Momwe mungagwiritsire ntchito Telmista 40?

Mlingo wa mawonekedwe a Telmists - mapiritsi: pafupifupi oyera kapena oyera, pamtunda wa 20 mg - kuzungulira, 40 mg - biconvex, chowulungika, 80 mg - biconvex, kapangidwe kake ka kapangidwe kake (mu chithuza cha zinthu zophatikizika 7 ma PC., Pabokosi la 2, 4, 8 , Matuza 12 kapena 14, m'matumba 10,. M'katoni 3, 6 kapena matuza 9.

Piritsi limodzi:

yogwira mankhwala: telmisartan - 20, 40 kapena 80 mg,
zotuluka: sodium hydroxide, lactose monohydrate, magnesium stearate, meglumine, povidone K30, sorbitol (E420).

Mankhwala

Telmisartan, chinthu chogwira ntchito cha Telmista, chili ndi antihypertensive katundu, chifukwa cha angiotensin II receptor antagonist (AT blocker₁zolandirira). Kuyika angiotensin II kulumikizana ndi cholandilira, sichikhala ndi chochita chogwirizana ndi receptor. Telmisartan kusankha ndipo kwa nthawi yayitali imangomangiriza kwa angiotensin II receptor subtype AT₁. Ilibe chiyanjano cha ma angiotensin receptors, kufunikira kogwira ntchito komwe kumachitika komanso zotsatira za zochuluka (chifukwa cha kugwiritsa ntchito telmisartan) mphamvu ya angiotensin II pa iwo sizinaphunzire.

Telmisartan imachepetsa kuchuluka kwa aldosterone m'magazi am'magazi, sizikhudzanso kuchuluka kwa renin komanso sikulepheretsa njira za ion. Zomwe zimagwiritsidwa ntchito sizimalepheretsa ACE (angiotensin-kutembenuza enzyme), yomwe imawononganso bradykinin, kotero sizotsatira zoyipa zomwe zimayambitsidwa ndi bradykinin zimadziwika.

Telmisartan, wotengedwa pa mlingo wa 80 mg, amatchinga kwathunthu matenda oopsa a angiotensin II. Pambuyo pa mlingo woyamba wa mankhwalawa kwa maola atatu, kumayambiriro kwa hypotgency zotsatira kumadziwika, zotsatira zake zimapitilira tsiku limodzi ndipo zimakhalabe zofunika kwa masiku awiri. Khola lodzikongoletsa nthawi zambiri limakhazikika pakatha milungu 4 mpaka 4 kuchokera pa chiyambi cha mankhwala.

Ndi ochepa matenda oopsa, mankhwalawa amathandizira kuchepetsa kuthamanga kwa magazi a systolic ndi diastolic (BP). Telmisartan ilibe vuto pa kugunda kwa mtima (kugunda kwa mtima).

Odwala omwe amachotsa telmisartan mwadzidzidzi, kuthamanga kwa magazi pang'onopang'ono kumabwereranso ku kufunika kwake koyambira, kudziwikanso kwa mankhwalawa sikumawonedwa.

Pharmacokinetics

mayamwidwe: ikailowetsedwa, imalowa mwachangu m'mimba. Bioavailability ndi 50%. Mukamamwa ndi chakudya, kuchepa kwa AUC (dera lomwe lili pansi pa pharmacokinetic pamapindikira) kumakhala kuchokera 6% mpaka 19% pa mlingo wa 40 ndi 160 mg, motsatana. Maola atatu atatha kutenga telmisartan, kuchuluka kwake m'magazi am'magazi (sikutengera nthawi yakudya). AUC ndi plasma yambiri ya zinthu (C_max) mwa azimayi amakhala pafupifupi 2 ndi 3 kuchulukitsa, motero, kuposa abambo. Panalibe zofunikira pakuchita bwino,
kugawa ndi kagayidwe: 99.5% ya zinthu zimagwirira kumapuloteni a plasma (makamaka alpha-1 glycoprotein ndi albin). Kuchulukitsa komwe kumawoneka pogawa ndende ndikufanana kwa 500 l. Metabolism imachitika mwa kulumikizana ndi glucuronic acid ndikupanga ma metabolac osachiritsika metabolites,
excretion: T_1/2 (kuchotsa theka-moyo) - oposa 20 maola. Thupi limapukusidwa mosasintha m'matumbo, mkodzo - wochepera 2%. Chilichonse chokwanira cha plasma ndichokwera kwambiri kuyerekeza ndi kuthamanga kwa magazi kwa hepatic (pafupifupi 1500 ml / min) ndipo pafupifupi 900 ml / min.

Magawo akuluakulu a pharmacokinetic a telmisartan akagwiritsidwa ntchito mwa ana ndi achinyamata a zaka zapakati pa 6 mpaka 18 kwa milungu 4 pamlingo wa 1 kapena 2 mg / kg nthawi zambiri amafanana ndi omwe ali m'magulu akuluakulu ndikutsimikizira ma pharmacokinetics osagwirizana ndi chinthu chomwe chikugwira, makamaka C_max.

Contraindication

mitundu yayikulu ya kusokonezeka kwa chiwindi (malinga ndi gulu la Mwana - Pugh - kalasi C),
bile duct chotchinga,
kuphatikiza ntchito ndi aliskiren mwa odwala omwe amalephera kwambiri kapena aimpso kulephera (kuchuluka kwa kusefedwa kwa minyewa zosakwana 60 ml / mphindi / 1.73 m 2) kapena ndi matenda a shuga.
lactase / sucrose / isomaltase akusowa, fructose tsankho, shuga-galactose malabsorption,
mimba ndi kuyamwa,
wazaka 18
Hypersensitivity payekha kwa telmisartan kapena chilichonse chothandiza cha mankhwalawa.

Achibale (matenda / mikhalidwe momwe kugwiritsira ntchito kwa Telmista kumafunikira kusamala):

aimpso kuwonongeka ndi / kapena chiwindi ntchito,
bilteryal aimpso mtsempha wamagazi kapena stenosis ya impso imodzi,
zinthu pambuyo pakuwonjezeka kwa impso (chifukwa cha kusazindikira kwa ntchito),
Hyperkalemia
hyponatremia,
kulephera kwa mtima
kuchepetsedwa kwa mavuvu kapena / kapena valavu yamitsempha,
GOKMP (hypertrophic obstriers cardiomyopathy),
kuchepa kwa bcc (kuchuluka kwa magazi ozungulira) chifukwa chamankhwala am'mbuyomu okodzetsa, kudya mchere wochepa, kusanza kapena kutsegula m'mimba,
chachikulu hyperaldosteronism (chitetezo ndi mphamvu sichinakhazikitsidwe).

Malangizo ogwiritsira ntchito Telmista: njira ndi mlingo

Mapiritsi a Telmist amatengedwa pakamwa, mosasamala nthawi yakudya.

Ndi ochepa matenda oopsa, tikulimbikitsidwa kuyamba kumwa 20 mg kapena 40 mg ya mankhwalawa kamodzi patsiku. Mwa odwala ena, ndizotheka kukwaniritsa hypotensive zotsatira za 20 mg / tsiku. Ngati osakwanira achire kwenikweni, mutha kuwonjezera mlingo waukulu tsiku lililonse wa 80 mg. Ndi kuchuluka kwa mankhwalawa, ziyenera kukumbukiridwa kuti kuchuluka kwapamwamba kwambiri kwa Telmista nthawi zambiri kumachitika pambuyo pa masabata 4-8 kuyambira pakuyamba kwa chithandizo.

Kuti muchepetse vuto la mtima ndi kufa, tikulimbikitsidwa kumwa mankhwalawa 80 mg 1 pa tsiku.

Pakumayambiriro kwa chithandizo, njira zowonjezerapo zamagazi zingafunike.

Sikoyenera kusintha mtundu wa odwala omwe ali ndi vuto la impso, kuphatikizanso omwe ali ndi hemodialysis.

Kwa chiwindi chobisalira ntchito yofatsa kapena yolimbitsa thupi (malinga ndi gulu la ana-Pugh - Gulu A ndi B), mlingo waukulu wa tsiku ndi tsiku wa Telmista ndi 40 mg.

Odwala okalamba, pharmacokinetics ya telmisartan sasintha, motero palibe chifukwa chosinthira mlingo wa mankhwalawo.

Zotsatira zoyipa

Mukamagwiritsa ntchito ma Telmists, zotsatirazi zotsatirazi zamagulu ndi ziwalo ndizotheka:

mtima: tachycardia, bradycardia,
Mitsempha yamagazi: orthostatic hypotension, kuchepa kwakukulu kwa kuthamanga kwa magazi,
kupukusa m'mimba: kupweteka kwam'mimba, kupweteka kwam'mimba, kukomoka, kusokonezeka m'mimba, kugona, kusanza, kupweteka kwamkamwa, kupweteka kwamkati pamlomo wamatumbo, matenda a chiwindi / matenda a chiwindi,
magazi ndi zamitsempha yamagazi: thrombocytopenia, eosinophilia, kuchepa magazi, sepsis (kuphatikizapo kupha sepsis),
mantha dongosolo: kusowa tulo, nkhawa, kukhumudwa, vertigo, kukomoka,
chitetezo chamthupi: hypersensitivity (urticaria, erythema, angioedema), anaphylactic zimachitika, pruritus, eczema, zotupa pakhungu (kuphatikizapo mankhwala), hyperhidrosis, angioedema (mpaka imfa), chotupa cha pakhungu.
mawonekedwe: masokonezo owoneka,
kupuma dongosolo, chifuwa ndi zam'mimba ziwalo: kutsokomola, kupuma movutikira, matenda amkati kupuma, matenda am'mapapo matenda (ubale wapagwiritsidwe ntchito kwa telmisartan sunakhazikitsidwe),
minofu ndi mafupa a minyewa: minyewa yam'mimba, arthralgia, minyewa yam'mimba (spasms ya minofu ya ng'ombe), myalgia, kupweteka kwa mwendo, kupweteka m'misempha (Zizindikiro zofanana ndi kufooka ndi kuwonongeka kwa minyewa ya tendon),
impso ndi kwamkodzo thirakiti: kuwonongeka kwaimpso ntchito (kuphatikizapo pachimake aimpso kulephera), matenda amkodzo thirakiti (kuphatikizapo cystitis),
thupi lonse: kufooka kwathunthu, matenda ofanana ndi chimfine, kupweteka pachifuwa,
othandizira ndi a labotale: kuwonjezeka kwa uric acid, creatinine m'madzi am'magazi, kuchepa kwa hemoglobin, kuchuluka kwa zochitika za hepatic transaminases, CPK (creatine phosphokinase) mu plasma ya magazi, hypoglycemia (odwala matenda a shuga mellitus), hyperkalemia.

Chiyanjano cha kuchuluka kwa mawonekedwe owonekera ndi zaka, jenda kapena mtundu wa odwala sichinakhazikitsidwe.

Malangizo apadera

Kugwiritsa ntchito nthawi yomweyo kwa Telmista ndi ACE zoletsa kapena inhibitor ya renin, aliskiren, chifukwa chakuchita kawiri pa RAAS (renin-angiotensin-aldosterone system) kumawonjezera kugwira ntchito kwa impso (kuphatikizapo kungayambitse kulephera kwa impso), komanso kumawonjezera chiopsezo cha hypotension ndi hyperkalemia . Ngati chithandizo cholandirachi ndichofunika kwambiri, chikuyenera kuchitika moyang'aniridwa ndi achipatala, komanso ngati mumayang'ananso ntchito ya impso, kuthamanga kwa magazi komanso kuchuluka kwa ma electrolyte m'madzi a m'magazi.

Odwala odwala matenda ashuga nephropathy, telmisartan ndi ACE zoletsa sizabwino.

Mu milandu yomwe mtima wamatumbo ndi impso zimadalira ntchito ya RAAS (mwachitsanzo, odwala omwe ali ndi matenda a impso, kuphatikizapo kuphatikizika kwa impso kapena stenosis ya mtsempha wama impso, kapena ndi vuto la mtima), kugwiritsa ntchito mankhwala omwe amakhudza RAAS kungayambitse kukula kwa hyperazotemia, pachimake ochepa hypotension, oliguria ndi pachimake aimpso kulephera (nthawi zina).

Mukamagwiritsa ntchito potaziyamu osagwiritsa ntchito mankhwala a potaziyamu, mchere wotsekemera wokhala ndi potaziyamu, mankhwala ena othandizira komanso mankhwala ena omwe amalimbikitsa kuchuluka kwa potaziyamu m'madzi a m'magazi limodzi ndi Telmista, ndikofunikira kuwongolera potaziyamu m'magazi.

Popeza telmisartan amachotseredwa ndi ndulu, ndimatenda ofooketsa a biliary thirakiti kapena ntchito ya chiwindi, kuchepa kwa chidziwitso cha mankhwalawa ndikotheka.

Ndi matenda a shuga ndi chiwopsezo chowonjezera cha mtima, mwachitsanzo, matenda a mtima (matenda a mtima), kugwiritsidwa ntchito kwa Telmista kungayambitse kuphedwa kwa myocardial infarction ndi kufa mwadzidzidzi kwamtima. Odwala omwe ali ndi matenda a shuga, matenda am'mitima ya coronary sangawonekere, chifukwa nthawi zambiri matendawa amapezeka. Chifukwa chake, musanayambe mankhwala osokoneza bongo, ndikofunikira kuchita mayeso oyenerera, kuphatikiza kuyesedwa kochita masewera olimbitsa thupi.

Odwala omwe ali ndi matenda a shuga amalandila mankhwala a insulin kapena pakamwa a hypoglycemic, hypoglycemia imatha kuchitika pakubwera ndi Telmista. Odwala otere amafunika kuwongolera kuchuluka kwa shuga m'magazi, chifukwa malinga ndi chizindikiro ichi, mankhwala a insulin kapena hypoglycemic ayenera kusintha.

Mu hyperaldosteronism yoyamba, kugwiritsa ntchito mankhwala a antihypertensive - RAAS inhibitors - nthawi zambiri sagwira ntchito. Odwala oterewa saloledwa kutenga Telmista.

Kugwiritsira ntchito mankhwalawa ndizotheka pamodzi ndi thiazide diuretics, popeza kuphatikiza koteroko kumapereka kuchepa kwa kuthamanga kwa magazi.

Kafukufuku akuwonetsa kuti Telmista sili yothandiza kwambiri kwa odwala a liwiro la Negroid. Kuchuluka kwa chiwindi pogwiritsa ntchito telmisartan kumaonekera kwambiri pakati pa anthu okhala ku Japan.

Mimba komanso kuyamwa

Malinga ndi malangizo, Telmista imapangidwa nthawi yapakati. Pofuna kuzindikira kuti ali ndi pakati, mankhwalawa amayenera kuyimitsidwa nthawi yomweyo. Ngati ndi kotheka, mankhwala a antihypertensive amakalasi ena omwe amavomerezedwa kuti agwiritsidwe ntchito pa nthawi ya pakati ayenera kufotokozedwa. Amayi omwe akukonzekera kukhala ndi pakati amalangizidwanso kuti agwiritse ntchito njira zina.

Mu maphunziro oyamba a mankhwalawa, zotsatira za teratogenic sizinapezeke. Koma kunapezeka kuti kugwiritsa ntchito angiotensin II receptor antagonists mu wachiwiri ndi wachitatu wozungulira matendawa kumayambitsa fetotoxicity (oligohydramnios, kuchepa kwa impso, kuchepa kwa mafupa a mafupa a chigaza cha chifuwa) ndi neonatal toxicity (ochepa hypotension, renal kulephera, hyperkalemia).

Makanda obadwa kumene omwe amayi awo adatenga Telmista panthawi yoyembekezera amafunika kuyang'aniridwa ndi achipatala chifukwa chotheka cha kusintha kwa ubongo.

Popeza palibe chidziwitso chokhudza kulowa kwa telmisartan mkaka wa m'mawere, mankhwalawa amatsutsana panthawi yoyamwitsa.

Ndi chiwindi ntchito

Sichikulimbikitsidwa kumwa mankhwalawa odwala omwe ali ndi vuto la chiwindi kwambiri (malinga ndi gulu la ana-Pugh - gulu C).

Ndi kufatsa pang'ono kwa hepatic kosakwanira (malinga ndi gulu la ana-Pugh - Gulu A ndi B), kugwiritsa ntchito kwa Telmista kumafuna kusamala. Mulingo woyenera wa tsiku lililonse wa mankhwalawa sayenera kupitirira 40 mg.

Kuyanjana kwa mankhwala osokoneza bongo

Kugwiritsidwa ntchito kwa telmisartan nthawi yomweyo ndi mankhwala ena kumatha kubweretsa zotsatirazi:

antihypertensive mankhwala: antihypertensive zotsatira,
warfarin, digoxin, ibuprofen, glibenclamide, hydrochlorothiazide, paracetamol, amlodipine ndi simvastatin: palibe mgwirizano wachipatala womwe unawonedwa. Nthawi zina, kuchuluka kwa plasma digoxin ndi pafupifupi 20% ndikotheka. Tikaphatikizidwa ndi digoxin, timalimbikitsidwa kuyang'anira momwe plasma ikuyendera,
potaziyamu yosalekerera okodzetsa (mwachitsanzo, spironolactone, amiloride, triamteren, eplerenone), potaziyamu, ACE inhibitors, angiotensin II receptor antagonists, NSAIDs (non-steroidal anti-kutupa), kuphatikiza kusankha cycloogesiase-hemporinphopin -phumpin -phumpin -phumpin -phampini-hepulini-2phin -phumpin -phampini-hepulini ndi trimethoprim: chiwopsezo cha hyperkalemia (chifukwa cha synergistic zotsatira),
ramipril: kuwonjezeka kwa zowonetsa za C-2_max ndi AUC_0-24 ramipril ndi ramiprilat,
Kukonzekera kwa lithiamu: kuwonjezereka kosinthika kwa kuchuluka kwa lithiamu m'madzi a m'magazi (anenedwapo nthawi zina) ndi kuphatikiza poizoni. Ndikulimbikitsidwa kuti nthawi ndi nthawi muziwonetsetsa kuchuluka kwa madzi a plamu,
NSAIDs (kuphatikizapo acetylsalicylic acid, NSAIDs osasankhidwa ndi cycloo oxygenase-2 inhibitors): kuchepetsa kuchepa kwa mphamvu ya telmisartan, kuonjezera ngozi yakulephera kwaimpso pachakudya. Kumayambiriro kwa kuphatikiza mankhwala ndi telmisartan ndi NSAIDs, ndikofunikira kulipiritsa bcc ndikuwunika ntchito ya impso,
amifostine, baclofen: mphamvu ya hypotensive zotsatira za telmisartan,
barbiturates, mowa, antidepressants ndi mankhwala osokoneza bongo: kuchuluka kwa orthostatic hypotension.

Mafanizo a Telmista ndi awa: Mikardis, Teseo, Telmisartan-Richter, Telmisartan-SZ, Telpres, Telsartan ndi ena.

Mlingo

Piritsi limodzi lili

Telmista®H40

ntchito: Telmisartan 40mg

hydrochlorothiazide 12,5 mg

zokopa: meglumine, sodium hydroxide, povidone K30, lactose monohydrate, sorbitol, magnesium stearate, mannitol, iron oxide red (E172), hydroxypropyl cellulose, anhydrous colloidal silicon dioxide, sodium stearyl fumarate

Telmista®H80

ntchito: Telmisartan 80mg

hydrochlorothiazide 12,5 mg

Telmista®ND 80

ntchito: telmisartan 80 mg

hydrochlorothiazide 25 mg

zokopa: meglumine, sodium hydroxide, povidone K30, lactose monohydrate, sorbitol, magnesium stearate, mannitol, iron oxide chikasu (E172) hydroxypropyl cellulose, anhydrous colloidal silicon dioxide, sodium stearyl fumarate

Mapiritsi Oval, biconvex, bilayer, kuyambira oyera mpaka oyera kapena ofiira oyera pamtunda mbali imodzi ndi pinki-marble kumbali ina (pamiyeso ya 40 mg / 12.5 mg ndi 80 mg / 12.5 mg).

Mapiritsiwo ndi oval, biconvex, awiri-wosanjikiza, kuyambira yoyera mpaka yoyera kumbali imodzi ndi mandala achikasu kumbali ina (kwa mulingo wa 80 mg / 25 mg).

Mankhwala

Pharmacokinetics

Kuchuluka kwa telmisartan ndi pakamwa makonzedwe kumatheka pambuyo 0,5-1.5 mawola. Mtheradi bioavailability wa telmisartan mu Mlingo wa 40 mg ndi 160 mg anali 42% ndi 58%, motero. Zakudya zomwezi munthawi yomweyo sizimachepetsa kukhudzana kwa telmisartan, kuchepetsa dera lomwe latsalira ndi kuchuluka kwa mankhwalawa m'magazi am'magazi (AUC) pafupifupi 6% mutatenga 40 mg komanso pafupifupi 19% mutatenga 160 mg. Kutsika pang'ono kwa ndende sikumakhudza kuchiritsa kwa mankhwalawa. Ma pharmacokinetics a telmisartan akaperekedwa pakamwa Mlingo wa 20-160 mg ndi nonlinear, Cmax ndi AUC motere amawonjezeka ndi kuchuluka kwa mankhwala. Pogwiritsa ntchito mobwerezabwereza, telmisartan imasonkhana pang'ono m'madzi a m'magazi.

Telmisartan imamanga bwino mapuloteni a plasma (> 99.5%), makamaka a albumin ndi alpha L-acid glycoproteins. Kuchuluka kwa kugawa kwa telmisartan kuli pafupifupi 500 L, komwe kumawonetsera zowonjezera zazingwe.

Kuposa 97% ya mankhwalawa akaperekedwa pakamwa amachotsera ndowe ndi biliary excretion. Zovuta zimapezeka mkodzo. Telmisartan imapangidwa ndi kuphatikizika kwa metabolacologic yogwira metabolites - acetyl glucuronides. Glucuronides ndi metabolites okhawo azinthu zoyambira zomwe amapezeka mwa anthu.

Patatha kamodzi muyezo wa telmisartan, zomwe zimakhala m'magazi a m'magazi zinali pafupifupi 11%. Telmisartan sikuti imapangidwa ndi isoenzymes ya cytochrome P450 system. Kuchuluka kwa madzi a m'magazi ndi oposa 1500 ml / min. The theka theka moyo wopitilira maola 20

Ndi pakamwa makonzedwe osakanikirana a telmisartan / hydrochlorothiazide, pachimake ndende ya hydrochlorothiazide imafikiridwa mu 1,3.0.0 mawola atakhazikitsa. Poganizira kuti hydrochlorothiazide imatha kudziunjikira panthawi ya impso, kuchotsa kwathunthu ndi 60%.

Hydrochlorothiazide ndi 68% yomanga mapuloteni a plasma ndipo kuchuluka kwake kogawika ndi 0.83-1.14 l / kg.

Hydrochlorothiazide siinapangidwe ndipo imangotsala pang'onong'ono pomwe kudzera mu impso. Pafupifupi 60% ya mankhwala amkamwa amachotsedwa pakapita maola 8

Moyo wothera theka la hydrochlorothiazide ndi maola 10-15.

Mankhwala

Kuphatikiza kosasinthika kwa telmisartan / hydrochlorothiazide ndi kuphatikiza kwa angiotensin II receptor antagonist, telmisartan ndi thiazide diuretic, hydrochlorothiazide, yomwe imapereka mulingo wapamwamba wa antihypertensive kwambiri kuposa kutenga gawo lililonse palokha. Mukamamwa kuphatikiza telmisartan / hydrochlorothiazide kamodzi patsiku, kuchepa kwamphamvu kwa kuthamanga kwa magazi mkati mwa njira ya achire kumatsimikiziridwa.

Telmisartan Kugwirira ntchito pakamwa ndipo ndi kotsutsa (kosankha) kotsutsana ndi angiotensin II receptor subtype 1 (AT1). Telmisartan ilowa m'malo mwa angiotensin II, popeza ili ndi mgwirizano wapamwamba wa receptors wa AT1 pamalo omangira, omwe amayang'anira zotsatira zokhazikitsidwa ndi angiotensin II. Telmisartan mokakamira komanso mosalekeza imamangirira ku AT1 receptors ndipo ilibe chiyanjano ndi zolandilira zina, kuphatikizapo AT2 ndi ma receptors ena a AT. Udindo wogwira wa ma receptor awa sunakhazikitsidwe, komanso zotsatira zake pakuchitika kwa vuto la angiotensin II, lomwe limawonjezeka mothandizidwa ndi telmisartan. Telmisartan amachepetsa plasma aldosterone misempha ndipo samalepheretsa zochitika za angiotensin-kutembenuza enzyme (kininase II), ndi kutenga nawo gawo komwe kumachepa kaphatikizidwe ka bradykinin, kotero kutha kwa zovuta za bradykinin sikuchitika.

Kuletsa kwa angiotensin II motsutsana ndi maziko a telmisartan kumatha kuposa maola 24 ndipo kumatenga maola 48.

Pambuyo pa kutenga telmisartan, ntchito za antihypertensive zimatheka mkati mwa maola atatu. Kutsika kwakukulu kwa kuthamanga kwa magazi nthawi zambiri kumachitika masabata 4-8 pambuyo poyambira chithandizo ndikupitiliza nthawi yayitali. Mphamvu ya antihypertensive imasungidwa kosalekeza kwa maola 24.

Odwala omwe ali ndi matenda oopsa, telmisartan imachepetsa kuthamanga kwa magazi kwa systolic ndi diastolic popanda kukhudza kugunda kwa mtima.

Ndi kusiyiratu kulandira chithandizo ndi telmisartan, kuthamanga kwa magazi pang'onopang'ono kumabwereranso m'masiku angapo popanda chitukuko cha "rebound syndrome" (kuwonjezereka kwa kuthamanga kwa magazi).

Thiazides amakhudza kubwezeretsanso kwa ma electrolyte m'matumbo a impso, kuwonjezera mwachindunji kutulutsa kwa sodium ndi chloride pafupifupi kuchuluka kofanana. Mphamvu ya diuretic ya hydrochlorothiazide imabweretsa kuchepa kwa magazi am'magazi, kuwonjezeka kwa plasma renin, kuwonjezeka kwa secretion ya aldosterone, yomwe imathandizira kuwonjezeka kwamkodzo wa potaziyamu ndi bicarbonates, motero, kuchepa kwa seramu potaziyamu. Kubwezeretsa kwa renin-angiotensin kwa dongosolo la aldosterone limodzi ndi telmisartan yophatikizika ndi diuretics kumabweretsa kutaya kwamphamvu kwa potaziyamu ndi thupi. Mukamwa hydrochlorothiazide, diuresis imayamba pambuyo 2 maola, pazipita diuretic zotsatira zimatheka pambuyo maola 4 pambuyo makonzedwe, kanthu kumatenga 6-12 maola.

Zizindikiro zogwiritsidwa ntchito

- mankhwala a ochepa matenda oopsa

Telmista®H40 ndi Telmista®H80 akuwonetsedwa kwa odwala omwe ndizosatheka kuwongolera kuthamanga kwa magazi pogwiritsa ntchito telmisartan kapena hydrochlorothiazide mwanjira ya monotherapy.

Telmista® ND80 imawonetsedwa kwa odwala akuluakulu omwe sangathe kuwongolera kuthamanga kwa magazi pogwiritsa ntchito Telmista® N80 kapena omwe kupanikizika kwake kudakhazikitsidwa kale pogwiritsa ntchito telmisartan ndi hydrochlorothiazide padera.

Mlingo ndi makonzedwe

Telmista®N40, Telmista®N80 kapena Telmista®ND80 ikuyenera kugwiritsidwa ntchito kamodzi patsiku, kutsukidwa ndi madzi pang'ono, mosasamala kanthu za chakudya.

Pamaso mankhwala ndi telmisartan / hydrochlorothiazide ayenera kuchitidwa

kusankha mlingo pa maziko a monotherapy ndi telmisartan. Ngati ndi kotheka, mutha kusintha pomwepo kuchokera ku monotherapy kupita kuchipatala pamodzi ndi kuphatikiza Mlingo wa mankhwala.

Telmista®H40 ikhoza kutumizidwa kwa odwala omwe kuthamanga kwa magazi sikulamulidwa mokwanira ndi telmisartan 40 mg.

Telmista ® H80 ikhoza kuperekedwa kwa odwala omwe kuthamanga kwa magazi sikuwongolera mokwanira ndi 80 mg telmisartan.

Telmista® ND80 ikhoza kuperekedwa kwa odwala omwe kuthamanga kwa magazi sikuwongolera mokwanira ndi Telmista® N80 kapena omwe kupanikizika kwake kudakhazikitsidwa kale pogwiritsa ntchito telmisartan ndi hydrochlorothiazide padera.

Pambuyo pakuyamba chithandizo ndi kuphatikiza kwa telmisartan / hydrochlorothiazide, mphamvu ya antihypertensive kwambiri imatheka mkati mwa masabata oyamba a 4-8. Ngati ndi kotheka, Telmista®H40, Telmista®H80 kapena Telmista®ND80 ingathe kutumizidwa limodzi ndi mankhwala ena a antihypertensive.

Odwala omwe ali ndi vuto la impso

Kuwunikira pafupipafupi kwa aimpso ndikofunikira.

Odwala omwe ali ndi vuto la chiwindi

Odwala omwe ali ndi kuchepa pang'ono kwa chiwindi, chiwindi sayenera kupitirira 1 piritsi Telmista®N40 (telmisartan 40 / hydrochlorothiazide 12.5 mg) kamodzi patsiku.

Palibe kusintha kwa mlingo kumene kwa odwala okalamba.

Zotsatira za pharmacological

Mapiritsi a Telmista - mankhwala othandiza pakukakamiza, ali ndi mtengo wotsika mtengo.

Chochita chake chikufuna kuthana ndi ma receptors a mtundu wa AT1, pomwe sichikhudza mitundu ina ya ma receptors.

Kwambiri hypotensive zotsatira za kutenga Telmista amawonedwa patatha mwezi umodzi, zomwe zikusonyeza kuchuluka kwa zotsatira za mankhwala.

Mphamvu za mankhwalawa zimachokera pa kuphatikiza kwa telmisartan ndi hydrochlorothiazide chinthu, chomwe ndi diuretic. Mankhwala ndi mtundu wosankha wotsutsana ndi zomwe angiotensin ii. Gawo lomwe limagwiritsa ntchito mankhwalawa limayanjana ndi AT1 receptor.

Mankhwala amachepetsa kuchuluka kwa aldosterone m'madzi a m'magazi. Mankhwala amachepetsa kuchuluka kwa aldosterone m'madzi a m'magazi. Palibe cholepheretsa mayendedwe a ion ndi renin. Mphamvu yolepheretsa zinthu za kininase II, zomwe zimachepera bradykinin, sizipezekanso.

Ndi magazi ati omwe ndiyenera kutenga?

Kuti muchepetse kuthamanga kwa magazi, 40 mg Telmista ndi mankhwala tsiku lililonse. Odwala ena, ngakhale ndi 20 mg 20 mg tsiku lililonse, zotsatira zokwanira zimatheka. Ngati kuchepetsa kufalikira kwa magazi sikukwaniritsidwa, dokotala akhoza kuwonjezera mlingo mpaka 80 mg patsiku.

Mankhwalawa amatha kuperekedwa limodzi ndi wothandizila kupha madzi m'gulu la thiazide (mwachitsanzo, hydrochlorothiazide). Mlingo uliwonse usanonjezeke, dokotala amayembekeza milungu inayi mpaka isanu ndi itatu, kuyambira pamenepo mphamvu ya mankhwalawo imawonetsedwa.

Pofuna kupewa kuwonongeka kwa mtima m'masiku omwe analipo, mlingo woyenera wa 80 mg wa telmisartan kamodzi patsiku. Kumayambiriro kwa chithandizo, kuwongolera pafupipafupi magazi kumalimbikitsa. Ngati ndi kotheka, dokotala amasintha mlingo kuti akwaniritse kutsata kwa magazi. Mapiritsi akulimbikitsidwa kuti amwe ndi madzi kapena osasamala zakudya.

Telmista H80

Mankhwala amatengedwa pakamwa 1 nthawi / tsiku, ngakhale kudya. Mapiritsi ayenera kutsukidwa ndi madzi pang'ono.

Telmista H80 ingathe kutumizidwa kwa odwala omwe kugwiritsa ntchito telmisartan muyezo wa 80 mg sikungayambitse kuyendetsa bwino magazi.

Werengani inenso nkhaniyi: Lasix: 40 mg mapiritsi ndi jakisoni

Asanayambe chithandizo, kusankha kwa mankhwalawa kuyenera kuchitidwa motsutsana ndi telmisartan monotherapy. Ngati ndi kotheka, mutha kusintha pang'onopang'ono kuchokera pa telmisartan monotherapy kukhala chithandizo ndi Telmista H80.

Ngati ndi kotheka, mankhwalawa amatha kuikidwa limodzi ndi mankhwala ena a antihypertensive.

Zotsatira zoyipa

Kugwiritsa ntchito kwa Telmista, monga mankhwala ena a antihypertensive, kumatha kubweretsa zotsatirapo zosiyanasiyana zoyipa kwa thupi.

Pakati pazotsatira zoyipa, malangizo ogwiritsira ntchito kusiyanitsa otsatirawa:

kuphwanya impso ndi kwamikodzo dongosolo,
fuluwenza limodzi ndi malungo
chifuwa, matenda opatsirana am'munsi komanso m'munsi mwa kupuma, kufupika,
kusakhazikika kwa zida zowonekera,
matenda a mtima, komwe tachycardia ndi bradycardia amaonekera,
kusokonezeka kwa m'mimba ndi matumbo, omwe amawonetsedwa ndi matenda am'mimba, nseru, ululu wosakhazikika komanso kukokana,
kukomoka, kusokoneza tulo, ulesi,
Hypersensitivity ku mphamvu zakunja zosiyanasiyana, zomwe zimadziwonetsa mu kuyimitsidwa kwa khungu ndi urticaria, anaphylactic mantha ndi hyperhidrosis,
kuchepa kwa magazi komanso kuopseza matenda oopsa a sepsis,
zotsatira zoyipa za kafukufuku wa zasayansi wodwala, wopangidwa ndi kuchuluka kwa uric acid, creatinine m'magazi, hypoglycemia ndi kuchepa kwambiri kwa hemoglobin.

Zina mwazotsatira izi zimatha kukhala nokha kapena kuphatikiza ndi zina. Kwa zizindikiro zokayikitsa, chisamaliro chamankhwala chofunikira chimafunikira kuti akonze dongosolo la mankhwalawo.

Ana, pa mimba ndi mkaka wa m`mawere

Kutetezeka ndi kugwiritsa ntchito bwino kwa telmisartan mwa ana sichinakhazikitsidwe, chifukwa chake mapiritsi a Telmista 40 mg, 80 mg ndi 20 mg sayenera kulembedwa kwa ana ndi achinyamata osakwana zaka 18.

Malinga ndi malangizo, Telmista imapangidwa nthawi yapakati. Pofuna kuzindikira kuti ali ndi pakati, mankhwalawa amayenera kuyimitsidwa nthawi yomweyo.

Popeza palibe chidziwitso chokhudza kulowa kwa telmisartan mkaka wa m'mawere, mankhwalawa amatsutsana panthawi yoyamwitsa.