Mikardis Plus > Chithandizo ndi kupewa

Kufotokozera kogwirizana ndi 24.08.2014

Dzina lachi Latin: Micardisplus
Code ya ATX: C09DA07
Chithandizo: Hydrochlorothiazide + Telmisartan (Hydrochlorothiaz>

Piritsi limodzi la Micardis Plus lili ndi 40 kapena 80 mg telmisartan ndi 12.5 mg hydrochlorothiazide.

Othandizira: sodium hydroxide, meglumine, povidone, sorbitol, magnesium stearate, lactose monohydrate, iron oxide ofiira microcrystalline cellulose, sodium carboxymethyl wowuma,wowuma chimanga.

Pharmacodynamics ndi pharmacokinetics

Mankhwala

Mikardis Plus ndi kuphatikiza telmisartan (receptor blocker angiotensin mtundu wachiwiri) ndi hydrochlorothiazide (okodzetsa mtundu wa thiazide). Kugwiritsa ntchito zinthuzi palimodzi kumapangitsa kuti chikhale champhamvu antihypertensive zotsatirakuposa kuzigwiritsa ntchito payekhapayekha. Kumwa mankhwalawa 1 nthawi patsiku kumabweretsa kuchepa kwapang'onopang'ono kwa mavuto.

Telmisartan - kusankha receptor blocker angiotensinmtundu wachiwiri. Ali ndi kuyanjana kwambiri ndi ma receptor angiotensin II AT1 subtype. Iye akutuluka angiotensin II kuchokera ku cholandila. Kumangirira ndikutalika. Telmisartan sichimaletsa ma receptor ena (kuphatikiza Mtundu wa AT2zolandirira) angiotensin. Telmisartanamachepetsa kaphatikizidwe aldosterone.

Mwa anthu okhala ndi ochepa matenda oopsa 80 mg telmisartan patsiku kwathunthu kuponderezana zotsatira angiotensinII. Kukhazikika kwa chochitika kumachitika patatha maola atatu atatha kumwa mankhwalawa. Mchitidwewu ukupitilira kwa tsiku limodzi. Wokhazikika antihypertensive zotsatira kukhazikika mwezi umodzi ntchito telmisartan.

Hydrochlorothiazide ndi okodzetsa mtundu wa thiazide. Zimakhudzanso kusinthika kwa ma elekitiroma mu ma tubules a impso, ndikuwonjezera mwachangu kuchuluka kwa sodium ndi chloride. Izi zimayambitsa kuchepa kuzungulira magazi, kuchuluka kwa zochita reninkuwonjezera kaphatikizidwe aldosterone.

Pambuyo kutsatira hydrochlorothiazide diuresis imadzuka patatha maola awiri, ndipo mphamvu yakeyo imatheka patatha maola anayi ndipo imakhala kwa maola 6-12.

Pharmacokinetics

Telmisartan.Amamwa mwachangu kuchokera mumimba. Kuzindikira kwakukulu telmisartanamabwera pasanathe ola limodzi. Bioavailability ndi 50%.

Kuyankha ndi mapuloteni amwazi - oposa 99,5%. Kupangidwa ndi kuyanjana ndi glucuronic acid. Zothandiza telmisartan pharmacologically osagwira.

Hafu ya moyo ndi pafupifupi maola 20. Amawachotsa ndi ndowe mawonekedwe ake oyambira komanso impso - mpaka 2%.

Pharmacokinetics telmisartanmwa okalamba, sizosiyana ndi odwala omwe ali ocheperako. Kusankhidwa kwa Mlingo sikofunikira.

Hydrochlorothiazide. Pambuyo pakamwa hydrochlorothiazide kuchuluka ndende zimatheka pambuyo maola 1-2. Bioavailability ukufika 60%.

Kuyankha ndi mapuloteni a plasma - 64%. Sipangidulidwe komanso kupukusidwa kudzera impso osasinthika.

Pharmacokinetics

Telmisartan

Ndikumamwa mankhwalawo mkati, amatengedwa kuchokera m'matumbo m'magazi kwakanthawi kochepa. Ndikofunikira kusiyanitsa bwino pakati pa mankhwala ndi chakudya. Ngati izi ziwiri zikuphatikizidwa, zothandiza Ubwino wa mankhwalawo watayika, mphamvu yake imatsika ndi makumi asanu. Kusinthika kumafikira gawo lofunikira maola atatu piritsi litatha kumwa.

Pambuyo kanthawi, mankhwalawa chikuwonetsedwa wakufinya m'matumbo osasinthika.

Kusintha kwa Mlingo sikuchitika malinga ndi zaka za wodwalayo. Mu thupi la abambo ndi amayi omwe amaphunzira, kusunthika kosiyanasiyana kwa chinthu kumawonedwa, izi zitha kutengera kulolera kwa ziwalozo komanso kuthamanga kwa mayamwa.

Odwala omwe ali ndi vuto laimpso, mankhwalawa amachotseredwa pang'onopang'ono kuposa ena. Koma pakhoza kukhalanso kusanganikirana kosiyanasiyana kwa zinthu zochizira mu zinthu zazimuna ndi zazikazi.

Kutumizidwa Mankhwala a Mikardis nthawi zambiri amakhala akuzindikira zovuta monga:

Matenda oopsa
Kusinthasintha kwa mtima
Pofuna kuchepetsa matenda amtima komanso kufa kwa odwala omwe adutsa zaka 60.

Contraindication

Mankhwala Mikardis osasankha mankhwalawa

Ngati wodwalayo wapezeka kuti ali ndi vuto lodetsa nkhawa kwa zigawo zikuluzikulu kapena zothandiza za mankhwalawo.
Mimba komanso kuyamwa mwa akazi,
Odwala ochepera zaka khumi ndi zisanu ndi zitatu
Ngati bronchitis yovuta kapena matenda enanso apezeka,
Ndi vuto la chiwindi,
Ngati fructose tsankho litapezeka,
Ndi chachikulu aldosteronism.

Mosamala, Mikardis amagwiritsidwa ntchito kuphwanya malamulo:

Ntchito ya chiwindi
Bilateral aimpso mtsempha wamagazi,
Potaziyamu yayikulu
Kuperewera kwa sodium
Kulephera kwamtima kosalekeza
Ndi zovuta zina zambiri zolimbitsa thupi.

Njira yogwiritsira ntchito

Mapiritsi a Mikardis amatengedwa pakamwa. Mlingo woyenera wa mankhwalawa ndi piritsi limodzi, lomwe limakhala ndi 40 mg kamodzi patsiku. Ngati izi sizokwanira, kuchuluka kwa mankhwalawa kumatha kuwirikiza, koma osatinso. Zotsatira kuchokera ku mankhwalawa, sangathe kuchitika mwachangu, kotero musathamangire kuti muwonjezere mlingo. Choyamba muyenera kudikirira nthawi yodziwika ya chithandizo, kuyambira milungu inayi mpaka isanu ndi itatu.

Odwala omwe akupitilira njira za hemodialysis safunikira kupitirira muyeso wosankhidwa ndi dokotala nthawi iliyonse.

Odwala omwe ali ndi vuto la chiwindi chochepa komanso chofatsa, mlingo wa tsiku ndi tsiku sapitilira 40 mg patsiku.

Kwa anthu okalamba, kuchuluka kwa mankhwalawa kuyenera kukhala kocheperako kuti asavulaze.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mikardis Plus imapangidwa ngati mapiritsi - biconvex, oval, awiri-awiri:

Mlingo wa 40 / 12,5 mg ndi 80 / 12,5 mg - utoto umodzi wamtundu wa pinki-beige, wachiwiri - utoto woyera wokhala ndi utoto wofiirira-beige, pamalo oyera pali chithunzi cha "H4" (40 / 12,5 mg) kapena "H8" (80 / 12.5 mg), ndi logo ya kampani (ma 7 ma PC.), pamakatoni a matuza 2, 4 kapena 8),
Mlingo wa 80/25 mg - wosanjikiza kamodzi ndi loyera, ndipo pamatha kutalika kwachikaso, chachiwiri ndi chikasu, pamaso oyera pamakhala pepala la "H9" ndi logo ya kampani (7 iliyonse pachimatumba, pamatampu a makatoni a 1, 2 kapena 4).

Piritsi limodzi lili:

zinthu zogwira: telmisartan - 40/80 mg + hydrochlorothiazide - 12,5 mg kapena telmisartan - 80 mg + hydrochlorothiazide - 25 mg,
zina zowonjezera: povidone, sodium hydroxide, meglumine, magnesium stearate, sorbitol, microcrystalline cellulose, lactose monohydrate, chimanga wowuma, sodium carboxymethyl wowuma, iron oxide red (40 / 12,5 ndi 80 / 12,5), iron oxide chikasu ( 80/25).

Telmisartan

Telmisartan ndi wotsutsa mwachindunji (blocker) wa A-II receptors (AT₁ subtype) kuwonetsa antihypertensive kwambiri pakamwa. Ili ndi kuyanjana kwambiri ndi AT₁ subtype of receptors A-II, kudzera momwe zochita zomalizirazi. Sizitulutsa zovuta pa receptor, komwe A-II imachoka. Zinthu zomwe zimagwirizana zimasankha ku AT₁ subtype ya A-II receptors, pomwe ilibe kuyanjana ndi AT₂ subtype, komanso ma angiotensin receptors ena. Kufunika kwa magwiridwe antchito izi ndi zomwe zimapangitsa kuti azitha kugwira ntchito kwambiri chifukwa cha mphamvu ya A-II, yomwe imawonjezeka ndi telmisartan, sanaphunzire. Gawo lomwe limagwira limapangitsa kuchepa kwa kuchuluka kwa aldosterone m'magazi, silimaletsa mayendedwe a ion ndipo siliponderezera kuchuluka kwa renin m'madzi a m'magazi. Telmisartan sichimalepheretsanso angiotensin-kutembenuza enzyme (ACE) - kininase II, yomwe imawononga bradykinin, motero, chiwopsezo cha zotsatira zosafunikira chifukwa cha bradykinin sichimayembekezeredwa.

Pamaso pa ochepa matenda oopsa, kugwiritsa ntchito telmisartan muyezo wa 80 mg kwathunthu timalepheretsa chiwopsezo cha A-II. Ntchito ya antihypertensive ya chinthu pambuyo pakamwa yake yoyamba imawonetsedwa mkati mwa maola atatu. Mphamvu ya mankhwalawa imatha kwa maola 24 ndipo imakhalabe yofunikira mpaka maola 48. Nthawi zambiri zimakwaniritsidwa masiku 28 pambuyo poyambira maphunziro, malinga ngati Mikardis Plus imatengedwa nthawi zonse.

Odwala omwe ali ndi matenda oopsa, telmisartan imachepetsa kuthamanga kwa magazi kwa systolic ndi diastolic popanda kusintha kugunda kwa mtima. Ngati kuli kofunika kuletsa mwadzidzidzi thupilo, kuthamanga kwa magazi pang'onopang'ono kumabwereranso kuzikhalidwe zake zoyambirira popanda chiopsezo chofuna kusiya matenda.

Mu maphunziro a telmisartan, milandu yakufa kwa mtima, kugunda kwa mtima osagwirizana ndi ena, kapena kuphedwa kwa chipatala chifukwa cha kufooka kwa mtima (CHF) kudawunikiridwa. Odwala omwe ali ndi zaka zopitilira 55 ndi sitiroko, matenda amitsempha yamagazi, matenda am'mitsempha kapena matenda a shuga. Mankhwala osokoneza bongo (matenda am'mitsempha yamagazi am'mimba, retinopathy, mbiri yakale ya micro- kapena microalbuminuria) iwonetsa kuchepa kwa mtima komanso kuvulala kwamtima.

Hydrochlorothiazide

Hydrochlorothiazide ndi thiazide okodzetsa. Thupi, monga nthumwi zina za gulu la antihypertensive othandizira, limakhudza kayendedwe ka kuphatikizanso kwa ma electrolyte mu aimpso tubules, ndikuwonjezera msanga kuchuluka kwa sodium ndi chloride (pafupifupi, ofanana). Zotsatira za ntchito ya diuretic ya mankhwalawa ndi kuchepa kwa magazi ozungulira (BCC), kuchuluka kwa madzi a plasma m'magazi, kuwonjezeka kwa kupanga kwa aldosterone komanso kuwonjezeka kwazomwe zili mu potaziyamu ndi bicarbonates mumkodzo, zomwe zimapangitsa kuchepa kwa kuchuluka kwa potaziyamu m'madzi a m'magazi.

Pogwiritsa ntchito mankhwala ophatikizidwa ndi telmisartan, mwina chifukwa chakutseka kwa renin-angiotensin-aldosterone system (RAAS), kutayika kwa potaziyamu komwe kumayenderana ndi diuretic kumachepetsedwa. Pambuyo pakamwa hydrochlorothiazide, kuchuluka kwa diuresis kumadziwika pambuyo 2 maola, ndipo zotsatira zake zimakhala pambuyo pafupifupi maola 4. Zochitikazo za Mikardis Plus zimawonedwa kwa pafupifupi maola 6-12.

Kugwiritsa ntchito hydrochlorothiazide kwakanthawi kochepa kumachepetsa chiopsezo cha zotupa zamtima ndi kufa kwa iwo.

Mphamvu ya antihypertensive ya Mikardis Plus, monga lamulo, imafika pakatha masabata 4-8 pambuyo poyambira chithandizo.

Bongo

Milandu yama bongo a mapiritsi a Mikardis Plus sakhazikika.

Zizindikiro za mankhwala osokoneza bongo omwe amagwiritsidwa ntchito ndi mankhwala atha kukhala:

telmisartan: bradycardia, tachycardia, kuchepa kwa kuthamanga kwa magazi,
hydrochlorothiazide: hypokalemia, hypochloremia ndi zovuta zina zamagetsi amagetsi a electrolyte, kuchepa kwa BCC, kuchititsa kupindika kwa minofu ndi / kapena kukulitsa kusokonezeka kwa mtima wama mtima (arrhythmias chifukwa chogwiritsa ntchito munthawi yomweyo mtima wama glycosides kapena mankhwala ena a antiarrhasmic.

Ndi kukula kwa izi, chizindikiro chamankhwala chimayikidwa, telmisartan sichimachotsedwa m'magazi pogwiritsa ntchito hemodialysis. Hydrochlorothiazide imachotsedwa m'thupi ndi hemodialysis, komabe, mtundu wake wochotsa sunakhazikitsidwe. Ndikofunikira kuyang'anira nthawi zonse mulingo wa creatinine ndi electrolyte bwino mu seramu yamagazi.

Malangizo apadera

Nthawi zina, chifukwa cha kuletsa ntchito ya RAAS munthawi ya mankhwala ndi mankhwala, makamaka mothandizidwa ndi mankhwala omwe amakhudza dongosolo lino, ntchito yaimpso imalephera (kuphatikizapo kukula kwa aimpso kulephera). Zotsatira zake, chithandizo chotsatira limodzi ndi blockade iwiri ya RAAS (mwachitsanzo, kuphatikiza kwa Mikardis Plus ndi ACE inhibitors kapena aliskiren) ziyenera kuchitidwa mosamalitsa, ndikuwunika mozama ntchito yaimpso (kuphatikizapo kuwunika mulingo wa potaziyamu ndi creatinine mu seramu yamagazi).

Odwala omwe ali ndi matenda a mtima (CHD) ndi matenda osokoneza bongo pamene akumwa mankhwala osokoneza bongo a A-II receptors, chiwopsezo chowopsa cha kuphedwa kwa myocardial infarction ndi kufa mwadzidzidzi kwamtima ndi mtima. Popeza pamaso pa matenda a shuga, matenda amkati amtima amatha kupezeka chifukwa cha asymptomatic, chifukwa atapezeka ndi kulandira chithandizo asanalandire chithandizo, Mikardis Plus imafunikira kufufuza koyenera (kuphatikizapo kuyesedwa ndi zochitika zolimbitsa thupi).

Hydrochlorothiazide imachokera ku sulfonamide ndipo imatha kuyambitsa kupangika kwa idiosyncratic reaction, yowonetsedwa mu mawonekedwe a khungu la kutsekeka kwatsekereza kwa khungu komanso kutsekemera kwapang'onopang'ono kwa myopia. Zizindikiro za zovuta izi zimaphatikizira kupweteka m'maso kapena kuchepa kwambiri kwa maonekedwe owoneka, omwe nthawi zambiri amapezeka kuchokera maola ochepa mpaka masabata angapo atayamba Mikardis Plus. Popeza palibe mankhwalawa, kukulitsa khungu lotsekeka kwambiri kumatha kuyambitsa masomphenya. Chithandizo cha izi, choyambirira, pamafunika kusiya yomweyo kumwa hydrochlorothiazide. Ngati intraocular yothamangitsidwayo singakhale yosalamulirika, kusamalitsa mwachangu kapena kuchitidwa opaleshoni kungakhale kofunikira. Zowopsa zomwe zimapangitsa kuti khungu lizitha kutsekeka kwambiri lingakhale mbiri ya chifuwa cha penicillin kapena sulfonamides.

Hydrochlorothiazide, monga mitundu ina ya thiazide okodzetsa, imatha kubweretsa zosokoneza m'magulu amagetsi a electrolyte ndi acid-base state (hyponatremia, hypokalemia, ndi hypochloremic alkalosis). Zizindikiro zake zimatha kukhala ndi ludzu, kukamwa kouma, kufooka, nkhawa, kugona, minofu, kufinya kapena kuthinana kwa minofu ya ng'ombe (crumpi), kuchepa kwa kuthamanga kwa magazi, mseru, kusanza, tachycardia, oliguria.

Kuopseza kwa hypokalemia kumachulukitsa makamaka kwa odwala omwe ali ndi vuto la chiwindi, motsutsana ndi kuwonjezeka kwa diuresis, chakudya chopanda mchere komanso kuphatikizika kwa Mikardis Plus ndi gluco- ndi mineralocorticosteroids kapena corticotropin.

Ngakhale kuti palibe hyperkalemia yofunika kwambiri yachipatala yomwe idalembedwa pamankhwala a Mikardis Plus, ziyenera kukumbukiridwa kuti zovuta zomwe zimachitika zimaphatikizapo matenda a shuga, mtima ndi / kapena kulephera kwaimpso.

Chidziwitso chotsimikizira kuthekera kwa Mikardis Plus kuchepetsa kapena kuletsa kukula kwa hyponatremia yoyambitsidwa chifukwa cha kukodzetsa mafuta sichipezeka. Hypochloremia imadziwika, monga lamulo, yopanda pake ndipo safunikira chithandizo.

Liazide diuretics imachulukitsa mwayi wa kuchepa kwa calcium kwa impso ndikuwoneka kosakhalitsa komanso kuwonjezeka pang'ono kwa kuchuluka kwa calcium calcium. Kukula kwa hypercalcemia kwambiri kungakhale chizindikiro cha hypentparathyroidism yam'mbuyo. Ngati chiwonetsero cha ntchito ya parathyroid chikufunika, thiazide diuretics iyenera kuyimitsidwa.

Kuchita kwa Mikardis Plus sikothandiza kwenikweni kwa odwala a liwiro la Negroid.

Zotsatira zoyipa

Kuchokera pakupuma: kufupika, kupuma mavuto syndrome.
Kuchokera kwamuzungulire: tachycardia, arrhythmias, bradycardia, kutsika kwamphamvu kwa kupanikizika.
Kuchokera ku dongosolo lamanjenje: kukomoka, paresthesiachizungulire kusowa tulonkhawa kukhumudwakusakwiya, kupweteka mutu.
Kuchokera m'mimba: chisawawa, kutsekula m'mimba,pakamwa lowuma, kupweteka pamimba, kudzimbidwagastritis, hypercholesterolemia, hyperglycemia, kapamba,jaundice dyspepsia.
Pa khungu: kutuluka thukuta.
Kuchokera kwamankhwala am'mimba: minofu kukokana, arthralgia, myalgia, arthrosiskupweteka pachifuwa.
Kuchokera ku hemopoietic system: leukopenia, eosinophilia, kuchepa magazi, neutropenia, thrombocytopenia, thrombocytopenia.
Kuchokera pamtundu wa genitourinary: kulephera kwa impso, nephritis, glucosuria.
Kuchokera m'maso: kuwonongeka kwa mawonekedwe, glaucoma, xanthopsia, pachimake myopia.
Matenda: sepsismatenda opuma (pharyngitis, bronchitis, sinusitis,, kutukusira kwa tizi m'maso.
Matenda a metabolism: kuchuluka creatinine, michere ya chiwindi, creatine phosphokinase, uric acid m'magazi hypertriglyceridemia, hyperkalemia, hypokalemia, hypoglycemia, hyponatremia, kukana hemoglobin.
Thupi lawo siligwirizana: pakhungu, angioedemazotupa erythema, anaphylactic zochita, eczema, systemic vasculitis, necrotic vasculitis.

Kuchita

Mukamagawana telmisartan ndi:

mankhwala ena a antihypertensive - kuwonjezeka kwa mphamvu ndikotheka antihypertensive zotsatira,
mankhwala lifiyamu - Kuchulukitsa kwakanthawi kochepa ndizotheka lifiyamu m'magazi
nonsteroidal anti-kutupa mankhwala - mawonekedwe pachimake aimpso kulephera Odwala ochepetsa magazi,
digoxin - kuwonjezeka kwa ndende ndikotheka digoxin m'magazi ndi 20%.

Ndi munthawi yomweyo hydrochlorothiazide ndi:

barbiturates, Mowa kapena opioid painkiller - Kukula ndikotheka orthostatic hypotension,
Metformin - Kukula ndi kotheka lactic acidosis,
wothandizira wa hypoglycemicndi insulin - kusintha kwa mlingo kumafunika mankhwala a hypoglycemic,
cholestyramine ndi colestipol- kuletsa kuyamwa ndikotheka hydrochlorothiazide,
osapondereza minofu - ndizotheka kuwonjezera zomwe amachita,
mtima glycosides - Kukula ndi kotheka hypokalemiakapena hypomagnesemia,
anti-gout othandizira - kuwonjezereka kwa zomwe zili uric acid m'magazi.
kukonzekera calcium- kuchuluka kuchuluka ndende calcium m'magazi chifukwa choletsa impso yake ndi impso.
amantadine- chiwopsezo chowonjezeka chopanga zotsatira zosafunikira ndizotheka amantadine,
m-anticholinergic blockers(atropine, biperiden- - kufooketsa matumbo motility, kuchuluka bioavailability thiazide okodzetsa,
nonsteroidal anti-kutupa mankhwala - kufooketsa okodzetsa ndi antihypertensive zotsatira.

1. Malangizo a kuvomerezedwa

M'nkhaniyo mutha kupeza zambiri pazomwe zikuwonetsa, njira yoyendetsera kapena kuchuluka kwake (ngati chikufunikira, momwe amawerengera), mawonekedwe, mawonekedwe omwe mankhwalawa amatha kupangidwa, kuphatikiza mankhwalawa ndi mankhwala ena, zikhalidwe zomwe sizivomerezeka kumwa mankhwala, kuchuluka kwa mitengo, analogi, komanso ndemanga za odwala omwe amamwa mankhwalawa.

Kuphatikiza apo, apa mutha kupezanso zomwe mungachite ngati mwadzidzidzi mumakhala ndi bongo wambiri. Chidziwitso chonsechi chikuyenera kuphunziridwa mosamala kuti zisayang'ane ndi zovuta.

Zotsatira zoyipa

Pa mankhwala ndi Mikardis, oterowo mgwirizano zotsatira:

Pakati mantha dongosolo - kukhumudwa, vertigo, nkhawa, kusowa tulo, kukomoka,
Matenda - cystitis, chapamwamba kupuma thirakiti matenda, sepsis,
Dongosolo lakuzungulira - thrombocytopenia, kuchepa magazi, kuchepa kwakukulu pamlingo wa hemoglobin,
Masomphenya - kuzindikira kwamaso pazithunzi kapena zovuta zina zitha kuwoneka,
Matumbo a pakamwa - mkamwa youma, kupweteka pamimba, kusanza, nseru,
Minyewa ndi mafupa - ululu wammbuyo, myalgia, kupweteka kwamisempha ndi mafupa, mikhalidwe yopweteka,
Ndipo zina zimachitikanso, mwachitsanzo, kufooka, kugona, kapena kupweteka m'malo ena athupi.

Kugwirizana kwina ndi mankhwala ena

The yogwira pophika mankhwala Mikardis amatha kuonjezera zotsatira za mankhwala ena, omwe amachepetsa kuthamanga kwa magazi.

Komanso kuchuluka kwa digoxin m'thupi kumachuluka, chifukwa chofunikira kuyang'anira mayeso nthawi zonse.

kugwiritsa ntchito mankhwala kwa nthawi yayitali Mikardis, mitengo ya ziletsa ingasinthe vasoconstrictor mankhwala, komanso amasintha mayendedwe a mitsempha zimachitika mthupi.

Malo osungira

Mankhwala ayenera kusungidwa kuti ana asawafikire. Mutha kukhala nayo m'chipinda momwe kutentha sikupita kutentha makumi atatu. Mapiritsi, ngati sanaphwanyidwe, maphukusi awo amawasungira pafupifupi zaka zitatu, atatha kugwiritsa ntchito osavomerezeka.

Ngakhale pa nthawi yosankha mankhwalawa, adandiuza kuti Mikardis ali ndi othandizira othandizira. Ndinaganiza zowayesa ndekha, makamaka popeza umboni udali waukulu. Imwani mapiritsi, adotolo adalemba milungu ingapo kuti akwaniritse zotsatira zake. Ndipo chithandizo chayamba. Zachidziwikire kuti mtengo wake unali wokwera kwa ine, koma ndidasankha kuti ma analogiwo sangakhale ndi vuto lofanana ndi a Mikardis mwiniwake ndikumwa choyambirira. Pasanathe sabata limodzi, ndinamvanso bwino. Tithokoza madotolo ndi a Mikardis.

Amayi anga atadwala, tinayeserera mankhwala ambiri, kuyesera kukhazikitsa bata, koma sizinathandize kwa nthawi yayitali. Nditakambirana ndi dokotala pachipatalachi, tinaganiza zoyesa mtengo wotsika mtengo wa Mikardis. Modabwitsa, mankhwalawa adayamba kugwira ntchito mwachangu nthawi yomweyo. Ndidakonda kuti mtengo ndiwovomerezeka komanso kapangidwe kazomwe zimagwira zomwe zimakwanira zosowa zathu. Tithokoze kwa aliyense yemwe adalimbikitsa kusankha kwathu mankhwalawa.

Dokotala adandiwuza kuti ndimwe mankhwalawo Mikardis kuphatikiza. Nditawerenga malingaliro osiyanasiyana okhudzana ndi mavuto ake mthupi, ndidaganiza zoyeserera. Zinkawoneka kuti ndizichita zovutirapo chifukwa chofooka thupi langa. Koma patapita nthawi, chithandizo chamankhwala chinali chochepa kwambiri ndipo adaganizirabe kuti angagwiritsenso ntchito mankhwala ochedwa micardis. Tsopano zakhala bwino.

Kuphatikizika ndi kuphatikizika kwa mankhwala

Chofunikira chachikulu pa mankhwalawa ndi telmisartan. Piritsi limodzi lamtunduwu lili ndi 80, 40, ndi 20 milligram. Omwe amachokera ku mankhwalawa omwe amasintha kuyamwa kwa chinthu chachikulu ndi: meglumine, sodium hydroxide, polyvidone, sorbitol ndi magnesium stearate. Mankhwalawa, kuphatikiza telmisartan, ali ndi ma milligram ena a 12.5 a hydrochlorothiazide - chinthu chomwe ndi diuretic. Kuphatikizidwa kwa okodzetsa ndi angiotensin antagonists kumapangitsa kuti zitheke kwambiri. Mphamvu ya diuretic imachitika pafupifupi maola awiri mutamwa mapiritsi.

Mikardis Plus ndi wotsutsana ndi ma receptors a mahomoni angiotensin. Hormone iyi imawonjezera mamvekedwe a makoma a mtima, zomwe zimapangitsa kuchepa kwa ziwonetsero zamitsempha yamagazi. Telmisartan imakhala yofanana mumapangidwe amakankhwala kwa masanjidwe a angiotensin receptors.

Pambuyo polowa m'thupi, mankhwalawa amapanga mgwirizano ndi ma receptor, omwe amachititsa kuti angiotensin asamuke, motero amachotsa chifukwa chachikulu chowonjezeka kwa kuthamanga kwa magazi. Telmisartan imabweretsa kuchepa kwa systolic ndipo, kuphatikiza, kukakamiza kwa diastoli, koma chinthu ichi sichimasintha mphamvu yake mwanjira iliyonse ndi kuchuluka kwa kugunda kwa minofu ya mtima. Kodi buku la Mikardis Plus likutiuza chiyani?

Kugwiritsa ntchito koyamba kwa mankhwalawa kumabweretsa kupendekera kwapang'onopang'ono: kumachepa pang'onopang'ono maola angapo. Antihypertensive kwambiri mutatha kumwa mapiritsi amawonekera kwa tsiku limodzi. Chifukwa chake, kuti muchepetse kupanikizika kwakanthawi komanso koyenera, timafunika kumwa mankhwalawo kamodzi kokha patsiku. Zambiri, komanso, nthawi yomweyo, kuchepa kwa kupanikizika kumachitika mwezi umodzi kuyambira chiyambi cha mankhwala ndi mankhwala omwe aperekedwa. Milandu yomwe mankhwalawo amathetsedwa mwadzidzidzi, mphamvu yochotsa sizichitika, ndiye kuti, kukakamiza kumabwereranso ku chisonyezo choyambirira osati mowopsa, koma, monga lamulo, izi zimachitika m'masabata angapo.

Zigawo zonse za Mikardis Plus, zikagwidwa pakamwa kuchokera m'matumbo, zimayamwa mwachangu, kufalikira kwa mankhwalawa kumafikira pafupifupi makumi asanu. Kuchuluka kwazonse kwa yogwira plasma kumatsimikiziridwa pambuyo maola atatu. Njira kagayidwe kumachitika kudzera telmisartan ndi glucuronic acid. Zomwe zimayambitsa metabolites sizigwira ntchito. Hafu ya moyo wa mankhwala imaposa maola makumi awiri. Mankhwala omwe amakonzedwamo amachotsera ndowe. Zokhudza mkodzo, mankhwala ochepera awiri peresenti amatuluka nawo.

Mapiritsi a Mikardis Plus amapezeka m'mitundu itatu: 80, 40 ndi 20 milligrams of telmisartan. Mosasamala kuchuluka kwa chophatikiza, mapiritsi onse ali ndi mawonekedwe ndi mtundu woyera. Zojambula za kampani zimasindikizidwa mbali imodzi ya piritsi. 40 mapiritsi a milligram amakhalanso ndi 51N. Awo omwe ali mamiligalamu 80 lirilonse alembedwa ndi mtengo 52N. Phukusi limodzi mumatuluka matuza awiri kapena asanu ndi atatu, chilichonse chimakhala ndi mapiritsi asanu ndi awiri.

Kodi muyenera kugwiritsa ntchito liti mankhwalawa?

Malinga ndi malangizowo, Mikardis Plus (80 + 12, 5 mg) adapangidwa kuti azithandiza matenda oopsa. Madokotala ena amapereka mankhwalawa kwa odwala opitirira zaka makumi asanu ndi zisanu omwe amapezeka kuti ali ndi chiopsezo chowonjezeka cha matenda amtima omwe amalumikizana ndi matenda oopsa a mtima. Ndikofunikira kudziwa kuti mankhwalawa amalembedwa pamlanduwu pomwe sizingatheke kukwaniritsa kuchepetsa kukakamiza kwinaku mukutenga mtundu wanthawi zonse wa mankhwalawa.

Sitikulimbikitsidwa kuti mupatseni mankhwalawa ndikusankha mtundu wake, chifukwa ndi dokotala yekha amene angadziwe zotsutsana mwatsatanetsatane pazowunikira wodwalayo. Kuopsa kwa zotsatila zimatengera momwe mankhwalawo amasankhidwa moyenera.

Kodi mankhwala amawaganizira kuti ndi amphaka liti?

Kuchiza ndi mankhwalawa sikuyenera kuchitika potsatira milandu:

Nthawi zina pomwe pali hypersensitivity pazinthu zazikulu kapena zowonjezera zamankhwala izi.
Mankhwalawa sioyenera azimayi omwe ali ndi udindo, koma kuwonjezera apo, ngati kuyamwitsa kumachitika.
Mankhwalawa sioyenera ngakhale odwala atakhala ndi ma biliary pathologies omwe amakhudza mawonekedwe awo onse.
Pamaso pa zovuta zazikulu pakugwira ntchito kwa impso ndi chiwindi.
Nthawi zina komwe mumabadwa fructose tsankho.

Analogs ayenera kusankhidwa pochiza matenda oopsa mu ana kapena achinyamata. Izi zimachitika makamaka chifukwa chakuti zotsatira za telmisartan pa chamoyo chomwe sizinapangidwe bwino sizinakhazikitsidwe. Malangizo ogwiritsira ntchito ndi Mikardis Plus akuwonetsa kuti, kuwonjezera pa zotsutsana zonse pamwambapa, sizingathe kulembedwa kwa odwala omwe ali ndi vuto la Reflexory hypercalcemia, ndipo, kuwonjezera apo, sioyenera hypokalemia, kuchepa chifukwa cha tsankho la galactose ndi lactose.

Contraindication wachilengedwe imaperekedwanso kwa mankhwala a Mikardis Plus (80 mg). Mwachitsanzo, madokotala amayenera kukhala osamala kwambiri ndikuwongolera chithandizo chamankhwala ocheperako ngati mu mbiri ya odwala matenda oopsa pali njira zotsatirazi:

Kukula kwa hyponatremia kapena hyperkalemia.
Kupezeka kwa mtima ischemia odwala.
Kukhazikika kwa matenda osiyanasiyana amtima, mwachitsanzo, mu mawonekedwe a kuperewera, zero stenosis kapena cardiomyopathy.
Maonekedwe a stenosis a mitsempha yonse ya impso. Nthawi zomwe wodwala amakhala ndi impso imodzi, chisamaliro chapadera chimayenera kuthandizidwa pakakhala stenosis yamitsempha yokhayo yomwe imagwira ntchito ya magazi.
Kukula kwa kusowa kwamadzi, komwe kumachitika chifukwa cha matenda omwe amayambitsidwa ndi kusanza kapena kutsegula m'mimba.
M'mbuyomu okodzetsa.
Kubwezeretsanso kwa odwala pambuyo pakupatsirana kwa impso.

Kuphatikiza pa matenda omwe ali pamwambawa, poika "Mikardis Plus," wina amayeneranso kusamala makamaka ngati odwala ali ndi matenda a shuga komanso gout.

Zotsatira zoyipa zomwe zikuchitika pakakonzedwe

Ndemanga za "Mikardis Plus" sizosiyanitsidwa nthawi zonse ndi mtundu wabwino. Odwala ena akuti akuwonekera pakusintha kosasangalatsa m'moyo wawo. Iyenera kutsimikizika nthawi yomweyo kuti kukula kwa zovuta zosadalira mwachindunji kumatengera kuchuluka kwa mankhwalawa, komanso, pazaka za odwala komanso kukhalapo kwa concomitant pathologies. Chifukwa chake, nthawi zambiri mumatha kuwona zotsatirazi mukamamwa mankhwalawa:

Kuwoneka kwa chizungulire chamkati, kupweteka mutu, kutopa ndi nkhawa limodzi ndi mkhalidwe wopsinjika, kugona, ndipo, nthawi zina, kukhudzika sikumachotsedwa.
Kuwonjezeka kwakukulu kwa chiwopsezo cha kupuma kwa matenda opatsirana omwe amapangitsa kuti pakhale matenda akuluakulu a pharyngitis, sinusitis, bronchitis, chifuwa cha paroxysmal ndi zina zotero.
Maonekedwe a vuto la dyspeptic mwanjira ya mseru, colic, komanso, kuwonjezera matenda am'mimba. Mwa odwala ena, mayeso angawonetsenso kuwonjezeka kwa enzyme ya hepatic.
Maonekedwe a hypotension - kupweteka pachifuwa. Komanso, kukula kwa tachycardia kapena, mosiyana, bradycardia sichitha.
Kupezeka kwa kupweteka kwa minofu ndi arthralgia. Maonekedwe a ululu m'dera lumbar.
Kukula kwa zotupa zapakati pa genitourinary thirakiti limodzi ndi madzi osungira mthupi.
The zimachitika thupi lawo siligwirizana mawonekedwe a khungu totupa, urticaria limodzi ndi angioedema, kuyabwa kapena erythema.
Monga gawo la zoyeserera zasayansi, hyperkalemia yokhala ndi zizindikiro za kuchepa magazi imatha kupezeka.

Mu dongosolo la preclinical maphunziro a mankhwalawa "Mikardis Plus," kufalikira kwa mankhwalawa kunakhazikitsidwa. Poganizira izi, ndikosayenera kumwa mankhwalawa panthawi yonse yovomerezeka. Zikachitika kuti mayi atenga pakati, ndiye kuti mkaziyo, malinga ndi lingaliro la dokotala, asinthane ndi mankhwala owopsa a antihypertensive. Muzochitika zapakati, kugwiritsa ntchito mankhwalawa kumayimitsidwa nthawi yomweyo.

Mawonekedwe akugwiritsidwa ntchito

Mankhwala "Mikardis Plus" ayenera kuyikidwa kokha ndi dokotala. Itha kugwiritsidwa ntchito yokha kapena ndi mankhwala ena, kukonza kwake komwe kumayendetsedwa ndikuwongolera kachitidwe ka mtima. Wopanga mankhwalawa amalimbikitsa kudya kwa Mikardis Plus tsiku lililonse kuti athe kukhala ndi piritsi limodzi lokha ndi mamiligalamu 40 a chinthucho.Koma panthawi imodzimodzi, ndikofunikira kuganizira kuti odwala omwe ali ndi vuto lochepa kwambiri, kupanikizika kopitilira muyeso nthawi zina kumatha kukhalanso kumwa Mlingo wa milligram.

Kusankhidwa kwa mankhwala ochizira kumachitika kwa milungu inayi. Pakufunika nthawi yochulukirapo kuti mankhwalawa awonetse mphamvu zake zowonjezera. Zotheka kuti zotsatira zomwe mukufuna sizinachitike panthawiyi, wodwalayo akulangizidwa kuti atenge Mikardis Plus mu kipimo cha 80 milligrams. Pamaso pa mitundu ina yolembetsa matenda oopsa, kuyendetsa mankhwalawa mu kuchuluka kwa ma milligram 300 a telmisartan ndikololedwa, ndiye kuti, mapiritsi awiri a 80 milligram amafunikira. Ndikofunika kudziwa kuti chifukwa cha diuretic yophatikizidwa ku Mikardis Plus (80 + 12, 5 mg), kuthamanga kwa odwala kumatsika mofulumira komanso bwino kuposa pamene mukumwa mankhwalawa.

Chifukwa chake, adotolo amasankha kuchuluka kwa mankhwala ophatikiza poyerekeza ndi zovuta za matenda oopsa. Ndemanga za "Mikardis Plus" nthawi zambiri zimatsimikizira mphamvu yake yotchulidwa. Mankhwala omwe amaperekedwa amatengedwa nthawi iliyonse ya tsiku. Potere, kugwiritsidwa ntchito kwa chakudya sikumakhudzanso digestibility ya zinthu za mankhwala. Kutalika konse kovomerezeka ndi dokotala, kutengera momwe wodwalayo alili, dokotalayo atha kukuthandizani kuti musinthe gawo la 20 mamilimita.

Odwala omwe ali ndi mbiri ya kuwonongeka kwa impso safunika kupatsidwa mlingo. Pakuchitika kuti pakhale kusintha kwamphamvu kwamatenda mu chiwindi mu anamnesis, ndiye kuchuluka kwa "40" komwe kumafunikira. Tiyenera kudziwa kuti kuwonjezeka kwamtundu uliwonse kumabweretsa kuwonongeka mu ntchito ya thupi. Ponena za odwala okalamba, safunikira kusintha kwa mlingo.

Mphamvu ya yogwira mankhwala potsatira mphamvu ya odwala kuwongolera machitidwe

Malangizo omwe aphatikizidwa ogwiritsira ntchito mankhwalawa "Mikardis Plus" (40 ndi 80 milligrams) akuti palibe mayeso apadera omwe adachitika pokhudzana ndi momwe mankhwalawo amathandizira chidwi, komanso kuthamanga kwa zomwe akuchita. Komabe, ngakhale mukumwa mankhwala osokoneza bongo oonetsa kukhudzika, aliyense ayenera kukumbukira kuti kukonzekera mankhwala m'gulu lino kumatha kuyambitsa kugona. Pomwe antchito omwe amakhudzidwa ndi njira zoperekera ntchito ali ndi zofananira, ndiye kuti ayenera kupatsidwa kufananizidwa ndi Mikardis Plus (80 kapena 40 mg).

Zomwe amasungira mankhwalawa komanso mtengo wake

Mankhwala amayenera kusungidwa pomwe ana sangapeze mwayi. Kutentha m'chipinda chosungira sikuyenera kupitirira digrii makumi atatu. Monga lamulo, mapiritsi okhala ndi mulingo wa 40 ndi 80 milligrams amatha kusungidwa popanda kuphwanya umphumphu wa chithupsa osaposa zaka zinayi kuyambira nthawi yomwe amapanga. Mapiritsi 20 a milligram ali ndi moyo waufupi wa zaka zitatu. Mtengo wa mankhwalawa "Mikardis Plus" mu pharmacy mwachindunji zimatengera muyeso wa mankhwala ophatikizira mankhwala:

Mutha kugula mankhwala a ma milligram 40, momwe muli mapiritsi khumi ndi anayi, ma ruble mazana asanu.
Mikardis Plus ma milligram 80 okhala ndi mapiritsi makumi awiri ndi asanu ndi atatu mu pharmacite amatenga ma ruble mazana asanu ndi anayi mphambu makumi asanu.
Mtengo wa yankho la mapiritsi makumi awiri mphambu asanu ndi atatu akuyamba kuchokera ma ruble mazana asanu ndi atatu ndi makumi asanu.

Zowona, chidziwitsochi sichili mu malangizo omwe mungagwiritse ntchito ndi Mikardis Plus.

Mitu ya mankhwalawa

Ndemanga za mankhwalawa ndi zabwino kwambiri, chifukwa anthu omwe amagwiritsa ntchito mankhwalawa amawona zomwe zimachitika kawirikawiri ndikunena kuti mankhwalawa ndiabwino, ndipo koposa zonse, amachepetsa kukakamiza. Zowona, ambiri pogula chida ichi amayimitsidwa ndi mtengo wake wokwera. Ziyenera kunenedwa nthawi yomweyo kuti adotolo amasankha ma analogi otsika mtengo a mankhwala a Mikardis Plus. Chifukwa chake, mankhwalawa ali m'gulu la mankhwala odziwika omwe ali ndi vuto lofanana ndi thupi: "Telmisartan", "Teveten", "Teseo", "Hypotel" ndi "Pritor".

Mtengo wa analogues a "Mikardis Plus" mwachindunji umatengera wopanga wawo, komanso, kuphatikiza mapiritsi. Pamtengo wotsika kapena wotsika, mutha kugula, mwachitsanzo, mankhwala monga Angiakand, Valz ndi Blocktran. Malangizo ogwiritsira ntchito analogues amayeneranso kuphunziridwa, chifukwa zimapangitsa kudziwa zonse zotsutsana ndi mfundo zamagwiritsidwe.

Mimba komanso kuyamwa

Amayi oyembekezera amagwiritsa ntchito Mikardis Plus ndi contraindified. Kulandila kwa okokana ndi ma A-II receptors mu trimester yoyamba ya mimba sikulimbikitsidwa. Pofuna kutsimikizira kuti muli ndi pakati, kugwiritsa ntchito mankhwalawa kuyenera kuyimitsidwa nthawi yomweyo. Ngati ndi kotheka, odwala amapatsidwa mankhwala ena a antihypertensive omwe ali ndi mbiri yoyenera pakudziletsa.

Mu II - III trimesters, mankhwala omwe ali ndi ma A-II receptor blockers amatsutsana, chifukwa nthawi zamaphunziro zimachitika kuti mayi amatha kutenga pakati amatha kupangitsa kuti munthu azitha kufinya, kulumikizana ndi khungu, oligohydramnion, kufooka kwa impso) (Hyperkalemia, hypotension, kulephera kwaimpso). Ngati chithandizo ndi antagonists a A-II receptors adalembedwa wachiwiri trimester wa mimba, ndi kuwunika kwa mafupa a chigaza ndi aimpso kuyenera kuchitidwa mu mwana wosabadwayo. Makanda obadwa kumene omwe amayi awo adamwa mankhwalawa amayenera kuyang'aniridwa kwambiri kuti asachite kunjenjemera.

Zomwe mungagwiritse ntchito hydrochlorothiazide mwa amayi apakati, makamaka oyamba trimester, ndizochepa. Amadziwika kuti chinthuchi chimadutsa mu chotchinga cha placental ndipo, poganizira zamankhwala zomwe zimapangidwira, zitha kuyembekezeredwa kuti kutenga Mikardis Plus mu II - III trimesters ya mimba imatha kuyambitsa kuphwanya kwa fetoplacental perfume ndipo imayambitsa zotsatira zosafunikira mu mluza / fetus, monga thrombocytopenia, jaundice, electrolyte vutoli. Hydrochlorothiazide sayenera kugwiritsidwa ntchito pakuwonjezera matenda oopsa ndi edema chifukwa cha kutenga pakati, preeclampsia (chifukwa chokulirapo kwa chiwopsezo cha kuchepa kwa kuchuluka kwa plasma ndi kuchepa kwa placental perfusion), komanso pakalibe zotsatira zabwino pazovuta zamankhwala izi.

Pochiza matenda oopsa mu azimayi oyembekezera, hydrochlorothiazide imatha kutumikiridwa pokhapokha ngati sizotheka kugwiritsa ntchito mankhwalawa.

Kulandiridwa Mikardis Plus pa yoyamwitsa ndi zotsutsana.

Kafukufuku wokhudza momwe mankhwalawa amakhudzira chonde chaumunthu sanachitike.

Madokotala amafufuza

Malinga ndi akatswiri, mankhwalawa ndi othandiza kwambiri. Zimathandiza mwachangu, sizowonjezera zomwe zimayambitsa thupi. Pali, mwachidziwikire, zotupa zotsika mtengo. Koma ngati muwerengera mulingo wamtengo wapatali, ndiye kuti mankhwala omwe afotokozedwawa amadzilungamitsa okha.

Tidawunikiranso malangizo omwe adzagwiritsidwe ntchito ndikuwunika kwa Mikardis Plus.

Mu vuto laimpso

Pamaso pa kuvulala kwambiri aimpso (CC pansipa 30 ml / min), Mikardis Plus imatsutsana.

Mochenjera, tikulimbikitsidwa kugwiritsa ntchito hypotensive wothandizila kumbuyo kwa minyewa ya stenosis ya impso imodzi kapena yamkati ya minyewa yamitsempha yama cell ndi mu vuto la impso. Odwala omwe ali ndi vuto lochepa kwambiri (aimpso 30 ml / min), kusintha kwa mtundu wa Mikardis Plus sikofunikira, koma amayenera kuwunika ntchito ya impso.

Ndi chiwindi ntchito

Pamaso pa kuphwanya kwambiri chiwindi (kalasi C pa sikelo ya Mwana-Pugh), kugwiritsa ntchito kwa Mikardis Plus kumatsutsana.

Odwala omwe ali ndi vuto la chiwindi chogwira ntchito kapena matenda opita patsogolo a chiwindi (Mwana ndi Pugh kalasi A ndi B) ayenera kugwiritsa ntchito mankhwalawa mosamala, popeza ngakhale ndi kusintha kakang'ono muyezo wamagetsi wamagetsi, chiopsezo chokhala ndi vuto la hepatic chikuwonjezeka. Ngati chiwindi chitalephera kugwira ntchito mofatsa / digiri yochepa, mlingo woyenera wa tsiku ndi tsiku wa Mikardis Plus sayenera kupitilira 40 / 12,5 mg.

Fayilo yotulutsidwa ya Mikardisplyus, ma CD ndi mankhwala.

Mapiritsiwo ndi oval, biconvex, awiri-wosanjikiza (wina wosanjikiza ndi wamtundu wa pinki, winayo ndi loyera ndi utoto wokhala ndi utoto wofiirira), chizindikiro ndi "H4" ndi logo ya kampani yoyera. 1 tabu telmisartan 40 mg hydrochlorothiazide 12,5 mg
Omwe amathandizira: povidone, meglumine, sodium hydroxide, sorbitol, magnesium stearate, microcrystalline cellulose, red iron oxide, sodium starch glycolate, lactose monohydrate, wowuma chimanga.
7 ma PC - matuza (2) - mapaketi a makatoni.
7 ma PC - matuza (4) - mapaketi a makatoni.
7 ma PC - matuza (8) - mapaketi a makatoni.
7 ma PC - matuza (12) - mapaketi a makatoni.
Mapiritsiwo ndi oval, biconvex, awiri-wosanjikiza (wina wosanjikiza ndi pinki-beige, winayo ndi loyera ndi kuthekera kokutidwa ndi pinkish-beige), pamtunda woyera ndiye chizindikiro "H8" ndi logo ya kampani. 1 tabu telmisartan 80 mg hydrochlorothiazide 12,5 mg
Omwe amathandizira: povidone, meglumine, sodium hydroxide, sorbitol, magnesium stearate, microcrystalline cellulose, red iron oxide, sodium starch glycolate, lactose monohydrate, wowuma chimanga.
7 ma PC - matuza (2) - mapaketi a makatoni.
7 ma PC - matuza (4) - mapaketi a makatoni.
7 ma PC - matuza (8) - mapaketi a makatoni.
7 ma PC - matuza (14) - mapaketi a makatoni.

Kufotokozera kwa mankhwalawa kumatengera malangizo ovomerezeka omwe angagwiritsidwe ntchito.

Zochita za pharmacological Mikardisplyus

Mankhwala a antihypertensive. Ndi kuphatikiza kwa telmisartan (an angiotensin II receptor antagonist) ndi hydrochlorothiazide - thiazide diuretic. Kugwiritsa ntchito nthawi imodzi ngati izi kumabweretsa zotsatira zambiri zosagwirizana ndi zovuta kuposa kugwiritsira ntchito kulikonse. Kuvomerezedwa MikardisPlyus 1 nthawi / tsiku kumabweretsa kuchepa kwapang'onopang'ono kwa kuthamanga kwa magazi.
Telmisartan ndi wotsutsa winawake wa angiotensin II receptors. Ili ndi kuyanjana kwakukulu kwa AT1 receptor subtype ya angiotensin II, kudzera momwe zochita za angiotensin II zimadziwika. Telmisartan imasamutsa angiotensin II kuchokera kumangiriza kwake kwa receptor, ikusowa chochita cha agonist mogwirizana ndi cholandilira ichi. Telmisartan amangomanga ku AT1 receptor subtype ya angiotensin II. Kulumikizana ndikupitilira. Telmisartan ilibe mgwirizano ndi ma receptors ena (kuphatikizapo AT2 receptors) a angiotensin. Kufunika kwa magwiridwe antchito izi, komanso momwe zimakhalira ndikulimbikitsa kwakukulu ndi angiotensin II, kugwiritsidwa ntchito kwa zomwe zimawonjezeka poika telmisartan, sikunaphunzire. Telmisartan imatsogolera kuchepa kwa milingo ya aldosterone. Telmisartan siimaletsa renin m'magazi ndi ma ion njira, siyimaletsa ACE, sikuti inactivate bradykinin.
Odwala omwe ali ndi matenda oopsa, telmisartan imachepetsa kuthamanga kwa magazi ndi magazi, popanda kukhudza kugunda kwa mtima.
Telmisartan pa mlingo wa 80 mg kwathunthu limatchinga matenda oopsa a angiotensin II. Zochita zake zimatenga maola opitilira 24, kuphatikiza maola 4 omaliza musanamwe mlingo wotsatira. Kuyamba kwa hypotensive kanthu kumadziwika mkati mwa maola atatu itatha konzedwe ka telmisartan. Pankhani ya telmisartan yadzidzidzi, kuthamanga kwa magazi pang'onopang'ono kumabwereranso ku msana wake popanda kusintha kwa matenda obwera nawo.
Hydrochlorothiazide ndi thiazide okodzetsa. Liazide diuretics imakhudzanso kubwezeretsanso kwa ma electrolyte mu impso tubules, kukulitsa zowonjezera zotulutsa za sodium ndi chloride (pafupifupi zofanana). Mphamvu ya diuretic ya hydrochlorothiazide imabweretsa kuchepa kwa bcc, kuwonjezeka kwa ntchito ya plasma renin, kuwonjezeka kwa secretion ya aldosterone ndipo kumayendetsedwa ndi kuwonjezeka kwamodine potaziyamu ndi bicarbonates, komanso hypokalemia. Mothandizidwa ndi telmisartan munthawi yomweyo, pamakhala chizolowezi choletsa kutaya kwa potaziyamu chifukwa cha zotupa zotere, mwina chifukwa chakutseka kwa renin-angiotensin-aldosterone.
Kugwiritsa ntchito nthawi yayitali hydrochlorothiazide kumachepetsa chiopsezo cha matenda amtima komanso kufa kwa iwo.
Pambuyo pa kutenga hydrochlorothiazide, diuresis imawonjezeka pambuyo pa maola awiri, ndipo mphamvu yakeyo imawonekera patatha pafupifupi maola 4.
Mulingo wambiri wa antihypertensive wa MikardisPlus nthawi zambiri umakwaniritsidwa masabata 4 pambuyo poyambira chithandizo.

Mlingo ndi njira ya mankhwala.

MikardisPlus iyenera kutengedwa pakamwa nthawi 1 / tsiku, mosasamala zakudya.
Mikardis Plus 40 / 12,5 mg imatha kuperekedwa kwa odwala omwe kugwiritsa ntchito Mikardis pa 40 mg kapena hydrochlorothiazide sikupangitsa kuti magazi azithamanga.
Mikardis Plus 80 / 12,5 mg imatha kuperekedwa kwa odwala omwe kugwiritsa ntchito Mikardis pamtunda wa 80 mg kapena Mikardis Plus 40 / 12,5 mg sikuti kumayambitsa kuthamanga kwa magazi.
Ndi kufatsa kapena kufatsa kwamkono ntchito, kusintha kwa mankhwala sikofunikira. Mwa odwala, ntchito ya impso iyenera kuyang'aniridwa.
Odwala omwe ali ndi chiwindi chofatsa kapena cholimbitsa, sayenera kugwiritsidwa ntchito tsiku ndi tsiku oposa 40 / 12,5 mg.
Kusintha kwa muyezo wachipatala mwa okalamba sikufunika.

Zotsatira zoyipa Mikardisplyus:

Zotsatira zoyipa zoyembekezeredwa kuchokera kuzomwe zimachitika ndi telmisartan
Kuchokera kupuma dongosolo: matenda a chapamwamba kupuma thirakiti (kuphatikizapo bronchitis, pharyngitis, sinusitis), kupuma movutikira.
Kuchokera mu mtima: bradycardia, tachycardia, chizindikiro cha kuchepa kwa magazi, kupweteka pachifuwa.
Kuchokera kumbali ya chapakati mantha dongosolo ndi zotumphukira mantha dongosolo: chisangalalo, mantha, kukhumudwa, chizungulire, kukomoka, ndi kusowa tulo.
Kuchokera pamimba yogaya: mkamwa youma, kutsitsa, kusanza, chiwindi ntchito.
Kuchokera kwamikodzo dongosolo: pachimake aimpso kulephera.
Kuchokera ku endocrine system: kuchepa kwa kuwongolera kwa kuchuluka kwa hypoglycemia mu matenda a shuga, kusokonezeka kwa glucose.
Kuchokera ku hemopoietic dongosolo: eosinophilia, utachepa hemoglobin, thrombocytopenia.
Kuchokera ku minculoskeletal system: arthralgia, arthrosis, kupweteka kwa m'mbuyo, kupweteka m'miyendo, myalgia, kupendekera mwamphamvu kwa minofu ya ng'ombe (krampi), zizindikiro zofanana ndi tendonitis, kufooka.
Kuchokera pamalingaliro: kuwonongeka kwamawonekedwe owoneka, vertigo.
Kuchokera kumbali ya kagayidwe: hypercholisterinemia, hyperuricemia, hypokalemia, hyperkalemia, hypercalcemia, kuchuluka kwa uric acid, creatinine, michere ya chiwindi, magazi a CPK.
Thupi lawo siligwirizana: eczema, erythema, pruritus, angioedema, urticaria ndi zina zotere (monga momwe ntchito angiotensin II antagonists).
Zina: Zizindikiro ngati chimfine, kuchuluka thukuta, kuchepa potency.
Zotsatira zoyipa zoyembekezeredwa kuchokera kuzomwe zachitika ndi hydrochlorothiazide
Kuchokera pakapumidwe: dyspnea, kupuma pamavuto syndrome (kuphatikizapo chibayo ndi pulmonary edema).
Kuchokera pamtima dongosolo: arrhythmias, orthostatic hypotension, necrotic angiitis.
Kuchokera kumbali ya dongosolo lamkati lamanjenje: kusangalala, mantha, nkhawa, nkhawa, kuyendayenda mukamayenda, paresthesia.
Kuchokera pamimba: kupweteka kwam'mimba, kutsegula m'mimba, kuuma, gastritis, anorexia, kusowa chilimbikitso, sialadenitis, kudzimbidwa, kapamba, chiwindi ntchito, jaundice (hepatocellular kapena cholestatic).
Kuchokera ku endocrine system: kuchepa kwa kuwongolera kwa kuchuluka kwa hypoglycemia mu matenda a shuga, kusokonezeka kwa glucose.
Kuchokera ku ziwalo zam'malingaliro: osachedwa kusinthika masomphenya, xanthopsia, vertigo.
Pa gawo la kagayidwe: hypercholisterinemia, hyperuricemia, hypokalemia, hyponatremia, kuchepa kwa BCC, kuphwanya kwa electrolyte metabolism, hyperglycemia, kuchuluka kwa triglycerides, glucosuria.
Kuchokera hemopoietic dongosolo: aplastic anemia, hemolytic anemia, chopinga cha marow hematopoiesis, leukopenia, neutropenia, agranulocytosis, thrombocytopenia.
Kuchokera kwamikodzo dongosolo: matenda a kwamikodzo dongosolo, interstitial nephritis, matenda aimpso.
Kuchokera ku minculoskeletal system: kufooka, kuphipha kwa minofu.
Thupi lawo siligwirizana: anaphylactic zimachitika, eczema, lupus ngati zimachitika, vasculitis, photosensitivity zimachitika, zotupa, kuchuluka kwa khungu kuwonekera kwa SLE, poizoni epermolosis, angioedema, urticaria ndi zina zotere (monga momwe mungagwiritsire ntchito angiotensin II antagonists).
Zina: Zizindikiro ngati chimfine, kutentha thupi, kuchepa kwa potency.

Malangizo apadera ogwiritsira ntchito Mikardisplyus.

Odwala omwe ali ndi vuto la chiwindi kapena matenda a chiwindi omwe akupita patsogolo, a MikardisPlus ayenera kugwiritsidwa ntchito mosamala, chifukwa ngakhale kusintha kochepa muyezo wamagetsi wamagetsi kumatha kuthandizira kukulira kwa chiwindi.
Odwala omwe ali ndi vuto limodzi la impso a stenosis kapena ochepa a stenosis, kugwiritsa ntchito telmisartan kumawonjezera pachiwopsezo cha ochepa owopsa komanso aimpso kulephera.
Palibe chochitika ndi MikardisPlus odwala omwe ali ndi vuto laimpso kapena odwala pambuyo pakuwonjezeka kwa impso. Popeza luso la kugwiritsa ntchito MikardisPlus odwala omwe ali ndi vuto lochepa laimpso ndilochepa, pazinthu zotere, kutsimikiza kwa serum potaziyamu ndi milingo ya creatinine ndikulimbikitsidwa. Kugwiritsa ntchito hydrochlorothiazide odwala omwe ali ndi vuto laimpso kungayambitse azotemia. Kuyang'anira ntchito za impso kumalimbikitsidwa.
Odwala omwe ali ndi BCC yochepetsedwa komanso / kapena hyponatremia chifukwa cha kukodzetsa kwambiri kwa magazi, kutsekeka kwa mchere, kutsegula m'mimba, kapena kusanza kumatha kudwala matenda oopsa kwambiri, makamaka atatha kumwa mankhwala oyamba. Musanagwiritse ntchito MikardisPlus, kukonza mankhwalawa ndikofunikira.
Nthawi yomwe mtima kamvekedwe ka minyewa ndi aimpso zimadalira ntchito ya renin-angiotensin-aldosterone, mwachitsanzo, odwala omwe ali ndi vuto lalikulu la mtima kapena matenda a impso, kuphatikizapo aimpso. zomwe zimakhudza dziko lino, zitha kutsatiridwa ndi kukula kwamankhwala ochepa, hyperazotemia, oliguria, kapena nthawi zina, kulephera kwaimpso.
Odwala omwe ali ndi matenda a aldosteronism oyambira, mankhwala a antihypertensive, momwe amagwiritsidwira ntchito poletsa ntchito ya renin-angiotensin-aldosterone, nthawi zambiri sagwira ntchito. Zikatero, kusankhidwa kwa MikardisPlus sikulimbikitsidwa.
Odwala omwe ali ndi aortic kapena mitral stenosis kapena hypertrophic cardiomyopathy, kugwiritsa ntchito MikardisPlus (monga vasodilators ena) kumafuna chisamaliro chapadera.
Kugwiritsa ntchito thiazide diuretics kumatha kulepheretsa kulolera kwa glucose.
Odwala omwe ali ndi matenda a shuga, kusintha kwa mankhwala a insulin kapena pakamwa. Mankhwalawa pogwiritsa ntchito hydrochlorothiazide, mtundu wina wamagulu a shuga umatha kuwonekera.
Nthawi zina, kugwiritsa ntchito hydrochlorothiazide kumatha kukhala hyperuricemia ndi gout.
Mukamagwiritsa ntchito MikardisPlus, kutsimikiza kwakanthawi kwamlingo wamagetsi m'magazi seramu ndikofunikira.
Thiazide okodzetsa, incl. hydrochlorothiazide, ikhoza kuyambitsa kusokonezeka muyezo wama electrolyte ndi KShchR (hypokalemia, hyponatremia ndi hypochloremic alkalosis). Zizindikiro za matendawa ndi pakamwa pouma, ludzu, kufooka, kugona, kuda nkhawa, kukoka kwa minyewa kapena kupindika kwa minofu ya ng'ombe, kufooka kwa minyewa, kusokonekera kwa hypertension, oliguria, tachycardia, nseru, kapena kusanza.
Mukamagwiritsa ntchito hydrochlorothiazide, hypokalemia ikhoza kukhala, koma telmisartan nthawi yomweyo imatha kuchepetsa vutoli. Chiwopsezo cha hypokalemia ndichopambana mwa odwala omwe ali ndi vuto lodana ndi cirrhosis, omwe ali ndi kuchuluka kwa diuresis, kubwezerera pakamwa kosakwanira kwa ma elekitirodi, komanso pankhani yogwiritsidwa ntchito nthawi yomweyo kwa GCS kapena ACTH. Telmisartan, yomwe ndi gawo la MikardisPlus, m'malo mwake, imatha kuyambitsa Hyperkalemia chifukwa chotsutsana ndi angiotensin II receptors. Ngakhale Hyperkalemia yofunika kwambiri pakadali pano sanafotokozedwe pogwiritsa ntchito Mikardis Plus, ziyenera kudziwitsidwa kuti ziwopsezo zomwe zimayambitsa kukula kwake zimaphatikizapo aimpso ndi / kapena kulephera kwa mtima ndi matenda a shuga.
Palibe umboni kuti MikardisPlus imatha kuchepetsa kapena kupewa hyponatremia yoyambitsidwa ndi diuretics. Chloride akusowa nthawi zambiri amakhala ochepa ndipo safuna kulandira chithandizo.
Hydrochlorothiazide imatha kuchepetsa calcium ndikuwonetsa (kusakhalapo kwa kusokonezeka kwa metabolic kwa ion) kuchepa kwapang'onopang'ono komanso kuwonjezeka pang'ono m'magawo a calcium ya seramu. Hypercalcemia yofunika kwambiri ikhoza kukhala chizindikiro cha hypentparathyroidism yam'mbuyo. Asanayambe kugwira ntchito kwa ziwopsezo za parathyroid, thiazide diuretics iyenera kuletsedwa.
Zawonetsedwa kuti hydrochlorothiazide imawonjezera kutulutsa kwa magnesium mkodzo, komwe kungayambitse hypomagnesemia.
Odwala omwe ali ndi ischemic cardiopathy kapena matenda a mtima, mankhwala ena aliwonse a antihypertensive ngati achedwa kwambiri magazi atha kupangitsa kuti akhale ndi myocardial infarction kapena stroke.
Mlingo wovomerezeka tsiku lililonse wa Mikardis Plus 40 / 12,5 kapena 80 / 12,5 uli ndi 169 kapena 338 mg wa sorbitol, motero. Chifukwa chake, mankhwalawa ndi contraindicated odwala ndi cholowa fructose tsankho.
Hypersensitivity zimachitika hydrochlorothiazide zitha kuchitika, makamaka kwa odwala omwe ali ndi mbiri ya chifuwa kapena bronchial mphumu.
MikardisPlus ikhoza, ngati pakufunika, igwiritsidwe ntchito molumikizana ndi mankhwala ena a antihypertensive.
Akaphatikizidwa ndi Mikardis Plus, potaziyamu okhala ndi ma okitamini, ma laxatives, corticosteroids, ACTH, amphotericin, carbenoxolone, penicillin G (sodium salt), salicylic acid ndi zotuluka zake, kuyang'anira potaziyamu yambiri m'madzi a m'magazi kumalimbikitsidwa.
Pogwiritsa ntchito kuphatikiza kwa Mikardis Plus ndi potaziyamu woteteza pakakonzedwe ka potaziyamu, mankhwala ena omwe angapangitse kuchuluka kwa potaziyamu mu seramu yamagazi (mwachitsanzo, sodium heparin), kapena mukachotsa mchere wa potaziyamu, kuwunika pafupipafupi kuchuluka kwa potaziyamu m'madzi a m'magazi kumavomerezeka.
Ngati mukufuna kugwiritsa ntchito kashiamu, muyenera kuyang'anira kuchuluka kwa calcium m'magazi ndipo ngati kuli koyenera, musinthe mankhwalawa.
Kugwiritsa Ntchito Kwa Ana
Kuchita bwino ndi chitetezo cha kugwiritsa ntchito Mikardis Plus mwa ana ndi achinyamata ochepera zaka 18 sizinakhazikitsidwe.
Kukopa pa kuyendetsa magalimoto ndi kayendedwe kazinthu
Kafukufuku wapadera wazomwe zimachitika ngati mankhwalawo amatha kuyendetsa galimoto ndikugwira ntchito ndi njira sizinachitike. Komabe, mukamayendetsa galimoto ndikugwiritsa ntchito njira, munthu ayenera kukumbukira mwayi wokhala ndi chizungulire ndi kugona pamene mukugwiritsa ntchito mankhwala a MikardisPlus.

Pharmacology

Mikardis Plus ndi kuphatikiza kwa telmisartan ndi hydrochlorothiazide. Ndi makonzedwe awo a munthawi yomweyo, mphamvu ya antihyertonic imayamba. Zotsatira zake, kuchepa kwa kukakamiza kumawonedwa.

Telmisartan ndi mtundu wosankha wa angiotensin 2 receptor blocker. Kulumikizana ndikupitilira. Kuphatikiza apo, izi zimathandizanso kuchepetsa kapangidwe ka aldosterone.

Hydrochlorothiazide ndi thiazide-mtundu diuretic. Zimakhudzanso kusunthika kwa ma electrolyte m'matumbo a impso, kuwonjezera mwachindunji kutulutsa kwa sodium mankhwala enaake m'thupi. Izi zimachepetsa kwambiri kuchuluka kwa magazi, kumawonjezera kapangidwe ka aldosterone, kumawonjezera ntchito ya renin.

Pambuyo pakukonzekera kwa hydrochlorothiazide, diuresis imadzuka kangapo, ndipo mphamvu yakeyo imatheka pambuyo maola ochepa ndipo imatenga maola 12.

Kuyanjana kwa mankhwala osokoneza bongo

Kuchita komwe kumatheka pogwiritsa ntchito telmisartan ndi mankhwala ena othandizira:

hydrochlorothiazide, warfarin, digoxin, simvastatin, glibenclamide, amlodipine: palibe mgwirizano wachipatala yemwe adapezeka, kuwonjezeka kwa kuchuluka kwa plasma ya digoxin m'magazi ndi pafupifupi 20% yomwe yapezeka, pogwiritsa ntchito telmisartan ndi digoxin, tikulimbikitsidwa nthawi ndi nthawi kudziwa kuchuluka kwa magazi, chomaliza.
Kukonzekera kwa lithiamu: nthawi zina, kuwonjezereka kwa zinthu za lithiamu m'magazi ndikotheka, kumachitika ndi zotsatira zoyipa, chifukwa chake kuyang'aniridwa kwake mu seramu kuyenera kuyang'aniridwa,
Mankhwala ena a antihypertensive: antihypertensive athari angachulukane, kuphatikiza kwa telmisartan ndi ramipril, kuwonjezeka kwa AUC kunadziwika._0-24 ndi C_max yomalizayi ndi metabolite (ramiprilat) maulendo 2,5, kufunikira kwakukhudzana ndi izi sikudziwika,
Mankhwala osapweteka a antiidal (NSAIDs), kuphatikizapo acetylsalicylic acid, ogwiritsidwa ntchito ngati mankhwala othana ndi kutupa (tsiku lililonse osaposa 3 g): NSAIDs zosasankhidwa komanso cycloo oxygenase-2 inhibitors (COX-2) mwa odwala omwe ali ndi BCC yolephera. , othandizira omwe akukhudza RAAS akhoza kuwonetsa synergistic zotsatira, ndi kuphatikiza kwa telmisartan ndi NSAIDs koyambirira kwamankhwala, ndikofunikira kulipiritsa bcc ndikuwongolera ntchito yaimpso, ndi kuphatikiza uku komanso ndi inhibiting prostaglandin vasodilator kanthu za telmisartan, kuchepa kugwira ntchito pamodzi ndi paracetamol ndi ibuprofen kukomoka zotsatira kwambiri sakunena.

Mogwirizana hydrochlorothiazide ophatikizika ndi mankhwala ena:

antidiabetesic pakamwa othandizira ndi insulin: kusintha kwa mankhwalawa kungakhale kofunikira,
barbiturates, opioid analgesics, ethanol: Kuopseza kwa orthostatic hypotension kwachulukitsidwa,
colestyramine, colestipol: mayamwidwe a hydrochlorothiazide akusokonekera,
metformin: imawonjezera chiopsezo cha lactic acidosis,
ma Pressor amines (kuphatikiza norepinephrine): kufooka kwa zomwe othandizawa amatha.
mtima glycosides: chiopsezo cha kukhala ndi hypomagnesemia / hypokalemia chifukwa cha thiazide okodzetsa, komanso mawonekedwe a arrhythmias oyambitsidwa ndi mtima glycosides
kupumula kwa minofu kosakhumudwitsa (kuphatikiza tubocurarine chloride): ndizotheka kupititsa patsogolo ntchito za othandizira,
Kukonzekera kwa calcium: kuchuluka kwa calcium kwa seramu kumatha kuchuluka chifukwa cha kuchepa kwa impso zake, ndi kuphatikiza uku, ndikofunikira kuyang'anira kuchuluka kwa calcium m'magazi ndipo, ngati kuli kotheka, musinthe mlingo wake.
anti-gout agents: kuchuluka kwa uric acid m'magazi seramu ndikotheka, komwe kungafune kusintha kwa uricosuric othandizira, kuchuluka kwa pafupipafupi kwa hypersensitivity reaction allopurinol,
biperidine, atropine ndi mankhwala ena a m-anticholinergic: matumbo am'mimba amachepa, bioavailability wa thiazide okodzetsa achulukitsidwa,
diazoxide, beta-blockers: angakulitse hyperglycemia yoyambitsidwa ndi mankhwalawa,
mankhwala osokoneza bongo, okodzetsa amene amachotsa potaziyamu, gluco- ndi mineralocorticosteroids, amphotericin B, corticotropin, benzylpenicillin, carbenoxolone, zotumphukira za acetylsalicylic acid ndi mankhwala ena omwe amatsogolera ku kuchotsa kwa potaziyamu ndikukula kwa hypokalemia chifukwa cha hypokalemia chifukwa cha hypokalemia. Telmisartan
NSAIDs: kufooketsa mphamvu ya antihypertensive ndi okodzetsa,
kukonzekera kwa potaziyamu, potaziyamu woleketsa okodzetsa ena ndi othandizira ena kukuwonjezera kuchuluka kwa potaziyamu m'magazi a seramu (heparin), kusintha kwa sodium kolorayidi ndi mchere wa potaziyamu: hyperkalemia ikhoza kuchitika, kuwunika kwa plasma ndende ya potaziyamu m'magazi kuyenera kuchitika,
cytotoxic agents (mwachitsanzo, cyclophosphamide, methotrexate): impso zotumphukira za othandizira awa zimachepa ndipo mphamvu yanga ya myelosuppression imatheka.
glycyrrhizic acid (muzu wa licorice): kutsika kwa potaziyamu mu seramu yamagazi ndikotheka (kukula kwa hypokalemia),
Amantadine: chiwopsezo cha zotsatira zosafunikira zomwe zimayambitsa chinthuchi zimachulukirachulukira.

Zofanizira za Mikardis Plus ndi: Telzap Plus, Telsartan N, Telpres Plus, ndi zina zambiri.

Njira yoyendetsera ndi kumwa

Malangizo a kumwa amati ndi bwino kumwa piritsi limodzi kamodzi patsiku. Kudya zilibe kanthu, koma pamimba yopanda kanthu, zotsatira zake zimachitika kangapo mwachangu.

Kutheka kwakukulu, monga lamulo, kumatheka pakatha mwezi umodzi mpaka iwiri chiyambireni mankhwala. Ngati pakufunika izi, ndiye kuti mankhwalawo atha kuthandizidwanso ndi mankhwala ena omwe amathandizira kuthamanga kwa magazi munthawi yochepa.

Kwa odwala omwe amapezeka kuti ali ndi matenda oopsa, dokotalayo amatha kuwonjezera kuchuluka kwa 160 mg patsiku.

Yang'anani! Hydrochlorothiazide imatha kusokoneza mkhalidwe wopitilira wa munthu yemwe adapezeka kuti wawonongeka ndi impso. Ndi matendawa, ndibwino kuti musinthe ma diuttics.

4. Kuphatikiza ndi njira zina

Ndi kuphatikiza pamodzi pa mankhwalawa:

Mankhwala a antihypertensive - kuwonjezeka kwa antihypertensive zotsatira tingaoneke,
Kukonzekera kwa Lithium - kuwonjezeka kwakanthawi kwa chinthuchi m'magazi kungawonedwe,
Digoxin - kuwonjezeka kwakanthawi kwa chinthu chomaliza m'magazi momwe 20% ingawonekere,
Ndi NSAIDs, mawonekedwe owopsa aimpso amawonedwa mwa odwala omwe ali ndi vuto lozungulira la magazi,
Ndi barbirutes, opioid painkiller - orthostatic hypotension imawonedwa,
Metformin - lactic acidosis imatha kuchitika
Colestipol ndi colestyramine - kuletsa kwa kuyamwa kwa hydrochlorothiazide kumawonedwa,
Mankhwala a insulin kapena hypoglycemic - kuwonjezereka kwa zochita zomaliza.
Mankhwala a anti-gout - kuchuluka kwa uric acid m'magazi a munthu
Osapweteka minofu omasuka - pali kuwonjezeka kwa kugwira ntchito kwawo,
Kukonzekera kwa calcium - mutha kuwona kuwonjezeka kwa kuchuluka kwa calcium m'magazi,
M-anticholinergics, mwachitsanzo, biperiden kapena atropine - angakulitse bioavailability wa thiazide diuretics.

Momwe mungamwe mankhwalawa panthawi yapakati?

Pa nthawi yobereka, makina a Mikardis Plus sayenera kupatula.

Izi ndichifukwa choti zinthu zomwe zimagwira zitha kulowa chiwalo chaching'ono, ndikuziyambitsa. Kuphatikiza apo, amathanso kukhudza mkhalidwe wa mayi aliyense.

Mukamayamwa, muyenera kusiyiratu mwayi woti mungamwe mankhwalawo. Ngati madyererowo akadali ofunikira, ndipo palibe misonkho yomwe ingakhale yabwino, ndiye kuti kuyamwitsa kuyimitsidwa.

7. Kusungidwa kwa mankhwalawa

Mankhwalawa amaikidwa bwino kwambiri m'chipinda chamdima chomwe chimatetezedwa ku chinyezi ndi dzuwa lowala. Malo abwino akhoza kukhala loko. Kuphatikiza apo, muyenera kuonetsetsa kuti mankhwalawa sagwera m'manja mwa ana aang'ono.

Mankhwalawa ayenera kusungidwa osaposa zaka zitatu. Ngati mankhwalawa adatha ntchito, ndiye kuti kugwiritsa ntchito kwina sikuvomerezeka.

Chida ichi, mtengo wake umatha kusiyanasiyana kutengera dera. Nkhaniyi ili ndi mitengo ya pamtengo ku Moscow ndi Kiev.

Ku Ukraine, muyenera kulipira 450 hryvnia pamankhwala awa.

Tiyenera kukumbukira kuti dokotala mwiniyo ayenera kuthana ndi kusankha kwa analogue, koma osati wodwala.

Mankhwalawa atha kulowa m'malo mwa Diocor, Valzap Plus, Gizaar, Teveten Plus, Co-Diovan, Valsacor, Atakand Plus, Valz N, Lorista N, Lisinopril, Ibertan, Tareg, Blocktran, Cardosten, Vazotens, Losacor, Valsacor, Kandek , Norotivan, Lozarep, Renikard, Angiakand.

Ngati mukudziwa zomwe mumagwiritsa ntchito mankhwalawa, ndiye siyani kuwunikira za mankhwalawa.

Ndemanga za akatswiri a mtima okhudzana ndi mankhwala a Mikardis Plus ali ndi tanthauzo labwino. Ngati simukuphwanya Mlingo ndi kukayezetsa ngati pali matenda omwe angakupatseni mankhwala a Mikardis Plus, mankhwala asanayambe, zotsatira zake sizikhala zazitali.

Potere, mavuto amabwera posowa kwambiri. Akatswiri a mtima amawona kukhudzidwa kochepa pa kugunda kwa mtima. Ngakhale ndi matenda oopsa oopsa, zotsatira zabwino zimadziwika. Kutalika kwa nthawi yayitali kumatha pafupifupi maola 48.

Ndemanga za odwala zimakhudzanso mankhwalawa. Choyipa chokha cha mankhwalawa ndi mtengo wake. Chowonadi ndi chakuti si aliyense amene ali wokonzeka kulipira ndalama zotere pachida ichi.

Kutulutsa mafomu ndi kapangidwe kake

Mankhwala amapangidwa mwanjira ya mapiritsi, omwe ali ndi 2 yogwira mankhwala - telmisartan ndi hydrochlorothiazide.

Monga zowonjezera zomwe zimapangitsa kuti mayendedwe azikhala othamanga komanso kuti zitheke, ndi:

wowuma chimanga
shuga mkaka
cellcrystalline mapadi,
sodium hydroxide
utoto wazitsulo,
povidone
sorbitol
meglumine.

Mapiritsi amapangidwa ozungulira ndi biconvex kumtunda. Wothandizira antihypertensive samapangidwa ngati njira yothira mafuta, gel, kapena yankho la makolo.

Mankhwala amapangidwa mwanjira ya mapiritsi, omwe ali ndi 2 yogwira mankhwala - telmisartan ndi hydrochlorothiazide.

Pakati mantha dongosolo

Ndi kukhumudwa kwa chapakati mantha dongosolo ndi kukula kwa mavuto amisala mwa munthu, kapangidwe kake kamasintha - mkhalidwe wopsinjika, malingaliro a nkhawa amawonekera.

Chizungulire, kupweteka mutu, paresthesia, kufooka wamba, kusokonezeka kwa tulo kumatha kuchitika.

Zokhudza mphamvu pakuwongolera njira

Mankhwalawa sasokoneza kugwira ntchito kwamanjenje komanso luso labwino lamagalimoto. Nthawi yomweyo, ndikofunikira kuwunika mosamala mukamagwira ntchito zovuta komanso poyendetsa galimoto, chifukwa ndikotheka kutaya chikumbumtima, mawonekedwe a zovuta (kugona, chizungulire). Zotsatira zoyipa zingayambitse kuchepa kwa chidwi komanso kuthamanga kwa zochitika zama psychomotor zofunikira poyendetsa.

Gwiritsani ntchito pa nthawi yoyembekezera

Amayi panthawi yoyembekezera amaletsedwa kutenga Mikardis pokhudzana ndi chiwopsezo cha kubereka kwa fetal.

Mukukonzekera kwa embryonic, kuyika kwa mtima ndi kwamikodzo machitidwe amatha kuwonongeka.

Mukamalandira mankhwala, ndikofunikira kusiya kuyamwitsa.

Mukamalandira mankhwala osokoneza bongo, Mikardis Plus iyenera kusiya kuyamwitsa.

Omvera zamtima

Elena Bolshakova, katswiri wa zamtima, Moscow

Ndidachita kafukufuku monga gawo la zotsutsana ndimankhwala, chifukwa ndimatha kulankhula molimba mtima za momwe Mikardis amagwirira ntchito. Mankhwalawa amathandizira kukhazikika kwapakati pazipondedwe komanso kuchepetsa kuthamanga kwa mafunde amkati, zomwe zimayambitsa kukulitsa kwa matenda a mtima. Mankhwalawa amagwira ntchito bwino kwa achinyamata ndi okalamba. Zotsatira zoyipa zomwe zingafune chithandizo cholowa m'malo, machitidwe sizinachitike. Mankhwala samakhudzana ndende.

Sergey Mukhin, katswiri wamtima, Tomsk

Ndikuganiza kuti mankhwalawa ndi njira yochepetsera kuthamanga kwa magazi. Mukamamwa kamodzi patsiku, achire amalimbikira tsiku limodzi. Mtengo ndi wokwera. Mndandanda waukulu wamakampani. Koma mankhwalawa ndi othandizira odwala matenda amtundu wa 2, matenda a mtima okhazikika. Ndi zoletsedwa kugwiritsa ntchito odwala omwe ali ndi vuto la mtima. Thupi langa siligwirizana nthawi zambiri limawonedwa m'chipatala.

Mikardis Plus ikhoza kusinthidwa ndi Pritor, yomwe imasungidwa m'malo olekanitsidwa ndi radiation ya ultraviolet pamtunda wa + 8 ... + 25 ° C.

Dmitry Gavriilov, wazaka 27, Vladivostok

Matenda oopsa a arterial anayamba, chifukwa chomwe madzulowo kunali thanzi lofooka, kusowa kwa mpweya, komanso kupindika. Madokotala adalemba mapiritsi a Mikardis. Mankhwalawa adayamba kugwira ntchito patsiku loyamba. Patatha maola atatu mutatha kumwa mapiritsi, kupanikizika kumatha maola 20 otsatira. Pankhaniyi, ndikofunikira kumwa mankhwala ena omwe angakuthandizeni kuchita izi. Ndikupangira kukambirana ndi dokotala wanu za zakudya zomwe zimayenderana ndi mavitamini.

Alexandra Matveeva, wazaka 45, St. Petersburg

Kukumana ndi matenda oopsa pambuyo pakuchita opaleshoni ya chithokomiro. Cardiologist adalemba mapiritsi a MikardisPlus a nthawi yayitali. Ndinkakonda mankhwala, amachepetsa magazi. Zotsatira za mankhwalawa sizikhudza thupi ndipo sizimayambitsa zovuta, anaphylactic. Kupanikizika kufikira 130/80 ndipo akukhalabe mulingo uwu. Ndikukulangizani kuti muchepetse masabata awiri mukamamwa mankhwalawa.