Mita 80 Mita - umarnin don amfani

Telmista 80 MG - wani ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta, takamaiman mai adawa da masu karɓar angiotensin II (nau'in AT1).

1 kwamfutar hannu 1 MG:

Abubuwan da ke aiki: Telmisartan 80.00 MG

Mahalarta: meglumine, sodium hydroxide, povidone-KZO, lactose monohydrate, sorbitol (E420), magnesium stearate.

Allunan 80 MG: Kwalayen-mai-launi, allunan biconvex farin ko kusan farin launi.

Pharmacodynamics

Telmisartan takamaiman mai karɓa ne na angiotensin II mai karɓar rayayyiya (ARA II) (nau'in AT1), mai tasiri idan aka sha shi da baki. Yana da babban kusanci ga masu karɓar AT1 na masu karɓar angiotensin II, ta hanyar abin da aikin angiotensin II ya tabbata. Bayyanar da angiotensin II daga haɗin tare da mai karɓa, ba mallakan aikin agonist dangane da wannan mai karɓa ba. Telmisartan ya ɗaure kawai zuwa nau'in AT1 na nau'in masu karɓar angiotensin II. Haɗin yana ci gaba. Ba shi da alaƙa ga sauran masu karɓar, ciki har da masu karɓar AT2 da sauran masu karɓar angiotensin marasa ƙarancin karatu. Babban mahimmancin mahimmancin waɗannan masu karɓar, har ma da tasirin tasirin tasirinsu mai yawa tare da angiotensin II, wanda yake ƙaruwa wanda yake ƙaruwa da amfani da telmisartan, ba a yi nazari ba. Yana rage maida hankali na aldosterone a cikin jini na plasma, baya hana renin cikin jini jini da tashoshi na ion n ion. Telmisartan baya hana angiotensin mai canza enzyme (ACE) (kininase II) (enzyme wanda shima ya rushe bradykinin). Saboda haka, haɓaka sakamako masu illa da aka haifar da bradykinin ba a tsammanin.

A cikin marasa lafiya, telmisartan a kashi na 80 MG gaba daya yana toshe sakamakon tasirin hauhawar jini na angiotensin II. An lura da fara aikin rigakafi a cikin sa'o'i 3 bayan aiwatarwa na farko na telmisartan. Tasirin magungunan ya ci gaba na tsawon awanni 24 kuma ya kasance har zuwa sa'o'i 48. Pronounwaƙwalwar ƙwayar cuta mai narkewa koyaushe yana tasowa bayan makonni 4-8 na gudanarwa na yau da kullum na telmisartan.

A cikin marasa lafiya tare da hauhawar jini na jijiya, telmisartan lowers systolic da diastolic pressure (BP) ba tare da shafi yawan zuciya ba (HR).

Game da sakewa na telmisartan ba zato ba tsammani, hawan jini sannu a hankali ya dawo zuwa matakinsa na asali ba tare da ci gaba da cututtukan "cirewa" ba.

Pharmacokinetics

Lokacin da aka sha shi a baki, yana shan saurin narkewa daga cikin gastrointestinal fili (GIT). Bioavailability shine 50%. Raguwar a cikin AUC (yanki a ƙarƙashin lokutan taro-lokaci) tare da yin amfani da telmisartan a lokaci guda tare da abincin abinci yana daga 6% (a kashi 40 mg) zuwa 19% (a kashi na 160 mg). 3 hours bayan shigowa, maida hankali a cikin jini yana gudana, ba tare da la'akari da lokacin cin abinci ba. Akwai bambanci a cikin yawan ƙwayar plasma a cikin maza da mata. Matsakaicin mafi girman hankali (Cmax) a cikin jini na jini da AUC a cikin mata idan aka kwatanta da maza sun kasance kusan 3 da 2 sau mafi girma, bi da bi (ba tare da tasiri mai tasiri ba).

Sadarwa tare da sunadaran plasma jini - 99.5%, akasarinsu tare da albumin da glycoprotein alpha-1.

Matsakaicin darajar bayyana girman rarraba a cikin ma'aunin daidaitawa shine lita 500. Yana da metabolized ta conjugation tare da glucuronic acid. Metabolites ba su da magunguna. Rabin-rabi (T1 / 2) ya fi awoyi 20. An cire shi ta hanyar hanjin a cikin wani tsari mara canzawa da kuma ta kodan - kasa da 2% na yawan da aka karɓa. Jimlar aikin zubar jini yana da yawa (900 ml / min), amma idan aka kwatanta da zubar jini na "hepatic" (kimanin 1500 ml / min).

Contraindications

Contraindications a cikin yin amfani da Telmista miyagun ƙwayoyi:

Hypersensitivity ga abu mai aiki ko tsoffin ƙwayoyi.
Ciki
Lokacin shayarwa.
Cututtuka masu illa na biliary fili.
Mai tsananin rashin lafiyar hepatic (Yara-Pugh class C).
Amfani mai gamsarwa tare da aliskiren a cikin marasa lafiya da masu ciwon sukari mellitus ko matsakaici zuwa ga ƙarancin ƙyallen ƙimar ƙasa (ƙimar ƙirar ƙasa (GFR)

Side effects

Abubuwan da aka lura da sakamako na sakamako masu illa basu yi daidai da jinsi ba, shekaru ko tseren marasa lafiya ba.

Cututttuka da cututtukan fata: sepsis, gami da kamuwa da cuta mai narkewa, cututtukan urinary fili (gami da cystitis), cututtukan ƙwayar cuta na sama.
Rashin hankali daga jini da tsarin lymphatic: anaemia, eosinophilia, thrombocytopenia.
Rashin hankali daga tsarin rigakafi: halayen anaphylactic, hypersensitivity (erythema, urticaria, angioedema), eczema, itching, fatar fata (gami da miyagun ƙwayoyi), angioedema (tare da sakamako mai ƙisa), hyperhidrosis, fatar fata mai guba.
Rashin lalacewar tsarin juyayi: damuwa, rashin bacci, rashin kwanciyar hankali, fainting, vertigo.
Rashin lafiyar sashin hangen nesa: hargitsi na gani.
Take hakkin zuciya: bradycardia, tachycardia.
Take hakkin tasoshin jini: raguwar alama cikin hauhawar jini, tashin hankali na orthostatic.
Rashin daidaituwa na tsarin numfashi, gabobin kirji da matsakaici: karancin numfashi, tari, cutar huhun ciki * (* a cikin lokacin cinikin bayan amfani, an bayyana yanayin cututtukan huhun ciki, tare da haɗin wucin gadi da telmisartan.Haka dai,, babu wata alaƙa ta rashin amfani da amfani da telmisartan an shigar da shi).
Rashin narkewa: zafin ciki, zawo, bushewar bakin mucosa, dyspepsia, flatulence, rashin jin daɗin ciki, amai, yawan dandano (dysgeusia), lalacewar aikin hanta / cutar hanta * (* bisa ga sakamakon lura bayan tallace-tallace a cikin mafi yawan An gano abubuwan da ke tattare da aikin hanta / cutar hanta a cikin mazaunan Japan).
Rashin hankali daga musculoskeletal da nama mai haɗuwa: arthralgia, ciwon baya, raunin ƙwayar tsoka (ƙwanƙwasa tsokoki maraƙi), jin zafi a ƙarshen ƙarshen, myalgia, raunin jijiya (alamu mai kama da bayyanar tendonitis).
Rashin damuwa daga kodan da hanjin kumburin hanji: lalacewar aikin na koda, gami da gazawar cutar koda.
Babban rikicewa da rikice-rikice a wurin allurar: zafin kirji, ciwo mai kama da mura, rauni gaba ɗaya.
Bayanan dakin gwaje-gwaje da kayan aiki: raguwa a cikin haemoglobin, karuwa a cikin taro na uric acid, creatinine a cikin jini na jini, karuwa a cikin ayyukan "hanta" enzymes, creatine phosphokinase (CPK) a cikin jini na jini, hyperkalemia, hypoglycemia (a cikin marasa lafiya tare da ciwon sukari mellitus).

Yin hulɗa tare da wasu kwayoyi

Telmisartan na iya kara tasirin antihypertensive na sauran magungunan antihypertensive. Sauran nau'ikan hulɗa da mahimmancin asibiti ba a gano su ba.

Amfani da ciki tare da digoxin, warfarin, hydrochlorothiazide, glibenclamide, ibuprofen, paracetamol, simvastatin da amlodipine baya haifar da ma'amala mai mahimmanci a asibiti. Markedara yawan adadin digoxin a cikin plasma na jini da kimanin kashi 20% (a kashi ɗaya, cikin kashi 39%). Ta amfani da telmisartan da digoxin na lokaci guda, yana da kyau a tantance taro na lokaci-lokaci a cikin jini.

Kamar sauran magunguna waɗanda ke aiki akan tsarin renin-angiotensin-aldosterone (RAAS), yin amfani da telmisartan na iya haifar da hyperkalemia (duba sashe "Umarni na Musamman"). Hadarin na iya ƙaruwa idan aka yi amfani da su a lokaci ɗaya tare da sauran kwayoyi, wanda kuma zai iya tayar da haɓakar hyperkalemia (maye gurbin mai cike da potassium, dattin-potassium, masu hana ACE, ARA II, magungunan anti-mai kumburi steroidal NSAIDs, gami da cyclooxygenase-2 inhibitors | COX-2 | immunosuppressants cyclosporine ko tacrolimus da trimethoprim.

Haɓaka hyperkalemia ya dogara da abubuwan haɗari masu haɗari. Hakanan ana kara haɓarin haɗarin haɗuwa ta haɗuwa ta haɗuwa ta sama. Musamman ma, hadarin yana da girma musamman idan aka yi amfani dashi lokaci guda tare da daskararren-potassium, tare da masu maye gurbin gishiri. Misali, amfani da kwanciyar hankali tare da masu hana ACE ko NSAIDs ba karamar haɗari bane idan an dauki tsauraran matakan kariya. ARA II, kamar telmisartan, rage asarar potassium a lokacin diuretic far. Amfani da sinadarin da ke amfani da daskararren potassium, alal misali, spironolactone, eplerenone, triamteren ko amiloride, abubuwan da ke dauke da sinadarin potassium ko madadin abubuwan da ke dauke da gishiri na iya haifar da karuwa mai yawa a cikin sinadarin potassium. Ya kamata a yi amfani da amfani da hypokalemia na lokaci guda ayi amfani da shi tare da taka tsantsan tare da saka idanu na yau da kullum a cikin potassium a cikin jini. Ta amfani da telmisartan da ramipril lokaci guda, an ƙara ƙaruwa sau biyu a cikin AUC0-24 da Cmax na ramipril da ramipril. Ba a kafa mahimmancin asibiti na wannan sabon abu ba. Tare da yin amfani da inhibitors na ACE da shirye-shiryen lithium a lokaci guda, an lura da karuwa mai sauƙin abin da ke cikin ƙwayar plasma, tare da illa mai guba. A cikin mafi yawan lokuta, irin waɗannan canje-canje an ruwaito su tare da shirye-shiryen ARA II da shirye-shiryen lithium. Tare da yin amfani da lithium da ARA II a lokaci guda, ana bada shawara don sanin abun ciki na lithium a cikin jini. Kulawa da NSAIDs, ciki har da acetylsalicylic acid, COX-2, da kuma NSAIDs marasa zaɓi, na iya haifar da gazawar ƙirar koda a cikin marassa lafiyar marasa lafiya. Magunguna masu aiki akan RAAS na iya samun tasirin tasirin rubutu. A cikin marasa lafiya da ke karɓar NSAIDs da telmisartan, bcc dole ne a rama su a farkon jiyya da kuma kula da aikin renal. Amfani mai gamsarwa tare da aliskiren a cikin marasa lafiya da masu ciwon sukari mellitus ko matsakaici zuwa ga rashin cin nasara na koda