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ანაპრილინი / ANAPRILIN | მედიკამენტები | vidal.ge

შემადგენლობა
ანაპრილინის ერთი ტაბლეტი შეიცავს აქტიური ნივთიერების - პროპრანოლოლის ჰიდროქლორიდის 10 მგ-ს ან 40 მგ-ს.
**მოქმედების მექანიზმი**
არასელექციური ბეტა-ადრენობლოკატორი, მოქმედებს ბეტა1- და ბეტა2-ადრენორეცეპტორებზე. ახასიათებს ანტიანგინალური, ჰიპოტენზიური და ანტიარითმიული მოქმედება. ამცირებს სინუსური კვანძის ავტომატიზმს, აიშვიათებს გულის შეკუმშვათა სიხშირეს, ანელებს AV გამტარობას, ამცირებს მიოკარდის კუმშვადობას და ჟანგბადზე მოთხოვნილებას, მიოკარდის აგზნებადობასა და ექტოპიური უბნების წარმოქმნას, გააჩნია მემბრანოსტაბილიზაციის უნარი. არტერიული წნევა რეგულირდება მკურნალობის დაწყებიდან მეორე კვირის ბოლოს. პრეპარატი აძლიერებს ბრონქების გლუვი კუნთების ტონუსს. პერორალურად მიღებული პრეპარატის დაახლოებით 90% აბსორბირდება კუჭ-ნაწლავის ტრაქტიდან, მეტაბოლიზდება ღვიძლში “პირველადი გავლის” გზით. Cmax მიიღწევა 1-1.5 სთ-ში. პლაზმის ცილებს უკავშირდება 93%. ნახევარგამოყოფის პერიოდი - 3-5 სთ. გამოიყოფა მეტაბოლიტების სახით თირკმლების საშუალებით.
ჩვენებები
არტერიული ჰიპერტენზია; დაძაბვის სტენოკარდია, არასტაბილური სტენოკარდია; სინუსური ტაქიკარდია (მათ შორის ჰიპერთირეოზის ფონზე განვითარებული), პარკუჭზედა ტაქიკარდია, წინაგულების ციმციმის ტაქისისტოლური ფორმა, პარკუჭოვანი და პარკუჭზედა ექსტრასისტოლა; ესენციალური ტრემორი, შაკიკის პროფილაქტიკა, თირეოტოქსიკოზისა და შიშის სინდრომის დროს სიმპტომური მკურნალობა.
მიღების წესები და დოზები
დოზირება ხდება ინდივიდუალურად.
რეკომენდებული საწყისი დოზა შეადგენს 20 მგ-ს, ერთჯერადი დოზა - 40-80 მგ-ს. პრეპარატი ინიშნება 2-3-ჯერ დღეში. მაქსიმალური დღიური დოზა - 320 მგ.
გვერდითი მოვლენები
გულ-სისხლძარღვთა სისტემის მხრივ: ბრადიკარდია, AV ბლოკადა, არტერიული ჰიპოტენზია, გულის უკმარისობა. საჭმლის მომნელებელი სისტემის მხრივ: იშვიათად - გულისრევა, დიარეა, პირის სიმშრალე, ყაბზობა. ცენტრალური ნერვული სისტემის მხრივ: იშვიათად - თავის ტკივილი, ძილის დარღვევა, ასთენია, ფსიქომოტორული რეაქციების დაქვეითება, დეპრესია, პარესთეზია და კიდურების გაციება, თვალის ლორწოვანის სიმშრალე, მხედველობის სიმახვილის დარღვევა, კერატოკონიუნქტივიტი. სასუნთქი სისტემის მხრივ: ბრონქოსპაზმი. ალერგიული რეაქცია: კანზე გამონაყარი, ქავილი.
უკუჩვენება
II და III ხარისხის AV ბლოკადა, სინოატრიალური ბლოკადა, ბრადიკარდია, არტერიული ჰიპოტონია, II-ბ და III სტადიის გულის ქრონიკული უკმარისობა, გულის მწვავე უკმარისობა, ბრონქული ასთმა და სასუნთქი სისტემის სხვა ობსტრუქციული დაავადებები, რეინოსა და სისხლძარღვთა სხვა მაობლიტირებელი დაავადებები, მეტაბოლური აციდოზი, პროპრანოლოლისადმი მაღალი მგრძნობელობა.
განსაკუთრებული მითითებები
ორსულობის პერიოდში პრეპარატის დანიშვნის აუცილებლობა დედისათვის უნდა აჭარბებდეს მის ტერატოგენულ გავლენას ნაყოფზე. დანიშვნის აუცილებლობისას მშობიარობამდე 48-72 სთ-ით ადრე საჭიროა პრეპარატის მოხსნა. პროპრანოლოლი გამოიყოფა დედის რძესთან ერთად. ლაქტაციის პერიოდში აუცილებელია ბავშვზე მუდმივი დაკვირვება ან ძუძუთი კვების შეწყვეტა. ანაპრილინი სიფრთხილით ინიშნება ღვიძლისა და თირკმლების დაზიანებისას, შაქრიანი დიაბეტის არსებობისას. მკურნალობის პერიოდში შესაძლებელია ფსორიაზის გამწვავება, ხოლო ფეოქრომოციტომის დროს ანაპრილინის დანიშვნა შესაძლებელია მხოლოდ ალფა-ადრენობლოკატორების მიღების შემდეგ. ხანგრძლივი მკურნალობის შემდეგ ანაპრილინის მოხსნა ხდება თანდათანობით. პროპრანოლოლი ამცირებს სიმპატომიმეტიკების (ეპინეფრინი, ეფედრინი) ბრონქების გამაფართოებელ ეფექტს. მოსალოდნელი ბრადიკარდიის თავიდან აცილების მიზნით, ანაპრილინით მკურნალობის ფონზე მიუღებელია ვერაპამილისა და დილთიაზემის ინტრავენური შეყვანა. ანაპრილინისა და კლონიდინის, რეზერპინის და სხვა ჰიპოტენზიური საშუალებების ერთდროული მიღებისას მოსალოდნელია არტერიული ჰიპოტონიისა და ბრადიკარდიის განვითარება. ამიოდარონი ან სხვა ანტიარითმიული პრეპარატები ანაპრილინთან კომბინაციაში იწვევს გულის გამტარობისა და კუმშვადობის გაუარესებას. ანაპრილინი აძლიერებს ჰიპოგლიკემიური საშუალებების მოქმედებას. საინჰალაციო სანარკოზე საშუალებები ანაპრილინთან ერთად ზრდიან მიოკარდის ფუნქციური უკმარისობისა და ჰიპოტენზიის განვითარების რისკს, ამდენად სანარკოზე საშუალების მიღებამდე რამდენიმე დღით ადრე საჭიროა ანაპრილინის მოხსნა. ციმეტიდინი ზრდის პროპრანოლოლის კონცენტრაციას სისხლის პლაზმაში, ხოლო რიფამპიცინი - ამცირებს.
შენახვის პირობები და ვადები
პრეპარატის ვარგისიანობის ვადაა 4 წელი, ინახება 10-25oC ტემპერატურაზე, სინათლისაგან დაცულ, მშრალ, ბავშვებისათვის ხელმიუწვდომელ ადგილზე!
აფთიაქში გაცემის წესი
ექიმის რეცეპტის მიხედვით!
რეგისტრაციის # და თარიღი
ბრძ. N68/ო 21.03.2008 ბრძ. N68/ო 21.03.2008

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