Telzap - ntuziaka maka ojiji, nyocha, ụdị analogs na usoro onunu ogwu (mbadamba 40 mg, 80 mg, Plus 80 mg 12, 5 mg na diuretic hydrochlorothiazide) ọgwụ maka ọgwụgwọ ọbara mgbali elu na iwetulata mgbali ọbara na ndị okenye, ụmụaka na ime.

N'isiokwu a, ị nwere ike gụọ ntuziaka maka iji ọgwụ Telzap. Na-enye nzaghachi sitere na ndị ọbịa na saịtị ahụ - ndị na-eri ọgwụ a, yana echiche nke ndị ọkachamara n'ịgwọ ọrịa gbasara iji Telzap na omume ha. Nnukwu arịrịọ bụ ka ịgbakwunye nyocha gị gbasara ọgwụ ahụ: ọgwụ ahụ nyeere aka ma ọ bụ enyereghị aka iwepụ ọrịa ahụ, ihe nsogbu na nsonaazụ ndị a hụrụ, ikekwe ọ bụ ọkwa onye nrụpụta na nkọwapụta. Analogs nke Telzap n'ihu ọnụnọ analogues dịnụ. Ojiji maka ọgwụgwọ nke ọbara mgbali elu dị ala na nrụgide dị ala n’ime ndị okenye, ụmụaka, yana n’oge afọ ime na n’ara. Ngwakọta ọgwụ ahụ.

Telzap - ọgwụ antihypertensive.

Telmisartan (ihe na-arụ ọrụ na Telzap) bụ onye na - emegide mmụọ anakpọ angiotensin nke abụọ (ụdị AT1), nke na - adị irè mgbe a na -eme ya n'ọnụ. O nwere ezigbo mmekọ dị na AT1 receptor subtype, nke a ga-esite na ya mee ihe omume nke angiotensin 2. Telmisartan napụrụ angiotensin 2 site na njikọta na onye na-anabata ya, na-enweghị ọrụ nke agonist n'ihe metụtara nnata a, na-ejikọ naanị na AT1 receptor subtype nke angiotensin 2. Njikọ ahụ kwụ chịm. Telmisartan enweghị mmekọrịta maka ndị na-anabata ndị ọzọ, incl. nye ndị na-anabata AT2 na ndị na-anabataghị angiotensin na-amụchaghị amụ. Ọdịghị uru ọrụ ndị nnata a bara, yana nsonaazụ nke ike ha nwere ike ọfụma ya na angiotensin 2, amụchaghị nke na-abawanye na nhọpụta nke telmisartan. Telmisartan na -ebelata mkpokọta nke aldosterone na plasma ọbara, anaghị ebelata ọrụ nke renin, ọ dịghịkwa egbochi ọwa ion. Telmisartan anaghị egbochi ACE (kininase 2), nke na-emekwa ka mbibi nke bradykinin mebie. Nke a na - egbochi mmetụta ndị metụtara nsonyezụ bradykinin (dịka ọmụmaatụ, ụkwara akọrọ).

Telzap na a dose nke 80 mg kpamkpam egbochi hypertensive mmetụta nke angiotensin 2. A na-ahụ mmalite mmalite nke antihypertensive n'ime awa 3 mgbe ọgwụ mbụ nke telmisartan. Mmetụta ọgwụ ahụ na-adịgide ruo awa 24 ma na-adịkarị egwu ruo na awa 48. Mmetụta ọgwụ na-egbu egbu na-ebikarị izu 4-8 mgbe ejiri ya mgbe niile.

N'ime ndị ọrịa nwere ọbara mgbali elu, telmisartan na-ebelata systolic na ọbara mgbali, na-enweghị emetụta mmetụ obi.

N'ọnọdụ kwụsịrị iwere Telzap, ọbara mgbali jiri nwayọ laghachi ọkwa mbụ ya karịa ọtụtụ ụbọchị na-enweghị mmepe nke ọrịa mwepụ.

Ọnụnọ nke okpukpu okpukpu dara nke ukwu na telmisartan ma e jiri ya tụnyere ndị na-egbochi ACE.

Mgbochi Ọrịa Obi

Ndị ọrịa gbara afọ 55 ma ọ bụ karịa site na ọrịa akwara obi, ọrịa strok, ọrịa ọnụnọ nke ọrịa, ọrịa mbibi, ma ọ bụ nsogbu nke ụdị ọrịa shuga 2 (dịka ọmụmaatụ, retinopathy, hypertrophy nke aka ekpe, macro- ma ọ bụ microalbuminuria) nke nwere ihe ize ndụ nke ọrịa obi. nke ihe omume, Telzap nwere mmetụta yiri nke ramipril na ibelata njedebe ejikọtara ọnụ: mkpụrụ ndụ akwara site na infarction myocardial na-enweghị nsonaazụ na-egbu egbu, ọrịa strok na-enweghị nsonaazụ na-egbu egbu na steeti. Oriri na-edozi n’ihi ọrịa obi na-ekweghị ala ala.

Telmisartan rụpụtara ọrụ dị ka ramipril n'ibelata ugboro ole isi ihe: ọnwụ obi, infarction myocardial na-adịghị egbu egbu.

A na-ejikarị ụkwara ọwụwa na angioedema akọwa ya na telmisartan ma e jiri ya tụnyere ramipril, ebe mgbagha ọbara na-ejikarị telmisartan.

Hydrochlorothiazide dị ka akụkụ nke Telzap Plus bụ thiazide diuretic. Thiazides na-emetụta nlọghachi nke electrolytes na teliles akụrụngwa, si otú a na-abawanye mkpịsị nke sodium na ion kloride na mkpokọ nha. Mmetụta diuretic hydrochlorothiazide na-eduga na mbelata na BCC, mmụba na ọrụ nke plasma renin, mmụba na mmepụta nke aldosterone, sochiri mmụba nke ọdịnaya potassium na bicarbonates na mmamịrị na mbelata ọdịnaya nke potassium na plasma ọbara. Ojiji nke telmisartan na-enyere aka belata mmebi nke potassium nke diuretic a kpatara, ikekwe n'ihi mgbochi RAAS. Mgbe iwere hydrochlorothiazide, diuresis na-abawanye mgbe oge awa 2 gasịrị, mmetụta kachasị na-etolite mgbe ihe dị ka awa anọ gasịrị, mmetụta ahụ dị ihe dị ka awa 6-12.

Ọmụmụ Epidemiological achọpụtala na ọgwụgwọ hydrochlorothiazide ogologo oge na-ebelata ihe ize ndụ nke ọrịa obi na ọnwụ.

Ngwakọta

Ndị na-ahụ maka Telmisartan.

Telmisartan + Hydrochlorothiazide + Ndị na-ere ahịa (Telzap Plus).

Mlọ ọgwụ

Mgbe e ji ọnụ kwuo okwu, a na-etinye Telzap ngwa ngwa site na nri diges. Bioavailability bụ 50%. A na-ejikọ Telmisartan na protein ndị dị na plasma, ọkachasị na albumin na alpha-1 acid glycoprotein. A na-agagharị ya site na conjugation na glucuronic acid. Na conjugate enweghị ọrụ ọgwụ. Ọ nọ na mpaghara eriri afọ na-agbanweghi, kpụrụ akụrụ - ihe na-erughị 1%.

Hydrochlorothiazide na-adịghị metabolized n'ime mmadụ. Ọ na - apịchachacha na mmamịrị ahụ. Ihe dị ka 60% nke ọgwụ a na -ewere ọnụ na-agbanweghị agbanwe n'ime awa 48. Mwepụ ntaramahụhụ bụ 250-300 ml / min.

Pharmacokinetics na otu ọrịa ọrịa pụrụ iche

Enwere ọdịiche na mkpokọta plasma nke telmisartan n'ime ụmụ nwoke na ụmụ nwanyị. Cmax na AUC gbara ihe dị ka ugboro atọ na ugboro abụọ karịa nke ụmụ nwanyị ma e jiri ya tụnyere ụmụ nwoke na-enweghị nnukwu mmetụta na arụmọrụ.

N'ime ụmụ nwanyị, enwere ebumnuche nke hydrochlorothiazide na plasma ọbara, nke a abụghị ihe dị mkpa n'ụlọ ọgwụ.

Aclọ ọgwụ ọgwụ nke telmisartan na ndị ọrịa agadi kariri afọ 65 dị iche na ndị ọrịa na-eto eto. Dose ukpụhọde adịghị.

N'ime ndị ọrịa nwere nsogbu gbasara akụrụngwa na-adịghị ala ala, ọ dị mkpa idozigharị nke telmisartan. Ndị ọrịa nwere nnukwu akụrụ gbasara akwara na ndị ọrịa nọ n'ọbara ha na-atụ aro obere mbido mbụ nke 20 mg kwa ụbọchị. Telmisartan adịghị agwọ ọrịa.

N'ime ndị ọrịa nwere ọrịa imeju na-arụ ọrụ dị nro ma ọ bụ nke na-adịghị ala (klas A na B dịka nhazi nke nwatakịrị).

Ihe na-egosi

ọbara mgbali elu,
mbelata onwu na ọrịa obi na ndị okenye nwere ọrịa obi nke ọrịa atherothrombotic sitere (IHD, ọnya ma ọ bụ akụkọ ihe mere eme nke ọrịa akwara) yana ụdị ọrịa shuga 2 nke ọrịa mebiri emebi.

Dị Mwepụta

Mbadamba 40 mg na 80 mg.

Mbadamba 80 mg + 12.5 mg (Telzap Plus).

Ntụziaka maka ojiji na usoro onunu ogwu

A na-a oụ ọgwụ ahụ ọnụ, 1 oge kwa ụbọchị, n'agbanyeghị nri oriri, a ga-eji mbadamba mmiri kwụọ mbadamba mmiri.

Ọgwụ mbụ a tụrụ aro Telzap bụ 40 mg (1 mbadamba) otu ugboro n'ụbọchị. Somefọdụ ndị ọrịa, ị theụ ọgwụ ahụ n'ihe dị ka 20 mg kwa ụbọchị nwere ike ịdị irè. Enwere ike inweta 20 mg site na ịkekọrịta mbadamba 40 mg na ọkara n'ihe ize ndụ. N'ọnọdụ ebe enweghị ọgwụgwọ ọgwụgwọ, enwere ike ịba ụba dose a tụrụ aro nke Telzap ruo 80 mg otu ugboro n'ụbọchị.

Dika ozo, enwere ike iburu Telzap yana aru oyuzu nke thiazide, dika imaatu hydrochlorothiazide, nke, mgbe ejikọtara ya, nwere uto antihypertensive. Mgbe ị na-ekpebi ma ịbawanye ọgwụ ahụ, ekwesịrị iburu n'uche na mmetụta antihypertensive kachasị na-arụkarị n'ime izu 4-8 mgbe mmalite nke ọgwụgwọ.

Mbelata ọnwụ na ọrịa obi

Usoro a tụrụ aro ya na Telzap bụ 80 mg otu ugboro n'ụbọchị. N'oge izizi ọgwụgwọ, a na-atụ aro ilegide ọbara mgbali anya; enwere ike ịchọ mgbazi ọgwụgwọ antihypertensive.

Ahụmịhe na telmisartan na ndị ọrịa nwere nnukwu akụrụ okpu ma ọ bụ ndị ọrịa na-agwọ ọrịa metụtara akwara dị oke. A na-atụ aro ndị ọrịa a obere mbido ọgwụ nke 20 mg kwa ụbọchị. Maka ndị ọrịa nwere nnukwu ọrụ mkpado na-adịghị ala ala, a naghị achọ ndozi ya.

A na-egbochi contraccantant nke Telzap na aliskiren n'ime ndị ọrịa nwere ọdịda akụrụngwa (GFR erughị 60 ml / min / 1.73 m2 nke akụkụ ahụ dị elu).

Inwe oge eji eme Telzap ya na ndị na - egbochi ACE na ndị ọrịa nwere ọrịa nephropathy.

Ekwesịrị iji nlezianya debe ndị ọrịa nwere nsogbu imeju dị nro na nke kwesịrị ekwesị (klas A na B), ọgwụ ekwesịghị ịkarị 40 mg otu ugboro n'ụbọchị. A na-eke Telzap na ndị ọrịa nwere nnukwu ahụ ọria ya ịba ọcha n'anya (klas C dịka nhazi nke nwatakịrị).

N'ime ndị ọrịa agadi, anaghị achọ mmegharị dose.

N'ime, otu ugboro n'ụbọchị, were mmiri mmiri sachaa ya, n'agbanyeghị nri nri.

Ndị ọrịa nke enweghị ike ịchịkwa BP nke ọma na monotherapy na telmisartan ma ọ bụ hydrochlorothiazide kwesịrị ịnara Telzap Plus. Tupu ịgbanwee nha nha maka oge edobere, a na-atụ aro itinye otu ụzọ maka nkeji ọ bụla. N'ọnọdụ ụfọdụ, a pụrụ ịtụle mgbanwe site na monotherapy gaa ọgwụgwọ yana nchikota nke ịke.

Enwere ike iji ọgwụ a bụ Telzap Plus otu ugboro n'ụbọchị maka ndị ọrịa nke enweghị ike ịchịkwa ọbara mgbali ya nke ọma mgbe ha na-ewere telmisartan na ọgwụ 80 mg kwa ụbọchị.

Mmetụta akụkụ

Ọkpụkpụ nke urinary na-efe efe, tinyere cystitis,
ọrịa akụkụ nke akụkụ okuku ume na elu, gụnyere pharyngitis na sinusitis,
sepsis, gụnyere egbu egbu
anaemia, eosinophilia, thrombocytopenia,
mmeghachi omume anaphylactic,
hypersensitivity
hyperkalemia
hypoglycemia (n'ime ndị ọrịa na-arịa ọrịa shuga mellitus),
ehighi ura
ịda mba
nchegbu
ịkụda mmụọ
iro ụra
nsogbu ndị a na-ahụ anya
vertigo
bradycardia
mbelata nke ọbara mgbali elu,
orthostatic hypotension,
tachycardia
mkpụkpu ume
ụkwara
ọrịa ngụgụ
mgbu afọ
afọ ọsịsa
dyspepsia
flatulence
vomiting
ọnụ kpọrọ nkụ
erughi ala na afo
imebi uto
ọrụ imeju na-arụ ọrụ / mmebi imeju,
akpụkpọ anụ?
hyperhidrosis
ihe nwu
anakedeede (nke na egbu egbu)
amu amu
erythema
urticaria
Ọgwụ ọgwụ
akpukpo aru aru
sciatica
akwara mgbu
myalgia
arthralgia,
mgbu mgbu
Ọrịa tendon,
arụ ọrụ ezumike, gụnyere nnukwu ọrụ gbasara akụrụ,
ụba plasma creatinine,
mbelata hemoglobin,
ụba plasma uric acid,
ụba ọrụ nke enzymes imeju na CPK,
obi mgbu
asthenia
oria-di ka oria.

Ihe ngbanwe

ọrịa biliary ọnya na-egbochi,
oke nsị nke imeju (-mụ-Pugh klas C),
jikọtara ya na aliskiren n'ime ndị ọrịa nwere ọrịa mellitus ma ọ bụ oke akụrụ oke ume (GFR erughị 60 ml / min / 1.73 m2 nke akụkụ ahụ dị elu),
n'otu oge iji ACE inhibitors na ndị ọrịa na-arịa ọrịa mamịrị nephropathy,
ihe nketa fructose anabataghi (n'ihi na ọnụnọ nke sorbitol ke mejupụtara ọgwụ),
tụụrụ ime
oge inye ara,
afọ ruo afọ 18 (arụpụtaghị na ịdị adị na nchekwa),
hypersensitivity na ihe na-arụ ọrụ ma ọ bụ ndị ọ bụla ọgwụ ọgwụ.

Ime na lactation

Ugbu a, ozi a pụrụ ịdabere na nchekwa nke telmisartan na ụmụ nwanyị dị ime adịghị. N'ime ọmụmụ anụmanụ, achọpụtawo nsị na ọgwụ ọjọọ nke ọgwụ. Ihe eji egbochi Telzap n’oge di ime.

Ọ bụrụ na ịchọrọ ịgwọ ọrịa ogologo oge na Telzap, ndị ọrịa na-eme atụmatụ ịtụrụ ime kwesịrị ịhọrọ ọgwụ mgbochi antihypertensive ọzọ nwere profaịlụ nchekwa pụtara maka iji n'oge afọ ime. Mgbe emechara eziokwu banyere afọ ime, a ga-akwụsị ọgwụgwọ na Telzap ozugbo, ma ọ bụrụ na ọ dị mkpa, ekwesịrị ịmalite usoro ọgwụgwọ ọzọ.

Dabere na nyocha ụlọ ọgwụ, ojiji nke angiotensin 2 antagonist antagonists na oge nke abụọ na nke atọ nke afọ ime nwere mmetụta na-egbu egbu na nwa ebu n’afọ (ọrụ ezughị ezu ọrụ, oligohydramnios, ossification of the skull) na nwa amụrụ ọhụrụ (renal keliki, hypotension and hyperkalemia). Mgbe ị na-eji angiotensin 2 antagonist antagonists na ọnwa nke abụọ nke afọ ime, a na-atụ aro ultrasound nke akụrụ na okpokoro isi nke nwa ebu n’afọ. Whosemụaka ndị nne natara angiotensin 2 na-anabata ndị na-emegide ihe n'oge afọ ime kwesịrị ka elebara ha anya iji chọpụta hypotension.

Ihe omuma banyere ojiji nke telmisartan n'oge inye umu ara adighi adi. Iji ọgwụ Telzap eme ihe n’oge a na-enye nwa ara. Ekwesịrị iji ọgwụ ọzọ dị mma nke nwere nchekwa nchekwa kachasị mma, ọkachasị mgbe ị na-enye nwa amụrụ ọhụrụ ma ọ bụ amụtaghị nwa.

Jiri na umuaka

Ejiri ọgwụ Telzap na-erubeghị afọ 18 na contraindicated (adịghị ike na nchekwa adịghị).

Jiri ndị ọrịa agadi

N'ime ndị ọrịa agadi, anaghị achọ mmegharị dose.

Ntụziaka pụrụ iche

Ọrụ imeju na-arụ ọrụ

Ojiji nke Telzap bụ contraindicated na ndị ọrịa nwere cholestasis, mgbochi nke biliary ma ọ bụ ọrụ imeju na-arụ ọrụ nke ọma (Child-Pugh klas C), ebe ọ bụ na telmisartan kachasị na bile. Ekwenyere na ndị ọrịa dị otú ahụ belatara ikike ịba ọcha n'anya nke telmisartan. N'ime ndị ọrịa nwere ogo imeju dị nwayọ ma ọ bụ na-agafe agafe (klas A na B dabere na nhazi nke Child-Pugh), ekwesịrị iji nlezianya mee ihe Telzap.

Ndị ọrịa nwere akwara mkpụrụ ndụ akwara Stenosis ma ọ bụ stenosis akwara nke otu akụrụ na-arụ ọrụ na-abawanye ihe ọghọm hypotension akwara na ọdịda akụrụngwa mgbe a na-agwọ ya ọgwụ na-eme RAAS.

Ọrụ akụrụ na arụ ọrụ yana akụrụ

Mgbe ị na-eji Telzap na ndị ọrịa nwere akụrụngwa ezumike, a na-atụ aro ileba anya na ọdịnaya nke potassium na creatinine na plasma ọbara kwa oge. Enweghị ahụmịhe ọgwụgwọ dị na Telzap na ndị ọrịa agwogharịgharị akụrụ.

Sympotomatic artpot hypotension, ọkachasị mgbe nchịkwa izizi nke Telzap, nwere ike ịdakwasị ndị ọrịa belata BCC na / ma ọ bụ sodium na plasma ọbara megide mmalite nke usoro ọgwụgwọ mbụ na nsị, mmachi nnu, afọ ọsịsa, ma ọ bụ vomiting. Ọnọdụ ndị a (mmiri na / ma ọ bụ ụkọ sodium) kwesịrị iwepụ tupu iwere Telzap.

Ihe mgbochi abụọ nke RAAS

A na - egbochi contraccantant iji telmisartan na aliskiren na ndị ọrịa nwere ọrịa mellitus ma ọ bụ ọdịda akụrụngwa (GFR erughị 60 ml / min / 1.73 m2 nke akụkụ ahụ dị elu).

Inwe oge nke Telzap na ACE inhibitors na-contraindicated na ndị ọrịa na-arịa ọrịa mamịrị nephropathy.

Site na mgbochi nke RAAS, artpot hypotension, fainting, hyperkalemia, na arụ ọrụ gbasara arụrụala (gụnyere nnukwu gbasara akụrụ okpu) a chọpụtara na ndị ọrịa ebuputere nke a, ọkachasị ijikọ ọtụtụ ọgwụ na-eme ihe na sistemụ a. Maka nke a, mmadụ abụọ anaghị egbochi RAAS (dịka ọmụmaatụ, ka ị na-ewere telmisartan na ndị ọzọ na-emegide RAAS).

N'ihe gbasara ịdabere na olu akwara na ọrụ akụrụ na-arụkarị ọrụ RAAS (dịka ọmụmaatụ, na ndị ọrịa nwere ọrịa obi na-adịghị ala ala ma ọ bụ ọrịa akụrụ, gụnyere ọrịa akwara ma ọ bụ stenosis nke akụrụ akwara), iji ọgwụ na-emetụta usoro a nwere ike. esonyere mmepe nke nnukwu akwara ọbara, hyperazotemia, oliguria, na n'ọnọdụ ụfọdụ, nnukwu ọdịda akwara afọ n’ala.

N'ime ndị ọrịa nwere ọrịa hyperaldosteronism nke mbụ, ọgwụgwọ na ọgwụ ọgwụ antihypertensive, mmetụta a na-arụ site na mgbochi nke RAAS, anaghị adịkarị mma. N'akụkụ a, akwadoghị ọgwụ Telzap akwadoro.

Aortic na mitral valve stenosis, cardiomyopathy na-egbochi hypertrophic

Dị ka ọ dị na ndị ọzọ vasodilalis, ndị ọrịa nwere aortic ma ọ bụ mitral stenosis, yana ọrịa hypertrophic na-egbochi cardiomyopathy, kwesịrị ịkpachara anya mgbe ha na-eji Telzap.

Ndị ọrịa nwere ọrịa shuga natara insulin ma ọ bụ ọgwụ hypoglycemic maka nchịkwa ọnụ

Na-emegide usoro ọgwụgwọ na Telzap, ndị ọrịa dị otú ahụ nwere ike ịnwe hypoglycemia. Ekwesiri ime ka njikwa glycemia dị ka enwere ike ịdị mkpa maka ịmegharị insulin ma ọ bụ onye na-ahụ maka hypoglycemic.

Ojiji nke ọgwụ na-eme na RAAS nwere ike ibute hyperkalemia. N'ime ndị ọrịa agadi, ndị ọrịa nwere oke akụrụ ma ọ bụ ọrịa mellitus, ndị ọrịa na-a drugsụ ọgwụ na-abawanye ọkwa plasma, yana / ma ọ bụ ndị ọrịa nwere oria confe, hyperkalemia nwere ike igbu.

Mgbe ị na-ekpebi iji ọgwụ ọnụọgụ nje ihe na-eme ihe na RAAS, ọ dị mkpa iji chọpụta ruru ihe ọghọm na uru. Ihe ndị dị mkpa maka hyperkalemia kwesịrị ịtụle bụ:

ọrịa shuga mellitus, ọdịda akụrụngwa, afọ (ndị ọrịa karịrị afọ 70),
jikọtara ya na otu ọgwụ ma ọ bụ karịa na-eme RAAS, na / ma ọ bụ ihe mgbakwunye nri nri nwere potassium. Ọgwụ ma ọ bụ usoro ọgwụgwọ nke ọgwụ nwere ike ibute hyperkalemia bụ ntụgharị nnu nke nwere potassium, potassium-sparing diuretics, ACE inhibitors, angiotensin 2 antagonist, ọgwụ mgbochi na-abụghị steroidal (NSAIDs) (gụnyere nhọrọ ndị na-egbochi COX-2 inhibitors), heparin, immunosuppressants (cyclosporine ma ọ bụ tacrolimus) na trimethoprim,
ọrịa intercurrent, ọkachasị akpịrị mmiri, oke obi nkụda mmụọ, metabolic acidosis, ọrụ akụrụ na-arụ ọrụ, sytolysis syndrome (dịka ọmụmaatụ, ischemia ukwu, rhabdomyolysis, trauma sara ụba).

A na-adụ ndị ọrịa nọ n'ihe ize ndụ ka ha jiri nlezianya nyochaa ọdịnaya potassium na plasma ọbara.

Telzap nwere sorbitol (E420). Ndị ọrịa nwere mkpụrụ osisi fructose na-eketa ekwo ekwo ekwesịghị ị drugụ ọgwụ.

Dịka amapụtara maka ndị na - egbochi ACE, telmisartan na ndị ọzọ antagonensin 2 antagonist yiri ka ọ na - agbada ọbara mgbali dị ala karịa ndị ọrịa nke agbụrụ Negroid karịa na agbụrụ ndị ọzọ, ikekwe n'ihi amụma dị ukwuu iji belata ọrụ renin na ọnụ ọgụgụ ndị ọrịa.

Dị ka ọgwụ ndị ọzọ antihypertensive, mbelata nke ukwuu na ọbara mgbali na ndị ọrịa nwere ọrịa obi na-arịa ischemic cardiomyopathy ma ọ bụ ọrịa obi nwere ike iduga mmepe nke infarction ma ọ bụ ọrịa strok.

Mmetụta ikike ịkwọ ụgbọ ala na usoro nchịkwa

Eduzi omumu ihe omumu nke puru iche iji hu ihe ogwu riri na ike inya ugboala. Mgbe ị na-anya ma na-arụ ọrụ site na iji usoro ịchọrọ nlebara anya ka ukwuu, a ga-elezi anya, n'ihi ujo na ujo di obere aputaghi na iji Telzap.

Mkparịta ụka ọgwụ ọjọọ

Ihe mgbochi abụọ nke RAAS

A na - egbochi contraccantant nke Telzap na aliskiren n'ime ndị ọrịa nwere ọrịa mellitus ma ọ bụ ọdịda akụrụngwa (GFR erughị 60 ml / min / 1.73 m2 nke akụkụ ahụ dị elu) ma akwadoghị ndị ọrịa ndị ọzọ.

Na ojiji nke telmisartan na ACE inhibitors na contraindicated na ndị ọrịa na-arịa ọrịa mamịrị nephropathy.

Omumu ihe omumu gosiputara na mgbochi abuo nke RAAS site na ijiri oru ndi ACE inhibitors, angiotensin 2 antagonist antagonist, ma obu aliskiren nwere nmekorita nke ihe ojoo dika obi uto, hyperkalemia, na oru mkpuru akuko (tinyere akuko gbasara akwara). ọgwụ na-eme ọgwụ na RAAS.

Ihe ọghọm nke ịba hyperkalemia nwere ike ịbawanye elu mgbe ejiri ọgwụ ndị ọzọ nwere ike ime ka hyperkalemia (mgbakwunye nri nri na mgbakwunye nnu nke nwere potassium, spredinolactone, eplerenone, triamterene ma ọ bụ amiloride), NSAIDs (gụnyere nhọrọ COX-2 inhibitors) , heparin, immunosuppressants (cyclosporine ma ọ bụ tacrolimus) na trimethoprim). Ọ bụrụ na ọ dị mkpa, na-emegide usoro nke akwụkwọ hypokalemia edekọ, iji ọgwụ ọnụ jikọtara ọnụ kwesịrị iji nlezianya na nlezianya nyochaa ọdịnaya nke potassium na plasma ọbara.

Site na iji telmisartan na digoxin, juputara na-abawanye na Cmax nke digoxin na plasma site na 49% na Cmin site na 20%. Na nmalite ọgwụgwọ, mgbe ị na-ahọrọ otu ọgwụ na ịkwụsị ọgwụgwọ na telmisartan, a ga-elezi anya itinye uche nke digoxin na plasma ọbara iji kwado ya n'ime usoro ọgwụgwọ ahụ.

Mkpụrụ ọgwụ na-eme ka ọ̀ na-egbu puruum ma ọ bụ na-enwe ihe oriri na-eme ka ihe ndị ọzọ na-edozi ahụ

Ndị na-emegide Angiotensin 2, dị ka telmisartan, belata ọnwụ na-akpata potassium. Ihe ndị na-enye potassium n’ịkpa mkpụrụ (dịka, spironolactone, eplerenone, triamteren, ma ọ bụ amiloride), ihe mgbakwunye nri nwere potassium, ma ọ bụ nnọchi nnu nwere ike ibute oke mmụba na potassium plasma. Ọ bụrụ na egosiputara iji ihe oriri, ebe enwere hypokalemia edepụtara, ekwesịrị iji ha kpachara anya ma megide ngbanyechi mgbe niile ilekọta potassium na plasma ọbara.

Site na iji lithium mejuputa ya na ACE inhibitors na angiotensin 2 antagonist antagonist, tinyere telmisartan, mmụba na-agbanwe agbanwe na mkpo lithium na plasma ọbara na mmetụta ya na-egbu egbu bilitere. Ọ bụrụ na ịchọrọ iji ọgwụ a jikọtara ọnụ, a na-atụ aro ka ị jiri nlezianya nyochaa oke nke lithium na plasma ọbara.

NSAIDs (i.e., acetylsalicylic acid na doses ejiri maka ọgwụgwọ mgbochi, COX-2 inhibitors na NSAIDs na-adịghị ahọpụta) nwere ike ịkụda mmetụta antihypertensive nke ndị na-anabata antiotensin 2 na ụfọdụ ndị ọrịa na-arụ ọrụ mgbapụta na-adịghị mma (dịka ọmụmaatụ, ndị ọrịa nwere oke mmiri, ndị ọrịa agadi nwere ọrụ ezigharị ọrụ) juputara na angiotensin 2 antagonist antagonists na ọgwụ ndị na-egbochi COX-2 nwere ike ibute mmebi nke ọrụ akụrụ, gụnyere mmepe nke nnukwu akwara na-ada ada. tatochnosti, nke na-abụkarị reversible. Ya mere, ejikọtara ọgwụ ọnụ ka akpachara anya jiri nlezianya mee ya, ọkachasị ndị agadi. Ekwesịrị ịnye mmiri dị mma, na mgbakwunye, na mmalite nke ijikọ ọnụ na oge na-aga n'ihu, a ga-enyocha ihe ngosipụta akụrụngwa.

Diuretics (thiazide ma ọ bụ akaghị)

Ọgwụ ọgwụgwọ buuru ọgwụ dị elu, dị ka furosemide (a “loop” diuretic) na hydrochlorothiazide (a thiazide diuretic), nwere ike ibute hypovolemia na nsogbu nke hypotension na mbido ọgwụgwọ telmisartan.

Ọgwụ ndị ọzọ na - alụ ọgụ

Enwere ike ịbawanye utịp Telzap site na ijikọ ọgwụ ndị ọzọ na - egbochi ọgwụ mgbochi.

Dabere na Njirimara ọgwụ nke baclofen na amifostine, enwere ike iche na ha ga-ebulite mmetụta ọgwụgwọ nke ọgwụ niile na - egbochi ọgwụ, gụnyere telmisartan. Na mgbakwunye, orthostatic hypotension nwere ike ịka njọ site na iji ethanol (mmanya), barbiturates, ọgwụ ma ọ bụ ọgwụ mgbochi.

Corticosteroids (maka iji ya arụ ọrụ)

Corticosteroids na-ebelata ike nke telmisartan.

Analogs nke ọgwụ Telzap

Anakpụrụ nke analogues nke na-arụ ọrụ:

Mikardis,
Mikardis Gụnyere,
Ochichi
Tanidol
Itinye
Telzap gbakwunyere,
Telmisartan
Telmista
Telpres
Telpres Plus,
Telsartan
Telsartan N.

Analogs na otu ọgwụ ọgwụ (angiotensin 2 antagonist antagonist):

Azu,
Aprovel
Artinova,
Atacand
Ngọngọ
Brozaar
Vasotens,
Valz
Valz N,
Aha ya bụ Valsartan
Valsacor
Vamloset
Gizaar
Hyposart,
Diovan
Duopress,
Zisakar
Ibertan
Irbesartan
Izar
Candecor
Candesartan
Cardomin
Cardos,
Cardosal
Cardosten
Karzartan
Ngalaba Exforge,
Coaprovel
Cozaar
Xarten
Lozap,
Lozap Plus,
Lozarel
Losartan
Losartan n
Lorista
Losacor
Mikardis,
Naviten
Nortian
Olimestra
Ordiss
Ochichi
Presartan
Nkọwapụta
Sartavel
Tanidol
Tareg
Tweensta
Gụrụ
Telmisartan
Telpres
Telsartan
Firmast
Edarby
Ike
Ndi Exfotans,
Eprosartan Mesylate.

Nhazi ọkwa nosological (ICD-10)

Mbadamba ihe mkpuchi	Taabụ 1.
ike ọrụ:
telmisartan	40/80 mg
ndị na-ebu ụzọ: 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

Mlọ ọgwụ

Telmisartan bụ otu usoro ARA II (AT subtype)₁), dị irè mgbe ejiri ọnụ kwuo ya. Telmisartan nwere ezigbo mmekọrịta AT₁-echeta nke esiri mee ihe omume anakpo angiotensin II. Ọ na - eme ka angiotensin nke abụọ ghara inwe nkekọ na onye na - anabata ihe, na - ejighi ihe onye na - akpata ihe gbasara nnabata. Telmisartan na-ejikọ naanị na AT subpepe₁ndị na-anabata angiotensin II. Nkwurịta okwu na-adigide. Telmisartan enweghị mmekọrịta maka ndị na-anabata ndị ọzọ, incl. AT₂ndị na-anabata ya na ndị ọzọ na - erughị nnabata angiotensin. Amamịghe ọrụ nke ndị nnabata ndị a, yana nsonaazụ nke ike ha nwere na angiotensin nke abụọ, amụchaghị nke na-abawanye na nhọpụta nke telmisartan. Telmisartan na -ebelata mkpokọta nke aldosterone na plasma ọbara, anaghị ebelata ọrụ nke renin, ọ dịghịkwa egbochi ọwa ion. Telmisartan anaghị egbochi ACE (kininase II), nke na-emekwa ka mbibi nke bradykinin mebie. Nke a na - egbochi mmetụta ndị metụtara nsonyezụ bradykinin (dịka ọmụmaatụ, ụkwara akọrọ).

Ọbara mgbali dị mkpa. N'ime ndị ọrịa, telmisartan na ọgwụ nke 80 mg kpamkpam egbochi mmetụta ọbara mgbali nke angiotensin II. A na-ahụ mmalite mmalite nke ọgụ ọgwụ mgbochi n'ime awa 3 mgbe nchịkwa izizi nke telmisartan. Mmetụta ọgwụ ahụ na-adịgide ruo awa 24 ma na-adịkarị egwu ruo na awa 48. Mmetụta ọgwụ na-egbu egbu na-ebikarị izu 4-8 mgbe ejiri ya mgbe niile.

N'ime ndị ọrịa nwere ọbara mgbali elu, telmisartan na-ebelata ọbara mgbali na nna na-enweghị emetụta mmetụ obi.

N'ihe banyere njedebe dị nkọ nke telmisartan, ọbara mgbali elu ọtụtụ ụbọchị jiri nwayọọ nwayọọ laghachi ọkwa mbụ ya na-enweghị mmepe nke ọrịa mwepụ.

Dika nsonaazụ nke ihe omumu ihe omumu gosiputara, mmetụta antihypertensive nke telmisartan nwere ike imetụta mmetụta antihypertensive nke ọgwụ nke klas ndị ọzọ (amlodipine, atenolol, enalapril, hydrochlorothiazide na lisinopril). Ọnụnọ nke okpukpu okpukpu dara nke ukwu na telmisartan ma e jiri ya tụnyere ndị na-egbochi ACE.

Mgbochi ọrịa obi. Ndị ọrịa 55 gbara afọ ma ọ bụ karịa site na ọrịa akwara obi, ọrịa strok, ọrịa ọnụnọ nke ọrịa, ọrịa mbibi, ma ọ bụ nsogbu nke ụdị ọrịa shuga 2 (dịka ọmụmaatụ retinopathy, hypertrophy ekpe, macro- ma ọ bụ microalbuminuria) na akụkọ ihe mere eme nke obi, telmisartan nwere mmetụta yiri nke ramipril n'ibelata njedebe ejikọtara ọnụ: ọnwụ obi, adịghị ike myocardial infarction, ọrịa strok na-adịghị egbu egbu na u nke na njikọ na CHF.

Telmisartan rụpụtara ọrụ dị ka ramipril n'ibelata ugboro ole isi ihe: ọnwụ obi, infarction myocardial na-adịghị egbu egbu. A na-ejikarị ụkwara ọwụwa na angioedema akọwa ya na telmisartan ma e jiri ya tụnyere ramipril, ebe hypotension na-adịkarịkarị na telmisartan.

Ndị ọrịa nwata. Emebeghi nchekwa na arụmọrụ nke telmisartan na ụmụaka na ụmụaka nọ n’agbata afọ 18.

Mlọ ọgwụ

Egwu. Mgbe a na - ahazi ya, a na - etinye telmisartan ngwa ngwa site na nri diges. Bioavailability bụ 50%. Mgbe ewere nri n'otu oge, mbelata na AUC sitere na 6% (na nari 40 mg) ruo 19% (na ọgwụ nke 160 mg). Mgbe awa atọ gachara, ochichi ọbara nke plasma nke ọbara ka emechara n'agbanyeghị ma ewerela telmisartan n'otu oge. Enwere ọdịiche na mkpokọta plasma na ụmụ nwoke na ụmụ nwanyị. C_max na AUC dị ihe dịka ugboro atọ na ugboro abụọ karịa nke ụmụ nwanyị ma e jiri ya tụnyere ụmụ nwoke na-enweghị nnukwu mmetụta na arụmọrụ.

Enweghị mmekọrịta kwụ ọtọ n'etiti ị theụ ọgwụ ahụ yana ịta ụbara plasma ya. C_max na, na ntinye ka obere, AUC na-abawanye n'ụzọ a na-ezigaghị ya na iji ọgwụ na-abawanye mgbe ị na-eji ọgwụ dị elu karịa 40 mg / ụbọchị.

Nkesa. Telmisartan jikọtara ya na protein ndị dị na plasma (> 99.5%), ọkachasị na albumin na alfa₁-acid glycoprotein.

Pụtara pụtara V_ss odika lita 500.

Metabolism. A na-agagharị ya site na conjugation na glucuronic acid.

Na conjugate enweghị ọrụ ọgwụ.

Ojiji. Ndi_1/2 O karịrị awa 20. A na-ewepụta ya site na eriri afọ na - agbanweghi, akụrụ ewepụrụ ya na - erughi 1%. Mkpokọta plasma zuru oke (ihe dị ka 1000 ml / min) ma e jiri ya tụnyere ọbara ọbara ịba ọcha n'anya (ihe dị ka 1500 ml / min).

Onu ogugu ndi mmadu puru iche

Agadi. Thelọ ọgwụ ọgwụ telmisartan na ndị ọrịa karịrị afọ 65 afọ adịghị iche na ndị ọrịa na-eto eto. Dose ukpụhọde adịghị.

Renrụ ọrụ na-arụ ọrụ na ụlọ. N'ime ndị ọrịa nwere nsogbu gbasara akụrụngwa na-adịghị ala ala, ọ dị mkpa idozigharị nke telmisartan.

Ndị ọrịa nwere nnukwu akụrụ gbasara akwara na ndị nọ n'ọbara ha ka a na-atụ aro obere mbido mbụ nke 20 mg / ụbọchị (lee “Ntuziaka Pụrụ Iche”). Telmisartan adịghị agwọ ọrịa.

Ọrụ imeju na-arụ ọrụ. N'ime ndị ọrịa nwere ọrịa imeju na-arụ ọrụ dị nro ma ọ bụ nke na-adịghị ala (klas A na B dịka nhazi nke nwatakịrị).

Mpempe usoro onunu ogwu

Otu mbadamba ihe

bekee arụ ọrụ: telmisartan 40,000 ma ọ bụ 80,000 mg, karị,

hydrochlorothiazide 12.500 mg ma ọ bụ 25,000 mg, n'otu n'otu,

ndị na-ebu ụzọ: sorbitol, sodium hydroxide, povidone 25, magnesium stearate

Mbadamba mbadamba ụrọ nke nwere biconvex dị n’elu ala site na ọcha ruo odo, nke nwere nọmba “41” n’akụkụ otu mbadamba ahụ, ihe dịka 12 mm n’ogologo na ihe dịka 6 mm sara mbaramaka usoro onunu ogwu 40 mg / 12.5 mg).

Mbadamba ụrọ nke nwere biconvex dị elu nwere agba site na ọcha ruo odo, nke nwere nọmba “81” n'otu akụkụ mbadamba ụrọ ahụ, ihe dịka 16.5 mm n'ogologo, ihe dịka 8.3 mm n'obosara.maka onunu ogwu nke 80 mg / 12.5 mg).

Mbadamba mbadamba ụrọ nke nwere biconvex dị n’elu ọcha ruo na odo, nke nwere “82” n’otu akụkụ mbadamba ihe ahụ, ihe dịka 16 mm n’ogologo, ihe dịka 8 mm sara mbara (maka onunu ogwu nke 80 mg / 25 mg).

Na-egosi Telzap ®

mbelata onwu na ọrịa obi na ndị okenye:

- yana ọrịa obi nke ọrịa atherothrombotic sitere (ọrịa obi na-efe efe, ọrịa strok ma ọ bụ akụkọ banyere akwara akwara).

- nwere ụdị ọrịa shuga mellitus nke 2 nwere ihe mebiri emebi.

Ihe ngbanwe

hypersensitivity na ihe na-arụ ọrụ ma ọ bụ ndị ọ bụla ọgwụ ọgwụ,

ime na lactation,

ọrịa biliary ọnya na-egbochi,

oke nsị nke imeju (-mụ-Pugh klas C),

jikọtara ya na aliskiren n'ime ndị ọrịa nwere mellitus ọrịa shuga ma ọ bụ oke nrụrụ akụrụ (GFR erughị 60 ml / min / 1.73 m 2) (lee “Mmekọrịta” na “Ntuziaka Pụrụ Iche”),

Nkwekorita nke fructose (maka onodu nke sorbitol na mbadamba),

n'otu oge iji ndị na - egbochi ACE na ndị ọrịa nwere ọrịa nephropathy (lee "Mmekọrịta" na "Ntụziaka pụrụ iche"),

afọ ruo afọ 18 (nrụpụta na nchekwa esighi ike).

Iji nlezianya: biyunteji akwara artery stenosis ma ọ bụ stenosis nke otu akụrụ na-arụ ọrụ, ọrụ akụrụ na-arụ ọrụ dị nro, obere nfe ịba ọcha n'anya, belatara BCC ma e jiri ya mee ihe mmachi, mmachi nke sodium chloride, afọ ọsịsa ma ọ bụ vomiting, hyponatremia, hyperkalemia, ọnọdụ mgbe ebugharị akụrụ (ahụmịhe ahụrụ anọghị ya), nnukwu ọrịa obi na-adịghị ala ala, aortic na mitral valve stenosis, hypertrophic obstructive cardiomyopathy, isi hyperaldosta. onizm (nrụpụta na nchekwa na-adịghị a guzosie ike), ọgwụgwọ nke ojii ọrịa.

Ime na lactation

Ugbu a, ozi a pụrụ ịdabere na nchekwa nke telmisartan na ụmụ nwanyị dị ime adịghị. N'ime ọmụmụ anụmanụ, achọpụtawo nsị na ọgwụ ọjọọ nke ọgwụ. A machiri iji Telzap ® n'oge afọ ime (lee “Contraindications”).

Ọ bụrụ na ọ dị mkpa iji ogologo oge agwọ ọrịa na Telzap ®, ndị ọrịa na-eme atụmatụ ịtụrụ ime kwesịrị ịhọrọ ọgwụ mgbochi antihypertensive ọzọ nwere profaịlụ nchekwa pụtara iji maka n’oge ime. Mgbe emechara eziokwu banyere afọ ime, a ga-akwụsị ọgwụgwọ na Telzap immediately ozugbo a ga-amalite ọgwụgwọ ọzọ ma ọ bụrụ na ọ dị mkpa.

Dị ka nsonaazụ nke nyocha ụlọ ọgwụ gosipụtara, ojiji nke ARA II na ọkara nke afọ atọ na nke III nwere afọ ojuju na nwa ebu n'afọ (ọrụ ezigharị ọrụ, oligohydramnios, igbu oge okpokoro isi) na nwa amụrụ ọhụrụ (ọdịda akụrụ, ọdịda hypotension na hyperkalemia). Mgbe ị na-eji ARA II n’oge ọnwa nke abụọ nke ịtụrụ ime, a na-atụ aro ultrasound nke akụrụ na okpokoro isi nke nwa ebu n’afọ.

Shouldmụaka ndị nne ha buru ARA II n’oge a dị ime ha kwesịrị ka ejiri nlezianya na-enyocha ha.

Ihe omuma banyere ojiji nke telmisartan n'oge inye umu ara adighi adi. Telnara Telzap ® n'oge ị na-a breastụ ara na - egbochi ọgwụ (lee "Contraindications"), a ga - eji ọgwụ antihypertensive ọzọ nwere profaịlụ nchekwa ka mma, ọkachasị mgbe ị na - enye nwa amụrụ ọhụrụ ma ọ bụ amụtabeghị nwa.

Nsonaazụ

Dabere na WHO, a na-ekepụta mmetụta ndị na-achọghị dịka oge mmepe ha dị ka ndị a: oge mgbe (≥1 / 10), ọtụtụ mgbe (site na /1 / 100 ruo ọnwụ).

N'akụkụ ọbara na sistem lymphatic: ugboro ugboro - anaemia, adịkarịghị - eosinophilia, thrombocytopenia.

Si dịghịzi usoro: adịkarịghị - mmeghachi omume anaphylactic, hypersensitivity.

Site n'akụkụ nke metabolism na nri oriri: ugboro ugboro - hyperkalemia, adịkarịghị - hypoglycemia (na ndị ọrịa nwere ọrịa mellitus).

Si psyche: oge adighi - ehighi ura, obi erughi ala, oge adighi anya.

Si ụjọ usoro: ugboro ugboro - ịda mba, adịkarịghị - ụra ụra.

Site n'akụkụ akụkụ ahụ nke ịhụ ụzọ: nsogbu ndị a na-ahụ anya.

Na akụkụ ahụ anụ ntị na nsogbu nnụnụ Labyrinth: ugboro ugboro - vertigo.

Site n'obi: ugboro ugboro - bradycardia, adịkarịghị - tachycardia.

Site na arịa: ugboro ugboro - mbelata ọbara mgbali elu, ọbara orthostatic.

Site na sistem iku ume, obi na akụkụ akụkụ ahụ: ugboro ugboro - mkpụmkpụ ume, ụkwara, ụkwara obere - ọrịa ngụgụ.

Site na eriri afọ: ugboro ugboro - afọ mgbu, afọ ọsịsa, dyspepsia, flatulence, vomiting, adịkarịghị - akpịrị ọnụ, ahụ erughị ala na afo, imebi uto nke mmetụta.

N'akuku nke imeju na akwara biliary: adịkarịghị - arụ ọrụ imeju / mmebi imeju.

Na akpụkpọ anụ ahụ ugboro ugboro - akpụkpọ mgbu, hyperhidrosis, ihe ngbu, adịkarịghị - angioedema (nke na-egbu egbu), eczema, erythema, urticaria, friji ọgwụ, nfụkasị anụ ahụ.

Site na usoro akwara na mọzụlụ: ugboro ugboro - mgbu azụ (sciatica), ihe mgbu akwara, myalgia, adịkarịghị - arthralgia, mgbu aka, mgbu akaị (dịka ọrịa akwara).

Site na akụrụ na eriri afọ: ugboro ugboro - arụ ọrụ na-arụ ọrụ na ụlọ, gụnyere nnukwu gbasara akụrụ.

Ọrịa na nkwarụ izugbe na saịtị ịgba ahụ: ugboro ugboro - mgbu obi, asthenia (adịghị ike), adịkarịghị - ọrịa na-efe efe.

Mmetụta nsonaazụ ụlọ nyocha na akụrụngwa: ugboro ugboro - mmụba na mkpokọta nke creatinine na plasma ọbara, adịkarịghị - mbelata ọdịnaya nke Hb, mmụba nke ọdịnaya uric acid na plasma ọbara, mmụba na ọrụ nke enzymes imeju na CPK.

Mmekorita

Ihe mgbochi abụọ nke RAAS. A na - eme contrainditant nke telmisartan na aliskiren n'ime ndị ọrịa nwere ọrịa mellitus ma ọ bụ ọdịda akụrụngwa (GFR erughị 60 ml / min / 1.73 m 2) na akwadoghị ndị ọrịa ndị ọzọ.

Inye aka nke telmisartan na ACE inhibitors na-abụkarị ndị ọrịa nwere ọrịa nephropathy (lee "Contraindications").

Nnyocha ọmụmụ gosipụtara na mgbochi abụọ nke RAAS n'ihi ojiji nke ACE inhibitors ejikọtara ọnụ, ARA II, ma ọ bụ aliskiren jikọtara ya na mmụba nke ihe omume dịka artpot hypotension, hyperkalemia, na ọrụ ịgbazigharị arụmọrụ (gụnyere nnukwu gbasara gbasara akụrụ), ma e jiri ya tụnyere naanị otu ọgwụ eme ihe na RAAS.

Ihe ọghọm nke ịbawanye hyperkalemia nwere ike ịba ụba mgbe ejiri ọgwụ ndị ọzọ nwere ike ibute hyperkalemia (mgbakwunye nri nri na mgbakwunye nnu nke nwere potassium, spredinolactone, eplerenone, triamterene ma ọ bụ amiloride), NSAIDs, gụnyere nhọrọ COX-2 inhibitors, hepari , immunosuppressants (cyclosporine ma ọ bụ tacrolimus) na trimethoprim.Ọ bụrụ na ọ dị mkpa, megide ndabere nke akwụkwọ hypokalemia, ọgwụ ejikọtara ọnụ kwesịrị ịme. kpachara anya ma na-enyocha ihe ndị dị na potassium n'ime plasma ọbara.

Digoxin. Site na njikọta nke telmisartan na digoxin, agara ịrị elu na C_max plasma digoxin na 49% na C_min site na 20%. Na nmalite ọgwụgwọ, mgbe ị na-ahọrọ otu ọgwụ na ịkwụsị ọgwụgwọ na telmisartan, a ga-elezi anya itinye uche nke digoxin na plasma ọbara iji kwado ya n'ime usoro ọgwụgwọ ahụ.

Mkpụrụ ọgwụ na-eme ka ọ̀ na-egbu puruum ma ọ bụ na-enwe ihe oriri na-eme ka ihe ndị ọzọ na-edozi ahụ. ARA II, dika telmisartan, na -ebelata mmebi nke potassium nke diuretic kpatara. Ihe ndị na-enye ume n’ahụ́ bekee na-eme ka ihe n’ahụ bụrụ potassium, dịka ọmụmaatụ spironolactone, eplerenone, triamteren ma ọ bụ amiloride, mgbakwunye nri nwere nri ma ọ bụ nnọchi nnu nwere ike ibute oke ihe na potassium n’ime plasma ọbara. Ọ bụrụ na egosiputara iji ihe oriri, ebe enwere hypokalemia edepụtara, ekwesịrị iji ha kpachara anya ma megide ngbanyechi mgbe niile ilekọta potassium na plasma ọbara.

Nkwadebe Lithium. Mgbe emechara lithium ya na ndị mgbochi ACE na ARA II, gụnyere telmisartan, mmụba na-emetụta ọnya mmiri nke lithium na nsonaazụ ya. Ọ bụrụ na ịchọrọ iji ọgwụ a jikọtara ọnụ, a na-atụ aro ka ị jiri nlezianya nyochaa oke nke lithium na plasma ọbara.

Ndị NSAID. NSAIDs (i.e., acetylsalicylic acid na doses eji maka ọgwụgwọ mgbochi, COX-2 inhibitors na NSAIDs na-adịghị ahọrọ) nwere ike ịkụda mmetụta antihypertensive nke ARA II. N’ebe ụfọdụ ndị ọrịa nwere nsogbu gbasara akụrụngwa (dịka ọmụmaatụ, ịhydụ mmiri, ndị ọrịa nwere nsogbu gbasara akụrụngwa), jikọtara ọnụ nke ARA II na ọgwụ ndị na-egbochi COX-2 nwere ike ibute mmebi nke ọrụ akụrụ, gụnyere mmepe nke nnukwu gbasara akụrụ, nke, dịka iwu, agbanwee. Ya mere, ejikọtara ọgwụ ọnụ ka akpachara anya jiri nlezianya mee ya, ọkachasị ndị agadi. Ọ dị mkpa iji hụ na a ga-enyocha mmiri kwesịrị ekwesị, na mgbakwunye, na mmalite nke ijikọ ọnụ na oge ụfọdụ n'ọdịnihu, a ga-enyocha ihe ndị na-egosi ọrụ akụrụ.

Diuretics (thiazide ma ọ bụ akaghị). Ọgwụ gara aga nwere nnukwu ọgwụ mkpịsị akwara, dị ka furosemide (loop diuretic) na hydrochlorothiazide (thiazide diuretic), nwere ike ibute hypovolemia na nsogbu nke hypotension na mbido ọgwụgwọ na telmisartan.

Ọgwụ ndị ọzọ na - alụ ọgụ. Enwere ike imeziwanye mmetụta nke telmisartan site na iji ọgwụ ndị ọzọ na - egbochi ihe mgbochi. Dabere na Njirimara ọgwụ nke baclofen na amifostine, enwere ike iche na ha ga-ebulite mmetụta ọgwụgwọ nke ọgwụ niile na - egbochi ọgwụ, gụnyere telmisartan. Na mgbakwunye, hypotension orthostatic nwere ike ịbawanye na mmanya, barbiturates, ọgwụ, ma ọ bụ ọgwụ antidepressants.

Corticosteroids (maka iji usoro). Corticosteroids na-ebelata ike nke telmisartan.

Usoro onunu ogwu na nhazi

N'ime, otu ugboro n'ụbọchị, were mmiri mmiri sachaa ya, n'agbanyeghị nri ị na-eri.

Ọbara ọbara. Usoro izizi nke Telzap ® bụ 1 mbadamba. (40 mg) otu ugboro n'ụbọchị. Patientsfọdụ ndị ọrịa nwere ike ịnwe nnabata 20 mg / ụbọchị. Enwere ike inweta 20 mg site na ịkekọrịta mbadamba 40 mg na ọkara n'ihe ize ndụ. N'ọnọdụ ebe enweghị ọgwụgwọ ọgwụgwọ, enwere ike ịba ụba dose a tụrụ aro nke Telzap ® ka ọ bụrụkarị 80 mg otu ugboro n'ụbọchị. Dika ozo, enwere ike iburu Telzap combination yana thiazide diuretics, imaatu, hydrochlorothiazide, nke, mgbe ejikọtara ya, nwere ihe mmetuta ozo.

Mgbe ị na-ekpebi ma ịbawanye ọgwụ ahụ, ekwesịrị iburu n'uche na mmetụta antihypertensive kachasị na-arụkarị n'ime izu 4-8 mgbe mmalite nke ọgwụgwọ.

Na-ebelata na ọnwụ na ugboro nke ọrịa obi. Usoro akwadoro nke Telzap ® bụ 80 mg otu ugboro n'ụbọchị. N'oge izizi ọgwụgwọ, a na-atụ aro ilegide ọbara mgbali anya; enwere ike ịchọ mgbazi ọgwụgwọ antihypertensive.

Onu ogugu ndi mmadu puru iche

Renrụ ọrụ na-arụ ọrụ na ụlọ. Ahụmịhe na telmisartan na ndị ọrịa nwere nnukwu akụrụ okpu ma ọ bụ ndị ọrịa na-agwọ ọrịa metụtara akwara dị oke. A na-atụ aro ka ndị ọrịa a obere mbido ọgwụ nke 20 mg / ụbọchị (lee. "Ọgwụ pụrụ iche"). Maka ndị ọrịa nwere nnukwu ọrụ mkpado na-adịghị ala ala, a naghị achọ ndozi ya. A na - eme contraindicated na Telzap ® na aliskiren n'ime ndị ọrịa nwere ọdịda akụrụngwa (GFR erughị 60 ml / min / 1.73 m 2) (lee. "Contraindications").

A na - eme contraindicated na Telzap ® na ndị na - egbochi ACE na ndị ọrịa nwere ọrịa nephropathy (lee "Contraindications").

Ọrụ imeju na-arụ ọrụ. A na - akpọ Telzap ® n'ime ndị ọrịa nwere nnukwu ọrịa ịba ọcha n'anya (Nwa-Pugh klas C) (lee "Contraindications"). N'ime ndị ọrịa nwere obere ịba ọcha n'anya ruo na obere (klaasị A na B dị ka nhazi nke ụmụaka-Pugh, dị iche iche), a na-enye ọgwụ ahụ ka ọ kpachara anya, ọnye ahụ agaghị agafe 40 mg otu ugboro n'ụbọchị. "Jiri nlezianya").

Agadi. Maka ndị ọrịa agadi, ọ chọghị ime mgbanwe dose.

Umuaka na umuaka. A na - ekwekọrịta ojiji nke Telzap ® n'ime ụmụaka na ndị nọ n'afọ iri na asatọ n'ihi enweghị nchekwa na arụmọrụ dị mma (lee "Contraindications").

Dodoụbiga ya ókè

Ọrịa Ihe ngosipụta kachasị nke ịdoụbiga mmanya ókè bụ mbelatala mgbali ọbara na tachycardia, bradycardia, ọgbụgba, ịba ụba nke ọbara na ọdịda akụrụ oke.

Ọgwụgwọ: Telmisartan adịghị agwọ ọrịa. Ekwesịrị iji nlezianya nyochaa ndị ọrịa na ịrịa ọrịa yana yana nlekọta nkwado. Approachzọ ị ga-esi gwọọ ọgwụgwọ na-adabere na oge gafere mgbe ị theụsịrị ọgwụ ahụ, yana ogo mgbaàmà ya. Usoro ndị a tụrụ aro gụnyere iwebata vom na / ma ọ bụ gastric lavage; iji carbon eme ka eme ka arụ ọrụ dị mma. Ekwesiri ilebara Plasma electrolytes na creatinine anya. Ọ bụrụ na mbelata ọbara mgbali elu, onye ọrịa ahụ kwesịrị iji ukwụ kwụ ọtọ na ụkwụ aka ekpe, ebe ọ dị mkpa ịmegharị bcc na electrolytes ngwa ngwa.

Ntụziaka pụrụ iche

Ọrụ imeju na-arụ ọrụ. Ojiji nke Telzap ® bụ contraindicated na ndị ọrịa nwere cholestasis, bile mgbochi mgbochi ma ọ bụ ọrụ imeju na-arụ ọrụ nke ọma (Child-Pugh klas C) (lee "Contraindications"), ebe ọ bụ na telmisartan kachasị na bile. Ekwenyere na n'ime ndị ọrịa dị otú a, a na-ebelata mkpochapu hepatic nke telmisartan. N'ime ndị ọrịa nwere nkwarụ hepatic dị nro ma ọ bụ nke na-adịghị ala ala (nwatakịrị Pugh klas A na B), ekwesịrị iji nlezianya mee ihe Telzap ((lee. Jiri nlezianya).

Ọbara mgbali elu. Na ọgwụgwọ ọgwụ na-eme ihe na RAAS na ndị ọrịa nwere akwara mkpọnwa akwara ma ọ bụ stenosis akwara na-arụ otu akụrụ, nnukwu nsogbu akwara ọbara na ọdịda akụrụ.

Ọrụ akụrụ na arụ ọrụ akụrụ. Mgbe ị na-eji Telzap ® na ndị ọrịa nwere ọrụ akwara nwere nsogbu, a na-atụ aro ileba anya na ọdịnaya nke potassium na creatinine na plasma ọbara kwa oge. Enweghị ahụmike a na-agwọ ọrịa na Telzap ® n'ime ndị ọrịa nwatakịrị agbatịgharị akụrụ.

Mbelata na BCC. Symptomatic artpot hypotension, ọkachasị mgbe nchịkwa izizi nke Telzap ®, nwere ike ịdakwasị ndị ọrịa nwere obere BCC na / ma ọ bụ sodium na plasma ọbara megide ndabere nke usoro ọgwụgwọ gara aga yana mmerụ ahụ, mgbochi mgbochi nke nnu, afọ ọsịsa ma ọ bụ vomiting.

Ọnọdụ ndị a (mmiri na / ma ọ bụ ụkọ sodium) kwesịrị iwepụ tupu iwere Telzap ®.

Ihe mgbochi abụọ nke RAAS. A na - eme contraindicated na telmisartan na aliskiren na ndị ọrịa nwere ọrịa mellitus ma ọ bụ ọdịda akụrụngwa (GFR erughị 60 ml / min / 1.73 m 2) (lee. "Contraindications").

Inye aka nke telmisartan na ACE inhibitors na-abụkarị ndị ọrịa nwere ọrịa nephropathy (lee "Contraindications").

N'ihi mgbochi nke RAAS, akwara hypotension, nkụda mmụọ, hyperkalemia, na arụ ọrụ na-arụ ọrụ (gụnyere nnukwu gbasara akụrụ oke) kwuru na ndị ọrịa ebuputere nke a, ọkachasị mgbe ejikọtara ya na ọtụtụ ọgwụ na-eme ihe na sistemụ a. Maka nke a, mmadụ abụọ anaghị egbochi RAAS (dịka ọmụmaatụ, ka ị na-ewere telmisartan na ndị ọzọ na-emegide RAAS).

N'ihe banyere ịdabere na olu akwara na ọrụ akụrụ na-arụkarị ọrụ RAAS (dịka ọmụmaatụ, na ndị ọrịa nwere nkụda obi ma ọ bụ ọrịa akụrụ, gụnyere akwara renal stenosis ma ọ bụ stenosis nke otu akụrụ akwara), nchịkwa ọgwụ na-emetụta usoro a nwere ike sonyere mmepe nke nnukwu. hyperazotemia, oliguria na ọrịa ndị dị ụkọ, nnukwu akwara na-ada ada.

Isi hyperaldosteronism. N'ime ndị ọrịa nwere hyperaldosteronism bụ isi, ọgwụgwọ na ọgwụ ọgwụ antihypertensive, mmetụta nke a na-enweta site na igbochi RAAS, anaghị adịkarị mma. N'akụkụ a, akwadoghị ọgwụ Tezap ® ka akwadoro.

Stenosis nke aortic na mitral valves, hypertrophic na-egbochi cardiomyopathy. Dị ka ọ dị na ndị ọzọ vasodilalis, ndị ọrịa nwere aortic ma ọ bụ mitral stenosis, yana hypertrophic obstructive cardiomyopathy, kwesịrị ịkpachara anya mgbe ha na-eji Telzap ®.

Ndị ọrịa nwere ọrịa shuga natara insulin ma ọ bụ ọgwụ hypoglycemic maka nchịkwa ọnụ. Na-emegide usoro ọgwụgwọ na Telzap ®, ndị ọrịa a nwere ike ịnwe hypoglycemia. N'ime ndị ọrịa dị otú ahụ, ekwesịrị ime ka nchịkwa glycemic dị ike, dịka enwere ike ịdị mkpa maka ịmegharị insulin ma ọ bụ onye na-ahụ maka hypoglycemic.

Hyperkalemia Renabata ọgwụ na-eme ihe na RAAS nwere ike ịkpata hyperkalemia. N'ime ndị ọrịa agadi, ndị ọrịa nwere ọrịa akụrụ ma ọ bụ mellitus ọrịa shuga, ndị ọrịa na-a thatụ ọgwụ na-abawanye ụba plasma potassium, na / ma ọ bụ ndị ọrịa nwere oria confered, hyperkalemia nwere ike igbu.

Mgbe ị na-ekpebi iji ọgwụ ọgwụ ọnụọgụ na - eme ọgwụ RAAS, ọ dị mkpa iji chọpụta nha uru ọghọm dị. Ihe ndị dị mkpa maka hyperkalemia kwesịrị ịtụle bụ:

- ọrịa shuga mellitus, ọdịda akụrụ, afọ (ndị ọrịa karịrị afọ 70),

- ngwakọta na otu ma ọ bụ karịa ọgwụ na-arụ ọrụ na RAAS, na / ma ọ bụ ihe mgbakwunye nri nwere potassium. Ọgwụ ma ọ bụ klaasị ọgwụ nke nwere ike ibute hyperkalemia bụ ntụgharị nnu nke nwere potassium, ọgwụ ndị na-enye potassium, ACE inhibitors, ARA II, NSAID, gụnyere ndị na-ahọpụta ihe ndị a na-akpọ COX-2, heparin, immunosuppressants (cyclosporin ma ọ bụ tacrolimus) na trimethoprim,

- ọnọdụ dị n'etiti ọrịa / ọrịa, na akpịrị ịkpọ nkụ, nkụchi obi na - adịghị ala ala, metabolic acidosis, ọrụ akụrụngwa arụrụala, cytolysis syndrome (dịka ọmụmaatụ, oke ụkwụ ischemia, rhabdomyolysis, nnukwu trauma).

A na-atụ aro ndị ọrịa nọ n'ihe ize ndụ ka ha jiri nlezianya nyochaa ọdịnaya potassium na plasma ọbara (lee "Mmekọrịta").

Sorbitol. Ogwu a nwere sorbitol (E420). Ndị ọrịa nwere mkpụrụ osisi fructose na-eketa ekwo ekwo ekwesịghị ịta Telzap ®.

Ndịrịta iche nke agbụrụ. Dabere na ndị ACE inhibitors, telmisartan na ndị ọzọ ARA II yiri ka ọ na - agbada ọbara mgbali elu n'ụzọ dị irè karị na ndị ọrịa nke agbụrụ Neroid karịa ndị nnọchite nke agbụrụ ndị ọzọ, ikekwe n'ihi oke atụmanya nke mbelata nke ọrụ renin na ọnụ ọgụgụ ndị ọrịa a.

Misc Dị ka ọgwụ ndị ọzọ antihypertensive, mbelata ọbara mgbali elu na ndị ọrịa nwere ischemic cardiomyopathy ma ọ bụ CHD nwere ike iduga mmepe nke infarction ma ọ bụ ọrịa strok.

Mmetụta ikike ịkwọ ụgbọala, usoro. Eduzi omumu ihe omumu nke puru iche iji hu ihe ogwu riri na ike inya ugboala. Mgbe ị na-anya ma na-arụ ọrụ site na iji usoro ịchọrọ nlebara anya ka ukwuu, a ga-elezi anya, n'ihi ọgbụgba na ura nwere ike ọ gaghị adịkarị mgbe ị na-ewere Telzap ®.

Emeputa

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

Mpaghara Kucukkaryshtyran, St. Merkez, Nke 223 / A, 39780, Buyukkaryshtyran, Luleburgaz, Kırklareli, Turkey.

Onye jidere asambodo idebanye aha. Sanofi Russia JSC. 125009, Russia, Moscow, ul. Tverskaya, 22.

Ekwesịrị izipu maka ịdị mma nke ọgwụ ahụ na adreesị nke Sanofi Russia JSC: 125009, Russia, Moscow, ul. Tverskaya, 22.

Tẹ.: (495) 721-14-00, faksị: (495) 721-14-11.

Mwepụta wepụtara ya na ihe mejupụtara

Telzap dị n'ụdị mbadamba ụrọ nke mkpuchi ihe nkiri dị 40 mg na 80 mg. A na-ere mkpụrụ 10 n'ime blisters, na ngwungwu kaadiboodu enwere 3, 6 ma ọ bụ 9 blisters na ntuziaka maka iji Telzap.

Otu mbadamba 1 nwere ihe eji arụ ọrụ: telmisartan - 40 mg ma ọ bụ 80 mg na ngwa inyeaka: povidone 25, meglumine, sodium hydroxide, sorbitol, magnesium stearate.

N'agbanyeghị nke ahụ, mepụtara mbadamba Telzap Plus 80 mg + 12.5 mg, nwere 80 mg nke telmisartan na 12.5 mg nke hydrochlorothiazide - diuretic.

Omume ọgwụ

Ihe na-arụ ọrụ bụ telmisartan nwere njirimara nke ụfọdụ ndị na - ahụ maka ọgwụ angiotensin II. Mgbe etinyere ya, ọgwụ ahụ nwere ike iwepụ angiotensin II site na njikọ ya na onye na-anabata ya. Ọzọkwa, n'ihe metụtara nnabata a, ọ bụghị ọkà mmụta sayensị. Telmisartan naanị na-anabata ndị na-anabata angiotensin II ATl. Ihe eji arụ ọrụ ego anaghị egosipụta ngwa ahịa yiri nke ahụ maka ihe nnabata AT2 na ụfọdụ ndị ọzọ.

N'okpuru mmetụta nke ọgwụ ahụ na plasma ọbara, itinye uche nke aldosterone na-ebelata. N'otu oge ahụ, ọrụ renin na-anọgide n'otu ọkwa ahụ ma anaghị egbochi ọwa ion.

Enzyme Angiotensin-na-agbanwegharị nke na-ejikọ mbibi bradykinin adịghị egbochi. Njirimara a na - enyere gị aka iwepụ ihe ize ndụ nke ịmalite nsonaazụ dịka ụkwara akọrọ.

Mgbe ị na-eji usoro ọgwụ nke 80 mg na ndị ọrịa, a na-egbochi mmetụta ọbara mgbali elu nke angiotensin II. A na-enweta nsonaazụ ahụ awa 3 mgbe ị firstụchara ọgwụ mbụ. Omume ahụ na-ewe awa 24. Ọ na-atụle ọgwụ na-adị irè ruo 48 awa. Iri mbadamba mgbe nile maka izu 4-8 na-eduga n'ịmepụta ihe antihypertensive akpọ.

Ojiji nke Telzap n'ime ndị ọrịa nwere ọbara mgbali elu nwere ike belata diastolic na ọbara mgbali systolic. Ka ọ dị ugbua, ọkwa obi anaghị agbanwe agbanwe.

A na-eji ọgwụ ahụ agwọ ọrịa ọrịa obi. N'ime ndị ọrịa agadi nwere ọrịa nke usoro akụrụngwa, mbadamba nkume nwere mmetụta nke mbelata ugboro:

ụkwara
infarction myocardial
onwu n’ihi ọrịa obi.

Ihe ngosi maka ojiji

Gịnị na-enyere Telzap aka? Isi ihe eji egosi mbadamba ihe:

IHD n’ime ndị ọrịa karịrị afọ 55.
Mgbochi ọrịa nke usoro obi.
Mgbochi nke ọnwụ n'ihi ọgụ ọgụ na ọrịa na ọrịa (maka mgbochi nke nkụchi obi, ọnya obi, nkụchi obi na nsonaazụ na-egbu egbu).
Mgbochi nsogbu sitere na obi na arịa ọbara gbasara ọrịa shuga nke 2.
Nnukwu ọbara mgbali elu - dị elu karịa 140/90 maka ụdị dị oke mkpa ọbara mgbali.
Dịka akụkụ nke usoro ọgwụgwọ siri ike ma ọsịsọ ọrịa strok.

Ọbara ọbara

A na-egbochi contraccantant nke Telzap na aliskiren n'ime ndị ọrịa nwere ọdịda akụrụngwa (GFR erughị 60 ml / min / 1.73 m2 nke akụkụ ahụ dị elu).

Inwe oge eji eme Telzap ya na ndị na - egbochi ACE na ndị ọrịa nwere ọrịa nephropathy.

N'ime ndị ọrịa agadi, anaghị achọ mmegharị dose.

Telzap gbakwunyere

Were ọnụ, otu ugboro n'ụbọchị, were mmiri mmiri sachaa ya, n'agbanyeghị nri ahụ.

Ndị ọrịa nke enweghị ike ịchịkwa BP nke ọma na monotherapy na telmisartan ma ọ bụ hydrochlorothiazide kwesịrị ịnara Telzap Plus.

Tupu ịgbanwee nha nha maka oge edobere, a na-atụ aro itinye otu ụzọ maka nkeji ọ bụla. N'ọnọdụ ụfọdụ, a pụrụ ịtụle mgbanwe site na monotherapy gaa ọgwụgwọ yana nchikota nke ịke.

Guo akwukwo a: Gini kedu inu inu mmanya mmanya: ntuziaka, onu ahia na nyocha

Nsonaazụ

N'ime ụfọdụ ndị ọrịa, iburu Telzap nwere ike ịkpasu ọdịdị nke nsonaazụ ndị ọzọ.

Dyspnea na ụkwara adịkarịghị eme. N’oge na-adịghị anya, ọrịa ngụgụ na-apụta.
Patientsfọdụ ndị ọrịa na-eme mkpesa nke ehighị ụra, ịda mba, ụba nchegbu. N'ọnọdụ ndị a na-adịghị ahụkebe, enwere nkụda mmụọ.
N’ime ụmụ nwanyị, ọrịa mbufụt nke usoro omumu nwere ike ime, n’ọnọdụ ndị a na-adịghị ahụkebe, a na-ahụta usoro nsọ nwoke. N'ime ụmụ nwoke, enwere ike ịba ezighi ezi.
Enwere ihe akaebe banyere mmepe nke thrombocytopenia, eosinophilia na haemoglobin dị ala.
N'ime ndepụta mmetụta ndị dị otú ahụ a ga-akpọ hyperhidrosis, itching skin, rash. Eczema, angioedema, erythema, Mmiri nsi na ọgwụ ụkwara na-adịkarị chọpụtara.
N'ime mmetụta dị iche iche a na-akpọ ọrụ akwara nwere nsogbu. Otu n'ime ọrịa ndị a bụ ọdịda gbasara akụrụ.
Site na nri diges, afọ ọsịsa, mgbu nke afọ, ọgbụgbọ, flatulence na dyspepsia na-apụta ugboro ugboro karịa ndị ọzọ. Ọrịa ire ụtọ, ahụ erughị ala na mpaghara epigastric, mucosa akọrọ na onu a na-ahụkarị.

Usoro akwara obi na-adighi anabata mmebi ojoo na aruogwu Telzap. Ka ọ dị ugbu a, ndị ọrịa ga-ekwe omume:

wedata ọbara mgbali elu na mgbanwe n ’ọnọdụ ahụ,
hypotension ada mba
ibelata ma ọ bụ mụbaa na ọnụego obi.

Ọrịa ọgbụgba na imeju na-adịkarị obere.

Iji ọgwụ nwere ike ime ka mbelata ọbara shuga na metabolic acidosis.

Ihe mmeghachi omume nfụkasị ahụ, ihe ndị a ka enwere ike:

Ngwongwo ogwu

Mlọ ọgwụ

Ojiji nke hydrochlorothiazide na telmisartan anaghị emetụta ọgwụ ọgwụ nke ọgwụ ndị a.

Telmisartan: Mgbe nchịkwa ọnụ gasịrị, a na-enweta ọnụ ọgụgụ kachasị elu nke telmisartan mgbe awa 0,5 - 1.5. Nnukwu bioavailability nke telmisartan na dose 40 mg na 160 mg bụ 42% na 58%, otu. Mgbe ị na-ewere telmisartan n'otu oge na nri, mbelata na AUC (mpaghara n'okpuru oge ịta ahụhụ) sitere na 6% (na dose 40 mg) ruo 19% (na dose 160 mg). Mgbe awa 3 a malitesịrị ịbanye n'ọbara plasma ọbara, ọ gụpụrụ nri. Mbelata nke obere na AUC anaghị ebute mbelata nke arụmọrụ ọgwụgwọ. Thelọ ọgwụ ọgwụ ọgwụ telmisartan nke a na-ekwu okwu bụ ihe edoghị anya na ọnụọgụ nke 20-160 mg yana mmụba dị ukwuu n'ọbara plasma (Cmax na AUC) na-abawanye ụba. Onweghi otutu mkpocha egwu telmisartan achoputara.

Hydrochlorothiazide: Mgbe nchịkwa ọnụ nke Telzap Plus, oke nke hydrochlorothiazide eruola ihe dị ka awa 1.0 ruo 3.0 mgbe ị theụsịrị ọgwụ ahụ. Dabere na mkpịsị mkpụrụ mmiri nke hydrochlorothiazide, bioavailability zuru oke bụ ihe dịka 60%.

Telmisartan dabere na protein ndị dị na plasma (karịa 99.5%), ọkachasị nwere albumin na alfa-1-acid glycoprotein. Olu nkesa nkesa bụ ihe ruru 500 L, nke na-egosi ijikọ anụ ahụ ọzọ.

Hydrochlorothiazide Ihe nchebe 68% na protein plasma na olu nke nkesa bụ 0.83 - 1.14 l / n'arọ.

Telmisartan metabolized site na njiko nke acylglucuronide na-arụ ọrụ ọgwụ. Glucuronide nke ogige nne na nna bụ naanị metabolite nke ahụrụla n’ime ụmụ mmadụ. Mgbe otu ọgwụ 14C nke akara telmisartan kpọrọ akara, glucuronide bụ ihe dịka 11% nke redioachibidoro plasma tụọ. Cytochrome P450 na isoenzymes anaghị esonye na metabolism nke telmisartan.

Hydrochlorothiazide adịghị metabolized na mmadụ

Telmisartan: Mgbe ọgwụgwọ intravenous ma ọ bụ nke ọnụ ọgụgụ 14C kpọrọ akara telmisartan, a na-apụtakarị ọtụtụ ọgwụ (> 97%) na feces site na mpụta biliary. A hụrụ obere mpịakọta na mmamịrị.

Mkpokọta plasma nke telmisartan mgbe nchịkwa ọnụ bụ> 1500 ml / min. Nkeji ọkara ndụ bụ> 20 awa.

Hydrochlorothiazide N'ime ihe dị na mmamịrị agbanwebeghị.Ihe dị ka pasent 60 nke ọgwụ a na-apụ apụ n'ime awa 48. Mkpochapu ntaramahụhụ dị ihe dị ka 250 - 300 ml / min. Nkeji ọkara ndụ bụ 10 ka awa iri na ise.

Ndị okenye na-arịa ọrịa

Aclọ ọgwụ ọgwụ telmisartan adịghị iche na ndị agadi na ndị ọrịa na-erubeghị afọ 65.

Ihe plasma nke telmisartan ruru ugboro abụọ n'ime ụmụ nwanyị karịa nke ụmụ nwoke. Na omumu ihe omumu ihe banyere ogwu, enweghi oke mmetuta nke nzaghachi obara ma obu otutu onodu orthostatic n’ime ndi nwanyi. Dose ukpụhọde adịghị. A chọpụtara na ụmụ nwanyị na-enwekarị oghere Plasma nke hydrochlorothiazide karịa ụmụ nwoke. O nweghi ihe di nkpa.

Ọrịa enweghị akụrụ

Rezọ ịgba ụgwọ adịghị emetụta mwepụ telmisartan. Dabere na nsonaazụ nke obere ahụmịhe na Telzap Plus n'ime ndị ọrịa nwere obere mkpụkọ akwara nwa obere (ikike idozi 30-60 ml / min, nkezi nke ihe dị ka 50 ml / min), ndozi dose adịghị mkpa na ndị ọrịa nwere obere ọrụ gbasara ọrụ. A naghị ewepụ Telmisartan n'ọbara site na hemodialysis. N'ime ndị ọrịa nwere nsogbu gbasara akụrụngwa, ọnụego mkpochapu hydrochlorothiazide belatara. N'ime ihe omumu na ndi ọrịa nwere ikike okike okike 90 ml / min, ọkara nke hydrochlorothiazide mụbara. N'ime ndị ọrịa nwere akụrụ na-anaghị arụ ọrụ, iwepu ọkara ndụ bụ ihe dịka 34 awa.

Ndị ọrịa nwere ọrịa imeju

N'ime ndị ọrịa nwere oke ịba ọcha n'anya, bioavailability zuru oke nke telmisartan na-abawanye na 100%. Ndụ ọkara nke imeju anaghị agbanwe agbanwe.

Farmakodinamika

Telzap Plus bụ ngwakọta nke antagonistin II receptor antagonist (ARAII), telmisartan, na thiazide diuretic, hydrochlorothiazide. Nchikota nke ihe ndi a nwere uto antihypertensive, na-wedata obara mgbali elu karie ihe obula mebere ya. Telzap Plus mgbe ewere ya otu ugboro n’ụbọchị na-eduga n'ịbelata ọbara mgbali elu nke ọma.

Telmisartan bụ nti angiotensin II angagonensin II receagonor antagonist (ụdị AT1) maka nchịkwa ọnụ. Telmisartan nwere nnukwu ihe yiri nke a na - achụpụ angiotensin nke II site na saịtị ya na-anabata ndị nabatara ụdị subtype 1 (AT1), bụ ndị na-ahụ maka mmetụta a maara nke angiotensin II. Telmisartan anaghị egosipụta ọrụ agonist ọ bụla na-emegide onye na-anabata AT1. Telmisartan ahọrọ nke ọma na onye na-anabata AT1. Idochi mmadu aru ogologo oge. Telmisartan egosighi ịdị ka ibe ya maka ndị nnabata ndị ọzọ, gụnyere ndị nnabata AT2 na ndị ọzọ, ndị na-anabataghị ndị na-anabata AT.

Amamịghe ọrụ nke ndị nnabata ndị a, yana nsonaazụ nke ike ha nwere na angiotensin nke abụọ, amụchaghị nke na-abawanye na nhọpụta nke telmisartan.

Telmisartan na-ebelata ọkwa Plasma aldosterone, anaghị egbochi renin na plasma na ion nke mmadụ.

Telmisartan anaghị egbochi enzyme angiotensin na-agbanwe agbanwe (kinase II), nke na-ebelata mmepụta bradykinin. Yabụ, enweghị nkwanye ugwu nke mmetụta ọ bụla metụtara ihe bradykinin.

Mkpụrụ 80 mg nke telmisartan, nke enyere ndị ọrụ afọ ofufo ahụike ahụ ike, ihe fọrọ nke nta ka ọ bụrụ na ọ na-egbochi mmụba nke nrụgide sitere na ikpughe na angiotensin II. Mmetụta inhibitory na-adịgide karịa 24 awa (ruo awa 48).

Mgbe ị takingụsịrị ọgwụ mbụ nke telmisartan, ọbara mgbali na-ebelata mgbe awa 3 gachara. Mbelata kachasị na mgbali ọbara, dịka iwu, a na-enweta izu 4-8 mgbe mmalite ọgwụgwọ wee dịgide maka ọgwụgwọ ogologo oge.

Mmetụta antihypertensive na-ewe awa 24 mgbe ị theụsịrị ọgwụ ahụ, gụnyere 4 awa tupu ị doseụ ọgwụ ọzọ, nke nkwenye ọbara na-enyocha ya, yana ọgwụ kwụsiri ike (karịa 80%) nke kacha nta na oke nke ọgwụ ahụ mgbe ịghasịrị 40 na 80 mg nke telmisartan na placebo-achịkwa. omumu akwukwo.

N'ime ndị ọrịa nwere ọbara mgbali elu, telmisartan na-ebelata ma mgbagha ọbara systolic na diastolic na-enweghị na-emetụta ọnụego obi. Antidị arụmọrụ antimispertensive nke telmisartan bụ ihe yiri ndị nnọchianya nke klas ndị ọzọ nke antihypertensive (dị ka egosiri na ọmụmụ ụlọ ọgwụ na-atụnyere telmisartan na amlodipine, atenolol, enalapril, hydrochlorothiazide, na lisinopril).

N'ime nnwale ihu abụọ gbara okpukpu abụọ, ọgwụ a na-achịkwa (N = 687 ndị ọrịa na-enyocha maka arụmọrụ), ndị mmadụ anabataghị mgbakwunye 80 mg / 12.5 mg gosipụtara mmetụta nwayọ nke iweda ọbara mgbali elu nke njikọ 80 mg / 25 mg ma e jiri ya tụnyere ọgwụgwọ ogologo oge na dose 80 mg / 12.5 mg 2.7 / 1,6 mmHg (SBP / DBP) (ọdịiche na mgbanwe mgbanwe agbadoro agbakwunyere na ntọala otu). N'ime ọmụmụ ya na ngwakọta 80 mg / 25 mg, ọbara mgbada belatara, na-ebute mbelata ihe dịka 11.5 / 9.9 mmHg. (GARDEN / DBP).

Nnyocha zuru oke nke izu abụọ yiri nke 8 kpuru ìsì abụọ, ọnwụnwa a na-ejikwa ọgwụ na-atụnyere valsartan / hydrochlorothiazide 160 mg / 25 mg (N = 2121 ndị ọrịa nyochachara maka arụmọrụ) gosipụtara mmetụta ka ukwuu nke wedata ọbara mgbali elu 2.2 / 1.2 mm Hg . (SBP / DBP) (ihe dị iche na mgbanwe pụtara mgbanwe site na ntanetị, otu dị iche iche) iji kwado nchikota nke telmisartan / hydrochlorothiazide 80 mg / 25 mg.

Mgbe etinyere ọgwụgwọ nke ọma na telmisartan, ọbara mgbali ji nwayọọ nwayọọ laghachi uru mbụ ya n'ime ọtụtụ ụbọchị na-enweghị ihe ịrịba ama nke ọbara mgbali elu.

N'ime nyocha ụlọ ọgwụ na-atụnyere ọgwụgwọ abụọ ahụ, ọnọdụ ụkwara dị ala belatara nke ukwuu na ndị ọrịa na-anata telmisartan karịa ndị na-anata enzyme enzyme enzyme.

Ihe omumu ihe omumu nke PRoFESS mere na ndi oria karia iri-ise n’enweghi oria gosiputara na-abawanye sepsis na telmisartan ma e jiri ya tụnyere placebo, 0.70% ma e jiri ya tụnyere 0.49% MA 1.43 (nkeji oge ntụkwasị obi 95% na 1.00 - 2.06), ugboro ole ọnwụ sitere na sepsis dị elu na ndị ọrịa na-ewere telmisartan (0.33%) ma e jiri ya tụnyere ndị ọrịa na-ewere placebo (0.16%) MA 2.07 (95% nkeji oge ntụkwasị obi 1.14 - 3.76). Mmụba a chọpụtara na oghere nke metụtara sistemu nke telmisartan nwere ike ịbụ ihe efu ma ọ bụ nwere ike jikọtara ya na usoro a na-amaghị ugbu a.

Amaghi ihe nsogbu nke telmisartan na onwu na akwara. Hydrochlorothiazide bụ thiazide diuretic. Amaghị usoro nke antihypertensive mmetụta nke thiazide diuretics. Thiazides na-emetụta usoro sistemụ nke reabsorption nke electrolytes na tubules, na-abawanye mkpirisi nke sodium na chloride na mkpokọ nha. Mmetụta diuretic nke hydrochlorothiazide na-ebelata oke olu nke plasma, na-eme ka ọrụ plasma renin dịkwuo elu, na-eme ka mkpụrụ ndụ nke aldosterone na-esochi, mmụba na potassium na mmamịrị, mfu nke bicarbonate na mbelata na protein nke serum. Achọpụtara site na mgbochi nke sistemụ renin-angiotensin-aldosterone, njikwa nke telmisartan, dịka iwu, na-egbochi mfu nke potassium metụtara diuretics ndị a. Mgbe ị na-eji hydrochlorothiazide, mmalite nke diuresis na-apụta mgbe elekere abụọ gachara, mmetụta kachasị elu na-apụta mgbe ihe dị ka awa anọ gasịrị, ebe mmetụta ahụ na-adịgide ruo ihe dịka awa 6-12.

Ọmụmụ Epidemiological egosila na ọgwụgwọ ogologo oge na hydrochlorothiazide na-ebelata ihe ize ndụ nke ọnwụ obi na ọrịa.

Childrenmụaka, n’oge ime na lactation

Enweghị ozi a pụrụ ịdabere na ya banyere nchekwa nke ọgwụ a n'oge afọ ime. Ọ bụrụ na onye ọrịa ahụ na-eme atụmatụ ịtụrụ ime, na ọ kwesiri ị medicineụọ ọgwụ iji belata nrụgide ahụ, a na-atụ aro ị takeụ ọgwụ ndị ọzọ.

Ojiji nke ọgwụ site na otu nke inhibitors, angiotensin antagonists na ọkara nke abụọ na nke atọ na - enye aka na mmepe nke mmebi akụrụ, imeju, igbu oge nke okpokoro isi nke nwa ebu n’afọ, oligohydramnion (mbelata oke nke mmiri ọmụmụ).

Iji ọgwụ eme ihe n'oge a na-enye nwa ara machibidoro iwu.

Mkparịta ụka ọgwụ ọjọọ

A na-ejikarị Telzap dị ka akụkụ nke ọgwụgwọ siri ike, yabụ ịkwesịrị ịtụle ndakọrịta nke mbadamba ya na ọgwụ ndị ọzọ.

Anaghị anabata ndị ọrịa nwere ụdị ọrịa shuga 2 ka ha gaa telmisartan ndị ọzọ na-egbochi ACE n'otu oge. N'ọnọdụ ka ukwuu, nke a na-akpata hypoglycemia.

Ọgwụ akwadoghị maka iji: