Etu esi eji ọgwụ ọgwụ Telsartan N?

Nkọwa nke ụdị usoro onunu ogwu

Mbadamba ụrọ 12.5 mg + 40 mg. Oval, biconvex, okpukpu abụọ, otu oyi akwa si na pink dị ka pink, nke ọzọ na-acha ọcha site na-acha ọcha ruo ihe fọrọ nke nta ka ọ bụrụ nke na-acha pinki pinki. N’ihe dị ọcha n’elu mbadamba nkume ahụ enwere ihe ize ndụ na itinye “T” na “1” n’akụkụ nke ya.

Mbadamba ụrọ 12.5 mg + 80 mg. Oval, biconvex, okpukpu abụọ, otu oyi akwa si na pink dị ka pink, nke ọzọ na-acha ọcha site na-acha ọcha ruo ihe fọrọ nke nta ka ọ bụrụ nke na-acha pinki pinki. N’ihe dị ọcha n’elu mbadamba nkume ahụ enwere ihe ize ndụ ma tinye “T” na “2” n’akụkụ nke ya.

Mpempe usoro onunu ogwu

Njirimara nke anụ ahụ na kemịkal:

mbadamba ụrọ sitere na ọcha ruo ihe fọrọ nke nta ka ọ bụrụ ọcha, na-enweghị shei, nke nwere okpu, na-ebi akwụkwọ “T” na “L” n'akụkụ abụọ nke mmebi ahụ n'otu akụkụ yana mbipụta “40” (maka mbadamba 40 mg) ma ọ bụ ntụgharị “80” ( maka mbadamba 80 mg) na akuku nke ozo.

Ihe ngbanwe

Hypersensitivity (gụnyere ndị ọzọ n'ụkpụrụ sulfonamide, cholestasis, ọrịa imeju siri ike, nnukwu akwara na-ada mba (CC erughi 30 ml / min), hypokalemia, hyponatremia, hypercalcemia, hereditary fructose anagide (nwere sorbitol), ịtụrụ ime, lactation, afọ rue afọ 18 (etinyere arụmọrụ na nchekwa adịghị) C ịkpachara anya: Ọkpụkpụ imeju ma ọ bụ ọrịa imeju na-aga n'ihu (ihe egwu hepatic coma n'ihi electrolyte aghara), nsogbu abụọ nke akụrụ. akwara akwara ma ọ bụ stenosis nke otu akụrụ akwara, akwara nke akụrụ, ọnọdụ mgbe ebesịrị akụrụ, mbelata na bcc (ọgwụ ịla azụ, nri nwere mmachi nnu, afọ ọsịsa ma ọ bụ ọgbụgbọ), obi ike, aortic ma ọ bụ mitral stenosis, GOKMP, ọrịa shuga mellitus, CHD, SLE gout.

Etu esi eji: usoro onunu ogwu na usoro ọgwụgwọ

N'ime, n'agbanyeghị nri nri, otu oge kwa ụbọchị.

Mbadamba nwere oke nke telmisartan / hydrochlorothiazide 40 / 12.5 mg na 80 / 12.5 mg ka enwere ike inye ndị ọrịa ike iji telmisartan na ọgwụ nke 40 ma ọ bụ mg ma ọ bụ hydrochlorothiazide na ọgwụ nke 12.5 mg anaghị ebute nchịkwa zuru oke nke ọbara mgbali.

Dose mmezi maka ọdịda akwara nke ogo obere yana ogo oke, yana ndị ọrịa adịghị agadi.

Site na ọrịa imeju dị nro na nfe na-agafe agafe, dose ekwesịghị gafere 40 / 12.5 mg kwa ụbọchị.

Omume ọgwụ

Telmisartan bụ onye na - emegide ụzọ nnabata angiotensin II (ụdị AT1). Na-egosiputa angiotensin nke II site na njikọ ya na onye na-anabata ihe, na-ejighi ihe onye na-atụgharị uche na nnabata a. Ọ na-etolite mmekọrịta ogologo oge naanị na AT1 n'ụdị nke nnabata angiotensin II. O nweghi nmekorita ya nye ndi nnabata ozo, nke gụnyere ndi nnabata AT2 na ndi ozo, ndi natara nnabata angiotensin. Telmisartan na-eduga n'ịbelata mkpokọta aldosterone na plasma ọbara. Ọ dịghị emetụta ọrụ plasma renin na ọwa ion, ACE, anaghị eme ka bradykinin rụọ ọrụ.

N'ihe dị ka 80 mg, mmetụta ọbara mgbali elu nke angiotensin II na-egbochi kpamkpam. Mmetụta nke ọgwụ ahụ na-adịgide karịa awa 24, gụnyere awa anọ ikpeazụ gara aga tupu ị takingụ ọgwụ ọzọ. Mmalite nke nrụgide ga-achọpụta n'ime awa 3 mgbe ọgwụ nke mbụ gasịrị. A na-ahụkarị mbelata ọbara mgbali elu ka izu anọ gachara ịmalite ọgwụgwọ.

Site na ọbara mgbali elu, ọ na - ebelata ọbara mgbagha systolic na diastolic, na - enweghị emetụta mmetụ obi. N'ihe banyere kagbuo telmisartan na mberede, ọbara mgbali jiri nwayọ laghachi ọkwa mbụ ya na enweghị mmepe nke ọrịa "ndọrọpụ".

Hydrochlorothiazide bụ thiazide diuretic. Ọ naghị emetụta reabsorption nke electrolytes na tọọles renal, na-abawanye ihu nsọ Na + na Cl- (ihe ruru nha). Nsonaazụ diuretic na-eduga na mbelata bcc, mmụba na ọrụ nke plasma renin, mmụba na nzuzo nke aldosterone ma sonyere mmụba nke ọdịnaya K + na bicarbonates na mmamịrị, yana hypokalemia. Site na nlekọta nke telmisartan n’otu oge, a na-ebelata ọnwụ nke K + nke hydrochlorothiazide kpatara, a ga-atụ anya n'ihi mgbochi nke sistemụ renin-angiotensin-aldosterone. Mgbe iwere hydrochlorothiazide, diuresis na-agbasi ike mgbe oge awa abụọ gasịrị, a na-ahụ mmetụta kachasị mgbe ọ gachara awa 4. Mmetụta diuretic na-adịgide ruo ihe dịka awa 6-12.

Mmetụta antihypertensive kachasị na ọgwụ a na-enwetakarị izu 4 mgbe mmalite ọgwụgwọ.

Nsonaazụ

Site na sistem iku ume: ọrịa ọgụ na akụkụ akụkụ akụkụ elu (nke gụnyere bronchitis, pharyngitis, sinusitis), mkpụmkpụ ume, dyspnea, nsogbu iku ume (gụnyere oyi baa na ụkwara ume ọkụ).

Site na CCC: bradycardia, tachycardia, arrhythmia, mbelata ọbara mgbali elu, orthostatic hypotension, necrotic angiitis (vasculitis), mgbu obi.

Site n'akụkụ nke sistemụ akwara: ụba mgbakasị ahụ, echiche nke ụjọ, ịda mba, nchekasị, ọgbụgbọ, nkụda mmụọ, enweghị ụra mgbe ọ bụla ije, paresthesia.

Site na usoro nri: mgbu afọ, afọ ọsịsa, dyspepsia, gastritis, anorexia, agụụ, agụụ, siladenitis, ọnụ akọrọ, flatulence, vomiting, constipation, pancreatitis, jaundice (hepatocellular or cholestatic).

Site na usoro endocrine: hyperglycemia, glucosuria, tolerance glucose.

Site n'akụkụ nke metabolism: hypercholesterolemia, hyperuricemia, hypokalemia, hyponatremia, belatara BCC, ụkọ electrolyte metabolism, hypercalcemia.

Site na akụkụ ahụ haemopoietic: eosinophilia, ọrịa ana-akwoteju, hemolytic anemia, myelodepression, leukopenia, neutropenia / agranulocytosis, thrombocytopenia.

Site na usoro urinary: ọrịa nke usoro urinary, nephritis interstitial, ọrụ akwara nwere nsogbu.

Site na usoro akwara: arthralgia, ogbu na nkwonkwo, mgbu azụ, mgbu mgbu ụkwụ, myalgia, mgbu azụ nke akwara nwa ehi (crumpi), ihe mgbaàmà dịka akwara, ike ọgwụgwụ, akwara umeji.

Mmeghachi omume nfụkasị: mmeghachi omume anaphylactic, eczema, erythema, akpụkpọ itchy, lupus-skin skin reaction, skin vasculitis, photoensitivity, friji anụ ahụ, oke mbibi SLE, ọnya ọnya ọgbụgba necrolysis, angioedema, urticaria.

Site na akwara anụ ahụ: ọgba aghara acuity visual, anya na-ahụ anya (transient), xanthopsia, vertigo.

Site na usoro omumu: ikike nwere mbelata.

Ndị na-egosi ụlọ nyocha: mbelata na Hb, hypercreatininemia, ụba ọrụ nke transminases "imeju", hypertriglyceridemia.

Ihe ozo: oria-di ka oria, ahu oku, ubara ozo. Ihe mgbaàmà (telmisartan): akara akara mbelata ọbara mgbali, tachycardia na / ma ọ bụ bradycardia.

Ọrịa (hydrochlorothiazide): hypokalemia (spasm muscle, ụba arrhythmia nke mere site n'otu oge eji cardiac glycosides ma ọ bụ ọgwụ antiarrhythmic), hypochloremia, akpịrị ịkpọ nkụ n'ihi oke diuresis, ọgbụgbọ, ụra.

Ọgwụ: itinye ọgbụgbọ na ọgbụgba, ọnya afọ, unyi na-arụ ọrụ, usoro ọgwụgwọ na inye nkwado, na-eleba anya n'ihe gbasara elektrik na creatinine n'ọbara. N'ihe banyere mbelata ọbara mgbali elu, ekwesịrị idobe onye ọrịa ahụ na ọnọdụ kwụ ọtọ, na-emezigharị ụkọ electrolytes, bcc.

Achọpụghị Telmisartan. Ogo ogo mwepu nke hydrochlorothiazide n’oge emere ya ka akabeghi ike.

Ntụziaka pụrụ iche

N'ime ndị ọrịa nwere akwara mkpụrụ ndụ akwara stenosis ma ọ bụ stenosis akwara nke naanị akụrụ na-arụ ọrụ mgbe ị na-eji ọgwụ ọjọọ emetụta sistemụ renin-angiotensin-aldosterone, ihe ọghọm nke mbelata na ọdịda akụrụngwa na-abawanye.

Enweghị ahụmịhe na nkwadebe n’ime ndị ọrịa nwere nnukwu akụrụ oke ma ọ bụ mgbe akụrụ gbasara akụrụ. Site na ịdị mkpụmkpụ nwayọ nwayọ ma ọ bụ agafeghị oke nke akwara, mkpebi oge nke itinye uche K +, a na-atụ aro creatinine n'ime ọbara. Ojiji nke thiazide diuretics n'ime ndị ọrịa nwere akụrụ gbasara akwara nwere ike ibute ọrịa azotemia. A na-atụ aro maka oge akụrụngwa maka ọrụ akụrụ.

N'ime ndị ọrịa nwere mbelata BCC na / ma ọ bụ hyponatremia (n'ihi usoro ọgwụgwọ ọrịa akwara, mmachi nke nnweta nnu, afọ ọsịsa ma ọ bụ vomiting), ọgwụ akpọrọ mbelata ọbara mgbali elu nwere ike ịmalite, ọkachasị mgbe ị firstụchara ọgwụ mbụ. Tupu iji ọgwụ ahụ, mgbazi nke nsogbu ndị a dị mkpa.

N'ime ndị ọrịa nwere ajọ ọrịa CHF, akwara akwara stenosis, iji ọgwụ ọjọọ eme ihe na-emetụta steeti usoro renin-angiotensin-aldosterone nwere ike sonyere mmepe nke mbelata ọbara mgbali elu, hyperazotemia, oligouria, ma ọ bụ, n'ọnọdụ ndị obere, nnukwu ọrịa gbasara akụrụ.

N'ime ndị ọrịa nwere ọrịa hyperaldosteronism mbụ, ọgwụ antihypertensive, usoro nke iji gbochie ọrụ nke sistemụ renin-angiotensin-aldosterone adịghị arụ ọrụ. N'ọnọdụ ndị dị otú a, akwadoghị nhọpụta ọgwụ a ka akwadoro.

N'ime ndị ọrịa nwere ọrịa shuga, ọ ga-adị mkpa ịgbanwe mgbanwe insulin ma ọ bụ ọgwụ hypoglycemic ọgwụ. Mgbe a na-eji ọgwụ ndị a na-agwọ thiazide, ụdị ọrịa shuga nwere ike igosipụta.

N'ọnọdụ ụfọdụ, ojiji nke thiazide diuretics nwere ike ịmalite hyperuricemia na gout.

N'oge ọgwụgwọ, nleba anya oge nke itinye uche nke electrolytes n'ọbara ọbara dị mkpa.

Ihe ize ndụ nke hypokalemia na-abawanye na ndị ọrịa nwere ọrịa cirrhosis, na ịba ụba diuresis, na-ezughị ezu iji mejupụta electrolytes, yana n'ihe banyere n'otu oge GCS ma ọ bụ ACTH

Telmisartan, nke bụ akụkụ nke ọgwụ ahụ, nwere ike ibute hyperkalemia. Agbanyeghị na enwebeghị ego hyperkalemia n'ụlọ ọgwụ ka ejiri nkwadebe ahụ, ekwesịrị iburu n'uche na ihe ndị nwere ike ibute mmepe ya gụnyere akụrụ gbasara akwara na / ma ọ bụ nkụchi obi na ọrịa shuga mellitus.

Enweghị ihe akaebe na ọgwụ nwere ike belata ma ọ bụ gbochie hyponatremia nke ọgwụ diuretic kpatara. A na-akpọkarị hypochloremia ntakịrị ma ọ chọghị mgbazi.

Hydrochlorothiazide nwere ike ibelata ntụpọ Ca2 + na ihe kpatara (na enweghị ọnụnọ metabol nke Ca2 mara amara) ntakịrị ume na obere hypercalcemia. Nnukwu hypercalcemia dị ịrịba ama nwere ike ịbụ akara nke hyperparathyroidism na-adịte aka. Tupu ị na-ekpebi ọrụ nke glands parathyroid, a ga-akagbu ọgwụ ahụ.

N'ime ndị ọrịa nwere ọrịa akwara ọbara, mbelata ọbara mgbali elu nwere ike iduga infarction myocardial ma ọ bụ ọrịa strok.

Usoro a na-atụ aro kwa ụbọchị nke 40 / 12.5 ma ọ bụ 80 / 12.5 nwere 169 ma ọ bụ 338 mg nke sorbitol, n'otu n'otu.

Ihe ọghọm nke imepụta ihe nfụkasị ahụ na hydrochlorothiazide na-abawanye na ndị ọrịa nwere ọrịa ọrịa ma ọ bụ ụkwara ume ọkụ.

Enwere akụkọ banyere mmepe nke SLE site na iji thiazide diuretics.

Enwere ike iji ọgwụ ahụ, ma ọ bụrụ na ọ dị mkpa, yana ọgwụ ndị ọzọ na - egbochi ọgwụ mgbochi.

N'oge ọgwụgwọ, a ga-akpachara anya mgbe ị na-eme ihe egwu nwere ike ịdị (gụnyere ịnya ụgbọ ala) nke chọrọ ịbawanye ụba nke ntị na ọsọ nke mmeghachi omume psychomotor (enwere ike ịmalite ọgbụgba na ihi ụra mgbe ị na-eji ọgwụ antihypertensive).

Telmisartan enweghị mmetụta teratogenic, mana ọ nwere mmetụta fetotoxic. N'ihe banyere ịtụrụ ime, a ga-eji ọgwụ ọgwụ ndị ọzọ akwadoro iji mee afọime. Ọ bụrụ n’afọ guzobere ime, ịkwesịrị ịkwụsị ị .ụ ọgwụ ahụ ozugbo.

Na ngụkọta oge nke abụọ nke II na nke III, iji ọgwụ nwere ike ibute ọgbaghara electrolyte na nwa ebu n’afọ. Mmepe nke osụhọ nke thrombocytopenia, jaundice (n’ime nwa ebu n’afọ ma ọ bụ n’afọ ọhụrụ) n’ihe gbasara nne na-a tụ ọgwụ thiazide. Amabeghị ma telmisartan na-abanye na mmiri ara, thiazide diuretics na-abanye na mmiri ara ara ma nwee ike igbochi ịra anụ.

Mmekorita

Site n'otu oge iji Li + na angiotensin II na-emegide ndị na-emegide ime mmụọ, mmụba nke mkpokọta Li + n'ọbara ọbara yana mmụba na nsonaazụ ndị na-egbu egbu. Ojiji hydrochlorothiazide na-ebelata nhichapụ nke Li +. Jiri nlezianya nyochaa ihe dị mkpa, na-eleba anya n'ihe gbasara Li + n'ọbara.

Mmetụta hypokalemic nke hydrochlorothiazide bụ nke sitere na potassium-sparing mmetụta nke telmisartan. Agbanyeghị, enwere ike ịbawanye ike hypokalemic hydrochlorothiazide site na ọgwụ ndị ọzọ na-ebute hypokalemia (gụnyere ọgwụ ndị ọzọ, laxatives, GCS, ACTH, amphotericin, carbenoxolone, penicillin G sodium, salicylic acid na ihe ndị e ji eme ya).

Ojiji nke ihe ndị na-eme ka ihe na-egbu potassium dị ka ọgwụ, K + na ọgwụ ndị ọzọ nwere ike ịbawanye mkpụrụ nke serum K + (gụnyere sodium heparin), K + -nweta nri nri nwere ike ibute hyperkalemia.

N'iji ojiji a na-eji klycosides cardiac eme ihe, antiarrhythmic na ọgwụ ndị ọzọ na-akpata ọrịa arrhythmias dị ka pirouette, a na-atụ aro nlebara anya nke itinye uche K + na plasma ọbara.

Telmisartan na-akwalite mmetụta hypotensive nke ọgwụ ndị ọzọ antihypertensive.

Ọgwụ nwere ike ime ka mkpocha digoxin (ruru 39%), yabụ, ịchọrọ ileba anya na plasma nke digoxin.

Iji hydrochlorothiazide na ethanol, barbiturates, narcotic analgesics - ihe egwu nke ịmalite orthostatic hypotension, na ndị na - ahụ ike hypoglycemic (ma ọnụ ma insulin) - enwere ike ịchọrọ ịsesụ ọgwụ hypoglycemic, na metformin - ihe ize ndụ nke lactic acidosis, colestiramly na colestiramism ya na cardioac glycosides - ihe ize ndụ nke hypokalemia ma ọ bụ hypomagnesemia (arrhythmias), na NSAIDs - mbelata diuretic, natriuretic na mmetụta antihypertensive hydrochlorothiazide, ya na amines pressor (gụnyere norepinephrine - adịghị ike nke mmetụta pressor amines, na-enweghị depolarizing muscle relaxants) (gụnyere tubocurarine) - mmụba na ọrụ nke izu ike akwara, na antigout - idozi dose nke ọgwụ uricosuric nwere ike ịchọ, n'ihi (n'ihi hyper kpatara hydrochlorothiazide), ya na allopurinol - mmụba ugboro ugboro nke hypersensitivity mmeghachi omume na allopurinol, na Ca2 + salts - ihe ọghọm nke ịmalite hypercalcemia (n'ihi mbelata ya na ntụpọ ya), yana mgbochi beta-adrenergic na diazok mkpụrụ - ihe egwu nke ịba ụba hyperglycemia, ya na m-anticholinergics (gụnyere atropine, biperiden) - mmụba na bioavailability nke hydrochlorothiazide (n'ihi mbelata motility gastrointestinal).

Ọgwụ ahụ nwere ike ịbawanye ohere nke nsonaazụ nke amantadine, belata mkpịsị akụrụngwa ọgwụ ọgwụ cytotoxic (gụnyere cyclophosphamide, methotrexate) ma welie mmetụta myelosuppressive ha.

Mlọ ọgwụ

Hydrochlorothiazide bụ thiazide diuretic. Thiazide diuretics emetụta reabsorption nke electrolytes n'ime akụrụ renal, na-abawanye mkpachapụ nke sodium na chlorides (ihe dị ka nha). Mmetụta diuretic nke hydrochlorothiazide na-eduga ná mbelata nke bcc, mmụba na ọrụ plasma renin, mmụba na nzuzo nke aldosterone, ihe na-esote mmụba na ikuku potassium na hydrogen carbonates na, n'ihi ya, mbelata nke potassium na plasma ọbara.Site na nchịkwa nke oge a na telmisartan, enwere echiche nke ịkwụsị ọnwụ nke ihe ọkụ ọkụ ndị a kpatara, na-apụtakarị n'ihi mgbochi RAAS.

Mgbe nchịkwa ọnụ gachara, diuresis na-abawanye mgbe awa 2 gachara, ana-ahụkarị nsonaazụ ihe dị ka elekere anọ .. Mmetụta diuretic nke ọgwụ ahụ na-adịgide ruo ihe dịka awa 6-12.

Ogologo oge iji hydrochlorothiazide na-ebelata ihe egwu nke ọrịa obi na onwu site na ha.

Telmisartan - Uzo a kapịrị ọnụ nke ARA II (Typedị AT₁), dị irè mgbe ejiri ọnụ kwuo ya. Nwere mmekọ dị elu maka AT subtype₁ndị na-anabata angiotensin nke Abụọ, site na nke a na-achọpụta ihe nke angiotensin II. Na-egosiputa angiotensin II site na njikọ ya na onye na-anabata ya, na-egosighi akụrụngwa nke agonist n'ihe metụtara onye nnabata a. Telmisartan na-ejikọ naanị INtype AT₁ndị na-anabata angiotensin II. Njikọ ahụ na-aga n'ihu. O nweghi nmekorita diri ndi nnata ozo, ntinye. ka AT₂ihe nnabata na ndị ọzọ na - erughi 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 egbochi mmiri renin na plasma ọbara ma ọ dịghị egbochi ụzọ ion. Telmisartan anaghị egbochi ACE (kininase II), nke na-ejikwa mmebi nke bradykinin. Yabụ, atụghị anya mmụba nke mmetụta n'akụkụ bradykinin kpatara.

N'ime ndị ọrịa nwere ọbara mgbali elu, telmisartan na dose 80 mg kpamkpam na-egbochi mmetụta ọbara mgbali nke angiotensin II. Mmalite ọgwụ antihypertensive pụtara n'ime awa 3 mgbe nchịkwa mbụ nke telmisartan. Mmetụta ọgwụ ahụ na-adịgide ruo awa 24 ma na-adịgide ruo ihe dị ka awa 48. Mmetụta ọgwụ na-egbu egbu na-amalitekarị izu anọ mgbe ị ofụ ọgwụ ahụ.

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

N'ihe banyere kagbuo telmisartan na mberede, ọbara mgbali jiri nwayọ laghachi ọkwa mbụ ya na-enweghị mmepe nke ọrịa mwepụ.

N'ime ọmụmụ na telmisartan, a tụlere okwu banyere ọnwụ obi, ọrịa na-anaghị egbu egbu, ọrịa strok na-adịghị egbu, ma ọ bụ ụlọ ọgwụ n'ihi nkụchi obi. Mbelata na ọrịa obi na ọrịa obi na ndị ọrịa nwere nnukwu ọrịa obi (ọrịa akwara akwara, ọrịa obi, ọrịa obi ike ma ọ bụ ọrịa mellitus na ọnya ọnya na-emetụta akụkụ ahụ dịka retinopathy, hypertrophy hapụrụ, macro-ma ọ bụ microalbuminuria na akụkọ ihe mere eme) egosila. Ihe karịrị afọ 55.

Mmetụta antihypertensive kachasị nke ọgwụ Telsartan ® N na-arụkarị izu izu anọ mgbe ịmalite ọgwụgwọ.

Mlọ ọgwụ

Nchịkọta ojiji nke telmisartan na hydrochlorothiazide anaghị emetụta ọgwụ pharmokokinetics nke ọgwụ ọgwụ ọ bụla.

Mgbe nchịkwa ọnụ nke ọgwụ Telsartan ® N C_max plasma hydrochlorothiazide ruru n'ime awa 1. N'ime bioavailability zuru oke bụ ihe dịka 60% (nke sitere na ngụkọta akụrụ). Ihe nchebe Plasma jikọtara 64% nke hydrochlorothiazide, na V_d bụ (0.8 ± 0.3) l / n'arọ. Hydrochlorothiazide adịghị metabolized n'ime ahụ ma wepụta ya site na akụrụ na-agbanweghi agbanwe. Ihe dị ka 60% nke ọgwụ ingesits na-ewepụ n'ime awa 48. Nkwụcha ntaramahụhụ dị ihe dịka 250-300 ml / min. Ndi_1/2 hydrochlorothiazide bụ awa 10-15.

Enwere ọdịiche na mkpokọta plasma na ụmụ nwoke na ụmụ nwanyị. N'ime ụmụ nwanyị, mkpokọta telmisartan na plasma dị okpukpu abụọ karịa nke ụmụ nwoke, ụmụ nwanyị na-enwekarị mmụba dị ukwuu na mkpokọta plasma nke hydrochlorothiazide.

Ọdịda ya. N'ime ndị ọrịa nwere nsogbu gbasara akụrụngwa, ọnụego mkpochapu hydrochlorothiazide belatara. Mmụta n'ime ndị ọrịa nwere 90 ml / min creatinine Cl gosipụtara na T_1/2 hydrochlorothiazide na-abawanye. N'ime ndị ọrịa nwere obere ọrụ gbasara akụrụngwa T_1/2 ihe dịka 34 awa

Mgbe ingested ngwa ngwa etinye obi gị dum si Ọkpụkpụ afọ. Bioavailability dị ihe dịka 50%. Ntinye uche kachasị elu mgbe ihe dị ka awa 0,5-1.5 gachara. Mgbe ewere nri n'otu oge, mbelata na AUC sitere na 6 ruo 19% (mgbe ị na-a aụ 40 na 160 mg, n'otu n'otu). Mgbe awa 3 a malitesịrị ịbanye na ya, a na-etinye uche gị na plasma ọbara ọbara n'agbanyeghị nri ahụ.

Enwere ọdịiche na mkpokọta telmisartan na plasma n'ime ụmụ nwoke na ụmụ nwanyị. C_max na plasma, ihe dị ka ugboro atọ na AUC ihe dị ka ugboro abụọ karịa nke ụmụ nwanyị ma e jiri ya tụnyere ụmụ nwoke na-enweghị nnukwu mmetụta na arụmọrụ. Agbanyeghị, a naghị achọpụta mmụba dị na hypotensive na ụmụ nwanyị.

Mkpakọrịta dị oke mkpa na protein protein (ihe karịrị 99.5%), tumadi na albumin na alfa₁-acid glycoprotein. Ise_d odika lita 500

A na-agbanye Telmisartan site na conjugation na glucuronic acid. Metabolites anaghị arụ ọrụ ọgwụ. Ndi_1/2 karịrị awa iri abụọ

Ọ na-ewepụta ya na eriri afọ na - agbanweghi, na - ewepụta site na akụrụ - ihe na - erughị 2%. Nchịkọta zuru oke nke plasma dị elu (ihe dịka 900 ml / min).

Ndị okenye na-arịa ọrịa. Pharmlọ ọgwụ ọgwụ telmisartan na ndị ọrịa agadi adịghị iche na ndị ọrịa na-eto eto. Dose ukpụhọde adịghị.

Ọdịda ya. Notgbanwe dose nke telmisartan na ndị ọrịa nwere akụrụ gbasara akwara abụghị ihe achọrọ, gụnyere ndị ọrịa na hemodialysis. Achọpụghị Telmisartan.

Imeju imeju. Ọmụmụ nke ọgwụ pharmacokinetics na ndị ọrịa nwere ọrịa imeju gosipụtara mmụba zuru oke na bioav adị nke ihe ruru 100%. Na imeju imeju T_1/2 anaghị agbanwe (lee. "Usoro ọgwụgwọ na nchịkwa").

Ime na lactation

Iji ọgwụ eme ihe bụ Telsartan ® N mebiri emebi n'oge afọ ime.

Ahụmahụ hydrochlorothiazide n'oge afọ ime, ọkachasị n'oge ọnwa atọ.

Hydrochlorothiazide na-agafe ihe mgbochi placental. Nyere usoro ogwu nke aru nke hydrochlorothiazide, ekwenyere na ojiji ya n’ime oge nke abuo na nke ato nke ime nwere ike imeghari udiri fetoplacental ma mekwaa mgbanwe n’ime ẹmbrayo na nwa n’afọ, dịka ọrịa jaundice, ọgba aghara na mmiri-electrolyte itule na thrombocytopenia.

Ekwesighi iji Hydrochlorothiazide na-agwọ ọbara mgbali dị mkpa n'ime ụmụ nwanyị dị ime, belụsọ n'ọnọdụ ndị ahụ dị ụkọ ebe enweghị ike iji ọgwụgwọ ndị ọzọ.

Ojiji nke ARA II n'oge ime nwere contraindicated.

Mgbe ịchoputara afọ ime, ekwesịrị ịkwụsị ọgwụ a ozugbo.

Ọ bụrụ na ọ dị mkpa, ekwesịrị iji usoro ọgwụgwọ ọzọ (klas ndị ọzọ nke ọgwụ nje na-akwadoro iji mee n'oge afọ ime).

Usoro ọgwụgwọ nke Telsartan ® H ka machibidoro oge ị theụ ara.

N'ime ihe omumu anumanu, egoputaghi nsogbu nke telmisartan na hydrochlorothiazide na ọmụmụ. Emebeghị nnyocha banyere mmetụta nke ọmụmụ ụmụ mmadụ.

Usoro onunu ogwu na nhazi

N'ime n'agbanyeghị nri.

Ekwesịrị ịhapụ Telsartan ® N oge 1 kwa ụbọchị.

Enwere ike inyefe Telsartan ® N (12.5 mg + 40 mg) ndị ọrịa nke monotherapy nwere telmisartan na dose 40 mg ma ọ bụ monotherapy nwere hydrochlorothiazide adịghị eduga n'ịchịkwa ọbara mgbagha zuru oke.

Enwere ike ịkọwa Telsartan ® N (12.5 mg + 80 mg) ndị ọrịa nke monotherapy nwere telmisartan na dose 80 mg ma ọ bụ ọgwụ Telsartan ® N (12.5 mg + 40 mg) anaghị eduga n'ịchịkwa ọbara mgbali zuru oke.

N'ime ndị ọrịa nwere nnukwu ọbara ọgbụgba, ọnụọgụ kachasị kwa ụbọchị nke telmisartan bụ 160 mg / ụbọchị. Anabatụrụ ọgwụ a nke ọma ma dịkwa irè.

Ndị otu ọrịa pụrụ iche

Renrụ ọrụ na-arụ ọrụ na ụlọ. Ahụmịhe nwere mmachi na iji njikọta hydrochlorothiazide na telmisartan na ndị ọrịa nwere obere akwara na-adị obere ma ọ bụ na-adịghị agafe agafe anaghị atụgharị mgbanwe n'ọnọdụ ndị a. N'ime ndị ọrịa dị otú a, a ga-enyocha ọrụ renal (ya na Cl creatinine erughị 30 ml / min, lee "Contraindications").

Ọrụ imeju na-arụ ọrụ. N'ime ndị ọrịa nwere ọrịa imeju na-arụ ọrụ dị nro na mkpụmkpụ (Child-Pugh nke A na B), ọgwụ kwa ụbọchị nke Telsartan ® N ekwesịghị gafere 12.5 mg + 40 mg kwa ụbọchị (lee Pharmacokinetics).

Agadi. Usoro usoro usoro ọgwụgwọ adịghị achọ mgbanwe.

Dodoụbiga ya ókè

Onweghi ihe a chọpụtara na ịdoụbiga ihe oke ókè. Ihe mgbaàmà enwere ike ị doụbiga ihe ọ areụ areụ nwere oke nke ọgwụ ahụ.

Mgbaàmà nke nnyefere hydrochlorothiazide: ọgba aghara na nguzo mmiri-electrolyte nke ọbara (hypokalemia, hypochloremia), mbelata na BCC, nke nwere ike ibute ọrịa akwara na / ma ọ bụ na-ebute nsogbu site na CCC: arrhythmias kpatara n'otu oge nke cardiac glycosides ma ọ bụ ụfọdụ ọgwụ antiarrhythmic.

Mgbaàmà nke oke nnyefe nke telmisartan: akara akara mgbali ọbara, tachycardia, bradycardia.

Ọgwụgwọ: usoro ọgwụgwọ symptomatic, ịba ọcha n'anya adịghị arụ ọrụ. Ogo ogo mwepu nke hydrochlorothiazide n’oge emere ya ka akabeghi ike. Inwe nlebara anya mgbe niile maka ọdịnaya electrolyte yana serum creatinine.

Emeputa

Dr. Reddy's Laboratories Ltd., India. Dr. Reddy's Laboratories Ltd., India. Nkeji Usoro-III, Sy. Nke 41, Obodo Bachupally Village, Qutubullapur Mandal, Ranga Reddy District, Telangana, India.

Ekwesịrị izipu ozi banyere mkpesa na mmeghachi ọgwụ ọjọọ na-enweghị isi na adreesị a: ụlọ ọrụ nnọchite anya Dr. Reddy's Laboratories Ltd. 115035, Moscow, Ovchinnikovskaya nab., 20, p.

Tẹ.: (495) 795-39-39, faksị: (495) 795-39-08.

Ngwongwo ogwu

Telmisartan bụ onye na - emegide ụzọ nnabata angiotensin II (ụdị AO 1), na - eme ihe gbasara nchịkwa ọnụ. Inwe mmekọrịta dị elu, telmisartan dochie angiotensin II na njikọta ya na AO 1 subtype receptor, nke a na-ahụ maka ọrụ nke angiotensin II. Telmisartan anaghị egosi ọrụ ọ bụla na-anabata onye na-anabata AO 1 dị ka agonist. Telmisartan ahọrọ nke na-ejikọ ndị na-anabata AO 1 ogologo oge. Ọgwụ ahụ egosighi ịdị ọcha maka ndị na-anabata ndị ọzọ, gụnyere AO 2 na ndị ọzọ amachaghị nke ndị na-anabata AT. Amaghị ọrụ nke ndị nnabata ndị a, yana nsonaazụ nke mkpali oke ha nwere na angiotensin II, ọkwa nke na-abawanye telmisartan. Telmisartan na -ebelata ọkwa plasma aldosterone ọbara. A dịghị egbochi plasma renin nke Telmisartan, ọ dịghịkwa egbochi ọwa mmiri. Telmisartan anaghị egbochi ACE (kinase II), nke na-akụrisịkwa bradykinin. Ya mere, mmadụ ekwesịghị ịtụ anya ka mmụba nke mmeghachi omume ọjọọ metụtara bradykinin.

N'ime mmadụ, telmisartan na ọgwụ nke 80 mg fọrọ nke nta ka ọ bụrụ na ọ na - egbochi mmetụta nke angiotensin II na ịbawanye ọbara mgbali.

Arụmọrụ arụmọrụ yana nchekwa

Ọgwụ nke ọbara mgbali dị mkpa

Mgbe usoro izizi nke telmisartan, mmetụta antihypertensive ji nwayọọ nwayọọ malite ịpụta n'ime elekere 3:00. Mbelata kachasị na mgbali ọbara na-abụkarị izu 4-8 mgbe mmalite nke ọgwụgwọ ma dịgidere maka usoro ọgwụgwọ ogologo oge.

Mmetụta antihypertensive ahụ na-adịgide kwa ụbọchị karịa mgbe ị theụsịrị ọgwụ ahụ, gụnyere elekere anọ nke elekere isii tupu usoro ọgwụgwọ ọzọ, dị ka egosipụtara na njikwa ọbara mgbali elu. A na-ekwenye nke a ugboro ugboro site na nha mkpụsị nke nsonaazụ kachasị elu, nke kariri 80% mgbe ejiri ọgwụ were 40 na 80 mg nke telmisartan na ule ọgwụ na-achịkwa placebo. Enwere mmekọrịta doro anya n'etiti dose na oge mgbake nke mgbali ọbara systolic mbụ (SBP). Ihe data gbasara ọbara mgbali ọbara (DBP) ekwekọghị.

N'ime ndị ọrịa nwere ọbara mgbali elu, telmisartan na-ebelata ma mgbagha ọbara systolic na nsogbu diastolic, ebe ọ naghị emetụta ọnụego opi. Ekpebila onyinye nke ọrịa diuretic na natriuretic nke ọrụ ya dị oke egwu. Ofdị irè nke telmisartan na wedata ọbara mgbali elu dị ka ọgwụ ndị ọzọ na-anọchite anya klas ndị ọzọ nke antihypertensive (ọmụmụ ụlọ ọgwụ iji tụọ telmisartan na amlodipine, atenolol, enalapril, hydrochlorothiazide na lisinopril).

Site na ịkwụsị ọrịa telmisartan na mberede, ọbara mgbali na-eji nwayọ alaghachi n'ọkwa dị tupu ọgwụgwọ maka ọtụtụ ụbọchị na-enweghị ihe ịrịba ama nke ọbara mgbali elu.

N'ime ule nke ụlọ ọgwụ, site na ntụnyere nke ọgwụ abụọ na-egbochi ọgwụ, nsogbu nke ụkwara akọrọ adịchaghị ka ọhụụ na telmisartan karịa ndị ACE inhibitors.

A na-etinye Telmisartan ngwa ngwa, n'agbanyeghị na ego ọ na-anabata na-adị iche. Onu ogugu izizi nke Telemisartan ruru 50%. Mgbe ị na-eji telmisartan nri, mpaghara dị n'okpuru usoro ịta ahụhụ (AUC 0-∞) na-agbadata na nha site na 6% (na dose 40 mg) ruo 19% (na dose 160 mg). 3: 3 mgbe emechara, ịta telmisartan na plasma ọbara bụ otu ihe ahụ mgbe ewere ya na afọ na-enweghị isi ma ọ bụ mgbe ejiri nri.

A na-atụ anya ntakịrị mbelata na AUC ka ọ belata mmetụta ọgwụgwọ ahụ. Enweghị mmekọrịta kwụ ọtọ n'etiti usoro ịsesụ ọgwụ na ịta plasma nke ọgwụ ahụ. C max na, ruo na obere obere, AUC na-abawanye n'ụzọ a na-ezighi ezi na ọnụọgụ 40 mg.

Telmisartan nwere ihe jikọrọ protein na plasma (> 99.5%), ọkachasị nwere albumin na alfa-1 acid glycoprotein. Ogologo nza nke nkesa (V dss) na nha anya ruru 500 L.

A na-agbanye Telmisartan site na conjugation nke ogige nne na nna na glucuronide, conjugate enweghị ọrụ ọgwụ.

Ihe eji mara Telmisartan bu ihe eji eme otutu ogwu ihe na ndu ogugu ihe kariri iri-abuo. Oke plasma ịta (C max) na, n'obere opekata mpe, mpaghara n'okpuru usoro ịta ụta (AUC) na-abawanye nke ukwuu na dose ahụ. Onweghi ihe akaebe banyere mkpokoro ogwu di egwu nke Telemisartan mgbe ị na-eji ọgwụ a tụrụ aro ya. N'ime ụmụ nwanyị, ntụpọ plasma dị elu karịa ụmụ nwoke na-enweghị nnukwu mmetụta nrụpụta ọrụ.

Mgbe nchịkwa onu gachara, telmisartan fọrọ nke nta ka ọ bụrụ na feces, ọkachasị adịghị agbanwe agbanwe. Mkpokọta ọgwụ a nwere mmamịrị bụ afọ 70. Njikọ ya na ọgwụ ndị ọzọ na-emetụta sistemụ renin-angiotensin-aldosterone, yana / ma ọ bụ ihe mgbakwunye potassium nwere.

A na-atụ aro iji nlezianya na-atụle ọkwa potassium na ndị ọrịa nọ n'ihe ize ndụ.

ACE inhibitors, telmisartan, na ndị ọzọ na-anabata antagonensin II antagonist adịghị arụ ọrụ dị ala na mbelata ọbara mgbali n'ime ndị ọrịa nke agbụrụ Negroid karịa na agbụrụ ndị ọzọ, ikekwe n'ihi eziokwu ahụ bụ na ndị ọrịa nwere ọbara mgbali elu nke agbụrụ Negroid nwere ike yikarịrị ka enwee renin.

Mgbe ị na-eji ọgwụ antihypertensive ọ bụla, mbelata ọbara mgbali elu na ndị ọrịa nwere ọrịa cardioathy ischemic ma ọ bụ ọrịa ischemic nwere ike iduga infarction myocardial ma ọ bụ ọrịa strok.

Jiri n’oge ime ma ọ bụ n’ịra

Enweghị data dị mkpa maka ojiji nke Telmisartan maka ụmụ nwanyị dị ime.

Ihe ndabere nke oria ojoo nke ihe egwu teratogenicity n'ihi ihe ACE inhibitors n’oge onwa ato nke ime apughi ime obi uto, mana enweghi ike iwelie ihe nwute.

Ekwesighi ịmalite ndị na-anabata ihe nnabata Angiotensin II n'oge afọ ime. Ọ bụrụ na a ka na-eleba anya na usoro ọgwụgwọ na antagonensin II antagonists ka ọ dị mkpa, yana onye ọrịa ahụ na-eme atụmatụ ịtụrụ ime, a na-atụ aro ka iji dochie usoro ọgwụgwọ antihypertensive na profaịlụ nchekwa nchekwa n'oge ịtụrụ ime. Ọ bụrụ na akwadobe afọ ime, a ga-akwụsị ịgwọ ndị ọrịa antiotensin II ozugbo ha kwesịrị ịmalite usoro ọgwụgwọ ọzọ kwesịrị ekwesị.

A maara na iji angiotensin II receagonor antagonists n’oge oghe nke afọ II na III nke afọ ime na-akpata fetotoxicity na mmadụ (arụ ọrụ na-arụ ọrụ gbasara arụ ọrụ, oligohydramniosis, oge na-egbu oge nke ọkpụkpụ cranial) na nsonye obi na-egbu egbu (akwara renal, hypotension, hyperkalemia). Ọ bụrụ na ojiji nke angiotensin II receagonor antagonists bidoro n’oge ọnwa nke abụọ nke afọ ime, a na-atụ aro ka ọ nyochaa akụrụngwa nke akụrụ na ọkpụkpụ nke okpokoro isi nke nwa ebu n’afọ. Ekwesịrị iji nlezianya nyochaa ọnọdụ ụmụ amụrụ ọhụrụ ndị nne ha nwetara nnabata antiotensin II (lee ngalaba “Contraindications” na “Akụkụ eji”).

A naghị akwado Telmisartan n'oge inye nwa ara, ebe ọ bụ na amabeghị ma mmiri ara ehi ya. Usoro ọgwụgwọ ọzọ ejiri profaịlụ nchekwa nke ọma ka amachara, ọkachasị mgbe ị na-enye nwa amụrụ ọhụrụ ma ọ bụ nwa.