Telmisartan

**Telmisartan** is an angiotensin II receptor blocker (ARB) primarily used in veterinary medicine for the management of **feline chronic kidney disease (CKD)** to reduce proteinuria, and for the treatment of **systemic hypertension** in cats. It is available as an oral solution that is generally well-tolerated. > **Clinical Warning:** The safety and efficacy of telmisartan for managing systemic hypertension above 200 mmHg has not been investigated. Blood pressure monitoring is highly recommended, especially in cats showing signs of hypotension or those undergoing general anaesthesia. **Clinical Pearl:** Telmisartan appears to be as effective as benazepril at delaying the deterioration of proteinuria over 6 months in cats with IRIS stage IIa to IV CKD.

กลไกการออกฤทธิ์: Telmisartan is a specific **Angiotensin II receptor (type AT1) antagonist**. By blocking this receptor, it inhibits the detrimental effects of angiotensin II, including: * **Vasoconstriction** → lowers systemic blood pressure. * **Aldosterone synthesis** → reduces sodium and water retention. * **Renal, vascular, and cardiac remodelling**. In the kidneys, blocking angiotensin II reduces **glomerular capillary hypertension** and decreases protein in the glomerular filtrate, which helps prevent the triggering or potentiation of interstitial fibrosis.

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