Brand: Ya Bao

Functions and Indications: Decreasing blood pressure. Used for hypertension.

Composition: Clonidine Hydrochloride, Dihydrochlorothiazede, Rutin, Extractum Flos Chrysanthemi, Lndici, Concha Margaritifera Usta.

Dosage and Administration: One tablet each time, three times daily.

Cautions:

1. Not for use during pregnancy, athlete.

2. Cross allergy: with sulfa drugs, furosemide, bumetanide, carbonic anhydrase inhibitors cross reaction.

3,It can lead to impaired glucose tolerance and may promote atherosclerosis

4,The following should be used with caution in patients with Zhenjujiangya tablets: no urine or severe renal insufficiency, because this kind of medicine effect, application of large dose can cause drug accumulation, increased toxicity; diabetes mellitus; hyperuricemia or gout disease; severe liver function damage, water and electrolyte disorders can induce hepatic coma; hypercalcemia; hyponatremia endotoxemia; systemic lupus erythematosus, can aggravate the condition or induced activity; pancreatitis; sympathetic nerve resection to strengthen the hypotensive effect of jaundice infants.

5,Examination: blood electrolyte, blood sugar, serum uric acid, blood myo enzyme, urea nitrogen, blood pressure.

6, Medication should be initiated at the least effective dose to reduce side effects and reduce reflex renin and aldosterone secretion.

7, Patients with hypokalemia tend to supplement potassium or potassium diuretics.

Drug interaction :

1, Corticosteroids, adrenocorticotropic hormone, estrogen, amphotericin B (intravenous medication) can reduce the diuretic effect of this medicine and increase the chance of electrolyte disturbance, especially hypokalemia.

2, Combined with antihypertensive drugs, diuretic and hypotensive effects were enhanced.

3, Nonsteroidal anti-inflammatory drugs, especially indomethacin, can reduce the diuretic effect of hydrochlorothiazide, which is related to the inhibition of prostaglandin synthesis by the former.

4, To reduce the absorption of hydrochlorothiazide in the gastrointestinal tract, the oral administration should be taken 1 hours before or 4 hours after oral administration of this drug.

5, Combined with dopamine, diuresis strengthens

6, Combined with the quasi cross feeling drugs, the diuretic effect is reduced.

7, Urotropine and hydrochlorothiazide combined into formaldehyde inhibited effect decreased.

8, The role of anticoagulant drugs weakened, mainly due to diuretic after the body plasma capacity decreased, blood coagulation factor levels increased, coupled with diuresis to improve the liver blood supply, synthesis, coagulation factors increased.

9, Combined with sodium bicarbonate, there is an increased chance of low chloride alkalosis.

10, Digitalis, amiodarone and hydrochlorothiazide combination, should beware of side effects caused by hypokalemia.

11, Combined with lithium, because hydrochlorothiazide can reduce the renal clearance of lithium, lithium increased renal toxicity.

12, When combined with an anti gout drug, the latter should adjust the dose.

13, Increasing the effect of non depolarizing muscle relaxants is associated with decreased blood potassium.

14, Reduce the effect of hypoglycemic agents.

Product Name : ZhenJu JiangYa Pian 珍菊降压片

Packing: 0.3gX60 tablets/one box

Manufacturer : ShanXi YaBao Pharmaceutical Co.

【药品名称】通用名称：珍菊降压片

【成份】珍珠层粉、野菊花膏粉、芦丁、氢氯噻嗪、盐酸可乐定。

【功能主治】降压药。用于高血压症。

【用法用量】口服。一次1片，一日3次或遵医嘱。

【不良反应】
珍菊降压片的大多不良反应与剂量和疗程有关，主要内容如下：
1.水、电解质紊乱：水、电解质紊乱所致的副作用较为常见，表现为口干、烦渴、肌肉痉挛、恶心、呕吐和极度疲乏无力等。包括：易发生低钾血症(与氢氨噻嗪的排钾作用有关)，如长期缺钾可损伤肾小管，严重失钾可引起肾小管上皮的空泡变化以及严重快速性心律失常。低氯性碱中毒或低氯、低钾碱中毒(因氢氯噻嗪可增加氯化物的排泄)。低钠血症，可导致中枢神经系统症状及加重肾损害。脱水，可造成血容量和肾血流量减少，也可引起肾小球过率降低。

2.可干扰肾小管排泄尿酸，引起高尿酸血症;少数可诱发痛风发作。

3.可使糖耐量降低，血糖升高，这可能与抑制胰岛素释放有关。

4.可使低密度脂蛋白和三酰甘油升高，高密度脂蛋白降低，有促进动脉粥样硬化的可能。

5.可致过敏反应，如荨麻疹，但较为少见。

6.少见白细胞减少或缺乏、血小板减少性紫癜等。

7.其他，可见胆囊炎、胰腺炎、性功能减退、光敏感、色觉障碍等，但较罕见。

【禁忌】尚不明确。

【注意事项】

1.交叉过敏：与磺胺类药物、呋塞米、布美他尼、碳酸酐酶抑制剂交叉反应。

2.对诊断干扰：可致糖耐量降低，有促进动脉粥样硬化的可能。

3.下列患者应该慎用珍菊降压片：无尿或严重肾功能减退者，因本类药效果差，应用大剂量时可致药物蓄积，毒性增加;糖尿病;高尿酸血症或有痛风病史者;严重肝功能损害者，水、电解质紊乱可诱发肝昏迷;高钙血症;低钠血症;红斑狼疮，可加重病情或诱发活动;胰腺炎;交感神经切除者降压作用加强;有黄疸的婴儿。

4.随访检查：血电解质;血糖;血尿酸;血肌酶，尿素氮;血压。

5.应从最小有效剂量开始用药，以减少副作用的发生，减少反射性肾素和醛固酮分泌。

6.有低钾血症倾向的患者，应酌情补钾或保钾利尿药合用。

【药物相互作用】

1.肾上腺皮质激素、促肾上腺皮质激素、雌激素、两性霉素B(静脉用药)，能降低本药的利尿作用，增加发生电解质紊乱的机会，尤其是低钾血症。

2.与降压药合用，利尿降压作用均加强。

3.非甾体类消炎镇痛药尤其是吲哚美辛能降低氢氯噻嗪的利尿作用，与前者抑制前列腺素合成有关。

4.考来烯胺(消胆胺)能减少胃肠道对氢氯噻嗪的吸收，故应在口服考来烯胺1小时前或4小时后服用本药。

5.与多巴胺合用，利尿作用加强。

6.与拟交感受类药物合用，利尿作用减弱。

7.乌洛托品与氢氯噻嗪合用，其转化为甲醛受抑制，疗效下降。

8.使抗凝药作用减弱，主要是由于利尿后机体血浆容量下降，血中凝血因子水平升高，加上利尿使肝脏血液供应改善，合成凝血因子增多等。

9.与碳酸氢钠合用，发生低氯性碱中毒机会增加。

10.洋地黄类药物、胺碘酮等与氢氯噻嗪合用时，应慎防因低钾血症引起的副作用。

11.与锂制剂合用，因氢氯噻唪可减少肾脏对锂的清除，增加锂的肾毒性。

12.与抗痛风药合用时，后者应调整剂量。

13.增强非去极化肌松药的作用，与血钾下降有关。

14.降低降糖药的作用。

【贮藏】密封。

【有效期】36个月。

【批准文号】国药准字Z14020772

【生产企业】企业名称：亚宝药业集团股份有限公司