Presartan N

Setlhare se nang le antihypertensive effect, se bua ka lithethefatsi, tseo e leng li-blocker tse ikhethang. angiotensin li-receptors (mofuta AT1) Ha e thibele enzyme (kinase II) se senyang bradykinin. Presartan lowers khatello ea mali aldosterone le norepinephrine, OPSS, HELL, e fokotsa khatello ea mali ka mora khatello ea "mali" a manyane ho potoloha mali, e na le phello ea maikutlo. E thibela nts'etsopele ea hypertrophy ea myocardial. Ho bakuli ba nang le CHF e eketsa ho hanyetsa ho ikoetlisa.

Kamora tekanyetso e le 'ngoe ea Presartan, phello ea antihypertensive e fihla ho boleng ba eona bo phahameng ka mor'a lihora tse 6, ebe butle-butle ea fokotseha ka letsatsi le hlahlamang. Phello e phahameng ea hypotensive e bonahala ka khoeli e le ngoe kamora ho qala kalafo ka moriana.

Presartan, litaelo tsa tšebeliso (Mokhoa le litekanyetso)

Presartan e nkuoa ho sa tsotelehe takatso ea lijo, nako e le 'ngoe ka letsatsi. Ka kalafo khatello ea kelello ea methapo Ho khothaletsoa lethal dose ea letsatsi le letsatsi ea 50 mg, eo, haeba ho hlokahala, e ka eketsoang ho 100 mg. Haeba mokuli a nka tekanyetso e phahameng ea diuretics, litekanyetso li lokela ho fokotsoa ho 25 mg ka letsatsi.

Bakeng sa kalafo CHF Tekanyetso ea pele ea letsatsi le letsatsi ke 12,5 mg, e nkuoa ka nako, ka nako le nako, beke e ntse e eketseha makhetlo a 2 (12,5, 25, 50 mg). Tekanyetso ea tlhokomelo ke 50 mg ka letsatsi. Ho ntlafatsa sephetho sa hypotensive, ho khothalletsoa ho fana ka taelo Presartan N (Losartan le moemeli oa antihypertgency).

Tšebelisano

Tšebeliso e lekanang ea lithethefatsi le lithethefatsi tse nang le potasiamo (litokisetso tsa potasiamo, diuretics tsa potasiamo) e eketsa kotsi ea nts'etsopele hyperkalemia. Motsoako oa ho noesa moriana o nang le diuretics o ka baka lerotholi le matla HELL. Kamohelo e kopaneng ea Presartan le NSAIDs e thusa ho fokotsa phello ea khatello ea lithethefatsi. Ka tsamaiso e tšoanang ea lithethefatsi tse ling tse nang le lithethefatsi tse ling tsa antihypertensive, ka bobeli tšusumetso e matla.

Sokolla foromo le sebopeho

Mofuta oa litekanyetso tsa Presartan ke matlapa a koahetsoeng ka filimi: ka litekanyetso tsa 25 le 50 mg - bophara ba biconvex, pinki, 25 mg, mela e nang le karohano ka lehlakoreng le le leng, ka tekanyo ea 100 mg - lerotholi le bopehileng, le biconvex, le lesoeu kapa le batlang le le tšoeu. 100 "ka lehlakoreng le leng le" BL "ka lehlakoreng le leng (li-PC tse 10. Ka blist, lithutso tse 3 lebokoseng la karete ea karete, li-pcs tse 14.).

Letlapa le le leng la 1 25/50 mg:

• ntho e sebetsang: potasiamo ea losartan - 25/50 mg,
• likarolo tse thusang: lesela le omisitsoeng, cellulose e bitsoang microcrystalline, talc e hloekisitsoeng, colloidal silicon dioxide, sodium starch glycolate, magnesium stearate, isopropyl alcohol, methylene chloride, opadry OY-55030, dae e khubelu ea krimsone.

Letlapa le le leng la 100 mg:

• ntho e sebetsang: potasiamo ea losartan - 100 mg,
• likarolo tse thusang: starch ea poone, cellcose ea microcrystalline, talc, colloidal silicon dioxide, sodium carboxymethyl starch, magnesium stearate, hypromellose, titanium dioxide, talc, macrogol.

Mofumahali

Presartan e kenngoa ka potlako ho tsoa pampiring ea gastrointestinal (GIT). E entsoe ka ho fetela ka har'a sebete. Tekanyo ea ho tlama liprotheine tsa plasma tsa losartan le metabolites ea eona ke 92-99%. Bioavailability - 33% (tšebeliso ea lijo ha e na phello). Ha e le hantle lithethefatsi ha li kenelle mothong oa mali le bokong. Ha e bokelle 'meleng, excretion e etsoa ka moroto le bile. Bophelo ba halofo ea losartan ke lihora tse 2.

Matšoao a ho sebelisoa

• hypertension ea methapo ea kutlo le hypertrophy ea ventricular e tlohetsoeng (ho fokotsa kotsi ea ho ba le methapo ea pelo le lefu la setho),
• mofuta II lefu la tsoekere la mellitus le proteinuria (ho fokotsa kotsi ea proteinuria le hypercreatininemia),
• lefu la pelo le sa foleng le sebelisoa e le karolo ea phekolo ea ho kopanya ha ho sa khonehe ho sebelisa li-inhibitors tsa angiotensin (ACE).

Contraindication

• ho hloleha ho matla ha sebete "points lintlha tse 9 ho tekanyo ea bana-bakeng sa bana (litafole tse 100 mg),
• ho ima le ho nyekeloa,
• lilemo tse 18
• kutloisiso e eketsehileng ea likarolo tsa Presartan.

Contraindication e amanang (bakeng sa matlapa a 100 mg):

• gout
• hyperuricemia
• karabelo ea ho kulisa nakong ea phekolo ea nakong e fetileng le ACE inhibitors kapa lithethefatsi tse ling,
• asthma ea lefu la bronchial,
• mafu a systemic mali
• Sekhahla sa mali se potolohang (BCC),
• hypotension
• tšebelisano-mmoho le lithethefatsi tse seng khahlanong le ts'oaetso tsa li -idalidal (NSAIDs),
• lefu la pelo
• botsofali.

Litaelo tsa ho sebelisa Presartan: mokhoa le litekanyetso

Matlapa a Presartan a nooa ka molomo nako e le 'ngoe ka letsatsi, ho sa tsotelehe lijo tse ngata.

Tekanyetso e bontšitsoeng:

• hypertension ea methapo ea kutlo: lethal dose ea pele e khothalelitsoeng ke 25 mg / ka letsatsi, tekanyetso e tloaelehileng ke 50 mg / letsatsi, haeba ho hlokahala, e ka eketsoa ho 100 mg / ka letsatsi, ha ho ntse ho lumelloa meriana ka makhetlo a 2 ka letsatsi.
• ho nyekeloa ke pelo: tekanyetso ea pele e khothalelitsoeng ke 12,5 mg / ka letsatsi, titration titigation e etsoa ka sekhahla sa beke. Tekanyo e tloaelehileng ea tlhokomelo ke 50 mg / ka letsatsi,
• thibelo ea methapo ea pelo le lefu la mafu ho bakuli ba nang le methapo ea methapo ea methapo le methapo ea methapo ea methapo: tekanyetso ea pele e khothalelitsoeng ke 50 mg / ka letsatsi, ebe e eketsoa ho 100 mg / ka letsatsi, kapa tšebeliso e kopaneng ea hydrochlorothiazide e laetsoe,
• mofuta II lefu la tsoekere la mellitus le proteinuria: lethal dose le khothalletsoang ke 50 mg / ka letsatsi, ebe le eketsoa ho 100 mg / ka letsatsi.

Lihlopheng tse ikhethang tsa bakuli:

• ho hloleha ha sebete (˂ lintlha tse 9 ho tekanyo ea bana-Pugh), ho nka tekanyetso e phahameng ea diuretics, hemodialysis, lilemo tse fetang 75: tekanyetso ea pele ea lithethefatsi ha ea lokela ho feta 25 mg / ka letsatsi,
• ts'ebetso ea ho senyeha ha sebete: litekanyetso tse tlase tsa moriana li lokela ho sebelisoa.

Litlamorao

Presartan ka tekanyetso ea 25 le 50 mg hangata e mamelloa hantle. Litla-morao li ka hlaha ka mokhoa oa lets'ollo, dyspepsia, bohloko ba mesifa, ho ruruha, hlooho, ho tsekela, likhathatso tsa boroko, hyperkalemia (potasiamo mahloriso> 5.5 meq / l), maemong a sa tloaelehang, ho khohlela, ho hloleha ho phefumoloha, tachycardia, angioedema ( molomo, sefahleho, pharynx le / kapa leleme), urticaria, ts'ebetso e eketsehileng ea li-enzyme tsa sebete, boemo ba serum bilirubin.

Litla-morao tse ka bang teng ha u nka matlapa a Presartan ka litekanyetso tsa 100 mg:

• tsamaiso ea methapo ea pelo: tachycardia, palpitations, nosebleeds, hypotension e amanang le lethal, hyphensionmias, bradycardia, vasculitis, angina pectoris, infraction ea myocardial,
• tsamaiso ea tšilo ea lijo: ho ts'oaroa ke mpa, ho opeloa ke mpa, ho nyekeloa ke pelo, ho omella ka hanong molomong, ho ipolaisa tlala, ho hlatsa, ho opeloa ke meno, ho sokela, lefu la mokokotlo, lefu la ho akheha, hepatitis, ho senyeha ha ts'ebetso ea sebete,
• Mokhoa oa musculoskeletal: mesifa ea mesifa ea namane, bohloko ba ka morao le ba leoto, arthralgia, ramatiki, bohloko mahetleng, lengole, fibromyalgia,
• letlalo: erythema, letlalo le omeletseng, ecchymosis, photosensitivity, alopecia, mofufutso o eketsehileng,
• karohano e bakoang ke ho ruruha: lekhopho la letlalo, ho hlohlona, ​​urticaria, angioedema (ho kenyeletsoa le edema ea larynx, leleme),
• hematopoiesis: thrombocytopenia, eosinophilia, morero oa Schoenlein - Genoch, ho fokotseha hanyane ha hemoglobin le hematocrit,
• tsamaiso ea methapo: hlooho ea hlooho, ho tsekela, ho hloka boroko, ho tšoenyeha, ho otsela, ho tšoenyeha ha boroko, ho senyeha ha mohopolo, ho teba ha pelo, ho ferekana kelellong, ho thothomela, ataxia, khatello ea maikutlo, tinnitus, ho akheha, ho sitisoa ha maikutlo, migraine, conjunctivitis, ho senyeha ha pono,
• Sistimi ea phefumoloho: ho khohlela, pharyngitis, bronchitis, tšubuhlellano ea nasal, sinusitis, ts'oaetso ea phepelo ea phepelo ea methapo,
• Sistimi ea genitourinary: Tšoaetso ea pampiri ea urine, ho ruruha, ho ruruha ha litho tsa tsebe, ho fokotsa libido, ho hloka matla,
• tse ling: asthenia, bohloko ba sefuba, mokhathala, edema ea ho potoloha, ho mpefatsa le ho feta ha lefu la sethoathoa,
• paramethara ea laboratori: hyperuricemia, keketseho ea khatello ea urea, naetrojene e setseng le leqheine serum ea mali, keketseho ea tšebetso ea li-transaminase tsa hepatic (tekano), hyperbilirubinemia.

Litaelo tse khethehileng

E, ha o qala ho nka Presartan, o lokela ho lokisa ho omella ho bakoang, mohlala, ka ho nka li-diuretics ka tekanyetso e phahameng, haeba ho se na monyetla oa ho fetola BCC, kalafo e lokela ho qala ka tekanyo e tlase ea moriana.

Lithethefatsi tse amang RAAS (renin-angiotensin-aldosterone system) li khona ho eketsa khatello ea methapo ea mali maling le serum creatinine ho bakuli ba nang le pelo le methapo ea methapo ea methapo.

Tšusumetso ho bokhoni ba ho khanna makoloi le mekhoa e rarahaneng

Ho entsoe lithuto tse khethehileng mabapi le litlamorao tsa Presartan mabapi le bokhoni ba ho khanna makoloi le mekhoa e meng e rarahaneng. Leha ho le joalo, ho lokela ho nahanoa ka nts'etsopele ea litlamorao tse ka bang teng, joalo ka ho otsela le ho tsekela, ho hloka tlhokomeliso e eketsehileng ha u etsa lintho tse ka bang kotsi.

Ho sebelisana le lithethefatsi

• diuretics tse hahelletsoeng ka potasiamo, litokisetso tsa potasiamo: kotsi ea ho ba le hyperkalemia,
• diuretics: kotsi ea ho fokotseha ho matla ha khatello ea mali,
• beta-blockers le kutloelo-bohloko: li ntlafatsa phello ea tsona,
• rifampicin, flucanazole: fokotsa khatello ea "metabolite" e sebetsang ea losartan maling.
• lithium: ho eketseha ha khatello ea mali maling hoa khoneha,
• Li-NSAIDs: phello e matlafatsang ea lithethefatsi e fokotsehile,
• lithethefatsi tse ling tsa antihypertensive: litlamorao tsa tsona tse matlafatsang lia ntlafatsoa.

Litšoantšiso tsa Prezartan ke Brozaar, Blocktran, Vazotens, Zisakar, Kozaar, Lozap, Cardomin-Sanovel, Lozartan, Renikard, Lakea, Vero-Lozartan, Lorista.

Mokhoa oa ho sebelisa: litekanyetso le kalafo

Matlapa a Presartan N a nooa ka molomo, ho sa tsotelehe lijo tse jang.

Motsoako oa pele le oa tlhokomelo ke 1 Letlapa le 12,5 mg + 50 mg 1 nako e le ngoe ka letsatsi. Phello e phahameng ea antihypertensive e fihlella ka nako ea libeke tse tharo tsa kalafo. Ho fihlella phello e boletsoeng haholoanyane, ho ka etsahala hore o eketse tekanyetso ea lithethefatsi ho matlapa a 2 ka litekanyetso tsa 12,5 mg + 50 mg hang ka letsatsi. Tekanyetso e kholo ea letsatsi le letsatsi ke matlapa a mabeli a Presartan N.

Ho bakuli ba nang le palo e khutsitseng ea mali a potoloha (mohlala, ha ba ntse ba nka litekanyetso tse kholo tsa diuretics), lethal e le khothalletsoang la losartan ho bakuli ba nang le hypovolemia ke 25 mg hang ka letsatsi. Mabapi le sena, kalafo le Presartan N e tlameha ho qala kamora ho felisoa ha diuretics le tokiso ea hypovolemia.

Ho bakuli ba tsofetseng le bakuli ba nang le bothata ba ho leka-lekanya ha a leka-lekane ho kenyelletsa ba nang le dialysis, ha ho hlokahale hore ho fetoloe tokiso ea tekanyetso ea pele.

Fokotsa kotsi ea ho fokolloa ke pelo le lefu ho bakuli ba nang le khatello ea methapo ea methapo le methapo e kholo ea methapo ea methapo

Tekanyetso e tloaelehileng ea losartan ke 50 mg 1 nako ka letsatsi. Bakuli ba sa khoneng ho fihlella khatello ea mali e lebelletsoeng ha ba ntse ba nka losartan 50 mg / ka letsatsi ba hloka kalafo ka kopanyo ea losartan e nang le litekanyetso tse tlase tsa hydrochlorothiazide (12,5 mg), mme ha ho hlokahala, eketsa tekanyetso ea losartan ho isa ho 100 mg hammoho le hydrochlorothiazide ka tekanyo ea 12,5 mg / ka letsatsi, nakong e tlang - keketseho ea matlapa a mabeli a moriana ho litekanyetso tsa 50 / 12,5 mg ka kakaretso (100 mg ea losartan le 25 mg ea hydrochlorothiazide ka letsatsi hang).

Ketso ea pharmacological

Presartan H e na le motsoako oa losartan le hydrochlorothiazide, likarolo tseo ka bobeli li na le phello e eketsang ea antihypertensive, li theola khatello ea mali (BP) haholo ho feta karolo e 'ngoe le e ngoe ka thoko.

Losartan ke angiotensin II receptor antagonist (subtype AT1) bakeng sa tsamaiso ea molomo. Losartan le metabolite ea eona e sebetsang ea pharmacologically (E 3174) ka bobeli ka vitro le vivo li thibela melemo eohle ea 'mele ea angiotensin II, ho sa tsotelehe mohloli kapa tsela ea motsoako. Losartan e ikamahanya le li-receptor tsa AT1 ka mokhoa o ikhethileng mme ha e tlame kapa ho thibela li-receptor tsa lihormone tse ling le liteishene tsa ion, tse etsang karolo ea bohlokoa ho bonts'a ts'ebetso ea tsamaiso ea methapo ea pelo. Ntle le moo, losartan ha e thibele eniotensin-e fetolang enzyme (ACE) - kininase II, 'me, ka hona, ha e thibele ho timetsoa ha bradykinin, ka hona litlamorao tse sa amaneng ka kotloloho le bradykinin (mohlala, angioedema) ha li na seoelo.

Ha u sebelisa losartan, ho ba sieo ha tšusumetso ea maikutlo a mabe mabapi le secretion ea renin ho lebisa hoketseho ea mosebetsi oa plasma renin. Keketseho ea tšebetso ea renin e lebisa keketseho ea angiotensin II maling a mali. Leha ho le joalo, ts'ebetso ea antihypertgency le ho fokotseha ha tekanyo ea aldosterone ho plasma ea mali e ntse e phehella, e bonts'ang thibelo e sebetsang ea li-receptors tsa angiotensin II. Losartan le metabolite ea eona e sebetsang e na le tšebelisano e kholo ho li-engiotensin I receptors ho feta li-angiotensin P. receptors. Metabolite e sebetsang ke makhetlo a 1040 ho feta a sebetsang ho feta losartan.

Kamora taolo e le 'ngoe ea molomo, matla a antihypertensive (ho fokotseha ha methapo ea mali le syastolic) a fihla ka bongata kamora lihora tse 6, ebe butle-butle o fokotseha ka nako ea lihora tse 24. Phello e phahameng ea antihypertensive e hlaha libeke tse 3-6 ka mor'a ho qala ha moriana.

Hydrochlorothiazide - e leng thiazide diuretic, e sitisa ho ts'oaroa ha sodium, chlorine, potasiamo, ion le magnesium ka har'a distphine ea distal, e liehisa tlhahiso ea calcium, uric acid. Keketseho ea phello ea renal ea li-ion tsena e tsamaisana le ho eketseha ha bongata ba moroto (ka lebaka la ho tlangoa ha metsi ka osmotic). E fokotsa bongata ba plasma ea mali, e eketsa ts'ebetso ea plasma renin le secretion ea aldosterone. Ha e nooa ka tekanyetso e phahameng, hydrochlorothiazide e eketsa tlhahiso ea li-bicarbonate, ha tšebeliso ea nako e telele e fokotsa ts'oarelo ea khalsiamo.

Matla a antihypertgency a hlaha ka lebaka la ho fokotseha ha molumo oa mali a potoloha (BCC), liphetoho ho mokokotlo oa mokokotlo oa mokokotlo, ho fokotseha ha khatello ea khatello ea li-vasoconstrictor amines (adrenaline, norepinephrine) le keketseho e mpe ea phello ea gang gang. Ha e ame khatello ea mali e tloaelehileng. Phello ea diuretic e bonoa kamora lihora tse 1-2, e fihla hofihlella kamora lihora tse 4 mme e nka lihora tse 6-12. Matla a antihypertensive a etsahala matsatsing a 3-4, empa ho hlokahala libeke tse 3-4 ho fihlela sephetho se nepahetseng sa kalafo.

Lipotso, likarabo, litlhahlobo mabapi le lithethefatsi Presartan N

Tlhahisoleseling e fanoeng e reretsoe litsebi tsa bongaka le tsa meriana. Tlhahisoleseling e nepahetseng ka ho fetelletseng ka lithethefatsi e fumaneha litaelong tse tlamelletsoeng ke moqapi. Ha ho na tlhahisoleseling e thathamisitsoeng leqepheng lena kapa leha e le efe ea sebaka sa rona sa marang-rang e ka sebeletsang e le sebaka sa boipiletso ba motho ho setsebi.

Fomu ea tokollo, lipakete le sebopeho Presartan N

Matlapa, 'mala o mosehla oa filimi, ke oval biconvex, karolong ea sefapano.

Bahlomphehi: lactose monohydrate 111.50 mg, microcrystalline cellulose 58 mg, pregelatinized starch 3 mg, poone starch 12 mg, colloidal silicon diabetes 1 mg, magnesium stearate 2 mg.

Sebopeho sa Shell:
hypromellose 2.441 g, titanium dioxide 0,60 mg, talc 1.50 mg, macrogol-6000 0.40 mg, quinoline e dae 0.058 mg.

14 li-PC. - Liphutheloana tsa lithutsoana (2) - lipakete tsa karete.

Tekanyetso le tsamaiso

Ka khatello ea mali ea methapo, lethal dose la letsatsi le letsatsi ke 25 mg, karolelano ea letsatsi le letsatsi ke 50 mg, khafetsa ea tsamaiso ke 1 nako / letsatsi.

Phello e phahameng ea hypotensive e hlaha libeke tse 3-6 kamora hore moriana a qale. Haeba ho hlokahala, tekanyetso ea moriana e ka eketsoa ho 1 00 mg ka letsatsi. Tabeng ena, ho ka etsahala hore u noe lithethefatsi makhetlo a 2 ka letsatsi.

Tekanyetso ea pele ea bakuli ba nang le ho nyekeloa ke pelo ke 12,5 mg 1 nako / letsatsi. Ka tloaelo, litekanyetso li fanoa ka linako tse ling tsa beke le beke (i.e. 12,5 mg / letsatsi, 25 mg / letsatsi. 50 mg / letsatsi) ho ea ho karolelano ea tekanyetso ea 50 mg 1 nako / letsatsi, ho latela tumello ea mokuli ho moriana.

Ha u fana ka litlhare ho bakuli ba fumanang litekanyetso tse phahameng tsa tekanyetso, tekanyetso ea pele e lokela ho fokotsoa ho 25 mg 1 nako / ka letsatsi.

Bakuli ba nang le bothata ba ho sebetsa ha sebete ba lokela ho fuoa litekanyetso tse tlase tsa losartan,

Ho bakuli ba tsofetseng, hammoho le bakuli ba nang le ts'ebetso ea renal e holofetseng, ho kenyelletsa le bakuli ba hemodialysis, ha ho na lebaka la ho fetola tekanyetso ea pele ea moriana.

Presartan e ka laeloa hammoho le lithethefatsi tse ling tsa antihypertgency. Losartan e ka sebelisoa ho sa tsotelehe takatso ea lijo.

Litla-morao

Presartan hangata e mamelloa hantle. Ho ka bonoa: lets'ollo, dyspepsia, bohloko ba mesifa, ho ruruha, ho tsekela, ho tsosa boroko, hlooho e bohloko, hyperkalemia (potasiamo maling e fetang 5,5 meq / l). Maemong a sa tloaelehang, ho ka ba le ho khohlela, ho hloleha ho phefumoloha, tachycardia, angioedema (ho kenyelletsa ho ruruha sefahleho, molomo, pharynx le / kapa leleme), urticaria, ts'ebetso e eketsehileng ea transaminase ea "sebete", bilirubin maling.

Likarolo tsa ts'ebeliso

Ho bakuli ba nang le ho felloa ke metsi 'meleng (mohlala, ho fumana kalafo e nang le tekanyetso e phahameng ea diuretics), hypotension ea matšoao e ka hlaha qalong ea kalafo le Presartan. Hoa hlokahala ho lokisa ho felloa ke metsi 'meleng pele ho pelepelo kapa ho qala kalafo ka tekanyo e tlase.

Lintlha tsa pharmacological li bonts'a hore khatello ea "losartan" ea plasma maemong a bakuli ba nang le lefu la cirrhosis e eketseha haholo, ka hona, bakuli ba nang le nalane ea lefu la sebete ba lokela ho fuoa tekanyetso e tlase ea moriana.

Lithethefatsi tse ling tse amang sisteme ea kipinapgiotensin li ka eketsa urea ea mali le serum creatinine ho bakuli ba nang le ts'ebetso ea kutlo ea mokokotlo.

Ha ho tsejoe hore na losartan e pepesitsoe lebeseng la matsoele. Ha presartanan e beoa nakong ea kemaro, qeto e lokela ho etsoa ho emisa ho anyesa, kapa ho emisa kalafo ka lithethefatsi.