Ihe ọmụma
Olmesartan na olmesartan medoxomil bụ ogige ndị nwere njikọ chiri anya ejiri na ọgwụgwọ ọbara mgbali elu, mana ha abụghị otu. Olmesartan bụ ụdị ọgwụ na-arụ ọrụ, ebe olmesartan medoxomil bụ ọgwụ na-agbanwe na olmesartan n'ime ahụ. Ọdịiche a dị oke mkpa maka ịghọta ka ọgwụ si arụ ọrụ yana ihe kpatara eji hazie ya n'otu ụzọ. Na blọọgụ a, anyị ga-enyocha ọdịiche dị n'etiti ogige ndị a wee banye n'akụkụ dị iche iche nke olmesartan medoxomil ntụ ntụ, usoro ya, mmetụta ya, na ihe nwere ike ime karịa ọgwụgwọ ọbara mgbali elu.
Kedu ka olmesartan medoxomil ntụ ntụ si arụ ọrụ n'ime ahụ?
Olmesartan medoxomil ntụ ntụ bụ usoro ọgwụ emebere iji nyefee ogige nọ n'ọrụ, olmesartan, n'ahụ nke ọma. Ịghọta usoro omume ya na-achọ ileba anya na njem ọgwụ a na-ewe site na ịṅụ ọgwụ na mmetụta ọgwụgwọ ya.
Mgbe nchịkwa ọnụ gasịrị, olmesartan medoxomil na-abanye ngwa ngwa na tract gastrointestinal. Agbanyeghị, ọ naghị adị n'ụdị a ogologo oge. Akụkụ medoxomil ester nke molecule na-eje ozi dị ka prodrug, nke pụtara na ọ bụ ihe na-adịghị arụ ọrụ nke na-eme mgbanwe n'ime ahụ ka ọ bụrụ ọgwụ na-arụ ọrụ. Ngbanwe a na-esite na usoro a na-akpọ de-esterification, nke bụ isi na mgbidi eriri afọ.
N'oge de-esterification, enzymes na eriri afọ epithelium na-ekewa ndị medoxomil na molekul, na-ahapụ ụdị ọrụ: olmesartan. Ntughari a na-adị ngwa ma na-arụ ọrụ nke ọma, na-emekarị n'ime nkeji oge nke nnabata. Olmesartan nke a na-esi na ya pụta na-abanyekwa n'ọbara, ebe ọ nwere ike ịkpata mmetụta ọgwụgwọ ya.
Olmesartan so na klaasị ọgwụ akpọrọ angiotensin II receptor blockers (ARBs). Usoro izizi ya gụnyere igbochi ndị na-anabata angiotensin II ụdị 1 (AT1). Angiotensin II bụ vasoconstrictor nwere ike yana akụkụ bụ isi nke sistemu renin-angiotensin-aldosterone (RAAS), nke na-arụ ọrụ dị mkpa n'ịhazi ọbara mgbali elu na nguzozi mmiri n'ime ahụ.
Site n'igbochi ndị na-anabata AT1, olmesartan na-egbochi angiotensin II ijikọta ndị a na-anabata ya na anụ ahụ dị iche iche, gụnyere arịa ọbara, obi, akụrụ, na gland adrenal. Mgbochi a na-arụpụta ọtụtụ uru bara uru:
1. Vasodilation: Na-egbochi ndị na-anabata AT1 n'ime arịa ọbara na-eduga na ntụrụndụ nke anụ ahụ dị nro na mgbidi arịa, na-eme ka ha gbasaa. Vasodilation a na-ebelata nguzogide mpụta ma belata ọbara mgbali elu.
2. Mbelata mmepụta aldosterone: Angiotensin II na-akpali mmepụta nke aldosterone na gland adrenal. Site na igbochi mmetụta a, olmesartan na-ebelata ọkwa aldosterone n'ụzọ na-edoghị anya, na-eduga na mbelata sodium na njide mmiri.
3. Ọrụ renal na-emeziwanye: nkwụsị nke AT1 ndị na-anabata ya na akụrụ nwere ike inye aka mee ka ọbara na-erugharị na akụrụ na ịkwalite nsị sodium, na-enye aka na mbelata ọbara mgbali.
4. Mmetụta mgbochi obi: Site n'ibelata mmetụta angiotensin II kpọmkwem na obi, olmesartan nwere ike inye aka gbochie imegharị obi na imeziwanye ahụike obi n'ozuzu ya.
Ojiji olmesartan medoxomil ntụ ntụ dị ka prodrug na-enye ọtụtụ uru. Nke mbụ, ọ na-akwalite bioavailability ọnụ nke ogige nọ n'ọrụ. Medoxomil ester na-eme ka molekul ahụ dịkwuo lipophilic, na-eme ka mmịnye ya dị na mgbidi eriri afọ. Mmụba nke a emelitere na-asụgharị ka ọ dị mma yana nsonaazụ ọgwụgwọ a na-atụ anya ya.
Na mgbakwunye, usoro prodrug na-enye ohere iji otu ugboro kwa ụbọchị, nke nwere ike imeziwanye nnabata onye ọrịa. Mgbe agbanwechara na olmesartan, ọgwụ na-arụ ọrụ nwere ogologo ndụ ọkara nke ihe dị ka awa 13, na-ejigide mmetụta na-ebelata ọbara mgbali kwa ụbọchị.
Ọ dị mma ịmara na mgbe ahụ olmesartan medoxomil ntụ ntụ Emebere ya maka nchịkwa ọnụ, a pụkwara inye olmesartan na-arụ ọrụ n'ime intravenous n'ụfọdụ ntọala ụlọ ọgwụ. Agbanyeghị, ụdị prodrug nke ọnụ na-anọgide na-abụkarị ụzọ kacha mma ma dịkwa mma maka nnyefe maka njikwa ọbara mgbali elu na-adịghị ala ala.
Enwere ike iji olmesartan medoxomil maka ọnọdụ ndị na-abụghị ọbara mgbali elu?
Ọ bụ ezie na olmesartan medoxomil bụ nke akwadoro ma jiri ya mee ihe maka ọgwụgwọ ọbara mgbali elu, nyocha enyochala uru ọ nwere na ọnọdụ ahụike ndị ọzọ. Usoro ọgwụgwọ nke ọgwụ ahụ, karịsịa mmetụta ya na renin-angiotensin-aldosterone system (RAAS), emeela nchọpụta banyere ịdị irè ya maka ọrịa dị iche iche nke obi na akwara.
1. Ọrịa mamịrị nephropathy:
Olmesartan medoxomil egosila nkwa n'ibelata ọganihu nke ọrịa shuga nephropathy, ọrịa akụrụ na-eme dị ka mgbagwoju anya nke ọrịa shuga. Nnyocha ROADMAP (Randomized Olmesartan na Mgbochi Ọrịa shuga Microalbuminuria) gosiri na olmesartan nwere ike igbu oge mmalite nke microalbuminuria, akara mmalite nke mmebi akụrụ, na ndị ọrịa nwere ụdị ọrịa shuga 2.
A na-eche na mmetụta renoprotective nke ọgwụ ahụ bụ n'ihi ike ya ibelata nrụgide intraglomerular na ibelata proteinuria. Site na igbochi mmetụta nke angiotensin II na efferent arteriole nke glomerulus, olmesartan na-enyere aka ịnọgide na-arụ ọrụ akụrụ ma belata ọrịa akụrụ na-arịa ọrịa shuga.
2. Obi mgbawa:
Ọ bụ ezie na ọ bụghị ọgwụgwọ mbụ maka ọdịda obi, olmesartan medoxomil na ARB ndị ọzọ ka a mụọla maka uru ha nwere na ọnọdụ a. Ikike ọgwụ ahụ iji belata ibu dị n'ime obi yana igbochi usoro imezigharị obi na-emerụ ahụ na-eme ka ọ bụrụ onye ndoro-ndoro maka njikwa nkụda obi, ọkachasị na ndị ọrịa na-enweghị ike ịnabata ndị na-egbochi ACE.
Ụfọdụ nnyocha egosiwo na olmesartan nwere ike imeziwanye ọrụ ventricular aka ekpe ma belata ụlọ ọgwụ na ndị ọrịa nwere nkụda mmụọ. Otú ọ dị, a chọkwuru nnyocha iji gosi nke ọma ọrụ ya na ọgwụgwọ nkụda obi.
3. Atherosclerosis:
Olmesartan medoxomil egosila ikike ibelata ọganihu nke atherosclerosis, mwube nke plaque n'ime akwara. OLIVUS (Mmetụta Olmesartan na Ọganihu nke Atherosclerosis nke Atherosclerosis: Nyocha site na Intravascular Ultrasound) ọmụmụ gosiri na olmesartan nwere ike belata ọganihu nke atherosclerosis nke akwara obi na ndị ọrịa nwere angina pectoris kwụsiri ike.
A na-eche na mmetụta mgbochi atherosclerotic nke olmesartan na-emetụta ya na ihe ndị na-egbochi mkpali ya na ikike ya imeziwanye ọrụ endothelial, karịa mmetụta mbelata ọbara ya.
4. Ọrịa Metabolic:
Ụfọdụ nnyocha egosila na olmesartan medoxomil nwere ike inwe mmetụta bara uru na akụkụ nke ọrịa metabolic. Nnyocha e mere egosila mmụba nke mmetụta insulin na profaịlụ lipid na ndị ọrịa ejiri olmesartan gwọọ ya. Mmetụta ndị a nwere ike ịba uru karịsịa maka ndị ọrịa nwere ọbara mgbali elu ndị nwekwara ọrịa metabolic syndrome ma ọ bụ nọ n'ihe ize ndụ maka ịmalite ịmalite ọrịa shuga 2.
5. Mgbochi ọrịa strok:
Ọ bụ ezie na ọbara mgbali elu n'onwe ya bụ isi ihe na-akpata ọrịa strok, ikike olmesartan medoxomil nwere na mgbochi ọrịa strok karịrị mmetụta ọ na-ebelata ọbara mgbali. Ụfọdụ ọmụmụ atụwo aro na ARB dị ka olmesartan nwere ike inye mmetụta neuroprotective ma melite nsonaazụ na ndị ọrịa nwere ọrịa strok.
6. Ọrịa akụrụ na-adịghị ala ala:
N'ime ndị ọrịa nwere ọrịa akụrụ na-adịghị ala ala nke ọrịa shuga adịghị akpata, olmesartan medoxomil egosila na enwere ike ibelata ọganihu ọrịa. Ikike ya ibelata proteinuria na idowe ọnụego nzacha glomerular na-eme ka ọ bụrụ nhọrọ bara uru na njikwa ọbara mgbali elu na ndị ọrịa nwere ọrịa akụrụ.
7. Aneurysm Aortic:
Nchoputa nke mbu egosila na olmesartan medoxomil nwere ike inye aka belata uto nke aneurysms aortic. Site n'ibelata mbufụt na imeziwanye ọrụ vaskụla, ọgwụ ahụ nwere ike inye aka mee ka aneurysms kwụsie ike ma belata ihe egwu nke mgbawa.
8. Atirial fibrillation:
Ụfọdụ ọmụmụ enyochala ikike olmesartan nwere n'igbochi fibrillation atrial, karịsịa na ndị ọrịa nwere ọbara mgbali elu. Mmetụta ọgwụ a na-emezigharị obi na ikike ya ibelata nrụgide atrial aka ekpe nwere ike itinye aka na mbelata ihe ize ndụ nke fibrillation atrial.
Ọ bụ ezie na enwere ike iji olmesartan medoxomil gafere ọbara mgbali elu na-ekwe nkwa, ọ dị mkpa iburu n'obi na ọtụtụ n'ime ngwa ndị a ka na-enyocha. Ndị ụlọ ọrụ nchịkwa anabataghị ọgwụ ahụ ugbu a maka ihe ngosi ndị a, yana ojiji ya maka ọnọdụ ndị a ka a ga-ewere dị ka ahaghị aha.
Ọzọkwa, ekwesịrị iji nlezianya mee mkpebi iji olmesartan medoxomil maka ọnọdụ ndị na-abụghị ọbara mgbali elu, na-atụle ọnọdụ ahụike onye ọrịa n'ozuzu ya, uru ndị nwere ike ime na ihe egwu. Dị ka ọ bụla ọgwụ, ojiji nke olmesartan medoxomil maka ihe nrịbama na-apụ apụ kwesịrị ịdị n'okpuru nlekọta anya nke ọkachamara ahụike.
Ọ bụrụ na ị nwekwara mmasị na ngwaahịa a ma chọọ ịmatakwu nkọwa ngwaahịa, ma ọ bụ chọọ ịmata maka ngwaahịa ndị ọzọ metụtara, biko nweere onwe gị ịkpọtụrụ. iceyqiang@aliyun.com.
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