angiotensin II receptor blocker

angiotensin II receptor blocker (aii. aar. bii. ess.), aupcharikpane angiotensin II receptor prakar 1 (aii. tii. 1) virodhi, jyanna angiotensin receptor blocker, angiotensin II receptor virodhi kinwa aii. tii. 1 receptor virodhi asehi mhanatat, haah aushadhancha eka gut aahe joou angiotensin II receptor prakar 1 (aii. tii. 1) laa bandhato aanee avarodhit karato aanee tyadvare renin-angiotensin pranaliche dhamani sankuchan aanee soodiyam dharana prabhav avarodhit karato.
uchch raktadab (uchch raktadab), madhumehi nephropathy (madhumehamule mutrapindache nuksan) aanee hradayavikarachya zatkyavar upchar karane heey tyanche mukhya upayog aahet. teey aii. tii. 1 receptorchya sakriyatela nivadakpane avarodhit karatat, jyamule ess avarodhakanchya tulanet angiotensin II chey bandhan rokhate.
davya bajuchya hrudayavikarachya zatkyasah uchch raktadab vikasit prapt rugnanmadhye arbs aanee samaan-attributed ess inhibitors heey donhi pratham-ola antihypertensive mhanoon soochit kele jaatat. tathapi, ess avarodhakanchya tulanet arbs qamee pratikool parinam nirman karatat asey disate.
vaidyakeey vapar.
angiotensin II receptor blockercha vapar pramukhyane uchch raktadabavaril upcharansathi keela jaato, jethe rugna pramukhyane satat aanee/kinwa koradya khokalyamule ess avarodhak upcharpaddhaticha asahishnu asato. teey bradykinin kinwa itar kinninsche vighatan rokhat naheet aanee asha prakare keval kvachitach satatcha korada khokala aanee/kinwa angioedemashi sambandhit asatat jeey ess avarodhak upcharpaddhati maryadit karatat. agadi alikade, tyancha vapar ess avarodhak upcharpaddhati, visheshtah candesartencha asahishnu asalelya rugnanmadhye hrudayavikarachya upcharansathi keela gela aahe. irbuserton aanee loserton yanchyakade chachanichi mahitee aahe jee type 2 madhumeh asalelya uchch raktadab asalelya rugnanmadhye fayda darshavate aanee madhumehachya nephropathychya pragatila vilamb houu shakato. shakato duheri andh abhyasat asey aadhalun aale qee "licinoprilne insulinchi sanvedansheelata sudharali, tarr losartonne tyavar parinam keela nahee."ardhashishichya pratibandhatmak upcharanmadhye candesartencha prayog mhanoon vapar keela jaato. ardhashishi rokhanyasathi candesartenpeksha licinopril qamee vela prabhavi asalyache aadhalun aale aahe.
angiotensin II receptor blockermadhye raktadab niyantranachya sandarbhat bhinn kshamata asatat, jyache kamal matrevar sankhyikiyadrushtya bhinn parinam hotat. vaidyakeey vyavharat vaparlyas, vaparlela vishisht ghatak aavashyak pratisadachya pramananusar badaloo shakato.
yapaiki kahee aushadhancha euricosuric prabhav asato.
losarton (kozar) navachya aarabchya 10 aathvadyanchya upcharanantar eka abhyasat, laingikdrushtya aksham asalelya uchch raktadab asalelya 88 takke purushanni laingikatechya kiman eka kshetrat sudharana nondavali aanee ekoon laingik samadhan 7.3 varoon 58.5% paryant sudharle. beeta-blocker carvedillachi tulana valsartenshee kelelya abhyasat, angiotensin II receptor blockercha keval laingik karyavar konatahi hanikarak parinam jhaala nahee, tarr pratyakshat tyat sudharana jhaali. itar aarbsmadhye candesarten (atakand), telmisarton (micardis) aanee vulsarton (deoven), fimasartan (kanrab) yancha samavesh hoto.
aii. tii. 1 receptor uttejanadvare angiotensin II heey eka pramukh tanav samprerak aahe aanee kaaran (arbs) yaa receptorsna avarodhit karatat, tyanchya uchch raktadabavirodhi prabhavanvyatirikt, tanav-sambandhit vikaranchya upcharansathi vicharat ghetale jaau shakate.
2008 madhye, alzheimer rogashi (aii. dii.) tyancha ullekhaneey nakaratmak sambandh asalyache nondavale gele. amerikechya majee sainik vyavhar pranalichya vibhagasah pannas laakh rugnanchya nondinchya purvalakshi vishleshanat asey aadhalun aale qee samanyatah vaparlya jaanarya vividh prakarchya uchcharaktadabavirodhi aushadhanche jahirat parinam khoop vegale hote. angiotensin receptor blocker (aii. aar. bii. ess.) aushadh rugnanna itar uchcharaktadabavirodhi aushadhe aushadhe tulanet jahirat vikasit honyachi shakyata 35 teey 40 takke qamee hotee.
1968 chya strokechya rugnanchya purvalakshi abhyasatoon asey disun aale qee aar. bii. saha prestroke upchar heey strokechi tivrata qamee karane aanee changle parinam yaa donhinshi sambandhit asoo shakatat. haah shodh prayogik mahitishi sahmat aahe jeey soochit karate qee aii. aar. bii. chaa cerebral protective effect aahe.
pratikool parinam.
yaa shrenichi aushadhe sahasa changlya prakare sahan kelee jaatat. samanya pratikool aushadh pratikriyanmadhye (aii. dii. aar. ess.) khaleel goshtincha samavesh hotoh chakkar yene, dokedukhi aanee/kinwa hyperclemia. upcharashi sambandhit kvachitach kvachitach upcharanmadhye pudhil goshtincha samavesh hotoh orthostatic hypotention, pural, atisar, apasmruti, yakrutache asamanya karya, snayu aakunchan, myalgia, pathdukhi, nidranash, haemoglobinchi patali qamee hone, mutrapindatil ashaktapana, grasnishoth aanee/kinwa anunasik gardi. yadruchchik niyantrit chachanyanvar aadharit 2014 chya cochrain paddhatshir punaravalokanat asey nondavale gele aahe qee ess avarodhak aushadh rugnanchi tulana aar. bii. aushadh rugnanshi kartana, ess avarodhak rugnanpeksha pratikool ghatananmule aar. bii. chey qamee rugna abhyasatoon mage hutley.
yaa vargachya vaparache eka mukhya kaaran mhanje satat korada khokala aanee/kinwa ess avarodhak upcharpaddhatishi sambandhit angioedema talhane, kvachitach teey ajunahi udbhavu shakatat. yavyatirikt, ess inhibitor therapys angioedemacha anubhav ghetalelya rugnanmadhye cross-reactivitycha eka lahansa dhoka dekhil aahe.
myocardial infarction.
angiotensin II receptor antagonistsamule myocardial infarction (emm. aay. kinwa haart attack) dhoka kinchit vadhato qee nahee yaa prashnachi sadhya chaukashi kelee jaat aahe. kahee abhyas asey suchavatat qee aarbsamule mea. aay. chaa dhoka vadhu shakato. tathapi, itar abhyasanmadhye asey aadhalun aale aahe qee aarbsamule mea. aay. chaa dhoka vadhat nahee. aajtagayat, aarbsmadhye myocardial infarction dhoka vadhavanyachi pravrutti aahe qee nahee yavar ekmat naslyamule, pudhil tapas suru aahe.
kharokhar, aii. tii. 1 nakabandicha parinam mhanoon, arbs nakaratmak-pratisad loopche jodani kadhoon angiotensin II chee patali baselinechya anek patine vadhavtat. parisanchari angiotensin II chya vadhalelya patalimule aii. tii. 2 receptorsche binvirodh uttejan hote, jeey yavyatirikt, niyantrit asatat. tathapi, alikadil aakadevari suchavate qee aii. tii. 2 receptor uttejana purvi prastavit kelelya tulanet qamee fayadeshir asoo shakate aanee vadhicha prachar, fibrosis aanee hypertrophy madhyasthidvare tasech protherogenic aanee proinflammatory prabhavanchya madhyamatoon kahee vishisht paristhitinmadhye hanikarak dekhil asoo shakate.
karkarog.
2010 madhye prakashit jhalelya eka abhyasane heey nishchit kele...yadruchchik niyantrit chachanyanche meta-vishleshan asey suchavate qee urbs heey karkarogachya naveen nidanachya samanya vadhalelya jokhamishi sambandhit aahet. maryadit mahitee dilyas, pratyek vishisht aushadhashi sambandhit karkarogachya achook jokhmibaddal nishkarsh kadhane shakya nahee. heey nishkarsh pudhil tapasachi hummy detat."yu. dwara nantarche meta-vishleshan.ess. arabschi itar upcharanshi tulana prapt 31 yadruchchik niyantrit chachanyanchya ann aanee aushadh prashasanat (eff. dii. aii.) arabs prapt prapt rugnanmadhye karkarog, karkarog-sambandhit mrutyu, stanacha karkarog, fuffusacha karkarog kinwa prostate karkarogachya vadhiv jokhamicha konatahi purava aadhalala nahee. 2013 madhye, daha lakhanhun adhik majee sainikanchya anubhavavar united stateschya majee sainik vyavhar vibhagachya tulanatmak parinamkarak sanshodhanat fuffusacha karkarog (uchch raktadab niyatkalikatil mool lekh) kinwa prostate karkarogasathi konatahi vadhalela dhoka aadhalala nahee. sanshodhakanni assa nishkarsh kadhalah "united stateschya diggajanchya yaa mothya deshvyapi samoohat, vapar naan naan tulanet arbschya naveen vaparkartyanmadhye fuffusachya karkarogachya vadhiv jokhamichya konatyahi chinteche samarthan karnyasathi aamhala konatahi purava sapadala nahee. aamche nishkarsh arbschya sanrakshanatmak prabhavashi susangat hote."
meey 2013 madhye, ann aanee aushadh prashasanatil varishtha niyamak, vaidyakeey pathakache nete thomas aii. karkarogacha dhoka vadhalela nahee yaa eff. dii. aii. chya adhikrut nishkarshachya ulat, upalabdh eff. dii. aii. aakadevarichya rugna-darr-rugna tapasaninantar, placibo kinwa itar aushadhe aushadh rugnanchya tulanet, aar. bii. chya rugnanmadhye fuffusachya karkarogacha dhoka sumare 24 takkyanni vadhala aahe assa nishkarsh tyanni kadhala hota, asey markiniyakne sarvajanikaritya ughad kele. marciniakne kelelya tikanpaiki eka teeka ashee hotee qee purvichya eff. dii. aii. meta-vishleshanat fuffusachya carcinomala karkarog mhanoon ganale gele nahee. tyanni tapasalelya akra abhyasanpaiki dahamadhye, marciniakne sangitale qee niyantran gatapeksha aii. aar. bii. gatamadhye fuffusachya karkarogachi prakarane jaast aahet. merciniakcha samavesh asalelya aushadh-moolyankan vibhagache pramukh ellis ungar yanni takrarinna 'dishabhul' mhatale aanee eka mulakhatit mhatale, 'aamhala janatela naveen kahee sanganyache kaaran nahee."yaa vadabaddalchya eka lekhat, wall street journalne tyanchi matey jaanun ghenyasathi itar teen doctoranchi mulakhat ghetali; ekane karkarogacha dhoka vadhavala, ekane chinta vyakt kelee aanee adhik mahitee pahaychi hotee aanee aanee vyaktila vatale qee ektar konatehi sambandh naheet kinwa qamee varanvarta asalele sambandh shodhane katheen aahe.
2016 chya meta-vishleshanat 148,334 rugnansah, arbchya vaparashi sambandhit karkarogachya ghatananmadhye konatahi lakshaniy farak aadhalala nahee.
mootrapind nikami hone.
jaree urbsche madhumeh aanee purviche uchch raktadab asalelya rugnansathi urbsche prashasana naan karata mutrapindache rog vikasit honyapasoon sanrakshanatmak parinam asale taree, arbs mutrapindachi karye bighadavu shakatat jase qee aadhipasoon astitvat asalelya prathinuriya, mootrapind dhamani stenosis, hypertensive nephrosclerosis, hrudayavikaracha tras, polycystic mutrapindacha rog, junat mutrapindacha rog, interstitial fibrosis, phokal segmental glomerulosclerosis kinwa arbs-upcharit parantu tarihi chikitsalayinadrushtya uchch raktadab darshavite jyamule mutrapindatil raktavahinya asamanyapane sankuchit hotat jyamule avayavala auxigen aanee poshak dravyancha puravatha thambato.
rachana.
losarton, irbsarten, olmesarton, candesarten, vulsarton, fimasartan aanee azilsartanmadhye tetrazole gut (chaar nitrogen aanee eka carbon asaleli vartul) samavisht aahe. losarton, irbsarten, olmesarton, candesarten aanee telmisartanmadhye eka kinwa done imidazole gatancha samavesh hoto.
krutichi yantrana.
heey padarth 1-receptor virodhi aahet; mhanje, teey 1 receptorsver angiotensin II chya sakriyates avarodhit karatat. aii. tii. 1 receptors heey vahinyanchya gulgulit snayu peshi, adhivrukk granthichya cortical peshi aanee adhivrukk majjatantu synapsmadhye aadhaltat. aii. tii. 1 receptorschya adthalyamule thet vasodilation hote, vasopressincha srav qamee hoto aanee itar krutinmadhye, aldosteronche utpadan aanee srav qamee hoto. ektrit parinam raktadab qamee karato.
yaa vargatil pratyek aii. aar. bii. chee vishisht parinamkarakta teen pharmacodynamic (pii. dii.) aanee pharmacokinetic (pii. keey.) mapdandanchya sanyojanavar avalambun asate. parinamkaraktesathi prabhavi staravar teen pramukh pii. dii./pii. keey. kshetranchi aavashyakta asate; teen vaishishtyanche mapdand khaleel taktyapramane sankalit karane aavashyak aahe, duplication kadhoon takane aanee sarvasamaveshak mulyanvar pohochane; nantarche aata bhinn aahet.
daab pratibandh.
gart patalivaril daab avarodhan-heey angiotensin II chya raktadab vadhavanyachya (daab) prabhavachya avarodhan kinwa pratibandhachya pramanashi sambandhit aahe. tathapi, daab pratibandh heey raktadab qamee karnyachya (bii. pii.) karyakshamateche "swatahun" mojmap nahee. yuu madhye soochibaddha kelele darr.ess. darr.ess tasala yaa prabhavachya pratibandhasathi ann aanee aushadh prashasana (eff. dii. aii.) package samavisht (pii. aay. ess.) khalilpramane aaheth (pii. aay. madhye soochibaddha serve matra samavisht aahet)
aii. tii. 1 effinity viruddha aii. tii. 2.
vishisht arbschya bandhan sambandhanmadhye aii. tii. 1 teey aii. tii. 2 chey gunottar khalilpramane darshavile aahet. tathapi, aii. tii. 1 viruddha aii. tii. 2 heey raktadab pratisadasathi arthpurn soochak nahee.
ghatak.
telmisartan aanee approsarton vagalata jawaljawal serve aarbsmadhye biphenyltetrazole bhag asato.
sakriy pratinidhi.
losartonmadhye vishamchakra imidazole asate tarr valsartonmadhye nonplanner acelated amino acid asate.
jaivik ardh-jeevan.
aarabchya ekoon karyakshamateche chitra purn karnyasathi aavashyak asalele tisare kshetra mhanje tyache jaivik ardh-jeevan. yuu pasoon ardha jeevan.ess. ann aanee aushadh prashasana (eff. dii. aii.) package samavisht (pii. aay. ess.) khalilpramane aaheth
sanshodhan.
dirghayushya.
aii. jee. tii. aar. 1 aii. januk, jeey aii. tii. 1. laa sanketikrut karate, tyachya nockoutmule undaranchya aayurmanat niyantranachya tulanet 26 takkyanni lakshaniy vaadh hote. oxidative nuksan qamee karane (visheshtah mitochondria) aanee mutrapindachya proservival janukanchi atipradarshana hii sambhavya yantrana aahe. arbscha parinam sarkhach disato.
fibrosis pratigaman.
losarton sarkhya arbs snayu, yakrut, hriday aanee mutrapindachya tantumay rogala aala ghalatat kinwa qamee karatat asey disun aale aahe.
vistrut mahadhamani mool pratigaman.
2003 saalee candesarten aanee walsartoncha vapar karoon kelelya abhyasat, mahadhmanichya ruteecha aakar mage ghenyachi kshamata darshavili gelee.
ashuddhata.
nitrosamines.
2018 aanee 2019 madhye, yuu.ann aanee aushadh prashasanala (eff. dii. aii.) angiotensin II receptor blocker (aii. aar. bii.) aushadh utpadane valsarton, losarton aanee irbsartonmadhye aine. dii. emm. aii. aanee aine. dii. aii. ashuddhateche ansh aadhalale. eff. dii. aii. neey mhatale aahe qee, "juuna 2018 madhye, eff. dii. aii. laa eka api utpadkakadun aine-nitrosodymethylamine (aine. dii. emm. aii.) mhanoon olakhalya olakhalya ashuddhatechya upasthitichi mahitee denyat aalee hotee. tevhapasoon, eff. dii. aii. neey itar prakarchya nitrosamine sanyuge, udaa.jee.aine-nitrosodithylamine (aine. dii. aii.) heey, vulsarton aanee aii. aar. bii. vargatil itar aushadhanchya anek aii. pii. aay. utpadkankadun aii. pii. aay. madhye asvikarya patalivar upasthit asatat."2018 madhye, eff. dii. aii. neey udhyoganna ashuddhateche moolyankan aanee niyantran kase karave yabaddal margadarshan kele.
august 2020 madhye, european medicine agencyne (eae. emm. aii.) vipanan adhikrutata dharkanna manvi aushadhanmadhye nitrosamine ashuddhatechi upasthiti kashee talhavi yabaddal margadarshan kele aanee tyanna nitrosamineschya sambhavya upasthitisathi serve rasayanik aanee jaivik manvi aushadhancha aadhava ghenyas aanee jokhamichya utpadananchi chachani karnyas sangitale.
november 2020 madhye, eae. emm. aii. chya manvi vaparasathichya aushadhi utpadananchya samiteene (see. etch. emm. pii.) sarton aushadhanmadhil nitrosamine ashuddhata maryadit karnyachya shifarashi itar prakarchya aushadhansathi jaaree kelelya shifarshinsah sanrekhit kelya. mukhya badal nitrosamineschya maryadanshi sambandhit aahe, jeey purvi sakriy ghatkanvar lagoo hote parantu aata tyaeivaji tayar utpadananna lagoo hotat (udaa.jee. golya). aantarrashtriy staravar manya mankanvar (aay. see. etch. emm. 7 (aar. 1)) aadharit yaa maryada, aajivan upcharasathi aushadh aushadh vyaktisathi konatyahi sarton aushadhanmadhye nitrosaminesmule karkarogacha atirikt dhoka 100,000 paiki 1 peksha qamee aahe yachee khatri karoon ghetil.
yaa sarton aushadhanmadhye eka vishisht ring structure (tetrazole) asate jyachya sanshleshanamule nitrosamine ashuddhata tayar houu shakate. agilsarton, approsarton aanee telmisartan yasarkhya itar sarton aushadhancha yaa punaravalokanat samavesh karnyat aala navhata, parantu tyanantarchya itar aushadhanchya punaravalokanat tyancha samavesh karnyat aala aahe.
azids.
april 2021 madhye, aushadhanchya gunvattesathichya european sanchalanalayane (adqm) tetrazole-yukt sartanmadhye naun-nitrosamine ashuddhatemule (visheshtah, azido sanyuge) dooshit honyachya jokhamicha ishara deela. september 2021 madhye, adqmne jaheer kele qee tapasanit eka naveen azido dooshit padarth ughad jhaala aahe joou keval losartonmadhye (losarton azide kinwa losarton azido ashuddhata) aadhalato aanee joou emes chachanivar utparivartaniy asalyache aadhalun aale.
nantar 2021 aanee 2022 madhye, losarton, irbsarten aanee walsartonmadhye azido ashuddhatemule dooshit jhalyachi anek prakarane aadhalali, jyamule austreliya, brazil aanee europemadhye (switzerlands) tapasapasoon teey bajaratoon paise kadhanyaparyant aanee savadhgirichya paratavyanparyant niyamak pratisadanna chalana midali.
tewa pharmaceuticalsne jaheer kele qee teey yaa ashuddhatemule bhavishyat honare pradushan rokhanyasathi tyanchi losarton utpadan prakriya badaltil aanee bharatiy api utpadak iol chemicals aanee pharmaceuticalsne azido dooshit padarthanpasun mukt honyasathi tayar kelelya losartonchya naveen sanshleshanavar petantsathi arj keela.

