Небиволол является липофильным, кардиоселективным, бета1-адр... Инструкция
Показания к применению
Артериальная гипертензия (пациентам, которым показана комбинированная терапия).
Противопоказания
Повышенная чувствительность к компонентам препарата, к другим бета-адреноблокаторам, к гидрохлортиазиду и другим производным сульфонамида, тяжелые нарушения функции печени, острая сердечная недостаточность, кардиогенный шок, хроническая сердечная недостаточность в стадии декомпенсации (требующая проведения инотропной терапии), синдром слабости синусового ...
Таблетки Небилонг Н снижают артериальное давление в состоянии покоя, при физической нагрузке и в условиях психологического стресса. Действие препарата приводит к снижению риска стенокардических приступов и повышение толерантности к физической нагрузке. Стабилизация артериального давления на целевом уровне отмечается по прошествии 1 месяца от начала лечения.
Фармакологические свойства
Небиволол является липофильным, кардиоселективным, бета1-адреноблокатором с вазодилатирующими свойствами. Снижает ЧСС и АД в покое и при физической нагрузке, уменьшает конечное диастолическое давление левого желудочка, снижает ОПСС, улучшает диастолическую функцию сердца (снижает давление наполнения), увеличивает фракцию выброса. Снижая потребность миокарда в кислороде, уменьшает количество и тяжесть приступов стенокардии и улучшает переносимость физической нагрузки. Антиаритмическое действие обусловлено подавлением автоматизма сердца (в т.ч. в патологическом очаге) и замедлением AV-проводимости. Антигипертензивный эффект развивается на 2-5 день лечения, стабильное действие отмечается через 1 месяц. Данный эффект сохраняется при длительном лечении. Гидрохлортиазид - тиазидный диуретик. Снижает реабсорбцию ионов натрия в кортикальном сегменте петли Генле, не влияя на ее участок, проходящий в мозговом слое почки. Блокирует карбоангидразу в проксимальном отделе извитых почечных канальцев, усиливает выведение почками ионов калия, гидрокарбонатов и фосфатов. Практически не влияет на кислотно-основное состояние. Усиливает выведение почками ионов магния, задерживает в организме ионы кальция и торможит выведение уратов. Диуретический эффект развивается через 1-2 ч, достигает максимума через 4 ч, продолжается до 10-12 ч.
Показания к применению
Артериальная гипертензия (пациентам, которым показана комбинированная терапия).
Противопоказания
Повышенная чувствительность к компонентам препарата, к другим бета-адреноблокаторам, к гидрохлортиазиду и другим производным сульфонамида, тяжелые нарушения функции печени, острая сердечная недостаточность, кардиогенный шок, хроническая сердечная недостаточность в стадии декомпенсации (требующая проведения инотропной терапии), синдром слабости синусового узла, включая синоатриальную блокаду, AV-блокада II и III степени (без искусственного водителя ритма), тяжелые формы бронхиальной астмы и ХОБЛ, феохромоцитома (без одновременного применения альфа-адреноблокаторов), депрессия, метаболический ацидоз, брадикардия (ЧСС менее 60 уд./мин), тяжелая артериальная гипотензия (систолическое АД менее 90 мм рт.ст.), тяжелые нарушения периферического кровообращения ("перемежающаяся" хромота, синдром Рейно), непереносимость лактозы, дефицит лактазы или глюкозо-галактозная мальсорбция (препарат содержит лактозу), гиповолемия, трудноконтролируемый сахарный диабет, острая почечная недостаточность, болезнь Аддисона, анурия, хроническая почечная недостаточность (КК менее 30 мл/мин), рефрактерная гипокалиемия, гипонатриемия, гиперкальциемия.
Применение при беременности и в период грудного вскармливания
При беременности назначают только по строгим показаниям, когда польза для матери превышает риск для плода (в связи с возможным развитием у новорожденного брадикардии, артериальной гипотензии, гипогликемии и паралича дыхания). Лечение необходимо прерывать за 48-72 ч до родов. Гидрохлортиазид проникает в грудное молоко, поэтому, если применение препарата является абсолютно необходимым, то кормление грудью следует прекратить.
Способ применения и дозы
Внутрь, желательно принимать в одно и то же время, 1 раз в сутки независимо от времени приема пищи, не разжевывая и запивая достаточным количеством жидкости. В начале терапии следует принимать по 1 таблетки в сутки. При недостаточной выраженности терапевтического эффекта через 2 недели дозу можно увеличить до 2-х таблеток. Максимальная суточная доза 2 таблетки в сутки.
Симптомы: выраженное снижение АД, острая тахикардия, потеря сознания, судороги, спазмы икроножных мышц, тошнота, рвотаЛечение: промывание желудка, прием активированного угля. В случае выраженного снижения АД необходимо придать пациенту горизонтальное положение с приподнятыми ногами, при необходимости в/в введения жидкости или вазопрессоров.
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