Okodzetsa: Ntchito, zopangidwa wamba, komanso zambiri zachitetezo

Zambiri Zamankhwala

Mndandanda wa okodzetsa | Kodi diuretics ndi chiyani? | Momwe amagwirira ntchito | Ntchito | Mitundu | Ndani angatenge okodzetsa? | Chitetezo | Zotsatira zoyipa | Mtengo

Ma diuretics, omwe amadziwika kuti mapiritsi amadzi, amachulukitsa kuchuluka kwa madzimadzi omwe amatulutsidwa mthupi kudzera mumkodzo. Mmodzi mwa odziwika kwambiri, diuretics wachilengedwe ndi caffeine, yemwe amapezeka mu khofi ndi tiyi. Komabe, caffeine imakhala ndi diuretic yofatsa ndipo siimagwiritsidwa ntchito ngati diuretic m'malo azachipatala.

Mbiri yamakono ya diuretics idayamba 1919 pamene wophunzira zamankhwala anapeza kuti jakisoni wokhala ndi mercury anali wothandiza kutulutsa madzi mwa odwala chindoko. Sizinapitirire mpaka 1950s ndi 1960s zomwe zimafotokozedwa kuti thiazide ndi ma diuretics ozungulira amapezeka ndipo amagwiritsidwa ntchito kwambiri. Masiku ano, ma diuretics amalembedwa kuti athetse kuthamanga kwa magazi ndi zina.

Pitirizani kuwerenga kuti mudziwe zambiri za mitundu yosiyanasiyana ya okodzetsa, kagwiritsidwe kake, ndi zotsatirapo zake.

Mndandanda wa okodzetsa
Dzina Brand (dzina generic)	Avereji ya ndalama	Mtengo umodzi	Dziwani zambiri
Microzide (hydrochlorothiazide)	$ 56 pa 30, mapiritsi 25 mg	Pezani ma coupon a hydrochlorothiazide	Zambiri za Hydrochlorothiazide
Zowonjezera (chlorthalidone)	$ 31 pa 30, mapiritsi 25 mg	Pezani makuponi a chlorthalidone	Zambiri za Chlorthalidone
Lozol (indapamide)	$ 46 pa 30, mapiritsi a 2.5 mg	Pezani makuponi a indapamide	Zambiri za Indapamide
Zaroxolyn (metolazone)	$ 105 pa 30, mapiritsi a 2.5 mg	Pezani ma coupons a metolazone	Zambiri za Metolazone
Bumex (bumetanide)	$ 91 pa 30, mapiritsi 1 mg	Pezani ma couponide a bumetanide	Zambiri za Bumetanide
Lasix (furosemide)	$ 26 pa 30, 20 mg mapiritsi	Pezani makuponi a furosemide	Zambiri za Furosemide
Demadex (kutalika)	$ 35 pa 30, mapiritsi a 20 mg	Pezani ma coupons a torsemide	Zambiri za Torsemide
Edecrin (ethacrynic acid)	$ 95 pa mapiritsi 4, 25 mg	Pezani ma coupon a ethacrynic acid	Tsatanetsatane wa asidi amtundu
Midamor (amiloride)	$ 42 pa 30, mapiritsi 5 mg	Pezani ma coupon amiloride	Zambiri za Amiloride
Dyrenium (katatu)	$ 478 pa 30, 50 mg mapiritsi	Pezani ma coupon a triamterene	Zambiri za Triamterene
Aldactone (spironolactone)	$ 30 pa 30, mapiritsi 25 mg	Pezani makuponi a spironolactone	Zambiri za Spironolactone
Inspra (eplerenone)	$ 235 pa 30, mapiritsi 25 mg	Pezani makuponi a eplerenone	Zambiri za Eplerenone

Zojambula zina

• Diuril (chlorothiazide)
• Chikhalidwe (bendroflumethiazide)
• Enduron (methyclothiazide)
• Renese (polythiazide)
• Saluroni (hydroflumethiazide)
• Diamox (acetazolamide)
• Daranide (dichlorphenamide)
• Neptazane (methazolamide)
• Diurex (pamabrom)
• Osmitrol (mannitol)

Kodi diuretics ndi chiyani?

Mwinanso amatchedwa mapiritsi amadzi, okodzetsa ndi mankhwala omwe amachulukitsa mchere ndi madzi omwe amatulutsidwa mthupi. Mankhwalawa amakulitsa kupanga mkodzo wopangidwa mu impso, zomwe zimapangitsa kuti mkodzo uwonjezeke, kapena diuresis. Diuretics amagwiritsidwa ntchito pochiza kuthamanga kwa magazi (matenda oopsa) komanso kusungunuka kwamadzimadzi, kapena edema, komwe kumayamba kukhala chizindikiritso cha mtima kulephera, mavuto a impso, komanso kufooka kwa chiwindi. Ma diuretics ena atha kugwiritsidwanso ntchito kuthana ndi kutupa muubongo komwe kumachitika chifukwa chovulala mutu kwambiri kapena kutupa m'maso komwe kumayambitsidwa ndi mawonekedwe amaso ngati khungu .

Kodi diuretics amagwira ntchito bwanji?

Ma diuretics amagwira ntchito posintha kuchuluka kwa madzi, mchere, ndi ma electrolyte mthupi.

Makamaka, zimakhudza njira zosiyanasiyana mu impso zomwe zimagwira ntchito pakubwezeretsanso kwa sodium ndi electrolyte. Pali mitundu yosiyanasiyana ya okodzetsa. Aliyense wa iwo atha kugwira ntchito m'malo osiyanasiyana a impso , gawo losefa la thupi. Chifukwa cha kuchuluka kwa sodium yotulutsidwa mu impso, madzi ambiri amatuluka m'thupi mkodzo.

Kungakhale kofunikira kumvetsetsa kapangidwe ka impso ndi momwe zimagwirira ntchito kuti mumvetsetse momwe ma diuretics amagwirira ntchito. Impso iliyonse ili ndi oposa 1 miliyoni nephrons, omwe ndi magulu osefera omwe amachotsa zonyansa ndikupanga mkodzo mthupi. Kutengera mtundu wa diuretic, mankhwalawa amagwira ntchito mu chubu chophatikizika, chiwalo chokwera cha kuzungulira kwa Henle, distule yosakanikirana, kapena chubu chosonkhanitsira.

Kodi diuretics amagwiritsidwa ntchito bwanji?

Ma diuretics atha kugwiritsidwa ntchito pochiza matenda osiyanasiyana omwe amakhudza mtima, impso, ndi chiwindi. Amagwiritsidwanso ntchito ngati antihypertensives kuti achepetse kuthamanga kwa magazi. Madokotala okodzetsa nthawi zina amazunzidwa ndi omwe ali ndi vuto la kudya kuti achepetse kunenepa. Odzetsa amatha kupezeka ndi mankhwala ndipo atha kugwiritsidwa ntchito pochita izi:

• Mtima kulephera
• Kulephera kwamitsempha yamanzere
• Kuthamanga kwa magazi
• Pachimake aimpso kulephera
• Oliguric aimpso kulephera
• Miyala ya impso
• Kuvulala kwakukulu kwa impso
• Matenda a impso
• Matenda a chiwindi
• Edema ya m'mapapo
• Mlingo wambiri wa calcium (hypercalcemia)
• Mlingo waukulu wa potaziyamu wamagazi (hyperkalemia)
• Nephrogenic shuga insipidus
• Kuthamanga kwakukulu
• Glaucoma

Mitundu ya okodzetsa

Odzetsa okodzetsa

Thiazides amayang'ana sodium-chloride cotransporter kuti aletse kuyambiranso kwa sodium, komwe kumathandizira kuwongolera kuchuluka kwa sodium ndi magazi. Monga gulu la mankhwala, thiazide diuretics imalepheretsa kubwezeretsanso pafupifupi 5% wa sodium mu distal convoluted tubule. Thiazides amalepheretsanso potaziyamu, yomwe imatha kubweretsa potaziyamu m'thupi. Potaziyamu otsika (hypokalemia) imatha kubweretsa zovuta za mtima, pakati pamavuto ena. Chifukwa cha zovuta zawo, thiazides nthawi zambiri amagwiritsidwa ntchito ngati chithandizo choyamba cha matenda oopsa m'malo mwa ACE inhibitors. Zitsanzo za thiazides ndi Microzide (hydrochlorothiazide) ndi Hygroton (chlorthalidone).

Odzetsa okhathamira

Monga thiazides, kuzungulira diuretics kumathandizanso kuwongolera kuchuluka kwa sodium mu impso. Komabe, ma diuretiki a loop amagwira ntchito mu gawo lokwera la kuzungulira kwa Henle mu nephron. Mankhwalawa amalimbana ndi sodium-potaziyamu-kloride cotransporter kuti aletse kuyambiranso kwa sodium ndi madzi. Loure diuretics amathanso kuchepa kuyamwa kwa potaziyamu, komwe kumatha kubweretsa kutsika kwa potaziyamu mthupi. Ma diuretics a Loop atha kugwiritsidwa ntchito pochiza kulephera kwa mtima, impso kulephera, potaziyamu wambiri (hyperkalemia), kuchuluka kwa calcium (hypercalcemia), ndi mitundu yambiri ya edema, monga edema ya m'mapapo. Zitsanzo za ma diuretiki ophatikizika amaphatikizapo Bumex (bumetanide) ndi Lasix (furosemide) , komanso Demadex (torsemide).

Mankhwala okhudzana ndi potaziyamu

Mankhwala oteteza potaziyamu samayambitsa kutulutsa potaziyamu mumkodzo. Mankhwala oteteza potaziyamu monga amiloride amamanga njira za sodium kuti achepetse kuyambiranso kwa sodium m'magazi. Izi zimawonjezera kutayika kwamadzimadzi popanda kuchepa kwa potaziyamu. Mitundu ina yosungunulira potaziyamu monga spironolactone imagwira ntchito mu distal tubule ndikusonkhanitsa timadontho toletsa zotsatira za aldosterone, hormone ya steroid yomwe imawonjezera kukonzanso kwa sodium. Zitsanzo za potassium-sparing diuretics ndi Midamor (amiloride), Dyrenium (triamterene), Aldactone (spironolactone), ndi Inspra (eplerenone).

Mpweya wa anhydrase inhibitors

Carbonic anhydrase ndi enzyme yomwe imapezeka m'malo osiyanasiyana amthupi, kuphatikiza maselo ofiira ofiira komanso chifuwa cholumikizira cha impso. Enzyme imeneyi imathandiza kuti thupi libwezeretsenso sodium, bicarbonate, ndi chloride. Carbonic anhydrase inhibitors amaletsa ma enzyme awa kuti atulutse zinthu izi ndi madzi owonjezera amthupi. Carbonic anhydrase inhibitors amagwiritsidwa ntchito pochizira glaucoma. Zitsanzo ndi Diamox (acetazolamide) ndi Neptazane (methazolamide).

Zojambula zina

Xanthine okodzetsa ndi mtundu wa diuretic wofatsa womwe umalepheretsa kubwezeretsanso kwamadzimadzi mu chifuwa chachikulu cha impso. Zitsanzo za xanthine diuretics ndi caffeine ndi Diurex (pamabrom). Zosangalatsa za Osmotic gwiritsani ntchito njira ya osmosis kuti muthe madzimadzi ndikuchepetsa kusungidwa kwamadzimadzi. Osmotic okodzetsa makamaka amagwira ntchito mu proximal tubule ndi kuzungulira kwa Henle. Osmotic diuretic yomwe imagwiritsidwa ntchito kwambiri ndi Osmitrol (mannitol), yomwe imagwiritsidwa ntchito pochepetsa kupsinjika kwa mtima ndikuchiza kulephera kwa impso.

Ndani angatenge okodzetsa?

Akuluakulu

Ma diuretics amagwiritsidwa ntchito kwambiri pochizira edema ndi matenda ena amtima mwa akulu. Kugwiritsa ntchito okodzetsa mwa akulu kumadalira momwe amathandizira.

Ana

Ana atha kupatsidwa diuretics kuti achepetse madzimadzi amadzaza chifukwa cha kupsinjika kwa mtima komanso kulephera kwa impso. Kugwiritsa ntchito okodzetsa mwa ana kumadalira momwe amathandizidwira. Mlingo wa okodzetsa mwa ana nthawi zambiri amawerengedwa ndi kulemera kwa thupi.

Kodi okodzetsa ndi otetezeka?

Odzetsa nthawi zambiri amakhala mankhwala otetezeka akagwiritsidwa ntchito monga momwe akunenera. Chifukwa cha momwe zimakhudzira madzi, mchere, ndi kubwezeretsanso mphamvu kwa ma electrolyte, zimatha kuyambitsa kusamvana kwamadzimadzi ndi ma electrolyte. Kuchulukanso kwamadzimadzi kumathandizanso kuti odwala ena asowe madzi m'thupi. Maselo ochepa a potaziyamu amathanso kukhala okhumudwitsa ndi okodzetsa ambiri kupatula ma diuretiki osungira potaziyamu.

Kugwiritsa ntchito diuretics ndi digoxin kapena lithiamu kumafunika kuyang'aniridwa kapena kupewa. Lankhulani ndi othandizira azaumoyo pazomwe zingachitike mukamagwiritsa ntchito mankhwala osokoneza bongo.

Odzoza amakumbukira

Palibe zokumbukira zaposachedwa kuyambira pa Marichi 2021.

Kuletsa kwa okodzetsa

Musatenge okodzetsa ngati mukugwirizana ndi zosakaniza za okodzetsa. Ma diuretics ena amakhala ndi sulfa, yomwe imatha kuyambitsa vuto kwa anthu omwe adakumana ndi vuto la mankhwala a sulfonamide monga sulfamethoxazole.

Okalamba ena angafunike kuyang'aniridwa akamamwa diuretics. Odzetsa amatha kuonjezera chizungulire kapena kugwa mwa anthu okalamba chifukwa cha postural hypotension , kapena kuchepa kwachangu kuthamanga kwa magazi posintha malo okhala ndi oyimirira.

Kodi mungatenge okodzetsa mukakhala ndi pakati kapena mukuyamwitsa?

Nthawi zina olembetsa amalembedwa panthawi yoyembekezera chifukwa cha matenda oopsa kapena mtima. Komabe, chitetezo chawo sichinatsimikizidwe ndi maphunziro. Odzetsa ayenera kugwiritsidwa ntchito pokhapokha phindu likaposa chiwopsezo chake. Mlingo waukulu wa okodzetsa umakhudza kupezeka kwa mkaka ndikupondereza kuyamwa kwa azimayi omwe akuyamwitsa. Funsani othandizira azaumoyo kuti akalandire malangizo asanagwiritse ntchito diuretics mukakhala ndi pakati kapena mukuyamwitsa.

Kodi ma diuretics amayang'aniridwa ndi zinthu?

Ayi, ma diuretics sakhala zinthu zowongoleredwa.

Zotsatira zodziwika bwino za okodzetsa

Zotsatira zofala kwambiri za okodzetsa ndi monga:

• Kukodza pafupipafupi
• Chizungulire
• Kupepuka
• Kutopa kapena kutopa
• Mutu
• Chitupa
• Kupweteka kwa minofu
• Kutsekula m'mimba
• Kulephera kwa Erectile
• Kuchuluka kwa shuga m'magazi

Zotsatira zoyipa za okodzetsa zimaphatikizapo potaziyamu wochepa, kapena hypokalemia, yomwe imatha kubweretsa mikhalidwe yachilendo ya mtima. Popanda chithandizo, potaziyamu yotsika imatha kubweretsa zovuta zowononga moyo. Mankhwala oteteza ku potaziyamu sangayambitse mbalizi koma amatha kuyambitsa potaziyamu (hyperkalemia). Ma diuretics amatha kuyambitsa kusamvana kwina kwama electrolyte monga ma sodium otsika (hyponatremia) ndi calcium yotsika (hypocalcemia).

Ma diuretics amathanso kuyambitsa kusowa kwa madzi m'thupi chifukwa cha kutulutsa madzi ambiri. Zizindikiro zakusowa madzi m'thupi zimaphatikizaponso ludzu kwambiri, chisokonezo, ndi mkodzo wamdima.

Mankhwala ena okodzetsa monga thiazides atha kukulitsa cholesterol pang'ono.

Uzani dokotala wanu ngati muli ndi mbiri ya zinthu izi musanagwiritse ntchito diuretic:

• Matenda a shuga
• Gout
• Mavuto a impso
• Kutaya madzi m'thupi
• Pancreatitis
• Lupus
• Mavuto akusamba

Lankhulani ndi omwe amakuthandizani kuti muphunzire za zovuta zina, machenjezo, ndi zodzitetezera zomwe zimakhudzana ndi okodzetsa.

Kodi ma diuretics amawononga ndalama zingati?

Ma diuretics nthawi zambiri amakhala mankhwala otchipa komanso otsika mtengo omwe amapezeka m'maina azizindikiro komanso generic. Pafupifupi mapulani onse a Medicare ndi ma inshuwaransi amatenga ma diuretics. Mtengo umasiyana kutengera dongosolo la inshuwaransi yanu. Popanda inshuwaransi, mtengo wa okodzetsa umatha kusiyanasiyana kutengera kuchuluka kwa mapiritsi oyenera. Komabe, kugwiritsa ntchito Khadi lochotsera mankhwala kuchokera ku SingleCare itha kuthandiza kuchepetsa mtengo wa okodzetsa.