Torasemide: cov lus qhia rau siv. "Torasemid sandoz": nqe, piav qhia, kev txheeb xyuas

"Torasemide" yog ib qho kev niaj hnub ua kom lub cev tsis zoo uas zoo heev rau kev kho mob mus ntev ntawm cov kab mob nrog rau cov tsos mob ntawm lub cev. Vim tias muaj tsawg dua ntawm cov kev mob tshwm sim hauv plab, qhov dav ntawm nws txoj kev siv tshuaj kho siab dua. Nws muaj kev ruaj ntseg dua lwm cov voj diuretics thiab muaj ntau cov cim. Nyob rau hauv kev kho mob ntawm ntau cov kab mob, nws cov tshuaj yog hloov. Tsis tas li ntawd, nws muaj feem xyuam rau qhov teeb meem ntawm kev ua haujlwm hauv lub raum, txawm tias muaj tsawg npaum li cas pom los ntawm glomerulus ntawm nephrons.

Los ntawm Torasemide

"Torasemide" raws li ib tug neeg sawv cev voj (ntsev) pab pawg neeg diuretics kuj nyob rau hauv lub luminal ib feem ntawm lub epithelium ntawm tubules ntawm lub nephron nyob rau hauv lub ascending feem ntawm lub voj ntawm Henle. Muaj cov nyhuv nyhav rau ntawm kev sib koom tes ntawm potassium, chlorine thiab sodium ions, nws txo qis ntawm cov hluav taws xob nyob hauv qhov av ntawm epithelium ntawm tus nephron. Qhov tshwm sim ntawm blockade ntawm ion thauj yog ib qho kev ua txhaum ntawm qhov rov qab nqus ntawm sodium los ntawm cov zis thawj, uas ua kom mob diuresis.

Zoo txhua lub voj voos diuretics ua rau electrolyte disturbances vim cov nyhuv muaj zog rau lub reabsorption ntawm potassium, sodium, magnesium thiab chlorine ions. "Torasemide" rau tsawg dua qhov cuam tshuam kev tso tawm cov potassium thiab magnesium, vim li cas ho tsis tshua ua rau arrhythmias, anorexia, constipation, nqaij tsis muaj zog. Tsis tas li ntawd, cov tshuaj siv rau ib qho me me li qhov tsim ntawm thromboxane A2, nthuav tawm cov hlab ntsha. Nws tseem thaiv cov neeg txais tos ntawm myocardial aldosterone, inhibiting cov txheej txheem ntawm fibrosis ntawm lub plawv mob.

Kev qhia

Cov lus qhia siv rau "Torasemide" npaj muaj cov lus qhia txog cov kab mob uas nws siv. Torasemide yog tshwm rau:

• Pathogenetic kev kho mob ntawm cov ntshav siab, kev tiv thaiv nrog kev kho mob nrog ob leeg ua ke ntawm ACE inhibitors (ARBs) nrog thiazide diuretics;
• Kev kho mob ntawm lub plawv tsis ua hauj lwm, ua ke nrog ib tshaj ntawm cov ntshav ncig voj voog;
• Kev mob raum tsis ua haujlwm, xws li thaum tsis muaj qhov pom tsawg (tsawg dua 20 ml / min);
• Symptomatic treatment of hepatic (txuam nrog hypoalbuminemia) edema ua lwm txoj rau Furosemide.

Nyob rau hauv cov ntaub ntawv ntawm arterial hypertension, "Torasemide", analogues thiab nws cov generics yog siv nyob rau hauv cov ntaub ntawv ntawm ineffectiveness ntawm thiazide diuretics. Thiab nrog lub raum tsis muaj txhij txhua, cov tshuaj yuav qhia tau ntev ntev vim tias muaj tsawg tsawg ntawm cov kev mob tshwm sim hauv lub cev thiab kev phom sij. Xws li "Torasemide" yog qhov tsawg tshaj li ntawm "Furosemide".

Lus qhia rau kev siv

Raws li cov kev soj ntsuam raws li kev cai rau cov tshuaj "Torasemide" phau ntawv qhia comprises cov yam ntxwv ntawm cov tshuaj noj tshuaj npaum cas yuav tsum tau kev kho mob thiab kev kho ntawm lub hom phiaj kab mob. Thiab cov tshuaj nws tus kheej yog tsim nyob rau hauv cov ntsiav tshuaj nrog cov nram qab no yeeb tshuaj: 2.5 mg, 5 mg, 10 mg, 20 mg, 50 mg, 100 mg, 200 mg.

Cov tshuaj yog noj rau ib ntsiav tshuaj thaum sawv ntxov, tsis hais txog khoom noj. Rau cov dosages ntawm yeeb tshuaj "Torasemide" tus nqi txawv: nws yog qis dua ntawm qhov qis tshaj thiab qhov siab tshaj plaws ntawm qhov siab tshaj. Raws li cov ntaub ntawv muab rau nruab nrab, 30 ntsiav tshuaj ntawm cov tshuaj ntawm 5 mg nqi kwv yees li 400 rubles. Nyob rau hauv cov ntaub ntawv no, lub koob tshuaj yog faib raws li nram no raws li lub indications:

• Nyob rau hauv kev kho mob ntawm kub siab yog npaum li cas 2.5 - 10 mg / hnub;
• Nrog lub plawv tsis ua hauj lwm thaum 10-20 mg / hnub;
• Kev mob raum tsis ua hauj lwm - 50 thiab ntau dua;
• Nrog rau daim ntawv tsis txaus siab yuav tsum tau txhaj ib koob tshuaj.

Tej teebmeem ntawm Torasemide

Cov lus qhia siv rau "Torasemide" npaj muaj cov lus qhia txog ntau yam kev mob tshwm sim. Hauv kev siv tshuaj, uas yog txog li 200 mg rau ib hnub, nws muaj kev pheej hmoo siab ntawm cov teeb meem mob thromboembolic, ischemia ntawm lub plawv, lub hlwb. Nws tsub kom kev pheej hmoo ntawm nraum ischemic tawm tsam thiab myocardial infarction, pulmonary embolism, arrhythmias. Tsis tas li ntawd, muaj ib qho kev tshwm sim ntawm kev ua xua ua xua los yog ua qog nqaij hlav nrog tus neeg mob.

"Torasemide" qee zaum ua rau xeev siab lossis ntuav, tsis tshua muaj kev sib to taub dyspepsia, raws plab. Tib neeg mob plab hnyuv pancreatitis rau tom qab ntawm daim ntawv thov ntawm "Torasemide" piav qhia. Hematic transaminases kuj nce siab, uas qhia tias cov tshuaj lom cov tshuaj lom kab mob hauv cov tshuaj loj. Qee zaus cov neeg mob muaj kev txhawj xeeb txog kev sib tsoo hauv pob ntseg, kev pom teeb meem.

Thaum noj tshuaj hauv ib qho tshuaj lom, ib qho kev noj tshuaj ntau dhau nrog tsawg tsawg ntawm cov tsos mob. Overdosage yog nrog los ntawm cov kua qaub hauv cov zis: kev mob plab yog ntev thiab nquag, qhov hypotension, vascular collapse, tsaus muag, thiab mob stroke ntawm keeb kwm ntawm cerebral ischemia.

Contraindications thiab cov kev txwv ntawm kev siv

Cov tshuaj "Torasemide", analogs thiab nws cov generics tsis tuaj yeem siv nyob rau hauv kev muaj cov kev tsis sib haum xeeb. Cov no yog cov kev fab tshuaj rau cov tshuaj los yog khi. "Torasemide" raug txwv tsis pub siv cov kev mob hauv lub ntsws nrog anuria, nrog rau kev mob ntsws tsis muaj zog hauv lub xeev ntawm comatic, nrog tachyarrhythmias. Contraindicated nyob rau hauv lactation thiab cev xeeb tub, thiab raws li muaj hnub nyoog 18 xyoo, hypersensitivity rau sulfonamides.

Tej teebmeem ntawm "Torasemide"

Nyob rau hauv kev kho ntawm kub siab, Torasemide ntsiav tshuaj muaj peev xwm muaj ib qho tsis zoo ntawm cov chav kawm ntawm gout. Vim tias cov khoom ua rau nkag mus rau hauv cov hlab ntsha ntawm cov nephron los ntawm kev thauj mus los, muaj ib qho kev sib tw ntawm uric acid excretion. Tiv thaiv tom qab ntawm kev siv "Torasemide", qhov tshwm sim ntawm hyperuricemia thiab exacerbation ntawm gout tam sim no yog qhov zoo.

Kev noj tshuaj "Torasemide" yog ib qho kev ntxim muaj tshwm sim ntawm cov tubular epithelium ntawm cov pob txha ntawm Henle lub voj voog. Vim yog lub cev tsis muaj zog thiab qhov tsis txaus ntawm lub cev, qhov no ua rau muaj kev cuam tshuam cov tshuaj pharmacological. Lawv yog cov txaus ntshai, tsis tseem ceeb thiab txaus. Ntawm qhov teeb meem thiab tseem ceeb yog:

• Kev siv cov koob txhaj tshuaj (ntawm 50 mg / hnub) "Torasemide" thaum nrog cov tshuaj platinum ua rau kom muaj cov tshuaj lom neeg tom kawg;
• Cov hnyuv loj ntawm "Torasemide" (ntawm 50 mg / hnub) ua rau cov nyhuv ntawm nephrotoxic thiab ototoxic ntawm aminoglycoside tshuaj tua kab mob;
• Hauv cephalosporin tshuaj tua kab mob, thaum ua ke nrog "Torasemide" ntawm ib qho tshuaj ntawm 50 mg / hnub, cov khoom muaj nephrotoxicity tshwm;
• Salicylates nrog rau "Torasemide" (los ntawm 50 mg / hnub) yog cov xeeb txawm los ntawm neurotoxicity.
• "Torasemide" tiv thaiv lub keeb kwm yav dhau ntawm ib tug txheeb ze hypokalemia tsub kom lub nyhav ntawm lub myocardium rau mob glycosides, kom lawv inotropic thiab antiarrhythmic nyhuv, kom txoj kev pheej hmoo ntawm tshuaj muaj taug;
• Txoj kev pheej hmoo ntawm hypokalemia tsub kom nrog kev siv lub "Torasemide" nrog corticosteroids los yog ntsev laxatives;
• "Torasemide" ua rau cov nyhuv ntawm "Theophylline" thiab cov kab mob zoo li cov leeg mob.

Lub txiaj ntsig zoo ntawm kev sib koom ua ke

Ntawm qhov teebmeem uas yuav tsum tswj, muaj tshua txo qis hauv cov ntshav siab nyob hauv keeb kwm ntawm kev khomob nrog ACE covcub. "Torasemide" vim qhov kev tshem tawm ntawm kua thiaj li lub hydrostatic siab ntawm cov ntshav mus kho ib tug nco nyob rau hauv cov ntshav siab. Qhov ntawm no yog ib qho tseem ceeb hauv kev kho siab ntawm kev kub ntxhov thiab yuav tsum tau hloov cov kab mob ACE inhibitor. Ntxiv mus, nyob rau hauv kev kho mob ntawm cov tshuaj hypertensive tiv taus cov kev kho mob, ua ke ntawm ACE inhibitors thiab Torasemide tso cai ua kom tau normalization ntawm BP hauv 90% ntawm cov neeg mob.

Hauv kev kho mob ntawm lub plawv tsis ua hauj lwm, cov nyhuv ntawm kev txo cov kev ua rau cov catecholamines yog qhov tseem ceeb. Lub plawv tiv thaiv tus keeb kwm ntawm diuretic therapy "Torasemide" tsis tshua pom cov lus teb rau stimulating cov teeb liab ntawm adrenaline thiab norepinephrine. Txawm li cas los xij, tib cov nyhuv ua rau cov tshuaj epinephrine thiab norepinephrine siv tau zoo thaum lub sij hawm kho mob.

Tsis zoo los ntawm kev sib raug zoo

Muaj cov teebmeem ntawm kev tiv thaiv kev siv tshuaj thaum siv nrog lwm cov tshuaj. Hauv particular:

• Kev npaj ntawm pawg neeg ntawm cov kua qaub qaum kuj tau txo qhov kev ntes ntawm "Torasemide" los ntawm txoj hnyuv, ua rau lub cev qaug zog zuj zus;
• Non-narcotic analgesics (NSAIDs) txo cov kev ua haujlwm ntawm Torasemide;
• "Probenecid" vim yog qhov kev sib zog ntawm cov txheej txheem uricosuric inhibits tus cais ntawm "Torasemide" nyob rau hauv lub lumen ntawm lub tubules, txo nws cov hauj lwm zoo.

Sib piv cov yam ntxwv ntawm "Torasemide"

Nyob rau hauv kev npaj "Torasemide" analogs tuaj yeem yog cov chav kawm, kev sib txuas lus thiab kev ua lag luam. Ntawm cov hoob kawm analogues muaj cov sawv cev: "Furosemide", "Bumetanid", "Etakrinaic acid". Nyob rau hauv kev sib piv nrog "Furosemide", "Torasemide" yog tus cwj pwm los ntawm kev pib qeeb thiab ua ntev ntev nrog kev sib ntxiv ntawm kev kho mob. Muaj ib qho kev ntxim ntxaug ntawm cov pob txha tib yam xws li Furosemide, Torasemide muaj tsawg dua cov teebmeem uas tshwm sim los ntawm lub cev tsis muaj zog ntawm electrolyte.

"Bumetanide" yog qhia los ntawm ib qho khoom xaj hluav taws xob muaj zog, uas yog txuam nrog ntau cov kev mob tshwm sim. Ectric acid muaj tsawg dua ntawm qhov pib ntawm cov diuretic nyhuv thiab tshua kev siv tshuaj tsis tshua siv. Hauv lub khw muag tshuaj ntawm "Torasemide", cov kws tshawb fawb kev txheeb xyuas cov ntsiab lus tseem ceeb. Cov tshuaj tsis muaj "ricochet" vaj tse: tom qab txhawb nqa kev noj qab haus huv vim kev tshem tawm ntawm sodium, tsis muaj kev ncua sij hawm rau hauv lub cev.

Pharmacokinetic analogues ntawm "Torasemide"

Tus "Torasemide" npaj muaj cov ntsiab lus qhia txog nws txoj kev siv ntshav siab. Nrog rau cov tshuaj no, thiazide thiab potassium-sparing diuretics kuj tseem siv los kho cov ntshav siab. Thiab thiazide vim qhov kev qeeb qeeb thiab cov kev siv tshuaj tiv thaiv kab mob ntev ntev yog cov tshuaj xaiv.

Cov neeg ua hauj lwm yuav tsum ua raws li cov lus qhia hauv qab no: kev kho mob ntawm cov tshuaj tiv thaiv kom tsis txhob muaj kev kub ntxhov rau kev kho nrog ob leeg ua ke ntawm ACE (los yog angiotensin receptor blockers) nrog thiazides. Tsis tas li ntawd, "Torasemide" yog siv rau kev kho mob ntawm lub raum tsis ua hauj lwm nrog kev lim kua.

Generics "Torasemide"

Nyob rau hauv kev npaj "Torasemide" cov lus qhia rau kev siv, analogs, indications thiab contraindications nkaus characterize nws lub ntsiab effect - nce diuresis. Thiab qhov kev txiav txim no yog thawj cov tshuaj thiab nws cov khoom siv. Cov yav tas muaj cov nyiaj tib yam "Torasemide", tab sis lawv ua rau lwm cov lag luam tawm.

Cov feem ntau nrov: Britomar, Diver, Torasemid Sandoz, Trifas, Torsid, Trigrim. Thaum kuaj zis heev ntawm cov tshuaj yeeb tshuaj nyob rau hauv Russia, tsis muaj qhov txawv ntawm qhov lawv tau muab sau tseg. Txhua yam ntawm cov tshuaj noj saum toj no hloov ntau lwm tus.

Kev nrhav kev kho ntawm Torasemide

Nyob rau hauv cov kev kho mob ntawm kub siab thaum lub thiazide diuretics yog ices nyob rau hauv ua ke nrog nrog ACE inhibitors (los yog ARBs), yuav tsum muab cov tshuaj kho mob "Torasemide": cov lus qhia rau kev siv cav ib koob tshuaj thaum lub sij hawm ib hnub. Tus nqi them txhua hli yog kwv yees li ntawm 400 rubles ntawm tus nqi ntawm 60 ntsiav tshuaj ntawm cov tshuaj txog 760-800 rubles. Rau kev sib piv: tus nqi ntawm Furosemide tus nqi txhua hli tsis tshua muaj ntau tshaj 20 plhom. Tab sis rau cov kev kho mob ntawm kev kho mob siab kawg rau yav tas los yog ntawm kev siv me ntsis.

Hauv kev mob plawv tsis ua hauj lwm nrog kev ua pa ntawm ob lub voj voog, qhov nqi ntawm ib hlis kev kho mob ntawm Furosemide yog li 20-30 rubles. Cov tshuaj "Torasemide" yog 10-15 npaug ntau. Nyob rau tib lub sij hawm, tom kawg muaj cov nyhuv me me, uas yog, nws tsis tuaj yeem ua kom qhov tso zis rau thawj teev ntawm kev tso npe. Hauv Furosemide, cov yam ntxwv yog ntxig: nws loj tuaj zis ntau npaum li cas ntawm thawj ob xuab moos nrog kev ua kom muaj zog zuj zus ntawm diureis.

Yog vim li no, nws tsim nyog siv lub npe hu ua "Torasemide" rau cov neeg mob uas muaj mob qog ntshav siab los yog mob raum tsis ua hauj lwm, qhov kev qhia ntawv (tus nqi yuav tsum tau sau saum toj), rau daim ntawv thov uas tsis muaj cov ntaub ntawv hais txog kev mob lub cev diuresis thaum thawj zaug nkag. Txawm li cas los xij, hauv cov neeg mob ntawm cov hnub nyoog so haujlwm, nrog kev tsis tuaj yeem tuaj ua haujlwm, kev ceev ntawm diureis yuav luag tsis tseem ceeb. Qhov no tsis tsim teeb meem, thiab yog li ntawd peb yuav tsum txais ib chav kawm ntawv pheej yig analogue - Furosemide.