Pehea e hoʻohana ai iā Telmista 40? > He hoʻomaʻemaʻe a me ke pale aku

Nā Dmage form Telmists - papa: aneane keʻokeʻo a keʻokeʻo paha, ma ke ʻano o 20 mg - puni, 40 mg - biconvex, oval, 80 mg - biconvex, capsule-ʻano (i kahi blister o nā mea i hui pū me 7 p.., I loko o kahi pahu pahu 2, 4, 8 , He 12 a he 14 paha blisters, i kahi blister 10 pcs., I kahi pahu pahu pepa 3, 6 a he 9 paha blisters).

ʻO ka hoʻonohonoho ʻana o hoʻokahi papa:

mea hana: telmisartan - 20, 40 a 80 mg,
nā mea waiwai: sodium hydroxide, lactose monohydrate, magnesium stearate, meglumine, povidone K30, sorbitol (E420).

Lapaʻau lāʻau

ʻO Telmisartan, ka waiwai ikaika o Telmista, he waiwai antihypertensive, ʻo ia ka ʻāmaʻomaʻo ʻāmaʻomaʻo reseptotin II (AT blocker.₁nā mea hoʻonaʻau). ʻO ka haʻalele i ka angiotensin II mai ka pilina me ka mea nāna i hopu, ʻaʻole ia e loaʻa nā hana a kahi agonist e pili ana i kēia mea iʻa. Telmisartan koho a no ka manawa lōʻihi hiki ke hoʻopaʻa wale i ka angiotensin II receptor subtype AT₁. ^ E Ha yM. ʻAʻole ia he mea pili i ka ʻona ʻē aʻe o ka mea hoʻonaninikena, ʻo ka hana koʻikoʻi o ia a me ka hopena o ka hopena (ma muli o ka hoʻohana ʻana o telmisartan) ka hopena o ka angiotensin II ma luna o lākou ʻaʻole i aʻo ʻia i ke ʻano.

Ke hōʻemi nei ʻo Telmisartan i ke kao o ka ald testosterone i ka plasma koko, ʻaʻole i hoʻopilikia i ka neʻe o ka renin a ʻaʻole paʻa i nā kaila wai. ʻAʻole ka mea i hoʻoneʻe ʻia i ka ACE (angiotensin-hoʻohuli i ka enzyme), ka mea e luku ai i ka bradykinin, no laila ʻaʻole ʻike ʻia ka hopena ʻaoʻao e ka bradykinin.

ʻO Telmisartan, i lawe ʻia ma kahi awa o 80 mg, papale piha i ka hopena hypertensive o ka angiotensin II. Ma hope o ka hopena mua o ka lāʻau no 3 mau hola, ua hoʻomaka ka hoʻomaka ʻana o ka hopena hypotensive, e hoʻomau ka hopena no kahi lā a hoʻomau ka nui a hiki i nā lā ʻelua. Hoʻokomo pinepine kahi hopena hypotensive ma hope o 4-8 mau pule mai ka hoʻomaka ʻana o ka mālama ʻana me ka hoʻokele maʻamau o ka telmisartan.

Me ka hypertension arterial, kōkua ka lāʻau lapaʻau e hōʻemi i ka systolic a me ka diastolic blood pressure (BP). ʻAʻohe Telmisartan i ka hopena o ka puʻuwai puʻuwai (hōʻemi o ka puʻuwai).

I nā maʻi me ka hiki ke hoʻopau loa i ka telmisartan, hoʻemi kahe koko i kona ʻokoʻa i kāna waiwai mua, ʻaʻole i ʻike ʻia ka pale haʻalele.

Lapaʻau lāʻau

hano o ka ʻāpono: ia manawa i hoʻāhu ʻia ai, ua pālahalaha ʻia ma ka gastrointestinal tract. ʻO Bioavailability 50%. I ka wā e lawe ai me ka meaʻai, ka hōʻemi o ka AUC (ma lalo o ka pāpaʻi pharmacokinetic) ma waena o 6% a 19% ma kahi o 40 a 160 mg, ma kahi. 3 mau hola ma hope o ka lawe ʻana i ka telmisartan, ʻo ka ʻike ʻana i ka pae ʻai koko i waho (ʻaʻole i hilinaʻi i ka manawa e ʻai ai). AUC a me ke kaila plasma kiʻekiʻe loa o ka waiwai (C_max) ka wahine i like me 2 a me 3 mau manawa iʻoi aku, ma mua o nā kāne. ʻAʻohe hopena koʻikoʻi i ka hoʻoikaika,
ka hoʻoili ʻana a me ka metabolism: 99.5% o ka waiwai e hoʻopili ai i nā protein plasma (ʻoi aku ka alpha-1 glycoprotein a me ka albumin). ʻO ka ʻike maʻamau o ka hoʻoili ʻana i ka ʻike kaulike ma ka awelika 500 l. Hoʻomoe ka metabolism ma ka hoʻokūkū me ka hoʻohuihui glucuronic me ka hoʻokumu ʻana o nā metabolite kālaiʻike pharmacologically,
I'āpā: T_1/2 (elimination half-life) - ʻoi aku ma mua o 20 mau hola. Hoʻololi ʻole ka waihona waiwai ma loko o nā ʻōpū, me ka urine - ma lalo o 2%. Hōʻeu loa ka huakaʻi holoʻokoʻa plasma me ke kahe koko hepatic (ma kahi o 1500 ml / min) a ma kahi o 900 ml / min.

ʻO nā hoʻohālikelike pharmacokinetic nui o ka telmisartan i ka wā i hoʻohana ʻia i nā keiki a me nā ʻōpio mai ka 6 a 18 mau makahiki he mau makahiki no ka 4 wiki ma kahi o ka maʻi 1 a i ʻole 2 mg / kg i hoʻohālikelike ʻia me nā mea i nā maʻi pākeke a hōʻoia i ka pharmacokinetics non-linear o ka mea ikaika, me ka mahalo pū me C_max.

Nā Hoʻohui

nā kumu nui o ka hōʻaʻe o ka ate (e like me ke ʻano o ke keiki - Pugh - papa C),
bile pauku
hoʻohui me aliskiren i nā mea maʻi me ka hōʻeha ʻole a hōʻemi paha i ka ʻole o ka renal fail ʻole (glomerular filtration rate me ka haʻahaʻa ma mua o 60 ml / min / 1.73 m 2) a me ka maʻi mellitus,
lactase / sucrose / isomaltase hemahema, frolose intolerance, glucose-galactose malabsorption,
hapai a me ka lactation manawa,
makahiki i 18 makahiki
hypersensitivity pilikino i ka telmisartan a i ʻole kekahi o nā mea kōkua o ka lāʻau.

ʻO ka maʻi (nā maʻi / nā kūlana e pono ai ka hoʻohana ʻana o Telmista i ka mālama):

pilikia hāpau a me / a hana pāpaʻi,
bilateral renal aren stenosis a i ʻole stenosis kahi o hoʻokahi keiki,
mau kūlana ma hope o ka hiki ʻana o ka kidney (no ka hemahema o ka ʻike no ka hoʻohana ʻana),
hyperkalemia
hyponatremia,
nāwaliwali o ka puʻuwai
hniki ana i ka mitral a me / a ihae aortic,
GOKMP (hypertrophic obstructive cardiomyopathy),
ka hoʻemi ʻana i ka bcc (ka nui o ke koko e hele ai) ma muli o ka mālama mua ʻana me ka diuretics, ka palena o ka paʻakai, ka luaʻi a i ʻole ke kala ʻana,
ʻO ka hyperaldosteronism maʻamau (palekana a ʻaʻole pono i hoʻokō ʻia).

Nā ʻōkuhi no ka hoʻohana ʻana iā Telmista: ʻano a me ka helu ʻana

Lawe ʻia nā papa Telmist ma ke alo, me ke ʻano o ka manawa ʻaina.

Me ka hypertension arterial, ʻōlelo ʻia e hoʻomaka e lawe me ka 20 a 40 paha o ka lāʻau lapaʻau 1 manawa i kēlā me kēia lā. I kekahi mau mea maʻi, hiki i ka hoʻokō ʻia he hopena hypotensive ma ke ʻano o 20 mg / lā. I ka hopena o ka hopena therapeutic hopena, hiki iā ʻoe ke hoʻonui i ka nui i kekahi lāʻau kuʻuna no kēlā me kēia lā he 80 mg. Me ka hoʻonui ʻana o ka waiū, pono e noʻonoʻo pono ia i ka hopena hypotensive kiʻekiʻe o Telmista e hana pinepine ma hope o 4-8 mau pule mai ka hoʻomaka ʻana o ka hopena.

No ka hōʻemi i ka morbidity cardiovascular a me ka make, e hoʻolauna ʻia e lawe i ka 80 mg o ka lāʻau lapaʻau 1 mau manawa i kēlā me kēia lā.

I ka hoʻomaka mua o ka mālama ʻana, pono paha nā ala hou no ka hoʻoponopono ʻana i ke koko.

ʻAʻole pono ia e hoʻoponopono i ka regimen dosage no nā mea maʻi me ka hiki ʻole o nā renal, a me nā mea ma ka hemodialysis.

No ka hana hemahema o ka puʻuwai a i ʻole ka paʻakikī (e like me ka helu ʻana o nā keiki-Pugh - Class A a me B), ʻo ka nui loa o ka lā helu o Telmista he 40 mg.

I nā poʻe maʻi kahiko, ʻaʻole i loli nā pharmacokinetics o telmisartan, no laila ʻaʻohe mea pono e hoʻoponopono i ke ʻano o ka lāʻau lapaʻau no lākou.

Nā hopena hopena

I ka hoʻohana ʻana i nā Telmists, hiki i kēia mau hopena ʻino mai nā ʻōnaehana a me nā huina:

puʻuwai, tachycardia, bradycardia,
nā kīʻaha koko: nā orthostatic hypotension, he nui ke emi ʻana i ke koko,
hoʻoweliweli ʻōnaehana: ʻeha, ʻeha o ka ʻōpū, dyspepsia, ʻōpū hopohopo, lemulā, ka luaʻi ʻana, dysgeusia (perversion o ka ʻono), ka pale o ka mucous mucile o ka waha waha, ʻehaʻeha a me ka hana o ka puʻuwai,
ke koko a me ka ʻōnaehana lymphatic: thrombocytopenia, eosinophilia, anemia, sepsis (me ka momona sepsis),
ʻōhumu: systemnia, hopohopo, hopohopo, vertigo, nāwaliwali,
ka hiʻi kino: hypersensitivity (urticaria, erythema, angioedema), reaksi anaphylactic, pruritus, eczema, ʻehaʻeha o ka ʻili (me ka huaʻala), hyperhidrosis, angioedema (a hiki i ka make), ka ʻehaʻeha o ka ʻili,
hui o nā hiʻohiʻona: nā pilikia haunaele,
ʻōpū o ka hanu, umauma a me nā ʻōpū mediastinal: kō, ka pōkole o ka hanu, nā maʻi ʻōpū o ke ala kiʻekiʻe, nā maʻi maʻi interstitial (kahi kumu hoʻopili me ka hoʻohana ʻana o telmisartan, ʻaʻole i hoʻokau).
ka musculoskeletal a me ka hoʻopili hoʻohui: ʻeha hope, arthralgia, nā māka palu (spasms o nā ʻalā bipi keiki), myalgia, ʻeha ʻeha, ʻeha i nā tendons (mau hōʻailona e like me nā hōʻike ʻana o ka mumū a me ka hoʻoneʻe ʻana o ka tendon kiko).
nā pēpē a me nā hana o ka urinary: hana hana ʻole a ka huina (e komo pū ana i ka hopena o ka renal), ka maʻi urinary tract (me ka cystitis),
ke kino holoʻokoʻa: nā nāwaliwali laulā, nā maʻi like ka maʻi, ke ʻeha o ka umauma,
nā mea hana a me nā noiʻi noiʻi: nā mahuahua o nā kiko o ka uric acid, ka mea hana i loko o ke koko koko, he hoʻemi i ka pae o ka hemoglobin, he hoʻonui i ka hana o nā transaminases hepatic, ʻo CPK (creatine phosphokinase) i loko o ke koko koko, hypoglycemia (ma nā mea maʻi me ka maʻi mellitus), hyperkalemia.

ʻAʻole i hoʻokū ʻia ka pilina o ke kiʻekiʻe o ka hopena o nā hopena hopena me ka wā ʻōpiopio, ka wahine a me ka lāhui paha o nā maʻi.

Nā ʻōlelo kikoʻī

ʻO ka hoʻohana like ʻana o Telmista a me ACE inhibitors a i ʻole kahi mea paʻa o ka renin, aliskiren, ma muli o ke hana pālua ma ka ʻōnaehana RAAS (renin-angiotensin-aldosterone) e hoʻopilikia i ka hana o nā pūlū (a me ke ʻano paha i ka hana ʻole ʻana o ka maʻi renal), a hoʻonui hoʻi i ka hōʻeha o ka hypotension a me hyperkalemia. . ^ E Ha yM. Inā pono ʻo ia ke ʻano o kēlā hui kuʻuna, pono e alakaʻi ʻia ma lalo o ka mākaʻi o ka olakino, me ka hoʻomaʻamaʻa pinepine ʻana i ka hana o ka pēpē, ke koko a me ka pae o ka electrolyte i ka plasma koko.

I nā maʻi me ka nephropathy maʻi maʻi, ʻaʻole i ʻōlelo ʻia nā telmisartan a me ACE inhibitors.

I nā hihia i pili ai ka hana vascular a me ka hana i ka mea hana i ka hana o RAAS (no ka laʻana, i ka poʻe maʻi me ka maʻi o ka huehue, me ka stenosis bilateral renal artery stenosis a i ʻole ka stenosis o hoʻokahi arteritis hoʻokahi, a me ka paʻa ʻole paha o ka puʻuwai), ka hoʻohana ʻana i nā lāʻau lapaʻau e pili ana iā RAAS hiki ke alakaʻi i ka hoʻomohala ʻana. hyperazotemia, haehae arterial hypotension, oliguria a me ka hopena ʻole o ka renal nodula (i nā hihia loaʻa).

Ke hoʻohana nei i ka diuretics pākuhi potasi, pili i ka paʻakai pā paʻakai, hoʻohui ʻia a me nā lāʻau ʻē aʻe e hoʻonui ana i ka paʻū o ka pāima i loko o ka plasma koko a me Telmista, pono e kāohi i ka pae o ka paʻakai ma ke koko.

No ka mea ua hoʻōla ʻia ka telmisartan me ka hua bile, me ka maʻi o ka papa o ka biliary tract a i ʻole ka hana ʻalopona ka hana hōʻemi, hiki i ka hiki ke hōʻemi.

Me ka maʻi maʻamau a me ka puʻuwai cardiovascular hou aku, no ka laʻana, ka maʻi naʻau coronary (maʻi coronary heart), ʻo ka hoʻohana ʻana o Telmista e hiki ai i ka make myocardial infarction a me ka make cardiovascular ākea. I nā maʻi me ka maʻi mellitus, ʻaʻole e ʻike ʻia ka maʻi naʻau o ka coronary, no ka mea, ʻaʻole mau ka hopena i loko o kēia hihia. No laila, ma mua o ka hoʻomaka ʻana i ka lāʻau lapaʻau lāʻau, pono ia e hoʻokau i nā hoʻokolokolo diagnostic kūpono, me ka hōʻike ʻana me ka hoʻoikaika kino.

I nā maʻi me ka maʻi maʻi e loaʻa ana ka mālama ʻana me ka lālani a i ʻole nā lāʻau hypoglycemic waha, e ulu ka hypoglycemia i ka wā o ka maʻi me Telmista. Pono ia mau mea maʻi e kāohi i ka kaila o ka glucose i ke koko, no ka mea e hilinaʻi ana i kēia kuhikuhi, pono ke hoʻoponopono ʻia ka hopena o ka insulin a i ʻole hypoglycemic drug.

Ma ka maʻamau o ka hyperaldosteronism, hoʻohana ʻole ʻia ka hoʻohana ʻana o nā lāʻau antihypertensive - ʻāwīwī RAAS - i ʻole ka maikaʻi. ʻAʻole manaʻo ʻia kēlā mau maʻi e lawe iā Telmista.

Hiki i ka hoʻohana ʻana i ka lāʻau lapaʻau me ka hui pū me ka diuret thiazide, no ka mea, ʻo ia hui pū kekahi e hāʻawi i ka emi ʻana o ke kahe koko.

Ua hōʻike ʻia nā noiʻi ʻaʻole liʻiliʻi ʻo Telmista i nā mea maʻi o ka lāhui Negroid. Ua nānā ʻia ka lawelawe ʻana o ka ate me ka telmisartan i nā hapa nui ma waena o nā kamaʻāina o Iapana.

ʻŌpū a me ka lactation

Wahi a nā ʻōlelo kuhikuhi, ua contraindicated ʻo Telmista i ka wā hāpai. Ma ka hihia o ka hāpai ʻana o ka wā hapai, pono e hoʻokuʻu koke i ka lāʻau. Inā kūpono, pono i nā lāʻau antihypertensive o nā papa ʻē aʻe i ʻae ʻia no ka hoʻohana ʻana i ka wā hāpai. Manaʻo ʻia aku nā wahine hoʻolālā i ka wā e hoʻohana ai i nā lāʻau lapaʻau hou.

Ma nā noi preclinical o ka lāʻau, ʻaʻole i ʻike ʻia nā hopena teratogenic. Akā i ʻike ʻia ʻo ka hoʻohana ʻana o ka antagonis reseptor angiotensin II i ka mea hoʻomaʻamaʻa lua a me ke kolu o ka hapai i ka hapai ʻana i ka fetotoxicity (oligxidamnios, hoʻemi i ka hana renalous, aihue ossification o nā iwi o ka ʻōiwi palupalu) a me nā toxin neonatal (hypotension arterial, renal failed, hyperkalemia).

ʻO nā pēpē i hāpai ʻia e ko lākou mau makuahine iā Telmista i ka wā hapai e mālama i ka mālama olakino ma muli o ka hiki ke hoʻomohala ʻia o ka hypotension arterial.

No ka mea ʻaʻohe ʻike e pili ana i ke komo ʻana o ka telmisartan i loko o ka waiū umauma, ua hoʻomau ʻia ka lāʻau lapaʻau i ka wā o ka hānai.

Me ka hana pūpū hemahema

ʻAʻole ia e hāʻawi i ka lāʻau lapaʻau i nā mea maʻi me ka hana koʻikoʻi maʻi maʻi (e like me ke ʻano o ke keiki-Pugh - papa C).

Me ka haʻahaʻa o ka maʻi hepatic haʻahaʻa (e like me ke ʻano o ke Keiki-Pugh - Class A a me B), pono ke hoʻohana ʻana o Telmista. ʻAʻole oi aku ka nui o ka nui o nā lā o ka lāʻau i kēia hihia ma mua o 40 mg.

Hoʻohui nūhou

ʻO ka hoʻohana ʻana o ka telmisartan i kekahi mau manawa me kekahi mau lāʻau e alakaʻi ai i ka hoʻomohala ʻana i kēia mau hopena:

nā lāʻau antihypertensive: hoʻonui i ka hopena antihypertensive,
warfarin, digoxin, ibuprofen, glibenclamide, hydrochlorothiazide, paracetamol, amlodipine a simvastatin: ʻaʻohe i pili pono i ka hoʻopulapula hui. I kekahi mau hihia, hiki i ka nui o nā mea i loko o ka plasma digoxin ma o ka awelika o 20% hiki. Ke hoʻohui a me ka digoxin, ʻoi aku ia e nānā i kēlā me kēia manawa i kona kaʻa ʻana i ka plasma,
Diuretics pākōlele (no ka laʻana a me kaethethoprim: hoʻonui i ka nui o ka hyperkalemia (ma muli o kahi hopena synergistic),
ramipril: he hoʻonui ʻana ʻo ka 2.5-pa i nā hōʻailona C_max a me AUC_0-24 Ramipril
mākaukau lithium: kahi hoʻi i hoʻihoʻi ʻia o ka loaʻa ʻana o ka lithium i loko o ke koko koko (ua hōʻike ʻia ma nā hihia loaʻa ʻole) me ka hopena pili ʻole. Hoʻolaha ʻia ʻoe e nānā i nā pae plasma i ka lithium.
Nā NSAIDs (e pili ana i ka acetylsalicylic acid, non-selective NSAIDs a me nā cyclooxygenase-2 inhibitors): hoʻemi i ka hopena hypotensive o ka telmisartan, hoʻonui i ka hopena o ka hiki ʻole o ka pale renal i ka wā o ka hoʻomehana. I ka hoʻomaka ʻana o ka hui pū ʻana me ka telmisartan a me nā NSAID, pono ia e hoʻopiʻi i ka bcc a ka loiloi i ka hana o ka pēpē,
amifostine, baclofen: potentiation o ka hopena hypotensive o ka telmisartan,
barbiturates, inu waiʻona, antidepressants a me nā lāʻau lapaʻau: hōʻemi o ka orthostatic hypotension.

Nā mea hoʻohālikelike o Telmista: Mikardis, Teseo, Telmisartan-Richter, Telmisartan-SZ, Telpres, Telsartan a me nā mea'ē aʻe.

Pākuʻi helu

Aia ma ka papa papa

Telmista®H40

mea waiwai: Telmisartan 40mg

hydrochlorothiazide 12.5 mg

nā mea hoʻowalewale: meglumine, sodium hydroxide, povidone K30, lactose monohidrat, sorbitol, magnesium stearate, mannitol, iron oxide red (E172), hydroxypropyl cellulose, anhydrous colloidal silicon dioxide, sodium stearyl fumarate

Telmista®H80

mea waiwai: Telmisartan 80mg

hydrochlorothiazide 12.5 mg

Telmista®ND 80

mea waiwai: telmisartan 80 mg

hydrochlorothiazide 25 mg

nā mea hoʻowalewale: meglumine, sodium hydroxide, povidone K30, lactose monohidrat, sorbitol, magnesium stearate, mannitol, iron oxide yellow (E172) hydroxypropyl cellulose, anhydrous colloidal silicon dioxide, sodium stearyl fumarate

ʻO nā papa oval, ka biconvex, ke bilayer, mai ke keʻokeʻo a kokoke i ke keʻokeʻo a i ʻole pinkish-keʻokeʻo hoʻi i ke kala ma kekahi ʻaoʻao a me nā ʻulaʻula-ʻulaʻula ma ka ʻaoʻao (no nā dosages no 40 mg / 12.5 mg a me 80 mg / 12.5 mg).

ʻO nā papa oval, ka biconvex, ʻelua-papana, mai ke keʻokeʻo a i ka keʻokeʻo-keʻokeʻo i ke kala ma ka ʻaoʻao hoʻokahi a me ka melemele-ʻepa i ka ʻaoʻao ma kahi ʻē aʻe (no ke ʻano he 80 mg / 25 mg).

ʻO nā waiwai Pharmacological

Lapaʻau lāʻau

ʻO ka hoʻokūkū kiʻekiʻe o ka telmisartan me ka hoʻokele waha i loaʻa ma hope o 0.5-1,5 hola ma hope o ka hoʻokele ʻana. ʻO ka bioavailability piha o ka telmisartan i nā inapo o 40 mg a me 160 mg ka 42% a me 58%. ʻAʻole ka emi iki o ka ʻai meaʻai i ka bioavailability o ka telmisartan, e hōʻemi ana i ka wahi ma lalo o ka pae kiʻekiʻe o ka laikini i ka plasma koko (AUC) ma kahi o 6% i ka wā e lawe ai i ka 40 mg a ma kahi o 19% ma hope o ka lawe ʻana i 160 mg. ʻO ka liʻiliʻi o ka hōʻemi o ka pīpī kiʻekiʻe ʻaʻole i hoʻopilikia i ka pono o ka hopena o ka lāʻau. ʻO ka pharmacokinetics o telmisartan i ka wā i lawelawe ʻia i waena o nā papa o 20-160 mg ʻaʻole nonlinear, Cmax a me AUC hoʻonui me ka hoʻonui nui ʻana. Me ka hoʻohana hou ʻana, hōʻiliʻili iki ka telmisartan i loko o ke koko koko.

Hoʻopili maikaʻi loa ʻo Telmisartan i nā protein protein (> 99,5%), ka mea nui i ka albumin a me nā alpha L-acid glycoproteins. ʻO ka ʻike maʻamau o ka hoʻoili ʻana o ka telmisartan ma kahi o 500 L, e hōʻike ana i kahi pili kino hou.

ʻOi aku ma mua o ka 97% o ka lāʻau i ka wā e hoʻopuka ʻia ai i nā waha ma nā feces ma ka exima ka biliary. ʻIke ʻia nā wahi i ka urine. Hoʻopili ʻia ka Telmisartan e ka hui kuʻuna i ka metabolacaktically inactite metabolites - acetyl glucuronides. ʻO Glucuronides wale nō nā metabolites o nā mea hoʻomaka i loaʻa i loko o nā kānaka.

Ma hope o hoʻokahi wai o ka telmisartan, nā kiko o ka glucuronides i loko o ke koko koko e like me 11%. ʻAʻole launa ʻia ka Telmisartan e nā isoenzymes o ka ʻōnaehana cytochrome P450. ʻO ka hoʻomaʻemaʻe ʻana mai ka wae koko ma mua o 1500 ml / min. ʻO ka hapalua hapalua o nā ola ma mua o 20 mau hola

Me ka hoʻokele waha o ka hui paʻa o ka telmisartan / hydrochlorothiazide, ua hōʻea ka ʻike o ka hydrochlorothiazide ma kahi o 1.0-3.0 mau hola ma hope o ka hoʻokele ʻana. E noʻonoʻo e hiki ke hōʻuluʻulu i ka hydrochlorothiazide i ka wā o ka hoʻopā ʻana o nā renal, ʻo ka bioavailability kūʻokoʻa 60%.

ʻO ka Hydrochlorothiazide he 68% hoʻopaʻa ʻia i nā protein plasma a me kāna ʻike kiko e ʻike nei he 0.83-1.14 l / kg.

ʻAʻole i hoʻohālikelike ʻia ka Hydrochlorothiazide a ua loli loa ia i loko o nā ʻōpū me ka urine. Ma kahi o 60% o ka kūlohelohe waha e hoʻololi ʻia i loko o nā hola 8.

ʻO ka hapalua nā hapalua o nā hau o ka hydrochlorothiazide he 10-15 hola.

Lapaʻau lāʻau

ʻO ka hui pū ʻana o ka telmisartan / hydrochlorothiazide ka hui ʻana o kahi antagonist reseption ngiotensin II, telmisartan a me ka diuretic thiazide, hydrochlorothiazide, e hāʻawi ana i kahi kiʻekiʻe kiʻekiʻe o ka hopena antihypertensive ma mua o ka lawe i kēlā me kēia o nā ʻāpana. Ke lawe nei i kahi hui paʻa o ka telmisartan / hydrochlorothiazide hoʻokahi manawa i ka lā, e hōʻoia ka maikaʻi a me ka hoʻonaninani ʻano i loko o ke koko i loko o ka hopena therapeutic.

Telmisartan kamono i ka wā e lawe loiloi ai a ʻo ia hoʻi kahi kikoʻī o ka angiotensin II receptor subtype 1 (AT1). Ke hoʻololi nei ʻo Telmisartan i ka angiotensin II, no ka mea he pilina kona kiʻekiʻe no nā mea hoʻokipa AT1 ma ka wahi paʻa, nona ka hopena i nā hopena paʻa o ka angiotensin II. Hoʻololi mau ʻo Telmisartan a paʻa mau i nā mea ʻaeʻa AT1 a ʻaʻohe pilina no nā mea ʻē aʻe, e komo pū ana ʻo AT2 a me kekahi mea ʻē aʻe o kā AT. ʻAʻole paʻa i ka hana hana o kēia mau mea nānā, a me kā lākou hopena ma ka hanana ʻana o ka hyperstimulation hiki ʻana i ka angiotensin II, ke kiʻekiʻe o ka hoʻonui ʻia ma lalo o ka mana o telmisartan. Hoʻololi ʻo Telmisartan i nā pae aldosterone plasma a ʻaʻole ia i pale i ka hana o ka angiotensin-hoʻohuli o ka enzyme (kininase II), me ka komo pū o ka mana o ka bradykinin, no laila ʻaʻole ka hopena o ka hopena o ka hopena o ka bradykinin.

Ke hōʻike nei o ka angiotensin II e pili ana i ke kua o ke telmisartan eʻoi aku ma mua o 24 mau hola a lōʻihi a hala nā 48 hola.

Ma hope o ka lawe ʻana i ka telmisartan, loaʻa i ka hana antihypertensive ma loko o 3 mau hola. ʻO ka haʻahaʻa loa i ke kahe o ke koko ua loaʻa i ka 4-8 mau pule ma hope o ka hoʻomaka ʻana o ka mālama ʻana a hoʻomau i ka wā lōʻihi. Mālama ka hopena antihypertensive ma ka pae mau no 24 mau hola.

I ka poʻe maʻi me ka hypertension, hoʻemi ka telmisartan i nā kaila koko systolic a me ka diastolic me ka hoʻopono ʻole ʻana i ka hapa o ka puʻuwai.

Me ka hoʻoluhi koʻikoʻi o ka mālama ʻana me ka telmisartan, e hoʻi ka neʻe ʻana i ke koko i kona pae mua no nā lā he nui me ka hoʻomohala ʻana i kahi "rebound syndrome" (ke piʻi ʻana o ke kahe koko).

Hoʻokomo ka Thiazides i ka reabsorption o nā electrolytes i loko o nā pā o nā pūpū, e hoʻonui pinepine i ka hoʻonui ʻana o ka sodium a me nā klorika ma kahi o nā kumukūʻai like. Hoʻonui ka hopena diuretic o ka hydrochlorothiazide i ka hoʻohaʻahaʻa ʻana i ka nui o ka plasma koko, he piʻi i ke kiʻekiʻe o ka plasma renin, he nui ke kaʻe ʻana o ka aldosterone huna, ka mea i kōkua i ka hoʻonui ʻana i ka pā o urine o kā potassium a me nā bicarbonates. ʻO ka poloka o ka renin-angiotensin o ka ʻōnaehana ald testosterone me ka hoʻohana pū ʻana o ka telmisartan me nā diuretics e alakaʻi ana i ka nalowale o ka pākia e ke kino. Ke lawe nei i ka hydrochlorothiazide, hoʻomaka ka diuresis ma hope o 2 mau hola, ua loaʻa ka hopena diuretic loa i ka mau hola 4 ma hope o ka hoʻokele ʻana, mau ka hana a 6-12 mau hola.

Nā hōʻailona no ka hoʻohana ʻana

- ka hoʻomaʻamaʻa ʻana o ka hypertension arterial

Hōʻike ʻia ka Telmista®H40 a me Telmista®H80 no nā maʻi nā mea hiki ʻole ke pale i ke kaina o ke koko ma o ka hoʻohana ʻana i ka telmisartan a i ka hydrochlorothiazide ma ke ʻano o ka monotherapy.

Hōʻike ʻia ka Telmista® ND80 no nā maʻi pākahi i hiki ʻole ke pale i ke kahe o ke koko ma o ka hoʻohana ʻana iā Telmista® N80 a i ʻole ua hoʻokuʻi ʻia ke kaumaha ma mua o ka hoʻohana ʻana i ka telmisartan a me hydrochlorothiazide ma kahi kaʻawale.

ʻLoe a me ke kākele

Pono e hoʻohana ʻia ʻo Telmista®N40, Telmista®N80 a i Telmista®ND80 hoʻokahi manawa i ka lā, e holoi ʻia me ka wai liʻiliʻi, me ka mālama ʻole o ka meaʻai.

Ma mua o ka mālama ʻana me ka telmisartan / hydrochlorothiazide pono e hana

ke kau koho ma ka ʻaoʻao o ka monotherapy me ka telmisartan. Inā pono, hiki iā ʻoe ke hoʻololi koke mai ka monotherapy i ka mālama ʻana me ka hoʻohui ʻana o nā kaomi paʻa o ka lāʻau.

Hiki ke kuhikuhi ʻia ka Telmista®H40 i nā maʻi i ʻike ʻole ʻia e ke kaomi koko me ka telmisartan 40 mg.

Hiki ke kuhikuhi ʻia ka Telmista® H80 i nā maʻi i ʻike ʻole ʻia e ke kaomi koko e 80 mg telmisartan.

Hiki ke kuhikuhi ʻia ka Telmista® ND80 i nā maʻi i ʻike ʻole ʻia e ke kaomi koko e Telmista® N80 a i ʻole ua hoʻokuʻi ʻia ke kaumaha ma mua o ka hoʻohana ʻana i ka telmisartan a me ka hydrochlorothiazide ʻokoʻa.

Ma hope o ka hoʻomaka ʻana i ka mālama ʻana me ka hui pū ʻana o ka telmisartan / hydrochlorothiazide, e loaʻa ana ka hopena antihypertensive kiʻekiʻe i loko o nā 4 mau pule mua. Inā pono, iā Telmista®H40, Telmista®H80 a i Telmista®ND80 hiki ke kuhikuhi pū me ka lāʻau hou antihypertensive.

ʻO nā mea maʻi me ka maikaʻi ʻole o ka pūpū

Kuhi ʻia ka nānā ʻana i nā hana hana.

ʻO nā maʻi me ka palaualohi maʻa

I nā maʻi me ka hōʻemi ʻana o ka maʻi hepatic i hōʻemi ʻia, ʻaʻole pono ka nui o ka nui o ka papa ʻaina 1 tablet Telmista®N40 (telmisartan 40 / hydrochlorothiazide 12.5 mg) hoʻokahi i ka lā.

ʻAʻole koi ka hoʻoponopono hoʻoponopono ʻana i nā maʻi maʻi maʻi.

Ka hana lāʻau lapaʻau

ʻO nā papa Telmista - kahi lāʻau lapaʻau ikaika no ke kaomi ʻana, he kumukūʻai kūpono loa.

ʻO kāna hana e kuhikuhi ana i ka pale ʻana i nā mea ʻae o nā ʻano AT1, ʻoiai ʻaʻole ia e pili i nā ʻano ʻē aʻe.

Loaʻa ka hopena hypotensive kiʻekiʻe e lawe ai i ka Telmista ma hope o hoʻokahi mahina o ka lapaʻau, e hōʻike ana i ka hopena lōʻihi o ka lāʻau.

ʻO nā hiʻohiʻona o ka lāʻau lapaʻau e pili ana i ka hui pū ʻana o ka telmisartan me ka waiwai hydrochlorothiazide, kahi mea diuretic. ʻO ka lāʻau lapaʻau kahi ʻano antagonist mau i hoʻokomo i ka hana o ka angiotensin ii. ʻO ka hana koʻikoʻi o ka lāʻau lapaʻau kahi pilina lōʻihi me ka AT1 receptor.

ʻO ka lāʻau lapaʻau e hōʻemi i ka nui o aldosterone i loko o ke kaila koko. ʻO ka lāʻau lapaʻau e hōʻemi i ka nui o aldosterone i loko o ke kaila koko. ʻAʻohe mea pale i ka hopena ma nā ʻoni a me ka renin. Hoʻopili i ka hopena blocking ma ka kininase II mea, kahi i loaʻa ai ka hopena i ka bradykinin, ʻokoʻa hoʻi ia.

He aha ke ʻano koko e pono ai?

Ke hoʻemi i ke koko, e kuhikuhi ʻia ka 40 mg Telmista i kēlā me kēia lā. I kekahi mau mea maʻi, ʻoiai me kahi koina o kēlā me kēia lā o 20 mg, hiki ke loaʻa kahi hopena kūpono. Inā ʻaʻole i hoʻokō ʻia ka mea i hōʻemi ʻia i ke koko, e hoʻonui paha ke kauka i ka maʻi i 80 mg i kēlā me kēia lā.

Hiki ke mālama ʻia ka lāʻau lapaʻau me ka hui pū me ka mīkini dehydrating mai ka pūʻulu thiazide (no ka laʻana, ka hydrochlorothiazide). Ma mua o kēlā me kēia hoʻonui i ka waiū, e kali ke kauka mai ka eha a ʻewalu mau pule, mai ia manawa ua hōʻike ʻia ka hopena kiʻekiʻe loa o ka lāʻau.

I mea e pale ai i ka pōʻino vascular i nā kūlana o mua, ʻo ka 80 aʻoi ka nui o ke telmisartan i hoʻokahi lā i ka lā hoʻokahi. I ka hoʻomaka ʻana o ka mālama ʻana, ua ʻōlelo pinepine ʻia ka mālama ʻana i ke koko. Inā kūpono, e hoʻoponopono ke kauka i ka dosage e hoʻokō ai i ke koko o ka hopena. Hoʻolaha ʻia nā papa e lawe ʻia me ka wai ʻole a i ʻole he koʻi meaʻai.

Telmista H80

Lawe ʻia ka lāʻau lapaʻau i ka manawa 1 i ka lā / lā, no ke kō ʻana o ka meaʻai. Pono e kāohi ʻia nā papa i ka wai liʻiliʻi.

Hiki ke kuhikuhi i ka Telmista H80 i nā maʻi nā mea ka hoʻohana ʻana o ka telmisartan i kahi maʻi o 80 mg ʻaʻole ia e alakaʻi i ka kaohi pono o ke koko.

E heluhelu pū i kēia ʻatikala: Lasix: 40 mg tablet and injections

Ma mua o ka hoʻomaka ʻana i ka mālama ʻana, pono e hoʻohana ʻia kahi koho ʻana i ka maʻi monmisartan. Inā pono, hiki iā ʻoe ke hoʻololi koke mai ka monotherapy telmisartan e mālama ai me Telmista H80.

Inā kūpono, hiki ke kauoha ʻia ka lāʻau lapaʻau i hoʻohui pū me kekahi lāʻau lapaʻau antihypertensive.

Nā hopena hopena

ʻO ka hoʻohanaʻana o Telmista, e like me nā lāʻau antihypertensive e hiki ke alakaʻi i nā hopena maikaʻi ʻole no ke kino.

I waena o nā hopena hopena, nā ʻōkuhi no ka hoʻohana ponoʻī i nā ʻano aʻe:

kue i nā moʻo a me ka urinary system,
ʻo ka maʻi pākuʻi e hele pū ai e ka maʻi maʻi a me ka malima maʻamau.
huhū, huʻi maʻi ʻo nā ʻaoʻao o ka ʻōpū a me ka ʻōpū, hoʻopau loa i ka hanu,
hiki ke hōʻike i ke kino,
nā maʻi kalepa o ka puʻuwai, e kū ana i nā tachycardia a me ka bradycardia,
nā pūnāwai o ka ʻōpū a me nā puʻu, ka mea i hōʻike ʻia e ka lolo, nausea, nā mea hoʻohui ʻole nā maʻi a me ka pelu.
nāwaliwali, nāmo hiamoe, lethargy,
hypersensitivity i nā ʻano like ʻole o waho, ka mea e hōʻike ana iā ia iho ma ke ʻano o ka ʻeha a me ka urticaria, ka pīhoihoi anaphylactic a me ka hyperhidrosis,
anemia a me kahi hoʻoweliweli o sepsis momona,
nā hopena maikaʻi ʻole o kahi hoʻopaʻa noiʻi o ka biomaterial o ka mea maʻi, ka mea i hōʻike ʻia i ka kaiko kiʻekiʻe o ka wa uric acid, nā mea hana i loko o ke koko, hypoglycemia a me ka hoʻēmi ʻana i ka hemoglobin.

Hiki i kekahi o kēia mau hopena kūpono ke ʻano kū hoʻokahi a i hui pū ʻia paha me nā mea ʻē aʻe. No nā hōʻailona kānalua, pono ka mālama ʻana i ka lāʻau lapaʻau e hoʻoponopono i ka regimen mālama.

ʻO nā keiki, i ka wā hāpai a me ka lactation

ʻAʻole paʻa i ka palekana a me ka pono o ka hoʻohana ʻana o telmisartan i nā keiki maʻi, no laila, ʻaʻole i hoʻokau ʻia nā papa Telmista 40 mg, 80 mg a me 20 mg i nā keiki a me nā ʻōpio ma lalo o 18 makahiki.

Wahi a nā ʻōlelo kuhikuhi, ua contraindicated ʻo Telmista i ka wā hāpai. Ma ka hihia o ka hāpai ʻana o ka wā hapai, pono e hoʻokuʻu koke i ka lāʻau.

No ka mea ʻaʻohe ʻike e pili ana i ke komo ʻana o ka telmisartan i loko o ka waiū umauma, ua hoʻomau ʻia ka lāʻau lapaʻau i ka wā o ka hānai.