"Torasemide": malangizo ntchito. "Sandoz Torasemide": mtengo, malo, ndemanga

"Torasemide" - masiku wamphamvu diuretic mankhwala amene ali wangwiro kwa mankhwala yaitali matenda kugwirizana ndi maonekedwe a edema. Chifukwa chiwerengero ang'onoang'ono a zotsatira kukomoka zofunika mbali, m'lifupi mwa ntchito zake achire kwambiri. Ndi otetezeka kuti okodzetsa ena kuzungulira ndi Umboni kwambiri. Mankhwalawa matenda osiyanasiyana mlingo akasintha. Ndiponso, ntchito ngati insufficiency wa ntchito impso ngakhale pa otsika kusefera mathamangidwe glomeruli nephrons.

Zotsatirapo "torasemide"

"Torasemide" monga nthumwi kuzungulira (mchere) gulu okodzetsa akuchita mu luminal mbali ya epithelium wa tubules wa nephron mu akwera gawo la kuzungulira wa Henle. Wakulimbira zimakhudzanso ochepetsera pa zoyendera anzake a ayoni potaziyamu ndi sodium kolorayidi, izo kwambiri amachepetsa angathe electrochemical pa epithelium padziko nephron lapansi. Anatseka misewu chifukwa ndi chisokonezo cha ion zoyendera ndi sodium reabsorption ku mkodzo chachikulu, amene kumawonjezera diuresis.

Pafupifupi okodzetsa onse kuzungulira chifukwa chisokonezo electrolyte chifukwa wamphamvu chikoka reabsorption wa ayoni potaziyamu, sodium, magnesium ndi chlorine. "Torasemide" Pamlingo wamng'ono bwanji kusankha potaziyamu ndi magnesium, chifukwa chimene m'munsi zochitika za arrhythmias, anorexia, kudzimbidwa, kufooka minofu. Komanso, mankhwala ndi pang'ono mmene midadada mapangidwe thromboxane A2, anakafika ziwiya. Iye midadada aldosterone zolandilira infarction, inhibiting njira ya fibrosis a minofu mtima.

umboni

Mayina mankhwala "Torasemide" malangizo Buku kakunena za matenda, imene anagwiritsa ntchito kuchipatalako. "Torasemide" akusonyeza kuti:

• pathogenetic chithandizo cha wolumikizira oopsa kugonjetsedwa mankhwala ndi osakaniza zoletsa Ace (ARBs) thiazide okodzetsa;
• mankhwalawa kulephera aakulu mtima, yokhudza magazi mabwalo zimamuchulukira;
• symptomatic mankhwala kulephera aakulu aimpso, kuphatikizapo imathandiza pa liwiro otsika (zosakwana 20 ml ya \ Mph);
• symptomatic mankhwala a chiwindi (ndi hypoalbuminemia kugwirizana) edema monga njira ina m'malo "Furosemide".

Pamene matenda oopsa "Torasemide" analogues ndi generics ntchito pokhapokha kulephera kwa okodzetsa thiazide. mankhwala A angathe kuperekedwa yaitali chifukwa cha ochepa zotsatira kukomoka zofunika ndi oopsa mbali mu kulephera aimpso. Anthu "torasemide" ndi zochepa kwambiri kuposa "Furosemide".

Malangizo ntchito

Zochokera malangizo kuchipatala mankhwala "Torasemide" malangizo Buku limapangidwa ndi makhalidwe a Mlingo mankhwala chofunika chithandizo ndi chilangizo cha matenda chandamale. M'menemo mankhwala yokha akupezeka miyala yomwe zosakaniza zotsatirazi: 2.5 mg, 5 mg, 10 mg, 20 mg, 50 mg, 100 mg, 200 mg.

Kutenga mankhwala pa cholembapo m'mawa, kaya chakudya. Pakuti Mlingo awa mankhwala "Torasemide" mtengo osiyana: ndi m'munsi pa mlingo osachepera ndi apamwamba pa pazipita lapansi. Malinga ndi kafukufuku wa pakuchitika, mapiritsi 30 a mankhwala pa 5 mg pafupifupi 400 rubles. Pamene kulandira mankhwalawa amafalitsidwa motere malinga ndi zizindikiro za:

• mankhwalawa matenda oopsa anatengedwa 2.5 - 10 mg / tsiku;
• analandira 10-20 mg / tsiku kulephera aakulu mtima;
• aakulu aimpso kulephera - 50 mg kapena zambiri;
• chiwindi kulephera masinthidwe mlingo payekha.

Zotsatira zoyipa "torasemide"

Mayina mankhwala "Torasemide" malangizo Buku kakunena za zotsatira angapo mbali. Pa mlingo achire, mwachitsanzo, mpaka 200 mg pa tsiku kumaonjezera ngozi ya mavuto thromboembolic, mtima ischemia, ubongo. Iwo kumaonjezera ngozi ya chosakhalitsa kuukira ischemic ndi m'mnyewa wamtima infarction, embolism m'mapapo mwanga, arrhythmias. Palinso Mwina zosayembekezereka wa totupa thupi lawo siligwirizana kapena ming'oma pamene wodwalayo kumakhala kutengera.

"Torasemide" amayambitsa nseru kapena kusanza, kawirikawiri ayimire dyspepsia, kutsekula m'mimba. Anafotokoza milandu akutali a kapamba pa mankhwala ndi "torasemide". Komanso kuchuluka transaminases kwa chiwindi, kusonyeza chiwindi kawopsedwe wa mankhwala mlingo waukulu. Nthawi zina odwala nkhawa akamaganizira za, kusawona bwino.

Mukalandira mlingo poizoni kukhala boma cha mankhwala osokoneza bongo ndi zizindikiro pang'ono. Ambiri osokoneza limodzi ndi kufa madzimadzi mkodzo: diuresis yaitali pafupipafupi, angathe hypotension, mtima kugwa, kukomoka, sitiroko, ischemia oziziritsa chakumbuyo.

Contraindications ndi zofooka za ntchito

Mankhwala "Torasemide" analogues ndi mankhwala angaperekedwe sangathe ntchito pamaso pa contraindications mtheradi. Awa ndi matupi awo sagwirizana anachita mankhwala kapena binders. "Torasemide" choletsedwa ntchito kulephera aimpso ndi anuria, chiwindi kulephera pamene mu mkhalidwe chikomokere kwa chiwindi, ndi tachyarrhythmias. Contraindicated wambiri pa mkaka wa m'mawere ndi mimba, komanso pansi zaka 18, hypersensitivity kuti sulfonamides.

Mbali ndi zotsatira ophatikizana "torasemide"

Mankhwalawa matenda oopsa mankhwala "Torasemide 'angathe zoyipa pa njira ya gout. Popeza tubules proximal wa nephron yogwira mankhwala ingested ndi zoyendera yogwira, pali mpikisano chopinga wa excretion asidi uric. Against maziko a ntchito "torasemide" mkulu Mwina wa hyperuricemia ndi pachimake gout.

Medicament "Torasemide" amakhala ndi kanthu chapadera pa gawo proximal wa tubular epithelium kuzungulira wa Henle. Chifukwa amphamvu diuretic zotsatira ndipo electrolyte vutoli zimenezi zimachititsa mosavuta ankachita kukomoka zofunika pharmacological. Ndi oopsa, osafunika ndi zofunika. Pakati zoopsa ndi ofunika awa:

• mkulu mlingo (50 mg / tsiku) "torasemide" pamene ntchito molumikizana ndi kukonzekera pulatinamu timapitiriza kawopsedwe wa otsiriza;
• Mlingo lalikulu "torasemide" (50 mg / tsiku) kuonjezera zotsatira nephrotoxic ndi ototoxic antibayotiki aminoglycoside;
• mu mankhwala cephalosporin, pamene ntchito limodzi ndi "torasemide" mu mlingo wa 50 mg / tsiku limapezeka katundu nephrotoxicity;
• salicylates pamodzi ndi "torasemide" (50 mg / tsiku) yodziwika neurotoxicity.
• "Torasemide" ndi maziko a hypokalemia wachibale kumawonjezera chiwopsezo cha myocardium kuti glycosides mtima, kuwonjezeka inotropic awo ndi zotsatira antiarrhythmic, kuwonjezera chiopsezo cha kawopsedwe;
• chiopsezo hypokalemia ndi chinawonjezeka ndi concomitant ntchito "torasemide" ndi corticosteroids kapena saline Mankhwalawa;
• "Torasemide" timapitiriza zotsatira za "theophylline" curariform ndi minofu relaxants.

Anakhumba zotsatira za ntchito kuphatikiza

Zotsatira ankafuna kuti amafuna polojekiti, ndi kuchepa magazi pa mankhwala ndi Ace zoletsa. "Torasemide" chifukwa kuchotsa madzimadzi kumachepetsa kuthamanga hydrostatic wa magazi kuti ayimire dontho magazi. Mbali imeneyi ndi yofunika kwambiri mankhwala a matenda oopsa ndipo amafuna kuwukonza mlingo wa Ace zoletsa. Komanso mankhwalawa mankhwala zosagwira oopsa ndi osakaniza ndi Ace woletsa "torasemide" amatilola kukwaniritsa normalization wa magazi 90% odwala.

Mankhwalawa kulephera aakulu mtima ndi kukomoka zofunika zotsatira za kuchepetsa vasoconstrictor ntchito makatekolamaini. Mtima pa maziko diuretic mankhwala "torasemide" chosalimba momuuza kuti stimulatory chizindikiro zikuwonjezereka masiku ano ndi noradrenaline. Komabe, zotsatira yomweyo kuchepetsa mphamvu ya Epinephrine ndi norepinephrine pa kuwatsitsimula.

mavuto obwera chifukwa cha mogwirizana ndi

Pali zotsatira efficacy chopinga pamene pamodzi ndi zinthu zina. Makamaka:

• Kukonzekera kwa sequestrants ya ndulu asidi achepetse adani "torasemide" wa matumbo, kufooketsa mphamvu ya wotsiriza,
• analgesics chomwa mankhwalawa (NSAIDS) kuchepetsa mphamvu ya "torasemide";
• "Probenecid" chifukwa njira amveke urikozuricheskih kumabwezera mmbuyo kusankha "torasemide" mu lumen wa tubules ndi kuchepetsa nchito zake.

makhalidwe poyerekeza "torasemide"

Pokonzekera "Torasemide" analogs kungakhale kalasi, kayendedwe ndi generics. Pakati kalasi ankaimira analogues: "Furosemide", "bumetanide," "asidi ethacrynic". Poyerekezera ndi "Furosemide" "Torasemide" amakhala ndi isanayambike wozengereza kanthu ndi zotsatira zina yaitali chilamulira chikhalidwe ndi kuchuluka diuresis. Kupereka zotsatira diuretic ndi pafupifupi mphamvu mofanana "Furosemide" "Torasemide" mavuto ochepa zimapezeka ndi mofulumira electrolyte vutoli.

"Bumetanide" amakhala ndi amphamvu diuretic katundu aliyense amene amagwirizana ndi zotsatira ambiri mbali. asidi Ethacrynic ali m'munsi isanayambike mlingo diuretic zotsatira ndipo sikawirikawiri ntchito mankhwala osokoneza bongo. The pharmacokinetics wa mankhwala "Torasemide" amakambirana akatswiri kuzindikira mfundo inanso yofunika kwambiri. Mankhwala ali zimatha "linagawidwa": diuresis pambuyo amveke ndi Kupeleka ndi sodium palibe compensatory posungira ake.

Pharmacokinetic analogues "torasemide"

The "Torasemide" mankhwala kalozera likunena zambiri pa tanthauzo lake odwala ndi wolumikizira oopsa. Pamodzi ndi mankhwala, zochizira matenda oopsa ndipo amagwiritsidwa ntchito okodzetsa thiazide, potaziyamu-yosalekerera. Ndipo thiazide chifukwa pang'onopang'ono kubwera ndi yaitali diuretic zotsatira ndi mankhwala wosankha.

Mogwirizana ndi awa pharmacokinetic zimaonetsa analogues ntchito yokonza "Torasemide" ntchito kungakhale zotsatirazi: zochizira matenda oopsa, kugonjetsedwa ndi mankhwala muyezo ndi ma Ace woletsa (kapena angiotensin cholandilira blocker) ndi thiazide a. Komanso, "Torasemide" ntchito aakulu aimpso kulephera chithandizo ndi mphamvu wotsikirapo kusefera.

Generics "torasemide"

Pokonzekera "Torasemide" Buku malangizo, analogues, zizindikiro ndi contraindications kwathunthu zimaonetsa mphamvu zake zazikulu - kuchuluka diuresis. Komanso zimenezi ali ndi mankhwala oyambirira ndi generic. Yotsirizira muli nambalayi a "torasemide", koma kutulutsa pansi mayina ena mtundu.

Wotchuka kwambiri: "Britomar", "Diuver", "Sandoz Torasemide", "Trifas", "Torcida", "Trigrim". Pa kuyezetsa kwambiri wothandizila pharmacological kusiyana kwambiri anali anaona pakati pawo ku Russia. Aliyense wa formulations pamwamba m'malo bwinobwino ena a iwo.

mbali Economic mankhwala "torasemide"

Mankhwalawa matenda oopsa pamene okodzetsa thiazide sizithandiza osakaniza ndi zoletsa Ace (kapena ARBs), angathe kuperekedwa mankhwala "Torasemide": malangizo ntchito akunenetsa mlingo umodzi masana. The mtengo mwezi wa mankhwala 400 rubles pa mtengo wa mapiritsi 60 mankhwala za 760-800 rubles. Yerekezerani mtengo mwezi wa mankhwala "Furosemide" kawirikawiri upambana 20 rubles. Koma chomalizachi mankhwala mosalekeza za matenda oopsa ndi phindu lochepa.

Mu kulephera aakulu mtima ndi edema wa onse mtengo makope mabwalo a mwezi chithandizo "Furosemide" ndi za 20-30 rubles. Pokonzekera "Torasemide" mtengo nthawi 10-15 wamkulu. Yotsirizira kumakhudza modekha kuti ali wauzimu kumawonjezera excretion wa mkodzo mu maola woyamba wa phwando. The "Furosemide" makhalidwe a n'zosiyana ndi: izo kumawonjezera kwambiri kuchuluka kwa mkodzo mu maola awiri oyambirira ndi kufooka mwapang'onopang'ono linanena bungwe mkodzo.

Chifukwa, odwala employable ndi matenda oopsa kapena aakulu aimpso insufficiency kapena magazi bwino ntchito "Torasemide" malangizo (Mtengo wake tanena) pa ntchito imene muli mfundo za kuwongola kwambiri a diuresis mu nthawi yoyamba ya phwando. Komabe, pantchito zaka odwala, pakalibe kufunika kubwera kwa ntchito, mkodzo linanena bungwe liwiro pafupifupi ogwirizana. Zilibe kulenga mavuto, choncho amalola kulandira wotchipa kalasi analogue - "Furosemide".