Ekwelashweni kwe-hypertension, udokotela angabeka i-Telmista 40 mg. Umuthi futhi usetshenziswa njenge-prophylaxis yezifo kanye nokuvimbela ukubulawa kwabantu abanobungozi obukhulu benhliziyo eneminyaka engu-55 nangaphezulu.
Igama Lezwe elingafanele
Igama elingelona elihweba ngezidakamizwa yi-Telmisartan. Umuthi osebenzayo wesidakamizwa ubizwa nangokuthi, futhi ekuphekeni kukhonjiswa ngesiLatin - iTelmisartanum.
Ekwelashweni kwe-hypertension, udokotela angabeka i-Telmista 40 mg.
I-ATX
C09CA07 Telmisartan
Khipha amafomu nokwakheka
Umuthi uyatholakala ngesimo samaphilisi angama-40 mg. Ngaphezu kwe-telmisartan yezinto ezisebenzayo, ukwakheka kuqukethe izakhi ezisizayo:
- i-meglumine;
- i-lactose monohydrate;
- i-povidone K30;
- i-sodium hydroxide;
- i-sorbitol;
- i-magnesium stearate.
Izibhebhe ziphekwe ngefilimu, zingama-biconvex, zinokuma okusaqanda nombala omhlophe. Kwiphakheji lekhadibhodi, kungahle kube nenombolo ehlukile yamathebulethi - 7 noma 10 ama-PC. ku-1 blister: 14, 28, 30, 56, 60, 84, 90 noma 98 ezibhebheni.
Isenzo se-Pharmacological
Umuthi unamandla okwenza ukuthi umfutho wegazi ube ngokwejwayelekile. Ezigulini, umfutho wegazi we-systolic ne-diastolic wehla, kanti amaphilisi awathinti isilinganiso senhliziyo.
I-Telmisartan yisiphikisi esithile se-angiotensin 2. Ihlanganisa kuphela kuma-receptors e-AT1, ngaphandle kokuthinta amanye ama-subtypes. Ngalezi zi-receptors, i-angiotensin II inomthelela emikhunjini, iyinciphise futhi ibangele ukwanda kwengcindezi. I-Telmisartan ayivumeli i-angiotensin II ukuthi ithinte uhlelo lwenhliziyo, ilususe ekuxhumaneni kwalo ne-receptor.
Umuthi unamandla okwenza ukuthi umfutho wegazi ube ngokwejwayelekile.
Ukuxhumeka okwakheka i-telmisartan nama-receptors, ngakho-ke umphumela womuthi ungahlala amahora angama-48.
Into esebenzayo i-Telmista yehlisa ukuhla kwe-aldosterone esegazini, kepha ayivimbeli i-renin ne-ACE.
I-Pharmacokinetics
Umuthi udonswa ngokushesha lapho uthathwa ngomlomo, i-bioavailability yawo ingu-50%. Umuthi unesikhathi eside sokuphila, udlula amahora angama-24. Ama-Metabolites akhiwa ngenxa yokuhlangana nge-glucuronic acid, awunawo umsebenzi we-pharmacological. Inguquko yenzeka esibindini, khona-ke umuthi ukhishwa ngethambo elenziwa ngaphakathi emathunjini.
Izinkomba zokusetshenziswa
I-Telmista ichazwe ekwelapheni umfutho wegazi ophakeme. Futhi, isidakamizwa sisetshenziswa njenge-prophylaxis yezifo zenhliziyo nezemithambo futhi sinciphise ukufa kwabantu ngenxa yokuthuthuka kwabo. Udokotela ubeka amaphilisi uma eqaphela ukuthi isiguli sisengozini ngenxa ye-anamnesis, indlela yokuphila kanye nelifa.
I-Telmista ichazwe ekwelapheni umfutho wegazi ophakeme.
Contraindication
I-Telmista ayinqunyelwe iziguli ezine-hypersensitivity ezingxenyeni zayo eziyinhloko nezisizayo. Umuthi ubuye uhlukaniswe kwezinye izimo:
- ukwehluleka kwesibindi okunzima;
- ukuvimbela kwe-bile duct;
- i-hypolactasia ne-fructose malabsorption;
- ukukhulelwa nokukhipha umunyu.
Musa ukunquma umuthi lapho uthatha iFliskiren ngabanesifo sikashukela nge-pathologies yezinso.
Ngokunakekela
Uma isiguli sine-renovascular hypertension ngenxa ye-stenosis yemithambo yezinso zombili izinhlangothi, ukuthatha umuthi kungandisa ubungozi be-hypotension ezinzima noma umsebenzi wezinso ongasebenzi kahle. Ngakho-ke, ukwelashwa kufanele kubhekwe ngudokotela futhi kulungiswe uma kunesidingo.
Ekwehlulekeni kwezinso, ukwelashwa kuhambisana nokuqapha okuvamile kwe-plasma creatinine nama-electrolyte. Ngokuqapha, umuthi ubekelwe i-:
- i-stenosis ye-aorta, i-aortic ne-mitral valve;
- ukusebenza kwesibindi kokulimala okungatheni;
- izifo ezinzima ze-CVS, kufaka phakathi isifo senhliziyo;
- ukwanda kwezifo zesisu (isibonelo, isilonda se-peptic sesisu noma i-duodenum);
- i-hyponatremia kanye nethamo elinciphile lokujikeleza kwegazi ngenxa yokuthatha isisu, ngokuhuda noma ukugabha.
Ezigulini ezine-hyperaldosteronism eyisisekelo, isidakamizwa asinqunyelwe ngenxa yokuthi umphumela wokwelapha awukho noma uvezwe kancane.
Ungayithatha kanjani iTelmista 40?
Izibhebhe ziphuzwa ngomlomo, kungakhathalekile ukuthi kudliwani. Umuthi kufanele ugezwe phansi ngamanzi ahlanzekile.
Umthamo udonswa ngudokotela ngokuya ngomlando wesiguli. Ekwelapheni umfutho wegazi ophakeme, isilinganiso esincane sokuqala somuntu omdala yithebhulethi eli-1 eliqukethe 40 mg wento ngosuku. Uma kungekho umphumela odingekile, udokotela angalungisa umthamo ngokuwukhulisa kumatafula ama-2 ama-40 mg ngosuku.
Njengoba umphumela utholakala ngemuva kwezinyanga eziyi-1-2, umbuzo wokulungiswa kwamthamo akufanele uvuswe ezinsukwini zokuqala zokwelashwa.
Uma inhloso yokuphuza umuthi ukuvimbela ukukhula kwezifo zenhliziyo nezemithambo, umthamo onconyiwe ngu-80 mg ngosuku.
Ukuthatha umuthi wesifo sikashukela
Lapho enquma lesi sidakamizwa esigulini esinesifo sikashukela, udokotela kufanele akhumbule ukuthi kungenzeka enze inkambo yamuva yesifo senhliziyo esigulini esinjalo. Ngakho-ke, ngaphambi kokuqala umuthi, isiguli kufanele sidluliselwe ocwaningweni lokuthola isifo se-coronary artery isifo.
Uma isiguli esinesifo sikashukela selashwa nge-insulin noma ngemithi ekwehlisa ushukela egazini, ukuthatha i-telmisartan kung kumbangela i-hypoglycemia. Ngakho-ke, kubalulekile ukubheka njalo amazinga kashukela egazini futhi, uma kunesidingo, ukuguqula umthamo wezidakamizwa ze-hypoclycemic.
Izibhebhe ziphuzwa ngomlomo, kungakhathalekile ukuthi kudliwani.
Imiphumela emibi
Ekutadisheni imiphumela engathandeki, ukuhlangana ngobudala, ubulili kanye nohlanga akubange kwenziwe. Lapho kuhlolwa amanani elabhorethri, kutholakale amazinga aphansi e-hemoglobin egazini, futhi kwabanesifo sikashukela, i-hypoglycemia nayo yabonwa. Ngasikhathi sinye, bekukhona ukwanda kwe-uric acid, hypercreatininemia kanye nokwanda kwe-CPK egazini. Ezimweni ezingavamile, ukuphazamiseka okubukwayo kuye kwabonwa.
Amapheshana wesisu
Imiphumela engathandeki ohlelweni lokugaya ukudla ithuthukiswe ngaphansi kwamacala ayi-1%. Lokhu ukuphazamiseka kwengqondo, ukudangala nobuhlungu besisu, isicanucanu, ukugabha nohudo. Ezinye iziguli zaphawula umlomo owomile, ushintsho ekunambithekeni, kanye nokwenyuka kwerhasi. EJapan, kwaba nezimo zokungasebenzi kahle kwesibindi.
Izitho zeHematopoietic
Ukwehla kwe-hemoglobin amazinga kungaholela kwezimpawu ze-anemia. Egazini, ukwehla kwenani lamaplatelet kanye nokwanda kwama-eosinophils kungenzeka.
Isistimu yezinzwa ephakathi
Ukwemukelwa kweTelmista ngesinye isikhathi (ngaphansi kwe-1% yamacala) kungahle kuhambisane nokuqwasha, ukukhathazeka nesimo sokudangala. Ngesikhathi sokwelashwa, isiyezi, ikhanda nokufelwa kungakhula.
Kusuka ohlelweni lokuphefumula
Kwesinye isikhathi kungaba khona ukwehla kokumelana nezifo ezithinta ipheshana lokuphefumula. Ngenxa yalokhu, kuvela izimpawu ezinjengomkhuhlane, njengokukhwehlela noma ukuphefumula. I-Pharyngitis nezilonda zamaphaphu zingakhula.
Engxenyeni yesikhumba
Ukuthatha i-telmisartan kungaholela ku-erythema, eczema, ekuqhekekeni kwesikhumba (izidakamizwa noma ubuthi) nokulunywa.
I-Telmisartan ingadala i-erythema.
Kusuka ohlangothini lokuzivikela komzimba
Ukuzivikela komzimba kuvame ukuvela njenge-anaphylaxis. Lokhu kungaba yizibonakaliso esikhumbeni ezifana ne-urticaria, edema noma i-erythema. Lapho kuvela izimpawu ezinjalo, kuyaphuthuma ukuxhumana ne-ambulensi, ngoba i-edema kaQuincke ingaholela ekufeni.
Kusuka ohlelweni lwezinhliziyo
Kwezinye iziguli, izinguquko kusigqi senhliziyo zaqoshwa - i-bradycardia noma i-tachycardia. Umphumela we-antihypertensive kwesinye isikhathi uholele ekwehlekeni okukhulu komfutho wegazi kanye ne-orthostatic hypotension.
Kusuka ezicutshini zemisipha
Ezinye iziguli zaphawula izinhlungu emalungeni (i-arthralgia), izicubu zomzimba (myalgia) kanye nama-tendon ngesikhathi sokwelashwa. Ubuhlungu obungajwayelekile ukuvela emuva nasemilenzeni, ukuqina kwemisipha yomlenze nezimpawu ezifanayo nokubonakaliswa kwenqubo yokuvuvukala kuma-tendon.
Kusuka ohlelweni lwezitho zofuzo
Ukwehla kokubekezelelana kwama-microorganisms kungaholela ekukhuleni kwezifo zohlelo lwe-genitourinary, ngokwesibonelo, i-cystitis. Ukusuka ohlangothini lwezinso, ukwephulwa kwemisebenzi yazo kutholakele kuze kube ukuthuthukiswa kokwehluleka kwezinso okubucayi.
Allergies
Ngokwe-hypersensitivity engatholakali ezingxenyeni zomuthi, ukusabela kwe-anaphylactic kungakhula, kuvezwe ngokuncipha okukhulu komfutho wegazi kanye ne-edema kaQuincke. Lezi zimo zidinga ukunakekelwa kwezokwelashwa ngokushesha. Kwesinye isikhathi umuthi ungakubangela ukulunywa, ukuqubuka nobomvu esikhunjeni.
Nge-hypersensitivity engatholakali ezingxenyeni zomuthi, ukusabela kwe-anaphylactic, okuvezwe njenge-edema kaQuincke, kungahle kube khona.
Imiyalo ekhethekile
Ezinye iziguli zidinga ukuqokwa kwe-blockade ephindwe kabili, i.e., ukusetshenziswa kanyekanye kwe-angiotensin receptor antagonist ene-ACE inhibitors noma i-Aliskiren (i-renin inhibitor eqondile). Ukuhlanganiswa okunjalo kungadala ukuphazamiseka ekusebenzeni kwezinso, ngakho-ke ukwelashwa kufanele kuhambisane nokuhlolwa kwezokwelapha nokuhlolwa okujwayelekile.
Ukuhambisana notshwala
Ngesikhathi sokwelashwa kwe-telmisartan, utshwala buhlotshaniswa, ngoba bungakhulisa hypotension ye-orthostatic.
Umthelela ekhonweni lokulawula izindlela
Yize kungekho ocwaningweni ngalolu daba, ngenxa yokuthi kungenzeka ukuthi kube nemiphumela emibi njengokujola nesiyezi, umuntu kufanele aqaphele futhi alalelisise ngenkathi eshayela noma lapho esebenza ngemishini. Uma isiguli sibona ukwehla kokuxineka, khona-ke kufanele iyeke ukusebenza.
Sebenzisa ngesikhathi sokukhulelwa nokukhishwa komzimba
Umuthi unobuthi be-fetotoxicity ne-neonatal, ngakho-ke, buhlanjaniswa ngaso sonke isikhathi sokukhulelwa. Uma isiguli sihlela ukukhulelwa noma sizwa ngokuqala kwayo, udokotela unquma enye indlela yokwelashwa.
Nge-lactation, ukuphuza amaphilisi kufakwa ku-contraindicated ngenxa yokuthi akukho lwazi mayelana nekhono lwento ukungena ngaphakathi ubisi lwebele.
Ukuqokwa kweTelmist yezingane ezingama-40
Ukuqokwa kwe-telmisartan yezingane ezingaphansi kweminyaka engu-18 akubonisiwe, ngoba abukho ubufakazi bokuphepha nokusebenza kwalokhu kwelashwa.
Ukuqokwa kwe-telmisartan yezingane ezingaphansi kweminyaka engu-18 akubonisiwe.
Sebenzisa ebudaleni
Ama-pharmacokinetics asebekhulile ayalingana nasezigulini ezisencane. Ngakho-ke, ukulungiswa kwamthamo kwenziwa ngesisekelo salezo zifo ezikhona esigulini sobudala.
Isicelo sokusebenza kokulimala kwezinso
Asikho isidingo sokulungiswa kwamthamo ezigulini ezinjalo. I-Hemodialysis ayisisusi isidakamizwa, ngakho-ke uma isinqunyelwe, imithamo nayo ayiguquki.
Sebenzisa umsebenzi wesibindi okhubazekile
Ngokuhluleka kwesibindi okubuyisiwe futhi okubolile, umthamo wansuku zonke kufanele ube ngaphansi kwama-40 mg. Ukwephulwa okukhulu kwesibindi kanye nezimo ezivimbelayo zepheji le-biliary kungukuphikisana nokuqokwa.
Ukweqisa
Amacala we-Telmista okweqile kwe-40 awarekhodwa. Ukweqisa umthamo ovumelekile kungadala ukwehla okubukhali kwengcindezi yegazi, ukuthuthukiswa kwe-bradycardia noma i-tachycardia. Ukwelashwa kwezimo ezinjalo ukudambisa izimpawu.
Ukweqa umthamo ovumelekile kungadala ukukhula kwe-bradycardia.
Ukuxhumana nezinye izidakamizwa
Ukuphathwa kanyekanye kwe-telmisartan neminye imithi ye-hypertension kuholela ekuthatheni isenzo (noma ukwanda komphumela lapho ubeka i-hydrochlorothiazide). Uma inhlanganisela yezidakamizwa zokulondolozwa kwe-potassium inqunyelwe, i-hyperkalemia ingaqhamuka. Ngakho-ke, ngokuqapha unikeze i-telmisartan ngokuhlanganiswa ne-ACE inhibitors, izithako zokudla eziqukethe i-potassium, ama-NSAIDs, ama-Heparin kanye ne-potasium-sparing diuretics.
I-Telmista inganyusa amazinga we-digoxin emzimbeni. Ama-Barbiturates kanye nama-antidepressants akhulisa ubungozi be-orthostatic hypotension.
Ama-Analog
Ngaphezu kweTelmista, ezinye izidakamizwa eziqukethe i-telmisartan zingabekwa:
- UMikardis;
- I-Telmisartan-SZ;
- I-Telzap;
- I-Prirator;
- I-Tanidol;
- I-Telpres
- ITelsartan.
Amanye amabhlokhi we-receptor e-AT1 asetshenziswa njengezikhalazo:
- IValsartan.
- I-Irbesartan.
- Azilsartan Medoxomil.
- I-Candesartan.
- Losartan.
- Fimasartan.
- I-Olmesartan Medoxomil.
- Eprosartan.
Zonke izinguquko zomuthi kufanele zenziwe ngaphansi kokuqondisa udokotela.
Imibandela yeholide i-Telmista 40 evela emakhemisi
Umuthi ungathengwa kuphela ngokubhaliwe.
Ngingakwazi ukuthenga ngaphandle kadokotela?
Ikhemisi kumele lifune incwadi kadokotela elungiselelwe kahle kusuka kudokotela, ngakho-ke ukuthenga isidakamizwa ngaphandle kwedokhumenti ngeke kusebenze. Ngokuthengisa i-telmisartan ngaphandle kwencwadi kadokotela, usokhemisi wephula umthetho.
Intengo
Izindleko zincike kwinani lamathebulethi futhi zikububanzi bama-ruble angama-218-790. Intengo ephakathi nepakethe ngalinye lamathebhulethi angama-28 ngama-ruble angama-300.
Izimo zokugcina i-Telmista 40
Umuthi kufanele ugcinwe kwiphakheji elivaliwe ekushiseni kwegumbi kungabi ngaphezu kuka + 25 ° C. Kufanele uqiniseke ukuthi ingane ayikwazi ukuwuthola umuthi.
Isikhathi sokuphelelwa yisikhathi
Iminyaka engu-3 kusuka ngosuku oluboniswe kuphakheji. Ngemuva kokuphelelwa yisikhathi kwethuluzi alikwazi ukusetshenziswa.
Umkhiqizi
I-KRKA, eSlovenia.
Ukubuyekezwa ku-Telmista 40
Umuthi, onqunywe ngokuya izinkomba futhi ngokuya nge-anamnesis, unikeza umphumela wokuphendula okungatheni. Lokhu kufakazelwa izibuyekezo.
Odokotela
U-Ana, oneminyaka engama-27 ubudala, udokotela wezokwelapha, u-Ivanovo.
Umuthi osebenzayo ekwelapheni izigaba 1 no-2 we-hypertension, ikakhulukazi ezigulini ezisebasha. Ukuqedwa kwesigamu sempilo kufinyelela emahoreni angama-24, lokhu kufaka isiguli iphutha lokwemukelwa ngengozi. Yize ukusetshenziswa kwe-1 isikhathi ngosuku kunciphisa amathuba okuthi weqe okungenani. Umuthi muhle ngoba ukhishwa isibindi, okusho ukuthi ungabhekelwa ezigulini ezinezinkinga zezinso. Okubi ukuthi i-monotherapy yesigaba 3 somfutho wegazi ophezulu ayisebenzi.
UDenis, oneminyaka engama-34 ubudala, udokotela wezifo zenhliziyo, eMoscow.
Njenge-monotherapy, ibhekana ne-degree yokuqala ye-hypertension, ngokuhlangana nezinye izidakamizwa iyasebenza kwesibili. Imiphumela emibi yeminyaka engu-8 yokuzilolonga ayizange ibonwe noma kusetshenziswe isikhathi eside. Ukubuyekezwa okungalungile kungahle kuhlotshaniswe nemizamo yokuzelapha phakathi kweziguli.
Iziguli
U-Elena, oneminyaka engama-25 ubudala, e-Orenburg.
Ngathenga umama lo muthi, umphumela waba, kepha isikhumba sakhe nolwelwesi lwamehlo lwaphenduka ophuzi. Lapho beya kudokotela, wathi umama kaTelmista waphulwa umthetho. Ngincoma umuthi, ngoba umphumela wawumuhle, kodwa angikucebisi ukuzelapha.
UNikolay, oneminyaka engama-40, eSt.
Isikhathi eside, baphuza lo muthi nodokotela, ngaphambi kokuba amaTelmists azame izinketho ezi-6 noma ezi-7. Wumuthi kuphela lo osizayo, kuyilapho kungekho zimpendulo ezimbi ngisho nangemva kokusetshenziswa kwezinyanga ezi-2. Ngokuhle, ukuthi ukwamukela 1 isikhathi ngosuku. Isifundo asishibhile, kepha umuthi ungowekhwalithi ephezulu, futhi impilo ibaluleke kakhulu.
