Telmisartan (Mikardis)

Kufotokozera kogwirizana ndi 04.11.2016

• Dzina lachi Latin: Telmisartan
• Code ya ATX: C09CA07
• Chithandizo: Telmisartan (Telmisartan)
• Wopanga: Bungwe la mankhwala a TEVA, JSC la Ratiopharm International GmbH, Hungary / Germany

Kutengera mtundu wa kumasulidwa, piritsi limodzi lili ndi 80 kapena 40 mg ya chinthu chomwe chikugwira ntchito.

Mankhwala

Telmisartan ndi osankha angiotensin II receptor antagonist. Imachita mpikisano ndi angiotensin womangiriza ku AT1 receptors. Palibe kuyanjana ndi zolandirira ena komwe kudadziwika.

Telmisartan sikuletsa ntchito ya renin, ACE, siimaletsa njira zomwe zikuyendetsa ma ions, zimachepetsa zomwe zili aldosterone mu magazi.

Mlingo wa 80 mg pafupifupi umathetsa kuchuluka konse kuthamanga kwa magazichifukwa cha angiotensin II. Kuchuluka kwake kumatenga maola 24, ndiye kumayamba kuchepa. Pankhaniyi, kuchuluka kwa mankhwalawa kumamveka pafupifupi maola 48 mutatha kumwa mapiritsi.

Telmisartan imachepetsa mayesero onse a systolic ndi diastolic, koma sizimakhudza kugunda kwa mtima. Palibe vuto lililonse pakukonda kapena kudziwika kwakuthupi m'thupi.

Pharmacokinetics

Pambuyo pakulowetsa, mankhwalawo amakhala bwino ndikuwamwa msanga. Bioavailability pafupifupi 50%. Amamangidwa bwino kwambiri ndi mapuloteni a plasma.

Kuchuluka kwa plasma ndende nthawi zambiri kumakhala kwakukulu mwa azimayi akamamwa Mlingo womwewo. Koma izi sizikhudza kutha.

Kupenda amapezeka m'chiwindi. Izi zimakhala zopanda ntchito metaboliteKuchotsa komwe kumachitika makamaka m'matumbo. Hafu ya moyo wa thupi ili pafupifupi maora 20.

Zizindikiro zogwiritsidwa ntchito

Amagwiritsidwa ntchito pochiza ochepa matenda oopsa komanso kupewa kutetezedwa ndi matenda a mtima pambuyo sitiroko, vuto la mtimazotumphukira mtima matenda lamanzere lamitsempha lamanzere.

Contraindication

Sizoletsedwa kupereka Telmisartan ndi:

• Matenda oletsa kupezeka m'mimba,
• kwambiri kulephera kwa chiwindi,
• choyambirira aldosteronism,
• fructose tsankho,
• kumva kwambiri zomwe zimagwiritsidwa ntchito kapena china chilichonse chomwe ndi gawo la mankhwalawo.
• wa mimba,
• wosakwana zaka 18.

Zotsatira zoyipa

Zotsatira zoyipa ndizochepa.

Mmodzi mwa odwala 100-1000 omwe amamwa mankhwalawa ali ndi zizindikiro zotsatirazi:

Mu 1 mwa 1000-10000 odwala adati:

• matenda amkodzo ndi kupuma (cystitis, pharyngitis, sinusitis) kapena sepsis,
• thrombocytopenia,
• kuchepetsa magazi hemoglobin,
• kumverera kwa nkhawa
• zosokoneza zowoneka
• tachycardia,
• dontho la kuthamanga kwa magazi posintha maonekedwe a thupi (kuchokera kumanzere kupita pamzere),
• kusasangalala m'mimba
• kamwa yowuma
• chiwindi ntchito,
• kuchuluka kwa chiwindi michere,
• kuchuluka kwa plasma ndende ya uric acid,
• kupweteka kwa molumikizana
• erythema,
• angioedema,
• zotupa zoyipa,
• zotupa zotupa.

Zotsatira zoyipa zomwe sizisowa kwenikweni kapena momwe ma frequency ake sangadziwike chimodzimodzi:

• kupweteka kwa tendon ofanana tendonitis,
• kuchuluka kwa eosinophils m'magazi.

Kuchita

Kugwirizana kwa Telmisartan ndi mankhwala ena:

• Baclofen, Amifostine ndi othandizira ena antihypertgency - zotsatira za hypotensive zimatheka,
• barbiturates, mankhwala a narcotic, ethanol ndi antidepressants - mawonekedwe a orthostatic hypotension amawonjezeredwa kapena chiwopsezo chake chimawonjezeka,
• Furosemide, Hydrochlorothiazide ndi okodzetsa ena - zotsatirazi zimawonjezera,
• Digoxin - kuchuluka ndende Digoxin mu plasma
• Kukonzekera kwa lithiamu - kuwonjezereka kosinthika kwa kuchuluka kwa lithiamu m'magazi, kuyang'anira chidziwitso ichi ndikofunikira,
• NSAIDs - chiopsezo cha zizindikiro zowopsa chikuchulukirachulukira kulephera kwa aimpsomakamaka ndi kusowa kwamadzi
• potaziyamu wothandiza okodzetsa, potaziyamu, Heparin, Cyclosporin, Tacrolimus, Trimethoprim - kuchuluka kwa potaziyamu mu seramu yamagazi,
• GCS - mphamvu ya antihypertgency yafupika,
• Amlodipine - Kugwira ntchito kwa Telmisartan kukukulira.

Zotsatira za pharmacological

Angiotensin II receptor antagonist.

Telmisartan ndi wotsutsa winawake wa angiotensin II receptors. Ili ndi kuyanjana kwakukulu kwa AT1 receptor subtype ya angiotensin II, kudzera momwe zochita za angiotensin II zimadziwika. Telmisartan imasamutsa angiotensin II kuchokera kumangiriza kwake kwa receptor, ikusowa chochita cha agonist mogwirizana ndi cholandilira ichi. Telmisartan amangomanga ku AT1 receptor subtype ya angiotensin II. Kulumikizana ndikupitilira. Telmisartan ilibe chiyanjano ndi ma receptors ena (kuphatikizapo AT2 receptors) ndi zina zochepa zomwe zimaphunzitsidwa ndi angiotensin receptors. Kufunika kwa magwiridwe antchito izi, komanso momwe zimakhalira ndikulimbikitsa kwambiri ndi angiotensin II, kuphatikiza komwe kumawonjezeka poika telmisartan, sikunaphunzire. Amachepetsa kuchuluka kwa aldosterone m'magazi, sikuletsa renin m'magazi am'magazi ndipo saletsa njira za ion, sikuletsa ACE (kininase II, enzyme yomwe imawonongeranso bradykinin). Chifukwa chake, kuwonjezeka kwa zoyipa zoyambitsidwa ndi bradykinin sikuyembekezeredwa.

Telmisartan pa mlingo wa 80 mg kwathunthu limatchinga matenda oopsa a angiotensin II. Kuyamba kwa hypotensive kanthu kumadziwika mkati mwa maola atatu itatha konzedwe ka telmisartan. Mphamvu ya mankhwalawa imatha kwa maola 24 ndipo imakhalabe yofunikira mpaka maola 48. Kutchulidwa kotsimikizika kwa mankhwalawa kumachitika pakatha masabata 4-8 pambuyo pakudya pafupipafupi.

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

Pankhani ya telmisartan yadzidzidzi, kuthamanga kwa magazi pang'onopang'ono kumabwereranso ku msana wake popanda kusintha kwa matenda obwera nawo.

Mlingo ndi makonzedwe

Mankhwala ndi mankhwala pakamwa, ngakhale kudya zakudya.

Ndi ochepa matenda oopsa, woyamba kumwa mankhwala ndi piritsi limodzi 40 mg kamodzi patsiku. Muzochitika zomwe achire samakwaniritsa, mlingo umakhala wokwanira 80 mg kamodzi patsiku. Mukafuna kudziwa kuchuluka kwa mankhwalawa, ziyenera kukumbukiridwa kuti mphamvu yayitali kwambiri ya antihypertgency nthawi zambiri imatheka mkati mwa masabata 4-8 pambuyo poyambira chithandizo.

Kuchepetsa kuchepa kwa matenda a mtima ndi kufa, mlingo womwe umalimbikitsidwa ndi piritsi limodzi (80 mg) kamodzi patsiku. Mu nthawi yoyamba ya chithandizo, kuwongolera kowonjezereka kwa magazi kungafunike.

Odwala omwe ali ndi vuto la aimpso (kuphatikizapo omwe ali ndi hemodialysis), odwala okalamba, kusintha kwa mankhwalawa sikofunikira.

Odwala omwe ali ndi chiwindi chochepa komanso chochepa zolimbitsa thupi (kalasi A ndi B pa kukula kwa Mwana), mlingo wa tsiku ndi tsiku sayenera kupitilira 40 mg.

Zotsatira zoyipa

Milandu yomwe idawonedwako idakhudzana ndi chikhalidwe, zaka kapena mtundu wa odwala.

Matenda: sepsis, kuphatikizapo kupha sepsis, matenda amkodzo thirakiti (kuphatikizapo cystitis), matenda am'mimba opatsirana kudzera m'mapapo.

Kuchokera ku hemopoietic dongosolo: kuchepa kwa hemoglobin, kuchepa magazi, eosinophilia, thrombocytopenia.

Kuchokera kumbali ya chapakati mantha dongosolo: kusowa tulo, nkhawa, kukhumudwa, chizungulire.

Kuchokera pamtima dongosolo: kuchepa kwa kuthamanga kwa magazi (kuphatikizapo orthostatic hypotension), bradycardia, tachycardia, kukomoka.

Kuchokera pakapumidwe: kufupika.

Kuchokera pamiyambo ya chakudya: mkamwa youma, kuphwasuka, kusokonezeka m'mimba, kusanza, kutsegula m'mimba, kupweteka kwam'mimba, kuphwanya chiwindi, kuwonjezeka kwa ntchito ya hepatic transaminases.

Kuchokera kwamikodzo dongosolo: mkhutu aimpso ntchito (kuphatikizapo pachimake aimpso kulephera), zotumphukira edema, hypercreatininemia.

Kuchokera ku minculoskeletal system: arthralgia, kupweteka kwa msana, kupindika kwa minofu (kukokana kwa minofu ya ng'ombe), kupweteka m'munsi, myalgia, kupweteka kwa tendons (Zizindikiro zofanana ndi mawonekedwe a tendonitis), kupweteka pachifuwa.

Thupi lawo siligwirizana: anaphylactic zimachitika, hypersensitivity zimachitikira yogwira mankhwala kapena wothandiza zigawo za mankhwala, angioedema, chikanga, erythema, kuyabwa pakhungu, kuphatikizapo mankhwala), urticaria, poizoni.

Zizindikiro zasayansi: hyperuricemia, kuchuluka kwa magazi a CPK, hyperkalemia.

Zina: hyperhidrosis, syndrome ngati chimfine, kuwonongeka kwa mawonekedwe, asthenia (kufooka).

Kugwiritsa ntchito kwa mankhwala a MIKARDIS® pa nthawi ya pakati komanso mkaka wa m`mawere

Mikardis ® imaphatikizidwa mu mimba ndi mkaka wa m`mawere.

Ndi mimba yomwe yakonzedwa, Mikardis ® iyenera kusinthidwa ndi mankhwala ena a antihypertensive. Mimba ikakhazikitsidwa, Mikardis iyenera kusiyidwa posachedwa.

M'maphunziro a preclinical, palibe teratogenic wa mankhwalawa omwe adapezeka, koma zotsatira za fetotoxic zidadziwika.

Malangizo apadera

Odwala ena, chifukwa cha kuponderezedwa kwa RAAS, makamaka akamagwiritsa ntchito mankhwala osakanikirana ndi dongosololi, ntchito yaimpso (kuphatikizapo kuperewera kwaimpso) imalephera. Chifukwa chake, mankhwalawa omwe amaphatikizidwa ndi magawo awiri amtundu wa RAAS amayenera kuchitidwa mosamalitsa komanso kuwunikira ntchito yaimpso (kuphatikiza kuwunika kwa serum potaziyamu ndi ma protein a creatinine).

Pankhani yodalira mtima kamvekedwe ka minyewa ndi ntchito yaimpso makamaka pantchito ya RAAS (mwachitsanzo, odwala omwe ali ndi vuto la mtima, kapena matenda a impso, kuphatikizanso ndi aimpso a stenosis kapena artery stenosis a impso imodzi), kusankha mankhwala omwe amakhudza dongosolo lino. akhoza limodzi ndi chitukuko cha pachimake ochepa hypotension, hyperazotemia, oliguria, ndipo, kawirikawiri, kulephera kwambiri aimpso.

Kutengera ndi luso logwiritsa ntchito mankhwala ena omwe amakhudza RAAS, kugwiritsa ntchito limodzi kwa Mikardis ® ndi potaziyamu-osasamala okodzetsa, zina za potaziyamu, mchere wokhala ndi potaziyamu, ndi mankhwala ena omwe amachititsa kuchuluka kwa potaziyamu m'magazi (mwachitsanzo, heparin), chizindikirochi chikuyenera kuyang'aniridwa mwa odwala.

Mwinanso, Mikardis ® ikhoza kugwiritsidwa ntchito limodzi ndi thiazide diuretics, monga hydrochlorothiazide, yomwe imathandizanso kwambiri (mwachitsanzo, MikardisPlus® 40 mg / 12.5 mg, 80 mg / 12.5 mg).

Odwala omwe ali ochepa matenda oopsa, kuchuluka kwa telmisartan 160 mg patsiku limodzi ndi hydrochlorothiazide 12,5-25 mg anali wololera komanso wogwira ntchito.

Mikardis ® siyothandiza kwenikweni kwa odwala a liwiro la Negroid.

Kutulutsa mawonekedwe ndi kapangidwe kake

Fomu ya Mlingo - mapiritsi: ozungulira, osazungulira, okhala ndi scaffold ndi chamfer, oyera kapena oyera oyera achikaso (5, 7, 10 ndi 20 ma PC.) Mumapaketi a matuza, pamatumba a chikatoni 1, 2, 3, 4, 5, 8 kapena mapaketi 10, 10, 20, 28, 30, 40, 50, ndi zidutswa zana limodzi, m'matumbo okhala ndi zotchingira ndi zida zoyambira zowongolera kapena zotseguka pazovala zamkokomo kapena zoyambira zowononga koyambirira, pabokosi lamatabwa 1 Paketi iliyonse ilinso ndi malangizo ogwiritsira ntchito Telmisartan).

Piritsi 1:

• yogwira pophika: telmisartan - 40 kapena 80 mg,
• zotupa (mapiritsi a 40/80 mg): croscarmellose sodium –12/24 mg, sodium hydroxide-- 3,35 / 6.7 mg, povidone-K25- 12/24 mg, lactose monohydrate (mkaka wa shuga )- 296.85 / 474.9 mg, magnesium stearate - 3.80 / 6.4 mg, meglumine - 12/24 mg.

Matenda oopsa

Kugwiritsa ntchito telmisartan muyezo wa 80 mg kwathunthu kumatseka hypertra zotsatira za AT II. Mphamvu ya antihypertensive imayamba patatha pafupifupi maola atatu itatha yoyamba mlingo, imatha kwa maola 24 ndipo imakhalabe yofunikira mpaka maola 48. Njira yodziwika ngati achire imayamba pambuyo pa masabata 4-8 ogwiritsa ntchito mankhwalawa.

Mu ochepa matenda oopsa, telmisartan lowers systolic and diastolic magazi (BP) osakhudza kugunda kwa mtima (HR).

Pambuyo pakuleka kwakumwa kwa mankhwalawo, kuthamanga kwa magazi kumabweranso ku mtengo wake woyambira masiku angapo. Kuchotsa matenda sikukula.

Malinga ndi kuyerekezera kachipatala, zotsatira za telmisartan ndizofanana ndi mankhwala omwe amapezeka m'makalasi ena (mwachitsanzo, atenolol, hydrochlorothiazide, enalapril, lisinopril, amlodipine). Komabe, chifuwa chowuma cha odwala omwe amalandila telmisartan sichinachitike kawirikawiri kuposa momwe odwala omwe akutenga ACE inhibitors.

Mtima Kupewa matenda

Odwala azaka zapakati pa 55 ndi akulu omwe amakhala ndi vuto losakhazikika lachiwonetsero, sitiroko, matenda a mtima (CHD), zotupa zam'mitsempha yamagazi ndi zovuta za mtundu wa 2 matenda ashuga (monga kumanzere kwamitsempha yamagazi, michere kapena microalbuminuria, retinopathy) kwa anthu omwe ali pachiwopsezo cha zovuta zamtima, telmisartan anali ndi vuto lofanana ndi la ramipril pakuchepetsa maziko osakanikirana: kuchipatala chifukwa cha mtima wolephera kukomoka kwamitsempha yamatumbo, infalation yamkati yamatumbo, kufa kwa mtima.

Telmisartan, yofanana ndi ramipril, yawonetsedwanso kuti ikuthandiza kuchepetsa kufalikira kwa mfundo zachiwiri: kusapha kopanda kanthu, kufa kwa myocardial infarction, kufa kwamtima.

Kuchita kwa telmisartan mu Mlingo wochepera 80 mg kuti muchepetse chiopsezo cha kufa kwamtima sikunaphunzire.

Mosiyana ndi ramipril, telmisartan samakonda kuyambitsa zovuta monga chifuwa chowuma ndi angioedema. Komabe, ochepa hypotension nthawi zambiri amapezeka pakukonzekera.

Fomu ya Mlingo:

Piritsi limodzi lili:

Mlingo 40 mg

ntchito yogwira: telmisartan - 40 mg

obwera: sodium hydroxide - 3.4 mg, povidone K 30 (polyvinylpyrrolidone sing'anga wamolekyu) - 12.0 mg, meglumine - 12.0 mg, mannitol - 165.2 mg, magnesium stearate - 2.4 mg, talc - 5.0 mg .

Mlingo wa 80 mg

ntchito: telmisartan - 80 mg

zokopa: sodium hydroxide - 6,8 mg, povidone K 30 (polyvinylpyrrolidone sing'anga wamolekyu) - 24.0 mg, meglumine - 24.0 mg, mannitol - 330.4 mg, magnesium stearate - 4,8 mg, talc - 10,0 mg.

Mapiritsiwo ndi oyera kapena pafupifupi oyera, ozungulira, osalimba-okhala ndi bevel ndi notch.

Mankhwala

Mankhwala

Telmisartan ndi ena angiotensin II receptor antagonist (mtundu wa AT₁), yogwira mtima mukamamwa. Ili ndi kuyanjana kwambiri ndi AT subtype₁ angiotensin II receptors pomwe zochita za angiotensin II zimadziwika. Kuyika angiotensin II kulumikizana ndi cholandilira, osakhala ndi zochita za agonist mokhudzana ndi cholandilira ichi.

Telmisartan amangomanga kokha ku subtype ya AT₁ angiotensin II zolandila. Kulumikizana ndikupitiliza. Alibe kuyanjana ndi ma receptor ena, kuphatikizapo ma antibodies₂ receptor ndi zina zochepa zomwe amaphunzira angiotensin receptors. Kufunika kwa magwiridwe antchito izi, komanso momwe zimakhalira ndikulimbikitsa kwakukulu ndi angiotensin II, kugwiritsidwa ntchito kwa zomwe zimawonjezeka poika telmisartan, sikunaphunzire. Amachepetsa ndende ya aldosterone m'magazi, samalepheretsa renin m'magazi am'magazi ndipo saletsa njira ya ion.Telmisartan sichimalepheretsa angiotensin kutembenuza enzyme (kininase II) (enzyme yomwe imawononganso bradykinin). Chifukwa chake, kuwonjezeka kwa zoyipa zoyambitsidwa ndi bradykinin sikuyembekezeredwa.

Odwala, telmisartan pa mlingo wa 80 mg kwathunthu limalepheretsa hypertensive zotsatira za angiotensin II. Kukhazikika kwa antihypertensive kanthu kumadziwika mkati mwa maola atatu itatha konzedwe ka telmisartan. Mphamvu ya mankhwalawa imapitilira maola 24 ndipo imakhalabe yofunikira mpaka maola 48. Mankhwala otchulidwa kuti antihypertensive nthawi zambiri amakula mpaka masabata 4-8 pambuyo pokonzekera pakamwa pafupipafupi.

Odwala omwe ali ndi matenda oopsa, telmisartan lowers systolic and diastolic magazi (BP) osakhudza kugunda kwa mtima (HR).

Pankhani yakuchotsedwa kwadzidzidzi kwa telmisartan, kuthamanga kwa magazi pang'onopang'ono kumabwereranso ku msika wake wopanda chitukuko cha matenda a "kuchoka".

Pharmacokinetics

Ikamamwa pakamwa, imatengedwa mwachangu kuchokera m'mimba. Bioavailability ndi 50%. Mukamamwa pamodzi nthawi yomweyo ndi chakudya, kuchepa kwa AUC (dera lozunguliridwa ndi nthawi yayitali) kumachokera ku 6% (pa 40 mg) mpaka 19% (pa mlingo wa 160 mg). Pakadutsa maola atatu atatha kumwa, ndende ya m'madzi am'magazi imayendetsedwa, ngakhale nthawi yakudya. Pali kusiyana pamaganizidwe a plasma mwa amuna ndi akazi. Ndi_max(kuchuluka kwambiri) ndi AUC anali pafupifupi 3 ndi 2 nthawi, motero, apamwamba mwa akazi poyerekeza ndi abambo omwe alibe phindu lalikulu.

Kuyankhulana ndi mapuloteni am'madzi am'magazi - 99,5%, makamaka ndi albumin ndi alpha-1 glycoprotein. Mtengo wapakati wamawonekedwe ogajirika m'ndende zofanana ndi 500 malita. Zimapangidwa ndi kuphatikizika ndi glucuronic acid. Ma metabolabolites ndi opanga ma pharmacologic. Kuthetsa theka-moyo woposa maola 20. Amafukusidwa kudzera m'matumbo osasinthika, impso ndi impso - osachepera 2% ya mlingo womwe umatenge. Chilolezo chonse cha plasma ndi chachikulu (900 ml / min) poyerekeza ndi magazi a "hepatic" (pafupifupi 1500 ml / min.).

Ma pharmacokinetics a telmisartan mwa odwala okalamba samasiyana ndi achinyamata achinyamata. Kusintha kwa Mlingo sikofunikira.

Odwala omwe ali ndi vuto la impso

Kusintha kwa odwala omwe ali ndi vuto la aimpso sikofunikira, kuphatikiza odwala pa hemodialysis. Telmisartan samachotsedwa ndi hemodialysis.

Odwala omwe ali ndi vuto la chiwindi

Odwala omwe ali ndi chiwindi chochepa komanso chochepa zolimbitsa thupi (kalasi A ndi B pa kukula kwa Mwana), mlingo wa tsiku ndi tsiku sayenera kupitilira 40 mg.

Kugwiritsa ntchito kwa ana

Zizindikiro zazikulu za pharmacokinetics za telmisartan mwa ana a zaka zapakati pa 6 mpaka 18 atatenga telmisartan pa mlingo wa 1 mg / kg kapena 2 mg / kg kwa masabata 4, kwakukulu, amafananizidwa ndi deta yomwe yapezeka mu chithandizo cha akuluakulu, ndikutsimikizira kusagwirizana kwa pharmacokinetics ya telmisartan makamaka ponena za C_max.

Kuyanjana kwa mankhwala osokoneza bongo

Telmisartan imatha kuonjezera mphamvu ya ena othandizira. Mitundu ina ya zochitika zamatenda azachipatala sizinadziwikebe.

Ntchito zophatikizidwa ndi digoxin, warfarin, hydrochlorothiazide, glibenclamide, ibuprofen, paracetamol, simvastatin ndi amlodipine sizitengera mgwirizano wamphamvu. Kuwonjezeka kwakukulu kwa kuchuluka kwa digoxin m'madzi am'magazi ndi pafupifupi 20% (munthawi imodzi, ndi 39%). Ndi munthawi yomweyo makonzedwe a telmisartan ndi digoxin, ndikofunikira kuti nthawi zina azindikire kuchuluka kwa digoxin m'magazi.

Ndi kugwiritsa ntchito pamodzi kwa telmisartan ndi ramipril, kuwonjezeka kwa 2,5 kwa AUC0-24 ndi Cmax ya ramipril ndi ramipril kunawonedwa. Kufunika kwamankhwala pazinthu izi sikunakhazikitsidwe.

Ndi munthawi yomweyo makonzedwe a ACE zoletsa ndi kukonzekera lifiyamu, kuwonjezereka kosintha kwa ndende ya magaziamu kunawonedwa, limodzi ndi poyizoni. Nthawi zina, zosintha zoterezi zidanenedwa ndi makonzedwe a angiotensin II receptors. Ndi munthawi yomweyo makonzedwe a lithiamu ndi angiotensin II receptor antagonists, tikulimbikitsidwa kudziwa kuchuluka kwa lithiamu m'magazi.

Kuchiza ndi NSAIDs, kuphatikiza acetylsalicylic acid, COX-2 inhibitors, komanso NSAIDs yosasankha, kungayambitse kulephera kwa impso kwa odwala omwe alibe madzi m'thupi. Mankhwala osokoneza bongo omwe amagwiritsa ntchito renin-angiotensin-aldosterone system (RAAS) amatha kukhala ndi synergistic. Odwala omwe alandila NSAIDs ndi telmisartan, bcc iyenera kulipidwa poyambira chithandizo ndikuwonetsa kuyinso.

Kutsika kwa mphamvu ya ma antihypertensive othandizira, monga telmisartan, kudzera mu chopinga cha vasodilating zotsatira za prostaglandins kwawonedwa ndi mgwirizano wa NSAIDs.

Mlingo ndi makonzedwe

Mapiritsi a Telmisartan amakonzedwa kuti azilankhulidwa pakamwa tsiku lililonse ndipo amatengedwa ndi madzi, osadya kapena wopanda chakudya.

Chithandizo cha ochepa matenda oopsa

Mulingo woyamwa wabwino ndi 40 mg kamodzi tsiku lililonse.

Mu milandu yomwe kuthamanga kwa magazi sikukwaniritsidwa, mlingo wa Telsartan® utha kuwonjezereka mpaka 80 mg kamodzi patsiku.

Mukachulukitsa mlingo, muyenera kukumbukiranso kuti mphamvu yotsalira ya antihypertgency nthawi zambiri imakwaniritsidwa patatha milungu inayi mpaka isanu ndi itatu mutayamba chithandizo.

Telsartan ® ikhoza kugwiritsidwa ntchito limodzi ndi thiazide diuretics, mwachitsanzo, hydrochlorothiazide, yomwe kuphatikiza ndi telmisartan imakhala ndi hypotensive yowonjezera.

Odwala omwe ali ndi matenda oopsa oopsa, mlingo wa telmisartan ndi 160 mg / tsiku (mapiritsi awiri a Telsartan® 80 mg) komanso osakanikirana ndi hydrochlorothiazide 12,5-25 mg / tsiku anali wololera komanso wogwira ntchito.

Kupewa matenda a mtima komanso kufa

Mlingo womwe umalimbikitsa ndi 80 mg kamodzi tsiku lililonse.

Sizinatsimikizike ngati Mlingo womwe uli pansi pa 80 mg ndiwothandiza kuchepetsa kuchepa kwa mtima ndi kufa.

Poyamba kugwiritsidwa ntchito kwa mankhwalawa Telsartan ® popewa kuchepa kwa mtima ndi kufa kwa magazi, ndikofunikira kuti magazi azithamanga (BP), mwina zingakhale zofunikira kukonza magazi ndi mankhwala omwe amachepetsa kuthamanga kwa magazi.

Telsartan ® imatha kutengedwa mosasamala kanthu za kudya.

Kusintha kwa odwala omwe ali ndi vuto la aimpso sikofunikira, kuphatikiza odwala pa hemodialysis. Palibe zochitika zochepa zochizira odwala omwe amalephera kwambiri aimpso ndi hemodialysis. Kwa odwala oterowo, tikulimbikitsidwa kuti muyambe ndi mlingo wotsika wa 20 mg. Telsartan ® samachotsedwa mu magazi pa kukomoka kwa magazi.

Odwala omwe ali ndi chiwindi chochepa kwambiri, ntchito ya tsiku ndi tsiku sayenera kupitirira 40 mg kamodzi patsiku.

Kusintha kwa Mlingo sikofunikira.

Gulu la Nosological (ICD-10)

Wopanga:

Severnaya Zvezda CJSC, Russia

Adilesi yovomerezeka ya wopanga:

111141, Moscow, Zeleny promekt, d. 5/12, p. 1

Funani kupanga ndi adilesi yolandila:

188663, dera la Leningrad., Dera la Vsevolozhsk, malo okhala m'matauni Kuzmolovsky, kumanga kwa malo ochitira msonkhano N. 188

Mimba komanso kuyamwa

Kugwiritsa ntchito kwa Telmisartan-SZ kumapangidwa pakati pa nthawi yapakati. Pozindikira kuti muli ndi pakati, mankhwalawa amayenera kuyimitsidwa nthawi yomweyo. Ngati ndi kotheka, njira zina zochiritsira ziyenera kutumizidwa (magulu ena a antihypertensive mankhwala ovomerezeka kuti agwiritsidwe ntchito pa nthawi yapakati).

Kugwiritsidwa ntchito kwa ARA II panthawi yachiwiri komanso yachitatu ya amayi omwe ali ndi pakati pamimba amatsutsana.

Mu maphunziro oyamba a telmisartan, zotsatira za teratogenic sizinawonekere, koma fetotoxicity idakhazikitsidwa. Amadziwika kuti kukhudzana ndi ARA II panthawi yachiwiri komanso yachitatu ya kutenga pakati kumayambitsa fetotoxicity mwa munthu (kuchepa kwa ntchito yaimpso, oligohydroamnion, kuchepa kwa khungu la chifuwa), komanso neonatal toxicity (aimpso, hypotension, hyperkalemia). Odwala omwe akukonzekera kutenga pakati ayenera kupatsidwanso njira zina zochiritsira. Ngati mankhwala a ARA II adachitika panthawi yachiwiri ya mimba, tikulimbikitsidwa kuwunika ntchito yaimpso ndi mawonekedwe a chigaza mu mwana wosabadwayo ndi ultrasound.

Makanda obadwa kumene omwe amayi awo adalandira ARA II ayenera kuyang'aniridwa kwambiri kuti asachite kunjenjemera.

Chithandizo cha mankhwalawa ndi Telmisartan-SZ chimapangidwa pakukhazikitsa mkaka wa m'mawere.

Palibe maphunziro pa chonde omwe adachitika.