Okodzetsa: zomwe ali, mitundu ndi momwe amagwirira ntchito

Zamkati

• 1. Zodzikongoletsera za Thiazide
• 2. Odzetsa okodzetsa
• 3. Mankhwala osungunulira potaziyamu
• 4. Osmotic okodzetsa
• 5. Carbonic anhydrase inhibitor okodzetsa

Ma diuretics ndi mankhwala omwe angagwiritsidwe ntchito payekha kapena kuphatikizidwa ndi zinthu zina zogwira ntchito, pochiza matenda oopsa, kutupa komwe kumayambitsidwa ndi matenda a mtima, impso kapena chiwindi, pakati pa ena.

Pali mitundu ingapo ya ma diuretiki yomwe ilipo, monga thiazides, loop, potassium-sparing, osmotic kapena carbonic anhydrase inhibitors, okhala ndi njira zosiyanasiyana zogwirira ntchito ndikugwira ntchito m'malo osiyanasiyana a impso, zomwe ziyenera kuperekedwa kutengera vuto lomwe angalandire.

1. Zodzikongoletsera za Thiazide

Ma diureticswa ali ndi magwiridwe antchito awo kuletsa kubwezeretsa kwa sodium m'chigawo choyambirira cha distal tubule tubule, kukulitsa kutulutsa kwake, komanso kutulutsa ma chloride, komanso pang'ono, potaziyamu ndi magnesium, zomwe zimapangitsa kuchotsa madzi. Mankhwalawa amakhala ndi mphamvu zochepa.

Mayina achibadwa / amalonda: Zitsanzo zina za thiazide diuretics ndi indapamide (Natrilix, Indapen, Flux), hydrochlorothiazide (Diurix, Hidromed) ndi chlorothalidone (Higroton).

Zizindikiro zochiritsira: Nthawi zambiri, okodzetsa m'kalasi muno amawonetsedwa kuti amachepetsa kuthamanga kwa magazi komanso kuchiza matenda opatsirana a edema omwe amabwera chifukwa cha kulephera kwa mtima, chiwindi cha chiwindi ndi matenda a impso.

Zotsatira zoyipa kwambiri: Zina mwazovuta zomwe zimachitika mukamalandira mankhwalawa ndi chizungulire, kupweteka mutu, kufooka, nseru, kusanza, kukokana, kutsegula m'mimba, kudzimbidwa, cholecystitis, kapamba ndi magazi ndi khungu.

2. Odzetsa okodzetsa

Ma diuretics a Loop amachita poletsa kubwezeretsanso kwa sodium mu nthambi yomwe ikukwera ya Henle, zomwe zimapangitsa kuti madzi abwezeretsenso. Kuphatikiza apo, mankhwalawa amathandizanso pakuyenda kwa magazi, kuchititsa vasodilation ndikuchepetsa kukana kwamitsempha yamitsempha. Mankhwalawa ali ndi mphamvu yotulutsa diuretic, posachedwa mwachidule

Mayina achibadwa / amalonda: Furosemide (Lasix, Neosemid) ndi chitsanzo cha chimake chogwiritsa ntchito kwambiri. Phunzirani momwe mungagwiritsire ntchito komanso zomwe zimatsutsana ndi furosemide.

Zizindikiro zochiritsira: Odzetsa okodzetsa amawonetsedwa kuti azitha kuwongolera edema m'mapapo mwanga ndi mitundu ina yayikulu ya edema, kulephera kwa impso koopsa komanso kuthamanga kwa magazi. Kuphatikiza apo, atha kugwiritsidwanso ntchito kuthana ndi hypercalcemia yovuta, chifukwa amalimbikitsa kutulutsa kwamikodzo kashiamu.

Zotsatira zoyipa kwambiri: Zina mwa zoyipa zomwe zimachitika mukalandira chithandizo ndi kusokonekera kwa ma electrolyte, kusowa kwa madzi m'thupi, hypovolemia, kuchuluka kwa creatinine ndi triglycerides m'magazi, kuukira kwa gout ndikuwonjezera kuchuluka kwamikodzo.

3. Mankhwala osungunulira potaziyamu

Mankhwalawa amaletsa kutuluka kwa potaziyamu pamalo osanjikiza a distal adadutsa tubule komanso mu chubu chosonkhanitsira, chomwe chingakhale ndi aldosterone chotsutsana nacho.

Spironolactone ndi wotsutsana ndi aldosterone, yemwe amakhala makamaka pamalo osinthanitsa ndi sodium ndi potaziyamu osakanikirana ndi aldosterone, omwe amapezeka pakatikati mwa impso zomwe zimapangitsa kuti sodium ndi madzi ziwonjezeke, pomwe potaziyamu amasungidwa.

Mayina achibadwa / amalonda: Zitsanzo zina za potaziyazi-sparing diuretics ndi amiloride, yomwe imangogwirizanitsidwa ndi zinthu zina zogwira ntchito, ndi spironolactone (Aldactone, Diacqua). Onani njira zina zochiritsira za spironolactone.

Zizindikiro zochiritsira: Mankhwala osungunuka a potaziyamu amakhala ndi vuto lochepa lodzikongoletsera, motero, sagwiritsidwa ntchito patokha pochiza edema kapena matenda oopsa, ndipo nthawi zambiri amagwirizanitsidwa ndi ma diuretics ena. Kuwongolera kwake kumawonjezera kutulutsa kwa diuretic komanso kuyankha kwa antihypertensive kwa thiazide ndi loop diuretics.

Zotsatira zoyipa kwambiri: Zina mwazovuta zomwe zimatha kuchitika ndikukula kwa kuchuluka kwama cell, kuperewera kwa madzi m'thupi ndi hypernatremia.

4. Osmotic okodzetsa

Mankhwalawa amachulukitsa kupendekera kwa glomerular filtrate, komwe kumapangitsa kuyenda kwa madzi amtundu wamkati kulowa m'malo owonjezera am'magazi, ndikupangitsa diuresis yodziwika bwino, motero kumachepetsa kupsyinjika kwa m'mimba ndi edema komanso kuthamanga kwa intraocular.

Mayina achibadwa / amalonda: 20% Mannitol. Pezani momwe mannitol amagwiritsidwira ntchito.

Zizindikiro zochiritsira: 20% ya mannitol imasonyezedwa pochizira matenda a ubongo, pachimake glaucoma, kulephera kwakukulu kwa impso ndikukonzekera opaleshoni ya ophthalmic.

Zotsatira zoyipa kwambiri: Zina mwazovuta zomwe zimachitika ndi mseru, kusanza, ludzu, kupweteka mutu, chizungulire, kunjenjemera, malungo, kugunda kwa mtima, kupweteka pachifuwa, hypernatremia, kuchepa kwa madzi m'thupi, kusawona bwino, ming'oma kapena matenda oopsa.

5. Carbonic anhydrase inhibitor okodzetsa

Mankhwalawa amaletsa carbonic anhydrase, yomwe ndi ma enzyme omwe amachititsa kuti mankhwala azigwira ntchito omwe amaphatikizapo kutulutsa mpweya wa carbon dioxide komanso kutaya madzi a carbonic acid. Zotsatira zake, kuchepa kwa asidi ya carbonic kumabweretsa kuchepa kwa mkodzo, zomwe zimalimbikitsa diuresis.

Mayina achibadwa / amalonda:acetazolamide (Diamox). Pezani momwe mungagwiritsire ntchito komanso zomwe zotsutsana ndi Diamox zili.

Zizindikiro zochiritsira: Carbonic anhydrase inhibitors amawonetsedwa pochiza glaucoma, kwamikodzo alkalinization, kagayidwe kachakudya alkalosis ndi pachimake pamapiri matenda.

Zotsatira zoyipa kwambiri: Zina mwazovuta zomwe zimatha kuchitika ndi kagayidwe kachakudya acidosis, kukulitsa kwa kuchuluka kwa madzi amadzimadzi owonjezera, hyponatremia, mutu, kuwodzera, nseru, kusanza ndi kusowa madzi m'thupi.