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ატენორიკის ერთი ტაბლეტი შეიცავს აქტიური ნივთიერებების _ ატენოლოლის 100 მგ-სა და ქლორტალიდონის 25 მგ-ს.
მოქმედების მექანიზმი
კომბინირებული ჰიპოტენზიური საშუალება, რომლის ხანგრძლივი მოქმედება დამყარებულია შემადგენელი კომპონენტების ეფექტურობაზე. ატენოლოლი - კარდიოსელექციური ბეტა-1-ადრენობლოკატორი. ახასითებს ანტიანგინალური, ჰიპოტენზიური და ანტიარითმული მოქმედება. ამცირებს სინუსური კვანძის ავტომატიზმს, ატრიო-ვენტრიკულურ გამტარობას, მიოკარდიუმის მიერ ჟანგბადზე მოთხოვნილებას, მიოკარდიუმის აგზნებადობას, აიშვიათებს გულის შეკუმშვათა სიხშირეს. არტერიული წნევის დაქვეითება განპირობებულია ზემოაღნიშნული მექანიზმებითა და რენინის სეკრეციის დათრგუნვით. არ ახასიათებს სიმპატომიმეტური და მემბრანოსტაბილიზატორული აქტივობა. ქლორტალიდონი - ხანგრძლივი მოქმედების ზომიერად გამოხატული ეფექტის დიურეზული საშუალება. ნეფრონის დისტალურ მილაკებში არღვევს ნატრიუმის, ქლორის იონების და ეკვივალენტური აოდენობით წყლის რეაბსორბციას, ზრდის ორგანიზმიდან კალიუმის და მაგნიუმის იონების, ბიკარბონატების გამოდევნას, აფერხებს შარდმჟავასა და კალციუმის იონების გამოდევნას, ამცირებს სისხლძარღვის კედელში ნატრიუმის იონების შემცველობას, რაც ამცირებს მის მგრძნობელობას სისხლძარღვების შემავიწროებელი ფაქტორების მიმართ. პლაზმაში ატენოლოლის Cmax მიიღწევა პრეპარატის მიღებიდან 2-4 საათის შემდეგ. ნივთიერების 90% ორგანიზმიდან გამოიდევნება თირკმლების საშუალებით 48 საათის განმავლობაში. T1/2 შეადგენს 6-10 საათს. პლაზმაში ქლორტალიდონის Cmax მიიღწევა პრეპარატის მიღებიდან 17-30 საათის შემდეგ. T1/2-ს განაპირობებს მიღებული დოზა და 50 მგ-დან 200 მგ-ის დიაპაზონში შეადგენს 40 სთ-ს. ელიმინაცია ძირითადად ხდება თირკმლების საშუალებით და ნაწილობრივ - ნაღვლის გზით.

ჩვენებები
- არტერიული ჰიპერტენზია;
-დაძაბვის სტენოკარდია (ხანგრძლივი მკურნალობისთვის).

მიღების წესები და დოზები
არტერიული ჰიპერტენზიის დროს საწყისი დოზა შეადგენს 1/2 ტაბლეტს დღეში ერთხელ, არაეფექტურობისას - 1 ტაბლეტი დღეში ერთხელ. დოზის შემდგომი გაზრდა უმრავლეს შემთხვევაში აღარ იწვევს არტერიული წნევის დაქვეითებას. დასაშვებია პაციენტის გადაყვანა სხვა ჰიპოტენზიური საშუალებებიდან უშუალოდ ატენორიკზე, გარდა კლონიდინისა. თირკმლების გამომყოფი ფუნქციის დარღვევის მქონე ასაკოვან პაციენტებში ატენორიკის დოზა უნდა შეირჩეს კრეატინინის კლირენსის (კკ) გათვალისწინებით. კკ 15-35 მლ/წთ - 1/2 ტაბ/დღეში ან 1 ტაბლეტი დღეგამოშვებით. კკ ნაკლები 15 მლ/წთ - 1/2 ტაბლეტი დღეგამოშვებით. პრეპარატი ინიშნება დღეში ერთხელ ჭამის წინ მცირეოდენ სითხესთან ერთად, სასურველია დილით.

გვერდითი მოვლენები
გულ-სისხლძარღვთა სისტემის მხრივ: ბრადიკარდია, AV გამტარობის დარღვევა, კიდურების გაცივების შეგრძნება, ერთეულ შემთხვევაში გულის მწვავე უკმარისობის სიმპტომები. საჭმლის მომნელებელი სისტემის მხრივ: გულისრევა, შეკრულობა, დიარეა, პირის სიმშრალე. სასუნთქი სისტემის მხრივ: იშვიათად - ბრონქოსპაზმი.ენდოკრინული სისტემის მხრივ: ერთეულ შემთხვევაში - ჰიპოგლიკემიური მდგომარეობანი შაქრიანი დიაბეტით დაავადებულებში. სასქესო სისტემის მხრივ: ერთეულ შემთხვევაში - პოტენციის დაქვეითება. ალერგიული რეაქციები: ერითემა, ქავილი. ზოგჯერ: ოფლიანობა, საერთო სისუსტე, საცრემლე ჯირკვლის სეკრეციის დაქვეითება.

უკუჩვენება
გულის მწვავე უკმარისობა, გულის ქრონიკული უკმარისობა, ატრიო-ვენტრიკულური ბლოკადა II, III ხ., ბრადიკარდია, ლაბილური მიმ დინარეობის ინსულინდამოკიდებული შაქრიანი დიაბეტი (I ტიპის), სინოაურიკულური ბლოკადა, ბრონქული ასთმა, ჰიპოკალიემია, ღვიძლისა და თირკმლების ფუნქციის გამოხატული დარღვევები, ბავშვთა ასაკი, პრეპარატის კომპონენტებისადმი მაღალი მგრძნობელობა.

განსაკუთრებული მითითებები
ორსულობის პერიოდში პრეპარატის გამოყენების აუცილებლობა დედისათვის, უნდა აჭარბებდეს ნაყოფზე მისი უარყოფითი გავლენის პოტენციურ რისკს. ლაქტაციის პერიოდში უნდა გადაწყდეს ძუძუთი კვების აკრძალვის საკითხი. პრეპარატი დიდი სიფრთხილით ინიშნება თირკმლისა და/ან ღვიძლის ფუნქციის დარღვევის, რეინოს სინდრომის და პერიფერიული არტერიების სხვა მაობლიტირებელი დაავადებების არსებობის დროს. კონტაქტური ლინზების მომხმარებელმა პაციენტებმა პრეპარატი სიფრთხილით უნდა მიიღონ, ვინაიდან იგი ამცირებს საცრემლე ჯირკვლების სეკრეციის უნარს. არტერიული წნევის მკვეთრი მომატების თავიდან აცილების მიზნით, ფეოქრომოციტომით დაავადებულებში ატენორიკი ინიშნება მხოლოდ ალფა-ადრენობლოკატორებით მკურნალობის შემდეგ. ატენორიკი არ გამოიყენება სტენოკარდიული შეტევების კუპირებისათვის. “მოხსნის სინდრომის” თავიდან აცილების მიზნით ატენორიკით ხანგრძლივი მკურნალობის შეწყვეტა ხდება თანდათანობით. არტერიული წნევის მკვეთრი დაქვეითების თავიდან აცილების მიზნით, ატენორიკით მკურნალობის ფონზე დაუშვებელია ალკოჰოლის მიღება. დოზის გადაჭარბებისას: სიმპტომები - ბრადიკარდია, არტერიული ჰიპოტენზია, გულის მწვავე უკმარისობა, ბრონქოსპაზმი. ინსულინის ან ორალური ჰიპოგლიკემიური პრეპარატების ატენორიკთან კომბინაციაში გამოყენებისას ძლიერდება მათი მოქმედება. ერთდროულად ატენორიკისა და ეთანოლის, ანტიჰიპერტენზიული საშუალებების, ტრიციკლური ანტიდეპრესანტების, ბარბიტურატების, დიურეტიკების, ფენოტიაზინის, ასევე პერიფერიული ვაზოდილატატორების გამოყენებისას მოსალოდნელია არტერიული წნევის მკვეთრი ან მნიშვნელოვანი დაქვეითება. ატენორიკი (ზოგადად ბეტა-ბლოკატორები) არ ინიშნება ვერაპამილთან ერთად და თითოეული მათგანის მიღება დასაშვებია მხოლოდ მეორე პრეპარატის მოხსნიდან რამდენიმე დღის შემდეგ.

შენახვის პირობები და ვადები
პრეპარატის ვარგისიანობის ვადაა 3 წელი, ინახება 10-25oC ტემპერატურაზე, სინათლისაგან დაცულ, მშრალ, ბავშვებისათვის ხელ მიუწვდომელ ადგილზე!

აფთიაქში გაცემის წესი
ექიმის რეცეპტის მიხედვით!

რეგისტრაციის # და თარიღი
წს N რ - 002648 13.06.2007

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