Telmista 80 mg - malangizo ogwiritsira ntchito

Telmista 80 mg - mankhwala a antihypertensive, othandizira ena a angiotensin II receptors (mtundu wa AT1).

Piritsi limodzi 80 mg:

Zogwira pophika: Telmisartan 80.00 mg

Omwe amathandizira: meglumine, sodium hydroxide, povidone-KZO, lactose monohydrate, sorbitol (E420), magnesium stearate.

Mapiritsi 80 mg: Capsule-mawonekedwe, biconvex mapiritsi amtundu woyera kapena pafupifupi woyera.

Mankhwala

Telmisartan ndi angiotensin II receptor antagonist (ARA II) (mtundu wa AT1), wogwira ntchito mukamamwa. Ili ndi kuyanjana kwakukulu kwa AS1 subtype ya angiotensin II receptors, kudzera momwe zochita za angiotensin II zimadziwika. Kuyika angiotensin II kulumikizana ndi cholandilira, osakhala ndi zochita za agonist mokhudzana ndi cholandilira ichi. Telmisartan imamangiriza kokha ku AT1 subtype ya angiotensin II receptors. Kulumikizana ndikupitiliza. Ilibe chiyanjano ndi ma receptor ena, kuphatikizapo AT2 receptors ndi zina zochepa zomwe amaphunzira angiotensin receptors. Kufunikira kwa magwiritsidwe awa a ma receptor, komanso momwe mphamvu zawo zimakhudzira kwambiri ndi angiotensin II, kugwiritsidwa ntchito kwa zomwe zimawonjezeka ndi telmisartan, sikunaphunzire. Amachepetsa ndende ya aldosterone m'madzi am'magazi, samalepheretsa renin m'magazi am'magazi komanso ns block ma ion. Telmisartan sichimalepheretsa angiotensin kutembenuza enzyme (ACE) (kininase II) (enzyme yomwe imawononganso bradykinin). Chifukwa chake, kuwonjezeka kwa zoyipa zoyambitsidwa ndi bradykinin sikuyembekezeredwa.

Odwala, telmisartan pa mlingo wa 80 mg kwathunthu limalepheretsa hypertensive zotsatira za angiotensin II. Kukhazikika kwa antihypertensive kanthu kumadziwika mkati mwa maola atatu itatha konzedwe ka telmisartan. Mphamvu ya mankhwalawa imapitilira maola 24 ndipo imakhalabe yofunikira mpaka maola 48. Ananena kuti antihypertensive zotsatira zimachitika pambuyo 4-8 milungu yochitika pafupipafupi telmisartan.

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

Pankhani yakuchotsedwa kwadzidzidzi kwa telmisartan, kuthamanga kwa magazi pang'onopang'ono kumabwereranso ku gawo lake loyambirira popanda chitukuko cha "kusiya" matenda.

Pharmacokinetics

Ikamamwa pakamwa, imatengedwa mwachangu kuchokera m'matumbo am'mimba (GIT). Bioavailability ndi 50%. Kuchepa kwa AUC (dera lozungulira nthawi yokhazikika) pogwiritsa ntchito munthawi yomweyo telmisartan zakudya zimachokera ku 6% (pa 40 mg) mpaka 19% (pa mlingo wa 160 mg). Pakadutsa maola atatu atatha kumwa, ndende ya m'madzi am'magazi imayendetsedwa, ngakhale nthawi yakudya. Pali kusiyana pamaganizidwe a plasma mwa amuna ndi akazi. Kuchuluka kwa ndende (Cmax) mu madzi am'magazi ndi AUC mwa akazi poyerekeza ndi abambo kunali pafupifupi 3 ndi 2 nthawi, motero (popanda kuchitapo kanthu).

Kuyankhulana ndi mapuloteni am'madzi am'magazi - 99,5%, makamaka ndi albumin ndi alpha-1 glycoprotein.

Mtengo wapakati wamawonekedwe ogajirika m'ndende zofanana ndi 500 malita. Zimapangidwa ndi kuphatikizika ndi glucuronic acid. Ma metabolabolites ndi opanga ma pharmacologic. Hafu ya moyo (T1 / 2) ndi wopitilira maola 20. Amapukusidwa kudzera m'matumbo mu mawonekedwe osasinthika komanso impso - zosakwana 2% ya mlingo wotengedwa. Chilolezo chonse cha plasma ndi chachikulu (900 ml / min), koma kuyerekeza ndi magazi a "hepatic" (pafupifupi 1500 ml / min).

Contraindication

Contraindication pakugwiritsa ntchito mankhwala a Telmista:

Hypersensitivity ku yogwira mankhwala kapena excipients ya mankhwala.
Mimba
Nthawi yoyamwitsa.
Matenda owopsa a m'mimba.
Zowopsa za hepatic kuwonongeka (Gulu Lopanda Ana).
Kugwiritsira ntchito limodzi ndi aliskiren kwa odwala omwe ali ndi matenda osokoneza bongo kapena ochepa kwambiri aimpso kulephera (glomerular filtration rate (GFR)

Zotsatira zoyipa

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

Matenda opatsirana komanso ma parasitic: sepsis, kuphatikizapo matenda oopsa a sepsis, matenda amkodzo thirakiti (kuphatikizapo cystitis), matenda opatsirana am'mimba kwambiri.
Kusokonezeka kwa magazi ndi dongosolo la lymphatic: kuchepa magazi, eosinophilia, thrombocytopenia.
Kusokonezeka kwa chitetezo chathupi: anaphylactic reaction, hypersensitivity (erythema, urticaria, angioedema), eczema, kuyabwa, zotupa pakhungu (kuphatikizapo mankhwala), angioedema (wokhala ndi zotsatira zakupha), hyperhidrosis, zotupa pakhungu.
Kuphwanya kwamanjenje: nkhawa, kusowa tulo, kukhumudwa, kukomoka, vertigo.
Kusokonezeka kwa ziwalo zamasomphenya: Kusokonezeka kowoneka.
Kusweka kwa mtima: bradycardia, tachycardia.
Kuphwanya Mitsempha yamagazi: kuchepa kwamphamvu kwa kuthamanga kwa magazi, orthostatic hypotension.
Kusokonezeka kwa dongosolo la kupuma, ziwalo zam'mimba ndi Mediastinum: kufupika, kupuma, matenda am'mapapo * (* munthawi yogulitsa pambuyo pake, milandu yokhudzana ndi matenda am'mapapo yafotokozedwera, ndi kulumikizana kwakanthawi ndi telmisartan. yaikidwa).
Matenda am'mimba: kupweteka kwam'mimba, kutsegula m'mimba, kupweteka kwamlomo wam'mimba, kukomoka, kuphwanya m'mimba, kusokonezeka kwa m'mimba, kusanza, kulakwitsa kosokoneza (dysgeusia), chiwindi ntchito / matenda a chiwindi * (* malinga ndi zotsatira zakuwonetsa pambuyo pakutsatsa. milandu ya chiwindi ntchito / chiwindi matenda awonekera mu okhala Japan).
Kusokonezeka kwa minculoskeletal ndi minofu yolumikizana: arthralgia, kupweteka kwa msana, kupindika kwa minofu (kukokana kwa minofu ya ng'ombe), kupweteka m'munsi, myalgia, tendon ululu (Zizindikiro zofanana ndi chiwonetsero cha tendonitis).
Kusokonezeka kwa impso ndi kwamikodzo thirakiti: kuwonongeka kwaimpso, kuphatikizapo kupweteka kwaimpso.
Zovuta ndi zovuta zina pamalo a jakisoni: kupweteka pachifuwa, matenda ofanana ndi chimfine, kufooka wamba.
Zolemba zasayansi ndi othandizira: kuchepa kwa hemoglobin, kuwonjezeka kwa kuchuluka kwa uric acid, creatinine m'magazi am'magazi, kuwonjezeka kwa ntchito ya "chiwindi" michere, creatine phosphokinase (CPK) m'magazi am'magazi, hyperkalemia, hypoglycemia (odwala matenda a shuga).

Kuchita ndi mankhwala ena

Telmisartan imachulukitsa mphamvu ya antihypertensive ya mankhwala ena a antihypertensive. Mitundu ina ya zochitika zamatenda azachipatala sizinadziwikebe.

Kugwiritsa ntchito ndi digoxin, warfarin, hydrochlorothiazide, glibenclamide, ibuprofen, paracetamol, simvastatin ndi amlodipine sikuti kumabweretsa mgwirizano wamphamvu pakadutsa. Kuwonjezeka kwakukulu kwa kuchuluka kwa digoxin m'madzi am'magazi ndi pafupifupi 20% (munthawi imodzi, ndi 39%). Ndi munthawi yomweyo kugwiritsa ntchito telmisartan ndi digoxin, ndikofunikira kuti nthawi zina azindikire kuchuluka kwa digoxin m'madzi a m'magazi.

Monga mankhwala ena omwe amagwiritsa ntchito renin-angiotensin-aldosterone system (RAAS), kugwiritsa ntchito telmisartan kungayambitse hyperkalemia (onani gawo "Malangizo apadera"). Chiwopsezochi chikuwonjezeka ngati mugwiritsidwa ntchito nthawi yomweyo ndi mankhwala ena, omwe angayambitsenso kukulitsa kwa hyperkalemia (zotulutsa mchere wa potaziyamu, mankhwala osokoneza bongo a potaziyamu, zoletsa za ACE, AA II, osagwiritsa ntchito mankhwala a anti-yotupa a NSAIDs, kuphatikizapo kusankha kwa cycloo oxygenase-2 | TsOGG-2 | immunosuppressants cyclosporine kapena tacrolimus ndi trimethoprim.

Kukula kwa hyperkalemia kumadalira zochitika zangozi. Chiwopsezochi chimakulanso ngati mukugwiritsa ntchito zomwezi pamwambapa. Makamaka, chiwopsezo chimakhala chachikulu kwambiri ngati chikugwiritsidwa ntchito nthawi imodzi ndi potaziyamu ochepera okodzetsa, komanso m'malo mwa mchere wa potaziyamu. Mwachitsanzo, kugwiritsa ntchito limodzi ndi ACE inhibitors kapena NSAID sikumakhala pachiwopsezo chochepa kwambiri ngati machitidwe osamala akutengedwa. ARA II, monga telmisartan, amachepetsa kuchepa kwa potaziyamu nthawi ya mankhwala a diuretic. Kugwiritsa ntchito potaziyamu posungira diuretics, mwachitsanzo, spironolactone, eplerenone, triamteren kapena amiloride, zina zowonjezera potaziyamu kapena zotulutsa mchere wa potaziyamu zitha kubweretsa kuwonjezeka kwakukulu kwa seramu potaziyamu. Kugwiritsira ntchito nthawi yomweyo kwa hypokalemia zolembedwa kuyenera kugwiritsidwa ntchito mosamala komanso kuyang'anira potaziyamu yambiri m'magazi a magazi. Ndi kugwiritsa ntchito pamodzi kwa telmisartan ndi ramipril, kuwonjezeka kwa 2,5 kwa AUC0-24 ndi Cmax ya ramipril ndi ramipril kunawonedwa. Kufunika kwamankhwala pazinthu izi sikunakhazikitsidwe. Pogwiritsa ntchito munthawi yomweyo ACE zoletsa ndi kukonzekera kwa lifiyamu, kuwonjezereka kwa zinthu za m'magazi a plasma kumawonedwa, limodzi ndi zotsatira zoyipa. Nthawi zina, zosintha zoterezi zidanenedwa ndi ARA II ndi kukonzekera kwa lithiamu. Pogwiritsa ntchito munthawi yomweyo lifiyamu ndi ARA II, tikulimbikitsidwa kuti tidziwe zomwe zili mu lithiamu m'madzi a m'magazi. Kuchiza kwa NSAIDs, kuphatikizapo acetylsalicylic acid, COX-2, komanso NSAIDs yosasankha, kungayambitse kulephera kwa impso kwa odwala omwe alibe madzi m'thupi. Mankhwala omwe amagwiritsidwa ntchito pa RAAS amatha kukhala ndi synergistic. Odwala omwe alandila NSAIDs ndi telmisartan, bcc iyenera kulipidwa poyambira chithandizo ndikuwonetsa kuyinso. Kugwiritsira ntchito limodzi ndi aliskiren kwa odwala omwe ali ndi matenda osokoneza bongo kapena othina mwamphamvu kwambiri aimpso kulephera (kuchuluka kwa kusefedwa kwa GFR)