"Carvedilol": ndemanga. Malangizo ntchito mankhwala, analogues, mtengo

Mu mndandanda wa anafuna-pambuyo kukonzekera mtima "Carvedilol" nthawi pamafika. Akatswiri alendo kufotokoza iye monga mankhwala apamwamba kulephera mtima ndi kulamulira pa mfundo AV pa fibrillation matenda. Komanso akhoza ankagwiritsa ntchito zochizira matenda oopsa, zomwe zimachititsa kuti mankhwala wapatali kwambiri. Chifukwa cha zimenezi, makampani mankhwala apanga kukagulitsa generic "carvedilol". Aliyense wa iwo ali ndi makhalidwe yake ya kumasuka ndi kukhazikitsidwa kwa woipa achire magazi. Ngakhale ambiri iwo kuchita ntchito yawo.

Popeza mankhwala "Carvedilol" Anzawo kukhala ndi katundu wofunika, palibe kufunika chenicheni ndani wa iwo anasankha mankhwala. Ngakhale kafukufuku akusonyeza bioequivalence, wokhutiritsa ndi zotsatira lililonse limatisokoneza ndi zodula generic ndi choyambirira mankhwala. Choncho cholinga cha ndemanga izi ndi zopambana khalidwe kusankha analogues ndi mtengo wapatali achire.

System khalidwe medicament

Oimira achire, "Carvedilol" analogues ndi mankhwala angaperekedwe atsimikizira ogwira. Nkosafuna mankhwala mankhwala amatanthauza gulu la losakanizika blockers. Iwo akulephera ndi mitundu iwiri ya zikuwonjezereka masiku ano ndi noradrenaline zolandilira: Alpha ndi beta-maselo a mtundu woyamba. Woyamba ili mu mtima, ndipo chachiwiri - mu minofu Mitsempha. Inhibiting iwo, mankhwala kumapangitsa chitukuko cha zotsatira zingapo achire.

Pakati blocker kalasi ya mankhwala mu "Carvedilol" Palibe analogues wa mankhwala. Pali kokha chinthu ofanana pa njira ya kanthu. Makamaka mankhwala wapafupi "Nebivolol", alinso ndi zotsatira wapadera. Palinso wosavuta Anzawo kalasi. Zoperekazo cardioselective, kuti kusankha ndi ulemu kwa maselo beta-adrenergic a mtundu woyamba, "metoprolol" ndi "bisoprolol".

Poyerekeza "metoprolol" "Carvedilol" kusankha kwa beta-zolandilira, kusonyeza pafupifupi wofanana "bisoprolol" kuyandikana kwa maselo mtima beta-adrenergic. Mu izi kukonzekera "Carvedilol" uwu ndi wamphamvu antioxidant. Amenewa n'chofunika kwambiri kwa kukonzanso kwa mpanda mtima, kale anakhudzidwa ndi ndondomeko ya atherosclerosis. Malinga kufunika kwa chuma ichi wothandiza mankhwala amapereka mbali yapadera "Nebivolol." Izo zimayambitsa kutsegula azotzavisimyh zinthu za indofeliyamu, choncho angathe popewa zotupa atherosclerotic ya mitsempha.

Pharmacodynamics "carvedilol"

mankhwala amakono "Carvedilol" chifukwa zotsatira za beta anatseka misewu ya mtundu Ine ali zotsatira izi:

• kumachepetsa m'mnyewa wamtima contractility ndi kuchepetsa kufunika mtima minofu zakudya ndi mpweya (antianginal);
• Amatha inhibiting automaticity ndi madutsidwe (antiarrhythmic kanthu);
• Iwo kumabwezera mmbuyo ndi renin-angiotensin dongosolo la thupi (antihypertensive zochitika);
• amachepetsa nusu ya linanena bungwe mtima kuti ndichepe systolic magazi;
• angathe kuwonjezera zotumphukira mitsempha bedi.

Zotsatira yamasika ndithu amadziwika "Carvedilol". Reviews ntchito aakulu mankhwala zikuonetsa anatseka misewu obwera chifukwa cha adrenergic subtype alpha-chimodzi. Iwo zili zotumphukira, mwachitsanzo ziwiya minofu. anatseka misewu awo kumabweretsa dilation ya mitsempha yaing'ono. Izi amakwiya dontho mu okwana zotumphukira otaya kukana, chifukwa magazi m'munsi ndi kusintha minofu mphamvu.

A kuchita chimodzimodzi ali "Carvedilol" analogues ndi mankhwala angaperekedwe osati minofu chigoba, koma mu mtima. Zimenezi zitanthauza kuti n'zotheka ntchito odwala ndi kulephera aakulu mtima, amayamba ndi ischemia aakulu (inatsekeratu mtsempha wamagazi matenda). Ndipo popeza "Carvedilol" 1 kusankha beta-blocker ndi kuyandikana ena alpha-1-maselo ndi katundu odana ndi oxidant, ntchito yake ambiri.

Ntchito "carvedilol"

Popeza makhalidwe pharmacodynamic mankhwala akutsutsana zimaonetsa "Carvedilol", ndemanga za tanthauzo lake ayenera zimalimbikitsa mfundo izi kapena kutsutsa maweruzo olakwika. Phindu la mankhwala kale umboni, chifukwa yotsutsa kosamugonjera aliyense mfundo. Pachifukwa ichi, "Carvedilol" ntchito ngati mankhwala chofunika zotsatirazi zinthu matenda:

• ischemic mtima matenda;
• aakulu kulephera mtima;
• tachyarrhythmia;
• angina, pachimake m'mnyewa wamtima infarction, wosakhazikika angina;
• oopsa.

umboni

Pokonzekera "Carvedilol" zikuonetsa kutuluka tingachidziwe pharmacodynamic. Chifukwa magazi m'munsi, kuchepa zi- ndi afterload mu myocardium, komanso chifukwa cha antiarrhythmic wa mankhwala angagwiritsidwe ntchito pa nkhani ya matenda otsatirawa:

• oopsa II ndi III digiri ku zikuchokera chithandizo ophatikizana moyenera;
• digiri Ine oopsa pa mkulu mtima chiopsezo monotherapy;
• ndi tachyarrhythmia: matenda fibrillation mawonekedwe okhazikika, ndi pafupipafupi supraventricular arrhythmia;
• mu inatsekeratu matenda a mtima ndi mawonetseredwe pachimake (wosakhazikika angina kapena m'mnyewa wamtima infarction);
• ndi IBS ndi zochitika pachimake (khama angina, angina mwapang'onopang'ono);
• aakulu mtima kulephera, ku siteji ya HIIA Vasilenko-Strazhesko kapena FC NYHA III ndi zikuchokera moyenera mankhwala ophatikizana;
• mu symptomatic oopsa ndi nkusani tachycardia kugwirizana ndi hyperthyroidism kapena pheochromocytoma.

Alipo mankhwala "Carvedilol" Anzawo katswiri ndi zizindikiro deta. Iwo ntchito matenda ambiri mtima, mwachitsanzo, ndi inatsekeratu matenda mtsempha wamagazi ndi matenda a mtima. Komanso, mankhwala palinso timapangira kuchuluka kwa ntchito. Nkofunikira wolumikizira oopsa, ngakhale symptomatic, chikwiyire hyperthyroidism kapena pheochromocytoma, ndi bwino olamulidwa ndi beta-blockers.

contraindications

Ngakhale onse achire mbiri kuposa kusankha beta 1-blockers mu contraindications mankhwala kulibe, kuchepetsa tanthauzo lake. "Carvedilol" akhoza kudyedwa kuchita matenda pansi zinthu zotsatirazi:

• mphumu, COPD, chifukwa cha chiopsezo bronchospasm adakula;
• Iwo amaletsedwa kujambula "Carvedilol" pa pafupipafupi kumenyedwa mtima zosakwana 50 pa mphindi chifukwa cha chiopsezo bradycardia koopsya;
• choletsedwa Ndinapereka ndipo ntchito "Carvedilol" pa arrhythmias (CA-chipika, atrioventricular chipika 2 ndi digiri 3) ngati palibe pacemaker okhazikika;
• zosavomerezeka ntchito mankhwala matenda aakulu chiwindi;
• ntchito mankhwala oletsedwa mu CHF zinchito IV kalasi malinga NYHA (HIII ndi Vasilenko-Strazhesko) chifukwa yimitsira wa decompensated mtima contractility;
• "Carvedilol" choletsedwa woyembekezera, mkaka wa m'mawere, ana osaposa zaka 18;
• inadmissible ntchito odwala ndi thupi lawo siligwirizana ndi pophika ake yogwira kapena chigawo chimodzi cha mtundu mlingo;
• kukonzekera sichiri mwa mantha cardiogenic ndi SBP 85 mamilimita Hg. Art.

Ngakhale kuti "Carvedilol" mayankho anali qualitatively ndi mankhwala ndi otetezeka, tiyenera kutsatira malangizo amenewa. Iwo n'cholinga chofuna kuteteza mtima ndi katswiri zochitika osafunika. Chifukwa deta contraindications ali mtheradi ndi sitingakane chifukwa cha chiopsezo kuyan'anila amapha chamoyo.

zotsatira zoyipazi

Kupenda mavuto mankhwala "Carvedilol" mayankho si zimasonyeza. Odwala mu ziyenera zotengera malingaliridwe zotsatira matenda ndi mbali. Chifukwa rationally zochokera kafukufuku zowerengera. Mwa zambiri mavuto, akuwonetseredwa ndi pafupipafupi kuchokera 1 mpaka 10%, ali motere:

• ndi PNS ndi CNS angathe mutu, chizungulire, kufooka kwa thupi, matenda tulo, paresthesias monga maonekedwe a mbali yapadera;
• Zotsatira mtima (chosakhalitsa kapena kulimbikira bradycardia kapena chipika atrioventricular, orthostatic hypotension, nthawi zina kupunduka chifukwa matenda magazi a minofu kuwononga atherosclerosis);
• dongosolo kupuma: zotheka zizindikiro za dyspnea, amphuno kuchulukana, ndi hyperreactivity bronchial kapena obstructive matenda zotheka bronchoconstriction;
• Zotsatira zoyipazi kwa dongosolo m'mimba ndi kuwonetseredwa ululu m'mimba, kunyansidwa, pakamwa youma, kutsegula m'mimba, ndi sikawirikawiri zimachitika kudzimbidwa kapena kusanza, akhoza ziwonjezeke chiwindi transaminase;
• dongosolo hematopoietic Yankho sikawirikawiri thrombocytopenia kapena leukopenia;
• zotheka chikanga, pruritus, psoriasis exacerbation otaya, ndipo angagwe zochita sikawirikawiri anaphylactoid.

Komanso, popeza "Carvedilol" ndi chinthu chachilendo kuti lake, angathe zokhudza zonse kawopsedwe anachita. Kumaonetsa chimfine syndrome ndi chitukuko cha ululu nthambi, maso youma, mkodzo mkwiyo. Chikutanthauza "Carvedilol" mavuto kwambiri kuposa "metoprolol", ngakhale matenda efficacy ndi wamkulu kuposa zoyamba ziwiri.

ntchito makamaka yaitali "carvedilol"

Kuweta mlingo mitundu kumasula mankhwala - makapisozi ichi ndi miyala. "Carvedilol" akutengedwa kamodzi pa nkhani ya wolumikizira oopsa ndi kawiri ndi matenda ischemic mtima, matenda a mtima kapena arrhythmia. Poyambira mlingo ndi 6,25 mg wa kamodzi patsiku, kuti ndi kuchiza matenda oopsa. Mu CHF mankhwala inatsekeratu matenda a mtima kapena tachyarrhythmias akulimbikitsidwa kugwiritsa ntchito poyambira mlingo wa 6,25, kawiri pa tsiku. Ndiye, mwa titrating mlingo tsiku kusintha kwa 25-50 mg.

The mankhwala ndi zotheka ndi nkhani ya bwino munthu kulolerana umagwiritsidwa zonse. Iwo anafunika kulamulira arrhythmia kapena kuti tidzakhale ndi moyo mu CHF. Mbali imeneyi ya mankhwala, anatengedwa limodzi ndi okodzetsa ndi Ace zoletsa prolongs moyo. Ndipo bwino analekerera mu CHF mankhwala "Carvedilol" kuposa "bisoprolol". Ngakhale mankhwala chofunika kupewa galimoto ndi makalasi a zinthu zingakhale woopsawo, dongosolo ulamuliro.

Muyezo kumasulidwa mawonekedwe

Pokonzekera "Carvedilol" mtengo si kudziwa muyezo kusankha. Ndi zambiri zosavuta kusankha chiphunzitso bwino kwa wodwala makamaka. kaŵirikaŵiri mu zoweta ndi Western zopezera mankhwala kufalitsa mitundu itatu Mlingo mankhwala. Izi 25 mg, 12,5 mg wa ndi 6,25. magome ali odzaza mu matuza kapena muli polymeric. Kumwa mankhwala musanadye, ngati chofunika kuchepetsa mlingo wa ntchito, akamadya.

generics

mankhwala angaperekedwe ndi anthu mankhwala okhala "Carvedilol" makamaka mlingo mawonekedwe kuti likukwaniritsa zofunikira za bioequivalence poyerekezera ndi mankhwala pachiyambi. Ndipo tsopano, pali generics mu zoweta msika mankhwala, m'magulu atatu malingana ndi ndalama zawo:

• mkulu mtengo ( "Dilatrend", "Corioli ',' Carvedilol Sandoz");
• mtengo pafupifupi ( "Karvelend" "Carvedilol Zentiva," "Teva Carvedilol");
• ndi mtengo wochepa ( "MIKA-Carvedilol" "Carvedilol Belmed", "Karvetrend", "Karvenal", "Vedikardol").

"Dilatrend" Mtengo wa rubles 450-750, malingana mlingo: 6,25 mg - zosakwana 25 mg. A azimuth ofanana zimawonedwa zonse pa nkhani ya mankhwala ena. Pa "Corioli" mtengo wa rubles 250-500, "Carvedilol Sandoz" 300-550 rubles, "Carvedilol Zentiva" - 250-400 rubles. "Carvedilol Teva 'ofunika 200-300 rubles," Karvelend "- 170-330 rubles," Carvedilol Belmed "- 150-250," Karvetrend "- 170-290 rubles.

Kukonzekera "Carvedilol" mtengo si chizindikiro cha quality, ngakhale mankhwala odziwika wopanga ndi apamwamba. Mu chipatala kusiyana kwambiri pakati mankhwala okwera mtengo kunja ndi zoweta, n'zosavuta kwambiri kuzipeza analogues pang'ono. Clinicians zambiri nkhawa yekha zikusiyana chiphunzitso choyambirira. Choncho m'pofunika kusankha makapisozi generic zimene kuchepetsa gastrotoxicity ake.

analogues Apo ayi wotchipa kuonetsa yemweyo ntchito yachipatala ndi ogwira zochizira matenda a mtima ndi matenda oopsa. Komabe, ngati wodwalayo ali kale analandira generic, ndiye ayenera sudzasiyidwa kupitiriza. Chifukwa iye ntchito ndi makhalidwe a mtundu mlingo ndi mphamvu ya woipa kuwonjezeka plasma wa pophika yogwira, m'malo mankhwala kudzasiya bwino. Kenako adzauzidwa subjectively anaona kuti mankhwala sachiza kapena sachiza mmene amafunira.

Anzawo kalasi

Maphunziro Anzawo, kwambiri wangwiro zogwirizana amafuna achire, amapanga "carvedilol" mpikisano mu angapo zizindikiro. Makamaka mu oopsa kusankhidwa kapena "Bisoprolol" kapena "Nebivolol". Last, chifukwa cha mtengo wake mkulu sangathe ntchito ndi anthu ambiri odwala, ngakhale ndi mankhwala abwino. Ngati ife kukonza zonse cardioselective beta-blockers, mtengo kumawonjezera awo achire zakuti: ". Nebivolol" "bisoprolol", "metoprolol", "Carvedilol"

"Nebivolol" imatengedwa mankhwala abwino koposa matenda oopsa, ndi "Carvedilol" - zochizira CHF. Palibe mankhwala ena alibe zotsatira ambiri opindulitsa pa njira kulephera aakulu mtima monga "Carvedilol." Pachifukwa ichi, osakaniza ndi diuretic ndi Ace woletsa, ndi mwayi moyo wa munthu.

"Carvedilol" - izo ndi mankhwala ogwira antiarrhythmic, imene mukhoza conveniently kuyan'ana kugwiritsa ntchito mfundo AV. N'zofunika fibrillation matenda, pamene kuthekera kubwezeretsa mungoli komanso kukhala ndi sikupezeka. Komanso matenda fibrillation "Carvedilol" anatumizidwa mungoli kulamulira mu mothamanga-kwa cardioversion mtima.