Diuretics: zvavari, ndeapi mhando uye mashandiro avo

Zvemukati

• 1. Thiazide diuretics
• 2. Loop diuretics
• 3. Potassium-inodzivirira diuretics
• 4. Osmotic diuretics
• 5. Carbonic anhydrase inhibitor diuretics

Dhiureti mishonga inogona kushandiswa yoga kana kusangana nezvimwe zvinoshanda zvinhu, pakurapa arterial hypertension, kuzvimba kunokonzerwa nemoyo, itsvo kana chirwere chechiropa, pakati pevamwe.

Kune mhando dzinoverengeka dzedhiureti dziripo, senge thiazides, chiuno, potasium-inochengetedza, osmotic kana carbonic anhydrase inhibitors, nenzira dzakasiyana dzekuita nekuita munzvimbo dzakasiyana dzeitsvo, idzo dzinofanirwa kupihwa zvichienderana nedambudziko rinofanira kurapwa.

1. Thiazide diuretics

Aya ma diuretiki ane awo mashandiro ekuita kudzivirirwa kwesodium reabsorption muchikamu chekutanga cheiyo distal itsvo tubule, ichiwedzera kubuda kwayo, pamwe nekubuda kwema chloride uye, padiki padiki, ye potassium uye magnesium, izvo zvinokonzeresa ku kubviswa kwemvura. Iyi mishonga ine simba rine mwero.

Generic / mazita ekutengesa: Mimwe mienzaniso yetiyazide diuretics indapamide (Natrilix, Indapen, Flux), hydrochlorothiazide (Diurix, Hidromed) uye chlorothalidone (Higroton).

Zviratidzo zvekurapa: Kazhinji, diuretics mukirasi ino inoratidzirwa yekudzikisa BP uye yekurapa kusingaperi kweedema inosangana ne congestive moyo kutadza, chiropa cirrhosis uye chirwere cheitsvo.

Mhedzisiro inowanzoitika: Mimwe yemhedzisiro inowanzoitika panguva yekurapwa nemishonga iyi dzungu, kutemwa nemusoro, kushaya simba, kusvotwa, kurutsa, kurwadza, manyoka, kuzvimbirwa, cholecystitis, pancreatitis uye ropa uye ganda kusagadzikana.

2. Loop diuretics

Loop diuretics inoshanda nekudzivirira sodium reabsorption mubazi rinokwira rerupu reHenle, zvichitungamira kudzikiswa kwetubular mvura reabsorption. Uye zvakare, mishonga iyi zvakare ine mhedzisiro yakanangana nekuyerera kweropa, ichikonzera vasodilation uye yakaderedza renal vascular kuramba. Iyi mishonga ine simba rine diuretic mhedzisiro, nekukurumidza nekukurumidza kwenguva pfupi

Generic / mazita ekutengesa: Furosemide (Lasix, Neosemid) muenzaniso weiyo inoshandiswa zvakanyanya loop diuretic. Dzidza maitiro ekushandisa uye ndezvipi zvinopesana nefurosemide.

Zviratidzo zvekurapa: Loop diuretics inoratidzirwa yekutonga kweacute pulmonary edema uye mamwe akasimba edema marudzi, acute renal kutadza uye arterial hypertension. Uye zvakare, ivo vanogona zvakare kushandiswa kurapa kwakanyanya hypercalcemia, sezvo ivo vachisimudzira weti calcium excretion.

Mhedzisiro inowanzoitika: Mimwe mhedzisiro inogona kuitika panguva yekurapwa kushushikana kwe electrolyte, kupera mvura mumuviri, hypovolemia, kuwedzera mwero we creatinine uye triglycerides muropa, kurwisa kwe gout uye kuwedzerwa huwandu hweweti.

3. Potassium-inodzivirira diuretics

Iyi mishonga inodzivisa kubuda kwe potassium padanho rekupedzisira reiyo distal yakapfuura tubule uye mune yekuunganidza chubhu, iyo inogona kana inogona kunge iine aldosterone inopesana nekuita.

Spironolactone ndeye yakatarwa aldosterone antagonist, inoshanda zvakanyanya kune aldosterone-inotsamira sodiamu uye potasium ion nzvimbo yekutsinhana, iri mune yakasarudzika yakatsanangurwa tubule yeitsvo uye inotungamira kune yakawedzera huwandu hwesodium nemvura kuti ibudiswe, nepo potasium ichichengetwa.

Generic / mazita ekutengesa: Mimwe mienzaniso ye potassium-sparing diuretics ndeye amiloride, iyo inongobatanidzwa nezvimwe zvinhu zvinoshanda, uye spironolactone (Aldactone, Diacqua). Ona zvimwe zviratidzo zvekurapa zve spironolactone.

Zviratidzo zvekurapa: Potassium-inodzivirira diuretics ine isina kusimba diuretic chiito uye, nekudaro, haiwanzoshandiswa wega pakurapa edema kana hypertension, uye inowanzo kuve yakabatana nemamwe diuretics. Yayo co-manejimendi inowedzera iyo diuretic maitiro uye antihypertensive mhinduro kune thiazide uye loop diuretics.

Mhedzisiro inowanzoitika: Mimwe mhedzisiro yakaipa iyo inogona kuitika kuwedzera kweakawedzera maserura vhoriyamu, kushaya mvura uye hypernatremia.

4. Osmotic diuretics

Iyi mishonga inowedzera osmolarity yeiyo glomerular filtrate, iyo inokonzeresa kufamba kwemasiracularular mvura kuenda kune yekunze maseru uye nzvimbo yemasvomhu, inokonzeresa yakaratidzirwa diuresis, zvichideredza kudzikisira kwekumanikidza uye edema uye yakanyanya intraocular kumanikidza.

Generic / mazita ekutengesa: 20% Mannitol. Tsvaga kuti mannitol inoshandiswa sei.

Zviratidzo zvekurapa: 20% mannitol inoratidzirwa pakurapa kweuropi edema, acute glaucoma, kutadza kwakanyanya kwetsvo uye mukugadzirira opthalmic kuvhiyiwa.

Mhedzisiro inowanzoitika: Mimwe yemhedzisiro yakajairika inogona kuitika ndeyekusvotwa, kurutsa, nyota, kurwadziwa nemusoro, dzungu, kudedera, kupisa, kuwanda kwemoyo, kurwadziwa pachipfuva, hypernatremia, kupera mvura, kusaona zvakanaka, mikoko kana neBP.

5. Carbonic anhydrase inhibitor diuretics

Iyi mishonga inodzivisa carbonic anhydrase, inova enzyme inokonzeresa kuita kwemakemikari ayo anosanganisira hydrating carbon dioxide uye dehydrate carbonic acid. Nekuda kweizvozvo, pane kuderera kwecarbonic acid, iyo inotungamira kune alkalinization weti, inosimudzira diuresis.

Generic / mazita ekutengesa:acetazolamide (Diamox). Tsvaga maitiro ekushandisa uye izvo zvinopesana neDiamox zviri.

Zviratidzo zvekurapa: Carbonic anhydrase inhibitors inoratidzirwa pakurapa glaucoma, urinary alkalinization, metabolic alkalosis uye chirwere chemakomo chakakomba.

Mhedzisiro inowanzoitika: Mimwe mhedzisiro inokanganisa inogona kuitika ndeye metabolic acidosis, kuwedzera kwehuwandu hwezvakawandisa masero emvura, hyponatremia, musoro, kukotsira, kusvotwa, kurutsa uye kupera mvura mumuviri.