Diuver: ntuziaka maka ojiji, analogues na nyocha, ọnụahịa na ụlọ ahịa ọgwụ nke Russia

Mbadamba nkume ndị ahụ dị miliki ọcha, okirikiri, biconvex nwere bevel n'otu akụkụ yana ihe osise dijitalụ na nke ọzọ, nke dịgasị dabere na usoro nke ihe ndị bụ isi na-arụ ọrụ. Nnukwu 5 mg torasemidekwekọrọ na ọnụọgụ 915, yana mg 10 - 916 na azụ mbadamba.

A na-ere ngwaahịa ọgwụ ahụ na ngwungwu gbara agba nke ihe nkiri polymer na foil aluminom, na mbadamba 10 dị otú ahụ ọ bụla. Enwere igbe abụọ n’ime igbe kaadiboodu (iberibe iri abụọ n’ime igbe).

Omume ọgwụ

Diuver (INN - Diuver) Ọ bụ diuretic ọgwụ, otu loop urinary na-akpali akpali bekee, ya bụ, ihe bụ isi mmetụta ọgwụ a na-eme loop nke Henle (otu n’ime ihe dị n’ime akụkụ akụrụngwa nke akụrụ - nephron) Mmetụta ọgwụ ọgwụ kachasị bụ ihe mgbochi nke iweghachite sodium na ion chlorine na ikpere na-arịgo elu nke akaghị, nke gosipụtara na mbelata osmotic usoro nke mmiri intracellular. N'ihi ya, a na-egbochi ya renal reabsorption nke mmirikwa ụbọchị na-abawanye diuresis a na - ekpochapụ mmiri dị ukwuu n’ahụ.

Usoro nke ihe nkwadebe ogwu gha n’iru na-egbochi ndị na-ebugharị ion ke apical akụkụ nke ịrịgo (aha ọzọ maka nke bụ oké) akụkụ nke nephron loop. A na-egbochi ndị nnata aldosteronedị na akwara obi. Nke a na-enyere ndị ọzọ akamụbaa mmiri mmiri, ebe ọ bụ na homonụ nke adrenal gland na-eme ka mmadụ mụta inweta mmiri ọzọ.

Mmetụta obi na-enye ohere ịrụ ọrụ diiri arụmọrụ, ebe ọ bụ na a na - egbochi oke ibu na - egbochi (isi ihe na - akpata ọrịa obi na - esochi ọbara mgbali elu). N'ihi ogologo oge nke myocardium na ogologo oge ịbelata na-ebelata fibrosing na Ọrịa sclerosis akwara anụ ahụ nke mgbapụta nke ime.

Diuver nwekwara ike ime dị ka onye na-ahụ maka antihypertensive, ebe ọ bụ na ihe nke Torasemide, bụ isi ihe eji arụ ọrụ, ka amata n’ihi yambelata nguzogide nke akwara (bufee akụrụngwa, na-eduga n'ịba ụba ọrụ obi yana, n'ihi nke a, mụbara ọbara mgbali) Usoro nke ihe a bu mkpali nke potassium ion na-eme na mkpụrụ ndụ dị larịị nke akwara akwara nke akwara nke akwara, nke a na-ebelata mgbidi mmeghachi omume maka ihe ndị na - echekwa ihe ndị dị ndụ (ihe bekee, dịka ọmụmaatụ, catecholaminesma obu vasopressinhomonụ nke akụkụ azụ ahụ na-esote afọ).

O kwesịrị ka a rịba ama nke ahụ torasemidedị ka thiazide diuretic, enwere ọtụtụ uru ma e jiri ya tụnyere nkwadebe ọgwụ ọgwụ bụ isi - Furosemide:

• rue n’obere uzo, onodu oria a dika hypokalemia,
• ị basedụ ọgwụ torasemide elu
• mmetụta Diuver na-etinye na-agbatịkwu ogologo oge, nke na-enye ohere iji ọgwụ a na-echekwa ogologo oge.

Pharmacodynamics na pharmacokinetics

Anabata Diuver n'ọnụNgwa ngwa ngwabioavailabilityogwu bu 80-90 percent, dabere na njirimara nke anụ ahụ) na-adị mma site na eriri afọ. A na-ahụta itinye plasma kachasị nke ihe ndị nọ n'ọrụ ka emesịrị 1-2 awa, mgbe iwere mbadamba ahụ. N'ime ọbara torasemidena - ejikọ protin plasma, na - enye mmetụta diuretic na elekere asatọ na-esote. Ugboro ugboro nke urination na-abawanye otu oge nke ọgwụ, nke doro anya na ọ bụ njirimara dị mma nke ọgwụ ahụ (n'adịghị ka Furosemide, ọ naghị amanye ka amachibido ọrụ onye ọrịa ozugbo ị were mbadamba ihe).

Metabolizedọgwụ na imeju, n'okpuru ọrụ nke enzymes na sistemụ cytochrome P450. Chemical mmeghachi omume hydroiteslated metabolitesna - ejikọ protein protein plasma site na pasent 86-97 (nnweta nke njikọ a dabere na ntụgharị ndu nke ihe ndị mejupụtara ya na usoro nke sọlfọ na mmezi hydroxylation).

Na-egosipụtaMechie site na akụrụ (mwepụta gbasara akụrụ torasemidebụ 10 ml / min, megide nzụlite nke mkpokọta - 40 ml / min) n'ụdị metabolites na-adịghị arụ ọrụ, ihe dịka pasent iri asatọ nke otu ọgwụ. Ọkara-ndụ nkwadebe ọgwụ dị ihe dị ka awa 3-4 (ma ọ bụrụ na akụrụ gbasara akụrụ, ihe ngosi ahụ agbanweghị n'ụzọ ọ bụla). Obere akụkụ nke metabolites torasemideA na - apịpụ ya site na ịba ọcha n'anya.

Ihe ngosi Diuver

Ngosiputa zuru oke maka iji ọgwụ diuretic nke dabere torasemidebụ ọrịa edematous megide nzụlite usoro ọrịa dị iche iche. Yabụ na ọrịa nke akụrụ, umeji, akpa ume na usoro ọgwụgwọ siri ike, ọ bara uru gụnyere ọgwụ nke ime ya.

Ọrịa obi na-adịghị ala ala ọ bakwara uru karị ịgwọ ma ọ bụrụ na etinyere ya n'ọrụ loop diureticsna - enyere aka belata mkpokọ mmiri n’oghere na akwara.

Ihe ngosi maka iji Diuver na ọbara mgbali ike abụghị ihe zuru oke, mana imirikiti ndị ọrụ ụlọ ọgwụ na-eji ọgwụ a eme ihe na usoro ọgwụgwọ na-egbochi nchedo, ebe ọ nwere mmetụta siri ike ma na-adịgide adịgide ma e jiri ya tụnyere ọgwụ ndị ọzọ. Otu ezigbo ihe eji eme ihe Diuver bu ikike ya nke pharmacokinetic yana mmetụta daberena-enye ohere imeziwanye ọgwụgwọ ọgwụgwọ chọrọ.

Ihe ngbanwe

• hypersensitivity ma ọ bụ anabataghị akụkụ nke nkwadebe ọgwụ,
• ọdịda gbasara akwara na anuria,
• ụkọ lactase (na ntinye nke lactose, n'ihi nsonaazụ ya) ma ọ bụ enweghị nnabata nke glucose na galactose,
• akpịrị ịkpọ nkụ, exicosisọnọdụ hypovolemic,
• ịba ọcha n'anya,
• oge lactation,
• mmenaanya obi glycosides,
• akpọ hypokalemiama obu hyponatremia,
• nkọ glomerulonephritis,
• ntụpọ obi obi mgbawa (ọkachasị) stenosis nke oghere aortic na mitral),
• na-abawanye Central venous mgbali elu 10 mmHg,
• otu afọ ruru afọ iri na asatọ.

E nwekwara ọtụtụ ọnụọgụ ọrịa mgbe ekwesịrị ị drugụ ọgwụ ahụ naanị n'okpuru nlekọta nke ndị ọkachamara ruru eru na ọgwụgwọ inpatient (nke mere na site na mmepe nke mmetụta ọjọọ nke ọgwụgwọ mgbanwe, ekwesịrị inye enyemaka ozugbo enwere ike. Ọnọdụ ndị a gụnyere:

• hypotension akwara,
• atherosclerosis (karịsịa akwara akwara)
• ntụgharị aka ime ka mkpụkpọ Plasma nke urates,
• imebi mmamịrị si na urethra (ihe na - akpatakarị ya bụ) benign prostatic hyperplasia n'ime ụmụ nwoke ma ọ bụ usoro mkpali nke ụmụ nwanyị),
• nnukwu ogbo infarction myocardial (ihe ọghọm nke ịmalite iku ụjọ na ụzụ na usoro nke usoro a na-eto),
• ọrịa shuga mellitus (na-ebelata nnabata glucose nke sel ma belata mmetụta hypoglycemic nke ọgwụ),
• anaemia,
• ọrịa hepatorenal.

Nsonaazụ

Ọgwụ nwere ike ibute mmeghachi omume ndị a n'oge ọgwụgwọ mgbagwoju anya nke edema syndrome:

• Site na sisitemu obi:nnukwu ọrịa okpumbelata nke ọbara mgbali elu ruo ida, arrhythmias (nke ka nke tachycardia), mbelata olu nke inye ọbara.
• Site na usoro urinary: nnukwu urinary retentionna-amụba ịta nke uric acid nnu na plasma ọbara, hematuria(ọbara na mmamịrị) interstitial nephritis, hydronephrosis.
• Site na VEB na KSCHB: mbelata nke plasma nke sodium, potassium, chlorine, magnesium, calcium, metabolic alkalosis, hypovolemia, akpịrị ịkpọ nkụ, exicosis, ịta ọbarana abawanye na viscosity ọbara.
• Site na metabolism: hypercholesterolemia, hypertriglyceridemia na atherosclerosisN'ihi ya, mmụba nke mkpokọta nke creatinine na urea n'ime ọbara, gouty ọrịa, ibelata na nnabata glucose (mkpasu iwe ngosipụta nke ọrịa shuga).
• Iri nri: ọrịa dyspeptik (ọgbụgbọ, vomiting, ihe mgbu epigastric, afọ ọsịsa), imebi ọrụ nke enzymes imeju, ọria aru (nke kachasị nkọ).
• Site na sistemu akwara na akụkụ anụ ahụ: enwere ike ige ntị nti, tinnitusisi ọwụwa anya ntughari, paresthesia.
• Akpụkpọ ahụ: urticaria, akpụkpọ anụ?amụma nlegharị anya ọrịa akpịrị, ndise, vasculitis, mmeghachi omume anaphylactic na mmeghachi nke anaphylactoid (rue mmepe ujo ujo).
• Site na ọbara gbasara: mbelata ọnụ ọgụgụ platelet na sel ọbara (nke ikpeazụ na-egosi dịka agranulocytosis), ike aplastic ma obu hemolytic anaemia.

Diuver, ntuziaka maka ojiji (Usoro na usoro onunu ogwu)

A na-ewere ọgwụ n'ọnụya na obere mmiri. Ọ na-atụ aro ka ị theụọ ọgwụ ozugbo nri ụtụtụ, mgbe adsorption na eriri afọ na-akpali site na ntinye nri.

A na-akwado usoro usoro onunu ogwu site n'aka dibia bekee na-eburu n'uche udiri aru nke aru ya na ihe ndi n’egosiputa idozigharị umu anumanu, ya na ọrịa edematous usoro ọgwụgwọ nke mmalite dị iche iche bụ 5 mg torasemideotu ugboro n'ụbọchị. Nke nta nke nta, enwere ike ịbawanye ọgwụ kwa ụbọchị ruo 20 na ọbụna 40 mg n'otu oge, ọ bụrụ na ọnọdụ pathologies nke onye ọrịa chọrọ ya. Kwụsị ọgwụgwọ naanị mgbe mwepu nke edema (iji gosi na mmetụta dị mma, ịtụle njikwa na Nnwale McClure-Aldrich mkpụrụedemede zoro ezo).

Ntuziaka maka iji Diuver na ọbara mgbali ike dịtụ iche. Ọgwụ nke mbụ bụ 2.5 mg, ya bụ, ọkara mbadamba nkume ya na nnukwu ya torasemide5 mg (ma ọ bụ nkeji iri na ise, otu ụzọ, na 10 mg nke ihe ndị na-arụ ọrụ). Ọ bụrụ na ọ dị mkpa, mụbaa mmetụta ọgwụgwọ ahụ, ọgwụ kwa ụbọchị nwere ike ịbawanye ruo 5 mg.

Dodoụbiga ya ókè

Mmụba plasma nwere ụba na nchịkwa nchịkwa a na-achịkwaghị achịkwa na-akpata mgbaàmà ndị na-esonụ:

• ugboro ugboro obere mmamịrị na-emetụta oke
• oke ụkọ ọbara,
• ọnụ kwupụtara mgbali ọbara, ruo orthostatic hypotension,
• mmebi nke electrolyte na acid-base balance nke ahu,
• iwe na-ewe iwe,
• iro ụra,
• ndaba,
• ida- nnukwu ọrịa okirikiri ọdịda.

Kpọmkwem ọgwụ mgbochi, nke ga - enyere aka ị intoụ mmanya Diuver n'ahịa ọgwụ, mana enwere ụzọ ọgwụgwọ ọgwụgwọ na - akwụ ụgwọ maka ọnọdụ ahụ nke ọrịa. A na-eji ọtụtụ ihe eme ihe infusion intravenous ihe anakpo osiso na ihe otiti iji mezi ihe bcc. N'okpuru nchịkwa serum nke electrolytes na hemocrit nyere Ndị na-achịkwa CBS na VIB. N'ime ọnọdụ siri ike, enwere ike iji hannọchi ọbara na ihe ndị mejupụtara ọbara.

Ọ bụrụ na nsị ọgwụ ọjọọ megidere ndabere nke ọgwụ nwetụrụ ọgwụ a n'oge na-adịbeghị anya, ọ dị mma gastric lavage, na-akpasu iwe, mwepụ nke ihe ndị dị n’ime afọ n’ụdị niile (iji ma nchekwa, ọgwụ ọgwụ, na ụzọ ọgwụgwọ).

Mmekorita

Torasemide- Ngalaba ọgwụ na-arụ ọrụ nke nwere ike ịmekọrịta ọnụ na nnukwu ọgwụ ọgwụ. Yabụ na diuretic na-abawanye ịta ahụhụ, ma ọ bụ otu ihe ahụ nwere ike ịre na mmetụta ọ bụla na ọghọm (ọkachasị oto- na nephrotoxicity) nke ọgwụ ọjọọ dịka otu ọgwụ nje. cephalosporinna aminoglycosides, chloramphenicol, cisplatin, ethaclates acid, amphotericin B (na-eme ngagharị iwe dị ka egwuregwu na-asọmpi).

Iche iche, ọ bara uru arịba ama na Diuver na-ebelata arụmọrụndị ọrịa hypoglycemic, nke chọrọ mgbazi kwesịrị ekwesị banyere ọgwụgwọ na-arịa ọrịa shuga. Ma ọ bụghị ya, mmepe ga-ekwe omume hyperglycemic ma obu ketoacidotic coma na mgbanwe ndị a na-atụgharịghị agbanwe na microvasculature. Mmetụta ọgwụ na-ebelata. allopurinolọ bụrụ na usoro ọgwụgwọ siri ike na-agwakọta ọgwụ a na ọgwụ ndị metụtara Torasemide.

Diuver na –ebelata mwepu akuko nkwadebe lithium, ebe ọ bụ na nnukwu ego nke mmamịrị na-esighị ike na - zoro ezo (na - ewepụta mmiri ọpụrụiche, ngwa ọrụ ụwa na - arụ ọrụ ike). Ihe omume a na-eyi egwu mmepe ịhiụ mmanya na-egbu lithium, nke nwere ike igosipụta dịka ndị a:

• ọrịa dyspeptik (ọgbụgbọ, ọgbụgbọ, na ndị ọzọ)
• iwe na neuromuscular iwe,
• Akwụkwụ na-adọ ọdụ na nzuzu,
• ataxia,
• buru ibu ịma jijiji,
• ndaba, delirium,
• gbasara akwara.

Ọgwụ mgbochi mkpali belata mmetụta diuretic torasemide, ebe ha na-egbochi ịkpụzi prostaglandins, nke gosiputara onwe ya na mmebi nke ihe ndi ozo di ndu renin n'ọbara plasma. N’ihi ya, usoro ọbara gbasara akwara na-ebelata ma urination anaghịkwa arụ ọrụ. Otu usoro ọrụ nke NSAIDs na-akwalite mmetụta hypotensive nke ọgwụ diuretic (renin- ihe bụ isi akwara nke sisitemu akwara gbasara ọbara ọgbụgba, na - arụ ọrụ ihe mmetuta n’elu akwa akwara).

Ekwesighi ijikọ ya na usoro ọgwụgwọ dị mgbagwoju anya na ọgwụ ndị na-egbochi enzyme angiotensin na-agbanwe ma obu angiotensin receptor agonists ya na loop diuretics, ụdị ọgwụgwọ ahụ nwere ike ibute mbelata ọbara mgbali elu na mmepe nke akwara ọbara ruo mgbe ọ dara. N'ihe ngosiputa zuru oke, a na-atụ aro ka ewelata ọgwụgwọ ma ọ bụ kwụsịtụrụ nwa oge torasemide n'ọnọdụ ahụ.

N'ime ndị ọrịa nọ n'ihe egwu dị elu nke ọrịa akụrụ (nephropathyụdị etiologies) cyclosporine na torasemide, ebe nke a nwere ike ịbụ isi ihe na - akpata ọrịa dị oke njọ. Mmetụta cyclosporin bụ mebiri mkpụrụ ndụ nnu uric acid, torasemide, n'aka nke ya, na-ebute mmụba ha n'ọbara. Imekọ ihe ọnụ ga - enweghị atụ, ọ ga - eduga n'inweta urate ma ọ bụ mmepe nke ọrịa ogbu na nkwonkwo.

Ntụziaka maka iji Diuver, usoro onunu ogwu

Ezubere ọgwụ a maka nchịkwa ọnụ. Mbadamba ụrọ na-ewere ụtụtụ n'ụtụtụ mgbe ha risịrị nri ụtụtụ.

Maka ọgwụgwọ edematous syndrome, a na-edenye mbadamba 1 nke Diuver 5 mg 1 oge kwa ụbọchị. Ọ bụrụ na ọ dị mkpa, usoro onunu ogwu nwere ike jiri nwayọ gbagote 20-40 mg otu ugboro kwa ụbọchị. N'ọnọdụ ndị pụrụ iche, usoro ị ga-eji kwa ụbọchị nwere ike ịbụ 200 mg.

Maka ọgwụgwọ ọbara mgbali elu, a na-enye ọkara mbadamba ihe Diuver 5 mg (2.5 mg) 1 oge kwa ụbọchị. N'ọnọdụ ụfọdụ, na uche nke dọkịta, enwere ike ịba ụba usoro ọgwụ ahụ ruo 5 mg kwa ụbọchị.

Ancenabata ihe karịrị 5 mg kwa ụbọchị anaghị ebute mgbanye ọbara mgbali elu ma ọ bụ ndụmọdụ maka ọbara mgbali elu dị mkpa. Ekwesiri iburu n'uche na a na-enweta mmetụta kachasị hypeensive nke torasemide izu iri na abụọ mgbe ịmalite ọgwụgwọ.

Ekwesịrị ka edee ndị ọrịa agadi ka ejiri ọgwụ dụọ obere ọgwụ na mmegharị dose ahụ na ịkpachapụ anya.

Diuretic Diuver

Ntinye kachasị na ọgwụ ahụ bụ torasemide, nke na-arụ ọrụ dị ka onye ọrịa diuretic na-enwe mmetụta na-adịgide adịgide. Ngwa ndi ozo - stachi ọka, lactose monohydrate, sodium carboxymethyl stachi. O nwere magnesium stearate, silicon dioxide anhydrous. Diuver nke ogwu nwere ihe omuma nke iji in puoro, ihe omuma ya nyere aka:

• mbelata osmotic pressure na mkpụrụ ndụ akụrụ,
• na-ewepụ mmiri mmiri gabigara akwara,
• mmachi nke mmiri, sodium ion,
• melite ọrụ myocardial,
• na-egbochi iwepu potassium,
• belata fibrosis.

Diuver - nkuzi

Ngosiputa nke iji ogwu ahu bu nke ndi dọkịta kpebiri. Iji ọgwụ Diuver, ọ dị mkpa ịmụ ntuziaka ahụ, nke na-egosi iwu maka nnabata, usoro onunu ogwu ma na-atụ aro:

• buru n'uche nsogbu ndị ọzọ, contraindications,
• mee ọbara nwa oge
• n'otu oge a na-eri Veroshpiron iji chekwaa potassium,
• Soro nri gi na iji ogologo oge.

Dabere na ntuziaka maka ojiji, ọ dị mkpa:

• tupu ọgwụgwọ, dozie nguzo mmiri-electrolyte,
• lelee glucose maka ọrịa shuga,
• jiri ngwaahịa ahụ kpachara anya na ndị na - egbochi ATP - belata nrụgide n'ụzọ dị egwu.
• zere ịnya ụgbọ ala,
• na-a potassiumụ ihe ọ potassiumụ potassiumụ potassium
• ewepu ọrụ na ngalaba dị mgbagwoju anya.

Diuver - akaebe

Mgbe ị gụchara ntuziaka, ị nwere ike ịghọta na Diuver - ihe ndị na-egosi maka iji ya bụ eziokwu nke edematous syndromes nke mkpụrụ ndụ dị iche iche, nwere mmetụta n'ọtụtụ ebe nke ọgwụ. Ọ bụ ndị dibịa ọgwụ na endocrinologists, ndị nephrologists na cardiologist nyere ọgwụ a. Mbadamba mkpụrụ osisi dị iche iche nwere mmetụta na ọrịa:

• akụrụ
• ngụgụ
• imeju
• ọbara mgbali ọbara na ndị agadi,
• ike ọgwụgwụ nke obi.

Diuver - usoro onunu ogwu

Mgbe ị na-ahọpụta Diuver - ihe ngosipụta maka ojiji nke na-eto, dọkịta na-ebu ụzọ họrọ obere ọgwụ. Mgbe ị na-ele onye ọrịa, a na-agbanwe ọgwụgwọ. Onwe-anagide nchịkwa nke diuretics n'ihi ọnụnọ nke nsonaazụ, contraindications. A na-eri ọgwụ ahụ n'ụtụtụ, mgbe e risịrị nri, were mmiri sachaa ya. N'ọnọdụ ụfọdụ, a na-atụ aro iji ogologo ndụ ya. Usoro onunu ogwu nke Diuver kwa ubochi:

• ya na ọbara mgbali elu - 2.5 mg - ọkara mbadamba,
• n'oge ọrịa nkuume, akụrụ - 5 mg,
• na oke obi ọgbụgba - ruru 40 mg.

Diuver - contraindications

Ekwesịrị iji ọgwụ diuretic mee ihe n'okpuru nlekọta nke dọkịta, ọ bụghị naanị n'ihi na asachapụ ihe ndị dị mkpa n'ahụ ahụ chọrọ nyocha. Enwere contraindications Diuver:

• gbasara akụrụ, nke mmamịrị abanyeghị eriri afọ,
• ịba ọcha n'anya
• hyponatremia - mbelata nke ọkwa sodium,
• ihu abụọ,
• mbelata
• lactose anagide ihe,
• nnukwu glomerulonephritis.

Ojiji nke ọgwụ n’oge afọ ime, ụmụaka, ndị na-eto eto n’agbata afọ 18, ebe a na-anabataghị ara. A na - enye ọgwụ ahụ ọgwụ:

• Ọkpụkpụ nke mmanya na-egbu obi,
• akụkụ ahụ ọ bụla,
• mụbara nrụrụ agụụ,
• erughị eru ịmịkọta,
• gout
• nnukwu myocardial infarction,
• ọrịa shuga mellitus
• anaemia
• imebi mmamịrị,
• arrhythmias ventricular,
• afọ ọsịsa.

Ndị dọkịta, ịmara na mkpụrụedemede - ihe na-egosi iji ya oge niile ka etinyere na ntuziaka ahụ, dị irè na ọgwụgwọ, ekwesịrị ibute nsonaazụ ndị ọzọ. Onweghi udiri oge ahu n’anu ahu:

• cardiovaskụla - mgbada mgbada, ịkụda mmiri,
• urinary - njide urinary, ọdịdị ọbara dị na ya, belata ikike,
• digestive - afọ ọsịsa, vomiting, iwe nke pancreatitis, belatara agụụ,
• otiti, akwara aka, anya n’ile,
• mgbasa ọbara - mbelata sel ọbara ọbara, ọrụ nke sistem.

Diuver - analogues

Ọnụnọ nke nnukwu mmachi na-eme ka ndị dọkịta depụta ndị ọrịa, mgbe egosiri maka iji ya, mmekọrịta nke diuretics nwere ụdị ihe ọrụ a. Ntuziaka radar na-atụ aro analogs Diuver na ihe mejupụtara:

• Aquaphor,
• Aldacton
• Arifon Retard,
• Britomar,
• Brinerdin,
• Dịka,
• Brinaldix,
• Bufenox,
• Isobar
• Zokardis gbakwunyere,
• Indresspress
• Clopamide
• Lorvas
• Ndị Lespeflan
• Lasix
• Retapres
• Nebilong N,
• Trigrim
• Triamtel
• Spironolactone
• Furosemide
• Phytolysin.

Ọnụ ego maka Diuver

Enwere ike ịzụta ihe diuretis na tebụl n'ụlọ ahịa ọgwụ dị nso. Naanị ịchọrọ ọgwụ site na katalọgụ ma zụta n'ụlọ ahịa n'ịntanetị. Ọnụ ego ahụ dabere na ọnụọgụ mbadamba dị na ngwugwu ahụ, onye rụpụtara ya. Ọnụ ego maka Diuver na analogues:

Ihe eji arụ ọrụ, mg

Mmebi ọnụahịa, rubles

Kanefron H, dragee

Ekaterina, onye gbara afọ iri atọ na asatọ Torasemid Canon n’aka onye na-ahụ maka endocrinologist, ihe na-egosi iji ya bụ oke ọzịza. Ọ maghị ihe ọ ga -eje ije - ụkwụ ya adaghị akpụkpọ ụkwụ ọ bụla. Ọ masịrị m na ọgwụ dị nro, ọ nweghị agụụ na-aga mposi mgbe niile. Thebọchị nke abụọ, puff bidoro na-agafe, otu izu ka emesịrị chọpụtara - oke ibu malitere. Ọ dị m oke mma.

Eugenia, onye gbara afọ 58 Dika onye ọrịa nwere oke mmụọ na ahụmịhe, dọkịta na-ahụkarị m. N’ime ọgwụ ndị enyerela m ike kwa ụbọchị, e nwere ndị na-arịa ya. Na mbụ m Acụrụ Acetazolamide, mana ọ nwere ọnụahịa dị elu maka ndị lara ezumike nka, mgbe ahụ onye na-agwọ ọrịa dochiri ya na Indapamide. Ọgwụ ahụ adịghị ọnụ, na-eme ka nrụgide ahụ kwụsie ike, ọ dịghị ahụ erughị ala site na agụụ.

Valentina, onye gbara afọ 52. Mgbe a chọpụtara na m nwere ọrịa obi nkụchi, ha depụtara Veroshpilakton. Dọkịta ahụ kọwara na ọgwụ a anaghị ewepụ mmiri mmiri nke na-agbago, kama ọ na - echekwa potassium site na leaching, nke dị ezigbo mkpa maka cores. Isi ihe bụ na ọria ahụ niile agafela, n’agbanyeghi na anya ndị dị n’elu ahụ mechara hụwa.

Mlọ ọgwụ

Mgbe nchịkwa onu gachara, torasemide na - agbakarị ngwa ngwa ma ọ fọchaakwa nke ọma na eriri afọ. A na-ahụta mkpokọta torasemide dị na plasma ọbara dị ka awa 1-2 ka mmanya gachara. Bioavailability bụ 80-90% nwere obere ọdịiche ndị mmadụ n'otu n'otu.

Mmetụta ọrịa ahụ na-adịru ihe ruru awa 18, nke na-eme ka ịnagide ọgwụgwọ ghara ịdị n'ihi ọtụtụ urination ugboro ugboro na awa mbụ mgbe ị takingụ ọgwụ ahụ, na -emechi ọrụ nke ndị ọrịa.

Nkwukọrịta na protein plasma karịa 99%. Obere nkesa ya pụtara bụ lita iri na isii.

A na-agwakọta ya na imeju na-eji isoenzymes nke usoro cytochrome P450. N'ihi nsonaazụ na-esochi, hydroxylation, ma ọ bụ mmeghachi nke hydroxylation, a na-emepụta metabolites atọ (M1, M3, na M5), nke na-ejikọ protein protein site na 86%, 95%, na 97%, n'otu n'otu.

Ọkara ndụ (T1 / 2) nke torasemide na metabolites ya bụ awa 3-4 ma ọ gbanweghi na ọdịda akwara na-adịghị ala ala. Mkpochapu nke torasemide bụ 40 ml / min, mwepu renal - 10 ml / min. Ná nkezi, ihe dị ka 83% nke ọgwụ a na-ewere dị ka akụrụ: na-agbanweghi agbanwe (24%) na n'ụdị nke metabolites na-adịghị arụ ọrụ (Ml - 12%, M3 - 3%, M5 - 41%).

Na ọdịda akụrụngwa, T1 / 2 anaghị agbanwe agbanwe, T1 / 2 nke metabolites M3 na M5 na-abawanye. Torasemide na metabolites ya bụ ndị hịkọtara ọnụ na usoro ọgwụgwọ ọbara.

Na mmebi nke imeju, mkpokọta torasemide na plasma ọbara na-abawanye n'ihi mbelata metabolism nke ọgwụ na imeju. N'ime ndị ọrịa nwere ọrịa obi ma ọ bụ imeju T1 / 2 nke torasemide na M5 metabolite na-abawanye ntakịrị, nchịkọta nke ọgwụ adịghị ele anya.

Jiri nlezianya

Ọkpụkpụ akwara, stenosing atherosclerosis nke akụkụ ụkwara akwara, hypoproteinemia, ọnọdụ nke ịba ụba, mmerụ ahụ mmụba (ụkwara ume ọkụ na-ebelata, na-ebelata urethra ma ọ bụ hydronephrosis), akụkọ ihe mere eme nke ventricular arrhythmia, nnukwu ọrịa myocardial infarction, ọrịa obi ọgụ, cardi ọrịa shuga mellitus (ibelata nnabata glucose), ọrịa hepatorenal, gout, anaemia, ime.

Nsonaazụ

Dịka ntuziaka maka ojiji a ga-esonye, ​​nhọpụta Diuver (5/10 mg) yana nsonaazụ ndị a:

• akpukpọ mmiri na mmụba ọ na-ebute n'ọbara nke potassium, magnesium, calcium, chlorine na sodium,
• mbelata nke ọbara mgbali elu,
• arrhythmias na tachycardia, adịkarịghị ala,
• sporadic na mkpokọta urea na cholesterol n'ime ọbara,
• interstitial nephritis ma ọ bụ njigide urinary na-akpata
• Ọrịa pancreatitis na ọgba aghara dyspeptik,
• paresthesia
• ụnwunna iya nụ
• gbanwee onyonyo ọbara ruo n'ọbara na akwara ọbara,
• mmeghachi omume nfụkasị anụ ahụ, yana ujolactic.

Ọ bụrụ n ’ihe mgbaàmà pụtara na-egosi mmalite nke ihe ojoo, a na-atụ aro ka ị kwụsị ị theụ ọgwụ ahụ tupu ị gakwuru dọkịta gị.

Mmetụta diuretic nke ọgwụ ahụ na-adịru awa 18, yabụ, n'ime awa ndị mbụ mgbe ị takingụsịrị ya, enweghị nnukwu mkpali iji belata, na-egbochi ọrụ onye ọrịa.

Ihe ngbanwe

Diuver na-contraindicated na ndị a na-eso otu ọrịa:

• Site n'ịba ụba nke torasemide na / ma ọ bụ sulfonamides, yana ndị ọgwụ ọgwụ,
• N'ọnọdụ ndị a na-esochi enweghị mmamịrị na ọnya,
• Na ọnọdụ nke ọrịa ịba ọcha n'anya, nke e ji amata akụkụ akwara ozi, bụ́ nke kpatara nnukwu ihe mgbochi nke imeju,
• Na steeti predomatous,
• Na ọdịda akụrụngwa, nke ihe mgbaàmà na-egosi na ịba ụba azotemia,
• Na hypotension akwara,
• Na arrhythmia.

N'ihi enweghị ọmụmụ ụlọ ọgwụ n'oge a na-enye nwa ara, a naghị atụ aro ya maka ụmụ nwanyị na-enye nwa ara. Ọzọkwa, akwadoghị ọgwụ ahụ maka ụmụaka na-erubeghị afọ 18, ebe ọ bụ na e guzobebeghị nchekwa na ịdị mma ya maka ìgwè ndị ọrịa a.

N'oge afọ ime, iji Diuver bụ ihe ziri ezi naanị ma ọ bụrụ na ọ dị mkpa ngwa ngwa. Ekwesịrị ime nnabata na obere ntakịrị, n'okpuru ọnọdụ yana n'okpuru nlekọta nke dọkịta nwere nwanyị na-arụ ọrụ.

Igosiputa na nwa ebu n’afọ dịkwa mkpa, ebe ọ bụ na mgbe ọ na-abanye n’anụ ya, torasemide na-akpalite ọgba aghara na metabolism mmiri, yana thrombocytopenia.

Dodoụbiga ya ókè

Mgbe ị na-ewere Diuver dị elu na ndị ọrịa, ọ ga-ekwe omume ịmalite ọgba aghara mmiri, nnukwu diuresis, iro ụra, hypotension, ọgba aghara na enweghi ike akwara.

Na mgbakwunye, mmepe nke ọrịa eriri afọ.

Amaghị ọgwụ a kapịrị ọnụ amabeghị. Egosiputara nbibi nke ogwu ma obu onunu ogwu. Site na mgbaàmà siri ike nke ịdoụbiga mmanya ókè, a na-edozi mmiri-electrolyte ma dezie usoro ọgwụgwọ Symptomatic.

Jiri n'oge ime na lactation

Torasemide enweghị mmetụta teratogenic na fetotoxicity, na-abanye n'ihe mgbochi placental, na-akpata ọgba aghara na metabolism mmiri na thrombocytopenia na nwa ebu n’afọ.

Enwere ike iji ọgwụ Duver mee ihe n’oge afọ ime naanị ma ọ bụrụ na uru nne dị na ya karịrị ihe ọghọm nke nwa ebu n’afọ n’ọrụ naanị n’ọrụ dọkịta ma ọ bụ naanị n’obere ntakịrị.

Amaghị ma torasemide na-abanye na mmiri ara. Ọ bụrụ na ọ dị mkpa iji Diuver ọgwụ n’oge a na-enye ya ara, ọ dị mkpa ịkwụsị ị breastụ ara.

Analogs nke Diuver, ọnụahịa dị na ahịa ọgwụ

Ọ bụrụ na ọ dị mkpa, enwere ike dochie Diuver na analog nke ihe nọ n'ọrụ - ndị a bụ ọgwụ ọjọọ:

Mgbe ị na-ahọrọ analogues, ọ dị mkpa ịghọta na ntuziaka maka ojiji nke Diuver, ọnụahịa na nyocha nke ọgwụ nwere otu mmetụta emetụtaghị ya. Ọ dị mkpa ịnweta ndụmọdụ nke dọkịta na ịghara ime mgbanwe ọgwụ ọ bụla.

Ọnụahịa dị na ahịa ọgwụ nke Russia: mbadamba mkpụrụ osisi 5 mg 20 pcs. - site na 335 ruo 391 rubles, 10 mg 20 PC. - site na 425 ruo 439 rubles.

Na-echekwa na okpomọkụ ruo 30 ºС. Ekwela ka ụmụaka ghara iru ya. Ndụ shelf bụ afọ 3. A na-ere ọgwụ ndị ahụ site na ọgwụ ọgwụ.

Nyocha 3 maka "Diuver"

Ọ na - ewepu edema ma na - ebelata nrụgide, mana enwere nsonaazụ na - adịghị enye obi ụtọ ((

N'adịghị ka ndị ogbo ọzọ dị ọnụ, Diuver nwere ihe ndị ọzọ ọ na-akpata.

Ezi usọbọ. Nna m gburu Diuver n'ihi obi ịkwụsị iwepụ isi ọfụma (ụkwụ ya gbagọrọ agbagọ nke ukwuu, ọ ruru ogo nke enweghị ike ịkwaga onwe ya). Tupu Diuver, ha nwara ihe niile, mana enweghị mmetụta pụtara ìhè na mmetụta a na-atụ anya ya.

Diuver, ntuziaka maka ojiji: usoro na usoro onunu ogwu

Ekwesịrị ị tabletsụ mbadamba mkpụrụ osisi dị iche iche 1 ugboro kwa ụbọchị (mgbe nri ụtụtụ), were mmiri zuru oke sachaa.

Na-atụ aro otu (na kwa ụbọchị n'otu oge) doses:

• Ọrịa Edema: ọgwụ mbụ bụ 5 mg, ọ bụrụ na mmetụta ezughi oke, a na-abawanye ọgwụ ahụ ruo 20-40 mg, n'ọnọdụ ụfọdụ - ruo 200 mg. Ọ dị mkpa iji Diuver ruo mgbe edem na-apụ n'anya, ọgwụgwọ ogologo oge ga-ekwe omume,
• Ọbara ọgbụgba: ọnụọgụ mbido bụ 2.5 mg (1/2 mbadamba), ma ọ bụrụ na ọ dị mkpa, mee ka ọgwụ ahụ rute 5 mg.

Ntụziaka pụrụ iche

Diuver ga-emerịrị ya dị ka dọkịta nyere ya.

Mmetụta diuretic nke Diuver na-adịru awa 18, n'ihi nke, na awa mbụ mgbe nchịkwa ya gasịrị, ọ dịghị enwekarị mkpịsị oge ịre ute, na-egbochi ọrụ onye ọrịa.

Mgbe ị na-a Diụ ọgwụ mmiri nke Diuver ogologo oge, ihe ize ndụ nke ịmalite hypokalemia, hyponatremia na metabolic alkalosis na-abawanye, yabụ na-atụ aro ịrapara na nri nke nwere sodium chloride zuru ezu ma na-agbakwunye na-akwado potassium.

N'ime ndị ọrịa nwere ezughi oke akụrụ, nsogbu nke ịbawanye mmiri elektrọnte nsogbu na-abawanye, yabụ, n'oge ọgwụgwọ, ịchịkwa ịta nke electrolytes na plasma ọbara (gụnyere sodium, potassium, calcium na magnesium), steeti-acid, steeti nitrogen, na uric acid dị mkpa. na creatinine. N'ọnọdụ ụfọdụ, enwere ike ịchọ ọgwụgwọ mgbazi kwesịrị ekwesị, ọkachasị ndị ọrịa na-enwekarị ọgbụgbọ ma ọ bụ na-enweta mmiri mmiri.

N'ihe banyere ọdịdị ma ọ bụ sie ike nke oliguria na azotemia na ndị ọrịa nwere nnukwu akụrụ na-enwe ọganihu, a na-atụ aro ọgwụgwọ Diuver ka ọ kwụsị.

Nhọrọ dị mkpa Diuver dị mkpa maka ndị ọrịa nwere ọrịa ascites nke tolitere n'ihi ọrịa imeju kwesịrị ime n'ụlọ ọgwụ, ebe ọ bụ na ọgba aghara na nha ha na - elezi anya mmiri nwere ike ibute mmepe nke mmiri ịba ọcha n'anya. Na mgbakwunye, na ụdị ndị ọrịa, ekwesịrị ilebara plasma electrolytes anya.

N'ime ndị ọrịa nwere ntakịrị nnabata glucose na ọrịa shuga, ọ dị mkpa ịlele mgbe niile oke mkpokọ glucose na mmamịrị na ọbara.

N'ihi ihe ize ndụ nke njigide urinary na-adịghị njọ, njikwa mmamịrị dị mkpa maka ndị ọrịa nwere oke ọnya na hyperplasia prostatsia, yana ndị ọrịa nọ n'ọnọdụ amaghị.

Ime na lactation

• Pregba ime: Enwere ike iji akpachapụ anya na obere doses mgbe ọ tụlechara uru nke atụ anya na ihe ọghọm dị ugbu a, torasemide enweghị mmetụta teratogenic na fetotoxicity, na-abanye n'ihe mgbochi placental, nke na-ebute thrombocytopenia na mmiri na - enwe mmetụta mmiri metabolic na nwa ebu n'afọ,
• Lactation: ogwu na contraindicated.

Mkparịta ụka ọgwụ ọjọọ

• Aminoglycosides, cephalosporins, ethaclates acid, amphotericin B, chloramphenicol, cisplatin: itinye uche ha na ihe ize ndụ nke ịmalite ọrịa oto- na mmetụta nephrotoxic na-abawanye
• Theophylline, diazoxide, ọgwụ antihypertensive: a na-eme ka mmetụta ha dịkwuo mma,
• Akwara anụ ahụ (dịka ọmụmaatụ, suxamethonium): a na - akwalite ihe mgbochi akwara ha,
• Ndị na - anaghị eme ka akwara dị jụụ (dịka tubocurarine), allopurinol, ndị na - ahụ ike hypoglycemic: arụmọrụ ha na - ebelata,
• Torasemide, pressor amines: a na-ahụta ibelata mmetụta,
• Ọgwụ ndị na-egbochi ọgbụgba mmiri tubular: ụba serum torasemide ịta,
• Nkwadebe nke lithium: imebi akụrụ ha na ohere nke ịmalite ịxụbiga mmanya ókè.
• Cyclosporine: ohere dị ukwuu nke ibute ọrịa ogbu na nkwonkwo,
• Amphotericin B, glucocorticosteroids: ohere dị elu nke hypokalemia na-etolite,
• Cardiac glycosides: ihe ize ndụ nke ịmalite ị developingụbiga glycoside n'ihi hypokalemia na ịdị ogologo ndụ ọkara,
• Sucralfate, ọgwụ mgbochi mkpali nke steroidal: mmetụta diuretic nke Diuver belatara,
• Salicylates na oke doses: ihe ize ndụ nke egbu egbu na-abawanye,
• Ndị na-egbochi enzyme enzyme, ndị na-anabata antiotensin II: ndị nwere mbelata ọbara mgbali elu ga-ekwe omume,
• Methotrexate, probenecid: mkpochapu nke akwara ha na-ebelata, ịdị irè nke torasemide na-ebelata.

N'ime ndị ọrịa nwere nnukwu ihe ize ndụ nke ịmalite ọrịa nephropathy bụ ndị na-ewere Diuver, mgbe a na-elekọta ndị na-ahụ maka rediopa, ezumike akwara bụ ihe a na-ahụkarị karịa ndị ọrịa nwere nnukwu ihe ize ndụ nke nephropathy nke na-agbanye mmiri mmiri tupu nchịkwa nke radiopaque.

Analogs nke Diuver bụ: Torasemide, Torasemide-SZ, Torasemide Vertex, Trigrim, Trifas, Britomar.

Nyocha banyere Diuvere

Nyocha banyere Diuver na-akacha mma. Ndị ọrịa kọwara ya dị ka ihe diuretic dị nwayọ ogologo oge, jiri nwayọ ma jiri nwayọ wepụ mmiri mmiri, nke na-eduga na ahụmịpụta ụbụrụ n'ụkwụ na mbelata mgbali ọbara. Ọzọkwa, enwere ike ị ofụ ọgwụ ahụ ogologo oge dị ka uru. A na-eme atụmatụ na ọnụ ahịa ahụ dị elu.

Ngwakọta na ụdị ntọhapụ

Diuver dị n'ụdị mbadamba ọcha nke ụdị biconvex dị okirikiri, nke nwere ihe nkerisi nke dị n'otu akụkụ ma na-akanye na nke ọzọ. Isi ihe dị na ọgwụ ahụ bụ torasemide, ọdịnaya ya dị na mbadamba ihe osise:

Linlọ ọgwụ na ọgwụ ọgwụ: diuretic.

Gịnị na-enyere Diuver aka?

N'ikwekọ na ntuziaka ahụ, a na-atụ aro Diuver maka ndị ọrịa na-arịa ọrịa ngosipụta ọrịa edema n'ihi ọrịa obi na-adịghị ala ala, ọrịa nke akụrụ, akpa ume na umeji.

Nsonaazụ

Site n'iji ọgwụ n'ụzọ kwesịrị ekwesị yana ịlele dọkịta na-atụ aro, nsonaazụ ndị ọrịa na-etolite n'ọnọdụ ndị a na-adịghị ahụkebe Site n'ịgwọ onwe onye ma ọ bụ ojiji a na-achịkwaghị achịkwa, mmetụta ndị ọzọ na-eso nwere ike ịmalite:

• Site n'akụkụ nke mmiri-electrolyte na acid-base balance: hyponatremia, hypochloremia, hypokalemia, hypomagnesemia, laboalcemia, metabolic alkalosis. Ihe mgbaàmà na-egosi mmepe nke electrolyte na ọnọdụ acid nwere ike ịba isi ọwụwa, ọgba aghara, nkwonkwo, tetany, ike ọgwụgwụ, akwara obi na ọgba aghara dyspeptik, hypovolemia na akpịrịkpa (karịa mgbe ọ bụla na ndị agadi agadi), nke nwere ike ibute hemoconcentration nwere agwa nke thrombosis.
• Site na usoro akụrụngwa: mbelata nke ukwuu n'ọbara, ọbara orthostatic, ndakpọ, tachycardia, arrhythmias, mbelata nke olu nke na-ekesa ọbara.
• Site n'akụkụ nke metabolism: hypercholesterolemia, hypertriglyceridemia, mmụba dị mkpirikpi na ntinye nke creatinine na urea n'ọbara, mmụba nke mkpokọta uric acid n'ime ọbara, nke nwere ike ibute ma ọ bụ nwekwuo ngosipụta nke gout, mbelata nnabata glucose (enwere ike igosipụta ọrịa shuga mellitus latent).
• Site na sistemụ urinary: oliguria, njigide urinary na-egbu egbu (dịka ọmụmaatụ, yana prostatic hyperplasia, warara urera, hydronephrosis), nephritis interstitial, hematuria, nwere ikike belatara.
• Site na ngwe nri: ọgbụgbọ, ọgbụgbọ, afọ ọsịsa, intrahepatic cholestasis, ịba ụba nke enzymes "imeju", nnukwu pancreatitis.
• Site na sistemụ akwara na etiti, anụ ntị: nhụ ntị, na-atụgharịkarị, yana / ma ọ bụ tinnitus, ọkachasị ndị ọrịa nwere ọdịda akwara ma ọ bụ hypoproteinemia (ọrịa nephrotic syndrome), paresthesia.
• N’akụkụ anụ ahụ: itching skin, urticaria, other rashes or the skin skin, polymorphic erythema, exfoliative dermatitis, purpura, fever, vasculitis, eosinophilia, photoensitivity, oké anaphylactic ma ọ bụ mmeghachi omume anaphylactoid ka akọwapụtala ruo ugbu a nke akọwapụtarala ruo taa. mgbe nchịkwa intraven.
• Site n'ọbara na –akpata: thrombocytopenia, leukopenia, agranulocytosis, aplastic or hemolytic anemia.

N'ọnọdụ ndị a na-adịghị ahụkebe, ure ịba ọcha n'anya nwere ike ịmalite.

Ngwongwo ogwu

Diuver bụ diuretic ma nwekwaa mmetụta akpọrọ ihe ma nwee ahụ na ahụ. Ngwakọta ọgwụ ahụ na-arụ ọrụ nke ọma anaghị akpata mmepe nke hypokalemia, na iche na furosemide na analogues ndị ọzọ nke ọgwụ.

Mgbe ị takingụchara ọgwụ ahụ n’ime, a na-abanyekwa ihe ahụ na-arụ ọrụ n’ime ọbara izugbe, a na-ahụ mmetụta ọgwụgwọ nke ọgwụ ahụ mgbe awa 2 gachara. Ndị ọrịa na-anabata ọgwụ ahụ nke ọma, yabụ enwere ike iji ya ogologo oge ma ọ bụrụ na ọ dị mkpa.

N’oge ime ime

N'oge afọ ime, iji Diuver bụ ihe ziri ezi naanị ma ọ bụrụ na ọ dị mkpa ngwa ngwa. Ekwesịrị ime nnabata na obere ntakịrị, n'okpuru ọnọdụ yana n'okpuru nlekọta nke dọkịta nwere nwanyị na-arụ ọrụ. Igosiputa na nwa ebu n’afọ dịkwa mkpa, ebe ọ bụ na mgbe ọ na-abanye n’anụ ya, torasemide na-akpalite ọgba aghara na metabolism mmiri, yana thrombocytopenia.