"Valz": imiyalelo yokusetshenziswa, ubufakazi kanye nezinkomba. I-Analogue "Valza" ishibhile

Ukucindezeleka komzimba kuyisifo sezigidi zabantu esikhathini sethu. Sekuyiminyaka, amakhulu amakhulu emithi asetshenziselwe ukuthi ngokushesha futhi isikhathi eside ukuxazulula inkinga ye-spikes yokucindezeleka kwegazi, ikakhulukazi engozini yinkinga enkulu yegazi engasheshe iholele ekuhlakalweni okukhulu futhi kungenzeka ukufa komuntu. Ngeshwa, zonke izinto ezingasiphulukisa ngandlela-thile, zingalimaza. Lokhu kusebenza ngokukhethekile kumithi, ikakhulukazi, izidakamizwa "Valz", ezithinta umzimba wonke. Ngakho-ke, ngezinye izikhathi kuyadingeka ukukhetha i-analogue ye "Valza", uma ingahambisani nanoma yimiphi imingcele.

Incazelo yokulungiselela

Isidakamizwa sikhululwa ngendlela yamathebhulethi e-oval biconvex egobolini lefilimu, enezingozi zangasese kanye ne-labeling V endaweni eyodwa. Umbala uncike kokuqukethwe komuthi osebenzayo. Okuphuzi kusho ukutholakala kwama-40 noma i-160 mg we-valsartan, futhi i-pink isho u-80 mg wezithako ezisebenzayo.

Izinsiza ezisizayo zihlanganisa i-lactose monohydrate, i-microcrystalline cellulose, i-croscarmellose i-sodium, i-stediate ye-magnesium, i-povidone K29-32, i-talc ne-silicon colloidal dioxide.

Iqembu lezemithi

Isidakamizwa esithi "Valz" sibhekisela kuma-vasodilator we-peripheral, okungukuthi, ukwandisa imithwalo yegazi, kuholela ekunciphiseni kwegazi. Lokhu kusebenza ngenxa yezinto ezisebenzayo - i-valsartan, okuyi-blocker ethize ye-AT1 receptors ye-angiotensin II, engavimbeli i-ACE, engathinti inani legazi le-cholesterol, i-glucose, i-uric acid namazinga we-triglyceride.

Isenzo esiyinhloko sibonakala ngemva kwamahora amabili ngemuva kokuthi umuthi usetshenziswe, ufinyelele umphumela omkhulu emahoreni angu-4-6. Umphumela wokwelashwa ungadlula amahora angu-24. Ukudla njalo kwamathebulethi kuholela ekunciphiseni ukucindezeleka kwegazi emva kwamasonto amabili. Uma kunesidingo sokunqamuka okubukhali kwesidakamizwa, i-withdrawal syndrome ayitholakali.

Indlela yokusebenza

Ngemuva kokulawulwa komlomo, ukumiswa okusheshayo kwezinto ezisebenzayo kwenzeka ngokumelene nesizinda sezinga elihlukile lokumunca. Inkomba ye-bioavailability ngokuphelele isilinganiso esingu-23%. Ngemuva kokuphathwa komlomo, kubophezela amaprotheni e-plasma e-97%. Ukuba umphikisi we-angiotensin II, into esebenzayo ibangela ukwandiswa kwezindonga zemithambo yegazi, okuholela ekunciphiseni kwegazi. Isidakamizwa senziwa ngesistimu ethile ye-enzyme yamahora angu-9, okwathi ngemva kwalokho ithulwe ngu-70% ngokusebenzisa ithubhu lomathumbu nangama-30% ngosizo lwe-urinary system ngendlela eguquguquke kancane.

Ukuthatha umthamo owodwa wansuku zonke kuholela ekubutheni okuncane kakhulu kwezinto ezisebenzayo emzimbeni.

Izinkomba zokusetshenziswa

Isidakamizwa "u-Valz N", okufana nazo ezibekwe ematokhweni afanayo, zisetshenziselwa:

Ngcindezi yokuguquka komzimba;

• ekuhlulekeni kwenhliziyo okungapheli njengengxenye yokwelashwa okuphelele;

• ngemuva kokuhlukunyezwa kwe-myocardial (okukhethwe esikhathini esukela emahoreni angu-12 kuya kwezinsuku eziyishumi), kunzima ngokuqala ukwehluleka kwe-ventricular kwesokunxele, ukungasebenzi kwe-systolic kwe-ventricle kwesokunxele ngokumelene nesizinda se-hemodynamics esinezinzile.

Ukungafani

Ama-analog of the preparation "Valz", afana naye, awasetshenziswanga:

• Ukungena kwemvelo kwisithako esisebenzayo noma i-excipients;
• Ukuphulwa emsebenzini wesibindi (ikakhulukazi ekuthuthukiseni i-cholestasis noma i-cirrhosis ye-biliary);
• Ngokuphambene nezinhlobo ezehlukene ekusebenzeni kwezinso;
• Ngezikhathi ezahlukene zokukhulelwa nangesikhathi sokubeletha;
• Ezinganeni ezingaphansi kweminyaka engu-18;
• Nge-galactosemia ngenxa yokungenwa kahle kwe-galactose ne-lactose ukungabekezelelani.

Ukunciphisa ukucindezeleka kwegazi, okuqukethwe okwanele kwe-potassium kanye ne-sodium emzimbeni, ukuqubuzana kwamanye amazwe emiphakathini ye-renal, i-aortic ne-mitral stenosis, i-cardiomyopathy kanye ne-hyperaldosteronism eyinhloko kudinga ukusebenzisa ngokucophelela isidakamizwa esithi "Valz". I-Analogues isiRussia nayo inesicelo esithile, esidinga iseluleko sobuchwepheshe sokumisela ukwelashwa okuphephile.

Umphumela wecala

Njenganoma iyiphi i-agent esebenzayo, umuthi "u-Valz" ungabangela imiphumela eminingi emibi engxenyeni yezitho ezihlukahlukene:

• Ukwehlukana emsebenzini wezinhliziyo nemithambo yegazi kungabonakala njenge-hypotension e-orthostatic, i-vasculitis ayivami ukukhula, ngegazi ngezinye izikhathi kwenzeka;
• Ukuphulwa komshini ohlelweni lokuphefumula okubangelwa ukuguqulwa komkhuhlane kuningi;
• Ngezinye izikhathi uhudo kanye nobuhlungu besisu kungenzeka;
• Umphumela omubi kwisistimu yezinzwa kungabonakaliswa yisimo sosizi ngemuva, ukuphelelwa amandla, ukuleleka, ngezinye izikhathi i-neuralgia noma ikhanda;
• I-Neutropenia futhi ngezinye izikhathi i-thrombocytopenia;
• Ukuthuthukiswa kokuphendula okweqile;
• Ubuhlungu obuhlane noma imisipha yomzimba, kanye ne-arthritis ne-myalgia;
• Ngokuvamile lesi sidakamizwa sisiza ekunciphiseni ukuzivikela komzimba, okwenza kube khona ukutheleleka kwegciwane (sinusitis, pharyngitis conjunctivitis);
• Ngokuvamile kukhona umuzwa wokukhathala okungapheli, i-asthenia, i-edema iyaqala.

Ukubonakaliswa kwemiphumela enjalo kungadinga ukubonisana nodokotela ukuze ukhethe i-analogue yesidakamizwa "i-Valz".

Isilinganiso nomzila wokuphatha

Thatha amaphilisi ngaphakathi ngevolumu eyanele yamanzi, kungakhathaliseki ukuthi udla ukudla. Ukulinganisa kuncike esibangelweni sohlelo lokusebenza, ngoba ukulungiswa "i-Valz N", okufanayo "i-Valsakor", "i-Valsartan", "i-Valz" kanye nezinye zingasetshenziselwa kuphela ukucindezeleka komfutho wegazi.

Ukuze unciphise ukucindezelwa kwegazi, amaphilisi anikezwa ngomthamo we-80 mg (ongashadile nansuku zonke ngesikhathi esifanayo). Umphumela wokwelashwa ukhula kancane kancane phakathi kwamasonto amabili okuqala, ufinyelele ukubonakaliswa okukhulu kunazo zonke ngemuva kwenkambo yenyanga eyodwa. Uma le dose ingakusizi, ungayandisa ibe yi-160 mg ngosuku, ukuze usebenze ngokwengeziwe, ukwengeze ukwelashwa ngezidakamizwa. I-analogue "Valza" - ukulungiswa "i-Valz N" - akudingi inhlanganisela enjalo, njengoba isivele inayo, ngaphezu kwesakhi esisebenzayo se-valsartan, ne-hydrochlorothiazide ye-diuretic.

Ngokuthuthukiswa kwesifo senhliziyo esingapheli (CHF), ukwelashwa kuqala ngomthamo we 40 mg, ukuwubeka izikhathi ezimbili ngosuku. Uma kungekho umphumela omuhle okhethiwe, isiguli sidluliselwa ku-"Valz 80" - i-analogue ye "Valz 40", kanye nokudla kabili kwansuku zonke (isilinganiso esiphezulu singama-320 mg ngamanani amabili). Kungabuye kuhlanganiswe namanye ama-agent ahloselwe ukunqoba ukuhluleka kwenhliziyo okungapheli.

Ngokumelene nesizinda se-infarction ye-myocardial ku-anamnesis ezingeni elizinzile lokugeleza kwegazi, ukwelapha nge-valsartan kungaqalwa kungakapheli amahora angu-12 ngemva kokukhululeka kwesimiso esibucayi. Nika ngesikhathi esifanayo isigamu sebhetri "i-Valz 40" ekuseni nakusihlwa, ngokukhula kancane kancane (amasonto amaningana) kuya kumthamo we-160 mg kabili ngosuku, odlula kuma-40 no-80 mg amanani, ngokulandelana. Zihloselwe esimweni sesiguli, izinga lokubekezelelana kwezidakamizwa. Ukushintshela kumthamo we-80 mg kwenziwa ekupheleni kwesonto lesibili yokwelapha, kufinyelela kumthamo we-160 mg wezinto ezisebenzayo ekupheleni kwenyanga yesithathu yokwelashwa.

Iziguli ezinezinselele ezingasebenzi kahle, kodwa nge-QC ezingaphezu kuka-10 ml / iminithi, ungenzi izinguquko zesilinganiso. Iziguli ezinokukhubazeka kwesibindi emnene kuya ekulinganiseni (ngaphandle kwe-cholestasis, lapho okulungiselelwa khona "i-Valz", i-analogues isiRussia, kanye nabangaphandle, akusho), i-dose yansuku zonke evumelekile yalesi sidakamizwa isetshenziselwa ukufika ku-80 mg yesithako esisebenzayo.

Izici zohlelo lokusebenza

Njengoba le nsimbi inezinkambiso ezanele ngokwanele nemiphumela emibi, kufanele isetshenziswe ngokucophelela, ilandele zonke izincomo zikadokotela futhi ihambelane ngokuqinile nesilinganiso esinqunyiwe, ikakhulukazi uma kunokungajwayelekile emisebenzini yamanye amalungu nezinhlelo zomzimba.

Uma isiguli sisho ukungabi khona kwe-sodium kuhlanganise nokunciphisa kwe-BCC (okungenzeka ngenxa yokudla okuningi kwemithi yokuzivocavoca), ukwelashwa nge-"Valz N" (i-analogue "Valza") kungaholela ekudoneni okuphawulekayo kwengcindezi yegazi kakade ekuqaleni kwelashwa , Okuyinto engayithinta kabi inhlalakahle yesiguli. Ukuze ugweme umphumela onjalo lapho kukhona inkinga efanayo, kubalulekile ukubuyisela izinga lama-electrolyte nesilinganiso saso emzimbeni ngaphambi kokusebenzisa le mithi.

Ngomshini ophakeme we-renovascular type, ukulinganisa okujwayelekile kwezinga le-urea ne-creatinine kuyimpoqo.

Ukuphathwa kwezidakamizwa eziqukethe i-potassium noma ama-salts ayo, kanye nezindleko ezihlobene ne-diuretics-potering, ezidinga ukuhlolwa okuqhubekayo kwe-potassium eplasma.

Ukusetshenziswa kokulungiswa "i-Valz 160", okungafani nayo okungaqondwanga lesi sifo, ukwelashwa kweziguli ezine-CHF, kungabangela ukwehla kwegazi, okudinga ukuqapha izinkomba zayo.

Kulezi ziguli eziphethwe yisifo esisodwa esisodwa noma esisodwa esisodwa emiphakathini ye-renal, kuyadingeka ukuthi kutholakale isilinganiso esivamile sezinga le-urea nitrogen ne-creatinine e-serum yegazi.

Ngesikhathi ukwelashwa nalo muthi, udinga ukuqapha ngokushayela neminye imisebenzi ehilela ukugxila kokunakwa nokuphendula okusheshayo.

Isicelo ngesikhathi sokukhulelwa kanye ne-lactation

Ukusetshenziswa kwamaphilisi okuthi "Valz" ngesikhathi sokubeletha noma ukuncelisa kunceliswa ngokuphelele. Lokhu kungenxa yokuthi izifundo emiphumeleni ye-valsartan ebusweni azange zenziwe. Kodwa-ke, kuneziphakamiso ngenxa yezimpawu ezikhethekile ze-perfusion ye-renal ye-fetus, okuxhomeke ekubunjweni kwesistimu ye-renin-angiotensin, eqala ukusebenza kuphela ku-trimester yokugcina yokukhulelwa, ukungena kwezinto ezingena emgodleni wegazi lomntwana kuhambisana nethonya elibi kulo, ikakhulukazi ngesikhathi sesibili nesithathu sesithathu. Ngakho-ke, ukusungulwa kweqiniso lokukhulelwa kuyinkomba ekuqedeni ukwelashwa nomuthi "Valz". Ama-analogues, ukubuyekezwa mayelana nokwelashwa kunomqondo omuhle, kuphela abesifazane okufanele bakhethwe ngabesifazane abakhona ngokwemigomo yokuthomba. Ukwelashwa okwanele kuzovumela, ngaphandle kokulimaza ingane, ukusiza isiguli ukuba sinqobe inkinga.

Izifundo ekungeneni kwesithako esiwusizo ebisi lwebele azizange zenziwe, ngakho-ke, ezimweni ezidinga ukuthi izidakamizwa zibe nomfutho wegazi ophansi ngesikhathi sokudla, ukhetho luzokwenziwa phakathi kokukhansela ukwelashwa nokuphela kokuncelisa.

Overdose

Ukudlula ukulinganisa okungavumelekile noma ukusetshenziswa kabi kwezidakamizwa ezihlukahlukene kungaholela ekudlulelweni kwezinto ezidlulayo. Lesi simo sibonakala ngokuncipha okuphawulekayo kwengcindezi yegazi, phansi ekulahlekelweni kokuqwashisa nokuwa.

Ukwelashwa kuncishiswe ukugeza isisu, ukuthatha inani eliphelele lamathebulethi womlilo osebenzayo noma umjovo obangelwa ngu-0.9% isisombululo se-sodium chloride.

Ukusebenzisana nezinye izidakamizwa

Ukusetshenziswa kwe- "Valz", okufana nalezi zindlela ezifanayo zokusebenza, kudinga ukucatshangelwa ngokucophelela ngenkathi kugunyazwa izidakamizwa zamanye amaqembu ezemithi.

Izinto ezivela eqenjini le-potassium-sparing diuretics, kanye namalungiselelo e-potassium, ama-salts alo, ama-agent akhulisa izinga le-trace element e-plasma yegazi (isibonelo, "i-Heparin"), angavusa i-hyperkalemia.

Ukuphathwa kwamanye ama-antihypertensive drugs noma i-diuretics kwandisa umphumela wokunciphisa wezidakamizwa "amaVal". Izingxoxo zaso nazo zinokuxhumana okufanayo.

Ukusetshenziswa kwezidakamizwa ezingekho-steroidal ezilwa nokuvuvukala kungenza buthakathaka umthelela omzimba.

Ukuphathwa ngokubambisana kwe-ACE inhibitors kanye nezidakamizwa ezine-lithium kungabangela ukukhuphuka okuguquguqukayo ekugxileni kwalesi sici esilandelayo eplasma yegazi, kuze kuthuthukiswe inqubo enobuthi.

Ama-analogs for the main component

Uzokutshela ukuthi yisiphi isithako esisebenzayo siyingxenye yokulungiselela "Valz", imiyalelo yokusetshenziswa. Ama-analogs alo mkhakha, onomthelela ofanayo kumaphilisi omzimba - i-Valsafors "(eJalimane)," i-Valaar "," iValsakor "(iSlovenia)," uValsartan "(Switzerland)," iDivan "(eSwitzerland)," iTareg "(eSwitzerland) ), UNortivan (Hungary), uValsartan Zentiva (i-Czech Republic), iTantordio (India). Into enethonya lalezi zidakamizwa wuhlelo lwe-renin-angiotensin.

Ukulungiselela "Valz": i-analog yamathebhulethi ngamaqembu ezemithi

Lesi sidakamizwa singe- blockers ye-angiotensin II receptors, ngesisekelo lapho kungenzeka khona ukukhetha izidakamizwa ngendlela efana kakhulu yesenzo kanye nomphumela oveziwe. Kuze kube manje, inani elifanayo lemifanekiso efanayo yalesi sidakamizwa lenziwa, ikakhulukazi ezinkampanini zangaphandle.

Inani elikhulu lezidakamizwa likhiqizwa ngesisekelo sezinto ezidalwa i-losartan, ngezinye izikhathi zihambisana ne-hypotheazide diuretic. Lezi zidakamizwa ziyi "Cosaar", "Gisaar", "Lorista", "Lozap plus", "Vazotens" ne "Prozartan".

Isidakamizwa esithi "i-Valz" i-analog yamaphilisi "Diovan", "Co-Diovan", "Ukukhukhumeza", "i-Valsakor" yezingxenye ezisebenzayo ze-valsartan.

Into esebenzayo ye-eprosartan ingxenye ye "Teveten" kanye ne "Teveten Plus".

I-telmisartan ingxenye iqukethe imithi "Micardis" kanye "noMikardis plus".

Ingxenye ye-irbersartan iyingxenye yesidakamizwa "i-Aprovel", enokubaluleka kwamanye amazwe.

I-Waltz N: izifanisi zesiRashiya

Phakathi kwemithi efuywayo engaphansi kwalesi sigaba samakhemikhali, kungenzeka ukuba unikeze i-agent e-antihypertensive "i-Anghiakand" equkethe i-candesartan njengento esebenzayo. Lesi sidakamizwa sikhiqizwa eMoscow ngenkampani ethi "Canonfarma". Ukuthenga kungenziwa ngentengo kusuka ku-ruble 400 ukuya ku-700, kuye ngokuthi okuqukethwe kwesithako esisebenzayo nenombolo yamathebulethi kuphakheji.

Omunye umakethe weRussia wemithi imithi "ikhambi" le-"Bloktran", esekelwe kwisenzo se-losartan. Ikhishwe yi-Pharmstandard eKursk. Ezamakhemikhali, zingathengwa ngaphakathi kwepubleji engu-150-200 ngayinye.

Leli thuluzi (elifana "ne-Valza") nabo bonke abanye, elifana nalo, linomphumela ofanayo nokusebenza kahle, okuvumela ukuthi sikhuthaze ukusetshenziswa kwabo ukunciphisa ukucindezelwa kwegazi. Intengo yesidakamizwa "i-Bloktran" ingase ibonakale ikhangayo, kodwa enye ayikwazi ukusekela ukukhetha kwayo kuphela kwizindleko, kubalulekile ukucabangela ukusebenza komuthi, ukutholakala kwemiphumela emibi nezinye izici eziningi, ngakho-ke ukukhetha kufanele kugcinwe kuphela kuchwepheshe.

Ngakho-ke, leli qembu lezemithi lama-vasodilators liye labonisa ukuphumelela okukhulu ekunciphiseni ukucindezelwa kwegazi ngokumelene nesiphesenti samaphesenti aphansi kakhulu. Izinzuzo zezidakamizwa "i-Valz" nezifanekiselo zalo zihlanganisa ukungabi khona kwe-withdrawal syndrome, kungenzeka ukuthi uthathe amathebulethi kanye kanye ngosuku (mhlawumbe ngesikhathi esisodwa), ukungabi khona komphumela owakhuphuka.