Kodi Telmisartan amayenera kutengedwa ndi mavuto ati ndipo ndingatani kuti ndimalandire mankhwala?

Matenda oopsa a arterial ndi chikhalidwe cha pathological chodziwika ndi kuwonjezeka kwa kuthamanga kwa magazi, mtengo wake womwe umaposa kuchuluka kwa 140/90 mm RT. Art. Kuzindikira koteroko kumapangidwa kwa wodwala, bola ngati kuthamanga kwa magazi kumawonedwa mwa atatu mwa miyeso yake, yomwe idapangidwa nthawi zosiyanasiyana komanso motsutsana ndi maziko a malo abata. Pankhaniyi, ndikofunikira kwambiri kuti musananyengedwe munthu asanamwe mankhwala omwe amawonjezereka kapena, mosiyana, kuthamanga kwa magazi.

Zambiri zokhudzana ndi matendawa

Kodi ndi ndani yemwe amapezeka kuti ali ndi matenda oopsa? Malinga ndi akatswiri, matendawa amawonedwa pafupifupi 30% ya okalamba komanso azaka zapakati, ngakhale kukula kwamtundu wofanana sikumaphatikizidwa mwa achinyamata. Tiyeneranso kudziwa kuti kuchuluka kwa azimayi ndi abambo kumakhala ndi gawo limodzi lofanana.

Mwa mitundu yonse ya matenda oopsa, ochepa kwambiri mpaka 80%.

Mavuto, matenda

Matenda oopsa a arterial ndi vuto lalikulu lazachipatala komanso chikhalidwe. Kuperewera koyenera komanso kwakanthawi kwa matenda oterewa kumathandizira kukulitsa zovuta zazikulu komanso zowopsa. Izi zimaphatikizapo kugwidwa ndi myocardial infarction, zomwe zingapangitse munthu kulephera kugwira ntchito, komanso kufa.

Sitinganene kuti kuvulaza kapena kupitirira kwa nthawi yayitali kwa matenda oopsa kumabweretsa kuwonongeka kwakukulu kwa ziwalo zina zam'magazi (mwachitsanzo, maso, ubongo, impso, ndi mtima) komanso kuphwanya magazi awo.

Kodi matenda oopsa kwambiri angachiritsidwe? Chithandizo cha matenda otere chiyenera kukhazikitsidwa makamaka pakulimbitsa magazi. Komabe, chithandizo sichimathera pamenepo. Pamodzi ndi kumwa mankhwala omwe amachepetsa kuthamanga kwa magazi, kukonza kovomerezeka kwamatenda onse omwe alipo mkati mwa ziwalo zamkati kumafunika.

Akatswiri amati matenda omwe amafunsidwa nthawi zambiri amakhala osachiritsika. Palibe ntchito kuyembekezera kuchira kwathunthu muzochitika zotere, koma chithandizo chosankhidwa moyenera chimalepheretsa chitukuko cha matenda, komanso kuchepetsa kwambiri zovuta zapakati, kuphatikizapo mavuto oopsa.

Ndi mankhwala ati omwe nthawi zambiri amamulembera matenda oopsa? Chithandizo chotchuka kwambiri cha matendawa ndi Telmisartan. Malangizo ogwiritsira ntchito, ndemanga za mankhwalawa, kapangidwe kake, zoyipa zake, zotsutsana ndi zina zambiri zaperekedwa pansipa.

Kufotokozera za mankhwala, ma CD, kapangidwe ndi mawonekedwe a kumasulidwa

Kodi mankhwalawa "Telmisartan" amamasulidwa mwa mtundu uti? Kafukufuku wodwala akuti m'matumba a mankhwalawa mankhwalawa amapezeka mwanjira zozungulira ngati mapiritsi ozungulira ndi ma silyl a mitundu yoyera kapena ndi tinge ya chikasu, omwe ali pachiwopsezo ndi chamfer.

Chithandizo chophatikizika cha mankhwalawa ndi telmisartan. Ponena za omwe adzapezeke, ndiye kuti magawo ake ndi monga:

• meglumine
• lactose monohydrate (kapena shuga mkaka),
• sodium hydroxide
• sodium croscarmellose,
• povidone K25,
• magnesium wakuba.

Malinga ndi ndemanga, "Telmisartan" pamapiritsi amagulitsidwa ku malo ogulitsira omwe amakhala mu ma contour cell, omwe amaikidwa m'matumba a makatoni.

Pharmacology

Kodi mankhwala oti "Telmisartan" (40 mg) ndi ati? Ndemanga za akatswiri amati iyi ndi mankhwala a antihypertensive, omwe ndi otsutsana ndi mtundu wa AT1 receptors, ndiye kuti angiotensin II. Kukonzekera komwe kukufunsidwa kumakhudzana kwambiri ndi receptor subtype. Amasankha ndipo kwa nthawi yayitali amamangirira ku angiotensin II, ndipo pambuyo pake, chinthu chogwira ntchito chimachotsa muubwenzi ndi AT1 receptors.

Zina

Ndi zinthu zina ziti zokhudzana ndi Telmisartan? Ma ndemanga akuti gawo lomwe limagwiritsidwa ntchito pa mankhwalawa silikukhudza ACE kapena renin mwanjira iliyonse, komanso sililetsa njira zomwe zikuyendetsa ma ions.

Mankhwala omwe atchulidwa amachepetsa kuchuluka kwa aldosterone m'magazi. Mlingo wa 80 mg umathetsa kuthamanga kwa magazi komwe kunayambitsidwa ndi angiotensin II.

The achire zotsatira pambuyo kumwa mapiritsi kumatenga pafupifupi tsiku, kenako pang'onopang'ono. Tiyeneranso kudziwa kuti kuchuluka kwa mankhwalawa kumamveka patatha masiku awiri chiyambireni chithandizo.

Malinga ndi ndemanga, Telmisartan imatha kuchepetsa kupsinjika kwa systolic ndi diastolic. Komabe, mankhwalawa samakhudza mtima wamunthu. Komanso, munthawi yamankhwala, zomwe zimapangitsa kuti munthu azingomwa mankhwala osokoneza bongo komanso chidwi chambiri cha zinthu zomwe sizinachitike.

Pharmacokinetic katundu wa mankhwala

Kodi mankhwala a Telmisartan ndi ati? Malangizo ndi kuwunika kwa akatswiri akuti ukamamwa mankhwala mkati mwake, chinthu chake chomwe chimagwira chimatha msanga pachakudya. Zake bioavailability pafupifupi 50%.

Mukamagwiritsa ntchito mankhwalawa pamodzi ndi chakudya, kuchepa kwa AUC kumasiyana pakati pa 6-9% (pa mlingo wa 40-160 mg, motsatana).

Maola atatu atatha kumwa mankhwalawa, kugwiritsidwa ntchito kwake kwa madzi am'magazi kumachitika pang'onopang'ono (ngakhale atamwa mankhwalawo kapena chakudya kapena pamimba yopanda kanthu).

Chibale cha telmisartan ndi mapuloteni a plasma chili pafupifupi 99.5%. Izi zimapukusidwa kudzera mu kulumikizana ndi glucuronic acid. Pankhaniyi, metabolacologic yolimbitsa thupi imapangidwa.

Hafu ya moyo wa mankhwala omwe amafunsidwa ndi oposa maola 20. Zomwe zimagwiritsidwa ntchito zimayendetsedwa m'matumbo. Cumulative excretion kudzera m'magazi a impso ndi pafupifupi 1%.

Zisonyezero zoika mankhwalawa

Kodi mankhwalawa amakhala ngati mankhwala a Telmisartan? Ndemanga za madokotala akuti mankhwala omwe amagwiritsidwawo ntchito amagwiritsidwa ntchito mosamala pa matenda oopsa. Itha kuthandizanso kupewa matenda ku matenda a mtima, kuphatikiza mtima, kugunda, matenda am'mitsempha komanso kumanzere kwamitsempha yamagazi.

Zoletsa pakamwa

Kodi simuyenera kugwiritsa ntchito liti mapiritsi a Telmisartan? Kuyang'ana kwa akatswiri, komanso malangizo ogwiritsira ntchito mankhwalawa, ndikuwonetsa zotsutsana zotsatirazi:

• matenda oletsa a biliary thirakiti
• aldosteronism yoyamba,
• kulephera kwambiri kwa chiwindi,
• kuvulala kwambiri aimpso,
• fructose tsankho,
• kumva kwambiri kwa wodwala pazinthu zazikulu kapena zina za mankhwala,
• nthawi yapakati
• zaka zazing'ono
• nthawi yoyamwitsa.

Malangizo ogwiritsira ntchito

Kodi ndigwiritse ntchito bwanji Telmisartan (40 mg)? Ndemanga za madotolo zikuwonetsa kuti ndikofunikira kumwa mapiritsi omwe atchulidwa pakamwa (pakamwa), mosasamala za kudya.

Mukazindikira matenda oopsa oopsa, mankhwalawo nthawi zambiri amapatsidwa mankhwala 40 mg kamodzi patsiku. Komabe, nthawi zina, mlingo womwe umasonyezedwawu ungathe kuchepera (pokhapokha ngati mankhwalawo anali othandiza mu 20 mg).

Ngati, mukumwa 40 mg ya mankhwalawo, kufunika kwake sikunatheke, ndiye kuti muyezowo umakulitsidwa mpaka 80 mg. Pankhaniyi, kugwiritsa ntchito mlingo wonsewo kumachitika nthawi imodzi.

Mukakonza chithandizo, ziyenera kukumbukiridwa kuti chithandizo chokwanira sichikwaniritsidwa nthawi yomweyo, koma pambuyo pa miyezi 1-2 (pang'onopang'ono pakumwa mapiritsi).

Kuchepetsa kuthamanga kwa magazi, Telmisartan (80 mg), zomwe ndemanga zake zikuwonetsedwa pansipa, nthawi zambiri zimayikidwa limodzi ndi thiazide diuretics.

Kutenga mankhwalawa matenda amtima

Kugwiritsa ntchito bwino kwa mapiritsi a Telmisartan popewa kufa kwa odwala omwe ali ndi vuto la mtima kumawonedwa ndi mlingo wa 80 mg patsiku. Zotsatira zofananazo zikudziwika pamlingo wotsika sizikudziwika pakali pano.

Mu matenda a chiwindi ndi impso, ndikofunikira kuonetsetsa kuti mankhwalawa sanatchulidwe komwe kumayambitsa ziwalo zina. Chifukwa chake, muzochitika zoterezi, tikulimbikitsidwa kuti muyambe kulandira chithandizo cha 20 mg patsiku. Tiyeneranso kukumbukiranso kuti kwa anthu ambiri omwe ali ndi vuto la chiwindi, mulingo woposa 40 mg tsiku lililonse ndi wowopsa.

Zotsatira zoyipa

Zotsatira zoyipa zomwe Telmisartan 80 imabweretsa? Kuunika kwa akatswiri akuti zomwe zimapangitsa anthu kumwa mankhwalawo ndizosowa kwambiri. Komabe, nthawi zina, odwala amadandaula za zotsatirazi:

1. Bradycardia, kuchepa magazi, kupuma movutikira, kusanza, kuchuluka kwa creatinine m'magazi, kusokonezeka kwa tulo, kutsegula m'mimba, kupweteka kumbuyo.
2. Zovuta zamkati, dyspnea, vertigo, spasms ya ng'ombe, kukomoka, kuyabwa kwa khungu, kugwa kwamphamvu pamagazi, kupweteka pamimba, kufooka.
3. Dyspepsia, totupa, kupweteka kwa impso, Hyperkalemia, kupweteka pachifuwa, kuwonongeka kwaimpso, kuwonjezeka thukuta.
4. Kupweteka kwam'mimba, kupuma ndi kwamikodzo matenda (mwachitsanzo, cystitis, sinusitis, kapena pharyngitis), tachycardia, sepsis, kusokonezeka kowoneka, thrombocytopenia, ndi pakamwa lowuma.
5. Hemoglobin yafupika, kusokonezeka m'mimba, nkhawa, kupweteka kwa m'magazi, kutsika magazi, kusintha mphamvu ya chiwindi, kukomoka kwa chiwindi, erythema, kuchuluka kwa michere ya chiwindi, zotupa za chikodzo, kuchuluka kwa uric acid m'magazi.
6. Kupweteka kwa tendon, angioedema, tendonitis, totupa yoyipa, kuchuluka kwa eosinophils.

Ndikofunikira kudziwa!

Ndi chisamaliro chapadera, kukonzekera kwa Telmisartan kumapangidwira kuphwanya kwa chiwindi, aortic stenosis, zilonda zam'mimba ndi zilonda zam'mimba (panthawi yowonjezera), matenda a mtima, matenda a m'mimba, mitral valve stenosis, kugunda kwa mtima komanso matenda oopsa a hypertrophic.

Anthu omwe ali ndi BCC yochepetsedwa, komanso hyponatremia, amatha kudwala matenda ena (ngakhale mutamwa mapiritsi oyamba). Pankhaniyi, chithandizo chisanachitike pamafunika kukonzanso kwa izi.

Ndi zoletsedwa kugwiritsa ntchito telmisartan mwa odwala aldosteronism oyamba.

Kugwiritsira ntchito mankhwalawa ndizotheka pamodzi ndi thiazide diuretics, chifukwa kuphatikiza kotere kumapangitsa kuchepa kwa magazi.

Mankhwala ochokera kuthamanga kwa magazi "Telmisartan": ndemanga ndi analogues

Mndandanda wamankhwala omwe amafunsidwa ndi njira monga:

Musanagwiritse ntchito mankhwalawa kuti muthane ndi matenda oopsa oopsa, ziyenera kukumbukiridwa kuti ali ndi zawo zamankhwala, mbali zoyipa ndi zotsutsana.

Kodi Telmisartan ikuyenda bwino motani? Ndemanga za odwala za mankhwalawa ndizosowa kwambiri. Mwa malipoti omwe akupezeka lero, pafupifupi 80% ndi abwino. Anthu omwe akuvutika ndi zovuta zowonjezereka amati mapiritsi omwe atchulidwa amakulolani kusintha mwachangu komanso mwachilungamo. Komanso, odwala amasangalala chifukwa chakuti mankhwalawa samayambitsa mavuto.

Pharmacological katundu wa Telmisartan

Telmisartan (telmisartan) imatha kulimbana ndi zinthu zambiri, imathandiza odwala omwe ali ndi vuto kuti azitha kusintha msanga. Mankhwala ndi oimira gulu la mankhwala okhudzana ndi angiotensin 2 receptor antagonists.

Ili ndi tanthauzo lenileni:

1. Kukhala ndi kuthekera kosankha kosasintha ndikumangirira mosalekeza ku ma receptor enaake, mwamphamvu kuthamangitsa angiotensin 2, potero kuletsa kulumikizana kwake ndi ATC 1 receptor, osakhala ndi machitidwe a agonist kutsogolo kwa receptor iyi.
2. Ili ndi kuthekera kopanga kulumikizana kosalekeza kokha ndi ATP 1 angiotensin 2 receptors.
3. Zosagwirizana ndi ma angiotensin receptors ena.
4. Amachepetsa kuchuluka kwa aldetorene m'magazi amoyo.
5. Sichikakamiza bradykinin.
6. Sizimaletsa ntchito za renin, mayendedwe a ion ndi ACE.

Ndikofunika kudziwa izi:

• Telmisartan pa mlingo wa 80 mg limachepetsa matenda oopsa a angiotensin 2 bwino.
• The achire zotsatira za mankhwala kumatenga maola 24 ndipo kumatenga masiku awiri.
• Mphamvu yayikulu antihypertensive imadziwika patatha maola atatu mutamwa mapiritsi, ndipo chotsatira chachikulu chamankhwala chimawonedwa patatha mwezi umodzi chiyambireni maphunziro ake.
• Ndi kutha koopsa kwa kutenga Telmisartan, kuthamanga kwa magazi kukwera mwachipembedzo kumafikira kuzisonyezo zoyambirira popanda kuwonetsa ziwonetsero za kusiya.
• Mothandizidwa ndi mankhwalawa, pali kuchepa kwa thupi lamanzere kumanzere kwa anthu okhala ndi mpweya wokulira wamanzere komanso matenda oopsa.

The zikuchokera mankhwala

Chofunikira chachikulu cha mankhwalawa ndi telmisartan, yomwe imapezeka piritsi limodzi m'mitundu yosiyanasiyana:

Zowonjezera zomwe zimapangidwa ndi mapiritsi zilipo:

• meglumine
• sorbitol
• povidone
• chimakopa
• magnesium wakuba,
• hypopellose,
• sodium hydroxide.

Mtengo ndi mtundu wa nkhani

Mankhwala othandizira a Telmisartan amapezeka mu mtundu wokhawo wa mankhwala - piritsi. Mapiritsiwa amakhala ndi mawonekedwe osinthika omwe amakhala ndi notch kuti athyole ndipo ndi oyera kapena oyera.

Ndikofunikira kuyang'ana pa ma nuances ofunikira:

1. Telmisartan ikupezeka pa mankhwala okha.
2. Alumali moyo wamapiritsi ndi zaka 3 kuyambira tsiku lopangira.
3. Zosungirako - pamtunda wosaposa 25 digiri m'malo osatheka ndi mwana.
4. Mukamasunga mapiritsi, kupatula kuthekera kwa kuwunika kwachindunji.

Mtengo wa mankhwalawa m'mafakitiri zimadalira dziko lomwe amapanga. Mtengo wamba wa Telmisartan kuchokera kwa opanga osiyanasiyana ndi:

• Ukraine - 220 ma ruble.
• Slovenia - 900 ma ruble.
• Turkey - 350 ma ruble.

Kodi ndimatenda ati omwe mankhwalawa amalembedwa?

Telmisartan amalembedwa pamaso pa zotsatirazi zowawa:

• Zochizira matenda oopsa mu akulu.
• Mwa cholinga choteteza matenda a mtima ndi mtima mwa odwala omwe ali ndi matenda a shuga a 2.
• Odwala kwambiri atherothrombotic mtima matenda (sitiroko, matenda a zotumphukira ochepa ziwiya, matenda a mtima).

Contraindication ndi zoletsa kuvomereza

Mawu omwe alembedwa ndi Telmisartan akuwonetsa kuti mankhwalawa ali ndi zotsutsana zingapo, choncho muyenera kusamala mukamamwa mankhwalawa kuti mupewe mavuto osavomerezeka. Makamaka, sinafotokozeredwe kwa odwala omwe ali ndi:

• Mimba
• Kuchepetsa.
• Kulepheretsa kwamizere yodutsa.
• Ziwengo kwa telmisartan.
• Kusagwirizana ndi fructose kapena zigawo zina za mankhwala.

Kuphatikiza apo, ziyenera kutengedwa mosamala ndi odwala omwe ali ndi mbiri yotsatira ya ma pathologies kapena zikhalidwe za thupi:

• Kukanika kwa hepatatic
• Matenda amitsempha yamagazi.
• Matenda am'mimba.
• Ana osakwana zaka 18.
• Mitral valavu stenosis ndi msempha.
• Mavuto a mtima.
• Kuletsa hypertrophic cardiomyopathy.
• Zilonda zam'mimba komanso duodenum.

Amaganizira mfundo zotsatirazi:

1. Odwala omwe ali ndi vuto la impso pomwe amamwa mankhwalawa amayenera kuwunikira pafupipafupi kuti adziweinine ndi potaziyamu.
2. Pamaso pathupi la stenosis yamitsempha yamaitsempha kapena kuchepa kwamitsempha yama impso ndi impso imodzi yogwira ntchito, kugwiritsa ntchito mankhwalawa kumawonjezera chiopsezo cha matenda oopsa komanso aimpso.
3. Amayi omwe akukonzekera kutenga pakati ayenera kupewa kumwa Telmisartan, m'malo mwake ndi mankhwala omwe ali ndi zofanana zochizira.
4. Chifukwa chosakwanira pazinthu zomwe zingayambitse mkaka wa m'mawere, amayi oyamwitsa sayenera kugwiritsa ntchito mankhwalawa.

Kuphatikiza apo, ngati munthu ali ndi zovuta zina m'thupi, muyenera kudziwitsa dokotala za izi:

• Matenda a shuga.
• Matenda a chiwindi.
• Matenda a impso.
• Matenda am'mimba.
• Kumwa mankhwala ena.
• Kugwiritsa ntchito mankhwala azitsamba.
• Ziwengo kwa mankhwala.

Ngati opaleshoni ikukonzekera munthawi yogwiritsira ntchito mapiritsi, onetsetsani kuti mwadziwitsa opaleshoni ya zakumwa zake.

Mankhwala osokoneza bongo kwambiri ndi mbali

Malangizo ogwiritsira ntchito Telmisartan ali ndi zambiri zokhudzana ndi zovuta zake pa ziwalo ndi thupi la munthu. Komabe, Symbomatology yotere imawonetsedwa pamagawo apadera, nthawi zambiri mawonetseredwe ake amaphatikizidwa ndi mawonekedwe a thupi.

Momwe Telmisartan Imakhudzira Magwiridwe a Arterial

Zotsatira zakuchipatala za Telmisartan pamtima ndi mtima zili motere:

• Kuletsa zochitika za receptors a angiotensin, zomwe zimayambitsa kudumphira m'magazi.
• Pambuyo poletsa izi zolandilira, minyewa yam'mimba imakulirakulira, potero kuwongolera kutsika kwa magazi, komwe kumathandiza kutsitsa magazi.
• Odwala othamanga kwambiri, Telmisartan amachepetsa kuthamanga ndi kuthamanga kwa magazi popanda kukhudza kugunda kwa mtima ndi kugunda kwa mtima.
• Mothandizanso kugwiririra ntchito kwina kosavutikira mosasokoneza mtima.
• Monga kuyezetsa kwawonetsa, mankhwalawa amachepetsa kulumala kwamtima, mwakutero kuchepetsa mwayi wa kufa.
• Amachepetsa chiopsezo cha kugwidwa ndi matenda a mtima.
• Zimalepheretsa chitukuko cha atherosulinosis ndi ischemia, zimapangitsa magazi kutuluka kwamitsempha yamagazi.
• Mankhwala amakhala ndi mphamvu yochiritsa mu impso.

Njira yothetsera kumwa mankhwalawa pofuna kuthana ndi mavuto

Kodi kutenga telmisartan? Malinga ndi malangizo, mankhwalawa amayenera kuledzera 1 kamodzi patsiku kuchuluka kwa 20 mg mg, pomwe:

1. Kuti mukwaniritse zotsitsa za ena okalamba odwala, 20 mg ndi yokwanira.
2. Ngati ndi kotheka, Mlingo wa tsiku ndi tsiku umakwezedwa 80 mg.
3. Odwala aukalamba ndi anthu omwe ali ndi vuto loti aimpso safuna malamulo.
4. Odwala oopsa omwe ali ndi vuto la chiwindi choyambira, gawo lililonse la mankhwalawa limaperekedwa mu 40 mg.
5. Ndi gawo lapamwamba kwambiri la matenda oopsa, mlingo wa tsiku ndi tsiku ndi 160 mg, komanso wophatikiza ndi hydrochlorothiazide - 12,5-25 mg patsiku.

Kutalika kwa nthawi ya maphunzirowa kumadalira kuopsa kwa matenda oopsa, chifukwa, amatha miyezi yambiri kapena kutengedwa ndi wodwalayo moyo wonse. Zotsatira zabwino kwambiri zochizira zimawonedwa pambuyo pa masabata 4-8 kuyambira poyambira mankhwalawa.

Ndi zoletsedwa kusintha pawokha muyezo wa mankhwalawo ndikusiya chithandizo popanda chilolezo cha dokotala.

Zomwe zimayenderana ndi chakudya komanso mowa

The achire dzuwa la Telmisartan palokha chakudya. Malinga ndi akatswiri, pamene mukumwa mapiritsiwo ndi chakudya, pali kuchepa kwapang'onopang'ono mu mankhwala a antihypertgency, omwe samadwalitsa makhwala ake:

• Mlingo 40 mg - kuchokera 6%.
• Mlingo wa 160 mg - mpaka 19%

Komabe, maola atatu atatha kumwa mankhwalawa, kuchuluka kwa chinthu chachikulu cha mankhwalawa kumawonjezeka, ngakhale atagwiritsidwa ntchito - nthawi yomweyo ndi chakudya kapena pamimba yopanda kanthu.

Ponena ndi kuyanjana kwa mankhwalawa ndi zakumwa zoledzeretsa, Telmisartan ndi mowa ndizosagwirizana kwambiri. Ethanol imawonjezera mphamvu ya telmisartana, yomwe ingayambitse kuchepa kwambiri kwa kuthamanga kwa magazi kufikira milingo yovuta. Kuphatikiza apo, kuwonetseredwa kwa hypotension yayikulu kumatha kudzetsa zovuta zina zam'magazi.

Kuphatikiza ndi mankhwala amwini

Pochita ndi Telmisartan, odwala matenda oopsa ayenera kuganizira momwe amathandizirana ndi mankhwala ena, omwe angathandize kupewa chiwonetsero chazotsatira.

Telmisartan imaloledwa kutengedwa ndi thiazide diuretics, zomwe zimapangitsa kuchepa kowonjezera kwa kuthamanga kwa magazi kufikira wofunikira.

Mapepala omwe alipo

Mwa zofananira za mankhwala a Telmisartan, omwe ali ndi machitidwe apamwamba a antihypertensive, akatswiri akuti:

1. Tanidol.
2. Telpres.
3. Telmisartan-C3.
4. Presartan.
5. Losartan.
6. Losartan Canon.
7. Losartan teva.
8. Cozaar.
9. Mikardis.
10. Wotsogolera.
11. Valsartan.
12. Izi.

Makhalidwe oyerekeza ndi mankhwala ofanana

Kuyerekezera kofananira kotchuka kwambiri kwa Telmisartan - Valsartan ndi Losartan:

Ndizovuta kunena kuti ndi iti mwa mankhwalawa omwe amadziwika kuti ndi abwino kwambiri malinga ndi machitidwe awo achire, chifukwa zochitika zilizonse zamankhwala zimafuna njira ya munthu aliyense.

Iliyonse ya mankhwalawa imangoperekedwa ndi cardiologist pambuyo pofufuza mwatsatanetsatane zamaphunziro a kuthamanga kwa magazi ndi zotsatira za kuwunika kwa thupi.

Pomaliza

Telmisartan ndi wa gulu lazachipatala la sartani. Chifukwa cha kuthekera kwakukulu kwazokwanirana, zimathandiza odwala oopsa kuti azitha kuthamanga magazi.

Ndi kuvomereza koyenera ndikutsatira malangizo azachipatala, mankhwalawa samayambitsa mavuto. Mankhwalawa ali ndi malire pazakudya zake, choncho muyenera kuphunzira mosamala malangizo omwe aphatikizidwa .-

Gulu la mankhwala

Kukonzekera kosavuta kwa okopa angiotensin II. Khodi ya PBX C09C A07.

Chithandizo cha matenda oopsa mu akulu.

Kupewa matenda a mtima.

Kuchepetsa matenda a mtima ndi odwala omwe ali ndi:

chiwonetsero chachikulu cha atherothrombotic mtima matenda (mtima wamtima, sitiroko kapena mbiri ya zotumphukira mitsempha),

mtundu II matenda a shuga ndi omwe amadziwika kuti awononga ziwalo.

Mlingo ndi makonzedwe

Telmisartan-Teva iyenera kugwiritsidwa ntchito kamodzi patsiku pakamwa ndi madzi okwanira, mosasamala kanthu za chakudya.

Chithandizo cha matenda oopsa.

Mlingo woyenera ndi 40 mg patsiku. Kwa odwala ena, mlingo wa 20 mg patsiku uzikhala wokwanira. Ngati kuthamanga kwa magazi sikumatsika mpaka manambala omwe mukufuna, ndiye kuti mutha kuwonjezera mlingo wa 80 mg kamodzi patsiku. Telmisartan-Teva imatha kutumikiridwa limodzi ndi thiazide diuretics hydrochlorothiazide, omwe ali ndi zotsatira zowonjezera kutsika kwa magazi akamayikidwa limodzi ndi telmisartan. Mukafuna kudziwa kuchuluka kwa mankhwala, muyenera kukumbukira kuti kuchuluka kwa antihypertensive kumachitika pambuyo pa masabata 4-8 kuyambira pakuyambira kwa chithandizo.

Kupewa matenda a mtima.

Mlingo womwe umalimbikitsa ndi 80 mg 1 nthawi patsiku. Sizikudziwika kuti mlingo wa Telmisartan ochepera 80 mg umathandiza kuchepetsa kuchepa kwa mtima.

Kumayambiriro kwa chithandizo cha mankhwala a telmisartan, kuti muchepetse chiopsezo cha matenda amtima, tikulimbikitsidwa kuwunika bwino magazi. Zingakhale zofunikira kusintha bwino magwiritsidwe ntchito a mankhwala omwe amachepetsa kuthamanga kwa magazi.

Matenda aimpso.

Odwala omwe ali ndi vuto lochepa kwambiri laimpso, osafunikira, palibe chifukwa chofuna kusintha. Palibe chidziwitso chochepa chogwiritsidwa ntchito kwa odwala omwe ali ndi vuto la impso kapena hemodialysis. Kwa odwala awa, mlingo woyambirira wa 20 mg umalimbikitsidwa.

Kuwonongeka kwa chiwindi.

Kwa odwala omwe ali ndi vuto la chiwindi chofatsa kwa digiri yochepa, mlingo sayenera kupitirira 40 mg patsiku. Odwala omwe ali ndi vuto la chiwindi kwambiri, mankhwalawa amatsutsana.

Odwala okalamba.

Kusintha kwa Mlingo sikofunikira.

Kutulutsa mafomu ndi kapangidwe kake

Amapezeka piritsi. Yogwira pophika mankhwala ndi telmisartan. Piritsi limodzi lili ndi 80 mg yogwira ntchito, ndi yoyera ndi utoto. Mapiritsiwo sanapangidwe, aliyense wa iwo ali ndi zolemba nambala 80 mbali imodzi.

Monga zinthu zothandizira, sodium hydroxide, madzi, povidone, meglumine, magnesium stearate ndi machitidwe a mannitol.

Telsartan 80 ndi mankhwala omwe amagwiritsidwa ntchito pochiza matenda oopsa komanso zina.

Zotsatira za pharmacological

Mphamvu ya antihypertensive yogwira ntchito imatsimikiziridwa ndikuletsa kutsekeka kwa maselo a ziwiya zokhudzana ndi angiotensin 2. molekyulu ya telmisartan ili ndi mawonekedwe ofanana amtunduwu, chifukwa chake imafikira ku receptors m'malo mwa timadzi, kutseka kwake. Kamvekedwe ka mtima sikakukula, komwe kumayimitsa kukwera kwa magazi.

Yogwira pophika mankhwala imamangirira ma receptors kwa nthawi yayitali. Makhalidwe, ma receptor a AT1 subtype ndi oletsedwa. Ma subtypes ena a angiotensin receptors amakhalanso omasuka. Udindo wawo weniweni mthupi sunaphunziridwe mokwanira, chifukwa chake sayenera kukhala wololera kuyendetsa magazi.

Mothandizidwa ndi mankhwalawa, kupanga aldosterone yaulere imalepheretsanso. Nthawi yomweyo, kuchuluka kwa renin kumakhalabe chimodzimodzi. Ma membrane am'ma cell omwe amayendetsa ma ion samakhudzidwa.

Telsartan si angiotensin osintha enzyme inhibitor. Izi zimapangitsa kuti zikhale zovuta kuti zizindikire zina zosafunikira, chifukwa enzymeyi imathandizanso kuti bradykinin iwonongeke.

Pharmacokinetics

Mothandizidwa ndi pakamwa mankhwala, kachipangizoka kamadutsa msanga kudzera m'matumbo aang'ono. Imatsala pang'ono kunyamula ma peptides. Ambiri amayendetsedwa molumikizana ndi albin.

Zokwanira bioavailability wa mankhwala pafupifupi 50%. Zitha kuchepetsedwa ndi mankhwala okhala ndi zakudya.

Njira yayikulu yogwiritsira ntchito kusintha kwa kagayidwe kachakudya mu thupi ndi cholumikizira ku glucuronide. Zotsatira zomwe zilibe ntchito za pharmacological.

Telsartan InstructionTelsartan H Malangizo

Zambiri zomwe zimagwira zimachotsedwapo kale. Kutha kwa theka-moyo ndi maola 5-10. Chigawo chogwira ntchito bwino chimachoka m'thupi mkati mwa maola 24.

Zizindikiro zogwiritsidwa ntchito

Chida chimagwiritsidwa ntchito:

• matenda oopsa
• kupewa kufa kwa matenda a CVD mwa anthu azaka 55 omwe ali pachiwopsezo cha chitukuko chawo chifukwa cha kusokonezeka kwa dongosolo lamtima.
• kupewa zovuta za omwe ali ndi matenda osokoneza bongo omwe amadalira odwala omwe amapezeka ndi kuwonongeka kwa ziwalo zamkati zomwe zimayenderana ndi matenda oyamba.

Momwe mungatenge Telsartan 80

Mapiritsi amatengedwa tsiku lililonse. Mutha kumwa mosasamala nthawi yakudya, ndi madzi ofunika.

Mlingo woyambirira ndi 40 mg. Ngati kuchuluka kwa mankhwalawa sikulola kuwongolera kwathunthu kuthamanga kwa magazi, mlingo umachulukitsidwa.

Mlingo wapamwamba tsiku lililonse ndi 80 mg. Kuwonjezeranso kwina sikopanda phindu chifukwa sikumawonjezera kugwira ntchito kwa chida.

Tiyenera kudziwa kuti mphamvu ya mankhwalawa sikuwoneka nthawi yomweyo. Mphamvu yoyenera imatheka pambuyo pa miyezi 1-2 yogwiritsa ntchito mosalekeza.

Telsartan nthawi zina amaphatikizidwa ndi thiazide diuretics. Kuphatikiza uku kumakupatsani mwayi wochepetsera kupanikizika.

Woopsa matenda oopsa, n`zotheka kupereka 160 mg wa telmisartan osakaniza 12,5-25 mg wa hydrochlorothiazide.

Ndi matenda ashuga

Mtundu wachiwiri wa matenda ashuga, Telsartan angatengedwe kuteteza kupewetsa mtima kwa impso, mtima, ndi retina. Mankhwala ndi mankhwala 40% kapena 80 mg, malingana ndi kuopsa kwa mawonekedwe a matenda oopsa.

Mankhwalawa amatengedwa nthawi yayitali. Kafukufuku wachipatala akuwonetsa kuti magazi a systolic ndi diastolic amatsika ndi 15 ndi 11 mm Hg pamene atengedwa kuchokera ku masabata a 8 mpaka 12. Art. motero.

Odwala omwe ali ndi matenda ashuga komanso matenda oopsa amatha kuphatikizidwa ndi amlodipine. Kuphatikizika kumeneku kumakupatsani mwayi woti magazi azikhala opanda malire.

Musanagwiritse ntchito mankhwalawa, muyenera kufunsa dokotala nthawi zonse. Mlingo ndi nthawi yayitali ya chithandizo iyenera kusankhidwa payekha.

Ndikofunikira kukaonana ndi dokotala. Mlingo ndi nthawi yayitali ya chithandizo iyenera kusankhidwa payekha.

Hematopoietic ziwalo

Kuchokera ku ziwalo za hemopoietic zitha kuwoneka:

• kuchepa magazi
• thrombocytopenia
• eosinophilia
• kutsika kwa hemoglobin.

Chimodzi mwazotsatira zoyipa za Telsartan ndi kuchepa kwa hemoglobin.
Pakati mantha dongosolo atha kuyankha kugwiritsa ntchito mankhwalawa mwadzidzidzi.
Matenda okhumudwa amachitika mchikakamizo chotenga Telsartan.
Kutsegula m'mimba kumatha chifukwa cha telsartan.
Kusanza, kusanza ndi mavuto a Telsartan.
Kutenga Telsartan, kugona siachilendo.
Flatulence imachitika chifukwa chotenga Telsartine.

Pa khungu

Mbali ya kupuma, telsartan imatha kutsokomola.
Mphamvu ya minofu ndi mafupa amatha kuyankha mankhwalawa ndi Telsartan chifukwa cha kukomoka.Pa khungu, Telsartan amachititsa kuyabwa ndi zotupa.
Telsartan imatha kuyambitsa matenda opumira.
Mukamagwiritsa ntchito telsartan, eczema imatha kuchitika.
Dermatitis imachitika chifukwa cha mankhwala a Telsartan.
Kuchita thukuta kwambiri kumachitika chifukwa chotenga Telsartan.

Zokhudza mphamvu pakuwongolera njira

Kafukufuku wokhudzana ndi mphamvu ya mankhwalawa pakuwongolera machitidwe sanachitike. Ndikulimbikitsidwa kuti muchepetse nthawi yomwe mumagwiritsa ntchito poyendetsa zizindikiro za mbali yam'mimba.

Pochita mankhwala ndi Telsartan, tikulimbikitsidwa kuchepetsa nthawi yomwe mumayendetsa.

Malangizo apadera

Hypotension imatha kuyenda limodzi ndi muyezo woyamba wa mankhwalawa odwala omwe ali ndi magazi osakwanira kapena kuchuluka kwa plasma sodium.

Pachimake ochepa hypotension amatha kuchitika ngati wodwala aimpso mtima stenosis kapena congestive mtima kulephera.

Telmisartan siothandiza pochiza odwala omwe ali ndi hyperaldosteronism yoyamba.

Mosamala, mankhwalawa amaperekedwa kwa anthu omwe ali ndi stenosis ya aortic kapena mitral valve.

Kugwiritsa ntchito mankhwalawa kumatha kuyambitsa kuchuluka kwa potaziyamu m'magazi. Magulu ena odwala angafunike kuwunikira kwakanthawi ma electrolyte a plasma.

Pali chiopsezo cha hypoglycemia mwa anthu omwe amalandira insulin kapena mankhwala ena a antiidiabetes. M'pofunika kuganizira izi posankha mtundu wa mankhwalawa. Ndikofunikira kuyang'anitsitsa kuchuluka kwa shuga m'magazi.

Zotsatira zoyipa

Zotsatira zoyipa, kuphatikiza anaphylactic zimachitika ndi angioedema, n`zotheka zina, kulephera aimpso anawonekanso.

Matenda opatsirana komanso kuponderezedwa: Matenda opatsirana a chapamwamba kupuma thirakiti (kuphatikizapo pharyngitis ndi sinusitis), matenda opatsirana a kwamikodzo (kuphatikizapo cystitis), sepsis, kuphatikizapo wakupha 1.

Pa gawo la magazi ndi dongosolo la zamitsempha: magazi m'thupi, thrombocytopenia, eosinophilia.

Kuchokera ku chitetezo chathupi: hypersensitivity, anaphylactic reaction.

Metabolic, matenda a metabolic: hyperkalemia, hypoglycemia (odwala matenda a shuga).

Mavuto amisala: kukhumudwa, kusowa tulo, nkhawa.

Matenda a mitsempha: kukomoka, kugona.

Kuchokera kumbali ya gawo la masomphenyawo: kuwonongeka kwamawonekedwe.

Kumbali ya ziwalo zamakutu ndi ma vestibular zida: vertigo.

Kuchokera pamtima dongosolo: bradycardia, tachycardia, ochepa hypotension 2, orthostatic hypotension.

Kuchokera kupuma dongosolo, chifuwa ndi zam'mimba ziwalo: kufupika, kutsokomola, matenda am'mapapo.

Zovuta zamatenda am'mapapo ochepa zimawonedwa kwakanthawi ndi telmisartan pakaonedwe kotsatsa. Komabe, ubale wa causal sunakhazikitsidwe.

Kuchokera m'mimba thirakiti: kupweteka kwam'mimba, kutsegula m'mimba, kuuma, kugona, kusanza, kusapeza bwino m'mimba, pakamwa kowuma, dysgeusia.

Matenda am'magazi: chiwindi ntchito / chiwindi ntchito. Akuti odwala ochokera kumayiko aku Japan sakonda kuchita izi.

Pa khungu ndi subcutaneous minofu: hyperhidrosis, kuyabwa, zidzolo, erythema, angioedema (kuphatikizapo zakupha), dermatitis, mankhwala oopsa a khungu, chikanga, urticaria.

Kuchokera ku minculoskeletal system ndi minofu yolumikizana: myalgia, kupweteka kumbuyo (mwachitsanzo sciatica), minyewa yam'mimba, arthralgia, kupweteka kwamiyendo, kupweteka kwa tendons (zizindikiro za tendonitis).

Kuchokera kwamikodzo dongosolo: kuwonongeka kwaimpso, kuphatikizapo kupweteka kwaimpso.

Mavuto wamba: kupweteka pachifuwa, asthenia (kufooka), zizindikiro ngati chimfine.

Zizindikiro zasayansi: kuwonjezeka kwa metabolinine m'magazi, kuchuluka kwa uric acid m'magazi, kuchuluka kwa michere ya chiwindi, kuchuluka kwa CPK m'magazi, kuchepa kwa hemoglobin.

Kufotokozera kwa zomwe zimachitika munthu akamakumana ndi mavuto

Sepsis. Zinanenedwa kuti odwala omwe amatenga telmisartan amakhala ndi vuto lodziwika bwino la sepsis kuposa mwa omwe adalandira placebo. Izi zitha kukhala ngozi kapena chizindikiro cha njira, tanthauzo lake lomwe silikudziwikabe.

Hypotension. Zotsatira zoyipa izi zimawonedwa kawirikawiri kwa odwala omwe amayendetsedwa ndi magazi omwe amathandizidwa ndi telmisartan kuti achepetse matenda amtima komanso kuwonjezera chithandizo.

Kuwonongeka kwa chiwindi / kuwonongeka kwa chiwindi. Malinga ndi kafukufuku wotsatsa malonda, nthawi zambiri vuto la chiwindi / kuwonongeka kwa chiwindi limawonedwa mwa odwala amtundu wa Japan. Odwala amtundu waku Japan amakonda kuchita izi.

Matenda am'mapapo. Zovuta zamatenda am'mapapo ochepa zimawonedwa kwakanthawi ndi telmisartan pakaonedwe kotsatsa. Komabe, ubale wa causal sunakhazikitsidwe.

1 Akuwonjezeranso kuchuluka kwa sepsis pochizira telmisartan akuti poyerekeza ndi zomwe zili mu placebo. Izi zitha kukhala zowonetsera mwangozi kapena zimagwirizanitsidwa ndi makina omwe zochita zake sizikudziwika pakadali pano.

2 Amanenedwa pafupipafupi kwa odwala omwe amayendetsedwa ndi magazi omwe amathandizidwa ndi telmisartan kuti achepetse kuchepa kwa mtima kuwonjezera thanzi.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Mimba

Mankhwalawa amaperekedwa kwa amayi apakati kapena amayi omwe akukonzekera kutenga pakati. Ngati kutenga pakati kumatsimikiziridwa pakumwa mankhwalawa, kugwiritsa ntchito kwake kuyenera kuyimitsidwa nthawi yomweyo, ndipo ngati kuli koyenera, ndikusinthidwa ndi mankhwala ena ovomerezeka kuti agwiritsidwe ntchito mwa amayi apakati.

Palibe chidziwitso chokwanira pakugwiritsa ntchito telmisartan kwa amayi apakati.

Zoyambitsa mliri wa chiopsezo cha teratogenicity chifukwa chogwiritsa ntchito zoletsa za ACE nthawi yoyamba ya pakati sizinali kukhudzika, koma kuwonjezeka pang'ono pangozi sikungadziwike. Ngakhale palibe umboni wolamulira wa chiopsezo cha teratogenicity ndi angiotensin II receptor antagonists, zoopsa zofananazi zitha kukhalapo kagulu kamankhwala awa. Pokonzekera kutenga pakati, mankhwalawa ayenera kuthandizidwa ndi mankhwala ena a antihypertensive omwe ali ndi mbiri yoyenera kugwiritsa ntchito panthawi yomwe ali ndi pakati. Mimba ikakhazikitsidwa, chithandizo cha angiotensin II receptor antagonists iyenera kuyimitsidwa pomwepo ndikuthandizira njira zina ngati ziyenera kutero.

Amadziwika kuti kugwiritsa ntchito angiotensin II receptor antagonists pa II ndi III trimesters ya mimba imayambitsa fetotoxicity mwa anthu (kuwonongeka kwa impso, oligohydramnios, kuchedwa kwa mapangidwe a mafupa a cranial) komanso neonatal kawopsedwe (kulephera kwa impso, hypotension, hyperkalemia). Ngati kugwiritsa ntchito angiotensin II receptor antagonists adayamba mu nyengo yachiwiri ya kubereka, tikulimbikitsidwa kuti tichite kafukufuku wa impso ndi mafupa a chigoba cha fetal. Mkhalidwe ya akhanda omwe amayi awo adatenga angiotensin II receptor antagonists ayenera kuyang'aniridwa mosamala kuti asachite kunjenjemera.

Kuyamwitsa.

Popeza palibe chidziwitso chokhudza kugwiritsa ntchito telmisartan panthawi yoyamwitsa, kugwiritsa ntchito sikulimbikitsidwa ndipo njira zina zochiritsira zokhala ndi mbiri yokhazikitsidwa zotetezeka ziyenera kugwiritsidwa ntchito poyamwitsa, makamaka podyetsa ana akhanda kapena makanda asanakwane.

Mu maphunziro oyamba, zotsatira zoyipa za abambo ndi amuna sizinawululidwe.

Kuchita bwino komanso chitetezo cha mankhwalawa kwa ana osaposa zaka 18 sizinafufuzidwe.

Zolemba zogwiritsira ntchito

Mimba

Pa mimba, chithandizo cha angiotensin II receptor antagonists sichingayambitsidwe. Ngati kupitiliza kwa mankhwalawa sikungachitike kukhala kofunikira kwa wodwala yemwe akukonzekera kutenga pakati, ayenera kusinthana ndi njira ina yothandizira antihypertensive, yomwe imakhala ndi mbiri yotetezeka yogwiritsidwa ntchito panthawi yapakati. Mimba ikakhazikitsidwa, chithandizo cha angiotensin II receptor antagonists iyenera kuyimitsidwa nthawi yomweyo ndipo ngati kuli koyenera, njira zina zochiritsira ziyenera kuyambitsidwa (onani Magawo "Contraindication" ndi "Gwiritsani ntchito pakukhala ndi pakati kapena pobereka").

Telmisartan-Teva sayenera kugwiritsidwa ntchito mwa odwala omwe ali ndi cholestasis, matenda opatsirana a bile ndi kulephera kwambiri kwa chiwindi, chifukwa telmisartan imapukusidwa kwambiri mu bile. Odwala omwe ali ndi matendawa, chiwonetsero cha hepatic chilolezo chimachepetsedwa. Onetsetsani kuti mukugwiritsa ntchito Telmisartan-Teva odwala omwe ali ofatsa kuti azikhala osakwanira kwa hepatic.

Pali chiopsezo chachikulu cha ochepa hypotension ndi kulephera kwaimpso kwa odwala omwe ali ndi vuto la impso a artery stenosis kapena a impso artery stenosis a impso imodzi mukamalandira mankhwala omwe amakhudza dongosolo la renin-angiotensin-aldosterone.

Kulephera kwamkati ndi kupatsirana kwa impso.

Pogwiritsa ntchito mankhwalawa odwala omwe ali ndi vuto la impso, tikulimbikitsidwa kuti nthawi zina tizizindikira kuchuluka kwa potaziyamu ndi creatinine mu seramu yamagazi. Palibe chokuchitikirani ndi kugwiritsa ntchito mankhwalawa kwa odwala pambuyo pakuwonjezeka kwa impso.

Zizindikiro zamitsempha yama hypotension, makamaka pambuyo pa koyamba kwa mankhwalawa, zimatha kupezeka mwa odwala omwe amachepetsa magazi kapena hyponatremia, yomwe imayamba chifukwa cha kukonzekera kwambiri kwa diuretic, kudya ndi mchere wochepa kapena kutsegula m'mimba komanso kusanza. Zinthu zoterezi zimayenera kusinthidwa musanagwiritse ntchito mankhwala. Musanayambe chithandizo, ndikofunikira kusintha mulingo wa sodium ndi kuchuluka kwa magazi amitsempha yamagazi.

Ma blockade apawiri a renin-angiotensin-.

Pali umboni kuti kugwiritsa ntchito limodzi kwa ACE zoletsa, angiotensin II receptor blockers kapena aliskiren kumawonjezera chiopsezo cha hypotension, hyperkalemia ndikuchepetsa kugwira ntchito kwaimpso (kuphatikizapo kuperewera kwaimpso).

Chifukwa chake, kuphatikiza kwapawiri kwa renin-angiotensin poonjezera ACE inhibitor kwa angiotensin II receptor antagonist) sikofunikira. Ngati blockade iwiri imawonedwa ngati yofunikira, ziyenera kuchitika pokhapokha kuyang'aniridwa ndi katswiri ndikuyang'aniridwa mosamala ndi ntchito yaimpso, ma elekitirodi ndi kuthamanga kwa magazi.

ACE inhibitors ndi angiotensin II receptor blockers sayenera kugwiritsidwa ntchito munthawi yomweyo odwala odwala matenda ashuga.

Zina zomwe zimayendetsedwa ndi kukondoweza kwa renin-angiotensin-.

Odwala omwe mtima wawo wamatsempha ndi impso zimadalira ntchito ya renin-angiotensin- (mwachitsanzo, odwala omwe ali ndi vuto lalikulu la mtima kapena matenda a impso, kuphatikizanso ndi aimpso a minyewa ya m'mimba, chithandizo cha mankhwala omwe amakhudzanso dongosolo lino. angayambitse ochepa acterial hypotension, hyperazotemia, oliguria, kapena kuchepa, kufooka kwa impso.

Nthawi zambiri, odwala omwe ali ndi aldosteronism oyamba samayankha mankhwala a antihypertensive omwe amakakamiza dongosolo la renin-angiotensin, motero, sikulimbikitsidwa kuti apereke telmisartan kwa odwala omwe ali ndi vutoli.

Mitral ndi aortic valve stenosis, yolepheretsa hypertrophic cardiomyopathy.

Monga ma vasodilator ena, chisamaliro chimayenera kutengedwa kuti apereke mankhwala kwa odwala omwe ali ndi mitral ndi aortic stenosis kapena hypertrophic cardiomyopathy.

Kugwiritsa ntchito mankhwala omwe amakhudza renin-angiotensin-aldosterone kungayambitse hyperkalemia.

Odwala okalamba, odwala omwe ali ndi vuto la aimpso, odwala matenda ashuga, odwala omwe amalandila nthawi yomweyo mankhwala ena omwe amatha kuwonjezera kuchuluka kwa potaziyamu komanso / kapena odwala omwe ali ndi matenda ophatikizana, hyperkalemia imatha kupha.

Musanagwiritse ntchito nthawi yomweyo mankhwala omwe amachepetsa renin-angiotensin-aldosterone dongosolo, muyeso wa phindu ndi chiwopsezo uyenera kuyesedwa.

Zowopsa zomwe zimayambitsa hyperkalemia zomwe ziyenera kukumbukiridwa:

matenda a shuga, matenda a impso, zaka (> zaka 70),

kuphatikiza ndi mankhwala amodzi kapena zingapo zomwe zimakhudza dongosolo la renin-angiotensin-aldosterone, komanso / kapena ndi zina zowonjezera potaziyamu. Mankhwala kapena magulu othandizira omwe amapangitsa kuti mankhwala asokonezeke mosavuta omwe amapangitsa kuti munthu akhale ndi hyperkalemia amaphatikizira mchere wotsekemera wokhala ndi potaziyamu, mankhwala osokoneza bongo a ACE inhibitors, angiotensin II receptor antagonists, mankhwala osokoneza bongo a anti-yotupa (NSAIDs, kuphatikizapo kusankha COX-2 inhibitors), heparin ndi tacrolimus trimethoprim,

mawonetseredwe apakati, makamaka kuchepa kwa madzi m'mimba, kuwonongeka kwamtima kwamtima, metabolic acidosis, kuwonongeka kwa impso, kusokonezeka kwa impso (matenda opatsirana), cell lysis (mwachitsanzo, pachimake miyendo ischemia, rhabdomyolysis, kuvulala kwambiri.

Kusamala mosamala seramu potaziyamu mu odwala omwe ali pachiwopsezo akulimbikitsidwa.

Mankhwalawa amakhala ndi sorbitol (E 420), motero, sayenera kutumizidwa kwa odwala omwe ali ndi chibadwa cha tsankho.

Monga momwe zidawululidwa popereka mankhwala a ACE inhibitors, telmisartan ndi ma angiotensin receptor blockers sakwanitsa kuchepetsa kuthamanga kwa magazi mu liwiro la Negroid kuposa mitundu ina, mwina chifukwa mulingo wa renin mwa odwala a liwiro la Negroid okhala ndi matenda oopsa kwambiri mitundu ena.

Monga mankhwala ena a antihypertensive, kuchepa kwambiri kwa kuthamanga kwa magazi kwa odwala omwe ali ndi matenda a mtima komanso mtima. Kungayambitse kukula kwa myocardial infarction kapena stroke.

Odwala odwala matenda ashuga amathandizidwa ndi mankhwala a insulin kapena hypoglycemic.

Odwala omwe amalandira mankhwala a insulin kapena antidiabetesic amatha kukhala ndi hypoglycemia. Mwa odwala, ndikofunikira kuwongolera kuchuluka kwa shuga m'magazi, ndipo izi ziyeneranso kuganiziridwa mukamasintha mlingo wa insulin kapena antidiabetesic agents.

Odwala omwe ali ndi matenda a shuga, oopsa a mtima (odwala matenda a shuga, omwe ali ndi matenda am'mitsempha yamagazi), chiopsezo chokhala ndi vuto la kupha magazi mthupi ndi zotsatira zakupha ndipo mwadzidzidzi mtima wamoyo ukhoza kukhala wapamwamba mukalandira mankhwala a antihypertensive, monga angiotensin IIP receptor antagonists and inhibeptitors. Odwala omwe ali ndi matenda a shuga, njira yodwala yam'mitsempha ya m'mimba imatha kukhala yovuta kudziwa chifukwa chake atha kupezeka kuti sakudziwika. Odwala omwe ali ndi matenda ashuga amayenera kuwunikidwa mosamala, mwachitsanzo, poyesa kupanikizika kuti adziwe ndikuchiza matenda amtundu wam'magazi asanafotokoze mankhwala.

Kutha kukopa momwe zinthu zikuyendera mukamayendetsa magalimoto kapena njila zina

Mukamagwiritsa ntchito antihypertensive mankhwala, chizungulire kapena kugona kungachitike nthawi zina. Chifukwa chake, ngati kuli kotheka, magalimoto oyendetsa galimoto kapena agwiritse ntchito njira zina ayenera kuganiziridwanso.

Kuyanjana ndi mankhwala ena ndi mitundu ina yoyanjana

Pogwiritsa ntchito munthawi yomweyo telmisartan ndi digoxin, kuchuluka kwambiri kwa kuchuluka kwa plasma kwa digoxin (pofika 49%) ndi kutsika kocheperako (pofika 20%). Kumayambiriro kwa makonzedwe, ngati masinthidwe a mlingo ndi kuleka kwa telmisartan, digoxin ayenera kuyang'aniridwa kuti athe kuisamalira.

Monga mankhwala ena omwe amakhudza renin-angiotensin-aldosterone dongosolo, telmisartan ikhoza kuyambitsa hyperkalemia. Kuwopsa kumeneku kumatha kuwonjezereka ndikamaphatikizidwa ndi mankhwala ena omwe angapangitsenso hyperkalemia (potaziyamu wokhala ndi mchere wam'magazi, okodzetsa a potaziyamu, ma ACE inhibitors, angiotensin II receptor antagonists, NSAIDs (kuphatikizapo COX-2 inhibitors), heparin, immunosuppressants taclosporin ndi trimethoprim).

Kuchuluka kwa hyperkalemia kumadalira ndi zomwe zimayambitsa ngozi. Chiwopsezochi chimakulitsidwa mukamagwiritsa ntchito njira zophatikizira pamwambapa. Chiwopsezochi ndi chachikulu makamaka chikaphatikizidwa ndi potaziyamu woletsa mafuta ochepa komanso mchere wotsekemera wokhala ndi potaziyamu. Kuphatikiza, mwachitsanzo, ndi ACE inhibitors kapena NSAIDs, kumakhala pachiwopsezo chochepa mosamala kwambiri mukamagwiritsa ntchito.

Kugwiritsa ntchito mosavomerezeka sikulimbikitsidwa.

Ndi potaziyamu woleketsa okodzetsa kapena zakudya zina zokhala ndi potaziyamu.

AI angiotensin receptor antagonists, monga telmisartan, amachepetsa kuchepa kwa potaziyamu chifukwa cha okodzetsa. Potaziyamu yosawononga okodzetsa, monga spironolactone, eplerenone, triamteren kapena amiloride, zakudya zopatsa thanzi zomwe zimakhala ndi potaziyamu kapena potaziyamu zina zitha kupititsa patsogolo kuchuluka kwaminyewa ya seramu potaziyamu. Ngati ntchito munthawi yomweyo akuwoneka chifukwa cha hypokalemia, mankhwalawa ayenera kugwiritsidwa ntchito mosamala pokhapokha pakuwunika ma seramu potaziyamu.

Ndi munthawi yomweyo kugwiritsa ntchito lifiyamu ndi ACE zoletsa komanso angiotensin II receptor antagonists, kuphatikizapo telmisartan, kuchuluka kosintha kwa plasma lithiamu ndende ndi kawopsedwe adadziwika. Ngati kugwiritsa ntchito kuphatikiza koteroko ndikofunikira, kuwunika bwino kuchuluka kwa seramu lifiyamu ndikulimbikitsidwa.

Kugwiritsa ntchito nthawi imodzi, zomwe zimafunikira kusamala.

Mankhwala osokoneza bongo oletsa kuponderezana.

NSAIDs (mwachitsanzo, acetylsalicylic acid mu mlingo womwe umapangidwira zochizira zotupa, COX-2 inhibitors komanso NSAIDs zosasankha) zitha kuchepetsa mphamvu ya antihypertensive ya angiotensin II receptor antagonists.

Odwala ena omwe ali ndi vuto la impso (odwala omwe ali ndi vuto losowa madzi m'thupi kapena odwala okalamba aimpso ntchito), kugwiritsidwa ntchito nthawi yomweyo kwa angiotensin II receptor antagonists ndi othandizira omwe amaletsa COX kungapangitse kuwonjezereka kwa ntchito yaimpso, kuphatikizapo kuperewera kwaimpso. ndikosintha. Chifukwa chake, kuphatikiza koteroko kuyenera kugwiritsidwa ntchito mosamala, makamaka odwala okalamba. Odwala ayenera kulandira kuchuluka kwamadzi ambiri ndikuwunika kuyang'anira ntchito ya impso kuyenera kuyesedwa pambuyo poyambira chithandizo chanthawi yomweyo komanso pambuyo pake.

Kuchulukitsa pafupifupi 2,5 kwa AUC 0-24 ndi C max kunanenedwa kuti kumagwiritsidwa ntchito nthawi imodzi ndi ramipril ndi ramiprilat. Kufunika kwachipatala kwa uthengawu sikudziwika.

Diuretics (thiazide kapena loop).

Chithandizo choyambirira ndi kuchuluka kwamphamvu kwa okodzetsa, monga furosemide (loop diuretic) ndi hydrochlorothiazide (thiazide diuretic), kumatha kubweretsa kuchepa magazi komanso chiopsezo cha hypotension koyambirira kwa chithandizo ndi telmisartan.

Iyenera kuganiziridwa ndi kugwiritsa ntchito nthawi imodzi.

Mankhwala ena a antihypertensive.

Zotsatira za telmisartan - kuchepa kwa magazi - zimatha kuwonjezeka pamene zimagwiritsidwa ntchito ndi mankhwala ena a antihypertensive.

Poganizira zamankhwala omwe amapangidwira, titha kuyembekezera kuti mankhwala monga baclofen, amifostine, amatha kuyambitsa zotsatira za hypotensive zotsatira zama antihypertensive onse a mankhwala, kuphatikizapo telmisartan. Orthostatic hypotension imatha kukulira chifukwa chomwa mowa, kugwiritsa ntchito barbiturates, mankhwala osokoneza bongo kapena antidepressants.

Corticosteroids (kugwiritsa ntchito kwadongosolo).

Kuchepetsa antihypertensive kwambiri.

Ma blockade apawiri a renin-angiotensin-.

Zawonetsedwa kuti magawo awiri a renin-angiotensin- (RAAS) omwe amagwiritsidwa ntchito munthawi yomweyo a ACE inhibitors, angiotensin II receptor antagonists kapena aliskiren amadziwika ndi zochitika zambiri zosagwirizana ndi zovuta monga arterial hypotension, hyperglycemia, kuchepa kwa aimpso ntchito (kuphatikiza ndi kulephera kwamphuno) kugwiritsa ntchito monotherapy.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Chithandizo cha Telmisartan sichingaperekedwe panthawi yapakati. Ngati pakufunika kupitiliza mankhwala a antihypertensive, ndikofunikira kukaonana ndi dokotala. Adzasankha mankhwala oyenerera.

Ngati ndi kotheka, kugwiritsa ntchito ndalama zochizira azimayi panthawi yoyamwitsa kumalimbikitsidwa kusamutsa mwana kuti akwanitse kudya. Kusamala kumeneku ndi chifukwa chosazindikira zambiri za zotsatira za telmisartan, yomwe imatha kupezeka mkaka, mthupi la makanda.

Gwiritsani ntchito mu ukalamba

Kugwiritsa ntchito kwa Telsartan muukalamba kulibe mawonekedwe pokhapokha pali contraindication odwala.

Kugwiritsa ntchito kwa Telsartan muukalamba kulibe mawonekedwe pokhapokha pali contraindication odwala.

Mankhwala osokoneza bongo a Telsartan 80

Zambiri pa bongo ndizochepa. Hypotension, kuthamanga kapena kuchepa kwa kugunda kwa mtima nkotheka.

Ngati mukukayikira kuchuluka kwa telmisartan, muyenera kufunsa dokotala. Pankhaniyi, mankhwala othandizira amalimbikitsidwa. Hemodialysis siyothandiza.

Kuchita ndi mankhwala ena

Chipangizochi chimatha kugwiritsa ntchito mankhwala ena a antihypertensive.

Kuphatikizidwa kwa Telsartan ndi ma statins, paracetamol sikumabweretsa kuwoneka kwa zoyipa zilizonse.

Chidachi chitha kuwonjezera kuchuluka kwa mphamvu ya digoxin m'magazi. Izi zimafuna kuwunikira.

Sitikulimbikitsidwa kugwiritsa ntchito Telsartan yokhala ndi potaziyamu woletsa mankhwala ndi mankhwala, omwe ndi othandizira omwe ndi potaziyamu. Kuphatikiza koteroko kumatha kuyambitsa Hyperkalemia.

Kuphatikiza ndi kukonzekera komwe kumakhala ndi mchere wa lithiamu kumawonjezera kuwonongeka kwawo. Kugwiritsa ntchito kuphatikiza koteroko ndikofunikira pokhapokha kuyang'anitsitsa mosamala pazinthu za lithiamu zomwe zili m'magazi.

Acetylsalicylic acid ndi mankhwala ena osapweteka a antiidal omwe amachepetsa mphamvu ya mankhwalawa amachepetsa mphamvu ya mankhwalawa. NSAIDs zomwe zimalepheretsa ntchito ya cycloo oxygenase, kuphatikiza ndi telmisartan, zimatha kuyambitsa kuwonongeka kwa impso m'magulu ena a odwala.

Acetylsalicylic acid ndi mankhwala ena osapweteka a antiidal omwe amachepetsa mphamvu ya mankhwalawa amachepetsa mphamvu ya mankhwalawa.

Systemic glucocorticosteroids amachepetsa mphamvu ya antihypertensive mankhwala.

Kuyenderana ndi mowa

Sikulimbikitsidwa kumwa mowa wamtundu uliwonse mukamamwa ndi Telsartan.

Ma Analogs a chida ichi ndi:

• Mikardis,
• Wotsogolera
• Telmisartan-Ratiopharm,
• Telpres
• Telmista
• Tsart,
• Hipotel.

Hipotel ndi analogue ya Telsartin.
Telpres ndi analogue ya Telsartin.Mwa zofananira za Telsartin, mankhwala a Telmisartan-Ratiopharm amaperekedwa.
M'malo mankhwala Telsartin Pamaso.
Mankhwala a Mikardis ndi ofanana ndi a Telsartan.
Telmista ndi analogue ya Telsarpan.