"Metoprolol" yog siv tas li los ntawm cov kws kho plawv thiab cov kws kho mob hauv kev xyaum kho mob ntshav siab thiab kab mob plawv. Cov tshuaj tau zoo tiv thaiv kab mob, tab sis yuav tsum tau ua raws li kev saib xyuas ntawm tus kws kho mob, raws li cov lus qhia rau kev siv. "Metoprolol" thiab analogues, raws li cov kws tshaj lij thiab cov neeg mob, yog cov tshuaj zoo.
Pharmacological kev txiav txim ntawm cov tshuaj
"Metoprolol" muaj peev xwm ua rau beta 1 -adrenergic receptors, thaiv lawv, uas ua rau muaj kev hloov pauv hauv kev ua haujlwm ntawm lub cev thiab cov hlab ntsha. Cov tshuaj metoprolol tartrate pab txo cov ntshav siab, nthuav cov hlab ntsha ntawm lub plawv, muab cov nyhuv antianginal, thiab muaj cov nyhuv antiarrhythmic.
Tshuaj ua rau lub plawv dhia qeeb thiab lub zog ntawm kev cog lus ntawm lub plawv, uas ua rau lub plawv dhiacov leeg xav tau oxygen tsawg. Yog li ntawd, nyob rau hauv cov neeg mob uas muaj angina pectoris, lub peev xwm mus nqa tawm ib tug loj load yog nce thiab zaus ntawm angina tawm tsam yog txo.
Thaum lub sijhawm muaj kev ntxhov siab thiab kev ua si lub cev hauv cov ntshav ntawm tib neeg, cov tshuaj hormones adrenal nce, uas ua rau lub plawv dhia thiab nce ntshav siab, thiab Metoprolol (contraindications tau piav qhia hauv qab no) txo qhov cuam tshuam ntawm cov hlab plawv.. Nrog rau kev cuam tshuam ntawm lub suab thiab tachycardia nrog hyperthyroidism, cov tshuaj coj cov zaus rov qab mus rau qhov qub.
Kev cuam tshuam ntawm lub qhov txhab ua rau rov ua kom rov zoo li qub thiab ua kom qeeb ntawm kev ua kom lub zog ntawm lub atria thiab ventricles. Ua rau cov hlab ntsha ntawm lub hlwb, nws tawm tsam mob taub hau.
Cov tshuaj muaj peev xwm ua rau qee qhov cuam tshuam rau carbohydrate thiab rog metabolism, nce cov triglycerides hauv cov hlab ntsha, txo cov suab thaj, fatty acids thiab high-density lipoproteins.
Kev nqus thiab tshem tawm
Cov tshuaj tau dhau los ua cov tshuaj hloov pauv tseem ceeb nrog kev pab ntawm daim siab enzymes, raws li cov lus qhia rau kev siv Metoprolol. Raws li kev tshuaj xyuas ntawm cov kws kho mob tshwj xeeb uas saib xyuas cov neeg mob uas muaj teeb meem mob siab rau lub siab (mob cirrhosis), tom qab noj cov tshuaj, nws cov bioavailability yuav hloov pauv mus rau qhov nce thiab nce ntawm cov kev mob tshwm sim.
Qhov siab tshaj plaws, yuav luag tag nrho nqus los ntawm lub plab zom mov, cov tshuaj ncav cuag hauv ob teev. Cov tshuaj muaj lub peev xwm zoo los faib thiab sib sau hauv cov ntaub so ntswg. Nws ploj ntawm cov ntshav hauv qhov nruab nrab ntawm 3.5 teev, tawm los ntawm ob lub raum. Hauv cov kab mob hnyav ntawm cov kabmob no, cov khoom lag luam metabolic thib ob suav nrog hauv lub cev, uas tsis ua rau muaj kev nce ntxiv ntawm cov tshuaj.
Kab mob uas noj tshuaj
Metoprolol yog dab tsi rau:
- Arterial hypertension ntawm txhua qib hauv kev kho mob monotherapy thiab ua ib feem ntawm kev kho mob nyuaj.
- Angina, tus yam ntxwv los ntawm cov txheej txheem spastic hauv cov hlab ntsha ntawm lub plawv, ua rau mob thiab tsis muaj oxygen rau lub plawv cov leeg.
- Cov mob tom qab myocardial infarction (tom qab lub sijhawm mob hnyav) txhawm rau tiv thaiv cov xwm txheej rov qab thiab txo qis kev tuag ntawm nws.
- mob plawv tsis ua hauj lwm nyob rau theem ruaj khov ua ke nrog lwm cov kab mob plawv.
- Lub plawv tsis sib xws (supraventricular tachycardia, ventricular premature beats, atrial fibrillation).
- YFunctional tachycardia.
- siv tshuaj tiv thaiv kab mob migraine.
- Kev Tiv Thaiv ntawm tachycardia hauv hyperthyroidism.
Metoprolol yuav tsum tau siv raws li cov lus qhia thiab raws li kev teem caij ntawm tus kws tshaj lij.
Kev noj tshuaj
Cov kws kho mob yuav tsum siv ib tus neeg mus rau kev sau tshuaj, uas nyob ntawm tus kab mob. Raws li kev tshuaj xyuas ntawm cov lus qhia rau Metoprolol, cov neeg mob xav tau cov lus qhia ntxaws ntxiv rau cov tshuaj no.
Nyob rau hauv cov ntaub ntawv ntawm kub siab ntawm thawj thiab thib ob degree (systolic siab - mus txog 160 mm Hg. Art.), koj yuav tsum pib nrog 25-50 mg ntawm cov tshuaj ob zaug ib hnub twg nrog ib tug ncua sij hawm ntawm 12 teev. Kev noj tshuaj yuav raug nce ntxiv mus rau 100 mg ob zaug (200 mg tag nrho) lossis siv cov tshuaj txo cov ntshav siab ntxiv.
Rau kev kho mob angina, noj 25-50 mg mus txog peb zaug hauv ib hnub raws li kev tswj hwm ntawm qhov zaus ntawm ventricular contraction. Cov koob tshuaj yuav raug nce mus rau 200 mg thaum nruab hnub, lossis ntxiv tshuaj ntxiv rau kev kho mob angina pectoris.
Rau qhov kev tiv thaiv ntawm lub plawv nres, txog li ib puas milligrams raug muab tshuaj thaum nruab hnub hauv ob koob.
Nyob rau hauv cov ntaub ntawv ntawm arrhythmic pathologies, cov tshuaj yog qhia nyob rau hauv ib koob ntawm 25-50 mg mus rau peb zaug ib hnub twg. Yog tias nws tsis zoo txaus, nws muaj peev xwm nce mus rau 200 mg ib hnub twg lossis ntxiv lwm tus neeg sawv cev tiv thaiv arrhythmic.
Rau tachycardia ua haujlwm, noj 50 mus rau 100 mg ib hnub.
Rau kev tiv thaiv kab mob migraine, noj 50 mg ob zaug ib hnub. koob tshuaj yuav nce mus rau 100 mg ob zaug ib hnub twg.
Cov neeg mob uas muaj tachycardia, nrog rau cov ntsiab lus ntawm cov thyroid hormones ntau ntxiv hauv cov ntshav, tau muab tshuaj 50 mg mus txog plaub zaug hauv ib hnub raws li kev tswj hwm ntawm ntau zaus ntawm cov leeg mob plawv. Peb hnub tom qab kev kho mob, cov koob tshuaj tuaj yeem nce mus rau 100 mg 3-4 zaug hauv ib hnub, uas yuav sib npaug rau qhov siab tshaj plaws txhua hnub ntawm Metoprolol (400).mg per day).
Cov lus qhia rau "Metoprolol" qhia txog kev noj tshuaj thaum lub sijhawm lossis tom qab noj mov nrog dej txaus. Cov neeg mob yuav tsum tau qhia kom suav cov feeb ntawm lub plawv dhia, uas yuav tsum tsis pub tsawg tshaj 60 ntaus. Lub sijhawm nkag mus yog tus kheej thiab yuav tsum tau saib xyuas los ntawm kws kho mob. Kev rho tawm cov tshuaj yuav tsum tau ua kom qeeb qeeb kom tsis txhob dhia ntshav siab.
Contraindications rau kev siv "Metoprolol"
Koj tsis tuaj yeem sau tshuaj rau hauv cov xwm txheej yav dhau los paub txog ntawm tus kheej rhiab heev rau pawg no ntawm cov tshuaj, metoprolol tartrate nws tus kheej lossis cov khoom pabcuam ntawm cov tshuaj, suav nrog lactase deficiency.
Kev ua txhaum ntawm kev coj ua ntawm lub plawv hauv daim ntawv ntawm atrioventricular blockade ntawm qib thib ob thiab thib peb tsis tso cai siv "Metoprolol" hauv kev kho mob. Lwm yam contraindications yog mob sinus syndrome thiab bradycardia nrog lub plawv dhia qeeb qis dua 50 neeg ntaus ib feeb.
Lub plawv tsis ua hauj lwm, nrog rau pulmonary edema, ntshav siab thiab impaired peripheral ncig, ua rau nws tsis tuaj yeem noj cov tshuaj no.
Prinzmetal's Angina yog ib qho contraindication rau Metoprolol vim muaj peev xwm ncua nws qhov kev tawm tsam.
Nws yog qhov tsis xav noj cov tshuaj thaum muaj cov ntshav siab qis dua 90 mm Hg. st.
Metabolic acidosis, nrog rau kev txo qis hauv cov ntshav pH, -contraindication rau noj tshuaj.
mob hawb pob bronchial thiab obstructive bronchitis yog cov mob uas Metoprolol yog contraindicated.
Tsis txhob noj nrog MAO inhibitors (tshwj tsis yog MAO-B).
Peripheral circulatory disorders nyuaj los ntawm gangrenous lesions los yog kev hem thawj ntawm nws txoj kev loj hlob.
Tsis kuaj rau cov neeg muaj hnub nyoog qis dua 18 xyoo, yog li tsis tsim nyog rau menyuam yaus.
Contraindicated nyob rau hauv lub chaw tsim tshuaj paus los yog suspicion ntawm ib tug mob theem ntawm myocardial infarction nrog loj bradycardia (txog 45 neeg ntaus ib feeb), tsis tshua muaj ntshav siab thiab prolongation ntawm lub sij hawm P-Q.
Cardioselective beta1-blockers yog ib pab pawg loj ntawm cov tshuaj siv dav hauv kev kho mob. Yog li ntawd, contraindications yuav tsum tau muab coj mus rau hauv tus account ua ntej muab tshuaj.
Kev siv tshuaj thaum cev xeeb tub thiab lactation
Kev cev xeeb tub tsis yog ib qho contraindications. "Metoprolol" tuaj yeem raug sau tseg rau hauv rooj plaub thaum cov txiaj ntsig zoo ntawm cov tshuaj muaj kev cuam tshuam rau qhov tshwm sim tsis zoo rau tus menyuam hauv plab. Cov tshuaj tuaj yeem tsim kev puas tsuaj rau tus menyuam hauv plab, nkag los ntawm cov placenta, vim nws ua rau nws cov ntshav tsis txaus. Qhov no tuaj yeem ua rau muaj kev loj hlob thiab kev loj hlob, kev yug ntxov ntxov lossis kev tuag ntawm tus menyuam hauv plab.
Peb hnub ua ntej hnub yug, kev siv tshuaj yuav tsum raug tso tseg, vim tias muaj kev pheej hmoo ntawm bradycardia, poob siab thiab ntshav qab zib, nce bilirubin, thiab tseem ua rau ua pa tsis ua haujlwm. hauv tus menyuam. Rau cov me nyuam mos uas nws niam coj"Metoprolol" thaum cev xeeb tub, yuav tsum tau saib xyuas zoo rau peb hnub tom qab yug me nyuam.
Cov tshuaj tuaj yeem nkag mus rau hauv cov kua mis, yog li thaum siv cov tshuaj no, koj yuav tsum tsis txhob pub mis lossis hloov tshuaj. Yog tias leej niam tseem pub niam mis ntxiv thaum noj cov tshuaj no, tus menyuam yuav tsum tau saib xyuas bradycardia, ntshav siab, thiab ntshav qab zib tsawg.
Side effects
Tau kawm txog cov contraindications, cov kev phiv ntawm Metoprolol kuj yuav tsum tau them sai sai rau:
- Cov teebmeem mob plawv: qeeb lub plawv dhia qis dua 60 tus neeg ntaus ib feeb, nce - ntau dua 90 tus neeg ntaus, txo cov ntshav siab (ntau dua 10%); exacerbation ntawm lub plawv tsis ua hauj lwm, atrioventricular blockade ntawm thawj degree, mob nyob rau hauv lub projection ntawm lub plawv, kev loj hlob ntawm ib tug poob siab lub xeev nyob rau hauv lub mob plawv nres, txias ntawm lub distal extremities (1-9, 99%); kev ua haujlwm cuam tshuam ntawm kev sib dhos thiab kev ua haujlwm ntawm lub plawv (0.1-0.99%), kev raug mob necrotic ntawm ceg ceg (txog 0.0099%).
- Lub paj hlwb thiab lub siab lub cev tuaj yeem teb rau cov tshuaj nrog qaug zog (ntau dua 10%); kiv taub hau, tsis txaus ntseeg, mob taub hau (1-9, 99%); paresthesias ntawm daim tawv nqaij, cov tsos mob ntawm kev nyuaj siab, pw tsaug zog los yog hypersomnia, npau suav phem (0.1-0.99%); qhov muag tsis pom kev, o ntawm conjunctiva, qhov muag qhuav, paj hlwb (0.099-0.0099%); Kev nco tsis zoo, hnov lus tsis zoo, lub siab hloov pauv, tsis meej pem, hnov lus tsis zoo thiab tinnitus (txog 0.0099%).
- Cov kab mob ua pa tuaj yeem ua rau lawv ua haujlwm tsis zoo vim ua tsis taus pa (1-9, 99%); bronchospasm (0.1-0.99%); catarrhal manifestations ntawm mucous daim nyias nyias (0.099-0.0099%).
- Cov txiaj ntsig ntawm lub plab zom mov thiab lub siab: xeev siab, mob plab, quav quav (1-9, 99%); ntuav (0.1-0.99%); dryness ntawm mucous daim nyias nyias ntawm lub qhov ncauj, nce siab enzymes nyob rau hauv cov ntshav (0.099-0.0099%); saj cuam tshuam, o ntawm daim siab nqaij (txog 0.0099%).
- Ntshav thiab qog ntshav tuaj yeem cuam tshuam nrog txo qis hauv cov qe ntshav dawb thiab platelets (txog 0.0099%).
- Cov tawv nqaij, cov leeg thiab pob txha hnov mob tsis zoo rau cov tshuaj hauv daim ntawv ntawm: urticaria, tawm hws, mob pob qij txha, edema (0.1-0.99%); alopecia (0.099-0.0099%); mob pob qij txha, leeg tsis muaj zog, photosensitivity, psoriasis (txog 0.0099%).
- Cov teebmeem ntawm endocrine: qhov hnyav nce (0.1-0.99%); exacerbation ntawm yav tas los zais ntshav qab zib (0.099-0.0099%).
- raum thiab kev ua me nyuam raug kev txom nyem nyob rau hauv daim ntawv ntawm: impotence, Peyronie's kab mob - fibrous curvature ntawm noov (0.099-0.0099%).
Cov lus qhia tshwj xeeb
Muab lub peev xwm ua rau lub paj hlwb thiab lub cev hnov tsw ntawm Metoprolol, cov lus qhia thiab contraindications uas peb tau txiav txim siab, muaj peev xwm tsav tsheb thiab ua haujlwm hauv cov xwm txheej txaus ntshai thiab teeb meem yuav tsum tau txiav txim siab tus kheej hauv txhua qhov. cas.
Siv nrog ceev faj hauv kev mob hawb pob vim yog qhov tsis zoo ntawm pawg no ntawm cov tshuaj ntawm cov ntaub so ntswg bronchial.
Cov neeg mob ntshav qab zib mellitus yuav tsum tau soj ntsuam lawv cov ntshav qabzib ntau dua vim tias tuaj yeem txo qis los ntawmtshuaj.
Nyob rau hauv cov neeg uas raug kev txom nyem los ntawm psoriasis, lub chav kawm ntawm tus kab mob tej zaum yuav phem zuj zus mus, vim Metoprolol tuaj yeem ua rau muaj kev loj hlob ntawm daim tawv nqaij epidermal.
Rau cov qog adrenal, cov tshuaj yuav tsum tau ua ke nrog tus neeg sawv cev alpha-adrenergic.
Ua ntej siv tshuaj loog, koj yuav tsum qhia koj tus kws kho mob txog kev noj cov tshuaj kom tsis txhob muaj kev pheej hmoo ntawm kev txo qis hauv cov ntshav siab.
Nyob rau hauv cov neeg laus, cov tshuaj yuav tsum tau pib ntawm tsawg npaum li cas, nrog ceev faj thiab nyob rau hauv kev saib xyuas ntawm ib tug kws tshwj xeeb.
Cov neeg siv lo ntsiab muag yuav tsum paub txog qhov ua rau qhov muag qhuav los ntawm cov tshuaj no.
Kev sib cuam tshuam nrog lwm yam tshuaj
Cov tshuaj muaj peev xwm ntawm kev sib cuam tshuam tshuaj loj, yog li kev noj lwm yam tshuaj yog contraindications. Metoprolol yuav tsum tsis txhob noj ua ke:
- Nrog barbiturates, yog li lawv nce nws cov txiaj ntsig ntawm daim siab.
- "Verapamil", raws li kev pheej hmoo ntawm hypotension thiab bradycardia tau nce ntxiv, nrog rau qhov muaj feem ntau ntawm cov mob sinus syndrome.
- "Propafenone", txij li qhov kev txiav txim ntawm "Metoprolol" hauv kev sib xyaw ua ke tuaj yeem nce tsib zaug, uas ua rau muaj kev pheej hmoo loj ntawm kev phiv.
Kev kho koob tshuaj feem ntau xav tau thaum sib koom ua ke:
- Nrog Amiodarone (vim mob bradycardia hnyav).
- Thawj-chav antiarrhythmics uas tuaj yeem txo myocardial contractility.
- Cov tshuaj uas tsis yog-steroidal anti-inflammatory, vim lawv tuaj yeem ua rau tsis muaj zog ntawm Metoprolol hauv kev txo cov ntshav siab.
- "Diltiazem" (vim muaj peev xwm thaiv tau).
- "Diphenhydramine" (vim qhov ua kom nce ntxiv ntawm "Metoprolol").
- "Epinephrine" (vim nce ntshav siab thiab bradycardia hnyav).
- Muaj kev pheej hmoo ntawm lub plawv siab nrog norephedrine.
- "Quinidine", uas tuaj yeem txhim kho kev thaiv lub peev xwm ntawm "Metoprolol".
- "Clonidine" (vim qhov kev tshem tawm hnyav cuam tshuam nrog kev nce ntshav siab).
- "Rifampicin", uas tuaj yeem txo qhov concentration ntawm "Metoprolol" hauv plasma.
- Kev mob plawv glycosides, uas tuaj yeem ua rau bradycardia.
- Tshuaj uas txo cov concentration ntawm cov tshuaj CYP2D6 (metoprolol substrate), raws li lawv tuaj yeem txo nws cov nyiaj hauv cov ntshav (Terbinafine, Paroxetine, Sertraline, Fluoxetine, Celecoxib).
Analogues thiab nqi
Analogues ntawm "Metoprolol" (cov lus qhia yuav tsum tau kawm ib txwm ua ua ntej siv cov tshuaj) tsuas yog kws kho mob sau.
Analogues ntawm cov tshuaj yog:
- "Betaloc" tuam txhab AB "AstraZeneca", ua nyob rau hauv Sweden. Tus nqi ntawm cov tshuaj yog los ntawm 122 txog 973 rubles.
- Betaloc Zok los ntawm Swedish chaw tsim tshuaj paus AB AstraZeneca tus nqi ntawm 122 txog 491 rubles.
- "Egilok" tsim tawm ntawm cov tshuaj cog ntawm CJSC "Egis", hauv Hungary, raug nqi ntawm 67 txog 343 rubles ib pob.
- "Egilok Retard" ntawm cov nroj tsuag CJSC "Egis", nqe - los ntawm 81 txog 230rubles.
- "Metoprolol-Akri" tsim nyob rau hauv Lavxias Federation, cog JSC "Akrikhin HPC". Tus nqi sib txawv ntawm 39 txog 853 rubles.
- Metoprolol-Ratiopharm (tus nqi ntawm 28 txog 3150 rubles) ntawm German tuam txhab Ratiopharm.
- "Metoprolol Zentiva" ntawm Czech tuam txhab "Zentiva" rau 125 rubles.
- "Metoprolol-Teva" ntawm lub tuam txhab tshuaj "Teva" los ntawm cov neeg Ixayees. Tus nqi ntawm cov tshuaj nyob ntawm 19 txog 142 rubles.
Tus nqi hloov pauv yog nyob ntawm qhov ntau npaum ntawm cov tshuaj (25, 50, 100 mg) thiab cov ntsiav tshuaj hauv pob.
Kev tshuaj xyuas ntawm kev siv "Metoprolol"
Txhawm rau txhawm rau ntsuas cov tshuaj no, nws yuav tsum tau txais cov kev xav ntawm cov kws tshaj lij thiab cov neeg mob uas tau muab tshuaj.
"Metoprolol" thiab cov tshuaj xyuas analogues los ntawm cov kws kho mob feem ntau yog qhov zoo vim tias muaj txiaj ntsig zoo thiab dav dav. Txawm li cas los xij, ib qho yuav tsum tau ceev faj heev kom tsis txhob ua mob rau cov neeg mob, txiav txim siab contraindications thiab kev sib cuam tshuam tshuaj.
Cov neeg mob uas siv "Metoprolol" raws li cov lus qhia rau kev siv, kev tshuaj xyuas ntawm cov tshuaj no tuaj yeem tawm lub hom phiaj. Lub tswv yim zoo txog nws yog, raws li kev txheeb cais, los ntawm 82 txog 100 feem pua ntawm cov neeg. Kev tshuaj xyuas txog Metoprolol tsis tau qhia hauv cov lus qhia. Tab sis lawv yuav tsum raug coj mus rau hauv tus account los ntawm tus neeg mob uas tsis ntseeg lossis ntshai tsis noj cov tshuaj no los ntawm kws kho mob.
Tam sim no koj paub tag nrho cov ntaub ntawv hais txog cov tshuaj "Metoprolol": cov lus qhia rau kev siv,contraindications, muaj pes tsawg leeg thiab ntau npaum.
