"Metoprolol": ukubuyekezwa, izinkomba, imiyalelo kanye nezifanekiso

Kungani ngidinga iMetoprolol? Ukuphawula kweziguli mayelana nalesi sidakamizwa, ifomu lokukhululwa, ukwakheka kanye nemiphumela emibi kuzokwethula kamuva. Futhi sizokutshela ukuthi yiziphi izinkampani ezichasayo kanye nezinkomba ezivela kulo muthi, ngumuphi umthamo okumele uthathwe, kungakhathaliseki ukuthi kukhona okufanayo nokunye okunjalo.

Ukwakhiwa kokulungiselela kanye nendlela yayo yokukhululwa

Ngamuphi uhlobo iMetoprolol imithi edayiswe? Ubufakazi beziguli bathi kukhona izinhlobo ezintathu zalesi sidakamizwa ekhemisi. Cabanga ngamafomu okukhululwa nokubunjwa ngokuningiliziwe.

• Amathebulethi. Iqukethe isithako esinjalo esisebenzayo njenge-metoprolol tartrate (100, 50 no-25 milligram). Ngaphezu kwalokho, imithi ihlanganisa izingxenye eziwusizo ngesimo se-silicon dioxide colloidal anhydrous, microcrystalline cellulose, isitrodidi sodium carboxymethyl (uhlobo A) ne-stearate ye-magnesium. Isidakamizwa sithengiswa ngamaphilisi angu-50, 10, 30, 20 noma angu-40 kwiphakheji.
• Amathebulethi anezakhiwo zokukhululwa okuqhubekayo ("i-Metoprolol succinate"), eboshwe. Zinezinto ezifanayo ezisebenza futhi ezisizayo. Ema pharmacy umuthi onjalo ungatholakala kumathebulethi angu-30, 20 noma ayishumi kuphakheji.
• Isixazululo se-injection emangcwabeni ngama-ampoules ama-milliliters angu-5. Umuthi uthengiswa emkhakheni wekhadibhodi wama-ampoules angu-10.

Izakhiwo zamakhemikhali zomkhiqizo wokwelapha

Iyini injongo yomuthi weMetoprolol? Izinkomba zokusebenzisa leli thuluzi zizovela ngezansi. Manje ngifuna ukukutshela mayelana nezakhiwo zemithi zalesi sidakamizwa.

Lesi sidakamizwa sibhekisela kuma-blockers we-cardioselective beta-adrenergic receptor. Ayibonakali izakhiwo ezinamathele-mzimba futhi ayinayo umsebenzi wangaphakathi we-sympathomimetic. Kodwa-ke, lesi sidakamizwa singama-antihypertensive, antiarrhythmic and antianginal.

Imithi iyakwazi ukunciphisa isilinganiso senhliziyo yesiguli, ukunciphisa ukukhushulwa nokuvumelanisa kwe-myocardium, ukuqhuma kwe-AV kancane, nokunciphisa isidingo se-myocardium emoyeni.

Njengomthetho, umphumela we-hypotensive ubonakala ezigulini emva kwezinsuku eziyishumi nane emva kokuthatha lesi sidakamizwa. Lesi sidakamizwa sinciphisa ukuvama kokugubha ne-tachycardia engaphezulu, i-angina pectoris kanye ne-fibrillation ye-atrial. Ngenxa yalokho, isigqi senhliziyo sesiguli sijwayelekile.

Amathebulethi ngokukhululwa okulibala ("Metoprolol succinate") anenzuzo enkulu ngaphezu kwezivamile. Zivumela ukuba kugcinwe ukugxila kwento esebenzayo egazini, ngaleyo ndlela inikeze umphumela omuhle wokwelapha usuku lonke. Kumele kuqashelwe ukuthi isenzo se-"Metoprolol succinate" sisiza ukunciphisa ingozi ye-bradycardia nobuthakathaka, kancane kancane kuthinta imisipha ebushelelezi ye-bronchi.

I-Pharmacokinetics (ukumuncwa, ukugaya umzimba kanye nokwelashwa kwemithi)

Mayelana nezinkomba zokusetshenziswa kwezidakamizwa futhi ezitholakalayo ezidakamizwa "Metoprolol" analogues kuzochazwa ngezansi, kodwa manje ake sikhulume ngezici ze-pharmacokinetic.

Le ngxube ibambe ngokushesha futhi cishe ngokuphelele (cishe ngo-95%). I-concentration enkulu e-plasma yegazi ivame ukutholakala emaminithini angu-50-110 ngemva kokungenisa.

Esikhathini sokuqala kwesicelo, ukutholakala kwezidakamizwa yi-50%. Ngokuphindaphindiwe, kwanda kuma-70%. Ngendlela, ukudla ukudla kwandisa ukutholakala kwemithi ngo-20-40%. Kubuye kwandiswe uma isiguli sinesifo se-cirrhosis. Ukuxhumeka kwamaprotheni ngokwesilinganiso ku-10%.

Lesi sidakamizwa sidlula kahle ngokusebenzisa umkhawulo we-placental kanye negazi. Kanti futhi ngamanani amancane, athulwe ubisi lwebele.

Isidakamizwa sihlanganiswe esibindi. Futhi i-metabolites ayinayo umsebenzi wezokwelapha. Cishe u-5% wekhambi uyadalulwa izinso ezingashintshi. Ukwelashwa kwesiguli esinomsebenzi wokunciphisa umzimba akudingi ukwehlisa noma ukulungiswa kwesilinganiso semithi. Kodwa-ke, ukungavamile kokusebenza kwesibindi kunganciphisa umzimba we-metabolism. Kulesi simo, umthamo kufanele unciphise.

Imithi "Metoprolol": izinkomba zokusetshenziswa

Kukhona uhlu olubanzi lwezimo zokugula lapho lesi sidakamizwa sinqunywe khona. Cabanga ngabo.

• U-Akathisia, owabangelwa ama-neuroleptics;
• Ukucindezela komzimba okuphezulu kwe-1 st no-2 i-degree, isifo somfutho wegazi (mhlawumbe i-monotherapy, nasezikhungweni ezimbi - kanye nezidakamizwa kanye neminye imishanguzo ye-antihypertensive);
• I-Thyrotoxicosis (kuphela njengengxenye yokuphathwa okunzima);
• Ukuvimbela ukuhlasela kwe-angina kanye ne-angina pectoris;
• Ukuvimbela ukuhlasela kwe-migraine;
• Ukuphulwa kwesigqi senhliziyo (isibonelo, nge-extrasystole, i-paroxysmal ne-tachycardia engaphezulu, i-tachycardia engaphezulu);
• Ukunciphisa ingozi yokufa nokugula ekuhlulekeni kwenhliziyo kanye nesifo se-ischemic;
• Ukuvimbela kwesibili ngemuva kwe-infarction ye-myocardial ne-infarction ephawulekayo ye-myocardial;
• I-prolapse ye-valve mitral;
• I-Cardiomyopathy dilatation idiopathic;
• I-hyperkinesis yenhliziyo iyadingeka, i-cardiac hyperkinetic syndrome, ukungasebenzi komzimba.

Ukubuyekeza mayelana nomuthi

Ngokwezibuyekezo zalabo abawake bathatha lesi sidakamizwa, sibhekane ngokuphumelelayo nomsebenzi futhi sithinta kahle umsebenzi wenhliziyo. Nokho, kufanele kuqashelwe ukuthi ezinye iziguli azikhulumi kahle ngomuthi. Njengomthetho, lokhu kubangelwa ukuthi kunezinkambiso eziningi nemiphumela emibi. Mayelana nokuthi iziguli zikhononda ngani uma uthatha lesi sidakamizwa, sizotshela ngezansi.

Ukungahambisani nokusetshenziswa kwemithi

Ngakho-ke, manje uyazi ukuthi ukulungiselela "i-Metoprolol" kuhloswe ngani (izinkomba zokusetshenziswa zichazwe ngenhla). Noma kunjalo, le mithi inezinamba eziningi zokuphikisana. Lokhu kufaka:

• Ukungabekezelelani komunye umuntu (ie hypersensitivity kuya ezingxenyeni ezisebenzayo noma ezifinyelelekayo);
• Ukuvimbela ama-Atrioventricular we-2 nd no-3 degree degree;
• Ukusetshenziswa kwesikhathi esisodwa nge-MAO inhibitors;
• Ukuvinjelwa kuyinothi;
• Ukuphazamiseka okukhulu kwe-circulatory (peripheral);
• I-Bradycardia sinusovaja (uma imvamisa yezinhlanzi zenhliziyo - engaphansi kwamashumi ayisithupha ngomzuzu);
• Hypoglycemia kanye nesimo se-labile sesifo sikashukela;
• I-syndrome yobuthakathaka besici se-sinus;
• Ukumiswa kwesiguli ku-bronchospasm (okungukuthi, nge-asthma ne-bronchial hyperreaction);
• I-metabolic acidosis;
• I-hypotension ye-arterial (engaphansi kuka-100 mm Hg);
• Ukumangaza i-cardiogenic (lesi sidakamizwa asikhuthazwa iziguli ezixilongwa ngokuthi "i-infarction eyingozi ye-myocardial" noma okusolakala ngayo);
• Ukuhluleka kwenhliziyo okunamandla, okungapheli (2 no-3 rd esigabeni) futhi kungagunyaziwe.

Ukulinganiselwa ekusetshenzisweni kwezidakamizwa (ukuthatha ngokuqapha okukhulu)

Kuziphi izimo okufanele ulinganise ukusetshenziswa komuthi weMetoprolol? Ochwepheshe bathi umthamo kumele unciphise i-hyperthyroidism, i-emphysema, umlando wokuhlushwa, i-asthma, isifo esingenalutho, i-psoriasis, i-pheochromocytoma, izifo zesibindi, izinso (ngezinye izikhathi), ukucindezeleka, i-myasthenia gravis kanye ne-anesthesia ejwayelekile.

Kungenzeka yini ukunikeza izingane isidakamizwa seMetoprolol? Ukusetshenziswa kwalesi sidakamizwa ngabantu abangaphansi kweminyaka engu-18 kuvunyelwe. Ukuvinjelwa kokuthatha lesi sidakamizwa kusebenza nakwabesifazane abakhulelwe abangamama abahlengikazi. Uma lezi zincomo zingalandelwa, kunengozi enkulu yokuthuthukisa i-bradycardia, i-hypoglycemia kanye ne-hypotension enganeni esanda kuzalwa.

Uma udinga ukuthatha imithi ngenkathi ukondla, khona-ke ngalesi sikhathi i-lactation kufanele iphazamiseke.

Amalungiselelo "Metoprolol" ne "Metoprolol succinate": imiyalelo yokusetshenziswa

Njengomthetho, isidakamizwa esithi "Metoprolol" ngosuku sithathwa ngesamba sika 100 mg. Le vidiyo ihlukaniswe ngamanani amaningi. Ukufezekisa umphumela omuhle wezokwelapha, ukwamukela kunganda izikhathi ezimbili. Kodwa-ke, isilinganiso esiphezulu semithi akumele sibe ngaphezu kuka 400 mg.

Uma ijojowe nge-intravenously kusuka ku-2 kuya ku-5 mg yesidakamizwa. Kulesi simo, isilinganiso esiphezulu siyi-15-20 mg. Uma kungekho umphumela omuhle, kuvunyelwe ukuletha lesi sidakamizwa futhi (ngemva kwemizuzu emihlanu).

Khansela ukuthatha le mithi kufanele kube kancane kancane. Ngokuvamile kwenziwa ngezinsuku eziyishumi ngaphansi kokuqondiswa okukhethekile kukadokotela.

Isilinganiso sokuqala sesidakamizwa "I-Metoprolol succinate" ne-tachycardia engaphezulu, i-angina pectoris, i-hypertension ye-arterial kanye ne-extrasystole ingaba ngu-50-100 mg kanye ngosuku. Ngomuthi wokondla we-infarction ye-myocardial, imithi ithathwa ngomthamo we-200 mg.

Isikhathi esincane sokwelashwa nge-metoprolol succinate yizinyanga ezingu-3. Uma isiguli sithola ukuthi sinesifo senhliziyo esingapheli, umthamo ukhethwe ngamunye. Okokuqala umuthi uthathwa ngesamba se-12.5 mg kanye namasonto amabili, bese kuthi emva kwezinsuku ezingu-14 umthamo uphindwe kabili.

Ngokubekezelelana okuhle komuthi, ukudla okuphezulu ngosuku kungabafinyelela ku-200 mg.

Izenzakalo ezimbi. Ukubuyekezwa kwesineke

Imithi ye-Metoprolol ingalimaza umzimba? Ukubuyekeza mayelana nalesi sidakamizwa kunolwazi oluningi oluthi ngemva kokuwuthola kunemiphumela emibi. Yimiphi imihlobo esiyikhuluma ngayo?

• Esikhathini sesimiso sezinzwa: ukubuthakathaka kwemisipha, ukukhathala, ukulimala, ukucindezeleka, ikhanda, ukukhathazeka, ukunciphisa ukuhamba kwezimoto nokuzizwa kwengqondo, ukulahlekelwa ukunakekelwa, i-paresthesia emilenzeni, ukukhubazeka okwesikhashana, ukulala noma ukuphambene nokulala.
• Kusukela ezinhliziyweni: ukwehla ekusithekeni kwamanzi okukhipha izinyembezi, ukunciphisa umbono, ukuguqulwa kwesibindi, ukukhathazeka nokumelela kwamehlo amancane, ama- tinnitus.
• Kusukela ohlelweni lwezinhliziyo: i-arrhythmia, i-sinus bradycardia, i-cardialgia, i-conductivity yokukhubazeka kwe-myocardial, ukwehlisa ukucindezelwa kwegazi, ukubonakaliswa kwe-angiospasm, i-orthostatic hypotension, ukunciphisa ukuthengiswa kwe-myocardial nesizungu.
• Esikhathini senqubo yokugaya ukudla: umlomo owomile, ubuhlungu besisu, isicanucanu, ukukhubazeka kwesibindi, ukuqotshwa, ukuhlanza, isifo sohudo kanye nokunambitheka kweshintsho.
• Isikhumba: ukubhekwa, i-alopecia eguquguqukayo, imifuba, i-hyperemia, ukuqhuma, ukujuluka okukhulu, ukukhuphuka kwe-psoriasis, i-photodermatosis, i-exanthema ne-psoriasis-like like reaction reaction.
• Esikhathini senqubo yokuphefumula: i-dyspnea, ukuminyanisa kwesisu, i-bronchospasm nobunzima bokuphefumula.
• Esikhathini senqubo ye- endocrine: hypothyroidism, hypoglycemia kanye ne-hyperglycemia.
• Ucwaningo lwesayensi: i-thrombocytopenia, i-agranulocytosis, i-hyperbilirubinemia, i-leukopenia nomsebenzi okwandisiwe we-enzyme e-hepatic.
• Ukuthinta isitho sowesifazane ngesicelo sowesifazane okhulelwe: ukuphuza kwe-intrauterine ukukhulelwa, i-bradycardia ne-hypoglycemia.

Phakathi kwezinye izinto, ngemuva kokuthatha lesi sidakamizwa, ezinye iziguli ziphawula ukuthi kwenzeke ubuhlungu emajoyini noma emuva. Ngokuvamile abantu babonisa ukuthi banesisindo somzimba esincane, banciphisa i-libido noma i-potency.

Isiqondiso esiqondile mayelana nokusetshenziswa komkhiqizo wokwelapha

Njengamanje, kunoma iyiphi ikhemisi ungathenga umuthi weMetoprolol. A recipe ayidingekile. Kodwa-ke, isiguli esithatha imithi kumele siqaphele njalo udokotela oya khona. Lokhu kuyiqiniso ikakhulu kulabo abagulayo abanesifo sikashukela noma i-angina.

Kumele kuqashelwe ukuthi uma umthamo wanda (ngaphezu kuka 200 mg ngosuku) i-cardioselectivity iyancipha. Ngaphambi kokuhluleka kwenhliziyo, ukwelashwa kuqaliswa kuphela ngemuva kokuba isiteleka senxephezelo sesifinyelelwe.

Abantu abasebenzisa ama-lens othintana nabo kufanele bacabange ukuthi ngemuva kwesizinda sokwelashwa nesidakamizwa esithi "Metoprolol" ukukhiqizwa kokukhipha amanzi okuncipha kunciphisa.

Ngezinye izikhathi le mithi ibonisa ezinye ze-thyrotoxicosis. Ngesikhathi esifanayo, ukuhoxiswa okukhulu kwezidakamizwa ezigulini ezilelesi sifo kuyaphikisana, njengoba lokhu kunomthelela ekukhuleni izimpawu.

Uma kunesidingo sokwenza umsebenzi, isiguli kufanele sitshele ngokucacile i-anesthesiologist mayelana nokwelashwa nomuthi.

Ngenkathi ukwelashwa nomuthi "Metoprolol" kubalulekile ukugqoka izingubo ezifanele. Lokhu kungenxa yokuthi isidakamizwa singabangela ukusabela okweqile esikhumbeni ngenxa yelanga.

Umuntu akanakusiza ukusho ukuthi imithi "i-Metoprolol" (okufana nale mithi) phakathi kwabantu asebekhulile ingabangela ukubukeka kwebradycardia ekhulayo, ukwehla okushiwo ekucindezelweni kwegazi, nokuvinjelwa kwe-atrioventricular. Yingakho ukulawula okhethekile kuyadingeka kulabo bantu.

Ngaphezu kwalokho, ngesikhathi ukwelashwa nalesi sidakamizwa kufanele ugweme ukushayela ezokuthutha futhi uyeke ukusebenza emisebenzini enobungozi edinga ukugxilwa nokujula kokuphendula kwengqondo. Kunconywa ukuthi kungabandakanyi ukusetshenziswa kwe-ethanol.

Ama-analogues akhona omkhiqizo wokwelapha

Yini okufanele uyenze uma isiguli singenakuthola imithi enqunywe udokotela Metoprolol? Ama-analogue atholakala kunoma iyiphi ikhemisi. Eziningi zazo ziqukethe izinto ezifanayo ezisebenzayo, ngenxa yokuthi zinezici ezifanayo njengokwenziwe okukhulunywe ngakho. Phakathi kwemithi enjalo kukhona okulandelayo: Metoprolol-Acry, Metolol, Metocor Adipharm nabanye.

Emva kokuthola lezi zimali, isiguli sinconywa ukuthi sifunde imiyalelo enamathiselwe bese uxhumana nodokotela. Lokhu kungenxa yokuthi izindlela zokuphatha zingase zihluke emithonjeni ye-ejenti eshiwo ngenhla.

Yiziphi ezinye izifaniso ezenza le mithi ibe nayo? Ungashintsha umuthi owenziwe udokotela ngemithi elandelayo: i-Bisoprolol, i-Metoprolol-Ratiofarm, iMetocard, i-Corvitol, i-Metozok, i-Lidalok, i-Serdol, i-Egilok, i-Emzok nabanye.

Kanjani futhi kungakanani ukugcina umkhiqizo wokwelapha?

Manje uyazi ukuthi kusho ukuthini, imithi nokuthi "imithi ye-Metoprolol" ethathwe kanjani futhi ngayiphi isilinganiso. Gcina endaweni epholile (isibonelo, efrijini) noma igumbi lapho izinga lokushisa lomoya lingedluli ama-degree angu-25. Kulesi simo, isidakamizwa kumele sivikelwe elangeni eliqondile.

Impilo yesilwane yomuthi futhi iningi labalingani bayo iminyaka emihlanu kusukela ngosuku lokukhiqizwa. Ekupheleni kwalesi sikhathi, kuvunyelwe ukusebenzisa umkhiqizo wokwelapha ngezinhloso zokwelapha kanye ne-prophylactic. Kufanele ilahlwe.