho sinjalo izidakamizwa "enalapril" izinkomba ukusetshenziswa, kodwa umkhuba wokuzilimaza medicate noma kunjalo is hhayi Kunconywa. Kuphela onguchwepheshe ungenza lesifanele ukwelashwa lwemithi futhi ukunquma imithamo.

Phakathi ukuhlolwa, udokotela wakho uzokwazi ukusungula khona noma ukungabi khona Izimo kungenzeka. Lezi zihlanganisa izifo kanye iziyaluyalu ukusebenza kwezitho:

1. ukuzwela landa isithako zomuthi (efana "Enalapril" ngesikhathi esifanayo futhi ufuna ukukhansela, njengoba nje kuvamile namanje Ezimweni eziningi ezifana nalezi ekwakhiweni izidakamizwa).
2. Ukukhulelwa, lactation futhi izingane ezingaphansi kweminyaka engu-18.
3. Langaphambilini icala angioedema ngesikhatsi ukwelashwa amalungiselelo kusukela iqembu ACE-inhibitor.
4. esingamahlalakhona Cerebrovascular, nezinye izifo cerebrovascular.
5. hematopoiesis Cerebrovascular.
6. izifo kwezinso, kuhlanganise kwezinso Umthambo stenosis (sohlangothi olulodwa noma zamazwe amabili), ukwehluleka kwezinso, khona isitho utshalwe.
7. isifo sesibindi.
8. Izifo yaleli pheshana emathunjini, ephelezelwa sohudo kanye nokubuyisa.
9. Scleroderma nezinye izifo sokuhlasela kwamasosha omzimba ezithinta izicubu zezinzwa.
10. Ukwephula izinqubo umzimba emzimbeni, kuhlanganise hyperkalemia.
11. Ngifundise ngesifo sikashukela.

Ukwamukelwa "Enalapril" kuzo zonke lezi zimo ezichazwe ngenhla kufanele ochithiwe, noma ukwelashwa wenziwa ngaphansi ebhekiwe ongoti.

Umuthi 'enalapril ": uhlu side effects

Naphezu izinzuzo ezinkulu zomuthi, lapho yokwamukela iziguli zingase zibhekane ezihlukahlukene amathuba okuba nemiphumela engemihle ethinta cishe yonke isitho izinhlelo. Ulwazi izigameko ezingezinhle ezavela kuqukethwe ethebuleni elingezansi.

Ngokuyinhloko lezi zenzakalo cuphuluza ithonya ngqo emzimbeni main izidakamizwa esebenzayo izidakamizwa "Enalapril". Analogs (yokusetshenziswa wabo iqukethe ukwaziswa okuningiliziwe on the subject) ingabagulisa iziyaluyalu efanayo. Isiguli nodokotela wakhe Kubalulekile ukuqaphela izimpawu yemiphumela emibi, njengoba bangayinaka kungaholela thuthuva sina ekusebenzeni emzimbeni.

Indlela ukuthatha amaphilisi "enalapril": izindlela kanye umthamo

Ekulinganiseni blood pressure Ochwepheshe batusa ukusetshenziswa eside zomuthi (kuhlanganise analogue yalo, isibonelo, "hexane Enalapril" izidakamizwa). Ngesikhathi besanda kuqala ekwelapheni nomfutho wegazi ophezulu kunconywa ukuthatha izidakamizwa umthamo 5 mg ngosuku. Ukwanda esihleliwe ingcindezi phakathi nalawo masonto amabili okwelashwa umthamo luyanda 5 mg. Kuyaphawuleka ukuthi amahora okuqala angu-2-3 ngemuva kokuqala ukwelashwa, isiguli kufanele kube ngaphansi kweso lwezokwelapha. Lokhu kusiza ukuhlonza side effects ekuseni ekuthuthukisweni kwabo. Umthamo esiphezulu kumele singeqi mg 40 ngosuku, kodwa ngisho ukusetshenziswa isamba zomuthi kungenzeka kuphela uma tolerability ngampela futhi egculisayo we nomuthi.

Ngemva kwamasonto 2-3 ngemuva kokuqala monotherapy "Enalapril" izidakamizwa, iziguli zidluliselwa asekelayo izidakamizwa reception imodi. Phakathi nale nkathi, umthamo nsuku zonke 10-40 mg izidakamizwa. Tablets zidinga ukuphuziswa izikhathi 1-2 ngosuku. Kunconywe ngesikhatsi ukwelashwa ukukala njalo blood pressure.

Izincomo ngenhla kusebenza yalezo ziguli musa uhlushwa izifo concomitant ezifana hyponatremia kanye nomfutho wegazi ophezulu renovascular. Ngayiphi ngemithamo kufanele athathe izidakamizwa? Njengomthetho, incike izici ngamunye isiguli nezinga isifo. Umthamo kokuqala noma kunjalo ingabalwa kuphela udokotela ukuba khona.

Isikhathi reception we nomuthi kuxhomeke ezicini eziningana, ezihlanganisa isimo lesiguli kanye imiphumela yokuhlolwa yase-laboratory. Ochwepheshe uqaphele ukuthi ukuhoxiswa ngokuzumayo zomuthi kungase kube nemiphumela engemihle. Ngakho-ke, ngisho noma ngokweqile ukwehlisa wegazi ophakeme esikhathini seziguli ezithola lesi sidakamizwa "enalapril" kufanele kancane kancane ukunciphisa umthamo.

Izimpawu kanye nokwelashwa izidakamizwa ukweqisa izidakamizwa

Ngakho, sabuka izici eziyisisekelo lesi sidakamizwa "enalapril" (amaphilisi), okuvela kulo zisiza futhi imiphumela reception kwabo kokuphela. Sekuyisikhathi uqhubekela ingxoxo yawo lo magazini, ukweqisa izidakamizwa yalesi izidakamizwa. Ngokuvamile iziguli bavame ukuthatha amaphilisi amaningi izidakamizwa ngethemba ukuqeda izimpawu ezingezinhle. Kuleso simo, uma kwenzeka imithi "Enalapril" umuntu, imiphumela ingase ibe mibi kakhulu. Nge zokunciphisa blood pressure nciphisa kungenzeka in iziguli kaningi esiholela sina isilethikusebenza noma i-cerebral kwegazi iziyaluyalu.

Ngokuvamile, izimpawu lokuqala ukweqisa izidakamizwa kukhona nokulahlekelwa ukwazi, esimweni stupor noma ukubukeka kwalesi sifo. Futhi, zingase zibe khona ezinye izimpawu lesion we-cerebral ukugeleza kwegazi futhi kwezinso inhliziyo: ayilutho isikhumba, ubuhlungu bekhanda, ubuhlungu ngemuva breastbone.

Ukwelashwa kwe-nesineke ukweqisa izidakamizwa of "Enalapril" izidakamizwa lingaze. Ngo ubuthi omnene kuboniswa ethola nosawoti kanye lavage esiswini. Ngo ngaphezulu Ezimweni ezimbi kakhulu kungase kudinge umjovo emthanjeni of nosawoti ne-plasma esikhundleni, kanye hemodialysis.

izidakamizwa ekuhlanganyeleni

Tablets "Enalapril" asakwazi ukwenza atypically, kuyilapho reception kanye neminye imithi. izidakamizwa Nonsteroidal eqeda ukuvuvukala ( "Ibuprofin" futhi m. P.) Futhi estrogensoderzhashie izidakamizwa kakhulu ukunciphisa wesenzo hypotensive. Blocker, nitratsoderzhaschie izidakamizwa, imithi ebulala izinzwa kanye ethanol ukwandisa umphumela lesi sidakamizwa "enalapril". izidakamizwa isisu zithathwa kanye amaphilisi ukwehlisa ingcindezi, kungabangela ukuthuthukiswa hyperkalemia. Ngokucophelela okukhulu kumele ayiswe izidakamizwa kusukela iqembu immunosuppressants, ngoba edilini lomshado ezikanye imithi aqukethe enalapril kakhulu ukuthuthukisa haematotoxicity yayo.

imithi Izibuyekezo

Kuze kube manje mayelana izidakamizwa ungezwakala kokubili impendulo emihle nemibi. Eyokuqala inzuzo enkulu "Enalapril" amaphilisi - Inani (20-25 ruble iphakethe ngalinye), okungakwazi ukuthi lalotshwa okusezingeni eliphezulu. Ngaphezu kwalokho, baziswa ekulungiseleleni futhi ukusebenza yayo kakhulu. Indima nemiphumela ethile engathandeki emikhulu eminingi ohlangothini ukusabela ingozi eliphezulu yezinkinga ebukhoneni izifo concomitant.

Iziguli eziningi 'Enalapril' amaphilisi asiza balahle ukwanda ehlelekile wegazi. Ukuze abathengi abanokuhlangenwe isivumelwano sabo sokuhlangana iye yabangela yokuphazamiseka ukusebenza kwezitho ahlukahlukene, ke kwadingeka ayeke ukuhlala hhayi nje endaweni izidakamizwa, kodwa futhi kusukela analogue yayo, njengoba ezimweni eziningi, ziqukethe ketshezi asebenzayo efanayo noma okunye okunjalo enalapril indapamide. Yingakho izazi is hhayi Kunconywa ukuthatha imithi amaningi kunciphise umfutho wegazi.

Analogs "Enalapril": umehluko, ngebuhle nebubi

On kukhona izidakamizwa eziningi ezithi azifane lesi sidakamizwa "enalapril" wemithi emakethe emhlabeni. Ngokuvamile, basuke babe intengo ephakeme, okungadingi njalo ukuqinisekisa ukungabi khona ukusabela ezingezinhle noma ngaphezulu ngempumelelo izidakamizwa. Cabanga uhlu izidakamizwa ukuthi yakhiwa lomcebo asebenzayo, ncamashí nalokho eziqukethwe "Enalapril" amaphilisi. Ngokuvamile, lawo amalabhorethri ezithaka imithi emazweni aseNtshonalanga isetshenziswa njengoba isakhi esiyinhloko amplodipin enalapril, okuyinto iyahluka kwenye maleate enalapril kuphela kule ukwakheka kwama-molecule. Kungenjalo-ke has izici ezifanayo kanye izakhiwo.

Ezimakethe ezithaka imithi Russian kukhona analogs elandelayo "Enalapril":

1. Amaphilisi kanye amaphilisi ngoba komjovo "Enap" yinkampani Slovenian Krka. intengo zabo uqala ngo 280 futhi ukhuphukela ruble 4000 ngoba isembozo amaphilisi, futhi ruble 500 for 10 vials ikhambi. Njengoba singabona, ngokungafani kuya "Enalapril" izidakamizwa, intengo impela high, okwenza imikhiqizo yalesi brand ezingafinyeleleki inqwaba abathengi. Ngesikhathi esifanayo, ochwepheshe uqaphele high analog.
2. Tablets "Enalapril hexane" kamakhi German SANDOZ. izidakamizwa Domestic ukusebenza kwalo akukho ngingelutho uma ngiziqhathanisa nomuthi inikezwe. Izindleko Analogue ngaleyo ndlela kancane ephakeme kunaleyo intengo "Enalapril" futhi imayelana 78-100 ruble iphakethe ngalinye.
3. Tablets "Berlipril" ezivezwa nkampani German zemithi, "Berlin-Chemie". The main isithako zomuthi kuyinto amlodipine, enalapril. Ngenxa yokuthi irisidi zezakhi ziyinkimbinkimbi kakhulu futhi kuyabiza, ezibhebheni izindleko imayelana 140-180 ruble iphakethe ngalinye.
4. Tablets "Renitek" kusukela Merck, ukubaluleka okuyinto maphakathi no-range futhi ruble 80-150 iphakethe ngalinye.

Futhi ngo Pharmacy ungathola efanayo anjalo isakhiwo futhi isenzo emuthini analogue "Enalapril" ngokuthi "Kalpiren", "Miopril", "Envas", "Vazopren" futhi "Miopril". Nokho, ochwepheshe bathi izidakamizwa akukhulunywa ngaso sonke isikhathi ebesingase sisetshenziselwe indawo uye anisondelanga isiguli, ngoba noma ngabe yisiphi isizathu, umuthi yasekhaya. Iqiniso liwukuthi ukubunjwa yawo cishe ukuphinda "Enalapril" yethu, okusho ukuthi futhi kungadala ezihlukahlukene izinkinga. Futhi, odokotela belulekwa ukuba banake Ukwakheka ekhiqizwa phesheya nemithi. Amplodipin enalapril, okuyinto iyahluka kwenye maleate enalapril incane, kungase futhi isinyathelo omubi emzimbeni. Kunoma ikuphi, ngaphambi ukusebenzisa njengoba izidakamizwa eyinhloko yimiphi analogs okukhulunywe ngawo ngaphambili, kubalulekile ukuba ubonane nodokotela.