Pehea e hoʻohana ai i ka lāʻau lapaʻau Telsartan N?

ʻO ka wehewehe ʻana i ke ʻano dosis

Nā Papa Helu 12,5 mg + 40 mg. ʻOval, biconvex, ʻelua ʻāpana, hoʻokahi papa mai ke aniani ʻulaʻula a i ulaula, ka papa ʻē aʻe mai ke keʻokeʻo a hiki i keʻokeʻo me ka pink pink interspersed. Ke keokeo o nā papa i kahi ku e a me ke komo ʻana i ka "T" a me "1" ma nā ʻaoʻao like ʻole o ia.

Nā Papa Helu 12,5 mg + 80 mg. ʻOval, biconvex, ʻelua ʻāpana, hoʻokahi papa mai ke aniani ʻulaʻula a i ulaula, ka papa ʻē aʻe mai ke keʻokeʻo a hiki i keʻokeʻo me ka pink pink interspersed. Ma ke keokeo o nā papa i loko o ke āpau a loaʻa i ke "T" a me "2" ma nā ʻaoʻao ʻelua.

Pākuʻi helu

Nā pilikino pilikino a me nā huahana:

papa papa mai ke keʻokeʻo a kokoke i ke keʻokeʻo, ʻaʻohe pāpale, nā ʻāpana like ʻole, me nā paʻi "T" a me "L" ma nā ʻaoʻao ʻelua o ke kī hala ʻole ma kahi ʻaoʻao a me kahi paʻi o "40" (no nā papa he 40 mg) a i ʻole ka hoʻohālikelike ʻana i ka "80" ( no na papa o 80 mg) ma kela aoao.

Nā Hoʻohui

Hypersensitivity (me nā derivatives sulfonamide ʻē aʻe, cholestasis, hōʻeha o ka hōʻeha ʻeha, hōʻeha o ka renal nui (CC ma mua o 30 ml / min), hypokalemia, hyponatremia, hypercalcemia, holomua frolose intolerance (piha sorbitol), hapai, lactation, ʻokoʻa a hiki i ka 18 mau makahiki (ʻaʻole i hoʻokūpaʻa ʻia ka maikaʻi a me ka palekana). E mālama ʻia: ka hemahema ole a me ka maʻi ʻōpiopio holomua (ʻoi aku o ka coma hepatic ma muli o nā hana hoʻopalehu electrolyte), stenosis bilateral o ka keiki. arterial arteri a i ʻole stenosis o hoʻokahi arteritis kūloko, hōʻino o ka hakahaka, ke ʻano ma hope o ka hoʻololi ʻana i ka huehue, hoʻēmi i ka bcc (ʻoi i ka terapi diuretic o mua, kaʻai me ka paʻa ʻana o ka paʻakai o ka paʻakai, ka ʻōpū a me ka luaʻi paha), ka puʻuwai puʻuwai, aortic a mitral stenosis, GOKMP, diabetes mellitus, CHD, SLE kohola.

Pehea e hoʻohana ai: dosis a me ke ʻano o ka mālama ʻana

I loko o kēlā me kēia, kahi manaʻo o ka meaʻai, 1 manawa i kēlā me kēia lā.

ʻO nā papa me kahi pākuʻi o ka telmisartan / hydrochlorothiazide 40 / 12.5 mg a me 80 / 12.5 mg hiki ke kuhikuhi i nā poʻe maʻi nona ka hoʻohana ʻana i ka telmisartan ma ke ʻano he 40 a i ʻole a i ʻole hydrochlorothiazide ma loko o kahi o 12.5 mg ʻaʻole alakaʻi i kahi kūpono o ke kahe koko.

ʻAʻole pono ka hoʻoponopono ʻana o ka maʻi no ka hiki ʻole o ke kīpē i ke kaumaha a me ka hōʻemi a me ke ʻano, a me nā mea maʻi maʻi.

Me ka hiki ʻole o ka pale ʻana i ka hōʻemi a i ka hōʻemi i ka maʻule, ʻaʻole eʻoi aku ka make ma mua o 40 / 12.5 mg i kēlā me kēia lā.

Ka hana lāʻau lapaʻau

ʻO Telmisartan kahi antagonist kikoʻī o ka ʻākoakoa o ka ʻāuna o ka angiotensin II (type AT1). 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. Kūkulu ia i kahi pilina lōʻihi me ka AT1 subtype o nā ʻĀnio angiotensin II. ʻAʻohe ona pilina no nā mea ʻē aʻe o nā mea hou aku, me ka ʻae o ka AT2 ʻĀpana, a me nā poʻe ʻē aʻe, i ʻole ka ʻono o nā mea hoʻonaninani. Ke alakaʻi nei ʻo Telmisartan i kahi hōʻemi i loko o ke kao o ka ald testosterone i loko o ke koko koko. ʻAʻole pili i ka hana o ka plasma renin a me nā kaila ion, ACE, ʻaʻole ia e hana i ka bradykinin.

I kahi papa ʻana o 80 mg, kahi paʻa loa i ka hopena hypertensive o ka angiotensin II. Noho ka hopena o ka lāʻau i ka 24 mau hola, ʻoiai me nā hola 4 i hala ma mua o ka lawe ʻana i ka hopena hou. Hoʻomaka ʻia ka hoʻomaka ʻana o ka hana hypotensive i loko o 3 mau hola ma hope o ke ʻano mua. ʻO ka haʻahaʻa loa i ke kahe o ke koko e nānā pinepine ʻia i nā 4 wiki ma hope o ka hoʻomaka ʻana o ka mālama ʻana.

Me ka hypertension arterial, e hōʻemi ana ia i ke kaomi toto systolic a me ka diastolic, me ka hoʻopi ʻole ʻana i ka helu o ka puʻuwai. 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".

ʻO ka Hydrochlorothiazide kahi diuretic thiazide. ʻAʻole pili i ka hoʻopiʻi hou ʻana o nā electrolytes i nā pālola renal, e hoʻonui pololei ana i ka hōʻina o Na + a me Cl- (e like me nā helu like like). Hōʻalo ka hopena diuretic i ka hōʻemi o ka bcc, kahi hoʻonui i ka hana o ka plasma renin, he hoʻonui i ka neʻe o ka ald testosterone a hele pū ʻia me ka piʻi ʻana o ka ʻike o K + a me nā bicarbonates i ka urine, a me hypokalemia hoʻi. Me ka hui pū ʻana o ka telmisartan, kahi i hoʻemi ai i ka nalowale ʻana o K + i kumu ʻia e ka hydrochlorothiazide, ma muli o ka blockade o ka ʻōnaehana renin-angiotensin-ald testosterone. Ma hope o ka lawe ʻana i ka hydrochlorothiazide, hoʻonui ka diuresis ma hope o 2 mau hola, ʻikea ka hopena nui loa ma hope o nā hola 4. Ua hoʻomau ka hopena diuretic no nā hola 6-12.

Loaʻa ka hopena antihypertensive kiʻekiʻe o ka lāʻau i ka 4 mau wiki ma hope o ka hoʻomaka ʻana o ka mālama ʻana.

Nā hopena hopena

Mai ka papa hana hanu: nā maʻi hōʻeha o ka ʻōpū hanu (e komo pū ana me ka bronchitis, pharyngitis, sinusitis), ka pōkole o ka hanu, dyspnea, ʻehaʻeha o ka hanu (me nā pneumonia a me ka edema pulmonary).

Mai ka CCC: bradycardia, tachycardia, arrhythmia, hōʻailona hōʻailona i ka hoʻokahe ʻana i ke koko, a me ka hypotension orthostatic, kaiitis necrotic (vasculitis), ʻehaʻeha.

Mai ka ʻaoʻao o ka pūnaehana nūhou: hoʻonui i ka huhū, ka manaʻo hopohopo, kaumaha, hopohopo, dizziness, palupalu, insomnia, hiki i ka wā e hele ana, paresthesia.

Mai ka papa hana ʻana: ʻeha o ka ʻōpū, ka ʻōpū, ka dyspepsia, gastritis, anorexia, ka make ʻana o ka makemake, sialadenitis, ka waha maloʻo, ka lemela, ka luaʻi, ka constipation, ka pancreatitis, ka maʻi āpau (hepatocellular a cholestatic).

Mai ka pūnaehana endocrine: hyperglycemia, glucosuria, ka hoʻomanawanui i ka hoʻohaʻahaʻa glucose.

Mai ka ʻaoʻao o ka hana o ka metabolism: hypercholesterolemia, hyperuricemia, hypokalemia, hyponatremia, hoʻemi i ka BCC, ʻaila electrolyte impaired, hypercalcemia.

Mai nā lālā hemopoietic: eosinophilia, anemia aplastic, anemia hemolytic, myelodepression, leukopenia, neutropenia / agranulocytosis, thrombocytopenia.

Mai ka pūnaehana urinary: nā maʻi o ka ʻōnaehana urinary, interstitial nephritis, impalired renal function.

Mai ka pūnaehana musculoskeletal: arthralgia, arthrosis, ʻeha i ka ʻeha, nā ʻeha ʻeha loa, myalgia, koʻo twulching o nā ʻUlima puʻupuʻu (crumpi), nā hōʻailona e like me ka tendonitis, nāwaliwali o ka mākia, nā māpuna o ka naʻau.

He ʻano hopena: ke ʻano o ka anaphylactic, eczema, erythema, ka ʻehaʻeha, ka hopena ʻulaʻala o ka peʻe, ʻulaʻula a ka ʻula, photosensitivity, ʻiliʻili i ka ʻili o ka lā, SLE exacerbation, toxic epidermal necrolysis, angioedema, urticaria.

Mai nā papa inoa sensory: visual acuity disorders, blurred visual percept (transient), xanthopsia, vertigo.

Mai ka papa hana hua: hoʻemi i ka potency.

Nā hōʻailona kuhikuhi: ka hōʻemi i ka Hb, hypercreatininemia, hoʻonui i ka hana o ka "transaminases" ati, hypertriglyceridemia.

Nā mea'ē aʻe: maʻi like-flu, maʻi, hoʻonui ʻia ʻana. Nā hōʻailona (telmisartan): hōʻailona hōʻailona i ka hoʻokahe koko, tachycardia a me / a bradycardia.

Nā ʻōmole (hydrochlorothiazide): hypokalemia (spasm muscle, nui ka arrhythmia i kumu o ka hoʻohana ʻana o ka glycosides cardiac a i ʻole nā ​​antiarrhythmic lāʻau lapaʻau), hypochloremia, dehydration ma muli o ka diuresis nui, nausea, nā hiamoe.

Hoʻomaʻamaʻa: ka induction o ka luaʻi, gastage lavage, charcoal hoʻōla, hōʻailona a me ke kākoʻo kākoʻo, nānā i ke kāʻei o nā electrolytes a me ka hana i loko o ka serum koko. Ma ka hihia o kahi emi o ke neʻe i ke koko, pono e kau ka mea maʻi i kahi kūlana, e hoʻoulu hou ana i ka nalowale o nā electrolytes, bcc.

ʻAʻole neʻe ʻia ka Telmisartan e ka hemodialysis. ʻAʻole paʻa i ka kiʻekiʻe o ka wehe ʻana o ka hydrochlorothiazide i ka wā hemodialysis.

Nā ʻōlelo kikoʻī

I ka maʻi me ka bilateral renal stenosis stenosis a me ka stenosis arterial o ka mea hana wale nō i ka wā e hoʻohana ai i nā lāʻau lapaʻau e pili ana i ka renin-angiotensin-ald testosterone, ʻo ka hopena o ka hōʻemi a hoʻōla ʻole e hoʻonui.

ʻAʻoheʻike i loaʻa me ka hoʻomākaukau ma ka poʻe maʻi me ka hōʻeha ʻole o ka renal a i ʻole ma hope o ke hoʻololi ʻana i ka maʻi o ka maʻi. Me ka hoʻohaʻahaʻa a me ke kahakaha ʻole o ka hāʻule ʻole o ka renal, ua hoʻoholo ʻia ka manawa maʻamau o ka neʻe ʻana o K +, hoʻolālā ʻia ka mea hana i loko o ka serum koko. ʻO ka hoʻohanaʻana i ka diuret thiazide i nā maʻi me nā pilikia ʻole e hiki ke alakaʻi i ka azotemia. Hoʻomaopopo ʻia ka nānā ʻana no ka hana ʻana i nā hana o ka lolo.

I ka poʻe maʻi me ka hoʻohaʻahaʻa i ka BCC a me / a i ʻole hyponatremia (ma muli o ka diuretic therapy, ke kaupalena ʻana i ka paʻakai, ka maʻi a i ʻole ka luaʻi), i hoʻomoʻa ʻia kahi maʻi o ka hoʻokaʻina o ke koko e ulu, ʻo ia hoʻi ma hope o ka lawe ʻana i ka hopena mua o ka lāʻau. Ma mua o ka hoʻohana ʻana i ka lāʻau lapaʻau, pono ke hoʻoponopono ʻana i kēia mau maʻi.

I ka poʻe maʻi me ka maʻi nui o ka CHF, ka hopena o ka stenosis renal, ka hoʻohana ʻana i nā lāʻau lapaʻau e pili ana i ka mokuʻāina o ka renin-angiotensin-aldosterone system, hui pū ʻia me ka hoʻomohala ʻana i kahi nui o ka hoʻokahe nui ʻana i ke koko, hyperazotemia, oligouria, a i ʻole, i nā wā lohi, ʻo ka hopena ʻole ʻole o ka renal.

I ka poʻe maʻi me ka hyperaldosteronism maʻamau, nā lāʻau antihypertensive, ka hana o ka hana o ka mea e pale ai i ka hana o ka renin-angiotensin-aldosterone ka mea maʻamau. I kēlā mau kūlana, ʻaʻole i ʻōlelo ʻia ka koho ʻana o ka lāʻau.

I nā maʻi me ka maʻi maʻi, e hoʻoponopono ʻia ka hoʻoponopono ʻana i ka insulin a i ka lāʻau hypoglycemic waha paha. I ka wā o ka mālamaʻana me ka diuretics thiazide, hiki i kahi mea kikoʻī ke hōʻike i ka maʻi maʻi.

I kekahi mau hihia, hiki i ka hoʻohanaʻana o ka diuret thiazide e ulu i ka hyperuricemia a me ka gout.

I ka wā o ka mālama ʻana, pono ka nānā ʻana i kēlā me kēia ka paʻa o nā electrolytes i loko o ka serum koko.

Hōʻalo ka piʻi ʻana o ka hypokalemia i nā mea maʻi me ka cirrhosis, me ka nui o ka diuresis, ke hiki ʻole o ka hoʻokaʻoli ʻana i ka waha o ka electrolytes, a i ka hopena o ka hoʻohana like ʻana o ka GCS a i ka ACTH

ʻO Telmisartan, kahi ʻāpana o ka lāʻau lapaʻau, hiki ke alakaʻi iā hyperkalemia. ʻOiai ʻaʻole i hōʻike ʻia ka maʻi nui o ka hyperkalemia me ka hoʻohana ʻana i ka mākaukau, pono e hoʻomaopopo ʻia he mea pili nā pilikia no kona hoʻomohala ʻana i nā renal a / a i ʻole ka naʻau paʻakikī a me ka maʻi mellitus.

ʻAʻohe mea hōʻike i hiki i ka lāʻau e hōʻemi a pale aku i ka hyponatremia i kumu o nā lāʻau diuretic. Hōʻike iki pinepine ʻia ka hypyploremia a ʻaʻole pono ke hoʻoponopono.

Hiki i ka Hydrochlorothiazide ke emi i ka excretion Ca2 + a me ke kumu (i ka ʻike ʻole ʻana o ka hoʻopiʻi ʻana o Ca2 + metabolic mea hoʻolilo) transient a me hypercalcemia liʻiliʻi. ʻO nā hypercalcemia koʻikoʻi nui paha kahi hōʻailona o ka hyperparathyroidism latent. Ma mua o ka hoʻoholo ʻana i ka hana o nā kihi parathyroid, pono ke kāpae ʻia ka lāʻau lapaʻau.

I nā mea maʻi me ka maʻi ʻalopona coronary, kahi mākau i hōʻailona nui i ka neʻe koko e hiki ke alakaʻi i ka infocococion a my stroke ranei.

ʻO ka papa ʻōlelo i kēlā lā i kēia lā he 40 / 12.5 a i ʻole 80 / 12.5 he 169 a 338 mg o sorbitol, ia manawa.

Hoʻopilikia ka hopena o ka hoʻomohala ʻana i nā maʻi kūlohelohe i ka hydrochlorothiazide i nā mea maʻi me ka mōʻaukala o nā maʻi alaka i ʻole a paʻa bronchial.

Aia kekahi mau mana e pili ana i ka hoʻolālāʻana o SLE e hoʻohana ana i ka diuretics thiazide.

Hiki i ka lāʻau lapaʻau, inā pono, e hoʻohana pū me ka hui pū me nā lāʻau antihypertensive.

I ka wā o ka mālama ʻana, pono e mālama ʻia i ka wā e hoʻomaʻamaʻa ana i nā hana ʻeha (me ke kaʻa ʻana i kahi kaʻa) e pono ai ka nui o ka nānā ʻana a me ka wikiwiki o ka hopena psychomotor (ʻo ka hoʻomohala ʻana i ka hānā a me ka pohō i ka wā e hoʻohana ai i nā lāʻau antihypertensive).

ʻAʻoleʻike kahi Telmisartan i ka hopena teratogenic, akā loaʻa kahi hopena fetotoxic. I ka hihia o kahi hapai i hoʻolālā ʻia, pono e hoʻololi pono i ka lāʻau me nā lāʻau lapaʻau ʻē aʻe no ka hoʻohana ʻana i ka wā hāpai. Inā hoʻoholo ʻia ka male hāpai, pono ʻoe e ho'ōki i ka lawe ʻana i ka lāʻau.

I ka trimester II a me III, ʻo ka hoʻohanaʻana i ka lāʻau hiki ke hoʻopilikia i ka pilikia o ka electrolyte i ka pūpū. ʻO ka hoʻomohala ʻana o ka thrombocytopenia neonatal, jaundice (ma ka pūpū a i ʻole ka hānau keiki) ma ka hihia a ka makuahine e lawe ana i ka diuretics thiazide. ʻAʻole i ʻike ʻia inā hoʻokomo ka telmisartan i ka waiū umauma, hiki i ka diuretics thiazide i loko o ka waiū umauma a hiki ke pale i ka lactation.

Hoʻohui

Me ka hana like o Li + a me angiotensin II antagonist receptor, he hoʻonui i ke kahe ʻana o Li + i loko o ka serum koko a me ka hoʻonui ʻana i nā hopena o nā mea make. ʻO ka hoʻohana ʻana o ka hydrochlorothiazide e hōʻemi ana i ka holoi ʻana o Li +. Pono e nānā pono ai, nānā i ka ʻike ʻana o Li + ma ka serum.

Hoʻohālikelike ʻia ka hopena hypokalemic o ka hydrochlorothiazide e ka hopena o ka potassium-sparing of telmisartan. Eia naʻe, hiki ke hoʻonui ʻia i ka hopena hypokalemic o ka hydrochlorothiazide e nā lāʻau ʻē aʻe e alakaʻi ana i ka hypokalemia (me nā diuretics ʻē aʻe, laxatives, GCS, ACTH, amphotericin, carbenoxolone, penicillin G sodium, acid salicylic a me nā mea kikoʻī).

ʻO ka hoʻohana like ʻana o ka diuretics potassium-sparing, K + hoʻomākaukau, a me nā lāʻau lapaʻau hou e hiki ke hoʻonui i ka serum K + content (me ka sodium heparin), K + -ʻāpono i nā mea hoʻolako meaʻai hiki ke alakaʻi i ka hyperkalemia.

Me ka hoʻohana pū ʻana me ka glycosides cardiac, antiarrhythmic a me nā lāʻau lapaʻau ʻē aʻe e hoʻoulu ai i ka arrhythmias cardiac e like me ka pirouette, nānā pinepine ʻia nā kahe ʻana o K + i ka plasma koko.

Hoʻonui ka Telmisartan i ka hopena hypotensive o nā lāʻau anti antihypertensive.

Hiki i ka lāʻau lapaʻau ke hoʻonui i ke kao o ka digoxin (a hiki i 39%), no laila, hiki ke nānā aku i ka nānā ʻana o nā kukuna o ka plasma o ka digoxin.

ʻO ka hoʻohana pū ʻana o ka hydrochlorothiazide me ka ethanol, barbiturates, narcotic analgesics - ka hopena o ka hoʻomohala ʻana i ka hypotension orthostatic, me nā ʻaihue hypoglycemic (ma o waha a me ka insulin) - nā dosage o ka lāʻau hypoglycemic e koi ʻia, me ka metformin - ka hopena o ka waikawa lactic, me ka colestyramine a me ka colestiposis me nā glycosides cardiac - ka hopena o ka hypokalemia a i ʻole hypomagnesemia (arrhythmias), me nā NSAIDs - e hoʻemi ana i ka diuretic, natriuretic a me nā hopena antihypertensive hydrochlorothiazide, me ka mea hana nūmū (me ka norepinephrine - nā nāwaliwali o ka hopena o nā ʻōmino pressor, me nā mea hōʻeha ʻole i ka hoʻoneʻe ʻana i nā ʻōpū (e pili ana i ka tubocurarine) - ka hoʻonui ʻana i ka hana o nā hoʻomaha hoʻomaha o ka musio, me ka antigout - e koi ʻia paha ka hoʻoponopono ʻana o ka lāʻau uricosuric, no ka mea (ma muli o ke ʻano maʻi. i hoʻoneʻe ʻia e ka hydrochlorothiazide), me allopurinol - ke piʻi ʻana o ka hopena o ka hopena hypersensitivity i allopurinol, me nā kaona Ca2 + - ke kīpilikia o ka hoʻomohala ʻana i ka hypercalcemia (ma muli o ka emi ʻana o kona kaila), me nā beta-adrenergic blockers a me Diazok huaʻano - ka hopena o ka hoʻonui i ka hyperglycemia, me nā m-anticholinergics (me ka komo pū atropine, biperiden) - hoʻonui bioavailability o hydrochlorothiazide (ma muli o ka emi ʻana o ka make o gastrointestinal).

Hiki i ka lāʻau lapaʻau ke hoʻonui i ka hopena o nā hopena o ka amantadine, e hōʻemi i ka excretion renal o nā lāʻau cytotoxic (me ka cyclophosphamide, methotrexate) a hoʻonui i kā lākou myelosuppressive hopena.

Lapaʻau lāʻau

ʻO ka Hydrochlorothiazide kahi diuretic thiazide. Hoʻopilikia ka Thiazide diuretics i ka reabsorption o nā electrolytes i loko o nā renal renal, e hoʻonui pinepine i ka hoʻonui ʻana o ka sodium a me nā chlorides (ma kahi kokoke i nā helu like). Ka hopena o ka diuretic o ka hydrochlorothiazide i ka hoʻohaʻahaʻa i ka bcc, kahi hoʻonui i ka hana ʻo renin plasma, he hoʻonui i ka huna ʻana o ka aldosterone, e ukali ʻia ana e ka nui o ka pā ʻana i ka paʻakai a me ka hydrogen carbonates a, ma muli o kēia, he hoʻemi ma kā ka paʻakai i loko o ka plasma koko.Me ka hoʻomohala pinepine ʻana me ka telmisartan, aia ka manaʻo e hoʻōki i ka nalowale o ka paʻū ma muli o kēia mau diuretics, ʻo ke kumu paha me ka blockade RAAS.

Ma hope o ka lawelawe waha, hoʻonui ʻia ka diuresis ma hope o 2 mau hola, a ʻike ʻia ka hopena nui loa ma hope o nā hola 4. Ua hoʻomau ka hopena diuretic o ka lāʻau i nā hola 6-12.

ʻO ka hoʻohana wā lōʻihi o ka hydrochlorothiazide e hōʻemi i ka hopena o ka hoʻopiʻi o ka maʻi cardiovascular a me ka make ma o lākou nei.

Telmisartan - Kuhi ARA II (Kuhi AT₁), kūpono inā lawe ʻia ma ke ʻano. He kuleana koʻikoʻi ma ka subtype AT₁nā mea nānā aku o ka angiotensin II, kahi i ʻike ʻia ai ka hana o ka angiotensin II. Hōʻike i ka angiotensin II mai ka pilina me ka mea nāna i hōʻike, me ka ʻole e hōʻike ana i nā ʻano o kahi agonist e pili ana i kēia receptor. Hoʻopili wale ʻo Telmisartan i ka AT subtype₁nā ʻĀina o ka angiotensin II. Ke hoʻomau nei ka pilina. ʻAʻole loaʻa kahi pilina no nā receptors ʻē aʻe, incl. i AT₂nā mea ākea a me nā mea hou aku i ʻoluʻolu. 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 ke kao o ka ald testosterone i ka plasma koko, ʻaʻole i pale i ka renin i loko o ke koko koko a ʻaʻole paʻa i nā kao wai. ʻAʻole keʻae ʻo Telmisartan i ka ACE (kininase II), kahi e hoʻomaʻemaʻe hoʻi i ka hōʻemi o ka bradykinin. No laila, ʻaʻole i manaʻo ʻia ka hoʻonui ʻana o nā hopena i hoʻopiʻi ʻia e bradykinin.

I ka poʻe maʻi me ka hypertension arterial, telmisartan ma ke ʻano o ka 80 mg piha i ka hopena o ka 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 lawelawe mua ʻana o ka telmisartan. Noho ka hopena o ka lāʻau no 24 mau hola a kū mau i nā hola 48. He hopena antihypertensive e hoʻomaʻamaʻa pinepine i nā hebedoma 4 ma hope o ka hoʻohana maʻamau ʻana i ka lāʻau.

I ka poʻe maʻi me ka hypertension arterial, hōʻemi ʻo telmisartan i ka SBP a me DBP me ka hoʻopi ʻole ʻana i ka hapa o ka puʻuwai.

I ka hihia o ka hōʻano pani ʻana o ka telmisartan, pane iki ka maʻi koko i kona pae kumu me ka ʻole o ka hoʻomohala ʻana i ka maʻi withdrawal.

I loko o kahi haʻawina me ka telmisartan, nā loiloi o ka make ma cardiovascular, ʻaʻole he momona o myocardial infarction, non-fatal stroke, a i ʻole ka hoʻokipa ma muli o ka hiki ʻole o ka naʻau ma ka loiloi. ʻO ka emi ʻana o ka morbidity cardiovascular a me ka make ma ka poʻe maʻi me ka nui o ka maʻi cardiovascular (coronary artery disease, stroke, peripheral arterial maʻi a i ʻole diabetes mellitus me ka hoʻopiʻi ʻana i nā pōpoki i makemake ʻia e like me ka retinopathy, haʻalele i ka hypertrophy ventricular, macro-a i ʻole microalbuminuria i ka mōʻaukala) ua hōʻoia ʻia. ma luna o 55 makahiki.

ʻO ka hopena kiʻekiʻe antihypertensive o ka lāʻau Telsartan ® N i ʻike pinepine ʻia i nā 4 wiki ma hope o ka hoʻomaka ʻana o ka mālama ʻana.

Lapaʻau lāʻau

ʻO ka hui pū ʻana o ka telmisartan a me hydrochlorothiazide ʻaʻole i pili i ka pharmacokinetics o kēlā me nā mea pono o ka lāʻau.

Ma hope o ka hoʻoponopono waha ʻana i ka lāʻau Telsartan ® N C_max Loaʻa ka hydrochlorothiazide plasma i loko o nā hola 1-3.ʻO ka bioavailability piha pololei e pili ana i ka 60% (e pili ana i ka piha o ka kidney excretion). ʻO nā protein Plasma e hoʻopaʻa nei i ka 64% o ka hydrochlorothiazide, a me V_{e d} is (0.8 ± 0.3) l / kg. ʻAʻole i hoʻohālikelike ʻia ka Hydrochlorothiazide i loko o ke kino a hoʻopiʻi ʻia e nā keiki i aneane e loli ʻole. Ma kahi o 60% o ka nui kaʻauʻau i hoʻopau ʻia i nā hola 48. ʻO ka hoʻoneʻe ʻana o Renal ma kahi o 250-300 ml / min. T_1/2 ʻO ka hydrochlorothiazide he 10-15 mau hola.

Aia kekahi ʻokoʻa ma ka nānā ʻana o ka plasma i loko o nā kāne a me nā wahine. I nā wahine, ʻo ka pilu o ka telmisartan i ka plasma he 2-3 mau manawa ma mua o nā kāne, a ʻo nā wahine hoʻi ke ʻohi nui i ka nui o ka hōʻola i nā mea paʻa o ka plasma o ka hydrochlorothiazide.

ʻO Renal hiki ʻole. I ka poʻe maʻi me ka hana renal impaired, hoʻemi ʻia ka helu o ka haʻalele ʻana o ka hydrochlorothiazide. Nā hōʻike i nā maʻi me 90 ml / min creatinine Cl i hōʻike ʻia ʻo T_1/2 Hoʻonui ka hydrochlorothiazide. I ka poʻe maʻi me ka hoʻokaʻawale ʻana o nā hana ren T_1/2 ma kahi o 34 mau hola

I ka wa e nānā koke ʻia ai ʻŌpala Gastrointestinal. ʻO ka bioavailability e pili ana i ka 50%. Aia ka pae kiʻekiʻe ma hope o nā hola 0.5-1.5. I ka manawa like i ka manawa like me ka ʻai, ʻo ka emi ʻana o ka AUC mai 6 ka 19% (i ka wā e lawe ai i ka ʻai he 40 a me 160 mg, kēlā me kēia). 3 mau hola ma hope o ka nānā ʻana, e hoʻonaninā ʻia ka ʻike ʻana i ke kaila koko me ka manaʻo ʻole o ka ʻaina.

Aia ka ʻokoʻa ma ka ʻike ʻana o ka telmisartan ma ka plasma i nā kāne a me nā wahine. C_max i ka plasma, e pili ana i 3 mau manawa a me AUC e pili ana i 2 mau manawa ke kiʻekiʻe o nā wahine i hoʻohālikelike ʻia me nā kāne me ka loaʻa ʻole o kahi hopena koʻikoʻi. Eia naʻe, ʻaʻole mālama ʻia ka hopena o ka hopena hypotensive i loko o nā wahine.

ʻO ka hui nui me nā protein plasma (ma luna o 99.5%), ʻo ka nui me ka albumin a me alpha₁-acid glycoprotein. V_{e d} aneane 500 lita

Hoʻopili ʻia ka Telmisartan e ka hoʻokūkū me ka waikawa glucuronic. Lapaʻau nā metabolites me ka hana ʻole. T_1/2 he keu ma mua o 20 mau hola

Hoʻokuʻu ʻia ʻo ia ma o ka ʻōpū i ka loli, excretion e nā keiki - i emi iho ma mua o 2%. ʻO ka huina piha clearance plasma ke kiʻekiʻe (ma kahi o 900 ml / min).

ʻO nā maʻi maʻi. ʻAʻole ʻokoʻa nā pharmacokinetics o ke telmisartan i nā maʻi maʻi ma o nā mea maʻi ʻōpio. ʻAʻole pono ke hoʻoponopono ʻia.

ʻO Renal hiki ʻole. Ke loli nei i ka hapa o ka telmisartan i nā mea maʻi me ka loaʻa ʻole o ka pilikia ʻole i koi ʻia, me ka poʻe maʻi ma ka hemodialysis. ʻAʻole neʻe ʻia ka Telmisartan e ka hemodialysis.

ʻO ka hana hema ʻole. Hōʻike noiʻi o nā pharmacokinetics i nā mea maʻi me ka maikaʻi ole o ka naʻau e hoʻonui i ka bioavailability kūʻokoʻa a hiki i ka 100%. Me ka ʻiʻo hema o T_1/2 ʻaʻole e loli (ʻike. "Dosage a me ka hoʻokele").

ʻŌpū a me ka lactation

Hoʻopili ʻia ka hoʻohana ʻana o ka lāʻau Telsartan ® N i ka wā hāpai.

Loaʻa ka ʻike me ka hydrochlorothiazide i ka wā hapai, ʻoiai ʻo ia ka wā o ka trimester mua, ua kaupalena ʻia.

Hoʻopaʻa ka Hydrochlorothiazide i ka papale placental. Hāʻawi ʻia i ka papa hana ʻomakakaluma hana o ka hydrochlorothiazide, e manaʻo ʻia ai ka hoʻohana ʻana i ka wā o ka trimesters lua a me ke kolamu o ka hapai hiki ke hoʻonāukiuki i ka hoʻōla ʻana o ka fetoplacental a ma muli o nā loli i ka embryo a me ka fetus, e like me ka jaundice, nā haunaele ma ka kaulike wai-electrolyte a me ka thrombocytopenia.

ʻAʻole pono e hoʻohana ʻo Hydrochlorothiazide e mālama i ka hypertension koʻikoʻi i loko o nā wahine hāpai, koe wale nō i kēlā mau kūlana hanana i ʻole e hiki ai ke hoʻohana ʻia nā lāʻau ʻē aʻe.

Ua hoʻohana ʻia ka hoʻohana ʻana o ARA II i ka wā hāpai ʻana.

Ke hōʻike nei i ka hapai, pono e hoʻokuʻu koke i ka lāʻau.

Inā kūpono, pono e hoʻohana ʻia nā lāʻau lapaʻau ʻē aʻe (me nā papa ʻē aʻe o nā lāʻau antihypertensive i ʻae ʻia no ka hoʻohana ʻana i ka wā hāpai).

Ka maʻi me ka Telsartan ® H i ka wā o ka ʻōpū.

I nā haʻawina holoholona, ​​ʻaʻole i nānā ʻia nā hopena o ka telmisartan a me ka hydrochlorothiazide ma ka uluʻana. ʻAʻole i hana ʻia nā haʻawina e pili ana i nā hopena ma ka ulu ʻana o ke kanaka.

ʻ a me ke kākele

I loko e pili ʻole i ka mea ʻai.

Pono ka telsartan ® N i lawe i ka manawa 1 i kēlā me kēia lā.

Hiki ke kuhikuhi ʻia ʻo Telsartan ® N (12.5 mg + 40 mg) i nā mea maʻi i ka monotherapy me ka telmisartan ma ke ʻano o ka nui o ka 40 mg a i ʻole monotherapy me hydrochlorothiazide, ʻaʻole alakaʻi i ka lawa pono o ke kahe koko.

Hiki ke kuhikuhi ʻia ʻo Telsartan ® N (12.5 mg + 80 mg) i nā mea maʻi i loaʻa iā ia ka monotherapy me ka telmisartan ma ke ʻano o ka 80 mg a i ka lāʻau lapaʻau ʻo Telsartan ® N (12.5 mg + 40 mg) ʻaʻole alakaʻi i ka lawa pono o ke kahe koko.

I ka poʻe maʻi me ka maʻi hypertension arterial, ʻoi loa ka nui o ka nui o ka nui o ka telmisartan o 160 mg / lā. Ua hoʻomaopopo maikaʻi ʻia kēia pākē a me ka hana pono.

Nā hui ahonui kūikawā

Hola paʻa kino hana. ʻO ka ʻike palena ʻole i ka hoʻohana ʻana o ka hui ʻana o ka hydrochlorothiazide a me ke telmisartan i nā mea maʻi me ka maʻi liʻiliʻi a hōʻemi paha i ka hopena, ʻaʻole ia e koi i nā loli i kēia mau hihia. I kēlā mau mea maʻi, pono e nānā ʻia nā hana ʻoi aku (me Cl Clinine ma mua o 30 ml / min, e ʻike i "Contraindications").

Hōʻeha ka hana ʻoluʻolu. I nā mea maʻi me ka puʻuwai māmā i ka pehu lewa (hoʻolaʻa keiki-Pugh A a me B), nā awela o kēlā me kēia lā o Telsartan ® N ʻaʻole iʻoi aku i ka 12.5 mg + 40 mg i kēlā me kēia lā (e ʻike i ka Pharmacokinetics).

Mamua. ʻAʻole pono ka regimen dosage i nā loli.

Ke keu

ʻAʻole i hōʻike ʻia nā hihia o ka overdose. Loaʻa nā hōʻailona o kahi overdose i nā hōʻailona mai nā ʻāpana o ka lāʻau.

Nā hōʻailona o kahi overdose o ka hydrochlorothiazide: nā haunaele i ka wai o ka wai-electrolyte o ke koko (hypokalemia, hypochloremia), kahi hoʻemi ʻana i BCC, hiki iā ia ke alakaʻi i nā kuʻuna o nā muse a me / a i nā mea hoʻonāukiuki mai ka CCC: arrhythmias i kumu o ka hoʻohana ʻana o ka glycosides cardiac a i ʻole kekahi mau lāʻau antiarrhythmic.

Nā hōʻailona o kahi hanana o ka telmisartan: hōʻailona hōʻemi i ke koko, tachycardia, bradycardia.

Lāʻau: therapy maʻi maʻi maʻi, hemodialysis hiki ole. ʻAʻole paʻa i ka kiʻekiʻe o ka wehe ʻana o ka hydrochlorothiazide i ka wā hemodialysis. Pono ka nānā ʻana i nā ʻike electrolyte a me ka paʻa serum creatinine.

Mea hana

ʻO Dr. Reddy's Laboratories Ltd., India. Kauka. ʻO Reddy's Laboratories Ltd., India. ʻĀina Hana-III, Sy. No. 41, Village Bachupally, Qutubullapur Mandal, Ranga Reddy District, Telangana, India.

Pono e hoʻouna ʻia nā ʻike e pili ana i nā hoʻopiʻi a me nā hōʻemi ʻana i nā lāʻau lapaʻau ʻānō: Ke poʻo luna ʻo Dr. Reddy's Laboratories Ltd. 115035, Moscow, Ovchinnikovskaya nab., 20, p. 1.

Tel .: (495) 795-39-39, fax: (495) 795-39-08.

ʻO nā waiwai Pharmacological

ʻO Telmisartan kahi antagonist kikoʻī o ka receptor II ka angiotensin (type AO 1), e hana ana ma ke ʻano waha. Noho i kahi pilina kiʻekiʻe, ua loli ka telmisartan angiotensin II i kāna hana me ka mea hoʻokipa AO 1 subtype, nona ke kuleana o ka angiotensin II. ʻAʻole ia i hōʻike i Telmisartan i kekahi hana puʻupuʻu ma ka mea hoʻokipa AO 1 e like me kahi agonist. Hoʻopili paʻa nā Telmisartan i kahi mea hōʻike i ka AO 1 no ka manawa lōʻihi. ʻAʻole hōʻike ka lāʻau lapaʻau i ka pili o nā mea ʻē aʻe, e komo pū ana me AO 2 a me kekahi mau mea ʻē aʻe i nā mea i ʻae ʻia e AT. ʻAʻole maopopo ka hana koʻikoʻi o kēia mau mea nānā, a me ka hopena o kā lākou hiki ke hoʻoulu ʻia me ka angiotensin II, ka nui o ka hoʻonui ʻana i ka telmisartan. Ke hōʻemi nei ʻo Telmisartan i nā pae koko ald testosterone. ʻAʻole keʻae ʻia ka Telmisartan e ka plasma renin kanaka, ʻaʻole ia e kāohi i nā kahawai ion. ʻAʻole keʻae ʻo Telmisartan i ka ACE (kinase II), e hāhai ana hoʻi i ka bradykinin. No laila, ʻaʻole e manaʻo kekahi e hoʻonui i nā hopena ʻino e pili ana me ka bradykinin.

I nā kāne, ʻo ka telmisartan ma ke ʻano o 80 mg aneane e hoʻopau loa i ka hopena o ka angiotensin II ma ka hoʻonui ʻana i ke koko.

He mākaukau me ka palekana

ʻO ka mālamaʻana i ka hypertension pono

Ma hope o ka hopena mua o ka telmisartan, e hoʻomaka ka hopena antihypertensive i loko o 3:00. ʻO ka haʻahaʻa loa i ke kahe o ke koko e loaʻa iā 4-8 mau pule ma hope o ka hoʻomaka ʻana o ka lāʻau a hoʻomau i ka hoʻomehana lōʻihi.

Ke hoʻomau nei ka hopena antihypertensive no ka ʻoi aku o ka lā ma hope o ka lawe ʻana i ka ʻai, ʻo ia nō ma ka hola 4:00 ma mua o ka hopena hou, e like me ka hōʻike ʻana i ka outpatient ana i ke kahe o ke koko. Hōʻoiaʻiʻo ʻia kēia e ka ratio o ke koena i ka hopena hopena, ʻoi aku ka nui ma mua o ka 80% ma hope o ka hoʻohana ʻia ʻana o nā papa no 40 a me 80 mg o ka telmisartan i nā hoʻokolohua lapaʻau hau ʻia. Aia kahi pilina ma waena o ka inane a me ka hoʻihoʻi ʻana o ka manawa mua o ka systolic blood pressure (SBP). He ʻokoʻa nā ʻikepili e pili ana i ke koko koko diastolic (DBP).

I nā maʻi me ka hypertension arterial, hoʻemi ka telmisartan i nā hoʻonaninani systolic ʻelua a me ke kaomi diastolic, ʻoiai ʻaʻole ia e pili i ka ʻoli pulse. ʻO ke kumu o ka hopena diuretic a me ka natriuretic o ka lāʻau lapaʻau i kāna hana hypotensive ʻaʻole i hoʻoholo. ʻO ka hopena o ka telmisartan ma ke hoʻohaʻahaʻa ʻana i ke koko, ua hoʻohālikelike ʻia me nā lāʻau ʻē aʻe e hōʻike ana i nā papa ʻē aʻe o nā lāʻau antihypertensive (nā noiʻi hauoliau e hoʻohālikelike i ka telmisartan me ka amlodipine, atenolol, enalapril, hydrochlorothiazide a lisinopril).

Me ka wīwī wikiwiki ʻana i ka lāʻau telmisartan, hoʻemi kahe koko i ka pae i mua o ka mālama ʻana no nā lā he nui me nā hōʻailona ʻole e hoʻohuli ai i ka hypertension.

Ma nā hoʻokolohua lapaʻau, ma o ka hoʻohālikelike pono ʻana i ʻelua mau lāʻau antihypertensive, ʻoi aku ka nui o nā hihia o ka umu maloʻo ma mua o nā memai ACE inhibitors.

Hoʻopili koke ʻia ʻo Telmisartan, ʻoiai ke ʻano like ka ʻokoʻa o ka ʻili. ʻO ka awelika kūlohelohe kūʻokoʻa o ka telmisartan ma kahi o 50%. Ke hoʻohana nei i ka telmisartan me ka meaʻai, ka wahi ma lalo o ke kālai ʻana o ka manawa paʻa (AUC 0-decre) e emi ana i ka pae mai 6% (ma ke ʻano o 40 mg) i 19% (ma ke ʻano o 160 mg). 3:00 ma hope o ke noi ʻana, lawe like ka ʻike o ka telmisartan i loko o ke kaila koko i ka wā i lawe ʻia ai ma ka ʻōpū ʻole a i ʻole ke lawe ʻia me ka meaʻai.

ʻO kahi emi iki o AUC e manaʻo ʻia e hoʻemi i ka hopena therapeutic. ʻAʻohe pilina pilina ma waena o nā pona a me ka hoʻoliʻi plasma o ka lāʻau lapaʻau. C max a me, i ka meaʻuʻuku loa, hoʻonui ʻia ʻo AUC i ka disproportionately i ka nui o 40 mg.

Hoʻopili nui loa ʻo Telmisartan i nā protein plasma (> 99.5%), ʻo ka mea nui me ka albumin a me ka alpha-1 acid glycoprotein. ʻO ka nui nui o ka hoʻoili ʻana (V dss) i ka hoʻohālikelike e like me 500 L.

Hoʻohālikelike ʻia ka Telmisartan e ka conjugation o ka pūnaehana makua i ka glucuronide, ʻaʻohe hana o ka lāʻau lapaʻau me ka mea kipi.

Hāʻawi ʻia ka Telmisartan e ke kāneka ʻo pharmacokinetic bio-exponential me kahi hoʻopau hoʻopau hapa hapalua o nā ola ma mua o 20 mau hola. Ka umauma nui plasma (C max) a, ma kahi haʻahaʻa loa, ʻo ia ka wahi ma lalo o ka pihi-a me ka manawa o ka kukuna (AUC) e hoʻonui i ka maʻamau i ka pākī. ʻAʻohe mea iʻike i ka hōʻuluʻulu koʻikoʻi o ka tele o ka telmisartan i ka wā e hoʻohana ai i ka ʻoli i ʻōlelo ʻia ʻia. I nā wahine, ʻoi aku ka nui o nā kukuna plasma i mua o nā kāne me ka loaʻa ʻole o ka hopena koʻikoʻi.

Ma hope o ka lawelawe waha, ua pau loa nā telmisartan i nā feces, loli nui. ʻO ka huina piha o ka lāʻau me ka mimi he 70 mau makahiki. E hui pū me nā lāʻau ʻē aʻe e pili ana i ka renin-angiotensin-ald testosterone system, a me / a i ʻole ka hoʻohana ʻana i ka hoʻohui pā paʻakai.

Kuhi ʻia ka mālama pono ʻana i nā pae pākia i nā mea maʻi i ka pilikia.

ʻO nā pale o ACE, telmisartan, a me nā ʻili e hoʻonanea ai nā kahetensinin II II a ʻoi aku ka maikaʻi o ka hoʻohaʻahaʻa ʻana i ke kahe koko i nā mea maʻi o ka lāhui Negroid ma mua o nā lāhui ʻē aʻe, malia paha ma muli o ka poʻe maʻi me ka hypertension arterial o ka lāhui Negroid e hōʻemi i nā haʻahaʻa renin haʻahaʻa.

Ke hoʻohana nei i kekahi lāʻau lapaʻau antihypertensive, ʻo ka nui o ka hoʻokahe nui ʻana i ke koko i loko o nā mea maʻi me ka ischemic cardiopathy a i ʻole ischemic cardiovascular disease hiki ke alakaʻi i myocardial infarction a i ʻole stroke.

Hoʻohana i ka wā hāpai a lactation

ʻAʻohe data e pili ana i ka hoʻohana ʻana o Telmisartan no nā wahine hāpai.

ʻO ke kumu o ka epidemiological no ka hopena o ka teratogenicity ma muli o ka hoʻohana ʻana o nā inhibitor ACE i ka manawa mua o ka mākō mua o ka hapai i kūʻiʻo ʻole ʻia, akā, ʻaʻole i hoʻokele iki ʻia kahi liʻiliʻi i palena ʻole.

ʻAʻole pono e hoʻomaka ʻo Angiotensin II receptor antagonist i ka wā hāpai. Inā e hoʻomau ʻia ka hoʻomau ʻia o ka hoʻomau i ka lapaʻau ʻana me ka antagonist angiotensin II, a ke hoʻolālā nei ke kanaka maʻi i ka hapai ʻana, ʻoi aku ia e hoʻololi i ka mālama ʻana i ka terapi antihypertensive me kahi paʻa palekana paʻa i ka wā hāpai. Inā paʻa ka hānai, pono e hoʻokaʻawale koke i ka lāʻau me kaiotiotinin receptor antagonist.

Ua ʻike ʻia ka hoʻohana ʻana o ka angiotensin II antagonist receptor i ka wā o ka II a me III e hoʻomaʻamaʻa ʻana i ka hapai e hāpai ana i ka fetotoxicity i nā kānaka (hana ʻino ʻole i loko o ka maʻi, oligohydramniosis, lohi i ka hana o nā iwi cranial) a me nā meaʻeha o ka neonatal (pilikia ʻole, hypotension, hyperkalemia). Inā hoʻomaka ka hoʻohana ʻana o ka antagonist reseptor angiotensin II mai ka lua o ka hapalua o ka hapai ʻana, e kuhikuhi ʻia e hoʻokō i kahi loiloi ultrasound o ke akeʻa a me nā iwi o ka iwi ʻōlo. ʻO ke kūlana o nā pēpē i lawe ʻia e kona mau makuahine i ka anagonistin II receptor antagonist e nānā pono ʻia no ka maka o ka hypotension arterial (e nānā i nā Māhele "Contraindications" a "Features of use").

ʻAʻole makemake ʻia ʻo Telmisartan i ka wā mālama umauma, no ka mea ʻaʻole i ʻike ʻia inā ua excreted i ka waiū kanaka. Hoʻohana ʻia ka hana hou ʻana me ka maikaʻi palekana aʻo hou ʻia ka ʻoihana palekana, ʻoi aku ka nui o ka wā e hoʻolako ai i kahi pēpē a hānau keiki paha.