Mikardis Ntxiv > Kev khomob thiab kev tiv thaiv

Kev piav qhia cuam tshuam rau 24.08.2014

Lub npe Latin: Micardisplus
ATX Code: C09DA07
Yam tshuaj muaj sia: Hydrochlorothiazide + Telmisartan (Hydrochlorothiaz>

Ib ntsiav tshuaj Micardis Plus muaj 40 lossis 80 mg telmisartan thiab 12,5 mg hydrochlorothiazide.

Cov muaj tswv yim: sodium hydroxide, meglumine, povidone, sorbitol, magnesium stearate, lactose monohydrate, hlau oxide xim liab microcrystalline cellulose, sodium carboxymethyl hmoov txhuv nplej siab,pob kws nplej siab.

Pharmacodynamics thiab pharmacokinetics

Cov Tshuaj Hauv Tshuaj

Mikardis Plus yog qhov sib xyaw telmisartan (receptor blocker angiotensin thib ob hom) thiab hydrochlorothiazide (tshuaj kho mob thiazide yam). Kev siv ua ke ntawm cov khoom no ua rau muaj zog dua qub antihypertensive nyhuvdua li siv lawv tus kheej. Kev noj tshuaj ib zaug 1 zaug rau ib hnub yuav ua rau txo qhov ncauj txo qis hauv lub siab.

Telmisartan - xaiv cov tshuaj tiv thaiv blocker angiotensinhom ob. Muaj lub siab zoo rau cov txais khoom angiotensin II AT1 subtypeCov. Nws crowds tawm angiotensin II los ntawm cov kis. Kev khi yog lub sijhawm ntev. Telmisartan tsis thaiv lwm tus receptors (suav nrog AT2 homlub txais) angiotensin. Telmisartankuj txo synthesis aldosterone.

Hauv cov neeg nrog leeg ntshav siab 80 mg telmisartan ib hnub kiag li suppresses zoo angiotensinIICov. Qhov pib ntawm kev tshwm sim tshwm sim peb teev tom qab kev noj haus ntawm cov tshuaj. Qhov kev txiav txim mob tsawv rau ib hnub. Ua Neeg Nyob Tag Lawm antihypertensive nyhuv tsau ib hlis tom qab siv tas telmisartan.

Hydrochlorothiazide yog tshuaj kho mob thiazide yam. Nws cuam tshuam qhov thim rov qab nqus ntawm electrolytes nyob rau hauv cov tubules ntawm ob lub raum, ncaj qha nce ntxiv qhov tsis pom ntawm sodium thiab chlorides. Qhov no ua rau txo qis ntshav hauv cov ntshav ntau, ua haujlwm nce ntxiv reninnce synthesis aldosterone.

Tom qab thov hydrochlorothiazide diuresis nce tom qab ob teev, thiab cov nyhuv siab tshaj plaws tau tiav tom qab plaub teev thiab kav rau 6-12 teev.

Cov Tshuaj Pharmacokinetics

Telmisartan.Sai sai nqus los ntawm cov hnyuv. Qhov siab tshaj plaws telmisartanlos hauv ib teev. Bioavailability yog 50%.

Teb nrog cov ntshav protein - ntau dua 99.5%. Metabolized los ntawm kev sib cuam tshuam nrog glucuronic acidCov. Derivatives telmisartan pharmacologically tsis voos.

Ib nrab-lub neej nyob nrog txog 20 teev. Nws yog tawm nrog cov quav nyob rau hauv nws thawj daim ntawv thiab nrog ob lub raum - txog 2%.

Cov Tshuaj Pharmacokinetics telmisartanhauv cov laus, nws tsis txawv ntawm cov neeg mob uas muaj hnub nyoog yau. Koob xaiv tsis tas yuav.

Hydrochlorothiazide. Tom qab cov thawj coj hauv qhov ncauj hydrochlorothiazide qhov siab tshaj plaws yog tau tiav tom qab 1-2 teev. Bioavailability ncav cuag 60%.

Teb nrog cov ntshav plasma protein - 64%. Nws tsis yog metabolized thiab ua rau ntawm ob lub raum tsis hloov.

Cov Tshuaj Pharmacokinetics

Telmisartan

Thaum noj cov tshuaj hauv, nws nqus tau cov hnyuv mus rau hauv cov ntshav rau ib lub sijhawm luv. Nws yog ib qho tsim nyog yuav tsum qhia meej qhov sib txawv ntawm kev noj tshuaj thiab zaub mov. Yog tias ob qho kev coj ua no ua ke, pab tau qhov zoo ntawm cov tshuaj yog ploj, qhov ua hauj lwm txo qis los ntawm tsib caug feem pua. Concentration mus txog qib uas xav tau peb teev tom qab lub ntsiav tshuaj tau qaug lawm.

Tom qab qee lub sijhawm, cov tshuaj tso tawm kom pom raug tawm los ntawm txoj hnyuv tsis hloov pauv.

Koob tshuaj hloov kho tsis ua raws li lub hnub nyoog ntawm tus neeg mob. Hauv lub cev ntawm tus txiv neej thiab poj niam hauv kev tshawb fawb, kev sib txawv ntawm cov tshuaj yeeb dej caw tau pom, qhov no yuav vam khom rau kev kam ua ntawm cov Cheebtsam thiab qhov ceev ntawm kev nqus.

Hauv cov neeg mob uas lub raum lub raum tsis ua haujlwm, cov tshuaj tau tawm sai dua li ntawm lwm qhov. Tab sis kuj tseem yuav muaj qhov sib txawv ntawm kev kho tshuaj hauv cov kab mob hauv txiv neej thiab poj niam.

Muab ua Mikardis tshuaj feem ntau nyob rau ntawm qhov kev tshawb pom ntawm kev puas tsuaj xws li:

Arterial kub siab,
Lub plawv tsis sib xws cuam tshuam,
Txhawm rau kom txo qis kev mob plawv thiab kev tuag hauv cov neeg mob uas tau hla dhau rau caum xyoo pib.

Cov Yuav Tsum Muaj

Cov tshuaj Mikardis tsis xaiv rau kev kho mob nyob rau hauv xws li mob:

Yog tias tus neeg mob tau kuaj pom tias muaj mob tsis haum rau lub ntsiab lossis ntu ntawm cov tshuaj,
Cev xeeb tub thiab lactation hauv cov poj niam,
Cov neeg mob hnub nyoog qis dua kaum yim
Yog hais tias obstructive bronchitis los yog lwm yam kab mob uas zoo sib xws tau pom,
Nrog lub siab ua haujlwm tsis zoo,
Yog tias tshawb nrhiav fructose tsis kam haus,
Nrog rau aldosteronism thawj.

Nrog ceev faj, Mikardis yog siv rau kev ua txhaum:

Txoj haujlwm ua haujlwm ntawm daim siab
Ob leeg lub raum leeg ntshav hlab ntsha,
Muaj cov poov tshuaj ntau
Sodium tsis muaj peev xwm
Mob plawv nres
Thiab ntau lwm yam cuam tshuam ntawm lub cev ua haujlwm.

Txoj kev ntawm daim ntawv thov

Mikardis ntsiav tshuaj noj ntawm qhov ncauj. Qhov zoo ntawm cov tshuaj ntawm cov tshuaj yog ib ntsiav tshuaj, nrog ib qho siab ntawm 40 mg ib hnub ib zaug. Yog tias qhov no tsis txaus, ntau npaum li cas ntawm cov tshuaj tuaj yeem yog ob npaug, tab sis tsis muaj ntxiv. Nyhuv los ntawm kev kho mob, tej zaum yuav tsis tau tiav tam sim ntawd, yog li tsis txhob maj nce qhov tsuas tshuaj. Ua ntej koj yuav tsum tau tos rau lub sijhawm kho mob, uas yog los ntawm plaub rau yim lub lis piam.

Cov neeg mob uas niaj hnub ua raws li cov txheej txheem mob hemodialysis tsis tas yuav ntau tshaj qhov kev xaiv los ntawm tus kws kho mob nyob hauv ib qho xwm txheej twg.

Hauv cov neeg mob uas muaj lub siab thiab ua rau lub siab tsis haum, qhov kev siv tshuaj txhua hnub tsis pub tshaj 40 mg ib hnub.

Rau cov neeg laus dua, cov tshuaj yuav tsum tsawg tsawg thiaj li tsis ua kom raug mob.

Tso tawm daim ntawv thiab muaj pes tsawg leeg

Mikardis Plus yog tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj - biconvex, oval, ob-txheej:

ntau npaum li 40 / 12.5 mg thiab 80 / 12.5 mg - ib txheej ntawm lub teeb paj yeeb-xim daj, qhov thib ob - xim dawb nrog kev sib xyaw xim liab-beige xim, ntawm lub ntsej muag dawb muaj qhov zoo siab "H4" (40 / 12.5 mg) lossis "H8" (80 / 12.5 mg), thiab lub tuam txhab logo (7 pcs. hauv qhov chaw khuam, hauv pob ntawv qhwv ntawm 2, 4 lossis 8 hlwv),
ntau npaum li 80/25 mg - ib txheej yog dawb, nrog daj tuaj yeem ua tau, daj thib ob yog daj, saum thaj chaw dawb muaj “H9” luam tawm thiab lub tuam txhab logo (7 ib qho hauv cov hlwv ntim, ib pob duab los qhia 1, 2 lossis 4 hlwv).

1 ntsiav tshuaj muaj:

cov tshuaj txuam: telmisartan - 40/80 mg + hydrochlorothiazide - 12.5 mg lossis telmisartan - 80 mg + hydrochlorothiazide - 25 mg,
cov khoom siv ntxiv: povidone, sodium hydroxide, meglumine, magnesium stearate, sorbitol, microcrystalline cellulose, lactose monohydrate, pob kws hmoov nplej, sodium carboxymethyl hmoov txhuv, hlau oxide liab (40 / 12.5 thiab 80 / 12.5), hlau oxide daj ( 80/25).

Telmisartan

Telmisartan yog qhov tshwj xeeb kev thaiv (thaiv) ntawm A-II receptors (AT₁ subtype) ua qauv pom antihypertensive nrog kev siv hauv qhov ncauj. Nws tau ua kom muaj siab rau AT₁ lub subtype ntawm A-II cov txais, los ntawm cov kev ua ntawm qhov kawg yog nqa tawm. Nws tsis siv qhov teeb meem tsis zoo ntawm lub receptor, los ntawm qhov A-II tawm chaw. Cov tshuaj nquag xaiv khi rau AT₁ subtype ntawm A-II receptors, thaum nws tsis muaj kev sib txuam rau AT₂ subtype, thiab zoo li lwm yam angiotensin receptors. Kev ua haujlwm tseem ceeb ntawm cov receptors thiab qhov tshwm sim ntawm lawv qhov kev ua haujlwm ntau dhau los vim muaj kev cuam tshuam ntawm A-II, qib uas nce nrog telmisartan, tsis tau kawm. Cov txiaj ntsig kev ua haujlwm ua rau txo qis ntawm kev ua kom muaj aldosterone hauv cov ntshav, tsis thaiv cov ion ion thiab tsis txwv qhov qib ntawm renin hauv ntshav ntshav. Telmisartan kuj tseem tsis tau inhibit angiotensin-hloov enzyme (ACE) - kininase II, uas rhuav tshem bradykinin, yog li, kev nce qib hauv kev pheej hmoo ntawm qhov tsis xav zam vim yog bradykinin tsis xav.

Hauv kev pom ntawm txoj kev hloov ntshav ntawm txoj hlab ntshav liab, kev siv cov telmisartan hauv ib koob ntawm 80 mg ua rau tag nrho cov kev cuam tshuam cov ntshav siab ntawm A-II. Cov tshuaj tiv thaiv kev kub ntxhov ntawm cov tshuaj tom qab nws thawj qhov ncauj tswj hwm tau manifested li 3 teev. Cov nyhuv ntawm cov tshuaj no kav rau 24 teev thiab tseem ceeb txog li 48 teev. Nws feem ntau ua tiav tau cov lus hais tawm hypotensive nyhuv 28 hnub tom qab pib ua haujlwm, muab tias Mikardis Plus ib txwm tau noj.

Hauv cov neeg mob ntsig txog kev mob ntshav siab, telmisartan txo qis ob qho systolic thiab diastolic ntshav tsis hloov lub plawv (HR). Yog tias nws yuav tsum tau muab tshem tawm sai sai, cov ntshav siab maj mam rov qab rau nws qhov tseem ceeb uas tsis muaj kev phom sij ntawm kev tshem tawm tus mob.

Hauv kev tshawb fawb ntawm telmisartan, mob ntawm lub plawv kev tuag, kev mob ntshav tsis tuag, tsis mob ntshav siab ntau, lossis pw hauv tsev kho mob vim mob plawv tsis ua haujlwm (CHF) tau raug soj ntsuam. Cov neeg mob uas muaj hnub nyoog ntau dua 55 xyoos uas mob stroke, mob hlab ntshav liab, mob hlab ntsha paj paws leeg lossis ntshav qab zib mellitus nrog cov mob ua rau cov leeg ntshav ntawm lub cev tsis ua haujlwm (sab laug ventricular hypertrophy, retinopathy, keeb kwm ntawm macro- lossis microalbuminuria) tau txo qis qis kev mob plawv thiab tuag.

Hydrochlorothiazide

Hydrochlorothiazide yog thiazide diuretic. Cov tshuaj yeeb tshuaj, zoo li lwm tus neeg sawv cev ntawm chav kawm ntawm cov neeg sawv cev tiv thaiv kab mob, cuam tshuam rau kev hloov kho ntawm cov roj ntsha hauv cov hlab ntsha, rov nce ncaj qha rau qhov tsis pom kev ntawm sodium thiab chlorides (kwv yees, hauv cov sib npaug). Qhov tshwm sim ntawm diuretic kev ua si ntawm cov tshuaj yog ib qho kev txo qis ntawm cov ntshav hauv lub cev (BCC), qhov nce ntawm plasma theem ntawm renin nyob rau hauv cov ntshav, nce ntxiv ntawm aldosterone thiab ib qho kev nce ntxiv hauv cov ntsiab lus ntawm cov potassium thiab bicarbonates hauv cov zis, uas ua rau txo qis ntawm cov poov tshuaj hauv ntshav plasma.

Nrog rau kev siv cov tshuaj sib xyaw nrog telmisartan, tejzaum nws vim yog thaiv ntawm cov renin-angiotensin-aldosterone system (RAAS), cov tshuaj potassium poob txuam nrog cov diuretic yog txo qis. Tom qab qhov ncauj tswj hwm ntawm hydrochlorothiazide, cov diuresis ntau zog tau sau tseg tom qab 2 teev, thiab cov nyhuv siab tshaj plaws yog tom qab txog 4 teev. Kev coj ua diuretic ntawm Mikardis Plus yog pom txog kwv yees li 6-12 teev.

Siv sijhawm ntev heev ntawm hydrochlorothiazide txo cov kev pheej hmoo ntawm cov teeb meem ntawm cov hlab plawv thiab lub neej ntawm lawv.

Cov nyhuv antihypertensive ntawm Mikardis Plus, raws li txoj cai, nce mus txog qhov siab 4-8 lub lis piam tom qab pib kho.

Noj ntau dhau

Cov mob ntawm kev noj tshuaj ntau tshaj ntawm Mikardis Plus ntsiav tshuaj tsis hloov kho.

Cov tsos mob ntawm kev noj haus ntau dhau ntawm cov nquag ua haujlwm ntawm cov tshuaj tuaj yeem yog:

telmisartan: bradycardia, tachycardia, cov cim txo rau hauv ntshav siab,
hydrochlorothiazide: hypokalemia, hypochloremia thiab lwm yam kev cuam tshuam ntawm cov dej-electrolyte ntshav tshuav, qhov txo qis hauv BCC, ua rau mob nqaij ntshiv thiab / lossis kev tsim txom cov hlab plawv tsis zoo (arrhythmias vim siv tib lub sijhawm ntawm lub plawv glycosides lossis qee cov tshuaj tiv thaiv kev tsis txaus siab).

Nrog rau kev txhim kho ntawm cov kev tawm tsam no, kev kho mob ntsig txog tshuaj kho mob yog raug kho, telmisartan tsis tshem tawm cov ntshav siv hemodialysis. Hydrochlorothiazide raug ntaws tawm hauv lub cev los ntawm hemodialysis, txawm li cas los xij, cov degree ntawm nws tshem tawm tsis tau tsim. Nws yog ib qho tsim nyog yuav tsum tau soj qab xyuas kom tsawg ntawm cov tshuaj creatinine thiab roj ntsha sib npaug hauv cov ntshav cov ntshav.

Cov lus qhia tshwj xeeb

Qee qhov xwm txheej, ua rau tsis muaj kev cuam tshuam los ntawm RAAS kev ua haujlwm thaum kho nrog tshuaj, feem ntau nrog kev kho mob nrog cov tshuaj uas cuam tshuam rau cov kab mob no, kev ua haujlwm hauv lub raum yog qhov tsis muaj zog (suav nrog kev loj hlob ntawm cov mob raum tsis ua haujlwm). Raws li qhov tshwm sim, kev kho mob nrog los ntawm kev thaiv ob zaug ntawm RAAS (piv txwv li, nrog kev sib xyaw ntawm Mikardis Plus nrog ACE inhibitors lossis aliskiren) yuav tsum tau coj tawm ncaj qha ntawm tus kheej, nrog kev ceev faj los saib xyuas ntawm lub raum muaj nuj nqi (suav nrog saib xyuas theem ntawm cov potassium thiab creatinine hauv cov ntshav).

Hauv cov neeg mob uas muaj mob plawv (CHD) thiab ntshav qab zib mellitus thaum noj cov antagonists ntawm A-II cov neeg txais, muaj kev pheej hmoo siab tuag taus myocardial infarction thiab mob plawv sai sai yog ua tau. Txij li thaum pom muaj mob ntshav qab zib mellitus, mob ntshav siab hauv lub plawv tuaj yeem raug kuaj mob vim tias asymptomatic chav kawm, rau nws txoj kev kuaj pom thiab kho ua ntej kev kho mob, Mikardis Plus xav tau kev kuaj mob tsim nyog (suav nrog kev sim nrog kev ua haujlwm ntawm lub cev).

Hydrochlorothiazide yog sulfonamide derivative thiab tuaj yeem ua rau kev nthuav dav ntawm idiosyncratic cov tshuaj tiv thaiv, ua kom pom tseeb hauv daim ntawv ntawm lub kaum ntse ntse-kaw glaucoma thiab mob hnyav myopia. Cov tsos mob ntawm cov teeb meem no suav nrog qhov mob qhov muag lossis qhov muag pom tsis meej, uas feem ntau tshwm sim txij li ob peb teev mus rau ntau lub lis piam tom qab pib Mikardis Plus. Thaum tsis muaj kev kho, txhim kho mob lub kaum ntse ntse lub qhov muag daj tuaj yeem ua rau tsis pom kev. Rau kev kho mob los ntawm cov tshuaj tiv thaiv no, ua ntej ntawm txhua yam, nws yuav tsum nres tam sim ntawd siv tshuaj hydrochlorothiazide. Yog hais tias lub siab ceev ceev tseem tswj tsis tau, kev kho mob ceev ceev lossis phais mob yuav tsim nyog. Cov teeb meem pheej hmoo ua rau mob lub ntsej muag kaw lub ntsej muag yuav yog keeb kwm kev ua xua rau penicillin lossis sulfonamides.

Hydrochlorothiazide, zoo li lwm yam thiazide diuretics, tuaj yeem ua rau cuam tshuam hauv dej-electrolyte tshuav thiab cov kua qaub-xeev lub xeev (hyponatremia, hypokalemia, thiab hypochloremic alkalosis). Cov cim ntawm qhov kev cuam tshuam no suav nrog kev nqhis dej, lub qhov ncauj qhuav, dav dav tsis muaj zog, ntxhov siab, nkees nkees, mob leeg tsis muaj zog, leeg nqaij lossis tawv nqaij txhaws txhaws txhaws qa ntawm cov leeg plab (pob txha), cim tau poob qis hauv ntshav siab, xeev siab, ntuav, tachycardia, oliguria.

Qhov kev hem thawj ntawm hypokalemia nce ntxiv nyob rau hauv cov neeg mob uas muaj lub siab ua rau lub siab, tawm tsam keeb kwm yav dhau los ntawm cov diuresis ntau ntxiv, nrog rau kev noj zaub mov ntsev tsis muaj txiaj ntsig thiab nyob rau hauv kev sib xyaw ntawm Mikardis Plus nrog gluco- thiab mineralocorticosteroids lossis corticotropin.

Txawm hais tias tsis muaj qhov tseem ceeb hauv tsev kho mob raug sau tseg hauv kev kho mob Mikardis Plus, nws yuav tsum tau yug los rau hauv lub siab tias qhov kev pheej hmoo rau nws tshwm sim muaj xws li mob ntshav qab zib mellitus, lub plawv thiab / lossis lub raum tsis ua haujlwm.

Cov ntaub ntawv lees paub lub peev xwm ntawm Mikardis Plus los txo qis lossis tiv thaiv kev txhim kho hyponatremia los ntawm kev nqus ntawm diuretics tsis muaj. Hypochloremia tau sau tseg, raws li txoj cai, tsis tseem ceeb thiab tsis xav tau kev kho mob.

Thiazide diuretics ua rau muaj qhov muaj feem yuav txo qis calcium ntau ntxiv los ntawm lub raum thiab qhov tshwm sim ntawm kev hloov pauv thiab nce me ntsis hauv cov calcium ntau ntau. Kev tsim tawm ntawm kev mob hypercalcemia ntau heev tuaj yeem yog cov tsos mob ntawm tus mob latent hyperparathyroidism. Yog tias kev ntsuas ntawm parathyroid muaj nuj nqi yog yuav tsum tau ua, thiazide diuretics yuav tsum tau txiav tawm.

Qhov kev txiav txim ntawm Mikardis Plus tsis muaj txiaj ntsig zoo hauv cov neeg mob ntawm cov haiv neeg Negroid.

Sab sij huam

Los ntawm txoj kev ua pa: ua pa luv, hawb pob mob siab.
Los ntawm cov kab mob ntshav: tachycardia, arrhythmias, bradycardia, lub zog poob qis hauv kev siab.
Los ntawm lub paj hlwb: tsaus muag, paresthesiakiv taub hau insomniantxhov siab kev nyuaj siabtxob taus, mob taub hau.
Los ntawm lub plab zom mov: flatulence, raws plab,lub qhov ncauj qhuav, mob plab, cem quavmob ncauj plab, hypercholesterolemia, hyperglycemia, pancreatitis,dajntoo dyspepsia.
Ntawm ib feem ntawm daim tawv nqaij: tawm hws.
Los ntawm cov leeg ua haujlwm: pob leeg mob, arthralgia, myalgia, arthrosismob hauv siab.
Los ntawm cov kab ke hemopoietic: leukopenia, eosinophilia, anemia, neutropenia, thrombocytopenia, thrombocytopenia.
Los ntawm cov genitourinary kheej: lub raum tsis ua haujlwm, nephritis, glucosuria.
Ntawm ob lub qhov muag: pom kev tsis taus, glaucoma, xanthopsia, mob myopia.
Cov kab mob: sepsismob ua pa (pharyngitis, mob ntsws, mob ntsws), o cov mob ua kua qaub ncaug.
Kev ntshaib plab metabolic: nce ntxiv creatinine, nplooj siab enzymes, creatine phosphokinase, uric acid hauv cov ntshav hypertriglyceridemia, hyperkalemia, hypokalemia, hypoglycemia, hyponatremia, poob hemoglobin.
Kev ua xua tsis haum: tawv nqaij khaus, angioedemaua pob erythema, anaphylactic kev tsis haum, eczema, systemic vasculitis, necrotic vasculitis.

Kev sib txuam

Thaum sib qhia telmisartan nrog:

lwm cov tshuaj antihypertensive - kev ua kom muaj zog yog tau antihypertensive nyhuv,
tshuaj lithium - cov lus qhia nyob ib ntus yog ua tau lithium hauv cov ntshav
nonsteroidal tshuaj tiv thaiv - tuaj yeem tshwm sim mob raum tsis ua haujlwm nyob rau hauv cov neeg mob uas txo qis ntshav ncig,
digoxin - tau nce nyob rau hauv concentration digoxin hauv cov ntshav 20%.

Nrog rau kev siv txhij hydrochlorothiazide nrog:

barbiturates, ethanol lossis opioid painkillers - kev txhim kho yog ua tau orthostatic hypotension,
Metformin - kev tsim kho ua tau lactic acidosis,
cov kab mob hypoglycemicthiab tshuaj insulin - koob tshuaj yuav tau kho cov tshuaj hypoglycemic,
cholestyramine thiab colestipol- kev txwv tsis pub nqus yog ua tau hydrochlorothiazide,
tsis-depolarizing nqaij relaxants - nws yog qhov ua tau los txhim kho lawv cov txiaj ntsig,
mob glycosides - kev tsim kho ua tau hypokalemialossis hypomagnesemia,
anti-gout cov neeg sawv cev - tau cov ntsiab lus nce ntxiv uric acid hauv cov ntshav.
calcium npaj- tau nce nyob rau hauv concentration calcium nyob rau hauv cov ntshav vim inhibition ntawm nws excretion los ntawm ob lub raum.
amantadine- ib qho kev nce hauv qhov kev pheej hmoo ntawm kev tsim pliaj pliaj muaj peev xwm ua tau amantadine,
m-anticholinergic blockers(atropine, tus npau suav) - ua tau kom tsis muaj zog ntawm txoj hnyuv, ua kom lub cev muaj zog tuaj thiazide diuretics,
nonsteroidal tshuaj tiv thaiv - muaj peev xwm ua kom tsis muaj zog tshuaj kho mob thiab antihypertensive nyhuv.

1. Cov lus qhia rau kev txais neeg kawm

Hauv tsab xov xwm koj tuaj yeem nrhiav cov ntaub ntawv ntawm qhov ntsuas, txoj kev tswj hwm lossis tsim nyog siv tshuaj (yog tias xav tau, yuav ua li cas nws yuav tsum tau xam), muaj pes tsawg leeg, daim ntawv uas cov tshuaj no tuaj yeem tsim, sib txuas ntawm cov tshuaj no nrog lwm cov tshuaj, tej yam kev mob uas tsis tsim nyog. noj cov tshuaj, cov nqi ntau, sib piv, nrog rau kev tshuaj xyuas ntawm cov neeg mob noj cov tshuaj no.

Tsis tas li, ntawm no koj tuaj yeem nrhiav pom cov ntaub ntawv ntawm yuav ua li cas yog tias koj cia li muaj tus haus dej sai sai. Tag nrho cov ntaub ntawv no yuav tsum tau ua tib zoo kawm thiaj li tsis raug lub ntsej muag tsis zoo.

Sab sij huam

Thaum kho nrog Mikardis, xws li dag zog cuam tshuam:

Cov kab mob hauv nruab nrab - kev nyuaj siab, vertigo, ntxhov siab, insomnia, tsaus muag,
Kev kis mob - cystitis, mob hlab pas sab saud, sepsis,
Cov kab mob ntshav - mob thrombocytopenia, ntshav liab, lub qog hem kom ntshav txo qis,
Lub zeem muag - qhov muag plooj ntawm cov duab lossis lwm yam kev tsis txaus siab yuav tshwm sim,
Lub plab zom mov - qhov ncauj qhuav, mob plab, ntuav, xeev siab.
Cov leeg thiab pob txha - mob nraub qaum, mob myalgia, mob hnyav hauv cov leeg thiab pob qij txha, mob hlwb,
Thiab lwm yam kev rov tshwm sim tuaj yeem tshwm sim, piv txwv li, qhov tsis muaj zog dav dav, tsaug zog, lossis mob hauv qee qhov ntawm lub cev.

Sib xyaw nrog lwm yam tshuaj

Cov tshuaj nquag ntawm cov tshuaj Mikardis tuaj yeem nce cov nyhuv ntawm lwm yam tshuaj, uas ua rau txo qis ntshav siab.

Thiab tseem qhov kev txiav txim siab ntawm digoxin hauv lub cev nce ntxiv, qhov txiaj ntsig ntawm qhov nws yog qhov yuav tsum tau soj ntsuam cov kev ntsuam xyuas tas li.

nrog lub sijhawm ntev ntawm kev siv cov tshuaj Mikardis, kev tiv thaiv tus nqi yuav hloov vasoconstrictor tshuaj, thiab kuj hloov pauv ntawm kev coj ntawm cov hlab ntsha hauv lub cev.

Cia rau cov neeg mob

Cov tshuaj yuav tsum muab khaws cia kom deb ntawm cov menyuam yaus. Koj tuaj yeem muaj nws nyob hauv ib chav uas qhov ntsuas kub tsis tshaj li peb caug degrees ntawm cua sov. Cov ntsiav tshuaj, yog tias tsis tawg, lawv tus kheej ntim tau khaws cia li peb xyoos, tom qab siv tsis pom zoo.

Txawm nyob rau theem ntawm kev xaiv cov tshuaj, Kuv tau hais tias Mikardis muaj kev ua kom nquag plias. Kuv txiav txim siab sim nws ntawm kuv tus kheej, tshwj xeeb tshaj yog vim cov pov thawj tseem ceeb. Siv tshuaj ntsiav tshuaj, tus kws kho mob tau hais rau ob peb lub lis piam kom ua tiav cov txiaj ntsig. Thiab cov kev kho mob tau pib. Tau kawg tus nqi tau siab rau kuv, tab sis kuv txiav txim siab tias cov analogs yuav tsis muaj txiaj ntsig zoo li Mikardis nws tus kheej thiab haus cov thawj. Hauv ib lub lis piam, kuv hnov zoo dua. Ua tsaug rau cov kws kho mob thiab Mikardis.

Thaum kuv niam mob, peb sim siv tshuaj ntau, sim ua kom nws tus mob zoo, tab sis lawv tsis pab ntev. Tom qab sab laj nrog tus kws kho mob hauv tsev kho mob, peb txiav txim siab los sim qhov pheej yig cov tshuaj ntawm Mikardis. Kuj ceeb tias, qhov yeeb tshuaj pib ua haujlwm nquag yuav luag tam sim ntawd. Kuv nyiam qhov tseeb tias tus nqi tau zoo thiab cov muaj pes tsawg leeg ntawm cov tshuaj yeeb dej caw sib txuam tag peb cov kev taw qhia. Ua tsaug rau txhua tus neeg uas tau pab peb xaiv yam tshuaj no.

Tus kws kho mob tau hais kom kuv noj cov tshuaj Mikardis ntxiv rau. Tom qab nyeem ntau cov kev tshuaj xyuas txog nws cov kev mob tshwm sim rau lub cev, Kuv txiav txim siab sim analogues. Lawv zoo li kuv ua tsawg ua rau kuv lub cev tsis muaj zog txaus. Tab sis tom qab qee lub sijhawm, qhov ua kom zoo rau kev kho mob yog qhov tsawg heev thiab nws tau txiav txim siab los siv cov tshuaj uas muaj npe micardis. Nws tau ua zoo dua.

Kev sib xyaw thiab cov tshuaj pharmacological zoo

Qhov tseem ceeb tshuaj ntxiv ntawm cov tshuaj yog telmisartan. Ib ntsiav tshuaj ntawm cov khoom siv no muaj 80, 40, thiab 20 milligrams. Tshwj xeeb ntawm cov tshuaj uas txhim kho kev nqus ntawm cov tshuaj tivthaiv tseem ceeb yog: meglumine, sodium hydroxide, polyvidone, sorbitol thiab magnesium stearate. Cov tshuaj no, ntxiv rau telmisartan, muaj ib qho ntxiv 12,5 milligrams ntawm hydrochlorothiazide - cov tshuaj uas yog cov diuretic. Kev sib xyaw ntawm diuretics thiab angiotensin antagonists ua rau nws ua tau kom ua tiav ntau dua hypotensive los. Cov nyhuv tshuaj diuretic tshwm sim kwv yees li ob teev tom qab noj tshuaj.

Mikardis Plus yog lub cev thaiv kev ntawm cov receptors rau cov tshuaj hormones angiotensin. Qhov cov tshuaj no nce lub suab nrov ntawm cov hlab ntsa, uas ua rau txo qis hauv kev tshem tawm ntawm cov hlab ntsha. Telmisartan zoo tib yam hauv cov qauv siv tshuaj rau lub subspecies ntawm angiotensin receptors.

Tom qab nkag mus rau hauv lub cev, cov tshuaj no tsim txoj kev sib koom tes nrog cov receptors, uas ua rau lub sijhawm hloov chaw ntawm angiotensin, yog li tshem tawm cov laj thawj tseem ceeb rau kev nce hauv cov ntshav siab. Telmisartan ua rau txo qis systolic thiab, ntxiv rau, diastolic siab, tab sis cov tshuaj no tsis hloov nws lub zog hauv txhua txoj kev nrog tus naj npawb ntawm qhov mob tawm ntawm cov leeg mob plawv. Phau Ntawv Mikardis Plus qhia dab tsi rau peb?

Qhov kev siv thawj zaug ntawm cov tshuaj ua rau maj mam hloov khov kho ntawm lub siab: nws maj mam txo qis dhau ob peb teev. Antihypertensive nyhuv tom qab noj cov ntsiav tshuaj yog pom tsawg kawg ib hnub. Yog li, txhawm rau kom lub siab ua haujlwm thiab tswj tau, nws yuav tsum haus cov tshuaj tsuas yog ib hnub ib zaug. Qhov siab tshaj plaws, thiab tib lub sijhawm, kev txo qis hauv lub siab tshwm sim ib hlis tom qab los ntawm kev pib kho nrog cov tshuaj uas nthuav tawm. Hauv qhov xwm txheej uas cov tshuaj tshem tawm sai sai, cov txiaj ntsig ntawm kev tshem tawm tsis tshwm sim, uas yog, lub siab rov qab rau qhov ntsuas qub tsis dhau los, tab sis, raws li txoj cai, qhov no tshwm sim hauv ob peb lub lis piam.

Tag nrho cov khoom siv ntawm Mikardis Plus, thaum muab cov lus tawm los ntawm txoj hnyuv, muaj qhov cuam tshuam sai heev, qhov kev nyab xeeb ntawm cov tshuaj tau nce mus txog yuav luag tsib caug feem pua. Qhov siab tshaj plaws ntawm cov nquag tivthaiv hauv cov ntshav tau txiav txim siab tom qab peb teev. Txheej txheem metabolization tshwm sim los ntawm cov tshuaj tiv thaiv ntawm telmisartan nrog glucuronic acid. Cov khoom noj rau lub cev muaj ntau yam ua haujlwm tsis muaj zog. Ib nrab-lub neej ntawm cov tshuaj no yog ntau tshaj nees nkaum teev. Cov tshuaj tiav tas nyob hauv cov quav. Raws li rau cov zis, tsawg dua ob feem pua ntawm cov tshuaj tau tawm nrog nws.

Cov tshuaj ntsiav Mikardis Plus muaj nyob rau hauv peb qho qauv: 80, 40 thiab 20 milligrams ntawm telmisartan. Tsis hais tus nqi ntawm cov khoom xyaw nquag, txhua cov ntsiav tshuaj muaj lub ntsej muag zoo nkauj thiab cov xim dawb. Lub engraving ntawm lub tuam txhab yog luam tawm ntawm ib sab ntawm cov ntsiav tshuaj. 40 milligram ntsiav tshuaj kuj muaj 51N embossed. Cov uas yog 80 milligrams txhua tus muaj engraved nrog tus nqi 52N. Hauv ib pob muaj los ntawm ob txog rau yim lub hlwv, txhua ntawm muaj xya lub tshuaj.

Thaum twg koj yuav tsum siv cov tshuaj?

Raws li cov lus qhia, Mikardis Plus (80 + 12, 5 mg) tau tsim rau kev kho mob ntshav siab. Qee tus kws kho mob tau sau ntawv rau cov tshuaj no rau cov neeg mob uas muaj hnub nyoog tsib caug tsib xyoos uas pom tau tias muaj kev pheej hmoo ntawm cov kab mob hlab plawv ntau dua uas cuam tshuam nrog kev mob ntshav siab. Nws tsim nyog sau cia tias cov tshuaj tau sau tseg rau hauv rooj plaub thaum nws tsis tuaj yeem ua tiav qhov kev txiav txim siab tseev kom txo qis thaum noj cov tshuaj ib txwm siv.

Nws tsis pom zoo kom sau ntawv rau cov tshuaj no rau koj tus kheej thiab xaiv nws cov ntau npaum li cas, vim tias tsuas yog tus kws kho mob tuaj yeem nrhiav pom qhov twg contraindications los ntawm kev ntsuas tus neeg mob txoj kev ntsuam xyuas kom raug. Qhov ntxim nyiam ntawm cov kev mob tshwm sim kuj yog nyob ntawm seb xaiv cov kev kho kom raug yog li cas.

Thaum twg yog cov tshuaj xav txiav txim siab contraindicated?

Kev kho mob nrog cov tshuaj yuav tsum tsis txhob nqa ua qee yam hauv qab no:

Nyob rau hauv qhov xwm txheej uas muaj qhov tsis haum rau cov khoom tseem ceeb lossis ntxiv ntawm cov khoom lag luam tshuaj no.
Cov tshuaj no tsis tsim nyog rau cov poj niam uas nyob hauv txoj hauj lwm, tab sis, ib qho ntxiv, yog kev pub mis niam.
Cov tshuaj tsis haum txawm tias thaum cov neeg mob muaj cov mob plab biliary pathologies uas cuam tshuam lawv tag nrho patency.
Nyob rau hauv muaj qhov cuam tshuam loj heev nyob rau hauv kev ua haujlwm ntawm lub raum thiab mob siab.
Nyob rau hauv qhov xwm txheej uas muaj kev coj ua fructose intolerance.

Kev ntsuas yuav tsum tau xaiv hauv kev kho mob ntshav siab hauv menyuam yaus lossis tub ntxhais hluas. Qhov no feem ntau yog vim qhov tseeb tias cov nyhuv ntawm telmisartan ntawm ib yam muaj sia uas tseem tsis tau tshwm sim los tseem tsis tau tsim. Cov lus qhia rau kev siv nrog Mikardis Plus qhia tau hais tias, ntxiv rau txhua qhov kev tiv thaiv sab saum toj no, nws tsis tuaj yeem raug kho rau cov neeg mob kev txom nyem los ntawm refractory hypercalcemia, thiab tsis tas li ntawd, nws tsis haum rau hypokalemia, deficiency vim tsis nkag rau galactose thiab lactose.

Cov tshuaj tiv thaiv sib deev kuj tseem muab rau cov tshuaj Mikardis Plus (80 mg). Piv txwv, cov kws kho mob yuav tsum tau ceev faj tshwj xeeb thiab sau ntawv kho mob qis rau hauv qhov xwm txheej ntawm cov neeg mob ntshav siab muaj cov kab mob hauv qab no:

Kev tsim kho ntawm hyponatremia lossis hyperkalemia.
Lub xub ntiag ntawm cov hlab plawv ischemia hauv cov neeg mob.
Kev tsim kho ntawm ntau cov kab mob hauv lub plawv, piv txwv li, hauv daim ntawv ntawm kev muaj mob tsis txaus, valve stenosis lossis cardiomyopathy.
Cov tsos ntawm stenosis ntawm ob txoj hlab ntsha ntawm ob lub raum. Hauv cov xwm txheej uas tus neeg mob tsuas muaj ib lub raum, yuav tsum tau saib xyuas tshwj xeeb thaum tswj hwm cov tshuaj thaum muaj stenosis ntawm cov leeg nkaus xwb uas ua haujlwm ntawm cov ntshav.
Kev tsim kho lub cev qhuav dej, uas yog tshwm sim los ntawm cov kab mob nrog nrog ntuav lossis raws plab.
Cov tshuaj kho mob yav dhau los.
Rov qab cov neeg mob tom qab hloov raum.

Ntxiv rau cov kab mob saum toj no, nrog rau kev teem caij Mikardis Plus, ib qho kuj yuav tsum tau ceev faj tshwj xeeb yog tias cov neeg mob ntshav qab zib thiab gout.

Tej zaum cov kev mob tshwm sim thaum tswj hwm

Kev txheeb xyuas txog "Mikardis Plus" tsis yog qhov ib txwm txawv los ntawm qhov kev ntsuas zoo. Qee tus neeg mob qhia txog qhov tshwm sim ntawm ntau yam tsis txawv txav hauv lawv lub neej. Nws yuav tsum tau hais meej tam sim ntawd tias kev txhim kho ntawm qhov tsis xav tau ncaj qha ncaj qha nyob ntawm qhov ntau npaum ntawm cov tshuaj, thiab, ntxiv rau, nyob rau lub hnub nyoog ntawm cov neeg mob thiab muaj cov concomitant pathologies. Yog li, feem ntau nws tuaj yeem soj ntsuam cov kev hloov hauv qab no thaum noj cov tshuaj no:

Cov tsos ntawm cov sij hawm kiv taub hau, mob taub hau, qaug zog thiab ntxhov siab nrog rau lub xeev kev nyuaj siab, pw tsaug zog, thiab, feem ntau tsis tshua muaj mob, mob tawm hauv tsev tsis suav nrog.
Ib qho kev nce ntxiv ntawm kev raug txais txiaj ntsig los ntawm cov kab mob ua pa mus rau cov kis kab mob, uas ua rau ua qhov tseem ceeb ntawm pharyngitis, sinusitis, mob ntsws, mob ntsws paroxysmal hnoos thiab lwm yam.
Cov tsos ntawm dyspeptic cuam tshuam nyob rau hauv daim ntawv ntawm xeev siab, colic, thiab, ntxiv rau, raws plab. Hauv qee tus neeg mob, kev kuaj mob kuj tseem tuaj yeem ua rau nce hepatic enzyme.
Cov tsos ntawm hypotension - mob hauv siab hauv siab. Tsis tas li ntawd, kev txhim kho tachycardia lossis, hloov chaw, bradycardia tsis raug cais.
Qhov tshwm sim ntawm cov leeg mob thiab mob pob txha. Cov tsos ntawm kev mob hauv thaj av lumbar.
Kev tsim kho ntawm cov mob txhab txhab ntxiv rau ntawm qhov ua pa nrog rau cov dej kom nyob hauv lub cev.
Qhov tshwm sim ntawm kev tsis haum tshuaj nyob rau hauv daim ntawv ntawm daim tawv nqaij ua pob, urticaria, nrog rau mob angioedema, khaus lossis erythema.
Ua ib feem ntawm kev kuaj sim, hyperkalemia nrog cov cim ntawm ntshav liab tuaj yeem kuaj.

Hauv lub moj khaum ntawm kev tshawb fawb preclinical ntawm cov tshuaj "Mikardis Plus," cov nyhuv fetotoxic ntawm cov tshuaj tau tsim. Muab qhov xwm txheej no, nws tsis tsim nyog siv cov tshuaj no thoob plaws thaum cev xeeb tub. Yog tias muaj kev npaj xeeb tub, ces tus pojniam, raws li kws kho mob pom zoo, yuav tsum hloov mus rau cov tshuaj tiv thaiv tsis zoo. Thaum muaj menyuam, kev siv cov tshuaj no yog nres tamsis ntawd.

Cov yam ntxwv ntawm kev siv

Cov tshuaj "Mikardis Plus" yuav tsum yog kws kho mob tshwj xeeb. Nws tuaj yeem siv ib leeg los yog nrog lwm cov kev npaj tshuaj, cov nyhuv ntawm kev ua kom muaj kev txhim kho kev ua haujlwm ntawm cov hlab plawv. Tus kws tsim tshuaj xav pom zoo kom noj Mikardis Plus ib hnub yuav tsum tau txwv rau ib ntsiav tshuaj nrog qhov noj tshuaj 40 milligrams ntawm cov tshuaj nquag.Tab sis tib lub sijhawm, nws yog ib qho tseem ceeb uas yuav tau txiav txim siab tias nyob rau hauv cov neeg mob kev txom nyem los ntawm kev mob sib khuav ntawm cov ntshav siab, cov nyhuv hypotensive pheej muaj peev xwm qee zaum muaj kev txhim kho thaum tab tom noj nees nkaum-milligram ntau npaum.

Kev xaiv ntawm txoj kev kho kom zoo dua yog nqa tawm tsawg kawg plaub lub lis piam. Yog li lub sijhawm yuav tsum tau rau qhov tshuaj no los qhia nws qhov kev ua haujlwm tag nrho. Nyob rau hauv qhov kev tshwm sim uas xav tau tsis tau tiav nyob rau lub sijhawm no, tus neeg mob tau qhia kom coj Mikardis Plus hauv qhov ntau npaum li 80 milligrams. Nyob rau hauv qhov muaj ntau dua ntawm cov qauv ntawm kev kub siab, kev tswj hwm ntawm cov tshuaj hauv qhov nyiaj ntawm 160 milligrams ntawm telmisartan raug tso cai, uas yog, yog li ntawd, ob ntsiav tshuaj ntawm 80 milligrams yog qhov yuav tsum tau ua. Nws yuav tsum raug sau tseg tias vim yog cov diuretic uas yog ib feem ntawm Mikardis Plus (80 + 12, 5 mg), lub siab ntawm cov neeg mob txo qis dua sai dua thiab zoo dua thaum noj cov tshuaj ib txwm siv.

Yog li, tus kws kho mob xaiv cov koob tshuaj ntawm cov tshuaj sib xyaw ua ke ua raws qhov mob loj ntawm cov chav kawm ntawm kev kub siab. Kev txheeb xyuas txog "Mikardis Plus" feem ntau lees tias nws cov nyhuv hypotensive. Cov tshuaj uas tau hais yuav noj thaum lub sijhawm hnub ntawd. Hauv qhov no, kev siv khoom noj khoom haus tsis muaj kev cuam tshuam cov zom zaub mov ntawm cov tshuaj ntawm cov tshuaj. Lub sijhawm tag nrho ntawm kev nkag mus yog txiav txim los ntawm tus kws kho mob, nyob ntawm tus neeg mob lub sijhawm, tus kws kho mob tuaj yeem pom zoo hloov mus rau kev saib xyuas txij li 20 milligrams.

Cov neeg mob uas muaj keeb kwm lub raum khiav tsis zoo tsis tas yuav muab ib koob tshuaj rau nws tus kheej. Yog tias muaj txoj kev hloov hauv lub siab txoj kev ua haujlwm hauv daim siab ua haujlwm hauv lub cev pob txha, tsuas yog tsuas tshuaj ntawm "40" xwb. Nws yuav tsum raug sau tseg tias txhua qhov kev nce siab hauv koob tshuaj ua rau muaj qhov tsis zoo hauv kev ua haujlwm ntawm lub cev. Raws li rau cov neeg laus cov neeg mob, lawv tsis xav tau hloov kho koob.

Cov nyhuv ntawm cov tshuaj tivthaiv nquag ntawm kev siv tshuaj ntawm lub peev xwm ntawm cov neeg mob los tswj kev ua haujlwm

Cov lus qhia txuas rau kev siv tshuaj "Mikardis Plus" (40 thiab 80 milligrams) qhia tias tsis muaj kev kuaj tshwj xeeb rau kev cuam tshuam txog cov nyhuv ntawm cov tshuaj ntawm cov tshuaj mloog zoo, nrog rau cov tshuaj tiv thaiv ceev. Tab sis, txawm li cas los xij, thaum noj tshuaj nrog cov nyhuv hypotensive ntawm kev kis tus kab mob, ib tug yuav tsum nco ntsoov nco ntsoov tias kev npaj tshuaj ntawm cov khoom no tuaj yeem ua rau qaug zog nrog lub sij hawm kiv taub hau. Thaum muaj cov neeg ua haujlwm sib cuam tshuam nrog kev pabcuam hauv lub cev muaj cov tsos mob zoo sib xws, tom qab ntawd lawv yuav tsum muab cov tshuaj pov thawj ntawm Mikardis Plus (80 lossis 40 mg).

Cov yam ntxwv ntawm kev khaws cia ntawm cov tshuaj thiab nws cov nqi

Cov tshuaj yuav tsum muab tso rau qhov chaw uas cov menyuam mus cuag tau tsis suav. Qhov kub nyob hauv chav tso khoom yuav tsum tsis pub tshaj peb caug degrees. Raws li txoj cai, ntsiav tshuaj nrog qhov tshuaj ntawm 40 thiab 80 milligrams tuaj yeem khaws cia yam tsis muaj kev ua txhaum kev ncaj ncees ntawm lub hlwv rau tsis pub dhau plaub xyoos txij li lub sijhawm ntawm lawv cov khoom. 20 milligram ntsiav tshuaj muaj lub txee ua lub neej luv luv tsawg dua peb xyoos. Tus nqi ntawm cov tshuaj "Mikardis Plus" hauv lub tsev muag tshuaj ncaj qha nyob ntawm qhov ntau npaum ntawm cov tshuaj nquag hauv tshuaj:

Koj tuaj yeem yuav cov tshuaj rau 40 milligrams, nyob rau hauv uas muaj kaum plaub ntsiav tshuaj, rau txog tsib puas rubles.
Mikardis Ntxiv 80 milligrams nrog nees nkaum-yim ntsiav tshuaj hauv ib lub tsev muag tshuaj tau them nyiaj nruab nrab ntawm cuaj puas thiab tsib caug rubles.
Tus nqi ntawm kev kho mob ntawm nees nkaum-yim ntsiav tshuaj pib los ntawm yim pua thiab tsib caug rubles.

Muaj tseeb, cov ntaub ntawv no tsis nyob rau hauv cov lus qhia rau kev siv nrog Mikardis Plus.

Analogues ntawm cov tshuaj

Kev tshuaj xyuas txog cov tshuaj feem ntau yog qhov zoo, vim tias cov neeg uas tau siv cov tshuaj no pom ib qho tshwm sim tsis tshua muaj kev phiv thiab qhia tias qhov tshuaj no zoo, thiab, tseem ceeb tshaj plaws, txo lub siab sai sai. Muaj tseeb, ntau yam los ntawm kev yuav khoom ntawm cov cuab yeej no yog nres los ntawm nws tus nqi siab. Nws yuav tsum tau hais tam sim ntawd tus kws kho mob yuav tsum xaiv cov tshuaj pheej yig dua ntawm cov tshuaj Mikardis Plus. Yog li, cov tshuaj hauv qab no yog rau cov tshuaj nto moo tshaj plaws uas muaj cov qauv zoo thiab ua rau lub cev: Telmisartan, Teveten, Teseo, Hipotel thiab Pritor.

Tus nqi ntawm cov analogues ntawm "Mikardis Plus" ncaj qha nyob ntawm lawv cov chaw tsim khoom, thiab, ntxiv rau, nyob ntawm qhov sib xyaw ntawm cov ntsiav tshuaj. Ntawm tus nqi ntau dua lossis tsawg tus nqi, koj tuaj yeem yuav, piv txwv li, cov tshuaj xws li Angiakand, Valz thiab Blocktran. Cov lus qhia rau kev siv analogues kuj yuav tsum tau kawm, vim nws yuav ua rau nws kom pom txhua qhov kev cuam tshuam nrog lub nuances ntawm kev siv.

Cev xeeb tub thiab lactation

Cov poj niam cev xeeb tub siv Mikardis Plus yog contraindicated. Kev txais tos ntawm cov neeg tawm tsam ntawm A-II cov neeg tau txais nyob hauv thawj peb hlis thaum cev xeeb tub tsis pom zoo. Yog tias kev pom zoo ntawm kev xeeb tub, kev siv cov tshuaj no yuav tsum nres tam sim ntawd. Yog tias tsim nyog, cov neeg mob tau sau tshuaj rau lwm cov tshuaj tiv thaiv kev tiv thaiv uas muaj tsim kev tiv thaiv kev nyab xeeb thaum cev xeeb tub.

Hauv II - III trimesters, kev kho nrog A-II receptor blockers yog contraindicated, vim hais tias thaum lub sijhawm tshawb fawb pom tau tias thaum lub sijhawm cev xeeb tub no tuaj yeem ua rau fetotoxicity hauv ib tus neeg (qeeb ossification ntawm lub pob txha taub hau, oligohydramnion, tsis hnov mob raum ua si), zoo li neonatal toxicity. (hyperkalemia, hypotension, lub raum tsis ua haujlwm). Yog hais tias kev kho mob nrog antagonists ntawm A-II cov neeg tau txais kev kho mob hauv lub hlis thib ob ntawm cev xeeb tub, yuav tsum tau kuaj ib qho scan ntawm cov pob txha pob txha taub hau thiab lub raum kev ua haujlwm yuav tsum tau ua nyob rau hauv tus menyuam. Cov menyuam mos uas lawv niam tau siv tshuaj hauv chav kawm no yuav tsum tau saib xyuas kev muaj ntshav tsis xwm yeem.

Cov kev paub ntawm kev siv hydrochlorothiazide rau cov poj niam cev xeeb tub, tshwj xeeb tshaj yog nyob rau thawj peb hlis, muaj tsawg. Nws paub tias cov khoom no dhau los ntawm qhov tsis haum xeeb chaw thiab, coj mus rau hauv kev txiav txim siab pharmacological mechanism ntawm nws cov kev ua, nws tuaj yeem cia siab tias noj Mikardis Plus nyob rau hauv II - III trimesters ntawm cev xeeb tub tuaj yeem ua txhaum kev ua txhaum ntawm fetoplacental perfusion thiab ua rau muaj kev cuam tshuam tsis zoo hauv lub embryo / fetus, xws li thrombocytopenia, daj tso zis, lub cev hluav taws xob tsis txaus. Hydrochlorothiazide yuav tsum tsis txhob siv rau cov hlab ntsha txhaws thiab edema vim tias cev xeeb tub, rau preeclampsia (vim qhov kev phem ntawm kev hem thawj ntawm qhov txo qis hauv ntshav ntim thiab txo qis hauv placental perfusion), thiab thaum tsis muaj qhov cuam tshuam zoo hauv cov chaw kuaj mob no.

Rau kev kho mob ntawm qhov kub siab tseem ceeb hauv cov poj niam cev xeeb tub, hydrochlorothiazide tuaj yeem tsuas yog muaj qee qhov xwm txheej tsawg, thaum nws tsis tuaj yeem siv lwm txoj kev kho mob.

Nkag tau Mikardis Plus thaum lub sijhawm pub mis niam yog contraindicated.

Cov kev tshawb fawb ntawm cov nyhuv ntawm cov tshuaj rau ntawm tib neeg kev muaj peev xwm tsis tau ua.

Cov kws kho mob tshuaj xyuas

Raws li cov kws tshaj lij, cov tshuaj no ua tau zoo heev. Nws pab sai sai, tsis tshua muaj ua rau muaj kev tsis zoo ntawm lub cev. Muaj, ntawm chav kawm, pheej yig dua analogues. Tab sis yog tias koj ntsuam xyuas tus nqi zoo-piv, tom qab ntawd cov tshuaj tau piav qhia hauv qhov no suav tias nws tus kheej tau ua tiav.

Peb tau soj ntsuam cov ntawv thov cov ntawv qhia thiab tshuaj xyuas rau Mikardis Plus.

Nrog lub raum tsis ua haujlwm

Nyob rau hauv qhov muaj qhov mob puas siab ntsws hnyav hnyav (CC hauv qab 30 ml / min), Mikardis Plus yog contraindicated.

Nrog kev ceev faj, nws raug nquahu kom siv tus neeg sawv cev hypotensive tiv thaiv keeb kwm yav dhau los ntawm cov leeg ntshav ntawm ib lub raum lossis ob leeg lub raum artery stenosis thiab nyob rau hauv qhov mob tom qab hloov raum. Hauv cov neeg mob uas muaj mob me / mob raum (raum tshaj 30 ml / min), tsis tas yuav hloov kho Mikardis Plus, tab sis lawv yuav tsum saib xyuas lub raum kom ntev.

Nrog lub siab ua haujlwm tsis zoo

Thaum muaj kev ua txhaum loj ntawm daim siab (chav kawm C ntawm Child-Pugh nplai), kev siv ntawm Mikardis Plus yog contraindicated.

Cov neeg mob uas muaj lub siab ua haujlwm tsis zoo los yog mob siab ua daim siab (Menyuam thiab Pugh chav A thiab B) yuav tsum siv cov tshuaj nrog ceev faj, vim tias txawm muaj kev hloov me me ntawm cov dej-electrolyte sib npaug, txoj kev pheej hmoo ntawm kev txhim kho hepatic tsis hnov qab tau nce ntxiv. Yog hais tias ua rau lub siab ua haujlwm tsis txaus ntawm kev kawm qib siab / mob hnyav, qhov siab tshaj plaws niaj hnub noj ntawm Mikardis Plus yuav tsum tsis pub tshaj 40 / 12.5 mg.

Mikardisplyus tso tawm daim ntawv, ntim tshuaj thiab muaj pes tsawg leeg.

Cov ntsiav tshuaj yog oval, biconvex, ob-txheej (ib txheej yog pinkish-beige hauv xim, lwm qhov yog xim dawb nrog tau sib nrug nrog pinkish-beige xim), kos cim yog "H4" thiab lub tuam txhab logo rau saum npoo dawb. 1 tab telmisartan 40 mg hydrochlorothiazide 12.5 mg
Cov kev zam: povidone, meglumine, sodium hydroxide, sorbitol, magnesium stearate, microcrystalline cellulose, oxide liab hlau, sodium starch glycolate, lactose monohydrate, hmoov txhuv nplej siab pob kws.
7 Pcs - hlwv (2) - pob khoom los ntawm cardboard.
7 Pcs - hlwv (4) - pob khoom los ntawm cardboard.
7 Pcs - hlwv (8) - pob khoom los ntawm cardboard.
7 Pcs - hlwv (12) - pob khoom los ntawm cardboard.
Cov ntsiav tshuaj yog oval, biconvex, ob-txheej (ib txheej yog pinkish-beige, lwm qhov yog dawb nrog tau sib tshuam nrog pinkish-beige), ntawm lub ntsej muag dawb yog kos "H8" thiab lub tuam txhab logo. 1 tab telmisartan 80 mg hydrochlorothiazide 12.5 mg
Cov kev zam: povidone, meglumine, sodium hydroxide, sorbitol, magnesium stearate, microcrystalline cellulose, oxide liab hlau, sodium starch glycolate, lactose monohydrate, hmoov txhuv nplej siab pob kws.
7 Pcs - hlwv (2) - pob khoom los ntawm cardboard.
7 Pcs - hlwv (4) - pob khoom los ntawm cardboard.
7 Pcs - hlwv (8) - pob khoom los ntawm cardboard.
7 Pcs - hlwv (14) - pob khoom los ntawm cardboard.

Cov lus piav qhia ntawm cov tshuaj yog ua raws cov lus qhia raug pom zoo rau siv

Pharmacological kev txiav txim siab Mikardisplyus

Cov tshuaj antihypertensive. Nws yog kev sib xyaw ntawm telmisartan (ib qho tshuaj angiotensin II receptor antagonist) thiab hydrochlorothiazide - thiazide diuretic. Kev siv tib lub zuj zus coj los ua cov txiaj ntsig antihypertensive ntau dua li siv cov khoom siv ib leeg ib leeg. Nkag tau MikardisPlyus 1 sijhawm / hnub ua rau txo qis ntshav siab poob qis.
Telmisartan yog tus paub tab ntawm kev tiv thaiv angiotensin II. Nws muaj qhov xwm txheej siab rau AT1 receptor subtype ntawm angiotensin II, dhau los ntawm qhov kev txiav txim ntawm angiotensin II yog pom tau hais. Telmisartan hloov chaw angiotensin II los ntawm nws cov lus cog rau lub receptor, tsis muaj qhov kev txiav txim ntawm agonist nyob rau hauv kev sib raug zoo nrog cov receptor no. Telmisartan tsuas yog khi rau AT1 receptor subtype ntawm angiotensin II. Kev muab ntawv txuas tas mus li. Telmisartan tsis muaj kev sib nyiam rau lwm tus txais (suav nrog AT2 receptors) ntawm angiotensin. Lub luag haujlwm tseem ceeb ntawm cov receptors, nrog rau cov txiaj ntsig ntawm lawv qhov kev xav tau dhau los nrog angiotensin II, qhov kev tsub zuj zus uas nce nrog kev teem sijhawm ntawm telmisartan, tsis tau kawm. Telmisartan ua rau txo qis cov ntshav aldosterone ntau ntau. Telmisartan tsis thaiv cov renin hauv cov ntshav thiab ion channels, tsis thaiv ACE, tsis inactivate bradykinin.
Hauv cov neeg mob ntsig txog kev mob ntshav siab, telmisartan txo qis systolic thiab diastolic ntshav siab, tsis cuam tshuam rau lub plawv dhia.
Telmisartan ntawm ib koob ntawm 80 mg ua rau tag nrho cov kev cuam tshuam ntawm kev kub siab ntawm angiotensin II. Nws qhov kev txiav txim kav ntev dua 24 teev, suav nrog 4 teev dhau los ua ntej noj dua. Qhov pib ntawm kev ua haujlwm ntawm hypotensive raug sau tseg tsis pub dhau 3 teev tom qab thawj thawj coj ntawm telmisartan. Thaum muaj kev tshem tawm sai ntawm telmisartan, cov ntshav siab maj mam rov qab los rau nws thawj qib tsis muaj kev txhim kho ntawm kev tshem tawm tus mob.
Hydrochlorothiazide yog thiazide diuretic. Thiazide diuretics cuam tshuam rau kev rov qab cov roj hluav taws xob hauv cov hlab ntsws, rov nce ncaj qha rau qhov tsis pom kev ntawm sodium thiab chlorides (kwv yees li qhov sib npaug). Cov nyhuv diuretic ntawm hydrochlorothiazide ua rau kev txo qis hauv bcc, ib qho kev ua rau plasma renin kev ua haujlwm, nce ntxiv ntawm kev tso cai ntawm aldosterone thiab yog los ntawm kev nce hauv cov zis potassium thiab bicarbonates, nrog rau hypokalemia. Nrog rau kev tswj hwm tib lub sijhawm ntawm telmisartan, muaj lub siab nyiam kom tsis txhob muaj cov poov tshuaj tshwm sim los ntawm cov diuretics, txawm tias yog qhov thaiv ntawm cov renin-angiotensin-aldosterone system.
Kev siv lub sijhawm ntev ntev ntawm hydrochlorothiazide txo cov kev pheej hmoo ntawm cov teeb meem ntawm cov kab mob plawv thiab kev tuag ntawm lawv.
Tom qab noj hydrochlorothiazide, diuresis ntau ntxiv tom qab 2 teev, thiab cov nyhuv siab tshaj plaws yog pom tom qab txog 4 teev. Cov diuretic nyhuv ntawm cov tshuaj tseem nyob ntev li 6-12 teev.
Qhov ua hauj lwm siab tshaj plaws ntawm MikardisPlus feem ntau ua tiav 4 lub lis piam tom qab pib ntawm kev kho mob.

Dosage thiab txoj hauv kev ntawm kev tswj hwm tshuaj.

MikardisPlus yuav tsum noj qhov ncauj 1 teev / hnub, tsis hais noj zaub mov dab tsi.
Mikardis Plus 40 / 12.5 mg tuaj yeem muab rau cov neeg mob uas siv Mikardis ntawm koob tshuaj 40 mg lossis hydrochlorothiazide tsis ua rau muaj kev tswj hwm ntshav siab txaus.
Mikardis Plus 80 / 12.5 mg tuaj yeem muab rau cov neeg mob uas siv Mikardis ntawm koob tshuaj 80 mg lossis Mikardis Plus 40 / 12.5 mg tsis ua rau muaj kev tswj ntshav siab txaus.
Nrog rau lub raum me me los yog txo lub raum kev ua haujlwm, kev hloov pauv koob tsis tas yuav tsum ua. Hauv cov neeg mob no, lub raum kev ua haujlwm yuav tsum raug saib xyuas.
Hauv cov neeg mob uas muaj mob me me los yog ua tsis tau zoo lub siab ua haujlwm, MikardisPlus yuav tsum tsis txhob siv nyob rau hauv cov tshuaj txhua hnub ntau dua 40 / 12.5 mg.
Hloov pauv qhov ntau npaum cov tshuaj rau cov neeg laus cov neeg mob tsis tas yuav tsum tau ua.

Sab nyhuv Mikardisplyus:

Cov kev mob tshwm sim los ntawm kev paub nrog telmisartan
Los ntawm cov txheej txheem ua pa: kis kab mob rau sab saud (suav nrog rau mob ntsws, pharyngitis, hlab ntsws), ua pa luv.
Los ntawm cov hlab plawv: bradycardia, tachycardia, cim txo qis hauv ntshav siab, mob hauv siab.
Los ntawm sab hauv nruab nrab ntawm lub hauv nruab nrab lub paj hlwb thiab lub paj hlwb: ua kom zoo siab, muaj kev ntshai, ntshai poob siab, kiv taub hau, tsaus muag, thiab pw tsis tsaug zog.
Los ntawm lub plab zom mov: lub qhov ncauj qhuav, pom pob, ntuav, ua kom lub siab ua haujlwm tsis zoo.
Los ntawm cov kab mob urinary: mob raum tsis ua haujlwm.
Los ntawm cov kab mob endocrine: poob ntawm kev tswj hwm ntawm theem ntawm cov ntshav qog ntshav qab zib hauv cov ntshav qab zib mellitus, ua rau cov ntshav qabzib tsis ua haujlwm.
Los ntawm cov kab mob hemopoietic: eosinophilia, txo qis hemoglobin, thrombocytopenia.
Los ntawm cov leeg mus rau hauv lub cev: mob pob txha caj qaum, mob caj dab, mob nraub qaum, mob ceg qis dua, mob leeg nqaij, txhaws ntswg ntawm cov leeg plab (krampi), cov tsos mob zoo li leeg mob, tsis muaj zog.
Los ntawm cov kev nkag siab: qhov muag tsis pom ntawm lub suab, pom dua.
Los ntawm ib sab ntawm cov metabolism: hypercholisterinemia, hyperuricemia, hypokalemia, hyperkalemia, hypercalcemia, nce ntawm uric acid, creatinine, daim siab enzymes, ntshav CPK.
Kev tsis haum tshuaj: eczema, erythema, pruritus, angioedema, urticaria thiab lwm yam kev xav zoo sib xws (xws li siv cov tshuaj angiotensin II antagonists).
Lwm yam: cov tsos mob zoo li ua npaws, tawm hws, tsis muaj zog.
Cov kev mob tshwm sim los ntawm kev paub nrog hydrochlorothiazide
Los ntawm cov txheej txheem ua pa: ua pa tawm, mob ntsws ua pa (nrog rau mob ntsws thiab mob ntsws).
Los ntawm cov hlab plawv system: arrhythmias, orthostatic hypotension, necrotic angiitis.
Los ntawm sab hauv lub hauv nruab nrab ntawm cov hlab ntsha hauv lub cev: muaj kev txaus siab, muaj kev ntshai, muaj kev ntxhov siab, muaj lub siab ntxhov siab, khiav ceev thaum taug kev, paresthesia.
Los ntawm lub plab zom mov: mob plab, mob raws plab, dyspepsia, mob plab, tsis nco qab, tsis qab los, mob sialadenitis, cem quav, pancreatitis, mob siab rau lub siab ua haujlwm, mob daj ntseg (hepatocellular lossis cholestatic).
Los ntawm cov kab mob endocrine: poob ntawm kev tswj hwm ntawm theem ntawm cov ntshav qog ntshav qab zib hauv cov ntshav qab zib mellitus, ua rau cov ntshav qabzib tsis ua haujlwm.
Los ntawm cov kab mob hauv lub siab: hloov pauv qhov muag plooj, xanthopsia, vertigo.
Ntawm ib feem ntawm cov metabolism: hypercholisterinemia, hyperuricemia, hypokalemia, hyponatremia, txo qis hauv BCC, kev tsis zoo ntawm cov electrolyte metabolism, hyperglycemia, kev nce hauv triglycerides, glucosuria.
Los ntawm cov kab mob hemopoietic: mob ntshav tsis txaus, hemolytic anemia, inhibition ntawm cov hlwb pob txha hematopoiesis, leukopenia, neutropenia, agranulocytosis, thrombocytopenia.
Los ntawm cov kab mob ntawm lub tso zis: kis kab mob ntawm cov mob txeeb zig, mob interstitial nephritis, ua kom lub raum khiav tsis zoo.
Los ntawm cov leeg musculoskeletal: tsis muaj zog, leeg pob txha.
Kev tsis haum tshuaj: anaphylactic kev ua xua, eczema, lupus-zoo li cov tshuaj tiv thaiv, vasculitis, kev tsis haum tshuaj, ua pob, ua rau tawv nqaij ua rau pom SLE, mob ua paug rau daim tawv nqaij, mob ua paug, mob ua paug, mob ua paug thiab lwm yam zoo sib xws (xws li siv tshuaj tiv thaiv angiotensin II antagonists).
Lwm yam: cov tsos mob zoo li ua npaws, kub taub hau, txo hwj chim.

Cov lus qhia tshwj xeeb rau kev siv Mikardisplyus.

Hauv cov neeg mob uas muaj lub siab tsis ua haujlwm lossis mob siab rau daim siab, MikardisPlus yuav tsum siv nrog ceev faj, vim tias txawm muaj kev hloov me me ntawm cov dej-electrolyte tshuav nyiaj tuaj yeem ua rau muaj kev txhim kho hepatic tsis nco qab.
Hauv cov neeg mob uas muaj ob leeg lub raum artery stenosis los yog arterial stenosis ntawm lub raum tsuas ua haujlwm, siv telmisartan ua rau muaj kev pheej hmoo ntawm cov ntshav khov ntau heev thiab lub raum tsis ua haujlwm.
Tsis muaj kev paub nrog MikardisPlus hauv cov neeg mob uas lub raum ua rau lub raum tsis zoo lossis hauv cov neeg mob tom qab hloov raum. Txij li thaum paub siv MikardisPlus hauv cov neeg mob uas muaj me me mus rau lub raum lub raum ua haujlwm me me, yog muaj li no, kev txiav txim siab ntawm cov ntshav poov tshuaj thiab qib creatinine pom zoo. Kev siv hydrochlorothiazide hauv cov neeg mob uas lub raum tsis ua haujlwm zoo tuaj yeem ua rau azotemia. Pom zoo sij hawm xyuas raum ua haujlwm lub raum.
Cov neeg mob uas muaj BCC txo thiab / lossis hyponatremia los ntawm kev kho mob ntau dhau, txwv tsis pub ntsev ntau, ua kom raws plab, lossis ntuav tuaj yeem tsim muaj kab mob ntshav siab ntau, tshwj xeeb yog tom qab noj thawj koob ntawm cov tshuaj. Ua ntej siv MikardisPlus, kev kho ntawm cov kev ntshawv siab no yog qhov tsim nyog.
Thaum muaj mob vascular thiab lub raum kev ua haujlwm feem ntau nyob ntawm kev ua si ntawm renin-angiotensin-aldosterone system (piv txwv li, hauv cov neeg mob uas muaj lub plawv tsis ua haujlwm loj los yog lub raum tsis ua haujlwm, nrog rau lub raum mob rwj), kev siv tshuaj, uas cuam tshuam rau lub xeev ntawm cov kab ke no, tuaj yeem nrog kev txhim kho ntawm cov mob ntshav thim ntshav, hyperazotemia, oliguria, lossis hauv qee qhov tsis tshua muaj tshwm sim, mob raum tsis ua haujlwm.
Hauv cov neeg mob uas muaj cov tshuaj tiv thaiv aldosteronism, cov tshuaj tiv thaiv kev tiv thaiv kab mob, cov txheej txheem ntawm kev ua haujlwm uas yog txhawm rau thaiv cov kev ua ntawm renin-angiotensin-aldosterone system, feem ntau yog qhov ua tsis muaj txiaj ntsig. Hauv cov xwm txheej zoo li no, kev teem caij MikardisPlus tsis pom zoo.
Hauv cov neeg mob nrog aortic lossis mitral stenosis lossis obtus hypertrophic cardiomyopathy, kev siv MikardisPlus (zoo li lwm cov vasodilators) xav tau kev saib xyuas tshwj xeeb.
Kev siv ntawm thiazide diuretics tuaj yeem ua rau tsis mob siab ntev.
Hauv cov neeg mob uas mob ntshav qab zib mellitus, kev hloov tshuaj ntau npaum li cas ntawm cov tshuaj insulin los yog qhov ncauj hypoglycemic yuav tsum tau. Thaum kho nrog hydrochlorothiazide, ib hom kab mob ntshav qab zib tuaj yeem tshwm sim.
Qee qhov xwm txheej, kev siv hydrochlorothiazide tuaj yeem txhim kho hyperuricemia thiab gout.
Thaum siv MikardisPlus, kev txiav txim siab ntu ntawm qib ntawm electrolytes hauv cov ntshav cov ntshav yog tsim nyog.
Thiazide diuretics, incl. hydrochlorothiazide, tuaj yeem ua rau muaj kev tsis sib haum xeeb hauv kev ntsuas hluav taws xob thiab KShchR (hypokalemia, hyponatremia thiab hypochloremic alkalosis). Cov tsos mob ntawm cov kev tsis txaus siab no yog lub qhov ncauj qhuav, nqhis dej, dav dav tsis muaj zog, qaug zog, tsaug zog, ntxhov siab, myalgia lossis plooj ntawm cov leeg nqaij, cov leeg tsis muaj zog, mob ntshav qis, oliguria, tachycardia, xeev siab, lossis ntuav.
Thaum siv hydrochlorothiazide, hypokalemia yuav tshwm sim, tab sis telmisartan tib lub sijhawm tuaj yeem txo qhov kev tsis zoo no. Txoj kev pheej hmoo ntawm hypokalemia yog qhov loj tshaj nyob rau hauv cov neeg mob uas muaj kab mob siab, nrog rau cov diuresis ntau dua, nrog qhov ncauj tsis txaus ntawm qhov them cov roj ntsha, nrog rau cov xwm txheej ntawm kev siv GCS lossis ACTH tib lub sijhawm. Telmisartan, uas yog ib feem ntawm MikardisPlus, ntawm qhov tsis sib xws, tuaj yeem ua rau hyperkalemia vim muaj kev thaiv cov kab mob rau angiotensin II receptors. Txawm hais tias thaj chaw kho mob tseem ceeb hyperkalemia tsis tau tshaj tawm nrog kev siv Mikardis Plus, nws yuav tsum tau yug los rau hauv lub siab tias qhov kev pheej hmoo txaus rau nws txoj kev loj hlob muaj xws li lub raum thiab / lossis lub plawv tsis ua haujlwm thiab ntshav qab zib mellitus.
Tsis muaj pov thawj qhia tias MikardisPlus tuaj yeem txo lossis tiv thaiv hyponatremia tshwm sim los ntawm diuretics. Chloride deficiency feem ntau yog me me thiab tsis tas yuav muaj kev kho mob.
Hydrochlorothiazide tuaj yeem txo cov calcium ntau yam thiab ua rau (thaum tsis paub txog cov teeb meem metabolic cuam tshuam ntawm no ion) kev hloov pauv thiab nce me ntsis hauv cov calcium ntau ntau. Ntau dua hypercalcemia tseem ceeb yuav yog ib qho kev mob latent hyperparathyroidism. Ua ntej txiav txim siab ua haujlwm ntawm cov qog ntshav parathyroid, thiazide diuretics yuav tsum tau muab tso tseg.
Nws tau pom tias hydrochlorothiazide tsub kom muaj qhov ntxiv ntawm cov magnesium nyob rau hauv cov zis, uas tuaj yeem ua rau mob ntshav qab zib hypomagnesemia.
Hauv cov neeg mob uas muaj ischemic cardiopathy lossis mob plawv, txhua yam tshuaj tiv thaiv kev mob ntshav siab los ntawm cov ntshav siab txaus yuav ua rau myocardial infarction lossis mob hlab ntsha tawg.
Cov koob tshuaj pom zoo txhua hnub ntawm Mikardis Ntxiv 40 / 12.5 lossis 80 / 12.5 muaj 169 lossis 338 mg ntawm sorbitol, ntsig txog. Yog li ntawd, cov tshuaj yog contraindicated nyob rau hauv cov neeg mob uas muaj keeb xeeb fructose intolerance.
Hypersensitivity kev tsis haum rau hydrochlorothiazide yuav tshwm sim, tshwj xeeb tshaj yog rau cov neeg mob uas muaj keeb kwm ua xua lossis bronchial hawb pob.
MikardisPlus tuaj yeem, yog tsim nyog, siv nrog rau lwm cov tshuaj tiv thaiv antihypertensive.
Thaum ua ke nrog Mikardis Plus, potassium-muaj cov diuretics, laxatives, corticosteroids, ACTH, amphotericin, carbenoxolone, penicillin G (sodium ntsev), salicylic acid thiab nws cov derivatives, kev soj ntsuam cov potassium hauv cov ntshav ntshav tau raug pom zoo.
Nrog rau kev siv ua ke ntawm Mikardis Plus thiab potassium-sparing diuretics, tshuaj poov tshuaj npaj, lwm yam tshuaj uas tuaj yeem nce cov ntsiab lus poov tshuaj hauv cov ntshav ntshav (piv txwv li, sodium heparin), lossis thaum hloov sodium chloride nrog ntsev ntsev, kev saib xyuas tsis tu ncua ntawm cov theem ntawm potassium hauv cov ntshav ntshav tau raug pom zoo.
Yog tias koj xav siv cov tshuaj calcium npaj, koj yuav tsum tau saib xyuas qhov tsis tu ncua ntawm cov calcium hauv cov ntshav thiab, yog tias tsim nyog, hloov cov koob tshuaj ntawm cov tshuaj no.
Kev Siv Khomob
Qhov kev ua tau zoo thiab kev nyab xeeb ntawm kev siv MikardisPlus hauv cov menyuam yaus thiab cov tub ntxhais hluas hnub nyoog qis dua 18 xyoo tsis tau teeb tsa.
Cuam tshuam rau kev muaj peev xwm tsav tsheb thiab tswj cov tshuab
Txoj kev kawm tshwj xeeb ntawm cov nyhuv ntawm cov tshuaj ntawm lub peev xwm tsav lub tsheb thiab ua haujlwm nrog cov txheej txheem tsis tau ua. Txawm li cas los xij, thaum tsav tsheb thiab ua haujlwm nrog cov txheej txheem, ib qho yuav tsum nco ntsoov qhov muaj peev xwm ntawm kiv taub hau thiab qaug zog thaum siv cov tshuaj MikardisPlus.

Kws Tshuaj

Mikardis Plus yog kev sib xyaw ntawm telmisartan thiab hydrochlorothiazide. Nrog lawv cov kev tswj fwm ib txhij, cov nyhuv antihyertonic muaj zog. Raws li qhov tshwm sim, ib qho kev txo qis hauv siab yog pom.

Telmisartan yog ib qho kev xaiv angiotensin type 2 receptor blocker. Kev muab ntawv txuas tas mus li. Ntxiv rau, cov tivthaiv no tseem tuaj yeem txo qhov kev sib txuas ntawm aldosterone.

Hydrochlorothiazide yog hom thiazide-diuretic. Nws cuam tshuam qhov thim rov qab nqus ntawm electrolytes nyob rau hauv cov tubules ntawm lub raum, ncaj qha nce ntxiv kev nthuav dav ntawm sodium chloride los ntawm lub cev. Qhov no ua rau txo qis ntau ntawm cov ntshav ncig, nce qhov kev sib txuas ntawm aldosterone, nce renin kev ua haujlwm.

Tom qab qhov ncauj tswj hwm ntawm hydrochlorothiazide, diuresis nce ntau zaus, thiab cov txiaj ntsig siab tshaj plaws tau tiav tom qab ob peb teev thiab kav ntev txog 12 teev.

Yeeb tshuaj sib cuam tshuam

Kev sib cuam tshuam uas muaj peev xwm ua tau nrog kev siv ua ke ntawm telmisartan nrog lwm cov tshuaj / cov neeg sawv cev:

hydrochlorothiazide, warfarin, digoxin, simvastatin, glibenclamide, amlodipine: tsis muaj kev cuam tshuam hauv kev kho mob tau pom, qhov nce ntawm qhov nruab nrab plasma concentration ntawm digoxin hauv cov ntshav los ntawm kwv yees li 20% tau tshawb pom, nrog kev sib xyaw ntawm telmisartan thiab digoxin, nws raug pom zoo kom qee ntu txiav txim siab txog qib theem ntawm cov ntshav tom kawg,
lithium kev npaj: hauv qee qhov tsis tshua muaj tshwm sim, qhov rov qab nce ntxiv ntawm cov ntsiab lus lithium hauv cov ntshav yog ua tau, taug kev nrog cov tshuaj lom, nyob rau hauv kev sib txuas nrog qhov nws cov concentration hauv cov dej yuav tsum tau saib xyuas,
lwm cov tshuaj tiv thaiv antihypertensive: cov nyhuv antihypertensive yuav nce ntxiv, nrog kev sib xyaw ntawm telmisartan thiab ramipril, qhov nce ntawm AUC raug sau tseg_0-24 thiab C_max lub tom kawg thiab nws cov khoom siv tshuaj (ramiprilat) 2,5 zaug, qhov tseem ceeb hauv kev kho mob ntawm kev cuam tshuam no tsis paub,
non-steroidal anti-inflammatory tshuaj (NSAIDs), suav nrog cov tshuaj acetylsalicylic acid, siv los ua cov tshuaj tiv thaiv kab mob (hauv cov tshuaj tiv thaiv ib hnub twg tsis ntau tshaj 3 g): tsis siv tshuaj NSAIDs thiab cyclooxygenase-2 inhibitors (COX-2) hauv cov neeg mob uas txo BCC tuaj yeem ua rau muaj kev txhim kho ntawm cov mob raum tsis zoo. , cov neeg sawv cev uas cuam tshuam rau RAAS tuaj yeem ua rau pom qhov ua tau zoo, nrog kev sib xyaw ntawm telmisartan thiab NSAIDs thaum pib kho, nws yog qhov tsim nyog los them rau bcc thiab tswj raum kev ua haujlwm, nrog kev sib xyaw no tseem los ntawm inhibiting prostaglandin vasodilator kev txiav txim ntawm telmisartan, ib tug txo nyhuv thaum ua ke nrog paracetamol thiab ibuprofen clinically tseem ceeb cov nyhuv yog tsis qhia.

Kev sib cuam tshuam muaj peev xwm nrog kev siv ua ke ntawm hydrochlorothiazide nrog lwm cov tshuaj / cov neeg sawv cev:

tshuaj tiv thaiv kab mob hauv lub qhov ncauj thiab insulin: kev kho cov tshuaj no yuav tsim nyog,
barbiturates, opioid analgesics, ethanol: kev hem thawj ntawm orthostatic hypotension yog qhov hnyav,
colestyramine, colestipol: qhov nqus ntawm hydrochlorothiazide cuam tshuam,
metformin: ua rau muaj kev pheej hmoo ntawm tus kab mob lactic acidosis,
pressor amines (suav nrog norepinephrine): kev ua kom tsis muaj zog ntawm kev ua ntawm cov neeg sawv cev no yog qhov ua tau,
mob glycosides: txoj kev pheej hmoo ntawm kev tsim hypomagnesemia / hypokalemia vim thiazide diuretics, zoo li cov tsos mob ntawm arrhythmias tshwm sim los ntawm kev siv tshuaj glycosides, yog aggravated
tsis-depolarizing nqaij relaxants (suav nrog tubocurarine chloride): nws muaj peev xwm txhim kho qhov kev ua ntawm cov neeg sawv cev no,
calcium npaj: ntshiab ntshav calcium ntau ntau yuav nce vim qhov txo qis ntawm nws lub cev los ntawm lub raum, nrog rau kev sib xyaw ua ke no, nws yuav tsum tau soj ntsuam kom tsis txhob muaj cov calcium ntau ntxiv hauv cov ntshav thiab, yog tias tsim nyog, hloov nws cov koob tshuaj,
los tiv thaiv tus mob gout: kev nce qib ntawm uric acid nyob rau hauv cov ntshav cov ntshav tau, uas yuav tsum tau muab cov tshuaj uricosuric ntau npaum li cas, ib qho kev nce ntxiv ntawm qhov kev tsis haum siab rau allopurinol yuav raug sau tseg,
biperidine, atropine thiab lwm yam tshuaj m-anticholinergic: lub plab zom mov tsis muaj zog, kev noj qab haus huv ntawm thiazide diuretics tau nce,
diazoxide, beta-blockers: tej zaum yuav nce lub hyperglycemia tshwm sim los ntawm cov tshuaj no,
laxatives, diuretics uas tshem cov poov tshuaj, gluco- thiab mineralocorticosteroids, amphotericin B, corticotropin, benzylpenicillin, carbenoxolone, derivatives ntawm acetylsalicylic acid thiab lwm yam tshuaj uas ua rau muaj kev cuam tshuam ntawm cov potassium thiab kev txhim kho hypokalemia: cov nyhuv hypokalalic yog kom ua kom zoo, thiab cov Telmisartan
NSAIDs: muaj peev xwm ua kom tsis muaj zog ntawm antihypertensive thiab diuretic teebmeem,
cov poov tshuaj npaj, cov tshuaj potassium-sparing diuretics thiab lwm tus neeg sawv cev uas ua rau muaj kev nce qib ntau ntawm cov poov tshuaj hauv cov ntshav (heparin), kev hloov sodium hauv sodium chloride nrog cov ntsev potassium: hyperkalemia yuav tshwm sim, kev soj ntsuam ib zaug ntawm lub plasma concentration ntawm potassium hauv cov ntshav yuav tsum tau nqa tawm,
cytotoxic tus neeg sawv cev (piv txwv li cyclophosphamide, methotrexate): lub raum tsis ua haujlwm ntawm cov kab mob no tsawg zuj zus thiab lawv cov nyhuv myelosuppressive zoo dua,
glycyrrhizic acid (licorice hauv paus): txo qis hauv cov theem ntawm cov poov tshuaj hauv cov ntshav cov ntshav yog ua tau (kev txhim kho ntawm hypokalemia),
amantadine: qhov kev pheej hmoo ntawm cov kev tsis txaus ntseeg tshwm sim los ntawm cov khoom no ua rau hnyav dua.

Cov yeeb yaj kiab ntawm Mikardis Plus yog: Telzap Plus, Telsartan N, Telpres Plus, thiab lwm yam.

Txoj kev ntawm kev coj thiab ntau npaum

Cov lus qhia rau kev noj tshuaj pom zoo kom noj cov tshuaj no ib ntsiav tshuaj ib hnub ib zaug. Noj mov tsis txawv, tab sis ntawm lub plab khoob, cov nyhuv tau tiav ntau zaus sai dua.

Cov txiaj ntsig siab tshaj plaws, raws li txoj cai, tau tiav hauv ib txog ob hlis tom qab kev pib noj tshuaj. Yog tias muaj qhov xav tau ntawd, ces siv cov tshuaj ntxiv tuaj yeem ua ntxiv nrog lwm cov tshuaj uas pab txo cov ntshav siab hauv lub sijhawm luv.

Rau cov neeg mob uas kuaj pom muaj mob ntshav siab heev, tus kws kho mob yuav nce ntxiv rau 160 mg rau ib hnub.

Saib xyuas! Hydrochlorothiazide tuaj yeem cuam tshuam tsis zoo rau tus neeg mob ntxiv uas tau pom yav dhau los ua rau muaj kev mob raum tsis zoo. Nrog rau tus kab mob no, nws yog qhov zoo tshaj rau kev tso cov voj diuretics.

4. Kev sib xyaws nrog lwm txoj kev

Nrog rau kev sib txuam ua ke ntawm cov tshuaj no nrog:

Cov tshuaj tiv thaiv antihypertensive - kev nce siab hauv cov tshuaj tiv thaiv antihypertensive kuj tau pom,
Kev npaj lithium - kev nce ntxiv ib ntus hauv cov khoom no hauv cov ntshav tuaj yeem pom,
Digoxin - qhov kev nce ntxiv ib ntus nyob rau hauv qhov kev tsom xam ntawm qhov kawg ntawm feem ntshav hauv ntau li 20% yuav raug sau tseg,
Nrog NSAIDs, ib daim ntawv mob raum tsis ua haujlwm yog pom nyob rau hauv cov neeg mob uas tsis muaj zog txaus tso ntshav tawm,
Nrog barbirutes, opioid painkillers - orthostatic hypotension yog pom,
Metformin - lactic acidosis yuav tshwm sim
Colestipol thiab colestyramine - kev txwv ntawm kev nqus ntawm hydrochlorothiazide tau pom,
Cov tshuaj insulin lossis cov tshuaj hypoglycemic - nce ntxiv hauv kev nqis tes ntawm cov neeg sawv cev kawg,
Tshuaj tiv thaiv gout - tej zaum yuav muaj cov ntsiab lus ntawm uric acid hauv cov ntshav ntawm tus neeg,
Tsis-depolarizing nqaij relaxants - muaj kev nce hauv lawv cov hauj lwm zoo,
Kev npaj calcium - koj tuaj yeem soj ntsuam kev nce siab ntxiv ntawm cov calcium uas nyob hauv cov ntshav,
M-anticholinergics, piv txwv li, biperiden lossis atropine - yuav ua rau kom muaj kev nyab xeeb ntawm thiazide diuretics.

Yuav ua li cas noj cov tshuaj no thaum cev xeeb tub?

Thaum cev xeeb tub, kev tswj hwm qhov ncauj ntawm Mikardis Plus yuav tsum raug cais tawm.

Qhov no yog vim qhov tseeb tias cov tshuaj yeeb dej caw tuaj yeem nkag mus rau hauv cov kab mob me, ua rau muaj kev cuam tshuam tsis zoo rau nws. Ib qho ntxiv, nws kuj tseem tuaj yeem cuam tshuam cov mob ntawm leej niam.

Thaum pub niam mis, koj yuav tsum cais lub sijhawm ntawm kev noj tshuaj. Yog tias qhov kev txais tos tseem tsim nyog, thiab tsis muaj ib qho ntawm cov nyiaj tau los uas tsim nyog, ces kev pub niam mis yuav tsum tau nres.

7. Kev khaws cia ntawm cov tshuaj

Cov tshuaj no zoo tshaj plaws nyob rau hauv chav tsaus nti uas yuav muaj kev tiv thaiv los ntawm noo noo thiab ncaj qha tshav ntuj. Qhov chaw zoo tshaj yuav yog chav rau khoom. Ib qho ntxiv, koj kuj yuav tsum xyuas kom meej tias cov tshuaj tsis poob rau hauv tes ntawm cov menyuam yaus.

Cov tshuaj no yuav tsum khaws cia tsis pub tsawg tshaj peb xyoos. Yog tias cov tshuaj no tau tas sijhawm, tom qab ntawd nws txoj kev siv ntxiv yog txwv tsis pub ua.

Rau cov cuab yeej no, tus nqi yuav txawv txav raws lub cheeb tsam. Cov ntawv muaj cov nqi nruab nrab tau coj hauv Moscow thiab Kiev.

Hauv Ukraine, koj yuav tsum them 450 hryvnia rau cov tshuaj no.

Nws yuav tsum tau yug hauv siab tias tus kws kho mob nws tus kheej yuav tsum cuam tshuam nrog kev xaiv ntawm analogue, tab sis tsis yog tus neeg mob.

Cov tshuaj no tuaj yeem hloov los ntawm cov neeg xws li Diocor, Valzap Plus, Gizaar, Teveten Plus, Co-Diovan, Valsacor, Atakand Plus, Valz N, Lorista N, Lisinopril, Ibertan, Tareg, Blocktran, Cardosten, Vazotens, Losacor, Valsacor, Kandek , Norotivan, Lozarep, Renikard, Angiakand.

Yog tias koj muaj kev paub ntawm tus kheej uas siv cov khoom no, tom qab ntawd rov los tshuaj xyuas txog cov tshuaj no.

Kev txheeb xyuas cov kws kho plawv txog cov tshuaj Mikardis Plus muaj qhov kev sib raug zoo feem ntau. Yog tias koj tsis ua txhaum qhov kev txiav txim thiab kev kuaj mob rau kev kuaj pom cov kab mob uas yuav yog qhov cuam tshuam nrog kev noj Mikardis Plus, ua ntej pib txoj kev noj tshuaj, cov nyhuv yuav tsis ntev tom ntej.

Hauv qhov no, qhov kev mob tshwm sim tsis tshua muaj tshwm sim. Kev kho plawv nco ntsoov ib qho tshwm sim tsawg ntawm lub plawv dhia. Txawm hais tias kev mob ntshav siab ntev, cov txiaj ntsig zoo tau sau tseg. Lub sijhawm ua haujlwm ntev ntev li 48 teev.

Kev ntsuas tus neeg mob kuj tseem zoo txog cov tshuaj. Tsuas yog qhov tsis zoo ntawm cov tshuaj no yog nws cov nqi. Qhov tseeb yog tias tsis yog txhua tus neeg npaj txhij them cov nyiaj zoo li no rau cov khoom siv no.

Tso cov ntaub ntawv thiab cov nyob ua ke

Cov tshuaj yog tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, uas muaj 2 lub tebchaw nquag - telmisartan thiab hydrochlorothiazide.

Raws li cov khoom sib ntxiv uas txhim kho qhov nrawm thiab tiav ntawm kev nqus, yog:

pob kws nplej siab
mis nyuj qab zib
microcrystalline cellulose,
sodium hydroxide
hlau oxide dyes,
povidone
sorbitol
meglumine.

Cov ntsiav tshuaj tau ua cov oval nrog lub ntsej muag biconvex. Tus neeg sawv cev tiv thaiv kab mob tsis tiv thaiv kab mob yog tsis ua cov tshuaj tsuag, kua pleev, lossis kua tshuaj.

Cov tshuaj yog tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, uas muaj 2 lub tebchaw nquag - telmisartan thiab hydrochlorothiazide.

Nruab nrab hauv lub paj hlwb

Nrog kev nyuaj siab ntawm lub hauv nruab nrab lub paj hlwb thiab kev loj hlob ntawm lub hlwb kev xav ntawm ib tug neeg, tus cwj pwm tus qauv hloov - lub xeev muaj kev ntxhov siab, lub siab ntxhov siab tshwm sim.

Kiv taub hau, mob taub hau, plhws, qhov tsis muaj zog ntau, pw tsaug zog yuav tshwm sim.

Cuam tshuam rau lub peev xwm los tswj cov tshuab

Cov tshuaj tsis cuam tshuam rau kev ua haujlwm ntawm lub leeg tsis muaj zog thiab cov txuj ci zoo ntawm lub cev. Nyob rau tib lub sijhawm, nws yuav tsum tau saib xyuas kev ceev faj thaum ua haujlwm nrog cov txheej txheem tsis yooj yim thiab thaum tsav tsheb, vim tias nws muaj peev xwm ua kom tsis nco qab, qhov tshwm sim ntawm kev mob tshwm sim (tsaug zog, kiv taub hau). Cov kev xav tsis zoo tuaj yeem ua rau poob qis ntawm kev mloog zoo thiab ceev ntawm lub cev kev xav uas tsim nyog rau kev tsav tsheb.

Siv thaum cev xeeb tub thiab lactation

Cov poj niam thaum cev xeeb tub raug txwv tsis pub noj Mikardis hauv kev sib txuas nrog qhov pheej hmoo ntawm tus me nyuam hauv plab.

Hauv cov txheej txheem ntawm embryonic txoj kev loj hlob, kev tso ntawm cov hlab plawv thiab cov leeg yuav tuaj yeem ua puas lawm.

Thaum mus kho kev siv tshuaj, nws yog ib qho tsim nyog yuav tsum tsis txhob pub mis niam.

Thaum mus kho kev siv tshuaj, Mikardis Plus yuav tsum tsum tsis txhob pub mis niam.

Kev kho plawv

Elena Bolshakova, kws kho plawv, Moscow

Kuv tau ua ib qho kev tshawb fawb ua ib feem ntawm kev tawm tswv yim rau cov teebmeem ntawm cov tshuaj, yog li kuv tuaj yeem ntseeg tau tham txog qhov ua tau zoo ntawm Mikardis Cov tshuaj pab ua kom lub hauv nruab nrab ntawm lub siab qhov tseem ceeb thiab txo qis kev tshaj tawm ntawm lub plawv, uas ua rau muaj kev loj hlob ntawm cov kab mob plawv. Cov tshuaj muaj txiaj ntsig zoo rau ob leeg rau cov hluas thiab rau cov laus. Cov kev mob tshwm sim uas yuav xav tau cov kev kho mob hloov, hauv kev coj ua tsis tau ua tiav. Cov tshuaj tsis cuam tshuam rau lub siab.

Sergey Mukhin, kws kho plawv, Tomsk

Kuv xav tias cov tshuaj yog txoj hauv kev zoo rau txo ntshav siab. Thaum noj ib zaug ib hnub, cov nyhuv ua haujlwm tseem nyob rau ib hnub. Tus nqi yog siab. Ib daim ntawv loj loj ntawm contraindications. Tab sis cov tshuaj muaj txiaj ntsig zoo rau yam type 2 ntshav qab zib, mob plawv ruaj khov. Nws raug txwv tsis pub siv rau hauv cov neeg mob nrog mob plawv tsis zoo. Kev tsis haum qhov tsis tshua pom tshwm sim hauv kuv txoj kev kho mob.

Mikardis Plus tuaj yeem hloov nrog Pritor, uas yog khaws cia rau hauv ib qho chaw sib cais los ntawm ultraviolet hluav taws xob ntawm qhov kub ntawm + 8 ... + 25 ° C.

Dmitry Gavriilov, 27 xyoo, Vladivostok

Arterial hypertension pib, vim tias nyob rau yav tsaus ntuj muaj kev noj qab haus huv tsis zoo, qhov tsis tu ncua ntawm huab cua, thiab arrhythmia tsim. Cov kws kho mob sau ntawv Mikardis ntsiav tshuaj. Cov tshuaj pib ua rau thawj hnub. 3 teev tom qab noj cov ntsiav tshuaj, lub siab ruaj khov rau 20 teev tom ntej. Hauv qhov no, nws yog ib qho tseem ceeb uas yuav tsum tau noj lwm yam tshuaj uas yuav pab tswj tau qhov tshwm sim no. Kuv pom zoo kom sab laj nrog koj tus kws kho mob txog kev kho cov zaub mov noj ua ke nrog cov vitamin ua ntau ntxiv.

Alexandra Matveeva, 45 xyoo, St. Petersburg

Ntsib nrog kub siab tom qab phais mob qog. Tus kws kho plawv tawm tshuaj MikardisPlus cov ntsiav tshuaj ntawm lub sijhawm ntev. Kuv nyiam cov tshuaj no, nws maj mam ua kom ntshav siab. Cov nyhuv ntawm cov tshuaj tsis cuam tshuam rau lub cev thiab tsis ua rau muaj kev tsis zoo, qhov tsis haum tshuaj. Lub siab tau mus txog 130/80 thiab tseem nyob qib no. Kuv qhia koj kom mus so ntawm 2 lub lis piam thaum noj tshuaj.