Izidakamizwa: ziyini, yiziphi izinhlobo nokuthi zisebenza kanjani

-Delile

• 1. I-Thiazide diuretics
• 2. Izindwangu zesisu
• 3. Ama-diuretics asindisa i-Potassium
• 4. isisu Osmotic
• 5. I-Carbonic anhydrase inhibitor diuretics

I-diuretics ngamakhambi angasetshenziswa wedwa noma ahlanganiswe nezinye izinto ezisebenzayo, ekwelapheni umfutho wegazi ophakeme, ukuvuvukala okubangelwa izifo zenhliziyo, izinso noma isibindi, phakathi kwabanye.

Kunezinhlobo eziningi zemishanguzo etholakalayo, njengama-thiazide, i-loop, i-potassium-sparing, i-osmotic noma i-carbonic anhydrase inhibitors, enezindlela ezahlukahlukene zokwenza nokusebenza ezifundeni ezahlukahlukene zezinso, okufanele zinikezwe ngokuya ngenkinga ezolashwa.

1. I-Thiazide diuretics

La ma-diuretics anendlela yawo yokwenza ukuvinjelwa kokubuyiselwa kabusha kwe-sodium engxenyeni yokuqala ye-distal tubule tubule, okwandisa ukuphuma kwayo, kanye nokukhishwa kwama-chloride futhi, kancane, i-potassium ne-magnesium, okuholela ekuholeni ukuqedwa kwamanzi. La makhambi asebenza ngamandla alinganiselayo.

Amagama ejwayelekile / wokuthengisa: Ezinye izibonelo ze-thiazide diuretics yi-indapamide (Natrilix, Indapen, Flux), i-hydrochlorothiazide (i-Diurix, i-Hidromed) ne-chlorothalidone (i-Higroton).

Izinkomba zokwelapha: Ngokuvamile, okwehlisa isisu kulesi sigaba kuboniswa ukwehlisa umfutho wegazi nokwelashwa okungamahlalakhona kwe-edema okuhambisana nokuhluleka kwenhliziyo okucinana, isifo sokuqina kwesibindi nesifo sezinso.

Imiphumela emibi ejwayelekile: Eminye yemiphumela emibi kakhulu engenzeka ngesikhathi sokwelashwa ngalezi zidakamizwa isiyezi, ikhanda, ubuthakathaka, isicanucanu, ukuhlanza, amajaqamba, uhudo, ukuqunjelwa, i-cholecystitis, i-pancreatitis kanye nokuphazamiseka kwegazi nesikhumba.

2. Izindwangu zesisu

I-Loop diuretics isebenza ngokuvimbela ukubuyiselwa kabusha kwe-sodium egatsheni elinyukayo le-loop kaHenle, okuholele ekwehlisweni kokubuyiselwa kwamanzi kabusha kwe-tubular. Ngaphezu kwalokho, la makhambi abuye abe nemiphumela eqondile ekugelezeni kwegazi, okudala i-vasodilation futhi kunciphise ukumelana nemithambo yegazi yezinso. La makhambi anomthelela onamandla wokukhishwa isisu, ngokuqala okusheshayo kwesikhathi esifushane

Amagama ejwayelekile / wokuthengisa: I-Furosemide (i-Lasix, i-Neosemid) iyisibonelo se-loop diuretic esetshenziswa kabanzi. Funda ukuthi ungayisebenzisa kanjani nokuthi yikuphi ukuphikisana kwe-furosemide.

Izinkomba zokwelapha: I-Loure diuretics ikhonjisiwe ekulawuleni i-edema ye-pulmonary acute nezinye izinhlobo ze-edema ezinamandla, ukwehluleka okukhulu kwezinso kanye nomfutho wegazi ophakeme. Ngaphezu kwalokho, zingasetshenziselwa ukwelapha i-hypercalcemia ebukhali, njengoba zikhuthaza ukuphuma kwe-calcium yomchamo.

Imiphumela emibi ejwayelekile: Eminye yemiphumela emibi engaba khona ngesikhathi sokwelashwa ukuphazamiseka kwe-electrolyte, ukwehla emzimbeni, i-hypovolemia, amazinga akhuphukile e-creatinine kanye ne-triglycerides egazini, ukuhlaselwa yi-gout nokukhuphuka kwevolumu yomchamo.

3. Ama-diuretics asindisa i-Potassium

La makhambi avimbela ukukhishwa kwe-potassium ezingeni lokugcina le-distal edlula i-tubule nasethunjini lokuqoqa, okungenzeka noma kungabi nesenzo esiphikisayo se-aldosterone.

I-Spironolactone ingumphikisi othile we-aldosterone, osebenza ikakhulukazi endaweni yokushintshana ye-aldosterone ne-potassium ion exchange, etholakala kwishubhu esichazwe kude leso lezinso nokuholela ekwandeni kwenani le-sodium namanzi okumele akhishwe, kuyilapho i-potassium igcinwa.

Amagama ejwayelekile / wokuthengisa: Ezinye izibonelo ze-poture-sparing diuretics yi-amiloride, ehlotshaniswa kuphela nezinye izinto ezisebenzayo, ne-spironolactone (i-Aldactone, i-Diacqua). Bona ezinye izinkomba zokwelapha ze-spironolactone.

Izinkomba zokwelapha: Ama-diuretics okonga i-potassium anesenzo esibuthakathaka sokuchama futhi, ngakho-ke, akuvamile ukuthi asetshenziswe yedwa ekwelapheni i-edema noma umfutho wegazi ophakeme, futhi ngokuvamile ahlotshaniswa nezinye isisu. Ukuphatha ngokubambisana kukhulisa umphumela we-diuretic nempendulo ye-antihypertensive ku-thiazide ne-loop diuretics.

Imiphumela emibi ejwayelekile: Eminye yemiphumela emibi engahle yenzeke ukunwetshwa kwevolumu engaphandle kwamangqamuzana, ukwehla emzimbeni kanye ne-hypernatremia.

4. isisu Osmotic

Le mithi inyusa i-osmolarity ye-glomerular filtrate, eyenza ukuhamba kwamanzi angaphakathi kwamangqamuzana angene esikhaleni samangqamuzana nasemithanjeni, okwenza i-diuresis emakiwe, ngenxa yalokho inciphise ingcindezi ye-intracranial kanye ne-edema kanye nengcindezi ephezulu ye-intraocular.

Amagama ejwayelekile / wokuthengisa: 20% Mannitol. Thola ukuthi i-mannitol isetshenziswa kanjani.

Izinkomba zokwelapha: I-20% ye-mannitol ikhonjisiwe ekwelapheni i-cerebral edema, i-acute glaucoma, ukwehluleka okukhulu kwezinso nokulungiselela ukuhlinzekwa kwamehlo.

Imiphumela emibi ejwayelekile: Eminye yemiphumela emibi kakhulu engaba khona yisicanucanu, ukuhlanza, ukoma, ikhanda elibuhlungu, isiyezi, ukundindizela, imfiva, ukukhuphuka kwenhliziyo, ubuhlungu besifuba, i-hypernatremia, ukwehla emzimbeni, ukungaboni kahle, isifuba noma umfutho wegazi ophakeme.

5. I-Carbonic anhydrase inhibitor diuretics

Le mithi ivimbela i-carbonic anhydrase, okuyi-enzyme evuselela ukusabela kwamakhemikhali okubandakanya ukufakela i-carbon dioxide ne-dehydrating carbonic acid. Ngenxa yalokho, kukhona ukwehla kwe-carbonic acid, okuholela ekwenziweni kwe-alkalinization komchamo, okukhuthaza i-diuresis.

Amagama ejwayelekile / wokuthengisa:i-acetazolamide (Diamox). Thola ukuthi ungasebenzisa kanjani nokuthi yiziphi iziphikiso zeDiamox.

Izinkomba zokwelapha: I-Carbonic anhydrase inhibitors ikhonjisiwe ekwelapheni i-glaucoma, i-alkalinization ye-urinary, i-metabolic alkalosis kanye nesifo esibuhlungu sezintaba.

Imiphumela emibi ejwayelekile: Eminye yemiphumela emibi engaba khona yi-metabolic acidosis, ukwandiswa kwevolumu ye-extracellular fluid, i-hyponatremia, ikhanda elibuhlungu, ukozela, isicanucanu, ukugabha nokoma.