Hypothiazide: malangizo ogwiritsira ntchito

Munkhaniyi, mutha kuwerengera malangizo ogwiritsira ntchito mankhwalawa Hypothiazide. Amapereka ndemanga kuchokera kwa alendo omwe amabwera patsamba lino - ogula mankhwalawa, komanso malingaliro a akatswiri azachipatala pakugwiritsa ntchito Hypothiazide pamachitidwe awo. Chopempha chachikulu ndikuti muwonjezere ndemanga zanu za okodzetsa: mankhwalawo adathandizira kapena sanathandizire kuchotsetsa matendawa, ndizovuta ziti komanso zoyipa zomwe zinaonedwa, mwina sizinalengezedwe ndi wopanga. Hypothiazide analogu pamaso pa kupezeka kwa mawonekedwe ake. Gwiritsani ntchito mankhwalawa ochepa matenda oopsa komanso edematous matenda akulu, ana, komanso pa mimba ndi mkaka wa m`mawere.

Hypothiazide - diuretic (diuretic). Njira yayikulu yogwiritsira ntchito thiazide diuretics ndikuwonjezera diuresis poletsa kubwezeretsanso kwa sodium ndi chlorine ion koyambirira kwa mafupa aimpso. Izi zimabweretsa kuwonjezeka kowonjezera kwa sodium ndi chlorine ndipo, motero, madzi. Kutupa kwa ma electrolyte ena, omwe ndi potaziyamu ndi magnesium, kumakulanso. Muli mankhwala okwanira othandizira, ma diuretic / natriuretic ofan onse a thiazides ali ofanana.

Natriuresis ndi diuresis zimachitika mkati mwa maola 2 ndikufika pamlingo wapamwamba pambuyo pafupifupi maola 4.

Thiazides amachepetsa ntchito ya carbonic anhydrase powonjezera kuchuluka kwa ma bicarbonate ion, koma izi nthawi zambiri zimakhala zopanda mphamvu ndipo sizikhudza pH ya mkodzo.

Hydrochlorothiazide (yogwira mankhwala a Hypothiazide) ilinso ndi antihypertensive katundu. Liazide diuretics sizimakhudza kuthamanga kwa magazi.

Kupanga

Hydrochlorothiazide + okonda.

Pharmacokinetics

Hypothiazide ndiyosakwanira, koma imakamizidwa mwachangu kuchokera mumimba. Izi zimapitirira kwa maola 6 mpaka 12. Hydrochlorothiazide imawoloka chotchinga ndikuthiridwa mkaka wa m'mawere. Njira yayikulu yotsatsira ndi impso (kusefera ndi chinsinsi) mu mawonekedwe osasinthika.

Zizindikiro

• matenda oopsa a arterial (onse a monotherapy komanso ophatikizana ndi mankhwala ena a antihypertensive),
• edema syndrome yamavuto osiyanasiyana (mtima osalephera, nephrotic syndrome, premenstrual tension syndrome, pachimake glomerulonephritis, kulephera kwaimpso, portal matenda oopsa, chithandizo ndi corticosteroids),
• kuwongolera polyuria, makamaka ndi nephrogenic shuga insipidus,
• kupewa mapangidwe amwala mumkodzo thirakiti odwala omwe atuluka (a kuchepa kwa hypercalciuria).

Kutulutsa Mafomu

Mapiritsi 25 mg ndi 100 mg.

Malangizo ogwiritsira ntchito ndi mlingo

Mlingo uyenera kusankhidwa payekha. Ndi kuyang'aniridwa kosalekeza kwa madokotala, mlingo wochepa wothandiza umakhazikitsidwa. Mankhwala ayenera kumwedwa pakudya.

Ndi matenda oopsa oopsa, mlingo woyambirira ndi 25-50 mg patsiku kamodzi, mu mawonekedwe a monotherapy kapena kuphatikiza ena othandizira. Kwa odwala ena, mlingo woyambirira wa 12,5 mg ndiwokwanira (onse monga monotherapy komanso osakaniza). Ndikofunikira kugwiritsa ntchito mlingo wochepera, osapitirira 100 mg patsiku. Kuphatikiza kwa hypothiazide ndi mankhwala ena a antihypertensive, pangafunike kuchepetsa mlingo wa mankhwala ena kuti muchepetse kuthamanga kwa magazi.

Mphamvu ya antihypertensive imawonetsedwa mkati mwa masiku 3-4, koma zingatenge masabata 3-4 kuti mukwaniritse bwino. Pambuyo pa kutha kwa chithandizo, hypotensive zotsatira zimapitilira sabata 1.

Ndi edematous syndrome yamavuto osiyanasiyana, mlingo woyambira ndi 25-100 mg patsiku kamodzi kapena nthawi imodzi m'masiku awiri. Kutengera ndi mayankho a chipatala, mlingo ungachepetse 25-50 mg patsiku kamodzi kapena kamodzi pa masiku awiri. Nthawi zina zovuta, kumayambiriro kwa chithandizo, kuchuluka kwa mankhwalawa kwa 200 mg patsiku kungafunike.

Ndi premenstrual tension syndrome, mankhwalawa amadziwitsidwa pa 25 mg tsiku ndipo amagwiritsidwa ntchito kuyambira kumayambiriro kwa zizindikiro mpaka kumayamba kwa msambo.

Ndi nephrogenic shuga insipidus, tsiku lililonse mlingo wa 50-150 mg ndi bwino (zingapo Mlingo).

Chifukwa cha kuwonjezeka kwa kutayika kwa potaziyamu ndi ion ya magnesium panthawi yamankhwala (kuchuluka kwa seramu potaziyamu kungakhale

Zotsatira za pharmacological

Mphamvu ya diuretic ya hydrochlorothiazide imayang'anira gawo loyambirira la kubwezeretsanso kwa Na + ndi SG mu distal tubules. Mothandizidwa ndi iye, excretion ya Na + ndi SG imakongoletsedwa ndipo, chifukwa cha izi, madzi am'madzi, komanso potaziyamu ndi magnesium. Mphamvu ya diuretic ya hydrochlorothiazide imachepetsa kuchuluka kwa plasma, imawonjezera ntchito ya plasma renin, imathandizira kuchulukitsidwa kwa aldosterone, chifukwa chomwe chimbudzi cha potaziyamu ndi bicarbonate pamkodzo chimawonjezeka komanso kuchuluka kwa potaziyamu mu seramu kumachepa. Angiotensin-P amawongolera ma renin-aldosterone, chifukwa chake, kugwiritsidwa ntchito kwa angiotensin-P receptor antagonist kumatha kusintha njira yotulutsa potaziyamu yokhudzana ndi thiazide diuretic.

Mankhwalawa amakhalanso ndi mphamvu yolepheretsa kuchepa kwa carbonic anhydrase, pang'ono, kotero, kupititsa patsogolo katulutsidwe ka bicarbonate, pomwe palibe kusintha kwamkodzo pH.

Pharmacokinetics

Hydrochlorothiazide imatengedwa bwino pambuyo pakukonzekera pakamwa, mphamvu zake zokhudzana ndi okodzetsa zimachitika mkati mwa maola 2 mutatha kuyang'anira ndikufika pazokwanira pambuyo pafupifupi maola 4. Izi zichitike kwa 6-12

Chotsegulidwa kudzera mu impso mu mawonekedwe osasinthika. Hafu ya moyo wa odwala omwe ali ndi vuto la impso ndi maola 6.4, kwa odwala omwe amalephera kupweteka aimpso - maola 11.5, komanso chifukwa cha kulephera kwambiri kwaimpso ndi creatinine chilolezo chosakwana 30 ml / min. - maola 20,7. Hydrochlorothiazide imawoloka chotchinga ndikuchotsedwa mkaka wa m'mawere pang'ono.

Zizindikiro zogwiritsidwa ntchito

• Hypertension (m'mitundu yofatsa - yonse mu mawonekedwe a monotherapy, komanso osakanikirana ndi mankhwala ena a antihypertensive).

• Edema ya mtima, hepatic kapena aimpso etiology, premenstrual edema, edema yotsatana ndi pharmacotherapy, monga corticosteroid.

• Ndi nephrogenic shuga insipidus yochepetsa polyuria (paradoxical athari)

• Kuchepetsa hypercalciuria.

Contraindication

• Hypersensitivity a mankhwalawa kapena ena sulfonamides

• Impso zazikulu (kulengedwa kwa creatinine pansi pa 30 ml / min) kapena kulephera kwa chiwindi

• Osakana kuchiza hypokalemia kapena hypercalcemia

• Zizindikiro Hyperuricemia (gout)

Mankhwalawa sawonetsedwa kuti azigwiritsidwa ntchito mwa ana ochepera zaka 6.

Mimba komanso kuyamwa

Zomwe zimachitika ndi hydrochlorothiazide pa nthawi yapakati, makamaka trimester yoyamba, ndizochepa. Zambiri zomwe zimapezeka pakuyesa nyama ndizosakwanira. Hydrochlorothiazide imawoloka chotchinga. Ngati hydrochlorothiazide imagwiritsidwa ntchito munthawi yachiwiri ndi yachitatu, iyo (chifukwa cha zochitika zake zamankhwala) imatha kusokoneza kufooka kwa fetoplacental ndikupanga jaundice wa mwana wosabadwa kapena wakhanda, electrolyte imbalance and thrombocytopenia.

Hydrochlorothiazide sayenera kugwiritsidwa ntchito panthawi yoyembekezera kuchitira edema, matenda oopsa kapena preeclampia, chifukwa m'malo momangokhala ndi phindu pamatendawa, amawonjezera kuwopsa kwa kuchepa kwa plasma voliyumu ndikuwopseza magazi omwe awonongeka m'matumbo a chiberekero ndi placenta.

Hydrochlorothiazide sangagwiritsidwe ntchito pochiza matenda oopsa mu azimayi oyembekezera, pokhapokha ngati chithandizo china sichitha kugwiritsidwa ntchito.

Mapiritsi a Hydrochlorothiazide sayenera kugwiritsidwa ntchito panthawi yomwe ali ndi pakati - amatha kugwiritsidwa ntchito pokhapokha pokhazikika.

Hydrochlorothiazide imadutsa mkaka wa m'mawere; kugwiritsidwa ntchito kwake kumatsutsana panthawi yoyamwitsa. Ngati ntchito yake singapewere, kuyamwitsa kuyenera kuyimitsidwa.

Mlingo ndi makonzedwe

Mlingo uyenera kusankhidwa payekhapayekha ndipo umafunika kuyang'aniridwa mosadwala. Chifukwa cha kuwonjezeka kwa kutayika kwa potaziyamu ndi magnesium panthawi yamankhwala (seramu potaziyamu ikhoza kutsika pansi pa 3.0 mmol / l), pakufunika kubwezeretsedwa kwa potaziyamu ndi magnesium. Kusamalidwa makamaka kuyenera kuchitika kwa odwala omwe ali ndi vuto la mtima, odwala omwe ali ndi vuto la chiwindi, kapena odwala omwe akulandira chithandizo cha digitis glycoside. Mapiritsi ayenera kumwedwa mutatha kudya.

Monga antihypertgency wothandizira, tsiku lililonse mlingo woyambira 25-25 wa mg mu muyezo umodzi, mu mawonekedwe a monotherapy kapenanso mankhwala ena a antihypertensive. Kwa odwala ena, mlingo woyambirira wa 12,5 mg ndiwokwanira, onse mu mawonekedwe a monotherapy komanso osakaniza. Ndikofunikira kuyamwa osachepera 100 mg pa tsiku. Ngati hypothiazide ikuphatikizidwa ndi mankhwala ena a antihypertensive, pangafunike kuchepetsa kuchuluka kwa mankhwalawa kuti musataye magazi ochuluka.

Mphamvu ya antihypertensive imawonetsedwa mkati mwa masiku 3-4, komabe, kuti mukwaniritse bwino, zingatenge mpaka milungu 3-4. Pambuyo pa chithandizo, hypotensive zotsatira zake zimapitilira sabata.

Mankhwalawa edema Mulingo woyambira aliyense ndi 25-100 mg wa mankhwala kamodzi patsiku kapena kamodzi masiku awiri. Kutengera ndi mayankho a chipatala, mlingo uyenera kuchepetsedwa mpaka 25-50 mg kamodzi patsiku kapena kamodzi masiku awiri. Muzovuta zina, Mlingo woyamba wa 200 mg patsiku ungafunikire.

Mu preemastrual edema, mankhwalawa amakhala 25 mg tsiku lililonse ndipo amagwiritsidwa ntchito kuyambira kumayambiriro kwa Zizindikiro mpaka kusamba.

Ndi nephrogenic shuga insipidus Mulingo woyenera wa tsiku lililonse wa 50-150 mg (mu milingo ingapo) akulimbikitsidwa.

Mlingo uyenera kukhazikitsidwa potengera kulemera kwa mwana. Mlingo wokhazikika wa ana masiku onse, 1-2 mg / kg kulemera kwa thupi kapena 30-60 mg pa sikweya mita imodzi pamasamba, amatchulidwa kamodzi patsiku. Mankhwala tsiku lililonse kwa ana azaka 6 mpaka 12 ndi 37,5-100 mg patsiku.

Bongo

Itanani dokotala wanu kapena chipinda chodzidzimutsa ngati mwalandira mankhwala ochulukirapo!

Chowonekera kwambiri cha poyizoni wa hydrochlorothiazide ndichotayika pachakudya chamadzimadzi ndi ma electrolyte, omwe awonetsedwa muzizindikiro ndi zizindikiro zotsatirazi:

Zokhudza mtima: Tachycardia, hypotension, mantha

Neuromuscular: kufooka, chisokonezo, chizungulire komanso minyewa kukokana, paresthesia, kusokonezeka chikumbumtima, kutopa.

M'mimba: nseru, kusanza, ludzu,

Chophimba: polyuria, oliguria kapena anuria.

Zizindikiro zasayansi - hypokalemia, hyponatremia, hypochloremia, alkalosis, kuchuluka kwa nayitrogeni m'magazi (makamaka mwa odwala omwe amalephera impso).

Mankhwala osokoneza bongo:

Kuyambitsa kusanza, chapamimba thirakiti imatha kukhala njira zokuthandizira mankhwala. Kuyamwa kwa mankhwalawa amatha kuchepetsedwa pogwiritsa ntchito kaboni yoyambitsa. Pankhani ya hypotension kapena mantha, kuchuluka kwa ma plasma ozungulira ndi ma elekitirodiya (potaziyamu, sodium, magnesium) kuyenera kulipiridwa.

Mulingo wamagetsi am'madzi (makamaka kuchuluka kwa seramu potaziyamu) ndi ntchito ya impso ziyenera kuyang'aniridwa mpaka mfundo zabwinobwino zikakhazikitsidwa.

Kuchita ndi mankhwala ena

Onetsetsani kuti mwadziwitsa othandizira azaumoyo za mankhwala onse omwe mumamwa, ngakhale zitachitika mwanjira.

Mwina kuyanjana pakati pa thiazide diuretics ndi mankhwala otsatirawa pogwiritsa ntchito munthawi yomweyo.

Mowa, barbiturates, anesthetics ndi antidepressants:

Zitha kupititsa patsogolo hypotension ya orthostatic.

Othandizira odwala matenda ashuga (mkamwa ndi insulin):

Mankhwala a Thiazide amachepetsa kulolera kwa glucose. Mungafunike kusintha mlingo wa mankhwala a hypoglycemic. Metformin iyenera kugwiritsidwa ntchito mosamala chifukwa cha chiopsezo cha lactic acidosis chifukwa chakulephera kugwira ntchito kwaimpso komwe kumayenderana ndi hydrochlorothiazide.

Othandizira ena othandizira:

Colestyramine ndi ma colestipol resins:

Pamaso pa anion kusinthana mains, kuyamwa kwa hydrochlorothiazide kuchokera m'mimba yamagetsi kumayipa. Mulingo umodzi wa colestyramine kapena ma colestipole resins amamanga hydrochlorothiazide ndikuchepetsa kuyamwa kwake m'matumbo amimba, 85% ndi 43%.

Ma Pressor amines (mwachitsanzo adrenaline):

Ndizotheka kuti machitidwe a Pressor amines afooka, koma osafikira poletsa kugwiritsa ntchito kwawo.

Kupuma kosakhumudwitsa minofu (mwachitsanzo tubocurarine):

Mphamvu yotsitsimutsa minofu imatha kukula.

Ma diuretics amachepetsa chilolezo cha lithiamu ndikuwonjezera kwambiri chiopsezo cha lithiamu. Kugwiritsa ntchito nthawi imodzi sikulimbikitsidwa. Mankhwala ochizira gout (phenenicid, sulfinpyrazone ndi allopurinol):

Kusintha kwa mlingo wa uricosuric othandizira kungafunike, popeza hydrochlorothiazide ingakulitse kuchuluka kwa seramu uric acid. Kuwonjezeka kwa mlingo wa probenicide kapena sulfinpyrazone kungafunike. Kugwiritsa ntchito nthawi imodzi kwa thiazides kumatha kukulitsa kuchuluka kwa ma hypersensitivity zimachitikira ku allopurinol.

Anticholinergics (mwachitsanzo, atropine, biperiden):

Chifukwa chakuchepa kwa mphamvu ya m'mimba komanso kuchuluka kwa m'mimba, kutsekeka kwa diuretic ya mtundu wa thiazide kumawonjezeka.

Othandizira a Cytotoxic (mwachitsanzo, cyclophosphamide, methotrexate):

Thiazides amatha kuchepetsa aimpso a cytotoxic mankhwala ndikuwonjezera mphamvu yanga ya myelosuppressive.

Pankhani ya michere yambiri ya salicylates, hydrochlorothiazide ingalimbikitse poizoni wama salicylates pakatikati kwamanjenje.

Nthawi zina, hemolytic anemia imadziwika kuti imagwiritsidwa ntchito nthawi yomweyo ya hydrochlorothiazide ndi methyldopa.

Kugwiritsira ntchito limodzi ndi cyclosporine kungakulitse hyperuricemia ndi chiopsezo chotenga zovuta monga gout.

Hypokalemia kapena hypomagnesemia yoyambitsidwa ndi thiazide ingathandizire kukulitsa kwa arrhythmias oyambitsidwa ndi digitis.

Mankhwala omwe amakhudzidwa ndi kusintha kwa seramu potaziyamu:

Kutsimikiza kwa seramu potaziyamu wambiri komanso kujambula kwa electrocardiogram tikulimbikitsidwa ngati hydrochlorothiazide imagwiritsidwa ntchito nthawi yomweyo ndi mankhwala omwe amakhudzidwa ndi kusintha kwa serum potaziyamu (mwachitsanzo, glycosides ndi mankhwala a antiarrhythmic) tachycardia) (kuphatikiza mankhwala ena a antiarrhythmic), chifukwa hypokalemia ndi yomwe imathandizira kukulitsa tachycardia monga pirouette:

• antiarrhythmic mankhwala a kalasi 1a (mwachitsanzo, quinidine, hydroquinidine, disopyramide),

• mankhwala a antiarrhythmic a kalasi III (mwachitsanzo, amiodarone, sotalol, dofetilide, ibutilide),

• ma antipsychotic ena (mwachitsanzo, thioridazine, chlorpromazine, levomepromazine, trifluoperazin, cyamemazine, sulpiride, sultopride, amisulpride, tiapride, pimozide, haloperidol, droperidol),

• Mankhwala ena (mwachitsanzo, bepridil, chisapride, diphemanil, erythromycin, introfantrine, misolastine, pentamidine, terfenadine, intravenous vincamine.

Liazide diuretics imachulukitsa kuchuluka kwa calcium ya seramu chifukwa cha kuchepa kwa chimbudzi. Ngati pakufunika kusankhidwa kwa nthumwi zomwe zimabweza calcium, ndikofunikira kuwongolera kuchuluka kwa calcium mu seramu ndipo, mogwirizana ndi izo, sankhani calcium.

Kuyanjana pakati pa mankhwala ndi mayeso a labotale: Chifukwa cha mphamvu ya calcium metabolism, thiazides amatha kupotoza zotsatira za mayeso a ntchito ya parathyroid

Zolemba ntchito

Kuwunika kwamankhwala ndi kwachilengedwe ndikofunikira chifukwa choopsa cha hyponatremia.

Othandizirana a Iodini:

Ngati vuto la kuperewera kwa madzi m'thupi chifukwa cha okodzetsa, chiopsezo cha kulephera kwaimpso chimawonjezeka, makamaka mukamagwiritsa ntchito mankhwala osokoneza bongo a iodini. Musanagwiritse ntchito ayodini, ndikofunikira kubwezeretsanso madzi m'thupi la odwala.

Amphotericin B (parenteral), corticosteroids, ACTH ndi mankhwala othandizira ena:

Hydrochlorothiazide imatha kupangitsa kuti electrolyte ikhale ndi vuto, makamaka kukula kwa hypokalemia.

Kutulutsa mawonekedwe ndi kapangidwe kake

Fomu ya Mlingo: mapiritsi ndi ozungulira, athyathyathya, okhala ndi mzere mbali imodzi ndipo amalemba "H" mbali inayo, yoyera kapena pafupifupi (ma PC 20. M'matumba, pamakatoni a chikhazikitso 1 ndi malangizo ogwiritsira ntchito Hypothiazide).

Chosakaniza chophatikizacho ndi hydrochlorothiazide, zomwe zili piritsi limodzi ndi 25 kapena 100 mg.

Zigawo zothandiza: gelatin, stearate ya magnesium, kukhuthala kwa chimanga, talc, lactose monohydrate.

Mankhwala

Gawo lothandiza la Hypothiazide ndi thiazide diuretic hydrochlorothiazide, kapangidwe kake kogwiritsira ntchito komwe ndikuwonjezera diuresis poletsa kubwezeretsanso kwa sodium ndi chlorine ion koyambirira kwa mafupa aimpso. Zotsatira zake, kuchuluka kwa sodium, chlorine, ndipo, motero, madzi amawonjezereka. Kuphatikiza apo, kuchuluka kwa ma electrolyte ena - potaziyamu ndi magnesium - kukukula. Mphamvu ya diuretic / natriuretic ya ma thiazides onse atamwa kwambiri pazomwe achire Mlingo umakhala wofanana.

Natriuretic zochita ndi okodzetsa zimachitika 2 hours, kufikira kwambiri pambuyo pafupifupi maola 4.

Liazide diuretics, kuwonjezera, poonjezera kuchuluka kwa ma bicarbonate ions amachepetsa ntchito ya carbonic anhydrase, koma nthawi zambiri izi zimafotokozedwa mosavuta ndipo sizikhudza mkodzo pH.

Hydrochlorothiazide ili ndi antihypertensive katundu. Liazide diuretics sizimakhudza kuthamanga kwa magazi (BP).

Hypothiazide, malangizo ntchito: njira ndi mlingo

Mapiritsi a Hypothiazide amatengedwa pakamwa mutatha kudya.

Mlingo amasankhidwa payekha pa chithandizo. Kuwona momwe wodwalayo alili, dokotala amakupatsani mlingo wothandiza wa hypothiazide.

Dosing yoyamba ya akulu:

• Edematous matenda a etiology osiyanasiyana: 25-100 mg 1 nthawi patsiku kapena 1 nthawi 2 masiku, ovuta - 200 mg patsiku. Popeza maupangidwe azachipatala, ndizotheka kuchepetsa mlingo kukhala 25-50 mg patsiku kamodzi kapena kamodzi pa masiku awiri,
• Zizindikiro za kusokonekera kwa mankhwalawa: 25 mg kamodzi patsiku, makonzedwe amayamba kuyambira pomwe zizindikiritso zoyambirira zisanachitike.
• Matenda oopsa a arterial (ophatikizidwa ndi monotherapy): 25-50 mg kamodzi patsiku, kwa ena odwala 12,5 mg ndiokwanira. Mlingo wothandiza osachepera 100 mg patsiku. The achire zotsatira kuwonekera mkati mwa masiku 3-4, mulingo wolimba wa kuthamanga kwa magazi (BP) zingatenge milungu itatu. Pambuyo pochotsa hypothiazide, zotsatirapo zake zimakhala kwa sabata limodzi. Pofuna kupewa kuchepa kwambiri kwa kuthamanga kwa magazi panthawi yophatikiza mankhwalawa, kuchepetsa kuchuluka kwa ma antihypertgency othandizira kungafunike,
• Nephrogenic shuga insipidus: 50-150 mg patsiku kangapo.

Hypothiazide Mlingo wa ana amawerengedwa potengera kulemera kwa mwana. Mlingo wa ana masiku onse nthawi zambiri umakhala wa 1-2 mg pa kilogalamu imodzi ya kulemera kwa mwana kapena 30-60 mg pa mita imodzi ya mraba. thupi thupi 1 nthawi patsiku, kwa ana a zaka 3 mpaka 12 - 37.5-100 mg patsiku.

Zotsatira zoyipa

Kugwiritsa ntchito hypothiazide kumatha kuyambitsa zotsatirazi:

• Matumbo a dongosolo: anorexia, kutsekula m'mimba kapena kudzimbidwa, cholecystitis, cholestatic jaundice, kapamba, sialadenitis,
• Metabolism: uchidakwa, chisokonezo, kuchepa kwa njira yoganiza, kukhudzika, kukwiya, kutopa, minofu kukokana pa maziko a hypercalcemia, hypomagnesemia, hypokalemia, hyponatremia. Mitundu yosasinthika ya mtima, pakamwa pouma, ludzu, kutopa kosazolowereka kapena kufooka, kusinthika kwa psyche kapena kusinthasintha, kupsinjika ndi kupweteka kwa minofu, nseru, kusanza chifukwa cha hypochloremic alkalosis (kuphatikiza, hypochloremic alkalosis ingayambitse hepatic encephalopathy kapena chikomokere). Glycosuria, hyperuricemia ndi chitukuko cha kuukira kwa gout. Hyperglycemia, yomwe ingayambitse kukula kwa matenda ashuga a m'mbuyomu. Kugwiritsa ntchito mlingo waukulu kumatha kuwonjezera ma seramu lipids,
• Mtima dongosolo: arrhythmia, vasculitis, orthostatic hypotension,
• Hematopoietic dongosolo: kawirikawiri - thrombocytopenia, leukopenia, hemolytic anemia, agranulocytosis, aplastic anemia,
• Mitsempha yamitsempha yam'maso: Kusintha kwamaso kwakanthawi, mutu, chizungulire, paresthesia,
• Kwamikodzo dongosolo: interstitial nephritis, zinchito kuwonongeka kwa impso,
• Thupi lawo siligwirizana: urticaria, photosensitivity, necrotic vasculitis, purpura, Stevens-Johnson syndrome, anaphylactic zochita mpaka kugwedezeka. Matenda a kupumula, kuphatikizaponso chibayo ndi edema yosapatsa mtima;
• Zina: kuchepa kwa potency.

Malangizo apadera

Pa nthawi yayitali chithandizo, m`pofunika kuwongolera matenda zizindikiro za mkhutu madzi-electrolyte bwino, makamaka odwala mkhutu chiwindi, matenda a mtima dongosolo.

Kugwiritsa ntchito hypothiazide kumalimbikitsa kuchulukitsidwa kwa ma magnesium ndi ion ya potaziyamu, motero, mogwirizana ndi njira yothandizira, njira ziyenera kuchitidwa kuti athetse kusowa kwawo.

Odwala omwe ali ndi vuto la impso, kuwongolera kwa creatinine kuyenera kuyang'aniridwa mwadongosolo; muzochitika za oliguria, funso loti atengere hypothiazide liyenera kuyankhidwa.

Odwala omwe ali ndi vuto la chiwindi, ma thiazides ayenera kugwiritsidwa ntchito mosamala, popeza kusintha pang'ono pamagetsi amadzimadzi a electrolyte ndi serum ammonia kungayambitse kupweteka kwa hepatic.

Kugwiritsa ntchito hypothiazide kwa odwala omwe ali ndi vuto lalikulu la ubongo ndi matenda amkati amafunika chisamaliro chapadera.

Kutenga nthawi yayitali mankhwala opatsirana a shuga komanso kuwonetsa shuga. Kuyenera kuyendera limodzi ndi kuwunika kwa kagayidwe kazakudya komanso kusintha kwa mankhwala a hypoglycemic.

Kuwunika pafupipafupi za vutoli kumafuna odwala omwe ali ndi vuto la uric acid metabolism.

Chithandizo cha nthawi yayitali, nthawi zina, chitha kubweretsa kusintha kwa matenda a parathyroid.

Mimba komanso kuyamwa

Hydrochlorothiazide imadutsa chotchinga, chifukwa chake pamakhala chiopsezo cha fetal / jaundice yatsopano, thrombocytopenia, ndi zina.

Kugwiritsa ntchito hypothiazide mu trimester yoyamba ya mimba kumatsutsana kwambiri. Mu II - III trimesters, mankhwalawa amalembedwa pokhapokha ngati pakufunika, pomwe phindu lomwe mayi akuyembekezeralo ndi lokwera kuposa chiwopsezo cha mwana wosabadwayo.

Hydrochlorothiazide amachotsekera mkaka wa m'mawere. Ngati mukufuna kuzigwiritsa ntchito panthawiyi, muyenera kusiya kuyamwitsa.

Kupanga ndi mawonekedwe a kumasulidwa

mu chithuza chamtundu 20 ma PC,, pabokosi lamatabwa 1 chithuza.

Zizindikiro Hypothiazide ®

matenda oopsa a ubongo (ogwiritsidwa ntchito onse mu monotherapy komanso kuphatikiza mankhwala ena a antihypertensive),

edema syndrome yamitundu yosiyanasiyana (matenda a mtima osalephera, nephrotic syndrome, premenstrual syndrome, pachimake glomerulonephritis, kulephera kwaimpso, portal matenda oopsa, chithandizo cha corticosteroids),

kuwongolera polyuria, makamaka ndi nephrogenic shuga insipidus,

kupewa mapangidwe miyala mu genitourinary thirakiti odwala atengeke (kuchepetsa hypercalciuria).

Mimba komanso kuyamwa

Hydrochlorothiazide imawoloka chotchinga. Kugwiritsa ntchito mankhwala koyamba nthawi ya mimba kumapangidwa. Mu ma II ndi III omwe amatenga pathupi, mankhwalawa amatha kuikidwa pokhapokha akufunika kwambiri, pomwe phindu kwa mayi limaposa chiwopsezo cha mwana wosabadwayo ndi / kapena mwana. Pali chiopsezo chotenga jaundice wa mwana wosabadwa kapena wakhanda, thrombocytopenia ndi zotsatira zina.

Mankhwalawa amapita mkaka wa m'mawere, ngati kugwiritsa ntchito mankhwalawa ndikofunikira, kuyamwitsa kuyenera kutha.

Hypothiazide

Hypothiazide ndi mankhwala opanga a diuretic ochokera pagulu la benzothiadiazine. Mphamvu ya diuretic ya hypothiazide imatheka chifukwa cha kuchepa kwa mayamwidwe a chlorine, ma ayoni a sodium mu mafupa aimpso. Kuchuluka kwa sodium kuchokera m'thupi kumakhudzanso kuchepa kwa madzi. Zotsatira zakuchotsa madzi, kuchuluka kwa magazi ozungulira kumachepa, komwe kumapangitsa kutsika kwa magazi (ngati adakwezedwa, kuthamanga kwa magazi sikuchepa). Mankhwala amalimbikitsanso kuchulukitsidwa kwa potaziyamu, ma bicarbonates ndi ma magnesium ion kuchokera mthupi, koma mpaka pang'ono.

Mphamvu ya diuretic (diuretic) imayamba maola awiri atatha kumwa mankhwalawa, imafikira pakatha maola 4 ndipo imatha maola 6 mpaka 12. Kuchepetsa kugwiritsa ntchito mchere ndi chakudya kumathandizira kudziwa zotsatira za mankhwala.

Kupanikizika kwa intraocular kumacheperanso ndi Hypothiazide. Mankhwala amatha kudutsa chotchinga. Wotsekedwa mkodzo ndi mkaka wamawere. Ndi kulephera kwa aimpso, kumasulidwa kwa mankhwalawa kumachepetsedwa kwambiri.

Zomwe zimagwiritsidwa ntchito ndi mankhwalawa hydrochlorothiazide.

Chithandizo cha Hypothiazide

Ndi kunenepa kwambiri, pamakhala chizolowezi chosungira madzi mthupi chifukwa cha kuchuluka kwa hydrophilicity. Kuphatikiza apo, nthawi zambiri motsutsana ndi maziko a kunenepa kwambiri, kulephera kwamtima kumayamba, kukulira kuchuluka kwa madzi. Ndipo pali kufunika kothandizira mankhwalawa osati mankhwala a mtima okha, komanso okodzetsa. Mwa okodzetsa, hypothiazide imagwiritsidwa ntchito nthawi zambiri, chifukwa cha kukongoletsa kwake komanso kawirikawiri samachitika.

Komabe, kugwiritsa ntchito hypothiazide pakuchepetsa thupi kuyenera kukhala osamala kwambiri komanso motsogozedwa ndi dokotala. Kugwiritsira ntchito diuretic iyi popanda chifukwa chabwino kumatha kubweretsa zotsatirapo zovuta - mawonekedwe osanenepetsa a kunenepa kwambiri amakula chifukwa chogwiritsa ntchito ma diuretics kwa nthawi yayitali kumapangitsa kuti pakhale zovuta: kusefukira kwamadzi mu minofu kumadziunjikira mwachangu.

Ndikosavuta komanso ndibwino kuchotsa zochuluka mthupi kuchokera mthupi pogwiritsa ntchito mankhwala osokoneza bongo (bere, mahatchi, ndi zina zambiri).
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