I-Telsartan N ingeyeqembu lezidakamizwa ze-antihypertensive. Lokhu kulungiswa okuningxenye ezimbili. Kubonakala ngesenzo esihlanganisiwe. Lo mkhiqizo wehlukile kwi-analogue yaseTelsartan lapho kukhona i-diuretic. Ngenxa yale ngxenye, umphumela omuhle wokwelashwa onomfutho wegazi ophakeme utholakala ngokushesha okukhulu.
Igama Lezwe elingafanele
I-Telmisartan + Hydrochlorothiazide
I-ATX
C09DA07
Khipha amafomu nokwakheka
Ungathenga umuthi kuphela ezibhebheni. Izithako ezisebenzayo ezibonisa umsebenzi we-antihypertensive yilezi: telmisartan (40 no-80 mg); hydrochlorothiazide (12.5 mg). Lapho unquma, kufanele kukhunjulwe ukuthi okwesibili kwezinto zihlala ziqukethe umthamo ofanayo, futhi inani le-telmisartan lenyuka amahlandla ama-2.
I-Telsartan N yezidakamizwa iyatholakala emabhulashini aqukethe amaphilisi ayi-6, 7 noma ayi-10.
Umuthi uyatholakala emabhulashini aqukethe amaphilisi ayi-6, 7 noma ayi-10. Inani lamaphakeji weseli ebhokisini lekhadibhodi nalo liyahluka futhi liyi-2, 3 ne-4 ama-pcs.
Isenzo se-Pharmacological
I-Telmisartan isebenza njenge-angiotensin II receptor antagonist. Lokhu kusho ukuthi umsebenzi wabo uvinjelwe ngaphansi kwethonya lale ngxenye. Umphumela ofiselekayo uyatholakala ngenxa yokuhambisana kwe-angiotensin II receptors nge-AT1. Ukwanda kwe-lumen yemithambo yegazi kwenzeka ngokudluliselwa kwe-hormone (angiotensin II), okuthinta ithoni yezindonga zabo.
Ngenxa yalokhu, ubukhulu bokugeleza kwegazi buyancipha, ingcindezi ijwayelekile. I-Telmisartan isebenza ngendlela yokuthi ngesikhathi sokwelashwa, impendulo yemvelo ye-receptor ingenzeki ngesikhathi sokuxhumana. Ngenxa yalokhu, imikhumbi ayithambekele ekunciphiseni. Ngokuthambekela kokuqina komfutho wegazi ophakeme, into edakayo inikeza umphumela omuhle ngenkathi isiguli siselashwa. Lapho usuqede ukuphatha, lesi simo singaphinde sibe sibi kakhulu, ngoba i-telmisartan ayiqedi imbangela yalesi sifo.
Umuthi unezici ezihlukanisa kusukela ezinhlangeni eziningana:
- ukuntuleka kwekhono lokuvimba isenzo se-renin ku-serum yegazi;
- ayivimbeli ukusebenza kwe-eniotensin-eguqula;
- kukhona ukushesha kokuwohloka kwe-bradykinin;
- ukwehla kokuxineka kwe-aldosterone ku-plasma yegazi.
Ngesikhathi sokwelashwa, ingcindezi iyancipha (systolic, diastolic arterial). Kodwa-ke, le nqubo ayihambisani nokushintsha kwesilinganiso senhliziyo. Lokhu kusho ukuthi iziguli ezithatha i-Telsartan H zisengozini enkulu yemiphumela emibi evela ohlelweni lwezinhliziyo, kodwa inqobo nje uma umuthi ungaphazamiseki.
Uma umuthi ubekelwe imvelaphi yengozi enkulu yokuba nezifo zenhliziyo nezemithambo, khona-ke ngenxa ye-telmisartan, amathuba wokuhlaselwa yisifo senhliziyo, unhlangothi uyancishiswa. Izinga lokushona kwabantu liyehla futhi.
Enye isithako esisebenzayo (hydrochlorothiazide) ingeqembu le-thiazide diuretics. Le nto isiza ukusheshisa ukugeleza kwamanzi emzimbeni. Kodwa-ke, akukho mingcele ekubambeni usawoti. IHydrochlorothiazide igqugquzela ukuphuma kwe-sodium ne-chloride. Umphumela we-antihypertensive ubonakaliswa ngokunciphisa umthamo wegazi elijikelezwe emithanjeni.
Ngasikhathi sinye, kube nokwanda komsebenzi wenqubo yokukhiqiza i-aldosterone. Ngenxa yalokhu, okuqukethwe kwe-potassium esegazini kuyancipha, kepha ngasikhathi sinye ukugxilisa umchamo kuyanda. I-telmisartan ebhekwa ngaphambili isiza ukunciphisa ijubane lokulahleka kwe-potassium. Ngenxa yenhlanganisela yalawa mathuluzi, umphumela oyifunayo uyatholakala.
I-Pharmacokinetics
Isenzo se-diuretic sigcinwa amahora angama-6 kuya kwayi-12. Ukwanda kokuqina kwenqubo ye-liquid excretion ibonwa ngemizuzu engu-120 ngemuva kokuthatha umuthi wokuqala womuthi. Ukusebenza kwesiqongo se-hydrochlorothiazide kutholakala ngemuva kwamahora ama-4. Ukuze uqhathanise, i-telmisartan iqala ukusebenza ngokwengeziwe ngemuva kwamahora ama-3. Umphumela otholakala uhlala usuku olu-1. Umphumela we-antihypertensive ugcinwa emahoreni angama-48 alandelayo.
Ukuhlelwa ngokwejwayelekile kwesimo sesiguli ngesikhathi sokwelashwa ngeTelsartan N kwenzeka kancane kancane. Imiphumela emihle ingatholakala emavikini ama-4 ngemuva kokuqala kokwelashwa. I-bioavailability ye-telmisartan ingama-50%. Ngokusetshenziswa kanyekanye kokudla, ukusebenza kahle kwomuthi kuyancipha. Kodwa-ke, amahora ama-3 ngemuva kokuthatha umuthi, ukuqina kwawo ku-plasma yegazi kuyinto ejwayelekile.
Izinkomba eziphambili ze-pharmacokinetics ze-telmisartan kwabesifazane ziphakeme izikhathi eziphindwe kabili kuya kwezamadoda. Ngaphandle kwalokhu, umuthi usebenza ngokulingene ekwelapheni iziguli kuwo womabili amaqembu. Akukho ukwanda komphumela we-antihypertensive ngesikhathi sokwelashwa kwabesifazane. Izinto ezitholwe ngenxa yokuguqulwa kwe-telmisartan azikhombisi umsebenzi. Ukuphila kwengxenye ende yalesi sakhi kuyaphawulwa. Iyakhululwa kungakapheli amahora angama-20 ngemuva kokuthatha umuthi wokugcina.
I-Hydrochlorothiazide ayikhiqizwanga. Le nto isuswa emzimbeni ngokubamba iqhaza kwezinso. Amandla okubopha kumaprotheni e-plasma kanye ne-bioavailability ye-hydrochlorothiazide, ngokulandelana i-64 ne-60%.
Izinkomba zokusetshenziswa
Umuthi ubonakala yindawo emincane yokusetshenziswa. Kubekelwe umfutho wegazi ophakeme. Ngaphezu kwalokho, inkomba yokusetshenziswa kweTelsartan N yi-monotherapy ene-telmisartan noma i-hydrochlorothiazide, uma behluleka ukuthola umphumela oyifunayo.
I-Telsartan N yezidakamizwa ibonakala yindawo emincane yokusebenzisa, ibekelwe umfutho wegazi ophakeme.
Contraindication
Izimo zepathological lapho kungenzeki khona ukusebenzisa umuthi okukhulunywa ngawo:
- ukusabela kwe-hypersensitivity engxenyeni esebenzayo;
- izifo zepheshana elihlanganisiwe, lapho inqubo yokususwa kwe-bile iphazamiseka khona;
- izimo ze-pathological lapho izinga le-creatinine lifinyelela ku-30 ml ngomzuzu futhi liyehla kancane;
- ukushoda kwe-potassium;
- ikhalsiamu eyeqile
- i-glucose galactose malabsorption syndrome;
- ukuntuleka kwe-lactase emzimbeni;
- ukusabela kwe-hypersensitivity engeqi ngokweqile kwe-lactose.
Ngokunakekela
Ithuluzi elibaliwe lisetshenziswa ngaphansi kokuqondisa kukachwepheshe emacaleni amaningi:
- i-hypertension ye-arterial;
- ukwehla okumenyezelwe ku-lumen kwemithambo ye-renal, okubangelwa i-stenosis (inqubo yokuqothula uhhafu wempilo yezinto ezisebenzayo yehlisa ijubane, obangela ukwanda kokuxinana nomuthi kanye nokwanda komphumela wawo we-hypotensive);
- ukwelashwa kwakamuva neqembu lama-diuretics;
- potassium ngokweqile;
- isikhathi sokululama ngemuva kokufakwa kwezinso;
- ukhubazeka kakhulu kwenhliziyo, kufaka phakathi ukwehluleka kwenhliziyo okungapheli;
- ukukhiqizwa ngokweqile kwe-cholesterol, triglycerides, calcium ephezulu;
- Izifo ezinzima zesibindi ngesikhathi sokukhula okusebenzayo (ubungozi bokuqalwa kwe-hepatic coma lenyuka);
- ukwehla kwe-lumen ye-mitral ne-aortic valve;
- isifo sikashukela mellitus;
- izinguquko ze-gouty;
- ukwanda kwe-uric acid egazini;
- ukulimala okukhulu kwezitho zombono.
Umuthi uthathwa ngokuqapha uma kwenzeka kulimala kakhulu izitho zombono.
Ungayithatha kanjani iTelsartan N?
Inani lansuku zonke ithebhulethi engu-1 (12,5 + 40 mg). Imithamo ephezulu yomuthi (i-12.5 + 80 mg) isetshenziswa uma ukuqashwa kokuqala kunganikeli umphumela oyifunayo. Inani lansuku zonke le-telmisartan lenyuka laya ku-160 mg ezimweni lapho umfutho wegazi ophakeme ukhula.
Ngoshukela
Ngesikhathi sokulashwa nalesi sidakamizwa, ingozi yokuba nesifo sikashukela se-latent ikhuphuka. Ukuhlolwa okungapheli kwezinkomba eziphambili zegazi kuyadingeka. Ezimweni eziningi, iziguli zinikezwa imithamo evunyelwe yomuthi okungenani.
Imiphumela emibi uTelsartan N
Amapheshana wesisu
Ubuningi bokwakheka kwegesi kuyenyuka, kuvela umlomo owomile. Isakhiwo sokushintshwa kwendle (iba uketshezi). Ukugaya, izinqubo zokuguguleka esiswini mancane kakhulu amathuba okuba ukuvela, ukugabha, ukuqina kwesisu kwenzeke, futhi inqubo yokukhupha indle iba nzima kakhulu.
Izitho zeHematopoietic
Izimo ze-pathological ezinjenge-hyponatremia, i-hypokalemia ziyakhula. Iqoqo le-uric acid ku-plasma liyanda.
Isistimu yezinzwa ephakathi
Izimo eziwohlokayo, ukuphazamiseka kokulala, ukuqwasha njalo kuvame ukwenzeka. Ukuxakeka kuyaziveza, kwesinye isikhathi ukucindezeleka kuyavela.
Kusuka ohlelweni lomchamo
Izinkinga zesifo sezinso.
Kusuka ohlelweni lokuphefumula
Ukuvuvukala kwamaphaphu, ukufushane komoya, inyumoniya.
Engxenyeni yesikhumba
I-Erythema.
Kusuka ohlelweni lwezitho zofuzo
Ukungasebenzi ngocansi ngemuva kokungasebenzi kahle kwe-erectile.
Kusuka ohlelweni lwezinhliziyo
Shintsha izinga lokushaya kwenhliziyo, hypotension.
Kusuka ohlelweni lwe-musculoskeletal kanye nezicubu ezithintekayo
Ubuhlungu emhlane, izicubu ezithambile, izinkontileka ezethusayo zemisipha yethole.
Engxenyeni yesibindi ne-biliary
Izinkinga zokukhulisa izifo zesibindi.
Allergies
I-Urticaria, i-angioedema.
Ubuhlungu emuva kanye nobuhlungu bezicubu ezithambile kungenzeka ngemuva kokuthatha kukaTelsartan N.
Umthelela ekhonweni lokulawula izindlela
Njengoba kunikezwe ingozi enkulu yesiyezi, ukozela, ukuqaphela kufanele kusetshenziswe ngenkathi ushayela. Uma kungenzeka, kungakuhle ukwenqaba ukwenza imisebenzi edinga ukunakwa.
Imiyalo ekhethekile
Nge-renal artery stenosis, amathuba okuthuthuka kwe-hypotension ayanda.
Ngokuphikisana nesizinda sikashukela, ingozi yezimpawu zokuhlaselwa yisifo senhliziyo, isifo senhliziyo siyanda.
Nge-glaucoma yokuvalwa kwe-angle, ukwelashwa okufika ngesikhathi kuyadingeka, ngoba uma kungenjalo, ukungasebenzi kahle kwamehlo kuzoholela ekulahlekelweni ngokuphelele kombono.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Umuthi awubekelwe abesifazane abathola izingane kanye nabancelisa ibele. Lokhu kungenxa yokuthi izifundo zomtholampilo zemiphumela yalesi sidakamizwa ku-fetus zingaqhutshwa.
Ukuqokwa kukaTelsartan N wezingane
Ayisebenzi, ngoba alukho ulwazi olwanele ngokuphepha komkhiqizo.
Sebenzisa ebudaleni
Asikho isidingo sokushintsha umthamo womuthi, ngoba izinqubo ze-pharmacokinetic ezigulini zaleli qembu zihamba ngesivinini esifanayo nangamandla njengasebasha.
Isicelo sokusebenza kokulimala kwezinso
Asikho isidingo sokushintsha umthamo we-telmisartan ne-hydrochlorothiazide. Umuthi uvunyelwe ukusetshenziselwa, kepha kuphela uma ukuhluleka kwezinso okusesilinganisweni noma okubuthakathaka kukhula. Ngomonakalo omkhulu kulesi sitho, umuthi awusetshenziswa. Lokhu kungenxa yokuthi izinso zibandakanyeka ekumbeni kwezitho ezisebenzayo ezivela emzimbeni. Esimweni esibi ngokwedlulele, isilinganiso somuthi singabuyekezwa (inani elincinci linqunyelwe). Kulokhu, isiguli singaphansi kokuqashwa njalo kwezokwelapha.
Sebenzisa umsebenzi wesibindi okhubazekile
Ngokulashwa ngeTelsartan H, kukhuphuka i-bioavailability ye-telmisartan kuya ku-100%. Ukuphila kwesigamu sale nto akushintshi. Ingxenye yesibili esebenzayo isuswa emzimbeni ngokuya kancane, engadala ukulandisa komthamo. Ukulimazeka okukhulu kokusebenza kwesibindi kuwukuphikisana nokusetshenziswa kwaso.
Ukweqisa
Amacala wokuthuthukiswa kokuboniswa okungekuhle okuphikisana nesizinda sokwenyuka komthamo awurekhodwanga. Kodwa-ke, izinto ngazinye ezisebenzayo zingasiza ekuthuthukiseni i-tachycardia, i-hypotension, kanye nokwephulwa kwemali esele ye-electrolyte.
Ukuxhumana nezinye izidakamizwa zeTelsartan N
Ngokusebenzisa kanyekanye i-telmisartan nezinye izidakamizwa, isenzo esihlose ukwehlisa ingcindezi, kukhuphuka umphumela wezokwelapha nomuthi okukhulunywa ngawo.
Iqoqo le-lithium lenyuka ngesikhathi sokwelashwa ngezidakamizwa eziqukethe i-lithium.
Ukuqokwa kanyekanye kwama-NSAIDs kanye neTelsartan N kungadala ukuthuthukiswa kokwehluleka kwezinso okubucayi. Lokhu kusho ukuthi isiguli sihlolwa njalo ngesikhathi sokwelashwa.
Ngokuphikisana nesizinda sokuthatha i-Aliskiren, kukhuphuka izehlakalo zemiphumela emibi.
Ukusetshenziswa kanyekanye kwalesi sidakamizwa okukhulunywa ngaso nezindlela zeqembu lama-narcotic analgesics, barbiturates ne-ethanol kuyisici esikhulu esivimbela ukuthuthukiswa kwe-orthostatic hypotension.
Ukuhambisana notshwala
Akunconyelwe ukuphuza iziphuzo eziqukethe utshwala ngesikhathi sokwelashwa, njengoba ubungozi bokuthi baphumule kakhulu ngemikhumbi benyuka, okuzobandakanya izinkinga ezinkulu.
Ama-Analog
Ukufakwa esikhundleni okusebenzayo:
- I-Telpres Plus;
- I-Telzap Plus;
- ITelsartan.
Imibandela yekhefu lekhemisi
Umuthi umuthi.
Ngingakwazi ukuthenga ngaphandle kadokotela?
Kudingeka ukuqokwa kukadokotela.
Intengo yeTelsartan N
Izindleko ezijwayelekile ngama-ruble angama-400.
Izimo zokugcina zomuthi
Ukushisa okunconyiwe - hhayi okuphakeme kuno- + 25 ° С.
Isikhathi sokuphelelwa yisikhathi
Umuthi ugcina izakhiwo iminyaka emi-2 kusukela ngosuku lokukhishwa.
Umkhiqizi
Umkhiqizo wakhiqizwa nguDkt Reddy's eNdiya.
I-analogue yesidakamizwa ingaba yiTelpres Plus.
Ukubuyekezwa ku-Telsartan N
UValentina, oneminyaka engama-48, uKaluga
Wathatha lesi sidakamizwa isikhathi eside, ngezikhathi ezithile ethatha ikhefu. Ngiyakhuthazelela kalula, kepha kwesinye isikhathi imiphumela emibi ivela: isiyezi, ukuphazamiseka kokulala. Kungemva kokukhanselwa kuphela lapho ingcindezi iphinda ikhuphuke.
UGalina, oneminyaka engama-39, uNovomoskovsk
UTelsartan akazange alunge. Umuthi unamandla. Angizange ngiyithathe isikhathi eside, ngoba njalo nesiyezi. Kodwa wehlisela ingcindezi ngokushesha, futhi phakathi nosuku, umfutho wegazi ugcinwa ezingeni elijwayelekile.
