03 May, 2024
    Mankhwala

    Chithandizo cha Mtima

    Mankhwala a antihypertensive a mtundu wachiwiri wa matenda osokoneza bongo amasankhidwa payekhapayekha, chifukwa cha momwe impso imagwirira ntchito, komanso momwe zimayambira pamafuta amafuta ndi chakudya chamagulu. Matenda oopsa a arterial amaperekera 80% ya iwo omwe ali ndi vuto la hyperglycemia. Matenda amawonjezera kugwira ntchito kwa ziwalo zamkati, kusokoneza njira zachilengedwe za kagayidwe.

    Mawonekedwe

    Chithandizo cha mapiritsi opanikizika kwa odwala matenda ashuga ndiwovuta chifukwa chosatheka, kuwonetsera komwe kumachitika chifukwa cha kukanika kwa kagayidwe kazakudya.

    Kusankha kwa mankhwalawa kwa matenda oopsa ndi hyperglycemia kumatengera ndi mikhalidwe:

    • Kuchita bwino, zotsatira zoyipa zochepa,
    • Cardio ndi nephroprotective effect (kuteteza mtima ndi impso),
    • Zosagwirizana ndi kuchuluka kwa lipids ndi shuga m'magazi.

    Mankhwala ochita mwachangu

    Ngati mumakonda kudumpha mwadzidzidzi mu kuthamanga kwa magazi, aliyense payekha mankhwala oyenera a matenda oopsa a shuga ayenera kukhala pafupi.

    Ngati chithandizo chadzidzidzi chikufunika, gwiritsani ntchito njira yomwe thupi lake limapitilira maola opitilira 6. Zinthu zogwira ntchito zomwe ndi gawo limodzi la mayina wamba azachipatala:

    Mankhwala othandizira pakachitidwe

    Kuwerenga pafupipafupi pamtunda wa 130/80 mm Hg. Art. chifukwa odwala matenda ashuga ali ndi zovuta za michere, kukula kwa atherosulinosis, kupitilira kwa matenda a shuga angiopathies. Pankhaniyi, kugwiritsa ntchito mankhwala osokoneza bongo nthawi zonse kumalimbikitsidwa, pomwe nthawi yomweyo kumatsata zakudya zamchere komanso zopatsa mphamvu. Zotsatira zamankhwala othinana ndi matenda ashuga ayenera kukhala osalala. Dontho la kuthamanga kwa magazi kutsatiridwa ndi kudumpha kumawonongetsa ngakhale dongosolo lamtima wamunthu wathanzi.

    ACE zoletsa

    Pakukhazikika pang'onopang'ono kwa mawonekedwe a matenda oopsa, ma blocker a angiotensin (ACE) amagwiritsidwa ntchito, omwe amathandizira kapangidwe ka angiotensin. Pochepetsa kuchuluka kwa angiotensin, tiziwalo timene timatulutsa adrenal timatulutsa aldosterone yochepa, yomwe imasunga sodium ndi madzi m'thupi. Vasodilation imachitika, madzi ochulukirapo ndi mchere amachotsedwa, zotsatira za hypotonic zimawonekera.

    Zinthu zogwira zomwe zimatchinga ACE:

    • Enalapril
    • Perindopril,
    • Quinapril,
    • Fosinopril
    • Kalamazoo,
    • Ramipril.

    Zoyipa za zoletsa ndizoleza kuzengereza kwa potaziyamu ndikuwachedwa kugwira ntchito. Zotsatira zakugwiritsidwazo siziwunikiridwa pasanathe milungu iwiri atasankhidwa.

    Angiotensin Receptor blockers (ARBs)

    Amaletsa kaphatikizidwe ka renin, kamene kamapangitsa kusintha kwa angiotensin, komwe kumayambitsa kuchepa kwa makoma amitsempha yamagazi. Ma ARB amadziwika ngati tsankho kwa ACE inhibitors likhazikitsidwa. Makina awo amomwe amapangira zamankhwala amodzi ndizosiyana, koma cholinga ndi chimodzimodzi - kuchepetsa zotsatira za angiotensin ndi aldosterone.

    Gululi limatchedwa sartani kumapeto kwa mayina a zinthu zomwe zimagwira ntchito:

    Ma diuretics amakhala ndi hypotonic yofatsa, imayikidwa limodzi ndi mankhwalawa pogwiritsa ntchito mapiritsi ena oopsa a shuga.

    1. Ma loop diuretics (furosemide, lax) amaphatikiza bwino ndi zoletsa za ACE, sizimakhudza kuchuluka kwa shuga, lipids, ndipo ndi oyenera kuti pakanthawi kochepa ayendetse kufafaniza thukuta lalikulu. Kugwiritsidwa ntchito kosalamulirika kumayambitsa kuthamangitsidwa kwa potaziyamu, komwe kungapangitse kuwonjezeka kwa hypokalemia ndi mtima arrhythmia.
    2. Chifukwa cha kufatsa kwambiri kwa okodzetsa, thiazide-diuretics (indapamide) sikukhumudwitsa kuchuluka kwa glucose, acid acid, potaziyamu, ndipo sikukhudza magwiridwe antchito a impso.
    3. Thiazide diuretics (hypothiazide) Mlingo watsiku ndi tsiku woposa 50 mg amatha kuwonjezera shuga ndi cholesterol. Mankhwala amawayang'anira mosamala mulingo wocheperako chifukwa chakuchepa kwa impso ndi gout.
    4. Zinthu zoteteza potaziyamu (Veroshpiron) sizikulimbikitsidwa kuti mugwiritse ntchito mtundu wa shuga wachiwiri, limodzi ndi vuto laimpso.

    Beta blockers

    Mankhwala angapo omwe amaletsa kukondoweza kwa adrenoreceptors ndi adrenaline ndi norepinephrine amawerengedwa makamaka pochizira ischemia, mtima, kulephera kwa mtima. Ndi hyperglycemia, mapiritsi a matenda oopsa amasankhidwa ndi zina zowonjezera vasodilating:

    Otsutsa a calcium

    Calcium calcium blockers - gulu la mankhwala omwe amachepetsa kuchuluka kwa calcium ion. Pumulani ndikukula makoma amitsempha yamagazi, mitsempha, maselo osalala. Magulu omwe agawidwa m'magulu:

    1. Verapamil, diltiazem. Kukhudza ntchito ya myocardium ndi maselo amtima, chepetsani kugunda kwa mtima. Kugwiritsa ntchito pamodzi ndi beta-blockers kumatsutsana.
    2. Amachokera ku dihydropyridine - nifedipine, verapamil, nimodipine, amlodipine. Amatsitsimula makoma a minofu yosalala, kumawonjezera kugunda kwa mtima.

    Ma calcium antagonists samasokoneza chakudya chamafuta, lipid metabolism. Mukagwiritsidwa ntchito ngati mankhwala opondera, mtundu wachiwiri wa matenda ashuga ndiwabwino, koma uli ndi zotsutsana zingapo. Nifedipine imatsutsana mu angina pectoris, kulephera kwa mtima ndi impso, koyenera kupumula kumodzi. Amlodipine imatha kutupa. Verapamil imakhudzidwa ndi impso, koma imatha kuyambitsa bronchodilators.

    Zochita payekha

    Mankhwala a antihypertensive amaphatikizidwa wina ndi mnzake, osankhidwa poganizira matenda ophatikizana, mankhwala omwe amatengedwa. Hypertension, limodzi ndi matenda ashuga a intracellular kagayidwe, amachititsa zosiyanasiyana zoyipa zimachitika.

    Musanagwiritse ntchito, muyenera kuphunzira mndandanda wazotsatira zoyipa, njira zowathetsera.

    Mukamatenga, mphamvu zamagazi zimawonedwa. Nthawi yomweyo, mulingo wa glycated hemoglobin, cholesterol, triglycerides, glucose othamanga komanso mukatha kudya amayang'aniridwa. Kupatuka kosayenera pamlingo wovomerezeka kumafuna kuti pakhale mankhwala.

    Ndi zitsamba ziti zomwe zingathandize ndi matenda ashuga?

    Munthu amene amakumana ndi matenda amtundu uliwonse amataika, chifukwa ndi matendawa muyenera kukonzanso moyo wanu, kusintha machitidwe ndi zizolowezi. Matenda a 2 a shuga amatha kukhala moyo wokangalika, muyenera kungotsatira malamulo ena. Mankhwala azitsamba azithandizanso kuti moyo ukhale wosavuta, kusankha zitsamba zoyenera za matenda ashuhupi sikovuta.

    Kodi zitsamba zingathandize bwanji?

    Zomera zimathandiza munthu nthawi zovuta. Amathandizira kupewa matenda ndipo amatha kugwiritsidwa ntchito ngati chakudya ndi zonunkhira. Pankhaniyi, chilengedwe chimapatsa anthu chuma chenicheni. Ndi matenda a shuga, zitsamba zamankhwala zimagawidwa m'magulu awiriawiri:

    • Kutsitsa shuga. Amakhala ndi mankhwala okhala ndi insulin, chifukwa chake ndizotheka kuwongolera kuchuluka kwa shuga m'thupi la wodwalayo.
    • Ena. Zomwe zimathandizira kuti thupi lizigwira ntchito bwino, ndikuyeretsa poizoni ndi ziphe, kulimbitsa chitetezo cha mthupi komanso kulimbikitsa ntchito ya ziwalo ndi machitidwe amodzi (impso, chiwindi, mitsempha yamagazi).

    Zomera zam'magulu oyamba zimatha kukhala maziko othandizira matenda a shuga 2, makamaka ngati agwiritsidwa ntchito limodzi ndi zakudya zapadera komanso zolimbitsa thupi. Pankhani yamatenda oyenera, amalimbikitsidwa kuti atengedwe monga kuwonjezera kukonzekera kwa insulin. Tsoka ilo, sizithandiza mtundu wa 1 ashuga.

    Zitsamba kuchokera pagulu la "ena" zimathandizira kuletsa kuwonongeka kwa matendawa, zimathandizira kugwira ntchito kwa chakudya cham'mimba, kulimbitsa mitsempha yamagazi, ndikuthandizira kuchepetsa njira yotupa.Izi ndizothandiza kwa odwala matenda ashuga ndipo amalemba 1 ndi 2. Tengani iwo pafupipafupi kapena mumaphunziro. Ndipo mugwiritse ntchito osati ma decoctions ndi infusions okha. Malipiro ena amagwiritsidwa ntchito ngati compress kuthandiza mabala kuchira msanga, chifukwa mu odwala matenda ashuga, kusinthika kumayamba pang'onopang'ono.

    Kutenga ndi kumwa?

    Kupeza kuphatikiza udzu si vuto pompano, koma sikuti nthawi zonse chitsimikiziro chakuti zitsamba zonse zimasonkhanitsidwa m'malo oyera. Chifukwa chake, kugwiritsa ntchito zitsamba pochiza matenda a shuga, malamulo otsatirawa ayenera kutsatiridwa:

    • Poyamba, muyenera kufunsira kokha ndi phytotherapist, komanso ndi dokotala, kuti avomerezedwe ndi upangiri.
    • Ndikofunika kugula mankhwala azitsamba ku malo ogulitsa mankhwala kapena kwa anthu odalirika omwe ali odalirika ndipo akhala akuchita bizinesiyi kwazaka zoposa.
    • Musanagule zitsamba, muyenera kuganizira nthawi ndi malo omwe mukukolola. Zophatikiza zazitali siziyenera kutengedwa, chifukwa sizomera zonse zomwe zimakhala ndi alumali.
    • Omwe akufuna kudzikongoletsa okha azitsamba ayenera kudziwa nthawi ndi momwe angatolere mbewu, ndi gawo liti lake lomwe limagwiritsidwa ntchito. Malo osonkhaniramo sayenera kukhala mkati mwa mzindawu ndi malo opitilira ntchito. Malo abwino kwambiri kunja kwa mzindawu, kutali ndi mpweya woipa.
    • Munthawi yonse ya chithandizo, munthu amayenera kuwunika kuchuluka kwa shuga m'magazi, momwe amakhalira bwino ndi momwe thupi limayankhira azitsamba.
    • Zizindikiro zikawonetsa kusaloledwa kwa mankhwalawo, muyenera kuchepetsa mankhwalawo, ngati izi sizikuthandizani, muyenera kusankha chomera china chomwe chikugwirizana.
    • Ndikulimbikitsidwa kugwiritsa ntchito chindapusa kuchokera ku zitsamba zingapo. M'nyengo yotentha, msuzi wopangidwa ndi mapangidwe okonzekereratu amasungidwa bwino mufiriji kuti asawonongeke.

    Njira iliyonse ili ndi njira yake yophikira. Mankhwala azitsamba sathamanga, pafupifupi, maphunziro amodzi amakhala miyezi iwiri. Pambuyo pa izi, kupumula kwa masabata osachepera awiri, ndiye, maphunzirowa atha kubwerezedwa. Sindikukulangizani kugwiritsa ntchito ndalama zingapo nthawi imodzi, ndibwino kumaliza kamodzi, kupuma kwa mwezi, kenako wina.

    Ndi zitsamba ziti zomwe zingagwiritsidwe ntchito?

    Zomera zosiyanasiyana zimatha kugwiritsidwa ntchito kuphika. Zitsamba zilizonse zimakhudza thupi. Pansipa pazikhala mayina azomera ndi zomwe amagwiritsidwa ntchito. Ambiri aiwo angatchulidwe m'magulu angapo, koma kwakukulukulu amawonekera komwe adalembedwa.

    • Muli ndi zinthu ngati insulin. Izi zimaphatikizapo mbewu monga burdock, clover, nyemba nyemba, elecampane, blueberries, peony, mpesa waku China wa magnolia ndi oats.
    • Kulimbikitsa kokwanira. Muzu wagolide, yesero, eleutherococcus, ginseng.
    • Kuwongolera kagayidwe. Filakisi, chomera, linden, knotweed, tirigu wokwawa, bere, wort wa St.
    • Muli mavitamini ndi ma organic acid - duwa lakuthengo, lingonberry, phulusa laphiri.
    • Zomera zam'munda zomwe zimathandizira "kukhathamiritsa" thupi ndi mavitamini komanso zinthu zina zofunika kuzitsatira. Beets wofiira, adyo ndi anyezi, sipinachi ndi saladi, kabichi ndi udzu winawake, adyo wamtchire ndi kaloti, barele ndi oats.

    Kugwiritsa ntchito mankhwala a phytotherapy a mtundu wachiwiri wa matenda a shuga, ndikofunikira kukumbukira kuti sizomera zonse zomwe zimapangidwa pamodzi, motero ndikofunika kugula mitengo yolipirika ya mankhwala ndikugwiritsa ntchito.

    Maphikidwe a matenda ashuga

    Kuchepetsa shuga m'magazi a odwala matenda ashuga amtundu wa 2 ndikuwongolera ntchito za thupi, pali ndalama zambiri. Mutha kuwapeza okonzeka ku malo azamankhwala kapena kugula masamba aliwonse payekhapayekha, kenako kusakaniza musanaphike. Aliyense amasankha kwa ndani komanso njira yabwino. Zosagwiritsidwa ntchito nthawi zonse;

    Osakaniza amakonzedwa kuchokera ku youma zida: nyemba wamba nyemba 20g, rosehip 15g, bilberry masamba 20g, chamomile maluwa 10g. Munda wamahatchi 15g, Aralia Manchurian mizu 10g, wort wa St. Amasakanikirana mumtsuko wamagalasi ndikuphimbidwa ndi chivindikiro kuti asunjike chinyezi.Kukonzekera kulowetsedwa, muyenera 2 tbsp. zosakaniza. Madzulo, udzu umathiridwa mu thermos ndikutsanulira 500 ml ya madzi otentha ndikuphimba ndi chivindikiro.

    M'mawa, kulowetsedwa zakonzeka, zimasefa ndi kumwa chikho 1/3 theka la ola musanadye. Maphunzirowa ndi masiku 21-28, ndiye kupumula kwa masabata osachepera awiri ndipo kubwereza. Mu chaka, ndi mtundu 2 shuga mellitus, mankhwala 3-4 zitha kuchitidwa.

    Kukonzekera choperekachi muyenera: maluwa a mullein a skgper ngati 15g, masamba a sitiroberi wamtchire (25g) ndi mabulosi abulu (40g), maluwa a linden 20g. Kusakaniza kouma kale kumatha kusungidwa pabokosi lamakatoni kapena pachidebe china. Kukonzekera decoction, supuni ziwiri za zosonkhanazo zimathiridwa ndi magalasi awiri a madzi otentha ndikuyika madzi osamba kwa mphindi 15. Pambuyo pake, tsimikizirani kwa theka la ola ndikufota. Ndikofunikira kubweretsa kuchuluka kwa msuzi pamlingo wake woyambirira, chifukwa, madzi owiritsa amawonjezeredwa. Imwani kapu imodzi ya mphindi 30 musanadye, katatu patsiku.

    Masamba a Bilberry ndi mphukira zazing'ono zimasakanizika ndi mizu ya dandelion ndi masamba ofowoka a nettle amawonjezeredwa, zonse zimatengedwa pamtunda wofanana. Pofuna kuchiza matenda amtundu wa 2 shuga, tengani supuni yosakaniza ndi kutsanulira madzi otentha. Kuumirira maola 8 ndikusintha. Njira ya mankhwala 2 miyezi, kumwa chikho an ola limodzi musanadye katatu pa tsiku.

    Kugwiritsa ntchito mankhwala azitsamba matenda a shuga sikuti kungothandiza, komanso kumakupatsani mwayi wowonjezera komanso kusamalira ziwalo zina. Mu matendawa, izi ndizofunikira kwambiri, chifukwa ngati simupereka chidwi ndi matenda amtundu wa 2, ndiye kuti zitha kulowa 1, ndipo izi ndi zowopsa kale.

    Mankhwala osokoneza bongo a shuga

    Ma diuretics a matenda a shuga a mellitus (DM) amagwiritsidwa ntchito makamaka pochiza matenda ogwirizana (AH), kulephera kwa mtima, kapena kuthetsedwa kwa edema yodwala mwendo. Pakadali pano, pali mitundu yambiri yamankhwala omwe angakulitse diuresis (kuchuluka kwa mkodzo wothandizidwa).

    Komabe, nkovuta kunena mosatsimikiza kuti ndi uti wabwino koposa. Chithandizo chilichonse chimakhala ndi mphamvu ndi zolephera zake ndipo kwa odwala ena amatha kuwonetsa kapena kuletsa.

    Matenda a shuga komanso okodzetsa

    Ma diuretics onse chifukwa cha mphamvu pazotsatira zawo zitha kugawidwa:

    1. Wamphamvu (Furosemide, Torasemide, Mannitol).
    2. Kuchita kwapakatikati (Hypothiazide, Hydrochlorothiazide, Indapamide, Clopamide).
    3. Zofooka (Diacarb, Dichlorfenamide, Spironolactone).

    Gulu loyamba la mankhwalawa limagwiritsidwa ntchito poyimitsa (kuchiritsa) njira zopweteka kwambiri, monga matenda am'mimba kapena ascites. Gulu lachiwiri ndi loyenereradi kugwiritsa ntchito nthawi yayitali pochiza matenda osachiritsika (matenda oopsa, matenda ashuga).

    Ndalama zotsalazo zimagwiritsidwa ntchito ngati chithandizo chokonzanso kuphatikiza ndizopukutira zina, kuwonjezera mphamvu yawo.

    Mankhwala osokoneza bongo a shuga: mitundu

    Kutengera ndi magwiridwe antchito, magulu otsatira a mankhwalawa amasiyanitsidwa:

    1. Loop: Torasemide, Furosemide, Ethacrinic acid. Limbikitsani kuwonjezereka mwachangu komanso koyenera pakutulutsa kwamkodzo. Amatha kuchotsa mwachangu madzi ambiri mthupi. Gwirani ntchito m'chiuno cha Henle nephron. Amakhala ndi mavuto ambiri.
    2. Thiazide: Hypothiazide, Dichlothiazide, Indapamide. Zolemba pamiyeso za anthu odwala matenda ashuga zimawerengedwa kuti ndi "golide woyenera" wochepetsa kuthamanga kwa magazi ndikuchotsa kudzikuza.
    3. Osmotic: Mannitol, Urea, Potaziyamu acetate. Zida zamphamvu zomwe zimatha kuchotsa mkodzo wambiri mumphindi. Amagwiritsidwa ntchito ngati matenda owopsa. Zosayenera kugwiritsa ntchito nthawi yayitali.
    4. Kuteteza kwa Potaziyamu: Spironolactone, Triamteren. Zotsatira zoyipa zazikulu zamankhwala zomwe tafotokozazi ndi kutaya kwa sodium, potaziyamu ndi magnesium. Gululi linapangidwa kuti lisale kusokonezeka pamagetsi a electrolyte.

    Ndi mankhwala ati omwe ali bwino?

    Liazide diuretics ya matenda a shuga a mtundu 2 amagwiritsidwa ntchito kwambiri.

    Kugwiritsira ntchito okodzetsa ngati vuto la 1 la matendawa limawonedwa pafupipafupi chifukwa chosowa matenda oopsa nthawi zambiri:

    1. Indapamide. Mwinanso, za mankhwalawa, titha kunena kuti ndi njira yabwino kwambiri yothandizira matenda ashuga. Imakhala ndi mphamvu ya sing'anga mphamvu. Katundu wamkulu yemwe madokotala amamukonda ndi kusachita kwake kwa chakudya chamafuta ndi mafuta metabolism m'thupi. Indapamide sasintha kuchuluka kwa glucose ndi cholesterol m'magazi. Wopezeka piritsi 1.5 mg. Ndikofunikira kutsatira 1 tabu. kamodzi m'mawa osasamala chakudyacho. Njira yochizira imayikidwa ndi adokotala.
    2. Hypothiazide. Mankhwala abwino omwe ali m'gulu la mankhwala ovuta a shuga ndi matenda oopsa. Ili ndi zochulukirapo pang'ono poyerekeza ndi woyimilira wa gululi. Kubwezeretsa kwakukulu ndi zotsatira za shuga ndi cholesterol metabolism. Pogwiritsa ntchito nthawi yayitali mankhwala osakwanira, kukula kwa matenda oyambitsidwa ndi matenda atherosulinosis. Wogulitsa mapiritsi a 0,025 g. Gwiritsani tabu 1. m'mawa asanadye. Nthawi yovomerezeka ndi masiku 3-7, ndikutsatira masiku 4.
    3. Hydrochlorothiazide. Zofanana ndi mankhwala akale. Zimasiyananso mumachitidwe ena apamwamba ndi mawonekedwe ogwiritsira ntchito. Muyenera kumwa mapiritsi a 1-4. tsiku mutatha kadzutsa katatu pa sabata. Dokotala amafotokoza njira yeniyeni ya chithandizo, kutengera kuopsa kwa matendawo.

    Palibe chifukwa chofanizira zomwe zili zabwino mwa mankhwalawa. Dokotala wanu adzakusankhirani diuretic yabwino kwa inu kutengera zomwe mumachita mwakuthupi.

    Mankhwala Othandizira

    Ma diuretics ofotokozedwa a shuga amatha kutulutsa potaziyamu kuchokera m'thupi. Pofuna kupewa zovuta zamavuto omwe amadza chifukwa choperewera pakompyuta iyi, potaziyamu wambiri wa potaziyamu ayenera kugwiritsidwa ntchito limodzi.

    Wodziwika kwambiri komanso wodziwika bwino ndi Spironolactone (Veroshpiron). Imakhala ndi kufatsa kotsitsa, koma kumalepheretsa kutayika kwa chinthu china chake chofunikira. Ndi gawo lamankhwala ovomerezeka pochiza matenda oopsa komanso matenda ashuga.

    Mapiritsi a mankhwalawa ali ndi 25 kapena 100 mg yogwira ntchito. Mulingo wamba wa tsiku ndi tsiku ndi 50-100 mg, kutengera kuthamanga kwa magazi. Njira ya mankhwala osachepera milungu iwiri.

    Nthawi zambiri amagwiritsa ntchito okodzetsa

    Mankhwala monga Mannit, Torasemide, Furosemide (Lasix), Urea ali ndi mphamvu yoletsa msanga komanso yamphamvu. Komabe, sioyenera kugwiritsidwa ntchito kwa nthawi yayitali ndi odwala omwe ali ndi "matenda okoma".

    Chifukwa chake chimakhalabe ndi mavuto ambiri:

    1. Kutsika kwakuthwa kwa kuthamanga kwa magazi, myocardial ischemia, angina pectoris.
    2. Kusanza, kusanza, kusowa kwamadzi.
    3. Arrhythmias, atrive fibrillation.
    4. Metabolic alkalosis.
    5. Edema ya Quincke, urticaria, anaphylactic.

    Kuphatikiza apo, amachitapo kanthu mwachangu, koma zotsatira zake sizikhala motalika, zomwe zimapangitsa kuti wodwala azitenge nthawi zambiri. Kugwiritsa ntchito ma diuttics awa ndikulimbikitsidwa kuchipatala.

    Zizindikiro zazikulu ndi:

    • Kutupa kwaubongo kapena mapapu
    • Mtima wowongoka kapena kulephera kwambiri kwaimpso,
    • Ascites
    • Kuchulukana kwamadzi kovuta m'madera akumunsi.

    Kugwiritsira ntchito okodzetsa kuyenera kuvomerezedwa ndi dokotala wanu.

    Ma diuretics a matenda a shuga a 2: mapiritsi a okodzetsa a odwala matenda ashuga

    Diuretics (diuretic mankhwala) zimakhudza ntchito ya impso, zimathandizira kuti inapita patsogolo msambo wa mkodzo kuchokera mthupi. Limagwirira ntchito mwa ndalama zoterezi ndizokhazikitsidwa ndi kuthekera kwolepheretsa kuyamwa kwa ma elekitiromajeni mu aimpso. Ndi kuwonjezeka kwa kuchuluka kwa ma electrolyte otulutsidwa, madzi ena amathandizidwa.

    Diuretic yoyamba idawonekeranso zaka za m'ma 1800, pomwe adadziwika za mankhwala a zebury, omwe amagwiritsidwa ntchito kwambiri pochiza syphilis.Komabe, pochiza matendawa, mankhwala enaake a zebelo sanadziwonekere mwanjira iliyonse, koma zotsatira za kuwonekera kwa thupi la munthu zidapezeka.

    Pambuyo kanthawi, kukonzekera kwa mercury kunasinthidwa ndi mankhwala oopsa komanso oopsa. Kusintha kwina kwa ma diuretics kunapangitsa kuti pakhale mankhwala amphamvu a diuretic.

    Mankhwala othandizira odwala othandizira, othandizira komanso othandizira amatha. Ndi gawo lokonza, ma diuretics amatengedwa mosalekeza, ndi mankhwala othandizira, ntchito Mlingo woyenera wa othandizira wamphamvu umasonyezedwa.

    Ngati okodzetsa amatchulidwa

    Dziwani kuti ma diuretics okha samakhala ndi vuto lililonse la matenda ashuga, chifukwa cha ichi amalimbikitsidwa kuti atengedwe limodzi ndi beta-blockers, ACE inhibitors.

    Choyamba, ndi matenda a shuga a 2, beta-blockers amalembedwa:

    • osankha komanso osasankha
    • lipophilic ndi hydrophilic,
    • ndi sympathomimetic ntchito ndipo popanda izo.

    Njira za gululi ndizofunikira kwa odwala matenda ashuga, omwe ali ndi mbiri yolephera kwamtima, matenda a mtima, munthawi yovuta kwambiri ya infaration.

    Mu matenda a shuga, okodzetsa nthawi zambiri amalimbikitsidwa kuti achepetse kuchepa kwa magazi komanso kuthetsa kutupa. Ndikofunikira kudziwa kuti si diuretic iliyonse yomwe imaloledwa kugwiritsidwa ntchito pamavuto a insulin, chifukwa chake kudzisamalira kungawononge kwambiri thanzi.

    Kutsika kwa kuchepa kwa okosijeni m'matumbo a mtima pakuthandizira okodzetsa kumafotokozedwa ndi kupumula kwa maselo am'mnyewa wamtima, kulemera kumanzere kwamitsempha, kusintha kwamphamvu kwa impso, komanso kutsika kwa kupendekera kwa mapulateni.

    Odwala ambiri omwe ali ndi vuto losakanizira kwa mitsempha yodwala amamuwonjezera thiazide diuretics kwa nthawi yayitali, koma amachititsa kuchepa kwa sodium. Nthawi yomweyo:

    1. triglycerides, cholesterol ndi glucose kuchuluka
    2. pali zoletsa kugwiritsa ntchito ma diuretics oterowo.

    Koma kafukufuku waposachedwa wakuwonetsa kuti kugwiritsa ntchito ma diuretics mu shuga kumapereka zotsatira zoyipa mthupi pokhapokha ngati mugwiritsa ntchito mankhwala okwanira.

    Mukatenga thiazide diuretics, ndikofunikira kuti odwala matenda ashuga azitha kudya masamba ndi zipatso zambiri, zomwe zimathandiza kulipirira kutayika kwa sodium, potaziyamu ndi magnesium. Muyeneranso kukumbukira kuthekera kwa kuchepa kwa chidwi cha maselo kupita ku insulin ya mahomoni. Munthawi ya chithandizo, ndikofunikira kuwongolera kuchuluka kwa shuga m'magazi, ndipo ngati ndi kotheka, kuwonjezera kuchuluka kwa diuretic.

    Kwa edema ya miyendo yokhala ndi matenda a shuga a 2, adokotala amatha kukupatsani mankhwala a Indapamide kapena a Arifon. Mankhwalawa onse sangakhudze kagayidwe kazakudya, kofunika kwambiri pamavuto a shuga. Njira inanso yoperekera chithandizo ndi ma diuretics iyi ndikuti phindu lopindulira silidalira kuchuluka kwa mankhwala, chifukwa chake mutha kumwa piritsi limodzi patsiku.

    Zodyetsa zina sizachilendo mu mtundu 2 wa matenda ashuga, chifukwa chake mutha kutenga:

    • kukonzekera kwazungulira (kokha kufulumira kwa kukakamizidwa),
    • kuphatikiza potaziyamu, kuphatikiza thiazide (kuonetsetsa kuchepetsa kwambiri kutayika kwa potaziyamu).

    Mu shuga 2, kugwiritsa ntchito mankhwala okodzetsa kumatha kubweretsa vuto losafunikira monga kuchepa kwa insulin. Zamoyo zotere zimatha kuonedwa ngakhale osagwiritsa ntchito nthawi yayitali matenda oopsa.

    Othandizira otsala omwe amapereka okodzetsa mphamvu amagwiritsidwa ntchito nthawi zambiri, pokhapokha zinthu zina zitachitika.

    Zambiri

    Diuretic diuretics zotchulidwa pa matenda a matenda oopsa mu shuga, ndi chiwindi matenda enaake ndi mtima. Kusankhidwa kwa ma diuretics othandizira ayenera kusankhidwa payekha ndi dokotala.Ndi matenda oopsa, okodzetsa a gulu la thiazide amadziwika. Amayambitsa kuchotsedwa kwa sodium m'thupi, koma nthawi yomweyo kumawonjezera triglycerides, glucose ndi cholesterol. Dozi lalikulu limachulukitsa njirayi ndipo imayambitsa ngozi mthupi. Ndikofunikira kuwongolera kuchuluka kwa shuga pochiza matendawa pogwiritsa ntchito okodzetsa.

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    Zifukwa zogwiritsira ntchito ma diuretics

    Dokotalayo amapereka mankhwala othandizira odwala matenda okodzetsa ngati izi:

    • kuthamanga kwa magazi (matenda oopsa, matenda oopsa),
    • kuwonongeka kwaimpso,
    • ascites
    • kulephera kwa aimpso
    • matenda a mafupa
    • Matenda a Liddle
    • glaucoma
    • mtima wotupa
    • matenda ammbuyo.

    Ndi chiwonetsero chantchito cha impso, okodzetsa a gulu lodyedwa amatengedwa, zomwe zimakhudza impso. Ndi ochepa matenda oopsa, thiazide okodzetsa sakhala pachiwopsezo mthupi, amachepetsa chiopsezo cha stroke.

    Mlingo wapamwamba umatha kukulitsa vuto la hypokalemia, chifukwa chake muyenera kugwiritsa ntchito mosamala komanso pokhapokha ngati dokotala akutsatira, kutsatira malangizo ake.

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    Zowopsa mu shuga

    Ntchito yayikulu ndikuchepetsa shuga m'magazi kuti ikhale yovomerezeka.

    Ndi matenda a shuga, zomwe zimayambitsa matenda oopsa zimatha kukhala zosiyana. Nthawi zambiri zimachitika ndi metabolic syndrome, yomwe imachitika isanayambike matenda a shuga 2. Nthawi zina adotolo sangapeze chomwe chimayambitsa kuwoneka kwa kuthamanga kwa magazi. Zomwe zinapangitsa kuti mukhale ndi matenda oopsa:

    • kuchepa kwa magnesium
    • kupsinjika mosalekeza komanso m'maganizo,
    • poyizoni kapena kuledzera kwamthupi chifukwa cha mankhwala a zebury, cadmium kapena lead.
    • arteriosulinosis yamitsempha.

    Kuwonongeka kwa impso kumayambitsa matenda oopsa chifukwa cha kuchotseka kwa sodium m'thupi la wodwalayo. Chozungulira chowopsa chimapangidwa: Ntchito zofooka za impso zimalipidwa ndi kuthamanga kwa magazi, komwe kumawonjezera mu re imp glulieruli. Izi zimayambitsa kufa kwa glomeruli chifukwa chothina nthawi yayitali. Kulephera kwamkati kumachitika. Ngati mankhwalawa ayamba kumayambiriro kwa matenda ashuga nephrosis, matendawa amachiritsidwa. Ntchito yayikulu ndikuchepetsa shuga m'magazi mpaka muyeso wovomerezeka.

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    Mitundu ya ma diuretics

    Matenda aliwonse amafunikira chithandizo ndi mankhwala enaake omwe amachitika mwachindunji pazomwe zimayambitsa matendawa. Mankhwala a diuretic ali ndi njira ina yochitira. Malinga ndi izi, aliyense okodzetsa aliyense ndi wa gulu linalake:

    Komanso, ma diuretics onse amagawidwa m'magulu molingana ndi mphamvu ya sodium excretion:

    • yatulutsa bwino kwambiri kuchokera pa 15% ndi kupitirira,
    • ndi mphamvu yokwanira 5-10%,
    • kuchotsa 5% kapena kuchepera thupi.

    Aliyense diuretic ali ndi cholinga chake. Ma diuretics osagwira bwino ntchito amathandizira thupi kuphatikiza ndi mankhwala ena. M'maphunziro, zidapezeka kuti kuchuluka kwa mapuloteni mumkodzo, kukwera kwake kudzakhala ndi matenda oopsa. Mankhwala othandiza kwambiri nthawi zambiri amagwiritsidwa ntchito ngati pakufunika kwakanthawi kochepa.

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    Magulu a okodzetsa

    Ma diuretics amagawika m'magulu molingana ndi momwe amakopera thupi:

    1. Loopback - chotsani madzi owonjezera pakanthawi kochepa. Izi ndi monga: "Furosemide", "Ethaconic acid" ndi ena.
    2. Thiazide diuretics - nthawi zambiri amagwiritsidwa ntchito pa matenda ashuga ndipo amawerengedwa ngati amodzi mwa mankhwala othandiza kwambiri. Chepetsani kupsinjika ndikuthandizira kuthetsa kutupira. Izi ndi monga: "Hypothiazide", "Indapamide", "Dichlothiazide".
    3. Osmotic diuretics - chotsani madzi mu nthawi yochepa kwambiri. Kugwiritsidwa ntchito pangozi zadzidzidzi. Choletsedwa kuti chigwiritsike ntchito kwa nthawi yayitali. Izi ndi monga: Urea, Mannitol, Potaziyamu Acetate.
    4. Potaziyamu woletsa kukodzetsa kumachepetsa kuwonongeka kwa electrolyte bwino, kumathandizira kuwonetsa kwa potaziyamu ndi sodium kuchokera m'thupi. Izi zikuphatikiza: Triamteren, Spironolactone.

    Zotsatira zoyipa zimachitika chifukwa chogwiritsa ntchito diuretics pochiza matenda a shuga kwa nthawi yayitali. Chifukwa chake, kuti mugwiritse ntchito bwino mankhwalawa moyenera, dokotala amayenera kupereka mankhwala pambuyo polemba mayeso onse ofunikira. Kudzipatsa wekha kungayambitse matenda oopsa, chifukwa chake amaletsedwa kuthana nawo.

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    Ndibwino kuti mukugwiritsa ntchito ma diabetes?

    Diuretic yotere imagwiritsidwa ntchito kwambiri pothandizira matenda a shuga mellitus, omwe ali m'gulu la thiazide kapena thiazoid. Ma diuretics omwe ali a thiazide ones (Dichlothiazide, Poithiazide) ndipo amatengedwa ku matenda oopsa ndi mtundu 1 wa matenda a shuga amakhala othandiza kwambiri pa Mlingo wochepa. Chimodzi mwa mankhwala othandiza kwambiri ndi Indapamide. Imakhala ndi mphamvu yokwanira, koma zinthu zazikulu zomwe zimadziwika ndi madokotala ndizosagwirizana ndi mafuta komanso chakudya.

    Nthawi zambiri, diuretics imagwiritsidwa ntchito limodzi ndi mankhwala ena.

    A diuretic monga Hypothiazide nthawi zambiri amagwiritsidwa ntchito popanga zovuta za matenda a shuga ndi kuthamanga kwa magazi. Chimodzi mwazinthu zoyipa ndizopanga mankhwala, zomwe zimakhudza kusinthana kwa shuga ndi cholesterol. Chithandizo chosalamulirika chimayambitsa matenda a atherosulinosis komanso imachulukitsa matenda omwe amayambitsa. The hydrochlorodiazide diuretic imakhala ndi zotsatira zofanana ndi hypothiazide.

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    Zothandiza pa matenda ashuga a 2

    Zolembera zamagetsi amtundu wachiwiri za shuga sizikulimbikitsidwa pamiyeso yambiri. Ma diuretics omwe ali m'gulu la thiazide ali ndi malo omwe amasokoneza kupanga insulin ndikuwonjezera kuchuluka kwa shuga. Kutenga mankhwala oterowo paokha ndizoletsedwa. An osmotic diuretic imatha kuyambitsa matenda monga hyperosmolar coma yosagwiritsa ntchito mosagwirizana.

    Mankhwala a diuretic a shuga, a gulu la potaziyamu kapena loop, saloledwa. Kusiyira limodzi ndi makonzedwe a nthawi imodzi panthawi yadzidzidzi. Ndi matenda oopsa, omwe amaphatikizidwa ndi matenda a shuga a 2, mankhwalawa amagwiritsidwa ntchito mosamala.

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    Nthawi yomweyo mankhwala okakamiza odwala matenda ashuga

    Mankhwala a diuretic a shuga amapatsidwa mankhwala ena omwe ayenera kumwedwa kuti athetse chiwopsezo cha zotsatira zoyipa za mankhwala. Ma diuretics onse okulirapo kapena ocheperako amatsuka potaziyamu wina m'thupi. Kuperewera kwa potaziyamu kumabweretsa zotsatira zosasintha. Chifukwa chake, pofanana ndi kudya kwa okodzetsa, mankhwala ochepetsa mphamvu a potaziyamu amatengedwa. Izi zikuphatikizapo mankhwala "Spironolactone." Zomwe zimapangidwira zimalepheretsa kuchepa kwa potaziyamu. Dokotala amamulembera mankhwalawa mosachiritsika panthawi yochizira matenda oopsa a shuga mellitus.

    Diuretics (diuretic mankhwala) zimakhudza ntchito ya impso, zimathandizira kuti inapita patsogolo msambo wa mkodzo kuchokera mthupi. Limagwirira ntchito mwa ndalama zoterezi ndizokhazikitsidwa ndi kuthekera kwolepheretsa kuyamwa kwa ma elekitiromajeni mu aimpso. Ndi kuwonjezeka kwa kuchuluka kwa ma electrolyte otulutsidwa, madzi ena amathandizidwa.

    Diuretic yoyamba idawonekeranso zaka za m'ma 1800, pomwe adadziwika za mankhwala a zebury, omwe amagwiritsidwa ntchito kwambiri pochiza syphilis. Komabe, pochiza matendawa, mankhwala enaake a zebelo sanadziwonekere mwanjira iliyonse, koma zotsatira za kuwonekera kwa thupi la munthu zidapezeka.

    Pambuyo kanthawi, kukonzekera kwa mercury kunasinthidwa ndi mankhwala oopsa komanso oopsa.Kusintha kwina kwa ma diuretics kunapangitsa kuti pakhale mankhwala amphamvu a diuretic.

    Mankhwala othandizira odwala othandizira, othandizira komanso othandizira amatha. Ndi gawo lokonza, ma diuretics amatengedwa mosalekeza, ndi mankhwala othandizira, ntchito Mlingo woyenera wa othandizira wamphamvu umasonyezedwa.

    Mawonetsero olakwika a okodzetsa

    Sonyezani shuga yanu kapena sankhani jenda kuti mulimbikitsidwe

    Ma diuretics a matenda ashuga a 2 nthawi zina amachulukitsa kuchuluka kwa uric acid m'magazi. Chifukwa chake, odwala omwe adapezanso ndi gouty nyamakazi amatha kuwona kuwonongeka muumoyo.

    Othandizira a gulu la thiazide, mwachitsanzo, mapiritsi a Hypothiazide, Hydrochlorothiazide, amatha kuyambitsa zovuta, zomwe zimawonetsedwa ndi mutu, kufooka, kutsegula m'mimba, kutsukidwa, kumva kupweteka pamlomo wamkamwa.

    Ndi kusalinganika kwa ayoni kumachitika:

    1. Anachepetsa libido mwa amuna,
    2. arrhasmia,
    3. kufooka kwa minofu
    4. zotupa
    5. spasms mu chigoba minofu.

    Kugwiritsa ntchito diuretic Furosemide kumachepetsa kuchuluka kwa magnesium, calcium, potaziyamu, komanso kukodza pafupipafupi. Izi, zimayambitsa kuchepa kwa kumva, paresthesia.

    Otsutsana ndi Aldosterone adzayambitsa mutu, kukhumudwa, kusanza, kutsegula m'mimba, zotupa za pakhungu, gynecomastia. Amayi odwala matenda ashuga omwe ali ndi mlingo wochepa, kusamba kwa msambo komanso hirsutism zitha kuonedwa.

    Mankhwala Dibicor

    Dibicor ndi chida chatsopano chothandizira kukonza kagayidwe kamatenda, kamene kamakhudzanso diuretic. Piritsi limodzi lili:

    • taurine
    • cellcrystalline mapadi,
    • kukhuthala
    • zinthu zina.

    Malangizo ogwiritsira ntchito akuwonetsa kuti, ngati atagwiritsika ntchito kwa nthawi yayitali, wodwala matenda ashuga amawonetsa kusintha kwakukulu pamkhalidwe wake, kufalikira kwa magazi ake m'ziwalo zooneka msanga.

    Dibicor mu Mlingo wocheperako amathandizira kuchepetsa zoyipa zomwe zimachitika pakugwiritsa ntchito mankhwala ena pakutseka njira za calcium. Kuphatikiza apo, pali kuchepa kumverera kwa chiwindi kwa othandizira.

    Kwa odwala matenda ashuga, palinso kuphatikiza kwa kugwiritsa ntchito Dibicor - muyezo waukulu, kwa masiku 14, kumachepetsa kuchuluka kwa shuga m'magazi.

    Ndikofunikira kutenga Dibicor pakamwa ndi madzi okwanira opanda mpweya. Mlingo weniweni umatengera:

    1. mtundu wa matenda ashuga
    2. kuuma kwake.

    Ngati munthu ali ndi mbiri yodwala matenda a mtima kapena kulephera kwa mtima, ndikulimbikitsidwa kumwa 250-500 mg wa yogwira patsiku mphindi 15 musanadye. Kutalika kwa chithandizo ndi mwezi umodzi. Ngati ndi kotheka, mlingo umasinthidwa. Nthawi zina matenda a shuga amathandizidwa ndi Dibicor 1.5 miyezi.

    Mu shuga mellitus wa mtundu wachiwiri, Dibicor amatengedwa mu mlingo wa 500 mg kawiri patsiku, amatha kuchotsa owonjezera madzi m'thupi pokhapokha ngati amagwiritsidwa ntchito limodzi ndi othandizira a hypoglycemic.

    Hypercholesterolemia yolimbitsa thupi ikafika, ndikokwanira kumwa kamodzi pamankhwala kuti muchepetse magazi. Ndemanga zambiri za odwala zimatsimikizira zabwino za mapiritsi omwe ali kale sabata yachiwiri kapena yachitatu ya maphunzirowa.

    Msika wogulitsa mankhwala ukhoza kupereka mitundu ingapo ya Dibikor, pakati pawo mankhwala azitsamba. Mtengo wa analogues ungasiyane kutengera wopanga, kuchuluka kwa taurine, zinthu zina.

    Ma fanizo odziwika a mankhwala:

    • Mildrazine
    • Kapikor,
    • Taufon
    • Mildronate Mildronate amagwiritsidwa ntchito makamaka pa matenda a shuga a 2.

    Zofananira zachilengedwe za diuretic mankhwala ziyenera kudziwika tincture wa maluwa ndi masamba a hawthorn.

    Fure okodzetsa

    Ndi matenda a shuga a 2, simungagwiritse ntchito ma diuretics okha, komanso mankhwala achikhalidwe.Komabe, musanagwiritse ntchito, muyenera kufunsa dokotala, izi zidzakuthandizani:

    1. khazikitsani mlingo wake
    2. yang'anani malonda kuti agwirizane ndi mankhwala ofunikira.

    Nthawi zambiri, madokotala amalimbikitsa udzu kutsokomola, umagwiritsidwa ntchito mwa mawonekedwe atatu katatu patsiku kwa supuni ziwiri. Ndiwothandiza kwambiri kumwa mankhwala oterowo limodzi ndi malo osamba nthawi zonse. Njirayi imachitika bwino nthawi yogona.

    Kuchotsa madzi ochulukirapo m'thupi kumatha kuchitika mwa kudya wakuda wakuda, womwe umapangidwanso. Zofanana zimasiyanasiyana muzu wakuda wa elderberry. Mapepala a Blueberry ali ndi diuretic ndi tonic effect, chida chimagwiritsidwa ntchito kutulutsa njira zonse mu ziwalo za odwala matenda ashuga.

    Kusintha magwiridwe antchito, masamba owoneka bwino ndi odana ndi michere amatha kukhala ndi diuretic. Muzu wa Ginseng umathandizira kukulitsa mphamvu za matenda ashuga komanso kukhazikitsa bata. Chida ichi chimawonedwa kuti ndizothandiza kwambiri kwa matenda ashuga amtundu uliwonse.

    Njira zothandizira odwala matenda ashuga zimayesedwa kwa nthawi yayitali, ambiri mwa magawo awo amadziwika ndi mankhwala ovomerezeka ndipo amagwiritsidwa ntchito kuti athetse vuto la metabolic syndrome. Ndizosavuta kuti zitsamba ndi ma decoctions amaloledwa kumwa pamodzi ndi antidiabetesic ndi mankhwala ena. Zokhudza izi komanso za njira zatsopano zochizira matenda ashuga - mu kanema munkhaniyi.

    Sonyezani shuga yanu kapena sankhani jenda kuti mulimbikitsidwe

    Home »Chithandizo» Mankhwala » Kuchokera pa matenda ashuga ndi matenda oopsa - ndi ma diuretics otani omwe angatengedwe ndipo ndi chiyembekezo chotani kwa iwo?

    Ma diuretics adawonekera m'zaka za zana la 19, koma adagwiritsidwa ntchito koyamba kutsitsa magazi mu 60s ya zaka zapitazi.

    Kukula kwa diuretics kumachitika chifukwa cha impso ntchito mwanjira yoti imathandizira njira ya mkodzo kuchokera mthupi.

    Ngati kugwiritsa ntchito okodzetsa pochiza matenda am'mitsempha yamagazi ndi mitsempha yamagazi (limodzi ndi kuthamanga kwa magazi) sikukayikira, ndiye kuti kugwiritsa ntchito mankhwala othandizira odwala matenda ashuga ndi kuthamanga kwa magazi kuyenera kufikiridwa mosamala, pokambirana ndi dokotala. Pali magulu anayi a ma diuretics, omwe tikambirana mwatsatanetsatane.

    Mitundu ya okodzetsa omwe amagwiritsidwa ntchito mu shuga ndi matenda oopsa

    Loop diuretics (mankhwala omwe amachulukitsa kuchuluka kwa mapangidwe a mkodzo) ndiye wolimba kwambiri pazakumwa zonse zogwiritsidwa ntchito pakuchita kuchipatala.

    Mankhwala oterewa amagwiritsidwa ntchito nthawi zambiri pa edema yamavuto osiyanasiyana komanso matenda oopsa. Dzinalo la gululi limachokera ku chakuti gawo lalikulu lakuwalimbikitsa limapezeka m'chiuno cha Henle - malo omwe madzi amabwezedwanso m'thupi.

    Furosemide kuzungulira okodzetsa

    Vutoli limachitika chifukwa cha “chopinga” cha kubwezeretsanso, kuthira madzi ndi kupanga mkodzo mwachangu, pomwe thupi limachotsa madzi ndi mchere. Mukamagwiritsa ntchito zida zodukiza, kumasuka kwa minofu yosalala ya mitsempha yamagazi ndi kuwonjezeka kwa magazi a impso kumachitika.

    Kuphatikiza pa matenda oopsa, mankhwalawa amatha kuikidwa pa matenda a ubongo, hypercalcemia, kulephera kwa mtima, poyizoni ndi magulu ena a ziphe ndi kulephera kwaimpso. Zokonzekera zimapezeka mwanjira ya mapiritsi kapena ma ampoules a jakisoni. Chithandizo chodziwika bwino m'gululi ndi Furosemide.

    Mtundu wamtundu wa mankhwala sioyenera kuthandizira matenda oopsa mu shuga. Kungogwiritsa ntchito kamodzi kokha pochepetsa kupweteka kwambiri.

    Thiazide okodzetsa amapanga gulu lina la mankhwala omwe ali ndi mankhwala okodzetsa, omwe ali ndi vuto limodzi.

    Zinthu za mankhwala zimasiyana mu mphamvu ndi nthawi yayitali.

    M'mayiko ambiri padziko lapansi, mankhwala omwe ali ogulitsawa ndi okwera mtengo kwambiri: amawagulitsa m'mafakitala popanda mankhwala ndipo ali ndi mitengo yotsika mtengo. Othandizira a Thiazide samagwiritsidwa ntchito pongothandiza matenda oopsa, komanso kuwonjezereka kwa kutaya mtima, komwe kumakhala chifukwa cha chiwindi, mtima kapena kulephera kwa impso.

    Kalasi ya diuretic iyi idapezeka mkatikati mwa zaka zapitazi. Liazide diuretics imakhala ndi tanthauzo la "kawiri": onse ndi mankhwala komanso mamolekyulu apadera omwe ali ndi mawonekedwe apadera.

    Komabe, pali mankhwala angapo omwe ali ndi vuto lofananalo, kutengera zomwe palibe mamolekyulu a thiazide kuchokera ku lingaliro la mankhwala.

    Pazifukwa izi, thiazide ndi thiazide-monga okodzetsa ayenera kusiyanitsidwa. Omalizawa akuphatikizapo Metolazone ndi Chlortalidone.

    Mwina chinsinsi chodabwitsa kwambiri cha gulu ili la mankhwalawa ndi njira yothandizira odwala yomwe ili ndi thupi. Kufikira pamapeto pake, mapangidwe a thiazides sanaphunzire. Zimadziwika mosakayikira kuti zinthu zofunikira zikafika mthupi la munthu, njira zopangira mkodzo zimathandizira, mtima wake ndi kuchuluka kwa madzi m'magazi kumachepetsedwa.

    Mtundu wa thiazide okodzetsa umagwira kwambiri ku matenda oopsa, omwe amayamba chifukwa cha matenda osokoneza bongo.

    Pogwiritsa ntchito thiazide diuretics kwa nthawi yayitali, "kupumula" kwa minofu yosalala ya ziwiya kumawonedwa, komwe kumapangitsa kuchepa kwa kukana kwamphamvu. Omalizirawo amatenga gawo lofunikira polimbana ndi matenda oopsa.

    Mitundu yonse ya mankhwala a thiazide amatha kugawidwa m'magulu awiri:

    • zotumphukira za chlorobenzamide ndi quinazolinone,
    • zotumphukira za benzothiadiazine ndi phthalimidine.

    Oyimira gulu loyamba ali ndi mawonekedwe: iwo pamlingo uliwonse wa kulephera kwa impso amakhala ndi mphamvu yokodzetsa.

    Malinga ndi chikhalidwe chawo pakupanga mankhwala, kukonzekera kwa gululi kumakumbutsa kwambiri zida zotentha.

    Zina mwazotsatira zoyipa ndizomwe zimachitika chifukwa chosagwirizana, kusabala, dermatitis, hyperglycemia, paresthesia, kapamba, cholecystitis, kupweteka komanso kupsinjika pamimba.

    Mitundu yodziwika kwambiri ya thiazide ndiyophatikizira:

    • Clopamide
    • Indapamide,
    • Chlortalidone
    • Hydrochlorothiazide,
    • Metolazone
    • Quinetasone.

    Osmotic

    Osmotic diuretics imapangitsa kuchotsedwa kwa madzimadzi kuchokera kumankhwala am'minyewa pakuchepetsa kuthamanga kwa magazi. Chifukwa cha izi, kuthamanga kwa magazi kumangowonjezera kwete mu zovuta, komanso mu nephrons.

    Yotsirizirayi imabweretsa kusinthika kwa kusefedwa kwa zinthu mu ziwalo zothandizirana ziwalo. Mofananamo, kubwezeretsanso kwamphamvu kwa sodium ndi chlorine pakukwera kwa bondo la Henle kumachepa.

    Osmotic diuretics nthawi zonse amathandizira kudzera m'mitsempha. Pakati pawo, wamba:

    Zotsirizira zimayikidwa nthawi zambiri chifukwa cha zotsatira zazitali. Awiri oyambayo amadziwika ndi kufooka, kwakanthawi kochepa.

    Gulu lama diuretics limasungunuka bwino m'thupi ndipo limayamba kudziunjikira. Chifukwa chake, kusinthidwanso kwa madzi ndi sodium ion kumasokonekera, zomwe zimapangitsa kuti achotsedwe m'thupi. Pamodzi ndi iwo, mankhwalawa nawonso amawachotsa.

    Mwa zina zoyipa tikhoza kuzimva mutu, nseru, kukha magazi, minofu necrosis pamene mankhwalawo salowa m'mitsempha, koma pansi pa khungu. Mankhwala osokoneza bongo a gululi sakhazikitsidwa osati kokha chifukwa cha matenda oopsa, komanso poizoni, kuchepa kwa Hypovolemic komanso prophylactic kwa anuria.

    Sizoletsedwa kutenga osmotic diuretics pakulephera kwa mtima.

    Mwakutero, mtundu uwu wa mankhwala ungagwiritsidwe ntchito kwa matenda ashuga, koma ali ndi kanthawi kochepa. Njira yayitali ya chithandizo nthawi zambiri siyimasankhidwa, chifukwa ndi yoyenera kugwiritsa ntchito kamodzi.

    Kuteteza potaziyamu

    Makina a zochita za potaziyamu osokoneza bongo ali ndi gawo limodzi lodziwika: amasunga potaziyamu m'thupi, omwe amatsatira dzina la gulu la mankhwala.

    Mankhwala amathandizira kwambiri maselo akuluakulu a distal tubule ya nephron.

    Kuwonekera kwa mfundo kumapangitsa kuti muchepetse kusamutsa kwa potaziyamu kupita ku maselo ndipo potero amatchinga kutuluka kwawo limodzi ndi mkodzo. Potaziyamu ndi chinthu chofunikira kwambiri mthupi. Kuphatikiza apo, kupulumutsidwa kwake ndikofunikira kwambiri kwa anthu omwe ali ndi vuto la hypokalemia, lomwe limatsagana ndi kuchepa kwa kuchuluka kwa ions ya potaziyamu m'madzi a m'magazi.

    Potaziyamu yosungirako diuretics imalembedwa osati kokha kwa odwala matenda oopsa, komanso mankhwalawa matenda osowa a adrenal cortex, gout, mtima kulephera komanso kuthetsa edema pakulepheretsa kupanga kwa adrenal mahomoni.

    Potaziyamu yosawononga okodzetsa imadziwika ndi kufooka thupi, ndichifukwa chake mankhwalawa amawonedwa ngati osagwira ntchito.

    Pachifukwachi, samadziwika ngati maziko a chithandizo, ndipo nthawi zambiri amakhala ngati mankhwala othandiza. Ngati mukumwa mankhwalawo palibe kusintha kwamthupi komwe kumayang'aniridwa konse, ndiye kuti mankhwalawo sayenera kupitilizidwa.

    Mankhwala amangoyimitsidwa kapena “ndi inertia” amapitilizidwa kwakanthawi kuti atsimikizire kulephera kwa mankhwalawa. Mwa njira, mankhwalawa amawonedwa ngati osagwira ntchito mosayenera. Ndiwosungika kwambiri pakati pa okodzetsa, chifukwa chake, kutengeka kwake "kumakupangitsani kuti mudikire."

    Potaziyamu yosagwiritsa ntchito shuga mu shuga imawonedwa ngati yopanda pake chifukwa cha chiwopsezo chachikulu cha zotsatirapo zake zoyipa.

    Zofooka zochepa zimakhala chifukwa chakuti mankhwalawa amatsutsana ndi aldosterone. Aldosterone ndi mahormoni akuluakulu a adrenal cortex, omwe amathandizira molingana ndi mulingo wamadzi amthupi. Ma diuretics ali ndi mphamvu yolepheretsa mahomoni awa.

    Aldosterone ndi yoletsedwa ndi ma aligorivimu awiri:

    • imathandizira kuyendetsa ma ayoni a sodium,
    • "Zoletsa" kupanga kwa timadzi tambiri, timene timagwira mosiyanasiyana monga momwe sodium umatulutsidwira mkodzo, ndipo potaziyamuyo amadzuka.

    Potaziyamu yosunga diuretics imangolembedwa osati kokha ndi mavuto ndi kuthinikizidwa, komanso kuti muchepetse kutupa ndi kuchotsa madzi ambiri.

    Pazifukwa izi, mankhwala amtunduwu amaperekedwa ngakhale kwa amayi apakati omwe ali omaliza.

    Mankhwalawa mulinso mndandanda wazotsatira zoyipa, kuphatikiza mseru, kusanza, chizungulire, kutsekula m'mimba, kuchepa kwa msambo, kusanza, kugona, kutopa ndi kukhumudwa.

    Potaziyamu yosunga diuretic Veroshpiron

    Mndandanda wa mankhwala othandiza kwambiri poteteza potaziyamu ndi awa:

    Ndi mankhwala ati omwe amagwiritsidwa ntchito bwino?

    Ma diuretics ochokera ku kalasi ya thiazide ndi thiazide-ngati amadziwika kuti ndi gulu la "opita patsogolo" kwambiri okodzetsa, omwe samayambitsa mavuto ambiri ndipo amatha bwino pochotsa kutupa ndikuchepetsa magazi.

    Gulu la osmotic limatha kupangitsa kuti mkodzo uchoke mu maola ochepa, koma zotsatira zake ndizakanthawi. Kwa chithandizo chakanthawi yayitali, ndi chosakwanira ndipo chimagwiritsidwa ntchito pokhapokha ngati pakufunika kuchepetsa mwachangu kapena kuchepetsa kupanikizika.

    Mankhwala osokoneza bongo a Potaziyamu amaonedwa kuti ndi otha ntchito, amatha kuyambitsa mavuto ambiri, kotero amangogwiritsidwa ntchito ngati othandizira pochita matenda oopsa. Loop okodzetsa bwino amatha kupirira kuchepetsa.

    Kuchita kwawo ndikwachilengedwe komanso kumachepera m'chiuno cha Henle. Gulu la mankhwala amaonedwa kuti ndi diuretic yamphamvu, motero kugwiritsa ntchito nthawi yayitali sikulimbikitsidwa.

    Njira ya mankhwala, ndipo, motero, mtundu wa okodzetsa uyenera kutumizidwa ndi katswiri wazachipatala.Ndi dokotala yekhayo amene angasankhe mankhwala oyenera ochizira wodwala wina, poganizira mawonekedwe a thupi lake.

    Makanema okhudzana nawo

    Kodi ndimotani momwe mungachiritsire matenda oopsa mu shuga? Mayankho mu kanema:

    Mwa njira, awa omwe mankhwalawa amatha kutengedwa ngati prophylaxis yotsutsana ndi matenda osokoneza bongo. Mukamamwa mankhwala osmotic, muyenera kusamala kwambiri kugwiritsa ntchito mankhwala ena. Gulu lokhalo la okodzetsa lokha ndi lomwe limapangitsa chotchinga cha magazi kulowa mu mankhwala ena, omwe angayambitse kutaya magazi.

    Ma diuretics a matenda a shuga a mellitus (DM) amagwiritsidwa ntchito makamaka pochiza matenda ogwirizana (AH), kulephera kwa mtima, kapena kuthetsedwa kwa edema yodwala mwendo. Pakadali pano, pali mitundu yambiri yamankhwala omwe angakulitse diuresis (kuchuluka kwa mkodzo wothandizidwa).

    Komabe, nkovuta kunena mosatsimikiza kuti ndi uti wabwino koposa. Chithandizo chilichonse chimakhala ndi mphamvu ndi zolephera zake ndipo kwa odwala ena amatha kuwonetsa kapena kuletsa.

    Diuretic ndi matenda ashuga

    Ma diuretics omwe amagwiritsidwa ntchito pa matenda a shuga amadziwika kuti ndi amodzi mwa mankhwala othandiza kwambiri antihypertensive. Koma muyenera kukumbukira kuti ndi matenda oopsa, omwe amaphatikizidwa ndi matenda osokoneza bongo, ndikofunikira kumwa mosamala mankhwalawa.

    Mutha kuzigwiritsa ntchito moyang'aniridwa ndi dokotala. Diuretics olondola aimpso ntchito ndipo amakhudza kwamikodzo poizoni kuchuluka.

    Diuretics (diuretics) zochizira matenda oopsa mu shuga

    Ma diuretics (okodzetsa) ndi amodzi mwa magulu ofunikira kwambiri a antihypertensives chifukwa chogwira ntchito kwambiri, kulolerana kwabwino pamtengo wotsika kapena wotsika mtengo. Pakadali pano, ndi matenda oopsa a arterial, makamaka thiazide (hypothiazide, hydrochlorothiside, etc.) ndi thiazide-like (indapamide, chlortalidone, xipamide) okodzetsa amagwiritsidwa ntchito, zomwe zimagwirizanitsidwa ndi kuwonjezeka kwapadera mumkodzo wa sodium.

    Loop diuretics (furosemide, etc.) siigwiritsidwa ntchito kwa nthawi yayitali pochita matenda oopsa, koma amawonetsedwa kwa odwala omwe amachepetsa mphamvu yaimpso m'malo mwa thiazide diuretics. Potaziyamu yosawononga okodzetsa (triamteren, etc.) ataya kwambiri kufunika kwa mankhwalawa.

    Mpaka posachedwa, thiazide diuretics yochizira matenda oopsa a shuga a 2 mtundu akhala akugwiritsidwa ntchito pang'ono chifukwa chokhoza kuchepetsa mphamvu zama cell insulin, kuchuluka kwa glucose, komanso cholesterol ndi triglycerides m'magazi.

    Komabe, zidapezeka kuti zotsatirazi zimachitika pokhapokha ngati pali kugwiritsa ntchito mankhwala yayitali nthawi yayitali, ndipo Mlingo wocheperako samakhudza kagayidwe kazakudya ndi lipid metabolism. Liureide ngati Thiazide ndi thiazide samachotsa sodium kokha, komanso potaziyamu, komanso magnesium kuchokera m'thupi.

    Kuchulukitsidwa kwa zakudya zamafuta a potaziyamu ndi magnesium (zipatso zatsopano ndi zouma ndi zipatso, masamba, mbatata yophika, oatmeal ndi buckwheat, etc.) kumalepheretsa kuti thupi liwonongeke ndi mcherewu. Mukatenga mapiritsi a thiazide osakanikirana ndi potaziyamu (triampur, triamco), zotayika za potaziyamu ndizochepa.

    Thiazide-ngati diuretics, yomwe imakhudza pang'ono kagayidwe kazakudya ndi lipid metabolism, amalimbikitsidwa kuphatikiza matenda oopsa komanso mtundu wa 2 matenda a shuga, ngakhale kuti utsogoleri wa insulin ungakulitse kufunika kwa insulini. Mankhwala oyamba kusankha ndi indapamide retard (arifon), amene amatengedwa kamodzi patsiku.

    Ma diuretics amatsimikizira kuti achepetse kuthamanga kwa magazi mu shuga

    Zotsatira zoyipa za metabolism za mankhwala okodzetsa ndi vuto lofunika kwambiri.Makamaka, chifukwa cha chiwopsezo cha matenda a shuga, omwe mu maphunziro osiyanasiyana omwe amapezeka mu 25-30% ya milandu, Mlingo wa mankhwala ogwiritsira ntchito pakadali pano umatsika kwambiri poyerekeza ndi omwe amagwiritsidwa ntchito pakuphunzira bwino kwawo m'mbuyomu.

    Kuphatikiza apo, kuphatikiza kuli ndi mwayi kuti pakuphatikiza uku ndikusakanikirana kwa zotsatira zosafunikira za mankhwalawa mokhudzana ndi shuga ndi potaziyamu, ndiye kuti, kafukufuku wa PATHWAY3, zinali zopindulitsa kawiri kwa odwala omwe akutenga nawo mbali.

    Kafukufuku wa PATHWAY3 anathandizidwa ndi a Britain Heart Foundation ndi National Institute for Health Research. Munaphatikizanso odwala omwe samawerengetsa matenda oopsa (magazi a systolic> 140 mmHg), omwe amatha kupatsidwa mankhwala a diuretic.

    Ophunzira adalinso ndi gawo limodzi lowonjezera la metabolic syndrome. Odwala okwanira 440 anali osasankhidwa kuti 10-20 mg amiloride, kapena 5-10 mg amiloride ndi 12-25-25-25 mg GHTZ, kapena 25-50 mg GHTZ. Mapeto ake oyamba anali kusuntha kwa zotsatira za kuyesedwa kwa mayeso a 2-glucose a 2-maola kuyerekeza ndi koyambirira.

    Mosiyana ndi izi, kuphatikiza kwa amiloride ndi HCTZ kunapangitsa kuti shuga asagwiritsidwe ntchito maola 2 (kusiyana poyerekeza ndi HCTZ pambuyo pa masabata 24 kunali 0.58 mmol / L). Ponena za kuthamanga kwa magazi, mankhwalawa onse mu mlingo wonse amachepetsa ndi 14 mmHg. Art., Koma motsutsana ndi kumbuyo kwa kuphatikiza kwa amiloride / GHTZ, kuchepa kowonjezereka kwa 3.4 mm RT kunapezeka. Art.

    Ndikofunikira kuti izi zisachitike chifukwa chakuchepa kwa chitetezo, osagwirizana ndi potaziyamu. Palibe wodwala yemwe anali ndi kuchuluka kwa potaziyamu pamwamba pa 5.8 mmol / L, ngakhale munthawi yomweyo kugwiritsa ntchito ACE inhibitors kapena angiotensin receptor blockers.

    Pothirira ndemanga zomwe zapezedwa, olemba ntchitoyi akuti, malinga ndi momwe iwo akuonera, ndikofunikira kusiya malingaliro omwe akhazikitsidwa kuti thiazide diuretics angagwiritsidwe ntchito kokha mu Mlingo wotsika. Lingaliro ili silinangotengera kuti kuchuluka kwa ma thiazides omwe amagwiritsidwa ntchito tsiku ndi tsiku ndiotsika kuposa omwe ntchito zawo zatsimikiziridwa mu mayeso azachipatala, komanso chifukwa choti zoyeserera zambiri zamankhwala, makamaka aku Britain, zimaganizira za thiazide diuretics zomwe zimakondedwa, komanso kuchepetsa mphamvu yawo yopangira mankhwala.

    Kafukufuku wa PATHWAY3 adapeza kuti pali njira yothandizira onse kupewa chiopsezo cha matenda ashuga ndikukwaniritsa kuthamanga kwa magazi. Ndizotheka kuti kuphatikiza kwa amiloride ndi GHTZ ndizoyenera makamaka kwa odwala omwe ali ndi insulin kukana kapena metabolic syndrome.

    Gulu la mitundu - mitundu ya ma diuretics

    Ma diuretics amakono okodzetsa - chimodzi mwazabwino kwambiri zamankhwala amkati pazaka 25 zapitazi. Pochita nephrological, zotsatirazi Magulu anayi a okodzetsa:

      thiazide diuretics (benzothiazidine zotumphukira - thiazides), malupu okodzetsa - furosemide ndi ethacotic acid, potaziyamu osasamala okodzetsa, osmotic diuretics.

    Ma diuretics ena apakale samagwiritsidwa ntchito ngati matenda a impso chifukwa cha nephrotoxicity (zebulamu diuretics) kapena chifukwa chosakwanira (theophylline, ammonium chloride).

    Thiazide okodzetsa

    Gulu la thiazide la okodzetsa - hypothiazide (dichlothiazide, hydrochlorothiazide), cyclumbazide ndi ena akuletsa kudziwikanso kwa sodium m'chigawo cha cortical cha nephron. Mphamvu ya kukodzetsa imayamba mkati mwa 1 - 2 maola, kumatenga maola 10 - 12 kapena kupitilira, motero ndibwino kumwa mankhwalawa m'mawa.

    Mphamvu ya saluretic ya gululi la okodzetsa imakhala yochepa, pafupifupi 10% ya sodium yosefera amasulidwa. Komabe, ngakhale atasintha modabwitsa, mankhwalawa ali ponseponse, popeza ndi osavuta kugwiritsa ntchito, amakhala ndi vuto lofuna kudziwa zambiri, komanso amasinthanso njira ya nephrogenic shuga insipidus ndi idiopathic hypercalciuria.

    Localization wa zochita za diuretic mankhwala mu nephron

    Zotsatira zoyipa za thiazide diuretics:

      Kuchulukitsa kuchulukitsidwa kwa potaziyamu ndi kusintha kwa hypokalemia, nthawi zina kagayidwe kachakudya, kuwonjezera kuchuluka kwa calcium mu mkodzo - kuonjezera zomwe zili mu seramu (ichi ndiye maziko awo ogwiritsira ntchito mankhwalawa a idiopathic hypercalciuria) Kuchepetsa (kusinthika) kwa chidziwitso cha thupi. zomwe zimatsogolera ku hyperglycemia, komanso matenda oopsa a shuga (chifukwa chake kugwiritsa ntchito matenda ashuga a shuga). Kulephera kwamkati kumatha kukulira, motero, ndi kulephera kwakamaimpso, kugwiritsa ntchito mankhwalawa kumatsutsana. Zotsatira zoyipa za okodzetsa zimaphatikizapo milandu ya kapamba, matupi awo sagwirizana ndi photosensitivity kapena necrotic angiitis.

    Ma loop olemba mitundu

    Furosemide imakhumudwitsa momwe yogwiritsidwanso ntchito kwa chlorine, imagwira makamaka m'chigawo chokweza cha nephron, komanso (mumadontho waukulu) mu proximal tubules. Ili ndi mwachangu, kwakanthawi kochepa komanso kotchedwa diuretic effect, 20-30% ya sodium yosefa imatulutsidwa mu mkodzo.

    Ngakhale mutamwa mankhwalawo mkati, amkamwa mwachangu komanso mokwanira. Mphamvu ya diuretic imayamba pasanathe ola limodzi pambuyo pa utsogoleri, mwachangu (mu mphindi 15 - 20) imakhala yayitali ndipo imatha kwa maola 4. Pambuyo pakukonzekera kwa mtsempha wamkati, mawonekedwe a diuretic amadziwika kwa mphindi zingapo ndikusowa pambuyo pa maola awiri.

    Kuphatikiza pa kuchiza matenda a edematous, izi zimadukiza mtundu wa diuretic zimagwiritsidwanso ntchito kwa pachimake tubular necrosis kupewa (kapena kuthetsa) anuria. Mukamamwa mankhwalawo mkati, mlingo woyambirira ndi 20 - 40, wokwera ndi 400 - 600 milligrams, wokhala ndi Mlingo wovomerezeka, ndalamazo zimachokera pa 20 mpaka 1200 milligram.

    Mosiyana ndi thiazides, furosemide pang'ono imachulukitsa kusefedwa, motero ndi njira yosankhira kulephera kwa aimpso. The diuretic nthawi zambiri imalekeredwa. Pogwiritsa ntchito nthawi yayitali, hyperuricemia imatha kukhala gout, kugontha (makamaka mukamamwa maantibayotiki nthawi imodzi), thrombocytopenia.

    Hyperglycemic zotsatira ndizosatheka. Osowa kawirikawiri (akamamwa maantibayotiki ku gulu la cephalosporin), ntchito ya impso imatha kusokoneza. Mosiyana ndi thiazides, zingayambitse kuchepa kwambiri kwa sodium chloride ndi kukula kwa hyponatremia. Ethaconic acid (uregitis) ndi mtundu wina wotseka wamtundu wina womwe umagwira chimodzimodzi furosemide, ngakhale uli ndi mitundu yosiyanasiyana ya mankhwala.

    Chiwopsezo cha diuresis chimachitika patatha maola 2 mutatha kumwa mankhwalawa mkati, mphamvu ya kukodzetsa imayima pambuyo maola 6 - 9. Perekani mkati, kuyambira ndi mapilogalamu 50 (piritsi limodzi), ndikuwonjezera mlingo wa tsiku ndi tsiku mpaka 200 mg ngati kuli kotheka. Imwani mankhwala mukatha kudya. Hyperuricemia ndi zotsatira zoyipa za okodzetsa. Nthawi zina, ugonthi umayamba, nthawi zambiri sukusintha (makamaka pakumwa mankhwalawo ndi maantibayotiki).

    Kuphatikiza kwakukulu

    Popeza makina ochitira zinthu zamagulu osiyanasiyana a okodzetsa sakhala omwewo, ayenera m'malo mwake ngati osagwira ntchito ndi wina kapena palimodzi. Kuphatikiza kotsatiraku koyenera ndi njira zamankhwala zingalimbikitsidwe. Proximal action saluretics iyenera kuphatikizidwa ndi othandizira oteteza potaziyamu.

    Mutha kuphatikiza mankhwala osokoneza bongo komanso kutseka.Chifukwa chake, furosemide, yomwe idayambitsidwa nthawi yayikulu diuresis yoyambitsidwa ndi thiazides, imawonjezera diuresis (nthawi yomweyo, thiazides samachulukitsa diuresis yoyambitsidwa ndi furosemide). Thiazides amatha kupititsa patsogolo mphamvu ya ethacrine acid - furosemide alibe malo awa).

    Eufillin wothandizidwa pang'onopang'ono amatha kupititsa patsogolo mphamvu za natriuretics akaperekedwera pamtunda wa kukwera kwa diuresis (mwachitsanzo, mphindi 30 mutatenga furosemide kapena ethacrine acid.

    Kuphatikiza koopsa kwa okodzetsa

    Ndikofunikira kukumbukira kuphatikiza kowopsa kwa ma diuretics ndi mankhwala ena. Kuphatikiza kwa ethaconic acid kapena furosemide ndi kanamycin, gentamicin, streptomycin kungayambitse ugonthi. Kuphatikiza kwa ethaconic acid kapena furosemide ndi cephaloridine ndi nephrotoxic.

    Ndi kuphatikiza kwa diuretics ndi acetylsalicylic acid, katulutsidwe wake umasokonekera impso. Ngati ma diuretics ndi calcium akukonzekera nthawi imodzi, hypercalcemia ikhoza kukhala. N.E. de Wardener (1973) akuvomereza kutsatira kutsatizanaku kwotsatira kwa okakamiza:

      kuti muchepetse potaziyamu mu mkodzo, mankhwalawa amayenera kuyamba ndi veroshpiron kapena triamteren, okodzetsa thiazide ayenera kuphatikizidwa pambuyo masiku 2 mpaka 3, ngati thiazides sangathe, m'malo mwake ndi furosemide kapena ethaconic acid. Iwonjezereni mankhwalawa furosemide tsiku lililonse mpaka isanayambike diursis kapena kufikira ma miliyoni 4000 mamililita tsiku lililonse, ngati diuresis sizichitika, pitilizani kumwa furosemide (gawo lina la mankhwalawa limaperekedwa kudzera mu mtsempha), pomwe mukuchulukitsa magazi ochulukirapo pakubwera kwa albumin kapena dextran yopanda mchere. Zotulukazo zimathekera kwambiri ngati mannitol imathandizidwa. Wodwala ayenera kulemedwa tsiku lililonse. Izi zimapereka lingaliro labwino kwambiri la kuchuluka kwa madzi kuposa muyeso wa diuresis ndi madzi omwe mumamwa. Ndi kutha kwa edema, okodzetsa aletsedwa.

    Chithandizo cha diuretic

    Mukamapereka mankhwala okodzetsa, mfundo zotsatirazi ziyenera kukumbukiridwa (mwapadera tazinena kale).
    Izi zimatha kuyambitsa hypokalemia ndi metabolic alkalosis. Ngati loop-mtundu diuretic yakhazikitsidwa, kukonzekera kwa potaziyamu kumafunikiranso.

    Hypothiazide ndi furosemide muzokonda kunja zimasankhidwa mu maphunziro apanthawi (mwachitsanzo, masiku awiri pa sabata kapena tsiku lina lililonse). Mankhwala a diuretic amatha kutha kuchepa kwambiri kwa sodium chloride ndi kutsika kwa bcc ndikomwe kumayambira kutsika kwa proabsortion. Ma diuretics, kuchepa kwa bcc, kumabweretsa kuwonjezereka kwa renin ndi aldosterone.

    Mu kwambiri hyperaldosteronism, kumeza potaziyamu popanda kuwonjezera kwa veroshpiron sikukhudza hypokalemia.
    Odwala omwe ali ndi edema yotalikirapo amene akhala akutenga nthawi yayitali, hyponatremia imayamba kukhazikika (zomwe zimakhala mu sodium m'thupi zitha kuchuluka).

    Kutsika kwa kuchuluka kwa sodium kumaphatikizidwa ndi zotumphukira za mtima zosakwanira (kuchepa kwa hypovolemic), hyperaldosteronism yachiwiri, kuchepa kwa potaziyamu, alkalosis, kuchepa kwa CF, kuwonjezeka kwa ndende ya urea.
    CF ikakhala yochepera 20 ml / min, furosemide ndi chithandizo cha kusankha, chomwe chimalola kuwonjezera kudya kwa sodium chloride (sodium chloride), mwina kuchulukitsa CF.

    Veroshpiron ndi triamteren sayenera kutumizidwa chifukwa choopsa cha hyperkalemia. Mankhwala a odwala omwe ali ndi matenda aimpso osakhazikika, tiyenera kukumbukira kuti kuchepa kwamadzi, kutsatiridwa ndi kuchepa kwa bcc, kungayambitse kuwonongeka kwa impso. Kusokonezeka kwa electrolyte kumachitika mosavuta - hyperkalemia, hypochloremia, alkalosis, hypercalcemia, komanso hyperuricemia ndi hyperglycemia. Mukamamwa mankhwala akuluakulu a furosemide ndi ethaconic acid, kusokonezeka kwamakutu kumatha kuchitika.

    Chithandizo cha ochepa matenda oopsa mu shuga. Zodzikongoletsera

    Popeza kusungidwa kwa Na ndi zamadzimadzi ndi vuto la hypervolemia zomwe zimapangitsa gawo lalikulu la matenda oopsa a matenda amtundu wa 1 ndi mtundu wa 2 shuga, kugwiritsa ntchito ma diuretics kuphatikiza kuthamanga kwa magazi ndi koyenera. Komabe, si magulu onse a diuretic omwe ali otetezeka komanso ogwira ntchito kwa odwala matenda ashuga.

    Gulu la okodzetsa

    Ntchito yeniyeni yokhudzana ndi kukodzetsa kwa machitidwe zimaperekedwa:

    Malo ochitira diuretics ndi makina ake

    Thiazide diuretics Mankhwalawa amagwira makamaka pama cell a distal opukusidwa kuchokera mkati, pomwe amaletsa kukodzetsa kumachitika patatha maola 1-2 pambuyo pakukonzekera pakamwa ndikuchitika, monga lamulo, maola 12-18 (hypothiazide) mpaka maola 24 (chlortalidone). Thiazide diuretics ndi amphamvu kwambiri potaziyamu-okodzetsa.

    Limagwirira a diabetic zotsatira za thiazides ndi chifukwa kutchulidwa potaziyamu owonjezera mphamvu ya mankhwalawa. Kuwonongeka kwa extracellular ndi intracellular potaziyamu mu β-maselo a kapamba motsogozedwa ndi thiazides kumayambitsa kubisala insulin katulutsidwe ndi hyperglycemia. The kwambiri diuretic amachotsa potaziyamu, ndi kukhathamiritsa yake matenda ashuga.

    Pakufufuza kwatsatanetsatane kwa thiazide diuretics, zidapezeka kuti mphamvu ya potaziyamu yowonjezera ya thiazides imangodalira mlingo wachilengedwe. Kudalira kwa potaziyamu pochotsa zotsatira za hypothiazide (mankhwala ogwiritsidwa ntchito kwambiri a thiazide ku Russia) amaperekedwa.

    Kudalira kwa potaziyamu-wochotsa zotsatira za hypothiazide pa mlingo wake

    Chifukwa chake, ndi mlingo wa hypothiazide wa 12,5 mg / tsiku kapena mochepera, mphamvu yake ya potaziyamu siyothandiza. Ngati mphamvu ya potaziyamu-yochotsa mphamvu ya thiazides imatengera mlingo wa mankhwalawa, ndiye kuti diabetogenic zotsatira za ma diuretics (okhudzana mwachindunji ndi kuchuluka kwa potaziyamu) ayeneranso kukhala oledzera, i.e., kukhala okwanira pa mlingo waukulu wa mankhwala komanso ochepa.

    Zowonadi, maphunziro ochulukirapo awonetsa kuti kuchuluka kwa thiazide komwe kumakhala kocheperako, sikuchepetsa mphamvu ya kagayidwe kazachilengedwe. Ndi kipimo cha hypothiazide pamtunda wa 50 mg / tsiku, chiwopsezo cha matenda a shuga 2 chafika pa 7% (kafukufuku wa MRFIT), ndi mlingo wa 25 mg kapena kuchepera, palibe kuchuluka kwakukulu pachiwopsezo cha matenda a matenda a shuga 2 (SHEP, TOMHS).

    Kudalira kwa kagayidwe kachakudya kagayidwe kachakudya pa thiazide diuretics

    Pakufufuza kwakukulu kwa anthu ambiri ARIC, komwe kunaphatikizapo anthu opitilira 12,000 opanda matenda a shuga, zinawonetsedwa kuti kutenga thiazide diuretics pa mlingo wa 12.5-25 mg / tsiku kwa zaka 6 siziphatikizidwa ndi chiwopsezo chowonjezeka cha matenda a shuga 2 (OP = 0.91) . Chifukwa chake, maphunziro olamulidwa ndi multicenter atsimikizira kuti chiopsezo chokhala ndi matenda a shuga a 2 de novo omwe amagwiritsidwa ntchito kwa nthawi yayitali a thiazide diuretics ndi ochepa kwambiri pamene mlingo wawo sunapamwamba kuposa 25 mg / tsiku.

    Zotsatira za thiazide diuretics pa lipid metabolism zimatengera nthawi ya mankhwalawo komanso pocheperako pang'ono pa mlingo wake. Chifukwa chake, mutatenga thiazides kwa miyezi 3-12. mulingo wa cholesterol wa seramu ukuwonjezeka ndi 5-7%. Nthawi yomweyo, mayesero azachipatala omwe amayang'aniridwa ndi placebo omwe amawonetsa kuti kugwiritsa ntchito mankhwala kwa nthawi yayitali (kwa zaka 3-5) kwenikweni sikukhudza kagayidwe ka lipid. Mu maphunziro a HAPPHY ndi EWPHE, hypercholesterolemia yoyambira idadziwika (mulingo wa OX woposa 6.5 mmol / L).

    Zotsatira zakugwiritsira ntchito kwa nthawi yayitali kwa thiazide diuretics pa lipid metabolism

    Chifukwa chake, palibe umboni wotsimikiza kuti thiazide diuretics sangathe kupatsidwa kwa anthu omwe ali ndi dyslipidemia, ngati pakufunika kuchepetsa magazi.

    Kuchokera pa matenda ashuga ndi matenda oopsa - ndi ma diuretics otani omwe angatengedwe ndipo ndi chiyembekezo chotani kwa iwo?

    Ma diuretics adawonekera m'zaka za zana la 19, koma adagwiritsidwa ntchito koyamba kutsitsa magazi mu 60s ya zaka zapitazi.

    Kukula kwa diuretics kumachitika chifukwa cha impso ntchito mwanjira yoti imathandizira njira ya mkodzo kuchokera mthupi.

    Ngati kugwiritsa ntchito okodzetsa pochiza matenda am'mitsempha yamagazi ndi mitsempha yamagazi (limodzi ndi kuthamanga kwa magazi) sikukayikira, ndiye kuti kugwiritsa ntchito mankhwala othandizira odwala matenda ashuga ndi kuthamanga kwa magazi kuyenera kufikiridwa mosamala, pokambirana ndi dokotala. Pali magulu anayi a ma diuretics, omwe tikambirana mwatsatanetsatane.

    Zothandiza odwala matenda ashuga

    Kuti muchepetse kuthamanga kwa magazi (BP), okodzetsa a shuga amadziwika. Amayikidwa ngati pali katundu wambiri pamtima (CVS) kapena ngati pali kuphwanya kwa mkodzo ndi impso. Gulu lalikulu lazachipatala limakhazikitsidwa pamapangidwe, momwe kusankha kwa mankhwala omwe ali pachiwonetsero cha matenda kumakhazikitsidwa.

    Pankhani ya matenda a shuga a mellitus (DM), mankhwalawa amaperekedwanso kuti athandizidwe, chifukwa chake okodzetsa amalembedwa ndi adokotala okhawo malinga ndi mankhwala omwe ali pamndandandawo. Amakhala ndi mavuto ambiri.

    Zizindikiro za matenda ashuga

    Ndi matenda ashuga, mtundu 2 ndi mtundu 1 okodzetsa amatchulidwa:

    • kuthetsa kupusa,
    • mpumulo wa kulephera kwa mtima,
    • kutulutsa mkodzo chifukwa cha matenda a impso komanso kukokoloka kwa ntchito,
    • Chithandizo cha kuthamanga kwa magazi
    • Kuchotsa poizoni ndi ziphe.

    Chifukwa cha kusintha mthupi, sodium mu matenda ashuga amadziunjikira. Amachotsedwa ndi okodzetsa amtundu wa shuga wachiwiri. Ndi kugwiritsidwa ntchito kwawo, kuthinikizidwa kwa mtima wama mtima kumachepa ndipo mphamvu zamagetsi zimabweranso mwakale. Kugwiritsa ntchito diuretic diuretics, madokotala amapereka okakamiza diureis (kuchotsa poizoni ndi impso ndimankhwala) ngati kuli kofunikira pothandizira matenda a shuga.

    Mitundu ya mankhwala

    Mitundu yayikulu ndi mitundu yamakina oonekera:

    Magulu a okodzetsa malinga ndi mfundo zoyenera kuchitapo.

    • loopback - ntchito kudzera m'chiuno cha Henle nephron ("Torasemide", "Furosemide", "Ethacrine acid"),
    • thiazide - kuchepetsa matenda oopsa, nthawi zambiri amalembera odwala matenda ashuga ("Hypothiazide", "Dichlothiazide", "Indapamide", "Arifon", "Noliprel"),
    • osmotic - yogwiritsidwa ntchito kamodzi ndikuchotsa kuchuluka kwamadzimadzi ("Mannitol", "Urea", "Potaziyamu acetate"),
    • kuteteza kwa potaziyamu - kukhalabe osamala electrolyte ("Spironolactone", "Triamteren", "Veroshpiron").

    Mankhwala a diuretic a shuga amawagawa m'magulu:

    • mphamvu zochepa (5%),
    • sing'anga (10%),
    • mkulu (kupitirira 15%).

    Ma diuretics a shuga a mtundu 2 ndi mtundu 1 ali ndi opanga osiyanasiyana, ali m'magulu osiyanasiyana amitengo. Zina mwa izo zimagulitsidwa ndi mankhwala, zina zimagulitsidwa popanda. Mitundu yambiri ya okodzetsa amatha kutsitsa wodwala koma osayimira mtunduwo. Muyenera kuphunzira mosamala malangizo, pharmacodynamics, momwe mungachitire, contraindication komanso mwayi wophatikiza ndi zina zomwe zimagwira. Mphamvu ya diuretic imakhazikika pa sodium excretion.

    Ndi ma diuretics ati omwe amafunikira shuga?

    Kusankha kwa mankhwala ochepetsa kuthamanga kwa magazi mu shuga kuyenera kutengera chithunzi cha matendawa, thanzi la wodwalayo, zaka zake ndi cholinga chogwiritsa ntchito. Dokotala amawona chomwe chimayambitsa kuchuluka kwa madzimadzi ndipo, pamaziko a izi, diuretic imalembedwa. Chiwerengero, chosonyeza zotsatira zoyipa, kufunikira kwa kugwiritsa ntchito kwawo zovuta ndi mankhwala ena kumachepetsa kufunafuna diuretic yovomerezeka.

    Mtundu woyamba wa matenda ashuga, kukondera kumapangidwa pa gulu la thiazide la mankhwala ochepa. Ena mwa mankhwalawa amasokoneza kagayidwe ka glucose, kamayenera kuganiziridwa mukamamwa. Kutsika kwamphamvu kwa kuthamanga kwa magazi kumachitika pogwiritsa ntchito dioptureure. Kugwiritsa ntchito kwawo kwakanthawi sikuvomerezeka. Ndi kutaya kwakukulu kwa potaziyamu, komwe kumakhala koopsa ku thanzi, kusankha kumakhazikitsidwa ndi gulu lomwe limateteza potaziyamu kuti tisungire chinthuchi mthupi.

    Mndandanda wamankhwala

    Mapiritsiwo amayikidwa mogwirizana ndi cholinga cha mankhwalawo komanso mkhalidwe wa anthu odwala matenda ashuga onse, monga momwe dokotala amamuwunikira. Ndi matenda oopsa, odwala matenda ashuga ayenera kusamala posankha mankhwala osamwa mankhwala okhala ndi chikoka chachikulu kuposa chofunikira. Izi zili ndi vuto laimpso komanso kuwonjezeka kwa matenda ashuga amtundu wa 2. Gome lokhala ndi mndandanda wa mankhwala omwe amagwiritsidwa ntchito amaperekedwa.

    Kuphatikizika kwa mankhwalawa, kufotokoza kwina ndi pharmacotherapy

    Mankhwalawa amapangidwa ndi makampani azachipatala momwe amapangira mapiritsi amkamwa.

    Mankhwala omwe ali pamwambapa ali ndi zokutira zamafuta.

    Chofunikira chachikulu chothandizira cha mankhwalawa ndi indapamide, piritsi limodzi lili ndi 2,5 mg ya pawiri.

    Kuphatikiza pazomwe zimagwira, mankhwala ena owonjezera omwe ali ndi gawo lothandizira amathandizidwa ndikupanga mankhwala.

    Mapulogalamu othandizira ndi awa:

    • lactose monohydrate,
    • povidone-K30,
    • crospovidone
    • magnesium wakuba,
    • sodium lauryl sulfate,
    • talcum ufa.

    Zomwe zikuchokera pamwamba pa chiganamba cha mapiritsi ndi izi:

    1. Hypromellose.
    2. Macrogol 6000.
    3. Talc.
    4. Titanium dioxide

    Mapiritsiwo ali ndi mawonekedwe ozungulira, opindika ndipo ali penti yoyera.

    Mankhwala ndi a gulu la mankhwala a diuretic. Malo ake ali pafupi kwambiri ndi thiazide diuretics.

    Pambuyo kumwa mankhwalawa, kwamikodzo excretion wa sodium ndi chlorine kuchokera mthupi la munthu umachuluka. Pocheperako zimakhudza njira ya excretion wa potaziyamu ndi magnesium ayoni thupi.

    Mankhwalawa amatha kuletsa njira zamkati mwa calcium ndikuwonjezera kukhuthala kwa khoma lamitsempha yama mitsempha, kuchepetsa kukanikizika kwathunthu kwamitsempha yama thupi.

    Kumwa mankhwalawa kumathandiza kuchepetsa hypertrophy ya mtima wamanzere wamitsempha.

    Kugwiritsa ntchito mankhwalawa sikukhudza kuchuluka kwa kuchuluka kwa lipid m'magazi ndipo sikukhudza kagayidwe kazakudya.

    Kumwa mankhwala kumakuthandizani kuti muchepetse kuzindikira kwa khoma lamitsempha ku zotsatira za norepinephrine ndi angiotensin II pamenepo, ndipo amakupatsani mwayi wolimbitsa kaphatikizidwe ka prostaglandin E2 m'thupi.

    Kugwiritsa ntchito mankhwala kumachepetsa kukula kwa mapangidwe a ma free radicals komanso okhazikika mthupi.

    Kupitilira kwamphamvu kwa mankhwalawa kumachitika sabata pambuyo pa kuyamba kwa mankhwalawa ndikupitilira tsiku limodzi pakapita tsiku limodzi.

    Diuretics okodzetsa

    Kodi okakamiza nthawi zambiri amafunsa dokotala. Ma diuretics ndi okodzetsa amtundu wina wochita ndi kutanthauzira kukodzetsa kwenikweni. Tsoka ilo, onsewa ali ndi zovuta komanso kugwiritsa ntchito kwawo popanda malangizo a dokotala ndizowopsa paumoyo. Kodi okodzetsa ndi chiyani?

    Maphikidwe othandiza

    Ndalama zomwe zimachokera ku zitsamba za matenda oopsa komanso matenda a shuga 2 zimagwira bwino kwambiri.

    Mankhwala othandizira kwambiri odwala matenda ashuga ndi okodzetsa. Tithokoze, njira yopanga kukodza kwamkodzo m'thupi imapangidwa, zomwe zimapangitsa kuwonjezeka kwamizere, komanso kutulutsidwa kwamphamvu kwa thupi la munthu kuchokera kumadzi ndi mchere wambiri.

    Chifukwa chake, dongosolo lonse la magazi limatsitsidwa, kuthamanga kwa magazi kumachepa ndipo mitsempha yomweyo ya magazi ndi yopapatiza.

    Chifukwa chiyani gwiritsani ntchito diuretics a shuga

    Nthawi zambiri, mitundu yosiyanasiyana ya mankhwala a diuretic imayikidwa kuti ichiritse matenda oopsa. Koma madokotala amalimbikitsanso mankhwalawa chifukwa cha matenda a kutupa komanso miyendo. Ndipo sizodabwitsa, chifukwa matendawa amatha kuwonetsa kukhalapo kwa kulephera kwa mtima.

    Mu shuga mellitus, ma diuttics omwe amafunsidwa ayenera kugwiritsidwa ntchito mosamala kwambiri, chifukwa si onse okodzetsa omwe ali oyenera kuchita izi kapena chamoyo chimenecho. Chifukwa chake, ndikofunikira kupita kukakambirana ndi katswiri wazachipatala yemwe angakuwuzeni kuti ndi mankhwala ati omwe mungathe kumwa omwe ali ndi matenda ashuga.

    Monga mukudziwa, diuretic mankhwala a shuga amatha kukhala osiyanasiyana. Mwachitsanzo, mankhwala osokoneza bongo a potaziyamu ndi masoka otayirira siabwino kuti muchiritse bwino matenda oopsa mu shuga mellitus.

    Ndikofunikira kudziwa kuti gawoli ndiloyenera kugwiritsidwa ntchito kamodzi, ndiye kuti, kuti tichotse mwachangu kumverera kowawa komwe kumawonekera. Omwe amasankhidwa pang'ono pakadali pano ndi okakamira potaziyamu, popeza m'nthawi yamakono awa amawoneka kuti ndi achikale komanso opatsidwa zovuta zambiri zoyipa.

    Othandizira ngati a Thiazide ndi thiazide

    Othandizira a Thiazide ndi thiazide amadziwika kuti ndi otchuka kwambiri pochiza matenda osokoneza bongo, komanso matenda oopsa. Amaganizika okodzetsa okodzetsa am'matenda amtundu wachiwiri amatha kumwedwa pang'ono.

    Izi zikuphatikizapo Poithiazide ndi Dichlothiazide. Zoyipa zawo zimakhala chifukwa chakuchepetsa mphamvu ya maselo kupita ku insulin yomwe imaperekedwa.

    Nthawi zambiri, izi zimachitika chifukwa chogwiritsa ntchito kwambiri mankhwalawa. Zowonadi, milandu yotereyi imatha kuchitika m'mbuyomu m'njira zoyipa zosiyanasiyana.

    Mankhwala okhala ndi diazitrate ngati Thiazide amatha kutengedwa ndi odwala omwe ali ndi matenda osokoneza bongo popanda mantha apadera. Magenge monga indapamide ndi zinthu zofatsa kwambiri.

    Pogwiritsa ntchito zinthuzi, mutha kuchotsa potaziyamu, sodium, magnesium m'thupi. Chifukwa chake, ndi chithandizo, odwala omwe ali ndi matenda ashuga ayenera kudya zakudya zomwe zanenedwa pamwambapa.

    Izi ndi phala la buckwheat, oatmeal, Zipatso, mtedza, ndipo, zipatso zatsopano.

    Ndi matenda ashuga, mankhwala wowerengeka azitha kugwiritsidwanso ntchito. Komabe, musanagwiritse ntchito mwachindunji, ndikofunikira kufunsa dokotala kuti mupeze yankho lenileni ndikuwunika kuti agwirizane ndi mankhwala othandizira.

    Malangizo ogwiritsira ntchito mapiritsi

    Kuvomerezeka kwa mankhwalawa kumachitika mosasamala ndondomeko yakudya. Zakudya zam'mapiritsi zimayenera kutsatiridwa ndikumwa madzi ambiri. Nthawi yomwe amakonda kumwa mankhwalawa ndi m'mawa.

    Mlingo wamba wabwinowu wothandizidwa ndi 2,5 mg kapena piritsi limodzi patsiku. Ngati pambuyo pa masabata 4-8 a chithandizo chomwe mukufuna sichikwaniritsidwa, mulingo sayenera kuchuluka. Kuwonjezeka kwa mlingo kungasokoneze chitukuko m'thupi la zotsatira zoyipa kuchokera ku kugwiritsa ntchito mankhwalawa.

    Pakakhala zotsatila zamankhwala, tikulimbikitsidwa kusintha mankhwalawo kukhala othandiza kwambiri. Zikachitika kuti mankhwalawa amachitika pogwiritsa ntchito mankhwala awiri, mlingo wa Indapamide amakhalabe osasinthika pa 2,5 mg patsiku.

    Zizindikiro ndi contraindication chifukwa cha mankhwala

    Chizindikiro chachikulu chakumwa mankhwala a shuga ndikutukuka kwa wodwala yemwe ali ndi matenda oopsa.

    Monga chida china chilichonse chachipatala, Indapamide imakhala ndi zotsutsana zingapo kuti zigwiritsidwe.

    Kugwiritsa ntchito mankhwalawa kumaloledwa pokhapokha ngati pali zotsutsana ndi wodwala.

    Milandu ikuluikulu yomwe imagwiritsidwa ntchito ngati mankhwala ndi awa:

    • wodwala amakhala ndi chidwi chambiri ndi mankhwala omwe amapangidwa pamaziko a sulfonamide,
    • tsankho kwa odwala ndi lactose,
    • wodwala ali ndi galactosemia,
    • munthu akaulula zizindikiro za malabsorption matenda a shuga kapena galactose,
    • Kuzindikira wodwala wolephera aimpso,
    • kukhalapo kwa zizindikiro za hypokalemia,
    • kupezeka kwa kulephera kwa chiwindi,
    • matenda a shuga a impso
    • nthawi ya bere ndi kuyamwitsa,
    • zaka wodwala zafika 18,
    • kuchitira chithandizo momwe munthawi yomweyo makonzedwe a othandizira amatha kutalikitsa nthawi ya QT akuchitika.

    Mochenjera, muyenera kumwa mankhwalawa mukazindikira kuti pali vuto la impso ndi chiwindi, ngati wodwala akupezeka m'magazi a electrolyte, pamaso pa hyperparathyroidism.

    Kuphatikiza apo, Indapamide iyenera kugwiritsidwa ntchito mosamala pochita mankhwala omwe antiarrhythmic mankhwala amagwiritsidwa ntchito kale.

    Chenjezo limagwiritsidwa ntchito ngati mankhwala opanga matenda a shuga kumapeto kwa kuwonongeka.

    Mndandanda wamankhwala, mawonekedwe omasulidwa, mtengo wake komanso malo osungira

    Mankhwala amapezeka mu mawonekedwe a mapiritsi okhala ndi piritsi, piritsi lililonse lili ndi 2.5 mg ya mankhwalawa.

    Mapiritsi a zidutswa 10 amadzaza phukusi lapadera la contour cell lopangidwa ndi polyvinyl chloride film komanso yokutira ndi zojambulajambula za aluminium. Mapaketi atatu apadera, komanso malangizo ogwiritsira ntchito mankhwalawa, aikidwa m'mathumba a makatoni.

    Mankhwalawa amawaika kuti azisungidwa pamalo amdima pamoto pa 15 mpaka 25 digiri Celsius. Malo osungira mankhwalawa sayenera kupezeka kwa ana.

    Alumali moyo wa mankhwala ndi zaka 3. Ikatha nthawi yosungirako, mankhwalawo ndi oletsedwa. Mankhwala omwe atha ntchito amataya.

    Kuphatikiza pa Indapamide, mankhwala adapangidwa omwe ali ndi mawonekedwe ake.

    Odziwika kwambiri ndi otchuka ndi awa:

    1. Arifon Repard - analog wodziwika bwino wa Indapamide, samakhudza kagayidwe kazachilengedwe.
    2. Acriptamide ndi analog ya Indapamide, yomwe ndi yaku Russia.
    3. Indap ndi mankhwala opangidwa ku Czech Republic.
    4. Noliprel ndi mankhwala osakanikirana omwe ndi othandiza kwambiri.
    5. Perinide ndi mankhwala otchuka omwe ali oyenera odwala ambiri.

    Mtengo wa Indapamide ku Russian Federation pafupifupi umachokera 12 mpaka 120 ma ruble, kutengera wopanga ndi dera lomwe mankhwalawo amagulitsidwa.

    Katswiri kuchokera pa kanema munkhaniyi azikamba za zamtundu wa Indapamide.

    Kusiya Ndemanga Yanu

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