Momwe mungagwiritsire ntchito mankhwala a Mikardis?

Mankhwala Telmisartan ndi chiwopsezo chotsimikizika ndi chothandiza cha angiotensin II receptor antagonist (mtundu wa AT1). Telmisartan, yokhala ndi mgwirizano wambiri kwambiri, umalowa m'malo mwa angiotensin II m'malo ake omangira ku AT1 receptors, omwe amachititsa zotsatira za thupi za angiotensin II. Telmisartan siziwonetsa ntchito zoyipa motsutsana ndi AT1 receptors. Chomangirira cholandiracho ndichotsimikizika komanso chitalizitali. Telmisartan ilibe chiyanjano ndi ma receptor ena, kuphatikizapo AT2 ndi ma receptors ena a AT. Udindo wogwira ntchito kwa ma receptor awa sichikudziwika, monga momwe mphamvu zawo zitha kupitilira ndi angiotensin II, omwe kuchuluka kwake kumawonjezeka motsogozedwa ndi telmisartan, sikunawululidwe. Telmisartan imachepetsa plasma aldosterone milingo, sichikhudza ntchito ya plasma renin, siyimaletsa mayendedwe a ion, sikuletsa ACE (kininase II), enzyme yomwe imapatsanso bradykinin. Chifukwa chake, kugwiritsa ntchito mankhwalawa sikuyenda limodzi ndi zovuta zomwe zimakhudzana ndi kudziwitsidwa kwa bradykinin.
Mukamamwa mlingo wa 80 mg, telmisartan pafupifupi imalepheretsa kuthamanga kwa matenda a angiotensin II, mphamvu yotchulidwa ya antihypertgency imapitilira maola 24 ndipo imakhalabe yofunikira mpaka maola 48.
Pambuyo pa kumwa koyamba kwa telmisartan, mphamvu ya antihypertensive imayamba pang'onopang'ono kwa maola atatu, ndipo zotsatira zake ndizofunikira kwambiri pakatha masabata 4 mpaka 8 chiyambireni chithandizo ndikumapitiriza kugwiritsa ntchito mankhwalawa. Mphamvu ya antihypertgency imakhalabe yokhazikika kwa maola 24 mutatha kuphatikiza, kuphatikizapo maola 4 omaliza asanatsatire dongosolo lina. Izi zikutsimikiziridwa ndikuwunika kwa magazi.
Odwala odwala matenda oopsa (ochepa matenda oopsa), telmisartan imachepetsa kuthamanga kwa magazi kwa systolic ndi diastolic popanda kukhudza kugunda kwa mtima. Kuchoka kwadzidzidzi kwa mankhwalawa, kuthamanga kwa magazi pang'onopang'ono kumabwereranso ku gawo loyambirira popanda chitukuko cha matenda obwera nawo.
Kafukufuku wachipatala adatsimikizira kuti chithandizo cha telmisartan chimachepetsa kwambiri kumanzere kwamitsempha yamagazi yamanzere amanzere ndi kumanzere kwamitsempha yama cell ambiri mwa odwala omwe ali ndi matenda oopsa (matenda oopsa) komanso kumanzere kwamitsempha yamagazi.
M'maphunziro azachipatala, zidapezeka kuti telmisartan ndiyosachepera ACE inhibitors kuyambitsa kukula kwa chifuwa.
Pharmacokinetics Amamwa mwachangu pambuyo pakumwa pakamwa, pafupifupi mwamtheradi bioavailability pafupifupi 50%. Ngati mankhwalawa amatengedwa ndi zakudya, kuchepa kwa AUC kumasiyana kuchokera 6% (pamene amwedwa ndi 40 mg) mpaka 19% (pamene amamwa mlingo wa 160 mg). Patatha maola atatu mutatha kumwa mankhwalawa, kuchuluka kwa madzi am'magazi kumatha ndipo sikudalira kuti Telmisartan adatengedwa pamimba yopanda kanthu kapena chakudya.
Telmisartan imagwirizanitsidwa kwambiri ndi mapuloteni a plasma (99.5%), makamaka ndi albumin ndi alpha-1-acid glycoprotein. Kuchuluka kwa magawo mu ofanana ndi 500 malita. Telmisartan imapangidwa ndi kuphatikizika ndi glucuronide. Conjugate ilibe zochitika zamankhwala. Telmisartan imadziwika ndi mbiri yakale ya pharmacokinetic yokhala ndi moyo theka pachaka chodwala cha maola opitilira 20. Kuzungulira kwakukulu m'madzi am'magazi ndi AUC kumawonjezera mosasinthika kwa mlingo. Palibe umboni wa kukokomeza kwamankhwala kwakuthupi m'thupi mukamagwiritsa ntchito mulingo woyenera. Kuchuluka kwa plasma mwa akazi ndiwokwera kuposa amuna, osasintha magwiridwe.
Pambuyo pakamwa, telmisartan imatulutsidwa kwathunthu ndowe, nthawi zambiri osasinthika, kukodza kwamkodzo kumachepera 2% ya mlingo. Chilolezo chonse cha madzi am'magazi ndi okwera kwambiri (pafupifupi 900 ml / min), tikayerekeza ndi magazi a hepatic (pafupifupi 1500 ml / min).
Magulu apadera a odwala
Odwala okalamba
Ma pharmacokinetics a telmisartan mwa okalamba samasiyana ndi omwe amakhala ndi odwala ochepa.
Odwala ndi mkhutu aimpso ntchito
Odwala omwe ali ndi vuto la impso akuyesedwa dialysis, m'munsi mwa plasma ndende ya telmisartan imadziwika, koma izi sizothandiza kwenikweni. Telmisartan imakhala ndi mapuloteni ambiri amadzi a plasma, motero, sichimapukusidwa panthawi ya dialysis.
Odwala omwe ali ndi vuto la chiwindi
Odwala omwe ali ndi vuto la chiwindi, bioavailability imawonjezeka mpaka 100%.

Kutulutsa mawonekedwe ndi kapangidwe kake

Fomu ya Mlingo - mapiritsi: oblong, pafupifupi oyera kapena oyera, mbali imodzi - olembedwa "51N" (mapiritsi 40 mg) kapena "52H" (mapiritsi 80 mg), mbali inayo - chizindikiro cha kampani (7 ma PC. Mukatoni okhala ndi matuza a 2 kapena 4 okhala ndi mapiritsi a 40 mg kapena 2, 4 kapena 8 matuza okhala ndi mapiritsi a 80 mg ndi malangizo ogwiritsira ntchito Mikardis).

Zogwira pophika: telmisartan, zomwe zili mu piritsi limodzi ndi 40 kapena 80 mg.

Omwe amathandizira: sodium hydroxide, polyvidone (collidone 25), sorbitol, meglumine, magnesium stearate.

Mankhwala

Mphamvu yogwira ya Mikardis - telmisartan, imatsutsana ndi angiotensin II receptors. Amadziwika ndi chiyanjano chachikulu cha AT subtype₁zolandila za angiotensin II, zomwe zochita za angiotensin II. Telmisartan sikuti imapangitsa chidwi cha angiotensin II ndikuyichotsa pakulumikizana ndi cholandilira, ndipo mafomu olumikizana ndi AT subtype okha₁zolandila za angiotensin II, pomwe zomangirazi ndizokhalitsa.

Mankhwalawa alibe kuyanjana ndi ma angiotensin receptors ena, kuphatikizapo AT subtype₂. Kufunika kwawo kogwira ntchito komanso momwe angapangire kukondoweza ndi angiotensin II, kugwiritsidwa ntchito kwake komwe kumawonjezera ndi telmisartan, sikunaphunzire.

Telmisartan amachepetsa kuchuluka kwa aldosterone m'magazi. Sichotsetsa mayendedwe a ion ndipo sichimaletsa renin m'madzi a m'magazi. Siponderezera kininase II (angiotensin-converting enzyme) ndi enzyme yomwe imakhalanso ndi mphamvu yowonongeka motsutsana ndi bradykinin, chifukwa chake, kuwonjezeka kwa zotsatira zoyambitsidwa ndi bradykinin sikuyembekezeredwa.

Ngati kumwa 80 mg, telmisartan kwathunthu limaletsa hypertgency zotsatira za angiotensin II. Mphamvu ya mankhwalawa imadziwika mkati mwa maola atatu itatha kumwa koyamba, imatha kwa maola 24 ndipo imakhalabe yofunikira kwa maola 48. Mphamvu yotchulidwa antihypertensive imayamba pambuyo pa masabata 4-8 ogwiritsira ntchito Mikardis mosalekeza.

Odwala omwe ali ndi matenda oopsa, Mikardis amachepetsa kuthamanga kwa magazi kwa diastoli ndi systolic, koma sizikhudza kugunda kwa mtima.

Pambuyo pakuchotsa kwadzidzidzi kwa telmisartan, zizindikiro za kuthamanga kwa magazi zimabwereranso pang'onopang'ono, zomwe sizikuyenda ndi chitukuko cha kusiya.

Pharmacokinetics

Telmisartan imatengedwa mwachangu kuchokera m'mimba thirakiti pambuyo pakamwa pa Mikardis. Zake bioavailability ndi 50%. Pankhani ya kudya munthawi yomweyo, mtengo wa AUC umachepa (dera lomwe limakhala munthawi yopondera): chizindikiro chimachokera ku 6% (pa mlingo wa telmisartan 40 mg) mpaka 19% (pa mlingo wa 160 mg). Maola atatu atatha kutenga Mikardis, kuchuluka kwa mankhwalawa kumayendetsedwa mosasamala nthawi yomwe chakudya chimatenge.

Telmisartan imadziwika ndi chomanga kwambiri mapuloteni a plasma (makamaka albin ndi alpha₁- glycoprotein) - oposa 99.5%.Kuchuluka kwa magawidwe ofanana pa equilibrium kuli pa 500 l.

Mankhwalawa amakonzedwa ndi kulumikizana ndi glucuronic acid, chifukwa chomwe ma metabolac osagwira metabolites amapangidwa. Amapakidwa kudzera m'matumbo mu mawonekedwe osasinthika, ochepera 2% ya impso amapukusidwa ndi impso.

Kutha kwa theka-moyo wopitilira maola 20. Kupezeka konse kwa plasma ndi 900 ml / min, magazi a hepatic ndi 1500 ml / min.

Pharmacokinetics pazochitika zapadera zamankhwala:

jenda: mwa amayi, kuchuluka kwakukulu ndi AUC ndizokwera kuposa amuna, pafupifupi 3 ndi 2, motsatana, pomwe palibe kusiyana kwakukulu pakuchita bwino kwa Mikardis,
ukalamba: magawo a pharmacokinetic mu odwala okalamba samasiyana ndi omwe ali ndi odwala achinyamata, chifukwa chake kusintha kwa mankhwalawa sikofunikira,
Ana a zaka zapakati pa 6 mpaka 18: poika mankhwala a Mikardis pa 1 mg / kg kapena 2 mg / kg kwa masabata anayi, pharmacokinetics ya telmisartan ali ofanana ndi omwe ali akulu, omwe amatsimikizira kusakhala kwa mzere wa pharmacokinetics ya thunthu, makamaka pokhudzana ndi kuchuluka kwakukulu,
kulephera kwa aimpso ndi hemodialysis: machitidwe a telmisartan sasintha, kotero kusintha kwa mankhwala sikofunikira. Hemodialysis siyimathandizira pakuchotsa mankhwalawa m'thupi,
kufatsa kuwongolera chiwindi ntchito (Makanda a ana ndi Pugh A ndi B): tsiku lililonse telmisartan sayenera kupitirira 40 mg.

Contraindication

Herederal fructose tsankho (chifukwa cha sorbitol),
Matenda owopsa a chiwindi (kalasi C malinga ndi kukula kwa Mwana),
Matenda owopsa a m'mimba
Kupitilira muyeso
Osakwana zaka 18
Mimba komanso kuyamwa
Hypersensitivity pamagawo a mapiritsi a Mikardis.

Hyperkalemia
Hyponatremia,
Matenda a mtima (CHD),
Kulephera kwamtima kosalekeza
Idiopathic hypertrophic subaortic stenosis,
Stenosis wa msempha wa msempha,
Kutsika kwamagazi kozungulira chifukwa cha kutsekula m'mimba kapena kusanza, kutsekeka kwa mchere ndi / kapena chithandizo cham'mbuyomu chamkati,
Kuchepa kwa chiwindi ndi / kapena impso,
Mgwirizano wamitsempha wamatsenga kapena matenda am'mimba a impso imodzi,
Zinthu pambuyo kupatsirana kwa impso.

Kufotokozera kwamapangidwe a kuchitapo kanthu: pharmacodynamics and pharmacokinetics

Angiotensin II amapangidwa kuchokera ku angiotensin I makamaka motsogozedwa ndi angiotensin kutembenuza enzyme (ACE). Ma Vasoactive ma cell amakhudza kuthamanga kwa magazi kudzera pa AT1 receptors. Angiotensin II imayambitsa vasoconstriction ndikuwonjezera gawo la zochitika zachisoni zamitsempha, zomwe zimabweretsa kuwonjezeka kwa sodium reabsorption mu impso ndi secretion ya aldosterone m'magazi a adrenal.

Rec1 receptor

Telmisartan, monga ena angiotensin II receptor antagonists, ndi benzimidazole. Amasankha mosamala ma 1 angiotensin receptors ndipo amachepetsa kuthamanga kwa magazi.

Telmisartan imatengeka mwachangu. Miyezo yambiri ya plasma imachitika pambuyo pa ola limodzi. Mankhwalawa amakhala ndi kagayidwe kake. Bioavailability amadalira Mlingo kuyambira 40 mpaka 60%. Nthawi yomweyo, chakudya chimachepetsa kuyamwa kwa mankhwalawa. Telmisartan imaphatikizidwa ndi glucuronic acid ndipo imapakidwa kudzera mu bile ndi chopondapo. Hafu ya moyo ili pafupifupi maola 24. Zowonjezera pazamankhwala ndi mitengo zitha kupezeka mu kaundula wa mankhwala (RLS).

Maphunziro azachipatala

Telmisartan anayerekezedwa ndi placebo ndi mankhwala ena a antihypertensive. Maphunziro ambiri anaphatikizapo amuna ndi akazi azaka zonse. M'maphunziro awiri olamulidwa ndi placebo, antihypertensive zotsatira za telmisartan adatsimikiziridwa. Pakati pa 20 mpaka 80 mg / tsiku, mankhwalawa adachepetsa kukakamiza. Pamwamba pa 80 mg / tsiku, zotsatira zake sizinawonjezeke, komabe, zovuta zake ndizofunikira.

Pakufufuza kwakawiri, anthu 385 adalandira telmisartan ndipo anthu 193 adalandira lisinopril. Mlingo woyamba wa telmisartan anali 40 mg / tsiku kamodzi ndi 10 mg / tsiku la lisinopril. Ngati kuthamanga kwa magazi kwa diastolic sikugwera pansi pa 90 mmHg Pambuyo pa milungu 4, mlingo unachulukitsidwa m'magulu onse awiri. Kenako odwala anapitiliza kumwa mankhwala kwa milungu 48. Telmisartan monotherapy inali yokwanira mu 44% ya milandu. Kuthamanga kwa magazi kunachepetsedwa ndi pafupifupi 18/16 mm Hg. Kwa lisinopril, manambala ofanana anali 48% ndi 19/16 mm Hg. Kuphatikiza ndi hydrochlorothiazide, telmisartan adachepetsa kuthamanga kwa magazi ndi 2 mmHg. Art. kuposa lisinopril.

Hydrochlorothiazide

Malingana ndi chiwembu chofanana, telmisartan anayerekezedwa ndi enalapril kwa miyezi isanu ndi umodzi. Phunziroli linakhudza anthu 272 omwe anali osachepera zaka 65. Mlingo wa telmisartan unachokera 40 mpaka 80 mg, ndipo enalapril - kuyambira 1 mpaka 5-20 mg patsiku. Zinthu zonsezi zikuwonetsa kufanana kwa antihypertensive.

Pakufufuza kawiri kwa milungu 6, odwala 222 adalandira placebo, telmisartan (40 kapena 80 mg / tsiku kamodzi), kapena losartan. Kutsika kwapakati pa kuthamanga kwa magazi kunali 14/9 mm Hg. (40 mg / tsiku) kapena 16/10 mmHg mukamagwiritsa ntchito telmisartan.

Odwala 232 adalandira telmisartan (40-120 mg / tsiku), amlodipine (5-10 mg / tsiku), kapena placebo milungu 12. Othandizira awiri a antihypertgency adayamba kupatsidwa mankhwala ochepera. Ngati kuthamanga kwa magazi kwa diastolic sikunachepetse, mlingowo unakulitsidwa. Kuthamanga kwa magazi kunachepa ndi pafupifupi 17/12 ndi telmisartan ndi 18/12 mm Hg. ndi amlodipine. Mu gulu la telmisartan, mlingo woyambirira sunali wokwanira. Mu gulu la amlodipine, ndi 40% yokha mwa odwala omwe anali ndi mlingo wa mankhwalawo. Komanso mu kafukufukuyu, zidadziwika kuti mlingo wa telmisartan woposa 80 mg / tsiku uli ndi mphamvu yaying'ono yowonjezera antihypertensive.

Malinga ndi kafukufuku wina, telmisartan imachitanso chimodzimodzi ndi atenolol (1 nthawi kuyambira 50 mpaka 100 mg / tsiku). M'maphunziro ena, odwala ena adayang'aniridwa ndi magazi maola a 24. Zinapezeka kuti telmisartan imakhala ndi mphamvu yocheperako kuposa zinthu zomwe zimakhala ndi moyo wamfupi wamoyo (mwachitsanzo, losartan). Komabe, poyerekeza ndi enalapril, palibe kusiyana komwe kunapezeka. Pakafukufuku wotseguka, telmisartan idapezeka kuti imagwira ntchito ngati enalapril mwa anthu omwe ali ndi matenda oopsa.

Zotsatira zoyipa

Chizungulire, kupweteka mutu, kufooka matenda, kusabala, mseru, matenda am'mimba, komanso matenda amtundu wa kupuma angayambike mutatenga mycardis. Zotsatira zoyipa izi zinali zofanana ndi placebo. Odwala ena adadandaulanso za kutsokomola.

Mlandu wa angioedema wapezeka m'maphunziro. Izi zikutsimikizira zomwe zidachitika m'mbuyomu kuti mavuto awiriwa, ngakhale ali ocheperako poyerekeza ndi ACE inhibitors, amathanso kuchitika ndi otsutsa a AT1 receptor. Poyeserera nyama, kukokoloka ndi zilonda zam'mimba zimachitika pafupipafupi ndi telmisartan.

Mlingo ndi makonzedwe

Mapiritsi amatengedwa pakamwa mosasamala chakudya.

Mlingo woyamba wa Mikardis pochiza matenda oopsa: piritsi 1 (40 mg) 1 nthawi patsiku. Kuwonjezeka kwa 2% kwa mlingo kumaloledwa pokhapokha ngati mukutenga 40 mg patsiku, njira zochiritsidwira sizikwaniritsidwa. Koma posankha kuwonjezera kuchuluka kwa mankhwalawa, ndikofunikira kudziwa kuti kuchuluka kwa antihypertensive kwambiri nthawi zambiri kumatha kungoyembekezeka pa masiku 28-56 atangoyamba kumene chithandizo.

Mlingo wa mankhwalawa kuti muchepetse vuto la mtima ndi kufa kwa piritsi 1 piritsi (80 mg) nthawi imodzi patsiku. Kumayambiriro kwa zamankhwala, kukonza kowonjezereka kwa magazi kungafunike.

Mlingo wa tsiku ndi tsiku wa Mikardis wa chiwindi chovuta kugwira ntchito modekha komanso moyenera (kalasi A ndi B pa kukula kwa Mwana) sayenera kupitilira 40 mg.

Kuwongolera kwa mlingo wa odwala okalamba ndi odwala omwe ali ndi vuto la impso (ngakhale omwe ali pa hemodialysis) sikufunika.

Malangizo apadera

Nthawi zina, chifukwa cha kuponderezedwa kwa dongosolo la renin-angiotensin-aldosterone, makamaka mukamagwiritsa ntchito mankhwala osokoneza bongo omwe amakhudza dongosolo lino, ntchito yaimpso imalephera (kuphatikizapo kuperewera kwaimpso). Pankhaniyi, chithandizo chotsatira limodzi ndi njira yofanana ndi ya renin-angiotensin-aldosterone, mwachitsanzo, kuwonjezera kwa angiotensin-kutembenuza enzyme zoletsa kapena a renin inhibitor, aliskiren, kuti angiotensin II receptor antagonist blockers), iyenera kuchitidwa mosamalitsa komanso moyenera impso (kuphatikiza kuwunika kwa serum creatinine ndi potaziyamu).

Pamene ntchito impso ndi mtima kamvekedwe zimatengera ntchito ya renin-angiotensin-aldosterone dongosolo (mwachitsanzo, odwala matenda a impso kapena mtima kulephera, kuphatikizapo ndi aimpso a stenosis kapena a stenosis a impso imodzi, kugwiritsa ntchito mankhwala omwe amakhudza pa izi akhoza kukhala limodzi ndi oliguria, hyperazotemia, pachimake ochepa hypotension ndipo, kawirikawiri, pachimake aimpso kulephera.

Poganizira momwe ntchito yogwiritsira ntchito mankhwala ena omwe amakhudzanso renin-angiotensin-aldosterone dongosolo mukamapereka mankhwala a Mikardis osakanikirana ndi zina za potaziyamu, mankhwala osokoneza bongo a potaziyamu, mchere wambiri wa potaziyamu komanso mankhwala ena omwe amalimbikitsa kuchuluka kwa potaziyamu m'magazi (mwachitsanzo, heparin), tikulimbikitsidwa kuwongolera chizindikiro ichi mwa odwala.

Pankhani ya matenda a shuga ndi matenda owopsa a mtima, mwachitsanzo, odwala omwe ali ndi matenda a shuga komanso matenda a mtima, kugwiritsa ntchito mankhwala omwe amachepetsa kuthamanga kwa magazi (monga angiotensin kutembenuzira ma enzyme inhibitors kapena angiotensin II receptor antagonists) ndi kufa mwadzidzidzi kwamtima. Matenda a mtima omwe ali ndi matenda a shuga amatha kukhala asymptomatic, ndipo pachifukwa ichi sichodziwika kuti sadzapezeka. Pankhaniyi, musanayambe mankhwala a Mikardis mwa odwala matenda a shuga, ndikulimbikitsidwa kuti kuyesedwa koyenera kuchitike, kuphatikizapo kuyeseza masewera olimbitsa thupi kuti muzindikire ndikuchiza matenda a mtima.

Ngati njira ina yothandizira, mankhwalawa angagwiritsidwe ntchito limodzi ndi thiazide diuretics (hydrochlorothiazide), yomwe imapangidwanso ndi hypotensive (mwachitsanzo, Mikardis Plus).

Mu aldosteronism yayikulu, mankhwala a antihypertensive, omwe njira yake yogwirira ntchito ikuletsa renin-angiotensin-aldosterone, monga lamulo, alibe zotsatira.

Telmisartan imapukusidwa makamaka ndi bile. Ndi matenda olepheretsa amisempha yodwala kapena kulephera kwa chiwindi, kuchepa kwa chidziwitso cha mankhwala ndikotheka.

Tiyenera kudziwa kuti a Mikardis satha kugwiritsa ntchito bwino omwe ali mu liwiro la Negroid.

Kuwonongeka kwa ntchito ya chiwindi pakudya telmisartan kumawonedwa kwambiri pakati pa anthu okhala ku Japan.

Odwala panthawi ya chithandizo ayenera kusamala pochita zinthu zoopsa zomwe zimafunikira chidwi chochulukirapo komanso kuthamanga kwa zochitika zama psychomotor.

Kuyanjana kwa mankhwala osokoneza bongo

Zokhudzana kwambiri ndi zachipatala, kuwonjezera pa kuthekera kwa telmisartan kuonjezera kuchuluka kwa zochita za antihypertensive, sizinazindikiridwe.

Kugwiritsa ntchito telmisartan kuphatikiza ndi amlodipine, simvastatin, paracetamol, ibuprofen, glibenclamide, hydrochlorothiazide, warfarin kapena digoxin sikupangitsa kuti pakhale kulumikizana kwakukulu.

Ndi kugwiritsa ntchito pamodzi kwa telsmisartan ndi digoxin, kuwonjezeka kwachiwiri kwa plasma kumayang'aniridwa ndi pafupifupi 20% (munthawi imodzi, ndi 39%). Pankhani imeneyi, tikulimbikitsidwa mukamagwiritsa ntchito kuphatikiza kotero kuti nthawi ndi nthawi muzindikire kuchuluka kwa digoxin m'magazi.

Pogwiritsa ntchito telmisartan kuphatikiza ndi ramiprilat (ramipril), kuwonjezeka kwa 2,5 kwa Cmax ndi AUC0-24 kwa wothandizira wachiwiri adawonedwa (kufunikira kwakanthawi kachulukidwe kameneka sikunakhazikike).

Panthawi yomweyo kugwiritsa ntchito angiotensin-kutembenuza enzyme zoletsa ndi kukonzekera kwa lifiyamu, kuwonjezereka kosintha kwa ndende ya lithiamu m'magazi kunawonedwa, komwe kumayendera limodzi ndi poizoni. Osati kawirikawiri, zosintha zoterezi zidanenedwa ndi angiotensin II receptor antagonists. Ndikulimbikitsidwa kuti kutsata kwa lifiyamu m'magazi kutsimikizidwe ndi chithandizo cha munthawi yomweyo kukonzekera kwa lithiamu ndi angiotensin II receptor antagonists.

Chithandizo cha mankhwala omwe si a anti -idalidal anti-yotupa, kuphatikizapo cycloo oxygenase-2 inhibitors, acetylsalicylic acid ndi mankhwala osagwiritsa ntchito mankhwala osokoneza bongo omwe angayambitse matenda, amatha kupititsa patsogolo kulephera kwaimpso kwa odwala omwe ali ndi vuto lodana ndi thupi.

Mankhwala omwe amagwira pa renin-angiotensin-aldosterone amatha kukhala ndi synergistic. Odwala omwe amatenga mankhwala osapweteka a anti-yotupa ndi telmisartan, kumayambiriro kwa chithandizo, amalimbikitsidwa kuti alipire kuchuluka kwa kuzungulira magazi ndikupanga maphunziro a impso.

Kuchita bwino kwa telmisartan kumachepetsedwa chifukwa cha kuletsa kwa vasodilating mphamvu ya ma prostaglandins pomwe kugwiritsa ntchito Mikardis ndimankhwala osapweteka a antibroid.

Chithandizo cha Hypertension

M'masiku amakono, kugunda kwa mtima ndi stroko zimapangitsa pafupifupi 70% ya imfa zonse. Masiku ano, anthu asanu ndi awiri mwa khumi amafa chifukwa cha mitsempha ya mtima kapena ubongo. Choopsa kwambiri ndichakuti anthu ambiri sakayikira konse kuti akudwala matenda oopsa. Odwala ambiri chifukwa cha izi amaphonya mwayi wokonza kena kake, potero amadziweruza kuti afe.

Pankhani imeneyi, simungakhale opanda chidwi ndi thanzi lanu komanso osanyalanyaza mayeso azachipatala omwe madokotala amatipatsa. Ndipo pochitika kuti mankhwalawa apezeka, ndikofunikira kuchitapo kanthu pamankhwala ake. Chida chothandiza kwambiri pochiza matendawa ndi mankhwala omwe amatchedwa "Mikardis".

Zambiri pazamankhwala

Mankhwalawa amadziwika kuti ndi wothandiza kangapo kuposa Losartan. Malinga ndi malangizo, Mikardis ndi mankhwala osakaniza ndi mafuta. Imakhala ndi mayamwidwe abwino, imalowetsedwa bwino m'thupi la thupi, ndipo palibe kusiyana komwe, chiyani, ndi kuchuluka kwa chakudya chomwe munthu amadya. Mankhwalawa, monga lamulo, amayamba kumamwa pakatha ola limodzi ndi theka. Ponena za kukakamiza, imayamba kugwa patatha maola atatu mutamwa mapiritsi. Ili ndiye gawo lalikulu la Mikardis. Mankhwala samapanga mikhalidwe yopanga metabolites yogwira. Kuchokera mthupi la munthu, mankhwalawa amachotsedwa mu ndulu.

Mankhwalawa akuwonetsedwa, kuphatikiza kwa odwala omwe ali ndi vuto la impso. Malinga ndi malangizo ogwiritsira ntchito, "Mikardis" sinafotokozedwe kwa anthu omwe ali ndi chiwindi chodwala, komanso, kwa iwo omwe ali ndi mavuto ndi thirakiti la biliary. Odwala omwe ali ndi vuto lowona aimpso sangatenge oposa mamiligalamu 40 patsiku.

Njira ntchito ndi tanthauzo la mankhwala

Monga momwe malangizo a Mikardis akusonyezera, kumwa mankhwalawa kumafunikira kamodzi patsiku, mosasamala kanthu ndi chakudya. Mlingo wa tsiku ndi tsiku ndi 40 milligrams. Ndi matenda oopsa oopsa, mankhwalawa amayamba ndi ma milligram 20, mwa mitundu yayikulu, kuchuluka kwa mankhwalawa kumatha kuwonjezeredwa mpaka 160 milligrams.

Kugwiritsa ntchito bwino kwa mankhwalawa kumatengera mlingo. Mukachulukitsa mlingo watsiku ndi tsiku kuyambira 20 mpaka 80 milligrams, izi zitanthauza kuti kukakamira kumatsika kawiri. Kuchulukitsa Mlingo wa Mikardis kupitirira mamiligalamu opitilira 80 sikofunikira, chifukwa izi sizingathandizenso kuchepa kwamphamvu. Mlingo wokonza mankhwalawa ndi mamiligalamu 40 patsiku. Pakatha mwezi umodzi w kumwa mankhwalawo, kupsinjika mwa munthu nthawi zambiri kumakhala kwabwinobwino. Chachikulu ndikuyang'anira kuchuluka kwa mayikidwe a Mikardis.

Ngati wodwalayo ali ndi gawo loyambirira la matenda oopsa, ndikwanzeru kugula mankhwala omwe ali ndi kuchuluka kwa mamiligalamu 40 ndikutenga theka la piritsi patsiku (ndiye kuti mamiligalamu 20). Ngati munthu ali ndi mawonekedwe osachiritsika, ndiye kuti mutenge mamiligalamu 40.

Mapangidwe a "Mikardis"

Chifukwa chake, mankhwala omwe amaperekedwa amakhala ndi telmisartan, yomwe ndi yogwira ntchito. Kuphatikiza apo, zinthu zomwe zimapanga hydrochlorothiazide, polyvidone, sodium hydroxide, meglumine, magnesium stearate ndi sorbitol zimaphatikizidwa ngati othandizira ku Mikardis.

Kodi zikuwonetsedwa bwanji Mikardis?

Zizindikiro zogwiritsidwa ntchito

Zizindikiro za angiotensin blockers zikusonyeza kuti wodwalayo amakhala ndi vuto la mtima komanso nephropathy, yomwe imawoneka ngati kuthamanga kwa magazi komanso matenda ashuga. Malinga ndi malangizo, mankhwalawa amatengedwa kuti akwaniritse zolinga zotsatirazi:

Chithandizo cha kuthamanga kwa magazi.
Kupewa matenda a mtima ndi mtima.

Pofunika liti kumwa mankhwalawa mosamala?

Malinga ndi malangizo omwe agwiritsidwa ntchito, mankhwalawa "Mikardis" ayenera kumwedwa mosamala komanso moyang'aniridwa ndi dokotala kwa anthu omwe akudwala matenda otsatirawa:

Matenda a mtima.
Stenosis ya onse aimpso.
Kulephera kwamtima kosalekeza.
Stenosis yamtima mavavu.
Cardiomyopathy kapena matenda aimpso.
Hyperkalemia
Kusokonezeka kwamkati ndi kupatsidwa chiwalo.
Kulakwila kwa kutuluka kwa ndulu.
Kuchepa kwa chiwindi.
Matenda a shuga.
Kuthetsa madzi kumbuyo kwa poyizoni wa chakudya. Ndikofunika kudziwa kuti pamenepa, kutaya kwa madzimadzi kuyenera kubwezeretsedwa musanatenge Mikardis. Malangizowa amatsimikizira izi.

Mikardis, malangizo ntchito: njira ndi mlingo

Mapiritsi a Mikardis ayenera kutengedwa pakamwa. Kudya sikukhudza kutha kwa mankhwalawa.

Kwa matenda oopsa, mankhwalawa tikulimbikitsidwa kuti muyambe ndi mlingo wa 40 mg wa 1 mg. Ngati achire sakukwanira, mlingo wa tsiku ndi tsiku umachulukitsidwa mpaka 80 mg mu 1 mlingo, pomwe ziyenera kukumbukiridwa kuti kupezeka kwakukulu kwa zotsatira za Mikardis kumachitika pakadutsa masabata 4-8 atangoyamba kumene chithandizo.

Kuchepetsa chiopsezo cha kuchepa kwa mtima, ndikofunikira kutenga 80 mg kamodzi patsiku. Kumayambiriro kwa chithandizo, kuwongolera kowonjezereka kwa magazi kungafunike.

Mlingo wa tsiku ndi tsiku wa Mikardis kwa odwala omwe ali ndi vuto la chiwindi chodwala komanso chopatsa mphamvu (makalasi A ndi B pa kukula kwa Mwana-Pugh) sayenera kupitirira 40 mg.

Mankhwala omwe amakhala ndi moyo nthawi yayitali

Mikardis kwenikweni ndi sartan, kapena angiotensin receptor blocker. Mankhwalawa amagwiritsidwa ntchito pochiza magazi. Mfundo zoyenera kuchitidwa ndi sartan ndikuti impso zimapanga renin pambuyo pakumwa, zomwe zimasintha mawonekedwe osagwira a angiotensinogen kukhala angiotensin-1, omwe amachepetsa mitsempha yamagazi komanso okodzetsa.Kutsatira m'thupi kumakhala zochita zosiyanasiyana zomwe zimalepheretsa matenda oopsa.

Chifukwa chake, kuthamanga kwa magazi posachedwa kumakhala kwabwinobwino ngati kwakwezedwa. Ndipo ndendende chifukwa cha izi, moyo wa wodwala wodwala matenda oopsa komanso mtima, komanso, matenda a mtima, umakulitsidwa kwambiri.

Pansipa tikambirana fanizo la Mikardis.

Analogi Osokoneza Mankhwala

Mapiritsi a Mikardis amapangidwa ku Austria, chifukwa chake mtengo wa Mikardis ndi wokwera kwambiri ndipo umafikira ma ruble masauzande ambiri, momwe muli mapiritsi makumi awiri ndi asanu ndi atatu. Koma pali mitundu yotsika mtengo ya mankhwalawa, yomwe imapangidwa ku Russia, tikulankhula za "Angiakand", "Blocktran", "Aprovel", "Candesartan", "Atakanda", "Lozartan", "Cozaar", "Lozape", " Vomerezani ”ndi“ Valsartan ”.

Mankhwala onse omwe ali pamwambawa ali ndi chithandizo chofanana ndi cha Mikardis, koma amasiyana mu kapangidwe ndi kapangidwe kake. Zofanizira zoterezi ndizotsika mtengo, zochokera ma ruble zana limodzi ndi makumi atatu phukusi lililonse. Mwa zina zomwe zimafananizidwa ndi Mikardis, ndikofunikira kutchula mankhwala monga Telmista pamodzi ndi Teseo, Priitor, Twinsta, Telpres, Telsartan, Tsart ndi Hipotel.

Telmista ndi mankhwala osokoneza bongo. Amapezeka piritsi. Mankhwala othandizira telmisartan, omwe ali ndi antihypertensive katundu, ndi angiotensin II receptor antagonist.

Amawonetsedwa kwa matenda oopsa, chiwopsezo chachikulu cha matenda amtima wamtundu wazaka zoposa 55. Amaphatikizidwa mwa mitundu yayikulu ya kukanika kwa chiwindi, kufooka kwa biliary, kuphatikiza ndi aliskiren odwala omwe ali ndi vuto lochepa kapena matenda a shuga, kuperewera kwa lactase / iscralt / isomaltase, kupatsirana kwa fructose, shuga mpaka zaka 18, Hypersensitivity payekhapayekha kapena chilichonse chothandizira cha mankhwalawa.

Mtengo wa mankhwala opangidwa ndi Germany omwe ali ndi zotsatira zofanana, komanso mankhwala a opanga aku Hungary ndi Chipolishi, monga lamulo, ndiokwera kangapo kuposa oloweza mmalo a Russia a Mikardis. Koma ndikofunikira kudziwa kuti masiku ano palibe mankhwala aku Russia omwe ali ndi ntchito yofanana.

Yerekezerani ndi mankhwala ena

Odwala ambiri nthawi zambiri amafunsa kuti kodi ndibwino kutenga chiyani - "Lorista" kapena "Mikardis"? Mankhwalawa onse amachepetsa kukakamizidwa, koma mankhwala omwe amapezeka mwa iwo ndi osiyana kwambiri. Mtengo ulinso wosiyana. Mwachitsanzo, mankhwalawa "Lorista" amatenga ma ruble mazana atatu, pomwe "Mikardis" amawononga makasitomala katatu.

Poyerekeza "Mikardis" ndi "Valz", ndikofunikira kudziwa kuti mankhwalawa ndiwotsika mtengo kwambiri. "Valz" imawononga ndalama pafupifupi ma ruble mazana atatu. Koma amazigwiritsa ntchito ngati gawo limodzi la chithandizo cha matenda a mtima osalephera. Itha kugwiritsidwanso ntchito pochiza odwala omwe ali ndi vuto la stroke kapena matenda a mtima.

Nthawi zambiri anthu amayesanso kuyerekeza Mikardis ndi Lisinopril. Ndiyenera kunena kuti mankhwalawa ali m'magulu osiyanasiyana a mankhwalawa. Mankhwalawa ali ndi zinthu zosiyanasiyana zomwe zimagwira, kuphatikiza apo, kapangidwe ka kayendedwe ka thupi lawo kamasiyana. "Lisinopril" amagwira ntchito ngati choletsa ACE ndipo kuwonjezera pamayambitsa zosiyanazi zingapo. Izi zimapangidwa ku Russia, ndipo mtengo wake ndi pafupifupi ma ruble zana ndi makumi awiri.

Muyeneranso kuyerekezera Mikardis ndi Concor. Mankhwala omwe aperekedwawa amakhalanso ndi njira ina yochitira. "Concor" imagwira ntchito pokhapokha ngati wodwala ali ndi matenda oopsa, komanso motsutsana ndi maziko a ischemia ndi kulephera kwa mtima.Mankhwalawa onse amakhala otalikirana ndi odwala, malinga ndi Mlingo. Concor ili ndi kupanga kwa Germany, ndipo mtengo wake ndi ma ruble mazana atatu ndi makumi asanu.

Ndikofunika kudziwa kuti atasiya kulandira chithandizo ndi Mikardis, odwala samakumana ndi zovuta zochotsera, ndipo magawo omwe amakumana nawo, pang'onopang'ono, amabwerera pazomwe adachita kale. Tiyeneranso kutsimikiza kuti Mikardis imagwira ntchito ngati antihypertensive mankhwala omwe amalolera odwala. Kuphatikiza apo, mankhwalawa ali ndi zochepa zotsutsana.

Koma mankhwala omwe aperekedwawa ali ndi mtengo wokwera, chifukwa chake, ndi chithandizo cha nthawi yayitali, odwala ambiri amayesa kupeza ma analogu okwera mtengo. Pankhaniyi, ndikofunikira kukumbukira kuti ndi dokotala yekha yemwe amatha kusintha m'malo mwa mankhwala, chowonadi ndichakuti ngakhale ma jenotiki nthawi zonse samakhala ndi zotere zofanana.

Zotsatira zoyipa za Mikardis

Mankhwalawa, monga akuwunikira mu malangizo ogwiritsira ntchito mankhwalawa, ali ndi mitundu ingapo yazotsatira zoyipa zomwe zimachitika kawirikawiri, komabe zimawonedwa. Tikuyankhula za kutsekula m'mimba, myalgia, chizungulire, kukhumudwa, kuwonjezeka kwa nkhawa, kuwoneka kwa ululu mu sternum ndi chifuwa chosabereka. Kuphatikiza apo, kupezeka kwa kutupa kwa mucous nembanemba kungakhalepo limodzi ndi magazi m'thupi, urticaria ndi pruritus.

Kodi kugwirizana kwa Mikardis ndi mowa ndi chiyani?

Kodi ndingathe kuphatikiza ndi mowa?

Mankhwalawa, kumwa mowa, komanso, kumwa mankhwala aliwonse omwe amaphatikizapo Mowa, ndizoletsedwa. Ndi kuphatikiza uku, zovuta komanso zovuta zina zimatha kuchitika.

Onani ndemanga za Mikardis.

Ndemanga za akatswiri a zamankhwala zamatsenga zamankhwala

Ndemanga za akatswiri a zamankhwala zamatsenga za mankhwalawa ndizabwino kwambiri. Malinga ndi madotolo, ngati simukuphwanya malangizowo komanso musanagwiritse ntchito mayeso oyenera kuti pakhale matenda omwe akuphwanya kugwiritsa ntchito Mikardis, ndiye kuti zotsatirapo zake zidzakhaladi.

Akatswiri amalemba kuti mankhwalawa pogwiritsa ntchito mankhwalawa nthawi zambiri amachitika popanda zovuta zoyipa. M'mawu azachipatala, akutsimikiziridwa kuti ngakhale zitakhala kuti zovuta zimawonekera, zimachitika mwa njira yofooka kwambiri. Akatswiri a mtima anati mphamvu yaying'ono ya mankhwalawa pamtima. Mwa zina, akatswiri amawona kugwira bwino kwambiri kwa mankhwala omwe aperekedwa, ngakhale motsutsana ndi maziko aza matenda oopsa.

Kuphatikiza apo, madokotala pakuwunika "Mikardis" akuti, malinga ngati njira yoyenera yomwera mankhwalawa imawonedwa, mankhwalawa amatulutsa mphamvu yayitali m'thupi la wodwalayo, lomwe limatenga maola makumi anayi ndi asanu ndi atatu.

Ndemanga za Odwala

About ndemanga ya "Mikardis" ya mankhwala kuchokera kwa odwala nawonso ndi abwino kwambiri. Chokhacho chomwe chingabweretsereni mankhwala awa aku Germany, malinga ndi anthu, ndi mtengo wake wokwera. Mtengo wa mankhwalawo, monga tawonera kale, ndi ma ruble chikwi chimodzi. Zachidziwikire, mtengo wotere suyenera aliyense. Makamaka, omwe amapuma pantchito omwe amafunika kuwononga ndalama zawo mwezi uliwonse amadandaula ndi vutoli.

Mwa ena mwa ndemanga zabwino za mankhwalawa pali ndemanga kuti chithandizo cha "Mikardis" chikutsatiridwa bwino. Chifukwa chake, ndikokwanira kumwa piritsi limodzi lokha kamodzi patsiku, kotero kuti kupumula kwa tsiku kumakhala bwino ndikuyenda ndi zovuta. Odwala, monga madokotala, amatsimikizira kuti zoyipa zilizonse zomwe zimagwiritsidwa ntchito pogwiritsa ntchito mankhwalawa ndizosowa kwambiri.

Mwa zina, anthu adanena kuti chifukwa cha Mikardis adatha kuchotsa chizungulire komanso kupendekeka kwadzidzidzi chifukwa chakakamizidwa.Zimadziwika kuti kale mwezi umodzi utatha kudya, kupanikizika kumasiya kulumpha ndikukhalanso kwabwinobwino. Ogwiritsanso ntchito amayamikiranso mankhwalawa chifukwa chothandiza kuchepetsa kuthamanga kwa magazi popanda kuwonongeka kwa kugunda kwa mtima.

Odwala ena pakuwunika kwawo akuti amamwa mankhwalawo "Mikardis" osakanikirana ndi mankhwala ena kuti achepetse magazi. Makamaka, odwala omwe ali ndi vuto losautsa kwambiri amatsatira njira zamankhwala zotere. Ogwiritsa ntchito amalemba kuti pamenepa, Mikardis amachita bwino ndi ntchito yake, koma nthawi zina khungu limasenda.

Momwe mungatengere ndi kukakamiza, mulingo

Chizindikiro chokhacho cha telmisartan ndi matenda oopsa. Telmisartan sayenera kutengedwa chifukwa cholephera mtima.

Mikardis imapezeka m'mapiritsi a 40 ndi 80 mg. Mapiritsi sayenera kuthyoka chifukwa chachilengedwe. Mankhwalawa amaperekedwa kamodzi patsiku. Mlingo woyambirira ndi 40 mg / tsiku. Zolemba malire zikuyembekezeka mkati mwa milungu 4. Ngati ndi kotheka, mlingo ungakhale wowirikiza mpaka 80 mg / tsiku. Telmisartan imayenda bwino ndi thiazide diuretic. Mikardis ayenera kugwiritsidwa ntchito mosamala ngati madzi atha kuchepa, koma osalephera. Pankhani ya kukanika kwa chiwindi, tikulimbikitsidwa kuti muchepetse mlingo.

Monga onse angiotensin receptor antagonists, telmisartan imaphatikizidwa ndi pakati (kulephera kwaimpso kwa mwana wosabadwayo). Palibe zokumana nazo zoyamwitsa.

Mayina akuluakulu amalonda a omwe amalowa m'malo mwa mankhwala:

Zofunika! Mankhwala amaperekedwa mosamalitsa malinga ndi mankhwala omwe adokotala amapita. Sitikulimbikitsidwa kugula mankhwala osagwiritsa ntchito mankhwala.

Kuchita

Telmisartan imatha kubweretsa kuwonjezeka kwakukulu kwa kuchuluka kwa digoxin m'magazi, ngakhale kuti kupangira izi sikumveka bwino. Chifukwa chake, milingo ya digoxin iyenera kuyang'aniridwa pamene chithandizo cha telmisartan chikuyamba kapena kusiya. Kuphatikiza apo, zimaganiziridwa kuti angiotensin II receptor antagonists angakulitse milingo ya lithiamu. Sitikulimbikitsidwanso kutenga telmisartan yokhala ndi zipatso za mphesa.

Madzi a mphesa

Mowa umaletsa chapakati mantha dongosolo waukulu Mlingo ndipo akhoza kusintha vasodilating mphamvu ya mankhwala. Iwo ali osavomerezeka kumwa mowa pa mankhwala. Mlingo wocheperako, ethanol imakhala yovuta kwambiri pa pharmacodynamics ndi pharmacokinetics ya mankhwala, koma muyezo waukulu umatha kuyambitsa poizoni.

Uphungu! Musanagwiritse ntchito mankhwalawa, muyenera kufunsa katswiri wamtima. Ndi oletsedwa kugula pawokha komanso kugwiritsa ntchito mankhwalawa popanda mankhwala a dokotala. Kugwiritsidwa ntchito mosasamala kumatha kubweretsa zotsatira zoyipa.

Zizindikiro zogwiritsidwa ntchito

Komanso, mankhwalawa amagwiritsidwa ntchito kuti achepetse kuchepa kwa mtima ndipo, chifukwa chake, anthu omwe ali ndi zaka zopitilira 55 omwe ali ndi chiopsezo chotenga matenda a mtima.

Mlingo ndi njira yoyendetsera

Malangizo ogwiritsira ntchito akuwonetsa kuti Mikardis adayikidwa mkati, mosasamala kanthu za kudya.

Kuchepetsa kuchepa kwa mtima ndi kufa, mlingo womwe umalimbikitsa ndi 1 tabu. (80 mg) 1 nthawi / tsiku. Mu nthawi yoyamba ya chithandizo, kuwongolera kowonjezereka kwa magazi kungafunike.
Ndi matenda oopsa, matenda oyamba a Mikardis ndi 1 tabu. (40 mg) nthawi 1 / tsiku. Muzochitika momwe achire samakwaniritsa, mlingo wa mankhwalawa ukhoza kuwonjezeka mpaka 80 mg 1 nthawi / tsiku. Mukafuna kudziwa kuchuluka kwa mankhwalawa, ziyenera kukumbukiridwa kuti mphamvu yayitali kwambiri ya antihypertgency nthawi zambiri imatheka mkati mwa masabata 4-8 pambuyo poyambira chithandizo.

Odwala omwe ali ndi vuto la aimpso (kuphatikiza omwe ali ndi hemodialysis) kusintha kwa mankhwalawa sikufunika.

Odwala omwe ali ndi vuto la chiwindi ntchito yofatsa kwa digiri yochepa (kalasi A ndi B pa Child-Pugh), tsiku lililonse mankhwalawa sayenera kupitilira 40 mg.

Mlingo wothandizira odwala okalamba sufuna kusintha.

Zosungirako ndi moyo wa alumali

Sungani pamalo owuma osafikirika ndi ana pa kutentha kosaposa + 30 ° С.

Mikardis ndi mankhwala osokoneza bongo.
Muli zinthu zotsatirazi, monga telmisartan, sodium hydroxide, polyvidone, meglumine, sorbitol, magnesium stearate.
Zigawo za mankhwalawa zimathandizira pakukula kwa mitsempha ya magazi, yomwe imachepetsa kuthamanga kwa magazi. Mankhwala othandiza kwambiri, machitidwe ake amapezeka patatha maola ochepa.

Kodi amalembetsa?: onani ☜

Mankhwala anawonjezera: 2010-03-11.
Malangizo omwe asinthidwa: 2017-08-25

Malangizo achidule ogwiritsira ntchito, contraindication, kapangidwe

Zizindikiro (zimathandiza chiyani?)
Amagwiritsidwa ntchito kwambiri pothana ndi matenda oopsa. Nthawi zambiri amagwiritsidwa ntchito pofuna kupewa, kukalamba, kuchepetsa matenda a mtima.

Contraindication
Ndi zoletsedwa kugwiritsa ntchito mycardis pamene:
1. wodwala akuvutika ndi chiwindi,
2. wapadera osazindikira thupi la fructose ndi lactose,
3. zoletsa zaka (achinyamata azaka khumi ndi zisanu ndi zitatu),
4. Mimba,
5. Pali matenda am'mabala.
Ndi chisamaliro chapadera, odwala amapatsidwa matenda a impso, a hyponatremia, a hyperkalemia, kwa impso pambuyo pakupatsirana, chifukwa cha mtima wosalephera, chifukwa cha mitundu yosiyanasiyana ya stenosis.

Njira yogwiritsira ntchito (mulingo)
Mapiritsi amlomo, mosasamala kanthu za kudya. Mlingo umayikidwa payekhapayekha kwa wodwala aliyense, njira ya chithandizo ndi yayitali. Mankhwalawa mlingo umodzi kamodzi patsiku, ngati kuli kotheka, utha kuwonjezeredwa.

Machenjezo
Sizoletsedwa kugwiritsa ntchito mycardis ndi aliskeren (ya shuga). Sizowoneka bwino kuphatikiza ndi mankhwala okhala ndi lithiamu.

Zotsatira zoyipa
Mikardis amayambitsa zovuta zingapo:
1. wapamwamba matenda opatsirana thirakiti,
2. cystitis
3. kuchepa magazi,
4. kusowa tulo, kukhumudwa, nkhawa,
5. Kuwonongeka koonera,
6. Kuchepetsa kwambiri magazi,
7. bradycardia, tachycardia,
8. kufooka kwa minofu, kufupika,
9. kupweteka kwam'mimba, kuphwanya m'mimba, kutsegula m'mimba,
10. Pakamwa pakamwa, mseru, kusanza,
11. thupi lawo siligwirizana (zotupa, urticaria, kuyabwa),
12. kupweteka kwa mwendo, kukokana,
13. Matenda a impso, mpaka kulephera kwa aimpso.
14. kupweteka pachifuwa ndi kufooka kwathunthu kwa thupi.

Bongo
Panalibe milandu ya mankhwala osokoneza bongo.

Kutulutsa Fomu
Amapangidwa ngati mapiritsi, oyera, oblongani, mumtengo wazithunzithunzi za ma unit 7.

Malangizo / ndemanga za madokotala: tili ndi gawo lalikulu la zokambirana patsamba lathu, komwe mankhwala a Mikardis amakambitsidwapo kamodzi ndi odwala ndi madokotala - onani

Mikardis - mankhwala kupewa matenda a mtima

"Mikardis" ndi mankhwala omwe amapangidwa pamaziko a chinthu chapadera /

Ndiwogwirizana makamaka ndi zotsutsa za angiotensin receptors.

Zomwe mankhwalawa amakupatsani zimakhudza thupi laumunthu komanso zimapereka chofunikira kwambiri pochiza matenda.

1. Malangizo ogwiritsira ntchito

Masiku ano "Mikardis" imagwiritsidwa ntchito kwambiri pochita zamankhwala. Mapiritsiwa amathandizidwa ndi madokotala kuti azichiza matenda osiyanasiyana.

Malinga ndi malangizo, mankhwalawa atha kumwa mankhwala otsatirawa:

Kufunika kwa mankhwala kwa odwala omwe akuvutika ndi kuwonetseredwa kwa matenda oopsa.

Zochizira matenda osiyanasiyana a mtima dongosolo (kwa anthu omwe ali ndi mbiri ya matenda ashuga, komanso omwe ali ndi vuto la matenda a mtima kapena matenda a mtima).
Pofuna kupewa kuwonekera kwa matenda ena a mtima.

2. Mlingo ndi makonzedwe

Mapiritsi a Mikardis ayenera kumwedwa ndi pakamwa, pakumwa madzi akumwa ambiri. Kumwa mankhwalawa sikudalira nthawi yakudya.

Ndi ochepa matenda oopsa, odwala akulangizidwa kuti azisankha muyeso woyambirira wa mankhwalawa, womwe sungapitirire 40 mg patsiku. Nthawi zina, kugwiritsa ntchito mlingo wotere, sizingatheke kukwaniritsa zomwe mukufunikira, chifukwa chake, ndikofunikira kuti muwonjezere mlingo mpaka 80 mg kamodzi patsiku.

Ndikofunikira kukumbukira kuti nthawi zambiri kuphatikiza kwakukulu kwa mankhwalawa kumatha kuwonekera pambuyo pa miyezi 1-2 kuyambira poyambira chithandizo.

Pofuna kuchepetsa mwayi wamatenda amtima, monga lamulo, odwala amatenga mapiritsi a 80 mg tsiku lililonse patsiku limodzi. Kwa anthu ena, kumayambiriro kwa maphunzirowo, kuwongolera magazi kungakhale kofunikira.

Anthu omwe ali ndi vuto la impso sayenera kusankha mtundu uliwonse wapadera.

Kwa odwala omwe ali ndi vuto la chiwindi chodziwikiratu, mankhwalawa amalimbikitsa tsiku lililonse osapitilira 40 mg kamodzi patsiku.

Pafupifupi ku Russia, mbiri imapangidwa podziwitsa za matendawa - angina pectoris. Dziwani zambiri za zisonyezo ndi chithandizo cha matendawa:

Njira zamakono zamankhwala.
Zizindikiro zazikulu za angina pectoris.

Mikardis amapangidwa mwanjira ya oblong, mapiritsi ang'onoang'ono omwe ndi oyera kapena oyera.

Zotsatirazi zimagwiritsidwa ntchito ngati mankhwala a mankhwala:

Telmisartan ndi chinthu chogwira ntchito.
Omwe amathandizira: magnesium stearate, povidone, sorbitol, sodium hydroxide, meglumine.

Kukopa pa kuthekera koyendetsa magalimoto ndi njira zowerengeka

Kafukufuku wapadera wazachipatala wonena za mphamvu ya Mikardis pa kuthekera kwakuya kwambiri komanso kuthamanga kwa zomwe anachita sizinachitike. Komabe, poganizira zovuta zakumbuyo monga kugona ndi chizungulire, tikulimbikitsidwa kusamala mukamayendetsa ndikugwira ntchito ndi zida zoopsa.

Mimba komanso kuyamwa

Kafukufuku wokhudza zotsatira za telmisartan pa chonde chaumunthu sichinachitike.

Mu trimester yoyamba ya mimba, angiotensin II receptor antagonists amaletsedwa. Pankhani ya kuzindikira pakati pa chithandizo cham'mimba, Mikardis iyenera kuthetsedwa ndipo ngati pakufunika kuthandizidwa, mankhwalawa ayenera kulembedwa (antihypertensive mankhwala a magulu ena omwe aloledwa kugwiritsidwa ntchito nthawi ya bere).

Mu ma trimesters achiwiri a II ndi III, kugwiritsa ntchito Mikardis sikulimbikitsidwa. Ngakhale mphamvu za teratogenic sizinapezeke mu maphunziro oyamba, kufalikira kwa impso, kuchepera kwa khungu, oligohydramnion) ndi neonatal toxity (ochepa hypotension, hyperkalemia, kulephera kwa aimpso).

Chifukwa chake, Mikardis amatsutsana panthawi yapakati. Ngati pazifukwa zina mankhwalawo amagwiritsidwa ntchito mu II trimester, tikulimbikitsidwa kuti kuyezetsa mafupa ndi impso za mwana wosabadwayo. Makanda obadwa kumene omwe amayi awo adalandira telmisartan amayenera kuyang'aniridwa bwino kuti apititse patsogolo matenda owonjezera.

Amayi omwe akukonzekera kukhala ndi pakati ayenera kupatsidwa mankhwala ena.

Panthawi yoyamwa, kugwiritsa ntchito Mikardis kumatsutsana.

Ndi mkhutu aimpso ntchito

Odwala omwe ali ndi vuto la aimpso, kuphatikiza omwe ali ndi hemodialysis, safuna kuti mankhwala a Mikardis asinthe.

Mochenjera, Mikardis ayenera kugwiritsidwa ntchito pazinthu zotsatirazi: kuwonongeka kwa impso, kukanika kwa impso kapena stenosis ya mtsempha wama impso, ndi vuto pambuyo pakupatsidwa impso.

Ndi chiwindi ntchito

Mikardis amatsutsana ndi milandu ya chiwopsezo chachikulu cha hepatic (kalasi C pa sikelo ya Mwana-Pugh) komanso kuphwanya patency ya patupa.

M'malo ochepa komanso ocheperako a hepatic kusokonezeka (Makonda a ana ndi Pugh A ndi B), mlingo woyenera wa tsiku lililonse wa telmisartan ndi 40 mg.

Kugwiritsa ntchito mankhwala Mikardis

Akuluakulu Zakudya zomwe amalimbikitsa kuti azidya tsiku lililonse ndi akulu ndi 40 mg. Mwa odwala ena, mlingo wa 20 mg / tsiku ukhoza kukhala wogwira mtima. Ndiwosakwanira, mlingo wa mankhwalawa ukhoza kuwonjezeka mpaka 80 mg kamodzi patsiku kapena kugwiritsidwa ntchito limodzi ndi thiazide diuretics (hydrochlorothiazide), womwe umapereka mphamvu kwambiri podziyerekeza ndi monotherapy. Ndi kuchuluka kwa mankhwalawa, muyenera kukumbukira kuti kuchuluka kwa antihypertgency kumayamba pambuyo pa masabata 4-8 kuyambira pakuyamba chithandizo.
Odwala omwe ali ndi matenda oopsa (ochepa oopsa) amatha kuthandizidwa ndi Telmisartan monotherapy pa mlingo wa 160 mg / tsiku kapena osakanikirana ndi hydrochlorothiazide pa mlingo wa 12,5-25 mg / tsiku, kuphatikiza uku ndikothandiza.
Mankhwalawa amatengedwa mosasamala chakudya.
Kutalika kwa mankhwalawa kumatsimikiziridwa payekhapayekha, zimatengera mtundu wa matendawa ndikuyenda bwino kwa mankhwalawa.
Odwala ndi mkhutu aimpso ntchito. Kudwala odwala aimpso kulephera sikufuna kusintha kwa mlingo. Telmisartan samachotsedwa m'magazi panthawi ya kuwonongeka kwa magazi.
Odwala omwe ali ndi vuto la chiwindi. Odwala omwe ali ndi chiwindi chofatsa kapena pakati, chiwindi chilichonse sayenera kupitirira 40 mg.
Palibe kusintha kwa mlingo kwa achikulire.
Palibe chidziwitso chokhudza chitetezo cha Mikardis pakagwiritsidwe ntchito ka ana ndi achinyamata ochepera zaka 18.

Zotsatira zoyipa za mankhwala Mikardis

Zomwe zimachitika pazochitika zoyipa mukatenga telmisartan (41.4%) nthawi zambiri zimakhala zofanana poyerekeza ndi placebo (43.9%) m'maphunziro olamulidwa ndi placebo. Zomwe zimayambitsa zovuta sizimadalira mlingo komanso jenda, zaka kapena mtundu wa odwala. Zotsatira zoyipa zomwe zidafotokozedwa pansipa zidazindikirika pakuyesedwa kwa odwala 5788 omwe adatenga telmisartan.
Matenda ndi zofukiza: matenda a kwamkodzo thirakiti (kuphatikiza cystitis), matenda amtundu wa kupuma kwamatumbo.
Mavuto amisala: nkhawa.
Kuchokera kumbali ya gawo la masomphenyawo: kuphwanya malo okhala (masomphenya osalongosoka).
Vestibular vuto: chizungulire.
Matumbo: kupweteka kwam'mimba, kutsegula m'mimba, kukamwa kowuma, dyspepsia, flatulence, kuphwanya m'mimba ntchito.
Kuchokera pakhungu kapena minyewa yotsika: chikondwerero, kuchuluka thukuta.
Kuchokera minofu ndi mafupa ofunikira: arthralgia, kupweteka kwa msana, kudzimbidwa kwa minofu ya ng'ombe kapena kupweteka kwa mwendo, myalgia, zizindikiro zofanana ndi tendonitis.
Zophwanya wamba: kupweteka pachifuwa, zizindikiro ngati chimfine.
Kuphatikiza apo, milandu ya erythema, pruritus, syncope / kusowa kwa chikumbumtima, kusowa tulo, kukhumudwa, kusanza, hypotension (kuphatikizapo arterial orthostatic hypotension), bradycardia, tachycardia, chiwindi choperewera, ntchito ya impso, kuphatikizapo kuperewera kwaimpso (onani ZINSINSI, zinanenedwa). APPLICATIONS), Hyperkalemia, kupuma movutikira, magazi m'thupi, eosinophilia, thrombocytopenia, kufooka komanso kusowa wogwira ntchito. Pafupipafupi momwe zimachitikira izi sizikudziwika.
Monga ena angiotensin II okonda, zochitika zapadera za angioedema, urticaria, ndi zina zoterezi zidanenedwapo.
Kafukufuku wa Laborator: kawirikawiri panali kuchepa kwa hemoglobin kapena kuwonjezeka kwa uric acid, milandu ya kuchuluka kwa michere ya creatinine kapena chiwindi imanenedwanso, koma pafupipafupi inali yofanana kapena yotsika poyerekeza ndi placebo.
Kuphatikiza apo, milandu yakuwonjezeka kwa kuchuluka kwa ma seramu CPK idanenedwa kuchokera pakuwonera pambuyo polembetsa.

Kuchita mankhwala osokoneza bongo Mikardis

Telmisartan imatha kupangitsa chidwi cha zochita zina za antihypertensive.
Mapiritsi omwe adawerengera kafukufuku wa pharmacokinetics: digoxin, warfarin, hydrochlorothiazide, glibenclamide, ibuprofen, paracetamol, simvastatin ndi amlodipine.
Kwa digoxin yokhayo, kuchuluka kwa 20% (nthawi zina 39%) kumawonjezera kuchuluka kwake m'magazi am'magazi omwe amapezeka pamlingo wambiri kumadziwika, motero, kufunika koyang'anira kuchuluka kwa digoxin m'madzi a m'magazi kuyenera kukumbukiridwa.
Pogwiritsa ntchito munthawi yomweyo ndi mchere wa lithiamu, ndikotheka kuwonjezera kuchuluka kwa lifiyamu m'magazi am'magazi komanso kupanga poyizoni, chifukwa chake ndikofunikira kuyang'anira nthawi zonse kuchuluka kwa lifiyamu m'madzi a m'magazi.
Mankhwala a NSAID (kuphatikiza acetylsalicylic acid mu Mlingo woposa 0.3 g patsiku, ndi COX-2 inhibitors) angayambitse kukulitsa kulephera kwaimpso kwa odwala omwe alibe madzi m'thupi. Mankhwala omwe amakhudza dongosolo la renin-angiotensin, mwachitsanzo telmisartan, amakhala ndi synergistic. Kumayambiriro kwa kuphatikiza mankhwala a NSAIDs ndi Mikardis, odwala amafunika kuwonetsetsa hydrate yowunika ndikuwonetsetsa ntchito yaimpso. Ndi mankhwala omwewo munthawi ya NSAIDs, kuchepa kwa mphamvu ya antihypertensive mankhwala, monga telmisartan, akuti chifukwa cha kuletsa kwa vasodilator mphamvu ya prostaglandins.

6. Migwirizano ndi magwiritsidwe ake osungirako

"Mikardis" iyenera kusungidwa m'malo owuma ndi mpweya wochepa, womwe umasunthidwa nthawi zonse ndikutetezedwa ku dzuwa. Mankhwalawa sayenera kupezeka ndi ana aang'ono.

Moyo wa alumali mankhwalawa ndi zaka ziwiri.

M'masitolo ogulitsa mankhwala omwe amapezeka ku gawo la Russian Federationmapiritsi amatengera 300 rubles phukusi lililonse.

Mu malo azachipatala aku Ukraine mtengo wawo umachokera pafupifupi 115 hhucnias.

Ma fanizo odziwika bwino a mankhwalawa ndi awa:

Ndemanga za mankhwala a Mikardes ndizabwino kwambiri, odwala amawona zotsatira zabwino za mankhwalawa mthupi, mwachitsanzo Alina analemba kuti: “Mankhwala othandiza. Munali ndi chithandizo chake kuti ndinachotsa matenda oopsa oopsa. Sindinapeze vuto lililonse. Ndimalimbikitsa aliyense amene alibe zolakwika. ”

Alena: “Kukonzekera mofewa. Dokotala adaletsa kupewa matenda a mtima. Ndinkasangalala kwambiri ndi zotsatirapo zake. ”

Mutha kudziwana ndikuwunika kwa ogwiritsa ntchito ena, komanso kugawana malingaliro anu kumapeto kwa nkhaniyo.

Mankhwala Mikardes amatchulidwa zochizira matenda angapo a mtima. Mankhwala sinafotokozedwe pa mimba, kuphwanya kwambiri chiwindi ndi impso, panthawi yoyembekezera. Pofuna kupewa zovuta komanso mankhwala osokoneza bongo osokoneza bongo, mankhwalawa amayenera kutengedwa mosamalitsa adokotala.

Piritsi limodzi la Micardis lili ndi 40 kapena 80 mg telmisartan (chinthu yogwira).

Othandizira: sodium hydroxide, polyvidone, meglumine, sorbitol, magnesium stearate.

Mtengo wa Mikardis

Ku Russia, phukusi la 80 mg No. 28 lidzawononga ndalama kuchokera pa 830 mpaka 980 rubles. Ku Ukraine, mtengo wa Mikardis mu mtundu womwewo wa nkhani ukuyandikira 411 hhucnias.

Mankhwala ogulitsa pa intaneti ku Russia
Mankhwala ogulitsa pa intaneti ku UkraineUkraine
Mankhwala ogulitsa pa intaneti ku Kazakhstan

Mikardis Plus mapiritsi 80 mg + 12.5 mg 28 ma PC Boehringer Ingelheim Böhringer Ingelheim
Mikardis mapiritsi 80 mg 28 ma PC.
Mikardis mapiritsi 40 mg 28 ma PC Boehringer Ingelheim Böhringer Ingelheim

Mikardis 40mg No. 28 mapiritsiBeringer Ingelheim Pharma GmbH ndi CoKG
Mikardis kuphatikiza 80mg / 12.5mg No. 28 mapiritsiBeringer Ingelheim Pharma GmbH ndi CoKG
Mikardis 40mg No. 14 mapiritsi 14Beringer Ingelheim Pharma GmbH ndi CoKG
Mikardis 80mg No. 28 mapiritsiBeringer Ingelheim Pharma GmbH ndi CoKG

Pani Pharmacy

Chingwe cha Mikardis. 80mg No. 28Beringer Ingelheim
Chingwe cha Mikardis. 80mg No. 28Beringer Ingelheim

Mikardis® Plus 80 mg / 12.5 mg No. 28 mapiritsi a Boehringer Ingelheim Pharma KG (Germany)
Mikardis® 80 mg No. 28 mapiritsi a Boehringer Ingelheim Pharma KG (Germany)

LAPANI ZOTSATIRA! Zambiri pamankhwala omwe ali pamalowo ndizokhudza zonse, zomwe zimatengedwa kuchokera kwa anthu ndipo sizingagwiritsidwe ntchito ngati lingaliro la kugwiritsa ntchito mankhwalawa munthawi ya chithandizo. Musanagwiritse ntchito mankhwala Mikardis, onetsetsani kuti mwawonana ndi dokotala.

Mankhwala "Mikardis": analogues, malangizo, ntchito, ndemanga:

Mikardis adalembedwa kuti azithandiza odwala kuti athetse matenda oopsa. Mankhwala amakhala ndi katundu wopitilira muyeso, mlingo wa wodwala aliyense umasankhidwa payekha. Musanamwe mankhwala, tikulimbikitsidwa kuti muwerenge malangizo ake, kuti muphunzire contraindication, komanso mavuto ena.

The kapangidwe ka mankhwala "Mikardis"

Chithandizo, chomwe chiri chachikulu pakuphatikizana kwa learism, ndi telmisartan. Piritsi limodzi limatha kukhala ndi mamilimita 20 mpaka 80. Zowonjezera zomwe zimathandizira kuyamwa mwachangu zomwe zapezeka pano ndi:

yoxitalamic acid
sodium hydroxide
polyvinylpyrrolidone,
glucite
magnesium wakuba.

Kudya koyamba kwa "Mikardis" kumapangitsa kuti magazi azikhala pang'ono pang'onopang'ono. Amachepa pang'onopang'ono maola angapo. Antihypertensive zotsatira zimachitika tsiku mutamwa mankhwalawa.

Izi zikutanthauza kuti kuti mukhale ndi magazi abwinobwino, ndikofunikira kutenga piritsi limodzi la Mikardis patsiku. Kutsika kwakukulu kwambiri kwa kupanikizika kumatha kuwonekera pakatha mwezi kuyambira chiyambi cha mankhwalawa.

Ndi kusiyiratu kutenga "Mikardis" palibe zotsatira za "kuletsa", zizindikiro zoyambirirazo zimabweranso patatha milungu itatu.

Zinthu zonse zomwe ndi gawo la mankhwalawa, mukamamwa mkatikati, zimayamwa mwachangu, kuchuluka kwa zinthu zomwe zimagwira kumafikira pafupifupi 50%.

Momwe mungamwe mankhwalawo?

Nthawi zina, mankhwalawa amalamulidwa kwa odwala azaka zopitilira 55, omwe ali pachiwopsezo chotenga matenda akulu a mtima omwe amayamba chifukwa cha kuthamanga kwa magazi.

Kuphatikiza pa "Mikardis" wanthawi zonse, mankhwalawa "Mikardis kuphatikiza" amapangidwa. Chotsirizachi chili ndi mamiligoramu 12.5 a hydrochlorothiazide, omwe ali ndi mphamvu ya diuretic.

Kuphatikiza kwa mankhwala a diuretic okhala ndi chidwi ndi angiotensin kumathandizira kukwaniritsa kwambiri. Zotsatira za diuretic zimayamba kuonekera patatha maola awiri atamwa mankhwalawa. "Mikardis kuphatikiza" imalembedwa ngati sizingatheke kukwaniritsa kutsika mukamatenga "Mikardis" wamba.

Palibe chifukwa chomwe muyenera kuperekera nokha mankhwalawo komanso muyezo wanu, chifukwa adokotala wokha ndi omwe ayenera kudziwa zolakwika zonse ndikuwunika zomwe wodwalayo akuwunika.

Mikardis pa nthawi yapakati

Kafukufuku wachipatala adatsimikizira momwe mankhwalawo amathandizira mwana. Chifukwa chake, "Mikardis" sungatengedwe m'matumbo onse a pakati ndi pakubala. Ngati mayi akufuna kubereka, ndiye kuti madokotala amamuthandiza kuti asinthe mankhwala otetezeka. Mimba ikachitika, mankhwalawo amasiya.

Momwe mungamwe mankhwalawa "Mikardis"?

Mankhwalawa amalembedwa ndi adokotala okha ndipo amatha kugwiritsidwa ntchito palokha komanso mankhwala ena omwe ali ndi cholinga chothandizira kayendedwe ka mtima. The Russian Mikardis analogues ali nawonso mawonekedwe ofanana.

Malangizo ogwiritsira ntchito akuwonetsa kuti kudya kwa tsiku lililonse kwa mankhwalawa kuyenera kukhala piritsi limodzi la 40 mamiligalamu.

Tiyenera kukumbukira kuti odwala omwe ali ndi vuto lochepa kwambiri, kuchepa kwa magazi kumachitika pakumwa piritsi limodzi ndi mamiligalamu 20 a chinthu chogwira. Kusankhidwa kwa mankhwala othandizira kumachitika mu nthawi yopitilira milungu inayi.

Kwenikweni, nthawi yochulukirapo ndiyofunika kuti Mikardis awonetse zotsatira zake zabwino mthupi la wodwalayo.

Ngati m'mwezi watenga "Mikardis 20" zotsatira zomwe sizinabwere, dokotala amakupatsani mankhwala omwe ali ndi mulingo wama milligram 80, omwe amafunikanso kumwa piritsi limodzi patsiku.

Woopsa matendawa, adotolo atha kukulembera "Mikardis" mu kipimo cha ma milligram 160, ndiko kuti, muyenera kumwa mapiritsi awiri patsiku, 80 milligrams.

Nthawi zina, wodwala amalephera kutsitsa magazi ngati mankhwala amodzi, ndiye kuti wodwala amamulembera "Mikardis kuphatikiza", chifukwa chomwe kupsinjika kumacheperachepera. Mlingo wa mankhwala pankhaniyi amasankhidwa potengera matenda oopsa. Ndemanga za "Mikardis" ndi analogues zimatsimikizira zake pakuchepetsa kuthamanga kwa magazi.

Odwala omwe mbiri yawo yachipatala yomwe ili ndi vuto la Impso safuna kuti munthu amupatseni mankhwala.

Ngati chidziwitsocho chili ndi zolembedwa za kupatuka kwamphamvu kwa chiwindi, wodwala ayenera kutenga "Mikardis 40".

Simungathe kuwonjezera mlingo wa mankhwalawa: izi zimapangitsa kuti minofu ndi chiwindi zizigwira bwino. Odwala okalamba samasintha mlingo.

Odwala omwe ali ndi matenda a shuga, komanso matenda a mtima kapena matenda ena amtima, chiopsezo cha kuphedwa kwa myocardial kufa ndi kufa mwadzidzidzi chikuwonjezeka chifukwa chogwiritsa ntchito mankhwala a Mikardis.

Matenda a mtima m'matumbo a shuga amatha kuchitika popanda zizindikiro ndipo mwina sangapezeke. Chifukwa chake, musanayambe chithandizo ndi mankhwala a Mikardis, muyenera kudutsa mayeso onse ofunikira ndikukupimirani.

Kuwongolera njira zovuta mukamatenga "Mikardis kuphatikiza" ndi analogies

Malangizo ogwiritsira ntchito akuwonetsa kuti palibe maphunziro apadera omwe adachitika pokhudzana ndi momwe chinthu chomwe chikugwirira ntchito (telmisartan), chomwe ndi gawo la mankhwala komanso ambiri amafotokozera, chimakhudza chidwi cha anthu komanso kuthekera kuyendetsa galimoto. Koma! Kumbukirani kuti mankhwala okhala ndi zida zokhala ndi diuretic angapangitse kugona komanso chizungulire.

Mankhwala "Mikardis" amayenera kusungidwa m'malo osakwaniritsidwa ndi ana, kutentha osaposa 30 digiri. Moyo wamafoloko:

Mapiritsi okhala ndi mulingo wa 40 ndi 80 mamililita - zaka 4.
Mapiritsi okhala ndi mulingo wa 20 mamililita - 3 zaka.

Mankhwala amaperekedwa mosamalitsa malinga ndi mankhwala. "Mikardis" amaletsedwa ana osaposa zaka 18.

Mikardis: analogues, ndemanga

Malangizo ogwiritsidwira ntchito akuti mutha kumwa mankhwalawa nthawi iliyonse masana, kudya sikumatha mphamvu ya thupi kuyamwa mankhwalawo.

Kutalika konse kwa chithandizo kumatengera dokotala, atatha kudziwa momwe wodwalayo alili, dokotalayo atha kukuthandizani kuti musinthe ma milligram 20.

Anthu omwe amamwa mankhwalawa amawona kuchepa kwambiri kwa kuthamanga kwa magazi komanso kusowa kwa zotsatira zoyipa. Koma odwala ambiri kuchokera pakugula kwa mankhwalawa amayimitsidwa ndi mtengo wake wokwera.

Ma analogi otsika mtengo a "Mikardis kuphatikiza" amasankhidwa ndi adotolo, mankhwala odziwika kwambiri omwe ali ndi vuto lofananalo akuphatikizapo:

Mtengo wa analogues a mankhwala a Mikardis zimatengera dziko lomwe amapanga komanso mawonekedwe ake. Potsika mtengo, mutha kugula ma fanizo otsatirawa:

Blocktran ndi generic yotsika mtengo komanso yokwera mtengo kwambiri pochizira matenda oopsa komanso kulephera kwa mtima.Amasiyana ndi Mikardis mu chigawo chachikulu ndi Mlingo.
"Valz" - amapangidwa m'matumba a mapiritsi 28, omwe ndi ochuluka kuposa mankhwala "Mikardis", motero, ndimankhwala osakhalitsa, "Valz" ndiotsika mtengo. Zomwe amapangira mankhwalawa zimasiyanasiyana, popeza Valsartan (40 milligrams) amagwiritsidwa ntchito ku Valz.
"Angiakand" - imasiyanasiyana pakapangidwe, gawo lokhazikika la mankhwala ndi mlingo wake. Amaloledwa kutenga ndi kuthamanga kwa magazi komanso kulephera kwamtima kosalekeza. Ili ndi zotsutsana zina, motero tikulimbikitsidwa kuti muwerenge mosamala malangizo musanayambe kugwiritsa ntchito.

Mikardis Plus: malangizo ogwiritsira ntchito, ma analogues

Mankhwala "Mikardis kuphatikiza" adapangidwira zochizira matenda amtima komanso kuchepetsa kufa. Amawonetsedwa pamatenda am'matumbo am'matumbo mwa anthu azaka zoposa 55-60. Mankhwala ofotokozedwawo amapangidwa ku Germany. Musanagwiritse ntchito, muyenera kufunsa dokotala, kafukufuku watsatanetsatane wazomwe zimatsimikizidwa ndikuwonetsa, zomwe zili ndi malangizo ogwiritsira ntchito mankhwala a Mikardis.

Kupanga, limagwirira ntchito ndi mawonekedwe a kumasulidwa

Mankhwalawa akupezeka ngati mapiritsi oyera ndi logo ya kampani mbali imodzi, mbali yachiwiri - lolemba "51N" kapena "52N", kutengera mlingo. Mu phukusi la makatoni, mankhwalawa amatha kukhala ndi magawo awiri mpaka atatu ndi mapiritsi 7 aliwonse. Kuphatikizika kwa piritsi limodzi "Mikardis" kumaphatikizapo zinthu zomwe zozama zimayang'aniridwa pagome.

Kufotokozera kogwirizana ndi 21.08.2014

Dzina lachi Latin: Micardis
Code ya ATX: C09CA07
Chithandizo: Telmisartan (Telmisartan)
Wopanga: BOEHRINGER INGELHEIM PHARMA (Germany)

Piritsi limodzi la Micardis lili ndi 40 kapena 80 mg telmisartan (chinthu yogwira).

Othandizira: sodium hydroxide, polyvidone, meglumine, sorbitol, magnesium stearate.

Bongo

Milandu yamankhwala osokoneza bongo salembetsedwa.

Ngati zizindikiro monga: kuchepa kwamphamvu kwa kuthamanga kwa magazi, tachycardia, bradycardia, symptomatic therapy ikufunika. Hemodialysis siyothandiza.

Malangizo apadera

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

Odwala ena, chifukwa cha kuponderezedwa kwa RAAS, makamaka akamagwiritsa ntchito mankhwala osakanikirana ndi dongosololi, ntchito yaimpso (kuphatikizapo kuperewera kwaimpso) imalephera. Chifukwa chake, chithandizo chothandizirana ndi mawonekedwe awiri ofanana a RAAS (mwachitsanzo, ndi kuwonjezeredwa kwa ACE inhibitors kapena renin inhibitor, aliskiren, kuti angiotensin II receptor antagonist blockers), ziyenera kuchitidwa mosamalitsa komanso mosamala kuyang'anira ntchito ya aimpso. serum creatinine).

Odwala omwe ali ndi matenda osokoneza bongo komanso chiwopsezo chowonjezera cha mtima, mwachitsanzo, odwala omwe ali ndi matenda a shuga komanso matenda a mtima, kugwiritsa ntchito mankhwala omwe amachepetsa kuthamanga kwa magazi, monga angiotensin II receptor antagonists kapena ACE inhibitors, angakulitse chiopsezo cha kuphedwa kwa myocardial infarction komanso mtima wamtima mwadzidzidzi. imfa ya mtima. Odwala omwe ali ndi matenda ashuga, matenda a mtima amatha kukhala asymptomatic motero sangadziwike. Musanayambe kugwiritsa ntchito mankhwala a Mikardis kuti mupeze ndi kulandira matenda a mtima, muyenera kudziwa za matenda oyenera, kuphatikizapo kuyesa ndi zolimbitsa thupi.

Kutengera ndi luso la kugwiritsa ntchito mankhwala ena omwe amakhudza RAAS, pomwe mukupatsa mankhwala a Mikardis ndi potaziyamu otaya mphamvu, mankhwala a potaziyamu, mchere wotsekemera wa potaziyamu, ndi mankhwala ena omwe amachititsa kuchuluka kwa potaziyamu m'magazi (mwachitsanzo, heparin), chizindikirochi chikuyenera kuyang'aniridwa mwa odwala.

Odwala omwe ali ndi matenda a aldosteronism, mankhwala a antihypertensive, momwe amagwirira ntchito omwe ndi chopinga cha RAAS, nthawi zambiri sagwira ntchito.

Mwinanso, Mikardis angagwiritsidwe ntchito limodzi ndi thiazide diuretics, monga hydrochlorothiazide, yomwe imathandizanso ndi hypotensive zotsatira (mwachitsanzo, Mikardis Plus 40 mg / 12.5 mg, 80 mg / 12.5 mg).

Muyenera kusamala mukamagwiritsa ntchito mankhwala a Mikardis (komanso ma vasodilator ena) mwa odwala aortic kapena mitral stenosis komanso matenda oopsa a mtima.

Odwala omwe ali ndi ochepa matenda oopsa, mlingo wa telmisartan 160 mg / tsiku osakanikirana ndi hydrochlorothiazide 12,5-25 mg anali wothandiza komanso wololera.

Telmisartan imapukusidwa makamaka ndi bile. Odwala omwe ali ndi vuto la mtima kapena matenda a chiwindi, kuchepa kwa mankhwalawa kungayembekezeredwe.

Kutha kwa chiwindi poika telmisartan nthawi zambiri kunawonedwa mwa okhala ku Japan.

Mikardis sothandiza kwenikweni kwa odwala a liwiro la Negroid.

Kuyanjana kwa mankhwala osokoneza bongo

Mukamagwiritsa ntchito mankhwalawa, ndikofunikira kuganizira momwe mungagwiritsire ntchito mankhwala ena:

Telmisartan imatha kuonjezera mphamvu ya ena othandizira. Mitundu ina yolumikizana ndi kufunika kwachipatala sizinadziwikebe.
Pogwiritsa ntchito munthawi yomweyo telmisartan ndi ramipril, kuwonjezeka kwa 2 mu AUC0-24 ndi Cmax kwa ramipril ndi ramipril kunawonedwa. Kufunika kwamankhwala pazinthu izi sikunakhazikitsidwe.
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.
Kuchiza kwa NSAIDs, kuphatikiza acetylsalicylic acid, COX-2 inhibitors, komanso NSAIDs yosasankha, kungayambitse kulephera kwa impso kwa odwala omwe ali ndi vuto lodana ndi thupi. Mankhwala omwe amagwiritsidwa ntchito pa RAAS amatha kukhala ndi synergistic. Odwala omwe alandila NSAIDs ndi telmisartan, BCC iyenera kulipidwa koyambirira kwa chithandizo ndipo maphunziro a impso ayenera kuchitidwa.
Ndi kugwiritsa ntchito pamodzi kwa ACE zoletsa ndi kukonzekera kwa lifiyamu, kuwonjezereka kosinthika kwa kuchuluka kwa lithiamu m'magazi kunawonedwa, limodzi ndi poizoni. Nthawi zina, zosintha zoterezi zidanenedwa ndi makonzedwe a angiotensin II receptor antagonists. Ndi munthawi yomweyo makonzedwe a lithiamu kukonzekera ndi angiotensin II receptor antagonists, tikulimbikitsidwa kudziwa ndende ya lithiamu m'magazi.
Kutsika kwa mphamvu ya ma antihypertensive othandizira, monga telmisartan, poletsa vuto la vasodilating la prostaglandins kumawonedwa ndi munthawi yomweyo ngati NSAIDs.

Tidalemba ndemanga za anthu omwe amamwa mankhwalawo:

Natalya. Ndachita mantha. Ndili ndi zaka 59. Matenda oopsa Atamwa mankhwalawo, miyendo yake inayamba "buzz", adadandaula dotolo, adayamba kulimbikira kuti apitilize kumwa mankhwalawo, nanena kuti manambala akapanikizika anali abwino. Ndimawadalirabe mawu awa a adotolo. Manja adayamba "buzz". Ndinkachita mantha (mwezi ndi theka la chithandizo chodutsa). Anayimitsa kumwa mankhwalawo. Manja "achepetsa", miyendo yatupa kwa miyezi itatu.
Katherine. Mycardis adandiuza kuti adokotala. Poyamba, mlingo anali 40 mg, kenako adawonjezeredwa mpaka 80. Mankhwalawa adathandizadi kuimitsa kukhazikika kwa matenda oopsa, zotsatira zoyipa zimawonekera mwa mawonekedwe a chizungulire cha nthawi ndi nthawi. Ndikadapitiliza kukhala wokondwa kuchitira Mikardis, koma mtengo wake udali wopitilira ndalama zanga. Adokotala adatenga analogue yotsika mtengo.
Semen. Pambuyo pamtima Ndakhala ndikuumwa kwa chaka chimodzi.Patatha mwezi umodzi atatenga, kupanikizika kunasiya kudumpha, kumakhala kwabwino - 120/70. Tsopano Mikardis amamwa mkazi wake ndi mlongo wake.

Zofanana muzochitika zamagulu:

Musanagwiritse ntchito fanizo, funsani dokotala.