danarti N2 atenolol

preparatis samedicino gamoyenebis instruqcia
atenololi nikomedi
Atenolol Nycomed
saregistracio nomeri:
savaWro saxelwodeba
atenololi nikomedi
tia
l
saerTaSoriso aradapatentebuli saxelwodeba
atenololi
en
wamlis forma
Semogarsuli tabletebi
fid
Semadgenloba
erTi tableti Seicavs:
aqtiuri nivTiereba
atenololi 50 mg an 100 mg
C
on
damxmare nivTierebebi:
Jelatini (50 mg dozirebisaTvis – 2.1 mg; 100 mg dozirebisaTvis – 4.2 mg),
natriumis laurilsulfati (50 mg dozirebisaTvis – 3.3 mg; 100 mg
dozirebisaTvis – 6.6 mg), magniumis stearati (50 mg dozirebisaTvis – 5 mg; 100 mg
dozirebisaTvis – 10 mg), simindis saxamebeli (50 mg dozirebisaTvis – 60 mg; 100
mg dozirebisaTvis – 120 mg), magniumis karbonati (50 mg dozirebisaTvis – 87.5 mg;
100 mg dozirebisaTvis – 175 mg)
ny
garsi: propilenglikoli (50 mg dozirebisaTvis – daaxloebiT 0.4 mg; 100 mg
dozirebisaTvis – daaxloebiT 0.8 mg), titanis dioqsidi (50 mg dozirebisaTvis –
daaxloebiT 0.8 mg; 100 mg dozirebisaTvis – daaxloebiT 1.7 mg), talki (50 mg
dozirebisaTvis – daaxloebiT 0.8 mg; 100 mg dozirebisaTvis – daaxloebiT 1.7
mg), hipromeloza
15 (50 mg dozirebisaTvis – daaxloebiT 2.1 mg; 100 mg
dozirebisaTvis – daaxloebiT 4.2 mg).
pa
aRwera
Semogarsuli tabletebi 50 mg: ormxriv amoburculi, kafsulismagvari tabletebi
TeTri feris, Semogarsuli, gasayofi xaziT da warweriT AB55.
C
om
Semogarsuli tabletebi 100 mg: ormxriv amoburculi, kafsulismagvari
tabletebi TeTri feris, Semogarsuli, gasayofi xaziT da warweriT AB57.
farmakoTerapiuli jgufi:
beta 1-adrenoblokatori seleqciuri.
aTq kodi:
C07AB03.
farmakologiuri Tvisebebi
farmkodinamika
kardioseleqciuri beta 1-adrenoblokatori, ar gaaCnia membranomastabilizebeli
da Sinagani simpaTomimeturi aqtivoba. axdens antihipertenziul, antianginalur
da antiariTmiul moqmedebas. dabal dozebSi blokavs ra gulis beta 1-
C
om
pa
ny
C
on
fid
en
tia
l
adrenoreceptorebs, amcirebs cikluri adenozinmonofosfatas warmoqmnas
adenozintrifosfatisgan, amcirebs kalciumis ionebis Sidaujredovan dinebas,
axdens uaryofiT qrono-, dromo-, baTmo—da inotropul moqmedebas (amcirebs
gulis SekumSvebis sixSires), Trgunavs gamtarobasa da agznebas, amcirebs
miokardiumis SekumSvadobas.
betaadrenoblokatorebis gamoyenebis dasawyisSi (Sinaganad miRebidan pirveli 24
saaTis ganmavlobaSi) saerTo periferuli sisxlZarRvovani winaaRmdegoba
izrdeba (alfa-adrenoblokatorebis aqtivobis reciprokuli zrdisa da beta 2adrenoreceptorebis stimulaciis aRmofxvris Sedegad), rac 1-3 dRis Semdeg
ubrundeba sawyis maCvenebels, xolo xangrZlivi gamoyenebisas mcirdeba.
antihipertenziuli
efeqti
dakavSirebulia
sisxlis
nakadis
wuTobrivi
moculobis
SemcirebasTan,
renin-angiotenzin-aldosteronuli
sistemis
aqtivobis SemcirebasTan (gaaCnia ufro didi mniSvneloba reninis sawyisi
hipersekreciis mqone avadmyofebisaTvis), aortis rkalis baroreceptorebis
mgrZnobelobasTan (ar xdeba maTi aqtivobis gaZliereba arteriuli wnevis
dawevaze pasuxisas) da centralur nervul sistemaze zemoqmedebasTan.
antihipertenziuli moqmedeba vlindeba rogorc sistoluri, aseve diastoluri
arteriuli wnevis daweviT, sisxlis mimoqcevis dartymiTi da wuTobrivi
moculobis SemcirebiT. saSualo Terapiul dozebSi ar moqmedebs periferiuli
arteriebis
tonusze.
antihipertenziuli
efeqti
grZeldeba
24
saaTi,
regularuli miRebisas stabilizdeba 2-kviriani mkurnalobis bolosken.
antianginaluri efeqti ganisazRvreba Jangbadze miokardiumis moTxovnis
SemcirebiT gulis SekumSvebis sixSiris Semcirebisa (diastolis gaxangrZliveba
da miokardiumis perfuziis gaumjobeseba) da SekumSvadobis Sedegad, agreTve
simpatomimeturi stimulaciis zemoqmedebisadmi miokardiumis mgrZnobelobis
SemcirebiT. amcirebs gulis SekumSvebis sixSires mosvenebul mdgomareobaSi da
fizikuri datvirTvisas.
marcxena parkuWSi saboloo diastoluri wnevis momatebam da parkuWebis
kunTovani boWkoebis daWimulobis momatebam SeiZleba gazardos moTxovna
Jangbadze, gansakuTrebiT gulis qronikuli ukmarisobis mqone pacientebSi.
antiariTmiuli
efeqti
ganpirobebulia
ariTmogenuri
faqtorebis
moxsniT (taqikardiebi, simpaturi nervuli sistemis aqtivobis momateba, camf-s
Semcvelobis momateba, arteriuli hipertenzia), riTmis sinusuri da eqtopiuri
matareblis spontanuri agznebis siCqaris SemcirebiT da atrioventrikuluri
gamtarobis dayovnebiT. impulsebis gamtarobis daTrgunva aRiniSneba upiratesad
antegradul da naklebad, retrogradul mimarTulebebSi atrioventrikuluri
kvanZis gavliT da damatebiTi gzebiT.
araseleqciuri beta-adrenoblokatorebisagan gansxvavebiT, saSualo Terapiul
dozebSi
daniSvnisas
axdens
naklebad
gamoxatul
zemoqmedebas
beta2adrenoreceptorebis Semcvel organoebze (kuWqveSa jirkvali, ConCxis kunTebi,
periferiuli arteriebis, bronqebisa da saSvilosnos gluvi muskulatura) da
naxSirwylovan cvlaze; aterogenuli moqmedebebis gamoxatuleba ar gansxvavdeba
propranololis moqmedebebisagan. maRali dozebiT gamoyenebisas (dRe-RameSi 100
mg-ze meti) axdens mablokirebel efeqts adrenoreceptorebis orive qvetipze.
uaryofiTi qronotropuli efeqti vlindeba miRebidan 1 saaTis Semdeg, maqsimums
aRwevs 2-4 saaTis Semdeg, grZeldeba 24 saaTamde.
farmakokinetika
absorbcia kuW-nawlavis traqtidan – swrafi, arasruli (45-60%), bioSeRwevadoba
– 40-50%, sisxlis plazmaSi maqsimaluri koncentraciis miRwevis dro – 2-4 sT.
cudad aRwevs hematoencefalur barierSi, umniSvnelo raodenobiT gadadis
placentis barierSi da dedis rZeSi. sisxlis plazmis cilebTan SekavSireba
SedarebiT dabalia da Seadgens 5%-ze naklebs.
C
om
pa
ny
C
on
fid
en
tia
l
praqtikulad ar metabolizdeba RviZlSi. sisxlis plazmidan naxevargamoyofis
periodi – 6-8 sT (es dro izrdeba xandazmuli asakis pacientebSi). gamoidevneba
TirkmelebiT gorgliseburi filtraciiT (85-100% ucvleli saxiT).
Tirkmelebis funqciis darRvevas Tan axlavs naxevargamoyofis periodisa da
kumulaciis gaxangrZliveba (aucilebelia dozis Semcireba): kreatininis
klirensisas 35ml/wT/1.73m2-ze dabla, naxevargamoyofis periodi Seadgens 16-27
saaTs, kreatininis klirensisas 15 ml/wT-ze dabla – 27 saaTze mets, anuriis
dros xangrZlivdeba 144 saaTamde. gamoidevneba hemodializis dros.
gamoyenebis Cvenebebi
- arteriuli hipertenzia;
- stabiluri
stenokardiis
Setevebis
profilaqtika
(princmetalis
stenokardiis gamoklebiT);
- gulis riTmis darRvevebi: sinusuri taqikardia, parkuWzeda taqiariTmiebis
profilaqtika.
ukuCvenebebi
• momatebuli mgrZnobeloba preparatisadmi
• Soki (kardiogenuri da hipovelemiuris CaTvliT);
• II-III xarisxis av blokada
• gulis mwvave ukmarisoba an gulis dekompensirebuli qronikuli
ukmarisoba;
• gamoxatuli bradikardia (gulis SekumSvebis sixSire wuTSi 40
dartymaze naklebi)
• sinusuri kvanZis sisustis sindromi
• sinoatrialuri blokada
• kardiomegalia gulis qronikuli ukmarisobis niSnebis gareSe
• princmetalis stenokardia
• gamoxatuli
arteriuli
hipotenzia
(miokardiumis
infarqtisas
gamoyenebis dros, 100-ze dabali sistoluri arteriuli wnevisas)
• monoaminooqsidazas inhibitorebis imavdroulad miReba
• laqtaciis periodi
• 18 wlamde asaki (efeqtianoba da usafrTxoeba dadgenili ar aris)
• feoqromocitoma, alfaadrenoblokatorebiT Tanmxlebi Terapiis
gamoklebiT;
gamoiyeneba sifrTxiliT Semdeg SemTxvevebSi:
1 da 2 tipis Saqriani diabeti, metaboluri acidozi, hipoglikemia, alergiuli
reaqciebi anamnezSi, filtvebis qronikuli obstruqciuli daavadeba, bronquli
asTma, filtvebis emfizema, I xarisxis av blokada, gulis qronikuli ukmarisoba
(kompensirebuli), periferiuli sisxlZarRvebis maoblitirebeli daavadebebi
(“gardamavali”
koWloba,
reinos
sindromi),
feoqromocitoma
(alfaadrenoblokatorebis imavdroulad miRebisas), RviZlis ukmarisoba, Tirkmlis
qronikuli ukmarisoba, miasTenia, Tireotoqsikozi, depresia (maT Soris
anamnezSi), fsoriazi, orsuloba, xandazmuli asaki.
gamoyeneba orsulobisa da laqtaciis periodSi
orsulebSi atenololi nikomedi iniSneba mxolod im SemTxvevebSi, rodesac
sargebeli dedisaTvis ufro mniSvnelovania, vidre riski nayofisaTvis.
atenololi gadadis dedis rZeSi, amitom laqtaciis periodSi, atenololi
nikomedis gamoyenebis aucileblobisas, aucilebelia ZuZuTi kvebis Sewyveta.
gamoyenebis wesi da dozebi
iniSneba Sinaganad Wamamde, daReWvis gareSe, mcire raodenobis siTxis
miyolebiT.
arteriuli hipertenzia. mkurnaloba iwyeba 50 mg atenololi nikomediT dReRameSi 1-jer. stabiluri hipotenziuri efeqtis misaRwevad saWiroa 1-2 kviris
ganmavlobaSi
preparatis
miReba.
hipotenziuri
efeqtis
arasakmarisi
gamoxatulebisas doza izrdeba 100 mg-mde erT miRebaze. dozis Semdgomi gazrda
rekomendebuli ar aris, vinaidan mas Tan ar axlavs hipotenziuri moqmedebebis
gaZliereba.
pacientebisaTvis
15-ze naklebi
27-ze meti
rekomendebulia
Semdegi
maqsimaluri doza
C
on
15-35
naxevargamoyofis
periodi
(sT)
16-27
ny
kreatininis klirensi
(ml/wT/1.73m2)
mqone
fid
Tirkmlis
ukmarisobis
maqsimaluri dozebi:
en
tia
l
stenokardia
sawyisi doza Seadgens dRe-RameSi 50 mg-s. Tu kviris ganmavlobaSi ar miiRweva
optimaluri Terapiuli efeqti, doza izrdeba 100 mg-mde dRe-RameSi. zogjer
SesaZlebelia dozis gazrda 200 mg-mde dRe-RameSi erTjer. xandazmuli asakis
pacientebsa
da
Tirkmelebis
gamomyofi
funqciis
darRvevebis
mqone
pacientebisaTvis
aucilebelia
dozirebis
reJimis
koreqcia.
Tirkmlis
ukmarisobisas rekomendebulia dozis koreqcia kreatininis klirensis mixedviT.
Tirkmlis ukmarisobis mqone pacientebSi 35ml/wT/1.73m2-ze maRali kreatininis
klirensis maCveneblisas (normaluri maCveneblebi Seadgens 100-150 ml/wT/1.73m2-s)
atenololis mniSvnelovani kumulacia ar xdeba.
50 mg dRe-RameSi
100 mg dRegamoSvebiT
50 mg dRegamoSvebiT
100
mg
oTx
dReSi
erTxel
pa
hemodializze myof pacientebs atenololi nikomedi eniSnebaT doziT 25 an 50 mg
dRe-RameSi yoveli dializis Catarebis Semdeg, rac aucileblad unda Catardes
stacionarul pirobebSi, vinaidan SeiZleba adgili hqondes arteriuli wnevis
dawevas.
C
om
xandazmuli pacientebisaTvis sawyisi erTjeradi doza – 25 mg (SeiZleba
gaizardos arteriuli wnevis, gulis SekumSvebis sixSiris kontroliT). 100 mg-ze
metad sadReRamiso dozis gazrda rekomendebuli ar aris, vinaidan Terapiuli
efeqti ar Zlierdeba, xolo gverdiTi efeqtebis ganviTarebis albaToba
matulobs.
gverdiTi moqmedeba
Zalian xSiri (>1/10); araxSiri (>1/100, <1/10); araxSiri (>1/1000, <1/100); iSviaTi (>1/10
000, <1/1000); Zalian iSviaTi (<1/10 000).
gul-sisxlZarRvTa sistemis mxriv:
xSirad: bradikardia, qveda kidurebis gaciveba, hipotenzia
iSviaTad: gulis qronikuli ukmarisobis ganviTareba an garRmaveba, av-blokada,
ariTmiebi, gulis wasvla, periferiuli SeSupebebi, tkivili gul-mkerdis areSi,
gulis gamtarobis darRveva, orTostatikuri hipotenzia da gonebis dakargva,
reinos sindromi
Zalian iSviaTad: miasTenia
siTxis
sekreciis
Semcireba,
en
grZnobis organoebis mxriv:
mxedvelobis darRveva, lorwovani
simSrale da tkivili, koniunqtiviti.
tia
l
centraluri nervuli sistemis mxriv:
xSirad: asTenia, kunTebis sisuste
araxSirad: Zilis darRveva (Zilianoba an uZiloba)
iSviaTad:
“koSmaruli”
sizmrebi,
halucinaciebi,
fsiqozebi,
depresia,
cnobierebis areva an gonebis xanmokle dakargva, mousvenroba, Tavbrusxveva,
Tavis tkivili, kidurebis paresTeziebi (pacientebSi gardamavali koWlobiTa da
reinos sindromiT), krunCxvebi, gemos cvlileba.
Tvalebis
fid
endokrinuli sistemis mxriv:
araxSirad: SeiZleba aRiniSnos hiperTireozis simptomebi. hipoglikemiebi
(pacientebSi, romlebic iReben insulins) an hiperglikemiebi (2 tipi Saqriani
diabetis mqone pacientebSi).
C
on
sunTqvis sistemis mxriv:
iSviaTad:
bronqospazmi,
xvrinva,
qoSini
qoSinisadmi
winaswarganwyobil
pacientebSi da/an maRali dozebis miRebisas, cxviris Segubeba.
saWmlis momnelebeli sistemis mxriv:
xSirad: gulisreva, pirRebineba, muclis tkivili, yabzoba an diarea.
iSviaTad: piris Rrus lorwovani garsis simSrale, qolestazi.
pa
ny
laboratoriuli maCveneblebi
araxSirad: “RviZlismieri” transaminazebis aqtivobis momateba
iSviaTad: Trombocitopenia, agranulocitozi, leikopenia, hiperbilirubinemia
Zalian iSviaTad: dadebiTi Sedegebi testebSi antinuklearul antisxeulebze.
C
om
kanis safaris mxriv:
iSviaTad: kanze gamonayari, Seqcevadi alopecia, purpura, fsoriazis gamwvaveba
da kanis qavili.
Zalian iSviaTad: mglurasmagvari sindromi. fsoriazismagvari gamonayari kanze,
momatebuli mgrZnobelobis reaqciebi, maT Soris angionevrozuli SeSupeba da
WinWris gamonayari.
sxva:
iSviaTad: potenciis daqveiTeba.
Zalian iSviaTad: libidos daqveiTeba.
zedozireba
simptomebi:
gamoxatuli bradikardia, Tavbrusxveva, arteriuli wnevis gamoxatuli daweva,
ariTmiebi, parkuWovani eqstrasistolia, II-III xarisxis av blokada, gulis
qronikuli ukmarisoba, frCxilebis an xelis gulebis cianozi, krunCxvebi,
sunTqvis gaZneleba, bronqospazmi.
mkurnaloba:
av gamtarobis darRvevebisas da/an bradikardiis dros – venebSi Seiyvaneba 1-2 mg
atropini, epinefrini (adrenalini) an droebiTi kardiostimulatoris Cadgma;
parkuWovani eqstrasistoliisas – lidokaini (I
klasis preparatebi ar
gamoiyeneba);
tia
l
arteriuli
wnevis
gamoxatuli
dawevisas
pacienti
unda
imyofebodes
trendelenburgis mdgomareobaSi. Tu ar aRiniSneba filtvebis SeSupebis niSnebi
– venebSi plazmaSemcvleli xsnarebi, araefeqturobisas – epinefrinis, dopaminis,
dobutaminis Seyvana; gulis qronikuli ukmarisobisas – gulis glikozidebi,
diuretikebi, glukagoni; krunCxvebisas – venebSi diazepami; bronqospazmisas –
inhalaciurad an parenteralurad – betaadrenostimulatorebi. SesaZlebelia
hemodializis Catareba.
C
on
fid
en
urTierTqmedeba sxva samkurnalo saSualebebTan
atenololTan erTad insulinis, peroraluri hipoglikemiuri saSualebebis
imavdroulad miRebisas – Zlierdeba am ukanasknelTa mahipoglikemizirebeli
moqmedeba.
sxvadasxva jgufis hipotenziur saSualebebTan an nitratebTan erTad miRebisas
aRiniSneba hipotenziuri moqmedebebis gaZliereba. atenololisa da verapamilis
(an dilTiazemis) erTdroulma gamoyenebam SeiZleba gamoiwvios am preparatebis
moqmedebebis urTierTgaZliereba.
antihipertenziul efeqts asusteben astrogenebi (natriumis Sekaveba) da
arasteroiduli anTebis sawinaaRmdego preparatebi, glukokortikosteroidebi.
C
om
pa
ny
atenololisa da gulis glikozidebis erTdrouli gamoyenebisas matulobs
bradikardiisa da av gamtarobis darRvevebis ganviTarebis riski.
atenololTan
erTad
rezerpinis,
meTildopas,
klonidinis,
verapamilis
daniSvnisas SeiZleba ganviTardes gamoxatuli bradiakrdiebi.
verapamilisa da dilTiazemis erTdroulma Seyvanam venebSi SeiZleba moaxdinos
gulis gaCerebis provocireba; nifedipinma SeiZleba gamoiwvios arteriuli
wnevis mniSvnelovani daweva.
atenololTan erTad ergotaminis, qsantinis warmoebulebis miRebisas misi
efeqtianoba mcirdeba.
atenololisa da klonidinis kombinirebuli gamoyenebis Sewyvetisas klopidiniT
mkurnaloba grZeldeba atenololis miRebis Sewyvetidan kidev ramdenime dRe.
lidokainTan erTad gamoyenebisas SeiZleba Semcirdes misi gamoyofa da
gaizardos lidokainis toqsikuri moqmedebebis riski.
fenoTiazinis warmoebulebTan erTad gamoyeneba xels uwyobs TiToeuli
preparatis koncentraciis momatebas sisxlis SratSi.
fenitoini venebSi Seyvanisas, zogadi anesTeziis samkurnalo saSualebebi
(naxSirwyalbadis
warmoebulebi)
zrdian
kardiodepresiuli
moqmedebebis
gamoxatulebas da arteriuli wnevis dawevis albaTobas.
eufilinTan da
TeofilinTan erTad gamoyenebisas SeiZleba aRiniSnos
Terapiuli efeqtebis urTierTdaTrgunva.
rekomendebuli ar aris mao inhibitorebTan erTad gamoyeneba hipotenziuri
moqmedebebis mniSvnelovani gaZlierebis Sedegad, intervali mao inhibitorebisa
da atenololis miRebebs Soris unda Seadgendes ara nakleb 14 dRes.
alergenebi,
romlebic
gamoiyeneba
imunoTerapiisaTvis
an
alergenebis
eqstraqtebi kanis sinjisaTvis zrdian mZime sistemuri alergiuli reaqciebis an
anafilaqsiis ganviTarebis risks.
sainhalacio sanarkoze saSualebebi (naxSirwyalbadis warmoebulebi) zrdian
miokardiumis funqciis daTrgunvisa da arteriuli hipertenziis ganviTarebis
risks.
tia
l
amiodaroni zrdis bradikardiisa da av gamtarobis daTrgunvis ganviTarebis
risks.
cimetidini zrdis koncentracias sisxlis plazmaSi (aferxebs metabolizms).
venebSi Sesayvani iodis Semcveli rentgenokontrastuli saSualebebi zrdian
anafilaqsuri reaqciebis ganviTarebis risks.
axangrZlivebs
aramadepolarizebeli
miorelaqsantebis
moqmedebas
da
kumarinebis antikoagulaciur efeqts.
en
trida
tetracikluri
antidepresantebi,
antifsiqozuri
saSualebebi
(neiroleptikebi), eTanoli, sedaciuri da saZile saSualebebi aZliereben
centraluri nervuli sistemis daTrgunvas.
C
om
pa
ny
C
on
fid
gansakuTrebuli miTiTebebi
im pacientebSi, romlebic iReben atenolol nikomeds, aucilebelia gulis
SekumSvebis sixSirisa da arteriuli wnevis kontroli (mkurnalobis dasawyisSi
– yoveldRiurad, Semdeg 3-4 TveSi erTxel), xolo Saqriani diabetis mqone
pacientebSi unda Semowmdes sisxlSi glukozis koncentraciebi (4-5 TveSi
erTxel). xandazmuli pacientebisaTvis rekomendebulia Tirkmelebis funqciis
kontroli (4-5 TveSi erTxel).
avadmyofma unda Seiswavlos gulis SekumSvebis sixSiris gamoTvlis meTodika
da mas unda mieces gafrTxileba, rom mimarTos eqims, Tu gulis SekumSvebis
sixSire iqneba wuTSi 50 dartymaze naklebi.
Tireotoqsikozis
dros
atenolol
nikomedma
SeiZleba
SeniRbos
Tireotoqsikozis klinikuri niSnebi (magaliTad, taqikardia). preparatis miRebis
erTbaSad
Sewyveta ukunaCvenebia, vinaidan SeiZleba aRiniSnos simptomatikis
gaZliereba. Saqriani diabetis dros SeiZleba SeiniRbos hipoglikemiiT
gamowveuli
taqikardia.
araseleqciuri
beta-adrenoblokatorebisagan
gansxvavebiT praqtikulad ar aZlierebs insuliniT gamowveul hipoglikemias da
ar
aferxebs
sisxlSi
glukozis
koncentraciebis
aRdgenas
normalur
maCveneblebamde.
gulis iSemiuri daavadebis mqone pacientebisaTvis beta-adrenoblokatorebis
erTbaSad moxsnam SeiZleba gamoiwvios stenokardiis Setevebis sixSiris an
simZimis momateba, amitom gulis iSemiuri daavadebis mqone pacientebSi
preparatis miRebis Sewyveta unda moxdes TandaTan. doza unda Semcirdes 2
kviris an meti drois ganmavlobaSi.
araseleqciur beta-adrenoblokatorebTan SedarebiT, kardioseleqciur betaadrenoblokatorebs gaaCnia naklebi zemoqmedeba filtvebis funqciaze, amasTan,
sasunTqi gzebis obstruqciuli daavadebebisas atenolol nikomedi gamoiyeneba
mxolod absoluturi Cvenebebis SemTxvevaSi. maTi daniSvnis aucileblobisas
SeiZleba beta2-adrenoblokatorebis miRebis rekomendireba.
bronqospastikuri
daavadebebis
mqone
pacientebisaTvis
SeiZleba
kardioseleqciuri adrenoblokatorebis daniSvna sxva antihipertenziuli
saSualebebis autanlobis da/an araefeqturobis SemTxvevaSi, magram amasTan
mkacrad unda iyos daculi dozireba. Warbi dozis miRebisas SeiZleba aRiniSnos
bronqospazmi.
gansakuTrebuli yuradReba aris saWiro, Tu pacienti, romelic iRebs atenolol
nikomeds, saWiroebs qirurgiul Carevas narkozis qveS. preparatis miReba unda
ny
C
on
fid
en
tia
l
Sewydes Carevamde 48 saaTiT adre. anesTetikis saxiT unda SeirCes preparati
minimaluri uaryofiTi inotropuli moqmedebiT.
atenolol nikomedisa da klopidinis erTdrouli miRebisas atenolol
nikomedis miReba unda Sewydes klopidinis Sewyvetamde ramdenime dRiT adre
“moxsnis” sindromis Tavidan acilebis mizniT.
SeiZleba gaZlierdes momatebuli mgrZnobelobis reaqciebis gamoxatuleba da
epinefrinis
Cveulebrivi
dozebis
efeqtis
ararseboba
damZimebuli
alergologiuri anamnezis fonze.
samkurnalo saSualebebma, romlebic amcireben kateqolaminebis (magaliTad,
rezerpinis) maragebs, SeiZleba gaaZlieron beta-adrenoblokatorebis moqmedeba.
amitom, pacientebi, romlebic iReben amgvar kombinaciebs, unda imyofebodnen
eqimis meTvalyureobis qveS arteriuli wnevis dawevis an bradikardiebis
gamosavlenad.
xandazmuli asakis pacientebSi bradikardiis (wuTSi 40 dartymaze naklebi),
arteriuli hipotenziis (sistoluri arteriuli wneva 100-ze dabali), av
blokadis, bronqospazmis parkuWovani ariTmiebis, RviZlisa da Tirkmelebis
funqciis mZime darRvevebisas aucilebelia dozis Semcireba an mkurnalobis
Sewyveta.
rekomendebulia
Terapiis
Sewyveta
beta-adrenoblokatorebiT
gamowveuli
depresiis ganviTarebisas.
verapamilis venebSi Seyvanis aucileblobisas es unda gakeTdes atenololi
nikomedis miRebidan ara nakleb 48 saaTis Semdeg.
atenololi nikomedis gamoyenebisas SeiZleba Semcirdes lorwovani siTxis
warmoeba, rac mniSvnelovania im pacientebisaTvis, romlebic xmaroben kontaqtur
linzebs.
ar SeiZleba mkurnalobis erTbaSad Sewyveta mZime ariTmiebisa da miokardiumis
infarqtis ganviTarebis riskis gamo. preparatis moxsna unda moxdes TandaTan,
dozis SemcirebiT 2 kviris an meti drois ganmavlobaSi (doza mcirdeba 25%-iT
3-4 dReSi).
preparati unda moixsnas sisxlsa da SardSi kateqolaminebis, normetanefrinisa
da
vanililmindalis
mJavas
Semcvelobis
gamokvlevamde;
antinukleuri
antisxeulebis titrebamde (1-2 dRiT adre).
pa
mwevelebSi beta-adrenoblokatorebis efeqtianoba dabalia.
zemoqmedeba satransporto saSualebebis marTvis unarze da iseTi samuSaoebis
Sesruleba, romlebic moiTxoven momatebuli yuradRebis koncentracias da
fsiqomotoruli reaqciebis siswrafes
C
om
mkurnalobis periodSi aucilebelia sifrTxilis gamoCena satransporto
saSualebebis marTvisas da potenciurad saSiSi iseTi samuSaoebis Sesrulebisas,
romlebic moiTxoven momatebuli yuradRebis koncentracias da fsiqomotoruli
reaqciebis siswrafes.
gamoSvebis forma
Semogarsuli tabletebi 50 mg da 100 mg.
30 tableti plastmasis flakonebSi, xraxniani TavsaxuriT, mosaxsneli rgoliT,
romelic uzrunvelyofs pirveli gaxsnis controls. etiketis nawili
mimagrebulia flakonze specialuri webovani lentiT, romelic etiketis awevis
saSualebas iZleva. gamoyenebis instruqcia Sedgenilia dakecili furclis
saxiT da moTavsebulia etiketis moZravi nawilis qveS, instruqciis kide
fiqsirebulia flakonze.
Senaxvis pirobebi
inaxeba mSral, sinaTlisagan dacul adgilas, ara umetes 250C-ze.
inaxeba bavSvebisaTvis miuwvdomel adgilas.
tia
en
nikomed gmbh, germania
lenicStrase 70-98, 16515, oranienburgi
Nycomed GmbH, Germany
Lehnitzstrasse 70-98, 16515, Oranienburg
C
on
damfasoebeli da SemfuTveli
nikomed dania aps, dania
langebiergi 1, roskilde, dania
Nycomed Danmark ApS, Denmark
Langebjerg 1, Roskilde
nikomed gmbh, germania
lenicStrase 70-98, 16515, oranienburgi
Nycomed GmbH, Germany
Lehnitzstrasse 70-98, 16515, Oranienburg
fid
mwarmoebeli
nikomed dania aps, dania
hvidovre,
helsexolmen
9
dk-2650
dania
Nycomed Danmark ApS, Denmark
Helseholmen 9 DK-2650 Hvidovre, Denmark
l
vargisianobis vada
5 weli
ar gamoiyeneba SefuTvaze miTiTebuli TariRis Semdeg.
gacemis wesi
farmakologiuri produqti jgufi II - gamoiyeneba eqimis daniSnulebiT.
xarisxis kontroli
nikomed dania aps, dania
langebiergi 1, roskilde, dania
Nycomed Danmark ApS, Denmark
Langebjerg 1, Roskilde
nikomed gmbh, germania
lenicStrase 70-98, 16515, oranienburgi
Nycomed GmbH, Germany
Lehnitzstrasse 70-98, 16515, Oranienburg
pa
ny
saregistracio mowmobis mflobeli
nikomed dania aps, dania
langebiergi 1, roskilde, dania
Nycomed Danmark ApS, Denmark
Langebjerg 1, Roskilde
C
om
momxmarebelTa pretenziebi gaigzavnos misamarTze:
Sps “nikomed distribiuSen cente”
119048 moskovi, usaCovas 2, 1
tel: (495) 9335511
faqsi: (495) 5021635
el-fosta: [email protected]
firmis warmomadgeneli
registraciis specialisti: