Angiotensin II receptor blockers (ARBs): Zvishandiso, zvakajairika zvigadzirwa, uye ruzivo rwekuchengetedza
Drug Info Angiotensin II receptor blockers (ARBs) inorapa yakakwira BP uye moyo kutadza. Dzidza zvakawanda nezve mhando dzeARBs uye chengetedzo yavo pano.ARBs rondedzero | Chii chinonzi maARB? | Mashandiro avo | Zvishandiso | Ndiani angatora maARB? | Kudzivirirwa | Zvimwe zvinokanganisa | Mariro
Kuwedzera kweropa ndeye chirwere chinowanzoitika chinokanganisa mazana emamiriyoni evaAmerica. Angiotensin II receptor blockers (ARBs) kirasi yemishonga inoshandiswa kudzikisa BP uye ndeimwe yemhando yekutanga yemishonga iyo vanachiremba vachapa kune ino mamiriro. Iwo anoshanda zvakanyanya uye ave achishandiswa kurapa hypertension (yakakwira BP) kwemakumi emakore. MaARB anoshandiswa kurapa mamwe marudzi ehutano hwemwoyo zvakare. Ichi chinyorwa chinopa muongororwo wekirasi iyi yemishonga. Tichanyora mazita akasiyana ezita nemazita, kupa ruzivo pamutengo wavo, kuratidza mashandiro anoita mishonga, nekuvhara mashandisiro avo uye nekufunga kwekuchengetedza.
| Chinyorwa cheARBs | |||
|---|---|---|---|
| Zita reBrand (zita regeneral) | Avhareji yemari mutengo | SingleCare kuchengetedza | Dzidza ZVIMWE |
| Kurwisa (candesartan) | $ 127 pa 30, 16 mg mahwendefa | Tora macandesartan coupons | Candesartan ruzivo |
| Avapro (irbesartan) | $ 104 pa 30, 300 mg mahwendefa | Tora irbesartan coupons | Irbesartan ruzivo |
| Benicar (olmesartan) | $ 182 pa 30, 20 mg mahwendefa | Tora Olmesartan coupons | Olmesartan ruzivo |
| Cozaar (losartan) | $ 98 pa 30, 50 mg mahwendefa | Tora losartan coupons | Zvinyorwa zveLosartan |
| Diovan (valsartan) | $ 234 pa 30, 320 mg mahwendefa | Tora valsartan coupons | Valsartan ruzivo |
| Micardis (telmisartan) | $ 170 pa30, 20 mg mahwendefa | Tora telmisartan coupons | Telmisartanicardis ruzivo |
Mamwe maARB
- Edarbi (azilsartan)
- Teveten (eprosartan)
MaARB anowanzo sanganiswa nemimwe mishonga inodzvinyirira-yakadai se diuretic kana calcium chiteshi blocker- kudzikisa huwandu hwemapiritsi anotorwa nevarwere pazuva. Pazasi pane mimwe mienzaniso:
- Exforge (valsartan uye amlodipine)
- Avalide (irbesartan uye hydrochlorothiazide)
- Azor (olmesartan uye amlodipine)
- Twynsta (telmisartan uye amlodipine)
- Hyzaar (losartan uye hydrochlorothiazide)
- Diovan HCT (valsartan uye hydrochlorothiazide)
- Benicar HCT (olmesartan uye hydrochlorothiazide)
- Micardis HCT (telmisartan uye hydrochlorothiazide)
Ndeapi angiotensin II receptor blockers (ARBs)?
Angiotensin II receptor blockers - kana maARB mapfupi - ndiwo kirasi yemishonga inoshandiswa kurapa yakakwira BP. Kunyange ese maARB ari FDA anotenderwa kurapa yakakwira BP, mamwe maARB ane FDA tendero yekushandisa mune mamwe makiriniki mamiriro sekutadza kwemoyo, chirwere cheitsvo chine chekuita nechirwere cheshuga, kana kudzivirira kwezviitiko zvemoyo. MaARB anowanzo nyorwa uye ave achishandiswa kubvira kuma1990.
MaARB anoshanda sei?
Mutumbi unogadzirisa BP uye vhoriyamu uchishandisa network yekutaurirana inonzi renin-angiotensin-aldosterone system (RAAS). Iyi sisitimu inobvumira itsvo kutumira masign kune tsinga dzeropa uye dzimwe nhengo. Itsvo dzinogadzira protein inonzi renin. Iyi protein inoshandiswa kugadzira angiotensin II, mahormone anotaurira tsinga dzeropa, gland pituitary, uye adrenal gland kuwedzera kuwedzera kweropa uye huwandu hweropa.
Apa ndipo panouya maARB. Iyi mishonga inovhara mhedzisiro yeAngiotensin II kuitira kuti hormone iyi isakwanise kutaura nedzimwe nhengo. Nekudaro, maARB anodzivirira kukwira kweropa uye huwandu hweropa.
MaARB akafanana chaizvo neimwe kirasi yeropa BP mishonga. Angiotensin-inoshandura enzyme inhibitors, kana ACE inhibitors kwenguva pfupi, inopindirawo neRAAS system. Nekudaro, ACE inhibitors inoputsa kutaurirana pakutanga mukuratidzira kupaza, kuchikanganisa mimwe mitsara yekutaurirana. MaARB anopindira gare gare mukukwikwidza uye anovharira maseru ayo anonyanya kuratidza kudzvinyirira kweropa. Neichi chikonzero, maARB anokonzeresa mashoma mhedzisiro kana ichienzaniswa neACE inhibitors.
Ndeapi maARB anoshandiswa?
Ese maARBs ari FDA anotenderwa neBP . Mamwe maARB senge losartan, candesartan, uye valsartan zvakare FDA inogamuchirwa kune chaiyo chirwere chemoyo chinonzi congestive kutadza kwemoyo . Aakananga maARB ane zvimwe zvinoratidza FDA-zvinogamuchirwa zvinosanganisira:
- Kudzivirirwa kwezviitiko zveCV mune varwere vane kuruboshwe kwemhepo ventricular kusagadzikana mushure meye myocardial infarction (moyo wekurwadziwa)
- Chirwere cheitsvo chinokonzerwa ne chirwere cheshuga (proteinuria / microalbuminuria)
- Kuruboshwe ventricular hypertrophy
Iyo chati iripazasi inopfupikisa iyo FDA inogamuchirwa zvinoratidza kune chaiwo maARB:
| Chiratidzo | MaARB anotenderwa kushandiswa |
| Hypertension | MaARB ese |
| Kutadza kwemoyo | Candesartan, avakuru |
| Kuruboshwe ventricular hypertrophy | Losartan, losartan-hydrochlorothiazide |
| Myocardial infarction | Valsartan |
| Chirwere cheitsvo chinokonzerwa nechirwere cheshuga | Losartan, pamira |
MaARB anoshandiswa asiri-label mune mamwe makiriniki mamiriro akadai se:
- Atrial fibrillation
- Chirwere chetsvo chisingaperi (CKD)
- Scleroderma
- Migraine kudzivirira
MaARB akasiyana anoratidza zvimiro zvakasiyana. Neichi chikonzero, mamwe maARBS anonyanya kubatsira kune mamwe marapirwo. Semuenzaniso, candesartan ine yakaratidza kushanda kwekudzivirira migraines nekuda kwayo lipophilic zvivakwa.
Kunyange maARB mazhinji anogona kushandiswa kune imwe mamiriro, chaiwo maARB anogona kudikanwa zvichienderana nehunhu hwevarwere. Semuenzaniso, losartan ndiyo ARB yesarudzo kune varwere vane hyperuricemia, nepo candesartan, olmesartan, uye valsartan inogona kukuvadza mamiriro aya. Mamwe maARB anogona kusarudzika pamusoro pevamwe kune mamwe mamiriro emakiriniki. Losartan ndiyo yekutanga-mutsara sarudzo yevarwere vane hutachiona hwakanyanya vari panjodzi yekurohwa nesitiroko. Pakupedzisira, zviri kumusoro kwekufunga kwechiremba kuti aone yakanakisa ARB yemumwe murwere.
Ndiani angatora maARB?
Vacheche, vana, uye vachiri kuyaruka
MaARB mazhinji akachengeteka uye anoshanda pakurapa kwehypertension muvana. Losartan, valsartan, uye olmesartan vane FDA mvumo yekushandiswa muvana vane makore anodarika matanhatu, nepo candesartan ine mvumo yekushandiswa muvana vakura kupfuura gore rimwe. Sekureva kweNational Kidney Foundation, mishonga iyi inogona kuve inosarudzwa vamiririri kunonoka kufambira mberi kweCKD muvana. Mamwe maARB akatemerwa asiri-echiratidzo muvana, kunyangwe paine mashoma data ekutsigira kuchengetedzeka uye kugona mune ino huwandu. Kushandiswa kwakachengeteka uye kunoshanda kweARB muvana kunoda kuchinjiswa kwedosi zvichienderana nezera uye huremu.
Vakuru
MaARB anowanzoonekwa akachengeteka uye anoshanda kuti ashandiswe muvakuru. Mhedzisiro inowanzoitika idiki uye inogona kusanganisira dzungu, kurwadziwa nemusoro, kukosora, uye kukotsira. Vamwe varwere vanogona kusangana nemhedzisiro isingashande. Izvo zvakakosha kuti ubvunze mupi wezvehutano nezvematambudziko anokanganisa kuti kurapwa kugadziriswe zvinoenderana.
Vakuru
MaARB akachengetedzeka uye anoshanda kuvarwere vakwegura sezvavari mune varwere vadiki. Vagari vechikuru ndivo varwere vazhinji vanowana renal kutsiva kurapwa, uye maARB anogona kupa chakakosha bhenefiti nekudzora kufambira mberi kwechirwere cheitsvo. Mhedzisiro yakakoshesesa yakakosheswa muvarwere vakura vanotora maARB yakawedzerwa serum potasium (hyperkalemia). Kuvhara kuongorora kweserum potasium inokurudzirwa kune vakawanda varwere sezvo njodzi yehyperkalemia inowedzera nezera uye huwandu hwe comorbidities.
Murwere nekukanganiswa kwechiropa
Varwere vane chirwere chechiropa avo vari kutora maARB vangangoda kutanga nedosi yakaderera. Iyo yekutanga dosi yeLosartan ndeye 25 mg yevarwere vane kukanganiswa kwechiropa; iyo ndiyo hafu yenguva dzose inokurudzirwa kutanga dosi. Iyo pasuru inoisa macandesartan zvakare inokurudzira kushandisa hafu yenguva dzose yekutanga dosi yevarwere vane chirwere chechiropa. Nekuti maARB anonyanya kubviswa kubva mumuviri nechiropa, zvakakosha kuti utange padosi yakaderera uye nekuchenjerera wedzera kurapa muhuwandu hwevarwere.
MaARB akachengeteka here?
ARB inoyeuka
Vazhinji vanogovera valsartan, losartan, uye irbesartan-zvine zvigadzirwa zvakayeukwa nekuda kweNMBA tsvina. Iwo anoyeuka akatanga pakati-2018 uye akaenderera kusvika munaGunyana 2019. An Archive of inogadziridza uye yekushambadzira zviziviso zvine chekuita nezvezviyeuchidzo zvinotumirwa pamhepo neDFA, pamwe ne yakazara runyorwa yezvose zvigadzirwa zvine chekuita nekurangarira kunoenderera kwemishonga yeARB. Vagadziri vakakanganiswa nezviyeuchidzo vanosanganisira, asi havasi ivo chete, Teva, Macleods, Mylan, Torrent, Aurobindo, Solco Healthcare, Prinston, uye Camber Pharmaceuticals. Wemishonga wako anogona kubatsira nemibvunzo kana zvinonetsa zvine chekuita nazvo akarangarira mishonga.
Kurambidzwa kweARB
Usatore chero mishonga yeARB kana paine inozivikanwa hypersensitivity kune chero zvigadzirwa zvacho.
MaARB anofanirwa kushandiswa nekuchenjerera kune varwere vane kusaenzana kwe electrolyte kusanganisira yakaderera sodium (hyponatremia) uye yakakwira potasiamu mazinga (hyperkalemia). MaARB anogona kuwedzera kusaenzana uku ne kudzikira kwekuchengetwa kwesodium pane proximal uye distal tubules yeitsvo, uye na kudzikira kwekuchengetedzwa kwepotasium munzira yekunhonga .
Varwere vane chirwere chevascular, chinozivikanwa se renal artery stenosis (RAS), mune itsvo mbiri, kana varwere vane itsvo imwechete inoshanda uye kuongororwa kweRAS, havafanirwe kutora maARB. MaARB anokanganisa kutenderera kweropa paitsvo, izvo zvinogona kudzikisira iyo glomerular filtration rate muvarwere vane chirwere chakakomba cheitsvo. Izvi zvinogona kukuvadza kushanda kweitsvo uye kutungamira kukundikana kwetsvo.
Saizvozvowo, kupera kwehuwandu kunofanirwa kugadziriswa mune varwere vasati vatanga kurapwa neARB. Kana murwere vhoriyamu yapera, itsvo 'filtration chiyero chinonyanya kuvimba neangiotensin II, nekudaro maARB anogona kuwedzera kukanganisa kweitsvo kana ikatorwa mudunhu rino.
MaARB haafanire kutorwa nevarwere vari kushandisa ACE inhibitors kana kunanga renin-inhibitors (DRI) senge Tekturna (aliskiren). Ese matatu marudzi emishonga anoshanda pane renin-angiotensin system uye kuatora iwo pamwechete inosanganisa njodzi yekuremara kweitsvo, hyperkalemia, uye hypotension. Ita shuwa kuti chiremba wako anoziva nezvese mishonga yauri kutora kuitira kuti udzivise kudyidzana kwezvinodhaka zvine njodzi.
Unogona here kutora maARB uchiri nepamuviri kana kuyamwisa?
Rega kutora ARB nekukurumidza paunofungidzira kuti ungangove nepamuviri uye bata chiremba wako nekukasira. MaARB anofanirwa kudzivirirwa panguva yekuzvitakura nekuyamwisa kana zvichibvira. Yese mishonga yeARB inotakura nhema bhokisi rekunyevera nezve zvinogona kukuvadza kana kufa kune fetus kana maARB achishandiswa pakubata.
Arbs inodzorwa zvinhu here?
Kwete, angiotensin II vanogamuchira vanopokana havana kudzorwa zvinhu.
Zvakajairika ARB mhedzisiro
Izvi zvinotevera divi rakajairika rinogona kuitika uchitora maARB. Iyi haisi rondedzero yakakwana, sezvo ichingovhara mhedzisiro inowanzoitika kune ese maARB. Kuwedzera mhedzisiro mhedzisiro inogona kuve yakajairika kune yega madhiragi mukati mekirasi iyi. Kana iwe uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinge uchinetseka zvinonetsa kana kuti zvisingashiviriki
- Kutemwa nemusoro
- Manyoka
- Kukosora
- Utachiona hwepamusoro hwekufema (URI)
- Yakakwira potasium (hyperkalemia)
- Hypotension
- Dzungu
- Kuneta
- Asthenia (kushaya simba kana kushomeka kwesimba)
- Musculoskeletal kurwadziwa
MaARB ave achizivikanwa nekukonzera kwakakomba divi mhedzisiro inonzi angioedema. Nekudaro, iyi divi mhedzisiro haina kujairika zvakanyanya mumaARBs kana ichienzaniswa neACE inhibitors. Iyi divi mhedzisiro inofungidzirwa kuti inokonzerwa ne bradykinin, pepodidhi yevasodilating iyo inogona kukonzera kuzvimba uye kuzvimba. MaARB haawedzere bradykinin kune imwe nhanho seACE inhibitors.
MaARB anodhura zvakadii?
Mazhinji emishonga iri mukirasi ino anowanikwa semageniki pamutengo wakaderera pane wavo wezita rezita. Semuyenzaniso, Benicar inogona kudhura kumusoro kwe $ 300 kune 30-mazuva ekupa. Iyo generic vhezheni, olmesartan, inowanikwa isingasvike $ 5 ine SingleCare koponi. Kunyange akawanda mazita ezita reARBs anodhura anodarika madhora mazana maviri, mageneral generic anodhura asingasviki madhora makumi matatu kuburikidza neSingleCare.
MaARB anofukidzwa neakawanda maMedare uye zvirongwa zveinishuwarenzi, kunyangwe mamwe maARBs angafarirwa kupfuura mamwe. Semuenzaniso, losartan inowanzo kuverengerwa sedanho 1 mushonga - kana kusarudza zvinodhaka-nepo mimwe mishonga yakasanganiswa secandesartan-hydrochlorothiazide inogona kunge isingavharwe zvachose. Pamusoro pezvo, chirongwa chako cheinishuwarenzi chinogona kuona kufukidzwa zvichibva pakutsvaga kwakaratidzwa pane zvakanyorwa nemurwere. Hypertension ndiyo inonyanya kuongororwa kuti iwanikwe.
Kunyangwe kana chirongwa cheinishuwarenzi chichifukidza mishonga yako, zvinogona kunge zvisingadhuri kushandisa a SingleCare koponi .
Zvishandiso:
- Ongororo yegeneric angiotensin receptor blockers , LOUSE. Pharmacist
- Zvimwe zvinodzivirira anti-migraine kurapwa: ACE inhibitors, ARBs, calcium chiteshi blockers, serotonin vanopikisana, uye NMDA vanogamuchira vanopokana , Ikozvino Kurapa Sarudzo muNeurology
- Vanopfuura mamirioni zana veAmerica vane BP yakakwira , American Moyo Sangano
- Sarudzo dzakasiyana dzekurapa nemaARB. Ndeupi wekupa? Rini? Sei? , American Zvinyorwa zveMwoyo Mishonga
- KDIGO 2021 kiriniki yekudzidzira nhungamiro ye manejimendi eropa mune chirwere chetsvo chisingaperi , Itsvo International
- Kubudirira kweangiotensin-inoshandura enzyme inhibitors uye angiotensin receptor blockers mukudzivirira kwekudzivirira episodic migraine muvakuru. , Ikozvino Marwadzo uye Misoro Misoro Mishumo
- Kubudirira uye kuchengetedzwa kweangiotensin II receptor blockade mune vakwegura varwere vane chirwere cheshuga, American Chirwere cheshuga Association
- Angiotensin receptor blockers inoshandura iyo circadian mutinhimira wekumanikidza kweropa nekudzvinyirira tubular sodium reabsorption , American Nhoroondo yePhysology
- Hyperkalemia inosangana neangiotensin-inoshandura enzyme inhibitors uye angiotensin receptor blockers , Cardiovascular Therapeutics
- Angiotensin II Receptor Blockers (ARB) - StatPearls
- Angiotensin-inoshandura enzyme inhibitors uye receptor blockers mumoyo kukundikana uye chirwere chisingaperi cheitsvo - kusimbisa kupokana - Indian Mwoyo Zvinyorwa
