U ka sebelisa Telmista 40 joang?

Mokhoa oa litekanyetso tsa Telmists - matlapa: hoo e ka bang bosoeu kapa bosoeu, ka tekanyetso ea 20 mg - ho pota, 40 mg - biconvex, oval, 80 mg - biconvex, capule-e emisitsoeng (ka blouse ea lisebelisoa tse kopaneng tsa 7, li-lebokoseng la 2, 4, 8 , Malepa a 12 kapa a 14, ka blister li-pcs tse 10., Lebokoseng la 3, 6 kapa 9 maleiri.

Sebopeho sa letlapa le le leng:

ntho e sebetsang: telmisartan - 20, 40 kapa 80 mg,
excipients: sodium hydroxide, lactose monohydrate, magnesium stearate, meglumine, povidone K30, sorbitol (E420).

Mofumahali

Telmisartan, ntho e sebetsang ea Telmista, e na le thepa ea ho thibela thepa, hobane ke mohanyetsi oa angiotensin II receptor antagonist (AT blocker₁li-receptors). Ho lahla angiotensin II ho hokahana le li-receptor, ha e na ketso ea agonist mabapi le receptor ena. Telmisartan ka khetho le ka nako e telele e ka tlama feela ho angiotensin II receptor subtype AT₁. Ha e na kamano ea li-receptor tse ling tsa angiotensin, bohlokoa ba ts'ebetso ba ona le sephetho sa tse feteletseng (ka lebaka la tšebeliso ea telmisartan) tšusumetso ea angiotensin II ho tsona ha e e-so ithutoe.

Telmisartan e fokotsa bongata ba aldosterone ho plasma ea mali, ha e ame khatello ea motsoako oa renin hape ha e thibele liteishene tsa ion. Ntho e sebetsang ha e thibelle ACE (angiotensin-e fetolang enzyme), e senyang le bradykinin, ka hona ha ho ameha lehlakore le leng le bakoang ke bradykinin.

Telmisartan, e nkiloeng ka tekanyetso ea 80 mg, e thibela ka botlalo phello ea khatello ea mali ea angiotensin II. Kamora tekanyetso ea pele ea moriana bakeng sa lihora tse 3, ho qala ha phello ea hypotensive ho tsejoa, phello e phehella letsatsi mme e lula e le bohlokoa ho fihlela matsatsi a mabeli. Phello e tsitsitseng ea hypotensive hangata e hlaha kamora libeke tse 4 ho isa ho tse 4 ho tloha qalong ea kalafo ka tsamaiso e tloaelehileng ea telmisartan.

Ka khatello ea mali ea methapo, lithethefatsi li thusa ho fokotsa khatello ea mali ea systolic le diastolic (BP). Telmisartan ha e na phello ho sekhahla sa pelo (sekhahla sa pelo).

Bakeng sa bakuli ba felisitsoeng ka tšohanyetso ea telmisartan, khatello ea mali butle-butle e khutlela boleng ba eona ba pele, syndrome ea ho ntša mpa ha e bonoe.

Mofumahali

ho monya: ha e kenelletsoa, e kenella ka potlako mokhorong oa mpa. Bioavailability ke 50%. Ha ho nkuoa ka lijo, ho fokotseha ha AUC (sebaka se ka tlasa mokokotlo oa pharmacokinetic) ho tloha ho 6% ho isa ho 19% ka tekanyo ea 40 le 160 mg, ka ho latellana. Lihora tse 3 kamora ho nka telmisartan, khatello ea eona maemong a plasma ea mali e tsoa (ha e ea itšetleha ka nako ea ho ja). AUC le boholo ba plasma ea ntho ena (C_max) ho basali ho na le makhetlo a ka bang 2 ho isa ho a 3, ka tatellano, ho feta ho banna. Ha ho na phello e kholo ea katleho,
phetisetso le metabolism: 99,5% ea ntho e tlama liprotheine tsa plasma (haholo-holo alpha-1 glycoprotein le albin). Bophahamo bo bonahalang ba karolelano ea mahlakore a lekanang a karolelano ea 500 l. Metabolism e etsahala ka ho kopanya ka glucuronic acid le ho etsoa ha li-metabolites tse sa sebetseng tsa kemaro,
excretion: T_1/2 (felisoa halofo ea bophelo) - lihora tse fetang 20. Ntho ena ha e sa fetoloe ka mala, ka moroto - tlase ho 2%. Hlakollo e felletseng ea plasma e phahame haholo ha e bapisoa le phallo ea mali a hepatic (hoo e ka bang 1500 ml / min) mme e ka ba 900 ml / min.

Litekanyetso tse ka sehloohong tsa pharmacokinetic tsa telmisartan ha li sebelisoa ho bana le lilemong tsa bocha ho tloha ho tse 6 ho isa ho 18 bakeng sa libeke tse 4 ka tekanyo ea 1 kapa 2 mg / kg ka kakaretso li tšoantšoa le ho bakuli ba baholo mme li tiisa li-pharmacokinetics tse seng molaong tsa ntho e sebetsang, haholoholo mabapi le C_max.

Contraindication

mefuta e matla ea ho hlobaela ha sebete (ho latela sehlopha sa bana - Pugh - sehlopha sa C),
bile duct obstruction,
Sebelisa hammoho le aliskiren ho bakuli ba nang le bothata bo matla ba ho hlaphoheloa ha renal kapa "bo lekaneng" (glomerular filtration rate le ka tlase ho 60 ml / min / 1,73 m 2) kapa le lefu la tsoekere.
lactase / sucrose / isomaltase haello ea mali, ho se mamellane ha fructose, tsoekere e mpe ea glucose-galactose,
nako ea kemolo le ea pelehi,
lilemo tse 18
hypersensitivity ea motho ka mong ho telmisartan kapa eng kapa eng ea likarolo tse thusang tsa lithethefatsi.

Setsoalle (maloetse / maemo ao ho ona ts'ebeliso ea Telmista e hlokang tlhokomeliso):

ts'ebeliso e mpe ea renal le / kapa ea sebete,
bilteryal renal stenosis kapa artery stenosis ea a le mong,
maemo kamora ho fetisoa ha menoana (ka lebaka la ho hloka ts'ebeliso ea ts'ebeliso),
hyperkalemia
hyponatremia,
pelo e sa foleng
fokotsa lenane la mitral le / kapa aortic,
GOKMP (hypertrophic obstriers cardiomyopathy),
fokotseha ha bcc (bongata ba mali a potoloha) ka lebaka la kalafo e fetileng e nang le diuretics, ho ja letsoai le fokolang, ho hlatsa kapa lets'ollo,
hyperaldosteronism ea mantlha (polokeho le katleho ha e thehiloe).

Litaelo tsa ts'ebeliso ea Telmista: mokhoa le litekanyetso

Matlapa a Telmist a nkuoa ka molomo, ho sa tsotelehe nako ea lijo.

Ka khatello ea mali ea methapo, ho kgothaletswa ho qala ho nka ka 20 kapa 40 mg ea moriana o le mong ka letsatsi. Ho bakuli ba bang, hoa khoneha ho fihlella phello ea hypotensive ka tekanyo ea 20 mg / ka letsatsi. Tabeng ea kalafo e sa lekaneng, u ka eketsa lethal dose ho ea ho lethal dose e phahameng ea letsatsi le letsatsi ea 80 mg. Ka keketseho ea lethal dose, ho lokela ho tsotelloa hore phello e phahameng ea hypotensive ea Telmista hangata e fihlelleha ka mor'a libeke tse 4 - 8 ho tloha qalong ea kalafo.

Ho fokotsa khatello ea maikutlo le lefu la pelo, ho kgothaletswa ho nka 80 mg ea moriana o le mong ka letsatsi.

Boemong ba pele ba kalafo, ho ka hlokahala mekhoa e meng ea ho eketsa khatello ea mali.

Ha ho hlokahale ho fetola mofuta oa kalafo bakeng sa bakuli ba nang le bothata ba ho phekoloa ke methapo, ho kenyeletsa le ba nang le hemodialysis.

Bakeng sa ts'ebetso ea sebete e senyehileng ea ho teba kapa ho leka-lekana ho latela (ho latela sehlopha sa bana-Pugh - Sehlopha sa A le B), lethal dose le phahameng la letsatsi le letsatsi la Telmista ke 40 mg.

Ho bakuli ba tsofetseng, pharmacokinetics ea telmisartan ha e fetohe, ka hona ha ho na lebaka la ho fetola tekanyetso ea lithethefatsi bakeng sa bona.

Litlamorao

Ha o sebelisa Telmists, likarabelo tse latelang tse mpe tsa tsamaiso le litho li ka etsahala:

pelo: tachycardia, bradycardia,
methapo ea mali: hypotension ea orthostatic, phokotseho e kholo ea khatello ea mali,
tsamaiso ea tšilo ea lijo: lets'ollo, bohloko ba ka mpeng, ho hlohlona, ho nyekeloa ke mpa, ho ruruha, ho hlatsa, dysgeusia (ho kheloha ha tatso), mucous membrane ea mucous ea molomo, ts'ebetso ea lesapo la mokokotlo / lefu la sebete,
mali le tsamaiso ea methapo ea kutlo: thrombocytopenia, eosinophilia, anemia, sepsis (ho kenyeletsa le sepsis e bolaeang),
tsamaiso ea methapo: ho hloka boroko, ho tšoenyeha, khatello ea maikutlo, vertigo, ho akheha,
Boits'ireletso ba mmele: hypersensitivity (urticaria, erythema, angioedema), maikutlo a anaphylactic, pruritus, eczema, lekhopho la letlalo (ho kenyeletsa le lithethefatsi), hyperhidrosis, angioedema (ho fihlela lefung), lekhopho la letlalo le nang le chefo,
sebono sa pono: likhathatso tsa pono,
tsamaiso ea phefumoloho, sefuba le methapo ea methapo ea methapo: ho khohlela, ho hema hanyane, tšoaetso ea phepelo ea phepelo ea mafu a kaholimo, mafu a tšoaetso ea matšoafo (kamano ea ts'ebetso ea ts'ebeliso ea telmisartan ha e so theoe),
mesifa ea mokokotlo le e amehang: bohloko ba morao, arthralgia, mesifa ea mesifa (mesifa ea mesifa ea namane), myalgia, bohloko ba leoto, bohloko methapong (matšoao a tšoanang le lipontšo tsa ho ruruha le ho senyeha ha lithane tsa tendon),
liphio le pampitšana ea ho ntša urine: ts'ebetso ea ho tšoaroa ke masapo e sa senyeheng (ho kenyeletsa le ho hloleha ho hlobaetsang ha renal), ts'oaetso ea ts'ebetso ea moroto (ho kenyeletsa cystitis)
'mele ka kakaretso: Bofokoli bo akaretsang, lefu le kang la ntaramane, bohloko ba sefuba,
lithuto tse sebetsang tsa maiketsetso le tsa laboratori: keketseho ea litaba tsa uric acid, creatinine maling a mali, ho fokotseha hoa hemoglobin, keketseho ea tšebetso ea liprotheine tsa hepatic, CPK (creatine phosphokinase) ka har'a plasma ea mali, hypoglycemia (ho bakuli ba nang le lefu la tsoekere mellitus), hyperkalemia.

Kamano ea tekanyo ea lipontšo tsa litlamorao le lilemo, bong kapa morabe oa bakuli ha e so theoe.

Litaelo tse khethehileng

Ts'ebeliso e tšoanang ea Telmista le ACE inhibitors kapa inhibitor e tobileng ea renin, aliskiren, ka lebaka la ketso e habeli ho RAAS (renin-angiotensin-aldosterone system) e mpefatsa ts'ebetso ea liphio (ho kenyeletsoa le ho ka baka ho se sebetse hantle ha renal), hape e eketsa kotsi ea hypotension le hyperkalemia . Haeba kalafo e kopaneng joalo e hlile e hlokahala, e lokela ho etsoa ka tlhahlobo e haufi ea bongaka, hammoho le ho hlahloba ts'ebetso ea liphio kamehla, khatello ea mali le maemo a electrolyte maling a mali.

Ho bakuli ba nang le lefu la tsoekere le nephropathy, telmisartan le ACE inhibitors ha ba khothaletsoe.

Maemong moo molumo oa methapo ea kutlo le ts'ebetso ea ho hlaba li itšetlehang haholo ka tšebetso ea RAAS (mohlala, ho bakuli ba nang le lefu la liphio, ho kenyelletsa le methapo ea methapo ea methapo kapa stenosis ea methapo e le 'ngoe ea methapo, kapa lefu le sa foleng la pelo), ts'ebeliso ea lithethefatsi tse amang RAAS e ka lebisa ho ntlafatso ea hyperazotemia, a hlobaetsang le maikutlong a amanang le mathata a phahameng haholo, oliguria le ho hloleha ho matla ha renal (maemong a sa tloaelehang).

Ha o sebedisa diuretics tsa potasiamo tse bolokang potasiamo, tse nang le matsoai a nang le potasiamo, litlatsetso le lithethefatsi tse ling tse eketsang khatello ea potasiamo ka plasma ea mali hammoho le Telmista, ho hlokahala hore o laole boemo ba potasiamo maling.

Kaha telmisartan e pepesitsoe haholo ka bile, ka mafu a thibelang a ts'ebetso ea biliary kapa ts'ebetso ea sebete e fokolisang, ho fokotseha hoa hlakileng ha lithethefatsi ho ka etsahala.

Ka lefu la tsoekere le kotsi e eketsehileng ea pelo, mohlala, lefu la pelo (lefu la pelo), ts'ebeliso ea Telmista e ka baka infarction e mpe ea lefu la pelo le lefu la pelo ka tšohanyetso. Ho bakuli ba nang le lefu la tsoekere mellitus, lefu la pelo le coronary le ka 'na la se ke la fumanoa, hobane matšoao a bona ketsahalong ena ha a hlahe hangata. Ka hona, pele u qala kalafo ea lithethefatsi, ho bohlokoa ho etsa tlhahlobo e nepahetseng ea tlhahlobo, ho kenyeletsoa le liteko tse nang le boikoetliso ba 'mele.

Ho bakuli ba nang le lefu la tsoekere ba fumanang kalafo ka meriana ea insulin kapa ea molomo, hypoglycemia e ka hlaha nakong ea kalafo le Telmista. Bakuli ba joalo ba hloka ho laola ho kenella ha glucose maling, hobane ho latela pontšo ena, litekanyetso tsa li-insulin kapa lithethefatsi tsa hypoglycemic li tlameha ho fetoloa.

Ho hyperaldosteronism ea mantlha, tšebeliso ea lithethefatsi tse thibelang antihypertensive - RAAS inhibitors - hangata ha e sebetse. Bakuli ba joalo ha ba khothalletsoe ho nka Telmista.

Ts'ebeliso ea lithethefatsi e khonahala hammoho le thiazide diuretics, hobane motsoako o joalo o fana ka phokotso e eketsehileng ea khatello ea mali.

Boithuto bo bontšitse hore Telmista ha e sebetse hantle ho bakuli ba mofuta oa Negroid. Ho se sebetse hantle ha sebete ka tšebeliso ea telmisartan ho ile ha bonoa hangata ho baahi ba Japane.

Bokhachane le pelehi

Ho latela litaelo, Telmista e tšoaetsoa nakong ea boimana. Maemong a tlhahlobo ea bokhachane, moriana o lokela ho emisoa hanghang. Haeba ho hlokahala, lithethefatsi tsa antihypertensive tsa litlelase tse ling tse amoheloang bakeng sa tšebeliso nakong ea kemolo li lokela ho beoa. Basali ba rerileng ho ima ba boetse ba eletsoa ho sebelisa mefuta e meng ea kalafo.

Lithutong tsa pele tsa lithethefatsi, litlamorao tsa teratogenic ha lia ka tsa fumanoa. Empa ho ile ha fumaneha hore tšebeliso ea lingiotensin II receptor antagonists ho ea bobeli le ea boraro ea li-trimesters tsa boimana li baka fetotoxicity (oligohydramnios, e fokotsehile ts'ebetso ea renal, ea liehisa ossization ea masapo a lesapo la fetal) le neonatal toxicity (arterial hypotension, renalhluleka, hyperkalemia).

Masea a sa tsoa tsoaloa ao bo-'m'ae ba ileng ba nka Telmista nakong ea kemolo a hloka ho hlahlojoa ke ngaka ka lebaka la kholo ea kholo ea methapo.

Kaha ha ho na tlhahisoleseling mabapi le ho kenella ha telmisartan ho lebese la matsoele, moriana o kopantsoe nakong ea kanyeso.

Ka ho se sebetse hantle ha sebete

Ha ho kgothaletswe ho nka moriana ona ho bakuli ba nang le ts'ebetso e matla ea sebete "(ho latela sehlopha sa bana-Pugh - sehlopha sa C).

Ka bonolo ba ho haelloa ke hepatic ka mokhoa o itekanetseng (ho latela sehlopha sa bana-Pugh - Class A le B), ts'ebeliso ea Telmista e hloka tlhokomeliso. Tekanyo e phahameng ea letsatsi le letsatsi ea moriana ena e lokela ho feta 40 mg.

Ho sebelisana le lithethefatsi

Ts'ebeliso ea telmisartan ka nako e ts'oanang le lithethefatsi tse ling e ka lebisa nts'etsopele ea litlamorao tse latelang:

antihypertensive lithethefatsi: eketseha antihypertensive phello,
warfarin, digoxin, ibuprofen, glibenclamide, hydrochlorothiazide, paracetamol, amlodipine le simvastatin: ha ho ts'ebelisano e bohlokoa ea kliniki e ileng ea bonoa. Maemong a mang, keketseho ea litaba tsa plasma digoxin ka karolelano ea 20% e ka khonahala. Ha e kopantsoe le digoxin, ho kgothaletsoa ho lekola nako le nako ho ts'oaroa ha eona ea plasma,
potrateum-sparing diuretics (mohlala, spironolactone, amiloride, triamteren, eplerenone), potasiamo e le ling, li-ACE inhibitors, lingiotensin II receptor antagonists, NSAIDs (li-non-steroidal anti-inflammatory antiponist), ho kenyelletsa le cycloo oxygenase-hemporinphopini-2mpopini-hemporin 2phopini-hemporin 2phopini-hemporin 2opampini-hemporin 2phampini-hemporini le trimethoprim: Kotsi e eketsehileng ea hyperkalemia (ka lebaka la phello ea synergistic),
ramipril: keketseho ea makhetlo a 2,5 ea matšoao a C_max le AUC_0-24 ramipril le ramiprilat,
Litokisetso tsa lithium: keketseho e feto-fetohang ea khatello ea lithium ho plasma ea mali (ho tlalehiloe maemong a sa tloaelehang) ka phello e tsamaeang le chefo. Ho khothalletsoa hore nako le nako u hlahlobe maemo a plasma a lithium,
Li-NSAIDs (ho kenyelletsa acetylsalicylic acid, li-NSAIDs tse sa khethang le li-inhibitors tsa cycloo oxygenase-2): fokotseha matla a ho baka ha telmisartan, eketsa kotsi ea ho hloleha ha reef haholo ka nako ea metsi. Qalong ea phekolo e kopaneng le telmisartan le NSAIDs, hoa hlokahala ho lefa chelete ea bcc le ho hlahloba ts'ebetso ea liphio,
amifostine, baclofen: tšusumetso ea phello e matla ea telmisartan,
barbiturates, joala, lithibela-mafu le lithethefatsi: ho eketsoa ha hypthension ea orthostatic.

Litaba tse amanang le Telmista ke: Mikardis, Teseo, Telmisartan-Richter, Telmisartan-SZ, Telpres, Telsartan le ba bang.

Foromo ea litekanyetso

Letlapa le leng le na le

Telmista®H40

Lintho tse sebetsang: Telmisartan 40mg

hydrochlorothiazide 12,5 mg

Baeti: meglumine, sodium hydroxide, povidone K30, lactose monohydrate, sorbitol, magnesium stearate, mannitol, red oxide red (E172), hydroxypropyl cellulose, anhydrous colloidal silicon diode, sodium stearyl fumarate

Telmista®H80

Lintho tse sebetsang: Telmisartan 80mg

hydrochlorothiazide 12,5 mg

Telmista®ND 80

Lintho tse sebetsang: telmisartan 80 mg

hydrochlorothiazide 25 mg

Baeti: meglumine, sodium hydroxide, povidone K30, lactose monohydrate, sorbitol, magnesium stearate, mannitol, iron oxide yellow (E172) hydroxypropyl cellulose, anhydrous colloidal silicon diode, sodium stearyl fumarate

Matlapa a Oval, biconvex, bilayer, ho tloha ho tšoeu ho isa ho o mosoeu kapa o mopinki o mosoeu ka 'mala o mong le pinki-'mele ka lehlakoreng le fapaneng (bakeng sa litekanyetso tsa 40 mg / 12.5 mg le 80 mg / 12.5 mg).

Matlapa ke oval, biconvex, mekhahlelo e 'meli, ho tloha ho o mosoeu ho isa ho o mosoeu ka lehlakoreng le leng le' mala oa mosehla lehlakoreng le leng (bakeng sa litekanyetso tsa 80 mg / 25 mg).

Melemo ea pharmacological

Mofumahali

Pherekano e phahameng ea telmisartan e nang le tsamaiso ea molomo e fihlelleha ka mor'a lihora tse 0.5-1,5 ka mor'a taolo. The bioavailability e phethahetseng ea telmisartan ka tekanyetso ea 40 mg le 160 mg e ne e le 42% le 58%, ka ho latellana. Ho ja lijo ka nako e le 'ngoe ha ho fokotse haholo bioavailability ea telmisartan, ho fokotsa sebaka se tlas'a khatello e phahameng ea lithethefatsi maling a mali (AUC) ka 6% ha u nka 40 mg mme ka 19% ka mor'a ho nka 160 mg. Ho fokotseha hanyane ha mahlaseli a phahameng a tlhase ha ho ame katleho ea bongaka ea meriana. Li-pharmacokinetics tsa telmisartan ha li fanoa ka molomo ka tekanyetso ea 20-160 mg ha li na palo, Cmax le AUC ka tekanyo e itseng li eketseha ka tekanyo e ntseng e eketseha. Ha e sebelisoa khafetsa, telmisartan e bokellana hanyane plasma ea mali.

Telmisartan e kopana hantle le liprotheine tsa plasma (> 99.5%), haholo-holo tsa albin le alpha L-acid glycoprotein. Bophahamo bo bonahalang ba karolelano ea telmisartan ke hoo e ka bang 500 L, e bonts'ang lithane tse ling tse tlamang.

Ho feta 97% ea lithethefatsi ha li fanoa ka molomo li qheleloa ka mantle ke biliary excretion. Matšoao a fumanoa moroto. Telmisartan e tšelisoa ke conjugation ho li-metabolites tse sa sebetseng tsa meriana - li-glucuronides tsa acetyl. Li-glucuronides ke tsona feela metabolite ea lintho tse qalang tse fumanoeng bathong.

Kamora tekanyetso e le 'ngoe ea telmisartan, litaba tsa glucuronides tse plasma ea mali li ne li ka ba 11%. Telmisartan ha e tšeloe ke isoenzymes ea sistimi ea cytochrome P450. Sekhahla se tsoang ho plasma ea mali se feta 1500 ml / min. Bophelo ba halofo ea bophelo bo fetang lihora tse 20

Ka tsamaiso ea molomo ea motsoako o tsitsitseng oa telmisartan / hydrochlorothiazide, tlhoriso e phahameng ea hydrochlorothiazide e fihlella ka lihora tse 1,3-3.0 kamora ho busa. Ha ho nahanoa hore hydrochlorothiazide e ka bokellana nakong ea ho hlaba masapo, bioavailability e felletseng ke 60%.

Hydrochlorothiazide e 68% e tlameletsoe ho liprotheine tsa plasma mme bosholu ba eona bo bonahalang ke 0,83-1.14 l / kg.

Hydrochlorothiazide ha e tšeloe 'mele' me e batla e sa fetoloe ka ho phethahala ka liphio ka moroto. Hoo e ka bang 60% ea tekanyetso ea molomo ha e fetoloe ka nako ea lihora tse 8

Bophelo ba halofo ea bophelo ba hydrochlorothiazide ke lihora tse 10-15.

Mofumahali

Motsoako o hlophisitsoeng oa telmisartan / hydrochlorothiazide ke motsoako oa angiotensin II receptor antagonist telmisartan le thiazide diuretic hydrochlorothiazide, e fanang ka boemo bo phahameng ba phello ea antihypertensive ho feta ho nka karolo ka 'ngoe. Ha o nka motsoako o tsitsitseng oa telmisartan / hydrochlorothiazide hang ka letsatsi, ho netefatsoa ho fokotseha hoa khatello ea mali ka mokhoa o phethahetseng le kahare ho kalafo ea kalafo.

Telmisartan e sebetsa hantle ha e nkuoa ka molomo mme e le mohanyetsi ea itseng (ea khethang) mohanyetsi oa angiotensin II receptor subtype 1 (AT1). Telmisartan e nka sebaka sa angiotensin II, kaha e na le tumellano e phahameng bakeng sa li-receptor tsa AT1 sebakeng se tlamang, tse ikarabellang bakeng sa litlamorao tse thehiloeng tsa angiotensin II. Telmisartan e khetha ebile e tsoela pele ho kopanya li-receptors tsa AT1, 'me ha e na kamano le li-receptor tse ling, ho kenyeletsoa AT2 le li-receptor tse ling tsa AT. Karolo e sebetsang ea li-receptor tsena ha e e-so thehoe, hammoho le litlamorao tsa eona ha ho ka etsahala hyperstimulation ea angiotensin II, eo boemo ba eona bo eketsehang ka tlasa tšusumetso ea telmisartan. Telmisartan e theola maemo a aldosterone ea plasma mme ha e thibele tšebetso ea angiotensin-e fetolang enzyme (kininase II), ka ho nka karolo ha eona ho na le ho fokotseha ha sebopeho sa bradykinin, ka hona, tšebeliso ea litlamorao tse mpe tsa bradykinin ha e etsahale.

Thibelo ea angiotensin II khahlanong le semelo sa telmisartan e nka lihora tse fetang 24 mme e nka lihora tse 48.

Kamora ho nka telmisartan, ts'ebetso ea antihypertensive e fihlella ka nako ea lihora tse 3. Phokotso e phahameng ea khatello ea mali hangata e fihlelletse libeke tse 4 ho8 kamora ho qala kalafo mme e tsoela pele nakong ea kalafo ea nako e telele. Matla a antihypertensive a ile a bolokoa maemong a sa khaotseng bakeng sa lihora tse 24.

Ho bakuli ba nang le khatello ea mali, telmisartan e fokotsa khatello ea mali ea systolic le diastolic ntle le ho ama lebelo la pelo.

Ka ho khaotsa ho phekoloa ka kalafo ka telmisartan, butle-butle khatello ea mali e khutlela boemong ba eona ba pele matsatsi a 'maloa ntle le ho ba le "rebound syndrome" (keketseho e matla ea khatello ea mali).

Li-Thiazides li ama ho ts'oaroa ha li-electrolyte ka har'a lipeo tsa liphio, ho eketsang ka kotloloho tlhahiso ea sodium le chloride ka bongata bo lekanang. Phello ea diuretic ea hydrochlorothiazide e lebisa ho fokotseha ha bongata ba plasma ea mali, keketseho ea plasma renin, keketseho ea secretion ea aldosterone, e tlatsetsang keketseho ea moriti oa tlhahiso ea potasiamo le bicarbonate, 'me ka hona, ho fokotseha ha boemo ba potasiamo ea serum. Thibelo ea renin-angiotensin ea sistimi ea aldosterone ka ts'ebeliso e kopaneng ea telmisartan e nang le diuretics e lebisa tahlelong e ka fetolang ea potasiamo ke 'mele. Ha o nka hydrochlorothiazide, diuresis e qala kamora lihora tse peli, phello e matla ea diuretic e fihlella lihora tse 4 kamora tsamaiso, ketso e nka lihora tse 6-12.

Matšoao a ho sebelisoa

- kalafo ea khatello ea methapo ea kutlo

Telmista®H40 le Telmista®H80 li bontšoa ho bakuli bao ho ke keng ha khoneha ho laola boemo ba khatello ea mali ka ho sebelisa telmisartan kapa hydrochlorothiazide ka mokhoa oa monotherapy.

Telmista® ND80 e bontšoa ho bakuli ba baholo bao ho leng thata ho bona ho laola boemo ba khatello ea mali ka ho sebelisa Telmista® N80 kapa eo khatello ea pele e neng e tsitsitse ka ho sebelisa telmisartan le hydrochlorothiazide ka thoko.

Tekanyetso le tsamaiso

Telmista®N40, Telmista®N80 kapa Telmista®ND80 e lokela ho sebelisoa hanngoe ka letsatsi, e hlatsuoe ka metsi a fokolang, ho sa tsotelehe lijo tseo motho a li jang.

Pele kalafo e kopantsoe le telmisartan / hydrochlorothiazide e lokela ho etsoa

khetho ea lethal monokotsoai oa monotherapy ka telmisartan. Haeba ho hlokahala, o ka fetoha hang-hang ho tloha monotherapy ho ea kalafo ka kopantsoe le litekanyetso tse tsitsitseng tsa moriana.

Telmista®H40 e ka fuoa bakuli bao khatello ea mali e sa laoloeng ka ho lekana ke telmisartan 40 mg.

Telmista® H80 e ka fuoa bakuli bao khatello ea mali e sa laoloeng ka ho lekana ke 80 mg telmisartan.

Telmista® ND80 e ka fuoa bakuli bao khatello ea mali e sa laoloeng ka ho lekana ke Telmista® N80 kapa eo khatello ea pele e neng e tsitsitse ka ho sebelisa telmisartan le hydrochlorothiazide ka thoko.

Kamora ho qala kalafo ka kopanelo ea telmisartan / hydrochlorothiazide, phello e phahameng ea antihypertensive e fihlelleha nakong ea libeke tse 4 ho isa ho tse8. Haeba ho hlokahala, Telmista®H40, Telmista®H80 kapa Telmista®ND80 e ka ngolloa hammoho le sethethefatsi se seng sa antihypertensive.

Bakuli ba nang le ho hloleha ha meno

Ho khothalletsoa ho lekola khafetsa ts'ebetso ea renal.

Bakuli ba nang le bothata ba sebete

Ho bakuli ba nang le ts'oaetso e fokolang ea hepatic e leka-lekaneng, lethal dose ha ea lokela ho feta Letlapa le le leng Telemista®N40 (telmisartan 40 / hydrochlorothiazide 12.5 mg) hang ka letsatsi.

Ha ho phetoho ea litekanyetso ho bakuli ba tsofetseng.

Ketso ea pharmacological

Letlapa la Telmista - sethethefatsi se sebetsang sa khatello, se na le theko e tlase.

Ketso ea eona e etselitsoe ho thibela li-receptors tsa mofuta oa AT1, leha e sa ame mefuta e meng ea li-receptors.

Phello e phahameng ea hypotensive ea ho nka Telmista e bonoa kamora khoeli ea kalafo, e bonts'ang phello e telele ea lithethefatsi.

Melemo ea lithethefatsi e thehiloe ts'ebelisanong e kopaneng ea telmisartan le ntho ea hydrochlorothiazide, e leng diuretic. Lithethefatsi ke mofuta o ikhethileng o loantšang ts'ebetso ea angiotensin ii. Karolo e sebetsang ea lithethefatsi e na le kamano e telele le receptor ea AT1.

Setlhare se fokotsa bongata ba aldosterone ho plasma ea mali. Setlhare se fokotsa bongata ba aldosterone ho plasma ea mali. Ha ho na tšusumetso e thibehang ho liteishene tsa ion le renin. Tšusumetso e thibelang thepa ea kininase II, e nang le phello e fokotsehang ea bradykinin, le eona ha e eo.

Ke khatello efe ea mali eo ke lokelang ho e nka?

Ho fokotsa khatello ea mali, 40 mg Telmista e beoa ka letsatsi. Ho bakuli ba bang, leha e le ka tekanyetso ea letsatsi le letsatsi ea 20 mg, ho ka ba le phello e lekaneng. Haeba phokotso ea sepheo sa khatello ea mali e sa fihlehe, ngaka e ka eketsa lethal dose ho 80 mg ka letsatsi.

Setlhare se ka tsamaisoa hammoho le moemeli oa dehydrating ho tsoa sehlopheng sa thiazide (mohlala, hydrochlorothiazide). Pele ho keketseho e 'ngoe le e' ngoe ea tekanyetso, ngaka e tla emela ho tloha libeke tse 'ne ho isa ho tse robeli, ho tloha ka nako eo phello e phahameng ea lithethefatsi e bonahatsoang.

Ho thibela tšenyo ea vascular maemong a pele ho nako, lethal dose le khothalletsoang ke 80 mg ea telmisartan hang ka letsatsi. Qalong ea kalafo, ho khothalletsoa ho lekola khatello ea mali khafetsa. Haeba ho hlokahala, ngaka e tla fetola litekanyetso ho fihlela sepheo sa mali. Matlapa a khothalletsoa hore a noe ka metsi kapa ho sa tsotelloe lijo tse ngata.

Telmista H80

Moriana o nooa ka molomo nako e le ngoe / ka letsatsi, ho sa tsotelehe lijo tse ngata. Matlapa a lokela ho hlatsuoa ka metsi a manyane.

Telmista H80 e ka laeloa bakuli bao ts'ebeliso ea telmisartan e tsoang ka tekanyetso ea 80 mg e sa iseng taolong e lekaneng ea khatello ea mali.

Bala hape sengoloa sena: Lasix: matlapa le liente tsa 40 mg

Pele o qala kalafo, khetho ea lethal dose e lokela ho etsoa khahlano le telmisartan monotherapy. Haeba ho hlokahala, o ka fetola hanghang ho tloha telmisartan monotherapy ho ea kalafo ka Telmista H80.

Haeba ho hlokahala, moriana o ka laeloa hammoho le moriana o mong oa antihypertensive.

Litlamorao

Ts'ebeliso ea Telmista, joalo ka lithethefatsi tse ling tsa antihypertensive, e ka lebisa litlamorao tse fapaneng bakeng sa mmele.

Har'a litla-morao, litaelo tsa tšebeliso li khetholla tse latelang:

tlolo ea liphio le tsamaiso ea moroto,
ntaramane e tsamaeang le feberu le malaise ka kakaretso,
ho khohlela, ho ruruha ha lisele tsa ho phefumoloha ka holimo le ka tlase, ho hema hanyane,
ts'ebeliso ea lisebelisoa tsa bonono,
lefu la morethetho oa pelo, leo ho lona ho hlahang tachycardia le bradycardia,
mathata a ka mpeng le mala, a bonahatsoang ke lets'ollo, ho nyekeloa le pelo, li-syndromes le bohloko bo sa sebetseng,
ho akheha, likhathatso tsa boroko, ho tepella,
hypersensitivity ho litšusumetso tse fapaneng tsa kantle, tse iponahatsang ka mokhoa oa ho hlohlona ha letlalo le urticaria, ho makala ha anaphylactic le hyperhidrosis,
anemia le tšokelo ea lefu la sepsis,
litlamorao tse mpe tsa thuto ea mahlale ea biomaterial ea mokuli, e hlahisoang ka bongata ba uric acid, creatinine maling, hypoglycemia le phokotseho e matla ea hemoglobin.

Mang kapa mang ea litla-morao tsena a ka hlaha a le mong kapa a le hammoho. Bakeng sa matšoao a belaetsang, tlhokomelo ea bongaka e potlakileng e hlokahala ho lokisa mofuta oa kalafo.

Bana, nakong ea kemaro le lebone

Tšireletseho le katleho ea ts'ebeliso ea telmisartan ho bana ha e so thehiloe, ka hona, matlapa a Telmista 40 mg, 80 mg le 20 mg ha a lokela ho fuoa bana le bacha ba ka tlase ho lilemo tse 18.

Ho latela litaelo, Telmista e tšoaetsoa nakong ea boimana. Maemong a tlhahlobo ea bokhachane, moriana o lokela ho emisoa hanghang.

Kaha ha ho na tlhahisoleseling mabapi le ho kenella ha telmisartan ho lebese la matsoele, moriana o kopantsoe nakong ea kanyeso.