Dzina lachi Latin: Hydrochlorothiazide

Code ya ATX: C03AA03

Zothandizira: Hydrochlorothiazide (Hydrochlorothiazide)

Analogs: Hypothiazide, Hydrochlorothiazide-SAR Hydrochlorothiazide-Verte, Dichlothiazide

Wopanga: Valenta Pharmaceuticals OJSC (Russia), Borshchagovsky HFZ (Ukraine), LEKFARM LLC, (Republic of Belarus)

Kufotokozera kwaposachedwa pa: 03/10/17

Mtengo muma pharmacist opezeka pa intaneti:

Hydrochlorothiazide ndi diuretic yomwe imagwiritsidwa ntchito matenda a impso, mapapu, chiwindi ndi mtima kuti muchepetse edema.

Zizindikiro zogwiritsidwa ntchito

• matenda oopsa oopsa (kuthamanga kwa magazi),
• matenda a shuga insipidus (kuphwanya kwamchere wamchere mthupi, zomwe zimachitika chifukwa chakuchepa kwa katulutsidwe ka maselo a antidiuretic),
• kulephera kwamtima,
• yade ndi nephrosis,
• matenda a chiwindi
• mwala prophylaxis,
• mavuto apakati: kuwonongeka kwa impso, edema, eclampsia (kuthamanga kwambiri kwa magazi),
• edematous syndrome yamavuto osiyanasiyana,
• mitundu yambiri ya glaucoma.

Contraindication

• Hypersensitivity zigawo zikuluzikulu,
• kuperewera kwa lactose, galactosemia ndi mayamwidwe wa galactose ndi shuga,
• aimpso ndi chiwindi ntchito,
• matenda ashuga kwambiri, gout, anuria (kusowa kwa mkodzo mu chikhodzodzo),
• hypercalcemia (calcium yayikulu calcium),
• zokhudza zonse lupus erythematosus, kapamba.

Zotsatira zoyipa

Kugwiritsa ntchito hydrochlorothiazide kumatha kuyambitsa zotsatirazi:

• kusanza, nseru, matenda a kukamwa, mkamwa youma, dyspepsia (matenda am'mimba),
• chiwindi ntchito, jaundice, cholecystitis (kutupa kwa ndulu), kapamba (kutupa kwa kapamba),
• zopweteka, chisokonezo, ulesi, kuchepa kwa chidwi, kusakwiya, kutopa,
• kugunda kofooka, kusinthasintha kwa mtima, thrombocytopenia, agranulocytosis,
• urticaria, kuyabwa pakhungu, chidwi cha kuwala (kuchuluka kwa chidwi)
• yafupika libido, potency wosakhwima, kupweteka kwapakhosi, hypokalemia (magawo ochepa a potaziyamu m'magazi).

Bongo

Ngati bongo wa hydrochlorothiazide, mawonetserowa angachitike:

• nseru, kufooka,
• chizungulire
• kusokonezeka kwakukulu muyezo wamagetsi wamagetsi,
• kuchuluka kwa gout.

Palibe mankhwala enieni. Zizindikiro chithandizo ndi kuwongolera kwa ma elekitirodi ammadzi mthupi amadziwika.

Pankhani ya hypokalemia, kugwiritsa ntchito potaziyamu mankhwala enaake kapena prarkam ndikulimbikitsidwa. Nthawi zina zimakhala zotheka kupanga mapangidwe a hyperchloremic alkalosis (kusintha kwa kagayidwe ka electrolyte). Kenako wodwalayo adayambitsa kuyambitsa 0.9% saline (sodium chloride). Pankhani ya mawonekedwe ofatsa a gout, allopurinol imagwiritsidwa ntchito.

Mukamamwa Mlingo waukulu, wodwala, mosakayikira, ayenera kukhala kuchipatala moyang'aniridwa ndi akatswiri.

Hypothiazide, Hydrochlorothiazide-ATS Hydrochlorothiazide-Verte, Dichlothiazide.

Zotsatira za pharmacological

Mphamvu ya diuretic ya hydrochlorothiazide yagona pakukhazikitsa potaziyamu, bicarbonate ndi magnesium ion pamodzi ndi mkodzo.

• Amapereka kuchepetsedwa kwa reabsorption (chosinthira mayamwidwe) amadzimadzi, chlorine ndi sodium ions mu distal tubules. Imagwira pa thumles za distal, kuchepetsa kuphipha kwa calcium ion ndikuletsa kupangidwe kwa miyala ya calcium mu impso.
• Kuchulukitsa mphamvu ya impso, kumalepheretsa kukhazikika kwa makoma amitsempha yamagazi kuchitapo kanthu kwa oyimira pakati, omwe akuphatikizidwa pakupatsira mitsempha. Mapiritsi amagwiritsidwanso ntchito pochiza anthu omwe amalandila chithandizo ndi mahomoni othandizira (estrogens, corticosteroids).
• Amadziwika ndi hypotensive zotsatira, komanso amachepetsa mapangidwe a mkodzo kwambiri mwa anthu omwe ali ndi matenda a shuga. Kuphatikiza apo, mankhwalawa nthawi zina amatha kuchepetsa kukakamira kwina.
• Pambuyo pakukonzekera pakamwa, imayamwa bwino m'matumbo ndikuwonetsa impso pafupifupi osasinthika.
• Kuchita bwino kumawonedwa maola 4 pambuyo pa kuperekedwa ndipo kumachitika maola 12 otsatira. Imatha kudutsa mwa placenta ndikuyamwa mkaka wa m'mawere.

Malangizo apadera

• Mochenjera kwambiri, amathandizira odwala okalamba, odwala atherosulinosis a ziwiya zamkati ndi ubongo, komanso matenda a shuga.
• Mankhwalawa, ndikofunikira kupewa kuthana ndi dzuwa nthawi yayitali, chifukwa mankhwalawa amachititsa kuti khungu lizizindikira kuwala.
• Mankhwala amatha kutumikiridwa pokhapokha pofufuza mosamala za kuchuluka kwa chiwopsezo cha odwala omwe ali ndi vuto la mafuta m'thupi, kuchuluka kwa ma triglycerides ndi cholesterol m'madzi a m'magazi, komanso ndi ochepa a sodium m'thupi.

Kuyanjana kwa mankhwala osokoneza bongo

• Ndi munthawi yomweyo kugwiritsa ntchito mankhwala osapweteka a minofu, ma antihypertensive othandizira, mphamvu zawo zimakulitsidwa.
• Mukaphatikizidwa ndi corticosteroids, pamakhala chiopsezo cha hypokalemia ndi orthostatic hypotension.
• Ndi munthawi yomweyo kugwiritsa ntchito Mowa, diazepam, barbiturates, chiopsezo chokhala ndi orthostatic hypotension chikuwonjezeka.
• Ndi makina ovuta a ACE inhibitors, mphamvu ya antihypertensive imatheka.
• Ndi munthawi yomweyo makonzedwe amkamwa hypoglycemic, kutha kwawo kumachepa.

Hydrochlorothiazide

Dzina lachi Latin: Hydrochlorothiazide

Code ya ATX: C03AA03

Zogwira pophika: hydrochlorothiazide (Hydrochlorothiazide)

Wopanga: Atoll LLC (Russia), Pharmstandard-Leksredstva OJSC (Russia), Pranafarm LLC (Russia)

Sinthani mafotokozedwe ndi chithunzi: 07/10/2019

Mitengo muma pharmacies: kuchokera ku ma ruble 42.

Hydrochlorothiazide ndi okodzetsa.

Kutulutsa mawonekedwe ndi kapangidwe kake

Fomu ya Mlingo - mapiritsi: ozungulira, osazungulira, okhala ndi mphako mbali imodzi ndi chamfele mbali zonse ziwiri, pafupifupi oyera kapena oyera (10 ndi 20 zidutswa zamatumba, 10, 20, 30, 40, 50, 60 ndi Ma PC ma 100 azitini, pamakatoni olembetsera 1, 2, 3, 4, 5, 6, 10 mapaketi kapena 1 akhoza ndi malangizo ogwiritsira ntchito hydrochlorothiazide).

Piritsi 1:

• yogwira mankhwala: hydrochlorothiazide - 25 kapena 100 mg,
• othandizira: chimanga wowuma, microcrystalline cellulose, lactose monohydrate (mkaka wa shuga), magnesium stearate, povidone-K25.

Mankhwala

Hydrochlorothiazide ndi sing'anga mphamvu thiazide diuretic.

Mankhwalawa amachepetsa kubwezeretsanso kwa sodium m'chigawo chakumaso kwa Henle, pomwe sikukhudza gawo lomwe limadutsa muubongo wa impso. Izi zikufotokozera mphamvu yofooka ya okosijeni wa hydrochlorothiazide kuposa furosemide.

Hydrochlorothiazide imalepheretsa carbonic anhydrase mu ma proximal opukutira tubules, imakulitsa kuchuluka kwa impso zama hydrocarbons, phosphates, ndi potaziyamu (mu distal tubules, sodium imasinthidwa potaziyamu). Iachedwetsa calcium calcium mu thupi ndi excretion wa urate. Kuchulukitsa kuchulukitsidwa kwa magnesium. Pafupifupi palibe mphamvu pa asidi-base boma (sodium amachotsedwa pamodzi ndi klorine kapena ndi bicarbonate, motero, ndi acidosis, chimbudzi cha chlorides chimakulitsidwa, ndi alkalosis - bicarbonates.

Mphamvu ya diuretic ya hydrochlorothiazide imayamba mkati mwa maola 1-2 mutatha kumwa mankhwalawa, imafikira patatha maola 4 ndipo imatha kwa maola 6 mpaka 12. Zotsatira zimachepa ndi kuchepa kwa kusefukira kwa glomerular, ndi mtengo wake 2 thupi lonse 1 nthawi patsiku. Mlingo wa tsiku lililonse wa ana wazaka 3-12 ungakhale wa 37,5 mpaka 100 mg. Pambuyo masiku 3-5 chithandizo, tikulimbikitsidwa kuti mupumule masiku omwewo. Ndi kukonza mankhwala, mankhwalawa amatengedwa pa mlingo 2 kawiri pa sabata. Odwala omwe amalandila chithandizo chamankhwala a Hydrochlorothiazide kamodzi pakapita masiku atatu kapena limodzi ndi makonzedwe a 2-3 masiku otsatiridwa ndi kupuma, zovuta zoyipa zimachitika kawirikawiri ndipo chithandizo chokwanira sichimatchulidwa.

Zotsatira zoyipa

Zotsatira zoyipa zomwe zalongosoledwa pansipa zimasankhidwa malinga ndi kuchuluka kwa chitukuko motere: nthawi zambiri - zochulukirapo 1/10, nthawi zambiri kuposa 1/100, koma zosakwana 1/10, zosakwanira - zoposa 1/1000, koma zosakwana 1/100, kawirikawiri - zoposa 1/1 10 000, koma ochepera 1/1000, kawirikawiri kwambiri - ochepera 1/10 000, kuphatikiza mauthenga amodzi:

• Kusokonezeka kwa mphamvu yamagetsi am'madzi: nthawi zambiri - hypercalcemia, hypomagnesemia, hypokalemia, hyponatremia (yowonetsedwa ndi minyewa kukokana, kutopa, kuchepa kwa malingaliro, kusokonekera, kusakwiya, kusokonekera, kuperewera, khunyu), hypochloremic alkalosis (yowonetsedwa ndi mucous membrane wam'mero. , kusanza, kusanza, kusinthasintha kwa mitsempha ndi psyche, arrhasmia, kukokana ndi kupweteka kwa minofu, kufooka kapena kutopa mwadzidzidzi), komwe kumayambitsa hepatic e tsefalopatiyu kapena kwa chiwindi chikomokere,
• matenda a metabolic: pafupipafupi - glucosuria, hyperglycemia, hyperuricemia ndi kukula kwa matenda a gout, kukula kwa kulolerana kwa shuga, chiwonetsero cha matenda osokoneza bongo a latent, pogwiritsa ntchito hydrochlorothiazide mu Mlingo wambiri - kuchuluka kwa lipids mu seramu yamagazi,
• kwa mtima dongosolo: kawirikawiri - orthostatic hypotension, bradycardia, vasculitis,
• Kuchokera kwamankhwala am'mimba: kawirikawiri - kufooka kwa minofu,
• Kuchokera ku ziwalo za hemopoietic: kawirikawiri - hemolytic / aplastic anemia, agranulocytosis, leukopenia, thrombocytopenia,
• Kuchokera kumimba: kawirikawiri - sialadenitis, kutsegula m'mimba, kudzimbidwa, nseru, kusanza, anorexia, cholestatic jaundice, kapamba, cholecystitis,
• Kuchokera kwamankhwala amanjenje ndi ziwalo zam'maganizo: kawirikawiri - mawonekedwe osasunthika, kuwukira kwapadera kwa kutsekeka kwa glaucoma, pachimake myopia, chizungulire, kupweteka kwa mutu, kukomoka, paresthesia,
• Hypersensitivity zimachitika: kawirikawiri - photosensitivity, purpura, zotupa pakhungu, kuyabwa, urticaria, necrotizing vasculitis, Stevens-Johnson syndrome, anaphylactic zimachitika kukhumudwitsa, kupuma mavuto syndrome (kuphatikizapo pneumonitis ndi sanali Cardiogenic pulmonary edema),
• ena: kukhathamiritsa kwa systemic lupus erythematosus, interstitial nephritis, kuphwanya kwaimpso ntchito, kuchepa kwa potency.

Mtengo mumafakisi

Mtengo wa hydrochlorothiazide phukusi limodzi ndikuchokera ku ma ruble 50.

Malongosoledwe patsamba lino ndi mtundu wosavuta wa mtundu wazovomerezeka zamankhwala. Chidziwitsochi chimaperekedwa kuti chizidziwitso chokha komanso sikuti chitsogozo chodzidzipangira nokha. Musanagwiritse ntchito mankhwalawa, muyenera kufunsa katswiri kuti mudziwe malangizo omwe amavomerezedwa ndi wopanga.

Mlingo ndi makonzedwe

Kuchepetsa kuthamanga kwa magazi: pakamwa, 25-50 mg / tsiku, pomwe diuresis pang'ono ndi natriuresis zimawonetsedwa pokhapokha tsiku loyambirira la mankhwala (zotchulidwa kwa nthawi yayitali limodzi ndi mankhwala ena a antihypertensive: vasodilators, angiotensin-converting enzyme inhibitors, sympatholytics, beta-blockers). Ndi kuwonjezeka kwa mlingo kuchokera 25 mpaka 100 mg, kuchuluka ochulukirapo kwa diuresis, natriuresis ndi kuchepa kwa magazi kumawonedwa. Mu gawo limodzi lopitilira 100 mg, kuwonjezeka kwa diuresis ndi kuchepa kwakukulu kwa kuthamanga kwa magazi ndizosafunikira, kutayika kwakukulu kwa ma electrolyte, makamaka potaziyamu ndi magnesium ion. Kuchulukitsa kwa mlingo wa 200 mg ndizosatheka, chifukwa kuchuluka diuresis sikuchitika.

Ndi edematous syndrome (kutengera momwe wodwalayo alili ndi momwe wodwalayo alili) adafotokozedwa tsiku lililonse 25 mg wa 25 mg, amatengedwa kamodzi (m'mawa) kapena mu 2 Mlingo (m'mawa) kapena nthawi imodzi m'masiku awiri.

Anthu okalamba - 12,5 mg 1 - 2 kawiri pa tsiku.

Kwa ana zaka 3 mpaka 14 - 1 mg / kg / tsiku.

Pambuyo masiku 3 mpaka 5 a chithandizo, ndikulimbikitsidwa kuti mupumule kwa masiku atatu mpaka asanu. Monga kukonza mankhwala muyezo mankhwala zotchulidwa 2 pa sabata. Mukamagwiritsa ntchito njira yokhazikika yothandizirana ndi makonzedwe pambuyo pa masiku 1 mpaka 3 kapena masiku 2 mpaka 3, kutsatiridwa ndi kupuma, kuchepa kwake kwa mphamvu kumacheperachepera ndipo mavuto amayamba kuchepa pafupipafupi.

Kuchepetsa kupanikizika kwapakati 25 mg ndi zotchulidwa kamodzi masiku 1 mpaka 6, zotsatira zake zimachitika pambuyo pa maola 24 - 48.

Ndi matenda a shuga - 25 mg 1 - 2 kawiri pa tsiku ndi kuwonjezeka kwapang'onopang'ono kwa mlingo (tsiku ndi tsiku - 100 mg) mpaka chithandiziro chokwanira (kuchepa kwa ludzu ndi polyuria), kuchepetsa kwina kwa mankhwalawa ndikotheka.

Zolemba zogwiritsira ntchito

Ndi chithandizo chotenga nthawi yayitali, ndikofunikira kuwunika mosamala mawonetseredwe am'mimba omwe ali ndi vuto lamagetsi lamagetsi, makamaka odwala omwe ali pachiwopsezo chachikulu: odwala omwe ali ndi matenda a mtima ndi chiwindi ntchito.

Hypokalemia imatha kupewedwa pogwiritsa ntchito mankhwala okhala ndi potaziyamu kapena zakudya zopezeka mu K + (potaziyamu) (zipatso, masamba), makamaka ngati atayika kwambiri K + (diuresis yayikulu, chithandizo cha nthawi yayitali) kapena kuchitira munthawi yomweyo ndi mtima glycosides kapena glucocorticosteroids.

Imawonjezera kuchulukitsidwa kwa magnesium mu mkodzo, komwe kungayambitse hypomagnesemia.

Kulephera kwa aimpso (CRF), kuwunika kwa nthawi yayitali kwa creatinine chilolezo. Kulephera kwa aimpso, mankhwalawa amatha kudziunjikira ndikupangitsa kukula kwa azotemia. Ndi chitukuko cha oliguria, kuthekera kwa kusiya mankhwala kuyenera kuganiziridwanso.

Panthawi yofatsa komanso yodwala matenda a chiwindi omwe amapita patsogolo, mankhwalawa amadziwitsidwa mosamala, popeza kusintha pang'ono m'madzi ndi ma electrolyte komanso kuchuluka kwa ammonia mu seramu kungayambitse kukomoka kwa hepatic.

Pankhani ya matenda oopsa a m'matumbo ndi coronary sclerosis, kugwiritsa ntchito mankhwalawa kumafunikira chisamaliro chapadera.

Zitha kusokoneza kulolera kwa shuga. Pa nthawi yayitali ya chithandizo cha matenda osokoneza bongo a chiwonetsero cha matenda osokoneza bongo, kuwunika kwa kagayidwe kake ndikofunikira; kusintha kwa mankhwala a hypoglycemic kungafunike. Pa mankhwala, kuunika kwa uric acid ndende ndikofunikira.

Ndi chithandizo cha nthawi yayitali, nthawi zina, kusintha kwamatenda a parathyroid kumawonedwa, limodzi ndi hypercalcemia ndi hypophosphatemia. Zingakhudze zotsatira za mayeso a labotale a parathyroid ntchito, chifukwa chake, musanayambe kugwira ntchito kwa ziwopsezo za parathyroid, mankhwalawo ayenera kusiyidwa.

Hydrochlorothiazide imatha kuchepetsa kuchuluka kwa ayodini omwe amamangiriza mapuloteni a seramu osawonetsa zizindikiro za chithokomiro chodwala.

Mu gawo loyambirira la kugwiritsa ntchito mankhwala (kutalika kwa nthawi imeneyi kumatsimikiziridwa payekhapayekha), tikulimbikitsidwa kuti tisayendetse ntchito ndikuwonetsetsa kuti pamafunika chidwi chochuluka komanso kuthamanga kwa zochitika zama psychomotor (chifukwa cha kukula kwa chizungulire ndi kugona), mtsogolomo, kusamala kuyenera kuchitidwa.

Pharmacological zimatha mankhwala

Mapiritsi a Hydrochlorothiazide ndi thiazide diuretics. Yogwira popanga mankhwala amasokoneza mayamwidwe a sodium, madzi ndi chlorine m'magawo akutali a aimpso, komanso imathandizanso kuchulukitsidwa kwa potaziyamu ndi magnesium ion.

Achire kwambiri achire zotsatira za 2 pambuyo kumwa mapiritsi mkati ndi kumatenga maola 12.

Chifukwa cha kuchotsedwa kwa madzi ochulukirapo m'thupi, zinthu zomwe zimagwira mu diuretic zimathandiza kuchepetsa kuthamanga kwa magazi, kuchepetsa edema, komanso kuchepetsa polyuria mwa odwala omwe ali ndi matenda a shuga.

Kugwiritsa ntchito mankhwalawa panthawi yapakati komanso poyamwitsa

Kugwiritsa ntchito mapiritsi a hydrochlorothiazide m'nthawi yoyamba kubereka ndi koletsedwa, chifukwa nthawi imeneyi kupangika kwa ziwalo za fetal ndi machitidwe zimachitika, ndipo mankhwala amatha kusokoneza njirayi.

Kugwiritsa ntchito mankhwalawa mu 2nd ndi 3 trimesters ya mimba kumatheka pokhapokha kuwunika kwathunthu kwa zizindikiro za phindu / zoopsa komanso kuyang'aniridwa ndi dokotala.

Kugwiritsa ntchito mankhwalawa panthawi yoyamwitsa sikuletsedwa, chifukwa magawo omwe amagwira ntchito amatha kulowa mkaka wa m'mawere, kenako ndikulowa m'thupi la mwana ndi chakudya. Ngati chithandizo cha hydrochlorothiazide ndi chofunikira, mkaka wa mkaka uyenera kutha!

Zotsatira zoyipa

Pogwiritsa ntchito bwino mankhwalawa, zotsatira zoyipa zimachitika pokhapokha nthawi zina. Ngati muyima mopitirira muyeso woyenera wa mankhwalawo kapena kugwiritsa ntchito mankhwalawa mosasamala, zotsatirazi zingayambike mwa odwala:

• Matenda am'mimba: kutupa kwa kapamba, cholecystitis, kusokonezeka kwa tulo, kusowa chilakolako cha chakudya, jaundice, kupweteka pachiwindi.
• Zowonongeka
• Chizungulire kapena mutu,
• Kumverera kwa "kukwawa" pakhungu,
• Kukula kwa vasculitis, kuchepa magazi, leukopenia, hyponatremia,
• Kutembenuka motsutsana ndi maziko akumaphwanya mulingo wamadzi mthupi,
• Chisokonezo kapena kuwonjezeka kwamanjenje
• Udzu wambiri, kamwa yowuma,
• Kuchepetsa mseru komanso kugwa
• Kukula kufooka kapena ulesi,
• Thupi lawo siligwirizana - urticaria, angioedema, totupa,
• Kupweteka kwa minofu
• Kuphwanya impso ndi chiwindi, ovuta, kukula kwa chiwindi kulephera.

Kuchita kwa mankhwala ndi mankhwala ena

Ndi munthawi yomweyo kugwiritsa ntchito mapiritsi a hydrochlorothiazide okhala ndi mankhwala osapinga a cellidal kapena anticoagulants, chithandizo chamatumbo chimapangidwadi, chomwe chiyenera kukumbukiridwa popereka mankhwala.

Kugwiritsa ntchito munthawi yomweyo mankhwalawa antidepressants, barbiturates, kapena Mowa, pamakhala kuwonjezeka kwake.

Ntchito yogwira ya hydrochlorothiazide imachepetsa mphamvu zakulera zam'mapiritsi oletsa kubereka, omwe ayenera kuchenjezedwa kwa odwala omwe amakonda mtundu wotetezedwa ku mimba yosafunikira.

Mapiritsi a diuretic, makamaka hydrochlorothiazide, amawonjezera chiopsezo cha zotsatira zoyipa pakumwa mankhwala a mtima glycosides.

Zoyenera kugawa ndikusunga mankhwalawo

Mapiritsi a Hydrochlorothiazide amawagawa m'mapiritsi popanda mankhwala kwa dokotala. Mankhwalawa amayenera kusungidwa kuchokera kwa ana kuti azitha kutentha osapitirira 20. Alumali moyo wa mapiritsi ndi zaka 2 kuyambira tsiku lopanga.

Mtengo wapakati wa mankhwalawa Hydrochlorothiazide mu mawonekedwe a mapiritsi am'malo ogulitsa mankhwala ku Moscow ndi ma ruble 60-70.