Telsartan (40 mg) Telmisartan > Chithandizo ndi kupewa

Mapiritsi 40 mg, 80 mg

Piritsi limodzi lili

ntchito yogwira - telmisartan 40 kapena 80 mg, motero,

zokopa: meglumine, sodium hydroxide, povidone (PVP K 30), mannitol, magnesium stearate, madzi

40 mg mapiritsi - mapiritsi kuyambira oyera mpaka oyera, oyera, ofiira osemedwa ndi "T" ndi "L" ndi notch mbali imodzi ndi "40" mbali inayo

Mapiritsi a 80 mg - mapiritsi kuchokera oyera mpaka oyera, oyera, ofiira osanjikiza okhala ndi "T" ndi "L" ndi notch mbali imodzi ndi "80" mbali inayo.

Mankhwala

Pharmacokinetics

Telmisartan imatengedwa mwachangu, kuchuluka kwake komwe kumamwa kumasiyana. The bioavailability wa telmisartan pafupifupi 50%.

Mukamamwa telmisartan nthawi yomweyo ndi chakudya, kuchepa kwa AUC (dera lozunguliridwa ndi nthawi yoponderezedwa) kumachokera ku 6% (pa 40 mg) mpaka 19% (pa mlingo wa 160 mg). Pakadutsa maola atatu atatha kumwa, kuchuluka kwa madzi am'magazi kumatha, ngakhale chakudya. Kutsika pang'ono kwa AUC sikupangitsa kuti mankhwalawa athe kuchepa.

Pali kusiyana pamaganizidwe a plasma mwa amuna ndi akazi. Cmax (ndende yozungulirapo) ndi AUC anali okwera pafupifupi katatu ndi kawiri mwa azimayi poyerekeza ndi abambo popanda phindu lalikulu.

Kuyankhulana ndi mapuloteni a plasma oposa 99.5%, makamaka ndi albumin ndi alpha-1 glycoprotein. Kuchuluka kwa magawo ndi 500 malita.

Telmisartan imapangidwa poyanjanitsa zinthu zoyambira ndi glucuronide. Palibe pharmacological ntchito ya conjugate yomwe idapezeka.

Telmisartan ali ndi chikhalidwe chodziwika bwino cha pharmacokinetics ndikuchotsa kupatula kwa theka-moyo> maola 20. Cmax ndi - mochepera - AUC ichulukane mosasamala ndi mlingo. Palibe kondwerero yofunika kwambiri ya telmisartan yomwe yapezeka.

Pambuyo pakumwa pakamwa, telmisartan imangotsala kwathunthu kudzera m'matumbo osasinthika. Kutulutsa kwathunthu kwamkodzo kumachepera 2% ya mlingo. Chilolezo chonse cha plasma ndi chachikulu (pafupifupi 900 ml / min) poyerekeza ndi magazi a hepatic (pafupifupi 1500 ml / min).

Odwala okalamba

Ma pharmacokinetics a telmisartan mwa odwala okalamba sasintha.

Odwala omwe ali ndi vuto la impso

Odwala omwe ali ndi vuto la impso akukumana ndi hemodialysis, kutsika kwa plasma kumawonedwa. Odwala omwe amalephera kupweteka kwa impso, telmisartan imagwirizanitsidwa kwambiri ndi mapuloteni a plasma ndipo samachotsa pakhungu. Ndi kulephera kwa aimpso, theka la moyo silisintha.

Odwala omwe ali ndi vuto la chiwindi

Odwala ndi hepatic kusowa, kutsimikizika bioavailability wa telmisartan ukuwonjezeka mpaka 100%. Hafu ya moyo wa chiwindi kulephera sasintha.

The pharmacokinetics ya jakisoni awiri a telmisartan adayesedwa mwa odwala omwe ali ndi matenda oopsa (n = 57) azaka 6 mpaka 18 atatenga telmisartan pa Mlingo wa 1 mg / kg kapena 2 mg / kg pakanthawi kwamankhwala anayi. Zotsatira za kafukufukuyu zatsimikiza kuti pharmacokinetics ya telmisartan mwa ana osaposa zaka 12 amagwirizana ndi omwe ali ndi akulu, makamaka, chikhalidwe chosagwirizana ndi Cmax chatsimikiziridwa.

Mankhwala

Telsartan ® ndi njira yogwira mtima komanso yosankha (yosankha) ya angiotensin II receptor antagonist (mtundu wa AT1) woperekera pakamwa. Telmisartan yokhala ndi ogwirizana kwambiri imasamutsa angiotensin II kuchokera m'malo ake omangiramo malo a AS1 subtype receptors, omwe ali ndi udindo wothandizira angiotensin II. Telmisartan ilibe agonist mphamvu pa AT1 receptor. Telmisartan mosamala imamangirira ku receptors a AT1. Kulumikizana ndikupitiliza. Telmisartan siziwonetsa kuyanjana kwa receptor ena, kuphatikizapo AT2 receptor ndi ena, sanaphunzire kwambiri AT receptors.

Kufunika kwa magwiridwe antchito izi, komanso momwe zimakhalira ndikulimbikitsa kwakukulu ndi angiotensin II, kugwiritsidwa ntchito kwa zomwe zimawonjezeka poika telmisartan, sikunaphunzire.

Telmisartan imachepetsa plasma aldosterone, sichiletsa renin mu plasma ya anthu ndi njira za ion.

Telmisartan sichimaletsa enzyme yotembenuza-angiotensin (kinase II), yomwe imawononga bradykinin. Chifukwa chake, palibe kukonzekera kwa mavuto omwe amabwera chifukwa cha bradykinin.

Mwa anthu, mlingo wa 80 mg wa telmisartan pafupifupi umalepheretsa kuthamanga kwa magazi (BP) chifukwa cha angiotensin II. Mphamvu ya inhibitory imasungidwa kwa maola opitilira 24 ndipo imatsimikiziridwabe pambuyo pa maola 48.

Chithandizo cha ochepa matenda oopsa

Mutatenga mlingo woyamba wa telmisartan, kuthamanga kwa magazi kumachepa pambuyo pa maola atatu. Kutsika kwakukulu kwa kuthamanga kwa magazi kumatheka pang'onopang'ono masabata 4 pambuyo poyambira chithandizo ndikusungidwa kwanthawi yayitali.

Mphamvu ya antihypertgency imatha kwa maola 24 mutatha kumwa mankhwalawa, kuphatikiza maola 4 musanamwe mlingo wotsatira, womwe umatsimikiziridwa ndi kuchuluka kwa kuthamanga kwa magazi, komanso kukhazikika (kwapamwamba 80%) pazakuchepera komanso kuzama kwa mankhwala mutatenga 40 ndi 80 mg ya Telsartan ® pakuwongolera mayesero azachipatala.

Odwala omwe ali ndi matenda oopsa, Telsartan® imachepetsa kuthamanga kwa magazi kwa systolic ndi diastolic popanda kusintha kugunda kwa mtima.

Mphamvu ya antihypertensive ya telmisartan ikufanizidwa ndi oimira magulu ena a antihypertensive mankhwala, monga: amlodipine, atenolol, enalapril, hydrochlorothiazide, losartan, lisinopril, ramipril ndi valsartan.

Pankhani ya telmisartan yadzidzidzi, magazi amayenda pang'onopang'ono mpaka asanalandire chithandizo kwa masiku angapo popanda chizindikiro chodwalanso matenda oopsa.

Kafukufuku wachipatala awonetsa kuti telmisartan imagwirizanitsidwa ndi kuchepa kwakukulu kwa kuchuluka kwamanzere kwamitsempha yamanzere yamanzere yamanzere yamitsempha yamagazi kwa odwala omwe ali ndi matenda oopsa komanso osagwirizana ndi hypertrophy yamanzere.

Odwala omwe ali ndi matenda oopsa komanso odwala matenda ashuga nephropathy omwe amathandizidwa ndi Telsartan® amawonetsa kuchepa kwakukulu kwa proteinuria (kuphatikizapo microalbuminuria ndi macroalbuminuria).

M'mayesero azachipatala apadziko lonse lapansi, zinawonetsedwa kuti panali owerengeka ochepa odwala omwe amatenga telmisartan kuposa odwala omwe amalandila angiotensin-converting enzyme inhibitors (ACE inhibitors).

Kupewa matenda a mtima komanso kufa

Odwala azaka zapakati pa 55 ndi akulu omwe ali ndi mbiri ya matenda amitsempha yamagazi, matenda opha ziwalo, zotupa za m'mitsempha, komanso matenda a shuga. Zokhudza kufooka kwa mtima komanso kuchepetsa kufa kwa matenda amtima.

Mphamvu ya antihypertensive ya telmisartan idayesedwa mwa odwala omwe ali ndi zaka 6 mpaka 18 (n = 76) atatenga telmisartan pa mlingo wa 1 mg / kg (ankachitira n = 30) kapena 2 mg / kg (ankachitira n = 31) pakanthawi yamankhwala anayi .

Kuthamanga kwa magazi kwa systolic (SBP) kutsika kuchokera pa mtengo woyambira ndi 8.5 mm Hg ndi 3.6 mm Hg. m'magulu a telmisartan, 2 mg / kg ndi 1 mg / kg, motsatana. Kuthamanga kwa magazi kwa diastolic (DBP) pafupifupi kunachepa kuchoka pamtengo woyambira ndi 4.5 mmHg. ndi 4.8 mmHg m'magulu a telmisartan, 1 mg / kg ndi 2 mg / kg, motsatana.

Kusintha kudalira mlingo.

Mbiri ya chitetezo idafanana ndi yomwe imachitika mwa achikulire odwala.

Mlingo ndi makonzedwe

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

Chithandizo cha ochepa matenda oopsa

Mulingo woyamwa wabwino ndi 40 mg kamodzi tsiku lililonse.

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

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

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

Odwala omwe ali ndi matenda oopsa oopsa, mlingo wa telmisartan ndi 160 mg / tsiku (mapiritsi awiri a Telsartan® 80 mg) komanso osakanikirana ndi hydrochlorothiazide 12.5-25 mg / tsiku anali wololera komanso wogwira ntchito.

Kupewa matenda a mtima komanso kufa

Mlingo womwe umalimbikitsa ndi 80 mg kamodzi tsiku lililonse.

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

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

Telsartan ® imatha kutengedwa mosasamala kanthu za kudya.

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

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

Kusintha kwa Mlingo sikofunikira.

Zotsatira zoyipa

M'mayeso omwe amayendetsedwa ndi placebo odwala omwe ali ndi matenda oopsa, kuchuluka kwa zoyipa zomwe zimanenedwa ndi telmisartan (41.4%) nthawi zambiri zimafanana ndi kuchuluka kwa zoyipa zomwe zimachitika ndi placebo (43.9%). Chiwerengerochi cha zoyipa sizinali zodalira mlingo, ndipo sizinkagwirizana ndi jenda, zaka, kapena mtundu wa odwala.

Chitetezo cha telmisartan mwa odwala omwe amamwa mankhwalawa pofuna kupewa matenda amtima komanso kufa kwake komwe kumafanana ndi mbiri ya chitetezo kwa odwala omwe ali ndi matenda oopsa.

Zotsatira zoyipa zomwe zidafotokozedwa pansipa zidapezeka chifukwa cha mayeso owongolera azachipatala omwe odwala omwe ali ndi matenda oopsa anachitapo kanthu, komanso kuchokera ku maphunziro atatsatsa malonda. Kuphatikiza apo, zovuta zoyipa komanso zoyipa zomwe zidapangitsa kuti mankhwalawa athetsedwe, zomwe zimanenedwa m'mayesero atatu azachipatala omwe akukhudza 21,642 odwala omwe adatenga telmisartan kuti ateteze kuchepa kwa mtima ndi kufa kwa zaka zisanu ndi chimodzi.

Zochitika zoyipa zalembedwa pansipa kugwiritsa ntchito magulu awa: nthawi zambiri ≥1 / 100 kuti

Kutulutsa mawonekedwe ndi kapangidwe kake

Mankhwala amamasulidwa ngati mapiritsi oyera kapena oyera. Kumbali imodzi ya mapiritsi kuli pachiwopsezo.

Piritsi limodzi, Telmisartan imatha kukhala 40 kapena 80 mg wa chinthu chomwechi. Omwe amathandizira ndi sodium hydroxide, meglumine, povidone, magnesium stearate, hydroxypropyl methylcellulose, mannitol.

Zotsatira za pharmacological

Telmisartan ndiwotsutsana ndi angiotensin receptors 2. Imakhala ndi mgwirizano wabwino wa mankhwala ndi Amlodipine, chifukwa chake nthawi zambiri amaphatikizidwa. Pafupifupi maola 2.5-3 atamwa mankhwalawa, kuchepa kwa magazi kumawonedwa. Kutsika kwakukulu pazomwe zimachitika kumatha masabata 4 pambuyo pa chithandizo.

Ndi kuchepa kwa kupanikizika, mankhwalawa alibe mphamvu pa mtima komanso pamitsempha yamafungo. Mitsempha yamagazi yokha ya diastolic ndi systolic imadziwika ndi zotsatira za mankhwala. Ichi ndi chimodzi mwazinthu zomwe zimagwira.

Malangizo ogwiritsira ntchito

Telmisartan imasunga kuthamanga kwa magazi kudutsa malire abwinobwino. Malangizo ogwiritsira ntchito amapereka mankhwala osokoneza bongo mosasamala za kudya. Imwani yonse osakudula. Sambani pansi ndi madzi pang'ono. Sitikulimbikitsidwa kumwa ndi timadziti, makamaka mphesa, chifukwa zimathandizira mphamvu ya mankhwalawa.

Mulingo woyenera tsiku lililonse osaposa 40 mg. Mphamvu ya mankhwalawa imapitirira pafupifupi maola 24. Imayamba kugwira ntchito pambuyo pa maola 1.5 mutatha kuperekera. Mlingo wapamwamba ndi 80 mg. Koma ndi zovuta za chiwindi, amaloledwa kumwa zosaposa 40 mg patsiku.

Ndi kugwiritsidwa ntchito kosalekeza kwa mwezi umodzi, kufanana kwazitsulo kumatsimikiziridwa kuzowonetsa zofunika.

Mukaphatikizidwa ndi ACE inhibitors, potseum-yosalira okodzetsa komanso mankhwala okhala ndi potaziyamu, kuyang'anira kokhazikika kwa kayendetsedwe kofunikira ndikofunikira. Mankhwalawa angayambitse hyperkalemia. Kuphatikiza apo, amalimbikitsa kuwonjezeka kwa lithiamu ndi dioxin m'magazi.

Telmisartan zochizira matenda oopsa

Nthawi zambiri zotchulidwa 40 mg patsiku. Koma mlingo umatha kuchepetsedwa mpaka 20 mg ngati mankhwalawo angagwire bwino ntchito.

Ngati simungathe kukwaniritsa zomwe mukufuna ndi 40 mg ya tsiku lililonse, mutha kuonjezera, koma mpaka 80 mg. Mlingo wonse umatengedwa nthawi. Mukamaganiza za kusintha kwa mankhwalawa, ndikofunikira kudziwa kuti mphamvu yayikulu siyikupezeka mwachangu, koma pafupifupi miyezi iwiri ya kumwa mapiritsi.

Pofuna kuchepetsa kuthamanga kwa magazi, Telmisartan imakonda kutumikiridwa nthawi imodzi ndi thiazide diuretics.

Telmisartan kwa moyo kukulira matenda a mtima

Kugwira ntchito kwa Telmisartan popewa kufa kwa anthu omwe ali ndi matenda amtima kumaonekera pa mlingo wa 80 mg tsiku lililonse. Kaya zotsatira zofanana zimawonedwa pamlingo wotsika sizikudziwika.

Ngati mukukumana ndi vuto la impso kapena chiwindi, muyenera kuonetsetsa kuti mulingo wakewo sukuyambitsa mavuto kuchokera ku ziwalozi. Ndikofunika kuyamba ndi mlingo wa 20 mg patsiku. Kwa odwala ambiri omwe ali ndi vuto la chiwindi, Mlingo woposa 40 mg tsiku lililonse ndi wowopsa.

Werengani inenso nkhaniyi: Lercanidipine: mapiritsi 10 mg ndi 20 mg

Contraindication

Telmisartan sanalembedwe milandu izi:

osavomereza kufooka thupi,
kuphwanya patency yam'mbereu,
mimba ndi mkaka wa m`mawere
ana ndi achinyamata (mpaka zaka 18),
Hypersensitivity zigawo zikuluzikulu,
kukanika kwambiri kwa hepatic ndi aimpso,
kuchuluka kwa mahomoni aldosterone - matenda a Conn, omwe amayamba chifukwa cha chotupa cha zotupa mu ma gren adrenal,
glucose-galactose malabsorption.

Anthu omwe ali ndi vuto la mtima, zilonda zam'mimba kapena zilonda zam'mimba, amatha magazi, ndikofunikira kupenda kuwerengera magazi ndi kumvetsera malingaliro awo.

Dokotala amayenera kuwunika momwe odwala alili kuti apewe zovuta.

Zotsatira zoyipa

Mukamagwiritsa ntchito mankhwala, mavuto ena amatha kumachitika, kuphatikizapo kupezeka kwa matenda akumwa pambuyo poti mugwiritse ntchito:

chifuwa chachikulu
myalgia
kusanza ndi kusanza
ukufalikira
hypercreatininemia,
pharyngitis
mutu
kufalikira kwamphepo,
arthralgia
chizungulire
kupweteka ndi kusasangalala m'dera lumbar,
kuchepa magazi
kuchuluka kwa hepatic transaminases,
kutsika kwa magazi,
kuchuluka kukwiya
mavuto
kudzimbidwa
Khungu
kusayenda bwino kwamapapu
Edema ya Quincke (kawirikawiri),
zosokoneza tulo
zotupa
kuchepa kwa hemoglobin m'madzi am'magazi,
kupweteka pachifuwa
arrhythmia ndi tachycardia.

Malangizo apadera

Chenjezo liyenera kuchitika kwa odwala omwe amayendetsa galimoto kapena omwe ntchito yawo imawonjezera chidwi, chifukwa chimodzi mwazotsatira zake ndi chizungulire.

Muyenera kuwunika kusintha kwam'magazi a electrolyte, BCC, kuwunika mosamalitsa mkhalidwe wa odwala omwe adakumana ndi mavuto pachiwindi kapena impso kapena stenosis yamitsempha impso, stenosis ya aorta kapena mitral valagia mtima, vuto la mtima, matenda a mtima, zilonda zam'mimba, magazi kapena magazi.

Kuyanjana kwa mankhwala osokoneza bongo

Ngati mumamwa Telmisartan 80 mg kapena 40 mg ndi Digoxin, ndiye kuti kuchuluka kwa omwe ali m'magazi kudzawonjezeka. Nthawi yomweyo, kumwa mankhwala omwe afotokozedwera pamwambapa komanso osavomerezeka a potaziyamu osavomerezeka. Kuyendetsa munthawi yomweyo kwa Telmisartan ndi NSAIDs (omwewa ndi a aspirin) kumachepetsa mphamvu, mkati mwake momwe kuthamanga kwa wodwala kumachepa.

Kutenga Telmisartan ndi mankhwala ena omwe amachepetsa kuthamanga kwa magazi, mutha kukwaniritsa kuchepa kwambiri kwa kuthamanga kwa magazi mpaka kufa. Chifukwa chake, ndibwino kuti musamwe mitundu ingapo ya mankhwala nthawi imodzi, cholinga chake ndikubweretsa kuthamanga kwa magazi.

Ngati mumamwa Telmisartan 40 kapena 80 nthawi imodzi ndi corticosteroids, izi zimachepetsa mphamvu ya antihypertensive (kutsitsa anzawo).

Analogs a Telmisartan

Kapangidwe kamene kamayimira fanizo:

Angiotensin 2 receptor antagonists akuphatikizapo analogues:

Valsacor
Kandachime,
Lorista
Irsar
Karzartan
Cardosal
Irbesartan
Olimestra
Muziyamwa
Mikardis Kuphatikiza,
Ibertan
Atacand
Valz
Valsartan
Hyposart,
Cardostin
Lozarel
Cozaar
Zisakar
Nortian
Telsartan
Diovan
Tantordio
Naviten
Tanidol
Xarten
Telzap
Vasotens,
Telmista
Blocktran
Ordiss
Losacor
Lotor
Renicard
Edarby
Losartan
Telmisartan
Lozap,
Cardosten
Tareg
Aprovel
Ma Valsafors,
Wotsogolera
Pano,
Firmast
Nyanja
Presartan,
Makandulo
Sartavel
Angiakand.

Kutulutsa mafomu ndi kapangidwe kake

Mankhwalawa ndi piritsi yoyera yoyera yopanda chipolopolo, convex mbali zonse ziwiri. Pamwambapa aliyense wa iwo ali ndi zoopsa zosweka ndi zilembo "T", "L", m'munsi - chiwerengero "40". Mkati, mutha kuwona zigawo ziwiri: chimodzi ndichipi cha mitundu yosiyanasiyana, china chimakhala choyera, nthawi zina chimakhala ndi timalingaliro tating'ono.

Mu piritsi 1 la mankhwala osakanikirana - 40 mg ya kaphatikizidwe kamene kamapezeka ndi telmisartan ndi 12,5 mg wa hydrochlorothiazide diuretic.

Zinthu zothandiza zimagwiritsidwanso ntchito:

mannitol
lactose (shuga mkaka),
povidone
meglumine
magnesium wakuba,
sodium hydroxide
polysorbate 80,
utoto E172.

Mu piritsi 1 la mankhwala osakanikirana - 40 mg ya kaphatikizidwe kamene kamapezeka ndi telmisartan ndi 12,5 mg wa hydrochlorothiazide diuretic.

Mapiritsi a 6, 7 kapena 10 ma PC. kuyikidwa mu matuza okhala ndi zojambula za aluminium zojambulazo ndi filimu ya polima. Atanyamula makatoni 2, 3 kapena 4 matuza.

Pharmacokinetics

Kuphatikiza kwa telmisartan ndi hydrochlorothiazide sikumasintha ma pharmacokinetics a zinthu. Awo wonse bioavailability ndi 40-60%. Zigawo zogwira ntchito za mankhwalawa zimatengedwa mwachangu kuchokera kugaya chakudya. Kuchuluka kwa telmisartan kudzikundikira m'madzi am'magazi pambuyo pa maola 1-1,5 ndi kutsika kwa 2-3 kwa amuna kuposa akazi. Kutenga pang'ono kwa mthupi kumachitika m'chiwindi, umatulutsidwa m'zimbudzi. Hydrochlorothiazide imachotsedwa m'thupi pafupifupi osasinthika ndi mkodzo.

Zizindikiro zogwiritsidwa ntchito

mankhwalawa matenda oyamba ndi owopsa ochepa, pamene chithandizo chokhala ndi telmisartan kapena hydrochlorothiazide chokha sichimapereka zotsatira zomwe mukufuna,
popewa zovuta zamatenda amtima kwambiri mwa anthu azaka zopitilira 55-60,
popewa zovuta zomwe zili ndi odwala omwe ali ndi matenda amtundu wa II (osagwirizana ndi insulin) omwe amawonongeka chifukwa cha matenda oyambitsidwa ndi matendawa.

Gwiritsani ntchito pa nthawi yoyembekezera komanso mkaka wa m`mawere

Mimba

Mankhwalawa amaperekedwa kwa amayi apakati kapena amayi omwe akukonzekera kutenga pakati. Ngati mimba yatsimikiziridwa pakuthandizidwa ndi wothandizirayi, ntchito yake iyenera kuyimitsidwa nthawi yomweyo ndipo ngati kuli koyenera, imasinthidwa ndi mankhwala ena ovomerezeka kuti agwiritsidwe ntchito mwa amayi apakati (onani zigawo "Contraindication" ndi "Mbali zogwiritsidwa ntchito").
Palibe zambiri zogwirizana ndi ntchito ya Telmisartan kwa amayi oyembekezera.

Zoyambitsa mliri wa chiopsezo cha teratogenicity chifukwa chogwiritsa ntchito zoletsa za ACE nthawi yoyamba ya pakati sizinali kukhudzika, koma kuwonjezeka pang'ono pangozi sikungadziwike. Ngakhale palibe umboni wolamulira wa chiopsezo cha teratogenicity ndi angiotensin II receptor antagonists, zoopsa zofananazi zitha kukhalapo kagulu kamankhwala awa.

Angiotensin II receptor antagonists sayenera kuyamba pomwe ali ndi pakati. Ngati kupitiliza kwa mankhwalawa ndi angiotensin II okondedwa akuwoneka kuti ndikofunikira, ndipo wodwalayo akukonzekera kutenga pakati, tikulimbikitsidwa kuti tichotse mankhwalawa ndi antihypertensive mankhwala okhala ndi mbiri yotetezeka panthawi yapakati. Ngati mimba yakhazikika, chithandizo cha angiotensin II receptor antagonists iyenera kusiyidwa pomwepo ndipo njira yoyenera yothandizira iyenera kuyambitsidwa.

Amadziwika kuti kugwiritsa ntchito angiotensin II receptor antagonists pa II ndi III trimesters ya mimba imayambitsa kufalikira kwa anthu (kuwonongeka kwa impso, oligohydramniosis, kuchedwa kwa mapangidwe a mafupa a cranial) komanso neonatal kawopsedwe (kulephera kwa impso, hypotension, hyperkalemia). Ngati kugwiritsa ntchito angiotensin II receptor antagonists adayamba mu nyengo yachiwiri ya kubereka, tikulimbikitsidwa kuti tichite kafukufuku wa impso ndi mafupa a chigoba cha fetal. Mkhalidwe wa akhanda omwe amayi awo adatenga angiotensin II receptor antagonists ayenera kuyang'aniridwa mosamala kuti pakhale kuwonongeka kwa hyperial hypotension (onani Magawo "Contraindication" ndi "Makhalidwe Ogwiritsira Ntchito").

Kuyamwitsa.

Telmisartan siyikulimbikitsidwa pakuyamwitsa, chifukwa sizikudziwika ngati amathiridwa mkaka wa munthu. Njira zina zochiritsira zosagwiritsidwa ntchito ndi njira yophunziridwa bwino ndiyabwino, makamaka poyamwitsa mwana wakhanda kapena asanabadwe.

Bongo

Zambiri pa mankhwala osokoneza bongo mwa anthu ndizochepa.

Zizindikiro Zodziwika kwambiri za mankhwala osokoneza bongo a telmisartan anali hypotension ndi tachycardia, ndi bradycardia, chizungulire, kuchuluka kwa serum creatinine, komanso kulephera kwa impso kunanenedwanso.

Chithandizo. Telmisartan siwotsimikizika pa hemodialysis. Odwala ayenera kuyang'aniridwa mosamala komanso moyenera komanso ndi chithandizo chothandizira chomwe adalandira. Chithandizo chimatengera nthawi yomwe yatha mutatha kumwa kwambiri komanso kuopsa kwa Zizindikiro. Njira zomwe akutsimikiza zimaphatikizira kusanza ndi kutsuka kwamatumbo. Yoyambitsa kaboni ingakhale yothandiza mankhwalawa bongo. Onani pafupipafupi ma seramu electrolyte ndi mamiliyoni a creatinine. Ngati wodwalayo ali ndi hypotension, ayenera kutenga ma supine, amafunikanso kuyamba mwachangu kubwezeretsa madzi ndi ma electrolyte.