Diuretic - ndichiyani? Gawo ndi ntchito ya okodzetsa

Anthu ambiri atamva mawu monga "diuretic." Chimene icho chiri, tidzayesetsa kuthetsa pansipa. Gulu la mankhwala ali gulu ake, katundu ndi makhalidwe a

Diuretic - ndichiyani?

Okodzetsa amatchedwanso okodzetsa mankhwala. Iwo mankhwala kupanga kapena chiyambi Mmera wonse, umene angathe kuwonjezera excretion wa mkodzo ndi impsozo. Kupyolera mu izi, pamodzi ndi kumatheka mkodzo excretion a mchere ndi madzi, komanso amachepetsa mlingo madzi mu cavities ndipo zimakhala. Chifukwa cha ichi kuchepetsedwa kapena kutha edema. Okodzetsa - mankhwala ankagwiritsa ntchito mu mankhwala a matenda oopsa (kukwezeka magazi). Mankhwalawa amagwiritsidwa ntchito pofuna kuchiza wofatsa congestive mtima kulephera, mtundu ndi chiwerengero cha matenda chiwindi ndi matenda kugwirizana ndi mkhutu kufalitsidwa kuti tifulumizane stagnation mu thupi. Mankhwala amagwiritsidwa ntchito okodzetsa kuchepetsa kapena kuthetsa zizindikiro za flatulence, amene nthaŵi zina limodzi ndi PMS kapena kale akuwonetseredwa pa msambo. Kugwilizana kwambiri ndi chithandizo kamwedwe ndi mlingo okodzetsa musati kuyambitsa zotsatira aakulu mbali. Ali bwino ndithu ntchito.

Okodzetsa pa mimba

gynecologists ambiri si analangiza kuti azimwa okodzetsa mimba. Mankhwala akhoza kukhala otetezedwa kwa mwana wosabadwayo ndi thanzi la mayi. The zoipa anapeza osati kale. Poyamba, mankhwala diuretic ntchito kuchepetsa edema mimba, zinthu zimene preeclampsia neri Al.

Okodzetsa: Gawo

Pali mitundu yosiyanasiyana ya mankhwala diuretic. Aliyense gulu zovuta zake mphamvu ndi zofooka. Pakali pano, pali gulu la mankhwala:

• Loop mankhwala.
• potaziyamu-yosalekerera okodzetsa.
• mankhwala Thiazide.
• thiazide wothandizira.

Za magulu awa zafotokozedwa mokwanira pansipa.

kuzungulira okodzetsa

gulu la mankhwala ndi ambiri. Izi zikuphatikizapo mankhwala monga "asidi ethacrynic," "Torasemide" "Furosemide" "piretanide" "bumetanide". Ngakhale kuti kapangidwe mankhwala zingasiyane kwambiri, okodzetsa amenewa limagwirira womwewo wa ntchito. Kukonzekera Izi mankhwala ziletsa reabsorption zinthu monga sodium, mankhwala enaake ndi potaziyamu. Mutu "kuzungulira okodzetsa" chifukwa limagwirira zochita. Resorption akupezeka kukwera kuzungulira wa Henle gawo. Iwo ikuchitika ndi kutsekereza wa sodium, chlorine, potaziyamu mu Kakhungu apical wa tubular maselo zaminyewa. Zikomo kuti ntchito ili kuletsedwa dongosolo pachimake-counterflow mu impso. Komanso, okodzetsa angathe mtundu kukuza ziwiya kotekisi lapansi.

Zotsatira zoyipa za okodzetsa kuzungulira

Mphamvu zotsatira za mankhwala awa ndi yaikulu kwambiri: iwo angadwale mkodzo linanena bungwe ndi 25%. Mosiyana ndi mankhwala ena kuti kutaya kwenikweni ndi normalization wa Bcc, ndi okodzetsa kuzungulira-mtundu wotere anapitiriza bwinobwino. Ndi kuyamika wamphamvu kanthu diuretic iwo zimachititsa mavuto. Kwambiri kawirikawiri ndi kovuta - akuponya magazi, hypovolemia, yafupika mlingo glomerular kusefera ndi aimpso magazi. Chifukwa cha kuchotsedwa mwai wa hydrogen, chlorine na potassium sangathe lilibe kagayidwe kachakudya alkalosis. Nthawi zina kuzungulira okodzetsa amakwiya hyponatremia ndi hypokalemia. Nthawi zina - hyperglycemia, hyperuricemia. Zotsatira mbali inayo monga: chizungulire, nseru, kufooka. Medicine "asidi ethacrynic" Nthawi zambiri amakwiya chokhalitsa kapena zosakhalitsa kugontha, ndi neutropenia. Mankhwala mtundu onse amene tatchula, m'thupi ntchito impso, metabolizing mu chiwindi.

Mmene okodzetsa kuzungulira

Mankhwala awa analamula kuti mitundu yonse ya matenda a mtima. Ndipo iwo n'zofunika kwambiri makamaka matenda monga mtima kulephera refractory mtundu ndi edema m'mapapo mwanga. Mankhwala Zimathandizanso mu hyponatremia, hypoalbuminemia, hypokalemia, hypochloremia ndi kulephera aimpso. Okodzetsa kuzungulira mtundu kupitiriza kugwira ntchito pamene okodzetsa zina gulu ndi ma zake ndi osamveka. Ichi ndi phindu lalikulu. Choncho, mtundu umene wafala - ndi kuzungulira diuretic. Kodi izo, ife kale anachita nawo.

okodzetsa thiazide

Kukonzekera Izi mankhwala ndi ena ofanana awo ( "Indapamide" "chlorthalidone" ndi "Metolazone") amagwiritsidwa ntchito kawirikawiri ndithu. Kwenikweni, ndi chifukwa mlingo mkulu wa mayamwidwe kapepala kakuti m'mimba, komanso mlingo wabwino wa tolerability mtima. okodzetsa Thiazide sakhala wamphamvu kuposa kuzungulira, koma chifukwa cha nthawi yaitali kanthu amaoneka kuti anthu amene akudwala matenda aakulu monga wolumikizira matenda oopsa a zofunika mtundu ndipo sanali aakulu congestive kulephera mtima, mtundu. okodzetsa Thiazide ali analamula kuti makonzedwe m'kamwa. Diuresis zambiri akuyamba pambuyo maola 1-2, koma achire antihypertensive zotsatira zina, mwina anaona miyezi pokhapokha 3 mankhwala mosalekeza. The kholo la gulu ili chlorothiazide. Iwo amakhala ndi otsika zamadzimadzi solubility, ndipo chifukwa otsika bioavailability. Chifukwa cha ichi, kuti zotsatira achire amafuna mlingo mankhwala apamwamba. Mankhwala "chlorthalidone" pang'onopang'ono kwambiri odzipereka, choncho ndi mowonjezera kanthu nthawi. Amatanthauza "Metolazone" nthawi zambiri kumakhala kuti kwambiri odwala ndi ntchito mkhutu aimpso, monga kuyenera mankhwala ena mu gulu ili.

Potaziyamu-yosalekerera okodzetsa

Palinso potaziyamu asayambe okodzetsa. Ndi chiyani icho? Mankhwalawa amagwiritsidwa ntchito zochizira matenda oopsa osakaniza ndi zina mankhwala. Iwo kuteteza excretion kwambiri thupi potassium amene ali wamba mbali zotsatira za mankhwala diuretic magulu ena. Hypokalemia - kuchepa msinkhu wa potaziyamu mu madzi a. Ndi nthaŵi zonse okodzetsa thiazide, zimene zimachizidwa analamula kuti mankhwala oopsa. Pamene mlingo potaziyamu yafupika kwambiri, wodwalayo amayamba kuona ofooka, kutopa msanga, iye ali arrhythmia mtima. Pofuna kupewa izi, pamodzi ndi mankhwala thiazide nthawi zambiri zotchulidwa potaziyamu-yosalekerera okodzetsa. Iwo thupi pamodzi ndi potaziyamu ndi mchere zina zofunika - magnesium ndi calcium. Choncho iwo zayamba musazengereze kusiya a madzimadzi owonjezera ndi sodium wochuluka. Kupanda mankhwala potaziyamu-yosalekerera ili. Potaziyamu misinkhu mu plasma achuluke kwambiri (kuposa 5 mmol / l.). chikhalidwe Ichi chikudziwika ngati hyperkalemia. Zingayambitse minofu ziwalo ndi arrhythmias mtima, mpaka mabasi. Chitukuko cha matenda ambiri n'zotheka odwala insufficiency aimpso.

The ntchito zochizira matenda oopsa

Okodzetsa kwa oopsa ndi kutsimikiziridwa. Amathandiza kuti kuchotsa madzimadzi m'thupi, potero kuchepetsa magazi. Kutsimikiziridwa mfundo ndi kuti mankhwala diuretic ndi aluso zochizira odwala achikulire poyerekeza ndi beta-blockers. Okodzetsa mankhwala m'gulu mndandanda wa woyamba mzere mankhwala, amene ntchito matenda a kuthamanga magazi. Malinga ndi malangizo a United States madokotala, gulu ayenera kugwiritsidwa ntchito mankhwala koyamba oopsa (wopepuka). Chifukwa cha kufunika kwa ulamuliro magazi kuthamanga ndi kuchepetsa chiopsezo mtima mu mankhwala, chisamaliro chapadera analipira zotsatira kagayidwe kachakudya, amene ali achilendo mankhwala antihypertensive. Chinanso chofunika ndi yaikulu njira ya matenda awo ndi makhalidwe limba-kugwirizana.

Thiazide ndi thiazide mankhwala kwa oopsa

Poyamba, matenda oopsa kawirikawiri ankapatsidwa okodzetsa kuzungulira. Koma tsopano iwo ayamba ntchito zochizira impso, matenda a mtima ndi edema. Zotsatira zake zinasonyeza efficacy mankhwala thiazide-mtundu wabwino. Iwo bwino kuti madokotala ananena zawo za matenda oopsa. Komabe, kuchepetsa chiopsezo cha zochitika inatsekeratu ntchito ndalama awa sanali kutchulidwa poyerekeza zotsatira kuyembekezera. Kugwiritsa ntchito mankhwala thiazide kumachititsa wa arrhythmias. Odwala ena mungathe ngakhale mwadzidzidzi arrhythmic imfa. Nthawi zimachitika matenda a zimam'patsa ndi zamadzimadzi kagayidwe, komanso hyperuricemia. Izo zikhoza aziwonjezereka kwa atherosclerosis ndi shuga. Medpreparty gulu kawirikawiri pamodzi ndi diuretic potaziyamu-yosalekerera.

Mlingo wotsatira wa zamoyo wa okodzetsa kuchiza matenda oopsa thiazide zida zitsulo. Makamaka, bwino kutsimikiziridwa apanga mu 1974 kholo lawo - mankhwala "Indapamide". Ubwino ndi kuti tiazidopodobnye zikutanthauza zotsatira kuli pa reabsorption sodium, kutanthauza kuti kuli linanena bungwe la potaziyamu thupi. Choncho, chokhwima kagayidwe kachakudya ndi diabetogenic zotsatira ali pafupifupi kwina. Tsopano kutsimikiziridwa kuti ntchito Mlingo ka mankhwala "Indapamide" kupatula kanthu diuretic amatha kuchita ntchito ya kashiamu antagonist wa ntchito vasodilator ndi kupangidwa kwa prostaglandin E2.

Zinthu zamakono za mankhwala thiazide ndi thiazide ankagwiritsa ntchito osati kuchepetsa magazi, komanso ngati muyeso njira, komanso zochizira zotupa yotsiriza limba. Mankhwalawa nthawi zambiri kwambiri zotchulidwa mu maphunziro kuphatikiza mankhwala. Iwo bwino kutsimikiziridwa choncho chimagwiritsidwa ntchito padziko lonse.