"Torasemide": imiyalelo ukusetyenziswa. "Sandoz Torasemide": ixabiso, indawo, ncomo

"Torasemide" - onamandla isiyobisi umchamo mihla Ogqibeleleyo ukuba unyango lwexesha elide izifo ezinxulumene kunye ukubonakala nokudumba. Ngenxa inani elincinci yeziphumo ebezingalindelekanga ngokwezonyango ebalulekileyo, ububanzi ukusetyenziswa kwayo zonyango ngakumbi. Kungcono kwezinye womchamo noyi kwaye unobungqina ngakumbi. Xa unyango lwezifo idosi sele ilungiswe. Kwakhona, nakangangokuba unakho xa insufficiency umsebenzi kwezintso maxa wambi ukuhluza ephantsi nephrons Velocity glomeruli.

Imiphumela "torasemide"

"Torasemide" njengoko ndzhendzheleko (ityuwa) iqela omele womchamo omele luminal inxenye epithelium of tubules le nephron kwi ekunyukeni isabelo yomtya ka Henle. Linalo isiphumo inhibitory kwicala lothutho odibeneyo ion potassium kesodiyam chloride, oko ngokubonakalayo kunciphisa amathuba electrochemical kwi umphezulu epithelium le nephron. Ukuvimba kubangela ukuphazamiseka zothutho ion sodium reabsorption ukusuka umchamo lokuqala, okwandisa diuresis.

Phantse zonke womchamo loop kubangela ukuphazamiseka electrolyte ngenxa asiyeyamagorha impembelelo reabsorption of ion potassium, isodiyam, magnesium chlorine. "Torasemide" kangangoko sincinane kuchaphazela ukhetho potassium nezinki, ngenxa apho obunamanani aphantsi kakhulu arrhythmias, ukudla, ukuqhina, buthathaka kwezihlunu. Kwakhona, ichiza ukuya kancinane iibhloko ubukhulu ukuyilwa thromboxane A2, ngokwandisa izitya. Kwakhona iibhloko aldosterone receptor iqhosha, ziyibuyisela iinkqubo abanesigulo kwemisipha kwentliziyo.

ubungqina

Okuqhotyoshelwe ichiza "Torasemide" umyalelo manual iqulathe ulwazi malunga nesifo, leyo esetyenziselwa unyango. "Torasemide" Libonisa ukuba:

• unyango pathogenetic of umfutho wegazi ukumelana kuthomalaliso kunye izayamaniso inhibitors ACE (ARBs) womchamo thiazide;
• unyango sisifo sentliziyo esinganyangekiyo, ebandakanya i izangqa sindisa kwegazi;
• unyango kwangumqondiso ukusilela esingapheliyo kwezintso, kuquka nokuyicoca ngesantya ephantsi (ngaphantsi kwama-20 ml \ min);
• unyango kwangumqondiso kwesibindi (kunye hypoalbuminemia ezinxulumene) nokudumba njengendlela eyenye "Furosemide".

Xa lwegazi analogue "Torasemide" kunye generics zisetyenziswa kuphela emva kokuba ukungaphumeleli womchamo thiazide. A chiza nga maliqhutywe yi elide ngenxa yokuba inani elincinane yeziphumo ebezingalindelekanga ngokwezonyango ezibalulekileyo eziyingozi ukusilela kwezintso. Abo "torasemide" kuba ngaphantsi kakhulu kunalowo "Furosemide".

Imiyalelo yokusebenzisa

Ngokusekelwe izikhokelo zonyango ukuze iziyobisi "Torasemide" yemiyalezo iquka iimpawu lwendlela iziyobisi ezifunekayo unyango kunye nokulungiswa izifo target. Enigcoba ngalo ichiza ngokwayo ifumaneka emacwecweni eziqulathe izithako zilandelayo: 2.5 mg, 5 mg, 10 mg, 20 mg, 50 mg, 100 mg, 200 mg.

Ukuthabatha nesiyobisi elucwecweni kusasa, kungakhathaliseki ukuba ukutya. Kuba ezi yamathamo ichiza "Torasemide" ixabiso ezahlukeneyo: kuba ngaphantsi kwi idosi minimum kunye aphezulu eliphezulu lemali. Ngokutsho data avareji, 30 amacwecwe amachiza mg 5 malunga 400 engange. Xa lo ithamo ziya kusiwa ngolu hlobo lulandelayo ngokunxulumene okukhomba:

• kwi unyango nomfutho ethathwe 2.5 - 10 mg / ngosuku;
• wafumana 10-20 mg / imini ngokusilela intliziyo ezinganyangekiyo;
• ezingapheliyo ukusilela kwezintso - 50 mg okanye ngaphezulu;
• isibindi kufuna uhlengahlengiso zedosi ngamnye.

Side Effects "torasemide"

Okuqhotyoshelwe ichiza "Torasemide" umyalelo manual iqulathe ulwazi malunga neziphumo ebezingalindelekanga ezininzi. Ngelo ithamo enyangayo, okt ukuya kutsho kwi-200 mg ngosuku kwandisa umngcipheko iingxaki thromboembolic, ischemia kwentliziyo, lobuchopho. It kwandisa umngcipheko kuhlaselo ezidlulayo kobuchopho kwaye iposi engabalulekanga, Embolism yemiphunga, arrhythmias. Kukho kwakhona yindlela isenzeko irhashalala komzimba okanye ezindlwini zazo xa ukuthambekela yesigulane.

"Torasemide" maxa wambi kubangela nezisu okanye ukugabha, kunqabile ukulamla ukuqunjelwa, urhudo. Wachaza iimeko angawodwa pancreatitis ngexesha unyango with "torasemide". Kwakhona anda transaminases hepatic, ibonisa isibindi ubuthi beziyobisi ngeedosi eziphezulu. Ngamanye amaxesha izigulane bakhathazekile malunga unkenteza ezindlebeni, ukungaboni.

Xa ufumana idosi eyityhefu ekuphuhliseni imo libanda, iimpawu kancinane. Libanda, sikhatshwa ilahleko kolwelo kwi umchamo: diuresis elide kunye rhoqo, ukuze aphuhlise hypotension, ukuwa semithambo, niphele, stroke, ischemia ebuchotsheni ngasemva.

Izimo kunye abaziqondi isicelo

Drug "Torasemide" analogue kunye namachiza generic alinakusetyenziswa phambi Izimo epheleleyo. Ezi indlela kukwalisa ichiza okanye yokuhlanganisa. "Torasemide" Akuvunyelwe ukusebenzisa ukusilela kwezintso kunye anuria, ukusilela isibindi ngoxa isiqaqa hepatic, kunye tachyarrhythmias. Ukuqalwa Contraindicated ngexesha zisanyisa kunye nokukhulelwa, kwakunye ngaphantsi kweminyaka eli-18, hypersensitivity ukuya sulfonamides.

Side kunye neziphumo zidibene "torasemide"

Xa unyango iipilisi lwegazi "Torasemide" enokuba nempembelelo embi ikhondo sifo. Ekubeni tubules proximal le nephron into esebenzayo tapeworm yothutho esebenzayo, kukho inhibition lokhuphiswano kukhuthaza uric acid. Ngokuchasene imvelaphi yokusetyenziswa "torasemide 'Amathuba aphezulu hyperuricemia kunye sifo oyingozi.

Medicament "Torasemide" lubonakala ngokuba intshukumo ethile kwinxalenye proximal of tubular epithelium yomtya of Henle. Ngenxa asiyeyamagorha umchamo ukusebenza kunye electrolyte ukungalingani oku kubangela okuba leendibano ngokwezonyango ebalulekileyo imithi. Ukuba ziyingozi, azibalulekanga kwaye ibe zezinqwenelekayo. Phakathi yingozi kwaye ebalulekileyo yile:

• ithamo eliphezulu (50 mg / ngosuku) "torasemide" xa ukusetyenziswa kudibaniso nge ngamalungiselelo platinum kuphucula ubuthi wamva;
• ngeedosi ezinkulu "torasemide" (50 mg / ngosuku) ukwandisa iziphumo nephrotoxic kunye ototoxic imithi aminoglycoside;
• e antibiotics cephalosporin, xa esetyenziswa kunye "torasemide" xa umthamo we-50 mg / imini kubonakala nephrotoxicity ipropati;
• salicylates kunye ne "torasemide" (50 mg / ngosuku) luphawulwa neurotoxicity.
• "Torasemide" ngokuchasene nentsukaphi a hypokalemia isihlobo kwandisa susceptibility le myocardium ukuya glycosides kwentliziyo, ukwandisa inotropic labo kunye nefuthe antiarrhythmic, nto leyo eyandisa amathuba yetyhefu;
• umngcipheko hypokalemia linyuke ukusetyenziswa "torasemide" ezihamba kunye corticosteroids okanye laxatives saline;
• "Torasemide" iphucula isiphumo "theophylline" curariform kunye nokuqaqamba relaxants.

ezikufunayo yokusebenzisa ehlangene

Neziphumo ezinqwenelwayo ezifuna esweni, linciphileyo uxinzelelo lwegazi ngethuba unyango kunye ACE inhibitor. "Torasemide" ngenxa yokususwa kolwelo kunciphisa uxinzelelo hydrostatic ye egazini solamlo ukuhla uxinzelelo lwegazi. Lo mba ubaluleke kakhulu xa ukunyanga lwegazi kwaye ifuna ukulungiswa le ithamo ACE inhibitor. Ngaphezu koko, xa lo unyango nomfutho unyango-ukumelana kunye indibanisela i ACE inhibitor "torasemide" ikuvumela ukuba kufikelelwe kuqheleke wegazi 90% yezigulane.

Xa unyango lwe ukusilela kwentliziyo esingapheliyo isiphumo ngokwezonyango ebalulekileyo zokunciphisa umsebenzi vasoconstrictor of catecholamines. Heart kwisiqalo therapy umchamo "torasemide" wasabela siethe ukuba ububona imiqondiso iadrenaline kunye noradrenaline. Nakuba kunjalo, isiphumo olufanayo lokunciphisa impumelelo epinephrine kunye norepinephrine ngexesha yokurhaxwa.

imiphumela emibi ukuhlangana

Kukho iziphumo inhibition ngempumelelo xa zidibene izinto ezithile. Ngokukodwa:

• amalungiselelo sequestrants inyongo acid umthamo "torasemide" of namathumbu, buthathaka isiphumo evuthisayo;
• analgesics ezidakumbisayo (NSAIDS) ukunciphisa impumelelo "torasemide";
• "Probenecid" ngenxa yeenkqubo yokukhulisa urikozuricheskih abangaphangeliyo ukhetho "torasemide" kwi mithambo le tubules, isehlisa ukusebenza kwayo.

iimpawu zothelekiso "torasemide"

Xa Elungiselela "Torasemide" analogs kunokuba iklasi, entshukumo generics. Phakathi iklasi zimelwe analogue: "Furosemide", "bumetanide," "ethacrynic acid". Xa kuthelekiswa "Furosemide" "Torasemide" lubonakala ngokuba nokuqalisa olucothayo amanyathelo kunye nempembelelo elide ngakumbi ngamazinga nokonyuka diuresis. Ukunika ukusebenza umchamo phantse amandla efanayo naleyo "Furosemide" "Torasemide" lineziphumo ebezingalindelekanga ezimbalwa ezinxulumene okukhawulezayo electrolyte ukungalingani.

"Bumetanide" luphawulwa impahla esinamandla umchamo ukuba lu dityanisiwe neziphumo ebezingalindelekanga ezininzi. Ethacrynic acid lubanesiphumo rate umchamo esezantsi isiqalo kwaye kunqabile wasebenzisa iziyobisi. Le pharmacokinetics beziyobisi "Torasemide" kwakhona iingcali ukubona omunye ingongoma ebalulekileyo. Eli chiza iimpawu "nkobe": diuresis emva okhulisa ngokuthi ibanike uncedo-sodium akukho zembuyekezo ukugcinwa yayo.

nucleoside Pharmacokinetic "torasemide"

I "Torasemide" guide iyeza inika ingcaciso isicelo yayo izigulane umfutho wegazi. Kunye ichiza, kuba unyango lwe lwegazi kunye nazo kusetyenziswa womchamo thiazide, potassium-engashiyi. Kwaye ngenxa thiazide ngokucotha eza kunye nefuthe elide umchamo na iziyobisi yokhetho.

Ngokuphathelele ezi pharmacokinetic features analogue yokulungisa "Torasemide" isicelo iya kuba yile ilandelayo: unyango lwe lwegazi, ukumelana kuthomalaliso eqhelekileyo kunye nendibaniselwano ACE inhibitor (okanye angiotensin receptor blocker) kunye thiazide. Kwakhona, "Torasemide" lisetyenziswa ezingapheliyo unyango ukusilela kwezintso, kubanjiswane product kuyehla.

Generics "torasemide"

Xa Elungiselela "Torasemide" umyalelo manual, analogue, imbonakaliso kunye Izimo abonakalisa ngokupheleleyo isiphumo yayo ephambili - ukwanda diuresis. Ngaphezu koko, isenzo esinjalo na ichiza kunye nalawo yokuqala. Le yokugqibela ziqulathe inani elifanayo "torasemide", kodwa ekhutshwe phantsi kwezinye amagama eemveliso.

Eyona idumileyo zezi: "Britomar", "Diuver", "Sandoz Torasemide", "Trifas", "Torcida", "Trigrim". Ngexesha uvavanyo olunzulu lwezinto amayeza umahluko bubalulekileyo waphawula phakathi kwabo eRashiya. Ngalinye imixube ngasentla ithatha ngokupheleleyo omnye kubo.

iinkalo zoqoqosho unyango "torasemide"

Xa unyango nomfutho xa womchamo thiazide olungasebenziyo kunye inhibitors ACE (okanye ARBs), unako kusetyenziswa unyango ngamachiza "Torasemide": imiyalelo zokusetyenziswa uthi idosi enye ngexesha lasemini. Iindleko zenyanga nganye unyango malunga 400 engange ngexabiso iipilisi 60 ichiza malunga 760-800 engange. Thelekisa, ixabiso ngenyanga onyango "Furosemide" kunqabile ngaphezulu engange-20. Kodwa ke yokugqibela unyango oluqhubekayo nomfutho kuba luncedo kangako.

Xa ukusilela intliziyo ezingapheliyo kunye nokudumba zombini iindleko Izangqa ejikeleza zonyango ngenyanga "Furosemide" imalunga 20-30 engange. Xa Elungiselela "Torasemide" ixabiso le amaxesha 10-15 mkhulu. Le yokugqibela lubanesiphumo wobulali, oko ayinamsebenzi kwandisa kukhuthaza umchamo kwiiyure lokuqala ulwamkelo. Ezona mpawu 'Furosemide "ye abhalwe: oko konyusa kakhulu isixa umchamo kwiiyure ezimbini zokuqala kunye buthathaka chu imveliso umchamo.

Ngenxa yoko, izigulane ukuqesheka kunye lwegazi okanye insufficiency esinganyangekiyo kwezintso okanye kwegazi isicelo ngokufanelekileyo "Torasemide" umyalelo (ixabiso layo kubonisiwe ngentla) nakwifom yesicelo olo luqulethe ulwazi malunga nophuculo ebalulekileyo diuresis ngexesha lokuqala ulwamkelo. Nangona kunjalo, iminyaka yomhlalaphantsi lwezigulana kungekho mfuneko ukuza emsebenzini, isantya umchamo yemveliso phantse awungeni ndawo. Singadali neengxaki, yaye ngoko ke likuvumela ukuba ufumana udidi analogu cheap - "Furosemide".