Telmista 80 mg - mau ʻōlelo no ka hoʻohana ʻana

Telmista 80 mg - kahi lāʻau antihypertensive, kahi antagonist kikoʻī o ka ʻāmaʻomaʻi o ka angiotensin II (type AT1).

1 papa 80 mg:

ʻO kēia papa hana: Telmisartan 80.00 mg

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

Nā Papa 80 mg: Nā kāpena Capsule, nā biconvex papa 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. Ke hoʻomau nei ka pilina. 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).

Nā Hoʻohui

Nā maʻi hoʻohālikelike i ka hoʻohana ʻana o ka lāʻau 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.
• ʻO ka maʻi o ke ʻano o ke kino: ke kūpaʻa anaphylactic, hypersensitivity (erythema, urticaria, angioedema), eczema, haki, ʻehaʻeha o ka ʻili (me ke ʻano lāʻau lapaʻau), angioedema (me nā 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 ʻ umauma o ka umauma a me ka mediastinum: ke pōkole o ka hanu, ka mākeke, ka maʻi ʻōpū interstitial * (* i ka wā o ke kūʻai ʻana o ke kūʻai ʻana, ua hōʻike ʻia nā hihia o ka maʻi maʻi interstitial, me kahi pili pōkole 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).

Hoʻopili pū me nā lāʻau ʻē aʻe

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 i ka ʻōnaehana renin-angiotensin-aldosterone (RAAS), hiki i ka hoʻohana ʻana o ke telmisartan ke hoʻoulu i ka hyperkalemia (e ʻike i ka ʻāpana "Kūlana kūikawā"). Hiki ke hoʻonui ʻia ka hopena inā hoʻohana pū ʻia me 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 II, ARA II, non-steroidal anti-inflammatory drug NSAIDs, me nā selclooxygenase-2 inhibitors | COX-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, pākuhi pili pālato a pili ana i ka paʻakai pākeke pili i ka paʻakai hiki ke alakaʻi i kahi nui i ka potassium sima. 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 hoʻohana like ʻana o ka inhibitor ACE a me ka hoʻomākaukau ʻana o ka lithium, kahi mākaʻikaʻi hoʻi i hoʻihoʻi ʻia i ka ʻike lithium ma ka plasma ua ʻike ʻia, i hoʻopiʻi ʻia. Ma nā hihia pilikia ʻole, ua hōʻike ʻia nā loli like me ka ARA II a me ka hoʻomākaukau ʻana o ka 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, e komo pū ana ka acetylsalicylic acid, COX-2, a me nā NSAID hemahema ʻole, hiki ke hōʻeha i ka hopena ʻole o ka maʻi 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 hoʻopōlole i nānā. Hoʻohana me ka aliskiren i nā mea maʻi me ka maʻi mellitus no ka maʻi mellitus a i ʻole ka hōʻemi i ka hopena o ke kaulike (glomerular filtration rate GFR