"Nebivolol": analogue, yokusetshenziswa, ukubuyekezwa. "Nebivolol Sandoz"

Amalungiselelo kusukela blocker iqembu kabanzi ukwelapha izifo eziningi zenhliziyo. Phakathi naleli qembu izidakamizwa kakhulu abelwe "Nebivolol". Analogs yalesi izidakamizwa futhi wathola udumo olukhulu ngenxa ekulenzeni libe namandla. Hlobo luni imithi, ukuthi isebenza kanjani futhi nini ungayisebenzisa?

Kuyini lokhu izidakamizwa?

"Nebivolol" libhekisela eqenjini we-beta-blocker. Umthelela eyinhloko lena izidakamizwa antihypertensive (izidakamizwa kunciphisa ingcindezi). Umthelela is okuphawulwe ngokukhetha ivimbela i-beta-receptor elise izitsha (nomthelela receptor beta-1-adrenergic).

Okwamanje isetshenziswa "Nebivolol Sandoz."

Lesi sidakamizwa luyinhlanganisela ehlanganisa isomers eziningana (D- futhi L-ligijima). Lokhu inhlanganisela izinto ezuzisa ekuthuthukiseni ukusebenza emitholampilo. Omunye isomer libukene nokuthuthukiswa isenzo antihypertensive, kanti eyesibili kunomphumela omkhulu ku kwenhliziyo.

Umuthi esanda kutholakala, phakathi nekhulu leminyaka eledlule. Kusukela ngaleso sikhathi, abantu abaningi sebekholelwa imvelo inhliziyo. "Nebivolol Sandoz" Isidakamizwa oluthandwa ekwelapheni ezithile inhliziyo isigqi iziyaluyalu nomfutho wegazi ophezulu kanye.

Pho-ke, usebenza izidakamizwa futhi yini iziphathimandla banesibopho digestibility yayo?

Pharmacokinetics

Kuhle ugxile "Nebivolol Sandoz." Umuthi is kahle ugxile pheshana emathunjini. Zingafundwa kanye ukudla (ukumuncwa akuyona sawohloka). Bioavailability kuqhathaniswa ongaphakeme - mayelana 12 amaphesenti. Uma kungenzeka, gwema ukwabelana imithi ngotshwala, kusukela kungenzeka amathuba okuba nemiphumela engemihle.

Kwake kwathi ngo-oketshezini olungenambala lwegazi, umuthi sibopha ukuthi albumin futhi yakha izakhiwo zingaxazululeki. Lokhu lesibopho ifomu ukutholakala zomuthi imayelana amaphesenti angu-98, isb. E. kakhulu zonke ugxile "Nebivolol Sandoz". analogue zako ziyizindlela ngendlela efanayo ngaphambi kokuba singene oketshezini olungenambala lwegazi futhi akusho uxhumane ne amaprotheni.

Musa internalize umuthi ethathwe pheshana emathunjini kanye nezinso. It is kucutshungulwe kwesibindi, lapho sibopha ukuthi glucuronic acid.

Ingxenye-ukuphila zomuthi in iziguli metabolite esasizosheshisa imayelana ngosuku. Endabeni umzimba kancane "Nebivolol" kungaba buthelela futhi wasigcina plasma cishe amahora angu-48.

Ngo ezicutshini izidakamizwa akusho buthelela ukuthi it ugwema ukweqisa izidakamizwa (kungenzeka kuphela uma ukusetshenziswa kwalo in iziguli izinso noma kwesibindi iziyaluyalu).

izinkomba

Kwezinye izimo, Nokho esimisiwe 'Nebivolol "analogue izidakamizwa noma imithi nge efanayo isinyathelo kwemithi?

Inkomba yokuqala umuthi nomfutho wegazi ophezulu. Ngokusebenzisa i-beta-blocker yakhetha ukwehluleka usebenzisa ACE inhibitor ( "Enalapril", "captopril"). Ngaphezu kwalokho, "Nebivolol" ukusetshenziswa futhi endocrine nomfutho wegazi ophezulu.

Esinye, okubonisa kubaluleke ngokufanayo ukusetshenziswa "Nebivolol" kuyinto isifo senhliziyo. Nge exacerbations njalo angina kanye nokuvinjelwa ukuhlaselwa okunjalo, futhi ibonisa "Nebivolol". analogue yayo Kulokhu kungaba ngisho kuphumelela ngaphezu isidakamizwa okumsulwa uqobo.

Kuhlanganisa "Nebivolol" futhi ingxenye ukwelashwa ekwelapheni ezingamahlalakhona yokumelwa yinhliziyo. Kulokhu ukulungiswa kunomthelela ngcono inhliziyo, wehlise pre- kanye afterload ekamelweni umzimba, kanye ukwehla ingcindezi.

Ungakwazi ukusebenzisa imithi kanye nokuvinjelwa wesimo unesifo sikashukela, kanye labo abanemizimba izilonda atherosclerotic imithambo palsy.

Izimo

Lapho-ke akudingekile ukusebenzisa "Nebivolol"? Yokusetshenziswa ngokuvamile kuhlanganisa zonke lezo zimo lapho sezihlonziwe emtholampilo, lapho ngemuva ukusetshenziswa kwezimali wabona ukuthuthukiswa yezinkinga ezihlukahlukene. Ngenxa umphumela oqinile ejenti antihypertensive akufanele ebekiwe ezinzima hypotension.

Okokuqala, it kungavunyelwe ukusebenzisa izidakamizwa e-acute yokumelwa yinhliziyo. Lokhu kungenxa yokuthi anakho inotropic umphumela, okungaba nomphumela omubi umzimba ngenxa yokwehluleka umsebenzi inhliziyo.

With ukuthuthukiswa pheochromocytoma ibuye ekusebenziseni "Nebivolol." Yokusetshenziswa ubonisa ukuthi kule enikeziwe endocrine isimila ukulungiselela ingasetshenziswa kuphela ngokuhlangana ne-blocker-alpha yokwamukela.

Akubalulekile ukuba amise izidakamizwa kubantwana nezinkinga zempilo yengqondo ezikhona.

"Nebivolol" is contraindicated kubantu nge ukungabekezelelani ngakunye izidakamizwa. Ngesikhathi izimpawu zokuqala (Ukubhidliza, iphika) kufanele ngokushesha ayeke ukusebenzisa izidakamizwa futhi ukuthuthela kukho ephephile.

side effects

Njenganoma iyiphi izidakamizwa, "Nebivolol" has siqu side effects yayo. The main phakathi kwabo kukhona:

isimiso sezinzwa - ikhanda, ukucindezeleka, ukozela, ukuqwasha, ukuhhema, yokufikelwa, isiyezi.

A side effect wokugaya ukudla kuyinto isicanucanu, ukuqunjelwa, nomlomo owomile nokuhlanza. Mhlawumbe ukubukeka iziyaluyalu dyspeptic, futhi ngesikhathi coadministration ngezilapha magciwane - dysbiosis.

Isimiso senhliziyo nemithambo yegazi iphendula ukwethulwa "Nebivolol" bradycardia, dyspnea, edema, ukuthuthukiswa ukwehluleka oyingozi inhliziyo, vimba atrioventricular, Raynaud Syndrome. Overdose kungaholela hypotension engalawuliwe, okungase kube nzima wokugoqa futhi nakwisyncope. Ezimweni ezimbi kakhulu, ukushaqeka eba.

side effect "Nebivolol" ingavela njengoba ukuqubuka erythematous, psoriasis.

Ezimweni ezimbi kakhulu angioneurotic edema (angioedema). Ezimweni onomoya omnene, kukhona ukuthuthukiswa sneezing okungenakudanjiswa noma ukukhwehlela.

Izici ukusetshenziswa kwezidakamizwa

Umuthi isetshenziswa ngokuqapha in iziguli esingamahlalakhona kwezinso, ngifundise ngesifo sikashukela, noma ukukhiqiza ngokwedlulele kwama-hormone egilo. Ukususwa zomuthi olwenziwa kancane kancane phezu izinsuku 10-14. Ekuqaleni ukwelashwa ngempela kumele alawulwe BP bebahlungela. Uma kungenzeka ngesikhathi ukusetshenziswa kwezidakamizwa Kufanele uyeke ukubhema. Ngaphambi kokuba ahlinzwe oluzayo qiniseka abatshele ukuthi izinzwa ukuthi isiguli usebenzisa beta-blocker.

Phakathi naso sonke isikhathi ukusetshenziswa kwezidakamizwa uma kwenzeka ngifa ukulawula amazinga kashukela egazini, ikakhulukazi abanesifo sikashukela. Ngaphezu kwalokho, kumelwe sibukeze filtration ikhono nezinso (ikakhulukazi amazinga creatine kanye urea), uma isikhathi eside inikezwa "Nebivolol". Yokusetshenziswa (analogs ube nomphumela ofanayo) ixwayisa ngokuthi kungenzeka ukuthuthukisa ukwehluleka kwezinso benikezwe aphoyintimenti izidakamizwa engenangqondo.

Akuvunyelwe ukusebenzisa izidakamizwa ezinganeni ezingaphansi kweminyaka engu-18 ubudala futhi iziguli esezikhulile nge decompensated yokumelwa yinhliziyo. Lo mthetho ngokuyinhloko ngenxa kungenzeka ukuthuthukisa iziyaluyalu umzimba kanye ukubukeka inkinga ingcindezi.

Njengoba uma usebenzisa izidakamizwa angagcina isiyezi, akusiyo kunesidingo sokujuba abashayeli futhi odokotela.

Ukusebenzisa izidakamizwa abakhulelwe

Inhloso yalesi imithi owesifazane okhulelwe kungenzeka kuphela emva kokubonisana udokotela wezifo zabesifazane futhi owelapha. Umuthi kuyaqabukela ukusetshenziswa ngenxa nomthelela omubi kukamama kanye nengane.

Umuthi kunikezwa kuphela uma udingeka kakhulu, kusukela kungenzeka ukuthuthukiswa bradycardia, hypotension, kahle kungakhuphula izinga likashukela, ukukhubazeka zokuphefumula, nokuquleka.

Ezinsukwini ezintathu ngaphambi kokuzalwa kulindeleke kuyadingeka ukulahla ukusetshenziswa kwalesi imithi. Uma lokhu kungeke kwenzeke, ekuqaleni kwawo-inkathi kwangemva kokubeletha kudinga ukuqapha ngokucophelela ukubeletha okunempilo kanye nengane. Qiniseka uma usebenzisa izinzwa emgogodleni, lo obulala izinzwa ukuze ixwayise ukwelashwa blocker eqhubekayo.

Kufanele kukhunjulwe ukuthi isizinda ukusetshenziswa kwezidakamizwa angagcina hypoxia fetus. umphumela Teratogenic zomuthi engakaze wazibonakalisa, kodwa kukhona amacala imiphumela enjalo embungwini.

Uma namanje ukhulelwe esabelwe 'Nebivolol "imfundo on isicelo ixwayisa ukuthi ukuhlanekezela okungenzeka isenzo oqabulayo izidakamizwa isikhundla salo ngezincwadi magnesium emthanjeni.

Ukuxoxa namanye amaqembu amalungiselelo okwelapha

Ukwabelana "Nebivolol" futhi antiarrhythmics ekilasini 1 kungaholela anda nomphumela omubi inotropic. Mhlawumbe ukuthuthukiswa AV block. A nomphumela ofanayo siyenzeka uma ukusetshenziswa ngesikhathi esisodwa-calcium channel blocker kanye "Nebivolol Sandoz."

Imiyalelo enquma uxwayisa ngokuthi lapho zaphathwa ngemithambo yegazi kungenzeka ukuboshwa inhliziyo (inqobo nje uma izidakamizwa iqondiswa ngokuhlanganyela "Verapamil"). Kulokhu, udinga eziphuthumayo cardioversion usebenzisa cardioversion.

Kukhona kunengozi enkulu ebangela hypotension ezinzima lapho ekhipha izidakamizwa ukuze "nitroglycerin".

Ukuqokwa ngesikhathi esisodwa sympathomimetic futhi "Nebivolol" kunomthelela yokucindezela zokugcina.

Ukusetshenziswa ahlangene izidakamizwa ngenjongo izinzwa kungaholela iconsi elibukhali blood pressure, ezizosebenza njengoba inkomba ukupholisa mechanical ukusetshenziswa kwezidakamizwa abanomfutho wegazi ophakeme.

Lapho ukuphatha izidakamizwa angagcina insulini i-hormone ukweqisa izidakamizwa futhi esikhoselweni izimpawu zokwelashwa kahle kungakhuphula izinga likashukela.

Isikali

Ngakho lokho udinga ukusebenzisa ngemithamo efanayo zomuthi, ukuthuthukisa ukusebenza emitholampilo kudingekile? Uma usebenzisa "Nebivolol Sandoz", imfundo manual inikeza uhlobo elandelayo nokushintsha kokudla nokufakwa.

Umthamo elilungile kakhulu omdala 20 mg ngosuku. Umuthi isetshenziswa ngaphakathi ekuseni esiswini esingenalutho. Umthelela esiphezulu umthamo esetshenziswa ithuthukiswe ngokusebenzisa Evikini elilodwa noma amabili ukuqala ukwelashwa. Uma kudingeka, lemali nsuku zonke imithi kungase kukhule-10 mg. Ezigulini amadala, umthamo sangemihla 5 angu futhi elilungile ngoba impatho - 2.5 angu ngosuku. Ukuze imali abakhulelwe ukulungiselela kuyakhethwa ngokuvumelana izimpawu emitholampilo isisindo emzimbeni. Kungcono ukusebenzisa "Nebivolol Sandoz" (5 mg) amaphilisi.

Uma ukwephula kwesibindi noma izinso kungcono ukulahla ukusetshenziswa "Nebivolol" noma babela it umthamo ubuncane.

Lapho ukuphatha concomitant ka sympathomimetics futhi "Nebivolol" kungenzeka potentiation umphumela, okwenza kube lula ukunciphisa inani umthamo nelinganikezelwa zomuthi.

Ukusebenzisa izidakamizwa ngemithamo ezincane akunamthelela emzimbeni. Kwangathi ukuthuthukisa ukubekezelelana kuya la mangqamuzana izidakamizwa nokuphathwa eside amazinga okukhishwa ongaphakeme zomuthi.

izidakamizwa analogue

Akukhona njalo engenzeka ukuthola Pharmacy ekulungiseleleni kudingekile, ukuze ube iphendukele ukusetshenziswa analogs. Ngenxa ukunwetshwa emakethe kwemithi, thola imikhiqizo efanayo akunzima. Yini imithi esikhundleni "Nebivolol"?

Analogs (omqondofana) ukulungiselela zimi kanje:

• "Binelol";
• "Nebivator";
• "Nebivolol njengeziyingxenye yohlu lwezincwadi zeBhayibheli";
• "Nebivolol STADA";
• "Nebivolol teva;
• "Nebikar";
• "Nebilet";
• "Nebilong";
• "Palates HOD."

Ngayinye yalezi izidakamizwa inezici yayo emihle nemibi. Ezinye zazo ziba zinkulu kunokuba Classic "Nebivolol." Nokho, Yokusetshenziswa ngamunye wala, esixwayisa imiphumela emibi ngaphezulu. Ngakho-ke, ukuze anqume umbuzo, onjani izidakamizwa kungcono, angasiza kudorhodere nabanekhono.

Akubalulekile ukusebenzisa lezi zimali bebodwa, ngaphandle kokukhuluma nodokotela, ngoba kuphela ngale ndlela kungayisiza kakhulu ukuba zimbi kakhulu isimo sabo futhi zilimaze kokubili impilo yabo futhi impilo nabangani kanye nomndeni wakho.

Izibuyekezo amalungiselelo

Iziguli eziningi izenzo ezibonisa ukudumisa kwi zindlela izidakamizwa njengoba "Nebivolol Sandoz." Uphenyo ke zitholakala ogxile omuhle, ngoba izidakamizwa wasiza ukwelapha noma kuboshwe izimpawu zesifo, iziguli eziningi kakhulu.

Nakuba imiphumela emibi possessed izidakamizwa, kubhekwa omunye ukhiye ekwelapheni ingcindezi ephakeme kanye esingamahlalakhona senhliziyo ebuthaka.

Lots of okubuyayo has a "Nebivolol." Ihlanzekile Analogue zomuthi umuntu ofanelekayo, umuntu - kancane, ukuze imibono iziguli ziyahlukahluka. Kumelwe futhi acabangele comorbidities, ezingasetshenziswa kakhulu ona umphumela umuthi.

Kufanele nakanjani acabangele engu iziguli ziphathwe lokhu imithi.

Kuzo zonke betaadrenoblokatorov isetshenziswe ezigulini inhliziyo, endaweni yokuqala "Nebivolol" (analogue). Izibuyekezo lomutsi enze kube nokwenzeka ukuba ukukubiza ngokuthi izidakamizwa ngempumelelo kakhulu leli qembu izidakamizwa.