A wane irin matsin lamba ne aka rubuta Enap da umarnin magani

Enap ingantaccen kayan aiki ne wanda aka kirkira don inganta hawan jini a koda yaushe. Abubuwan da ke aiki da miyagun ƙwayoyi, enalapril, shine mafi kyawun magungunan antihypertensive a Rasha, Belarus, Ukraine. Ana yin nazari sosai, an yi amfani dashi fiye da shekaru goma sha biyu, an tabbatar da ingancin binciken da dama. WHO ta haɗa da magungunan Enalapril a cikin jerin mahimman magunguna masu mahimmanci. Kawai mafi inganci, mai lafiya kuma a lokaci guda magunguna masu tsada waɗanda aka tsara don bi da cututtukan da suka fi yawa da haɗari sun faɗi akan wannan jerin.

Wanene aka wajabta maganin?

Hawan jini shine matsalar gama gari na masu kwantar da hankali, likitocin zuciya, endocrinologists, da nephrologists. Hawan jini shine abokin tafiya na yawan ciwon sukari da cuta na rayuwa, mafi mahimmancin al'amari ga abin da ya faru na cututtukan zuciya da jijiyoyin jini. Ko da ƙaramin matsin lamba a sama da matakin ƙima yana da haɗari, musamman ga marasa lafiya da ke da yiwuwar rikicewar cututtukan zuciya. A matsin lamba sama da 180/110, haɗarin lalacewar zuciya, kwakwalwa, da kodan yana ƙaruwa sau goma.

Hawan jini wani yanayi ne na kullum, don haka yakamata marassa lafiya su sha magani kowace rana a rayuwarsu. A wane matsa lamba ne don fara allunan shan giya ya dogara da cututtukan concomitant. Ga yawancin mutane, ana daukar 140/90 matsayin tsattsauran ra'ayi ne. Ga masu ciwon sukari, ƙananan ƙananan ne - 130/80, wanda ke ba ku damar kare ɗayan mafi kyawun gabobin cikin waɗannan marasa lafiya - kodan. A cikin gazawar renal, yana da kyau a kiyaye matsin dan kadan ƙasa, don haka allunan sun fara sha, suna farawa daga matakin 125/75.

A matsayinka na doka, ana ba allunan Enap a farkon cutar, kai tsaye bayan gano cutar hawan jini. Magungunan yana ba ku damar rage matakin babba, systolic, matsin lamba ta 20, da ƙananan, diastolic, ta raka'a 10. Wannan raguwa yana sa ya yiwu a daidaita matsin lamba a cikin kashi 47 na marasa lafiya. Tabbas, muna magana ne game da alamomin ƙididdiga. Ga waɗancan marasa lafiya waɗanda ba su kai matakin manufa ba, ana yin ƙarin ƙarin ƙarin magungunan antihypertensive 1-2.

Dangane da umarnin, ana amfani da allunan Enap a cikin waɗannan lambobin:

1. Babban abin nuni ga amfanin Enap shine hauhawar jini, shine matsin lamba a hankali. Enalapril ana ɗauka ɗayan maganin gargajiya don magance hauhawar jini, sabili da haka, a cikin binciken da yawa na asibiti, ana kwatanta sabbin magunguna dangane da tasiri tare da shi. An gano cewa matakin rage karfin matsin lamba yayin jiyya tare da Enap shine kusan daidai lokacin da ɗaukar wasu magungunan antihypertensive guda ɗaya, gami da na zamani. A yanzu, babu ɗayan magungunan da suka fi ƙarfin wasu. Likitocin, suna zaɓar wasu magungunan kwayoyi don matsa lamba, akasarinsu suna jagorantar su ta hanyar ƙarin kayansu da matakin aminci ga wani haƙuri.
2. Enap yana da tasirin cutar zuciya, sabili da haka, an wajabta shi don cututtukan zuciya: an riga an gano gazawar zuciya, babban haɗarin gazawar marasa lafiya tare da hauhawar jini na ventricular hagu. A cewar likitocin zuciya, yin amfani da Enap da analogues na analogues a cikin irin wannan marasa lafiya na iya rage mace-mace, rage yawan asibitoci, rage jinkirin ci gaba da cutar, kuma a wasu lokuta inganta halayyar motsa jiki da rage tsananin alamun. Hadarin mutuwa a cikin marasa lafiya waɗanda ke rage karfin jini ta hanyar Enap ko haɗuwa da Enap tare da diuretics shine 11% ƙasa da waɗanda ke amfani da diuretics kawai don magance hauhawar jini. A cikin rauni na zuciya, ana ba da umarnin miyagun ƙwayoyi sau da yawa a cikin babban allurai, ƙasa da kullun a matsakaici.
3. Enap yana da kaddarorin anti-atherosclerotic, saboda haka an ba da shawarar don ischemia na jijiyoyin zuciya. Amfani da shi a cikin cututtukan zuciya na zuciya yana ba ka damar rage haɗarin bugun jini da kashi 30%, da kuma haɗarin mutuwa da kashi 21%.

Yaya maganin yake aiki?

Aiki mai aiki na allunan Enap shine enalapril maleate. A cikin asalin sa, ba shi da tasirin magani, sabili da haka, yana nufin prodrugs. Enalapril yana shiga cikin jini kuma yana canzawa zuwa hanta tare da shi, inda ya juya zuwa enalaprilat - wani abu tare da ƙayyadaddun ƙaddara mai faɗi. Kusan 65% na enalapril yana shiga cikin jini, 60% daga ciki wanda ya shiga hanta ya juya zuwa enalaprilat. Saboda haka, jimlar bioavailability na miyagun ƙwayoyi ya kusan 40%. Wannan kyakkyawan sakamako ne mai kyau. Misali, a cikin lisinopril, wanda har yanzu yake aiki a cikin kwamfutar hannu kuma baya buƙatar sa hanta, wannan adadi shine 25%.

Matsakaici da yawan sha enalapril da jujjuyawar shi zuwa enalaprilat ba ya dogara da cikar ƙwayar gastrointestinal ba, don haka ba za ku iya damuwa ba, shan wannan magani kafin abinci ko bayan. A cikin abubuwan biyu, mafi girman matakin aiki a cikin jini zai kasance bayan awa 4 daga lokacin gudanarwa.

Enap ba magani ne mai saurin motsa jiki ba, ba a son shi ba don dakatar da tashin hankali. Amma tare da shigarwar yau da kullun, yana nuna sakamako tabbatacce. Dangane da sake dubawa game da marasa lafiya da ke shan maganin, matsa lamba kan Enap abu ne mai wuya. Domin allunan suyi aiki da ƙarfi, dole ne su bugu don aƙalla kwanaki 3 ba tare da katsewa ba a kusan lokaci guda.

Hawan jini da hauhawar jini za su kasance abubuwan da suka gabata - kyauta

Cutar zuciya da bugun jini sune sanadin kusan kashi 70% na duk mutuwar a duniya. Bakwai daga cikin mutane goma suna mutuwa saboda toshewar hanyoyin zuciya ko kwakwalwa. A kusan dukkanin lokuta, dalilin irin wannan mummunan ƙarshen shine guda ɗaya - matsin lamba akan hauhawar jini.

Yana yiwuwa kuma dole don sauƙaƙe matsi, in ba haka ba komai. Amma wannan ba ya warkar da cutar da kanta, amma kawai tana taimakawa wajen magance bincike, kuma ba dalilin cutar ba.

• Normalization na matsa lamba - 97%
• Cirewa kan jijiyoyin mara wuya - 80%
• Cire zuciyar mai karfin zuciya - 99%
• Cire ciwon kai - 92%
• Increasearuwar kuzarin rana, inganta bacci da dare - 97%

Kimanin 2/3 na enalapril yana cikin fitsari, 1/3 - tare da feces. Tare da gazawar koda, excretion na iya zama da wahala, maida hankali kan matsalar enalapril a cikin jini yana ƙaruwa, don haka marasa lafiya na iya buƙatar rage sashi a ƙarƙashin matsayin.

Dangane da haɗin gwiwar kungiyar likitancin, kungiyar enalapril shine mai hana ACE. An ƙirƙira shi a cikin 1980 kuma ya zama na biyu a cikin rukuninta bayan captopril. An bayyana aikin Enap daki-daki a cikin umarnin don amfani. An yi niyya don murƙushe tsarin tsarin matsin lamba - RAAS. Magungunan yana hana toshewar enzyme na angiotensin, wanda yake wajibi ne don samuwar angiotensin II - wani sinadari wanda yake gundarin jijiyoyin jini. Katange na ACE yana haifar da shakatawa na tsokoki na jijiyoyin gefe da raguwa cikin matsin lamba. Bugu da ƙari da tasirin hypotensive, Enap yana shafar kira na aldosterone, hormone antidiuretic, adrenaline, potassium da renin a cikin jini, sabili da haka, maganin yana da kaddarorin da yawa waɗanda suke da amfani ga marasa lafiya masu hauhawar jini, ba kirga raguwar matsin lamba:

1. Hawan jini yana tilasta ventricle hagu (babban ɗakin zuciya) yayi aiki sosai, wanda yawanci yakan haifar da faɗaɗawa. Damuwa, rashin walƙiyar bangon zuciya yana haifar da damar arrhythmia da gazawar zuciya sau 5, bugun zuciya sau 3. Allunan Enap ba zasu iya hana kara hauhawar jini a cikin hagu ba, amma kuma suna haifar da tashin hankali, kuma ana lura da wannan tasirin har ma a cikin tsofaffi marasa lafiyar.
2. A cikin duk rukuni na kwayoyi don matsa lamba, Enap da sauran masu hana ACE suna da tasirin nephroprotective da aka fi sani. Tare da glomerulonephritis, nephropathy na ciwon sukari a kowane mataki, miyagun ƙwayoyi suna jinkirta ci gaban lalacewar koda. Dogon lokaci (lura ya wuce shekaru 15) maganin enalapril yana hana nephropathy a cikin masu ciwon sukari tare da microalbuminuria.
3. Hanyoyi guda ɗaya kamar yadda a cikin ventricle na hagu (shakatawa, raguwar kaya), lokacin da aka yi amfani da Enap, yana faruwa a cikin dukkanin tasoshin. Sabili da haka, ayyukan endothelium an dawo da hankali, tasoshin suna da ƙarfi kuma suna naɗa.
4. Menopauseuse a cikin mata yakan haifar da bayyanar hauhawar jini ko kuma ƙaruwa da tsananin cutar data kasance. Dalilin wannan shine rashi estrogen, wanda ke haifar da karuwa a cikin ayyukan ACE. ACE inhibitors suna da irin wannan sakamako tare da estrogen akan RAAS, sabili da haka, ana amfani da shi sosai a cikin mata masu postmenopausal. Dangane da sake dubawa, allunan Enap a cikin wannan rukuni na marasa lafiya ba kawai rage karfin jini da kyau ba kuma ana iya jurewa cikin sauƙi, amma kuma suna rage ƙarfi: rage gajiya da farin ciki, ƙara yawan libido, haɓaka yanayi, cire fitilun zafi da kuma ɗumi.
5. Cututtukan huhu na yau da kullun na iya haifar da hauhawar huhu. Boye a cikin irin wannan marasa lafiya na iya rage matsin lamba daga hanji, kara juriya, da kuma hana gazawar zuciya. Sama da makonni 8 na gudanarwa, matsakaicin raguwar matsin lamba shine raka'a 6 (daga 40.6 zuwa 34.7).

Fitar saki da sashi

Manufacturer Enap - wani kamfanin kasa-da-kasa ne mai suna Krka, wanda ke samar da magungunan gargajiya. Enap alama ce ta asalin enalapril da kamfanin Merck ya kera a karkashin sunan alamar Renitec. Abin ban sha'awa shi ne, sanannan da kuma yawan kifin tallace-tallace na Enap a Rasha sun fi girma fiye da na Renitek, duk da cewa farashin magungunan kusan iri ɗaya ne.

Enalapril maleate, magani ne na magungunan Enap, an yi shi ne a Slovenia, Indiya da China. A masana'antar kamfanin, an gabatar da ingantaccen tsarin kula da ingancin matakai masu yawa, saboda haka, ba tare da yin la’akari da wurin da ake samar da enalapril ba, allunan da aka gama suna da inganci iri ɗaya. Stamping da kwantena na allunan ana yin su ne a Slovenia da Russia (KRKA-RUS plant).

Enap yana da magunguna masu yawa:

Baya ga Enap guda-daya, Krka yana samarda magungunan hade tare da enalapril da diuretic hydrochlorothiazide (Enap-N, Enap-NL) a cikin zabin guda uku.

Abinda ke taimakawa hadewar jiyya tare da Enap-N:

• rage matsin lamba a cikin marasa lafiya masu hauhawar jini, wanda wakili na antihypertensive bai bada tasirin da ake so ba;
• yana rage zafin tasirin sakamako. Ana iya ɗaukar Enalapril a cikin ƙananan kashi idan kun ƙara diuretic a ciki;
• Allunan kwamfyutocin Enap-N suna da tabbacin zasu yi aiki na sa'o'i 24 ko fiye, saboda haka ana nuna su ga marasa lafiya waɗanda sakamakon tasirin enalapril ya lalace har ƙarshen rana.

Enalapril tare da hydrochlorothiazide shine ɗayan mafi kyawun ma'ana da haɓaka aiki. Wadannan abubuwan suna hada gwiwa da juna, wanda sakamakon hakan ya inganta tasirinsu, kuma hadarin sakamako zai iya raguwa.

Hakanan akwai magani na gaggawa a cikin layin Enap, wanda yake a cikin hanyar mafita. Likitoci suna amfani da shi don rage matsin lamba yayin rikici. Ba kamar Allunan ba, Enap-R ba prodrug bane. Abunda yake aiki shine enalaprilat, yana fara aiki nan da nan bayan gudanarwar jijiyoyin jini, an sami mafi girman taro bayan mintina 15.

Duk zaɓuɓɓuka don sakin allunan Enap:

Yadda ake ɗauka

Umarnin amfani da Enap bai nuna lokacin da yakamata ayi: safe ko yamma, allunan. Likitoci yawanci suna bayar da magani na safiya domin likitan ya sami nasarar ramawa game da ayyukan jiki, damuwa da sauran damuwa. Koyaya, akwai hujja cewa ƙarshen ƙarshen sakamakon enalapril yana ƙaruwa. Duk da gaskiyar cewa raguwar tasirin yana dauke da ƙima (mafi girman 20%), wasu marasa lafiya na iya ƙara matsa lamba a cikin safiya.

Tsarin magani yana da mahimmanci don magance hauhawar jini. Enap yana bugu kullun, yana gujewa tsangwama. Magungunan yana tarawa a cikin jiki na kwanaki da yawa kafin tasirin sa ya zama mai iyaka. Sabili da haka, har ma da izinin tafiya guda ɗaya na iya tsokani mai tsawo (har zuwa kwanaki 3), amma yawanci ƙaramin ƙaruwa ne a cikin matsi. Ba wai kawai al'amura na yau da kullun ba ne kawai, har ma lokaci guda na shigarwa. Dangane da bincike, Enap yana ba da kyakkyawan sakamako a cikin marasa lafiya waɗanda suka ɗauki magunguna a agogo ƙararrawa, suna gujewa karkacewa daga jadawalin fiye da awa 1.

Dangane da umarnin, gudanarwar Enap yana farawa tare da farawa na farko, wanda likita ya ƙaddara, la'akari da matakin matsin lamba da kasancewar wasu cututtuka. Mafi yawan lokuta, ana daukar 5 ko 10 mg azaman kashi na farko. Bayan kwamfutar hannu ta farko, ana auna karfin karfin jini sau da yawa a rana, kuma ana yin rikodin sakamakon. Idan ba'a cimma matsa lamba kan matsa lamba (140/90 ko ƙasa ba) ko kuma akwai ƙarfin juji, za a ƙara yawan sashi bayan kwana 4. Yawancin lokaci yana ɗaukar kusan wata guda don zaɓin kashi. Enap yana da zaɓi mai yawa na sashi. Bugu da kari, duk Allunan, farawa daga 5 MG, an sanye su da daraja, wato, ana iya raba su rabi. Godiya ga wannan kashi, zaku iya zaɓar gwargwadon iko.

Ga yawancin marasa lafiya, farashin kula da hauhawar jini yana da mahimmanci, kuma wani lokacin yanke hukunci. Enap yana nufin magunguna masu araha, koda za'ayi amfani da shi azaman sashi. Farashin matsakaici na kowane wata, wanda aka ƙididdige shi bisa ga nazarin haƙuri, shine 180 rubles. Sauran masu hana ACE ba su da tsada sosai, alal misali, perindopril na masana'anta guda ɗaya (Perinev) zai sayi 270 rubles.

Nawa ne kudin Enap:

M sakamako masu illa

Dangane da sakamakon bincike na asibiti, masana kimiyya suna kimanta haƙuri na Enap da kyau. Ko yaya, tasirin maganin yana haifar da bayyanar wasu sakamako masu illa, don haka ya kamata a fara jiyya tare da yin taka tsantsan. Bai kamata a ɗauki allunan farko ba idan jikin yana bushewa sakamakon zawo, amai, isasshen ruwan da gishiri. A cikin sati, yawan lodi, wuce gona da iri, tuki mota, aiki mai tsayi ba da shawarar ba.

Side effects na Enap bisa ga umarnin:

Contraindications

Jerin tsauraran matakan hana Enap:

1. Hypersensitivity to enalapril / enalaprilat da sauran magunguna masu alaƙa da masu hana ACE.
2. Angioedema bayan amfani da magungunan da ke sama.
3. A cikin cututtukan cututtukan fata da cututtukan koda, yin amfani da Enap tare da aliskiren shine contraindication (Rasilez da analogues).
4. Hypolactasia, saboda kwamfutar hannu ta ƙunshi sinadarin lactose monohydrate.
5. Cututtukan hematological - matsanancin rashin jini, cutar porphyrin.
6. Rashin shayarwa. Enalapril a cikin adadi kaɗan ya shiga cikin madara, sabili da haka, yana iya tsokanar raguwar matsin lamba a cikin yaro.
7. Shekarun yara. An yi amfani da maganin enalapril a cikin ƙarancin rukuni na yara sama da shekaru 6, shan 2.5 a kowace rana ana ɗaukar saurin lafiya. Ba a samu izinin yin amfani da Enap a cikin yara ba, sabili da haka, a cikin umarnin sa, ana kiran shekarun yara ga contraindications.
8. Ciki A cikin watanni biyu na 3 da na 3, Enap yana contraindicated, a cikin 1st trimester ba da shawarar ba.

Shan allunan Enap ta matan masu haihuwa sunada bukatar kulawa ta musamman. Dole ne ayi amfani da ingantattun hanyoyin hana haihuwa cikin magani. Idan ciki ya faru, ana soke maganin nan da nan bayan an gano shi. Ba a buƙatar zubar da ciki, tun da haɗarin tayi wanda bai kai makonni 10 na haɓaka ba.

Jagorori don amfani da gargaɗi: idan an dauki Enap a cikin karni na biyu, to akwai haɗarin oligohydramnios, aikin nakuda na tayin, da kuma ƙasusuwa ƙasusuwa na kwanyar. Don yanke shawara kan ci gaba da daukar ciki, kuna buƙatar duban dan tayi na kodan, kwanyar, ƙudurin adadin ruwan amniotic. Jariri wanda mahaifiyarsa ta dauki Enap yayin daukar ciki tana cikin hatsarin hauhawar jini.

Enap da barasa ba a cika haɗuwa ba. Ko da tare da kashi ɗaya na ethanol a cikin haƙuri yana ɗaukar magungunan antihypertensive, zai iya haifar da raguwa mai ƙarfi. Rushewar Orthostatic yawanci yana tasowa: matsa lamba da sauri yana raguwa tare da canjin yanayi. Hawan jini ya yi duhu a idanu, mai tsananin yawa yana faruwa, kuma rauni yana yiwuwa. Tare da maimaita zagi, karfin giya tare da miyagun ƙwayoyi ya zama mafi muni. Sakamakon maye, mai haƙuri yana da matsanancin spasm na tasoshin, wanda ke haifar da hauhawar yawan matsa lamba. Spasm ta ci gaba har na tsawon kwanaki 3 bayan ƙarshen maganin ethanol.

Analogs da wasu abubuwa

Akwai wasu allunan da ke rijista sama da dozin guda biyu tare da abubuwan iri ɗaya iri a cikin Tarayyar Rasha. Daga cikin marasa lafiyar masu cutar hawan jini, wadannan analogues na Enap sun fi shahara:

• Swiss Enalapril Hexal daga kamfanin harhada magunguna Sandoz;
• Enalapril FPO na kamfanin Rasha Obolenskoye;
• Enalapril na Rasha daga Izvarino da Ozone;
• Sabunta Sabunta Kamfanin Enalapril;
• Enalapril daga Hemofarm, Serbia;
• Ednit dan kasar Hungary, Gideon Richter;
• Burlipril na Jamus, BerlinHemi;
• Renetek, Merck.

Ana iya maye gurbin Enap tare da waɗannan magunguna kowace rana; ba a buƙatar shawarar likita. Babban abu shine ɗaukar sabon magani a cikin kashi ɗaya kuma a iri ɗaya. Mafi ƙarancin magunguna daga wannan jerin shine Enalapril Sabuntawa, Allunan 20. Mita 20 ne kawai 22 rubles. Mafi tsada shi ne Renitek, allunan 14. Mita 20 kowannensu zaikai 122 rubles.

Idan masu hana ACE suna haifar da rashin lafiyar jiki, allunan rigakafi daga wasu kungiyoyi na iya zama maye gurbin Enap. Zaɓin magani na musamman da likita ke halarta bayan tantance yanayin hauhawar jini. Dangane da shawarar WHO, an wajabta diuretics (mafi mashahuri ne hydrochlorothiazide da indapamide), antagonists na calcium (amlodipine) ko beta-blockers (atenolol, bisoprolol, metoprolol). Sartans ba a son su, tunda suna da kusanci ga aikin Enap kuma suna iya tayar da hankalin mutum.

Lokacin da ciki ya faru, an tsara wasu magungunan rigakafi maimakon Enap. Ana amfani da waɗancan allunan waɗanda kawai aka tabbatar da amincinsu don tayi. A matsayinka na mai mulkin, wadannan sune magungunan gargajiya na yau da kullun. An dauki magungunan farko-farko na methyldopa (Dopegit). Idan ba za a iya tsara ta ba saboda wasu dalilai, zaɓi atenolol ko metoprolol.

Kwatantawa da irin kwayoyi

Tsarin sunadarai na masu hana ACE abubuwa ba su da yawa. Abin mamaki, sakamakon wadannan abubuwan a jikin mutum kusan iri daya ne. Hanyar aikin, jerin abubuwan da ba a son su har ma da contraindications suna da kusanci da su. An kuma kimanta ingancin magungunan kwayoyi kamar guda.

Koyaya, wasu bambance-bambance a cikin masu hana ACE akwai har yanzu:

1. Da farko dai, sashi ya bambanta. Lokacin canzawa daga Enap zuwa analog na rukuni, ana buƙatar zaɓin kashi sabo, fara daga ƙarami.
2. Ya kamata a bugu da ƙwaƙwalwa a kan komai a ciki, da sauran kwayoyi daga ƙungiyar - ba tare da la'akari da lokacin cin abinci ba.
3. Mafi mashahuri enalapril, captopril, lisinopril, perindopril ana keɓe su galibi ta hanyar kodan, sabili da haka, tare da gazawar koda, akwai babban haɗarin yawan zubar jini. Kodan suna da hannu cikin kawar da trandolapril da ramipril zuwa ƙarancin ƙayyadaddun, har zuwa 67% na kayan yana metabolized a cikin hanta.
4. Yawancin masu hana ACE, ciki har da enalapril, sune prodrugs. Suna aiki mafi muni tare da cututtukan hanta da cututtukan hanji. Captopril da lisinopril suna fara aiki, sakamakorsu baya dogaro da yanayin tsarin narkewa.

Zaɓin takamaiman magani, likita yayi la'akari ba kawai waɗannan nuances ba, har ma da kasancewar maganin. Idan an rubuta Enap a gare ku kuma an yarda da shi sosai, ba da shawarar canza shi zuwa wasu allunan. Idan Enap bai samar da tsayayyen kulawar matsin lamba ba, ana ƙara wani wakili na rigakafi zuwa tsarin kulawa.

Neman Masu haƙuri