"Torasemide": mirayiridzo kushandiswa. "Sandoz Torasemide": mutengo, nzvimbo, wongororo

"Torasemide" - rechimanjemanje simba diuretic mushonga kuti akakwana nokuda kwenguva refu kurapa zvirwere chokuita nechitarisiko edema. Nokuda vashomanana akaora chinokosha nemishonga, noupamhi hwayo kuchirapa kushandiswa zvikuru. Zviri nani kune dzimwe loop diuretics uye ane zvakawanda uchapupu. In kurapwa kwezvirwere siyana ari chipimo chemushonga unogadzurudzirwa. Uyewo, zviri kushanda pakuparwa insufficiency kuti itsvo basa kunyange panguva yakaderera filtration velocity glomeruli nephrons.

Zvazvinoita "torasemide"

"Torasemide" somumiririri loop (munyu) boka diuretics achishanda ari luminal chikamu epithelium pakati tubules zviri nephron iri vachikwira chikamu loop pakati Henle. Kushanda nesimba ane inhibitory zvainoita vadyi chokufambisa kuti potassium ions uye yavaibvisa chloride, izvozvo yekudyidzana kunoderedza electrochemical zvinogona panguva pose epithelium yacho nephron. Blockade mugumisiro ndiko kuvhiringidza Ion chokufambisa yavaibvisa reabsorption kubva chikuru weti, izvo anowedzera diuresis.

Zvinenge zvose loop diuretics vanokonzera electrolyte vachivavhiringidza yakafanira kune simba rokuchinja reabsorption kuti potassium ions, yavaibvisa, magnesium uye kuiisa chlorine. "Torasemide" kune muduku kumwero sei kusarudzwa potassium uye magnesium, nokuda uyo zvikuru yakaderera kuitika arrhythmias, kudya kupatira, tsandanyama simba. Uyewo, kuti zvinodhaka zvishoma zvakadini kutigumbura paumbwe thromboxane A2, kuvakoka midziyo. Naiyewo Zvidhinha aldosterone receptors infarction, zvichivhiringidza ari dzinotsanagura fibrosis mwoyo tsandanyama.

umboo

Vasiyana mushonga "Torasemide" mirayiridzo Chinyorwa rine ruzivo pamusoro chirwere, raakanga kushandiswa kurapwa. "Torasemide" kunoratidzwa nokuti:

• pathogenetic Mabatirwo chirwere cheBP husingakwanisi kurapa pamwe mubatanidzwa ACE FIs (ARBs) thiazide diuretics;
• pakurapa chirwere chemwoyo, dzinobatanidza kweropa zadzisa madenderedzwa;
• symptomatic mabatiro echirwere renal kukundikana, kusanganisira inonzwika apo yakaderera kumhanya (asingasviki 20 Rine mamiririta \ Maminitsi);
• symptomatic Mabatirwo chiropa (pamwe akabatanidza hypoalbuminemia) edema serimwe rinogona kutsiva "Furosemide".

Kana neBP "Torasemide" analogues generics anoshandiswa chete pashure kukundikana thiazide diuretics. A mushonga anogona kupiwa ari akareba vashoma akaora anokosha uye ngozi nemishonga iri renal kukundikana. Vaya 'torasemide "riri shoma zvikuru pane kuti" Furosemide ".

Mirayiridzo yokushandisa

Pachishandiswa zvekuchipatara nhungamiro zvinodhaka "Torasemide" mirayiridzo Chinyorwa unotora zvainyanya zvinodhaka dosages hunodiwa kunorapwa uye nokururamiswa kubaya chirwere. Chine mushonga pacharo Inowanika mahwendefa ane zvinotevera zvokubikisa: 2.5 MG, 5 MG, 10 MG, 20 MG, 50 MG, 100 MG, 200 MG.

Kutora mushonga pahwendefa mangwanani, pasinei kudya. For mishonga ava zvinodhaka "Torasemide" mutengo zvakasiyana: zviri kudzika panguva shoma dose uye rokumusoro panguva kufadza. Maererano neavhareji data, mahwendefa 30 mushonga pa 5 MG vari rubles anenge 400. Kana kugamuchira dose ichi anoparadzirwa sezvinotevera maererano zvairatidza:

• pakurapa neBP wakatorwa 2.5 - 10 MG / zuva;
• akapiwa 10-20 MG / zuva chisingaperi mwoyo kutadza;
• chisingaperi renal kukundikana - 50 MG kana kupfuura;
• chiropa kukundikana kunoda nomumwe dose kugadziriswa.

Side Migumisiro "torasemide"

Vasiyana mushonga "Torasemide" mirayiridzo Chinyorwa rine ruzivo pamusoro vakawanda nemishonga. Panguva kuchirapa dose, kureva kuti 200 MG pazuva kunowedzera mikana thromboembolic yematambudziko, cardiac ischemia, chepfungwa. It kunowedzera ngozi yokubatwa zvinopfuura ischemic kurwiswa uye myocardial infarction, pulmonary embolism, arrhythmias. Panewo ndingangokuvara panowanikwa sema rashes kana mikoko apo murwere kubatwa.

"Torasemide" dzimwe nguva anoita kuda kurutsa kana kurutsa, kashoma svitsanisa dyspepsia, manyoka. Zvinorondedzerwa voga nyaya pfungwa nomuviri zvemwana asati panguva kurapwa ne "torasemide". Rakawedzera hepatic transaminases, richiratidza chiropa toxicity zvinodhaka riri kumusoro mishonga. Dzimwe nguva varwere ainetseka pamusoro achirira munzeve, madzerere.

Kana ukapiwa ane muchetura dose kuva ezvinhu ovhadhozi pamwe shoma zviratidzo. Ovhadhozi achabatsirwa kurasikirwa mvura iri weti: diuresis refu uye kakawanda, anogona kuva hypotension, vascular kuondomoka, kufenda, sitiroko, chepfungwa ischemia necheseri.

Contraindications uye zvausingakwanisi chikumbiro

Drug "Torasemide" analogues zvinodhaka Generic hazvigoni kushandiswa pamberi mhedziso contraindications. Ndivo sema pavakanzwa mushonga kana binders. "Torasemide" rambidzwa kuzoshandisa renal kukundikana pamwe anuria, chiropa kukundikana paaiva ezvinhu hepatic pakoma, pamwe tachyarrhythmias. Contraindicated yaunodya panguva lactation uye pamuviri, uyewo pasi makore 18, hypersensitivity kune sulfonamides.

Side uye aibatanidza migumisiro "torasemide"

Pakurapa neBP mapiritsi "Torasemide" aigona kuva kunambwa nzira gout. Sezvo proximal tubules ari nephron vanoshingaira fuma anwa ne basa chokufambisa, pane kukwikwidzana chinovhiringidza pakati excretion pakati uric acid. Tikafunga kushandiswa "torasemide" mukuru ndingangokuvara hyperuricemia uye rikwanise gout.

Medicament "Torasemide" kunoratidzwa yakananga chiito pamusoro proximal chikamu tubular epithelium loop pamusoro Henle. Nokuda simba diuretic kushanda uye electrolyte kusaenzana ichi hunokonzera mukana wokuti akaora zvinokosha pharmacological mukukurukurirana. Vane ngozi seasingakoshi uye kwakanaka. Pakati ngozi uye zvinokosha;

• yakakwirira dose (50 MG / zuva) "torasemide" kana kushandiswa pachiimbwa Platinum kugadzirira runogonesa kuti toxicity okupedzisira;
• mishonga makuru "torasemide" (50 MG / zuva) kuwedzera nephrotoxic uye ototoxic migumisiro aminoglycoside mishonga inorwisa mabhakitiriya;
• muna cephalosporin mishonga, kana kushandiswa pamwe "torasemide" ari dose 50 MG / zuva rinowanika pfuma nephrotoxicity;
• salicylates pamwe "torasemide" (50 MG / zuva) Paaiita neurotoxicity.
• "Torasemide" tikafunga hama hypokalemia kunowedzera susceptibility ari myocardium kuti cardiac glycosides, ichiwedzera inotropic dzavo uye antiarrhythmic zvazviri, kuwedzera ngozi toxicity;
• ngozi hypokalemia iri yakawedzera concomitant kushandiswa "torasemide" pamwe corticosteroids kana sesaline laxatives;
• "Torasemide" runogonesa migumisiro "theophylline" curariform uye tsandanyama relaxants.

Akakumbira migumisiro kushandiswa yaisanganisa

Pakati aida nemigumisiro kuti zvinoda zvichiongororwa, ndiko kuderera BP panguva kurapwa pamwe ACE FIs. "Torasemide" nokuda nokubviswa Urume kunoderedza kuti hydrostatic aomerwa ropa kuti svitsanisa kuderedza BP. Izvi zvakakosha pakurapa neBP uye kunoda kururamiswa pamusoro dose pakati ACE FIs. Uyezve, mune mishonga yokurapa nemishonga neBP uye mubatanidzwa ane ACE inhibitor "torasemide" anotibvumira kuti vabudirire normalization ropa nevamwe 90% wevarwere.

In pakurapa chirwere chemwoyo akaora chinokosha chaizvoizvo kuderedza vasoconstrictor basa catecholamines. Heart uri kumashure diuretic kurapa "torasemide" ikarumbidzwa simba kuti stimulatory anonongedzera adrenaline uye noradrenaline. Zvisinei, zvimwechetezvo kuderedza kubudirira epinephrine uye norepinephrine panguva nokumutswa.

Negative Migumisiro kudyidzana

Pane Migumisiro chinovhiringidza efficacy kana ikashandiswa pamwe chete zvimwe zvinhu. In zvikuru:

• kugadzirirwa bile asidhi sequestrants kuderedza kubatwa "torasemide" pakati bowel zvoderedza kubata yokupedzisira;
• marwadzo analgesics (NSAIDS) kuderedza kubudirira "torasemide";
• "Probenecid" nokuda amplification pezvakaitwa urikozuricheskih kuchititadzisa kusarudzwa "torasemide" iri lumen pakati tubules, nokuderedza simba raro.

Okufananidza Unhu "torasemide"

Mukugadzirira "Torasemide" analogs zvinogona kirasi, kinetic uye generics. Pakati kirasi dzinomiririrwa analogues: "Furosemide", "bumetanide," "ethacrynic asidhi". Noku "Furosemide" "Torasemide" kunoratidzwa zvishoma kutanga chiito uye nomugumisiro zvakawanda kwenguva refu correlated pamwe zvakawedzera diuresis. Kupa diuretic nezvinozoitika rinenge simba zvakafanana "Furosemide" "Torasemide" rine zvishoma nemishonga chokuita nokukurumidza electrolyte kusaenzana.

"Bumetanide" iri ichazivikanwa noku kunyange kusimba diuretic pfuma kuti chokuita zvakawanda nemishonga. Ethacrynic asidhi ane rezasi Pazvinotanga zvazvingava diuretic kushanda uye kashoma kushandiswa kwezvinodhaka. The pharmacokinetics zvinodhaka "Torasemide" akaongororazve vanachiremba vanoziva mumwe chinokosha. The mushonga une ehupfumi kuti "rebound": diuresis pashure amplification kuburikidza allocating yavaibvisa hapana compensatory ayo chengetedzo.

Pharmacokinetic analogues "torasemide"

The "Torasemide" mishonga gwaro rinopa mashoko ayo kushanda mu varwere chirwere cheBP. Pamwe chete chinodhaka, nokuti dambudziko neBP uye anoshandiswawo thiazide diuretics, potassium-neusimbe. Uye thiazide yakafanira zvishoma nezvishoma kuuya uye refu diuretic chaizvoizvo ndiwo zvinodhaka resarudzo.

Nezvokumutswa izvi pharmacokinetic inoratidza analogues achigadzirira "Torasemide" chikumbiro angava zvinotevera: kurapa BP, husingakwanisi mureza kurapa pamwe ACE inhibitor mubatanidzwa (kana angiotensin Kanotokonya blocker) pamwe thiazide. Uyewo, "Torasemide" rinoshandiswa chisingaperi renal kukundikana kurapwa pamwe kuderedzwa filtration vanokwanisa.

Generics "torasemide"

Mukugadzirira "Torasemide" mirayiridzo manual, analogues, zviratidzo uye contraindications zvakazara maitiro ayo chikuru mugumisiro - kwakawedzera diuresis. Uyezve, chiito chakadaro ine yepakutanga zvinodhaka uye Generic. Ekupedzisira ane chete nhamba "torasemide", asi anobudiswa pasi mamwe mazita muchiso.

Yakakurumbira vari: "Britomar", "Diuver", "Sandoz Torasemide", "Trifas", "Torcida", "Trigrim". Panguva dzakawanda kuidzwa pharmacological yomuchipatara Misiyano vakanga kuchengetwa pakati pavo Russia. Mumwe nomumwe pamusoro Formulations zvakazara unotsiva mumwe wavo.

Economic zvinobatanidzwa kurapwa "torasemide"

Pakurapa neBP kana thiazide diuretics hadzibatsiri akabatana ACE FIs (kana ARBs), anogona kupiwa zvinodhaka kurapwa "Torasemide": mirayiridzo kushandiswa anoti kuroora dose masikati. The pamwedzi mutengo kurapwa kuri rubles anenge 400 ari mutengo mahwendefa 60 zvinodhaka vanenge 760-800 rubles. Enzanisa remwedzi mutengo kurapa "Furosemide" kashoma kupfuura 20 rubles. Asi vapedzisira kuti kuramba kurapwa kuti BP ndiyo shoma kushandiswa.

In chisingaperi mwoyo nokukundikana pamwe edema vose madenderedzwa wokufambisa mari pamwedzi kurapwa "Furosemide" anenge 20-30 rubles. Mukugadzirira "Torasemide" mutengo uri 10-15 nguva zvikuru. Ekupedzisira ane munyoro chaizvoizvo, kuti ndiye chisingaoneki kunowedzera excretion kuti weti iri maawa nokugamuchirwa wokutanga. The "Furosemide" zvechadenga neizvi: nayo anowedzera zvikuru huwandu weti ari mumaawa maviri okutanga ane zvishoma nezvishoma kwakaderera ari weti goho.

Somugumisiro, varwere employable vane BP kana chirwere renal insufficiency kana kweropa zvinoshandawo "Torasemide" mirayiridzo (mutengo wayo apa) pamusoro pokushandisa ine ruzivo pamusoro chinokosha enhancement kuti diuresis rokutanga panguva mabiko. Zvisinei, kuti mudyandigere zera varwere pasina kudiwa kuuya kubasa, weti goho kukurumidza ndiye anenge hazvishandi. Hazvina kusika nezvinetso, uye saka unokubvumira kugamuchira serisina kirasi analogue - "Furosemide".