TELMISTA® N 40 Hydrochlorothiazide, Telmisartan

Sigar tsari Telan Telmists - allunan: kusan fararen fari ne ko fari, a ƙarshen 20 MG - zagaye, 40 MG - biconvex, oval, 80 MG - biconvex, kamannin-kwalliya (a cikin boyayyar kayan haɗin 7 pcs., A cikin kwali na kwali 2, 4, 8 , Blister 12 ko 14, a cikin murhun ciki guda 10., A cikin kwali na kwali 3, 6 ko 9 blisters).

Hadarin kwamfutar hannu ɗaya:

• abu mai aiki: telmisartan - 20, 40 ko 80 MG,
• tsofaffi: sodium hydroxide, lactose monohydrate, magnesium stearate, meglumine, povidone K30, sorbitol (E420).

Pharmacodynamics

Telmisartan, abu mai aiki na Telmista, yana da kayan antihypertensive, kasancewar mai karɓar angiotensin II antagonist (AT blocker₁masu karɓa). Bayyanar da angiotensin II daga haɗin tare da mai karɓa, ba shi da ikon aikin agonist dangane da wannan mai karɓa. Telmisartan aka zaɓa kuma na dogon lokaci zai iya ɗaure wa angiotensin II receptor subtype AT kaɗai mai ƙarfi₁. Ba shi da alaƙa ga sauran masu karɓar angiotensin, mahimmancin aiki wanda kuma sakamakon ƙari (saboda amfani da telmisartan) tasirin maganin angiotensin II akan su ba a yi nazari ba.

Telmisartan yana rage maida hankali na aldosterone a cikin jini na plasma, baya tasiri kan maida hankali kuma baya toshe tashoshin ion. Abunda yake aiki baya hana ACE (angiotensin-mai canza enzyme), wanda kuma yana lalata bradykinin, don haka ba'a lura da halayen gefen da aka haifar da bradykinin ba.

Telmisartan, wanda aka ɗauka a kashi 80 na MG, ya toshe tasirin cutar rashin ƙarfi ta angiotensin II. Bayan kashi na farko na miyagun ƙwayoyi na tsawon awanni 3, an lura da farkon tasirin sakamako, tasirin yana ci gaba har tsawon kwana ɗaya kuma zai ci gaba har zuwa kwana biyu. A barga hypotensive sakamako tasowa bayan makonni 4-8 daga farkon jiyya tare da gudanarwa na yau da kullum na telmisartan.

Tare da hauhawar jini na jijiya, ƙwayar tana taimakawa wajen rage yawan tashin hankali na jini na jini (BP). Telmisartan ba shi da tasiri a kan bugun zuciya (bugun zuciya).

A cikin marasa lafiya tare da kwaskwarimar kwastomar telmisartan, hawan jini sannu a hankali ya dawo ga darajar sa ta asali, ba a lura da cirewar cutar ba.

Pharmacokinetics

• sha: lokacin da aka saka shi, yana cikin hanzari ya shiga cikin hanji. Bioavailability shine 50%. Lokacin da aka ɗauki shi da abinci, raguwa a cikin AUC (yanki a ƙarƙashin murfin likitancin) yana cikin kewayon daga 6% zuwa 19% a kashi 40 da 160 mg, bi da bi. 3 hours bayan shan telmisartan, maida hankali ne akan matakan jini (ba ya dogara da lokacin cin abinci). AUC da matsakaiciyar ƙwayar plasma (C_max) a cikin mata yakai kusan sau 2 da sau uku, bi da bi, fiye da na maza. Babu wani tasiri mai tasiri akan inganci,
• rarrabuwa da aikin metabolism: kashi 99.5% na kwayoyin sunadarai ga furotin na plasma (galibi alpha-1 glycoprotein da albumin). Volumeararrawar bayyana a cikin rarraba ma'auni yana kan matsakaita 500 l. Metabolism yana faruwa ta hanyar haɗuwa tare da glucuronic acid tare da samuwar ƙwaƙwalwar ƙwaƙwalwar ƙwayoyi marasa aiki,
• excretion: T_1/2 (kawar da rabin rayuwar) - sama da awanni 20. Abinda yafi galibi ba'a canza shi ta cikin hanjin, tare da fitsari - kasa da 2%. Gabaɗayan aikin plasma yana da faɗi sosai idan aka kwatanta da hawan jini na hepatic (kusan 1500 ml / min) kuma kusan 900 ml / min.

Babban ma'aunin magunguna na telmisartan lokacin da ake amfani da shi a cikin yara da matasa daga shekaru 6 zuwa 18 don makonni 4 a kashi na 1 ko 2 mg / kg duk ana iya kwatanta su da waɗanda ke cikin marasa lafiyar manya kuma sun tabbatar da magungunan magungunan marasa layi na kayan aiki mai mahimmanci, musamman game da C_max.

Contraindications

• mai tsanani siffofin hanta dysfunction (bisa ga rarrabuwa Yaron - Pugh - aji C),
• bile shigowa,
• haɗewar amfani da aliskiren a cikin marasa lafiya da rauni mai rauni ko matsakaici na kasawa na ƙira (ƙimar ƙirar ƙasa da ƙasa da 60 ml / min / 1.73 m 2) ko tare da ciwon sukari na mellitus,
• lactase / sucrose / isomaltase rashi, rashin jituwa na fructose, glucose-galactose malabsorption,
• ciki da lactation,
• shekaru zuwa shekaru 18
• daidaikun mutum zuwa telmisartan ko kowane ɓangare na kayan taimako na miyagun ƙwayoyi.

Dangi (cututtuka / yanayi wanda amfani da Telmista yana buƙatar taka tsantsan):

• mai lalacewa na koda da / ko aikin hanta,
• biyun koda na jijiya arte stenosis ko artery stenosis na koda daya,
• yanayi bayan sakewar koda (saboda karancin kwarewar amfani),
• hyperkalemia
• hyponatremia,
• na kullum zuciya
• kunkuntar na mitral da / ko aortic bawul,
• GOKMP (ciwon zuciya yana hana mutum zuciya),
• raguwa a cikincccc (yawan yaduwar jini) saboda magani na baya tare da diuretics, iyakantaccen yawan gishiri, amai ko gudawa,
• asalin hyperaldosteronism (aminci da inganci ba a kafa su ba).

Umarnin don amfani da Telmista: hanya da sashi

Ana ɗaukar allunan Telmist na baka, ba tare da la'akari da lokacin cin abinci ba.

Tare da hauhawar jijiyoyin jini, ana bada shawara don fara shan tare da 20 ko 40 mg na miyagun ƙwayoyi 1 lokaci a rana. A cikin wasu marasa lafiya, yana yiwuwa a cimma tasirin hypotensive a kashi na 20 MG / rana. Game da isasshen sakamako na warkewa, zaku iya ƙara yawan zuwa mafi girman adadin yau da kullun na 80 MG. Tare da karuwa a cikin kashi, dole ne a la'akari da cewa mafi girman tasirin sakamako na Telmista yawanci ana samun shi ne bayan makonni 4-8 daga farkon farfaɗo.

Don rage cututtukan zuciya da mace-mace, ana ba da shawarar shan 80% na miyagun ƙwayoyi 1 lokaci a rana.

A matakin farko na jiyya, ana buƙatar ƙarin hanyoyin don daidaita al'ada hawan jini.

Ba lallai ba ne don daidaita tsarin jigilar magunguna ga marasa lafiya da gazawar renal, har da waɗanda ke kan hemodialysis.

Don ƙarancin aikin hanta mai rauni mai sauƙi ko matsakaici (gwargwadon rarrabuwa da Yara-Pugh - Class A da B), matsakaicin adadin yau da kullun na Telmista shine 40 MG.

A cikin tsofaffi marasa lafiya, likitan magunguna na telmisartan ba ya canzawa, don haka babu buƙatar daidaita sashi na maganin a gare su.

Side effects

Lokacin amfani da Telmists, halayen da suka biyo baya daga tsarin da gabobin suna yiwuwa:

• zuciya: tachycardia, bradycardia,
• tasoshin jini: orthostatic hypotension, raguwar hauhawar jini,
• tsarin narkewa: zawo, zafin ciki, dyspepsia, rashin jin daɗin ciki, ƙwanƙwasa, amai, dysgeusia (ɓarna da dandano), bushewar mucous na bakin ciki, rauni na hanta / cutar hanta,
• jini da tsarin lymphatic: thrombocytopenia, eosinophilia, anemia, sepsis (gami da sepsis mai kisa),
• tsarin juyayi: rashin bacci, damuwa, damuwa, damuwa, vertigo, fainting,
• tsarin rigakafi: rashin lafiyar jiki (urticaria, erythema, angioedema), halayen anaphylactic, pruritus, eczema, fatar fata (gami da magani), hyperhidrosis, angioedema (har ya mutu), fatar fata mai guba,
• sashin hangen nesa: hargitsi na gani,
• tsarin numfashi, kirji da sassan gabobin jiki: tari, gazawar numfashi, cututtukan huhu na sama, cututtukan huhu (cututtukan mahaifa da amfani da telmisartan ba a kafa ba),
• musculoskeletal da nama mai haɗuwa: ciwon baya, arthralgia, cramps muscle (spasms of theጡንቻ maraƙi), myalgia, zafin kafa, jin zafi a cikin tendons (alamu masu kama da bayyanar kumburi da lalacewar jijiya),
• kodan da urinary fili: lalacewar aikin na koda (ciki har da rashin lafiyar koda), cututtukan urinary fili (gami da cystitis),
• jiki gaba daya: rauni gaba ɗaya, mura-kamar ciwo, ciwon kirji,
• nazarin kayan aiki da kuma dakin gwaje-gwaje: karuwa a cikin abubuwan uric acid, creatinine a cikin jini na jini, raguwa a cikin matakin haemoglobin, karuwa a cikin ayyukan hepatic transaminases, CPK (creatine phosphokinase) a cikin jini na jini, hypoglycemia (a cikin marasa lafiya da ciwon sukari mellitus), hyperkalemia.

Ba a kafa dangantakar matsayin bayyanar tasirin sakamako tare da shekaru, jinsi ko tseren marasa lafiya ba.

Umarni na musamman

Amfani na lokaci guda na Telmista da ACE inhibitors ko mai hana kai tsaye na renin, aliskiren, saboda aikin sau biyu akan RAAS (tsarin renin-angiotensin-aldosterone) yana haɓaka aikin kodan (ciki har da na iya haifar da gazawa ta ƙarancin aiki), sannan kuma yana ƙara haɗarin hauhawar jini da hyperkalemia. . Idan irin wannan haɗin gwiwa ya zama dole, dole ne a gudanar dashi karkashin kulawa ta fuskar lafiya, kamar yadda ake duba aikin koda, akai-akai da matakan ƙwayoyin cuta a cikin jini.

A cikin marasa lafiya da masu ciwon sukari mai narkewa, telmisartan da ACE inhibitors ba su bada shawarar ba.

A cikin yanayin da sautin jijiyoyin bugun gini da aikin na koda ya dogara da aikin RAAS (alal misali, a cikin marasa lafiya da cutar koda, ciki har da ƙananan ƙwayar cutar koda da jijiyoyin ƙwayar koda, ko tare da raunin zuciya), yin amfani da magungunan da suka shafi RAAS na iya haifar da ci gaban hyperazotemia, matsanancin rashin lafiyar jijiya, rashin ƙarfi da rashin aiki na koda (a lokuta mafi ƙaranci).

Lokacin amfani da daskararru na potassium, mai maye gurbin gishiri a cikin potassium, kari da sauran magunguna waɗanda ke ƙara haɗuwa da potassium a cikin jini tare da Telmista, ya zama dole don sarrafa matakin potassium a cikin jini.

Tunda telmisartan an ware shi musamman tare da bile, tare da cututtukan cututtukan cututtukan hanji ko aikin hanta mai rauni, raguwar maganin zai yiwu.

Tare da ciwon sukari da ƙarin haɗarin cututtukan zuciya, alal misali, cututtukan zuciya da jijiyoyin jini (cututtukan zuciya), yin amfani da Telmista na iya haifar da rauni mai rauni na zuciya da mutuwar zuciya kwatsam. A cikin marasa lafiya da ciwon sukari mellitus, cututtukan zuciya na zuciya ba za a iya gano su ba, tun da alamun ta a wannan yanayin ba koyaushe bane ke faruwa. Sabili da haka, kafin fara maganin ƙwayar cuta, ya zama dole a gudanar da gwaje-gwajen cututtukan da suka dace, gami da gwaji tare da aikin jiki.

A cikin marasa lafiya da masu ciwon sukari suna karbar magani tare da insulin ko maganganun hypoglycemic na baki, hypoglycemia na iya haɓaka yayin jiyya tare da Telmista. Irin waɗannan marasa lafiya suna buƙatar sarrafa tattarawar glucose a cikin jini, tunda ya dogara da wannan alamar, dole ne a daidaita yawan insulin ko magungunan hypoglycemic.

A cikin hyperaldosteronism na farko, yin amfani da magungunan antihypertensive - RAAS inhibitors - yawanci ba shi da tasiri. Irin waɗannan marasa lafiya ba a ba da shawarar su dauki Telmista ba.

Yin amfani da miyagun ƙwayoyi yana yiwuwa a hade tare da thiazide diuretics, tunda irin wannan haɗin yana samar da ƙarin raguwa a cikin karfin jini.

Nazarin ya nuna cewa Telmista ba shi da tasiri a cikin marasa lafiya na tseren Negroid. An lura da lalacewar hanta tare da amfani da telmisartan a mafi yawan lokuta tsakanin mazaunan Japan.

Haihuwa da lactation

Dangane da umarnin, Telmista yana contraindicated yayin daukar ciki. Game da bayyanar cutar ciki, ya kamata a dakatar da maganin nan da nan. Idan ya cancanta, ya kamata a ba da magunguna na antihypertensive na wasu azuzuwan da aka yarda dasu amfani dasu yayin daukar ciki. An kuma shawarci matan da ke shirin daukar ciki suyi amfani da madadin magani.

A cikin binciken kwaskwarima na miyagun ƙwayoyi, ba'a gano tasirin teratogenic ba. Amma an gano cewa yawan amfani da angiotensin II mai hana antagonists a cikin na biyu da na uku a cikin ciki yana haifar da fetotoxicity (oligohydramnios, rage aiki na renal, rage ossification na kasusuwa na tayin) da kuma cututtukan cututtukan cututtukan zuciya (artpot hypotension, renal failure, hyperkalemia).

Jariri wanda mahaifiyarsa suka dauki Telmista a lokacin daukar ciki suna bukatar kulawa ta fuskar lafiya saboda yuwuwar ci gaban yanayin jijiya.

Tunda babu wani bayani game da shigar shigar da tabin telmisartan cikin nono, an sanya maganin a yayin shayarwa.

Tare da aikin hanta mai rauni

Ba'a ba da shawarar shan magungunan ba a cikin marasa lafiya da ke fama da rauni na hanta (bisa ga rarrabuwa da Yara-Pugh - aji C).

Tare da laushi zuwa matsakaici rashin daidaituwa na hepatic (bisa ga rarrabuwa da Yara-Pugh - Class A da B), yin amfani da Telmista yana buƙatar taka tsantsan. Matsakaicin maganin yau da kullun a cikin wannan yanayin bai kamata ya wuce 40 MG ba.

Hulɗa da ƙwayoyi

Yin amfani da telmisartan lokaci guda tare da wasu kwayoyi na iya haifar da haɓaka sakamako masu zuwa:

• antihypertensive kwayoyi: karuwa sakamako mai illa,
• warfarin, digoxin, ibuprofen, glibenclamide, hydrochlorothiazide, paracetamol, amlodipine da simvastatin: ba a lura da muhimmiyar hulɗa a asibiti. A wasu halaye, haɓaka abun cikin ƙwayar plaoma da kashi 20% mai yiwuwa ne. Idan aka haɗu da digoxin, ana bada shawara don saka idanu akan ƙwayar plasma na lokaci-lokaci,
• urearfin potassium-sparing diuretics (misali, spironolactone, amiloride, triamteren, eplerenone), masu maye gurbin potassium, ACE inhibitors, angiotensin II receptor antagonists, NSAIDs (magungunan anti-mai kumburi steroidal), gami da zaɓi cyclooxygenase-hemporin-2-azimonpin-cyimpin da trimethoprim: haɓakar haɗarin hyperkalemia (saboda tasirin tasirin gaske),
• ramipril: karuwa sau biyu a alamomin C_max da AUC_0-24 damatra da kamara,
• Shirye-shiryen lithium: farfadowar ƙaruwa a cikin taro na lithium a cikin jini (an ba da rahoton a lokuta mafi wuya) tare da sakamako mai guba. An ba da shawarar kuyi lokaci-lokaci don duba matakan lithium,
• NSAIDs (ciki har da acetylsalicylic acid, NSAIDs waɗanda ba zaɓaɓɓu ba da masu hana cyclooxygenase-2 inhibitors): rage tasirin mai ƙwarin jini na telmisartan, ƙara haɗarin rashin lalacewa mai ƙuna yayin tashin ruwa. A farkon hadewar jijiyar jiki tare da telmisartan da NSAIDs, ya zama dole don rama don bcc da duba aikin koda,
• amifostine, baclofen: potentiation na mai tasiri tasirin telmisartan,
• barbiturates, barasa, maganin rigakafi da magunguna: ofarfin tashin hankali na orthostatic.

Misalin ana amfani da Telmista sune: Mikardis, Teseo, Telmisartan-Richter, Telmisartan-SZ, Telpres, Telsartan da sauransu.

Form sashi

Tabletaya daga cikin kwamfutar hannu ya ƙunshi

Telmista®H40

abubuwa masu aiki: Telmisartan 40mg

hydrochlorothiazide 12.5 MG

magabata: meglumine, sodium hydroxide, povidone K30, lactose monohydrate, sorbitol, magnesium stearate, mannitol, baƙin ƙarfe oxide (E172), hydroxypropyl cellulose, celhydlose silsila na anhydrous, sodium stearyl fumarate

Telmista®H80

abubuwa masu aiki: Telmisartan 80mg

hydrochlorothiazide 12.5 MG

magabata: meglumine, sodium hydroxide, povidone K30, lactose monohydrate, sorbitol, magnesium stearate, mannitol, baƙin ƙarfe oxide (E172), hydroxypropyl cellulose, celhydlose silsila na anhydrous, sodium stearyl fumarate

Telmista®ND 80

abubuwa masu aiki: telmisartan 80 MG

hydrochlorothiazide 25 MG

magabata: meglumine, sodium hydroxide, povidone K30, lactose monohydrate, sorbitol, magnesium stearate, mannitol, baƙin ƙarfe oxide (E172) hydroxypropyl cellulose, celhydlose siliki na anhydrous, sodium stearyl fumarate

Allunan launuka, biconvex, bilayer, daga fari zuwa kusan fari ko ruwan hoda mai launin shuɗi-launi a gefe ɗaya da ruwan hoda-marble a gefe ɗaya (na maganin 40 mg / 12.5 mg da 80 mg / 12.5 mg).

Allunan launuka, biconvex, kashi biyu, daga fari zuwa launin fari zuwa launin fari a gefe guda da launin rawaya-maraƙi a gefe ɗaya (don sashi na 80 mg / 25 MG).

Kayan magunguna

Pharmacokinetics

Mafi girman taro na telmisartan tare da kula da baka yana faruwa bayan sa'o'i 0.5-1.5 bayan gudanarwa. Ainihin bioavailability na telmisartan a allurai na 40 mg da 160 mg shine 42% da 58%, bi da bi. Samun abinci na lokaci guda ba ya ragewa bioavailability na telmisartan, rage yankin a ƙarƙashin ganiya da miyagun ƙwayoyi a cikin jini na jini (AUC) da kusan 6% lokacin shan 40 MG da kusan 19% bayan shan 160 mg. Decreasearamin raguwa a cikin taro mafi girma ba ya tasiri da ingancin warkewar magani. Magungunan magunguna na telmisartan lokacin da aka yi amfani da su ta hanyar maganganu a cikin allurai na 20-160 MG ba su da layi, Cmax da AUC gwargwadon ƙaruwa tare da ƙaruwa da yawa. Tare da sake maimaitawa, telmisartan dan kadan yana tara jini a cikin jini.

Telmisartan yana ɗaure da kyau ga ƙwayoyin plasma (> 99.5%), galibi albumin da glycoproteins alpha L-acid. Volumeararren ɗaukar telisbartan yana kusan 500 L, wanda ke nuna ƙarin haɗin nama.

Fiye da 97% na miyagun ƙwayoyi lokacin da aka gudanar da shi ta hanyar magana an watsa shi a cikin feces ta hanyar biliary excretion. Ana samun hanyoyi a fitsari. Telmisartan yana metabolized by conjugation zuwa pharmacologically m metabolites - acetyl glucuronides. Glucuronides sune kawai metabolites na kayan farawa wanda aka samo a cikin mutane.

Bayan kashi ɗaya na telmisartan, abubuwan da ke cikin glucuronides a cikin jini yana kusan 11%. Telmisartan ba shi metabolized ta hanyar isoenzymes na tsarin cytochrome P450. Matsakaicin yarda daga plasma jini ya wuce 1500 ml / min. M rabin rayuwar fiye da 20 hours

Tare da gudanarwa na baka na ajali ambatacce na telmisartan / hydrochlorothiazide, mafi girman taro na hydrochlorothiazide an kai shi cikin awa 1.0-3.0 bayan gudanarwa. Idan akai la'akari da cewa hydrochlorothiazide na iya tarawa yayin shakatawa na renal, cikakken bioavailability shine kashi 60%.

Hydrochlorothiazide yana da kimanin kaso 68% ga furotin na plasma kuma sanannen rarrabuwarsa shine 0.83-1.14 l / kg.

Hydrochlorothiazide ba metabolized bane kuma kusan an cire shi gaba daya ta hanyar koda tare da fitsari. Kusan kashi 60% na maganin baka yana canzawa ba a cikin awanni 8. Shafin hukunci

Rabin tashar tasirin hydrochlorothiazide awoyi 10-15 ne.

Pharmacodynamics

Fixedaƙƙarfan haɗuwa na telmisartan / hydrochlorothiazide shine haɗin haɗin antiotistin II receptor antagonist, telmisartan da thiazide diuretic, hydrochlorothiazide, wanda ke samar da babban matakin antihypertensive sakamako fiye da ɗayan kowane kayan haɗin daban. Lokacin ɗaukar tsayayyen haɗaka na telmisartan / hydrochlorothiazide sau ɗaya a rana, ana samun ingantaccen raguwa mai tasiri cikin hawan jini tsakanin ƙwayar warkewa.

Telmisartan inganci lokacin ɗauka ta baki kuma takamaiman (zaɓi ne) na gaba na angiotensin II receptor subtype 1 (AT1). Telmisartan ya maye gurbin angiotensin II, saboda yana da babban kusanci ga masu karɓar AT1 a wurin mai ɗauri, waɗanda ke da alhakin kafawar tasirin angiotensin II. Telmisartan ya zaɓi kuma ya ci gaba da ɗaure wa masu karɓar AT1 kuma ba shi da wata ma'amala ga sauran masu karɓar, ciki har da AT2 da sauran masu karɓar AT. Har yanzu ba a kafa aikin mai karɓar waɗannan masu karɓar ba, har ma da tasirin tasirin su yayin yiwuwar hauhawar cutar angiotensin II, matakin wanda ke ƙaruwa a ƙarƙashin rinjayar telmisartan. Telmisartan yana rage matakan plasma aldosterone kuma baya hana ayyukan angiotensin-mai canza enzyme (kininase II), tare da halartar wanda akwai raguwa a cikin kwayar bradykinin, don haka ƙarfin ƙarfin mummunan tasirin bradykinin baya faruwa.

Arfin angiotensin II akan asalin telmisartan yana ɗaukar sama da awanni 24 kuma yana ɗaukar awowi 48.

Bayan ɗaukar telmisartan, ana samun aikin maganin damuwa a cikin 3 hours. Matsakaicin mafi girman raguwa a cikin jini shine an cimma shi a cikin makonni 4-8 bayan farawar magani kuma ya ci gaba yayin jinya mai tsawo. An kiyaye tasirin antihypertensive a matakin akai-akai na awanni 24.

A cikin marasa lafiya tare da hauhawar jini, telmisartan yana rage duka systolic da diastolic saukar jini ba tare da shafi raunin zuciya ba.

Tare da katsewar jiyya tare da telmisartan, hawan jini a hankali ya dawo zuwa matakin da ya gabata na kwanaki da yawa ba tare da ci gaba da “sake dawo da cutar” (haɓaka haɓakar hawan jini ba).

Thiazides yana da tasiri ga tsarin rerosorption na electrolytes a cikin tubules na kodan, yana haɓaka fitowar ሶodi da chlorides a kusan daidai adadin. Sakamakon diuretic na hydrochlorothiazide yana haifar da raguwa a cikin ƙwayar plasma jini, karuwa a cikin ƙwayar plasma renin, karuwa a cikin narkewar aldosterone, wanda ke ba da gudummawa ga haɓakar fitsari a cikin ƙwayoyin potassium da bicarbonates kuma, a sakamakon haka, raguwa a cikin matakan ƙwayoyin ƙwayar ƙwayar mai. Theoyewar renin-angiotensin na tsarin aldosterone tare da haɗin telmisartan tare da diuretics yana haifar da asarar ƙwayar potassium ta jiki. Lokacin ɗaukar hydrochlorothiazide, diuresis yana farawa bayan sa'o'i 2, ana samun sakamako mafi yawan diuretic a cikin sa'o'i 4 bayan gudanarwa, aikin yana ɗaukar awanni 6-12.

Alamu don amfani

- lura da hauhawar jijiya

An nuna Telmista®H40 da Telmista®H80 ga marasa lafiya waɗanda waɗanda ba shi yiwuwa a sarrafa matakin hauhawar jini ta amfani da telmisartan ko hydrochlorothiazide a cikin hanyar monotherapy.

An nuna Telmista® ND80 ga marasa lafiya marasa lafiya a cikinsu waɗanda ba shi yiwuwa a iya sarrafa matakin hawan jini ta amfani da Telmista® N80 ko a cikin wanda an riga an tsayar da matsin lamba ta amfani da telmisartan da hydrochlorothiazide daban.

Sashi da gudanarwa

Ya kamata a yi amfani da Telmista®N40, Telmista®N80 ko Telmista®ND80 sau ɗaya a rana, a wanke da ruwa kaɗan, ba tare da la'akari da abinci ba.

Kafin jiyya tare da telmisartan / hydrochlorothiazide hade ya kamata a yi

kashi na zaɓi akan asalin monotherapy tare da telmisartan. Idan ya cancanta, zaku iya canzawa kai tsaye daga monotherapy zuwa magani tare da haɗuwa da madaidaitan allurai na miyagun ƙwayoyi.

Ana iya ba da magani na Telmista®H40 ga marasa lafiya waɗanda waɗanda ba su kula da karfin jini sosai ta hanyar telmisartan 40 MG.

Ana iya ba da magani na Telmista® H80 ga marasa lafiya waɗanda waɗanda ba su kula da karfin jini ta hanyar 80 mg telmisartan.

Ana iya ba da magani na Telmista80 ND80 ga marasa lafiya waɗanda a cikin waɗanda ba a kula da karfin jini ta Telmista® N80 ko a cikin wanda aka riga an tsayar da matsin lamba ta amfani da telmisartan da hydrochlorothiazide daban.

Bayan fara magani tare da haɗuwa da telmisartan / hydrochlorothiazide, ana samun tasirin antihypertensive matsakaici a cikin makonni 4-8 na farko. Idan ya cancanta, za a iya ba da umarnin Telmista®H40, Telmista®H80 ko Telmista®ND80 a hade tare da wani magani na antihypertensive.

Marasa lafiya tare da gazawar koda

Ana bada shawarar saka idanu akai-akai na aikin koda.

Marasa lafiya tare da raunin hanta

A cikin marasa lafiya da raunin matsakaici na matsakaici zuwa matsakaici, kashi bai kamata ya wuce tebur 1 na Telmista®N40 (telmisartan 40 / hydrochlorothiazide 12.5 mg) sau ɗaya a rana.

Babu buƙatar daidaituwa na kashi a cikin marasa lafiya tsofaffi.

Aikin magunguna

Allunan Telmista - magani mai tasiri don matsin lamba, yana da araha mai araha.

Ayyukansa an yi niyya don toshe masu karɓar nau'in AT1, alhali ba shi da tasiri ga sauran nau'in masu karɓar karɓa.

Matsakaicin tasirin mai ɗaukar nauyi na shan Telmista ana lura dashi bayan wata daya na maganin, wanda ke ba da shawara game da tasirin magani na tsawon lokaci.

Abubuwan da ke tattare da miyagun ƙwayoyi sun dogara ne akan haɗin haɗin ƙwaƙwalwar telmisartan tare da abu na hydrochlorothiazide, wanda shine diuretic. Magungunan ƙwayar cuta shine mai zaɓin nau'in antagonist wanda ke aiwatar da aikin angiotensin ii. Abubuwan da ke aiki da ƙwayar suna da dangantaka mai tsawo tare da mai karɓar AT1.

Magungunan yana rage adadin aldosterone a cikin jini na jini. Magungunan yana rage adadin aldosterone a cikin jini na jini. Babu wani sakamako mai toshewa a tashoshin ion da renin. Sakamakon toshewa a cikin abu na kininase II, wanda ke da tasiri ragewa akan bradykinin, shima ba ya nan.

Wani irin jini ya kamata in sha?

Don rage karfin jini, ana wajabta 40m Telmista kowace rana. A cikin wasu marasa lafiya, har ma tare da maganin yau da kullun na 20 MG, ana iya samun sakamako mai dacewa. Idan ba'a cimma manufar rage karfin jini ba, likitan na iya kara kashi zuwa 80 MG kowace rana.

Ana iya gudanar da maganin a hade tare da wakili na bushewa daga ƙungiyar thiazide (alal misali, hydrochlorothiazide). Kafin kowane ƙaruwa a cikin kashi, likita zai jira daga makonni huɗu zuwa takwas, tun daga nan aka bayyana girman tasirin maganin.

Don hana lalacewar jijiyoyin jiki a cikin yanayin da suka rigaya, matakin da aka ba da shawarar shine 80 MG na telmisartan sau ɗaya a rana. A farkon jiyya, ana ba da shawarar saka idanu akai-akai game da karfin jini. Idan ya cancanta, likita zai daidaita sashi don cimma burin saukar jini. Allunan suna bada shawarar a dauki su da ruwa ko da menene abinci.

Harshen Telmista H80

Ana shan maganin a baki 1 lokaci / rana, ba tare da la'akari da cin abinci ba. Allunan ya kamata a wanke su da karamin adadin ruwa.

Ana iya ba da magani na Telmista H80 ga marasa lafiya waɗanda amfani da telmisartan a cikin kashi na 80 MG ba ya haifar da ingantaccen iko da karfin hawan jini.

Karanta wannan labarin: Lasix: allunan 40 MG da allura

Kafin fara magani, yakamata a yi wani zaɓi na kashi akan telmisartan monotherapy. Idan ya cancanta, zaku iya canzawa kai tsaye daga telmisartan monotherapy zuwa magani tare da Telmista H80.

Idan ya cancanta, za a iya ba da maganin tare da wani magani na antihypertensive.

Side effects

Amfani da Telmista, kamar sauran magungunan antihypertensive, na iya haifar da sakamako mara kyau ga jiki.

Daga cikin sakamako masu illa, umarnin don amfani da bambanci masu zuwa:

• keta kodan da tsarin urinary,
• mura tare da zazzabi da zazzabin cizon sauro,
• tari, ciwon raunuka daga cikin manya da ƙananan hanji, gajeruwar numfashi,
• rashin tsaro na kayan gani,
• cututtukan zuciya, wanda tachycardia da bradycardia suka bayyana,
• rikicewar ciki da hanji, wanda ke bayyana ta zawo, tashin zuciya, uncharacteristic pain syndromes da cramps,
• suma, damuwa bacci, shuru,
• hypersensitivity to daban-daban tasirin waje, wanda bayyana kanta a cikin hanyar fata itching da urticaria, anaphylactic tura da hyperhidrosis,
• matsalar rashin jini da barazanar tozarewa,
• mara kyau sakamakon binciken dakin gwaje-gwajen kwayoyin halitta na marasa lafiya, waɗanda aka bayyana a babban taro na uric acid, creatinine a cikin jini, hypoglycemia da hauhawar raguwar haemoglobin.

Kowane ɗayan waɗannan sakamako masu illa na iya faruwa ko dai kaɗai ko a hade tare da wasu. Don alamun bayyanar, ana buƙatar kulawa ta gaggawa don gyara tsarin kulawa.

Yara, yayin ciki da lactation

Ba a kafa aminci da tasiri na amfani da telmisartan a cikin ilimin yara ba, saboda haka, bai kamata a tsara allunan Telmista 40 MG, 80 MG da 20 MG ga yara da matasa masu shekaru 18 da haihuwa ba.

Dangane da umarnin, Telmista yana contraindicated yayin daukar ciki. Game da bayyanar cutar ciki, ya kamata a dakatar da maganin nan da nan.

Tunda babu wani bayani game da shigar shigar da tabin telmisartan cikin nono, an sanya maganin a yayin shayarwa.

Analogs na maganin Telmist

Tsarin yana tantance analogues:

1. Telmisartan
2. Harshawarwar H,
3. Telsartan
4. Tanidol
5. Karin
6. Yana da
7. Mikardis Da,
8. Firimiya
9. Labarun
10. Bayanin Karin
11. Mikardis.

Angiotensin 2 masu adawa da karba sun hada da analogues:

1. Gizaar
2. Karzartan
3. 'Yanfofi,
4. Sartavel
5. Telsartan
6. Kayani
7. Zisakar
8. Lozarel
9. Irbesartan
10. Vasotens,
11. Co-Exforge,
12. Naviten
13. Firimiya
14. Losartan
15. Cardosten
16. Tareg
17. Bugawa
18. Lorista
19. Atacand
20. Losartan n
21. Olimestra
22. Afuwan,
23. Irsar
24. Edarby
25. Lozap,
26. Umurni
27. Cozaar
28. Mikardis,
29. Valz
30. Xarten
31. Vamloset
32. Losacor
33. Lozap Plus,
34. Cardomin
35. Telmisartan
36. Tanidol
37. Hyposart,
38. Candecor
39. Maimaitawa
40. Labarun
41. Diovan
42. Duopress,
43. Eprosartan Mesylate,
44. Valsacor
45. Valsartan
46. Exforge
47. Artinova,
48. Ibertan
49. Firmast
50. Bayanai,
51. Cardos,
52. Aprovel
53. Presartan,
54. Tweensta
55. Teveten
56. Brozaar
57. Coaprovel
58. Nortian
59. Cardosal.