Pehea e hoʻohana ai iā Telmista?

Telmista 40 mg - kahi lāʻau antihypertensive, kahi ngiotensin II antagonist receptor (type AT1).

No 1 papa 40 mg:

ʻO kēia papa hana: Telmisartan 40.00 mg

Nā mea hoʻihoʻi: meglumine, sodium hydroxide, povidone-KZO, lactose monohydrate, sorbitol (E420), magnesium stearate.

ʻOi, ka papa ʻaina biconvex o ke keʻokeʻo a ʻokoʻa paha ke keʻokeʻo.

Lapaʻau lāʻau

ʻO Telmisartan kahi mauʻāmaʻomaʻo ala ala ʻāmaʻomaʻi (ke ARA II) kūikawā (ke ʻano AT1), i hana ʻia a lawe ʻia ʻia. He wahi kūlana kiʻekiʻe ia no ka AT1 subtype o ka ʻĀina ʻānō o ka angiotensin II, kahi i ʻike ʻia ai ka hana a ka angiotensin II. Hōʻike i ka angiotensin II mai ka pilina me ka mea nāna i hopu, ʻaʻole i loaʻa ka hana a kahi agonist e pili ana i kēia receptor. Hoʻopaʻa wale ʻo Telmisartan i ka AT1 subtype o nā ʻalem hoʻi ma ka angiotensin II. He lōʻihi ke kamaʻilio ʻana. ʻAʻohe ia i kahi pilina no nā mea ʻē aʻe, me ka ʻili o AT2 a me nā mea hou aku i hoʻolaʻa ʻia i like me nā ʻili. Ka hana koʻikoʻi o kēia mau mea nānā, a me ka hopena o ko lākou hiki ke hoʻoulu ʻia me ka angiotensin II, ʻo ke ʻano o ka piʻi ʻana me ka hoʻohana ʻana i ke telmisartan, ʻaʻole i aʻo ʻia ʻia. Hoʻemi ia i ka hoʻoneʻeʻana o ald testosterone i loko o ke kaila koko, ʻaʻole pale i ka renin i ka plasma koko a me nā ns poloka i nā kahe wai. ʻAʻole i hoʻoneʻe ke Telmisartan i ka angiotensin e hoʻohuli ana i ka enzyme (ACE) (kininase II) (he enzyme e wāwahi ana hoʻi i ka bradykinin). No laila, ʻaʻole i manaʻo ʻia ka hoʻonui ʻana o nā hopena i hoʻopiʻi ʻia e bradykinin.

I ka poʻe maʻi, ka telmisartan ma ke ʻano o 80 mg paʻa i ka hopena hypertensive o ka angiotensin II. ʻO ka hoʻomaka ʻana o ka hana antihypertensive ua hoʻomaopopo ʻia i loko o 3 mau hola ma hope o ka hoʻokele mua o ka telmisartan. Ke hoʻomau nei ka hopena o ka lāʻau i 24 mau hola a kū mau i nā hola 48. Kūkulu ʻia kahi hopena antihypertensive e ulu ma hope o 4-8 mau pule o ka hoʻokele maʻamau o telmisartan.

I nā mea maʻi me ka hypertension arterial, hoʻohaʻahaʻa ka telmisartan systolic a me ka diastolic blood pressure (BP) me ka hoʻopiʻi ʻana i ka puʻuwai puʻuwai (HR).

I ka hihia o ka hōʻano pani ʻana o ka telmisartan, hoʻohaʻahaʻa kahe koko i kona pae mua me ka ʻole o ka hoʻomohala ʻana i ka maʻi "withdrawal".

Lapaʻau lāʻau

I ka wā e lawe laka ʻia, e hoʻoiho koke ʻia mai ka gastrointestinal tract (GIT). ʻO Bioavailability 50%. ʻO ka emi ʻana o AUC (ma lalo o ka pihi paona-manawa) a me ka hoʻohana ʻana o ka telmisartan me ka ʻai ʻana o ka meaʻai mai ka 6% (ma ke ʻano he 40 mg) a i 19% (ma kahi kikoʻī o 160 mg). 3 mau hola ma hope o ka nānā ʻana, ua hoʻonaninā ʻia ka ʻike ʻana i ke plasma koko, me ka ʻole o ka manawa e ʻai ai. Aia kekahi ʻokoʻa ma ka nānā ʻana o ka plasma i loko o nā kāne a me nā wahine. Ka palena nui (Cmax) i loko o ke kaila koko a me ka AUC i nā wahine i hoʻohālikelike ʻia me nā kāne he like me 3 a me 2 mau manawa i kiʻekiʻe, kēlā me kēia (ʻaʻohe hopena koʻikoʻi ma muli o ka hana).

Ke kamaʻilio pū ʻana me nā protein plasma koko - 99.5%, nui me ka albumin a me alpha-1 glycoprotein.

ʻO ka ʻike kumukūʻai o ka nui ʻike o ka hoʻoili ʻana i ka hoʻoheheʻe kūlike ʻo 500 lita. Hoʻomiliʻia ia e ka conjugation me ka waikawa glucuronic. Lapaʻau nā metabolites me ka hana ʻole. ʻO ka hapa hapalua (T1 / 2) ʻoi aku ma mua o 20 mau hola. Hoʻokuʻu ʻia ia ma waena o ka ʻōpū ma kahi ʻano i hoʻololi ʻole ʻia e nā keiki - i emi iho ma mua o 2% o nā kiʻi i lawe ʻia. ʻO ke kūʻokoʻa o ka plasma holoʻokoʻa ka nui (900 ml / min), akā ke hoʻohālikelike ʻia me ke kahe koko "hepatic" (e pili ana i 1500 ml / min).

Hoʻohana ʻo Pediatric

ʻO nā hōʻailona nui o ka pharmacokinetics o ka telmisartan i nā keiki i keiki a 6 a 18 paha mau makahiki ma hope o ka lawe ʻana i ka telmisartan ma ke kūkaʻi o 1 mg / kg a i ʻole 2 mg / kg no 4 mau pule ka hoʻohālikelike ʻia me nā ʻike i loaʻa i ka mālama ʻana i nā mea maʻi makua a hōʻoia i ka nonlineity pharmacokinetics o ka telmisartan, e pili pū ana i ka Cmax.

Nā Hoʻohui

Nā Contraindications i ka hoʻohana ʻana o Telmista:

• ʻO ka hypersensitivity i ke ʻano ikaika a i ʻole nā ​​mea waiwai o ka lāʻau.
• Kahawai
• ʻO ka wā o ka hoʻomaʻamaʻa.
• Nā maʻi hōʻeha o ka palaki biliary.
• ʻO ka maʻi hepatic hōʻeha (keiki-Pugh papa C).
• Hoʻohana me ka aliskiren i nā maʻi me ka maʻi mellitus no ka maʻi mellitus a i ʻole ka hōʻemi i ka hopena o ke kaulike (glomerular filtration rate (GFR)

Nā hopena hopena

ʻO nā hihia i ʻike ʻia i nā hopena maikaʻi ʻaʻole i hoʻoponopono me ka wahine, ka makahiki a me ka lāhui o nā mea maʻi.

• Nā maʻi hōʻeha a me nā maʻi parasit: sepsis, me ka sepsis momona, nā maʻi urinary tract (e pili ana i ka cystitis), nā maʻi ʻeha o ka ʻōpū.
• Nā maʻi mai ke koko a me ka papahana lymphatic: anemia, eosinophilia, thrombocytopenia.
• Nā maʻi mai ke ʻano o ke kanalelo: nā hopena anaphylactic, hypersensitivity (erythema, urticaria, angioedema), eczema, hōʻeha, ka ʻāʻaka o ke kino (me ka lāʻau lapaʻau), angioedema (me ka hopena momona), hyperhidrosis, hōʻeha kino ʻeha.
• Nā kuhihewa o ka ʻōnaehana hoʻonāukiuki: hopohopo, insomnia, palupalu, nāwaliwali, vertigo.
• Loaʻa nā hemahema o ke kino o ka ʻike.
• Nā kuhihewa o ka naʻau: bradycardia, tachycardia.
• Nā kuhihewa o nā kīʻaha koko: ke ʻano o ka hōʻemi i ke koko, a me ka hypotension orthostatic.
• Nā pilikia o ka ʻōpū o ka ʻōpū, nā umauma ʻ umauma a me ka mediastinum: ke pōkole o ka hanu, ka pipi, ka maʻi māmā interstitial * (* i ka wā o ke kūʻai ʻana o ke kūʻai ʻana, ua hōʻike ʻia nā hihia o ka maʻi leʻaleʻa interstitial, me kahi pilina hala ʻole me ka telmisartan. Akā, ʻaʻohe mea kumu me ka hoʻohana ʻana o telmisartan. i hoʻonohonoho 'ia).
• ʻO ka maʻi hanu: ʻeha o ka ʻōpū, ka ʻōpū, ka mucosa maloʻo maloʻo, ka dyspepsia, ka lemulewa, ka ʻōpū ʻole, ka luaʻi, ke ʻono o ka ʻono (dysgeusia), ka hana o ka puʻuwai a me nā maʻi o ka puʻu * (* e like me nā hopena o ka nānā i ke nānā aku i ka mākaʻi nā hihia no ka maʻi pāpaʻi / maʻi maʻi hopu i hōʻike ʻia ma nā kānaka o Iapana).
• Hōʻeha i ka musculoskeletal a me ka hoʻopili pili: arthralgia, ʻeha hōʻeha, nā mākina o nā ʻōpū (nā hōʻeha o nā ʻeha o ke keiki bipi), ʻeha ma ka lalo o lalo, myalgia, ʻeha tendon (nā hōʻailona e like me ka hōʻike ʻana o ka tendonitis).
• ʻO nā pilikia mai nā pūpū a me nā hana urinary: hana i ʻole ke kauā, a me ka maikaʻi ʻole.
• ʻO nā maʻi maʻamau a me nā maʻi i ka pūnaewele hōʻeha: ʻeha ka naʻau, ka maʻi like ʻole, ka nāwaliwali ākea.
• He ʻikepili a me ka waiwai kōkua: kahi hōʻemi i ka hemoglobin, he hoʻonui nui ʻana o ka waikik uric, ka mea hana i loko o ke koko koko, he nui ka hana o nā "enzyme" enzymes, creatine phosphokinase (CPK) i ka punela koko, hyperkalemia, hypoglycemia (i nā mea maʻi me ka maʻi mellitus).

Hoʻohui nūhou

Hiki paha ke Telmisartan i ka hopena antihypertensive o nā lāʻau lapaʻau antihypertensive. ʻAʻole i ʻike ʻia nā ʻano ʻē aʻe o nā mea pili i ka haukapila.

ʻO ka hoʻohana me ka digoxin, warfarin, hydrochlorothiazide, glibenclamide, ibuprofen, paracetamol, simvastatin a me amlodipine ʻaʻole alakaʻi i kahiʻoihana koʻikoʻi pili i nā maʻi. Ka hoʻonui iki i ka awelika o ka hoʻokaʻawale ʻana o digoxin i loko o ke koko koko ma o ka awelika o 20% (ma ka hihia hoʻokahi, ma ka 39%). Me ka hoʻohana pinepine ʻana o ka telmisartan a me ka digoxin, e noʻonoʻo e nānā i kēlā me kēia manawa i ka nānā ʻana o ka digoxin i loko o ke koko koko.

E like me nā lāʻau ʻē aʻe e hana ana ma ka renin-angiotensin-aldosterone system (RAAS), hiki i ka hoʻohana ʻana o ke telmisartan ke hoʻoulu i ka hyperkalemia (e ʻike i ka ʻāpana "Kūlana kūikawā"). Hiki ke piʻi aʻe ka hopena i ka hoʻohana pinepine ʻana i nā lāʻau lapaʻau ʻē aʻe, hiki iā ia ke hoʻonāukiuki i ka hoʻomohala ʻana o ka hyperkalemia (pā paʻakai paʻakai o ka paʻakai, potassium-sparing diuretics, ACE inhibitors, ARA II, non-steroidal anti-inflammatory drug NSAIDs, me nā selclooxygenase-2 | TsOGG-2 | immunosuppressants cyclosporine a i tacrolimus a me ka trimethoprim.

Hoʻokumu ka hoʻomohala ʻana i ka hyperkalemia i nā mea koʻikoʻi concomitant. Hoʻonui ʻia ka pilikia ma ka hoʻohana ʻana i nā manawa like o nā huakaʻi i luna. Ma keʻano pilikino, ʻoi aku ka nui o ka loaʻa inā hoʻohana pinepine ʻia me ka diuretics potassium-sparing, a me ka pā paʻakai pākaʻi paʻakai. No ka mea, hoʻohālikelike me ka hoʻohana ʻana me ACE inhibitors a i ʻole NSAID i hōʻemi ʻia inā he mālama pono ʻia. ʻO ARA II, e like me ka telmisartan, hoʻemi i ka poho potoma i ka wā diuretic therapy. Ka hoʻohana ʻana o ka diuretics pākōlani, no ka laʻana, spironolactone, eplerenone, triamteren a amiloride, hoʻohui pālolo, a pākia paʻakai pākēa hiki ke alakaʻi i kahi nui i loko o ka paʻakai serum. Pono e hoʻohana pū ʻia ka hypokalemia hoʻokaʻawale ʻia me ka mālama a me ka mālama pinepine ʻana i ka paʻakai i ka kaila koko. Me ka hoʻohana like ʻana o ka telmisartan a me ramipril, ua ʻike ʻia kahi hoʻonui 2.5-pi i ka AUC0-24 a me Cmax o ka ramipril a me ramipril. ʻAʻole paʻa i ke kumu koʻikoʻi o kēia hanana. Me ka hana like o nā ACE inhibitors a me ka hoʻomākaukau ʻana i ka lithium, kahi i hoʻoliʻi ʻia o ka hoʻōla ʻana o ka maʻi lithium plasma ua ʻike ʻia, i hoʻopiʻi ʻia e nā hopena o nā mea make. Ma nā hihia pilikia ʻole, ua hōʻike ʻia nā loli like me ka ARA II a me ka hoʻomākaukau ʻana o lithium. Me ka hana like o lithium a me ARA II, e hoʻoholo ʻia e hoʻoholo i nā ʻike o ka lithium ma ka plasma koko. ʻO ka mālama ʻana i nā NSAID, me ka acetylsalicylic acid, COX-2, a me nā NSAID hemahema ʻole, hiki ke hōʻeha i nā hana renal i nā maʻi maʻi dehydrated. Hiki i ka lāʻau ke hana ma RAAS i ka hopena synergistic. I nā poʻe maʻi e loaʻa ana i ka NSAIDs a me ka telmisartan, pono ka uku o ka bcc i ka hoʻomaka ʻana o ka mālama ʻana a me ka hana hoʻopōlohelohe i mālama ʻia. Hoʻohana me ka aliskiren i nā mea maʻi me ka maʻi mellitus no ka maʻi mellitus a i ʻole ka hōʻemi a me ka hōʻeha nui ʻole (glomerular filtration rate GFR ʻO ke kumukūʻai kumukūʻai o Telmista 40 mg ma Moscow kīhāpai o:

• 28 papa no nā pūpū - 300-350 mau rubles.
• 84 mau pākolo i ka pā - 650-700 rubles.

E hoʻokuʻu i ke ʻano a me ka ʻano

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).

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 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.

ʻO ka wehewehe o ka hana o ka hana: pharmacodynamics a me pharmacokinetics

ʻO Telmisartan kahi ʻano 1 angiotensin receptor antagonist. E like me nā lāʻau āpau i kēia papa, neʻe pio ka telmisartan ka angiotensin II nui loa mai ka pae hoʻokipa ʻana o ka AT1. Hoʻomau ke Telmisartan i nā moku koko me ka hoʻohaʻahaʻa i ke koko.

Telmisartan

Wahi a nā noiʻi hou, ua hoʻopili pū ka telmisartan i nā mea momona ʻokoʻa kūikawā ma ke kino. Mālama nā mea kanu i ka hoʻololi ʻana o ka huamina i ka momona a hoʻonui i ka ʻike ʻana i nā momona momona i ka insulin. Noho pū ʻia nā mea maʻi he nui hypertensive mai nā maʻi lipid koko a me ka hoʻoponopono koko kōpili (metabolic syndrome). No kēia mau mea maʻi, ʻo ka telmisartan ka pono o ka hoʻohaʻahaʻa ʻana i ke kōpaʻa o ke kō a me ka insulin, a me ke kaʻi ʻana o ka triglycerides i ke koko me ka hoʻonui ʻana o ka HDL.

Hoʻomaʻamaʻa maikaʻi ʻia ʻo Telmisartan. ʻO ka hopena antihypertensive e lōʻihi ma kahi o 24 mau hola ma hope o ke kaʻina waha. Hoʻopau like ka lāʻau lapaʻau i loko o ke ake. Me ka hoʻomehana lōʻihi, hiki i ka telmisartan kona hopena kiʻekiʻe ma hope o ʻeono a ʻewalu mau pule.

Ma hope o ka hoʻoponopono waha ʻana o ka telmisartan, hiki ke hōʻola ʻia ka plasma i loko o nā hola 0.5-1. I kahi pākēneka o 40 mg, loaʻa ka bioavailability o 40%. Ma kahi wai o 160 mg, loaʻa i ka 58% bioavailability, kahi i hilinaʻi wale ʻia i ka meaʻai. ʻAʻole ke kāʻili i nā maʻi Renal i ka hoʻopā o ka telmisartan, no laila, ʻaʻole koi ʻia kahi hoʻemi hoʻoneʻe i ka poʻe maʻi me nā maʻi renal a maʻalahi hoʻi. ʻAʻohe hopena o ka lāʻau lapaʻau ma ka piʻi ʻana o ka puʻuwai.

No ka mea, ʻaʻole i hoʻopili ʻia ka cytochrome P450 isoenzymes (CYP) i loko o ka metabolism telmisartan, ʻo ka launa pū me nā lāʻau e hoʻokaʻawale a i ʻole ke ʻano o ka CYP i manaʻo ʻia. Hoʻonui ka Telmisartan i ka nui a me ka hoʻokaʻawale ʻana o ka digoxin hoʻoneʻe ʻia ma 49% a 20%, kēlā me kēia. ʻAʻole pili ka lāʻau lapaʻau i ka pono o ke warfarin, no laila, hiki ke hoʻohana ʻia me ka mālama aka i ka wā anticoagulant therapy.

Warfarin

I ka hoʻohālikelike ʻana i nā mea hoʻomohala o nā sartans, hiki i kekahi ke nānā i ka like o kona hoʻolālā ʻana i ka molekui o thiazolidinediones - nā mea hoʻonaninani o ka insulin receptors pioglitazone a me rosiglitazone. ʻO Telmisartan wale nō ka sartan e hoʻomaikaʻi ai i ka lipidila a me ka hoʻoliʻi gula. Hoʻohui i nā mea hoʻohālikelike me ka thiazolidinediones, ʻo ka telmisartan kahi nui ka puana ma mua o nā sartans, e hōʻike ana i kahi nui o ka hoʻowalewale nui o ka waiwai. Ma muli o kēia mau waiwai, ua kālai ʻia ʻo ia he waiwai me nā hopena cardiometabolic.

ʻO ka hopena therapeutic o ka hana PPAR i aʻo ʻia ma ke ʻano he agonist koho e like me ke ʻano he kumu hoʻohālike. Ua hōʻike ka mua o ka haukapila i mua ʻole i ka telmisartan e hoʻopiʻi i nā hopena ʻokoʻa ma muli o ka hoʻoneʻene koho koho o ka PPAR-g. Inā hoʻāʻo ʻia kēia mau noiʻi noiʻi ma mua, i hōʻoia ʻia i loko o nā hōʻike loiloi nui, ua hōʻoia ʻia, hiki ke telmisartan i mea waiwai nui no ka pale ʻana a me ka mālama ʻana i ka metabolic syndrome, maʻi diabetes mellitus a me atherosclerosis.

E hoʻokuʻu i nā palapala a me ka ʻano

ʻO ka lāʻau lapaʻau ma ke ʻano o nā papa keʻokeʻo.Hiki i ko lākou ʻano ke ʻano: he 20 mg o ka nui o ka ʻike hoʻoliʻiliʻi, 40 mg - oval convex ma nā ʻaoʻao ʻelua, 80 mg - capsules like a convex form on 2 ʻaoʻao. Loaʻa ma loko o nā rumi, nā pahu pepa.

ʻO ke ʻano hana he telmisartan. Hoʻohui ia, ʻo ka pūnaehana e pili ana: sodium hydroxide, sorbitol, povidone K30, meglumine, magnesium stearate, lactose monohydrate.

Ka hana lāʻau lapaʻau

Loaʻa ka lāʻau lapaʻau i kahi hopena antihypertensive. ʻO ka papa hana hoʻoheheʻe ʻo kahi aniotensin II receptor antagonist. ʻO kēia māhele o ka lāʻau lapaʻau ka neone o ka angiotensin 2, ʻoiai ʻaʻole ia he agonist no ka mea kūʻai. Eia kekahi, hana ia i ka aldosterone liʻiliʻi i loko o ka plasma. Kōkua i ke kahe koko haʻahaʻa, hoʻomau mau ka naʻau.

Me ka mālama pono

E nānā pono ka mālama ʻana inā he hewa i loko o ka hana o ke kao o ka maʻi paʻakikī. Pono e nānā ʻia ma lalo o ka mākaʻi o ke kauka no ka stenosis bilateral renal aren stenosis. Inā ua holoi ʻia kahi kuhi hoʻokahi a nānā ʻia ka stenosis arela hae, pono e mālama ʻia nā lāʻau lapaʻau me ka mālama. I ka manawa like, ʻike ʻia nā hana o ka pūpū.

Pono e mālama ʻia i ka mālama ʻana no ka poʻe me ka hyperkalemia, ka nui o ka sodium, hypomyrophic obstruktive cardiomyopathy, he ʻano ʻano paʻakikī o ka puʻuwai, nā ʻāwili o ka aortic a mitral paha, he hōʻemi i ka puni koko, a me ka hyperaldosteronism mua.

E nānā pono ka mālama ʻana inā he hewa i loko o ka hana o ke kao o ka maʻi paʻakikī.

Pehea e lawe ai i Telmista

E kūkākūkā i kāu kauka e hoʻoholo i ke kūleʻa a me ka regimen kūpono. Lawe ʻia nā papa ʻōlelo. ʻAʻole pili me ka hoʻohana ʻana i nā lāʻau lapaʻau me ka hoʻokomo ʻana i ka meaʻai.

ʻĀ nā kauoha a ka poʻeʻelemakule e lawe i ka 20-40 mg hoʻokahi i ka lā. Ke koi nei kekahi mau maʻi i ka 80 mg e hōʻike i ka hopena hypotensive o ka telmisartan. ʻAʻole pono nā kānaka ʻōpiopio a me nā mea maʻi me ka maʻi ʻōpiopio i ka hoʻoponopono hoʻoponopono ʻia.

Me nā pathologies ate, 40 mg o kēlā me kēia lā he 40 mg. Eia kekahi, i nā hoʻomaka mua o ka maʻi, pono ʻoe e inu i nā lāʻau lapaʻau e hoʻomaʻamaʻa i ke koko.

Hoʻohana i ka wā hāpai a me ka lactation

ʻAʻole kuhikuhi ʻia ka lāʻau lapaʻau no ka hapai a me ka lactating: e kumu ana i ka maʻi o ka neonatal. Inā lawe ka makuahine i kēia lāʻau lapaʻau i ka wā o ka gestation, hiki i ka pēpē e loaʻa ai ka hypotension arterial.

ʻAʻole kuhikuhi ʻia ka lāʻau lapaʻau no ka hapai a me ka lactating: e kumu ana i ka maʻi o ka neonatal.

Hoʻopili pū me nā lāʻau ʻē aʻe

Me ka hoʻokolohua hoʻohālikelike me nā lāʻau lapaʻau antihypertensive ʻē aʻe, e hoʻonui ʻia ka hopena o ka lāʻau.

Aia ka nui o ka hoʻonuiʻana o ka lithium i loko o ke kaila koko a me kāna hopena e hoʻonā ai i ka wā e hoʻohana ai i ka lāʻau lapaʻau me ka lālani i loaʻa ka mea trace.

Ke lawe ʻia me ka inhibitor ACE, me ka diuretics pākeleka me ka paʻakai, me nā kāmeka o ka pākia, a ʻoi aku ka nui o nā ʻāpana o nā wahi i loko o ke kino.

Me ka hoʻokolohua hoʻohālikelike me nā lāʻau lapaʻau antihypertensive ʻē aʻe, e hoʻonui ʻia ka hopena o ka lāʻau.

Ke hoʻohana ʻia me nā NSAID, e lilo ka hopena o ka lāʻau lapaʻau.

ʻO ka lāʻau lapaʻau ka nui o nā mea like. Pūnaewele: Teseo, Telpres, Mikardis, Telzap, Prirator. Ua hoʻohana ʻia ʻo Valz, Lorista, Edbari, Tanidol.

Hōʻikeʻike Telmistar

Ma muli o kona hopena wikiwiki antihypertensive, ua loaʻa i ka lāʻau lapaʻau ka nui o nā loiloi maikaʻi.

ʻO Diana, 44 makahiki, Kaluga: "'Aʻole wau e kuhikuhi pinepine i kēia lāʻau i nā mea maʻi. Pono, hoʻomaka koke e hana, hiki pinepine nā hopena ʻaoʻao. "

Nā ʻōlelo kelepona Telmista Nā papa kuhikuhi kiʻekiʻe loa

ʻO Alisa, 57 makahiki, ʻo Moscow: “Kauoha ke kauka iā Telmist e inu no ka make koko nui. E kōkua ka lāʻau lapaʻau e hōʻemi i ke koko. Ua maikaʻi wau ma hope o ka lawe ʻana i ka lāʻau.

Dmitry, 40 makahiki, Penza: "Ua nui ka lāʻau lapaʻau, kōkua ia i ka hoʻemi ʻana i ke koko, hiki koke ke hopena. Akā ma muli o ka ʻai, hoʻomaka nā pilikia o kaʻeha. Pono wau e ʻike i ke kauka, e koho i kahi lāʻau hou. "

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 ʻano pālua ma ka ʻōnaehana RAAS (renin-angiotensin-aldosterone) ke kino i ka hana ʻana o nā kaukau (a hiki i ke alakaʻi i ka pono ʻole o ka renal) a hoʻonui pū kekahi i ka hopena o ka maʻi 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 ke kao o ka pāima i loko o ka plasma koko a me Telmista, pono ia 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 nui o ka kahe koko.

Ua hōʻike ʻia nā noiʻi ʻaʻole liʻiliʻi ʻo Telmista i nā mea maʻi o ka lāhui Negroid. Hoʻohana ʻia ka lawelawe o ka ate me ka hoʻohana ʻana i ka telmisartan i nā hapa nui loa i waena o nā poʻe noho o Iapana.

Nā hōʻailona no ka hoʻohana ʻana

• i ke alo o pono hypertension,
• no ka mālamaʻana i ka maʻi maʻi type 2, kahi i pili ai nā kino o ke kino,
• me ka pohihihi o nā make i mua o nā maʻi o ka ʻōnaehana cardiovascular ma ka mea maʻi ma luna o nā makahiki he 50.

No ka lawelawe prophylactic, hoʻohana ʻia ka lāʻau lapaʻau i nā wā i loaʻa i ka mea maʻi ka mōʻaukala o nā maʻi a me nā kaʻina pathological e like me ka hōʻeha, ka hoʻomaʻemaʻe ʻana i ka hana o nā kīʻaha koko peripheral i hoʻokumu ʻia e ka pōʻai a i kū mai ka maʻi mellitus. Hoʻololi pinepine ʻana i ka lāʻau i ka hōʻemi o ka puʻuwai ʻana a me ka hōʻeha.

No ka hoʻokele prophylactic, hoʻohana ʻia ka lāʻau lapaʻau no ka mai.

ʻŌpala Gastrointestinal

ʻO nā hopena like e like me ka ʻeha ma ka ʻōpū, ke kīpē o ke kīwaha i ke ʻano o ke ʻano o ka maʻi o ka maʻi, ka hoʻomohala ʻana o ka dyspepsia, ka maʻi mau a me ka lemela, a lele mai nā hōʻeha a me ke ʻano like ʻole. ʻAʻole kupaianaha loa ia, akā ʻaʻole hiki ke kaawale ka hopena o nā ʻano hōʻailona e like me ka maloʻo ʻana i ka puʻu waha, ʻoluʻolu ʻole i loko o ka ʻōpū, a me ka hūnā i ka hoʻāʻo ʻana.

ʻO nā hopena ʻaoʻao e like me ka ʻeha ma loko o ka ʻōpū e loaʻa pinepine ʻole ai.

Mai ka musculoskeletal a me ka hoʻopili pili

ʻO ka hoʻomohala ʻana o ka sciatica (ke ʻano o ke ʻeha i loko o ka ʻōpū), nā ʻōpū o ka ʻāʻī, ke kaumaha ma ka tendon.

ʻO nā hopena ʻili ma ka ʻili a me ka ʻulaʻula, ka urticaria, ka hoʻolālā ʻana o ka erythema a me ka eczema. Kuhi maʻalahi, lawe ʻia ka lāʻau lapaʻau e hoʻonāukiuki i ka hoʻomohala ʻana o ka pīhoihoi anaphylactic.

Kuhi maʻalahi, lawe ʻia ka lāʻau lapaʻau e hoʻonāukiuki i ka hoʻomohala ʻana o ka pīhoihoi anaphylactic.

Hoʻopilikia i ka hiki ke mālama i nā mīkini

ʻAʻohe paʻa i ka lawe ʻana i kahi kaʻa a hana pū me nā mea paʻakikī. Akā e pono nō ia e noʻonoʻo i ka mea e kūpaʻa ka hope o ka hoʻohana ʻana i kēia lāʻau lapaʻau, ʻaʻole i palena ʻole ka hopena o ka hoʻolālā ʻana i kēlā me kēia ʻaoʻao.

ʻAʻohe paʻa i ka lawe ʻana i kahi kaʻa a hana pū me nā mea paʻakikī.

Hoʻohana no ka hana renal impaired

Maʻalahi loa i kuhikuhi ʻia no nā maʻi me ka renal dysfunction. I kēlā kūlana, pono e hoʻokumu i ka kaohi o ka pā maʻa o ka pāhana ma ke koko a me nā mea hana a nā mea hana.

Hoʻopili ʻia nā mea koʻikoʻi me ka hua bile, a ma kēia mea, e hoʻokau i kahi ukana nui o nā akeʻa a me ka hoʻonui ʻana i nā maʻi.

Ke noi no ka hana lawelawe lēʻaleʻa

ʻO ka hoʻohana ʻana i ka lāʻau lapaʻau e nā mea maʻi me nā maʻi like ʻole e like me ka cholestasis, ka maʻi ʻeha o ka biliary tract a me ka hana ʻole ʻana paha i pāpā ʻole ʻia. Hoʻopili ʻia nā mea koʻikoʻi me ka hua bile, a ma kēia mea, e hoʻokau i kahi ukana nui o nā akeʻa a me ka hoʻonui ʻana i nā maʻi.

Hoʻohana ʻia e lawe i ka lāʻau lapaʻau wale nō inā he ʻoluʻolu a maʻalahi ke maʻi o ka maʻi maʻi. Akā ʻo ka ʻeha ma nā kūlana e pono ai he liʻiliʻi, a ʻo ka lāʻau lapaʻau e pono e lawe ʻia ma lalo o ka mālama ʻana o kekahi kauka.

Ke keu

Loaʻa nā pilikia o ka overdose e nānā. Hiki i nā hōʻailona o ka hōʻino i ulu me ka hoʻohana nui ʻana o ka lāʻau lapaʻau ka hoʻomohala ʻana i ka tachycardia a me ka bradycardia, hypotension.

ʻO ka Therapy inā he ʻano koʻikoʻi ke ʻano. ʻAʻole hoʻohana ʻia nā Hemodialysis ma muli o ka hikiʻole o ke kāpae i nā māhele o ka lāʻau mai ke koko.

Nā Hōʻikeʻike ma Telmista 80

He kūpono ka manaʻo o nā mea maʻi a me nā kauka e pili ana i ka lāʻau lapaʻau i ka hapa nui. ʻO ka mea paahana, i hoʻohana pololei ʻia, ʻaʻohe mea hoʻonāukiuki i ka hoʻomohala ʻana i nā hōʻailona ʻaoʻao. Ua hōʻike pū ʻia ka lāʻau lapaʻau ponoʻī iā ia iho he prophylactic, e hōʻemi ana i nā hōʻemi o nā hoʻomaka ʻana i nā hōʻeuʻeu o ka puʻuwai a me nā hōʻeha i nā poʻe mai 55 makahiki o kona mau makahiki.

Cyril, 51, cardiologist: "ʻO ke kāmeʻa o Telmista 80 wale nō ka hopena kumulamu, ʻoiai ʻo ka hapa nui o nā mea maʻi e makemake e hōʻoluʻolu koke i ko lākou kūlana. Ke kuhikuhi nei wau i ka lāʻau lapaʻau i nā poʻeʻelemakule he mau moʻolelo o ka hōʻeha ʻana o ka naʻau. "Mālama ka hāmeʻa mai nā hoʻopiʻi he nui a hōʻemi i nā pōʻino o ka make, e like me ka hōʻike ʻia e ka nānā lōʻihi."

Marina, 41 mau makahiki, ka mea maʻi maʻamau: "Manaʻo Telmista 80 i ka mālama maikaʻi ʻana i ka maʻi hypertension mua, a me ka lāʻau hoʻohui like he mea kūpono no ka mālama ʻana i ka maʻi hypertension 2nd. Me ka hoʻohana mau ʻana i ka lāʻau lapaʻau, ʻike ʻia kahi hopena kūpono ma hope o nā hebedoma 1-2, e kāpae i kahi hōʻailona maikaʻi ʻole e like me ka lele mau ʻana ma ke ʻano. Loaʻa loa nā hopena ʻaoʻao. "

Maxim, 45 mau makahiki, ʻo ʻAtana: "Ua koho kekahi kauka iā Telmist e mālama i ka hana mua o ka maʻi hypertension. Ma mua o koʻu hoʻāʻo ʻana i ka nui o nā mea, akā aia nā ʻano ʻē aʻe i hopena i nā hopena ʻaoʻao a ʻaʻole hoʻi i kōkua iki. ʻAʻohe pilikia i loaʻa kēia lāʻau lapaʻau. 2 mau pule ma hope o ka hoʻomaka ʻana o ke kau ʻana, ua hoʻi hou ke kaumaha i ka maʻamau a mālama ʻia i ka pae like, me ka kū ʻole ʻole.

Ksenia, 55 makahiki, Berdyansk: "Ua hoʻomaka wau e lawe i ka telmist ma hope o ka hoʻomaka ʻana o ka menopause, no ka mea kaumaha ka hoʻokaumaha ʻia. Ua kōkua maikaʻi ka lāʻau i nā hana maʻamau i nā hōʻailona. ʻOiai inā e pili ana nā lele, he mea waiwai ʻole lākou a ʻaʻole hoʻi e hopohopo nui. "

Andrei, 35 makahiki, Moscow: "Ua hāʻawi ke kauka i ke Telmist 80 i koʻu makuakāne, he 60 paha kona mau makahiki, a ua loaʻa pū he ʻeha iā ia. ʻO kaʻoiaʻiʻo e lele mau nei ʻo ia i ka paʻakikī, aia ke kiʻekiʻe kiʻekiʻe e kū hou mai ka hōʻeha puʻuwai lua. Ua aneane hoʻokahi mahina no ka ʻoihana e hoʻomaka ai ka hana, akā ua makemake ka makua kāne i ka hopena o ka lawe ʻana, hoʻihoʻi ke ʻano i ke ʻano maʻamau. ”

Pehea e lawe ai a ma ke kumu a ke kaomi, ka nui

Ua nīnau ka nui o nā kānaka e: ma kahi o ke koko e lawe ai ka telmist. Ke hoʻemi i ke koko, e kuhikuhi ʻia ka 40 mg telmist 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 ʻia ka telmisartan i hoʻokahi manawa i ka lā. 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.

Pākuʻi helu

40 mg a me nā papa 80 mg

Aia ma ka papa papa

mea waiwai - telmisartan 40 a 80 mg, kēlā

nā mea hoʻowalewale: meglumine, sodium hydroxide, povidone, lactose monohydrate, sorbitol, magnesium stearate

ʻO nā papa oval o ka lula me kahi papa biconvex o ke keʻokeʻo a ʻokoʻa paha ke keʻokeʻo (no ka dosage o 40 mg).

ʻO nā papa i kā ʻia Capsule me kahi papa biconvex o ke keʻokeʻo a ʻokoʻa paha ke keʻokeʻo (no ka dosage o 80 mg)

Hoʻopili me nā lāʻau lapaʻau ʻē aʻe

ʻOiai ʻo ka telmisartan ʻaʻole biotransformed e ka cytochrome P-450, he liʻiliʻi iki o ka pilina. ʻAʻole ia e pili i ka hana metabola o ka P-450 isoenzymes i loko o nā hōʻike vitro, me ka ʻokoʻa ʻole o ka pale iki ʻana o ka isoenzyme CYP2C19.

ʻAʻole pili nā pharmacokinetic o nā telmisartan i ka hoʻokele ʻana o ka warfarin. ʻO ka liʻiliʻi o ka neʻe o ka warfarin (Cmin) i hoʻoemi iki, akā naʻe ʻaʻole ʻia kēia i nā hoʻokūkū koko. I ka hoʻopaʻaʻana o ka pilina me nā mea hana olakino 12, ʻo ka telmisartan i hoʻonui i nā AUC, Cmax, a me Cmin digoxin pae i ka 13%. ʻO kēia paha ma muli o ka wikiwiki o ka hoʻololi ʻana o ka digoxin, ʻoiai ka manawa no ka piʻi ʻana o ka plasma wela (Tmax) i hoʻoneʻe ʻia mai 1 a 0.5 mau hola. Ke hoʻoponopono nei i ka maʻa o ka digoxin i hui pū me ka telmisartan, pono ke nānā ʻia ka pae o kēia ʻano.

Ua hōʻike ʻia nā haʻawina ʻē aʻe o ka laumoleokinetic e pili pū me ka telmisartan hiki ke hoʻopaʻa pū me ka simvastatin (40 mg), amlodipine (10 mg), hydrochlorothiazide (25 mg), glibenclamide (1.75 mg), ibuprofen (3x400 mg) a i paracetamol (1000 mg).

ʻO ka hole waiwai

Paki! Ma mua o ka hoʻohana ʻana i kekahi lāʻau lapaʻau, pono e nīnau i kāu kauka. ʻAʻole ikaika ia e lawe i ka lāʻau lapaʻau ikaika ikaika loa i kāu iho a me ka ʻole o ka nīnau ʻana i ke kauka.

ʻO nā waiwai Pharmacological

Lapaʻau lāʻau

Hoʻopili koke ʻia ʻo Telmisartan, ʻokoʻa ka nui o ka mea i hoʻopili ʻia. ʻO ka bioavailability o ka telmisartan ma kahi o 50%.

Ke lawe nei i ka telmisartan me ka meaʻai, ka nui o ka kaila o AUC (ma lalo o ka pihi ʻana i ka manawa o ka paʻa) ma waena o 6% (ma kahi iki o 40 mg) ka 19% (ma kahi kikoʻī o 160 mg). 3 mau hola ma hope o ke kauā ʻana, ka ʻike ʻana i ke kahe o ka plasma koko i waho, ma kahi o ka pāʻina. ʻO kahi emi iki ma AUC, ʻaʻole ia eʻae i kahi hōʻemi i kahi hopena therapeutic.

Aia kekahi ʻokoʻa ma ka nānā ʻana o ka plasma i loko o nā kāne a me nā wahine. ʻO Cmax (ʻoi loa ka ʻike) a me AUC paha ma kahi o 3 a 2 mau manawa ke kiʻekiʻe o nā wahine i hoʻohālikelike ʻia me nā kāne me ka loaʻa ʻole o kahi hopena koʻikoʻi.

ʻO ke kamaʻilio me nā protein plasma iʻoi aku ma mua o 99.5%, ʻo ka mea nui me ka albumin a me alpha-1 glycoprotein. ʻO ka nui o ka hoʻolaha e like me 500 lita.

Hoʻopili ʻia ka Telmisartan e ka hoʻopili ʻana i ka mea hoʻomaka me ka glucuronide. ʻAʻole i loaʻa kahi hana lapaʻau me kahi o ka conjugate.

He ʻano biexponential ʻo Telmisartan o ka pharmacokinetics me kahi hoʻopau hoʻopau hapa hapa-ola> 20 mau hola. Cmax a - i kahi kikoʻī liʻiliʻi - hoʻonui ʻia ʻo AUC disproportionately me ka ʻōpū. ʻAʻole i ʻike ʻia kekahi kumulāʻau koʻikoʻi o ke telmisartan.

Ma hope o ka lawelawe waha, ua pau nā telmisartan ma loko o ka ʻōpū o ka ʻōpū. Ka huina o ka urinary excretion ma mua o 2% o ka nui o ka huapalapala. Kūpono ka huina piha piha plasma (ma kahi o 900 ml / min) i hoʻohālikelike ʻia me ke kahe koko hepatic (ma kahi o 1500 ml / min).

ʻO nā maʻi maʻi

ʻAʻole loli nā pharmacokinetics o ke telmisartan i nā maʻi maʻi maʻi.

ʻO nā mea maʻi me ka maikaʻi ʻole o ka pūpū

I ka poʻe maʻi me ka renal ka hoʻomaʻemaʻe ʻana i ka hemodialysis, ʻike ʻia nā kaila plasma ma lalo. I ka poʻe maʻi me ka pilikia ʻole, pili ka telmisartan i ka protein plasma a ʻaʻole i hoʻopā ʻia i ka wā o ka dialysis. Me ka nele o ka renal, ʻaʻole i loli ka hapalua.

ʻO nā maʻi me ka palaualohi maʻa

I ka poʻe maʻi me ka maʻi hepatic, ʻo ka bioavailability piha loa o ka telmisartan e hoʻonui i ka 100%. ʻO ka hapalua hapalua no ke akeʻai ʻaʻole loli.

Lapaʻau lāʻau

ʻO Telmista® kahi hana kūpono a me ka kikoʻī (selektif) angiotensin II receptor antagonist (type AT1) no ka hoʻoponopono waha. Ke pio nei ʻo Telmisartan me ka puʻuwai kiʻekiʻe i ka angiotensin II mai kāna mau wahi hoʻopaʻa ʻia i nā mea hoʻokipa sublipe AT1, nona ka hopena i ʻike ʻia o ka angiotensin II. ʻAʻohe Telmista® i kahi hopena agonist i ka mea hoʻokipa AT1. Hoʻopili paʻa a Telmista® i nā ʻĀpana AT1. He lōʻihi ke kamaʻilio ʻana. ʻAʻole i hōʻike ʻo Telmisartan i ka pilina no nā mea hoʻohana ʻē aʻe, e komo pū ana me ka ʻĀpana AT2 a me nā mea ʻē aʻe, i haʻahaʻa ʻia nā mea i ʻae ʻia ʻo AT.

Ka hana koʻikoʻi o kēia mau mea nānā, a me ka hopena o ko lākou hiki ke hoʻoulu ʻia me ka angiotensin II, ke ʻano o ka piʻi ʻana me ke koho ʻana i ka telmisartan, ʻaʻole i aʻo ʻia ʻia.

Hoʻololi ʻo Telmista® i nā pae aldosterone plasma, ʻaʻole paʻa i ka renin i ka plasma o ke kanaka a me nā kaila ion.

ʻAʻole i hoʻoneʻe Telmista® i ka angiotensin-hoʻohuli i ka enzyme (kinase II), e hoʻopau ai i ka bradykinin. No laila, ʻaʻohe mea hoʻoikaika o nā hopena ʻili e pili ana i ka hana a bradykinin.

I loko o nā kānaka, he hapa o 80 mg o telmisartan aneane e pale iki i ka hoʻonui ʻana i ke kahe o ke koko (BP) i manaʻo ʻia e ka angiotensin II. Mālama ʻia ka hopena pale ma mua o 24 mau hola a hoʻopaʻa ʻia nō hoʻi ma hope o 48 mau hola.

Ka hoʻomaʻamaʻa ʻana o nā hypertension arterial pono

Ma hope o ka lawe ʻana i ka hapa mua o ka telmisartan, hoʻemi ʻia ke koko ma hope o 3 mau hola. ʻO ka manawa kiʻekiʻe o ke koʻi koko e hōʻemi pono nei i nā hebedoma 4 ma hope o ka hoʻomaka ʻana o ka mālama ʻana a mālama ʻia no ka manawa lōʻihi.

Pono ka hopena antihypertensive no 24 mau hola ma hope o ka lawe ʻana i ka lāʻau, me ka 4 mau hola ma mua o ka lawe ʻana i ka hopena hou, kahi i hōʻoia ʻia e nā ana nui o ka maʻi maʻi o ka maʻi maʻi, a me ka paʻa (ma luna o 80%) nā kuʻina o ka liʻiliʻi loa a me ka lōʻihi o ka hōʻemi ma hope o ka lawe ʻana i ka 40 a me 80 mg o telmisartan i nā hoʻokolohua lapaʻau paʻa. . ^ E Ha yM.

I nā maʻi me ka maʻi hypertension, hōʻemi ʻo Telmista® i ke kaila koko systolic a me ka diastolic me ka ʻole o ka loli ʻana o ka puʻuwai puʻuwai.

Ua hoʻohālikelike ʻia ka hopena antihypertensive o ka telmisartan me nā ʻelele o nā papa ʻē aʻe o nā lāʻau antihypertensive, e like me: amlodipine, atenolol, enalapril, hydrochlorothiazide, losartan, lisinopril, ramipril a me valsartan.

I ka hihia o ka hōneʻe ʻana o ka telmisartan, hoʻoliihoi ka piʻi ʻana o ke koko i nā helu ma mua o ka mālama ʻana no kekahi mau lā me ka ʻole o nā hōʻailona o ka hoʻomau wikiwiki o ka hypertension (ʻaʻohe ʻano rebound syndrome).

Ua hōʻike ʻia nā haʻawina haukaʻi e pili ana ka telmisartan me kahi hoʻoliʻelika nui a me ka nui o ka lehulehu o ka ventricular mass a waiho i ka index ventricular mass i ka poʻe maʻi me ka hypertension arterial a waiho aku i ka hypertrophy ventricular.

ʻO nā mea maʻi me ka maʻi hypertension a me ka nephropathy maʻi i mālama ʻia me ka telmisartan e hōʻike nei i kahi emi nui o ka nui o ka proteinuria (me ka microalbuminuria a me ka macroalbuminuria).

I nā hoʻokolohua lapaʻau ākea multicenter, ua hōʻike ʻia aia nā mea liʻiliʻi o nā maʻi maloʻo ma ka poʻe maʻi e lawe nei i ka telmisartan ma mua o nā mea maʻi e loaʻa ana i ka angiotensin-hoʻololi ʻana i ka hana o ka enzyme (ACE inhibitors).

Kāohi i ka morbidity cardiovascular a me ka make

I nā mea maʻi 55 mau makahiki a ʻoi aku ka mua o ka mōʻaukala o ka maʻi ʻalani coronary, stroke, maʻi vipula peripheral, a me ka maʻi mellitus a me ka maʻi ʻona moku (retinopathy, hypertrophy ventricular, macro a me microalbuminuria), hiki i ka telmisartan ke hōʻemi i ka hiki ʻana o myocardial infarction, stroke, a me ka mālama ʻana i ka maʻi maʻi. puʻuwai naʻau a hōʻemi i ka make ma mua o nā maʻi cardiovascular.

ʻLoe a me ke kākele

Ka hoʻomaʻamaʻa ʻana o nā hypertension arterial pono

ʻO ka dosis ʻōpiopio i ʻōlelo ʻia e 40 mg hoʻokahi i kēlā me kēia lā.

I kekahi mau mea maʻi, he maʻi ka nui o kēlā me kēia lā he 20 mg paha.

I nā hihia i loaʻa ʻole ai ke koko i makemake ʻia, hiki ke hoʻonui ʻia i loko o ke ʻano o Telmista® ka nui o 80 mg hoʻokahi i ka lā.

Ke hoʻonui nei i ka pona, pono e noʻonoʻo ia i ka hopena antihypertensive ka hopena e hana pinepine ʻia ma loko o ʻehā a ʻewalu mau pule ma hope o ka hoʻomaka ʻana o ka mālama ʻana.

Hiki ke hoʻohana ʻia ke Telmisartan me ka hoʻohui me ka diuret thiazide, no ka laʻana, hydrochlorothiazide, i hui pū ʻia me ka telmisartan i kahi hopena hypotensive hou.

I ka poʻe maʻi me ka maʻi hypertension arterial, ʻo ka nui o ka telmisartan he 160 mg / lā a me ka hui pū me ka hydrochlorothiazide 12.5-25 mg / lā i hoʻohaʻomaʻi maikaʻi ʻia a paʻa ʻia.

Kāohi i ka morbidity cardiovascular a me ka make

ʻO ka dosis i ʻōlelo ʻia e 80 mg hoʻokahi i kēlā me kēia lā.

ʻAʻole i hoʻoholo ʻia inā he mau haʻahaʻa ma lalo o ka 80 mg i mea e hōʻemi ai i ka morbidity cardiovascular a me ka make.

I ka hoʻomaka mua o ka hoʻohana ʻana o telmisartan no ka pale ʻana o ka morbidity cardiovascular a me ka make, he ʻōlelo ʻia ʻana ke neʻe o ke koko, a e pono paha e loaʻa ke hoʻoponopono o BP me nā lāʻau lapaʻau e hoʻohaʻahaʻa i ke koko.

Hiki ke kāhea ʻia ka Telmista® me ka noʻonoʻo ʻole i nā mea ʻai.

ʻAʻole koi ʻia nā loli i nā maʻi me nā pilikia ʻole, a me nā mea maʻi ma ka hemodialysis. ʻAʻole lawe ʻia ke Telmisartan mai ke koko i ka wā o ka hemofiltration.

I ka poʻe maʻi me ka pīhoihoi haʻalulu maʻalahi ke ʻano, ʻaʻole pono ka nui o ka lāʻau i kēlā me kēia lā he 40 mg hoʻokahi i ka lā.

ʻAʻole pono ke hoʻoponopono ʻia.

ʻAʻole paʻa i ka palekana a me ka hana pono o ka telmisartan ma nā keiki ma lalo o 18 makahiki o kona mau makahiki.

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.