{"id":59484,"date":"2024-02-28T06:00:08","date_gmt":"2024-02-28T06:00:08","guid":{"rendered":"https:\/\/medsname.com\/angiplat\/"},"modified":"2026-05-01T10:49:15","modified_gmt":"2026-05-01T10:49:15","slug":"angiplat","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/angiplat\/","title":{"rendered":"Angiplat"},"content":{"rendered":"

<\/p>\n

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\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Angiplat?<\/h3>\n

Angiplat<\/strong> je nitroglycerin (glyceryltrinitr\u00e1t) 2,5 mg tobolky s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm<\/strong>, pou\u017e\u00edvan\u00fd k profylaxi<\/em> (prevenci) chronick\u00e9 stabiln\u00ed anginy pectoris. Obvykl\u00e1 po\u010d\u00e1te\u010dn\u00ed d\u00e1vka je jedna tobolka dvakr\u00e1t a\u017e t\u0159ikr\u00e1t denn\u011b<\/strong> s 8\u201312hodinov\u00fdm intervalem bez d\u00e1vky nitr\u00e1t\u016f<\/strong> p\u0159es noc. Angiplat je ne<\/strong> vhodn\u00fd pro zastaven\u00ed akutn\u00edho z\u00e1chvatu anginy \u2014 k tomuto \u00fa\u010delu pou\u017eijte sublingv\u00e1ln\u00ed nitroglycerin nebo isosorbid dinitr\u00e1t.<\/p>\n<\/div>\n

\nCo z\u00edsk\u00e1te s MedsBase:<\/strong> V\u00fdrobce certifikovan\u00fd WHO-GMP \u00b7 Diskr\u00e9tn\u00ed balen\u00ed \u00b7 Celosv\u011btov\u00e1 doprava \u00b7 V\u00edce ne\u017e 1 400 ov\u011b\u0159en\u00fdch recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a>\n<\/div>\n

\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n

Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n

Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n

Angiplat 2,5 mg<\/strong> je peror\u00e1ln\u00ed kapsle s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm (SR) nitroglycerinu ur\u010den\u00e1 pro denn\u00ed u\u017e\u00edv\u00e1n\u00ed u pacient\u016f s chronickou stabiln\u00ed anginou pectoris. Ka\u017ed\u00e1 kapsle obsahuje 2,5 mg glyceryltrinitr\u00e1tu (nitroglycerinu)<\/strong> v kontrolovan\u00e9m uvol\u0148ovac\u00edm syst\u00e9mu, kter\u00fd postupn\u011b uvol\u0148uje \u00fa\u010dinnou l\u00e1tku po dobu 6\u20138 hodin. Tento prodlou\u017een\u00fd profil uvol\u0148ov\u00e1n\u00ed umo\u017e\u0148uje d\u00e1vkov\u00e1n\u00ed dvakr\u00e1t nebo t\u0159ikr\u00e1t denn\u011b nam\u00edsto velmi kr\u00e1tk\u00e9ho \u00fa\u010dinku sublingv\u00e1ln\u00edho nitroglycerinu.<\/p>\n

Angiplat je \u0161iroce p\u0159edepisov\u00e1n v kardiologick\u00e9 praxi jako sou\u010d\u00e1st dlouhodob\u00e9ho antiangin\u00f3zn\u00edho re\u017eimu \u2014 obvykle spolu s betablok\u00e1torem (atenolol, metoprolol, bisoprolol) nebo blok\u00e1torem kalciov\u00fdch kan\u00e1l\u016f (amlodipin, diltiazem), plus aspirin a statin pro sekund\u00e1rn\u00ed prevenci koron\u00e1rn\u00edch p\u0159\u00edhod. Sni\u017euje po\u010det a z\u00e1va\u017enost epizod anginy pectoris, zlep\u0161uje toleranci z\u00e1t\u011b\u017ee a m\u016f\u017ee sn\u00ed\u017eit pot\u0159ebu kr\u00e1tkodob\u011b p\u016fsob\u00edc\u00edch z\u00e1chrann\u00fdch l\u00e9k\u016f b\u011bhem dne.<\/p>\n

K \u010demu se Angiplat pou\u017e\u00edv\u00e1?<\/h2>\n

Angiplat je indikov\u00e1n pro:<\/p>\n

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  • Dlouhodob\u00e1 profylaxe chronick\u00e9 stabiln\u00ed anginy pectoris<\/strong> \u2014 sn\u00ed\u017een\u00ed frekvence epizod bolesti na hrudi<\/li>\n
  • Angina pectoris vyvolan\u00e1 n\u00e1mahou<\/strong> \u2014 premedikaci p\u0159ed p\u0159edv\u00eddatelnou z\u00e1t\u011b\u017e\u00ed (ch\u016fze do kopce, stoup\u00e1n\u00ed po schodech)<\/li>\n
  • Sm\u00ed\u0161en\u00e1 angina pectoris<\/strong> (kombinace n\u00e1mahy a spazmu) \u2014 jako dopl\u0148kov\u00e1 terapie<\/li>\n
  • Lev\u00e9 komorov\u00e9 selh\u00e1n\u00ed s anginou pectoris<\/strong> \u2014 sn\u00ed\u017een\u00ed p\u0159edt\u00ed\u017een\u00ed a isch\u00e9mie<\/li>\n<\/ul>\n

    Angiplat nen\u00ed ne<\/em> indikov\u00e1n pro akutn\u00ed z\u00e1chvaty anginy pectoris. Peror\u00e1ln\u00ed nitroglycerin s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm m\u00e1 n\u00e1stup \u00fa\u010dinku za 30\u201345 minut \u2014 p\u0159\u00edli\u0161 pomal\u00fd na p\u0159eru\u0161en\u00ed prob\u00edhaj\u00edc\u00ed ischemick\u00e9 epizody. Pro tuto indikaci pou\u017eijte sublingv\u00e1ln\u00ed tabletu nebo sprej s nitroglycerinem, nebo sublingv\u00e1ln\u00ed tabletu isosorbid dinitr\u00e1tu 5 mg.<\/p>\n

    Jak funguj\u00ed nitr\u00e1ty?<\/h2>\n

    V\u0161echna nitr\u00e1tov\u00e1 l\u00e9\u010diva maj\u00ed stejn\u00fd z\u00e1kladn\u00ed mechanismus \u00fa\u010dinku. Po vst\u0159eb\u00e1n\u00ed jsou enzymaticky p\u0159em\u011bn\u011bny na oxid dusnat\u00fd (NO)<\/strong> uvnit\u0159 bun\u011bk hladk\u00e9ho svalstva c\u00e9v. NO aktivuje guanyl\u00e1tcykl\u00e1zu, \u010d\u00edm\u017e zvy\u0161uje intracelul\u00e1rn\u00ed cGMP a uvol\u0148uje hladk\u00e9 svalstvo c\u00e9v. Klinick\u00e9 \u00fa\u010dinky jsou:<\/p>\n

      \n
    • \u017diln\u00ed dilatace<\/strong> (dominantn\u00ed p\u0159i n\u00edzk\u00fdch d\u00e1vk\u00e1ch) \u2014 sni\u017euje \u017eiln\u00ed n\u00e1vrat k srdci, \u010d\u00edm\u017e se sni\u017euje p\u0159edt\u00ed\u017een\u00ed<\/em>. Takto nitr\u00e1ty sni\u017euj\u00ed spot\u0159ebu kysl\u00edku myokardem.<\/li>\n
    • Arteri\u00e1ln\u00ed dilatace<\/strong> (vy\u0161\u0161\u00ed d\u00e1vky) \u2014 sni\u017euje syst\u00e9movou c\u00e9vn\u00ed rezistenci a dot\u00ed\u017een\u00ed<\/em>, co\u017e d\u00e1le sni\u017euje srde\u010dn\u00ed pr\u00e1ci.<\/li>\n
    • Dilatace koron\u00e1rn\u00edch tepen<\/strong> \u2014 zlep\u0161uje pr\u016ftok krve do ischemick\u00fdch oblast\u00ed srde\u010dn\u00edho svalu, zejm\u00e9na p\u0159i koron\u00e1rn\u00edm spasmu.<\/li>\n<\/ul>\n

      V\u00fdsledn\u00fdm efektem je m\u00e9n\u011b bolest\u00ed na hrudi, m\u00e9n\u011b angin\u00f3zn\u00edch epizod a lep\u0161\u00ed tolerance z\u00e1t\u011b\u017ee u pacient\u016f se stabiln\u00ed ischemickou chorobou srde\u010dn\u00ed.<\/p>\n

      Nitr\u00e1tov\u00e1 tolerance \u2014 kritick\u00e9 d\u00e1vkovac\u00ed pravidlo<\/h2>\n

      Nitr\u00e1tov\u00e1 tolerance je nejd\u016fle\u017eit\u011bj\u0161\u00edm konceptem pro ka\u017ed\u00e9ho pacienta u\u017e\u00edvaj\u00edc\u00edho nitr\u00e1ty. Pokud se nitr\u00e1t pod\u00e1v\u00e1 nep\u0159etr\u017eit\u011b \u2013 s konstantn\u00ed hladinou v krvi 24 hodin denn\u011b \u2013 antiangin\u00f3zn\u00ed \u00fa\u010dinek se vytr\u00e1c\u00ed b\u011bhem 48 a\u017e 72 hodin. Jedn\u00e1 se o dob\u0159e zdokumentovan\u00fd, reprodukovateln\u00fd farmakologick\u00fd jev, nikoli o domn\u011bl\u00fd efekt.<\/p>\n

      \u0158e\u0161en\u00ed je jednoduch\u00e9 a nezpochybniteln\u00e9: ka\u017ed\u00fd 24hodinov\u00fd cyklus mus\u00ed zahrnovat nitr\u00e1tov\u00fd interval alespo\u0148 8\u201312 hodin<\/strong>, obvykle p\u0159es noc. Standardn\u00ed strategie jsou:<\/p>\n

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      • Asymetrick\u00e9 d\u00e1vkov\u00e1n\u00ed dvakr\u00e1t denn\u011b (nap\u0159. v 7 hodin r\u00e1no a ve 3 hodiny odpoledne, pot\u00e9 nic a\u017e do n\u00e1sleduj\u00edc\u00edho r\u00e1na)<\/li>\n
      • Jednou denn\u011b pod\u00e1van\u00e9 tablety s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm navr\u017een\u00e9 tak, aby udr\u017eovaly n\u00edzkou hladinu<\/li>\n
      • Odstran\u011bn\u00ed transderm\u00e1ln\u00ed n\u00e1plasti po 12\u201314 hodin\u00e1ch no\u0161en\u00ed<\/li>\n<\/ul>\n

        Nep\u0159est\u00e1vejte ne<\/em> nep\u0159id\u00e1vejte dal\u0161\u00ed d\u00e1vky \u201cp\u0159ed span\u00edm\u201d nebo b\u011bhem noci, pokud v\u00e1m l\u00e9ka\u0159 v\u00fdslovn\u011b nep\u0159edep\u00ed\u0161e nep\u0159etr\u017eitou terapii z konkr\u00e9tn\u00edho d\u016fvodu.<\/p>\n

        D\u00e1vkov\u00e1n\u00ed Angiplatu<\/h2>\n

        Pro chronickou stabiln\u00ed anginu pectoris u dosp\u011bl\u00fdch:<\/p>\n

          \n
        • Po\u010d\u00e1te\u010dn\u00ed d\u00e1vka:<\/strong> 2,5 mg (jedna tobolka) dvakr\u00e1t a\u017e t\u0159ikr\u00e1t denn\u011b, s j\u00eddlem<\/li>\n
        • Titrace:<\/strong> Pokud angina z\u016fst\u00e1v\u00e1 nekontrolovan\u00e1 po 1\u20132 t\u00fddnech, l\u00e9ka\u0159i mohou d\u00e1vku zv\u00fd\u0161it na 5 mg (dv\u011b tobolky) dvakr\u00e1t nebo t\u0159ikr\u00e1t denn\u011b, nebo p\u0159ej\u00edt na Angispan-TR 6,5 mg<\/li>\n
        • Interval bez dusi\u010dnan\u016f:<\/strong> Mezi posledn\u00ed d\u00e1vkou jednoho dne a prvn\u00ed d\u00e1vkou n\u00e1sleduj\u00edc\u00edho dne nechte minim\u00e1ln\u011b 8\u201312 hodin. Nejjednodu\u0161\u0161\u00ed zp\u016fsob: u\u017e\u00edvejte v 7 hodin r\u00e1no a ve 15 hodin odpoledne, pot\u00e9 nic a\u017e do n\u00e1sleduj\u00edc\u00edho r\u00e1na.<\/li>\n
        • Maxim\u00e1ln\u00ed d\u00e1vka:<\/strong> 26 mg\/denn\u011b v rozd\u011blen\u00fdch d\u00e1vk\u00e1ch (z\u0159\u00eddka pot\u0159ebn\u00e9)<\/li>\n<\/ul>\n

          Tobolky se polykaj\u00ed cel\u00e9 a zap\u00edjej\u00ed vodou; nedrtit, ne\u017ev\u00fdkat ani neotev\u00edrat \u2014 to ni\u010d\u00ed syst\u00e9m prodlou\u017een\u00e9ho uvol\u0148ov\u00e1n\u00ed a zp\u016fsob\u00ed rychl\u00e9 uvoln\u011bn\u00ed nitroglycerinu s n\u00e1slednou silnou bolest\u00ed hlavy a hypotenz\u00ed.<\/p>\n

          Vynechan\u00e1 d\u00e1vka: u\u017eijte ji, jakmile si vzpomenete, pokud to nen\u00ed do 3 hodin od dal\u0161\u00ed pl\u00e1novan\u00e9 d\u00e1vky \u2014 v tom p\u0159\u00edpad\u011b vynechanou d\u00e1vku vynechejte. Nikdy ned\u00e1vejte dvojn\u00e1sobnou d\u00e1vku.<\/p>\n

          Kdo by nem\u011bl u\u017e\u00edvat Angiplat?<\/h2>\n

          Existuje jedna absolutn\u00ed kontraindikace, kterou mus\u00ed ka\u017ed\u00fd pacient pochopit p\u0159ed prvn\u00ed d\u00e1vkou:<\/p>\n

          \n

          Nikdy nekombinujte \u017e\u00e1dn\u00fd nitr\u00e1t s inhibitorem PDE5.<\/strong> Sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) a avanafil (Stendra) zesiluj\u00ed vazodilata\u010dn\u00ed \u00fa\u010dinek nitr\u00e1t\u016f a mohou zp\u016fsobit \u017eivot ohro\u017euj\u00edc\u00ed hypotenzi, kolaps, c\u00e9vn\u00ed mozkovou p\u0159\u00edhodu nebo infarkt myokardu. Po\u010dkejte alespo\u0148 24 hodiny po pod\u00e1n\u00ed sildenafilu\/vardenafilu<\/strong> a 48 hodin po pod\u00e1n\u00ed tadalafilu<\/strong> ne\u017e u\u017eijete jakoukoli d\u00e1vku nitr\u00e1tu. Toto plat\u00ed pro v\u0161echny formy \u2013 peror\u00e1ln\u00ed, sublingv\u00e1ln\u00ed, transderm\u00e1ln\u00ed a sprej.<\/p>\n<\/div>\n

          Dal\u0161\u00ed d\u016fle\u017eit\u00e9 kontraindikace:<\/p>\n

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          • T\u011b\u017ek\u00e1 hypotenze nebo hypovol\u00e9mie (systolick\u00fd TK < 90 mmHg)<\/li>\n
          • T\u011b\u017ek\u00e1 an\u00e9mie (nitr\u00e1ty mohou zhor\u0161it dod\u00e1vku kysl\u00edku do tk\u00e1n\u00ed)<\/li>\n
          • Hypertrofick\u00e1 obstruk\u010dn\u00ed kardiomyopatie (HOCM) \u2013 nitr\u00e1ty mohou zhor\u0161it v\u00fdtokovou obstrukci<\/li>\n
          • T\u011b\u017ek\u00e1 aort\u00e1ln\u00ed sten\u00f3za \u2013 riziko synkopy<\/li>\n
          • Zv\u00fd\u0161en\u00fd nitrolebn\u00ed tlak nebo ned\u00e1vn\u00e9 poran\u011bn\u00ed hlavy<\/li>\n
          • Infarkt prav\u00e9 komory \u2013 preload je z\u00e1sadn\u00ed, nitr\u00e1ty jej sni\u017euj\u00ed<\/li>\n
          • Konstriktivn\u00ed perikarditida nebo srde\u010dn\u00ed tampon\u00e1da<\/li>\n
          • Zn\u00e1m\u00e1 p\u0159ecitliv\u011blost na organick\u00e9 nitr\u00e1ty<\/li>\n
          • Sou\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed stimul\u00e1tor\u016f solubiln\u00ed guanyl\u00e1tcykl\u00e1zy (riociguat)<\/li>\n<\/ul>\n

            Pou\u017e\u00edvejte opatrn\u011b v t\u011bhotenstv\u00ed (kategorie C) a konzultujte s odborn\u00edkem. P\u0159i kojen\u00ed je ob\u010dasn\u00e9 u\u017e\u00edv\u00e1n\u00ed obecn\u011b p\u0159ijateln\u00e9, ale rutinn\u00ed terapii by m\u011bl posoudit kardiolog.<\/p>\n

            \u010cast\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky Angiplatu<\/h2>\n

            V\u011bt\u0161ina ne\u017e\u00e1douc\u00edch \u00fa\u010dink\u016f nitr\u00e1t\u016f je p\u0159\u00edm\u00fdm d\u016fsledkem jejich vazodilata\u010dn\u00edho \u00fa\u010dinku a obvykle ustupuje b\u011bhem prvn\u00edch 1\u20132 t\u00fddn\u016f l\u00e9\u010dby.<\/p>\n

            Velmi \u010dast\u00e9 (>10 % pacient\u016f):<\/strong><\/p>\n

              \n
            • Bolest hlavy<\/strong> \u2014 pulzuj\u00edc\u00ed, \u010deln\u00ed bolesti, \u010dasto nejhor\u0161\u00ed v prvn\u00edch dnech. Paracetamol je bezpe\u010dn\u00fd. Bolest hlavy obvykle ustoup\u00ed b\u011bhem 7\u201314 dn\u016f, jak si t\u011blo zvyk\u00e1; je ne<\/em> zn\u00e1mkou p\u0159ed\u00e1vkov\u00e1n\u00ed.<\/li>\n
            • Z\u00e1vrat\u011b nebo mot\u00e1n\u00ed hlavy, zejm\u00e9na p\u0159i postaven\u00ed<\/li>\n
            • Z\u010derven\u00e1n\u00ed obli\u010deje<\/li>\n<\/ul>\n

              B\u011b\u017en\u00e9 (1\u201310 %):<\/strong><\/p>\n