I kēiaʻatikala, hiki iā ʻoe ke heluhelu i nā ʻōkuhi no ka hoʻohana ʻana i ka lāʻau lapaʻau Telzap. ^ E Ha yM. Hāʻawi i ka hoihoi mai ka poʻe kipa i ka pūnaewele - nā mea kūʻai o kēia lāʻau lapaʻau, a me nā manaʻo o nā loea lapaʻau e pili ana i ka hoʻohana ʻana o Telzap i kā lākou hoʻomaʻamaʻa. ʻO kahi noi nui, ʻo ia ke hoʻoikaika ikaika i kāu mau loiloi e pili ana i ka lāʻau lapaʻau: kōkua ka lāʻau lapaʻau a ʻaʻole hoʻi i kōkua i ka hoʻopiʻi ʻana i ka maʻi, nā mea hoʻopiʻi a me nā hopena ʻaoʻao, ua ʻike ʻia, ʻaʻole paha e hoʻolaha ʻia e ka mea hana ma ka palapala. Nā kikowaena o Telzap ma ke alo o nā kikowaena hoʻonohonoho ʻenehana o mua. Hoʻohana no ka mālama ʻana i ka hypertension koʻikoʻi a hoʻoemi i ka pume ma ka pākeke, nā keiki, a me ka wā hapai a me ka lactation. ʻO ka hiʻohiʻona o ka lāʻau lapaʻau.

Telzap - ka lāʻau antihypertensive.

ʻO Telmisartan (ka hana ikaika o ka lāʻau Telzap) he antagonist kikoʻī o ka angiotensin 2 receptors (type AT1), ka hana i ka wā e lawe ʻia ai. He wahi pilikino loa ia no ka AT1 receptor subtype, ma laila e maopopo ai i ka hana o ka angiotensin 2 ua paʻa ʻo Telmisartan angiotensin 2 mai kahi paʻa i ka ʻona, me ka ʻole o ka hana a kahi agonist e pili ana i kēia mea hoʻokipa, e kāohi wale ana i ka AT1 suburika subtype o ka angiotensin. ʻAʻole ʻae ʻia ka Telmisartan no nā mea ʻē aʻe i hiki mai, incl. i nā ʻāpana AT2 a me nā mea ʻimi ʻē aʻe i hoʻowahāwahā ʻia na lehulehu. Ka hana koʻikoʻi o kēia mau mea nānā, a me ka hopena o kā lākou hiki ke hoʻōla maoli me ka angiotensin 2, ʻo ke ʻano o ka piʻi ʻana me ka koho o ka telmisartan, ʻaʻole i aʻo ʻia ʻia. Ke hōʻemi nei ʻo Telmisartan i ka hoʻoneʻeʻana o ka ald testosterone i ka plasma koko, ʻaʻole e hōʻemi i ka hana o renin, ʻaʻole paʻa i nā kahawai ion. ʻAʻole keʻae ʻo Telmisartan i ka ACE (kininase 2), kahi e hoʻomaʻamaʻa nei i ka luku ʻana o ka bradykinin. Hōʻalo kēia i nā hopena ʻaoʻao pili i ka hana o ka bradykinin (no ka laʻana, ka ʻōpala maloʻo).

ʻO Telzap i kahi aniani o 80 mg paʻa maoli i ka hopena hypertensive o ka angiotensin 2. Hoʻomaka ka hoʻomaka ʻana o ka hana antihypertensive ma loko o 3 mau hola ma hope o ka hopena o ka telmisartan mua loa. Noho ka hopena o ka lāʻau no 24 mau hola a noho mau i ka maʻi nui a hiki i nā hola 48. Hoʻomaka pinepine kahi hopena antihypertensive e hoʻomaka i ka 4-8 mau pule ma hope o ka hoʻohana maʻamau.

I nā mea maʻi me ka hypertension arterial, hoʻemi ka telmisartan i ka hoʻokahe koko systolic a me ka diastolic, me ka hoʻopi ʻole ʻana i ka hapa o ka puʻuwai.

Ma ka hihia o kahi koi o ka lawe ʻana iā Telzap, ke kahe ana ke koko ma luna o ke mau lā he nui ka lā e hoʻi hou i kona pae mua me ka ʻole o ka hoʻomohala ʻana i kahi maʻi hoʻomaha.

E like me nā hōʻike o nā haʻawina hoʻohālikelike hoʻohālikelike, hoʻohālikelike ʻia ka hopena antihypertensive o ka telmisartan i ka hopena antihypertensive o nā lāʻau lapaʻau o nā papa ʻē aʻe (amlodipine, atenolol, enalapril, hydrochlorothiazide a lisinopril).

ʻO ka ulu ʻana o ka ʻōpala maloʻo nui loa me ka telmisartan i hoʻohālikelike ʻia me nā mea hoʻohana o ACE.

Kāohi pilikia Cardiovascular

ʻO nā mea maʻi 55 mau makahiki a ʻoi aku ka maʻi me ka maʻi ʻalopona coronary, stroke, hōʻeha me ka puʻuwai ischemic, peripheral arterial damage, a me nā hoʻopiʻi o nā ʻano maʻi mellitus type 2 (e.g., retinopathy, waiho i ka hypertrophy ventricular, macro- a i ʻole microalbuminuria) me kahi mōʻaukala o ka hopena cardiovascular. nā hanana, ʻo Telzap kahi hopena e like me ka hopena o ka ramipril ma ka hoʻohaʻahaʻa ʻana i ka hopena i hui pū ʻia: ʻo ka maʻi cardiovascular mai ka make myocardial me ka hopena o ka mea make, ka uha ʻole a me ka hopena hōʻeha a me ka mokuʻāina ʻO kaʻaiʻai ma muli o ka nele o ka puʻuwai kani.

ʻO Telmisartan e like me ka ramipril i ka hoʻemi ʻana i ke kahe o nā kekona: ʻo ka make ʻana o ka maʻi cardiovascular, non-fatal myocardial infarction, a i ʻole he momona i hōʻeha.

ʻO ka umauma maloʻo a me ka angioneurotic edema i ʻike pinepine ʻia me ka telmisartan i hoʻohālikelike ʻia me ramipril, ʻoiai he hypotension arterial pinepine me ka telmisartan.

ʻO Hydrochlorothiazide ma ke ʻano o ka Telzap Plus kahi diuretic thiazide. Hoʻokomo ʻia ʻo Thiazides i ka hoʻihoʻi ʻana o nā electrolytes i nā pākōkō, a me ka hoʻonui ʻana i nā kūmole o ka pā o ka sodium a me nā klorida, ma kahi o nā nui like. Hoʻonui ka hopena diuretic o ka hydrochlorothiazide i ka hoʻohaʻahaʻa i ka BCC, kahi hoʻonui i ka hana o ka plasma renin, he hoʻonui i ka hana o aldosterone, e ukali ana i ka hoʻonui ʻia o ka pāhana me ka bicarbonates i loko o ka urine a me kahi hoʻēmi ʻana ma ka waihona o ka pāima i loko o ka plasma koko. ʻO ka hoʻohana like ʻana o ka telmisartan kōkua i ka hōʻemi i ka nalowale o ka potasi i lawe ʻia ma kēia diuretic, ma muli paha o RAAS blockade. Ma hope o ka lawe ʻana i ka hydrochlorothiazide, hoʻonui ka diuresis ma hope o 2 mau hola, e ulu ka hopena nui ma hope o ka hola 4, ua mau ka hopena e pili ana i nā hola 6-12.

Ua ʻike ʻia nā haʻawina ʻo Epidemiological e hoʻolōʻihi i ka hoʻomehana hydrochlorothiazide e hōʻemi i ka hopena o ka morbidity cardiovascular a me ka make.

Hōʻike

Nā poʻe Telmisartan + poʻe keu.

Telmisartan + Hydrochlorothiazide + Hoʻokomo (Telzap Plus).

Lapaʻau lāʻau

Ke lawe hewa ʻia, lawe nui ʻia ʻo Telzap mai ke kaʻe ʻana o ka huina. ʻO Bioavailability 50%. Hoʻopaʻa ikaika ka Telmisartan i nā protein plasma, ʻo ka mea nui me ka albumin a me nā alpha-1 acid glycoprotein. Hoʻomiliʻia ia e ka conjugation me ka waikawa glucuronic. ʻAʻohe o ka conjugate i ka hana lapaʻau. Hoʻokuʻu ʻia kēia ma o ka ʻōpū i ka loli, excretion e nā keiki - i emi iho ma mua o 1%.

ʻAʻole ka hanu o ka Hydrochlorothiazide i nā kānaka. Ke keʻakeʻa ʻia nei ua loli ʻole ia i loko o ka urine. Ma kahi o 60% o nā momona i lawe ʻia ma ka waha he hoʻololi i loko o nā hola 48. ʻO ka hoʻomaʻemaʻe Renal ʻo 250-300 ml / min.

ʻO ka Pharmacokinetics i nā hui hoʻomanawanui kūikawā

Aia ka ʻokoʻa ma nā kaohū o plasma i ka telmisartan i nā kāne a me nā wahine. ʻO Cmax lāua ʻo AUC ma kahi kokoke i 3 a me 2 mau manawa i kēlā me ke kiʻekiʻe o nā wahine i hoʻohālikelike ʻia me nā kāne me ka loaʻa ʻole o kahi hopena koʻikoʻi.

I nā wahine, aia ka manaʻo o nā kikowaena kiʻekiʻe o ka hydrochlorothiazide i loko o ke kaila koko, ʻaʻole iʻike nui kēia.

ʻO nā pharmacokinetics o telmisartan i nā maʻi maʻi ma mua o 65 mau makahiki he ʻokoʻa ʻole nā ​​maʻi ʻōpio. ʻAʻole pono ke hoʻoponopono ʻia.

I nā mea maʻi me ka malia functionally renal impable, ʻaʻole koi ʻia ka hoʻoponopono ʻana o ka telmisartan. ʻO nā mea maʻi me ka hikiʻole o ka pilikia a me nā mea maʻi ma ka hemodialysis e hōʻike ʻia ana i kahi haʻahaʻa mua o 20 mg i ka lā. ʻAʻole kahi a Telmisartan i hoʻoiho ʻia e hemodialysis.

I nā maʻi me ka pēpē palupalu a me ka hana maʻalahi (kahi A a me B e like me ka helu ʻana o nā keiki-Pugh), ʻaʻole pono ka lāʻau o kēlā me kēia lā e 40 mg.

Nā Hōʻike

  • pono hypertension,
  • ka hoʻohaʻahaʻa o ka maʻi maʻamau a me nā maʻi cardiovascular i nā poʻe maʻi pākeke me nā maʻi cardiovascular o ka hopena atherothrombotic origin (IHD, stroke a i ʻole o ka mōʻaukala o ka maʻi pāpaʻi peripheral) a me ka type 2 diabetes mellitus me nā pōpoki organ target.

E hoʻokuʻu i nā palapala

Nā Papa 40 mg a me 80 mg.

Nā Papa Helu 80 mg + 12.5 mg (Telzap Plus).

Nā ʻōkuhi no ka hoʻohana a me ka helu ʻana

Lawe ʻia ka lāʻau lapaʻau, 1 ka manawa i kēlā me kēia lā, me ka ʻai o ka meaʻai, pono e holoi ʻia nā papa me ka wai.

ʻO ka inumapa mua o Telzap ma mua o 40 mg (1 papa) i hoʻokahi lā. I kekahi mau mea maʻi, lawe i ka lāʻau lapaʻau ma ke ʻano o 20 mg i kēlā me kēia lā e kūpono paha. Hiki ke loaʻa ka hopena o 20 mg ma ka hoʻokaʻawale ʻana i kahi papa 40 mg ma ka hapalua i ka pilikia. I nā hihia i loaʻa ʻole ka hopena therapeutic, hiki ke hoʻonui ʻia i loko o ka manaʻo i loko o Telzap i ke kiʻekiʻe o 80 mg hoʻokahi i ka lā.

Ma kahi koho aʻe, hiki ke lawe ʻia ʻo Telzap i hoʻohui pū me ka diuret thiazide, no ka laʻana, ka hydrochlorothiazide, kahi i hoʻohana pū ʻia ai he hopena antihypertensive hou. Ke hoʻoholo nei inā he hoʻonui i ka maʻa, pono e noʻonoʻo pono i ka hopena antihypertensive ka hopena e loaʻa pinepine ma loko o 4-8 mau pule ma hope o ka hoʻomaka ʻana o ka mālama ʻana.

E hoʻemi i ke kumu make a me ka lohi o nā maʻi cardiovascular

ʻO ka dosis ʻona ʻo Telzap e 80 mg hoʻokahi i ka lā. I ka manawa mua o ka mālama ʻana, e mālama ʻia ka nānā ʻana i ke koko, e koi ʻia ka hoʻoponopono ʻana i ka lāʻau antihypertensive.

Loaʻa ka ʻike me ka telmisartan i nā mea maʻi me ka maikaʻi ʻole o ka pilikia a i ʻole nā ​​maʻi ma ka hemodialysis. Kuhi ʻia kēia mau mea maʻi ma kahi haʻahaʻa haʻahaʻa haʻahaʻa o 20 mg i kēlā me kēia lā. No ka mea maʻi me ka maluhia o ka renal hāmeʻa maʻalahi, ʻaʻole koi.

ʻO ka hoʻohana mau ʻana o Telzap me ka aliskiren ua contraindicated i ka poʻe maʻi me ka pilikia ole (GFR ma mua o 60 ml / min / 1.73 m2 o ka pālahalaha ʻike o ke kino).

ʻO ka hoʻohana like ʻana o Telzap me nā inhibitor ACE ua contraindicated i ka poʻe maʻi me ka nephropathy maʻi.

ʻO nā mea maʻi me ka haʻahaʻa o ka maʻi hepatic moderate (ʻo nā keiki-Pugh papa A me ka B) e pono e kuhikuhi ʻia me ka mālama akahele, ʻaʻole pono ka lāʻau i ka 40 mg hoʻokahi i ka lā. Contzicated ʻo Telzap i nā maʻi me nā maʻi hepatic koʻikoʻi (papa C e like me ka helu ʻana o nā keiki-Pugh).

I nā poʻe maʻi maʻi, ʻaʻole pono ka hoʻoponopono ʻana o ka inika.

I loko, hoʻokahi lā i ka lā, holoi ʻia me ka wai ʻole, me ka ʻaʻa o ka meaʻai.

ʻO nā mea maʻi e hiki ʻole ke pulehu ʻia ʻo BP me ka monotherapy me ka telmisartan a i ʻole hydrochlorothiazide e lawe i ka Telzap Plus. Ma mua o ka hoʻololi ʻana i kahi hui paʻa-paʻa paʻa, ʻomi ʻia nā kaha titration o kēlā me kēia mahele. I kekahi mau kūlana maʻi, hiki ke noʻonoʻo pono i kahi hoʻololi kūwaho mai ke monotherapy i ka mālama ʻana me ka hui pūnaʻina paʻa i ka hopena paʻa.

ʻO ka lāʻau Telzap Plus, hiki ke hoʻohana ʻia i hoʻokahi manawa no ka poʻe maʻi ʻaʻole hiki ke mālama pono i ke kahe koko i ka wā e lawe ai i ka telmisartan i kahi maʻi o 80 mg i kēlā me kēia lā.

Loaʻa ka hopena

  • nā maʻi ʻeha pūpū, me ka cystitis,
  • nā maʻi ʻeha hanu luna hou, ʻo ia hoʻi ka pharyngitis a me ka sinusitis,
  • sepsis, hui pū hoʻokoe
  • anemia, eosinophilia, thrombocytopenia,
  • hopena anaphylactic,
  • haaheo
  • hyperkalemia
  • hypoglycemia (i loko o nā maʻi me ka maʻi mellitus),
  • ʻōpala
  • manaʻo ʻino
  • hopohopo
  • mai nāwaliwali
  • hiamoe
  • nā hui ʻike
  • vertigo
  • brieociaia
  • kahe nui ʻana i ke koko,
  • orthostatic hypotension,
  • tachycardia
  • ʻaʻano pōkole
  • huhū
  • maʻi ʻino interstitial
  • ʻeha ka ʻōpū
  • nā ninia
  • ʻĀpepsia
  • he ʻano hūnā
  • utuka
  • ka malo maloʻo
  • ʻeha ma loko o ka ʻōpū
  • kuʻe ʻana o ka hoʻāʻo
  • haalulu ʻia nā hana holo / ʻeha pio,
  • kaʻiliʻili
  • hipehuxikisis
  • ʻohiʻala
  • hoʻopea
  • eczema
  • erythema
  • urticaria
  • lāʻau lapaʻau hoʻoluhi
  • nā ʻili kino ʻili
  • sciatica
  • wahī ʻaʻe
  • myalgia
  • huhuhu,
  • ʻeha hōʻeha
  • tendon-like syndrome,
  • functioning renal akea, me ka hoʻohui pūpū o ka renal hana ole,
  • ua hoʻonui plasma hana,
  • hemoglobin hoʻemi,
  • ua hoʻonui plasma uric acid,
  • i ka hana o ka pānao naʻau a me ka CPK,
  • ʻeha ka ʻōpū
  • ʻaiaiaia
  • maʻiʻo-lepe maʻi.

Nā Hoʻohui

  • maʻi hoʻomehana biliary tract
  • uha o ka pepeha hanohano (keiki-Pugh papa C),
  • hui me ka aliskiren i nā mea maʻi me ka maʻi mellitus o ka maʻi mellitus a i ʻole ka hopena o ka renal impairment (GFR ma lalo o 60 ml / min / 1.73 m2 o ka ʻōpū o ke kino o ke kino),
  • hana like me ACE inhibitors i loko o nā maʻi me ka nephropathy maʻi,
  • he olakolosia fructose uluʻala (ma muli o ka hiki ʻana o ka sorbitol i ke ʻano o ka lāʻau lapaʻau),
  • hapai
  • umauma umauma,
  • a hiki i 18 makahiki (ʻaʻole i hoʻokumu ʻia ka pono a me ka palekana),
  • hypersensitivity i ka mea ikaika a i ʻole nā ​​mea kuʻi o ka lāʻau.

ʻŌpū a me ka lactation

I kēia manawa, ʻaʻohe ʻike ka ʻike e pili ana i ka palekana o ka telmisartan i nā wahine hāpai. Ma nā noiʻi holoholona, ​​ua hōʻike pono ʻia nā huaʻawaʻi o ka pono o ka lāʻau. Hoʻopili ʻia ka hoʻohana ʻana o ka lāʻau Telzap i ka wā hāpai.

Inā makemake ʻoe i ka mālama lōʻihi me Telzap, ʻo nā mea maʻi e hoʻolālā ana i kahi wā hāpai e koho i kahi lāʻau lapaʻau antihypertensive hou e ʻike ʻia ka ʻike palekana palekana no ka hoʻohana ʻana i ka wā hāpai. Ma hope o ka hoʻokumu ʻana i ka ʻoiaʻiʻo o ka hāpai ʻana, e hoʻopau koke ʻia ka mālama ʻana me Telzap a, inā pono, pono e hoʻomaka ʻia nā ʻano aʻoaʻo.

Wahi a nā nānā loea, ʻo ka hoʻohana ʻana o ka antagonist reseptor angiotensin 2 i nā mea aloha a me ka 3 trimesters o ka hāpai ʻana he hopena ʻona i ka ʻōpio (hana renal functioning, oligohydramnios, lohi ossification o ka ʻōpala) a me ka pēpē (renal failed, hypotension a hyperkalemia). Ke hoʻohana nei i ka angiotensin 2 antagonist receptor i ka 2 mau trimester o ka hāpai ʻana, e nānā ʻia ana ka ultrasound o nā pūpū a me ke ʻōpala o ka pūpū. ʻO nā keiki i loaʻa i ka mau makuahine nā angiotensin 2 antagonist reseptor i ka wā hapai e pono e nānā pono ʻia e ʻike i ka hypotension arterial.

ʻAʻole loaʻa ka ʻike i ka hoʻohana ʻana o telmisartan i ka wā o ka umauma. Ua hoʻohana ʻia ka hoʻohana ʻana i ka lāʻau Telzap i ka wā o ka umauma. Pono e hoʻohana ʻia kahi lāʻau antihypertensive hou me ka maikaʻi ʻoi ka maikaʻi palekana maikaʻi, ʻoi loa ia e hānai ana i kahi pēpē a hānau keiki maoli paha.

Hoʻohana i nā keiki

Ua hoʻohana ʻia ka hoʻohana ʻana i ka lāʻau Telzap ma lalo o ke 18 makahiki (ʻaʻole paʻa i ka pono a me ka palekana).

Hoʻohana i nā mea maʻi maʻi

I nā poʻe maʻi maʻi, ʻaʻole pono ka hoʻoponopono ʻana o ka inika.

Nā ʻōlelo kikoʻī

Hōʻeha ka hana ʻoluʻolu

ʻO ka hoʻohana ʻana o Telzap i kontraindicated i ka poʻe maʻi me ka cholestasis, ka ālai biliary a i ʻole hana koʻikoʻi o ka ate (keiki-Pugh class C), no ka mea, ua hoʻopuka ʻia ka telmisartan ma ka bile. Ke manaʻoʻiʻo nei ua hōʻemi nā mea maʻi i ka maʻi hepatic o ka telmisartan. I nā mea maʻi me ka hoʻowahāwahā haʻahaʻa a me ke kaulike (kahi A a me B e like me ke ʻano o nā keiki-Pugh), pono ʻo Telzap e akahele me ka akahele.

ʻO ka maʻi me ka bilateral renal aren stenosis a i ʻole ka stenosis arterial o ka hoʻokahi hana hana e hoʻonui ai i ka hōʻeha o ka hypotension arterial nui a me ka hoʻokau ʻole ʻana i ka wā e mālama ʻia me nā lāʻau lapaʻau e hana ana ma RAAS.

Hoʻopiʻi ka hana a pau a me ka hoʻololi ʻana i ka huehue

Ke hoʻohana nei i ke Telzap i nā maʻi me ka hana pūpū o ka ʻole o ka hana, ka nānā ʻana i ka manawa maʻamau o ka waihona o ka pāima a me ka hana i loko o ke koko koko. ʻAʻoheʻike lāʻau lapaʻau me Telzap i nā maʻi nā mea i hoʻohālikelike hou i nā maʻi hoʻololi keiki.

ʻO ka hypotension arterial Symptomatic, ʻoiai ma hope o ka hoʻokele mua o Telzap, hiki i nā mea maʻi me ka hoʻohaʻahaʻa i ka BCC a me / a i ka sodium i loko o ke kaila koko me ka mua o ka mālama mua ʻana me ka diuretics, nā mea paʻa ma ka kōkuhi o ka paʻakai, ka ʻeha ʻana, a me ka hoʻomau. ʻO kēlā mau ʻano (wai a me / wai ʻole o ka paʻakai) pono e hoʻopau ʻia ma mua o ka lawe ʻana iā Telzap.

Kāua pahu pā o RAAS

ʻO ka hoʻohana pinepine ʻana o ka telmisartan me ka aliskiren ua contraindicated i ka poʻe maʻi me ka maʻi mellitus a i ʻole ke kaulahao (GFR ma mua o 60 ml / min / 1.73 m2 o ka ʻōpū o ka ʻōpū o ke kino).

ʻO ka hoʻohana like ʻana o Telzap a me ACE inhibitors cont conticated i loko o nā mea maʻi me ka nephropathy maʻi.

Ma muli o ke kāohi ʻana o RAAS, i ka hypotension arterial, syncope, hyperkalemia, a me nā hana ʻole a me ka pale ʻole (me ka hopena ʻole o ka renal) i ʻike ʻia i nā mea maʻi e hoʻomaka ana i kēia, ʻoiai inā hoʻohui pū me nā lāʻau lapaʻau e hana nei i kēia ʻōnaehana. No laila, ʻaʻole i ʻōlelo ʻia kahi papa pālua ʻelua o ka RAAS (no ka laʻana, ʻoiai ke lawe nei i ka telmisartan me nā mea ʻē aʻe RAAS).

Ma nā hihia i hilinaʻi ʻia ai ke ʻano vascular a me ka hana ʻana i ka hana nui ma luna o ka hana RAAS (no ka laʻana, i nā mea maʻi me ka maʻi ʻole o ka naʻau a i ʻole ka maʻi puʻuwai, ʻo ia hoʻi me ka stenosis renal a i ʻole stenosis o hoʻokahi arteritis kū hoʻokahi), ka hoʻohana ʻana i nā lāʻau lapaʻau e pili ana i kēia ʻōnaehana paha i hui pū ʻia me ka hoʻomohala ʻana o ka maʻi arterial hypotension, hyperazotemia, oliguria, a ma nā hihia e loaʻa ʻole, ka hopena hana ʻole.

I ka poʻe maʻi me ka hyperaldosteronism maʻamau, mālama ʻia me nā lāʻau antihypertensive, ʻo ka hopena i loaʻa ia e ka hoʻopaʻa ʻana iā RAAS, ka mea maʻamau ʻole ka maikaʻi. Ma kēia e nānā ʻole ʻia ai ka hoʻohana ʻia ʻana o ka lāʻau Telzap.

ʻO ka stenosis aortic a me ka mitral, stenosis hypertrophic obstructive

E like me nā vasodilator'ē aʻe, ʻo nā maʻi me ka stenosis aortic a mitral, a me ka cardiomyopathy obertive hypertrophic, pono e akahele loa i ka wā e hoʻohana ai iā Telzap.

ʻO nā mea maʻi me ka maʻi maʻi maʻi i loaʻa a i ʻole a me hypoglycemic agents no ka hoʻokō waha

E kūʻē i ke kūleʻa o ka mālama ʻana me Telzap, hiki i kēlā mau maʻi ke hōʻeha i ka hypoglycemia. Pono ka mana o ka glycemia e like me aia paha he pono no ka hoʻoponopono hoʻoponopono ʻana i ka insulin a i ʻole a hypoglycemic agent.

Hiki i ka hoʻohana ʻana i nā lāʻau lapaʻau e hana ana ma RAAS hiki i ka hyperkalemia. I nā poʻe maʻi ʻelemakule, nā mea maʻi me ka maikaʻi ʻole a me ka diabetes mellitus, nā mea maʻi e lawe nei i nā lāʻau lapaʻau e hoʻonui ana i ka kiʻekiʻe o ka potassium potassium, a / a i ʻole nā ​​mea maʻi me nā maʻi concomitant, hiki i ka maʻi hyperkalemia.

I ka hoʻoholo ʻana i ka hoʻohana pono ʻana i nā lāʻau lapaʻau e hana ana ma ka RAAS, pono ia e loiloi i ka pae o ke kūleʻa a me ka loaʻa. ʻO nā mea koʻikoʻi e pili i ka hyperkalemia e pono e noʻonoʻo ʻia.

  • diabetes mellitus, renal gagal, ʻelemakule (nā mea maʻi ma mua o 70 mau makahiki),
  • hui pū me hoʻokahi a i ʻole he mau lāʻau lapaʻau e hana ana ma ka RAAS, a me / a i ʻole ʻāpono i hoʻohui ʻia nā meaʻai. ʻAno i nā hopena o nā lāʻau lapaʻau e hiki ai i ka maʻi hyperkalemia ke kālele i ka paʻakai ka paʻakai, ka diuretics potassium-sparing, na ACE inhibitor, angiotensin 2 antagonist receptor, nā lāʻau anti-inflammatory non-steroidal (NSAIDs) (me nā poʻe koho COX-2 inhibitor). heparin, immunosuppressants (cyclosporine a i ʻole tacrolimus) a me ka trimethoprim,
  • nā maʻi kūwaho, ka nui o ka make me ka mālama ʻole o ka puʻuwai, ka hōʻemi o ka metabolic acidosis, ka hopena o ka renal functioning, cytolysis syndrome (e.g., ischemia paleka paleka, rhabdomyolysis, nui trauma).

Hoʻomaopopo ʻia nā mea maʻi i ka pilikia e nānā pono i ka manaʻo o ka potassium ma loko o ke kaila koko.

ʻO ka telzap ka sorbitol (E420). ʻO ka mea maʻi me ka lōlō o ka frolose nehu lehulehu ʻaʻole lawe i ka lāʻau.

E like me ka mea nāna i hoʻopaʻa aku i ka ACE, telmisartan a me nā maniotensin 2 receptor antagonist e emi iho nei i ke kahe o ke koko e emi ana ka hopena i nā mea maʻi o ka lāhui Negroid ma mua o nā lāhui ʻē aʻe, aia paha ma muli o ka predisposition nui i ka emi ʻana o ka hana i loko o ka lehulehu kanaka.

E like me nā lāʻau āpau antihypertensive, ʻo ka nui o ka hoʻemi ʻana o ke kaomi koko i loko o nā mea maʻi me ka ischemic cardiomyopathy a i ʻole ka maʻi ʻeha coronary hiki ke alakaʻi i ka hoʻomohala ʻana i ka maʻi myocardial or stroke.

Hoʻokomo i ka hiki ke lawe i nā kaʻa a kāohi i nā mīkini

Ma nā noiʻi noiʻi kūikawā e noiʻi ai i ka hopena o ka lāʻau lapaʻau ma ka hiki ke ke kaʻa i kahi kaʻa a ʻaʻole i lawe ʻia nā mīkini. Ke hoʻokele a hana a me nā hana e pono ai ka hoʻonui ʻana o ka makaʻala, pono mālama ʻia luhi a hiki ʻole ke luhi me ka luhi a me ka hoʻohana ʻana o Telzap.

Hoʻohui nūhou

Kāua pahu pā o RAAS

ʻO ka hoʻohana mau ʻana o Telzap me ka aliskiren ua contraindicated i ka poʻe maʻi me ka maʻi mellitus a i ʻole ka pale ʻana i ka maʻi (GFR ma mua o 60 ml / min / 1.73 m2 o ka ʻona papa o ke kino) a ʻaʻole i'ōlelo ʻia no nā maʻi ʻē aʻe.

ʻO ka hoʻohana like ʻana o ka telmisartan a me ACE inhibitors ke contraindicated i nā maʻi me nā nephropathy maʻi.

Ua hōʻike ʻia nā haʻawina haukaʻi ʻo ka blockade pālua o RAAS ma muli o ka hoʻohana hoʻohui ʻana o ka ACE inhibitors, angiotensin 2 receptor antagonists, a aliskiren pili pū me ka nui o ka hanana o ka hanana ʻino e like me ka arotial hypotension, hyperkalemia, a me ka hana ʻole i ka hana (me ka hana ʻole ʻoi ʻole) i hoʻohālikelike ʻia me ka hana hoʻokahi ka lāʻau lapaʻau e hana ana ma RAAS.

Hiki ke hoʻonui paha i ka hopena o ka hoʻoulu ʻana i ka hyperkalemia inā hoʻohana pū ʻia me nā lāʻau ʻē aʻe e hiki ai ke kumu i ka hyperkalemia (hoʻohui ʻia ka meaʻai me ka paʻakai a me nā paʻuhi a paʻakai e loaʻa ana i ka potassium, potassium-sparing diuretics (no ka laʻana, spironolactone, eplerenone, triamterene a amiloride), NSAIDs (me nā koho o ka COX-2 pipili) , heparin, immunosuppressants (cyclosporine a tacrolimus) a me ka trimethoprim). Inā pono, e kū'ē i ka ʻikepili o ka hypokalemia i hoʻopaʻa ʻia, pono e lawe ʻia ka hoʻohana ʻana i nā lāʻau lapaʻau me ka mālama aka a kiaʻi pinepine ʻia i nā manaʻo o ka pāhana i ke kaila koko.

Me ka hoʻohana pū ʻana o ka telmisartan me digoxin, kahi hoʻonui hoʻonui Cmax o ka digoxin i plasma a 49% a Cmin ma 20% i kaulana. I ka hoʻomaka ʻana o ka mālama ʻana, i ka wā e koho ai i ka hoʻōla a me ka hoʻopau ʻana i ka mālama ʻana me ka telmisartan, ʻo ka nānā ʻana o ka digoxin i loko o ke koko koko e nānā pono ʻia e mālama i loko o ka laoa therapeutic.

Pāʻai paʻakai-sparing a i ʻole kai piha i loko o nā lako momona

ʻO Angagonensin 2 receptor antagonist, e like me ka telmisartan, e hōʻemi ana i ka potoma potoma diuretic. Potae-sparing diuretics (e.g., spironolactone, eplerenone, triamteren, a i amiloride), pākuhi ʻai me nā paʻakai, a i ʻole he paʻakai paʻakai e alakaʻi i ka hoʻonui nui ʻana i ka paʻakai plasma. Inā hōʻike ʻia ka hoʻohana concomitant, no ka mea i kākau ʻia ka hypokalemia, pono e hoʻohana ʻia me ka akahele a me ke kūkaʻi ʻana o ka mālama pinepine ʻana o ka pāima i ka kaila koko.

Me ka hui pū ʻana o ka hoʻomākaukau o ka lithium me ka ACE inhibitors a me ka angiotensin 2 antagonist receptor, me ka telmisartan, he hoʻonui hou ʻana i ka neʻe o ka lithium i loko o ke kō koko a me kona hopena makeʻe. Inā makemake ʻoe e hoʻohana i kēia hui o nā lāʻau lapaʻau, pono ia e mālama pono i ka nānā ʻana o ka lithium ma ka plasma koko.

ʻO NSAIDs (i.e., acetylsalicylic acid i loko o nā inika i hoʻohana ʻia no ka hoʻōla kino anti-inflammatory, COX-2 inhibitors a non-selective NSAIDs) hiki ke hoʻonāwaliwali i ka hopena antihypertensive o ka angiotensin 2 antagonist reseptor. hana hanohano lima ʻole) hoʻohana hoʻohana i ka angiotensin 2 antagonist receptor a me nā lāʻau lapaʻau e kālai ana i ka COX-2 hiki ke hoʻomohala hou aʻe i ka hana ʻoi, me ka hoʻomohala ʻia tatochnosti, i mea IeAUPIIe, IAa IO reversible. No laila, ʻo ka hui pū ʻana i nā lāʻau lapaʻau e pono e mālama ʻia me ka makaʻala, ʻoi loa i nā poʻe maʻi maʻi. Pono e mālama ʻia ka hoʻohana ʻana i ka wai ʻauʻau, ʻo ia hoʻi, i ka hoʻomaka ʻana o ka hoʻohui pū ʻana a me ia manawa i ka wā e hiki mai ana, e nānā pono nā māka o ka hana.

Hoʻopuni (thiazide a loop)

Ma mua o ka hoʻōla ʻana me ka diuretosis kiʻekiʻe, e like me ka furosemide (kahi "diuretic" diuretic) a me ka hydrochlorothiazide (kahi diuretic thiazide), hiki ke alakaʻi i ka hypovolemia a me ka hopena o ka hypotension ma ka hoʻomaka ʻana o ka hoʻomaʻamaʻa telmisartan.

ʻO nā lāʻau lapaʻau antihypertensive

Hiki ke hoʻonui ʻia ka hopena o Telzap e ka hoʻohui hoʻohui ʻana o nā lāʻau lapaʻau antihypertensive ʻē aʻe.

Wahi a nā mea kanu lāʻau o ka baclofen a me amifostine, hiki ke manaʻo ʻia e hoʻonui lākou i ka hopena therapeutic o nā lāʻau antihypertensive āpau, me ka telmisartan. Eia kekahi, hiki ke hoʻonui ʻia i ka hypotension orthostatic ma ka hoʻohana ʻana o ka ethanol (wai inu), barbiturates, nā lāʻau a i ʻole ka antidepressants.

ʻO nā corticosteroids (no ka hoʻohana ʻana i nā ʻōnaehana pono)

Ua hoʻonāwī iho ʻo Corticosteroids i ka hopena o ke telmisartan.

Nā kuʻina o ka lāʻau Telzap

Hoʻololi nā kumu hoʻohālike o ka waiwai ikaika:

  • Mikardis,
  • Mikardis Plus
  • Koiā ʻia
  • Tanidol
  • Eni,
  • Hoʻolālā,
  • Telmisartan
  • Telmista
  • Telpres
  • Hoʻouka Telpres,
  • Nā Telsartan
  • Kahalehua N.

Nā kikowaena i ka hui lāʻau lapaʻau (angiotensin 2 antagonist receptor):

  • ʻApeleka,
  • Apolo
  • Artinova,
  • Atacand
  • Blocktran
  • Brozaar
  • Vasotens,
  • Valz
  • Valz N,
  • Valsartan
  • Kāleka
  • Vamloset
  • Gizaar
  • Hyposart,
  • Diovan
  • Paopopa,
  • Zisakar
  • Ibertan
  • Irbesartan
  • Irsar
  • Kukuiono
  • Candesartan
  • Kāleka
  • Nā kāleka,
  • Kāleka
  • Cardosten
  • Karzartan
  • Hoʻoikaika Co-Exforge,
  • Coaprovel
  • Keola
  • Xawai
  • Lozap,
  • Lozap Plus,
  • Lozarel
  • Losartan
  • Losartan n
  • Lorista
  • Kālehu
  • Mikardis,
  • Naviten
  • Nortian
  • Olimestra
  • Hoʻōla
  • Koiā ʻia
  • Presartan,
  • Renicard
  • Sartavel
  • Tanidol
  • Tareg
  • Kauakae
  • Teveten
  • Telmisartan
  • Telpres
  • Nā Telsartan
  • Hoʻolaha
  • Edarby
  • Pāʻauhau
  • Kipakuo,
  • Eprosartan Mesylate.

Nosological ʻano papa (ICD-10)

Nā papa hana ʻulaʻī1 kōpō.
mea ikaika:
telmisartan40/80 mg
nā mea hoʻowalewale: meglumine - 12/24 mg, sorbitol - 162.2 / 324.4 mg, sodium hydroxide - 3.4 / 6.8 mg, povidone 25 - 20/40 mg, magnesium stearate - 2.4 / 4.8 mg

Lapaʻau lāʻau

ʻO Telmisartan kahi kikoʻī ARA II (AT subtype1), kūpono inā lawe ʻia ma ke ʻano. He inoa nui loa ka Telmisartan no ka AT1-receptors ma o ke aha ka hopena o ka hana angiotensin II. Ua haʻalele 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 ʻia ʻo Telmisartan i ka AT subtype1nā ʻĀina o ka angiotensin II. Hoʻomau ke kamaʻilio ʻana. ʻAʻole ʻae ʻia ka Telmisartan no nā mea ʻē aʻe i hiki mai, incl. AT2nā mea nānā aku a me nā mea hou aku i hoʻopaʻa ʻia i ka ʻāaoe hou. 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. Ke hōʻemi nei ʻo Telmisartan i ka hoʻoneʻeʻana o ka ald testosterone i ka plasma koko, ʻaʻole e hōʻemi i ka hana o renin, ʻaʻole paʻa i nā kahawai ion. ʻAʻole keʻae ʻo Telmisartan i ka ACE (kininase II), kahi e hoʻomaʻamaʻa nei i ka luku ʻana o ka bradykinin. Hōʻalo kēia i nā hopena ʻaoʻao pili i ka hana o ka bradykinin (no ka laʻana, ka ʻōpala maloʻo).

Koi nui ʻia. 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. Noho ka hopena o ka lāʻau no 24 mau hola a noho mau i ka maʻi nui a hiki i nā hola 48. Hoʻomaka pinepine kahi hopena antihypertensive e hoʻomaka i ka 4-8 mau pule ma hope o ka hoʻohana maʻamau.

I nā poʻe maʻi me ka hypertension arterial, hōʻemi ka telmisartan i ke koko a me nā makuakāne me ka ʻole e hoʻopi i ka holo naʻau.

I ka hihia o ka pau ʻana o ka telmisartan, ke kahe ana ke koko i kekahi mau lā i ka hoki i hoʻi i kona pae mua me ka ʻole o ka hoʻomohala ʻana i kahi maʻi withdrawal.

E like me nā hōʻike o nā haʻawina hoʻohālikelike hoʻohālikelike, hoʻohālikelike ʻia ka hopena antihypertensive o ka telmisartan i ka hopena antihypertensive o nā lāʻau lapaʻau o nā papa ʻē aʻe (amlodipine, atenolol, enalapril, hydrochlorothiazide a lisinopril). ʻO ka ulu ʻana o ka ʻōpala maloʻo nui loa me ka telmisartan i hoʻohālikelike ʻia me nā mea hoʻohana o ACE.

Kākoʻo o ka maʻi cardiovascular. ʻO nā mea maʻi he 55 a ʻoi aku ka makahiki me ka maʻi ʻōpū o ka coronary, stroke, ka hōʻeha ischemic attack, peripheral arterial damage, a i nā hoʻopiʻi o nā ʻano maʻi diabetes mellitus (e.g. retinopathy, waiho i ka hypertrophy ventricular, macro- a i ʻole microalbuminuria) me ka mōʻaukala o nā hanana cardiovascular, telmisartan i like ka like me ka ramipril i ka hoʻemi ʻana i ka hopena i hui pū ʻia: make mortvascular, non-fatal myocardial infarction, non-fatal stroke and manao o ka pili me CHF.

ʻO Telmisartan e like me ka ramipril i ka hoʻemi ʻana i ke kahe o nā kekona: ʻo ka make ʻana o ka maʻi cardiovascular, non-fatal myocardial infarction, a i ʻole he momona i hōʻeha. ʻO ka umauma maloʻo a me ka angioedema i ʻike pinepine ʻia me ka telmisartan i hoʻohālikelike ʻia me ramipril, ʻoiai he hypotension arterial pinepine pinepine me telmisartan.

ʻO nā poʻe maʻi o ke wā ʻōpiopio a me ka wā ʻōpio. ʻAʻole paʻa i ka palekana a me ka hana pono o ka telmisartan i nā keiki a me nā wā'ōpiopio ma lalo o 18 makahiki o kona mau makahiki.

Lapaʻau lāʻau

Kapehu. I ka wā e lawelawe ʻia, ka wikiwiki o ka telmisartan mai ka digestive tract. ʻO Bioavailability 50%. I ka manawa like i ka manawa like me ka meaʻai, ke kahe ʻana o ka AUC ma waena o 6% (ma kahi iki o 40 mg) a i 19% (ma kahi kikoʻī o 160 mg). Ma hope o 3 mau hola ma hope o ka hoʻokele ʻana, hoʻāla ʻia ka manaʻo o ke plasma koko me ka manaʻo ʻole o ka telmisartan i lawe ʻia i ka manawa like o ka meaʻai a ʻaʻole paha. Aia kekahi ʻokoʻa ma ka nānā ʻana o ka plasma i loko o nā kāne a me nā wahine. Cmax a ʻo AUC i like me 3 a me 2 mau manawa i kahi kiʻekiʻe i nā wahine i hoʻohālikelike ʻia me nā kāne no ka loaʻa ʻole kahi hopena nui o ka efficacy.

ʻAʻohe pilina pili ʻole ma waena o ke ʻano o ka lāʻau a me kona kaila plasma. Cmax a, ma kahi liʻiliʻi, hoʻonui nui ʻo AUC i ka disproportionately i ka piʻi ʻana i ka wā e hoʻohana ana i nā dosis ma luna o 40 mg / lā.

Kahele. Hoʻopili loa ʻo Telmisartan i nā protein plasma (> 99.5%), ʻo ka nui me ka albumin a me ka alpha1-acid glycoprotein.

Wanana Vai ʻo ss aneane 500 lita.

Hāpai. Hoʻomiliʻia ia e ka conjugation me ka waikawa glucuronic.

ʻAʻohe o ka conjugate i ka hana lapaʻau.

Leʻaleʻa. T1/2 ʻoi aku ia ma mua o nā hola o 20. Ua hoʻopiʻi ʻia ma o ka ʻōpū i ka loli, excretion e nā keiki - i emi iho ma mua o 1%. Kūpono ka huina piha piha plasma (ma kahi o 1000 ml / min) i hoʻohālikelike ʻia me ke kahe koko hepatic (ma kahi o 1500 ml / min).

ʻO nā papalapa kanaka kūikawā

Mamua. ʻO nā pharmacokinetics o telmisartan i nā maʻi ma mua o 65 mau makahiki he ʻokoʻa ʻole nā ​​maʻi ʻōpio. ʻAʻole pono ke hoʻoponopono ʻia.

Hola paʻa kino hana. I nā mea maʻi me ka malia functionally renal impable, ʻaʻole koi ʻia ka hoʻoponopono ʻana o ka telmisartan.

ʻO nā mea maʻi me ka maikaʻi ʻole o ka renal a me ka poʻe ma ka hemodialysis e kuhikuhi ʻia i kahi haʻahaʻa haʻahaʻa o 20 mg / lā (e ʻike i nā "Nānā Manaʻo kūikawā"). ʻAʻole kahi a Telmisartan i hoʻoiho ʻia e hemodialysis.

Hōʻeha ka hana ʻoluʻolu. I nā maʻi me ka pēpē palupalu a me ka hana maʻalahi (kahi A a me B e like me ka helu ʻana o nā keiki-Pugh), ʻaʻole pono ka lāʻau o kēlā me kēia lā e 40 mg.

Pākuʻi helu

Aia ma ka papa papa

mea waiwai: 40,000 telmisartan a i ʻole 80,000 mg, kēlā,

hydrochlorothiazide 12.500 mg a 25.000 mg, kēlā,

nā mea hoʻowalewale: sorbitol, sodium hydroxide, povidone 25, magnesium stearate

Nā papa papa ʻōlelo i hoʻohiki ʻia me kahi papa biconvex mai ke keʻokeʻo a hiki i ka melemele, me kahi helu extruded "41" ma kahi ʻaoʻao o ka pākaukau, he 12 mm ka lōʻihi a ma kahi a 6 mm ākea (no ka helu 40 mg / 12.5 mg).

Nā papa papa i kaha pololei ʻia me kahi papa biconvex mai ke keʻokeʻo a hiki i ka melemele, me kahi helu extruded "81" ma kahi ʻaoʻao o ka pākaukau, he 16,5 mm lōʻihi, e pili ana iā 8,3 mm ākea (no ka helu ana iā 80 mg / 12.5 mg).

ʻO nā papa pālona pololei me ka pā biconvex mai ke keʻokeʻo a hiki i ka melemele, me kahi helu extruded "82" ma kahi ʻaoʻao o ka pākaukau, he 16 mm lōʻihi, he 8 mm ākea (no nā kakio no 80 mg / 25 mg).

Nā Kauka Telzap ®

ka hōʻemi ʻana o ka make a me ka maʻi cardiovascular i nā maʻi maʻi makua.

- me nā maʻi cardiovascular o ka puka atherothrombotic kumu (coronary heart heart, stroke a me ka moʻolelo o nā peripheral arteri),

- me ke ʻano maʻi diabetes mellitus 2 me nā mea ʻoki kino huna.

Nā Hoʻohui

hypersensitivity o ka hana ikaika a i ʻole nā ​​mea kuʻi o ka lāʻau lapaʻau,

hapai a me lactation,

maʻi hoʻomehana biliary tract

uha o ka pepeha hanohano (keiki-Pugh papa C),

hoʻohui me aliskiren i nā mea maʻi me ka maʻi mellitus o ka maʻi mellitus a i ʻole ka hopena ʻole o ka ʻōpū (GFR ma lalo o 60 ml / min / 1.73 m 2) (e nānā i "Interaction" a "Manaʻo Nānā Manaʻo)".

he olakolino fructose uluola (ma muli o ka hiki ʻana o ka sorbitol i ka papa),

ka manawa like me nā ACE inhibitors i loko o nā maʻi me ka nephropathy maʻi maʻi (e ʻike i "Interaction" a "" Manaʻo Hoʻohālikelike "),

ʻoi aku a hiki i 18 makahiki (ʻaʻole maikaʻi ʻia ka maikaʻi a me ka palekana).

Me ka mālama: stenosis bilateral renal arenial o ka stenosis arterial o ka hoʻokahi hana hana, ka hoʻopihapiha hana ʻole, ʻoluʻolu a me ke ʻano hepatic hōʻemi, hoʻoneʻe ʻo BCC i hoʻohālikelike ʻia me ka hana mua o ka diuretics, ka palena o ka inu ʻana i ka sodium klorida, ʻeha a hoʻoweliweli, hyponatremia, hyperkalemia, ʻokoʻa ma hope o ka hoʻololi ʻana i ka maʻi o ka diuretics, ka palena o ka ʻai ʻana i ka sodium klorida, ʻeha a hoʻohuihui, hyponatremia, hyperkalemia, ʻokoʻa ma hope o ka hoʻololi ʻana i ka maʻi. ka haʻalele ʻana), ke kaumaha nui o ka puʻuwai paʻakikī, stenosis aortic and mitral valen stenosis, hypertrophic obstructive cardiomyopathy, hyperaldosta kumu onizm (hopenaʻoi loa a me ka maluhia i ole, ua hoʻokumu 'ia), hana maikaʻiʻole o ka Naʻau nā mea maʻi.

ʻŌpū a me ka lactation

I kēia manawa, ʻaʻohe ʻike ka ʻike e pili ana i ka palekana o ka telmisartan i nā wahine hāpai. Ma nā noiʻi holoholona, ​​ua hōʻike pono ʻia nā huaʻawaʻi o ka pono o ka lāʻau. Hoʻopili ʻia ka hoʻohana ʻana o Telzap ® i ka wā hāpai (ʻike "Contraindications").

Inā pono ka lōʻihi o ka mālama ʻana me Telzap ®, pono i nā mea maʻi e hoʻolālā ana i ka hapai e koho i kahi lāʻau lapaʻau antihypertensive hou me ka ʻaoʻao palekana e hōʻoia ʻia no ka hoʻohana ʻana i ka wā hāpai. Ma hope o ka hoʻokumu ʻana i ka ʻoiaʻiʻo o ka hāpai ʻana, e hoʻopau koke ʻia ka mālama ʻana me Telzap ® a inā pono, pono e hoʻomaka ʻia ke ʻano lāʻau lapaʻau.

E like me nā hōʻike o ka nānā ʻana o ka lāʻau lapaʻau, ʻo ka hoʻohana ʻana o ARA II i nā mea hoʻomaʻamaʻa II a me III nā mea hoʻomaʻamaʻa o ka hāpai ʻana he hopena ʻona i ka ʻōpio (hana renal functioning, oligxidamnios, lohi ossification o ka ʻōpala) a me ka pēpē (renal failed, hypotension arterial a hyperkalemia). Ke hoʻohana nei i ka ARA II i ka wā ʻelua o ka hapō ʻana o ka hapai ʻana, ʻōlelo ʻia ke ultrasound o nā pūpū a me ke ʻūhā o ka pūpū.

ʻO nā keiki i lawe i kā ARA II i ka wā hāpai, e mālama pono ʻia lākou no ka hypotension arterial.

ʻAʻole loaʻa ka ʻike i ka hoʻohana ʻana o telmisartan i ka wā o ka umauma. ʻO ka lawe ʻana iā Telzap ® i ka wā o ka hoʻoulu ʻana i ka maʻi (see "Contraindications"), he ʻano lapaʻau hou antihypertensive me kahi ʻoluʻolu palekana e hoʻohana pono ʻia, ʻo ia hoʻi no ka hānai ʻana i kahi pēpē a hānau keiki mua paha.

Nā hopena hopena

Wahi a ka WHO, helu like ʻole nā ​​hopena i like me ko lākou pinepine i ka neʻe ʻana i lalo: mau pinepine (≥1 / 10), pinepine (mai ≥1 / 100 a hiki i ka mea hōʻeha.

Ma ka ʻāpana o ke koko a me ka ʻōnaehana lymphatic: pinepine - anemia, luhi - eosinophilia, thrombocytopenia.

Mai ka pānaʻi: lohi - reaksi anaphylactic, hypersensitivity.

Mai ka ʻaoʻao o ka metabolism a me kaʻaiʻai: pinepine - hyperkalemia, luhi - hypoglycemia (i loko o nā maʻi me ka maʻi mellitus).

Mai ka ʻaoʻao mai o ka psyche: pinepine - insomnia, kaumaha, luhi - hopohopo.

Mai ka ʻōnaehana hoʻonāukiuki: pinepine - nāwaliwali, luhi - hiamoe.

Mai ka ʻaoʻao o ke kino o ka hihio: nā hui ʻike.

Ma ka ʻāpana o ka hui hoʻolohe a me nā pilikia labyrinth: ʻohi - vertigo.

Mai ka naʻau: pinepine - bradycardia, līkeke - tachycardia.

Mai nā kī: pinepine - he mau maka o ka hoʻokahe koko, a me hypotension orthostatic.

Mai ka papa hanu, umauma a me nā ʻōpū mediastinal: pinepine - hapa o ka hanu, ka ʻōpala, kahi liʻiliʻi loa - maʻi maʻi interstitial.

Mai ka palaki kuʻekuʻe: pinepine - ʻeha o ka ʻōpū, ka ʻōpū, ka ʻōpū, ka palupalu, aʻiʻaʻi ʻole, loaʻa ʻole - kūwaho maloʻo, ʻeha ʻole i loko o ka ʻōpū, ka hōʻemi ʻana i nā naʻau o ʻono.

Ma ka ʻāpana o ka ate a me ka pēpē biliary: hoʻokaʻawale - hōʻino nā mākaʻawaʻawa / kāpili.

Ma ka ʻāpana o ka ʻili a me ka kiko. infrequent - ʻeha ka ʻāʻī, hyperhidrosis, ʻāʻī, ʻaʻohe - angioedema (pū kekahi), ʻola, erythema, urticaria, lāʻau lapaʻau, hōʻeha ʻeha o ke kino.

Mai ka ʻōnaehana musculoskeletal a me nā ʻili pili: pinepine - ʻehaʻeha (sciatica), nā ʻeha o ka naʻau, myalgia, loaʻa ʻole - arthralgia, ʻeha hōʻeha, nā ʻeha tendon (like me tendon-like syndrome).

Mai nā pūpū a me ka maʻi urinary: pinepine - hana i ka hana renal hana, me ka nui o ka renal hina ʻole.

ʻO nā maʻi maʻamau a me nā pilikia i ka pūnaewele hōʻola: pinepine - ʻehaʻeha umauma, asthenia (nāwaliwali), nāwaliwali - maʻi like-flu.

Hoʻokomo ka hopena i nā hopena o ka hoʻokolohua a me nā haʻawina kōkua: i ka pinepine - he hoʻonui i ka neʻe o ka creatinine i loko o ke koko koko, ʻokoʻa - ka hoʻemi ʻana o nā ʻike o Hb, ka nui o ka ʻike o ka waikū uric i loko o ke kaila koko, he hoʻonui i ka hana o nā huina o ka huina a me ka CPK.

Hoʻohui

Kāua pahu pā o RAAS. ʻO ka hoʻohana nui ʻana o ka telmisartan me ka aliskiren ua contraindicated i ka poʻe maʻi me ka maʻi mellitus a i ʻole ka hopena ʻole (GFR ma mua o 60 ml / min / 1.73 m 2) a ʻaʻole i'ōlelo ʻia no nā maʻi ʻē aʻe.

ʻO ka hoʻohana like ʻana o ka telmisartan a me ACE inhibitors ke contraindicated i loko o ka poʻe maʻi me ka nephropathy maʻi (ʻike "Contraindications").

Ua hōʻike ʻia nā haʻawina haukaʻi i ka pālua o RAAS ma muli o ka hoʻohana ʻana o ka inhibitions ACE, ARA II, a i ʻole aliskiren i pili me ka nui o nā hanana ʻino e like me ka hypotension arterial, hyperkalemia, a me nā hana ʻole i ke kīlohelohe (e komo pū ana me ka hana ʻole ʻoi) a hoʻohālikelike ʻia. e hana ana ma RAAS.

Ma ka hopena o ka ulu ʻana i ka hyperkalemia e hoʻonui paha i ka wā i hoʻohana pū ʻia me nā lāʻau ʻē aʻe e hiki ai ke kumu i ka hyperkalemia (kālai ʻia i ka ʻai me ka paʻakai a me nā paʻakai pākuhi e pili ana i ka potassium, potassium-sparing diuretics (e.g. spironolactone, eplerenone, triamterene a amiloride), NSAIDs, me nā selective COX-2 inhibitors, hepari , nā immunosuppressants (cyclosporine a i tacrolimus) a me ka trimethoprim.Ike pono, e kūʻē ana i ke ʻano o ka hypokalemia i hoʻopaʻa ʻia, pono e lawe ʻia aku ka hoʻohana pono ʻana i nā lāʻau lapaʻau. e makaʻala a kiaʻi mau i ka ʻike o ka potassium ma loko o ke kaila koko.

Digoxin. Me ka hoʻokele ʻana o ka telmisartan me digoxin, ua hoʻonui ʻia kahi hoʻonui iki ma Cmax Hōʻike ka plasma digoxin i 49% a me Cmin e 20%. I ka hoʻomaka ʻana o ka mālama ʻana, i ka wā e koho ai i ka hoʻōla a me ka hoʻopau ʻana i ka mālama ʻana me ka telmisartan, ʻo ka nānā ʻana o ka digoxin i loko o ke koko koko e nānā pono ʻia e mālama i loko o ka laoa therapeutic.

Pāʻai paʻakai-sparing a i ʻole kai piha i loko o nā lako momona. ʻO ARA II, e like me ka telmisartan, hoʻemi i ka nalowale o ka pāhana potassium e hoʻoulu ʻia e kahi diuretic. Pane ka paʻakai pākēneka, e like me spironolactone, eplerenone, triamteren a amiloride, pākuhi ʻai me ka paʻakai, a i ʻole he paʻakai paʻakai e alakaʻi i ka hoʻonui nui ʻana i ka paʻakai plasma. Inā hōʻike ʻia ka hoʻohana concomitant, no ka mea i kākau ʻia ka hypokalemia, pono e hoʻohana ʻia me ka akahele a me ke kūkaʻi ʻana o ka mālama pinepine ʻana o ka pāima i ka kaila koko.

Hoʻomākaukau lithium. I ka wā i lawe maikaʻi ʻia ai ka hoʻomākaukau ʻana lithium me ka ACE me ARA II inhibitors, me ka telmisartan, he hoʻonui hou i ka hoʻoliʻi ʻana o ka plasma lithium a kū mai kona hopena makeʻe. Inā makemake ʻoe e hoʻohana i kēia hui o nā lāʻau lapaʻau, pono ia e mālama pono i ka nānā ʻana o ka lithium ma ka plasma koko.

Nā NSAID. ʻO nā NSAIDs (i.e., acetylsalicylic acid i loko o nā inikua i hoʻohanaʻia no ka hoʻōla anti-inflammatory, a me nā māhā COX-2 a me nā NSAID ʻaʻole i koho) hiki ke hoʻonāwaliwali i ka hopena antihypertensive o ka ARA II. I kekahi mau mea maʻi me ka hana renal impaired (e.g., dehydration, nā mea maʻi me nā maʻi renal impaired), ʻo ka hui pū ʻana o ka ARA II a me nā lāʻau e hoʻokaʻawale ana i ka COX-2 hiki ke hoʻomau i ka hana hou ʻana i ka hana renal, me ka hoʻomohala ʻana o ka maikaʻi ʻole o ka renal, ʻo ia hoʻi, ma ke ʻano he kānāwai. he pili hou. No laila, ʻo ka hui pū ʻana i nā lāʻau lapaʻau e pono e mālama ʻia me ka makaʻala, ʻoi loa i nā poʻe maʻi maʻi. Pono e mālama i ka hoʻohana ʻana i ka wai kūpono, ʻo ia hoʻi, i ka hoʻomaka ʻana o ka hoʻohana pū ʻana a i kēlā me kēia manawa i ka wā e hiki mai ana, e nānā pono nā māka o ka hana.

Diuretics (thiazide a loop). ʻO ka mālama ʻana ma mua o nā diuretics kiʻekiʻe, e like me ka furosemide (loop diuretic) a me hydrochlorothiazide (thiazide diuretic), hiki ke alakaʻi i ka hypovolemia a me nā hopena o ka hypotension i ka hoʻomaka ʻana o ka mālama ʻana me ka telmisartan.

ʻO nā lāʻau lapaʻau antihypertensive. Hiki ke hoʻonui ʻia ka hopena o ka telmisartan me ka hoʻohana pū ʻana me nā lāʻau ʻala antihypertensive. Wahi a nā mea kanu lāʻau o ka baclofen a me amifostine, hiki ke manaʻo ʻia e hoʻonui lākou i ka hopena therapeutic o nā lāʻau antihypertensive āpau, me ka telmisartan. Eia kekahi, hoʻonui paha nā orthostatic hypotension me ka waiʻona, barbiturates, nā lāʻau lapaʻau, a i ʻole antidepressants.

Corticosteroids (no ka hoʻohana ʻana i nā ʻōnaehana pono). Ua hoʻonāwī iho ʻo Corticosteroids i ka hopena o ke telmisartan.

ʻLoe a me ke kākele

I loko, i hoʻokahi lā, i holoi ʻia me ka wai ʻole, me kahi manaʻo ʻole o ka meaʻai.

He maʻi haole. ʻO ka papa ʻōlelo aʻo mua loa o Telzap® 1 papa. (40 mg) hoʻokahi i ka lā. Hiki i kekahi mau mea maʻi ke hoʻoikaika ikaika o 20 mg / lā. Hiki ke loaʻa ka hopena o 20 mg ma ka hoʻokaʻawale ʻana i kahi papa 40 mg ma ka hapalua i ka pilikia. I nā hihia i loaʻa ʻole ka hopena o ka therapeutic, hiki ke hoʻonui ʻia i loko o ka manaʻo i loko o Telzap® ka nui o 80 mg hoʻokahi i ka lā. ʻO kahi koho hou, hiki ke lawe ʻia ke Telzap ® me ka hoʻohui me ka thaizide diuretics, no ka laʻana, ka hydrochlorothiazide, ka mea i hoʻohana pū ʻia, he hopena antihypertensive hou.

Ke hoʻoholo nei inā he hoʻonui i ka maʻa, pono e noʻonoʻo pono i ka hopena antihypertensive ka hopena e loaʻa pinepine ma loko o 4-8 mau pule ma hope o ka hoʻomaka ʻana o ka mālama ʻana.

Hoʻopau i ka make ma ke ala a me ka piʻi o nā maʻi cardiovascular. ʻO ka ʻōlelo aku ʻānō ʻo Telzap® he 80 mg hoʻokahi i ka lā. I ka manawa mua o ka mālama ʻana, e mālama ʻia ka nānā ʻana i ke koko, e koi ʻia ka hoʻoponopono ʻana i ka lāʻau antihypertensive.

ʻO nā papalapa kanaka kūikawā

Hola paʻa kino hana. Loaʻa ka ʻike me ka telmisartan i nā mea maʻi me ka maikaʻi ʻole o ka pilikia a i ʻole nā ​​maʻi ma ka hemodialysis. A ʻōlelo ʻia kēia mau mea maʻi ma kahi haʻahaʻa haʻahaʻa haʻahaʻa o 20 mg / lā (ʻike. "Hoʻopapa kūikawā"). No ka mea maʻi me ka maluhia o ka renal hāmeʻa maʻalahi, ʻaʻole koi. ʻO ka hoʻohana mau ʻana o Telzap ® me ka aliskiren ua contraindicated i ka poʻe maʻi me ka pilikia ole (GFR ma mua o 60 ml / min / 1.73 m 2) (e nānā. "Contraindications").

ʻO ka hoʻohana like ʻana o Telzap ® me nā inhibitor ACE ua contraindicated i loko o nā poʻe maʻi me ka nephropathy maʻi (e nānā "Contraindications").

Hōʻeha ka hana ʻoluʻolu. Ua hoʻohālikelike ʻia ʻo Telzap ® i nā mea maʻi me nā maʻi hepatic koʻikoʻi (Anak-Pugh class C) (see "Contraindications"). I nā maʻi me ka maʻi maʻi hepatic maʻalahi (haʻawina A a me B e like me ke ʻano o nā keiki-Pugh, ma kēlā me kēia), ua kauoha ʻia ka lāʻau lapaʻau me ka mālama ʻana, ʻaʻole pono ka nui o ka dosis ma mua o 40 mg hoʻokahi i ka lā (ʻike. "Me ka mālama").

Mamua. No nā poʻe maʻi maʻi, ʻaʻole pono ka hoʻoponopono ʻana o ka inika.

Nā keiki a ʻōpio. ʻO ka hoʻohana ʻana o Telzap ® i nā keiki a me nā ʻōpio ma lalo o ka makahiki 18 he contraindicated ma muli o ka nele o ka palekana a me ka waiwai efficacy (e ʻike i "Contraindications").

Ke keu

Nā Hoʻomaka nā hōʻike keu a pau o ka overdose i hōʻike ʻia i ke emi ʻana o ke kahe o ke koko a me ka tachycardia, a me ka bradycardia, ka ʻōpū, kahi i hoʻonui ʻia i loko o ka serum creatinine a me ke kūleʻa o nā hana renal i hōʻike ʻia.

Lāʻau: ʻAʻole kahi a Telmisartan i hoʻoiho ʻia e hemodialysis. ʻO ka poʻe maʻi e nānā pono ʻia a me ka hōʻailona a me ka mālama pono ʻana e pono hoʻi e mālama. Ma muli o ke ala e pili ai i ka mālama ʻana i ka manawa i hala ma hope o ka lawe ʻana i ka lāʻau, a me ka nui o nā hōʻailona. Hoʻokomo ʻia nā hana i hāpai ʻia me ka hoʻoulu ʻana i ka luaʻi a me / a i ʻole ka gastric lavage; ʻO nā electrolytes Plasma a me ka hana hana pono e nānā mau ʻia. Inā hele ʻia kahi hōʻailona i ka hoʻokahe koko, pono e lawe ka mea maʻi i kahi kūlana me nā wāwae i hāpai ʻia, ʻoiai e pono e hoʻopiha hou i ka bcc a me nā electrolytes.

Nā ʻōlelo kikoʻī

Hōʻeha ka hana ʻoluʻolu. ʻO ka hoʻohana ʻana o Telzap ® i contraindicated i ka poʻe maʻi me ka cholestasis, kaʻaina o ka biliary tract a i ʻole ka hopena o ka ʻeha a ke kaumaha (keiki-Pugh C) (e nānā i "Contraindications"), no ka mea ua hoʻopuka ʻia ka telmisartan ma ka bile. I manaʻoʻiʻo ia ma kēlā mau maʻi, hoʻemi ʻia ka hoʻomaʻemaʻe hepatic o ka telmisartan. I nā maʻi me ka maʻi palupalu haʻahaʻa a me ke ʻano (kahi A a me B e like me ke ʻano o ke keiki-Pugh), pono ʻo Telzap ® me ka akahele (e nānā Me ka mālama pono).

Hōʻano maʻi renovascular. I ka mālama ʻia ʻana o nā lāʻau lapaʻau e hana ana ma RAAS i nā mea maʻi me ka stenosis aralula ginalula a i ʻole ka nui o ka stenosis o ke keiki hoʻokahi, e hōʻeha ʻia ka hypotension arterial a me nā hana ʻole.

Hoʻopiʻi ka hana a pau a me ka hoʻololi ʻana i nā keiki. Ke hoʻohana nei i Telzap ® i nā mea maʻi me ka hana renal impaired, mālama ʻia ka manawa o nā waihona o ka pāima a me ka creatinine i loko o ke koko koko. ʻAʻoheʻike lāʻau lapaʻau me Telzap ® i nā maʻi i loaʻa i ka wā hou ka hoʻohālikelike keiki.

Hoʻolaha i BCC. ʻO ka hypotension arterial Symptomatic, ʻoiai ma hope o ka hoʻokele mua o Telzap ®, hiki i nā mea maʻi me ka BCC haʻahaʻa a me / a me ka sodium i loko o ke koko koko i ka wā e pili ana i ka mua o ka mālama ʻana me ka diuretics, nā mea paʻa ma ka komo ʻana o ka paʻakai, ka ʻeha a me ka luaʻi.

ʻO kēlā mau ʻano (wai a me / wai ʻole o ka paʻakai ʻoi ʻia) e hoʻopau ʻia ma mua o ka lawe ʻana i ka Telzap ®.

Kāua pahu pā o RAAS. ʻO ka hoʻohana pinepine ʻana o ka telmisartan me ka aliskiren ua contraindicated i ka poʻe maʻi me ka maʻi mellitus a i ʻole ka hopena ʻole (GFR ma mua o 60 ml / min / 1.73 m 2) (e nānā. "Contraindications").

ʻO ka hoʻohana like ʻana o ka telmisartan a me ACE inhibitors ke contraindicated i loko o ka poʻe maʻi me ka nephropathy maʻi (ʻike "Contraindications").

Ma muli o ke kāohi ʻana o RAAS, i ka hypotension arterial, nāwaliwali, hyperkalemia, a me ka hana ʻole o ka renal function (me ka hopena ʻole o ka hopena o ka renal) i ʻike ʻia i nā mea maʻi e pili ana i kēia, ʻoiai inā i hui pū ʻia me nā lāʻau lapaʻau e hana nei i kēia ʻōnaehana. No laila, ʻaʻole i ʻōlelo ʻia kahi papa pālua ʻelua o ka RAAS (no ka laʻana, ʻoiai ke lawe nei i ka telmisartan me nā mea ʻē aʻe RAAS).

Ma nā hihia i hilinaʻi ʻia ai ke ʻano vascular a me ka hana ʻana i ka hana nui ma luna o ka hana RAAS (no ka laʻana, i ka poʻe maʻi me ka puʻuwai o ka naʻau a i ʻole ka maʻi puʻuwai, ʻo ia hoʻi o ka stenosis renal a i ʻole stenosis o ke kino kani hoʻokahi), ʻo ka hana ʻana i nā lāʻau e pili ana i kēia ʻōnaehana me ka hoʻopili ʻia ʻana o ka maʻi hypotension arterial, hyperazotemia, oliguria a ma nā hihia līkia, hanaʻole i ka hopena o ka renal.

ʻO ka hyperaldosteronism mua. I ka poʻe maʻi me ka hyperaldosteronism maʻamau, mālama ʻia me nā lāʻau antihypertensive, ʻo ka hopena i loaʻa ia e ka hoʻopaʻa ʻana iā RAAS, ka mea maʻamau ʻole like ʻole. Ma kēia e nānā ʻole ʻia ai ka hoʻohana ʻana o ka lāʻau ʻo Tezap ®.

ʻO ka Stenosis o aveic a me ka mitral valves, hypomyrophic obstract cardiomyopathy. E like me nā vasodilator ʻē aʻe, ʻo nā maʻi me ka stenosis aortic a mitral, a me ka cardiomyopathy obertive hypertrophic, pono e akahele loa i ka wā e hoʻohana ai iā Telzap ®.

ʻO nā mea maʻi me ka maʻi maʻi maʻi i loaʻa a i ʻole a me hypoglycemic agents no ka hoʻokō waha. E kūʻē i ke kūleʻa o ka mālama ʻana me Telzap ®, hiki i kēia mau maʻi ke loaʻa i ka hypoglycemia. I kēlā mau mea maʻi, pono e hoʻoikaika ʻia ka mana glycemic, like aia paha he pono no ka hoʻoponopono hoʻoponopono ʻana i ka insulin a i ʻole a hypoglycemic agent.

Hyperkalemia Hiki i nā lāʻau lapaʻau e hana ana ma ka RAAS ke kumu i ka hyperkalemia. I nā poʻe maʻi ʻelemakule, hiki i ka mea maʻi me ka hoʻopiʻi o ka palaka a me ka maʻi mellitus paha, nā mea maʻi e lawe ana i nā lāʻau lapaʻau e hoʻonui pū ana i ka potassium potassium, a / a i ʻole nā ​​mea maʻi me nā maʻi concomitant, hiki i ka maʻi hyperkalemia.

I ka hoʻoholo ʻana i ka hoʻohana pono ʻana i nā lāʻau lapaʻau e hana ana ma ka RAAS, pono e loiloi i ka pae e loaʻa ana i ka hopena o ka hopena. ʻO nā mea koʻikoʻi e pili i ka hyperkalemia e pono e noʻonoʻo ʻia.

- ka maʻi diabetes mellitus, ka hopena renal, ka makahiki (nā maʻi i ʻoi aku ma mua o 70 mau makahiki),

- ka hui pū me nā mea hoʻokahi a keu paha nā lāʻau e hana ana ma ka RAAS, a me / a me nā mea hoʻohui kai me kā potassium. ʻO nā hopena a me nā papa lāʻau o nā lāʻau lapaʻau e hiki ai ke hana i ka hyperkalemia he mau paʻakai paʻakai e loaʻa ana i ka paʻakai, potassium-sparing diuretics, ACE inhibitors, ARA II, NSAIDs, including nā mākeke COX-2, heparin, immunosuppressants (cyclosporin a tacrolimus) a me ka trimethoprim,

- nā kūlana / waena o nā maʻi, i ka lula, ka palaualelo o ka naʻau, ka acidababae acidab, heʻō i hana pono, hana cytolysis syndrome (no ka laʻana, ischemia umauma mākala, rhabdomyolysis, nui trauma).

Manaʻo ʻia nā mea maʻi i ka pilikia e nānā pono i ka manaʻo o ka potassium ma loko o ke koko koko (e ʻike i ka "Interaction").

ʻO Sorbitol. ʻO kēia lāʻau lāʻau ka maʻi sorbitol (E420). ʻO nā mea maʻi me ka intolerance fructose i loaʻa ʻole i ka ʻai ʻana, ʻaʻole pono e lawe i ka Telzap ®.

ʻOkoʻa nā ʻano ʻē. E like me ka mea nāna i hoʻopaʻa aku i ka ACE, telmisartan a me nā mea ARA II e hoʻohaʻahaʻa iho i ke kahe koko ke emi iki i ka poʻe maʻi o nā lāhui Negroid ma mua o nā ʻelele o nā lāhui ʻē aʻe, aia paha ma kahi o ka predisposition nui i ka hōʻemi o ka hana ʻo renin ma ka lehulehu o kēia mau maʻi.

Misc. E like me nā lāʻau āpau antihypertensive, ʻo ka hoʻohaʻemi nui o ke kahe koko i loko o nā mea maʻi me ka ischemic cardiomyopathy a i ʻole CHD hiki ke alakaʻi i ka hoʻomohala ʻana i ka myocardial infarction a i ʻole ka hahau ʻana.

Hoʻokomo i ka hiki ke lawe i nā kaʻa, nā mīkini. Ma nā noiʻi noiʻi kūikawā e noiʻi ai i ka hopena o ka lāʻau lapaʻau ma ka hiki ke ke kaʻa i kahi kaʻa a ʻaʻole i lawe ʻia nā mīkini. Ke hoʻokele a hana a me nā hana e pono ai ka hoʻonui ʻana o ka makaʻala, pono mālama ʻia luhi a hiki ʻole luhi i ka luhi a ka wā e lawe ai i ke Telzap ®.

Mea hana

Zentiva Saalyk Yurunleri Sanayi ve Tijaret A.Sh., Turkey.

Apana Kucukkaryshtyran, st. Merkez, No. 223 / A, 39780, Buyukkaryshtyran, Luleburgaz, Kırklareli, Turkey.

Ka mea paʻa o kahi palapala hoʻopaʻa inoa. Sanofi Lūkia JSC. 125009, Rusia, Moscow, ul. Tverskaya, 22.

ʻO nā hoʻopiʻi e pili ana i ka maikaʻi o ka lāʻau lapaʻau e pono e hoʻouna ʻia i ka helu o Sanofi Russia JSC: 125009, Russia, Moscow, ul. Tverskaya, 22.

Tel .: (495) 721-14-00, fax: (495) 721-14-11.

E hoʻokuʻu i ke ʻano a me ka ʻano

Loaʻa ke Telzap i ke ʻano o nā papa i hoʻopili ʻia me ka uhi ʻana o ka film me 40 mg a me 80 mg. Kuhi ʻia nā ʻāpana he 10 i nā blisters, i loko o kahi pūlama pepa aia he 3, 6 a 9 mau blisters a me nā ʻōkuhi no ka hoʻohana ʻana iā Telzap.

1 papa i nā mea waiwai: telmisartan - 40 mg a i ʻole 80 mg a me nā ʻāpana kōkua: povidone 25, meglumine, sodium hydroxide, sorbitol, magnesium stearate.

Hoʻopau hou i nā papa Telzap Plus 80 mg + 12.5 mg, nona ka 80 mg o ka telmisartan a me 12,5 mg o ka hydrochlorothiazide - kahi diuretic.

Ka hana lāʻau lapaʻau

ʻO ka telmisartan hāmeʻa ikaika ka waiwai o nā antagonis reseptor angiotensin II. Ke nānā ʻia, hiki i ka lāʻau lapaʻau ke hōʻole i ka angiotensin II mai kāna pilina me ka mea nāna i hopu. Eia kekahi, e pili ana i kēia mea i kēia mea manaʻo, ʻaʻole ia he agonist. Hoʻopili wale ʻia ʻo Telmisartan me nā ʻoniʻoni me ka angiotensin II ATl. ʻAʻole ia e hōʻike i ka waiwai i nā mea like me ko ka ʻĀpana AT2 a me kekahi.

Ma lalo o ka hopena o ka lāʻau i ka plasma koko, e emi ana ke ʻano o ka ald testosterone. I ka manawa like, noho ka hana renin i ka pae like a ʻaʻole i ʻae ʻia nā neʻe ion.

ʻO Angiotensin-hoʻohuli i ka enzyme e hoʻopili ai i ka luku ʻana i ka bradykinin ʻaʻole i kālai ʻia. Hāʻawi kēia hiʻohiʻona iā ʻoe e kāpae i ka hopena o ka hoʻomohala ʻana i nā hopena ʻaoʻao e like me ka pau ʻana maloʻo.

Ke hoʻohana nei i kahi maʻa o 80 mg i nā maʻi, ua pāpā ʻia nā hopena hypertensive o ka angiotensin II. Loaʻa ka hopena i nā hola 3 ma hope o ka hopena mua. Hana ka hana i 24 mau hola. Hoʻāʻo ʻia ia e paʻa pono ma nā hola 48. ʻO ka hoʻohana pinepine ʻana i nā papa no 4-8 mau wiki e alakaʻi i ka hopena antihypertensive.

ʻO ka hoʻohanaʻana o Telzap i nā maʻi me ka hypertension arterial hiki ke hoʻemi i ka hoʻokahe koko diastolic a me ka systolic. I ka manawa, ʻaʻole loli ka puʻuwai puʻuwai.

Hoʻohana ʻia ka lāʻau lapaʻau e mālama i nā maʻi cardiovascular. I nā poʻe maʻi maʻi me nā pathologies o ka ʻōnaehana cardiovascular, ua loaʻa i nā papa nā hopena o ka hōʻemi ʻana i ka nui o:

  • pohō
  • myocardial infarction
  • make kino ma muli o ka maʻi cardiovascular.

Nā hōʻailona no ka hoʻohana ʻana

He aha ka mea e kōkua ai iā Telzap? Nā hōʻailona nui no ka hoʻohana ʻana i nā papa:

  • ʻO IHD i nā maʻi ma mua o 55 mau makahiki keu.
  • ʻO ka paleʻana i nā maʻi o ka ʻōnaehana ponoʻī.
  • ʻO ka pale ʻana i ka make ma muli o nā hōʻeha cardiovascular ma nā maʻi e hōʻeha (no ka pale ʻana i ka hōʻeha ʻana o ka puʻuwai, hōʻeha, ka hōʻemi o ka naʻau me ka hopena hōʻeha).
  • ʻO ka pale ʻana i nā hoʻopiʻi mai ka naʻau a me nā kīʻaha koko i ke ʻano maʻi type 2.
  • He koko koko nui - ma luna o 140/90 no kekahi mea nui a me kekahi mau ʻano o ka hypertension hōʻailona.
  • Ma kahi ʻāpana o nā lāʻau paʻakikī ma hope o kahi hōʻeha a i ʻole ka ischemic attack.

He maʻi haole

ʻO ka inumapa mua o Telzap ma mua o 40 mg (1 papa) i hoʻokahi lā. I kekahi mau mea maʻi, lawe i ka lāʻau lapaʻau ma ke ʻano o 20 mg i kēlā me kēia lā e kūpono paha. Hiki ke loaʻa ka hopena o 20 mg ma ka hoʻokaʻawale ʻana i kahi papa 40 mg ma ka hapalua i ka pilikia. I nā hihia i loaʻa ʻole ka hopena therapeutic, hiki ke hoʻonui ʻia i loko o ka manaʻo i loko o Telzap i ke kiʻekiʻe o 80 mg hoʻokahi i ka lā.

Ma kahi koho aʻe, hiki ke lawe ʻia ʻo Telzap i hoʻohui pū me ka diuret thiazide, no ka laʻana, ka hydrochlorothiazide, kahi i hoʻohana pū ʻia ai he hopena antihypertensive hou. Ke hoʻoholo nei inā he hoʻonui i ka maʻa, pono e noʻonoʻo pono i ka hopena antihypertensive ka hopena e loaʻa pinepine ma loko o 4-8 mau pule ma hope o ka hoʻomaka ʻana o ka mālama ʻana.

Loaʻa ka ʻike me ka telmisartan i nā mea maʻi me ka maikaʻi ʻole o ka pilikia a i ʻole nā ​​maʻi ma ka hemodialysis. Kuhi ʻia kēia mau mea maʻi ma kahi haʻahaʻa haʻahaʻa haʻahaʻa o 20 mg i kēlā me kēia lā. No ka mea maʻi me ka maluhia o ka renal hāmeʻa maʻalahi, ʻaʻole koi.

ʻO ka hoʻohana mau ʻana o Telzap me ka aliskiren ua contraindicated i ka poʻe maʻi me ka pilikia ole (GFR ma mua o 60 ml / min / 1.73 m2 o ka pālahalaha ʻike o ke kino).

ʻO ka hoʻohana like ʻana o Telzap me nā inhibitor ACE ua contraindicated i ka poʻe maʻi me ka nephropathy maʻi.

ʻO nā mea maʻi me ka haʻahaʻa o ka maʻi hepatic moderate (ʻo nā keiki-Pugh papa A me ka B) e pono e kuhikuhi ʻia me ka mālama akahele, ʻaʻole pono ka lāʻau i ka 40 mg hoʻokahi i ka lā. Contzicated ʻo Telzap i nā maʻi me nā maʻi hepatic koʻikoʻi (papa C e like me ka helu ʻana o nā keiki-Pugh).

I nā poʻe maʻi maʻi, ʻaʻole pono ka hoʻoponopono ʻana o ka inika.

Hoʻolālā Plus

Lawe ʻia ma mua, i ka lā hoʻokahi, e holoi ʻia me ka wai ʻole, me ka ʻaʻa ʻole.

ʻO nā mea maʻi e hiki ʻole ke pulehu ʻia ʻo BP me ka monotherapy me ka telmisartan a i ʻole hydrochlorothiazide e lawe i ka Telzap Plus.

Ma mua o ka hoʻololi ʻana i kahi hui paʻa-paʻa paʻa, ʻomi ʻia nā kaha titration o kēlā me kēia mahele. I kekahi mau kūlana maʻi, hiki ke noʻonoʻo pono i kahi hoʻololi kūwaho mai ke monotherapy i ka mālama ʻana me ka hui pūnaʻina paʻa i ka hopena paʻa.

E heluhelu pū i kēia ʻatikala: Ma ke ʻano o ke koʻikoʻi e inu ai iā Corinfar: nā ʻōlelo aʻo, kumu a me nā loiloi

ʻO ka lāʻau Telzap Plus, hiki ke hoʻohana ʻia i hoʻokahi manawa no ka poʻe maʻi ʻaʻole hiki ke mālama pono i ke kahe koko i ka wā e lawe ai i ka telmisartan i kahi maʻi o 80 mg i kēlā me kēia lā.

Nā hopena hopena

I kekahi mau mea maʻi, lawe i Telzap hiki ke hoʻonāukiuki i ka ʻano o nā hopena o nā ʻaoʻao.

  • Hoʻopele pinepine ʻia ka dyspnea a me ka ʻopa. Inā loaʻa pinepine ʻia ka maʻi maʻi interstitial.
  • Hoʻopiʻi kekahi poʻe maʻi i ka insomnia, ke kaumaha, hoʻonui nui i ka hopohopo. I nā hihia pinepine ʻole nā ​​luhi.
  • I nā wahine, hiki ke hōʻeha nā maʻi maʻi o ka ʻōpiopio, i nā hihia kīnā ʻole, ʻike ʻia kahi hana hānai kāne. I nā kāne, hiki i kahi neʻe erectile.
  • Aia kahi hōʻike o ka hoʻolālāʻana o ka thrombocytopenia, eosinophilia a me ka hemoglobin haʻahaʻa.
  • I ka papa inoa o nā hopena like ʻole e kapa ʻia ʻo hyperhidrosis, ʻehaʻeha, ʻeha. ʻO ka eczema, angioedema, erythema, toxic a me nā lāʻau lapaʻau ʻokoʻa ke nānā pinepine ʻia.
  • I waena o nā hopena hopena i kapa ʻia ʻo ka fāaline renal function. I waena o kēia mau papa ʻaia he hāʻule ʻole.
  • Mai ka pūnaʻi ʻana o ka ʻōpū, ka ʻeha, ka ʻeha o ka ʻōpū, ka luaʻi ʻana, ka lemela a me nā dyspepsia i pinepine pinepine ʻia ma mua o ka poʻe. ʻO ka maʻi ʻeha, hoʻonāukiuki i ka wahi o ka epigastric, mucosa maloʻo i ka waha waha.

ʻAʻole palupalu ka ʻōnaehana cardiovascular i nā hanana pōʻino me ka ʻoihana Telzap. I ka manawa, hiki i nā mea maʻi:

  • hoʻohaʻahaʻa i ke koko i ka hoʻololi ʻana i ke kūlana o ke kino,
  • nāwaliwali maʻemaʻe
  • hōʻemi a hoʻonui paha i ka piʻi ʻana o ka naʻau.

ʻO nā maʻi āpau o ka puʻuwai a me nā puʻuwai ke loaʻa pinepine loa.

Hiki i ka lāʻau lapaʻau ke kumu i ka emi ʻana o ke kō koko a me ka hoʻoneʻe metabolic.

No nā maʻi kūlohelohe, hiki i nā mea penei:

ʻO nā waiwai Pharmacological

Lapaʻau lāʻau

ʻO ka hoʻohana pū ʻana o ka hydrochlorothiazide a me telmisartan, ʻaʻole i pili i ka pharmacokinetics o kēia mau lāʻau.

Telmisartan: Ma hope o ka lawelawe waha, ua hōʻea nā kiʻekiʻe telmisartan ma hope o nā hola 0.5 - 1.5. ʻO ka bioavailability piha loa o ka telmisartan ma ke ʻano he 40 mg a ʻo 160 mg ka 42% a 58%, ʻokoʻa. 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, me kahi ʻaʻai ʻole. ʻO kahi emi iki o AUC ʻaʻole ka mea e hoʻoemi ai i ka hopena o ka therapeutic efficacy. Kuhi ole nā ​​pharmacokinetics o ka telmisartan waha i nā inika o 20-160 mg me ka hoʻonui hou aʻe o ka hoʻonui ʻana i ka hoʻoulu ʻana i ka plasma (Cmax a me AUC) me ka hoʻonui nui ʻana. ʻAʻole i ʻike ʻia kekahi kumulāʻau koʻikoʻi o ke telmisartan.

ʻO ka hole waiwai: Ma hope o ka hoʻoponopono waha ʻana o Telzap Plus, ua hōʻea ka ʻike o ka hydrochlorothiazide ma kahi o 1.0 a 3 mau hola ma hope o ka lawe ʻana i ka lāʻau. Hoʻokumuʻia i ka excretion renalative renal of hydrochlorothiazide, kahi o ka bioavailability kūʻokoʻa e pili ana i ka 60%.

Telmisartan haki loa ia i nā protein plasma (ma mua o 99.5%), ka mea nui me ka albumin a me nā alpha-1-acid glycoprotein. ʻO ka nui o nā puʻupuʻu e pili ana i ka 500 L, e hōʻike ana i nā kikoo ʻē aʻe.

ʻO ka hole waiwai 68% i hoʻopaʻa ʻia i nā protein plasma a me ka nui o ka hoʻolaha i 0.83 - 1.14 l / kg.

Telmisartan ka hoʻāliʻi ʻana e ka conjugation me ke kūkulu ʻana i nā acylglucuronide pharmacologically inactive. ʻO ka glucuronide o ka ʻōlelo a ka makua ka mea i ʻike ʻia i loko o ka poʻe. Ma hope o kahi wai hoʻokahi o ka telmisartan hōʻailona inoa 14C, ʻo ka glucuronide e pili ana i 11% o ka radioactivity plasma i hoʻopaʻa ʻia. ʻAʻole i komo ka Cytochrome P450 a me nā isoenzymes i ka metabolism o ke telmisartan.

ʻO ka hole waiwai ʻaʻole i hoʻopaʻa ʻia i loko o nā kānaka

Telmisartan: Ma hope o ka lawe ʻana i ka telmisartan a me ka waha o ka telmisartan, ua hōʻea ʻia ka nui o nā kaila i hoʻoponopono ʻia (> 97%). Loaʻa nā helu liʻiliʻi i loko o ka pāʻai.

ʻO ka huina piha o ka plasma o ka telmisartan ma hope o ka hoʻoponopono waha he> 1500 ml / min. ʻO ka hapa hapa o ke ola he> 20 mau hola.

ʻO ka hole waiwai excreted aneane i loli ole i loko o ka uki.Ma kahi o 60% o kahi kūlohelohe waha e excreted i loko o 48 mau hola. ʻO ka wehe ʻana o Renal ma kahi o 250 - 300 ml / min. ʻO ka hapalua noho ola he 10 a me 15 hola.

Nā maʻi maʻi maʻi

ʻAʻole ʻokoʻa nā pharmacokinetics o telmisartan i nā poʻe kahiko a me nā poʻe maʻi i ʻoi aku ma mua o 65 makahiki o kona mau makahiki.

ʻO 2-3 ka nui o nā hui o ka telmisartan i nā manawa he 2-3 i ʻoi aku ka nui o nā kāne ma mua o nā kāne. I nā haʻawina loiloi, ʻaʻohe nui o ka piʻi o ka pane o ke koko a i ʻole ka piʻi o ka hypthension orthostatic i nā wahine. ʻAʻole pono ke hoʻoponopono ʻia. Ke nānā nei i ka piʻi o ka plasma kiʻekiʻe o ka hydrochlorothiazide i nānā ʻia i nā wahine ma mua o nā kāne. ʻAʻole ia he hōʻailona koʻikoʻi.

ʻO nā mea maʻi me ka maikaʻi ʻole o ka pūpū

ʻAʻole pili ʻo ka excretion Renal i ka hoʻomaʻamaʻa telmisartan. Wahi a nā hualoaʻa o ka ʻike liʻiliʻi me Telzap Plus i nā mea maʻi me ka hōʻola ʻana i ka renal moderole (hōʻoki ʻana i hana ʻia o 30-60 ml / min, ka waiwai o ka nui o 50 ml / min), ʻaʻole pono ke hoʻoponopono ʻia. ʻAʻole lawe ʻia ke Telmisartan mai ke koko e ka hemodialysis. I ka poʻe maʻi me ka hana renal impaired, hoʻemi ʻia ka helu o ka haʻalele ʻana o ka hydrochlorothiazide. I loko o kahi noiʻi i nā mea maʻi me ka clearance creatinine awelika o 90 ml / min, i hoʻonui nui ʻia ka hapalua o ke ola o ka hydrochlorothiazide. I ka poʻe maʻi me ka pōpoki maʻi ʻole, hoʻopau ʻia ka hapalua-ola he 34 mau hola.

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.

Farmakoi ka lāmika

ʻO Telzap Plus ka hui ʻana o kahi anagonensin II receptor antagonist (ARAII), telmisartan, a me kahi diuretic thiazide, hydrochlorothiazide. ʻO ka hui pū ʻana o kēia mau māhele he hopena hoʻohui antihypertensive, e hoʻohaʻahaʻa ana i ke kahe koko i ka nui ma mua o kēlā me kēia ʻāpana. ʻO Telzap Plus ke lawe ʻia i hoʻokahi manawa i kahi lā e alakaʻi i ke emi o ke kaila o ka neʻe koko.

ʻO Telmisartan kahi hana kūpono a me ka kikoʻī (koho) angiotensin II receptor antagonist (type AT1) no ka hoʻoponopono waha. ʻO Telmisartan me ka like a me ka mea like loa i ka huki angiotensin II mai kāna mau wahi paʻa i nā ʻāpana o ka subtype 1 (AT1), nona ka hopena i ʻike ʻia o ka angiotensin II. ʻAʻole i hōʻike ʻo Telmisartan i kahi hana agonist ʻokoʻa kū'ē i ka mea hoʻokipa AT1. Hoʻopili paʻa a Telmisartan i nā mea hoʻokipa AT1. ʻO ka wā paʻa. 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.

Hoʻopau ʻo Telmisartan i nā pae aldosterone plasma, ʻaʻole pale i ka renin i ka plasma o ke kanaka a me nā kaila ion.

ʻAʻole ʻo Telmisartan i kāohi i ka angiotensin-hoʻololi i ka enzyme (kinase II), e hōʻemi ana i ka hana o ka bradykinin. No laila, ʻaʻohe mea hoʻoikaika o nā hopena ʻili e pili ana i ka hana a bradykinin.

ʻO kahi 80 mg dosis o telmisartan, hoʻolako ʻia i nā limahana olakino, aneane ʻae loa i ka hoʻonui ʻana i ke kaomi ma o ka loaʻa ʻana o ka angiotensin II. Ke hoʻomau nei ka hopena pale i nā 24 hola (a hiki i 48 mau hola).

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 haʻahaʻa loa i ke kahe o ke koko, i mea lula, ua hoʻokau ma 4-8 mau pule ma hope o ka hoʻomaka ʻana o ka hoʻomaʻamaʻa ʻana a hoʻomau i ka mālama lōʻihi.

E mau ana 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, e hōʻoia ʻia ana e ke ana ʻana o ke koko, a me ka pae o ka outpatient (ma luna o 80%) o nā kuʻina o ka liʻiliʻi a me ka lōʻihi o ka hōʻemi ma hope o ka lawe ʻana a 40 a me 80 mg o telmisartan i loko o kahi plebo-control mau haʻawina loiloi.

I ka poʻe maʻi me ka hypertension, hoʻemi ka telmisartan i nā kaila koko systolic a me ka diastolic me ka hoʻopi ʻole ʻana i ka hapa o ka puʻuwai. Hoʻohālikelike ka pono o ka antihypertensive o ka telmisartan me nā ʻelele o nā papa inoa o nā lāʻau antihypertensive (e like me ka hōʻike ʻana ma nā noiʻi haukaʻi e hoʻohālikelike ana i ka telmisartan me ka amlodipine, atenolol, enalapril, hydrochlorothiazide, a me lisinopril).

Ma kahi ʻelua makapō, nā hoʻokolohua olakino hoʻokele (N = 687 nā mea maʻi i loiloi ʻia no ka pono), ʻo nā poʻe i kū ʻole i ka hopena o 80 mg / 12.5 mg hōʻike i kahi hopena hōʻemi i ka hoʻohaʻahaʻa ʻana i ke koko o ka 80 mg / 25 mg hui hoʻohālikelike ʻia me ka lōʻihi o ka mālama ʻana i ka hopena lōʻihi 80 mg / 12.5 mg 2.7 / 1.6 mmHg (SBP / DBP) (ʻokoʻa i ka loli hoʻololi maʻamau i ka pae waihona pili). Ma kahi noiʻi me ka hui pū o 80 mg / 25 mg, ua hoʻemi ʻia ke koko, e kū ana i kahi hōʻemi holoʻokoʻa o 11.5 / 9.9 mmHg. (GARDEN / DBP).

ʻO kahi loiloi laulā o ʻelua mau wiki he 8, ʻelua-makapō, nā maʻi ʻohiʻoki o ka pleboebo i hoʻohālikelike ʻia i ka hoʻowalewale o valsartan / hydrochlorothiazide 160 mg / 25 mg (N = 2121 nā mea maʻi i loiloi ʻia no ka hana mau) hōʻike ʻoi i ka hopena nui o ka hoʻohaʻahaʻa i ke koko koko 2.2 / 1.2 mm Hg . ^ E Ha yM. (SBP / DBP) (ʻokoʻa i ka loli hoʻololi maʻamau mai ka palena, kēlā me kēia) i ke ʻano o ka hui ʻana o telmisartan / hydrochlorothiazide 80 mg / 25 mg.

Ma hope o ka pau ʻana o ka hoʻomaʻamaʻa ʻia me ka telmisartan, hoʻemi kahe koko i kona waiwai nui ma mua o kekahi mau lā me ka ʻole o nā hōʻailona o ke ʻano "rebound" hypertension.

I nā haʻawina hōʻike hoʻohālikelike hoʻohālikelike i nā hanana ʻelua, ʻo ka ulu ʻana o ka umī maloʻo ka haʻahaʻa o ka maʻi i ka poʻe maʻi e loaʻa ana i ka telmisartan ma mua o ka mea e loaʻa ana i ka angiotensin-hoʻololi ʻana i ka enzyme inhibitors.

ʻO ka haʻawina ʻo PRoFESS i mālama ʻia i nā mea maʻi ma mua o 50 mau makahiki i hala iho nei i kahi hōʻeha ua hōʻike i ka nui o ka sepsis me ka telmisartan hoʻohālikelike ʻia me ka placebo, 0.70% hoʻohālikelike ʻia me 0.49% OR ʻO 1,33 (95% kikowaena hilinaʻi 1.00 - 2.06), ʻo ka nui o ka make mai ka sepsis ke kiʻekiʻe i ka poʻe maʻi e lawe ana i ka telmisartan (0.33%) hoʻohālikelike ʻia me nā mea maʻi e lawe nei i ka placebo (0.16%) OR 2.07 (95% kikowaena hilinaʻi 1.14 - 3.76). ʻO ka hoʻonui ʻia i ka ulia o ka sepsis e pili ana me ka hoʻohana ʻana o telmisartan, he hanana a he hanana maoli paha a hui ʻia paha me kahi ʻano ʻike i kēia wā i ʻike ʻole ʻia.

ʻAʻole ʻike ʻia nā hopena o ka telmisartan ma ka make me ke aniani morbidity. ʻO ka Hydrochlorothiazide kahi diuretic thiazide. ʻO ka mīkini o ka hopena antihypertensive o ka diuretics thiazide ʻaʻole maopopo loa. Ua hoʻopilikia ʻo Thiazides i nā hana ʻoi o ka hana reabsorption o nā electrolytes i nā pālolo, hoʻomāhuahua i ka hoʻonui ʻana o ka sodium a me ka klorika i nā mea like. Hoʻonui ka hopena diuretic o ka hydrochlorothiazide i ka nui o ka plasma, hoʻonui i ka hana ʻana i ka plasma renin, hoʻonui i ka huna kino o ka aldosterone, e ukali ʻia ana e ka nui o ka pāima i loko o ka urine, lilo i ka bicarbonate a me ka hoʻemi ʻana i ka kāʻai sima. ʻĀnō ma o ka blockade o ka ʻōnaehana renin-angiotensin-ald testosterone, ka hui pū ʻana o ka telmisartan, ma ke ʻano he kānāwai, pale i ka nalowale o ka pāhare pili me kēia mau diuretics. Ke hoʻohana nei i ka hydrochlorothiazide, hoʻomaka ka diuresis ma hope o 2 mau hola, a loaʻa ke hopena hopena ma hope o ka hola 4 paha, ʻoiai ka hopena e pili ana no 6-12 mau hola.

Ua hōʻike ʻia nā haʻawina ʻo Epidemiological i ka lōʻihi o ka mālama ʻana me ka hydrochlorothiazide e hoʻemi ana i ka hopena o ka maʻi cardiovascular a me ka morbidity.

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

ʻAʻole ʻike ka ʻike pili pono i ka palekana o kēia lāʻau lapaʻau i ka wā hāpai. Inā hoʻolālā kēia ka mea maʻi i ka hapai, a pono ʻo ia e lawe i ka lāʻau lapaʻau e hoʻohaʻahaʻa i ke kaumaha, pono ʻia e lawe i nā ʻano maʻi ʻē aʻe.

ʻO ka hoʻohana ʻana i nā lāʻau lapaʻau mai ka pūʻulu o nā mea paʻa, nā angiotensin antagonist i ka mea aloha a me ka 3 trimesters e kōkua i ka hoʻomohala ʻana i nā pōʻino o ka ʻōpū, ka ate, ka lūlū ʻana i ka ʻoki i ka ʻōpala, oligohydramnion (kahi hoʻemi i ka nui o nā wai amniotic).

ʻO ka hoʻohanaʻana i ka lāʻau lapaʻau i ka wā o ka hoʻouluʻana, ua contraindicated loa.

Hoʻohui nūhou

Hoʻohana pinepine ʻia ʻo Telzap ma ke ʻano o ka hoʻomaʻamaʻa paʻakikī, no laila pono ʻoe e noʻonoʻo e pili ana i ka like ʻana o nā papa me nā lāʻau ʻē aʻe.

ʻAʻole ʻae ʻia nā mea maʻi me ka maʻi diabetes type 2 e lawe i ka telmisartan me nā mea ʻē aʻe ACE kekahi i ka manawa like. I ka hapanui, he kumu kēia no hypoglycemia.

ʻAʻohe nā lāʻau lapaʻau i hoʻohana ʻia no ka hoʻohana ʻana:

  • ole-anti-lauleia anti-inflammatory,
  • Diuretics pākoleka-sparing
  • nā huahana e loaʻa ai nā hydrochlorothiazide,
  • immunosuppressants
  • Hoʻohui kalima
  • heparin.

Hiki ke koi ʻia ka mālama ʻana i nā lāʻau lapaʻau a me ka hoʻoponopono ʻia o ka dosage me ka hoʻohana pū ʻana o ka telmisartan a me nā lāʻau lapaʻau e hiki mai ana:

  • corticosteroids
  • huluhula
  • pani ʻia
  • Hoʻomākaukau lithium
  • kāmakua
  • ʻenehana.

Nā kuʻuna o ka lāʻau lapaʻau Telzap

E hoʻoholo ke ana i ke kumuhana:

  1. Mikardis.
  2. Kahalehua N.
  3. Telmisartan.
  4. ʻPreslelo Telpres.
  5. Hoʻolālā Plus.
  6. Nā Telsartan.
  7. Telmista.
  8. Tanidol.
  9. Telpres.
  10. Kauhi.
  11. MikardisPlus.
  12. Koiā ʻia.

Hoʻonohonoho nā Angiotensin 2 mau anagonist e hoʻopili:

  1. Gizaar.
  2. Nortian.
  3. Lorista.
  4. Nā kāleka.
  5. Kukuiono.
  6. Ibertan.
  7. Renicard.
  8. Presartan.
  9. Kāleka.
  10. Keola.
  11. Hoʻolaha.
  12. Koiā ʻia.
  13. Mikardis.
  14. ʻO Vasotens.
  15. Tareg.
  16. Pāʻauhau.
  17. ʻApeleka.
  18. Teveten.
  19. Eprosartan Mesylate.
  20. Hoʻoikaika Co-exforge.
  21. Lozap.
  22. Irbesartan.
  23. Artinova.
  24. Kāleka.
  25. Tanidol.
  26. Candesartan.
  27. Lozarel.
  28. Telpres.
  29. Naviten.
  30. Atakand.
  31. Hoʻōla.
  32. Valz N.
  33. Losartan.
  34. Alohalani N.
  35. Brozaar.
  36. Xawai.
  37. Twinsta.
  38. Kāleka.
  39. ʻO Duopress.
  40. Vamloset.
  41. Valz.
  42. Edarby.
  43. Olimestra.
  44. ʻO Lozap Plus.
  45. Karzartan
  46. Kālehu.
  47. Zisakar.
  48. Sartavel.
  49. Nā Telsartan.
  50. Apolo.
  51. Cardosten.
  52. Diovan.
  53. Coaprovel.
  54. Irsar.
  55. Valsartan.
  56. Telmisartan.
  57. Nā mea hoʻohālike.
  58. Blockchain.
  59. Nā Hyposart.

Waiho I Kou ManaʻO HoʻOpuka