Tenorric

Tenorik is a complex antihypertensive drug with a rather long therapeutic effect.

Indications Tenorica

It is used to reduce excessively elevated blood pressure values.

Release form

The preparation is produced in tablet form, inside blister plates or strips, with 28 or 100 tablets inside the pack.

Pharmacodynamics

The tenoric contains the atenolol element, which is a cardioselective β-blocker and has an antihypertensive effect, and in addition chlortalidone, which has diuretic properties. Both these components have a long-term drug half-life, which allows for an antihypertensive effect lasting a minimum of 24 hours.

Atenolol is an artificial cardioselective adrenoreceptor blocker that does not have membrane stabilization or partial sympathomimetic agonist influence.

Pharmacokinetics

Atenolol

Absorption and distribution processes.

After oral administration, the active element is absorbed inside the gastrointestinal tract by approximately 45-50%. The Cmax level of this component within the blood plasma is recorded after 2-3 hours after ingestion. The synthesis with protein is rather weak - only about 5-15%.

Exchange processes and excretion.

It is known that atenolol is not metabolized inside the liver. More than 90% of the substance absorbed into the circulatory system is excreted completely unchanged.

The half-life is approximately 6-9 hours, but if the renal insufficiency is severe, this indicator may increase, because atenolol excretion occurs mainly through the kidneys.

Chloramide

Absorption and distribution processes.

After ingestion of chlorthalidone by mouth, about 60-65% of the substance is absorbed inside the gastrointestinal tract. Plasma Cmax values are noted approximately after 10-12 hours. Chlorthalidone has a rather strong synthesis with protein - about 70-75%.

Excretion.

Excreted through the kidneys, and the half-life of the substance fluctuates within 50 hours.

Dosing and administration

The average dosage for an adult is 0.1 g per day. At the same time to begin treatment is still recommended with a single intake of 0.05 g of the drug per day.

For elderly people, it is recommended to use lower dosages of the drug.

People with problems in the work of the kidney in the event of such a need should reduce the frequency of drug use.

It is also necessary to take into account that with prolonged use of Tenor, its cancellation should be carried out gradually, without finishing the reception very sharply.

Use Tenorica during pregnancy

Use Tenorik during pregnancy is allowed only if there are life indications.

Contraindications

The main contraindications:

• bradycardia, having a high degree of intensity;
• cardiogenic shock;
• decreased values of blood pressure in a pronounced or progressive form;
• feohromocytoma;
• the metabolic form of acidosis;
• disorders of peripheral blood flow in a severe degree;
• AB blockade, which has 1 or 3 degrees;
• SSSU;
• diabetes mellitus or hypoglycemia;
• insufficiency of cardiac function (having a chronic or acute stage);
• Variable angina pectoris;
• bronchial asthma, which has a progressive form;
• obstructive bronchitis;
• myasthenia or gout;
• hepatitis, which has a sharp form;
• acute renal failure;
• presence of hypersensitivity to medicinal elements.

Side effects Tenorica

Taking a medication can trigger the emergence of certain side-effects:

• disorders in the SSS area: the development of bradycardia, orthostatic collapse, Raynaud's disease, arrhythmia and AV blockade, and in addition, increased manifestations of cardiac insufficiency, cold extremities and the appearance of signs of intermittent claudication;
• disorders affecting the work of the PNS or CNS: headaches, confusion, lability of mood, dizziness, hallucinations, and in addition, acute psychosis, sleep disorders, paresthesia, apathy, visual disturbances, increased fatigue and a sense of disorientation;
• problems with the digestive function: abnormalities of the gastrointestinal tract, dry mouth mucosal, nausea (due to the influence of chlorthalidone), hepatotoxicity against intrahepatic cholestasis, pancreatitis, increased liver transaminases, anorexia and constipation;
• disorders of hematopoietic activity: agranulocytosis, thrombocyto- or leukopenia, eosinophilia or purpura;
• lesions affecting the epidermis: dryness of the ocular membranes, exacerbation of psoriasis, or psoriasis-like symptoms, as well as alopecia, photosensitivity and eruptions;
• impairment of respiratory function: bronchial spasms;
• laboratory data: hypokalemia, hyperuricemia, or hyponatremia;
• others: weakening potency, increasing the number of antinuclear antibodies and a tolerance disorder for glucose.

But in general, Tenoric is often tolerated by patients without significant complications. Negative manifestations are rare and have a very weak degree of expression, bearing, for the most part, a transient nature.

[1]

Overdose

Intoxication with the drug can cause intense bradycardia, cardiac insufficiency in the acute form, lowering the values of AD, convulsions with bronchial spasms, and a strong sense of drowsiness.

To eliminate such manifestations, sometimes even hospitalization with placement in the ICU is required, where gastric lavage is performed under the control of doctors.

If there is a pronounced decrease in the level of blood pressure and a strong shock, it is required to administer the affected plasma or a plasma substitute.

When bronchial spasms develop, bronchodilators are used.

If necessary, hemoperfusion or a hemodialysis procedure can be performed.

Interactions with other drugs

When a combination of a drug with dihydropyridine (nifedipine) and its derivatives can increase the likelihood of a decrease in blood pressure, and in people with hidden heart failure, this combination can lead to severe disorders of the circulatory system.

In addition, it is required to abandon the combination of the substance with SG and β-adrenoblockers, because, as a result, the AB-conduction index can significantly increase.

In addition, β-adrenoblockers can exacerbate the course of ricochet hypertension, which often appears with a sharp discontinuation of clonidine. Provided that the therapy scheme involves the use of both drugs, admission of β-blockers is required to be canceled a few days before the end of the use of clonidine. If there is a need to replace clonidine with a β-blocker, the latter should be started a couple of days after the end of the treatment with the use of clonidine.

It should be noted that very carefully, β-blockers should be combined with antiarrhythmic drugs of the 1st category, because such combinations can lead to a summation of the cardiodepressive effect.

Neutralize therapeutic effect of β-blockers and significantly increase the values of blood pressure can be used together with individual sympathomimetics - norepinephrine (norepinephrine) or epinephrine (epinephrine).

To reduce the antihypertensive properties of β-blockers lead drugs such as indomethacin with ibuprofen (substances from the group of NSAIDs and salicylates). In addition, with the use of salicylates in high dosages, the toxic effect of these elements on the central nervous system increases.

The use of medicines containing lithium in their composition must also be excluded if diuretics are used simultaneously with them. Because of this combination, the values of lithium clearance within the kidneys decrease.

An increase in the likelihood of lowering blood pressure (or a sharp drop in these indicators) can cause a combination of β-blockers with drugs of general anesthesia. In addition, there is a risk of potentiating the properties of muscle relaxants curare-like.

The use of Tenoric in combination with MAOI can lead to an increase in blood pressure.

After simultaneous use of a drug with ACE inhibitors (such as enalapril or captopril), at the initial stage of treatment, a sharp increase in hypotensive effect can be expected.

Combined therapy with furosemide, GCS, and amphotericin B leads to an increase in potassium excretion.

The medication effectiveness of insulin and the effect of oral antidiabetics may be weakened by combining with Tenorik. In this regard, people who take these medications need to constantly monitor the blood sugar values inside the blood.

Separate antihypertensive substances (among them barbiturates, tricyclics, diuretics and phenothiazines with vasodilators) are capable of potentiating the antihypertensive properties of Tenoric.

The use of β-blockers simultaneously with drugs blocking the activity of the Ca channels leads to the development of a negative inotropic effect and enhances its effect. Extreme caution is needed for people with reduced myocardial contractility and AV and sinoatrial conduction disorders, because such combinations can lead to intense bradycardia, a strong decrease in blood pressure and heart failure. It is forbidden to take Ca channel blockers in the period of 48 hours after the abolition of the use of β-blockers.

The expressed form of a bradycardia can develop at combination of a medicine with clonidine, reserpine, and also guanfacin.

[2]

Storage conditions

The tenor is required to be kept in a dark place and closed from penetration of moisture, which will be closed from the access of young children. Store the drug under temperature conditions within the limits of 20-25 ° C.

Shelf life

A tenorik can be used within 36 months from the date of manufacture of the medicament.

Application for children

The use of people under the age of 18 is prohibited.

[3]

Analogues

Analogues of the therapeutic drug are drugs Atenol, Tenoret, as well as Dinoric.

Reviews

Tenorik receives quite diverse reviews. Among its advantages patients allocate basically low cost, and also enough high medicamental efficiency.

Among the cons are the development of side-effects, of which the development of seizures is most often discussed, as well as impotence or alopecia arising from prolonged drug administration.