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- Pharmacology For Telmisartan + Hydrochlorothiazide
Telmisartan + Hydrochlorothiazide Pharmacology
Telmisartan + HydrochlorothiazideAbout Telmisartan + HydrochlorothiazideN/AMechanism of Action of Telmisartan + HydrochlorothiazideN/APharmacokinets of Telmisartan + HydrochlorothiazideN/AOnset of Action for Telmisartan + HydrochlorothiazideN/ADuration of Action for Telmisartan + HydrochlorothiazideN/AHalf Life of Telmisartan + HydrochlorothiazideN/ASide Effects of Telmisartan + HydrochlorothiazideN/AContra-indications of Telmisartan + HydrochlorothiazideN/ASpecial Precautions while taking Telmisartan + HydrochlorothiazideN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Telmisartan + HydrochlorothiazideN/AInteractions for Telmisartan + HydrochlorothiazideN/ATypical Dosage for Telmisartan + HydrochlorothiazideN/ASchedule of Telmisartan + HydrochlorothiazideN/AStorage Requirements for Telmisartan + HydrochlorothiazideN/AEffects of Missed Dosage of Telmisartan + HydrochlorothiazideN/AEffects of Overdose of Telmisartan + HydrochlorothiazideN/A
TelmisartanAbout TelmisartanAngiotensin II Receptor antagonist, Antihypertensive.Mechanism of Action of TelmisartanIt is a competitive antagonist of angiotensin-2 at AT-1 receptor. It decreases peripheral resistance and lowers BP in hypertensive individuals. It blocks all overt actions of angiotensin-2 such as: - 1. Vasoconstriction, 2. Central & Peripheral sympathetic stimulus, 3. Release of aldosterone and adrenaline, 4. Salt and water reabsorption, 5. Central actions like thirst, vasopressin release, and growth promoting actions on heart and blood vessels.Pharmacokinets of TelmisartanAbsorption: Absorbed orally, bioavailability is about 42% Distribution: It is distributed in to the body in a highly protein bound form, Metabolism: Metabolized by glucuronide conjugation in to an inactive metabolite. Excretion: Excreted mainly through faeces and rest is excreted through urine.Onset of Action for TelmisartanN/ADuration of Action for Telmisartan24 hoursHalf Life of Telmisartan24 hoursSide Effects of Telmisartan1.Dizziness
11.Upper respiratory tract infections
12.Urinary tract infections
13.Elevated liver enzymes
20.Precipitate renal failure in renal artery stenosis, and in insufficient renal blood flow
Contra-indications of TelmisartanHypersensitivity to the drugSpecial Precautions while taking Telmisartan1.Renal impairment
4.Aortic or mitral valve stenosis
6.Use cautiously in volume depleted and salt depleted individuals, these conditions should be corrected before starting the therapy
7.Patient should be cautiously involve in driving or operating heavy machinery during therapy
8.Avoid alcohol or use with caution during therapy
9.Use with caution in hyperkalemia and along with potassium sparing diuretics
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationContraindicatedIndications for Telmisartan1.HypertensionInteractions for TelmisartanN/ATypical Dosage for Telmisartan40mg once daily
Maintenance dose: 20 to 80mg once daily
Schedule of TelmisartanHStorage Requirements for TelmisartanStore at room temperature at a range of 15 to 30 degree C. protects from direct heat and light and store in a tightly closed container. Do not remove blisters until just before taking tablets
Effects of Missed Dosage of TelmisartanTake the missed dose as soon as remember; if it is the time of next dose then skip the missed dose and take the regular doseEffects of Overdose of TelmisartanTreatment is supportive and symptomatic. If hypotension occur kept patient in supine position and if required give I.V. infusion of normal saline
HydrochlorothiazideAbout HydrochlorothiazideThiazide derivatibve, Diuretic.Mechanism of Action of HydrochlorothiazideIt is thiazide diuretic which exerts its action by acting at site-3(central dilating segment of early distal tubule). It binds to Na+Cl- symporter and inhibits Na+Cl- symport at the luminal membrane. It has additional carbonic anhydrase inhibitory actions in proximal tubules. It increases natriuresis, kaliuresis and diuresis. It decreases Ca2+ excretion and increases Mg2+excretion. It also has minor carbonic anhydrase inhibitory action. It also causes direct arteriolar vasodilatation and decreases total peripheral resistance. The antihypertensive actions of the drug may be attributable to depletion of sodium and subsequent reduction in plasma volume and a decrease in peripheral resistance. Decrease in peripheral resistance is due to either the loss of sodium from the arteriolar wall or a direct action on the vascular bed. It is an effective drug in edema associated with congestive heart failure.
Vertigo: Diuretics are used in vertigo in assumption that vertigo is due to endolymphatic hydrops. They reduce labyrinthine fluid pressure
Pharmacokinets of HydrochlorothiazideAbsorption: It is absorbed after oral administration.
Metabolism: It is not metabolized in the body.
Excretion: Excreted unchanged in urine.
Onset of Action for Hydrochlorothiazide1 to 3 hoursDuration of Action for Hydrochlorothiazide12 to 16 hoursHalf Life of Hydrochlorothiazide5 to 15 hoursSide Effects of Hydrochlorothiazide1. Dizziness
2. Blurred vision
4. Tingling fingers
5. Dry mouth
14. Elevated levels of glucose, calcium and lipids
15. Gastro intestinal disturbances
17. Electrolyte imbalance
24. Muscle cramps
26. Blood dyscrasias
Contra-indications of Hydrochlorothiazide1. Hyper uricaemia
2. Hyper calcaemia
3. Renal impairment
4. Hepatic impairment
6. Hypersensitivity to the drug
7. Hyper sensitivity to sulfonamides
8. Fluid and electrolyte imbalance
Special Precautions while taking Hydrochlorothiazide1. Gout
2. Diabetes mellitus
3. Renal impairment
4. Hepatic impairment
5. Monitor and correct Fluid and electrolyte imbalance
6. Hyper parathyroidism
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationMay be usedIndications for Hydrochlorothiazide1. Hypertension
2. Oedema associated with heart failure
3. Oedema due to renal and hepatic diseases
4. Diabetes insipidus
5. Idiopathic hypercalciurea.
Interactions for HydrochlorothiazideCholestyramine & Colestipol: decrease absorption of hydrochlorothiazide.
Diazoxide: Additive action - may cause hyperglycemia, hyperuricaemia and hypotension.
Digitalis: Diuretics induced hypokalaemia may precipitate digitalis toxicity.
Lithium: Hydrochlorothiazide potentiates therapeutic and toxic effects by increasing its renal excretion.
Frusemide: Synergy leading to profound diuresis and greater than predicted electrolyte loss.
Non-depolarizing muscle relaxants: Diuretics induced hypokalaemia enhances efficacy.
Sulfonylureas: Efficacy decreased due to hydrochlorothiazide induced glucose intolerance.
Propantheline: Bioavailability of hydrochlorothiazide increased.
Metoclopramide: Bioavailability of hydrochlorothiazide decreased.
NSAIDs: Natriuretic effect of hydrochlorothiazide decreased.
Typical Dosage for HydrochlorothiazideAdults:
Hypertension: 25mg once daily or in divided doses. Increased to 50mg if required; depending up on the patient`s response.
Children: 1mg/kg single daily dose.
Starts with 25 to 50mg. Increased the dose until desired response is obtained.
Maximum dose: 200mg/day
Maintenance dosage: 25 to 100mg daily or on alternate days.
Children: 1mg/kg single daily dose or 1 to 3mg/kg/day in two divided doses
Schedule of HydrochlorothiazideGStorage Requirements for HydrochlorothiazideStore at room temperature in a well closed container and protected from light.Effects of Missed Dosage of HydrochlorothiazideTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose.Continue the regular schedule.Do not double the dose.Effects of Overdose of HydrochlorothiazideTreatment is supportive and symptomatic. Remove drug from the body by induced emesis and gastric lavage. Monitor and assist respiratory, cardiovascular, and renal function as indicated. Monitor and support fluid and electrolyte balance.
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