Nyob hauv kab lus, xav txog cov npe ntawm ACE inhibitor tshuaj.
Hypertension yog ib yam kab mob ntawm lub plawv. Feem ntau, kev nce siab tuaj yeem ua rau muaj kev cuam tshuam ntawm inactive angiotensin I. Txhawm rau tiv thaiv nws cov cawv, cov tshuaj uas inhibit qhov kev txiav txim ntawm cov tshuaj hormones no suav nrog hauv kev kho mob. Cov tshuaj no yog angiotensin-hloov enzyme inhibitors. Cov hauv qab no yog cov npe ntawm cov tiam tshiab ntawm ACE inhibitors.
Cov tshuaj no yog dab tsi?
ACE inhibitors yog ib pawg ntawm cov khoom siv hluavtaws thiab cov tshuaj lom neeg uas nws siv tau pab ua tiav kev kho mob ntawm cov neeg mob vascular thiab plawv pathologies. ACEs tau siv rau ntau tshaj plaub caug xyoo. Thawj cov tshuaj yog Captopril. Tom ntej no, Lisinopril thiab Enalapril tau ua ke. Tom qab ntawd lawv tau hloov los ntawm inhibitors ntawm ib tiam tshiab. Nyob rau hauv lub teb ntawm cardiology, xws li tshuajsiv los ua cov ntsiab lus tseem ceeb uas muaj cov nyhuv vasoconstrictor.
Qhov txiaj ntsig ntawm qhov tseeb ACE inhibitors nyob rau hauv lub sijhawm ntev ntawm kev thaiv cov tshuaj hormones, uas yog angiotensin II. Cov tshuaj hormone no yog qhov tseem ceeb uas cuam tshuam rau kev nce hauv tib neeg lub siab. Tsis tas li ntawd, cov tshuaj angiotensin-hloov cov enzyme tuaj yeem tiv thaiv kev tawg ntawm bradykinin, ua rau kom txo qis hauv qhov tsis kam ntawm cov hlab ntsha, lawv kuj tso nitric oxide thiab ua kom cov concentration ntawm vasodilating prostaglandin..
New generation
Nyob rau hauv pawg kws tshuaj ntawm ACE inhibitors, cov tshuaj uas yuav tsum tau noj ntau zaus (piv txwv li, Enalapril) suav tias yog siv tsis tau, vim lawv tsis tuaj yeem muab cov txiaj ntsig xav tau. Muaj tseeb tiag, Enalapril tseem yog ib qho kev kho mob nrov uas qhia tau hais tias muaj txiaj ntsig zoo hauv kev kho mob ntshav siab. Tsis tas li ntawd, tsis muaj pov thawj tseeb tias cov tshuaj ACE los ntawm cov tiam tshiab (piv txwv li, cov tshuaj xws li Perindopril, Fosinopril, Ramipril, Zofenopril thiab Lisinopril) muaj txiaj ntsig ntau dua li lawv cov neeg koom nrog plaub caug xyoo dhau los.
Cov npe tshuaj ACE inhibitor yog qhov dav heev.
tshuaj vasodilating ACE
Vasodilatory tshuaj ACE hauv plawv plawv feem ntau yog siv los kho cov hlab ntshav siab. Nov yog cov lus piav qhia sib piv thiab cov npe ntawm ACE inhibitors, uas yog cov neeg nyiam tshaj plawscov neeg mob:
- Enalapril yog ib qho kev tiv thaiv kab mob tsis ncaj uas txo cov ntshav siab sai thiab txo qhov hnyav ntawm lub plawv. Cov tshuaj no ua rau lub cev mus txog rau 6 teev thiab raug tso tawm, raws li txoj cai, los ntawm ob lub raum. Tsis tshua muaj peev xwm ua rau tsis pom kev. Tus nqi yog 200 rubles.
- "Captopril" yog ib qho kev cuam tshuam rau lub sijhawm luv luv. Cov tshuaj no stabilizes ntshav siab zoo, txawm li cas los xij, cov tshuaj no yuav xav tau ntau koob. Kev noj tshuaj yog txiav txim los ntawm tus kws kho mob. Cov tshuaj muaj cov haujlwm antioxidant. Muaj tsawg zaus, nws tuaj yeem ua rau tachycardia. Tus nqi yog 250 rubles.
- Cov tshuaj "Lizinopril" muaj lub sijhawm ntev ntawm kev ua haujlwm. Nws ua haujlwm kiag li ntawm nws tus kheej, nws tsis tas yuav tsum tau metabolized hauv daim siab. Cov tshuaj no yog tawm los ntawm lub raum. Cov tshuaj no haum rau txhua tus neeg mob, txawm tias cov neeg muaj kev rog rog. Nws tuaj yeem siv rau hauv cov neeg mob uas mob raum mob. Cov tshuaj no tuaj yeem ua rau mob taub hau nrog rau ataxia, tsaug zog thiab tshee. Tus nqi yog 200 rubles.
- Tshuaj "Lotensin" pab txo cov ntshav siab. Cov tshuaj no muaj vasodilating kev ua haujlwm. Nws ua rau txo qis hauv bradykinin. Cov tshuaj no yog contraindicated nyob rau hauv lactating poj niam thiab cev xeeb tub. Cov tshuaj tsis tshua muaj peev xwm ua rau ntuav nrog xeev siab thiab raws plab. Tus nqi ntawm cov tshuaj yog khaws cia nyob rau hauv 100 rubles.
- Cov tshuaj "Monopril" slows down metabolism ntawm bradykinin. Cov nyhuv ntawm nws daim ntawv thov yog tiav, raws li txoj cai, tom qab peb teev. Covtshuaj tsis yog tshuaj. Nws yuav tsum tau siv nrog ceev faj hauv cov neeg mob uas muaj kab mob raum ntev. Tus nqi yog 500 rubles.
- Cov tshuaj "Ramipril" yog cardioprotector uas tsim ramiprilat. Cov tshuaj no txo qis peripheral vascular kuj, nws yog contraindicated nyob rau hauv lub xub ntiag ntawm arterial stenosis. Tus nqi yog 350 rubles.
- Cov tshuaj "Akkupril" tuaj yeem pab txo cov ntshav siab. Cov tshuaj no tuaj yeem tshem tawm qhov tsis kam ntawm cov hlab ntsws pulmonary. Tsis tshua muaj, cov tshuaj no tuaj yeem ua rau muaj kev cuam tshuam vestibular thiab tsis saj (ib qho kev phiv ntawm ACE inhibitors). Tus nqi nruab nrab yog 200 rubles.
- Tshuaj "Perindopril" pab cov metabolite nquag tsim hauv tib neeg lub cev. Nws qhov kev ua tau zoo tshaj plaws tuaj yeem ua tiav peb teev tom qab thov. Tsis tshua muaj, nws tuaj yeem ua rau raws plab nrog xeev siab thiab qhov ncauj qhuav. Tus nqi yog 400 rubles. Cov npe ntawm cov tiam tshiab ntawm ACE inhibitor tshuaj tsis xaus rau ntawd.
- Tshuaj "Trandolapril" tawm tsam keeb kwm yav dhau los ntawm kev siv mus sij hawm ntev txo qhov hnyav ntawm myocardial hypertrophy. Kev noj tshuaj ntau dhau tuaj yeem ua rau mob hnyav heev nrog rau angioedema. Tus nqi yog 100 rubles.
- Cov tshuaj "Khinapril" cuam tshuam rau renin-angiotensin ua haujlwm. Cov tshuaj no txo qis cov haujlwm ntawm lub plawv. Nws tsis tshua muaj peev xwm ua rau muaj kev tsis haum tshuaj thiab raug nqi 360 rubles.
Nws yog dab tsi - ACE inhibitor tshuaj, tsis yog txhua tus paub.
Kev faib tawm
Muaj ntau yam kev txwv kev cais tawm ib zaug. Cov tshuaj no raug cais raws li txoj kev uas lawv tau tawm ntawm lub cev thiab kev ua haujlwm ntawm kev ua. Cov tshuaj niaj hnub siv dav siv tshuaj ACE kev faib tawm ntawm cov tshuaj, uas suav nrog pawg hauv qab no:
- sulfhydryl pawg;
- carboxyl pawg (peb tab tom tham txog cov tshuaj dicarboxylate);
- phospinyl pawg (phosphonate-muaj tshuaj);
- pab pawg ntawm natural compounds.
Sulfhydryl pawg
ACE inhibitors ntawm pab pawg no ua raws li calcium antagonists.
Cia sau cov tshuaj nto moo tshaj plaws los ntawm pawg sulfhydryl:
- "Benazepril";
- Captopril, nrog rau Epsitron, Kapoten, thiab Alkadil;
- YZofenopril thiab Zocardis.
Carboxyl pawg
hom tshuaj no muaj txiaj ntsig zoo rau lub neej ntawm cov neeg mob ntshav siab. Cov tshuaj no tsuas yog siv ib hnub ib zaug xwb. Koj tsis tuaj yeem coj lawv nrog kab mob plawv, tiv thaiv keeb kwm ntawm ntshav qab zib thiab lub raum tsis ua haujlwm. Nov yog cov npe ntawm cov tshuaj nto moo tshaj plaws los ntawm pawg no: Perindopril nrog rau Enalapril, Lisinopril, Diroton, Lisinoton, Ramipril, Spirapril, Quinapril thiab lwm yam. Feem ntau, cov tshuaj no yog siv los kho lub raum tsis ua haujlwm thiab kub siab.
Phosphonate-muaj inhibitors
Datatshuaj muaj peev xwm nkag mus rau hauv cov ntaub so ntswg ntawm tib neeg lub cev, ua tsaug rau lawv siv, siab, raws li txoj cai, stabilizes rau lub sij hawm ntev. Cov feem nrov txhais tau tias los ntawm pab pawg no yog Fosinopril thiab Fozicard.
Tus kws kho mob yuav pab koj xaiv qhov zoo tshaj plaws ACE inhibitors.
Natural inhibitors
Cov nyiaj no yog ib hom kev sib koom tes uas txwv cov txheej txheem ntawm cov xov tooj ntawm tes kom muaj zog. Lub siab ntawm cov keeb kwm yav dhau los ntawm lawv cov kev noj haus tau txo qis vim qhov txo qis hauv peripheral vascular tsis kam. Ntuj inhibitors uas nkag mus rau hauv lub cev nrog cov khoom siv mis nyuj yog hu ua casokinins thiab lactokinins. Cov me me muaj nyob hauv qej, whey, thiab hibiscus.
Cov lus qhia rau kev siv
Cov tiam tshiab ntawm cov khoom uas tau hais los saum toj no tau siv niaj hnub no txawm tias hauv kev phais yas. Muaj tseeb, ntau zaus lawv tau muab rau cov neeg mob kom txo cov ntshav siab thiab rau cov neeg mob uas muaj teeb meem hauv kev ua haujlwm ntawm lub plawv thiab cov hlab ntsha rau kev kho mob ntawm arterial hypertension. Nws tsis pom zoo kom siv cov tshuaj no ntawm lawv tus kheej, vim tias lawv muaj ntau contraindications thiab kev phiv. Cov lus qhia tseem ceeb rau kev siv cov tshuaj no yog cov hauv qab no pathologies:
- tus neeg mob muaj ntshav qab zib nephropathy;
- nrog kev ua haujlwm tsis zoo ntawm sab laug ventricle ntawm lub siab;
- tawm tsam keeb kwm ntawm kev txhim kho atherosclerosis ntawm cov hlab ntsha carotid;
- tawm tsam keeb kwm ntawm myocardial infarction;
- yog tias koj muaj ntshav qab zib;
- tawm tsam keeb kwm ntawm obstructive bronchial kab mob;
- yog tias atrial fibrillation tshwm sim;
- tawm tsam keeb kwm ntawm metabolic syndrome.
Cov tiam tshiab ntawm ACE inhibitors tau siv niaj hnub no.
siv ntshav siab
Cov tshuaj no zoo thaiv cov tshuaj angiotensin-hloov enzymes. Cov tshuaj niaj hnub no muaj txiaj ntsig zoo rau tib neeg kev noj qab haus huv thiab tiv thaiv lub raum thiab lub plawv. Ntawm lwm yam, inhibitors tau pom dav siv hauv ntshav qab zib mellitus. Cov tshuaj no ua kom cov cellular rhiab heev rau insulin, txhim kho cov piam thaj. Raws li txoj cai, txhua yam tshuaj tshiab rau ntshav siab yog noj ib zaug ib hnub. Nov yog cov npe ntawm cov tshuaj inhibitors niaj hnub uas tau siv dav hauv kev kub siab: Moexzhril, nrog rau Lozzopril, Ramipril, Talinolol, Physinopril thiab Cilazapril.
Cov npe ntawm cov tiam tshiab ACE inhibitors mus rau.
Inhibitors rau lub plawv tsis ua hauj lwm
Ntau zaus kev kho mob plawv tsis ua hauj lwm cuam tshuam nrog kev siv cov inhibitors. Pawg no ntawm cardioprotectors nyob rau hauv cov ntshav plasma tiv thaiv kev hloov ntawm inactive angiotensin I mus rau active angiotensin II. Vim li no, nws cov teebmeem tsis zoo ntawm ob lub raum, lub plawv thiab peripheral vascular txaj yog tiv thaiv. Nov yog cov npe tshuaj tiv thaiv kab mob cardioprotective pom zoo rau lub plawv tsis ua haujlwm: Enalapril nrog rau Captopril, Verapamil, Lisinopril thiab Trandolapril.
Mechanism of action of inhibitors
Lub tshuab ua haujlwm ntawm inhibitors ua haujlwm li casHauv kev txo qis hauv kev ua haujlwm ntawm angiotensin-hloov enzymes, uas ua rau kev hloov pauv ntawm angiotensin inactive mus rau active. Cov tshuaj no inhibits kev tawg ntawm bradykinin, uas yog suav hais tias yog ib tug haib vasodilator. Cov tshuaj no txo cov ntshav khiav mus rau lub plawv, txo kev ntxhov siab thiab tiv thaiv ob lub raum los ntawm cov teebmeem ntawm ntshav qab zib thiab kub siab.
Kev noj cov tshuaj niaj hnub no
Ntau tus neeg mob ntshav siab feem ntau xav paub yuav ua li cas thiaj li siv tau cov cim tshiab ACE inhibitors? Teb cov lus nug no, nws yuav tsum tau hais tias kev siv cov tshuaj nyob rau hauv pab pawg no yuav tsum tau pom zoo nrog tus kws kho mob yam tsis tau poob. Feem ntau, inhibitors tau noj ib teev ua ntej noj mov, uas yog, ntawm lub plab khoob. Kev noj ntau npaum li cas, kev siv ntau zaus thiab lub caij nyoog ntawm cov tshuaj yog txiav txim los ntawm tus kws kho mob tshwj xeeb. Thaum kho nrog inhibitors, nws yog ib qho tsim nyog yuav tsum tso tseg cov tshuaj tiv thaiv kab mob uas tsis yog-steroidal, cov khoom noj uas muaj cov poov tshuaj.
Tom ntej no, peb yuav pom tias cov tshuaj no tsis pom zoo rau cov neeg mob noj.
Inhibitors thiab contraindications rau lawv siv
Cov npe ntawm cov txheeb ze contraindications rau kev siv cov inhibitors yog raws li nram no:
- tus neeg mob muaj cov hlab ntsha nruab nrab hypotension;
- muaj lub raum tsis ua haujlwm ntev ntev;
- nyob rau hauv thaum yau;
- yog tias koj muaj ntshav qab zib hnyav.
Tsis muaj contraindications muaj xws li hypersensitivity, lactation, ob sab lub raum hlab ntsha stenosis, hnyav hypotension,cev xeeb tub thiab hyperkalemia.
Cov neeg tuaj yeem ntsib cov kev mob tshwm sim los ntawm ACE inhibitors xws li khaus, khaus khaus, tsis muaj zog, hepatotoxicity, txo libido, stomatitis, kub taub hau, palpitations, ceg o, thiab lwm yam.
Side effect
Kev siv sijhawm ntev ntawm cov tshuaj no tuaj yeem ua rau hematopoiesis tawm tsam. Yog li ntawd, cov ntsiab lus ntawm erythrocytes, leukocytes thiab platelets hauv cov ntshav txo qis. Yog li ntawd, thaum lub sij hawm kho, yuav tsum tau rov ua kom tiav cov ntshav tas li.
Kev tsis haum tshuaj thiab kev tsis haum tshuaj kuj tuaj yeem tsim. Qhov no yog manifested, raws li txoj cai, los ntawm khaus, liab ntawm daim tawv nqaij, urticaria, photosensitivity.
Ntxiv rau, kev ua haujlwm ntawm lub plab zom mov tuaj yeem cuam tshuam, ua rau saj perversion, xeev siab thiab ntuav, tsis xis nyob hauv plab. Qee lub sij hawm tib neeg raug mob raws plab lossis cem quav, lub siab tsis ua haujlwm li qub. Qee zaum, qhov mob (afta) tshwm sim hauv qhov ncauj.
Lub suab ntawm lub paj hlwb parasympathetic tuaj yeem ua rau muaj kev cuam tshuam ntawm cov tshuaj, nrog rau kev sib txuas ntawm prostaglandins tau qhib. Muaj hnoos qhuav thiab hloov lub suab. Cov tsos mob tuaj yeem daws tau los ntawm kev noj cov tshuaj uas tsis yog steroidal anti-inflammatory, tab sis tsis yog los ntawm kev siv tshuaj tua kab mob. Yog hais tias cov neeg mob muaj ib tug pronounced nqaim ntawm lub raum hlab ntsha, ces ib tug paradoxical nce nyob rau hauv cov ntshav siab yog tsis cais. Hyperkalemia tshwm sim nyob rau qee kis, pob txha ntawm cov pob txha ntawm ceg ceg thaum lub caij nplooj zeeg tshwm sim ntau zaus.
Cov lus yogtiam kawg ACE inhibitors tshuaj xyuas.
