替米沙坦培训.pptVIP

通用名称：替米沙坦片 商标名：安内强 性状：白色或类白色片 适应症：原发性高血压 规格：40mg×14片/28片 80mg×7片/14片 用法用量：40-80mg,每日一次 谷/峰比值和24-小时血压控制 肾脏病人用药剂量 由于替米沙坦经胆汁排泄，所以对于肾脏病人无需调节剂量 替米沙坦的血清蛋白结合率为 99.5% ，透析不能清除 替米沙坦能够有效减少轻、中、重度的肾功能病人或终末期肾病病人的SBP和DBP 药理学特点 替米沙坦高选择性与 AT1 结合并且非常牢固 替米沙坦在所有ARB中半衰期最长、分布容积最大 替米沙坦在常规剂量下有 PPARg 作用。 不同年龄和性别不需调整剂量 替米沙坦经肝脏代谢，肾功能不全患者不需调整剂量 替米沙坦与常规药物无相互作用 高降压质量 80mg替米沙坦的降压疗效和优于氯沙坦50mg和缬沙坦80mg,和氨氯地平相似 有效控制清晨血压,避免清晨心血管事件 替米沙坦在目前上市ARB类抗高血压药中谷/峰比值最高 END The RAAS, in particular angiotensin II, contributes to cardiovascular disease by increasing blood pressure and also by causing inflammation, leading to sclerosis and tissue hypertrophy. ARBs and angiotensin-converting enzyme (ACE) inhibitors block the RAAS by different mechanisms. ACE inhibitors block the conversion of angiotensin I to angiotensin II. However, angiotensin II can be formed by other pathways. This can lead to a gradual return of angiotensin levels to baseline, a phenomenon termed ‘angiotensin II escape’.1 ACE inhibitors also have other physiological effects, some beneficial,2 but which can also result in cough. Two principal receptors mediate the effects of angiotensin II in humans. The AT1 receptor is responsible for most of the pathological effects associated with angiotensin II, whereas the AT2 receptor counteracts these effects.3 ARBs specifically block the AT1 receptor. Because ARBs specifically block the AT1 receptor but allow continued activation of the AT2 receptor, they can provide tissue-protective effects beyond their effects on blood pressure. Hanon S, et al. Persistent formation of angiotensin II despite treatment with maximally recommended doses of angiotensin converting enzyme inhibitors in patients with chronic heart failure. J Renin Angiotensin Aldosterone Syst 2000;1:147–150. Chen R, et al. Important role of nitric oxide in the effect of angiotensin-converting enzyme inhibitor imidapril on vascular injury. Hypertension 2003;42:542–547. Hurairah H, Ferro A. The role of the endothelium in the control