"Kardosal": diiwaanka, dib u eegista, sharaxaada, analogs

"Kardosal" (magaca caalamiga ah - "olmesartan medoxomil") waa antagonist ah angiotensin II receptor (nooca AT1) - aasaasiga Raas hormone vasoactive ku saabsan horumarinta hypertension lagama maarmaanka ah.

Foomka sii daayo daroogada, qaybaha

daroogada waxaa laga heli karaa kiniin in lagu daboolay by galkeeda. walax aasaasiga ah, taas oo medicament ah medoxomil olmesartan loo isticmaalay kaniiniga ka mid ah min 10 ilaa 40 mg ( "Kardosal 10", "20 Kardosal", "Kardosal 40").

Intaa waxaa dheer, daroogada lagu daray milmahayn magnesium, cellulose mikrokristallin, laktosmonohydrat lactose. Sidoo kale, sida koponentov giproloza isticmaalo kaabayaal iyo giproloza bedelay hooseeyo. qolof waxaa abuuray titanium dioxide la Rusheyn kartaa daray oo hypromellose.

saamaynta pharmacological

Waxaa la malaysan in daroogada "Kardosal" simaha on shaqeeyo, kordhinayaan in xanibeen saamaynta angiotensin II, _AT1 receptor dhexdhexaadiyeen. In medicament hypertension hoos u cadaadiska halbowlayaasha, saamayn this socdaa muddo dheer. Ma jiraan wax xog rumayn dhacdo ee hypotension ka dib isticmaalka koowaad ee dose hore ee daroogada iyo tachycardia ay sabab u tahay daaweynta mudada dheer ( "Kardosal 20", "Kardosal 40"), muuqaalka kore ee bixitaanka Ulasocto kor u kac wayn ee cadaadiska dhiigga.

Isticmaalka daroogada mar natiijada maalin ee hoos u fudud in tilmaamayaasha cadaadiska dhiigga. Saamaynta la doonayo horumarisa ka badan 24 saacadood. Caadi ahaan, saamaynta hypotensive waxaa lagu gaarayaa maalinteedii afar iyo daaweynta, natiijada ugu wanaagsan arkay daaweynta ku saabsan laba bilood ka dib.

Pharmacokinetics

nuugista ee daroogada, ay qaybinta

kiniin ah cabbay, si degdeg ah qaadataa foomka of metabolite a pharmacologically firfircoon ee xiidmaha (sabab u tahay tallaabada iyo cunfiga by ensaymes) iyo dhiig portal (inta lagu guda jiro nuugista ka mareenka caloosha iyo mindhicirka).

Inta lagu jiro daweynta Halabuurka ee plasma dhiigga aan la ogaan walax firfircoon beddelin. bioavailability celcelis ahaan ku saabsan tahay 26%. Heerka ugu badan ee daroogada helay celcelis ahaan laba saacadood ka dib qaadashada, iyada oo qiyaasta sii kordhaya (dose hal - 80 mg) waxaa ka mid ah u kordhiyaa.

"Kardosal 40", iyo sidoo kale waxyaabaha la qiyaasta kala duwan ee qayb firfircoon, waxaa la qaadan karaa iyada oo aan diiradda on isticmaalka hadhuudhka. Cunista shiidaa saameyn ah kuma laha bioavailability.

Xidhiidh la leh protein plasma durba waa complete, oo u dhiganta 99.7%. Si kastaba ha ahaatee, isticmaalka wadajira "Kardosala" vysokosvyazyvayuschimisya la daroogooyinka kale waxaa ku ool ah hoos.

Dheef-Drug iyo Digo jidhka ka

beerka Asal ahaan daroogada dheefay (60%), inta kale (40%) - kelyaha. wareegga Intrahepatic oo ah walaxda firfircoon waa qiimo lahayn. Tan iyo markii Digo la soo saaray inta badan by beerka, daaweynta la wakiilada "Kardosal daray" waxaa ka mamnuuc ah haddii bukaanku leeyahay xirma biliary mareenka. isticmaalka Ka dib soo noqnoqda ee daawada qayb bandhigay celcelis ahaan 12 saacadood. saamayn wanaagsan ayaa lagu arkay dul qaata qiyaasta ah daroogada, taas oo u dhiganta dhowr jeer "Kardosala". Saameyn weyn joogo iyo afar iyo toban maalmood ee daaweynta ka dib, raasamaal halkan ma dhici karto. Sawirkaan, sida ansixin kelyaha ma saamayn qiyaasta daawada oo kala duwan, waa in kala duwan ee ka soo 0.5 si 0.7 L / h (qiyaastii).

Xaaladaha caafimaad oo Gaar ah

bukaanka ah kuwa lagu helay xadgudub ku ah function kelyaha (khafiif ah, dhexdhexaad ah, oo daran), midowga afrika ayaa kordhay 62, 82 iyo 179%, marka xaalad ka mid deggan.

Marka dhibaatooyinka beerka, wax yar oo dhexdhexaad ah ayaa muujiyay, hal dose midowga afrika kordhinta hab ka caawisaa in ay 6 iyo 65%.

maragga

Magacaabista macnihiisu yahay "Kardosal" edbinta ku saabsan codsiga awood ogaanshaha of hypertension lagama maarmaanka ah.

Loola dhaqmo "Kardosalom" inta ay uurka aan la aqbali karin. Haddii aad uur leedahay waa in habka daaweynta, waxaa lagama maarmaan ah in la sameeyo la baabiiyo of daroogada.

Sabab u la'aanta xogta taageeridda nabadgelyada daaweynta nuujinta waqtiga nuujinta daaweyn joojin.

Si aad u awoodo in ay soo iibsato "Kardosal" oo ay bilaabaan in la daweeyo la, dhakhtarku waa qoro warqad.

sababo

Sababo ka mid ah diidmo kuwa walxaha kuwaas oo ka mid ahaa dejinta, ilmaha (ka yar 18 sano), uurka, naas-nuujinta. Intaa waxaa dheer, kiniinka aan qoray in arrimaha soo socda:

• xanibaadii mareenka biliary;
• joogitaanka nuugeynin syndrome, galactosemia;
• la'aanta lactase;
• muddo ka dib marka kelyaha ah,
• renal failure at QC hooseeyo (in ka yar 20 ml / min).

"Kardosal" - daroogada in la maamulo si taxadir leh xad-dhaaf ah bukaanada qaba xaaladaha:

• cudurka halbowlaha wadnaha,
• hyperaldosteronism (hoose);
• cudurada ku dhaca beerka,
• kelyaha, taas oo KK waa ka weyn yahay 20 ml / min;
• stenosis, nabar ku weheliyay mitral ama tubada aortic;
• socodka wadnaha chronic,
• cudurka cerebrovascular;
• cuntada la socda qaadashada sodium xaddidan;
• hyponatremia, hyperkalemia (waxaa jira halis kaafi kelyaha, hypotension ama fuuq-bax);
• gobolka marka qoral la hoos u muuqan matag, shuban,
• stenosis, garaacid oo halbowle ah kelyaha oo keliya, stenosis laba geesood ah, kaas oo halbowle ah kelyaha saameysey,
• cardiomyopathy obstructive hypertrophic;
• da'da 65 sano,
• baahida loo qabo diuretics.

Isticmaalka "Kardosala"

"Kardosal" diiwaanka ku talinaysaa isticmaalaya 10 mg, taas oo u dhiganta qiyaas hore. Marka caadi ku filnayn ee cadaadiska dhiigga waa la wada baabbi'in maalin kasta ilaa 20 mg ah ee daawada. dose ka badan 40 daroogada mg maalintii aan la aqbali karin. daawo Daily waa in ay cabaan hal mar, hal iyo waqti isku mid ah. Waayo, dadka qaba dhibaatooyinka kelyaha shaaca ka qaaday khafiif ama dhexdhexaad ah darnaanta, marka ansixin waa kala duwan ee 20 ilaa 60 ml / min, qiyaasta ugu badan "Kardosala" ma noqon karaan in ka badan 20 mg. Mararka ay dhacdo waxaa loo baahan yahay in la xoojiyo saamayn ku keentay la soo saaray daaweynta adag (marka laga reebo "Kardosala" codsan "Hydrochlorothiazide").

waxyeellooyin

In daaweynta daawada "Kardosal" diiwaanka ogolaan waxyeelo sida:

• falcelin xun ka nidaamyada neefsashada iyo dheefshiidka, muuqaalka kore ee rabshooyin nidaamka muruqyada, marinka kaadida iyo kelyaha, la beddelo oo xuduudaheedu shaybaarka qaar ka mid ah, horumarinta a xanuunada qof guud (inta badan waxyeelo sida dhacaan);
• horumarinta angina, muuqaalka kore ee xanuunada saameeya habka dareemayaasha jirka (oo mararka qaarkood muuqan);
• isbeddel ah ee nidaamka wadnaha iyo, horumarinta hyperkalemia (dhif arkay).

Dhibaatooyinka ay keento in kac aad u dhif ah ka dib markii la helo medicament tilmaamaha "Kardosal" loo isticmaalo waxaa ka mid ah:

• rabshooyin nidaamka hematopoietic;
• qufacdo,
• foomka ba'an ee kelyaha,
• Dhibaatooyinka maqaarka;
• syndrome asthenic;
• madax xanuun, muuqaalka wareer;
• myalgia;
• gobolka convulsive;
• lalabo Ulasocto matag, calool xanuun,
• siyaadiyaa HOL, kariyaatiniin ee dhiigga,
• isbeddel ah ee beerka - kordhay dhaqdhaqaaqa of falgalka ay.

badinta

Iska badinta waxaa suurtagal ah, waxaa muuqato hoos u calaamadeysan of tilmaamayaasha cadaadiska dhiigga. In the case of sabab u ah daaweynta sida u baahan tahay la socodka joogtada ah ee bukaanka ah. Si aad u baabi'iyo calaamadaha in la socon badinta ka dhigan tahay "Kardosal", dhakhaatiirta ku talinaynaa in aad u qabtaan dib u eegista daaweynta calaamadaha iyo daryeel taageero si caadi cadaadiska dhiigga. Xaaladdan oo ah qiyaasta xad dhaafka bukaanka jiifay dhabarka iyo kor lugihii. Waxaa intaa dheer, marka la isticmaalayo qiyaasta badan oo daroogada waxaa lagu talinayaa in ay sameeyaan lavage gastric, siin qofka carbon firfircoonaan. Waxaa loo baahan yahay bedelka mugga, tirtiridda fuuqbax iyo dib u soo celinta ee dheelitirka biyaha-cusbo. Warbixin ku saabsan suurtagalnimada of Digo of walxaha olmesartan medoxomil by dialysis halkaas.

ganaaxyada

In bukaanka hor therapy culus loola dhaqmo si diuretics iyo hogaansamey cunto in ka saaraysaa isticmaalka cusbo, waxay keeni kartaa hypotension iyada oo sababtu tahay qiyaasta isticmaalka ugu horeysay ee daroogada. Natiijadan ayaa waxa ay la mid laga dheehan karo in bukaanka ka dhacay matag ama shuban. Sababta reaction this ee jidhka - yareynta BCC. dhacdo Dacdarrada dabiiciga ah waa in laga hortagi. Halista ay dhacdo waa in la tixgeliyaa ka hor inta aadan bilaabin daaweynta.

Haddii qof ayaa jebiyey kelyaha, waxaa muhiim ah in si teelteel ah u hubiso tirooyinkani ahaayeen serum sida kariyaatiniin, potassium. Isticmaalka celiyeyaasha ACE by bukaanka laga helay hyperaldosteronism (hoose), waa wax aan waxba tarayn, si aanay u qori macnihiisu yahay "Kardosal" (ratings aan lahayn wax jawaab u celiyeyaasha ACE).

Maskaxda ku hay in hoos u dhac xooggan ee cadaadiska dhiigga ee bukaanka qaba atherosclerosis, taas oo saameyn ku weelasha maskaxda, ama cudurka halbowlaha wadnaha keeni kartaa horumarinta xaaladaha khatarta ah sida stroke ischaemic iyo Wadnaxanuun myocardial.

Haddii qof uu leeyahay si ay u qabtaan dayactirka mishiino farsamo ahaan adag ama wado baabuur ah, waxaa muhiim ah in la ogaado in qaadashada "Kardosala" waxay sababi kartaa sii daraysa ah caafimaadka (daal, daciifnimo, dawakhsanaan), inkasta oo ay tani dhif dhacaya.

Due to content ee lactose ee daroogada ka qaadan waxaa mamnuuc ah in bukaanka qaba dhaxlo qof dulqaad galactose. Isla sidaas u dhaqmaan bukaanka qaba nuugeynin syndrome galactose iyo glucose, deficiency lactase ee jirka.

Dhexgalka daroogooyinka kale

dhakhtarka waa in ay qoraan warqad iyo aad u ogaato haddii bukaanka waxaa lagu daaweeyaa siyaabo kale si looga hortago in dareen diidmo oo aan loo baahnayn. Waxaa laguma talinayo in la isticmaalo labada "Kardosalom" oo ah noocyada soo socda ee daroogada:

• waxay ka dhigan tahay ku jirto potassium,
• beddeli karo milixda, kuwaas oo ka mid ah kuwa of potassium waa la joogo;
• Potassium-uubatooyin diuretics;
• daawooyin waxyeela heerarka potassium in serum dhiigga (sii kordhaya tirada this).

Tusaale ka mid ah hab oo kale waa "heparin". Waa inay awoodaan inay saamayn ku content ee potassium in dhiigga. At adagtahay in daaweynta analogues "Kardosal" bixiyaan fursad lagu sameeyo ciddii beddesha.

Xoojinta saamaynta antihypertensive lagu arkay marka daaweynta daawooyinka kale antihypertensive iyo NSAIDs, sida hirgelinta daaweynta dhamaystiran. Therapy leh hab isku dhafan oo ku lug leh isticmaalka Cox-2 inhibitors, acetylsalicylic acid (dose maalin kasta - in ka badan 3 g). tallaabo ee angiotensin II Doodeen receptor noqon kartaa synergistically saameyn sifeynta ee glomerular ay hoos.

Iyada oo la isticmaalo isku mar ah medicaments sida angiotensin II Doodeen receptor, iyo NSAIDs, waxaa jira suurtagalnimada ah qaab kelyaha ba'an bukaan-socodka. Sababtan awgeed, la socodka xaaladda kelyaha bilowga hore ee daaweynta waa in si joogto loo sameeyaa. daaweynta noocan oo kale ah waa in si xaqiiqo ah cabto cabitaan ku filan. Si kastaba ha ahaatee, hoos u suurto gal ah in darnaanta ficilka antihypertensive, dheehan sii daraysa waxa inta badan lagu arkay waxtarka therapy.

Haddii "Kardosal" waxaa loo isticmaalaa in ka laabjeexa muddada daawaynta, kuwaas oo hydroxide aluminium iyo magnesium, waxaa jira dhimista halista ee bioavailability ah oo ah walaxda firfircoon (dhexdhexaad ah) a.

Waxaa la sheegay heerka korodhka lithium karo in serum dhiigga iyo muujiyaan guryaha sun ka dhashay qaybsiga celiyeyaasha ACE, angiotensin II Doodeen receptor iyo daroogada oo ka kooban lithium. In xidhiidh la leh isku dhafan sida fariimaha therapy "Kardosalom" iyo daroogada, mid ka mid ah oo ka kooban - Lithium, laguma talinayo. Si kastaba ha ahaatee, haddii ay baahi noocan oo kale ah ay ka jirto, control of dhiigga waa in ay si joogto ah.

qiimaha dawooyinka, analogs, dib u eegista

Marka uu u xilsaarayo kiniin "Kardosal" sida qiimaha ma aha bukaan oo dhan, si ay xiiso u suurtagalnimada ee daaweynta iyadoo la isticmaalayo kale, hab wax ku ool ah. "Kardosal" la content ee 10 mg ah qayb firfircoon laga iibsan karaa xoqin 610, daroogada taas oo ka kooban 20 mg ah ee firfircoon -. In ka badan 756 masaxo. "Kardosal", kuwaas oo qiimo ku saabsan yahay 860 rubles., Ka kooban 40 mg ah qayb weyn ee.

Sida isbarbardhig, marka aad leedahay inay doorato kale hab fulinta therapy ah, halkii ay ka "Kardosala" waxaad dalban kartaa daawada "Olimestra" ama soo saaraan daawada isku dhafka ah ee ku salaysan isticmaalka "hydrochlorothiazide", "medoxomil olmesartan". Waxaad ka faaiidaysan karaan facooda sida "Lozarel 'ama' Cozaar '. Intaa waxaa dheer, in bedel lagu daroogada ku haboon "Nortivan" "Valsartan Zentiva".

Aware ee daawooyinka sida "Olmesar", "Plaunak". Sida caadiga ah kursiga keydka ka duwan lacagta asalka ah, mid ka mid ah kala duwanaanshaha waa qiimo macquul ah oo xuduudaheedu bioavailability la dhimay, si ay waxtar yar yihiin, inkasta oo ay ula qabsan kartaa hawsha.

Analogs waxaa mar kasta loo isticmaalo iyada oo ay kormeerayaan joogta ah takhasus u leh, waxaa lagama maarmaan ah in si joogto ah loo hubiyo cadaadiska dhiigga. Haddii aad u baahan tahay si ay u soo qaado analoogga xarunta "Kardosal" ka badan bedeli daroogada this, dhakhtarka ayaa go'aan ka, iyada oo la tixgelinayo daqiiqado kala duwan. Marka la ogaado dhacdooyinka xun lagu jiro muddada daawaynta analoogga waa in ay ahaataa in la sameeyo ficilada loo baahan yahay in hab wakhti loogu talagalay ay hareen. Inta lagu guda jiro daawaynta waxaa lagama maarmaan ah si uu u hubiyo saamaynta on jidhka.

Marka asalka ah oo aan qalabka la beddelo ma aan samayn karo, waa in la siiyo doorashada si daroogada macmalay shirkadaha Yurub tijaabiyey. Marka la qorshaynayo in lagu badalo analogues kiniin "Kardosal" aad u leeyihiin in ay doortaan ugu tayada sareeya.

Comments tagay on forums dhakhtar bukaan-ka, ayaa muujinaya in daawada "Kardosal" inta lagu jiro daaweynta inta badan sababa dhibaato, ugu badan ee taas - xanuun xabadka iyo daal joogto ah. Laakiin inkastoo kuwan daqiiqado xun, saamaynta hypotensive had iyo jeer waa heer sare ah. Imaansho ee dhibaatooyinka u baahan gudbinta takhasus leh wixii talo ah, waana is beddeli karaan daawada.

In daaweynta bukaannada qaba hypertension halbowlaha ayaa shaaca ka qaaday, waxaa muhiim ah in si joogto ah bukaanka. Hirgelinta therapy, sidaas ku siin doonaa saameyn la doonayo, oo raac gobolka ee u shaqeeyo, iyo in kiiska xadgudubyada - si ay u hagaajin wakhtiga. Muhiim dhafan hab, laakiin daaweynta daroogada kuma filna, waa in aan sidoo kale dooran hadhuudh ah oo gaar ah. Waxaa ka mid ah shuruudaha daaweynta loo baahan yahay - waafaqsan hab tur shaqada, takhalusaya caadooyinka xun, xaddiddo dhaqdhaqaaqa jirka iyo waafaqsanaanta golayaasha kale in la soo jeediyey ee dhakhtarka natiijooyinka daaweynta ugu fiican.