"Carvedilol": wongororo. Mirayiridzo kushandiswa kwezvinodhaka, analogues, mutengo

Pane zvakarongwa pamusoro vakatsvaka-pashure gadziriro cardiac "Carvedilol" yakareba inosvika. Nyanzvi Guest anorondedzera iye somunhu yepamusoro kurapa mwoyo nokukundikana uye kudzora pamusoro AV raiva pedyo nebundu panguva atrial fibrillation. It inogonawo kushandiswa chaizvo pakurapa BP, izvo zvinoita kuti munhu anokosha chaizvo zvinodhaka. Nokuda kwechikonzero ichi, makambani akawanda mishonga synthesized uye otengesa Generic "carvedilol". Mumwe nomumwe wavo ane yayo maitiro yokusunungurwa pakagadzwa kuchirapa ropa kuwanda. Kunyange zvazvo vakawanda vanoita basa ravo.

Sezvo vose zvinodhaka "Carvedilol" dzomuzana vane ehupfumi zvinokosha, hapana chaiko kunokosha izvo kwavari zvinofanira kusarudzwa kuti anorapwa. Kunyange zvazvo ongororo dzinoratidza bioequivalence, womunatsi uye manyoro nomugumisiroi vane anodhura Generic uye yepakutanga zvinodhaka. Naizvozvo chinangwa pakudzokorora uku hwakanakisisa kusarudza analogues dzakakwirira kuchirapa ukoshi.

System mamirire medicament

Sezvo kuchirapa vamiririri, "Carvedilol" analogues zvinodhaka Generic kunge nekusimba kunobudirira. Pasina mushonga fuma anoreva boka yakavhenganiswa-blockers. Vari hwakaipa ne mhando mbiri adrenaline uye noradrenaline receptors: Arufa Beta-receptors wokutanga mhando. Chokutanga iri mumwoyo, uye wechipiri - iri tsandanyama rwengarava ropa. Zvichivhiringidza kwavari, mushonga kunomutsa kukura anoverengeka kuchirapa migumisiro.

Pakati blocker Kirasi zvinodhaka "Carvedilol" Hapana analogues zvinodhaka. Kune chete yakafanana fuma pamusoro zvigadziriswe kuita. Kunyanya, zvinodhaka riri pedyo "Nebivolol", iyewo ane akasiyana kushanda. Kunewo mamwe nyore kirasi dzomuzana. Vakapa cardioselective, kuti haangotongi panyaya Beta-adrenergic receptors ari mhando rokutanga, "metoprolol" uye "bisoprolol".

Zvichienzaniswa "metoprolol" "Carvedilol" mamwe zvokusarudza kuti Beta-receptors, kuratidza anenge yakafanana "bisoprolol" sungano nokuda cardiac Beta-adrenergic receptors. Mukugadzirira "Carvedilol" ichi ndicho ariwo antioxidant simba. Izvi kunokosha zvikuru kuti yagadziriswa ari vascular rusvingo, nechekare kukanganiswa nedanho atherosclerosis. Maererano kukosha ichi hwebetsero enzvimbo zvinodhaka anopa yakasiyana zviri "Nebivolol." Kunoita activation azotzavisimyh endothelial zvinhu, uye saka anokwanisa kudzivirira atherosclerotic maronda ose arteries.

Pharmacodynamics "carvedilol"

Modern mushonga "Carvedilol" nokuda migumisiro Beta blockade kuti mhando I ane zvinotevera migumisiro:

• kunoderedza myocardial contractility Akaroromesawo kudiwa cardiac tsandanyama muviri uye okisijeni (antianginal);
• anokwanisa zvichivhiringidza automaticity uye conductivity (antiarrhythmic chiito);
• It kuchititadzisa ari renin-angiotensin hurongwa muviri (antihypertensive kushanda);
• akazoita chikamu cardiac goho kutapudzwa systolic BP;
• inokwanisa kuwedzera peripheral midziyo mubhedha.

Zvapedzisira kushanda iri chokwadi ndozvavava "Carvedilol". Reviews echirwere kushandiswa kwezvinodhaka kunoratidza blockade migumisiro adrenergic Alpha-imwe subtype. Ivo riri peripheral, kureva tsandanyama midziyo. blockade wavo unotungamirira dilation pamusoro arteries duku. Izvi chinokurwadzai kuderedza zvachose peripheral aibuda nemishonga, zvichiguma yakaderera BP uye kuvandudza tsandanyama simba.

A ndozvinoitawo ane "Carvedilol" analogues zvinodhaka Generic kwete chete muna skeletal tsandanyama, asi mumwoyo. Izvi anosiya mukana kushandiswa kwayo varwere chirwere chemwoyo, kukonzerwa chisingaperi ischemia (coronary tsinga chirwere). Uye sezvo "Carvedilol" 1 kusarudza Beta-blocker neumwe sungano nokuda Alpha-1-receptors uye Anti-oxidant ehupfumi, kushandiswa kwayo sezvo zvikuru.

Kushandiswa "carvedilol"

Sezvo pharmacodynamic zvechadenga zvinodhaka zvakanaka zvaizobatsira "Carvedilol", wongororo kuti chikumbiro chayo chinofanira kana kusimbisa mhedziso izvi kana kuti kuramba yakakanganiswa kutonga. Migumisiro yacho zvinodhaka akatorarama akaratidza, nokuti zvinonzwisisika achinyatsoramba haritorwi chero chokwadi. Nokuda kwechikonzero ichi, "Carvedilol" anobatsira ari mushonga hunodiwa zvinotevera zvekuchipatara ezvinhu:

• ischemic cardiac chirwere;
• chisingaperi mwoyo kutadza;
• tachyarrhythmia;
• angina, chenjera myocardial infarction, kusagadzikana angina;
• BP.

umboo

Mukugadzirira "Carvedilol" zvairatidza vape- ayo pharmacodynamic maitiro. Nokuda yakaderera BP, kuderera chi- uye afterload ari myocardium, uyewo nokuda antiarrhythmic mugumisiro zvinodhaka zvinogona kushandiswa pane zvakaitika zvinotevera zvirwere:

• neBP II uye III dhigirii ari Kuronga kurapwa zvabatanidzwa akanaka;
• dhigirii I neBP panguva yakakwirira zvemwoyo pangozi monotherapy;
• pamwe tachyarrhythmia: atrial fibrillation zvachose chimiro, pamwe kakawanda supraventricular arrhythmia;
• mu nechirwere chemwoyo pamwe chakasimba kuratidzwa (kusagadzikana angina kana myocardial infarction);
• pamwe IBS ndiko chakasimba zviitiko (kuedza angina, angina mberi);
• chisingaperi mwoyo kukundikana, kubva padanho HIIA Vasilenko-Strazhesko kana FC NYHA III neboka mwero Kuronga kurapwa rechirume;
• mune symptomatic neBP uye sinus tachycardia chokuita hyperthyroidism kana pheochromocytoma.

Aripo chigadzirwa "Carvedilol" dzomuzana nevamwe nokuda zvairatidza mashoko. Ivo anoshandiswa rakajairika cardiac zvirwere, kureva pamwe coronary tsinga chirwere uye mwoyo nokukundikana. Uyewo, kuti mushonga kunewo yakakura kwakaita kushanda. Zvinokosha chirwere cheBP, kunyange symptomatic, vakatsamwisa hyperthyroidism kana pheochromocytoma, uye zvinobudirira kudzora Beta-blockers.

Contraindications

Pasinei rakasiyana kuchirapa Profile kupfuura kusarudza Beta 1-blockers ari zvinodhaka contraindications dziripo, vakaomerwa kushanda kwayo. "Carvedilol" haigoni kuparadzwa kurapwa tsika pasi zvinotevera ezvinhu:

• asima, COPD, nokuda mikana yakawanda bronchospasm;
• Zvinonzi rambidzwa kutora "Carvedilol" pane imwe kakawanda asingasviki 50 mwoyo anorova paminiti nokuda mukana dzinouraya bradycardia;
• rambidzwa kuti ndipe uye kushandisa 'Carvedilol "panguva arrhythmias (CA-chezvakaipa, atrioventricular nechigumbuso 2nd uye 3rd dhigirii) kana pasina pacemaker zvachose;
• zvisingagamuchirwi kushandiswa kwezvinodhaka kwazvo chiropa chirwere;
• kushandisa vairambidzwa chinodhaka CHF dzichipfekeka mukirasi IV maererano NYHA (HIII kubudikidza Vasilenko-Strazhesko) nokuda kudzvinyirira pamusoro decompensated cardiac contractility;
• "Carvedilol" warambidzwa panguva pamuviri, lactation, vana pasi pemakore 18;
• inadmissible kushandiswa varwere neutachiona kuti chacho vanoshingaira chirungiso kana chezvinonhuwira kuti chipimo chemushonga chimiro;
• gadziriro haisi kushanda mune cardiogenic kuvhunduka pamwe SBP 85 mm HG. Art.

Pasinei chokwadi chokuti "Carvedilol" mhinduro vaiva qualitatively uye njodzi mushonga, inofanira kuita zvinoenderana audzwa izvi. Vari yakagadzirirwa kudzivirira murwere uye nyanzvi kubva ezvinhu ndisingadiwi. Nekuti mashoko contraindications vane mhedziso uye hazvigoni kungotariswa nokuti mukuru mukana zvinouraya kutyorwa muviri.

nemishonga

Kuongorora divi zvinokonzerwa zvinodhaka "Carvedilol" mhinduro havasi INDICATIVE. Varwere vari kuzviitira tinyatsonzwisisa kuti kurapwa uye marwadzo. Nokuti rationally kwakavakirwa Statistical tsvakurudzo. Zvezvisarudzo kakawanda nemigumisiro, richiratidzwa pamwe kakawanda kubva 1 kusvika 10%, ndeinotevera:

• kubudikidza PNS uye CNS zvingamuka nomusoro, dzungu, tsandanyama simba, hope zvirwere, paresthesias sezvo kuratidzwa idiosyncrasy;
• zvemwoyo Migumisiro (inopfuura kana kuramba bradycardia kana atrioventricular mufurati, orthostatic hypotension, dzimwe nguva lameness nokuda kweropa kusagadzikana tsandanyama mu vatsvaire atherosclerosis);
• kufema maitiro: zvichiita zviratidzo dyspnea, nasal kuzara, uye nokuda Árbol hyperreactivity kana obstructive chirwere zvinobvira bronchoconstriction;
• marwadzo kubva zvomudumbu mamiriro zvinozarurwa abdominal kurwadziwa, kuda kurutsa, muromo yakaoma, manyoka, uye apo neapo chinoitika kupatirwa kana kurutsa, anogona ngazviwedzerwe chiropa transaminase;
• hematopoietic hurongwa anopindura chete Kashoma thrombocytopenia kana leukopenia;
• zvinogoneka eczema, pruritus, psoriasis exacerbation kuyerera, uye kunogona kuitika chete Kashoma anaphylactoid siyana.

Uyewo, sezvo "Carvedilol" ndiyo imwe fuma kuti muviri, anogona kuva systemic toxicity kuita. Kunoratidza dzihwa-kufanana chirwere pamwe kukura marwadzo ari maoko nemakumbo, maziso akaoma, Urinary neshungu. Panyaya iyi, "Carvedilol" zvakawanda nemishonga pane "metoprolol", kunyange zvazvo chiremba efficacy mukuru maviri okutanga.

kushandiswa kunyanya kwenguva yakareba "carvedilol"

Basic chipimo chemushonga siyana kusunungura mushonga - ichi capsules uye mahwendefa. "Carvedilol" chinobviswa kamwe panyaya chirwere cheBP uye kaviri chete ischemic mwoyo chirwere, mwoyo nokukundikana kana arrhythmia. Pokutangira dose ndiyo 6.25 MG kamwe pazuva, kuti inobatsira kurapa neBP. In CHF mushonga, mwoyo chirwere coronary kana tachyarrhythmias inokurudzirwa kushandisa pokutangira dose pamusoro 6.25, kaviri pazuva. Zvadaro, pedyo titrating nezuva dose iri kumamiriro 25-50 MG.

The mushonga zvinogoneka uye kune yakanaka nomumwe shiviriro rikashandiswa nguva dzose. It unodiwa kudzora arrhythmia kana kurebesa upenyu CHF. Ichi chinowanikwa chinodhaka, wakatorwa akabatana diuretics uye ACE FIs kunowedzera upenyu. Uye zvikuru nani akashivirira CHF mapiritsi "Carvedilol" pane "bisoprolol". Kunyange zvazvo mushonga kunodiwa varegedze kutyaira uye makirasi angangokuvadza nengozi mabasa, utungamiriri zvirongwa.

Mureza kusunungurwa fomu

Mukugadzirira "Carvedilol" mutengo hakusi Pakusarudza chokuratidza resarudzo. Zviri zvikuru zvokufambisa kusarudza zvinobudirira Pfungwa yokuti imwe murwere. Most kakawanda mudzimba uye Western chemishonga nomumbure kuparadzira mhando nhatu mishonga dosages. Izvi 25 MG, 12,5 MG uye 6.25. Mahwendefa vari kugara munzvimbo Maronda akasiyana kana polymeric mumagaba. Mushonga pamberi zvokudya, kana zvaida dose rutapudzo yebasa, panguva kudya.

generics

mishonga Generic ndivo zvinodhaka kuti ane "Carvedilol" mune imwe chipimo chemushonga chimiro rinonangana zvinodiwa bioequivalence mukuenzaniswa epakutanga zvinodhaka. Zvino, pane zvakawanda generics mudzimai chemishonga pamusika, akakamurwa zvitatu mhando maererano mutengo wavo:

• kudhura ( "Dilatrend", "Corioli ',' Carvedilol Sandoz");
• paavhareji mutengo ( "Karvelend" "Carvedilol Zentiva," "din email Carvedilol");
• pamwe yakaderera mutengo ( "MIKA-Carvedilol" "Carvedilol Belmed", "Karvetrend", "Karvenal", "Vedikardol").

"Dilatrend" Mari 450-750 rubles, zvichienderana chipimo chemushonga: 6.25 MG - asingasviki 25 MG. A yakafanana kuitika iri kuchengetwa nguva dzose kana zvimwe zvinodhaka. On "Corioli" mutengo 250-500 rubles, "Carvedilol Sandoz" 300-550 rubles, "Carvedilol Zentiva" - 250-400 rubles. "Carvedilol din email zvemadhenari 200-300 rubles," Karvelend "- 170-330 rubles," Carvedilol Belmed "- 150-250," Karvetrend "- 170-290 rubles.

Nokuti gadziriro "Carvedilol" mutengo hakusi chokukomborerwa quality, kunyange zvinodhaka anonyatsozivikanwa mugadziri zviri kumusoro. In kukirinika Misiyano pakati kupinza zvinodhaka dzinodhura uye mudzimba, nyore kuwanikwa analogues wedzeredzei. Vanachiremba kazhinji kunetseka chete musiyano yepakutanga Pfungwa. Naizvozvo zvakafanira kuti kusarudza Generic capsules kuti zvichaita kuderedza gastrotoxicity kwayo.

Zvikasadaro chipa analogues kuratidza chete kunotoda basa uye zvinobatsira kuti mishonga yezvirwere mwoyo uye BP. Zvisinei, kana murwere kare adzidziswa Generic, ipapo anofanira kusiya kupfuurira. Nekuti akashandiswa kuti zvechadenga chipimo chemushonga chimiro uye simba rinomutsa zvezvibereko yeplasma kuwanda yezviri chirungiso, kuti yokutsiva chigadzirwa achabviswa kunyatsofunga. Ipapo zvichava subjectively akacherechedza kuti mushonga asingadi kushanda kana asingadi kushanda sezvo achida.

kirasi dzomuzana

Kirasi dzomuzana, zvikuru yakakwana akakodzera kuchirapa zvinodiwa, vanoumba "carvedilol" makwikwi dzinoverengeka zvinoratidza. Kunyanya mu neBP kuti kusarudzwa kana "Bisoprolol" kana "Nebivolol". Last, nokuda kwayo kudhura hazvigoni kushandiswa vazhinji varwere, kunyange iri mushonga wakanaka. Kana isu kuronga zvose cardioselective Beta-blockers, avo kuchirapa ukoshi kunowedzera dzinoti: ". Nebivolol" "bisoprolol", "metoprolol", "Carvedilol",

"Nebivolol" anonzi kurapwa kuti BP, uye "Carvedilol" - nokuti mishonga CHF. Hapana zvimwe zvinodhaka vasina dzakawanda kwaibatsira mararamiro chisingaperi mwoyo kukundikana se "Carvedilol." Nokuda kwechikonzero ichi, pamwe chete diuretic uye ane ACE inhibitor, zviri kukwanisa kuwedzera upenyu hwevanhu.

"Carvedilol" - icho mishonga inoshanda antiarrhythmic, kuburikidza paunogona nyore kuongorora Implementation yacho AV raiva pedyo nebundu. Izvi zvinokoshawo atrial fibrillation, kana mukana kudzorera mutinhimira uye kuramba hazvina kuwanikwa. Uyewo atrial fibrillation "Carvedilol" basa mutinhimira rokudzora run-kuti murwere cardioversion.