"Torasemide": yokusetshenziswa. "Sandoz Torasemide": intengo, indawo, ukubuyekezwa

"Torasemide" - a yesimanje enamandla izidakamizwa isisu ukuthi uphelele ukulapha eside izifo ezihambisana ne ukubonakala edema. Ngenxa abambalwa emtholampilo ezibalulekile side effects, nobubanzi ukusetshenziswa zayo zokwelapha ngaphezulu. Kuphephe kwamanye isisu loop bese has ubufakazi obengeziwe. Esikhathini ekwelapheni izifo ezihlukahlukene umthamo beshintsha. Futhi, esebenzayo uma esingamahlalakhona umsebenzi izinso ngisho filtration ongaphakeme Isivinini glomeruli nephrons.

Imiphumela "torasemide"

"Torasemide" njengoba emelele iluphu (usawoti) iqembu isisu ojamele luminal ingxenye epithelium ka tubules we nephron engxenyeni ekuntweleni loop of Henle. Linalo umphumela inhibitory kwi ezokuthutha ngokuhlanganyela potassium ion futhi sodium chloride, ke iyehlisa ezingaba electrochemical ngesikhathi epithelium kobuso nephron. Ukuvinjelwa yi kuyinto ukuphazamiseka ion ezokuthutha sodium reabsorption elivela emchamweni okuyinto kwandisa diuresis.

Cishe bonke isisu iluphu kubangele electrolyte thuthuva ngenxa ithonya reabsorption eqinile potassium ion, sodium, magnesium chlorine. "Torasemide" ngezinga elincane kuthinte Ukukhetha i-potassium ne-magnesium, ngenxa okuyinto legciwane eliphansi kakhulu we arrhythmias, sokuzincisha ukudla, ukuqunjelwa, ukuba buthakathaka kwezicubu. Futhi, izidakamizwa ukuze kancane ngokwezinga amabhlogo kumiswa thromboxane A2, edlulisela izitsha. Wabuye amabhlogo aldosterone receptor infarction, ezivimbela izinqubo cystic of imisipha yenhliziyo.

ubufakazi

Njengoba unamathele izidakamizwa "Torasemide" imfundo manual liqukethe ulwazi ngalesi sifo, awusebenzisa ekwelapheni. "Torasemide" kuboniswa ngenxa:

• ukuphathwa pathogenetic of umfutho wegazi ophakeme emithanjeni amelana ukwelashwa nge inhlanganisela ACE inhibitor (ARBs) isisu thiazide;
• ekwelapheni ezingamahlalakhona inhliziyo ukwehluleka, uhilela kwegazi sindisa imibuthano;
• ukuphathwa siyefana ezingamahlalakhona ukwehluleka kwezinso, kuhlanganise gqwa ngesivinini ongaphakeme (ngaphansi kuka-20 ml \ imiz);
• ukuphathwa siyefana isibindi (nge hypoalbuminemia ezihambisana) edema esikhundleni "Furosemide".

Lapho umfutho wegazi ophakeme "Torasemide" analogue nama imithi ejwayelekile asetshenziswa kuphela emva ukwehluleka isisu thiazide. A ingasatshenziswa izidakamizwa lide ngenxa inombolo encane emtholampilo ezibalulekile futhi iyingozi side effects e ukwehluleka kwezinso. Labo we "torasemide" incane kakhulu kunaleyo "Furosemide".

Yokusetshenziswa

Ngokusekelwe iziqondiso zokwelapha for izidakamizwa "Torasemide" imfundo manual inalokhu izici izidakamizwa imithamo edingekayo ukuze athole ukwelashwa bese yokulungiswa isifo target. Lapho izidakamizwa ngokwayo itholakala amaphilisi equkethe izithako ezilandelayo: 2.5 mg, 5 mg, 10 mg, 20 mg, 50 mg, 100 mg, 200 mg.

Ukuthatha izidakamizwa esibhebheni ekuseni, kungakhathaliseki ukuthi ukudla. Ngenxa yalezi Ukweqiwa izidakamizwa "Torasemide" intengo ezahlukene: kuba ephansi ngesikhathi umthamo ubuncane futhi ophakeme kunabo ngaleso esiphezulu. Ngokusho idatha kuba khona isilinganiso sabangu, amaphilisi 30 zomuthi at 5 mg kukhona ruble 400. Lapho ethola lokhu umthamo anikezwa kanje ngokuvumelana izinkomba:

• ekwelapheni nomfutho wegazi ophezulu kuthathwe 2.5 - 10 mg / ngosuku;
• wathola 10-20 mg / ngosuku ezingamahlalakhona ukuhluleka kwenhliziyo;
• ezingamahlalakhona ukwehluleka kwezinso - 50 mg noma ngaphezulu;
• yokwehluleka kwesibindi ukusebenza kudinga umuntu umthamo izinguquko.

Side Effects "torasemide"

Njengoba unamathele izidakamizwa "Torasemide" imfundo manual liqukethe ulwazi mayelana amaningi okuba nemiphumela engemihle. Ngesikhathi umthamo zokwelapha, okungukuthi 200 mg ngelanga kwandisa ingozi yezinkinga thromboembolic, ischemia inhliziyo, palsy. It kwandisa ingozi lezivakashi ukuhlaselwa ischemic futhi isilethikusebenza, embolism yamaphaphu, arrhythmias. Kukhona amathuba okuvela ukuqubuka iguliswa noma isifuba lapho kungenzeka lesiguli.

"Torasemide" ngezinye izikhathi kubangela ukucanuzela kwenhliziyo noma ukuhlanza, akuvamile sokulamula dyspepsia, uhudo. Kuchazwe amacala elingalodwa pancreatitis ngesikhatsi ukwelashwa nge "torasemide". Futhi anda transaminases hepatic, okubonisa isibindi ubuthi zomuthi ebulilini. Ngezinye izikhathi iziguli ngokuthi enkeneneza ezindlebeni, angaboni kahle.

Uma uthola umthamo anobuthi ekuthuthukiseni isimo ukweqisa izidakamizwa nge izimpawu kancane. Overdose kuhambisana nokulahlekelwa oketshezini umchamo: diuresis eside futhi njalo, angagcina hypotension, nciphisa semithambo, yokufikelwa, unhlangothi, ischemia cerebral ngemuva.

Izimo kanye nemikhawulo kwesicelo

Izidakamizwa "Torasemide" analogue nama imithi ejwayelekile ayikwazi lisetshenziswe khona Izimo ngokuphelele. Lezi ukusabela iguliswa izidakamizwa noma binders. "Torasemide" kwenqatshelwe ukuyisebenzisa ukuhluleka kwezinso nge anuria, yokwehluleka kwesibindi ukusebenza ngenkathi isimo ikhoma hepatic, nge tachyarrhythmias. engayitholi contraindicated ngesikhathi lactation nokukhulelwa kanye ngaphansi kweminyaka eyi-18, hypersensitivity kuya sulfonamides.

Kohlangothi imiphumela kuhlanganiswe "torasemide"

Ekwelapheni nomfutho wegazi ophezulu amaphilisi "Torasemide" ingase ibe nomphumela ongemuhle inkambo sifo. Kusukela tubules proximal we nephron izidakamizwa esebenzayo udle ezokuthutha esebenzayo, kukhona okusithiyayo ukuncintisana excretion of uric acid. Against ngemuva ukusetshenziswa "torasemide" awokuthi hyperuricemia kanye sifo oyingozi.

Nomuthi "Torasemide" elinesimo isenzo esiqondile ingxenye proximal ka ijabulise epithelium iluphu of Henle. Ngenxa enamandla isisu umphumela futhi electrolyte ukungalingani lokhu kubangela amathuba ekuxhumaneni emtholampilo ezibalulekile kwemithi. Ziyakwazi eziyingozi, ongabalulekile futhi ezifiselekayo. Phakathi esiyingozi futhi yiziphi izinto ezintathu ezibalulekile:

• umthamo omkhulu (50 mg / usuku) "torasemide" lapho isetshenziswa ngesikhathi esifanayo ne-platinum amalungiselelo sithuthukisa ubuthi wale mithandazo;
• ukuphuza amaphilisi amaningi "torasemide" (50 mg / usuku) ukwandisa imiphumela nephrotoxic futhi ototoxic ka aminoglycoside imithi elwa namagciwane;
• e cephalosporin imithi elwa namagciwane, lapho asetshenziswe kanye "torasemide" in umthamo 50 mg / usuku livela impahla nephrotoxicity;
• salicylates kanye "torasemide" (50 mg / usuku) libhekene neurotoxicity.
• "Torasemide" ngokumelene isizinda hypokalemia isihlobo kwandisa ezifweni we myocardium ukuba glycosides inhliziyo, okwandisa inotropic nethonya antiarrhythmic, okwandisa ingozi ubuthi;
• ingozi hypokalemia luyanda concomitant ukusetshenziswa "torasemide" nge corticosteroids noma nosawoti laxatives;
• "Torasemide" sithuthukisa umphumela "theophylline" curariform futhi imisipha relaxants.

imiphumela oyifunayo yokusetshenziswa elihlangene

Of imiphumela oyifunayo adinga ukuqapha, kwehla wegazi ngesikhatsi ukwelashwa nge-ACE inhibitor. "Torasemide" ngenxa ukususwa uketshezi kunciphisa ingcindezi hydrostatic ka igazi sokulamula ukwehla komfutho wegazi. Lesi sici kubalulekile ekwelapheni nomfutho wegazi ophezulu kanye kudinga ukulungiswa umthamo we-ACE inhibitor. Ngaphezu kwalokho, ekwelapheni nomfutho wegazi ophezulu yokwelapha ukumelana futhi inhlanganisela i-ACE inhibitor "torasemide" kusivumela ukufeza ukuzinza wegazi e-90% eziguli.

Ekwelapheni ezingamahlalakhona yinhliziyo kuyinto nomphumela emtholampilo ebalulekile ekunciphiseni umsebenzi vasoconstrictor ka catecholamines. Inhliziyo on isizinda isisu yokwelapha "torasemide" phendula abangenamandla ukuze ukuvuselela amasignali adrenaline futhi noradrenaline. Nokho, umphumela efanayo ukunciphisa ukusebenza kwe epinephrine futhi norepinephrine ngesikhathi yokusiza umuntu ukuba aphefumule.

imiphumela emibi nokuxhumana

Kube onweba okusithiyayo ngempumelelo lapho kuhlangene izinto ezithile. Ikakhulukazi:

• unamasu Bile acid sequestrants ukunciphisa bamba "torasemide" of wamathumbu, buthaka umphumela bamuva;
• analgesics kwelashwa (ama-NSAID) ukunciphisa ukusebenza kwe "torasemide";
• "Probenecid" ngenxa okhulisa izinqubo urikozuricheskih kuvimbela Ukukhetha "torasemide" e mafutha anciphisa isikhala esingaphakathi we tubules, ekunciphiseni ekulenzeni libe namandla.

izici ngokuqhathanisa "torasemide"

Lapho belungela ukuya khona "Torasemide" analogs kungaba ekilasini, kinetic kanye imithi ejwayelekile. Phakathi isigaba emelelwa analogue: "Furosemide", "bumetanide," "ethacrynic acid". Uma eqhathaniswa "Furosemide" "Torasemide" elinesimo ukuqala kancane isinyathelo futhi ubungozi isikhathi eside kakhudlwana kuhlobene nezinga diuresis anda. Ukunikeza umphumela isisu cishe amandla efanayo nenkulumo ethi "Furosemide" "Torasemide" has ayinayo imiphumela eminingi engemihle elihlobene ne okusheshayo electrolyte ukungalingani.

"Bumetanide" libhekene esakhiweni aqinile isisu ukuthi lihlotshaniswa eminingi engemihle. Ethacrynic acid has a kuqala ephansi izinga isisu umphumela futhi kuyaqabukela esetshenziswa izidakamizwa. I pharmacokinetics zomuthi "Torasemide" libuyekeza Ochwepheshe baqaphela omunye iphuzu elibalulekile. Umuthi has izakhiwo "Rebound": diuresis ngemva okhulisa ngu ukwaba sodium kungekho compensatory nokugcinwa yayo.

Pharmacokinetic analogue "torasemide"

I "Torasemide" imithi Umhlahlandlela inikeza ulwazi isicelo yayo in iziguli umfutho wegazi ophakeme emithanjeni. Kanye izidakamizwa, ukwelapha umfutho ophakeme wegazi kanye nazo asetshenziswa isisu thiazide, i-potassium sizonge. Futhi thiazide ngenxa kancane eza nomphumela isikhathi eside isisu kuyizinto izidakamizwa lokuzikhethela.

Mayelana nalezi pharmacokinetic izici analogue ukulungiswa isicelo "Torasemide" kungenzeka lokhu okulandelayo: ekwelapheni nomfutho wegazi ophezulu, nemithi yokwelapha esezingeni nge ACE inhibitor inhlanganisela (noma angiotensin yokwamukela blocker) nge thiazide. Futhi, "Torasemide" isetshenziswa ezingamahlalakhona kwezinso ukwelashwa ukwehluleka enciphile filtration umthamo.

Imithi ejwayelekile "torasemide"

Lapho belungela ukuya khona "Torasemide" imfundo manual, analogue, izinkomba kanye contraindications elichaza ngokugcwele zako ezisemqoka - diuresis anda. Ngaphezu kwalokho, leso sinyathelo ine izidakamizwa yasekuqaleni futhi ejwayelekile. Lesi sakamuva aqukethe inani elifanayo "torasemide", kodwa kukhiqizwa ngaphansi amanye amagama brand.

Isenzakalo esidume kunazo zonke iwukuthi: "Britomar", "Diuver", "Sandoz Torasemide", "Trifas", "Torcida", "Trigrim". Phakathi ukuhlolwa olubanzi ejenti kwemithi kokungafani okukhulu babonakala phakathi kwabo eRussia. Ngamunye the ukwakhiwa ngenhla ingena esikhundleni ngokugcwele nezinye wabo.

izici Economic ukwelashwa "torasemide"

Ekwelapheni nomfutho wegazi ophezulu lapho isisu thiazide ayizwakali lihambisana ACE inhibitor (noma ARBs), ingasatshenziswa ukwelashwa izidakamizwa "Torasemide": yokusetshenziswa phikisana umthamo owodwa emini. Imali ekhokhwa nyanga zonke ukwelashwa kuyinto ruble 400 ngentengo amaphilisi 60 izidakamizwa ruble mayelana 760-800. Ukuze uqhathanise, intengo yenyanga yokwelashwa "Furosemide" azivamile idlule ruble angu-20. Kodwa yokugcina ukuze bayothola ukwelashwa okuqhubekayo nomfutho wegazi ophezulu lutho.

Ngo ezingamahlalakhona inhliziyo ukwehluleka ne edema kokubili izindleko imibuthano kunyatheliswa nyangazonke ukwelashwa "Furosemide" kuyinto ruble mayelana 20-30. Lapho belungela ukuya khona "Torasemide" intengo mkhulu izikhathi 10-15. Lesi sakamuva kunomphumela omnene, ukuthi akusho lutho kwandisa excretion of umchamo emahoreni lokuqala reception. Izimfanelo "Furosemide" we reverse: ukhula kakhulu inani umchamo e yokuqala amahora amabili nge lube buthaka kancane kancane okukhiphayo umchamo.

Ngenxa yalokhu, iziguli employable nge nomfutho wegazi ophezulu noma nesifo esingamahlalakhona kwezinso noma kwegazi okunengqondo ukusebenzisa "Torasemide" imfundo (wentengo kuboniswe ngenhla) ku isicelo equkethe ulwazi mayelana ngcono abalulekile diuresis e okokuqala i-reception. Nokho, yobudala umhlalaphansi iziguli singekho isidingo ukuza emsebenzini, isivinini umchamo okukhipha cishe ayibalulekile. Akukona ukudala nobunzima, futhi ngenxa yalokho ikuvumela ukuthola ezishibhile ekilasini Analogue - "Furosemide".