IMikardis Plus isho izidakamizwa zomlomo ze-antihypertensive. Umuthi unomphumela ohlangene wezinto ezimbili ezisebenzayo - i-telmisartan ne-diuretic. Ngenxa yale nhlanganisela yamakhemikhali, kutholakala umphumela omude we-hypotensive, ohlala amahora angama-6 kuya kwayi-6. Inhlanganisela ye-hydrochlorothiazide ne-telmisartan ikuvumela ukuba wenze ngokwejwayelekile izinga lomfutho wegazi ophezulu.
I-ATX
C09DA07.
IMikardis Plus isho izidakamizwa zomlomo ze-antihypertensive.
Khipha amafomu nokwakheka
Umuthi wenziwa ngesimo samathebulethi, anamakhompiyutha ama-2 asebenzayo - i-telmisartan ne-hydrochlorothiazide.
| Ukuxhuma okusebenzayo | Inhlanganisela yomthamo okungenzeka, mg | ||
| I-Telmisartan | 80 | 80 | 40 |
| I-Diuretic | 12,5 | 25 | 12,5 |
| Amaphilisi wombala | Kufakwe ngaphakathi okubomvu ngopinki | Okuphuzi ngokufaka okuphuzi | Ipinki |
Njengezinto ezengeziwe ezithuthukisa isivinini nokuphelela kokufakwa, yile:
- isitashi sommbila;
- ushukela wobisi;
- i-microcrystalline cellulose;
- i-sodium hydroxide;
- amadayi e-iron oxide;
- i-povidone;
- i-sorbitol;
- i-meglumine.
Amacwecwe enziwe okusaqanda nge-biconvex surface. I-ejenti ye-antihypertensive ayakhiqizwa ngohlobo lwe-spray, ijeli, noma isixazululo sabazali.
Umuthi wenziwa ngesimo samathebulethi, anamakhompiyutha ama-2 asebenzayo - i-telmisartan ne-hydrochlorothiazide.
Isenzo se-Pharmacological
I-Telmisartan inomphumela we-antihypertensive ngenxa yokubopha kuma-angiotensin II receptors. Ngokwakhiwa kwenkimbinkimbi enjalo, isakhi esisebenzayo siyaphazamisa umsebenzi we-vasoconstrictor enzyme futhi sinciphise ukugcwala kwe-aldosterone egazini. I-Angiotensin II ayikwazi ukudala ukuwohloka kwe-bradykinin, ngoba ivinjwe yi-telmisartan. Ngakho-ke, ukuhlanganiswa kwe-bradykinin kuyaqhubeka - i-vasodilator inyusa i-lumen egazini.
Umphumela we-vasodilating uthuthukisa i-hydrochlorothiazide ngenxa yomphumela we-diuretic. I-thiazide diuretic isiza ukunciphisa umfutho wegazi ophakeme ngomfutho omkhulu wegazi. Ngokusetshenziswa isikhathi eside, i-hydrochlorothiazide yehlisa ingozi yokuqhamuka ne-pathologies ye-carneovascular kanye nokufa kwabantu kulezi zifo.
Umphumela omkhulu wokwelapha utholakala kungakapheli amahora angama-3.5-4.
Izinkomba zokucindezela kwegazi zihlala zizinzile amahora angama-6 kuya kwayi-12.
I-Pharmacokinetics
Ngemuva kokusebenzisa, ithebhulethi iphulwa yi-enzyme yamathumbu.
Lapho ikhishwa, izingxenye ezisebenzayo zesidakamizwa iMikardis Plus zidonswa ngokushesha odongeni lwesibeletho esincane.
Lapho ikhishwa, izakhi ezisebenzayo zihushelwa ngokushesha odongeni lwesibeletho esincane bese zingena egazini. Ekujikelezweni kwe-systemic, i-telmisartan ne-hydrochlorothiazide zifinyelela ekugxileni okuphezulu ngemizuzu engama-30-90. I-bioavailability yohlobo lwesibili lwe-angiotensin receptor antagonist ifinyelela ku-50%, hydrochlorothiazide ngaphakathi kwe-60%. Izinto ezisebenzayo ziguqulwa kuma-hepatocytes.
Isigamu sempilo singamahora ayi-6. I-Telmisartan ishiya umzimba ngendlela yemikhiqizo yokubola engasebenzi ngohlelo lwe-urchin ngama-60-70%. IHydrochlorothiazide ikhishwe ingashintshiwe emchameni ngo-95%.
Izinkomba zokusetshenziswa
Umuthi uyadingeka ukuze unciphise umfutho wegazi ophezulu ngokungasebenzi kwe-telmirsartan therapy njenge-monotherapy.
Contraindication
Umuthi awuhloselwe ukwelashwa kweziguli ngokubekezelela komuntu ngamunye ezingxenyeni ezisebenzayo futhi ezengeziwe zeMikardis Plus. Izinqubo ezilandelayo ze-pathological zisebenza njenge-contraindication ukuze isetshenziswe:
- ukuvimbela kwe-bile duct nge-cholestasis ehambisanayo;
- ukusebenza kwesibindi okusebenzayo;
- ukwehla okuphawulwe kokusebenza kwezinso;
- isifo sikashukela esibuhlungu;
- ukukhuphuka kokuhlushwa kwe-calcium namazinga aphansi we-potassium emzimbeni;
- Ifa lokungabekezeleli i-galactose, i-fructose, i-lactose.
Umuthi awuvunyelwe ukusetshenziswa ezigulini ezihluleka ukuhlaselwa izinso kanye noshukela ngokusetshenziswa okufanayo kwe-Aliskiren.
Ungayithatha kanjani
Ngobunzima obusezingeni eliphansi be-pathology, uMikardis uthathwa isikhathi esingu-1 ngosuku, ngaphandle kokuhlafuna. Ukudla ngasikhathi sinye akubathinti ama-pharmacokinetics aseMikardis.
Ngobunzima obusezingeni eliphansi be-pathology, uMikardis uthathwa isikhathi esingu-1 ngosuku, ngaphandle kokuhlafuna.
Kwabadala
Umthamo ojwayelekile wansuku zonke uhlinzeka ngomthamo owodwa wethebhulethi equkethe ama-80 mg we-telmisartan no-12,5 mg we-hydrochlorothiazide. Uma umphumela we-hypotensive unganele, kepha ngokubekezelela okuhle, udinga ukuphuza amaphilisi aqukethe ama-80 mg we-telmisartan no-25 mg we-hydrochlorothiazide.
Umphumela we-hypotensive omkhulu ubonwa ngemuva kwezinyanga eziyi-1-2 ngemuva kokuqala kokwelashwa okulondolozayo.
Iziguli ezinomfutho wegazi ophakeme kufanele zithathe amaphilisi ama-2 ngosuku. Kulokhu, umthamo we-hydrochlorothiazide unqunywa udokotela oya kuye ngokuya ngemininingwane yemitholampilo yesiguli.
Ukuqokwa kukaMikardis Plus wezingane
Umuthi uphulwe ukuze usetshenziswe kuze kube iminyaka engu-18 ngenxa yokuntuleka kolwazi ngomphumela wezinto ezisebenzayo ekuthuthukisweni komuntu esikoleni sabafana nasenkulisa.
Umuthi iMikardis Plus uvunyelwe ukusetshenziswa kuze kufinyelele eminyakeni eyi-18.
Ukuthatha umuthi wesifo sikashukela
Iziguli ezinesifo sikashukela zidinga njalo ukuhlola amazinga azo kashukela. Ngesikhathi sokwelashwa ngeMikardis, kunengozi ye-hypoglycemia ngenxa yemiphumela ye-diuretic ye-hydrochlorothiazide.
Imiphumela emibi
Imiphumela emibi ibonakaliswa ngenxa yomthamo okhethwe ngokungafanele futhi ibonakala ezimweni eziningi ukuphazamiseka okuvamile.
Amapheshana wesisu
Kukhona ubungozi bokuthola izilonda zokulimala kwesisu kanye ne-gastritis. Ezinye iziguli zizwa ubuhlungu be-epigastric, ukuqunjelwa, isifo sohudo kanye nenausea.
Izitho zeHematopoietic
Izinga lezinto ezakhiwe kuplasma yegazi liyancishiswa.
Isistimu yezinzwa ephakathi
Ngokucindezelwa kohlelo lwezinzwa oluphakathi kanye nokukhula kokuphazamiseka kwengqondo kumuntu, imodeli yokuziphatha iyashintsha - isimo sokudangala, kubonakale ukukhathazeka.
Isiyezi, ikhanda, i-paresthesia, ubuthakathaka obujwayelekile, ukuphazamiseka kokulala kungenzeka.
Kusuka ohlelweni lomchamo
Ezigulini ezinenkinga yokuphuma komchamo (nge-benign prostatic hyperplasia, i-prostatitis), ukugcinwa kokuchama, ukuhlukaniswa kwe-bladder kungenzeka. Ezimweni ezingavamile, kukhona ukwanda kokuhlungwa kwe-plasma ye-uric acid.
Kusuka ohlelweni lokuphefumula
Ngokuphikisana nesizinda se-angioedema, ukubonakala kokuvinjwa komoya, ukubonakala kwe-bronchospasm kungenzeka.
Kusuka ohlelweni lwe-musculoskeletal
Ukuphendula okungalungile ohlelweni lwe-musculoskeletal kubonakaliswa ngokubonakala kwamaqhubu emisipha yethole, izinhlungu emalungeni nasemisipha, ikakhulukazi emuva.
Allergies
Emsebenzini wokuthengisa ngemuva, amacala okuvela kwe-systemic lupus erythematosus, angioedema, kanye nokuphendula kwesikhumba aqoshwe.
Imiyalo ekhethekile
Umuthi unomphumela ophikelelayo we-vasodilating. Ngomthamo ophansi wegazi elijikelezayo (i-BCC), ingcindezi esegazini izoncipha, ngoba uketshezi kanye nomthamo wegazi ngeke ube namandla kokujikeleza okujwayelekile. Ngenxa yamandla okuthola i-hypotension enesibonakaliso, iziguli ekudleni ezinamunyu olilinganiselwe kasawoti, ngesifo sohudo ngezikhathi ezithile nokuhlanza, lapho kuthatha imishanguzo ngaphambi kokuthatha iMikardis Plus, kuyadingeka ukubuyisela i-BCC.
Kwezinye izimo, umuthi ubangela ukuvela kwesikhumba.
Ukuthatha i-ejenti ye-hypotensive kungaholela ekukhuleni kwengozi ye-cerebrovascular or heart attack in iziguli ezine-ischemia yenhliziyo.
I-Hydrochlorothiazide iyakwazi ukuvusa uhlobo olubi lwe-myopathy noma ukubukeka kwe-angle-ukuvalwa kwe-glaucoma. Isimpawu sokuqala sezinqubo ze-pathological sibuhlungu obukhali emehlweni, obungahambi isikhathi eside. Uma uzwa izinhlungu futhi wehla nge-acuity ebonakalayo, kufanele ngokushesha uyeke ukuthatha iMikardis Plus.
Ukuhambisana notshwala
Ngesikhathi sokwelashwa kwe-antihypertensive, akunconywa ukuphuza utshwala.
I-Ethyl alcohol ingawenza buthaka umphumela we-antihypertensive, ikhuphule umphumela we-diuretic we-hydrochlorothiazide futhi ibangele ukuqina kwe-endothelium ye-vascular emikhunjini yecala.
Umthelela ekhonweni lokulawula izindlela
Umuthi awuthinti ukusebenza kohlelo lwezinzwa namakhono emoto amahle. Ngasikhathi sinye, kubalulekile ukubheka izinyathelo zokuphepha uma usebenza ngamasu ayinkimbinkimbi nalapho ushayela imoto, ngoba kungenzeka ulahlekelwe ukwazi, ukubukeka kwemiphumela emibi (ukozela, isiyezi). Imiphumela emibi ingadala ukwehla ekugxekeni kokunakwa kanye nesivinini sokuphendula kwe-psychomotor okudingekayo ukushayela.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Abesifazane ngesikhathi sokukhulelwa bayenqatshelwa ukuthatha iMikardis ngenxa yengozi engaba khona yokuhlukunyezwa kwengane.
Ngenqubo yokukhula kombungu, ukubekwa kwezinhlelo zenhliziyo nokuchama kungalimala.
Lapho uthola ukwelashwa kwezidakamizwa, kuyadingeka ukuyeka ukuncelisa ibele.
Lapho uthola ukwelashwa ngezidakamizwa, iMikardis Plus kumele iyeke ukuncelisa ibele.
Ukweqisa
Ngomthamo owodwa womthamo ophakeme odlula umthamo onconyiwe, ubungozi bezimpawu zokweqisa ngokweqile bukhuphuka. Izimpawu zifaka:
- ukwehlisa umfutho wegazi;
- ukukhuphuka noma ukuncipha kwenhliziyo;
- isicanucanu
- ukudideka kokwazi;
- ukozela
Kwezinye izimo, kuba nomphumela oqinile wokuguguleka. Ngenxa yokulahlekelwa umthamo omkhulu we-fluid, umzimba uphelelwa ngamanzi emzimbeni, futhi nezinga lama-electrolyte liyancipha. Ukuvela kwe-hypoglycemia kubangela ukuqina kwemisipha noma kuthuthukisa i-arrhythmia.
Uma kwenzeka kweqa ngokweqile, isiguli sidinga ukulaliswa esibhedlela. Ezimweni zokuma, ukwelashwa kugxile ekususeni izimpawu ezingezinhle futhi kujwayele ukulinganisela kwamanzi-electrolyte.
Ukuxhumana nezinye izidakamizwa
Ngokusetshenziswa ngasikhathi sinye kweMikardis enama-lithium aqukethe ama-lithium, ukwanda okuguqukayo kokuhlushwa kwe-serum lithium kungenzeka.
Kulokhu, ukususwa kwe-renal kwe-lithium kuyancipha futhi ukudakwa kuyathuthuka, yingakho kunganconywa ukuthi kunikezwe ukwelashwa okuhambisanayo nge-lithium nomuthi we-hypotensive. Isimo esifanayo siyabonakala ngamalungiselelo e-potassium.
Imithi enciphisa okuqukethwe kwe-potassium ku-plasma yegazi inengxenye ekwakhiweni kwe-hypokalemia. Ngokuphathwa kwabo kanyekanye noMikardis, kuyadingeka ukulawula izinga le-potassium emzimbeni.
Imithi engeyona eyemva kokulwa nokuvuvukala (i-NSAIDs) ingadala ukukhula komzimba, yingakho abantu abaneminyaka engaphezu kwengu-50 benengozi enkulu yokwehluleka kwezinso. Ama-NSAIDs anciphisa umphumela wokwelapha we-diuretics nezidakamizwa ze-antihypertensive.
Izidakamizwa ze-Anticholinergic kanye neMikardis Plus zinciphisa ukuhamba kwemisipha ebushelelezi yethumbu lesisu.
Izinsizakalo ze-barbituric acid nama-antipsychotic zivusa ukuthuthukiswa kwe-hypotension ye-orthostatic ngokulahlekelwa okwalandela.
I-Metformin yandisa ingozi ye-lactic acidosis lapho ihlangana ne-hydrochlorothiazide.
Ezinye izidakamizwa ze-antihypertensive ezihlanganiswa neMikardis ziyi-synergistic - umphumela we-hypotensive uyathuthukiswa kaningana ngokuya ngezimpawu zomuntu ngamunye.
I-cholesterol resins yehlisa ijubane ukumuncwa kwe-hydrochlorothiazide. Izidakamizwa ze-Anticholinergic zandisa i-bioavailability ye-thiazide diuretics, ngenxa yokuthi kukhona ukwehla kwe-peristalsis yemisipha ebushelelezi yethumbu lesisu.
Umkhiqizi
Beringer Ingelheim Ellas A.E., Koropi, Greece.
I-Mikardis Plus Analogs
Uma kungekho mphumela we-hypotensive, iMikardis ingathathelwa indawo ngomunye we-analogues:
- Lezi;
- I-Prirator;
- I-Lozap Plus;
- I-Telmisartan;
- I-Telmisartan Richter;
- I-Telmista.
Imibandela yekhefu lekhemisi
Umuthi ungathengwa ngokuqinile ngomuthi.
Intengo
Izindleko ezijwayelekile zamathebulethi ziyehluka kusuka kuma-ruble angama-1074 kuya kwangama-1100.
Izimo zokugcina zeMikardis Plus
Kunconywe ukuthi umenzeli we-antihypertensive agcinwe endaweni ehlukaniswe nemisebe ye-ultraviolet emazingeni okushisa we + 8 ... + 25 ° C.
Isikhathi sokuphelelwa yisikhathi
Iminyaka emithathu
Ukubuyekezwa mayelana neMikardis Plus
Ngokusho kososayensi bezinhliziyo neziguli, iMikardis iyithuluzi elisebenzayo ekulweni ne-hypertension.
Izazi zezenhliziyo
U-Elena Bolshakova, udokotela wezifo zenhliziyo, eMoscow
Ngenza ucwaningo njengengxenye ye-dissertation ngemiphumela yesidakamizwa, ngakho-ke ngingaxoxa ngokukhulu ukuzethemba ngempumelelo kaMikardis. Umuthi usiza ukuqinisa ingcindezi ephakathi ye-portal futhi wehlise ijubane lokusakazeka kwamagagasi enhliziyo, okuvusa ukukhula kwezifo zenhliziyo. Umuthi uyasebenza kubantu abasha nakwabakhulileyo. Imiphumela emibi ezodinga ukwelashwa okubuyiselwayo, ekusebenzeni ayihlangabezwanga. Umuthi awuthinti ukuhlushwa.
USergey Mukhin, udokotela wezifo zenhliziyo, uTomsk
Ngicabanga ukuthi umuthi uyithuluzi elisebenzayo lokunciphisa umfutho wegazi ophakeme. Lapho uthathwa kanye ngosuku, umphumela wokwelapha uphikelela usuku. Intengo iphakeme. Uhlu olukhulu lwe-contraindication. Kepha umuthi uyasebenza ngohlobo 2 sikashukela, isifo senhliziyo esizinzile. Kuyenqatshelwa ukusebenzisa ezigulini ezinokwehluleka kwenhliziyo okungapheli. Ukusabela kwe-allergic akuvamile ukubonwa kumkhuba wami wezokwelapha.
IMikardis Plus ingathathelwa indawo yiPritor, egcinwe endaweni esehlukaniswe nemisebe ye-ultraviolet emazingeni okushisa we- + 8 ... + 25 ° C.
Iziguli
UDmitry Gavriilov, oneminyaka engama-27, uVladivostok
I-hypertension ye-arterial yaqala, ngenxa yokuthi kusihlwa kwakukhona impilo engeyinhle, ukuntuleka komoya njalo, nokukhula kwethonya. Odokotela banquma amaphilisi eMikardis. Umuthi waqala ukusebenza ngosuku lokuqala. Emahoreni amathathu ngemuva kokuthatha amaphilisi, ingcindezi izinzile emahoreni angama-20 alandelayo. Kubalulekile ukuthatha eminye imithi ezosiza ukugcina lo mphumela. Ngincoma ukubonisana nodokotela wakho mayelana nokwelashwa okufanayo kokudla okunamavithamini.
U-Alexandra Matveeva, oneminyaka engama-45 ubudala, eSt
Ubhekene ne-hypertension ngemuva kokuhlinzwa kwi-gland yegilo. Udokotela wenhliziyo unikeze izibhebhe zeMikardisPlus zesenzo eside. Ngiwuthande umuthi, wehlise umfutho wegazi ngobumnene. Umphumela wesidakamizwa awuthinti umzimba futhi awubangeli ukusabela okubi, kwe-anaphylactic. Ingcindezi ifinyelele ku-130/80 futhi ihlala ikuleli zinga. Ngikweluleka ukuthi uthathe amakhefu amasonto amabili lapho uthatha umuthi.
