Losartan: cov lus qhia rau kev siv

Hauv tsab xov xwm no, koj tuaj yeem nyeem cov lus qhia rau kev siv tshuaj yaj yeeb LosartanCov. Muab tswv yim los ntawm cov neeg tuaj saib rau ntawm thaj chaw - cov neeg siv khoom ntawm cov tshuaj no, nrog rau kev xav ntawm cov kws kho mob tshwj xeeb txog kev siv Losartan hauv lawv cov kev coj ua. Qhov kev thov loj yog nquag ntxiv kev tshuaj xyuas koj ntawm cov tshuaj: cov tshuaj tau pab lossis tsis pab ua kom tshem tawm ntawm tus kabmob, muaj dab tsi tshwm sim thiab cov kev mob tshwm sim, tejzaum nws tsis tshaj tawm los ntawm tus tsim khoom hauv cov lus piav qhia. Cov qauv ntawm Losartan nyob rau hauv muaj cov qauv txheej txheem tam sim no. Siv rau kev kho mob ntshav siab thiab txo ntshav siab rau cov neeg laus, menyuam yaus, nrog rau thaum cev xeeb tub thiab lactation.

Losartan - antihypertensive tus neeg sawv cev. Nws yog qhov tsis yog peptide angiotensin 2 receptor blocker. Nws tau xaiv siab zoo thiab muaj kev cuam tshuam rau AT1 receptors (nrog rau kev koom nrog uas qhov kev cuam tshuam tseem ceeb ntawm angiotensin 2 tau paub). Los ntawm kev thaiv cov receptors no, losartan tiv thaiv thiab tshem tawm cov vasoconstrictive nyhuv ntawm angiotensin 2, nws cov nyhuv stimulating rau lub zais pa ntawm aldosterone los ntawm cov qog adrenal thiab qee qhov cuam tshuam ntawm angiotensin 2. Nws yog tus cwj pwm los ntawm lub cev ntev (24 teev lossis ntau dua), vim yog qhov tsim ntawm nws lub cev metabolite.

Muaj pes tsawg leeg

Losartan poov tshuaj + excipients.

Cov Tshuaj Pharmacokinetics

Tom qab qhov ncauj tswj hwm, losartan nrawm nrawm los ntawm lub plab zom mov. Bioavailability yog li ntawm 33%. Nws yog cov tshuaj tiv thaiv thaum "thawj tso cai" los ntawm daim siab nrog rau kev tsim cov carboxyl metabolite, uas muaj ntau qhov haujlwm ntawm cov kws kho mob ntau dua li losartan, thiab ntau lub cev tsis siv lub cev. Kev khi rau cov ntshav protein ntawm losartan thiab cov metabolite nquag muaj ntau - ntau dua 98%. Losartan tawm hauv cov zis thiab cov quav (nrog bile) tsis hloov thiab hauv daim ntawv ntawm metabolites. Txog 35% yog tawm hauv cov zis thiab li 60% - nrog quav.

Cov Khoom Qhia

• leeg ntshav siab
• kev txo qis hauv kev pheej hmoo ntawm cov kev mob plawv ntsig txog lub cev thiab kev tuag ntawm cov neeg mob ntshav siab thiab ntshav tawm ntawm lub cev tawg tuaj yeem ua rau muaj kev cuam tshuam qhov tsawg kawg ntawm cov zaus ntawm lub plawv kev tuag, mob hlab ntsha tawg thiab myocardial infarction,
• kev tiv thaiv lub raum hauv cov neeg mob uas muaj ntshav qab zib hom 2 uas muaj proteinuria - qeeb zuj zus ntawm lub raum tsis ua haujlwm, tshwm sim los ntawm kev txo qis ntawm hypercreatininemia, qhov tshwm sim ntawm cov theem kawg ntawm kev mob raum tsis ua haujlwm, xav tau hemodialysis lossis lub raum hloov pauv, cov neeg tuag, nrog rau kev txo cov proteinuria,
• mob plawv tsis ua hauj lwm nrog kev kho mob tsis ua hauj lwm los ntawm ACE inhibitors.

Tso Tawm Cov Ntawv

Coated ntsiav tshuaj 12,5 mg, 25 mg, 50 mg thiab 100 mg (tsim los ntawm Richter, Teva, H daim ntawv nrog diuretic hydrochlorothiazide).

Cov lus qhia rau kev siv thiab ntau npaum li cas

Cov tshuaj losartan yog noj ntawm qhov ncauj, tsis hais noj mov. Cov ntsiav tshuaj yog nqos tsis tau zom, ntxuav nrog dej. Tshaj tawm ntawm kev pub nkag - 1 zaug nyob rau ib hnub.

Nrog rau cov hlab ntsha o, qhov nruab nrab txhua hnub koob yog 50 mg 1 zaug hauv ib hnub. Txhawm rau kom ua tau zoo dua li kev kho mob kom ntau dua, cov tshuaj ntxiv tau nce mus rau 100 mg ib hnub twg.

Mob plawv nres

Thawj koob tshuaj rau cov neeg mob plawv tsis ua hauj lwm ntev yog 12,5 mg ib hnub ib zaug. Raws li txoj cai, koob tshuaj nce nrog rau lub lim piam ib zaug (i.e. 12,5 mg rau ib hnub, 25 mg rau ib hnub thiab 50 mg rau ib hnub) rau ib qho kev saib xyuas nruab nrab ntawm 50 mg 1 zaug hauv ib hnub, nyob ntawm tus neeg mob lub siab ntev rau cov tshuaj.

Cov neeg laus yuav tsum tsis txhob hloov kho ntxiv.

Txo txoj kev pheej hmoo ntawm txoj kev loj hlob, cov kab mob plawv (suav nrog mob hlab ntsha tawg) thiab tuag hauv cov neeg mob ntshav siab thiab ntshav tawm ntawm lub ntsws ventricular hypertrophy

Qhov kev siv tshuaj thawj zaug yog 50 mg 1 zaug nyob rau ib hnub. Yav tom ntej, hydrochlorothiazide ntxiv tau rau hauv koob tshuaj tsawg los yog koob tshuaj Losartan yuav nce ntxiv rau 100 mg hauv 1 lossis 2 koob tshuaj, suav nrog qhov txo qis ntshav siab.

Cov neeg mob uas mob hom ntshav qab zib hom 2 uas muaj proteinuria

Cov tshuaj tau sau tseg nyob rau hauv thawj zaug kev noj tshuaj ntawm 50 mg ib hnub ib zaug nrog ib qho kev nce ntxiv ntawm koob tshuaj rau 100 mg ib hnub twg (noj rau hauv qhov kev txiav txim siab txo cov ntshav siab) hauv ib lossis ob zaug.

Hauv cov neeg mob uas muaj BCC txo (piv txwv li, thaum noj cov tshuaj diuretics hauv qhov siab), qhov pom zoo thawj zaug ntawm Losartan yog 25 mg ib hnub ib zaug.

Cov neeg mob uas muaj mob hepatic tsis txaus (tsawg dua 9 cov ntsiab lus ntawm Child-Pugh nplai), thaum lub sijhawm ua haujlwm hemodialysis, zoo li cov neeg mob uas muaj hnub nyoog tshaj 75 xyoo, qhov pib qis dua ntawm cov tshuaj pom zoo - 25 mg ib hnub ib zaug.

Tsis muaj kev paub txaus nrog kev siv cov tshuaj hauv cov neeg mob uas muaj lub siab tsis ua haujlwm siab, yog li ntawd, cov tshuaj tsis raug pom zoo hauv pawg no ntawm cov neeg mob.

Cov tshuaj tsis muaj qhov peculiarities ntawm kev ua ntawm thawj koob tshuaj lossis thaum tso tseg, tab sis kev tswj ntshav siab yog tsim nyog xws li thaum noj ib qho tshuaj tiv thaiv kab mob antihypertensive.

Txais tos ntawm cov tshuaj antihypertensive yuav tsum nqa tawm tib lub sijhawm nyob ntawm kev pom zoo ntawm tus kws kho mob txhawm rau nce kho cov nyhuv. Yog tias koj hla kev noj tshuaj ib zaug, koj yuav tsum tau noj tshuaj ntxiv tom ntej lub sijhawm ze rau lub sijhawm noj tshuaj tsawg dua los yog lub sijhawm thaum koj nco qab tias koj tsis nco qab noj ntau ntxiv los ntawm txav lub sijhawm ntawm koob tshuaj ntxiv. Tsis txhob noj ob zaug ntawm cov tshuaj.

Sab sij huam

• kiv taub hau
• asthenia / nkees,
• mob taub hau
• insomnia
• kev txhawj xeeb
• kev ntxhov siab vim pw tsaug zog
• tsaug zog
• nco tsis meej
• cuab yeej neuropathies,
• paresthesia
• mob taub hau
• tshee hnyo
• kev nyuaj siab
• coov hauv pob ntseg
• saj kev ua txhaum
• kev pom kev hloov
• pom mob pob txha
• txhaws ntswg
• hnoos
• sab qaum cov mob ua pa (kub taub hau, mob caj pas),
• mob hlab ntsws
• pharyngitis
• rhinitis
• xeev siab, ntuav,
• zawv plab
• dyspeptic tshwm sim
• mob plab
• hnoos qeev qhuav,
• kev tsis nco qab
• cramps
• myalgia
• mob mob nraub qaum, hauv siab, ceg,
• arthralgia
• tachy lossis bradycardia,
• arrhythmias
• angina pectoris
• anemia
• myocardial infarction
• xav tso zis
• txo qis libido
• impotence
• daim tawv nqaij qhuav
• maj ntshav
• photosensitization,
• nce hws
• alopecia
• urticaria
• daim tawv nqaij ua pob
• khaus
• angioedema, suav nrog lub ntsej muag, daim di ncauj, mob taub hau thiab / lossis tus nplaig,
• npaws
• mob gout
• vasculitis
• eosinophilia
• purpura Shenlein-Genoch.

Cov Yuav Tsum Tau Ua

• cev xeeb tub
• kev pub mis
• hnub nyoog txog 18 xyoo
• mob rau daim siab ua haujlwm ntau (ntau dua li 9 ntsiab lus ntawm daim ntawv teev menyuam yaus-Pugh),
• cov keeb tiv thaiv kab mob galactose tsis haum, lactase deficiency lossis glucose-galactose malabsorption syndrome,
• ua kom lub cev tsis haum rau cov tshuaj ntawm cov tshuaj.

Cev xeeb tub thiab lactation

Kev siv cov tshuaj losartan thaum cev xeeb tub yog contraindicated. Nws paub tias cov tshuaj uas cuam tshuam ncaj qha rau renin-angiotensin-aldosterone system (RAAS), thaum siv nyob rau qib 2 thiab qib thib 3 ntawm cev xeeb tub, tuaj yeem ua rau muaj kev txhim kho lossis kev tuag ntawm kev loj hlob hauv lub plab. Yog li, thaum kuaj pom kev xeeb tub, noj cov tshuaj Losartan yuav tsum nres tam sim ntawd.

Nws tsis paub tseeb tias puas yog losartan nrog cov kua mis pub tawm. Nws tsis pom zoo kom noj cov tshuaj losartan thaum lactation. Yog hais tias noj Losartan yog tsim nyog thaum lactation, tom qab ntawd kev pub niam mis yuav tsum tau tsum.

Siv rau cov neeg mob laus

Cov neeg laus yuav tsum tsis txhob hloov kho ntxiv.

Cov neeg mob uas muaj hnub nyoog tshaj 75 xyoos raug pom zoo kom txo qis qhov pib ntawm cov tshuaj no - 25 mg ib hnub ib zaug.

Siv rau menyuam yaus

Contraindicated rau cov menyuam yaus thiab cov neeg hluas hnub nyoog qis dua 18 xyoo.

Cov lus qhia tshwj xeeb

Rau cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev nyob rau hauv uas muaj cov txiaj ntsig ruaj khov tau ua tiav los ntawm kev siv tshuaj ACE inhibitors, nws tsis pom zoo hloov mus rau kev noj tshuaj angiotensin 2 receptor antagonists, suav nrog tshuaj losartan.

Cov neeg mob mob siab (tsawg dua 9 ntsiab lus ntawm Chaydd-Pugh nplai, thiab tshwj xeeb tshaj yog mob qog ntshav), suav nrog hauv qhov anamnesis, nws yog ib qhov tsim nyog los tsa me dua koob tshuaj.

Hauv cov neeg mob lub cev qhuav dej (piv txwv li, tau txais kev kho mob nrog kev tso tshuaj ntau dhau), cov tsos mob ntawm kev tso ntshav siab yuav tshwm sim thaum pib los ntawm kev kho tus mob (nws yog qhov tsim nyog los kho lub cev qhuav dej ua ntej losartan lossis pib kho nrog koob tshuaj qis dua).

Cov neeg mob uas lub raum tsis zoo lub cev, ob qho tib si nrog thiab tsis mob ntshav qab zib, feem ntau muaj kev cuam tshuam ntawm electrolyte cuam tshuam (hyperkalemia), uas yuav tsum tau hais kom sib haum. Nyob rau ntawm qhov muaj mob loj los yog mob raum tsis ua haujlwm, losartan yuav ua rau lub raum ua haujlwm tsis zoo nrog lossis tsis muaj mob hyperkalemia.

Thaum kho nrog losartan, cov poov tshuaj ntau ntau hauv cov ntshav yuav tsum tau saib xyuas tas li, tshwj xeeb tshaj yog nyob rau cov neeg laus thiab cov uas lub raum tsis ua haujlwm. Kev siv losartan nrog rau potassium-sparing diuretics yuav tsum zam ua ke.

Hauv cov neeg mob laus siv cov tshuaj tsis-tshuaj steroidal, nrog rau kev siv tshuaj diuretics tib lub sijhawm, lossis nrog lub raum tsis ua haujlwm, kev siv losartan tuaj yeem ua rau lub raum tsis ua haujlwm, suav nrog kev muaj feem mob raum tsis ua haujlwm. Cov teebmeem no feem ntau yuav thim rov qab. Nws yog ib qho tsim nyog los ua ntu zus saib xyuas lub raum kev ua haujlwm hauv cov neeg mob noj cov tshuaj losartan thiab tsis siv tshuaj tsis haum steroidal.

Cov ntaub ntawv hais txog kev nyab xeeb thiab ua haujlwm ntawm cov tshuaj hauv cov menyuam yaus tsis txaus.

Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab

Lub peev xwm ntawm cov tshuaj los cuam tshuam rau kev ceev ntawm psychomotor cov kev xav thiab lub peev xwm tsav tsheb lossis lwm yam kev siv tshuab tsis tau kawm. Ceev faj yuav tsum tau siv thaum ua cov haujlwm nyob rau qhov chaw muaj kev phom sij uas xav tau kev saib xyuas ntau ntxiv thiab cov kev xav hauv lub hlwb sai.

Yeeb tshuaj sib cuam tshuam

Cov tshuaj losartan tuaj yeem siv ua ke nrog lwm cov tshuaj tiv thaiv antihypertensive.

Kev sib txuam txhim kho cov nyhuv ntawm beta-blockers thiab sympatholytics.

Cov khoom siv sib xyaw ua ke ntawm losartan nrog diuretics ua rau muaj kev cuam tshuam ntxiv.

Tsis muaj kev sib txuam ntawm cov tshuaj pharmacokinetic ntawm losartan nrog hydrochlorothiazide, digoxin, warfarin, cimetidine, phenobarbital, ketoconazole thiab erythromycin tau pom.

Cov tshuaj Rifampicin thiab fluconazole tau qhia tawm txog kev txo qis ntawm cov metabolite nquag hauv ntshav ntshav. Cov tseem ceeb ntawm cov kab mob sib cuam tshuam no tseem tsis tau paub.

Ib yam li lwm tus neeg sawv cev uas inhibit angiotensin lossis nws cov txiaj ntsig, kev siv ua ke ntawm losartan nrog cov tshuaj potassium-sparing diuretics (piv txwv li, spironolactone, triamteren, amiloride), kev npaj tshuaj poov tshuaj, thiab ntsev uas muaj cov tshuaj potassium ua rau muaj kev pheej hmoo ntawm hyperkalemia.

Cov tshuaj nonsteroidal anti-inflammatory (NSAIDs), suav nrog kev xaiv cyclooxygenase-2 inhibitors (COX-2), tuaj yeem txo cov nyhuv ntawm diuretics thiab lwm yam tshuaj tiv thaiv antihypertensive.

Nrog rau kev siv ua ke ntawm angiotensin 2 thiab lithium receptor antagonists, nce ntxiv ntawm plasma lithium concentration yog tau. Muab qhov no, nws yog qhov yuav tsum tau hnyav lub txiaj ntsig thiab kev pheej hmoo ntawm kev tswj hwm ntawm losartan nrog cov roj ntsha lithium. Yog tias tsim nyog, kev sib koom tes ntawm kev siv tshuaj, nws yog ib qho tsim nyog yuav tsum soj ntsuam kom tsis txhob muaj cov tshuaj lithium hauv cov ntshav ntshav.

Cov tshuaj ntawm cov tshuaj Losartan

Cov qauv ntawm cov qauv ua haujlwm:

• Blocktran
• Brozaar
• Vasotens,
• Vero Losartan
• Zisakar
• Cardomin Sanovel,
• Karzartan
• Cozaar
• Lakea
• Lozap,
• Lozarel
• Losartan mcleods,
• Losartan Richter,
• Losartan teva,
• Lorista
• Losacor
• Lotor
• Tubkawm Presartan
• Los Tsuas.

Daim ntawv tso tawm

daj, zaj duab xis-coated biconvex oblong ntsiav tshuaj, nrog cov xim dawb (lossis yuav luag dawb) tub ntxhais, lub hlwv ntawm aluminium lossis PVC zaj duab xis, duab los qhia

Muaj tshuaj ua siv

Losartan Potassium (50, 100 mg)

Tshwjxeeb

Microcrystalline cellulose, sodium stearyl fumarate, anhydrous colloidal silicon dioxide (Aerosil), croscarmellose sodium, prosolv HD 90

Lub plhaub muaj pes tsawg leeg: titanium dioxide, microcrystalline cellulose, macrogol stearate, hypromellose

Cov Tshuaj Hauv Tshuaj

Losartan yog ib qho tshuaj tiv thaiv kabmob. Ua ib qho tsis yog peptide blocker ntawm AT2 receptors, nws sib tw thaiv AT1 receptors, tiv thaiv angiotensin II tsis cuam tshuam rau lawv. Cov tshuaj qib tso tawm ntawm vasopressin, catecholamines, aldosterone thiab renin, tiv thaiv txoj kev loj hlob ntawm cov hlab ntsha arterial thiab sab laug ventricular hypertrophy. Nws tsis muaj qhov cuam tshuam rau ntawm angiotensin-hloov mus rau enzyme, tsis cuam tshuam rau lub zog kinin-kallikrein, thiab tsis tso cai rau bradykinin mus ntxiv.

Cov nquag metabolite ntawm Losartan, tsim nyob rau hauv cov txheej txheem ntawm kev hloov pauv roj ntsha, tsim cov tshuaj tawm tsam.

Cov Tshuaj Pharmacokinetics

Tom qab kev tswj hwm ntawm qhov ncauj, cov tshuaj (hauv cov koob tshuaj txog 200 mg) tau zoo nqus, thiab, tom qab lub cev presystemic metabolism, ua rau cov metabolite ntawm carboxylic acid nquag tawm hauv cov ntshav. Cov kab ke lom neeg nyob ntawm Losartan yog 33%. Thaum noj ntawm qhov ncauj, tsis pub dhau ib teev nws mus txog qhov siab tshaj plaws hauv cov ntshav ntshav, khi 99% rau albumin. Qhov ntim ntawm kev faib tawm yog 34 litres. Tom qab 3-4 teev, C max nce mus txog lub zog metabolite ntawm cov tshuaj. Ib nrab-lub neej ntawm Losartan yog 2 teev, nws lub cev metabolite yog 9 teev. Qhov siab tshaj plaws antihypertensive nyhuv los ntawm kev siv cov tshuaj yog pom tom qab 2-4 lub lis piam los ntawm kev pib tswj hwm hauv cov neeg mob ntawm txhua lub hnub nyoog, poj niam txiv neej thiab haiv neeg.

4% ntawm cov koob tshuaj tau tawm los ntawm ob lub raum tsis hloov, 6% - nyob rau hauv daim ntawv ntawm kev siv tshuaj tiv thaiv. Tom qab cov neeg siv qhov ncauj, 35% ntawm nplooj losartan tawm nrog cov zis, 58% - nrog quav. Nrog rau ib daim ntawv thov tsis nthuav tawm hauv lub cev.

Hauv cov neeg mob laus uas raug kev txom nyem los ntawm kev mob ntshav siab, qhov tsom ntawm cov tshuaj nquag thiab nws cov nquag metabolite tsis txawv ntawm kev saib xyuas hauv cov neeg hluas nrog kev mob ntshav siab. Rau cov poj niam, qhov concentration ntawm cov tshuaj hauv plasma ntau dua 2 npaug ntawm cov tshuaj lom neeg hauv tus txiv neej. Qhov tshwj xeeb ntawm cov nquag metabolite hauv cov txiv neej thiab poj niam yog nyob rau tib theem.

Dab tsi yog losartan rau?

• Qhov tseem ceeb arterial tawg,
• Arterial hypertension thiab sab laug ventricular hypertrophy (kom txo qis kev phom sij thiab tiv thaiv kev tuag),
• Mob plawv tsis ua hauj lwm (raws li cov tshuaj uas yog ib feem ntawm kev sib xyaw ua ke),
• Mob ntshav qab zib nephropathy cuam tshuam nrog proteinuria thiab hypercreatininemia nyob rau hauv cov neeg mob uas muaj hom II mob ntshav qab zib mellitus.
• Raws li cov tshuaj rau cov tshuaj kho mob los tiv thaiv kev kho mob.

Cov Yuav Tsum Tau Ua

• Hypersensitivity / tus kheej intolerance mus rau lub Cheebtsam ntawm cov tshuaj,
• Cev xeeb tub thiab lactation
• Daim siab ua haujlwm
• Lub cev qhuav dej (lub cev qhuav dej)
• Cov ntshav hauv lub cev refractory,
• Cov kua dej qab zib-galactose malabsorption, lactose tsis haum, lactase tsis txaus,
• Siv nrog aliskiren (thaum lub raum lub raum tsis ua haujlwm lossis ntshav qab zib mellitus),
• Lub hnub nyoog txog 18 xyoo.

Losartan yuav tsum ua nrog ceev faj hauv cov xwm txheej hauv qab no:

• lub plawv tsis ua haujlwm tshwm sim nyob rau ntawm qhov muaj mob raum loj tsis ua haujlwm,
• txoj sia txo neeg txoj sia,
• Ischemic mob plawv,
• Ob leeg (mob hnyav heev ib tog) lub raum leeg ntshav hlab ntsha,
• hyperkalemia
• ua txhaum ntawm dej-electrolyte tshuav,
• txo qis hauv bcc (ntim ntawm cov ntshav ncig),
• cerebrovascular pathology,
• lub raum tsis ua hauj lwm
• mitral lossis aortic stenosis,
• thawj hyperaldosteronism,
• angioedema,
• obstructive hypertrophic cardiomyopathy.

Tsuas tshuaj thiab tswj hwm

Cov neeg mob txom nyem los ntawm kev mob ntshav siab, Losartan tau noj 1 zaug nyob rau ib hnub ntawm 50 mg, cov tshuaj yuav tsum noj tsis hais noj mov, tsis noj thiab tsis haus dej ntau. Thaum tsis muaj kev cia siab ua kom zoo li tau txais txiaj ntsig, qhov tshuaj rau txhua hnub tau tso cai kom nce siab txog 100 mg. Qhov siab tshaj qhov ua rau siab ntawm cov tshuaj tshwm sim tom qab 3-6 lub lis piam los ntawm kev pib siv. Cov neeg uas txo qis cov ntshav ncig ntshav tau pom zoo kom noj 25 mg ib hnub twg.

Nrog raum tsis ua hauj lwm thiab rau cov neeg laus, noj tshuaj txhua hnub rau cov tshuaj tsis kho. Cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev tau pom tias noj Losartan hauv thawj 12,5 mg. Yuav kom ua tiav cov phiaj tshuaj ntau npaum li cas (50 mg), yuav tsum maj mam nce ntxiv nyob rau ncua sij hawm 2-3 lub lis piam.

Thaum lub cev ua haujlwm tsis zoo, kev txo qis hauv cov tshuaj txhua hnub yuav tsum ua.

Yeeb tshuaj sib cuam tshuam

Cov tshuaj tsis cuam tshuam nrog warfarin, erythromycin, phenobarbital, cimetidine, digoxin.

Nrog rau kev siv ua ke nrog fluconazole lossis rifampicin hauv ntshav, ib qho kev txo qis hauv theem ntawm cov khoom noj nquag tau teev tseg. Losartan muaj peev xwm txhim kho qhov kev txiav txim ntawm diuretics, IAAF thiab adrenergic blockers.

Thaum siv ua ke nrog cov tshuaj potassium-sparing diuretics lossis nrog cov tshuaj poov tshuaj npaj, hyperkalemia yuav tshwm sim (kuaj kev kuaj xyuas qib ntawm cov poov tshuaj hauv cov ntshav yog tsim nyog).

Cov tshuaj nonsteroidal anti-inflammatory (nrog rau xaiv CO2 inhibitors) txo cov nyhuv hypotensive ntawm Losartan.

Sab sij huam

• kiv tob hau, mob taub hau,
• tsis muaj zog
• insomnia
• txos cov ntshav siab
• mob ntsws hypotension tsos mob,
• tachycardia
• mob taub hau
• myalgia
• dyspepsia, xeev siab, mob plab,
• cov tsos mob ntawm tus mob ua pa
• kab mob siab thiab lwm daim siab ua rau lub siab ua haujlwm tsis zoo,
• hnoos qeev qhuav,
• eosinophilia, thrombocytopenia, anemia,
• hyperkalemia
• kev ua kom muaj zog ntawm creatinine, urea, cov pa nitrogen ntau,
• kev ua xua ntawm daim tawv nqaij
• angioedema,
• anaphylaxis,
• aggravation ntawm gout,
• taub ntswg.

Cov lus qhia tshwj xeeb

Hauv cov neeg mob uas tsis muaj cov ntshav ntau dhau los (ib qho kev tshwm sim ib ntus ntawm kev siv tshuaj kho mob ntshav qab zib ntau), losartan tuaj yeem ua rau muaj kev puas siab puas ntsws ntawm txoj hlab ntshav siab. Yog li, ua ntej pib kho nrog cov tshuaj no, nws yog ib qho tsim nyog yuav tsum tau tshem tawm cov kev ua txhaum uas twb muaj lawm, lossis siv cov tshuaj hauv cov tshuaj me me.

Cov neeg mob uas tau mob los ntawm kev mob ntshav siab (daim siab me los sis mob hnyav) tom qab siv tus neeg sawv cev siab, qhov siab ntawm cov tshuaj tiv thaiv thiab nws cov metabolite nquag muaj ntau dua li cov neeg noj qab haus huv. Hauv qhov no, hauv qhov xwm txheej no, kuj nyob rau hauv cov txheej txheem ntawm kev kho, txo cov koob tshuaj yuav tsum tau ua.

Thaum lub cev tsis zoo ua haujlwm, kev loj hlob ntawm hyperkalemia (nce poov tshuaj concentration hauv cov ntshav) tau. Yog li no, thaum tab tom kho cov kab mob, nws yuav tsum tau saib xyuas kom tsawg ntawm cov qib microelement no.

Nrog rau kev tswj hwm ua ke ntawm cov tshuaj uas cuam tshuam rau renin-angiotensin system nyob rau hauv cov neeg mob raum mob raum (ib leeg lossis ob sab), cov ntshav creatinine thiab urea tuaj yeem nce ntxiv. Tom qab kev txiav tawm ntawm cov tshuaj, tus mob feem ntau normalizes. Hauv qhov xwm txheej no, nws tseem yog qhov yuav tsum tau ua hauv kev soj ntsuam tas mus li ntawm cov theem ntawm cov kab mob biochemical ntawm kev ua haujlwm ntawm lub raum glomerular.

Cov ntaub ntawv hais txog kev cuam tshuam ntawm Losartan txog kev muaj peev xwm tsav tsheb los yog ua haujlwm uas xav tau qhov kev xav ntau ntxiv thiab ceev ntawm cov kev xav psychomotor tsis tau txheeb xyuas qhov tseeb.

Dab tsi yog losartan

INN (npe thoob ntiaj teb nonproprietary) - Losartan. Hauv qhov radar, tshuaj teev npe tshuaj, Losartan tau muab cais ua cov tshuaj lag luam tshuaj ntawm angiotensin 2 tshuaj thaiv cov yeeb yam nrog hypotensive nyhuv. Tom qab kev tswj hwm, cov nyhuv mob tsawv rau ib hnub, yog li cov tshuaj Lozartan thiab nws cov analogues tau raug lees paub los ntawm cov kws kho mob ua ib qho ntawm cov txiaj ntsig zoo tshaj plaws.

Cov tshuaj muaj cov khoom siv theem pib thiab ntu sib txuam. Cov tshuaj nquag ntawm cov tshuaj, uas pab ua kom paub tseeb tias muaj txiaj ntsig zoo los ntawm daim ntawv thov, yog Losartanum potassium, cov lus sib piv rau losartan potassium. Cov khoom sib ntxiv uas pabcuam los txuas cov tshuaj nquag muaj xws li:

• lactose monohydrate,
• magnesium stearate,
• povidone
• colloidal silicon dioxide,
• microcrystalline cellulose,
• croscarmellose sodium.

Mechanism ntawm kev ua

Lub tshuab ua haujlwm ntawm kev ua haujlwm yog ua raws li kev thaiv ntawm angiotensin 2 receptors cov khoom ua si nruab nrab ua rau lub hwj chim ntawm cov hlab ntsha, txhawb nqa kev ua haujlwm ntawm lub plawv cov leeg. Cov qog adrenal pib ua cov tshuaj hormone aldosterone, txo cov ntshav siab. Tsis tas li ntawd, losartan ua lub diuretic, pab txhim kho kev nthuav tawm ntawm dej hauv lub cev.

Uric acid thiab cov ntsev ntsev yuav tawm nrog zis, thiab cov ntsev ntsev ntawm ntsev uas tsim nyog rau kev ua haujlwm ntawm lub siab tsis tu ncua. Tom qab cov ntsiav tshuaj nkag mus rau sab hauv, cov tshuaj nquag losartan poov tshuaj yog yaj thiab nqus los ntawm txoj hnyuv. Bioavailability yog li ntawm 33%. Qhov kev txaus siab hauv cov ntshav tau mus txog tom qab 1-1.5 teev. Qhov tawg ntawm cov tshuaj tshwm sim hauv lub siab, raug tawm hauv txoj hnyuv.

Kev ntsuas rau siv

Cov tshuaj yog rau cov pab pawg ntawm cov tshuaj uas tsis tuaj yeem siv tsis tau kev pab los ntawm kws kho mob. Tus kws kho mob tshwj xeeb yuav pab koj xaiv cov tshuaj zoo, tham txog lub ntsiab contraindications thiab muaj kev phiv tshuaj. Txhawm rau txiav txim siab seb koj puas xav ntsib tus kws kho mob, koj yuav tsum ntsuas qhov ntsuas lub siab thiab tsom mus rau koj lub siab.

Yog tias qhov ntsuas kub tonomet tshaj 140 los ntawm 90, thiab ib tus neeg hnov ​​lub plawv dhia ceev, tsis muaj zog, mob taub hau hauv 5-6 hnub, koj yuav tsum tau mus rau kws kho mob lub chaw ua haujlwm thiab xaiv cov tshuaj kho mob ntshav siab. Cov cim tseem ceeb rau kev siv yog:

• thawj theem ntawm kev kub siab,
• mob plawv mob plawv
• ntshav qab zib hom 2 uas muaj proteinuria (los tiv thaiv ob lub raum),
• mob plawv tsis ua hauj lwm.

Kev siv cov tshuaj tsis tu ncua tuaj yeem txo qis kev pheej hmoo ntawm kev mob plawv mob ntsig txog thiab kev tuag ntawm cov neeg mob. Tsis tas li ntawd, losartan yog siv los tiv thaiv cov hlab ntsha tawg thiab myocardial infarction hauv cov neeg mob sab laug ventricular hypertrophy thiab ruaj khov ntshav siab. Nrog kev pabcuam ntawm cov khoom siv no, kev npaj tau ua rau kev hloov pauv thiab hemodialysis ntawm lub raum. Kev teem sijhawm rau kev kho mob ntawm lub plawv tsis ua haujlwm tshwm sim tom qab lwm cov tshuaj tiv thaiv tau ua tsis muaj txiaj ntsig.

Cov lus qhia ntawm losartan

Qhov ntau npaum li cas thiab kev siv sijhawm ntev npaum li cas rau kev tswj hwm yog xam los ntawm tus kws kho mob raws li cov lus qhia. Cov hau kev ntxiv rau kev txiav txim siab kho cov neeg mob yog nug tus neeg mob, tshuaj xyuas cov ntaub ntawv kho mob uas qhia pom tias muaj mob ntev. Raws li cov lus piav qhia, yog tias losartan tau tsim tawm rau thawj zaug, koj yuav tsum tau txhaj tshuaj ib nrab kom pom tias muaj kev fab tshuaj rau cov tshuaj no. Rau txhua tus kab mob, nws muaj qhov sib txawv tshuaj noj.

Arterial kub siab

Thaum sau ntawv rau Losartan txog kev kho mob ntshav siab raws li cov lus qhia, nws pom zoo kom haus cov ntsiav tshuaj yam tsis yog kev zom, sau tsis hais siv. Nyob rau lub sijhawm kho, koj yuav tsum tau saib xyuas qhov muaj zog ntawm tus kab mob uas siv cov kev ntsuas txhua hnub. Nyob ntawm seb muaj mob hnyav npaum li cas, cov neeg mob tau hais kom noj 50 mg rau ib hnub. Ntawm kev txiav txim siab ntawm tus kws kho mob, qhov tshuaj yuav raug nce mus rau qhov yuav tsum tau ntau tshaj plaws txhua hnub ntawm 100 mg.

Mob plawv nres

Txhawm rau txo qis kev pheej hmoo ntawm cov teeb meem los ntawm lub plawv tsis ua hauj lwm, Losartan ntsiav tshuaj tau pib nrog kev noj tsawg kawg yog 12.5 mg / hnub. Txhua lub lis piam, qhov tshuaj txhaj yog ob npaug. Txog kev saib xyuas kev kho mob ntawm lub plawv tsis siv ntau dua 50 mg rau ib hnub. Kev nquag soj ntsuam nrog lub ntsuas ntshav siab yog pom zoo kom tsis txhob muaj ntshav nce siab ntau ntxiv.

Cov tshuaj tiv thaiv zoo ntawm Losartan suav nrog cov tshuaj uas muaj kev cuam tshuam zoo ib yam rau kev noj qab haus huv. Tag nrho cov ntawm lawv muaj cov tshuaj zoo sib xws. Tus thawj Losartan txawv tsuas yog nyob rau hauv cov tsos ntawm pob, daim ntawv tso tawm, ntau npaum thiab chaw tsim tshuaj paus. Hauv qee qhov kev npaj, lwm cov ntu pabcuam siv.

Kev hloov cov tshuaj tau raug muab yog tias cov tshuaj tiv thaiv tsis muaj teeb meem. Txhawm rau txiav txim siab seb hom tshuaj twg zoo tshaj plaws rau kev kub siab, tus kws kho mob tsim nyog yuav tsum. Cov npe ntawm cov siv ntau yam muaj xws li:

• Blocktran
• Lorista
• Lozap Ntxiv,
• Los Tsuas
• Lozarel
• Vasotens,
• Brozaar
• Tubkawm Presartan
• Lakea
• Zisakar
• Losartan Richter,
• Karzartan
• Hypothiazide,
• Losacor
• Lotor
• Vero Losartan
• Losartan Canon.

Nqe rau losartan

Tus nqi ntawm losartan tsawg, nws nyob rau hauv ib qho ntawm cov tshuaj pheej yig tshaj plaws rau kev kub siab. Tus nqi ntawm nws nyob ntawm thaj av uas muag qhov khoom nqa tawm, cov naj npawb ntawm cov ntsiav tshuaj muaj ntim hauv pob. Hauv nroog Moscow thiab St. Petersburg, koj tuaj yeem yuav cov tshuaj pheej yig, tsis yog los ntawm cov chaw muag tshuaj, tab sis kuj hla cov khw hauv online.

Kev Sib Sau thiab daim ntawv ntawm tso tawm

• poov tshuaj losartan,
• magnesium stearate,
• titanium dioxide
• cawv polyvinyl,
• talcum hmoov.

Daim ntawv tso tawm yog nyob rau hauv cov ntsiav tshuaj muaj lub tiaj tus kheej, thiab hauv crystalline hmoov. Lawv muaj cov zas dawb. Tus nqi ntawm cov khoom xyaw nquag rau ib ntsiav tshuaj yog 25, 50, 100 ml.

Pharmacological kev txiav txim, pharmacodynamics

Thaum noj cov tshuaj, ntshav siab pib poob qis zuj zus, vim cov tshuaj no tau sau tseg rau ntau yam mob ntshav siab. ACE inhibitor.

Sai sai nqus los ntawm cov hnyuv. Qhov siab tshaj plaws tshwm sim 6-7 teev tom qab noj tshuaj ntsiav. Kev zam - nrog quav thiab tso zis tsis pauv. Kev siv dag zog ntawm kev siv lub cev ua kom nquag plias muaj li ntawm 65%. Nws khi rau cov protein ntau los ntawm 99%. Txhawm rau kom lub siab tuaj cuag li ib txwm, nws yog ib qhov tsim nyog yuav tau yauv mus rau lub chaw kho - tsawg kawg yog 1-2 hlis.

Losartan yog tsim nyog kho tsis tsuas yog rau kev kub siab, tab sis kuj rau lwm yam kab mob.

Txoj kev ntawm kev thov, pom zoo ntau npaum

Losartan ntsiav tshuaj ntxuav nrog ib qho kua tshuaj me me. Cov hmoov yaj kom yaj hauv dej kom txog thaum muaju hauv nruab yaj yaj. Koj tuaj yeem noj ob qho ua ntej noj mov thiab tom qab. Cov tshuaj noj hauv txhua kis tau tsim tshwj rau txhua tus neeg mob.

Cov lus qhia tau qhia tias pom zoo pes tsawg.

Thawj thawj koob tshuaj, nws raug nquahu kom noj rau hauv ib txoj kev tshuaj ntawm 50 ml. Nws mob tsawv rau tag nrho cov chav kawm ntawm kev kho mob, yog tias qhov xwm txheej ntawm cov neeg mob tsis zoo. Nrog tsis txaus cov tshuaj pharmacological ntawm kev siv tshuaj, qhov ntau npaum ntawm yog muab ob npaug. Yog tias ib qho loj yuav noj lwm cov tshuaj uas ua rau txo cov ntshav siab, qhov koob tshuaj yog txo rau 25 mg.

Cov neeg mob uas muaj lub siab ua mob rau lub siab yog qhov sau tsawg kawg (25 mg). Hauv kev mob plawv tsis ua haujlwm - tsis ntau tshaj 12,5 mg. Kev kho mob nyob rau hauv cov xwm txheej zoo li no yog ua tiav los ntawm kev saib xyuas mob.

Nws yog ib qho tsim nyog yuav tsum tau noj tshuaj ib hnub ib zaug, tib lub sijhawm. Nws yog ib qho tseem ceeb kom ua raws li cov kev muab tshuaj uas koj tus kws kho mob zam kom tsis txhob noj tshuaj ntau dhau thiab muaj kev phiv.

Cov menyuam yaus tsis tau xaj tshuaj. Yog tias qhov xav tau ntawd tshwm sim, qhov kev siv tshuaj tiv thaiv tsawg kawg nkaus yog - 12,5 mg rau ib hnub.

Nkag tau rau lub sijhawm cev xeeb tub thiab pub niam mis

Cov tshuaj yog contraindicated nyob rau hauv cev xeeb tub, tsis hais lub sij hawm. Kev tuaj yeem tuaj yeem ua rau me nyuam hauv plab tuag lossis kev loj hlob pathology. Kev txawv txav tsis zoo hauv kev txhim kho tus me nyuam tuaj yeem ua raws li hauv qab no: kev txhim kho ntawm pob txha, nce siab, lub plawv tsis ua haujlwm.

Nyob rau lub sijhawm lactation, cov tshuaj nquag nkag mus rau hauv tus menyuam lub cev nrog rau niam cov kua mis. Qhov tshwm sim yog kev ua txhaum ntawm txoj hnyuv zom mov, xeev siab, tso quav tsis taus, tsaus muag, thiab lwm yam kev mob siab.

Teeb meem tshwm sim tuaj

• palpitations
• ntuav
• ua xua
• inhibition ntawm lub hauv nruab nrab lub paj hlwb,
• laryngeal edema,
• hloov quav (quav tawv, raws plab),
• daim tawv nqaij ua pob,
• mob plab
• o ntawm cov qog ua kua,
• txo nyob rau hauv nrig txog kev pom tseeb,
• xeev siab
• tsaus muag xeev
• angina pectoris
• hnoos qhuav
• leukopenia
• hypersensitivity rau lub hnub,
• mob taub hau
• tsaug zog
• insomnia
• bronchospasm
• ua xua rhinitis
• ua txhaum ntawm saj
• tab kaum kev cuam tshuam hauv lub hlwb,
• pos hniav los ntshav
• o ntawm lub siab
• txo qis hauv hemoglobin.

Yog muaj qhov tshwm sim tsis zoo, cov tshuaj txuas mus ntxiv. Tus kws kho mob xaiv lwm yam tshuaj ntxiv.

Kev cuam tshuam nrog lwm yam tshuaj

Kev kho mob nyhuv ntawm losartan thaum noj cov tshuaj diuretics pib nce.

Nws yog txwv tsis pub siv ib txhij siv lwm txoj kev, qhov kev ua los ntawm kev ua kom txo qis siab.

Cov tshuaj tsub kom lub txiaj ntsig kho tau zoo ntawm cov tshuaj muaj cov poov tshuaj, uas ua rau muaj kev tsis zoo.

Kev siv yooj yim nrog cov tshuaj tsis-tshuaj steroidal cuam tshuam tsis zoo rau lub raum. Yuav tsum tau kuaj ultrasound.

Yog tias tus neeg mob noj lwm yam tshuaj, yuav tsum tau kev sab laj ntawm kws kho mob.

Cov nqi hauv cov chaw muag tshuaj

Tus nqi nyob ntawm qhov ntim - ntawm 100 txog 500 rubles. Ntim loj yog txaus rau ib chav kawm ntawm txoj kev kho.

• Lozap,
• Alcadil
• Kapoten,
• Lorista
• Normio
• Zisakar
• Golten
• Kab mob khaub thuas
• Hyperium
• Blockordil
• Kaptopres,
• Norton
• Captopril
• Epistron
• Los Tsuas
• Kev siv biosynthesis
• Blockchain.

Kev tshuaj xyuas txog cov tshuaj

Ib cov tshuaj zoo rau txoj kev npaj kho mob ntshav siab hauv cov neeg laus thiab cov neeg hluas .Nws ua rau maj mam thiab khov kho. Nws yog ib qho tsim nyog yuav tsum coj mus rau hauv qhov kev txuam ntawm cov tshuaj, ntawm qhov tod tes, tsis muaj kev tshem tawm ib yam li nrog kev tshem tawm ntawm enalapril. Kev mob siab rau cov neeg mob: tias txoj kev pheej hmoo ntawm lub plawv nres thiab cwj nrag tau txo qis, qhov no zoo heev rau cov neeg mob.

Kuv tsis tau ntsib qhov tsis nkag siab thiab phiv rau hauv kev xyaum.

Losartan yog qhov kev kho mob zoo, kho ntshav siab. Kev pab kom nrawm nrawm rau qhov qub. Ntawm tus nqi, lub cuab yeej muaj peev xwm. Raws li kuv paub, nws tsis ua kev mob tshwm sim. Tus kheej, Kuv tiv nws zoo. Phiv los yeej tsis tau muaj. Tau kawm ib txoj kev pab, yeej tau pab tshem tawm qhov kub siab uas kuv muaj txij li thaum kuv tseem hluas.

Marina Klimenko, Nizhnekamsk (tus neeg mob)

Yeej tsis muaj ntshav siab. Tab sis tsis ntev los no, nws pib tas li nce. Tus kws kho mob tau sau tshuaj kho nrog lozartan ntsiav tshuaj. Tsuas tshuaj - rau ib ntsiav tshuaj tag nrho. Nws tus mob cia zoo dua tom qab ob peb hnub, txawm hais tias ua ntej ntawd, nws lub taub hau yog qhov tsis hnov ​​mob. Siab rov qab los zoo li qub tom qab ib txoj kev kho mob. Zoo ntawm tus nqi pheej yig.

Cov yam ntxwv ntawm Pharmacological

Cov lus qhia ntawm Losartan qhia tau hais tias cov tshuaj tau muab cais ua cov tshuaj tshwj xeeb ntawm angiotensin II receptors. Cov tshuaj losartan, los ntawm uas nws muaj cov nyhuv hypotensive, txo qhov kev tawm tsam dav dav hauv cov hlab ntshav.

Nws koom tes hauv kev txo cov ntshav siab, txo cov qog adrenaline thiab aldosterone hauv cov ntshav, txo cov load ntawm lub plawv mob, thiab tseem nyob rau hauv muab cov nyhuv diuretic. Losartan pab ua kom lub cev muaj zog tsis ua hauj lwm hauv cov neeg mob uas muaj cov cim plawv nres, thiab tseem tuaj yeem tiv thaiv kev txhim kho ntawm myocardial hypertrophy.

Qhia kev kho mob rau siv

Ntawm dab tsi siab yog losartan tshuaj? Cov neeg mob txom nyem los ntawm kev mob ntshav siab, Losartan tau noj 1 zaug nyob rau ib hnub ntawm 50 mg, cov tshuaj yuav tsum noj tsis hais noj mov, tsis noj thiab tsis haus dej ntau. Thaum tsis muaj kev cia siab ua kom zoo li tau txais txiaj ntsig, qhov tshuaj rau txhua hnub tau tso cai kom nce siab txog 100 mg. Qhov siab tshaj qhov ua rau siab ntawm cov tshuaj tshwm sim tom qab 3-6 lub lis piam los ntawm kev pib siv. Cov neeg uas txo qis cov ntshav ncig ntshav tau pom zoo kom noj 25 mg ib hnub twg.

Nrog raum tsis ua hauj lwm thiab rau cov neeg laus, noj tshuaj txhua hnub rau cov tshuaj tsis kho. Cov neeg mob uas muaj lub plawv tsis ua haujlwm ntev tau pom tias noj Losartan hauv thawj 12,5 mg. Yuav kom ua tiav cov phiaj tshuaj ntau npaum li cas (50 mg), yuav tsum maj mam nce ntxiv nyob rau ncua sij hawm 2-3 lub lis piam.

Thaum lub cev ua haujlwm tsis zoo, kev txo qis hauv cov tshuaj txhua hnub yuav tsum ua.

Siv thaum cev xeeb tub thiab lactation

Kev siv cov tshuaj losartan thaum cev xeeb tub yog contraindicated. Nws paub tias cov tshuaj uas cuam tshuam ncaj qha rau renin-angiotensin-aldosterone system (RAAS), thaum siv nyob rau qib 2 thiab qib thib 3 ntawm cev xeeb tub, tuaj yeem ua rau muaj kev txhim kho lossis kev tuag ntawm kev loj hlob hauv lub plab. Yog li, thaum kuaj pom kev xeeb tub, noj cov tshuaj Losartan yuav tsum nres tam sim ntawd.

Nws tsis paub tseeb tias puas yog losartan nrog cov kua mis pub tawm. Nws tsis pom zoo kom noj cov tshuaj losartan thaum lactation. Yog hais tias noj Losartan yog tsim nyog thaum lactation, tom qab ntawd kev pub niam mis yuav tsum tau tsum.

Yuav coj menyuam li cas?

Contraindicated rau cov menyuam yaus thiab cov neeg hluas hnub nyoog qis dua 18 xyoo.

1. Blocktran
2. Brozaar
3. Vasotens,
4. Vero Losartan
5. Zisakar
6. Cardomin Sanovel,
7. Karzartan
8. Cozaar
9. Lakea
10. Lozap,
11. Lozarel
12. Losartan mcleods,
13. Losartan Richter,
14. Losartan teva,
15. Lorista
16. Losacor
17. Lotor
18. Tubkawm Presartan
19. Los Tsuas.

Thaum xaiv cov tshuaj analogues, nws yuav tsum nco ntsoov tias cov lus qhia rau kev siv losartan, tus nqi thiab tshuaj xyuas cov tshuaj ntawm hom no tsis raug. Kev hloov cov tshuaj yog tso cai tsuas yog tom qab kev pom zoo los ntawm kws kho mob.

Cov kev rov xyuas dua tham txog dab tsi?

Yeej, kev tshuaj xyuas txog cov tshuaj no yog qhov zoo, uas tau lees tias muaj txiaj ntsig zoo ntawm kev noj tshuaj. Txawm li cas los xij, tseem muaj tshuaj xyuas, feem ntau yog hais txog Lozartan Richter, qhov twg tib neeg yws txog cov kev mob tshwm sim tsis tshua pom tshwm sim tshwm sim. Nws yuav tsum tau hais tias muaj kev phiv tshuaj tshwm sim tom qab ob peb koob tshuaj ntawm cov tshuaj no.